Minerva anestesiologica
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Minerva anestesiologica · Aug 2011
Multidetector computed tomography (MDCT) for preoperative airway assessment in children with mucopolysaccharidoses.
Accumulation of glycosaminoglycans is known to cause significant problems in the anesthetic management of children with mucopolysaccharidoses (MPS). Clinical and standard radiological evaluation may convey insufficient information about the upper airway and trachea in children with MPS. Multidetector computed tomography (MDCT) images have been used to define the central airway and previous studies have recommended this tool to assess the airway of children who are considered at risk of difficult intubation. However, MDCT has not been recommended in MPS children. The aim of this clinical scenario study was to verify whether information from MDCT reconstruction of the airway is useful in airway management planning of children with MPS. ⋯ Airway reconstruction using MDCT images from a previous CT scan may provide a useful assessment tool for preoperative airway evaluation and planning in MPS children.
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Minerva anestesiologica · Aug 2011
Letter Randomized Controlled TrialModification of endotracheal intubation using AirwayScope™ videolaryngoscope for straight reinforced tubes.
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Minerva anestesiologica · Aug 2011
Sevoflurane as a potential replacement for halothane in diagnostic testing for malignant hyperthermia susceptibility: results of a preliminary study.
To diagnose malignant hyperthermia (MH) susceptibility, muscle bundles are exposed to halothane and caffeine. We investigated whether sevoflurane, which is more clinically relevant but less potent of an anesthetic, could replace halothane in diagnostic MH testing. ⋯ The rapid application of a high sevoflurane concentration but not an increasing stepwise application allowed for the diagnostic discrimination of susceptible individuals.
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Minerva anestesiologica · Aug 2011
Review Meta AnalysisContinuous intravenous infusion of ketamine for maintenance sedation.
Ketamine HCl is a rapidly acting general anesthetic with sedative and analgesic properties that has been reported to have favorable effects on the cardiovascular and pulmonary systems. The goal of this review is to determine the hemodynamic and pulmonary effects of continuous intravenous (IV) ketamine infusion in mechanically ventilated patients, and to determine whether sufficient evidence exists to support its use as an agent for maintenance anesthesia. PubMed/Medline, EMBASE, and Index Medicus databases as well as relevant bibliographies were searched. ⋯ It also improves respiratory rate and oxygenation, and does not promote respiratory depression. Additionally, ketamine does not result in significant perturbations in blood pressure, heart rate, or vascular resistance. Ketamine may be a safe and effective tool for maintenance sedation of mechanically ventilated patients, however a large prospective clinical trial is warranted.
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Minerva anestesiologica · Aug 2011
ReviewNew approaches for empiric therapy in Gram-positive sepsis.
Nosocomial bloodstream infections (BSIs) have become an important cause of morbidity and mortality, particularly in intensive care units (ICUs). Gram-positive organisms are the prevalent causes of antibiotic-resistant BSI, especially Staphylococcus aureus, coagulase-negative staphylococci and enterococci. In recent years, several reports have shown an increase in antimicrobial resistance among Gram-positive bacteria isolated from patients in ICUs. ⋯ Here we describe the microbiological, pharmacological and clinical characteristics of three new antibacterials helpful in severe infections in ICU patients: linezolid, tigecycline and daptomycin. These new drugs have some limitations, and the possibility developing resistance is real. Knowledge of both old and new antibacterials is necessary to utilize them most effectively.