Minerva anestesiologica
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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.
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Minerva anestesiologica · Sep 2014
ReviewGlucocorticoid administration in sepsis and septic shock:time for a paradigm change?
The use of corticosteroids in patients with septic shock remains controversial. Questions remain regarding the more appropriate dose, the optimal timing to initiate therapy, the selection of patients who will benefit most from the treatment and the exact mechanisms involved in their effectiveness. ⋯ However, altered expression and/or function of corticosteroid receptors may still suggest that higher hydrocortisone doses are necessary to overcome this so-called "steroid-resistance". In this article, we summarized these recent concepts and discussed how they could influence the administration of corticosteroids in such patients.
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Minerva anestesiologica · Sep 2014
Observational StudyMathematical coupling of data between global end diastolic volume index and cardiac index calculated by the PiCCO device: myth or reality?
Aim of the study was to investigate whether cardiac index (CI) and global end diastolic volume index (GEDVi) determined from the same thermodilution curve are mathematically coupled during the infusion of an inotropic agent in critically ill patients. ⋯ Our study provides evidence that changes in GEDVi are mathematically coupled to changes in CI during dobutamine infusion. Therefore, clinicians using PiCCO device to evaluate GEDVi must be aware of the underlying formula to avoid placing undue reliance on artifactual correlations due to mathematical coupling.