Aim of this study: This study seeks to investigate, whether extubation of tracheally intubated patients admitted to intensive care units (ICU) postoperatively either immediately at the day of admission (day 1) or delayed at the first postoperative day (day 2) is associated with differences in outcomes. Materials and methods: We performed a retrospective analysis of data from an Austrian ICU registry. Adult patients admitted between January 1^st, 2012 and December 31^st, 2019 following elective and emergency surgery, who were intubated at the day 1 and were extubated at day 1 or day 2, were included. We performed logistic regression analyses for in-hospital mortality and over-sedation or agitation following extubation. Results: 52 982 patients constituted the main study population. 1 231 (3.3%) patients extubated at day 1 and 958 (5.9%) at day 2 died in hospital, 464 (1.3%) patients extubated at day 1 and 613 (3.8%) at day 2 demonstrated agitation or over-sedation after extubation during ICU stay; OR (95% CI) for in-hospital mortality were OR 1.17 (1.01–1.35, p = 0.031) and OR 2.15 (1.75–2.65, p<0.001) for agitation or over-sedation. Conclusions: We conclude that immediate extubation as soon as deemed feasible by clinicians is associated with favourable outcomes and may thus be considered preferable in tracheally intubated patients admitted to ICU postoperatively.

Background: Noncompressible truncal hemorrhage is a major contributor to preventable deaths in trauma patients and, despite advances in emergency care, still poses a big challenge. Objectives: This study aimed to assess the clinical efficacy of trauma resuscitation care incorporating Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) compared to standard care for managing uncontrolled torso or lower body hemorrhage. Methods: This study utilized a target trial design with a matched case–control methodology, emulating randomized 1 : 1 allocation for patients receiving trauma resuscitation care with or without the use of REBOA. The study was conducted at a high-volume trauma center in Southern Austria, including trauma patients treated between January 2019 and October 2023, aged 16 and above, with suspected severe non-compressible torso hemorrhage. The primary outcome was 30-day in-hospital mortality. Secondary outcomes were in-hospital mortality rates at 3, 6, 24 h, and 90 days, need for damage control procedures, time to these procedures, computed tomography (CT) scan rates during resuscitation, complications, length of intensive care and in-hospital stay, and causes of death. Results: Median age was 55 [interquartile range (IQR) 42–64] years. Median total injury severity, assessed by Injury Severity Score, was 46.5 (IQR: 43–57). There was no significant difference in 30-day in-hospital mortality between groups [9/22 (41%) vs. 9/22 (41%), odds ratio: 1.00, 95% confidence interval (CI): 0.3–3.36, P > 0.999]. Lower mortality rates within 3, 6, and 24 h were observed in the REBOA group; in a Cox proportional hazards model, hazard ratio (95% CI) for mortality in the REBOA group was 0.87 (0.35–2.15). Timing to damage control procedures did not significantly differ between groups, although patients in the REBOA group underwent significantly more CT scans. Bleeding was cited as the main cause of death less frequently in the REBOA group. Conclusion: In severely injured patients presenting with possible major non-compressible torso hemorrhage, a systematically implemented resuscitation strategy including REBOA during the initial hospital phase, is not associated with significant changes in mortality.

Patient Blood Management (PBM) is a multidisciplinary strategy to optimise patient outcomes by preserving autologous blood and reducing unnecessary transfusion. Although PBM initiatives exist worldwide, the consistency of national guideline recommendations remains unclear. This review compared international PBM programmes and explored reasons for variation. A systematic review was conducted in accordance with PRISMA guidelines. In March 2024, Medline, Cochrane Library, and Google Scholar were searched for publications from the past 20 years, supplemented by governmental and institutional sources. Guidelines were assessed using the International Centre for Allied Health Evidence checklist. Laws, nationally implemented guidelines, or documents with ministerial involvement were included for a comparative text analysis if they addressed defined PBM elements, were freely accessible, and met quality criteria. The review was registered on PROSPERO and completed in 2025. Forty national and institutional guidelines were analysed. The greatest variability concerned strategies to reduce diagnostic blood loss. In contrast, most other PBM domains showed substantial agreement, particularly regarding restrictive transfusion strategies, most defined by a haemoglobin threshold of 7 g dl^-1 (22 guidelines) or lower (nine guidelines). National standardisation was frequently absent, even in countries with advanced hospital-level PBM programmes. Guidance for acute care and intensive care was usually issued by specialty societies rather than national authorities; prehospital recommendations were scarce. National guidelines on Patient Blood Management remain fragmented, as comprehensive policy frameworks and multidisciplinary coordination are lacking. Greater harmonisation and structured change management are required to support wider global adoption of PBM. CRD420251032664 (PROSPERO).

Background/Objective: The primary aim of this study was to establish a clinically relevant cut-off for detecting postpartum anaemia using non-invasive haemoglobin measurement, and to compare the non-invasive method with laboratory haemoglobin testing. This study was conducted as a prospective observational study at a single centre. Pregnant women giving birth vaginally or by caesarean birth at a university hospital were included in this study. Methods: We measured haemoglobin by non-invasive and laboratory means at delivery room discharge and after childbirth in the operation room. We then calculated a clinically relevant cut-off for detecting postpartum anaemia using the non-invasive measurement method. The main outcomes were the invasively and non-invasively measurements of haemoglobin and the correlation between the two measurements. Results: In total, 466 complete measurement pairs from 323 women were included, and 179 (38.4%) laboratory measurements were found to be anaemic (haemoglobin value < 11 g dL⁻¹). Maximising specificity while maintaining a minimum sensitivity of 80%, we identified a cut-off of 13.75 g dL⁻¹, which achieved a sensitivity of 81.0% and a specificity of 54.7%. The NPV at this threshold was 82.2%, while the PPV was 52.7%. The mean difference between measurements was found to be +2.3 g dL⁻¹ (CI 95% 2.16 to 2.43). Conclusions: Non-invasive haemoglobin measurement did not sufficiently detect anaemia compared to laboratory measurement values in the setting of early postpartum women, even after adjusting for bias. However, the proposed cut-off could potentially aid healthcare providers in low-resource situations.

Zusammenfassung: Die nichtkomprimierbare Blutung des Körperstamms stellt nach wie vor eine große Herausforderung mit hoher Mortalität dar und hat insbesondere präklinisch wenig Therapieoptionen. Das Abdominal Aortic & Junctional Tourniquet könnte eine weitere Maßnahme zur temporären Stabilisierung darstellen und wurde an der Medizinischen Universität Graz untersucht.