Minerva anestesiologica
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Minerva anestesiologica · May 2020
ReviewVasopressors to treat refractory septic shock: a narrative review.
Norepinephrine is the first line vasopressor used in patients with septic shock. However, norepinephrine doses above 1 µg/kg/min are associated with mortality rates of over 80%, suggesting a need to implement adjunctive strategies prior to reaching this dosage. The present study therefore sought to review the existing and emergent vasopressor agents for patients with refractory septic shock. ⋯ Angiotensin II is another emerging option that uses a different signaling pathway. However, nitric oxide synthase inhibitors and methylene blue do not appear to be appropriate in the management of patients with refractory septic shock. In conclusion, the use of different adjunctive agents in combination with the use of norepinephrine may be useful in patients with refractory septic shock, but care must be taken to avoid excessive vasoconstriction.
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Minerva anestesiologica · May 2020
Nutrition deficit during intensive care stay: incidence, predisposing factors and outcomes.
Adequate nutrition support during intensive care has several benefits including lower amount of infectious complications, improved wound healing, shorter length of stay (LOS) and decreased morbidity. The aim of the present study was to survey the adequacy of nutrition throughout Intensive Care Unit (ICU) stay and to examine various factors associated to cumulative nutrition inadequacy during ICU stay. ⋯ The majority of ICU patients did not reach 60% of nutrition adequacy. Nutrition inadequacy was a common finding throughout the study population. Nutrition inadequacy might be partially avoidable since adequacy less than 60% was related to underprescription and failure to administer the prescribed nutrition. Bolus enteral nutrition might be an efficient method to deliver energy in ICU setting.
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Minerva anestesiologica · May 2020
Meta AnalysisLidocaine for postoperative sore throat: a meta-analysis of randomized controlled trials.
Postoperative sore throat (POST) is a common complication after tracheal intubation. Various studies have examined the efficacy of interventions using lidocaine to prevent POST. Here, we present a meta-analysis assessing their efficacy. ⋯ This meta-analysis indicated that intracuff lidocaine and intravenous lidocaine are effective in preventing POST. In addition, intracuff lidocaine was associated with reducing the risk of both cough and hoarseness.