Minerva anestesiologica Journal Impact Factor & Information

Journal description

The journal Minerva Anestesiologica publishes scientific papers on anesthesiology, resuscitation, analgesia and intensive care. Frequency: Monthly. Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation, and Intensive Care.

Current impact factor: 2.27

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 2.272
2012 Impact Factor 2.818
2011 Impact Factor 2.656
2010 Impact Factor 2.581
2009 Impact Factor 1.614
2008 Impact Factor 1.627

Impact factor over time

Impact factor
Year

Additional details

5-year impact 2.12
Cited half-life 3.00
Immediacy index 0.61
Eigenfactor 0.00
Article influence 0.41
Website Minerva Anestesiologica website
ISSN 1827-1596

Publications in this journal

  • Minerva anestesiologica 07/2015;
  • Minerva anestesiologica 04/2015;
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    ABSTRACT: This study compares the performance of the McGrath MAC and King Vision laryngoscope systems for endotracheal intubation in adult patients with predicted normal airways when used by experienced laryngoscopists with limited prior video laryngoscopy experience. The study is a randomized controlled trial in a general adult operating suite at an academic medical center in the South Eastern United States. Sixty--six adult surgical patients with predicted easy intubation were enrolled and randomized to undergo endotracheal intubation withì either the McGrath MAC video laryngoscope or the King Vision video laryngoscope using the channeled blade attachment. The primary outcomes were success on first attempt and time of intubation. The laryngoscopic view, lowest observed oxygen saturation; number of attempts, assist maneuvers, and documented airway trauma events were also recorded. The median time for successful intubation was shorter in the McGrath MAC group compared to the King Vision group (17 vs. 38 seconds; p<0.001). There was a higher first attempt success rate in the McGrath MAC group compared to the King Vision group (100% vs. 89%, P<0.01). Also, more patients in the King Vision group had an oxygen desaturation below 90% compared to the McGrath MAC group (3 vs. 0; p< 0.034). There were no significant differences between groups in laryngoscopic view, number of attempts, requirement for assist maneuvers, or airway trauma. The McGrath MAC video laryngoscope allowed for significantly shorter times to endotracheal intubation, higher success rates on first attempt, and fewer desaturations compared to the King Vision video laryngoscope when used by experienced laryngoscopists with limited prior video laryngoscopy experience.
    Minerva anestesiologica 04/2015;
  • Minerva anestesiologica 04/2015;
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    ABSTRACT: The use of low tidal volume ventilation and low to moderate PEEP levels is a widespread strategy to ventilate patients with non injured lungs during general anesthesia and in intensive care as well with mild to moderate acute respiratory distress syndrome (ARDS). Higher PEEP levels have been recommended in severe ARDS. Due to the presence of alveolar collapse, recruitment maneuver (RMs) by causing a transient elevation in airway pressure (i.e. transpulmonary pressure) has been suggested to improve the lung inflation in the not and in the poor inflated lung regions. Various type of RMs such as sustained inflation at high pressure, intermittent sighs and stepwise increases of PEEP and/or airway plateau inspiratory pressure have been proposed. The use of RMs has been associated with mixed results in terms of physiological and clinical outcomes. The optimal method for RMs has not yet been identified. The use of RMs is not standardized and left to the individual physician experience. Similarly to ARDS patients, RMs have been proposed to improve lung aeration during general anesthesia. Aim of this clinical review is to present the clinical evidence of RMs in patients during general anesthesia and with ARDS and as well their potential biological effects in experimental models of acute lung injury.
    Minerva anestesiologica 04/2015;
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    ABSTRACT: Surveillance cultures are essential in the management of infection in the intensive care unit. They are crucial in the assessment of the efficacy of selective digestive decontamination.
    Minerva anestesiologica 04/2015;
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    ABSTRACT: To assess the long--term physical and psychological disabilities and their economic impact in severe trauma survivors. adult patients with ISS>15 and AIS ≤3 admitted to the ICU of a Level 1 trauma centre in the Lazio Region and discharged alive from hospital underwent a structured interview 12--24 months after the event. Self--reported somatic symptoms, autonomy, anxiety and depression were evaluated using a Likert--type scale, Barthel index and Hospital Anxiety and Depression Score (HADS), respectively. Patients' working and economic status were also investigated. A total of 32/58 patients matching the inclusion criteria were included in the final analysis. Eighteen patients (56%) reported at least a partial restriction in daily activities. Most common symptoms included muscle or joint pain, fatigue, and headache. All patients were receiving rehabilitation 1--2 years after the event. Fifty--eight percent of the patients spent more than €3600/year from their family budget for rehabilitation and medical care, however only 25% were receiving financial support from regional social services and 44% were unemployed at the time of the interview. Thirty patients (94%) had HADS depression score ≥11. survivors of severe trauma in our cohort had limited autonomy and need long--term rehabilitation. Most of them rely on private healthcare services with a significant financial impact on their family budget. Almost all patients had moderate to severe depression. Future post--ICU counseling services should facilitate access to rehabilitation and psychological support for these patients.
    Minerva anestesiologica 04/2015;
  • Minerva anestesiologica 04/2015;
  • Minerva anestesiologica 04/2015;
  • Minerva anestesiologica 04/2015;
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    ABSTRACT: Robertson et al. ( JAMA 2014; 312:36--47) investigated the effects of two different thresholds of hemoglobin (Hb) to guide red blood cells transfusions (RBCT; 7 g/dL vs. 10 g/dL) in patients suffering from traumatic brain injury (TBI). In a t wo--center, controlled, open--label trial (from May 2006 and August 2012), comatose patients with a closed TBI were randomized within 6 hours since initial resuscitation to one of the two RBCT strategies and, in a factorial design (2x2), to receive erythropoietin (EPO) or placebo. Patients were excluded if they had a Glasgow Coma Scale (GCS) score of 3 with fixed and dilated pupils, penetrating trauma, pregnancy, life--threatening systemic injuries and severe preexisting diseases. A total of 200 patients (7 g/dL with [n=49] or without EPO [n=50]; 10 g/dL with [n=53] or without EPO [n=48]) were enrolled among 598 who were screened. There was no interaction between EPO and Hb thresholds on the primary outcome, which was the occurrence of favorable neurological outcome, assessed using the Glasgow Outcome Scale (GOS) at 6 months after the injury (favorable = GOS 4--5). Favorable outcome was similar between patients included in the 7g/dL (37/87 - 43%) and the 10g/dL group (31/94 - 33%) as if receiving EPO or placebo, even after adjustment for several covariates. Thromboembolic events were significantly more frequent in the group transfused at 10 g/dL (22/101 [22%] vs. 8/99 [8%]; p = 0.009). We discussed how theses results might influence the management of such patients as well as the methodological limitations that underline the need for further investigations.
    Minerva anestesiologica 03/2015;
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    ABSTRACT: Brain injury is frequently observed after sepsis and may be primarily related to the direct effects of the septic insult on the brain (e.g. brain edema, ischemia, seizures) or to secondary/indirect injuries (e.g. hypotension, hypoxemia, hypocapnia, hyperglycemia). Management of brain injury in septic patients is first focused to exclude structural intracranial complications (e.g. ischemic/hemorrhagic stroke) and possible confounders (e.g. electrolyte alterations or metabolic disorders, such as dysglycemia). Sepsis--associated brain dysfunction is frequently a heterogeneous syndrome. Despite increasing understanding of main pathophysiologic determinants, therapy is essentially limited to protect the brain against further cerebral damage, by way of "simple" therapeutic manipulations of cerebral perfusion and oxygenation and by avoiding over--sedation. Non--invasive monitoring of cerebral perfusion and oxygenation with transcranial Doppler (TCD) and near--infrared spectroscopy (NIRS) is feasible in septic patients. Electroencephalography (EEG) allows detection of SAE--related seizures and holds promise also as sedation monitoring. Brain CT--scan detects intra--cerebral structural lesions, while magnetic resonance imaging (MRI) provides important insights into primary mechanisms of sepsis--related direct brain injury, (e.g. cytotoxic vs. vasogenic edema) and the development of posterior reversible encephalopathy. Together with EEG and evoked potentials (EP), MRI is also important for coma prognostication. Emerging clinical evidence suggests monitoring of the brain in septic patients can be implemented in the ICU. The objective of this review is to summarize recent clinical data about the role of brain monitoring - including TCD, NIRS, EEG, EP, CT, and MRI - in patients with sepsis and to illustrate its potential utility for the diagnosis, management and prognostication.
    Minerva anestesiologica 03/2015;
  • Minerva anestesiologica 03/2015;
  • Minerva anestesiologica 03/2015;
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    ABSTRACT: A rehabilitation program, a multimodal strategy favoring rapid postoperative return to autonomy, has rarely been undertaken after thoracic surgery compared to colectomy. The primary outcome of this fast--track program was the length of postoperative stay. Secondary outcomes concerned the feasibility of this strategy, the incidence of postoperative complications and 3--month postoperative mortality. Patients were included in this prospective single--center observational study if they were scheduled for lung resection (lobectomy or wedge resection) performed by postero--lateral thoracotomy. The rehabilitation program, coordinated by a referent nurse, included a list of actions to be done, especially early feeding and ambulation, multimodal analgesia including epidural analgesia, early removal of chest tube. One hundred and two patients were included in total with two exclusions (failure of epidural analgesia). The postoperative hospital stay was 8[7 - 10] days (median[25th-75th percentiles]); this duration was similar to that of the historical cohort which was 9[7--13] days (P = 0.06). Most actions were conducted with a high level of acceptance except for the insertion of a single chest tube (19%) and its removal later than expected in the program. Only 50% of patients left hospital shortly after exit criteria were met suggesting failure in the organization. Patients' satisfaction rate reached 77% and no postoperative death was reported during the follow--up period. A program for early rehabilitation is feasible after thoracotomy. Chest drainage and organization to optimize the length of stay are crucial points.
    Minerva anestesiologica 03/2015;
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    ABSTRACT: Statin use prior to cardiac surgery has been reported to improve outcomes in the postoperative period because of other effects apart from decreasing lipid levels. To analyse mortality and acute renal failure (ARF) during the cardiac surgery postoperative period in patients treated with or without statins. This prospective cohort study comprised adult patients who underwent cardiac surgery at 11 institutions in the Andalusian community from March 2008 to July 2012 included in the ARIAM adult cardiac surgery project. We performed a first analysis in the whole cohort and in a second analysis statin users prior to surgery were pair matched with non-users according to their propensity score based on demographics, comorbidities, medication and surgical data. We analysed differences in outcomes, ARF, need for renal replacement therapy (RRT) and a composite end point with mortality or major morbidity in both groups. The study included 7276 patients, of whom 3749 were treated with statins. Overall, hospital mortality was 10.1%, 10.5% developed ARF and 2.5% required RRT. In the whole non-matched cohort, statins were associated with lower hospital mortality (OR 0.70; 95% CI, 0.67-0.93) and less ARF (OR 0.79; 95% CI, 0.68-0.93). However, after propensity score analysis in the matched cohort of 3056 patients (1528 in each group), statin use was not consistently associated with less ARF (OR 0.94; 95% CI, 0.74-1.19), hospital mortality (OR 0.83; 95% CI, 0.68-1.1) or composite outcome (OR 0.857; 95% CI, 0.723-1.015). Despite better outcomes for the statin users in the whole cohort, the matched analysis showed that statin use before cardiac surgery was not associated with a lower risk of ARF. Nor was pre-surgery statin use associated with lower hospital mortality.
    Minerva anestesiologica 03/2015;
  • Minerva anestesiologica 03/2015;
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    ABSTRACT: When patients are incompetent, advance directives (AD) can help physicians take crucial medical decisions. However, prevalence remains low. The objective was to investigate physicians' perspectives and attitudes towards AD in order to determine potential targets for improvement. Observational study by se lf--administered questionnaires to general practitioners and specialists potentially involved in the care of patients scheduled for major cardiovascular surgery in a Swiss canton. 1 64 (40%) questionnaires were completed. Men: 116 (71%). Specialties: I nternists : 73 (45%); General Practitioners : 50 (31%); Intensivists : 22 (13%); Cardiologists : 18 (12%). 138/162 (85%) physicians thought that AD were useful and 124/161 (77%) were ready to help patients write AD {to allow them to decide on their fate [115/124 (93%)] and to increase their ease in expressing their wishes [108/124 (87%)]}. Men and cardiologists were least likely to do so. Factors associated with lower interest in promoting AD were not logistical but personal such as "the topic can induce fear {21/34 (62%)} or unease [16/34 (47%)], and lack of knowhow [15/34 (44)]". 22/160 (14%) physicians had never heard about AD, especially men. Not all physicians knew the concept of AD. The majority thought that AD were useful and would help patients write them, in order to respect their autonomy. Personal--related factors such as feelings of inducing fear or harm patients were more important than logistic factors in impeding the promotion of AD. Emphasizing AD during medical school might present a potential target to increase AD prevalence, particularly in the preoperative setting.
    Minerva anestesiologica 02/2015;
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    ABSTRACT: Augmented renal clearance (ARC) or renal hyperfiltration is increasingly reported in intensive care unit (ICU) patients. The goal of this analysis was to study the epidemiology of ARC in a cohort of mixed ICU patients. Single center retrospective cohort study of adult ICU patients (12/2008--2/2010). When data were available, urinary creatinine clearance (CL CR ) was calculated for all patients throughout their ICU stay. ARC was defined as a body surface adjusted CL CR ≥130 mL/min/1.73m 2 . We sought to study the incidence of ARC and identify patient characteristics associated with ARC. A total of 1081 patients were included in the analysis, generating 4472 ICU patient days. Median age was 62 y (IQR 50--72), and 63% were male. The initial CL CR was 86 (39--151) mL/min and the maximal CL CR was 145 (76--237) mL/min. ARC occurred in 55.8% of patients, and was about as frequent in men and women (37%% vs. 35%%, p = 0.73). Patients with ARC were younger (57 vs. 67 years, p<0.001) and were less frequently treated with vasopressors (37% vs. 39%, p<0.01). ARC incidence was 36.6 ARC days per 100 ICU days. ARC throughout the ICU stay occurred in 32.8% of patients. ARC was a frequent finding in this cohort of ICU patients, with more than half of the patient expressing ARC at least once during their ICU stay, and an incidence of 36.6 ARC days/100 patient days.
    Minerva anestesiologica 02/2015;