Der Anaesthesist
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Case Reports
[Intraoperative coronary artery spasm with cardiac arrest: cardiologic acute intervention].
Ventricular fibrillation occurred intraoperatively during a laparoscopy-assisted resection of the rectum in a 63-year-old patient. A coronary artery spasm was identified as the cause. ⋯ Excellent interdisciplinary cooperation combined with favourable timing and spatial conditions, made this outcome possible for the patient without neurological deficits. In addition to presenting the actual treatment procedure, possible underlying pathogenetic mechanisms will also be presented.
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The aim of this study was to assess cardiac function in vascular surgery patients with known coronary artery disease (CAD) who received continuous perioperative beta blocker therapy with esmolol alone versus esmolol in combination with the phosphodiesterase (PDE) III inhibitor enoximone. ⋯ Inotropic therapy with the PDE III inhibitor enoximone improves cardiac function in high risk patients with known CAD undergoing vascular surgery and also when receiving systematic heart rate control by continuous infusion of esmolol.
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Based on the 2005 International Consensus Conference on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations of the International Liaison Committee on Resuscitation (ILCOR), guidelines were published for managing basic and advanced life-saving procedures in the event of cardiac arrest. The fact that special circumstances sometimes must be considered in patient treatment resulted in a separate chapter. This first part of a two-part article reviews essential information as well as necessary modifications of the standard advanced life support algorithm in cases of life-threatening drowning, asthma, anaphylaxis, and poisoning. The second part will deal with electrolyte disorders, hypothermia, electrical emergencies, trauma, cardiac arrest during pregnancy, and cardiac surgery.
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Over the last 10 years the technique of target-controlled infusion (TCI) has substantially influenced the development and practice of intravenous anaesthesia. It opened the possibility of many new and exciting applications of perioperative anaesthetic care. ⋯ This review explains the fundamentals and applications of intravenous drug delivery by TCI and gives practice guidelines to successfully implement the technique into clinical practice. The aim is to provide a comprehensive reference based on clinically proven evidence.
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Acute occlusion of an endotracheal tube (ETT) is a feared, potentially life-threatening complication of mechanical ventilation. In the presence of a thoracic trauma, a blood clot needs to be taken into consideration as the cause of airway obstruction. This report describes a case of sudden ventilation failure due to acute ETT obstruction by a blood clot caused by intrapulmonary haemorrhaging in a child following multiple trauma accompanied by blunt thoracic trauma in the absence of dyspnoe or haemoptysis.