Minerva anestesiologica
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Minerva anestesiologica · Apr 2001
Multicenter StudyEvolution in the utilization of the mechanical ventilation in the critical care unit.
Use of mechanical ventilation has increased in recent years and constitutes a major therapeutic modality in the intensive care unit (ICU). In the recent years, changes in the ventilatory modes, in the ventilatory strategies and in the weaning from mechanical ventilation have occurred. We have compared the data obtained from the Spanish ICUs in studies that were carried out in three periods of the nineties, with the aim to test whether the aforementioned innovations have modified the clinical practice. ⋯ Concerning to weaning, over the course of the decade occurred an increase in use of pressure support ventilation and spontaneous breathing trial, being this method the most frequently used at the end of the decade. The performance of the tracheostomy has been lesser and earlier over the time. The results obtained suggest that findings from research on mechanical ventilation are incorporated into clinical practice at a very slow pace whereas the evidence obtained from the clinical trials about weaning has had a better reception.
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Minerva anestesiologica · Mar 2001
Multicenter StudyUse of sedative and analgesic drugs in the first week of ICU stay. A pharmaco-epidemiological perspective.
To assess the current practice of pharmacological sedation and analgesia in patients admitted in Italian intensive care units. ⋯ Our results depict a relatively low prevalence of sedation in Italy, with the use of large number of different agents. We also observed a larger than expected use of some drugs, like propofol and fentanyl, that could be due to the unavailability of new sedative and analgesic drugs in Italy on 1994. In conclusion, Italian intensivists seem to be very conservative about the practice of pharmacological sedation in critically ill patients.
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Minerva anestesiologica · Sep 2000
Randomized Controlled Trial Multicenter Study Clinical Trial[N2O-free sevoflurane anesthesia. Clinical evaluation].
The characteristics of sevoflurane make it able to be used without N2O avoiding its undesirable effects to this associates. The aim of the study is to evaluate the clinical characteristics of sevoflurane anesthesia "N2O free" in comparison to sevoflurane anesthesia with N2O. ⋯ We didn't observe differences between the two groups. In conclusions, omitting N2O during sevoflurane anesthesia can be considered a safe technique, avoiding the acute and chronic side effects associated with the use of N2O, without modifying the intraop consumption of opioid, the recovery and the early postoperative incidence of nausea, vomiting and analgesia.
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Minerva anestesiologica · Jul 2000
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialPropofol 1% and propofol 2% are equally effective and well tolerated during anaesthesia of patients undergoing elective craniotomy for neurosurgical procedures.
The 2% formulation of the intravenous anaesthetic agent, propofol (Diprivan), delivers half the amount of lipid compared with the original 1% formulation. This may provide an acceptable alternative for patients who have an impaired ability to metabolise lipids. ⋯ We conclude that propofol 2% is as effective and as well-tolerated as propofol 1% for anaesthesia and is an acceptable alternative to propofol 1% in patients undergoing elective craniotomy in neurosurgery. The lower lipid load suggests it may be of particular benefit to patients with disorders of lipid metabolism.
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Minerva anestesiologica · Oct 1999
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial[Comparison of manual infusion of propofol and target-controlled infusion: effectiveness, safety and acceptability].
Diprifusor TCI is a newly developed target-controlled system for the infusion of propofol. Purpose of this study is to evaluate the acceptability, efficacy and safety of Diprifusor TCI in comparison with the manually controlled technique. ⋯ The TCI technique is effective and safe, and has a better acceptability than the manually controlled infusion technique.