Acta anaesthesiologica Scandinavica. Supplementum最新文献

{"title":"Difficult intubation.","authors":"M Lagerkranser","doi":"10.1111/j.1399-6576.1997.tb05504.x","DOIUrl":"https://doi.org/10.1111/j.1399-6576.1997.tb05504.x","url":null,"abstract":"The incidence of failed intubation among experienced anaesthesiologists is approximately 1 /2300 in a general surgical population, and 1/300 in obstetric anaesthesia [l]. Inability to ventilate the patient because of upper airway obstruction, leading to inadequate oxygenation, and, ultimately, neurologic damage or death, is the single most common cause of serious anaesthetic related complications [21. Nevertheless, such events are extremely uncommon, occumng less than once in every 10.000 anaesthetics 131. Despite its rare occurrence, virtually every anaesthesiologist will sometime during his/her career run into some kind of \"cannot intubate, cannot ventilate\"situation. To avoid this, be it anatomical or pathological conditions that predispose for a difficult intubation, the anaesthesiologist must be able to identify the problem and choose an appropriate strategy beforehand.","PeriodicalId":75373,"journal":{"name":"Acta anaesthesiologica Scandinavica. Supplementum","volume":"110 ","pages":"65-6"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1399-6576.1997.tb05504.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20191630","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":"Prehospital care, importance of early intervention on outcome.","authors":"G Regel,&nbsp;M Stalp,&nbsp;U Lehmann,&nbsp;A Seekamp","doi":"10.1111/j.1399-6576.1997.tb05508.x","DOIUrl":"https://doi.org/10.1111/j.1399-6576.1997.tb05508.x","url":null,"abstract":"<p><p>The improvement of rescue systems and on-scene therapy has lead to a significant reduction of early posttraumatic death. It was the goal of this study to critically analyse the value of prehospital care in respect to early but also to delayed complications (single = SOF or multiple organ failure = MOF) In a retrospective analysis 1223 polytraumatized patients treated during 1984 and 1994, with an injury severity of more than 20 points according to the Injury Severity Score = ISS, on-scene therapy (\"field stabilization\") was evaluated. We could show that a sufficient preclinical airway management has major influence on late prognosis (MOF). We therefore definitely recommend early intubation at the scene in these patients. The intravenous access at the emergency place is always necessary independent whether the patient is in hemorrhagic shock or not. Loss of time can increase shock mechanisms making intravenous access even more difficult. If there is already a peripheral vasoconstriction and the localisation of an peripheral vein renders more difficult, one possibility is a venae section to get safe access. Concerning the amount of preclinical infusion controverse opinions exist. Our evaluation could not give an satisfactory statement because of a differing high incidence of mass bleeding in the groups with low (< 1000 ml) and high (> 2000 ml) preclinical infusion. The improvement of rescue systems and on-scene therapy has lead to a significant reduction of early posttraumatic death. Especially in those injuries, that are directly associated with the development of early death, i.e. intracranial bleeding, massive hemorrhage from thoracic and intraabdominal lesions these regimens on scene improved survival significantly (Fig 1) (Trunkey 1983). Nevertheless it is still discussed whether a longer rescue time is then justified to intensify on scene therapy. Recent publications demonstrate for instance that infusion therapy beginning on scene is not always necessary and sometimes especially in severe hemorrhagic shock can even aggrevate bleeding (Bickell 1989, Bickell 1991, Bickell 1993, Crawford 1991, Gross 1988, Stern 1993). On the other hand the value of on scene intubation and ventilation and chest tubing in these patients is critically discussed (Mattox 1989). Most of these studies however have their origin in the USA and are related exclusively to penetrating trauma (knife and gunshot wounds), which is completely different from underlying pathomechanisms (pure hemorrhagic shock). Only one reports of the same experience with blunt trauma (Barone 1986). Thus for severe blunt trauma the question is still open: \"field stabilization\" or \"load and go\" (Krausz 1992). A decision that always has to be related to the definite rescue time (Smith 1985). It was the goal of this study to critically analyse the value of prehospital care in respect to early but also to delayed complications (single = SOF or multiple organ failure = MOF).</p>","PeriodicalId":75373,"journal":{"name":"Acta anaesthesiologica Scandinavica. Supplementum","volume":"110 ","pages":"71-6"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1399-6576.1997.tb05508.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20191634","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":"Human sleep/wake regulation.","authors":"M Gillberg","doi":"10.1111/j.1399-6576.1997.tb05482.x","DOIUrl":"https://doi.org/10.1111/j.1399-6576.1997.tb05482.x","url":null,"abstract":"<p><p>The present paper gives a short overview on what is known about human sleep/wake regulation and focuses on two main component, the homeostatic component and the circadian. The homeostatic components increases sleep need exponentially as a function of prior wakefulness whereas the circadian component is a consequence of the 24-hour physiological rhythm facilitating sleep during the night and counteracting sleep during the day. Normally, these components interact, in an additive way. This interaction has been described in mathematical models that can be used to predict sleep duration, depth of sleep and the level of alertness given the knowledge of circadian phase and prior time awake.</p>","PeriodicalId":75373,"journal":{"name":"Acta anaesthesiologica Scandinavica. Supplementum","volume":"110 ","pages":"8-10"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1399-6576.1997.tb05482.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20191741","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":"Cerebral dysfunction after anaesthesia.","authors":"J T Møller","doi":"10.1111/j.1399-6576.1997.tb05484.x","DOIUrl":"https://doi.org/10.1111/j.1399-6576.1997.tb05484.x","url":null,"abstract":"Many anaesthesiologists see patients who survive their operation and anaesthetic without obvious complications, but who for days to years complain of or suffer from psychological dysfunction, usually problems with memory and concentration,. This syndrome, postoperative cognitive dysfunction (POCD), must be situated in the grey-zone between patients experiencing no detectable sequelae after uneventful anaesthesia and recovery and the patients with severe brain damage related to stroke or severe cerebral hypoxia. The syndrome can be grouped into three main areas: postoperative delirium, mild neurocognitive disorder, and dementia.","PeriodicalId":75373,"journal":{"name":"Acta anaesthesiologica Scandinavica. Supplementum","volume":"110 ","pages":"13-6"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1399-6576.1997.tb05484.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20191743","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":"Reversal of nondepolarizing block: only when necessary.","authors":"J Savarese","doi":"10.1111/j.1399-6576.1997.tb05519.x","DOIUrl":"https://doi.org/10.1111/j.1399-6576.1997.tb05519.x","url":null,"abstract":"","PeriodicalId":75373,"journal":{"name":"Acta anaesthesiologica Scandinavica. Supplementum","volume":"110 ","pages":"103"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1399-6576.1997.tb05519.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20192817","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":"Arguments for the use of thermal indicators to measure whole body blood flow.","authors":"J Takala","doi":"10.1111/j.1399-6576.1997.tb05534.x","DOIUrl":"https://doi.org/10.1111/j.1399-6576.1997.tb05534.x","url":null,"abstract":"Measurement of cardiac output by thermodilution is the established standard method for the evaluation of whole body blood flow in critically ill patients. Its main advantages are practicality, feasibility for routine clinical use, ease of user training, and wellestablished sources of variability and error. Comparisons against the golden standard, the Fick method, indicates acceptable bias and precision and good correlation in detecting changes in trends (1). The negative bias (smaller values with the thermodilution) observed in several recent studies in the critically ill patients is at least in part due to the increased oxygen consumption of the lung in acute inflammation (2). The recently introduced continual thermodilution methods offer the additional advantage of automated, continual trending of cardiac output (3). Since cardiac output is a variable with both rapid and slower dynamic variability, it is conceivable that the measurement of thermodilution cardiac output is bound to have variability, which is a function of the dynamic variability of actual cardiac output and the error of he method (4). Large fluctuations in airway temperature in patients with acute respiratory distress may accentuate the variability due to unstable pulmonary artery temperature. These sources of variability can be satisfactorily controlled by performing the injections randomly over the respiratory cycle and accepting only those measurements with an appropriately shaped thermal dilution curve, and increasing the number of measurements, when the variability is high.","PeriodicalId":75373,"journal":{"name":"Acta anaesthesiologica Scandinavica. Supplementum","volume":"110 ","pages":"138"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1399-6576.1997.tb05534.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20238160","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":"The multicompartment block.","authors":"G Mitterschiffthaler","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75373,"journal":{"name":"Acta anaesthesiologica Scandinavica. Supplementum","volume":"111 ","pages":"105-6"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20348211","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":"Support of spontaneous breathing in the intubated patient: automatic tube compensation (ATC) and proportional assist ventilation (PAV).","authors":"R Stocker,&nbsp;B Fabry,&nbsp;L Eberhard,&nbsp;C Haberthür","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75373,"journal":{"name":"Acta anaesthesiologica Scandinavica. Supplementum","volume":"111 ","pages":"123-8"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20348221","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":"Assessment of myocardial viability by dobutamine echocardiography.","authors":"H Baumgartner","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75373,"journal":{"name":"Acta anaesthesiologica Scandinavica. Supplementum","volume":"111 ","pages":"269-71"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20348594","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":"Small-volume hyperosmolar resuscitation.","authors":"U Kreimeier,&nbsp;M Thiel,&nbsp;K Peter,&nbsp;K Messmer","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75373,"journal":{"name":"Acta anaesthesiologica Scandinavica. Supplementum","volume":"111 ","pages":"302-6"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20348608","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}