Der Anaesthesist
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Perioperative stroke is defined as an ischemic cerebrovascular event that occurs during or within 30 days after surgery and is associated with an increased perioperative risk of morbidity and mortality. Depending on the type of surgery stroke is diagnosed in up to 11% of all patients in the perioperative period. Patients with a history of ischemic stroke or transitory ischemic attack have an increased risk for perioperative stroke. ⋯ Importantly, individualized blood pressure management is essential for optimization of cerebral perfusion during the perioperative period. This article provides a summary of the epidemiology, risk factors, and etiology of perioperative stroke. Moreover, possible preventive strategies relevant for the anesthesiologist are reviewed.
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Delays in the start of morning operations cause a loss of expensive OR capacity as well as frustration and potential conflicts among the different professions involved. There are a lot of reasons which can lead to delayed anesthesia ready time (ART). This is the first large multicenter study to identify incidence, extent and reasons of delay in ART. ⋯ Delays in anesthesia ready time have a high prevalence in most hospitals, however the reasons for delay are manifold, making interventions to reduce delay complex.
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The present guidelines ( http://leitlinien.net ) focus exclusively on cardiogenic shock due to myocardial infarction (infarction-related cardiogenic shock, ICS). The cardiological/cardiac surgical and the intensive care medicine strategies dealt with in these guidelines are essential to the successful treatment and survival of patients with ICS; however, both European and American guidelines on myocardial infarction and heart failure and also position papers on cardiogenic shock focused mainly on cardiological aspects. ⋯ A total of 95 recommendations, including 2 statements were compiled and based on these 7 algorithms with defined instructions on the course of treatment.
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Randomized Controlled Trial Multicenter Study
[FX06-COVID: Improvement of arterial oxygenation in intensive care patients with a severe course of COVID-19].
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The COVID-19 pandemic necessitated a time-critical expansion of medical staff in intensive care units (ICU) and emergency rooms (ER). ⋯ Blended learning concepts, such as hospital paramedics, can quickly qualify medical personnel for use in system-relevant settings, relieve nursing staff and thus create an expansion of intensive care capacities. Existing or pending pandemic and contingency plans should be complemented by such blended learning training so that they are immediately available in case of a second pandemic wave, future pandemics or other crisis situations.