Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Häufige urologisch-sexualmedizinische Themen in der Praxis sind das Thema des MMW-Webinars am 5. Juni von 17.30 bis 19 Uhr. Konkret geht es um die Frage, wann bei Harnwegsinfektionen auf Antibiotika verzichtet werden kann, und um ein Update zur Therapie von Libido- und Potenzstörungen des Mannes. Der dritte Vortrag behandelt sexuell übertragbare Krankheiten. Stellen Sie Ihre Fragen an die Experten und sammeln Sie 2 CME-Punkte. Jetzt gleich anmelden!
Erweiterte Suche
Anmelden
nach oben
Critical Care
Erschienen in: Critical Care 5/2012

01.10.2012 | Review

Bench to bedside review: Extracorporeal carbon dioxide removal, past present and future

verfasst von: Matthew E Cove, Graeme MacLaren, William J Federspiel, John A Kellum

Erschienen in: Critical Care | Ausgabe 5/2012

Einloggen, um Zugang zu erhalten

Abstract

Acute respiratory distress syndrome (ARDS) has a substantial mortality rate and annually affects more than 140,000 people in the USA alone. Standard management includes lung protective ventilation but this impairs carbon dioxide clearance and may lead to right heart dysfunction or increased intracranial pressure. Extracorporeal carbon dioxide removal has the potential to optimize lung protective ventilation by uncoupling oxygenation and carbon dioxide clearance. The aim of this article is to review the carbon dioxide removal strategies that are likely to be widely available in the near future. Relevant published literature was identified using PubMed and Medline searches. Queries were performed by using the search terms ECCOR, AVCO2R, VVCO2R, respiratory dialysis, and by combining carbon dioxide removal and ARDS. The only search limitation imposed was English language. Additional articles were identified from reference lists in the studies that were reviewed. Several novel strategies to achieve carbon dioxide removal were identified, some of which are already commercially available whereas others are in advanced stages of development.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Villar J, Blanco J, Anon JM, Santos-Bouza A, Blanch L, Ambros A, Gandia F, Carriedo D, Mosteiro F, Basaldua S, Fernandez RL, Kacmarek RM: The ALIEN study: incidence and outcome of acute respiratory distress syndrome in the era of lung protective ventilation. Intensive Care Med. 2011, 37: 1932-1941. 10.1007/s00134-011-2380-4.CrossRefPubMed
2.
Rubenfeld GD, Caldwell E, Peabody E, Weaver J, Martin DP, Neff M, Stern EJ, Hudson LD: Incidence and outcomes of acute lung injury. N Engl J Med. 2005, 353: 1685-1693. 10.1056/NEJMoa050333.CrossRefPubMed
3.
Phua J, Badia JR, Adhikari NK, Friedrich JO, Fowler RA, Singh JM, Scales DC, Stather DR, Li A, Jones A, Gattas DJ, Hallett D, Tomlinson G, Stewart TE, Ferguson ND: Has mortality from acute respiratory distress syndrome decreased over time?: A systematic review. Am J Respir Crit Care Med. 2009, 179: 220-227.CrossRefPubMed
4.
Weinert CR, Gross CR, Marinelli WA: Impact of randomized trial results on acute lung injury ventilator therapy in teaching hospitals. Am J Respir Crit Care Med. 2003, 167: 1304-1309. 10.1164/rccm.200205-478OC.CrossRefPubMed
5.
Young MP, Manning HL, Wilson DL, Mette SA, Riker RR, Leiter JC, Liu SK, Bates JT, Parsons PE: Ventilation of patients with acute lung injury and acute respiratory distress syndrome: Has new evidence changed clinical practice?. Crit Care Med. 2004, 32: 1260-1265. 10.1097/01.CCM.0000127784.54727.56.CrossRefPubMed
6.
Kalhan R, Mikkelsen M, Dedhiya P, Christie J, Gaughan C, Lanken PN, Finkel B, Gallop R, Fuchs BD: Underuse of lung protective ventilation: Analysis of potential factors to explain physician behavior. Crit Care Med. 2006, 34: 300-306. 10.1097/01.CCM.0000198328.83571.4A.CrossRefPubMed
7.
Rubenfeld GD, Cooper C, Carter G, Thompson BT, Hudson LD: Barriers to providing lung-protective ventilation to patients with acute lung injury. Crit Care Med. 2004, 32: 1289-1293. 10.1097/01.CCM.0000127266.39560.96.CrossRefPubMed
8.
Kregenow DA, Rubenfeld GD, Hudson LD, Swenson ER: Hypercapnic acidosis and mortality in acute lung injury. Crit Care Med. 2006, 34: 1-7.CrossRefPubMed
9.
Terragni PP, Del Sorbo L, Mascia L, Urbino R, Martin EL, Birocco A, Faggiano C, Quintel M, Gattinoni L, Ranieri VM: Tidal volume lower than 6 ml/kg enhances lung protection: role of extracorporeal carbon dioxide removal. Anesthesiology. 2009, 111: 826-835. 10.1097/ALN.0b013e3181b764d2.CrossRefPubMed
10.
Hager DN, Krishnan JA, Hayden DL, Brower RG: Tidal volume reduction in patients with acute lung injury when plateau pressures are not high. Am J Respir Crit Care Med. 2005, 172: 1241-1245. 10.1164/rccm.200501-048CP.PubMedCentralCrossRefPubMed
11.
Network TARDS: Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network. N Engl J Med. 2000, 342: 1301-1308.CrossRef
12.
13.
O'Croinin DF, Nichol AD, Hopkins N, Boylan J, O'Brien S, O'Connor C, Laffey JG, McLoughlin P: Sustained hypercapnic acidosis during pulmonary infection increases bacterial load and worsens lung injury. Crit Care Med. 2008, 36: 2128-2135. 10.1097/CCM.0b013e31817d1b59.CrossRefPubMed
14.
O'Toole D, Hassett P, Contreras M, Higgins BD, McKeown ST, McAuley DF, O'Brien T, Laffey JG: Hypercapnic acidosis attenuates pulmonary epithelial wound repair by an NF-kappaB dependent mechanism. Thorax. 2009, 64: 976-982. 10.1136/thx.2008.110304.CrossRefPubMed
15.
Mekontso Dessap A, Charron C, Devaquet J, Aboab J, Jardin F, Brochard L, Vieillard-Baron A: Impact of acute hypercapnia and augmented positive end-expiratory pressure on right ventricle function in severe acute respiratory distress syndrome. Intensive Care Med. 2009, 35: 1850-1858. 10.1007/s00134-009-1569-2.PubMedCentralCrossRefPubMed
16.
Kolobow T, Gattinoni L, Tomlinson TA, Pierce JE: Control of breathing using an extracorporeal membrane lung. Anesthesiology. 1977, 46: 138-141. 10.1097/00000542-197702000-00012.CrossRefPubMed
17.
Maclaren G, Combes A, Bartlett RH: Contemporary extracorporeal membrane oxygenation for adult respiratory failure: life support in the new era. Intensive Care Med. 2011, 38: 210-220.CrossRefPubMed
18.
19.
Lim MW: The history of extracorporeal oxygenators. Anaesthesia. 2006, 61: 984-995. 10.1111/j.1365-2044.2006.04781.x.CrossRefPubMed
20.
Kolff WJ, Berk HT, ter Welle M, van der LEYAJ, van Dijk EC, van Noordwijk J: The artificial kidney: a dialyser with a great area. 1944. J Am Soc Nephrol. 1997, 8: 1959-1965.PubMed
21.
Bramson ML, Osborn JJ, Main FB, O'Brien MF, Wright JS, Gerbode F: A new disposable membrane oxygenator with integral heat exchange. J Thorac Cardiovasc Surg. 1965, 50: 391-400.PubMed
22.
Kolobow T, Bowman RL: Construction and evaluation of an alveolar membrane artificial heart-lung. Trans Am Soc Artif Intern Organs. 1963, 9: 238-243.PubMed
23.
Kolobow T, Spragg RG, Pierce JE, Zapol WM: Extended term (to 16 days) partial extracorporeal blood gas exchange with the spiral membrane lung in unanesthetized lambs. Trans Am Soc Artif Intern Organs. 1971, 17: 350-354.PubMed
24.
Peek GJ, Killer HM, Reeves R, Sosnowski AW, Firmin RK: Early experience with a polymethyl pentene oxygenator for adult extracorporeal life support. ASAIO J. 2002, 48: 480-482. 10.1097/00002480-200209000-00007.CrossRefPubMed
25.
Khoshbin E, Roberts N, Harvey C, Machin D, Killer H, Peek GJ, Sosnowski AW, Firmin RK: Poly-methyl pentene oxygenators have improved gas exchange capability and reduced transfusion requirements in adult extracorporeal membrane oxygenation. ASAIO J. 2005, 51: 281-287. 10.1097/01.MAT.0000159741.33681.F1.CrossRefPubMed
26.
Toomasian JM, Schreiner RJ, Meyer DE, Schmidt ME, Hagan SE, Griffith GW, Bartlett RH, Cook KE: A polymethylpentene fiber gas exchanger for long-term extracorporeal life support. ASAIO J. 2005, 51: 390-397. 10.1097/01.mat.0000169111.66328.a8.CrossRefPubMed
27.
Gaylor JD: Membrane oxygenators: current developments in design and application. J Biomed Eng. 1988, 10: 541-547. 10.1016/0141-5425(88)90113-6.CrossRefPubMed
28.
29.
Gattinoni L, Pesenti A, Mascheroni D, Marcolin R, Fumagalli R, Rossi F, Iapichino G, Romagnoli G, Uziel L, Agostoni A, et al: Low-frequency positive-pressure ventilation with extracorporeal CO2 removal in severe acute respiratory failure. JAMA. 1986, 256: 881-886. 10.1001/jama.1986.03380070087025.CrossRefPubMed
30.
Morris AH, Wallace CJ, Menlove RL, Clemmer TP, Orme JFJ, Weaver LK, Dean NC, Thomas F, East TD, Pace NL, Suchyta MR, Beck E, Bombino M, Sittig DF, Bohm S, Hoffmann B, Becks H, Butler S, Pearl J, Rasmusson B: Randomized clinical trial of pressure-controlled inverse ratio ventilation and extracorporeal CO2 removal for adult respiratory distress syndrome. Am J Respir Crit Care Med. 1994, 149: 295-305.CrossRefPubMed
31.
Wang D, Zhou X, Liu X, Sidor B, Lynch J, Zwischenberger JB: Wang-Zwische double lumen cannula-toward a percutaneous and ambulatory paracorporeal artificial lung. ASAIO J. 2008, 54: 606-611. 10.1097/MAT.0b013e31818c69ab.CrossRefPubMed
32.
Batchinsky AI, Jordan BS, Regn D, Necsoiu C, Federspiel WJ, Morris MJ, Cancio LC: Respiratory dialysis: reduction in dependence on mechanical ventilation by venovenous extracorporeal CO2 removal. Crit Care Med. 2011, 39: 1382-1387. 10.1097/CCM.0b013e31820eda45.CrossRefPubMed
33.
Gramaticopolo S, Chronopoulos A, Piccinni P, Nalesso F, Brendolan A, Zanella M, Cruz DN, Ronco C: Extracorporeal CO2 removal - a way to achieve ultraprotective mechanical ventilation and lung support: the missing piece of multiple organ support therapy. Contrib Nephrol. 2010, 165: 174-184.CrossRefPubMed
34.
Zapol WM, Snider MT, Hill JD, Fallat RJ, Bartlett RH, Edmunds LH, Morris AH, Peirce EC, Thomas AN, Proctor HJ, Drinker PA, Pratt PC, Bagniewski A, Miller RG: Extracorporeal membrane oxygenation in severe acute respiratory failure. A randomized prospective study. JAMA. 1979, 242: 2193-2196. 10.1001/jama.1979.03300200023016.CrossRefPubMed
35.
Gattinoni L, Kolobow T, Tomlinson T, Iapichino G, Samaja M, White D, Pierce J: Low-frequency positive pressure ventilation with extracorporeal carbon dioxide removal (LFPPV-ECCO2R): an experimental study. Anesth Analg. 1978, 57: 470-477.CrossRefPubMed
36.
Brunet F, Mira JP, Belghith M, Monchi M, Renaud B, Fierobe L, Hamy I, Dhainaut JF, Dall'ava-Santucci J: Extracorporeal carbon dioxide removal technique improves oxygenation without causing overinflation. Am J Respir Crit Care Med. 1994, 149: 1557-1562.CrossRefPubMed
37.
Bein T, Weber F, Philipp A, Prasser C, Pfeifer M, Schmid FX, Butz B, Birnbaum D, Taeger K, Schlitt HJ: A new pumpless extracorporeal interventional lung assist in critical hypoxemia/hypercapnia. Crit Care Med. 2006, 34: 1372-1377. 10.1097/01.CCM.0000215111.85483.BD.CrossRefPubMed
38.
Zimmermann M, Bein T, Arlt M, Philipp A, Rupprecht L, Mueller T, Lubnow M, Graf BM, Schlitt HJ: Pumpless extracorporeal interventional lung assist in patients with acute respiratory distress syndrome: a prospective pilot study. Crit Care. 2009, 13: R10-10.1186/cc7703.PubMedCentralCrossRefPubMed
39.
Conrad S, Zwischenberger J, Grier L, Alpard S, Bidani A: Total extracorporeal arteriovenous carbon dioxide removal in acute respiratory failure: a phase I clinical study. Intensive Care Med. 2001, 27: 1340-1351. 10.1007/s001340100993.CrossRefPubMed
40.
Conrad SA, Green R, Scott LK: Near-fatal pediatric asthma managed with pumpless arteriovenous carbon dioxide removal. Crit Care Med. 2007, 35: 2624-2629. 10.1097/01.CCM.0000288104.97602.B3.CrossRefPubMed
41.
Iglesias M, Martinez E, Badia JR, Macchiarini P: Extrapulmonary ventilation for unresponsive severe acute respiratory distress syndrome after pulmonary resection. Ann Thorac Surg. 2008, 85: 237-244. 10.1016/j.athoracsur.2007.06.004. discussion 244CrossRefPubMed
42.
Bein T, Zimmermann M, Hergeth K, Ramming M, Rupprecht L, Schlitt HJ, Slutsky AS: Pumpless extracorporeal removal of carbon dioxide combined with ventilation using low tidal volume and high positive end-expiratory pressure in a patient with severe acute respiratory distress syndrome. Anaesthesia. 2009, 64: 195-198. 10.1111/j.1365-2044.2008.05735.x.CrossRefPubMed
43.
Johnson P, Frohlich S, Westbrook A: Use of extracorporeal membrane lung assist device (Novalung) in H1N1 patients. J Card Surg. 2011, 26: 449-452. 10.1111/j.1540-8191.2011.01261.x.CrossRefPubMed
44.
Elliot SC, Paramasivam K, Oram J, Bodenham AR, Howell SJ, Mallick A: Pumpless extracorporeal carbon dioxide removal for life-threatening asthma. Crit Care Med. 2007, 35: 945-948. 10.1097/01.CCM.0000257462.04514.15.CrossRefPubMed
45.
Bartosik W, Egan JJ, Wood AE: The Novalung interventional lung assist as bridge to lung transplantation for self-ventilating patients - initial experience. Interact Cardiovasc Thorac Surg. 2011, 13: 198-200. 10.1510/icvts.2011.266346.CrossRefPubMed
46.
Livigni S, Maio M, Ferretti E, Longobardo A, Potenza R, Rivalta L, Selvaggi P, Vergano M, Bertolini G: Efficacy and safety of a low-flow veno-venous carbon dioxide removal device: results of an experimental study in adult sheep. Crit Care. 2006, 10: R151-10.1186/cc5082.PubMedCentralCrossRefPubMed
47.
Ruberto F, Pugliese F, D'Alio A, Perrella S, D'Auria B, Ianni S, Anile M, Venuta F, Coloni GF, Pietropaoli P: Extracorporeal removal CO2 using a venovenous, low-flow system (Decapsmart) in a lung transplanted patient: a case report. Transplant Proc. 2009, 41: 1412-1414. 10.1016/j.transproceed.2009.03.048.CrossRefPubMed
48.
Moscatelli A, Ottonello G, Nahum L, Lampugnani E, Puncuh F, Simonini A, Tumolo M, Tuo P: Noninvasive ventilation and low-flow veno-venous extracorporeal carbon dioxide removal as a bridge to lung transplantation in a child with refractory hypercapnic respiratory failure due to bronchiolitis obliterans. Pediatr Crit Care Med. 2010, 11: e8-12. 10.1097/PCC.0b013e3181b0123b.CrossRefPubMed
49.
Burki N, Mani R, Herth F, Schmidt w, Teschler H, Bonin F: A novel extracoporeal CO2 removal system: application of the hemolung in patients with hypercapnic respiratory failure. Am J Respir Crit Care Med Med. 2011, 183: A1697-
50.
Mortensen JD, Berry G: Conceptual and design features of a practical, clinically effective intravenous mechanical blood oxygen/carbon dioxide exchange device (IVOX). Int J Artif Organs. 1989, 12: 384-389.PubMed
51.
Cox CSJ, Zwischenberger JB, Kurusz M: Development and current status of a new intracorporeal membrane oxygenator (IVOX). Perfusion. 1991, 6: 291-296. 10.1177/026765919100600409.CrossRefPubMed
52.
Conrad SA, Eggerstedt JM, Grier LR, Morris VF, Romero MD: Intravenacaval membrane oxygenation and carbon dioxide removal in severe acute respiratory failure. Chest. 1995, 107: 1689-1697. 10.1378/chest.107.6.1689.CrossRefPubMed
53.
Gentilello LM, Jurkovich GJ, Gubler KD, Anardi DM, Heiskell R: The intravascular oxygenator (IVOX): preliminary results of a new means of performing extrapulmonary gas exchange. J Trauma. 1993, 35: 399-404. 10.1097/00005373-199309000-00011.CrossRefPubMed
54.
Murdoch LJ, Boyd OF, Mackay J, Bennett ED, Grounds RM: The peri-operative management of surgical insertion and removal of the intravenous oxygenator device (IVOX). A report of nine cases. Anaesthesia. 1993, 48: 845-848. 10.1111/j.1365-2044.1993.tb07411.x.CrossRefPubMed
55.
Zanella A, Patroniti N, Isgro S, Albertini M, Costanzi M, Pirrone F, Scaravilli V, Vergnano B, Pesenti A: Blood acidification enhances carbon dioxide removal of membrane lung: an experimental study. Intensive Care Med. 2009, 35: 1484-1487. 10.1007/s00134-009-1513-5.CrossRefPubMed
56.
Tao W, Schroeder T, Bidani A, Cardenas VJJ, Nguyen PD, Bradford DW, Traber DL, Zwischenberger JB: Improved gas exchange performance of the intravascular oxygenator by active blood mixing. ASAIO J. 1994, 40: M527-32. 10.1097/00002480-199407000-00056.CrossRefPubMed
57.
Federspiel WJ, Hout MS, Hewitt TJ, Lund LW, Heinrich SA, Litwak P, Walters FR, Reeder GD, Borovetz HS, Hattler BG: Development of a low flow resistance intravenous oxygenator. ASAIO J. 1997, 43: M725-730. 10.1097/00002480-199709000-00078.CrossRefPubMed
58.
Hattler BG, Lund LW, Golob J, Russian H, Lann MF, Merrill TL, Frankowski B, Federspiel WJ: A respiratory gas exchange catheter: In vitro and in vivo tests in large animals. J Thorac Cardiovasc Surg. 2002, 124: 520-530. 10.1067/mtc.2002.123811.CrossRefPubMed
59.
Zwischenberger JB, Nguyen TT, Tao W, Bush PE, Cox CS, Traber DL, Herndon DN, Bidani A: IVOX with gradual permissive hypercapnia: a new management technique for respiratory failure. J Surg Res. 1994, 57: 99-105. 10.1006/jsre.1994.1117.CrossRefPubMed
60.
Makarewicz AJ, Mockros LF, Anderson RW: A dynamic intravascular artificial lung. ASAIO J. 1994, 40: M747-750. 10.1097/00002480-199407000-00099.CrossRefPubMed
61.
Mihelc KM, Frankowski BJ, Lieber SC, Moore ND, Hattler BG, Federspiel WJ: Evaluation of a respiratory assist catheter that uses an impeller within a hollow fiber membrane bundle. ASAIO J. 2009, 55: 569-574. 10.1097/MAT.0b013e3181bc2655.CrossRefPubMed
62.
Kaar JL, Oh HI, Russell AJ, Federspiel WJ: Towards improved artificial lungs through biocatalysis. Biomaterials. 2007, 28: 3131-3139. 10.1016/j.biomaterials.2007.03.021.PubMedCentralCrossRefPubMed
63.
Chang BS, Garella S: Complete extracorporeal removal of metabolic carbon dioxide by alkali administration and dialysis in apnea. Int J Artif Organs. 1983, 6: 295-298.PubMed
64.
Gille JP, Saunier C, Schrijen F, Hartemann D, Tousseul B: Metabolic CO2 removal by dialysis: THAM vs NaOH infusion. Int J Artif Organs. 1989, 12: 720-727.PubMed
65.
Nolte SH, Benfer RH, Grau J: Extracorporeal CO2 removal with hemodialysis (ECBicCO2R): how to make up for the bicarbonate loss?. Int J Artif Organs. 1991, 14: 759-764.PubMed
66.
Cressoni M, Zanella A, Epp M, Corti I, Patroniti N, Kolobow T, Pesenti A: Decreasing pulmonary ventilation through bicarbonate ultrafiltration: an experimental study. Crit Care Med. 2009, 37: 2612-2618. 10.1097/CCM.0b013e3181a5668a.CrossRefPubMed
67.
Russ M, Deja M, Ott S, Bedarf J, Keckel T, Hiebl B, Wagner JJ, Unger JK: Experimental high-volume hemofiltration with predilutional tris-hydroxymethylaminomethane for correction of low tidal volume ventilation-induced acidosis. Artif Organs. 2011, 35: E108-118. 10.1111/j.1525-1594.2011.01204.x.CrossRefPubMed
68.
Pesenti A, Patroniti N, Fumagalli R: Carbon dioxide dialysis will save the lung. Crit Care Med. 2010, 38: S549-S554.CrossRefPubMed
Metadaten
Titel
Bench to bedside review: Extracorporeal carbon dioxide removal, past present and future
verfasst von
Matthew E Cove
Graeme MacLaren
William J Federspiel
John A Kellum
Publikationsdatum
01.10.2012
Verlag
BioMed Central
Erschienen in
Critical Care / Ausgabe 5/2012
Elektronische ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc11356

Weitere Artikel der Ausgabe 5/2012

Critical Care 5/2012 Zur Ausgabe

Journal club critique

Weighing risks and benefits of stress ulcer prophylaxis in critically ill patients

Letter

Number needed to treat for subglottic secretion drainage technology as a ventilator-associated pneumonia prevention strategy

Research

Optimal glycemic control in neurocritical care patients: a systematic review and meta-analysis

Research

Reversal of Vitamin K Antagonist (VKA) effect in patients with severe bleeding: a French multicenter observational study (Optiplex) assessing the use of Prothrombin Complex Concentrate (PCC) in current clinical practice

Letter

Potential for overuse of corticosteroids and vasopressin in septic shock

Research

Comparative effects on glucose absorption of intragastric and post-pyloric nutrient delivery in the critically ill

Neu im Fachgebiet AINS

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.

hier abonnieren
Bildnachweise