[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

[Aggression and subjective risk in emergency medicine : A survey].
Abstract BACKGROUND: Healthcare personnel may be faced with different degrees of violence and aggression, particularly concerning preclinical care. However, systematic data with respect to the frequency and type of violence in emergency medicine in Germany has not been researched. METHODS AND OBJECTIVES: At an anesthesiology congress, an anonymous survey was distributed about the different kinds and extent of violent acts that the participants had experienced during their work in emergency medicine. Moreover, the participants' subjective feelings toward professional and personal safety when handling emergency...
Source: Der Anaesthesist - July 8, 2016 Category: Anesthesiology Authors: Petersen S, Scheller B, Wutzler S, Zacharowski K, Wicker S Tags: Anaesthesist Source Type: research

[Intern(euron)al affairs : The role of specific neocortical interneuron classes in the interaction between acetylcholine and GABAergic anesthetics].
Abstract Acetylcholine is a neuromodulator which is released throughout the central nervous system and plays an essential role in consciousness and cognitive processes including attention and learning. Due to its 'activating' effect on the neuronal and behavioral level its interaction with anesthetics has long been of interest to anesthesiologists. It is widely held that a reduction of the release of acetylcholine by general anesthetics constitutes part of the anesthetic effect. This notion is backed by numerous human and animal studies, but is also in seeming contradiction to findings that acetylcholine activates...
Source: Der Anaesthesist - July 5, 2016 Category: Anesthesiology Authors: Liebig L, Grasshoff C, Hentschke H Tags: Anaesthesist Source Type: research

Randomized crossover study assessing oropharyngeal leak pressure and fiber optic positioning : Laryngeal Mask Airway Supreme™ versus Laryngeal Tube LTS II™ size 2 in non-paralyzed anesthetized children.
Randomized crossover study assessing oropharyngeal leak pressure and fiber optic positioning : Laryngeal Mask Airway Supreme™ versus Laryngeal Tube LTS II™ size 2 in non-paralyzed anesthetized children. Anaesthesist. 2016 Jul 5; Authors: Gasteiger L, Ofner S, Stögermüller B, Ziegler B, Brimacombe J, Keller C Abstract BACKGROUND: As there are currently no data available comparing the practicability of the laryngeal mask airway (LMA) Supreme™ size 2 versus the laryngeal tube LTS II™ size 2 in children, this trial was conducted to quantify the differences betwe...
Source: Der Anaesthesist - July 5, 2016 Category: Anesthesiology Authors: Gasteiger L, Ofner S, Stögermüller B, Ziegler B, Brimacombe J, Keller C Tags: Anaesthesist Source Type: research

[Performance development of a university operating room after implementation of a central operating room management].
r M Abstract The difficult financial situation in German hospitals requires measures for improvement in process quality. Associated increases in revenues in the high income field "operating room (OR) area" are increasingly the responsibility of OR management but it has not been shown that the introduction of an efficiency-oriented management leads to an increase in process quality and revenues in the operating theatre. Therefore the performance in the operating theatre of the University Medical Center Göttingen was analyzed for working days in the core operating time from 7.45 a.m. to 3.30 p.m. from...
Source: Der Anaesthesist - July 5, 2016 Category: Anesthesiology Authors: Waeschle RM, Sliwa B, Jipp M, Pütz H, Hinz J, Bauer M Tags: Anaesthesist Source Type: research

[Perioperative coagulation management during ascending aorta replacement on apixaban].
Abstract The direct oral anticoagulants (DOACs) present a valid therapeutic alternative to vitamin K antagonists in patients with non-valvular atrial fibrillation, for the prevention of venous thromboembolism, and for the treatment and prevention of the recurrence of pulmonary embolisms and deep vein thrombosis. Despite Idarucizumab as an antagonist of Dabigatran there are no other specific antidotes available yet. Therefore, perioperative coagulation management by DOACs is challenging in patients undergoing emergency surgical procedures with a high risk of bleeding complications. This case study de...
Source: Der Anaesthesist - July 5, 2016 Category: Anesthesiology Authors: Dumps C, Halbeck E, Schimpf J, Forst H Tags: Anaesthesist Source Type: research

[Anesthesiological approach for patients with spinal cord injuries].
This article summarizes the specific pathophysiology of SCI and how AD can be avoided as well as also providing anesthetists with strategies for perioperative and intensive care management of patients with SCI. PMID: 27371543 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - July 1, 2016 Category: Anesthesiology Authors: Rand A, Litz RJ, Zahn P Tags: Anaesthesist Source Type: research

[Mortui vivos docent : The dead teach the living].
r M Abstract There are considerable similarities and intersections between forensic medicine and emergency medicine. This applies especially to frustraneously resuscitated patients or other lethal clinical courses of traumatized patients who are subject to latter forensic autopsy. Cooperation between departments of emergency and forensic medicine not only has emergency medical training potential, but also the possibility of retrospective evaluation of medical emergency measures - both in individual cases and with regard to epidemiological aspects. In particular, the widespread registration of autopsied pre-hospita...
Source: Der Anaesthesist - June 29, 2016 Category: Anesthesiology Authors: Buschmann C, Kleber C, Tsokos M, Kerner T, Püschel K, Schmidt U, Fischer H, Stuhr M Tags: Anaesthesist Source Type: research

[Sepsis: case numbers increasing worldwide but new strategies too].
t K Abstract With the numbers of cases rising worldwide and consistently high mortality, sepsis is one of the world's most significant health issues. The Jena Symposium was dedicated to the challenges in research and development, new approaches to treatment, internationally successful strategies, and a potentially successful new initiative for improving the quality of prophylaxis, early diagnosis, and therapy. The importance of intensifying efforts in the fight against sepsis is becoming increasingly recognized by health care policy. Knowledge of lay people/the public about sepsis is lacking and the standards of q...
Source: Der Anaesthesist - June 29, 2016 Category: Anesthesiology Authors: Rüddel H, Weinmann C, Reinhart K Tags: Anaesthesist Source Type: research

[Intensive care studies from 2015/2016].
er T PMID: 27324154 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 20, 2016 Category: Anesthesiology Authors: Reuß CJ, Bernhard M, Beynon C, Hofer S, Jungk C, Michalski D, Weigand MA, Brenner T Tags: Anaesthesist Source Type: research

[Pre-operative documentation of individual in-patient therapy goals : A medical staff questionnaire].
DISCUSSION: Our study shows the dilemma of insufficiently structured directives for changing treatment goals as well as a high number of legal procedures to obtain proxy decisions due to missing out-patient advance health planning. From a medical staff perspective there is strong support for the concept of SSAD based on medical, ethical, economic and organizational reasons. PMID: 27324155 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 20, 2016 Category: Anesthesiology Authors: Umgelter K, Landscheidt J, Jäger K, Blobner M, Kochs E Tags: Anaesthesist Source Type: research

[Catheter-related thrombosis during intravascular temperature management].
We report on a case of catheter-related thrombosis after 7‑day catheter placement during intravascular temperature management (IVTM), in spite of the use of prophylactic anticoagulants. There were no clinical sequelae. According to the literature, occult thrombosis during ITVM could be more frequent than previously reported and dedicated monitoring for potential thrombosis may be indicated. However, a study comparing IVTM with surface cooling found no differences in clinical outcome. Therefore, n either of the methods can be recommended over the other. Further studies should evaluate the rate of occult thrombos...
Source: Der Anaesthesist - June 17, 2016 Category: Anesthesiology Authors: Kerz T, Beyer C, Oswald S, Moringlane R Tags: Anaesthesist Source Type: research

[PONV after strabismus surgery : Risk adapted prophylaxis?]
CONCLUSION: The overall incidence could be reduced to a level below 20 %. Particularly in patients with a high risk of PONV, TIVA could clearly reduce the incidence. However, the incidence in patients with 2 risk factors is still high (30-39 %). Therefore, it is important to reconsider the effort involved with risk screening and individually adapting anesthesia. Risk stratification means a pre- and perioperative effort. Therefore, we advocate a more liberal approach for PONV prophylaxis. PMID: 27295547 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 13, 2016 Category: Anesthesiology Authors: Wolf R, Morinello E, Kestler G, Käsmann-Kellner B, Bischoff M, Hager T, Schöpe J, Eberhart LH Tags: Anaesthesist Source Type: research

[Comment on: Acetylsalicylic acid before coronary surgery: Black, white or grey at least?]
PMID: 27287403 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 10, 2016 Category: Anesthesiology Authors: Kienbaum P, Rellecke P Tags: Anaesthesist Source Type: research

[Dexmedetomidine in the treatment of acute alcohol withdrawal delirium].
Abstract Alcohol withdrawal syndrome has a high clinical prevalence. Severe cases must be treated in an intensive care unit and are associated with a high mortality rate, depending on patient comorbidities. Clinical requirements include sedation, control of vegetative symptoms, treatment of hallucinations and, when necessary, anticonvulsive therapy. Currently, there is no single substance that fulfills these requirements. National and international guidelines recommend a combination of various substances. The central α2-adrenergic receptor agonist clonidine is used as a therapeutic adjuva...
Source: Der Anaesthesist - June 10, 2016 Category: Anesthesiology Authors: Gerresheim G, Brederlau J, Schwemmer U Tags: Anaesthesist Source Type: research

[Focus on hygiene: an issue for ultrasound too!]
PMID: 27287405 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 10, 2016 Category: Anesthesiology Authors: Greim CA Tags: Anaesthesist Source Type: research

[Comment on: Effect of inhaled Xenon on brain damage in comatose patients of out-of-hospital cardiac arrest].
g; M PMID: 27287406 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 10, 2016 Category: Anesthesiology Authors: Gruß M Tags: Anaesthesist Source Type: research

[Comment on: Importance of driving pressure for survival of controlled mechanically ventilated ARDS patients].
PMID: 27273201 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - June 7, 2016 Category: Anesthesiology Authors: Neumann P Tags: Anaesthesist Source Type: research

[Risk management in anesthesia and critical care medicine].
Abstract Throughout its history, anesthesia and critical care medicine has experienced vast improvements to increase patient safety. Consequently, anesthesia has never been performed on such a high level as it is being performed today. As a result, we do not always fully perceive the risks involved in our daily activity. A survey performed in Swiss hospitals identified a total of 169 hot spots which endanger patient safety. It turned out that there is a complex variety of possible errors that can only be tackled through consistent implementation of a safety culture. The key elements to reduce complications are con...
Source: Der Anaesthesist - June 6, 2016 Category: Anesthesiology Authors: Eisold C, Heller AR Tags: Anaesthesist Source Type: research

[Inhalation and intravenous anesthesia in pediatric patients].
r M Abstract Inhalation as well as total intravenous anesthesia have both advantages and disadvantages. The pros of an inhalation technique are mask induction without the initial need for intravenous access and precise dosing; the pros of an intravenous technique are postoperative quiet recovery and a low incidence of vomiting. With both techniques the aim is to reach a certain, most often constant effect site concentration, which after a short latent period equals the blood concentration. Initially, with both techniques a higher dosing is required to wash in the compound. An inhalational technique allows the end-...
Source: Der Anaesthesist - June 6, 2016 Category: Anesthesiology Authors: Jöhr M Tags: Anaesthesist Source Type: research

[Perioperative management of transthoracic oesophagectomies : Fundamentals of interdisciplinary care and new approaches to accelerated recovery after surgery].
e T Abstract Locally advanced carcinomas of the oesophagus require multimodal treatment. The core element of curative therapy is transthoracic en bloc oesophagectomy, which is the standard procedure carried out in most specialized centres. Reconstruction of intestinal continuity is usually achieved with a gastric sleeve, which is anastomosed either intrathoracically or cervically to the remaining oesophagus. This thoraco-abdominal operation is associated with significant postoperative morbidity, not least because of a vast array of pre-existing illnesses in the surgical patient. For an optimal outcome, t...
Source: Der Anaesthesist - May 31, 2016 Category: Anesthesiology Authors: Lambertz R, Drinhaus H, Schedler D, Bludau M, Schröder W, Annecke T Tags: Anaesthesist Source Type: research

[Monitoring tidal volumes when using the Ventrain® emergency ventilator].
CONCLUSION: The tested respiratory function monitor using hot-wire anemometer technology has the potential to monitor tidal volumes applied by the Ventrain®. With the software thus adapted, the RFM measures precise inspiratory and expiratory tidal volumes within common technical tolerance. This could help perform adequate patient ventilation with Ventrain® and reduce the potential risk of patient trauma. PMID: 27245923 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 31, 2016 Category: Anesthesiology Authors: Schmidt AR, Ruetzler K, Haas T, Schmitz A, Weiss M Tags: Anaesthesist Source Type: research

[Not either/or: both!]
PMID: 27245924 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 31, 2016 Category: Anesthesiology Authors: Eich C Tags: Anaesthesist Source Type: research

[A Germany-wide survey on anaesthesia in thoracic surgery].
CONCLUSION: The study reveals considerable differences in the anaesthetic practice in thoracic surgery. These focus mostly on the postoperative surveillance, the availability of bronchial blockers, and the use of regional anaesthetic techniques. Furthermore, it is evident that specific algorithms are needed for the difficult airway in thoracic anaesthesia. A recommendation for the high-tech work environment of thoracic anaesthesia could enhance the structural quality and optimize patient outcomes. Independent of a hospital's level of care, uniform requirements could help establish national quality standards in thoracic ana...
Source: Der Anaesthesist - May 31, 2016 Category: Anesthesiology Authors: Defosse J, Schieren M, Böhmer A, von Dossow V, Loop T, Wappler F, Gerbershagen MU Tags: Anaesthesist Source Type: research

[Identification and economic evaluation of anesthesiologic secondary diagnoses on the basis of intraoperative medication].
In this study, secondary diagnoses were identified through drug administrations during anaesthesia and were economically evaluated by regrouping these cases. METHODS: All intraoperative drug administrations from 2008 were extracted from a database. After exclusion of synonyms and procedure-specific drug administrations, all remaining drugs were matched to explicit secondary diagnoses. All cases were regrouped with their newly defined secondary diagnoses by G‑DRG grouper software, and changes in cost weight were evaluated. RESULTS: A total of 29 drugs could be assigned to 18 secondary diagnos...
Source: Der Anaesthesist - May 25, 2016 Category: Anesthesiology Authors: Brammen D, Rickert V, Esser T, Prätsch F, Röhrig R, Hachenberg T, Ebmeyer U Tags: Anaesthesist Source Type: research

[Mitochondrial disorders require a comprehensive perioperative management].
PMID: 27221391 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 25, 2016 Category: Anesthesiology Authors: Finsterer J, Zarrouk-Mahjoub S Tags: Anaesthesist Source Type: research

[MEK clarification: What is the task of the anesthesiologist?]
PMID: 27225931 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 25, 2016 Category: Anesthesiology Authors: Haas A, Wappler F Tags: Anaesthesist Source Type: research

[Implementation of a thermal management concept to prevent perioperative hypothermia : Results of a 6‑month period in clinical practice].
CONCLUSION: We conclude that temperature management is a challenge in the clinical situation, and that it is difficult to achieve rates of hypothermia close to zero. The addition of prewarming was very effective in improving the results in our patients. PMID: 27188499 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 17, 2016 Category: Anesthesiology Authors: Menzel M, Grote R, Leuchtmann D, Lautenschläger C, Röseler C, Bräuer A Tags: Anaesthesist Source Type: research

[Cost analysis of patient blood management].
CONCLUSIONS: PBM combines various alternatives to the transfusion of red blood cells and improves clinical outcome. Costs of PBM vary from institution to institution and depend on the extent to which different aspects of PBM have been implemented. The quantification of costs associated with PBM is essential in order to assess the economic impact of PBM, and thereby, to efficiently re-allocate health care resources. Costs were determined at a single university hospital. Thus, further analyses of both the costs of transfusion and the costs of PBM-principles will be necessary to evaluate the cost-effectiveness of PBM. PM...
Source: Der Anaesthesist - May 9, 2016 Category: Anesthesiology Authors: Kleinerüschkamp AG, Zacharowski K, Ettwein C, Müller MM, Geisen C, Weber CF, Meybohm P Tags: Anaesthesist Source Type: research

[Surgical site infections: of miasma, airborne threats and other risk factors].
e R PMID: 27146284 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)
Source: Der Anaesthesist - May 4, 2016 Category: Anesthesiology Authors: Schulze-Röbbecke R Tags: Anaesthesist Source Type: research

[Anesthesia in thoracic surgery].
Abstract Thoracic surgery represents a special challenge for anesthesia and requires a high level of human and material resources. Accurate knowledge of the pathophysiology is essential for selection of the anesthetic procedure, the separation of the lungs, monitoring and treatment of hemodynamics as well as for postoperative follow-up care. The increasing number of thoracic interventions and patients who are often suffering from complex diseases require close interdisciplinary cooperation between surgeons, anesthesiologists and intensive care specialists. In addition to the anesthetic techniques particular attent...
Source: Der Anaesthesist - May 4, 2016 Category: Anesthesiology Authors: Kammerer T, Speck E, von Dossow V Tags: Anaesthesist Source Type: research

[Prevention of postoperative surgical site infections : Between tradition and evidence].
Abstract Postoperative wound infections represent a relevant complication of invasive interventions. Current European prevalence data show that for participating hospitals from Germany (n = 132) surgical site infections represent the most commonly occurring nosocomial infection with 24.3 %. This corresponds to a point prevalence of 1.31 %. It is assumed that approximately 25-33 % of all infections acquired in hospital could be prevented if all possible precautions would be taken. Recent studies have indicated that this rate might be even higher for individual infection entities. Infection...
Source: Der Anaesthesist - May 4, 2016 Category: Anesthesiology Authors: Scheithauer S, Artelt T, Bauer M, Waeschle RM Tags: Anaesthesist Source Type: research

[Pharmacogenetics in anesthesia and intensive care medicine : Clinical and legal challenges exemplified by malignant hyperthermia].
Abstract Pharmacotherapy is a key component of anesthesiology and intensive care medicine. The individual genetic profile influences not only the effect of pharmaceuticals but can also completely alter the mode of action. New technologies for genetic screening (e.g. next generation sequencing) and increasing knowledge of molecular pathways foster the disclosure of pharmacogenetic syndromes, which are classified as rare diseases. Taking into account the high genetic variability in humans and over 8000 known rare diseases, up to 20 % of the population may be affected. In summary, rare diseases are not rare. M...
Source: Der Anaesthesist - May 3, 2016 Category: Anesthesiology Authors: Klingler W, Pfenninger E Tags: Anaesthesist Source Type: research