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Der Anaesthesist

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https://www.readbyqxmd.com/read/28447107/-role-of-anesthesiology-in-pain-medicine-and-palliative-care-treatment-in-german-hospitals-survey-of-department-heads-of-anesthesiology-on-treatment-structures
#1
J Erlenwein, F Petzke, U Stamer, W Meißner, F Nauck, E Pogatzki-Zahn, W Koppert, C Maier
BACKGROUND: The aim of this analysis was to describe the role of anesthesiology departments in pain medicine and palliative care services in German hospitals. METHOD: In the year 2012, all heads of departments of anesthesiology registered with the German Society of Anesthesiology and Intensive Care Medicine were surveyed about structures of pain medicine and palliative care services in their hospitals using a standardized postal questionnaire. RESULTS: Out of 408 returned questionnaires (response rate 47%) 403 could be evaluated...
April 26, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28429038/-phosphodiesterase-4-inhibition-for-treatment-of-endothelial-barrier-and-microcirculation-disorders-in-sepsis
#2
REVIEW
J Wollborn, N Schlegel, M A Schick
Sepsis is commonly associated with loss of microvascular endothelial barrier function (capillary leak) and dysfunctional microcirculation, which both promote organ failure. The development of a distinct therapy of impaired endothelial barrier function and disturbed microcirculation is highly relevant because both of these phenomena constitute crucial processes which critically influence the prognosis of patients. Numerous in vivo and in vitro trials over the past years have fostered a better understanding of the pathophysiology of capillary leak...
April 20, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28424835/-future-of-emergency-medicine-in-germany-2-0
#3
REVIEW
A Gries, M Bernhard, M Helm, J Brokmann, J-T Gräsner
In 2003 an article on the future of prehospital emergency medicine in Germany was published in the journal Der Anaesthesist. Emergency medicine in Germany, which at that time was almost exclusively defined as prehospital emergency rescue, has evolved and now in-hospital domains have increasingly moved into the focus. At that time, the primary goal was to connect prehospital management with a smooth transition to hospital admission and further care in the hospital and to further optimize the rescue chain from the actual emergency through to causative treatment...
April 19, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28409198/-safe-treatment-of-acute-hyperkalemia-the-1-4-and-other-principles
#4
REVIEW
P Groene, G Hoffmann
Acute hyperkalemia is a dangerous electrolyte disorder, which must be treated immediately. It can lead to cardiac arrhythmia and death due to alterations in cell membrane potentials. The resulting alterations in the electrocardiogram (ECG) are multifarious and need to be rapidly recognized. Treatment consists of various stages. In addition to membrane stabilization, which is always necessary, potassium must be displaced into the intracellular space and then eliminated from the body. A commonly applied method for displacement of potassium into the intracellular space involves the administration of insulin-glucose mixtures, which is associated with many complications...
April 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28405722/-legal-cases-in-emergency-medicine-the-swiss-legal-situation
#5
LETTER
B Dörr, M Brüesch, T Krones
No abstract text is available yet for this article.
April 12, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28396935/state-of-the-art-in-fluid-and-volume-therapy-a%C3%A2-user-friendly-staged-concept-english-version
#6
M Rehm, N Hulde, T Kammerer, A S Meidert, K Hofmann-Kiefer
Adequate intraoperative infusion therapy is essential for the perioperative outcome of a patient. Both hypo- and hypervolemia can lead to an increased rate of perioperative complications and to a worse outcome. Perioperative infusion therapy should therefore be needs-based. The primary objective is the maintenance of preoperative normovolemia using a rational infusion strategy. Perioperative fluid losses should be differentiated from volume losses due to surgical bleeding or protein losses into the interstitial space...
April 10, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28386683/-quality-indicators-for-rescue-operations-in-terrorist-attacks-or-other-threats-a%C3%A2-pilot-study-after-the-w%C3%A3-rzburg-terrorist-attack-of-july-2016
#7
T Wurmb, P Justice, S Dietz, R Schua, T Jarausch, U Kinstle, J Greiner, G Möldner, J Müller, M Kraus, S Simon, U Wagenhäuser, N Roewer, M Helm
BACKGROUND: Terrorist attacks have become reality in Germany. The aim of this work was, after the Würzburg terrorist attack, to define quality indicators and application characteristics for rescue missions in life-threatening situations. The results can be used to record data from future missions using this template in order to make them comparable with each other. METHODS: After approval of the local ethic committee, the first step was to designate a group of experts in order to define the template in a consensus process...
April 6, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28386682/-update-in-neuroanesthesiology-key-publications
#8
V-S Eckle, G Schneider
One of the aims of the Scientific Working Group Neuroanesthesia (WAKNA) of the German Society of Anesthesiology and Intensive Care Medicine is to disseminate new findings in the field of neuroscience and neuroanesthesia and to propagate novel therapeutic and diagnostic options into clinical practice. Once a year, the WAKNA displays and discusses recent noteworthy publications from the past 12 months at the German Anesthesia Meeting. In 2016, a new pharmacologic strategy with dexmedetomidine to prevent postoperative pain after craniotomy, the impact of the widely used anesthetic drug propofol on GABA receptor surface expression, a study highlighting the ultrasound-guided detection of increased intracranial pressure, and an article showing the interactions of neuromuscular blocking drugs on the BIS neuromonitoring were presented...
April 6, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28378133/-palliative-therapy-concepts-in-intensive-care-medicine
#9
M Schuster, M Ferner, M Bodenstein, R Laufenberg-Feldmann
Involvement of palliative care is so far not common practice for critically ill patients on surgical intensive care units (ICUs) in Germany. The objectives of palliative care concepts are improvement of patient quality of life by relief of disease-related symptoms using an interdisciplinary approach and support of patients and their relatives considering their current physical, psychological, social and spiritual needs. The need for palliative care can be identified via defined screening criteria. Integration of palliative care can either be realized using a consultative model which focusses on involvement of palliative care consultants or an integrative model which embeds palliative care principles into the routine daily practice by the ICU team...
April 4, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28364306/-antipyretics-in-intensive-care-patients
#10
A Simon, A Leffler
BACKGROUND: Antipyretics are among the most widely prescribed drugs in German hospitals. Despite this widespread use, their role for treatment of critically ill patients still remains unclear. In particular, the questionable positive effects of reducing fever are discussed. OBJECTIVES: In this review we aimed to summarize and discuss current study results covering the use of antipyretics in critically ill patients. Suspected effects with regard to fever reduction and lethality should be considered...
March 31, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28364305/-international-guidelines-from-the-surviving-sepsis-campaign-2016-update
#11
J Briegel, P Möhnle
An update to the international guidelines for sepsis therapy was published by the Surviving Sepsis Campaign (SSC) in March 2017. The guidelines have been completely restructured and comprehensively deal with new evidence. The guidelines discuss sepsis-specific therapeutic measures and provide detailed recommendations on general intensive care measures for sepsis. This article summarizes the most important amendments and suggests delving deeper into the guidelines.
March 31, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28357453/erratum-zu-intensivtherapie-nach-aneurysmatischer-subarachnoidalblutung
#12
U Jaschinski
No abstract text is available yet for this article.
March 29, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28353068/-interhospital-transport-of-patients-with-ards
#13
N Jahn, M T Voelker, S Bercker, U Kaisers, S Laudi
In patients with severely compromised gas exchange, interhospital transportation is frequently necessary due to the need to provide access to specialized care. Risks are inherent during transport, so the anticipated benefits of transportation must be weighed against the possible negative outcome during the transport. The use of specialized teams during transportation can help to reduce adverse events. Diligent planning of the transportation, monitoring and medical staff during transport can decrease adverse events and reduce risks...
March 28, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28353067/-conflict-matrix-risk-management-tool-in-the-operating-room
#14
D Andel, K Markstaller, H Andel
BACKGROUND: In business conflicts have long been known to have a negative effect on costs and team performance. In medicine this aspect has been widely neglected, especially when optimizing processes for operating room (OR) management. In the multidisciplinary setting of OR management, shortcomings in rules for decision making and lack of communication result in members perceiving themselves as competitors in the patient's environment rather than acting as art of a multiprofessional team...
March 28, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28353066/-comment-on-what-is-the-appropriate-anesthesia-for-thrombectomy
#15
M Coburn, H Van Aken, R Rossaint
No abstract text is available yet for this article.
March 28, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28303282/-advance-directives-in-clinical-practice-living-will-healthcare-power-of-attorney-and-care-directive
#16
J Hack, B Buecking, C L Lopez, S Ruchholtz, C A Kühne
In clinical practice, situations continuously occur in which medical professionals and family members are confronted with decisions on whether to extend or limit treatment for severely ill patients in end of life treatment decisions. In these situations, advance directives are helpful tools in decision making according to the wishes of the patient; however, not every patient has made an advance directive and in our experience medical staff as well as patients are often not familiar with these documents. The purpose of this article is therefore to explain the currently available documents (e...
March 16, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28289767/-update-on-muscle-relaxation-what-comes-after-succinylcholine-rocuronium-and-sugammadex
#17
N Zoremba, G Schälte, C Bruells, F K Pühringer
Due to the great advantages, it is not possible to imagine current practice in anesthesia without the adminstration of muscle relaxants. For a long time the administration of succinylcholine for rapid sequence induction (RSI) was considered to be the state of the art for patients at risk for aspiration. The favorable characteristics are, however, accompanied by many, sometimes severe side effects. Due to the development of non-depolarizing muscle relaxants, in particular rocuronium in combination with sugammadex, there is the possibility to achieve a profile of action similar to succinylcholine with low side effects...
March 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28289766/-complications-and-monitoring-standards-after-elective-craniotomy-in-germany
#18
C Henker, C Schmelter, J Piek
BACKGROUND: The increasing endeavors to make inpatient treatment processes more effective leads to a reduction of the length of stay in hospital and minimization of postoperative monitoring. Therefore, the aim of our study was to determine potential postoperative complications for neurosurgical patients undergoing elective surgery with respect to assessment of the relevance for intensive medical care. Furthermore, our approach was compared with the standard of postoperative care of such patients in Germany...
March 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28289765/-palliative-medicine-at-the-borderlines-of-life-and-death
#19
EDITORIAL
C Bausewein
No abstract text is available yet for this article.
March 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28289764/erratum-to-good-neurological-outcome-after-primary-accidental-hypothermia-presenting-with-asystole
#20
I Eckert, P Imboden, P Paal, J Koppenberg
No abstract text is available yet for this article.
March 13, 2017: Der Anaesthesist
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