Minerva anestesiologica
-
Minerva anestesiologica · Feb 2015
Recommendations for the organization of intensive care follow-up clinics; report from a survey and conference of Dutch intensive cares.
With the increasing awareness of postintensive care syndrome and the unbridled development of post-ICU clinics in the Netherlands, guidelines for ICU after care are needed. The purpose of this study was to develop recommendations for the set-up of post-ICU clinics. ⋯ This study recommends how to organize post-ICU clinics based on literature and expert opinion. The implementation of the recommendations will facilitate the set-up of post-ICU clinics, research on effectiveness of post-ICU clinics and benchmarking of quality of ICU care.
-
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.
-
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.
-
Minerva anestesiologica · Feb 2015
Real-time ultrasound guided percutaneous dilatational tracheostomy -with and without bronchoscopic control : an observational study.
Real-time ultrasound guidance may enable precise introducer needle and guidewire insertion during percutaneous dilatational tracheostomy (PDT). However, the safety of PDT done solely under ultrasound guidance has not been compared to additional bronchoscopic confirmation. We aimed to compare the efficacy, incidence of complications and procedural times of real-time ultrasound guided PDTs done with and without bronchoscopic confirmation. ⋯ Ultrasound guidance for PDT may be equally safe, even without bronchoscopic confirmation; the incidence of hypoxic episodes may be less and the procedure can be performed in less time.