Minerva anestesiologica
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Minerva anestesiologica · Jun 2021
Good clinical practice for the use of vasopressor and inotropic drugs in critically ill patients: state-of-the-science and expert consensus.
Vasopressors and inotropic agents are widely used in critical care. However, strong evidence supporting their use in critically ill patients is lacking in many clinical scenarios. Thus, the Italian Society of Anesthesia and Intensive Care (SIAARTI) promoted a project aimed to provide indications for good clinical practice on the use of vasopressors and inotropes, and on the management of critically ill patients with shock. ⋯ A modified semi-quantitative RAND/UCLA appropriateness method has been used to determine the appropriateness of specific clinical scenarios. The panel identified 29 clinical questions for the use of vasopressors and inotropes in patients with septic shock and cardiogenic shock. High level of agreement exists among the panel members about appropriateness of inotropes/vasopressors' use in patients with septic shock and cardiogenic shock.
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Minerva anestesiologica · Jun 2021
Randomized Controlled TrialEffects of lung-protective ventilation strategy on lung aeration loss and postoperative pulmonary complications in moderate-risk patients undergoing abdominal surgery.
There is a controversy about whether the use of a lung-protective ventilation strategy(LPVS) can reduce the incidence of postoperative pulmonary complications (PPCs) and improve the clinical outcomes in moderate-risk patients were assessed by the Assess Respiratory Risk in Surgical Patients in Catalonia(ARISCAT). ⋯ The LPVS can decrease lung aeration loss assessed by LUS and reduce the incidence of PPCs in moderate-risk patients.
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Minerva anestesiologica · Jun 2021
Causes of arterial hypotension during anaesthetic induction with propofol investigated with perfusion index and ClearSightTM in young and elderly patients.
Mechanism underlying the hypotension during anesthetic induction in elderly patients is inferred to differ from that in younger patients due to structural changes in arteries. The aim of the study was to determine if a decrease in cardiac output (CO) or systemic vascular resistance (SVR) is the main mechanism of the hypotension. ⋯ The main mechanisms of hypotension during anesthetic induction contribute to the decrease in CO in elderly and reduction of SVR in younger. PI only shows the vascular tone of a finger but can be a surrogate for SVR.