Abstract:
BACKGROUND:The ideal tidal volume (TV) during one-lung ventilation (OLV) remains controversial. High TVs may increase the incidence of postoperative lung injury after thoracic surgery. There is nonetheless little evidence that the use of low TV during OLV will fail to provide adequate arterial oxygenation. We evaluated the influence of low (5 mL/kg-1) and high (10 mL/kg-1) TV on arterial oxygenation during one-lung ventilation in clinical conditions. METHODS:A hundred patients scheduled for lung surgery were studied. Patients were randomly assigned to either 30 minutes of one-lung ventilation with a TV of 10 mL/kg-1 at a rate of 10 breaths/minute (Group 10, N.=50) or a TV of 5 mL/kg-1 with 5 cmH2O PEEP at a rate of 20 breaths/minute (Group 5, N.=50). According to the rules of crossover design during the subsequent 30 minutes, each patient received the alternative management. Arterial blood partial pressures, hemodynamic responses, and ventilatory parameters were recorded. Results are presented as means ± SDs; P<0.05 was considered statistically significant. RESULTS:PaO2 was unaffected by TV (10 mL/kg-1: 218±106 versus 5 mL/kg-1: 211±119 mmHg, P=0.29). Calculated intrapulmonary shunt fraction was also similar with each TV during OLV (5 mL/kg-1: 25±9% versus 10 mL/kg-1: 24±8%, p=0.14). In contrast, low TV significantly increased PaCO2 (10 mL/kg-1: 39±6 versus 5 mL/kg-1: 44±8 mmHg, P<0.001). There were significant differences both in peak (10 mL/kg-1: 27±6 versus 5 mL/kg-1: 21±5 cmH2O, P<0.001) and plateau airway pressure values (10 mL/kg-1: 22±6 versus 5 mL/kg-1: 18±5 cmH2O, P<0.001) during OLV. CONCLUSION:Low TV (5 mL/kg-1) accompanied by 5 cmH2O PEEP provides comparable arterial oxygenation and intrapulmonary shunt fraction during one-lung ventilation as higher TV (10 mL/kg-1) without PEEP.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Végh T,Juhász M,Szatmári S,Enyedi A,Sessler DI,Szegedi LL,Fülesdi Bsubject
Has Abstractpub_date
2013-01-01 00:00:00pages
24-32issue
1eissn
0375-9393issn
1827-1596pii
R02127870journal_volume
79pub_type
杂志文章,随机对照试验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:Although esophageal pressure measurement could help clinicians to improve the ventilatory management of acute respiratory distress syndrome (ARDS) patients, it has been mainly used in clinical research. Aim of this study was to compare the measurements of end-expiratory esophageal pressure, end-expiratory tr...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.20.14458-4
更新日期:2020-10-01 00:00:00
abstract::Despite consistent improvement in its treatment, amatoxin poisoning still extolls an elevated overall mortality, ranging between 10 and 15%, which approaches 100% when severe (grade 3-4 encephalopathy) hepatic failure supervened. Therefore, the proper treatment of intoxication by amatoxin containing mushrooms, and par...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1991-06-01 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::Intraoperative hemodynamic and respiratory data from one-year experience of orthotopic liver transplantation with veno-venous bypass (10 cases) were collected. Seven different phases of OLT was submitted to one way analysis of variance. Variability is due to degree and duration of liver disease. Basal conditions inclu...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1990-04-01 00:00:00
abstract::Cardiac surgery patients often develop a restrictive pulmonary impairment and gas exchange abnormalities in the early postoperative period. Chest physiotherapy is routinely prescribed in order to reduce or prevent these complications. Besides early mobilization, positioning and shoulder girdle exercises, various breat...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Patient safety is a top priority in healthcare. Little is known about the visual behavior of professionals during high-risk procedures. The aim of this study was to assess feasibility, usability and safety of eye-tracking to analyze gaze patterns during the extubation process in the intensive care unit. MET...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.20.14468-7
更新日期:2020-11-01 00:00:00
abstract::Nutrition in critically ill patients should be considered as therapy: assessing the energy expenditure and the termogenic effect of food, and knowing the differences among composition and amount of given substrates, it is possible restore, maintain, or at least limit the derangement of energy equilibrium. Energy metab...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2006-06-01 00:00:00
abstract::A brief account of the physiopathology and clinical treatment of antigen-antibody reactions is followed by the description of a personal technique used for over 20 years in the detection of drug allergy. The method consists of a skin test followed by administration of increasing doses of the drug under examination. At...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1980-01-01 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::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::Noninvasive positive pressure ventilation (NPPV) via nasal mask is well known to be effective in the treatment of acute respiratory failure (ARF) secondary to chronic obstructive pulmonary disease (COPD). A case of ARF with hypercapnic coma due to exacerbation of COPD is described. Six hours of conservative therapy wi...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1997-07-01 00:00:00
abstract:BACKGROUND:To test validity, safety, costs and healing-outcome of surgical minitracheotomy after cannula removing. METHODS: DESIGN:Opened, perspective. Site: Polyvalent ICU. PATIENTS:40 patients underwent surgical minitracheotomy, in a year. Traditional surgical technique was adopted. Minitracheotomy was performed b...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:2000-04-01 00:00:00
abstract::Cardiac arrest carries a very poor prognosis. More than 70% of cardiac arrests are caused by acute myocardial infarction (AMI) or massive pulmonary embolism (PE). Thrombolysis during CPR has two major effects: first, it causally treats the condition that caused cardiac arrest and second, it has been shown to have bene...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2005-06-01 00:00:00
abstract::The nonsteroidal anti-inflammatory drugs (NSAIDs) cover a wide range of selectivity, from the nonselective cyclooxygenase (COX) inhibitors to the preferential COX-2, and the newest coxibs, selective COX-2, with 1000-fold selectivities for COX-2. Coxibs belong to the distinct classes of sulphonamides, methylsulphones, ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2005-07-01 00:00:00
abstract:UNLABELLED:In last the 50 years many studies have described the causes of mortality. In newborns and infants between 5 and 6 months the risk is higher. The heart is not developed as in older/grown child and these infants need more oxygen than the older ones. Probably, the interaction or interference of positive pressur...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2004-05-01 00:00:00
abstract::Acute respiratory failure (ARF) in cancer patients remains a frequent and severe complication, despite the general improved outcome over the last decade. The survival of cancer patients requiring ventilatory support in Intensive Care Unit (ICU) has dramatically improved over the last years. The diagnostic approach, in...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2014-06-01 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::Primary Acute Lung Injury (ALI) after lung resection (or "post-pneumonectomy pulmonary edema") is a rare form of acute respiratory failure characterized by dyspnea, hypoxemia, diffuse infiltrates on chest radiogram, and rapid evolution often unresponsive to therapy. ALI occurs almost exclusively following pneumonectom...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2004-04-01 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: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:BACKGROUND:Multiple organ dysfunction can occur in patients undergoing Veno-arterial Extra Corporal Membrane Oxygenation (VA-ECMO); however, liver function has not been well studied in this setting. METHODS:In a review of our institutional ECMO database (n=162), we collected aspartate (AST) and alanine (ALT) transamin...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.16.11442-7
更新日期:2017-03-01 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:INTRODUCTION:Extubation failure (EF) refers to the inability to maintain spontaneous breathing after removal of endotracheal tube. The aim of this review is to identify the best parameter to predict EF in adult intensive care patients. EVIDENCE ACQUISITION:We searched for publications in PubMed (2000-2016). Studies of...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.18.12627-7
更新日期:2019-03-01 00:00:00
abstract::Peer review is the process by which manuscripts submitted to medical journals are evaluated for scientific soundness and priority, and potentially improved in terms of clarity. Constructive interaction between editors, reviewers, and authors is critical for the effectiveness of the entire process. Although empirical e...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2009-10-01 00:00:00
abstract::Early strategies to diagnose, manage and predict outcome of sepsis are essential to further improve morbidity and mortality of sepsis. Whereas biomarkers have become mainstay in other fields of medicine, their clinical utility in sepsis remains generally much less proven and so biomarkers are much less used clinically...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Although blood gas analysis (BGA) is important for supplemental oxygen titration, it is invasive, intermittent, costly, and burdensome for staff. We assessed whether the Oxygen Reserve Index (ORi™), a novel pulse oximeter-based index that reflects the partial pressure of oxygen (PaO2), could determine the am...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.20.14895-8
更新日期:2020-12-15 00:00:00
abstract::The authors report the case of a patient suffering from central sleep apnea (CSA) who underwent neurosurgery for ventriculo-peritoneal derivation under general anesthesia. Given the risk of postoperative hypoventilation in CSA, intraoperative anesthesia was induced using remifentanyl, an opiate with a plasma half-life...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1999-09-01 00:00:00
abstract::Spinal and peridural anaesthesia has several advantages over general anaesthesia due to their low influence to endocrine and metabolic activity and their capacity to reduce postoperative surgical complications, intraoperative bleeding and deep venous thromboembolism incidence. Nevertheless, these anaesthesiologic tech...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2003-10-01 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