Minerva anestesiologica
-
Minerva anestesiologica · May 2002
ReviewAntithrombin III in Sepsis. New evidences and open questions.
Antithrombin III (ATIII) has been found to be a marker for DIC and to be of prognostic significance in septic patients. Several studies have shown that administration of ATIII in patients with sepsis related DIC is effective in shortening the duration of DIC. ⋯ However the concomitant use of heparin, which does not seem to have an additional beneficial effect, may have obscured the efficacy of ATIII. More studies are needed to understand mechanism of action of ATIII and better define patient population that may benefit from ATIII.
-
In appropriately selected patients, NPPV decreases intubation rate, improves survival, and is cost-effective. Pressure support ventilation is commonly used successfully for NPPV. ⋯ A concern with portable pressure ventilators is the potential for rebreathing of carbon dioxide. Despite these issues, pressure support ventilation has been used successfully for noninvasive ventilation in thousands of patients with acute respiratory failure.
-
Minerva anestesiologica · May 2002
Clinical TrialPumpless extracorporeal lung assist using an arterio-venous shunt. Applications and limitations.
We report the use of a pumpless extracorporeal lung assist (PECLA) in 70 patients with severe pulmonary failure of various causes. The device was used under rescue conditions in patients with preserved cardiac function. By establishing a shunt between femoral artery and vein using the arterio-venous pressure gradient as the driving force for the blood flow through the oxygenator, PECLA proved to be extremely effective in terms of oxygenation and carbon dioxide removal.
-
Minerva anestesiologica · May 2002
Clinical TrialExtracorporeal respiratory support and minimally invasive ventilation in severe ARDS.
To evaluate the results of treatment of severe acute respiratory distress syndrome (ARDS) with extracorporeal life support (ECLS), minimal sedation and low pressure supported ventilation in adults. ⋯ A high survival rate can be obtained in adult patients with severe ARDS using ECLS, minimal sedation and pressure-supported ventilation with low inspiratory pressures. Surgical complications are amenable to surgical treatment during ECLS and bleeding problems can be controlled.
-
Direct costs of critical care are increasing more than in other health care sectors. Tools are needed to evaluate adequacy of ICU admission in order to have a proper allocation of ICU resources. ⋯ Despite the difficulties imposed by he rigid nurses' work organization in Italy, a daily data collection about level of care, severity of illness, workload utilization could provide, together with standard administrative indexes, the necessary framework to assess and to improve adequacy of ICU admission.