Der Anaesthesist
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The prevalence of patients living with long-term mechanical circulatory support (MCS) is rapidly increasing due to improved technology, improved survival, reduced adverse event profiles, greater reliability and mechanical durability, and limited numbers of organs available for donation. Patients with long-term MCS are very likely to require emergency medical support due to MCS-associated complications (e.g., right heart failure, left ventricular assist device malfunction, hemorrhage and pump thrombosis) but also due to non-MCS-associated conditions. Because of the unique characteristics of mechanical support, management of these patients is complicated and there is very little literature on emergency care for these patients. The purpose of this national scientific statement is to present consensus-based recommendations for the initial evaluation and resuscitation of adult patients with long-term MCS.
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Review
[Coronavirus disease 2019 (COVID-19): update for anesthesiologists and intensivists March 2020].
The current outbreak of coronavirus disease (COVID-19) has reached Germany. The majority of people infected present with mild disease, but there are severe cases that need intensive care. Unlike other acute infectious diseases progressing to sepsis, the severe courses of COVID19 seemingly show prolonged progression from onset of first symptoms to life-threatening deterioration of (primarily) lung function. ⋯ Severe ARDS reflects the hallmark of a critical course of the disease. Preventing nosocomial infections (primarily by correct use of personal protective equipment) and maintenance of hospitals' operational capability are of utmost importance. Departments of Anaesthesia, Intensive Care and emergency medicine will envisage major challenges.
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Review Biography Historical Article
[A protestant pastor as the pioneer of emergency medicine : Sebastianus Albinus published the first emergency manual 400 years ago].
In 1588 Sebastian Weiß, the son of a miller, became the first Lutheran pastor of Dittersbach in Saxony. At home he had repeatedly witnessed successful resuscitation of drowned persons by means of simple measures by his parents. ⋯ This Kurtze Bericht und Handgrieff (Brief report and handgrip) attracted great attention amongst physicians, especially the reprint of 1675 of which a few copies still exist. The first printed edition from 1620 was lost until, some years ago, the apparently only still existing copy was rediscovered in the Herzog August Library in Wolfenbüttel.
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Review
[Foundations of Volumetric capnography : Principles of monitoring of metabolism and hemodynamics].
Capnography is the graphical representation of the carbon dioxide (CO2) concentration in expired air. Using this monitoring procedure, the kinetics of CO2 of mechanically ventilated patients can be assessed in a noninvasive way and in real time. This article highlights the importance, particularly of volumetric capnography (VCap), for clinical monitoring of mechanically ventilated patients. The procedure provides important information on the breathing, ventilation, metabolism and hemodynamics of patients.