Abstract:
:A randomized, multicenter trial conducted in 32 northern European general intensive care units (ICUs) enrolled some patients with septic shock randomly assigned to receive a red blood cell transfusion when the hemoglobin (Hb) level was ≤7 g/dL ("lower threshold"; N.=502) or ≤9 g/dL ("higher threshold"; N.=496) throughout the ICU stay. Patients were excluded if they had an acute coronary syndrome, life-threatening bleeding, acute burn injury, had already been transfused or had previously experienced transfusion-related reactions. The two groups of patients had comparable severity of disease scores and chronic cardiovascular conditions. Median Hb values were 7.7 g/dL in the lower and 9.3 g/dL in the higher threshold groups and these values remained stable during the study period. There was no significant difference in 90-day mortality (primary end-point) between the two groups (216/502, 43.0% in the lower vs. 223/496, 45.0% in the higher group, RR 0.94 [95% CI: 0.78-1.09; P=0.44]), even after adjustment for several confounders. In the higher threshold group, approximately twice as many transfusions were given (3088 vs. 1545 units transfused, P<0.001) as in the lower threshold group. In the lower threshold group, more patients received no RBC transfusion (36% vs. 1.2%, P<0.001) than in the higher threshold group, but there were also more temporary protocol suspensions (5.9 % vs. 2.2%, P=0.004), in particular because of myocardial ischemia (6/488, 1.2% vs. 0/489), life-threatening bleeding (18/488, 3.7% vs. 9/489, 1.8%) and need for higher Hb levels during extracorporeal membrane oxygenation therapy. We discuss how anemia should be managed in patients with sepsis or other critical illness, especially in the context of the potential risks associated with RBC transfusion and data from other recent large randomized trials.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Lelubre C,Vincent JL,Taccone FSsubject
Has Abstractpub_date
2016-09-01 00:00:00pages
1010-6issue
9eissn
0375-9393issn
1827-1596pii
R02Y9999N00A160009journal_volume
82pub_type
杂志文章,评审abstract:BACKGROUND:The "bone cement implantation syndrome" is a rare but severe complication observed especially during the insertion of cemented prostheses in hip and knee replacement surgery. Several mechanisms are involved: effects of methylmethacrilate, embolism of fat, air and bone marrow, and release of tissue thrombopla...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:2002-06-01 00:00:00
abstract:: ...
journal_title:Minerva anestesiologica
pub_type: 评论,信件
doi:10.23736/S0375-9393.19.13630-9
更新日期:2019-07-01 00:00:00
abstract::The authors briefly discuss the advantages and limits of sedation in critically ill patients. They also focus the importance of an individualized sedative approach which provides pain relief and modulates stress response, allowing patients to be easily arousable and cooperative as necessary. ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2002-04-01 00:00:00
abstract::About 80% of nosocomial infections are caused by aerobic bacteria. The Pseudomonas aeruginosa is a Gram-negative bacterium pertaining to the Pseudomonadaceae family. P. aeruginosa is responsible for 6-22% of all hospital infections. The aim of this paper is to evaluate the efficacy of both hyperbaric oxygen-therapy (H...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1996-09-01 00:00:00
abstract::Ziconotide is a synthetic peptide equivalent of an w-conotoxin, obtained from the marine snail Conus magus, which acts by blocking N-type calcium channels in the spinal cord, reducing the perception of pain. It is a newly marketed drug, exclusively for intrathecal use, indicated for severe chronic pain. Ziconotide cam...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2008-12-01 00:00:00
abstract:OBJECTIVE:Weaning from mechanical ventilation is often possible in the most of patients, even if sometimes it is very difficult. For example, 25-53% of COPD patients cannot be weaned. The different modalities used do not justify this. The aim of the study was the evaluation of a further weaning trial in tracheotomized ...
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
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::Accidents during anaesthesia may be clinical or technical. To avoid the latter, stress is laid on the by no means new concept that techniques and handling must fit contingent requirements and that they may be dangerous as much for their inadequate as for their excessive use. ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1980-01-01 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::Anaesthetic management in asthmatic patients has been focused on avoiding bronchoconstriction and inducing bronchodilation. However, the definition of asthma has changed over the past decade. Asthma has been defined as a clinical syndrome characterized by an inflammatory process that extends beyond the central airways...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:The aim of this prospective, randomized, double-blind study was to evaluate the effects of adding 1 microg/kg clonidine to 20 ml of ropivacaine 0.75% for axillary brachial plexus anesthesia. METHODS:With Ethical Committee approval and written consent, 30 ASA physical status I-II in-patients, undergoing uppe...
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:2001-05-01 00:00:00
abstract::The introduction of use of propofol in the anesthetists' pharmacopoeia has reinvigorated the research for a totally intravenous anaesthesia, for which the Authors propose a diagram. However, in experience related to the supplementary use of N2O, in virtue of its analgesic power, demonstrates yet another utility, permi...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1992-04-01 00:00:00
abstract::Thoracic trauma frequently involve damage to the cardiac structures and in the worst cases, the progressive degeneration and necrosis of the damaged tissue lead to cardiac rupture. The high mortality resulting from cardiac tamponade requires the prompt execution of diagnostic tests to provide as much useful informatio...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2000-06-01 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: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 rel...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:To describe the use of an automatic fluid control system, Equaline, during high flux continuous hemofiltration. DESIGN:Prospective descriptive study. SETTING:General intensive care unit in a general hospital. PATIENTS:15 consecutive patients suffering from septic shock, hypercatabolic with acute renal fail...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1994-01-01 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::Diabetes mellitus is a common endocrinopathy. Diabetic patients undergoing surgery have to be carefully evaluated in order to lower the risk of perioperative complications. The author reviews the possible pathological involvement of target organs, focusing on cardiovascular pathology, neuropathy, nephropathy, respirat...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2001-04-01 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
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::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 extracorporea...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2012-03-01 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::Chronic musculoskeletal pain is a highly prevalent condition that is commonly encountered in both general and specialist practice. Nonetheless, it still represents a significant challenge to the practitioners because of the lack of substantial evidence-based guidance. This review aimed to summarize the main pathophysi...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.20.14573-5
更新日期:2020-12-01 00:00:00
abstract::Nosocomial bloodstream infections (BSIs) have become an important cause of morbidity and mortality, particularly in intensive care units (ICUs). Gram-positive organisms are the prevalent causes of antibiotic-resistant BSI, especially Staphylococcus aureus, coagulase-negative staphylococci and enterococci. In recent ye...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2011-08-01 00:00:00
abstract::Vecuronium bromide was employed in 26 pediatric patients; 18 received vecuronium infusion and 11 intermittent bolus administration. The aim of the study was to evaluate the pharmacodynamics of the drug, the lack of cumulative properties, the best infusion rate, the possible advantage of the infusion technique. Neuromu...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1992-03-01 00:00:00
abstract:AIM:The aim of this study was to evaluate and compare the parameters for mechanical respiration in pediatric patients undergoing controlled ventilation with a laryngeal mask (LM) and an uncuffed orotracheal tube. METHODS:The study examined 100 ASA 1 patients undergoing general anesthesia with myoresolution and mechani...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Local anesthetics (LA) work by blocking sodium conductance through voltage-gated sodium channels. Complete local anesthetic resistance is infrequent, and the cause is unknown. Genetic variation in sodium channels is a potential mechanism for local anesthetic resistance. A patient with a history of inadequate...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Goal-directed fluid management using stroke volume variation (SVV) analysis is not well studied in free flap reconstruction surgery in patients with head and neck cancer. METHODS:Patients operated due to cancer of the head and neck with free flap reconstruction during 2008-2010 and 2012-2014 in Oulu Univers...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.16.11451-8
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:It is common practice to administer a premedication to patients about to undergo anesthesia. This study compared the effects of a small intravenous bolus of propofol versus midazolam administered as a premedication. METHODS:In this prospective, randomized, double-blind, placebo-controlled study, 60 healthy ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2008-05-01 00:00:00
abstract::Developing a computer program to simulate the uptake, distribution, and elimination of inhalational anesthetics allow the anesthesiologist to address specific problems, but intense skills are required to translate the involved process first into a set of mathematical equations and then into a satisfactory computer pro...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00