Minerva anestesiologica
-
Minerva anestesiologica · Feb 2017
Randomized Controlled Trial Multicenter Study Pragmatic Clinical TrialNeurological assessment with validated tools in general ICU: multicenter, randomized, before and after, pragmatic study to evaluate the effectiveness of an e-learning platform for continuous medical education.
International guidelines recommend systematic assessment of pain, agitation/sedation and delirium with validated scales for all ICU patients. However, these evaluations are often not done. We have created an e-learning training platform for the continuous medical education, and assessed its efficacy in increasing the use of validated tools by all medical and nursing staff of the participating ICUs during their daily practice. ⋯ This e-learning program shows encouraging effectiveness, and the increase in the use of validated tools for neurological monitoring in critically ill patients lasts over time.
-
Minerva anestesiologica · Dec 2016
Randomized Controlled Trial Multicenter Study Comparative StudyBacterial colonization is decreased after tunneling femoral perineural catheters.
Infection of perineural catheter is rare, although bacterial colonization is frequent. An observational study reported that subcutaneous tunneling perineural catheter could decrease its colonization rate. We performed a comparative study to assess the incidence of catheter related bacterial colonization of tunnelized femoral perineural catheters. ⋯ Tunneled subcutaneous perineural catheter decreased the incidence of colonization. Moreover, tunnelization is an effective technique for securing the perineural catheter.
-
Minerva anestesiologica · Dec 2016
Multicenter Study Observational StudyResidual neuromuscular blockade in the postanesthesia care unit. Observational cross-sectional study of a multicenter cohort.
Residual neuromuscular blockade after general anesthesia using nondepolarizing neuromuscular blocking agents has pathophysiological, clinical, and economic consequences. A significant number of patients under muscle relaxation sustain residual curarization. ⋯ The incidence of residual blockade in Spain is similar to that published in other settings and countries. Female gender, longer duration of surgery, and halogenated drugs for anesthesia maintenance were related to residual paralysis, as were NMBA specific items, such as the use of benzylisoquinoline drugs, and the absence of reversal or reversal with neostigmine.
-
Minerva anestesiologica · Dec 2016
Multicenter StudyHospital disaster preparedness in Italy: a preliminary study utilizing the World Health Organization hospital emergency response evaluation toolkit.
Natural and human-initiated disasters are occurring with greater devastating consequences and increased frequency. During these events, hospitals have the burden to care for acutely ill and injured patients. The aim of this study was to evaluate the level of disaster preparedness of Italian hospitals. ⋯ The study revealed that a large majority of Italian hospitals evaluated are not well prepared to manage potential disasters. Also, all important elements of hospital preparedness, such as the command system, surge capacity, and safety, were insufficiently implemented. Nationwide standards, guidelines and procedures are required to improve hospital disaster preparedness in Italy.
-
Minerva anestesiologica · Apr 2016
Multicenter Study Observational Study"Italian Registry of Complications associated with Regional Anesthesia" (RICALOR). An incidence analysis from a prospective clinical survey.
Regional anesthesia (RA) is associated with many advantages, but side effects also occur. Several registries were developed to investigate such complications in many countries, which produced conflicting results. In consideration of the ongoing evolution and improvements in RA, and its widespread diffusion in Italy in the last decade (with increasing experience by anesthesiologists), a reappraisal of the incidence and the characteristics of major complications are useful to improve patient's safety. ⋯ We confirmed RA as generally safe, but monitoring and diagnosis, together with further research efforts, are needed to improve patients' care and clarify potential risk factors.