Minerva anestesiologica
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Minerva anestesiologica · Mar 2011
Case ReportsTherapeutic hypothermia for space-occupying Herpes simplex virus encephalitis.
Development of space-occupying edema in patients with severe Herpes simplex virus encephalitis is a major factor for high morbidity and mortality. Conventional intracranial pressure-lowering modalities are limited and more aggressive treatment options for such patients have rarely been described. ⋯ Induced moderate hypothermia of 33 °C resulted in fast and sustained control of intracranial pressure. After three months, the patient had a fairly good functional outcome with a Glasgow Outcome Scale score of 4.
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Minerva anestesiologica · Mar 2011
Non-invasive ventilation outside of the Intensive Care Unit: an Italian survey.
Non-invasive ventilation (NIV) is increasingly utilized for patients with acute respiratory failure (ARF). The shortage of Intensive Care Unit (ICU) beds, a growing confidence with the technique, and the opportunity to treat ARF in a more responsive phase lead to the application of NIV outside of the ICU. The Study Group on Emergency of the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) promoted a national survey to collect data on NIV use outside of the ICU. ⋯ In Italy, NIV is extensively applied in non-intensive wards, and its use is not free from criticalities and contradictions. Further prospective studies and possibly guidelines are needed.
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Minerva anestesiologica · Mar 2011
Randomized Controlled TrialStress doses of hydrocortisone reduce systemic inflammatory response in patients undergoing cardiac surgery without cardiopulmonary bypass.
Systemic inflammatory response occurs after cardiac surgery (CS) and leads to a worse outcome in many cases. Stress doses of hydrocortisone have been successfully used to reduce SIRS and to improve outcome of patients after CS with cardiopulmonary bypass grafting (on-pump CABG), but the effect of hydrocortisone on patients undergoing CS without cardiopulmonary bypass grafting (off-pump CABG) is unclear. Therefore, we evaluated the effect of stress doses of hydrocortisone in this group of patients. ⋯ We conclude that intravenous stress doses of hydrocortisone lead to a reduction of systemic inflammation and to a potential improvement in the early outcome of patients undergoing off-pump CABG.
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Minerva anestesiologica · Mar 2011
Randomized Controlled Trial Comparative StudyAuricular acupuncture for postoperative pain after gynecological surgery: a randomized controlled trail.
Acupuncture for postoperative pain remains controversial. Potential sources of bias are failures in patient-blinding and therapist-patient interactions. Our study investigates the effects of electrical auricular acupuncture (AA) on postoperative pain in patients undergoing laparoscopy with an emphasis on patient-blinding and the exclusion of therapist-patient interactions. ⋯ Our study shows no reduction in postoperative pain or an opioid sparing effect of auricular acupuncture in women undergoing laparoscopic procedures. Because we emphasized blinding of the patients and the exclusion of therapist-patient interactions, our study suggests that electrical auricular acupuncture has no effect on postoperative pain.