Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2015
Review[Robot-assisted surgery in visceral and thoracic surgery gynaecology, urology - importantanaesthetic considerations].
Robot-assisted surgery, as a development of laparoscopic surgery, has an increasing field of application. Beside urology, this technique has also been implemented in visceral and thoracic surgery and gynaecology. For the surgeon an enhanced view of the surgical field and a better mobility of the instruments are the most important advantages. ⋯ Therefore, a standardised order and protection of all i. v.-lines, cables and the ventilation-hose of the (double-lumen) tube is essential. After the roboter is connected to the patient, it is nearly impossible to change or extend patient monitoring. Especially in case of emergency, e. g. respiratory complications or heart failure, a close communication with the surgeon and a team approach are indispensable.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2015
Review[Sepsis and multiple organfailure - Potential therapeutic interventions].
Sepsis therapy is aiming to eliminate the focus of infection and to obtain or to restore microcirculation. Severe sepsis and septic shock have to be treated as fast and aggressively as hemorrhagic shock, because the time between onset of disease and initiating the therapy is crucial for the probability of survival. ⋯ The compliance with the bundle measures and consequent training of medical staff to predefined goal measures and therapy protocols is determining the success of sepsis therapy. The bundle measures of the first six hours (resuscitation bundle) deserve special attention.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2015
Review[Blood culture diagnostic - Challenge or routine standard of care?].
Blood cultures are an essential diagnostic tool to investigate suspected cases of sepsis. However, several studies indicate that (compared with other countries) blood culture diagnostics is only rarely performed in German healthcare facilities. Reasons for this are unknown, but could include clinicians' perception that the turn-around time of results is delayed or that contamination rates are high. Therefore, this article aims to summarize important aspects involved in assuring quality of blood culture diagnostics as well as innovative approaches.