Minerva anestesiologica
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Minerva anestesiologica · Dec 2019
Observational StudyElevated ferritin and soluble CD25 in critically ill patients are associated with parameters of (hyper) inflammation and lymphocyte cytotoxicity.
Critically ill patients may develop a potentially fatal hyperinflammatory condition known as secondary (acquired) hemophagocytic lymphohistiocytosis (sHLH), the cause of which is unclear. We evaluated serum ferritin and soluble CD25 (sCD25) in critically ill patients, and their association with other parameters of inflammation and critical illness. Moreover, aiming to better understand the pathogenesis of sHLH, we also evaluated lymphocyte cytotoxicity parameters and correlations with the inflammatory markers ferritin and sCD25. ⋯ Our study suggests that hyperferritinemia and sCD25 correlate with other laboratory parameters indicative of severe hyperinflammation and organ dysfunction in critically ill ICU-patients, indicating their value in identifying hyperinflammatory critically ill patients for early intervention. Furthermore, it suggests that hyperferritinemia and hyperinflammation may partly be associated with a low percentage circulating NK-cells, and hence, the associated low lymphocyte cytotoxicity.
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Minerva anestesiologica · Dec 2019
Comparative StudyAutomated measurement of tracheal and main bronchial diameters: a feasibility study.
A thoracic computed tomography scan is rarely used to help choose the appropriate double-lumen tube. Nowadays, bronchial measurements can be automated using dedicated software. The aim of this prospective monocentric study was to compare manual and automated measurements of the diameter of the trachea and both main bronchi in adult patients free from a history of lung surgery or disease. ⋯ This feasibility study has mixed results since automated measurements were not feasible in around 20% of the cases.
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Minerva anestesiologica · Dec 2019
Randomized Controlled Trial Comparative StudySurgical Pleth Index And Analgesia Nociception Index for intraoperative analgesia in patients undergoing neurosurgical spinal procedures, a comparative randomized study.
The Surgical Plethysmographic Index (SPI) and the Analgesia Nociception Index (ANI) have been suggested for the non-invasive intraoperative monitoring of nociception/anti-nociception balance. We aimed to compare patterns of intraoperative use of opioids, postoperative cortisol levels and postoperative pain scores after intraoperative analgesia guided either by ANI, SPI or anesthesiologist's judgment. ⋯ Both ANI and SPI guidance significantly modified intraoperative opioid use, but no modification of postoperative cortisol levels and postoperative pain was observed.
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Minerva anestesiologica · Dec 2019
Randomized Controlled Trial Comparative StudySensory assessment and block duration of transmuscular quadratus lumborum block at L2 versus L4 in volunteers: a randomized controlled trial.
The efficacy of an ultrasound guided transmuscular quadratus lumborum block (QLB) for perioperative analgesia of the upper and lower abdomen remain debatable. The purpose of this study was to compare the cutaneous sensory blocked area (CSBA) between QLB blocks performed at the L2 vs. L4 levels. ⋯ Ultrasound guided transmuscular QLB injection of 0.375% 20 mL ropivacaine at the L2 level produced a widespread cutaneous sensory blockade and a prolonged sensory block to cold sensation compared with the L4 level.