Minerva anestesiologica
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Minerva anestesiologica · Oct 2011
A new difficult airway management algorithm based upon the El Ganzouri Risk Index and GlideScope® videolaryngoscope: a new look for intubation?
An El Ganzouri risk index test (EGRI) score of seven and the ability to achieve difficult laryngeal exposure with the GlideScope® may represent a highly predictive decisional threshold. Hence, we hypothesized that a new difficult airways algorithm that is EGRI- and GlideScope®-based may enable tracheal intubation in every patient. ⋯ Adherence to the decisional process of the algorithm and to GlideScope® videolaryngoscopy achieved successful tracheal intubation in our cohort of patients.
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Minerva anestesiologica · Oct 2011
Relationship between mixed venous oxygen saturation and regional cerebral oxygenation in awake, spontaneously breathing cardiac surgery patients.
In search of a non-invasive method for estimation of the oxygen balance this prospective study evaluates the relationship between regional cerebral oxygenation (rScO2) and mixed venous oxygen saturation in awake, spontaneously breathing patients after cardiac surgery. ⋯ The rScO2 measured by near infrared spectroscopy was sufficiently representing mixed venous oxygen saturation in awake, hemodynamically stable, spontaneously breathing patients after cardiac surgery. The agreement was comparable to the agreement between SvO2 and ScvO2 with smaller differences in the lower ranges of SvO2.
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Minerva anestesiologica · Oct 2011
ReviewItalian intersociety consensus statement on antithrombotic prophylaxis in hip and knee replacement and in femoral neck fracture surgery.
Anticoagulant prophylaxis for preventing venous thrombembolism (VTE) is a worldwide established procedure in hip (HR) and knee replacement (KR) surgery, as well as in the treatment of femoral neck fractures (FNF). Different guidelines are available in the literature, with quite different recommendations. None of them is a multidisciplinary effort as the one presented. ⋯ This inter-society consensus statement aims at simplifying the grading system reported in the literature, and thus at improving its proper application. Special focus is given to fragile patients, those with high bleeding risk, and on those receiving chronic antiplatelet and vitamin K antagonists treatment. A special chapter is dedicated to regional anesthesia and VTE prophylaxis.
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Sepsis is a significant public health problem that affects children and adults alike. Despite some similarities in the approach to pediatric and adult septic shock, there are key differences as it relates to pathophysiology, clinical presentation, and therapeutic approaches. In this review article, we discuss these differences under 4 headings: a) Developmental differences in the hemodynamic response, b) Activated Protein C, c) Thrombocytopenia associated multiple organ failure and d) Hemophagocytic Lymphohistiocytosis (HLH).
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Minerva anestesiologica · Oct 2011
Reliability of the HemoCue® hemoglobinometer in critically ill patients: a prospective observational study.
The aim of the study was to assess the reliability of hemoglobin measurements made with HemoCue®, compared with those made with the reference method in critically ill patients. ⋯ Capillary HemoCue® is not sufficiently accurate to make a therapeutic decision such as whether a blood transfusion should be performed. The method's performance was moderately improved by the use of arterial blood.