[Perioperative coagulation management during ascending aorta replacement on apixaban].
Abstract The direct oral anticoagulants (DOACs) present a valid therapeutic alternative to vitamin K antagonists in patients with non-valvular atrial fibrillation, for the prevention of venous thromboembolism, and for the treatment and prevention of the recurrence of pulmonary embolisms and deep vein thrombosis. Despite Idarucizumab as an antagonist of Dabigatran there are no other specific antidotes available yet. Therefore, perioperative coagulation management by DOACs is challenging in patients undergoing emergency surgical procedures with a high risk of bleeding complications. This case study de...
Source: Der Anaesthesist - July 4, 2016 Category: Anesthesiology Authors: Dumps C, Halbeck E, Schimpf J, Forst H Tags: Anaesthesist Source Type: research

[Anesthesiological approach for patients with spinal cord injuries].
This article summarizes the specific pathophysiology of SCI and how AD can be avoided as well as also providing anesthetists with strategies for perioperative and intensive care management of patients with SCI. PMID: 27371543 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 30, 2016 Category: Anesthesiology Authors: Rand A, Litz RJ, Zahn P Tags: Anaesthesist Source Type: research

[Mortui vivos docent : The dead teach the living].
r M Abstract There are considerable similarities and intersections between forensic medicine and emergency medicine. This applies especially to frustraneously resuscitated patients or other lethal clinical courses of traumatized patients who are subject to latter forensic autopsy. Cooperation between departments of emergency and forensic medicine not only has emergency medical training potential, but also the possibility of retrospective evaluation of medical emergency measures - both in individual cases and with regard to epidemiological aspects. In particular, the widespread registration of autopsied pre-hospita...
Source: Der Anaesthesist - June 28, 2016 Category: Anesthesiology Authors: Buschmann C, Kleber C, Tsokos M, Kerner T, Püschel K, Schmidt U, Fischer H, Stuhr M Tags: Anaesthesist Source Type: research

[Sepsis: case numbers increasing worldwide but new strategies too].
t K Abstract With the numbers of cases rising worldwide and consistently high mortality, sepsis is one of the world's most significant health issues. The Jena Symposium was dedicated to the challenges in research and development, new approaches to treatment, internationally successful strategies, and a potentially successful new initiative for improving the quality of prophylaxis, early diagnosis, and therapy. The importance of intensifying efforts in the fight against sepsis is becoming increasingly recognized by health care policy. Knowledge of lay people/the public about sepsis is lacking and the standards of q...
Source: Der Anaesthesist - June 28, 2016 Category: Anesthesiology Authors: Rüddel H, Weinmann C, Reinhart K Tags: Anaesthesist Source Type: research

[Intensive care studies from 2015/2016].
er T PMID: 27324154 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 19, 2016 Category: Anesthesiology Authors: Reuß CJ, Bernhard M, Beynon C, Hofer S, Jungk C, Michalski D, Weigand MA, Brenner T Tags: Anaesthesist Source Type: research

[Pre-operative documentation of individual in-patient therapy goals : A medical staff questionnaire].
DISCUSSION: Our study shows the dilemma of insufficiently structured directives for changing treatment goals as well as a high number of legal procedures to obtain proxy decisions due to missing out-patient advance health planning. From a medical staff perspective there is strong support for the concept of SSAD based on medical, ethical, economic and organizational reasons. PMID: 27324155 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 19, 2016 Category: Anesthesiology Authors: Umgelter K, Landscheidt J, Jäger K, Blobner M, Kochs E Tags: Anaesthesist Source Type: research

[Catheter-related thrombosis during intravascular temperature management].
We report on a case of catheter-related thrombosis after 7‑day catheter placement during intravascular temperature management (IVTM), in spite of the use of prophylactic anticoagulants. There were no clinical sequelae. According to the literature, occult thrombosis during ITVM could be more frequent than previously reported and dedicated monitoring for potential thrombosis may be indicated. However, a study comparing IVTM with surface cooling found no differences in clinical outcome. Therefore, n either of the methods can be recommended over the other. Further studies should evaluate the rate of occult thrombos...
Source: Der Anaesthesist - June 16, 2016 Category: Anesthesiology Authors: Kerz T, Beyer C, Oswald S, Moringlane R Tags: Anaesthesist Source Type: research

[PONV after strabismus surgery : Risk adapted prophylaxis?]
CONCLUSION: The overall incidence could be reduced to a level below 20 %. Particularly in patients with a high risk of PONV, TIVA could clearly reduce the incidence. However, the incidence in patients with 2 risk factors is still high (30-39 %). Therefore, it is important to reconsider the effort involved with risk screening and individually adapting anesthesia. Risk stratification means a pre- and perioperative effort. Therefore, we advocate a more liberal approach for PONV prophylaxis. PMID: 27295547 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 12, 2016 Category: Anesthesiology Authors: Wolf R, Morinello E, Kestler G, Käsmann-Kellner B, Bischoff M, Hager T, Schöpe J, Eberhart LH Tags: Anaesthesist Source Type: research

[Comment on: Acetylsalicylic acid before coronary surgery: Black, white or grey at least?]
PMID: 27287403 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 9, 2016 Category: Anesthesiology Authors: Kienbaum P, Rellecke P Tags: Anaesthesist Source Type: research

[Dexmedetomidine in the treatment of acute alcohol withdrawal delirium].
Abstract Alcohol withdrawal syndrome has a high clinical prevalence. Severe cases must be treated in an intensive care unit and are associated with a high mortality rate, depending on patient comorbidities. Clinical requirements include sedation, control of vegetative symptoms, treatment of hallucinations and, when necessary, anticonvulsive therapy. Currently, there is no single substance that fulfills these requirements. National and international guidelines recommend a combination of various substances. The central α2-adrenergic receptor agonist clonidine is used as a therapeutic adjuva...
Source: Der Anaesthesist - June 9, 2016 Category: Anesthesiology Authors: Gerresheim G, Brederlau J, Schwemmer U Tags: Anaesthesist Source Type: research

[Focus on hygiene: an issue for ultrasound too!]
PMID: 27287405 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 9, 2016 Category: Anesthesiology Authors: Greim CA Tags: Anaesthesist Source Type: research

[Comment on: Effect of inhaled Xenon on brain damage in comatose patients of out-of-hospital cardiac arrest].
g; M PMID: 27287406 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 9, 2016 Category: Anesthesiology Authors: Gruß M Tags: Anaesthesist Source Type: research

[Comment on: Importance of driving pressure for survival of controlled mechanically ventilated ARDS patients].
PMID: 27273201 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 6, 2016 Category: Anesthesiology Authors: Neumann P Tags: Anaesthesist Source Type: research

[Risk management in anesthesia and critical care medicine].
Abstract Throughout its history, anesthesia and critical care medicine has experienced vast improvements to increase patient safety. Consequently, anesthesia has never been performed on such a high level as it is being performed today. As a result, we do not always fully perceive the risks involved in our daily activity. A survey performed in Swiss hospitals identified a total of 169 hot spots which endanger patient safety. It turned out that there is a complex variety of possible errors that can only be tackled through consistent implementation of a safety culture. The key elements to reduce complications are con...
Source: Der Anaesthesist - June 5, 2016 Category: Anesthesiology Authors: Eisold C, Heller AR Tags: Anaesthesist Source Type: research

[Inhalation and intravenous anesthesia in pediatric patients].
r M Abstract Inhalation as well as total intravenous anesthesia have both advantages and disadvantages. The pros of an inhalation technique are mask induction without the initial need for intravenous access and precise dosing; the pros of an intravenous technique are postoperative quiet recovery and a low incidence of vomiting. With both techniques the aim is to reach a certain, most often constant effect site concentration, which after a short latent period equals the blood concentration. Initially, with both techniques a higher dosing is required to wash in the compound. An inhalational technique allows the end-...
Source: Der Anaesthesist - June 5, 2016 Category: Anesthesiology Authors: Jöhr M Tags: Anaesthesist Source Type: research

[Perioperative management of transthoracic oesophagectomies : Fundamentals of interdisciplinary care and new approaches to accelerated recovery after surgery].
e T Abstract Locally advanced carcinomas of the oesophagus require multimodal treatment. The core element of curative therapy is transthoracic en bloc oesophagectomy, which is the standard procedure carried out in most specialized centres. Reconstruction of intestinal continuity is usually achieved with a gastric sleeve, which is anastomosed either intrathoracically or cervically to the remaining oesophagus. This thoraco-abdominal operation is associated with significant postoperative morbidity, not least because of a vast array of pre-existing illnesses in the surgical patient. For an optimal outcome, t...
Source: Der Anaesthesist - May 30, 2016 Category: Anesthesiology Authors: Lambertz R, Drinhaus H, Schedler D, Bludau M, Schröder W, Annecke T Tags: Anaesthesist Source Type: research

[Monitoring tidal volumes when using the Ventrain® emergency ventilator].
CONCLUSION: The tested respiratory function monitor using hot-wire anemometer technology has the potential to monitor tidal volumes applied by the Ventrain®. With the software thus adapted, the RFM measures precise inspiratory and expiratory tidal volumes within common technical tolerance. This could help perform adequate patient ventilation with Ventrain® and reduce the potential risk of patient trauma. PMID: 27245923 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 30, 2016 Category: Anesthesiology Authors: Schmidt AR, Ruetzler K, Haas T, Schmitz A, Weiss M Tags: Anaesthesist Source Type: research

[Not either/or: both!]
PMID: 27245924 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 30, 2016 Category: Anesthesiology Authors: Eich C Tags: Anaesthesist Source Type: research

[A Germany-wide survey on anaesthesia in thoracic surgery].
CONCLUSION: The study reveals considerable differences in the anaesthetic practice in thoracic surgery. These focus mostly on the postoperative surveillance, the availability of bronchial blockers, and the use of regional anaesthetic techniques. Furthermore, it is evident that specific algorithms are needed for the difficult airway in thoracic anaesthesia. A recommendation for the high-tech work environment of thoracic anaesthesia could enhance the structural quality and optimize patient outcomes. Independent of a hospital's level of care, uniform requirements could help establish national quality standards in thoracic ana...
Source: Der Anaesthesist - May 30, 2016 Category: Anesthesiology Authors: Defosse J, Schieren M, Böhmer A, von Dossow V, Loop T, Wappler F, Gerbershagen MU Tags: Anaesthesist Source Type: research

[Identification and economic evaluation of anesthesiologic secondary diagnoses on the basis of intraoperative medication].
In this study, secondary diagnoses were identified through drug administrations during anaesthesia and were economically evaluated by regrouping these cases. METHODS: All intraoperative drug administrations from 2008 were extracted from a database. After exclusion of synonyms and procedure-specific drug administrations, all remaining drugs were matched to explicit secondary diagnoses. All cases were regrouped with their newly defined secondary diagnoses by G‑DRG grouper software, and changes in cost weight were evaluated. RESULTS: A total of 29 drugs could be assigned to 18 secondary diagnos...
Source: Der Anaesthesist - May 24, 2016 Category: Anesthesiology Authors: Brammen D, Rickert V, Esser T, Prätsch F, Röhrig R, Hachenberg T, Ebmeyer U Tags: Anaesthesist Source Type: research

[Mitochondrial disorders require a comprehensive perioperative management].
PMID: 27221391 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 24, 2016 Category: Anesthesiology Authors: Finsterer J, Zarrouk-Mahjoub S Tags: Anaesthesist Source Type: research

[MEK clarification: What is the task of the anesthesiologist?]
PMID: 27225931 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 24, 2016 Category: Anesthesiology Authors: Haas A, Wappler F Tags: Anaesthesist Source Type: research

[Implementation of a thermal management concept to prevent perioperative hypothermia : Results of a 6‑month period in clinical practice].
CONCLUSION: We conclude that temperature management is a challenge in the clinical situation, and that it is difficult to achieve rates of hypothermia close to zero. The addition of prewarming was very effective in improving the results in our patients. PMID: 27188499 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 16, 2016 Category: Anesthesiology Authors: Menzel M, Grote R, Leuchtmann D, Lautenschläger C, Röseler C, Bräuer A Tags: Anaesthesist Source Type: research

[Cost analysis of patient blood management].
CONCLUSIONS: PBM combines various alternatives to the transfusion of red blood cells and improves clinical outcome. Costs of PBM vary from institution to institution and depend on the extent to which different aspects of PBM have been implemented. The quantification of costs associated with PBM is essential in order to assess the economic impact of PBM, and thereby, to efficiently re-allocate health care resources. Costs were determined at a single university hospital. Thus, further analyses of both the costs of transfusion and the costs of PBM-principles will be necessary to evaluate the cost-effectiveness of PBM. PM...
Source: Der Anaesthesist - May 8, 2016 Category: Anesthesiology Authors: Kleinerüschkamp AG, Zacharowski K, Ettwein C, Müller MM, Geisen C, Weber CF, Meybohm P Tags: Anaesthesist Source Type: research

[Surgical site infections: of miasma, airborne threats and other risk factors].
e R PMID: 27146284 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 3, 2016 Category: Anesthesiology Authors: Schulze-Röbbecke R Tags: Anaesthesist Source Type: research

[Anesthesia in thoracic surgery].
Abstract Thoracic surgery represents a special challenge for anesthesia and requires a high level of human and material resources. Accurate knowledge of the pathophysiology is essential for selection of the anesthetic procedure, the separation of the lungs, monitoring and treatment of hemodynamics as well as for postoperative follow-up care. The increasing number of thoracic interventions and patients who are often suffering from complex diseases require close interdisciplinary cooperation between surgeons, anesthesiologists and intensive care specialists. In addition to the anesthetic techniques particular attent...
Source: Der Anaesthesist - May 3, 2016 Category: Anesthesiology Authors: Kammerer T, Speck E, von Dossow V Tags: Anaesthesist Source Type: research

[Prevention of postoperative surgical site infections : Between tradition and evidence].
Abstract Postoperative wound infections represent a relevant complication of invasive interventions. Current European prevalence data show that for participating hospitals from Germany (n = 132) surgical site infections represent the most commonly occurring nosocomial infection with 24.3 %. This corresponds to a point prevalence of 1.31 %. It is assumed that approximately 25-33 % of all infections acquired in hospital could be prevented if all possible precautions would be taken. Recent studies have indicated that this rate might be even higher for individual infection entities. Infection...
Source: Der Anaesthesist - May 3, 2016 Category: Anesthesiology Authors: Scheithauer S, Artelt T, Bauer M, Waeschle RM Tags: Anaesthesist Source Type: research

[Pharmacogenetics in anesthesia and intensive care medicine : Clinical and legal challenges exemplified by malignant hyperthermia].
Abstract Pharmacotherapy is a key component of anesthesiology and intensive care medicine. The individual genetic profile influences not only the effect of pharmaceuticals but can also completely alter the mode of action. New technologies for genetic screening (e.g. next generation sequencing) and increasing knowledge of molecular pathways foster the disclosure of pharmacogenetic syndromes, which are classified as rare diseases. Taking into account the high genetic variability in humans and over 8000 known rare diseases, up to 20 % of the population may be affected. In summary, rare diseases are not rare. M...
Source: Der Anaesthesist - May 2, 2016 Category: Anesthesiology Authors: Klingler W, Pfenninger E Tags: Anaesthesist Source Type: research

[Brown urine : Myoglobin-induced renal failure after concomitant administration of simvastatin and amiodarone].
We report a case of myoglobin-induced acute renal failure secondary to the concomitant use of simvastatin and amiodarone. The risk of rhabdomyolysis is mainly determined by the statin dose; in the case of the concomitant use of CYP3A4 inhibitors, a maximal daily dose of 20 mg is recommended to avoid harmful drug interactions. PMID: 27142363 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 2, 2016 Category: Anesthesiology Authors: Pietsch U, Müller-Höcker C, Filipovic M Tags: Anaesthesist Source Type: research

[Hygiene aspects in ultrasound-guided regional anesthesia].
CONCLUSION: The use of sterile ultrasound probe covers and sterile ultrasound contact media is an important prerequisite to avoid cross-infection between patients. An appropriate scientific evaluation should serve as evidence in this field. PMID: 27142364 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 2, 2016 Category: Anesthesiology Authors: Marhofer P, Schebesta K, Marhofer D Tags: Anaesthesist Source Type: research

[Isadora Duncan syndrome : Lethal strangulation injuries caused by filling equipment].
Abstract Aside from suicide attempts or autoerotic accidents, serious injuries from strangulation are rare. In 1929, the accidental death of the famous dancer Isadora Duncan gained high profile. However, even today there are reports of accidental strangulations. These are referred to as Isadora Duncan or long-scarf syndrome and are oftentimes lethal. In the pre-hospital setting, airway management has been challenging, as even a correctly placed airway device may initiate a rapid and marked deterioration of the patient's condition. The case history at hand outlines the death of a 47-year-old female, ...
Source: Der Anaesthesist - May 2, 2016 Category: Anesthesiology Authors: Jansen G, Mertzlufft F Tags: Anaesthesist Source Type: research

[Human resource planning in operative anaesthesia : Structured interviews with 23 supervising senior physicians].
CONCLUSIONS: This study analyzed structures established in human resource planning in the anesthesiology departments for the first time. Time for planning varies significantly in comparable departments indicating suboptimal processes. Throughout Germany, the requirements for human resources planning are similar; for example, the software should integrate all aspects of HR planning. Different approaches are under evaluation but so far no software solution has prevailed. The used solutions vary substantially and therefore a comparison is difficult. There is no software solution with wide adoption. PMID: 27142366 [PubMed...
Source: Der Anaesthesist - May 2, 2016 Category: Anesthesiology Authors: Bent F, Ahlbrandt J, Wagner A, Weigand MA, Hofer S, Lichtenstern C Tags: Anaesthesist Source Type: research

Donor-derived tuberculosis in an anesthetist after short-term exposure : An old demon transplanted from the past to the present.
We report a case of a 27-year-old anesthetist who acquired tuberculosis (TB) while performing general anesthesia in a renal transplant (RTX) patient who had donor-derived contagious TB. The anesthetist developed pleural TB 6 months after exposure. Contact investigations (CIs) did not include health care workers (HCWs) of the Department of Anesthesiology, thereby missing the opportunity for the early diagnosis and treatment of TB. Genomic fingerprinting revealed identical Mycobacterium tuberculosis (MT) isolates in the anesthetist and in the RTX patient. The recipient had acquired disseminated TB from th...
Source: Der Anaesthesist - April 28, 2016 Category: Anesthesiology Authors: Freytag I, Bucher J, Schoenberg M, Stangl M, Schelling G Tags: Anaesthesist Source Type: research

[Current legislation in the healthcare system 2015/2016].
This article gives a review of the most important new legislative regulations in the healthcare system and presents the fundamental consequences for the practice. PMID: 27072311 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 11, 2016 Category: Anesthesiology Authors: Martenstein I, Wienke A Tags: Anaesthesist Source Type: research

[Medical Emergency Preparedness in offshore wind farms : New challenges in the german north and baltic seas].
s C Abstract BACKGROUND: Offshore windfarms are constructed in the German North and Baltic Seas. The off-coast remoteness of the windfarms, particular environmental conditions, limitations in offshore structure access, working in heights and depths, and the vast extent of the offshore windfarms cause significant challenges for offshore rescue. Emergency response systems comparable to onshore procedures are not fully established yet. Further, rescue from offshore windfarms is not part of the duty of the German Maritime Search and Rescue Organization or SAR-Services due to statute and mandate reasons. Scientific rec...
Source: Der Anaesthesist - April 11, 2016 Category: Anesthesiology Authors: Stuhr M, Dethleff D, Weinrich N, Nielsen M, Hory D, Kowald B, Seide K, Kerner T, Nau C, Jürgens C Tags: Anaesthesist Source Type: research

[Continuous cuff pressure measurement during laryngeal mask anesthesia : An obligatory measure to avoid postoperative complications].
In this study the influence of continuous measurement of cuff pressure on the incidence of postoperative sore throat was investigated in patients who underwent laryngeal mask anesthesia. PATIENTS/MATERIAL AND METHODS: In the context of a retrospective audit all patients who underwent laryngeal mask anesthesia were asked to complete a questionnaire on anesthesia. The primary endpoint of the study was the postoperative occurrence of a sore throat. For analysis the patients were divided into two groups. In the first group the cuff pressure was controlled only by clinical means and in the second group the cuff pressure wa...
Source: Der Anaesthesist - April 11, 2016 Category: Anesthesiology Authors: Hensel M, Güldenpfennig T, Schmidt A, Krumm M Tags: Anaesthesist Source Type: research

[General principles of wound management in emergency departments].
KG Abstract Wound management is one of the major tasks in emergency departments. The surrounding intact skin but not the wound itself should be disinfected before starting definitive wound treatment. Hair should first be removed by clipping to 1-2 mm above the skin with scissors or clippers as shaving the area with a razor damages the hair follicles and increases the risk of wound infections. Administration of local anesthetics should be performed directly through the exposed edges of the wound. After wound examination, irrigation is performed with Ringer's solution, normal saline or distilled water. The nex...
Source: Der Anaesthesist - April 7, 2016 Category: Anesthesiology Authors: Zacher MT, Högele AM, Hanschen M, von Matthey F, Beer AK, Gebhardt F, Biberthaler P, Kanz KG Tags: Anaesthesist Source Type: research

Clinical presentation and blood gas analysis of multiple trauma patients for prediction of standard coagulation parameters at emergency department arrival.
g; Abstract OBJECTIVES: Trauma-induced coagulopathy (TIC) in multiple trauma patients is a potentially lethal complication. Whether quickly available laboratory parameters using point-of-care (POC) blood gas analysis (BGA) may serve as surrogate parameters for standard coagulation parameters is unknown. The present study evaluated TraumaRegister DGU® of the German Trauma Society for correlations between POC BGA parameters and standard coagulation parameters. METHODS: In the setting of 197 trauma centres (172 in Germany), 86,442 patients were analysed between 2005 and 2012. Of these, 40,129 (72 % me...
Source: Der Anaesthesist - April 7, 2016 Category: Anesthesiology Authors: Hilbert-Carius P, Hofmann GO, Lefering R, Stuttmann R, Struck MF, German TraumaRegister DGU® Tags: Anaesthesist Source Type: research

["Why mothers die" : Learning from the analysis of anaesthesia-related maternal deaths (1985-2013)].
["Why mothers die" : Learning from the analysis of anaesthesia-related maternal deaths (1985-2013)]. Anaesthesist. 2016 Apr 5; Authors: Neuhaus S, Neuhaus C, Fluhr H, Hofer S, Schreckenberger R, Weigand MA, Bremerich D Abstract Every day, more than 800 women die from causes related to pregnancy or childbirth. Since 1952 the Confidential Enquiry of Maternal Deaths Reports (CEMD) have collected and analysed data on maternal mortality in the United Kingdom and Northern Ireland. This publication analyses the CEMD from 1985-2013 regarding anaesthesia- and analgesia related maternal deaths during ...
Source: Der Anaesthesist - April 4, 2016 Category: Anesthesiology Authors: Neuhaus S, Neuhaus C, Fluhr H, Hofer S, Schreckenberger R, Weigand MA, Bremerich D Tags: Anaesthesist Source Type: research

[Erratum to: Venous thrombosis and pulmonary embolism. Updated S2 guidelines on diagnostics and therapy].
PMID: 27048846 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 4, 2016 Category: Anesthesiology Authors: Volk T Tags: Anaesthesist Source Type: research

Erratum zu Anästhesie bei Leberinsuffizienz.
Erratum zu Anästhesie bei Leberinsuffizienz. Anaesthesist. 2016 Apr 4; Authors: Sinner B, Camboni-Schellenberg EL PMID: 27041250 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 3, 2016 Category: Anesthesiology Authors: Sinner B, Camboni-Schellenberg EL Tags: Anaesthesist Source Type: research

Local anesthetic toxicity: Who is ready for lipid resuscitation? : A survey of German Hospitals.
HE Abstract PURPOSE: Toxic reactions to local anesthetics are rare but potentially lethal. In fact, animal studies and case reports demonstrate that the administration of lipid emulsions after initializing cardiopulmonary resuscitation is a promising treatment option. The aim of this study was to determine how many hospitals in Germany are prepared to treat toxic reactions to local anesthetics with lipid infusion and to identify how often and what type of toxic reactions occur and if treatment was successful. Further, we aimed to elucidate if current guidelines lead to more immediate availability of lipid emulsio...
Source: Der Anaesthesist - April 3, 2016 Category: Anesthesiology Authors: Rosenthal G, Wetsch WA, Neumann T, Padosch SA, Böttiger BW, Marcus HE Tags: Anaesthesist Source Type: research

[Existential questions prior to elective surgery : Survey in a preoperative anesthesia consultation service].
CONCLUSIONS: Although the majority of the respondents were willing to talk about difficult issues before an operation, it remains unclear to what extent these results can be generalized. However, the results justify efforts to carefully inquire about and document the will of sick patients prior to major surgery. Both the treatment team and the relatives are relieved if the patient's will is known when difficult decisions have to be made. PMID: 27033115 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 30, 2016 Category: Anesthesiology Authors: Meyer-Zehnder B, Bucher E, Vogt DR, Pargger H Tags: Anaesthesist Source Type: research

Determination of the median effective dose (ED50) of spinal plain ropivacaine for motor block in adults.
CONCLUSION: the ED50 for motor block in spinal plain ropivacaine decreases with advancing age, indicating that age has an influence on the potency of spinal ropivacaine. PMID: 27023257 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 28, 2016 Category: Anesthesiology Authors: Chen MQ, Chen C, Fang W Tags: Anaesthesist Source Type: research

[Prone positioning of patients during venovenous extracorporeal membrane oxygenation is safe and feasible].
CONCLUSION: Prone positioning significantly reduces the mortality of patients with severe ARDS. In this series of 26 patients with severe ARDS during ECMO therapy no serious adverse events were found during the use of prone positioning. PMID: 27007777 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 22, 2016 Category: Anesthesiology Authors: Voelker MT, Jahn N, Bercker S, Becker-Rux D, Köppen S, Kaisers UX, Laudi S Tags: Anaesthesist Source Type: research

[Guidelines desirable for treatment of carbon monoxide poisoning].
n J PMID: 26961767 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 9, 2016 Category: Anesthesiology Authors: Drinhaus H, Nüsgen S, Hinkelbein J Tags: Anaesthesist Source Type: research

[Structure follows Process follows Strategy].
PMID: 26961768 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 9, 2016 Category: Anesthesiology Authors: Heller AR Tags: Anaesthesist Source Type: research

[Anesthesiological approach to postpartum hemorrhage].
Abstract Peripartum hemorrhage (PPH) is a frequent obstetric emergency situation with increasing incidence in the last decades. It requires a fast, coordinated and interdisciplinary management. This life-threatening situation is often recognized too late and not adequately treated (too little is done too late); therefore, it is important to be aware of the most important risk factors for PPH known as the 4 Ts (i.e. tonus, trauma, tissue and thrombin). Due to the special patient population there is only little evidence-based data on hemostatic therapy in this situation; therefore, the currently available studi...
Source: Der Anaesthesist - March 8, 2016 Category: Anesthesiology Authors: Knapp J, Hofer S, Lier H Tags: Anaesthesist Source Type: research

[Glucocorticoids as an adjunct in peripheral regional anesthesia : Move to the "Holy Grail of perineural analgesia" ?!]
CONCLUSIONS: After reviewing the actual literature, the authors prefer a systemic application mode (intravenously) over a perineural route of administration of dexamethasone as an adjunct for peripheral nerve blocks. This is due to the better understanding of potential side effects of the drug when applied intravenously. Dexamethasone might be a useful drug adjunct to prolong peripheral single shot nerve blocks. PMID: 26952122 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 7, 2016 Category: Anesthesiology Authors: Wiesmann T, Volk T, Steinfeldt T Tags: Anaesthesist Source Type: research

[Emergency departments - 2016 update].
s A Abstract Acute medical care in hospital emergency departments has experienced rapid development in recent years and gained increasing importance not only from a professional medical point of view but also from an economic and health policy perspective. The present article therefore provides an update on the situation of emergency departments in Germany. Care in emergency departments is provided with an increasing tendency to patients of all ages presenting with varying primary symptoms, complaints, illnesses and injury patterns. In the process, patients reach the emergency department by various routes and...
Source: Der Anaesthesist - March 7, 2016 Category: Anesthesiology Authors: Zimmermann M, Brokmann JC, Gräff I, Kumle B, Wilke P, Gries A Tags: Anaesthesist Source Type: research