Leserbrief.
PMID: 31525783 [PubMed - in process] (Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS)
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - September 1, 2019 Category: Intensive Care Authors: Fichtner A Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

Antwort auf den Leserbrief.
PMID: 31525784 [PubMed - in process] (Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS)
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - September 1, 2019 Category: Intensive Care Authors: Gamon E Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

Maligne Hyperthermie: vom kryptischen Krankheitsbild zur gut untersuchten Komplikation.
PMID: 31525785 [PubMed - in process] (Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS)
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - September 1, 2019 Category: Intensive Care Authors: Roewer N, Kranke P Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Malignant Hyperthermia - Update on Pathophysiology, Diagnostics and Treatment].
Abstract Malignant hyperthermia (MH) is a rare, heterogenic syndrome leading to potentially life-threatening skeletal muscle hypermetabolism following exposure to inhalational anesthetics and succinylcholine. In more than 50% of affected individuals a pathogenic variant in the RYR1 gene coding for the sarcoplasmic reticulum calcium channel is responsible for the underlying pathology of uncontrolled calcium liberation. While the genetic prevalence of MH is as high as 1 : 2750, the incidence of clinical MH reactions is considerably lower, suggesting a dominant pattern of inheritance with incomplete penetrance. D...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - September 1, 2019 Category: Intensive Care Authors: Johannsen S, Schuster F Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Malignant Hyperthermia - Diagnosis in Practice].
Abstract Testing for malignant hyperthermia (MH) susceptibility is usually performed either in relatives of MH susceptible persons or in patients with an MH suspicious clinical event. There are two diagnostic options: muscle biopsy with in-vitro contracture testing and molecular genetic diagnosis. Patients with familial MH mutations are usually tested genetically. A genetic screening can be performed in clinical events with a high pretest probability. MH susceptibility can be confirmed by presence of a diagnostic MH mutation. Absence of MH mutations cannot exclude MH. The only option to exclude MH susceptibility i...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - September 1, 2019 Category: Intensive Care Authors: Girard T, Bandschapp O Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Pharmacological Treatment of Malignant Hyperthermia: Update 2019].
Abstract Malignant hyperthermia (MH) is a pharmacogenetic disorder of skeletal muscle presenting as a hypermetabolic response to potent volatile anesthetics such as sevoflurane, desflurane, isoflurane and the depolarizing muscle relaxant succinylcholine. Following introduction of the hydantoin derivative dantrolene, the previously high mortality of fulminant MH episodes could be reduced from> 80% to less than 10%. For treatment of MH an initial intravenous bolus of 2.5 mg/kg dantrolene based on the actual body weight should be applied. If symptoms are not improving after the initial dose, up to 10...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - September 1, 2019 Category: Intensive Care Authors: Schuster F, Johannsen S Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

["Status Thymolymphaticus" - a Risk of Anaesthesia?]
["Status Thymolymphaticus" - a Risk of Anaesthesia?] Anasthesiol Intensivmed Notfallmed Schmerzther. 2019 Sep;54(9):562-570 Authors: Goerig M Abstract The administration of narcotics such as ether and chloroform to combat pain during surgery was overshadowed from the beginning by serious, often fatal incidents. Even the use of local anaesthetics, which were praised as being less dangerous, was not as uncomplicated as had initially been hoped for and was often fatal. Investigations into the various causes of anaesthetic incidents were carried out at an early stage, but usually did not lead to...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - September 1, 2019 Category: Intensive Care Authors: Goerig M Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

Propofol-Infusionssyndrom bei Behandlung eines Status epilepticus.
PMID: 31525790 [PubMed - in process] (Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS)
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - September 1, 2019 Category: Intensive Care Authors: Hachenberg T, Wohlers C Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

Aufkl ärung und Patientenwille.
Aufklärung und Patientenwille. Anasthesiol Intensivmed Notfallmed Schmerzther. 2019 Jul;54(7-08):454-456 Authors: Koppert W, Neitzke G, Trachsler D PMID: 31344741 [PubMed - in process] (Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS)
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - July 1, 2019 Category: Intensive Care Authors: Koppert W, Neitzke G, Trachsler D Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Informed Consent: an Update].
Abstract An indication for a medical intervention alone is not sufficient to justify its implementation. In addition, consent has to be obtained from the patient who has been given relevant information by a doctor. If, instead of the patient, other persons are entitled to decide for him (parents for children incapable of consent, authorised representatives, carers), they must be informed. If the patient, who is aware of the significance of his decision, refuses to consent to the measure as a whole or to parts of it, the physician is bound by it - even if the patient's refusal is based on religious, ideological or ...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - July 1, 2019 Category: Intensive Care Authors: Biermann E Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Determining Patient's Wishes and Preferences].
Abstract It is legally required to determine and respect patient preferences and wishes as much as possible under the circumstances given. This also applies to emergency medicine and intensive care, particularly if a patient is unconscious and is not able to give his consent by him-/herself. According to German law, patients' explicit written statements (advance directive, living will) are mandatory. If no advance directive is available, or if the directive does not match the current medical circumstances, other (oral) statements of the individual patient have to be scrutinized to identify presumed wishes and esta...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - July 1, 2019 Category: Intensive Care Authors: Neitzke G Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Legal Proxies in Medicine: Representatives and Legal Guardians].
Abstract Patients' rights need to be protected, particularly if the patient is unconscious or otherwise unable to consent. According to German law, a legal proxy is mandatory. Spouses and adult children do not automatically function as legal proxies. There are two alternative ways to become a legal proxy: a patient representative (Bevollmächtigter) is authorized by a written power of attorney (Vorsorgevollmacht), signed by the patient. If there is no power of attorney, a legal guardian (Betreuer) has to be appointed by a guardianship court. Both representatives and guardians are obliged to support the patient...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - July 1, 2019 Category: Intensive Care Authors: Neitzke G Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Pharmacokinetics in Children - What is Important for Correct Drug Dosage?]
Abstract Under- or overdosage of medication can lead to severe side effects in children. To avoid this, precise knowledge of age-specific liberation, absorption, distribution, metabolism and excretion - LADME for short - is necessary. Absorption can take place intravenously, orally, rectally, intranasally, transdermally or epidurally/caudally and is associated with numerous special features in children, depending on age and route of application. The distribution in children is faster due to more permeable organ barriers between individual organs and must be adapted for hydrophilic and lipophilic drugs to the patie...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - July 1, 2019 Category: Intensive Care Authors: Fideler F Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

Gerinnungsst örungen.
Gerinnungsstörungen. Anasthesiol Intensivmed Notfallmed Schmerzther. 2019 Jun;54(6):385 Authors: Rosenberger P PMID: 31212329 [PubMed - in process] (Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS)
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - June 1, 2019 Category: Intensive Care Authors: Rosenberger P Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Perioperative Bleeding Disorders: Diagnostics and Treatment].
Abstract Perioperative bleeding disorders leading to major blood losses have a severe impact on patient morbidity and mortality. Despite efficient communication with the surgical team, a profound knowledge concerning the underlying mechanisms, diagnostic possibilities and available therapeutic strategies is essential for the anesthesiologist in charge. This clinical review summarizes the preoperative assessment of the most common preexisting bleeding disorders, as well as intraoperative diagnostics and management. A special focus is set on novel point-of-care tests, such as viscoelastic coagulation assays that all...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - June 1, 2019 Category: Intensive Care Authors: Keller M, Magunia H Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Blood Coagulation Disorders During ECMO and LVAD Therapy].
In conclusion, the management of the ECMO- and LVAD-associated coagulopathy is based on the understanding of its contributing factors. Respective causes for thrombotic and/or hemorrhagic complications should be identified with coagulation assays including viscoelastic point of care tests and platelet aggregometry. Once the underlying reason for the observed coagulopathy has been identified further treatment measures should be individually tailored. PMID: 31212331 [PubMed - in process] (Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS)
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - June 1, 2019 Category: Intensive Care Authors: Straub A Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Trauma-Induced Coagulopathy: Pathophysiology and Management].
r J Abstract Persistent, uncontrolled bleeding after trauma is one of the leading causes of fatalities in patients with severe injuries. 40% of trauma deaths are associated with massive haemorrhage. Hypoperfusion due to major loss of blood volume leads to tissue damage. In combination with acidosis and hypothermia, a generalized immune response with activation of coagulation is triggered. This leads to trauma-induced coagulopathy. A suitable, early treatment might lead to a significant reduction in morbidity and mortality. PMID: 31212332 [PubMed - in process] (Source: Anasthesiologie, Intensivmedizin, Notfall...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - June 1, 2019 Category: Intensive Care Authors: Schlömmer C, Meier J Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Role of Procalcitonin as a Sepsis Marker].
Abstract Adequate diagnosis and therapy of sepsis is of major prognostic relevance. Besides the gold standard (blood culture diagnostics) biomarkers, e.g. serum procalcitonin (PCT), are clinically increasingly used in the diagnosis and for guiding anti-infective treatment. Recent guidelines recommend early determination of PCT. However, trauma, burns, surgical procedure, and intoxications may significantly impact PCT levels. As a rare cause, PCT producing tumors have been described and may be potentially misleading in the clinical setting. While several other constellations for increased PCT in the absence of seps...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - June 1, 2019 Category: Intensive Care Authors: Kleinbrahm K, Wappler F, Sakka SG Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Acute Facial Swelling Following Dental Procedure - an Allergic Reaction?]
ng C Abstract The most common cause of facial edema after dental or medical treatment is an allergic reaction. At our emergency department, a 58-year old female patient presenting with swollen right face after dental crown preparation, was initially treated with antiallergic medication. After three hours the patient was stable, swelling was still present and then crepitus could be observed on second palpation. Cervicofacial subcutaneous emphysema was confirmed with an unenhanced CT of the head and paranasal sinus; it is a rare complication after dental treatment and within the last years only few cases have been r...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - June 1, 2019 Category: Intensive Care Authors: Vonderlin N, Gießen-Jung C Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

Pulmonale Hypertonie.
PMID: 31083756 [PubMed - in process] (Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS)
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - May 1, 2019 Category: Intensive Care Authors: Hachenberg T Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Pulmonary Hypertension: Diagnostics, Classification and Therapy].
reiber J Abstract Pulmonary hypertension is a chronic, incurable disease with poor prognosis. The therapeutic aim is a stabilization of patients showing signs of right heart failure as well as disease progression. A pulmonary hypertension is diagnosed in patients displaying a mean pulmonary arterial pressure of> 25 mmHg in resting state. Invasively measured hemodynamics evaluated by right heart catheterization (mean pulmonary arterial pressure [mPAP], pulmonary arterial wedge pressure [PAWP], diastolic pressure gradient [DPG] and pulmonary vascular resistance [PVR]) allows to differentiate between...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - May 1, 2019 Category: Intensive Care Authors: Lücke E, Schmeißer A, Schreiber J Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Anaesthesia in Patients with Pulmonary Hypertension].
p T Abstract The perioperative management of patients with pulmonary hypertension requires an in-depth knowledge of the underlying disease, its related pathophysiology, effects of anaesthesia and surgery, as well as the appropriate pharmacotherapy. With respect to preoperative assessment, it is essential to review all available diagnostic findings, evaluate the patient's physical state, and to plan the anaesthetic procedure. Intraoperatively, the prevention of increases in pulmonary resistance and right ventricular decompensation appears essential. For this purpose, stress, hypothermia, decreased systemic perfusio...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - May 1, 2019 Category: Intensive Care Authors: Hötzel A, Loop T Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Increased Arterial Blood-Pressure Previous to Elective Surgery - How to Proceed?]
Abstract Guidelines concerning the widespread disease "essential arterial hypertension" have been available for a long time. Recently, the Association of Anaesthetists of Great Britain and Ireland (AAGBI) and the British Hypertension Society (BHS) presented a guideline that is focused on the handling of patients suffering arterial hypertension previous to elective surgery. Is there any effort and/or benefit in postponing the operation? Within this guideline we find a concrete statement and recommendation how to deal with this question and how to evaluate the cardiovascular risk regarding this parameter. ...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - May 1, 2019 Category: Intensive Care Authors: Unterberg M, Nowak H Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Speckle Tracking Echocardiography - a New Tool for the Intensive Care Unit?]
tz T Abstract The noninvasive evaluation of cardiac morphology and function by echocardiography is an essential part of modern intensive care therapy. However, this procedure can be challenging and beginners often lack the ability to objectively state the correct global and regional myocardial function. Recent developments allow a semi-automatic deformation (strain) analysis by a couple of more objective respective parametric techniques. Strain describes the change in length of a myocardial segment during the cardiac cycle. While this is primarily a regional analysis, an insight into the global left ventricular de...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - May 1, 2019 Category: Intensive Care Authors: Reckefuß N, Heuer JF, Butz T Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[A Fatal Case of Fulminant Necrotising Fasciitis in a 47-Year-Old Male].
Abstract Necrotising fasciitis (NF) is a rare soft tissue infection characterized by rapid progressive necrosis. Initially patients usually present with nonspecific symptoms like fever, severe pain and skin lesions that progress rapidly. It requires prompt recognition and early treatment with extensive surgical debridement and intravenous antibiotics. Mortality despite adequate therapy is high, ranging between 15 and 46%. NF has previously been reported in literature. Some assumed premorbid conditions associated with NF are diabetes mellitus, chronic kidney injury, adiposity, peripheral artery occlusive disease, a...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - May 1, 2019 Category: Intensive Care Authors: Gamon E, Rahe K, Beckschulze H Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

Adipositas in der An ästhesie – Big is beautiful?
Adipositas in der Anästhesie – Big is beautiful? Anasthesiol Intensivmed Notfallmed Schmerzther. 2019 Apr;54(4):240-241 Authors: Bein B, Scholz J PMID: 30978747 [PubMed - in process] (Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS)
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - April 1, 2019 Category: Intensive Care Authors: Bein B, Scholz J Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Anaesthesia in Adult Patients with Obesity].
Abstract The prevalence of obesity has substantially increased worldwide during the last ten years. Hence, more anaesthetic procedures will be performed in obese patients in the future and more hospitals have to be prepared for the perioperative treatment of extremely obese patients including medical, technical and organisational issues. These include not only the management of the perioperative problems of adiposity, but also of its numerous concomitant diseases. Besides hyperlipidemia, diabetes mellitus, arterial hypertension and coronary heart disease, the obstructive sleep-apnea syndrome (OSAS) challenges the ...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - April 1, 2019 Category: Intensive Care Authors: Fudickar A, Bein B Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[The Critically Ill Obese Patient: Too Big to Fail?]
Abstract Worldwide, currently more than 1.9 billion adults are overweight, 650 million of them are obese. Hereby they pose a significant burden on the budget of the health system and on the workload of intensive care units. Mechanical ventilation of critically ill obese patients needs to take into account the characteristic pathologic alterations of their respiratory system. Setting the respirator also requires careful consideration. Cornerstones include judicious preoxygenation, selection of a tidal volume of 6 - 8 ml/kg ideal body weight, a level of positive end-expiratory pressure titrated to compens...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - April 1, 2019 Category: Intensive Care Authors: Lewandowski K Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Ultrasound-Guided Regional Anaesthesia in Obesity].
Abstract Obesity is associated with a number of anaesthesia-relevant risks. Regional anaesthesia procedures offer a number of advantages, but they also pose an anaesthetic challenge. For example, the identification of superficial landmarks according to the degree of obesity is difficult to impossible, which reduces the success rate compared to normal weight patients. The use of ultrasound (US) technology with the ability to visualize the target structures may be helpful in performing neuraxial and peripheral blockades. However, a lot of experience and training is required because the ultrasound imaging of very low...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - April 1, 2019 Category: Intensive Care Authors: Kessler P Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Stroke Thrombectomy: Anaesthesiologic Aspects].
z U Abstract Ischemic Stroke is a focal neurological deficit based on an acute ischemia. rt-PA lysis and thrombectomy are therapeutic options. Thrombectomy can be performed under local anaesthesia, sedation or general anaesthesia. Early studies clearly favoured sedation compared to general anaesthesia regarding neurological outcome. The following prospective, randomized trials could not detect harmful effects of general anaesthesia. Nonetheless in anaesthesia care of ischemic stroke patients many (patho-)physiological and pharmacological aspects should be taken into account for the best neurological outcome. ...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - April 1, 2019 Category: Intensive Care Authors: Wolf A, Mölders P, Yilmaz U Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Intrahepatic Hematoma and Pulmonary Embolism in a Young Woman with Oral Contraceptives Complicated by Type II Heparin Induced Thrombocytopenia Requiring ECMO-Therapy: a Case Report].
l;ger K Abstract A 46-year-old woman on oral contraceptives developed an intrahepatic hematoma due to a benign hepatic tumor. As an incidental finding, a computed tomography showed a pulmonary embolism. Unfractionated heparin was given in a prophylactic dosing in an attempt to balance the risk of further intrahepatic bleeding with that of thrombosis. Ten days later, the patient developed a second pulmonary embolism along with acute right heart failure requiring cardiopulmonary resuscitation. As a sufficient circulation and oxygenation could not be reestablished, a veno-arterial extracorporeal membrane oxygenation ...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - April 1, 2019 Category: Intensive Care Authors: Brück S, Skrabal C, Liebold A, Mols G, Träger K Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

Heute aus der Pr ämedikationsambulanz: Hernioplastik bei 10 Monate altem Kind.
Heute aus der Prämedikationsambulanz: Hernioplastik bei 10 Monate altem Kind. Anasthesiol Intensivmed Notfallmed Schmerzther. 2019 Apr;54(4):302-306 Authors: Bergold M, Gill-Schuster D, Holzer L, Empting PA, Zacharowski K PMID: 30978753 [PubMed - in process] (Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS)
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - April 1, 2019 Category: Intensive Care Authors: Bergold M, Gill-Schuster D, Holzer L, Empting PA, Zacharowski K Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

Patient Blood Management.
PMID: 30866020 [PubMed - in process] (Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS)
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - March 1, 2019 Category: Intensive Care Authors: Zacharowski K Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Cell Salvage in Anesthesiology].
m P Abstract Re-infusion of washed autologous blood cell salvage from the operative field and wound drainages is used as part of blood conservation strategy within Patient Blood Management (PBM). Cell salvage is an effective method to reduce allogeneic blood transfusion. A main advantage of cell salvage is the prevention of storage-related damage to the erythrocytes.Cell salvage has wide applications in surgeries with expected blood loss higher than 500 ml like cardiac, vascular, orthopedic surgery, and by the use of blood irradiation also in cancer surgery. PMID: 30866021 [PubMed - in process] (Source...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - March 1, 2019 Category: Intensive Care Authors: Westphal S, Zacharowski K, Choorapoikayil S, Füllenbach C, Meybohm P Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Patient Blood Management: Preoperative Anemia and Case Reports from the Anemia Walk-In Clinic].
m P Abstract Preoperative anemia is independently associated with increased morbidity and mortality and represents the strongest predictor for transfusion of red blood cells. Iron deficiency anemia is the most frequent form of anemia and could easily be treated by supplementation with iron. Patient Blood Management (PBM) focusses on prevention and management of anemia to optimize the patient and reduce unnecessary allogeneic blood products. PMID: 30866022 [PubMed - in process] (Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS)
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - March 1, 2019 Category: Intensive Care Authors: Westphal S, Isik S, Choorapoikayil S, Füllenbach C, Zacharowski K, Meybohm P Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Blood Transfusion: a Guide to Clinical Decision Making].
MM Abstract Nowadays, management of hemotherapy is regulated in Germany by the transfusion act and several guidelines while the transfusing physician is responsible for correct implementation at the bedside. Indications for blood products have to be carefully adapted to the patient's current clinical situation and pre-existing diseases have to be considered as well. Today, for most perioperative elective surgeries, evidence-based transfusion thresholds for packed red blood cell concentrates (RBC) have been defined and should be considered. Platelet concentrates (PC) have to be transfused in bleeding patients with...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - March 1, 2019 Category: Intensive Care Authors: Tanner L, Müller MM Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Staphylococcus aureus Bacteraemia - an Interdisciplinary Challenge].
CONCLUSION: SAB is associated with high morbidity and mortality. Clinical management is complex. By adhering to diagnostic and therapeutic measures, the prognosis can be improved. PMID: 30866024 [PubMed - in process] (Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS)
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - March 1, 2019 Category: Intensive Care Authors: Hagel S, Kaasch AJ, Weis S, Seifert H, Pletz MW, Rieg S Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Dysphagia in Tracheostomized Patients after Long-Term Mechanical Ventilation - Become Sensitive to Reduced Pharyngo-Laryngeal Sensitivity].
Abstract Independent of the type of critical illness, tracheostomized patients have a high risk of developing a dysphagia. This is potentially life-threatening as it can lead to aspiration and pneumonia. It is therefore essential to perform swallowing diagnostics by means of a bolus dyeing test and/or FEES before oral feeding. Since a physiological airflow through the larynx and adequate subglottic pressure are key components of an effective swallowing act, oralisation should be avoided as far as possible with a blocked tracheal cannula. PMID: 30866025 [PubMed - in process] (Source: Anasthesiologie, Intensivm...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - March 1, 2019 Category: Intensive Care Authors: Heidler MD Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

Vigilanzst örung nach ambulanter Narkose bei einer HNO-Operation.
Vigilanzstörung nach ambulanter Narkose bei einer HNO-Operation. Anasthesiol Intensivmed Notfallmed Schmerzther. 2019 Mar;54(3):224-226 Authors: Hachenberg T, Wohlers C, Schroeder HG, Schaffartzik W PMID: 30866026 [PubMed - in process] (Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS)
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - March 1, 2019 Category: Intensive Care Authors: Hachenberg T, Wohlers C, Schroeder HG, Schaffartzik W Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

Ultraschall in AINS.
PMID: 30769349 [PubMed - in process] (Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS)
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - February 1, 2019 Category: Intensive Care Authors: Wulf H, Wiesmann T Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Focused Transthoracic Echocardiography in the Perioperative Setting].
Abstract With focused transthoracic echocardiography (TTE) we rapidly and non-invasively receive up-to-date information on a patient's hemodynamic status. These can subsequently influence our therapy and thus our risk management. Postoperatively, TTE has proved its worth as an examination method in the recovery room and in the intensive care unit to promptly diagnose life-threatening causes of circulatory depression. Acute pathology such as a pericardial tamponade or fulminant pulmonary artery embolism can be detected quickly and thus possibly time-consuming transport to a CT can be avoided. Also, preoperatively, ...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - February 1, 2019 Category: Intensive Care Authors: Vojnar B, Zoremba M Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Lung Ultrasound for Anesthesia, Intensive Care and Emergency Medicine].
Abstract Lung ultrasound is an underrated tool in preclinical emergency situations, intensive care units, ORs and emergency rooms. For certain clinical questions, there is a drastically higher sensitivity in comparison to chest X-ray examinations (sensitivity in pneumothorax diagnostics 86 vs. 28%, specificity 97 vs. 100%. A standardized examination improves the quality of the ultrasound examination and thus the diagnostic value. The article provides basic information on pulmonary ultrasound and aims to highlight the superiority of ultrasound over x-ray procedures for anesthesia, intensive care and emergency medic...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - February 1, 2019 Category: Intensive Care Authors: Armbruster W, Eichholz R, Notheisen T Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Focused Abdominal Ultrasound in Emergency, Perioperative and Intensive Care Medicine].
Abstract The rising impact of perioperative sonography is mainly based on mobile high quality ultrasound systems. Relevant bleedings or functional limitations of the abdomen are easy to identify with sonography. The FAST-Concept can be the first access to continue proceedings in ultrasound examination of the abdomen. This paper demonstrates some important ultrasound examinations of the abdomen. The clinical main issues are traumatic and atraumatic bleedings of heart, liver and spleen with haemodynamic instability and functional limitations of abdominal organs like bile cystitis, gastrointestinal passage disability...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - February 1, 2019 Category: Intensive Care Authors: Schreiber M, Greim CA Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Coffee, Cigarettes, Chewing Gum - Myths and Facts About Preoperative Fasting].
Abstract Consumption of clear liquids (including coffee and orange juice without pulp) up to 2 hours before the start of anaesthesia is unproblematic. Contrary to the recommendations of the professional societies, the intake of beverages containing milk (up to 50% of the total volume) in small quantities seems to be harmless. Drinks containing alcohol can considerably delay emptying of the stomach. Immediate preoperative nicotine consumption has no influence on the risk of aspiration, but short-term nicotine abstinence in patients with CHD can reduce the risk of intraoperative myocardial ischaemia. Chewing gum has...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - February 1, 2019 Category: Intensive Care Authors: Schieren M, Wappler F Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Violence in the Emergency Medicine (Emergency Rescue Service and Emergency Departments) - Current Situation in Germany].
Abstract BACKGROUND: During the last years healthcare personnel is more often faced with different degrees of violence and aggression while doing their jobs. However, systematic data with respect to offender profiles, reasons, frequency and types of violence in emergency medicine in Germany has not been systematically analyzed. AIM: The aim of this article is to overview the data of present German studies. RESULTS: Only a few German studies could be included. Data suggest that violence in emergency medicine is an underreported but ubiquitous, persistent problem. 90% of the participants in the surveyed re...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - February 1, 2019 Category: Intensive Care Authors: Hofmann T, Hachenberg T Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

Sepsis – weiter eine große Herausforderung!
Sepsis – weiter eine große Herausforderung! Anasthesiol Intensivmed Notfallmed Schmerzther. 2019 Jan;54(1):8-9 Authors: Marx G PMID: 30620951 [PubMed - in process] (Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS)
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - January 1, 2019 Category: Intensive Care Authors: Marx G Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Sepsis Update: Definition and Epidemiology].
This article describes the previously and the currently available definition of sepsis and gives an overview of the epidemiology of this disease. PMID: 30620952 [PubMed - in process] (Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS)
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - January 1, 2019 Category: Intensive Care Authors: Bracht H, Hafner S, Weiß M Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Diagnostic Approaches in Sepsis - Part 1: General Diagnostic Principles, Focus Identification and Source Control].
Abstract Sepsis and septic shock represent medical emergencies with persistently high mortality rates. According to the lately revised Surviving Sepsis Campaign (SSC) guidelines, focus identification/pathogen detection and the initial administration of broad-spectrum antibiotics are to be secluded within one hour after recognition of the symptoms of sepsis. However, there is dispute concerning the so called hour-1 bundle. Being a core aspect of focus identification, imaging modalities mainly depend on the suspected site of infection and the individual patient. Contrast agent-enhanced computed tomography (CT) is th...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - January 1, 2019 Category: Intensive Care Authors: Richter DC, Heininger A, Schmidt K, Schmoch T, Bernhard M, Mayer P, Weigand MA, Brenner T Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Diagnostic Approaches in Sepsis - Part 2: Pathogen Detection].
Abstract Despite the dissemination of innovative, molecular biology-based and commercially available devices for pathogen detection, culture-based methods with susceptibility testing remain the key principles for guiding antimicrobial treatment of patients suffering from sepsis or septic shock on the ICU. Culture-based methods are able to facilitate pathogen detection from a diversity of specimen (respiratory secretion, intraoperatively obtained smears, aspirates, and so forth). However, the latency from obtainment of the specimen up to pathogen detection with susceptibility testing is a major disadvantage of cult...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - January 1, 2019 Category: Intensive Care Authors: Richter DC, Heininger A, Schmidt K, Schmoch T, Bernhard M, Mayer P, Weigand MA, Brenner T Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

[Sepsis Update: Evidence-Based Therapy].
This article provides an overview of the current evidence of sepsis and septic shock therapy and its implementation into clinical practice. PMID: 30620955 [PubMed - in process] (Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS)
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - January 1, 2019 Category: Intensive Care Authors: Martin L, Bickenbach J, Marx G Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research