Noninvasive cardiac output assessment during heart surgery.

Objective: To evaluate the reliability of a new noninvasive method for the assessment of cardiac output with the partial carbon dioxide rebreathing technique.

Methods: This technique was applied to patients undergoing heart surgery. Values of cardiac index obtained with this equipment were compared with the artero-venous CO2 gradient, a reliable index of cardiovascular status.

Effect of general and epidural anaesthesia on thyroid hormones and immunity in neonates.

Background: The aim of this study was to verify if variations of thyroid hormones related to circumstances of delivery and mode of maternal anaesthesia can contribute to neonatal neutrophil respiratory burst and natural killer cell activity.

Methods: We evaluated 10 infants born by vaginal delivery (group A), 10 infants born by caesarean section after epidural anaesthesia with lidocaine (group B) and 10 infants born by caesarean section after general anaesthesia with sevoflurane (group C).

Results: A significant reduction of neutrophil respiratory burst test was found in groups A and C compared with group B.

Does ethnicity predict lactation? A study of four ethnic communities.

Human lactation is influenced by a variety of interrelated factors. The purpose of the study was to see whether the racial/ethnic factor is predictive of the onset of lactation and of the volume of breast milk. We planned a prospective study enrolling 269 women who were classified into four ethnic groups: Group 1 Arabs, Group 2 Africans, Group 3 Eastern Europeans, Group 4 Italians.

[Single lung transplantation retrospective analysis of intraoperative cardiovascular problems].

Background: Analysis of haemodynamic problems during single-lung transplantation and of methodologies employed for their treatment.

Design Of The Study: clinical retrospective study.

Setting: General University Hospital.

Can anesthesiologic strategies for caesarean section influence newborn jaundice? A retrospective and prospective study.

Rationale And Objectives: Neonatal jaundice is a frequent problem in neonatology and can be influenced by many factors. Our study arose from the clinical observation that among all newborns delivered by caesarean section in our center, some had a more intense physiological jaundice. We began by reviewing clinical anesthesiological case-sheets to ascertain whether this difference was linked to the use of different anesthesiologic strategies.

Case reports in anesthesiology: their trend through 17 years.

Unlabelled: The study objective was to delineate the trend of case reports (the simplest of the descriptive forms of study) in the anesthesiological literature by analyzing the frequency of publication, and citation, and especially of the place of citation of a sample of published case reports. It is our opinion that case report in anesthesia is particularly suitable for this specialty rather than for others and is often the first signal of a complication, an adverse event, an anesthetic problem in rare disease and alerts other anesthesiologists to the possibility of unexpected events.

Methods: We analyzed the case reports published on an Anesthesiological journal placed in the middle in term of Impact Factor, from January 1980 to December 1997.

Impact of the Hawthorne effect in a longitudinal clinical study: the case of anesthesia.

Clinical research can be influenced by many factors that are capable of invalidating results, and one of these factors is known as the Hawthorne effect: the mere awareness of being under observation can alter the way in which a person behaves. In experimental research this effect can be the undesired effect of the experiments themselves, and the stronger its presence, the greater it can influence the results. In anesthesia practice, owing to the particular emotional condition of a patient facing a surgical operation, the Hawthorne effect could be especially strong.

Unexpected finding of barium sulphate on the surface of a microspinal catheter.

During a study with a scanning electron microscope to evaluate the structure of microspinal catheter after its removal from subarachnoid space, we found an unusual case. The observation with the microscope of the tip of a catheter removed at the end of an operation for hip replacement in a old female showed the presence of grounded particles with a crystal shape covering the outer surface. Further analysis of this material with an Energy-Dispersive Spectrometer (EDS) showed that it was barium.

Natural killer cell activity and delivery: possible influence of cortisol and anesthetic agents. A study on newborn cord blood.

The aim of this study was to evaluate the influence of the method of delivery, the level of cord blood lidocaine, and the cortisol concentration on the cord blood natural killer (NK) activity in the full-term healthy newborn. We studied healthy newborns delivered by elective cesarean section without labor under general anesthesia (n = 24), delivered by cesarean section under epidural anesthesia (n = 21), and delivered vaginally with uncomplicated labor (n = 19). The NK cell activity was significantly lower in newborns delivered by cesarean section under epidural anesthesia than it was in the general anesthesia group, while it was similar to the levels found in vaginally delivered newborns.

Anesthesia with sevoflurane in bariatric surgery.

Background: Sevoflurane is a good halogen agent for bariatric surgery anesthesia because of its physical and chemical characteristics and its repartition coefficient (blood/gas = 0.65).

Method: From November 1997 to April 1998, 98 bariatric surgery procedures with sevoflurane anesthesia were done: 17 lipectomies, 71 vertical gastroplasties, and 10 biliopancreatic diversions in 71 women and 27 men, average age 30.

Is there a bilateral block of the thoracic sympathetic chain after unilateral intrapleural analgesia?

Unlabelled: This study was designed to ascertain, by telethermography and clinical observation, the effect of injecting anesthetic solutions into the intrapleural space on thoracic sympathetic chains and splanchnic nerves. We studied 15 patients with neoplastic (n = 8) or benign (n = 7) pain, divided into three groups of 5 patients each. The first group received 20 mL of bupivacaine 0.

[A method for the evaluation of resource use in cardiac surgery: application of the ICR beta in an Italian reality].

The decreased availability of economic resources requires the use of methods to assess hospital efficiency. The aim of our study was to retrospectively evaluate the applicability to the Italian reality of a catalogue of medical acts (CdAM-champs beta) set up for the French Health System. We wanted to evaluate the amount of resource utilization of a Cardiothoracic Operating Room of a IRCCS regional general hospital.

The influence of race on breast feeding.

We evaluated the beginning of lactogenesis and the milk quantity until the fifth post-delivery day, before discharge, in 10 primiparae and 11 pluriparae Gypsies, as compared to 12 primiparae and 11 pluriparae Italian women. The results showed that both in primiparae and in pluriparae Gypsies, the lactogenesis started significantly earlier and the milk quantity was significantly greater than in Italian women.

Aortic arch surgery: retrospective analysis of outcome and neuroprotective strategies.

Objective: To review intra- and postoperative data regarding surgical reconstruction of the aortic arch performed at our cardiosurgical centre during the past four years, and thus to deepen understanding of neurologic morbidity and of what constitutes the most effective neuroprotection.

Experimental Design: Retrospective study.

Setting: Regional University Hospital.

Effect of lidocaine on neutrophil chemotaxis in newborn infants.

Anesthetic drugs can influence the immune system, particularly granulocyte function. The goal of the present study was to evaluate if lidocaine used for epidural anesthesia during cesarean section can influence neonatal neutrophil chemotaxis. We measured chemotaxis and plasma cord lidocaine and cortisol levels in (A) 15 infants born by cesarean section with epidural anesthesia, (B) 15 infants born by vaginal delivery, and (C) 20 infants born by cesarean section with general anesthesia.

Graphic data representation in anaesthesiological journals: a proposed methodology for assessment of appropriateness.

Few authors have addressed the topic of graphic data presentation. The purpose of our study was to combine several guidelines in order to evaluate three anaesthesiology journals listed in Index Medicus (Australian, American and Italian) in terms of the appropriateness and the quality of presentation of graphs. Our analysis was based on concepts expressed by Cox and Tufte.