Minerva anestesiologica
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Minerva anestesiologica · Jun 2020
Acute reduction of cerebrospinal fluid volume prior to spinal anaesthesia: implications for sensory block extent.
Multiple patient and clinical characteristics contribute to the variable outcome of spinal anesthesia (SPA). Acute reduction of cerebrospinal fluid (CSF) volume may alter the effect of SPA. The objective of the present study was to test if aspiration of 10 mL CSF immediately prior to SPA is associated with higher extent of sensory block. ⋯ Acute reduction of CSF volume by 10 mL prior to SPA leads to a higher thoracic level of sensory block.
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Minerva anestesiologica · Jun 2020
Electroencephalographic density spectral array monitoring during propofol sedation in teenagers, using the narcotrend electroencephalographic monitor.
Recently published articles address concerns about the safe use of currently available index-based depth of hypnosis monitors. Electroencephalographic Density Spectral Array monitoring facilitates the interpretation of unprocessed electroencephalogram data, providing the anesthesiologist with real-time drug-specific information on hypnotic depth. The primary aim of this study was to investigate the clinical applicability of Density Spectral Array with a commercially available monitor as the Narcotrend EEG monitor in teenagers under procedural sedation using propofol. ⋯ We were able to show that DSA displayed in real time, on a commercially available DoA monitor (the Narcotrend EEG monitor), can provide the anesthesiologist with understandable information regarding the dose-dependent EEG effects of propofol in teenagers.
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Minerva anestesiologica · Jun 2020
Impact of imipenem concentration in lung perfusate and tissue biopsy during clinical ex vivo lung perfusion (EVLP) of high-risk lung donors.
Normothermic ex-vivo lung perfusion (EVLP) limits organ donor shortage by potentially using high-risk donor lungs. Microbial burden reduction has been demonstrated after EVLP using antibiotic prophylaxis with imipenem. However, no data have been published on the clinical consequences of the potential residual bacterial burden. ⋯ Recipients with the same bacterial species isolated in their donors had higher risk of pulmonary inflammation and early post-transplant pneumonia. Improvements in antimicrobial strategies during EVLP are warranted to minimize the consequences of donor associated respiratory infection.
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Minerva anestesiologica · Jun 2020
Correction to: A year in review in Minerva Anestesiologica 2019. Critical care.
This corrects the article DOI:10.23736/S0375-9393.20.14384-0.
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Minerva anestesiologica · Jun 2020
Levosimendan to facilitate weaning from cardiorespiratory support in critically ill patients: current evidence and future directions.
Appropriate weaning is of crucial importance for critically ill patients requiring respiratory support. However, a remarkable proportion of them are difficult to wean. Levosimendan is a positive inotropic agent characterized by vasodilatory properties, which is used for the treatment of acute decompensated heart failure or in patients needing inotropic treatment, including cardiogenic shock, septic shock, pulmonary hypertension and right ventricular dysfunction, needed for hemodynamic support in patients with diuretic resistance, and weaning either from ventilator or from extracorporeal membrane oxygenation. This position paper will discuss the use of levosimendan in facilitating weaning from cardiorespiratory support in critically ill patients, according to available evidence and the personal experience of a group of Italian Experts.