Minerva anestesiologica
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Minerva anestesiologica · Nov 2016
Randomized Controlled TrialPropofol versus midazolam for premedication. A placebo-controlled, randomized double-blinded study.
It has been previously reported that subhypnotic doses of propofol could offer an advantage over midazolam for premedication. This study was designed to test the hypothesis that a 20 mg IV dose of propofol would be more effective than a standard 2 mg IV dose of midazolam for reducing acute anxiety prior to induction of anesthesia. ⋯ When administered ~5 min prior to entering the OR, propofol, 20mg IV, was as effective as midazolam 2mg IV in reducing anxiety.
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Minerva anestesiologica · Nov 2016
Randomized Controlled TrialPropofol-remifentanil anesthesia for upper airway endoscopy in spontaneous breathing patients: the ENDOTANIL randomized trial.
The ENDOTANIL Trial aimed at comparing an association of target-controlled infusion (TCI) of remifentanil and propofol to TCI of propofol alone on the clinical conditions during pan endoscopy for assessment of the upper airway (pan endoscopy) performed under tubeless general anesthesia. ⋯ The adjunction of remifentanil to propofol TCI, at a dose that maintain spontaneous breathing, did not improve the conditions for pan endoscopy, but attenuates the hemodynamic response induced by upper airway stimulation.
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Minerva anestesiologica · Nov 2016
Randomized Controlled TrialNon-invasive haemodynamic optimization in major abdominal surgery: a feasibility study.
Today, most of the pre-emptive hemodynamic optimization algorithms are based on variables associated with invasive techniques like arterial cannulation. The non-invasive Nexfin™ technology is able to estimate continuous Cardiac Index (CI) and pulse pressure variation (PPV). However, the efficiency of an early goal directed therapy (EGDT) algorithm based on non-invasive variables has to be proven. The aim of our study was to investigate the feasibility of a non-invasive driven EGDT protocol and its impact on patient's outcome. ⋯ In this patient collective, we could demonstrate the feasibility of a non-invasive approach for hemodynamic optimization. However, EGDT based on non-invasive variables was not able to significantly improve outcome.
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Minerva anestesiologica · Nov 2016
Serum S100β as a prognostic marker in patients with non-traumatic intracranial hemorrhage.
The serum concentration of S100β protein reportedly predicts outcomes after brain injury. We examined the prognostic accuracy of S100β in patients with non-traumatic intracranial hemorrhage. ⋯ Serum S100β concentration corresponds with the severity of neurological insult and predicts poor outcome in patients with non-traumatic intracranial hemorrhage.
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Minerva anestesiologica · Nov 2016
Diaphragmatic ultrasonography as an adjunct predictor tool of weaning success in patients with difficult and prolonged weaning.
Diaphragmatic ultrasonography has been recently considered as a new weaning predictor method. Previous studies checked diaphragmatic excursion and thickness during quiet or deep breathing in unselected populations of critically ill patients. Our study aimed to investigate diaphragmatic excursion during quiet and unassisted breathing, in comparison to standard predictor tools, such as Rapid Shallow Breathing Index (RSBI) and Maximal Inspiratory Pressure (Pimax), in patients with difficult and/or prolonged weaning. ⋯ Our results suggest that DEx threshold of 10 mm and 7 mm for right and left hemidiaphragms respectively could be used as adjunct tool in the predictive algorithm of weaning in difficult to wean patients.