The use of fiberoptic bronchoscopy during percutaneous dilatational tracheostomy with laryngeal mask.

UNLABELLED: The aim of our research is to evaluate the advantage by the combined use of fiberoptic bronchoscopy and laryngeal mask during the performance of percutaneous dilatational tracheostomy in an intensive care unit. PATIENTS: 16 adult patients who were candidates to middle-long term mechanical ventilation. ENVIRONMENT: Intensive Care Unit of a Community General Hospital. RESULTS: We experienced 3 minor complications (2 minor bleedings and 1 neck emphysema). Difficulties were found in 3 patients with particular anatomical conformation (obese patients with short neck and limited mobility of the cervical spine). CONCLUSION: The combined use of fiberoptic tracheo-bronchoscopy with the laryngeal mask permits a better endoscopic visualisation of the operatory field, providing a more secure and precise procedure.

[Abdominal aortic aneurysm ruptured into the inferior vena cava. Presentation of a clinical case. Review of the literature]. / Aneurisma dell'aorta addominale rotto in vena cava inferiore. Presentazione di un caso clinico. Revisione della letteratura.

Rupture of the major veins is a rare complication of abdominal aortic aneurysms and is generally followed by sudden haemodynamic changes, whose importance is strictly dependent on the size of the fistula and rapidity of onset. The final result is invariably hyperdynamic congestive heart failure, oligoanuria and hyperazotemia, expression of renal insufficiency. Early recognition and surgical operation, together with appropriate postoperative intensive care, are the key for successful treatment of aorto-caval fistulas. Despite the improvement of surgical and anaesthesiology techniques, operative mortality rate still remains elevated (36%), but not higher than in other abdominal aortic aneurysms ruptures. The aim of this paper is to review the literature and to report one case of a seventy-year-old patient affected by an aorto-caval fistula and successfully treated in our Surgery Division.

[Hyperbaric oxygen therapy in acute carbon monoxide poisoning. Illustration of a treatment protocol]. / L'ossigenoterapia iperbarica nell'avvelenamento acuto da monossido di carbonio. Illustrazione di un protocollo di trattamento.

After a brief digression on the etiopathogenesis of carbon monoxide poisoning, the paper underlines the importance of the timely use of hyperbaric oxygen treatment not only to impede the immediate effects of CO, but also to reduce the incidence of neurological complications. The paper illustrates the paroxysm protocol and hyperbaric oxygen treatment protocol used by the Authors.

[Nimesulide in the treatment of postoperative pain in minor orthopedic surgery]. / La nimesulide nel trattamento del dolore postoperatorio in chirurgia ortopedica minore.

The study assesses the effect of Nimesulide in the treatment of post-operative pain in minor orthopedic surgery. Twenty-five patients who had received regional peridural or subarachnoid anesthesia were included in the study. After a variable interval of 60 to 90 minutes, the average level of pain, evaluated using a "pain score", was considerably reduced. This effect lasted for an average of 360 +/- 120 minutes. There were minimum side-effects.