Minerva anestesiologica
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Minerva anestesiologica · Aug 2011
Differential effects of the calcitonin gene-related peptide on cardiac performance in acute myocardial ischemia and reperfusion in isolated rat hearts.
The cardioprotective effects of the calcitonin gene-related peptide (CGRP) are known; however, the profiles of CGRP given pre- and postischemia as a therapeutic agent in acute myocardial ischemia and reperfusion remain elusive. ⋯ The results indicated a differential effect of CGRP on cardiac performance following acute ischemia/reperfusion.
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Minerva anestesiologica · Aug 2011
Review Meta AnalysisThe preventive role of higher PEEP in treating severely hypoxemic ARDS.
This review summarizes knowledge and evidence on the use of positive end-expiratory pressure (PEEP) in patients with severely hypoxemic acute respiratory distress syndrome (ARDS). More specifically, it documents the current evidence on the effects of higher PEEP in preventing (or attenuating) lung damage during the ventilatory management of patients with severely hypoxemic ARDS. No established threshold has been set to define severely hypoxemic ARDS and higher PEEP. ⋯ Higher PEEP should be used with caution in patients less severe hypoxemic (acute lung injury). To deliver optimal PEEP to those ARDS patients with the highest lung recruitability, this technique should be monitored at the bedside. Alternative methods are under investigation as part of a decremental PEEP trial.
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Anesthetics are widely used in the management of neurocritical patients, although has never been proved that the use of these drugs can contribute to positive outcome. The aim of this review was to evaluate the expected benefit of anesthetics use in relation to the altered physiology of the damaged brain while considering possible related complications.
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Minerva anestesiologica · Aug 2011
Fluid balance in critically ill patients. Should we really rely on it?
The computation of fluid balances (FBs) by subtracting fluid outputs from inputs is a common critical care practice. Limited information exists about the accuracy and consistency of nurse-registered cumulative FBs and regarding the value of suggested corrections for non-measurable losses. ⋯ For a large portion of patients nurse-registered cumulative FBs are neither accurate nor do they agree with standardised BW measurements. Patient care and clinical decision-making should be based on more objective techniques.