Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2014
Review[Vascular cannulation and hemodynamic monitoring for cardiac and thoracic vascular surgery - a review].
Cardiac surgery requires cardiopulmonary bypass (CPB) with extracorporeal circulation (ECC) for intracardiac procedures. The surgical strategy determines access for monitoring and insertion sites with high-flow cannulas. ⋯ Therefore, the knowledge of the vascular anatomy is essential to provide professional care to patients undergoing ECC during thoracic vascular and cardiac surgery. This article is a review of hemodynamic monitoring and access for ECC in patients for adult cardiac surgery for anaesthesiologists and intensivists.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2014
Review[Coagulation disorders in the context of cardiac surgery - Clinical basics and mechanism based therapy].
Intra- and postoperative bleeding disorders are common in cardiac surgery. The etiology of perioperative coagulopathy frequently becomes apparent as a combination of several acquired and inherited disorders. ⋯ Point-of-care-systems can provide fast bed-sided analysis, which contribute to early diagnosis and intervention. Individual and regularly revised algorithms, adapted to the individualized institutional infrastructure, may facilitate resource-saving treatment of perioperative coagulopathy.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2014
Review[Nausea and vomiting after anaesthesia for children - Big problems for little patients].
Postoperative nausea and vomiting are undesirable and unpleasant side effects after surgery and anaesthesia associated with delayed oral intake and postoperative recovery, and impaired parental satisfaction. Since current modalities against PONV are cheap, highly effective, and almost free from relevant side-effects - providing contraindications are appropriately considered -, recommendations tend to move away from risk-score guided administration of antiemetic towards a more liberal administration policy or even favour routine administration to children undergoing general anaesthesia for surgery combined with total-intrevanous anaesthesia using propfol and reduction of perioperative opioid administration.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2014
Case Reports[Residual relaxant block due to pseudocholinesterase deficiency - First manifestation in an elderly patient].
Pseudocholinesterase or butyrylcholinesterase (BChE) inactivates the relaxant drugs mivacurium and suxamethonium. A deficiency in plasma activity of this enzyme may result in prolonged muscular paralysis and subsequently the need for an extended duration of mechanical ventilation. We report the case of a 65-year-old patient who was diagnosed with butyrylcholinesterase deficiency for the first time during elective surgery. Neuromuscular monitoring constitutes a central diagnostic asset in ensuring patient safety.