Minerva anestesiologica
-
Minerva anestesiologica · Sep 2012
Controlled Clinical TrialThe use of Modified Early Warning Score may help anesthesists in postoperative level of care selection in emergency abdominal surgery.
The Modified Early Warning Score (MEWS) was proposed for early identification of patients deterioration. The purpose of this study was to determine if MEWS calculation can help the anaesthesist select the correct level of care to avoid inappropriate admission to the ICU and to enhance the use of the High Dependency Unit (HDU) after emergency surgical procedures. ⋯ This study suggests that the use of a simple and reproducible score system may help in reducing ICU admissions after emergency surgery.
-
Minerva anestesiologica · Sep 2012
Influence of different flow-triggering levels on the breathing effort of mechanically ventilated patients.
Although a sensitive flow triggering (FT) level is supposed to be associated with reduced breathing effort, the incidence of autotriggering (AT) is likely to be increased. The actual effects of various FT levels on the work of breathing and occurrence of AT in mechanically ventilated patients are unknown. We investigated the effects of different FT levels (1-8 L/min) on breathing effort and incidence of AT in mechanically ventilated patients under pressure support ventilation using a Puritan-Bennett 840 ventilator. ⋯ A higher FT level was associated with lower incidence of AT, but without a significant increase in breathing effort. A higher FT level may be more reasonable in mechanically ventilated patients with this particular ventilator.
-
Minerva anestesiologica · Sep 2012
Clinical TrialA reorientation strategy for reducing delirium in the critically ill. Results of an interventional study.
A wide variability in the approach towards delirium prevention and treatment in the critically ill results from the dearth of prospective randomised studies. ⋯ A timely reorientation strategy seems to be correlated with significantly lower occurrence of delirium.
-
Minerva anestesiologica · Sep 2012
No additive effects of inhaled iloprost and prone positioning on pulmonary hypertension and oxygenation in acute respiratory distress syndrome.
In acute respiratory distress syndrome (ARDS), pulmonary hypertension is associated with a poor prognosis. Prone position is effective to improve oxygenation whereas inhaled iloprost can treat pulmonary hypertension. However, combination of these interventions has not been examined before. The hypothesis was that this combination had additive effects on oxygenation and pulmonary hemodynamics as compared with each intervention alone. ⋯ Although iloprost reduced pulmonary arterial pressures, and prone positioning improved oxygenation; there are no additive effects of the combination of both interventions on both parameters. To treat both pulmonary hypertension and hypoxemia, application of iloprost in prone position is suggested.