Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2008
[Acute renal failure - anticoagulation in continuous renal replacement therapy].
Anticoagulation plays a pivotal role for the efficacy of continuous renal replacement therapy. The equilibrium between avoiding bleeding complications and keeping the system open considering patients} multiple diseases demands an individual and dynamic reasoned anticoagulation regime. For patients at risk of bleeding citrate anticoagulation has shown high efficacy and lesser bleeding complications than the standard heparin or other alternative anticoagulants such as regional protamin-heparin-, prostaglandin-heparin-anticoagulation or no anticoagulation.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2008
Review[The role of patient flow and surge capacity for in-hospital response in mass casualty events].
Mass casualty events make demands on emergency services and disaster control. However, optimized in- hospital response defines the quality of definitive care. Therefore, German federal law governs the role of hospitals in mass casualty incidents. ⋯ To minimise inhospital patient overflow casualty surge principles have to be implemented in both, pre-hospital and in-hospital disaster planning. World soccer championship 2006 facilitated the initiation of surge and damage control principles in in-hospital disaster planning strategies for German hospitals. The presented concept of strict control of in-hospital patient flow using surge principles minimises the risk of in-hospital breakdown and increases definitive hospital treatment capacity in mass casualty incidents.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2008
Review[Prehospital management of geriatric patients].
The prehospital management of geriatric patients involves an understanding of the physiology of aging and necessitates the special acknowledgement of diagnosis and treatment of emergencies in the elderly. It is essential to keep in mind the prevention of an underestimation of the severity of disease and the necessity of an adequate therapy. The prehospital management of moribund patients gains special importance.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2008
Review Meta Analysis[Emergency medicine and myocardial ischaemia - thrombolysis during cardiopulmonary resuscitation - available data and recommendations].
Patients suffering cardiac arrest still have a poor prognosis. Up to the present, no drug therapy has shown to improve longterm survival after cardiac arrest. Acute myocardial infarction (AMI) or massive pulmonary embolism (PE) are the underlying causes for sudden cardiac arrest in 50-70 % of patients. ⋯ Thrombolysis during CPR today can not be recommended as a standard therapy in patients suffering cardiac arrest. However, it should be considered if a massive PE is supposed to be the cause of cardiac arrest or if conventional CPR has not been successful in a patient with presumed thrombotic cause of cardiac arrest. The expected bleeding risk is outweighed by the potential benefit of this therapy in selected patients.