We conclude that chronic PETN therapy in patients with CAD may be established for symptomatic treatment without adverse effects on endothelial function and with beneficial effects on the microcirculation.

We conclude that the beneficial effects of short-term effects of clopidogrel on endothelial function of patients with CAD are abolished after long-term clopidogrel treatment.

The molybdacarboranes [3‐{L‐κ2N,N}‐3‐(CO)2‐closo‐3,1,2‐MoC2B9H11] (L=2,2′‐bipyridine (2,2′‐bpy, 1 a) or 1,10‐phenanthroline (1,10‐phen, 1 b)) incorporating well‐known potentially non‐innocent ligands (CO, 2,2′‐bpy, 1,10‐phen) and the “non‐spectator” nido‐carborane ([η5‐C2B9H11]2−) ligand were prepared and fully characterised. High‐resolution mass spectrometry, single‐crystal X‐ray diffraction methods, spectroscopy (IR, (resonance) Raman, NMR), cyclic voltammetry and spectroelectrochemistry (electrochemical properties) were supported by theoretical investigations of the electronic structure (DFT, CAS‐SCF, TD‐DFT).

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ZusammenfassungTherapie mit Flüssigkeit ist von großer Bedeutung in Anästhesie und Intensivmedizin. Eine Flüssigkeits- oder Volumentherapie kann, vor allem bei nicht sachgemäßer Durchführung, eine Überwässerung des Patienten zur Folge haben, welche wiederum deletäre Folgen hat. Umgekehrt hat auch eine Hypovolämie unerwünschte Nebenwirkungen. Es ist daher essenziell herauszufinden, ob eine Volumengabe auch eine Steigerung des HZV nach sich ziehen wird (= Volumenreagibilität). Durch verschiedene Monitoring-Verfahren können der Volumenstatus und eine potenzielle Volumenreagibilität evaluiert werden. Es gibt eine Vielzahl an Limitationen, die den Behandlern und Nutzern der Verfahren bekannt sein sollten. Ein Algorithmus kann ein strukturiertes Vorgehen beim Monitoring der Volumentherapie erleichtern.

The transfusion of allogeneic blood products is associated with increased morbidity and mortality. An impaired hemostasis is frequently found in patients undergoing cardiac surgery and may in turn cause bleeding and transfusions. A goal directed coagulation management addressing the often complex coagulation disorders needs sophisticated diagnostics. This may improve both patients' outcome and costs. Recent data suggest that coagulation management based on a rational algorithm is more effective than traditional therapy based on conventional laboratory variables such as PT and INR. Platelet inhibitors, cumarins, direct oral anticoagulants and heparin need different diagnostic and therapeutic approaches. An algorithm specifically developed for use during cardiac surgery is presented.

Background The intubating laryngeal mask Fastrach™ is considered a gold standard for blind intubation as well as for fibreoptic guided intubation via a laryngeal mask. Recently, a single use version of the mask has been introduced. We compared the Fastrach single use with the new, low-priced single use intubating laryngeal mask Ambu Aura-i™. We hypothesised that the LMA Ambu Aura-i and the LMA Fastrach are comparable with respect to success rates for mask placement and blind tracheal intubation through the LMA device. Methods A prospective, randomised clinical trial. University Hospital Schleswig-Holstein, Campus Kiel, from April 2011 to April 2012. Eighty patients undergoing general anaesthesia with planned tracheal intubation were randomised and enrolled in the study. Blind intubation was performed with either laryngeal mask using two different tracheal tubes (Rüsch Super Safety Silk™ and LMA ETT™). A crossover-design was performed after an unsuccessful procedure. Primary outcome measure was the overall success rate of blind intubation. Secondary outcome measures were the time to the first adequate ventilation, a subjective handling score, and a fibreoptic control of placement, as well as the success rate of mask placement, time for mask removal after successful intubation, differences in airway leak pressure, and the incidence of postoperative sore throat and hoarseness. Results The success rate of tracheal intubation with the Fastrach for the first and second attempt was significantly better compared with the Ambu Aura-i. Tracheal intubation was also significantly faster (14.1 s. ±4.4 versus 21.3 s. ±9.0; p < 0.01), and the time interval for mask removal after successful intubation was significantly shorter using the Fastrach device (24.0 s. ±8.2 versus 29.4 s. ±7.5; p < 0.001). There were no significant differences between groups regarding the incidence of postoperative sore throat and hoarseness. Conclusion Both laryngeal mask devices are suitable for ventilation and oxygenation. Blind intubation remains the domain of the LMA Fastrach, the Ambu Aura-i is not suitable for blind intubation. Trial registration Clinicaltrials.gov Identification Number NCT03109678 , retrospectively registered on April 12, 2017.

ZusammenfassungNeben der Verwendung von Scores zur Früherkennung sich kritisch verschlechternder Patienten kann die Patientensicherheit durch zusätzliches Monitoring auch auf der Normalstation erhöht werden. Hierbei ist die Praktikabilität von entscheidender Bedeutung, wodurch die Auswahl geeigneter nichtinvasiver Verfahren im Rahmen der Behandlung auf Normalstation eingeschränkt ist.