Minerva anestesiologica
-
The drugs and techniques used in contemporary anaesthesia may provoke numerous side effects, including cardiac rhythm disturbances. The prolongation of the repolarization time, reflected by the QT interval in a surface electrocardiogram, is one of the mechanisms that lead to the occurrence of arrhythmias. In the paper, we present the primary mechanism that is responsible for QT interval prolongation and subsequent torsade de pointes ventricular tachycardia. The influence of anesthetics, regional anesthesia and perioperative supportive therapy on cardiac repolarization is described.
-
Minerva anestesiologica · Apr 2012
ReviewHumidification of inspired gases during mechanical ventilation.
Humidification of inspired gas is mandatory for all mechanically ventilated patients to prevent secretion retention, tracheal tube blockage and adverse changes occurring to the respiratory tract epithelium. However, the debate over "ideal" humidification continues. Several devices are available that include active and passive heat and moisture exchangers and hot water humidifiers Each have their advantages and disadvantages in mechanically ventilated patients. This review explores each device in turn and defines their role in clinical practice.
-
Minerva anestesiologica · Apr 2012
Case ReportsAcute liver failure due to acute fatty liver of pregnancy.
Acute fatty liver of pregnancy (AFLP) is a rare but serious liver disease and typically occurs during the third trimester. It carries the risk for significant perinatal and maternal mortality. Therefore an early diagnosis and delivery, followed by close monitoring and optimized management of the impaired liver function with all associated problems are necessary to prevent maternal and foetal death. This case report focuses on the management of acute liver failure due to AFLP in a 31 year old women treated in our intensive care unit (ICU) after an emergency C-section.
-
Minerva anestesiologica · Apr 2012
Echocardiographic evaluation and N-terminal pro-brain natriuretic peptide measurement of patients hospitalized for heart failure during weaning from mechanical ventilation.
Weaning patients with heart failure who have required mechanical ventilation remains challenging. We evaluated echocardiographic indexes and N-terminal pro-brain natriuretic peptide (NT-proBNP) as markers of acute cardiac dysfunction before and after spontaneous breathing trials (SBT) in such patients to assess their ability to predict subsequent successful extubation. ⋯ Neither NT-proBNP level nor the studied echocardiographic indices before SBT were able to predict SBT outcome in patients presenting with severe heart failure. Failure to increase the cardiac index and increases in both E/Ea ratio and NT-proBNP levels were seen at end-SBT in patients who failed the SBT, and may reflect failure of myocardial reserve to cope with the stress of SBT.
-
Minerva anestesiologica · Apr 2012
Ultrasound identification of nerve cords in the infraclavicular fossa: a clinical study.
This study aimed to analyze nerve trunk anatomy in the infraclavicular fossa and to correlate these data with the most common anthropometric parameters. ⋯ Sono-anatomic study of the infraclavicular region adds important data that is useful when conducting nerve blocks to improve safety and likelihood of success.