Minerva anestesiologica
-
Minerva anestesiologica · May 2014
ReviewChemotherapy induced cardiovascular toxicity: Beyond anthracyclines.
It is not uncommon for anesthesiologists to encounter cancer patients who have received chemotherapy agents known to cause cardiovascular toxicities such as heart failure, systemic hypertension and thromboembolic events. Anthracyclines have been for several decades the most studied agents because of their known cardiovascular effects and relatively high incidence of heart failure. ⋯ Thus, anesthesiologist needs to be aware of the clinical features of each type of cardiac toxicity. This review will summarize the current clinical evidence on cardiovascular toxicity induced by chemotherapeutic agents and will try to shed light on the current information regarding the perioperative management of patients with chemotherapy-induced cardiovascular toxicity.
-
Minerva anestesiologica · May 2014
Doppler study of the effects of inhaled nitric oxide and intravenous almitrine on regional pulmonary blood flows in patients with Acute Lung Injury.
Lung ultrasound can be used at bedside to assess initial lung morphology in hypoxemic patients. We hypothesized that blood flow in consolidated lung and therefore effects of inhaled nitric oxide (iNO) and intravenous almitrine could be directly assessed using Doppler transesophageal echocardiography (TEE). ⋯ Doppler of consolidated LLL allows assessment of regional pulmonary circulation in ICU settings. It detects changes in flow profiles resulting from the administration of NO and/or almitrine. Further applicability remains to be determined.
-
Minerva anestesiologica · May 2014
Hemodynamics and tissue oxygenation after hemodilution with ultrahigh molecular weight polymerized albumin.
Compared to blood transfusion, plasma expanders (PEs) are more cost effective, have a longer shelf-life, and elicit a milder immune response. High molecular weight (MW) dextrans preserve microvascular function during extreme hemodilution. Dextrans, however, evokes negative hemostatic effects, including red blood cell (RBC) aggregation and reduce platelet adhesion, that limit their clinical use. Therefore, polymerization of human serum albumin (HSA) presents a simple strategy to increase HSA's molecular size. ⋯ PolyHSA during extreme anemia supported systemic and microvascular hemodynamics by increasing plasma viscosity without increasing vascular resistance. These findings can aid to design of studies to understand the role of the PE biophysical properties in clinical scenarios.