Minerva anestesiologica
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Minerva anestesiologica · Aug 2019
Randomized Controlled Trial Multicenter StudyProportional Assist Ventilation feasibility in the early stage of respiratory failure: a prospective randomized multicenter trial.
Proportional assist ventilation (PAV+) is an assisted ventilator mode usually applied during weaning. We aimed to determine the feasibility of using PAV+ in the early phase of acute respiratory failure compared to volume-assist control ventilation (V-ACV) in order to shorten the length of mechanical ventilation (MV). ⋯ The use of high-assistance PAV+ in the early phase of MV does not present benefits compared to V-ACV. The high rate of PAV+ failure reinforces the need for sedative optimization, learning curve, and better patient selection.
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Minerva anestesiologica · Aug 2019
ReviewJoint consensus on anesthesia in urologic and gynecologic robotic surgery: specific issues in management from a task force of the SIAARTI, SIGO, and SIU.
Proper management of patients undergoing robotic-assisted urologic and gynecologic surgery must consider a series of peculiarities in the procedures for anesthesiology, critical care medicine, respiratory care, and pain management. Although the indications for robotic-assisted urogynecologic surgeries have increased in recent years, specific guidance documents are still lacking. ⋯ This consensus document provides guidance for the management of urologic and gynecologic patients scheduled for robotic-assisted surgery. Moreover, the identified unmet needs highlight the requirement for further prospective randomized studies.
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Minerva anestesiologica · Aug 2019
Observational StudyEarly dysglycemia and mortality in traumatic brain injury and subarachnoid hemorrhage.
Traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) are the most common causes of severe acute brain injury in younger Intensive Care Unit (ICU) patients. Dysglycemia (abnormal peak glycemia, glycemic variability, mean glycemia, nadir glycemia) is common in these patients but its comparative outcome associations are unclear. ⋯ In TBI and SAH patients, greater dysglycemia is associated with greater mortality. This association is significantly stronger than in the general population and it is significantly stronger in patients with TBI compared with SAH.
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Minerva anestesiologica · Aug 2019
An in-vitro study to evaluate high-volume low-pressure endotracheal tube cuff deflation dynamics.
High-volume low-pressure (HVLP) endotracheal tube (ETT) cuffs for critically ill patients often deflate during the course of mechanical ventilation. We performed an in-vitro study to comprehensively assess HVLP cuff deflation dynamics and potential preventive measures. ⋯ In controlled in-vitro settings, ETT cuffs consistently deflate over time, and the cuff pilot balloon valve plays a central role in this occurrence. Deflation rate decreases when cuffs are inflated within a plastic artificial tracheal model and mechanical ventilation is activated.
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Minerva anestesiologica · Aug 2019
Comparative StudyComparison of the incidence of perioperative cardiovascular risk events among patients with and without a history of neoadjuvant chemotherapy.
Chemotherapy predisposes individuals to increased risk for future cardiac events. ⋯ Patients who underwent neoadjuvant chemotherapy prior to radical mastectomy were more prone to cardiovascular risk events than those without chemotherapy history.