87 research outputs found
Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis
No full textThis is a protocol for a Cochrane Review (Intervention). The objectives are as follows:
1. To compare the efficacy and safety of different prophylactic pharmacological interventions (antiemetic drugs) either against no
treatment, placebo or against each other (as mono- or combination prophylaxis) for the prevention of postoperative nausea and
vomiting in adults undergoing any type of surgery under general anaesthesia.
2. To explore the best dose or dose range of the antiemetic drugs in terms of efficacy and safety.
3. To generate a clinically useful ranking of antiemetic drugs (mono- and combination prophylaxis) according to efficacy and safety
Association between propofol dose and 1-year mortality in patients with or without a diagnosis of solid cancer
No full textPreclinical data suggest suppression of cancer proliferation by propofol, and retrospective studies suggest improved survival after cancer surgery with propofol-based anaesthesia
Temporal Changes in Ventilator Settings in Patients With Uninjured Lungs: A Systematic Review
No full textIn patients with uninjured lungs, increasing evidence indicates that tidal volume (VT) reduction improves outcomes in the intensive care unit (ICU) and in the operating room (OR). However, the degree to which this evidence has translated to clinical changes in ventilator settings for patients with uninjured lungs is unknown. To clarify whether ventilator settings have changed, we searched MEDLINE, Cochrane Central Register of Controlled Trials, and Web of Science for publications on invasive ventilation in ICUs or ORs, excluding those on patients 25% of patients with acute respiratory distress syndrome (ARDS). Our primary end point was temporal change in VT over time. Secondary end points were changes in maximum airway pressure, mean airway pressure, positive end-expiratory pressure, inspiratory oxygen fraction, development of ARDS (ICU studies only), and postoperative pulmonary complications (OR studies only) determined using correlation analysis and linear regression. We identified 96 ICU and 96 OR studies comprising 130,316 patients from 1975 to 2014 and observed that in the ICU, VT size decreased annually by 0.16 mL/kg (-0.19 to -0.12 mL/kg) (P < .001), while positive end-expiratory pressure increased by an average of 0.1 mbar/y (0.02-0.17 mbar/y) (P = .017). In the OR, VT size decreased by 0.09 mL/kg per year (-0.14 to -0.04 mL/kg per year) (P < .001). The change in VTs leveled off in 1995. Other intraoperative ventilator settings did not change in the study period. Incidences of ARDS (ICU studies) and postoperative pulmonary complications (OR studies) also did not change over time. We found that, during a 39-year period, from 1975 to 2014, VTs in clinical studies on mechanical ventilation have decreased significantly in the ICU and in the OR
Ventilation with high versus low peep levels during general anaesthesia for open abdominal surgery does not affect postoperative spirometry: A randomised clinical trial
No full textBACKGROUNDInvasive mechanical ventilation during general anaesthesia for surgery typically causes atelectasis and impairs postoperative lung function.OBJECTIVEWe investigated the effect of intraoperative ventilation with high positive end-expiratory pressure (PEEP) and recruitment manoeuvres (RMs) on postoperative spirometry.DESIGNThis was a preplanned, single-centre substudy of an international multicentre randomised controlled trial, the PROVHILO trial.SETTINGUniversity hospital from November 2011 to January 2013.PATIENTSNonobese patients scheduled for major abdominal surgery at a high risk of postoperative pulmonary complications (PPCs).INTERVENTIONIntraoperative low tidal volume ventilation with PEEP levels of 12cmH(2)O and RM (the high PEEP group) or with PEEP levels of 2cmH(2)O or less without RM (the low PEEP group).MAIN OUTCOME MEASURESTime-weighted averages (TWAs) of the forced expiratory volume in 1s (FEV1) and the forced vital capacity (FVC) up to postoperative day five.RESULTSThirty-one patients were allocated to the high PEEP group and 32 to the low PEEP group. No postoperative spirometry test results were available for 6 patients. In both groups, TWA of FEV1 and FVC until postoperative day five were lower than preoperative values. Postoperative spirometry test results were not different between the high and low PEEP group; Data are median [interquartile range], TWA FVC 1.8 [1.6 to 2.4] versus 1.7 [1.2 to 2.4] l (P=NS) and TWA FEV1 1.2 [1.1 to 2.5] versus 1.2 [0.9 to 1.9] l (P=NS). Patients who developed PPCs had lower FEV1 and FVC on postoperative day five; 1.1 [0.9 to 1.6] versus 1.6 [1.4 to 1.9] l (P=0.001) and 1.6 [1.2 to 2.6] versus 2.3 [1.7 to 2.6] l (P=0.036), respectively.CONCLUSIONPostoperative spirometry is not affected by PEEP and RM during intraoperative ventilation for open abdominal surgery in nonobese patients at a high risk of PPCs, but rather is associated with the development of PPCs.TRIAL REGISTRATIONClinicalTrials.gov NCT0144179
Systemfrage Hochschulverlag: Workflows, Tools und Finanzierbarkeit für nachhaltiges Diamond Open Access
No full textAm 18. November 2025 fand der Transferworkshop als abschließender Höhepunkt des Verbundprojektes „OA-WFMS – Workflow-Management-Systeme für Open-Access- Hochschulverlage“ (September 2023 – September 2025, verlängert bis Dezember 2025) in der Wissenschaftsetage Potsdam statt. Neben den Projektpartnern der HTWK Leipzig und Universitätsbibliothek Potsdam (UBP) diskutierten Vertreter*innen aus Open-Access- Hochschulverlagen der AG Universitätsverlage, Universitäts- und Hochschulbibliotheken und dem BMFTR über nachhaltige Infrastrukturen für Diamond-Open-Access und Finanzierbarkeit. Bezugspunkt bildete dabei ein Workflow-Management-System (WFMS) sowie der in den letzten Monaten entwickelte Demonstrator für eine mögliche technische Umsetzung.
Einleitende Worte der Projektverantwortlichen Dr. Andreas Kennecke (UBP) und Prof. Dr. Michael Reiche (HTWK Leipzig) zeichneten die Genese des Projektes und dessen Verlauf nach. Der Vizepräsident und CIO der Universität Potsdam Dr. Peter Kostädt gab eine kurze Einordnung des Projekts in die Gesamtstrukturen des Hochschulbetriebs. Sodann schlossen sich am Vormittag zunächst zwei Impulsvorträge zu Bedarfen, Vorstellungen und Herausforderungen bezüglich eines WFMS (Diana Tillmann, Marco Winkler) sowie der Rolle der AG Universitätsverlage in diesem Zusammenhang (Robert Wiese) an. Nach einer kurzen Pause traten Vertreterinnen aus finanzieller Förderlinie (VDI/VDE-IT, i.V. des BMFTR, Rebecca Puchta) und fachthematischer Servicestelle (Servicestelle Diamond Open Access (SeDOA), Katharina Schulz) auf, die die Positionen der durch sie repräsentierten Institutionen darlegten.
Im zweiten Teil der Veranstaltung wurden in drei Workshops die Teilnehmenden zur Mitarbeit aufgefordert: Vorgestellt und diskutiert wurden zunächst das im Projekt entwickelte WFMS-Konzept. In Gruppenarbeit wurden im Anschluss in Workshop II Fragen zu Kosten und Nutzen eines WFMS diskutiert. In Workshop III wurden mit Hilfe der RACI- Methode Governance und Organisation eines solchen abgewägt. Zum Abschluss der Tagung wurden die Ergebnisse der Workshops vorgestellt, und noch einmal gemeinsam auf den Tag und auf die Arbeit der zurückliegenden Jahre zurückgeblickt.On November 18, 2025, a transfer workshop took place in Potsdam as the final, culminating event of the joint project “OA-WFMS – Workflow Management Systems for Open Access University Publishers” (September 2023 – September 2025, extended until December 2025). Representatives from open access university publishers of the AG Universitätsverlage, university libraries, and the BMFTR joined project partners from the HTWK Leipzig and Potsdam University Library (UBP) to discuss sustainable infrastructures for diamond open access and their financial feasibility. A workflow management system (WFMS) and demonstration of a possible technical implementation that had been developed in recent months served as the basis for discussion.
In their introductory comments, project leaders Dr. Andreas Kennecke (UBP) and Prof. Dr. Michael Reiche (HTWK Leipzig) traced the project’s genesis and its subsequent development. University of Potsdam Vice President and CIO, Dr. Peter Kostädt, gave a brief overview of the project‘s position within the university’s overall organizational structures. This was followed in the morning by two keynote speeches on the requirements, conceptions, and challenges relating to a WFMS (Diana Tillmann, Marco Winkler) and the role of the AG Universitätsverlage in this context (Robert Wiese). Following a short break, speakers representing financial funders (VDI/VDE-IT, on behalf of the BMFTR, Rebecca Puchta) and from the specialist service center (Servicestelle Diamond Open Access (SeDOA), Katharina Schulz) each presented the positions of their respective institutions.
In the second part of the event, participants were invited to take part in three workshops: First, the WFMS concept developed as part of the project, was presented and discussed. In Workshop II, questions about the costs and benefits of a WFMS were discussed in small groups. In Workshop III, the RACI method was used to assess the governance and organization of such a system. At the conference’s conclusion, the results of the workshops were presented, and participants reflected on the day and work of the past years
Total intravenous anesthesia vs single pharmacological prophylaxis to prevent postoperative vomiting in children: A systematic review and meta-analysis
No full textTunneling and Suture of Thoracic Epidural Catheters Decrease the Incidence of Catheter Dislodgement
No full textBackground. Dislocation of epidural catheters (EC) is associated with early termination of regional analgesia and rare complications like epidural bleeding. We tested the hypothesis that maximum effort in fixation by tunneling and suture decreases the incidence of catheter dislocation. Methods. Patients scheduled for major surgery (n=121) were prospectively randomized in 2 groups. Thoracic EC were subcutaneously tunneled and sutured (tunneled) or fixed with adhesive tape (taped). The difference of EC length at skin surface level immediately after insertion and before removal was determined and the absolute values were averaged. Postoperative pain was evaluated by numeric rating scale twice daily and EC tips were screened microbiologically after removal. Results. Both groups did not differ with respect to treatment duration (tunneled: 109 hours ±46, taped: 97±37) and postoperative pain scores. Tunneling significantly reduced average extent (tunneled: 3 mm ±7, taped: 10±18) and incidence of clinically relevant EC dislocation (>20 mm, tunneled: 1/60, taped: 9/61). Bacterial contamination showed a tendency to be lower in patients with tunneled catheters (8/59, taped: 14/54, P=0.08). Conclusion. Thorough fixation of EC by tunneling and suturing decreases the incidence and extent of dislocation and potentially even that of bacterial contamination
Electrical impedance tomography during major open upper abdominal surgery: a pilot-study
No full textIn Vitro impairment of whole blood coagulation and platelet function by hypertonic saline hydroxyethyl starch
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