Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2014
Review Case Reports[Management of anaesthesia and intensive care for acute ischemic insult].
The acute ischemic stroke (AIS) is a major cause of death and disability in Germany. The treatment of patients with AIS focuses on rapid recanalization of close brain vessels. ⋯ The advantage and risk of general anaesthesia during a neuroradiology procedure is shown. We make recommendations for blood pressure, blood glucose and temperature management.
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Management of ischemic stroke is targeted on four therapeutic objectives: limitation of neurological deficit, prevention of earyl stroke recurrence, protection against complications, and secondary prevention. Intravenous thrombolysis within 4.5h of stroke onset is the only proven therapy to improvefunctional outcome. ⋯ Subcutaneous heparin/low molecular weight heparin, mobilisation, nasogastric tube, and decompressive craniectomy may protect from venous thromboembolism, aspiration pneumonia, and malignant brain edema, respectively. Secondary prevention is guided by stroke etiology, e.g. oral anticoagulation in the presence atrial fibrillation or endarterectomy in case of sympomatic high-grade carotid stenosis.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2014
Review[Injuries caused by acids and bases - Emergency treatment].
Emergency medical care for injuries caused by acids and bases is challenging for rescue services. They have to deal with operational safety, detection of the toxic agent, emergency medical care of the patient and handling of the rescue mission. Because of the rareness of such situations experience and routine are largely missing. This article highlights some basic points for the therapy and provides support for such rescue missions.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2014
Review[Ischemic stroke - Interventional therapy].
In addition to the long-established local thrombolysis by means of a catheter, other mechanical procedures for the interventional treatment of acute ischemic stroke have been introduced over the last ten years. These new methods have proved to be effective for the recanalization of occluded vessels supplying the brain and can, in principle, also be employed outside of the therapeutic window valid for intravenous thrombolysis. ⋯ Since this is still a very new therapeutic procedure it has not yet been conclusively demonstrated that the interventional method, in spite of all theoretical advantages in comparison with intravenous thrombolysis, really does lead to a better outcome for the patients. The indication must thus be made on an individual basis at the interdisciplinary level.