Minerva anestesiologica
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Minerva anestesiologica · Dec 2018
Implementing a donation after circulatory death program in a setting of donation after brain death activity.
Donation after circulatory death (DCD) is an emerging way to implement organ procurement for transplantation. In Italy, until June 2016, the only formal DCD program was implemented in Pavia, the so-called "Alba program." ⋯ A DCD program was feasible and increased procurement of splancnic organs (kidney and liver). Starting a DCD program in a traditionally oriented to DBD poses some organizational and cultural problems. A skilled, experienced ECMO team is necessary to guarantee organ ex vivo perfusion. Another important aspect for the implementation of a DCD program is the collaboration with the emergency system which allows a therapeutic approach of patients with cardiac arrest.
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Minerva anestesiologica · Dec 2018
Letter Case ReportsUltrasound-guided serratus plane block and image-guided microwave ablation of a rib metastasis.
Abstract
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Minerva anestesiologica · Dec 2018
Determination of 1,3-ß-D-glucan in the peritoneal fluid for the diagnosis of intra-abdominal candidiasis in critically ill patients: a pilot study.
Decision to start an anti-fungal therapy in intra-abdominal candidiasis (IAC) is complex. Yeast culture, considered the gold standard, suffers from a delayed response time and exposes the patient to delayed introduction of anti-fungal therapy. We sought to evaluate the performance and feasibility of measuring 1,3-β-D-glucan (1,3-BDG) in the peritoneal fluid (PF) for the diagnosis of IAC. ⋯ In secondary peritonitis, a peritoneal measurement of 1,3-BDG ≤310 pg/mL could rule out IAC.
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Minerva anestesiologica · Dec 2018
Randomized Controlled Trial Comparative StudyANI-guided intraoperative fentanyl consumption and postoperative analgesia in patients receiving scalp block versus incision-site infiltration for craniotomy.
Scalp block or local anesthetic infiltration for craniotomy blunts hemodynamic response to noxious stimuli, reduces opioid requirement and decreases postoperative pain. Analgesia Nociception Index (ANI) provides objective information about the magnitude of pain (rated from 0 to 100 with 0 indicating extreme nociception and 100 indicating absence of nociception) and adequacy of intra-operative analgesia. This study compared intra-operative fentanyl consumption guided by ANI and postoperative pain in patients who receive scalp block with those who receive incision-site local anesthetic infiltration for craniotomy. ⋯ ANI-guided analgesic administration during craniotomy demonstrated lower intra-operative fentanyl consumption in patients receiving scalp block as compared to incision-site local anesthetic infiltration. No correlation was seen between postoperative NRS and ANI.
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Minerva anestesiologica · Dec 2018
Randomized Controlled TrialPost-operative cognitive dysfunction and short-term neuroprotection from blueberries: a pilot study.
General anesthesia may be a risk factor for post-operative cognitive impairment, which could be counteracted by neuroprotective compounds. The aims of this study were to determine cognitive functions impaired by general anesthesia and to test blueberry juice as a neuroprotective agent against neuropsychological dysfunctions induced by general anesthesia. ⋯ General anesthesia induces a short-term impairment of verbal memory and selective and divided attention. Blueberry compounds may prevent these neuropsychological deficits through a neuroprotective action in patients undergoing general anesthesia.