Minerva anestesiologica
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Minerva anestesiologica · May 2013
ReviewThe usage of the Boussignac continuous positive airway pressure system in acute respiratory failure.
Traditionally, continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP) devices have been used to treat patients in acute respiratory failure. However they require an electric power source, are relatively large in size, and may be difficult to use in prehospital settings. The recently introduced Boussignac CPAP system is capable of delivering 10 cmH2O of CPAP, is compact, portable and requires only an oxygen source. ⋯ In one study, implementing Boussignac CPAP reduced intubation rate and hospital stay. Most hospital staff found Boussignac CPAP easy to use and complication rates were low. Boussigac CPAP is a useful device in the treatment of patients with acute respiratory failure, especially in the prehospital setting.
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Minerva anestesiologica · May 2013
Randomized Controlled TrialPreconditioning effects of the anesthetic administered to the donor on grafted kidney function in living donor kidney transplantation recipients.
In living donor kidney transplantation (LDKT), we evaluated if there was any difference in grafted kidney function according to the type of anesthetic used in the donor because some laboratory studies have demonstrated that volatile anesthetics at clinically relevant concentrations protect the kidneys against renal ischemia-reperfusion injury. ⋯ The inhalational anesthetic administered to donors does not improve grafted kidney function in recipients undergoing LDKT to a greater extent than propofol.
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Minerva anestesiologica · May 2013
Randomized Controlled TrialPreoperative medication with oral morphine sulphate and postoperative pain.
The administration of an analgesic drug prior to nociceptive surgical stimulus could result in a better postoperative pain management. The aim of this study was to evaluate the effect of preoperative oral morphine sulphate on postoperative pain relief. ⋯ In major abdominal surgery, premedication with oral morphine sulphate produces better postoperative pain control and has an opioid-sparing effect without delaying gastrointestinal canalization time.
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Minerva anestesiologica · May 2013
Comparative Study Clinical TrialT-piece improves arterial and central venous oxygenation in trachestomized patients as compared to continuous positive airway pressure/pressure support ventilation.
T-piece has been widely used as T-piece trial to identify patients who are ready for extubation but it is seldom used as a weaning tool. Our objective was to investigate the effects of breathing via T-piece on gas exchange as compared to continuous positive airway pressure with pressure support (CPAP+PS) and CPAP with automatic tube compensation (CPAP+ATC) as it has not been evaluated yet. ⋯ On the same FiO2 and PEEP setting, breathing via T-piece improved oxygenation and resulted in increased ScvO2 as compared to breathing on CPAP with PS. Our observations suggest a potential role of T-piece during weaning from mechanical ventilation.
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Minerva anestesiologica · May 2013
Current practice of brain death determination and use of confirmatory tests in an Italian University hospital: a report of 66 cases.
Time to final brain death (BD) determination is fundamental to rapidly identify donors without organ deterioration. Guidelines for BD determination are different from country to country and, through years, they have been subjected to several revisions, to simplify the procedure. The aim of this study was to describe a one-year experience according to the latest Italian Guidelines for BD in our University hospital and to focus on timing of final BD declaration according to the ancillary tests executed. ⋯ In Italy, the same guidelines ensure the same approach in every hospital, with multi-specialist cooperation. The EEG is mandatory and prompt recognition of the first, flat EEG is fundamental to reduce time to the final procedure. A multimodal neurophysiological approach with trained specialists, neurosonologists and monitoring devices in intensive care units may represents a valid help to further reduce time for BD diagnosis.