Der Anaesthesist
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Review
[Intensive Care ventilation-New norm establishes a uniform nomenclature for ventilation modes].
The current naming of ventilation modes in anesthesiology and critical care is characterized by manufacturer-specific inconsistent acronyms. This is confusing for users and potentially life-threatening for patients. The standard, published in August 2021 in its German version as DIN EN ISO 19223:2021, aims to introduce a uniform classification with corresponding nomenclature. ⋯ Standardized terminology and semantics in respiratory care are necessary and desirable for error reduction. However, the recently presented standard fulfils these expectations only to some extent and in its current form will probably lead to further ambiguities and problems in the clinical routine. Accordingly, it is imperative that this first version of DIN EN ISO 19223:2021 be understood as the starting point for a discussion of its content, even outside the standards committees, so that its obvious weaknesses can be eradicated and the nomenclature made suitable for everyday use.
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Despite the ever-gaining popularity of mountain bike sports, the number of studies in regards to injury patterns and organizational aspects of rescue services is rather sparse. To efficiently support mass events such as the Union Cycliste Internationale (UCI) World Cup and UCI Championship, the World Championships and Swiss Epic Marathon, efficient rescue concepts are crucial. Challenges include high risk of injury in disciplines such as Downhill as well as the need to cover events in remote and often rough terrain in the Swiss Alps during the Swiss Epic Marathon, providing medical services not only for participants but also for spectators. We analysed the number of injuries sustained by participants as well as the different challenges for rescue services at these events. ⋯ Mass events require rescue concepts tailored to the competition's sport as well as it's terrain. The number of injuries was low but their severity necessitates highly qualified personnel and efficient rescue logistics to be planned beforehand. GPS-tracking and central disposition of mobile rescue resources is essential for marathon races while track competitions benefit from a mix of stationary posts and mobile units.
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To date no biomarker has been identified bringing together perfect sensitivity and specificity to discriminate between inflammation and infections. Since the 1930s new markers of tissue damage and endothelial damage have been identified but which are incapable of identifying infections in every clinical setting to enable initiation of early antibiotic treatment. In this review the most important classical biomarkers and upcoming new PCR-based approaches are addressed. ⋯ The issue of discrimination between inflammation and infection is not yet solved. Based on one single biomarker it is impossible to decide whether infection is the reason for the patient's worsening condition but the combination of biomarkers or the integration of new biomarkers may be a meaningful supplement. The measurement of different biomarkers of infection or inflammation is part of the routine in critical care and will be essential in the future.