Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2005
Review[The present role of interventional lung assist (ILA) in critical care medicine].
The development of low resistance oxygenators widens the therapeutic options for patients with acute respiratory failure (ARDS). Pumpless arteriovenous interventional lung assist systems (ILA) can be used in a subgroup of patients with ARDS. ILA might be indicated in earlier stages of ARDS following a multimodal treatment approach.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2005
Clinical Trial[Extravasal position of central venous catheters despite unsuspicious ECG-guidance].
Does the electrocardiographic method for central venous catheter positioning distinguish between a correct intravasal and a malpositioned extravasal position? ⋯ The electrocardiographic method can not differentiate between intra- and extravasal position of a central venous catheter, and thus, presumably fails to identify malpositioning as a result of vascular perforation.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2005
Case Reports[Procalcitonin as a marker for severe sepsis in an immunosuppressed patient].
A 22 year old female was admitted to the emergency department with high fever up to 41,5 degrees C, tachycardia, and arterial hypotension. Clinically, she presented with bilateral pulmonary coarse crackles. Diagnosis on admission was pneumonia with septic shock. ⋯ Remarkably, the course of PCT levels reflected the severity of septic shock in that it paralleled noradrenaline demand. Ten months previously, the patient had been diagnosed with acute disseminated brainstem encephalitis (ADEM), and had received two cycles of intravenous cyclophosphamide. Our case illustrates that PCT is an early marker for sepsis and it indicates that PCT may also be a valuable marker for the severity of sepsis in immunosuppressed patients.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2005
Guideline[Guidelines for preventing health-care-associated pneumonia].
Because of the high morbidity and mortality associated with health-care-associated pneumonia, it is important to implement evidence-based prevention measures. Recently by CDC published Guidelines for Preventing Health-Care-Associated Pneumonia describe prevention measures based on evaluated studies, randomized controlled trials or meta-analyses. In this paper the most important prevention measures are given, as well as the evidence classification. "Among the changes in the recommendations to prevent bacterial pneumonia, especially ventilator-associated pneumonia, are the preferential use of or tracheal rather than naso-tracheal tubes in patients who receive mechanically assisted ventilation, the use of noninvasive ventilation to reduce the need for and duration of endotracheal intubation, changing the breathing circuits of ventilators when they malfunction or are visibly contaminated, and (when feasible) the use of an endotracheal tube with a dorsal lumen to allow drainage of respiratory secretions."