Minerva anestesiologica
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Minerva anestesiologica · Jul 2016
Paediatric anaesthesia and neurotoxicity: can we translate findings from animals to humans?
Many studies have demonstrated a neurodegenerative effect of anesthetic drugs in cubs and young animals, raising the concern that similar effects can happen in children, and that the administration of anesthesia in young children undergoing surgical or diagnostic procedures may cause long-term neurocognitive impairment. Thus, several epidemiological studies have been performed with the aim to find a possible association between early anesthesia exposure and poor long-term outcome, like learning disabilities or worse school grading and two prospective trials are currently running, the GAS and the PANDA study. ⋯ Nonetheless, studies in animals are necessary to better understand the effects of anesthetics and the mechanistic of potential anesthesia-related neurotoxicity. Studies in humans must run in parallel in order to determine whether similar effects may occur in young patients.
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Minerva anestesiologica · Jul 2016
How to improve communication quality with patients and relatives in the ICU.
The experience of intensive care for patients and their families is known to be very stressful and may result in both acute and chronic psychological problems that include sleep disturbance, depression, anxiety and post-traumatic stress disorder. While some non-modifiable risk factors for psychological harm are known, there are also a several modifiable risk factors that may be addressed using strategically planned interventions such as optimal communication techniques. ⋯ One situation which is central to communication in the ICU is the family meeting. Similar to other procedures in the ICU, training, practice, preparation and reflective review may improve performance when conducting family meetings and lead to better outcomes for patients and families.
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Minerva anestesiologica · Jul 2016
Adjusting ventilator off-cycling in invasively ventilated COPD patients needs comprehensive adjustments.
Patient-ventilator asynchrony that prolongs weaning and increases morbidity and mortality is common during invasive ventilation of patients with chronic obstructive pulmonary disease (COPD). In this context, the inspiratory cycling criteria (iCC) of the ventilator during assisted pressure support (PS) ventilation is a poorly acknowledged key factor. We investigated the changes of flow and pressure parameters that resulted from varying the iCC in a simulated COPD lung model. ⋯ Non-adapted ventilator iCC can cause patient-ventilator asynchrony. The success of assisted invasive ventilation and weaning relies on meticulous adjustments.