Minerva anestesiologica
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Minerva anestesiologica · Jan 2010
Etiology of respiratory failure is related to mortality in critically ill patients affected by a hematological malignancy: a retrospective study.
The outcomes of patients affected by hematologic malignancies (HM) admitted to Intensive Care Units (ICUs) because of life-threatening complications are still considered to be poor. The aim of this study was to assess the incidence and impact of cardiac dysfunction on the outcome of these patients. ⋯ ICU patients with HM have high mortality. Respiratory failure caused by cardiac dysfunction seems to be associated with a lower risk of death.
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Minerva anestesiologica · Jan 2010
Case ReportsEfficacy and safety of quinine-artesunate in an HIV-positive patient with severe falciparum malaria.
Severe falciparum malaria is a medical emergency that is associated with a high rate of mortality, even when treated in an Intensive Care Unit. Until recently, intravenous quinine was the standard treatment; however, artemisin derivatives are now regarded as the first-line treatment for multidrug-resistant falciparum malaria. Although several studies have demonstrated the superiority of Artesunate, this drug is not licensed in many countries. ⋯ Parasite clearance was rapidly achieved; however, on day IV, the patient developed acute respiratory distress syndrome that required mechanical ventilation. The patient was extubated on day XIV and discharged on day XXV. Due to its rapid action, artesunate was likely responsible for the good clinical outcome in this case; however, in order to clarify the role of this new combination therapy, further studies are required.
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Securing an adequate airway and ventilation is of outmost importance in day case anesthesia/sedation, as elsewhere in anesthesia. Since its introduction, the LMA has made a major contribution to the development of safe and efficacious airway management in elective day case anesthesia. ⋯ The use of a LMA should always be based on individual patient assessment, and a rescue plan for inadequate airway and or ventilation should be in place. Intubation is still the technique of choice in emergency situations.
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Minerva anestesiologica · Jan 2010
Randomized Controlled Trial Comparative StudyComparison of intrathecal hyperbaric and isobaric levobupivacaine in urological surgery.
The aim of our study was to compare the efficacy of hyperbaric and isobaric solutions of intrathecal levobupivacaine for transurethral endoscopic surgery. ⋯ We concluded that the clinical efficacy of hyperbaric levobupivacaine was superior to the isobaric form in spinal anesthesia for transurethral resection.