Der Anaesthesist
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Residual neuromuscular block is a major risk factor behind critical events in the immediate postoperative period. Residual weakness due to muscle relaxants is seen in more than thirds of postoperative patients with ventilatory failure and hypoxia. Residual neuromuscular block should therefore be regarded as a serious adverse event in the same way as we regard ventilatory depression due to opioids and anaesthetic agents. This presentation aim to clarify our present knowledge and shortcomings in the field of residual neuromuscular blockade.
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The introduction of Perfluorochemicals into medicine and especially into the treatment of severe lung injury is a fascinating scientific task. Many recall the famous experiments from Clark et al. in 1966 when he demonstrated "liquidventilation with perfluorocarbons" in the mammal species for the first time. After this hallmark, perfluorocarbons were subsequently introduced in research of acute lung injury by the techniques of Total- and Partial-Liquid-Ventilation (TLV; PLV). ⋯ These questions need to be clarified before this technique can be applied clinically. However, the inhalation of vapor, a technique already familiar to anaesthesiologists should avoid risks of large amounts of fluids in the bronchoalveolar space. Furthermore, this technique can be administered by established anaesthetic equipment with the advantage of exact dosing, continuous monitoring, and demand application in a way near to clinical routine.