[Assessment of the transplantation scandal by the media : Scientific discourse analysis of selected German newspapers.]
CONCLUSION: German newspapers as important opinion-leading and opinion-forming media have a substantial impact in accomplishing the demands for objective and factual information of transplantation medicine. Physicians, ethicists, journalists and politicians are invoked to have a closer collaboration in the future. PMID: 25501682 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - December 13, 2014 Category: Anesthesiology Authors: Hoisl A, Barbey R, Graf BM, Briegel J, Bein T Tags: Anaesthesist Source Type: research

[Epigenetic regulation in sepsis : Current state of knowledge.]
This article provides a current overview of epigenetic sepsis research and the sepsis-induced effects on the immune system. PMID: 25471356 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - December 5, 2014 Category: Anesthesiology Authors: Weiterer S, Uhle F, Siegler BH, Lichtenstern C, Bartkuhn M, Weigand MA Tags: Anaesthesist Source Type: research

[Airway management in emergency medicine.]
PMID: 25468255 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - December 4, 2014 Category: Anesthesiology Authors: - Tags: Anaesthesist Source Type: research

[Patron saints of anesthesia.]
Abstract Patron saints act as facilitators between God and humans. Humans appeal to patron saints for support in devastating, often futile situations in life. Patron saints may intercede for trade and professional guilds, every so often they hold a protective hand over objects. Saint Barbara is venerated as the patron saint of surgeons. In anesthesia she also oversees barbiturates, protects anesthetized patients, anesthetists and anesthesia nursing personnel. Within the Anglo-American language area Saint René is venerated by anesthetists and anesthesia nursing personnel. During anesthesia or critical care t...
Source: Der Anaesthesist - December 4, 2014 Category: Anesthesiology Authors: Lewandowski K Tags: Anaesthesist Source Type: research

[Negative behavioral changes in children and adolescents after anesthesia : Development of a German language version of the Post Hospitalization Behavior Questionnaire.]
CONCLUSION: With the German translation of the PHBQ presented here an instrument is available to detect negative behavioral changes after anesthesia in children among German speaking populations. The translation is comparable to the English version with minor differences concerning its factorial structure, which may be due to the predominant role of anxiety in all items. Like the original, this questionnaire does not per se discriminate between anesthesia and hospitalization induced behavioral changes. However, the German translation of the PHBQ is a questionnaire that is feasible for clinical routine and scientific settin...
Source: Der Anaesthesist - December 3, 2014 Category: Anesthesiology Authors: Buehrer S, Klaghofer R, Weiss M, Schmitz A Tags: Anaesthesist Source Type: research

[Air rescue : Current significance and practical issues.]
pp E Abstract Germany has a nationwide and powerful helicopter emergency medical services system (HEMS), which executes primary rescue missions and interhospital transfer of intensive care patients. In recent years the range of HEMS missions has become modified due to demographic changes and structural changes in the healthcare system. Furthermore, the number of HEMS missions is steadily increasing. If reasonably used air rescue contributes to desired reductions in overall preclinical time. Moreover, it facilitates prompt transport of patients to a hospital suitable for definitive medical care and treatment can be...
Source: Der Anaesthesist - November 29, 2014 Category: Anesthesiology Authors: Schellhaaß A, Popp E Tags: Anaesthesist Source Type: research

[Standardized telephone-assisted instructions on resuscitation by laypersons : Feasibility study using Video-assisted quality analysis.]
CONCLUSION: The results demonstrate that the local T-CPR concept for untrained laypersons is feasible in a mock scenario. No substantial errors were observed for the majority of the untrained responders but the simulation also showed that not every emergency witness implemented the instructions according to the dispatcher's expectations. The T-CPR procedure was also more time-consuming than expected; therefore, every standardized T-CPR concept should be tested for local practicability. In accordance with current studies, the results suggest that the focus should be on compression-only CPR instructions in urban settings. Di...
Source: Der Anaesthesist - November 29, 2014 Category: Anesthesiology Authors: Nest JC, Steinbrunner D, Karger M, Hiltl M, von Kaufmann F, Kanz KG, Kreimeier U Tags: Anaesthesist Source Type: research

[Anesthesiological management of awake craniotomy : Asleep-awake-asleep technique or without sedation.]
Abstract Awake craniotomy is indicated in deep brain stimulation (DBS) for treatment of certain movement disorders, such as in Parkinson disease patients or in the surgery of brain tumors in close vicinity to the language area. The standard procedure is the asleep-awake-asleep technique where general anesthesia or analgosedation is intermittently interrupted for neurological testing. In DBS the intraoperative improvement of symptoms, stereotactic navigation and microelectrode reading guide to the optimal position. In brain tumor resection, reversible functional impairments during electrical stimulation on the brai...
Source: Der Anaesthesist - November 26, 2014 Category: Anesthesiology Authors: Seemann M, Zech N, Graf B, Hansen E Tags: Anaesthesist Source Type: research

Anesthesia in swine : Optimizing a laboratory model to optimize translational research.
In conclusion, swine are an excellent laboratory animal for bench to bedside research and can be managed properly when basic knowledge and adequate skills on careful handling, anesthesia and surgical considerations are present. PMID: 25384955 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - November 12, 2014 Category: Anesthesiology Authors: Pehböck D, Dietrich H, Klima G, Paal P, Lindner KH, Wenzel V Tags: Anaesthesist Source Type: research

[Simulation as possible training for palliative emergencies : Prospective initial data analysis of participants from two simulation training sessions.]
CONCLUSION: The literature review and the expectations of the participants underlined that the development and characteristics of palliative emergencies will become increasingly more important in outpatient emergency medicine. All participants considered palliative care to be very important concerning the competency for end-of-life decisions in palliative patients. For this reason, special curricula and simulation for dealing with palliative care patients and special treatment decisions in emergency situations seem to be necessary. PMID: 25384956 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - November 12, 2014 Category: Anesthesiology Authors: Wiese CH, Bosse G, Schröder T, Lassen CL, Bundscherer AC, Graf BM, Zausig YA Tags: Anaesthesist Source Type: research

[Malignant hyperthermia.]
Abstract Malignant hyperthermia (MH) is a rare hereditary, mostly subclinical myopathy. Trigger substances, such as volatile anesthetic agents and the depolarizing muscle relaxant succinylcholine can induce a potentially fatal metabolic increase in predisposed patients caused by a dysregulation of the myoplasmic calcium (Ca) concentration. Mutations in the dihydropyridine ryanodine receptor complex in combination with the trigger substances are responsible for an uncontrolled release of Ca from the sarcoplasmic reticulum. This leads to activation of the contractile apparatus and a massive increase in cellular ener...
Source: Der Anaesthesist - November 12, 2014 Category: Anesthesiology Authors: Metterlein T, Schuster F, Graf BM, Anetseder M Tags: Anaesthesist Source Type: research

[Power of words.]
PMID: 25384958 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - November 12, 2014 Category: Anesthesiology Authors: Meissner K, Merrow M Tags: Anaesthesist Source Type: research

[Every year …]
[Every year …] Anaesthesist. 2014 Nov 12; Authors: Wappler F PMID: 25384959 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - November 12, 2014 Category: Anesthesiology Authors: Wappler F Tags: Anaesthesist Source Type: research

[Acute perioperative hemodilution without using hydroxyethyl starch : Hemodynamic alterations under "controlled" hypovolemia.]
CONCLUSION: In the study population, the loss of intravascular fluid during perioperative haemodilution could be compensated by an increase in cardiac performance. However, whether patients with a reduced cardiac capacity (i.e. older patients) are capable to improve their cardiac output sufficiently in order to compensate hypovolemia accompanying perioperative haemodilution with crystalloids remains questionable. PMID: 25380794 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - November 9, 2014 Category: Anesthesiology Authors: Hofmann-Kiefer K, Chappell D, Jacob M, Schülke A, Helfen T, Anetzberger J, Rehm M Tags: Anaesthesist Source Type: research

[Eleven years of core data set in intensive care medicine : Severity of disease and workload are increasing.]
This study analyzed the core date set of the DIVI between 2000 and 2010 in respect to changes in disease severity using the simplified acute physiology score (SAPS II), the sequential organ failure assessment (SOFA), the need for therapeutic interventions with the therapeutic intervention scoring system (TISS 28) and intensive care unit (ICU) mortality. MATERIAL AND METHODS: Inclusion criteria were participation in the registry for at least 4 years, SAPS II, SOFA, TISS28 scores available and data on ICU discharge. A standardized mortality rate (SMR) was calculated for each year. RESULTS: The mean SAPS II score in...
Source: Der Anaesthesist - November 8, 2014 Category: Anesthesiology Authors: Bingold TM, Lefering R, Zacharowski K, Waydhas C, Scheller B Tags: Anaesthesist Source Type: research

[Nocebo effects and negative suggestion in anesthesia.]
Abstract Anesthetists have an impact on patients and healing processes not only through drugs, interventions and therapy but also significantly by their words and personality. A substantial part of observed side effects is caused by nocebo effects and negative suggestion, i.e. by the doctor and the medical surroundings. Every symptom of an illness, side effect or complication can also be induced by the wrong way of talking about it. Patients perceive medical situations, such as an emergency, anesthesia or intensive care as extreme or even as life-threatening. This can induce a natural trance, an altered state of c...
Source: Der Anaesthesist - October 19, 2014 Category: Anesthesiology Authors: Zech N, Seemann M, Hansen E Tags: Anaesthesist Source Type: research

[Perioperative management of patients with rheumatoid arthritis.]
g W Abstract Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by joint and systemic manifestations. As the prevalence in the adult population is approximately 1 %, anesthesia management in patients with RA has to be performed on a regular basis. Besides elective orthopedic surgery, e.g. surgery of the cervical spine, all other types of planned and emergency surgery should also be anticipated. Administering anesthesia to a patient with RA can be challenging not only due to a higher incidence of difficult intubation but also because of various organ manifestations as well as an elevated...
Source: Der Anaesthesist - October 17, 2014 Category: Anesthesiology Authors: Müller M, Pippi-Ludwig W Tags: Anaesthesist Source Type: research

[Question prompt list for premedication consultation : Patient-oriented information on anesthesia.]
CONCLUSION: The QPL-A is a useful tool for meeting the subjective information needs of patients which could improve the patient orientation of the anesthesia premedication consultation. PMID: 25318622 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - October 17, 2014 Category: Anesthesiology Authors: Fischbeck S, Zimmer S, Laufenberg-Feldmann R, Laubach W Tags: Anaesthesist Source Type: research

[Terminology in the context of anesthesia for preterm and term newborns and infants.]
This article provides an overview of conventional definitions and technical terms. It also puts forward terminological principles for a model of risk stratification of anesthesia in the newborn period and infancy. PMID: 25287297 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - October 8, 2014 Category: Anesthesiology Authors: Entenmann A, Michel M, Detsch O Tags: Anaesthesist Source Type: research

[Unexpected hemorrhage complications in association with celecoxib : Spontaneously reported case series after perioperative pain treatment in gynecological operations.]
Abstract A series of cases of postoperative bleeding were reported to the Drug Commission of the German Medical Association (Arzneimittelkommission der deutschen Ärzteschaft, AkdÄ) within the spontaneous reporting system after the regimen for postoperative pain treatment was changed from diclofenac (150 mg per day) to celecoxib (400 mg per day). All patients underwent elective gynecological surgery and 7 out of 11 patients with postoperative bleeding required revision surgery. Although alternative causes for the hemorrhage incidents could not be excluded, the documented circumstances could have...
Source: Der Anaesthesist - October 4, 2014 Category: Anesthesiology Authors: Stammschulte T, Brune K, Brack A, Augenstein H, Arends G, Gundert-Remy U Tags: Anaesthesist Source Type: research

[Interdisciplinary management of trauma patients : Update 3 years after implementation of the S3 guidelines on treatment of patients with severe and multiple injuries.]
CONCLUSION: The recommendations on interdisciplinary trauma management contained in the S3 guidelines on the treatment of patients with severe and multiple injuries should be implemented into the clinical routine. Additionally, the knowledge gained from more recent scientific studies is necessary for anesthetists and emergency physicians to be able to adequately implement the core statements of the S3 guidelines for the treatment of patients with severe and multiple injuries. PMID: 25227879 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - September 18, 2014 Category: Anesthesiology Authors: Donaubauer B, Fakler J, Gries A, Kaisers UX, Josten C, Bernhard M Tags: Anaesthesist Source Type: research

[Differences of analgesic efficacy and complication rates between ultrasound and nervestimulator guided peripheral nerve catheters : Database analysis on patient-relevant target parameters.]
Abstract BACKGROUND: Peripheral nerve catheters (PNC) play an important role in postoperative pain treatment following major extremity surgery. There are several trials reported in the literature which investigated the efficacy and safety of ultrasound (US) and nerve stimulator (NS) guided PNC placement; however, most of these trials were only small and focused mainly on anesthesiologist-related indicators of block success (e.g. block onset time and procedure time) but not primarily on patient-related outcome data including postoperative pain during movement. AIM: This retrospective analysis compared the anal...
Source: Der Anaesthesist - September 18, 2014 Category: Anesthesiology Authors: Schnabel A, Middendorf B, Boschin MG, Gottschalk A, Van Aken H, Zahn PK, Pogatzki-Zahn EM Tags: Anaesthesist Source Type: research

[Spectrum of missions for a rescue helicopter : Changes in a south German urban area over the last 25 years.]
CONCLUSION: The changes in the spectrum of missions up to more emergencies involving non-trauma patients and older patients must be taken into consideration during training and advanced training. PMID: 25227881 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - September 18, 2014 Category: Anesthesiology Authors: Viergutz T, Bayer O, Weiss C, Braun J, Kalenka A Tags: Anaesthesist Source Type: research

[From fishing trip to the critical care unit : Successful resuscitation after a near drowning accident.]
DISCUSSION: Section 8 of the ERC guidelines provides additional information for resuscitation under specific conditions. In this case report, hypothermia was one of the main criteria leading to an adjusted pharmacological therapy. Furthermore, selection of the appropriate hospital for an optimal advanced treatment including controlled warming of the patient and management of hypothermia-induced complications had to be evaluated. PMID: 25227882 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - September 18, 2014 Category: Anesthesiology Authors: Kippnich M, Keller D, Jokinen J, Kilgenstein C, Muellenbach RM, Markus C, Roewer N, Kranke P Tags: Anaesthesist Source Type: research

[Sleep disorders among physicians on shift work.]
l B Abstract Sleep disorders in physicians who perform shift work can result in increased risks of health problems that negatively impact performance and patient safety. Even those who cope well with shift work are likely to suffer from sleep disorders. The aim of this manuscript is to discuss possible causes, contributing factors and consequences of sleep disorders in physicians and to identify measures that can improve adaptation to shift work and treatment strategies for shift work-associated sleep disorders. The risk factors that influence the development of sleep disorders in physicians are numerous and inclu...
Source: Der Anaesthesist - September 13, 2014 Category: Anesthesiology Authors: Schlafer O, Wenzel V, Högl B Tags: Anaesthesist Source Type: research

[Fluid resuscitation in hemorrhage.]
Abstract How fluid resuscitation has to be performed for acute hemorrhage situations is still controversially discussed. Although the forced administration of crystalloids and colloids has been and still is practiced, nowadays there are good arguments that a cautious infusion of crystalloids may be initially sufficient. Saline should no longer be used for fluid resuscitation. The main argument for cautious fluid resuscitation is that no large prospective randomized clinical trials exist which have provided evidence of improved survival when fluid resuscitation is applied in an aggressive manner. The explanation th...
Source: Der Anaesthesist - September 11, 2014 Category: Anesthesiology Authors: Roessler M, Bode K, Bauer M Tags: Anaesthesist Source Type: research

[Cost minimization analysis in postoperative pain management : Economic efficiency and effectiveness of two infusion pump systems.]
CONCLUSION: Both pain pump systems provide equally effective pain management, while the electronic model caused less costs. Both pumps offer advantages and disadvantages that should be considered based on local circumstantial demands. PMID: 25189935 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - September 6, 2014 Category: Anesthesiology Authors: Bräscher AK, Blunk J, Söhle S, Feldmann RE, Bauer M, Benrath J Tags: Anaesthesist Source Type: research

[Ernst von der Porten : Looking for facts before and after forced emigration.]
Abstract The Ernst von der Porten medal has been awarded for many years to exceptional personalities by the Alliance of German Anesthesiologists to honor the outstanding achievements of the physician Ernst von der Porten from Hamburg in the development of anesthesiology as an autonomous discipline Only recent access to hitherto inaccessible documents enabled the reconstruction of his final years. He was persecuted and excluded by the National Socialist (NS) regime due to his Jewish roots and finally forced to emigrate. Records revealed that even in the so-called safe exile, degrading treatment and humiliation cont...
Source: Der Anaesthesist - September 5, 2014 Category: Anesthesiology Authors: Goerig M, Bruijn L Tags: Anaesthesist Source Type: research

[Monitoring liver function.]
PMID: 25185862 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - September 5, 2014 Category: Anesthesiology Authors: - Tags: Anaesthesist Source Type: research

[Catheter complications in persistent left superior vena cava.]
PMID: 25163665 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - August 29, 2014 Category: Anesthesiology Authors: - Tags: Anaesthesist Source Type: research

[Pharmacokinetics and pharmacodynamics of antibiotic therapy.]
Abstract Antibiotic agents are crucial pillars in intensive care medicine and must be used rationally and sensibly. In the case of critically ill patients optimal dosing with respect to pharmacokinetic and pharmacodynamic principles (PK/PD) can be vital. Preclinical results demonstrated important differences between antibiotic classes and gave rise to differing clinical dosing strategies, e.g. high dose once daily regimens for aminoglycosides or extended/continuous infusion of betalactams. Critically ill patients with altered pharmacokinetic parameters and infections by pathogens with low susceptibility are most l...
Source: Der Anaesthesist - August 24, 2014 Category: Anesthesiology Authors: Beck S, Wicha SG, Kloft C, Kees MG Tags: Anaesthesist Source Type: research

[Correct performance of transfusion.]
Abstract The administration of blood products is strictly regulated. Warming of blood components at body temperature is required only in rare cases. Addition of drugs to blood products is not allowed. During transfusion the monitoring of the patient is continued. In the case of an adverse event, exclusion of acute hemolysis is very important. As emergency transfusions have a higher risk than standard transfusions, their indications have to be restricted. When transfusion is completed the blood bag has to be preserved for 24 h. The effects of the blood transfusion have to be controlled. The administration of b...
Source: Der Anaesthesist - August 22, 2014 Category: Anesthesiology Authors: Strobel E, Henschler R Tags: Anaesthesist Source Type: research

[Comments on: erythropoietin administration and transfusion regimen after traumatic brain injury.]
n M PMID: 25142317 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - August 22, 2014 Category: Anesthesiology Authors: Höllig A, Coburn M Tags: Anaesthesist Source Type: research

[General anesthesia for ambulatory surgery : Clinical pharmacological considerations on the practical approach.]
lhelm W Abstract Due to modern surgical and anesthesia techniques, many patients undergoing small or even medium surgical procedures will recover within minutes and can then be discharged after a few hours of monitoring. Aside from an optimized surgical technique, a precise and differentiated anesthesia concept is needed to guarantee rapid recovery and home readiness. Nowadays, remifentanil-propofol represents the standard regime in ambulatory anesthesia. The use of alfentanil, desfluran or sevofluran is also possible whereas other intravenous or inhaled anesthetics or other opioids are rarely used. If endotrachea...
Source: Der Anaesthesist - August 20, 2014 Category: Anesthesiology Authors: Löser S, Herminghaus A, Hüppe T, Wilhelm W Tags: Anaesthesist Source Type: research

To what extent can local anesthetics be reduced for infraclavicular block with ultrasound guidance?
CONCLUSION: The results show that US guidance is more effective in maintenance of successful ICB than neurostimulation guidance alone and a reduction of LA doses even to 70 % of conventionally used doses seems possible with US guidance. This article is published in English. PMID: 25098777 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - August 8, 2014 Category: Anesthesiology Authors: Eren G, Altun E, Pektas Y, Polat Y, Cetingok H, Demir G, Bilgi D, Tekdos Y, Dogan M Tags: Anaesthesist Source Type: research

[Survey on the need for information during the preanesthesia visit.]
This study carried out to evaluate if the expected extent of information regarding anesthesia during the preanesthesia visit was dependent on group-specific variables. MATERIAL AND METHODS: A total of 699 adult patients with forthcoming elective non-cardiac surgery were anonymously interviewed concerning their expectations and informational needs during the preanesthesiavisit. The questionnaire contained 15 demographic variables, one being the question on health-related quality of life (HRQoL). The ASA classification was the only patient data assessed by the anesthesiologist after the consultation. In the second part ...
Source: Der Anaesthesist - August 8, 2014 Category: Anesthesiology Authors: Umgelter K, Anetsberger A, Schmid S, Kochs E, Jungwirth B, Blobner M Tags: Anaesthesist Source Type: research

[Comments on: Target value of mean arterial blood pressure in patients with septic shock.]
x G PMID: 25096069 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - August 7, 2014 Category: Anesthesiology Authors: Schürholz T, Marx G Tags: Anaesthesist Source Type: research

[Correct preparation of a transfusion : Part 1.]
[Correct preparation of a transfusion : Part 1.] Anaesthesist. 2014 Aug 3; Authors: Strobel E, Henschler R Abstract The administration of blood products is strictly regulated. Several weeks before the operation the preparation for transfusion begins with optimizing the patient's hematological and hemostaseological situation. In elective surgery blood group testing and antibody screening are performed soon after admission of the patient. The identification of the blood sample is important. Informed consent of the recipient has to be obtained. On the day before the operation a further blood sample ...
Source: Der Anaesthesist - August 3, 2014 Category: Anesthesiology Authors: Strobel E, Henschler R Tags: Anaesthesist Source Type: research

[Veno-arterial extracorporeal membrane oxygenation : Indications, limitations and practical implementation.]
Abstract Due to the technical advances in pumps, oxygenators and cannulas, veno-arterial extracorporeal membrane oxygenation (va-ECMO) or extracorporeal life support (ECLS) has been widely used in emergency medicine and intensive care medicine for several years. An accepted indication is peri-interventional cardiac failure in cardiac surgery (postcardiotomy low cardiac output syndrome). Furthermore, especially the use of va-ECMO for other indications in critical care medicine, such as in patients with severe sepsis with septic cardiomyopathy or in cardiopulmonary resuscitation has tremendously increased. The basic...
Source: Der Anaesthesist - July 31, 2014 Category: Anesthesiology Authors: Lunz D, Philipp A, Dolch M, Born F, Zausig YA Tags: Anaesthesist Source Type: research

[Risk consideration for peridural catheter removal in acute coronary syndrome : Epidural hematoma versus stent thrombosis.]
dmann R Abstract Perioperative pain therapy using an epidural catheter is the standard operating procedure for numerous surgical interventions. The necessity of initiating anticoagulant therapy in a patient with an epidural catheter requires a careful weighing up between thromboembolic complications and epidural hematoma. The case presented here of a 47-year-old female patient who was operated on for mastectomy with a latissimus dorsi myocutaneous flap demonstrates a possible solution to this dilemma. The patient sustained a perioperative ST elevation myocardial infarction treated with drug-eluting stents while un...
Source: Der Anaesthesist - July 25, 2014 Category: Anesthesiology Authors: Böhle H, Fröhlich J, Laufenberg-Feldmann R Tags: Anaesthesist Source Type: research

[Improvement of emergency physician education through simulator training : Consideration on the basis of the model project "NASimSaar25"]
CONCLUSION: A simulator-based course concept can result in an improvement of emergency medical education. The model project NASimSaar25 was well received by the target audience and mostly very well evaluated in terms of learning and reality. If this project becomes established the demand on simulation-based training will increase. The training should achieve a consistent standard of quality. PMID: 25056410 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 24, 2014 Category: Anesthesiology Authors: Armbruster W, Kubulus D, Schlechtriemen T, Adler J, Höhn M, Schmidt D, Duchêne S, Steiner P, Volk T, Wrobel M Tags: Anaesthesist Source Type: research

[Homozygous and compound heterozygous RYR1 mutations : New findings on prevalence and penetrance of malignant hyperthermia.]
CONCLUSION: In the two patients described the presence of two mutated RYR1 alleles seemed to have an additive effect on the functional restriction of the (RYR1 receptor and to lead to a stronger response both in the IVCT and with regard to clinical signs. The patients with no detected RYR1 mutations possibly have a RYR1 mutation with smaller effects outside the hot spot regions tested and/or false positive IVCT results. The data from a small patient group indicate a substantially higher prevalence of MH with a correspondingly lower penetrance in the German population than previously assumed. PMID: 25047158 [PubMed - a...
Source: Der Anaesthesist - July 23, 2014 Category: Anesthesiology Authors: Wolak S, Rücker B, Kohlschmidt N, Doetsch S, Bartsch O, Zechner U, Tzanova I Tags: Anaesthesist Source Type: research

[Cardiac arrest in spectators in German football stadiums : Precautionary measures, frequency and short-term outcome.]
CONCLUSIONS: Cardiac arrests are not a rare occurrence in German soccer stadiums. The participating stadiums are overall well prepared for such incidents in terms of organization, staff and technology and due to short response times, the resuscitation success by far surpasses that of the standard emergency medical services. These findings may in addition serve as a motivational example to start resuscitation early in public information campaigns. PMID: 25047159 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 23, 2014 Category: Anesthesiology Authors: Luiz T, Preisegger T, Rombach D, Madler C Tags: Anaesthesist Source Type: research

[Complications in pediatric anesthesia.]
Abstract As in adult anesthesia, morbidity and mortality could be significantly reduced in pediatric anesthesia in recent decades. This fact cannot conceal the fact that the incidence of anesthetic complications in children is still much more common than in adults and sometimes with a severe outcome. Newborns and infants in particular but also children with emergency interventions and severe comorbidities are at increased risk of potential complications. Typical complications in pediatric anesthesia are respiratory problems, medication errors, difficulties with the intravenous puncture and pulmonal aspiration. In ...
Source: Der Anaesthesist - July 10, 2014 Category: Anesthesiology Authors: Becke K Tags: Anaesthesist Source Type: research

[Use of biomarkers in sepsis : Update and perspectives.]
Abstract Sepsis and related complications are a challenge for intensive care medicine. Despite many advances in antibiotic therapy sepsis remains one of the most common diseases of patients in intensive care units and is designated as the main cause of death in critically ill patients. Persisting sepsis leads to impaired immunity, resulting in immunosuppression. Unspecific predictive signs complicate an early diagnosis; however, an early initiation of adequate therapy is of crucial importance for the prognosis. Scoring systems can be applied for the initial evaluation but are controversially discussed concerning t...
Source: Der Anaesthesist - July 9, 2014 Category: Anesthesiology Authors: Siegler BH, Weiterer S, Lichtenstern C, Stumpp D, Brenner T, Hofer S, Weigand MA, Uhle F Tags: Anaesthesist Source Type: research

[Monitoring of liver function in the critically ill.]
Abstract Liver failure and hepatic dysfunction represent diagnostic and therapeutic challenges for the intensivist. Besides acute liver failure, hypoxic hepatitis, sepsis and (secondary) sclerosing cholangitis may lead to massive liver dysfunction with subsequent multiorgan dysfunction syndrome that limits survival. Among classical laboratory parameters (so-called static liver parameters) liver function tests may help with the diagnosis to allow early treatment or prevention of liver dysfunction. The aim of this article is to present the current aspects of liver function monitoring and to provide guidelines to the...
Source: Der Anaesthesist - July 6, 2014 Category: Anesthesiology Authors: Sponholz C, Gonnert FA, Kortgen A, Bauer M Tags: Anaesthesist Source Type: research

[Out-of-hospital airway management : Five scenes of a tragedy.]
PMID: 24994015 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 5, 2014 Category: Anesthesiology Authors: Byhahn C, Schalk R, Russo SG Tags: Anaesthesist Source Type: research

[Anesthesia in a patient after endoscopic lung volume reduction : First anesthesiological experiences with implanted endobronchial valves.]
In conclusion the care of patients with implanted endobronchial valves after ELVR does not differ from COPD patients without ELVR. A close cooperation between surgeons, anesthesiologists and internists is mandatory in the care of these patients. PMID: 24994016 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 5, 2014 Category: Anesthesiology Authors: Hilbert P, Litwinenko KP, Niemann B, Zur Nieden K Tags: Anaesthesist Source Type: research

[Risks in pediatric anesthesia : Causes and prevention of complications.]
r M PMID: 24994017 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 5, 2014 Category: Anesthesiology Authors: Jöhr M Tags: Anaesthesist Source Type: research

[Application fields of intraoperative transesophageal 3D echocardiography.]
Abstract Intraoperative transesophageal echocardiography (TEE) is an established diagnostic tool and has to be regarded as the standard of care for intraoperative monitoring and cardiac surgical decision-making. Furthermore, intraoperative TEE is also used for monitoring and assessment of hemodynamic changes and the detection of previously unknown pathologies. In the past few years 3D-TEE has extended the spectrum of 2D-TEE by allowing pathomorphological features to be more easily and intuitively linked to the anatomy of the heart and the great vessels. Thus, a comprehensive 2D-TEE examination is favorably complem...
Source: Der Anaesthesist - July 3, 2014 Category: Anesthesiology Authors: Magunia H, Rosenberger P Tags: Anaesthesist Source Type: research