Der Anaesthesist
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Modern medicine has succeeded in achieving enormous technical developments. One recent highlight has been the introduction of postmortem organ transplantation. At the same time, serious objections have been raised concerning the radical changes in the cultural conception of the inviolable body. ⋯ The beneficiary of the treatment is not the donor, but another person, the recipient. The concept of human dignity does not allow the use of a person for purposes other than the ones he/she consents to, as Immanual Kant stated. Although the human corpse is not a person in the full sense, even if it is protected by the thought of respect for the former person, the life-interest of the organ recipient had to be considered legitimate.(ABSTRACT TRUNCATED AT 250 WORDS)
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Comparative Study
[Arterial blood pressure measurement with oscillometric instruments in newborns and infants].
Non-invasive blood pressure measurements by the auscultatory method do not provide reliable, reproducible blood pressure values in many neonates because the Korottkoff sounds are often very difficult to detect. This resulted in the development of many alternative indirect methods. Devices utilizing the Doppler ultrasound technique have not found wide acceptance. ⋯ The manufacturers should provide devices that display comparative results and improve the algorithms for detection of artefacts, increasing the accuracy of their blood pressure monitors. This could be done with the help of simulators. Considering the pathophysiological characteristics of neonates and infants, the systematic differences between the five monitors have to be regarded as serious.
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A 25-year-old woman with Kartagener's syndrome was admitted to hospital for laparoscopy because of sterility. Kartagener's syndrome is a rare disorder involving the combination of situs inversus, bronchiectasis and sinusitis. ⋯ Anticholinergic and antitussive medications are relatively contraindicated, as are nasal tubes. In the present case an intubation anaesthesia with thiopental, nitrous oxide, enflurane and succinylcholine was carried out; cefoxitin was administered for antibiotic treatment, and the patient made an uneventful recovery.
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As early as 1974, Brian advocated the prone position for ventilated patients. He suggested that this position might enhance ventilation of the dorsal parts of the lungs, thereby improving oxygenation. These considerations have been confirmed by several experimental and clinical studies. ⋯ This is in good accordance with other studies, however, this is the first study to report an observation period of more than 6 days of repeatedly turning the patient. These positive effects on gas exchange can be attributed to sudden improvement of the ventilation-perfusion ratio within the lung areas that become dependent after turning to the prone position. Due to reduced hydrostatic pressure and relative hyperventilation, previously collapsed alveoli are recruited in the lung areas that become non-dependent after turning to the prone position.