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Biomedical subjects

G Manani

Publications and source records attributed to G Manani.

At least 19 recordsLinked to original sources
PubMed2001

[Prevalence of nosocomial infections in Intensive Care Units in Triveneto area, Italy].

BACKGROUND: Nosocomial infection is one of the most common complications affecting patients admitted in intensive care units (ICU). The aim of this study is to evaluate rates of ICU-acquired infections, potential risk factors for these infections, causative microorganisms and antibiotic resistance patterns. METHODS: A 1-day point-prevalence study was conducted in 39 ICUs in Triveneto area (Italy) in November 1998. The overall study population included 188 patients with mean age of 61.4+/-19.3 years; the mean SAPS II score at entry into the ICU was 44.4+/-16.8 and the median duration of hospitalization was 9 days (range 2-636). RESULTS: A total of 59 patients (31.4%) had 79 episodes of ICU-acquired infections; pneumonia (45.5%), bloodstream infection (30.4%), and urinary tract infection (11.4%) were the most frequent types of infection. The leading causative microorganisms were S. aureus (24.4%, 77% of them were resistant to methicillin), Enterobacteriaceae (24.4%), P. aeruginosa (23.2%), fungi (12.2%), coagulase-negative staphylococci (7.3%) and Enterococcus spp (4.9%). Independent risk factors for nosocomial infections were duration of hospitalization >7 days (OR 4.29, 95% CI 1.82-10.1), SAPS II score >30 (OR 3.34, 95% CI 1.0-11.18), total parenteral nutrition (OR 2.69, 95% CI 1.19-6.07) and tracheostomy (OR 1.88, 95% CI 0.84-4.20). CONCLUSIONS: Nosocomial infections are relatively frequent in Triveneto area ICUs. The predominance of pneumonia and bloodstream infection, and the high frequency of antibiotic-resistant pathogens indicate that resources had to be assigned towards the implementation of control programs of those infections, monitoring of antibiotic resistance and prescription, and antibiotic therapy guidelines.

Adolescent↗
PubMed1996

Respiratory depression following administration of low dose buprenorphine as postoperative analgesic after fentanyl balanced anaesthesia.

Opioids 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.

Analgesics, Opioid↗
PubMed1995

Prevalence of unsuspected myopathy in infants presenting for clubfoot surgery.

The objective of this study was an evaluation of the prevalence of myopathies in paediatric patients scheduled for orthopaedic surgery (clubfoot) performed under regional anaesthesia. Seventeen infants scheduled for lower limb orthopaedic surgery were studied to verify coexisting neuromuscular disorders with electromyography and muscle biopsy during surgery. All surgical procedures were performed under caudal block or spinal anaesthesia, associated with light general anaesthesia. No major cardiorespiratory, neurological or malignant hyperthermic complications (muscle rigidity, arrhythmias, hyperpyrexia) were observed. Combined neurological, electromyographic and biopsy studies showed a high rate of myopathic changes (70%). Performance of clubfoot surgery under light general anaesthesia with regional techniques was free from any problems. The high rate of myopathic changes (70%) observed in the muscle biopsies suggests that precautions should be taken with paediatric patients for clubfoot surgery and a regional anaesthesia technique with adequate monitoring may be helpful to prevent possible malignant hyperthermia related problems.

Anesthesia, Conduction↗
PubMed1995

[Influence of droperidol on the hypnotic effect of thiopental].

We studied the effect of DBP on thiopentone hypnosis in 580 patients aged 20 to 30 and 560 patients aged 40 to 50. The hypnotic effect of thiopentone was evaluated after 5, 15, 30, 45 and 60 minutes from intravenous administration of 0.05 mg.kg-1 of DBP by using dose-effect curves to identify the ED50 dose. The ED50 value of thiopentone decreased up to 15 minutes after DBP (about 1.1 mg.kg-1 in both age groups) and increased after 30, 45 and 60 minutes, the increase being higher in the patients aged 40 to 50. We concluded that DBP has a synergic effect with thiopentone and the pharmacokinetic and alpha 1-lytic effects of DBP are responsible of an increased need of barbituric in the patients aged 40 to 50.

Adjuvants, Anesthesia↗
PubMed1992

Interaction between thiopentone and subhypnotic doses of ketamine.

The hypnotic effects of thiopentone and ketamine were studied in ASA Grade I female patients aged 20-30 without premedication. The dose-response curves of ketamine 0.4 mg kg-1 and thiopentone following ketamine 0.4 mg kg-1 were determined by probit analysis. The interaction between ketamine and thiopentone was found to be an antagonistic one. This effect can be interpreted as a consequence of the different neurophysiological spectra of action of the two drugs.

Adult↗
PubMed1989

Clinical uses of high frequency jet ventilation in anaesthesia.

Since 1981, high frequency jet ventilation (HFJV) has been used in 300 patients undergoing surgery, most commonly during i.v. general anaesthesia for endoscopy and surgery of the airways: laryngoscopy, bronchoscopy, laryngeal microsurgery and laser surgery (more than 230 patients); repair of tracheal stenosis, tracheal sleeve pneumonectomy and tracheal sleeve lobectomy. HFJV was administered through a narrow injection catheter inserted in the airway, with a second rigid catheter positioned distally to the injector in the airway for gas sampling and measurement of airway pressure. In all subjects gas exchange was satisfactory, even during tracheoplasty and bronchoplasty.

Adolescent↗
PubMed1989

Measurement of the flow-resistive properties of double-lumen bronchial tubes in vitro.

This study measures the resistance to gas flow of different double-lumen bronchial tubes used for separate ventilation of each lung in critically ill patients. Different-sized Robertshaw and Carlens' tubes were studied, as well as a new device that consisted of a cuffed bronchial catheter introduced through a standard tracheal tube. The pressure-flow relationship was curvilinear in all cases. Robertshaw and Carlens' tubes were generally found to have bronchial and tracheal channels with almost similar resistance and offered total resistances similar to those of 7.0-8.0 mm internal diameter tracheal tubes. The new device had a higher resistance than others of equal external diameter. This must be taken into account when its use is recommended for prolonged respiratory support.

Airway Resistance↗
PubMed1987

[Anesthesia and nanism. Apropos of 2 cases].

The authors describe the favourable outcome of general anaesthesias in a female patient with achondroplastic dwarfism and in another patient with dystrophic dwarfism. In the first patient the gall-bladder was removed and a plastic reconstruction of the diaphragm was carried out. In the second patient a Girdlestone's operation was performed. The difficulty of intubation of the dystrophic dwarf due to stiffness of the cervical spine suggested a procedure of intubation under fibroscopy. The doses of agents and the size of the tracheal tubes were calculated on the basis of the patients weight and the controlled ventilation was carried out after determining the current volume and the respiratory frequency in the awaken patient.

Achondroplasia↗
PubMed1985

[Cardiocirculatory responses to tracheal intubation in the heart patient].

Laryngo-tracheal nebulization with 10% lidocaine was performed in 10 patients undergoing cardiosurgery for substitution of mitral valve, five min. before induction of anesthesia with 0.007 mg . kg-1 of Fentanyl. Hemodynamic studies of these cases were compared to similar observations without nebulization. It appears tha laryngotracheal lidocaine nebulization reduces circulatory disturbances and attenuates the adrenosympathetic response to intubation.

Aerosols↗