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 patients who underwent mechanical ventilation for at least 15 days in several ICU and in whom several attempts of weaning failed. DESIGN:A retrospective study (January 1993-February 1995). SETTING:Intermediate Intensive Respiratory Care Unit of Centro Medico Di Montescano. PATIENTS:Thirty-nine patients (29 male; 26 COPD, 3 post-surgery respiratory failure, 5 restrictive diseases, 4 with cardiovascular failure and 1 neurological disease) who had been tracheotomized and undergoing mechanical ventilation from at least 15 days. An initial evaluation in which respiratory mechanics and echocardiography were performed was made and then they underwent further weaning trials based on progressive decrease of the level of pressure support and periodic disconnection from MV and on medical therapy and strong physiokinesitherapy. RESULTS:Twenty-six out of 39 patients (66%) could reach definitive weaning (COPD 65%, post-surgery respiratory failure 66%, restrictive 60%, cardiovascular failure 100%, neurological disease 0%) after 17 days of average time of ventilation (range from 4 to 90). Among the important factors in determining a difficult or impossible weaning there are: a) previous wrong ventilation settings 8/26; b) cardiovascular problems 7/26; c) alterations in respiratory mechanics 2/26; d) previous excessive sedation 2/26; e) uncorrect timing of disconnection 2/26; f) poor physiokinesitherapy 2/26; g) unknown causes 3/26. Also the ICU from which the patients has been transferred plays an important role. CONCLUSIONS:The conclusion is drawn weaning from mechanical ventilation can be reached also in a part of those patients who are thought not weanable with a further, prolonged and expensive weaning trial.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Rubini F,Zanotti E,Brigada P,Nava Ssubject
Has Abstractpub_date
1998-11-01 00:00:00pages
513-20issue
11eissn
0375-9393issn
1827-1596journal_volume
64pub_type
临床试验,杂志文章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:BACKGROUND:To compare the anaesthetic epidural effects of levobupivacaine plus fentanyl versus bupivacaine plus fentanyl in patients undergoing lower limb surgery. METHODS:A single blind, randomised, prospective, multicentre study was designed to compare both therapies. The study was conducted in 10 tertiary hospitals...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,多中心研究,随机对照试验
doi:
更新日期:2008-07-01 00:00:00
abstract::Recently inhaled nitric oxide (iNO) has been used as pulmonary vasodilator without any effect on systemic hemodynamics. iNO has been also used in cardiac and thoracic surgery, involving lung transplantation. In this case report a patient, 41 years old female, affected by bronchiectasis, underwent bilateral sequential ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1998-06-01 00:00:00
abstract::Awareness during anesthesia (AGA) is known as an intraoperative incident which could lead to a series of untoward effects, among them symptoms compatible with the posttraumatic stress syndrome (PTSS). Incidence of AGA ranges between 0.1% and 0.7%, most of the reports indicating a 0.2% rate of all general anesthesias. ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2002-12-01 00:00:00
abstract::Cerebral edema complicates many neurosurgical conditions, such as head injuries, neoplasms and infections, and is the direct result of operative trauma. The recognition and the treatment of brain edema are of great practical importance, particularly in those conditions leading to brain herniations and/or intracranial ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:1992-04-01 00:00:00
abstract::Intraoperative brain mapping has the goal of aiding with maximal surgical resection of brain tumors while minimizing functional sequelae. Retrospective randomized studies on large populations have shown that this technique can optimize the surgical approach while reducing postoperative morbidity. During direct electri...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2008-06-01 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::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: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:BACKGROUND:The analysis of the arterial pulse contour obtained by means of a non-invasive device (Finapres) seems to be an ideal method to measure cardiac output (CO). An individual calibration factor (Z) dimensionally equal to aortic impedence is the necessary pre-requisite to calculate CO by pulse contour analysis. T...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1998-03-01 00:00:00
abstract::The preoperative evaluation of the enzymatic level concerning the functioning of the neuromuscular system, is of particular importance. The diseases of these regions may lead to Malignant Hyperthermia (MH) in the course of general anaesthesia. The authors illustrate the case of a young asymptomatic patient with consta...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1998-01-01 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::Non invasive ventilation (NIV) has been shown to be an effective therapy in selected patients with acute respiratory failure. Due to its benefit and relative ease of use, NIV is frequently used. In addition, the shortage and high cost of intensive care beds have prompted the use of NIV outside the intensive care unit....
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2009-07-01 00:00:00
abstract:AIM:To verify, in dissection adenotonsillectomy (AT) performed in Rose position under general anaesthesia with oro-tracheal intubation, the following: 1) the ability of tramadol to produce an effective intra- and postoperative analgesia without any considerable side effects or interferences with the normal post-surgica...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1998-12-01 00:00:00
abstract::The utility of laparoscopic cholecystectomy in reducing postoperative pain and patient's hospital discharge is already known. Nevertheless peritoneal gas insufflation required by surgical procedure can modify respiratory homeostasis during general anesthesia. The aim of this study was to evaluate the effect of laparos...
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::A case is presented of severe visceral leishmaniasis initially misdiagnosed owing to the old age of the patient and the contemporary presence of a carcinoma of the sigmoid. Admitted in ICU for severe post operative cardiorespiratory failure. During ICU stay the patients presented a bilateral pneumothorax and a long QT...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract::Regional nerve injury is a recognized complication of plexus anesthesia. Nerve damage after regional anesthesia is the most frightening complication for the patient, the anesthetist and the surgeon too. In order to limit possible medico-legal issues, the anesthetist has to follow an algorithm. The indication and infor...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2005-06-01 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
abstract:AIM:The aim of the paper was to examine the attitudes of the health care workers (HCW) of five Italian Hospitals towards intensive supports, in the hypothesis that a large involvement could help to solve the problems of a more adequate management of vital supports. METHODS: DESIGN:Hospital HCWs' attitudes towards car...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2007-03-01 00:00:00
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, p...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:1996-03-01 00:00:00
abstract::A case of high spinal anesthesia complicating an interscalene brachial plexus block is described. After an apparently straightforward location of the plexus with good paresthesias, the injection of 10 ml of local anesthetic caused a high spinal block whose main feature was apnea. The patient retained his consciousness...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1980-03-01 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::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
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::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:The partial pressure of carbon dioxide (pCO2) gap is the difference between pCO2 values in the arterial and mixed venous blood; values higher than six mmHg may be predictive of tissue hypoperfusion. It is still doubtful if central venous blood can be used to assess the gap. This study was aimed to compare th...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.19.13554-7
更新日期:2019-12-01 00:00:00
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
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Postoperative opioid analgesia increases the incidence of postoperative nausea and vomiting (PONV). We investigated whether a combination of the neurokinin-1 antagonist aprepitant and dexamethasone decreases PONV incidence compared with dexamethasone alone in high-risk patients receiving continuous epidural ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2015-04-01 00:00:00
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:
更新日期:1992-07-01 00:00:00
abstract::Data concerning antibiotic therapy in italian ICUs are presented. These data were not directly measured: they have been derived from a previous study on costs of intensive care treatments. 78% of 1065 patients received antibiotic therapy. Empirical therapy was started in 82% of septic patients. 93% of septic patients ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2001-04-01 00:00:00