[Goal-directed hemodynamic therapy : Concepts, indications and risks].
Abstract Goal-directed hemodynamic therapy is becoming increasingly more interesting for anesthesiologists and intensive care physicians. Meta-analyses of studies evaluating perioperative therapy algorithms demonstrated a reduction of postoperative morbidity compared to the previous clinical practices. In this review article the basic concepts of goal-directed hemodynamic therapy and the principles of previously employed therapy algorithms are described and discussed. Furthermore, the questions of how these therapy strategies can be transferred into daily clinical practice and whether these therapeutic approaches ...
Source: Der Anaesthesist - June 17, 2015 Category: Anesthesiology Authors: Haas SA, Saugel B, Trepte CJ, Reuter DA Tags: Anaesthesist Source Type: research

[Home mechanical ventilation : Invasive and noninvasive ventilation therapy for chronic respiratory failure].
Abstract Home mechanical ventilation represents a valuable therapeutic option to improve alveolar ventilation in patients with chronic respiratory failure. For this purpose both invasive ventilation via tracheostomy and noninvasive ventilation via facemasks are available. The primary goal of home mechanical ventilation is a reduction of symptoms, improvement of quality of life and in many cases reduction of mortality. Elective establishment of home mechanical ventilation is typically provided for noninvasive ventilation in respect to clinical symptoms and partial pressure of carbon dioxide depending on the underly...
Source: Der Anaesthesist - June 12, 2015 Category: Anesthesiology Authors: Huttmann SE, Storre JH, Windisch W Tags: Anaesthesist Source Type: research

[Pressure and gases : Current guidelines on diving accidents].
PMID: 26040965 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 4, 2015 Category: Anesthesiology Authors: Gries A Tags: Anaesthesist Source Type: research

[Potential and effectiveness of a telemedical rescue assistance system : Prospective observational study on implementation in emergency medicine].
This article presents a newly developed and evaluated total telemedical concept (TemRas) that encompasses organizational, medical and technical components. The use of intelligent and robust communication technology and the implementation of this add-on system allows the telemedical support of the rescue service for all emergencies. METHODS: After development of the telemedical rescue assistance system, which includes organizational, medical and technical components, a telemedical centre and six ambulances in five different districts in North-Rhine Westphalia were equipped with this new tool. During the evaluation phas...
Source: Der Anaesthesist - June 3, 2015 Category: Anesthesiology Authors: Brokmann JC, Rossaint R, Bergrath S, Valentin B, Beckers SK, Hirsch F, Jeschke S, Czaplik M Tags: Anaesthesist Source Type: research

[Tension pneumomediastinum and tension pneumothorax following tracheal perforation during cardiopulmonary resuscitation].
This article presents the case of a 41-year-old woman who suffered cardiopulmonary arrest after undergoing elective mandibular surgery. During CPR the upper airway could not be secured by orotracheal intubation due to massive craniofacial soft tissue swelling. A surgical airway was established with obviously unrecognized iatrogenic tracheal perforation and subsequent development of tension pneumomediastinum and tension pneumothorax during ventilation. Neither the tension pneumomediastinum nor the tension pneumothorax were decompressed and accordingly resuscitation efforts remained unsuccessful. This case illustrates the ne...
Source: Der Anaesthesist - June 3, 2015 Category: Anesthesiology Authors: Buschmann CT, Tsokos M, Kurz SD, Kleber C Tags: Anaesthesist Source Type: research

[Sudden cardiac death during a city marathon run].
d C Abstract Sudden cardiac death (SCD) in young athletes during physical stress is a rare event with an incidence of 1-3 deaths per 100,000 athletes per year. A coronary anomaly is the second most common cause of death following hypertrophic cardiomyopathy. Symptomatic prodromes occur in 20 % of cases prior to the SCD event. This case report describes a 35-year-old male who collapsed near the finishing line of a half marathon run. Despite immediate resuscitation attempts and initial return of spontaneous circulation (ROSC), a pulseless electrical activity (PEA) followed and the patient died 1 h after ...
Source: Der Anaesthesist - June 2, 2015 Category: Anesthesiology Authors: Beutler J, Schmid E, Fischer S, Hürlimann S, Konrad C Tags: Anaesthesist Source Type: research

[Diagnosis and treatment of diving accidents : New German guidelines for diving accidents 2014-2017].
r O, Schöppenthau H Abstract In 2015 the German Society for Diving and Hyperbaric Medicine (GTÜM) and the Swiss Underwater and Hyperbaric Medical Society (SUHMS) published the updated guidelines on diving accidents 2014-2017. These multidisciplinary guidelines were developed within a structured consensus process by members of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI), the Sports Divers Association (VDST), the Naval Medical Institute (SchiffMedInst), the Social Accident Insurance Institution for the Building Trade (BG BAU), the Association of Hyperbaric Trea...
Source: Der Anaesthesist - May 30, 2015 Category: Anesthesiology Authors: Jüttner B, Wölfel C, Liedtke H, Meyne K, Werr H, Bräuer T, Kemmerer M, Schmeißer G, Piepho T, Müller O, Schöppenthau H Tags: Anaesthesist Source Type: research

[From the legacy of Carl Koller : Notations on his experiments with cocaine].
Abstract The history of local anesthesia began with the discovery of the anesthetic properties of cocaine by the physician Carl Koller from Vienna 130 years ago. After he had realized the options for painless surgery using this substance, he analyzed cocaine in detail from this point of view and evaluated the drug's significance in animal experiments, in self-experiments and in colleagues. The findings of his experiments were accurately recorded by Koller and after his death remained in the possession of the family for a long time until his daughter Hortense Becker-Koller handed these documents over to the Library...
Source: Der Anaesthesist - May 28, 2015 Category: Anesthesiology Authors: Goerig M Tags: Anaesthesist Source Type: research

[Ultrasound-guided intermediate cervical plexus block : Anatomical study].
CONCLUSION: The compartment between the superficial and the prevertebral layer of the cervical fascia is a suitable target for cervical plexus blocks. This injection site describes an intermediate cervical plexus block. As the compartment contains the sensory terminal branches of the spinal nerves C2-4, it may be referred to as C2-C4 compartment. The cranio-caudal spread of the injectate allows lateromedial needle guidance in the horizontal plane. As the superficial lamina is not a barrier to the injectate an additional subcutaneous infiltration of the nerve area appears dispensable. The prevertebral lamina proved to be im...
Source: Der Anaesthesist - May 27, 2015 Category: Anesthesiology Authors: Seidel R, Schulze M, Zukowski K, Wree A Tags: Anaesthesist Source Type: research

[Anesthesia in children and adolescents with congenital heart defects].
Abstract The incidence of congenital heart defects (CHD) has remained constant over many years; however, due to improved therapeutic options an increasing number of children and adolescents even with complex heart defects now reach adulthood. The increasing prevalence of adults with persisting or surgically corrected CHD as well as age-dependent non-cardiac comorbidities will increase the need for medical and non-cardiac surgical treatment in this population. Although elective medical care for these patients should be reserved for highly specialized centers, emergency treatment might become necessary in a non-spec...
Source: Der Anaesthesist - May 27, 2015 Category: Anesthesiology Authors: Baehner T, Boehm O, Kliemann M, Heinze I, Breuer J, Hoeft A, Baumgarten G, Knuefermann P Tags: Anaesthesist Source Type: research

[Obstructive shock].
Abstract An acute obstruction of blood flow in central vessels of the systemic or pulmonary circulation causes the clinical symptoms of shock accompanied by disturbances of consciousness, centralization, oliguria, hypotension and tachycardia. In the case of an acute pulmonary embolism an intravascular occlusion results in an acute increase of the right ventricular afterload. In the case of a tension pneumothorax, an obstruction of the blood vessels supplying the heart is caused by an increase in extravascular pressure. From a hemodynamic viewpoint circulatory shock caused by obstruction is closely followed by card...
Source: Der Anaesthesist - May 21, 2015 Category: Anesthesiology Authors: Pich H, Heller AR Tags: Anaesthesist Source Type: research

[Severe traumatic head injury].
PMID: 25991055 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 20, 2015 Category: Anesthesiology Authors: Jantzen JP Tags: Anaesthesist Source Type: research

["Survivors" : New patient collective in anesthesia].
["Survivors" : New patient collective in anesthesia]. Anaesthesist. 2015 May 20; Authors: Müller M PMID: 25991056 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 20, 2015 Category: Anesthesiology Authors: Müller M Tags: Anaesthesist Source Type: research

[Erratum to: Implementation of a new emergency room protocol at a University Medical Center in Germany : Basis for improved flow of information, adequate quality management and scientific assessment].
PMID: 25991057 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 20, 2015 Category: Anesthesiology Authors: Ross D, Hinz J, Mansur A, Mielck F, Roessler M, Quintel M, Bauer M Tags: Anaesthesist Source Type: research

[Pediatric emergence agitation].
CONCLUSION: Emergence agitation is still seen as a relevant clinical problem by experienced pediatric anesthesiologists. Propofol is first choice when it comes to pharmacological prevention and treatment of emergence agitation. Postoperative parental presence was considered beneficial by the majority of anesthesiologists. PMID: 25986408 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 19, 2015 Category: Anesthesiology Authors: Lehmann V, Giest J, Wermelt J, Bode C, Becke K, Ellerkmann RK Tags: Anaesthesist Source Type: research

[Do not harm anybody].
PMID: 25986409 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 19, 2015 Category: Anesthesiology Authors: Standl T Tags: Anaesthesist Source Type: research

[S3 guidelines on volume therapy : Comments on publication 2014].
This article critically reviews and summarizes the essential recommendations. PMID: 25967944 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 13, 2015 Category: Anesthesiology Authors: Rosenberger P, Kaisers U Tags: Anaesthesist Source Type: research

Self-poisoning in the acute care medicine 2005-2012.
CONCLUSION: Acute self-poisoning is an increasing medical issue. Psychotropic drugs remain the most common means of suicide attempt. Although alcohol intoxication is very frequent, intake of illicit drugs as the cause of emergency admission is increasing. PMID: 25951922 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 8, 2015 Category: Anesthesiology Authors: Sorge M, Weidhase L, Bernhard M, Gries A, Petros S Tags: Anaesthesist Source Type: research

[Ketamine as anesthetic agent in electroconvulsion therapy].
This study was carried out to test if the occurrence of side effects is comparable and if seizure quality is better with ketamine when compared to thiopental. MATERIAL AND METHODS: This retrospective study analyzed a total of 199 patients who received ketamine anesthesia for a total of 2178 ECT sessions. This cohort was compared to patients who were treated with thiopental for 1004 ECT sessions. RESULTS AND DISCUSSION: A repeated measurement multiple logistic regression analysis revealed significant advantages in the ketamine group for seizure concordance and postictal suppression (both are surrogates for central...
Source: Der Anaesthesist - May 6, 2015 Category: Anesthesiology Authors: Janke C, Bumb JM, Aksay SS, Thiel M, Kranaster L, Sartorius A Tags: Anaesthesist Source Type: research

[Optimization of blood gas analysis in intensive care units : Reduction of preanalytical errors and improvement of workflow].
CONCLUSION: The implementation of a new BGA system with labeled syringes and automated processing of the specimens was possible without any difficulties under daily clinical routine conditions in this 10-bed intensive care unit (ICU). A gain of time could not be measured but a reduction in preanalytical errors using the labeled syringes with automated processing was found. Delayed analysis of blood samples can lead to significant changes in pO2 and pCO2 depending on the type of syringe used. PMID: 25896414 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 21, 2015 Category: Anesthesiology Authors: Kieninger M, Zech N, Mulzer Y, Bele S, Seemann M, Künzig H, Schneiker A, Gruber M Tags: Anaesthesist Source Type: research

[Venoarterial extracorporeal membrane oxygenation in an awake patient : Use of the mobile ECMO team for fulminant pulmonary embolism].
Abstract The current report highlights the use of venoarterial extracorporeal membrane oxygenation (va-ECMO) in a case of pulmonary embolism complicated by right ventricular failure. A 38-year-old woman was admitted to a secondary care hospital with dyspnea and systemic hypotension. Diagnostic testing revealed a massive pulmonary embolism. Thrombolytic therapy was unsuccessful necessitating thromboendarterectomy in the presence of cardiogenic shock. To allow the necessary transport of the highly unstable patient to a tertiary care center a mobile ECMO team was called in. The team immediately initiated awake va-ECM...
Source: Der Anaesthesist - April 21, 2015 Category: Anesthesiology Authors: Keller D, Lotz C, Kippnich M, Adami P, Kranke P, Roewer N, Kredel M, Schimmer C, Leyh R, Muellenbach RM Tags: Anaesthesist Source Type: research

[Anesthesia and pain management during pregnancy].
Abstract During the perioperative and postoperative care of pregnant women it is prudent to pay close attention to the changed physiology of these patients. The main principles of care are the preservation of maternal and fetal homeostasis as well as avoidance of any substances with toxic effects on the fetus. In order to provide pregnant patients with good quality care, all relevant disciplines should be involved as early as possible. Modern anesthetic drugs can be used as they seem to be without teratogenic effects. Adequate perioperative surveillance and assessment of the fetus is also important.The mainstay of...
Source: Der Anaesthesist - April 16, 2015 Category: Anesthesiology Authors: Ninke T, Thoma-Jennerwein S, Blunk J, Annecke T Tags: Anaesthesist Source Type: research

[Chain of survival in hospital : Decisive measures after in-hospital cardiac arrest].
PMID: 25875717 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 15, 2015 Category: Anesthesiology Authors: Zimmermann M Tags: Anaesthesist Source Type: research

[Patients with implanted ventricular assist devices : Challenge for emergency medicine].
This article presents an overview of the most common problems and pitfalls regarding VADs. It also presents an algorithm for dealing with emergencies involving these patients including the diagnostics, treatment and primary transport. PMID: 25870001 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 14, 2015 Category: Anesthesiology Authors: Bunz M, Kerscher C, Foltan M, Rupprecht L, Graf BM, Zausig YA Tags: Anaesthesist Source Type: research

[Metformin-induced lactic acidosis : Severe symptoms with difficult diagnostics].
Abstract Metformin-induced lactic acidosis is a rare but severe disease for the individual patients. A case of a 64-year-old patient with diabetes mellitus type 2 suffering from this disease is presented where metformin accumulation was caused by prerenal acute kidney failure. The clinical evaluation up to the final diagnosis, the pathophysiology and the appropriate therapy are presented in detail. Additionally, the current guidelines regarding the perioperative management of metformin administration are summarized. The case described aims to direct attention to the rare but, nevertheless, severe symptoms of metfo...
Source: Der Anaesthesist - April 14, 2015 Category: Anesthesiology Authors: Decker SO, Wortmann M, Siegler BH, Ulrich A, Hofer S, Brenner T Tags: Anaesthesist Source Type: research

[Therapy of acute respiratory distress syndrome : Survey of German ARDS centers and scientific evidence].
CONCLUSIONS: Lung protective ventilation with reduced tidal volumes as well as inspiratory pressures represents the current standard of care and was utilized in all network centers. Prone positioning was widely used. Promising adjuvant therapies such as the muscle relaxation during the early phase of the ARDS, fluid restriction and corticosteroids were used less frequently. During ECMO respirator therapy was generally continued with ultraprotective ventilator settings. PMID: 25824000 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 1, 2015 Category: Anesthesiology Authors: Kredel M, Bierbaum D, Lotz C, Küstermann J, Roewer N, Muellenbach RM Tags: Anaesthesist Source Type: research

[High-dose magnesium sulfate in the treatment of aconite poisoning].
This article reports the case of a 62-year-old male patient who ingested the roots of Monkshood (Aconitum napellus) and white hellebore (Veratrum album) dissolved in alcohol with a suicidal intention and suffered cardiotoxic and neurotoxic symptoms. After contacting the Poison Information Centre ventricular arrhythmia was treated with high-dose magnesium sulphate as the only antiarrhythmic agent and subsequently a stable sinus rhythm could be established after approximately 3 h. Aconitum napellus is considered the most poisonous plant in Europe and it is found in gardens, the Alps and the Highlands. Poisoning is mainl...
Source: Der Anaesthesist - March 27, 2015 Category: Anesthesiology Authors: Clara A, Rauch S, Überbacher CA, Felgenhauer N, Drüge G Tags: Anaesthesist Source Type: research

[Antibiotic dosing for renal function disorders and continuous renal replacement therapy].
Abstract For patients with acute kidney injury (AKI) and continuous renal replacement therapy, it is essential that the dosing of antibiotics is adequately adjusted in order to achieve an effective drug level above the minimum inhibition concentration but avoiding toxic side effects. In the selection of substances, preference should be given to antibiotics with a broad therapeutic spectrum, low incidence of side effects and, as far as possible, extrarenal elimination. Determination of serum levels should always be carried out, when this is possible. In any case, a sufficiently high loading dose should be included....
Source: Der Anaesthesist - March 27, 2015 Category: Anesthesiology Authors: Michael E, Kindgen-Milles D Tags: Anaesthesist Source Type: research

Randomized comparison of the i-gel(TM) with the LMA Supreme (TM) in anesthetized adult patients.
This study compared the devices regarding efficacy, safety, ease of use and incidence of adverse events, focusing on the postoperative rate of sore throat, dysphagia or dysphonia and development with time, in patients undergoing laparoscopic cholecystectomy procedures under general anesthesia. METHODS: This was a prospective, randomized, controlled clinical study including 140 patients randomized into 2 groups undergoing elective laparoscopic cholecystectomy to use either i-gel or LMA-S. After the general anesthesia procedure, the speed of insertion, success rates, ease of insertion of the drain tube, leak pressure an...
Source: Der Anaesthesist - March 24, 2015 Category: Anesthesiology Authors: Beleña JM, Núñez M, Vidal A, Gasco C, Alcojor A, Lee P, Pérez JL Tags: Anaesthesist Source Type: research

[Variation in closeness to reality of standardized resuscitation scenarios : Effects on the success of cognitive learning of medical students].
CONCLUSION: For simulation-based learning the outcome depends not only on knowledge, practical skills and motivational variables but also on the onset of negative emotions, perception of own ability and personality profile. Simulation training alone does not appear to guarantee learning success but it seems to be necessary to establish a simulation setting suitable for the education level, needs and personality characteristics of the students. PMID: 25791322 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 20, 2015 Category: Anesthesiology Authors: Schaumberg A Tags: Anaesthesist Source Type: research

[Implementation of a new emergency room protocol at a University Medical Center in Germany : Basis for improved flow of information, adequate quality management and scientific assessment].
CONCLUSION: The structured and elaborated documentation was limited to the target of two sides and succeeds in incorporating trauma patients as well as non-trauma patients in the ER. PMID: 25782779 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 18, 2015 Category: Anesthesiology Authors: Ross D, Hinz J, Mansur A, Mielck F, Roessler M, Quintel M, Bauer M Tags: Anaesthesist Source Type: research

[Management for the operating room].
r G Abstract Business companies, which in the current times also includes hospitals, must create customer benefits and as a prerequisite for this must sustainably generate profits. Management in the world of business means the formation and directing of a company or parts of a company on a permanent basis, whereby management in this context is not exercising power but function. This concept of management is exemplary developed in this article for the important services sector of the operating room (OR) and individual functions, such as resource control, capacity planning and materials administration are presented ...
Source: Der Anaesthesist - March 18, 2015 Category: Anesthesiology Authors: Tschudi O, Schüpfer G Tags: Anaesthesist Source Type: research

[Communication with children : Practical hints and tools for the anesthesiology routine].
CONCLUSION: Meeting at eye level, talking to the child instead of just about it, a language appropriate for children but not childish, comprehensible information and explanations, return of control and care more than pure technical distance, all play an important role. A serious look into such communication strategies can help the anesthetist to overcome uncertainties that a child can easily sense. PMID: 25776207 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 17, 2015 Category: Anesthesiology Authors: Zech N, Seemann M, Signer-Fischer S, Hansen E Tags: Anaesthesist Source Type: research

[Telemedicine : Stopgap or future concept?]
r S PMID: 25776208 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 17, 2015 Category: Anesthesiology Authors: Prückner S Tags: Anaesthesist Source Type: research

[Protoplasm, coagulation and colloids : Forgotten chapter in the research history of anesthesia between zeitgeist and paradigm].
Abstract The historically most important mechanistic theories attributed the fundamental cause of anesthesia to interactions betweeen anesthetics and proteins as early as the 1870s. According to the underlying thought, the resulting changes in the consistency of cellular protoplasm were the cause of the anesthetized state of the whole organism.These protoplasm coagulation theories, as they were collectively referred to, brought the contemporary enthusiasm for protoplasm, the rapid advances in colloid chemistry and the unified theory of narcosis proclamed by Claude Bernard under a unified mechanistic theory that re...
Source: Der Anaesthesist - March 17, 2015 Category: Anesthesiology Authors: Perouansky M Tags: Anaesthesist Source Type: research

[Current capabilities of telemedicine in anaesthesiology].
Abstract Because of an ageing population and a relative lack of professionals, the German health system is under great pressure. In rural regions in particular, anesthesiology is also affected - nursing staff, anesthetists, intensive care physicians, and emergency physicians often have to be supported by freelancers from other regions and from abroad - at least periodically. In addition to the increasing number of treatments, the potential quality of therapy is also increasing owing to progress in medical research. Against this background the need for resources is increasing to ensure the optimal quality of treatm...
Source: Der Anaesthesist - March 14, 2015 Category: Anesthesiology Authors: Czaplik M, Brokmann J, Hochhausen N, Beckers SK, Rossaint R Tags: Anaesthesist Source Type: research

[Necessity for standards in pediatric anesthesia].
Authors: PMID: 25764347 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 13, 2015 Category: Anesthesiology Tags: Anaesthesist Source Type: research

Cafedrine/theodrenaline in anaesthesia : Influencing factors in restoring arterial blood pressure.
This study aimed to examine the drug combination in real-life clinical practice and recorded time to 10 % mean arterial blood pressure (MAP) increase and heart rate. Furthermore, potential factors that influence drug effectiveness under anaesthesia were assessed. METHODS: Data were collected within a standardised anaesthesia protocol. A total of 353 consecutive patients (female/male = 149/204) who received cafedrine/theodrenaline after a drop in MAP ≥ 5 % were included in the study. The time to 10 % increase in MAP, dosage of cafedrine/theodrenaline, volume loading, blood p...
Source: Der Anaesthesist - March 11, 2015 Category: Anesthesiology Authors: Heller AR, Heger J, Gama de Abreu M, Müller MP Tags: Anaesthesist Source Type: research

[Safety in pediatric anesthesia : Standards and checklists].
r M PMID: 25757553 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 11, 2015 Category: Anesthesiology Authors: Jöhr M Tags: Anaesthesist Source Type: research

[Stress and job satisfaction of future colleagues in anesthesiology].
er S PMID: 25757554 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 11, 2015 Category: Anesthesiology Authors: Kasch R, Eßer J, Merk H, Adler S Tags: Anaesthesist Source Type: research

[Perioperative evaluation and treatment of cardiovascular risk patients for noncardiac surgery : Guidelines of the European Society of Cardiology/European Society of Anaesthesiology 2014.]
This article summarizes the essential aspects of the guidelines in a clearly arranged form. PMID: 25701066 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 22, 2015 Category: Anesthesiology Authors: Grossmann E, Ninke T, Probst S, Kaisers UX Tags: Anaesthesist Source Type: research

[Coping with complex medical emergency situations : Competent and successful decision-making, communication and leadership.]
CONCLUSION: Research in aviation and psychology has provided various tools to improve performance during stressful events and should be taken into consideration for routine daily use. PMID: 25701067 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 22, 2015 Category: Anesthesiology Authors: Vetter B, Gasch B, Padosch SA Tags: Anaesthesist Source Type: research

[Form and extent of informed consent on anesthesia risks : Evaluation of a survey of all legal experts in Austria.]
CONCLUSION: In future new methods of knowledge transfer to the patients should be developed. In addition, a standardization of the evaluation criteria for CWs in terms of improvement of legal certainty would be desirable. PMID: 25630518 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 30, 2015 Category: Anesthesiology Authors: Andel D, Röder G, Markstaller K, Andel H Tags: Anaesthesist Source Type: research

[Multimodal therapy programs for chronic pain.]
Abstract Chronic pain is a common and disabling disorder with major consequences for patient quality of life and it is also a major economic burden to society. The management of chronic pain comprises a large range of different intervention strategies including pharmacological therapy, non-medicinal and invasive therapeutic options. While non-pharmacological and multimodal options are underused, monomodal options, especially pharmacotherapy and invasive therapies are overused. The effectiveness of multidisciplinary and multimodal treatment programs including physical and rehabilitation interventions and psychologi...
Source: Der Anaesthesist - January 25, 2015 Category: Anesthesiology Authors: Kopf A, Gjoni E Tags: Anaesthesist Source Type: research

[Multimodal pain therapy : End of an odyssey.]
er W PMID: 25616570 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 25, 2015 Category: Anesthesiology Authors: Meißner W Tags: Anaesthesist Source Type: research

[Acute treatment of patients with severe traumatic brain injury.]
CONCLUSION: Hypoxia, hypotension and hypercarbia should strictly be avoided to improve survival and neurological outcome in patients with severe TBI. The prehospital decision to intubate must be made on a case by case basis at the accident site. A level I trauma center should be the destination for this patient group. PMID: 25608499 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 23, 2015 Category: Anesthesiology Authors: Juratli TA, Stephan SE, Stephan AE, Sobottka SB Tags: Anaesthesist Source Type: research

[Standardized treatment protocols in acute postoperative pain therapy : Analysis of contents of standardized medicinal concepts.]
CONCLUSION: Content, structure and type of the evaluated treatment standards showed a considerable heterogeneity with respect to the availability of rescue and baseline medication. Safety aspects were not addressed in many cases. These findings show that despite the requirements of the German guidelines for treatment of perioperative and posttraumatic pain for treatment standards, there are still no practical recommendations with respect to contents and structure of such standards. PMID: 25608500 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 23, 2015 Category: Anesthesiology Authors: Erlenwein J, Emons M, Hecke A, Nestler N, Wirz S, Bauer M, Meißner W, Petzke F Tags: Anaesthesist Source Type: research

[Occupational exposure to blood in multiple trauma care.]
CONCLUSION: The process of treatment in prehospital settings is less predictable than in other settings in which invasive procedures are performed. Periodic training and awareness programs for trauma care personnel are required to increase the knowledge of occupational infections and the compliance with standard precautions. The legal and ethical aspects of testing an index patient for blood-borne pathogens after a needlestick injury of a healthcare worker have to be clarified in Germany. PMID: 25566692 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 9, 2015 Category: Anesthesiology Authors: Wicker S, Wutzler S, Schachtrupp A, Zacharowski K, Scheller B Tags: Anaesthesist Source Type: research

[Spinal anesthesia in high-volume, low-concentration technique for Caesarean sections : Retrospective analysis.]
CONCLUSION: The high-volume, low-concentration technique is an effective approach for spinal anesthesia with a small number of cases needing general anesthesia or additional analgesics. The rate of hypotension was moderate compared to other studies; however, because of the retrospective and non-randomized study design the dependence of this rate on dose and given volume should be interpreted with caution. PMID: 25537617 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - December 25, 2014 Category: Anesthesiology Authors: Jokinen J, Adametz V, Kredel M, Muellenbach RM, Hönig A, Wöckel A, Dietl J, Roewer N, Kranke P Tags: Anaesthesist Source Type: research

[Pediatric emergencies in the emergency medical service.]
This article provides a practical approach concerning the diagnostics and therapy of emergencies involving children. PMID: 25523319 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - December 20, 2014 Category: Anesthesiology Authors: Silbereisen C, Hoffmann F Tags: Anaesthesist Source Type: research