Abstract:
:Although the central nervous system is the primary endpoint of most general anesthetics, it is still the least monitored organ in clinical anesthesiology. In the last decade, technological research has expanded the application of near-infrared spectroscopy to allow continuous, non-invasive, and bedside monitoring of cerebral oxygen saturation (rSO(2)) through the scalp and skull, providing accurate information on the balance between brain oxygen supply and demand. The aim of this review is to provide an overview on relevant technological issues of cerebral oximetry, describe a systematic approach to its use, and summarize current information on its possible impact on our daily practice. We reviewed studies published on peer-reviewed journals about technological development and clinical application of rSO(2) monitoring in different fields of application to clinical practice. Due to the wide patient-to-patient variability of baseline rSO(2) values in each patient the baseline value should be determined before inducing general anesthesia, and cerebral ischemia is related more to the changes from baseline than to the absolute value: a reduction of 20% from baseline is usually accepted as clinical threshold of cerebral ischemia. If baseline rSO(2) is lower than 50% the critical threshold should be reduced to 15%. Routine use of rSO(2) monitoring in patients undergoing cardiac surgery to guide the anesthesia plan has been demonstrated to improve patient outcome and shorten hospital stay. However, rSO(2) monitoring does not seem to provide information accurate enough to indicate the placement of a Javid's shunt during carotid endarterectomy. In patients with neurological pathology or head trauma rSO(2) monitoring has been reported accurate enough in detecting early changes in cerebral blood flow that might result in cerebral ischemia. In aged patients undergoing major abdominal surgery rSO(2) monitoring to guide the anesthesia plan has been reported to reduce the exposition to cerebral ischemia with less effects on cognitive decline and shorter hospital stay. In conclusion several clinical conditions routinely encountered in our daily practice have the potential to disrupt the balance between the brain oxygen supply and demand, exposing to the risk of intraoperative cerebral ischemia. These alterations in brain oxygen balance remain totally undiagnosed if we do not specifically monitor it; while the possibility of monitoring regional cerebral oxygen saturation through a simple and totally non-invasive device has the potential for optimizing our anesthesia plan to the real needs of our main targeted organ: the brain.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Casati A,Spreafico E,Putzu M,Fanelli Gsubject
Has Abstractpub_date
2006-07-01 00:00:00pages
605-25issue
7-8eissn
0375-9393issn
1827-1596journal_volume
72pub_type
杂志文章,评审abstract::Ziconotide is a synthetic peptide equivalent of an w-conotoxin, obtained from the marine snail Conus magus, which acts by blocking N-type calcium channels in the spinal cord, reducing the perception of pain. It is a newly marketed drug, exclusively for intrathecal use, indicated for severe chronic pain. Ziconotide cam...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2008-12-01 00:00:00
abstract:: ...
journal_title:Minerva anestesiologica
pub_type: 评论,信件
doi:10.23736/S0375-9393.19.13630-9
更新日期:2019-07-01 00:00:00
abstract::The improvement in the success of solid organ transplantation over the past decades is remarkable and well documented. It is now a well-accepted treatment modality for patients with end-stage organ disease. Within the field of transplantation, abdominal organ transplantation is significantly more common than thoracic ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2010-04-01 00:00:00
abstract::A qualified nursing care is mandatory in patients after SAH. Clinical and instrumental monitoring are basilar to assure the rapid control of dangerous ICP or CPP changes and of epileptic crisis. Prophylaxis of infections is greatly minimized when coherent treatments are applied to any invasive devices, patient body, p...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:1998-05-01 00:00:00
abstract::Xenon is an interesting anesthetic as it appears to lack negative inotropicy and vasodilatation, giving great advantages to both patients with limited cardiovascular reserve or those who require hemodynamic stability. It has low toxicity and is not teratogenic. Xenon gives rapid induction and recovery, due to its low ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:Few studies have investigated the incidence of pulmonary anaerobes in a specific population in surgical Intensive Care Unit (ICU). The objective of this work was to determine the incidence of anaerobes in surgical ICU patients with suspected pneumonia. METHODS:This was a prospective observational, single-ce...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2014-10-01 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:BACKGROUND:A short hospital stay is nowadays desirable and affordable for a wide range of surgical pathology, respecting safety of care and home discharge. In the present study, the Authors investigated the use of TIVA with propofol/remifentanil during microsurgical vertebral disc resection to maintain a controlled vas...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:2002-09-01 00:00:00
abstract::In 1947 John Bonica as new Chief of Anesthesiology at Tacoma General Hospital organized one of the first around-the-clock labor anesthesia services and when became the first chairman of the new Department of Anesthesiology at the University of Washington (1960), caudal anesthesia was the primary technique used for pro...
journal_title:Minerva anestesiologica
pub_type: 传,历史文章,杂志文章
doi:
更新日期:2005-09-01 00:00:00
abstract::The term "chronic" is often used in daily clinical practice to indicate a type of pain that lasts over time and is accompanied by diagnostic and therapeutic difficulties. The common feeling is that in this category are actually collected many different clinical cases with the unique characteristic that the pain lasts ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2012-06-01 00:00:00
abstract::Non invasive ventilation (NIV), primarily applied in cardiogenic pulmonary edema, decompensated COPD and hypoxemic respiratory failure, has also found a wide application in the postoperative period. The expanding indications to the transcatheter treatment of diseased left heart valves have led to an increase in cardia...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2011-07-01 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::Accidents during anaesthesia may be clinical or technical. To avoid the latter, stress is laid on the by no means new concept that techniques and handling must fit contingent requirements and that they may be dangerous as much for their inadequate as for their excessive use. ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract::Humoral immunity (immunoglobulins and C3) as well as nutritional conditions (serum albumin, transferrin) have been investigated in 23 patients in the acute phase after surgery and/or trauma. Immunoglobulin deficiency, well correlated with the severity of trauma, was observed in the most critically ill patients in the ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1981-08-01 00:00:00
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::The overall use of allogeneic blood transfusions in clinical practice remains relatively high and still varies widely among centres and practitioners. Moreover, allogeneic blood transfusions have historically been linked with risks and complications: some of them (e.g. transfusion reactions and transmission of pathoge...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2015-10-01 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::During video assisted thoracoscopy (VAT) the lung should be well collapsed. When the separation of the lungs is strictly indicated, use of difficult tube, such as double lumen tube (DLT) or Univent tube cannot be avoided, despite the presence of a difficult airway. If a patient has a recognized difficult airway, awake...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2004-05-01 00:00:00
abstract::The authors report the results of two clinical studies on postoperative pain relief with PCA. In the first clinical study 44 patients, undergoing gynecologic surgery, were assigned at random to two groups. The first was treated by PCA (infusor Baxter) with morphine i.v. (basal bolus 0.05 mg/kg, loading doses 1 mg ever...
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:1993-10-01 00:00:00
abstract::This review focuses on recent developments in preservation techniques in liver transplantation. First, we discuss mechanisms of organ injury when using high-risk organs, including donation after circulatory death and steatotic grafts and we summarize pathways of ischemia reperfusion injury together with their link to ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:10.23736/S0375-9393.17.12016-X
更新日期:2018-02-01 00:00:00
abstract::It is well known that the organizational model of day surgery, concerning surgical problems defined by the literature as minor, has the aim of optimising the use of hospital resources and facilitating patients and their families, from a psychological and social point of view, by reducing hospitalisation time and the a...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2001-09-01 00:00:00
abstract::Mechanical ventilation (MV) with positive pressure insufflations of gas into the lung may be required to ensure sufficient oxygenation of blood and elimination of carbon dioxide in acute respiratory failure. Interfacing spontaneous breathing and mechanical ventilation has been used to improve gas exchange and may offe...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2006-04-01 00:00:00
abstract::Thoracic trauma frequently involve damage to the cardiac structures and in the worst cases, the progressive degeneration and necrosis of the damaged tissue lead to cardiac rupture. The high mortality resulting from cardiac tamponade requires the prompt execution of diagnostic tests to provide as much useful informatio...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2000-06-01 00:00:00
abstract::Postanaesthetic shivering is one of the leading causes of discomfort for patients recovering from general anesthesia. During EMG records, the distinguishing factor from shivering in fully awake patients is the existence of clonus similar to that recorded in patients with spinal cord transection. They coexist with the ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2003-05-01 00:00:00
abstract::Awareness during anesthesia (AGA) is known as an intraoperative incident which could lead to a series of untoward effects, among them symptoms compatible with the posttraumatic stress syndrome (PTSS). Incidence of AGA ranges between 0.1% and 0.7%, most of the reports indicating a 0.2% rate of all general anesthesias. ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2002-12-01 00:00:00
abstract::The importance of Ketamine in continuous perfusion is described on the basis of a studied carried out in 30 patients. The clinical data are compared with results predicted by the mathematical model. Special study was made of the behaviour of the cardiocirculatory apparatus, particularly in reference to myocardial cont...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1980-08-01 00:00:00
abstract::Coagulopathy associated with massive operative blood loss is an intricate, multicellular and multifactorial event. Massive bleeding can either be anticipated (during major surgery with high risk of bleeding) or unexpected. Management requires preoperative risk evaluation and preoperative optimization (discontinuation ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2007-07-01 00:00:00
abstract::Spontaneous thrombolysis is a quite rare event. It's not predictable through a clinical examination of the patient, but there are some markers that are supposed to be diagnostic because of the high percentage of their occurrence in coincidence with spontaneous thrombolysis. The goal of the authors is to describe a cas...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1993-09-01 00:00:00
abstract:BACKGROUND:To compare the anaesthetic epidural effects of levobupivacaine plus fentanyl versus bupivacaine plus fentanyl in patients undergoing lower limb surgery. METHODS:A single blind, randomised, prospective, multicentre study was designed to compare both therapies. The study was conducted in 10 tertiary hospitals...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,多中心研究,随机对照试验
doi:
更新日期:2008-07-01 00:00:00
abstract::The authors describe a case of prolonged neuromuscular blockade following suxamethonlum in a patient with a normal cholinesterase activity and dibucaine number > or = 75%. In this case a peripheral nerve stimulator and capnography allowed neuromuscular blockade evaluation and fresh frozen plasma infusion led to a norm...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1995-01-01 00:00:00