Minerva anestesiologica
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Minerva anestesiologica · May 2015
Review Meta AnalysisPharmacological treatments for acute respiratory distress syndrome: systematic review.
Our objective was to systematically review the effect of pharmacological therapies on mortality in patients with acute respiratory distress syndrome (ARDS), focusing on randomized controlled trials (RCTs) published since a previous review in 2004. ⋯ Effective pharmacotherapy for ARDS remains extremely limited. Cis-atracurium is a promising treatment for early moderate-severe ARDS (using Berlin definition nomenclature) and merits further investigation in a large RCT.
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Minerva anestesiologica · May 2015
Review Meta AnalysisThe effect of analgesic modality on outcome following open liver surgery: a systematic review of post-operative analgesia.
Postoperative analgesia following liver resection remains controversial. The traditional standard of care of thoracic epidural is increasingly questioned due to perceived associated complications and delays to recovery. Evidence supporting alternative analgesic techniques is emerging however best practice is not yet established. ⋯ Epidural offered equivalent or superior pain scores when compared to alternative techniques. In summary current evidence suggests alternative analgesic modalities may provide favorable recovery outcomes following liver surgery but consistent evidence is limited. Epidurals provide superior pain relief to alternatives but this does not translate into reduced length of stay or complication rate following liver surgery.
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Minerva anestesiologica · May 2015
ReviewOcular complications in robotic-assisted prostatectomy: a review of pathophysiology and prevention.
Ocular complications reported after robotic-assisted laparoscopic radical prostatectomy (RALP) include corneal abrasion and ischemic optic neuropathy. While corneal abrasions often resolve without permanent sequelae, scarring or infection can occasionally lead to vision loss and other adverse outcomes. ⋯ A review of the pathophysiology and incidence of ocular complications specific to robotic-assisted laparoscopic prostatectomy as well as the potential preventative measures in the current literature is presented to further inform and guide perioperative patient care. In addition we address other potential ocular complications and the impact of patient's ocular history on choice of RALP as a surgical treatment modality.
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Microcirculatory alterations are frequent in sepsis and different mechanisms can be implied and variously studied. The severity of microvascular alterations is associated with organ dysfunction and mortality. The aim of this review is to make an overview of the most actual and used techniques applied on septic humans. We aimed at focus on the impact of different techniques on the evaluation of patients' management and outcome.