Minerva anestesiologica
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Minerva anestesiologica · Dec 2013
A Systematic Review And Individual Patient Data Meta-Analysis On Intraabdominal Hypertension In Critically Ill Patients: The Wake-Up Project World Initiative on Abdominal Hypertension Epidemiology, a Unifying Project (WAKE-Up!).
Background: Intraabdominal hypertension (IAH), defined as a pathologically increase in intraabdominal pressure, is commonly found in critically ill patients. While IAH has been associated with several abdominal as well as extra-abdominal conditions, few studies have examined the occurrence of IAH in relation to mortality. Objective: To evaluate the prognostic role of IAH and its risk factors at admission in critically ill patients across a wide range of settings and countries. ⋯ Five hundred thirteen patients (30.8%) died in intensive care. The independent predictors for intensive care mortality were IAH, SAPS II score, SOFA score and admission category. Conclusions: This systematic review and individual patient data meta-analysis shows that IAH is frequently present in critically ill patients and it is an independent predictor for mortality.
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Minerva anestesiologica · Dec 2013
ReviewFungal Sepsis in the ICU: Are We Doing Better? - Trends in Incidence, Diagnosis, and Outcome.
Despite the availability of broad-spectrum antifungal agents, fungal sepsis remains an issue in Intensive Care Unit (ICU) patients. In terms of occurrence rates, the most important fungal infections are invasive candidiasis and invasive pulmonary aspergillosis. Early diagnosis is essential to optimize the chances of survival. ⋯ Given the problematic diagnosis of invasive aspergillosis no reliable trend data are available. Outcome following fungal sepsis remains cumbersome. Given the availability of potent antifungal agents any progress in survival is likely to come from a more timely diagnosis.
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Minerva anestesiologica · Dec 2013
Review Meta AnalysisThe Efficacy of Intravenous Lidocaine versus Placebo on Attenuating Cardiovascular Response to Laryngoscopy and Tracheal Intubation: A Systematic Review of Randomized Controlled Trials.
Cardiovascular response to laryngoscopy and tracheal intubation may be harmful in surgical patients with cardiovascular and cerebral diseases. The efficacy of intravenous lidocaine on attenuating the hemodynamic changes remains controversial. This systematic review aims to determine the efficacy of lidocaine versus placebo. ⋯ No significant publication bias across trials was found. Intravenous lidocaine helps reduce cardiovascular responses to laryngoscopy and tracheal intubation in patients of all age groups compared to placebo. Further studies are needed to clarify the effects of dosage and timing of lidocaine on hemodynamic changes.
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Minerva anestesiologica · Dec 2013
Multicenter StudyClinical characteristics and prognosis of pneumonia and sepsis: multicenter study.
Pneumonia is the primary source of sepsis and is significantly associated with mortality. However, only a few studies focus on its clinical characteristics and outcomes. ⋯ In patients admitted with sepsis, the pneumonia infection independently predicts 28-day in-hospital mortality. Combining the levels of serum lactate and PF ratio could be a useful approach in predicting mortality of these patients.
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Minerva anestesiologica · Dec 2013
Comparative StudyA comparative study of the efficacy of Pediatric Airtraq® with conventional laryngoscope in children.
Management of pediatric airway may pose a challenge to anesthesiologists. Many modifications in maneuvers and equipments have been made overtime to overcome the problem. Pediatric optical laryngoscope (Airtraq®) is one of the newer equipments for managing simple and difficult pediatric airway. Here we have evaluated the comparative efficacy of pediatric Airtraq® optical laryngoscope with conventional laryngoscope in children scheduled for routine surgeries. ⋯ Pediatric Airtraq® provides better intubating conditions in children compared to conventional laryngoscope with less frequent complications.