Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 1998
Randomized Controlled Trial Clinical Trial[Pulse oximetry and capnography in intensive care transportation: combined use reduces transportation risks].
Due to the growing number of diagnostic and therapeutical procedures intensive-care patients must be transported intra- and interhospitally more often. These transports are among the most critical events during intensive-care therapy, with a high incidence of potentially life-threatening mishaps [23]. The aim of this study was to evaluate the possible benefit of the combined application of pulse oximetry and capnometry for patient safety during transport. ⋯ The combination of pulse oximetry and capnometry offers the possibility to detect potentially life-threatening problems in ventilated patients during transport. This allows for early therapeutical consequences and may help to reduce the risk of transports.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 1998
Review[Volume replacement solutions--pharmacology and clinical use].
PHYSIOLOGY AND PATHOPHYSIOLOGY: Total body water represents 60% of body weight (BW), consisting of 40% BW intra- and 20% BW extracellular fluid. Extracellular fluid is divided into 16% BW interstitial fluid and 4% BW plasma volume (Fig. 1). The colloid oncotic pressure (COP) of the plasma proteins, which is about 25 mmHg (Fig. 2), is the main factor for the retention of intravascular volume and the prevention of interstitial edema. ⋯ Special indications of 10% HES 200/0.5 are rapid hypervolaemic replacement of massive blood losses and increase of COP in intensive care patients without capillary leak. Synthetic colloids as well as albumin may lead to adverse reactions, which are generally very rare. In large-scala studies, no significant differences have been found with regard to incidence and severity.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 1998
Comparative Study[Level concept of analgesic dosing in intensive care medicine with sufentanil].
The efficacy of a 3-level regimen of analgesia and sedation was investigated in a clinical setting. Level 1 consisted of continuous administration of sufentanil, in level 2 continuous administration of midazolam and level 3 continuous administration of midazolam and clonidine was added according to patients' needs. ⋯ Continuous infusion of sufentanil only for analgesia and sedation is suitable for intensive-care patients with a short stay in the ICU. Respiratory depression during spontaneous breathing is not significant. The supplementary administration of midazolam and clonidine according to the presented regimen was shown to be of advantage for patients with a longer stay in ICU.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 1998
[Laughing gas as the principle substance in assessing occupational exposure to inhalation anesthetics].
In the Federal Republic of Germany limits for the chronic exposure to nitrous oxide and volatile anaesthetics have been prescribed by legislation. According to the technical rules for the handling of hazardous substances TRGS 402 it is legal to measure a single substance in a mixture of hazards, unless the behaviour of all substances is known. Studies about corresponding concentrations of nitrous oxide and volatile anaesthetics in anaesthetic working areas have not yet been carried out. ⋯ Although it is not possible to calculate desflurane concentrations from the nitrous oxide concentrations, measurement of nitrous oxide as leading substance is a valid procedure to assess the exposure of the anaesthesiology workplace to nitrous oxide and volatile anaesthetics. Significant higher nitrous oxide concentrations during desflurane anaesthesia result from early extubation of patients expiring higher concentrations of nitrous oxide.