Mechanical ventilation is a life-critical intervention provided to patients in a wide variety of clinical settings, involving the careful interplay of physiology, pathology, physics and technology. This unique text explains the underlying physiological and technical concepts of ventilation, aided by numerous full colour diagrams, and places these concepts into clinical context with practical examples. Core Topics in Mechanical Ventilation provides a broad and in-depth coverage of key topics encountered in clinical practice, from the initial assessment of the patient to transportation of the ventilated patient and weaning from ventilation. Issues such as sedation, analgesia and paralysis and the management of complications are reviewed, along with a discussion of various ventilation modes and practical advice on patients with pre-existing diseases. Appealing to doctors, nurses, physiotherapists and paramedics, this book is applicable to a wide range of settings including intensive care, anaesthesia, respiratory medicine, acute medicine and emergency medicine.

Stress is everywhere, experienced by all. No one is immune, particularly the nurse anesthetist or CRNA. A qualitative inquiry was launched to explore occupational stress among Certified Registered Nurse Anesthetists (CRNAs) and to answer four research questions: 1.What are the roles and responsibilities of the CRNAs as they see them? 2.What are the CRNAs perceived stressors encountered on the job? 3.What are their coping strategies related to the perceived stressors? 4.What is the relationship between CRNA job stress and interpersonal work connections? The answers to the research questions underscore the necessity that the shortage of Registered Nurses and anesthetists needs to be addressed in order to more effectively tackle the participants perceived stressors. This book is a rare gem given its unique qualitative, in-depth inquiry into a topic of ever-increasing importance. This work is aimed at the healthcare professional, especially CRNAs and operating room personnel, and also nursing and anesthesia students. If you have ever stepped foot into an operating room, whether as a professional or a patient, you will find this research revealing and honest

This evidence-based guide is the first of its kind to outline the surgical and perioperative management of patients with anatomical anomalies and support clinical decision-making under these difficult circumstances. Presented in a simple, accessible format and organized by anatomical area, this book contains all the essential topics required by trainees and practitioners to assess the patient quickly, diagnose anatomic anomalies, determine the feasibility and safety of the planned surgical and anesthetic procedures, and arrange for advanced consults and care, if needed. Newer techniques for surgical and anesthetic management of patients with anatomic anomalies are presented to facilitate practitioners' development of their skills. Chapters include the latest ultrasound techniques and images, as well as case studies. Physicians, nurses, and trainees involved in the surgical, anesthetic, perioperative, or critical care of patients will find this guide to be their go-to resource in the OR, lab, or pain clinic.

Some important constraints of anesthesia must be taken into consideration when the pharmacological properties of modern anesthetics are discussed. The most imp- tant of these could be that the target effect be achieved preferably within seconds, at most within a few minutes. Similarly, offset of drug action should be achieved within minutes rather hours. The target effects, such as unconsciousness, are pot- tially life-threatening, as are the side effects of modern anesthetics, such as respi- tory and cardiovascular depression. Finally, the patient's purposeful responses are not available to guide drug dosage, because, either the patient is unconscious, or more problematically, the patient is aware but unable to communicate pain because of neuromuscular blockade. These constraints were already recognised 35 years ago, when in 1972 Volume XXX entitled "Modern Inhalation Anesthetics" appeared in this Handbook Series. The present volume is meant as a follow up and extension of that volume. At the beginning of the 1970's anesthesia was commonly delivered by inhalation, with only very few exceptions. The clinical understanding of that time considered anesthesia as a unique state achieved by any of the inhalation anesthetics, in- pendent of their specific molecular structure. "The very mechanism of anesthetic action at the biophase" was discussed within the theoretical framework of the "u- tary theory of narcosis".

Decision making regarding fluid volume loading, fluid restriction, or administration of vasoactive drugs may vary among physicians, depending solely upon their clinical experience in the absence of evidence-based measurement. The initial distribution volume of glucose (IDVG) is believed to be clinically relevant as a marker of cardiovascular and fluid management in critically ill patients without a significant modification of glucose metabolism. This book covers all aspects of IDVG measurement, including the basic concept, its relationship with other fluid volumes, and the clinical application of this technique in the intensive care unit based on both the authors studies and their clinical experience with more than 4000 IDVG determinations. When the concept of IDVG is properly understood and its measurement is then performed routinely, daily fluid and cardiovascular management in critically ill patients can be improved based on evidence-based measurement."

This compact book contains colour coded sections of checklists and flow charts for the immediate management of a wide range of paediatric situations including resuscitation, trauma, anaesthetic and medical emergencies. The 'age-by-page' section consists of tables of commonly used anaesthetic and resuscitation drugs, pre-calculated for a specific weight within the WHO weight range, for that specific age. Each page includes medication doses, airway equipment including size of endotracheal tubes, laryngeal masks and airway adjuncts, resuscitation fluids including blood products and mannitol and stabilisation infusions such as sedatives and inotropes for ongoing management of the patient. In addition to the emergency guideline sections, the anaesthetic management of 50 common syndromes and congenital conditions are included and the drug formulary providing a convenient reference section of doses and indications of common paediatric medications. An essential quick-reference handbook for anaesthetists, intensive care and emergency department physicians, and trainees.

Inhalational anaesthesia was the first medical and scientific technique to become a legitimate means of pain relief. Its introduction to medicine in 1846 sparked one of the most intense public debates of the period. It challenged religious principles and at its center posed one of medicine's fundamental questions: risk versus benefit of medical intervention. This book explains how the introduction of anaesthesia intertwines with a wide variety of other nineteenth century medical and cultural issues: the growing elitism of surgery, the emerging professionalism of medicine, the popular and progressive culture of science and the secularization of society.

This superbly illustrated book provides a comprehensive overview of all aspects of regional anaesthesia for the trainee and practising anaesthetist alike. Written by a team of experts who are well known in the field of regional anaesthesia, the book is structured logically, with essential anatomy being followed by indications and then the block techniques themselves, all sections being organised by region of the body, for ease of reference. Section one, 'Principles and Practice', outlines the benefits of regional anaesthesia and details of the contraindications and complications, safety aspects and precautions for safeguarding patient welfare. A brief description of the pharmacology of local anaesthetics is also included. Section two covers peripheral blocks in detail. This section is arranged in a logical manner from the lower limb through the abdomen, the thorax and the upper limb to the head and neck, allowing the reader to revise the nerve supply to a particular operative site and select suitable nerve blocks in advance of a surgical list. Section three describes the central neuraxial and major peripheral nerve blocks in detail. Line and perspective diagrams to clarify and define the skills required for each technique complement the written descriptions. Section four contains a detailed appendix with useful index of specific techniques and a comprehensive further reading list, divided by section and sub-section. Fully illustrated in colour throughout with all illustrations produced especially for this book, it is the essential, one-stop guide to regional anaesthesia for all anaesthetists.

The first edition of this publication was aimed at defining the current concepts of trauma induced coagulopathy by critically analyzing the most up-to-date studies from a clinical and basic science perspective. It served 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 is provided with a full understanding of the tests that are used to study trauma induced coagulopathy. With the growing interest in understanding and managing coagulation in trauma, this second edition has been expanded to 46 chapters from its original 35 to incorporate the massive global efforts in understanding, diagnosing, and treating trauma induced coagulopathy. The evolving use of blood products as well as recently introduced hemostatic medications is reviewed in detail. The text provides therapeutic strategies to treat specific coagulation abnormalities following severe injury, which goes beyond the first edition that largely was based on describing the mechanisms causing coagulation abnormalities. Trauma Induced Coagulopathy 2nd Edition is a valuable reference to clinicians that are faced with specific clinical challenges when managing coagulopathy.

In recent years, neurocritical care has grown and matured as a subspecialty of Critical Care Medicine with the advent of new monitoring, diagnostic, and therapeutic capabilities. The goal of neurocritical care is to rapidly deliver acute medical therapies and appropriate interventions through effective monitoring of both neurological and end organ function. Neurocritical Care provides 'at the bedside' guidance on the medical knowledge and technical skills required to care for critically ill patients with neurologic conditions such as cerebrovascular disorders, neurotrama, neuro-oncology, refractory seizures, neuromuscular diseases, infections, alterations in consciousness, and perioperative neurosurgical care. Part of the Pittsburgh Critical Care Medicine series, this compact volume is an ideal reference for physicians and trainees working in either a general ICU or specialty Neuro ICU unit. Readers will gain an understanding of background knowledge and concrete solutions to questions and situations encountered in daily practice.

Continuous update in critical care medicine is a real challenge due to the growing dimensions of its contents; these elements are the result of new research acquisitions, and of those clinical situations where the physician is able to intervene at a given moment, with the use of effective prevention techniques. They are also the result of new technologies able to define complex sub-clinical diagnostic aspects; lastly, they are the result of effective therapeutic techniques available, and of treatment strategies able to influence radically and positively the patient's clinical course. Critical care medicine is playing a key role in the most advanced environments, as it represents a cross-sectional field of action, involving several specialties, such as anesthesiology, general medicine, surgery, pediatrics.

Since its launch in 1998 the European Society for Intravenous Anaesthesia (EuroSIVA) has come a long way in providing educational material and supporting the research and clinical application of intravenous anaesthesia. After the first two annual meetings held in Barcelona and Amsterdam in 1998 and 1999, three other successful meetings took place in Vienna, Gothenburg and Nice in 2000, 2001 and 2002. Next to these main meetings, starting in the year 2000, a smaller winter meeting has been organised every last week of January in Crans Montana, Switzerland. Both the main summer and the winter meetings breathe the same atmosphere of sharing the latest on intravenous anaesthesia research in the presence of a friendly environment and good company. Since the first meetings the educational tools of EuroSIVA have increased in quantity and technical quality allowing digital slide and video presentation along with the use of the computer simulation program TIVAtrainer during the speaker sessions and the workshops. Furthermore, EuroSIVA now exploits a website www. eurosiva. org that allows for continuous exchange of information on intravenous anaesthesia, the TIVAtrainer, the EuroSIVA meetings and online registration for these meetings. The EuroSIVA is currently engaged in friendly contacts with the Asian Oceanic Society for Intravenous Anaesthesia (AOSIVA), the United Kingdom Society for Intravenous Anaesthesia (UKSIVA), the Korean Society for Intravenous Anaesthesia (KSIVA), the European Society of Anaesthesiology (ESA) and the International Society for Applied Pharmacology (ISAP).

Sektion A.- 1 Qualitatssicherung und Risikomanagement.- Qualitatsmanagement.- "Risikomanagement".- Verhalten bei und nach Zwischenfallen.- Resumee.- 2 Risikovermeidung - Simulatoren in der Anasthesie.- Training am Simulator.- Konzepte des Krisenmanagements.- Chancen und Perspektiven durch Simulatortraining.- 3 Monitoringstandards.- Bedeutung von Standards.- Monitoringparameter.- Empfehlungen deutschsprachiger Fachgesellschaften.- Europaische Norm EN 740.- Zusammenfassung.- Sektion B.- 4 Herz-Kreislauf-System.- Intraoperativer Herz-Kreislauf-Stillstand.- Akuter Myokardinfarkt, akute Myokardischamie.- Arrhythmien.- Herzschrittmacherpatienten.- 5 Respirationstrakt.- Monitoring zur Erkennung respiratorischer Komplikationen.- Respiratorische Insuffizienz.- Veranderung der respiratorischen Funktion unter der Anasthesie.- Dekompensation der respiratorischen Funktion (bei vorbestehenden pulmonalen Funktionseinschrankungen).- Atemwegsobstruktion.- Akut auftretende pulmonale Funktionseinschrankungen.- Fehlerhaftes oder fehlerhaft verwendetes Anasthesiegerat.- 6 Neurologie.- Erhoehter intrakranieller Druck.- Postoperative emotionale Stoerungen.- Nichterwachen nach Anasthesie.- Postoperative Verwirrtheitszustande.- Das zentral-anticholinergische Syndrom.- 7 Renales System.- Beurteilung der Nierenfunktion.- Veranderung der Nierenfunktion unter Anasthesie.- Oligurie.- Polyurie.- Anasthesie bei Patienten mit eingeschrankter oder fehlender Nierenfunktion.- Harnretention.- 8 Perioperativ relevante Stoerungen des Flussigkeitsund Elektrolythaushaltes.- Physiologie.- Stoerungen des Flussigkeitshaushalts.- Stoerungen des Elektrolythaushalts.- 9 Stoerungen der Synthese oder der Funktion des Hamoglobins.- Sichelzellerkrankung.- Porphyrien.- Methamoglobinamie.- 10 Gerinnungsstoerungen - Thrombose - Lungenembolie.- Physiologie - Pharmakologie.- Diagnostik.- Therapie.- Haufige perioperative Gerinnungsstoerungen.- Thrombose.- Lungenembolie.- Heparininduzierte Thrombozytopenie.- 11 Endokrines System.- Diabetes mellitus.- Schilddrusenfunktionsstoerungen.- Funktionsstoerungen der Nebenschilddruse.- Funktionsstoerungen der Nebenniere.- Stoerungen der Hypophyse.- Adipositas.- 12 Lebererkrankungen und Anasthesie.- Anatomie und Physiologie.- Pathologie und Pathophysiologie.- Medikamentenclearance.- Anasthesievorbereitung bei Lebererkrankungen.- Anasthesie.- Volatile Anasthestika.- Sektion C.- 13 Unmittelbare Reaktionen auf Lokalanasthetika.- Systemische Reaktionen.- Methamoglobinamie.- Allergie.- Lokale Intoxikation des Gewebes.- Systemische Reaktionen aufVasokonstriktoren.- Wertung.- 14 Ruckenmarknahe Leitungsanasthesien (RMNLA).- Kardiovaskulare Veranderungen.- Ploetzlicher Herzstillstand.- Ateminsuffizienz.- UEbelkeit und Erbrechen.- Blasen- und Darmstoerungen.- Postspinaler Kopfschmerz.- Ruckenschmerzem.- Akzidenteile intravasale Injektion.- Massive Epiduralanasthesie.- Totale Spinalanasthesie.- Katheterkomplikationen.- Bronchospasmus.- Neurologische Komplikationen.- Gerinnungshemmende Medikamente und RMLNA.- Aseptische Meningitis.- Pneumozephalus.- Praexistente Erkrankungen des Zentralnervensystems.- Diabetes und periphere Neuropathie.- Wertung.- 15 Brachiale Plexusblockade.- 16 Intravenoese Regionalanasthesie.- 17 Epidurale Opioide.- 18 Neurolytische Blockaden.- Neurolytische Substanzen.- Allgemeine Komplikationen.- Spezielle neurolytische Blockaden.- Sektion D.- 19 Kombinierte Anasthesieverfahren.- Neurologische Komplikationen.- Hamodynamische Komplikationen.- Weitere potentielle Komplikationen.- 20 Atemwegssicherung.- Erschwerte bzw. unmoegliche Intubation.- Larynxmaske.- 21 Aspiration und praoperative Nahrungskarenz.- Inzidenz perioperativer Aspiration.- Lagerung.- Ursachen und Risikofaktoren der perioperativen Aspiration.- Praoperative Nahrungskarenz.- 22 Kritische Stoerungen der Beatmung.- Pathophysiologie.- Ursachen fur Stoerungen der Ventilation, ihre Behandlung bzw. Vermeidung.- Verlegte Atemwege

Physicians, nurses, and safety experts comprehensively review sedation and analgesia to provide a completely new reference guide to safe sedation practices consistent with existing guidelines. Starting with an integrated review of the basic physiology and neurobiology of the sedated state, the authors proceed through clinical guidelines and practices, and conclude with an examination of quality-outcome measures and processes. They also review current mandates for safe sedation practices and address the key clinical issues of pharmacology, monitoring, and recovery. Special tables and figures throughout the book summarize protocols, regulatory requirements, recommended dosages, monitoring requirements, and quality assurance tools.

Manual de procedimientos de anestesia clinica del Massachusetts General Hospital es una obra concebida por anestesiologos expertos y residentes en anestesiologia de Mass Gen con un formato de facil consulta y referencia rapida que lo ha convertido en un clasico entre los residentes de anestesia por su tamano portable y entre los medicos especialistas por ser una referencia asequible y dinamica. Esta 10.a edicion presenta varias mejoras, cada capitulo ha sido reescrito por un autor distinto al de la edicion anterior para asi actualizar significativamente el contenido de cada apartado, en los que se refleja la practica clinica actual en el MGH y las pautas mas recientes, amplias, concisas, consistentes y clinicamente relevantes sobre todas las facetas de la anestesia, el cuidado perioperatorio, el cuidado critico y el manejo del dolor conservando en todo momento su aplicacion practica y enfoque clinico para residentes en anestesia, estudiantes de medicina y personal de enfermeria. Esta nueva edicion continua formada por tres apartados: evaluacion del paciente antes de la anestesia, administracion de la anestesia y cuidados perioperatorios. Ademas, incluye 3 apendices: medicamentos con rangos terapeuticos y potencial de dano; farmacos comunmente usados y antibioticos intravenosos comunes.

Leading investigators critically evaluate the latest information on how anesthetics work at the molecular, cellular, organ, and whole animal level. These distinguished experts review anesthetic effects on memory, consciousness, and movement and spell out in detail both the anatomic structures and physiological processes that are their likely targets, as well as the cellular and molecular mechanisms by which they operate. Comprehensive and authoritative, Neural Mechanisms of Anesthesia draws together and critically reviews all the recent research on anesthetic mechanisms, highlighting the precise routes along which these substances operate, and how this deeper understanding will lead to the design of effective drugs free ofundesirable side effects.

Over two decades an abundance of knowledge has been accumulated focus ing on the understanding of the molecular and cellular pathomechanisms of stressful conditions like systemic inflammation and sepsis. We have learned that there is a clear correlation between the magnitude of the inciting traumatic event and the degree of inflammatory dysbalance. The immunoinflammatory disintegration comprises a simultaneous col lapse of the otherwise very smoothly balanced pro- and antiinflammatory vectors of cytokine regulation. Most recently, we understood that it is predominantly the dysregulation of antiinflammatory mediators that plays a pivotal role for the phenomenon of trauma-induced depression or paralysis of cell-mediated immune responses. The substantial intellectual and logistic investments of numerous investi gators towards understanding the biology of sepsis inevitably lead us towards a rewarding status in terms of reaching spheres of clinical relevance. From the evolutionary collection of a multitude of ex-vivo and in-vivo immuno mechanistic parameters, some were found to represent most significant bio logical markers to support the clinician to characterize better the severity of inflammatory illness and to predict outcome. Chapter one of this book, authored by G. Grass and E.A.M. Neugebauer, analyses elegantly our current knowledge on the assessment of the immuno logical status in terms of risk and prognosis of sepsis.

This method of local anaethesia, developed by a dermatologist and a pharmacologist, is presented to demonstrate its use in cosmetic liposuction and other procedures. Richly illustrated to show details of the technique and with serialphotographs of many clinical cases, the book explains the advantages of this new technique and provides practical instruction in how to perform it.

Regional Analgesia in Obstetrics provides an account of the developments in the provision of regional analgesia and anaesthesia in obstetrics over the last decade. The book covers the attitudes to obstetric analgesia in different countries; the indications for regional analgesia in labour; the effects of regional analgesia on outcome; and operative delivery.

1 Methoden.- 1.1 Elektroenzephalographie (EEG).- 1.1.1 Einfuhrung.- 1.1.2 Entstehungsmechanismen des EEG.- 1.1.3 Methodik der EEG-Ableitung.- 1.1.4 Das normale EEG.- 1.1.5 Pathologische EEG-Veranderungen.- 1.1.6 Diagnostisch relevante EEG-Befunde.- 1.1.7 EEG-Indikationen im Intensivbereich.- 1.2 Ultraschalldiagnostik.- 1.2.1 Physikalische und apparative Voraussetzungen.- 1.2.2 Anatomische und physiologische Voraussetzungen.- 1.2.3 Untersuchungsgang.- 1.2.4 Indikationen der Ultraschalldiagnostik in der Intensivmedizin.- 1.3 Somatosensibel evozierte Potentiale (SEP).- 1.3.1 Einfuhrung.- 1.3.2 Methodik.- 1.3.3 Ursprungsorte der SEP-Komponenten.- 1.3.4 Auswertung und Normwerte.- 1.3.5 Ausfallsmuster bei typischen Schadigungsorten.- 1.3.6 Indikationen zur Ableitung von SEP.- 1.4 Fruhe akustisch evozierte Potentiale (FAEP).- 1.4.1 Einfuhrung.- 1.4.2 Methodik.- 1.4.3 Generatoren des FAEP.- 1.4.4 Auswertung und Normwerte.- 1.4.5 Lokalisationsdiagnostische Bedeutung der FAEP.- 1.4.6 Indikationen zur Ableitung von FAEP.- 1.5 Motorisch evozierte Potentiale (MEP).- 1.5.1 Einfuhrung.- 1.5.2 Wirkungsweise der Magnetstimulation.- 1.5.3 Methodik.- 1.5.4 Auswertung.- 1.5.5 Kontraindikationen.- 1.5.6 Besonderheiten der MEP-Untersuchung auf der Intensivstation.- 1.5.7 Einsatz der MEP auf der neurologischen Intensivstation und im Neuromonitoring.- 1.6 Visuell evozierte Potentiale (VEP).- 1.6.1 Einfuhrung.- 1.6.2 Anatomische und physiologische Grundlagen.- 1.6.3 Technische Durchfuhrung.- 1.6.4 Auswertung.- 1.6.5 Beeinflussung der VEP.- 1.6.6 Indikationen fur VEP-Ableitung in der Intensivmedizin.- 1.7 Elektromyographie (EMG) und Neurographie.- 1.7.1 Einfuhrung.- 1.7.2 Elektromyographie.- 1.7.3 Motorische Neurographie.- 1.7.4 Sensible Neurographie.- 1.7.5 Prufung der neuromuskularen UEberleitung.- 1.7.6 F-Antworten.- 1.7.7 Reflexmessungen.- 1.8 Untersuchung des autonomen Nervensystems.- 1.8.1 Anatomie.- 1.8.2 Physiologie.- 1.8.3 Methodik: Grundlagen.- 1.8.4 Pathophysiologie.- 1.8.5 Methodik: Analyse der Herzfrequenzvariabilitat.- 1.8.6 Allgemeine Befunde.- 1.8.7 Blutdruckmonitoring.- 1.8.8 Methodik: Sympathische Hautreaktion.- 1.9 Exogene und endogene Einflusse auf neurophysiologische Parameter.- 1.9.1 Einfuhrung.- 1.9.2 Exogene Einflusse.- 1.9.3 Endogene Einflusse.- 2 Neuromonitoring bei Intensivtherapiepflichtigen Erkrankungen.- 2.1 Schadel-Hirn-Trauma.- 2.1.1 Einfuhrung.- 2.1.2 Pathophysiologie.- 2.1.3 Klinische Diagnostik.- 2.1.4 Radiologische Diagnostik.- 2.1.5 Neurophysiologische Diagnostik.- 2.2 Hypoxisch-ischamische Hirnschadigung.- 2.2.1 Einfuhrung.- 2.2.2 Ursachen und Pathophysiologie.- 2.2.3 Klinisches Erscheinungsbild.- 2.2.4 Prognose aufgrund der klinischen Untersuchung.- 2.2.5 Bedeutung neurophysiologischer Methoden fur Diagnostik, Verlauf und Prognose.- 2.2.6 Andere Untersuchungen.- 2.3 Intrakranielle Blutungen.- 2.3.1 Einfuhrung.- 2.3.2 Infratentorielle intrazerebrale Blutungen.- 2.3.3 Supratentorielle intrazerebrale Blutungen.- 2.3.4 Subarachnoidalblutungen.- 2.4 Hirninfarkt.- 2.4.1 Einfuhrung.- 2.4.2 Klinische und radiologische Klassifikation der Hirninfarkte.- 2.4.3 Ultraschalldiagnostik.- 2.4.4 Elektroenzephalographie (EEG).- 2.4.5 Fruhe akustisch evozierte Potentiale (FAEP).- 2.4.6 Motorisch evozierte Potentiale (MEP).- 2.4.7 Somatosensibel evozierte Potentiale (SEP).- 2.5 Meningoenzephalitis.- 2.5.1 Einfuhrung.- 2.5.2 Bedeutung neurophysiologischer Methoden fur Verlauf und Prognose.- 2.6 Metabolische und septische Enzephalopathien.- 2.6.1 Einfuhrung.- 2.6.2 Hepatische Enzephalopathie.- 2.6.3 Uramische Enzephalopathie und Dysequilibrium-Syndrom.- 2.6.4 Hypoglykamie.- 2.6.5 Hyperglykamie und hyperosmolares Koma.- 2.6.6 Elektrolytstoerungen.- 2.6.7 Schilddrusenfunktionsstoerungen.- 2.6.8 Weitere metabolische Enzephalopathien.- 2.6.9 Septische Enzephalopathie.- 2.7 Toxische Enzephalopathien.- 2.7.1 Einfuhrung.- 2.7.2 Intoxikation mit Barbituraten und Benzodiazepinen.- 2.7.3 Intoxikation mit Neurol

Anesthesia for the New Millenium: Modern Anesthetic Clinical Pharmacology contains the refresher course lectures of the 1999 meeting and is a review of the current state of the art in anesthesia clinical pharmacology. The authors of the individual chapters are among the world's most widely recognized experts in the pharmacology of perioperative medicine. The book features sections on new pharmacology concepts, new drug delivery techniques, recently released drugs and novel thinking about older drugs. It also addresses several areas that have recently emerged as very hot clinical and research topics, including depth of anesthesia monitoring technology and anesthesia drug interactions. The textbook is the seventeenth in a continuing series documenting the proceedings of the postgraduate course.

This book addresses the ethical problems that physicians have to face every day while caring for critically ill patients. Advances in medical technology, ageing societies worldwide, and their increased demands on health care systems have, on the one hand, led to better care and remarkable longevity in many parts of the world. On the other hand, however, improved treatments in many medical fields, amongst others in emergency and critical care, have resulted in more patients surviving with reduced quality of life. This entails tradeoffs for many patients, their families, and the teams caring for them. At the same time, health care expenditures have risen dramatically and have to be balanced against costs for other public goods. Finally, the humane aspects of care have often failed to keep pace with the remarkable technological strides made in recent years. In this book, experts in their respective fields describe compelling ethical challenges resulting from these discrepancies and discuss potential solutions. The book is primarily intended for clinicians who care for two of the most vulnerable patient subpopulations - those being treated in ambulances or emergency rooms, and those being treated at intensive care units - due in part to the fact that they may be temporarily or permanently incapacitated. Core medical skills, such as diagnosis and predicting outcomes, as well as implementing treatment, remain challenging. However, without adequate communication and collaboration both within the inter-professional treatment teams and between the teams and the patients/their families, delivering excellent care is difficult at best. Therefore, the so-called "soft skills" are given the attention they deserve in order to overcome the gap between technological progress and interpersonal standstill.

The anesthesia and intensive care in infants and children have assumed positions of primary importance in contemporary medicine. In these delicate sectors of medicine, clinical research activities must be continually supported by interdisciplinary collaborations. Neonatal and pediatric intensive care requires that all involved physicians, including the surgeon and anesthesiologist, be willing to work together as a team. However, coordination of the various pathophysiological and clinical aspects of neonatal and pediatric critical medicine is highly complex. A complete and current review of the anaethesia and intensive care of infants and children must include discussions of morbidity rates, so as to guide the clincians in choosing the diagnostic approach, as well as of monotoring techniques appropriate to support the therapeutic decision. Recent progress in intensive care medicine for infants and children has been significant.

Sepsis represents a life threatening condition to ICU patients. The evolution of sepsis to severe sepsis or septic shock may occur in an unpredictable way. In the coming millennium the prevention and management of sepsis and organ dysfunction will present a real challenge for researchers and clinicians.