Minerva anestesiologica
-
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.
-
Minerva anestesiologica · Sep 2020
Meta AnalysisEffects of anesthesia depth on postoperative cognitive function and inflammation: a systematic review and meta-analysis.
Postoperative cognitive dysfunction (POCD) and postoperative delirium (POD) are common postoperative complications in elderly patients. The effect of anesthesia depth on cognitive function remains unknown. We aimed to assess the correlations between anesthesia depth, cognitive function, and inflammation. ⋯ Light anesthesia was associated with a decrease in POD and may promote better neurocognitive function postoperatively in comparison with deep anesthesia.
-
Minerva anestesiologica · Apr 2020
A noninvasive postoperative clinical score to identify patients at risk for postoperative pulmonary complications: the airtest score.
Postoperative pulmonary complications (PPCs) negatively affect morbidity, healthcare costs and postsurgical survival. Preoperative and intraoperative peripheral oxyhemoglobin saturation (SpO2) levels are independent risk factors for postoperative pulmonary complications (PPCs). The air-test assesses the value of SpO2 while breathing room-air. We aimed at building a clinical score that includes the air-test for predicting the risk for PPCs. ⋯ The simple, non-invasive and inexpensive bedside air-test score, evaluating pre- and postoperatively SpO2 measured on room-air, helps to predict the risk for PPCs.
-
Minerva anestesiologica · May 2020
Randomized Controlled TrialChanges in plasma volume before and after major abdominal surgery following stroke volume variation-guided fluid therapy: a randomized controlled trial.
The aim of intraoperative fluid therapy is to avoid both hypovolemia and hypervolemia; however, the patient's exact volume status is difficult to determine during surgery. Fluid optimization guided by stroke volume variation (SVV) has been widely used in patients undergoing major open abdominal surgery. The aim of this study was to evaluate the changes in plasma volume before and after surgery following SVV-guided fluid therapy. ⋯ Fluid administration during surgery to maintain SVV below 13% was effective for maintaining the preoperative plasma volume until the end of surgery in patients undergoing major open stomach or colorectal surgery. This result supports the validity of SVV-guided fluid therapy, which maintains the SVV value below 13%, in terms of maintaining patient volume status.
-
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.