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 or modification of anticoagulant drugs, prophylactic coagulation therapy). Intraoperatively, the causal diagnosis of the complex pathophysiology of massive bleeding requiring rapid and specific coagulation management is critical for the patient's outcome. Treatment and transfusion algorithms, based on repeated and timely point-of-care coagulation testing and on the clinical judgment, are to be encouraged. The time lapse for reporting results and insufficient identification of the hemostatic defect are obstacles for conventional laboratory coagulation tests. The evidence is growing that rotational thrombelastometry or modified thrombelastography are superior to routine laboratory tests in guiding intraoperative coagulation management. Specific platelet function tests may be of value in platelet-dependent bleeding associated e.g. with extracorporeal circulation, antiplatelet therapy, inherited or acquired platelet defects. Therapeutic approaches include the use of blood products (red cell concentrates, platelets, plasma), coagulation factor concentrates (fibrinogen, prothrombin complex, von Willebrand factor), pharmacological agents (antifibrinolytic drugs, desmopressin), and local factors (fibrin glue). The importance of normothermia, normovolemia, and homeostasis for hemostasis must not be overlooked. The present article reviews pathomechanisms of coagulopathy in massive bleeding, as well as routine laboratory tests and viscoelastic point-of-care hemostasis monitoring as the diagnostic basis for therapeutic interventions.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Kozek-Langenecker Ssubject
Has Abstractpub_date
2007-07-01 00:00:00pages
401-15issue
7-8eissn
0375-9393issn
1827-1596pii
R02075048journal_volume
73pub_type
杂志文章,评审abstract：BACKGROUND:Maximal inspiratory pressure (MIP) can help to evaluate inspiratory muscle strength. However its determination in ventilated patients is cumbersome and needs special equipment. We hypothesized that MIP could be obtained by using the expiratory hold knob of the ventilator. The aim of this study was to verify ...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：2015-01-01 00:00:00
abstract：AIM:Videoassisted thoracic surgical technique in children is being used with increasing frequency for an extensive variety of diagnostic and therapeutic procedures. The aim of the study was to assess respiratory, cardiocirculatory and body temperature changes in children undergoing thoracoscopy and to identify if the t...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：2007-03-01 00:00:00
abstract：BACKGROUND:The aim of this study was to investigate the value of serial quantitative (QC) and non-quantitative (NQC) endotracheal aspirate (ETA) surveillance cultures in predicting the causative pathogen of ventilator associated pneumonia (VAP) in patients receiving antibiotic therapy and the factors associated with th...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：2010-08-01 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：BACKGROUND:Postoperative opioid analgesia increases the incidence of postoperative nausea and vomiting (PONV). We investigated whether a combination of the neurokinin-1 antagonist aprepitant and dexamethasone decreases PONV incidence compared with dexamethasone alone in high-risk patients receiving continuous epidural ...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,随机对照试验
doi：
更新日期：2015-04-01 00:00:00
abstract：:A size 3 laryngeal mask was used in 20 patients who underwent elective general surgery. It consists of a silicon tube attached to mask which must be inserted into the hypopharynx and then inflated. No curarisation nor laryngoscopy is needed. Operations were performed in assisted or spontaneous ventilation, with good a...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：1992-05-01 00:00:00
abstract：BACKGROUND:Pharyngolaryngeal discomfort is a significant complication following the use of laryngeal mask airway (LMA). The present study aimed to investigate the relation of LMA cuff pressure and the occurrence of pharyngolaryngeal discomfort during spontaneous ventilation (SV), pressure support (PSV) and pressure con...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,随机对照试验
doi：
更新日期：2014-05-01 00:00:00
abstract：:The anaesthetic technique chosen for a laparohysterectomy in a woman affected by Apert's acrocephalosyndactilia is described. Difficulties in performing tracheal intubation were overcome by mean of loco-regional anesthesia (LRA). In order to minimize the anaesthetic risk, a standardised preoperative evaluation and ass...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：1997-05-01 00:00:00
abstract：BACKGROUND:Patient-ventilator asynchronies are challenging during pediatric mechanical ventilation. We hypothesized that monitoring the electrical activity of the diaphragm (EAdi) together with the "standard" airway opening pressure (Pao) and flow-time waveforms during pressure support ventilation would improve the abi...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：10.23736/S0375-9393.20.14543-7
更新日期：2020-08-04 00:00:00
abstract：:Over the past 15 years, there have been dramatic changes in the management of blunt hepatic trauma, specifically in the imaging techniques, and in the non-operative management. Actually, in more than 80% of blunt hepatic trauma, non operative management is used. In the last 20% the surgical option has to be taken with...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,评审
doi：
更新日期：2002-04-01 00:00:00
abstract：:Pulmonary gas exchange is regularly impaired during general anaesthesia with mechanical ventilation. This results in decreased oxygenation of blood. Major causes are collapse of lung tissue (atelectasis) and airway closure. Collapsed lung tissue is present in 90% of all subjects, both during spontaneous breathing and ...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,评审
doi：
更新日期：2002-05-01 00:00:00
abstract：BACKGROUND:Multifactor neuropathic pain is one of the most frequent symptoms in AIDS patients and analgesic treatment is primarily based on the use of drug combination of opioids, tricyclic antidepressants and antiepileptics. However, the chronic use of opioids in AIDS patients presents a risk due to the immunosuppress...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：2013-08-01 00:00:00
abstract：:This article is a review of present knowledge of the hormonal and metabolic responses to trauma and surgery. The factors which may mediate the responses are discussed and the potential value of different therapeutic manipulations are reviewed. The accelerated breakdown of muscle following significant injury is the mos...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,评审
doi：
更新日期：1992-06-01 00:00:00
abstract：BACKGROUND:Breakthrough pain (BTP) is a common problem during labor analgesia. Programmed intermittent epidural bolus (PIEB) has demonstrated superior to background epidural infusion (BEI) concerning BTP, but the effect of combining both modes remains unknown. We hypothesized that this combination could reduce BTP inci...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,随机对照试验
doi：10.23736/S0375-9393.19.13470-0
更新日期：2019-10-01 00:00:00
abstract：OBJECTIVE:To evaluate the usefulness of the modified Harris-Benedict formula predicting Energy Expenditure (EE) in pressure support ventilated, critically ill patient. SETTING:The intensive care unit (ICU) of a teaching hospital. PATIENTS:Fiftyfive patients admitted to ICU for acute respiratory failure, requiring mec...
journal_title：Minerva anestesiologica
pub_type： 临床试验,杂志文章
doi：
更新日期：1996-05-01 00:00:00
abstract：: ...
journal_title：Minerva anestesiologica
pub_type： 信件
doi：10.23736/S0375-9393.19.13663-2
更新日期：2019-09-01 00:00:00
abstract：BACKGROUND:The goal of the present work is to describe the development and results of the pediatric epidural analgesia program at the ''Hospital Nacional de Pediatria Prof. Dr. J. P. Garrahan'' in Argentina. METHODS:Patients with thoracotomy, abdominal surgery, osteotomy, amputations or severe trauma were included in ...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：2007-11-01 00:00:00
abstract：BACKGROUND:Labile iron is important in the pathogenesis of acute kidney injury (AKI). Neutrophil gelatinase-associated lipocalin (NGAL) and hepcidin control iron metabolism and are upregulated during renal stress. However, higher levels of urinary NGAL are associated with AKI severity whereas higher urinary hepcidin le...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：2015-11-01 00:00:00
abstract：:Clinical neurophysiology is both an extension of clinical examination and an integration of neuroimaging. It plays a role in diagnosis, prognosis and monitoring in the Intensive Care Unit (ICU). Electroencephalography (EEG) and somatosensory evoked potentials (SEPs) are the most informative neurophysiological tests. B...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,评审
doi：
更新日期：2012-09-01 00:00:00
abstract：BACKGROUND:Predictive models of acute kidney injury after cardiac surgery (CS-AKI) include emergency surgery and patients with hemodynamic instability. Our objective was to evaluate the performance of validated predictive models (Thakar and Demirjian) in elective cardiac surgery and to propose a better score in the cas...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,多中心研究
doi：10.23736/S0375-9393.18.12257-7
更新日期：2019-01-01 00:00:00
abstract：:Paracetamol is widely used in the management of acute and chronic pain. The purpose of this review is to give anesthesiologists answers to some of the most common questions about paracetamol, specifically the following questions. What is the mechanism of action of paracetamol? Is paracetamol a NSAID? Which endogenous ...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,评审
doi：
更新日期：2009-11-01 00:00:00
abstract：:The swine-origin influenza A (H1N1) virus was responsible for the pandemic infection in 2009. We report a case of encephalitis diagnosed as the H1N1 virus infection in a young child. The H1N1 virus infection can be causative of the encephalitis, as with other influenza virus infections. For patients presenting with in...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：2010-06-01 00:00:00
abstract：:A case of high spinal anesthesia complicating an interscalene brachial plexus block is described. After an apparently straightforward location of the plexus with good paresthesias, the injection of 10 ml of local anesthetic caused a high spinal block whose main feature was apnea. The patient retained his consciousness...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：1980-03-01 00:00:00
abstract：BACKGROUND:The aim of this paper was to determine if there were any significant differences between the effects of fentanyl delivered as a bolus or remifentanil delivered as a continuous infusion on the QT interval and QT dispersion (QTD) during the induction of anesthesia and tracheal intubation. METHODS:This was a p...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,随机对照试验
doi：
更新日期：2011-02-01 00:00:00
abstract：:Intravenous administration of 400-600 mg/day potassium canrenoate normalised plasma osmolarity and permitted rapid re-establishment of the metabolic picture in 9/12 patients with hyperosmolarity admitted to a resuscitation department for complex physiopathological pictures. The soundness of the drug in this sense is a...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：1979-09-01 00:00:00
abstract：:Bowel dysfunction, especially ileus, has been increasingly recognized in critically ill patients. Ileus is commonly associated to constipation, however abnormal motility can also concern the upper digestive tract, therefore impaired gastrointestinal transit (IGT) seems to be a more appropriate term. IGT, especially co...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：10.23736/S0375-9393.20.14778-3
更新日期：2020-09-01 00:00:00
abstract：BACKGROUND:Evidences supporting the use of ICP monitoring after aneurysmal subarachnoid hemorrhage (aSAH) are limited. The aim of our paper is to examine whether elevated intracranial pressure (ICP) and ICP-derived variables predict mortality and functional outcomes after aSAH. METHODS:A systematic review of the liter...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：2016-04-05 00:00:00
abstract：BACKGROUND:Sudden cardiac arrest is one of the leading causes of death in Europe and the whole world. Effective chest compressions and advanced airway management have been shown to improve survival rates. Supraglottic airway devices such as the laryngeal tube (LT) are a well-known strategy for patients with cardiac arr...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：10.23736/S0375-9393.20.14446-8
更新日期：2020-12-10 00:00:00
abstract：:Upper airway obstruction (UAO) can cause severe respiratory distress in young children by increasing inspiratory muscle load and decreasing alveolar ventilation, ultimately resulting in hypercapnia and hypoxemia which have long term negative cardiovascular effects. Although non-invasive continuous positive airway pres...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：2015-02-01 00:00:00
abstract：:More and more evidence accumulates suggesting that the reversal of the catabolic responses to surgery is associated with better outcome. The potential for anesthesiologists to be involved in altering outcome by simply preserving a normal blood glucose, providing optimal pain control and perioperative feeding is tremen...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,评审
doi：
更新日期：2006-06-01 00:00:00
