Minerva anestesiologica
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Minerva anestesiologica · Apr 2001
Review Randomized Controlled Trial Clinical TrialPathophysiology of prone positioning in the healthy lung and in ALI/ARDS.
Prone position was initially introduced in healthy anesthetized and paralyzed subjects for surgical specific reasons. Then, it was used during acute respiratory failure to improve gas exchange. The interest on prone position during ALI/ARDS progressively increased, even if the mechanisms leading to a respiratory improvement are not yet completely understood. ⋯ The proportion of responders increased to 85% after 6 hours of prone positioning. The incidence of maneuver-related complications and severe and life-threatening complications was extremely rare. The overall mortality at ICU discharge was 51% and the ICU stay was similar in survivors and non survivors (17.8 +/- 11.6 vs 17.8 +/- 11.4 days).
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Minerva anestesiologica · Apr 2001
Randomized Controlled Trial Comparative Study Clinical TrialEnd tidal carbon dioxide monitoring in spontaneously breathing, nonintubated patients. A clinical comparison between conventional sidestream and microstream capnometers.
To evaluate the end tidal carbon dioxide estimation in nonintubated, spontaneously breathing patients using either conventional sidestream or microstream capnometers. ⋯ The microstream capnometer provides a more accurate end tidal CO2 partial pressure measurement in nonintubated, spontaneously breathing patients than conventional sidestream capnometers, allowing for adequate monitoring of the respiratory function in nonintubated patients.
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Minerva anestesiologica · Apr 2001
Case ReportsExperiences with continuous intra-arterial blood gas monitoring.
Management of critically ill patients requires frequent arterial blood gas analyses for assessing the pulmonary situation and adjusting ventilator settings and circulatory therapeutic measures. Continuous arterial blood gas analysis is a real-time monitoring tool, which reliably detects the onset of adverse pulmonary effects. It gives rapid confirmation of ventilator setting changes and resuscitation and helps to ensure precise adjustment of therapy. ⋯ The Paratrend 7+ sensor proved to be clinical feasible and showed an improved precision in terms of clinical situations with an arterial pO2 smaller than 50 kPa. However, the results are not much different regarding the findings with older systems consisting of hybrid technology combining optodes and electrochemical oxygen measurement. The advantages might be seen if the sensor is used for a period over several days in patients on ICU as demonstrated by the two case reports.
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Minerva anestesiologica · Apr 2001
Historical ArticleAccidents and mishaps in anesthesia: how they occur; how to prevent them.
The problem of safety and accidents prevention is a primary issue in modern anesthesia. Throughout the last twenty years, much effort has been made to assess the causes of mishaps, introducing new technology and safer drugs. The author presents a well known model to describe factors affecting accidents causality, proposing old and new strategies to ensure safety during the everyday practice.