Langenbecks Archiv für Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft für Chirurgie. Kongress
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Ever-increasing knowledge of the pathomechanisms and the phasic pathogenesis of ARDS has increased the demand for adequate monitoring and has modified therapeutic strategies. The influence of monitoring by double indicator dilution technique (COLD system) with the close measurement of extravascular lung water on the diagnosis and therapy of ARDS is presented. Pressure-controlled ventilation (< 35 cm H2O) in combination with moderate PEEP, kinetic therapy (prone position) and elective CVVH already in the early stages of ARDS can be regarded as the standard therapy. The effectiveness of NO inhalation, prostaglandins and radical scavengers still has to be improved in controlled clinical trials.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Evaluation models for therapy planning/standardization exemplified by infection].
Models of evaluation in therapeutic management pathways (practice guidelines, clinical algorithms) are demanded today, both by public health research and health policy. However, practical achievements are lacking. ⋯ It was shown that there was no agreement between the providers and the daily users. However, every surgeon has a firm, personal view about sepsis.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Surgical interventions in extracorporeal membrane oxygenation (ECMO)].
Extracorporeal membrane oxygenation is a suitable technique for short-term treatment of resistant respiratory failure with a comparably low mortality rate of 32%. However, pulmonary complications are quite often encountered during ECMO therapy making thoracic interventions necessary. The most frequent of these complications is hemorrhage followed by lung fistula, which remain resistant to conventional therapy. The indication for operative lung resection during ECMO treatment must remain restricted to selected cases, since these procedures have a high morbidity.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
Comparative Study[Surgical research and publications in Germany--an analysis of 1984-1994].
The present study analyses a selection of German and American surgical and cancer research journals from the years 1984 and 1994. The aim of the study was to evaluate the amount of publications by German surgeons in these journals. ⋯ In parallel, German surgeons are still the major contributors to German language journals, but increasingly publish in the American ones as well. The impact factor is one of the major selection criteria on to which journal a paper shall be submitted.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[The trauma register of the 'Polytrauma' Committee of the German Society of Trauma Surgery as the basis for quality management in the management of severely injured patients].
The data of 1037 severely injured patients (mean ISS = 20) from 15 clinics were centrally and prospectively collected in the Trauma Registry of the German Society of Trauma Surgery and analyzed anonymously. Significant differences in respect to the treatment criteria (i.e., duration of basic diagnostics in severe trauma) and quality of outcome (TRISS method and Z statistic) were revealed for some clinics. The feedback of their data offers the associated clinics the possibility of identification of treatment phases that are worth being optimized.