Minerva anestesiologica
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Minerva anestesiologica · Apr 2013
Role of anhepatic time in endothelial-related coagulation in liver transplantation.
Disturbances in coagulation homeostasis are common in patients undergoing orthotopic liver transplantation (OLT) and anhepatic period is one of the important factors related to the coagulation abnormalities. The endothelium can regulate hemostasisby producing substances such as thrombomodulin (TM). The primary aim was to evaluate the effect of an hepatic time on the thrombomodulin-protein C system in patients undergoing OLT. ⋯ Patients with prolonged anhepatic time had greater changes in the thrombomodulin-protein C system.
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Minerva anestesiologica · Apr 2013
Evaluation of a new training device to simulate the epidural and subarachnoid spaces for neuraxial anesthesia techniques.
We are introducing a new epidural/spinal simulation unit to be used either as a part-task trainer to teach and learn regional anesthesia techniques or to be inserted in the manikin's back to allow reliable advanced simulation scenarios. The aim of this study was to determine if it may be a useful tool for training novice anesthesiologists in these procedures according to the evaluation performed by experienced anesthetists. ⋯ This device to be inserted in a full scale manikin may be a promising tool for training of neuraxial procedures. It could be also an essential component of more complex high fidelity scenarios when neuraxial anesthesia is one of the major learning goals.
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Minerva anestesiologica · Apr 2013
ReviewRecommendations for anesthesia and perioperative management of patients with neuromuscular disorders.
Patients with neuromuscular disorders are at high risk of intraoperative and postoperative complications. General anesthesia in these patients may exacerbate respiratory and cardiovascular failure due to a marked sensitivity to several anesthetic drugs. Moreover, succinylcholine and halogenated agents can trigger life-threatening reactions, such as malignant hyperthermia, rhabdomyolysis and severe hyperkalemia. ⋯ Anesthesia and perioperative management of patients with neuromuscular disorders are described in this article. To grade the strength of recommendations and the quality of evidence we adopted the GRADE approach. In case of low-quality evidence, these recommendations represent the collective opinion of the expert panel.
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Minerva anestesiologica · Apr 2013
Intensive care of patients requiring open abdomen treatment: a case-series analysis.
This retrospective overview examines the management of patients with temporary open abdomen (OA). ⋯ The intensive care of patients with OA is challenging but can achieve better outcomes than expected. Continuous abdominal lavage improves the evacuation of contaminated fluid or debris and, coupled with antiseptics and low antibiotic pressure, reinforces the control of infection. The gut can be used for nutrition (even without gastrointestinal continuity), and long-term light sedation (mainly enteral) with minimal impact on perfusion, ventilation and gut motility.