Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2016
Review[Weaning: more than terminating mechanical ventilation].
Mechanical ventilation is an essential part of modern intensive care. It is used in patients with acute respiratory failure and, depending on the type of respiratory failure, different modes of application. ⋯ In about 20% of ventilated patients, however, an extremely protracted and complex weaning process can be observed, even though the cause necessitating ventilation has long since been eliminated. In addition to the stages in the process of weaning from the ventilator, in particular the pathophysiological processes that lead to prolonged weaning are addressed in this article.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2016
Review[Pathophysiology, diagnosis and treatment of asthma: focusing on a chronic disease].
Bronchial asthma is one of the most common chronic diseases. Its pathogenesis is still not fully understood and its progression is still not predictable. ⋯ In recent years great improvements in medical treatment and patient care have been achieved. This article summarizes the pathogenesis, clinical picture, diagnosis and treatment of bronchial asthma.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2016
Review[Hyperoxia in Anesthesia and Intensive Care Medicine - too much of a good thing?].
For decades the administration of oxygen has been a corner stone in the treatment of various medical emergencies, e.g. acute myocardial infarction. Several arguments support the perioperative use of high oxygen concentrations (>80%) for the prevention of surgical site infections. However, effects of oxygen include an increase in systemic vascular resistance, a reduction in heart rate and stroke volume and thus an impairment of the microcirculation, e.g. in the coronary and cerebral vasculature. ⋯ Recent data suggest that hyperoxia may be more harmful than beneficial and may increase morbidity and mortality in surgical and intensive care patients. Also, the current guidelines from the European Resuscitation Council from 2015 address the potentially harmful effects of high oxygen concentrations in various emergency settings. The aim of this article is to give an overview about the physiological and clinical effects of hyperoxia with a focus on its use in perioperative and intensive care medicine.