Holger Langenstein

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Die Arbeit gibt einen Überblick zur Handhabung von schwierig zu intubierenden erwachsenen Patienten. Die schwierige Intubation kommt bei 1–18% aller Intubationen vor. Der schwerwiegendste Fall, in dem weder intubiert noch mit Gesichtsmaske beatmet werden kann („cannot ventilate – cannot intubate“, ca. 2 bis 0,01 pro 10000 Narkosen), führt häufig zu(More)
Measurement of respiratory gas composition by a mass spectrometer lags behind the measurement of gas flow. To obtain specific gas volumes (e.g., the N2 volume) by multiplication and integration of concentration and flow, one has to synchronize flow and concentration signals using the delay time (TD) of the gas analyzer. During the N2 washout, however, gas(More)
To improve the success of blind intubation through a laryngeal mask, Dr. A.I.J. Brain constructed the intubating laryngeal mask airway (ILMA), marketed under the name Fastrach. The new construction allows blind intubation with highly flexible endotracheal tubes up to 8 mm ID with cuff (straight Woodbridge type), securing the airway around the intubation(More)
UNLABELLED The conventional laryngeal mask airway ("Standard" laryngeal mask airway SLMA is of outstanding importance in the management of the difficult airway. The intubating laryngeal mask airway (ILMA, commercial name Fastrach) has become available recently. First results indicate that the excellent ventilation characteristics of SLMA are maintained, but(More)
RAPID and accurate diagnosis of the misplacement of an endotracheal tube in the esophagus remains one of the most important problems in anesthesia and intensive care. Clinical signs observed through auscultation, inspection of thoracic excursions, refilling of the breathing bag, or water vapor condensing at the endotracheal tube may be misleading in as many(More)
A 50-year-old man sustained severe skull-brain trauma with intracerebral bleeding, cortical contusion foci and fracture of the petrosal bone. He went into coma a few hours after the accident. Three days after surgical removal of an intracerebral bleeding via a frontoparietal osteoclastic trepanation (removal of a 4 x 5 cm piece of bone) there occurred(More)
In intensive care medicine, pulmonary compliance is one of the very helpful diagnostic indices. Because of technical difficulties, however, the measurement of pulmonary compliance is often reduced to a rough guess of the compliance of the total respiratory system. The technical problems can be overcome using a computer to solve the basic equations with the(More)
In patients ventilated for acute respiratory failure PEEP was changed either by gradual increase and decrease (5 cm H2O/min) or in steps of 5 cm H2O. The effects on gas exchange, pulmonary mechanics and pulmonary and systemic circulation were studied. Total compliance did not change uniformly and cardiac index decreased so much due to PEEP that the increase(More)
Variations of functional residual capacity (FRC, estimated by the N2-washout technique) and oxygenation (PaO2/FIO2) were investigated in patients mechanically ventilated for acute respiratory failure (ARF, caused by pneumonia). The various ventilatory modes were compared. The results were as follows: 1. If FRC is reduced due to ARF, the reduction is(More)