Minerva anestesiologica
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Minerva anestesiologica · Apr 2023
Electroencephalographic Density Spectral Array monitoring in pediatric anesthesia: clinical background and practical applications.
Depth of hypnosis monitoring using numerical index based processed electroencephalography is part of the standard anesthesia equipment in many operating rooms. Unfortunately, this method has its limitations, especially in pediatric patients. ⋯ Electroencephalographic density spectral array (DSA) monitoring is a real-time technique that can be used in all age groups and with all common anesthetics. We present a practice-oriented introduction to the principle of DSA monitoring in pediatric anesthesia for pediatric anesthesiologists and two algorithms for using this technology in children under sevoflurane and propofol anesthesia.
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Minerva anestesiologica · Apr 2023
Implementation of a spontaneous awakening/spontaneous breathing trial protocol in a surgical intensive care unit: a before and after study.
Prolonged invasive mechanical ventilation (IMV) influences patient outcome in multiple ways. In this regard the early weaning from IMV is a major goal to be achieved in the treatment of ICU patients. Adopting a weaning protocol that incorporates a Spontaneous Awakening Trial (SAT) and a Spontaneous Breathing Trial (SBT) seems to be essential to reach this goal. Most studies investigating the effectiveness of SAT/SBT protocols in ICU patients' outcomes have focused mainly on medical or mixed (medical and surgical), but not on exclusively surgical patient populations. Surgical patients usually experience more complications and often undergo revision surgeries, therefore needing longer sedation periods and adequate analgo-sedation therapy. Moreover, the longer IMV times make the weaning process more arduous. ⋯ We conclude that even for an exclusively surgical patient population, the implementation of a SAT/SBT protocol could result in a higher rate of successful extubation.
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Minerva anestesiologica · Apr 2023
Tricuspid annular plane systolic excursion to predict arterial hypotension caused by general anesthesia induction.
Hypotension, which may develop after anesthesia induction, may cause ischemic stroke, myocardial damage, acute kidney injury, and postoperative mortality. Various assessments can be used to predict hypotension. We aimed to test the relationship of tricuspid annular plane systolic movement (TAPSE) with hypotension. ⋯ TAPSE predicted the development of hypotension after general anesthesia induction. Further studies are required to prove the diagnostic accuracy of TAPSE as a predictor of hypotension after general anesthesia induction.