Minerva anestesiologica
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Minerva anestesiologica · Nov 2020
Randomized Controlled Trial Multicenter StudyHands-free induction of general anaesthesia: a randomised pilot study comparing usual care and high-flow nasal oxygen.
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Minerva anestesiologica · Nov 2020
Randomized Controlled TrialA randomised trial comparing the Ambu® Aura-i TM and the Ambu® Aura Gain TM laryngeal mask as conduit for tracheal intubation in children.
The Ambu Aura Gain is a newer second-generation supraglottic airway device designed for fibreoptic bronchoscopy (FOB)-guided tracheal intubation. ⋯ The Ambu Aura Gain served as a reliable device for FOB-guided tracheal intubation. Even if the time for intubation, when intubation was possible did not differ, the Aura-i showed only 79% intubation success, making it a doubtful device for FOB-guided tracheal intubation in cases of emergency and severe hypoxemia in small children.
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Minerva anestesiologica · Nov 2020
Pediatric pain review: what has happened since the First World Congress on Pediatric Pain in 1988? The past, the present and the future.
The present article summarizes the development within the field of pediatric pain during the last 30 years, with a special focus on pediatric postoperative pain. Insights concerning pain ontogeny, how pain influences the neuro-endocrine stress response and the induction of a "pain memory" is discussed as well as established and new options with regards to treatment of postoperative pain. Lastly, some aspects concerning future development within this field is discussed. ⋯ The use of regional anesthetic techniques should be used whenever possible and combined with appropriate systemic options, thereby producing multi-modal analgesia. However, new concepts and drugs are unfortunately few and, thus, progress often lies in using established drugs in more efficient ways. The concept of Enhanced Recovery After Surgery (ERAS) also provides a framework where high-quality postoperative pain relief is of essence for the best possible outcome after both minor and major surgery.
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Minerva anestesiologica · Nov 2020
CommentNoninvasive respiratory support in acute hypoxemic respiratory failure associated with COVID-19 and other viral infections.
Noninvasive respiratory support (NRS) such as noninvasive ventilation (NIV) and high flow nasal therapy (HFNT) have been used in the treatment of acute hypoxemic respiratory failure (AHRF) related to the coronavirus disease (COVID-19) and other viral infections. However, there is a lack of consensus in favor of or against NRS use due to the risks of worsening hypoxemia, intubation delay, and aerosols environmental contamination associated with the use of these tools. We aimed to summarize the evidence on the use of NRS in adult patients with COVID-19 and other viral pneumonia (i.e. H1N1, SARS, MERS) and AHRF. We also searched for studies evaluating the risk of aerosolization/contamination with these tools. ⋯ Use of NRS and treatment failure in the context of COVID-19 and viral infection associated-AHRF, varied widely. Dispersion of exhaled air is different depending on the type of respiratory therapies and interfaces. Data from randomized controlled trials are lacking.
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Minerva anestesiologica · Nov 2020
Observational StudyThe doctor's point of view: eye-tracking as an investigative tool in the extubationprocess in intensive care units. A pilot study.
Patient safety is a top priority in healthcare. Little is known about the visual behavior of professionals during high-risk procedures. The aim of this study was to assess feasibility, usability and safety of eye-tracking to analyze gaze patterns during the extubation process in the intensive care unit. ⋯ Eye-tracking can demonstrate that there is a mismatch between physicians' subjective evaluations and corresponding objective real-life measurements. Structured and standardized extubation processes should be performed to improve patient safety. In the immediate postextubation phase, long dwell time on the patient shows that clinical observation remains the most important cornerstone beyond monitoring devices.