[Experience of an intermediate respiratory intensive therapy in the treatment of prolonged weaning from mechanical ventilation].

Abstract:

:109 patients who suffered from an episode of acute respiratory failure, necessitated mechanical ventilation (MV) in a general Intensive Care Unit (ICU) and admitted to our Respiratory Intermediate Intensive Unit (RIIU), were retrospectively evaluated for outcome and weaning success. The patients, 69 +/- 9 years old, presented the following diseases: COLD (70%), cardiovascular (15%) and neuromuscular (15%). A relapse of underlying disease (62%), pneumonia (20%), thoraco-muscular pump failure (15%) and pulmonary embolism (3%) were the relapsing causes needing the ICU admission. Patients remained intubated for 12 +/- 6 days and ventilated for 25 +/- 10 days. They were transferred to RIIU on pressure support ventilation (70%); the causes of prolonged and/or difficult weaning were as following: lung failure (48%), pump failure (12%), cardiac and haemodynamic instability (28%) others (12%). Apache II score was 18 +/- 5. Maximal inspiratory pressure (31 +/- 7 cmH2O) and respiratory rate/tidal volume (83 +/- 34) were measured within 48 hours after RIIU admission. 82 subjects (75%) were weaned after 6 +/- 4 days of MV using in 87% of patients pressure support technique with spontaneous breathing cycles with oxygen supplementation. 8 patients on 109 (7%) died; 20 patients on 109 (18%) were discharged after 40 +/- 9 days of stay in RIIU necessitating home MV more than 18 hours/day by means of a tracheostomy. All patients stay in RIIU for 17 +/- 7 days with a mean cost per die of 750 thousands lire. Our data suggest that a RIIU institution for prolonged weaning in chronic diseases may be a useful solution to decrease superfluous stays in ICU decreasing costs without ba worsening in quality of care.

journal_name

Minerva Anestesiol

journal_title

Minerva anestesiologica

authors

Vitacca M,Clini E,Porta R,Sereni D,Ambrosino N

subject

Has Abstract

pub_date

1996-03-01 00:00:00

pages

57-64

issue

3

eissn

0375-9393

issn

1827-1596

journal_volume

62

pub_type

杂志文章,评审
  • [The effect of various drugs on post-operative pain-producing sensations].

    abstract::The influence of diazepam, the hemisuccinic ester of oxazepam, fentanyl and pentazocine on pain-producing sensation after surgery was tested in 160 patients subjected to ordinary and major surgery. Use was made of Dundee and Moore's modification of Clutton-Brock's test, and Bromage's test. Analysis of the results indi...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Gerardi AU,Miletti S,Miele G

    更新日期:1980-05-01 00:00:00

  • Acute reduction of cerebrospinal fluid volume prior to spinal anesthesia: implications for sensory block extent.

    abstract:BACKGROUND:Multiple patient and clinical characteristics contribute to the variable outcome of spinal anesthesia (SPA). Acute reduction of cerebrospinal fluid (CSF) volume may alter the effect of SPA. The objective of the present study was to test if aspiration of 10 mL CSF immediately prior to SPA is associated with h...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:10.23736/S0375-9393.20.14138-5

    authors: Bjurström MF,Mattsson N,Harsten A,Dietz N,Bodelsson M

    更新日期:2020-06-01 00:00:00

  • Reduction of operating and recovery room times and overnight hospital stays with interscalene blocks as sole anesthetic technique for rotator cuff surgery.

    abstract:BACKGROUND:The effort to decrease hospital stays and to increase operating room efficacy has become an important consideration in the practice of anesthesia. METHODS:Fifty-three patients who underwent shoulder rotator cuff repair in the sitting position were divided into four groups according to the anesthesia techniq...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Chelly JE,Greger J,Al Samsam T,Gebhard R,Masson M,Matuszczak M,Sciard D

    更新日期:2001-09-01 00:00:00

  • How to optimize the lung donor.

    abstract::Over the last two decades, lung transplantation emerged as the standard of care for patients with advanced and terminal lung disease. Despite the increment in lung transplantation rates, in 2016 the overall mortality while on waiting list in Italy reached 10%, whereas only 39% of the wait-list patients were successful...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:10.23736/S0375-9393.17.12130-9

    authors: Sales G,Costamagna A,Fanelli V,Boffini M,Pugliese F,Mascia L,Brazzi L

    更新日期:2018-02-01 00:00:00

  • Anesthesiological management and outcome of 100 ''beating heart'' coronary artery bypass grafting.

    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:

    authors: Zangrillo A,Gerli C,Landoni G,Sparicio D,Roberti A,Sottocorna O,Mantovani L,Scandroglio AM,Crescenzi G

    更新日期:2006-10-01 00:00:00

  • [Anesthesiology problems for implant and explant of left ventricular Novacor systems].

    abstract:OBJECTIVES:To review experience with anaesthetic management in patients undergoing a left ventricular assist system (LVAS) Novacor implant as a bridge to cardiac transplantation. DESIGN:Retrospective clinical study. SETTING:Cardiothoracic operating room in a university hospital. PATIENTS:Nine, aged 37-62 years, suff...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Domenegati E,Ceriana P,Chiaudani MG,Pagani F

    更新日期:1996-06-01 00:00:00

  • Timing and duration of intracranial hypertension versus outcomes after severe traumatic brain injury.

    abstract:BACKGROUND:The goal of this paper was to investigate the association between patterns of intracranial hypertension (IH) and outcomes, to describe the treatment of patients with different patterns of IH, and to examine whether IH is an independent predictor of mortality and unfavourable outcome, respectively. METHODS:A...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Majdan M,Mauritz W,Wilbacher I,Brazinova A,Rusnak M,Leitgeb J

    更新日期:2014-12-01 00:00:00

  • [Cardiac rupture in thoracic trauma].

    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:

    authors: Siniscalchi A,Barbieri A,De Pietri L,Rossi R

    更新日期:2000-06-01 00:00:00

  • Esmolol for septic shock: more than just heart rate control?

    abstract::Excessive adrenergic stimulation may be associated with several adverse events and contribute to increase mortality in critically ill septic patients. Few clinical data exist on the effects of adrenergic blockade in this setting. The objective of this study was to investigate the effect of a short acting b-blocker (es...

    journal_title:Minerva anestesiologica

    pub_type: 评论,杂志文章

    doi:

    authors: Orbegozo Cortes D,Njimi H,Dell'Anna AM,Taccone FS

    更新日期:2014-02-01 00:00:00

  • [Propofol, fentanyl, nitrous oxide: useful and current combination?].

    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:

    authors: Taddia G,Affuso A,Navi A,Orlandi C,Pompei F,Damanzo A

    更新日期:1992-04-01 00:00:00

  • Diuretics in acute kidney injury.

    abstract:BACKGROUND:In an acute care setting, diuretics are often prescribed to maintain or increase urine output in patients presenting with acute kidney injury (AKI). The rationale behind giving diuretics is that they may protect the kidney from ischemic injury by maintaining a nonoliguric state. There have been many studies ...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,评审

    doi:

    authors: Karajala V,Mansour W,Kellum JA

    更新日期:2009-05-01 00:00:00

  • [Surgical indications for the treatment of cervico-spinal cord injuries].

    abstract::The surgical treatment of cervico-medullary traumas is indicated, in unstable lesions, in large lesions of the mobile rachidic segment in the presence of neurological complications or following worsening of prior neurological symptomatology. The purpose of the operation is at least three-fold: to obtain alignment of v...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,评审

    doi:

    authors: Fasano VA

    更新日期:1989-03-01 00:00:00

  • [Anesthesia in Apert syndrome].

    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:

    authors: Ciceri G,Arosio G,Brunatti M,Fontana G,Riedo R,Vesconi S

    更新日期:1997-05-01 00:00:00

  • Fasting guidelines concerning intake of solids of the American Society of Anesthesiologists are not in concert with those of the European Society of Anaesthesiologists.

    abstract:: ...

    journal_title:Minerva anestesiologica

    pub_type: 评论,信件

    doi:10.23736/S0375-9393.19.13553-5

    authors: Avidan A

    更新日期:2019-07-01 00:00:00

  • Incidence of anaerobic bacteria in patients with suspected pneumonia in surgical Intensive Care Unit.

    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:

    authors: Clavier T,Gouin P,Frebourg N,Rey N,Royon V,Bergis A,Hobeika S,Dureuil B,Veber B

    更新日期:2014-10-01 00:00:00

  • How to optimize and use predictive models for postoperative pulmonary complications.

    abstract::Pulmonary complications are a source of greater postoperative morbidity and mortality and longer hospital stays. Although many factors have been implicated as predictors, few models have been developed with the rigorous methodology required for clinically useful tools. In this article we attempt to describe what to lo...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,评审

    doi:

    authors: Mazo V,Sabaté S,Canet J

    更新日期:2016-03-01 00:00:00

  • [Effectiveness of regional anesthesia for loco-regional carotid surgery. Retrospective review of 147 interventions].

    abstract::The Authors present a retrospective review that compares general anesthesia with regional anesthesia performed during carotid endarterectomy surgery. The study includes 147 procedures, performed on 144 patients: 76 had general anesthesia and 71 had regional anesthesia. After emphasizing the importance of conscience pr...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Bartoloni A,Savron F,Rigo V,Pasetto A,Spezie C,Ischia A,Perbellini A

    更新日期:1991-03-01 00:00:00

  • [Althesin in general surgery].

    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:

    authors: Liistro A

    更新日期:1980-02-01 00:00:00

  • Absent SEP during therapeutic hypothermia did not reappear after re-warming in comatose patients following cardiac arrest.

    abstract:BACKGROUND:Early prediction of neurological outcome for patients resuscitated from cardiac arrest (CA) is a challenging task. Therapeutic hypothermia (TH) has been shown to improve neurological outcome after CA. Two recent studies indicated that somatosensory evoked potentials (SEP) recorded during TH retains high pred...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Grippo A,Carrai R,Fossi S,Cossu C,Mazzeschi E,Peris A,Bonizzoli M,Ciapetti M,Gensini GF,Pinto F,Amantini A

    更新日期:2013-04-01 00:00:00

  • [Continuous intravenous infusion with patient-controlled anesthesia for postoperative analgesia in cesarean section: morphine versus buprenorphine].

    abstract::A double blind comparison between morphine and buprenorphine was performed in 20 patients using a new demand and continuous infusion analgesic system to provide analgesia after cesarean section. The patients were randomized in two equal groups to receive either morphine 1 mg/h or buprenorphine 0.03 mg/h. The PCA syste...

    journal_title:Minerva anestesiologica

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Capogna G,Celleno D,Sebastiani M,Costantino P,Reggio S

    更新日期:1989-01-01 00:00:00

  • Comparative effectiveness of pharmacologic interventions to prevent shivering after surgery: a network meta-analysis.

    abstract:INTRODUCTION:Although many drugs have been studied to prevent postoperative shivering, their comparative effectiveness is unknown. We attempted to assess the comparative effectiveness of the pharmacologic strategies to prevent shivering after surgery including intravenous (IV) and intrathecal (IT) meperidine, IV and IT...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,meta分析,评审

    doi:10.23736/S0375-9393.18.12813-6

    authors: Kang P,Park SK,Yoo S,Hur M,Kim WH,Kim JT,Bahk JH

    更新日期:2019-01-01 00:00:00

  • Closed loop ventilation mode in Intensive Care Unit: a randomized controlled clinical trial comparing the numbers of manual ventilator setting changes.

    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

    authors: Arnal JM,Garnero A,Novotni D,Corno G,Donati SY,Demory D,Quintana G,Ducros L,Laubscher T,Durand-Gasselin J

    更新日期:2018-01-01 00:00:00

  • Prediction of extubation failure in Intensive Care Unit: systematic review of parameters investigated.

    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

    authors: Lombardi FS,Cotoia A,Petta R,Schultz M,Cinnella G,Horn J

    更新日期:2019-03-01 00:00:00

  • Mechanical ventilation in cancer patients.

    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:

    authors: Saillard C,Mokart D,Lemiale V,Azoulay E

    更新日期:2014-06-01 00:00:00

  • Two doses of oral ketamine, given with midazolam, for premedication in children.

    abstract:BACKGROUND:Oral premedication is common practice in paediatric anaesthesia. The aim of this study was to assess the quality of premedication using oral ketamine, with midazolam. METHODS:Clinical randomized and blind-study on 120 patients, aged between 2 and 6 years, listed for minor surgery. Patients were divided in t...

    journal_title:Minerva anestesiologica

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Astuto M,Disma N,Crimi E

    更新日期:2002-07-01 00:00:00

  • Chronic pain: not only a matter of time.

    abstract::The term "chronic" is often used in daily clinical practice to indicate a type of pain that lasts over time and is accompanied by diagnostic and therapeutic difficulties. The common feeling is that in this category are actually collected many different clinical cases with the unique characteristic that the pain lasts ...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Bonezzi C,Demartini L,Buonocore M

    更新日期:2012-06-01 00:00:00

  • Mid-regional pro-adrenomedullin as prognostic biomarker in septic shock.

    abstract:BACKGROUND:The aim was to ascertain the prognostic value of mid-regional pro-adrenomedullin (MR-proADM), measured within 24 hours from the onset of septic shock (SS). METHODS:We performed a prospective, observational study on all patients admitted to our hospital's Intensive Care Unit with SS over a one year period fr...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: DE LA Torre-Prados MV,Garcia-DE LA Torre A,Enguix A,Mayor-Reyes M,Nieto-González M,Garcia-Alcantara A

    更新日期:2016-07-01 00:00:00

  • Hemodynamic monitoring in ICU.

    abstract::Oxygen supply to all tissues is possible only in a condition of adequate blood circulation. Oxygen demand is the driving force that is responsive of hemodynamic adjustment. The human body acts on four modulators (intravascular volume, inotropy, vasoactivity, chrono-tropy) in order to adjust the hemodynamic state. Hemo...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Stucchi R,Poli G,Fumagalli R

    更新日期:2006-06-01 00:00:00

  • [Neuroleptic malignant syndrome. Problems of differential diagnosis. Description of a clinical case].

    abstract::Neuroleptic malignant syndrome (NMS) in its most severe form ranging from disorders of consciousness to coma is now reported relatively frequently in intensive care journals. Having observed such a case in the intensive care ward of their hospital, the Authors investigate the possibility of differential diagnosis betw...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Musto P,Vinay P,Coalda M,Bono D,Vai G

    更新日期:1992-07-01 00:00:00

  • [Use of atracurium for the prevention of fasciculations and succinylcholine myalgia in athletes undergoing orthopedic surgery].

    abstract::The Authors report their clinical experience about the use of atracurium besylate in preventing succinylcholine-induced fasciculations and postoperative myalgias in fifty athletes (ASA class 1), submitted to arthroscopic meniscectomy. The patients were pretreated with atracurium 5 mg i.v. or saline solution in a doubl...

    journal_title:Minerva anestesiologica

    pub_type: 临床试验,杂志文章,随机对照试验,评审

    doi:

    authors: Pagani I,Ramaioli F,Albertario F,Mora R,Dionigi RV

    更新日期:1990-11-01 00:00:00