Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2001
Review Guideline[CPR--guidelines 2000. New international guidelines for cardiopulmonary resuscitation].
The "Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. An International Consensus an Science" are the first true international CPR guidelines in the history of resuscitation medicine. Experts from major international resuscitation organizations (International Liaison Committee on Resuscitation, ILCOR) achieved a consensus of recommendations which had to pass a rigorous review procedure applying the tools of evidence-based medicine: all proposed guidelines or guideline changes had to be based on critically appraised pieces of evidence which had to be integrated into a final class of recommendations. The most important changes compared to previous recommendations from either the European Resuscitation Council or the American Heart Association are presented and commented upon.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2001
Case Reports[On-scene helicopter transport at night].
Air medical rescue services at night are associated with an increased risk for life and health of the helicopter crew. They are not allowed in all federal states of Germany and only a few bases provide this service. ⋯ Two case reports demonstrate that requests for helicopters at night may even lead to a transportation associated delay of treatment because of the time until the helicopter arrives on-scene. Thus emergency physicians have to know the possibilities and limitations of helicopter emergency medical services at night.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2001
Case Reports[A patient with nodal tachycardia after general anesthesia during medication with a selective serotonin reuptake inhibitor].
We report on a 62 year old female patient treated with paroxetine, a selective serotonin reuptake inhibitor, because of an anxiety neurosis undergoing a vaginal hysterectomy in general anesthesia. Apart from a dietary treated diabetes mellitus there were no other diseases. There were no complications during the operation. ⋯ No clinical or laboratory findings indicated a cardiac ischemia and an additional Holter ECG-Recording showed no further cardiac arrhythmias. No other complications occurred afterwards and the patient was discharged after two weeks. This case report demonstrates clearly that despite a reduced rate of cardiovascular complications compared to other types of antidepressants selective serotonin reuptake inhibitors can lead to perioperative cardiac arrhythmias.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2001
Review[Are there certified indications for the use of antithrombin III in intensive care].
The serine-protease-inhibitor antithrombin III (AT III) has often been recommended for the therapy of septic patients as it provides anticoagulant and antiinflammatory actions. In animal studies the prophylactic treatment with AT III in a dose > 250 U/kg prevented the development of disseminated intravascular coagulopathy and vital organ dysfunction during sepsis and lowered the mortality rate. ⋯ In these patients AT III-therapy improved laboratory changes of disseminated intravascular coagulopathy but was unable to lower the mortality rate. Hereditary AT III deficiency, lack of heparin effect due to low AT III levels, disseminated intravascular coagulation disorders are indications for the use of AT III while beneficial effects of AT III in patients suffering from SIRS, sepsis or septic shock have not yet been demonstrated.