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  • 1995-1999  (4)
  • 1960-1964
  • Cardiac surgery  (2)
  • Esophagoscopy  (2)
  • 1
    Electronic Resource
    Electronic Resource
    Tracheobronchoskopie und Ösophagoskopie in der Hals-Nasen-Ohren-Heilkunde Eine Standortbestimmung* (1998)
    Springer
    HNO 46 (1998), S. 643-650 
    Details
    ISSN: 1433-0458
    Keywords: Schlüsselwörter Tracheobronchoskopie ; Ösophagoskopie ; HNO ; Komplikationen ; Key words Tracheobronchoscopy ; Esophagoscopy ; Surgical complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary It is the task of each medical specialty to develop guidelines for diagnosis and therapies. Examinations done by several specialties should follow a common consensus. A randomized survey at 70 German ENT departments investigated the current position of tracheobronchoscopy and esophagoscopy at each institution. Sixty questionnaires were evaluable. Altogether 8,295 tracheobronchoscopies and 10,404 esophagoscopies were performed. Thirty-six percent of all tracheobronchoscopies and 6% of all esophagoscopies were done with a flexible system. Approximately 58% of all tracheobronchoscopies and 55% of all esophagoscopies were performed for tumor staging. Complications during tracheobronchoscopy occurred in 0.8% of cases and in 0.58% of the esophagoscopies. Using these data an interdisciplinary quality assurance concept was developed for tracheobronchoscopy and esophagoscopy. Current experience has shown that a otolaryngologists in Germany mainly perform rigid tracheobronchoscopy and esophagoscopy. Although endoscopy is mostly done in cases with varied anatomic structures, complications are very rare and comparable to flexible techniques. Greater experience with flexible systems also is to be encouraged in ENT departments.
    Notes: Zusammenfassung Hintergrund: Es muß Aufgabe jedes einzelnen Fachbereichs sein, Leitlinien für die von ihm behandelten Erkrankungen und durchgeführten Untersuchungen zu erstellen. Für fachübergreifende Behandlungen ergibt sich die Forderung nach einem gemeinsamen Konsens. Material und Methoden: Durch eine anonymisierte Umfrage an 70 HNO-Kliniken und Belegabteilungen sollte ein Ist-Stand der Tracheobronchoskopie und Ösophagoskopie in der Hals-Nasen-Ohren-Heilkunde erhoben werden. Ausgewertet werden konnten insgesamt 60 Fragebögen. Unter Berücksichtigung dieser Ergebnisse wurde ein Leitlinienentwurf „Tracheobronchoskopie und Ösophagoskopie” erarbeitet. Ergebnisse: Insgesamt wurden 8295 Tracheobronchoskopien und 10404 Ösophagoskopien durchgeführt; 36% der Tracheobronchoskopien und 6% der Ösophagoskopien erfolgten mit einem flexiblen System. In 58% der Fälle erfolgte die Tracheobronchoskopie zum Tumorstaging, bei der Ösophagoskopie betrug die Anzahl der Untersuchungen zum Tumorstaging 55%. Die Komplikationsrate bei der Tracheobronchoskopie betrug 0,8%, bei der Ösophagoskopie 0,58%. Aufbauend auf diesen Strukturdaten wurde ein interdisziplinär erarbeiteter Leitlinienentwurf in einem Delphiverfahren abgeglichen. Schlußfolgerungen: Die Hals-Nasen-Ohren-Ärzte in Deutschland führen mehrheitlich die starre Tracheobronchoskopie und Ösophagoskopie durch. Obwohl größtenteils bei veränderten anatomischen Strukturen endoskopiert wird, geschieht dies mit Komplikationsraten, die vergleichbar sind mit internationalen Studien bei Einsatz flexibler Systeme. Trotzdem sollte sich der HNO-Arzt vermehrt auch um die flexiblen Techniken bemühen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001060050289
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Flexible Endoskopie im HNO-Bereich (1998)
    Springer
    HNO 46 (1998), S. 654-659 
    Details
    ISSN: 1433-0458
    Keywords: Schlüsselwörter Flexible Endoskopie ; Ösophagoskopie ; Tracheobronchoskopie ; Laryngoskopie ; Key words Flexible endoscopy ; Esophagoscopy ; Tracheobronchoscopy ; Laryngoscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Although rigid esophagoscopy and tracheobronchoscopy have always been a domain of the ENT surgeon, the development of flexible endoscopes has increased diagnostic and therapeutic indications in clinical practice. Component elements of fiberendoscopes and CCD endoscopes are shown. Techniques in flexible bronchoscopy, flexible esophagoscopy and rhinolaryngoscopy are explained. General and special indications of fiberendoscopy are listed. Possibilities and limitations of flexible bronchoscopy are shown. Flexible techniques for removing foreign bodies of the esophagus and indications for mini-endoscopy are demonstrated. Experience has shown that flexible endoscopy has brought the diagnosis and therapy of tubular organs into a new perspective. Since flexible techniques do not replace rigid ones and complement each another, ENT surgeons must be trained in both techniques.
    Notes: Zusammenfassung Hintergrund: Die Endoskopie von Ösophagus und Tracheobronchialbaum war als starre Technik stets eine Domäne des HNO-Arztes. Mit der Entwicklung der flexiblen Endoskope haben sich die diagnostischen und therapeutischen Anwendungsmöglichkeiten erweitert. Material und Methoden: Dargestellt werden der technische Aufbau der Fieberglasendoskope und der CCD-Endoskope. Der Untersuchungsablauf der Bronchoskopie, der Ösophagoskopie und der Rhinolaryngoskopie werden erläutert. Ergebnisse: Allgemeine und spezielle Indikationen der Fiberendoskope werden aufgeführt, außerdem werden die Möglichkeiten und Grenzen der flexiblen Bronchoskopie diskutiert. Techniken der flexiblen Ösophagusfremdkörperentfernung und Anwendungsbeispiele für Miniendoskope werden erläutert. Schlußfolgerung: Die flexible Endoskopie hat die Diagnostik und Therapie von Hohlorganen in eine neue Dimension gebracht und ihr zu einer weiten Verbreitung verholfen. Flexible Verfahren ersetzen nicht die Starren, sondern sie ergänzen sich gegenseitig und das Repertoire eines HNO-Arztes sollte sich auf beide Techniken erstrecken.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001060050290
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Effects of continuous (CPAP) and bi-level positive airway pressure (BiPAP) on extravascular lung water after extubation of the trachea in patients following coronary artery bypass grafting (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1345-1350 
    Details
    ISSN: 1432-1238
    Keywords: Weaning CPAP ; BiPAP ; Extravascular lung water ; Cardiac surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To evaluate the effects of continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP) on extravascular lung water during weaning from mechanical ventilation in patients following coronary artery bypass grafting. Design Prospective, randomized clinical study. Setting Intensive care unit at a university hospital. Patients Seventy-five patients following coronary artery bypass grafting. Interventions After extubation of the trachea, patients were treated for 30 min with CPAP via face mask (n=25), with nasal BiPAP (n=25), or with oxygen administration via nasal cannula combined with routine chest physiotherapy (RCP) for 10 min (n=25). Measurements and results Extravascular lung water (EVLW), pulmonary blood volume index (PBVI) and cardiac index (CI) were obtained during mechanical ventilation (T1), T-piece breathing (T2), interventions (T3), spontaneous breathing 60 min (T4) and 90 min (T5) after extubation of the trachea using a combined dye-thermal dilution method. Changing from mechanical ventilation to T-piece breathing did not show any significant differences in EVLW between the three groups, but a significant increase in PBVI from 155±5 ml/m2 to 170±4 ml/m2 could be observed in all groups (p〈0.05). After extubation of the trachea and treatment with BiPAP, PBVI decreased significantly to 134±6 ml/m2 (p〈0.05). After treatment with CPAP or BiPAP, EVLW did not change significantly in these groups (5.5±0.3 ml/kg vs 5.0±0.4 ml/kg and 5.1±0.4 ml/kg vs 5.7±0.4 ml/kg). In the RCP-treated group, however, EVLW increased significantly from 5.8±0.3 ml/kg to 7.1±0.4 ml/kg (p〈0.05). Sixty and 90 min after extubation, EVLW stayed at a significantly higher level in the RCP-treated group (7.5±0.5 ml/kg and 7.4±0.5 ml/kg) than in the CPAP-(5.6±0.3 ml/kg and 5.9±0.4 ml/kg). No significant differences in CI could be observed within the three groups during the time period from mechanical ventilation to 90 min after extubation of the trachea. Conclusions Mask CPAP and nasal BiPAP after extubation of the trachea prevent the increase in extravascular lung water during weaning from mechanical ventilation. This effect is seen for at least 1 h after the discontinuation of CPAP or BiPAP treatment. Fuether studies have to evaluate the clinical relavance of this phenomenon.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709549
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 4
    Electronic Resource
    Electronic Resource
    Effects of continuous (CPAP) and bi-level positive airway pressure (BiPAP) on extravascular lung water after extubation of the trachea in patients following coronary artery bypass grafting (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1345-1350 
    Details
    ISSN: 1432-1238
    Keywords: Key words Weaning ; CPAP ; BiPAP ; Extravascular lung water ; Cardiac surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To evaluate the effects of continuous positive airway pressure (CPAP) and bi-level positive airway pressure (BiPAP) on extravascular lung water during weaning from mechanical ventilation in patients following coronary artery bypass grafting. Design; Prospective, randomized clinical study. Setting; Intensive care unit at a university hospital. Patients; Seventy-five patients following coronary artery bypass grafting. Interventions; After extubation of the trachea, patients were treated for 30 min with CPAP via face mask (n=25), with nasal BiPAP (n=25), or with oxygen administration via nasal cannula combined with routine chest physiotherapy (RCP) for 10 min (n=25). Measurements and results: Extravascular lung water (EVLW), pulmonary blood volume index (PBVI) and cardiac index (CI) were obtained during mechanical ventilation (T1), T-piece breathing (T2), interventions (T3), spontaneous breathing 60 min (T4) and 90 min (T5) after extubation of the trachea using a combined dye-thermal dilution method. Changing from mechanical ventilation to T-piece breathing did not show any significant differences in EVLW between the three groups, but a significant increase in PBVI from 155±5 ml/m2 to 170±4 ml/m2 could be observed in all groups (p〈0.05). After extubation of the trachea and treatment with BiPAP, PBVI decreased significantly to 134±6 ml/m2 (p〈0.05). After treatment with CPAP or BiPAP, EVLW did not change significantly in these groups (5.5±0.3 ml/kg vs 5.0±0.4 ml/kg and 5.1±0.4 ml/kg vs 5.7±0.4 ml/kg). In the RCP-treated group, however, EVLW increased significantly from 5.8±0.3 ml/kg to 7.1±0.4 ml/kg (p〈0.05). Sixty and 90 min after extubation, EVLW stayed at a significantly higher level in the RCP-treated group (7.5±0.5 ml/kg and 7.4±0.5 ml/kg) than in the CPAP-(5.6±0.3 ml/kg and 5.9±0.4 ml/kg) or BiPAP-treated groups (5.2±0.4 ml/kg and 5.2±0.4 ml/kg). No significant differences in CI could be observed within the three groups during the time period from mechanical ventilation to 90 min after extubation of the trachea. Conclusions: Mask CPAP and nasal BiPAP after extubation of the trachea prevent the increase in extravascular lung water during x weaning from mechanical ventilation. This effect is seen for at least 1 h after the discontinuation of CPAP or BiPAP treatment.Further studies have to evaluate the clinical relevance of this phenomenon.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709549
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
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