Minerva anestesiologica
-
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.
-
Minerva anestesiologica · Sep 2014
Review Meta AnalysisUpdate of recommendations for analgosedation in Pediatric Intensive Care Unit.
Effective and adequate therapy to control pain and stress are essential in managing children in Pediatric Intensive Care Unit (PICU) undergoing painful invasive procedures, this should be, but is not yet, one of our main aims. Aware that this difficult mission must be pursued in a systematic, multimodal and multitasking way, the Studying Group on Analgosedation in PICU from the Italian Society of Neonatal and Paediatric Anesthesia and Intensive Care (SARNePI) is providing its recommendations.
-
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.