Minerva anestesiologica
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Minerva anestesiologica · Jul 2011
ReviewEffects of hypercapnia and hypercapnic acidosis on attenuation of ventilator-associated lung injury.
Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are associated with impaired gas exchange, severe inflammation and alveolar damage including cell death. Patients with ALI or ARDS typically experience respiratory failure and thus require mechanical ventilation for support, which itself can aggravate lung injury. Recent developments in this field have revealed several therapeutic strategies that improve gas exchange, increase survival and minimize the deleterious effects of mechanical ventilation. ⋯ The clinical implications of hypercapnia and hypercapnic acidosis are still not entirely clear. However, future research should focus on the intracellular signaling pathways that mediate ALI development, potentially focusing on the role of reactive biological species in ALI pathogenesis. Future research can also elucidate how such pathways may be targeted by hypercapnia and hypercapnic acidosis to attenuate lung injury.
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Minerva anestesiologica · Jul 2011
Epidural analgesia and liver resection: postoperative coagulation disorders and epidural catheter removal.
The aim of this study was to quantify the duration and severity of postoperative coagulopathy in order to establish the optimal time for epidural catheter removal. ⋯ Despite this, no epidural or spinal haematoma was recorded.