Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2014
Review[Indications, risk factors, specialities and after-care of surgical treatment for cardiac and thoracic vascular diseases].
Despite a known high risk and complexity in the operative therapy of cardio-thoracic patients, cardiac surgery is medical routine activity today. The German Society of Cardiothoracic Surgery regularly analyses the more than 100.000 cases a year in Germany. Fixing procedural statics, it gives us the knowledge of individual risk factors and success rates for surgical therapy of our patients. Following we want to shortly summarize indications, risk factors, specialities and after-care of surgical treatment for cardiac and thoracic vascular diseases in adults.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2014
Review[Vascular cannulation and hemodynamic monitoring for cardiac and thoracic vascular surgery - a review].
Cardiac surgery requires cardiopulmonary bypass (CPB) with extracorporeal circulation (ECC) for intracardiac procedures. The surgical strategy determines access for monitoring and insertion sites with high-flow cannulas. ⋯ Therefore, the knowledge of the vascular anatomy is essential to provide professional care to patients undergoing ECC during thoracic vascular and cardiac surgery. This article is a review of hemodynamic monitoring and access for ECC in patients for adult cardiac surgery for anaesthesiologists and intensivists.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2014
Review[Coagulation disorders in the context of cardiac surgery - Clinical basics and mechanism based therapy].
Intra- and postoperative bleeding disorders are common in cardiac surgery. The etiology of perioperative coagulopathy frequently becomes apparent as a combination of several acquired and inherited disorders. ⋯ Point-of-care-systems can provide fast bed-sided analysis, which contribute to early diagnosis and intervention. Individual and regularly revised algorithms, adapted to the individualized institutional infrastructure, may facilitate resource-saving treatment of perioperative coagulopathy.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2014
Review[Anaesthesia for extrathoracal vascular surgery - Part 2: anaesthesiological management].
The anaesthesiological management in patients undergoing vascular surgical procedure need an individual approach, because of the high incidence of coexisting diseases with an increased risk of cardiovascular complications. The choice of anaesthesiogical method und perioperative monitoring depends on planned vascular procedures.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2014
Case Reports[Residual relaxant block due to pseudocholinesterase deficiency - First manifestation in an elderly patient].
Pseudocholinesterase or butyrylcholinesterase (BChE) inactivates the relaxant drugs mivacurium and suxamethonium. A deficiency in plasma activity of this enzyme may result in prolonged muscular paralysis and subsequently the need for an extended duration of mechanical ventilation. We report the case of a 65-year-old patient who was diagnosed with butyrylcholinesterase deficiency for the first time during elective surgery. Neuromuscular monitoring constitutes a central diagnostic asset in ensuring patient safety.