Abstract:
:Pulmonary tuberculosis can lead to acute respiratory distress syndrome (ARDS) which is associated with high mortality. We report the case of a patient with pulmonary tuberculosis and severe ARDS (PaO2/FiO2<100 mmHg) who was initially managed with advanced up-to-date treatments (protective ventilation and extracorporeal membrane oxygenation, ECMO) but failed to improve. After a month of failure and the development of bilateral pneumothoraces, we drastically changed our therapeutic strategy: we maximized ECMO support to maintain oxygenation, we greatly reduced ventilation pressures and we left the pneumothoraces undrained. From then on, the patient improved and he eventually survived. This case suggests that ECMO permits large reductions in lung inflation and ventilation to rest the lungs, while maintaining acceptable oxygenation. The combination of ECMO and markedly attenuated ventilation strategy may be effective in cases of severe ARDS.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Mauri T,Foti G,Zanella A,Bombino M,Confalonieri A,Patroniti N,Bellani G,Pesenti Asubject
Has Abstractpub_date
2012-03-01 00:00:00pages
385-9issue
3eissn
0375-9393issn
1827-1596pii
R02116964journal_volume
78pub_type
杂志文章abstract:BACKGROUND:Presurgical cognitive impairment (PreCI) is frequently seen in older age, but the influence on postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) remains unclear. The present study sought to determine the association between PreCI, POD and POCD with special focus to different PreCI d...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.20.13903-8
更新日期:2020-04-01 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
doi:
更新日期:2014-11-01 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::Non invasive ventilation (NIV) has been shown to be an effective therapy in selected patients with acute respiratory failure. Due to its benefit and relative ease of use, NIV is frequently used. In addition, the shortage and high cost of intensive care beds have prompted the use of NIV outside the intensive care unit....
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2009-07-01 00:00:00
abstract::In extreme emergency situations, patients may need to undergo endotracheal intubation, while in a non-supine position. This manuscript offers several options to the anesthesiologist to cope with tracheal intubations in non-standard positions. The authors stress that there is a need for adequate training in an anaesthe...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2013-06-01 00:00:00
abstract::Regional nerve injury is a recognized complication of plexus anesthesia. Nerve damage after regional anesthesia is the most frightening complication for the patient, the anesthetist and the surgeon too. In order to limit possible medico-legal issues, the anesthetist has to follow an algorithm. The indication and infor...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2005-06-01 00:00:00
abstract::We herein evaluated the analgesic effectiveness of low doses of buprenorphine with or without a primer and the practicality and usefulness of a constant flow disposable infusion set (Infusor Baxter 2 ml/h). Our series consists of 300 patients, seen between January 1992 and December 1993, randomly distributed in three ...
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:1994-10-01 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::Data concerning antibiotic therapy in italian ICUs are presented. These data were not directly measured: they have been derived from a previous study on costs of intensive care treatments. 78% of 1065 patients received antibiotic therapy. Empirical therapy was started in 82% of septic patients. 93% of septic patients ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2001-04-01 00:00:00
abstract::Worldwide about 1 in 1000 adults every year has a sudden cardiac arrest in out-of-hospital. That means 350,000-400,000 persons in the USA alone, 60,000 persons in Italy. Over 70% of times sudden cardiac arrest occurs at home, the remaining 30% in public settings. The chain of survival concept emphasizes four links ass...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2000-07-01 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::Recently, efforts have been undertaken to investigate the effects of thrombolysis during cardiopulmonary resuscitation (CRP) in patients suffering from massive pulmonary embolism or acute myocardial infarction. In up to 70% of patients with cardiac arrest, one of these two diseases is the underlying cause of deteriora...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2002-04-01 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::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::Fifteen to 30% of patients develop acute renal failure (ARF) following rhabdomyolysis and rhabdomyolysis accounts for 5 to 9% of all ARF. Experimental studies revealed two critical factors that predispose to myoglobinuric ARF: hypovolemia/dehydration and aciduria. At the nephron level, three basic mechanisms underlie ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:1999-05-01 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::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
abstract:INTRODUCTION:This meta-analysis aims to determine whether continuous nerve block (CNB) provides better pain relief and functional recovery than single-shot nerve block (SSNB) after total knee arthroplasty (TKA). EVIDENCE ACQUISITION:Embase, PubMed, and the Cochrane Library databases were comprehensively searched. Rand...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,meta分析
doi:10.23736/S0375-9393.19.13842-4
更新日期:2020-02-01 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::Sepsis is a condition at high risk for the patients to develop organ(s) or system dysfunction/failure and represent a very limiting process for survival. Researchers and clinicians proposed standardization of terminology for sepsis and related problems to improve communication and to evaluate the efficacy of preventiv...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:1999-07-01 00:00:00
abstract:: ...
journal_title:Minerva anestesiologica
pub_type: 信件
doi:10.23736/S0375-9393.18.12938-5
更新日期:2018-12-01 00:00:00
abstract::Prehospital care is a fundamental element for the patient's outcome, in the field of medical and surgical emergencies. There are different strategies about it, defined "scoop and run" and "stay and play". The choice among the different strategies, in our opinion, must be well-suited to the underlying pathophysiology o...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2000-12-01 00:00:00
abstract::Acute respiratory distress syndrome (ARDS) commonly affects intensive care unit patients and is associated with high mortality. In addition to etiologic treatment and protective ventilation, non-ventilatory therapies represent a significant part of ARDS care. Pharmacological treatments, extra corporeal devices and pro...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:10.23736/S0375-9393.18.12328-5
更新日期:2018-09-01 00:00:00
abstract::Results obtained with Althesin as anaesthetic in 100 patient subjected to urological surgery are presented. The continuous perfusion of Althesin gave a level of stable and flexible anaesthesia that, like the return to consciousness, was particularly appreciated by aged patients. Stress is laid on the fact that the har...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract:OBJECTIVE:Inhaled NO can improve arterial oxygenation in ARDS. We evaluated the incidence and the magnitude of this effect during a short test of NO inhalation. This was performed in 24 consecutive mechanically ventilated patients with ARDS in order to assess the interest of NO for the therapy of hypoxemia in each case...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1995-04-01 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::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:The use of second generation supraglottic airway devices is recommended for airway rescue in failed tracheal intubation. This study was performed to compare the clinical performance of the i-gel™ with that of the AuraGain™ in patients with simulated cervical immobilization. METHODS:We conducted a prospectiv...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.20.14237-8
更新日期:2020-07-01 00:00:00
abstract::Invasive candidiasis (IC) includes candidemia, disseminated candidiasis with deep organ involvement, endocarditis and meningitis. IC has an attributable mortality of 40% to 50% and is increasingly reported in intensive care units (ICUs). Candida albicans and non-albicans strains are both responsible for infections in ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2009-07-01 00:00:00
abstract:AIM:High-flow-oxygen-therapy is provided by various techniques and patient interfaces, resulting in various inspired-fraction of oxygen (FiO2) and airway-pressure levels. However, tracheal measurements have never been performed. METHODS:Three oxygen-delivery-devices were evaluated: 1) standard-high-flow-oxygen-facemas...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:2013-12-01 00:00:00