Minerva anestesiologica
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Minerva anestesiologica · Nov 2024
ReviewMultimodal analgesic strategies in polytraumatized patients.
In recent years, the resuscitation of trauma patients has improved; however, pain related to trauma remains associated with systemic complications. In trauma patients, pain should be considered a vital sign, and its control is crucial for reducing complications, improving patient satisfaction, and enhancing the quality of life. ⋯ In this review, we offer the reader an updated general framework of the various approaches available for pain treatment in polytraumatized patients, with a focus on the opportunities presented by regional anesthesia. We will examine different types of locoregional anesthesia blocks and describe ultrasonographic execution techniques.
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Minerva anestesiologica · Nov 2024
Randomized Controlled TrialSex related differences in applied tidal volume with flow-controlled ventilation: a subgroup analysis.
Flow-controlled ventilation (FCV) ensures a constant gas flow whereby precise determination of dynamic compliance is feasible. Accordingly, ventilator pressure settings can be adjusted to achieve the highest compliance. This setting will automatically adapt tidal volume to the functionally available lung volume as a personalized approach. This is in contrast to current ventilation settings, where fixed tidal volumes according to predicted body weight (PBW) are recommended. Aim of this subgroup-analysis was to determine whether applied tidal volume differs in male and female patients after compliance guided individualization of ventilation parameters. ⋯ Female patients were found to receive lower tidal volumes after compliance guided individualization compared to men during cardiac surgery. This finding may indicate that the functionally available lung volume in women is lower and thus using PBW may not adequately comply with sex related differences, which supports the use of a personalized ventilation strategy.
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Minerva anestesiologica · Nov 2024
Meta Analysis Comparative StudyCiprofol versus propofol for adult sedation in gastrointestinal endoscopic procedures: a systematic review and meta-analysis.
Although propofol is widely preferred as a sedative agent in gastrointestinal endoscopy, its use is commonly associated with hemodynamic adverse events. New sedatives, such as ciprofol, are emerging with promising results. Thus, we aimed to perform a systematic review and meta-analysis to compare efficacy-, safety-, and satisfaction-related outcomes between ciprofol and propofol for adult sedation in gastrointestinal endoscopy. ⋯ This systematic review and meta-analysis demonstrated similar clinical efficacy and better safety profile of ciprofol compared with propofol for adult sedation in gastrointestinal endoscopies. Furthermore, patient satisfaction scores were higher with ciprofol.
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Minerva anestesiologica · Nov 2024
Multicenter StudyBeliefs and attitudes of PICU doctors and nurses on parental presence and open visiting policies: an Italian nationwide survey.
The aim of the study is to investigate doctors' and nurses' beliefs and attitudes towards family presence and open visiting policies in Pediatric Intensive Care Units (PICUs) in Italy. ⋯ Most healthcare professionals in Italian PICUs believe that an open visiting policy for families is beneficial for both the patient and his/her family. However, despite an overall positive attitude among PICU staff members, there is still some resistance in Italy, particularly among nurses and in cardiac surgery units.
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Minerva anestesiologica · Nov 2024
Randomized Controlled TrialIndividualized positive end-expiratory pressure in laparoscopic surgery: a randomized controlled trial.
The reduction in functional residual capacity (FRC) is a significant pathological factor in the development of postoperative pulmonary complications. Appropriate positive end-expiratory pressure (PEEP) is critical to preserve FRC during mechanical ventilation. Our previous study suggests that using driving pressure-guided PEEP can reduce postoperative pulmonary complications. In this study, we hypothesize that individualized PEEP can increase immediate postoperative FRC and improve lung ventilation. ⋯ Driving pressure-guided PEEP can preserve postoperative FRC and provide better ventilation and oxygenation for patients undergoing laparoscopic colorectal surgery.