Die Anaesthesiologie最新文献

{"title":"[Focus on ventilation, oxygen therapy and weaning 2022-2024 : Summary of selected intensive care studies].","authors":"M O Fiedler-Kalenka, T Brenner, M Bernhard, C J Reuß, C Beynon, A Hecker, C Jungk, C Nusshag, D Michalski, M A Weigand, M Dietrich","doi":"10.1007/s00101-024-01455-9","DOIUrl":"10.1007/s00101-024-01455-9","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115602","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":"[Water, taken in moderation, cannot hurt anybody].","authors":"Felix Kork","doi":"10.1007/s00101-024-01472-8","DOIUrl":"10.1007/s00101-024-01472-8","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142360715","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":"[Collaborations in publications on pediatric anesthesiology in the D-A-CH countries].","authors":"Alexander Dejaco, M Nemeth, A Sablewski, J Rosenberger, C Miller","doi":"10.1007/s00101-024-01459-5","DOIUrl":"10.1007/s00101-024-01459-5","url":null,"abstract":"<p><strong>Background: </strong>Collaborations are an essential element of scientific activity and particularly important in fields such as pediatric anesthesiology, where the evidence base in general is relatively limited. A recent scientometric analysis revealed a geographic diversification of publication activity in pediatric anesthesiology within the last two decades, accompanied by a surge in international collaborations.</p><p><strong>Objectives: </strong>Given the hypothesis of a similar growth in the activity and dynamics of publications in pediatric anesthesiology, the objective of this scientometric study was to analyze the publication activity and collaboration habits in research in pediatric anesthesiology from Germany, Austria and Switzerland (D-A-CH).</p><p><strong>Method: </strong>This secondary analysis identified all publications on pediatric anesthesiology with an affiliation from the D‑A-CH countries between 2001 and 2020 from PubMed and Web of Science. The query parameters included the timeframe 2001-2020, authors' affiliations tied to anesthesiology departments (using various forms of the term \"anesthesia\"), and the mention of pediatric interest in titles or abstracts. The data underwent standardization to account for linguistic variations. The publications were assigned to a state, city and institution based on the correspondence address, to a year based on the publication date and to a source based on the journal. The primary endpoint was publication activity and dynamics, represented by the number of publications and the respective growth rates (calculated as the linear regression slope). Secondary endpoints included the share of collaborations within and outside the D‑A-CH region (at the country and institutional level), the distribution of publication activity and the most prominent sources of publications.</p><p><strong>Results: </strong>Between 2001 and 2020 a total of 3406 publications on pediatric anesthesiology involving authors from the D‑A-CH countries were identified. Of these 2807 (82.4%) had a correspondence address in D‑A-CH. The average annual growth rate of publications with a correspondence address was + 2.9% for the D‑A-CH countries and + 7.7% for publications with collaborations. The number of publications in which an institution from D‑A-CH was named as a coauthor from a correspondence address outside D‑A-CH also increased by an average of 7.4% per year during the study period. The majority of collaborations occurred between institutions within the D‑A-CH region, although Swiss institutions exhibited a much higher proportion of collaborations outside the region. Of all publications with a correspondence address 90% originated from 46 cities. The most prominent source was Die Anästhesiologie for publications from Germany, and Pediatric Anesthesia for publications from Austria and Switzerland.</p><p><strong>Conclusion: </strong>The number of publications in pediatric anesthesiology from the D‑A-CH countrie","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309254","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":"[Anesthesia for cesarean section with diastrophic dysplasia].","authors":"Michaela Sieker, Thomas Weber, Heike Vogelsang, Peter Kern","doi":"10.1007/s00101-024-01440-2","DOIUrl":"10.1007/s00101-024-01440-2","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894935","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":"Effect of remimazolam for general anesthesia on postoperative nausea and vomiting : A systematic review and meta-analysis.","authors":"Su Yeon Kim, Kyu Man Sim, Hyo-Seok Na, Bon-Wook Koo, Hyun-Jung Shin","doi":"10.1007/s00101-024-01454-w","DOIUrl":"10.1007/s00101-024-01454-w","url":null,"abstract":"<p><strong>Background: </strong>Benzodiazepines reduce postoperative nausea and vomiting (PONV); however, conflicting results have been reported regarding the use of remimazolam, a novel benzodiazepine.</p><p><strong>Objective: </strong>This meta-analysis examines whether remimazolam reduces PONV incidence compared with propofol or volatile agents used in general anesthesia.</p><p><strong>Material and methods: </strong>Electronic databases, including PubMed, EMBASE, CENTRAL, and Web of Science, were searched on 31 July 2023. The primary outcome was the incidence of PONV. Secondary outcomes included PONV severity, rescue antiemetic use, amounts of remifentanil used, and participant satisfaction scores. Odds ratios (OR) and mean differences (MD) with 95% confidence intervals (CI) were calculated using a random-effects model. The risk of bias (RoB) was assessed using the Cochrane RoB2 tool.</p><p><strong>Results: </strong>A total of 1514 adult patients from 11 randomized controlled trials were included. The incidences of PONV in the remimazolam and control groups were 16.1% and 16.5%, respectively. Remimazolam did not increase the incidence of PONV (OR 0.62; 95% CI, 0.37-1.04; p = 0.0676; I² = 48%). Subgroup analysis showed a significant reduction in PONV with remimazolam vs. volatile agents (OR 0.25; 95% CI, 0.13-0.47; P = 0.0000; I² = 0%) but not vs. propofol (OR 1.04; 95% CI, 0.70-1.56; p = 0.8332; I² = 0%). More remifentanil was used in the remimazolam group vs. the volatile group, with no significant difference between remimazolam and propofol groups. Participant satisfaction scores were higher with remimazolam.</p><p><strong>Conclusion: </strong>Remimazolam did not increase PONV risk compared to propofol and reduced PONV incidence compared to volatile agents, with higher participant satisfaction. To validate the present findings, further well-planned large clinical trials are required.</p>","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302444","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":"[Retrospective analysis of the resuscitation room management of nontraumatic critically ill children in a university emergency department (OBSERvE-DUS-PED study)].","authors":"Claudia Priebe, Hans Martin Bosse, Mark Michael, Olaf Picker, Michael Bernhard, Juliane Tautz","doi":"10.1007/s00101-024-01457-7","DOIUrl":"10.1007/s00101-024-01457-7","url":null,"abstract":"<p><strong>Background: </strong>The establishment of a resuscitation room management for nontraumatic critically ill children appears to make sense. This study collected data of pediatric patients suffering from nontraumatic critically ill conditions treated in a resuscitation room.</p><p><strong>Methods: </strong>The retrospective OBSERvE-DUS-PED study (November 2019-October 2022) recorded pediatric patients (age < 18 years) who were admitted to the emergency department (ED) for resuscitation room care. The routinely documented data on treatment were taken from the hospital information system MEDICO® and the patient data management system COPRA® in accordance with the OBSERvE dataset. The study was approved by the Ethics Committee of the Medical Faculty of the Heinrich Heine University (2023-2377).</p><p><strong>Results: </strong>The study included 52 pediatric resuscitation room patients. Adolescents aged 14-17 years were the most frequent in the cohort representing 37% of the total and neonates/infants (0-1 year) were lowest at 8%. The most common symptoms categorized according to ABCDE problems were disturbance of consciousness (D) at 61%, cardiovascular failure (C) at 25%, respiratory insufficiency (B) at 6%, airway obstruction (A) and exposure/environment (E) problems each at 4%. The out-of-hospital and in-hospital emergency procedures were performed with the following frequencies: venous (58% vs. 65%), intraosseous (14% vs. 2%) and central venous access (0% vs. 12%), invasive airway management (35% vs. 8%), cardiopulmonary resuscitation (21% vs. 10%), vasopressors (15% vs. 17%), and intra-arterial pressure measurement (0% vs. 17%). The mean duration of resuscitation room management was 70 ± 43 min. The 30-day mortality was 17%.</p><p><strong>Conclusion: </strong>The OBSERvE-DUS-PED study demonstrates the major challenges in the care of critically ill nontraumatic pediatric patients, both in out-of-hospital and in-hospital management. The variety and complexity of the referral diagnoses as well as the immediate vital threat to the patients make it appear sensible to treat such patients primarily in a resuscitation room of the ED due to the available material, infrastructural and personnel resources.</p>","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115603","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":"[Transport of severely injured trauma patients in an ambulance with and without a rigid neck orthosis: comparative biomechanical measurements].","authors":"Martin Kieninger, Corinna Schneider, Simon Auer, Lukas Reinker, Ina Adler, Sebastian Dendorfer, Johanna Rosenberger, Daniel Popp, Christoph Eissnert, Dominik Ludsteck, Christopher Cyrus, Johannes Hoffmann, Sarah Morag, Bernhard Graf, Bärbel Kieninger","doi":"10.1007/s00101-024-01462-w","DOIUrl":"10.1007/s00101-024-01462-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The actual significance of prehospital immobilization of the cervical spine in severely injured trauma patients remains unclear. In view of possible negative implications, such as an increase in intracranial pressure due to the application of a rigid cervical spine orthosis, the long-term use must be critically questioned. Further studies are required to justify the long-term use of a rigid cervical spine orthosis in the prehospital setting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Comparative measurements of the mobility of the cervical spine during immobilization using a vacuum mattress with or without the additional application of a rigid cervical spine orthosis after positioning on the stretcher were carried out.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material and methods: &lt;/strong&gt;Biomechanical measurements of the movement of the cervical spine were carried out by attaching inertial measurement units to a test person during the loading and unloading process in a modern ambulance and during the journey along a predefined parkour. The test person on whom the measurements were carried out was immobilized on a vacuum mattress with the option of lateral fixation of the head and chin and forehead strap on an electrohydraulic stretcher. The complete standard monitoring was set up to simulate as realistic a transport of a severely injured patient as possible. A total of 30 test runs were realized. In one half of the tests, the cervical spine was additionally immobilized using a rigid orthosis and in the other half a cervical spine orthosis was not used. For each of the 30 tests, the angles, axial rotation, lateral bending and flexion/extension as well as the first and second derivatives were considered for loading, transport and unloading and the parameters mean deviation from the zero position, size of the swept angle range and maximum were calculated for each test run.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Statistically significant differences were only found for some biomechanical parameters in the sagittal plane (flexion and extension). No significant differences were found for the measured parameters in the other directions of movement (axial rotation, lateral flexion). In general, only very small angular deflections were measured both in the tests with the cervical spine orthosis and without the cervical spine orthosis (on average in the range of 1-2° for axial rotation and flexion/extension and up to 3° for lateral flexion).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;If immobilization is carried out correctly using a vacuum mattress with the option of lateral stabilization of the head and chin and a forehead strap on an electrohydraulic stretcher with a loading system, there are no relevant advantages with respect to the restriction of movement of the cervical spine by the additional use of a rigid cervical spine orthosis for the loading and unloading process or during the transport in a modern ambulance. It could therefore be advantageous to remove the ri","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333696","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":"[Extracorporeal procedures in sepsis].","authors":"Alice Bernard, Michael Koeppen","doi":"10.1007/s00101-024-01464-8","DOIUrl":"10.1007/s00101-024-01464-8","url":null,"abstract":"<p><p>Sepsis and septic shock are frequent and severe clinical pictures in intensive care medicine that result from a dysregulated immune response to an infection and cause a high mortality rate. This article provides an overview of the various extracorporeal procedures used to treat sepsis. Various procedures are used to treat sepsis and septic shock. These include high-volume hemofiltration (HVHF), very high-volume hemofiltration (VHVHF), high cut-off filter (HCO), polymyxin B hemoperfusion and cytokine adsorption filters. The HVHF and VHVHF remove inflammatory mediators but show no significant benefit in terms of stabilization and survival in sepsis patients. The HCO filters effectively eliminate cytokines but so far there is no evidence of a survival benefit. Polymyxin B hemoperfusion shows promising results in initial studies in certain patient groups, while evidence for cytokine adsorption filters is limited. Combined plasma filtration and adsorption (CPFA) and therapeutic plasma exchange (TPE) have so far shown promising results in small studies. Although CPFA shows no survival benefit, TPE may have protective effects on the vascular glycocalyx. Extracorporeal procedures carry risks such as thrombosis and loss of proteins and clotting factors. The therapeutic benefit of these procedures in the treatment of sepsis remains unclear and further prospective randomized multicenter studies are needed to evaluate their efficacy and safety. There are currently no guideline recommendations for the routine use of these procedures in sepsis.</p>","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333692","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":"[Meta-analyses-Explained my means of examples from anesthesia and pain medicine].","authors":"Petra Bäumler, Dominik Irnich","doi":"10.1007/s00101-024-01460-y","DOIUrl":"10.1007/s00101-024-01460-y","url":null,"abstract":"<p><p>Meta-analyses are a central part of systematic reviews. The term meta-analysis describes the statistical methods to summarize the results of the available scientific studies providing the highest possible evidence. In medicine, meta-analyses aim to guide clinical decisions. This article provides an overview of the necessary work steps.The classical meta-analysis summarizes the results of randomized controlled trials that compare an intervention against a control intervention. This is illustrated by means of an example from a Cochrane Review on videolaryngoscopy in comparison to direct laryngoscopy. Crucial methodological aspects such as the weighting of individual studies when pooling their results as well as the evaluation of study heterogeneity and potential publication bias are explained.The second part of the article focusses on two extensions of meta-analyses: the individual patient data meta-analysis and the network meta-analysis. The individual patient data meta-analysis makes use of the information that is available from the patient-level data of the included studies. As an example, the work accomplished by an international collaboration on the efficacy of acupuncture in chronic pain is presented. A network meta-analysis enables the comparison of more than two interventions by making use not only of the available direct but also of the respective indirect evidence. This is illustrated by means of a Cochrane Review on drugs for the prophylaxis of postoperative nausea and vomiting.</p>","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302443","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 sepsis and general intensive care medicine 2023-2024 : Summary of selected intensive medical care studies].","authors":"C J Reuß, M Bernhard, C Beynon, M O Fiedler-Kalenka, A Hecker, C Jungk, C Nusshag, D Michalski, F C F Schmitt, T Brenner, M A Weigand, M Dietrich","doi":"10.1007/s00101-024-01456-8","DOIUrl":"https://doi.org/10.1007/s00101-024-01456-8","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302442","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}