Der Anaesthesist
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Clinical Trial
[Preanalytical errors on the determination of arterial O(2)-partial pressure and their impact on the AaDO(2)].
The paO(2) and AaDO(2) are routinely measured for evaluating pulmonary gas exchange. The normal value of the AaDO(2) amounts 10 mmHg when breathing atmospheric air and is said to increase with rising FIO(2). This increase is discussed controversially. One possible reason for incongruities in AaDO(2) measurement may be the impact of so called preanalytical errors during paO(2) measurement, which are often neglected. Therefore, the aim of this study was to evaluate the relevance of preanalytical errors on the AaDO(2) under hyperoxic conditions. ⋯ The present results show that the assumption of an increasing AaDO(2) with rising FIO(2) is questionable. It could be proved that neglecting preanalytical paO(2) errors leads to a significant overestimation of the AaDO(2). The consequence would be a misinterpretation of the patient's condition in relation to a reduced pulmonary gas exchange, which should in fact be attributed solely to the preanalytical errors.
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Minor laryngopharyngeal complaints following anaesthesia considerably determine postoperative patient comfort. They cannot be eliminated but reduced by experience and careful preparation and insertion technique. The incidence of minor laryngopharyngeal symptoms following the use of the laryngeal mask airway is similar to that following endotracheal intubation. ⋯ Measurement of cuff pressure is not obligatory, instead reduction of cuff volume to a "just seal" situation seems to be a reasonable approach. The laryngeal mask airway has definitely changed anaesthesiology airway management. Whether this is due to its supposedly less invasiveness compared to endotracheal intubation has not been proven by scientific investigations.
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Multicenter Study Clinical Trial
[Postoperative cognition disorders in elderly patients. The results of the "International Study of Postoperative Cognitive Dysfunction" ISPOCD 1)].
Cognitive dysfunction is a known problem after operations and may be especially relevant in the elderly. The aim of this international multicentre study was to investigate short- and long-term cognitive dysfunction in elderly patients and to elucidate the relevance of hypoxaemia and hypotension as causative factors. ⋯ With this investigation long-term cognitive dysfunction could be proven definitively for elderly patients after major operations under general anaesthesia. No factors with prophylactic or therapeutic influence were detectable so that aetiology and pathophysiology of POCD could not be further determined.