Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2007
Review[Anesthesia in children with congenital heart disease].
Anesthesiologists involved in the care of children with congenital heart disease (CHD) have to understand the pathophysiology of each cardiac lesion and anticipate the impact of the planned procedure. Often the dimished margin of hemodynamic stability determines the guidelines of care. ⋯ Left-to-right shunting means a volume load to the left ventricle frequently combined with pulmonary hypertension. Right-to-left shunting leads to a central cyanosis.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2007
Review[Therapeutic options for patients with acute lung injury].
The treatment of acute lung injury is one of the most challenging tasks in intensive care medicine. Conventional therapeutic options cover lung protective mechanical ventilation with low tidal volumes and adequate PEEP, restrictive fluid management, prone positioning, and early recruitment maneuvers. ⋯ In cases of refractory hypoxemia, inhaled nitric oxide offers in most patients a successful rescue option. In specialized centers the application of ECMO remains as a final ultima ratio.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2007
Review[Xenon--the ideal anaesthetic agent?].
The noble gas xenon, besides its anaesthetic and analgesic properties, shows many characteristics of an ideal anaesthetic agent. However, due to high production costs, its application is limited In daily clinical routine. Recent studies suggested not only outstanding haemodynamic stability and rapid emergence from anaesthesia, but also xenon's capacity to mediate protection against ischaemic damage in various organs and tissues. Since xenon is devoid of toxicity and relevant side effects, it could be beneficial at least in a subset of patients at high risk, and xenon therefore may become a reasonable alternative in this patient population.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2007
Case Reports[Case report: bilateral block of the brachial plexus--approaches, dosage and effectiveness].
A young man squeezed both hands in a bending machine with the result of complex hand injuries. Because of a high risk for general anesthesia, operation as well as postoperative analgesia was performed under bilateral brachial plexus block with the axillary approach. We discuss the considerations concerning the possible approaches with bilateral anesthesia of the brachial plexus under consideration of side effects and effectiveness. The needed dosage of the local anesthetics will be discussed.