Minerva anestesiologica
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Minerva anestesiologica · Nov 2024
Randomized Controlled TrialSex related differences in applied tidal volume with flow-controlled ventilation: a subgroup analysis.
Flow-controlled ventilation (FCV) ensures a constant gas flow whereby precise determination of dynamic compliance is feasible. Accordingly, ventilator pressure settings can be adjusted to achieve the highest compliance. This setting will automatically adapt tidal volume to the functionally available lung volume as a personalized approach. This is in contrast to current ventilation settings, where fixed tidal volumes according to predicted body weight (PBW) are recommended. Aim of this subgroup-analysis was to determine whether applied tidal volume differs in male and female patients after compliance guided individualization of ventilation parameters. ⋯ Female patients were found to receive lower tidal volumes after compliance guided individualization compared to men during cardiac surgery. This finding may indicate that the functionally available lung volume in women is lower and thus using PBW may not adequately comply with sex related differences, which supports the use of a personalized ventilation strategy.
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Minerva anestesiologica · Nov 2024
Practice GuidelineRecommendations for fast-track extubation in adult cardiac surgery patients: a consensus statement.
Enhanced recovery after cardiac surgery in selected low-risk patients, has the potential to improve outcomes and reduce the burden of healthcare costs. Anesthesia-related challenges play a major role in the successful implementation of Enhanced Recovery After Surgery (ERAS) protocols, with particular emphasis placed on fast-track extubation. Acknowledging the importance of this practice, the Italian Association of Cardiac Anesthesiologists and Intensive Care (ITACTAIC) has advocated for an initiative to establish a consensus offering practical recommendations for fast-track extubation after adult cardiac surgery. ⋯ In the first consensus document ever published by a scientific society addressing practical recommendations for fast-track extubation post-cardiac surgery, the authors identified sixteen interventions commonly associated with fast-track extubation in selected adult cardiac surgery patients.
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Minerva anestesiologica · Nov 2024
Observational StudyMaximum extension and regression rate of cutaneous sensory block obtained with the external oblique intercostal block or the modified thoracoabdominal nerves block through perichondrial approach in patients undergoing laparoscopic cholecystectomy.
Several studies demonstrate that both external oblique ıntercostal block (EOIB) and modified thoracoabdominal nerves block through perichondrial approach (M-TAPA) contribute to analgesia in the anterior abdomen by targeting the thoracoabdominal nerves through distinct pathways. However, the sensory assessment and dermatomal analysis remain poorly understood. ⋯ Bilateral EOIB and M-TAPA produce a comparable sensory cutaneous block in the anterior abdomen, particularly in the umbilical and epigastric regions. Additionally, the midabdominal cutaneous blocked area was greater in patients undergoing M-TAPA, suggesting a more consistent distribution along the anterior cutaneous branches of the thoracoabdominal nerves.