Zusammenfassung
Erst seit etwa 1950 hat apparatives Monitoring langsam Einzug in die Routine der Anästhesie gehalten. Zuerst war die auskultatorische Blutdruckmessung mittels Oberarmmanschette und EKG üblich, ab 1985 die Pulsoxymetrie und danach schließlich die Kapnometrie. Dieser Entwicklung hat die Überzeugung zugrunde gelegen, daß der Einsatz solcher Methoden eine lückenlosere, fehlerarmere und genauere Patientenüberwachung als die alleinige klinische Beobachtung möglich macht, somit die Sicherheit des Patienten erhöht und eine bessere Steuerung der Anästhesie gestattet. Erst in den letzten Jahren sind zunehmend Versuche unternommen worden, diese plausible Auffassung mit harten Daten zu untermauern. Eindeutige, allen methodischen Kriterien standhaltende wissenschaftliche Belege, daß apparatives Monitoring den Outcome des Patienten nachweisbar verbessert, haben sich aber bislang trotz aller Bemühungen nicht finden lassen. Dennoch sind aus Gründen, die im folgenden dargestellt werden, weitaus die meisten Anästhesisten überzeugt, daß apparatives Monitoring während und unmittelbar nach der Anästhesie nicht nur sinnvoll, sondern sogar notwendig ist. Folgerichtig sind deshalb in praktisch allen Ländern von den Fachgesellschaften für Anästhesiologie und Intensivmedizin Empfehlungen oder sogar Standards verabschiedet worden, in denen zumindest der Minimalumfang des verfügbaren oder einzusetzenden Monitorings festgehalten ist (s Kap. 1.5 und 1.6).
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Pasch, T. (1998). Outcome und ökonomische Aspekte. In: List, W.F., Metzler, H., Pasch, T. (eds) Monitoring in Anästhesie und Intensivmedizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-12541-0_7
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