Minerva anestesiologica
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Minerva anestesiologica · Jan 2016
Randomized Controlled Trial Comparative StudyRandomized controlled trial comparing the McGrath MAC video laryngoscope with the King Vision video laryngoscope in adult patients.
This study compares the performance of the McGrath MAC and King Vision laryngoscope systems for endotracheal intubation in adult patients with predicted normal airways when used by experienced laryngoscopists with limited prior video laryngoscopy experience. ⋯ The McGrath MAC video laryngoscope allowed for significantly shorter times to endotracheal intubation, higher success rates on first attempt, and fewer desaturations compared to the King Vision video laryngoscope when used by experienced laryngoscopists with limited prior video laryngoscopy experience.
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Minerva anestesiologica · Jan 2016
ReviewThe evolution of nutritional support in long term ICU patients: from multisystem organ failure to persistent inflammation immunosuppression catabolism syndrome.
Multiple organ failure (MOF) is an evolving pathologic phenotype that plagues intensive care units globally. This manuscript aims to depict the evolution of single organ failure through multiple organ failure, ending in the newest phenotype called persistent inflammation, immunosuppression, catabolism syndrome (PICS). ⋯ Discussed in these sections are possible etiologies for the various progression of MOF, total enteral nutrition (TPN) versus early enteral nutrition (EEN), early versus late parenteral nutrition, glycemic control, and new enteral formulas. Finally, as the newest phenotype, PICS, has evolved we try to make inferences from similar pathologic states to recommend nutritional support that has proven beneficial.
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Minerva anestesiologica · Jan 2016
Observational StudyFeasibility and results of a fast-track protocol in thoracic surgery.
A rehabilitation program, a multimodal strategy favoring rapid postoperative return to autonomy, has rarely been undertaken after thoracic surgery compared to colectomy. The primary outcome of this fast-track program was the length of postoperative stay. Secondary outcomes concerned the feasibility of this strategy, the incidence of postoperative complications and 3-month postoperative mortality. ⋯ A program for early rehabilitation is feasible after thoracotomy. Chest drainage and organization to optimize the length of stay are crucial points.
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Minerva anestesiologica · Jan 2016
Ethical issues associated with in-hospital emergency from the Medical Emergency Team's perspective: a national survey.
Medical Emergency Teams (METs) are frequently involved in ethical issues associated to in-hospital emergencies, like decisions about end-of-life care and intensive care unit (ICU) admission. MET involvement offers both advantages and disadvantages, especially when an immediate decision must be made. We performed a survey among Italian intensivists/anesthesiologists evaluating MET's perspective on the most relevant ethical aspects faced in daily practice. ⋯ Italian intensivists/anesthesiologists reported that ethical issues associated with in-hospital emergencies are occurring commonly and are having a significant negative impact on MET well-being. Conflicts with ward physicians happen frequently. They also conveyed that hospitals don't offer ethics training and have no protocols in place to address ethical issues.
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Minerva anestesiologica · Jan 2016
Improving preoperative medication compliance with standardized instructions.
Patient medication adherence in the perioperative setting is challenging, and failure to comply with medication instructions has serious clinical consequences. Many factors contribute to medication nonadherence, but a modifiable cause is inadequate physician instruction of patients. Variable formats, language and legibility impede patient-physician communication regarding proper use of medications. We hypothesized that the use of a standardized, electronic medical record (EMR)-derived medication instruction template would improve medication compliance on the day of surgery. ⋯ Use of standardized, EMR-generated preoperative instructions improves patient medication adherence on the morning of surgery. Even with this intervention, medication nonadherence most often involves medications that could seriously interfere with perioperative care.