Minerva anestesiologica
-
Minerva anestesiologica · Nov 2011
ReviewWhy, when and how to propose noninvasive ventilation in cystic fibrosis?
Cystic fibrosis (CF) lung disease is characterized by progressive airflow obstruction, due to mucus plugging and inflammation within the bronchial walls, and destruction of the lung parenchyma secondary to bronchiectasis. These alterations result in an increase of the work of breathing, leading to alveolar hypoventilation predominantly during sleep, exercise and acute respiratory exacerbations. ⋯ Several ventilatory modes may be used in cystic fibrosis patients but the most physiological mode is pressure support. However, validated criteria to start NPPV as well as data on long term outcome, notably in terms of improved survival and quality of life, are lacking and should be assessed in the future.
-
Minerva anestesiologica · Nov 2011
Incidence of postoperative urinary retention (POUR) after joint arthroplasty and management using ultrasound-guided bladder catheterization.
Postoperative urinary retention (POUR) following lower limb arthroplasty is a common complication. The aim of this observational study was to establish the incidence of POUR and assess the usefulness of an ultrasonographic nurse-driven protocol, thereby avoiding elective bladder catheterization. ⋯ Bladder scanners timely detect POUR following lower joint arthroplasty, making elective bladder catheterization unnecessary.
-
Minerva anestesiologica · Nov 2011
Pain, postdural puncture headache, nausea, and pruritus after cesarean delivery: a survey of prophylaxis and treatment.
The need for a cesarean delivery may interfere negatively with the overall experience of childbirth. Several factors related to anesthesiological management such as postoperative pain and discomfort, nausea and pruritus, and postdural puncture headache (PDPH), may lead to dissatisfaction and have a negative impact on early mobilization and a new mother's ability to care for her newborn baby. Optimal prophylaxis and treatment decrease these complications, increase satisfaction, and prevent chronic pain. This survey determined how prophylaxis and treatment of pain, PDPH, nausea, and pruritus after cesarean section (CS) is managed. ⋯ Apart from conservative treatment of PDPH, prophylaxis and treatment of pain after cesarean delivery, PDPH, nausea, and pruritus varied widely, indicating the need for the qualitative evaluation of overall management.
-
Minerva anestesiologica · Nov 2011
The use of the Foley Airway Stylet Tool® to guide tracheal intubations through an intubating laryngeal mask airway.
Blind insertion of endotracheal tubes through the intubating laryngeal mask airway (ILMA) is unsuccessful in almost 50% of cases on the first attempt, with an overall success rate of approximately 90%. We used a portable fiber optic device (Foley Airway Stylet Tool® FAST) to detect the reasons for failed intubations and tested its use in facilitating endotracheal tube placement. ⋯ A grade II view or worse indicated misalignment of the ILMA with the glottis. An endotracheal tube inserted blindly through the misaligned ILMA will impinge on and potentially damage laryngeal structures. The use of a portable fiber optic device can help reduce the failure rate of endotracheal intubations by utilizing ILMA in emergent situations.