Minerva anestesiologica
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Minerva anestesiologica · Sep 2014
Right ventricular stroke volume variation: a tool to assess right ventricular volume responsiveness.
So far, only left ventricular functional preload indices are used as a routine to assess volume responsiveness. Right ventricular (RV) functional preload indices have been described, but offer no continuous monitoring. ⋯ RVSVV seems to reflect volume requirement of the right ventricle and it might prove a reliable parameter to assess volume responsiveness in RVF.
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Minerva anestesiologica · Sep 2014
ReviewFriday night ventilation a safety starting tool kit for mechanically ventilated patients.
We wish to report here a practical approach to an acute respiratory distress syndrome (ARDS) patient as devised by a group of intensivists with different expertise. The referral scenario is an intensive care unit of a Community Hospital with limited technology, where a young doctor, alone, must deal with this complicate syndrome during the night. The knowledge of pulse oximetry at room air and at 100% oxygen allows to estimate the PaO2 and the cause of hypoxemia, shunt vs. ⋯ PEEP from 5 to 10, from 10 to 15 and greater than 15 cmH2O should be set in mild, moderate and severe ARDS, respectively. Prone position should be applied in severe ARDS, if experience is available. In case of unchanged conditions or increased ARDS severity a referral center should be contacted.
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Minerva anestesiologica · Sep 2014
Observational StudyMathematical coupling of data between global end diastolic volume index and cardiac index calculated by the PiCCO device: myth or reality?
Aim of the study was to investigate whether cardiac index (CI) and global end diastolic volume index (GEDVi) determined from the same thermodilution curve are mathematically coupled during the infusion of an inotropic agent in critically ill patients. ⋯ Our study provides evidence that changes in GEDVi are mathematically coupled to changes in CI during dobutamine infusion. Therefore, clinicians using PiCCO device to evaluate GEDVi must be aware of the underlying formula to avoid placing undue reliance on artifactual correlations due to mathematical coupling.
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Minerva anestesiologica · Sep 2014
A PILOT STUDY OF TRANSCRANIAL DOPPLER GUIDED INITIAL RESUSCITATION OF TRAUMATIC AND NON TRAUMATIC COMATOSE PATIENTS.
The aim of this study was to evaluate the usefulness of early Transcranial Doppler (TCD) in guiding initial resuscitation of traumatic and non-traumatic comatose patients before diagnostic imaging and invasive neurologic monitoring. ⋯ Our study suggests that early TCD is feasible to evaluate qualitative information about cerebral perfusion in comatose patients while they are waiting for diagnostic imaging studies.