Minerva anestesiologica
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Minerva anestesiologica · Jul 2022
Randomized Controlled TrialIs HFJV a better alternative ventilation technique for percutaneous dilatational tracheostomy? A randomised trial.
High-frequency jet ventilation (HFJV) has been used for the treatment of tracheal lesions, airway surgery, and treatment of secondary lesions after tracheostomy for many years however, reports on the use of HFJV during percutaneous dilatational tracheostomy (PDT) are limited. This study compares the use of traditional method, ventilation with laryngeal mask airway (LMA), and HFJV through endotracheal tube (ETT) with respect to the duration of PDT procedure and complications. ⋯ HFJV may be a more effective alternative method for airway management during PDT, facilitating and reducing the duration of the intervention.
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Minerva anestesiologica · Jul 2022
Point of care coagulation management in anesthesiology and critical care.
Point of care (POC) devices are increasingly used in the ICU and in anesthesia. Besides POC-devices for blood gas analysis, several devices are available for coagulation measurements. Although basic principles for thromboelastographic measurements are not novel, some promising developments were made during the last decade improving both user-friendliness and measurement reliability. ⋯ On the other hand, benefits of POC-devices need to be balanced against limitations, which include technical restrictions and operator related errors, mainly affecting reproducibility and interpretation of results. Therefore, it is recommendable to consider results of POC-coagulation testing in comparison to standard laboratory tests (SLT). Nevertheless, in urgent or emergency situations POC results enable fast decision making to optimize patient care.
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Minerva anestesiologica · Jul 2022
Observational StudyUse of an intraoperative veno-venous bypass during liver transplantation: an observational, single center, cohort study.
As previous studies demonstrated conflicting results, we investigated the hemodynamic and renal outcomes of the intra-operative use of a veno-venous bypass during liver transplantation. ⋯ Our data suggest that the use of a veno-venous bypass fails to release the increased renal venous backflow from inferior vena cava clamping resulting in renal congestion with reduced renal perfusion pressure.
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Minerva anestesiologica · Jul 2022
Prediction of platelet counts with ROTEM-sigma in cardiac surgery.
Excessive bleeding is common after cardiac surgery. According to transfusion algorithms based on ROTEM results (TEM International Inc., Munich, Germany), platelet transfusion is recommended when FIBTEM amplitude is normal and EXTEM amplitude is reduced. The aim of this study was to evaluate whether ROTEM (TEM International Inc.) parameters may predict accurately platelet counts in cardiac surgery patients, and to determine which of these parameters is the most useful for predicting platelet counts. ⋯ This study demonstrates the reliability of considering early ROTEM (TEM International Inc.) results and the feasibility of using PLTEM A5 to predict platelet counts and so, improve our ability to decide the need of platelet transfusion in cardiac surgery patients.