Minerva anestesiologica
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Minerva anestesiologica · Jun 2018
Randomized Controlled Trial Comparative StudyPatient controlled epidural analgesia with and without basal infusion using ropivacaine 0.15% and fentanyl 2γ/mL for labour analgesia: a prospective comparative randomised trial.
Patient-controlled epidural analgesia (PCEA) is a common practice for labor pain relief. This study aimed to compare two different settings of a PCEA device using the same solution to obtain labor analgesia. ⋯ The addition of background infusion plus PCEA demand bolus doses increased local anesthetic consumption and reduced breakthrough pain without affecting maternal satisfaction and neonatal outcomes.
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Minerva anestesiologica · Jun 2018
Randomized Controlled Trial Comparative StudyA prospective, randomised trial of the Ambu AuraGain laryngeal mask versus the LMA Protector Airway in paralysed, anaesthetised adult men.
We hypothesize that oropharyngeal leak pressures differ between the LMA® Protector™ and the AuraGain™, two novel supraglottic airway devices offering the possibility of intubation. ⋯ Because of the higher success rate in first time insertion of the laryngeal mask and the gastric tube, respectively, as well as the lower resistance to insertion of the endotracheal tube we conclude a possible easier handling of the AuraGainTM in anesthetized male patients.
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Minerva anestesiologica · Jun 2018
Can red blood cell distribution width predict outcome after cardiac arrest?
In critically ill patients, high red blood cell distribution width (RDW) values have been associated with increased hospital mortality, but there are no data on the impact of RDW on outcomes of patients resuscitated from cardiac arrest (CA). The aim of this study was to investigate the relationship between RDW and long-term neurologic outcome in CA survivors. ⋯ High RDW values are associated with poor neurological outcome among CA survivors.
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Minerva anestesiologica · Jun 2018
Observational StudyAssociation between Bispectral Index System (BISTM) and airway obstruction, an observational prospective cohort analysis during third molar extractions.
Sedation regimes during oral procedures frequently associated with airway obstruction. The aim of this study was to define the association of Bispectral Index (BIS) to the depth of sedation and airway obstruction events. ⋯ This study demonstrates that the BIS could potentially be a valid continuous monitoring method to avoid airway obstruction during sedation for patients undergoing dental surgery.
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Minerva anestesiologica · Jun 2018
ReviewForgoing life-sustaining treatments in the ICU. To withhold or to withdraw: is that the question?
In the last decades, mortality from severe acute illnesses has considerably declined thanks to the advances in intensive care medicine. Meanwhile, critical care physicians realized that life-sustaining treatments (LST) may not be appropriate for every patient, and end-of-life care in the Intensive Care Unit (ICU) started to receive growing attention. Most deaths occurring in the ICU now follow a decision to forgo life-sustaining treatments (DFLST), which can be implemented either by withdrawing (WDLST) or withholding (WHLST) life-sustaining treatments. ⋯ Secondly, the preferences of ICU physicians towards WDLST and WHLST are examined. Finally, some arguments are offered outlining pros and cons of WDLST and WHLST, stressing that the clinician's attention should focus on an early and thorough recognition of patients in need of a DFLST, rather than on the theoretical strength and weakness of the two practices. This approach will enable physicians to make informed decisions on how to implement the limitation of LSTs, considering the patients' clinical conditions and preferences, the circumstances and needs of their families.