Minerva anestesiologica
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Minerva anestesiologica · Nov 2012
Admission decisions to a medical intensive care unit are based on functional status rather than severity of illness. A single center experience.
Few data exist on Medical Intensive Care Unit (MICU) triage practices. We assessed MICU triage practices in our medical center. ⋯ MICU admission decisions are implicitly based on patients' baseline functional status rather than severity of illness.
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Minerva anestesiologica · Nov 2012
Editorial CommentA call for research on sepsis in developing countries.
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Minerva anestesiologica · Nov 2012
Editorial CommentAirway closure: nothing good during anesthesia.
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Fever is a common symptom of sepsis usually believed to predict better survival. Experimental data suggest that body temperature elevation may slow micro-organism growth and enhance host immune responses. In patients with sepsis, however, the high energy cost of fever may exacerbate the life-threatening situation. ⋯ A recent controlled trial in patients with septic shock suggests that external cooling for fever control may diminish vasopressor requirements and improve early survival. In this review, we examine the benefits and risks of fever and of controlled normothermia. The fever control modalities that provide the best risk/benefit ratio in sepsis are discussed.
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Minerva anestesiologica · Nov 2012
Randomized Controlled TrialRespiratory mechanics at different PEEP level during general anesthesia in the elderly: a pilot study.
General anesthesia could imply that the closing capacity exceed the functional residual capacity. This phenomenon, associated with a reduction of maximal expiratory flow, could lead to expiratory flow limitation (EFL). The aim of our study was to verify 1) a new method of determining EFL during anesthesia (PEEP test); 2) if anesthesia could be associated with the development of EFL; 3) if the use a small amount of PEEP is able to reverse the possible negative effects of low lung volume ventilation. ⋯ The PEEP test allowed to verify that EFL during anesthesia is a valuable phenomenon. The use of 5 cmH(2)O of PEEP was helpful to prevent the deterioration of lung mechanics that occurs during surgery.