Geburtshilfe: die peripartale Kardiomyopathie.

The peripartum cardiomyopathy (PPCM) is an idiopathic heart failure secondary to left-ventricular dysfunction occuring at the end of pregnancy or in the months after delivery. Other causes for heart failure must not exist. The current state of knowledge about PPCM, based on a mini-literature-review, will be presented. We will focus on peripartal anaesthesiologic management and the case of a patient with respiratory insufficiency and lung edema secondary to PPCM.

[Case report - Intraosseous infusion as an alternative solution in the therapy of septicaemia in an adult]. / Kasuistik - Die intraossäre Infusion als Alternative in der Sepsistherapie beim Erwachsenen.

The intraosseous access can be more often found in the guidelines and recommendations of the medical societies when an peripheral or central venous catheter cannot be established. For the adult this can mostly be found for the cardiopulmonary resuscitation or the patient with major trauma. In pediatrics and neonatology it is a reliable solution for the child in septic shock. In our case a 36 year old presented with an endocarditis and tricuspid valve insufficiency III° by known intravenous drug-abuse and septic shock. It was initially impossible to establish an adequate peripheral or central venous catheter. For this reason a humeral intraosseous access was established. After stabilizing circulatory function and volume replacement a central-venous catheter could be placed and the patient was successfully surgically sanified. We used the EZ-IO((Vidacare Corporation, San Antonio/USA). Appropriate systems should extensively be available in the clinical setting.