Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2008
[Decompressive craniectomy in traumatic brain injury and malignant brain infarction].
High intracranial pressure (ICP) is the most frequent cause of death and disability after severe traumatic brain injury and malignant cerebral infarction. After failure of general therapeutic maneuvers and first line therapies, "second tier" therapies have to be considered. ⋯ In this review indications and techniques of decompressive craniectomy are described and current literature is discussed. The author concludes that decompressive craniectomy is no routine, but should be considered in individual cases.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2008
[Conservative treatment of brain edema--which way is leading to Rome?].
In patients with brain edema the pathophysiology of the different forms of edema have to be considered to ensure the prompt, sensible and consistent use of the limited treatment modalities available. Brain edema may be classified into cytotoxic and vasogenic edema, these two types often coexist in one patient. ⋯ In the future considering the autoregulatory capacity of the individual patient will possibly lead to a more effective action of the treatment modalities described. Further research will open new perspectives how aquaporines are involved in the genesis and mobilisation of brain edema.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2008
[Alcohol-related disorders in the preclinical medicine].
Alcohol is the most frequently abused drug in Germany. Approximately 50.000 individuals die annually due to alcohol-related disorders. ⋯ Agitation, suicidal intent, trauma and a multitude of degenerative and other somatic disorders may further complicate diagnosis and treatment on scene. The motivation of patients to participate in withdrawal programs should be built and strengthened already in emergency medicine.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2008
Review[Dysregulation of homeostasis in severe sepsis: relevance and therapeutic options].
Severe sepsis and septic shock may have a lasting effect on all human endocrinologic, coagulatory and metabolic regulatory circuits with the consequence of severe dysregulation of homoeostasis. Adjunctive therapeutic options like intensive insulin therapy, low-dose hydrocortisone and modulation of coagulation by drotrecogin alfa (activated) are still controversial discussed, but should be used according to the national and international guidelines for a sophisticated treatment of septic heterostasis.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2008
Review[Postoperative cognitive dysfunction in geriatric patients].
Postoperative cognitive dysfunction occurs in geriatric patients after major operations and influences morbidity and mortality of these patients. Clinical observations and neuropsychological tests can be used to diagnose cognitive disorders after an operation. Until today no specific medical treatment is known for the therapy of cognitive dysfunctions after an operation and, therefore, in high risk patients perioperative preventive measures is the only way to decrease the incidence and extend of this disease.