Minerva anestesiologica
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Minerva anestesiologica · Nov 2020
Observational StudyProspective evaluation of preoperative lung ultrasound for prediction of perioperative outcome and myocardial injury in adult patients undergoing vascular surgery (LUPPO Study).
Myocardial injury after non-cardiac surgery (MINS) is a frequent perioperative event in vascular surgery, associated both with worse outcome and subsequent cardiovascular events. Current guidelines advocate troponin (hs-cTnT) and NT-proBNP measurements in selected patients before surgery, but accurate preoperative identification of patients at risk for MINS is an unmet clinical need. Focused lung ultrasound (LUS) might help to select patients at increased risk for MINS, because it can visualize B-line artifacts correlating to cardiopulmonary disease. Therefore, we investigated whether quantification of B-line artifacts improves perioperative risk predictive accuracy for MINS. ⋯ Lung ultrasound in combination with hs-cTnT showed a better test accuracy than hs-cTnT alone and might guide clinicians to identify vascular patients at increased risk for MINS.
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Minerva anestesiologica · Nov 2020
Validity of presepsin for the diagnosis and prognosis of sepsis in elderly patients admitted to the intensive care unit.
Preliminary reports suggested that presepsin was a powerful biomarker for sepsis in a general population. However, presepsin levels change with age. This study aimed to investigate the diagnostic and prognostic value of presepsin among elderly patients with sepsis in the intensive care unit (ICU). ⋯ The presepsin level was significantly higher in elderly patients with sepsis compared with the non-infection and infection groups. Presepsin has a reliable early diagnostic ability for sepsis comparable to that of PCT. However, it cannot be defined as a perfect biomarker for prognosis of 30-day mortality in elderly patients. An overall and continual assessment of all the clinical indexes for sepsis during the course of the disease is necessary.