Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS最新文献

{"title":"[Correction: Specific Fasting Requirements for Special Patient Groups].","authors":"Christiane Beck, Susanne Greve, Cynthia Olotu","doi":"10.1055/a-2777-9995","DOIUrl":"10.1055/a-2777-9995","url":null,"abstract":"","PeriodicalId":520554,"journal":{"name":"Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS","volume":" ","pages":"144"},"PeriodicalIF":0.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Gender-specific Aspects and Patient Blood Management - New Perspectives for Anesthesiology].","authors":"Kai Zacharowski","doi":"10.1055/a-2731-9920","DOIUrl":"https://doi.org/10.1055/a-2731-9920","url":null,"abstract":"","PeriodicalId":520554,"journal":{"name":"Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS","volume":"61 1","pages":"15-16"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145937313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Correction: Palliative Patients and Prehospital Emergency Medicine - Which Aspects Should the Prehospital Emergency Physician Know?]","authors":"Christoph H R Wiese, Vera Peuckmann-Post","doi":"10.1055/a-2746-8882","DOIUrl":"10.1055/a-2746-8882","url":null,"abstract":"","PeriodicalId":520554,"journal":{"name":"Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS","volume":" ","pages":"66"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Digital Instead of Discontinuous - How Wearables Create New Opportunities in the Struggle Against Failure to Rescue].","authors":"Johannes Späth, Catherina A B Bubb","doi":"10.1055/a-2688-2245","DOIUrl":"10.1055/a-2688-2245","url":null,"abstract":"<p><p>Medical wearables are considered a promising solution for mobile and continuous vital sign monitoring in general wards, with the objective of significantly reducing the existing monitoring deficit for high-risk patients in German hospitals and consequently lowering post-operative mortality and \"failure to rescue\" rates. The integration of wearables into early warning systems such as the NEWS (National Early Warning Score) and their intelligent combination with predictive algorithms, has the potential to provide new perspectives, but such integration has not yet been implemented. Technical challenges include the high incidence of false alarms and the subsequent issue of alarm fatigue. The utilisation of artificial intelligence (AI) for the detection of artefacts presents a viable solution to this issue; however, it necessitates the development and validation of complex, device-specific software. In addition to these challenges, there are structural issues that require attention, including the inadequate digitalization of many hospitals, the high investment and maintenance costs that are yet to be reimbursed, and concerns regarding data protection and the clarification of responsibilities in the domain of IT security. Despite these challenges, the potential is widely acknowledged, particularly in terms of enhancing patient safety and reducing the workload of nursing staff. Numerous visions for the future, including non-invasive haemodynamic or biochemical monitoring, are already being developed, but clinically reliable sensors are not yet ready for use. Prospective studies, regulatory guidelines and a clear roadmap for digital transformation are required. It is asserted that the transition of medical wearables from a niche market to standard care can only be achieved through a combination of technical innovation, clinical validation and political decision-making.</p>","PeriodicalId":520554,"journal":{"name":"Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS","volume":"61 1","pages":"58-66"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145937277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Patient Blood Management in Women].","authors":"Florian Rumpf, Peter Kranke, Kai Zacharowski, Vanessa Neef","doi":"10.1055/a-2549-2866","DOIUrl":"10.1055/a-2549-2866","url":null,"abstract":"<p><p>In women of reproductive age, particularly during pregnancy and childbirth, patient blood management (PBM) plays an important role in reducing the risk of anemia and hemorrhage. These conditions are leading causes of maternal morbidity and mortality worldwide. By promoting early detection and treatment of iron deficiency anaemia, the implementation of a holistic PBM programme enables better outcomes for both, the mother and child. Implementing PBM protocols in perioperative care of women and perinatal care of parturients is essential to enhancing women's, maternal and neonatal health on a global scale.</p>","PeriodicalId":520554,"journal":{"name":"Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS","volume":"61 1","pages":"30-43"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145937334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Physiological and Pharmacological Characteristics of Women].","authors":"Johanna Wohlfart, Vivienne Theobald, Dania Fischer","doi":"10.1055/a-2549-2849","DOIUrl":"10.1055/a-2549-2849","url":null,"abstract":"<p><p>This review article summarises current knowledge on gender-specific differences in physiology and pharmacology and discusses their clinical relevance. Historically, women have often been regarded as a \"deviating norm\" in research, clinical studies and practice. Gender-specific medicine closes these gaps by systematically recording differences in the endocrine system, metabolism, immune system and pharmacokinetics/pharmacodynamics and integrating them into diagnostics, therapy and prevention. For this purpose, a literature search was conducted, taking into account review articles and primary studies on the above topic.Gender-specific differences in haematology and homeostasis influence transfusion decisions, perioperative volume control and haematological risk assessment. Throughout a woman's life, oestrogen and progesterone modulate vascular tone, lipid and glucose metabolism, and inflammatory processes. Premenopausal women benefit from the cardioprotective effect of oestrogens; postmenopausal women, on the other hand, exhibit increased vascular vulnerability. The higher body fat percentage, differences in fat distribution and lower muscle mass in women influence various metabolic pathways. Numerous functions of glucose and lipid metabolism are modulated by oestrogen, resulting in the maintenance of energy homeostasis, the reduction of oxidative damage, lipid-induced inflammation and excessive fat accumulation, and the prevention of nitrogen excess.Women have a more innate and adaptive immune response, but are also more frequently affected by autoimmune diseases. Women also differ from men in their perception and processing of pain, with women often experiencing pain more intensely and for longer periods of time. Regarding to pharmacokinetics and pharmacodynamics, women show differences in bioavailability, distribution, metabolism and renal clearance. This leads to higher plasma levels or altered effects of drugs. Individual risk assessment and drug dosing in therapies are therefore necessary. In conclusion, taking gender-specific differences into account in perioperative, emergency medical and pain therapy contexts enables more precise diagnostics, safer medication, optimised analgesia and improved patient safety. There is a future need to integrate these differences into guidelines, perioperative algorithms and clinical studies in order to minimise gender-specific outcome differences.</p>","PeriodicalId":520554,"journal":{"name":"Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS","volume":"61 1","pages":"45-57"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145937303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Gender-specific Differences in Anesthesiology].","authors":"Marie Charlotte Hennighausen, Kai Zacharowski, Lea Valeska Blum","doi":"10.1055/a-2549-2772","DOIUrl":"10.1055/a-2549-2772","url":null,"abstract":"<p><p>Gender specific differences are a current and increasingly discussed topic. Cardiovascular conditions in women are often diagnosed later and with more advanced severity. Similarly, women are frequently underrepresented in studies investigating the effects of anesthetics on the central nervous system. In the field of anesthesiology, scientific interest in this topic has grown rapidly. Gender specific differences arise from anatomical, physiological, and psychosocial factors, all of which can significantly influence the perioperative and postoperative management. This highlights the importance of awareness and appropriately addressing these differences. The aim of this review article is to summarize the most relevant sex-specific differences in the field of anesthesiology.</p>","PeriodicalId":520554,"journal":{"name":"Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS","volume":"61 1","pages":"17-29"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145937343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Fasting Recommendations Throughout the Ages].","authors":"Anne Rüggeberg, Patrick Meybohm, Eike Nickel","doi":"10.1055/a-2505-3519","DOIUrl":"10.1055/a-2505-3519","url":null,"abstract":"<p><p>When anaesthesia was in its infancy, the purpose of preoperative fasting was to prevent nausea and vomiting. In these early days of anaesthesia, liquid fasting periods were kept short to avoid exhaustion. The later introduction of the 'nothing by mouth after midnight' rule aimed to prevent aspiration. For decades, no distinction was made between clear liquids and solids. However, as studies could not demonstrate a difference in gastric residual volume when consuming clear liquids within the last 2-4 hours versus fasting for over 4 hours, the guideline recommendation regarding clear liquids was reduced to 2 hours by the end of the last century. As solid food remains in the stomach for longer, fasting periods of 6-8 hours are required. These should be adapted according to the type of food and the characteristics of the patient. However, periods of liquid fasting often exceed the recommended 2 hours, with a median duration of 9-12 hours. This can lead to dehydration, insulin resistance, and postoperative complications. As clear liquids leave the stomach quickly, an international, multidisciplinary consensus statement recommends implementing institutional protocols to minimise preoperative fasting times for liquids. These protocols can either encourage patients to drink clear liquids up to 2 hours before anaesthesia is induced or allow for liberal liquid fasting times.</p>","PeriodicalId":520554,"journal":{"name":"Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS","volume":"60 11-12","pages":"607-622"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145608484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Myth \"Volume Deficiency in Sepsis\"].","authors":"Maximilian Markus, Leo Fabig, Vladimir Skrypnikov, Claudia Spies, Oliver Hunsicker","doi":"10.1055/a-2254-3340","DOIUrl":"https://doi.org/10.1055/a-2254-3340","url":null,"abstract":"<p><p>Septic shock is a life-threatening condition caused by a dysregulated immune response to an infection and can lead to tissue and organ damage and ultimately to death. Early recognition and elimination of tissue perfusion loss caused by sepsis are key elements in the treatment of patients with septic shock. Hemodynamic management is divided into four phases. 1) initial phase, 2) optimization, 3) stabilization, 4) de-escalation. Fluid therapy is widely accepted in the initial phase, but recent evidence challenges its universality, highlighting fluid overload risks and increased mortality, necessitating individualized treatment.Recent research has identified five distinct hemodynamic phenotypes in septic shock based on echocardiographic and clinical parameters:Phenotype 1: Well resuscitated: Patients exhibit normal cardiac output and venous oxygen saturation (ScvO₂) without signs of volume depletion or overload.Phenotype 2: Left ventricular systolic dysfunction: Characterized by low left ventricular ejection fraction (LVEF) and cardiac output, these patients require inotropic support rather than additional fluids.Phenotype 3: Hyperkinetic state: Marked by increased cardiac output and LVEF, these patients appear volume-responsive but do not benefit from further fluid administration.Phenotype 4: Right ventricular failure: Patients exhibit significant right ventricular dysfunction and increased right-to-left end-diastolic area ratio, making them particularly vulnerable to fluid overload.Phenotype 5: Still hypovolemic: Defined by low cardiac index and volume responsiveness, these patients benefit from additional fluid administration.These phenotypes provide a framework for precision medicine in septic shock, guiding fluid and vasopressor therapy. Tools such as passive leg raise (PLR) testing and echocardiographic monitoring are essential for assessing fluid responsiveness and optimizing treatment. Additionally, early norepinephrine administration enhances fluid efficiency, preventing unnecessary volume expansion.A patient-specific approach incorporating hemodynamic phenotyping can improve outcomes by balancing resuscitation needs with the risk of fluid overload, ultimately optimizing survival in septic shock.</p>","PeriodicalId":520554,"journal":{"name":"Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS","volume":"60 11-12","pages":"652-658"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145608420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Specific Fasting Requirements for Special Patient Groups].","authors":"Christiane Beck, Susanne Greve, Cynthia Olotu","doi":"10.1055/a-2505-3616","DOIUrl":"10.1055/a-2505-3616","url":null,"abstract":"<p><p>Recommendations regarding preoperative fasting have been an integral part of anaesthesiological practice for decades. In recent years, in addition to the traditional focus on reducing the risk of aspiration, the pathophysiological consequences of (excessively) long fasting periods have increasingly been taken into consideration. The aim is no longer exclusively to provide standardised recommendations that are applicable to as large a group of patients as possible, but to achieve implementation that results in short, realistic fasting periods for patients.It remains important to reliably identify patients who are at potentially increased risk of perioperative aspiration to individually adjust not only the immediate perioperative procedure but also the preoperative fasting periods. Patients with delayed gastric emptying play a significant role in this context. This can occur idiopathically but also in the context of comorbidities such as diabetes mellitus, Parkinson's disease, autoimmune diseases, diseases of the autonomic nervous system or connective tissue (e.g. scleroderma), infections of the gastrointestinal tract or after previous major surgery. In addition, numerous medications - including opioids, tricyclic antidepressants and GLP-1 receptor agonists in particular - can lead to significant delayed gastric emptying.Particularly vulnerable risk groups in connection with excessively long fasting periods are children, the very elderly and frail, pregnant women and women in labour. These groups must be protected from excessively long fasting periods because they have limited compensatory mechanisms.The following overview provides an update on preoperative fasting in children, older people and pregnant women and presents further risk constellations associated with delayed gastric emptying. It can be seen as a best practice recommendation for specific issues.</p>","PeriodicalId":520554,"journal":{"name":"Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS","volume":"60 11-12","pages":"636-650"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145608448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}