Minerva anestesiologica
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Minerva anestesiologica · Apr 2012
Letter Case ReportsPrucalopride in a case of severe opioid induced constipation.
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Minerva anestesiologica · Apr 2012
Randomized Controlled TrialEffect of three different doses of ketamine prior to general anaesthesia on postoperative pain following Caesarean delivery: a prospective randomized study.
Ketamine is an analgesic suitable for the induction of anesthesia during Caesarean delivery. This double blind, randomized trial examined the effect of intravenous ketamine used before the induction of general anesthesia on morphine consumption, immediate and long term postoperative pain after Cesarean delivery. ⋯ There was no difference regarding early and late postoperative pain and morphine consumption with ketamine at doses of 0.25, 0.5, and 1 mg kg(-1) in women undergoing Caesarean delivery under general anaesthesia, compared with the control group.
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Minerva anestesiologica · Apr 2012
ReviewHumidification of inspired gases during mechanical ventilation.
Humidification of inspired gas is mandatory for all mechanically ventilated patients to prevent secretion retention, tracheal tube blockage and adverse changes occurring to the respiratory tract epithelium. However, the debate over "ideal" humidification continues. Several devices are available that include active and passive heat and moisture exchangers and hot water humidifiers Each have their advantages and disadvantages in mechanically ventilated patients. This review explores each device in turn and defines their role in clinical practice.
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Patients in the Intensive Care Unit (ICU) experience qualitative and quantitative sleep disruption leading to sleep deprivation and adverse sequelae. Patient-related factors, environmental factors, and health-support techniques contribute to sleep disruption. This quality improvement study examines potential factors contributing to poor sleep in the ICU. ⋯ Patients commonly report poor sleep in the ICU related to environmental factors that are potentially modifiable.
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Minerva anestesiologica · Apr 2012
Echocardiographic evaluation and N-terminal pro-brain natriuretic peptide measurement of patients hospitalized for heart failure during weaning from mechanical ventilation.
Weaning patients with heart failure who have required mechanical ventilation remains challenging. We evaluated echocardiographic indexes and N-terminal pro-brain natriuretic peptide (NT-proBNP) as markers of acute cardiac dysfunction before and after spontaneous breathing trials (SBT) in such patients to assess their ability to predict subsequent successful extubation. ⋯ Neither NT-proBNP level nor the studied echocardiographic indices before SBT were able to predict SBT outcome in patients presenting with severe heart failure. Failure to increase the cardiac index and increases in both E/Ea ratio and NT-proBNP levels were seen at end-SBT in patients who failed the SBT, and may reflect failure of myocardial reserve to cope with the stress of SBT.