Minerva anestesiologica
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Minerva anestesiologica · Jul 2009
Non-invasive ventilation outside the Intensive Care Unit for acute respiratory failure: the perspective of the general ward nurses.
The introduction of non-invasive ventilation outside the Intensive Care Unit (ICU) is an increasing phenomenon, motivated by the shortage of intensive care beds and growing confidence with the technique. However, although general ward nurses are responsible for carrying out the daily management of the treatment and the extra monitoring it requires, their perspective on non-invasive ventilation (NIV) has never before been studied, and as a result their training is often neglected. ⋯ Nurses indicated a strong demand for training on NIV, in order to improve their involvement with the therapeutic program and for better communication with the MET and ward doctors. We conclude that active research towards understanding their point of view should be included as part of the quality control of NIV treatments outside the ICU.
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Minerva anestesiologica · Jul 2009
Randomized Controlled TrialSubarachnoid anesthesia vs monitored anesthesia care for outpatient unilateral inguinal herniorrhaphy.
Inguinal herniorrhaphy is one of the most commonly performed surgical procedures in a same-day surgery setting. The prerequisite of having to discharge the surgical outpatient on the same day has an influence on the choice of the anesthetic technique. ⋯ LA+TCI was shown to be more effective than selective SA at low doses in terms of shorter time to recovery after unilateral inguinal herniorrhaphy procedures.
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Minerva anestesiologica · Jul 2009
ReviewNon-invasive ventilation outside the Intensive Care Unit for acute respiratory failure.
Non invasive ventilation (NIV) has been shown to be an effective therapy in selected patients with acute respiratory failure. Due to its benefit and relative ease of use, NIV is frequently used. ⋯ Choosing the right time and type of patient with acute respiratory failure to improve the chances of success with NIV requires an appropriate environment and monitoring. This review presents and discusses the currently available data regarding NIV success outside the intensive care unit, the optimal ventilatory strategy, possible solutions to the mechanical problems and the minimum monitoring required.
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Minerva anestesiologica · Jul 2009
Randomized Controlled TrialEffects of recombinant human activated protein C on the fibrinolytic system of patients undergoing conventional or tight glycemic control.
Recombinant human activated protein C (rh-APC) and tight glycemic control (TGC) have been shown to reduce mortality in septic patients. Both interventions can reduce the plasma concentration and/or activity of the most powerful suppressor of fibrinolysis, plasminogen activator inhibitor-1 (PAI-1). Our aim was to evaluate the effects on the fibrinolytic system after the administration of rh-APC in septic patients undergoing conventional or TGC. ⋯ Both rh-APC and TGC appear to improve fibrinolysis in septic patients. The reduction in the impairment of fibrinolysis associated with rh-APC treatment seems greater in patients undergoing conventional glycemic control than in those undergoing TGC.