Minerva anestesiologica
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Minerva anestesiologica · Dec 2013
ReviewDiagnosis of pneumonia in mechanically ventilated patients. What is the meaning of the CPIS?
Ventilator associated pneumonia (VAP) is one of the most common nosocomial infections in critically ill patients, especially in those being mechanically ventilated. Beside increased healthcare costs due to prolonged hospital stay, VAP is associated with a consistently high morbidity and mortality. Although pathomechanisms leading to VAP are well known, it remains challenging to diagnose VAP accurately and in a timely manner. ⋯ Several evidence based strategies have been described for the diagnosis of ventilator associated pneumonia, potentially leading to better or faster treatment and thereby influencing the outcome. Current diagnostic approaches and the value of the CPIS are therefore considered within this article. A bundle approach, regarding time management and several diagnostic pathways should be evaluated in further studies.
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Minerva anestesiologica · Dec 2013
Validation Of Visual Analogue Scale For Anxiety (Vas-A) In Preanesthesia Evaluation.
Anxiety is a relevant but still underscored perioperative problem. The Visual Analogue Scale for Anxiety (VAS-A) seems to be effective, fast and manageable, but has not been fully validated yet. The aim of this study is to validate VAS-A comparing it to, Corah's Dental Anxiety Scale (CDAS) Spielberger's State Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI). ⋯ Our study confirms that VAS-A is a reliable indicator of preoperative anxiety and may detect patients with depressive symptoms also. Values of VAS-A around 50 mm are a reliable threshold for a clinically meaningful level of preoperative anxiety.