Minerva anestesiologica
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Minerva anestesiologica · Mar 2020
Thoracic continuous spinal anesthesia for high-risk comorbid older patients undergoing major abdominal surgery: one-year experience of an Italian geriatric hospital.
General anesthesia is associated with high morbidity/mortality in comorbid older adults. Thoracic continuous spinal anesthesia/analgesia (TCSA) may be an alternative for major abdominal surgery. We report a one-year experience of the use of TCSA in an Italian geriatric center. ⋯ TCSA may be a valid alternative to general anesthesia in high-risk older patients undergoing major abdominal surgery. Further studies are needed to confirm its safety and benefits.
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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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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.