Der Anaesthesist
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One-lung ventilation causes adverse effects in pulmonary gas exchange and cardiocirculatory function. These adverse effects become particularly important for patients with underlying cardiopulmonary comorbidities. Alterations in pulmonary gas exchange have been investigated in several experimental and clinical trials. ⋯ Furthermore, no conclusive recommendations exist as to which kind of hemodynamic monitoring should be preferred in the situation of one-lung ventilation. Many issues regarding hemodynamic monitoring in one-lung ventilation remain unacknowledged. This article will review the current literature on hemodynamic monitoring in one-lung ventilation in order to derive recommendations for the application of hemodynamic monitoring in this specific peri-operative situation.
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Since the introduction of intraoperative echocardiography into clinical practice in the 1970's its use and utility in the perioperative period has become increasingly more evident. Especially in patients undergoing cardiac surgical procedures intraoperative echocardiography has gained great diagnostic importance. Intraoperative transesophageal echocardiography (TEE) and epiaortic ultrasound are two important and complementing diagnostic modalities in this patient population. ⋯ In addition TEE can be performed during ongoing cardiopulmonary resuscitation and does not interfere with patient management. This review introduces the clinician to the current evidence of the impact of intraoperative echocardiography on intraoperative surgical decisions during surgical procedures. It helps the clinician to identify indications and realize the potential applications of intraoperative echocardiography.
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The new version of the guidelines, which have now been renamed Cross-sectional guidelines on therapy with blood components and plasma derivatives, is distinguished by focusing on key recommendations. In each section clear recommendations for the selection and indications for the use of each blood product are presented and these recommendations are classified with respect to their strength and evidence level. The most important recommendations in section 1 "Erythrocyte concentrates", which is especially important for the faculty of anesthesiology, will be presented in this article with special reference to the data on which the recommendations are based.