Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2013
Historical Article[Ether Day - no laughing matter. The birth of modern anaesthesia].
Since centuries the first public demonstration of the anaesthetic properties of ether by William Thomas Green Morton at the Massachusetts General Hospital in Boston on October 16th 1846 is celebrated as "Ether Day" world-wide. The news of the beneficial effects, primarily disposed as a "Yankee Invention", spread over all continents quickly. ⋯ The important discovery later became a patent case and was overshadowed by a long lasting priority claim. Nevertheless the readers of the New England Journal of Medicine voted in a survey that this article was the most important publication in the 200 years journals history ever.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2013
[Weaning from mechanical ventilation: Which strategies are useful?].
During acute respiratory failure, intubation and invasive mechanical ventilation may be life saving procedures. However, with increasing time on the ventilator, the rate of complications increases and prolonged mechanical ventilation is associated with increased morbidity, mortality and high ICU cost. ⋯ These include an early screening of weaning readiness based on established criteria, the choice of the concept of ventilation and ventilator modes, the use of weaning protocols, "closed loop" automated ventilation and weaning. This article describes the relevance of the different ventilator strategies that are applied during weaning from mechanical ventilation.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2013
Review[Current concepts of weaning children from invasive ventilation].
Timely weaning from invasive ventilation is of major importance to limit time of invasive ventilation and improve outcomes. However, in pediatrics only limited knowledge on the optimal weaning approach is available. ⋯ Standardized daily evaluation of weaning readiness, daily interruption of sedation, use of pediatric sedation protocols, application of noninvasive ventilation and prophylactic treatment with steroids of patients with high risk for post-extubation upper airway obstruction have been shown to decrease duration of invasive ventilation or to decrease the risk of extubation failure. However, due to the heterogeneous patient population in pediatric intensive care units, an individual approach might be necessary for certain subgroups of pediatric patients.