principles of anesthesia for medical students speaker:landoni g vita-salute university of milano may...
TRANSCRIPT
![Page 1: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/1.jpg)
Principles of anesthesia for Principles of anesthesia for medical studentsmedical students
Speaker:Speaker: Landoni GLandoni G Vita-Salute University of MilanoVita-Salute University of Milano
May 14° 2009May 14° 2009
IRCCS Ospedale San Raffaele MilanoIRCCS Ospedale San Raffaele MilanoUniversità Vita-Salute San RaffaeleUniversità Vita-Salute San Raffaele
![Page 2: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/2.jpg)
ITACTA ONGOING RCTsTOPICS HOSPITALS PATIENTS GRANTS
VOLATILE ANESTHETICS
FENOLDOPAM
DESMOPRESSIN
ESMOLOL LEVOSIMENDAN VALVOLE PERCUTANEE
4 200 AIFA 2006
34 1.000 MINISTRY 2008
3 200
3 200 10 1.000 3 150
![Page 3: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/3.jpg)
![Page 5: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/5.jpg)
HSR
100 ANESTHESIOLOGISTS30 students/residents (6 per year)
![Page 6: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/6.jpg)
![Page 7: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/7.jpg)
Clinical dutiesResearchTeachingCongresses(developing countries)
![Page 8: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/8.jpg)
Anesthesiology (US)
Anesthesiologists are physicians that administer anesthetics to alleviate pain and suppress consciousness, as well as monitor and support life functions during surgery. They also provide medical care and consultation outside the operating room and participate in the diagnosis and treatment of pain syndromes.
![Page 9: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/9.jpg)
CLINICAL DUTIES (ITALY)
ANESTHESIAINTENSIVE CAREEMERGENCY DEPARTMENTIN-HOSPITAL EMERGENCYOUT-OF-HOSPITAL EMERGENCIESHYPERBARIC MEDICINEPAIN THERAPY
![Page 10: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/10.jpg)
CLINICAL DUTIES (ITALY)
ANESTHESIA
![Page 11: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/11.jpg)
![Page 12: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/12.jpg)
![Page 13: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/13.jpg)
IPNOSISMUSCLE RELAXATIONPAIN(REFLEXES)
![Page 14: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/14.jpg)
CLINICAL DUTIES (ITALY)
ANESTHESIAINTENSIVE CARE
![Page 15: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/15.jpg)
![Page 16: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/16.jpg)
NEUROLOGIC STATUSLUNGSCARDIOVASCULARKIDNEYSDRUGS
![Page 17: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/17.jpg)
CLINICAL DUTIES (ITALY)
ANESTHESIAINTENSIVE CAREEMERGENCY DEPARTMENTIN-HOSPITAL EMERGENCYOUT-OF-HOSPITAL EMERGENCIES
![Page 18: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/18.jpg)
![Page 19: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/19.jpg)
BLSALSATLS
![Page 20: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/20.jpg)
INVASIVE PROCEDURES
Hai mai utilizzato un vero defibrillatore manuale? Si No 97% Hai mai utilizzato un vero defibrillatore semi-automatico? Si No 94% Hai mai effettuato una cardioversione sincronizzata? Si No 95%
Hai effettuato la gestione di base delle vie aeree (apertura delle vie aeree, estensione del capo, posizionamento cannula orofaringea)? Si No 81%
Hai effettuato la gestione avanzata delle vie aeree (intubazione orotracheale, posizionamento maschera laringea)? Si No 88%
Hai effettuato una cricotiroidotomia? Si No 100%
Hai effettuato una ventilazione manuale con pallone autoespansibile (“Ambu”)? Si No 70%
![Page 21: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/21.jpg)
Department of Cardiothoracic and Vascular Anesthesia and Intensive Care
Vita-Salute San Raffaele University, Milan, Italy
INTRA AORTIC BALLOON PUMP
![Page 22: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/22.jpg)
Hai posizionato un’agocannula venosa? Si No 39% Hai effettuato un prelievo venoso? Si No 0% Hai effettuato un prelievo arterioso (emogasanalisi)?
Si No 9%
1. Hai effettuato una rachicentesi? Si No 99% Hai posizionato un sondino naso-gastrico? Si No 73% Hai effettuato una paracentesi? Si No 95% Hai posizionato un drenaggio toracico? Si No 99% Hai effettuato una pericardiocentesi? Si No 100%
![Page 23: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/23.jpg)
Hai effettuato esercitazioni di rianimazione cardiopolmonare? Si No 69% ( 0%)
Hai effettuato esercitazioni sull’esame del paziente adulto in rapido peggioramento?
Si No 87% Hai effettuato esercitazioni di valutazione e assistenza al paziente
critico pediatrico? Si No 81%
Ti senti adeguatamente preparato per una prima valutazione ed assistenza ad un paziente critico?
Si No 82%
![Page 24: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/24.jpg)
Clinical dutiesResearch (ENGLISH)TeachingCongresses(developing countries)
![Page 25: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/25.jpg)
Levosimendan and Mortality in Cardiac Surgery
Review: LEVOSIMENDAN CCH (12/1/2009)Comparison: 01 perioperative levosimendan Outcome: 02 Mortality
Study Levosimendan Control Peto OR Peto ORor sub-category n/N n/N 95% CI 95% CI
Al-Shawaf 1/14 1/16 1.15 [0.07, 19.41] Alvarez 2005 1/15 0/15 7.39 [0.15, 372.38] Alvarez 2006 1/25 1/25 1.00 [0.06, 16.45] Barisin 0/21 0/10 Not estimable De Hert 2007 0/15 3/15 0.12 [0.01, 1.22] De Hert 2008 1/40 4/20 0.11 [0.02, 0.72] Husedzinovic 0/12 0/12 Not estimable Jarvela 1/12 0/12 7.39 [0.15, 372.38] Levin 6/69 17/68 0.31 [0.13, 0.77] Tritapepe 0/12 0/12 Not estimable
Total (95% CI) 235 205 0.35 [0.18, 0.71]Total events: 11 (Levosimendan), 26 (Control)Test for heterogeneity: Chi² = 8.27, df = 6 (P = 0.22), I² = 27.4%Test for overall effect: Z = 2.95 (P = 0.003)
0.001 0.01 0.1 1 10 100 1000
Favours levosimendan Favours control
![Page 26: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/26.jpg)
11/235=4.7% v 26/205=12.7% P=0.007 NNT = 12
Levosimendan and Mortality in Cardiac Surgery
![Page 27: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/27.jpg)
Journal
NEW ENGL J MED LANCET JAMA ANNALS OF INTERNAL MEDICINE CIRCULATION J AM COLL CARDIOL EUR HEART J CRITICAL CARE MEDICINE CLINICAL CHEMISTRY ANESTHESIOLOGY ANAESTHESIA ANALGESIA
Impact Factor 2006
51,325,823,214.8
10,99,77,36,65,54,22,1
![Page 28: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/28.jpg)
![Page 29: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/29.jpg)
![Page 30: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/30.jpg)
Cardioprotection & anaesthesia
Volatile AnestheticsVolatile Anesthetics
blockers “recommended”
Statins “suggested” in selected pts
2 agonists “may be considered” in selected pts
Ca++ antagonists “may be considered” in selected pts
Insulin “reasonable” in hyperglycaemic pts
Volatile Anesthetics “can be beneficial”
![Page 31: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/31.jpg)
Looking for evidence?
![Page 32: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/32.jpg)
![Page 33: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/33.jpg)
Every 1.000 patients receiving extended release METOPROLOL
PREVENTION OF 15 MYOCARDIAL INFARCTON PREVENTION OF 3 CABG PREVENTION OF 7 ATRIAL FIBRILLATION
![Page 34: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/34.jpg)
Every 1.000 patients receiving extended release METOPROLOL
EXCESS OF 8 DEATHS EXCESS OF 5 STROKE EXCESS 53 HYPOTENSION EXCESS 42 BRADICARDIA
![Page 35: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/35.jpg)
NON-RCT
![Page 36: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/36.jpg)
![Page 37: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/37.jpg)
![Page 38: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/38.jpg)
![Page 39: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/39.jpg)
![Page 40: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/40.jpg)
![Page 41: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/41.jpg)
![Page 42: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/42.jpg)
Name of the Hospital% mortality at 30 days
CLINICA SAN ROCCO - BRESCIA 0,26%
OSPEDALE SAN RAFFAELE MILANO 0,36%
PRESIDIO OSPEDALIERO "C. POMA" MANTOVA 0,48%
OSPEDALE CIVILE LEGNANO - MI 0,67%
OSPEDALE SANTA CROCE E CARLE CUNEO 1,15%
OSPEDALE S. CHIARA TRENTO 1,16%
NUOVO POLO CARDIOLOGICO - TRIESTE 1,22%
HESPARIA HOSPITAL S.R.L. MODENA 1,32%
![Page 43: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/43.jpg)
Clinical dutiesResearch (ENGLISH)TeachingCongressesDEVELOPING COUNTRIES
![Page 44: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/44.jpg)
![Page 45: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/45.jpg)
![Page 46: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/46.jpg)
![Page 48: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/48.jpg)
AWARENESS
![Page 49: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/49.jpg)
Are you still with me?
All of you?
![Page 50: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/50.jpg)
WHERE DID IT ALL START?
![Page 51: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/51.jpg)
![Page 52: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/52.jpg)
![Page 53: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/53.jpg)
![Page 54: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/54.jpg)
![Page 55: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/55.jpg)
![Page 56: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/56.jpg)
![Page 57: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/57.jpg)
![Page 58: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/58.jpg)
![Page 59: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/59.jpg)
![Page 60: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/60.jpg)
ITACTA ONGOING RCTsTOPICS HOSPITALS PATIENTS GRANTS
VOLATILE ANESTHETICS
FENOLDOPAM
DESMOPRESSIN
ESMOLOL LEVOSIMENDAN VALVOLE PERCUTANEE
4 200 AIFA 2006
34 1.000 MINISTRY 2008
3 200
3 200 10 1.000 3 150
![Page 61: Principles of anesthesia for medical students Speaker:Landoni G Vita-Salute University of Milano May 14° 2009 IRCCS Ospedale San Raffaele Milano Università](https://reader036.vdocument.in/reader036/viewer/2022070312/5542eb4b497959361e8b88d8/html5/thumbnails/61.jpg)
For these and further slides on these topics please feel free to visit the
metcardio.org website:
http://www.metcardio.org/slides.html