Abstract:
AIM:The aim of this study was to evaluate and compare the parameters for mechanical respiration in pediatric patients undergoing controlled ventilation with a laryngeal mask (LM) and an uncuffed orotracheal tube. METHODS:The study examined 100 ASA 1 patients undergoing general anesthesia with myoresolution and mechanical ventilation using a Servo Ventilator 900 (constant flow, 25% insufflation, 10% teleinspiratory pause, tidal volume 10 ml/kg). All patients were divided into 2 groups matched for age and weight. An uncuffed orotracheal tube was used in one group (Group T) and a laryngeal mask (LM) in the other (Group M). The following parameters were measured: peak and pause pressure in the respiratory passage (Paw), total inspiratory resistance (R tot), compliance (C) and air loss expressed as a fraction of inspired volume (Vi-Ve/Vi). The statistical analysis of results was performed using Student's "t"-test and the level of significance was p < 0.05. RESULTS:Peak pressures were comparable in the two groups and were lower than the pressure needed to open the lower esophageal sphincter. These values could be further reduced by the extension of insufflation time achieved by abolishing the teleinspiratory pause included in the study to measure air resistances and compliance. Air losses were also similar in both groups, being respectively 13 and 11%. This means that environmental pollution using LM was not greater than with the uncuffed tube and confirms that, even with the latter, the protection of the airways cannot be regarded as absolute. Total inspiratory resistances were respectively 16.1 cm H2O/l/sec in group T and 15.1 cm H2O/l/sec in group M. This occurred in spite of the fact that the latter showed an in vitro capacity to oppose lower resistances compared to the corresponding tubes given that it was shorter with a larger diameter. Studies using the mechanical model did not include the laryngeal mask--larynx connection which may cause increased resistance owing to the variable position of the epiglottis, although this cannot be identified clinically. CONCLUSIONS:The laryngeal mask allows mechanical ventilation with low pressure in the respiratory passage and reduced air losses compared to the uncuffed tracheal tube. The risk of gastroesophageal insufflation is therefore minimal and artificial ventilation is reliable, if correctly performed. Lower levels of inspiratory resistance might be an advantage in spontaneous breathing owing to the consequent reduction of respiratory effort, but they do not appear to be significantly lower than with the tracheal tube.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Tartari S,Poole D,Bocchi A,Sgarbi A,Alvisi Rkeywords:
subject
Has Abstractpub_date
2000-01-01 00:00:00pages
33-7issue
1-2eissn
0375-9393issn
1827-1596journal_volume
66pub_type
临床试验,杂志文章abstract:INTRODUCTION:The world population is mostly male at birth, although there is a shift in predominance over 55 years of age with more females than males. Male gender was recently hypothesized to be a risk factor for sepsis and septic shock; the reasons and the consequences of this odd discrepancy are yet a matter of deba...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.17.12187-5
更新日期:2018-04-01 00:00:00
abstract::Over the last two decades, experimental and clinical data have begun to shape a more discriminating approach to intravascular (IV) fluid infusions in the resuscitation of trauma patients with presumed internal hemorrhage. This approach takes into account the presence of potentially uncontrollable hemorrhage (e.g., dee...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the incidence of colonization and infection by methicillin-resistant in PICU. DESIGN:Prospective cohort study during 2 years for the surveillance of nosocomial infections. SETTING:Four beds Pediatric Intensive Care Unit. PATIENTS:We studied two-hundred patients with duration of hospitalization ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1995-06-01 00:00:00
abstract:METHODS:Published studies, including abstracts, has been reviewed and summarized. RESULTS:Studies in sheep have demonstrated no significant differences in pharmacokinetic and placental transfer of levobuvacaine when compared with bupivacaine. Clinical studies on cesarean section confirmed similar performance between t...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2001-09-01 00:00:00
abstract::Two large phase-III prospective, multicenter, controlled, double-blind, randomized clinical trials (the PROTECT III study; the SYNAPSE study) evaluated the effectiveness of an early administration of progesterone in patients with moderate to severe traumatic brain injury (TBI). In the PROTECT III Trial, patients were ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND: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. METHODS: DESIGN AND SETTING:observational study in a tertiary referral center, Intensive Care Unit, Astrid Li...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:2002-05-01 00:00:00
abstract::Anaesthesia with atracurium, fentanyl, and continuous intravenous infusion of propofol in two myasthenic patients is described. There were no intra and postoperative problems and operative conditions were considered excellent. This technique offers a safe alternative to inhalational anaesthesia for patients with myast...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:1992-03-01 00:00:00
abstract::The detection of tissue hypoxia and its correction is one of the aim of the hemodynamic monitoring. Classical hemodynamic variable often fail to achieve this goal. Lactate measurements may be a good indicator of tissue hypoxia. Selected review of the articles on lactate in critically ill patients. Tissue hypoxia is as...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND:Oral premedication is common practice in paediatric anaesthesia. The aim of this study was to assess the quality of premedication using oral ketamine, with midazolam. METHODS:Clinical randomized and blind-study on 120 patients, aged between 2 and 6 years, listed for minor surgery. Patients were divided in t...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2002-07-01 00:00:00
abstract::The Authors, after a brief review of malignant hyperthermia (MH), describe the use of NLA a Harrington's surgical procedure in a malignant hyperthermia susceptible (MHS) patient. Such an anaesthesiological procedure, using benzodiazepines, droperidol, fentanyl, pancuronium and N2O/O2, didn't lead to any form of MH cri...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1989-09-01 00:00:00
abstract:AIM:Define pathophysiology, epidemiology, diagnosis and therapy in case of spinal bleeding after central neural blockade (CNB). METHODS:Spinal epidural hematoma (SEH) following CNB may occur due to vascular trauma from needle/catheter placement and can occur in subdural and epidural spaces. Epidural artery bleeding se...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2001-09-01 00:00:00
abstract::Cervical vertebral dislocations and fractures require the complete immobility of the neck until an intervention of stabilization of the spinal cord, by surgery or external means, is performed. Endotracheal intubation, which might represent a harmful operation, can become difficult when the stabilization of the spinal ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1989-03-01 00:00:00
abstract:BACKGROUND:Blind insertion of endotracheal tubes through the intubating laryngeal mask airway (ILMA) is unsuccessful in almost 50% of cases on the first attempt, with an overall success rate of approximately 90%. We used a portable fiber optic device (Foley Airway Stylet Tool® FAST) to detect the reasons for failed int...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:The aim was to investigate whether tramadol had toxic effect on cerebral neurons and/or spinal cord neurons when it was administered into the cerebrospinal fluid. Due to lipid peroxidation (LPO) and myeloperoxidation (MPO) levels are not specific predictors of neuronal damage, these biochemical markers of ti...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2014-08-01 00:00:00
abstract:: ...
journal_title:Minerva anestesiologica
pub_type: 评论,信件
doi:10.23736/S0375-9393.19.13835-7
更新日期:2019-10-01 00:00:00
abstract::A double blind comparison between morphine and buprenorphine was performed in 20 patients using a new demand and continuous infusion analgesic system to provide analgesia after cesarean section. The patients were randomized in two equal groups to receive either morphine 1 mg/h or buprenorphine 0.03 mg/h. The PCA syste...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1989-01-01 00:00:00
abstract::AIM. To evaluate the validity of general anesthesia using the laryngeal mask airway (LMA) in pediatrics in a series of 163 patients. MONITORING. ETCO2 and SpO2 were evaluated five minutes after the insertion of LMA and then at five minute intervals. SpO2 was evaluated every two minutes after the removal of LMA. Use of...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract:AIM:Transcatheter aortic valve implantation (TAVI) is an emergent alternative technique to surgery in high-risk patients with aortic stenosis. Here, we describe the anesthesiological management of patients undergoing TAVI at our institution over an 18-month period. METHODS:After a proper assessment of surgical risk an...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2010-02-01 00:00:00
abstract:AIM:The aim of our study was to compare the efficacy of hyperbaric and isobaric solutions of intrathecal levobupivacaine for transurethral endoscopic surgery. METHODS:Urological patients who were scheduled for elective surgery under spinal anesthesia were enrolled. The heavy group received 13.5 mg of hyperbaric levobu...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2010-01-01 00:00:00
abstract::Two groups of 15 children aged from 15 days to 6 years, undergoing surgery on cardiopulmonary by-pass for congenital heart disease have been retrospectively analyzed. Group A received a low-dose aprotinin treatment (30,000 KIU/kg in the priming solution); group C (control group) did not receive any aprotinin. Groups w...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1994-07-01 00:00:00
abstract::All 54 chest trauma patients admitted to Resuscitation II of Pavia's S. Matteo Polyclinic in the period 1974-1979 have been reviewed in a critical analysis. Particular attention was paid to mortality in relation to age, associated pathology, treatment and the complications arising during the course of the trauma. Resu...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1981-11-01 00:00:00
abstract:BACKGROUND:Thrombocytopenia is associated with worse outcomes in critically ill patients. The clinical relevance of other platelets indices is less studied. We investigated the ability of the platelets distribution width (PDW) and the mean platelet volume (MPV) to predict mortality in critically ill patients. We hypoth...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.20.14528-0
更新日期:2020-09-22 00:00:00
abstract::Factor VIIa might be a useful treatment for coagulopathy and massive hemorrhage following implantation of a mechanical circulatory assist device, but there is a theoretical risk of device thrombosis. To date this complication has not been reported. We describe the first case of clotting of a left ventricular assist de...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2008-04-01 00:00:00
abstract::The authors report their own experience in three cases of paediatric phaeochromocytoma. Before surgery the patients received alpha-adrenergic blocking drugs; two of them also received calcium channels blocking drugs and in one of them was employed a beta-adrenergic blocking drug too. Before surgery the patients receiv...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:Clinical studies have raised concerns about the safety of 6% hydroxyethylstarch (HES) 130/0.42, but the pathomechanisms of this renal impairment remain unknown. To evaluate the effects of different HES concentrations, molar substitutions and molecular weights in HES-induced renal impairment, we used a porcin...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2015-06-01 00:00:00
abstract:AIM:Little information is available on efficacy and safety of the new supraglottic device, PA(Xpress), in anesthetized patients. The aim of this prospective observational study was to evaluate the use of this new supraglottic device in clinical practice. METHODS:Ninety-one patients (mean age: 45+/-11 years) undergoing...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,多中心研究
doi:
更新日期:2003-06-01 00:00:00
abstract::Inhalation agents represent a basic drug used in modern balanced anesthesia. In the present review, the pharmacokinetics, effectiveness and clinical effects of inhalation agents on different systems are discussed. Data concerning the metabolism and related toxicity of halogenated agents is reviewed, with particular re...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2010-03-01 00:00:00
abstract::An account is given of the employment of althesin as an induction and maintenance anaesthetic. It is free of the drawbacks observed with thiopentone induction, and has negligible haemodynamic and respiratory effects. Its association with leptophen permitted excellent analgesia at minimal leptophen doses, without secon...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract::The authors report our experience on 19 cases of discitis developed after operations for herniated lumbar disc. Because of the negativity of the neuroradiological studies in the acute stage, the recognition of the typical syndrome (severe back pain, spasm of the paravertebral lumbar muscles, limited spinal motility, f...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1992-04-01 00:00:00
abstract:OBJECTIVE:To describe the use of an automatic fluid control system, Equaline, during high flux continuous hemofiltration. DESIGN:Prospective descriptive study. SETTING:General intensive care unit in a general hospital. PATIENTS:15 consecutive patients suffering from septic shock, hypercatabolic with acute renal fail...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00