Surgical tracheostomy versus percutaneous dilatational tracheostomy. A prospective-randomized study with long-term follow-up.

Background: To compare surgical tracheostomy (ST) versus percutaneous dilatational tracheostomy (PDT) in terms of complication rates. In particular we specifically studied the late tracheal complications of both methods by means of endoscopic controls of patients up to 6 months after the procedures.

Design: prospective-randomized clinical study.

End tidal carbon dioxide monitoring in spontaneously breathing, nonintubated patients. A clinical comparison between conventional sidestream and microstream capnometers.

Background: To evaluate the end tidal carbon dioxide estimation in nonintubated, spontaneously breathing patients using either conventional sidestream or microstream capnometers.

Methods: Patients received a regional anesthesia technique, while the end tidal carbon dioxide partial pressure (EtCO2) was sampled through a nasal cannula (Nasal FilterLine, Nellcor, Plesanton, CA, USA) and measured using either a conventional sidestream capnometer with a 200 ml.min-1 aspiration flow rate, or a microstream capnometer (NBP-75, Nellcor Puritan Bennett, Plesanton, CA, USA) with an aspiration flow rate of 30 ml.

Accuracy of end-tidal carbon dioxide monitoring using the NBP-75 microstream capnometer. A study in intubated ventilated and spontaneously breathing nonintubated patients.

Arterial carbon dioxide partial pressure measurements using the NBP-75 microstream capnometer were compared with direct PaCO2 values in patients who were (a) not intubated and spontaneously breathing, and (b) patients receiving intermittent positive pressure ventilation of the lungs and endotracheal anaesthesia. Twenty ASA physical status I-III patients, undergoing general anaesthesia for orthopaedic or vascular surgery were included in a prospective crossover study. After a 20-min equilibration period following the induction of general anaesthesia, arterial blood was drawn from an indwelling radial catheter, while the end-tidal carbon dioxide partial pressure was measured at the angle between the tracheal tube and the ventilation circuit using a microstream capnometer (NBP-75, Nellcor Puritan Bennett, Plesanton, CA, USA) with an aspiration flow rate of 30 mL min(-1).

Cervical plexus anesthesia for carotid endarterectomy: comparison of ropivacaine and mepivacaine.

Purpose: To evaluate the effectiveness of cervical plexus block performed with ropivacaine 0.75% or 1%, or mepivacaine 2%.

Methods: In a prospective, randomized, double-blind study, 60 patients received deep cervical plexus block with 0.

[Percutaneous or surgical trachetomy. Prospective, randomized comparison of the incidence of early and late complications].

Background: To compare early and late complications after either conventional surgical or percutaneous dilatational tracheostomy.

Design: Prospective, randomized study.

Setting: General intensive care unit and neuro-surgical intensive care unit in a university hospital.

Antithrombin III (ATIII) replacement therapy in patients with sepsis and/or postsurgical complications: a controlled double-blind, randomized, multicenter study.

Background: ATIII is decreased in sepsis and/or shock and its baseline value correlates with mortality. The efficacy of ATIII therapy on mortality was assessed in a selected group of patients admitted to the intensive care unit (ICU) in a double-blind, randomized, multicenter study.

Methods: 120 patients admitted to the ICU with an ATIII concentration < 70% were randomized to receive ATIII (total dose 24000 units) or placebo treatment for 5 days; 56 patients had septic shock.

Low IGF-I levels are often uncoupled with elevated GH levels in catabolic conditions.

Increased GH together with decreased IGF-I levels pointing to peripheral GH insensitivity in critically ill patients have been reported by some but not by other authors. To clarify whether elevated GH levels are coupled with low IGF-I levels in all catabolic conditions, basal GH and IGF-I levels were evaluated in patients with sepsis (SEP, no.=13; age [mean+/-SE]=59.

Treatment of severe acidemia in a young woman affected by diabetic ketoacidosis.

The case of a 32-year-old woman admitted to Hospital for diabetic coma (GCS 8), with arterial blood pH below usually reported vital range, is described. After First Aid admittance an arterial blood gas analysis adjusted for patient's temperature showed PaO2 10.77 kPa, PaCO2 7.

Hyperacute pneumonitis in a patient with overwhelming Strongyloides stercoralis infection.

The case of a 64-year-old man who was admitted to hospital with fever, general deterioration and anorexia is reported. For the past 4 years, the patient had been receiving corticosteroid therapy for a chronic inflammatory demyelinating polyradiculoneuropathy. Soon after admission the patient developed respiratory insufficiency as a result of a massive pneumonitis, with severe hypoxia, acute anaemia, acute renal failure and a systemic inflammatory response syndrome (SIRS) requiring admission to the Intensive Care Unit (ICU).

Measured versus calculated energy expenditure in pressure support ventilated ICU patients.

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 mechanical ventilation.

Simultaneous kidney and pancreas transplantation at the San Raffaele Scientific Institute: clinical experience and results.

Pancreas and kidney transplantation is performed in uremic IDDM patients to cure end-stage renal failure and diabetes. Seventy-two simultaneous kidney-pancreas transplantations were performed at our Institution between July 1985 and November 1994. All transplants were performed using heart-beating cadaver donors.

[Conventional radiology and computerized axial tomography in the diagnosis of pneumothorax in intensive therapy. Retrospective study of 2 years of activity].

The role played by chest radiograph and CT scan in diagnosis of pneumothorax is analyzed in a retrospective study based on two years of activity in Intensive Care Unit. The sensibility of traditional chest radiography was 75% while the sensibility of CT scan resulted higher (87.5%).

[Tumor markers in colorectal neoplasm pathology: our experience of the diagnostic and prognostic importance of CEA antigen].

It is well known that the presence of a tumour may be accompanied by production and release into the serum of a substantial number of protein and/or hormonal substances. Only relatively recently, however, have investigators begun to identify which of these supposed markers may actually be clinically useful. A picture is thus gradually emerging of a number of markers (in actual fact only very few) which are already clinically useful, as well as others which are clinically promising and numerous markers which require more thorough clinical evaluation.