Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 1995
Case Reports[Polytrauma and malignant neuroleptic syndrome. Case presentation with diagnostic problems].
The neuroleptic malignant syndrome (NMS) is a rare but potentially fatal reaction associated with neuroleptic drugs. The role of an acute reduction in brain dopamine activity in the development of NMS is commonly accepted as underlying pathogenesis. The diagnosis is maintained by the classic findings of extrapyramidal signs, hyperthermia and autonomic dysfunction. ⋯ NMS developed during the second week after the polytrauma. Discontinuation of neuroleptic therapy was followed by complete recovery. The report underlines problems of diagnosis due to the ambiguity of the diagnostic criteria of neuroleptic malignant syndrome in the presence of polytrauma.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 1995
[Ventilator weaning after long-term ventilation--the concept of a regional ventilator weaning center].
Long-term mechanical ventilation implies a significant number of weaning failures. The basis of this unweanability is chronic fatigue of the inspiratory muscles which is due to depletion of energy store (e.g. glycogen). Considering this pathophysiological principle, the decisive therapeutic option during weaning from long-term mechanical ventilation consists of resting the respiratory muscles. ⋯ This reduces minute ventilation and, therefore, the work of breathing. In patients still exhibiting chronic fatigue of the respiratory muscle pump after successful weaning, intermittent home ventilation is initiated via a breathing mask. Apart from the concept described above, successful weaning from the respirator after long-term ventilation is based upon dedicated patient care and depends on the architectural characteristics of the intensive care unit.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 1995
Biography Historical Article[Otto Kappeler--a pioneer in anesthesia in German-speaking regions].
The publication of textbooks on anaesthesiology reflects the enormous progress made over the last decades. This new branch of medicine was first completely described in Germany by Otto Kappeler from Switzerland, who was asked to do so by his famous colleague Theodor Billroth from Vienna. Starting with remarks concerning the history of anaesthesiology, he described on more than 220 pages everything that was known about the anaesthetics used at that time. ⋯ He believed it would be possible to exclude the dangers of overdosing drugs by introducing devices to perform anaesthesia. In using his self-designed device, which was a modification of the device used at that time, invented by Junker, he was able to come closer to the goal of "in somno securitas" he so vehemently fought for. This confidence he derived from the fact that he was already a strong believer in the advantage of the "self-conducted chloroformation or anaesthesia".