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Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie最新文献

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[Neuromuscular Blockade in the Critically Ill]. [危重病人的神经肌肉阻滞]。
IF 0.3 4区 医学
Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie Pub Date : 2024-08-01 Epub Date: 2024-08-28 DOI: 10.1055/a-2195-8851
Carolin Jung, Thomas Stüber
{"title":"[Neuromuscular Blockade in the Critically Ill].","authors":"Carolin Jung, Thomas Stüber","doi":"10.1055/a-2195-8851","DOIUrl":"https://doi.org/10.1055/a-2195-8851","url":null,"abstract":"<p><p>The management of sedation in intensive care medicine has changed substantially in the last few years. Neuromuscular blocking agents (NMBA) are only rarely indicated in modern intensive care medicine. In this review, the mechanism of action, potential side effects, and special considerations for the application of NMBA to critically ill patients will be discussed. We further present the rationale for the use of NMBA for the remaining indications, such as endotracheal intubation, selected cases of severe acute respiratory distress syndrome, and shivering during temperature control after cardiac arrest. The review will close with a description of potential side effects of NMBA use in the intensive care setting, such as awareness, acquired skeletal muscle weakness as well as corneal injuries, and how monitoring of sedation and peripheral muscle blockade may be handled.</p>","PeriodicalId":7789,"journal":{"name":"Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie","volume":"59 9","pages":"506-516"},"PeriodicalIF":0.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142091421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Quiz intensiv – stellen Sie die Diagnose! 强化测验--做出诊断！
IF 0.3 4区 医学
Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie Pub Date : 2024-07-01 Epub Date: 2024-07-29 DOI: 10.1055/a-2239-5748
Nicolas Hall, Evangelos Karasimos
{"title":"Quiz intensiv – stellen Sie die Diagnose!","authors":"Nicolas Hall, Evangelos Karasimos","doi":"10.1055/a-2239-5748","DOIUrl":"10.1055/a-2239-5748","url":null,"abstract":"","PeriodicalId":7789,"journal":{"name":"Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie","volume":"59 7-08","pages":"480-483"},"PeriodicalIF":0.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141791712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Emergency Treatment of Traumatic Brain Injury]. [创伤性脑损伤的紧急治疗]。
IF 0.3 4区 医学
Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie Pub Date : 2024-07-01 Epub Date: 2024-07-29 DOI: 10.1055/a-2075-9193
Tobias Hofmann
{"title":"[Emergency Treatment of Traumatic Brain Injury].","authors":"Tobias Hofmann","doi":"10.1055/a-2075-9193","DOIUrl":"10.1055/a-2075-9193","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) is a temporary or permanent damage to the cerebral functions caused by external force on the skull. TBI is one of the most common causes of death worldwide and has significant socioeconomic and health consequences. This article examines classification, clinical pictures and adequate emergency treatment with diagnostics, surgical therapy and prognosis.</p>","PeriodicalId":7789,"journal":{"name":"Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie","volume":"59 7-08","pages":"412-419"},"PeriodicalIF":0.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141791709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Aktuelles Management bei Schädel-Hirn-Trauma. 目前对脑外伤的管理。
IF 0.3 4区 医学
Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie Pub Date : 2024-07-01 Epub Date: 2024-07-29 DOI: 10.1055/a-2329-6724
Thomas Hachenberg
{"title":"Aktuelles Management bei Schädel-Hirn-Trauma.","authors":"Thomas Hachenberg","doi":"10.1055/a-2329-6724","DOIUrl":"10.1055/a-2329-6724","url":null,"abstract":"","PeriodicalId":7789,"journal":{"name":"Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie","volume":"59 7-08","pages":"408-411"},"PeriodicalIF":0.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141791711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Anaesthesiological Management of Traumatic Brain Injury]. [创伤性脑损伤的麻醉管理]。
IF 0.3 4区 医学
Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie Pub Date : 2024-07-01 Epub Date: 2024-07-29 DOI: 10.1055/a-2075-9299
Raphael-Donatus Hein, Jan Arne Blancke, Stefan J Schaller
{"title":"[Anaesthesiological Management of Traumatic Brain Injury].","authors":"Raphael-Donatus Hein, Jan Arne Blancke, Stefan J Schaller","doi":"10.1055/a-2075-9299","DOIUrl":"10.1055/a-2075-9299","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) is the main cause of death in people < 45 years in industrial countries. Minimising secondary injury to the injured brain is the primary goal throughout the entire treatment. Anaesthesiologic procedures aim at the reconstitution of cerebral perfusion and homeostasis. Both TBI itself as well as accompanying injuries show effects on cardiac and pulmonary function. Time management plays a crucial role in ensuring a safe anaesthesiologic environment while minimizing unnecessary procedures. Furthermore, growing medical drug pre-treatment demands for further knowledge e.g., in antagonization of anticoagulation.</p>","PeriodicalId":7789,"journal":{"name":"Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie","volume":"59 7-08","pages":"420-437"},"PeriodicalIF":0.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141791706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Current Aspects of Intensive Medical Care for Traumatic Brain Injury - Part 2 - Secondary Treatment Strategies, Long-term Outcome, Neuroprognostics and Chronification]. [创伤性脑损伤重症医疗护理的现状 - 第二部分 - 辅助治疗策略、长期疗效、神经诊断和慢性化]。
IF 0.3 4区 医学
Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie Pub Date : 2024-07-01 Epub Date: 2024-07-29 DOI: 10.1055/a-2332-1423
André Hagedorn, Helge Haberl, Michael Adamzik, Alexander Wolf, Matthias Unterberg
{"title":"[Current Aspects of Intensive Medical Care for Traumatic Brain Injury - Part 2 - Secondary Treatment Strategies, Long-term Outcome, Neuroprognostics and Chronification].","authors":"André Hagedorn, Helge Haberl, Michael Adamzik, Alexander Wolf, Matthias Unterberg","doi":"10.1055/a-2332-1423","DOIUrl":"https://doi.org/10.1055/a-2332-1423","url":null,"abstract":"<p><p>This two-part article deals with the intensive medical care of traumatic brain injury. Part 1 addresses the primary treatment strategy, haemodynamic management and multimodal monitoring, Part 2 secondary treatment strategies, long-term outcome, neuroprognostics and chronification. Traumatic brain injury is a complex clinical entity with a high mortality rate. The primary aim is to maintain homeostasis based on physiological targeted values. In addition, further therapy must be geared towards intracranial pressure. In addition to this, there are other monitoring options that appear sensible from a pathophysiological point of view with appropriate therapy adjustment. However, there is still a lack of data on their effectiveness. A further aspect is the inflammation of the cerebrum with the \"cross-talk\" of the organs, which has a significant influence on further intensive medical care.</p>","PeriodicalId":7789,"journal":{"name":"Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie","volume":"59 7-08","pages":"466-478"},"PeriodicalIF":0.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141791708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Current Aspects of Intensive Medical Care for Traumatic Brain Injury - Part 1 - Primary Treatment Strategies, Haemodynamic Management and Multimodal Monitoring]. [创伤性脑损伤重症医疗护理的现状 - 第一部分 - 初级治疗策略、血流动力学管理和多模式监测]。
IF 0.3 4区 医学
Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie Pub Date : 2024-07-01 Epub Date: 2024-07-29 DOI: 10.1055/a-2075-9351
Helge Haberl, Matthias Unterberg, Michael Adamzik, André Hagedorn, Alexander Wolf
{"title":"[Current Aspects of Intensive Medical Care for Traumatic Brain Injury - Part 1 - Primary Treatment Strategies, Haemodynamic Management and Multimodal Monitoring].","authors":"Helge Haberl, Matthias Unterberg, Michael Adamzik, André Hagedorn, Alexander Wolf","doi":"10.1055/a-2075-9351","DOIUrl":"https://doi.org/10.1055/a-2075-9351","url":null,"abstract":"<p><p>This two-part article deals with the intensive medical care of traumatic brain injury. Part 1 addresses the primary treatment strategy, haemodynamic management and multimodal monitoring, Part 2 secondary treatment strategies, long-term outcome, neuroprognostics and chronification. Traumatic brain injury is a complex clinical entity with a high mortality rate. The primary aim is to maintain homeostasis based on physiological targeted values. In addition, further therapy must be geared towards intracranial pressure. In addition to this, there are other monitoring options that appear sensible from a pathophysiological point of view with appropriate therapy adjustment. However, there is still a lack of data on their effectiveness. A further aspect is the inflammation of the cerebrum with the \"cross-talk\" of the organs, which has a significant influence on further intensive medical care.</p>","PeriodicalId":7789,"journal":{"name":"Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie","volume":"59 7-08","pages":"450-465"},"PeriodicalIF":0.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141791707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Neurosurgical Management of Traumatic Brain Injury]. [创伤性脑损伤的神经外科管理]。
IF 0.3 4区 医学
Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie Pub Date : 2024-07-01 Epub Date: 2024-07-29 DOI: 10.1055/a-2075-9315
Anton Früh, Stefan J Schaller, Katharina Faust
{"title":"[Neurosurgical Management of Traumatic Brain Injury].","authors":"Anton Früh, Stefan J Schaller, Katharina Faust","doi":"10.1055/a-2075-9315","DOIUrl":"https://doi.org/10.1055/a-2075-9315","url":null,"abstract":"<p><p>The neurosurgical management of traumatic brain injury (TBI) plays a critical role in ensuring acute survival and mitigating secondary brain damage, which significantly impacts patients' quality of life. TBI is defined as an external force impacting the skull, leading to brain injuries and subsequent functional impairments. It is a leading cause of mortality and morbidity, particularly among young individuals. The initial clinical examination is crucial, with external signs like scalp injuries, hematomas, nasal fluid leakage, skull deformities, and neurological deficits providing important clues to injury patterns. Pupil examination is particularly critical, as mydriasis coupled with reduced consciousness may indicate an acute life-threatening increase in intracranial pressure (ICP), necessitating immediate neurosurgical intervention. TBI assessment often utilizes the Glasgow Coma Scale (GCS), classifying injuries as mild (GCS 13-15), moderate (GCS 9-12), or severe (GCS < 9). Even mild TBI can lead to long-term complications. TBI should be viewed as a disease process rather than a singular event. Primary brain damage results from shearing forces on the parenchyma, manifesting as contusions, hematomas, or diffuse axonal injury. Secondary brain damage is driven by mechanisms such as inflammation and spreading depolarizations. Treatment aims not only to secure immediate survival but also to reduce secondary injuries, with ICP management being crucial. Neurosurgical interventions are guided by cranial pathologies, with options including ICP monitoring, burr hole trepanation, craniotomy. In severe TBI cases with refractory ICP elevation, decompressive craniectomy may be performed as a last resort, significantly reducing mortality but often resulting in high morbidity and vegetative states, necessitating careful consideration of indications.</p>","PeriodicalId":7789,"journal":{"name":"Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie","volume":"59 7-08","pages":"438-449"},"PeriodicalIF":0.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141791710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Regional Anaesthesia in the Prehospital Setting]. [院前区域麻醉]。
IF 0.3 4区 医学
Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie Pub Date : 2024-06-01 Epub Date: 2024-06-24 DOI: 10.1055/a-2265-8168
Christine Gaik, Nicholas Schmitt, Ann-Kristin Schubert, Hinnerk Wulf, Benjamin Vojnar
{"title":"[Regional Anaesthesia in the Prehospital Setting].","authors":"Christine Gaik, Nicholas Schmitt, Ann-Kristin Schubert, Hinnerk Wulf, Benjamin Vojnar","doi":"10.1055/a-2265-8168","DOIUrl":"10.1055/a-2265-8168","url":null,"abstract":"<p><p>Pain is often the main symptom in trauma patients. Although peripheral nerve blocks (PNB) provide fast, safe, and adequate analgesia, they are currently only rarely used outside the perioperative setting. In Germany, intravenous analgesia with non-opioid analgesics (NOPA) and strong opioids is the main treatment concept for prehospital pain. However, the use of highly potent opioids can be associated with significant side effects, especially in emergency patients. Therefore, PNBs are used in many hospitals for the treatment of perioperative pain. As with perioperative use, the advantages of early PNB in the prehospital analgesic treatment of trauma patients are obvious, especially for elderly and multimorbid patients. Early prehospital PNB can also facilitate the reduction of dislocated fractures or dislocated joints as well as the technical rescue of trauma patients. Common geriatric fractures, such as proximal femur or humerus fractures, can be treated appropriately and adequately with PNB.In this article, we show which PNB procedures can be useful in prehospital patient care and which requirements should be met for their safe use. We also present a concept for assessing whether and to what extent the prehospital use of PNB is indicated and appropriate. The aim of this article is to draw attention to PNB as a possible part of prehospital care concepts for trauma patients and to discuss its prehospital use.</p>","PeriodicalId":7789,"journal":{"name":"Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie","volume":"59 6","pages":"386-399"},"PeriodicalIF":0.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141445290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Intensive Care after Severe Trauma]. [严重创伤后的重症监护]。
IF 0.3 4区 医学
Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie Pub Date : 2024-06-01 Epub Date: 2024-06-24 DOI: 10.1055/a-2304-3118
Frank Wappler, Thorsten Annecke
{"title":"[Intensive Care after Severe Trauma].","authors":"Frank Wappler, Thorsten Annecke","doi":"10.1055/a-2304-3118","DOIUrl":"https://doi.org/10.1055/a-2304-3118","url":null,"abstract":"","PeriodicalId":7789,"journal":{"name":"Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie","volume":"59 6","pages":"338-339"},"PeriodicalIF":0.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141445289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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