Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
-
Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2012
Review[Surgical therapy and critical care medicine in severely burned patients - Part 1: the first 24 ours].
Critical care medicine in severely burned patients should be adapted to the different pathophysiological phases. Accordingly, surgical and non-surgical therapy must be coordinated adequately. Initial wound care comprises topical treatment of less severely injured skin and surgical debridement of severely burned areas. ⋯ In the further course wound treatment with split-thickness skin grafts is the major aim of surgical therapy. Critical care is focused on the avoidance of complications like infections and ventilator associated lung injury. Therefore, lung-protective ventilation strategies, weaning and sedation protocols, and early enteral nutrition are important cornerstones of the treatment.
-
Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2012
Review[Pathophysiology and epidemiology of pain in thoracic surgery].
Acute and chronic pain are significant problems after thoracic surgery with a multifactorial pathogenesis. On the one hand iatrogenic procedures as surgical access and complexity of treatment procedures, and on the other hand constitutional factors as psychosocial comorbidities affect individual pain threshold and the development of a Postthoracic Pain Syndrome (PTPS). ⋯ The characterization of pathophysiological pathways wants to point out treatment options. In conclusion there is a need for well organized, multimodal pain therapy concepts to minimize the risk of perioperative and chronic pain.
-
Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2012
[Hospital hygiene - transport of patients with multi-resistant pathogens].
An ever occurring problem in the health-care services is the handling of patients who are carriers of multi-resistant pathogens (MRP). As a general rule, these patients must be isolated. ⋯ As a rule, the measures of "standard hygiene" are sufficient for an adequate protection of patients and personnel. Above all, hand disinfection is of decisive importance.
-
Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2012
Review[Therapy of trauma-induced coagulopathy - what is the evidence?].
The increasing understanding of trauma-induced coagulopathy has led to an expansion of treatment strategies in the acute management of trauma patients. The aim of this manuscript is to give a summary of current recommendations for the treatment of trauma-induced coagulopathy based on current literature and valid guidelines. Thetrauma-induced coagulopathyis an independentacutemultifactorial diseasewith significantimpact on the mortalityof severelyinjured patients. ⋯ For diffuse bleeding or thrombocytopathic patients desmopressin might be a therapeutic option. If a factor XIII (FXIII) measurement is not promptly available, a factor XIII blind-dose should be considered in severe ongoing bleeding. The use of recombinant activated coagulation factor VII (rFVIIa) be considered if major bleeding persists despite standard attempts to control bleeding and best practice use of blood components.