Minerva anestesiologica
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Minerva anestesiologica · Aug 2021
ReviewCharacteristics, outcomes and global trends of respiratory support in patients hospitalized with COVID-19 pneumonia: a scoping review.
To date, a shared international consensus on treatment of Coronavirus disease 2019 (COVID-19) with invasive or non-invasive respiratory support is lacking. Patients' management and outcomes, especially in severe and critical cases, can vary depending on regional standard operating procedures and local guidance. ⋯ Global employment of respiratory supports and related outcomes are very heterogeneous. The most frequent respiratory support in patients with COVID-19 pneumonia is IMV, while NIV and CPAP are less frequently and equally applied, the latter especially in Europe, while data on NIV/CPAP-related mortality is often under-reported. Integrated and comprehensive reporting is desirable and needed to construct evidence-based recommendations.
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Minerva anestesiologica · Jun 2021
ReviewUpdates on neurologic complications in pediatric regional anesthesia.
Regional anesthesia has grown in popularity as a multimodal approach to analgesia. However, some anesthesiologists are fearful of regional blocks in pediatric patients as most require general anesthesia. ⋯ This review aimed to provide an update on the relevant literature regarding neurologic complications and the safety of regional blocks in pediatric patients. These large data sets have confirmed that regional anesthesia is a useful and safe modality in pediatric patients.
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Minerva anestesiologica · Jun 2021
Meta AnalysisRisk factors of postoperative delirium after liver transplantation: a systematic review and meta-analysis.
The aim of this study was to summarize the incidence and risk factors of postoperative delirium (POD) after liver transplantation (LT) and associations of POD after LT with outcomes. ⋯ POD after LT was common and multifactorial in etiology. There are significant associations of POD after LT with some clinical outcomes. Effective interventions during perioperative period may be promising to reduce the risk of POD after LT.
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Minerva anestesiologica · Jun 2021
Good clinical practice for the use of vasopressor and inotropic drugs in critically ill patients: state-of-the-science and expert consensus.
Vasopressors and inotropic agents are widely used in critical care. However, strong evidence supporting their use in critically ill patients is lacking in many clinical scenarios. Thus, the Italian Society of Anesthesia and Intensive Care (SIAARTI) promoted a project aimed to provide indications for good clinical practice on the use of vasopressors and inotropes, and on the management of critically ill patients with shock. ⋯ A modified semi-quantitative RAND/UCLA appropriateness method has been used to determine the appropriateness of specific clinical scenarios. The panel identified 29 clinical questions for the use of vasopressors and inotropes in patients with septic shock and cardiogenic shock. High level of agreement exists among the panel members about appropriateness of inotropes/vasopressors' use in patients with septic shock and cardiogenic shock.
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Minerva anestesiologica · Jun 2021
ReviewA matter of timing: EEG monitoring for neurological prognostication after cardiac arrest in the era of targeted temperature management.
Neuromonitoring with electroencephalography (EEG) is an essential tool in neurological prognostication post-cardiac arrest. EEG allows reliable and real-time assessment of early changes in background patterns, development of seizures and epileptiform activity, as well as testing for background reactivity to stimuli despite use of sedation or targeted temperature management. Delayed emergence of consciousness post-cardiac arrest is common, therefore longitudinal monitoring of EEG allows the detection of trends indicative of neurological improvement before coma recovery can be observed clinically. In this review, we summarize essential recent literature in EEG monitoring for neurological prognostication post-cardiac arrest in the context of targeted temperature management, with a particular focus on the importance of the evolution of EEG patterns in the first few days following resuscitation.