[The right opioid for my patient].
r M PMID: 28993842 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - October 9, 2017 Category: Anesthesiology Authors: Schäfer M Tags: Anaesthesist Source Type: research

[Bacterial sepsis : Diagnostics and calculated antibiotic therapy].
stern C Abstract The mortality of patients with sepsis and septic shock is still unacceptably high. An effective antibiotic treatment within 1 h of recognition of sepsis is an important target of sepsis treatment. Delays lead to an increase in mortality; therefore, structured treatment concepts form a rational foundation, taking relevant diagnostic and treatment steps into consideration. In addition to the assumed focus and individual risks of each patient, local resistance patterns and specific problem pathogens must be taken into account for selection of anti-infection treatment. Many pathophysiological a...
Source: Der Anaesthesist - October 4, 2017 Category: Anesthesiology Authors: Richter DC, Heininger A, Brenner T, Hochreiter M, Bernhard M, Briegel J, Dubler S, Grabein B, Hecker A, Krüger WA, Mayer K, Pletz MW, Störzinger D, Pinder N, Hoppe-Tichy T, Weiterer S, Zimmermann S, Brinkmann A, Weigand MA, Lichtenstern C Tags: Anaesthesist Source Type: research

[Use of near-infrared spectroscopy for control of limb perfusion during venoarterial ECMO treatment : Application and limitations].
YA Abstract Patients undergoing peripheral venoarterial extracorporeal membrane oxygenation have a high risk of lower limb ischemia. In general, regular controls are carried out based on clinical and laboratory parameters in order to quickly detect and treat complications. These controls are challenging due to states of shock, nonpulsatile flow and vasopressor therapy. As additional monitoring the use of near-infrared spectroscopy (NIRS) is described in the literature as being very successful in detecting ischemia. The present article describes the use and possible limitations of NIRS for the diagnostics of perip...
Source: Der Anaesthesist - October 4, 2017 Category: Anesthesiology Authors: Werner T, Lunz D, Philipp A, Flörchinger B, Graf BM, Zausig YA Tags: Anaesthesist Source Type: research

[Differential indications of opioids in pain therapy].
Abstract Due to their strong analgesic potency opioids are highly effective in the therapy of acute and particularly cancer-induced chronic pain; however, the individual opioids differ considerably with respect to their pharmacokinetic and physicochemical properties and may therefore not be equally applicable for every patient. Caution should be taken especially in patients with impaired organ function. Furthermore, the metabolism of opioids leads to active or inactive metabolites. This process can be substantially influenced by genetic polymorphisms or drug interactions. Knowledge of all these factors for individ...
Source: Der Anaesthesist - October 2, 2017 Category: Anesthesiology Authors: Heyn J, Azad SC Tags: Anaesthesist Source Type: research

[Does annual simulation training influence the safety climate of a university hospital? : Prospective 5 ‑year investigation using dimensions of the safety attitude questionnaire].
[Does annual simulation training influence the safety climate of a university hospital? : Prospective 5‑year investigation using dimensions of the safety attitude questionnaire]. Anaesthesist. 2017 Oct 02;: Authors: St Pierre M, Gall C, Breuer G, Schüttler J Abstract BACKGROUND: Simulation-based training with a focus on non-technical skills can have a positive influence on safety relevant attitudes of participants. If an organization succeeds in training sufficient staff, it may experience a positive change in the safety climate. As the effects of a single training are of a ...
Source: Der Anaesthesist - October 2, 2017 Category: Anesthesiology Authors: St Pierre M, Gall C, Breuer G, Schüttler J Tags: Anaesthesist Source Type: research

[One size does not fit all].
PMID: 28956072 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - September 27, 2017 Category: Anesthesiology Authors: Bercker S, Laudi S, Stehr SN Tags: Anaesthesist Source Type: research

[Polytrauma following a truck accident : How to save lives by guideline-oriented emergency care].
DISCUSSION: In modern emergency medical services, treatment based on defined algorithms is recommended and also increasingly established in dealing with critical patients. The guideline-oriented emergency care of patients with polytrauma requires invasive measures, such as intubation and thoracic decompression in the preclinical setting. The foundation for this procedure includes training in theory and practice both of the non-medical and medical rescue service personnel. PMID: 28956075 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - September 27, 2017 Category: Anesthesiology Authors: Kippnich M, Jelting Y, Markus C, Kredel M, Wurmb T, Kranke P Tags: Anaesthesist Source Type: research

[Cave: interscalene catheters].
This article describes seven  cases of misplaced catheters. The etiology and symptoms are discussed as well as recommendations regarding the prevention of catastrophic complications. As a result, internal practice guidelines are recommended for anesthesia departments in order to enhance the safety and quality of regional anesthesia. PMID: 28936539 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - September 21, 2017 Category: Anesthesiology Authors: Gaus P, Kutz P, Bachtler JA, Lindner R, Saur P Tags: Anaesthesist Source Type: research

Repeated 2% sevoflurane administration in 7 ‑ and 60-day-old rats : Neurotoxicity and neurocognitive dysfunction.
CONCLUSION: Our findings suggested that sevoflurane can induce neuroapoptosis and cognitive dysfunction in adolescent rats that received repeated sevoflurane (2% for 1 h) during the postnatal period. These findings will promote further studies to investigate the effects of repeated sevoflurane exposure on the development of the central nervous system and function of learning and memory, as well as the underlying mechanisms in vitro and in vivo. PMID: 28914327 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - September 15, 2017 Category: Anesthesiology Authors: Huang H, Liu CM, Sun J, Jin WJ, Wu YQ, Chen J Tags: Anaesthesist Source Type: research

[The IDEALE-handover].
t H PMID: 28914331 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - September 15, 2017 Category: Anesthesiology Authors: Hölz W, Zinsmeister T, Forst H Tags: Anaesthesist Source Type: research

[Comment on: ketamine for prevention of postoperative delirium and pain].
PMID: 28914332 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - September 15, 2017 Category: Anesthesiology Authors: Ziemann S, Coburn M Tags: Anaesthesist Source Type: research

[Sepsis masquerading as delirium].
Abstract A previously healthy 60-year-old patient presented to the emergency department with severe headache, altered personality and fever. He was treated for bacterial meningitis with delirium of unknown cause but presumed to be due to alcohol withdrawal. Despite receiving the antibiotic therapy regimen recommended for bacterial meningitis the patient's condition rapidly deteriorated with profound delirium and tachypnea. The intensivist who was consulted immediately suspected sepsis-associated organ failure and admitted the patient to the intensive care unit (ICU). The blood culture was positive for Listeri...
Source: Der Anaesthesist - September 8, 2017 Category: Anesthesiology Authors: Seifert A, Hartog CS, Zweigner J, Schummer W, Reinhart K Tags: Anaesthesist Source Type: research

Erratum to: Ultrasound-guided interscalene brachial plexus block in a  child with acute upper respiratory infection.
Erratum to: Ultrasound-guided interscalene brachial plexus block in a child with acute upper respiratory infection. Anaesthesist. 2017 Sep 04;: Authors: Ergönenç T, Can H, Beyaz SG PMID: 28871309 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - September 4, 2017 Category: Anesthesiology Authors: Ergönenç T, Can H, Beyaz SG Tags: Anaesthesist Source Type: research

[Neurophysiological monitoring during surgical procedures].
l;hle M Abstract The application of intraoperative neurophysiological monitoring (IONM) is gaining more and more importance in daily clinical practice. The use of IONM allows the localization of neural structures and to control functioning of the peripheral and central nervous systems in anesthetized patients. This enables surgeons to identify and to protect neural structures and cerebral areas. The use of IONM also enables anesthesiologists to adjust anesthesia and cardiopulmonary therapy to the individual needs of the patient. Thereby, it may be possible to reduce the incidence of postoperative delirium and the ...
Source: Der Anaesthesist - August 24, 2017 Category: Anesthesiology Authors: Michels P, Bräuer A, Bauer M, Söhle M Tags: Anaesthesist Source Type: research

[The central nervous system as the target organ of general anesthesia].
e T PMID: 28831498 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - August 22, 2017 Category: Anesthesiology Authors: Kreuer S, Hüppe T Tags: Anaesthesist Source Type: research

[Migration of an axillary plexus catheter fragment : A severed catheter tip unnoticed on removal wandered into the central nervous system].
Abstract MIGRATION OF AN AXILLARY PLEXUS CATHETER FRAGMENT INTO THE INTRACEREBRAL COMPARTMENT: During removal of an axillary plexus catheter used for pain therapy, the catheter was probably inadvertently and unnoticed severed together with the suture fixation. The error went unnoticed and an approximately 14 cm long catheter fragment remained in the patient. The patient complained of neck pain, nausea and vomiting 2.5 years later. A computed tomography scan of the cranium and neck region revealed a tubular foreign body with a diameter of ca. 1 mm and a length of ca. 14&thi...
Source: Der Anaesthesist - August 22, 2017 Category: Anesthesiology Authors: Brandt L, Artmeier-Brandt U Tags: Anaesthesist Source Type: research

[Airway anatomy : Relevant structures in emergency medicine].
Abstract The subject of this article is the anatomy of the respiratory tract with an emphasis on the larynx. A differentiation is made between the upper and lower airways according to topographical and functional aspects, the limits of which are marked by the lower section of the larynx. The focus is on the anatomy of the structures involved, which are relevant for emergency medicine. PMID: 28808821 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - August 14, 2017 Category: Anesthesiology Authors: Schulze M, Wree A Tags: Anaesthesist Source Type: research

Diagnostic precision of triage algorithms for mass casualty incidents. English version.
CONCLUSION: Triage procedures with acceptable diagnostic quality exist to identify the most severely injured. Due to its high rate of false positive results (over-triage) the recently developed PRIOR algorithm will cause overload of available resources for the severely injured within mass casualty incident missions. Non-surgical patients still are poorly identified by the available algorithms. PMID: 28798972 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - August 10, 2017 Category: Anesthesiology Authors: Heller AR, Salvador N, Frank M, Schiffner J, Kipke R, Kleber C Tags: Anaesthesist Source Type: research

Ultrasound-guided interscalene brachial plexus block in a  child with acute upper respiratory infection : A case report.
Ultrasound-guided interscalene brachial plexus block in a child with acute upper respiratory infection : A case report. Anaesthesist. 2017 Aug 09;: Authors: Ergönenç T, Can H, Gökhan Beyaz S Abstract The brachial plexus is commonly blocked at the interscalene level for shoulder and proximal humeral surgery. There are only a few publications about the interscalene technique in pediatric patients for a peripheral nerve block. Ultrasound-guided peripheral nerve block has become increasingly more popular for pediatric patients because of high success rates and safety c...
Source: Der Anaesthesist - August 9, 2017 Category: Anesthesiology Authors: Ergönenç T, Can H, Gökhan Beyaz S Tags: Anaesthesist Source Type: research

[Approaches to pre-hospital bleeding management : Current overview on civilian emergency medicine].
Abstract Severe bleeding is a typical result of traumatic injuries. Hemorrhage is responsible for almost 50% of deaths within the first 6 h after trauma. Appropriate bleeding control and coagulation therapy depends on an integrated concept of local hemostasis by primary pressure with the hands, compression, and tourniquets accompanied by prevention of hypothermia, acidosis and hypocalcemia. Additionally, permissive hypotension is accepted for suitable patients and tranexamic acid should be administered early. Multiple publications prove that prehospital transfusion of blood products (e. g. red blood ...
Source: Der Anaesthesist - August 7, 2017 Category: Anesthesiology Authors: Lier H, Bernhard M, Knapp J, Buschmann C, Bretschneider I, Hossfeld B Tags: Anaesthesist Source Type: research

[Rudolf Frey - a biographical sketch on the occasion of his 100th  birthday].
[Rudolf Frey - a biographical sketch on the occasion of his 100th birthday]. Anaesthesist. 2017 Aug 03;: Authors: Goerig M, Jantzen JPAH Abstract The life of an outstanding human being, a creative personality, will find the interest of posterity if he is acknowledged not only as a representative of his time but also decades later can be described as a formative character. This applies to Rudolf Frey who, like no other, has deeply influenced the development of German language anesthesiology after the Second World War. In the 1950s and 1960s as a visionary he already portrayed the fo...
Source: Der Anaesthesist - August 3, 2017 Category: Anesthesiology Authors: Goerig M, Jantzen JPAH Tags: Anaesthesist Source Type: research

[Anesthesia management in microsurgical reconstructions].
er M Abstract Microsurgical procedures for construction of anastomoses present new challenges for anesthetists in the perioperative setting. Despite their increasing importance, so far no perioperative management guidelines for these patients existed. Anesthetists can influence the success of surgery (e. g. successful perfusion of a flap) via an optimal preoperative, intraoperative and postoperative approach. Patients should be carefully evaluated preoperatively for increased risks to avoid poor postoperative outcomes. Perioperatively, the choice of anesthetic procedure as well as the management of flu...
Source: Der Anaesthesist - August 1, 2017 Category: Anesthesiology Authors: Rand A, Ayoub M, Meyer-Frießem CH, Zahn PK, Bauer M Tags: Anaesthesist Source Type: research

[Erratum to: Residual neuromuscular blockade].
PMID: 28752183 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 27, 2017 Category: Anesthesiology Authors: Fuchs-Buder T, Schmartz D Tags: Anaesthesist Source Type: research

[Hans  F. E. Killian and Rudolf Frey-two pioneers of German anesthesia].
[Hans F. E. Killian and Rudolf Frey-two pioneers of German anesthesia]. Anaesthesist. 2017 Jul 27;: Authors: Zwissler B, Rossaint R PMID: 28752184 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 27, 2017 Category: Anesthesiology Authors: Zwissler B, Rossaint R Tags: Anaesthesist Source Type: research

[Hans Killian - surgical protagonist of German anesthesia].
n H PMID: 28726013 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 19, 2017 Category: Anesthesiology Authors: Böhrer H, Petermann H Tags: Anaesthesist Source Type: research

[Diagnostic quality of triage algorithms for mass casualty incidents].
CONCLUSION: Triage procedures with acceptable diagnostic quality exist to identify the most severely injured. Due to its high rate of false positive results (overtriage) in this study, the recently developed PRIOR algorithm could result in exhaustion of available resources for the severely injured and therefore to undertreatment of correctly assigned triage category I cases within mass casualty incidents. Non-surgical patients are still poorly allocated by the available algorithms. Contribution available free of charge by "Free Access". PMID: 28710612 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 14, 2017 Category: Anesthesiology Authors: Heller AR, Salvador N, Frank M, Schiffner J, Kipke R, Kleber C Tags: Anaesthesist Source Type: research

[Hans Franz Edmund Killian - nestor of German anesthesia : Critical appraisal on the 125th anniversary of his birth].
Abstract The surgeon Hans Killian was born on 5 August 1892 in Freiburg im Breisgau, Germany. Together with the pharmacologist Hellmut Weese and the surgeon Helmut Schmidt he was one of the nestors of modern German anesthesia. Early on during his scientific and clinical career, he addressed problems of surgical anesthesia and in 1928 he became one of the editors of the first German journal of anesthesia Narcosis and Anesthesia ("Narkose und Anästhesie"). In 1934 he published the textbook Anesthesia for Surgical Purposes ("Narkose zu operativen Zwecken"). Between World Wars I and ...
Source: Der Anaesthesist - July 11, 2017 Category: Anesthesiology Authors: Brandt L, Goerig M, Artmeier-Brandt U Tags: Anaesthesist Source Type: research

[Erratum to: Structured patient handovers in perioperative medicine: rationale and implementation in clinical practice].
er B PMID: 28685255 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 6, 2017 Category: Anesthesiology Authors: Merkel MJ, von Dossow V, Zwißler B Tags: Anaesthesist Source Type: research

[Anesthesia for thrombectomy].
l;sel J PMID: 28681071 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 5, 2017 Category: Anesthesiology Authors: Schönenberger S, Wick W, Bösel J Tags: Anaesthesist Source Type: research

[Heart in sepsis : Molecular mechanisms, diagnosis and therapy of septic cardiomyopathy].
z T Abstract An impairment of cardiac function is a key feature of cardiovascular failure associated with sepsis; however, its clinical relevance is still underestimated. Recent advancements in echocardiography in patients with septic shock enable a better characterization of septic cardiomyopathy by unmasking a severe, cardiac dysfunction even in the presence of preserved left ventricular ejection fraction. The pathophysiology of septic cardiomyopathy involves a complex mixture of systemic factors and molecular, metabolic, and structural changes of the cardiomyocytes. A better understanding of...
Source: Der Anaesthesist - July 4, 2017 Category: Anesthesiology Authors: Martin L, Derwall M, Thiemermann C, Schürholz T Tags: Anaesthesist Source Type: research

[Is neurological assessment sufficient for carotid endarterectomy under regional anesthesia?]
PMID: 28677017 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 4, 2017 Category: Anesthesiology Authors: Eckle VS Tags: Anaesthesist Source Type: research

[Importance of instrument-based neuromonitoring during carotid surgery using regional anesthesia].
r M PMID: 28677018 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 4, 2017 Category: Anesthesiology Authors: Koköfer A, Nawratil J, Opperer M Tags: Anaesthesist Source Type: research

[Acute respiratory distress syndrome : Basic principles and treatment].
u M Abstract Even after many years of intensive research acute respiratory distress syndrome (ARDS) is still associated with a high mortality. Epidemiologically, ARDS represents a central challenge for modern intensive care treatment. The multifactorial etiology of ARDS complicates the clear identification and evaluation of new therapeutic interventions. Lung protective mechanical ventilation and adjuvant therapies, such as the prone position and targeted extracorporeal lung support are of particular importance in the treatment of ARDS, depending on the severity of the disease. In order to guarantee an individuali...
Source: Der Anaesthesist - July 4, 2017 Category: Anesthesiology Authors: Spieth PM, Güldner A, Gama de Abreu M Tags: Anaesthesist Source Type: research

[Choosing wisely in anesthesia : An important step in quality optimization].
PMID: 28667420 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 30, 2017 Category: Anesthesiology Authors: Rossaint R, Coburn M Tags: Anaesthesist Source Type: research

[Intensive care studies from 2016/2017].
er T PMID: 28667421 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 30, 2017 Category: Anesthesiology Authors: Reuß CJ, Bernhard M, Beynon C, Hecker A, Jungk C, Michalski D, Nusshag C, Weigand MA, Brenner T Tags: Anaesthesist Source Type: research

[Erratum to: Difficulties with children of abnormal weight].
g P PMID: 28660412 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 28, 2017 Category: Anesthesiology Authors: Wirtz S, Eich C, Becke K, Brenner S, Callies A, Harding U, Höhne C, Hoffmann F, Kaufmann J, Landsleitner B, Marung H, Nicolai T, Reifferscheid F, Trappe U, Jung P Tags: Anaesthesist Source Type: research

[Sharpen the classical view of septic cardiomyopathy].
PMID: 28660413 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 28, 2017 Category: Anesthesiology Authors: Mirtschink P, Stehr SN Tags: Anaesthesist Source Type: research

[Stocks of dantrolene in anesthesia and intensive care units in Germany : Nationwide online survey with 1673 participants].
CONCLUSION: Almost all anesthesiologists participating in the online survey use volatile anesthethics and/or succinylcholine. Whereas almost all participants have access to dantrolene, more than half of the units have a stock of dantolene, which is less than that recommended by the DGAI. In the case of low dantrolene stock, only 61% of anesthesia departments have access to additional dantrolene within a time frame of 15min . The results of this online survey demonstrate that the stock of dantrolene may be insufficient in some German hospitals and anesthesiology practices. PMID: 28660414 [PubMed - as s...
Source: Der Anaesthesist - June 28, 2017 Category: Anesthesiology Authors: Pfenninger E, Heiderich S, Klingler W Tags: Anaesthesist Source Type: research

[New onset atrial fibrillation in patients with sepsis].
CONCLUSION: Further research is needed to unveil the optimal therapeutic strategies for patients with new onset atrial fibrillation during sepsis. PMID: 28660415 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 28, 2017 Category: Anesthesiology Authors: Keller M, Meierhenrich R Tags: Anaesthesist Source Type: research

Effect of low tidal volume with PEEP on respiratory function in infants undergoing one-lung ventilation.
CONCLUSION: Low TV with PEEP could be an effective intraoperative ventilation strategy for infants undergoing OLV during video-assisted thoracoscopic surgery and may reduce the risk of lung injury. However, this strategy, as well as the influence of intraoperative hypercapnia on infants, needs further investigation. PMID: 28656353 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 27, 2017 Category: Anesthesiology Authors: Liu J, Liao X, Li Y, Luo H, Huang W, Peng L, Fang Q, Hu Z Tags: Anaesthesist Source Type: research

Application of Benford's law: a valuable tool for detecting scientific papers with fabricated data? : A  case study using proven falsified articles against a comparison group.
CONCLUSION: All 12 of the known falsified articles violated Benford-Newcomb's law, which indicated that this analysis had a high sensitivity. The low specificity of the assessment may be explained by the assumptions made about the articles identified for comparison. Violations of Benford-Newcomb's law about the frequencies of the leading digits cannot serve as proof of falsification but they may provide a basis for deeper discussions between the editor and author about a submitted work. PMID: 28653153 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 26, 2017 Category: Anesthesiology Authors: Hüllemann S, Schüpfer G, Mauch J Tags: Anaesthesist Source Type: research

[Consideration of the habitus increases the accuracy of estimation in the application of cognitive aids in pediatric emergences].
PMID: 28600587 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 9, 2017 Category: Anesthesiology Authors: Erker CG, Rotermund J Tags: Anaesthesist Source Type: research

[Difficulties with children of abnormal weight].
PMID: 28597082 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 8, 2017 Category: Anesthesiology Authors: Hoffmann F, Kaufmann J, Landsleitner B, Marung H, Nicolai T, Reifferscheid F, Trappe U, Jung P Tags: Anaesthesist Source Type: research

[Integration of palliative care into intensive care : Systematic review].
DISCUSSION: Trigger factors can reduce barriers which hold back the integration of palliative care in ICUs. Early integration of palliative care can improve quality of care by offering psychological support to patients and their families and by providing collegial consultation. An ongoing prospective study is investigating the acceptance of trigger factors in the daily routine among ICU physicians in Germany. PMID: 28589374 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 6, 2017 Category: Anesthesiology Authors: Adler K, Schlieper D, Kindgen-Milles D, Meier S, Schwartz J, van Caster P, Schaefer MS, Neukirchen M Tags: Anaesthesist Source Type: research

[Intracranial hemorrhage secondary to vitamin  K deficiency in an infant despite oral vitamin K prophylaxis : Also a challenge for the anesthesiologist].
This article presents the case of a 6-week-old infant who, despite oral vitamin K prophylaxis and otherwise normal developmental progress, suffered a severe intracerebral and subdural hemorrhage, which required surgical evacuation. The interdisciplinary approach is described with emphasis on the management of hemostasis. Furthermore, the clinical picture of intracranial bleeding due to vitamin K deficiency, which is nowadays rare in the Western World, is described in the anesthesiology literature for the first time. The usual recommendations regarding prophylaxis as well as certain risk factors are pres...
Source: Der Anaesthesist - June 2, 2017 Category: Anesthesiology Authors: Ackermann S, Schimpf J, Richter M Tags: Anaesthesist Source Type: research

[Preoperative evaluation of adult patients before elective, noncardiothoracic surgery : Joint recommendation of the German Society of Anesthesiology and Intensive Care Medicine, the German Society of Surgery, and the German Society of Internal Medicine].
CH), Zwissler B Abstract Evaluation of the patient's medical history and a physical examination are the cornerstones of risk assessment prior to elective surgery and may help to optimize the patient's preoperative medical condition and to guide perioperative management. Whether the performance of additional technical tests (e. g. blood chemistry, ECG, spirometry, chest x‑ray) can contribute to a reduction of perioperative risk is often not very well known or is controversial. Similarly, there is considerable uncertainty among anesthesiologists, internists and surgeons with respect to the periope...
Source: Der Anaesthesist - June 1, 2017 Category: Anesthesiology Authors: Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Deutsche Gesellschaft für Innere Medizin (DGIM), Deutsche Gesellschaft für Chirurgie (DGCH), Zwissler B Tags: Anaesthesist Source Type: research

[Residual neuromuscular blockade].
Abstract Even small degrees of residual neuromuscular blockade, i. e. a train-of-four (TOF) ratio>0.6, may lead to clinically relevant consequences for the patient. Especially upper airway integrity and the ability to swallow may still be markedly impaired. Moreover, increasing evidence suggests that residual neuromuscular blockade may affect postoperative outcome of patients. The incidence of these small degrees of residual blockade is relatively high and may persist for more than 90 min after a single intubating dose of an intermediately acting neuromuscular blocking agent, such as roc...
Source: Der Anaesthesist - June 1, 2017 Category: Anesthesiology Authors: Fuchs-Buder T, Schmartz D Tags: Anaesthesist Source Type: research

[Structured patient handovers in perioperative medicine : Rationale and implementation in clinical practice].
er B Abstract Clear and consistent communication is pivotal for well-functioning teamwork, in operating theatres as well as intensive care units. However, patient handovers significantly vary between specialties and locations. If communication is not well structured, it might increase the risk for mishaps and malpractice. Therefore, implementing structured handover protocols is pivotal. The perioperative setting is a high-risk environment that is prone to communication failures due to operational design (frequent change of shift due to working time restrictions) and a high work load and multitasking (ope...
Source: Der Anaesthesist - May 18, 2017 Category: Anesthesiology Authors: Merkel MJ, von Dossow V, Zwißler B Tags: Anaesthesist Source Type: research

[Caring for patients-but carefully of course : Structured Handover].
PMID: 28510036 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 16, 2017 Category: Anesthesiology Authors: Vogt L, Sopka S Tags: Anaesthesist Source Type: research

[Anesthesiological care of trauma patients in orthogeriatric co-management].
Abstract Elderly patients increasingly need to undergo surgery under anesthesia, especially following trauma. A timely interdisciplinary approach to the perioperative management of these patients is decisive for the long-term outcome. Orthogeriatric co-management, which includes geriatricians and anesthesiologists from an early stage, is of great benefit for geriatric patients. Patient age, comorbidities and self-sufficiency in activities of daily life are decisive for an anesthesiological assessment of the state of health and preoperative risk stratification. If necessary additional investigations, such as echoca...
Source: Der Anaesthesist - May 12, 2017 Category: Anesthesiology Authors: Luger MF, Luger TJ Tags: Anaesthesist Source Type: research