Minerva anestesiologica
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Minerva anestesiologica · Sep 2014
ReviewFriday night ventilation a safety starting tool kit for mechanically ventilated patients.
We wish to report here a practical approach to an acute respiratory distress syndrome (ARDS) patient as devised by a group of intensivists with different expertise. The referral scenario is an intensive care unit of a Community Hospital with limited technology, where a young doctor, alone, must deal with this complicate syndrome during the night. The knowledge of pulse oximetry at room air and at 100% oxygen allows to estimate the PaO2 and the cause of hypoxemia, shunt vs. ⋯ PEEP from 5 to 10, from 10 to 15 and greater than 15 cmH2O should be set in mild, moderate and severe ARDS, respectively. Prone position should be applied in severe ARDS, if experience is available. In case of unchanged conditions or increased ARDS severity a referral center should be contacted.
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Minerva anestesiologica · Sep 2014
Review Meta AnalysisUpdate of recommendations for analgosedation in Pediatric Intensive Care Unit.
Effective and adequate therapy to control pain and stress are essential in managing children in Pediatric Intensive Care Unit (PICU) undergoing painful invasive procedures, this should be, but is not yet, one of our main aims. Aware that this difficult mission must be pursued in a systematic, multimodal and multitasking way, the Studying Group on Analgosedation in PICU from the Italian Society of Neonatal and Paediatric Anesthesia and Intensive Care (SARNePI) is providing its recommendations.
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Minerva anestesiologica · Sep 2014
A PILOT STUDY OF TRANSCRANIAL DOPPLER GUIDED INITIAL RESUSCITATION OF TRAUMATIC AND NON TRAUMATIC COMATOSE PATIENTS.
The aim of this study was to evaluate the usefulness of early Transcranial Doppler (TCD) in guiding initial resuscitation of traumatic and non-traumatic comatose patients before diagnostic imaging and invasive neurologic monitoring. ⋯ Our study suggests that early TCD is feasible to evaluate qualitative information about cerebral perfusion in comatose patients while they are waiting for diagnostic imaging studies.
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Minerva anestesiologica · Sep 2014
Right ventricular stroke volume variation: a tool to assess right ventricular volume responsiveness.
So far, only left ventricular functional preload indices are used as a routine to assess volume responsiveness. Right ventricular (RV) functional preload indices have been described, but offer no continuous monitoring. ⋯ RVSVV seems to reflect volume requirement of the right ventricle and it might prove a reliable parameter to assess volume responsiveness in RVF.