Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2013
Review[Evidence-based renal replacement therapy--intermittent versus CRRT].
Continuous and intermittent renal replacement procedures are equally adequate therapies for acute kidney injury. The choice of modality should be made individually and on the basis of the specific clinical situation which may include switching between modalities during the course of treatment. In patients with haemodynamic instability or at risk of disequilibrium and cerebral edema CRRT or prolonged intermittent treatment may offer advantages whilst IHD should be preferred for the acute treatment of life-threatening electrolyte abnormalities or metabolic acidosis. Overall, the different modalities should be viewed as complementary.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2013
Review[Acute kidney injury--recovery--which patients and why?].
Acute kidney injury occurs in up to 30% of all ICU patients. Renal replacement therapy is required in approx. 8%, and mortality in the latter group is up to 50%. Dialysis dependency occurs in 10-30% of survivors. ⋯ Even in those with initial recovery the subsequent risk of chronic renal failure is high. Specific interventions to promote renal-recovery are not available. Nevertheless, there is some evidence that if continuous renal replacement therapies are used instead of intermittent haemodialysis the chance of recovery to independence from dialysis is increased.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2013
Case Reports[Bicycle accident on the way to school--an interactive case report].
We report on the case of a multiply injured 14-year-old girl with severe open brain trauma, prehospital cardiopulmonary rescuscitation and immediate decompressive craniectomy. Despite the extremely poor prognosis, a very good outcome has been achieved. We discuss the influence of the time management on the outcome.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2013
Review[The implementation of an independent and differentiated pain management SOP (Standard Operating Procedure) for the interdisciplinary intensive care unit].
Up to the present day, pain management in the ICU (Intensive Care Units) is a unresolved clinical problem due to patient heterogeneity with complex variation in etiopathology and treatment of the underlying diseases. Therefore, therapeutic strategies in terms of standard operating procedure (SOP) are a necessary to improve the pain management for intensive care patients. Common guidelines for analgosedation are often inadequate to reflect the clinical situation. ⋯ In addition to our pre-existing SOP for analgosedation we implemented a pain management SOP for our interdisciplinary, anaesthesiologic ICU. A exploratory survey among the nurse staff was conducted to assess the efficacy of the SOP. The results of the evaluation after a 6 month follow-up indicated a faster onset of pain management and good acceptance by the nursing staff.