Minerva anestesiologica
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Postpartum chronic pain is a clinical reality which affects 6.1% to 11.5% of women after delivery and affects their recovery. The large range of incidence observed in the literature relies on criteria used to define chronic postpartum pain. The features depend on the type of delivery. ⋯ In opposite, after vaginal delivery, chronic pelvic pain and perineal pain have an important negative impact on women's mood and quality of life. As for any chronic pain, individual risk factors account more than degree of tissue trauma. From actual reports in the field, better pain education of both women and health care providers might help to reduce the problem.
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Minerva anestesiologica · Mar 2019
Observational StudyEvaluation of an active decision support system for hemodynamic optimization during elective major vascular surgery.
Active decision support systems implementing goal directed therapy may be an approach to reduce disparities in outcome between different health care providers. We assessed feasibility of and adherence to an active decision support system (ADSS) comprising fluids, vasopressors, and dobutamine to optimize hemodynamics during high-risk vascular surgery. ⋯ High rates of compliance underline clinical acceptability and feasibility of this ADSS during vascular surgery. It may therefore facilitate the work of anesthesiologists and reduce disparities in patient outcomes due to different healthcare providers. Particularly, rapidly developing hemodynamic perturbances as well as co-factors the ADSS as of now does not anticipate are current limitations. These findings may serve to further improve this stand-alone real-time ADSS.
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Minerva anestesiologica · Mar 2019
Prediction of extubation failure in intensive care unit: systematic review of parameters investigated.
Extubation failure (EF) refers to the inability to maintain spontaneous breathing after removal of endotracheal tube. The aim of this review is to identify the best parameter to predict EF in adult intensive care patients. ⋯ This review shows that all parameters used to predict EF have a low PPV. Therefore, the limitation of use of such predictive tests may prolong unnecessarily the intubation and increase the unfavorable outcome. A prospective study involving all variables could be useful to predict the EF in ICU.
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Minerva anestesiologica · Mar 2019
CommentPredicting extubation success: instrumental assessment, clinical tests and cave diving.
Abstract