Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Despite of some discussion, there is general acceptance of the brain death criterion. As for Germany, there is a quasi legal regulation (TPG §16): two physicians with a longstanding experience in the management of patients with severe brain lesions are personally responsive for the diagnostic procedure lege artis. ⋯ Nevertheless, discussions on brain death should not be instrumentalized by circumstances of organ explantation. Brain death should be part of a good educational background, to anticipate reflections free from the emotional binding of an acute incident.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2012
[Mental disorders in intensive care medicine - part 1: Principles and diagnostics].
This two-part article on mental disorders in intensive care medicine aims to provide an understanding of the most frequent mental disorders in critical care medicine. Part 1 highlights the basic principles, disturbances and diagnostics and part 2 deals with prevention and therapeutic approaches. ⋯ The consequences thereof include increased morbidity, mortality, and duration of hospitalization. The early participation of a psychiatrist in the diagnostic process is to be recommended.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2012
Review[New aspects of minimally invasive cardiac output monitoring].
The variety of minimally invasive cardiac output (CO) monitoring devices is growing rendering it difficult to keep track of new developments. In this article technical principles, limitations and validation procedures considering new aspects are reviewed. ⋯ CO should be interpreted in combination with clinical information and other hemodynamic parameters. It's evident that not the monitor per se, but only the protocol / therapy based on the hemodynamic data can improve patients outcome.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2012
Review[Effects of advanced haemodynamic monitoring on perioperative outcome in high-risk patients].
Advanced haemodynamic monitoring provides information on blood flow, volume status, and oxygen supply to demand ratio. Together with related therapeutic algorithms these variables can be used to optimize cardiac preload and oxygen delivery in the perioperative period. There is increasing evidence that a goal-directed therapy can improve perioperative outcome. In this review we will briefly describe different target variables and their relevance for the haemodynamic optimization of high-risk surgical patients.