Minerva anestesiologica
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Minerva anestesiologica · May 2015
Comparative StudyMeasurement of the Nociceptive Balance by Analgesia Nociception Index (ANI) and Surgical Pleth Index (SPI) during Sevoflurane - Remifentanil Anaesthesia.
Evaluation of the nociception-anti-nociception balance during anesthesia is still challenging and routinely based on clinical criteria such as movement or vegetative response. Recently, the Analgesia Nociception Index (ANI) derived from heart rate variability and the Surgical Pleth Index (SPI) derived from photoplethysmographic signal were introduced for quantification of the analgesic component of anesthesia. ⋯ Non-invasive monitoring of ANI and SPI reflected nociceptive stimulation during sevoflurane-remifentanil anesthesia and therefore may indicate the nociception - anti-nociception balance. Whether guidance of anesthesia by these variables will improve anesthesia care during surgery needs to be further evaluated.
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Minerva anestesiologica · May 2015
Elevated Beta-lactam concentrations are associated with neurological deterioration in ICU septic patients.
Although β-lactams are considered to have a safe therapeutic profile, neurotoxicity has been reported. The aim of this study was to assess the association between β-lactam concentrations and neurological alterations in septic ICU patients. ⋯ We found a correlation between high β-lactam trough concentrations and increased occurrence of neurological deterioration in septic ICU patients. Although our data cannot determine causality, monitoring of β-lactam levels should be considered when deterioration of neurological status occurs during critical illness.
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Minerva anestesiologica · May 2015
Observational StudyFocused intraoperative transthoracic echocardiography by anesthesiologists - a feasibility study.
Focused transthoracic echocardiography (TTE) is frequently used perioperatively for hemodynamic monitoring and diagnosis of cardiovascular instability, but less commonly intraoperatively. ⋯ TTE can be applied in the operating theatre during surgery, although its use during abdominal surgery is somewhat limited.