Minerva anestesiologica
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Owing to their immune modulatory, anti-inflammatory, antioxidant, antithrombotic, and endothelial action, statins are widely used in the critical care setting in several disease scenarios. The present review focuses on the evidence supporting an even wider utilization of statins in intensive care practice for diverse indications. A search of the literature was carried out in PubMed, Cochrane and EMBASE databases up to January 2016. ⋯ References were also searched for other potentially useful articles. It was concluded that beneficial effects of statins are observed in cardiac surgery; however, no robust evidence supports their effectiveness in diverse critical care settings. The decision to discontinue statins in native users should be taken in consideration of particular clinical circumstances.
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Minerva anestesiologica · May 2017
Randomized Controlled TrialReal-time ultrasound guided spinal anesthesia in patients with predicted difficult anatomy.
There are limited reports of lumbar neuraxial blocks using real-time US in patients with predicted difficulties. We compared the number of attempts to perform spinal anesthesia using real-time US guidance versus landmark technique in patients meeting predefined criteria for difficult spinal anesthesia. We also compared procedure time, block success, patient satisfaction and difficulty scores between groups. ⋯ This trial suggests that real-time US guidance for spinal anesthesia in challenging patients in comparison to the controlled group was completed in longer time, with lower needle insertion attempts, and higher patient satisfaction scores but without statistically significant differences.
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Minerva anestesiologica · May 2017
Observational StudyA simplified screening tool to identify seriously ill patients in the Emergency Department for referral to a palliative care team.
The aims of this study were to evaluate the feasibility of an Emergency Department (ED)-initiated screening to identify seriously ill patients in need of palliative care (PC) and to develop a simplified screening tool (SST). ⋯ Our study estimated that over one-third of the people with chronic diseases awaiting to be hospitalized after an ED visit were in need of PC and can be identified with this easy-to-use, non-disease-specific SST.
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Severe obstructive sleep apnea (sOSA) and oxygen desaturations are both risk factors for postoperative complications. In some but not all patients, sOSA is associated with frequent oxygen desaturation episodes during sleep. The aim of this retrospective study was to identify the risk factors for exhibiting oxygen desaturation in patients with sOSA. ⋯ Less than 50% of patients with sOSA experience nocturnal oxygen desaturation. Obesity and daily benzodiazepine intake are independent risk factors for these patients to exhibit nocturnal oxygen desaturation. Benzodiazepine in obese patients with sOSA should, therefore, be used cautiously.