Minerva anestesiologica
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Minerva anestesiologica · Dec 2000
Review[Mechanical ventilation in acute respiratory distress syndrome. New Trends].
Adult Respiratory Distress Syndrome (ARDS) is characterized by an inflammatory process affecting endothelial and epithelial lung tissue, with occurrence of hypoxemia, bilateral X-ray infiltrates, in absence of cardiogenic edema. The introduction of Computerized Tomography brought some improvements in understanding the ARDS lung, leading to a pulmonary model made up of three zones: 1) normally inflated, 2) recruitable and 3) consolidated. It has now been well established that mechanical ventilation of ARDS lung presents some iatrogenic effects that may affect mortality. ⋯ Another useful ventilatory tool for improving gas exchange and decreasing VALI in ARDS patients is likely the prone positioning, even if further studies are necessary to understand how this maneuver may really affect mortality. Another therapeutic instrument for improving oxygenation in ARDS patients is the inhalation of NO. Unfortunately, this pharmacological agent does not seem to affect the outcome of these patients.
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Minerva anestesiologica · Nov 2000
Case ReportsTotal intravenous anaesthesia without muscle relaxants in a child with diagnosed Duchenne muscular dystrophy.
The case of a 3 year old child, affected by Duchenne muscular dystrophy, who underwent adenoidectomy and bilateral myringotomy, is reported. Total intravenous anaesthesia (propofol 1% infusion (160 micrograms kg-1min-1) and remifentanil (0.55 microgram kg-1min-1) without any muscle relaxants was used. The postoperative period was uneventful.
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Minerva anestesiologica · Nov 2000
Randomized Controlled Trial Comparative Study Clinical Trial[The effects of remifentanil on hemodynamic response to intubation. A comparative study with fentanyl] .
The aim of this study was to evaluate the effects of remifentanil in comparison with those of fentanyl on the hemodynamic response to orotracheal intubation. ⋯ In conclusion remifentanil was found to properly control the hemodynamic response to intubation in comparison with fentanyl.
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Despite a wide range of therapeutic choice in the treatment of angina pectoris, there is a small but increasing population of patients that doesn't benefit of conventional therapy and whose life is invalidated by frequent attack of anginal pain. For this population, nonresponders to drug therapy not suitable for revascularization (coronary bypass surgery, angioplasty), neurostimulation of dorsal column has been described as an effective and safe therapy. The mechanism of action is not completely known, but is safety is sufficiently established. It may become a useful choice in the treatment of patients with intractable angina.