Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 1995
Case Reports[Apnoeic oxygenation in Boerhaave syndrome].
Boerhaave's syndrome (Hermann Boerhaave, 1724 [5]) stands for the atraumatic spontaneous rupture of the oesophagus, and still represents a life-threatening situation. Contrary to the surgical approach, the anaesthesiological management has been largely neglected so far. ⋯ During thoracic operations adverse situations may arise from the two antipodes artificial ventilation and acceptable surgical access. Alternative respiratory techniques, e.g. one-lung anaesthesia and/or high-frequency jet ventilation, are not always applicable, although the present case report indicates that a double lumen tube should be recommended. However, the clinical use of oxygenation by apnoeic oxygenation is a useful measure that can be realised in a simple and safe manner. The present case report may help to consider this particular alternative also during thoracic surgery (no influence of FRC size on pAO2 decrease). If applied correctly, apnoeic oxygenation obviously increases both the flexibility of the anaesthesist and patient safety, and additionally provides the ability of safe acting in clinical routine settings as well as during emergencies. In summary, knowledge of this technique of oxygenation seems to be an integral part of serious anaesthesiological education and clinical management.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 1995
Comparative StudyStatistical modelling in analysis of outcome after trauma Glasgow-Coma-Scale and Innsbruck-Coma-Scale.
The current study investigated the Glasgow-Coma-Scale (GCS) and the Innsbruck-Coma-Scale (ICS) for accuracy and reliability of prehospital prediction of non-survival. ⋯ The results of the present study not only suggest that it is possible to predict mortality prior to therapy for any individual GCS and ICS coma score, but also indicated the ICS to be safer to use than the GCS because of the greater distance of the median scores for survivors and non survivors.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 1995
Comparative Study[Effects of desflurane on liver microcirculation in comparison with isoflurane and pentobarbital. An intravital microscopy study in the rat].
It is well known that the volatile anaesthetics halothane, enflurane and isoflurane alter hepatic blood flow in a dose-dependent manner. However, there are only a few studies investigating the effect of the new anaesthetic desflurane on the hepatic blood flow. In particular no information is available about the influence of desflurane on liver microcirculation. Therefore, the aim of this study was to evaluate the effects of desflurane in comparison to isoflurane and pentobarbital on microcirculation of the liver in vivo using intravital fluorescence microscopy. ⋯ Hepatic microcirculation is not affected by one-hour anaesthesia with 0.75 MAC isoflurane or desflurane in comparison to pentobarbital.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 1995
Biography Historical Article[Alfred Kirstein (1863-1922)--pioneer in direct laryngoscopy].
On April 23rd 1895, in Berlin, Alfred Kirstein performed the first direct examination of the interior of the larynx. 23 days after his first view of larynx, he gave a comprehensive demonstration of autoscopy to the Berlin Medical Association. Until then laryngologists had been content with the technique of indirect laryngoscopy using mirrors, a method popularised by Garcia, Türck and Czermak. ⋯ He reported that the removal of foreign bodies from the trachea must be easier through an autoscope then by means of a tracheostomy; furthermore, catheterisation of the bronchi should now present no great difficulties. The similarity between the blades he used and those described in the 1940s by Macintosh and Miller is remarkable.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 1995
[Education of the medical student in first aid, emergency and disaster medicine--the Graz model].
In Austria emergency and disaster medicine is a young interdisciplinary subject. It is only a borderline discipline encompassing different medical subjects and was subdivided into emergency medicine for medical doctors only and first-aid for lay people and emergency technicians. ⋯ According to the three steps of the study lectures and practices, all parts of first-aid, emergency and disaster medicine were offered. In spite of the short time since this has been running, we found a good acceptance and we hope to increase the interest evinced by medical students in our training programme.