[Principles and pitfalls of arterial blood pressure measurement].
This article explains the principles of the individual methods, the sources of errors, advantages and disadvantages and discusses the fields of application in the clinical routine. PMID: 31270554 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 3, 2019 Category: Anesthesiology Authors: Meidert AS, Briegel J, Saugel B Tags: Anaesthesist Source Type: research

[Relevant aspects of the ESC guidelines for the management of cardiovascular diseases during pregnancy for  obstetric anaesthesia (update 2018)].
[Relevant aspects of the ESC guidelines for the management of cardiovascular diseases during pregnancy for obstetric anaesthesia (update 2018)]. Anaesthesist. 2019 Jul 02;: Authors: Brück S, Seeland U, Kranke E, Kranke P Abstract The current update of the ESC (European Society of Cardiology) guidelines on managing cardiovascular diseases during pregnancy provides instructions for doctors in daily practice. Heart diseases are the most common reason for maternal death during pregnancy in western countries. Among other things, the following topics are dealt with: congenital heart disease, pulmo...
Source: Der Anaesthesist - July 2, 2019 Category: Anesthesiology Authors: Brück S, Seeland U, Kranke E, Kranke P Tags: Anaesthesist Source Type: research

Hyperbaric oxygen therapy for iatrogenic arterial gas embolism after CT-guided lung biopsy : A  case report.
This article reports on a case of a 74-year-old male patient who underwent computed tomography (CT)-guided lung biopsy of suspect nodules after squamous cell carcinoma of the tonsils. During puncture, sudden cardiovascular arrest occurred. The CT scan documented severe arterial gas embolism in the aorta, spinal canal, left heart ventricle, and brain. The patient was then transferred to our hospital for HBOT. After the first HBOT, an additional CT scan showed regression of all gas inclusions. In the treatment of gas embolism, HBOT is considered the gold standard and is indispensable. It is primarily used to reduce...
Source: Der Anaesthesist - July 1, 2019 Category: Anesthesiology Authors: Hellinger L, Keppler AM, Schoeppenthau H, Perras J, Bender R Tags: Anaesthesist Source Type: research

[Mortality after high-risk surgery in Jehovah's Witness patients].
CONCLUSION: Given optimal management JW patients can undergo major surgery without an excessive risk of death. The 6.6% in-hospital mortality observed in this institution was in the range of the 4% generally observed after surgery in Europe. The majority of JW patients accepted a variety of blood conservation strategies following appropriate elucidation. This also included coagulation factor concentrates extracted from human plasma enabling an effective treatment of even severe bleeding complications. In this analysis postoperative hemoglobin concentrations below 6 g/dl in older JW patients were associated with a&nb...
Source: Der Anaesthesist - June 24, 2019 Category: Anesthesiology Authors: Habler O, Thörner M, Schmidt C, Hofmann P, Döbert U, Höhler M, Klingler S, Moog S, Oehme A, Schäufele M, Wege C, Voß B Tags: Anaesthesist Source Type: research

[Needlestick injuries of healthcare workers].
Abstract Injuries of healthcare workers with sharp instruments are considered among the most frequent occupational accidents in hospitals. In at least half of the cases, the instruments are contaminated with blood and therefore bear an infection risk with bloodborne pathogens, such as hepatitis B, hepatitis C and human immunodeficiency virus (HIV). Needlestick injuries require besides immediate medical intervention, such as rinsing and disinfection of the wound or skin contamination, a prompt clarification of the immune status and if necessary a postexposure prophylaxis. Furthermore, follow-up ...
Source: Der Anaesthesist - June 19, 2019 Category: Anesthesiology Authors: Ochmann U, Wicker S Tags: Anaesthesist Source Type: research

[Perioperative cardiovasular morbidity and mortality in noncardiac surgical interventions : Measures for optimal anesthesiological care].
nn J Abstract Because of new surgical techniques, advanced monitoring modalities and improvements in perioperative care, perioperative mortality and morbidity have been significantly reduced in the last decades; however, patients still suffer from high perioperative mortality and morbidity, especially those with pre-existing cardiovascular diseases. Not only perioperative myocardial infarction but also myocardial injury after non-cardiac surgery, which presents without clinical symptoms, is associated with an adverse outcome. Patients at risk require particular interdisciplinary attention throughout the perioperat...
Source: Der Anaesthesist - June 14, 2019 Category: Anesthesiology Authors: Janßen H, Dehne S, Giannitsis E, Weigand MA, Larmann J Tags: Anaesthesist Source Type: research

[Comparison of current critical care information systems from the perspective of clinical users : Summary of the results of a German nationwide survey].
CONCLUSION: Those functions that were identified as useful based on the ratings of clinical ICU staff should be implemented in current CCIS. The list of these functions might be regarded as a first step towards providing a catalog of functional requirements for CCISs. Furthermore, as the results show that the quality of the available functions was rated lower than the availability of the functions, manufacturers should shift more of the effort away from the development of new features and focus on improving the user-friendliness and quality of existing functions. PMID: 31168685 [PubMed - as supplied by publi...
Source: Der Anaesthesist - June 5, 2019 Category: Anesthesiology Authors: Suchodolski K, von Dincklage F, Lichtner G, Friesdorf W, Podtschaske B, Ragaller M Tags: Anaesthesist Source Type: research

[About guidelines, recommendations and the consequence!]
PMID: 31161294 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 3, 2019 Category: Anesthesiology Authors: Timmermann A, Wenzel V, Gries A Tags: Anaesthesist Source Type: research

[Concepts, training and the variety of providers].
t J PMID: 31161295 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 3, 2019 Category: Anesthesiology Authors: Jakisch B, Gräsner JT, Seewald S, Renzing N, Wnent J Tags: Anaesthesist Source Type: research

[Perioperative myocardial ischemia : Current aspects and concepts].
Abstract In the future an increasing number of older patients with significant comorbidities will have to undergo major surgical procedures. Perioperative cardiovascular events account for many major complications and even fatalities. While perioperative myocardial infarction (PMI) is a generally well-known and recognized complication, the less severe myocardial injury after non-cardiac surgery (MINS) has not gained widespread scientific attention until recently; however, two large observational trials (VISION 1 and VISION 2) have shown a significantly increased mortality after MINS with even s...
Source: Der Anaesthesist - June 3, 2019 Category: Anesthesiology Authors: Bein B, Schiewe R, Renner J Tags: Anaesthesist Source Type: research

[Saving more lifes].
PMID: 31161297 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 3, 2019 Category: Anesthesiology Authors: Leidel BA, Dahmen J, Kanz KG Tags: Anaesthesist Source Type: research

[Perioperative infusion therapy in children : Are infusion sets with precision flow regulators suitable for pediatric anesthesia?]
CONCLUSION: The actual flow rates differed considerably from the adjusted flow rates in the evaluated infusion sets. The flow rates substantially depended on the static level of the infusion. First and foremost, regulation of the administered infusion volume does not seem to be reliable when using an infusion set with a precision flow regulator. PMID: 31143986 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 29, 2019 Category: Anesthesiology Authors: Bollinger M, Keller C, Theis C, Russo SG Tags: Anaesthesist Source Type: research

[From comprehension to treatment of perioperative inflammation].
PMID: 31134300 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 27, 2019 Category: Anesthesiology Authors: Wunder C Tags: Anaesthesist Source Type: research

[Statement of the Austrian Society for Anesthesiology, Resuscitation and Intensive Care Medicine ( ÖGARI) on the use of laryngeal tubes by ambulancemen and paramedics].
[Statement of the Austrian Society for Anesthesiology, Resuscitation and Intensive Care Medicine (ÖGARI) on the use of laryngeal tubes by ambulancemen and paramedics]. Anaesthesist. 2019 May 21;: Authors: Trimmel H, Halmich M, Paal P Abstract Due to an increasing number of severe complications reported during the prehospital application of laryngeal tubes, the Austrian Society for Anesthesiology, Resuscitation and Intensive Care Medicine (ÖGARI) is prompted to formulate a respective statement. With regard to the current training situation and the applicable laws, ÖGARI recommends t...
Source: Der Anaesthesist - May 21, 2019 Category: Anesthesiology Authors: Trimmel H, Halmich M, Paal P Tags: Anaesthesist Source Type: research

Measures influencing post-mortem organ donation rates in Germany, the Netherlands, Spain and the UK : A  systematic review.
CONCLUSION: Donation after cardiac death (DCD), expanded donor criteria, increasing public awareness and introduction of an organ donor register should be discussed as measures to increase organ donation rates in Germany. PMID: 31101922 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 17, 2019 Category: Anesthesiology Authors: Tackmann E, Dettmer S Tags: Anaesthesist Source Type: research

[Health services research in intensive care medicine in Germany : Status quo and future challenges exemplified by acute pulmonary failure].
This article provides an overview of the current state of HSR in intensive care medicine in Germany using the example of acute respiratory distress syndrome (ARDS). The ARDS still represents a clinical disease with high intra-hospital mortality (30-60%) despite progress in intensive care medicine. Survivors of ARDS have substantial long-term limitations on physical and mental health. The treatment of ARDS patients is tedious, laborious for intensive care unit staff and complex. Despite evident treatment recommendations, these are only insufficiently implemented in the clinical routine. With the help of quality indicat...
Source: Der Anaesthesist - May 17, 2019 Category: Anesthesiology Authors: Blecha S, Weber-Carstens S, Bein T Tags: Anaesthesist Source Type: research

[Platelet function disorder in trauma patients, an underestimated problem? Results of a single center study].
Abstract BACKGROUND: Plasmatic coagulation disorders in trauma patients are common and their management is subject to current guidelines. Less evidence exists for platelet function. Although it is known that several trauma-associated factors have a negative influence on platelet function, routine monitoring has not yet become established. METHODS: A retrospective single center study was carried out at a German level 1 trauma center from 2010 to 2016. In all patients fulfilling the requirements for the German Trauma Society (DGU) Traumaregister® who were admitted directly from the scene of the inciden...
Source: Der Anaesthesist - May 16, 2019 Category: Anesthesiology Authors: Hofer V, Wrigge H, Wienke A, Hofmann G, Hilbert-Carius P Tags: Anaesthesist Source Type: research

[Perioperative inflammation].
CONCLUSION: This article discusses the causes and effects of inflammatory processes in the perioperative phase. Additionally, it highlights the immunomodulatory effects of perioperatively administered therapeutics and anesthetics. Knowledge of this topic enables the reader to make qualified decisions in the perioperative setting to improve the individual patient outcome. PMID: 31076810 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 10, 2019 Category: Anesthesiology Authors: Rossaint J, Margraf A, Zarbock A Tags: Anaesthesist Source Type: research

[Advanced medical post within hospitals as possible tactical instrument for handling mass casualty incidents].
DISCUSSION: During acute scenarios with only short prior notice, the authors prefer concepts that supplement the normal hospital operation through additional staff and material. In circumstances with prior notice of more than 60 min an advanced intrahospital advanced medical post, staffed by civil protection units, could be a concept that enables the absorption of the first patient arrivals within the first hour of a mass casualty incident without disturbing the functionality of hospitals to any great extent. Further practice runs are, however, necessary to further develop and adjust this concept to real-life circum...
Source: Der Anaesthesist - May 9, 2019 Category: Anesthesiology Authors: Kippnich M, Kippnich U, Markus C, Dietz S, Braun R, Pierags G, Hack M, Kraus M, Wurmb T Tags: Anaesthesist Source Type: research

[Staff and organizational requirements for pain services in hospitals : A  recommendation from the German Society for Anaesthesiology and Intensive Care Medicine].
[Staff and organizational requirements for pain services in hospitals : A recommendation from the German Society for Anaesthesiology and Intensive Care Medicine]. Anaesthesist. 2019 May 07;: Authors: Erlenwein J, Meißner W, Petzke F, Pogatzki-Zahn E, Stamer U, Koppert W Abstract Although pain services have been established in many hospitals, there is considerable heterogeneity among them with respect to organization of service, staff and qualifications of staff, and treatment approaches.With this recommendation, the German Society for Anesthesiology and Intensive Care Medicine defines requi...
Source: Der Anaesthesist - May 7, 2019 Category: Anesthesiology Authors: Erlenwein J, Meißner W, Petzke F, Pogatzki-Zahn E, Stamer U, Koppert W Tags: Anaesthesist Source Type: research

[Hygiene aspects of multidrug-resistant pathogens in the operating room and intensive care unit].
Abstract The major multidrug-resistant pathogens (MRE) in human medicine are methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE) and multidrug-resistant Gram-negative rod bacteria (MRGN). MRE are a very heterogeneous group with respect to epidemiology and therapeutic or hospital hygiene consequences. After MRSA played an important role among MREs at the beginning of the twenty-first century, VRE and MRGN have come to the fore in recent years. During work in the operating room and on the intensive care unit, there are many possibilities for transmission of MRE between the...
Source: Der Anaesthesist - May 2, 2019 Category: Anesthesiology Authors: Schuler F, Lanckohr C, Pillukat MH, Scherf R, Mellmann A Tags: Anaesthesist Source Type: research

[Anesthesiological aspects of liver transplantation].
Abstract Liver transplantation (LTPL) is the only curative option for patients with end stage liver disease (ESLD) or with hepatocellular carcinoma (HCC). Eurotransplant in Leiden, the Netherlands, is responsible for organ allocation. The model of end stage liver disease (MELD) score, which describes the severity of the liver disease, is decisive for organ allocation. The heterogeneous patient collective and hepatic-related comorbidities and their dynamics represent challenges. The anesthesiologist is responsible for evaluating the overall prognosis, whereby cardiac, pulmonary, renal and neurological comorbidities...
Source: Der Anaesthesist - May 2, 2019 Category: Anesthesiology Authors: Dehne S, Lund F, Larmann J, Schmidt K, Brenner T, Weigand MA, von Haken R Tags: Anaesthesist Source Type: research

[Restructuring of inpatient emergency treatment : What will change?]
Abstract The resolution on the restructuring of inpatient emergency treatment was passed by the Federal Joint Committee (G-BA) on 19 April 2018 based on the Hospital Structure Act and became binding with the publication in the Bundesanzeiger on 18 May 2018. The resolution describes the future structural and qualitative prerequisites for participation of hospitals in the provision of emergency treatment in three levels: basic emergency treatment, extended emergency treatment and comprehensive emergency treatment. Furthermore, a level of nonparticipation is also planned. In addition, there are special modules, e.g. ...
Source: Der Anaesthesist - April 25, 2019 Category: Anesthesiology Authors: Brokmann JC, Pin M, Bernhard M, Walcher F, Gries A Tags: Anaesthesist Source Type: research

Comparison of lateral and supine positions for tracheal extubation in children : A  randomized clinical trial.
CONCLUSION: In pediatric patients deep extubation in the lateral position improved SpO2 and reduced the incidence of stridor and laryngospasm in the early emergence period when compared to extubation in the supine position. PMID: 30993350 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 16, 2019 Category: Anesthesiology Authors: Jung H, Kim HJ, Lee YC, Kim HJ Tags: Anaesthesist Source Type: research

[Erratum to: Simulation training as part of clinical riskmanagement : A  health economic view].
[Erratum to: Simulation training as part of clinical riskmanagement : A health economic view]. Anaesthesist. 2019 Apr 12;: Authors: Speer T, Mühlbradt T, Fastner C, Schöffski O, Schröder S PMID: 30980182 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 12, 2019 Category: Anesthesiology Authors: Speer T, Mühlbradt T, Fastner C, Schöffski O, Schröder S Tags: Anaesthesist Source Type: research

[Erratum to: Certain and controversial components of "rapid sequence induction"].
[Erratum to: Certain and controversial components of "rapid sequence induction"]. Anaesthesist. 2019 Apr 12;: Authors: Mencke T, Zitzmann A, Reuter DA PMID: 30980183 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 12, 2019 Category: Anesthesiology Authors: Mencke T, Zitzmann A, Reuter DA Tags: Anaesthesist Source Type: research

[Erratum to: Catheterization of the subclavian vein and the risk of pneumothorax : Mechanical ventilation increases the risk of pneumothorax during infraclavicular subclavian vein catheterization: a  prospective randomized trial].
[Erratum to: Catheterization of the subclavian vein and the risk of pneumothorax : Mechanical ventilation increases the risk of pneumothorax during infraclavicular subclavian vein catheterization: a prospective randomized trial]. Anaesthesist. 2019 Apr 12;: Authors: Palmaers T, Frank P, Eismann H, Sieg L, Leffler A, Schmitt H, Scholler A PMID: 30980184 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 12, 2019 Category: Anesthesiology Authors: Palmaers T, Frank P, Eismann H, Sieg L, Leffler A, Schmitt H, Scholler A Tags: Anaesthesist Source Type: research

[Analysis of the personnel development in anesthesiology over the last two decades with special attention to gender aspects].
JC Abstract Skills shortage of nursing staff and physicians is a "hot topic" in health politics. For the future recruitment of medical staff in anesthesiology, an analysis of the staff development during the last decades considering gender aspects seems to be important. Therefore, the authors conducted a comparative analysis of data from the "Statistisches Bundesamt" (Fachserie 12 Reihe 7.3.1 and Fachserie 12 Reihe 6.1.1.) from 1994 until 2015. The analysis compared the development of anesthesiological staff (physicians) with the overall development of medical staff (physicians)...
Source: Der Anaesthesist - April 12, 2019 Category: Anesthesiology Authors: van den Bussche H, Scherer M, Zöllner C, Kubitz JC Tags: Anaesthesist Source Type: research

[Renal replacement therapy in acute kidney injury : From the indications to cessation].
CONCLUSION: Risk identification and prevention of AKI are essential. In the absence of absolute indications, initiation and accomplishment of RRT should be patient-adapted and carried out in the clinical context. Newly developed biomarkers could be helpful in the future for a better estimation of the prognosis and for a more precise definition of therapeutic strategies of RRT. PMID: 30980186 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 12, 2019 Category: Anesthesiology Authors: Küllmar M, Zarbock A Tags: Anaesthesist Source Type: research

[Deployment of the in-hospital emergency team in a  tertiary care university hospital : Data analysis for the time period 2013-2016 in North-Rhine/Westphalia].
CONCLUSION: Analysis of data revealed that the number of MET calls, total operating time and average deployment time increased from 2013 to 2016. The primary reason for MET activations was collapse or syncope and every 17th deployment was for cardiopulmonary resuscitation. The incidence of in-hospital cardiac arrests decreased during the study period. PMID: 30969357 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 10, 2019 Category: Anesthesiology Authors: Schmitz J, Kerkhoff S, Sander D, Schulz G, Warnecke T, Hinkelbein J Tags: Anaesthesist Source Type: research

[Publications by university Departments of Anaesthesiology from Germany, Austria and Switzerland in 2011-2015 : Scientific publications by university hospitals in D ‑A-CH].
CONCLUSION: Strategies to foster academic work in anaesthesiology in Germany, Austria and Switzerland are required. PMID: 30941445 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 2, 2019 Category: Anesthesiology Authors: Miller C, Ausserer J, Putzer G, Hamm P, Herff H, Wenzel V, Paal P Tags: Anaesthesist Source Type: research

Cardiopulmonary resuscitation: when guidelines provide no answers.
This article reports on a 71-year-old man who suffered an OHCA. Persisting gasping and recurrent ventricular fibrillation made the prehospital management difficult and imposed challenges on the whole team. The guidelines provided no answers to this specific situation. Wittingly, the emergency physician decided to abandon the standard approach. Based on this case, this article discusses the pathophysiological considerations and an approach deviating from the standard approach, which could have led to a positive patient outcome without casting doubt on the current resuscitation guidelines. PMID: 30937467 [PubM...
Source: Der Anaesthesist - April 1, 2019 Category: Anesthesiology Authors: Ventzke MM, Kemming GI Tags: Anaesthesist Source Type: research

[2018 update ESC/ESH guidelines on management of arterial hypertension : What is important for anesthesiologists?]
This article highlights the most important innovations in the ESC/ESH guidelines 2018 on management of arterial hypertension. PMID: 30937468 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 1, 2019 Category: Anesthesiology Authors: Löser B, Öner A Tags: Anaesthesist Source Type: research

[Surviving Sepsis Campaign update 2018: the 1  h bundle : Background to the new recommendations].
This article presents the background and discusses criticisms of the new recommendations. PMID: 30918985 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 27, 2019 Category: Anesthesiology Authors: Briegel J, Möhnle P Tags: Anaesthesist Source Type: research

[Antihypotensive drugs in cesarean sections : Treatment of arterial hypotension with ephedrine, phenylephrine and Akrinor ® (cafedrine/theodrenaline) during cesarean sections with spinal anesthesia].
CONCLUSION: The differences of the individual vasoactive substances seemed to be much smaller than one would expect based on the results of randomized clinical trials. The incidence and extent of bradycardia and neonatal acidosis were much lower than previously reported. The determined differences seemed to have no major clinical relevance. Although the A group required less bolus administrations and seemed to be the most potent substance, the results imply that the assessment of the effects of vasoactive substances should not be carried out without consideration of the accompanying measures. PMID: 30918986 [PubMed - ...
Source: Der Anaesthesist - March 27, 2019 Category: Anesthesiology Authors: Chappell D, Helf A, Gayer J, Eberhart L, Kranke P Tags: Anaesthesist Source Type: research

[Non-cardiac surgery in adults with congenital heart defects : Most important parameters in anesthesia management].
CONCLUSION: Decisive for the perioperative outcome of patients with CHD are the identification of high-risk patients, understanding of the individual situation with respect to the underlying pathophysiology and the intraoperative maintenance of cardiac output. PMID: 30911773 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 25, 2019 Category: Anesthesiology Authors: Massoth C, Zarbock A, Wenk M Tags: Anaesthesist Source Type: research

[Degree of implementation of structured answering of emergency calls in German emergency dispatch centers and effects of the introduction in daily practice].
CONCLUSION: Structured emergency call-taking has not yet been comprehensively implemented in German emergency dispatch centers. Wherever it is used consistently, important quality parameters are improved. Further investigations should aim to identify crucial factors for its implementation and to analyze additional quality parameters. PMID: 30899970 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 21, 2019 Category: Anesthesiology Authors: Luiz T, Marung H, Pollach G, Hackstein A Tags: Anaesthesist Source Type: research

[ESC guidelines 2018 on myocardial revascularization : What must anesthesiologists know?]
This article summarizes the most important changes of the ESC/EACTS guidelines on myocardial revascularization. PMID: 30899971 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 21, 2019 Category: Anesthesiology Authors: Löser B, Öner A Tags: Anaesthesist Source Type: research

[Catheterization of the subclavian vein and the risk of pneumothorax : Mechanical ventilation increases the risk of pneumothorax during infraclavicular landmark-guided subclavian vein puncture: a  prospective randomized study].
CONCLUSION: In this study landmark-guided infraclavicular SCV catheterization was associated with a significantly higher rate of pneumothorax when venipuncture was performed during mechanical ventilation and not in apnea. If a short phase of apnea is justifiable in the patient, mechanical ventilation should be discontinued during the venipuncture procedure. PMID: 30899972 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 21, 2019 Category: Anesthesiology Authors: Palmaers T, Frank P, Eismann H, Lion S, Leffler A, Schmitt H, Scholler A Tags: Anaesthesist Source Type: research

[Does hospital volume correlate with surgical process time? : Retrospective analysis of the five most common procedures for visceral surgery, trauma and orthopedic surgery and gynecology/obstetrics from the benchmarking program of the Berufsverband Deutscher An ästhesisten (BDA), Berufsverband Deutscher Chirurgen (BDC) and Verband für OP-Management (VOPM)].
CONCLUSION: The case volume only appeared to have a direct but limited influence on incision to suture times in laparoscopic and arthroscopic procedures. Overall, the hospital performance volume appeared to be of subordinate importance in terms of OR-economics. PMID: 30895350 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 20, 2019 Category: Anesthesiology Authors: Karaca O, Bauer M, Taube C, Auhuber T, Schuster M Tags: Anaesthesist Source Type: research

[Preclinical emergency anesthesia : A  current state analysis from 2015-2017].
CONCLUSION: The study of the current state of preclinical emergency anesthesia in Germany showed a deficient implementation of the pharmacological recommendations for action except for trauma patients. Reasons for divergence could arise due to different availability of rescue equipment, training concepts or discipline of emergency physicians. Suitable education and training could improve the quality of prehospital anesthesia in Germany. PMID: 30887074 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 18, 2019 Category: Anesthesiology Authors: Luckscheiter A, Lohs T, Fischer M, Zink W Tags: Anaesthesist Source Type: research

[Perioperative acute kidney injury].
CONCLUSION: For timely diagnosis and prevention of AKI the recommendations for action of the KDIGO guidelines should be implemented. High-risk patients should be detected early in the perioperative period in order to be able to initiate preemptive strategies in a timely manner. PMID: 30834951 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 5, 2019 Category: Anesthesiology Authors: Küllmar M, Meersch M Tags: Anaesthesist Source Type: research

[Neurobiology of opioid dependence].
Abstract Opioid dependence is a chronic mental disease with multifactorial etiology. The neurobiological theory of addiction focuses on the manipulation of the dopaminergic reward system as a basic property of substances with addictive potential including opioids. With regular opioid intake, the manipulation of the reward system results in a cognitive bias towards drug-related stimuli. In addition, opioids inhibit the locus caeruleus, resulting in symptoms of sympathetic rebound during opioid detoxification. The pharmacokinetics of opioids also influence the risk of addiction. These biological facto...
Source: Der Anaesthesist - March 1, 2019 Category: Anesthesiology Authors: Scherbaum N, Bonnet U Tags: Anaesthesist Source Type: research

[CPR after traumatic event: Don`t get under pressure!]
Abstract PMID: 30840109 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 1, 2019 Category: Anesthesiology Authors: Kulla M Tags: Anaesthesist Source Type: research

[Declaration of financial and non-financial interests in CME courses of Springer Medizin : Implementation of the regulation on the "Code on Continuing Medical Education" of the Medical Chamber North Rhine].
[Declaration of financial and non-financial interests in CME courses of Springer Medizin : Implementation of the regulation on the "Code on Continuing Medical Education" of the Medical Chamber North Rhine]. Anaesthesist. 2019 Mar;68(3):177-178 Authors: Herrmann P, Griebenow R Abstract PMID: 30840110 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 1, 2019 Category: Anesthesiology Authors: Herrmann P, Griebenow R Tags: Anaesthesist Source Type: research

Ventilator autotriggering : An underestimated phenomenon in the determination of brain death.
CONCLUSION: The phenomenon of VAT is inconsistently addressed in the national guidelines and recommendations for the determination of brain death and should, therefore, be included in future harmonized brain death codes. Detection and correction of VAT should be implemented as early as possible by a structured procedure. Additional training and information on this phenomenon should be made available to the entire intensive care unit staff. PMID: 30810759 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 27, 2019 Category: Anesthesiology Authors: Schwarz G, Errath M, Arguelles Delgado P, Schöpfer A, Cavic T Tags: Anaesthesist Source Type: research

[Treatment of carbon monoxide poisoning in Germany : A retrospective single center analysis].
CONCLUSION: Commonly known sources (fire, charcoal grills) aside, many poisonings by smoking a hookah were observed. This study highlights the importance of considering CO poisoning as a differential diagnosis when encountering patients, especially of younger age, with non-specific neurological symptoms, as well as the importance of early initiation of treatment. A direct correlation between CO-Hb values (whether measured noninvasively or by invasive BGA) and the initial symptoms could not be demonstrated. In total, substantial time expired between the diagnosis and start of treatment of patients transported to a...
Source: Der Anaesthesist - February 21, 2019 Category: Anesthesiology Authors: Eichhorn L, Kieback M, Michaelis D, Kemmerer M, Jüttner B, Tetzlaff K Tags: Anaesthesist Source Type: research

[Current treatment concepts for trauma-related cardiac arrest : Focal points, differences and similarities].
t J Abstract Trauma-related deaths are not only a relevant medical problem but also a socioeconomic one. The care of a polytraumatized patient is one of the less commonly occurring missions in the rescue and emergency medical services. The aim of this article is to compare the similarities and differences between different course concepts and guidelines in the treatment of trauma-related cardiac arrests (TCA) and to filter out the main focus of each concept. Because of the various approaches in the treatment of polytraumatized patients, there are decisive differences between trauma-related cardiac a...
Source: Der Anaesthesist - February 18, 2019 Category: Anesthesiology Authors: Jakisch B, Gräsner JT, Seewald S, Renzing N, Wnent J Tags: Anaesthesist Source Type: research

[Simulation training as part of clinical risk management : A  health economic view].
This article shows possible health economic considerations in the discussion about financing CRM-based simulation training. Cost-benefit and cost-effectiveness analyses are difficult to perform. They require an individual planning. Regardless of this, simulation training enables participants to experience (simulation) and reflect their own actions in critical situations (debriefing). With the help of specially trained CRM instructors, deviations from expected behavior can be detected. This non-conformity can be used as a starting point for the establishment and further development of patient safety by a structura...
Source: Der Anaesthesist - February 7, 2019 Category: Anesthesiology Authors: Speer T, Mühlbradt T, Fastner C, Schöffski O, Schröder S Tags: Anaesthesist Source Type: research

[Surgical treatment of proximal femoral fractures in high-risk geriatric patients under peripheral regional anesthesia : A  clinical case series].
[Surgical treatment of proximal femoral fractures in high-risk geriatric patients under peripheral regional anesthesia : A clinical case series]. Anaesthesist. 2019 Feb 05;: Authors: Seidel R, Barbakow E Abstract The authors describe in a clinical case series (n = 7) of older (age 78-95 years) high-risk patients the successful surgical treatment of proximal femoral fractures in a peripheral regional anesthesia technique. After positioning on the non-fractured side, a double injection technique (dual guidance concept: sonography plus nerve stimulation) was chosen. The ...
Source: Der Anaesthesist - February 5, 2019 Category: Anesthesiology Authors: Seidel R, Barbakow E Tags: Anaesthesist Source Type: research