Minerva anestesiologica
-
Minerva anestesiologica · Nov 2023
Multicenter Study Observational StudyPostoperative pulmonary complications and mortality after major abdominal surgery. An observational multicenter prospective study.
Postoperative pulmonary complications (PPCs) significantly contribute to postoperative morbidity and mortality. We conducted a study to determine the incidence of PPCs after major elective abdominal surgery and their association with early and 1-year mortality in patient without pre-existing respiratory disease. ⋯ The incidence of PPCs in patients without pre-existing respiratory disease undergoing elective abdominal surgery is high and associated with worse clinical outcome at one year after surgery. General surgery is associated with higher incidence of PPCs and mortality compared to gynecological and urological surgery.
-
Minerva anestesiologica · Nov 2023
Randomized Controlled TrialComparison of the effects of subcostal anterior quadratus lumborum block and thoracic paravertebral block in laparoscopic nephrectomy: a randomized study.
Thoracic paravertebral block (TPVB) may provide sufficient postoperative analgesia in laparoscopic nephrectomy (LSN) by ensuring ipsilateral somatic and visceral analgesia. However, there are serious reservations due to the complexity of the technique, and various complications thereof. Subcostal anterior quadratus lumborum block (S-QLB3) may be a safe alternative in LSN procedures. Therefore, this study aimed to compare the postoperative analgesic effects of TPVB and S-QLB3. ⋯ In this study, NRS and APS-POQ-R-TR scores were similar in the S-QLB3 and TPVB groups, whereas cumulative morphine consumption was modestly lower in the TPVB group. This suggested that S-QLB3 could be an alternative to TPVB in patients undergoing LSN.
-
Minerva anestesiologica · Nov 2023
Feasibility, safety and efficacy of COVID-19 severe acute respiratory distress syndrome management without invasive mechanical ventilation.
COVID-19 acute respiratory distress syndrome (ARDS) is often managed with mechanical ventilation (MV), requiring sedation and paralysis, with associated risk of complications. There is limited evidence on the use of high flow nasal cannula (HFNC). We hypothesized that management of COVID-19 ARDS without MV is feasible. ⋯ It is safe to monitor in ICU and use HFNC in patients affected by COVID-19 ARDS who initially present data suggesting an early need for intubation. The 41 patients admitted with a PaO
2 /FiO2 ratio <100 and initially treated only with HFNC show a 22% mortality that is in the lower range of what is reported in recent literature. -
Minerva anestesiologica · Nov 2023
Development and validation of an artificial neural network prediction model for postpartum hemorrhage with placenta previa.
Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity worldwide and placenta previa is one of the major risk factors for PPH in overall population. However, the clinical prediction of PPH remains challenging. This study aimed to investigate an ideal machine learning-based prediction model for PPH in placenta previa parturients with cesarean section. ⋯ Compared to the conventional machine learning approaches, artificial neural network model shows discriminative ability in identifying women's risk of PPH with placenta previa during cesarean section.