Minerva anestesiologica
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Minerva anestesiologica · May 2013
Current practice of brain death determination and use of confirmatory tests in an Italian University hospital: a report of 66 cases.
Time to final brain death (BD) determination is fundamental to rapidly identify donors without organ deterioration. Guidelines for BD determination are different from country to country and, through years, they have been subjected to several revisions, to simplify the procedure. The aim of this study was to describe a one-year experience according to the latest Italian Guidelines for BD in our University hospital and to focus on timing of final BD declaration according to the ancillary tests executed. ⋯ In Italy, the same guidelines ensure the same approach in every hospital, with multi-specialist cooperation. The EEG is mandatory and prompt recognition of the first, flat EEG is fundamental to reduce time to the final procedure. A multimodal neurophysiological approach with trained specialists, neurosonologists and monitoring devices in intensive care units may represents a valid help to further reduce time for BD diagnosis.
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Minerva anestesiologica · May 2013
Randomized Controlled Trial Comparative StudyForce and pressure distribution using Macintosh and GlideScope laryngoscopes in normal airway: an in vivo study.
Forces applied on oropharyngeal soft tissues by direct laryngoscopy may cause damage to the patients. The aim of this study was to measure the forces applied during the manoeuvres to achieve glottis visualization and tracheal intubation, comparing direct laryngoscopy and videolaryngoscopy in vivo. ⋯ Our study shows that in patients with normal airways the GlideScope allows a view of glottis and permits a successful tracheal intubation applying lower force (significantly in intubation) as compared to the Macintosh laryngoscope. Also, the GlideScope probe distributes the forces more homogeneously to the tissue thus further reducing the potential for tissue damage.
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Minerva anestesiologica · May 2013
ReviewThe usage of the Boussignac continuous positive airway pressure system in acute respiratory failure.
Traditionally, continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP) devices have been used to treat patients in acute respiratory failure. However they require an electric power source, are relatively large in size, and may be difficult to use in prehospital settings. The recently introduced Boussignac CPAP system is capable of delivering 10 cmH2O of CPAP, is compact, portable and requires only an oxygen source. ⋯ In one study, implementing Boussignac CPAP reduced intubation rate and hospital stay. Most hospital staff found Boussignac CPAP easy to use and complication rates were low. Boussigac CPAP is a useful device in the treatment of patients with acute respiratory failure, especially in the prehospital setting.