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Minerva Anestesiologica

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https://www.readbyqxmd.com/read/28726366/-i-am-in-pain-is-it-really-the-magic-formula-to-open-the-door-of-opioid-abuse
#1
Flaminia Coluzzi
No abstract text is available yet for this article.
July 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28726365/labor-epidural-failure-a-serious-concern
#2
Gaetano Draisci, Stefano Catarci
No abstract text is available yet for this article.
July 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28726364/new-frontiers-art-and-innovation-for-intraoperative-ventilatory-management
#3
Carlos Ferrando, F Javier Belda
No abstract text is available yet for this article.
July 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28726363/does-dexmedetomidine-offer-brain-protection
#4
Nelson N Algarra
No abstract text is available yet for this article.
July 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28726362/early-hypertension-after-vasopressor-weaning-during-septic-shock-associated-factors-and-prognostic-significance
#5
Rostane Gaci, Jérémie Lemarie, Marie Conrad, Aurélie Cravoisy, Pierre E Bollaert, Sébastien Gibot
BACKGROUND: During septic shock, early development of hypertension after vasopressors weaning seems paradoxical. The aim of this study was to authenticate this empirical observation, identify associated factors and document its prognostic significance. METHODS: We conducted a descriptive, retrospective study in a medical ICU of a teaching hospital among adult patients with septic shock. RESULTS: From 01.01.2013 to 31.12.2014, 262 consecutive patients over 18 years of age were admitted because of septic shock; 195 of them were successfully weaned from vasopressors...
July 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28726361/risk-of-spontaneous-fungal-peritonitis-sfp-in-hospitalized-cirrhotic-patients-with-ascites-a-systematic-review-of-observational-studies-and-meta-analysis
#6
Marco Fiore, Paolo Chiodini, Vincenzo Pota, Pasquale Sansone, Maria B Passavanti, Sebastiano Leone, Caterina Aurilio, Maria C Pace
INTRODUCTION: Spontaneous Fungal Peritonitis (SFP) is an infection of ascitic fluid occurring in cirrhotic patients. SFP prevalence varies from 0 to 41% of patients with spontaneous peritonitis (SP) and a positive ascitic fluid culture. Cirrhotic patients with SFP who fail to show improvement with empirical antibiotic therapy, before the identification of the fungal pathogen, have high mortality (89.5-100%). Although the weight of the disease is so dramatic, more recent guidelines on infections in cirrhosis do not consider SFP management...
July 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28726360/machine-perfusion-in-liver-transplantation-an-essential-treatment-or-just-an-expensive-toy
#7
Andrea A Schlegel, Marit Kalisvaart, Paolo Muiesan
This review focuses on recent developments in preservation techniques in liver transplantation. First, we discuss mechanisms of organ injury when using high-risk organs, including DCD and steatotic grafts and we summarize pathways of ischemia reperfusion injury together with their link to the immune response. Second, we report on improvement strategies of marginal liver grafts by different machine perfusion concepts and summarize perfusion approaches with recent clinical implementation.
July 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28726359/earplugs-during-the-first-night-after-cardiothoracic-surgery-may-improve-a-fast-track-protocol
#8
Johannes Menger, Bernhard Urbanek, Keso Skhirtladze-Dworschak, Viktoria Wolf, Arabella Fischer, Harald Rinösl, Martin Dworschak
BACKGROUND: Sleep deprivation after major surgery is common and associated with worse outcome. Noise is one important reason for sleep fragmentation, which contributes to enhanced morbidity. The purpose of this work was to evaluate the impact of earplugs on patients' sleep quality during their first night after cardiothoracic surgery to eventually improve an existing fast-track concept. METHODS: Sixty-three patients undergoing cardiothoracic surgery eligible for a postoperative fast- track regimen on our cardiothoracic post anaesthesia care unit (C-PACU) were prospectively included...
July 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28714298/effect-of-sugammadex-on-coagulation-as-detected-by-rotational-thromboelastometry-in-morbidly-obese-patients
#9
Michele Carron, Diana Bertini, Tancredi Prandini, Francesca Fanton, Mirto Foletto, Carlo Ori, Egle Perissinotto, Paolo Simioni
BACKGROUND: Sugammadex, which is used to reverse rocuronium-induced neuromuscular blockade, has a limited and transient effect on activated partial thromboplastin time and prothrombin time. However, no data are available on the effects of sugammadex on coagulation in morbidly obese patients, as assessed by rotational thromboelastometry (ROTEM®). METHODS: Sixty patients received sugammadex 2 mg/kg or 4 mg/kg to reverse moderate or deep rocuronium-induced neuromuscular blockade (n = 30/group) at the end of surgery under desflurane anesthesia...
July 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28707847/is-sedation-for-endoscopy-as-safe-as-you-think
#10
Germano DE Cosmo, Elisabetta Congedo
No abstract text is available yet for this article.
July 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28707846/palliative-sedation-ethical-aspects
#11
Guido Miccinesi, Augusto Caraceni, Marco Maltoni
Palliative sedation (PS), the medical act of decreasing a patient's awareness to relieve otherwise intractable suffering, is considered by some commentators to be controversial because of its consequences on residual survival and/or quality of life, and to be inappropriate for treating pure existential suffering. We will argue that PS must be always proportional, i.e. controlling refractory symptoms while keeping the loss of personal values (communication, affective relationships, care relationship) as low as possible, and that imminence of death is necessary too, from an ethical point of view, if a deep and continuous sedation (DCS) is proposed...
July 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28707845/clinical-ethics-what-the-anaesthesiologist-and-the-intensivist-need-to-know
#12
Marco Vergano, Emma Magavern, Nereo Zamperetti
Clinical ethics if often perceived as an intuitive understanding of what is right versus wrong. This is insufficient for healthcare workers in general, but particularly for anesthesiologists and intensivists, who often must weigh up complex and emergent life or death decisions and subsequently justify these decisions to their team and patients, as well as patient's families. Articulating the rationale for such decisions is an arduous task. Thus, a brief introduction to the basic conceptual framework and vocabulary of clinical ethics may be useful to this population of physicians...
July 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28679202/the-ultrasound-guided-transmuscular-quadratus-lumborum-block-for-perioperative-analgesia-in-open-nephrectomy-a-case-report
#13
Ruggero M Corso, Emanuele Piraccini, Massimiliano Sorbello, Daniele Bellantonio, Mario Tedesco
No abstract text is available yet for this article.
July 5, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28679201/physiological-effects-of-the-open-lung-approach-during-laparoscopic-cholecystectomy-focus-on-driving-pressure
#14
Davide D'Antini, Michela Rauseo, Salvatore Grasso, Lucia Mirabella, Luigi Camporota, Antonella Cotoia, Savino Spadaro, Alberto Fersini, Rocco Petta, Rosaria Menga, Alberto Sciusco, Michele Dambrosio, Gilda Cinnella
BACKGROUND: During laparoscopy, respiratory mechanics and gas exchange are impaired because of pneumoperitoneum and atelectasis formation. We applied an open lung approach (OLA) consisting in lung recruitment followed by a decremental positive-end expiratory pressure (PEEP) trial to identify the level of PEEP corresponding to the highest compliance of the respiratory system (best PEEP). Our hypothesis was that this approach would improve both lung mechanics and oxygenation without hemodynamic impairment...
July 5, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28679200/closed-loop-ventilation-mode-in-intensive-care-unit-a-randomized-controlled-clinical-trial-comparing-the-numbers-of-manual-ventilator-setting-changes
#15
Jean-Michel Arnal, Aude Garnero, Dominik Novotni, Gaëlle Corno, Stéphane Y Donati, Didier Demory, Gabrielle Quintana, Laurent Ducros, Thomas Laubscher, Jacques Durand-Gasselin
BACKGROUND: There is an equipoise regarding closed-loop ventilation modes and the ability to reduce workload for providers. On one hand some settings are managed by the ventilator but on another hand the automatic mode introduces new settings for the user. METHODS: This randomized controlled trial compared the number of manual ventilator setting changes between a full closed loop ventilation and oxygenation mode (INTELLiVENT-ASV®) and conventional ventilation modes (volume assist control and pressure support) in intensive care unit (ICU) patients...
July 5, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28679199/ultrasound-guided-genitofemoral-nerve-block-for-inguinal-hernia-repair-in-the-male-adult-a-randomized-controlled-pilot-study
#16
Luciano Frassanito, Bruno A Zanfini, Sara Pitoni, Paolo Germini, Miryam Del Vicario, Gaetano Draisci
BACKGROUND: Ultrasound-guided (USG) ilioinguinal/iliohypogastric nerve (II/IHN) block is a widely validated anesthetic technique for inguinal herniorrhaphy. As the spermatic cord, scrotum, and adjacent thigh receive sensory innervation from the genital branch of genitofemoral nerve (GFN), the addition of GFN block has been suggested to improve the quality of perioperative anesthesia and analgesia. The aim of this study is to compare GFN block plus II/IHN block with II/IHN block alone for intraoperative anesthesia and post-operative pain management...
July 5, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28679198/post-anoxic-status-epilepticus-which-variable-could-modify-prognosis-a-single-centre-experience
#17
Christian Lettieri, Grazia Devigili, Giada Pauletto, Miriam Isola, Sara Rinaldo, Riccardo Budai, Roberto Eleopra
BACKGROUND: Status epilepticus (SE) is associated with high mortality in post-anoxic coma despite antiepileptic treatment. The aim of our study was to assess the percentage of awakening in a consecutive series of post-anoxic comatose patients with an EEG pattern consistent with SE and to verify any correlation with clinical, neurophysiological or pharmacological parameters. METHODS: We retrospectively analyzed data collected from seventeen patients affected by post- anoxic SE matching them with outcome scores by means of univariate statistical analysis...
July 5, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28643999/dexmedetomidine-and-general-anesthesia-a-narrative-literature-review-of-its-major-indications-for-use-in-adults-undergoing-non-cardiac-surgery
#18
Arthur Davy, Julien Fessler, Marc Fischler, Morgan le Guen
BACKGROUND: In Europe, dexmedetomidine has marketing approval only for sedation in intensive care units. However, its use during general anesthesia has been widely reported. The aim of this narrative review is to draw a picture of potential indications in anesthesia. METHODS: We searched in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials using the keywords "Dexmedetomidine, Dexdor, Precedex and Dexdomitor". The research ended in December 2016...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28643998/survey-in-expert-clinicians-on-validity-of-automated-calculation-of-optimal-cerebral-perfusion-pressure
#19
Romy Steijn, Roy Stewart, Marek Czosnyka, Joseph Donnelly, Ari Ercole, Antony Absalom, Jan W Elting, Christina Haubrich, Peter Smielewski, Marcel Aries
BACKGROUND: Optimal cerebral perfusion pressure (CPPopt) targeting in traumatic brain injury (TBI) patients constitutes an active and controversial area of research. It has been suggested that an autoregulation guided CPP therapy may improve TBI outcome. Prerequisites of a CPPopt intervention study would be objective criteria for the CPPopt detection.. This study compared the agreement between automated and visual CPPopt detection. METHODS: Twenty-five clinicians from 18 centres worldwide, familiar with brain monitoring and using dedicated software, reviewed ten 4-hour CPPopt screenshots at 48 hrs after ictus in selected TBI patients...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28643997/brain-monitoring-in-adult-and-pediatric-ecmo-patients-the-importance-of-early-and-late-assessments
#20
Roberto Lorusso, Fabio S Taccone, Mirko Belliato, Thijs Delnoij, Paolo Zanatta, Mirjana Cvetkovic, Mark Davidson, Jan Belohlavek, Nashwa Matta, Carl Davis, Hanneke Ijsselstijn, Thomas Mueller, Ralf Muellenbach, Dirk Donker, Piero David, Matteo Di Nardo, Dirk Vlasselaers, Dinis Dos Reis Miranda, Aparna Hoskote
Monitoring brain integrity and neuro-cognitive function is a new and important target for the management of a patient treated with extracorporeal membrane oxygenation (ECMO), in particular because of the increasing awareness of cerebral abnormalities that may potentially occur in this setting. Continuous regular monitoring, as well as repeated assessment for cerebral complications has become an essential element of the ECMO patient management. Besides well-known complications, like bleeding, ischemic stroke, seizures, and brain hypoperfusion, other less defined yet relevant injury and clinical manifestations are increasingly reported and impacting on ECMO patient prognosis at short term...
June 22, 2017: Minerva Anestesiologica
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