Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2016
Biography Historical Article[Crawford Williamson Long - The true discoverer of anesthesia?]
October 16, 1846 is regarded as the birth of anaesthesia at the Massachusetts General Hospital in Boston. However, was this really the first anaesthesia with sulphuric ether? In the priority dispute that started already in 1846 there were more participants: WTG Morton, CT Jackson and H Wells. Not involved was CW Long, who has already administered ether anaesthesia in 1842. He has published his results only 1849 and therefore he gained no glory.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2016
Review[Remote Ischaemic Conditioning - an overview].
The strategy of Remote Ischaemic Conditionings (RIC) is easy to apply, cost effective, low in side effects and belongs to the most potent cardioprotective strategies evaluated within recent years. Its practical application is carried out by simple use of a blood pressure cuff, more precise by 4 repetitive cycles of inflating the cuff above 200 mmHg for 5 minutes followed by an equal long break between the cycles. ⋯ Nevertheless, given the neutral results of two recent clinical multicentre trials, the clinical significance and benefits of RIC in cardiac surgery patients remains uncertain. The combination of co-medication and narcotic agents is thought to be responsible for the failed transfer into the clinical practice.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2016
Review[Hemodynamic monitoring - imaging procedures / cardiac ultrasound].
Echocardiography as an imaging method in anaesthesia and intensive care medicine has enabled a new dimension of hemodynamic monitoring: the direct visualization of the cardiac function and its disruptions. Preconditions for a broad application in this area was the development of mobile, high-definition ultrasonic devices and the origination of focused examination techniques. ⋯ For TTE and TEE focused examination techniques are illustrated and evaluated with regards to their applicability to hemodynamic monitoring. Furthermore, the requirements on devices and education of the examiner are discussed.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2016
Review[Invasive and minimally invasive hemodynamic monitoring].
Advanced hemodynamic monitoring is necessary for adequate management of high-risk patients or patients with derangement of circulation. Studies demonstrate a benefit of early goal directed therapy in unstable cardiopulmonary situations. In these days we have different possibilities of minimally invasive or invasive hemodynamic monitoring. ⋯ Pulmonary artery, transpulmonary thermodilution and lithium dilution technology have acceptable accuracy in cardiac output measurement. For therapy of unstable circulation there are additionally parameters to obtain. The pulmonary artery catheter is the device with the largest rate of complications, used by a trained crew and with a correct indication, his use is unchained justified.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2016
Review[Hemodynamic monitoring - Basic monitoring].
Basic haemodynamic monitoring is an essential part of the anaesthesia work place. This includes Monitoring of ECG, blood pressure and pulse oximetry. ⋯ Knowledge of function, principles and limitations ais necessary for proper interpretation of the measured values. Here, we describe the function and application of ECG, non - invasive intermittent blood pressure and pulse oximetry in the perioperative setting.