Der Anaesthesist
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The record of anesthesia is used for different clinical purposes, most importantly for the control of patient care. Thinking about the minimum contents of an anesthesia record we think that the choice of the minimum contents means a first valuation. ⋯ Therefore, the principal content of the documentation may include more than the specialist medical considerations. A precise anesthetic protocol must be kept for every patient, and is an essential part of the responsibilities of a clinical anesthesist.
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The effects of Disoprivan on cerebral blood flow (CBF), cerebral oxygen consumption, and CO2-reactivity of the cerebral vessels were studied in 11 male patients between 49 and 63 years of age who were about to undergo coronary artery bypass surgery. Mean perfusion pressure was decreased by 25% under anaesthesia by 0.2 mg/kg per minute Disoprivan, but remained within the ranges of autoregulation. ⋯ Hypoventilation was followed by a 67% increase in CBF and a 44% decrease in CVR cerebral oxygen consumption was decreased by 38%. This study shows that the reactivity of the cerebral vessels to changes in paCO2 is well maintained under Disoprivan.
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A new module of the Dräger modular device system provides a means for demand CPAP (to increase FRC) and assisted spontaneous breathing. Both features together may largely increase the potency of ventilatory therapy for spontaneously breathing patients. The machine may reduce the need for full ventilatory support in acute respiratory failure, but also provides a valid and rational tool for respiratory therapy.