{"title":"[ARDS Diagnostics and Treatment after the Coronavirus Pandemic - Everything as it was?]","authors":"Rolf Dembinski","doi":"10.1055/a-2043-8628","DOIUrl":"https://doi.org/10.1055/a-2043-8628","url":null,"abstract":"<p><p>ARDS is a syndrome that can develop as a result of various underlying diseases. For a long time, the prevailing belief was that the course of the disease was comparable regardless of the underlying disease. However, even before the COVID-19 pandemic, it was suspected that there were different manifestations that could be treated more individually and thus reduce the high mortality rate of ARDS, which has remained unchanged for years. The various findings on the heterogeneity of the course of the disease in COVID-related ARDS appear to confirm these assumptions. It is therefore to be expected that the diagnosis and treatment of non-COVID-related ARDS will also have to be individualised according to such phenotypes in the future. However, as long as the effectiveness of such strategies has not been proven in clinical trials, the current recommendations for ARDS therapy will remain valid for the time being. However, the adjustments already formulated in this context to individual pathophysiological conditions with regard to respiratory mechanics, ventilation-perfusion distribution and possible cardiac dysfunction should be made more meticulously than has usually been the case to date.</p>","PeriodicalId":7789,"journal":{"name":"Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie","volume":"59 1","pages":"24-33"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139401507","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}
Sarah-Helene Müller, Philipp Anton Holzner, Torsten Loop
{"title":"[Asymptomatic SARS-CoV-2 Infection and \"in situ split\" Liver Resection with Fatal Outcome - A Case Report].","authors":"Sarah-Helene Müller, Philipp Anton Holzner, Torsten Loop","doi":"10.1055/a-2141-4052","DOIUrl":"10.1055/a-2141-4052","url":null,"abstract":"<p><p>We report the perioperative course of a 47-year-old patient who underwent a two-stage liver resection for bilobar metastatic colorectal carcinoma. The respiratory asymptomatic patient was tested positive for SARS-CoV-2 by PCR detection one day before the second surgical procedure. Postoperatively, the patient suffered cardiovascular arrest on postoperative day 8 and died despite immediately initiated resuscitative measures. With an initial clinical suspicion of vascular liver failure, postmortem pathologic examination revealed the underlying cause of death to be COVID-19-related myocarditis with acute right heart failure. Individual multidisciplinary risk assessment should be considered very critically when deviating from the \"7-week rule\" because the benefit is difficult to objectify, even in oncologic patients.</p>","PeriodicalId":7789,"journal":{"name":"Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie","volume":"58 11-12","pages":"660-664"},"PeriodicalIF":0.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138497652","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}
{"title":"EEG-Messung in Narkose.","authors":"Richard Ellerkmann, Martin Söhle","doi":"10.1055/a-2006-9907","DOIUrl":"10.1055/a-2006-9907","url":null,"abstract":"<p><p>Based on the existing literature, the application of designated, processed EEG-monitors to measure anesthetic depth and the associated clinical implications are explained. EEG-monitors quantify the hypnotic portion of anesthesia, but not the nociceptive properties of anesthetics. Depth of anesthesia monitoring is common practice in many German hospitals and helps to visualize the interindividual variability of anesthetics, especially of propofol. Although deep anesthesia is associated with increased long-term mortality, this relation seems not to be causally related. Nevertheless, depth of anesthesia monitors help to identify patients being especially susceptible to anesthetics. Moreover, they have shown to reduce the incidence of intraoperative awareness and postoperative delirium. The application of processed EEG-monitors to reduce the incidence of postoperative delirium is currently recommended by the European Society of Anaesthesiology and Intensive Care.</p>","PeriodicalId":7789,"journal":{"name":"Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie","volume":"58 11-12","pages":"626-638"},"PeriodicalIF":0.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138497656","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}
{"title":"[Methemoglobinemia Induced by Sildenafil Tablets Ordered in the Darknet - Importance of Syncopes' Causes].","authors":"Marc-Michael Ventzke, Felix Girrbach","doi":"10.1055/a-2141-3782","DOIUrl":"10.1055/a-2141-3782","url":null,"abstract":"<p><p>Drug-induced methemoglobinemia is a well-known phenomenon as well as induction by poppers (alcylnitrites substance group). Usually, suspicion is thrown in the right direction by a thorough medical history and environmental survey. But if intoxication is unintended and happens within the very private environment diagnosis might be very tricky. We report on an unusual case of accidental intoxication with probably contaminated tablets which were bought in the darknet. Finally, diagnosis was made by blood gas analysis' methemoglobine values.</p>","PeriodicalId":7789,"journal":{"name":"Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie","volume":"58 11-12","pages":"655-658"},"PeriodicalIF":0.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138497653","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}
Claudia Denke, Barbara Voigt, Henning Krampe, Claudia Spies, Matthias Rose
{"title":"[Psychosocial Care in the Intensive Care Unit].","authors":"Claudia Denke, Barbara Voigt, Henning Krampe, Claudia Spies, Matthias Rose","doi":"10.1055/a-2081-3521","DOIUrl":"10.1055/a-2081-3521","url":null,"abstract":"<p><p>The improvement of intensive care treatment options leads to an increasing number of patients being treated in this setting. For the majority of those affected and their relatives, this treatment is associated with tremendous stress, but also subsequent physical, psychological and cognitive impairments, the post-intensive care syndrome. The aim of psychosocial support in the intensive care unit is to stabilise and minimise the acute stress. This is done through care services oriented towards trauma therapy interventions and emergency psychology. Equally central are the needs of the patient's relatives and ways to stabilise and relieve them. The third pillar of psychosocial work in the intensive care unit is the support of the treatment team. Finally, an outlook is given for the specialised aftercare of these complex patients in PICS outpatient clinics.</p>","PeriodicalId":7789,"journal":{"name":"Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie","volume":"58 11-12","pages":"666-674"},"PeriodicalIF":0.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138497655","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}
{"title":"[New Approaches in Perioperative Algesimetry].","authors":"Thomas Ledowski","doi":"10.1055/a-2006-9923","DOIUrl":"10.1055/a-2006-9923","url":null,"abstract":"<p><p>The measurement of anaesthetic depth and muscle relaxation have been routine procedures during general anaesthesia for years. Quantification of intraoperative nociception, on the other hand, is still largely impossible. Various methods have been tested and commercialised for more than 10 years. However, a real breakthrough has not yet been achieved and the routine application of all methods available so far is not without problems. This article explains methodological similarities, but also points to specific aspects of various commercial solutions for perioperative algesimetry.</p>","PeriodicalId":7789,"journal":{"name":"Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie","volume":"58 11-12","pages":"640-653"},"PeriodicalIF":0.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138497654","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}
{"title":"Liebe Kolleginnen und Kollegen!","authors":"","doi":"10.1055/a-2152-5549","DOIUrl":"https://doi.org/10.1055/a-2152-5549","url":null,"abstract":"Viele ehemalige Intensivpatienten klagen noch Jahre nach der Erkrankung über Beeinträchtigungen. Doch auch wenn die Mortalität in der Intensivmedizin stetig abnimmt, steigt die Morbidität der Patienten nach Hospitalisierung oft sprunghaft an. Denn die Krankheit beziehungsweise der Zustand, der die Behandlung auf einer Intensivstation nötig gemacht hat, ist zwar überstanden, aber unvorhergesehene schwere physische, kognitive und psychische Einschränkungen im Alltag der Behandelten und ihrer Angehörigen erschweren ihnen die Rückkehr ins normale Leben. Dieser Zustand wird als Post-Intensive Care Syndrome – kurz PICS – bezeichnet und kann einer posttraumatischen Belastungsstörung ähneln.","PeriodicalId":7789,"journal":{"name":"Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie","volume":"46 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135411292","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}
{"title":"Die Deutsche Gesellschaft für Fachkrankenpflege und Funktionsdienste e. V. informiert","authors":"Susann Gebhardt, Dominik Zergiebel","doi":"10.1055/a-2152-5523","DOIUrl":"https://doi.org/10.1055/a-2152-5523","url":null,"abstract":"das Jahr neigt sich dem Ende zu, die Tage werden kürzer, und neben den kühlen Temperaturen freuen sich viele auf besinnliche Stunden und die kommenden Feiertage und den Jahreswechsel.","PeriodicalId":7789,"journal":{"name":"Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie","volume":"44 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135411301","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}