Minerva anestesiologica
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Minerva anestesiologica · Sep 1993
Case Reports[Unilateral pulmonary edema caused by heart failure. Report of 2 clinical cases].
The authors present two case reports of cardiogenic unilateral pulmonary edema. The information provided by hemodynamic monitoring have not been essential for diagnosis which was bases on clinical, radiological and echocardiographic findings and confirmed by the clinical response to a specific treatment. The authors briefly review the mechanisms which may cause the atypical distribution of the cardiogenic pulmonary edema.
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Minerva anestesiologica · Sep 1993
Review[Conventional radiology and computerized axial tomography in the diagnosis of pneumothorax in intensive therapy. Retrospective study of 2 years of activity].
The role played by chest radiograph and CT scan in diagnosis of pneumothorax is analyzed in a retrospective study based on two years of activity in Intensive Care Unit. The sensibility of traditional chest radiography was 75% while the sensibility of CT scan resulted higher (87.5%). In the authors opinion, when pneumothorax is suspected, particularly in patients with polytrauma, CT scan of the chest is mandatory unless patient's conditions or logistic difficulties related with transport of the patient contraindicate it.
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Minerva anestesiologica · Sep 1993
Comparative Study Clinical Trial Controlled Clinical Trial[Propofol-midazolam in continuous infusion for sedation in intensive care].
Two groups of 11 ICU respiratory patients ventilated with PSV have been sedated with propofol (group I) or with midazolam (group II). After the endovenous administration of the induction dose (propofol 1.5 mg/kg; midazolam 0.15 mg/kg) sedation was obtained with continuous infusion of the drugs (propofol 2 mg/kg/h; midazolam 0.24 mg/kg/h). ⋯ At induction midazolam caused a reduction of tidal volume for some minutes and a greatest sedation in comparison with propofol, while propofol caused reduction of MAP (p < 0.01) and transitory apnoea. Even if during the infusion of propofol the level of sedation decreased with time (p < 0.05; y = -0.0357 x + 3.07) it was more stable in comparison with that registered during continuous infusion of midazolam (p < 0.01; y = -0.2018 x + 5.19.
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Minerva anestesiologica · Jun 1993
Randomized Controlled Trial Comparative Study Clinical Trial[Combined anesthesia (epidural-general) in thoracic surgery: the cardiocirculatory response to induction. Propofol vs midazolam plus alfentanil].
Thoracic epidural block may unpredictably blunt the physiological sympathetic response to anaesthetic agents and profound hypotension could result at induction time. The authors evaluate two different induction regimens in 16 patients scheduled for major thoracic surgery in order to assess which of them would produce less hemodynamic changes. After the institution of high thoracic epidural block (6 ml lidocaine-CO2 2% + epinephrine 1/200,000 level: th.2-3), patients were randomly allocated in two induction groups: P and M. ⋯ In P group the fall in blood pressure is more pronounced than M group (p < 0.05). Noteworthy in both groups cardiac frequency do not increase and in M group significantly lowers. In the authors view the midazolam plus alfentanil induction technique compare well with propofol alone and would recommend its use in poor risk patients.