Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 1991
Biography Historical Article[Franz Kuhn (1866-1929) on the 125th anniversary of his birthday].
At the beginning of the 20th century, the German surgeon Franz Kuhn (1866-1929) was the leading protagonist of various endotracheal intubation technics. In the period between 1900 and 1912, he wrote several papers on this topic including a remarkable monograph on intubation, which was not widely appreciated for decades. In this, he discussed--among others--the advantages and possible risks of the endotracheal intubation, for patients during surgical procedures as well as in situations of cardiopulmonary resuscitation. ⋯ He was the first to incorporate a carbon-dioxide absorption system within the anaesthesia apparatus. Later, he developed technical devices for the perioperative intravenous administration of fluids or the injection of local anaesthetic drugs under high pressure. In honour of Kuhn's 125th birthday, the various contributions to anaesthesia and emergency medicine are outlined.
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Several studies have shown that most anaesthesia-related critical incidents are due to human error. There is evidence that cerebral monitoring procedures may be of value for an early detection of cerebral hypoxia or ischaemia. Monitoring of central nervous physiology includes both evaluation of systemic parameters like arterial blood pressure, arterial PO2, PCO2, and temperature, and more specific parameters for the assessment of central nervous system function and intracranial haemodynamics. ⋯ In contrast, non-invasive transcranial Doppler sonography may provide continuous information on intracranial haemodynamics. Relative changes in cerebral blood flow velocity have been shown to correlate closely to changes in cerebral blood flow. Cerebral perfusion pressure can be calculated by monitoring of intracranial pressure in patients with compromised intracranial compliance.