Der Anaesthesist
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In North America and Europe around 140 persons die every year due to avalanches, approximately 35 in North America, 100 in the European Alps, and 5 in other parts of Europe. Most of the victims are skiers and snowboarders. ⋯ Strategies to minimize the mortality due to avalanches and the on-site treatment of buried persons are discussed. Finally, possibilities to reduce the number of avalanche deaths are pointed out.
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Randomized Controlled Trial Comparative Study
[Comparison of two different laryngeal mask models for airway management in patients with immobilization of the cervical spine].
Reduced cervical spine mobility can impair laryngoscopy and tracheal intubation. Supraglottic airway devices can be important alternatives for oxygenation under these circumstances. The Ambu laryngeal mask (ALM) and the LMA-Classic (LMA) are compared in patients with immobilization of the cervical spine. ⋯ LMA-Classic and Ambu laryngeal masks are suitable for rapid and reliable airway management in patients with cervical immobilization.
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Case Reports
Vasopressin as adjunct vasopressor for vasodilatory shock due to non-occlusive mesenteric ischemia.
We present the case of an 83-year-old patient who underwent cardiac surgery and developed postoperative non-occlusive mesenteric ischemia (NOMI), which was treated with a local intra-arterial papaverine and prostaglandin E1 infusion. After successful mesenteric reperfusion, a multiple organ dysfunction syndrome with severe cardiovascular failure developed. ⋯ AVP stabilized vasodilatory shock, ensured adequate gut perfusion pressure and had no adverse clinical or angiographic effects on restitution of gut integrity. In conclusion, after reperfusion of NOMI in this patient, adjunct AVP therapy combined with local vasodilator infusion was beneficial as a potentially life-saving vasopressor.