Minerva anestesiologica
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Minerva anestesiologica · Jan 2021
Fluctuation in red cell distribution width predicts disseminated intravascular coagulation morbidity and mortality in sepsis: a retrospective single-center study.
Red cell distribution width (RDW) values increase in many diseases and conditions, including sepsis. However, the relationship between RDW fluctuation and prognosis in patients with sepsis or the likely morbidity associated with sepsis-induced disseminated intravascular coagulation (DIC) has not been previously investigated. This study examined the association between dynamic changes to RDW and DIC occurrence in sepsis, as well as the prognostic significance of changes to RDW during hospital stay in patients with sepsis. ⋯ The RDW-SD and RDW increase rate shown in the study as the indicators of RDW fluctuation can help predict sepsis-related DIC morbidity and prognosis in patients with sepsis.
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Minerva anestesiologica · Jan 2021
Meta AnalysisRole of dexmedetomidine in the treatment of delirium in critically ill patients: a systematic review and meta-analysis.
Although dexmedetomidine has been found to prevent delirium in critically ill patients, it is uncertain whether it can treat acute delirium. This study aimed to evaluate the efficacy and safety of dexmedetomidine in treating delirium, by analyzing and reviewing data from previous studies. ⋯ Dexmedetomidine promotes the resolution of delirium but also increases the incidence of bradycardia during treatment. Furthermore, it may be superior to haloperidol in treating delirium, although more studies are needed to confirm this.
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Minerva anestesiologica · Jan 2021
Haemoadsorption: effective in reducing circulating fragments of the endothelial glycocalyx during cardiopulmonary bypass in patients undergoing on-pump cardiac surgery?
The vascular endothelial glycocalyx is susceptible to ischemia and hypoxia. Released soluble components of the endothelial glycocalyx (EG) have been identified as potential damage associated molecular patterns (DAMPs) able to enhance an ongoing inflammatory response. Shedding of the EG has been associated with released atrial-natriuretic peptide (ANP) during cardiac surgery procedures. A novel hemoadsorption technique (CytoSorb®) has been shown to effectively remove molecules up to 55 kDa unspecifically from circulation. It is not known whether ANP or glycocalyx components can be removed successfully by this technique. ⋯ In this study representing a real-life scenario, we could demonstrate that the novel hemoadsorption device (CytoSorb®) was able to effectively adsorb HEP from the circulation if integrated in a CPB circuit. However, blood concentrations of HYA, SYN, and ANP could not be reduced during CPB in our investigation.