Minerva anestesiologica
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Minerva anestesiologica · Dec 2014
ReviewSurfactant from neonatal to pediatric ICU: bench and bedside evidence.
Surfactant is a cornerstone of neonatal critical care for the treatment of respiratory distress syndrome of preterm babies. However, other indications have been studied for various clinical conditions both in term neonates and in children beyond neonatal age. A high degree of evidence is not yet available in some cases and this is due to the complex and not yet totally understood physiopathology of the different types of pediatric and neonatal lung injury. ⋯ On the whole, surfactant is able to improve oxygenation in infection related respiratory failure, pulmonary hemorrhage and meconium aspiration syndrome. Bronchoalveolar lavage with surfactant solution is currently the only means to reduce mortality or need for extracorporeal life support in neonates with meconium aspiration. While surfactant bolus or lavage only improves the oxygenation and ventilatory requirements in other types of postneonatal acute respiratory distress syndrome (ARDS), there seems to be a reduction in the mortality of small infants with RSV-related ARDS.
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Minerva anestesiologica · Dec 2014
Resistive Index or Color-Doppler Semi-Quantitative Evaluation of Renal Perfusion by Inexperienced Physicians: Results of a pilot study.
Doppler-based renal resistive index (RI) calculation may help in the early detection of acute kidney injury (AKI). Its feasibility and reproducibility by inexperienced operators remain unknown. The main objective of this study was to compare performances of junior and senior operators in assessing renal perfusion using both the semiquantitative color-Doppler scale and RI calculation. ⋯ A brief course on renal Doppler allowed inexperienced operators to assess effectively renal perfusion with a good reliability when compared to senior operators. In addition, our results suggest the good diagnostic performance of both Doppler-based RI and semi-quantitative renal perfusion assessment in predicting short-term renal dysfunction reversibility.
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Minerva anestesiologica · Dec 2014
Validation study of Nexfin® continuous non-invasive blood pressure monitoring in critically ill adult patients.
Nexfin® (BMEYE, Amsterdam, The Netherlands) is a totally non-invasive blood pressure and cardiac output (CO) monitor based on finger arterial pulse contour analysis. ⋯ In this sample of critically ill patients we found a good correlation between MAPnex and invasive blood pressures obtained by PiCCO.