Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2008
Review[Transesophageal echocardiography in critically ill patients--techniques, indications and possibilities].
TEE is one of the most versatile modalities for diagnosing and guiding treatment of critically ill patients due to its ease of use at patient bedside, the high quality imaging, the rapid availability of diagnostic information and its low complication rate (2.6%). Numerous studies habe shown a significant diagnostic (67%) and therapeutic (36%) impact on patient management in critically ill patients, particularly in cardiological and cardiosurgical populations.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2008
Review[Parenteral, enteral or combined parenteral and enteral nutrition].
Perioperatively early oral food intake is achieved in most cases. A temporary protein and energy deficit is rarely associated with increased complication rates. Concerning the route of nutritional support there is no difference in mortality but in complication rates. ⋯ But in case of gastrointestinal failure nutritional support is limited to the intravenous route. Increasingly a combined parenteral and enteral nutrition is proposed in cases of malnutrition or expected perioperative complications with delayed enteral food ingestion. Up to now there is no good scientific evidence for such approach.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2008
Review[Pain relief with cannabinoids-- the importance of endocannabinoids and cannabinoids for pain therapy].
The endocannabinoid system reduces sensitization processes. Low doses of cannabinoids may enhance the potency of opioid-drugs and reduce the risk of tolerance to opioids. So far no cannabinoid has been approved for the treatment of acute pain due to lack of consistent data. ⋯ The adjunct of cannabidiol and the oromucosal formulation increase the therapeutic index of delta9-tetrahydrocannabinol. The differentiation of analgetic effects and cannabimimetic effects may be increased while compounds--such as ajulemic acid--are used which preferentially act on peripheral cannabinoid receptors and exert receptor independent effects. A further approach in this direction is the use of enzymes which metabolize endocannabinoids.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2008
Case Reports[Emergency care management of patients with cancer at the final stage of disease--seven cases].
The care of patients with cancer disease in the final stage amounts to 2.5% of all emergency-medical applications. This corresponded to the number of pediatric emergency cases. For this every emergency physician can be involved in the care of those patients. ⋯ Nevertheless, the emergency physicians were alarmed by the patients' relatives because of needing professional help at the moment. The differences of the cases appeared in the regulatory framework. The seven cases have shown that different legal meanings could be important in emergency therapy of palliative patients.