Minerva anestesiologica
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Minerva anestesiologica · Jan 2021
Meta AnalysisRole of dexmedetomidine in the treatment of delirium in critically ill patients: a systematic review and meta-analysis.
Although dexmedetomidine has been found to prevent delirium in critically ill patients, it is uncertain whether it can treat acute delirium. This study aimed to evaluate the efficacy and safety of dexmedetomidine in treating delirium, by analyzing and reviewing data from previous studies. ⋯ Dexmedetomidine promotes the resolution of delirium but also increases the incidence of bradycardia during treatment. Furthermore, it may be superior to haloperidol in treating delirium, although more studies are needed to confirm this.
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Minerva anestesiologica · Jan 2021
Observational StudyHigh-mobility group box 1 protein as a novel biomarker to diagnose healthcare-associated ventriculitis and meningitis: a pilot study.
The diagnosis of healthcare-associated ventriculitis and meningitis (HAVM) is challenging in the ICU setting. Traditional cerebrospinal fluid (CSF) markers and clinical signs of infection fail to diagnose HAVM in the critically ill setting. We sought to determine the diagnostic accuracy of measuring levels of high-mobility group box 1 (HMGB1) protein in cerebrospinal fluid (CSF) for the diagnosis of HAVM. ⋯ HMGB1 is an accurate marker of HAVM and it adds incremental diagnostic value when paired with CSF-glucose measurements. Future larger and multicenter studies should assess the incremental diagnostic value of HMGB1 data when used alongside other established CSF markers of infection, and the external validity of these preliminary results.
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Minerva anestesiologica · Jan 2021
Future in regional anesthesia: new techniques and technological advancements.
Regional anesthesia has a very interesting long history, initially preferred over general anesthesia because of safety concerns, then for a period general anesthesia became safer and was preferred. The use of innovative technologies such as ultrasound technology has made the blocks safer and successful by directly visualizing targeted nerves and the location of local anesthetics. ⋯ Moreover, new extended-release local anesthetic agents have begun to be promising time-efficient and longer duration of analgesia with a single injection. In this article, we attempt to summarize some of the novel block techniques, pharmacological agents, and new technologies in the field of regional anesthesia.