Abstract:
BACKGROUND:Devices that limit microaspiration through the cuffs of endotracheal tubes could help prevent ventilator-associated pneumonia (VAP). The amount of tracheal microaspirations could be a relevant study endpoint. The aim of our study was to assess whether amylase measured in tracheal secretions constituted a relevant marker for microaspiration. METHODS:Twenty-six patients, intubated for at least 48 h and supplied with a subglottic secretion-suctioning device, constituted a group with a high risk of microaspiration. Twelve non-ventilated patients that required a bronchoscopy procedure constituted a group with a low risk of microaspiration (the control group). Tracheal (T) amylase was compared between the groups. In the intubated group, a series of oral (O), subglottic (Sg) and tracheal (T) suction samples were collected and T/O, T/Sg, Sg/O amylase ratios were determined. RESULTS:Amylase was measured in 277 (89 Sg, 96 B, 92 T) samples from the intubated group and in 12 T samples from the control group. Tracheal amylase was lower in the control group than the intubated group (191 [10-917] vs. 6661 [2774-19,358] IU/L, P<0.001). Amylase gradually increased from tracheal (6661 [2774-19,358] IU/L), to subglottic (130,750 [55,257-157,717] IU/L), to oral samples (307,606 [200,725-461,300] IU/L), resulting in a median 5.5% T/O ratio. In a subset of intubated patients, T amylase samples were assessed in two different laboratories, and gave reproducible results. CONCLUSION:Tracheal amylase was easy to collect, transport, and measure. The T/O amylase ratio is a first step towards quantifying oropharyngeal to tracheal microaspiration in mechanically-ventilated patients.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Filloux B,Bedel A,Nseir S,Mathiaux J,Amadéo B,Clouzeau B,Pillot J,Saghi T,Vargas F,Hilbert G,Gruson D,Boyer Asubject
Has Abstractpub_date
2013-09-01 00:00:00pages
1003-10issue
9eissn
0375-9393issn
1827-1596pii
R02138516journal_volume
79pub_type
杂志文章abstract:AIM:The aim of this paper is to describe the anesthesiological management and the outcome of beating heart revascularization. METHODS:A prospective study has been performed in a tertiary teaching hospital on 100 consecutive patients undergoing off-pump coronary artery revascularization. The main features of anesthetic...
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
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
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更新日期:2009-11-01 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
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abstract::Drugs used in anesthesia do not always produce the expected neurophysiological results. By studying those cases in which the reappearance of intraoperative awareness is most common, an attempt was made to estimate how many and which levels of cerebral function could be identified. Four levels were recognised: awarenes...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
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更新日期:1990-05-01 00:00:00
abstract::An account is given of the employment of althesin as an induction and maintenance anaesthetic. It is free of the drawbacks observed with thiopentone induction, and has negligible haemodynamic and respiratory effects. Its association with leptophen permitted excellent analgesia at minimal leptophen doses, without secon...
journal_title:Minerva anestesiologica
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journal_title:Minerva anestesiologica
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journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
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更新日期:2009-05-01 00:00:00
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pub_type: 评论,信件
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journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2002-12-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1998-07-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.23736/S0375-9393.18.12188-2
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journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2007-06-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2012-05-01 00:00:00
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pub_type: 杂志文章
doi:
更新日期:2007-05-01 00:00:00
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pub_type: 临床试验,杂志文章
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doi:
更新日期:2015-10-01 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:
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journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1998-11-01 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:1996-12-01 00:00:00
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pub_type: 杂志文章,评审
doi:
更新日期:2010-10-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2006-03-01 00:00:00
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pub_type: 杂志文章
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更新日期:2015-01-01 00:00:00
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pub_type: 杂志文章,多中心研究
doi:
更新日期:2013-12-01 00:00:00
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pub_type: 杂志文章
doi:
更新日期:2002-04-01 00:00:00
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pub_type: 杂志文章
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