Minerva anestesiologica
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Minerva anestesiologica · Dec 2013
Case ReportsMechanical and electrical equipment interference provokes a misleading Neurally Adjusted Ventilatory Assist (NAVA) EAdi signal. A technical note.
Neurally Adjusted Ventilatory Assist (NAVA) offers synchronized proportional pressure in accordance with the electrical activity of the diaphragm (EAdi). NAVA relies on the EAdi to trigger the respiratory cycle and then adjusts the ventilatory assist to the neural drive. The technique necessitates a catheter with bipolar microelectrodes positioned near the crural diaphragm where this signal can be captured. Capturing a reliable EAdi signal is a condition sine qua non for using NAVA as a mode of ventilation. The displayed signal represents the sum of the electrical activity of the muscle action potential of the diaphragm and is expressed in microvolts. ⋯ We illustrate that the detection and therefore interpretation of the EAdi signal during NAVA can be influenced by mechanical and electrical interference by other equipment used in the ICU or from endogenous leaking cardiac activity.
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Minerva anestesiologica · Dec 2013
Comparative StudyA comparative study of the efficacy of Pediatric Airtraq® with conventional laryngoscope in children.
Management of pediatric airway may pose a challenge to anesthesiologists. Many modifications in maneuvers and equipments have been made overtime to overcome the problem. Pediatric optical laryngoscope (Airtraq®) is one of the newer equipments for managing simple and difficult pediatric airway. Here we have evaluated the comparative efficacy of pediatric Airtraq® optical laryngoscope with conventional laryngoscope in children scheduled for routine surgeries. ⋯ Pediatric Airtraq® provides better intubating conditions in children compared to conventional laryngoscope with less frequent complications.
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Minerva anestesiologica · Dec 2013
Parental experience of end-of life care in the pediatric intensive care unit.
There is a considerable variability among European countries regarding the management of end-of-life (EOL) care in the pediatric critical care setting. In Italy, recommendations on these issues are available but no study has investigated the parents' experience. The aim of this study was to explore parents' experience of EOL care in a Pediatric Intensive Care Unit (PICU) in Italy. ⋯ Our findings suggest that in order to improve pediatric EOL care we need to better integrate medical and parental priorities, in a shared process that allows parents to preserve their role and relationship with their child. The most critical aspect for parents was not related to the involvement (or not) in EOL decisions, but rather to the possibility of staying connected with their child during the hospitalization and at the time of death.