Minerva anestesiologica
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Minerva anestesiologica · Dec 2019
ReviewIntranasal dexmedetomidine in pediatrics: update of current knowledge.
Intranasal dexmedetomidine, although still off-label, recently boasted an increasing consensus for different uses, namely, in diagnostic non-painful procedures, in painful procedures and in surgical premedication. However, at present, there is no consensus regarding indications, dosage and timing for administration. ⋯ In summary, available pediatric evidence confirms efficacy and safety of dexmedetomidine for intranasal administration. Pharmacological profile for the various pediatric ages and procedures still needs quality studies and pharmacokinetic in-depth analysis.
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Minerva anestesiologica · Dec 2019
Comparative StudyIs the pCO2 gap obtained from the superior vena cava in agreement with that from the pulmonary artery?
The partial pressure of carbon dioxide (pCO2) gap is the difference between pCO2 values in the arterial and mixed venous blood; values higher than six mmHg may be predictive of tissue hypoperfusion. It is still doubtful if central venous blood can be used to assess the gap. This study was aimed to compare the values obtained with blood collected from the superior vena cava and the pulmonary artery. ⋯ pCO2 values are higher in the superior vena cava than in the pulmonary artery. As a consequence, the pCO2 gap calculated with the blood taken from the superior vena cava is overestimated, probably because it reflects the pCO2 arteriovenous difference of the upper part of the body, in particular of the brain.
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Minerva anestesiologica · Dec 2019
Comparative StudyAutomated measurement of tracheal and main bronchial diameters: a feasibility study.
A thoracic computed tomography scan is rarely used to help choose the appropriate double-lumen tube. Nowadays, bronchial measurements can be automated using dedicated software. The aim of this prospective monocentric study was to compare manual and automated measurements of the diameter of the trachea and both main bronchi in adult patients free from a history of lung surgery or disease. ⋯ This feasibility study has mixed results since automated measurements were not feasible in around 20% of the cases.