Minerva anestesiologica
-
Minerva anestesiologica · Mar 2009
The Competency-Based Training in Intensive Care Medicine in Europe (CoBaTrICE) Italian collaborative: national results from the Picker survey.
The aim of the Competency-Based Training in Intensive Care Medicine in Europe (CoBaTrICE) project is to create an internationally acceptable competency-based training program for specialists in intensive care medicine. The CoBaTrICE Project has performed a survey, in collaboration with the Picker institute, United Kingdom, to identify desirable characteristics of Intensive Care Unit (ICU) specialists, as expressed by patients and their relatives. ⋯ Priority in Italy was given to medical skills and competence. Involvement of patients and relatives in decision-making processes were among the items considered least important. Italian families preferred a paternalist approach to the end of life decision-making process.
-
Minerva anestesiologica · Mar 2009
Letter Case ReportsDifficult removal of an epidural catheter in a postpartum woman.
-
Non-invasive ventilation (NIV) is an effective technique that can avert side effects and complications associated with endotracheal intubation. NIV is primarily used to avert the need for endotracheal intubation in patients with early stage acute respiratory failure (ARF), and to prevent postextubation respiratory failure in patients considered to be at risk. ⋯ The success of NIV relies on several factors including the type and severity of ARF, the underlying disease, the timing, the location of treatment, and the experience of the team. In this review article, we analyze, compare, and discuss the results of studies in which NIV was applied in different pathologies and with different timing during the evolution of ARF.
-
Minerva anestesiologica · Jan 2009
The 2008 international guidelines for management of severe sepsis and septic shock: merits and weaknesses.
The Guidelines are intended to provide standard guidance for the care of patients by grouping evidence-based interventions into bundles that can be easily used by clinicians to improve patient outcome. The 2008 International guidelines for management of severe sepsis and septic shock is a large and extraordinary update of the literature offered by current leaders in the field. ⋯ Furthermore, they can change if new participants take part in the process. By considering the merits and weaknesses of practice guidelines, we conclude that guidelines cannot replace a physician's judgments, but rather should be a starting point for more robust and proficient scientific evidence.