Minerva anestesiologica
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Fluid management during thoracic anesthesia remains as a challenge for the anesthesiologists. The "safe zone" between volume overload (risk of pulmonary edema) and hypovolemia (potential risk of renal failure) is hard to determine and narrow. Relationship between perioperative fluid administration and postoperative lung injury has been clearly demonstrated but lung injury can even occur after the most restrictive management. ⋯ Fluid type (crystalloids or colloids) is also another unclear point, although balanced solutions should be preferred for crystalloids. Minimal discontinuation of oral hydration, early feeding and mobilization should be encouraged. This review summarizes current evidence on the topic and highlights unanswered questions.
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Minerva anestesiologica · Jun 2017
Randomized Controlled TrialAdding dexmedetomidine to ropivacaine for femoral nerve block inhibit local inflammatory response.
Peripheral nerve block has an anti-inflammatory effect that is confirmed in animal studies, while inconclusive in human studies. Dexmedetomidine (DEX), a highly selective α2-adenoceptor agonist, has a potent anti-inflammatory effect. The aim of this study was to evaluate the effect of DEX added to ropivacaine for femoral nerve block (FNB) on local inflammatory response after total knee arthroplasty (TKA). ⋯ Adding 1 µg/kg dexmedetomidine to ropivacaine for femoral nerve block had a significantly inhibitory effect on local inflammatory response and showed superior postoperative pain control to ropivacaine alone after TKA.
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Minerva anestesiologica · Jun 2017
Multicenter StudyEpidemiology and outcomes of cardiac arrest among children with Down syndrome: a multicenter analysis.
With the increasing prevalence of Down Syndrome, it is unknown if children with Down Syndrome are associated with increased incidence of cardiac arrest and poor outcomes after cardiac arrest. The objective of this study was to evaluate the epidemiology of cardiac arrest and mortality after cardiac arrest among critically ill children with and without Down Syndrome. ⋯ Both incidence of cardiac arrest, and mortality at hospital discharge in those with cardiac arrest vary substantially in children with and without Down Syndrome.
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Minerva anestesiologica · Jun 2017
Comparative Study Observational StudyCritically ill octogenarians and nonagenarians: evaluation of long-term outcomes, post-hospital trajectories and quality of life one year and seven years after ICU discharge.
The aim of this study was to investigate long-term outcomes, posthospital trajectories, and quality of life (QOL) in patients ≥80 years admitted to the Intensive Care Unit (ICU) of a tertiary care hospital. ⋯ Most critically ill long-term elderly survivors lived at home, perceived their QOL as acceptable, and wanted to be readmitted to the ICU if necessary. In older patients, age alone is a poor indicator of the possible value to be gained from an ICU admission.
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Minerva anestesiologica · Jun 2017
Observational StudyCauses of sore throat after intubation: a prospective observational study of multiple anaesthesia variables.
Sore throat is common after intubation for surgery. This observational study investigated cuff pressure and a large range of clinical covariates to explore the etiology of sore throat. ⋯ Only age and the presence of a nasogastric tube after surgery were significant predictors for sore throat. This result contradicts most other studies of cuff pressure where fewer covariates were measured.