Articles: cations « metajournal.com

Minerva anestesiologica · Nov 2021

Acquisition of skills in critical emergency medicine: an experimental study on the SIAARTI Academy CREM experience.

In 2019 the SIAARTI developed a seven-days course for residents, focused on critical emergency medicine (CREM) in a hostile environment, that grounds on simulation-based education and training with hands-on simulation, high-fidelity simulators and part-task trainers. This project aimed to evaluate the efficacy of this course in comparison to traditional learning programs in term of technical (TS) and non-technical (NTS) skills. We assessed the improvement in TS and NTS over time, and the ability to involve trainees in corporate activities. ⋯ SA-kit improvement in TS and NTS was higher than kit and control and was maintained over time. Participation in this course implemented participation in corporate activities among attendees.

keep going… or just mark as read…

Minerva anestesiologica · Nov 2021

Pain, the unknown: epistemological issues and related clinical implications.

Despite the huge development of pain management in the past decades, pain remains elusive and many patients still remain in the middle of the ford struggling between low drug efficacy and their overuse. A reason for pain elusiveness is its nature of subjective phenomenon, escaping the meshes of the objectivist, mechanist-reductionist net prevailing in medicine. Actually, pain is not only a symptom but an essential aspect of life, consciousness and contact with the world and its noetic and autonoetic components play a key role in the development of the concepts of pleasure-unpleasure and good-evil. ⋯ The outstanding effects of placebo and nocebo, behavioral and non-pharmacological techniques warrant the need for a shift from the traditional positivist idea of patient as passive carrier of disease to the patient as active player of recovery and move toward a patient's centered approach exploiting individual resources for recovery. Among the mentioned techniques, hypnosis has proved to increase pain threshold up to the level of surgical analgesia, improve acute and chronic pain as well as coping and resilience, helping to decrease both drug overuse and the costs of pharmacological therapy. The plethora of available data suggests the need for a holistic approach, aiming to take care of the individual as an inseparable mind-body unit in its interplay with the environment, where patient's inner world, his/her experience and cognition are taken into due account as powerful resources for recovery through a phenomenological-existential approach.

keep reading… or just mark as read…

Annals of surgery · Nov 2021

Multicenter Study Comparative Study

Comparative Propensity Matched Outcomes in Severe COVID-19 Respiratory Failure-Extracorporeal Membrane Oxygenation or Maximum Ventilation Alone.

Does extracorporeal membrane oxygenation (ECMO) improve outcomes in ECMO-eligible patients with COVID-19 respiratory failure compared to maximum ventilation alone (MVA)? ⋯ ECMO-eligible patients with severe COVID-19 respiratory failure demonstrate a 3-fold improvement in survival with ECMO. They are also in a better physical state at discharge and have lower overall complication rates. As such, strong consideration should be given for ECMO when mechanical ventilatory support alone becomes insufficient in treating COVID-19 respiratory failure.