Minerva anestesiologica
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Minerva anestesiologica · Feb 2013
Gaze-controlled, computer-assisted communication in Intensive Care Unit: "speaking through the eyes".
The aim of this study was to test the hypothesis that a gaze-controlled communication system (eye tracker, ET) can improve communication processes between completely dysarthric ICU patients and the hospital staff, in three main domains: 1) basic communication processes (i.e., fundamental needs, desire, and wishes); 2) the ability of the medical staff to understand the clinical condition of the patient; and 3) the level of frustration experienced by patient, nurses and physicians. ⋯ Our results show an improvement in the quality of the examined parameters. Better communication processes seem also to lead to improvements in several psychological parameters, namely anxiety and drop-out depression perceived by both patients and medical staff. Further controlled studies are needed to define the ET role in ICU.
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Minerva anestesiologica · Feb 2013
Randomized Controlled TrialAntiemetic effects of combined methylprednisolone and tropisetron in mastectomy.
Combined dexamethasone and tropisetron have been reported more effective than a single drug therapy in preventing postoperative nausea and vomiting (PONV). However, the safety use of dexamethasone has been questioned recently because of the risk of secondary adrenal deficiency. Therefore, we hypothesized that combined tropisetron and methylprednisolone, a short-lasting corticoid, might provide effective prophylaxis of PONV with less effect on endogenous cortisol level. ⋯ Methylprednisolone-tropisetron combination is more effective than tropisetron alone, and as equally effective as dexamethasone-tropisetron combination for preventing acute PONV in mastectomy.
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Minerva anestesiologica · Feb 2013
ReviewLung imaging in patients with acute respiratory distress syndrome: from an understanding of pathophysiology to bedside monitoring.
Over the last 25 years, lung imaging has changed our understanding of acute respiratory distress syndrome. Alveolar recruitment, hyperinflation, and positive end-expiratory pressure-induced changes in lung aeration have become evaluable using CT, PET, and ultrasonography. ⋯ Bedside tools allowing monitoring of mechanical ventilation, and testing of ventilator settings, are urgently required. The aim of the present review is to consider how lung imaging has facilitated the evolution of knowledge of this syndrome, and to place such knowledge in a clinical perspective.
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Colistin is a re-emerging old antibiotic that is used as a salvage treatment against multidrug-resistant Gram-negative infections. Because it is administrated as an inactive prodrug, colistin methanesulfonate (CMS) that undergoes rapid hydrolyze to colistin, pharmacokinetic studies using biological assays are unreliable. With the recent development of new assays using high performance liquid chromatography (HPLC) accurate pharmacokinetic of CMS and formed colistin is now available in various populations. This article aims to update previous reports on pharmacodynamics, pharmacokinetics, safety and clinical use of colistin, with a special focus on data useful to treat critically ill patients.