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BACKGROUND AND OBJECTIVE High-dose opioid anaesthesia contributes to decreasing metabolic and hormonal stress responses in patients undergoing cardiac surgery. However, the increase in context-sensitive half-life of opioids given as a high-dose regimen can affect postoperative respiratory recovery. In contrast, remifentanil can be given in high doses(More)
Over the past decades, echocardiography has undergone a continuous evolution in technology that has promoted its clinical application and acceptance throughout perioperative medicine. These technological advances include improvements in transducer development that permit superior imaging quality and a wider selection of probes for epicardial, epiaortic, and(More)
Der hohe Stellenwert der transösophagealen Echokardiographie (TEE) in der perioperativen Medizin ist unumstritten. Die TEE gestattet eine direkte bildgebende Darstellung von pathologischen Veränderungen des Herzens. Daher ist die TEE das Verfahren der Wahl zur Diagnose und Graduierung von Herzklappenerkrankungen. Über die direkte bildliche Darstellung(More)
We describe the perioperative management of a pregnant woman at 19 weeks' gestation with idiopathic thrombocytopenic purpura requiring laparoscopic splenectomy. The preoperative platelet count ranged between 1 and 5 x 10(9)/L and did not respond to conventional medical therapy. To reduce the risk of intracerebral hemorrhage, platelets were transfused before(More)
Epicardial echocardiography has been available since the early 1970s as an intraoperative diagnostic modality to assess ventricular and valvular function. With this technique, an ultrasonic transducer is placed directly on the epicardial surface of the heart, following sternotomy and pericardiotomy. Under the guidance of the cardiac anesthesiologist, the(More)
Due to the increasing age in western countries, combined with high rates of major surgical interventions in high-risk patients, perioperative reduction of cardiovascular complications becomes increasingly more important for perioperative physicians. After identifying patients with increased perioperative risk, specific interventions need to be considered to(More)
BACKGROUND The obstetric population has an increasing incidence of comorbid conditions. These, coupled with the possibility of acute embolic events involving air, amniotic fluid, and thrombus, increase the likelihood of hemodynamic instability. Although the utility of transesophageal echocardiography to guide management in cardiac and high-risk, non-cardiac(More)
AIM Acute kidney injury (AKI) is diagnosed by a 50% increase in creatinine. For patients without a baseline creatinine measurement, guidelines suggest estimating baseline creatinine by back-calculation. The aim of this study was to evaluate different glomerular filtration rate (GFR) equations and different GFR assumptions for back-calculating baseline(More)