Minerva anestesiologica
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Minerva anestesiologica · Jul 2015
Time course of cytokines, hemodynamic and metabolic parameters during hyperthermic intraperitoneal chemotherapy.
Systemic response to cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) causes the activation of endocrine, metabolic, hemodynamic and inflammatory processes. The aim of this work is to describe and analyze the time course of the inflammatory markers concentration during CRS+HIPEC in plasma and peritoneal fluids and the association with hemodynamic and metabolic parameters. ⋯ The most significant variations are those of IL-6 and PCT. The cytokines level parallel the hemodynamic derangements. Treatment during HIPEC should mimic the established treatment during sepsis and septic shock.
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Minerva anestesiologica · Jul 2015
Editorial CommentAbout the benefits and limitations of pilot studies.
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Minerva anestesiologica · Jul 2015
ReviewSurveillance samples and selective digestive decontamination in the intensive care unit.
Surveillance cultures are essential in the management of infection in the intensive care unit. They are crucial in the assessment of the efficacy of selective digestive decontamination.
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Minerva anestesiologica · Jul 2015
Use of selective digestive tract decontamination in European intensive cares: the ifs and whys.
Several studies have shown that the use of selective digestive tract decontamination (SDD) reduces mortality. However, fear for increasing multidrug resistance might prevent wide acceptance. A survey was performed among the units registered in the European Registry for Intensive Care (ERIC), in order to investigate the number of ICUs using SDD and the factors that prevented the use of SDD. ⋯ SDD is used in a minority of the European ICUs registered in the ERIC database. Larger ICUs and ICUs with a prudent antibiotic policy were more likely to use SDD. Neither antibiotic resistance nor the cluster randomized study design were determinants of the non-use of SDD.
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Minerva anestesiologica · Jul 2015
Randomized Controlled TrialThe effect of perfusion pressure on the splanchnic circulation after CPB: a pilot study.
The impact of different blood pressure targets is unknown for post cardiac surgery patient in the intensive care unit. We, therefore, investigated the effects of a mean arterial pressure (MAP) target of 65 or 85 mmHg on splanchnic oxygenation, metabolic function, cytokine regulation and gastric tonometry after cardiopulmonary bypass. ⋯ Achieving a MAP target of 85 mmHg by means of norepinephrine infusion after CPB appears safe for the splanchnic circulation.