Minerva anestesiologica
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Minerva anestesiologica · Mar 2018
Review Meta AnalysisEpidemiology of septic meningitis associated with neuraxial anesthesia: a historical review and meta-analysis.
Neuraxial anesthesia in the form of spinal and epidural are two of the most frequent forms of regional anesthesia. We aimed to describe and compare the relevant epidemiological, clinical and microbiological characteristics of all reported cases of septic meningitis associated with the use of spinal and epidural anesthetics. ⋯ While the true incidence remains speculative, this review suggests that given increasing indications for spinals and epidurals, septic meningitis remains an important associated with neuraxial anesthesia.
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Minerva anestesiologica · Dec 2017
Meta AnalysisRisk of spontaneous fungal peritonitis (SFP) in hospitalized cirrhotic patients with ascites: a systematic review of observational studies and meta-analysis.
Spontaneous fungal peritonitis (SFP) is an infection of ascitic fluid occurring in cirrhotic patients. SFP prevalence varies from 0% to 41% of patients with spontaneous peritonitis (SP) and a positive ascitic fluid culture. Cirrhotic patients with SFP who fail to show improvement with empirical antibiotic therapy, before the identification of the fungal pathogen, have high mortality (89.5-100%). Although the weight of the disease is so dramatic, more recent guidelines on infections in cirrhosis do not consider SFP management. The aim of this meta-analysis was to investigate the association between hospitalization (at least 48-72 hours after admission) and risk of SFP. ⋯ This meta-analysis suggests that hospitalization is related to a significant increase of SFP risk.
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Minerva anestesiologica · Aug 2017
Meta AnalysisBlood purification with continuous venovenous hemofiltration in patients with sepsis or acute respiratory distress syndrome. A systematic review and meta-analysis of randomized evidence.
Severe inflammatory conditions, as severe sepsis/septic shock and acute respiratory distress syndrome (ARDS), are related to high morbidity and mortality. We performed a meta-analysis of randomized trials to assess if blood purification with continuous veno-venous hemofiltration (CVVH) reduces mortality in these settings. ⋯ Overall, low-quality evidence indicates that blood purification with CVVH might be associated with a significant reduction in mortality when performed in patients with sepsis or ARDS. The evidence is still insufficient to support a definitive conclusion of benefit. Further high-quality randomized controlled trials, adequately powered for mortality, are needed to clarify the impact of CVVH on these conditions.
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Minerva anestesiologica · Aug 2017
Meta AnalysisEffect of remifentanil for general anaesthesia on parturients and newborns undergoing caesarean section: a meta-analysis.
The results presented by studies investigating the effect of remifentanil on both parturients and newborns during cesarean section differed significantly. Therefore, we performed a meta-analysis to estimate the effect of remifentanil on these patients. ⋯ Remifentanil shows potential value of maternal circulation response during general anesthesia, which reduces maternal blood pressure in response to intubation and surgery. However, whether it is beneficial for the neonate is still controversial. More randomized-controlled trials with larger sample size are required to assess the adverse effects of remifentanil.
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Minerva anestesiologica · Jul 2017
Meta AnalysisEffect of anesthesia methods on postoperative major adverse cardiac events and mortality after non-cardiac surgeries: a systematic review and meta-analysis.
Postoperative major adverse cardiac events (MACEs) are the main cause of postoperative mortality, and controversies exist regarding the effects of anesthesia methods on postoperative MACEs and mortality in high-risk cardiac patients after non-cardiac surgeries. ⋯ Sevoflurane anesthesia, or epidural combined with general anesthesia can provide short-term myocardial protective effect in high-risk cardiac patients undergoing intermediate- or high-risk non-cardiac surgeries.