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DerAnaesthesist.50440770.eng.abstr
|
DerAnaesthesist.50440770.eng.abstr
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[
{
"id": "DerAnaesthesist.50440770.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Parenteral nutrition required following surgery or injury should not only meet post-aggression caloric requirements but also match the specific metabolic needs so as not to worsen the metabolic disruptions already present in this situation . The primary objective of parenteral nutrition is body protein maintenance or restoration by reduction of protein catabolism or promotion of protein synthesis or both . Whether all parenteral energy donors , i.e. , glucose , fructose , other polyols , and lipid emulsions , are equally capable of achieving this objective continues to be a controversial issue . The objective of the present study was to answer the following questions : ( 1 ) Do glucose and fructose differ in their effects on the metabolic changes seen following surgery or injury , the changes in glucose metabolism in particular ? ( 2 ) Can the observation of poorer glucose utilization in the presence of lipids be confirmed in ICU patients ?"
],
"offsets": [
[
0,
954
]
]
}
] |
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"emulsions"
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] |
[] |
[] |
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] |
DerAnaesthesist.50440785.eng.abstr
|
DerAnaesthesist.50440785.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440785.eng.abstr-passage-0",
"type": "abstract",
"text": [
"For surgical removal of a malignant choroid melanoma , it is necessary to reduce systolic blood pressure to around 50-60 mmHg in order to prevent choroidal haemorrhages . However , blood pressure reduction is associated with the risk of cerebral ischaemia . We report a patient with a malignant choroid melanoma in whom waves I and II of the brainstem auditory evoked potentials ( BAEP ) disappeared during surgery under controlled arterial hypotension and hypothermia ( 31.1 ° C ) . The waves could be recorded again immediately after the mean arterial pressure was increased from 48 to 77 mmHg . The oesophageal temperature had dropped by 0.3 ° C at this time . The 2-channel electroencephalogram ( EEG ) showed no irregularities during this time period . A bilateral , reversible , apparently blood-pressure-dependent loss of waves I and II during arterial hypotension despite a normal EEG has to our knowledge not been previously described in the literature . The isolated loss of waves I and II with maintenance of waves III , IV , and V is unusual . The literature contains reports of acoustic neurinoma patients in whom only wave V could be recorded . This is regarded as an indication of continued impulse conduction despite the loss of waves I to IV . Others have observed a patient with temporary and reversible loss of BAEP wave I due to vasospasm of the internal auditory artery that apparently occurred during or shortly after manipulation of the internal auditory meatus . Assuming anatomic peculiarities in the blood supply to the generators of the BAEP waves , a stenosis of the basilar artery could be considered as the cause of the bilateral reversible loss of waves I and II . Another potential source could be the induced hypothermia , but this does not seem very likely because the patient's temperature was 0.3 ° C lower at the return of the waves than at their loss ."
],
"offsets": [
[
0,
1890
]
]
}
] |
[
{
"id": "DerAnaesthesist.50440785.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"surgical"
],
"offsets": [
[
4,
12
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0038895"
}
]
},
{
"id": "DerAnaesthesist.50440785.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"malignant"
],
"offsets": [
[
26,
35
]
],
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},
{
"id": "DerAnaesthesist.50440785.eng.abstr-s1-t3",
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"choroid"
],
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[
36,
43
]
],
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"db_id": "C0008520"
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]
},
{
"id": "DerAnaesthesist.50440785.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"melanoma"
],
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[
44,
52
]
],
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"db_id": "C0025202"
}
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},
{
"id": "DerAnaesthesist.50440785.eng.abstr-s1-t5",
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"text": [
"systolic"
],
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89
]
],
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},
{
"id": "DerAnaesthesist.50440785.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"blood"
],
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95
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],
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"db_id": "C0005768"
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"db_name": "UMLS",
"db_id": "C0005835"
}
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DerAnaesthesist.50440789.eng.abstr
|
DerAnaesthesist.50440789.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440789.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The needle type introduced by Edward Tuohy for continuous spinal anaesthesia in 1944 is still used as the standard instrument for epidural anaesthesia up to the present day . Puncture of the dura and severance of the epidural catheter are the typical , though rare , complications of this procedure , giving rise to most of the actions brought for damage suffered during obstetic anaesthesia . The cerebral spinal fluid loss caused by thick needles can have serious consequences , including subdural and intracranial haematoma , cranial nerve pareses , labyrinthine hearing impairments and pneumocephalus ."
],
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[
0,
606
]
]
}
] |
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{
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"Puncture"
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175,
183
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"id": "DerAnaesthesist.50440789.eng.abstr-s2-t2",
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"catheter"
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},
{
"id": "DerAnaesthesist.50440789.eng.abstr-s3-t1",
"type": "umlsterm",
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"needles"
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},
{
"id": "DerAnaesthesist.50440789.eng.abstr-s3-t2",
"type": "umlsterm",
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"haematoma"
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{
"id": "DerAnaesthesist.50440789.eng.abstr-s3-t3",
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"id": "DerAnaesthesist.50440789.eng.abstr-s3-t4",
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"id": "DerAnaesthesist.50440789.eng.abstr-s3-t6",
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"spinal fluid"
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},
{
"id": "DerAnaesthesist.50440789.eng.abstr-s3-t7",
"type": "umlsterm",
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"id": "DerAnaesthesist.50440789.eng.abstr-s3-t8",
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"id": "DerAnaesthesist.50440789.eng.abstr-s3-t9",
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[] |
[] |
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DerAnaesthesist.50440809.eng.abstr
|
DerAnaesthesist.50440809.eng.abstr
|
[
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"The routine use of succinylcholine for endotracheal intubation is being increasingly questioned . Initial studies have suggested that a combination of propofol and alfentanil without a muscle relaxant can provide good intubating conditions . However , most of these initial studies either did not have a double-blind design or did not include a control group with muscle relaxants . In this study , intubation conditions using fentanyl/propofol without a muscle relaxant were compared with the combinations of fentanyl/propofol/succinylcholine and sodium thiopental/succinylcholine ."
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0,
583
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[] |
[] |
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DerAnaesthesist.50440818.eng.abstr
|
DerAnaesthesist.50440818.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440818.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Increasing numbers of monitors at the anaesthesiologist's workplace , providing more than 20 different parameters of the patient's condition , have already made it impossible to record all the values in a handwritten form . Consequently , this most common method of record-keeping must be incomplete and inaccurate . In recent years computerised data-acquisition systems have been introduced into clinical practice in order to produce more reliable records . But after a 7-year experience in the use of such a system in cardiac anaesthesia , we have recognised certain problems that remain to be solved before automated record-keeping will achieve wider acceptance . The first is the handling problem , which was discussed in a previous paper [ 11 ] . The second major problem is the appearance of artifacts , caused mainly by mechanical manipulations during the operation . In this paper , 300 courses of anaesthesia that were recorded on-line during different cardiac surgery procedures were examined and the incidence as well as the kind of artifacts occurring were evaluated . Algorithms were developed for each haemodynamic parameter to suppress these artifacts automatically by a subsequent analysing process ; the efficiency of that \" artifact filter \" was validated in 35 of the 300 cases . Based on more than 30,000 values for each parameter , the incidence of artifacts was 3%-7% . However , only 0.1%-0.5% of the artifacts could not be eliminated by the filter . The method described here provided acceptable graphic printouts of the most important haemodynamic parameters ( Figs . 1b and 2b ) and would also be suitable to serve as an input filter for automatically running anaesthesia data-examination processes , which are currently being developed in our clinic ."
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[] |
[] |
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DerAnaesthesist.50440831.eng.abstr
|
DerAnaesthesist.50440831.eng.abstr
|
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[] |
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] |
DerAnaesthesist.50440843.eng.abstr
|
DerAnaesthesist.50440843.eng.abstr
|
[
{
"id": "DerAnaesthesist.50440843.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The mortality of patients with acute respiratory distress syndrome ( ARDS ) is still above 50% despite continuous progress in intensive care medicine . Recent therapy regimens such as the extra corporeal life support ( ECLS ) , permissive hypercarbia , high-frequency ventilation techniques and inhaled nitric oxide ( NO ) are being applied . All of the above techniques are aimed at different parts of the problems caused by ARDS . This study was designed to evaluate the possible additive benefits of superimposed high-frequency jet ventilation ( SHFJV ) and inhaled NO ."
],
"offsets": [
[
0,
573
]
]
}
] |
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{
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},
{
"id": "DerAnaesthesist.50440843.eng.abstr-s2-t2",
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},
{
"id": "DerAnaesthesist.50440843.eng.abstr-s2-t3",
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"id": "DerAnaesthesist.50440843.eng.abstr-s2-t7",
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{
"id": "DerAnaesthesist.50440843.eng.abstr-s2-t8",
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}
] |
[] |
[] |
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DerAnaesthesist.50440850.eng.abstr
|
DerAnaesthesist.50440850.eng.abstr
|
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}
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[] |
[] |
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DerAnaesthesist.50440859.eng.abstr
|
DerAnaesthesist.50440859.eng.abstr
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[] |
[] |
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DerAnaesthesist.50440863.eng.abstr
|
DerAnaesthesist.50440863.eng.abstr
|
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{
"id": "DerAnaesthesist.50440863.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Clinical course . We present a potentially fatal case of acute methaqualone ( M ) poisoning with very low serum concentrations of M but extremly high levels of its metabolite , 2-methyl-3-(2-hydroxymethyl-phenyl)-4 ( 3H ) -chinazoline ( Met-1). A 23-year-old man was admitted to the intensive care unit 2 days after ingestion of 4-5 g M in an suicidal attempt . On admission he was somnolent and poorly responsive to painful stimuli . Physical examination revealed a heart rate of 95 bpm , a blood pressure of 125/65 mmHg , and a normal body temperature . His chest was clear to auscultation , respirations were shallow , and the skin was cyanotic . The electrocardiogram was unremarkable . The chest radiograph showed a normal heart size without pulmonary infiltrates or venous congestion . The pupils were dilated but reactive to light . The neurologic examination was further remarkable for increased limb reflexes , myoclonia , and positive pyramidal signs . During the next 2 days the patient became comatose and developed respiratory insufficiency due to non-cardiogenic pulmonary oedema , which was confirmed by chest radiograph and haemodynamic investigations by means of right heart catheterisation . He required mechanical ventilation for 6 days . Finally , he recovered completely and was discharged in good condition ."
],
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[
0,
1330
]
]
}
] |
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] |
[] |
[] |
[
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DerAnaesthesist.50440875.eng.abstr
|
DerAnaesthesist.50440875.eng.abstr
|
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],
"offsets": [
[
0,
300
]
]
}
] |
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[] |
[] |
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DerAnaesthesist.50440880.eng.abstr
|
DerAnaesthesist.50440880.eng.abstr
|
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{
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"Neoplastic or traumatic lesions of the brain stem or the upper spinal cord frequently cause respiratory insufficiency necessitating permanent mechanical ventilation . If the integrity of the diaphragm and its nerves is not affected , adequate ventilation can be achieved by electric stimulation of the phrenic nerves [ 1 , 3 , 5 , 6 ] . Diaphragm pacing systems mean the patients can be independent of ventilator treatment . This is a psychological advantage for the patient , giving him or her the option of living in less specialized medical care units and perhaps even at home [ 4 , 9 ] ."
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591
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"id": "DerAnaesthesist.50440880.eng.abstr-s2-t2",
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[] |
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DerAnaesthesist.50440884.eng.abstr
|
DerAnaesthesist.50440884.eng.abstr
|
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"id": "DerAnaesthesist.50440884.eng.abstr-passage-0",
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"A separation of the individual latex layers is a known complication of endotracheal armoured tubes manufactured by immersion technique . This can result in herniation into the lumen with obstruction of the tube . Diffusion of nitrous oxide into the inner hernia considerably intensifies the obstruction . This can lead to life-threatening situations . We observed a similar herniation caused by layer separation with subsequent tube obstruction of silicolatex anaesthesia tubes used in paediatric circuit systems . This is caused by manufacturing defects and above all by damage incurred in reprocessing . Therefore it is important to process the tubes carefully . A too-high drying temperature can cause premature layer separation . The tubes should never be processed more than 80 times . Routine examination of the tubes is imperative , especially at the predilection sites for layer separation ."
],
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0,
899
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]
}
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DerAnaesthesist.60450002.eng.abstr
|
DerAnaesthesist.60450002.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450002.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Acute respiratory distress syndrome ( ARDS ) is rare but beset with a high mortality rate . In recent years , however , a trend towards higher survival rates has been observed . High inspiratory oxygen concentrations , large tidal volumes , and high peak inspiratory airway pressures applied during mechanical ventilation have been identified as harmful to the lung and can contribute to the progression of ARDS . This had led to reconsideration of the sequelae of ventilatory therapy . Mechanical ventilation and other adjunctive strategies in ARDS have changed from the conventional approach aiming at normalisation of physiological ventilatory parameters to an elaborated approach that intends to protect the ventilated lung , prevent oxygen toxicity , recruit the infiltrated atelectatic and consolidated lung and reduce the anatomical and alveolar dead space . This new approach consists of various forms of pressure-controlled mechanical ventilation with PEEP and permissive hypercapnia , body position changes , and inhalation of nitric oxide . Should these procedures fail to improve impaired gas exchange , extracorporeal membrane oxygenation is an additional therapeutic option . None of these therapeutic procedures , however , has been tested against traditional standard treatment in a classical randomised controlled trial . The following review focuses on the latest insights into the pathophysiology , diagnosis , and treatment of ARDS ."
],
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0,
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]
}
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DerAnaesthesist.60450019.eng.abstr
|
DerAnaesthesist.60450019.eng.abstr
|
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"id": "DerAnaesthesist.60450019.eng.abstr-passage-0",
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"Performed at the end of the mummification process , the \" mouth-opening \" ritual was a ceremony for the spiritual resurrection of the dead Pharaoh . The techniques used are astonishingly similar to modern emergency-room procedures . For example , the mouth-opening device was made of meteoric iron . In the Egypt of that time , the use of iron was very unusual and the higher levels of nickel in meteoric iron contributed to the stability of the instrument . There are other signs of medically sound methods in the mouth-opening ritual . Symbolically , the mummy's teeth were extracted , the eyes opened with a special device , and gold capsules inserted , perhaps in the sense of a breathing tube . There is a possibility that this ritual contains a forgotten synopsis of knowledge gained empirically in connection with the Egyptian cult of royal resurrection ."
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},
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}
] |
DerAnaesthesist.60450022.eng.abstr
|
DerAnaesthesist.60450022.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450022.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Due to its low blood : gas partition coefficient ( 0.69 ) and its neutral odor , sevoflurane ( S ) is suitable for inhalational induction of anaesthesia . At the moment halothane ( H ) is preferentially used for this purpose due to its non-irritating odor and the smoothness of anaesthetic action . However , experience is limited with the use of S in children , and concern exists about potential renal toxicity of its metabolite , i.e. fluoride . Therefore , we compared S and H in an open , randomized phase III trial ."
],
"offsets": [
[
0,
522
]
]
}
] |
[
{
"id": "DerAnaesthesist.60450022.eng.abstr-s1-t1",
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"blood"
],
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15,
20
]
],
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{
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{
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}
]
},
{
"id": "DerAnaesthesist.60450022.eng.abstr-s1-t2",
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"text": [
"gas"
],
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[
23,
26
]
],
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{
"db_name": "UMLS",
"db_id": "C0017110"
}
]
},
{
"id": "DerAnaesthesist.60450022.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"odor"
],
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[
74,
78
]
],
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{
"db_name": "UMLS",
"db_id": "C0028884"
}
]
},
{
"id": "DerAnaesthesist.60450022.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"sevoflurane"
],
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[
81,
92
]
],
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},
{
"id": "DerAnaesthesist.60450022.eng.abstr-s2-t1",
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"text": [
"halothane"
],
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[
169,
178
]
],
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"db_id": "C0018549"
}
]
},
{
"id": "DerAnaesthesist.60450022.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"odor"
],
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[
251,
255
]
],
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{
"db_name": "UMLS",
"db_id": "C0028884"
}
]
},
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"id": "DerAnaesthesist.60450022.eng.abstr-s2-t3",
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"text": [
"anaesthetic"
],
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278,
289
]
],
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"id": "DerAnaesthesist.60450022.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"use"
],
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[
340,
343
]
],
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}
]
},
{
"id": "DerAnaesthesist.60450022.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"children"
],
"offsets": [
[
352,
360
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0008059"
}
]
},
{
"id": "DerAnaesthesist.60450022.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"toxicity"
],
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[
404,
412
]
],
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{
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"db_id": "C0600688"
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]
},
{
"id": "DerAnaesthesist.60450022.eng.abstr-s3-t4",
"type": "umlsterm",
"text": [
"fluoride"
],
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[
438,
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]
],
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"db_id": "C0016327"
}
]
},
{
"id": "DerAnaesthesist.60450022.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"open"
],
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[
487,
491
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0266061"
}
]
}
] |
[] |
[] |
[
{
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},
{
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"normalized": []
},
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},
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},
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},
{
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},
{
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},
{
"id": "DerAnaesthesist.60450022.eng.abstr-s2-r1-t1.1-t2.1",
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{
"id": "DerAnaesthesist.60450022.eng.abstr-s2-r2-t3.1-t2.1",
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},
{
"id": "DerAnaesthesist.60450022.eng.abstr-s2-r4-t1.1-t3.1",
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},
{
"id": "DerAnaesthesist.60450022.eng.abstr-s3-r1-t3.1-t1.1",
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"arg2_id": "DerAnaesthesist.60450022.eng.abstr-s4-t1",
"normalized": []
}
] |
DerAnaesthesist.60450031.eng.abstr
|
DerAnaesthesist.60450031.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450031.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Sevoflurane is a \" new \" volatile inhaled anaesthetic . Owing to its lower blood-gas solubility coefficient , emergence from anaesthesia is faster with sevoflurane than with isoflurane , enflurane , or halothane . Sevoflurane undergoes metabolic biodegradation , releasing inorganic fluoride ions that could produce nephrotoxicity . In this study , we compared serum inorganic fluoride concentrations ( IFCs ) in patients receiving either sevoflurane or enflurane . Furthermore , indices of renal function were evaluated until the 3rd postoperative day ."
],
"offsets": [
[
0,
554
]
]
}
] |
[
{
"id": "DerAnaesthesist.60450031.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"Sevoflurane"
],
"offsets": [
[
0,
11
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0074414"
}
]
},
{
"id": "DerAnaesthesist.60450031.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"anaesthetic"
],
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[
42,
53
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0002932"
}
]
},
{
"id": "DerAnaesthesist.60450031.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"blood-gas"
],
"offsets": [
[
75,
84
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0005767"
},
{
"db_name": "UMLS",
"db_id": "C0005768"
},
{
"db_name": "UMLS",
"db_id": "C0005835"
}
]
},
{
"id": "DerAnaesthesist.60450031.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"blood-gas"
],
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[
75,
84
]
],
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{
"db_name": "UMLS",
"db_id": "C0017110"
}
]
},
{
"id": "DerAnaesthesist.60450031.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"solubility"
],
"offsets": [
[
85,
95
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0037628"
}
]
},
{
"id": "DerAnaesthesist.60450031.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"faster"
],
"offsets": [
[
140,
146
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0015663"
}
]
},
{
"id": "DerAnaesthesist.60450031.eng.abstr-s2-t5",
"type": "umlsterm",
"text": [
"sevoflurane"
],
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[
152,
163
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0074414"
}
]
},
{
"id": "DerAnaesthesist.60450031.eng.abstr-s2-t6",
"type": "umlsterm",
"text": [
"isoflurane"
],
"offsets": [
[
174,
184
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0022180"
}
]
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DerAnaesthesist.60450037.eng.abstr
|
DerAnaesthesist.60450037.eng.abstr
|
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[] |
[] |
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{
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},
{
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},
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},
{
"id": "DerAnaesthesist.60450037.eng.abstr-s2-r19-t1.1-t6.1",
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},
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},
{
"id": "DerAnaesthesist.60450037.eng.abstr-s3-r2-t7.2-t6.1",
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},
{
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},
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},
{
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},
{
"id": "DerAnaesthesist.60450037.eng.abstr-s3-r6-t7.2-t4.1",
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},
{
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},
{
"id": "DerAnaesthesist.60450037.eng.abstr-s3-r9-t1.1-t2.1",
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{
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},
{
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},
{
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{
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{
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},
{
"id": "DerAnaesthesist.60450037.eng.abstr-s3-r15-t2.1-t1.1",
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{
"id": "DerAnaesthesist.60450037.eng.abstr-s3-r16-t5.1-t4.1",
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}
] |
DerAnaesthesist.60450047.eng.abstr
|
DerAnaesthesist.60450047.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450047.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Does propofol or thiopentone enhance the effect of nondepolarizing muscle relaxants ? We evaluated the effects of propofol and thiopentone on the pharmacodynamics of atracurium and alcuronium in 43 surgical patients ( ASA I and II ) under general anaesthesia ."
],
"offsets": [
[
0,
260
]
]
}
] |
[
{
"id": "DerAnaesthesist.60450047.eng.abstr-s1-t1",
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"propofol"
],
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[
5,
13
]
],
"normalized": [
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"db_name": "UMLS",
"db_id": "C0033487"
}
]
},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"thiopentone"
],
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[
17,
28
]
],
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{
"db_name": "UMLS",
"db_id": "C0039925"
}
]
},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"muscle"
],
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[
67,
73
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0026845"
}
]
},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"propofol"
],
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[
114,
122
]
],
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{
"db_name": "UMLS",
"db_id": "C0033487"
}
]
},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"thiopentone"
],
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[
127,
138
]
],
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{
"db_name": "UMLS",
"db_id": "C0039925"
}
]
},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"pharmacodynamics"
],
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[
146,
162
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0243145"
}
]
},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"atracurium"
],
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[
166,
176
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0004234"
}
]
},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s2-t5",
"type": "umlsterm",
"text": [
"alcuronium"
],
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[
181,
191
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0001981"
}
]
},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s2-t6",
"type": "umlsterm",
"text": [
"surgical"
],
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[
198,
206
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0038895"
}
]
},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s2-t7",
"type": "umlsterm",
"text": [
"patients"
],
"offsets": [
[
207,
215
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s2-t8",
"type": "umlsterm",
"text": [
"ASA"
],
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[
218,
221
]
],
"normalized": [
{
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"db_id": "C0004057"
}
]
},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s2-t9",
"type": "umlsterm",
"text": [
"general anaesthesia"
],
"offsets": [
[
239,
258
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0002915"
}
]
}
] |
[] |
[] |
[
{
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"type": "interacts_with",
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},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s1-r2-t3.1-t1.1",
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},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s1-r3-t1.1-t3.1",
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"normalized": []
},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s1-r4-t3.1-t2.1",
"type": "produces",
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"normalized": []
},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s1-r5-t2.1-t3.1",
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"normalized": []
},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s1-r6-t2.1-t1.1",
"type": "interacts_with",
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"normalized": []
},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s2-r1-t9.1-t8.1",
"type": "uses",
"arg1_id": "DerAnaesthesist.60450047.eng.abstr-s2-t9",
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"normalized": []
},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s2-r2-t9.1-t6.1",
"type": "affects",
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"normalized": []
},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s2-r3-t9.1-t3.1",
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"normalized": []
},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s2-r4-t9.1-t5.1",
"type": "uses",
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"arg2_id": "DerAnaesthesist.60450047.eng.abstr-s2-t5",
"normalized": []
},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s2-r5-t6.1-t9.1",
"type": "performs",
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"normalized": []
},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s2-r6-t9.1-t1.1",
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"arg2_id": "DerAnaesthesist.60450047.eng.abstr-s2-t1",
"normalized": []
},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s2-r7-t9.1-t3.1",
"type": "affects",
"arg1_id": "DerAnaesthesist.60450047.eng.abstr-s2-t9",
"arg2_id": "DerAnaesthesist.60450047.eng.abstr-s2-t3",
"normalized": []
},
{
"id": "DerAnaesthesist.60450047.eng.abstr-s2-r8-t9.1-t2.1",
"type": "uses",
"arg1_id": "DerAnaesthesist.60450047.eng.abstr-s2-t9",
"arg2_id": "DerAnaesthesist.60450047.eng.abstr-s2-t2",
"normalized": []
}
] |
DerAnaesthesist.60450059.eng.abstr
|
DerAnaesthesist.60450059.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450059.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Portofemoro-axillary bypass systems are commonly used to treat adverse haemodynamic effects during the anhepatic phase of orthotopic liver transplantation ( OLT ) . However , low shunt flows may reduce the efficacy of these bypass systems . In order to improve veno-venous bypass management , a percutaneous cannulation technique ( PCT ) was used to insert large-bore catheters ( 21 F ) into the left femoral and subclavian veins . This study prospectively addresses the complications of the PCT in 195 adult patients undergoing 203 OLTs ."
],
"offsets": [
[
0,
539
]
]
}
] |
[
{
"id": "DerAnaesthesist.60450059.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"haemodynamic"
],
"offsets": [
[
71,
83
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0019010"
}
]
},
{
"id": "DerAnaesthesist.60450059.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"liver"
],
"offsets": [
[
133,
138
]
],
"normalized": [
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[] |
[] |
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DerAnaesthesist.60450066.eng.abstr
|
DerAnaesthesist.60450066.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450066.eng.abstr-passage-0",
"type": "abstract",
"text": [
"This is a report of a case of a subdural haematoma with resulting paraplegia after attempted spinal anaesthesia . Epidural and subdural haematomas are rare complications after central neural blockade . The complication described here was the result of an unsuccessful attempt to puncture the spinal channel . The patient was a 72-year-old woman with a fracture of the left femoral neck , which it was intended to stabilize operatively . Findings that made lumbar spinal puncture difficult were severe overweight , and lordosis and scoliosis of the lumbar spine resulting from degenerative changes . Spinal anaesthesia was suggested because the patient had eaten shortly before and because she suffered from asthma . From the aspect of haemostasis no contraindications were present , and the anaesthesist was experienced in spinal anaesthesia even under difficult anatomical conditions . Several unsuccessful attempts were made to puncture the lumbar spinal channel while the patient was lying on her right side . It was also impossible to reach the spinal channel from a median or left paramedian approach . We used atraumatic pencil-point needles ( Sprotte gauge 24 , 90 mm ) . No blood was aspirated during any of the attempts . The surgical intervention was finally performed under a general anaesthetic in view of the urgency . No significant complications occurred during the operation , and no neurological abnormalities were observed immediately after or in the next 8 h after the operation . At 12 h after the operation a paraparesis was found caudal to L3. After this had been verified by radiological and neurological tests , neurosurgical decompression was carried out as quickly as possible . During the operation a distinct subdural haematoma without any detectable source of bleeding was discovered . Even after surgical revision and evacuation of the remaining haematoma it was not possible to reverse the paraplegia , in spite of rehabilitation measures . Despite a certain fragility of the vessel and pretreatment with pentoxifylline and thromboembolic prophylaxis with low-molecular heparin starting postoperatively , it must be assumed that a vessel accompanying one of the spinal nerves was punctured , possibly , the radiculomedullary vessel of Adamkiewicz . A similar case was published in 1988 by Parker . In the present case it must be assumed that the vessel was punctured during a paramedian approach in the area of the foramen intervertebrale , as the spinal channel was definitely not entered . Although this is an extremely rare complication , we conclude that close neurological controls are essential at least during the first 24 h after surgery , even after an unsuccessful attempt at central neural blockade ."
],
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DerAnaesthesist.60450075.eng.abstr
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DerAnaesthesist.60450075.eng.abstr
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"The current increase in the cost of health care must be considered as a severe threat to the prehospital emergency services system . Two examples have been selected - the patient with polytrauma and the patient in cardiac arrest - to demonstrate the dilemma between a need for objective data and the requirements of emergency patients . Study results obtained in trauma patients indicating that total prehospital time , including scene time , is correlated to patient outcome have led to the conclusion that at the scene treatment by emergency physicians may be dispensable . It has , however also been demonstrated that the time required for medical treatment at the scene is equivalent to 20% of the total scene time , thus representing only a fraction of the total prehospital time . Correlating the total prehospital time or scene time to outcome therefore appears absurd . The treatment principle of aggressive shock treatment in polytrauma needs critical reevaluation on the basis of results obtained by recent preclinical studies in patients with penetrating torso injuries . Small volume resuscitation could not be demonstrated to improve outcome in polytrauma patients , although a slight improvement in patients with brain injury may be assumed . Endotracheal intubation and early artificial ventilation are proven therapeutic principles in polytraumatized patients . Unfortunately , for ethical reasons randomised carefully controlled comparative studies can not be performed in polytrauma patients unless the patient is fully conscious . The importance of endotracheal intubation and artificial ventilation in unconscious trauma patients becomes apparent under conditions of anaesthesia where the application of the endotracheal tube averts regurgitation , aspiration and concomitant morbidity and mortality . The common causes of cardiovascular collapse and their pathomechanisms , as well as the mechanisms of cardiopulmonary resuscitation , have been widely investigated . Nevertheless , various aspects of their application are still controversial . The most recent study results have recommended initial ventilation prior to thoracic compression . New methods of assisting mechanical cardiopulmonary resuscitation , such as ACD CPR or vest CPR , have shown promising results in animal experiments . However , the importance of results obtained by preclinical randomised controlled investigations in humans need to be confirmed by further studies as to outcome . The efficacy of defibrillation in cases of ventricular fibrillation has been clearly demonstrated , particularly with a view to the interval between ventricular fibrillation and defibrillation . It has further been demonstrated that basic cardiopulmonary resuscitation preserves ventricular fibrillation and thus improves the chance of survival . The present generation of defibrillators has been further improved , particularly by the introduction of biphasic defibrillator wave forms , which may reduce the required energy , as well as possible complications , while offering an increase in the efficacy of defibrillation and a reduction in defibrillator size . Scientific emergency medicine is responsible not only for the development and validation of new methods and concepts , but in particular for their application under quality control conditions . Politicians require an improvement in the quality of the validation of emergency measures , although the instruments available for the investigation of these measures are known to be obsolete ( experimental models , experimental design ) . Additionally , the financial support of research in emergency medicine suffers from being accourded low priority by public research funds such as the German Research Fund . However , in view of the rapid application of experimental results to daily practice it should be emphasized that patients also support research in emergency medicine via their direct financial contributions to the health insurance companies ."
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DerAnaesthesist.60450088.eng.abstr
|
DerAnaesthesist.60450088.eng.abstr
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528
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] |
DerAnaesthesist.60450113.eng.abstr
|
DerAnaesthesist.60450113.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450113.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Polymorphonuclear leukocytes ( PMNL ) constitute the first line of defence in the protection of the host from invading microorganisms . PMNL also contribute to the removal of cellular debris from necrotic tissues during reparative processes . For these purposes PMNL are armed with highly efficient bactericidal mechanisms which , under certain pathophysiological conditions , can be turned against the host himself . A vast body of evidence indicates that PMNL are able to cause lung injury which may be followed by the development of acute respiratory distress syndrome ( ARDS ) . Accordingly , in patients with ARDS blood concentrations of inflammatory activators of PMNL are elevated , cytotoxic mechanisms of PMNL are enhanced and sequestration of these cells has been demonstrated to be inversely proportional to gas exchange . The manifestation of ARDS in leukopenic patients , however , indicates the development of this clinical syndrome independently of the presence of PMNL . The ability to differentiate between PMNL-dependent and PMNL-independent pathways in the pathogenesis of this syndrome is not only of theoretical interest but also of therapeutic significance . Since the patient's systemic inflammatory response may vary according to the stage and type of the underlying disease , an exact qualitative and quantitative analysis of PMNL functions may provide the rationale for new anti-inflammatory drug regimens aimed at modifying the host's response without increasing the risk of infection ."
],
"offsets": [
[
0,
1513
]
]
}
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] |
[] |
[] |
[
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"type": "adjacent_to",
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DerAnaesthesist.60450131.eng.abstr
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DerAnaesthesist.60450131.eng.abstr
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"The era of modern anaesthesia in Germany began on January 24th , 1847. This day , professor in ordinary Johann Ferdinand Heyfelder anaesthetized a patient with sulphuric ether in the clinic of surgery and ophthalmology of the University of Erlangen . By March 17th , 1847 , Heyfelder had performed 121 surgical procedures under ether . The operations in majority were teeth-extractions , and a few more complex operations such as the treatment of a harelip or of lip cancer or the resection of the shoulder joint . Heyfelder described in detail 108 of these inhalations in a little book entitled The experiments with sulphuric ether . This monograph published in March , 1847 , represents one of the first complete dissertations on sulphuric ether in the German literature . In a special chapter he analyzed the development of various physiological and psychological parameters during etherization . Heyfelder also examined blood and urine of some etherized patients and reported that he did not find any important or specific alterations . In 1847 , Heyfelder was probably the first to apply salt-ether in man . After 4 administrations he concluded that salt ether acted more quickly but shorter than sulphuric ether . Advantageous were its application without problems and ease of induction . Disadvantageous were its high volatility , its price and the difficulty of getting it in a pure form . From December , 1847 , on Heyfelder started to use chloroform . He was now able to perform more major operations , for example the total resection of the hip-joint . In his book The experiments with sulphuric ether , salt ether , and chloroform he describes a great number of anaesthetic administrations using these 3 agents . In his summary Heyfelder concluded , that chloroform was undoubtly superior to sulphuric ether mainly because it was a quicker acting and longer lasting agent and leads to deeper narcosis . Moreover its application was much easier for it needed no special apparatus . However , because of its great anaesthetic potency , Heyfelder particularly demanded great caution in the application of chloroform . Explicitely he expected an assistant for chloroformizations , whose only duty was to supervise the inhalations and the patient - a forerunner of the modern specialized anaesthesiologist ."
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] |
DerAnaesthesist.60450140.eng.abstr
|
DerAnaesthesist.60450140.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450140.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Desflurane is a new volatile anaesthetic with an extremely low blood/gas partition coefficient of 0.42. This should provide a rapid recovery from anaesthesia . Methods . We studied 100 adult patients , ASA class I or II , undergoing elective orthopaedic surgery randomly assigned to anaesthesia with desflurane ( n=50) or isoflurane ( n=50) supplemented by nitrous oxide in oxygen . Clorazepat was given for premedication , fentanyl and thiopental for induction of anaesthesia , followed by maintenance with desflurane or isoflurane as clinically appropriate . Emergence from anaesthesia was measured as well as return of cognitive functions ( extended Aldrete score , digit symbol substitution test , and visual analogue scales [ VAS ] ) . Results . While the demographic characteristics and administrated doses of fentanyl and thiopental were comparable , the recovery profiles in both groups were different . After discontinuation of the volatile anaesthetics , times to extubation and ability to follow simple commands were significantly shorter after desflurane than after isoflurane . Extended Aldrete scores , estimation of the patients ' physical condition , results of the digit symbol substitution test , measuring cognitive functions , and rates of drowsiness and weakness on VAS showed better recovery with less impairment of cognitive function in the desflurane group than in isoflurane patients even 120 min after anaesthesia . VAS pain scores and doses of analgesic drugs given within the first 2 postoperative hours , however , showed no significant differences . Desflurane patients were also judged fit for discharge from the recovery room significantly faster . Conclusions . Our results demonstrate that desflurane anaesthesia , even when supplemented by premedication , intraoperative opioids , and nitrous oxide may offer clinical advantages over isoflurane as far as the post-anaesthetic recovery profile is concerned ."
],
"offsets": [
[
0,
1942
]
]
}
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DerAnaesthesist.60450146.eng.abstr
|
DerAnaesthesist.60450146.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450146.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Since the introduction of propofol into clinical practice , dreaming during general anaesthesia has been frequently reported with this drug . We investigated the incidence and character of these dreams with regard to distinction from intraoperative awareness and in comparison with habitual dreams or dreams during general anaesthesia with enflurane . Method . A total of 230 patients ( ASA I-II ) undergoing minor elective surgery were randomly assigned to one of two groups . Both groups received the same premedication ( 1 mg flunitrazepam ) the previous evening . After induction using etomidate 2 mg/kg , anaesthesia in group I was maintained using 0.8%-1.5% enflurane supplemented in the sense of \" balanced anaesthesia \" with fentanyl , vecuronium , and nitrous oxide . Anaesthesia in group II was induced with propofol 2 mg/kg . After a saturation phase of approximately 10 mg/kg - h , 5-6 mg/kg - h was administered for maintenance supplemented by fentanyl , Vecuronium , and N2O as in group I. Interviews were conducted preoperatively , just after recovery from anaesthesia , and 24 h later . We inquired about preoperative fears or concerns , sensory perceptions , and the incidence and character ( pleasant , unpleasant , indifferent ) of habitual dreams . After recovery the patients were asked if they had had any conscious perceptions , whether they believe them to be dreams or reality , and repeated the preoperative questions as to common feelings and the character of sensory perceptions . Results . The two groups were not entirely comparable due to the distribution of sex and age , but we did not find any differences in preoperative grades of fear and incidence of dreams . Of the propofol patients , 60% dreamed intraoperatively versus 11% in the enflurane group . No evidence of any intraoperative awareness was found . Because of the low incidence of dreams in the enflurane group , a comparison of detailed information between the groups could not be provided . Except for 1 , all patients in the propofol group had very pleasant dreams compared to their habitual dreams ( 4.5% in the enflurane group ) . One day after surgery 37% of all patients in the propofol group remembered having dreamed intraoperatively . We did not found any correlation to the incidence of habitual dreaming , preoperative fear , age , sex , duration of anaesthesia , or total dose of propofol . Furthermore , intraoperative dreams differed from habitual dreams in character and content . Conclusions . We conclude that sensory experiences during propofol anaesthesia are not stimulus-related perceptions or awareness , but dreams similar to normal ones . In view of the absence of clear signs of stimulus-related response , we presume that dreaming is a specific side effect of propofol . Because of the absence of difficulties , dreaming during propofol anaesthesia appears not to be a disadvantage with regard to the quality of anaesthesia ."
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DerAnaesthesist.60450154.eng.abstr
|
DerAnaesthesist.60450154.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450154.eng.abstr-passage-0",
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"text": [
"Absorption of irrigating fluid in transurethral prostatic resection ( TURP ) and percutaneous nephrolitholapaxy ( PNL ) into veins or delayed absorption due to fluid extravasation may result in a TURP syndrome . The measurement of end-tidal breath alcohol concentration ( et AC ) as a monitor of absorption of irrigating fluid labelled with 2% ethanol is limited by the disturbance of infrared sensors by volatile anaesthetics and nitrous oxide ( N2O) ( Fig . 2 ) . An electrochemical sensor is acceptable for this method . The aim of the present study was the evaluation of breath alcohol measurements using an electrochemical sensor device ( Alcomed 3010 , Envitec ) . The stability of the sensor in the presence of volatile anaesthetics was examined using a lung model . In a clinical investigation , the device was then applied to spontaneously breathing or mechanically ventilated patients inhaling volatile anaesthetics during endoscopic urological surgery ."
],
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[
0,
964
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]
}
] |
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] |
[] |
[] |
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DerAnaesthesist.60450171.eng.abstr
|
DerAnaesthesist.60450171.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450171.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A 3.5-year-old girl suffered from a thermal injury affecting 37% of the body surface area . The parents , being Jehovah's witnesses , refused permission for their child to receive blood transfusions . As the haemoglobin level was only 7.5% and a necrectomy was planned , the patient was likely to need blood transfusions . Indications for transfusion were defined as clinical signs of hypoxia and/or cardiovascular instability . A judicial declaration was proposed . Hb decreased during the therapy . To stimulate the erythropoiesis erythropoietin and iron were administered . During the clinical course the anaemia worsened . First , a conservative treatment with polyvidoniodine ointment for tanning was started , to avoid an operation during the acute phase after the injury , as in this case it was thought a blood transfusion would definitely be necessary . On the 19th day after the injury a necrectomy of 10% of the body surface was necessary because of fever and leucocytosis not responding to antibiotics . The most likely cause of the symptoms was an infection of the burned area . Hb was 4.6 g/dl%. General anaesthesia was performed with midazolam , ketamine and vecuronium and mechanical ventilation . No blood transfusion was required during the operation . Vital signs were stable during the preoperative period , during anaesthesia and following the operation . There were no signs of tissue hypoxia . Peripheral oxygen saturation ranged between 98% and 100% , lactate and arterial blood gas samples were normal , and the child was awake and cooperative before and after anaesthesia . The lowest Hb was 3.3 g/dl on the 22th day after injury ( 3rd postoperative day ) . In this phase the patient was still playing and riding a tricycle . On the 45th day after injury the child was discharged home with Hb of 10.9 g/dl and reticulocytosis of 33% ."
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DerAnaesthesist.60450213.eng.abstr
|
DerAnaesthesist.60450213.eng.abstr
|
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{
"id": "DerAnaesthesist.60450213.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Patients with a prior myocardial infarction ( MI ) have a high risk of perioperative reinfarction compared with the normal population ( 5%-8% vs. 0.1%-0.7%) [ 10 ] . According to Rao [ 13 ] , a reduction of this risk is possible when patients are monitored invasively and all haemodynamic parameters are kept within the physiological range . In most institutions it is not feasible to treat patients as Rao recommended : this would overstrain both hospital structure and financial resources . We studied the incidence of perioperative MI and other cardiac events in patients with prior MI . During the study period the anaesthesia and intensive care methods of our institution were neither changed nor influenced . In addition to this clinical evaluation , we performed perioperative Holter electrocardiographic monitoring and measured serum levels of the recently introduced marker troponin T ( parts II and III ) ."
],
"offsets": [
[
0,
916
]
]
}
] |
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[] |
[] |
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}
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DerAnaesthesist.60450220.eng.abstr
|
DerAnaesthesist.60450220.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450220.eng.abstr-passage-0",
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],
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[
0,
129
]
]
}
] |
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{
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] |
[] |
[] |
[
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}
] |
DerAnaesthesist.60450225.eng.abstr
|
DerAnaesthesist.60450225.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450225.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Diagnosis of a perioperative myocardial infarction ( PMI ) on the basis of measurement of the creatine kinase MB fraction ( CKMB ) alone is not always easy . Surgical traumatisation of muscle fibres can lead to false-positive elevations . Newly introduced laboratory tests for cardiac troponins seem to facilitate the diagnosis of PMI . We measured serum values of cardiac troponin T in 139 patients described in detail in part I and compared them with common diagnostic tools for myocardial infarction ."
],
"offsets": [
[
0,
504
]
]
}
] |
[
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"id": "DerAnaesthesist.60450225.eng.abstr-s1-t2",
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"id": "DerAnaesthesist.60450225.eng.abstr-s1-t4",
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{
"id": "DerAnaesthesist.60450225.eng.abstr-s2-t1",
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},
{
"id": "DerAnaesthesist.60450225.eng.abstr-s2-t2",
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185,
191
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},
{
"id": "DerAnaesthesist.60450225.eng.abstr-s3-t1",
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},
{
"id": "DerAnaesthesist.60450225.eng.abstr-s3-t4",
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256,
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[] |
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}
] |
DerAnaesthesist.60450231.eng.abstr
|
DerAnaesthesist.60450231.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450231.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Patient-controlled intravenous analgesia ( i.v. -PCA ) represents the gold standard in the management of acute postoperative pain . However , in many countries i.v. -PCA is rarely used . Recent clinical studies demonstrated that intranasal fentanyl titration provides a rapid and safe form and pain management . In the present study we investigated patients ' acceptance and assessment of patient-controlled intranasal analgesia ( PCINA ) and compared it to intravenous PCA and the customarily prescribed pain therapy ."
],
"offsets": [
[
0,
519
]
]
}
] |
[
{
"id": "DerAnaesthesist.60450231.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"analgesia"
],
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[
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] |
[] |
[] |
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] |
DerAnaesthesist.60450235.eng.abstr
|
DerAnaesthesist.60450235.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450235.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Intraoperative paradoxical air embolism may occur even if a patent foramen ovale ( PFO ) is excluded by contrast transoesophagal echocardiography ( TEE ) under 20 cmH2O positive airway pressure . It is questionable whether the combination of PEEP and ventilation with a large tidal volume increases the sensivity of contrast TEE in detecting a PFO . Methods . Eighty healthy patients ( ASA status I , II ) scheduled for surgery in the supine position and ranging from 25 to 72 years of age were investigated by TEE , which was performed in the biatrial viewing mode ( short axis ) . Echocardiographic contrast ( 10 ml agitated gelatine solution ) was injected during two different ventilation manoeuvres . Manoeuvre I : Contrast injection during the application of 20 cmH2O positive airway pressure for 5 s. The pressure was released when the right atrium became completely opacified by echo targets . The injected bolus was observed throughout the ventilatory cycle , with special attention being given to early expiration and systole . A right-to-left shunt was assumed if five echo targets were observed in the left atrium . Manoeuvre II : Contrast injection during ventilation with PEEP ( 15 cmH2O), a tidal volume of 1,200 ml , and a respiratory rate of 6/min. Results . The frequency of a PFO causing a right-to-left interatrial shunt was 8.7% ( 7 cases ) in manoeuvre I and 15% ( 12 cases ) in manoeuvre II . In one case a PFO was diagnosed intraoperatively by chance . Discussion . The use of provocation manoeuvres including ventilation with PEEP and high tidal volumes might improve the ability to detect a PFO presenting with right-to-left interatrial shunt by intraoperative contrast TEE , but does not have 100% sensitivity . However , our results clearly indicate that ventilation with PEEP and high tidal volumes may predispose to paradoxical embolism ."
],
"offsets": [
[
0,
1868
]
]
}
] |
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{
"id": "DerAnaesthesist.60450235.eng.abstr-s1-t2",
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"text": [
"embolism"
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{
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67,
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"id": "DerAnaesthesist.60450235.eng.abstr-s2-t1",
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"PEEP"
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] |
DerAnaesthesist.60450240.eng.abstr
|
DerAnaesthesist.60450240.eng.abstr
|
[
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"type": "abstract",
"text": [
"The right ventricle is more jeopardized by a cardiopulmonary bypass than the left one . Impaired right ventricular performance may profit from an afterload reduction . A selective reduction in pulmonary artery pressure ( PAP ) or pulmonary vascular resistance ( PVR ) without impairment of the systemic circulation seems to be possible by inhalation of nitric oxide ( NO ) . Therefore in the present study we looked for influences of NO inhalation on PAP , PVR and right heart parameters immediately after weaning from the bypass . The dependence of endothelial function on age , preoperative heart function and extracorporeal circulation is well established . The relevance of such parameters on NO inhalation was also investigated ."
],
"offsets": [
[
0,
734
]
]
}
] |
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}
] |
[] |
[] |
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DerAnaesthesist.60450249.eng.abstr
|
DerAnaesthesist.60450249.eng.abstr
|
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],
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[
0,
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]
}
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[] |
[] |
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},
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},
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},
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}
] |
DerAnaesthesist.60450255.eng.abstr
|
DerAnaesthesist.60450255.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450255.eng.abstr-passage-0",
"type": "abstract",
"text": [
"2-Agonists are being used increasingly in anaesthesia and intensive care medicine because of their antihypertensive , analgesic and sedative properties . Platelets bear 2-receptors on the cell surface . Stimulation of these receptors by agonists induces platelet aggregation . The present study examined whether in vitro incubation of blood with the 2-agonists clonidine and dexmedetomidine decreases 2-receptor density and hereby influences platelet aggregation ."
],
"offsets": [
[
0,
464
]
]
}
] |
[
{
"id": "DerAnaesthesist.60450255.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"care"
],
"offsets": [
[
68,
72
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0150499"
}
]
},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"medicine"
],
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[
73,
81
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0025118"
},
{
"db_name": "UMLS",
"db_id": "C0013227"
}
]
},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"antihypertensive"
],
"offsets": [
[
99,
115
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0003364"
}
]
},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"analgesic"
],
"offsets": [
[
118,
127
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0002771"
}
]
},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"sedative"
],
"offsets": [
[
132,
140
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0036557"
}
]
},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"intensive care"
],
"offsets": [
[
58,
72
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0085559"
}
]
},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"Platelets"
],
"offsets": [
[
154,
163
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0005821"
}
]
},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"cell"
],
"offsets": [
[
188,
192
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0007634"
}
]
},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"the cell"
],
"offsets": [
[
184,
192
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0007634"
}
]
},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"agonists"
],
"offsets": [
[
237,
245
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0243192"
}
]
},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"platelet"
],
"offsets": [
[
254,
262
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0005821"
}
]
},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"platelet aggregation"
],
"offsets": [
[
254,
274
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0032176"
}
]
},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"blood"
],
"offsets": [
[
335,
340
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0005767"
},
{
"db_name": "UMLS",
"db_id": "C0005768"
},
{
"db_name": "UMLS",
"db_id": "C0005835"
}
]
},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"clonidine"
],
"offsets": [
[
361,
370
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0009014"
}
]
},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"dexmedetomidine"
],
"offsets": [
[
375,
390
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0113293"
}
]
},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s4-t4",
"type": "umlsterm",
"text": [
"platelet"
],
"offsets": [
[
442,
450
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0005821"
}
]
},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s4-t5",
"type": "umlsterm",
"text": [
"in vitro"
],
"offsets": [
[
312,
320
]
],
"normalized": [
{
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"db_id": "C0021135"
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]
},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s4-t6",
"type": "umlsterm",
"text": [
"platelet aggregation"
],
"offsets": [
[
442,
462
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0032176"
}
]
}
] |
[] |
[] |
[
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{
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{
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{
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{
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{
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{
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},
{
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},
{
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},
{
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},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s4-r12-t2.1-t1.1",
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},
{
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},
{
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},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s4-r15-t5.1-t1.2",
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},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s4-r17-t3.1-t1.1",
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},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s4-r18-t2.1-t4.1",
"type": "disrupts",
"arg1_id": "DerAnaesthesist.60450255.eng.abstr-s4-t2",
"arg2_id": "DerAnaesthesist.60450255.eng.abstr-s4-t4",
"normalized": []
},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s4-r19-t2.1-t5.1",
"type": "affects",
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},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s4-r20-t1.1-t4.1",
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},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s4-r21-t3.1-t4.1",
"type": "disrupts",
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},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s4-r22-t2.1-t3.1",
"type": "interacts_with",
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},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s4-r23-t3.1-t5.1",
"type": "affects",
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"normalized": []
},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s4-r24-t1.1-t3.1",
"type": "produces",
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},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s4-r25-t4.1-t5.1",
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},
{
"id": "DerAnaesthesist.60450255.eng.abstr-s4-r26-t4.1-t1.2",
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"arg2_id": "DerAnaesthesist.60450255.eng.abstr-s4-t1",
"normalized": []
}
] |
DerAnaesthesist.60450271.eng.abstr
|
DerAnaesthesist.60450271.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450271.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Over a period of 10 years various orthopaedic-paediatric operations were performed under hyperbaric spinal anaesthsia ."
],
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DerAnaesthesist.60450278.eng.abstr
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[] |
[] |
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DerAnaesthesist.60450312.eng.abstr
|
DerAnaesthesist.60450312.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450312.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Clinical manifestations of sepsis , such as systemic inflammatory response and multiple organ dysfunction syndrome , are considered to be the results of a decompensated host defense response . If tissue injury is sufficiently severe to overwhelm local defense mechanisms , systemic activation of these essentially protective mechanisms may lead to autodestructive \" host defense failure disease . \" This is not always caused by invading bacteria ; sterile inflammation such as results from multiple trauma or pancreatitis can initiate a similar response . Evidence suggests that the activation of the macrophage/monocyte system that underlies the systemic inflammatory response may reflect one facet of a more generalized dysregulation of intercellular communication , as well as a dysfunction of such subcellular processes as signal transduction or stress gene expression . Alterations in signal transduction or stress gene expression can affect the host defense response to subsequent stressful events in either a negative or a positive sense . In particular , the sequential induction of acute phase and heat shock response may initiate programmed cell death , reflecting a potential molecular mechanism for the development of multiple organ dysfunction syndrome . The development of anti-inflammatory treatment strategies seems to be hampered by the discrepancy between locally protective and systemically deterimental properties of the host defense response ."
],
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}
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DerAnaesthesist.60450323.eng.abstr
|
DerAnaesthesist.60450323.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450323.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Numerous basic drugs are extensively bound to 1-acid glycoprotein . Fentanyl , with a pKa value of 8.43 , is also a basic drug . Protein binding studies have yielded contradictory results concerning binding of fentanyl to 1-acid glycoprotein . In this study we investigated time courses of serum protein concentrations and serum protein binding of fentanyl during postoperative acute phase reaction , assuming that an increase of 1-acid glycoprotein is accompanied by an increase of serum protein binding , if fentanyl is extensively bound to 1-acid glycoprotein . Fentanyl protein binding measurements using equilibrium dialysis can be affected by volume shifts and pH changes . Therefore , volume shifts from buffer to serum and the influence of various phosphate buffers on increasing pH due to loss of CO2 were also evaluated . Methods . Thirteen patients with no history of renal or hepatic disease undergoing an operation with a significant acute phase reaction were studied . Preoperatively and on the first 3 postoperative days serum concentrations of 1-acid glycoprotein , albumin , total protein and apolipoprotein A and B were determined by rocket immunoeolectrophoresis , biuret method and laser nephelometry , respectively . Corresponding serum protein binding of fentanyl was measured by adding 40 ng of fentanyl to 1 ml serum followed by equilibrium dialysis at 37 ° C for 4 h . A 0.167 M phosphate buffer ( pH 7.27 ) , which gave a final pH of 7.40 , was used . Volume shifts from buffer to serum were measured . Fentanyl concentration in serum before dialysis ( FS ) was determined by gas chromatography , and fentanyl concentration in buffer after dialysis ( FB ) was determined by radioimmunoassay . Serum protein binding ( SPB ) was calculated by the formula : SPB=(FS-FB-FB*c)/(FS-FB) where c is a correction factor . Ten randomly selected patient sera were dialyzed against four phosphate buffers of different pH values and molarities , and the serum pH at the end of equilibrium dialysis was measured . Results . Postoperatively , the serum concentration of 1-acid glycoprotein rose to 151% of the control value . In contrast , serum protein binding of fentanyl did not change significantly , with a slight decrease to 96% of control value . There was a significant decrease in serum concentrations of albumin ( 3rd postoperative day ) , total protein ( 2nd postoperative day ) and apolipoprotein B ( 1st-3rd postoperative day ) to 85% , 90% and 75% of control values , respectively . Changes in apolipoprotein A concentration were not significant . Protein binding of fentanyl did not correlate with 1-acid glycoprotein and apolipoprotein A , but there was a positive linear relationship between protein binding of fentanyl and albumin , total protein and apolipoprotein B. At the end of equilibrium dialysis the mean volumes of the serum and buffer compartments were 1114 +/- 72 and 834 +/- 68 µl, respectively . The two phosphate buffers , with pH 7.30 ( 0.15 M ) and pH 7.27 ( 0.167 M ) , gave final serum pH of 7.42 and 7.40 , respectively . Conclusions . Present findings suggest that in contrast to other basic drugs , fentanyl binding to 1-acid glycoprotein is of minor importance . In agreement with the findings of former studies , protein binding of fentanyl depended on albumin , total protein and apolipoprotein B concentrations . Due to unspecific binding of fentanyl by hydrophobic interactions , a major role of albumin , which amounts to about 60% of total protein , seems to be evident . Determining fentanyl protein binding by equilibrium dialysis , volume shifts must be taken into account if calculation is based on fentanyl concentrations in plasma ( serum ) and buffer after dialysis , and an appropriate buffer must be used ."
],
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0,
3772
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1719,
1732
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2100
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2164
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2172
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2321
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2394
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2421
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2533
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2535
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2580
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2600
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2643
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2648,
2662
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2727
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2747
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2759
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{
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2775
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{
"id": "DerAnaesthesist.60450323.eng.abstr-s21-t9",
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2780,
2794
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{
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2812,
2823
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{
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2832
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[] |
[] |
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DerAnaesthesist.60450330.eng.abstr
|
DerAnaesthesist.60450330.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450330.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Extracorporeal shock-wave lithotripsy ( ESWL ) is the method of choice for the treatment of solitary stones in the kidney or ureter . Early lithotripters required prolonged immobility of the patient and caused considerable pain , necessitating general or epidural anaesthesia during the procedure . Modern lithotripters are quicker , but still require analgesia . Intravenous opioids are currently the drugs in favour . The opioids most commonly used are fentanyl and its shorter-acting analogue , alfentanil . The latter has a more rapid onset and , because of its reduced lipid solubility , is less cumulative . Sufentanil is a new opioid that is also of the phenylpiperidone group and has been recently licensed and introduced in Germany . Its pharmacokinetic and pharmacodynamic properties suggest an intermediate duration of action , high analgesic potency , and cardiovascular stability with diminished respiratory depression . In this prospective double-blind study , the effects of alfentanil and sufentanil on cardiovascular and respiratory parameters , the quality of analgesia , degree of sedation and the number and type of side-effects were compared ."
],
"offsets": [
[
0,
1164
]
]
}
] |
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[] |
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DerAnaesthesist.60450337.eng.abstr
|
DerAnaesthesist.60450337.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450337.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Acute respiratory failure is characterised by mismatch of ventilation with perfusion ( V. A/Q . ) . The multiple inert gas elimination technique ( MIGET ) is a complex method which allows the description of a virtually continuous distribution of V. A/Q . ratios . We investigated V. A/Q . relationships in patients admitted to the intensive care unit due to acute respiratory failure and thus requiring for mechanical ventilation . Method . Eight patients ( mean APACHE II=22 +/- 4 ) who suffered from acute pneumonia ( n=4), traumatic lung contusion ( 2 ) , toxic lung failure ( 1 ) or massive bilateral atelectasis ( 1 ) were investigated by MIGET within 3 days after the begin of mechanical ventilation . A mixture of six inert gases , dissolved in isotonic saline , was infused continuously . Arterial and mixed venous blood samples and expired gas samples were obtained and analysed by gas chromatography . Blood-gas partition coefficients were determined , and the ratios of retention and excretion were calculated . The data were transformed in a 50-compartment model of blood flow and ventilation against V. A/Q . ratio . We assessed the amount of intrapulmonary shunt ( V. A/Q . =0 ) , low V. A/Q . regions ( V. A/Q . =0 . 005-0 . 1 ) , normal V. A/Q . regions ( V. A/Q . =0 . 11-10 ) , high V. A/Q . regions ( V. A/Q . =11-100 ) and dead space ventilation ( V. A/Q . > 100 ) . Furthermore , we calculated the logarithmic standard deviation of pulmonary perfusion distribution ( logSDQ . ) . Results . In all patients we found moderate to severe intrapulmonary shunt and V. A/Q . mismatching . The data are expressed as median values and ranges . Inert-gas-measured shunt was 21% ( 3-45 . 5% ) , whereas low V. A/Q . regions were little affected . Normal V. A/Q . regions ranged from 41.5% to 96.0% ( median 76.8% ) . The amount of alveolar dead space ventilation was 28% ( 19.7-41.8%). Median logSDQ . ( normal range 0.3-0.6) was calculated to be 0.855 ( 0.540-1.490). In patients presenting with moderate lung injury ( Murray score 3 ) , a moderate increase in shunt and a moderate V. A/Q . mismatch were observed . In contrast , patients with severe lung failure and critically decreased oxygenation ( Murray score > 3 ) were characterised by massive shunting and V. A/Q . mismatching . Additionally , low V. A/Q . and high V. A/Q . compartments and an increase in dead space ventilation was found in these patients . Conclusions . The impairment of oxygenation in patients with acute respiratory failure is due to several pathophysiological mechanisms : increase in intrapulmonary shunt , V. A/Q . -mismatching and dead space ventilation , according to the severity of lung failure . We conclude from our results that the prevention and/or reduction of non-ventilated lung areas ( atelectasis ) is an outstanding therapeutic strategy in the treatment of patients with acute respiratory failure . From this point of view , several techniques of systemic changes in body position should be integrated as supportive therapeutic strategies ."
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] |
[] |
[] |
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] |
DerAnaesthesist.60450343.eng.abstr
|
DerAnaesthesist.60450343.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450343.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Hyperoxic ventilation , used to prevent hypoxia during potential periods of hypoventilation , has been reported to paradoxically decrease whole-body oxygen consumption ( VO2). Reduction in nutritive blood flow due to oxygen radical production is one possible mechanism . We investigated whether pretreatment with the sulfhydryl group donor and O2 radical scavenger N-acetylcysteine ( NAC ) would preserve VO2 and other clinical indicators of tissue oxygenation in cardiac risk patients . Methods . Thirty patients , requiring hemodynamic monitoring ( radial and pulmonary artery catheters ) because of cardiac risk factors , were included in this randomized investigation . All patients exhibited stable clinical conditions ( hemodynamics , body temperature , hemoglobin , FIO2 0.5 ) . Cardiac output was determined by thermodilution and VO2 by cardiovascular Fick . After baseline measurements , patients randomly received either 150 mg kg-1 NAC ( n=15) or placebo ( n=15) in 250 ml 5% dextrose i.v. over a period of 30 min . Measurements were repeated 30 min after starting NAC or placebo infusion , 30 min after starting hyperoxia ( FIO2=1.0), and 30 min after resetting the original FIO2. Results . There were no significant differences between groups in any of the measurements before treatment and after the return to baseline FIO2 at the end of the study , respectively . NAC , but not placebo infusion , caused a slight but not significant increase in cardiac index ( CI ) , left ventricular stroke work index ( LVSWI ) and a decrease in systemic vascular resistance . Significant differences between groups during hyperoxia were : VO2 ( NAC : 108 +/- 38 ml min-1m-2 vs placebo : 79 +/- 22 ml min-1m-2; P =0 . 05 ) , CI ( NAC : 4.6 +/- 1.0 vs placebo : 3.7 +/- 1.11 min-1m-2; P =0 . 05 ) and LVSWI ( NAC : 47 +/- 12 vs placebo : 38 +/- 9 ; P =0 . 05 ) . The mean decrease of VO2 was 22% in the NAC group vs 47% in the placebo group ( P =0 . 05 ) and the mean difference between groups in venoarterial carbon dioxide gradient ( PvaCO2 ) was 14% ( P =0 . 05 ) . ST segment depression ( > 0.2 mV ) was significantly less marked in the NAC group ( NAC : -0 . 02 +/- 0.17 vs placebo : -0 . 23 +/- 0.15 ; P =0 . 05 ) . Conclusions . NAC helped preserve VO2, oxygen delivery , CI , LVSWI and PvaCO2 during brief hyperoxia in cardiac risk patients . Clinical signs of myocardial ischemia did not occur such as ST-depression if patients were prophylactically treated with NAC . This suggests that pretreatment with NAC could be considered to attenuate impaired tissue oxygenation and to preserve myocardial performance better in cardiac risk patients during hyperoxia ."
],
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DerAnaesthesist.60450351.eng.abstr
|
DerAnaesthesist.60450351.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450351.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Acute renal failure ( ARF ) is a serious complication following liver transplantation . Many therapeutic regimens have been used so far but with limited success . Urodilatin ( URO ) is a new member of the atrial natriuretic peptide ( ANP ) family . When administered intravenously , URO induces strong diuresis and natriuresis with tolerable hemodynamic side effects . Preliminary non-controlled clinical studies demonstrate beneficial effects using URO as a therapeutic agent in patients suffering from ARF following heart and liver transplantation ( HTx , LTx ) . These results prompted us to initiate this first controlled clinical trial to investigate whether URO infusion can improve renal function in patients with emerging ARF following LTx ."
],
"offsets": [
[
0,
749
]
]
}
] |
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"id": "DerAnaesthesist.60450351.eng.abstr-s3-t2",
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"id": "DerAnaesthesist.60450351.eng.abstr-s3-t3",
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"ANP"
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] |
[] |
[] |
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DerAnaesthesist.60450359.eng.abstr
|
DerAnaesthesist.60450359.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450359.eng.abstr-passage-0",
"type": "abstract",
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"Experimental studies have shown that in traffic accidents with frontal impact the new airbag system can significantly reduce the incidence of severe injuries and fatal outcome . The question of whether the airbag itself induces specific patterns of injury needs further investigation . Two cases of traffic accidents with airbag protection are presented here . The first case report clearly shows the life-saving and injury-reducing effect of the airbag system in a traffic accident with frontal impact at 100 km/h . In the second case only minor injuries of the face were diagnosed initially . Hemodynamic instability occurred after 3 h of hospitalization due to rupture of the azygos vein . Analysis of the presented cases shows that , besides the well-known benefits , there are certain injury patterns that seem to be related to the use of airbags . These have not been described before . It is concluded that patients who were involved in traffic accidents with airbag deployment have to be hospitalized and followed up carefully over time , even though they are initially stable , as potentially fatal sequelae of deceleration trauma can occur later . In our opinion it is not possible to estimate the severity of airbag-associated injuries with conventional methods ."
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DerAnaesthesist.60450413.eng.abstr
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DerAnaesthesist.60450413.eng.abstr
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"Prerequisites for experimental study designs are extremely difficult to realise under prehospital emergency conditions . Results obtained in animal experiments always need validation with prehospital or inhospital patient studies . Investigations related to emergency medicine are , however , an ethical obligation on behalf of the patient . A retrospective analysis of the available literature should be considered a prerequisite for prospective randomised and controlled studies . Frequently , a pilot study or feasibility trial needs to precede the actual study . Informed consent must be obtained for all patient studies . However , under emergency conditions informed consent cannot always be obtained due to unconsciousness , etc. Nevertheless , the following principles should be observed : ( a ) randomised studies are essential , even in emergency medicine ; ( b ) they are ethically acceptable if the treatment provided for the study group is at least equivalent to the therapy for the control group ; ( c ) only these preconditions guarantee that the patient always receives treatment in accordance with the standard of treatment . If the patient is unconscious or otherwise unable to give informed consent , the principle of deferred consent is acceptable . The deferred consent principle should be carefully documented . A prospective randomized study represents the gold standard for an investigation , even under emergency conditions . There are different principles of randomization : telephone or telefax randomisation , etc. Emergency medicine investigations need to be completed within a reasonable time frame which should , as a rule , not exceed 2 years . Otherwise , too many items might change without being noted . Curative treatment and the intention to treat are terms employed by ethics committees . If an investigation does not bear in itself additional risk factors , it does not necessarily have to be brought before the ethics committee . If , however , for example , the effect of obtaining blood samples is investigated separately for research purposes , the patient needs to be informed and sign the respective agreement . In Germany the ethics committees have agreed to accept their respective decisions . For multicentre and multinational studies , however , the ethics committees also need to accept decisions made by non-German ethics committees . Not all therapeutic principles can serve as the basis of prospective randomized studies because they need to be considered the present standard of care ( e.g. , endotracheal intubation , etc. ) . Nevertheless , the feasibility of a study should be assessed according to the 1-3 rating proposed by the American Heart Association . In principle , the overall emergency physician protocol does not fulfill scientific requirements . For all studies , particularly in the prehospital setting , an independent observer should be involved for documentation purposes . Scores can be of importance for investigating different treatment regimens . Biases in emergency medicine studies focus on the variability of EMS , personnel qualifications , etc. This is in part why it is extremely difficult to prove efficacy and efficiency in emergency medicine . The results of emergency medicine investigations should be published in suitable journals , i.e. , journals with a reasonable rating ."
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DerAnaesthesist.60450420.eng.abstr
|
DerAnaesthesist.60450420.eng.abstr
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620
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[] |
[] |
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] |
DerAnaesthesist.60450428.eng.abstr
|
DerAnaesthesist.60450428.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450428.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A combination of epidural opioids with local anaesthetics has been used to improve pain relief during labor and to reduce side effects , such as muscle weakness , usually seen when local anaesthetics are used alone . The addition of epidural fentanyl ( F ) produces highly effective analgesia , the only side effect being mild itching . Initial trials investigated the improvement in analgesia after a single administration of F during first- but not during second-stage labor . Even though pain perception during second-stage labor under epidural analgesia with local anaesthetics can be severe , the addition of opioids was avoided for fear of neonatal or maternal depression . A recent report found maternal and umbilical plasma concentrations following injection of 100 µg F to be safe and the investigators speculated that repeated addition of epidural/F to injections of local anaesthetic may prove beneficial for the parturient without exposing the mother or fetus to risk . We therefore studied maternal analgesia , maternal and umbilical plasma levels and associated side effects following repeated addition of 100 µg F to bupivacaine epidural analgesia during labor . Methods . Following institutional and governmental approval 53 parturients were randomly assigned to receive either 8 ml bupivacaine 0.25%+0.1 mg fentanyl ( B+F group ; n=28) or 8 ml bupivacaine 0.25%+2 ml saline ( BUP group ; n=25) in an epidural catheter at L2/3. The same dose was reinjected upon the patients ' request regardless of the degree of cervical dilatation . Blood pressure , heart rate , respiratory rate and the incidence of side effects were recorded before and following each epidural injection . Pain relief was determined at each injection and following cord clamping using the visual analogue pain scale ( VAS ; 0-100 mm ) . Maternal venous blood samples were collected to measure plasma F concentrations before and 20 and 40 min after each injection and at birth when umbilical venous and arterial blood was obtained . After centrifugation the samples were maintained at -20 ° C and then analyzed by radioimmunoassay . At delivery , Apgar scores and umbilical venous and arterial blood gas values were determined . Results . Both groups were comparable for age , weight , height , gestational age and parity . A total of 48 epidural injections were evaluated in the B+F group , 43 in the BUP group . No statistically significant group difference was found between the frequency of injections per delivery ( B+F : 2.2 ; BUP : 1.8 ) ; regarding the time between the initial and the first top-up dose ( B+F : 144 min ; BUP : 140 min ) or regarding the interval between the last injection and birth ( B+F : 94 min ; BUP ; 90 min ) . However , the quality of pain relief during labor and particularly at birth was significantly improved by F ( mean VAS in B+F group : 6 mm ; mean VAS in BUP group : 42 mm ) . Mild itching was observed in 43% of patients receiving F , moderate shivering in 13% versus 40% in patients not receiving F. At control mean maternal F plasma levels were not zero but 0.25 ng/ml . After the initial injection and following the first and second top-up dose mean maximum maternal F plasma concentrations were 0.54 ng/ml ( +/- 0.32 ; +/- SD ) , 0.88 ng/ml ( +/- 0.62 ) and 1.06 ng/ml ( +/- 0.4 ) ( range 0.18-2.76 ng/ml ) , respectively . The increase in maternal F concentrations with increasing injection frequency was statistically significant ( P 0.02 ) . Mean umbilical venous and arterial F concentrations at birth were 0.72 ng/ml ( +/- 1.16 ) and 0.62 ng/ml ( +/- 0.52 ) . No significant group differences were found regarding Apgar scores or umbilical blood gas analyses . In one newborn , radioimmunoassay resulted in unexplainably high umbilical F concentrations without any clinical signs of sedation , depressed vigilance and without any sequellae ."
],
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0,
3878
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}
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26,
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"id": "DerAnaesthesist.60450428.eng.abstr-s1-t2",
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"id": "DerAnaesthesist.60450428.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"labor"
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102,
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"id": "DerAnaesthesist.60450428.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"muscle"
],
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145,
151
]
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}
]
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{
"id": "DerAnaesthesist.60450428.eng.abstr-s1-t6",
"type": "umlsterm",
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"weakness"
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"id": "DerAnaesthesist.60450428.eng.abstr-s1-t8",
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"id": "DerAnaesthesist.60450428.eng.abstr-s1-t9",
"type": "umlsterm",
"text": [
"side effects"
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"id": "DerAnaesthesist.60450428.eng.abstr-s1-t10",
"type": "umlsterm",
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145,
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"id": "DerAnaesthesist.60450428.eng.abstr-s2-t1",
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"id": "DerAnaesthesist.60450428.eng.abstr-s4-t7",
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"fear"
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638,
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"type": "umlsterm",
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"id": "DerAnaesthesist.60450428.eng.abstr-s4-t9",
"type": "umlsterm",
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539,
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},
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"id": "DerAnaesthesist.60450428.eng.abstr-s4-t11",
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DerAnaesthesist.60450437.eng.abstr
|
DerAnaesthesist.60450437.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450437.eng.abstr-passage-0",
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"Mortality of severe acute respiratory distress syndrome ( ARDS ) in Germany is about 60% . Respiratory therapy can make the lung injury worse by high positive airway pressures , high tidal volumes and high inspiratory oxygen concentrations . Extracorporeal membrane oxygenation ( ECMO ) was employed to reduce aggressive mechanical ventilation , but it has not been proved to be superior to conventional ventilation . However , encouraged by recently developed improvements in the technique and concept of ECMO , we introduced this therapy into our program for the treatment of ARDS . Patients and methods . All patients with severe ARDS ( lung injury score > 2.5 ) admitted to our multidisciplinary intensive care unit from March 1992 to March 1995 were evaluated prospectively . After admission , the patients first underwent a conventional therapeutic approach , including pressure-controlled inverse-ratio ventilation , permissive hypercapnia , changes in body position ( in particular , the prone position ) , negative fluid balance , antibiotics , and low-dose hydrocortisone infusion . ECMO via a covalently heparin-coated , venovenous bypass-system with a vortex pump and two membrane lungs was performed if ARDS did not improve after 24-96 h of conventional therapy and if two of three of the slow-entry criteria for ECMO were fulfilled : ( 1 ) PaO2/FiO2 150 mmHg at PEEP > 5 mbar ; ( 2 ) semistatic compliance 30 ml/mbar ; ( 3 ) right-left shunt > 30% . Only in cases of life-threatening hypoxemia ( PaO2 50 mmHg at FiO2 1.0 and PEEP > 5 mbar for > 2 h ( fast-entry criteria ) was ECMO instituted immediately . Results . Sixty patients fulfilled the entry criteria for our study . Thirty-nine patients were treated with a conventional protocol , 37 after improvement of ARDS and 2 who had not improved but in whom there were contraindications to the use of ECMO . ECMO was performed in 10 patients who had not improved , but who fulfilled the slow-entry criteria and in 11 primarily hypoxemic patients who fulfilled the fast-entry criteria . The survival rate was 30/39 ( 77% ) for the conventional therapy group , 6/10 ( 60% ) for the slow-entry group , and 11/11 ( 100% ) for the fast-entry group . The onset of ECMO allowed a significant decrease in peak and mean airway pressures , tidal volume , ventilatory rate , minute volume and inspiratory oxygen concentration . Sufficient gas exchange was provided , and pulmonary artery pressures significantly decreased on bypass . The most frequent complications on bypass were pneumothorax ( 15/21 patients ) and bleeding ( 7/21 patients ) . Conclusion . In comparison with the historical results at our own institution , the present study demonstrates an improvement in the survival rate from 56% to 78% since ECMO has become available . We conclude that venovenous ECMO with a heparin-bonded bypass circuit is an effective additional option for the treatment of patients with severe ARDS ."
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DerAnaesthesist.60450449.eng.abstr
|
DerAnaesthesist.60450449.eng.abstr
|
[
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"id": "DerAnaesthesist.60450449.eng.abstr-passage-0",
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"Administration of highly concentrated , highly potent , and therefore highly dangerous drugs with syringe pumps is common in modern anaesthesia as well as in intensive care and emergency medicine . Because of their exact flow rates down to 1 ml/h , these pumps are predestined for delivery of drugs with short half-lives , such as catecholamines and vasodilators . But intravenous application of drugs with syringe pumps is not without problems . While it is well known that syringes not fixed correctly into the pump can empty themselves by the influence of gravity , it seems not to be known that hydrostatic pressure can influence the flow rate of a correctly connected system even during continuous infusion . In this situation a change of height of the syringe pump in relation to the patient's position can have tremedous effects on hemodynamics due to unintended acceleration or deceleration of the flow rate . This case report demonstrates that the elevation of a connected epinephrine pump while moving a cardiac surgery patient after ACB operation from the operation table into his bed led to critical increases of heart rate , blood pressure and left atrial pressure . In order to quantify the problem we repeated the situation experimentally . It could be demonstrated that the elevation of the syringe pump by 80-100 cm delivers an additional bolus of 4-5 drops as the central venous catheter outlet . Lowering the pump consecutively leads to the opposite effect . In the case reported , the accidentally administered bolus of epinephrine was 12-15 µg ( we use a concentration of 60 µg/ml epinephrine for continuous infusion with syringe pumps ) . From this accidental observation the following conclusion can be drawn : The change of height , in relation to the patient's position , of a running syringe pump during continuous infusion of highly concentrated cardiovascular drugs may cause considerable , even life-threatening hemodynamic disorders . Even in a closed infusion system ( syringe-extension-central venous catheter ) , hydrostatic pressure influences infusion rate . Elevation of the pump leads to unintended bolus administration , and lowering of the pump is followed by an interruption of the infusion . In the knowledge of this phenomenon , unexpected hemodynamic reactions during transport of critically ill patients cannot always be interpreted as a result of inadequate anesthesia or volume load , but may be a consequence of incorrect handling of the syringe pumps as described in this report ."
],
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0,
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]
]
}
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DerAnaesthesist.60450453.eng.abstr
|
DerAnaesthesist.60450453.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450453.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Using the PTB simulator , which emits real signals from patients , we examined the precision of the oscillometric blood pressure measurement with the Dinamap 1846 ( Critikon ) and the HP M-1008B ( Hewlett Packard ) . For this purpose we simultaneously registered invasive arterial pulsewave , cuff pressure and cuff pressure oscillations of 20 patients from our intensive care unit and stored them in the database of the simulator . The invasive reference blood pressure values were determined following the recommendations given by the Association for the Advancement of Medical Instrumentation . The invasive system showed a cut-off frequency of 35 Hz ; the damping constant was 0.21. With 49 record signals from patients we carried out 15 simulated measurements each . From a total of 49 bio-signals from patients the Dinamap 1846 was able to process 41 signals and the HP M-1008B 47 signals . The mean error of the oscillometric blood pressure measurement of the systolic , diastolic and mean arterial pressure amounted to -2 . 50 mmHg , 3.35 mmHg ( P 0.05 ) and 1.51 mmHg with the Dinamap 1846 and to -8 . 5 mmHg ( P 0.001 ) , -5 . 15 mmHg ( P 0.001 ) and -5 . 58 mmHg ( P 0.001 ) for the HP M-1008B. The 95% confidence limit for the systolic , diastolic and the mean arterial pressure amounts to 56 mmHg , 30 mmHg and 35 mmHg for the Dinamap 1846 and 50 mmHg , 38 mmHg and 35 mmHg for the HP M-1008B. The differences between that two instruments could be caused by the different algorithms for the calculation of blood pressure values and different artefact detection and elimination techniques . The results of the performance tests we achieved with the PTB simulator correspond to the results of other clinical examinations . The American Association for the Advanecement of Medical Instrumentation recommends a maximum mean error of 5 +/- 8 mmHg . None of the examined instruments lay within these limits . Due to the systematic and stochastic errors , we think that the Dinamap 1846 ( Critikon ) and the HP M-1008B ( Hewlett Packard ) do not achieve performance levels that are adequate for measuring critically ill patients ."
],
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[
0,
2136
]
]
}
] |
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DerAnaesthesist.60450460.eng.abstr
|
DerAnaesthesist.60450460.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450460.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Postoperatively , after an uncomplicated vaginal hysterectomy , a 58-year-old female patient developed the signs of disseminated intravascular coagulation and fever , which progressed to a septic shock . She received two units of autologous blood , one during and one after the operation . A blood culture from the patient and one unit of the autologous blood showed abundant growth of Pseudomonas cepacia and Serratia marcescens within 24 h and culture of this blood bag also showed slight growth of Staphylococcus epidermidis within 48 h . Culture of the second blood unit showed slight growth of Propionibacterium acnes . The source of bacterial contamination could not be identified . Autologous blood products thus also include a risk of infection that shouldn ' t be underestimated , and a strict medical indication to retransfusion is indispensable ."
],
"offsets": [
[
0,
857
]
]
}
] |
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DerAnaesthesist.60450495.eng.abstr
|
DerAnaesthesist.60450495.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450495.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The treatment of cancer pain with opioids is well accepted . However , the use of opioids for the treatment of non-cancer pain is still a matter of controversy . The main matters of concern are physical dependence and opioid abuse . Another argument against opioids is the lack of efficacy . Experiences with opioids in non-cancer pain have been published on about 850 patients , the longest therapy lasting almost 14 years . 85% of the patients treated with opioids had beneficial effects . In a number of investigations evaluating the opioid sensibility of pain by PCA and intravenous infusions , 67-80% of the patients with neuropathic pain responded to opioids . The efficacy of opioids in the treatment of non-cancer pain was proven in 3 placebo controlled studies . In 2 studies pain reduction in neuropathic pain was similar to that in nociceptive pain . When opioids are used , the administration has to be performed according to well defined standards . The indication for opioids must be made by a specialist in pain management . The diagnosis must clearly reveal an organic origin of the pain . Before the start of therapy the duration as well as the criteria for discontinuation must be set up . The treatment must be controlled by a specialist team and frequent regular follow up investigations must be performed . These must include proper documentation of the pain level , changes in patients ' function and in social activities . The reliable intake of prescribed medication must be assured if necessary by laboratory screening . The treatment of non-cancer pain with opioids may be an alternative for those patients , who didn ' t gain sufficient reduction of pain by other therapies . Standards for this therapy are an absolute necessity and are to be followed closely ."
],
"offsets": [
[
0,
1788
]
]
}
] |
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] |
DerAnaesthesist.60450512.eng.abstr
|
DerAnaesthesist.60450512.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450512.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Prompted by the ongoing discussion of the pros and cons of using succinylcholine , this study was conducted to compare the responses to bolus injections of atracurium or vecuronium with those after sequential injection of these drugs ( priming principle ) . We evaluated the earliest possible intubation times , intubating conditions , and the onset times ( i.e. times from the end of injection to the maximum blockade ) under conditions approaching real use as closely as possible . Methods . The randomized and double-blind study was carried out with 80 ASA risk class 1 and 2 patients . Approval of the institutional ethics committee was obtained , and each patient gave informed consent . Patients were randomly allocated to four study groups of 20 patients each . Isotonic saline was administered to those patients assigned to the atracurium or vecuronium bolus groups , whereas the patients assigned to the other two groups received a priming injection of either atracurium ( 0.05 mg/kg ) or vecuronium ( 0.01 mg/kg ) . We observed the patients for signs of incipient muscular weakness before the induction of anaesthesia . Anaesthesia was induced with thiopental 3.5 min after the first injection ( 5 mg/kg and 50-100 mg before intubation ) . After a further 1 min during which adequate mask ventilatin with oxygen was assured , corresponding to a priming interval of 4.5 min , 0.5 mg/kg of atracurium or 0.1 mg/kg of vecuronium was administered to the patients in the bolus groups and 0.45 mg/kg of atracurium or 0.09 mg/kg of vecuronium as intubating doses to those in the priming groups . Intubation was attempted at 90 , 120 , 150 and 180 s thereafter . Intubating conditions were evaluated on the basis of laryngoscopy , vocal cord movement and coughing or bucking of the patients . Neuromuscular function was monitored via accelerometry at the adductor pollicis muscle ( TOF stimulation of the ulnar nerve every 15 s ) . Results . The priming doses did not diminish the elicited twitches of the adductor pollicis muscle , but led to heavy eyelids and double vision in 35% of the atracurium patients and 47% of the vecuronium patients ; these symptoms were well tolerated by the patients . At the time of intubation the adductor pollicis muscle was relaxed to approximately the same degree in all groups ( mean +/- SD for the TOF ratios in the bolus groups was 0.46 +/- 0.37 for atracurium , 0.45 +/- 0.4 for vecuronium ; in the priming groups 0.52 +/- 0.39 for atracurium , 0.53 +/- 0.36 for vecuronium ) . The administration of the relaxants in divided doses significantly shortened the intubating time after atracurium ( 100 vs 124 s ) and improved the intubating conditions of vecuronium ( good vs tolerable ) , but had no effect on the time course of the neuromuscular blockade ( onset times in the bolus groups 224 +/- 84 s for atracurium and 209 +/- 64 s for vecuronium ; in the priming groups 249 +/- 112 s for atracurium and 205 +/- 52 s for vecuronium ) . Conclusions . The priming technique presented here is clinically superior to the bolus method and therefore should be preferred in all elective cases and in those patients in whom succinylcholine is contraindicated ."
],
"offsets": [
[
0,
3194
]
]
}
] |
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DerAnaesthesist.60450526.eng.abstr
|
DerAnaesthesist.60450526.eng.abstr
|
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"As it is the driving force in the development of a multiorgan dysfunction syndrome ( MODS ) , the gastro-intestinal region is at the centre of current discussion . Recently , hepatovenous oximetry has been used increasingly to monitor the relationship between oxygen supply and consumption in the splanchnic system . In the present paper we report an exclusively oximetrically controlled catheterisation procedure that can be carried out at the bedside without the use of imaging procedures . In the inferior vena cava a typical venous oxygen saturation profile can be expected . Near the opening of renal veins there is a peak in venous saturation due to the large extent to which the kidneys partake in the cardiac output and their relatively low oxygen consumption . Correspondingly there is a significant drop in saturation in the area around the opening of the hepatic veins . At the right atrium the oxygen saturation increases again due to admixing of more highly saturated blood from the superior vena cava . Taking these physiological facts into consideration it was attempted to find the opening of the hepatic veins into the inferior vena cava using only continuous in vivo oximetry and to insert a hepatovenous catheter ."
],
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0,
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"normalized": []
},
{
"id": "DerAnaesthesist.60450526.eng.abstr-s7-r18-t4.1-t2.1",
"type": "produces",
"arg1_id": "DerAnaesthesist.60450526.eng.abstr-s8-t4",
"arg2_id": "DerAnaesthesist.60450526.eng.abstr-s8-t2",
"normalized": []
},
{
"id": "DerAnaesthesist.60450526.eng.abstr-s7-r19-t1.1-t2.1",
"type": "interacts_with",
"arg1_id": "DerAnaesthesist.60450526.eng.abstr-s8-t1",
"arg2_id": "DerAnaesthesist.60450526.eng.abstr-s8-t2",
"normalized": []
},
{
"id": "DerAnaesthesist.60450526.eng.abstr-s7-r20-t4.2-t6.1",
"type": "connected_to",
"arg1_id": "DerAnaesthesist.60450526.eng.abstr-s7-t4",
"arg2_id": "DerAnaesthesist.60450526.eng.abstr-s8-t6",
"normalized": []
},
{
"id": "DerAnaesthesist.60450526.eng.abstr-s7-r21-t4.1-t6.1",
"type": "developmental_form_of",
"arg1_id": "DerAnaesthesist.60450526.eng.abstr-s8-t4",
"arg2_id": "DerAnaesthesist.60450526.eng.abstr-s8-t6",
"normalized": []
},
{
"id": "DerAnaesthesist.60450526.eng.abstr-s7-r22-t2.1-t4.1",
"type": "disrupts",
"arg1_id": "DerAnaesthesist.60450526.eng.abstr-s8-t2",
"arg2_id": "DerAnaesthesist.60450526.eng.abstr-s8-t4",
"normalized": []
},
{
"id": "DerAnaesthesist.60450526.eng.abstr-s7-r23-t4.2-t4.1",
"type": "derivative_of",
"arg1_id": "DerAnaesthesist.60450526.eng.abstr-s7-t4",
"arg2_id": "DerAnaesthesist.60450526.eng.abstr-s8-t4",
"normalized": []
},
{
"id": "DerAnaesthesist.60450526.eng.abstr-s7-r24-t2.1-t3.1",
"type": "interacts_with",
"arg1_id": "DerAnaesthesist.60450526.eng.abstr-s8-t2",
"arg2_id": "DerAnaesthesist.60450526.eng.abstr-s8-t3",
"normalized": []
},
{
"id": "DerAnaesthesist.60450526.eng.abstr-s7-r25-t3.2-t1.1",
"type": "uses",
"arg1_id": "DerAnaesthesist.60450526.eng.abstr-s7-t3",
"arg2_id": "DerAnaesthesist.60450526.eng.abstr-s8-t1",
"normalized": []
},
{
"id": "DerAnaesthesist.60450526.eng.abstr-s7-r26-t4.1-t1.1",
"type": "produces",
"arg1_id": "DerAnaesthesist.60450526.eng.abstr-s8-t4",
"arg2_id": "DerAnaesthesist.60450526.eng.abstr-s8-t1",
"normalized": []
},
{
"id": "DerAnaesthesist.60450526.eng.abstr-s7-r27-t4.1-t8.1",
"type": "developmental_form_of",
"arg1_id": "DerAnaesthesist.60450526.eng.abstr-s8-t4",
"arg2_id": "DerAnaesthesist.60450526.eng.abstr-s7-t8",
"normalized": []
},
{
"id": "DerAnaesthesist.60450526.eng.abstr-s7-r28-t4.2-t2.1",
"type": "consists_of",
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"arg2_id": "DerAnaesthesist.60450526.eng.abstr-s8-t2",
"normalized": []
},
{
"id": "DerAnaesthesist.60450526.eng.abstr-s7-r29-t1.1-t6.1",
"type": "disrupts",
"arg1_id": "DerAnaesthesist.60450526.eng.abstr-s8-t1",
"arg2_id": "DerAnaesthesist.60450526.eng.abstr-s8-t6",
"normalized": []
},
{
"id": "DerAnaesthesist.60450526.eng.abstr-s7-r30-t2.1-t1.1",
"type": "interacts_with",
"arg1_id": "DerAnaesthesist.60450526.eng.abstr-s8-t2",
"arg2_id": "DerAnaesthesist.60450526.eng.abstr-s8-t1",
"normalized": []
},
{
"id": "DerAnaesthesist.60450526.eng.abstr-s8-r1-t3.1-t4.1",
"type": "uses",
"arg1_id": "DerAnaesthesist.60450526.eng.abstr-s8-t3",
"arg2_id": "DerAnaesthesist.60450526.eng.abstr-s8-t4",
"normalized": []
}
] |
DerAnaesthesist.60450533.eng.abstr
|
DerAnaesthesist.60450533.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450533.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The action of local anaesthetics on isolated nerves is enhanced by high stimulation frequencies . The aim of our study was to investigate whether high-frequency stimulation enhances regional anaesthesia in man ."
],
"offsets": [
[
0,
211
]
]
}
] |
[
{
"id": "DerAnaesthesist.60450533.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"anaesthetics"
],
"offsets": [
[
20,
32
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0002932"
}
]
},
{
"id": "DerAnaesthesist.60450533.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"nerves"
],
"offsets": [
[
45,
51
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0027769"
}
]
},
{
"id": "DerAnaesthesist.60450533.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"frequencies"
],
"offsets": [
[
84,
95
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0376249"
}
]
},
{
"id": "DerAnaesthesist.60450533.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"local anaesthetics"
],
"offsets": [
[
14,
32
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0002934"
},
{
"db_name": "UMLS",
"db_id": "C0002921"
}
]
},
{
"id": "DerAnaesthesist.60450533.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"aim"
],
"offsets": [
[
102,
105
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0108800"
}
]
},
{
"id": "DerAnaesthesist.60450533.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"man"
],
"offsets": [
[
206,
209
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0025266"
},
{
"db_name": "UMLS",
"db_id": "C0024554"
}
]
},
{
"id": "DerAnaesthesist.60450533.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"regional anaesthesia"
],
"offsets": [
[
182,
202
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0002911"
}
]
}
] |
[] |
[] |
[
{
"id": "DerAnaesthesist.60450533.eng.abstr-s1-r1-t1.1-t2.1",
"type": "affects",
"arg1_id": "DerAnaesthesist.60450533.eng.abstr-s2-t1",
"arg2_id": "DerAnaesthesist.60450533.eng.abstr-s2-t2",
"normalized": []
},
{
"id": "DerAnaesthesist.60450533.eng.abstr-s1-r2-t2.1-t3.1",
"type": "occurs_in",
"arg1_id": "DerAnaesthesist.60450533.eng.abstr-s2-t2",
"arg2_id": "DerAnaesthesist.60450533.eng.abstr-s2-t3",
"normalized": []
},
{
"id": "DerAnaesthesist.60450533.eng.abstr-s1-r3-t1.1-t2.1",
"type": "treats",
"arg1_id": "DerAnaesthesist.60450533.eng.abstr-s2-t1",
"arg2_id": "DerAnaesthesist.60450533.eng.abstr-s2-t2",
"normalized": []
},
{
"id": "DerAnaesthesist.60450533.eng.abstr-s1-r4-t3.1-t2.1",
"type": "result_of",
"arg1_id": "DerAnaesthesist.60450533.eng.abstr-s2-t3",
"arg2_id": "DerAnaesthesist.60450533.eng.abstr-s2-t2",
"normalized": []
},
{
"id": "DerAnaesthesist.60450533.eng.abstr-s1-r5-t4.2-t1.1",
"type": "uses",
"arg1_id": "DerAnaesthesist.60450533.eng.abstr-s1-t4",
"arg2_id": "DerAnaesthesist.60450533.eng.abstr-s2-t1",
"normalized": []
},
{
"id": "DerAnaesthesist.60450533.eng.abstr-s1-r6-t4.2-t2.1",
"type": "affects",
"arg1_id": "DerAnaesthesist.60450533.eng.abstr-s1-t4",
"arg2_id": "DerAnaesthesist.60450533.eng.abstr-s2-t2",
"normalized": []
},
{
"id": "DerAnaesthesist.60450533.eng.abstr-s1-r7-t4.2-t2.1",
"type": "treats",
"arg1_id": "DerAnaesthesist.60450533.eng.abstr-s1-t4",
"arg2_id": "DerAnaesthesist.60450533.eng.abstr-s2-t2",
"normalized": []
},
{
"id": "DerAnaesthesist.60450533.eng.abstr-s1-r8-t4.2-t2.1",
"type": "uses",
"arg1_id": "DerAnaesthesist.60450533.eng.abstr-s1-t4",
"arg2_id": "DerAnaesthesist.60450533.eng.abstr-s2-t2",
"normalized": []
},
{
"id": "DerAnaesthesist.60450533.eng.abstr-s2-r1-t1.1-t2.2",
"type": "performs",
"arg1_id": "DerAnaesthesist.60450533.eng.abstr-s2-t1",
"arg2_id": "DerAnaesthesist.60450533.eng.abstr-s2-t2",
"normalized": []
}
] |
DerAnaesthesist.60450538.eng.abstr
|
DerAnaesthesist.60450538.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450538.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Even today , adequate postoperative analgesia is still a great problem . Based on positive results of former studies using a continuous infusion of tramadol for postoperative pain relief [ 2 , 15 ] , we aimed to improve this regimen . In order to investigate the effectiveness of preventive analgesia , one group of patients was given 100 mg tramadol ( Tramal ) at the time of extubation , followed by a maintenance infusion . The other group was treated with single boluses of tramadol on demand , thus representing common pain treatment ."
],
"offsets": [
[
0,
540
]
]
}
] |
[
{
"id": "DerAnaesthesist.60450538.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"postoperative"
],
"offsets": [
[
22,
35
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0032790"
}
]
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"analgesia"
],
"offsets": [
[
36,
45
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0002766"
}
]
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"tramadol"
],
"offsets": [
[
148,
156
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0040610"
}
]
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"postoperative"
],
"offsets": [
[
161,
174
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0032790"
}
]
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"pain"
],
"offsets": [
[
175,
179
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030193"
}
]
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"postoperative pain"
],
"offsets": [
[
161,
179
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030201"
}
]
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"preventive"
],
"offsets": [
[
280,
290
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0033110"
}
]
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"analgesia"
],
"offsets": [
[
291,
300
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0002766"
}
]
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"patients"
],
"offsets": [
[
316,
324
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s3-t4",
"type": "umlsterm",
"text": [
"tramadol"
],
"offsets": [
[
342,
350
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0040610"
}
]
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s3-t5",
"type": "umlsterm",
"text": [
"Tramal"
],
"offsets": [
[
353,
359
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0040611"
}
]
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s3-t6",
"type": "umlsterm",
"text": [
"time"
],
"offsets": [
[
369,
373
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0040223"
}
]
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s3-t7",
"type": "umlsterm",
"text": [
"maintenance"
],
"offsets": [
[
404,
415
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0024501"
}
]
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"single"
],
"offsets": [
[
460,
466
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0087136"
}
]
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"tramadol"
],
"offsets": [
[
478,
486
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0040610"
}
]
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"pain"
],
"offsets": [
[
524,
528
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030193"
}
]
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s4-t4",
"type": "umlsterm",
"text": [
"treatment"
],
"offsets": [
[
529,
538
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0087111"
},
{
"db_name": "UMLS",
"db_id": "C0039798"
}
]
}
] |
[] |
[] |
[
{
"id": "DerAnaesthesist.60450538.eng.abstr-s2-r1-t1.1-t4.1",
"type": "treats",
"arg1_id": "DerAnaesthesist.60450538.eng.abstr-s4-t1",
"arg2_id": "DerAnaesthesist.60450538.eng.abstr-s4-t4",
"normalized": []
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s2-r2-t1.1-t4.1",
"type": "diagnoses",
"arg1_id": "DerAnaesthesist.60450538.eng.abstr-s4-t1",
"arg2_id": "DerAnaesthesist.60450538.eng.abstr-s4-t4",
"normalized": []
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s2-r3-t3.1-t4.1",
"type": "associated_with",
"arg1_id": "DerAnaesthesist.60450538.eng.abstr-s4-t3",
"arg2_id": "DerAnaesthesist.60450538.eng.abstr-s4-t4",
"normalized": []
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s2-r4-t1.1-t3.1",
"type": "treats",
"arg1_id": "DerAnaesthesist.60450538.eng.abstr-s4-t1",
"arg2_id": "DerAnaesthesist.60450538.eng.abstr-s4-t3",
"normalized": []
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s2-r5-t1.1-t4.1",
"type": "affects",
"arg1_id": "DerAnaesthesist.60450538.eng.abstr-s4-t1",
"arg2_id": "DerAnaesthesist.60450538.eng.abstr-s4-t4",
"normalized": []
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s2-r6-t4.1-t3.1",
"type": "associated_with",
"arg1_id": "DerAnaesthesist.60450538.eng.abstr-s4-t4",
"arg2_id": "DerAnaesthesist.60450538.eng.abstr-s4-t3",
"normalized": []
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s3-r1-t3.1-t1.1",
"type": "issue_in",
"arg1_id": "DerAnaesthesist.60450538.eng.abstr-s4-t3",
"arg2_id": "DerAnaesthesist.60450538.eng.abstr-s4-t1",
"normalized": []
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s3-r2-t5.1-t4.1",
"type": "interacts_with",
"arg1_id": "DerAnaesthesist.60450538.eng.abstr-s3-t5",
"arg2_id": "DerAnaesthesist.60450538.eng.abstr-s4-t4",
"normalized": []
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s3-r3-t2.1-t1.1",
"type": "method_of",
"arg1_id": "DerAnaesthesist.60450538.eng.abstr-s4-t2",
"arg2_id": "DerAnaesthesist.60450538.eng.abstr-s4-t1",
"normalized": []
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s3-r4-t2.1-t4.1",
"type": "uses",
"arg1_id": "DerAnaesthesist.60450538.eng.abstr-s4-t2",
"arg2_id": "DerAnaesthesist.60450538.eng.abstr-s4-t4",
"normalized": []
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s3-r5-t4.1-t5.1",
"type": "interacts_with",
"arg1_id": "DerAnaesthesist.60450538.eng.abstr-s4-t4",
"arg2_id": "DerAnaesthesist.60450538.eng.abstr-s3-t5",
"normalized": []
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s3-r6-t2.1-t7.1",
"type": "isa",
"arg1_id": "DerAnaesthesist.60450538.eng.abstr-s4-t2",
"arg2_id": "DerAnaesthesist.60450538.eng.abstr-s3-t7",
"normalized": []
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s3-r7-t4.1-t1.1",
"type": "issue_in",
"arg1_id": "DerAnaesthesist.60450538.eng.abstr-s4-t4",
"arg2_id": "DerAnaesthesist.60450538.eng.abstr-s4-t1",
"normalized": []
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s3-r8-t2.1-t5.1",
"type": "uses",
"arg1_id": "DerAnaesthesist.60450538.eng.abstr-s4-t2",
"arg2_id": "DerAnaesthesist.60450538.eng.abstr-s3-t5",
"normalized": []
},
{
"id": "DerAnaesthesist.60450538.eng.abstr-s3-r9-t2.1-t3.1",
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DerAnaesthesist.60450545.eng.abstr
|
DerAnaesthesist.60450545.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450545.eng.abstr-passage-0",
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"The number of patients with congenital cyanotic heart disease who reach child-bearing age is increasing . This is partly a consquence of the high long-term survival and the haemodynamic benefits resulting from the Fontan procedure , which is used for the definitive palliation of such cyanotic heart disease as tricuspid atresia and single ventricle . However , so far little experience has been recorded with pregnant patients who have undergone right ventricular exclusion procedures . The particular physiology of a univentricular heart and a passive , non-pulsatile blood flow through the lungs has significant implications for the anaesthetic obstetric management of these patients . We report a case of successful pregnancy and caesarean delivery after a modified Fontan procedure ."
],
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0,
788
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]
}
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] |
[] |
[] |
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] |
DerAnaesthesist.60450550.eng.abstr
|
DerAnaesthesist.60450550.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450550.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Selecting a route for drug administration during CPR requires consideration of the speed with which access can be obtained , the technical difficulties involved in performing the procedure , the associated risk of complications , delays in drug delivery to the central circulation , and the duration of effective drug levels following injection . The peripheral venous route is the safest method , and drug delivery can be enhanced by a fluid bolus after injection of the medication . The circulation time is shortest after central venous injection , but there is some risk of complications . The femoral route is associated with a high incidence of unsuccessful catherization . The endotracheal tube provides an accessible route for administration of most drugs , but peak concentrations are lower than those obtained by other routes . While the results are almost the same as an intravenous injection , the intraosseous route is currently underrepresented in clinical practice . This method must not only be considered in pediatric patients , but in adult patients as well ."
],
"offsets": [
[
0,
1076
]
]
}
] |
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] |
[] |
[] |
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] |
DerAnaesthesist.60450587.eng.abstr
|
DerAnaesthesist.60450587.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450587.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Immediate-type hypersensitivity due to natural rubber ( latex ) products is an increasing problem for the anaesthetist , because a major part of products used for anaesthesia contains natural rubber . If the patient has a positive history of allergic symptoms after contact to natural rubber like urticaria , bronchospasm or anaphylaxis , preoperative skin tests , in vitro-tests , and if necessary even latex-glove wearing-test should be performed . If preoperative diagnosis of natural latex allergy is established , latex free anaesthesia is strictly recommended , otherwise life-threatening complications may ensue . Accordingly , we report on a patient who developed intraoperative anaphylactic shock following exposure to natural latex . In addition to the treatment with drugs , latex-containing products should be immediately replaced by latex free ones , in particular all persons should put on latexfree gloves . For prevention of anaphylactic episodes in sensitized patients the reader is provided an examplary list of latexfree products for anaesthesia . Because the incidence of immediate-type reactions to latex is still increasing , intraoperative occurence of an anaphylactic reaction to an unknown agent is likely to be due to allergy to natural rubber ."
],
"offsets": [
[
0,
1271
]
]
}
] |
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] |
DerAnaesthesist.60450597.eng.abstr
|
DerAnaesthesist.60450597.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450597.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Increased perception of the risks of homologous blood transfusion has focused substantial interest on autologous blood transfusion ( ABT ) . To evaluate the role of ABT in the Federal Republic of Germany ( FRG ) , we conducted postal surveys of German hospitals in 1989 and 1993. In the present study , the responses of 143 hospitals in the \" old \" federal states ( former West Germany ) that replied to both of our surveys were analysed . The objective was to examine trends in ABT practice in the FRG from 1989 to 1993. The study was restricted to the \" old \" federal states because data for the \" new \" federal states ( former German Democratic Republic ) were not available for that period . Methods . Data presented in this study were obtained by postal surveys of German hospitals in 1989 and 1993. Because of German reunification ( 3 October 1990 ) , only hospitals in the \" old \" federal states were surveyed in 1989 , while hospitals in both the \" old \" and \" new \" states were included in 1993. Four hundred randomly selected hospitals in the \" old \" federal states were included in both surveys , 143 of which responded to both . The completed questionaires of these 143 hospitals were analysed . In addition , to estimate the magnitude of positive selection bias , the data provided by these 143 hospitals were compared with data provided by another set of 162 hospitals in the \" old \" federal states that replied to the 1993 but not to the 1989 survey . Results . There were no significant changes from 1989 to 1993 in the 143 hospitals with respect to hospital size by number of beds and spectrum of surgical specialties . The proportion of hospitals that performed preoperative autologous blood donation grew by 20% ( from 74% to 89% ) and the proportion that used this technique regularly ( \" frequently \" and \" mostly \" ) rose by 80% ( from 25% to 45% ) . The percentage of hospitals that performed preoperative plasmapheresis had more than doubled ( from 8% to 19% ) . The proportion that used acute isovolaemic haemodilution grew by 32% ( from 62% to 82% ) , while those doing so regularly ( \" frequently \" and \" mostly \" ) increased by only 17% ( from 23% to 27% ) . The fraction of hospitals equipped with cell-washing devices grew by 29% ( from 35% to 45% ) . General transfusion practice , as measured by acceptance of postoperative haemoglobin levels of less than 10.0g/dl, had changed but little . Conclusions . Although the 143 hospitals are not representative on a national level , the findings of our study allow some conclusions on general trends in the \" old \" states of the FRG . The potential for ABT has substantially grown in the \" old \" states from 1989 to 1993 , although more consistent advantage of this potential could be taken ."
],
"offsets": [
[
0,
2768
]
]
}
] |
[
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"text": [
"perception"
],
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10,
20
]
],
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{
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}
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},
{
"id": "DerAnaesthesist.60450597.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"risks"
],
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[
28,
33
]
],
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},
{
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"blood"
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[
48,
53
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],
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{
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},
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"id": "DerAnaesthesist.60450597.eng.abstr-s1-t4",
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"blood"
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},
{
"id": "DerAnaesthesist.60450597.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"risks of"
],
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[
28,
36
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0035647"
}
]
},
{
"id": "DerAnaesthesist.60450597.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"blood transfusion"
],
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48,
65
]
],
"normalized": [
{
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},
{
"id": "DerAnaesthesist.60450597.eng.abstr-s1-t7",
"type": "umlsterm",
"text": [
"blood transfusion"
],
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113,
130
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],
"normalized": [
{
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},
{
"id": "DerAnaesthesist.60450597.eng.abstr-s1-t8",
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"text": [
"autologous blood transfusion"
],
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102,
130
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],
"normalized": [
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"id": "DerAnaesthesist.60450597.eng.abstr-s2-t1",
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DerAnaesthesist.60450614.eng.abstr
|
DerAnaesthesist.60450614.eng.abstr
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"id": "DerAnaesthesist.60450614.eng.abstr-passage-0",
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"Recently , professional anaesthesiologists organizations , have set up recommendations for intraoperative monitoring . These recommendations are based upon the assumption that anaesthesia-related deaths are largely preventable and that extensive monitoring will reduce mortality . Hypoxaemia appears to be an important pathophysiological mechanism , and this is why oxygen monitoring is given a high priority in safety standards in anaesthesia . However , no reduction in mortality has been definitively shown to follow the use of any monitoring device in randomized , controlled trials . Four techniques of oxygen monitoring are discussed and evaluated . Oxygen monitoring during inspiration can be recommended , although its implementation will probably prevent only a few anaesthesia-related deaths . Pulse oximetry is certainly highly recommended , but also has some deficiencies which are not sufficiently well known considering the popularity of this technique . Transcutaneous PO2 is considered mainly for historical reasons . Near infrared spectrometry is a new technique offering noninvasive and continuous monitoring of intracerebral oxygenation ."
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[] |
[] |
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DerAnaesthesist.60450626.eng.abstr
|
DerAnaesthesist.60450626.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450626.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A commercially available C1 inhibitor ( C1-INH) concentrate was used for short-term prophylaxis before surgery in two patients with hereditary angioneurotic oedema . The patients suffered from recurrent subcutaneous and submucosal oedema of the face , extremities , and gastrointestinal tract as the result of a hereditary C1-INH deficiency . Both patients were receiving tranexamic acid or danazol therapy as oral long-term prophylaxis . Over the years the patients underwent several operations in regional and general anaesthesia , with mask ventilation or intubation . The C1-INH plasma concentrations measured preoperatively were always very low ( 0.02-0.06 g/l , normal range 0.15-0.35 g/l ) , despite the oral long-term prophylaxis . Substitution treatment with 500-1000 U C1-INH was performed 1 h before surgery . No side effects were seen following the concentrate infusions . With this substitution treatment no specific symptoms of hereditary angioneurotic oedema were recognized in either case . The measurement of C1-INH plasma concentration 2 h or 4 h after C1-INH substitution showed a marked rise in both patients , though normal values were not reached in either . We suggest that infusion of C1 concentrate is an appropriate form of preoperative substitution treatment in patients with hereditary angioneurotic oedema , in view of the lower risk of infection than with infusion of fresh-frozen plasma and the observed effectiveness ."
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[] |
[] |
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] |
DerAnaesthesist.60450635.eng.abstr
|
DerAnaesthesist.60450635.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450635.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Epidural anaesthesia for elective caesarean section can have advantages over general anaesthesia . The anaesthesiologist can avoid endotracheal intubation as well as fetal depression following placental transfer of systemic anaesthetics . However , despite reaching an effective blockade preoperatively , intraoperative discomfort and pain may occur during epidural anaesthesia with local anaesthetics alone , necessitating supplemental systemic analgesics or even conversion to general anaesthesia [ 21 ] . Addition of epidural fentanyl has been shown to improve onset and quality of perioperative analgesia without evident side effects for mother or newborn [ 24 ] . Nevertheless , administration of epidural opioids before cord clamping is still hotly debated , some fearing maternal and or neonatal depression [ 6 , 26 ] . The aim of the present study was to investigate the quality of analgesia , associated side effects and the resulting maternal and neonatal plasma opiate concentrations after a single preoperative addition of 0.1 mg fentanyl to epidural bupivacaine analgesia in comparison to epidural bupivacaine analgesia alone ."
],
"offsets": [
[
0,
1140
]
]
}
] |
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DerAnaesthesist.60450643.eng.abstr
|
DerAnaesthesist.60450643.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450643.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Hypoxic pulmonary vasoconstriction ( HPV ) was first described by von Euler and Liljestrand in 1946 and is still the only known vascular feedback control mechanism in the lung . This technique results in a redistribution of blood flow away from poorly ventilated areas into better ventilated regions , thus reducing shunt . HPV functions as a local mechanism that acts in response to alveolar hypoxia but in the smallest areas of the lung , making it an important mechanism in all situations where ventilation perfusion mismatch occurs . To be effective , HPV needs normal pulmonary areas into which blood flow can be diverted . This explains why the efficacy of the treatment depends on the area that is vasoconstricted . The effect on PaO2 is maximal when the amount of the hypoxic lung ist 30-70% . If the area in vasoconstriction is small , the influence on PaO2 is negligible . On the other hand , when most of the lung is hypoxic , there is no significant normoxic region to which the hypoxic region can divert flow . In that case it does not matter , in terms of PaO2, whether the hypoxic region has active hypoxic pulmonary vasoconstriction or not . In this situation HPV becomes a rather detrimental mechanism , because it causes an increase in pulmonary arterial pressure . At some stage a turning point , where the gain in PaO2 is lost due to an increase in right ventricular afterload , inducing a decrease in CO . The reaction is diminished by exogenous manipulations , drugs ( inhalation anesthetics , direct vasodilators ) , endotoxin , very low PaO2 values , vasodilating mediators and changes in the acid-base balance . Acidosis and alcalosis inhibit HPV . Factors like spontaneous or mechanical ventilation , PEEP , open or closed chest , and the type of hypoxia ( atelectasis or nitrogen ) have no influence on HPV . The small arteries , those less than 500 µm in diameter , were identified as the location of the hypoxic constriction . Pulmonary vascular smooth muscle cells in pure culture undergo reversible and repeated hypoxic constriction . Examination of a histological lung section emphasizes that the small arteries are closely surrounded by alveoli gas on the outside and by mixed venous blood on the inside . Thus , the response is believed to be accounted for by each smooth muscle cell in the pulmonary arterial wall responding proportionally to the local oxygen tension in its vicinity and depending on alveolar as well as mixed venous oxygen pressure . The biochemical intracellular mechanism remains unknown ."
],
"offsets": [
[
0,
2544
]
]
}
] |
[
{
"id": "DerAnaesthesist.60450643.eng.abstr-s1-t1",
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"Hypoxic"
],
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0,
7
]
],
"normalized": [
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},
{
"id": "DerAnaesthesist.60450643.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"vasoconstriction"
],
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18,
34
]
],
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},
{
"id": "DerAnaesthesist.60450643.eng.abstr-s1-t3",
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"text": [
"HPV"
],
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[
37,
40
]
],
"normalized": [
{
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"db_id": "C0021344"
}
]
},
{
"id": "DerAnaesthesist.60450643.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"feedback"
],
"offsets": [
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137,
145
]
],
"normalized": [
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},
{
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"text": [
"control"
],
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]
],
"normalized": [
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}
]
},
{
"id": "DerAnaesthesist.60450643.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"lung"
],
"offsets": [
[
171,
175
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0024109"
}
]
},
{
"id": "DerAnaesthesist.60450643.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"technique"
],
"offsets": [
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183,
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],
"normalized": [
{
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},
{
"id": "DerAnaesthesist.60450643.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"blood"
],
"offsets": [
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224,
229
]
],
"normalized": [
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"db_id": "C0005835"
}
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},
{
"id": "DerAnaesthesist.60450643.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"HPV"
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DerAnaesthesist.60450674.eng.abstr
|
DerAnaesthesist.60450674.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450674.eng.abstr-passage-0",
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"Recently , two new halogenated volatile anaesthetics , sevoflurane and desflurane , have been approved for clinical use in Germany . Their low solubility in blood is the most important common property , and this represents the most obvious difference from the inhalational anaesthetics currently used . Extensive clinical and experimental evaluations have confirmed the superior pharmacokinetic properties predicted . Both sevoflurane and desflurane provide more rapid emergence from anaesthesia , permit easier titration of the anaesthetic dose during maintenance and offer more rapid recovery from anaesthesia . For sevoflurane , there are additional advantages : a pleasant odor , negligible airway irritation , and excellent pharmacodynamic characteristics that even provide cardiovascular stability comparable to isoflurane . A certain disadvantage and source of potential nephrotoxicity result from the metabolism of sevoflurane ( 2-5% ) to anorganic fluoride and degradation to compound A in carbon dioxide absorbents . The extensive clinical data reported to date have revealed no evidence that sevoflurane has adverse renal effects . New insight into the pathomechanism of nephrotoxicity associated with either production of fluoride or compound A may well support clinical experience . Desflurane strongly resists in vivo metabolism and because of this it appears to be devoid of toxicity . Nevertheless , potential side-effects may result from degradation in dry absorbents and subsequent release of CO , from its extreme pungency and irritating airway effects . Thus , desflurane is not recommended for induction of anaesthesia , especially in children . The tendency for desflurane transiently to stimulate sympathetic activity , especially at concentrations above 1.0 MAC , limits its application in patients with cardiac disease ."
],
"offsets": [
[
0,
1845
]
]
}
] |
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] |
DerAnaesthesist.60450694.eng.abstr
|
DerAnaesthesist.60450694.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450694.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The separation of whole blood into components is the state-of-the-art in transfusion of allogeneic blood . The main reasons are the negative effects of the buffy coat and the need for FFP . Nevertheless , especially in Germany whole blood is being rejected more and more even as autologous blood . However , most of the negative effects of the buffy coat do not apply to autologous blood . Additionally , these patients usually do not develop coagulation disorders and therefore do not need plasma as a hemostatic component . On the other hand , separation into components of autologous blood leads to an increase of costs and to logistic problems that restrict autologous blood predeposit to a few institutions . Therefore , we have reviewed the literature in order to find a scientific basis for this . Methods . We analysed all articles listed by MEDLINE during the last 12 years that dealt with the quality of whole blood or red cell concentrates . In addition , all references were included that contributed relevant information to the topic . A total of 135 original articles , abstracts , reviews , letters or editorials were analysed that referred to standard preparations and storage media . In 48 papers the in vivo red cell survival was studied . 28 of which fulfilled the prerequisites to be included into a meta-analysis . The following in vitro parameters were also evaluated : pH , potassium load of the units , ATP and DPG concentration of the red cells . Results and discussion . Whole blood ( resuspended in CPDA-1) and red cell units ( stabilized in CPDA-1 or additive solutions ) with a different buffy coat or leucocyte content have comparable pH values and red cell 2,3-DPG and ATP concentrations at the end of the approved storage time . The potassium load of a whole blood unit appears to be higher than red cell concentrates , but this is to some extent caused by the higher plasma content of whole blood and is not thought to be a clinically relevant problem for patients receiving only a few units . A number of studies demonstrate that dependent upon the leucocyte content of a red cell unit , leucocyte metabolites and enzymes are released and accumulate during storage . A detrimental influence on the integrity of the red cell membrane was found in several in vitro studies . Nevertheless , a significant improvement in red cell survival by leucocyte reduction was detected by only one group . Undoubtedly , non-hemolytic febrile transfusion reactions ( NHFTR ) are generally caused by an antibody-antigen interaction due to the transfusion of allogeneic buffy coat . On the other hand , there is some evidence that non-specific immunological mechanisms such as the release of histamine or cytokines are also capable of causing NHFTR . Thus , these reactions are expected to occur in autologous blood transfusion . However , so far , there are no data about the frequency and severity of these reactions and whether they are more likely to emerge after transfusion of blood units with a particular preparation . Blood transfusions can cause septic complications due to bacterial contamination of the transfused units . These fatal but rare complications may be reduced by pre-storage filtration of blood , but there is no indication that buffy coat reduction is effective . Three cases with septic complications have been reported after autologous transfusion , in two of which red cell concentrates ( at least one was free of buffy coat ) had been used . Thus , there is no justification for the conclusion that the risk of septic complications is increased by transfusion of whole blood . After all , whole blood and red cell concentrates exhibit only minor differences in relevant in vitro parameters . Hence , a higher incidence of adverse effects following the transfusion of autologous whole blood compared to autologous red cell concentrations is unlikely . Therefore , the 24 h in vivo recovery is considered to be the most valid criterion to assess the quality of red cell preparations ."
],
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"id": "DerAnaesthesist.60450694.eng.abstr-s5-t1",
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DerAnaesthesist.60450708.eng.abstr
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DerAnaesthesist.60450708.eng.abstr
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"Several methods have been developed to quantify central anaesthetic effects and monitor awareness during general anaesthesia . The most important of these are the PRST score , calculated from changes in blood pressure , heart rate , sweating , and tear production , the isolated forearm technique , where the patient is allowed to move during surgery , the processed electroencephalogram ( EEG ) and the derived parameters median frequency ( MF ) and spectral-edge frequency ( SEF ) , and midlatency auditory evoked potentials ( MLAEP ) . In clinical practice , the application of individual doses of anaesthetics is generally guided by autonomic vegetative clinical signs such as changes in blood pressure , heart rate , sweating , and tear production , quantified as the PRST score . Unfortunately , these parameters are not very reliable with regard to predicting the suppression of consciousness and awareness , especially when high-dose opioids are used in patients with cardiovascular medications and a variety of accompanying diseases . The PRST score probably indicates mainly the autonomic responses to painful stimuli , and seems to be useful in guiding the individual use of analgesics . The isolated forearm technique is a useful test of the patient's responsiveness during general anaesthesia , and thus an instrument for investigating the incidence of awareness during different anaesthetic regimens and when muscle relaxants are imployed . A disadvantage is that it can only be used for 20 to 30 min because of pressure-induced nerve blocks or lesions . It can not be employed when long-term relaxation is necessary and consciousness and awareness are to be monitored continuously . The processed EEG and the derived parameters MF and SEF are important scientific tools to quantify central effects of many anaesthetics and opioid analgesics that allow the development of pharmacodynamic-pharmacokinetic models of anaesthetic action . MF has proven to be useful in monitoring closed-loop feedback of intravenous drug administration . Unfortunately , until now there have been no clinical studies that document the usefulness of MF or SEF with regard to predicting intraoperative arousal or awareness . To the contrary , some experimental data failed to predict imminent arousal and response to surgical incision or verbal commands by MF or SEF . Therefore , the EEG seems to be of limited value for monitoring awareness , consciousness , or memory formation during anaesthesia . MLAEP are suppressed in a dose-dependent fashion by many general anaesthetics and correlate with wakefulness , awareness , and explicit and implicit memory during anaesthesia and seem to be a promising method of monitoring awareness during anaesthesia . Nevertheless , future studies will have to determine threshold values for the different MLAEP parameters for intraoperative awareness and explicit and implicit recall of intraoperatively presented information for the different commonly used anaesthetics . Only then will it be possible to determine the usefulness of the method in clinical practice ."
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DerAnaesthesist.60450722.eng.abstr
|
DerAnaesthesist.60450722.eng.abstr
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"id": "DerAnaesthesist.60450722.eng.abstr-passage-0",
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],
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217
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}
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{
"id": "DerAnaesthesist.60450722.eng.abstr-s1-t4",
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190,
198
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],
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{
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[] |
[] |
[
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DerAnaesthesist.60450737.eng.abstr
|
DerAnaesthesist.60450737.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450737.eng.abstr-passage-0",
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],
"offsets": [
[
0,
417
]
]
}
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}
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},
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] |
[] |
[] |
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] |
DerAnaesthesist.60450745.eng.abstr
|
DerAnaesthesist.60450745.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450745.eng.abstr-passage-0",
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"text": [
"Erythropoietin , the hematopoietic growth factor , is synthesised in the kidneys and liver and regulates red blood cell production . Within the last few years , recombinant DNA technology has produced synthetic erythropoietin ( rhEPO ) . Some patients , especially Jehova's Witnesses , will not accept blood transfusion . The perioperative administration of rhEPO increases the patients ' hematocrit ( HCt ) to a higher than physiological level ."
],
"offsets": [
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0,
446
]
]
}
] |
[
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},
{
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]
},
{
"id": "DerAnaesthesist.60450745.eng.abstr-s1-t3",
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},
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"id": "DerAnaesthesist.60450745.eng.abstr-s1-t4",
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{
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{
"id": "DerAnaesthesist.60450745.eng.abstr-s1-t9",
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]
},
{
"id": "DerAnaesthesist.60450745.eng.abstr-s1-t10",
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},
{
"id": "DerAnaesthesist.60450745.eng.abstr-s1-t11",
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},
{
"id": "DerAnaesthesist.60450745.eng.abstr-s2-t3",
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},
{
"id": "DerAnaesthesist.60450745.eng.abstr-s2-t4",
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{
"id": "DerAnaesthesist.60450745.eng.abstr-s3-t1",
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"id": "DerAnaesthesist.60450745.eng.abstr-s3-t2",
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},
{
"id": "DerAnaesthesist.60450745.eng.abstr-s3-t3",
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{
"id": "DerAnaesthesist.60450745.eng.abstr-s4-t1",
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},
{
"id": "DerAnaesthesist.60450745.eng.abstr-s4-t3",
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"hematocrit"
],
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],
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{
"db_name": "UMLS",
"db_id": "C0018935"
}
]
}
] |
[] |
[] |
[
{
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"type": "adjacent_to",
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{
"id": "DerAnaesthesist.60450745.eng.abstr-s1-r7-t2.2-t5.1",
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{
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{
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{
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{
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{
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{
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{
"id": "DerAnaesthesist.60450745.eng.abstr-s1-r14-t7.1-t2.1",
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{
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{
"id": "DerAnaesthesist.60450745.eng.abstr-s1-r16-t1.1-t4.1",
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{
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{
"id": "DerAnaesthesist.60450745.eng.abstr-s1-r19-t5.1-t9.1",
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},
{
"id": "DerAnaesthesist.60450745.eng.abstr-s1-r20-t4.1-t7.1",
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},
{
"id": "DerAnaesthesist.60450745.eng.abstr-s1-r21-t5.1-t2.2",
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},
{
"id": "DerAnaesthesist.60450745.eng.abstr-s1-r22-t9.1-t7.1",
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{
"id": "DerAnaesthesist.60450745.eng.abstr-s1-r23-t5.1-t4.1",
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DerAnaesthesist.60450750.eng.abstr
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DerAnaesthesist.60450750.eng.abstr
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[] |
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DerAnaesthesist.60450789.eng.abstr
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DerAnaesthesist.60450789.eng.abstr
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[] |
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"id": "DerAnaesthesist.60450789.eng.abstr-s2-r2-t3.2-t4.1",
"type": "evaluation_of",
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"normalized": []
},
{
"id": "DerAnaesthesist.60450789.eng.abstr-s2-r3-t1.1-t3.1",
"type": "uses",
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},
{
"id": "DerAnaesthesist.60450789.eng.abstr-s2-r4-t1.1-t4.1",
"type": "performs",
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},
{
"id": "DerAnaesthesist.60450789.eng.abstr-s2-r5-t2.1-t1.1",
"type": "associated_with",
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},
{
"id": "DerAnaesthesist.60450789.eng.abstr-s2-r6-t1.1-t2.1",
"type": "performs",
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},
{
"id": "DerAnaesthesist.60450789.eng.abstr-s4-r1-t1.1-t2.1",
"type": "performs",
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},
{
"id": "DerAnaesthesist.60450789.eng.abstr-s6-r1-t2.1-t1.1",
"type": "uses",
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},
{
"id": "DerAnaesthesist.60450789.eng.abstr-s7-r1-t1.1-t2.1",
"type": "performs",
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}
] |
DerAnaesthesist.60450798.eng.abstr
|
DerAnaesthesist.60450798.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450798.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In the presence of completely dry soda lime volatile anaesthetics will decompose to carbon monoxide ( CO ) . In an in vitro study , the absorbent ( soda lime , ICI ) was dried with a constant gas flow of 1 l/min oxygen for 120 h . The weight loss during the drying was 17.1% . Two vol% of halothane , enflurane or isoflurane in oxygen was administered with a constant flow of 0.5 l/min oxygen through the completely dry absorbent . Concentrations of gases were measured before and after the absorbent using mass spectrometry ( MGA 1100 , Perkin-Elmer ) and an electrochemical NO monitor ( Mini PAC CO , Draeger ) . The temperature inside the soda lime was monitored continuously . Shortly after adding the anaesthetic to the oxygen passing through the absorbent , carbon monoxide appeared in the outlet of the soda lime container . The measured peak concentrations varied around 450 ppm ( halothane ) , 3500 ppm ( enflurane ) and 3800 ppm ( isoflurane ) . The temperature inside the absorbent rose from the ambient temperature ( 19.8 °C) to a maximum of 52.1 °C during CO production and decreased when the CO production lowered after approximately 1 h ( all anaesthetics ) . During CO production no measurable concentration of halothane left the absorber . After passing through the absorbent the concentrations of isoflurane and enflurane were slightly lower than the corresponding concentrations in the fresh gas measured before absorption ."
],
"offsets": [
[
0,
1443
]
]
}
] |
[
{
"id": "DerAnaesthesist.60450798.eng.abstr-s1-t1",
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"dry"
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30,
33
]
],
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{
"db_name": "UMLS",
"db_id": "C0011682"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"anaesthetics"
],
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[
53,
65
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0002932"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"carbon"
],
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[
84,
90
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0007009"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"soda lime"
],
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[
34,
43
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0074716"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"carbon monoxide"
],
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[
84,
99
]
],
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{
"db_name": "UMLS",
"db_id": "C0007018"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"lime"
],
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[
153,
157
]
],
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{
"db_name": "UMLS",
"db_id": "C0064990"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"gas"
],
"offsets": [
[
192,
195
]
],
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{
"db_name": "UMLS",
"db_id": "C0017110"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"oxygen"
],
"offsets": [
[
212,
218
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030054"
},
{
"db_name": "UMLS",
"db_id": "C0184633"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"in vitro"
],
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[
115,
123
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0021135"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s2-t5",
"type": "umlsterm",
"text": [
"soda lime"
],
"offsets": [
[
148,
157
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0074716"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"weight"
],
"offsets": [
[
235,
241
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0005910"
},
{
"db_name": "UMLS",
"db_id": "C0043100"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"weight loss"
],
"offsets": [
[
235,
246
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0043096"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"halothane"
],
"offsets": [
[
289,
298
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0018549"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"enflurane"
],
"offsets": [
[
301,
310
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0014277"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"isoflurane"
],
"offsets": [
[
314,
324
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0022180"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s4-t4",
"type": "umlsterm",
"text": [
"oxygen"
],
"offsets": [
[
328,
334
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030054"
},
{
"db_name": "UMLS",
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}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s4-t5",
"type": "umlsterm",
"text": [
"oxygen"
],
"offsets": [
[
386,
392
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030054"
},
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"db_name": "UMLS",
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}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s4-t6",
"type": "umlsterm",
"text": [
"dry"
],
"offsets": [
[
416,
419
]
],
"normalized": [
{
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"db_id": "C0011682"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
"Concentrations"
],
"offsets": [
[
432,
446
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0086045"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
"gases"
],
"offsets": [
[
450,
455
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0017110"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s5-t3",
"type": "umlsterm",
"text": [
"spectrometry"
],
"offsets": [
[
512,
524
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0037805"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s5-t4",
"type": "umlsterm",
"text": [
"MGA"
],
"offsets": [
[
527,
530
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0026251"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s5-t5",
"type": "umlsterm",
"text": [
"PAC"
],
"offsets": [
[
594,
597
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0033036"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s5-t6",
"type": "umlsterm",
"text": [
"mass spectrometry"
],
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507,
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]
],
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}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s6-t1",
"type": "umlsterm",
"text": [
"temperature"
],
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630
]
],
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"db_id": "C0039476"
},
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"db_name": "UMLS",
"db_id": "C0005903"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s6-t2",
"type": "umlsterm",
"text": [
"lime"
],
"offsets": [
[
647,
651
]
],
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{
"db_name": "UMLS",
"db_id": "C0064990"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s6-t3",
"type": "umlsterm",
"text": [
"soda lime"
],
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[
642,
651
]
],
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{
"db_name": "UMLS",
"db_id": "C0074716"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s7-t1",
"type": "umlsterm",
"text": [
"anaesthetic"
],
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[
706,
717
]
],
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{
"db_name": "UMLS",
"db_id": "C0002932"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s7-t2",
"type": "umlsterm",
"text": [
"oxygen"
],
"offsets": [
[
725,
731
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030054"
},
{
"db_name": "UMLS",
"db_id": "C0184633"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s7-t3",
"type": "umlsterm",
"text": [
"carbon"
],
"offsets": [
[
764,
770
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0007009"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s7-t4",
"type": "umlsterm",
"text": [
"lime"
],
"offsets": [
[
815,
819
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0064990"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s7-t5",
"type": "umlsterm",
"text": [
"carbon monoxide"
],
"offsets": [
[
764,
779
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0007018"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s7-t6",
"type": "umlsterm",
"text": [
"soda lime"
],
"offsets": [
[
810,
819
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0074716"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s8-t1",
"type": "umlsterm",
"text": [
"concentrations"
],
"offsets": [
[
850,
864
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0086045"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s8-t2",
"type": "umlsterm",
"text": [
"halothane"
],
"offsets": [
[
889,
898
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0018549"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s8-t3",
"type": "umlsterm",
"text": [
"enflurane"
],
"offsets": [
[
914,
923
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0014277"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s8-t4",
"type": "umlsterm",
"text": [
"isoflurane"
],
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941,
951
]
],
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"db_name": "UMLS",
"db_id": "C0022180"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s9-t1",
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"text": [
"temperature"
],
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960,
971
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],
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"db_name": "UMLS",
"db_id": "C0039476"
},
{
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}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s9-t2",
"type": "umlsterm",
"text": [
"temperature"
],
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[
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1026
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],
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"db_id": "C0039476"
},
{
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}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s9-t3",
"type": "umlsterm",
"text": [
"production"
],
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1072,
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],
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}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s9-t4",
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"production"
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1119
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],
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}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s9-t5",
"type": "umlsterm",
"text": [
"anaesthetics"
],
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1158,
1170
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],
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"db_id": "C0002932"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s10-t1",
"type": "umlsterm",
"text": [
"production"
],
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1185,
1195
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],
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"db_name": "UMLS",
"db_id": "C0033268"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s10-t2",
"type": "umlsterm",
"text": [
"concentration"
],
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1210,
1223
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],
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{
"db_name": "UMLS",
"db_id": "C0086045"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s10-t3",
"type": "umlsterm",
"text": [
"halothane"
],
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[
1227,
1236
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0018549"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s11-t1",
"type": "umlsterm",
"text": [
"concentrations"
],
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[
1297,
1311
]
],
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{
"db_name": "UMLS",
"db_id": "C0086045"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s11-t2",
"type": "umlsterm",
"text": [
"isoflurane"
],
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[
1315,
1325
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0022180"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s11-t3",
"type": "umlsterm",
"text": [
"enflurane"
],
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[
1330,
1339
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0014277"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s11-t4",
"type": "umlsterm",
"text": [
"concentrations"
],
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[
1383,
1397
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0086045"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s11-t5",
"type": "umlsterm",
"text": [
"gas"
],
"offsets": [
[
1411,
1414
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0017110"
}
]
},
{
"id": "DerAnaesthesist.60450798.eng.abstr-s11-t6",
"type": "umlsterm",
"text": [
"absorption"
],
"offsets": [
[
1431,
1441
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0000854"
},
{
"db_name": "UMLS",
"db_id": "C0220777"
}
]
}
] |
[] |
[] |
[
{
"id": "DerAnaesthesist.60450798.eng.abstr-s1-r1-t4.1-t2.1",
"type": "interacts_with",
"arg1_id": "DerAnaesthesist.60450798.eng.abstr-s11-t4",
"arg2_id": "DerAnaesthesist.60450798.eng.abstr-s11-t2",
"normalized": []
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DerAnaesthesist.60450802.eng.abstr
|
DerAnaesthesist.60450802.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450802.eng.abstr-passage-0",
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"The administration of dry anaesthetic gases for ventilation leads to morphological changes of the tracheobronchial epithelium that may cause postoperative pulmonary complications . Therefore , additional humidification with a heat and moisture exchanger ( HME ) is suggested for ventilation during anaesthesia , particularly when using semi-open breathing systems . Recommendations concerning the use of a HME in the semi-closed system are controversial . There are no data in the literature as to whether a HME improves mucociliary transport under these conditions . We therefore studied bronchial mucus transport velocity ( BTV ) with and without the use of a HME in the semi-closed circle system in humans ."
],
"offsets": [
[
0,
710
]
]
}
] |
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DerAnaesthesist.60450807.eng.abstr
|
DerAnaesthesist.60450807.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450807.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Heated humidifiers ( HH ) as well as heat and moisture exchangers ( HME ) are commonly used in intubated patients as air-conditioning devices to raise the moisture content of the air , thus preventing mucosal damage and heat loss resulting from ventilation with dry inspired gases . In contrary to HME , HH are able to add heat and moisture to the inspired air in surplus , which is often stressed as an advantage in warming hypothermic patients or reducing major heat losses , e.g. , during long operations . The impact of air conditioning on the energy balance of man was calculated comparing HME and HH ."
],
"offsets": [
[
0,
607
]
]
}
] |
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[] |
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DerAnaesthesist.60450814.eng.abstr
|
DerAnaesthesist.60450814.eng.abstr
|
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],
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0,
517
]
]
}
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}
] |
[] |
[] |
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] |
DerAnaesthesist.60450826.eng.abstr
|
DerAnaesthesist.60450826.eng.abstr
|
[
{
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],
"offsets": [
[
0,
406
]
]
}
] |
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}
] |
[] |
[] |
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DerAnaesthesist.60450834.eng.abstr
|
DerAnaesthesist.60450834.eng.abstr
|
[
{
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],
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[
0,
280
]
]
}
] |
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{
"id": "DerAnaesthesist.60450834.eng.abstr-s2-t4",
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"text": [
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{
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{
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{
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}
]
}
] |
[] |
[] |
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DerAnaesthesist.60450839.eng.abstr
|
DerAnaesthesist.60450839.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450839.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Impaired pulmonary gas exchange can result from lung parenchymal failure inducing oxygenation deficiency and fatigue of the respiratory muscles , which is characterized by hyercapnia or a combination of both mechanisms . Contractility of and coordination between the diaphragm and the thoracoabdominal respiratory muscles predominantly determine the efficiency of spontaneous breathing . Sepsis , cardiac failure , malnutrition or acute changes of the load conditions may induce fatigue of the respiratory muscles . Augmentation of spontaneous breathing is not only achieved by the application of different technical principles or devices ; it also has to improve perfusion , metabolism , load conditions and contractility of the respiratory muscles . Intermittent mandatory ventilation ( IMV ) allows spontaneous breathing of the patient and augments alveolar ventilation by periodically applying positive airway pressure tidal volumes , which are generated by the respirator . Potential advantages include lower mean airway pressure ( PAW ) , as compared with controlled mechanical ventilation , and improved haemodynamics . Suboptimal IMV systems may impose increased work and oxygen cost of breathing , fatigue of the respiratory muscles and CO2 retention . During pressure support ventilation ( PSV ) , inspiratory alterations of PAW or gas flow ( trigger ) are detected by the respirator , which delivers a gas flow to maintain PAW at a fixed value ( usually 5-20 cm H2O) during inspiration . PSV may be combined with other modalities of respiratory therapy such as IMV or CPAP . Claimed advantages of PSV include decreased effort of breathing , reduced systemic and respiratory muscle consumption of oxygen , prophylaxis of diaphragmatic fatigue and an improved extubation rate after prolonged periods of mechanical ventilation . Minimum alveolar ventilation is not guaranteed during PSV ; thus , close observation of the patient is mandatory to avoid serious respiratory complications . Continuous positive airway pressure breathing ( CPAP ) maintains PAW above atmospheric pressure throughout the respiratory cycle , which may increase functional residual capacity and decrease the effort of breathing . CPAP has been conceptually designed for the augmentation of spontaneous breathing and requires the intact central and peripheral regulation of the respiratory system . Airway pressure release ventilation ( APRV ) improves alveolar ventilation by intermittent release of PAW , which is kept above atmospheric pressure by means of a high-flow CPAP system . The opening of an expiratory valve for 1-2 s induces a decreased PAW and lung volume , which increases rapidly to pre-exhalation values after closure of the valve due to the high gas flow within the circuit ( 90-100 l/min ) . APRV may improve haemodynamics and VA/Q distribution as compared with conventional mechnical ventilation . Biphasic positive airway pressure ( BIPAP ) is characterized by the combination of spontaneous breathing and time-regulated , pressure-controlled mechanical ventilation . During the respiratory cycle the ventilator generates two alternating CPAP levels , which can be modified with regard to time and pressure . As with APRV , alveolar ventilation is maintained even if the spontaneous breathing efforts of the patient cease , which improves the safety of both modes of respiratory therapy . The contribution of spontaneous breathing to total minute ventilation may be important , since a decreased shunt and improved VA/Q relationship have been observed in experimental non-cardiogenic lung oedema . These data give support to the concept that spontaneous breathing should be maintained and augmented in the setting of acute respiratory failure ."
],
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[
0,
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}
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DerAnaesthesist.60450856.eng.abstr
|
DerAnaesthesist.60450856.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450856.eng.abstr-passage-0",
"type": "abstract",
"text": [
"We describe unexpected episodes of paced tachycardia in two patients with rate-responsive pacemakers during anaesthesia . Five months after a heart transplant and implantation of a pacemaker a 43-year-old patient suffered cardiac tamponade as a result of chronic pericarditis . The second case involved embolic occlusion of the femoral artery in a 33-year-old female patient previously operated on for tricuspid valve replacement and implantation of a pacemaker . In both cases induction of anaesthesia was performed with fentanyl , etomidate and vecuronium . Following intubation and mechanical ventilation , the heart rates ( HR ) of the two patients increased to 140 and 130 min-1 respectively . This was interpreted as a sign of inadequate anaesthesia , and therefore additional doses of fentanyl and etomidate were given , with no effect on the tachycardia . After exclusion of other possible reasons for this complication such as hypokalaemia , hypercapnia , hypoxaemia or allergic reactions , unexpected functioning of the rate-responsive pacemakers due to thoracic impedance changes was assumed . Minute ventilation was reduced , lowering paced HR in 3-5 min ."
],
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[
0,
1168
]
]
}
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] |
DerAnaesthesist.60450900.eng.abstr
|
DerAnaesthesist.60450900.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450900.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Cimetidine is a commonly used H2-receptor antagonist that has been recommended for the prevention of acid aspiration syndrome and has been shown to potentiate vecuronium-induced neuromuscular block . The present study was designed to investigate the influence of a single IV dose of cimetidine on the neuromuscular effects of rocuronium , an analogue of vecuronium with a short onset time ."
],
"offsets": [
[
0,
390
]
]
}
] |
[
{
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],
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10
]
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52
]
],
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},
{
"id": "DerAnaesthesist.60450900.eng.abstr-s1-t3",
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"prevention"
],
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[
87,
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]
],
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{
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}
]
},
{
"id": "DerAnaesthesist.60450900.eng.abstr-s1-t4",
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"acid"
],
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[
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105
]
],
"normalized": [
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},
{
"id": "DerAnaesthesist.60450900.eng.abstr-s1-t5",
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"aspiration"
],
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116
]
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]
},
{
"id": "DerAnaesthesist.60450900.eng.abstr-s1-t6",
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],
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117,
125
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],
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{
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}
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},
{
"id": "DerAnaesthesist.60450900.eng.abstr-s1-t7",
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"text": [
"neuromuscular block"
],
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[
178,
197
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],
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},
{
"id": "DerAnaesthesist.60450900.eng.abstr-s1-t8",
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],
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101,
125
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},
{
"id": "DerAnaesthesist.60450900.eng.abstr-s2-t1",
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"text": [
"single"
],
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265,
271
]
],
"normalized": [
{
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}
]
},
{
"id": "DerAnaesthesist.60450900.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"cimetidine"
],
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[
283,
293
]
],
"normalized": [
{
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},
{
"id": "DerAnaesthesist.60450900.eng.abstr-s2-t3",
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"text": [
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],
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326,
336
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],
"normalized": [
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},
{
"id": "DerAnaesthesist.60450900.eng.abstr-s2-t4",
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"vecuronium"
],
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354,
364
]
],
"normalized": [
{
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]
},
{
"id": "DerAnaesthesist.60450900.eng.abstr-s2-t5",
"type": "umlsterm",
"text": [
"time"
],
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[
384,
388
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0040223"
}
]
}
] |
[] |
[] |
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DerAnaesthesist.60450903.eng.abstr
|
DerAnaesthesist.60450903.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450903.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Elderly patients may show an age-related decline in physiologic functions , which may be responsible for the prolonged duration of some neuromuscular blocking agents . Previous studies have yielded conflicting results as to the effects of these drugs in the elderly . Methods . After obtaining informed consent and approval of the Ethics Committee , we compared onset and recovery times of single IV doses of atracurium , rocuronium , and vecuronium given to 108 patients divided into three groups according to age ( 18-50 , 51-64 , > =65 years ) . Following oxazepam premedication and fentanyl and thiopentone induction , patients were randomly allocated to receive atracurium , rocuronium or vecuronium ( 0.5 , 0.6 , or 0.1 mg/kg , respectively ) in =0 . 8 vol . % enflurane ( end-tidal ) -nitrous oxide anaesthesia . Muscular relaxation was assessed by electromyographic ( EMG ) recording of the adductor pollicis muscle after supramaximal single-twitch stimulation of the ulnar nerve every 10 s. Onset time and recovery to 25% , 75% and 90% of twitch control values ( DUR25, 75 , 90 ) were recorded . Creatinine clearance predicted from serum creatinine ( Ccr ) was correlated with recovery from neuromuscular block . Results . Onset time was not different among groups or relaxants . The results showed a prolonged duration of action for atracurium ( DUR75, DUR90), rocuronium ( DUR25, DUR75), and vecuronium ( DUR25) in the elderly . A number of patients did not reach DUR75 or DUR90. There was a significant relationship between age and failure to return to control values during recovery from neuromuscular block , especially after atracurium and rocuronium . Ccr showed a negative correlation with age for all relaxants , but a negative significant correlation between Ccr and recovery was found only for rocuronium . Conclusions . This study suggests that onset time for atracurium , rocuronium and vecuronium is not age-dependent . Recovery was prolonged in the elderly for all three relaxants . This effect appears to be secondary to changes in body composition and function accompanying the aging process . Neither atracurium nor vecuronium depends significantly on the kidney for elimination , but the negative correlation between Ccr and rocuronium suggests an appreciable role for the kidney in the elimination of this relaxant . The long recovery times observed in this study could also be related to enflurane anaesthesia . We suggest that failure of EMG responses to return to baseline values during recovery from neuromuscular block may be related to age , especially for atracurium and rocuronium ."
],
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0,
2619
]
]
}
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],
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"functions"
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{
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{
"id": "DerAnaesthesist.60450903.eng.abstr-s2-t2",
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},
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"id": "DerAnaesthesist.60450903.eng.abstr-s4-t1",
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"Ethics"
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},
{
"id": "DerAnaesthesist.60450903.eng.abstr-s4-t4",
"type": "umlsterm",
"text": [
"atracurium"
],
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409,
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],
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"id": "DerAnaesthesist.60450903.eng.abstr-s4-t5",
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"rocuronium"
],
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] |
DerAnaesthesist.60450907.eng.abstr
|
DerAnaesthesist.60450907.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450907.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Laryngoscopy causes temporary postoperative dysfunction of the temporomandibular joint ( TMJ ) : during iatrogenic TMJ manipulation in anaesthetised patients , the TMJs have lost the protection afforded by the tone of the surrounding muscles . Thus far , the exact type and extent of TMJ movements have not been known . The purpose of this study was to develop a method to visualise and assess TMJ movements during intubation by means of electronic axiography , a diagnostic monitor of TMJ movements used in dentistry : registration of the hinge axis ( HA ) as an equivalent of the condylar paths on extra-oral sagittally mounted , parallel plates . The HA is individually defined in each patient by the pure , rotating TMJ movement during initial mouth opening ( no farward gliding of the condyles , incisor distance up to 10 mm ) . The parallel plates are placed in the TMJ region in the skull-mounted plate bow ; both registration tips ( \" drawing \" the HA tracings on the electronic plates ) are connected to the mandible by a face bow , paraocclusally fixed to the teeth . The face bow is individually shaped for each patient to allow mask ventilation and free movement of the laryngoscope during intubation . HA tracings are registered and calculated for both sides independently every 24 ms with the SAM/Klett system and presented on sagittal and frontal projections . In the operating theatre , the active mouth-opening traces ( MOT ) are registered first and the passive endotracheal intubation traces ( EIT ) after induction of anaesthesia ( same head position ) . With informed consent and approval by the ethics committee of the Landesaerztekammer Rheinland-Pfalz , 40 male patients ( ASA I , Mallampati I , limb surgery ) were randomly allocated to four groups ( n=10 each ) . OS : Oral intubation , suxamethonium ( 1.5 mg/kg ) ; OV : Oral intubation , vecuronium ( 0.1 mg/kg ) ; NS : Nasal intubation , suxamethonium ( 1.5 mg/kg ) ; and NV : Nasal intubation , vecuronium ( 0.1 mg/kg ) . Intubation was performed 100 s after injection of the relaxant . Pre- and postoperatively ( every 24 h over 3 days , in case of positive findings longer ) recorded were : active movements of the mandible ( maximal mouth opening/max . laterotrusion ) ; dysfunction of the TMJ ; and pain sensation in the TMJ ( Helkimo rating ) . MOTs and EITs were recorded and analysed with the system described and typical EIT patterns were identified : bland , clinically uneventful intubations ( n=7), massive distraction and laterotrusion of the EIT compared to the MOT ( n=24), and blocked or limited TMJ movements resulting in intubation problems ( n=1). With the method presented , TMJ movements could be visualised during endotracheal intubation for the first time . It can be used to assess techniques , routes , and instruments for intubation as well as to evaluate potential traumatising movements during endotracheal intubation ."
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DerAnaesthesist.60450923.eng.abstr
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DerAnaesthesist.60450923.eng.abstr
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"The technique of light-guided intubation is based on the principle that a source of light brought into the trachea results in clearly visible and defined transcutaneous illumination , while no illumination can be observed with the light source in the oesophagus ( Fig . 1-7 ) . The Trachlight is a reintroduced instrument for this alternative intubation technique . The essential developments are : a length-adjustable stylet with a removable internal metal wire , a brighter light source , a stable handle with tight fixation of the endotracheal tube , and a time-dependent warning device to avoid extended intubations . One hundred twenty patients ( Mallampati I , ASA I-III ) were included in the study ( conventional intubation [ group KL , n=60], Trachlight intubation [ group TT , n=60]. The goals of the investigation were to examine the handling , application , problems , limitations , and possible indications of the method . The recorded parameters were : number of intubation attempts : course and duration of intubation ; complications ; and difficulties . In 40 patients ( 20 in each group ) the indication for invasive blood presure measurement was given due to the surgical procedure , and circulatory parameters were recorded at defined moments during the intubation course . In group KL 55 patients were intubated in the attempt , 4 on the second , and 1 on the third ( mean duration 23.6 +/- 10.4 s , range 12-60 s ) . Complications were : unilateral intubation ( 3 patients ) , bradycardia ( 2 ) , asystole ( 1 ) and soft-tissue injury ( 1 ) . Of the 60 patients in group TT , 54 were intubated successfully , the mean time needed being 29.9 +/- 14.8 s ( range : 6-61 s ) . The remaining 6 were then intubated by the conventional method . Positive results in group TT included : easy handling and application , no injury to soft tissues or teeth , and invariably correct placement of the tube . Problems included : sufficient transillumination was achieved only after ( entire ) dimming of the room , insufficient control over the distal end of the tube due to an unfixed metal wire , unintentional switching off of the light while with-drawing the metal wire , difficulties in with-drawing the metal wire ( too strong fixation ) , as well as disturbing effects of the warning device ( blinking of the light 30 s after switching on ) . Reasons for the 6 intubation failures were introduction of the instrument into the oesophagus despite a supposed correct position , impossibility of correct placement in a patient with an extremely large goiter , and insufficiently clear transillumination in 3 extremely obese patients . The cardiovascular parameters showed no changes during laryngeal manipulation ; a clear rise in heart rate and blood pressure was recorded , however , when the tube was inserted into the trachea . The cardiovascular parameters during conventional intubations were similar . The light-guided intubation technique can be regarded as a further alternative for airway management , due to the described improvements of the instrument . The indication for the technique is given in patients in whom no difficulty with intubation is expected , to avoid soft tissue damage and traumatising temporomandibular joint movements . Preclinical use may be limited due to environmental brightness . In patients with expected difficult airway management , fiberoptic intubation will remain the method of choice ."
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DerAnaesthesist.60450941.eng.abstr
|
DerAnaesthesist.60450941.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450941.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Blood glucose alterations prior to cerebral ischaemia are associated with poor neurologic outcome , possibly due to extensive lactic acidosis or energy failure . Cerebral effects of hyper- or hypoglycaemia during cardiopulmonary resuscitation ( CPR ) are less well known . In addition , little information is available concerning cardiac effects of blood glucose alterations . The aim of this study was to evaluate the effects of pre-cardiac-arrest hypo- or hyperglycaemia compared to normoglycaemia upon haemodynamics , cerebral blood flow ( CBF ) and metabolism ( CMRO2), and regional cardiac blood flow during CPR subsequent to 3 min of cardiac and respiratory arrest and after restoration of spontaneous circulation . Methods . After approval by the State Animal Investigation Committee , 29 mechanically ventilated , anaesthetised pigs were instrumented for haemodynamic monitoring and blood flow determination by the radiolabeled microsphere technique . The animals were randomly assigned to one of three groups : in group I ( n=9) blood glucose was not manipulated ; in group II ( n=10) blood glucose was increased by slow infusion of 40% glucose to 319 +/- 13 mg/dl ; in group III ( n=10) blood glucose was lowered by careful titration with insulin to 34 +/- 2 mg/dl . After 3 min of untreated ventricular fibrillation and respiratory arrest , CPR ( chest compressor/ventilator ( Thumper ) and epinephrine infusion ) was commenced and continued for 8 min . Thereafter , defibrillation was attempted , and if successful , the animals were observed for another 240 min . Cerebral perfusion pressure ( CPP ) , CBF , CMRO2, coronary perfusion pressure ( CorPP ) , and regional cardiac blood flow were determined at control , after 3 min of CPR , and at 10 , 30 , and 240 min post-CPR . Results . In group I , 4/9 animals ( 44% ) could be successfully resuscitated ; in group II 4/10 ( 40% ) ; and in group III 0/10 ( 0% ) . Prior to cardiac arrest , mean arterial pressure , CPP , and CorPP in group III were significantly lower compared to groups I and II . In group I , CPP during CPR was 26 +/- 6 mmHg ; CBF 31 +/- 9 ml/min/100 g CMRO2 3.8 +/- 1.2 ml/min/100 g ; CorPP 18 +/- 5 mmHg ; and left ventricular ( LV ) flow 35 +/- 15 ml/min/100 g . In group II : CPP=21 +/- 5 ; CBF 21 +/- 7 ; CMRO2 1.8 +/- 0.8 ; CorPP 16 +/- 6 ; and LV flow 22 +/- 9 ; and in group III : CPP 15 +/- 3 ; CBF 11 +/- 8 ; CMRO2 1.5 +/- 1.1 ; CorPP 4 +/- 2 ; and LV flow 19 +/- 10. During the 240-min post-resuscitation period , there were no differences in CBF , CMRO2, or LV flow between groups I and II . Conclusion . Hypoglycaemia prior to cardiac arrest appears to be predictive for a poor cardiac outcome , whereas hyperglycaemia does not impair resuscitability compared to normoglycaemia . In addition , hyperglycaemia did not affect LV flow , CBF , or CMRO2. However , it has to be kept in mind that haemodynamics and organ blood flow do not permit conclusions with respect to functional neurologic recovery or histopathologic damage to the brain , which is very likely to be associated with hyperglycaemia ."
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0,
3096
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DerAnaesthesist.60450950.eng.abstr
|
DerAnaesthesist.60450950.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450950.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The lateral decubitus position is the standard position for nephrectomies . There is a lack of data about the effects of this extreme position upon respiratory mechanics and gas exchange . In 20 patients undergoing surgery in the nephrectomy position , we compared a new closed-loop-controlled ventilation algorithm , adaptive lung ventilation ( ALV ) , which adapts the breathing pattern automatically , to the respiratory mechanics with conventionally controlled mandatory ventilation ( CMV ) . The aims of our study were ( 1 ) to describe positioning effects on respiratory mechanics and gas exchange , ( 2 ) to compary ventilatory parameters selected by the ALV controller with traditional settings of CMV , and ( 3 ) to assess the individual adaptation of the ventilatory parameters by the ALV controller . The respirator used was a modified Amadeus ventilator , which is controlled by an external computer and possesses an integrated lung function analyzer . In a first set of measurements , we compared parameters of respiratory mechanics and gas exchange in the horizontal supine position and 20 min after changing to the nephrectomy position . In a second set of measurements , patients were ventilated with ALV and CMV using a randomized crossover design . The CMV settings were a tidal volume of 10 ml/kg body weight , a respiratory rate of 10 breaths/min , an I : E ratio of 1:1 . 5 , and an end-inspiratory pause of 30% of inspiratory time . With both ventilation modes FiO2 was set to 0.5 and PEEP to 3 cm H2O. During ALV a desired alveolar ventilation of 70 ml/kg KG - min was preset . All other ventilatory parameters were determined by the ALV controller according to the instantaneously measured respiratory parameters . Positioning induced a reduction of compliance from 61.6 to 47.9 ml/cm H2O; the respiratory time constant shortened from 1.2 to 1.08 s , whereas physiological dead space increased from 158.9 to 207.5 ml . On average , the ventilatory parameters selected by the ALV controller resembled very closely those used with CMV . However , an adaptation to individual respiratory mechanics was clearly evident with ALV . In conclusion , we found that the effects of positioning for nephrectomy are minor and may give rise to problems only in patients with restrictive lung disease . The novel ALV controller automatically selects ventilatory parameters that are clinically sound and are better adapted to the respiratory mechanics of ventilated patients than the standardized settings of CMV are ."
],
"offsets": [
[
0,
2526
]
]
}
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] |
[] |
[] |
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DerAnaesthesist.60450957.eng.abstr
|
DerAnaesthesist.60450957.eng.abstr
|
[
{
"id": "DerAnaesthesist.60450957.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Capnometry , the noninvasive measurement of end-expiratory CO2 concentration ( cCO2, vol%) or calculation of its respective partial pressure ( pCO2; mmHg ) is an established method . However , for prehospital settings , capnometry is still used very restrictively , mainly owing to the respective devices used . The prerequisite for their use is sufficient accuracy ( +/- 2 mmHg ) and easy handling . Two special capnometers ( STAT CAP , Nellcor : mainstream , semiquantitative estimation ; Capnocheck 8200 , BCI : sidestream , quantitative measurement , numeric display ) , developed recently for potential use in emergency medicine , are said to fit these criteria . Therefore , the objective of the present investigation was to assess the accuracy and precision of both devices , comparing methods under standardized in vitro ( reference gases ) and in vivo ( intubated and ventilated patients ) conditions ."
],
"offsets": [
[
0,
911
]
]
}
] |
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DerAnaesthesist.60450965.eng.abstr
|
DerAnaesthesist.60450965.eng.abstr
|
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"id": "DerAnaesthesist.60450965.eng.abstr-passage-0",
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"Hypnosis can be an alternative to cerebral sedatives with no side effects for sedation during regional anaesthesia , especially in high-risk and fearful patients . Patients who have experience with relating techniques like Jakobson's progressive muscle relaxation are very good candidates for hypnosis . It is contraindicated in patients with psychotic disorders , major depression , and abuse of hallucinogenic drugs . The authors shows his personal method of hypnosis based on fixation and suggestive techniques like muscle relaxation , temperature sensation , and creation of emotional pictures . Of ten cases , hypnosis was successful in six ( vegetative stress symptoms like tachycardia or shivering stopped immediately after induction of hypnosis ) , not completely successful in two ( interruption of hypnosis after 30 min ) and unsuccessful in two . Four cases where hypnosis was used during spinal anaesthesia for knee and hip surgery or brachial plexus block for open fixation of Colles ' fracture are discussed as examples . As it requires more time ( 15 to 45 min to inform and test the patient ) and special organisational conditions hypnosis will not become a routine procedure , but is still a good alternative for selected cases ."
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DerAnaesthesist.60451004.eng.abstr
|
DerAnaesthesist.60451004.eng.abstr
|
[
{
"id": "DerAnaesthesist.60451004.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Pain is a major , but largely neglected problem in AIDS patients . The aim of this article is to review the etiology of pain manifestations in AIDS patients in different organ systems and to discuss appropriate treatment strategies . The most common pain symptoms in AIDS patients are headache , oral cavity pain , dysphagia and adynophagia , chest pain , abdominal pain and pain related to peripheral neuropathy . Symptomatic pain treatment should be started while diagnostic work-up is still in progress , so that the patient does not suffer . If etiological treatment is possible , specific treatment should be started and symptomatic pain treatment tapered as tolerated . If etiological treatment is not possible , symptomatic pain treatment should be continued . In view of the multiple organs involved in the presentation of AIDS requiring multiple drugs , careful attention to side effects , contraindications and drug interactions is warranted , when administering pain medications . Fear of the complexity of these issues should , however , not prevent effective pain management for these patients , who suffer from a fatal disease . A multidisciplinary approach to painin AIDS patients , similar to the approach in patients with cancer , is desirable ."
],
"offsets": [
[
0,
1262
]
]
}
] |
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DerAnaesthesist.60451024.eng.abstr
|
DerAnaesthesist.60451024.eng.abstr
|
[
{
"id": "DerAnaesthesist.60451024.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Cisatracurium - one of the ten stereoisomers of atracurium - is an intermediate long-acting non-depolarizing neuromuscular blocking agent . Cardiovascular reactions have been described after administration of cisatracurium or vecuronium in surgical patients . Methods . After approval by our institutional review board , 62 patients ( ASA I-II ) were randomly assigned to three groups to either receive 3xED95 or 5xED95 of cisatracurium or 3xED90 of vecuronium prior to intubation as a bolus . After oral premedication with 2 mg lormetazepam anaesthesia was induced with thiopental ( 4-12 mg/kg ) and maintained with O2/N2O and isoflurane ( 1.5%-2%). Six minutes after administration of thiopental , patients received the muscle relaxant . Six minutes later 0.1-0.2 mg fentanyl was given and the trachea was intubated . Heart rate ( HR ) and blood pressure ( BP ) were monitored every minute . Changes of heart rate or blood pressure > 20% compared to baseline were defined as clinically significant . Results . After application of the study drug , median values of blood pressure and heart rate were stable . For each muscle relaxant , there were several patients who had statistically significant cardiovascular changes . After 3xED95 cisatracurium , 3 of 21 patients exhibited haemodynamic changes > 20% ( 2 exhibited hypotension and 1 tachycardia ) , while in the high-dose cisatracurium group 2 of 21 patients demonstrated a tachycardia that was predetermined to be statistically but not clinically significant . In the vecuronium group , 2 of 20 patients sustained statistically significant hypotension and 1 patient had statistically significant tachycardia . The frequency of all individual cardiovascular changes after the application of the muscle relaxant was not dose-dependent . Conclusion . After the administration of cisatracurium in two different doses ( 3xED95 and 5xED95 ) or vecuronium ( 3xED90 ) only minor cardiovascular changes were observed . Both drugs proved to be safe for use during induction of anaesthesia in patients ASA I-II . With regard to its cardiovascular effects , cisatracurium shares with vecuronium the requirements of an ideal muscle relaxant ."
],
"offsets": [
[
0,
2187
]
]
}
] |
[
{
"id": "DerAnaesthesist.60451024.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"Cisatracurium"
],
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] |
DerAnaesthesist.60451030.eng.abstr
|
DerAnaesthesist.60451030.eng.abstr
|
[
{
"id": "DerAnaesthesist.60451030.eng.abstr-passage-0",
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"In this study cerebral blood flow ( CBF ) was simultaneously measured with the Kety-Schmidt method and the intravenous 133Xe clearance technique . CBF , cerebral metabolic rate of oxygen ( CMRO2), and CO2 reactivity of CBF were compared under fentanyl-midazolam anaesthesia and varying paCO2 levels ."
],
"offsets": [
[
0,
300
]
]
}
] |
[
{
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"blood"
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23,
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}
]
},
{
"id": "DerAnaesthesist.60451030.eng.abstr-s1-t2",
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"CBF"
],
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36,
39
]
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}
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{
"id": "DerAnaesthesist.60451030.eng.abstr-s1-t3",
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92,
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]
},
{
"id": "DerAnaesthesist.60451030.eng.abstr-s1-t4",
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{
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150
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},
{
"id": "DerAnaesthesist.60451030.eng.abstr-s2-t2",
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180,
186
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},
{
"id": "DerAnaesthesist.60451030.eng.abstr-s2-t3",
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{
"id": "DerAnaesthesist.60451030.eng.abstr-s2-t4",
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]
},
{
"id": "DerAnaesthesist.60451030.eng.abstr-s2-t5",
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],
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[
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261
]
],
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]
},
{
"id": "DerAnaesthesist.60451030.eng.abstr-s2-t6",
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261
]
],
"normalized": [
{
"db_name": "UMLS",
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]
}
] |
[] |
[] |
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DerAnaesthesist.60451037.eng.abstr
|
DerAnaesthesist.60451037.eng.abstr
|
[
{
"id": "DerAnaesthesist.60451037.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The cerebral haemodynamic effects of vasodilators are of clinical interest because a decrease in mean arterial pressure ( MAP ) might alter global cerebral blood flow ( CBF ) . Luxury perfusion of the brain , in contrast , might be unfavourable in patients with reduced intracranial compliance . Despite the widespread use of nitroglycerine ( NTG ) , little is known about the cerebral haemodynamic consequences of NTG infusions in humans . This prospective , controlled study was designed : ( 1 ) to investigate the effects of NTG on CBF and cerebrovascular CO2 reactivity ."
],
"offsets": [
[
0,
575
]
]
}
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{
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"id": "DerAnaesthesist.60451037.eng.abstr-s1-t4",
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{
"id": "DerAnaesthesist.60451037.eng.abstr-s1-t5",
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{
"id": "DerAnaesthesist.60451037.eng.abstr-s1-t6",
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"CBF"
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169,
172
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{
"id": "DerAnaesthesist.60451037.eng.abstr-s2-t1",
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"id": "DerAnaesthesist.60451037.eng.abstr-s2-t2",
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"db_name": "UMLS",
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{
"id": "DerAnaesthesist.60451037.eng.abstr-s2-t3",
"type": "umlsterm",
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"contrast"
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{
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{
"id": "DerAnaesthesist.60451037.eng.abstr-s3-t1",
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{
"id": "DerAnaesthesist.60451037.eng.abstr-s3-t2",
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"id": "DerAnaesthesist.60451037.eng.abstr-s3-t4",
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{
"id": "DerAnaesthesist.60451037.eng.abstr-s4-t1",
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{
"id": "DerAnaesthesist.60451037.eng.abstr-s4-t2",
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{
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[] |
[] |
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DerAnaesthesist.60451051.eng.abstr
|
DerAnaesthesist.60451051.eng.abstr
|
[
{
"id": "DerAnaesthesist.60451051.eng.abstr-passage-0",
"type": "abstract",
"text": [
"During pressure support ventilation ( PSV ) , the timing of the breathing cycle is mainly controlled by the patient . Therefore , the delivered flow pattern during PSV might be better synchronised with the patient's demands than during volume-assisted ventilation . In several modern ventilators , inspiration is terminated when the inspiratory flow decreases to 25% of the initial peak value . However , this timing algorithm might cause premature inspiration termination if the initial peak flow is high . This could result not only in an increased risk of dyssynchronization between the patient and the ventilator , but also in reduced ventilatory support . On the other hand , a decreased peak flow might inappropriately increase the patient's inspiratory effort . The aim of our study was to evaluate the influence of the variation of the initial peak-flow rate during PSV on respiratory pattern and mechanical work of breathing ."
],
"offsets": [
[
0,
935
]
]
}
] |
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"pressure"
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"breathing"
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]
}
] |
[] |
[] |
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},
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},
{
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},
{
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},
{
"id": "DerAnaesthesist.60451051.eng.abstr-s7-r1-t1.1-t4.2",
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}
] |
DerAnaesthesist.60451059.eng.abstr
|
DerAnaesthesist.60451059.eng.abstr
|
[
{
"id": "DerAnaesthesist.60451059.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Temperature of the tympanic membrane is recommended as a \" gold standard \" of core-temperature recording . However , use of temperature probes in the auditory canal may lead to damage of tympanic membrane . Temperature measurement in the auditory canal with infrared thermometry does not pose this risk . Furthermore it is easy to perform and not very time-consuming . For this reason infrared thermometry of the auditory canal is becoming increasingly popular in clinical practice . We evaluated two infrared thermometers - the Diatek 9000 Thermoguide and the Diatek 9000 Instatemp - regarding factors influencing agreement with conventional tympanic temperature measurement and other core-temperature recording sites . In addition , we systematically evaluated user dependent factors that influence the agreement with the tympanic temperature ."
],
"offsets": [
[
0,
846
]
]
}
] |
[
{
"id": "DerAnaesthesist.60451059.eng.abstr-s1-t1",
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"Temperature"
],
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[
0,
11
]
],
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},
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}
]
},
{
"id": "DerAnaesthesist.60451059.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"membrane"
],
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[
28,
36
]
],
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}
]
},
{
"id": "DerAnaesthesist.60451059.eng.abstr-s1-t3",
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"gold"
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59,
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]
],
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]
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{
"id": "DerAnaesthesist.60451059.eng.abstr-s1-t4",
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"standard"
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]
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{
"id": "DerAnaesthesist.60451059.eng.abstr-s1-t5",
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"core-temperature"
],
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[
78,
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]
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"db_id": "C0039476"
},
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}
]
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{
"id": "DerAnaesthesist.60451059.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"tympanic membrane"
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19,
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{
"id": "DerAnaesthesist.60451059.eng.abstr-s2-t1",
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"use"
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{
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[] |
[] |
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DerAnaesthesist.60451067.eng.abstr
|
DerAnaesthesist.60451067.eng.abstr
|
[
{
"id": "DerAnaesthesist.60451067.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Heat loses during surgery occur mainly to the environment and due to infusions and irrigations . Infusions given at room temperature account for a great deal of the total heat deficit during major operations , e.g. , the infusion of 53 ml/kg 20 ° C fluid leads to a loss of 1 ° C in mean body temperature . Hence , heating i.v. fluids will add to the effect of other measures aimed at reducing heat loss to the environment . We investigated the efficacy of different warming methods for i.v. fluids in an experimental model by measuring the temperature at the end of the delivery line . Methods . The following in-line warmers were studied : Hotline HL-90 and System H-250/heat exchanger D-50 ( Level 1 Technologies , Marshfield , USA ) , Astotherm IFT 260 ( Stihler Elektronic GmbH , Stuttgart , Germany ) , RSLB 30 H Gamida ( Productions Hospitalieres Francaises , Eaubonne , France ) , Bair Hugger 241/Modell 500 Prototype ( Augustine Medical , Eden Prairie , USA ) . They were compared with prewarming infusions ( 39 ° C ) only using the Clinitherm S ( Labor Technik Barkey GmbH , Bielefeld , Germany ) and prewarming with \" active insulation \" of the delivery line using the Autotherm/Autoline system ( Labor Technik Barkey GmbH , Bielefeld , Germany ) . We investigated the influence of four variables on the efficacy of warming : ( 1 ) flow rate ( 50-15 , 000 ml/h ) ; ( 2 ) ambient temperature ( 20 ° C and 25 ° C ) ; ( 3 ) infusion bag temperature ( 6 ° C , 20 ° C , and 39 ° C ) ; and ( 4 ) length of infusion system downstream from the heat exchanger . Fluid temperatures were measured using thermistors of 1 mm diameter ( Modell YSI 520 , Yellow Springs Instruments Co. , Yellow Springs , USA ) incorporated into 3-way stopcocks . Temperatures were recorded using Hellige temperature monitors ( Hellige GmbH , Freiburg im Breisgau , Germany ) and the signals were collected at 10 Hz through an AD converter and averaged over 1 min . Flows were calculated by timed collection into calibrated cylinders ; 10 to 12 different flow rates were taken to define one temperature/flow plot . Effective warming was defined as a temperature > 33 ° C at the end of the infusion line . Results . At high flow rates ( > 2,500 ml/h ) using 20 ° C fluids at 20 ° C ambient temperature , the H-250/D-50 system gave the highest temperatures throughout the range and showed effective warming from 1,300 ml/h on over the entire range tested ( 35 ° C at 17,000 ml/h ) compared to the RSLB 30 H Gamida system ( 3,000-18,000 ml/h ) ( Fig . 2 ) . This difference in performance was almost abolished with fluids at 6 ° C ( Fig . 4 ) . Similar efficacy could be reached by using prewarmed infusions that gave effective warming at > 2,000 ml/h and reached 39 ° C at 13,000 ml/h . Prewarmed infusions could be used effectively down to > 80 ml/h applying \" active insulation \" ( Autotherm/Autoline ) to the whole infusion system . The Hotline HL-90 ( 50-4 , 700 ml/h ) appeared to be the most effective in-line warmer in the low ( 250 ml/h ) and middle ( 250-2 , 500 ml/h ) flow range , followed by the Astotherm IFT 260 ( 400-4 , 000 ml/h ) , but only if used with a length of 40 cm down-stream from the heat exchanger ( Fig . 1 ) . Increasing this distance to 145 cm markedly reduced its efficacy below the range of 2,000 ml/min ( 1,200-3,000 ml/h ) ( Fig . 5 ) . The Bair Hugger 241 Prototype showed a narrow effective range ( 700-1 , 300 ml/h ) that could be extended beyond 1,300 ml/h by the use of prewarmed infusions ( Figs . 1 and 3 ) . The performance for 6 ° C solutions and ambient temperatures of 25 ° C are given in Fig . 4 and Table 1. Conclusions . The importance of infusion warming increases with the amount of fluid given . In general , the infusion bag temperature only influenced the efficacy of in-line warmers within the high-flow range , challenging the performance of the heat exchanger . The length of uninsulated i.v. line downstream from the heat exchanger influenced the efficacy within the low- and middle-flow range ."
],
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4029
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DerAnaesthesist.60451075.eng.abstr
|
DerAnaesthesist.60451075.eng.abstr
|
[
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"id": "DerAnaesthesist.60451075.eng.abstr-passage-0",
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"Hypothermia ( core temperature 36 ° C ) is common after longer-lasting surgical procedures . Heat loss mainly occurs during anaesthesia and surgery and leads to increased risk , especially in the early recovery period of elderly patients . In the present study we investigated the effects of intraoperative forced-air warming , administered via an upper-body blanked ( \" Warm Touch \" , Mallinckrodt , USA ) , with the specific aims of : ( 1 ) drawing up heat balances ; and ( 2 ) analysing postoperative thermoregulation , oxygen consumption ( VO2) and cardiovascular reactions of mechanically ventilated patients . The general aim of our study was to compare intraoperative forced-air-warming and conventional patient-insulation with cotton blankets . Methods . Twenty four ASA II and III patients sheduled for elective colon surgery were randomly assigned to a control group ( n=12, no warming therapy , upper body covered with a cotton hospital blanket ) or a convective warming group ( n=12). Anaesthesia was administered with etomidate ( 0.2 mg/kg ) , fentanyl ( approximately 10 µg/kg) and vecuronium bromide ( 0.1 mg/kg ) . During surgery the lungs were mechanically ventilated with 70% nitrous oxide in oxygen and enflurane ( end-tidal-concentration max . 0.7% ) using a semiclosed circuit with a fresh gas flow of 3 l/min . A hygrophobe heat and moisture exchanger ( \" Sterivent , \" Darex Corp. , Italy ) was used . At the end of surgery patients were transferred to the ICU , covered with a hospital cotton-quilt and normo-ventilated using a Bennett 7200 a. Patients were sedated/kept free of pain by administering titrated doses of midazolam and/or piritramide . Postoperative oxygen consumption ( VO2) was recorded continuously with a Deltatrac Metabolic Monitor ( Datex Corp. , Finland ) . Pre- , intra- and postoperative measurements included heartrate , invasive blood pressure , core-temperature ( before and after operation : urinary bladder-temperature , during surgery : oesophageal temperature ) and mean-skin-temperature ( according to Ramanathan ) up to 180 min from the end of surgery . Shivering , pharmacological interventions ( e.g. pethidine ) and time of extubation were noted . Data are presented as median , minima and maxima . The results were analysed using the Mann-Whitney U test or Chi-Square test ( shivering ) . Statistical significance was assumed when P 0.05. Results . Both groups were comparable for gender , body weight , height , age , duration of their operations and amount of intraoperative fluids , narcotics and muscle relaxants . Room temperatures in the control group were significantly higher than in the forced air group ( 24 vs 22 ° C ) . Initial setting of the forced-air blower was \" high \" ( 42-46 ° high air flow ) . When the oesophageal-temperature reached 36,5 ° C , the blower temperature was reduced to 36-40 ° C. Reduction was necessary approximately 60 min from start in the operation . At the end of surgery/administration to the ICU core-temperatures of both groups differed significantly ( 35.2/35.4 ° C vs 36.3/36.2 ° C ) . Mean-skin temperatures were higher , too , but no statistical analysis was carried out for the intraoperative period , because warm air influenced skin thermometers located on the upper body . At admission to the ICU patients in the control group had a heat loss of 4.4 kJ/kg ; those in the convective warming group had a heat-gain of 0.8 kJ/kg . Further measurements of postoperative core temperatures did not differ significantly , but the skin-temperatures of patients who received forced-air warming in the theatre remained higher ( P 0.05 ) until 120 min from the end of surgery . Shivering was more frequent and lasted longer in the control group ( 8 patients , 20 min vs 4 patients , 9 min ; P 0.05 ) . Patients in the control group needed more drugs to stop increased cardiovascular reactions ( hypertension , tachycardia ) or shivering ."
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}
] |
DerAnaesthesist.60451082.eng.abstr
|
DerAnaesthesist.60451082.eng.abstr
|
[
{
"id": "DerAnaesthesist.60451082.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Etomidate has become an important induction agent in high-risk patients because of its cardiovascular stability . Its unwanted side-effects such as pain on injection and thrombophlebitis could be significantly reduced by a new ( medium chain triglyceride and soya bean ) emulsion formulation . Propofol is solved in a mixture of long chain triglyceride and soya bean emulsion . In this double-blind , randomized study we compared the haemodynamic effects , the patients ' sensations , signs of thrombophlebitis and postoperative nausea and vomiting ( PONV ) following injection of both drugs ."
],
"offsets": [
[
0,
593
]
]
}
] |
[
{
"id": "DerAnaesthesist.60451082.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"Etomidate"
],
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[
0,
9
]
],
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"db_name": "UMLS",
"db_id": "C0015131"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"patients"
],
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[
63,
71
]
],
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{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"pain"
],
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[
148,
152
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030193"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"injection"
],
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[
156,
165
]
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"normalized": [
{
"db_name": "UMLS",
"db_id": "C0021485"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"thrombophlebitis"
],
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[
170,
186
]
],
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{
"db_name": "UMLS",
"db_id": "C0040046"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"triglyceride"
],
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[
242,
254
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0041004"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s2-t5",
"type": "umlsterm",
"text": [
"soya"
],
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[
259,
263
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0037733"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s2-t6",
"type": "umlsterm",
"text": [
"bean"
],
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[
264,
268
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0004896"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s2-t7",
"type": "umlsterm",
"text": [
"emulsion"
],
"offsets": [
[
271,
279
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0014020"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s2-t8",
"type": "umlsterm",
"text": [
"soya bean"
],
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[
259,
268
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0037733"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"Propofol"
],
"offsets": [
[
294,
302
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0033487"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"triglyceride"
],
"offsets": [
[
340,
352
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0041004"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"soya"
],
"offsets": [
[
357,
361
]
],
"normalized": [
{
"db_name": "UMLS",
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}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s3-t4",
"type": "umlsterm",
"text": [
"bean"
],
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[
362,
366
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0004896"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s3-t5",
"type": "umlsterm",
"text": [
"emulsion"
],
"offsets": [
[
367,
375
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0014020"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s3-t6",
"type": "umlsterm",
"text": [
"soya bean"
],
"offsets": [
[
357,
366
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0037733"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"haemodynamic"
],
"offsets": [
[
434,
446
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0019010"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"patients"
],
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[
461,
469
]
],
"normalized": [
{
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}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"sensations"
],
"offsets": [
[
472,
482
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0036658"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s4-t4",
"type": "umlsterm",
"text": [
"signs"
],
"offsets": [
[
485,
490
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0220912"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s4-t5",
"type": "umlsterm",
"text": [
"thrombophlebitis"
],
"offsets": [
[
494,
510
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],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0040046"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s4-t6",
"type": "umlsterm",
"text": [
"postoperative"
],
"offsets": [
[
515,
528
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0032790"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s4-t7",
"type": "umlsterm",
"text": [
"nausea"
],
"offsets": [
[
529,
535
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0027497"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s4-t8",
"type": "umlsterm",
"text": [
"vomiting"
],
"offsets": [
[
540,
548
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0042963"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s4-t9",
"type": "umlsterm",
"text": [
"PONV"
],
"offsets": [
[
551,
555
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0520909"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s4-t10",
"type": "umlsterm",
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"injection"
],
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568,
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},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s4-t11",
"type": "umlsterm",
"text": [
"drugs"
],
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586,
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]
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"normalized": [
{
"db_name": "UMLS",
"db_id": "C0013227"
}
]
},
{
"id": "DerAnaesthesist.60451082.eng.abstr-s4-t12",
"type": "umlsterm",
"text": [
"postoperative nausea"
],
"offsets": [
[
515,
535
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0520904"
}
]
}
] |
[] |
[] |
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{
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{
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{
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{
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] |
DerAnaesthesist.60451085.eng.abstr
|
DerAnaesthesist.60451085.eng.abstr
|
[
{
"id": "DerAnaesthesist.60451085.eng.abstr-passage-0",
"type": "abstract",
"text": [
"100 ASA I and II children , aged 4 to 14 years , and scheduled for strabismus surgery , were randomly assigned to one of the following groups : group 1 ( n=50): endotracheal tube , group 2 ( n=50): laryngeal mask airway . Apart from airway management , the anaesthesiological procedures were identical in both groups : induction with 2-3 mg/kg propofol , 0.02 mg/kg alfentanil , 0.05 mg/kg vecuronium , and 0.01 mg/kg atropine . After endotracheal intubation or insertion of the laryngeal mask , anaesthesia was continued with 6-15 mg/kg - h propofol and 10-30 µg/kg - h alfentanil . All patients were ventilated with N2O/O2 ( 2:1 ) . No antiemetics were given , gastric contents were not aspirated . Postoperative nausea and vomiting ( PONV ) were recorded by 24 h , the incidence of sore throats was recorded 8 , 12 , and 24 h post-operatively ."
],
"offsets": [
[
0,
847
]
]
}
] |
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7
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25
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"strabismus"
],
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67,
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{
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"id": "DerAnaesthesist.60451085.eng.abstr-s2-t2",
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}
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},
{
"id": "DerAnaesthesist.60451085.eng.abstr-s6-t2",
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{
"id": "DerAnaesthesist.60451085.eng.abstr-s6-t3",
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"vomiting"
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734
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{
"id": "DerAnaesthesist.60451085.eng.abstr-s6-t4",
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"PONV"
],
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737,
741
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{
"id": "DerAnaesthesist.60451085.eng.abstr-s6-t5",
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781
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},
{
"id": "DerAnaesthesist.60451085.eng.abstr-s6-t6",
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790,
797
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{
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721
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{
"id": "DerAnaesthesist.60451085.eng.abstr-s6-t8",
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785,
797
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],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0242429"
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]
}
] |
[] |
[] |
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{
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{
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{
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{
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{
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{
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{
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{
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{
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{
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{
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{
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}
] |
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