Minerva anestesiologica
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Minerva anestesiologica · Nov 2017
Multicenter Study Observational StudyIndividual duration of axillary brachial plexus block is unpredictable: a prospective double centred observational study.
The duration of effect for axillary plexus block using ropivacaine is highly variable. The available literature does not offer any plausible means of predicting time of block offset for individual patients, making it difficult to give accurate information and plan postoperative analgesics. This study was designed to identify factors influencing axillary plexus block offset time. ⋯ This prospective study demonstrates a large inter individual variation in time of axillary plexus block offset using ropivacaine 0.75%. The lack of association between offset time and both demographic and block performance factors, makes predictability of individual duration of axillary plexus blocks in clinical practice extremely difficult. We suggest that all patients should be made aware of such variability in duration prior to block placement.
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Minerva anestesiologica · Jul 2017
Multicenter StudyCurrent adoption of lung ultrasound in Intensive Care Units: an Italian multi-centre survey.
Lung ultrasound (LUS) is a useful tool for assessing lung status in critically ill patients, but is not widely applied in intensive care units (ICUs). The aim of this study was to investigate the use of LUS in Italian ICUs. ⋯ LUS is performed in the majority of ICUs and is generally used to investigate known or suspected diseases. Frequency of use appears to be low and related to selected organizational factors. There is generally no standardized format for reporting LUS findings.
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Minerva anestesiologica · Jul 2017
Multicenter StudyEnd-of-life decisions in 34 Slovene intensive care units: a nationwide prospective clinical study.
The aim of this study was to determine how end-of-life decisions (EOLD) on limitations of life-sustaining treatment (LST) are made in three different types of intensive care units (ICUs) in Slovenia. ⋯ No differences were found between the three different types of ICUs in EOLD on limitation of LST even though limitation of LST was provided regularly. The most commonly limited LST measures include mechanical ventilation, inotropes/vasopressors, hemodialysis, and antibiotics. Almost none of the patients had advance directives in place. Palliative care team was available in only few cases.
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Minerva anestesiologica · Jun 2017
Multicenter Study Comparative StudyAggressive versus conservative antibiotic use to prevent and treat ventilator-associated pneumonia in patients with severe traumatic brain injury. Comparison of two case series.
In patients with traumatic brain injury (TBI), ventilator-associated pneumonia (VAP) is considered a dangerous complication, prompting early aggressive antibiotic treatment and prophylaxis. While this approach increases the selection of multidrug-resistant bacteria (MDR), its clinical benefit has not been demonstrated. ⋯ Although not conclusive, these results call into question the prevalent aggressive use of antibiotics in TBI patients and urge the scientific community to produce better evidence for clinical recommendations.
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Minerva anestesiologica · Jun 2017
Multicenter StudyEpidemiology and outcomes of cardiac arrest among children with Down syndrome: a multicenter analysis.
With the increasing prevalence of Down Syndrome, it is unknown if children with Down Syndrome are associated with increased incidence of cardiac arrest and poor outcomes after cardiac arrest. The objective of this study was to evaluate the epidemiology of cardiac arrest and mortality after cardiac arrest among critically ill children with and without Down Syndrome. ⋯ Both incidence of cardiac arrest, and mortality at hospital discharge in those with cardiac arrest vary substantially in children with and without Down Syndrome.