[Quo vadis, preclinical emergency physician? : Results of a survey of emergency medical services in Rhineland-Palatinate (Germany).]
CONCLUSION: The described problems are complex. Besides financial incentives, they necessitate greater general appreciation of the preclinical work of emergency physicians. Further studies including the emergency physicians concerned are necessary. The low percentage of female emergency physicians requires special consideration. PMID: 24595443 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 6, 2014 Category: Anesthesiology Authors: Luiz T, Jung J, Flick S Tags: Anaesthesist Source Type: research

[Pneumocephalus as a rare complication of general anesthesia.]
This article reports a case of massive postoperative pneumocephalus in a patient following general anesthesia for a urological procedure. The patient had sustained a severe head injury more than 10 years ago with long-term treatment in an intensive care unit (ICU) including decompressive craniectomy, tracheostomy followed by rehabilitation, decanulation and cranioplasty. The patient recovered but suffered severe hemiparesis and mild neurocognitive deficits. Immediately after the current operation the patient was disoriented and did not recover in an appropriate interval. A cranial computed tomography (CT) scan revealed mas...
Source: Der Anaesthesist - March 2, 2014 Category: Anesthesiology Authors: Welschehold S, Wegermann P, Reuland A Tags: Anaesthesist Source Type: research

[Hypoxic gas mixture delivery due to a defective vaporiser manifold : Case report, review of the literature and suggested emergency management algorithm.]
Abstract A case of delivery of a hypoxic gas mixture to a patient during total intravenous anesthesia is described. A progressive fall in inspiratory oxygen concentration followed by a drop in oxygen saturation below 90 % occurred during the advanced stages of a hitherto uneventful general anesthesia of a female patient undergoing anterior cervical fusion surgery. A malfunctioning defective rubber seal of a vaporizer manifold was identified as the cause of the gas leak. The leak had not been detected during the preanesthesia leak test. The problem of hypoxic gas mixtures and uncommon leaks in modern anesthe...
Source: Der Anaesthesist - March 2, 2014 Category: Anesthesiology Authors: Berlet T Tags: Anaesthesist Source Type: research

[Interaction of anesthetics and analgesics with tumor cells.]
Abstract The results of preclinical and clinical studies indicate that the perioperative period is a vulnerable period for cancer progression and metastasis. The risk of cancer cell dissemination is enhanced by the combination of surgical manipulation and perioperative immunosuppression. Whether the oncological outcome of cancer patients can be influenced by the choice of anesthetic techniques is still a matter of debate. This review summarizes the molecular characteristics of cancer and interaction of anesthetic and analgesic drugs with cancer cells. PMID: 24584840 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 2, 2014 Category: Anesthesiology Authors: Bundscherer A, Malsy M, Bitzinger D, Graf BM Tags: Anaesthesist Source Type: research

[Management of postpartum hemorrhage (PPH) : Algorithm of the interdisciplinary D-A-CH consensus group PPH (Germany - Austria - Switzerland).]
immermann R Abstract Postpartum hemorrhage (PPH) is one of the main causes of maternal deaths even in industrialized countries. It represents an emergency situation which necessitates a rapid decision and in particular an exact diagnosis and root cause analysis in order to initiate the correct therapeutic measures in an interdisciplinary cooperation. In addition to established guidelines, the benefits of standardized therapy algorithms have been demonstrated. A therapy algorithm for the obstetric emergency of postpartum hemorrhage in the German language is not yet available. The establishment of an international (...
Source: Der Anaesthesist - March 2, 2014 Category: Anesthesiology Authors: Schlembach D, Mörtl MG, Girard T, Arzt W, Beinder E, Brezinka C, Chalubinski K, Fries D, Gogarten W, Hackelöer BJ, Helmer H, Henrich W, Hösli I, Husslein P, Kainer F, Lang U, Pfanner G, Rath W, Schleussner E, Steiner H, Surbek D, Zimmermann R Tags: Anaesthesist Source Type: research

[Acute pancreatitis.]
Abstract Acute pancreatitis is a potentially fatal disease with individually differing expression of systemic involvement. For this reason early diagnosis with subsequent risk stratification is essential in the clinical management of this frequent gastroenterological disorder. Severe forms of acute pancreatitis occur in approximately 20 % of cases often requiring intensive care monitoring and interdisciplinary therapeutic approaches. In the acute phase adequate fluid replacement and sufficient analgesic therapy is of major therapeutic importance. Concerning the administration of antibiotics and the nutritio...
Source: Der Anaesthesist - March 2, 2014 Category: Anesthesiology Authors: Hecker M, Mayer K, Askevold I, Collet P, Weigand MA, Krombach GA, Padberg W, Hecker A Tags: Anaesthesist Source Type: research

[Awake ECMO therapy in airway stenosis : Bronchoscopic treatment using laser resection.]
This article presents the case of a 62-year-old patient with cancer in the left upper pulmonary lobe who underwent lobe resection with postoperative respiratory insufficiency. The right upper lobe had already been resected 5 years earlier because of an adenocarcinoma. Prior to the present surgery a computed tomography scan detected a narrow stenosis at the former resection site; however, both pulmonary lobes beyond this stenosis appeared to be sufficiently ventilated. After resection of the left upper lobe attempted extubation was unsuccessful due to insufficient global gas exchange as the stenosis prevented ventilation of...
Source: Der Anaesthesist - March 2, 2014 Category: Anesthesiology Authors: Duru JA, Menges T, Bodner J, Degen ME, Greifenberg D, Gehron J, Weigand MA, Henrich M Tags: Anaesthesist Source Type: research

[Mechanical resuscitation assist devices.]
Abstract In Germany 100,000-160,000 people suffer from out-of-hospital cardiac arrest (OHCA) annually. The incidence of cardiopulmonary resuscitation (CPR) after OHCA varies between emergency ambulance services but is in the range of 30-90 CPR attempts per 100,000 inhabitants per year. Basic life support (BLS) involving chest compressions and ventilation is the key measure of resuscitation. Rapid initiation and quality of BLS are the most critical factors for CPR success. Even healthcare professionals are not always able to ensure the quality of CPR measures. Consequently in recent years mechanical resuscitation d...
Source: Der Anaesthesist - February 27, 2014 Category: Anesthesiology Authors: Fischer M, Breil M, Ihli M, Messelken M, Rauch S, Schewe JC Tags: Anaesthesist Source Type: research

[Augmented spontaneous breathing in the weaning process : Technical gimmick or enrichment of intensive care medicine?]
PMID: 24569932 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 27, 2014 Category: Anesthesiology Authors: Ragaller M Tags: Anaesthesist Source Type: research

[Parental presence during induction of anesthesia in children : Pros and cons.]
This article explains the grounds and the premises for this practice and describes those factors which might be important to support parental presence during induction of anesthesia in children. Some practical advice and tips on how parental presence in the clinic can be practically implemented are given at the end of the article. PMID: 24569933 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 27, 2014 Category: Anesthesiology Authors: Machotta A Tags: Anaesthesist Source Type: research

[Overwhelming postsplenectomy infection syndrome.]
SO Abstract The overwhelming postsplenectomy infection syndrome (OPSI) is a fulminant sepsis that is mainly caused by Streptococcus pneumoniae and is characterized by a particular high mortality. Patients whose spleen was removed due to a hematological disease are at special risk. Even after the recommended immunization against Streptococcus pneumoniae 20-30 % of these patients do not develop an adequate level of antibody response. Therefore, this particular group of patients must be trained how to behave in case of fever and need to obtain immediate specific sepsis therapy with antibiotic prophylaxis. ...
Source: Der Anaesthesist - February 27, 2014 Category: Anesthesiology Authors: Fuchs C, Scheer C, Schulz K, Dombrowski F, Brückmann S, Kuhn SO Tags: Anaesthesist Source Type: research

[Prehospital non-invasive ventilation in Germany : Results of a nationwide survey of ground-based emergency medical services.]
CONCLUSION: Prehospital NIV in Germany was used by only one third of all respondents by the end of 2008. Based on the clinical data a growing application for pNIV is expected. Controlled prehospital studies are needed to enunciate evidence-based recommendations for pNIV. PMID: 24569935 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 27, 2014 Category: Anesthesiology Authors: Sellmann T, Conty C, Treschan T, Kindgen-Milles D Tags: Anaesthesist Source Type: research

[Placement of a central venous catheter in cases of persistent left superior vena cava.]
This article presents a case report on the placement of a central venous catheter (CVC) in a patient with an unknown persistent left superior vena cava (PLSVC). Normally, PLSVCs remain asymptomatic but can be associated with disastrous consequences for the patient during placement of a CVC particularly due to vascular perforation and pulmonary injury. A PLSCV is particularly common in association with congenital heart defects; however, otherwise healthy patients can also be affected. As the presence of a PLSCV is normally unknown special attention must be paid in every patient during placement of a CVC. PMID: 24566941...
Source: Der Anaesthesist - February 26, 2014 Category: Anesthesiology Authors: Seemann M, Zech N, Kieninger M, Graf B, Künzig H Tags: Anaesthesist Source Type: research

[Prehospital analgesia performed by paramedics : Quality in processes and effects under medical supervision.]
This study specifically focused on the medical results and associated processes and not on the legal aspects. MATERIALS AND METHODS: In a retrospective analysis analgesia performed by paramedics who had undergone standardized training with annual controls and under medical supervision was investigated with regard to administration processes and efficacy. Analysis endpoints included vital signs at baseline and on transfer to the emergency department, pain score as defined by a numeric rating scale (NRS 0-10), the amount of ketamine administered and the occurrence of side effects (e.g. respiratory and circulatory disord...
Source: Der Anaesthesist - February 23, 2014 Category: Anesthesiology Authors: Häske D, Schempf B, Gaier G, Niederberger C Tags: Anaesthesist Source Type: research

[Current concepts of augmented spontaneous breathing : New modes of effort-adapted weaning.]
Abstract The use of augmented spontaneous breathing is an important component in a bundle concept of weaning from mechanical ventilation as it was demonstrated that controlled ventilation with diaphragmatic underuse induces rapid muscle atrophy and impairs successful weaning. On the other hand spontaneous breathing is often associated with disturbed patient-ventilator interaction resulting in asynchrony (e.g. ineffective triggering, early termination of inspiration and overflow or underflow). It was shown that asynchrony can impair gas exchange, increase work of breathing and enhance deleterious aspects of mechani...
Source: Der Anaesthesist - February 19, 2014 Category: Anesthesiology Authors: Bein T Tags: Anaesthesist Source Type: research

[Preoperative risk evaluation of adult patients prior to elective non-cardiac surgery : Follow-up survey of the recommendations published in 2010.]
CONCLUSION: The joint recommendations are well known and positively rated among anesthetists in Germany responding to the questionnaire reflecting an effective implementation process over the last 2 years. The anesthetists who completed the questionnaire stated that the use of the recommendations leads to a more reasonable approach in preoperative risk evaluation which contributes to an increase in patient safety and satisfaction. PMID: 24535688 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 19, 2014 Category: Anesthesiology Authors: Böhmer AB, Defosse J, Geldner G, Mertens E, Zwissler B, Wappler F Tags: Anaesthesist Source Type: research

[Keep on pumping : Importance of mechanical resuscitation aids.]
PMID: 24531735 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 16, 2014 Category: Anesthesiology Authors: Helm M Tags: Anaesthesist Source Type: research

[Patients rights act : Consequences for medical treatment.]
Abstract With the justification that the treatment and medical liability act suffers from a lack of transparency and reliability due to being characterized by many isolated decisions, in 2013 this was made into statute law in the form of the patients rights act in the German Civil Code (BGB). It was considered that "currently existing comprehensive rights of patients" would be strengthened through clarity and "legal transparency" and that the practical "implementation" would be improved. That this target will be achieved with these new statutory provisions is doubtful. Instead of more...
Source: Der Anaesthesist - February 7, 2014 Category: Anesthesiology Authors: Ulsenheimer K Tags: Anaesthesist Source Type: research

[Target recognized - and not reached.]
e H PMID: 24499958 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 7, 2014 Category: Anesthesiology Authors: Bürkle H Tags: Anaesthesist Source Type: research

Lateral spread response monitoring during microvascular decompression for hemifacial spasm : Comparison of two targets of partial neuromuscular blockade.
CONCLUSION: Maintenance of partial NMB with a target T1/Tc ratio of 50 % resulted in a clinically acceptable success rate of LSR monitoring and surgical condition during MVD. Maintenance of partial NMB with a target T1/Tc ratio of 50 % rather than TOF count of two during LSR monitoring for MVD can therefore be recommended. PMID: 24499959 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 7, 2014 Category: Anesthesiology Authors: Chung YH, Kim WH, Lee JJ, Yang SI, Lim SH, Seo DW, Park K, Chung IS Tags: Anaesthesist Source Type: research

[Premedication visits in departments of anesthesiology in Hessen : Compilation of organizational and performance portfolios.]
CONCLUSION: The PAACs are now well established. This may make economic sense but is accompanied by an anonymization of care in anesthesiology. The high quality, safety and availability of modern anesthesiology procedures and monitoring concepts should be communicated to patients all the more as an expression of trust and high patient safety. These factors can be facilitated in particular by multimedia tools which have as yet only been sparsely implemented in PAACs. PMID: 24499960 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 7, 2014 Category: Anesthesiology Authors: Aust H, Veltum B, Wächtershäuser T, Wulf H, Eberhart L Tags: Anaesthesist Source Type: research

Effects of echinocandin preparations on adult rat ventricular cardiomyocytes : Preliminary results of an in vitro study.
CONCLUSIONS: Echinocandins impact the in vitro contractility of isolated cardiomyocytes of rats. This observation could be of great interest in the context of antifungal treatment. PMID: 24499961 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 7, 2014 Category: Anesthesiology Authors: Arens C, Uhle F, Wolff M, Röhrig R, Koch C, Schulte A, Weiterer S, Henrich M, Weigand MA, Schlüter KD, Lichtenstern C Tags: Anaesthesist Source Type: research

[Nalbuphine in pediatric anesthesia.]
Abstract Efficient and safe pediatric perioperative pain therapy in the context of a multimodal pain therapy concept requires a slight to moderate opioid analgesic. Nalbuphine is a nearly ideal opioid for this purpose due to its unique pharmacological properties as a μ-receptor antagonist/κ-receptor agonist and a high safety profile. Nalbuphine is used clinically primarily in postoperative pain therapy administered as a bolus, continuous infusion and patient-controlled analgesia. Furthermore, it is administered in different regimens for pediatric diagnostic and interventional sedation. PMID: 24504192...
Source: Der Anaesthesist - February 7, 2014 Category: Anesthesiology Authors: Schultz-Machata AM, Becke K, Weiss M Tags: Anaesthesist Source Type: research

[Quality management in intensive care medicine.]
Abstract Treatment of critical ill patients in the intensive care unit is tantamount to well-designed risk or quality management. Several tools of quality management and quality assurance have been developed in intensive care medicine. In addition to extern quality assurance by benchmarking with regard to the intensive care medicine, peer review procedures have been established for external quality assurance in recent years. In the process of peer review of an intensive care unit (ICU), external physicians and nurses visit the ICU, evaluate on-site proceedings, and discuss with the managing team of the ICU possibi...
Source: Der Anaesthesist - February 5, 2014 Category: Anesthesiology Authors: Martin J, Braun JP Tags: Anaesthesist Source Type: research

[Quality assurance at the interface between anesthesia and transfusion medicine.]
CONCLUSION: The measures described are appropriate to cost-effectively improve quality and patient safety. The optimization measures presented in this article can be implemented in other hospitals to increase quality and safety after individual adjustment to the local circumstances. PMID: 24469248 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 29, 2014 Category: Anesthesiology Authors: Waeschle RM, Michels P, Jipp M, Riech S, Schulze T, Schmidt CE, Bauer M Tags: Anaesthesist Source Type: research

[Stress and job satisfaction in the discipline of inpatient anesthesiology : Results of a web-based survey.]
This study revealed a high prevalence of unfavorable working conditions for anesthetists in hospitals. Taking the forthcoming shortage of qualified physicians in German hospitals into account, these results have to be considered as a cause for concern. Constant unfavorable working conditions have a negative effect on the mental and physical health of employees. Sooner or later a migration of qualified physicians abroad could be the consequence. To prevent a future shortage of qualified physicians and to make the hospital work place more appealing, working conditions have to be adapted to current needs and expectations of e...
Source: Der Anaesthesist - January 10, 2014 Category: Anesthesiology Authors: Bauer J, Groneberg DA Tags: Anaesthesist Source Type: research

[Rare complication after endoscopic discectomy.]
Abstract Surgical treatment of the lumbar spine is a standard procedure in orthopedic and neurosurgery. After endoscopic discectomy an otherwise healthy patient developed massive dyspnea in combination with severe abdominal pain. Sonography revealed a large volume of free fluid in the abdominal cavity which proved to be surgical irrigation solution after computed tomography (CT) guided puncture. After insertion of a drainage channel fluid could be removed and the patient was transferred to a peripheral ward after a 24 h monitoring period. This review reports on the complications and anesthetic characteristics...
Source: Der Anaesthesist - January 10, 2014 Category: Anesthesiology Authors: Hilbert T, Boehm O, Pflugmacher R, Wirtz DC, Baumgarten G, Knuefermann P Tags: Anaesthesist Source Type: research

[Perioperative antibiotic prophylaxis.]
Abstract In times of growing bacterial resistance against antimicrobiotic drugs the broad prescription of antibiotics in human medicine must be carefully considered. The perioperative antibiotic treatment is in the center of that conflict. On the one hand an efficient pathogen reduction for the preemptive treatment of infectious complications is desired but on the other hand it is suspected that this promotes the selection of multiresistant pathogens which could lead to an increase of more complicated nosocomial infections. The aim of this article is a critical appraisal of this subject on the basis of the 2012 gu...
Source: Der Anaesthesist - January 10, 2014 Category: Anesthesiology Authors: Reutter F, Reuter DA, Hilgarth H, Heilek AM, Goepfert MS, Punke MA Tags: Anaesthesist Source Type: research

[Advance directives in prehospital emergency treatment : Prospective questionnaire-based analysis.]
CONCLUSION: The results show that for an AD to apply in an emergency situation certain standards are necessary that assure the practicability, especially if a patient does not wish to be resuscitated. Most difficulties with ADs occurred with imprecise formulation, text length and inconsistency of statements. The following instructions were usually missing: hierarchy of those given power of attorney and specification on medication, information about the scope of the ADs, statement about resuscitation, extent and limitations of the desired treatment, especially with patients certified as terminally ill and instructions on wh...
Source: Der Anaesthesist - January 9, 2014 Category: Anesthesiology Authors: Brokmann JC, Grützmann T, Pidun AK, Groß D, Rossaint R, Beckers SK, May AT Tags: Anaesthesist Source Type: research

[Operation and hemophilia : No problem with good interdisciplinary management.]
PMID: 24399371 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 9, 2014 Category: Anesthesiology Authors: Klamroth R Tags: Anaesthesist Source Type: research

["Jump in at the deep end" : Simulator-based learning in acute care.]
["Jump in at the deep end" : Simulator-based learning in acute care.] Anaesthesist. 2014 Jan 5; Authors: Breuer G, Schweizer K, Schüttler J, Weiß M, Vladut A Abstract BACKGROUND: With high-fidelity simulators in a modern blended learning setting, students are able to acquire knowledge and practical skills in acute medicine in realistic scenarios. However, it has not yet been clarified if the sequence of linking between knowledge and simulator-based training of practical skills plays an important role for increasing knowledge, for the self-concept and learning emotions of trainees. ...
Source: Der Anaesthesist - January 5, 2014 Category: Anesthesiology Authors: Breuer G, Schweizer K, Schüttler J, Weiß M, Vladut A Tags: Anaesthesist Source Type: research

[Professional image of anesthetists in the general public : Influence of provision of information and previous experience with the discipline.]
CONCLUSION: Unfortunately, the perception of patients on the versatility and characteristics of anesthetists are poorly developed. However, the knowledge differs significantly depending on previous experience and gathered information. Interestingly patients with previous experience mostly showed better knowledge compared to interested patients. Results suggest that personal interaction, patient-physician communication in general and improved collaboration between general practitioners and anesthetists are the key elements for better patient knowledge, which could lead to increased patient satisfaction. PMID: 24352743 ...
Source: Der Anaesthesist - December 20, 2013 Category: Anesthesiology Authors: Baja J, Welker AS, Beck G, Schleppers A, Fischer M, Weiß C Tags: Anaesthesist Source Type: research

[Comments on: cooling and temperature management after cardiac arrest.]
s M PMID: 24352744 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - December 20, 2013 Category: Anesthesiology Authors: Brücken A, Fries M Tags: Anaesthesist Source Type: research

[Out-of-hospital emergency medicine in Germany, Austria and Switzerland : Randomized prospective studies from 1990 to 2012.]
CONCLUSION: A significant increase or decrease in the number of prospective randomized clinical trials in the out-of-hospital setting could not be found in German speaking countries despite the fact that the absolute numbers of studies had increased. Only about one prospective, randomized clinical trial with an emergency medicine core tracer diagnosis originated from Germany, Austria and Switzerland per year. PMID: 24337071 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - December 13, 2013 Category: Anesthesiology Authors: Ausserer J, Abt T, Stadlbauer KH, Paal P, Kreutziger J, Lindner KH, Wenzel V Tags: Anaesthesist Source Type: research

[Epigenetics and pain.]
Abstract Chronic pain affects approximately 20 % of adults worldwide and is often associated with a decrease in the quality of life and various comorbidities. Conventional analgesic therapies are frequently insufficient and sometimes lead to severe side effects. Therefore, great efforts are still being made to elucidate the signalling pathways in pain and to develop new, safe and effective therapies. Epigenetic mechanisms which interfere with the regulation of gene expression are involved in the pathogenesis of several diseases and are gaining increasing impetus in medical research. As they are also involve...
Source: Der Anaesthesist - December 13, 2013 Category: Anesthesiology Authors: Niederberger E Tags: Anaesthesist Source Type: research

[Invasive candidiasis in non-neutropenic adults : Guideline-based management in the intensive care unit.]
OA Abstract Invasive Candida infections represent a diagnostic and therapeutic challenge for clinicians particularly in the intensive care unit (ICU). Despite substantial advances in antifungal agents and treatment strategies, invasive candidiasis remains associated with a high mortality. Recent guideline recommendations on the management of invasive candidiasis by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) from 2012, the German Speaking Mycological Society and the Paul Ehrlich Society for Chemotherapy (DMykG/PEG) from 2011 and the Infectious Diseases Society of America (IDSA) ...
Source: Der Anaesthesist - December 5, 2013 Category: Anesthesiology Authors: Glöckner A, Cornely OA Tags: Anaesthesist Source Type: research

[Ventilator-induced diaphragm dysfunction : Clinically relevant problem.]
Abstract Mechanical ventilation is a life-saving intervention for patients with respiratory failure or during deep sedation. During continuous mandatory ventilation the diaphragm remains inactive, which activates pathophysiological cascades leading to a loss of contractile force and muscle mass (collectively referred to as ventilator-induced diaphragm dysfunction, VIDD). In contrast to peripheral skeletal muscles this process is rapid and develops after as little as 12 h and has a profound influence on weaning patients from mechanical ventilation as well as increased incidences of morbidity and mortality. In ...
Source: Der Anaesthesist - December 5, 2013 Category: Anesthesiology Authors: Bruells CS, Marx G, Rossaint R Tags: Anaesthesist Source Type: research

Impaired long-term quality of life in survivors of severe sepsis : Chinese multicenter study over 6 years.
CONCLUSIONS: The HRQOL in survivors of severe sepsis was impaired even up to 6 years after hospital discharge. PMID: 24292122 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - November 30, 2013 Category: Anesthesiology Authors: Zhang K, Mao X, Fang Q, Jin Y, Cheng B, Xie G, Li H, Yu L, Zhu T, Wang H, Liu X, Zhang Y, Jin Y, Zhang N, Lou T, Fang XM Tags: Anaesthesist Source Type: research

[Perioperative approach to restless legs syndrome.]
r W Abstract Restless legs syndrome (RLS) is one of the most common neurological disorders. The key feature is the urge to move, especially in the legs. New onset RLS can develop perioperatively or an existing RLS can be exacerbated. Severe insomnia, forced immobilization and acute iron deficiency are common trigger factors. Medicinal treatment can also be an important triggering or exacerbating factor. Drugs with dopamine antagonistic, serotonergic and opioid antagonistic effects should be avoided. The long-term medicinal treatment should be terminated as quickly as possible and if necessary bridged non-orally. F...
Source: Der Anaesthesist - November 30, 2013 Category: Anesthesiology Authors: Bartelke F, Pfister R, Kämmerer W Tags: Anaesthesist Source Type: research

[Comments on: long-term cognitive impairment after intensive care therapy.]
PMID: 24292124 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - November 30, 2013 Category: Anesthesiology Authors: Franck M, Radtke FM Tags: Anaesthesist Source Type: research

[Perioperative management of patients with hemophilia.]
Abstract Hemophilia A and hemophilia B are X chromosome-linked congenital bleeding disorders caused by a deficiency or absence of activity of coagulation factor VIII (hemophilia A) or factor IX (hemophilia B), which are graded in different degrees of severity (mild, moderate, severe). Depending on the severity patients may experience spontaneous bleeding episodes or will develop excessive bleeding in the context of injuries or surgery. Hemophilia should not be a contraindication for an invasive procedure; however, a number of conditions are required to provide successful surgery and an uncomplicated and safe posto...
Source: Der Anaesthesist - November 24, 2013 Category: Anesthesiology Authors: Lison S, Spannagl M Tags: Anaesthesist Source Type: research

[Management of critically ill patients in the resuscitation room : Different than for trauma?]
Abstract The general approach to the initial resuscitation of non-trauma patients does not differ from the ABCDE approach used to evaluate severely injured patients. After initial stabilization of vital functions patients are evaluated based on the symptoms and critical care interventions are initiated as and when necessary. Adequate structural logistics and personnel organization are crucial for the treatment of non-trauma critically ill patients although there is currently a lack of clearly defined requirements. For severely injured patients there are recommendations in the S3 guidelines on treatment of multiple...
Source: Der Anaesthesist - November 24, 2013 Category: Anesthesiology Authors: Bernhard M, Ramshorn-Zimmer A, Hartwig T, Mende L, Helm M, Pega J, Gries A Tags: Anaesthesist Source Type: research

[Medical operations at the 2010 love parade in Duisburg.]
Abstract On 24 July 2010 the love parade, a large scale open air concert was held in the city of Duisburg to which more than 500,000 guests were expected. During the course of the early evening a major tragic incident occurred in which 21 people were crushed to death and several hundred others were injured. In this article the preparation of the emergency and rescue services prior to the event is described and their operations entailing more than 1,600 staff members from all over Germany are illustrated. The article focuses on the mass casualty incident which took place in the tunnel in the early evening of that d...
Source: Der Anaesthesist - November 17, 2013 Category: Anesthesiology Authors: Marx F, Binsfeld M, Franke T Tags: Anaesthesist Source Type: research

[Precipitation of piritramide and cefazolin : Study of the dependence on concentration and pH.]
Abstract BACKGROUND: Drug incompatibility might lead to precipitation with subsequent serious complications, such as transient pulmonary embolism. Recently, incompatibility of the opioid piritramide with cephalosporin antibiotics was described. As both drugs are frequently administered in a perioperative setting, the present study addressed the question whether the precipitation effect depends on the piritramide concentration or on the pH of the solution. Moreover, it was tested whether the precipitate reversibly dissolves in a physiological saline solution. METHODS: Piritramide was diluted to the final test ...
Source: Der Anaesthesist - November 14, 2013 Category: Anesthesiology Authors: Eckle VS, Grasshoff C Tags: Anaesthesist Source Type: research

[Hydroxyethyl starch.]
PMID: 24220789 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - November 14, 2013 Category: Anesthesiology Authors: - Tags: Anaesthesist Source Type: research

[Reliability of emergency medical field triage : Exemplified by traffic accident victims.]
Abstract BACKGROUND: Trauma is the leading cause of death in the patient group under 40 years of age. Within the prehospital management of seriously injured trauma victims the accuracy of the field triage by emergency physicians is of utmost importance. OBJECTIVE: The aim of this study was to determine the accuracy of prehospital emergency physician field triage in road traffic accident victims. MATERIAL AND METHODS: The study involved a retrospective analysis and comparison of prehospital and inhospital trauma records of road traffic accident victims treated by a Helicopter Emergency Medical Service (HE...
Source: Der Anaesthesist - November 8, 2013 Category: Anesthesiology Authors: Helm M, Faul M, Unger T, Lampl L Tags: Anaesthesist Source Type: research

[Pain therapy in emergency medicine : Focus on emergency admissions.]
This article aims to provide an overview of the situation in pain management in emergency departments and to serve as a basis for recommendations for pain therapy in German emergency departments. This article particularly discusses the possibilities of pain evaluation, treatment options with various medications and under specific conditions, e.g. for children, pregnant women or the elderly or alternative ways of pain management. PMID: 24173544 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - November 1, 2013 Category: Anesthesiology Authors: Kumle B, Wilke P, Koppert W, Kumle K, Gries A Tags: Anaesthesist Source Type: research

[Obstetric anesthesia : More than just standard solutions are necessary.]
PMID: 24173545 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - November 1, 2013 Category: Anesthesiology Authors: Annecke T Tags: Anaesthesist Source Type: research

Effect of ultrasound-guided intercostal nerve block on postoperative pain after percutaneous nephrolithotomy : Prospective randomized controlled study.
Abstract BACKGROUND: The aim of the study was to investigate the effect of preoperative ultrasound-guided (US) intercostal nerve block (ICNB) in the 11th and 12th intercostal spaces on postoperative pain control and tramadol consumption in patients undergoing percutaneous nephrolithotomy (PCNL). METHODS: After obtaining ethical committee approval and written informed patient consent, 40 patients were randomly allocated to the ICNB group or the control group. For the ICNB group US-guided ICNB was performed with 0.5 % bupivacaine and 1/200,000 epinephrine at the 11th and 12th intercostal spaces after pre...
Source: Der Anaesthesist - November 1, 2013 Category: Anesthesiology Authors: Ozkan D, Akkaya T, Karakoyunlu N, Arık E, Ergil J, Koc Z, Gumus H, Ersoy H Tags: Anaesthesist Source Type: research

["Book of life" : On course for personalized anesthesia?]
["Book of life" : On course for personalized anesthesia?] Anaesthesist. 2013 Oct 27; Authors: Adamzik M PMID: 24158654 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - October 27, 2013 Category: Anesthesiology Authors: Adamzik M Tags: Anaesthesist Source Type: research