Minerva anestesiologica
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Minerva anestesiologica · May 2016
Review Meta AnalysisRestrictive versus liberal transfusion strategy for red blood cell transfusion in critically ill patients and in patients with acute coronary syndrome: a systematic review, meta-analysis and trial sequential analysis.
The risks and benefits of transfusing critically ill patients continue to evoke controversy. Specifically, the critically ill patients with active ischemic cardiac disease continue to represent a "gray area" in the literature. ⋯ Restrictive strategy is at least as effective to liberal strategy in critically ill patients. Nevertheless, there is insufficient evidence to recommend a restrictive strategy for patients with acute coronary syndrome.
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Minerva anestesiologica · May 2016
Residual neuromuscular blockade in a real life clinical setting. Correlation with sugammadex or neostigmine administration.
The aim of this study was to identify the frequency of residual neuromuscular blockade (RNMB) in the postanesthesia care unit (PACU) of a tertiary university hospital in Greece, and its correlation with reversal agents. The influence of other perioperative factors was assessed secondarily. ⋯ The frequency of RNMB was 10.8%. Patients who received sugammadex presented with higher TOF values at the PACU, although no difference in RNMB was detected compared to neostigmine. Female gender and the presence of comorbidities increased the possibility to exhibit RNMB at the PACU.
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Minerva anestesiologica · May 2016
Ultrasound evaluation of the stomach and gastric emptying in pregnant women at term: a case-control study.
This study aims to assess the rate of gastric emptying in pregnant women in the third trimester scheduled for elective caesarean section (CS), in view to highlight the aspiration risk. ⋯ In pregnant women at term, the stomach does not seem to be able to expand immediately after the meal. The transit of food is completed later than in not pregnant women. The ultrasound of the stomach allows identifying delays gastric emptying and highlighting patients at risk of aspiration.
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Minerva anestesiologica · May 2016
Observational StudyBlood-brain barrier permeability following traumatic brain injury.
Brain edema and intracranial hypertension is deleterious after traumatic brain injury (TBI), but the underlying pathophysiology is complex and poorly understood. One major subject of controversy is the time course and extent of blood-brain barrier (BBB) dysfunction following trauma, and previous studies in humans have only provided semi-quantitative data. The objective of the present study was therefore to quantify changes in BBB-permeability in the early course of TBI, when brain edema is still evolving. ⋯ Our results suggest that traumatic brain injury is associated with early focal increases in small molecular BBB-permeability. The results indicate that in the injured brain, capillary hydrostatic and oncotic pressures may influence edema formation.