Minerva anestesiologica
-
40% to 60% of children undergoing surgery under general anaesthesia develop anxiety in the preoperative period. Multiple factors contribute to the genesis of this disorder. Preoperative anxiety may complicate the induction of anaesthesia and can cause behavioural modifications in children even long after surgical procedures have been completed. ⋯ A preparation program, premedication and parental presence during induction of anaesthesia are valid tools for achieving this goal. We are herewith presenting a play preparation program carried out by play specialists and offered to all children prior to surgery. This approach proved effective in reducing preoperative anxiety in children and their mothers.
-
Adaptive Support Ventilation is a novel ventilation mode, a closed-loop control mode that may switch automatically from a PCV-like behaviour to an SIMV-like or PSV-like behaviour, according to the patient status. The operating principles are based on pressure-controlled SIMV with pressure levels and SIMV rate automatically adjusted according to measured lung mechanics at each breath. ⋯ In cardiac surgery tracheal extrubation was faster in ASV patients then in controls. In the early weaning phase of acute ventilatory insufficiency the need of resetting ventilator parameters was decreased, suggesting potential benefit for patient care.
-
Minerva anestesiologica · May 2002
Clinical TrialExtracorporeal respiratory support and minimally invasive ventilation in severe ARDS.
To evaluate the results of treatment of severe acute respiratory distress syndrome (ARDS) with extracorporeal life support (ECLS), minimal sedation and low pressure supported ventilation in adults. ⋯ A high survival rate can be obtained in adult patients with severe ARDS using ECLS, minimal sedation and pressure-supported ventilation with low inspiratory pressures. Surgical complications are amenable to surgical treatment during ECLS and bleeding problems can be controlled.
-
Minerva anestesiologica · May 2002
Clinical TrialPumpless extracorporeal lung assist using an arterio-venous shunt. Applications and limitations.
We report the use of a pumpless extracorporeal lung assist (PECLA) in 70 patients with severe pulmonary failure of various causes. The device was used under rescue conditions in patients with preserved cardiac function. By establishing a shunt between femoral artery and vein using the arterio-venous pressure gradient as the driving force for the blood flow through the oxygenator, PECLA proved to be extremely effective in terms of oxygenation and carbon dioxide removal.
-
Minerva anestesiologica · Apr 2002
ReviewSedation in the Intensive Care Unit. The basis of the problem.
The authors briefly discuss the advantages and limits of sedation in critically ill patients. They also focus the importance of an individualized sedative approach which provides pain relief and modulates stress response, allowing patients to be easily arousable and cooperative as necessary.