Der Anaesthesist
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Teamwork in the operating room and in the intensive care unit necessitates clear and precise communication; however, interruptions in communication frequently occur, especially in the perioperative phase. Patients are particularly susceptible to deficits in communication, e.g. due to higher stress peaks, simultaneous admission of several patients and concomitant treatment of emergency cases. The German Society of Anesthesiology and Intensive Care Medicine (DGAI) therefore recommends the implementation of the so-called SBAR concept (S situation, B background, A assessment, R recommendation) for standardization of patient handover. This concept was originally developed for high-risk areas and organizations with the aim of guaranteeing a rapid, effective and consistent transfer of information.
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Case Reports
[Extracorporeal CO2 removal as an alternative to tracheotomy in a patient with extubation failure].
We report a patient with chest trauma who was admitted to the ICU after surgery. As he fulfilled protocol-based criteria, he was extubated 7 days after admission. ⋯ Sufficient CO2 removal was established with a blood flow of 1.5 l/min and the patient was successfully extubated within a few hours. After 5 days of ECCO2‑R the patient could be weaned and transferred to a general ward in a stable condition.
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Observational Study
[Perioperative adverse respiratory events in overweight and obese children].
Overweight and obesity are increasing problems in pediatric anesthesia. This observational study was designed to examine how airway-related complications occur in overweight children and adolescents during general anesthesia and if this is a relevant problem in Germany. ⋯ This study demonstrated a very low incidence of respiratory problems, which may be caused by the low proportion of morbidly obese children and the older age of overweight children in comparison with other studies.
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Editorial Comment
[Highest level of clinical competence for endovascular interventions].