Search results for " anestesiologia"
showing 10 items of 158 documents
Comparisons of two diaphragm ultrasound-teaching programs: a multicenter randomized controlled educational study
2019
Abstract Background This study aims to ascertain whether (1) an educational program is sufficient to achieve adequate Diaphragm Ultrasound (DUS) assessments on healthy volunteers and (2) combining a video tutorial with a practical session is more effective in making learners capable to obtain accurate DUS measurements, as opposed to sole video tutorial. Results We enrolledstep 1: 172 volunteers naïve to ultrasound. After watching a video tutorial, a questionnaire was administered and considered to be passed when at least 70% of the questions were correctly answered. Course participants who passed the theoretical test were randomized to either intervention or control group. Learners randomiz…
Combined oral prolonged-release oxycodone and naloxone in chronic pain management
2013
Introduction: The use of opioids is associated with unwanted adverse effects, particularly opioid-induced constipation (OIC). The adverse effects of opioids on gastrointestinal function are mediated by the interaction with opioid receptors in the gastrointestinal tract. The most common drugs used for relieving OIC are laxatives, which do not address the opioid receptor-mediated bowel dysfunction and do not provide sufficient relief. Areas covered: This paper discusses the role of a combination of prolongedrelease formulation of oxycodone (OX) and naloxone (N) in the prevention and management of OIC, reporting efficacy and safety outcome of controlled studies. In a therapeutic area of great …
KPC - 3 Klebsiella pneumoniae ST258 clone infection in postoperative abdominal surgery patients in an intensive care setting: analysis of a case seri…
2013
Background: Abdominal surgery carries significant morbidity and mortality, which is in turn associated with an enormous use of healthcare resources. We describe the clinical course of 30 Intensive Care Unit (ICU) patients who underwent abdominal surgery and showed severe infections caused by Klebsiella pneumoniae sequence type (ST) 258 producing K. pneumoniae carbapenemase (KPC-Kp). The aim was to evaluate risk factors for mortality and the impact of a combination therapy of colistin plus recommended regimen or higher dosage of tigecycline. Methods: A prospective assessment of severe monomicrobial KPC-Kp infections occurring after open abdominal surgery carried out from August 2011 to Augus…
Should Reinke edema be considered a contributing factor to post-extubation failure?
2015
We read with interest the recently published review in Critical Care about post-extubation laryngeal edema and stridor by Pluijms et al. [1]. The review considers in detail the risk factors for post-extubation respiratory failure and describes a post-extubation algorithm for its prevention and reduction. We recently published a case report describing the occurrence of post-extubation stridor leading to post-extubation respiratory failure in a woman with a previously undiagnosed Reinke edema (RE) [2]. RE is a progressive laryngeal soft-tissue swelling. The condition typically manifests in female gender as hoarseness and as a gradually deepening voice in patients with a history of smoking, vo…
Update on perioperative management of the child with asthma
2012
Asthma represents the leading cause of morbidity from a chronic disease among children. Dealing with this disease during the perioperative period of pediatric surgical procedures is, therefore, quite common for the anesthesiologist and other professionalities involved. Preoperative assessment has a key role in detecting children at increased risk of perioperative respiratory complications. For children without an optimal control of symptoms or with a recent respiratory tract infection elective surgery should be postponed, if possible, after the optimization of therapy. According to clinical setting, loco-regional anesthesia represents the desirable option since it allows to avoid airway ins…
How to manage aspergillosis in non-neutropenic intensive care unit patients.
2014
Invasive aspergillosis has been mainly reported among immunocompromised patients during prolonged periods of neutropenia. Recently, however, non-neutropenic patients in the ICU population have shown an increasing risk profile for aspergillosis. Associations with chronic obstructive pulmonary disease and corticosteroid therapy have been frequently documented in this cohort. Difficulties in achieving a timely diagnosis of aspergillosis in non-neutropenic patients is related to the non-specificity of symptoms and to lower yields with microbiological tests compared to neutropenic patients. Since high mortality rates are typical of invasive aspergillosis in critically ill patients, a high level …
Perioperative management of obstructive sleep apnea: A systematic review
2018
Introduction Obstructive sleep apnea (OSA) is the leading sleep disordered breathing condition, with a prevalence rate of moderate to severe OSA of approximately 10-17% in the general population. Evidence acquisition We performed an Ovid-Medline search of all articles published up to August 2016. We included all articles providing updated evidence on epidemiology, pathophysiologic mechanisms and perioperative interventions. Evidence synthesis OSA is associated with a number of comorbidities and increased perioperative risks. Although in-laboratory polysomnography represents the gold-standard for diagnosis of OSA, it is costly and time-consuming. Anesthesiologists may screen patients for OSA…
Neutrophil CD64 as a marker of infection in patients admitted to the emergency department with acute respiratory failure
2014
Andrea Cortegiani, Vincenzo Russotto, Francesca Montalto, Grazia Foresta, Pasquale Iozzo, Santi Maurizio Raineri, Antonino Giarratano Department of Biopathology and Medical and Forensic Biotechnologies (DIBIMEF), Section of Anesthesiology, Analgesia, Emergency and Intensive Care, Policlinico “P Giaccone”, University of Palermo, Palermo, Italy Introduction: Cluster of differentiation 64 (CD64) is expressed on neutrophils during bacterial infections and sepsis. The aim of our study was to assess the CD64 expression in patients admitted to the emergency department (ED) with a triage diagnosis of acute respiratory failure (ARF) and/or dyspnea and to verify a relationship bet…
Simulation-based education for cardiopulmonary resuscitation and airway management protocols: a brief report of a systematic review and meta-analysis.
2014
We aimed to summarize the efficacy of simulation-based education in cardiopulmonary resuscitation and airway management [1].
The anesthesiologist and end-of-life care
2012
Purpose of review Anesthesiologists may face problematic situations when patients are close to death, in which clinical problems, decision-making processes, and ethical issues are often interconnected and dependent on each of them. The aim of this review is to assess the recent literature regarding the anesthesiological role for advanced cancer patients. Recent findings Palliative sedation in the dying patients, end-of-life problems in the ICU, and pain control in advanced cancer patients have been the subject of recent research. All these issues have shown that anesthesiologist would be expert in the field of pain and symptom control at the end of life. End-of-life care problems are common…