Nunn's Applied Respiratory Physiology, Ninth Edition, is your concise, one-stop guide to all aspects of respiratory physiology in health, disease, and in the many physiologically challenging situations and environments into which humans take themselves - coverage is from basic science to clinical applications. Trusted for over 50 years, this most comprehensive single volume on respiratory physiology will prove invaluable to those in training or preparing for examinations in anaesthesia, intensive care, respiratory medicine or thoracic surgery - as well as an essential quick reference for physiologists and the range of practitioners requiring ready access to current knowledge in this field. Now fully revised and updated, this ninth edition includes a larger page format for improved clarity, as well as full access to the complete, downloadable eBook version. This incorporates BONUS chapters, handy topic summaries, interactive self-assessment material and a NEW series of expert lectures on key topics. The result is a more flexible, engaging and complete resource than ever before. Enhancements to this edition include: A new dedicated chapter on obesity - covering the effects of this global challenge on the physiology of the respiratory system in health and disease, in both adults and children Expanded coverage of the adverse effects of hyperoxia - including the physiology of the now popular technique of high-flow nasal therapy A revised section on air pollution - reflecting the growing importance and understanding of the impact of pollution on the lungs and other body systems, along with the latest worldwide guidelines Detailed coverage of artificial ventilation during general anaesthesia - covering post-operative respiratory complications and the physiological basis of current best-practice for optimizing ventilation Print comes with enhanced eBook - includes access to the complete, fully searchable text, PLUS: bonus chapters handy chapter summaries interactive self-assessment material a NEW series of 25 expert lectures focusing on the most essential topics in respiratory physiology

Neues Berufsbild Honorararzt: AErzte, deren uberwiegende Tatigkeit nicht durch ein festes Angestelltenverhaltnis oder die klassische Niederlassung in der Praxis gekennzeichnet ist, sondern dadurch, dass die Einnahmen durch zeitlich und oertlich befristete, auftrags- oder projektbezogene Anstellungen erzielt werden. Nachdem Honorararzte in anderen Landern schon langer von Bedeutung sind (angloamerikanische Lander, Frankreich, Schweiz), ist diese Tatigkeitsform auch bei deutschen AErzten seit ca. 2007 zunehmend verbreitet. Alles Wissenswerte fur AErzte, die hauptberuflich oder erganzend als Honorararzt tatig sind oder werden wollen: Akquise, Organisation, Recht, Finanzen. Alle wichtigen Informationen fur Deutschland und alle anderen relevanten Lander. Kompakt, handfest, praxisrelevant: Mit Erfahrungsberichten und Zusatzinfos im Internet.

The aim of this text is to provide the framework for building a clinical trial as it pertains to operative and non operative invasive procedures, how to get it funded and how to conduct such a trial up to publication of results The text provides all details of building a scientifically and ethically valid proposal, including how to build the infrastructure for a clinical trial and how to move it forward through various funding agencies. The text also presents various types of clinical trials, the use of implantable devices and FDA requirements, and adjuncts to clinical trials and interaction with industry Clinical Trials Design in Invasive Operative and Non Operative Procedures will be of interest to all specialists of surgery, anesthesiologists, interventional radiologists, gastroenterologists, cardiologists, and pulmonologists

In der Intensivmedizin ist es oft notwendig, rasch erste therapeutische Massnahmen ohne Fehler und Unsicherheiten vorzunehmen. Dieses Buch bietet den Arzten wahrend ihrer intensivmedizinischen Ausbildung eine schnelle und ubersichtliche Hilfe in der kompetenten Betreuung eines breiten Patientenspektrums an einer chirurgischen Intensivstation. Haufige Krankheitsbilder aus Abdominalchirurgie, Thoraxchirurgie, Herzchirurgie, Traumatologie, Geburtshilfe und Innerer Medizin werden behandelt und die pathophysiologischen Vorstellungen erlautert. Daruber hinaus werden grundlegende Kenntnisse in Bezug auf kunstliche Beatmung sowie alternative Techniken vermittelt und die Thematik der parenteralen und enteralen Ernahrung ubersichtlich und praxisnah dargelegt. Krankheitsbildern wie Sepsis mit ihrer Pathophysiologie und damit verbundener Verzahnung von Gerinnung und Inflammation wurde besonderes Augenmerk gewidmet, so dass neue und teils noch in Entwicklung befindliche Therapieansatze beurteilt werden konnen."

The updated guide to the Australian and New Zealand College of Anaesthetists final fellowship examination

The format of the Australian and New Zealand College of Anaesthetists (ANZCA) final examination has evolved in recent years. This updated exam guide keeps pace with these developments and assists anaesthetic trainees in preparation for the exam.

"Examination Anaesthesia, 2nd Edition" is a comprehensive study guide that focuses solely on the anaesthetic exam, eliminating confusion between this and the intensive care exams.

This invaluable medical text itemises all requirements of the Fellow of the Australian and New Zealand College of Anaesthetists (FANZCA) training scheme.

Components of the final examination are also detailed, including a breakdown of the marking scheme and recent results.

Helpful resources outlined in "Examination Anaesthesia, 2nd Edition" include new developments on the ANZCA website, textbooks, journals and exam courses along with a broad list of anaesthesia reference and review articles.

Trainees will also benefit from separate chapters based on the major components of the written and clinical ANZCA examinations, plus practical strategies for restructuring life around exam preparation.

Andreas Meiser summarizes the current literature on inhalation sedation of critically ill patients. To meet clinical demands, he describes the development of new devices to administer volatile anesthetics together with common ICU ventilators. Their basic principle is called anesthetic reflection. The author discusses advantages and drawbacks of these devices in line with clinical studies demonstrating advantages of inhaled versus intravenous ICU sedation.About the Author:Dr. med. Andreas Meiser is working as a consultant anesthesiologist on the interdisciplinary operative ICU of the Saarland University Medical Center. He has been a pioneer in the field of inhalation ICU sedation. He has been treating patients using the AnaConDa administration devices since 2004, and has published many original articles in scientific journals on the subject.

Plum and Posner's Diagnosis and Treatment of Stupor and Coma, 5th edition, is a major update of the classic work on diagnosing the cause of coma, with the addition of completely new sections on treatment of comatose patients, by Dr. Jan Claassen, the Director of the Neuro-ICU at Columbia New York Presbyterian Hospital. The first chapter of the book provides an up-to-date review on the brain mechanisms that maintain a conscious state in humans, and how lesions that damage these mechanisms cause loss of consciousness or coma. The second chapter reviews the neurological examination of the comatose patient, which provides the basis for determining whether the patient is suffering from a structural brain injury causing the coma, or from a metabolic disorder of consciousness. The third and fourth chapters review the pathophysiology of structural lesions causing coma, and the specific disease states that result in coma. Chapter five is a comprehensive treatment of the many causes of metabolic coma. Chapter 6 review psychiatric causes of unresponsiveness and how to identify and treat them. Chapters 7 and 8 review the overall emergency treatment of comatose patients, followed by the treatment of specific causes of coma. Chapter 9 examines the long term outcomes of coma, including the minimally conscious state and the persistent vegetative state, and how they can be distinguished, and their implications for eventual useful recovery. Chapter 10 reviews the topic of brain death and the standards for examination of a patient that are required to make the determination of brain death. The final chapter 11 is by J.J. Fins, a medical ethicist who was invited by the other authors to write an essay on the ethics of diagnosis and treatment of patients who, by definition, have no way to approve of or communicate about their wishes. While providing detailed background for neurological and neurosurgical specialists, the practical nature of the material in this book has found its greatest use among Internists, Emergency Medicine, and Intensive Care specialists, who deal with comatose patients frequently, but who may not have had extensive neurological training.

In April of 1991, 425 partICIpants from 18 countries met in Hamamatsu in Japan for the 6th International Symposium on Computing in Anesthesia and Intensive Care (lSCAIC). The meeting was one of the most spectacular academic and fruitful in the history of ISCAIC. We had four days of fascinating presentations and discussions covering many areas of technology in Anesthesia and intensive care. New technologies were presented and old technology reexamined. The measures of success of the meeting were the excellent research material in oral and poster presentations, and state of the art reviews of the latest issues by distinguished worldwide key speakers. It must be sure that the meeting was most effective to promote and disseminate up-to-date information in these fields across the participating countries. The aim of this book is to record the exciting achievements of the meeting and extend them further among our colleagues. We hope the readers of this book will share the same excitation as well as the latest information in this speciality. Finally we would like to extend our deepest gratitude to all participants and others for the contribution to the compilation of this book. Kazuyuki Ikeda, M.D.

Why write a book on the tourniquet? The tourniquet is used routinely in op- ating theatres throughout the world, but as far as I know there is no single book that surveys the considerable literature that has accumulated. If used sensibly, the tourniquet is a safe instrument. Most of the few complications seen with its use are preventable. However, when something untoward happens, the tour- quet suddenly becomes an interesting subject, particularly if there is the likelihood of medicolegal consequences. This book summarises the scientific background of the tourniquet and describes a safe physiological approach to preventing complications. Examples of medicolegal problems are included. Considerable progress had been made since Lister first excised a tuberculous wrist joint in a bloodless field. Many researchers have studied the effects of ischaemia and pressure on nerves and muscles. Tourniquets have entered the age of computers and are now much more sophisticated. Despite this, there is still much dogma surrounding the tourniquet in operating theatres and in textbooks. This book is aimed at orthopaedic surgeons, anaesthetists and op- ating-theatre staff. I hope that this short text will stimulate a more widespread interest in the tour- quet and improve safe practice.

This comprehensive textbook, covering all aspects of the perioperative management of patients undergoing organ transplantation, serves as the standard reference for clinicians who care for transplant patients on a day-to-day basis as well as those who encounter organ transplantation only occasionally in their clinical practice. Anesthesia and Perioperative Care for Organ Transplantation covers transplantation of the heart, lung, liver, pancreas, and kidney, as well as multivisceral and composite tissue graft transplantations. For each kind of transplantation, the full spectrum of perioperative considerations is addressed: preoperative preparation, intraoperative anesthesia management, surgical techniques, and postoperative care. Each chapter contains evidence-based recommendations, relevant society guidelines, management algorithms, and institutional protocols as tables, flow diagrams, and figures. Photographs demonstrating surgical techniques, anesthesia procedures, and perfusion management are included. Anesthesia and Perioperative Care for Organ Transplantation is for anesthesiologists and critical care physicians; transplantation surgeons; nurse anesthetists; ICU nurses; and trainees.

As Sir William Osler said "The practice of medicine is an art, based on science". The authors believe that the art of precision medicine is knowing when the science of medicine should not be applied to your patient. This practical guide to managing patient expectations while maintaining a good medical practice presents as one of the only books of its kind. Written for anesthesiology residents in training, as well as practicing physicians, Practical Anesthetic Management focuses on giving clinicians the tools to create safer, more effective and efficient practices while catering to patient satisfaction. Featuring pearls for teaching purposes, Practical Anesthetic Management also covers topics like preoperative evaluation, tips on blood-gas analysis, and essentials of airway management, all complete with accompanying videos.

This text is aimed at defining the current concepts that define trauma induced coagulopathy by critically analyzing the most up-to-date studies from a clinical and basic science perspective. It will serve as a reference source for any clinician interested in reviewing the pathophysiology, diagnosis, and management of the coagulopathic trauma patient, and the data that supports it. By meticulously describing the methodology of most traditional as well as state of the art coagulation assays the reader will have full understanding of the tests that are used to study trauma induced coagulopathy. The evolving use of blood products as well as recently introduced hemostatic medications are reviewed in detail. Trauma Induced Coagulopathy will also be a valuable source for quick reference to the clinician that is faced with specific clinical challenges when managing coagulopathy.

Authored by top anesthetists, this Second Edition of Primary FRCA in a Box contains over 200 revision flashcards addressing almost all the topics needed to pass the Primary FRCA. Broad and wide-ranging subject areas are covered in easy-to-learn note format, including physiology, pharmacology, physics, and clinical measurement. The cards include key diagrams to aid understanding and are easy to reproduce in the oral exam.The cards include key diagrams to aid understanding and are easy to reproduce in the oral exam. Using standard question formats from the Royal College exams, Primary FRCA in a Box is an essential tool for effective revision and preparation for the Primary FRCA exams. It also provides essential revision for candidates studying for the Final FRCA exam who wish to have a concise review of Primary FRCA topics. These flashcards are recommended for all qualified and trainee anaesthetists and their trainers, and related health professionals.

Theodore H. Stanley, M. D. What's New in, Anesthesiology in 1988 contains the Refresher Course manuscripts of the presentations of the 33rd Annual Postgraduate Course in Anesthesiology which took place at the Marriott Hotel Convention Center in Salt Lake City, Utah, February 19-23, 1988. The chapters reflect new data, ideas and concepts within the general framework of most recent developments in "evaluation and monitoring cardiac function before, during and after surgery," "new anesthetics and their actions on the heart and peripheral vasculature, and other organ systems," "metabolism and elimination of anesthetics and anesthetic adjuvants," and "recent developments in the anesthetic management of patients with congenital heart disease, renal and pulmonary dysfunction, and diabetes insipidus. " In addition, there are chapters on new developments in "obstetrics," "regional anesthesia," and "anesthetic management of the newborn. " The purposes of the textbook are to 1) act as a reference for the anesthesio logists attending the meeting, and,2) serve as a vehicle to bring many of the latest concepts in anesthesiology to others within a short time of the formal presentation. Each chapter is a brief but sharply focused glimpse of the interests in anesthesia expressed at the conference. This book and its chapters should not be considered complete treatises on the subjects addressed but rather attempts to summarize the most salient points. This textbook is the sixth in a continuing series documenting the proceedings of the Postgraduate Course in Salt Lake City."

Theodore H. Stanley, M.D. W. Clayton Petty, M.D. Anesthesiology 1986 contains the Refresher Course manuscripts of the presentations of the 31st Annual Postgraduate Course in Anesthesiology which took place at the Westin Hotel Utah Convention Center in Salt Lake City, Utah, February 14-18, 1986. The chapters reflect recent and future developments in anesthetic techniques, monitoring instruments and devices, and anesthetic drugs. The purposes of the textbook are to 1) act as a reference for the anesthesiologists attending the meeting, and 2) serve as a vehi cl e to bri ng many of the 1 atest concepts in anesthesiology to others within a short time of the formal presentation. Each chapter is a brief but sharply focused glimpse of the interests in anesthesi a expressed at the conference. Thi s book and its chapters should not be considered complete treatises on the subjects addressed but rather attempts to summarlze the most salient points. This textbook is the fourth in a continuing series documenting the proceedings of the Postgraduate Course in Salt Lake City. We hope that this and the past and future volumes reflect the rapid and continuing evolution of anesthesiology in the late twentieth century. TABLE OF CONTENTS PHARMACOLOGY The New Neuromusucular Blocking Agents D. Ryan Cook, M.D.

It is a pleasure to have the privilege of writing the foreword for a book edited by Dr. Francis F. Foldes. Dr. Foldes has collected in one convenient place a discussion and description of enzyme systems of use to the anesthesiologist and to those other individuals, such as undergraduate and graduate students in related basic sciences, who will profit by and can make use of this body of information. The practicing anesthesiologist and those who work in related fields have become increasingly aware of the need to understand enzyme activities which influence the uptake, distribution, and excretion of those substances that are used in the anesthetic management of surgical patients. A variety of such is obvious when one considers that such diverse substances as activities and muscle re analgesic drugs, tranquilizers, hypnotics, anesthetic agents, laxants are strongly affected by these systems and have an influence over the basic understanding of how these drugs operate and act in the body, as well as providing a safety measure so necessary to the proper conduct of clinical anesthesia. The editor and his colleagues have rendered us a great service in collecting information that deals with the basic activity of enzymes including their structure, their kinetics, and to the degree that knowledge permits, mechanism of actions."

The diagnosis of cancer inspires fear, in part because of the high mortality rate associated with most malignancies, and in part because of the perception that cancer is a painful disease. Recently compiled statistics tend to support patients' fears. Pain is a major symptom in 70% of patients with advanced cancer [1]. Half of all patients undergoing anticancer therapy experience pain [2]. It has been estimated by members of the World Health Organization that 3. 5 million people worldwide suffer from cancer pain. One study of the severity of cancer pain estimates that pain is moderate to severe in 50% of cancer pain patients, very severe or excruciating in 30% [3]. An analysis of several reports of patients in developed countries estimates that 50-80% of patients had inadequate relief [2]. In underdeveloped countries, adequacy of treatment may be far lower because of lack of availability of medical facilities and legal constraints on the use of potent narcotics. The picture need not be this bleak. The reality is that, for most patients, cancer pain is relatively easy to control with simple, inexpensive measures. Several studies have indicated that cancer pain can be well controlled with oral morphine in over 90% of patients [4,5]. Long-acting orally effective opiate preparations such as time release morphine, methadone, and levorphanol allow patients to sleep comfortably through the night. When the oral route is impossible, narcotics can be administered rectally or by intravenous or subcutaneous infusion.

One of the most exciting developments in medicine in this century has been the discovery of opioid receptors and their pharmacology. The breadth of know- edge derived from such discovery has truly changed the practice of medicine today. The acceptance by the clinicians of the research data obtained by the basic scientist on spinal opioids is truly amazing. The clinical sequelae of the discovery of opioid receptors has been the development of the technique of intraspinal administration of opioids. In the last decade much has been written about indications, effects, and side effects of intraspinal opioids. The technique has become commonplace for cancer and postoperative pain. However, no standards of care and management of patients with spinally administered opioids have been developed. We need these standards to be developed and universally followed. The monograph was conceived to update clinicians on the applied pharma cology of spinal opioids. We were fortunate to have Drs. N. Rawal and D. Coombs agree to edit this monograph. They have been able to assemble world-renowned experts as contributing authors. It is our hope that the con tents of this book will be stimulating, informative, and useful to the reader. PREFACE Much has been written about the subject of spinal opioid analgesia, includ ing several notable reviews. We were stimulated to assemble this particular volume in this important series on pain management initiated by Dr. Raj for a number of reasons."

All anesthesiologists eventually face the fear of a "near miss," when a patient's life has been put at risk. Learning from the experience is crucial to professionalism and the ongoing development of expertise. Drawing on forty-plus years of practice in major metropolitan hospitals in the United States, Norway, and South Africa, John Brock-Utne, MD presents 80 carefully selected cases that provide the basis for lessons and tips to prevent potential disaster. The cases emphasize problem-centered learning and span a broad range of topics-from an outbreak of operating room infection (could it be the anesthesia equipment?), complications of fiberoptic intubations, and problems with epidural drug pumps, to performing an urgent tracheostomy for the first time, working with an aggressive surgeon, and what to do when a patient falls off the operating table during surgery.80 true-story clinical "near misses" never before published, ideal for problem-centered learning, recommendations, references, and discussions accompany most cases, rich basis for teaching discussions both in or out of the operating room, settings include sophisticated as well as rudimentary anesthetic environments, complements the author's other case book, "Clinical Anesthesia: Near Misses and Lessons Learned" (Springer, 2008).

"

Committed to providing safe anaesthetic care for paediatric patients, it is of paramount importance for clinicians to learn from suboptimal situations in order to continuously improve clinical performance. The first resource of its kind, this text analyses a selection of fascinating case studies and evaluates best practice in providing safe anaesthesia to children with recommendations on how to avoid the most common clinical pitfalls. Featuring over seventy chapters, topics include airway-related problems, vascular access, regional anaesthesia, medication related problems and the management of patients with pre-existing conditions. Each case study is supported by full colour images, making this essential reading for consultants and trainees in anaesthesia.