Minerva anestesiologica
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Minerva anestesiologica · Apr 2001
Case ReportsExperiences with continuous intra-arterial blood gas monitoring.
Management of critically ill patients requires frequent arterial blood gas analyses for assessing the pulmonary situation and adjusting ventilator settings and circulatory therapeutic measures. Continuous arterial blood gas analysis is a real-time monitoring tool, which reliably detects the onset of adverse pulmonary effects. It gives rapid confirmation of ventilator setting changes and resuscitation and helps to ensure precise adjustment of therapy. ⋯ The Paratrend 7+ sensor proved to be clinical feasible and showed an improved precision in terms of clinical situations with an arterial pO2 smaller than 50 kPa. However, the results are not much different regarding the findings with older systems consisting of hybrid technology combining optodes and electrochemical oxygen measurement. The advantages might be seen if the sensor is used for a period over several days in patients on ICU as demonstrated by the two case reports.
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Minerva anestesiologica · Apr 2001
Historical ArticleAccidents and mishaps in anesthesia: how they occur; how to prevent them.
The problem of safety and accidents prevention is a primary issue in modern anesthesia. Throughout the last twenty years, much effort has been made to assess the causes of mishaps, introducing new technology and safer drugs. The author presents a well known model to describe factors affecting accidents causality, proposing old and new strategies to ensure safety during the everyday practice.
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Quality of recovery after anesthesia and surgery is an important dimension of the patient's experience and may be related to the quality of anesthesia care. Quality of recovery is also related to patient satisfaction. We have developed and validated a quality of recovery (QoR) score. ⋯ Patient satisfaction is associated with higher QoR Scores. The measurement of quality of recovery is an important aspect of a quality anaesthetic practice. The QoR Score can be incorporated into routine practice and this should improve patient care and resultant levels of satisfaction.
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It is increasingly apparent that organ dysfunction in sepsis is caused, at least in part, by an acquired intrinsic derangement in cellular oxidative adenosine triphosphate (ATP) production. We have termed this phenomenon "cytopathic hypoxia". Although several different but mutually compatible mechanisms might account for the development of cytopathic hypoxia in sepsis, recent data from our laboratory point to activation of the nuclear enzyme, poly-ADP-ribosyl polymerase (PARP), as being the most important.