Der Anaesthesist
-
Fiberoptic intubation for the management of the difficult airway is usually achieved with the patient under light sedation. The goal of the present study was to evaluate the combination of propofol and remifentanil for sedation during fiberoptic intubation. ⋯ Our combination of remifentanil and propofol was shown to be a safe sedation regimen for fiberoptic intubation. Monitoring ventilation via nasal capnography and arterial oxygen saturation via pulse oximetry provided sufficient patient safety.
-
The aim of this follow-up study was to find out if severely injured patients with multiple organ failure (MOF) show any organotopic sequelae in the late course. Additionally the occupational rehabilitation result as well as the reasons for a poor occupational result were investigated. ⋯ Severely injured patients who survive MOF during their intensive care treatment, show no sequelae of organ failure. The occupational rehabilitation results were excellent with a "return to work rate" of 64% which was dependent on the severity of head injury, a decreased range of motion of the hip joint and general physical fitness.
-
Up to now 136 cases of myocardial infarction during pregnancy have been reported, and angiography revealed normal findings in 47%. In these cases coronary spasms have been discussed as the major mechanism of the disease. In isolated cases coronary artery dissection may also present with a normal coronary angiography. ⋯ It was pointed out recently that even in asymptomatic patients, plaques may be present in coronary vessels indicating an early stage of CAD that cannot be diagnosed by angiography. Plaque rupture is often triggered by hypertension and may lead to myocardial infarction, instable angina pectoris, or sudden ischemic death. As IVUS is a new diagnostic tool that allows diagnoses of even early stages of CAD we believe that myocardial infarction during pregnancy is more often caused by plaque rupture than may be expected according to the current literature.
-
Case Reports
[Transesophageal echocardiography as intraoperative monitoring for the resection of an intra-atrial tumor].
Fibrolamellar hepatocellular carcinomas (FLHCC) can grow into the inferior vena cava and the right atrium thus rendering it impossible to insert a pulmonary artery catheter or increasing the risk of tumor embolisation. We report of a young patient with intraatrial growth of a FLHCC where intraoperative transesophageal echocardiography (TEE) instead of a pulmonary artery catheter for continuous monitoring of hemodynamics was used. Hemodynamic parameters as well as the surgical result could easily be assessed.