Minerva anestesiologica
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Minerva anestesiologica · Feb 2013
Manuscript title: Super Refractory Status Epilepticus: The development of a paradigm for critical care management.
Super Refractory status epilepticus (SRSE) is a sub category of status epilepticus recently defined as seizures that persist following 24 hours of critical care sedation. SRSE is associated with a high morbidity and mortality. ⋯ The majority of the published literature relates to anecdotal reports, case series, reviews and opinion. The objective of this review is to consolidate the knowledge of the treatment of SRSE and develop a management paradigm providing a clear clinical guide to future clinical management and clinical trials.
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Minerva anestesiologica · Feb 2013
Prognostic indicators of mortality of mechanically ventilated patients with acute leukemia in a comprehensive cancer center.
The prognosis for adult acute leukemia patients that require intensive care unit (ICU) admission and invasive mechanical ventilation is poor. We aimed to identify prognostic indicators of 30-day hospital mortality in adult patients who had acute leukemia and respiratory failure, who had received invasive mechanical ventilation in the ICU but who had not received blood and marrow transplantation, were not admitted due to cardiopulmonary arrest or myocardial infarction and, had not recently undergone surgery. ⋯ Advanced disease status and elevated SOFA scores at intubation are strong predictors of 30-day mortality in patients with acute leukemia and respiratory failure. The protective effect of early endotracheal intubation warrants further investigation.
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The aim of the present study was to evaluate the frequency of different techniques, indications, timing, as well as procedural features, sedation and ventilation protocols, early and late complications of tracheostomy in Intensive Care Unit (ICU). ⋯ Percutaneous tracheostomy is well established in Italian ICUs and CBR is the most popular technique performed in patients requiring prolonged mechanical ventilation. Tracheostomy is usually performed by a dedicated team using a specific sedation-analgesia-neuromuscular blocking and ventilation protocol, guided by fiberoptic bronchoscope and/or neck ultrasounds. Bleeding controlled by compression was the most common early and late complication.
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Minerva anestesiologica · Feb 2013
Randomized Controlled Trial Comparative StudyIndirect videolaryngoscopy with C-MAC D-Blade and GlideScope: a randomized, controlled comparison in patients with suspected difficult airways.
Recently, indirect videolaryngoscopes have become increasingly important devices in difficult airway management. The aim of the present study was to investigate laryngoscopic view and intubation success using the new C-MAC® D-Blade in comparison to the established GlideScope® videolaryngoscope and conventional direct laryngoscopy in a randomized controlled trial. ⋯ Compared to direct Macintosh laryngoscopy, both C-MAC® D-Blade and GlideScope® comparably resulted in an improved view of the glottic opening with successful tracheal intubation in all patients.