Die Anaesthesiologie最新文献

{"title":"[Move as one! : Claiming sustainable growth for the commonwealth of modern anesthesiology].","authors":"Gunther Pestel","doi":"10.1007/s00101-026-01679-x","DOIUrl":"10.1007/s00101-026-01679-x","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"348-350"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678985","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":"[Contrast-induced nephropathy: a real issue or a myth?]","authors":"Silke Fortenbacher, Stefan John","doi":"10.1007/s00101-026-01662-6","DOIUrl":"10.1007/s00101-026-01662-6","url":null,"abstract":"<p><strong>Background: </strong>Contrast-induced nephropathy or contrast-induced acute kidney injury (CI-AKI) has been regarded for decades as a relevant complication of iodinated contrast medium administration, particularly in perioperative and intensive care settings. However, recent epidemiological and clinical data increasingly challenge this presumed causal relationship and suggest that the associated risk is substantially overestimated.</p><p><strong>Objective: </strong>The aim of this article is to critically appraise the current evidence and to reassess the clinical relevance of contrast medium administration within the context of multifactorial acute kidney injury development.</p><p><strong>Materials and methods: </strong>This editorial is based on a narrative and commentary-driven analysis of selected clinical studies, meta-analyses, and current recommendations regarding the use of iodinated contrast media in perioperative and intensive care settings. The published data were evaluated with a particular emphasis on patient-related risk factors and clinically relevant practical aspects.</p><p><strong>Results: </strong>The majority of contemporary studies demonstrate no or only a marginal causal association between the administration of iodinated contrast media and the development of AKI. Instead, the occurrence of AKI closely correlates with patient-related factors such as pre-existing chronic kidney disease, hemodynamic instability, sepsis, and systemic inflammation. Preventive measures beyond individualized volume therapy and hemodynamic optimization have not shown consistent effectiveness. Contrast medium administration frequently appears to be a marker of severe disease rather than a primary trigger for AKI.</p><p><strong>Conclusion: </strong>The long-assumed nephrotoxicity of iodinated contrast media requires reevaluation. From an anesthesiological perspective, the focus should shift away from contrast avoidance towards ensuring adequate organ perfusion and hemodynamic stability. Unwarranted reluctance to perform urgently indicated imaging may lead to diagnostic delays and potentially compromises patient safety. A rational evidence-based approach to contrast medium administration within an interdisciplinary risk-benefit assessment is essential.</p>","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"225-230"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328424","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":"[Focus on neurological intensive care medicine 2024/2025-Summary of selected studies in intensive care medicineal care].","authors":"Dominik Michalski, Christine Jungk, Christopher Beynon, Thorsten Brenner, Christian Nusshag, Christopher J Reuß, Mascha O Fiedler-Kalenka, Michael Bernhard, Andreas Hecker, Markus A Weigand, Maximilian Dietrich","doi":"10.1007/s00101-026-01653-7","DOIUrl":"10.1007/s00101-026-01653-7","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"268-281"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147291679","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":"[Regression analysis to calculate the time point of ROSC-A feasibility study].","authors":"André Luckscheiter, W Zink, M Thiel, V Schneider-Lindner","doi":"10.1007/s00101-026-01648-4","DOIUrl":"10.1007/s00101-026-01648-4","url":null,"abstract":"<p><strong>Background: </strong>A regression model to estimate the duration from the onset of resuscitation efforts to the return of spontaneous circulation (ROSC) could help improving both resuscitation care and the quality control of registries. This study aims to evaluate the prediction accuracy and to identify challenges for future model development.</p><p><strong>Method: </strong>Regression models based on M5P, random forest (RF) algorithms and a linear regression (LR) modified using M5P were retrospectively developed using a Belgian cohort of 84 individuals in whom ROSC was achieved. Model performance was assessed using quality metrics, such as the correlation coefficient (CC), coefficient of determination (R²), and root mean square error (RMSE) in a cross-validation approach.</p><p><strong>Results: </strong>In the cohort 61.9% were male with a mean age of 65.7 years. A shockable rhythm was present in 27.7% of cases and the bystander cardiopulmonary resuscitation (CPR) rate was 48.2%. The no-flow time averaged 5.13 min. The mean time from CPR onset to first defibrillation was 7.81 min and to first medication administration 11.31 min. The ROSC occurred after an average of 16.8 min, the LR showed the highest correlation (0.73, 95% confidence interval, CI 0.72-0.74) and R² (0.53 [0.52-0.55]) along with the lowest RMSE (6.76 min [6.63-6.90]). The M5P yielded similar not significantly different values (CC 0.72 [0.70-0.73], R² 0.52 [0.50-0.53], RMSE 6.84 min [6.69-6.99]). In contrast, RF performed significantly worse (CC 0.62 [0.61-0.63], R² 0.38 [0.37-0.40], RMSE 7.89 min [7.82-7.96], all p < 0.01). Only LR showed no significant difference between predicted and actual values in terms of mean (p = 0.75) and variance (p = 0.15). The proportion of potentially prematurely terminated resuscitation attempts, defined as cases with actual ROSC occurring later than predicted ROSC plus RMSE, ranged from 13% (M5P) to 18% (LR).</p><p><strong>Conclusion: </strong>The duration from the start of CPR to ROSC appears to be a process that is suitable for modelling with machine learning algorithms. At this early stage of development, the individual regression models did not demonstrate sufficient validity possibly due to low sample size and simplified data structure; however, the findings indicated potential for an application as a quality assurance tool to compare actual vs. predicted time to ROSC. Therefore, to increase the robustness the results require further evaluation in a larger cohort with additional variables and improved data quality based on the Utstein criteria.</p>","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"231-241"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A 4-year-old girl with traumatic carotid artery dissection and subsequent infarction of the middle cerebral artery].","authors":"Thorsten Walter, Mareike Schimmel, Stefan Siegert, Lars Behrens","doi":"10.1007/s00101-025-01634-2","DOIUrl":"10.1007/s00101-025-01634-2","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"252-255"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13043561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145947042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Desfluran – unverzichtbar oder obsolet?","authors":"Florian Gerheuser, Daniel Bolkenius, Stephanie Snyder-Ramos, Maika Berek, Susanne Koch, Theresa Krüger, Sebastian Gibb, Katja Nickel","doi":"10.1007/s00101-026-01675-1","DOIUrl":"10.1007/s00101-026-01675-1","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"263-264"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147534580","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":"[Precision immunotherapy improves organ dysfunction in sepsis].","authors":"Lennart Wild, Christian Bode","doi":"10.1007/s00101-026-01644-8","DOIUrl":"10.1007/s00101-026-01644-8","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"282-283"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013438","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":"Kontrastmittel und AKI : Von der Kausalitätsfrage zum Risikomanagement.","authors":"Melanie Meersch-Dini, Detlef Kindgen-Milles","doi":"10.1007/s00101-026-01665-3","DOIUrl":"10.1007/s00101-026-01665-3","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"223-224"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437793","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":"Seine Meinung (angesichts klimawissenschaftlicher Daten) zu ändern, ist auch eine Form von Freiheit: Klimametriken ersetzen keine klinische Abwägung!","authors":"Peter Kranke, Robert Kleinberg, Patrick Meybohm, Beverly Philip, Laurentiu Marin, Kai Zacharowski","doi":"10.1007/s00101-026-01674-2","DOIUrl":"10.1007/s00101-026-01674-2","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"265-267"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517251","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":"[Publish well in anesthesiology: Quality standards and dealing with predatory journals].","authors":"Theresa Tenge, Aileen Hill, David Radke, Götz Schmidt, Justus Student, Laura Borgstedt, Rene M Pembele, Richard-Felix Kraus, Sebastian Roth, Martin Scharffenberg","doi":"10.1007/s00101-026-01656-4","DOIUrl":"10.1007/s00101-026-01656-4","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"256-262"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13043557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}