Minerva anestesiologica
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The aim of this paper was to study long-term survival in patients treated in the Intensive Care Unit (ICU) and who survived to hospital discharge. ⋯ Patients who survive ICU treatment have a high risk of dying during the next year. This risk is almost as great the risk of dying during ICU and hospital treatment and increases with age and illness severity on admission to the ICU.
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Minerva anestesiologica · Dec 2012
Multicenter StudyEffectiveness and predictors of success of noninvasive ventilation during H1N1 pandemics: a multicenter study.
The use of non-invasive ventilation (NIV) in acute hypoxemic respiratory failure (AHRF) due to H1N1 virus infection is controversial. In this multicenter study we aimed to assess the efficacy of NIV in avoiding endotracheal intubation (ETI) and to identify predictors of success or failure. ⋯ The early application of NIV, with the aim to avoid invasive ventilation, during the H1N1 pandemics was associated with an overall success rate of 47/98 (48%). Patients presenting at admission with an high SAPS II score and a low PaO(2)/FiO(2) ratio and/or unable to promptly correct gas exchange are at high risk of intubation and mortality.
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Minerva anestesiologica · Dec 2012
ReviewDiagnostic strategy for oncology patients with acute respiratory failure.
Acute respiratory failure (ARF) is frequent and often fatal in patients with a malignancy. However, there is not one type of "oncology patient", and it's high time that both clinical management and further studies consider specific populations rather than the heterogeneous and artificial group of "cancer patients". ⋯ These non invasive tools have reduced but not weakened the value of fiberoptic bronchoscopy and bronchoalveolar lavage: some subsets of patients may always benefit from this technique, particularly when new protective strategies such as non invasive mechanical ventilation and target-controlled infusion of sedative drugs are used. The present review focuses on the personalised approach required in "oncology patients" with ARF, based on first identifying the pattern of immunodeficiency, then listing the most probable hypotheses in the light of clinical and radiological findings in order to, finally, select the most accurate diagnostic tools.
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Minerva anestesiologica · Dec 2012
Practice of analgesia and sedation in Italian Paediatric Intensive Care Units: did we progress?
No strong recommendation was reported in management analgesia and sedation of critically ill children. The present study was performed to describe the current practice of analgesia and sedation in Pediatric Italian Intensive Care Units, in order to evaluate the adherence to last published pediatric guidelines. ⋯ National pediatric intensivists identified the same drug strategy to obtain analgesia and sedation in their patients, according to last published guidelines. Assessment of analgesia and sedation was more diffuse but not regularly performed and different methods were used. Withdrawal syndrome was monitored in a minority of contacted centres. Considering our data the practice of analgesia and sedation in Italian Pediatric Intensive Care Units is improved but not yet completely adherent to last international recommendations.