Minerva anestesiologica
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Minerva anestesiologica · Jun 2017
ReviewRemote ischemic preconditioning in cardiac anesthesia: a review focusing on translation.
Remote ischemic conditioning (RIC) is a powerful cardioprotective strategy. Its clinical application is simple, cheap and so far free from secondary side effects. Given the heterogeneous results of recent large-scale clinical trials, its clinical relevant benefit is still doubted. ⋯ Their results are as heterogeneous as their monitored outcome parameters or strategies to apply RIC. The impressive experimental and clinical evidence in favor of RIC is opposed by the neutral results of the latest large-scale trials. While the underlying reasons for these neutral results are matter of on-going debate and could not be answered by recent published sub-investigations, additional adequately designed studies are encouraged by the mentioned results of experimental and pilot studies to exclude any confounding factors.
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Minerva anestesiologica · Jun 2017
ReviewFluid management in cardiac surgery patients: pitfalls, challenges and solutions.
Fluid administration is a powerful tool for hemodynamic stabilization as it increases preload and improves cardiac function in fluid-responsive patients. However, there are various types of fluid to choose from. The use of colloids and crystalloids in non-cardiac Intensive Care Units (ICU) has been reported, showing controversial results. ⋯ Improved clinical outcomes are evident in protocols for goal-directed therapy. In conclusion, the application of a close monitoring and a pre-defined goal-directed protocol are far more important than the choice of a single fluid. This review examines the available evidence on fluid management in cardiac surgery and in the ICU, and analyzes the key steps of fluid strategy in these settings.
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Minerva anestesiologica · Jun 2017
Comparative Study Observational StudyCritically ill octogenarians and nonagenarians: evaluation of long-term outcomes, post-hospital trajectories and quality of life one year and seven years after ICU discharge.
The aim of this study was to investigate long-term outcomes, posthospital trajectories, and quality of life (QOL) in patients ≥80 years admitted to the Intensive Care Unit (ICU) of a tertiary care hospital. ⋯ Most critically ill long-term elderly survivors lived at home, perceived their QOL as acceptable, and wanted to be readmitted to the ICU if necessary. In older patients, age alone is a poor indicator of the possible value to be gained from an ICU admission.
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Minerva anestesiologica · Jun 2017
Observational StudyCauses of sore throat after intubation: a prospective observational study of multiple anaesthesia variables.
Sore throat is common after intubation for surgery. This observational study investigated cuff pressure and a large range of clinical covariates to explore the etiology of sore throat. ⋯ Only age and the presence of a nasogastric tube after surgery were significant predictors for sore throat. This result contradicts most other studies of cuff pressure where fewer covariates were measured.