Minerva anestesiologica
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Minerva anestesiologica · Aug 2020
Meta AnalysisS100β as a potential biomarker of incident delirium: a systematic review and meta-analysis.
Delirium is an acute and fluctuating change in cognition, attention and consciousness, defined as an acute neuropsychiatric syndrome, but mechanism is extremely complex and still not well understood. Recently, the S100 calcium-binding protein B protein (S100β) has received attention in the biomarker research area of delirium. This meta-analysis was designed to investigate the relationship between S100β levels and delirium. ⋯ This meta-analysis provides evidence that serum S100β seems to be of limited value as a biomarker of delirium, but CSF S100β elevation may be more meaningful.
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Minerva anestesiologica · Aug 2020
Occurrence of ventilator associated pneumonia using a tracheostomy tube with subglottic secretion drainage.
Ventilator-associated pneumonia (VAP) is a significant cause of morbidity and mortality in critically ill patients who require mechanical ventilation (MV). Subglottic secretions above the endotracheal cuff are associated with bacteria colonization of lower respiratory tract, causing VAP. A preventive strategy to avoid subglottic secretion progression is the drainage with special tracheal tubes effective in preventing both early onset and late onset VAP. The purpose of this study was to measure VAP incidence in tracheostomized patients with suction above the cuff. ⋯ Subglottic secretion drainage reduces incidence of VAP in critically ill patients requiring ongoing MV via tracheostomy.
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Minerva anestesiologica · Aug 2020
ReviewNew techniques and recommendations in the management of free flap surgery for head and neck defects in cancer patients.
Free flap surgery is the gold standard surgical treatment for head and neck defects in cancer patients. Outcomes have improved considerably, probably due to recent advances in surgical techniques. In this article, we review improvements in the parameters traditionally used to optimize hematocrit levels and body temperature and to prevent vasoconstriction, and describe the use of cardiac output-guided fluid management, a technique that has proved useful in other procedures. Finally, we review other parameters used in free flap surgery, such as clotting/platelet management and nutritional optimization.