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Biomedical subjects

E Gualtieri

Publications and source records attributed to E Gualtieri.

15 recordsLinked to original sources
PubMed1995

Subclavian venous catheterization: greater success rate for less experienced operators using ultrasound guidance.

OBJECTIVE: To determine if ultrasound guidance can be safely performed and improve success rates for subclavian venous catheterization performed by less experienced operators. DESIGN: Prospective, randomized study. SETTING: Twenty-bed trauma-surgical-medical intensive care unit in a 524-bed, community, tertiary care, teaching hospital. PATIENTS: After the decision for central venous cannulation was made, informed consent was obtained, and less experienced operators then attempted to insert subclavian catheters in 33 critical care patients. INTERVENTIONS: Catheter placements were attempted, either by landmark technique, ultrasound technique, or by landmark attempts with ultrasound salvage. Catheterization techniques to be used were randomized using a random number table. MEASUREMENTS AND MAIN RESULTS: Fifty-three placement procedures were attempted in 33 patients. One procedure was excluded from data analysis. Successful catheterizations, occurrence rates of complications, number of attempts, and number of catheter kits used were recorded. In the analysis, 52 catheterization procedures were studied. Twelve (44%) catheters were successfully placed from 27 attempts using the landmark technique vs. 23 (92%) successful catheterizations during 25 ultrasound procedures (p = .0003). Fifteen failed landmark technique attempts had ultrasound salvage attempted, with 12 (80%) catheters successfully inserted. Eleven complications (minor) occurred in 27 attempts of subclavian venous catheterization using conventional landmark technique vs. one complication (minor) in 25 attempts of subclavian venous catheterization with ultrasound guidance (p = .002). There were no major complications in either group. The landmark group required an average of 2.5 venipunctures and 1.4 catheter kits per attempted catheterization. The ultrasound group required an average of 1.4 venipuncture attempts and 1.0 insertion kit. The statistical significance in differences in groups for the average number of venipunctures was p = .0007 and average number of kits used was p = .0003. CONCLUSIONS: Ultrasound guidance improves the success rate of subclavian venous catheterization performed by less experienced operators. There were no major complications in either group. Ultrasound guidance is usually successful in allowing performance of subclavian venous catheterizations when landmark techniques fail.

Catheterization, Central Venous↗
PubMed1993

Intra-hospital transport of the anaesthetized patient.

This study evaluated the anaesthetic management of 20 patients, undergoing intra-operative radiation therapy for pancreatic or rectal tumours. Patients with a re-approximated surgical incision were transferred from the operating room to the radiotherapy department while still under anaesthesia. The risks of such transport as well as guidelines for the patient's care during this phase are examined. The results of this study indicate that in order to transport anaesthetized patients safely it is necessary to ensure stable cardiovascular, respiratory and metabolic conditions prior to their transfer. It is also important to guarantee adequate analgesia and to establish appropriate monitoring during transport.

Aged↗
PubMed1991

[Intraoperative radiotherapy: anesthesiologic problems during transport of patients].

In this study the condition of anesthesia in 8 patients, undergoing intraoperative radiation therapy (IORT) for pancreatic or rectal tumors, is evaluated. Patients with reapproximated surgical incision were transferred from the operating room to the radiotherapy department while still under anesthesia. The risks of such transport as well as guidelines for the patient's care during this phase are examined. The results of this study indicate that in order to move anesthetized patients safely it is necessary to ensure stable cardiovascular, respiratory and metabolic conditions prior to their transfer. It is also important to guarantee adequate analgesia and to establish appropriate monitoring during transport.

Anesthesia↗
PubMed1990

[The effects of nitrous oxide on evoked potentials recorded during enflurane and isoflurane anesthesia].

The effects on median nerve somatosensory evoked potentials produced by nitrous-oxide (67%) were studied in 20 patients undergoing elective surgery under enflurane or isoflurane anaesthesia. This study demonstrates that nitrous-oxide does not significantly modify spinal (N13) and cortical (N20) component latencies nor central conduction time. The addition of nitrous-oxide to enflurane or isoflurane (up to 1 MAC) causes a significant reduction of N20 amplitude.

Adult↗