Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 2004
Review[Clinical impact of recruitment maneuvers in patients with acute respiratory distress syndrome].
In patients with acute respiratory distress syndrome (ARDS), recruitment maneuvers have been proposed as an adjunct to mechanical ventilation to open up atelectasis and to keep these alveoli open by the application of adequate high levels of positive end-expiratory pressure (PEEP). Though several studies reported that the responsiveness to recruitment maneuvers resulted in a marked improvement of oxygenation with a concomitant decrease in airway pressure and/or inspiratory fraction of oxygen, the performance of recruitment maneuvers still remains a matter of dispute, especially in patients ventilated with a lung protective ventilation strategy. ⋯ Successful recruitment depends on several factors like the applied recruitment pressure, the level of PEEP set before and after the recruitment maneuver, the stage and the underlying disease of the ARDS, chest wall mechanics and the transpulmonary pressure as well as the positioning of the patient. Regarding the current literature, recruitment maneuvers may be considered as a rescue therapy in the early stage of severe hypoxemic lung failure, if a lung protective ventilation strategy and other additive adjuncts like prone positioning or the application of inhaled vasodilators failed to induce adequate gas exchange.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 2004
Review[Xenon - noble gas with organprotective properties].
Besides it's anaesthetic properties, xenon may induce biological effects that may protect various organs from ischaemia-reperfusion injury. Xenon is an antagonist of the NMDA-receptor and reduces the neuronal injury mediated via these receptors. ⋯ Xenon reduces the post-ischaemic reperfusion injury and offers cardioprotection by inducing pharmacological preconditioning. These organ protective properties of xenon might be useful in special clinical situations.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 2004
[Heating capabilities of fluid warming systems during low infusion rates].
The aim of the study was to compare the effects of different fluid warming systems on their heating capabilities during low infusion rates. ⋯ In this laboratory investigation, Hotline performance was superior with respect to providing final temperatures > 32 degrees C during low to moderate infusion rates. Astotherm Plus 260 seems to be an alternative cost effective device in case of infusion rates of more than 300 ml/h.