Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2007
Review[Anesthesia and restrictive and obstructive pulmonary diseases].
Restrictive and obstructive pulmonary diseases are major risk factors of perioperative morbidity and mortality. The incidence of pulmonary complications may be in the range of 3 and 40% (3), depending on the underlying disease and the type of surgery. In this review the specific pathophysiology, preoperative evaluation and suitable anesthesia procedures are discussed for patients with restrictive and obstructive pulmonary diseases.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2007
Review[Critical illness polyneuropathy and myopathy. Pathogenesis and diagnostic].
Since the first description of Bolton et al., critical illness polyneuropathy (CIP) and critical illness myopathy (CIM) are increasingly observed as a complication in intensive care patients. CIP and CIM commonly occur in patients with an ICU length of stay exceeding one week. Typically, these patients show weakness of the limbs and difficulties in weaning from the respirator. Neurological and electrophysiological examinations as well as muscle biopsies if myopathy is of concern may help to characterize and identify polyneuropathy and myopathy.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2007
Review[Multiprofessional cooperation in palliative care].
"Nothing is more powerful than an idea whose time has come." (Victor Hugo) Originally referring to the beginning of the enlightenment (reconnaissance) of the French revolution the transcription of this words regarding to German palliative Care structures would mean a tremendous effort. The meaning of the new idea is a holistic kind of care for patients with a chronic disease at the end of their lives, so that they can die as most self determined as possible at a location of their choice. ⋯ The meaning of palliative care team as a team with special communication skills in between the team and with further cooperating partners is described. Communication in palliative care means more than telling facts.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 2007
Case Reports[Intraoperative blood transfusion in a child with blunt abdominal trauma].
Pediatric transfusion therapy is complex since there is a remarkable physiological change from neonate to child. Here we report the blood transfusion management of a 6-year-old male child after abdominal trauma. Particular normovolemia with ringer/hetastarch, the estimation of the maximal allowable blood loss, target transfusion hematocrit, transfusion with platelets and FFP are discussed.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2007
[Prevention and treatment of hypotension during Caesarean delivery].
Regional anesthesia for Caesarean delivery is often accompanied by a reduction in maternal blood pressure. Maternal hypotension may lead to a reduction in uteroplacental blood flow with consecutive fetal acidosis. ⋯ Nevertheless, maternal hypotension is not always preventable and the use of vasopressors is still frequently required. Although ephedrine has been considered the vasopressor of choice over the last decades, current studies show that fetal acidosis is less frequently encountered with the use of phenylephrine, which should thus be considered as a first-line agent.