Die Anaesthesiologie最新文献

{"title":"[Severe burns from a hairdryer during labor under epidural anesthesia].","authors":"Florian Marti, Christian Tschumi","doi":"10.1007/s00101-026-01723-w","DOIUrl":"10.1007/s00101-026-01723-w","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"720-722"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802290","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":"[Structures and perspectives of intensive care and anesthesia nursing in Germany: a nationwide cross-sectional survey].","authors":"Tilmann Müller-Wolff, Lars Krüger, Marina Ufelmann, Andreas Schäfer, Jan Teichert, Denise Schindele","doi":"10.1007/s00101-026-01728-5","DOIUrl":"10.1007/s00101-026-01728-5","url":null,"abstract":"<p><strong>Background: </strong>The long-standing shortage of qualified nursing staff in intensive care and anesthesia nursing poses substantial structural and organizational challenges for hospitals in Germany. Working conditions, qualification structures, nursing leadership resources and organizational frameworks have become increasingly more important for maintaining high-quality specialist nursing care and supporting professional nursing development. Despite ongoing discussions regarding workforce development, advanced nursing roles and qualitative skill and grade mix, systematic nationwide data describing leadership, team composition, qualification structures and organizational conditions within intensive care and anesthesia nursing in Germany have so far been lacking.</p><p><strong>Aim: </strong>The primary aim of this nationwide cross-sectional survey was to assess the current state of nursing development in intensive care and anesthesia nursing in Germany. Secondary objectives were to describe leadership structures, team composition, organizational characteristics and structures for specialist education, continuing professional development and qualification pathways.</p><p><strong>Methods: </strong>A quantitative nationwide cross-sectional online survey was conducted among individuals holding leadership positions in intensive care and anesthesia nursing in German hospitals. A 44-item questionnaire was distributed through professional nursing networks. Data were analyzed using descriptive and bivariate statistical methods.</p><p><strong>Results: </strong>Of the 749 participants 550 datasets (73.4%) were included in the analysis. State-certified specialist nurses (German postregistration specialist nursing qualification; Fachkrankenpflege) assumed extended professional responsibilities in some departments (17.1%, n = 94), whereas academically qualified nurses had so far only been integrated into clinical practice on a selective basis. Many nursing managers reported limited or no protected time for leadership responsibilities (35.9%, n = 118), despite simultaneously leading large teams and facing persistent staff shortages (49.6%, n = 273 reporting vacant positions). The team composition was heterogeneous and included registered nurses as well as other professional groups, including anesthesia technical assistants. Organizational structures supporting nursing development, specialist education, continuing professional development and nursing leadership varied considerably across institutions and frequently depended on the personal commitment of individual nursing managers.</p><p><strong>Conclusion: </strong>This nationwide cross-sectional survey demonstrates considerable variation in the organizational structures supporting intensive care and anesthesia nursing in Germany and identifies structural barriers to effective nursing leadership, qualification development and the systematic implementation of advanced nursing roles. The findings provi","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"705-715"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914531","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":"[Interdisciplinary training concept for evacuation of intensive care patients in fire events : Development, implementation and first experiences from a simulation exercise].","authors":"Thomas von Ahnen, Martin von Ahnen, Florian Meier, Michael Ströhla, Anne Heimburger, Markus Rehm, Steffen Herdtle","doi":"10.1007/s00101-026-01736-5","DOIUrl":"https://doi.org/10.1007/s00101-026-01736-5","url":null,"abstract":"<p><strong>Background: </strong>Fires in intensive care units (ICU) are rare but pose unique challenges due to patients' limited mobility, dependence on life-sustaining treatment, complex medical equipment and oxygen-enriched environments. Conventional evacuation strategies are often inadequate for critically ill patients requiring intensive care.</p><p><strong>Objective: </strong>Development and evaluation of an interdisciplinary training concept for the evacuation of critically ill ICU patients during fire emergencies involving both fire service personnel and hospital staff.</p><p><strong>Material and methods: </strong>In this single-center exploratory simulation study, a 6-module training program was developed following a structured hazard analysis. The contents included critical care medical principles, medical devices, crew resource management, hospital layout and evacuation planning, medical equipment management and simulation-based training. Subsequently, a realistic evacuation exercise involving firefighters, intensive care nursing personnel and physicians was conducted using two complex ICU patient scenarios. The primary endpoint was the successful evacuation of all patients.</p><p><strong>Results: </strong>Both simulated patients were successfully evacuated in all simulation runs. The mean evacuation time to reach the next safe fire compartment was 4 min 5 s, while an additional firefighting water supply was established after a mean of 3 min 15 s. Only one minor technical error was observed; no relevant disconnection of life support devices or interruptions of patient care occurred.</p><p><strong>Conclusion: </strong>The interdisciplinary training concept enabled the safe and feasible evacuation of critically ill ICU patients under realistic fire conditions. Regular joint simulation training involving fire service personnel and hospital staff, together with standardized evacuation protocols, could substantially improve patient safety and emergency preparedness in intensive care units.</p>","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119566","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":"[ITACS: preoperative intravenous iron slightly increases the number of days alive and at home and reduces the transfusion rate].","authors":"Florian Piekarski, Philipp Pütz","doi":"10.1007/s00101-026-01746-3","DOIUrl":"https://doi.org/10.1007/s00101-026-01746-3","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119137","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":"[Vasopressors or fluids in early septic shock].","authors":"Lennart Wild, Christian Bode","doi":"10.1007/s00101-026-01739-2","DOIUrl":"10.1007/s00101-026-01739-2","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"731-732"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984282","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":"[Anesthesia for robot-assisted surgery].","authors":"Frank Theil, Thomas Saller, Elisa Hiedl","doi":"10.1007/s00101-026-01731-w","DOIUrl":"10.1007/s00101-026-01731-w","url":null,"abstract":"<p><p>Robot-assisted surgery (RAS) has become firmly established in modern surgical practice, particularly in urology and is associated with well-documented surgical advantages. The combination of carbon dioxide pneumoperitoneum, often steep Trendelenburg positioning, prolonged operative times and restricted intraoperative patient access creates distinct physiological and organizational challenges for anesthetic management. This narrative review summarizes the anesthesiological implications of RAS with a focus on urological procedures. Relevant changes in respiratory mechanics during RAS include decreased lung compliance, increased airway pressures and impaired gas exchange. These changes require individually tailored lung-protective ventilation strategies. Hemodynamic alterations essentially result from increased intra-abdominal pressure and positional effects, including increased afterload, altered venous return and reduced cardiac efficiency, particularly in patients with limited cardiopulmonary reserve. Head and neck venous congestion can lead to airway edema and increased intraocular and intracranial pressures, while neurocognitive disorders are an additional concern in vulnerable patient populations. The generally poor accessibility of patients during RAS highlights the importance of meticulous preoperative planning, appropriate monitoring, standardized positioning and clearly defined emergency protocols. In particular, for patients with cardiopulmonary or neurocognitive risks an individual strategy is decisive to minimize perioperative morbidity. Ensuring the safety of anesthesia for RAS requires anticipating procedure-specific physiological stressors, providing individualized perioperative management and ensuring effective interdisciplinary coordination. Standardization, simulation-based training and protocol-driven emergency preparedness are essential to enhance patient safety as the use of robotic surgery continues to expand.</p>","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"683-695"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992703","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":"[Between evidence and individual cases-Anesthesiology for robotic interventions].","authors":"Felix Kork","doi":"10.1007/s00101-026-01747-2","DOIUrl":"10.1007/s00101-026-01747-2","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"681-682"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031953","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":"[Autoimmune encephalitis in intensive care medicine : Differentiation from infectious encephalitis].","authors":"Albrecht Günther, Dirk Brämer","doi":"10.1007/s00101-026-01732-9","DOIUrl":"10.1007/s00101-026-01732-9","url":null,"abstract":"<p><p>Autoimmune encephalitis (AIE) is a relatively new group within the spectrum of encephalitic diseases. Awareness and the pathophysiological understanding of these conditions are increasing. They are also gaining importance in the field of intensive care medicine as severe cases are frequently accompanied by unconsciousness, epileptic seizures up to treatment-refractory status epilepticus, autonomic dysregulation and the need for mechanical ventilation. A major challenge is the early differentiation between autoimmune and infectious encephalitides as symptoms, cerebrospinal fluid findings and changes in imaging examinations can often appear similar. While infectious encephalitis requires rapid anti-infective therapy, autoimmune forms necessitate early initiation of immunotherapy. Delays in commencing treatment worsen the prognosis. This article addresses the diagnostic criteria, antibody diagnostics, complications in intensive care settings and current immunotherapies.</p>","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"737-744"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031988","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":"Fehlende biophysikalische Plausibilität einer TASER®-induzierten Rhabdomyolyse.","authors":"Sebastian N Kunz, K K Witte","doi":"10.1007/s00101-026-01733-8","DOIUrl":"10.1007/s00101-026-01733-8","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"733-734"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013437","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":"Rhabdomyolyse nach Missbrauch von 3,4‑Methylendioxypyrovaleron und Amphetaminen, massiver psychomotorischer Agitation sowie potenziell additivem Effekt durch einen TASER®.","authors":"Felix Lehmann, Mark Ulrich Gerbershagen","doi":"10.1007/s00101-026-01734-7","DOIUrl":"10.1007/s00101-026-01734-7","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"735-736"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032015","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}