Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2012
Review[Is there any indication for perioperative use of the pulmonary artery catheter?].
The benefit of the pulmonary-artery catheter (PAC) is a matter of discussion since years. The development of alternative monitoring techniques especially for measurement of volume parameters has decreased routine use of the PAC. ⋯ The concerns about the available monitoring techniques bear mainly on the fear being too invasive. Up to now, there is no technique complying with all requirements of an ideal monitoring system.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2012
Review[New aspects of minimally invasive cardiac output monitoring].
The variety of minimally invasive cardiac output (CO) monitoring devices is growing rendering it difficult to keep track of new developments. In this article technical principles, limitations and validation procedures considering new aspects are reviewed. ⋯ CO should be interpreted in combination with clinical information and other hemodynamic parameters. It's evident that not the monitor per se, but only the protocol / therapy based on the hemodynamic data can improve patients outcome.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2012
Review[Effects of advanced haemodynamic monitoring on perioperative outcome in high-risk patients].
Advanced haemodynamic monitoring provides information on blood flow, volume status, and oxygen supply to demand ratio. Together with related therapeutic algorithms these variables can be used to optimize cardiac preload and oxygen delivery in the perioperative period. There is increasing evidence that a goal-directed therapy can improve perioperative outcome. In this review we will briefly describe different target variables and their relevance for the haemodynamic optimization of high-risk surgical patients.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2012
Review[Process optimization in pediatric anesthesia-- fast-track: what is possible: what makes sense?].
Process optimization offers the opportunity to improve the quality and efficiency of medical care. Various approaches are possible in a pre-, peri- and postoperative care setting: It is almost always possible to prepare the children for surgery on an outpatient basis. This allows for hospital admission the same day or the evening before the procedure. ⋯ Sufficient staff and facilities are a prerequisite for this. The use of ultrasound for vascular access and regional anesthesia raises the success rate and saves time. In the postoperative period good analgesia with a fixed therapeutic regime, immediate postoperative feeding and mobilization improve the care.