Der Anaesthesist
-
Many animal experiments have shown that anesthetics can have a neurotoxic effect on immature brains because they induce apoptosis and influence neurogenesis and synaptogenesis. In animal experiments this has substantial implications for the neurocognitive functions of animals in later life. ⋯ The prospective studies GAS and PANDA are designed to obtain a deeper insight and if possible to clarify this problem. Because of the high relevance of this topic and in order to achieve more clarity for this problem when dealing with parents, the scientific working group for neuroanesthesia and pediatric anesthesia of the German Society for Anesthesiology and Intensive Care Medicine (DGAI) has formulated a position document on the basis of currently available data.
-
Case Reports
[Treatment of a pregnant patient after multiple trauma: rare combination with thrombotic thrombocytopenic purpura].
Multiple trauma during pregnancy is a relatively rare situation which poses a great challenge for the team in charge of treatment. A concomitant disease, such as thrombotic thrombocytopenic purpura (TTP) with thrombocytic coagulopathy increases the complexity of the treatment problems. This article describes the case of a 36-year-old pregnant woman referred to this hospital suffering from multiple trauma with severe liver rupture. ⋯ Recurrent massive bleeding from the liver occurred after depacking and was treated successfully with recombinant factor VIIa. The concomitant TTP was treated by transfusion of fresh frozen plasma and corticosteroids. Rapid initiation of therapy was the goal to achieve hemostasis and prevent aggravation of the coagulation disorder and an unfavourable outcome despite severe thrombocytopenia.
-
Randomized Controlled Trial Comparative Study
[Efficacy of a novel warming blanket: prospective randomized trial].
Perioperative hypothermia is a common complication of general anesthesia and occurs in up to 50 % of patients during ear, nose and throat (ENT) surgery. In this prospective, randomized controlled study the hypothesis that a new conductive warming blanket (Barrier® EasyWarm®, Mölnlycke Health Care Erkrath, Germany) is better in reducing the incidence of perioperative hypothermia in ENT surgery than insulation with a conventional hospital duvet alone was tested. ⋯ In the studied patient group the new conductive warming blanket (Barrier® EasyWarm®) showed no superiority compared to conventional thermal insulation alone.
-
In the context of regional anesthesia procedures adverse events rarely occur but are predominantly systemic intoxication due to local anesthetics (0.01-0.035 %), nerve injuries (0.01-1.7 %) and infections (0-3.2 %). ⋯ Using a real-time computer-based tool for data capture makes a veritable detection of adverse events possible. Such a tool also has the power to monitor the effects of changes in clinical procedures (SOP). In this case it was possible to verify the successful introduction of an extended hygiene care bundle. The new regime significantly decreased the rate of infections in cPNB.