Minerva anestesiologica
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Minerva anestesiologica · Jun 2023
ReviewPathophysiology of COVID-19 pneumonia and respiratory treatment.
COVID-19 pandemic has seen an unprecedented number of patients presenting with acute respiratory distress syndrome to the intensive care units all over the world. Between August and November 2022, we performed research on PubMed screening all publications on COVID-19 disease and respiratory failure and its treatment. ⋯ The mainstay of the disease is the frequent presence of severe hypoxemia associated - at least at the beginning - to a near normal lung mechanics and PaCO
2 tension. The management of symptomatic patients, progressing through these temporal phases, is not possible without understanding the pathophysiology underlying the respiratory manifestation. -
Minerva anestesiologica · Jun 2023
Short time effects of compliance guided flow-controlled ventilation versus standard of care pressure-controlled ventilation - a prospective porcine trial.
Flow-controlled ventilation (FCV) represents a novel ventilation method, which guarantees a continuous gas flow during inspiration and expiration. Long term comparison to volume- and pressure-controlled ventilation (PCV) after five- and ten hours have shown improved gas exchange parameters and lung tissue aeration. Aim of this porcine trial was to compare gas exchange parameters and lung tissue aeration in short time application of FCV compared to PCV to determine effects which will most probably pertain in short lasting procedures under general anesthesia. ⋯ In this short-term ventilation comparison FCV improved gas exchange parameters without differences in lung tissue aeration compared to PCV.
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Minerva anestesiologica · Jun 2023
Meta AnalysisComparison of remimazolam and propofol about safety outcome indicators during general anesthesia in surgical patients: a systematic review and meta-analysis.
Remimazolam is a novel sedative drug that has been successively approved for procedural sedation and general anesthesia, however, which has not been fully explored due to limited clinical studies and a small sample size. Current clinical studies have focused on the use of remimazolam and propofol for general anesthesia (GA) as indicators of safety outcomes in surgical patients, but different studies have reached different conclusions. The aim of this study was to investigate whether the safety-related outcome indicators in GA were superior to propofol in surgical patients. ⋯ In this Meta-analysis, compared with propofol, remimazolam for GA reduced the incidence of hypotension, hypoxemia, nausea and vomiting, dizziness and injection site pain, and had a more stable MAP before and after intubation, which supported that remimazolam is a safer sedative. However, a large sample is needed to validate this finding.