Minerva anestesiologica
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Minerva anestesiologica · Feb 2013
Comparative StudyEchocardiography and pulse contour analysis to assess cardiac output in trauma patients.
Echocardiography is a valuable technique to assess cardiac output (CO) in trauma patients, but it does not allow a continuous bedside monitoring. Beat-to-beat CO assessment can be obtained by other techniques, including the pulse contour method MostCare. The aim of our study was to compare CO obtained with MostCare (MC-CO) with CO estimated by transthoracic echocardiography (TTE-CO) in trauma patients. ⋯ CO measured by MostCare showed good agreement with CO obtained by transthoracic echocardiography. Pulse contour analysis can complement echocardiography in evaluating hemodynamics in trauma patients.
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Minerva anestesiologica · Feb 2013
Gaze-controlled, computer-assisted communication in Intensive Care Unit: "speaking through the eyes".
The aim of this study was to test the hypothesis that a gaze-controlled communication system (eye tracker, ET) can improve communication processes between completely dysarthric ICU patients and the hospital staff, in three main domains: 1) basic communication processes (i.e., fundamental needs, desire, and wishes); 2) the ability of the medical staff to understand the clinical condition of the patient; and 3) the level of frustration experienced by patient, nurses and physicians. ⋯ Our results show an improvement in the quality of the examined parameters. Better communication processes seem also to lead to improvements in several psychological parameters, namely anxiety and drop-out depression perceived by both patients and medical staff. Further controlled studies are needed to define the ET role in ICU.
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The aim of the present study was to evaluate the frequency of different techniques, indications, timing, as well as procedural features, sedation and ventilation protocols, early and late complications of tracheostomy in Intensive Care Unit (ICU). ⋯ Percutaneous tracheostomy is well established in Italian ICUs and CBR is the most popular technique performed in patients requiring prolonged mechanical ventilation. Tracheostomy is usually performed by a dedicated team using a specific sedation-analgesia-neuromuscular blocking and ventilation protocol, guided by fiberoptic bronchoscope and/or neck ultrasounds. Bleeding controlled by compression was the most common early and late complication.
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Colistin is a re-emerging old antibiotic that is used as a salvage treatment against multidrug-resistant Gram-negative infections. Because it is administrated as an inactive prodrug, colistin methanesulfonate (CMS) that undergoes rapid hydrolyze to colistin, pharmacokinetic studies using biological assays are unreliable. With the recent development of new assays using high performance liquid chromatography (HPLC) accurate pharmacokinetic of CMS and formed colistin is now available in various populations. This article aims to update previous reports on pharmacodynamics, pharmacokinetics, safety and clinical use of colistin, with a special focus on data useful to treat critically ill patients.
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Minerva anestesiologica · Feb 2013
Randomized Controlled Trial Comparative StudyIndirect videolaryngoscopy with C-MAC D-Blade and GlideScope: a randomized, controlled comparison in patients with suspected difficult airways.
Recently, indirect videolaryngoscopes have become increasingly important devices in difficult airway management. The aim of the present study was to investigate laryngoscopic view and intubation success using the new C-MAC® D-Blade in comparison to the established GlideScope® videolaryngoscope and conventional direct laryngoscopy in a randomized controlled trial. ⋯ Compared to direct Macintosh laryngoscopy, both C-MAC® D-Blade and GlideScope® comparably resulted in an improved view of the glottic opening with successful tracheal intubation in all patients.