Minerva anestesiologica
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Minerva anestesiologica · Apr 2011
ReviewPositron emission tomography in ARDS: a new look at an old syndrome.
This is a review of some of the main findings obtained by positron emission tomography (PET) concerning the pathophysiology of acute respiratory distress syndrome (ARDS) and acute lung injury. PET (which is nowadays often combined with computed tomography) is a functional imaging technique based on the detection of a labeled molecule administered to a subject. Based on the molecule used, different lung functions can be imaged. ⋯ Administration of [18F]FDG facilitates the imaging of cellular metabolic activity, reflecting an acute neutrophil-sustained inflammatory process. This technique has been used in experimental ARDS and, more recently, in patients. It showed, for example, that inflammatory activity of the lungs is markedly increased even in "normally aerated" regions at levels that are, in some cases, even higher than in the non-aerated regions.
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Minerva anestesiologica · Apr 2011
Randomized Controlled TrialThe effects of physostigmine on recovery from general anesthesia in elderly patients.
Transient cognitive dysfunction after general anesthesia is a frequent finding among elderly patients. The aim of this study was to evaluate whether the use of physostigmine may enhance recovery from general anesthesia in elderly patients. ⋯ The intraoperative infusion of physostigmine enhances alertness, coordination, manual dexterity and mobilization after general anesthesia in elderly patients, but physostigmine administration does not affect orientation or sedation.
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Minerva anestesiologica · Apr 2011
Outcome and mortality risk factors in long-term treated ICU patients: a retrospective analysis.
Little is known about the prognosis and outcome of critically ill patients with a prolonged length of stay (LOS). The aim of this study was to examine mortality and its risk factors in patients requiring intensive care therapy for more than 30 days. ⋯ Although the long-term treatment of critically ill patients requires significant effort, the outcome for this particular cohort was reasonably favorable. Prolonged mechanical ventilation and weaning are the factors that influence mortality independently of sepsis. Because reasonable improvements can be shown even after a prolonged LOS, further attention should be paid to weaning processes.
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Minerva anestesiologica · Apr 2011
Bilateral Bispectral Index (BIS)-Vista as a measure of physiologic sleep in sleep-deprived anesthesiologists.
Anesthesiologists who work extended hours exhibit acute and chronic sleep deprivation. The newest bilateral Bispectral Index (BIS)-Vista monitor offers new advantages over earlier models, which include a new algorithm (version 1.4). One possible useful application for BIS monitoring of physiological sleep would be in critically ill patients who almost uniformly suffer from sleep disruption and deprivation because they loose their circadian rhythm due to the harsh noisy environment of critical care units. Previous studies, which used earlier versions of the BIS monitor to depict normal physiologic sleep, produced widely conflicting results. The aim of our study was to assess whether the new BIS-Vista monitor would exhibit a temporal decline that corresponds to natural physiologic sleep stages in healthy sleep-deprived, post-call anesthesiologists. ⋯ We demonstrated that although the BIS-Vista monitor was neither designed nor validated for monitoring normal physiologic sleep, it depicted a temporal decline that corresponds to normal physiologic sleep stages in sleep-deprived anesthesiologists.