Minerva anestesiologica
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Minerva anestesiologica · Dec 2014
Timing and duration of intracranial hypertension versus outcomes after severe traumatic brain injury.
The goal of this paper was to investigate the association between patterns of intracranial hypertension (IH) and outcomes, to describe the treatment of patients with different patterns of IH, and to examine whether IH is an independent predictor of mortality and unfavourable outcome, respectively. ⋯ Intracranial hypertension with early onset is independently associated with significantly worse outcome in patients with severe TBI. The total duration of IH shows a significant correlation to mortality.
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Minerva anestesiologica · Dec 2014
ReviewHypertrophic Cardiomyopathy: implications for anaesthesia.
Hypertrophic cardiomyopathy (HCM) is a genetic disorder and it is recognized as the most common cause of sudden cardiac death in the young, and an important substrate for disability at any age. Anesthetists may be confronted with clinically unrecognized HCM and must be prepared to anticipate the hemodynamic changes and cardiovascular instability that such patients may impose. When HCM patients are subjected to the stress of surgery, perioperative complications occur and can be devastating. ⋯ Factors that worsen the degree of left ventricle outflow tract obstruction and hemondynamic strategies to improve cardiac outoput are described in the present review. Strategies to respond to hypotension must be promptly instituted to prevent the development of cardiovascular collapse, and subsequent complications. Therefore, a complete understanding of the pathophysiology, hemodynamic changes and anesthetic implications is needed for successful perioperative outcome.