Medizinische Klinik, Intensivmedizin und Notfallmedizin
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Med Klin Intensivmed Notfmed · Nov 2013
Review[Patient safety in anesthesiology and intensive care medicine. Measures for improvement].
Technical improvements as well as various strategies for error detection and error prevention have made intensive care medicine and anesthesiology a safe medical specialty. Due to the introduction of "Patient safety in the ICU: the Vienna declaration" of the European Society of Intensive Care Medicine (ESICM) from October 2009 and the "Helsinki declaration on patient safety" of the European Society of Anaesthesiology (ESA) and the European Board of Anaesthesiology (EBA) from June 2010, there are now specific recommendations for all hospitals in Europe concerning the safety measures that are considered to be of essential importance. ⋯ Critical incident reporting systems, crisis resource management and checklists, e.g. the World Health Organization (WHO) checklist, are safety approaches of this kind. In addition to these, standardized drug labelling, hand disinfection, techniques for patient handover and simulation-based training have been exemplarily selected for this article as measures that can increase patient safety.
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Although acute liver failure is a rare disease with a prevalence of 5 per 1 million people, it has a considerablely high mortality rate of 34 %. The main causes in western civilizations are drug overdose (acetaminophen) and viral hepatitis. ⋯ Orthotopic liver transplantation is, therefore, frequently the only remaining effective therapy for severe acute liver failure. Due to organ shortage, new prognostic tools, e.g., the Acute Liver Failure Study Group (ALFSG) score, have been developed to improve patient selection using sufficiently stringent selection criteria.
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Med Klin Intensivmed Notfmed · Nov 2013
Comparative Study Observational StudyPredictive value of outcome scores in patients suffering from cardiogenic shock complicating AMI: APACHE II, APACHE III, Elebute-Stoner, SOFA, and SAPS II.
Scoring systems in critical care patients are essential for prediction of outcome and for evaluation of therapy. In this study we determined the value of the APACHE II, APACHE III, Elebute-Stoner, SOFA, and SAPS II scoring systems in the prediction of mortality in patients with cardiogenic shock (CS) complicating acute myocardial infarction (AMI). ⋯ These results suggest that at the time of diagnosis and at maximum value, the SAPS II, APACHE III, and APACHE II scores may be useful in predicting a high probability of survival of patients with CS complicating AMI.
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Abdominal compartment syndrome is defined as a pathological elevation of intraabdominal pressure associated with significant organ dysfunction and failure. Organ dysfunction mainly affects the renal, pulmonary, cardiac, gastrointestinal, and central nervous system. A high level of suspicion for this condition and early identification of patients at risk are mandatory for the successful management of abdominal compartment syndrome, which includes conservative and operative strategies.