Minerva anestesiologica
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Minerva anestesiologica · Jan 2023
Randomized Controlled TrialEffect of co-administration of intravenous lidocaine and dexmedetomidine on the recovery from laparoscopic hysterectomy: a randomized controlled trial.
Some evidences have reported that intravenous lidocaine and dexmedetomidine alone can improve the quality of recovery after surgery. The main purpose of our study to explore whether co-administration of lidocaine and dexmedetomidine infusion could further improve the quality of recovery after laparoscopic hysterectomy compared to either lidocaine or dexmedetomidine administration. ⋯ Co-administration of lidocaine plus dexmedetomidine infusion improved to some extent the quality of recovery on POD1 compared to lidocaine and dexmedetomidine alone, but it significantly increased the incidence of intraoperative bradycardia and hypoxemia in the PACU, and prolonged the length of PACU stay.
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Minerva anestesiologica · Jan 2023
Meta AnalysisBrain tissue oxygenation monitoring in subarachnoid hemorrhage for the detection of delayed ischemia: a systematic review and meta-analysis.
Subarachnoid hemorrhage (SAH) is a severe subtype of stroke which can be caused by the rupture of an intracranial aneurysm. Following SAH, about 30% of patients develop a late neurologic deterioration due to a delayed cerebral ischemia (DCI). This is a metanalysis and systematic review on the association between values of brain tissue oxygenation (PbtO2) and DCI in patients with SAH. ⋯ PbtO2 values were significantly lower in patients with DCI. Waiting for definitive results, monitoring of PbtO2 should be considered as a complementary parameter for multimodal monitoring of the risk of DCI in patients with SAH.
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Minerva anestesiologica · Jan 2023
Comparison of high-flow nasal therapy, noninvasive ventilation, and continuous positive airway pressure on outcomes in critically ill patients admitted for COVID-19 with acute respiratory failure.
The optimal first-line noninvasive respiratory support (NIRS) to improve outcome in patients affected by COVID-19 pneumonia admitted to ICU is still debated. ⋯ Among ICU patients admitted for severe COVID-19 pneumonia and managed with NIRS, the outcome seems to differ according to the initial chosen strategy. Prospective randomized controlled studies are warranted to identify the optimal strategy.
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Minerva anestesiologica · Jan 2023
Impact of corticosteroids on the procoagulant profile of critically ill COVID-19 patients: a before-after study.
Several studies have reported an increased risk of thrombotic events in COVID-19 patients, but the pathophysiology of this procoagulant phenotype remains poorly understood. We hypothesized that corticosteroids may attenuate this procoagulant state through their anti-inflammatory effects. The aim of this study was to evaluate the impact of dexamethasone (DXM) on the coagulation profile of severely ill COVID-19 patients. ⋯ In critically ill COVID-19 patients, dexamethasone use was associated with a decrease in both pro-inflammatory and procoagulant profile.
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Minerva anestesiologica · Jan 2023
Indications and measures of medical emergency teams: a retrospective evaluation of in-hospital emergency operations of the German Resuscitation Register.
The present study examines characteristics and interventions of medical emergency teams (MET) in in-hospital emergency care. ⋯ Current in-hospital emergency care requires special skills in invasive hemodynamic and airway interventions. Recommendations from professional societies are necessary to optimize equipment (e.g. videolaryngoscopy, invasive blood pressure management), training, care algorithms and staff composition against the background of an increasing shortage of resources in the healthcare system.