Minerva anestesiologica
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Non-invasive ventilation (NIV) is a very effective technique for severe acute exacerbations of COPD/COLD and acute pulmonary edema, but its interest is still a matter of debate for severe asthma attacks. However, despite a slow decrease in asthma mortality, which actually mainly concerns older people, the prevalence of asthma is still raising and is associated to a high level of emergency visits and ICU hospitalizations for severe asthma attacks. ⋯ From a technical point of view, one can expect in the future some improvements by combining NIV and nebulization and/or helium-oxygen therapy. Finally, there is a need for positive large randomized clinical trials before routine clinical use can be firmly recommended.
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Minerva anestesiologica · Aug 2013
Editorial CommentPerioperative administration of colloids: far from good?
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Minerva anestesiologica · Aug 2013
Predicting hospital mortality in adult patients with prolonged stay (>14 days) in surgical intensive care unit.
The aim of this paper was to identify the factors at surgical intensive care unit (SICU) admission and during the following SICU course that influence hospital mortality of patients with prolonged SICU stay (>14 days). ⋯ This validated predictive model reached clinically accurate discriminatory power, and may serve to improve patient care and resource utilization in the SICU.
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Minerva anestesiologica · Aug 2013
Effects of intraoperative colloid administration on outcome in a population-based general surgical cohort: a propensity score analysis.
Many studies on colloids have recently been retracted, leaving us with uncertain evidence of their safety. We aimed to analyze whether intraoperative colloid administration is associated with postoperative complications. ⋯ Our study suggests an association of intraoperative colloid administration, mainly of 130/0.4 hydroxyethyl starches, with diverse major postoperative complications and longer hospital stay. Controlled studies are urgently needed to assess the safety profile of colloid use in surgical patients.
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Minerva anestesiologica · Aug 2013
Observational StudyAmmonia plasma concentration and prolonged infusion of remifentanil in patients with acute kidney injury.
Glycine is an excipient of remifentanil and may induce side effects. To investigate glycine and ammonia concentration with the use of remifentanil in Intensive Care Unit patients with acute kidney injury (AKI) defined by a decrease in creatinine clearance above 50%. ⋯ Remifentanil was not associated with an accumulation of glycine or ammonia in patients with AKI. Plasma ammonia concentration was correlated with the mean rate of remifentanil and creatinine clearance. A 72-hours remifentanil infusion appeared safe for sedation of patients with AKI.