Minerva anestesiologica
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Minerva anestesiologica · Oct 2012
Comparative StudyThe sensibility and specificity of cerebral oximetry, measured by INVOS - 4100, in patients undergoing carotid endarterectomy compared with awake testing.
Selective shunting during carotid endarterectomy (CEA) is advocated to reduce shunt-related stroke. Cerebral monitoring is essential for temporary carotid shunting. Many techniques are available for cerebral monitoring; however, none is superior to monitoring the patient's neurological status (awake testing) while performing the procedure under local anesthesia (LA). Cerebral oximetry (CO) has previously been used to show the adequacy of cerebral circulation in patients undergoing CEA. This investigation was designed to compare the performance of the INVOS-4100 cerebral oximeter and the neurologic functions, by means of detecting cerebral ischemia induced by carotid cross-clamping, in patients undergoing CEA under LA, namely cervical plexus block. ⋯ The results of this study suggest that the usefulness of CO in predicting cerebral ischemia is modest. Cerebral monitoring with INVOS-4100 has a high negative predictive value, but the positive predictive value is low.
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Minerva anestesiologica · Oct 2012
Comparative StudyComparison of transpulmonary thermodilution, transthoracic echocardiography and conventional hemodynamic monitoring in neonates and infants after open heart surgery: a preliminary study.
Transpulmonary thermodilution (TPTD) is an increasingly popular method used to monitor the complex hemodynamic changes in critically ill children. The purpose of our study was to examine the relationship between transthoracic echocardiographic (TTE) parameters and global hemodynamic variables derived from TPTD and those derived from conventional measurements in infants and neonates undergoing corrective cardiac surgery. ⋯ Both TPTD and TTE may be used in the estimating volumetric preload parameters. The time course of TPTD-derived parameters may have clinical relevance in pediatric critical care practice.
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Minerva anestesiologica · Oct 2012
Neonatal congenital diaphragmatic hernia: respiratory and blood-gas derived indices in choosing surgical timing.
Congenital diaphragmatic hernia (CDH) still has a high mortality despite advanced assistance techniques. The aim of this study is to verify the validity of five respiratory and blood-gas-derived indices in defining presurgical stabilization: the oxygenation index (OI), the alveolar-arterial O(2) gradient (A-aDO(2)), the arterial-alveolar O(2) tension ratio (a/AO(2)), the arterial pH and the PaCO(2). ⋯ The study confirms the validity of these indices as a guide to the treatment of neonates with CDH, showing a good reliability in identifying presurgical stabilization.
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Minerva anestesiologica · Oct 2012
The use of social networking to explore knowledge and attitudes toward organ donation in Italy.
Currently, online social media have become increasingly popular and can provide the opportunity to provide and acquire information regarding knowledge and attitudes toward organ donation and transplantation. To evaluate participants' knowledge about organ donation, information sources and donation principles, an on-line survey was distributed through social network in Italy. ⋯ Efforts must be aimed at involving schools and family doctors in education about donation; the use of social networks can represent a way of improving such knowledge.
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Minerva anestesiologica · Oct 2012
Performance of different PEEP valves and helmet outlets at increasing gas flow rates: a bench top study.
Aim of the paper was to assess the performance of different expiratory valves and the resistance of helmet outlet ports at increasing gas flow rates. ⋯ Adjustable PEEP valves are not suggested for continuous-flow CPAP systems as their flow-dependency can lead to pressures higher than expected. Precalibrated and water seal valves exhibit the best performance. Different helmet outlet ports do not significantly affect the pressure generated during helmet CPAP. In order to avoid iatrogenic complications gas flow and pressure delivered during helmet CPAP must always be monitored.