Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2011
Review[Cardiac insufficiency: acute right heart failure].
Acute right heart failure (RHF) is a frequent and severe complication during perioperative and intensive care treatment in intensive care units (ICUs). The most common causes are pulmonary hypertension, left heart failure, pulmonary embolism, sepsis, acute lung injury (ALI) and thoracosurgical procedures. ⋯ Although many drugs are available for the treatment of RHF, randomized trials for this setting are still missing. This article gives an overview of aetiology and pathogenesis of RHF and reviews the diagnostic and therapeutic interventions currently available for providers in anaesthesiology and critical care.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2011
[Fungal infections in the intensive care unit].
Invasive infections through to sepsis caused by fungi in intensive care units have increased markedly in the past few years. In the mean time almost every tenth case of sepsis in the intensive care unit is the result of an invasive fungal infection. Not only hemato-oncological or organ-transplanted patients are affected but increasingly also those patients who have been under intensive care for a considerable time and who exhibit particular risk factors. ⋯ The diagnosis of fungal infections is still difficult; unambiguous, highly sensitive and specific test procedures are still lacking. The decision for therapy must often be made empirically and as early as possible. In the past few years newly developed antimycotic agents have opened up new options for therapy.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2011
Review[Acute respiratory insufficiency: prehospital management of obstructive pulmonary diseases].
Acute respiratory insufficiency due to obstructive pulmonary diseases is a common problem presenting to the emergency medical service. Most frequent causes are acute asthma attacks or acute exacerbations of chronic obstructive pulmonary disease (COPD). The preclinical differentiation of both diseases may be difficult, so that the diagnosis is often made by precise anamnesis. This article reviews the prehospital management of asthma and COPD, including pharmacological options and techniques of mechanical ventilatory support (non-invasive vs. invasive).
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2011
[DGAI-certified seminar series: anaesthesia focussed echocardiography: module 4 cardiosonography].
The use of ultrasonography in perioperative medicine has developed rapidly within the last decade. Today ultrasonic techniques are established methods for peripheral and central venous access as well as for regional anaesthesia. However, transthoracic ultrasonography by non-cardiologists has not yet been routinely established perioperatively, in intensive care medicine or in emergency medicine. With the current module 4: Cardiosonography of the DGAI-certified seminar series in Anaesthesia Focussed Sonography (AFS) it is intended to provide a basis for a quality assured training and implementation of transthoracic sonography in anaesthesia, intensive care medicine and emergency medicine.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2011
[Thoracoabdominal sonography (E-FAST plus) -AI training module 5 in anaesthesiologist: performed focussed sonography].
Anesthesiologists and Critical Care Physicians are confronted with the differential diagnoses of dyspnea, complications of mechanical ventilation or rapid assessment of trauma patients on a nearly daily basis. This requires the timely diagnosis or exclusion of a wide variety of disease processes including pleura effusion, pneumonia, pneumothorax as well as thoracical or abdominal bleeding. ⋯ Bedside ultrasound as the "visual stethoscope" of the acute care physician offers an alternative to other imaging modalities like X-ray and CAT scan and can reduce associated high-risk transportation of mechanically ventilated patients. In this article, we introduce a new training module based on the DGAI curriculum.