Minerva anestesiologica
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Minerva anestesiologica · Sep 2011
Systemic adverse events during 2005 phacoemulsifications under monitored anesthesia care: a prospective evaluation.
The aim of the study was to evaluate the systemic adverse events triggering on-call anesthesiologist's intervention during 2005 phacoemulsification under topical anesthesia on a day-surgery monitored anesthesia care regimen. ⋯ One-day cataract surgery performed under topical anesthesia with monitored anesthesia care required anesthesiologist intervention in 21.6% of cases, mainly because of agitation or hypertension. Agitation occurred more often in younger patients with neurological or psychiatric comorbidities. Hypertension occurred more often in older patients with higher ASA scores.
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Minerva anestesiologica · Aug 2011
Review Meta AnalysisThe preventive role of higher PEEP in treating severely hypoxemic ARDS.
This review summarizes knowledge and evidence on the use of positive end-expiratory pressure (PEEP) in patients with severely hypoxemic acute respiratory distress syndrome (ARDS). More specifically, it documents the current evidence on the effects of higher PEEP in preventing (or attenuating) lung damage during the ventilatory management of patients with severely hypoxemic ARDS. No established threshold has been set to define severely hypoxemic ARDS and higher PEEP. ⋯ Higher PEEP should be used with caution in patients less severe hypoxemic (acute lung injury). To deliver optimal PEEP to those ARDS patients with the highest lung recruitability, this technique should be monitored at the bedside. Alternative methods are under investigation as part of a decremental PEEP trial.