Minerva anestesiologica
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Minerva anestesiologica · Sep 2020
Donation after circulatory death: possible strategies for in-situ organ preservation.
Donation after circulatory death (DCD) is an accepted strategy to expand the potential donor pool. The complexity of organ procurement from DCD donors requires the development of new strategies for organ preservation. Standard DCD organ recovery involves a super rapid technique, with cold thoracic and abdominal perfusion. ⋯ New strategies designed to improve the preservation of in-situ DCD grafts include the use of normothermic regional perfusion (NRP) for abdominal organs and concomitant cold lung flushing. The use of in-situ NRP is a significant advance in abdominal organ retrieval and it has the potential to increase organ recovery rates due to its applicability in both controlled and uncontrolled DCD donors. We describe an innovative preservation strategy based on the combination of donor NRP for abdominal organ preservation and a normothermic open-lung approach with protective mechanical ventilation for lung preservation.
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Minerva anestesiologica · Sep 2020
Abdominal aortic aneurysm patients remain at risk for delirium on the surgical ward after intensive care unit dismissal.
The incidence of delirium following open abdominal aortic aneurysm (AAA) surgery is significant, with incidence rates ranging from 12% to 33%. However, it remains unclear on what level of care a delirium develops in AAA patients. The aim of this study was to investigate the incidence of delirium in the ICU and on the surgical ward after AAA surgery. ⋯ Delirium frequently occurs in patients who undergo AAA surgery. This study demonstrated that patients on the surgical ward remain at risk of developing a delirium after ICU dismissal. Patients with ICU delirium differ in clinical characteristics and outcomes from patients with a delirium on the surgical ward.
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Minerva anestesiologica · Sep 2020
Early and late blood flow changes in the brachial artery following brachial plexus block.
A nerve block causes various hemodynamic changes in the vessel system. The primary objective of the present study is to examine the volume flow values in the brachial artery in the early and late period following an infraclavicular brachial plexus block. The secondary objective is to evaluate arterial diameter, forearm temperature and other Doppler ultrasound measurements in the late period. ⋯ The increase in volume flow following a change in the flow morphology after an infraclavicular nerve block persists for at least 24 hours. This may be the explanation for clinical advantage in all types of surgery and in particular after fractures, graft and reimplantation surgery.