发布求助
文献互助 智能选刊 最新文献

Medizinische Klinik-Intensivmedizin Und Notfallmedizin最新文献

筛选
英文 中文
Passive leg raising test versus rapid fluid challenge in critically ill medical patients. 重症内科病人的被动抬腿试验与快速输液挑战。
IF 1.3 4区 医学
Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2024-09-06 DOI: 10.1007/s00063-024-01176-2
Natascha Majunke, Dan Philipp, Lorenz Weidhase, Bastian Pasieka, Kevin Kunz, Frank Seidel, Robert Scharm, Sirak Petros
{"title":"Passive leg raising test versus rapid fluid challenge in critically ill medical patients.","authors":"Natascha Majunke, Dan Philipp, Lorenz Weidhase, Bastian Pasieka, Kevin Kunz, Frank Seidel, Robert Scharm, Sirak Petros","doi":"10.1007/s00063-024-01176-2","DOIUrl":"https://doi.org/10.1007/s00063-024-01176-2","url":null,"abstract":"<p><strong>Background: </strong>The passive leg raising (PLR) test is a simple test to detect preload responsiveness. However, variable fluid doses and infusion times were used in studies evaluating the effect of PLR. Studies showed that the effect of fluid challenge on hemodynamics dissipates in 10 min. This prospective study aimed to compare PLR and a rapid fluid challenge (RFC) with a 300-ml bolus infused within 5 min in adult patients with a hemodynamic compromise.</p><p><strong>Materials and methods: </strong>Critically ill medical patients with signs of systemic hypoperfusion were included if volume expansion was considered. Hemodynamic status was assessed with continuous measurements of cardiac output (CO), when possible, and mean arterial pressure (MAP) at baseline, during PLR, and after RFC.</p><p><strong>Results: </strong>A total of 124 patients with a median age of 65.0 years were included. Their acute physiology and chronic health evaluation (APACHE) II score was 19.7 ± 6.0, with a sequential organ failure assessment (SOFA) score of 9.0 ± 4.4. Sepsis was diagnosed in 73.3%, and 79.8% of the patients were already receiving a norepinephrine infusion. Invasive MAP monitoring was established in all patients, while continuous CO recording was possible in 42 patients (33.9%). Based on CO changes, compared with those with RFC, the false positive and false negative rates with PLR were 21.7 and 36.8%, respectively, with positive and negative predictive values of 70.6 and 72.0%, respectively. Based on MAP changes, compared with those with RFC, the false positive and false negative rates with PLR compared to RFC were 38.2% and 43.3%, respectively, with positive and negative predictive values of 64.4 and 54.0%, respectively.</p><p><strong>Conclusion: </strong>This study demonstrated a moderate agreement between PLR and RFC in hemodynamically compromised medical patients, which should be considered when testing preload responsiveness.</p>","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Inspection of deceased : Issuing a death certificate]. [检查死者：签发死亡证明]。
IF 1.3 4区 医学
Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2024-09-05 DOI: 10.1007/s00063-024-01174-4
Markus A Rothschild, Judith Froch-Cortis
{"title":"[Inspection of deceased : Issuing a death certificate].","authors":"Markus A Rothschild, Judith Froch-Cortis","doi":"10.1007/s00063-024-01174-4","DOIUrl":"https://doi.org/10.1007/s00063-024-01174-4","url":null,"abstract":"<p><p>The obligatory post-mortem examination and the issuing of a death certificate are among the more unpopular medical tasks. Nevertheless, the legislature has entrusted the medical profession with a socially important task that should be carried out carefully. The examining physician decides whether the death remains a private matter or whether an official death investigation should first shed light on the circumstances of the death. The post-mortem examination system is the only instrument for the systematic detection of homicide offences. The prerequisite for issuing a death certificate is a carefully conducted external post-mortem examination, which must be carried out in full at least when certifying a natural or unexplained cause of death. In addition, the medical information on the death certificate serves epidemiological and health policy purposes and contains important information on infection control.</p>","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Skill-grade mix and shared governance in the intensive care unit: development of a management triangle and the advancement of nursing roles]. [重症监护病房的技能等级组合与共同治理：管理三角的发展与护理角色的提升]。
IF 1.3 4区 医学
Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2024-09-04 DOI: 10.1007/s00063-024-01175-3
Christian Siegling, Esther Mertins, Franziska Wefer, Christina Bolte, Lars Krüger
{"title":"[Skill-grade mix and shared governance in the intensive care unit: development of a management triangle and the advancement of nursing roles].","authors":"Christian Siegling, Esther Mertins, Franziska Wefer, Christina Bolte, Lars Krüger","doi":"10.1007/s00063-024-01175-3","DOIUrl":"https://doi.org/10.1007/s00063-024-01175-3","url":null,"abstract":"<p><strong>Background: </strong>In the Federal Republic of Germany, it has been possible for some years to study (intensive) nursing care alongside further training in intensive care and anaesthesia. This results in a nursing skill-grade mix in the intensive care unit (ICU), which nursing management must consider.</p><p><strong>Objectives: </strong>The aim is to show the development and implementation of a new nursing management structure in the ICU and also provide an overview of the parallel role development with preliminary results at a university hospital.</p><p><strong>Materials and methods: </strong>Within a working group of nursing management, a narrative analysis of the current situation was carried out with close involvement of the ICU ward managers and the staff units for nursing development, further education and nursing education. The content was organized into subject areas and a new management model was subsequently developed. The evaluation took place narratively within the context of employee interviews.</p><p><strong>Results: </strong>The management model in the ICU was divided into the areas of nursing management, nursing education, and nursing science as a management triangle. Nursing management is staffed by at least two people as ward managers and deputies, while the nursing education and science team leaders have equal decision-making powers in terms of shared governance. The respective specialist departments work together within the hospital in networks with other ICUs. Other specialist roles such as primary nurses, advanced practice nurses, heart failure nurses or practical instructors are given specific contact persons in the management team to match their tasks, which was viewed positively.</p><p><strong>Conclusions: </strong>The development of nursing practice can be promoted through close co-operation within the management team.</p>","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Weaning from ECLS: when, how and where?] [从 ECLS 断奶：何时、如何、何地？］
IF 1.3 4区 医学
Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2024-08-30 DOI: 10.1007/s00063-024-01173-5
Guido Michels, Christian Jung, Tobias Wengenmayer, Dawid L Staudacher
{"title":"[Weaning from ECLS: when, how and where?]","authors":"Guido Michels, Christian Jung, Tobias Wengenmayer, Dawid L Staudacher","doi":"10.1007/s00063-024-01173-5","DOIUrl":"https://doi.org/10.1007/s00063-024-01173-5","url":null,"abstract":"","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Visual diagnosis for experts]. [专家视觉诊断]。
IF 1.3 4区 医学
Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2024-08-22 DOI: 10.1007/s00063-024-01166-4
Laura Arheilger, Nicolas Müller, Mattia M Müller, Christoph Camille Ganter, Rene Hage, Mace Schuurmans, Sascha David
{"title":"[Visual diagnosis for experts].","authors":"Laura Arheilger, Nicolas Müller, Mattia M Müller, Christoph Camille Ganter, Rene Hage, Mace Schuurmans, Sascha David","doi":"10.1007/s00063-024-01166-4","DOIUrl":"https://doi.org/10.1007/s00063-024-01166-4","url":null,"abstract":"","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Bleeding in liver diseases]. [肝病出血]。
IF 1.3 4区 医学
Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2024-08-13 DOI: 10.1007/s00063-024-01167-3
Andreas Drolz
{"title":"[Bleeding in liver diseases].","authors":"Andreas Drolz","doi":"10.1007/s00063-024-01167-3","DOIUrl":"https://doi.org/10.1007/s00063-024-01167-3","url":null,"abstract":"<p><p>Bleeding events are feared complications in patients with advanced liver diseases and are associated with morbidity and mortality. In this context, gastrointestinal bleeding, particularly upper gastrointestinal bleeding, has a special clinical importance. In addition to endoscopic measures for hemostasis, reducing portal pressure in particular is a key component of treatment. Although the standard coagulation parameters are often altered in patients with liver diseases, optimizing coagulation plays a secondary role. Typically, a bundle of measures are employed in patients with portal hypertensive bleeding, which nowadays in most cases can halt the bleeding and stabilize the situation. The measures include endoscopy, antibiotic treatment, vasopressor treatment and, if necessary, shunt placement (transjugular intrahepatic portosystemic shunt).</p>","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Ethical aspects regarding the management of patients with liver disease in the intensive care unit]. [重症监护室肝病患者管理的伦理问题]。
IF 1.3 4区 医学
Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2024-08-12 DOI: 10.1007/s00063-024-01165-5
Georg Braun
{"title":"[Ethical aspects regarding the management of patients with liver disease in the intensive care unit].","authors":"Georg Braun","doi":"10.1007/s00063-024-01165-5","DOIUrl":"10.1007/s00063-024-01165-5","url":null,"abstract":"<p><strong>Background: </strong>Especially in terms of alcohol-related liver cirrhosis, discussions quickly arise in times of scarce resources about the justification for carrying out (prolonged) intensive care measures.</p><p><strong>Aims, materials, and methods: </strong>The following review aims to address ethical aspects specifically in patients with liver cirrhosis in the intensive care unit. A possible structured approach is presented.</p><p><strong>Conclusion: </strong>A general recommendation is not possible. Ultimately, decisions remain on a case-by-case basis and have to take a wide variety of perspectives into account.</p>","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Infections and liver cirrhosis]. [感染与肝硬化]。
IF 1.3 4区 医学
Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2024-08-09 DOI: 10.1007/s00063-024-01168-2
Miriam Dibos, Ulrich Mayr, Julian Triebelhorn, Roland M Schmid, Tobias Lahmer
{"title":"[Infections and liver cirrhosis].","authors":"Miriam Dibos, Ulrich Mayr, Julian Triebelhorn, Roland M Schmid, Tobias Lahmer","doi":"10.1007/s00063-024-01168-2","DOIUrl":"https://doi.org/10.1007/s00063-024-01168-2","url":null,"abstract":"<p><p>End-stage liver disease is a life-threatening clinical syndrome combined with a state of immune dysfunction. In this constellation patients are prone to bacterial, fungal and viral infections associated with markedly increased morbidity and mortality rates. Bacterial infections are the most prevalent kind of infection in patients with end-stage liver disease accounting for nearly 30%. The evolving rates of multidrug resistant organisms present enormous challenges in treatment strategies. Therefore, the urgent needs for prevention, early detection strategies and widespread treatment options are a necessity to handle the rising incidence of infection complications in end-stage liver disease.</p>","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Stress ulcer prophylaxis with proton pump inhibitors in intensive care medicine]. [重症监护医学中使用质子泵抑制剂预防应激性溃疡]。
IF 1.3 4区 医学
Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2024-08-09 DOI: 10.1007/s00063-024-01172-6
Philipp Kasper, Frank Tacke, Guido Michels
{"title":"[Stress ulcer prophylaxis with proton pump inhibitors in intensive care medicine].","authors":"Philipp Kasper, Frank Tacke, Guido Michels","doi":"10.1007/s00063-024-01172-6","DOIUrl":"https://doi.org/10.1007/s00063-024-01172-6","url":null,"abstract":"","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Influence of the no flow time on lung edema in the postresuscitation phase]. [无血流时间对复苏后阶段肺水肿的影响]。
IF 1.3 4区 医学
Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2024-08-08 DOI: 10.1007/s00063-024-01170-8
Ingo Voigt
{"title":"[Influence of the no flow time on lung edema in the postresuscitation phase].","authors":"Ingo Voigt","doi":"10.1007/s00063-024-01170-8","DOIUrl":"https://doi.org/10.1007/s00063-024-01170-8","url":null,"abstract":"","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
下一页 尾页
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整，为了账户安全，请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们：info@booksci.cn Book学术提供免费学术资源搜索服务，方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号：481959085
Book学术官方微信