Minerva anestesiologica
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Minerva anestesiologica · Feb 2015
Observational StudyDoes the child behavior checklist predict levels of preoperative anxiety at anesthetic induction and postoperative emergence delirium? A prospective cohort study.
preoperative anxiety at induction and postoperative emergence delirium (ED) in children are associated with postoperative behavioral changes and adjustment disorders. This study's aim is to assess the value of the Child Behavior Checklist (CBCL) score in order to predict anxiety during induction and emergence delirium after anesthesia in children undergoing elective day-care surgery. ⋯ The CBCL predicted anxiety at induction but not ED.
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Minerva anestesiologica · Feb 2015
Elevated soluble endothelial protein C receptor levels at ICU admission are associated with sepsis development.
The endothelial protein C receptor (EPCR) is a protein that regulates the protein C anticoagulant and anti-inflammatory pathways. A soluble form of EPCR (sEPCR) circulates in plasma and inhibits activated protein C (APC) activities. The clinical impact of sEPCR and its involvement in the septic process is under investigation. In this study, we assessed the role of sEPCR levels as an early indicator of sepsis development. ⋯ Upon ICU admission, sEPCR levels in initially non-septic critically-ill patients appear elevated in the subjects who will subsequently become septic.
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Minerva anestesiologica · Feb 2015
Osteopontin induces soluble urokinase-type plasminogen activator receptor production and release.
Osteopontin (OPN) and soluble urokinase plasminogen activator receptor (suPAR) have been proposed as markers of disease severity and risk-stratification in infection and inflammation. In breast cancer, OPN and the membrane bound form of urokinase plasminogen activator receptor (uPAR) are functionally related, as OPN-induced cell migration depends on uPAR triggering by urokinase plasminogen activator (uPA). The aim of this study was to prospectively evaluate the kinetic of OPN and suPAR blood levels in patients developing septic shock (SS) compared to those not developing SS, and to investigate the relationships between these two biomarkers in immune cells in vitro. ⋯ These data suggest that OPN is partly responsible for the increased plasma levels of suPAR and might be a valuable tool to predict the occurrence of septic shock.
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Minerva anestesiologica · Feb 2015
Case ReportsRespiratory failure due to upper airway obstruction in children: use of the helmet as bridge interface.
Upper airway obstruction (UAO) can cause severe respiratory distress in young children by increasing inspiratory muscle load and decreasing alveolar ventilation, ultimately resulting in hypercapnia and hypoxemia which have long term negative cardiovascular effects. Although non-invasive continuous positive airway pressure (CPAP) improves gas exchange in these patients, use of conventional interfaces (nasal mask, nasal pillow and facial mask) may cause significant discomfort and lead to CPAP intolerance. ⋯ Thereafter, patients received training with respect to a nasal CPAP interface, allowing successful long term treatment. In conclusion, these five clinical cases demonstrate that helmet-CPAP can be used acutely in children with UAO if compliance to conventional modalities is problematic, allowing for sufficient time to achieve compliance to nasal-CPAP.