Minerva anestesiologica
-
Minerva anestesiologica · Nov 2020
CommentNoninvasive respiratory support in acute hypoxemic respiratory failure associated with COVID-19 and other viral infections.
Noninvasive respiratory support (NRS) such as noninvasive ventilation (NIV) and high flow nasal therapy (HFNT) have been used in the treatment of acute hypoxemic respiratory failure (AHRF) related to the coronavirus disease (COVID-19) and other viral infections. However, there is a lack of consensus in favor of or against NRS use due to the risks of worsening hypoxemia, intubation delay, and aerosols environmental contamination associated with the use of these tools. We aimed to summarize the evidence on the use of NRS in adult patients with COVID-19 and other viral pneumonia (i.e. H1N1, SARS, MERS) and AHRF. We also searched for studies evaluating the risk of aerosolization/contamination with these tools. ⋯ Use of NRS and treatment failure in the context of COVID-19 and viral infection associated-AHRF, varied widely. Dispersion of exhaled air is different depending on the type of respiratory therapies and interfaces. Data from randomized controlled trials are lacking.
-
Minerva anestesiologica · Nov 2020
Observational StudyThe predictive value of the intraoperative renal pulsatility index for acute kidney injury in patients undergoing cardiac surgery.
The incidence of cardiac surgery-associated acute kidney injury (CSA-AKI) is very high. The Renal Resistive Index (RRI) is measured by transesophageal echocardiography (TEE) and can be used to predict the occurrence of CSA-AKI, but few studies have examined the Renal Pulsatility Index (RPI). The objective of this study was to explore the predictive value of intraoperative RPI for CSA-AKI. ⋯ An RPI at T2>1.86 is correlated with a higher incidence of postoperative AKI. Treatment guided and personalized on the base of this parameter should be investigated by further dedicated studies.