Medizinische Klinik, Intensivmedizin und Notfallmedizin
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Med Klin Intensivmed Notfmed · Oct 2012
Case Reports[Severe organic dysphagia after long-term ventilation in a patient with sepsis and multiorgan failure].
A case of severe chronic dysphagia lasting more than 1 year after long-term ventilation due to sepsis is presented. Fiber optic endoscopic examination of swallowing (FEES) revealed retention of food on both sides of the base of the tongue and in both valleculae combined with severe penetration and postglutitive aspiration into the larynx. ⋯ The adhesion was resected using a CO(2) laser. The final examination 3 months later showed complete recovery of normal swallowing function.
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All guidelines and algorithms for the management of difficult airways include the use of supraglottic airway devices. This report provides information on the different types of these devices and gives selection criteria for different scenarios.
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Med Klin Intensivmed Notfmed · Oct 2012
[Ethic rounds in intensive care. Possible instrument for a clinical-ethical assessment in intensive care units].
Ethical problems, such as medical end-of-life decisions or withdrawing life-sustaining treatment are viewed as an essential task in intensive care units. This article presents the ethics rounds as an instrument for evaluation of ethical problems in intensive care medicine units. The benchmarks of ethical reflection during the ethics rounds are considerations of ethical theory of principle-oriented medical ethics. ⋯ In contrast to the clinical ethics consultation, the ethicist in the ethics rounds model is integrated as a member of the ward round team. Therefore ethical problems may be identified and analyzed very early before the conflict escalates. This preventive strategy makes the ethics rounds a helpful instrument in intensive care units.