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Biomedical subjects

P Fritsche

Publications and source records attributed to P Fritsche.

At least 19 recordsLinked to original sources

[Decision making in borderline situations--anesthesiological aspects].

Over the last few decades, major biomedical developments have been taken place so that dying and death are nowadays more a matter of deliberate decision--a change that has profound ethical and legal implications. This progress has influenced medical decision-making generally and intensively, especially that of the surgeon and the anaesthesiologist. The representatives of these professions are often confronted with problems of life-sustaining therapy at the beginning and the end of life and of resuscitative measures. The surgeon and the anaesthesiologist have to accept the necessity of close partnership while maintaining a clear dividing-line between their responsibilities, but at the same time jointly doing their utmost for the good of the patient. Above all the physician has to give due consideration to the patient's will, but there are many and sometimes great variations in the individual situations of conscious or permanently unconscious patients. The highest courts in Germany have laid down that the principles of medical ethics must supplement the law.

Adult↗

[Pain and the experience of pain].

Pain research has been considerably expanded in the past few decades. Pain sensation must be differentiated from pain perception. The psychological experience of pain varies individually and depends on each patient's conditioning. Although there is an abundance of analgesics and sedatives, the patients' attitude towards pain and suffering, his or her motivation, past experiences, social environment and susceptibility towards suggestive guidance are of great importance.

Humans↗

[Respiratory depression after diazepam-fentanyl anaesthesia (author's transl)].

105 patients were given diazepam-fentanyl anaesthesia and the respiratory values were studied spirometrically before the operation, after intramuscular premedication and postoperatively (i.e. after additional doses of diazepam during induction). The occurrence of respiratory depression which has been reported by some authors was confirmed. Blood gas analyses performed in 79 patients during the recovery period showed a significant improvement after the patients had been made to breathe deeply for five minutes. The results confirm the observations made in more than 12000 patients who had this type of anaesthesia that they must be kept under surveillance during the first 30-40 minutes in the recovery ward, but can then be returned to the ward.

Adolescent↗

Renal malposition associated with omphalocele.

Nine patients with omphalocele had abnormally positioned kidneys; in 8, the kidneys were more cephalad than normal, immediately subdiaphragmatic in position. In one patient the kidneys were more caudal than normal. This renal malposition should be recognized in order to avoid unnecessary imaging procedures in patients with omphalocele.

Adult↗

[Experiences in the treatment of children with pseudocroup (author's transl)].

In most of the own 93 cases the paediatrician could manage the syndrome conservatively. In 14 children of them the question of an active procedure was discussed in cooperation of paediatricians, laryngologists and anaesthesiologists. In most of the cases this was necessary in the first 2 to 3 hours after admission. Recommendations for the active procedure are given in detail, generally spoken a balanced manner with confined prolonged orotracheal intubation.

Age Factors↗

[Anaesthesia for diagnostic and therapeutic endoscopy procedures (author's transl)].

The experienced anaesthetist in endoscopic anaesthesia in otolaryngology appreciates the need for adequate alveolar ventilation and that the risks are considerable. Certain principles, which have been found useful are presented. From five anaesthetic techniques for laryngeal microsurgery the injector method is described in detail. This method has proved very advantageous especially for surgical procedures on the posterior laryngeal commissure and for the treatment in special instances of tracheal stenosis. The technique mentioned were used without serious complications in about 1000 endoscopies in the last five years.

Anesthesia, General↗

[Long-term intubation (author's transl)].

Establishment of a clear airway has become increasingly frequent and is of high importance, especially in patients with severe injuries, head injuries or intoxications. Though the endotracheal intubation-technique has been improved and soft intubation-tubes are now available, tracheostomy is not rendered unnecessary. However, its indications have changed and have become restricted. This trend was proved by the own experiences in 841 patients. The presuppositions for nasal long-term intubation are described in details.

Adult↗

[Must therapy be continued at all costs (author's transl)].

In acknowledging the remarkable progress of medicine, the possible consequential harmful effects should not be overlooked. Judgement should be based on the total welfare of the patient and not on the ease with which technical procedures can be executed. The prolongation of life per se by any means is not the only principal of conduct, especially when it results in extension of the patient's misery. In some situations it may be necessary to renounce any form of treatment from the beginning or to abandon any already in progress. This apparent harshness however does not imply that the terminally ill must be abandoned in his suffering.

Brain Death↗