Skip to main content
Erschienen in: Der Anaesthesist 11/2015

01.11.2015 | Leitlinien und Empfehlungen

S1-Leitlinie Atemwegsmanagement

verfasst von: PD Dr. T. Piepho, E. Cavus, R. Noppens, C. Byhahn, V. Dörges, B. Zwissler, A. Timmermann

Erschienen in: Die Anaesthesiologie | Ausgabe 11/2015

Einloggen, um Zugang zu erhalten

Zusammenfassung

Seit der ersten deutschen „Leitlinie Atemwegsmanagement“ im Jahr 2004 haben sich neue Techniken im klinischen Alltag etabliert, und es wurden neue Erkenntnisse zu bestehenden Strategien publiziert. Konsequenterweise stellt die neue „Leitlinie Atemwegsmanagement“ der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin den aktuellen Stand der Wissenschaft dar und integriert die derzeit empfohlenen Techniken und Strategien. Die vorliegende Leitlinie soll dazu beitragen, eine optimale Versorgung der anästhesiologisch betreuten Patienten zu gewährleisten. Sie soll dem Anwender zur Orientierung und als Entscheidungshilfe dienen.
Literatur
1.
Zurück zum Zitat Braun U, Goldmann K, Hempel V, Krier C (2004) Airway Management. Leitlinie der Deutschen Gesellschaft für Anästhesiologie. Anaesth Intensivmed 45:302–306 Braun U, Goldmann K, Hempel V, Krier C (2004) Airway Management. Leitlinie der Deutschen Gesellschaft für Anästhesiologie. Anaesth Intensivmed 45:302–306
2.
Zurück zum Zitat Timmermann A, Byhahn C, Wenzel V, Eich C, Piepho T, Bernhard M, Dörges V (2012) Handlungsempfehlung für das präklinische Atemwegsmanagement. Anaesth Intensivmed 53:294–308 Timmermann A, Byhahn C, Wenzel V, Eich C, Piepho T, Bernhard M, Dörges V (2012) Handlungsempfehlung für das präklinische Atemwegsmanagement. Anaesth Intensivmed 53:294–308
3.
Zurück zum Zitat Böttiger B, Bernhard M, Lier H, Fischer M, Schüttler J (2011) Trauma-Update: S3-Leitlinie Polytrauma. Was muss der Anästhesist wissen? Anaesth Intensivmed 52:649–656 Böttiger B, Bernhard M, Lier H, Fischer M, Schüttler J (2011) Trauma-Update: S3-Leitlinie Polytrauma. Was muss der Anästhesist wissen? Anaesth Intensivmed 52:649–656
4.
Zurück zum Zitat Weiss M, Schmidt J, Eich C, Stelzner J, Trieschmann U, Müller-Lobeck L, Philippi-Höhne C, Becke K, Jöhr M, Strauß J (2011) Handlungsempfehlung zur Prävention und Behandlung des unerwartet schwierigen Atemwegs in der Kinderanästhesie. Anaesth Intensivmed 52:S54–S63 Weiss M, Schmidt J, Eich C, Stelzner J, Trieschmann U, Müller-Lobeck L, Philippi-Höhne C, Becke K, Jöhr M, Strauß J (2011) Handlungsempfehlung zur Prävention und Behandlung des unerwartet schwierigen Atemwegs in der Kinderanästhesie. Anaesth Intensivmed 52:S54–S63
5.
Zurück zum Zitat Cormack RS, Lehane J (1984) Difficult tracheal intubation in obstetrics. Anaesthesia 39:1105–1111CrossRefPubMed Cormack RS, Lehane J (1984) Difficult tracheal intubation in obstetrics. Anaesthesia 39:1105–1111CrossRefPubMed
6.
Zurück zum Zitat Kheterpal S, Han R, Tremper KK, Shanks A, Tait AR, O’Reilly M, Ludwig TA (2006) Incidence and predictors of difficult and impossible mask ventilation. Anesthesiology 105:885–891CrossRefPubMed Kheterpal S, Han R, Tremper KK, Shanks A, Tait AR, O’Reilly M, Ludwig TA (2006) Incidence and predictors of difficult and impossible mask ventilation. Anesthesiology 105:885–891CrossRefPubMed
7.
Zurück zum Zitat Langeron O, Masso E, Huraux C, Guggiari M, Bianchi A, Coriat P, Riou B (2000) Prediction of difficult mask ventilation. Anesthesiology 92:1229–1236CrossRefPubMed Langeron O, Masso E, Huraux C, Guggiari M, Bianchi A, Coriat P, Riou B (2000) Prediction of difficult mask ventilation. Anesthesiology 92:1229–1236CrossRefPubMed
8.
Zurück zum Zitat Kheterpal S, Healy D, Aziz MF, Shanks AM, Freundlich RE, Linton F, Martin LD, Linton J, Epps JL, Fernandez-Bustamante A, Jameson LC, Tremper T (2013) Tremper KK; Multicenter Perioperative Outcomes Group (MPOG) Perioperative Clinical Research Committee. Incidence, predictors, and outcome of difficult mask ventilation combined with difficult laryngoscopy: a report from the multicenter perioperative outcomes group. Anesthesiology 119:1360–1369CrossRefPubMed Kheterpal S, Healy D, Aziz MF, Shanks AM, Freundlich RE, Linton F, Martin LD, Linton J, Epps JL, Fernandez-Bustamante A, Jameson LC, Tremper T (2013) Tremper KK; Multicenter Perioperative Outcomes Group (MPOG) Perioperative Clinical Research Committee. Incidence, predictors, and outcome of difficult mask ventilation combined with difficult laryngoscopy: a report from the multicenter perioperative outcomes group. Anesthesiology 119:1360–1369CrossRefPubMed
9.
Zurück zum Zitat Lavery GG, McCloskey BV (2008) The difficult airway in adult critical care. Crit Care Med 36:2163–2173CrossRefPubMed Lavery GG, McCloskey BV (2008) The difficult airway in adult critical care. Crit Care Med 36:2163–2173CrossRefPubMed
10.
Zurück zum Zitat Adnet F, Racine SX, Borron SW, Clemessy JL, Fournier JL, Lapostolle F, Cupa M (2001) A survey of tracheal intubation difficulty in the operating room: a prospective observational study. Acta Anaesthesiol Scand 45:327–332CrossRefPubMed Adnet F, Racine SX, Borron SW, Clemessy JL, Fournier JL, Lapostolle F, Cupa M (2001) A survey of tracheal intubation difficulty in the operating room: a prospective observational study. Acta Anaesthesiol Scand 45:327–332CrossRefPubMed
11.
Zurück zum Zitat Samsoon GL, Young JR (1987) Difficult tracheal intubation: a retrospective study. Anaesthesia 42:487–490CrossRefPubMed Samsoon GL, Young JR (1987) Difficult tracheal intubation: a retrospective study. Anaesthesia 42:487–490CrossRefPubMed
12.
Zurück zum Zitat Krobbuaban B, Diregpoke S, Kumkeaw S, Tanomsat M (2005) The predictive value of the height ratio and thyromental distance: four predictive tests for difficult laryngoscopy. Anesth Analg 101:1542–1545CrossRefPubMed Krobbuaban B, Diregpoke S, Kumkeaw S, Tanomsat M (2005) The predictive value of the height ratio and thyromental distance: four predictive tests for difficult laryngoscopy. Anesth Analg 101:1542–1545CrossRefPubMed
13.
Zurück zum Zitat Khan ZH, Kashfi A, Ebrahimkhani E (2003) A comparison of the upper lip bite test (a simple new technique) with modified Mallampati classification in predicting difficulty in endotracheal intubation: a prospective blinded study. Anesth Analg 96:595–599PubMed Khan ZH, Kashfi A, Ebrahimkhani E (2003) A comparison of the upper lip bite test (a simple new technique) with modified Mallampati classification in predicting difficulty in endotracheal intubation: a prospective blinded study. Anesth Analg 96:595–599PubMed
14.
Zurück zum Zitat Reissell E, Orko R, Maunuksela EL, Lindgren L (1990) Predictability of difficult laryngoscopy in patients with long-term diabetes mellitus. Anaesthesia 45:1024–1027CrossRefPubMed Reissell E, Orko R, Maunuksela EL, Lindgren L (1990) Predictability of difficult laryngoscopy in patients with long-term diabetes mellitus. Anaesthesia 45:1024–1027CrossRefPubMed
15.
Zurück zum Zitat Vani V, Kamath SK, Naik LD (2000) The palm print as a sensitive predictor of difficult laryngoscopy in diabetics: a comparison with other airway evaluation indices. J Postgrad Med 46:75–79PubMed Vani V, Kamath SK, Naik LD (2000) The palm print as a sensitive predictor of difficult laryngoscopy in diabetics: a comparison with other airway evaluation indices. J Postgrad Med 46:75–79PubMed
16.
Zurück zum Zitat Wilson ME, Spiegelhalter D, Robertson JA, Lesser P (1988) Predicting difficult intubation. Br J Anaesth 61:211–216CrossRefPubMed Wilson ME, Spiegelhalter D, Robertson JA, Lesser P (1988) Predicting difficult intubation. Br J Anaesth 61:211–216CrossRefPubMed
17.
Zurück zum Zitat Shiga T, Wajima Z, Inoue T, Sakamoto A (2005) Predicting difficult intubation in apparently normal patients: a meta-analysis of bedside screening test performance. Anesthesiology 103:429–437CrossRefPubMed Shiga T, Wajima Z, Inoue T, Sakamoto A (2005) Predicting difficult intubation in apparently normal patients: a meta-analysis of bedside screening test performance. Anesthesiology 103:429–437CrossRefPubMed
18.
Zurück zum Zitat Arné J, Descoins P, Fusciardi J, Ingrand P, Ferrier B, Boudigues D, Ariès J (1998) Preoperative assessment for difficult intubation in general and ENT surgery: predictive value of a clinical multivariate risk index. Br J Anaesth 80:140–146CrossRefPubMed Arné J, Descoins P, Fusciardi J, Ingrand P, Ferrier B, Boudigues D, Ariès J (1998) Preoperative assessment for difficult intubation in general and ENT surgery: predictive value of a clinical multivariate risk index. Br J Anaesth 80:140–146CrossRefPubMed
19.
Zurück zum Zitat Pandit JJ, Duncan T, Robbins PA (2003) Total oxygen uptake with two maximal breathing techniques and the tidal volume breathing technique: a physiologic study of preoxygenation. Anesthesiology 99:841–846CrossRefPubMed Pandit JJ, Duncan T, Robbins PA (2003) Total oxygen uptake with two maximal breathing techniques and the tidal volume breathing technique: a physiologic study of preoxygenation. Anesthesiology 99:841–846CrossRefPubMed
20.
Zurück zum Zitat Tanoubi I, Drolet P, Donati F (2009) Optimizing preoxygenation in adults. Can J Anaesth 56:449–466CrossRefPubMed Tanoubi I, Drolet P, Donati F (2009) Optimizing preoxygenation in adults. Can J Anaesth 56:449–466CrossRefPubMed
21.
Zurück zum Zitat Mort TC (2005) Preoxygenation in critically ill patients requiring emergency tracheal intubation. Crit Care Med 33:2672–2675CrossRefPubMed Mort TC (2005) Preoxygenation in critically ill patients requiring emergency tracheal intubation. Crit Care Med 33:2672–2675CrossRefPubMed
22.
Zurück zum Zitat Dixon BJ, Dixon JB, Carden JR, Burn AJ, Schachter LM, Playfair JM, Laurie CP, O’Brien PE (2005) Preoxygenation is more effective in the 25 degrees head-up position than in the supine position in severely obese patients: a randomized controlled study. Anesthesiology 102:1110–1115CrossRefPubMed Dixon BJ, Dixon JB, Carden JR, Burn AJ, Schachter LM, Playfair JM, Laurie CP, O’Brien PE (2005) Preoxygenation is more effective in the 25 degrees head-up position than in the supine position in severely obese patients: a randomized controlled study. Anesthesiology 102:1110–1115CrossRefPubMed
23.
Zurück zum Zitat Altermatt FR, Munoz HR, Delfino AE, Cortinez LI (2005) Pre-oxygenation in the obese patient: effects of position on tolerance to apnoea. Br J Anaesth 95:706–709CrossRefPubMed Altermatt FR, Munoz HR, Delfino AE, Cortinez LI (2005) Pre-oxygenation in the obese patient: effects of position on tolerance to apnoea. Br J Anaesth 95:706–709CrossRefPubMed
24.
Zurück zum Zitat Delay JM, Sebbane M, Jung B, Nocca D, Verzilli D, Pouzeratte Y, Kamel ME, Fabre JM, Eledjam JJ, Jaber S (2008) The effectiveness of noninvasive positive pressure ventilation to enhance preoxygenation in morbidly obese patients: a randomized controlled study. Anesth Analg 107:1707–1713CrossRefPubMed Delay JM, Sebbane M, Jung B, Nocca D, Verzilli D, Pouzeratte Y, Kamel ME, Fabre JM, Eledjam JJ, Jaber S (2008) The effectiveness of noninvasive positive pressure ventilation to enhance preoxygenation in morbidly obese patients: a randomized controlled study. Anesth Analg 107:1707–1713CrossRefPubMed
25.
Zurück zum Zitat Baillard C, Fosse JP, Sebbane M, Chanques G, Vincent F, Courouble P, Cohen Y, Eledjam JJ, Adnet F, Jaber S (2006) Noninvasive ventilation improves preoxygenation before intubation of hypoxic patients. Am J Respir Crit Care Med 174:171–177CrossRefPubMed Baillard C, Fosse JP, Sebbane M, Chanques G, Vincent F, Courouble P, Cohen Y, Eledjam JJ, Adnet F, Jaber S (2006) Noninvasive ventilation improves preoxygenation before intubation of hypoxic patients. Am J Respir Crit Care Med 174:171–177CrossRefPubMed
26.
Zurück zum Zitat Byhahn C, Dorges V, Graf BM (2012) Maskenbeatmung vor Relaxation. Vom Dogma zur Individualität. Anaesthesist 61:397–398CrossRefPubMed Byhahn C, Dorges V, Graf BM (2012) Maskenbeatmung vor Relaxation. Vom Dogma zur Individualität. Anaesthesist 61:397–398CrossRefPubMed
27.
Zurück zum Zitat Jacomet A, Schnider T (2012) Obligate Maskenbeatmung vor Relaxation. Wo ist die Evidenz? Anaesthesist 61:401–406CrossRefPubMed Jacomet A, Schnider T (2012) Obligate Maskenbeatmung vor Relaxation. Wo ist die Evidenz? Anaesthesist 61:401–406CrossRefPubMed
28.
Zurück zum Zitat Warters RD, Szabo TA, Spinale FG, DeSantis SM, Reves JG (2011) The effect of neuromuscular blockade on mask ventilation. Anaesthesia 66:163–167CrossRefPubMed Warters RD, Szabo TA, Spinale FG, DeSantis SM, Reves JG (2011) The effect of neuromuscular blockade on mask ventilation. Anaesthesia 66:163–167CrossRefPubMed
29.
Zurück zum Zitat Ikeda A, Isono S, Sato Y, Yogo H, Sato J, Ishikawa T, Nishino T (2012) Effects of muscle relaxants on mask ventilation in anesthetized persons with normal upper airway anatomy. Anesthesiology 117:487–493CrossRefPubMed Ikeda A, Isono S, Sato Y, Yogo H, Sato J, Ishikawa T, Nishino T (2012) Effects of muscle relaxants on mask ventilation in anesthetized persons with normal upper airway anatomy. Anesthesiology 117:487–493CrossRefPubMed
30.
Zurück zum Zitat Seet E, Yousaf F, Gupta S, Subramanyam R, Wong DT, Chung F (2010) Use of manometry for laryngeal mask airway reduces postoperative pharyngolaryngeal adverse events: a prospective, randomized trial. Anesthesiology 112:652–657CrossRefPubMed Seet E, Yousaf F, Gupta S, Subramanyam R, Wong DT, Chung F (2010) Use of manometry for laryngeal mask airway reduces postoperative pharyngolaryngeal adverse events: a prospective, randomized trial. Anesthesiology 112:652–657CrossRefPubMed
31.
Zurück zum Zitat Chantzara G, Stroumpoulis K, Alexandrou N, Kokkinos L, Iacovidou N, Xanthos T (2014) Influence of LMA cuff pressure on the incidence of pharyngolaryngeal adverse effects and evaluation of the use of manometry during different ventilation modes: a randomized clinical trial. Minerva Anestesiol 80:547–555PubMed Chantzara G, Stroumpoulis K, Alexandrou N, Kokkinos L, Iacovidou N, Xanthos T (2014) Influence of LMA cuff pressure on the incidence of pharyngolaryngeal adverse effects and evaluation of the use of manometry during different ventilation modes: a randomized clinical trial. Minerva Anestesiol 80:547–555PubMed
32.
Zurück zum Zitat Stix MS, O’Connor CJ Jr (2003) Depth of insertion of the ProSeal laryngeal mask airway. Br J Anaesth 90:235–237CrossRefPubMed Stix MS, O’Connor CJ Jr (2003) Depth of insertion of the ProSeal laryngeal mask airway. Br J Anaesth 90:235–237CrossRefPubMed
33.
Zurück zum Zitat Mahajan R, Batra YK (2009) Water bubble test to detect malposition of PLMA. J Anesth 23:634–635CrossRefPubMed Mahajan R, Batra YK (2009) Water bubble test to detect malposition of PLMA. J Anesth 23:634–635CrossRefPubMed
34.
Zurück zum Zitat Cook TM, Silsby J, Simpson TP (2005) Airway rescue in acute upper airway obstruction using a ProSeal Laryngeal mask airway and an Aintree catheter: a review of the ProSeal Laryngeal mask airway in the management of the difficult airway. Anaesthesia 60:1129–1136CrossRefPubMed Cook TM, Silsby J, Simpson TP (2005) Airway rescue in acute upper airway obstruction using a ProSeal Laryngeal mask airway and an Aintree catheter: a review of the ProSeal Laryngeal mask airway in the management of the difficult airway. Anaesthesia 60:1129–1136CrossRefPubMed
35.
Zurück zum Zitat Heard AM, Lacquiere DA, Riley RH (2010) Manikin study of fibreoptic-guided intubation through the classic laryngeal mask airway with the Aintree intubating catheter vs the intubating laryngeal mask airway in the simulated difficult airway. Anaesthesia 65:841–847CrossRefPubMed Heard AM, Lacquiere DA, Riley RH (2010) Manikin study of fibreoptic-guided intubation through the classic laryngeal mask airway with the Aintree intubating catheter vs the intubating laryngeal mask airway in the simulated difficult airway. Anaesthesia 65:841–847CrossRefPubMed
36.
Zurück zum Zitat Blair EJ, Mihai R, Cook TM (2007) Tracheal intubation via the Classic and Proseal laryngeal mask airways: a manikin study using the Aintree Intubating Catheter. Anaesthesia 62:385–387CrossRefPubMed Blair EJ, Mihai R, Cook TM (2007) Tracheal intubation via the Classic and Proseal laryngeal mask airways: a manikin study using the Aintree Intubating Catheter. Anaesthesia 62:385–387CrossRefPubMed
37.
Zurück zum Zitat Piepho T, Fortmueller K, Heid FM, Schmidtmann I, Werner C, Noppens RR (2011) Performance of the C-MAC video laryngoscope in patients after a limited glottic view using Macintosh laryngoscopy. Anaesthesia 66:1101–1105CrossRefPubMed Piepho T, Fortmueller K, Heid FM, Schmidtmann I, Werner C, Noppens RR (2011) Performance of the C-MAC video laryngoscope in patients after a limited glottic view using Macintosh laryngoscopy. Anaesthesia 66:1101–1105CrossRefPubMed
38.
Zurück zum Zitat Aziz MF, Healy D, Kheterpal S, Fu RF, Dillman D, Brambrink AM (2011) Routine clinical practice effectiveness of the Glidescope in difficult airway management: an analysis of 2,004 Glidescope intubations, complications, and failures from two institutions. Anesthesiology 114:34–41CrossRefPubMed Aziz MF, Healy D, Kheterpal S, Fu RF, Dillman D, Brambrink AM (2011) Routine clinical practice effectiveness of the Glidescope in difficult airway management: an analysis of 2,004 Glidescope intubations, complications, and failures from two institutions. Anesthesiology 114:34–41CrossRefPubMed
39.
Zurück zum Zitat Cavus E, Neumann T, Doerges V, Moeller T, Scharf E, Wagner K, Bein B, Serocki G (2011) First clinical evaluation of the C-MAC D-Blade videolaryngoscope during routine and difficult intubation. Anesth Analg 112:382–385CrossRefPubMed Cavus E, Neumann T, Doerges V, Moeller T, Scharf E, Wagner K, Bein B, Serocki G (2011) First clinical evaluation of the C-MAC D-Blade videolaryngoscope during routine and difficult intubation. Anesth Analg 112:382–385CrossRefPubMed
40.
Zurück zum Zitat Noppens RR, Mobus S, Heid F, Schmidtmann I, Werner C, Piepho T (2010) Evaluation of the McGrath Series 5 videolaryngoscope after failed direct laryngoscopy. Anaesthesia 65:716–720CrossRefPubMed Noppens RR, Mobus S, Heid F, Schmidtmann I, Werner C, Piepho T (2010) Evaluation of the McGrath Series 5 videolaryngoscope after failed direct laryngoscopy. Anaesthesia 65:716–720CrossRefPubMed
41.
Zurück zum Zitat Cavus E, Bein B, Doerges V (2011) Atemwegsmanagement - Videoassistierte Verfahren. Anasthesiol Intensivmed Notfallmed Schmerzther 46:588–596CrossRefPubMed Cavus E, Bein B, Doerges V (2011) Atemwegsmanagement - Videoassistierte Verfahren. Anasthesiol Intensivmed Notfallmed Schmerzther 46:588–596CrossRefPubMed
42.
Zurück zum Zitat Noppens RR, Werner C, Piepho T (2010) Indirekte Laryngoskopie. Alternativen zur Atemwegssicherung. Anaesthesist 59:149–161CrossRefPubMed Noppens RR, Werner C, Piepho T (2010) Indirekte Laryngoskopie. Alternativen zur Atemwegssicherung. Anaesthesist 59:149–161CrossRefPubMed
43.
Zurück zum Zitat Herbstreit F, Fassbender P, Haberl H, Kehren C, Peters J (2011) Learning endotracheal intubation using a novel videolaryngoscope improves intubation skills of medical students. Anesth Analg 113:586–590PubMed Herbstreit F, Fassbender P, Haberl H, Kehren C, Peters J (2011) Learning endotracheal intubation using a novel videolaryngoscope improves intubation skills of medical students. Anesth Analg 113:586–590PubMed
44.
Zurück zum Zitat Bein B, Yan M, Tonner PH, Scholz J, Steinfath M, Doerges V (2004) Tracheal intubation using the Bonfils intubation fibrescope after failed direct laryngoscopy. Anaesthesia 59:1207–1209CrossRefPubMed Bein B, Yan M, Tonner PH, Scholz J, Steinfath M, Doerges V (2004) Tracheal intubation using the Bonfils intubation fibrescope after failed direct laryngoscopy. Anaesthesia 59:1207–1209CrossRefPubMed
45.
Zurück zum Zitat Halligan M, Charters P (2003) A clinical evaluation of the Bonfils Intubation Fibrescope. Anaesthesia 58:1087–1091CrossRefPubMed Halligan M, Charters P (2003) A clinical evaluation of the Bonfils Intubation Fibrescope. Anaesthesia 58:1087–1091CrossRefPubMed
46.
Zurück zum Zitat Falcetta S, Pecora L, Orsetti G, Gentili P, Rossi A, Gabbanelli V, Adrario E, Donati A, Pelaia P (2012) The Bonfils fiberscope: a clinical evaluation of its learning curve and efficacy in difficult airway management. Minerva Anestesiol 78:176–184PubMed Falcetta S, Pecora L, Orsetti G, Gentili P, Rossi A, Gabbanelli V, Adrario E, Donati A, Pelaia P (2012) The Bonfils fiberscope: a clinical evaluation of its learning curve and efficacy in difficult airway management. Minerva Anestesiol 78:176–184PubMed
47.
Zurück zum Zitat Aneeshkumar MK, Jones TM, Birchall MA (2009) A new indicator-guided percutaneous emergency cricothyrotomy device: in vivo study in man. Eur Arch Otorhinolaryngol 266:105–109CrossRefPubMed Aneeshkumar MK, Jones TM, Birchall MA (2009) A new indicator-guided percutaneous emergency cricothyrotomy device: in vivo study in man. Eur Arch Otorhinolaryngol 266:105–109CrossRefPubMed
48.
Zurück zum Zitat Eisenburger P, Laczika K, List M, Wilfing A, Losert H, Hofbauer R, Burgmann H, Bankl H, Pikula B, Benumof JL, Frass M (2000) Comparison of conventional surgical versus Seldinger technique emergency cricothyrotomy performed by inexperienced clinicians. Anesthesiology 92:687–690CrossRefPubMed Eisenburger P, Laczika K, List M, Wilfing A, Losert H, Hofbauer R, Burgmann H, Bankl H, Pikula B, Benumof JL, Frass M (2000) Comparison of conventional surgical versus Seldinger technique emergency cricothyrotomy performed by inexperienced clinicians. Anesthesiology 92:687–690CrossRefPubMed
49.
Zurück zum Zitat Johnson DR, Dunlap A, McFeeley P, Gaffney J, Busick B (1993) Cricothyrotomy performed by prehospital personnel: a comparison of two techniques in a human cadaver model. Am J Emerg Med 11:207–209CrossRefPubMed Johnson DR, Dunlap A, McFeeley P, Gaffney J, Busick B (1993) Cricothyrotomy performed by prehospital personnel: a comparison of two techniques in a human cadaver model. Am J Emerg Med 11:207–209CrossRefPubMed
50.
Zurück zum Zitat Schober P, Hegemann MC, Schwarte LA, Loer SA, Noetges P (2009) Emergency cricothyrotomy – a comparative study of different techniques in human cadavers. Resuscitation 80:204–209CrossRefPubMed Schober P, Hegemann MC, Schwarte LA, Loer SA, Noetges P (2009) Emergency cricothyrotomy – a comparative study of different techniques in human cadavers. Resuscitation 80:204–209CrossRefPubMed
51.
Zurück zum Zitat Murphy C, Rooney SJ, Maharaj CH, Laffey JG, Harte BH (2011) Comparison of three cuffed emergency percutaneous cricothyroidotomy devices to conventional surgical cricothyroidotomy in a porcine model. Br J Anaesth 106:57–64CrossRefPubMed Murphy C, Rooney SJ, Maharaj CH, Laffey JG, Harte BH (2011) Comparison of three cuffed emergency percutaneous cricothyroidotomy devices to conventional surgical cricothyroidotomy in a porcine model. Br J Anaesth 106:57–64CrossRefPubMed
52.
Zurück zum Zitat Fikkers BG, van Vugt S, van der Hoeven JG, van den Hoogen FJ, Marres HA (2004) Emergency cricothyrotomy: a randomised crossover trial comparing the wire-guided and catheter-over-needle techniques. Anaesthesia 59:1008–1011CrossRefPubMed Fikkers BG, van Vugt S, van der Hoeven JG, van den Hoogen FJ, Marres HA (2004) Emergency cricothyrotomy: a randomised crossover trial comparing the wire-guided and catheter-over-needle techniques. Anaesthesia 59:1008–1011CrossRefPubMed
53.
Zurück zum Zitat Keane MF, Brinsfield KH, Dyer KS, Roy S, White D (2004) A laboratory comparison of emergency percutaneous and surgical cricothyrotomy by prehospital personnel. Prehosp Emerg Care 8:424–426CrossRefPubMed Keane MF, Brinsfield KH, Dyer KS, Roy S, White D (2004) A laboratory comparison of emergency percutaneous and surgical cricothyrotomy by prehospital personnel. Prehosp Emerg Care 8:424–426CrossRefPubMed
54.
Zurück zum Zitat Mariappa V, Stachowski E, Balik M, Clark P, Nayyar V (2009) Cricothyroidotomy: comparison of three different techniques on a porcine airway. Anaesth Intensive Care 37:961–967PubMed Mariappa V, Stachowski E, Balik M, Clark P, Nayyar V (2009) Cricothyroidotomy: comparison of three different techniques on a porcine airway. Anaesth Intensive Care 37:961–967PubMed
55.
Zurück zum Zitat Metterlein T, Frommer M, Ginzkey C, Becher J, Schuster F, Roewer N, Kranke P (2011) A randomized trial comparing two cuffed emergency cricothyrotomy devices using a wire-guided and a catheter-over-needle technique. J Emerg Med 41:326–332CrossRefPubMed Metterlein T, Frommer M, Ginzkey C, Becher J, Schuster F, Roewer N, Kranke P (2011) A randomized trial comparing two cuffed emergency cricothyrotomy devices using a wire-guided and a catheter-over-needle technique. J Emerg Med 41:326–332CrossRefPubMed
56.
Zurück zum Zitat Bair AE, Panacek EA, Wisner DH, Bales R, Sakles JC (2003) Cricothyrotomy: a 5-year experience at one institution. J Emerg Med 24:151–156CrossRefPubMed Bair AE, Panacek EA, Wisner DH, Bales R, Sakles JC (2003) Cricothyrotomy: a 5-year experience at one institution. J Emerg Med 24:151–156CrossRefPubMed
57.
Zurück zum Zitat Dillon JK, Christensen B, Fairbanks T, Jurkovich G, Moe KS (2013) The emergent surgical airway: cricothyrotomy vs. tracheotomy. Int J Oral Maxillofac Surg 42:204–208CrossRefPubMed Dillon JK, Christensen B, Fairbanks T, Jurkovich G, Moe KS (2013) The emergent surgical airway: cricothyrotomy vs. tracheotomy. Int J Oral Maxillofac Surg 42:204–208CrossRefPubMed
58.
59.
Zurück zum Zitat Preussler NP, Schreiber T, Huter L, Gottschall R, Schubert H, Rek H, Karzai W, Schwarzkopf K (2003) Percutaneous transtracheal ventilation: effects of a new oxygen flow modulator on oxygenation and ventilation in pigs compared with a hand triggered emergency jet injector. Resuscitation 56:329–333CrossRefPubMed Preussler NP, Schreiber T, Huter L, Gottschall R, Schubert H, Rek H, Karzai W, Schwarzkopf K (2003) Percutaneous transtracheal ventilation: effects of a new oxygen flow modulator on oxygenation and ventilation in pigs compared with a hand triggered emergency jet injector. Resuscitation 56:329–333CrossRefPubMed
60.
Zurück zum Zitat Hamaekers AE, Borg PA, Enk D (2012) Ventrain: an ejector ventilator for emergency use. Br J Anaesth 108:1017–1021CrossRefPubMed Hamaekers AE, Borg PA, Enk D (2012) Ventrain: an ejector ventilator for emergency use. Br J Anaesth 108:1017–1021CrossRefPubMed
61.
Zurück zum Zitat Hamaekers AE, Borg PA, Goetz T, Enk D (2011) Ventilation through a small-bore catheter: optimizing expiratory ventilation assistance. Br J Anaesth 106:403–409CrossRefPubMed Hamaekers AE, Borg PA, Goetz T, Enk D (2011) Ventilation through a small-bore catheter: optimizing expiratory ventilation assistance. Br J Anaesth 106:403–409CrossRefPubMed
62.
Zurück zum Zitat Hamaekers AE, van der Beek T, Theunissen M, Enk D (2015) Rescue ventilation through a small-bore transtracheal cannula in severe hypoxic pigs using expiratory ventilation assistance. Anesth Analg 120(4):890–894CrossRefPubMedCentralPubMed Hamaekers AE, van der Beek T, Theunissen M, Enk D (2015) Rescue ventilation through a small-bore transtracheal cannula in severe hypoxic pigs using expiratory ventilation assistance. Anesth Analg 120(4):890–894CrossRefPubMedCentralPubMed
63.
Zurück zum Zitat Ovassapian A, Dykes MH, Golmon ME (1983) A training programme for fibreoptic nasotracheal intubation. Use of model and live patients. Anaesthesia 38:795–798CrossRefPubMed Ovassapian A, Dykes MH, Golmon ME (1983) A training programme for fibreoptic nasotracheal intubation. Use of model and live patients. Anaesthesia 38:795–798CrossRefPubMed
64.
Zurück zum Zitat Fuchs G, Schwarz G, Baumgartner A, Kaltenbock F, Voit-Augustin H, Planinz W (1999) Fiberoptic intubation in 327 neurosurgical patients with lesions of the cervical spine. J Neurosurg Anesthesiol 11:11–16CrossRefPubMed Fuchs G, Schwarz G, Baumgartner A, Kaltenbock F, Voit-Augustin H, Planinz W (1999) Fiberoptic intubation in 327 neurosurgical patients with lesions of the cervical spine. J Neurosurg Anesthesiol 11:11–16CrossRefPubMed
66.
Zurück zum Zitat Moore AR, Schricker T, Court O (2012) Awake videolaryngoscopy-assisted tracheal intubation of the morbidly obese. Anaesthesia 67:232–235CrossRefPubMed Moore AR, Schricker T, Court O (2012) Awake videolaryngoscopy-assisted tracheal intubation of the morbidly obese. Anaesthesia 67:232–235CrossRefPubMed
67.
Zurück zum Zitat Rosenstock CV, Thogersen B, Afshari A, Christensen AL, Eriksen C, Gatke MR (2012) Awake fiberoptic or awake video laryngoscopic tracheal intubation in patients with anticipated difficult airway management: a randomized clinical trial. Anesthesiology 116:1210–1216CrossRefPubMed Rosenstock CV, Thogersen B, Afshari A, Christensen AL, Eriksen C, Gatke MR (2012) Awake fiberoptic or awake video laryngoscopic tracheal intubation in patients with anticipated difficult airway management: a randomized clinical trial. Anesthesiology 116:1210–1216CrossRefPubMed
68.
Zurück zum Zitat Lee MC, Absalom AR, Menon DK, Smith HL (2006) Awake insertion of the laryngeal mask airway using topical lidocaine and intravenous remifentanil. Anaesthesia 61:32–35CrossRefPubMed Lee MC, Absalom AR, Menon DK, Smith HL (2006) Awake insertion of the laryngeal mask airway using topical lidocaine and intravenous remifentanil. Anaesthesia 61:32–35CrossRefPubMed
69.
Zurück zum Zitat Dhar P, Osborn I, Brimacombe J, Meenan M, Linton P (2001) Blind orotracheal intubation with the intubating laryngeal mask versus fibreoptic guided orotracheal intubation with the Ovassapian airway. A pilot study of awake patients. Anaesth Intensive Care 29:252–254PubMed Dhar P, Osborn I, Brimacombe J, Meenan M, Linton P (2001) Blind orotracheal intubation with the intubating laryngeal mask versus fibreoptic guided orotracheal intubation with the Ovassapian airway. A pilot study of awake patients. Anaesth Intensive Care 29:252–254PubMed
70.
Zurück zum Zitat Benumof JL, Cooper SD (1996) Quantitative improvement in laryngoscopic view by optimal external laryngeal manipulation. J Clin Anesth 8:136–140CrossRefPubMed Benumof JL, Cooper SD (1996) Quantitative improvement in laryngoscopic view by optimal external laryngeal manipulation. J Clin Anesth 8:136–140CrossRefPubMed
71.
Zurück zum Zitat Takahata O, Kubota M, Mamiya K, Akama Y, Nozaka T, Matsumoto H, Ogawa H (1997) The efficacy of the „BURP“ maneuver during a difficult laryngoscopy. Anesth Analg 84:419–421PubMed Takahata O, Kubota M, Mamiya K, Akama Y, Nozaka T, Matsumoto H, Ogawa H (1997) The efficacy of the „BURP“ maneuver during a difficult laryngoscopy. Anesth Analg 84:419–421PubMed
72.
Zurück zum Zitat Levitan RM, Mechem CC, Ochroch EA, Shofer FS, Hollander JE (2003) Head-elevated laryngoscopy position: improving laryngeal exposure during laryngoscopy by increasing head elevation. Ann Emerg Med 41:322–330CrossRefPubMed Levitan RM, Mechem CC, Ochroch EA, Shofer FS, Hollander JE (2003) Head-elevated laryngoscopy position: improving laryngeal exposure during laryngoscopy by increasing head elevation. Ann Emerg Med 41:322–330CrossRefPubMed
73.
Zurück zum Zitat Schmitt HJ, Mang H (2002) Head and neck elevation beyond the sniffing position improves laryngeal view in cases of difficult direct laryngoscopy. J Clin Anesth 14:335–338CrossRefPubMed Schmitt HJ, Mang H (2002) Head and neck elevation beyond the sniffing position improves laryngeal view in cases of difficult direct laryngoscopy. J Clin Anesth 14:335–338CrossRefPubMed
74.
Zurück zum Zitat Gataure PS, Vaughan RS, Latto IP (1996) Simulated difficult intubation. Comparison of the gum elastic bougie and the stylet. Anaesthesia 51:935–938CrossRefPubMed Gataure PS, Vaughan RS, Latto IP (1996) Simulated difficult intubation. Comparison of the gum elastic bougie and the stylet. Anaesthesia 51:935–938CrossRefPubMed
75.
Zurück zum Zitat Jabre P, Combes X, Leroux B, Aaron E, Auger H, Margenet A, Dhonneur G (2005) Use of gum elastic bougie for prehospital difficult intubation. Am J Emerg Med 23:552–555CrossRefPubMed Jabre P, Combes X, Leroux B, Aaron E, Auger H, Margenet A, Dhonneur G (2005) Use of gum elastic bougie for prehospital difficult intubation. Am J Emerg Med 23:552–555CrossRefPubMed
76.
Zurück zum Zitat Rose WD, Anderson LD, Edmond SA (1994) Analysis of intubations. Before and after establishment of a rapid sequence intubation protocol for air medical use. Air Med J 13:475–478CrossRefPubMed Rose WD, Anderson LD, Edmond SA (1994) Analysis of intubations. Before and after establishment of a rapid sequence intubation protocol for air medical use. Air Med J 13:475–478CrossRefPubMed
77.
Zurück zum Zitat Mort TC (2004) The incidence and risk factors for cardiac arrest during emergency tracheal intubation: a justification for incorporating the ASA Guidelines in the remote location. J Clin Anesth 16:508–516CrossRefPubMed Mort TC (2004) The incidence and risk factors for cardiac arrest during emergency tracheal intubation: a justification for incorporating the ASA Guidelines in the remote location. J Clin Anesth 16:508–516CrossRefPubMed
78.
Zurück zum Zitat Martin LD, Mhyre JM, Shanks AM, Tremper KK, Kheterpal S (2011) 3,423 emergency tracheal intubations at a university hospital: airway outcomes and complications. Anesthesiology 114:42–48CrossRefPubMed Martin LD, Mhyre JM, Shanks AM, Tremper KK, Kheterpal S (2011) 3,423 emergency tracheal intubations at a university hospital: airway outcomes and complications. Anesthesiology 114:42–48CrossRefPubMed
79.
Zurück zum Zitat Hasegawa K, Shigemitsu K, Hagiwara Y, Chiba T, Watase H, Brown CA 3rd, Brown DF, Japanese Emergency Medicine Research Alliance Investigators (2012) Association between repeated intubation attempts and adverse events in emergency departments: an analysis of a multicenter prospective observational study. Ann Emerg Med 60:749–754CrossRefPubMed Hasegawa K, Shigemitsu K, Hagiwara Y, Chiba T, Watase H, Brown CA 3rd, Brown DF, Japanese Emergency Medicine Research Alliance Investigators (2012) Association between repeated intubation attempts and adverse events in emergency departments: an analysis of a multicenter prospective observational study. Ann Emerg Med 60:749–754CrossRefPubMed
80.
Zurück zum Zitat Paolini JB, Donati F, Drolet P (2013) Review article: video-laryngoscopy: another tool for difficult intubation or a new paradigm in airway management? Can J Anaesth 60:184–191CrossRefPubMed Paolini JB, Donati F, Drolet P (2013) Review article: video-laryngoscopy: another tool for difficult intubation or a new paradigm in airway management? Can J Anaesth 60:184–191CrossRefPubMed
81.
Zurück zum Zitat Delaney KA, Hessler R (1988) Emergency flexible fiberoptic nasotracheal intubation: a report of 60 cases. Ann Emerg Med 17:919–926CrossRefPubMed Delaney KA, Hessler R (1988) Emergency flexible fiberoptic nasotracheal intubation: a report of 60 cases. Ann Emerg Med 17:919–926CrossRefPubMed
82.
Zurück zum Zitat Ortiz-Gomez JR, Palacio-Abizanda FJ, Fornet-Ruiz I (2014) Failure of sugammadex to reverse rocuronium-induced neuromuscular blockade: a case report. Eur J Anaesthesiol 31:708–709CrossRefPubMed Ortiz-Gomez JR, Palacio-Abizanda FJ, Fornet-Ruiz I (2014) Failure of sugammadex to reverse rocuronium-induced neuromuscular blockade: a case report. Eur J Anaesthesiol 31:708–709CrossRefPubMed
83.
Zurück zum Zitat Curtis R, Lomax S, Patel B (2012) Use of sugammadex in a ‚can’t intubate, can’t ventilate‘ situation. Br J Anaesth 108:612–614CrossRefPubMed Curtis R, Lomax S, Patel B (2012) Use of sugammadex in a ‚can’t intubate, can’t ventilate‘ situation. Br J Anaesth 108:612–614CrossRefPubMed
84.
Zurück zum Zitat Lawes EG, Campbell I, Mercer D (1987) Inflation pressure, gastric insufflation and rapid sequence induction. Br J Anaesth 59:315–318CrossRefPubMed Lawes EG, Campbell I, Mercer D (1987) Inflation pressure, gastric insufflation and rapid sequence induction. Br J Anaesth 59:315–318CrossRefPubMed
85.
Zurück zum Zitat Clark RK, Trethewy CE (2005) Assessment of cricoid pressure application by emergency department staff. Emerg Med Australas 17:376–381CrossRefPubMed Clark RK, Trethewy CE (2005) Assessment of cricoid pressure application by emergency department staff. Emerg Med Australas 17:376–381CrossRefPubMed
86.
Zurück zum Zitat Smith KJ, Dobranowski J, Yip G, Dauphin A, Choi PT (2003) Cricoid pressure displaces the esophagus: an observational study using magnetic resonance imaging. Anesthesiology 99:60–64CrossRefPubMed Smith KJ, Dobranowski J, Yip G, Dauphin A, Choi PT (2003) Cricoid pressure displaces the esophagus: an observational study using magnetic resonance imaging. Anesthesiology 99:60–64CrossRefPubMed
87.
Zurück zum Zitat Boet S, Duttchen K, Chan J, Chan AW, Morrish W, Ferland A, Hare GM, Hong AP (2012) Cricoid pressure provides incomplete esophageal occlusion associated with lateral deviation: a magnetic resonance imaging study. J Emerg Med 42:606–611CrossRefPubMed Boet S, Duttchen K, Chan J, Chan AW, Morrish W, Ferland A, Hare GM, Hong AP (2012) Cricoid pressure provides incomplete esophageal occlusion associated with lateral deviation: a magnetic resonance imaging study. J Emerg Med 42:606–611CrossRefPubMed
88.
Zurück zum Zitat Garrard A, Campbell AE, Turley A, Hall JE (2004) The effect of mechanically-induced cricoid force on lower oesophageal sphincter pressure in anaesthetised patients. Anaesthesia 59:435–439CrossRefPubMed Garrard A, Campbell AE, Turley A, Hall JE (2004) The effect of mechanically-induced cricoid force on lower oesophageal sphincter pressure in anaesthetised patients. Anaesthesia 59:435–439CrossRefPubMed
89.
Zurück zum Zitat Hocking G, Roberts FL, Thew ME (2001) Airway obstruction with cricoid pressure and lateral tilt. Anaesthesia 56:825–828CrossRefPubMed Hocking G, Roberts FL, Thew ME (2001) Airway obstruction with cricoid pressure and lateral tilt. Anaesthesia 56:825–828CrossRefPubMed
90.
Zurück zum Zitat Zeidan AM, Salem MR, Mazoit JX, Abdullah MA, Ghattas T, Crystal GJ (2014) The effectiveness of cricoid pressure for occluding the esophageal entrance in anesthetized and paralyzed patients: an experimental and observational glidescope study. Anesth Analg 118:580–586CrossRefPubMed Zeidan AM, Salem MR, Mazoit JX, Abdullah MA, Ghattas T, Crystal GJ (2014) The effectiveness of cricoid pressure for occluding the esophageal entrance in anesthetized and paralyzed patients: an experimental and observational glidescope study. Anesth Analg 118:580–586CrossRefPubMed
91.
Zurück zum Zitat Rice MJ, Mancuso AA, Gibbs C, Morey TE, Gravenstein N, Deitte LA (2009) Cricoid pressure results in compression of the postcricoid hypopharynx: the esophageal position is irrelevant. Anesth Analg 109:1546–1552CrossRefPubMed Rice MJ, Mancuso AA, Gibbs C, Morey TE, Gravenstein N, Deitte LA (2009) Cricoid pressure results in compression of the postcricoid hypopharynx: the esophageal position is irrelevant. Anesth Analg 109:1546–1552CrossRefPubMed
93.
Zurück zum Zitat Gaussorgues P, Boyer F, Piperno D, Gerard M, Leger P, Robert D (1988) Do corticosteroids prevent postextubation laryngeal edema? Prospective study of 276 adults. Crit Care Med 16:649CrossRefPubMed Gaussorgues P, Boyer F, Piperno D, Gerard M, Leger P, Robert D (1988) Do corticosteroids prevent postextubation laryngeal edema? Prospective study of 276 adults. Crit Care Med 16:649CrossRefPubMed
94.
Zurück zum Zitat Ho LI, Harn HJ, Lien TC, Hu PY, Wang JH (1996) Postextubation laryngeal edema in adults. Risk factor evaluation and prevention by hydrocortisone. Intensive Care Med 22:933–936CrossRefPubMed Ho LI, Harn HJ, Lien TC, Hu PY, Wang JH (1996) Postextubation laryngeal edema in adults. Risk factor evaluation and prevention by hydrocortisone. Intensive Care Med 22:933–936CrossRefPubMed
95.
Zurück zum Zitat Lee CH, Peng MJ, Wu CL (2007) Dexamethasone to prevent postextubation airway obstruction in adults: a prospective, randomized, double-blind, placebo-controlled study. Crit Care 11:R72CrossRefPubMedCentralPubMed Lee CH, Peng MJ, Wu CL (2007) Dexamethasone to prevent postextubation airway obstruction in adults: a prospective, randomized, double-blind, placebo-controlled study. Crit Care 11:R72CrossRefPubMedCentralPubMed
96.
Zurück zum Zitat Francois B, Bellissant E, Gissot V, Desachy A, Normand S, Boulain T, Brenet O, Preux PM, Vignon P, Association des Réanimateurs du Centre-Ouest (ARCO) (2007) 12-h pretreatment with methylprednisolone versus placebo for prevention of postextubation laryngeal oedema: a randomised double-blind trial. Lancet 369:1083–1089CrossRefPubMed Francois B, Bellissant E, Gissot V, Desachy A, Normand S, Boulain T, Brenet O, Preux PM, Vignon P, Association des Réanimateurs du Centre-Ouest (ARCO) (2007) 12-h pretreatment with methylprednisolone versus placebo for prevention of postextubation laryngeal oedema: a randomised double-blind trial. Lancet 369:1083–1089CrossRefPubMed
97.
Zurück zum Zitat Cook TM, Woodall N Frerk C, Fourth National Audit Project (2011) Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. Br J Anaesth 106:617–631CrossRefPubMed Cook TM, Woodall N Frerk C, Fourth National Audit Project (2011) Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. Br J Anaesth 106:617–631CrossRefPubMed
98.
Zurück zum Zitat Miller RL, Cole RP (1996) Association between reduced cuff leak volume and postextubation stridor. Chest 110:1035–1040CrossRefPubMed Miller RL, Cole RP (1996) Association between reduced cuff leak volume and postextubation stridor. Chest 110:1035–1040CrossRefPubMed
99.
Zurück zum Zitat M. Heck, M. Fresenius: Klinikmanual Anästhesie, 2. Aufl., Springer, Heidelberg, 2015 M. Heck, M. Fresenius: Klinikmanual Anästhesie, 2. Aufl., Springer, Heidelberg, 2015
Metadaten
Titel
S1-Leitlinie Atemwegsmanagement
verfasst von
PD Dr. T. Piepho
E. Cavus
R. Noppens
C. Byhahn
V. Dörges
B. Zwissler
A. Timmermann
Publikationsdatum
01.11.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Die Anaesthesiologie / Ausgabe 11/2015
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866
DOI
https://doi.org/10.1007/s00101-015-0087-6

Weitere Artikel der Ausgabe 11/2015

Der Anaesthesist 11/2015 Zur Ausgabe

Klinische Pharmakologie

Neuroprotektion durch Edelgase

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Delir bei kritisch Kranken – Antipsychotika versus Placebo

16.05.2024 Delir Nachrichten

Um die Langzeitfolgen eines Delirs bei kritisch Kranken zu mildern, wird vielerorts auf eine Akuttherapie mit Antipsychotika gesetzt. Eine US-amerikanische Forschungsgruppe äußert jetzt erhebliche Vorbehalte gegen dieses Vorgehen. Denn es gibt neue Daten zum Langzeiteffekt von Haloperidol bzw. Ziprasidon versus Placebo.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.