Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2007
Review[Therapeutic options for patients with acute lung injury].
The treatment of acute lung injury is one of the most challenging tasks in intensive care medicine. Conventional therapeutic options cover lung protective mechanical ventilation with low tidal volumes and adequate PEEP, restrictive fluid management, prone positioning, and early recruitment maneuvers. ⋯ In cases of refractory hypoxemia, inhaled nitric oxide offers in most patients a successful rescue option. In specialized centers the application of ECMO remains as a final ultima ratio.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2007
Review[Xenon--the ideal anaesthetic agent?].
The noble gas xenon, besides its anaesthetic and analgesic properties, shows many characteristics of an ideal anaesthetic agent. However, due to high production costs, its application is limited In daily clinical routine. Recent studies suggested not only outstanding haemodynamic stability and rapid emergence from anaesthesia, but also xenon's capacity to mediate protection against ischaemic damage in various organs and tissues. Since xenon is devoid of toxicity and relevant side effects, it could be beneficial at least in a subset of patients at high risk, and xenon therefore may become a reasonable alternative in this patient population.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2007
Case Reports[Case report: bilateral block of the brachial plexus--approaches, dosage and effectiveness].
A young man squeezed both hands in a bending machine with the result of complex hand injuries. Because of a high risk for general anesthesia, operation as well as postoperative analgesia was performed under bilateral brachial plexus block with the axillary approach. We discuss the considerations concerning the possible approaches with bilateral anesthesia of the brachial plexus under consideration of side effects and effectiveness. The needed dosage of the local anesthetics will be discussed.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2007
Review[Anesthesia for patients with congenital heart disease undergoing non-cardiac surgery].
An increasing number of children who have undergone corrective surgery for congenital heart disease (CHD) reach adulthood every year. These survivors defy commonly used classification schemes for adults undergoing non-cardiac surgery. ⋯ An interdisciplinary team approach is the corner stone for the safe delivery of anesthesia to this patient population. This review is meant to equip the anesthesiologist with the necessary tools for the safe perioperative sailing of his patient suffering from CHD.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2007
[How to calculate the budget of an anaesthetic or intensive care department from revenues of g-DRGs].
In Germany the economical framework of the health system in general and the hospitals in particular has changed dramatically over the last years. The conversion of funding to DRGs has implicated a reduction of budgets. ⋯ However, this calculation comprises some problems, because anaesthesia and intensive care medicine are interdisciplinary disciplines, which cannot influence its achievements and its processes solely by its own, but are dependent on efficiency and quality of its partners. Internal cost allocation for improving processes seems not to be sensible in the system of DRGs as long as it is used not only as an instrument of controlling, but also as an instrument of benchmarking.