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 pathogens) have been largely mitigated through advancements in blood banking whereas some others (e.g. immunomodulation and transfusion-related acute lung injury) appear to have more subtle etiologies and are more difficult to tackle. Furthermore, blood transfusions are costly and the supply of blood is limited. Finally, evidence indicates that a great number of the critically ill patients who are being transfused today may not be having tangible benefits from the transfusion. Patient blood management is an evidence-based, multidisciplinary, multimodal, and patient-tailored approach aimed at reducing or eliminating the need for allogeneic transfusion by managing anaemia, perioperative blood conservation, surgical haemostasis, and blood as well as plasma-derivative drug use. From this point of view, the reduction of allogeneic blood usage is not an end in itself but a tool to achieve better patient clinical outcome. This article focuses on the three-pillar matrix of patient blood management where the understanding of basic physiology and pathophysiology is at the core of evidence-based approaches to optimizing erythropoiesis, minimising bleeding and tolerating anemia. Anesthesiologists and critical care physicians clearly have a key role in patient blood management programmes are and should incorporate its principles into clinical practice-based initiatives that improve patient safety and clinical outcomes.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Liumbruno GM,Vaglio S,Grazzini G,Spahn DR,Biancofiore Gsubject
Has Abstractpub_date
2015-10-01 00:00:00pages
1127-37issue
10eissn
0375-9393issn
1827-1596pii
R02Y9999N00A140952journal_volume
81pub_type
杂志文章,评审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::The improvement in the success of solid organ transplantation over the past decades is remarkable and well documented. It is now a well-accepted treatment modality for patients with end-stage organ disease. Within the field of transplantation, abdominal organ transplantation is significantly more common than thoracic ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2010-04-01 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::In 61 patients submitted to subdural anesthesia for orthopedic operations, postoperative somatic pain was treated by double-blind iv injection of lysine acetylsalicylate 1.8 g or placebo randomly. Patients with persistent pain received methadone 10 mg im. No placebo response was obtained; LAS had similar but shorter e...
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:1981-05-01 00:00:00
abstract:BACKGROUND:There is an equipoise regarding closed-loop ventilation modes and the ability to reduce workload for providers. On one hand some settings are managed by the ventilator but on another hand the automatic mode introduces new settings for the user. METHODS:This randomized controlled trial compared the number of...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:10.23736/S0375-9393.17.11963-2
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:The coronary sinus oxygen saturation (SO2) can affect the oxygen saturation of the superior vena cava (superior cava SO2) and the pulmonary artery (pulmonary artery SO2), causing a gradient between the latter two (ΔSO2), as has been observed in different physiological and pathological conditions. The objecti...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2011-06-01 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
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract::Twenty eight elderly patients scheduled for urologic surgery were randomly assigned to receive in a double blind fashion subarachnoid hyperbaric bupivacaine 15 mg with the addition of 50 micrograms (group A, n = 7), 25 micrograms (group B, n = 7), 12.5 micrograms (group C, n = 7), of fentanyl or 1 ml of saline (group ...
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:1991-04-01 00:00:00
abstract:INTRODUCTION:The study aimed to compare Bispectral Index (BIS) and non-BIS anesthetic protocols on postoperative recovery outcomes. EVIDENCE ACQUISITION:Medline, PubMed, Cochrane, EMBASE, and Google Scholar databases were searched until January 21, 2016. EVIDENCE SYNTHESIS:Twenty-six studies were included with a tota...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:10.23736/S0375-9393.17.12033-X
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:The aim of the study was to investigate whether or not sevoflurane at different concentrations influenced the ED(effective dose) 50, 90 and 95 of cisatracurium and whether there is any relationship with age. METHODS:Individual dose response curves for cisatracurium were constructed in 80 consecutive patient...
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:2000-03-01 00:00:00
abstract:BACKGROUND:Sepsis is an important cause of mortality and morbidity in the intensive care unit (ICU). We performed a study to describe the epidemiology of sepsis syndromes in patients admitted to ICUs of the Piedmont region. METHODS:In this prospective, multicentre, observational study, all 3902 patients admitted to a ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,多中心研究
doi:
更新日期:2013-09-01 00:00:00
abstract:: ...
journal_title:Minerva anestesiologica
pub_type: 评论,信件
doi:10.23736/S0375-9393.19.13586-9
更新日期:2019-06-01 00:00:00
abstract::Postoperative pain management an important clinical issue. The clinicians tool-bag remains incomplete. Improvements in the management of postoperative pain will ultimately translate into the broader, safer application of surgical procedures upon a wider patient population. The application of multimodal therapy that in...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2006-03-01 00:00:00
abstract::A qualified nursing care is mandatory in patients after SAH. Clinical and instrumental monitoring are basilar to assure the rapid control of dangerous ICP or CPP changes and of epileptic crisis. Prophylaxis of infections is greatly minimized when coherent treatments are applied to any invasive devices, patient body, p...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:1998-05-01 00:00:00
abstract:INTRODUCTION:Ultrasound is a portable and safe technology that is increasingly used to assist anesthetic procedures and has been integrated into the routine practice of a wide range of invasive procedures. As a complementary diagnostic tool, publications related to perioperative support other than vascular access and n...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.17.12178-4
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:A wide variability in the approach towards delirium prevention and treatment in the critically ill results from the dearth of prospective randomised studies. METHODS:We launched a two-stage prospective observational study to assess delirium epidemiology, risk factors and impact on patient outcome, by enroll...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:2012-09-01 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::The authors illustrate some relevant emerging topics in pediatric anesthesia. Endotracheal cuffed tubes have entered into routine clinical practice in younger patients. Concerns about tracheal stenosis were overcome when manufactures began to produce a new class of high volume, low pressure endotracheal tubes. Ultraso...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Disorders in cerebral circulation following elevated intra-abdominal pressure (IAP) may lead to silent brain ischemia, which can be serious problem in sedated critically ill patients. The aim of the present study was to analyse the possible association between jugular venous bulb pressure (JVBP) and jugular ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2014-07-01 00:00:00
abstract::Transthoracic thermodilution (TTT) measures cardiac output without the need for right heart catheterization. In addition, two volumetric hemodynamic indices have been derived from the mathematical analysis of the TTT curve: the global end diastolic volume (a quantitative measure of cardiac preload) and the extravascul...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2010-11-01 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::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::The Authors have controlled the validity of VQI to quantify pulmonary shunt (Qs/Qt). The survey involved (group A) patients who had undergone major surgery and (group B) patients hospitalized in ICU for cardiorespiratory failure. Four subgroups were identified in both the groups according to different values of SaO2. ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract::In 8 patients who underwent abdominal surgery for non-neoplastic reasons, we have evaluated some parameters of renal function (PRP, NaU, GFR and diuresis) plasma levels of PRA and ADH and urinary prostaglandins PGE2 and 6-keto-PGF1 alpha. In 4 patients we found that surgery per se was associated with enhancements of P...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1990-04-01 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:OBJECTIVE:To evaluate efficacy and tolerability of enoximone, a phosphodiesterase inhibitor, in the treatment of cardiogenic shock. DESIGN:A prospective non randomized, non comparative study. SETTING:A general intensive care unit of a university hospital. PATIENTS:Six patients with cardiogenic shock (cardiac index <...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract::We studied haemostatic parameter and Antithrombin III (ATIII) level in 50 consecutive admissions for severe burns between 1990 to1994 to the Centro Grandi Ustionati Ospedale S. Eugenio, Rome. The criteria for inclusion in the study were age <16 years and the presence of major burns (extent of the burns >30 and second ...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:Studies on pregnant women undergoing cesarean delivery or elderly men scheduled for prostate brachytherapy have demonstrated the predictive value of heart rate variability (HRV) analysis for hypotension during spinal anesthesia. We conducted a prospective observational study to investigate if preoperative HR...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2015-07-01 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::The importance of Ketamine in continuous perfusion is described on the basis of a studied carried out in 30 patients. The clinical data are compared with results predicted by the mathematical model. Special study was made of the behaviour of the cardiocirculatory apparatus, particularly in reference to myocardial cont...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1980-08-01 00:00:00