Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2011
Review[Patient blood management (part 2). Practice: the 3 pillars].
Patient blood management (PBM) is a patient-specific multidisciplinary, multimodal, evidence-based concept to appropriately conserve and manage a patient's own blood as a vital resource. PBM is based on 3 pillars: the first is the optimization of the patient's endogenous red cell mass, the second is the minimization of bleeding and blood loss and the third involves harnessing and optimizing the patient-specific physiological tolerance of anemia, including adopting more restrictive transfusion thresholds. ⋯ PBM is applicable to surgical and medical patients. The application of PBM systematically reduces the impact of 3 major contributors to negative outcome: anemia, blood loss and transfusion.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2011
Review[Prophylaxis and therapy of postdural puncture headache--a critical evaluation of treatment options].
Since the first description of spinal and epidural anaesthesia, postdural puncture headache (PDPH) is a well known complication. Its prophylaxis and treatment has been studied and discussed for more than 100 years, but the evidence is still limited. Due to relatively low prevalence of PDPH, prospective RCTs are often missing, and the frequently self-limiting character of PDPH impedes an adequate interpretation of results from studies without a control group. ⋯ Noninvasive therapies like theophylline, sumatriptan and ACTH can be an alternative. However, an evidence-based recommendation is lacking. The development of standard operating procedures for accidental dural punctures and PDPH is recommended.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2011
Review[Postpartum hemorrhage--an update].
Postpartum hemorrhage remains a major cause of maternal morbidity and mortality. The incidence of postpartum hemorrhage appears to be increasing in developed countries due to an increased number of placenta accreta or percreta after previous Cesarean deliveries. The initial therapy of postpartum hemorrhage consists of uterotonic drugs and inspection of the uterine cavum. ⋯ Tranexamic acid may be considered as a first line choice, followed by fibrinogen if necessary. If bleeding continues, fresh frozen plasma and packed red cells should be ordered in a ratio of 1:1, as this ratio has been shown to improve survival in trauma victims. All labor and delivery suites should have standard operating procedures for the management of postpartum hemorrhage in place with regular drills.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2011
Retraction Of Publication[Triem JG, Röhm KD, Boldt J, Piper SN. [Comparison of a propofol-based anesthesia regimen using optimated target-controlled-infusion (OTCI) and manually-controlled infusion (MCI) technique]. Anasthesiol Intensivmed Notfallmed Schmerzther 2006; 41: 150-155. Retraction].
The editorial board of AINS requests the retraction of the named article, as the studie has no IRB-approval.