Impact of enhanced recovery program on clinical outcomes after elective colorectal surgery in a rural hospital. A single center experience.

Background: The main purpose was to determine the impact on postoperative outcomes of a standardized enhanced recovery program (ERP) for elective colorectal surgery in a rural hospital.

Methods: A prospective series of patients (N = 80) undergoing elective colorectal resection completing a standardized ERP protocol in 2018-2020 (ERP group) was compared to patients (N = 80) operated at the same rural hospital in 2013-2015 (pre-ERP group), before the implementation of the program. The exclusion criteria for both groups were: ASA score IV, TNM stage IV, inflammatory bowel disease, emergency surgery, and rectal cancer.

SARS-CoV-2 viremia and COVID-19 mortality: A prospective observational study.

Background: SARS-CoV-2 viremia has been found to be a potential prognostic factor in patients hospitalized for COVID-19.

Objective: We aimed to assess the association between SARS-CoV-2 viremia and mortality in COVID-19 hospitalized patients during different epidemic periods.

Methods: A prospective COVID-19 registry was queried to extract all COVID-19 patients with an available SARS-CoV-2 viremia performed at hospital admission between March 2020 and January 2022.

Risks of COVID-19 transmission in blood and serum during surgery A prospective cross-sectional study from a single dedicated COVID-19 center.

The present pandemic caused by the SARS COV-2 coronavirus is still ongoing, although it is registered a slowdown in the spread for new cases. The main environmental route of transmission of SARS-CoV-2 is through droplets and fomites or surfaces, but there is a potential risk of virus spread also in smaller aerosols during various medical procedures causing airborne transmission. To date, no information is available on the risk of contagion from the peritoneal fluid with which surgeons can come into contact during the abdominal surgery on COVID-19 patients.

Which dimension of parenting predicts the change of callous unemotional traits in children with disruptive behavior disorder?

Objective: Several studies suggested that in addition to child-driven factors (i.e., temperamental style), parenting behavior can, at least in part, influence the maintenance of Callous Unemotional (CU) traits in children; however, more information is needed to distinguish which styles (negative parenting or lack of positive parenting) predict increased levels of CU traits.

Responsiveness to intravenous administration of salbutamol in chronic obstructive pulmonary disease patients with acute respiratory failure.

Objective: In chronic obstructive pulmonary disease (COPD) patients with acute respiratory failure (ARF), bronchodilating agents administered by inhalation have, in general, little effect on dynamic hyperinflation and concurrent static intrinsic positive end-expiratory pressure (PEEPi,st). Since in COPD the severely obstructed segments of the lung may not be reached by inhaled medication, we reasoned that drug efficiency may be enhanced by intravenous administration of the agent.

Design: Physiological study.

Predictors of weaning outcome in chronic obstructive pulmonary disease patients.

Several threshold values for predicting weaning outcome from mechanical ventilation have been proposed. These values, however, have been obtained in nonhomogeneous patient populations. The aim of the present study was to determine the threshold values in chronic obstructive pulmonary disease (COPD) patients and compare them to those reported for nonhomogeneous patient populations.

Respiratory mechanics during and after anaesthesia for major vascular surgery.

To evaluate the effects of major vascular surgery on respiratory mechanics, 11 patients undergoing general anaesthesia for abdominal aortic surgery were studied. Before aortic cross-clamping, chest wall elastance and resistance both increased (by 126% and 58%, respectively) when surgical retractors were placed. After aortic cross-clamping, lung elastance increased by 29%, accompanied by a decrease in cardiac index (22%) and an increase in pulmonary (17%) and systemic (15%) vascular resistance.

Respiratory effects of pharingeal gas insufflation in patients with chronic obstructive pulmonary disease.

Objective: To evaluate the effects of pharyngeal gas insufflation (PGI) in clinically stable patients with chronic obstructive pulmonary disease (COPD).

Design: Prospective study in humans.

Setting: Department of Intensive Care Medicine at a University Hospital.

Additional inspiratory resistance imposed by the laryngeal mask airway: in vitro versus in vivo comparison.

The present study was designed: (a) to compare the additional inspiratory laryngeal mask airway (LMA) resistance measured in vitro during simulated ventilation and in vivo in five anaesthetised and mechanically ventilated patients; and (b) to evaluate the resistive pressure drop along the length of the LMA. After the differential pressure across the mask was measured, the pressure-flow relationship was characterised by Rohrer's equation and in vitro and in vivo resistance was calculated. Thereafter, the distal pressure measuring point was moved along the length of the LMA and differential pressure was measured at each point under in vitro and in vivo conditions.

[Survival in intensive care of patients with chronic obstructive bronchopneumopathy and acute respiratory failure undergoing mechanical ventilation. Retrospective study].

Objective: To collect valuable informations for the evaluation of the patients' clinical evolution and to perform a cost-effectiveness analysis on the utilization of resources in the management of patients with chronic obstructive pulmonary disease (COPD) undergoing mechanical ventilation (MV) for acute respiratory failure (ARF).

Setting: General ICU. University Hospital.

[Complete neurological recovery following prolonged cardiac arrest. Description of a clinical case].

We report a case of protracted intraoperative cardiac arrest (15 minutes), occurring in a patient with haemorrhagic shock in consequence of a bullet wound to the right hemithorax; external cardiac massage was immediately started and carried on until the restoration of spontaneous cardiac activity. In the immediate postoperative period, the patient presented seizure activity, treated with TPS in continuous infusion (2 mg/kg/h) and DPH (250 mg/die). Anticonvulsant therapy didn't allow a correct neurologic evaluation of the patient; that was possible only when treatment was suspended (4 days after ICU admission).

[Intraoperative fluid administration and severity of the clinical condition].

Fluid overload has been recently suggested to influence morbidity. The aim of this study was to investigate the relationship between the amount of fluid given in the operative room and the severity of illness, which is known to be different in scheduled and emergency surgery. We prospectively studied 78 surgical patients consecutively admitted to our Intensive Care Unit (ICU).

[Transplantation of the left lung in a 2-month-old piglet. The Study Group for Lung Transplantation].

Experimental surgery in animals remains an irreplaceable model for the clinical application of a new technique. We performed a single lung allotransplantation in young pigs. The pigs were organized into groups: 1) 6 to assess the surgical anatomy; 2) 10 to receive left transplantation; 3) 3 to study the pathophysiology of the transplanted lung.