Minerva anestesiologica
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Minerva anestesiologica · Sep 2019
Randomized Controlled Trial Multicenter Study Comparative StudyPostoperative analgesia and early functional recovery after day-case anterior cruciate ligament reconstruction: a randomized trial on local anesthetic delivery methods for continuous infusion adductor canal block.
This study assessed the effects of different local anesthetic delivery techniques for continuous adductor canal block, after arthroscopic day-case anterior cruciate ligament reconstruction (ACLR). ⋯ Intermittent boluses did not provide superior analgesia over continuous infusion for adductor canal block after outpatient ACLR, but significantly decreased the local anesthetic consumption. Both techniques are suitable for the early functional recovery.
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Minerva anestesiologica · Aug 2019
Randomized Controlled Trial Multicenter StudyProportional Assist Ventilation feasibility in the early stage of respiratory failure: a prospective randomized multicenter trial.
Proportional assist ventilation (PAV+) is an assisted ventilator mode usually applied during weaning. We aimed to determine the feasibility of using PAV+ in the early phase of acute respiratory failure compared to volume-assist control ventilation (V-ACV) in order to shorten the length of mechanical ventilation (MV). ⋯ The use of high-assistance PAV+ in the early phase of MV does not present benefits compared to V-ACV. The high rate of PAV+ failure reinforces the need for sedative optimization, learning curve, and better patient selection.
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Minerva anestesiologica · Feb 2019
Multicenter Study Observational StudyProlonged sedation in critically ill children: is dexmedetomidine a safe option for younger age? An off-label experience.
Dexmedetomidine (DEX) is an alpha-2-adrenergic agonist, recently approved by Italian-Medicines-Agency for difficult sedation in pediatrics, but few data exist regarding prolonged infusions in critically-ill children, especially in younger ages. Aim of our study was to evaluate DEX use and safety for prolonged sedation in Pediatric Intensive Care Units (PICUs). ⋯ DEX was confirmed as useful and relatively safe drug for prolonged sedation in critically-ill children, particularly in younger ages. Main AEs were cardiovascular, reversible, related with higher doses, with the concomitant use of benzodiazepines or multiple sedation drugs and with the presence of withdrawal syndrome.
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Minerva anestesiologica · Jan 2019
Multicenter Study Observational StudyPreoperative predictive model for acute kidney injury after elective cardiac surgery: a prospective multicenter cohort study.
Predictive models of acute kidney injury after cardiac surgery (CS-AKI) include emergency surgery and patients with hemodynamic instability. Our objective was to evaluate the performance of validated predictive models (Thakar and Demirjian) in elective cardiac surgery and to propose a better score in the case of poor performance. ⋯ We developed a new simple predictive model of CS-AKI in elective surgery based on available preoperative information. Our new model is easy to calculate and can be an effective tool for communicating risk to patients and guiding decision-making in the perioperative period. The study requires external validation.
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Minerva anestesiologica · Aug 2018
Multicenter StudyWorkload and severity of illness of patients on intensive care units with available intermediate care units: a multicenter cohort study.
Intermediate Care Units (IMCU) are established in many hospitals to better match the requirements of patient care with respect to their personnel, equipment and other resources. This should relieve Intensive Care Unit (ICU) capacities for more severely ill patients and reduce readmissions to ICU. This study was conducted to investigate the effects of IMCU use on ICU populations. ⋯ The use of IMCUs influences resource utilization of ICUs. Severity of illness and workload was higher in ICUs with high IMCU and more scheduled discharges occurred during the main working hours while readmission rates were similar.