Deutsche medizinische Wochenschrift
-
Dtsch. Med. Wochenschr. · Mar 2018
Case Reports[Rare Clinical Case of a Small Intestine Ileus Following an Invaginated Meckel's Diverticulum].
A 43-year old male patient was admitted because of diffuse abdominal discomfort for two days, which had started in the upper abdomen; medical history, no previous surgical interventions at the abdomen. ⋯ An invaginated Meckel's diverticulum belongs rather to the less frequent causes of an ileus of the small intestine and an unclear / acute abdomen in adults.
-
Dtsch. Med. Wochenschr. · Jan 2018
[Organ Donation in Victims of Non-Traumatic Out-of-Hospital Cardiac Arrest].
The out-of-hospital cardiac-arrest (OHCA) is one of the leading causes of death. However, although previous studies showed the possibility to transplant organs from resuscitated donors, organ donation following OHCA remains seldom. We therefore initiated this study to investigate the current percentage of organ donation in victims of OHCA in a german university hospital. ⋯ Organ donation following OHCA is seldom. We therefore would appreciate a more frequent diagnostics of brain death as currently not even all victims of OHCA with proven signs of brain damage in the computed tomography receive further diagnostics to confirm the diagnosis of brain death.
-
Dtsch. Med. Wochenschr. · Jan 2018
[Ethics Consultation on the ICU: The Clinically Oriented Method of Counselling].
When ethical conflicts arise on the ICU, an ethics case consultation is useful. The aim of this consult is a qualified reflection of the moral values, convictions and assumptions involved in the case. The "clinically oriented method of counselling" provides an adequate structure for case consultations on the ICU. ⋯ This method is familiar to hospital staff and will effectively support mutual understanding and agreement among physicians, nursing staff and family members. A consensus, facilitated by ethics consultation, expresses the shared belief, that the therapeutic options in question are both scientifically sound and humane. On the one hand the consensus assures the appropriateness of therapeutic goals and therapeutic means, on the other hand it proves the assessment, that patient wishes and preferences have been considered as conclusive as possible.
-
Family-centered care in the ICU is a quality criterion of modern intensive care. Relatives are not just visitors, caregivers and involved stakeholders, but also partners for the medical team, especially when eliciting patient preferences and during shared decisionmaking. The move towards family-centered care signifies that traditional roles are changing; family-centered care is becoming a critical component of optimizing patient outcomes in the ICU.
-
Dtsch. Med. Wochenschr. · Dec 2017
Case Reports[Sonography of the Optic Nerve: a New Bedside Tool in Intensive Care?]
History and clinical findings Here, we present the case history of a 76-year old man with out-of-hospital cardiac arrest due to a cardiogenic shock and a consecutive no-flow-time of approximately 10 minutes. After 25 minutes of resuscitation procedures a spontaneous return of circulation could be established. The patient was admitted to our center for emergency coronary angiography. ⋯ Measurement of the optic nerve sheath diameter with a maximum diameter of 7 mm indicated an increased intracranial pressure. In the subsequent CT scan of the brain signs of hypoxic encephalopathy with breakup of grey and white matter differentiation were present. Conclusions In case of clinical and/or laboratory-chemical indications for hypoxic encephalopathy and/or increased intracranial pressure the bedside-based sonography examination at the intensive care unit should imply an evaluation of the optic nerve in order to initiate early apparative neurological diagnostics.