Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2009
Review[The Intensive Care Delirium Screening Checklist (ICDSC)--translation and validation of intensive care delirium checklist in accordance with guidelines].
Although Delirium is the most common psychiatric disease in ICU settings, it is recognized late or not at all in up to 84 % of all cases. ⋯ The ICDSC is suitable for delirium screening by nurses even on ventilated patients. Besides a high sensitivity another advantage is the possibility to screen for a subsyndromal delirium.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2009
Review[Initial care of the severely burned patient].
The care of severely burned patient is still an interdisciplinary challenge. Despite improvements in the understanding of the pathophysiology of burn disease, mortality is high if more than 25 % of body surface area is burned. ⋯ Initially, the burn trauma leads to a capillary leakage syndrome, resulting in severe hypovolemia. Therefore, adequate volume substitution is the primary therapy to prevent potential life-threatening hypovolemic shock.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2009
[Anaesthetic considerations in endovascular repair of aortic aneurysms].
With advancing developments of endovascular techniques, the demands on anaesthesiological management are increasing. The transfemoral implantation of coated endografts in the aorta of cardiopulmonal impaired patients is a particular challenge for the interdisciplinary team. Guided by invasive monitoring, changing blood-pressure targets have to be achieved and in case of serious complications conversion to open surgery must be available immediately.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2009
[Anaesthesia for major vascular surgical procedures].
Vascular surgery carries a high perioperative risk for the patients, because of the high incidence of coexisting diseases with an increased risk of cardiovascular complications. Based on preoperative findings, anaesthetic technique, monitoring and postoperative management are planned. For risk optimization the anaesthetist should have a high theoretical and practical experience in the used anaesthetic techniques and a profound knowledge of the pathophysiological characteristics of the vascular procedures.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2009
[Integration of principles of palliative medicine into treatment of patients in intensive care units].
Intensive care medicine, as well as palliative medicine, is dealing with the limits of life-preserving care. Decision-making in matters of life and death is one of the greatest challenges for physicians, because it may be an area of conflict with regard to aspects of patient autonomy, medical prognosis and the ethics of medical care. At first sight palliative medicine and intensive care medicine seem to be at the opposite ends of care. ⋯ Approaches, tasks and goals of palliative and intensive care medicine are covering and targeting at different medical situations but are not at opposite ends of care. Shared priorities are pain control and management of other distressing symptoms, alleviation of suffering, comprehensive communication with both, patient and relatives, empathic care that includes the willingness to reflect on end-of-life matters and respect for a human being's dignity. Other common denominators of the team members are: inter-disciplinary teamwork of highly qualified specialists who are able to face and deal with extensive emotional and physical strain, the breaking down of hierarchical structures and team spirit.