Minerva anestesiologica
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Minerva anestesiologica · Mar 2020
Multicenter Study Observational StudyPediatric anesthesia practice in Italy: a multicenter national prospective observational study derived from the Apricot trial.
Pediatric anesthesia nowadays requires specific knowledge and expertise. The Anesthesia PRactice In Children Observational Trial (APRICOT) was a European multicenter study designed for the identification of perioperative severe critical events and management. We aimed at analyzing the Italian database in an attempt to determine the practice of anesthesia and the incidence of severe critical events in Italy. ⋯ This secondary analysis demonstrates that the incidence of severe critical incidence was lower in Italy in comparison to that reported for Europe. This low rate of critical events may be related to the high expertise and experience of the anesthesiologists in charge of the children in the Italian centres that participated to APRICOT.
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Minerva anestesiologica · Mar 2020
Randomized Controlled TrialEffect of remote ischemic preconditioning on hepatic ischemia-reperfusion injury in patients undergoing liver resection: a randomized controlled trial.
Studies in animal models have shown that remote ischemic preconditioning (RIPC) could protect the liver from hepatic ischemia-reperfusion injury (HIRI). The aim of this study was to examine whether RIPC could reduce HIRI in patients undergoing liver resection. ⋯ RIPC could reduce hepatic ischemia-reperfusion injury after liver resection.
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Minerva anestesiologica · Mar 2020
Meta AnalysisPredictive parameters of difficult intubation in thyroid surgery: a meta-analysis.
Airway management is a fundamental goal for the anesthesiologist. The rate of difficult laryngoscopy in patients undergoing thyroid surgery ranges from 6.8% to 9.6%. An accurate and detailed preoperative evaluation of the airway seems to be a promising tool to predict a potentially difficult airway management. We aimed to identify possible risk factors and physical findings that predict difficult intubation in thyroid surgery. ⋯ In thyroid patients, the presence of high Mallampati Score, shorter thyromental distance, interincisor gap, tracheal deviation (the unique thyroid pathology linked parameter), obesity and male gender were risk factors for difficult intubation. However, all these significant parameters should be used in preoperative assessment to anticipate difficult intubation in thyroid surgery.
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Cerebral ultrasound is a developing point of care tool for intensivists and emergency physicians, with an important role in the diagnosis of acute intracranial pathology, such as the assessment of cerebrovascular diseases and in the noninvasive intracranial pressure measurement both in the acute clinical settings and in intensive care unit (ICU). The traditional application of transcranial doppler (TCD) by assessing blood flow velocities in the main cerebral arteries, allows the evaluation and follow up of cerebral vasospasm, cerebral perfusion pressure, cerebral autoregulation and intracranial hypertension. The use of TCD, traditionally limited to the neurosonology laboratories settings, has expanded over the last years following the introduction of B-mode ultrasound and color Doppler, the transcranial color-coded duplex ultrasonography (TCCS), opening a new window to the assessment of cerebral anatomy not only in the neurocritical patients, but also in general ICU and emergency room patients. Here we report a brief review with the intent to up-to-date and describe the main applications and use of TCD/TCCS in the setting of Neurointensive Care.
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Minerva anestesiologica · Mar 2020
Randomized Controlled Trial Comparative StudyDevice stability and quality of ventilation of classic laryngeal mask airway versus air-Q and I-gel at different head and neck positions in anesthetized spontaneously breathing children.
Since its introduction into clinical practice, the use of laryngeal mask airway (LMA) has been dramatically increasing. We aimed to investigate the clinical performance of single use LMA classic, AIR-Q and I-gel at different head and neck positions and during the operative procedure in pediatric elective day case surgery. ⋯ Having the highest increase in OLP at neck flexion, the I-gel LMA exhibited the best ventilation parameters and fiberoptic view grade at different head and neck positions and throughout the intraoperative period.