Die Anaesthesiologie最新文献

{"title":"[Evaluation of the \"interprofessional late shift\" as elective subject in emergency medicine for medical students: a pilot study].","authors":"Marlene Kleinsorge, Jan Landwehrt, Verena Brause, Lena Balitzki, Berit Paul, Markus Ramm, Rupert Conrad, Alexander Zarbock, Gunther Joos, Alexander Schnabel","doi":"10.1007/s00101-026-01725-8","DOIUrl":"10.1007/s00101-026-01725-8","url":null,"abstract":"<p><strong>Background: </strong>Interprofessional teaching courses are generally considered useful but have rarely been implemented in German medical education curricula to date.</p><p><strong>Objective: </strong>The aim of this pilot study was to determine whether the newly planned teaching course \"interprofessional late shift\" improves students' attitudes towards interprofessional work and whether this can be further optimized by a short intervention at the beginning of the course.</p><p><strong>Material and methods: </strong>The quantitative assessment involved students completing the \"international socialization and valuing scale-9\" (ISVS-9), the \"University of the West of England Interprofessional Questionnaire German\" (UWE-IP-D) (only the \"communication and teamwork\" dimension) and the scale for general self-efficacy expectations (SWE) before and after the course. In addition, a brief assessment of the personality was carried out before the event using the Big Five Inventory-10.</p><p><strong>Results: </strong>This pilot study was conducted over two semesters. Questionnaires were completed by 30 students. The ISVS‑9 total scores increased in both groups (p = 0.011); however, a significant difference in the increase between the intervention and control groups could not be determined (p = 0.98). The total scores of the UWE-IP‑D decreased significantly (p = 0.002), which indicates an improvement in communication skills. Analyses of the influence of the personality showed a significant correlation between the increase in self-efficacy, neuroticism (p = 0.018) and agreeableness (p = 0.044).</p><p><strong>Conclusion: </strong>The results of the pilot study clearly show that the newly planned teaching course \"interprofesional late shift\" could be an effective tool for enhancing medical students' appreciation of interprofessional collaboration; however, the appreciation could not be additionally improved by a short intervention at the beginning of the course.</p>","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"696-704"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148852012","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":"[Situation-adapted personnel alerting and staff allocation in mass casualty incidents: concept, calculation and technical implementation].","authors":"Axel R Heller, Marc Gistrichovsky, Steffen Heider, Marc-Michael Ventzke","doi":"10.1007/s00101-026-01737-4","DOIUrl":"https://doi.org/10.1007/s00101-026-01737-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In mass casualty incidents (MCI), hospitals must mobilize substantial personnel resources within minutes to hours. Personnel alerting is a central element of the hospital emergency and contingency plan (HECP), yet in practice it is frequently insufficiently systematized and quantitatively underpinned. In addition, technical alerting infrastructures display parallelism and feedback limits that constrain the achievable alerting speed. Empirical data from a recent evaluation of a German hospital of basic and standard care showed that only 2.4% of the total workforce could be mobilized within a 1‑h interval when relying on manual telephone alerting, exposing a critical gap between formal HECP compliance and operational readiness. Comparable shortfalls are reported across a wide range of hospital sizes and are compounded by outdated contact lists, unclear responsibilities and low workforce awareness of the significance of alerting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;A specialty-specific (targeting individual professional groups) and modular (configurable into scalable bundles) alerting concept is presented, comprising a quantitative personnel requirement matrix, a multilevel call group architecture and a server-based, self-regulating alerting logic designed to prevent over-alerting. The concept explicitly addresses the transition zone between formal alerting plans and their operational reality and is designed to be technology-agnostic, allowing implementation on classical in-house alerting servers, commercial alerting services or modern app-based platforms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Based on a hospital distribution matrix agreed upon with the local civil protection authority, a detailed personnel requirement plan was developed. Taking into account response rates of off-duty staff (30-50%), alerting numbers and threshold values were programmed for a stepwise alerting server. Call groups were named according to a uniform phonetic alphabet and consolidated into scalable bundles. The interplay between server capacity, parallel outgoing line availability and staff response behavior was analyzed to identify the actual rate-limiting factor of alerting duration. Complementary intrahospital patient flow planning based on a ward-based 10% rule and the shared use of the alerting infrastructure for internal hazard scenarios (power outage, IT failure, fire, or threat situation) were integrated into the framework as second-line applications of the same technical platform.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;For a total admission capacity of 135 patients in 2 waves, 127 directly patient-related staff members were calculated as the minimum requirement. At a response rate of 30%, this translates into an alerting requirement of 423 staff members. The call group system comprises 16 specialty-specific groups, 2 scalable bundles and 1 overarching master bundle. A server-based procedure with defined feedback thresholds prevents systematic o","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066478","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":"Recruitment maneuvers and lung ultrasound-assessed aeration in laparoscopic cholecystectomy : A prospective randomized controlled trial.","authors":"Cansu Ofluoğlu, Arsen Güngör Ay, Doğa Meriç Yükselen, Kübra Taşkın Ayaz, Elif Acar Değer, Öznur Demiroluk, Arzu Yıldırım Ar","doi":"10.1007/s00101-026-01742-7","DOIUrl":"https://doi.org/10.1007/s00101-026-01742-7","url":null,"abstract":"<p><strong>Background: </strong>General anesthesia and CO₂ pneumoperitoneum during laparoscopic cholecystectomy can cause regionally heterogeneous loss of lung aeration. We evaluated whether two scheduled alveolar recruitment maneuvers (RM), added to otherwise identical low tidal volume ventilation, altered perioperative aeration measured by lung ultrasound (LUS).</p><p><strong>Methods: </strong>In this single-center, prospective, randomized controlled trial, 80 adults (American Society of Anesthesiologists (ASA) physical status I-III) scheduled for elective laparoscopic cholecystectomy were allocated 1:1 to an RM group (n = 40) or a no RM control group (n = 40). Both groups received tidal volumes of 6-8 mL/kg predicted body weight and positive end-expiratory pressure (PEEP) of 5 cmH2O₂O. In the RM group, a stepwise RM was performed immediately after establishment of pneumoperitoneum and repeated after pneumoperitoneum deflation, before emergence and extubation. An 8‑zone LUS protocol was applied at 5 predefined time points: before induction (T1), 5 min after induction (T2), after the first RM during pneumoperitoneum (T3), immediately after extubation and after the second RM (T4), and 30 min after extubation in the post-anesthesia care unit (PACU) (T5). The primary outcome was the composite LUS score trajectory analyzed using a linear mixed-effects model.</p><p><strong>Results: </strong>Baseline LUS scores were comparable between groups (median [IQR], 5 [4-6] vs. 5 [4-7]; p = 0.840). After pneumoperitoneum and the first RM, the LUS scores were lower in the RM group than in the no RM control group (3 [2-4] vs. 7 [5-8.25]; p < 0.001). The difference persisted immediately after extubation (4 [3-5] vs. 6 [5-7]; p < 0.001) and at PACU assessment (3 [2-4] vs. 6 [4-7.25]; p < 0.001). The group × time interaction was significant (χ²(4) = 63.02; p < 0.001) and remained significant after adjustment for age, sex, ASA status, and body weight. No significant between-group differences were detected in SpO₂, mean arterial pressure, or heart rate at any assessment (all p ≥ 0.070). No recruitment maneuver required premature termination for excessive peak inspiratory pressure or hemodynamic instability, and no rescue interventions were needed.</p><p><strong>Conclusion: </strong>Two scheduled RMs were associated with lower perioperative LUS scores through early PACU follow-up without detectable differences in the recorded oxygenation or hemodynamic variables. These findings demonstrate a physiological improvement in regional aeration but do not establish a reduction in postoperative pulmonary complications or other patient-centered outcomes.</p>","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042264","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":"[Hospital care in times of crisis : Are German hospitals prepared for military conflicts?]","authors":"E G Pfenninger, M Königsdorfer, S Witte, S Mayer, U X Kaisers, B Friemert","doi":"10.1007/s00101-026-01738-3","DOIUrl":"https://doi.org/10.1007/s00101-026-01738-3","url":null,"abstract":"<p><strong>Background: </strong>Considering the evolving security policy framework conditions in Europe, it is imperative to assess if the German hospital system is prepared to face military conflict scenarios, such as disasters, crises and wars.</p><p><strong>Methods: </strong>This study was conducted as a narrative literature review and covered the period from January 2020 to June 2026 in the PubMed and Google Scholar databases. The study used combinations of the search terms \"hospital preparedness\", \"hospital resilience\", \"war\", \"military conflict\", \"mass casualty incident\", \"disaster planning\", \"Germany\" and their German language equivalents. The search terms were used both individually and in various combinations. The study included original articles, reviews, guidelines, government reports and health policy publications in both German and English that addressed hospital preparedness for armed conflicts or comparable large-scale disasters. Publications without a direct connection to hospital care in crisis situations as well as those for which the full text was not available, were excluded.</p><p><strong>Results: </strong>There are no controlled, randomized and blinded studies (RCT) examining the question whether German hospitals are prepared for military conflicts. The available evidence on this topic consists primarily of expert recommendations, government reports and experiences from current military conflicts.</p><p><strong>Discussion and conclusion: </strong>Germany has a highly developed civilian healthcare system but recent studies and official risk analyses reveal shortcomings in its preparedness for large-scale military conflicts. There are particular concerns about its ability to handle long-lasting mass casualty incidents (MCI), and the systemic resilience of the healthcare system in general. Experience from the Russia-Ukraine war shows that modern wars generate enormous numbers of seriously injured patients and quickly push the healthcare system to its limits. While smaller influxes of wounded would be manageable, a large-scale military conflict would require additional military, logistical and international support. Challenges lie not only in infrastructure, but also in the availability of qualified personnel and intensive care capacity as well as in logistical resilience. Greater integration of civilian hospitals into national security planning, along with regular exercises and investments in resilience, could be the key to ensuring medical care during a military crisis.</p>","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992708","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":"Reguliert sich die Anästhesiologie ins Abseits?","authors":"Michael H Dück","doi":"10.1007/s00101-026-01729-4","DOIUrl":"10.1007/s00101-026-01729-4","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920943","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":"Preoperative video laryngoscopic examination for difficult intubation in obese patients.","authors":"Funda Atar, Fatma Özkan Sipahioğlu, Derya Özkan, Harun Karabacak, Cansu Ekici","doi":"10.1007/s00101-026-01730-x","DOIUrl":"https://doi.org/10.1007/s00101-026-01730-x","url":null,"abstract":"<p><strong>Background: </strong>Anatomical and physiological changes often observed in obese patients increase the risk of difficult tracheal intubation (DTI). In this study, we explored the potential of video-assisted laryngoscopy to prospectively predict DTI in obese patients.</p><p><strong>Material and methods: </strong>Patients scheduled for general anesthesia with a body mass index (BMI) higher than 30 were included in the study. The El-Ganzouri risk index (EGRI) was calculated during routine preoperative bedside evaluations. An EGRI of ≥ 4 was considered indicative of DTI. Following the application of a local anesthetic agent to the airway, the percentage of glottic opening (POGO) score was obtained using preoperative video laryngoscopy. In the POGO score, visibility of 50% or less of the glottic opening was considered indicative of difficult intubation. Intubation difficulties were assessed using the intubation difficulty scale (IDS), with an IDS score > 5 considered indicative of difficult intubation.</p><p><strong>Results: </strong>The study included 104 patients with an average BMI of 36.9 ± 4.8. According to the IDS, the incidence of DTI was 30.8% (n = 32). The POGO score displayed a significantly higher positive predictive value and sensitivity compared to the EGRI (p < 0.0001 for both). The ROC analysis showed better discriminative performance for the POGO score than for the EGRI (AUC: 0.868 vs. 0.436; p < 0.001). The preoperative POGO score was correlated with the IDS (r = 0.710, p < 0.001).</p><p><strong>Conclusion: </strong>Our findings suggest that the POGO score obtained during preoperative video-assisted laryngoscopy is associated with difficult tracheal intubation in obese patients.</p>","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908194","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":"Management of postpartum hemorrhage at a level 1 perinatal center : A retrospective analysis over a period of 18 years.","authors":"Sebastian Hafner, Martin Wepler, Benjamin Mayer, Daniel Haas, Bettina Jungwirth, Wolfgang Janni, Beate Hüner, Amelie de Gregorio, Nikolaus de Gregorio, Gebhard Fröba, Benedikt Schick","doi":"10.1007/s00101-026-01727-6","DOIUrl":"https://doi.org/10.1007/s00101-026-01727-6","url":null,"abstract":"<p><strong>Background: </strong>Postpartum hemorrhage (PPH) remains a clinically significant cause of maternal complications and death. Due to the increasing incidence, international recommendations have been implemented, such as the D‑A-CH algorithm, an interdisciplinary and transnational treatment algorithm for Germany, Austria and Switzerland. This study aims to evaluate both the impact of implementing a hemostaseology working group and adopting the internationally recognized D‑A-CH algorithm on the clinical management of PPH in a university hospital.</p><p><strong>Methods: </strong>In this single-center retrospective observational study, patient records were reviewed from all patients treated for PPH between March 2003 and July 2021 at the University Hospital Ulm, Germany (n = 341). Data were divided into three groups: (I) patients treated before the implementation of a working group for hemostaseology (n = 40), (II) patients treated after the implementation of a working group for hemostaseology and before the clinical application of the D‑A-CH-algorithm (n = 103) and (III) patients treated after the clinical application of the D‑A-CH algorithm (n = 198).</p><p><strong>Results: </strong>After the implementation of the D‑A-CH-algorithm, a significantly higher amount of fibrinogen (2.0 g, interquartile range, IQR, 0.0-3.0 g in group III vs. 0.0 g, IQR 0.0-2.0 g in group II and 0.0 g, IQR 0.0-0.0 g in group I ; p < 0.0001) and tranexamic acid (1.0 g, IQR 1.0-1.5 g in group III vs. 1.0 g, IQR 0.0-1.0 g in group II and 0.0 g, IQR 0.0-0.0 g in group I; p < 0.0001) was administered. Additionally, transfusion of allogeneic blood products (units of concentrated red cells: 2.0, IQR 0.0-4.0 in group III vs. 3.0, IQR 2.0-5.0 in group II and 3.0, IQR 0.0-7.8 in group I; p = 0.0036), intensive care unit (ICU) stay (3.0 days, IQR 2.0-4.0 days in group III vs. 3.0 days, IQR 2.0-5.0 days in group II and 3.0 days, IQR 2.0-4.3 days in group I; p = 0.0195) and hospital stay (5.0 days, IQR 3.0-7.0 days in group III vs. 7.0 days, IQR 5.0-9.0 days in group II and 7.0 days, IQR 5.0-9.0 days in group I; p < 0.0001) was significantly reduced. Implementation of a hemostaseology working group alone was only associated with increased fibrinogen and tranexamic acid administration.</p><p><strong>Conclusion: </strong>In this retrospective study, application of the D‑A-CH algorithm was associated with improved targeted hemostatic therapy and reduced transfusion requirements as well as shorter ICU and hospital stays, whereas implementation of a hemostaseology working group alone was only associated with increased fibrinogen and tranexamic acid administration. Due to the retrospective design of the study and inherent limitations therein, we were unable to draw a causative effect relationship. Nonetheless, our results warrant further study.</p>","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889455","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 Albumin: new perspectives for the clinical application in intensive care medicine : From the quantitative routine to qualitative individualized theranostics].","authors":"Gerd Klinkmann, Kristina Boss, Sophie Brabandt","doi":"10.1007/s00101-026-01724-9","DOIUrl":"10.1007/s00101-026-01724-9","url":null,"abstract":"<p><p>Human albumin plays a double role in intensive care medicine. It is therapeutically administered as a colloid and diagnostically employed as a laboratory parameter for risk and monitoring classification. For both fields of application, a quantitative logic has so far been dominant. Large randomized studies consistently show that human albumin is overall safer than crystalloids but does not provide a general benefit in most intensive care medical scenarios. Subgroup-specific risks must be considered: in cases of traumatic brain injuries the administration of hypotonic 4% albumin solution was associated with an increased mortality; new analyses indicate that the hypotonicity of the solution in particular and not the albumin molecule per se was the decisive risk factor. A target value-based albumin strategy also does not lead to any advantage with respect to mortality in cases of sepsis. Accordingly, current guidelines and international consensus recommendations position albumin as a targeted supplement after administration of crystalloids and not as first-line treatment.Parallel to the established evidence, the interest in a qualitative albumin perspective is growing. In cases of sepsis and septic shock albumin is not only quantitatively reduced but its function as transport and binding protein can also be measurably impaired. The term theranostics can be understood as an integrated approach in which a functional assay captures the individual albumin phenotype from which a phenotype-specific intervention can be derived and the success of treatment can be monitored based on the same parameters. Practical examples, from altered pharmacokinetics of furosemide in cases of reduced binding capacity to the differentiated assessment of albumin formulations in cases of brain injury, illustrate the concept. Taken as a whole, the available evidence indicates a paradigm shift away from the purely quantitative consideration to functional phenotype-based albumin theranostics, where the clinical benefits must be confirmed in prospective multicenter studies.</p>","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"607-617"},"PeriodicalIF":1.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802236","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":"[Ipsilateral venous puncture and catheter placement after axillary lymphadenectomy].","authors":"J Weber, F Wappler, M Schieren, J Defosse","doi":"10.1007/s00101-026-01694-y","DOIUrl":"10.1007/s00101-026-01694-y","url":null,"abstract":"<p><p>After axillary lymphadenectomy (ALND) or radiotherapy for breast cancer or malignant melanoma, damage to the lymphatic tissue can reduce the lymphatic transport capacity and increase interstitial fluid accumulation. This can lead to swelling, pain, progressive trophic skin changes and an elevated risk of infections. Moreover, functional impairment of the affected limb can result in significant psychosocial consequences. Affected patients are usually informed about their increased lifetime risk of developing lymphedema and current guidelines from numerous international and national societies recommend that ipsilateral medical interventions, such as vascular punctures for blood sampling or blood pressure measurements should be avoided. If contralateral venous access is difficult, suboptimal puncture sites such as the foot are chosen or a central venous catheter is placed, even though this is associated with limited access and reduced visualization of the puncture site. Unsuccessful venipuncture attempts can cause pain, discomfort and functional limitations; in particular, placing peripheral intravenous catheters at suboptimal sites such as the foot can substantially impair mobility and thus increase the risk of complications such as deep vein thrombosis. Until recently, evidence on ipsilateral procedures was scarce and largely derived from small case studies; however, emerging data indicate that isolated procedures such as venous puncture and catheter placement can be safely performed following ALND or axillary radiotherapy in the absence of pre-existing lymphedema. Likewise, noninvasive methods (e.g., blood pressure measurements) do not appear to elevate the risk of lymphedema, although ipsilateral interventions should remain contraindicated in patients with established lymphedema. Thus, following an unsuccessful contralateral puncture, an ipsilateral puncture should be considered before selecting unfavorable puncture sites or considering the placement of a central venous catheter.</p>","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"649-655"},"PeriodicalIF":1.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260602","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":"[Training and clinical use of focused echocardiography : Evaluation of the state of training and clinical application of perioperative focused echocardiography by anesthesiologists in Germany].","authors":"Timo Kummerow, Pablo Cavalié, Felix Reinecke, Melissa Barroux, Matthias Göpfert, P Scheiermann, R Tomasi","doi":"10.1007/s00101-026-01719-6","DOIUrl":"10.1007/s00101-026-01719-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Focused cardiac ultrasound (FOCUS) is a targeted point-of-care echocardiographic approach for rapid assessment of cardiac function and morphology. It is established in emergency and intensive care medicine and increasingly more relevant for making perioperative decisions. Data on its integration into perioperative workflows by anesthesiologists and on the role of training and supervision, remain limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This nationwide survey assessed FOCUS training, supervision and clinical application among anesthesiologists in Germany and examined how training and supervision were associated with self-reported confidence in performing FOCUS and the extent of its clinical use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material and methods: &lt;/strong&gt;We conducted an anonymized digital cross-sectional survey among physician members of the German Society of Anesthesiology and Intensive Care Medicine (DGAI). The standardized questionnaire comprised 21 items on professional background, echocardiographic training, supervised examinations, clinical integration of FOCUS and self-assessed skills. Training formats were grouped as no course, basic course, or basic plus advanced course. Supervision was recorded as the number of supervised FOCUS examinations after course attendance but the survey did not distinguish between bedside instruction, joint interpretation or image review. Complete datasets were analyzed using Pearson's χ&lt;sup&gt;2&lt;/sup&gt;-test and Wilson 95% confidence intervals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, 645 physicians participated and 469 completed the questionnaire. Senior physicians were overrepresented compared with the DGAI membership structure, whereas residents were underrepresented. More than 80% had completed at least one basic FOCUS course, yet more than 40% reported no supervised examinations before independently performing FOCUS in patients. Approximately 40% used FOCUS regularly, another 40% irregularly and 20% did not use it in practice. The FOCUS examination was used most often in emergency and intensive care situations, followed by intraoperative monitoring and preoperative evaluation. For elective preoperative assessment, cardiology was named most frequently, whereas before emergency surgery anesthesiologists were more often involved. Course participation was significantly associated with more frequent FOCUS use and supervised examinations showed an even stronger association with clinical use. Self-reported confidence in qualitative left ventricular function assessment and quantitative ejection fraction measurement increased with course level and supervision. Lack of qualification, insufficient supervision and time constraints were the main barriers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Despite high course participation and broad acceptance of FOCUS, the integration into perioperative practice remains limited. Courses alone appear insufficient for sustainable implementation. Supervision, continuous pra","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"618-626"},"PeriodicalIF":1.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762748","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}