Abstract：
BACKGROUND:Today, most of the pre-emptive hemodynamic optimization algorithms are based on variables associated with invasive techniques like arterial cannulation. The non-invasive Nexfin™ technology is able to estimate continuous Cardiac Index (CI) and pulse pressure variation (PPV). However, the efficiency of an early goal directed therapy (EGDT) algorithm based on non-invasive variables has to be proven. The aim of our study was to investigate the feasibility of a non-invasive driven EGDT protocol and its impact on patient's outcome. METHODS:Seventy-nine patients (ASA II-III) undergoing elective major abdominal surgery were randomized to either study group (SG, N.=39) or control group (CG, N.=40). The SG was treated according to an algorithm based on non-invasive CI and PPV, whereas the CG received standard of care. Postoperative complications up to 28 days and length of hospital stay (LOS) in both groups were recorded. RESULTS:There was no significant difference between the groups regarding demographics, hemodynamic variables, preoperative risk scores and duration of surgery. The total amount of complications was higher in the CG (SG 94 vs. CG 132 complications, P=0.22) without reaching statistical significance. LOS revealed no difference between both groups (SG, 9 [7-15] vs. CG, 9 [7-15.25] days, P=0.82). We have seen no impact of the non-invasive optimization protocol with respect to postoperative mortality. CONCLUSIONS:In this patient collective, we could demonstrate the feasibility of a non-invasive approach for hemodynamic optimization. However, EGDT based on non-invasive variables was not able to significantly improve outcome.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Broch O,Carstens A,Gruenewald M,Nischelsky E,Vellmer L,Bein B,Aselmann H,Steinfath M,Renner Jsubject
Has Abstractpub_date
2016-11-01 00:00:00pages
1158-1169issue
11eissn
0375-9393issn
1827-1596pii
R02Y9999N00A16062802journal_volume
82pub_type
杂志文章,随机对照试验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：:Brain injury occurs with a range of severity: even less severe cases should be carefully observed since they may deteriorate. By definition severe head injury has a Glasgow Coma Scale score of 8 or less; comatose patients are defined as cases who do not obey commands, do not open their eyes and do not speak. Very ofte...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,评审
doi：
更新日期：1999-06-01 00:00:00
abstract：:The Authors report on their experience about SvO2 continuous monitoring in order to find out the best therapeutic answer to inotropic drugs, knowing that, at constant values of SaO2 and Hb, possible variations of SvO2 reliably correspond with parallel variations of cardiac index (IC). Two groups of 15 patients each, s...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：1991-12-01 00:00:00
abstract：BACKGROUND:Few studies have investigated the incidence of pulmonary anaerobes in a specific population in surgical Intensive Care Unit (ICU). The objective of this work was to determine the incidence of anaerobes in surgical ICU patients with suspected pneumonia. METHODS:This was a prospective observational, single-ce...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：2014-10-01 00:00:00
abstract：BACKGROUND:A new pulmonary artery catheter and monitor for continuous cardiac output measurement (CCO), based on thermodilution principle, has been recently developed. Aim of our study was to evaluate the new system by comparing data obtained with the CCO with the standard bolus thermodilution method (TD). METHODS:Nin...
journal_title：Minerva anestesiologica
pub_type： 临床试验,杂志文章
doi：
更新日期：1998-09-01 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：BACKGROUND:The index E/e' derived from tissue Doppler imaging and pulsed Doppler is the ratio of the early transmitral flow velocity and the early mitral annular velocity and it correlates with left ventricular filling pressure. The purpose of this study was to investigate the relationship between intraoperative E/e' a...
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：:For several years now, the need for improving healthcare quality has determined the adoption of a businesslike philosophy in American hospitals, through quality control and improvement systems. In Italy, the introduction of this business concept in public healthcare is recent, while quality assurance is still widely i...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,评审
doi：
更新日期：1999-03-01 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:Combined epidural/general anaesthesia might theoretically emphasise the cardiovascular effects of epidural block alone. The goal of the present investigation was to evaluate the incidence of both hypotension and bradycardia during integrated epidural/general anaesthesia in a multicentric, observational study...
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：1998-07-01 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：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：:Tonomitor NG tube was positioned in the stomach of 11 critical ill patients during their stay in ICU and 48 measurements of intramucosal pH (pHi) have been performed. In 7 patients haemodynamic measurement were performed in concomitance with each pHi measure. The Authors looked for statistical relations between pHi an...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：1992-11-01 00:00:00
abstract：:Stroke is a devastating complication that is difficult to diagnose in the perioperative setting because of the effects of anesthetic and analgesic agents. Lingering anesthesia effects hinder clinicians in identifying stroke symptoms, frequently resulting in a delay in diagnosis and treatment and in unfavorable outcome...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：10.23736/S0375-9393.17.11976-0
更新日期：2017-11-01 00:00:00
abstract：:An original technique of analgesic anaesthesia, with the characteristics of brief and out-clinic anaesthesia, has been experimented in a group of patients undergoing light surgery (eye surgery). The technique employs an association of an analgesic--Fentanil--a low dose hypnotic and marked hyperventilation. Recovery ch...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：1982-01-01 00:00:00
abstract：:This report takes into consideration the complications due to "body packers" cocaine absorption. In particular we report a clinical case in which severe dysrhythmias occurred. We think an early insertion of a pacemaker able to rid ectopic focus by overdriving is essential by comparison with an effective anti-dysrhythm...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：1995-03-01 00:00:00
abstract：: ...
journal_title：Minerva anestesiologica
pub_type： 信件
doi：10.23736/S0375-9393.19.13457-8
更新日期：2019-08-01 00:00:00
abstract：BACKGROUND:Traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) are the most common causes of severe acute brain injury in younger Intensive Care Unit (ICU) patients. Dysglycemia (abnormal peak glycemia, glycemic variability, mean glycemia, nadir glycemia) is common in these patients but its comparative outco...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：10.23736/S0375-9393.19.13307-X
更新日期：2019-08-01 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：:Known for two centuries, positive pressure non invasive mechanical ventilation (VMNPP) has been widely applied in acute respiratory failure (IRA) only in the last ten years. The fact that VMNPP is able to improve gas exchange by avoiding endotracheal intubation and its complications is the most attractive aspect in bo...
journal_title：Minerva anestesiologica
pub_type： 历史文章,杂志文章,评审
doi：
更新日期：2000-10-01 00:00:00
abstract：:The bulbar hypotonizing activity of Althesin in eye surgery has been assessed. The anaesthetic was then utilized in the induction and maintenance of narcosis in cryoextraction operations on the crystalline lens. In the 50 narcoses examined, a mean decrease in ocular tone of 30% was noted with respect to basal value fi...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：1980-02-01 00:00:00
abstract：AIM:The aim of our study was to compare the efficacy of hyperbaric and isobaric solutions of intrathecal levobupivacaine for transurethral endoscopic surgery. METHODS:Urological patients who were scheduled for elective surgery under spinal anesthesia were enrolled. The heavy group received 13.5 mg of hyperbaric levobu...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,随机对照试验
doi：
更新日期：2010-01-01 00:00:00
abstract：OBJECTIVE:To evaluate the usefulness of the modified Harris-Benedict formula predicting Energy Expenditure (EE) in pressure support ventilated, critically ill patient. SETTING:The intensive care unit (ICU) of a teaching hospital. PATIENTS:Fiftyfive patients admitted to ICU for acute respiratory failure, requiring mec...
journal_title：Minerva anestesiologica
pub_type： 临床试验,杂志文章
doi：
更新日期：1996-05-01 00:00:00
abstract：BACKGROUND:Hypo- and hyperglycemia must be avoided to prevent additional brain damage following traumatic brain injury (TBI). However, the optimal blood glucose range requiring insulin remains unknown. Cerebral microdialysis is helpful in unmasking signs of metabolic impairment, thereby identifying deleterious blood gl...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：2010-11-01 00:00:00
abstract：:Surgery is currently the treatment of choice for acutely ruptured aneurysms, representing an efficient option both in the short and long term. We believe that the endovascular option may be of help in high surgical-risk cases. ...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：1998-04-01 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：: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：:Even moderate temperature elevations soon acute cerebral damage may markedly worsen initial brain injury. These effects may justify aggressive antipyretic treatment in neurosurgical intensive care unit (NICU). On the basis of a literature survey, it is observed that fever is extraordinarily common in the neurosurgical...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,评审
doi：
更新日期：2003-04-01 00:00:00
abstract：AIM:The study compares the intraoperative effects of combined versus general anesthesia during major liver surgery. METHODS:In this prospective randomized study, 70 patients were divided into 2 group of 35 subjects. Group A received general anesthesia (thiopentone, fentanyl, vecuronium, sevoflurane in a closed circuit...
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：2003-12-01 00:00:00
abstract：OBJECTIVE:To investigate the relationship between Therapeutic Intervention Scoring System (TISS), length of ICU stay and severity of illness. DESIGN:Prospective study lasting 1 year. SETTING:Two 4-bed surgical-medical ICU. PATIENTS:All consecutively ICU admitted patients. METHODS:Every day TISS of each patient duri...
journal_title：Minerva anestesiologica
pub_type： 临床试验,杂志文章
doi：
更新日期：1997-10-01 00:00:00
