Minerva anestesiologica
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Minerva anestesiologica · Jan 2014
Letter Case ReportsThoracic Aortic Mural Thrombus as a cause of multi-organ failure.
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Minerva anestesiologica · Jan 2014
Multicenter Study Observational StudyAccuracy of leptin serum level in diagnosing ventilator-associated pneumonia: a case-control study.
Undernutrition causes a reduction of body-fat mass and a decrease in the circulating concentration of leptin which impairs the production of proinflammatory cytokines and increases the incidence of infectious diseases. The main objective of this study was to determine whether leptin deficiency is a risk factor for ventilator-associated pneumonia (VAP). ⋯ In our study, leptin level was not associated with VAP occurrence. Further studies are needed to confirm our results, and to define the exact inflammatory role of leptin, and its interest as a biomarker in ICU patients.
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Minerva anestesiologica · Jan 2014
Randomized Controlled Trial Clinical TrialBlood from the right atrium may provide closer estimates of mixed venous saturation than blood from the superior vena cava. A pilot study.
As a rule, central venous catheters (CVC) should not be positioned in the right atrium (RA) to avoid the risk of perforation and cardiac tamponade. However, in ICUs where ECG monitoring can detect any initial damage of the atrial wall, CVCs may probably be safely positioned in the RA. We investigated whether mixed venous saturation (SvO2) was better estimated by measuring central venous saturation (ScvO2) in the RA or in the superior vena cava (SVC) in patients undergoing cardiac surgery. ⋯ In monitored patients, positioning CVC tips in the RA rather than in the SVC may allow closer estimates of SvO2 and may be safe. Yet, safety should be confirmed by further studies with larger samples of patients.
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Minerva anestesiologica · Jan 2014
ReviewUpdate on Anesthetic Complications of Robotic Thoracic Surgery.
In the last decade, there has been increasing use of the da Vinci® robot surgical system to perform minimally invasive thoracic surgery. The robotic technology can be applied for surgery of the lungs, mediastinum, and esophagus. A number of case reports have been shown steep learning curve, and promising surgical outcome with this new technology. ⋯ In addition, a unique operative setting, such as patient positioning and capnothorax can make anesthesia management further challenging. Hence, anesthesiologists should have better awareness of adverse events or complications related to the robotic surgery to accomplish successful anesthesia management. This review will focus on the potential complications of robotic thoracic surgery involving the lungs, mediastinum and esophagus.