Minerva anestesiologica
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Minerva anestesiologica · Oct 2024
Meta Analysis Comparative StudyBougie approach improves first-attempt success rate compared to stylet approach in patients with difficult airway needing endotracheal intubation: a meta-analysis.
Bougies and stylets are widely acknowledged as effective tools for managing endotracheal intubation, uncertainties persist regarding the comparative efficacy and safety of bougie versus stylet approaches in endotracheal intubation. ⋯ For patients with difficult airway characteristics, our recommendation is to perform endotracheal intubation (ETI) using the bougie approach over the stylet approach, as it has been associated with a better first-attempt success rate. Notably, the advantages of using a bougie may be less pronounced for patients without signs of a difficult airway.
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Septic cardiomyopathy is a common complication in patients with sepsis, and is one of the indicators of poor prognosis. Its pathogenesis is complex, involving calcium ion imbalance in cardiomyocytes, nitric oxide (NO) synthesis disorder, mitochondrial abnormalities and immune inflammatory reaction, especially mitochondrial abnormalities. In this paper, the mechanism of mitochondrial abnormalities causing septic cardiomyopathy was discussed from the aspects of mitochondrial structure change, mitochondrial energy metabolism disorder, redox imbalance, mitochondrial calcium overload, mitochondrial biosynthesis and autophagy abnormalities.
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Minerva anestesiologica · Oct 2024
Cognitive and non-cognitive factors affecting decision-making about deceased organ donation in Italy: a systematic review.
Decision-making about organ donation (OD) is influenced by interrelated cognitive and non-cognitive factors. The identification of these factors in the general population and among healthcare professionals (HCP) in Italy are key ethical and scientific requirements to inform targeted communication and policy-making interventions, and to promote decision-making processes that are truly informed. ⋯ The majority of the Italian population supports OD, but cognitive and non-cognitive barriers are present even among HCPs. Communication campaigns, encouraging family discussions about OD, providing better education for HCPs (including medical and nursing students), and making it easier to sign OD cards may promote informed decision-making and possibly increase consent rates.
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Minerva anestesiologica · Oct 2024
Measuring the outward migration of the nasotracheal tube at vocal cords with head and neck extension: a novel approach using a flexible bronchoscope in patients undergoing head and neck oncosurgery.
Head and neck extension achieves optimal surgical exposure during head and neck oncosurgeries. However, it can lead to cephalad migration of the tracheal tube, causing complications. Preventing shallow intubation is essential, especially in patients with difficult airway. Using an innovative technique, we aimed to measure the proximal migration of the nasotracheal tube at the vocal cords on neck extension in patients with difficult airway. ⋯ The major contributing factor for the increase in TT tip-to-carina distance on neck extension was tracheal elongation rather than outward migration of the TT at vocal cords.