Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Dec 2014
Review[Echocardiography for hemodynamic monitoring on ICU?].
A goal-directed hemodynamic therapy (GDT) using volume substitution and/or cardiovascular agents in order to increase stroke volume and consecutively tissue oxygenation has been shown to reduce perioperative complications. Previous hemodynamic monitoring devices mostly are only able to detect a restriction in several parameters of cardiovascular function not always diagnostically conclusive to their pathophysiological cause. However, this is mandatory for GDT. ⋯ It is introduced orally in the patient's esophagus and can remain up to 72 hours in situ. First clinical reports/studies were able to demonstrate that a short intensive training programme for physicians unexperienced in echocardiography was sufficient to adequately initiate GDT. However, further studies have to prove the clinical feasibility and the positive effect on patient's outcome.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Dec 2014
Review[Echocardiography - Hemodynamically focused echocardiography].
Based on the previously published international evidence-based recommendations for focused cardiac ultrasound, aim of this paper is to provide a possible approach to the complementary application of TTE and TOE in hemodynamically unstable patients. Thereby the cardiac ultrasound examination is centered on the search of an answer or solution to a clinically relevant question or problem and does not replace an all-encompassing examination performed by cardiologists.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Dec 2014
Case Reports[Case Report - A dangerous intoxication after ingestion of alkyl nitrite ("Poppers")].
This case report describes the inadvertent poisoning of a young man with "poppers" after having ingested an unknown amout of the drug. "Poppers" (alkyl nitrite) were made famous in the 1960s as a party drug, and during certain sexual practices, and are still in use today. The drug's inhalation leads to a short-lived rush, vasodilation and relaxtion of smooth muscles. An accidental ingestion can lead to a significant build-up of methemoglobin with dire consequences. The therapy consists of the intravenous administration of methylene blue.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Dec 2014
[Mass casualty incidents - Current concepts and developments].
Medical concepts and strategies are permanently changing. Due to the emergency response in a mass casualty incident everyone who is involved has to work together with different organisations and public authorities, which are not part of the regular emergency medical service. ⋯ They will be a permanent part of regional plannings for mass casualty incidents. This article highlights current concepts and developments in different parts of Germany.