[Second victim : Deliberations on dealing with treatment complications.]
PMID: 23982197 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - August 29, 2013 Category: Anesthesiology Authors: Wulf H Tags: Anaesthesist Source Type: research

[Anesthesiological management of Gitelman syndrome : Teaching example on physiology and pathophysiology of electrolyte balance.]
Abstract Gitelman syndrome is a rare autosomal recessive inherited disease that affects the thiazide-sensitive sodium chloride cotransport channels and the magnesium channels of the distal renal tubuli. Characteristic features are hypokalemia, hypomagnesemia, metabolic alkalosis and hypocalciuria. This case report presents the anesthesiological management of the Gitelman syndrome. The article demonstrates the pathophysiology, symptoms, diagnosis and therapy of this disease from the anesthesiologists point of view. PMID: 23928687 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - August 10, 2013 Category: Anesthesiology Authors: Schneck E, Schaumberg S, Koch C, Rickert M, Lichtenstern C Tags: Anaesthesist Source Type: research

[Significantly shorter anesthesia time for surgery of the lumbar spine : Process analytical comparison of spinal anesthesia and intubation narcosis.]
Abstract INTRODUCTION: Most surgery of the lumbar spine is performed with the patient under general anesthesia (GA); however, qualitative benefits of spinal anesthesia (SA) have been reported. The goal of this study was to compare time efficiency between these two anesthesia methods in lumbar spine surgery. To test the hypothesis that the use of SA leads to significant time saving compared to GA for lumbar spine surgery, key points in the preoperative, intraoperative and postoperative anesthesiology care times were analyzed. The focus was on anesthesia time excluding surgery time. MATERIALS AND METHODS: Elect...
Source: Der Anaesthesist - August 9, 2013 Category: Anesthesiology Authors: Singeisen H, Hodel D, Schindler C, Frey K, Eichenberger U, Hausmann ON Tags: Anaesthesist Source Type: research

[Accidental hypothermia.]
Abstract Uncertainty exists on how to treat patients suffering from accidental hypothermia and on the optimal transport decisions. The aim of this review is to provide an updated evidence-based reference for the pre-hospital and in-hospital management of patients with accidental hypothermia and for the transport decisions required to facilitate treatment. Advances in the efficiency and availability of rewarming techniques have improved the prognosis for patients presenting with hypothermia. For hypothermic patients with a core body temperature ≥ 28 °C without cardiac instability there is incre...
Source: Der Anaesthesist - August 9, 2013 Category: Anesthesiology Authors: Brugger H, Putzer G, Paal P Tags: Anaesthesist Source Type: research

[Hydroxyethyl starch : Position statement by the Presidents of the DGAI (German Society of Anaesthesiology and Intensive Care Medicine), the BDA (Professional Association of German Anaesthetists) and the DAAF (German Academy for Further Education in Anaesthesiology).]
PMID: 23925464 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - August 9, 2013 Category: Anesthesiology Authors: Werner C, Geldner G, Koch T Tags: Anaesthesist Source Type: research

[Comments on: in-flight medical emergencies.]
PMID: 23925463 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - August 8, 2013 Category: Anesthesiology Authors: Coburn M Tags: Anaesthesist Source Type: research

[Limited applications for hydroxyethyl starch : Background and alternative concepts.]
CONCLUSIONS: The third generation HES solutions cannot be completely replaced by other colloids and in future crystalloids will more strongly again broadly form the basis for infusion therapy. In this aspect balanced crystalloids have priority with respect to the acid-base equilibrium. The history of HES has impressively shown that infusion therapy must be adjusted on a scientifically founded basis, whether in intensive care medicine, perioperative or emergency medicine. Large prospective studies with clinically relevant endpoints are urgently needed. PMID: 23925465 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - August 8, 2013 Category: Anesthesiology Authors: Rehm M Tags: Anaesthesist Source Type: research

[Hepatorenal syndrome.]
Abstract Hepatorenal syndrome (HRS) is a unique form of acute renal failure occurring in patients with advanced cirrhosis or acute liver failure. In patients with ascites the incidence of HRS is 8 % and in end-stage liver disease 75 % of patients suffer from HRS. Vasodilation of splanchnic arteries with subsequent decrease of effective blood volume, arterial pressure and renal vasoconstriction is hypothesized to be the central pathophysiological mechanism leading to acute renal failure. Moreover, cardiac output might be decreased in advanced cirrhosis. There are two types of HRS: while HRS type 1 is ...
Source: Der Anaesthesist - July 13, 2013 Category: Anesthesiology Authors: Huschak G, Kaisers UX, Laudi S Tags: Anaesthesist Source Type: research

[Diagnostics of acid-base disorders.]
Authors: PMID: 23836143 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 10, 2013 Category: Anesthesiology Tags: Anaesthesist Source Type: research

[Perioperative care of palliative patients by the anesthetist : Medical, psychosocial and ethical challenges.]
This article addresses these areas of conflict and the aim is to enable anesthetists to provide the best possible perioperative care to this vulnerable patient group with the goal to maintain quality of life and keep postoperative recovery as short as possible. PMID: 23836144 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 10, 2013 Category: Anesthesiology Authors: Lassen CL, Abel R, Eichler L, Zausig YA, Graf BM, Wiese CH Tags: Anaesthesist Source Type: research

[Patient Blood Management : Three pillar strategy to improve outcome through avoidance of allogeneic blood products.]
Abstract Blood transfusions are commonly viewed as life-saving interventions; however, current evidence shows that blood transfusions are associated with a significant increase of morbidity and mortality in a dose-dependent relationship. Not only explanatory models of basic research but also the results from randomized controlled trials suggest a causal relationship between blood transfusion and adverse outcome. Therefore, it can be claimed that the current state of science debunks the long held belief in the so-called life-saving blood transfusion by exposing the potential for promoting disease and death. Adheren...
Source: Der Anaesthesist - July 10, 2013 Category: Anesthesiology Authors: Gombotz H, Hofmann A Tags: Anaesthesist Source Type: research

[Anesthesiological aspects of deep brain stimulation : Special features of implementation and dealing with brain pacemaker carriers.]
Abstract Deep brain stimulation (DBS) provides a very effective treatment for a number of neurological diseases including Parkinson's disease, movement disorders and epilepsy. In DBS microelectrodes are positioned in defined cerebral target areas and connected to a pacemaker. It is most often performed as an awake craniotomy with intraoperative testing. Various anesthesiological regimes are used to protect the patient from surgical stress on the one hand and to achieve ideal test conditions on the other. They include local anesthesia or scalp blocks, intermittent general anesthesia or analgosedation with or withou...
Source: Der Anaesthesist - July 3, 2013 Category: Anesthesiology Authors: Seemann M, Zech N, Lange M, Hansen J, Hansen E Tags: Anaesthesist Source Type: research

[Medicine from the computer.]
Abstract Small molecules can have a significant effect on human metabolic processes. Computational drug design aims at constructing specialized small molecules that selectively and efficiently address specific proteins. The basic ideas of computational molecular design are presented and it will be shown how a virtual protein can be computer designed. This virtual protein can be used to predict the binding affinity of given small molecules without having to synthesize them in a laboratory. Modern computational drug design goes far beyond the lock and key principle. Possible future developments are discussed and a c...
Source: Der Anaesthesist - July 3, 2013 Category: Anesthesiology Authors: Andrae K, Durmaz V, Fackeldey K, Scharkoi O, Weber M Tags: Anaesthesist Source Type: research

Propofol sedation in total knee replacement : Effects on oxidative stress and ischemia-reperfusion damage.
This study aimed to show the effect of propofol sedation on oxidative stress and inflammation resulting from ischemia-reperfusion. METHODS: After having obtained written informed consent from the patients and ethics committee approval, 36 patients were randomly allocated to 2 groups: group C, control and group P, propofol. Spinal anesthesia was administered to both groups with 15 mg bupivacaine. Patients in group P received a propofol infusion of 2 mg/kgBW/h and the patients in group C received a placebo infusion in an equal dose. Malondialdehyde (MDA), superoxide dismutase (SOD) and the total antioxidative ...
Source: Der Anaesthesist - June 30, 2013 Category: Anesthesiology Authors: Ozkan D, Akkaya T, Yalcindag A, Hanci T, Gönen E, Gümüs H, Delibas N Tags: Anaesthesist Source Type: research

["Blood is thicker than water"]
["Blood is thicker than water"] Anaesthesist. 2013 Jun 30; Authors: Meier J Abstract PMID: 23812274 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 30, 2013 Category: Anesthesiology Authors: Meier J Tags: Anaesthesist Source Type: research

[Hot topics in neuroanesthesia : The five most important publications from the previous year.]
Abstract PMID: 23812273 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 29, 2013 Category: Anesthesiology Authors: Pilge S, Schneider G Tags: Anaesthesist Source Type: research

[Precurarization with a non-depolarizing muscle relaxant.]
Authors: Abstract PMID: 23743925 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 8, 2013 Category: Anesthesiology Tags: Anaesthesist Source Type: research

[Ultrasound-guided thoracic paravertebral block for acute thoracic trauma : Continuous analgesia after high speed injury.]
r J Abstract Paravertebral blocks have experienced a renaissance because ultrasound-guidance is becoming common practice. The method is often presented as an alternative to thoracic epidural anaesthesia, mainly in the field of elective thoracic surgery. It is also propagated as an opioid-saving analgesic procedure in breast tumor surgery. In this case report it was successfully used as a continuous intervention for acute pain therapy of a severe injury of the left thorax. A transverse probe position in the fifth intercostal space was combined with an in-plane needle technique from lateral to medial. An ultrasound-...
Source: Der Anaesthesist - June 5, 2013 Category: Anesthesiology Authors: Reisig F, Büttner J Tags: Anaesthesist Source Type: research

[Peripheral regional anesthesia in patients under general anesthesia : Risk assessment with respect to parasthesia, injection pain and nerve damage.]
k T Abstract Nerve injury after peripheral regional anesthesia is rare and is not usually permanent. Some authors believe that inducing peripheral nerve blocks in patients during general anesthesia or analgosedation adds an additional risk factor for neuronal damage. This is based on published case reports showing that there is a positive correlation between paresthesia experienced during regional anesthesia and subsequent nerve injury. Therefore, many sources recommend that regional nerve blocks should only be performed in awake or lightly sedated patients, at least in adults. However, there is no scientific basi...
Source: Der Anaesthesist - June 5, 2013 Category: Anesthesiology Authors: Kessler P, Steinfeldt T, Gogarten W, Schwemmer U, Büttner J, Graf BM, Volk T Tags: Anaesthesist Source Type: research

[Quality of postoperative pain therapy : Evaluation of an established anesthesiology acute pain service.]
CONCLUSIONS: As described in many prospective studies, this evaluation revealed that for postoperative pain control, regional anesthesia is superior to intravenous patient-controlled analgesia with strong opioids in terms of analgesia and side effects. In the setting of a well-organized acute pain service with frequent education and training of all members involved, postoperative pain management is safe and effective. However, regular re-evaluation of the defined and certified procedures is necessary. PMID: 23670580 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 15, 2013 Category: Anesthesiology Authors: Kainzwaldner V, Rachinger-Adam B, Mioc-Curic T, Wöhrle T, Hinske LC, Luchting B, Ewert T, Azad SC Tags: Anaesthesist Source Type: research

Bupivacaine crystal deposits after long-term epidural infusion.
Abstract The case of a 45-year-old male patient (body weight 52 kg, height 1.61 m) with a locally invasive gastric carcinoma infiltrating into the retroperitoneal space is reported. Because of severe cancer pain a tunnelled thoracic epidural catheter (EC) was placed at thoracic spinal level 7/8 and a local anesthetic (LA) mixture of bupivacaine 0.25 % and morphine 0.005 % was infused continuously at 6 ml h(-1). To optimize pain therapy the concentration was doubled (bupivacaine 0.5 %, morphine 0.01 %) 3 months later but the infusion rate was reduced to 3 ml ...
Source: Der Anaesthesist - May 15, 2013 Category: Anesthesiology Authors: Balga I, Gerber H, Schorno XH, Aebersold Keller F, Oehen HP Tags: Anaesthesist Source Type: research

[Patients at the end of life in the intensive care unit : Cultural aspects of accompaniment.]
den Abstract The accompaniment of people in the face of death offers insights into dimensions which are mostly not seen in ordinary life. These insights also exist in intensive care in German hospitals and are highly relevant in medical decision making. End-of-life decisions in particular often determine medical, cultural and spiritual aspects concerning medical treatment and therapeutic targets and if necessary new therapy targets. The following article especially illuminates cultural aspects and their characteristics in patients at the end of life in the intensive care unit. PMID: 23657536 [PubMed - as supp...
Source: Der Anaesthesist - May 10, 2013 Category: Anesthesiology Authors: Grom IU, Vagts DA, Kampa U, Pfeiffer G, Schreiber-Winzig L, Wiese CH, Expertengruppe Palliativ- und Notfallmedizin Akademie für Palliativmedizin und Hospizarbeit Dresden Tags: Anaesthesist Source Type: research

[Subdural hematoma after dural puncture : Fateful complication of epidural anesthesia].
This article reports a case of postdural puncture headache in a 43-year-old woman after accidental dural puncture during attempted placement of an epidural catheter for induction of abortion. Bed rest, analgesics, theophylline and hydration were to no avail and only a blood patch improved the headaches. The patient presented 7 weeks later with headache and left-sided hemiplegia. Magnetic resonance imaging showed a right frontoparietal subdural intracranial hematoma which had to be surgically evacuated. The patient recovered completely. Intracranial hematoma is a rare but serious complication of central neuroaxial block. Ac...
Source: Der Anaesthesist - May 1, 2013 Category: Anesthesiology Authors: Schott M, Gehrke A, Gaab M, Jantzen JP Tags: Anaesthesist Source Type: research

[Peripartum cardiomyopathy : Interdisciplinary challenge].
This article presents the case of a patient in advanced pregnancy with signs of acute severe heart failure and a suspected diagnosis of PPCM. The patient presented as an emergency case and delivery of the child was carried out using peridural anesthesia with a stand-by life support machine. PMID: 23584315 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 1, 2013 Category: Anesthesiology Authors: Löser B, Tank S, Hillebrand G, Goldmann B, Diehl W, Biermann D, Schirmer J, Reuter DA Tags: Anaesthesist Source Type: research

[Peripartum cardiomyopathy : Diagnostic and therapeutic challenge].
PMID: 23649492 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 1, 2013 Category: Anesthesiology Authors: Weig T Tags: Anaesthesist Source Type: research

[On preoperative risk evaluation of adult patients before elective non-cardiac surgery : Results of a survey on clinical practice in the Federal State of Hessen].
CONCLUSIONS: Corresponding to the high significance of local standards for the decision of indicating preoperative diagnostic procedures, the development of local standards that are in agreement with the recommendations seems to be a reasonable way to facilitate the implementation of the recommendations. PMID: 23657533 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 1, 2013 Category: Anesthesiology Authors: Aust H, Veltum B, Wächtershäuser T, Eberhart L, Wulf H, Rüsch D Tags: Anaesthesist Source Type: research

[Anesthesiological considerations for patients with trisomy 21 (Down syndrome)].
[Anesthesiological considerations for patients with trisomy 21 (Down syndrome)]. Anaesthesist. 2013 May;62(5):407-19 Authors: Ihringer K, Russ N, Walther A, Schiff JH Abstract The most common chromosomal abnormality is trisomy 21 which is also known as Down syndrome and occurs in approximately 1 in 800 births. The majority of the resulting disabling conditions cannot be cured and affect people of all ages, ethnicity and economic levels. Life expectancy has increased with advances in medical care in the same way as in the rest of the population. One of the major tasks for health care professionals is t...
Source: Der Anaesthesist - May 1, 2013 Category: Anesthesiology Authors: Ihringer K, Russ N, Walther A, Schiff JH Tags: Anaesthesist Source Type: research

[Transversus abdominis plane block : Anesthesia procedure for abdominal wall surgery only].
This article presents a case report demonstrating that it is possible to perform three consecutive operation procedures within 7 days using only a bilateral TAP catheter technique. The TAP block without any co-medication provides high patient comfort and should be recognized as a good alternative for abdominal wall surgery. PMID: 23657535 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 1, 2013 Category: Anesthesiology Authors: Schönfeld S Tags: Anaesthesist Source Type: research

[Assessment of prehospital injury severity in children : Challenge for emergency physicians].
CONCLUSIONS: The assessment of prehospital injury severity in children is unreliable. In order to evaluate injury severity the use of anatomical trauma scores alone is insufficient. The adequate documentation of the mechanism of injury implies that the mechanism of injury seems to play a relevant role in the assessment of prehospital injury severity. The unreliable assessment of the injury severity, the arrival in the ER in on-call hours and the private transport to the hospital is a challenge to the ER leader in trauma life support for children. PMID: 23657537 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 1, 2013 Category: Anesthesiology Authors: Muhm M, Danko T, Winkler H, Ruffing T Tags: Anaesthesist Source Type: research

[Anesthesiological acute pain therapy in Germany : Telephone-based survey].
CONCLUSIONS: Since 1999 the number of hospitals that have implemented an APS has risen from 36.1 % to 64.2 %. The lack of consistent documentation of the OPS 8-919 will probably not increase the likelihood that it will become redeemable in the near future. Certain therapy methods, such as EA and PCA were still well established with oral therapy gaining in significance. The uncertainty regarding limits for coagulation values before removal of an epidural catheter could perhaps be reduced by a statement from the German Society of Anesthesia and Intensive Care. PMID: 23670579 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 1, 2013 Category: Anesthesiology Authors: Lassen CL, Link F, Lindenberg N, Klier TW, Graf BM, Maier C, Wiese CH Tags: Anaesthesist Source Type: research

[Legal position of non-medical personnel in hospitals].
This article illuminates the legal status quo. PMID: 23670582 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 1, 2013 Category: Anesthesiology Authors: Kirschner MH, Nebendahl M, Russo SG, Tecklenburg A, Bauer M Tags: Anaesthesist Source Type: research

[Commentary on: Monitoring of residual gastric volume during enteral nutrition : Influence on the incidence of ventilator-associated pneumonia in ventilated patients].
PMID: 23695720 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 1, 2013 Category: Anesthesiology Authors: Rossaint R Tags: Anaesthesist Source Type: research

[Peripartum aortic dissection].
r W Abstract A 29-year-old primagravida developed severe chest pains during labor. An emergency caesarean section was performed as the symptoms persisted. Imaging diagnosis immediately after delivery revealed an acute proximal (type A) aortic dissection. The patient was transferred to the nearest cardiothoracic surgery centre and successful emergency surgical aortic repair was performed. The perioperative course of a type A aortic dissection during pregnancy and labor is complicated by time pressure, diagnostic restrictions until delivery and potentially fatal uterine bleeding during cardiopulmonary bypass and hyp...
Source: Der Anaesthesist - April 1, 2013 Category: Anesthesiology Authors: Pachler C, Knez I, Petru E, Dörfler O, Vicenzi M, Toller W Tags: Anaesthesist Source Type: research

[Supraglottic airway devices in emergency medicine : Impact of gastric drainage].
;ller M Abstract This case report describes a life-saving use of a supraglottic airway device (LT-D™-Larynxtubus, VBM Medizintechnik, Sulz, Germany) in an out-of-hospital emergency patient suffering from severe traumatic brain injury. Mechanical ventilation with the laryngeal tube was complicated by repeated airway obstructions and pronounced gastric distension with air as a consequence of oropharyngeal leakage. In this situation pulmonary ventilation of the patient was compromised so that emergency endotracheal intubation became necessary in the resuscitation area with vital indications. In this context the...
Source: Der Anaesthesist - April 1, 2013 Category: Anesthesiology Authors: Mann V, Mann ST, Alejandre-Lafont E, Röhrig R, Weigand MA, Müller M Tags: Anaesthesist Source Type: research

[Use of 2 % hyperbaric prilocaine for spinal anesthesia : Sensitivity analysis in outpatient surgery].
CONCLUSIONS: For German framework conditions the use of hyperbaric prilocaine 2 % can provide an economical advantage compared to the use of hyperbaric bupivacaine 0.5 % if staff assignment can be flexible. PMID: 23535895 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 1, 2013 Category: Anesthesiology Authors: Vagts DA, Bley CH, Mutz CW Tags: Anaesthesist Source Type: research

[Anesthesia for electroconvulsive therapy].
Abstract Electroconvulsive therapy is a well-established form of treatment for a broad spectrum of severe psychiatric disorders. The treatment, in which a generalized epileptic seizure is provoked by electrical stimulation of the brain, is performed with the patient under anesthesia and muscle relaxation. Therefore, sufficient knowledge of the physiological and pharmacological characteristics is an essential requirement for safe anesthesia. The following review is intended to provide some new aspects of the procedure and management of anesthesia. PMID: 23558716 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 1, 2013 Category: Anesthesiology Authors: Grundmann U, Schneider SO Tags: Anaesthesist Source Type: research

[Quality of results of therapy of acute respiratory failure : Changes over a period of two decades].
Abstract Progress in intensive care (ICU) treatment of acute respiratory distress syndrome (ARDS) over the last 20 years includes the introduction of extracorporeal membrane oxygenation (ECMO) for CO2 removal and the widespread use of evidence-based lung-protective ventilatory strategies. Little is known, however, about whether these changes have resulted in improvements in short-term and long-term outcome of acute respiratory distress syndrome (ARDS) within the two decades after introduction. In a retrospective study 167 long-term survivors of severe ARDS who were transferred to the clinic for anesthesiology of t...
Source: Der Anaesthesist - April 1, 2013 Category: Anesthesiology Authors: Briegel I, Dolch M, Irlbeck M, Hauer D, Kaufmann I, Schelling G Tags: Anaesthesist Source Type: research

[International guidelines of the Surviving Sepsis Campaign : Update 2012].
This article discusses the most important amendments in the first two sections and delving deeper into the guidelines. PMID: 23558718 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 1, 2013 Category: Anesthesiology Authors: Briegel J, Möhnle P Tags: Anaesthesist Source Type: research

[Disorders of serum sodium in emergency patients : Salt in the soup of emergency medicine].
Abstract Electrolyte disorders are common and potentially fatal laboratory findings in emergency patients. Approximately 20 % of patients in the emergency department present with either hyponatremia or hypernatremia. Recently it was shown that disorders of serum sodium are not only an expression of the severity of the underlying disease but independent predictors for the outcome of patients. They directly influence patient daily life by causing not only gait and concentration disturbances but also an increased tendency to fall together with a reduced bone mass. Given these new data it is even more important...
Source: Der Anaesthesist - April 1, 2013 Category: Anesthesiology Authors: Lindner G, Exadaktylos AK Tags: Anaesthesist Source Type: research

[Transfusion-related acute lung injury].
Abstract Transfusion-related acute lung injury (TRALI) developed into the leading cause of transfusion-related morbidity and mortality after the first description by Popovsky et al. approximately three decades ago. It was the most frequent reason for transfusion-related fatalities worldwide before implementation of risk minimization strategies by donor selection. Plasma-rich blood products, such as fresh frozen plasma and apheresis platelets seem to be the leading triggers of TRALI. Hypoxemia and development of pulmonary edema within 6 h of transfusion are the diagnostic criteria for TRALI. The differentiatio...
Source: Der Anaesthesist - April 1, 2013 Category: Anesthesiology Authors: Tank S, Sputtek A, Kiefmann R Tags: Anaesthesist Source Type: research

[Erratum to: Nutrition in intensive care medicine : Part 2: special nutritional problems].
PMID: 23558722 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 1, 2013 Category: Anesthesiology Authors: Hecker M, Felbinger TW, Mayer K Tags: Anaesthesist Source Type: research

[Mass casualty incidents : Preparedness of German soccer arenas].
CONCLUSIONS: Most of the participating arenas were adequately staffed to manage the first phase of MCIs but in contrast command structures and transport capacities often focused on individual emergencies. Although most of the participants stated that they planned the resources provision according to well established algorithms, the resources actually available at the arenas varied considerably. The frequency of MCIs in soccer arenas was surprisingly high in contrast to the frequency of MCI-related drills. PMID: 23576092 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 1, 2013 Category: Anesthesiology Authors: Luiz T, Preisegger T, Madler C Tags: Anaesthesist Source Type: research

[TRAILI - A lecture for hemovigilance].
PMID: 23595793 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 1, 2013 Category: Anesthesiology Authors: Biscoping J Tags: Anaesthesist Source Type: research

[Midazolam for premedication in pediatric patients: pros and cons debate].
r M PMID: 23475173 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 1, 2013 Category: Anesthesiology Authors: Jöhr M Tags: Anaesthesist Source Type: research

[Faulty internal tube in a co-axial ventilation tube system: cause of a massive postoperative hypercapnia].
This article presents the case of a patient with massive postoperative hypercapnia during mechanical ventilation in the intensive care unit (ICU). With normal tidal volumes and clearly visible chest movements, adequate findings with regard to auscultation, oxygenation and correct respirator settings, no cause for the increasing hypercapnia was initially found; however, replacement of the respirator led to a return to normal carbon dioxide levels. When checking the replaced respirator a service technician found the cause of the respirator failure: the internal tube of the co-axial ventilation system was faulty leading to an...
Source: Der Anaesthesist - March 1, 2013 Category: Anesthesiology Authors: Günther JH, Börning P, Bahlmann L Tags: Anaesthesist Source Type: research

[Intraneural injection of local anesthetics: importance for a successful nerve block].
PMID: 23475175 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 1, 2013 Category: Anesthesiology Authors: Kessler P Tags: Anaesthesist Source Type: research

[Nutrition in intensive care medicine: Part 2: special nutritional problems].
Abstract Therapy of intensive care patients is often complicated by co-morbidities or complex systemic disorders such as sepsis. The necessity to generate an individualized nutritional regime has gained in importance in recent years as this essential part of supportive care has a direct impact on the prognosis of the patient. In the present article a special focus is put on particular questions of nutritional aspects of intensive care patients. The current guidelines and study data on disorders relevant in intensive care medicine, such as acute or chronic renal and liver failure, acute respiratory distress syndrom...
Source: Der Anaesthesist - March 1, 2013 Category: Anesthesiology Authors: Hecker M, Felbinger TW, Mayer K Tags: Anaesthesist Source Type: research

[Actually a routine matter: ischemia after catheterization of the radial artery].
This article discusses the risks associated with invasive blood pressure monitoring and treatment options in cases of critical ischemia. The authors conclude that there is no consensus concerning optimal treatment and that a discussion on options for preoperative risk assessment and quickest possible recognition of such complications is worthwhile. Despite the risk of ischemia invasive blood pressure monitoring is an indispensable procedure. PMID: 23483231 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 1, 2013 Category: Anesthesiology Authors: Pasternak I, Rees M, Steinauer A, Plaschy S, Hillermann T Tags: Anaesthesist Source Type: research

Intra-articular injection of levobupivacaine.
PMID: 23494020 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 1, 2013 Category: Anesthesiology Authors: Zink W, Zausig YA, Graf BM Tags: Anaesthesist Source Type: research

[Distal sciatic nerve blocks: randomized comparison of nerve stimulation and ultrasound guided intraepineural block].
In this study 250 adult patients were randomly allocated either to the nerve stimulation group (group NS, n = 125) or to the ultrasound guidance group (group US, n = 125). The sciatic nerve was anesthetized with 20 ml prilocaine 1% and 10 ml ropivacaine 0.75%. In the US group the goal was an intraepineural needle position. In the NS group progress of the block was observed by a second physician using ultrasound imaging but blinded for the investigator performing the nerve stimulation. The main outcome variables were time until readiness for surgery (performance time and onset time), su...
Source: Der Anaesthesist - March 1, 2013 Category: Anesthesiology Authors: Seidel R, Natge U, Schulz J Tags: Anaesthesist Source Type: research