[Prevention of infections under anesthetic breathing with breathing filters: concerted recommendations of the Deutsche Gesellschaft für Krankenhaushygiene e.V. (DGKH) and the Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin e.V. (DGAI)].

An interdisciplinary working group from the German Society of Hospital Hygiene (DGKH) and the German Society for Anesthesiology and Intensive Care (DGAI) worked out the following recommendations for infection prevention during anesthesia by using breathing system filters (BSF). The BSF shall be changed after each patient. The filter retention efficiency for airborne particles is recommended to be >99% (II).

Infection prevention during anaesthesia ventilation by the use of breathing system filters (BSF): Joint recommendation by German Society of Hospital Hygiene (DGKH) and German Society for Anaesthesiology and Intensive Care (DGAI).

An interdisciplinary working group from the German Society of Hospital Hygiene (DGKH) and the German Society for Anaesthesiology and Intensive Care (DGAI) worked out the following recommendations for infection prevention during anaesthesia by using breathing system filters (BSF). The BSF shall be changed after each patient. The filter retention efficiency for airborne particles is recommended to be >99% (II).

[Evaluation of the new supraglottic airway devices Ambu AuraOnce and Intersurgical i-gel. Positioning, sealing, patient comfort and airway morbidity].

Background: Supraglottic airway devices (SGAD) have become more important in airway management over the past years and an objective comparison of the available devices is in order.

Methods: In a prospective study the four SGADs LMA-Classic(cLMA), LMA-ProSeal (PLMA), Ambu AuraOnce and Intersurgical i-gel were compared in groups of 40 patients in ambulatory surgery, with respect to the feasibility of positioning, leak tightness, patient comfort and airway morbidity. The seal test of the airway devices was carried out with a specially constructed pneumotachograph.

Devices used to humidify respired gases.

The efficiency of HMEs decreases with increasing tidal volumes. HMEs always result in an elevation of the inspiratory and expiratory airway resistances; this should be considered especially in cases that involve spontaneous respiration. The pressure drop across HMEs should be less than 2 hPa for a flow of 60 L/min, a level that also has been measured for cascade humidifiers.

Evaluation of heated humidifiers for use on intubated patients: a comparative study of humidifying efficiency, flow resistance, and alarm functions using a lung model.

Objective: Evaluation of humidification efficiency, flow resistance, and alarm functions of heated humidifiers (HH;(Kendall-Aerodyne-delta, Fisher&Paykel-MR 730; Dräger-Aquapor; Puritan-Bennett-Cascade II) in accordance with ISO/EN-8185:1997 and on a ventilated lung model in accordance with ISO/EN-9360:2000.

Methods: Humidification efficiency was evaluated by (a) measuring the water content of the inspiratory air on perfusion with different gas flows, (b) measuring the water loss of a lung model, and (c) simultaneous measurement of the in- and expiratory water content with a capacitive hybrid sensor. The resistance characteristics were measured, the data were compared with a mathematical approximation.

[Measurement of water vapour pressure in the airways of mechanically ventilated patient using different types of humidifiers].

Unlabelled: AIM OF THE INVESTIGATION: To evaluate the performance of different types of humidifying systems (heat and moisture exchanger, HME, and heated humidifier, HH) in the tracheo bronchial airway system of intubated mechanically ventilated patients.

Methods: A heated and fast responding capacitive sensor with a time constant of 0,23 s was used to measure the water vapor pressure at different locations in the tracheo bronchial airway system of 12 patients after therapeutic bronchoscopy. The sensor was immersed in an airstream of app.

[Frozen shoulder--MRI-verified continuous block of suprascapular nerve].

Suprascapular nerve block may provide sufficient analgesia in painful immobilisation of the shoulder joint. In the following case report a 41 year old male presenting with adhesive capsulitis (frozen shoulder) has been treated successfully by performing continuous delivery of local anesthetics to the suprascapular nerve via catheter. The location of the catheter has been verified using MRI examination.

[Rapid measurement of water vapor partial pressure at the saturation point with a new hybrid humidity sensor].

A new hybrid humidity sensor comprising a conventional capacitance humidity sensor and a planar heating element is described. Owing to its short response time of only a few milliseconds, its great measuring accuracy, large measuring range, and simplicity in handling, the sensor is suitable for measuring water vapour partial pressure in gases with rapidly changing flow and direction, e.g.

Comparison of ventilatory and haemodynamic effects of BIPAP and S-IMV/PSV for postoperative short-term ventilation in patients after coronary artery bypass grafting.

The aim of the present multiple cross-over study was to compare the effects of biphasic positive airway pressure (BIPAP) ventilation with synchronized intermittent mandatory ventilation combined with pressure support ventilation (S-IMV/PSV) in sedated and awake patients after coronary artery bypass grafting (CABG) surgery. Twenty-four patients with no evidence of preoperative respiratory dysfunction and an uncomplicated intraoperative course were investigated. The patients were randomly assigned to one of two groups starting with either BIPAP or S-IMV/PSV mode.

[Climatization of anesthetic gases using different breathing hose systems].

Background: During general anaesthesia gas climate significantly is improved by performance of low flow techniques. Gas climatisation, however, markedly also will be influenced by the temperature loss at, and corresponding water condensation within the hoses, factors which are related to the technical design and material of the patient hose system. The objective of this prospective study was to investigate 1.

[Emergency and intensive care medicine as an interdisciplinary training requirement].

While substantial and practical qualification for medical practice within the framework of emergency medical services have to be proven by an advanced training, there are no special training programs for in-hospital emergency situations. As in the emergency room a transparent in-hospital emergency management has to be established including definite competencies to avoid time delays and inadequate treatment due to disputes about competence. Especially surgical intensive care medicine is an interdisciplinary task, requiring the participation of the surgeon as a responsible partner.

Determination of airway humidification in high-frequency oscillatory ventilation using an artificial neonatal lung model. Comparison of a heated humidifier and a heat and moisture exchanger.

Objective: Thus far only few data are available on airway humidification during high-frequency oscillatory ventilation (HFOV). Therefore, we studied the performance and efficiency of a heated humidifier (HH) and a heat and moisture exchanger (HME) in HFOV using an artificial lung model.

Methods: Experiments were performed with a pediatric high-frequency oscillatory ventilator.

Severe accidental hypothermia: rewarming strategy using a veno-venous bypass system and a convective air warmer.

Objective: To study a rewarming strategy for patients with severe accidental hypothermia using a simple veno-venous bypass in combination with a convective air warmer.

Setting: Eighteen beds in a university hospital intensive care unit.

Patients: Four adults admitted with a core temperature less than 30 degrees C.

Microbiology of the swine head meat deboning process.

The microbiology of swine head meat was evaluated by comparing the levels of aerobic plate count (APC), coliforms, and Escherichia coli as well as the incidence and levels of Salmonella spp. in swine head meat harvested by either the old or a new improved procedure. Based on 144 samples (72 by each procedure), the levels of APC, coliforms, and E.

[Causes of failure and dangers in the use of motor driven infusion pumps. Accidental closure of the infusion system].

Unlabelled: Syringe drivers are used in anaesthetics, intensive care and emergency medicine to deliver small volumes of highly potent drugs with continuous, constant and reproducible flow. For early recognition of interruptions of the drug delivery caused by occlusion of the infusion system, an alarm is triggered as soon as the system pressure exceeds a certain limit. The sensitivity of this alarm depends on the flow rate, type-specific cut-off pressure and the elastic parameters of the infusion system.

The influence of controlled mandatory ventilation (CMV), intermittent mandatory ventilation (IMV) and biphasic intermittent positive airway pressure (BIPAP) on duration of intubation and consumption of analgesics and sedatives. A prospective analysis in 596 patients following adult cardiac surgery.

The aim of the study was the determination of the influence of ventilation modes on the consumption of analgesics and sedatives, duration of intubation and pulmonary gas exchange. Assist/controlled mandatory ventilation (S-CMV, 123 patients), synchronized intermittent mandatory ventilation (S-IMV, 431 patients) and biphasic positive airway pressure ventilation (BIPAP, 42 patients) were compared in a prospective, controlled, open clinical trial over an 18-month period. Five hundred and ninety-six adult patients with normal pulmonary function before surgery and uneventful course following coronary artery bypass graft surgery were studied.

Airway humidification in mechanically ventilated neonates and infants: a comparative study of a heat and moisture exchanger vs. a heated humidifier using a new fast-response capacitive humidity sensor.

Objective: To study the efficiency of a heated humidifier and a heat and moisture exchanger in mechanically ventilated neonates and infants.

Design: Prospective, controlled, clinical study.

Setting: University pediatric intensive care unit.

Prevention of patient bacterial contamination of anaesthesia-circle-systems: a clinical study of the contamination risk and performance of different heat and moisture exchangers with electret filter (HMEF).

The microbiological contamination of 250 breathing system tubes after use in anaesthesia circle systems with reduced fresh gas flow was investigated. The lungs of 50 patients were ventilated without any filtering device between the endotracheal tube and the Y-piece. A total of 51, 49 and 100 patients, respectively, were given different types of heat and moisture exchanger with electret filters (HMEF).