Minerva anestesiologica
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Minerva anestesiologica · Jan 2015
A methodological approach for determination of maximal inspiratory pressure in patients undergoing invasive mechanical ventilation.
Maximal inspiratory pressure (MIP) can help to evaluate inspiratory muscle strength. However its determination in ventilated patients is cumbersome and needs special equipment. We hypothesized that MIP could be obtained by using the expiratory hold knob of the ventilator. The aim of this study was to verify whether: 1) the end expiratory occlusion technique can be used for MIP determination; and 2) if this technique provides different results compared to those obtained by the traditional method of MIP calculation. ⋯ MIP can be easily determined at the bedside by pressing the expiratory hold knob of ventilator. However, MIPVent and MIPOcc are different in terms of absolute value probably because they were determined at diverse lung volume.
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Minerva anestesiologica · Jan 2015
Randomized Controlled TrialValidity and fidelity of the upper airway in two high-fidelity patient simulators.
Human patient simulators are frequently used for airway management training and research. However, little is known about their fidelity and validity. The use of these simulators as a benchmark model remains highly questionable. The objective of this study was to evaluate the validity and fidelity of two patient simulators (compared to actual patients) for anaesthesia residents performing three airway management techniques. ⋯ Patient simulators are not a valid alternative to human patients for conducting scientific evaluations of supraglottic airway management techniques. HAL and SimMan do have adequate validity for endotracheal intubation, but the fidelity and validity are low when a laryngeal mask is used or if mask ventilation is performed. Therefore, previous simulation-based airway device evaluation studies must be interpreted with great caution.
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Surgical site infections (SSIs) are a frequent cause of morbidity following surgical procedures. Gram-positive cocci, particularly staphylococci, cause many of these infections, although Gram-negative organisms are also frequently involved. The risk of developing a SSI is associated with a number of factors, including aspects of the operative procedure itself, such as wound classification, and patient-related variables, such as preexisting medical conditions. ⋯ Broad spectrum antibiotics should be avoided due to the risk of promoting bacterial resistance. Cephalosporins are the most commonly used antibiotics in surgical prophylaxis; specifically, cefazolin or cefuroxime are mainly used in the prophylaxis regimens for cardio-thoracic surgery, vascular surgery, hip or knee arthroplasty surgery, neurosurgical procedures and gynecologic and obstetric procedures. A review of the prophylactic regimens regarding the main surgical procedures is presented.