Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2013
[Weaning - Defintion and clinical context from the neurologist's view].
Special conditions in neurologic patients arise, first, from abnormal breathing patterns with brain lesions. These however may be managed effectively by adaptive ventilator settings together with special drugs thus not ultimatively precluding weaning. ⋯ In acute neuromuscular diseases during the weaning process special attention should be payed to the parameters of muscle strength, and for disturbances of swallowing at least after extubation. In degenerative terminally decompensated neuromuscular disease, an exact diagnosis and information is essential to help the patient in decision-making towards terminal weaning or long-term home ventilatory support.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2013
Review Case Reports[In Process Citation].
Patients with univentricular congenital heart disease are treated with Fontan-procedure for more than 40 years resulting in mainly good life-quality for pediatric and now more and more adult patients. Due to prolonged life expectation and adequate physical state, adolescent and adult Fontan-patients participate in normal life activities like the main population. Mass events like open-air concerts and sport events belong to these activities. ⋯ Visitors with minor or major health problems are treated by emergency response services like the German Red Cross, the German St Johns Ambulance and the German Order of Malta. The article refers to the special pathophysiology and management of Fontan-patients in emergency and anaesthesiologic settings based on a case report from the Southside Festival. Due to increasing "fontanpopulation" profound education of attending physicians and paramedics is inevitable to provide good quality in prehospital and innerhospital care.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2013
Review[Monitoring of the respiratory muscle function during weaning from mechanical ventilation].
Early weaning and discontinuation of mechanical ventilation can help prevent respiratory muscle dysfunction in critically ill patients. Prolonged mechanical ventilation and failure to use adequate strategies to discontinue mechanical ventilation can even enhance and perpetuate respiratory muscle dysfunction. ⋯ Therefore, accurate monitoring of the respiratory muscle function is a valuable tool for the clinician at the bedside to assess to optimal weaning strategy and, ideally, would predict either weaning failure or success. In this review, we briefly summarize the available techniques, measurements and equipment required for the monitoring of respiratory muscle function in the intensive care unit.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2013
[Helsinki Declaration on Patient Safety in Anaesthesiology -Part 9: Recommendations for clinical airway management organisation].
In the Helsinki Declaration terms and conditions are demanded to control problems in airway management in perioperative care situations. A differentiated airway management can reduce morbidity and mortality. ⋯ In this regard paediatric care requires special consideration. Furthermore the fibreoptic as the gold standard for the difficult airway as well as surgical airway management are essential and must be available at all times, whereas videolaryngoscopy takes on increasing evidence as an additional technique.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2013
Historical Article[Ether Day - no laughing matter. The birth of modern anaesthesia].
Since centuries the first public demonstration of the anaesthetic properties of ether by William Thomas Green Morton at the Massachusetts General Hospital in Boston on October 16th 1846 is celebrated as "Ether Day" world-wide. The news of the beneficial effects, primarily disposed as a "Yankee Invention", spread over all continents quickly. ⋯ The important discovery later became a patent case and was overshadowed by a long lasting priority claim. Nevertheless the readers of the New England Journal of Medicine voted in a survey that this article was the most important publication in the 200 years journals history ever.