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Gesundheitswesen 2020 Jul 10. Epub 2020 Jul 10.

Katholische Stiftungshochschule München, München.

Background: Outpatient intensive care for people with long-term mechanical ventilation is a rapidly growing area with a wide range of care demands. The aim of this Scoping Review is to present the current state of research on the quality of care for people with home mechanical ventilation in Germany and to identify research gaps.

Methods: Based on predefined inclusion criteria, 4 databases were searched for publications dealing with the care of people with home ventilation in Germany. Read More

Anaesthesist 2020 Jul;69(7):514-517

Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland.

Nervenarzt 2020 Jul 8. Epub 2020 Jul 8.

Klinik für Neurologie, Universitätsklinikum Essen, Essen, Deutschland.

In the past few decades, research on pain and placebo analgesia has gained importance both scientifically and clinically. In this article, the current findings and focus of research as well as the significance of placebo research for assessing the effectiveness of pain medication are illustrated. The underlying mechanisms of placebo analgesia not only have implications for theoretical models but also offer clinically relevant guidelines for everyday interventions in pain treatment. Read More

Orthopade 2020 Jul 8. Epub 2020 Jul 8.

Univ.-Gewebebank, Institut für Transfusionsmedizin, Charité - Universitätsmedizin Berlin, CCM, Charitéplatz 1, 10117, Berlin, Deutschland.

Introduction: Transplantation of cancellous tissue from human femoral heads (FK) is an established method in the reconstruction of bony defects in orthopedic and trauma surgery. Standardized rating systems with respect to the morphological quality of this tissue are not available.

Materials And Methods: In 91/105 patients who had been a regular, clinically-indicated surgery (arthroplasty of the hip joint) the respective femoral head (FK) was taken under standardized conditions. Read More

BMJ Open 2020 Jul 8;10(7):e038532. Epub 2020 Jul 8.

Faculty of Medicine - LMU, Walter-Brendel Center of Experimental Medicine, München, Germany.

Introduction: Sepsis is defined as detrimental immune response to an infection. This overwhelming reaction often abolishes a normal reconstitution of the immune cell homeostasis that in turn increases the risk for further complications. Recent studies revealed a favourable impact of ketone bodies on resolution of inflammation. Read More

Anaesthesist 2020 Jul 3. Epub 2020 Jul 3.

Schmerzambulanz der Klinik für Anästhesiologie mit S. op. Intensivmedizin, Charité-Universitätsmedizin Berlin, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Deutschland.

Prevention of phantom limb pain is one of the biggest and still largely unsolved challenges in perioperative medicine. Despite many study efforts and optimization of postoperative pain treatment over the last 30 years, a significant reduction in the incidence of phantom limb pain has not been achieved. Current studies have also shown that at least 50% of patients develop phantom pain after 6 months. Read More

Anaesthesist 2020 Jul 3. Epub 2020 Jul 3.

Klinik für Anästhesie und Intensivtherapie, UKGM Gießen-Marburg, Standort Marburg, Baldingerstr., 35033, Marburg, Deutschland.

By implementation of sonography for regional anesthesia, truncal blocks became more relevant in the daily practice of anesthesia and pain therapy. Due to visualized needle guidance ultrasound supports more safety and helps to avoid complications during needle placement. Additionally, complex punctures are possible that were associated with higher risk using landmarks alone. Read More

Anaesthesist 2020 Jul 3. Epub 2020 Jul 3.

Klinik für Anästhesiologie, Anästhesie, Intensiv‑, Notfall- und Schmerzmedizin, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland.

Background: The prevalence of Vibrio vulnificus heavily depends on the temperature and salinity of the sea water. In the course of climate change an increase in cases of fatal sepsis caused by V. vulnificus at the German Baltic Sea coast could be detected. Read More

Ophthalmologe 2020 Jul;117(7):602-608

Klinik für Augenheilkunde, Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.

Early ophthalmological care of patients in intensive care with SARS-CoV‑2 (Severe-Acute-Respiratory-Syndrom-Corona-Virus-2) infections is very time-consuming; however, this approach might prevent other ophthalmological diseases, such as lagophthalmos. There is no difference in ophthalmological treatment between SARS-CoV‑2 positive and other intensive care patients. Due to the small number of cases in our observational study, a specific ophthalmological clinical pattern related to SARS-CoV‑2 infections cannot currently be identified; however, the increased occurrence of subconjunctival hemorrhage in intensive care SARS-CoV‑2 patients is remarkable. Read More

Anaesthesist 2020 Jul 2. Epub 2020 Jul 2.

Klinik für Anästhesiologie, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.

Background: In 2016 the German Society of Anesthesiology and Intensive Care Medicine (DGAI) and the Association of German Anesthetists (BDA) published 10 quality indicators (QI) to compare and improve the quality of anesthesia care in Germany. So far, there is no evidence for the feasibility of implementation of these QI in hospitals.

Objective: This study tested the hypothesis that the implementation of the 10 QI is feasible in German hospitals. Read More

Anaesthesist 2020 Jun 26. Epub 2020 Jun 26.

Klinik und Poliklinik für Anästhesiologie und Spezielle Intensivmedizin, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.

A 42-year-old female patient suffered an infranuclear hypoglossal nerve paresis with right-sided swelling and weakness of the tongue following a short duration mask anesthesia for a follicle puncture. This resulted in dysarthria and dysphagia persisting for more than 3 months. A return to work was initially impossible. Read More

Laryngorhinootologie 2020 Jul 25;99(7):450-452. Epub 2020 Jun 25.

Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg.

Drug-induced sleep endoscopy (DISE) is a procedure for the assessment of the upper airways in patients with obstructive sleep apnea (OSA) and was first described by Croft and Pringle in 1991 1. So far, it has not been clarified to what extent the DISE can be compared to natural sleep. Eastwood and colleagues ultimately described a correlation in terms of the tendency to collapse in sedation and during natural sleep. Read More

Med Klin Intensivmed Notfmed 2020 Jun 24. Epub 2020 Jun 24.

Abteilung für Anästhesiologie und Intensivmedizin, Traumazentrum Wien, Standort Meidling, Meidling, Österreich.

Background: In the field of intensive care medicine, but also increasingly in cardiac surgery, the use of adsorptive blood purification technologies for the treatment of hyperinflammatory conditions is becoming progressively more important. In addition to the CytoSorb concept, which is more and more clinically accepted and currently the most frequently used method, other companies-particularly from China-have recently entered the market with similar concepts.

Objectives: Given this, the aim of this article is to analyze the different aspects of the various hemoadsorption products offered on the market today and to take a critical look at the available evidence. Read More

Anaesthesist 2020 Jun 22. Epub 2020 Jun 22.

Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsmedizin Rostock, Schillingallee 35, 18057, Rostock, Deutschland.

Perioperative phases of hypotension are associated with an increase in postoperative complications and organ damage. Whereas some years ago hemodynamic stabilization was primarily carried out by volume supplementation, in recent years the use and dosing of cardiovascular-active substances has significantly increased. But like intravascular volume therapy, also substances with a cardiovascular effect have therapeutic margins, and thus, potential side effects. Read More

Chirurg 2020 Jun 22. Epub 2020 Jun 22.

Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Kliniken Landkreis Karlsruhe, Fürst-Stirum-Klinik Bruchsal und Rechbergklinik Bretten, Gutleutstr. 1-14, 76646, Bruchsal, Deutschland.

Background: Delays in beginning operations in the morning lead to a loss of valuable operating time and can cause frustration among the medical personnel involved.

Objective: So far there are no prospective, multicentric investigations of the incidence and reasons for delayed first incision times in the morning. The effect of planning list instability of first cases on late operating room starts has not yet been evaluated. Read More

Anaesthesist 2020 Jun 19. Epub 2020 Jun 19.

Klinik für Anästhesiologie und Operative Intensivmedizin, Schmerzzentrum, Universitätsklinikum Mannheim GmbH, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.

Background: Chronic stress and high workload in physicians can lead to loss of interest, emotional exhaustion and finally in burnout syndrome. This can cause serious consequences not only for the physicians personally and their own health by developing extensive health impairments, e.g. Read More

Tierarztl Prax Ausg G Grosstiere Nutztiere 2020 Jun 18;48(3):191-197. Epub 2020 Jun 18.

Universitätsklinik für Wiederkäuer, Department für Nutztiere und öffentliches Gesundheitswesen in der Veterinärmedizin, Veterinärmedizinische Universität Wien.

A 2-month-old goat and a 5-year-old sheep were referred to the clinic due to severe lameness. The goat had a 5-week-old infected comminuted, left metacarpal fracture with extended osteomyelitis of the distal metacarpal bones. The sheep presented with an open oblique fracture of the left tibia and a concurrent, perforating wound of the fetlock joint in the same hindlimb. Read More

Tierarztl Prax Ausg K Kleintiere Heimtiere 2020 Jun 18;48(3):157-162. Epub 2020 Jun 18.

Klinik für Kleintiere, Abteilung für Anästhesiologie und Intensivmedizin, Veterinärmedizinische Fakultät der Universität Leipzig.

Objective: The aim of this study was to assess the accuracy of anesthetic risk evaluation in dogs by using the ASA-classification system (ASA = American Society of Anesthesiologists). In human medicine, several studies criticize ranking patients prior to anesthesia via the ASA-classification due to its subjectivity and substantial variance. This study intends to detect and analyze possible comparable effects when applying the ASA-classification system to dogs. Read More

Anaesthesist 2020 Jul;69(7):451-452

Klinik für Anästhesiologie, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.

Chirurg 2020 Jun 16. Epub 2020 Jun 16.

Medizinische Fakultät und Uniklinik, Klinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.

Background And Objective: Transthoracic esophagectomy is generally accepted as the standard of surgical care for patients with esophageal cancer. Despite improvements in the perioperative management this surgical procedure is associated with a clinically relevant morbidity. Fast-track protocols (synonym: enhanced recovery after surgery, ERAS) are conceived to perioperatively maintain the physiological homoeostasis and thereby to accelerate postoperative rehabilitation and reduce morbidity. Read More

Notf Rett Med 2020 10;23(4):241-242. Epub 2020 Jun 10.

Deutscher Rat für Wiederbelebung/German Resuscitation Council, Ulm, Deutschland.

Anaesthesist 2020 Jul;69(7):487-488

Intensivstation, Universitätsspital Basel, Petersgraben 4, 4031, Basel, Schweiz.

Resuscitation 2020 Jun 6. Epub 2020 Jun 6.

Chefarzt der Abteilung Anästhesiologie u. Intensivmedizin, Park-Klinik-Weissensee, Schönstrasse 80, 13086 Berlin, Germany.

Cells 2020 Jun 8;9(6). Epub 2020 Jun 8.

Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum der Ruhr Universität Bochum Knappschaftskrankenhaus Bochum, 44801 Bochum, Germany.

Major complications after kidney transplantation are graft rejection and cytomegalovirus (CMV) infection, which are related to T-cell function, which depends on aquaporin3 (AQP3) expression. The impact of the AQP3 A(-1431)G promoter polymorphism in kidney transplant recipients was unelucidated and we explored the effect of AQP3 polymorphism on immune cell function and its association with graft rejection and CMV infection in 237 adult patients within 12 months after transplantation. AQP3 promoter polymorphism was molecular and functional characterized. Read More

Leukemia 2020 07 9;34(7):1805-1815. Epub 2020 Jun 9.

Klinik für Innere Medizin II, Hämatologie, Onkologie, Immunologie, Infektiologie und Palliativmedizin, Schwarzwald-Baar-Klinikum, Villingen-Schwenningen, Germany.

A subgroup of patients with severe COVID-19 suffers from progression to acute respiratory distress syndrome and multiorgan failure. These patients present with progressive hyperinflammation governed by proinflammatory cytokines. An interdisciplinary COVID-19 work flow was established to detect patients with imminent or full blown hyperinflammation. Read More

Chirurg 2020 Jun 8. Epub 2020 Jun 8.

Gefäßchirurgie und endovaskuläre Chirurgie, Medizinische Fakultät, Universitätsklinikum Augsburg, Stenglinstr. 2, 86156, Augsburg, Deutschland.

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) describes an endovascular procedure in which a blocking balloon is introduced into the aorta to reduce bleeding situated distal to the balloon and simultaneously to improve cardiac and cerebral oxygenation.

Objective: Presentation of the REBOA technique, the possible indications, the required material and possible complications of the procedure.

Material And Methods: Non-systematic review of the currently available literature. Read More

Radiologe 2020 Jul;60(7):642-651

Institut für Radiologie und Nuklearmedizin, Schwarzwald-Baar-Klinikum, Klinikstr. 11, 78052, Villingen Schwenningen, Deutschland.

Clinical Problem: The indication for resuscitation room care is an acute (potentially) life-threatening patient condition. Typical causes for this are polytrauma, acute neurological symptoms, acute chest and abdominal pain or the cause remains unclear at first. The care is always provided in a suitably composed interdisciplinary team. Read More

JACC Cardiovasc Interv 2020 Jun;13(11):1288-1290

Deutsches Herzzentrum München, Technische Universität München, Institut für Anästhesiologie, Munich, Germany. Electronic address:

Hamostaseologie 2020 Jun 4. Epub 2020 Jun 4.

Institut für Experimentelle Hämatologie und Transfusionsmedizin, Universitätsklinik Bonn, Bonn, Germany.

The novel coronavirus, SARS-CoV-2, is causing a global pandemic of life-threatening multiorgan disease, called COVID-19. Accumulating evidence indicates that patients with COVID-19 are at significant risk of thromboembolic complications, mainly affecting the venous, but also the arterial vascular system. While the risk of venous thromboembolism (VTE) appears to be higher in patients requiring intensive care unit support compared to those admitted to general wards, recent autopsy findings and data on the timing of VTE diagnosis relative to hospitalization clearly suggest that thromboembolic events also contribute to morbidity and mortality in the ambulatory setting. Read More

Anaesthesist 2020 Jun 3. Epub 2020 Jun 3.

Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena (UKJ), Am Klinikum 1, 07747, Jena, Deutschland.

Anaesthesist 2020 Jun 2. Epub 2020 Jun 2.

Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Leipzig AöR, Leipzig, Deutschland.

Adaequate antibiotic therapy is crucial for successful anti-infective therapy. In addition to the choice of the right antibiotic and the duration of therapy, the dose also plays a decisive role. Obesity has an influence on the pharmacokinetics of antibiotics, which can lead to underdosing if previous weight-independent dosing regimes are used. Read More

Anaesthesist 2020 Jun 2. Epub 2020 Jun 2.

Klinik für Anästhesiologie und Intensivmedizin, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.

Objective: Studies on stress factors for patients in intensive care units (ICU) have so far concentrated on whether certain stressors have occurred or how stressful they were. There are no studies on stress for patients in ICUs that measured both the perception of stress and the chances perceived to control it; however, loss of control can result in long-term psychopathological consequences, such as depression or posttraumatic stress disorder. Therefore, a questionnaire was developed to evaluate the influence of controllability on perception of stress. Read More

Anaesthesist 2020 Jul;69(7):477-486

Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Klinikum Konstanz, Konstanz, Deutschland.

Background: There is a risk of terror attacks in the Federal Republic of Germany, which might increase in the future. A timely comprehensive strategy for treatment and care of a large number of casualties helps minimize chaos and improve the outcome of patients. Adequate training is vital for successful implementation of an emergency plan. Read More

Schmerz 2020 Jun 2. Epub 2020 Jun 2.

Klinik für Palliativmedizin, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.

The corona pandemic has led to a number of restrictions and prohibitions, which in turn place large psychosocial or spiritual burdens on patients with COVID-19, their families and relatives and the treating personnel in the healthcare system. Patients with COVID-19 are not allowed to receive visitors and many hospitals and nursing homes have completely banned visitors. Many support services have been reduced or stopped completely. Read More

Clin Res Cardiol 2020 May 28. Epub 2020 May 28.

Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.

Unfallchirurg 2020 Jun;123(6):423

Klinik Günzburg, Unfall- und Wiederherstellungschirurgie, Kreiskliniken Günzburg-Krumbach, Ludwig-Heilmeyer-Straße 1, 89312, Günzburg, Deutschland.

Schmerz 2020 May 26. Epub 2020 May 26.

Schmerzmedizin, Klinik für Anästhesiologie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.

Procare 2020 16;25(4):6-8. Epub 2020 May 16.

3Medizinische Universität Graz, Universitätsklinik für Anästhesiologie und Intensivmedizin; Büro der Vizerektorin für Studium und Lehre, Clinical Skills Center (CSC, Graz, Deutschland.

Schmerz 2020 May 25. Epub 2020 May 25.

Schmerzklinik, Universitätsmedizin Göttingen, Göttingen, Deutschland.

The direct comparison of day care pain patients with patients from other treatment sectors with respect to sociodemographic, pain-related and psychological characteristics has not yet been the subject of systematic analyses. The project core documentation and quality assurance in pain therapy (KEDOQ-pain) of the German Pain Society (Deutsche Schmerzgesellschaft e.V. Read More

Anaesthesist 2020 May 23. Epub 2020 May 23.

Klinik und Poliklinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland.

Critical incidents in hospitals can often be predicted hours before the event and can mostly be detected earlier and presumably avoided. Quality management programs from US hospitals to reduce deaths following a severe postoperative complication (failure to rescue, FTR), have in this form not yet become established in Germany. A sensitive score-based early warning system for looming complications is decisive for successful in-hospital emergency management. Read More

Anaesthesist 2020 Jun;69(6):404-413

Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Klinikum Kassel, Kassel, Deutschland.

Background: The chances of surviving out-of-hospital cardiac arrest (OHCA) are still very low. Despite intensive efforts the outcome has remained relatively poor over many years. In specific situations, new technologies, such as extracorporeal cardiopulmonary resuscitation (eCPR) could significantly improve survival with a good neurological outcome. Read More

Geburtshilfe Frauenheilkd 2020 May 18;80(5):491-498. Epub 2020 May 18.

Asklepios Klinik Weißenfels, Weißenfels, Germany.

COVID-19, a new viral disease affecting primarily the respiratory system and the lung, has caused a pandemic posing serious challenges to healthcare systems around the world. In about 20% of patients, severe symptoms occur after a mean incubation period of 5 - 6 days; 5% of patients need intensive care therapy. Mortality is about 1 - 2%. Read More

Crit Care 2020 05 19;24(1):239. Epub 2020 May 19.

CytoSorbents Europe GmbH, Müggelseedamm 131, 12587, Berlin, Germany.

Background: Sepsis and septic shock remain drivers for mortality in critically ill patients. The heterogeneity of the syndrome hinders the generation of reproducible numbers on mortality risks. Consequently, mortality rates range from 15 to 56%. Read More

Anaesthesist 2020 Jul;69(7):471-476

Klinik für Anästhesiologie, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.

Background: Mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) syndrome is a rare progressive disease with acute neurological episodes caused by a mitochondriopathy. Due to a defect of oxidative phosphorylation in the respiratory chain, there is impaired mitochondrial energy production with subsequent lactic acidosis, especially in situations with increased stress. Due to the high risk of metabolic derailment MELAS syndrome is a great challenge with respect to the perioperative management of anesthesia. Read More

BMC Cardiovasc Disord 2020 May 18;20(1):230. Epub 2020 May 18.

Department of Anaesthesiology, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.

Background: Preoperative risk prediction in patients at elevated cardiovascular risk shows limited accuracy. Platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) indicate systemic inflammation. Both have been investigated for outcome prediction in the field of oncology and cardiovascular medicine, as well as risk prediction of adverse cardiovascular events in non-surgical patients at increased cardiovascular risk. Read More

Anaesthesist 2020 Jul 3. Epub 2020 Jul 3.

Klinik für Anästhesiologie, Universitätsklinikum RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.

Anaesthesist 2020 May 15. Epub 2020 May 15.

Klinik für Anästhesiologie, Universitätsklinikum RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.

Anaesthesist 2020 May 15. Epub 2020 May 15.

Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Hufelandstr. 55, 45147, Essen, Deutschland.

Anaesthesist 2020 Jul 14;69(7):489-496. Epub 2020 May 14.

Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, Haus R3, 24105, Kiel, Deutschland.

Background: After insertion of a central venous catheter (CVC) the catheter position must be controlled and a pneumothorax ruled out.

Objective: The aim was to examine whether the use of two standard acoustic windows known from emergency sonography examination techniques is feasible to 1) verify the correct intravenous localization and direction of the guidewire before final CVC insertion and 2) correctly predict the required CVC length for positioning of the catheter tip in the lower third of the superior vena cava.

Material And Methods: This single center prospective observational study included adult patients (age ≥18 years) with an indication for CVC insertion after institutional ethics approval was obtained. Read More

Anaesthesist 2020 Jul;69(7):463-469

Klinik für Anästhesiologie, Universitätsmedizin Göttingen, Von-Siebold-Str. 3, 37075, Göttingen, Deutschland.

Background: In the last five decades a continuous increase in the average global temperature has been recorded. Furthermore, natural disasters (e.g. Read More