Minerva anestesiologica
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Minerva anestesiologica · Jun 2019
Meta Analysis Comparative StudyInhalation versus intravenous anesthesia for adults undergoing heart valve surgery: a systematic review and meta-analysis.
Many studies have found that volatile anesthetics are associated with improved clinical outcomes for adults undergoing coronary artery bypass grafting. However, the effect of volatile anesthetics for adults after heart valve surgery has been unclear. So we conducted a meta-analysis of randomized controlled trials (RCTs) to explore whether the choice of an anesthetic regimen might influence patients' outcomes after valve surgery. ⋯ Among patients undergoing heart valve surgery, the use of inhalation anesthesia compared with TIVA failed to demonstrate superiority for survival and major postoperative complications, and the evidence was insufficient to draw firm conclusions due to the limited sample size. A determination of equivalence or superiority between these two anesthetic regimens requires further researches.
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Minerva anestesiologica · Jun 2019
Comment LetterStatins during daptomycin therapy: to give or not to give?
Abstract
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Minerva anestesiologica · Jun 2019
Randomized Controlled Trial Comparative StudyComparing low-dose bupivacaine with epidural volume extension to standard bupivacaine dosing for short obstetric procedures: a prospective, randomized study.
Intrathecal bupivacaine's long duration of action can unnecessarily increase the time to meet Postanesthesia Care Unit (PACU) discharge criteria for patients undergoing short obstetric procedures. We sought to use a technique known as epidural volume extension (EVE) to determine if we could provide an adequate surgical block while significantly decreasing the time required to meet PACU discharge criteria for patients undergoing short obstetric procedures. ⋯ The use of low-dose isobaric bupivacaine in combination with 10 mL of saline EVE allows for faster motor recovery and time to meet PACU discharge criteria in patients undergoing short obstetric procedures.
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Minerva anestesiologica · Jun 2019
Randomized Controlled TrialClosed loop administration of propofol based on a Smith predictor: a randomized controlled trial.
Delay in the propofol pharmacodynamics effect is commonly observed in total intravenous anesthesia (TIVA). To face the delay in the hypnosis control, we have proposed a proportional-integral (PI) controller with a Smith predictor (PI+Smith). We have evaluated the feasibility of this closed-loop control for propofol administration and compared the performance with manual administration guided by the Bispectral Index (BIS). ⋯ The use of a specific mechanism in the PI controller to deal with the delay outperformed satisfactorily manual practice. The controller was able to regulate propofol administration, maintaining the BIS value within a desirable range and coping with oscillations.
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Minerva anestesiologica · Jun 2019
Levels of circulating microparticles in septic shock and sepsis-related complications: a case-control study.
Microparticles (MP) have been largely studied as potential biomarkers in septic shock (SS) though their biological and clinical relevance is still unclear. This case-control study describes the trend of various MP subtypes during SS to evaluate their possible association with severity of illness and sepsis-related complications (disseminated intravascular coagulation [DIC] and acute kidney injury [AKI]). ⋯ A global response through extra-vesiculation of endothelial cells, leukocytes and platelets during the early stages of SS was confirmed. The cellular activation was detected until day 3 after diagnosis. PMP/platelets ratio at diagnosis may be useful to evaluate SS severity and DIC occurrence.