Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2015
Review Meta Analysis[Hyperbaric therapy and diving medicine - hyperbaric therapy part 1: evidence-based emergency care].
Hyperbaric oxygen therapy (HBOT), i. e. breathing pure oxygen at elevated ambient pressure, remains the gold standard of care in treating air or gas embolism and decompression illness. Guidelines are less clear on the value of HBOT in acute management of carbon monoxide (CO) poisoning or clostridial necrosis. ⋯ Part 1 assesses acute indications such as air or gas embolism, decompression sickness, CO-poisoning, clostridialmyonecrosis, necrotizing problem wounds, acute traumatic wounds and arterial retinal occlusion. Part 2 discusses further uses of HBOT as adjuvant treatment and highlights problems in assessing the value of HBOT using evidence-based medicine criteria.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2015
Review Meta Analysis[Hyperbaric therapy and diving medicine - hyperbaric therapy part 2: adjuvant therapy].
Hyperbaric oxygen therapy (HBOT), i. e. breathing pure oxygen at elevated ambient pressure, remains the gold standard of care in treating air or gas embolism and decompression illness. Guidelines are less clear on the value of HBOT in acute management of carbon monoxide (CO) poisoning or clostridial necrosis. ⋯ Part 1 assesses acute indications such as air or gas embolism, decompression sickness, CO-poisoning, clostridialmyonecrosis, necrotizing problem wounds, acute traumatic wounds and arterial retinal occlusion. Part 2 discusses further uses of HBOT as adjuvant treatment and highlights problems in assessing the value of HBOT using evidence-based medicine criteria.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2015
Review Case Reports Comparative Study[Hyperbaric therapy and diving medicine - hyperbaric chambers in use].
Hyperbaric oxygen therapy (HBOT) is a scientifically justified and internationally established therapy, which is however not well-known thus rarely used in Germany. During a HBOT, the ambient pressure is raised while the patient breathes 100% O2, causing tissue partial oxygen pressure (ptO2) to increase distinctly. Through that, various pressure- and O2-associated processes are initiated. Herein 3 case studies are described that illustrate the mechanism of action and the range of applications of HBOT.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2015
Review[Hyperbaric therapy and diving medicine - diving medicine - present state and prospects].
The diving accident (decompression incident, DCI) occurs in the decompression phase of dives. The DCI can either be caused by an arterial gas embolism (AGE) subsequent to a pulmonary barotrauma or by the formation of inert gas bubbles subsequent to a reduction of ambient pressure during the ascent from depth. In contrast to the traditional assumption that decompression incidents only occur if decompression rules are neglected, recent data indicate that a vast amount of diving accidents occur even though divers adhered to the rules. ⋯ Fluid substitution is performed by i. v. infusion of 500-1000ml/h of cristalloids. If consciousness is not impaired, the diver is positioned in a supine position, in case of impaired or absent consciousness in a lateral recovery position. Especially in severe cases of DCI a fast transfer to a qualified hyperbaric center and the earliest possible hyperbaric O2-therapy is essential.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2015
Case Reports[Case Report - Really a diving accident?].
A 17 y old male SCUBA diver presents himself for hospital admission after a suspected diving accident. All clinical signs are favouring the initial diagnosis: loss of leg motor function, paresthesia, disturbed vision and headache. What are your further diagnostic and therapeutic steps? Can you proof the initial diagnosis? What differential diagnoses are relevant or even mimicked?