Minerva anestesiologica
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Minerva anestesiologica · Mar 2014
Randomized Controlled Trial Comparative StudyOral Fiberoptic Intubation with Wire Reinforced Endotracheal Tube Vs. Parker Flex-Tip Tube: A Randomized Clinical Trial.
The aim of the study was to compare the Parker Flex-Tip (PFT) (group P) tube to a wire reinforced tracheal tube in two orientations, i.e., with posteriorly and anteriorly positioned tip bevels (WRP and WRA groups, respectively), for oral fiberoptic intubation. ⋯ Advancement of the ETT over a fiberoptic bronchoscope was easier with the PFT tube and with a posteriorly positioned wire-reinforced tube than with an anteriorly positioned wire-reinforced tube.
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Minerva anestesiologica · Mar 2014
Management program decreases postoperative nausea and vomiting in high-risk and in general surgical patients: a quality improvement cycle.
Preventing postoperative nausea and vomiting (PONV) is a major priority for postsurgical patient care. Our objective was to assess the efficacy of a multimodal postoperative nausea and vomiting (PONV) approach, which was associated with a continuous quality improvement program, in maintaining a low PONV incidence in the PACU. ⋯ We highlight the association with a sharp decrease in PONV incidence over a one-year period and a multimodal PONV approach using feedback to clinicians associated with continuous quality improvement program.
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Minerva anestesiologica · Mar 2014
Review Meta AnalysisA systematic review and individual patient data meta-analysis on intra-abdominal hypertension in critically ill patients: the wake-up project. World initiative on Abdominal Hypertension Epidemiology, a Unifying Project (WAKE-Up!).
Intra-abdominal hypertension (IAH), defined as a pathologically increase in intraabdominal pressure, is commonly found in critically ill patients. While IAH has been associated with several abdominal as well as extra-abdominal conditions, few studies have examined the occurrence of IAH in relation to mortality. The aim of this paper was to evaluate the prognostic role of IAH and its risk factors at admission in critically ill patients across a wide range of settings and countries. ⋯ Five hundred thirteen patients (30.8%) died in intensive care. The independent predictors for intensive care mortality were IAH, SAPS II score, SOFA score and admission category. This systematic review and individual patient data meta-analysis shows that IAH is frequently present in critically ill patients and it is an independent predictor for mortality.
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Minerva anestesiologica · Mar 2014
ReviewMechanical circulatory support for acute heart failure in 2013: an update on available devices, indications and results.
Severe acute heart failure often requires some form of mechanical support to circulation. The use of intraaortic balloon counterpulsation in postinfarction cardiogenic shock - perhaps the most common scenario of this kind - has been recently questioned in the IABP SHOCK trial. ⋯ Moreover, advances in technology and a reducing number of donors are leading to more extended indications to the implantation of ventricular assist devices. Herein, we offer a focused review on recent articles dealing with mechanical support to circulation in acute heart failure, which we found relevant in terms of their possible impact on therapeutic strategies and indication.