[Work-related fatigue in anesthesia and intensive care medicine : Review article on a structural problem]

Work-related fatigue is a serious psychophysiological phenomenon characterized by exhaustion, impaired concentration, reduced alertness and diminished decision-making capacity. It often results from disrupted sleep patterns and shift work and increases the risk of critical incidents in the clinical practice. Anesthetists are particularly affected as irregular working hours and frequent night shifts disrupt their circadian rhythms. Although fatigue is reversible with appropriate measures, it remains largely unrecognized as a structural issue within the German healthcare system.Over recent decades the working conditions across European healthcare settings have steadily deteriorated, a trend that culminated during the COVID-19 pandemic. This period clearly highlighted the urgent need to prioritize the well-being of healthcare professionals. The aim of this review article is to raise awareness of fatigue and provide insights into effective management strategies. It explores both international concepts and local solutions relevant to the German system.This review and analysis are based on studies and material developed as part of the European "Fatigue Project" and the "Fight Fatigue" campaign. It examines the effects of fatigue across all career stages and identifies practical strategies for risk reduction.The results show that fatigue affects anesthetists at all stages of their careers. Structured fatigue management is therefore a vital component of sustainable healthcare provision. In particular, fatigue risk management systems and optimized shift work planning have proven effective in reducing the burden on personnel and enhancing patient safety.