Abstract:
:This article describes the clinical history of a patient admitted to the Emergency Room after severe infrascapular pain unaffected by breathing or postural changes. After thoracic CT a type B aortic dissection was diagnosed. On admission to the CCU, the patient's blood pressure was still high (210/120 mmHg). Sodium nitroprusside (1 microg/kg/min drip) was initiated. As blood pressure remained high after 24 h, the infusion rate was increased gradually up to 18 microg/kg/min. In the evening of the following day the patient was transferred to the operating room because acute renal failure (BUN 108 mg/dL, Cr 4.00 mg/dL) occurred and arterial pressure was still high (180/60 mmHg). A thoracic endoprosthesis was then inserted. During this procedure the patient was relaxed and his blood pressure was satisfactory (140/80 mmHg) without drugs. In order to further lower blood pressure and afterload before positioning the second prosthetic segment within the aortic arch, 1 microg/kg/min nitroprusside drip was continued. A few minutes initiation of the drip an abrupt rise in blood pressure (systolic 200 mmHg) was observed, which had to be controlled before continuing the procedure. Increased nitroprusside infusion and repeated boluses of 10 mg urapidil (3-4 boluses with an interval of 15 min) and 30 microg clonidine were unsuccessful. After 15 min with an increased nitroprusside infusion rate, the patient showed psychomotor agitation and O2 his saturation dropped to 91% while arterial pH was 7.2 and lactate concentration was 3.5 mmol/L. Nitroprusside infusion was discontinued, while 0.1 microg/kg/min fenoldopam (started when the patient arrived in the operating room) was continued without improvement. In order to complete the procedure, general anaesthesia with sevflurane (2 MAC) in air (FiO2= 40%) was induced. After successful reduction in blood pressure the procedure was completed. In the postoperative course the patient was admitted to the ICU.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Nicoletta G,Cascelli M,Marchesini L,Tesoro Ssubject
Has Abstractpub_date
2007-09-01 00:00:00pages
471-3issue
9eissn
0375-9393issn
1827-1596journal_volume
73pub_type
杂志文章abstract:BACKGROUND:In this study, the level and the variation of a number of hormone and metabolic parameters during brain death treatment in potential organ donors have been monitored. METHODS:Thirty-nine consecutive brain-dead patients were enrolled in 3 Intensive Care Units of Regional Hospitals of the North of Italy. All ...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1999-10-01 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
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
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更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:Aim of the study was to validate commonly used bedside right-ventricular (RV) impedance parameters, which are utilized in determining heart-lung interactions during mechanical ventilation. METHODS:Fifteen pigs were equally assigned to either an open or a closed pericardium group. In all animals, an inflatab...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
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abstract:BACKGROUND:Trapeziectomy is one of the most painful procedures in ambulatory surgery. This prospective randomized trial aimed to compare postoperative pain control using distal peripheral nerve blocks (dPNB) with a low concentration of a long-acting local anesthetic versus conventional systemic analgesia. METHODS:Fift...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
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更新日期:2018-11-01 00:00:00
abstract::Fifty patients undergoing cardiac surgery suffering from coronary artery disease and valvular incompetence or stenosis, were randomly divided into two groups of 25 patients to compare the plasmapheresis effects on bleeding, transfusion requirements, economicity and paramedical staff compliance versus intraoperative au...
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:1995-07-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
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更新日期:1990-04-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2004-05-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2012-10-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1998-04-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2004-12-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.18.12720-9
更新日期:2018-10-01 00:00:00
abstract:: ...
journal_title:Minerva anestesiologica
pub_type: 评论,信件
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更新日期:2019-10-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2011-03-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2003-04-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:2006-10-01 00:00:00
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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:1999-11-01 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
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journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
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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:1992-03-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
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更新日期:2013-09-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
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更新日期:1999-03-01 00:00:00
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journal_title:Minerva anestesiologica
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journal_title:Minerva anestesiologica
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2014-04-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
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journal_title:Minerva anestesiologica
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journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:
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