Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2016
[Asthma bronchiale - Emergency medical treatment].
Treatment of patients with acute severe or life-threatening asthma in the emergency department or in rescue services is a challenge for the physician. The decision on which therapy is needed depends on the clinical assessment of severity. ⋯ If these treatments fail, systemic administration of bronchodilators, MgSO4 and theophylline should be carried in order to avoid intubation. Patients with incomplete or poor response should stay in hospital.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2016
Review[Hyperoxia in Anesthesia and Intensive Care Medicine - too much of a good thing?].
For decades the administration of oxygen has been a corner stone in the treatment of various medical emergencies, e.g. acute myocardial infarction. Several arguments support the perioperative use of high oxygen concentrations (>80%) for the prevention of surgical site infections. However, effects of oxygen include an increase in systemic vascular resistance, a reduction in heart rate and stroke volume and thus an impairment of the microcirculation, e.g. in the coronary and cerebral vasculature. ⋯ Recent data suggest that hyperoxia may be more harmful than beneficial and may increase morbidity and mortality in surgical and intensive care patients. Also, the current guidelines from the European Resuscitation Council from 2015 address the potentially harmful effects of high oxygen concentrations in various emergency settings. The aim of this article is to give an overview about the physiological and clinical effects of hyperoxia with a focus on its use in perioperative and intensive care medicine.