Minerva anestesiologica
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Minerva anestesiologica · Aug 2011
Interventional lung assist enables lung protective mechanical ventilation in acute respiratory distress syndrome.
The feasibility and safety of a pumpless arteriovenous extracorporeal lung assist system (pECLA) has been demonstrated in previous studies of patients with severe respiratory insufficiency. The aim of this report was to examine whether pECLA is feasible in a center that is new to the technology and to determine the positive and adverse effects associated with its use. ⋯ pECLA is an effective and manageable technique to support gas exchange in ARDS patients. This retrospective case series demonstrates the feasibility of pECLA in a center that did not have prior experience with this technique. pECLA may decrease further lung injury by minimizing the amount of time for which the lung is exposed to high stress and/or strain.
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Minerva anestesiologica · Aug 2011
ReviewNew approaches for empiric therapy in Gram-positive sepsis.
Nosocomial bloodstream infections (BSIs) have become an important cause of morbidity and mortality, particularly in intensive care units (ICUs). Gram-positive organisms are the prevalent causes of antibiotic-resistant BSI, especially Staphylococcus aureus, coagulase-negative staphylococci and enterococci. In recent years, several reports have shown an increase in antimicrobial resistance among Gram-positive bacteria isolated from patients in ICUs. ⋯ Here we describe the microbiological, pharmacological and clinical characteristics of three new antibacterials helpful in severe infections in ICU patients: linezolid, tigecycline and daptomycin. These new drugs have some limitations, and the possibility developing resistance is real. Knowledge of both old and new antibacterials is necessary to utilize them most effectively.
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Anesthetics are widely used in the management of neurocritical patients, although has never been proved that the use of these drugs can contribute to positive outcome. The aim of this review was to evaluate the expected benefit of anesthetics use in relation to the altered physiology of the damaged brain while considering possible related complications.
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Minerva anestesiologica · Aug 2011
Fluid balance in critically ill patients. Should we really rely on it?
The computation of fluid balances (FBs) by subtracting fluid outputs from inputs is a common critical care practice. Limited information exists about the accuracy and consistency of nurse-registered cumulative FBs and regarding the value of suggested corrections for non-measurable losses. ⋯ For a large portion of patients nurse-registered cumulative FBs are neither accurate nor do they agree with standardised BW measurements. Patient care and clinical decision-making should be based on more objective techniques.
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Minerva anestesiologica · Aug 2011
Letter Randomized Controlled TrialModification of endotracheal intubation using AirwayScope™ videolaryngoscope for straight reinforced tubes.