Minerva anestesiologica
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Minerva anestesiologica · May 2019
Observational StudySize and shape of the inferior vena cava before and after a fluid challenge: a pilot study.
Recent meta-analyses failed to support the reliability of ultrasound assessment of the inferior vena cava (IVC) to predict fluid responsiveness. However, the techniques utilized were heterogeneous. We hypothesized that the variability of the elliptic section and caliber of the IVC along its course may influence ultrasound evaluation. Therefore, we investigated IVC size and shape at four levels, before and after a fluid challenge. ⋯ The elliptic section should be considered when assessing IVC size. AP diameters are shorter and more affected by the respiratory cycle. After a fluid challenge, an increase of blood velocity associated with unchanged AP diameters may suggest fluid responsiveness.
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Minerva anestesiologica · May 2019
The velocity curve of the clotting waveform of rotational thromboelastometry predicts bleeding after cardiac surgery but conventional rotational thromboelastometric parameters do not.
Early detection of a risk of postoperative bleeding is essential in cardiac surgery patients. The aim of the present study was to evaluate the utility of the first derivative curve (the V-curve) of the clotting waveform of rotational thromboelastometry (ROTEM) in terms of predicting bleeding after cardiac surgery. ⋯ The ROTEM V-curve parameters can predict postoperative bleeding and clinical outcomes after cardiac surgery.
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Minerva anestesiologica · May 2019
Editorial CommentIntraoperative nociception: "if you can't measure it, you can't manage it".
Abstract