Minerva anestesiologica
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Minerva anestesiologica · May 2007
Continuous deep sedation in home palliative care units: case studies in the Florence area in 2000 and in 2003-2004.
The aim of this paper was to describe the frequency and the characteristics of continuous deep sedation in terminally ill patients. ⋯ The monitoring of end-of-life decision making and of medical practices involved in continuous deep sedation contributes to an enhancement in the quality of caring for terminally ill patients.
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Intensive care units traditionally have a closed structure in Italy. They generally have highly restrictive visiting policies, limiting the admission and attendance of family members. This article deals with the issue of open intensive care unit (ICU), i.e. a unit oriented towards the implementation of non-restrictive visiting policies and committed to removing all barriers that have no justifiable necessity, on the level of time, on the physical level and on the level of relationships. ⋯ On the contrary, opening ICUs offers a strategy which is to patients' advantage. Opening ICUs should come about not so much in answer to pressure generated by a growing social awareness, or in simple recognition of a right, but because this policy addresses more comprehensively the issue of respect for the patient, as well as providing more appropriate responses to many needs of both patients and families. It is a decision which requires doctors and nurses to rethink their relationships with patients and their families, which calls for original solutions for each individual situation, and which should be subject to periodic checks.
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Minerva anestesiologica · May 2007
Clinical TrialCentral venous catheter replacement in the ICU: new site versus guidewire exchange.
Catheter infection (central venous catheter, CVC-I) and catheter-related bacteremia (CRB) are of particular interest with ICU patients; more than 40-60% of them require a CVC. This prospective observational study was performed to determine if a second episode of catheterization and guidewire exchange was related to increased CRB and CVC-I rates in the ICU. ⋯ Prolonged indwelling time is a significant risk factor for catheter-related infections; the second episode of cannulation and guidewire exchange did not present significant risk factors for catheter-related infections. A strict stable protocol for catheter insertion, care and proper treatment are necessary to reduce both the catheter-related infection rate and cost.
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Minerva anestesiologica · May 2007
Effect of morbid obesity on kinetic of desflurane: wash-in wash-out curves and recovery times.
The aim of this paper was to compare wash-in and wash-out curves of desflurane in morbidly obese and nonobese patients. ⋯ Our results show that desflurane provides similar kinetic and recovery profiles in obese and nonobese patients.