[Introduction of Prehospital Emergency Ultrasound into an Emergency Medical Service Area].
CONCLUSION: Prehospital emergency ultrasound can be introduced into an emergency medical service area as a diagnostic modality that provides benefits to patients. Emergency physicians have to be specifically trained and to participate in continuous education activities. Especially in rural areas with longer transport routes and journey times, the early diagnosis of for example massive intra-abdominal bleeding is critical for the patient's prognosis. PMID: 27942784 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - December 9, 2016 Category: Anesthesiology Authors: Weilbach C, Kobiella A, Rahe-Meyer N, Johanning K Tags: Anaesthesist Source Type: research

[Factor  XIII : Pharmacodynamic and pharmacokinetic characteristics].
[Factor XIII : Pharmacodynamic and pharmacokinetic characteristics]. Anaesthesist. 2016 Dec 09; Authors: Adam EH, Kreuer S, Zacharowski K, Weber CF, Wildenauer R Abstract Factor XIII (FXIII) plays an important role in the field of blood coagulation. In the last decade, both congenital and acquired deficiencies have been investigated in clinical studies. FXIII is a versatile enzyme that leads to a covalent cross-linking of fibrin fibrils at the end of the clotting cascade and supports platelet adhesion to the damaged sub-endothelium with the result of a mechanically stable clot.Symptoms of FX...
Source: Der Anaesthesist - December 9, 2016 Category: Anesthesiology Authors: Adam EH, Kreuer S, Zacharowski K, Weber CF, Wildenauer R Tags: Anaesthesist Source Type: research

[Ventilator-associated pneumonia (VAP) : A  risk already at the time of anesthetic induction].
This article considers measures to prevent VAP during general anesthesia in adult patients (>18 years). Procedures beyond standard hygienic precautions for VAP prevention are reviewed. METHODS: A literature search in different databases (PubMed, Cochrane, Ovid und CINAHL) over the last five years. RESULTS: Beyond standard hygienic precautions, microaspiration should be avoided to prevent VAP. During mechanical ventilation at least 5 cm H2O PEEP is advised. Continuous monitoring and adjustment of cuff pressure is necessary. All patients mechanically ventilated after general anesthesia for more than ...
Source: Der Anaesthesist - December 9, 2016 Category: Anesthesiology Authors: Vetter L, Konrad C, Schüpfer G, Rossi M Tags: Anaesthesist Source Type: research

[Full-scale simulation in German medical schools and anesthesia residency programs : Status quo].
CONCLUSIONS: Important first steps have been taken to implement full-scale simulation in Germany. In addition to programs for medical students courses for physicians and nurses are available today. To reach everyone clinically involved in German anesthesiology on a regular basis the current capacities need to be dramatically increased. The basis for that to happen will be new concepts for funding, possibly supported by external requirements such as the national model curriculum for residency in anesthesiology. PMID: 27942787 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - December 9, 2016 Category: Anesthesiology Authors: Baschnegger H, Meyer O, Zech A, Urban B, Rall M, Breuer G, Prückner S Tags: Anaesthesist Source Type: research

[The old man and the I sea U : Essay on faith, fate and evidence - after the manner of Hemingway].
Abstract Robert Bartlett, emeritus Professor of surgery at the University of Michigan in Ann Arbor, USA, transformed classical works of world literature (Charles Dickens: A Christmas Carol, Lewis Carroll: Alice in Wonderland) into teaching aids for advanced training in intensive care medicine. He recently turned his hand to the well-known work of Ernest Hemingway: the Nobel Prize winning novel The Old Man and the Sea. Subsequent to Robert Bartlett's essay this article provides background information and comments on the current problems in modern intensive care medicine addressed in his essay. PMID: 27924353 [...
Source: Der Anaesthesist - December 6, 2016 Category: Anesthesiology Authors: Lewandowski K, Bartlett RH Tags: Anaesthesist Source Type: research

Recommendations of the German Association of Anesthesiology and Intensive Care Medicine (DGAI) on structured patient handover in the perioperative setting : The SBAR concept.
Abstract Teamwork in the operating room and in the intensive care unit necessitates clear and precise communication; however, interruptions in communication frequently occur, especially in the perioperative phase. Patients are particularly susceptible to deficits in communication, e.g. due to higher stress peaks, simultaneous admission of several patients and concomitant treatment of emergency cases. The German Society of Anesthesiology and Intensive Care Medicine (DGAI) therefore recommends the implementation of the so-called SBAR concept (S situation, B background, A assessment, R recommendation) for standardiza...
Source: Der Anaesthesist - November 29, 2016 Category: Anesthesiology Authors: von Dossow V, Zwissler B Tags: Anaesthesist Source Type: research

[Comment on: Dexmedetomidine for delirium prophylaxis in elderly patients after non-cardiac surgery in the intensive care unit].
PMID: 27900414 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - November 29, 2016 Category: Anesthesiology Authors: Van Waesberghe J, Eisert A, Coburn M Tags: Anaesthesist Source Type: research

[Management of anesthesia in endovascular interventions].
h T Abstract Cardiovascular diseases are one of the leading causes of morbidity and mortality in Germany. In these patients, the high-risk profile necessitates an interdisciplinary and multimodal approach to treatment. Endovascular interventions and vascular surgery have become established as an important element of this strategy in the past; however, the different anatomical localizations of pathological vascular alterations make it necessary to use a wide spectrum of procedural options and methods; therefore, the requirements for management of anesthesia are variable and necessitate a differentiated ap...
Source: Der Anaesthesist - November 29, 2016 Category: Anesthesiology Authors: Rössel T, Paul R, Richter T, Ludwig S, Hofmockel T, Heller AR, Koch T Tags: Anaesthesist Source Type: research

[Intensive care treatment after aneurysmal subarachnoid hemorrhage].
Abstract Aneurysmal subarachnoid hemorrhage (SAH) is a devastating disease and nearly one third of patients die in the acute phase. Due to the bleeding event, a hyperactive sympathetic nervous system and an uncontrolled inflammatory response have a profound local and systemic impact on other organ functions. Neuroendocrinological disorders and cardiopulmonary morbidity are dominant. Despite a decrease in hospital mortality for high volume centers, a high proportion of survivors suffer from neurological deficits. Knowledge of the pathophysiology of vasospasms in the later stages of the disease has in...
Source: Der Anaesthesist - November 29, 2016 Category: Anesthesiology Authors: Jaschinski U Tags: Anaesthesist Source Type: research

[Extracorporeal CO2 removal as an alternative to tracheotomy in a  patient with extubation failure].
We report a patient with chest trauma who was admitted to the ICU after surgery. As he fulfilled protocol-based criteria, he was extubated 7 days after admission. However, despite intermittent non-invasive ventilation, the patient had to be re-intubated on day 10 owing to progressive hypercapnia. We decided to support the patient with a mid-flow veno-venous extracorporeal carbon dioxide removal (ECCO2‑R) system instead of a tracheotomy. Sufficient CO2 removal was established with a blood flow of 1.5 l/min and the patient was successfully extubated within a few hours. After 5 days of E...
Source: Der Anaesthesist - November 28, 2016 Category: Anesthesiology Authors: Redel A, Ritzka M, Kraus S, Philipp A, Schlitt HJ, Graf B, Bein T Tags: Anaesthesist Source Type: research

[Highest level of clinical competence for endovascular interventions].
PMID: 27882390 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - November 23, 2016 Category: Anesthesiology Authors: Pestel G Tags: Anaesthesist Source Type: research

[The basis for well-founded simulations].
Abstract In medical education, simulation is gaining increasing importance for teaching a variety of subjects. A well-founded educational approach is necessary for effective use. In addition to material aspects, simulation environment, curriculum, learning environment, and methods of debriefing have to be considered. The role of a competent instructor should be emphasized and the importance of an elaborate change management process to implement a good concept should not be underestimated. PMID: 27832294 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - November 10, 2016 Category: Anesthesiology Authors: Meyer O, Rall M, Baschnegger H, Lazarovici M, Urban B Tags: Anaesthesist Source Type: research

[Under scrutiny by the state prosecutor : Legal pitfalls in emergency medicine].
Abstract Physicians who allow a suicide attempt to happen, which from an ex ante viewpoint was completely voluntary, cannot be held punishable for homicide or failing to provide medical assistance when the suicide corresponds to the putative will of the patient according to plausible information supplied by an authorized person with healthcare proxy. Guidelines for resuscitation also play a central role in the forensic practice for assessment of whether and when resuscitation can be terminated; therefore, it is urgently advised to follow and implement these guidelines: deviations are possible if they can be factua...
Source: Der Anaesthesist - November 3, 2016 Category: Anesthesiology Authors: Schelling P Tags: Anaesthesist Source Type: research

[Anesthesia for medical students : A brief guide to practical anesthesia in adults with a web-based video illustration].
Abstract In Germany, Austria and Switzerland, anesthesiologists are the second largest group of physicians in hospitals, but this does not correspond to the amount of anesthesiology teaching that medical students receive in medical schools. Accordingly, the chances of medical students recognizing anesthesiology as a promising personal professional career are smaller than in other disciplines with large teaching components. Subsequent difficulties to recruit anesthesiology residents are likely, although many reasons support anesthesiology as a professional career.Traditional strategies to teach medical st...
Source: Der Anaesthesist - October 27, 2016 Category: Anesthesiology Authors: Mathis S, Schlafer O, Abram J, Kreutziger J, Paal P, Wenzel V Tags: Anaesthesist Source Type: research

[Comment on: Decompressive craniectomy after traumatic brain injury].
n M PMID: 27787572 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - October 27, 2016 Category: Anesthesiology Authors: Höllig A, Coburn M Tags: Anaesthesist Source Type: research

[Comment on: Andexanet alfa for Acute Major Bleeding Associated with Factor Xa Inhibitors.]
PMID: 27778054 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - October 24, 2016 Category: Anesthesiology Authors: Lier H, Grottke O Tags: Anaesthesist Source Type: research

[Necessitas not habet legem? : The physician's tension between professional ethics and patient wishes].
PMID: 27778055 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - October 24, 2016 Category: Anesthesiology Authors: Biermann E Tags: Anaesthesist Source Type: research

[Unilateral spinal anesthesia : Literature review and recommendations].
n I Abstract Unilateral spinal anesthesia is a cost-effective and rapidly performed anesthetic technique. An exclusively unilateral block only affects the sensory, motor and sympathetic functions on one side of the body and offers the advantages of a spinal block without the typical adverse side effects seen with a bilateral block. The lack of hypotension, in particular, makes unilateral spinal anesthesia suitable for patients with cardiovascular risk factors e. g. aortic valve stenosis or coronary artery disease. Increasing numbers of surgical procedures are now being performed on an outpati...
Source: Der Anaesthesist - October 24, 2016 Category: Anesthesiology Authors: Büttner B, Mansur A, Bauer M, Hinz J, Bergmann I Tags: Anaesthesist Source Type: research

Erratum zu: Geschichte der An ästhesie – „Vom Narkotiseur zum perioperativen Homöostatiker“.
Erratum zu: Geschichte der Anästhesie – „Vom Narkotiseur zum perioperativen Homöostatiker“. Anaesthesist. 2016 Oct 17; Authors: Petermann H, Goerig M PMID: 27752712 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - October 17, 2016 Category: Anesthesiology Authors: Petermann H, Goerig M Tags: Anaesthesist Source Type: research

Ultrasound-guided intermediate cervical plexus block and perivascular local anesthetic infiltration for carotid endarterectomy : A  randomized controlled trial.
CONCLUSION: For ultrasound-guided intermediate blocks of the cervical plexus, an additional periarterial infiltration showed no advantage. Abandoning this technique leads to a relevant simplification of the blocking technique and tends to reduce block-related side effects. PMID: 27742968 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - October 14, 2016 Category: Anesthesiology Authors: Seidel R, Zukowski K, Wree A, Schulze M Tags: Anaesthesist Source Type: research

Stress-coping styles of 459  emergency care physicians in Germany : A pilot study.
Stress-coping styles of 459 emergency care physicians in Germany : A pilot study. Anaesthesist. 2016 Oct 14; Authors: Sand M, Hessam S, Sand D, Bechara FG, Vorstius C, Bromba M, Stockfleth E, Shiue I Abstract AIM: In addition to assessing stress-coping strategies in patients, equal attention should be paid to health-care professionals. The literature on the stress-coping strategies of emergency physicians - health-care professionals who are frequently subject to stress in a fast-paced clinical setting - is scant. Therefore, we aimed to investigate the stress-coping strategies of em...
Source: Der Anaesthesist - October 14, 2016 Category: Anesthesiology Authors: Sand M, Hessam S, Sand D, Bechara FG, Vorstius C, Bromba M, Stockfleth E, Shiue I Tags: Anaesthesist Source Type: research

[Perioperative adverse respiratory events in overweight and obese children].
e C Abstract BACKGROUND: Overweight and obesity are increasing problems in pediatric anesthesia. This observational study was designed to examine how airway-related complications occur in overweight children and adolescents during general anesthesia and if this is a relevant problem in Germany. METHODS: From October 2008 until August 2009, at the university clinic in Leipzig, 504 in- and outpatients, aged 2-18 years, ASA I-III, undergoing elective procedures (ENT and pediatric surgery), were observed. With the aid of special data sheets, the following parameters were determined: Mallampati Scor...
Source: Der Anaesthesist - October 10, 2016 Category: Anesthesiology Authors: Ulrici J, Hempel G, Sasse M, Vollrath J, Höhne C Tags: Anaesthesist Source Type: research

[Injuries to blood vessels near the heart caused by central venous catheters].
We report 6 patients in whom injury to the subclavian artery and vein led to life-threatening complications. Central venous catheters are associated with a multitude of risks, such as venous thrombosis, air embolism, systemic or local infections, paresthesia, hemothorax, pneumothorax, and cervical hematoma, which are not always immediately discernible. The subclavian catheter is at a somewhat lower risk of catheter-associated sepsis and symptomatic venous thrombosis than approaches via the internal jugular and femoral veins. Indeed, access via the subclavian vein carries a substantial risk of pneumo- and hemothorax. Damage...
Source: Der Anaesthesist - October 5, 2016 Category: Anesthesiology Authors: Abram J, Klocker J, Innerhofer-Pompernigg N, Mittermayr M, Freund MC, Gravenstein N, Wenzel V Tags: Anaesthesist Source Type: research

[Impairment of oxygenation of patients in surgical intensive care : Early symptom of severe sepsis].
CONCLUSION: An urgent worsening of pulmonary function in patients in intensive care requires immediate differential diagnostics due to substantial therapeutic consequences. Our results confirm that impairment of pulmonary oxygenation is the first prognostic symptom of severe onset of sepsis. Consequently, we recommend that this parameter be considered in diagnostic staging. After exclusion of a few differential diagnoses impairment of oxygenation can be the very first symptom of severe sepsis. The patient's age and time to sufficient antibiotic therapy are two very important prognostic factors with respect to mortalit...
Source: Der Anaesthesist - October 5, 2016 Category: Anesthesiology Authors: Hückstädt M, Hofmann GO, Mendel T, Stuttmann R, Hilbert-Carius P Tags: Anaesthesist Source Type: research

[Autonomy and welfare in intensive care medicine : Practical approach in difficult situations].
on F Abstract In intensive care units far-reaching decisions are often made at short notice that require the consent of the informed patient. If this is not possible due to the patient's condition, physicians and legal representatives must ascertain the previously expressed or presumed will of the patient and act accordingly. The legal principles are specified in the Patient Advance Directives Act and the Patient Rights Act. Any indications for medical treatment need a clearly defined aim of the therapy, which can be questioned during the progress of the disease. To avoid conflicts between patient autonomy an...
Source: Der Anaesthesist - September 29, 2016 Category: Anesthesiology Authors: Gruß M, Salomon F Tags: Anaesthesist Source Type: research

[Simulation-based training and OR apprenticeship for medical students : A  prospective, randomized, single-blind study of clinical skills].
CONCLUSION: With the methods applied, this study could not prove that 225 min of SBT before the operating room apprenticeship increased the medical students' clinical skills as evaluated in the operating room. Secondary endpoints indicate that medical students have better clinical skills at the end of the entire curriculum when they have been trained through SBT before the operating room apprenticeship. However, the authors believe that simulator training has a positive impact on students' acquisition of procedural and patient safety skills, even if the methods applied in this study may not mirror this aspect suf...
Source: Der Anaesthesist - September 27, 2016 Category: Anesthesiology Authors: Ott T, Schmidtmann I, Limbach T, Gottschling PF, Buggenhagen H, Kurz S, Pestel G Tags: Anaesthesist Source Type: research

[History of anesthesia : "From narcosis to perioperative homeostasis"].
[History of anesthesia : "From narcosis to perioperative homeostasis"]. Anaesthesist. 2016 Sep 21; Authors: Petermann H, Goerig M Abstract In the western World 16 October 1846 is often called "Ether Day", marking the beginning of anesthesia. Before that date, for physicians there was only a struggle against pain. In the following 170 years all fields of general anesthesia as well as regional and local anesthesia were continuously developed. Pharmacological developments and technical innovations made this evolution possible. The complexity of this field of medicine require...
Source: Der Anaesthesist - September 21, 2016 Category: Anesthesiology Authors: Petermann H, Goerig M Tags: Anaesthesist Source Type: research

[Knowledge and implementation of the S3 guideline on delirium management in Germany].
CONCLUSION: For the first time, this study documents knowledge and implementation of the German S3 guidelines for delirium in intensive care. Overall, the guidelines for delirium care are less well executed than those for sedation. With growing knowledge of the guidelines, diagnosis and treatment of delirium fits the guidelines more frequently. The facility to document a delirium score in intensive records is insufficient. Especially a nursing-based delirium strategy could possibly improve implementation of the guidelines, claiming an eight-hour screening and documentation. However, the small number of hospitals that have ...
Source: Der Anaesthesist - September 19, 2016 Category: Anesthesiology Authors: Saller T, V Dossow V, Hofmann-Kiefer K Tags: Anaesthesist Source Type: research

170  Jahre Anästhesie.
170 Jahre Anästhesie. Anaesthesist. 2016 Sep 19; Authors: Böhrer H PMID: 27646395 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - September 19, 2016 Category: Anesthesiology Authors: Böhrer H Tags: Anaesthesist Source Type: research

[Chest decompression in emergency medicine and intensive care].
Abstract Decompression of the chest is a life-saving invasive procedure for tension pneumothorax, trauma-associated cardiopulmonary resuscitation or massive haematopneumothorax that every emergency physician or intensivist must master. Particularly in the preclinical setting, indication must be restricted to urgent cases, but in these cases chest decompression must be executed without delay, even in subpar circumstances. The methods available are needle decompression or thoracentesis via mini-thoracotomy with or without insertion of a chest tube in the midclavicular line of the 2nd/3rd intercostal space ...
Source: Der Anaesthesist - September 14, 2016 Category: Anesthesiology Authors: Drinhaus H, Annecke T, Hinkelbein J Tags: Anaesthesist Source Type: research

[CHAOS in neonatal emergency care? : Tracheal agenesis in the obstetric theatre].
Abstract Tracheal agenesis (TA) is a very rare congenital malformation of unknown aetiology. It is often associated with polymalformative syndromes; the neonates commonly present a critical condition during post-natal treatment. Pathology revolves around the triad of aphonia, respiratory distress syndrome and impossibility of endotracheal intubation. In contrast to the most important differential diagnosis, i. e., congenital high airway obstruction syndrome (CHAOS), surgical airway management is also impossible due to the absence of tracheal structures. In most cases, prognosis is very poor. The c...
Source: Der Anaesthesist - September 9, 2016 Category: Anesthesiology Authors: Jansen G, Schmidt B, Mertzlufft F, Boesing T, Barthel M Tags: Anaesthesist Source Type: research

[Hemophagocytic lymphohistiocytosis : A diagnostic challenge on the ICU].
CONCLUSIONS: Because of the similar clinical presentation to that of sepsis, HLH is often not recognized, resulting in a fatal outcome. In "sepsis" patients on the ICU with deterioration despite a standard of care, HLH needs to be considered by testing for ferritin when considering differential diagnoses. The complexity of the illness requires interdisciplinary patient care with specific integration of the hematologist in the diagnostic workup and therapeutic management, because of the frequent use of chemotherapy-based immunosuppression. PMID: 27612865 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - September 9, 2016 Category: Anesthesiology Authors: Lachmann G, La Rosée P, Schenk T, Brunkhorst FM, Spies C Tags: Anaesthesist Source Type: research

[External post-mortem examination].
Abstract The external post-mortem examination in Germany is a non-delegable medical duty for determination of death, identity of the deceased, cause of death, manner of death, time of death and notifiable infectious diseases. Within the framework of rescue service missions the physician is limited to ascertaining that death has occurred. The determination of death must be reliable and is automatically followed by a complete external post-mortem examination of the body, if necessary by another physician. The certain signs of death are livor mortis, rigor mortis and putrefaction. Reliable features for the occurrence...
Source: Der Anaesthesist - September 7, 2016 Category: Anesthesiology Authors: Hartwig S Tags: Anaesthesist Source Type: research

[Complex control of the source of infection in sepsis : Extracorporeal membrane oxygenation (ECMO) as a  bridging concept for tracheal fistula repair in sepsis-associated ARDS].
[Complex control of the source of infection in sepsis : Extracorporeal membrane oxygenation (ECMO) as a bridging concept for tracheal fistula repair in sepsis-associated ARDS]. Anaesthesist. 2016 Sep 5; Authors: Weiterer S, Schmidt K, Deininger M, Ulrich A, Tochtermann U, Eberhardt R, Hofer S, Weigand MA, Brenner T Abstract Here, we present a case of a tracheal fistula due to an anastomotic insufficiency following abdominothoracic esophageal resection. Despite immediate discontinuity resection, the tracheal fistula could not be surgically closed, resulting in incomplete control of the s...
Source: Der Anaesthesist - September 5, 2016 Category: Anesthesiology Authors: Weiterer S, Schmidt K, Deininger M, Ulrich A, Tochtermann U, Eberhardt R, Hofer S, Weigand MA, Brenner T Tags: Anaesthesist Source Type: research

[Hereditary heterozygous factor VII deficiency in patients undergoing surgery : Clinical relevance].
DISCUSSION: Preoperative substitution using coagulation factor concentrates does not seem to be mandatory in patients with an FVII level ≥15 %. For decision-making on preoperative substitution, patient history of an increased tendency to bleed may be more important than the FVII level or increased INR value. PMID: 27586406 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - September 1, 2016 Category: Anesthesiology Authors: Woehrle D, Martinez M, Bolliger D Tags: Anaesthesist Source Type: research

[Erratum to: A new age of mass-casualty education?]
PMID: 27576464 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - August 30, 2016 Category: Anesthesiology Authors: Lorenz D, Armbruster W, Vogelgesang C, Hoffmann H, Pattar A, Schmidt D, Volk T, Kubulus D Tags: Anaesthesist Source Type: research

[Briefing improves the management of a difficult mask ventilation in infants : Simulator study using Web-based decision support].
e B Abstract BACKGROUND: Unanticipated airway problems in infants can rapidly develop into severe hypoxemia. Team members can provide support and suggest steps of action if a shared mental model of the next steps exists. Briefing prior to induction of anaesthesia may create such a shared mental model among all team members. OBJECTIVES: The aim of the study was to assess whether a short briefing on the recommendations for an unexpected difficult airway, developed by the Working Group on Paediatric Anaesthesia of the German Society for Anaesthesiology and Intensive Care Medicine, would influence ...
Source: Der Anaesthesist - August 26, 2016 Category: Anesthesiology Authors: St Pierre M, Breuer G, Strembski D, Schmitt C, Lütcke B Tags: Anaesthesist Source Type: research

[Erratum to: Dexmedetomidine in the treatment of acute alcohol withdrawal delirium].
PMID: 27554929 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - August 23, 2016 Category: Anesthesiology Authors: Gerresheim G, Brederlau J, Schwemmer U Tags: Anaesthesist Source Type: research

Erratum zu: Grundlegende Techniken des Wundverschlusses in der Notaufnahme.
KG PMID: 27506925 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - August 9, 2016 Category: Anesthesiology Authors: Zacher MT, Högele AM, Hanschen M, von Matthey F, Beer AK, Gebhardt F, Biberthaler P, Kanz KG Tags: Anaesthesist Source Type: research

[Preclinical fibrinolysis in patients with ST-segment elevation myocardial infarction in a rural region].
CONCLUSION: In emergency situations with long transportation times to the nearest suitable cardiac catheterisation laboratory, preclinical fibrinolysis in STEMI still represents a workable method. Success of this strategy requires particularly strong training of the emergency physicians in ECG and lysis therapy, and co-operation with nearby cardiac centres. PMID: 27503306 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - August 8, 2016 Category: Anesthesiology Authors: Viergutz T, Grüttner J, Walter T, Weiss C, Haaff B, Pollach G, Madler C, Luiz T Tags: Anaesthesist Source Type: research

[Cases and duration of mechanical ventilation in German hospitals : An analysis of DRG incentives and developments in respiratory medicine].
CONCLUSION: Due to advances in respiratory medicine, new ventilation methods have been introduced that are less prone to complications. This development has simultaneously improved survival rates. There was no evidence supporting the assumption that the duration of mechanical ventilation is influenced by the time intervals relevant for DRG grouping. However, presumably operational routines such as staff availability within early and late shifts of the hospital have a significant impact on the termination of mechanical ventilation. PMID: 27492151 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - August 5, 2016 Category: Anesthesiology Authors: Biermann A, Geissler A Tags: Anaesthesist Source Type: research

[Pulmonary hypertension : What is new in therapy?]
This article provides an overview of the new treatment recommendations in the current guidelines, e. g. for PH patients who are in intensive care units due to surgical interventions or progressive right heart insufficiency. PMID: 27492004 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - August 4, 2016 Category: Anesthesiology Authors: Sommer N, Hecker M, Tello K, Richter M, Liebetrau C, Weigand MA, Seeger W, Ghofrani A, Gall H Tags: Anaesthesist Source Type: research

[Chest pain at 32  weeks' gestation: pregnancy-related spontaneous coronary artery dissection].
[Chest pain at 32 weeks' gestation: pregnancy-related spontaneous coronary artery dissection]. Anaesthesist. 2016 Aug 2; Authors: Schmutz A, Quaas P, Grundmann S Abstract A 32-year-old woman at 32 weeks gestation presented with cardiac arrest due to ventricular tachycardia following acute chest pain at home. After immediate defibrillation with return of spontaneous circulation (ROSC), an ST segment elevation myocardial infarction due to coronary artery dissection was confirmed. Two drug-eluting stents were implanted and she was placed on dual antiplatelet therapy (DAPT). The echocardiog...
Source: Der Anaesthesist - August 2, 2016 Category: Anesthesiology Authors: Schmutz A, Quaas P, Grundmann S Tags: Anaesthesist Source Type: research

[Tracheal bronchus and contralateral pneumonectomy].
We report a patient with a tracheal bronchus on the right side presenting for left pneumonectomy, and present one possible solution to airway management. PMID: 27447936 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 22, 2016 Category: Anesthesiology Authors: Kratz S, Russo SG, Hinterthaner M, Bauer M, Bräuer A Tags: Anaesthesist Source Type: research

[The dark side of obesity].
PMID: 27447937 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 22, 2016 Category: Anesthesiology Authors: Bein T Tags: Anaesthesist Source Type: research

[Victory over surgical pain : 170 years ago the era of modern anesthesia began - but what happened in the operating theater in the time before?]
Abstract 170 years ago, on 6 October 1846, the dentist William Thomas Green Morton, sucessfully demonstrated ether anesthesia in a patient undergoing surgery in the operating theater of the Massachusetts General Hospital in Boston. He thereby put an end to the unthinkable suffering of patients who had to undergo surgery when fully conscious. Before this "discovery" surgical procedures resembled a battle for life and death. Only a few documents exist illustrating the attitude of surgeons concerning their actions and which tortures patients had to tolerate. One of the first German standard operating proced...
Source: Der Anaesthesist - July 15, 2016 Category: Anesthesiology Authors: Brandt L, Artmeier-Brandt U Tags: Anaesthesist Source Type: research

[Perioperative ventilation: naturally lung-protective!]
r T PMID: 27411522 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 13, 2016 Category: Anesthesiology Authors: Schädler D, Becher T Tags: Anaesthesist Source Type: research

[A new age of mass casuality education? : The InSitu project: realistic training in virtual reality environments].
CONCLUSION: Interactive, identifiable, and realistic training environments based on projector systems could in future enable a repetitive exercise with changes within a decision tree, in reproducibility, and within different occupational groups. With a hard- and software environment numerous accident situations can be depicted and practiced. The main expense is the creation of the virtual accident scenes. As the appropriate city models and other three-dimensional geographical data are already available, this expenditure is very low compared with the planning costs of a large-scale exercise. PMID: 274115...
Source: Der Anaesthesist - July 13, 2016 Category: Anesthesiology Authors: Lorenz D, Armbruster W, Hoffmann H, Pattar A, Schmidt D, Volk T, Kubulus D Tags: Anaesthesist Source Type: research

[Above and beyond BMI : Alternative methods of measuring body fat and muscle mass in critically ill patients and their clinical significance].
Abstract Obesity leads to better survival in critically ill patients. Although there are several studies confirming this thesis, the "obesity paradox" is still surprising from the clinician's perspective. One explanation for the "obesity paradox" is the fact that the body mass index (BMI), which is used in almost all clinical evaluations to determine weight categories, is not an appropriate measure of fat and skeletal muscle mass and its distribution in critically ill patients. In addition, height and weight are frequently estimated rather than measured. Central obesity has been identified in m...
Source: Der Anaesthesist - July 13, 2016 Category: Anesthesiology Authors: Weig T, Irlbeck T, Frey L, Paprottka P, Irlbeck M Tags: Anaesthesist Source Type: research

[Does intraoperative lung-protective ventilation reduce postoperative pulmonary complications?]
CONCLUSIONS: The use of intraoperative VT ranging from 6 to 8 ml/kg based on ideal body weight is strongly recommended. Currently, a recommendation regarding the level of PEEP during surgery is not possible. However, a PEEP increase that leads to a rise in driving pressure should be avoided. PMID: 27392439 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 8, 2016 Category: Anesthesiology Authors: Kiss T, Bluth T, Gama de Abreu M Tags: Anaesthesist Source Type: research