Minerva anestesiologica
-
Minerva anestesiologica · Feb 2011
ReviewSelective decontamination of the digestive tract as infection prevention in the critically ill. A level 1 evidence-based strategy.
Selective decontamination of the digestive tract (SDD) evolved into evidence-based medicine as a tool to prevent infections in critically ill patients. It significantly reduces mortality, pneumonia, bloodstream infections and the onset of resistance if the full four-component regimen is used. The use of only oral decontamination may reduce the incidence of pneumonia, but it has no significant impact on mortality. Moreover, the full SDD protocol significantly reduces the fecal carriage of multiresistant aerobic Gram-negative bacteria, whereas oral decontamination only is associated with increased carriage of multiresistant aerobic Gram-negative bacilli.
-
Minerva anestesiologica · Feb 2011
Clinical TrialThe low therapeutic efficacy of postoperative chest radiographs for surgical intensive care unit patients.
The clinical value of postoperative chest radiographs (CXRs) for surgical intensive care unit (ICU) patients is largely unknown. In the present study, we determined the diagnostic and therapeutic efficacy of postoperative CXRs for different surgical subgroups and related their efficacy to the time after ICU admission. ⋯ Although the diagnostic efficacy of clinically indicated and routinely obtained postoperative CXRs in surgical ICU patients appears to be significant, their therapeutic efficacy is low.
-
Minerva anestesiologica · Feb 2011
Closed tracheal suction and fluid aspiration past the tracheal tube. Impact of tube cuff and airway pressure.
This study investigated the effect of different tube cuff types and airway pressures on fluid leakage past the tracheal tube cuff during suction with a closed tracheal suction system (CTSS). ⋯ The use of PU tube cuffs and intermittent transient increases in cuff pressure during suction can effectively reduce fluid leakage past the tracheal tube during closed tracheal suctioning.
-
Minerva anestesiologica · Feb 2011
Case ReportsChest pain caused by tracheostomy tube malposition: the importance of choosing the right tube.
We describe a case of chest pain caused by tracheostomy tube malposition in a 65-year old woman with chronic respiratory failure due to chronic obstructive pulmonary disease. This report highlights the importance of the correct choice of tracheostomy tube devices for mechanically ventilated and/or spontaneously breathing patients.
-
Minerva anestesiologica · Feb 2011
Fast-track surgery: it is time for the anesthesiologist to get involved!
Fast-track methodology has been developed with the aim of improving postoperative recovery and reducing perioperative morbidity and mortality. A multidisciplinary approach involving surgeons, anesthesiologists, nurses and physiotherapists is necessary. While the surgical community has revised many of the standard principles used in clinical practice, anesthesiologists still need to contribute more to further optimize and facilitate recovery after surgery.