During passive ventilation pulse pressure variations are a predictor of fluid responsiveness when conditions to ensure its validity are observed, but may also reflect afterload effects of MV. Central venous pressure can be helpful to monitor the response of RV function to treatment. Echocardiography is suitable to visualize the RV and to detect acute cor pulmonale (ACP), which occurs in 20-25 % of cases. Inserting a pulmonary artery catheter may be useful to measure/calculate pulmonary artery pressure, pulmonary and systemic vascular resistance, and cardiac output. These last two indexes may be misleading, however, in cases of West zones 2 or 1 and tricuspid regurgitation associated with RV dilatation. Transpulmonary thermodilution may be useful to evaluate extravascular lung water and the pulmonary vascular permeability index. To ensure adequate intravascular volume is the first goal of hemodynamic support in patients with shock. The benefit and risk balance of fluid expansion has to be carefully evaluated since it may improve systemic perfusion but also may decrease ventilator-free days, increase pulmonary edema, and promote RV failure. ACP can be prevented or treated by applying RV protective MV (low driving pressure, limited hypercapnia, PEEP adapted to lung recruitability) and by prone positioning. In cases of shock that do not respond to intravascular fluid administration, norepinephrine infusion and vasodilators inhalation may improve RV function. Extracorporeal membrane oxygenation (ECMO) has the potential to be the cause of, as well as a remedy for, hemodynamic problems. Continuous thermodilution-based and pulse contour analysis-based cardiac output monitoring are not recommended in patients treated with ECMO, since the results are frequently inaccurate. Extracorporeal CO2 removal, which could have the capability to reduce hypercapnia/acidosis-induced ACP, cannot currently be recommended because of the lack of sufficient data.

Despite the fact that some patients remain in a poor neurological condition, quality of life after decompressive surgery for ischemic stroke seems to be acceptable to the patients.

The German Society of Anesthesiology and Intensive Care Medicine (DGAI) commissioneda revision of the S2 guidelines on “positioning therapy for prophylaxis or therapy of pulmonary function disorders” from 2008. Because of the increasing clinical and scientificrelevance the guidelines were extended to include the issue of “early mobilization”and the following main topics are therefore included: use of positioning therapy and earlymobilization for prophylaxis and therapy of pulmonary function disorders, undesired effects and complications of positioning therapy and early mobilization as well as practical aspects of the use of positioning therapy and early mobilization. These guidelines are the result of a systematic literature search and the subsequent critical evaluation of the evidence with scientific methods. The methodological approach for the process of development of the guidelines followed the requirements of evidence-based medicine, as defined as the standard by the Association of the Scientific Medical Societies in Germany. Recently published articles after 2005 were examined with respect to positioning therapy and the recently accepted aspect of early mobilization incorporates all literature published up to June 2014.

The general equations describing the nonlinear fluttering oscillations of shallow, curved, heated orthotropic panels have been derived. The formulation takes into account the location of the panel on the surface of a generic hypersonic vehicle, when calculating the aerodynamic loads. It is also shown that third order piston theory produces unsteady aerodynamic loading which is in close agreement with that based upon direct solution of the Euler equations. Results, for simply supported panels. are obtained using Galerkin's method combined with direct numerical integration in time to compute stable limit cycle amplitudes. These results illustrate the sensitivity of the aeroelastic behavior to the unsteady aerodynamic assumptions, temperature, orthowpicity and flow orientation.

Market research predicts, for the aircraft industry, a large growth in the number of passengers as well as the airfreight rate with the result of this leading to increased competition for the European aircraft industry, the efficiency of new aircraft has to be improved drastically. One approach, among others, is the aerodynamic optimization of the wing. The fixed wing is designed optimally only for one flight condition. This flight condition is described by the parameters altitude, mach number and aircraft weight, all of which permanently vary during the mission of the aircraft. Therefore, the aircraft is just periodically near to the chosen design point. To compensate for this major disadvantage, an 'adaptive wing' for optimal adaptation and variation of the profile geometry to the actual flight conditions will be developed. Daimler-Benz Aerospace Airbus, Daimler-Benz Research and the German Aerospace Center (DLR) are working as project partners on concepts for a variable camber and a local spoiler bump. In this paper a structural concept developed by the DLR for the adaptive spoiler will be presented. The concept is designed under the aspect of adaptive structural systems and requires a high integration of actuators, sensor and controllers in the structure. Special aspects of the design will be discussed and the first results, analytical, numerical as well as experimental, will be presented. Part of the concept design is also the development of new actuators optimized for the specific problem. A new actuator concept for the adaptive spoiler based on a cylindrical tube and activated either by pressure or multifunctional materials (e.g. shape memory alloys) will additionally be shown.