Search results for "Critical"

WHO needs high FIO2?

2017

World Health Organization and the United States Center for Disease Control have recently recommended the use of 0.8 FIO2 in all adult surgical patients undergoing general anaesthesia, to prevent surgical site infections. This recommendation has arisen several discussions: As a matter of fact, there are numerous studies with different results about the effect of FIO2 on surgical site infection. Moreover, the clinical effects of FIO2 are not limited to infection control. We asked some prominent authors about their comments regarding the recent recommendations.

From Neonatal Intensive Care to Neurocritical Care: Is It Still a Mirage? The Sicilian Multicenter Project

2021

Background. Neonatal brain injury (NBI) can lead to a significant neurological disability or even death. After decades of intense efforts to improve neonatal intensive care and survival of critically ill newborns, the focus today is an improved long-term neurological outcome through brain-focused care. The goal of neuroprotection in the neonatal intensive care unit (NICU) is the prevention of new or worsening NBI in premature and term newborns. As a result, the neonatal neurocritical care unit (NNCU) has been emerging as a model of care to decrease NBI and improve the long-term neurodevelopment in critically ill neonates. Purpose. Neurocritical care (NCC) Sicilian project includes three aca…

The role of physical activity and exercise in obesity and weight management: Time for critical appraisal

2016

The prevalence of overweight and obesity has increased dramatically during last 3 decades with devastating consequences to public health. Recommended strategies to reduce obesity have focused on healthier diet and physical activity (PA). Clearly, these approaches have not been successful, but whether this is due to failure to restrict energy intake or to maintain high levels of energy expenditure has been the subject of great controversy. Consequently, there has been a great deal of confusion about the role of PA and exercise in obesity and weight management. In this article, the theoretical basis for considering reduced PA and energy expenditure as the cause of obesity is appraised. Furthe…

Effectiveness of semi-permeable dressings to treat radiation-induced skin reactions. A systematic review

2017

The aim of this systematic review is to assess the available evidence concerning the effectiveness of semi-permeable dressings, on the full range of skin reactions, related to radiation therapy in cancer patients, from local erythema to moist desquamation, including subjective symptoms such as pain, discomfort, itchiness, burning and the effect on daily life activities. The bibliographic search was carried out looking for Randomised Clinical Trials (RCTs) indexed in PubMed, Cinhal, Cochrane plus and Biblioteca Nacional de Salud, published in the English and Spanish language, between 2010 and 2015. Data extraction and evaluation of study quality was undertaken by peer reviewers using the Cri…

Ethical reflections on Evidence Based Medicine

2013

BACKGROUND According to Potter’s point of view, medical ethics is the science of survival, a bridge between humanistic and scientific culture. The working out of judgements on right or wrong referred to the human being are studied by this science. Methodological quality is fundamental in clinical research, and several technical issues are of paramount importance in trying to answer to the final question “what is the true, the right thing?”. We know they are essential aspects as in medical ethics as in evidence based practice. AIM OF THE STUDY The aim of this paper is to talk about relationships and implications between ethical issues and Evidence Based Medicine (EBM). DISCUSSION EBM represe…

Usage of a semi-rigid intubation endoscope is not superior to a video laryngoscope. A prospective, randomised, controlled trial comparing the SensaSc…

2018

Abstract Introduction Numerous guidelines and techniques have been developed to manage difficult airways and to prevent problems in airway management. To achieve an optimal view of the glottis, various video laryngoscopes and video stylets have been developed and introduced in clinical anaesthesia. The aim of this study was to compare the time to place the tracheal tube (TT) with the McGrath™ Series 5 (McG; Medtronic Dublin, Ireland) and the semi-rigid intubation endoscope SensaScope™ (Sc; Acutronic Medical Systems AG, Hirzel, Switzerland) in elective surgery patients. Methods With the approval of the local ethics committee, patients were recruited for this prospective, randomised clinical …

2017

IntroductionThe direct laryngoscopy technique using a Macintosh blade is the first choice globally for most anaesthetists. In case of an unanticipated difficult airway, the complication rate increases with the number of intubation attempts. Recently, McGrath MAC (McGrath) video laryngoscopy has become a widely accepted method for securing an airway by tracheal intubation because it allows the visualisation of the glottis without a direct line of sight. Several studies and case reports have highlighted the benefit of the video laryngoscope in the visualisation of the glottis and found it to be superior in difficult intubation situations. The aim of this study was to compare the first-pass in…

Rationing in a Pandemic: Lessons from Italy.

2020

In late February and early March 2020, Italy became the European epicenter of the COVID-19 pandemic. Despite increasingly stringent containment measures enforced by the government, the health system faced an enormous pressure, and extraordinary efforts were made in order to increase overall hospital beds’ availability and especially ICU capacity. Nevertheless, the hardest-hit hospitals in Northern Italy experienced a shortage of ICU beds and resources that led to hard allocating choices. At the beginning of March 2020, the Italian Society of Anesthesia, Analgesia, Resuscitation, and Intensive Care (SIAARTI) issued recommendations aimed at supporting physicians in prioritizing patients when …

Tropical diseases in the ICU: Please do not forget hemophagocytic lymphohistiocytosis

2018

Predictors of mortality and early detection strategies for hepatopulmonary syndrome in liver transplant patients☆

2016

Introduction: Hepatopulmonary syndrome (HPS) is a serious, progressive disease. Its pathophysiology resides in a hypoxic intrapulmonary shunt and severe clinical deterioration. Liver transplantation (LT) is the only effective treatment in appropriately selected patients. Objective: To acknowledge the importance of early diagnosis of HPS. Patients and methods: Observational, descriptive, retrospective trial including 8 patients with HPS that received LT between April 2006 and August 2014. The clinical data prior to transplantation and follow-up after the procedure were reviewed. A multivariate analysis (stepwise forward logistic regression analysis) was used to identify the variable that cou…