Minerva anestesiologica
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Minerva anestesiologica · Apr 2017
Comparative StudyComparison of terminal extubation and terminal weaning as mechanical ventilation withdrawal in ICU patients.
Terminal extubation (TE) is applied in some Intensive Care Units (ICU) patients when a decision of withdrawal of mechanical ventilation is decided. Other units prefer terminal weaning (TW) with no removal of the endotracheal tube. We report our experience with these two procedures. ⋯ In our Unit, TE is a practice largely approved by family members. This procedure does not require higher doses of sedatives and allows the nearest relatives to be present at time of death.
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Minerva anestesiologica · Apr 2017
Randomized Controlled Trial Comparative StudyComparing incidence of emergence delirium between sevoflurane and desflurane in children following routine otolaryngology procedures.
Emergence delirium (ED) is a state of aggressive agitation that can occur temporarily in the process of emerging from anesthesia in children exposed to volatile or intravenous anesthetics. Emergence delirium is typically assessed using the published and validated Pediatric Emergence Delirium (PAED) Scale. Due to some variation in properties between sevoflurane and desflurane for maintenance of anesthesia after standard sevoflurane induction, we designed a prospective study to examine potential differences in emergence behavior and incidence of ED in children undergoing elective ear-nose-throat surgery. ⋯ In conclusion, the use of desflurane for maintenance of anesthesia did not significantly affect the incidence or duration of ED when compared to sevoflurane. However, desflurane did not demonstrate any increase in adverse events, which may support its routine use in this patient population.
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Minerva anestesiologica · Apr 2017
ReviewClinical indices and biomarkers for perioperative cardiac risk stratification: an update.
European Society of Cardiology (ESC)/ European Society of Anesthesiology (ESA) highlighted that anesthesiologist has a leading role in perioperative cardiovascular assessment and management in the year of 2014. During cardiovascular assessment one can rely on cooperation of multidisciplinary specialists like: other anesthesiologists, cardiologists and surgeons. For the purpose of precise systematization and decision making the Lee Score or NSQUIP database can be used besides the traditionally used ASA Score. ⋯ Biomarkers are considered to represent a foundation of evidence based medicine and they help anesthesiologists in the decision-making process. They increase the chance to achieve the best clinical outcome for each patient. An ideal biomarker does not exist and therefore new research are currently being conducted with the aim to find and declare more specific biomarkers like heart-type fatty acid-binding protein, micro RNA, PAMP and high sensitivity troponins T.