Minerva anestesiologica
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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.
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Minerva anestesiologica · Nov 2016
Targeting blood products transfusion in trauma: what is the role of thromboelastography?
Viscoelastic hemostatic assays (VHAs), mainly thromboelastography (TEG) and the rotational thromboelastometry (ROTEM), provide global information on clot formation and dissolution at patient bedside, allowing fast identification of coagulation disorders. In trauma patients, VHAs are able to predict massive transfusion and mortality. ⋯ These goal-directed, individualized treatment algorithms seem to reduce blood product transfusion without deleterious effects on patient outcome. Nevertheless, a clear outcome benefit of using VHAs remains to be demonstrated in trauma patients.