1,721,001 research outputs found
Relationship between central venous pressure and bioimpedance vector analysis in critically ill patients
No full textOBJECTIVE: To assess the relationship between central venous pressure values and bioelectrical impedance vector analysis (BIVA), which may be used as complementary methods in the bedside monitoring of fluid status. DESIGN: Cross-sectional evaluation of a consecutive sample. SETTING: Intensive care unit of a university hospital. PATIENTS: One hundred and twenty-one consecutive Caucasian, adult patients of either gender, for whom routine central venous pressure measurements were available. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Central venous pressure values and impedance vector components (i.e., resistance and reactance) were determined simultaneously. Total body water predictions were obtained from regression equations according to either conventional bioimpedance analysis or anthropometry (Watson and Hume formulas). Variability of total body water predictions was unacceptable for clinical purposes. Central venous pressure values significantly and inversely correlated with individual impedance vector components (r2 = .28 and r2 = .27 with resistance and reactance, respectively), and with both vector components together (R2 = .31). Patients were classified in three groups according to their central venous pressure value: low (0 to 3 mm Hg); medium (4 to 12 mm Hg); and high (13 to 20 mm Hg). Three BIVA patterns were considered: vectors within the target (reference) 75% tolerance ellipse (normal tissue hydration); long vectors out of the upper pole of the target (dehydration); and short vectors out of the lower pole of the target (fluid overload). The agreement between BIVA and central venous pressure indications was good in the high central venous pressure group (93% short vectors), moderate in the medium central venous pressure group (35% normal vectors), and poor in low central venous pressure group (10% long vectors). CONCLUSIONS: Central venous pressure values correlated with direct impedance measurements more than with total body water predictions. Whereas central venous pressure values >12 mm Hg were associated with shorter impedance vectors in 93% of patients, indicating fluid overload, central venous pressure values <3 mm Hg were associated with long impedance vectors in only 10% of patients, indicating tissue dehydration. The combined evaluation of intensive care unit patients by BIVA and central venous pressure may be useful in therapy planning, particularly in those with low central venous pressure in whom reduced, preserved, or increased tissue fluid content can be detected by BIV
Respiratory depression following administration of low dose buprenorphine as postoperative analgesic after fentanyl balanced anaesthesia
No full textOpioids are among the most ancient and widely used drugs in anaesthesiology. The pharmacology of opioid analgesics and their receptors is a complex and not fully understood matter; even more complex are the interactions between different classes of opioids at both molecular and clinical levels. We want to report here a clinical observation to emphasize the importance of the theoretical basis of anaesthesiology. This paper contains a clinical observation of respiratory depression following the administration of buprenorphine as postoperative analgesic after balanced anaesthesia with fentanyl. The observed case is interpreted in the light of the pharmacokinetics and pharmacodynamics of the different classes of opioid drugs (agonists, agonists-antagonists, antagonists) and of the interactions with their respective receptors
Comparison of cardiovascular effects of high frequency jet ventilation and continuous positive pressure ventilation in the normovolemic dog
No full textSpinal anesthesia in outpatient knee surgery: 22-Gauge versus 25-gauge sprotte needle
No full textSpinal anesthesia in day-care surgery is still controversial because of the possibility of postdural puncture headache (PDPH). The use of the Sprotte needle with a conical tip that spreads the dural fibers may reduce the incidence of PDPH. The aim of this study was to compare the 22-gauge and 25- gauge Sprotte needles with respect to PDPH and postoperative complaints in outpatients undergoing arthroscopy. The rate of spinal anesthesia failure and the feasibility of unilateral spinal anesthesia when using a low dose of anesthesia was also verified. For this randomized, prospective study, 234 patients undergoing elective arthroscopy were chosen. Patients were allocated randomly to have spinal anesthesia with either a 22-gauge or 25-gauge Sprotte needle. Dural puncture was performed with the patient in a lateral flexed decubitus position. After the injection of anesthetic solution (0.5-1.2 mL of 1% bupivacaine in 8% glucose) patients remained in the lateral decubitus position for 30 min. ..
Anestesia generale nella pratica odontostomatologica ambulatoriale Esperienza personale di 183 casi
No full textAdvanced instrumental odour monitoring system for the continuous management and control of environmental odour in complex industrial plants
No full textOdour emissions from complex industrial plants may cause potential impacts on the surrounding areas and, as consequence, complaints with the local residents. The identification of specific odour control plan is therefore needed in the plant management. The current challenge is the definition of Instrumental Odour Monitoring Systems (IOMSs) that allow the continuous odour characterization. No regulation or standardized procedure exist at present. Limited data are available in the literature with reference to the characteristics and operational procedure of this systems for the environmental odours monitoring. The study presents a novel prototype of intelligent and integrated IOMS for the continuous classification and quantification of the odours emitted in ambient air by complex industrial plants, with the scope to control the plants emissions in an objective and continuous manner, thus avoiding odour impact. The architecture and the principal components of the IOMS are highlighted. The operational procedures are presented and discussed.
Results highlights the importance and the flexibility of the proposed IOMS in the odour monitoring. Real-time and accurate information are provided by the system about the source and concentration of the odour emission
Hangman's fracture in a paediatric patient: considerations for anaesthesia
No full textCervical spree injuries are quite uncommon in children. When occurring, these lesions are of particular concern for the anaesthesiologist. This case refers to an hangman's fracture diagnosed in a four-month-old female infant, which probably occurred at birth. We describe the anaesthetic management adopted in this infant undergoing diagnostic procedures and conservative treatment. The problems related to airway control and the anaesthetic management utilized to diagnose and treat this unusual paediatric pathology are highlighted
Traumi cranio-encefalici: sintesi di un anno di esperienza e proposta di una cartella-protocollo.
No full textCardiocirculatory effects of CPPV and HFJV with PEEP
No full textThis paper presents the original unpublished results of animal experimentation achieved using HFJV in the last four years at the Institute of Anaesthesiology and Intensive Care of Padua
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