Der Anaesthesist
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Perioperative phases of hypotension are associated with an increase in postoperative complications and organ damage. Whereas some years ago hemodynamic stabilization was primarily carried out by volume supplementation, in recent years the use and dosing of cardiovascular-active substances has significantly increased. But like intravascular volume therapy, also substances with a cardiovascular effect have therapeutic margins, and thus, potential side effects. ⋯ Special attention is paid to the question how to administrate them: central venous catheter vs. peripheral indwelling venous cannula. The authors come to the conclusion that it is not a question of whether it is principally allowed to apply cardiovascular-active drugs via peripheral veins but more importantly, what should be taken into consideration if a peripheral venous access is used. This article provides concise recommendations.
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The basis of all metabolic processes in the human body is the production and metabolism of carriers of energy. Lactate is the end-product of anaerobic glycolysis. ⋯ Hyperlactatemia can be associated with increased mortality, therefore in emergency medicine the search for the cause of hyperlactatemia is just as important as an effective causal treatment. Repetitive measurements of lactate are components of several treatment algorithms as observation of the dynamic development of blood lactate concentrations can help to make a better assessment of the acute medical condition of the patient and to evaluate the effectiveness of the measures undertaken.
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In 2018 Germany had the lowest rate of post-mortem organ donation in the Eurotransplant network. Healthcare trainees and students will be important advisors on organ donation for patients in the future. This study aimed to examine 1) attitudes and knowledge about post-mortem organ donation, 2) how past transplantation scandals have affected those attitudes and 3) how satisfied respondents were with the knowledge provided on the courses. ⋯ Given the knowledge gaps identified and the respondents' dissatisfaction with the knowledge they received, organ donation should be better integrated into curricula and training programs.
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Criteria for the identification of suitable applicants for undergraduate and postgraduate medical education are greatly and ubiquitously discussed. Apart from the acquisition of theoretical knowledge and practical skills, certain personality traits are necessary for practicing the medical profession; however, little is known on the personality traits required for medical subspecialties. This study had two objectives: 1) identification and evaluation of personality traits which are essential for performing anesthesiology and 2) establishment of a job specification for anesthesiology. ⋯ A job specification describing important personality traits can be useful to advise both undergraduates and postgraduates on their medical career and for medical team simulation tasks. For the clinical practice in anesthesiology, for example, high social interactive and cognitive personality traits are required.