Herausforderungen transdisziplinären Arbeitens im Reallabor „Wissensdialog Nordschwarzwald“

Das Reallabor „Wissensdialog Nordschwarzwald“ ist eng an den Nationalpark Schwarzwald gekoppelt: Wie lassen sich Chancen nutzen, die der Nationalpark für die nachhaltige Entwicklung der Region bietet? Was lässt sich aus den im Nationalparkgebiet stattfindenden ökologischen Prozessen lernen? Dies sind die zentralen Forschungsfragen des Projekts. Der vorliegende Beitrag stellt die Herausforderungen des spezifischen transdisziplinären Designs des Reallabors in den Vordergrund. Basierend auf Interviews mit Projektbeteiligten, dem Austausch in Projektgremien und eigenen Beobachtungen reflektieren die AutorInnen zentrale Designelemente sowie Kontextbedingungen des Projektes. Angesichts der besonderen Gegebenheiten des ländlichen Raumes postulieren sie den Bedarf, eine stärker an diesen angepasste Reallaborforschung zu entwickeln.The Real-world Laboratory “Knowledge Dialogue Northern Black Forest” is closely linked to the Black Forest National Park in Baden-Württemberg, Germany: How can one actually take advantage of the opportunities a national park offers for regional transformation towards sustainability, and what can be learnt from ecological processes in the park area? These are the project’s core questions. The following article focuses on the transdisciplinary project design and its challenges. Based on interviews with project members, discussions within project committees and own observations, the authors reflect on essential design elements and context conditions of the project. On this basis, they postulate a need for better adapting the real-world laboratory research to the specific conditions of rural areas

There is no evidence that carbon dioxide-enriched oxygen before apnea affects the time to arterial desaturation, but it might improve cerebral oxygenation in anesthetized obese patients: a single-blinded randomized crossover trial

Purpose Carbon dioxide (CO$_{2}$) increases cerebral perfusion. The effect of CO$_{2}$ on apnea tolerance, such as after anesthesia induction, is unknown. This study aimed to assess if cerebral apnea tolerance can be improved in obese patients under general anesthesia when comparing O$_{2}$/Air (95%O$_{2}$) to O$_{2}$/CO$_{2}$ (95%O$_{2}$/5%CO$_{2}$). Methods In this single-center, single-blinded, randomized crossover trial, 30 patients 18–65 years, with body mass index > 35 kg/m$^{2}$, requiring general anesthesia for bariatric surgery, underwent two apneas that were preceded by ventilation with either O$_{2}$/Air or O$_{2}$/CO$_{2}$ in random order. After anesthesia induction, intubation, and ventilation with O$_{2}$/Air or O$_{2}$/CO$_{2}$ for 10 min, apnea was performed until the cerebral tissue oxygenation index (TOI) dropped by a relative 20% from baseline (primary endpoint) or oxygen saturation (SpO$_{2}$) reached 80% (safety abortion criterion). The intervention was then repeated with the second substance. Results The safety criterion was reached in all patients before cerebral TOI decreased by 20%. The time until SpO$_{2}$ dropped to 80% was similar in the two groups (+ 6 s with O$_{2}$/CO$_{2}$, 95%CI -7 to 19 s, p = 0.37). Cerebral TOI and PaO$_{2}$ were higher after O$_{2}$/CO$_{2}$ (+ 1.5%; 95%CI: from 0.3 to 2.6; p = 0.02 and + 0.6 kPa; 95%CI: 0.1 to 1.1; p = 0.02). Conclusion O$_{2}$/CO$_{2}$ improves cerebral TOI and PaO$_{2}$ in anesthetized bariatric patients. Better apnea tolerance could not be confirmed