Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2009
[Anaesthetic considerations in endovascular repair of aortic aneurysms].
With advancing developments of endovascular techniques, the demands on anaesthesiological management are increasing. The transfemoral implantation of coated endografts in the aorta of cardiopulmonal impaired patients is a particular challenge for the interdisciplinary team. Guided by invasive monitoring, changing blood-pressure targets have to be achieved and in case of serious complications conversion to open surgery must be available immediately.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2009
[Anaesthesia for major vascular surgical procedures].
Vascular surgery carries a high perioperative risk for the patients, because of the high incidence of coexisting diseases with an increased risk of cardiovascular complications. Based on preoperative findings, anaesthetic technique, monitoring and postoperative management are planned. For risk optimization the anaesthetist should have a high theoretical and practical experience in the used anaesthetic techniques and a profound knowledge of the pathophysiological characteristics of the vascular procedures.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2009
[Integration of principles of palliative medicine into treatment of patients in intensive care units].
Intensive care medicine, as well as palliative medicine, is dealing with the limits of life-preserving care. Decision-making in matters of life and death is one of the greatest challenges for physicians, because it may be an area of conflict with regard to aspects of patient autonomy, medical prognosis and the ethics of medical care. At first sight palliative medicine and intensive care medicine seem to be at the opposite ends of care. ⋯ Approaches, tasks and goals of palliative and intensive care medicine are covering and targeting at different medical situations but are not at opposite ends of care. Shared priorities are pain control and management of other distressing symptoms, alleviation of suffering, comprehensive communication with both, patient and relatives, empathic care that includes the willingness to reflect on end-of-life matters and respect for a human being's dignity. Other common denominators of the team members are: inter-disciplinary teamwork of highly qualified specialists who are able to face and deal with extensive emotional and physical strain, the breaking down of hierarchical structures and team spirit.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2009
Review Case Reports[Preclinical use of intraosseous access (IO) in adults: literature review and case reports].
The treatment of acute life threatening conditions normally requires intravenous access for further therapeutic measures. In the current guidelines of the European Resuscitation Council (ERC), published in November 2005, the significance of intraosseous access had been newly regulated. ⋯ The translation of scientific knowledge into clinical practise takes several years as a general rule. The following article illustrates the basic literature and two case reports, and is designed to inspire trust in a method, which can provide a useful alternative to peripheral venous access for the emergency physician.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2009
Review[Radiological differential diagnosis of chronic back pain].
Back pain is a frequent phenomenon. Published guidelines should be used to avoid unnecessary diagnostic imaging ("European guidelines for the management of chronic non-specific low back pain" - www.backpaineurope.org). ⋯ Inflammation and tumour caused spine disease need special attention. A false choice of imaging procedure could delay the correct diagnosis.