[Basic manual skills in pediatric anesthesia].
r M PMID: 29736555 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 7, 2018 Category: Anesthesiology Authors: Jöhr M Tags: Anaesthesist Source Type: research

[Correct positioning of central venous catheters in pediatrics : Are current formulae really useful?]
CONCLUSION: The benefit of a formula for daily practice is very limited due to the problem of choosing the right insertion point. The recommended insertion depth should be considered as an indicator and a verification of the CVC tip position should be done using an imaging technique. PMID: 29736556 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 7, 2018 Category: Anesthesiology Authors: Cleff C, Boensch M, Eifinger F, Hinkelbein J Tags: Anaesthesist Source Type: research

[Comments on: Timing of operative treatment of fractures near the hip joint].
PMID: 29728710 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 4, 2018 Category: Anesthesiology Authors: Gerards MG, Haraszti B, Hess J, Houpert ACD, Idel PD, Klaeren FN, Krause J, Coburn M Tags: Anaesthesist Source Type: research

[Hemorrhage of the innominate artery during percutaneous dilatation tracheotomy].
e V Abstract The report describes the rare case of a periprocedural hemorrhage during percutaneous dilatation tracheotomy. In the final analysis, the innominate artery could be identified as the source of the hemorrhage. Particular attention must be paid to preprocedural evaluation of the puncture site and the procedure following unexpected hemorrhage. Continuation of the percutaneous tracheotomy, with only a clinical suspicion of a vascular injury while the bleeding source remained undetectable, seemed to be the most reasonable option. In this case the potentially life-threatening hemorrhage could be st...
Source: Der Anaesthesist - April 18, 2018 Category: Anesthesiology Authors: Hulde N, Köppen M, Gratzke M, Kisch-Wedel H, Brenner P, Huge V Tags: Anaesthesist Source Type: research

[Which patients benefit from transport with ongoing cardiopulmonary resuscitation? : Retrospective analysis of 70  patients with refractory preclinical cardiac arrest].
CONCLUSION: Selected patient collectives can benefit from transport to hospital with ongoing cardiopulmonary resuscitation (CPR). PMID: 29666925 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 17, 2018 Category: Anesthesiology Authors: Adler C, Paul C, Hinkelbein J, Michels G, Pfister R, Krings A, Lechleuthner A, Stangl R Tags: Anaesthesist Source Type: research

[Physiological changes during pregnancy].
Abstract The physiological state of a woman experiences multiple changes in the body during pregnancy. These alterations could be of particular importance in the medical care of pregnant women. This review article highlights the physiological developments of various organ systems throughout gestation with a focus on endocrinology, the cardiovascular system, hematology, the respiratory system and water balance. PMID: 29654495 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 13, 2018 Category: Anesthesiology Authors: Kohlhepp LM, Hollerich G, Vo L, Hofmann-Kiefer K, Rehm M, Louwen F, Zacharowski K, Weber CF Tags: Anaesthesist Source Type: research

[S3 guidelines on intensive medical care of cardiac surgery patients : Hemodynamic monitoring and cardiovascular system-an update].
This article describes the most important innovations of these comprehensive guidelines. PMID: 29644444 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 11, 2018 Category: Anesthesiology Authors: Habicher M, Zajonz T, Heringlake M, Böning A, Treskatsch S, Schirmer U, Markewitz A, Sander M Tags: Anaesthesist Source Type: research

[Perioperative onset of sarcoidosis : Rare differential diagnosis of a  difficult airway].
This article describes the onset of sarcoidosis in a case of an unexpected difficult airway. PMID: 29644445 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 11, 2018 Category: Anesthesiology Authors: Jansen G, Nowak A Tags: Anaesthesist Source Type: research

[The heart catheter table is not the operating table : Intraindividual comparison of pulmonary artery pressures].
CONCLUSION: An elevated pulmonary pressure obtained preoperatively during right heart catheterization is not indicative of an elevated pulmonary pressure either intraoperatively or postoperatively. There are various explanations for the differences (e.g., different physiological and pathophysiological settings, such as sedation with potential hypercapnia versus anesthesia with vasodilation when measured; newly prescribed medication coming into effect between the right heart catheterization and surgery; intraoperative positioning). Even though the inherent risks of a PAC seem to be low, we recommend refraining from usi...
Source: Der Anaesthesist - April 5, 2018 Category: Anesthesiology Authors: Ziegler MU, Reinelt H Tags: Anaesthesist Source Type: research

[Mechanical circulatory support in terminal heart failure].
CONCLUSION: Due to the increasing number of patients on long-term mechanical circulatory support, the chances are that physicians in the initial emergency admission are unfamiliar with these devices but need to operate them in emergency cases. Therefore, knowledge of these procedures and their complications becomes increasingly important. PMID: 29623383 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - April 5, 2018 Category: Anesthesiology Authors: Derwall M, Moza A, Brücken A Tags: Anaesthesist Source Type: research

[Fatal flecainide intoxication in a 17-year-old girl].
Abstract A 17-year-old girl was found vomiting and somnolent at home and was taken to a hospital. The girl initially presented with ventricular tachycardia with broad QRS complexes which was very difficult to control. During the course a subsequent cardiogenic shock developed and despite exhaustion of all therapeutic options the fatal outcome could not be averted. The medicolegal autopsy revealed no evidence of any form of violence but the signs of medical treatment. Furthermore, no pathology of internal organs was detected. The toxicological analyses revealed a lethal intoxication with flecainide a...
Source: Der Anaesthesist - March 28, 2018 Category: Anesthesiology Authors: Dokter M, Talarico G, Armbrust S, Below E, Bockholdt B Tags: Anaesthesist Source Type: research

[Hypotheses must be tested].
PMID: 29594408 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 28, 2018 Category: Anesthesiology Authors: Bernhard M, Behrens NH, Fischer M Tags: Anaesthesist Source Type: research

[Can a supraglottic airway device really be avoided during resuscitation?]
PMID: 29582090 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 26, 2018 Category: Anesthesiology Authors: Rossi R Tags: Anaesthesist Source Type: research

[Palliative medicine in emergency medical services].
Abstract The scope of emergency calls for emergency medical services staffed by an emergency physician (EMS-EP) includes calls to patients with life-limiting diseases. Symptom exacerbation as well as psychosocial overburdening of caring relatives are the most frequent reasons for activation of an EMS-EP. Pain crises, acute dyspnea, massive bleeding and/or an impending or overt cardiac arrest are the most frequent symptom exacerbations. Under the conditions of a prehospital emergency physician mission, particular challenges are the evaluation of the overall situation, the prognosis and the presumed will of the...
Source: Der Anaesthesist - March 21, 2018 Category: Anesthesiology Authors: Roessler M, Eulitz N Tags: Anaesthesist Source Type: research

[Influence of social characteristics on the duration of treatment, severity of the disease and social support of patients in a surgical intensive care unit].
CONCLUSION: In addition to the SES, sociodemographic characteristics of the individual patient are associated with the course of treatment in intensive care medicine. The extent of social support by the next of kin depends on intercultural and individual patient characteristics. An increasing size of the town of residence and private health insurance status positively influence intensive care outcomes. In order to evaluate these data, further epidemiological studies in intensive care medicine are necessary. PMID: 29564474 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 21, 2018 Category: Anesthesiology Authors: Blecha S, Schlitt HJ, Graf BM, Leitzmann M, Bein T Tags: Anaesthesist Source Type: research

[Epigenetics : Important aspects for anesthesiologists, pain and intensive care physicians].
HL Abstract Epigenetics, i.e. an altered reading of the genome without altering the genes themselves is a growing scientific field. A distinction is made between changes in the DNA by modification of the histones and non-coding RNA that alter the messenger (m)RNAs. Epigenetic modifications can be triggered by personal circumstances or other external factors and therefore influence the occurrence of diseases. Epigenetics are therefore of particular interest to anesthesiologists, pain specialists and intensive care physicians, as anesthetic drugs may have a long-term influence on protein transcription lea...
Source: Der Anaesthesist - March 20, 2018 Category: Anesthesiology Authors: Reinhold AK, Jentho E, Schäfer ST, Bauer M, Rittner HL Tags: Anaesthesist Source Type: research

[Correction to: Telephone enquiries on the topic of malignant hyperthermia].
t H PMID: 29523895 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 9, 2018 Category: Anesthesiology Authors: Petersen B, Busch T, Meinecke CD, Bastian B, Kluba K, Kaisers UX, Rüffert H Tags: Anaesthesist Source Type: research

[Certain and controversial components of "rapid sequence induction"].
[Certain and controversial components of "rapid sequence induction"]. Anaesthesist. 2018 Mar 05;: Authors: Mencke T, Zitzmann A, Reuter DA Abstract Rapid sequence induction (RSI) is a specific technique for anesthesia induction, which is performed in patients with an increased risk for pulmonary aspiration (e.g. intestinal obstruction, severe injuries and cesarean section). The incidence of acute respiratory distress syndrome (ARDS) is very low but 10-30% of anesthesia-related deaths are caused by the consequences of ARDS. The classical RSI with its main components (i.e. head-up positio...
Source: Der Anaesthesist - March 5, 2018 Category: Anesthesiology Authors: Mencke T, Zitzmann A, Reuter DA Tags: Anaesthesist Source Type: research

[Resuscitative endovascular balloon occlusion of the aorta : Option for incompressible trunk bleeding?]
Abstract Hemorrhage is the single largest cause of avoidable death in trauma patients, whereby in civil emergency medicine in Europe most life-threatening hemorrhages occur in the abdomen and the pelvis. This is one reason why endovascular balloon occlusion of the aorta (EBOA), a procedure especially established in vascular surgery, is increasingly propagated for rapid bleeding control in these patients. This review article provides a comprehensive overview of the technique, indications, contraindications and complications of resuscitative endovascular balloon occlusion of the aorta (REBOA). Additionally...
Source: Der Anaesthesist - March 5, 2018 Category: Anesthesiology Authors: Knapp J, Bernhard M, Haltmeier T, Bieler D, Hossfeld B, Kulla M Tags: Anaesthesist Source Type: research

[Simulator model for ultrasound-guided pericardiocentesis : Construction manual and practical evaluation].
Abstract An important challenge in learning ultrasound-assisted interventions, such as pericardiocentesis, is the navigation of the needle in a three-dimensional space on the basis of a two-dimensional image. In order to learn this in vitro realistic simulators are required. We manufactured a model which allows simulation of pericardiocentesis on the basis of ballistic gelatin (12.6%, 250 Bloom). Furthermore, the pericardiocentesis model was subjectively evaluated by 37 anesthetists in a pre-post design. The models used proved to be technically simple to manufacture, hard wearing and rea...
Source: Der Anaesthesist - March 2, 2018 Category: Anesthesiology Authors: Bergold MN, Beeck H, Meininger D, Byhahn C Tags: Anaesthesist Source Type: research

[The most important publications of the year 2017 from the Working Group Neuroanesthesia].
PMID: 29500579 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - March 2, 2018 Category: Anesthesiology Authors: Pilge S, Zanner R Tags: Anaesthesist Source Type: research

[Entrustable professional activities : Promising concept in postgraduate medical education].
Abstract Entrustable professional activities (EPAs) are characterized as self-contained units of work in a given typical clinical context, which may be entrusted to a trainee for independent execution at a certain point of training. An example could be the intraoperative anesthesia management of an ASA 1 patient for an uncomplicated surgical intervention as an EPA in early postgraduate anesthesia training. The EPAs can be described as an evolution of a competency-based medical educational concept, applying the concept of the competencies of a person to specific workplace contexts. In this way t...
Source: Der Anaesthesist - March 2, 2018 Category: Anesthesiology Authors: Breckwoldt J, Beckers SK, Breuer G, Marty A Tags: Anaesthesist Source Type: research

[Deep neuromuscular blockade : Benefits and risks].
Abstract Neuromuscular blockade (TOF count = 0) can improve tracheal intubation and microlaryngeal surgery. It is also frequently used in many surgical fields including both nonlaparoscopic and laparoscopic surgery to improve surgical conditions and to prevent sudden muscle contractions. Currently there is a controversy regarding the need and the clinical benefits of deep neuromuscular blockade for different surgical procedures. Deep neuromuscular relaxation improves laparoscopic surgical space conditions only marginally when using low intra-abdominal pressure. There is no outcome-relevant advantage ...
Source: Der Anaesthesist - March 1, 2018 Category: Anesthesiology Authors: Unterbuchner C, Blobner M Tags: Anaesthesist Source Type: research

[Full relaxation: magic bullet or marketing gag?]
PMID: 29487954 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 27, 2018 Category: Anesthesiology Authors: Fuchs-Buder T Tags: Anaesthesist Source Type: research

[Outpatient palliative medicine : Attitudes in the care of palliative emergencies. Prospective questionnaire-based investigation].
CONCLUSION: Outpatient palliative care in Germany has developed very positively during the last years; however, there are still deficits in terms of optimal patient care, one of which refers to the treatment of palliative care emergencies. In this context, optimization in the cooperation between outpatient palliative care services and emergency medical services should be discussed. PMID: 29480318 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 26, 2018 Category: Anesthesiology Authors: Wiese CHR, Silbereisen VMC, Graf BM, Bundscherer AC, Lassen CL Tags: Anaesthesist Source Type: research

[Abortive course of malignant hyperthermia following preclinical induction of general anesthesia using succinylcholine].
Abstract In a 59-year-old woman with a perforating eyeball injury to the right eye, the emergency physician induced a preclinical general anesthesia with propofol, fentanyl and the depolarizing muscle relaxant succinylcholine. Anesthesia was maintained using propofol and remifentanil infusion throughout the preoperative period and the subsequent surgical procedure. Postoperatively, isolated rhabdomyolysis with an increase in serum creatine kinase to>20,000 U/l was observed. The diagnosis of malignant hyperthermia (MH) susceptibility could be confirmed in the patient 4 months after the acute event by...
Source: Der Anaesthesist - February 26, 2018 Category: Anesthesiology Authors: Helf D, Schneiderbanger D, Markus CK, Johannsen S, Schuster F Tags: Anaesthesist Source Type: research

[Severe caffeine poisoning with rhabdomyolysis].
We report the case of a young man who took a large amount of caffeine powder dissolved in water in a suicide attempt. He was found comatose. The initial diagnosis was difficult. In hospital he suffered from rhabdomyolysis with renal failure and sepsis rapidly developed. After renal replacement treatment with hemodialysis, long-term artificial ventilation with tracheotomy and a 3‑week stay in the intensive care unit, the patient could be discharged to a rehabilitation center. PMID: 29468414 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 21, 2018 Category: Anesthesiology Authors: Wolter J, Grün D, Otto S Tags: Anaesthesist Source Type: research

[Hypovolemic and hemorrhagic shock].
Abstract The term "shock" refers to a life-threatening circulatory failure caused by an imbalance between the supply and demand of cellular oxygen. Hypovolemic shock is characterized by a reduction of intravascular volume and a subsequent reduction in preload. The body compensates the loss of volume by increasing the stroke volume, heart frequency, oxygen extraction rate, and later by an increased concentration of 2,3-diphosphoglycerate with a rightward shift of the oxygen dissociation curve. Hypovolemic hemorrhagic shock impairs the macrocirculation and microcirculation and therefore affe...
Source: Der Anaesthesist - February 5, 2018 Category: Anesthesiology Authors: Lier H, Bernhard M, Hossfeld B Tags: Anaesthesist Source Type: research

Catecholamine crisis during induction of general anesthesia : A  case report.
We report the case of a 75-year-old male who developed a hypertensive crisis during induction of general anesthesia for elective resection of a cervical neuroma due to an undiagnosed pheochromocytoma. Hemodynamic instability occurred immediately after the injection of fentanyl, propofol and rocuronium, prior to laryngoscopy and in the absence of any manipulation of the abdomen. In this case report, we present the management of this incident and discuss the underlying pathophysiology triggering a catecholamine crisis. PMID: 29404657 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 5, 2018 Category: Anesthesiology Authors: Sonntagbauer M, Koch A, Strouhal U, Zacharowski K, Weber CF Tags: Anaesthesist Source Type: research

[Miscommunication as a risk focus in patient safety : Work process analysis in prehospital emergency care].
CONCLUSION: A better interface communication helps to coordinate patient transfer and is an option for optimizing resources. Frequent training in communication is an option to avoid incidents. PMID: 29404658 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - February 5, 2018 Category: Anesthesiology Authors: Wilk S, Siegl L, Siegl K, Hohenstein C Tags: Anaesthesist Source Type: research

Efficacy of external nasal nerve block following nasal surgery : A  randomized, controlled trial.
In this study 100 adult patients who were scheduled for elective external nasal surgery with the patient under general anesthesia and nasal packing on each side, received external nasal nerve blocks postoperatively for 24 h with saline (group I) or 2% xylocaine (group II) with 1:200,000 epinephrine. Postoperative pain was measured at the postanesthesia care unit (PACU) utilizing a visual analog scale (VAS). Narcotics consumption was also measured. Emergence agitation and quality of recovery were also assessed. RESULTS: Pain scores were statistically significant between both groups. Requirements of equivale...
Source: Der Anaesthesist - February 1, 2018 Category: Anesthesiology Authors: Ibrahim M, Elnabtity AM, Keera A Tags: Anaesthesist Source Type: research

Thyromental distance ("Patil") revisited : Knowledge and performance of a  basic airway screening tool among European anesthetists.
Thyromental distance ("Patil") revisited : Knowledge and performance of a basic airway screening tool among European anesthetists. Anaesthesist. 2018 Feb 01;: Authors: Ilper H, Grossbach A, Franz-Jäger C, Byhahn C, Klages M, Ackermann HH, Zacharowski K, Kunz T Abstract Predicting and managing the difficult airway is a lifesaving and vital basic task for the anesthetist. Current guidelines of all important societies include thyromental distance (TMD, "Patil") as a possible predictor for a difficult airway and includes two important aspects for airway management: the m...
Source: Der Anaesthesist - February 1, 2018 Category: Anesthesiology Authors: Ilper H, Grossbach A, Franz-Jäger C, Byhahn C, Klages M, Ackermann HH, Zacharowski K, Kunz T Tags: Anaesthesist Source Type: research

[Oncology in anesthesia and operative intensive care medicine].
PMID: 29387894 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 31, 2018 Category: Anesthesiology Authors: Sinner B Tags: Anaesthesist Source Type: research

Bacterial sepsis : Diagnostics and calculated antibiotic therapy.
Abstract The mortality of patients with sepsis and septic shock is still unacceptably high. An effective calculated 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 infection and individual risks of each patient, local resistance patterns and specific problem pathogens must be taken into account during the selection of anti-infective treatment. Many pathophy...
Source: Der Anaesthesist - January 30, 2018 Category: Anesthesiology Authors: Richter DC, Heininger A, Brenner T, Hochreiter M, Bernhard M, Briegel J, Dubler S, Grabein B, Hecker A, Kruger WA, Mayer K, Pletz MW, Storzinger D, Pinder N, Hoppe-Tichy T, Weiterer S, Zimmermann S, Brinkmann A, Weigand MA, Lichtenstern C Tags: Anaesthesist Source Type: research

[Cancer patients in operative intensive care medicine].
k M Abstract Cancer is one of the leading causes of death worldwide. New targeted and individualized therapies and drugs provide a survival benefit for an increasing number of patients, but can also cause severe side effects. An increasing number of oncology patients are admitted to intensive care units (ICU) because of cancer-related complications or treatment-associated side effects. Postoperative care, respiratory distress and sepsis are the leading causes for admission. Tumor mass syndromes and tumor lysis may require urgent treatment. Traditional anticancer chemotherapy is associated with infections and ...
Source: Der Anaesthesist - January 24, 2018 Category: Anesthesiology Authors: Annecke T, Hohn A, Böll B, Kochanek M Tags: Anaesthesist Source Type: research

[Preclinical emergency medicine-thinking outside the box is worth it!]
PMID: 29352363 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 19, 2018 Category: Anesthesiology Authors: Bernhard M, Gries A Tags: Anaesthesist Source Type: research

[Accidental central venous administation of 0.1  % chlorhexidine mouthwash].
We describe a case of central venous administration of 0.1% CHX mouthwash, its potential complications and possibilities of treatment. In contrast to another case report our patient had no detectable adverse side effects. The immediate hemofiltration and cleansing of the i. v. line may have contributed to this favorable outcome. PMID: 29352364 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 19, 2018 Category: Anesthesiology Authors: Ploner M, Löffel LM, Schüpfer G, Besmer I, Konrad CJ Tags: Anaesthesist Source Type: research

[Anesthesia problem cards-indispensable yet problematic : Nationwide survey on experiences from clinical practice].
CONCLUSION: Anesthesia problem cards are considered a useful tool to increase patient safety and are frequently issued in clinical practice; however, in the document's current form its full potential for risk minimization cannot be exploited. Structural changes are required to increase documentation quality and reproducibility. Concerning its informational content, the spectrum of included complications and their individual solutions need to be expanded to meet the requirements of modern anesthetic practice. PMID: 29352365 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 19, 2018 Category: Anesthesiology Authors: Schieren M, Böhmer A, Golbeck W, Defosse J, Wappler F, Marcus HE Tags: Anaesthesist Source Type: research

[Drugs for intravenous induction of anesthesia: propofol].
Abstract In a series of articles dealing with hypnotics for induction of anesthesia, this article describes the development and current value of propofol. Its significance far exceeds that of a pure induction hypnotic (sedation in diagnostic and therapeutic procedures and on the intensive care unit). Propofol is also used for sedation in diagnostic and therapeutic procedures and on the intensive care unit. In the field of induction of anesthesia, the alternatives are barely used. Some contraindications are still controversial whereas others are no longer sufficiently anchored in the users' awareness (wid...
Source: Der Anaesthesist - January 15, 2018 Category: Anesthesiology Authors: Bolkenius D, Dumps C, Halbeck E Tags: Anaesthesist Source Type: research

[Antibiotic stewardship : Measures for optimizing prescription of anti-infective agents].
Abstract Antibiotic stewardship (ABS) comprises a bundle of different interventions to improve anti-infective treatment in a hospital setting. An important component of ABS interventions is the interdisciplinary approach to infection management. Besides improving infrastructural aspects on a hospital level, including surveillance of the use of anti-infective agents and nosocomial infections, collation and interpretation of statistics on resistance and formulation of local treatment guidelines, ABS teams go to the wards and advise treating physicians on antibiotic therapy. Frequent approaches for opt...
Source: Der Anaesthesist - January 8, 2018 Category: Anesthesiology Authors: Lanckohr C, Bracht H Tags: Anaesthesist Source Type: research

Out-of-hospital airway management during manual compression or automated chest compression devices : A  registry-based analysis.
Out-of-hospital airway management during manual compression or automated chest compression devices : A registry-based analysis. Anaesthesist. 2018 Jan 04;: Authors: Bernhard M, Behrens NH, Wnent J, Seewald S, Brenner S, Jantzen T, Bohn A, Gräsner JT, Fischer M Abstract BACKGROUND: Airway management during resuscitation is pivotal for treating hypoxia and inducing reoxygenation. This German Resuscitation Registry (GRR) analysis investigated the influence of the type of airway used in patients treated with manual chest compression (mCC) and automated chest compression devices (ACCD) after out-...
Source: Der Anaesthesist - January 4, 2018 Category: Anesthesiology Authors: Bernhard M, Behrens NH, Wnent J, Seewald S, Brenner S, Jantzen T, Bohn A, Gräsner JT, Fischer M Tags: Anaesthesist Source Type: research

[Perioperative bleeding in a  Jehovah's Witness].
We report the case of a 45-year-old man, who refused to accept red blood cell concentrates by a patient directive. A postoperative bleeding occurred after removal of a transplanted kidney. Despite critically low hemoglobin (3.1 g/dl) and hematocrit (9.5%) levels, the case was managed without red blood cell transfusions. The patient showed an amazingly quick recovery and was discharged from hospital after 24 days without any sequelae. PMID: 29294161 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - January 2, 2018 Category: Anesthesiology Authors: Heschl S, Schörghuber M, Kröll W Tags: Anaesthesist Source Type: research

[Antibiotic stewardship in a basic care hospital : A retrospective observational study].
Abstract BACKGROUND: In response to the global increase in antibiotic resistance, the concept of antibiotic stewardship (ABS) has become increasingly important in recent years. Several publications have demonstrated the effectiveness of ABS, mainly in university facilities. This retrospective observational study describes the implementation of ABS in a basic care hospital. MATERIAL AND METHODS: Following existing national guidelines, an ABS team was set up and measures were launched. These included: hospital guidelines, teaching, weekly antibiotic ward rounds and the restriction of definite substances. T...
Source: Der Anaesthesist - January 2, 2018 Category: Anesthesiology Authors: Bonsignore M, Balamitsa E, Nobis C, Tafelski S, Geffers C, Nachtigall I Tags: Anaesthesist Source Type: research

[Intramedullary injection with tethered cord : Case report of a rare complication during spinal anesthesia].
This report describes and analyses a case of spinal injury due to an undiagnosed tethered cord (TC) during spinal anesthesia for a cesarean section of a 31-year-old woman expecting twins. As a consequence of spinal dysraphism during embryogenesis, an atypically low conus level can occur and increase the risk of injury during neuraxial anesthesia, especially in the absence of symptoms. Injuries can be caused by mechanical trauma from direct needle injury, hematoma or neurotoxicity from local anesthetics. Special attention should therefore be paid to frequent symptoms, such as a hairy nevus on the back, deformities...
Source: Der Anaesthesist - December 21, 2017 Category: Anesthesiology Authors: Vogt L, Rodermond B, Post P, Iborra S, Stickeler E, Schiefer J, Alt JP, Rossaint R, Röhl A Tags: Anaesthesist Source Type: research

[Acute perioperative right heart insufficiency : Diagnostics and treatment].
CA Abstract Acute right heart failure is often overlooked as a cause of cardiopulmonary insufficiency. The various pathologies underlying right heart failure at the level of afterload, preload and contractility, make rapid, targeted diagnostics necessary. In addition to clinical symptoms and laboratory chemical parameters, echocardiography in particular is relevant for making a diagnosis. Symptomatic treatment of the endangered patient is essential. The focus is on a reduction of right ventricular pressure and afterload, a correction of systemic hypotension and positive inotropic support of the right ve...
Source: Der Anaesthesist - December 21, 2017 Category: Anesthesiology Authors: Schäfer B, Greim CA Tags: Anaesthesist Source Type: research

[Comments on: Daytime variation of perioperative myocardial injury in cardiac surgery].
e C PMID: 29234824 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - December 12, 2017 Category: Anesthesiology Authors: Schälte G, Stoppe C Tags: Anaesthesist Source Type: research

[Fulminant sepsis after Capnocytophaga canimorsus infection].
Abstract Capnocytophaga canimorsus is a Gram-negative bacterium present in the oral cavities of cats and dogs. It is known for its capability to cause life-threatening sepsis following a dog bite, especially in immunocompromised patients. We report the case of a 67-year-old man who suffered from septic shock and multiorgan failure presumably following contamination of a pre-existing minor skin lesion by canine saliva. The purpose of this report is to raise awareness of Capnocytophaga canimorsus among physicians when faced with a patient presenting with fulminant septic shock and Gram-negat...
Source: Der Anaesthesist - December 11, 2017 Category: Anesthesiology Authors: Feige K, Hartmann P, Lutz JT Tags: Anaesthesist Source Type: research

[Analysis and options for optimization of preoperative assessment for anesthesia at a  university hospital].
CONCLUSION: The analysis of processes and problems in the context of preoperative assessment for anesthesia revealed several options for optimization. Major efforts should be the implementation of an appointment system for the preoperative assessment clinic in order to generate a homogeneous distribution of patients during the course of a day. Furthermore, surgeons and case managers should be requested to refer patients to the preoperative assessment clinic only with complete records and test results according to the in-house standard. PMID: 29230500 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - December 11, 2017 Category: Anesthesiology Authors: Kieninger M, Eissnert C, Seitz M, Judemann K, Seyfried T, Graf B, Sinner B Tags: Anaesthesist Source Type: research

[Development of ground-based physician-staffed emergency missions in the city of Leipzig from 2003 to 2013].
r A Abstract BACKGROUND: The annual number of physician-based emergency missions reported is continuously increasing. Data from large cities concerning this development over long periods is sparse. MATERIAL AND METHODS: In this retrospective study the charts of all ground-based physician-staffed emergency missions in the city of Leipzig for the first quarters of 2003 and 2013 were analyzed. Patient characteristics, injury and illness severities, mission location, hospital admission rate, as well as emergency interventions were collated. The emergency mission rate was calculated as rescue missions per 1000 inh...
Source: Der Anaesthesist - December 11, 2017 Category: Anesthesiology Authors: Bader K, Bernhard M, Gries A, Kaul M, Schröder R, Ramshorn-Zimmer A Tags: Anaesthesist Source Type: research

[Acceptance of post-mortem organ donation in Germany : Representative cross-sectional study].
CONCLUSION: Education on organ donation can be a means to increase organ donation rates. The effects of the change in legislation and the establishment of the transplant register need to be evaluated. Further research regarding the influence of religion, especially among religious minorities, on organ donation rates in Germany needs to be conducted to identify possible obstacles. Moreover, the use of social networks to address potential organ donors has proven to increase registration numbers and could easily be implemented in Germany. PMID: 29230502 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - December 11, 2017 Category: Anesthesiology Authors: Tackmann E, Dettmer S Tags: Anaesthesist Source Type: research