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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Minerva anestesiologica · May 2013
Randomized Controlled Trial Comparative StudyPolyurethane does not protect better than polyvinyl cuffed tracheal tubes from microaspirations.
Mechanically ventilated patients are prone to develop ventilator associated pneumonia due to microaspirations of subglottic secretions around the endotracheal tube cuff (usually constructed of polyvinyl material). A novel polyurethane cuff has been designed to minimize these leakages. The aim of the study was to compare the tracheal sealing capacities between the two tubes. ⋯ These preliminary results suggest that both tubes are poorly effective in preventing microaspirations.
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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
ReviewThe usage of the Boussignac continuous positive airway pressure system in acute respiratory failure.
Traditionally, continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP) devices have been used to treat patients in acute respiratory failure. However they require an electric power source, are relatively large in size, and may be difficult to use in prehospital settings. The recently introduced Boussignac CPAP system is capable of delivering 10 cmH2O of CPAP, is compact, portable and requires only an oxygen source. ⋯ In one study, implementing Boussignac CPAP reduced intubation rate and hospital stay. Most hospital staff found Boussignac CPAP easy to use and complication rates were low. Boussigac CPAP is a useful device in the treatment of patients with acute respiratory failure, especially in the prehospital setting.
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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.