Minerva anestesiologica
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Minerva anestesiologica · Dec 2010
Review Meta AnalysisPalliative care in Italy: problem areas emerging from the literature.
The aim of this study was to review the Italian literature regarding attitudes toward palliative care in cancer patients, as well as cultural, educational and organizational problems in Italy with respect to palliative care services. The Italian literature published in the last ten years on PUBMED was reviewed. Clinical trials were excluded from this analysis, as their focus was beyond the scope of this study. ⋯ An appropriate place to die was often not guaranteed and was dependent on the availability of local resources. However, the most striking finding was that there were geographical differences in the distribution of palliative care resources. The development of a range of palliative care programs integrating primary territorial care and specialized palliative services may constitute the ideal synthesis to respond to patients' needs.
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Minerva anestesiologica · Dec 2010
Ex vivo changes in blood glucose levels seldom change blood glucose control algorithm recommendations.
Hyperglycemia and glycemic variabilities are associated with adverse outcomes in critically ill patients. Blood glucose control with insulin mandates an adequate and precise assessment of blood glucose levels. Blood glucose levels, however, can change ex vivo after sampling. The aim of this study was to determine whether this phenomenon affects the practice of blood glucose control. ⋯ Ex vivo changes in blood glucose levels, although statistically significant, seem clinically irrelevant.
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Minerva anestesiologica · Dec 2010
Extracorporeal membrane oxygenation for pandemic H1N1 2009 respiratory failure.
Severe respiratory failure related to infection with the pandemic influenza A/H1N1 2009 virus is uncommon but possibly life-threatening. If, in spite of maximal conventional critical care, the patient's condition deteriorates, extracorporeal membrane oxygenation (ECMO) may be a life-saving procedure. ⋯ Patients treated with veno-venous or veno-arterial ECMO for H1N1 2009-related respiratory failure may have a favorable outcome. Contributing factors may include the possibility of transport on ECMO, conversion from veno-venous (v-v) or veno-arterial (v-a) ECMO if necessary, high-flow ECMO to meet oxygen requirements and active surgery when needed.
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Minerva anestesiologica · Dec 2010
Randomized Controlled TrialA comparison of spinal anesthesia with low-dose hyperbaric levobupivacaine and hyperbaric bupivacaine for transurethral surgery: a randomized controlled trial.
The aim of this study was to compare spinal anesthesia effects of low-dose hyperbaric levobupivacaine and low-dose hyperbaric bupivacaine for transurethral procedures. ⋯ Although both techniques provide adequate spinal block and have few similar side effects for transurethral surgery, the use of low-dose hyperbaric levobupivacaine plus fentanyl may be preferable to low-dose hyperbaric bupivacaine plus fentanyl because of the reduced motor block, shorter duration of motor block, longer duration of sensory block and longer time to the first requirement for analgesia.