Der Anaesthesist
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Comparative Study
[Desflurane and isoflurane in minimal-flow anesthesia. Consumption and costs with forced fresh gas reduction].
In the present investigation we compared the consumption of desflurane (DES) and isoflurane (ISO) using a standardized minimal-flow protocol with a forced reduction of the fresh gas flow (FGF). ⋯ With a forced reduction of the FGF the DES consumption is still higher.
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In neonates and infants, arterial and central venous catheters are of vital importance to optimize perioperative surveillance during surgery as well as postoperative care in the intensive care unit. The insertion of umbilical venous (UVC) and umbilical arterial catheters (UAC) in neonates in the first days of life is relatively simple and associated with a low procedure-related risk. As with other centrally placed catheters, correct positioning must be verified and the catheters should not be used for more than 5-7 days. ⋯ In order to minimize the risk associated with catheter malposition, correct position must always be verified by appropriate imaging studies or ECG guidance. Surgically placed Broviac catheters are mainly used in patients with a long-term need for central venous access. Finally, it has been shown that adherence to strict guidelines for insertion and handling can significantly reduce catheter-associated infections.
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Thrombelastography (TEG) is a bedside method used to determine coagulation parameters such as clot formation, stabilization and lysis. This report describes a case of cardiopulmonary arrest due to fulminant pulmonary embolism in a 42-year-old postpartum patient. We discuss the dynamics of coagulation parameters during CPR and thrombolysis complicated by bleeding, as assessed by TEG.