{"title":"Role of rapid short-acting anesthetics, analgesics and muscle relaxants in ambulatory anesthesia.","authors":"P F White","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75373,"journal":{"name":"Acta anaesthesiologica Scandinavica. Supplementum","volume":"111 ","pages":"223-6"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20349913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How to practice and teach evidence-based medicine: role of the Cochrane Collaboration.","authors":"J Kleijnen, I Chalmers","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75373,"journal":{"name":"Acta anaesthesiologica Scandinavica. Supplementum","volume":"111 ","pages":"231-3"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20349916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G Trittenwein, G Fürst, J Golej, G Burda, M Hermon, G Wollenek, A Pollak
Background: Extracorporeal membrane oxygenation (ECMO), originally developed as an artificial replacement for respiratory assistance, is decreasingly used in neonates with respiratory failure. Nevertheless, there is a constant need for this invasive and expensive neonatal treatment modality.
Intervention: Review of our experience (80 recent ECMO performances because of circulatory failure) and the literature.
Results: In contrary to reduced ECMO performances out of respiratory insufficiency in neonates, ECMO as circulatory support is increasingly used. Neonatal sepsis, pre- and postoperative cardiac failure, combined circulatory and respiratory failure after resuscitation and with congenital diaphragmatic hernia result in a permanent need for ECMO, whenever there are fewer ECMO treatments per year. Nonocclusive pumps, portable devices, small priming volumes and tapered anticoagulation protocols enable survival through ECMO even in virtually hopeless hemodynamic conditions. Special efforts in investigation and prevention of permanent neurological impairment, especially after severe pre-ECMO hypoxia seem to be mandatory.
Conclusion: ECMO remains an important tool in neonatal and pediatric intensive care. However, the number of ECMO therapies was reduced due to respiratory therapeutic progress, but indications and ECMO technology have changed.
{"title":"Extracorporeal membrane oxygenation in neonates.","authors":"G Trittenwein, G Fürst, J Golej, G Burda, M Hermon, G Wollenek, A Pollak","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Extracorporeal membrane oxygenation (ECMO), originally developed as an artificial replacement for respiratory assistance, is decreasingly used in neonates with respiratory failure. Nevertheless, there is a constant need for this invasive and expensive neonatal treatment modality.</p><p><strong>Intervention: </strong>Review of our experience (80 recent ECMO performances because of circulatory failure) and the literature.</p><p><strong>Results: </strong>In contrary to reduced ECMO performances out of respiratory insufficiency in neonates, ECMO as circulatory support is increasingly used. Neonatal sepsis, pre- and postoperative cardiac failure, combined circulatory and respiratory failure after resuscitation and with congenital diaphragmatic hernia result in a permanent need for ECMO, whenever there are fewer ECMO treatments per year. Nonocclusive pumps, portable devices, small priming volumes and tapered anticoagulation protocols enable survival through ECMO even in virtually hopeless hemodynamic conditions. Special efforts in investigation and prevention of permanent neurological impairment, especially after severe pre-ECMO hypoxia seem to be mandatory.</p><p><strong>Conclusion: </strong>ECMO remains an important tool in neonatal and pediatric intensive care. However, the number of ECMO therapies was reduced due to respiratory therapeutic progress, but indications and ECMO technology have changed.</p>","PeriodicalId":75373,"journal":{"name":"Acta anaesthesiologica Scandinavica. Supplementum","volume":"111 ","pages":"143-4"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20349973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C M Müller, C G Krenn, G Urak, M Zimpfer, M Semsroth
Sevoflurane is a potent inhalational agent, combining several advantages of specific interest in paediatric anaesthesia. Rapid and smooth induction, a safe cardiovascular profile, rapid emergence and a short postoperative recovery with minimal side effects are ideal characteristics of this agent for the use in paediatric anaesthesiology. The apparent improvement in management should not obscure the fact that sevoflurane in higher MAC should be used with caution in renal impairment. For the future world of our children, the lack of chlorine in the structure makes sevoflurane theoretically less ozone-depleting than halothane and isoflurane, a substance contributing to environmental protection.
{"title":"Sevoflurane in paediatric anaesthesia.","authors":"C M Müller, C G Krenn, G Urak, M Zimpfer, M Semsroth","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Sevoflurane is a potent inhalational agent, combining several advantages of specific interest in paediatric anaesthesia. Rapid and smooth induction, a safe cardiovascular profile, rapid emergence and a short postoperative recovery with minimal side effects are ideal characteristics of this agent for the use in paediatric anaesthesiology. The apparent improvement in management should not obscure the fact that sevoflurane in higher MAC should be used with caution in renal impairment. For the future world of our children, the lack of chlorine in the structure makes sevoflurane theoretically less ozone-depleting than halothane and isoflurane, a substance contributing to environmental protection.</p>","PeriodicalId":75373,"journal":{"name":"Acta anaesthesiologica Scandinavica. Supplementum","volume":"111 ","pages":"150-1"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20349977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}