Minerva anestesiologica
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Minerva anestesiologica · Aug 2011
Sevoflurane as a potential replacement for halothane in diagnostic testing for malignant hyperthermia susceptibility: results of a preliminary study.
To diagnose malignant hyperthermia (MH) susceptibility, muscle bundles are exposed to halothane and caffeine. We investigated whether sevoflurane, which is more clinically relevant but less potent of an anesthetic, could replace halothane in diagnostic MH testing. ⋯ The rapid application of a high sevoflurane concentration but not an increasing stepwise application allowed for the diagnostic discrimination of susceptible individuals.
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Minerva anestesiologica · Aug 2011
Review Meta AnalysisContinuous intravenous infusion of ketamine for maintenance sedation.
Ketamine HCl is a rapidly acting general anesthetic with sedative and analgesic properties that has been reported to have favorable effects on the cardiovascular and pulmonary systems. The goal of this review is to determine the hemodynamic and pulmonary effects of continuous intravenous (IV) ketamine infusion in mechanically ventilated patients, and to determine whether sufficient evidence exists to support its use as an agent for maintenance anesthesia. PubMed/Medline, EMBASE, and Index Medicus databases as well as relevant bibliographies were searched. ⋯ It also improves respiratory rate and oxygenation, and does not promote respiratory depression. Additionally, ketamine does not result in significant perturbations in blood pressure, heart rate, or vascular resistance. Ketamine may be a safe and effective tool for maintenance sedation of mechanically ventilated patients, however a large prospective clinical trial is warranted.
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Minerva anestesiologica · Aug 2011
Randomized Controlled TrialIntrathecal atropine to prevent postoperative nausea and vomiting after Cesarean section: a randomized, controlled trial.
Postoperative nausea and vomiting (PONV) is a common adverse effect of intrathecal morphine, especially after Cesarean section. This randomized controlled trial investigated the effects of intrathecal administration of a small-dose of atropine on postoperative nausea and vomiting after Cesarean section. ⋯ Intrathecal atropine had a significant antiemetic effect, making it a useful adjunct for intrathecal opioid-related PONV.
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Minerva anestesiologica · Aug 2011
Case ReportsCoupled plasma filtration-adsorption in Weil's syndrome: case report.
Weil's syndrome is a form of leptospirosis characterized by jaundice, renal failure and hemorrhagic diathesis. Its pathogenesis is related with the invasiveness of leptospires and with the subsequent systemic inflammatory response. Coupled plasma filtration-adsorption (CPFA) is a modality of extracorporeal blood purification in which plasma is separated from the whole blood and directed into a sorbent cartridge. ⋯ Weaning from ventilation was achieved on day 6. Interestingly, diuresis started during the first course of CPFA, with a creatinine clearance of 63 ml/min on day 8 and a normalization of the ratio urinary to plasma osmolality on day 28. The patient was discharged on day 11 and 28 from the Intensive Care Unit and hospital respectively.
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Minerva anestesiologica · Aug 2011
Interventional lung assist enables lung protective mechanical ventilation in acute respiratory distress syndrome.
The feasibility and safety of a pumpless arteriovenous extracorporeal lung assist system (pECLA) has been demonstrated in previous studies of patients with severe respiratory insufficiency. The aim of this report was to examine whether pECLA is feasible in a center that is new to the technology and to determine the positive and adverse effects associated with its use. ⋯ pECLA is an effective and manageable technique to support gas exchange in ARDS patients. This retrospective case series demonstrates the feasibility of pECLA in a center that did not have prior experience with this technique. pECLA may decrease further lung injury by minimizing the amount of time for which the lung is exposed to high stress and/or strain.