Minerva anestesiologica
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Minerva anestesiologica · Oct 2020
Regional intratidal gas distribution in acute lung injury and acute respiratory distress syndrome--assessed by electric impedance tomography.
Regional tidal volume distribution and end-expiratory lung volume (EELV) distribution in patients with acute lung injury and acute respiratory distress syndrome (ALI, ARDS) have previously been investigated using computed tomograpy and electric impedance tomography (EIT). In the present study, we utilized the high temporal resolution of EIT to assess intratidal gas distribution. ⋯ On-line intratidal gas distribution monitoring offers additional information on recruitability and optimal PEEP.
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Minerva anestesiologica · Oct 2020
Observational StudyThe influence of pain expectation on pain experience after orthopedic surgery: an observational cohort study.
Current literature about the effects of patients' expectations on relevant outcome measures is still conflicting and incomplete. The aim of this prospective observational study was to assess the influence of expectations and the fulfillment of expectations on postoperative pain intensity and pain relief. Furthermore, clinical characteristics influencing expectations and the fulfillment of expectations were explored. ⋯ Our study indicates that postoperative pain and satisfaction with the treatment are associated with the degree of fulfillment of expectations rather than the expected pain itself.
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Minerva anestesiologica · Oct 2020
The predictive ability of carotid artery corrected flow time and respirophasic variation in blood flow peak velocity measured by ultrasonography for fluid responsiveness in parturients for cesarean delivery.
Ultrasonic measurements of carotid artery corrected flow time (FTc) and respirophasic variation in blood flow peak velocity (ΔV
peak ) were recently introduced to predict fluid responsiveness in non-obstetric patients. We designed the present study to evaluate the performance of these two ultrasonic indices in predicting fluid responsiveness in healthy parturients. ⋯ Compared with IVCins , IVCexp and IVCCI, FTc and ΔVpeak measured by ultrasonography seem to be the highly feasible and reliable methods to predict fluid responsiveness in parturients with spontaneous breathing undergoing elective cesarean delivery. -
Minerva anestesiologica · Oct 2020
The assessment of esophageal pressure using different devices: a validation study.
Although esophageal pressure measurement could help clinicians to improve the ventilatory management of acute respiratory distress syndrome (ARDS) patients, it has been mainly used in clinical research. Aim of this study was to compare the measurements of end-expiratory esophageal pressure, end-expiratory transpulmonary pressure and lung stress by three systems: a dedicated manual device, taken as gold standard, a new automatic system (Optivent) and a bedside equipment, consisting of a mechanical ventilator and a hemodynamic monitor. ⋯ Both Optivent and the bedside system showed clinically acceptability if compared to the gold standard device. The possibility to apply one of these systems could allow a wider use of esophageal pressure in clinical practice.
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Minerva anestesiologica · Oct 2020
Dynamic bedside assessment of the physiologic effects of prone position in acute respiratory distress syndrome patients by electrical impedance tomography.
Prone position (PP) improves acute respiratory distress syndrome (ARDS) survival by reducing the risk of ventilation-induced lung injury. However, inter-individual variability is a hallmark of ARDS and lung protection by PP might not be optimal in all patients. In the present study, we dynamically assessed physiologic effects of PP by electrical impedance tomography (EIT) and identified predictors of improved lung protection by PP in ARDS patients. ⋯ EIT enables dynamic bedside assessment of the physiologic effects of PP and might support early recognition of ARDS patients more likely to benefit from PP.