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Copyright of Medizinische Klinik: Intensivmedizin & Notfallmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The current S1 guidelines on the intraoperative clinical application of hemodynamic monitoring in patients scheduled for noncardiac surgery are presented based on a case report under the aspect of an optimized intraoperative anesthesiological management. The S1 guidelines were developed with the aim of identifying the questions on the intraoperative hemodynamic monitoring and management which are important for the routine daily clinical practice, to discuss them in a guideline group and to answer them based on the current state of scientific knowledge. The guidelines were written under the auspices of the German Society of Anesthesiology and Intensive Care Medicine (DGAI) and published by the AWMF in 2023 under the register number 001/049. [ABSTRACT FROM AUTHOR]

Copyright of Medizinische Klinik: Intensivmedizin & Notfallmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In both equestrian sports and alternative husbandry horses are more and more used as draft animal. Also in draft horses an efficiant power transmission plays an important role in regard to the animal’s wellbeing. The aim of the study was to classify the performance of working horses regarding their physical and psychological stress. Two defined traction forces (1300 N and 2600 N = target values) were continuously recorded during a load lasting for 30 min each in two pairs of Freiberger horses each on the braked and loaded carriage. The tractive forces that were recorded corresponded to the actual values. The work performed by the horses was assessed. Heart rate was recorded using POLAR training watches (V800). To assess the workload including a possible psychological component, blood samples were additionally taken before, during, and after work (0, 15, 30, and 60 min) in which cortisol, glucose, and non-esterified fatty acids (NEFA) were determined. Data analysis was done in a descriptive and statistical manner (paired t-test, Pearson correlation coefficient, using the statistical program R, significance level was p < 0.05). The average tensile forces were satisfactorily in accordance with the target values (1300 N and 2600 N, respectively): actual value pair 1/2: 1148 N and 2543 N, respectively, actual value pair 3/4: 1236 N and 2538 N, respectively. Traction forces and speeds resulted in traction powers of 813 and 2095 watts (1.11 and 2.85 horse power = hp) for each horse of pair 1/2 and 919 and 1934 watts (1.25 and 2.63 hp) for each horse of pair 3/4, respectively. Heart rates ranged from 94–124/min for both pairs at 1300 N and 124–171/min at 2600 N. Heart rates decreased by 50 % 60 sec after 15 min of work at 1300 N, and recovery times increased with longer and more intense work. At the tensile forces in the present work, glucose values of 4.79 mmol/l were measured on average for all horses at 1300 N and values of 4.68 mmol/l were measured at 2600 N. In the case of the older French mountain horse pair of carriage 3/4, an initial drop in blood glucose and a subsequent rise were more pronounced than in the French mountain horse pair of carriage 1/2. The older French mountain horses of carriage 3/4 were fed exclusively hay, while the horses of carriage 1/2 received an additional 2 kg of concentrates per day. The extent to which the low concentrate supplementation of the horses of the carriage 1/2 influenced the glucose metabolism remains speculative. The four French mountain horses achieved average NEFA values of 0.30 mmol/l at 1300 N and 0.53 mmol/l at 2600 N. At a traction level of 1300 N, plasma cortisol levels for the four French mountain horses ranged from 29.3–50.3 ng/ml, and at the traction level of 2600 N, plasma cortisol levels ranged from 24.8–58.8 ng/ml. In comparison, the values were higher in a previous study, where the average plasma cortisol values of nine Warmblood driving horses after 30–40 min of intensive training ranged from 60.72 ± 9.51 to 63.66 ± 10.07 ng/ml (Krumrych et al. 2018). Cortisol (nmol/l), glucose (mmol/), and NEFA (mmol/l) values in the present study indicated moderate to heavy work intensities. Cortisol levels correlated significantly (p < 0.05) with heart rate (r = 0.64) and NEFA (r = 0.53), indicating balanced activation of the adrenergic system and hypothalamic-pituitary-adrenal (HPA) axis and suggesting a psychological stress component as unlikely. [ABSTRACT FROM AUTHOR]

Copyright of Herz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Medizinische Klinik: Intensivmedizin & Notfallmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Herzschrittmachertherapie und Elektrophysiologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Herz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of German Journal of Exercise & Sport Research is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of German Journal of Sports Medicine / Deutsche Zeitschrift fur Sportmedizin is the property of Verein zur Forderung der Sportmedizin Hannover e.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of German Journal of Sports Medicine / Deutsche Zeitschrift fur Sportmedizin is the property of Verein zur Forderung der Sportmedizin Hannover e.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of German Journal of Sports Medicine / Deutsche Zeitschrift fur Sportmedizin is the property of Verein zur Forderung der Sportmedizin Hannover e.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Herz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Herz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Psychotherapie im Alter is the property of Psychosozial-Verlag and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Up to date, empiric evidence about effects of thoracic spine mobilisation (TH4) on the sympathetic nervous system is lacking. The primary goal of this feasibility study was to determine adherence rate, side effects and the protocol as well as the implementation of the study design. The secondary goal was to analyse and interpret acute effects on the sympathetic nervous system after thoracic mobilisation in anterior thrust and posterior thrust on six healthy participants on two following days. The feasibility of this study was adequate. The spine mobilisations did not produce any adverse effects. The anterior thrust spine mobilisations showed a tendency in reducing the heart rate activity. [ABSTRACT FROM AUTHOR]

Background: Polysomnography (PSG) is the gold standard for sleep analysis and the diagnosis of sleep-disordered breathing (SDB). As PSG is time-consuming and labor-intensive, it is the last step in a stepwise diagnostic workup. An early preliminary diagnosis can be obtained by a novel single-channel minimal-contact device which is placed under the patient’s mattress topper.Objectives: This study assessed the diagnostic accuracy of the novel minimal-contact device VitaLog (SWG Sportwerk GmbH & Co. KG, Dortmund, Germany) for sleep-wake classification and measurement of heart rate (HR). The results were compared to PSG.Materials and methods: VitaLog is a minimal-contact sensor that does not restrict sleep. The diagnostic accuracy of VitaLog was studied in 49 patients referred to our sleep research unit due to suspected SBD. Results obtained by VitaLog were compared to those of a simultaneous PSG to assess the diagnostic accuracy of VitaLog for sleep-wake classification and measurement of HR.Results: Compared to PSG, the accuracy of HR determined by VitaLog was excellent (r = 0.99) with a bias of 0.15 beats per min (bpm). Regarding total sleep time (TST), we found a good correlation of r = 0.8 and a bias of 14 min. For sleep efficiency (SE) estimated by VitaLog, the correlation was moderate with r = 0.6 with a bias of 4.0%. Sleep latency (SL) and wake after sleep onset (WASO) were underestimated by 1 and 12 min, respectively.Conclusions: VitaLog is a promising approach for the estimation of the sleep-related parameters TST, SE, SL, and WASO based on a minimal-contact sensor. In addition, it measures HR with excellent accuracy. However, algorithm modifications are desired to provide appropriate diagnostic accuracy in all sleep disorder cohorts. [ABSTRACT FROM AUTHOR]

Head-up tilt (HUT) has long been used to examine heart rate and blood pressure adaptation to changes in position. During such studies, incidental observations noted that some test subjects experienced total or near-total transient loss of consciousness and that, in some cases, hypotension was associated with unexpected marked bradycardia compatible with a vasovagal syncope (VVS) reaction. The first report of HUT as a clinical tool to confirm a diagnosis of suspected VVS was published in 1966, and led to the concept of using HUT as a diagnostic tool for VVS. Subsequently, HUT testing, either drug-free or, if necessary, with pharmacological provocation (usually nitroglycerin) has proven to be a useful and safe modality for identifying susceptibility to VVS. In this regard, it is recognized that VVS is best diagnosed by careful history taking. Unfortunately, the history may be non-diagnostic; HUT may be helpful in such cases. However, the interpretation of HUT requires care and experience; in particular, the outcome must be consistent with the patient’s clinical presentation. The reproduction of patient symptoms may not only provide a diagnosis, but also offer some comfort to the patient and family in that the medical team has documented the basis of symptoms and are thereby positioned to address therapy. [ABSTRACT FROM AUTHOR]

In the present study 20 warmblood horses were lunged standardized for 35 minutes in walk and trot and the heart rate was recorded. The horses under test were divided into two different groups depending on their training condition. The statistical analysis of the heart rate revealed that the untrained horses showed significantly higher values than the trained ones. The main reasons for this result are psychosomatic factors, which are particularly influential in the submaximal region, and animal-individual influences as well as the training condition. Also the energy requirement was calculated. The maintenance requirement according to estimated body weight was an average of 59.6 MJ ME. The requirement for performance, calculated on the basis of the working time averaged 12.44 MJ ME, calculated according to pulse frequency values, it was 11.88 MJ ME. No significant differences were found between the two calculated values. The summed total energy requirement was also not significantly different according to the dissimilar calculation methods of the performance requirement. In horses with an average pulse rate of 104 bpm and lower for the work performed, the total energy requirement with performance requirement depending on working time was higher, from an average frequency of 105 bpm the performance demand, which was calculated according to heart rate, was higher. From this it can be concluded that horses which have a lower or higher heart rate for standardized work than would be expected, misjudgments when calculating the requirement on the basis of working time are possible. [ABSTRACT FROM AUTHOR]

Copyright of Der Kardiologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Monatsschrift Kinderheilkunde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Herz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Notfall & Rettungsmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The recording of ECG and heart rate are indispensable parameters of cardiorespiratory polysomnography. Complementing neurophysiological signals this allows an assessment of the autonomous nervous regulation during sleep. An evaluation of the nocturnal ECG is possible in terms of cyclical variations of heart rate and in terms of respiration modulated changes of ECG morphology (amplitude of R wave and T wave). This provides a reliable estimation of sleep disordered breathing. The autonomous nervous system is regulated in a totally different way during slow wave sleep and during REM sleep. An assessment of beat-to-beat variability of heart rate allows deriving sleep stages based on the difference in autonomous nervous system regulation. In addition the transitions from wakefulness to sleep can be tracked to some degree by an analysis of heart rate variability. This paper presents the technical development of the analysis in a historical sequence from 1980 to 2015. Linked to this the increase in physiological and pathophysiological knowledge derived from the technical developments is presented. [ABSTRACT FROM AUTHOR]

Copyright of Research in Complementary Medicine / Forschende Komplementärmedizin is the property of Karger AG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Electroconvulsive therapy (ECT) is a well-established, safe and effective treatment for severe psychiatric disorders. Ketamine is known as a core medication in anesthesiology and has recently gained interest in ECT practice as there are three potential advantages: (1) ketamine has no anticonvulsive actions, (2) according to recent studies ketamine could possess a unique intrinsic antidepressive potential and (3) ketamine may exhibit neuroprotective properties, which again might reduce the risk of cognitive side effects associated with ECT. Objectives: The use of ketamine in psychiatric patients has been controversially discussed due to its dose-dependent psychotropic and psychotomimetic effects. This study was carried out to test if the occurrence of side effects is comparable and if seizure quality is better with ketamine when compared to thiopental. Material and methods: This retrospective study analyzed a total of 199 patients who received ketamine anesthesia for a total of 2178 ECT sessions. This cohort was compared to patients who were treated with thiopental for 1004 ECT sessions. Results and discussion: A repeated measurement multiple logistic regression analysis revealed significant advantages in the ketamine group for seizure concordance and postictal suppression (both are surrogates for central inhibition). S-ketamin also necessitated the use of a higher dose of urapidil and a higher maximum postictal heart frequency. Clinically relevant psychiatric side effects were rare in both groups. No psychiatric side effects occurred in the subgroup of patients with schizophrenia (ketamine: n = 30). The mean dose of S-ketamine used increased in the first years but stabilized at 63 mg per patient in 2014. From these experiences it can be concluded that S-ketamine can be recommended at least as a safe alternative to barbiturates. [ABSTRACT FROM AUTHOR]

Copyright of German Journal of Sports Medicine / Deutsche Zeitschrift fur Sportmedizin is the property of Verein zur Forderung der Sportmedizin Hannover e.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Herz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Herz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Hypotensive states that require fast stabilisation of blood pressure can occur during anaesthesia. In 1963, the 20:1 mixture of cafedrine/theodrenaline (Akrinor) was introduced in Germany for use in anaesthesia and emergency medicine in the first-line management of hypotensive states. Though on the market for many years, few pharmacodynamic data are available on this combination net beta-mimetic agent. Aim: This study aimed to examine the drug combination in real-life clinical practice and recorded time to 10 % mean arterial blood pressure (MAP) increase and heart rate. Furthermore, potential factors that influence drug effectiveness under anaesthesia were assessed. Methods: Data were collected within a standardised anaesthesia protocol. A total of 353 consecutive patients (female/male = 149/204) who received cafedrine/theodrenaline after a drop in MAP ≥ 5 % were included in the study. The time to 10 % increase in MAP, dosage of cafedrine/theodrenaline, volume loading, blood pressure and heart rate were monitored over time. Results: Patients were a mean (standard deviation) of 64.4 ± 15.1 years old with a baseline MAP of 82 ± 14 mmHg, which dropped to a mean of 63 ± 10 mmHg during anaesthesia without gender differences. Cafedrine/theodrenaline (1.27 ± 1.0 mg/kg; 64 ± 50 µg/kg) significantly increased MAP ( p < 0.001) by 11 ± 16 mmHg within 5 min, reaching peak values within 17.4 ± 9.0 min. Heart rate was not affected in a clinically significant manner. Cafedrine/theodrenaline induced a 10 % MAP increase after 7.2 ± 4.6 min (women) and after 8.6 ± 6.3 min (men) ( p = 0.018). Independent of gender, the dose of cafedrine/theodrenaline required to achieve the observed MAP increase of 14 ± 16 mmHg at 15 min was significantly different in patients with heart failure [1.78 ± 1.67 mg/kg (cafedrine)/89.0 ± 83.5 µg/kg (theodrenaline)] compared with healthy patients [1.16 ± 0.77 mg/kg (cafedrine)/58.0 ± 38.5 µg/kg (theodrenaline)] ( p = 0.005). Concomitant medication with beta-blocking agents significantly prolonged the time to 10 % MAP increase [9.0 ± 7.0 vs. 7.3 ± 4.3 min ( p = 0.008)]. Conclusion: Cafedrine/theodrenaline quickly restores MAP during anaesthesia. Female gender is associated with higher effectiveness, while heart failure and beta-blocker administration lower the anti-hypotonic effect. Prospective studies in defined patient populations are warranted to further characterise the effect of cafedrine/theodrenaline. [ABSTRACT FROM AUTHOR]

Copyright of Schweizerische Zeitschrift für Sportmedizin & Sporttraumatologie is the property of Schwiez Zschr Sportmed Sporttraumatologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Up to now hydroxyethyl starch preparations have frequently been used to compensate for volume deficits accompanying blood withdrawal during acute normovolemic hemodilution. This approach was questioned with respect to the current limitations for use of hydroxyethyl starch solutions imposed by the European Medicines Agency. Because crystalloids distribute evenly across the whole extracellular compartment, 80 % of the infused solution will be 'lost' to the interstitial space. Thus, a physiological adjustment of blood loss caused by hemodilution with crystalloids alone (1:5 ratio) seems hardly feasible and according to current data perhaps not even desirable. A 3:1 ratio (crystalloids versus blood loss) as applied in the current study can be regarded as a practical compromise between physiological needs and recommendations according to the literature (1.4:1) but will lead to moderate hypovolemia the hemodynamic consequences of which are not well described. Aim: The current study investigates the hemodynamic impact of a hemodilution with crystalloids under the precondition of a 3:1 substitution ratio compared to withdrawn blood. Methods: In the context of acute perioperative hemodilution 10 otherwise healthy women graded I and II on the American Society of Anesthesiologists (ASA) classification scheduled for open gynecological cancer surgery underwent an average blood withdrawal of 1097 ± 285 ml which was substituted by an average of 3430 ± 806 ml of Ringer's lactate. The resulting deficit in blood volume was exactly quantified by a double tracer technique. Hemodynamic changes were evaluated by a combination of thermodilution and pulse contour analysis (PiCCO system®). Subsequently, the remaining volume deficit was compensated by 245 ± 64 ml of a 20 % albumin solution and hemodynamic parameters were again evaluated. Results: When infusing Ringer's lactate in a 3:1 ratio compared to the actual blood loss, the blood volume decreased by 12 %. The volume effect of Ringer's lactate proved to be 17 %. While mean arterial pressure and heart rate remained constant, key hemodynamic parameters changed relevantly during the time course. A significant rise in cardiac output and myocardial contractility could be observed which was accompanied by a decrease in systemic vascular resistance. In contrast, cardiac preload and the parameters representing pulmonary vascular permeability remained unaltered. The infusion of 245 ± 64 ml of a 20 % albumin solution nearly completely restituted blood volume and led to an insignificant rise in systemic vascular resistance but did not normalize cardiac output or myocardial contractility. Conclusion: In the study population, the loss of intravascular fluid during perioperative haemodilution could be compensated by an increase in cardiac performance. However, whether patients with a reduced cardiac capacity (i.e. older patients) are capable to improve their cardiac output sufficiently in order to compensate hypovolemia accompanying perioperative haemodilution with crystalloids remains questionable. [ABSTRACT FROM AUTHOR]