Der Anaesthesist
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The operating room (OR) is one of the most expensive facilities in most hospitals. The demands on a professional and process-oriented controlling and reporting in the OR are increased due to the increasingly more limited financial margins at the end of the diagnosis related groups (DRG) convergence phase. This study gives an overview of the current situation for cost calculation, controlling and reporting in OR management in German hospitals in 2007. The data from 69 hospitals were evaluated and this represents the largest currently available data pool on this topic.
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Intensive care unit (ICU) patients have a high risk of developing venous thromboembolism (VTE) and prophylaxis is recommended. Venous thromboembolism confers considerable morbidity and mortality in hospitalized patients, although few studies have focused on critically ill patients. ⋯ The prescribed prophylaxis for thromboembolism in 98% of the German ICUs is surprisingly high compared to that given in the literature. A combination of mechanical and pharmacologic prophylaxis is the predominant prophylactic strategy.
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The use of therapeutic hypothermia has been shown to improve survival and neurological outcome following cardiac arrest. Patients with traumatic brain injury or ischemic stroke also responded positively to therapeutic hypothermia, which may be induced by various procedures including surface cooling, endovascular cooling catheter and cold infusion. Possible side effects include infection and hemorrhage, as well as changes in water and electrolyte levels. It is the aim of this article to provide an overview of studies to date, as well as practical guidance for the application of therapeutic hypothermia.