- Erratum zu: Geschichte der Anästhesie – „Vom Narkotiseur zum perioperativen Homöostatiker“. [PUBLISHED ERRATUM]
- AAnaesthesist 2016 Oct 17
- Stress-coping styles of 459 emergency care physicians in Germany : A pilot study. [Journal Article]
- AAnaesthesist 2016 Oct 14
- CONCLUSIONS: ECPs experience stress in the same manner as patients and other professionals, and they must address and cope with stress appropriately. For future research, studies with a longitudinal approach to monitor the underlying mechanisms are suggested. For clinical practice and policy-making, structural changes in work patterns and psychological support should be considered, which may be of particular benefit for female ECPs.
- Ultrasound-guided intermediate cervical plexus block and perivascular local anesthetic infiltration for carotid endarterectomy : A randomized controlled trial. [Journal Article]
- AAnaesthesist 2016 Oct 14
- CONCLUSIONS: For ultrasound-guided intermediate blocks of the cervical plexus, an additional periarterial infiltration showed no advantage. Abandoning this technique leads to a relevant simplification of the blocking technique and tends to reduce block-related side effects.
- [Perioperative adverse respiratory events in overweight and obese children]. [Journal Article]
- AAnaesthesist 2016 Oct 10
- CONCLUSIONS: This study demonstrated a very low incidence of respiratory problems, which may be caused by the low proportion of morbidly obese children and the older age of overweight children in comparison with other studies.
- [Impairment of oxygenation of patients in surgical intensive care : Early symptom of severe sepsis]. [Journal Article]
- AAnaesthesist 2016 Oct 5
- CONCLUSIONS: An urgent worsening of pulmonary function in patients in intensive care requires immediate differential diagnostics due to substantial therapeutic consequences. Our results confirm that impairment of pulmonary oxygenation is the first prognostic symptom of severe onset of sepsis. Consequently, we recommend that this parameter be considered in diagnostic staging. After exclusion of a few differential diagnoses impairment of oxygenation can be the very first symptom of severe sepsis. The patient's age and time to sufficient antibiotic therapy are two very important prognostic factors with respect to mortality. Early and sufficient antibiotic therapy, and in a few cases surgical intervention are of utmost importance.
- [Injuries to blood vessels near the heart caused by central venous catheters]. [Journal Article]
- AAnaesthesist 2016 Oct 5
- Injuries to blood vessels near the heart can quickly become life-threatening and include arterial injuries during central venous puncture, which can lead to hemorrhagic shock. We report 6 patients in...
Injuries to blood vessels near the heart can quickly become life-threatening and include arterial injuries during central venous puncture, which can lead to hemorrhagic shock. We report 6 patients in whom injury to the subclavian artery and vein led to life-threatening complications. Central venous catheters are associated with a multitude of risks, such as venous thrombosis, air embolism, systemic or local infections, paresthesia, hemothorax, pneumothorax, and cervical hematoma, which are not always immediately discernible. The subclavian catheter is at a somewhat lower risk of catheter-associated sepsis and symptomatic venous thrombosis than approaches via the internal jugular and femoral veins. Indeed, access via the subclavian vein carries a substantial risk of pneumo- and hemothorax. Damage to the subclavian vein or artery can also occur during deliberate and inadvertent punctures and result in life-threatening complications. Therefore, careful consideration of the access route is required in relation to the patient and the clinical situation, to keep the incidence of complications as low as possible. For catheterization of the subclavian vein, puncture of the axillary vein in the infraclavicular fossa is a good alternative, because ultrasound imaging of the target vessel is easier than in the subclavian vein and the puncture can be performed much further from the lung.
- [Autonomy and welfare in intensive care medicine : Practical approach in difficult situations]. [Journal Article]
- AAnaesthesist 2016 Sep 29
- In intensive care units far-reaching decisions are often made at short notice that require the consent of the informed patient. If this is not possible due to the patient's condition, physicians and ...
In intensive care units far-reaching decisions are often made at short notice that require the consent of the informed patient. If this is not possible due to the patient's condition, physicians and legal representatives must ascertain the previously expressed or presumed will of the patient and act accordingly. The legal principles are specified in the Patient Advance Directives Act and the Patient Rights Act. Any indications for medical treatment need a clearly defined aim of the therapy, which can be questioned during the progress of the disease. To avoid conflicts between patient autonomy and medical treatment, the aims of therapy must be regularly discussed with the patient, representatives or relatives and documented in a written form. Checklists can be useful for structured consultations, to promote transparency and to avoid misunderstandings. Ethics consultations can help to deescalate critical situations.
- [Simulation-based training and OR apprenticeship for medical students : A prospective, randomized, single-blind study of clinical skills]. [Journal Article]
- AAnaesthesist 2016 Sep 27
- CONCLUSIONS: With the methods applied, this study could not prove that 225 min of SBT before the operating room apprenticeship increased the medical students' clinical skills as evaluated in the operating room. Secondary endpoints indicate that medical students have better clinical skills at the end of the entire curriculum when they have been trained through SBT before the operating room apprenticeship. However, the authors believe that simulator training has a positive impact on students' acquisition of procedural and patient safety skills, even if the methods applied in this study may not mirror this aspect sufficiently.
- [History of anesthesia : "From narcosis to perioperative homeostasis"]. [Journal Article]
- AAnaesthesist 2016; 65(10):787-808
- In the western World 16 October 1846 is often called "Ether Day", marking the beginning of anesthesia. Before that date, for physicians there was only a struggle against pain. In the following 170 ye...
In the western World 16 October 1846 is often called "Ether Day", marking the beginning of anesthesia. Before that date, for physicians there was only a struggle against pain. In the following 170 years all fields of general anesthesia as well as regional and local anesthesia were continuously developed. Pharmacological developments and technical innovations made this evolution possible. The complexity of this field of medicine requires a specialist: the anesthesiologist, whose selection of the most suitable form of anesthesia for the patient makes the surgical intervention painless. In addition, the history of anesthesia was characterized by personalities who were responsible for the progress of this medical field. Anesthesia is one part of the discipline of anesthesiology, which also includes resuscitation, intensive care medicine, emergency medicine and pain therapy.
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- 170 Jahre Anästhesie. [Editorial]
- AAnaesthesist 2016; 65(10):725-726