Minerva anestesiologica
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Minerva anestesiologica · Aug 2013
Meta AnalysisEffect of angiotensin converting enzyme gene I/D polymorphism and its expression on clinical outcome in acute respiratory distress syndrome.
The role of the D allele of the angiotensin-converting enzyme (ACE) gene I/D polymorphism in the clinical outcomes of patients with acute lung injury and acute respiratory distress syndrome (ALI/ARDS) remains controversial. Our aim was to assess simultaneously the effect of the ACE I/D polymorphisms as well as the serum and BALF ACE levels on prognosis of patients with ARDS. ⋯ Serum ACE levels appear to be affected by the I/D polymorphism and are correlated with prognosis in patients with ALI/ARDS indicating that further investigation of the clinical significance of the ACE in ARDS might be of value.
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Minerva anestesiologica · Aug 2013
ReviewExtracorporeal lung support in patients with chronic obstructive pulmonary disease.
When patients with chronic obstructive lung disease (COPD) and acute on chronic respiratory insufficiency fail non-invasive ventilation (NIV) they are commonly intubated and treated with invasive mechanical ventilation (IMV) to ensure adequate gas exchange. However, IMV itself is associated with considerable complications which can aggravate any pre-existing lung disease and contribute to morbidity and mortality. ⋯ Recent technological improvements of extracorporeal devices have made ECLA more efficient and safe. This article discusses different types of ECLA, their potential indications in patients with COPD as well as the preliminary clinical evidence for their effectiveness and safety.
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Minerva anestesiologica · Aug 2013
Editorial CommentPerioperative administration of colloids: far from good?
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Minerva anestesiologica · Aug 2013
Observational StudyAmmonia plasma concentration and prolonged infusion of remifentanil in patients with acute kidney injury.
Glycine is an excipient of remifentanil and may induce side effects. To investigate glycine and ammonia concentration with the use of remifentanil in Intensive Care Unit patients with acute kidney injury (AKI) defined by a decrease in creatinine clearance above 50%. ⋯ Remifentanil was not associated with an accumulation of glycine or ammonia in patients with AKI. Plasma ammonia concentration was correlated with the mean rate of remifentanil and creatinine clearance. A 72-hours remifentanil infusion appeared safe for sedation of patients with AKI.