Minerva anestesiologica
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Minerva anestesiologica · May 2013
Evaluation of acid-base status in brain dead donors and the impact of metabolic acidosis on organ retrieval.
Background: Pathophysiologic changes after brain death can lead to acid-base disturbances. The primary aim of this study was to clarify the acid-base state and its source in brain dead donors using Stewart's approach. Additionally, we investigated whether the presence of metabolic acidosis affected the number of organs retrieved from donors. ⋯ Although more organs were retrieved from the donors without metabolic acidosis than those with metabolic acidosis (P=0.012), serum albumin level (P=0.010) and donor age (P<0.001), rather than metabolic acid-base disturbances, significantly correlated with the number of organs retrieved in multivariate regression analysis. Conclusion: Most brain dead donors exhibited metabolic acid-base disturbances. However, rather than metabolic acidosis, serum albumin level and donor age were well correlated with the number of organs retrieved.
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Survival of critically ill patients is frequently associated with significant functional impairment and reduced health-related quality of life. Early physiotherapy of acute respiratory distress syndrome (ARDS) patients has recently been identified as an important therapeutical tool and has become an important evidence-based component in the management of these patients. Nevertheless, availability and quality of physiotherapy performed in intensive care units (ICUs) is often inadequate. ⋯ The assessment and evidence-based treatment of these patients should include prevention and reduction of adverse consequences of immobilization and weaning failure. A variety of modalities of early physiotherapy in ICU are suggested by clinical research and should be applied according to the stage of disease, comorbidities, and patient's level of cooperation. Early ICU physiotherapy is an interdisciplinary team activity, involving physical therapists, occupational therapists, nurses and medical staff.
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Minerva anestesiologica · May 2013
Randomized Controlled Trial Comparative StudyForce and pressure distribution using Macintosh and GlideScope laryngoscopes in normal airway: an in vivo study.
Forces applied on oropharyngeal soft tissues by direct laryngoscopy may cause damage to the patients. The aim of this study was to measure the forces applied during the manoeuvres to achieve glottis visualization and tracheal intubation, comparing direct laryngoscopy and videolaryngoscopy in vivo. ⋯ Our study shows that in patients with normal airways the GlideScope allows a view of glottis and permits a successful tracheal intubation applying lower force (significantly in intubation) as compared to the Macintosh laryngoscope. Also, the GlideScope probe distributes the forces more homogeneously to the tissue thus further reducing the potential for tissue damage.
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Minerva anestesiologica · May 2013
Randomized Controlled TrialPreconditioning effects of the anesthetic administered to the donor on grafted kidney function in living donor kidney transplantation recipients.
In living donor kidney transplantation (LDKT), we evaluated if there was any difference in grafted kidney function according to the type of anesthetic used in the donor because some laboratory studies have demonstrated that volatile anesthetics at clinically relevant concentrations protect the kidneys against renal ischemia-reperfusion injury. ⋯ The inhalational anesthetic administered to donors does not improve grafted kidney function in recipients undergoing LDKT to a greater extent than propofol.
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Minerva anestesiologica · May 2013
Randomized Controlled TrialPreoperative medication with oral morphine sulphate and postoperative pain.
The administration of an analgesic drug prior to nociceptive surgical stimulus could result in a better postoperative pain management. The aim of this study was to evaluate the effect of preoperative oral morphine sulphate on postoperative pain relief. ⋯ In major abdominal surgery, premedication with oral morphine sulphate produces better postoperative pain control and has an opioid-sparing effect without delaying gastrointestinal canalization time.