Minerva anestesiologica
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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.
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Minerva anestesiologica · Jul 2011
Randomized Controlled TrialA liberal preoperative fasting regimen improves patient comfort and satisfaction with anesthesia care in day-stay minor surgery.
The aim of this study was to evaluate whether a single preoperative limited oral intake of a carbohydrate drink could improve perioperative patient comfort and satisfaction with anesthesia care in elective day-stay ophthalmologic surgery. ⋯ Standardized limited oral preoperative fluid intake increases patient comfort and satisfaction with anesthesia care and should be a part of modern day-stay ophthalmologic surgery.
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Minerva anestesiologica · Jul 2011
Case ReportsChest ultrasounds to guide manual reexpansion of a postoperative pulmonary atelectasis: a case report.
Reexpansion of a pulmonary atelectasis is often difficult, even after removing possible causes of bronchial obstruction. Chest ultrasounds, inexpensive and readily available at the patient bedside, may offer valuable support to guide recruitment maneuvers. We report the case of a 57-year-old woman that developed a complete collapse of the left lung seven days after undergoing an intestinal resection for perforation. ⋯ Manual reexpansion was then attempted, and ventilatory pressures as well as the duration of forced inspirations were based on real-time ultrasound images. Complete reexpansion was achieved within a few minutes and confirmed by chest X-ray. The patient was weaned from mechanical ventilation on the same day and discharged from ICU three days later.