Minerva anestesiologica
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Hypoxemia is considered to be the most important challenge during one-lung ventilation (OLV). Recent studies, however, have shown that one-lung ventilation can involve some lung damage and can therefore be per se a cause of hypoxemia. OLV can be associated to an injury: but the techniques used to improve oxygenation may also damage the lung. A new ventilator approach should be used and applied with regards to what is so far known in terms of "lung protection" also during OLV.
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Minerva anestesiologica · May 2011
HLA-DR and B7-2 (CD86) monocyte expressions after major cancer surgery: profile in sepsis.
HLA-DR monocyte expression may be affected by major surgery. A potential mechanism for monocyte activation is the engagement of costimulatory receptors (B7-2 or CD-86). The aim of the present study was to determine the possible role of monocyte HLA-DR and B7-2 molecules in the occurrence of postoperative sepsis after major cancer surgery. ⋯ Results suggest a key role for costimulatory molecules in modulating inflammatory response in the context of subsequent postoperative sepsis after major cancer surgery. These molecules may be involved, in association with HLA-DR, in postoperative monocyte dysfunction.
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Minerva anestesiologica · Apr 2011
Tidal volume is a major determinant of cyclic recruitment-derecruitment in acute respiratory distress syndrome.
Overdistension and cyclic recruitment-derecruitment contribute to ventilator-induced lung injury. High tidal volumes are thought to increase mortality mainly by inducing overdistension. However, experimental evidence suggests that tidal volume (VT) may also influence cyclic recruitment-derecruitment. Our main goal was to determine whether high tidal volumes increase cyclic recruitment-derecruitment in acute respiratory distress syndrome (ARDS) patients, as measured by dynamic computed tomography (CT). ⋯ High tidal volume is a major determinant of cyclic recruitment-derecruitment in ARDS patients with diffuse attenuations.