Minerva anestesiologica
-
Minerva anestesiologica · Jul 2013
Practice GuidelineII Italian intersociety consensus statement on antithrombotic prophylaxis in orthopedics and traumatology.
Pharmacological prophylaxis for preventing venous thromboembolism (VTE) is a worldwide established procedure in hip and knee replacement surgery, as well as in the treatment of femoral neck fractures, but few data exist to its regard in other fields of orthopedics and traumatology. Indeed, no guidelines or recommendations are available in the literature, except for a limited number of weak statements about knee arthroscopy and lower limb fractures. ⋯ The Italian Society for Studies on Hemostasis and Thrombosis (SISET), the Italian Society of Orthopedics and Traumatology (SIOT) and the association of Orthopedic Traumatology of Italian Hospitals (OTODI) together with the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) and the Italian Society of General Medicine (SIMG) have set down quick and easy suggestions for VTE prophylaxis in a number of surgical conditions for which only scarce evidence is available. This inter-society consensus statement aims at simplifying the approach to VTE prophylaxis in the single patient with the goal of improving its clinical application.
-
Minerva anestesiologica · Jul 2013
Survey on the current management of rapid sequence induction in Germany.
The practice of rapid sequence induction (RSI) differs widely within and between countries. We undertook this web-based survey to assess the variability in the practice of RSI amongst German anesthetists. We hypothesized that considerable variability exists. ⋯ This to date largest survey undertaken in the context of RSI documents large management differences in the practice of RSI amongst German anesthetists. These differences are unrelated to qualification, years of work experience and type of institution. This survey emphasizes the need for solid scientific evidence regarding all interventions undertaken in the context of RSI.
-
Minerva anestesiologica · Jul 2013
Comparative StudyEvaluation of continuous monitoring of stroke volume and cardiac output in patients supported by an intra-aortic balloon pump.
Currently available minimally invasive devices cannot provide continuous determination of stroke volume (SV) or cardiac output (CO) in patients supported with an intra-aortic balloon pump (IABP). Our aim was to evaluate the accuracy of Dat-con™ monitor for continuous SV and CO determination in such patients. ⋯ The accuracy and trending of continuous determination of SV and CO with Dat-con™ monitor in patients supported by IABP is equivalent to echocardiography.
-
Minerva anestesiologica · Jul 2013
Efficacy of endotoxin adsorption therapy (polymyxin B hemoperfusion) for methicillin-resistant Staphylococcus aureus toxic shock syndrome: a case report about five patients.
Toxic shock syndrome (TSS), which can be life-threatening, is clinically and pathologically characterized by the presence of high fever, skin rash, desquamation, hypotension, and multiple organ failure caused by an enterotoxin produced by Staphylococcus aureus. In this study, we evaluated the effects of endotoxin adsorption therapy (polymyxin B [PMX] hemoperfusion) in critical patients with methicillin-resistant Staphylococcus aureus TSS (MRSA-TSS) who showed no improvement with the conventional therapy. ⋯ Our results showed that PMX hemoperfusion significantly improved the hemodynamics and severity in patients with life-threatening MRSA-TSS.
-
Alteration of muscle mass and function is often observed in critically ill patients and its etiology is multifactorial. Besides the effects of acute disease on muscle metabolism, intensive care stay may per se contribute to muscle derangements. Recently, the concept of sarcopenia has been completely revisited, and indicates the loss of muscle mass and function. ⋯ Additionally, sarcopenia may promote functional disability in the long-term after hospital discharge. Limited data are available on the prevalence of sarcopenia at ICU admission. Considering the growing population of older adults with multiple comorbidities, modern intensive care medicine should pay attention to the prevention of ICU-related sarcopenia and also to the routine screening for sarcopenia at ICU admission.