HSR proceedings in intensive care & cardiovascular anesthesia
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HSR Proc Intensive Care Cardiovasc Anesth · Jan 2009
Most Care®: a minimally invasive system for hemodynamic monitoring powered by the Pressure Recording Analytical Method (PRAM).
Invasive hemodynamic monitoring is a cornerstone of the care of critically ill and hemodynamically unstable patients in both intensive care units and operating rooms. The assessment of cardiac output by means of the pulmonary artery catheter has been considered the clinical gold standard. Nevertheless, several concerns have been raised regarding its invasiveness, usefulness, and associated complica-tions. ⋯ PRAM provides the measurement of the main factors of hemodynamics, such as systemic blood pressures, stroke volume, cardiac output, and vascular resistances. Moreover, dynamic indices of fluid responsiveness are continuously displayed. In the present paper, we reviewed the current literature focusing on advantages and limitations of PRAM.
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Based upon the surgical location and indication, including redundant regions, eloquent areas, deep brain stimulation, and epilepsy foci, some patients will benefit from an awake craniotomy, which allows completion of neurocognitive testing during the intra-operative period. This paper suggests patient selection criteria through a new decision algorithm. ⋯ We describe the sequence of steps and anesthetic agents which has proved successful for our group. Finally, the use of the proposed decision algorithm simplifies preoperative anesthetic selection and prevents erroneous assignment of inappropriate patients to an awake technique.
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HSR Proc Intensive Care Cardiovasc Anesth · Jan 2009
Can timing of tracheal extubation predict improved outcomes after cardiac surgery?
Early tracheal extubation is a common goal after cardiac surgery. Our study aims to examine whether timing of tracheal extubation predicts improved postoperative outcomes and late survival after cardiac surgery. We also evaluated the optimal timing of extubation and its association with better postoperative outcomes. ⋯ Early extubation may predict improved outcomes after cardiac surgery. Extubation within 9 hours after surgery was the best predictor of uncomplicated recovery after cardiac surgery. Those patients intubated longer than 16 hours have a poorer postoperative prognosis. Early extubation predicts prolonged survival up to 16 months after surgery.
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HSR Proc Intensive Care Cardiovasc Anesth · Jan 2009
Where are italian anesthesiologists and intensive care specialists publishing? A quantitative analysis of publication activity.
With the continuing worldwide shortage of anesthesiologists, the demands of clinical duties allow very little time for research activities. Every dedicated biomedical center should provide doctors and scientists with the proper environment to facilitate education, clinical practice and research activities and promote publication in international peer-review journals. ⋯ Despite its obvious limitations such as the choice of a single database (Scopus), the absence of important qualitative indicators (e.g. impact factor, citation index), the inclusion of any type of publication (a letter to the editor or reviews counted like a randomized controlled study) and the possible exclusion of important scholars, this is the most up-to-date and comprehensive attempt to perform a quantitative analysis of publishing in Italy. Each of the 20 indexed Journals that most frequently hosted Italian authors only accepts manuscripts in English and has impact factor.