[Myalgia as symptom of COVID-19 illness].
PMID: 32780182 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - August 10, 2020 Category: Anesthesiology Authors: Dieselhorst V Tags: Anaesthesist Source Type: research

[Beyond coughing and pulse oximetry ….Which symptoms are important in COVID-19?]
[Beyond coughing and pulse oximetry….Which symptoms are important in COVID-19?] Anaesthesist. 2020 Aug 11;: Authors: Thomas-Rüddel D, Bauer M PMID: 32780183 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - August 10, 2020 Category: Anesthesiology Authors: Thomas-Rüddel D, Bauer M Tags: Anaesthesist Source Type: research

[Management of perioperative anaphylaxis].
Abstract The term anaphylaxis describes a severe, potentially life-threatening allergic reaction. It is caused by an acute, systemic immune response to substances against which in most cases a previous sensitization has taken place. An anaphylactic reaction can affect every organ system of the human body. The first signs of an allergic shock are symptoms such as hypotension, tachycardia, exanthema and dyspnea. The complete expression of anaphylactic shock can occur very quickly. A perioperative anaphylaxis, in particular, is not always easy to recognize. Therefore, it is important to know the possible pe...
Source: Der Anaesthesist - August 4, 2020 Category: Anesthesiology Authors: Kunzel S, Werschy A, Koch T Tags: Anaesthesist Source Type: research

[Lactate in emergency medicine].
d M Abstract The basis of all metabolic processes in the human body is the production and metabolism of carriers of energy. Lactate is the end-product of anaerobic glycolysis. Lactate can serve as a substrate for gluconeogenesis and as an oxidation substrate. Hyperlactatemia can be detected as the result of a multitude of acute events (e.g. shock, sepsis, cardiac arrest, trauma, seizure, ischemia, diabetic ketoacidosis, thiamine deficiency, liver failure and intoxication). Hyperlactatemia can be associated with increased mortality, therefore in emergency medicine the search for the cause of hyperlactatemia is...
Source: Der Anaesthesist - August 3, 2020 Category: Anesthesiology Authors: Kramer A, Al Agha S, Böhm L, Michael M, Schulze-Bosse K, Bernhard M Tags: Anaesthesist Source Type: research

[Perioperative stroke].
This article provides a summary of the epidemiology, risk factors, and etiology of perioperative stroke. Moreover, possible preventive strategies relevant for the anesthesiologist are reviewed. PMID: 32749502 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - August 3, 2020 Category: Anesthesiology Authors: Fischer M, Kahl U Tags: Anaesthesist Source Type: research

[On the future of machine learning in anesthesiology].
PMID: 32761520 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 31, 2020 Category: Anesthesiology Authors: Hinske LC Tags: Anaesthesist Source Type: research

[Local anesthetics: two are one too many].
PMID: 32761521 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 31, 2020 Category: Anesthesiology Authors: Booke H, Booke M Tags: Anaesthesist Source Type: research

[Local anesthetics-combine or not?]
PMID: 32761522 [PubMed - in process] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 31, 2020 Category: Anesthesiology Authors: Zink W, Steinfeldt T, Wiesmann T Tags: Anaesthesist Source Type: research

[Erratum to: COVID-19 pandemic: structured expansion of ventilation capacities using home respirators].
g; M PMID: 32725262 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 27, 2020 Category: Anesthesiology Authors: Summ O, Schute J, Byhahn C, Kahle T, Herrmann M, Schulte C, Bergold MN, Groß M Tags: Anaesthesist Source Type: research

Attitudes and knowledge about post-mortem organ donation among medical students, trainee nurses and students of health sciences in Germany : A  cross-sectional study.
This study aimed to examine 1) attitudes and knowledge about post-mortem organ donation, 2) how past transplantation scandals have affected those attitudes and 3) how satisfied respondents were with the knowledge provided on the courses. METHODS: A cross-sectional study was conducted between 20 March and 8 July 2019 at a university hospital and nursing schools in Berlin and Potsdam, Germany. Study participants were 209 medical students, 106 health sciences students and 67 trainee nurses. RESULTS: Of the respondents 29.3 and 50.8% knew the tasks of the German Organ Transpl...
Source: Der Anaesthesist - July 20, 2020 Category: Anesthesiology Authors: Tackmann E, Kurz P, Dettmer S Tags: Anaesthesist Source Type: research

[System and skill utilization in an Austrian emergency physician system: retrospective study].
CONCLUSIONS: No specific emergency physician interventions were required in the majority of call-outs. The current model of preclinical care does not appear to be patient-oriented and efficient. Furthermore, the low proportion of critically ill and injured patients already leads to a reduction in attractiveness for emergency physicians and may introduce the threat of quality issues due to insufficient routine experience and lack of training. PMID: 32696083 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 20, 2020 Category: Anesthesiology Authors: Prause G, Orlob S, Auinger D, Eichinger M, Zoidl P, Rief M, Zajic P Tags: Anaesthesist Source Type: research

[Ultrasound-guided peripheral venous puncture in patients with a poor venous status].
CONCLUSION: A greater vein diameter and a higher BMI contribute to a shorter time period for ultrasound-guided venous access. Obese patients with difficult venous access may benefit from ultrasound-guided venous access, which could be explained by the imaging contrast with a higher proportion of subcutaneous fatty tissue. PMID: 32671428 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 14, 2020 Category: Anesthesiology Authors: Kaiser P, Ghamari S, Gräff I, Ellerkmann R, Weber S, Hoeft A, Kim SC Tags: Anaesthesist Source Type: research

[Appropriate allocation of resources for interhospital transfer in emergency medical service-is a physician in the dispatch center helpful?]
CONCLUSION: The immediate clarification of interhospital transport requests by an emergency physician at the dispatch center leads to a significant reduction in unnecessary medical accompaniment of patient transfers. The choice of an appropriate transfer vehicle and staff should not be left to the requesting hospital physician alone. PMID: 32671429 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 14, 2020 Category: Anesthesiology Authors: Schröder H, Brockert AK, Beckers SK, Follmann A, Sommer A, Kork F, Rossaint R, Felzen M Tags: Anaesthesist Source Type: research

[Specific characteristics of cardiopulmonary resuscitation in times of SARS-CoV-2].
PMID: 32671430 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 14, 2020 Category: Anesthesiology Authors: Hoechter DJ, Groene P, Hoffmann F, Kreimeier U Tags: Anaesthesist Source Type: research

[Vibrio vulnificus, an increasing threat of sepsis in Germany?]
CONCLUSION: Sepsis due to V. vulnificus will probably increase over the coming years. Because there is a latency in some cases between infection and onset of sepsis, physicians beyond the coastal region must also be informed about this disease. PMID: 32620988 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 2, 2020 Category: Anesthesiology Authors: Metelmann C, Metelmann B, Gründling M, Hahnenkamp K, Hauk G, Scheer C Tags: Anaesthesist Source Type: research

Erratum zu: Neue Herausforderungen f ür die Anästhesie durch den Klimawandel.
Erratum zu: Neue Herausforderungen für die Anästhesie durch den Klimawandel. Anaesthesist. 2020 Jul 03;: Authors: Redaktion „Der Anaesthesist“ PMID: 32620989 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 2, 2020 Category: Anesthesiology Authors: Redaktion „Der Anaesthesist“ Tags: Anaesthesist Source Type: research

[Peripheral truncal blocks-Overview and assessment].
smann T Abstract By implementation of sonography for regional anesthesia, truncal blocks became more relevant in the daily practice of anesthesia and pain therapy. Due to visualized needle guidance ultrasound supports more safety and helps to avoid complications during needle placement. Additionally, complex punctures are possible that were associated with higher risk using landmarks alone. Next to the blocking of specific nerve structures, interfascial and compartment blocks have also become established, whereby the visualization of individual nerves and plexus structures is not of relevance. The present review a...
Source: Der Anaesthesist - July 2, 2020 Category: Anesthesiology Authors: Steinfeldt T, Kessler P, Vicent O, Schwemmer U, Döffert J, Lang P, Mathioudakis D, Hüttemann E, Armbruster W, Sujatta S, Lange M, Weber S, Reisig F, Hillmann R, Volk T, Wiesmann T Tags: Anaesthesist Source Type: research

[Perioperative measures for prevention of phantom pain: an evidence-based approach to risk reduction].
Abstract Prevention of phantom limb pain is one of the biggest and still largely unsolved challenges in perioperative medicine. Despite many study efforts and optimization of postoperative pain treatment over the last 30 years, a significant reduction in the incidence of phantom limb pain has not been achieved. Current studies have also shown that at least 50% of patients develop phantom pain after 6 months. A possible approach could be to combine multiple synergistic interventions and implement them as a perioperative phantom pain management strategy bundle. In addition to regional anesthesia,...
Source: Der Anaesthesist - July 2, 2020 Category: Anesthesiology Authors: Tafelski S Tags: Anaesthesist Source Type: research

[Implementation of anesthesia quality indicators in Germany : A  prospective, national, multicenter quality improvement study].
This study tested the hypothesis that the implementation of the 10 QI is feasible in German hospitals. MATERIAL AND METHODS: This prospective three-phase national multicenter quality improvement study was conducted in 15 German hospitals and 1 outpatient anesthesia center from March 2017 to February 2018. The trial consisted of an initial evaluation of pre-existing structures and processes by the heads of the participating anesthesia departments, followed by a 6-month implementation phase of the QI as well as a final re-evaluation phase. The implementation procedure was supported by web-based imple...
Source: Der Anaesthesist - July 1, 2020 Category: Anesthesiology Authors: Ziemann S, Coburn M, Rossaint R, Van Waesberghe J, Bürkle H, Fries M, Henrich M, Henzler D, Iber T, Karst J, Kunitz O, Löb R, Meißner W, Meybohm P, Mierke B, Pabst F, Schaelte G, Schiff J, Soehle M, Winterhalter M, Kowark A Tags: Anaesthesist Source Type: research

The effectiveness of an oral opioid rescue medication algorithm for postoperative pain management compared to PCIA : A  cohort analysis.
CONCLUSION: In this study PCIA provided a better reduction of pain intensity, when compared to a standardized protocol with oral opioid rescue medication. This effect was associated with increased opioid consumption. There were no differences in frequencies of opioid side effects. This study was a retrospective analysis of two cohorts of a major project. As with all retrospective studies, our analysis has several limitations to consider. Data can only represent the observation of clinical practice. It cannot reflect the quality of a statement of a randomized controlled trial. Observational stu...
Source: Der Anaesthesist - July 1, 2020 Category: Anesthesiology Authors: Erlenwein J, Emons MI, Petzke F, Quintel M, Staboulidou I, Przemeck M Tags: Anaesthesist Source Type: research

[Hypoglossal nerve palsy after follicle puncture].
Conclusion for clinical practice: In order to protect against lesions of the hypoglossal nerve, the pre-anaesthesiological examination should ask specifically about cervical problems as an indication of individual sensitivity to reclination. In such cases, special attention should be paid to careful patient positioning. Even shorter periods of reclination or compression of the soft tissues of the neck can result in lesions, therefore tolls such as a Wendl or Guedel tube should be used accordingly. PMID: 32591840 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 25, 2020 Category: Anesthesiology Authors: Bette B, Martini M, Klaschik S, Hilbert T Tags: Anaesthesist Source Type: research

[Perioperative pharmacological circulatory support in daily clinical routine].
This article provides concise recommendations. PMID: 32572502 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 21, 2020 Category: Anesthesiology Authors: Haas A, Schürholz T, Reuter DA Tags: Anaesthesist Source Type: research

[TEG-guided treatment of a dabigatran overdose in a  patient with acute kidney failure].
This article presents the case of a multimorbid male patient with an accidental dabigatran overdose caused by kidney failure in the context of an acute intestinal disorder. After effective initial antagonizing of the dabigatran effect using idarucizumab a dabigatran rebound was detected caused by a single hemodialysis leading to a severe intrapulmonary hemorrhage. As dabigatran plasma level testing was not available and conventional coagulation analysis was out of interpretable range due to the impact of dabigatran, continuous thrombelastography (TEG) was used to detect the effect of dabigatran and moni...
Source: Der Anaesthesist - June 19, 2020 Category: Anesthesiology Authors: Lorenz KW, Schäfer R Tags: Anaesthesist Source Type: research

[Pilot study on subjectively and objectively measurable stress reduction in the daily routine of a  university anesthesia department by an intervention program according to mindfulness-based stress reduction].
CONCLUSION: An MBSR-based intervention in combination with short exercises during and after work can be implemented in daily work of anesthetists at a university hospital. Furthermore, there was clear evidence that the intervention program increased resilience and reduced burnout symptoms for up to 6 months. These findings are in line with the literature that MBSR reduces risk of burnout symptoms. The decrease in well-being might be biased by a high amount of socially accepted answers at the beginning of the study (t0). PMID: 32561949 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 18, 2020 Category: Anesthesiology Authors: Gerber B, Scriba J, Geissler A, Reckling H, Fischer M, Karl D, Chung BY, Benrath J Tags: Anaesthesist Source Type: research

[Sustainability in anesthesiology].
PMID: 32556362 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 17, 2020 Category: Anesthesiology Authors: Coburn M, Schuster M, Kowark A Tags: Anaesthesist Source Type: research

[Severe noncardiogenic pulmonary edema due to permeability disorder after i.v. administration of CT contrast medium with subsequent venovenous extracorporeal membrane oxygenation].
This article presents the case of a 48-year-old man with NCPE who underwent elective coronary CT as part of the evaluation of recurrent syncope. After administration of iodinated contrast medium the patient developed a fulminant lung edema, which led to severe hypoxemia with cardiac arrest despite immediate treatment by the medical emergency team, including assisted ventilation, prednisolone, dimetindene and adrenaline. An early echocardiographic assessment after ROSC and intubation showed an intact cardiac function and no signs of valvular pathologies. Arterial blood gas analysis revealed a severe global respira...
Source: Der Anaesthesist - June 15, 2020 Category: Anesthesiology Authors: Poros B, Katchanov J, Curta A, Weig T Tags: Anaesthesist Source Type: research

[Summary of two studies on the validation of the Critical Care Pain Observation Tool (CPOT) for assessment of pain in intensive care patients incapable of communication].
PMID: 32533209 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 11, 2020 Category: Anesthesiology Authors: Kiesewetter I, Pilge S, Kirsch M, Emsden C Tags: Anaesthesist Source Type: research

[Long-term outcome of perioperative pain therapy assessed based on routine data (LOPSTER)].
“ PMID: 32494999 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 2, 2020 Category: Anesthesiology Authors: Schwarzkopf D, Studiengruppe „LOPSTER“ Tags: Anaesthesist Source Type: research

[Terrorist attack training exercise-What can be learned? : Baden-W ürttemberg counterterrorism exercise (BWTEX)].
CONCLUSION: A mass casualty incident resulting from a terrorist attack differs greatly from a conventional mass casualty incident. The scene of the attack has to be evacuated as quickly as possible, which means that a large number of patients arrive untreated at the nearest hospitals. The setting up of treatment facilities in city centers and areas close to the city seems to be counterproductive because the time delay may result in higher mortality rates of victims. The particularities of mass casualties caused by a terrorist attack have to be incorporated into terrorist attack training. PMID:...
Source: Der Anaesthesist - June 1, 2020 Category: Anesthesiology Authors: Pfenninger EG, Klingler W, Keiloweit T, Eble M, Wenzel V, Krüger WA Tags: Anaesthesist Source Type: research

[Stressors for patients in the intensive care unit : An analysis taking controllability into consideration].
e M Abstract OBJECTIVE: Studies on stress factors for patients in intensive care units (ICU) have so far concentrated on whether certain stressors have occurred or how stressful they were. There are no studies on stress for patients in ICUs that measured both the perception of stress and the chances perceived to control it; however, loss of control can result in long-term psychopathological consequences, such as depression or posttraumatic stress disorder. Therefore, a questionnaire was developed to evaluate the influence of controllability on perception of stress. The aim of this study was to answer the foll...
Source: Der Anaesthesist - June 1, 2020 Category: Anesthesiology Authors: Reinberger M, Bouchard R, Muhl E, Nau C, Hüppe M Tags: Anaesthesist Source Type: research

[Anti-infective treatment in obesity-"just double it?"]
[Anti-infective treatment in obesity-"just double it?"] Anaesthesist. 2020 Jun 02;: Authors: Simon P Abstract Adaequate antibiotic therapy is crucial for successful anti-infective therapy. In addition to the choice of the right antibiotic and the duration of therapy, the dose also plays a decisive role. Obesity has an influence on the pharmacokinetics of antibiotics, which can lead to underdosing if previous weight-independent dosing regimes are used. It is therefore necessary to carry out systematic measurements of concentrations in obese patients. Since pharmacokinetic differences bet...
Source: Der Anaesthesist - June 1, 2020 Category: Anesthesiology Authors: Simon P Tags: Anaesthesist Source Type: research

[Noninvasive evaluation of airways prior to sedation or anesthesia : An update within the framework of the revision of the German S1 guidelines on airway management 2015 of the German Society for Anesthesiology and Intensive Care Medicine].
;t M Abstract As a single and reliable parameter for prediction of the difficult airway is missing, the specialist societies for anesthesiology recommend the use of scores that combine the individual parameters. Contemporary scores include head-neck mobility, mouth opening and anatomical distances. Their training and correct performance are essential. For a broad acceptance the performance has to be easy and fast. In addition, before anesthesia a check must be made for pathological alterations (e.g. tumors) in the head and neck region and the patient history must be thoroughly determined. If the patient repor...
Source: Der Anaesthesist - May 28, 2020 Category: Anesthesiology Authors: Ilper H, Kunz T, Faißt M Tags: Anaesthesist Source Type: research

[Internal hospital emergency management : Concepts for optimization of patient safety in hospitals].
Abstract Critical incidents in hospitals can often be predicted hours before the event and can mostly be detected earlier and presumably avoided. Quality management programs from US hospitals to reduce deaths following a severe postoperative complication (failure to rescue, FTR), have in this form not yet become established in Germany. A sensitive score-based early warning system for looming complications is decisive for successful in-hospital emergency management. In addition to measurement rounds where the frequency is adapted to the severity, this includes effective communication of the results to the ward...
Source: Der Anaesthesist - May 22, 2020 Category: Anesthesiology Authors: Heller AR, Koch T Tags: Anaesthesist Source Type: research

[Preclinical management of cardiac arrest-extracorporeal cardiopulmonary resuscitation].
CONCLUSION: Survival after cardiac arrest and the subsequent quality of life dependent on many different factors. The time factor, i.e. the avoidance of a no-flow phase and reduction of the low-flow phase is of fundamental importance. The immediate restoration of the circulation and oxygen supply by eCPR can significantly improve survival; however, large randomized, controlled trials are currently not available. PMID: 32435820 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 19, 2020 Category: Anesthesiology Authors: Lotz C, Muellenbach RM, Meybohm P, Rolfes C, Wulf H, Reyher C Tags: Anaesthesist Source Type: research

[Is it really an acute respiratory distress syndrome? : Current definitions, pathophysiology and differentiated diagnoses].
Abstract Although the Berlin definition of the acute respiratory distress syndrome (ARDS) is generally recognized, the differentiation from other diseases with severe gas exchange disturbances is often difficult in clinical practice. In particular, the assessment of radiological findings and identification of primary noncardiogenic lung edema pose problems. In ARDS typical inflammatory processes can be found with involvement of activated neutrophilic granulocytes. Anti-inflammatory treatment strategies were unsuccessful. Lung protective ventilation strategies and prone positioning are the only evidence-based treat...
Source: Der Anaesthesist - May 18, 2020 Category: Anesthesiology Authors: Dembinski R Tags: Anaesthesist Source Type: research

[Management of patients with MELAS syndrome : A  case report and general characteristics from an anesthesiological perspective].
CONCLUSION: Patients with MELAS syndrome represent a challenging cohort with respect to management of anesthesia and an intensive monitoring of the metabolic status is crucial. In cases of increasing lactate values, the administration of intraoperative parenteral nutrition seems to be a suitable approach to avoid lactic acidosis and to improve the perioperative treatment of patients with MELAS syndrome in the future. PMID: 32424662 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 17, 2020 Category: Anesthesiology Authors: Roth S, Nienhaus J, Nickel F, Kindgen-Milles D, Kienbaum P, Huhn R Tags: Anaesthesist Source Type: research

„Next Generation Sequencing“ zur Diagnostik der Bakteriämie bei Sepsis – Next GeneSiS-Trial.
„Next Generation Sequencing“ zur Diagnostik der Bakteriämie bei Sepsis – Next GeneSiS-Trial. Anaesthesist. 2020 May 15;: Authors: Brenner T, TIFOnet Critical Care Trials Group PMID: 32415307 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 14, 2020 Category: Anesthesiology Authors: Brenner T, TIFOnet Critical Care Trials Group Tags: Anaesthesist Source Type: research

[Impact of premedication on anxiety: a multi-centre, prospective observational cohort study].
PMID: 32415308 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 14, 2020 Category: Anesthesiology Authors: Kowark A, Studiengruppe IMPACT Tags: Anaesthesist Source Type: research

[Improve Hip Fracture Outcome In The Elderly Patient (iHOPE): a multicentre randomized controlled trial to test the efficacy of spinal versus general anaesthesia].
“ PMID: 32415309 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 14, 2020 Category: Anesthesiology Authors: Kowark A, Studiengruppe „iHOPE“ Tags: Anaesthesist Source Type: research

[Ultrasound visualization of the guidewire and positioning of the central venous catheter : A  prospective observational study].
CONCLUSION: The presented intraprocedural ultrasound-based method using two standard acoustic windows is reliable for verification of the correct intravenous location and direction of the guidewire even before dilatation of the vessel puncture site for insertion of the catheter. Furthermore, the method allows the clinically acceptable measurement of the required length for catheter positioning. A chest radiograph can be waived provided the ultrasound examination (identification of the guidewire and exclusion of puncture-related complications such as pneumothorax) is unambiguous. PMID: 32409857 [PubMed - as supplied by...
Source: Der Anaesthesist - May 13, 2020 Category: Anesthesiology Authors: Zick G, Eimer C, Renner J, Becher T, Kott M, Schädler D, Weiler N, Elke G Tags: Anaesthesist Source Type: research

["Legal highs" (new psychoactive substances) : What does the anesthesiologist need to know?]
["Legal highs" (new psychoactive substances) : What does the anesthesiologist need to know?] Anaesthesist. 2020 May 13;: Authors: Eichler J, Rehm M, Azad SC Abstract In recent years, the social media, the press and the internet have reported more about the topic of "legal highs" and new psychoactive substances (NPS). The use of these drugs is accompanied by a serious risk of undesired side effects, intoxication and even death. The often unknown chemical composition, unspecific clinical presentations and lack of quickly available routine diagnostic tests are aggravating factors...
Source: Der Anaesthesist - May 12, 2020 Category: Anesthesiology Authors: Eichler J, Rehm M, Azad SC Tags: Anaesthesist Source Type: research

[New challenges for intensive care medicine due to climate change and global warming].
CONCLUSION: Intensive care medicine must be prepared for the challenges due to global warming and climate change. Slow but continuous changes (e.g. rise in temperature) as well as acute changes (e.g. heat waves and natural disasters) will induce an increased need for intensive medical care services (e.g. an increase in the need for renal replacement procedures). Intensive care physicians will need to be familiar with the diagnostics and management of diseases associated with the climate change. An initiative of the specialist societies involved would be welcomed. PMID: 32399720 [PubMed - as supplied by publisher] (Sou...
Source: Der Anaesthesist - May 11, 2020 Category: Anesthesiology Authors: Bein T, Karagiannidis C, Gründling M, Quintel M Tags: Anaesthesist Source Type: research

Successful management of anesthesia complications in a  child with Crouzon syndrome.
This article presents the case of a child aged 2 years and 7 months with CS scheduled for bilateral tonsillectomy and adenoidectomy. The patient had a difficult procedure of extubation and was reintubated and the tracheal intubation was removed 2 days after surgery. The CS is a rare condition with physical characteristics that can result in difficult airway manipulation. It is important for anesthesiologists to recognize and avoid potential airway complications in the management of such patients through detailed preoperative evaluation and careful observation after surgery to reduce perioperative r...
Source: Der Anaesthesist - May 5, 2020 Category: Anesthesiology Authors: Wang X, Xu Z, Xiao Y, Chen G Tags: Anaesthesist Source Type: research

Implementation of anesthesia quality indicators in Germany : A  prospective, national, multicenter quality improvement study.
This study tested the hypothesis that the implementation of the 10 QI is feasible in German hospitals. MATERIAL AND METHODS: This prospective three-phase national multicenter quality improvement study was conducted in 15 German hospitals and 1 outpatient anesthesia center from March 2017 to February 2018. The trial consisted of an initial evaluation of pre-existing structures and processes by the heads of the participating anesthesia departments, followed by a 6-month implementation phase of the QI as well as a final re-evaluation phase. The implementation procedure was supported by web-based imple...
Source: Der Anaesthesist - May 5, 2020 Category: Anesthesiology Authors: Ziemann S, Coburn M, Rossaint R, Van Waesberghe J, Bürkle H, Fries M, Henrich M, Henzler D, Iber T, Karst J, Kunitz O, Löb R, Meißner W, Meybohm P, Mierke B, Pabst F, Schaelte G, Schiff J, Soehle M, Winterhalter M, Kowark A Tags: Anaesthesist Source Type: research

[Does accelerated surgery result in a benefit for patients with geriatric traumatic hip fractures?]
PMID: 32367160 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 3, 2020 Category: Anesthesiology Authors: Roehl A, Coburn M Tags: Anaesthesist Source Type: research

[COVID-19 pandemic: structured expansion of ventilation capacities using home respirators].
g; M Abstract Due to the current COVID-19 pandemic there is a need for a rapid increase in intensive care and ventilation capacities. Delivery times for additional intensive care respirators are currently not foreseeable. An option to increase ventilation capacities not only for COVID-19, but for all patients requiring mechanical ventilation is to use home respirators. Home respirators are turbine respirators, so they can usually be operated without high-pressure oxygen connections and can therefore also be used in areas outside the classical intensive care medical infrastructure. Due to their limited te...
Source: Der Anaesthesist - April 28, 2020 Category: Anesthesiology Authors: Summ O, Schute J, Byhahn C, Kahle T, Herrmann M, Schulte C, Bergold MN, Groß M Tags: Anaesthesist Source Type: research

[New challenges for anesthesia due to the climate change].
CONCLUSION: (I) Volatile anesthetics are highly potent greenhouse gases, especially desflurane has a major global warming potential. Total intravenous anesthesia (TIVA) with propofol or regional anesthetic techniques have a much lower impact on the climate. (II) Using sustainable energy sources as well as initiating energy sparing techniques, such as light-emitting diodes (LED) and motion sensors, can reduce CO2 emissions. (III) Waste can be managed by the reduce, reuse, recycle, rethink and research concept. Doctors should actively contribute to reach the climate goals. PMID: 32346776 [PubMed - as...
Source: Der Anaesthesist - April 27, 2020 Category: Anesthesiology Authors: Koch S, Pecher S Tags: Anaesthesist Source Type: research

[Outpatient treatment of acute injuries of upper extremities with axillary plexus anesthesia in the emergency department-Is that possible without continuous anesthesia attendance?]
This article retrospectively reports the authors' experiences with a treatment algorithm in which emergency patients were treated by ultrasound-guided axillary brachial plexus blocks (ABPB) and surgery carried out in the emergency department without further anesthesia attendance. METHODS: Patients were preselected by the surgeon if they were suitable for a standardized treatment without anesthesia attendance during surgery. If there were no anesthesiological or surgical contraindications patients received an ABPB in the holding area of the operating room (OR) under standard monitoring. Blocks were performed as a ...
Source: Der Anaesthesist - April 27, 2020 Category: Anesthesiology Authors: Rand A, Avila González CA, Feigl GC, Mäcken T, Weiß T, Zahn PK, Litz RJ Tags: Anaesthesist Source Type: research

[Effect of implementation of a trauma leader on process parameters for polytrauma treatment in the shock room of a tertiary care hospital].
Abstract BACKGROUND: In patients up to the age of 40 years old severe trauma is the most frequent cause of death in Germany. According to the current S3 guidelines on treatment of polytrauma and the severely injured, since 2011 the presence of a shock room coordinator should be considered, who can improve the survival of patients by optimized treatment quality and times. The aim of the present study was to analyze various parameters of shock room treatment for polytraumatized patients before and after implementation of a shock room coordinator for treatment of polytrauma. MATERIAL AND METHODS: To en...
Source: Der Anaesthesist - April 23, 2020 Category: Anesthesiology Authors: Schmitz J, Battenberg T, Drinhaus H, Eifinger F, Ries C, Hinkelbein J Tags: Anaesthesist Source Type: research

[Anesthesia and intensive care ventilators: differences and usability in COVID-19 patients].
Abstract The current coronavirus disease 2019 (Covid-19) pandemia is a highly dynamic situation characterized by therapeutic and logistic uncertainties. Depending on the effectiveness of social distancing, a shortage of intensive care respirators must be expected. Concomitantly, many physicians and nursing staff are unaware of the capabilities of alternative types of ventilators, hence being unsure if they can be used in intensive care patients. Intensive care respirators were specifically developed for the use in patients with pathological lung mechanics. Nevertheless, modern anesthesia machines offer similar tec...
Source: Der Anaesthesist - April 23, 2020 Category: Anesthesiology Authors: Notz Q, Herrmann J, Stumpner J, Schmid B, Schlesinger T, Kredel M, Kranke P, Meybohm P, Lotz C Tags: Anaesthesist Source Type: research