Minerva anestesiologica
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Minerva anestesiologica · Aug 2021
Meta AnalysisVolatile anesthetics versus intravenous anesthetics for noncardiac thoracic surgery: a systematic review and meta-analysis.
We performed this meta-analysis of randomized controlled trials (RCTs) to investigate two types of anesthetics for noncardiac thoracic surgery regarding their effects on clinical outcomes and the inflammatory response. ⋯ In lung surgery, but not esophagectomy, volatile anesthetics may be a better choice than intravenous anesthetics, possibly because volatile anesthetics reduce airway inflammation.
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Minerva anestesiologica · Aug 2021
Meta AnalysisThe opioid sparing effect of erector spinae plane block for various surgeries: a meta-analysis of randomized-controlled trials.
The erector spinae plane block (ESPB) is a newer fascial plane block which has been broadly applied for postoperative analgesia after various surgeries, but the effectiveness in these populations is not well established. ⋯ ESPB may be a useful addition to the multimodal analgesic regimen for a variety of surgeries especially when the alternative is no block. Unanswered questions include determining of the mechanism of action, refining of the EPSB technique, and establishing recommended local anesthetic dose and volume.
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Minerva anestesiologica · Aug 2021
ReviewCharacteristics, outcomes and global trends of respiratory support in patients hospitalized with COVID-19 pneumonia: a scoping review.
To date, a shared international consensus on treatment of Coronavirus disease 2019 (COVID-19) with invasive or non-invasive respiratory support is lacking. Patients' management and outcomes, especially in severe and critical cases, can vary depending on regional standard operating procedures and local guidance. ⋯ Global employment of respiratory supports and related outcomes are very heterogeneous. The most frequent respiratory support in patients with COVID-19 pneumonia is IMV, while NIV and CPAP are less frequently and equally applied, the latter especially in Europe, while data on NIV/CPAP-related mortality is often under-reported. Integrated and comprehensive reporting is desirable and needed to construct evidence-based recommendations.
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Minerva anestesiologica · Aug 2021
Observational StudyImmunosuppressive strategies in invasively ventilated ARDS COVID-19 patients.
COVID-19 is associated with elevated levels of inflammatory cytokines. We present the characteristics and outcomes of patients treated in the Intensive Care Unit (ICU) with immunosuppressive drugs, either tocilizumab or anakinra compared with controls. ⋯ In invasively ventilated COVID-19 patients, treatment with anakinra was associated with a higher probability of clinical improvement compared to tocilizumab; however, treatment with either drug did not result in clinically meaningful improvements compared with controls.