Minerva anestesiologica
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Minerva anestesiologica · Dec 2016
Multicenter StudyHospital disaster preparedness in Italy: a preliminary study utilizing the World Health Organization hospital emergency response evaluation toolkit.
Natural and human-initiated disasters are occurring with greater devastating consequences and increased frequency. During these events, hospitals have the burden to care for acutely ill and injured patients. The aim of this study was to evaluate the level of disaster preparedness of Italian hospitals. ⋯ The study revealed that a large majority of Italian hospitals evaluated are not well prepared to manage potential disasters. Also, all important elements of hospital preparedness, such as the command system, surge capacity, and safety, were insufficiently implemented. Nationwide standards, guidelines and procedures are required to improve hospital disaster preparedness in Italy.
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Minerva anestesiologica · Dec 2016
Multicenter Study Observational StudyResidual neuromuscular blockade in the postanesthesia care unit. Observational cross-sectional study of a multicenter cohort.
Residual neuromuscular blockade after general anesthesia using nondepolarizing neuromuscular blocking agents has pathophysiological, clinical, and economic consequences. A significant number of patients under muscle relaxation sustain residual curarization. ⋯ The incidence of residual blockade in Spain is similar to that published in other settings and countries. Female gender, longer duration of surgery, and halogenated drugs for anesthesia maintenance were related to residual paralysis, as were NMBA specific items, such as the use of benzylisoquinoline drugs, and the absence of reversal or reversal with neostigmine.
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Minerva anestesiologica · Apr 2016
Multicenter Study Observational Study"Italian Registry of Complications associated with Regional Anesthesia" (RICALOR). An incidence analysis from a prospective clinical survey.
Regional anesthesia (RA) is associated with many advantages, but side effects also occur. Several registries were developed to investigate such complications in many countries, which produced conflicting results. In consideration of the ongoing evolution and improvements in RA, and its widespread diffusion in Italy in the last decade (with increasing experience by anesthesiologists), a reappraisal of the incidence and the characteristics of major complications are useful to improve patient's safety. ⋯ We confirmed RA as generally safe, but monitoring and diagnosis, together with further research efforts, are needed to improve patients' care and clarify potential risk factors.
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Minerva anestesiologica · Dec 2015
Randomized Controlled Trial Multicenter Study Comparative StudyThe effects of plasmalyte-148 versus hartmann's solution during major liver resection: a multicentre, double-blind, randomized controlled trial.
The acid-base, biochemical and hematological effects of crystalloid solutions have not been comprehensively evaluated in patients with liver resection. ⋯ In liver resection patients, HS and PL led to similar base excess values but different post operative plasma biochemistry and hematology values. Understanding of these effects may help clinicians individualize fluid therapy in these patients.
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Minerva anestesiologica · Nov 2015
Multicenter StudyInternational survey on the management of mechanical ventilation during extracorporeal membrane oxygenation in adults with severe respiratory failure.
No consensus exists on the optimal settings of mechanical ventilation during veno-venous extracorporeal membrane oxygenation (ECMO). Our aim was to describe how mechanical ventilation and related interventions are managed by adult ECMO centres. ⋯ We found large variability in ventilatory practices during ECMO. The clinicians' training background and the centres' experience had no influence on the approach to ventilation. This survey shows that well conducted studies are necessary to determine the best practice of mechanical ventilation during ECMO and its impact on patient outcome.