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18 results on '"Tavola, M."'

1. Use of critical care resources during the first 2 weeks (February 24–March 8, 2020) of the Covid-19 outbreak in Italy

Author

Tonetti T., Grasselli G., Zanella A., Pizzilli G., Fumagalli R., Piva S., Lorini L., Iotti G., Foti G., Colombo S., Vivona L., Rossi S., Girardis M., Agnoletti V., Campagna A., Gordini G., Navalesi P., Boscolo A., Graziano A., Valeri I., Vianello A., Cereda D., Filippini C., Cecconi M., Locatelli F., Bartoletti M., Giannella M., Viale P., Antonelli M., Nava S., Pesenti A., Ranieri V. M., Albano G., Alborghetti A., Aldegheri G., Antonini B., Belgiorno N., Bellani G., Beretta E., Bonazzi S., Borelli M., Cabrini L., Carnevale L., Carnevale S., Castelli G., Catena E., Chiumello D., Coluccello A., Coppini D., Covello D., DeFilippi G., DeiPoli M., Dughi P., Gallioli G., Gnesin P., Greco S., Guatteri L., Guzzon D., Keim R., Landoni G., Langer T., Lombardo A., Marino G., Merli G., Merlo D., Mojoli F., Muttini S., Natalini G., Petrucci N., Pezzi A., Radrizzani D., Raimondi M., Riccio M., Storti E., Tavola M., Vitale G., Bosco E., Calo M. A., Danzi V., DeRosa S., Farnia A., Lazzari F., Meggiolaro M., Munari M., Saia M., Sella N., Serra E., Tiberio I., Baiocchi M., Benedetto M., Bordini M., Caramelli F., Cilloni N., DellaGiovampaola M., Fanelli A., Frascaroli G., Fusari M., Maitan S., Martino C., Melotti R. M., Merola R., Minardi F., Moro F., Nardi G., Nolli M., Pierucci E., Potalivo A., Repetti F., Salsi P., Terzitta M., Tosi M., Venturi S., Volta C. A., Zani G., Zanoni A (COVID-19 Northern Italian ICU Network), Landoni G, Tonetti, Tommaso, Grasselli, Giacomo, Zanella, Alberto, Pizzilli, Giacinto, Fumagalli, Roberto, Piva, Simone, Lorini, Luca, Iotti, Giorgio, Foti, Giuseppe, Colombo, Sergio, Vivona, Luigi, Rossi, Sandra, Girardis, Massimo, Agnoletti, Vanni, Campagna, Anselmo, Gordini, Giovanni, Navalesi, Paolo, Boscolo, Annalisa, Graziano, Alessandro, Valeri, Ilaria, Vianello, Andrea, Cereda, Danilo, Filippini, Claudia, Cecconi, Maurizio, Locatelli, Franco, Bartoletti, Michele, Giannella, Maddalena, Viale, Pierluigi, Antonelli, Massimo, Nava, Stefano, Pesenti, Antonio, Ranieri, V Marco, Tonetti, T, Grasselli, G, Zanella, A, Pizzilli, G, Fumagalli, R, Piva, S, Lorini, L, Iotti, G, Foti, G, Colombo, S, Vivona, L, Rossi, S, Girardis, M, Agnoletti, V, Campagna, A, Gordini, G, Navalesi, P, Boscolo, A, Graziano, A, Valeri, I, Vianello, A, Cereda, D, Filippini, C, Cecconi, M, Locatelli, F, Bartoletti, M, Giannella, M, Viale, P, Antonelli, M, Nava, S, Pesenti, A, Ranieri, V, Langer, T, Tonetti, T., Grasselli, G., Zanella, A., Pizzilli, G., Fumagalli, R., Piva, S., Lorini, L., Iotti, G., Foti, G., Colombo, S., Vivona, L., Rossi, S., Girardis, M., Agnoletti, V., Campagna, A., Gordini, G., Navalesi, P., Boscolo, A., Graziano, A., Valeri, I., Vianello, A., Cereda, D., Filippini, C., Cecconi, M., Locatelli, F., Bartoletti, M., Giannella, M., Viale, P., Antonelli, M., Nava, S., Pesenti, A., Ranieri, V. M., Albano, G., Alborghetti, A., Aldegheri, G., Antonini, B., Belgiorno, N., Bellani, G., Beretta, E., Bonazzi, S., Borelli, M., Cabrini, L., Carnevale, L., Carnevale, S., Castelli, G., Catena, E., Chiumello, D., Coluccello, A., Coppini, D., Covello, D., Defilippi, G., Deipoli, M., Dughi, P., Gallioli, G., Gnesin, P., Greco, S., Guatteri, L., Guzzon, D., Keim, R., Landoni, G., Langer, T., Lombardo, A., Marino, G., Merli, G., Merlo, D., Mojoli, F., Muttini, S., Natalini, G., Petrucci, N., Pezzi, A., Radrizzani, D., Raimondi, M., Riccio, M., Storti, E., Tavola, M., Vitale, G., Bosco, E., Calo, M. A., Danzi, V., Derosa, S., Farnia, A., Lazzari, F., Meggiolaro, M., Munari, M., Saia, M., Sella, N., Serra, E., Tiberio, I., Baiocchi, M., Benedetto, M., Bordini, M., Caramelli, F., Cilloni, N., Dellagiovampaola, M., Fanelli, A., Frascaroli, G., Fusari, M., Maitan, S., Martino, C., Melotti, R. M., Merola, R., Minardi, F., Moro, F., Nardi, G., Nolli, M., Pierucci, E., Potalivo, A., Repetti, F., Salsi, P., Terzitta, M., Tosi, M., Venturi, S., Volta, C. A., Zani, G., Zanoni, A (COVID-19 Northern Italian ICU Network), and Landoni, G

Subjects
medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Respiratory rate, Socio-culturale, Critical Care and Intensive Care Medicine, Acute respiratory failure, acute respiratory failure, COVID-19, ICU, non-invasive ventilation, rationing, 03 medical and health sciences, 0302 clinical medicine, Anesthesiology, Intensive care, Retrospective analysis, Medicine, 030212 general & internal medicine, Non-invasive ventilation, Rationing, Case report form, business.industry, Research, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Outbreak, lcsh:RC86-88.9, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, 030228 respiratory system, Emergency medicine, Base excess, business
Abstract

Background A Covid-19 outbreak developed in Lombardy, Veneto and Emilia-Romagna (Italy) at the end of February 2020. Fear of an imminent saturation of available ICU beds generated the notion that rationing of intensive care resources could have been necessary. Results In order to evaluate the impact of Covid-19 on the ICU capacity to manage critically ill patients, we performed a retrospective analysis of the first 2 weeks of the outbreak (February 24–March 8). Data were collected from regional registries and from a case report form sent to participating sites. ICU beds increased from 1545 to 1989 (28.7%), and patients receiving respiratory support outside the ICU increased from 4 (0.6%) to 260 (37.0%). Patients receiving respiratory support outside the ICU were significantly older [65 vs. 77 years], had more cerebrovascular (5.8 vs. 13.1%) and renal (5.3 vs. 10.0%) comorbidities and less obesity (31.4 vs. 15.5%) than patients admitted to the ICU. PaO2/FiO2 ratio, respiratory rate and arterial pH were higher [165 vs. 244; 20 vs. 24 breath/min; 7.40 vs. 7.46] and PaCO2 and base excess were lower [34 vs. 42 mmHg; 0.60 vs. 1.30] in patients receiving respiratory support outside the ICU than in patients admitted to the ICU, respectively. Conclusions Increase in ICU beds and use of out-of-ICU respiratory support allowed effective management of the first 14 days of the Covid-19 outbreak, avoiding resource rationing.

Published
2020

2. Mortality attributable to different Klebsiella susceptibility patterns and to the coverage of empirical antibiotic therapy: a cohort study on patients admitted to the ICU with infection

Author

Bottazzi A., Chieregato A., Fumagalli R., Livigni S., Nardi G., Negro G., Olivieri C., Radrizzani D., Ripamonti C., Tavola M., Bertolini G., Nattino G., Carrara G., Rossi C., Crespi D., Mondini M., Tascini C., Poole D., Viaggi B., Langer M., Rossolini G. M., Malacarne P., Bottazzi, A, Chieregato, A, Fumagalli, R, Livigni, S, Nardi, G, Negro, G, Olivieri, C, Radrizzani, D, Ripamonti, C, Tavola, M, Bertolini, G, Nattino, G, Carrara, G, Rossi, C, Crespi, D, Mondini, M, Tascini, C, Poole, D, Viaggi, B, Langer, M, Rossolini, G, and Malacarne, P

Subjects
0301 basic medicine, Adult, Male, medicine.medical_specialty, Klebsiella, 030106 microbiology, Intensive Care Unit, Drug resistance, Critical Care and Intensive Care Medicine, Empirical antibiotic therapy, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Anesthesiology, Intensive care, Anti-Bacterial Agent, medicine, In patient, 030212 general & internal medicine, Carbapenem, Attributable mortality, Aged, biology, business.industry, Microbial Sensitivity Test, Middle Aged, biology.organism_classification, Klebsiella infection, Multicenter study, Klebsiella pneumoniae, Standardized mortality ratio, Italy, Female, Cohort Studie, business, Cohort study, Human
Abstract

Purpose: To evaluate the prognostic importance of different Klebsiella spp. sensitivity patterns: multi-susceptible Klebsiella (MS-K), extended-spectrum cephalosporin-resistant, but carbapenem-susceptible Klebsiella (ESCR-CS-K), and carbapenem-resistant Klebsiella (CR-K). Methods: We developed a prognostic model to predict hospital mortality in patients with infection on admission to the intensive care units (ICUs), and assessed its calibration in the subgroups of interest: patients with infections due to MS-K, ESCR-CS-K, CR-K. We assessed the calibration of the model also in ESCR-CS-K treated empirically with carbapenems and with piperacillin-tazobactam. Results: A total of 13,292 adults with an ongoing infection were admitted to 137 Italian ICUs in 2012–2013. Of 801 Klebsiella spp. infected patients, 451 had MS-K, 116 ESCR-CS-K, and 234 CR-K. The prognostic model calibrated well for the MS-K and ESCR-CS-K subgroups. In the CR-K subgroup there were more deaths than predicted (standardized mortality ratio 1.20; 95% CI 1.08–1.31), indicating a negative prognostic role of the infection, mainly in the medium and high risk-of-death patients. When infection was caused by ESCR-CS-K, treatment with piperacillin-tazobactam increased adjusted mortality among the most severe patients (similarly to CR-K), while treatment with carbapenems did not (similarly to MS-K). Conclusions: In low risk-of-death patients admitted to the ICU with a Klebsiella spp. infection, the appropriateness of empirical antibiotic therapy seemed uninfluential to eventual mortality, while it appeared to be crucial in high-risk ones. The use of piperacillin-tazobactam may be inappropriate in severe patients with ESCR-CS-K infection. CR-K is associated to a significant 20% increase of adjusted mortality, only for patients at higher risk of death.

Published
2018

3. The role of the intensive care unit in real-time surveillance of emerging pandemics: the Italian GiViTI experience

Author

Bertolini, G, Nattino, G, Langer, M, Tavola, M, Crespi, D, Mondini, M, Rossi, C, Previtali, C, Marshall, J, Poole, D, Abascià, A, Acquarolo, A, Adorni, A, Agnelli, V, Agostini, F, Alampi, D, Alberti, A, Alborghetti, A, Alleva, S, Ambrosoni, S, Antonini, B, Arditi, E, Avalli, L, Babini, M, Bagalini, G, Balata, A, Balicco, B, Barbagallo, M, Bartoli, T, Bassi, G, Becarelli, S, Beck, E, Bellin, M, Bellonzi, A, Bellorini, M, Benanti, C, Bensi, M, Bernasconi, Mo, Berruto, F, Bertolini, R, Besozzi, A, Biamino, C, Bianchi, T, Bianchin, A, Boccalatte, D, Bocchi, A, Bonaccorso, G, Bonazzi, M, Balsamo, C, Bonicalzi, V, Boniotti, C, Bonizzoli, M, Bottazzi, A, Breschi, C, Brizio, E, Brunetti, B, Brunori, E, Bubbico, G, Buscaglia, G, Calicchio, G, Calligaro, P, Calva, S, Candido, M, Capitanio, G, Caroleo, S, Casagli, S, Casalini, P, Castiglione, G, Cerana, M, Chiani, C, Chierego, G, Ciani, A, Ciceri, R, Cigada, Mg, Cima, M, Cingolani, E, Cinque, E, Coletta, Rp, Colombo, L, Colombo, R, Converso, M, Corrado, A, Cortis, G, Costagli, V, Crema, L, Crestan, E, Da, D, Cero, Pd, Ferro, Md, De Blasi RA, De Blasio, E, De Cristofaro MG, De Luca, A, Di Pasquale, D, Doroni, L, Fabi, Mc, Facondini, F, Fagoni, Nazzareno, Falzetti, G, Faraldi, L, Fiore, G, Fiume, C, Galeotti, E, Galleschi, N, Gallo, M, Gamberini, E, Garelli, A, Giacomello, S, Gianni, M, Giudici, R, Giuntini, R, Gnesin, P, Gorietti, A, Grassitelli, S, Greco, M, Irpino, A, Guadagna, A, Guadagnucci, A, Guagliardi, C, Laici, C, Lain, G, Lanza, G, Lefons, U, Leggieri, C, Lembo, R, Librenti, M, Liverani, C, Longobardo, A, Madeira, Sm, Madonna, R, Magatti, Mf, Mamprin, F, Mannolini, G, Marafon, S, Marchesi, G, Marifoglou, D, Martinelli, P, Martinelli, S, Escobar, Rm, Mastroianni, A, Mastropierro, R, Mediani, Ts, Messina, M, Milan, B, Molesi, A, Alberto, Cm, Mongelli, P, Morigi, A, Mosti, G, Muttini, S, Nardini, M, Nascimben, E, Natalini, G, Negri, G, Negro, G, Neri, M, Netto, R, Nonini, S, Odetto, L, Olivieri, C, Candida, Mo, Osti, D, Palmer, M, Parnigotto, A, Parrini, V, Pasculli, M, Pasetti, G, Passafiume, M, Pastorini, S, Patrignani, L, Pedeferri, M, Pegoraro, M, Pelati, E, Pelosi, G, Pera, L, Perino, P, Pero, A, Perzolla, D, Peta, M, Pinna, C, Pizzali, M, Postiglione, M, Potalivo, A, Raffaeli, M, Randellini, R, Rech, A, Renda, B, Ricciardi, G, Rizzi, S, Romagnoli, S, Rossi, G, Rossi, M, Rutta, C, Sagliaschi, U, Salcuni, R, Salvi, G, Scalera, M, Scarrone, S, Schiavuzzi, M, Aurelio, Ps, Selvaggi, P, Sicignano, A, Sorbara, C, Spagarino, E, Sparicio, D, Spinazzola, Ar, Sucre, Mj, Terzitta, M, Tetamo, R, Tibaldi, G, Todesco, L, Tomaselli, P, Torta, M, Turriziani, I, Ughi, L, Vaccari, C, Vaj, M, Vanzino, R, Vardanega, A, Vecchiarelli, P, Vedovati, S, Zanni, V, Zappa, S, Zardin, M, Zaro, G, Zuccaro, F, Barattini, M, Chieregato, A, Fumagalli, R, Livigni, S, Mengoli, F, Nardi, G, Palma, D, Portolani, L, Radrizzani, D, Terzitta, M., Bertolini, G, Nattino, G, Langer, M, Tavola, M, Crespi, D, Mondini, M, Rossi, C, Previtali, C, Marshall, J, Poole, D, Abascia, A, Acquarolo, A, Adorni, A, Agnelli, V, Agostini, F, Alampi, D, Alberti, A, Alborghetti, A, Alleva, S, Ambrosoni, S, Antonini, B, Arditi, E, Avalli, L, Babini, M, Bagalini, G, Balata, A, Balicco, B, Barbagallo, M, Bartoli, T, Bassi, G, Becarelli, S, Beck, E, Bellin, M, Bellonzi, A, Bellorini, M, Benanti, C, Bensi, M, Bernasconi, M, Berruto, F, Besozzi, A, Biamino, C, Bianchi, T, Bianchin, A, Boccalatte, D, Bocchi, A, Bonaccorso, G, Bonazzi, M, Balsamo, C, Bonicalzi, V, Boniotti, C, Bonizzoli, M, Bottazzi, A, Breschi, C, Brizio, E, Brunetti, B, Brunori, E, Bubbico, G, Buscaglia, G, Calicchio, G, Calligaro, P, Calva, S, Candido, M, Capitanio, G, Caroleo, S, Casagli, S, Casalini, P, Castiglione, G, Cerana, M, Chiani, C, Chierego, G, Ciani, A, Ciceri, R, Cigada, M, Cima, M, Cingolani, E, Cinque, E, Coletta, R, Colombo, L, Colombo, R, Converso, M, Corrado, A, Cortis, G, Costagli, V, Crema, L, Crestan, E, Da, D, Cero, P, Ferro, M, De Blasi, R, De Blasio, E, De Cristofaro, M, De Luca, A, Di Pasquale, D, Doroni, L, Fabi, M, Facondini, F, Fagoni, N, Falzetti, G, Faraldi, L, Fiore, G, Fiume, C, Galeotti, E, Galleschi, N, Gallo, M, Gamberini, E, Garelli, A, Giacomello, S, Gianni, M, Giudici, R, Giuntini, R, Gnesin, P, Gorietti, A, Grassitelli, S, Greco, M, Irpino, A, Guadagna, A, Guadagnucci, A, Guagliardi, C, Laici, C, Lain, G, Lanza, G, Lefons, U, Leggieri, C, Lembo, R, Librenti, M, Liverani, C, Longobardo, A, Madeira, S, Madonna, R, Magatti, M, Mamprin, F, Mannolini, G, Marafon, S, Marchesi, G, Marifoglou, D, Martinelli, P, Martinelli, S, Escobar, R, Mastroianni, A, Mastropierro, R, Mediani, T, Messina, M, Milan, B, Molesi, A, Alberto, C, Mongelli, P, Morigi, A, Mosti, G, Muttini, S, Nardini, M, Nascimben, E, Natalini, G, Negri, G, Negro, G, Neri, M, Netto, R, Nonini, S, Odetto, L, Olivieri, C, Candida, M, Osti, D, Palmer, M, Parnigotto, A, Parrini, V, Pasculli, M, Pasetti, G, Passafiume, M, Pastorini, S, Patrignani, L, Pedeferri, M, Pegoraro, M, Pelati, E, Pelosi, G, Pera, L, Perino, P, Pero, A, Perzolla, D, Peta, M, Pinna, C, Pizzali, M, Postiglione, M, Potalivo, A, Raffaeli, M, Randellini, R, Rech, A, Renda, B, Ricciardi, G, Rizzi, S, Romagnoli, S, Rossi, G, Rossi, M, Rutta, C, Sagliaschi, U, Salcuni, R, Salvi, G, Scalera, M, Scarrone, S, Schiavuzzi, M, Aurelio, P, Selvaggi, P, Sicignano, A, Sorbara, C, Spagarino, E, Sparicio, D, Spinazzola, A, Sucre, M, Terzitta, M, Tetamo, R, Tibaldi, G, Todesco, L, Tomaselli, P, Torta, M, Turriziani, I, Ughi, L, Vaccari, C, Vaj, M, Vanzino, R, Vardanega, A, Vecchiarelli, P, Vedovati, S, Zanni, V, Zappa, S, Zardin, M, Zaro, G, Zuccaro, F, Barattini, M, Chieregato, A, Fumagalli, R, Livigni, S, Mengoli, F, Nardi, G, Palma, D, Portolani, L, and Radrizzani, D

Subjects
medicine.medical_specialty, Epidemiology, surveillance system, law.invention, 03 medical and health sciences, Influenza A Virus, H1N1 Subtype, 0302 clinical medicine, Public health surveillance, law, Infectious disease epidemiology, influenza, pandemic, Humans, Influenza, Human, Intensive Care Units, Italy, Public Health Surveillance, Pandemics, Pandemic, medicine, human, 030212 general & internal medicine, medicine (all), Intensive care medicine, business.industry, Public health, Outbreak, 030208 emergency & critical care medicine, Monitoring system, medicine.disease, Intensive care unit, infectious disease epidemiology, humans, influenza a virus, h1n1 subtype, intensive care units, italy, public health surveillance, pandemics, infectious diseases, epidemiology, Infectious Diseases, Human mortality from H5N1, Medical emergency, business
Abstract

SUMMARYThe prompt availability of reliable epidemiological information on emerging pandemics is crucial for public health policy-makers. Early in 2013, a possible new H1N1 epidemic notified by an intensive care unit (ICU) to GiViTI, the Italian ICU network, prompted the re-activation of the real-time monitoring system developed during the 2009–2010 pandemic. Based on data from 216 ICUs, we were able to detect and monitor an outbreak of severe H1N1 infection, and to compare the situation with previous years. The timely and correct assessment of the severity of an epidemic can be obtained by investigating ICU admissions, especially when historical comparisons can be made.

Published
2015

4. The prognostic importance of chronic end-stage diseases in geriatric patients admitted to 163 Italian ICUs

Author

Poole, D., Finazzi, S., Nattino, G., Radrizzani, D., Gristina, G., Malacarne, P., Livigni, S., Bertolini, G., Sorgato, C., Mannoni, R., Agnelli, V., Chiani, C., Lanza, G., Venturini, E., Gianni, M., Olivieri, M. C., Guerriero, B., Della Mora, E., Palmer, M., Blasetti, A., Coletta, R., Covani Frigieri, F., Guarducci, M. D., Caracciolo, A., Lain, G., Bernard, M., DE Blasio, E., Zanni, V., Marchesi, G., Madeira, S. M., Spagarino, E., Potalivo, A., Mengoli, F., Parrini, V., Sagliaschi, U., Prandini, A., Rosano, A., Natalini, G., Piccioni, G., Schiavuzzi, M., Bronzini, N., Piva, S., Besozzi, A., Napoleone, A., Patrignani, L., Pisu, M., Mancosu, S., Chiarello, M., Pastorini, S., Bassi, G., Negro, G., Orsini, I., Marifoglou, D., Pota, V., Pegoraro, M., Sucre, M. J., DI Masi, P., Castiglione, G., Morello, G., Garofalo, G., Caroleo, S., Visconti, M. G., Gamberini, E., Mastroianni, A., Liccardi, M. M., Anelati, D., Martinelli, S., Bonato, A., Adorni, A., Colombo, D., Dal Cero, P., Crema, L., Petrucci, N., Beck, E., Alleva, S., Giuntini, R., DA Re, D., Casalini, P., Fabi, M. C., Galeotti, E., Bagalini, G., Bellonzi, A., Zoppellari, R., Lamborghini, S., Pera, L., Doni, L., Bonizzoli, M., Librenti, M., Barattini, M., Mangani, V., Terzitta, M., Guagliardi, C., Bruzzone, C., Arditi, E., Cerana, M., Tavola, M., Falini, S., Vespignani, M. G., Salvi, G., Ramello, P. L., Molesi, A., Ceradelli, M., Buonanno, R., Righini, E., DI Cocco, A., DI Martino, R., Cinque, E., Bonfiglio, M., Ciceri, R., Colombo, L., Nardini, M., Rossi, G., Boccalatte-Rosa, D. L., Babini, M., Zompanti, V., Negri, G., Antonini, B., Baratta, A., Zuccaro, F., Rossi, M., Pedeferri, M., Bellin, M., Sicignano, A., Pezzi, A., Leggieri, C., Fontana, G., Faraldi, L., Cigada, M. G., Magenta, P., Colombo, R., Colombo, S., Gonzi, S., Pizzali, M., Girardis, M., Piccinini, P., Bignone, P., Padovan, L., Bianchin, A., Caria, F. C., Randellini, R., Roticiani, V., Grassi, M., Belluomo Anello, C., Decristofaro, M., Postiglione, M., Giacomello, S., Olivieri, C., Vaccari, C., Dal Ferro, M., Messina, M., Belgiorno, N., Odetto, L., Pasetti, G. S., Balicco, B., Pizzaballa, M. L., Muraro, L., Pignataro, A., Guadagna, A., Fabbri, P. G., Tetamo, R., Bottazzi, A., Mediani, T. S., Gorietti, A., Breschi, C., Ciani, A., Segalini, P., Codeluppi, V., Berruto, F., Pastorelli, M., Comite, C., Pelati, E., Bertolini, R., Lefons, U., DI Pasquale, D. A., Mannolini, G., Vlassich, F., Becarelli, S., Garelli, A., Salsi, P., Rossi, S., Facondini, F., Alampi, D., Cingolani, E., Molino, F. M., Nardi, G., Casula, M., DE Blasi, R. A., Vulcano, G. A., Azzolini, M., Bernasconi, M. O., Bellato, V., Calicchio, G., Righetti, F., Turati, M., Dei Poli, M., Zaro, G., Brizio, E., Coaloa, M., Falzetti, G., Mamprin, F., Liverani, C. M., Clementi, S., Bonucci, P., Varesio, V., Pannacci, R., Fiore, G., Gallo, M., Torta, M., Selvaggi, P., Bert, P. P., Segala, V., Pettazzi, G., Bensi, M., Bocchi, A., Cima, M., Morbelli, M., Peta, M., DI Stella, R., Maggiolo, C., Lembo, R., Pero, A., Marafon, S., Carnevale, L., Vanzino, R., Vecchiarelli, P., and Marino, G.

Subjects
Male, medicine.medical_specialty, Cirrhosis, Disease, Severity of Illness Index, law.invention, 03 medical and health sciences, 0302 clinical medicine, Patient Admission, Postoperative Complications, law, Internal medicine, 80 and over, aged, critical care, prognosis, Medicine, Dementia, Humans, Hospital Mortality, Elective surgery, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Critical care, Prognosis, Female, Intensive Care Units, Italy, Chronic Disease, 030208 emergency & critical care medicine, Odds ratio, medicine.disease, Comorbidity, Intensive care unit, Anesthesiology and Pain Medicine, 030228 respiratory system, Cohort, business
Abstract

BACKGROUND The number of elderly patients undergoing major surgical interventions and then needing admission to intensive care unit (ICU) grows steadily. We investigated this issue in a cohort of 232,278 patients admitted in five years (2011-2015) to 163 Italian general ICUs. METHODS Surgical patients older than 75 registered in the GiViTI MargheritaPROSAFE project were analyzed. The impact on hospital mortality of important chronic conditions (severe COPD, NYHA class IV, dementia, end-stage renal disease, cirrhosis with portal hypertension) was investigated with two prognostic models developed yearly on patients staying in the ICU less or more than 24 hours. RESULTS 44,551 elderly patients (19.2%) underwent emergency (47.3%) or elective surgery (52.7%). At least one severe comorbidity was present in 14.6% of them, yielding a higher hospital mortality (32.4%, vs. 21.1% without severe comorbidity). In the models for patients staying in the ICU 24 hours or more, cirrhosis, NYHA class IV, and severe COPD were constant independent predictors of death (adjusted odds ratios [ORs] range 1.67-1.97, 1.54-1.91, and 1.34-1.50, respectively), while dementia was statistically significant in four out of five models (adjusted ORs 1.23-1.28). End-stage renal disease, instead, never resulted to be an independent prognostic factor. For patients staying in the ICU less than 24 hours, chronic comorbidities were only occasionally independent predictors of death. CONCLUSIONS Our study confirms that elderly surgical patients represent a relevant part of all ICUs admissions. About one of seven bear at least one severe chronic comorbidity, that, excluding end-stage renal disease, are all strong independent predictors of hospital death.

Published
2017

5. Antibiotic use and impact on outcome from bacteraemic critical illness: the BActeraemia Study in Intensive Care (BASIC)

Author

Corona, A, Bertolini, G, Lipman, J, Wilson, Ap, Singer, M, Rodriguez, A, Cueto, G, Canales, Hs, Acosta Gnass, S, Marinoni, M, Becherucci, A, Baccaro, F, Peake, S, Reece, G, Blythe, D, Mcfayden, B, French, C, Hawker, F, Dobb, G, Seppelt, I, Finfer, S, Skowronski, G, Banerjee, A, Richards, B, Neumark, G, Hiesmayr, M, Rutraert, P, Franck, S, Spapen, H, Ludovic, L, Bruzzi de Carvalho, F, Souza, P, Gasparovic, V, Barsic, B, Chytra, I, Novak, I, Pestel, G, Kaiser, S, Giokas, G, Matamis, D, Yap Hiu Yi, F, Kapadia, F, Iqbal, M, Batoli, T, Costanzo, E, Pistocchini, A, Acquarolo, A, Greco, S, Di Masi, P, Quattrocchi, P, Navarra, M, Rotella, S, Giugiaro, P, Todesco, L, Borromeo, R, Ostando, M, Benassai, C, Pezzi, G, Marchi, M, Luise, C, Di Filippo, A, Mangani, V, Pelagatti, C, Pasetti, G, Salvi, G, Salcuni, R, Marongiu, A, Tavola, M, Rossi, G, Biffali, F, Brunori, E, Piccioni, G, Guadagnucci, A, David, Antonio, Pulici, M, Ughi, F, Sicignano, A, Leggieri, C, Fiore, G, Banfi, G, Lanza, S, Postiglione, M, Bosso, R, Piga, G, Croce, G, Sapuppo, Mf, Giarratano, A, Barbagallo, M, Favetta, P, Gorietti, A, Breschi, C, Andrei, O, Bertolini, R, Bonfà, A, Rossi, S, Asti, A, Rendina, F, Bilotta, F, Azzeri, F, Piacevoli, Q, Hellmann, F, Vaira, C, Avarello, N, Clementi, S, Della Valle, A, Segala, V, Berardino, M, Vaj, M, Sega, P, Bcchi, A, Pizzaballa, Ml, Cohen, J, Sprung, C, Hashimoto, S, Baskiene, R, Mcdonald, J, Sollid, S, Paiva, Ja, Moreno, R, Gloria, C, Yaghi, A, Voga, G, Joo Lee, Y, Zaragoza, R, Valles, J, Gonzalez Diaz, G, Alvarez Lerma, F, Sirvent, Jm, Herve, Z, Romand, Ja, Niblett, D, Laurenson, J, Peters, T, von der Osten, I, and Tomic, V.

Subjects
Adult, Male, Microbiology (medical), medicine.medical_specialty, Pediatrics, Asia, Critical Care, medicine.drug_class, Critical Illness, Antibiotics, Bacteremia, Microbial Sensitivity Tests, Outcome (game theory), Pharmacotherapy, Intensive care, Epidemiology, medicine, Humans, Pharmacology (medical), Prospective Studies, Antibiotic use, Intensive care medicine, bloodstream infections, critically ill patients, prevalence, antibiotic strategy, Aged, Aged, 80 and over, Pharmacology, Australasia, business.industry, Septic shock, Mortality rate, Odds ratio, Middle Aged, South America, medicine.disease, Drug Utilization, Confidence interval, Anti-Bacterial Agents, Europe, Treatment Outcome, Infectious Diseases, Critical illness, Female, business, Fungemia
Abstract

The lack of prospective, randomized, controlled trial data to guide optimal antibiotic use in bacteraemic critically ill patients has led to a wide variety of strategies and major issues with drug resistance. We therefore prospectively investigated the epidemiology of bacteraemia and fungaemia in intensive care units (ICUs); and the impact of timing, type and appropriateness of antibiotic intervention.We conducted a multinational, multicentre, prospective observational study in 132 ICUs from 26 countries with no interventions.1702 patients [European (69.6%), Australasian (12.2%), South American (8.3%) and Asian (9.9%)] developed 1942 bacteraemic episodes over the study period. Mortality rates were similar for those receiving empirical (40.5%), semi-targeted (37.6%) or fully targeted (33.3%) antibiotic therapy (P=0.40), and in those initially receiving broad- (39.3%) or restricted-spectrum (39.1%) therapy (P=0.94). First-line therapy was effective in terms of the antibiogram (where available) in 70.4% of cases. This in vitro susceptibility ranged from 76.3% for broad-spectrum antibiotics to 46.3% for restricted-spectrum antibiotics (P0.0001). However, no antibiotic policy-associated variable, including in vitro susceptibility (odds ratio 0.89, 95% confidence interval 0.61-1.30), was a statistically significant predictor of mortality.We could not show an impact of antibiotics on mortality in critically ill patients, despite in vitro activity and early commencement. Randomized, multicentre trials are urgently needed to establish the appropriate duration, timing and combinations of antibiotics that will both optimally treat infection and minimize development of resistance and other complications.

Published
2010

6. Recommendations for anesthesia and sedation in nonoperating room locations [Raccomandazioni per l'esecuzione dell'anestesia e della sedazione al di fuori dei blocchi operatori]

Author

Calderini, E., Accorsi, A., Adrario, E., Bettelli, G., Cornara, G., Gasperi, A., Della Rocca, G., Di Castri, D., Frova, G., Gregorini, P., Iapichino, G., Landoni, G., Lombardo, G., Mondello, E., Paolillo, G. M., Peduto, V. A., Petrini, F., Piazza, L., Pierdominici, S., Pietropaoli, P., Rosi, R., Salvo, I., Santagostino, R., Savoia, G., Serafini, G., maurizio solca, Stella, L., Tavola, M., Torri, G., Tufano, R., Vesconi, S., Zoia, E., Zuccoli, P., Calderini, E, Accorsi, A, Adrario, E, Bettelli, G, Cornara, G, De Gasperi, A, Della Rocca, G, Di Castri, D, Frova, G, Gregorini, P, Iapichino, G, Landoni, Giovanni, Lombardo, G, Mondello, E, Paolillo G., M, Peduto V., A, Petrini, F, Piazza, L, Pierdominici, S, Pietropaoli, P, Rosi, R, Salvo, I, Santagostino, R, Savoia, G, Serafini, G, Solca, M, Stella, L, Tavola, M, Torri, G, Tufano, R, Vesconi, S, Zoia, E, Zuccoli, P., Calderini, E., Accorsi, A., Adrario, E., Bettelli, G., Cornara, G., De Gasperi, A., Della Rocca, G., Di Castri, D., Frova, G., Gregorini, P., Iapichino, G., Landoni, G., Lombardo, G., Mondello, E., Paolillo, G. M., Peduto, V. A., Petrini, F., Piazza, L., Pierdominici, S., Pietropaoli, P., Rosi, R., Salvo, I., Santagostino, R., Savoia, G., Serafini, G., Solca, M., Stella, L., Tavola, M., Torri, G., Tufano, Rosalba, Vesconi, S., and Zoia, E.

Published
2005

7. Guidelines for completing the Perioperative Anesthesia Record

Author

Calderini, E., Accorsi, A., Adrario, E., Bettelli, G., Carrani, L., Cornara, G., De Gasperi, A., Della Rocca, G., Di Castri, D., Frova, G., Gregorini, P., Iapichino, G., Landoni, G., Lombardo, G., Mondello, E., Paolillo, G. M., Peduto, V. A., Petrini, F., Piazza, L., Pierdominici, S., Pietropaoli, Paolo, Rosi, R., Salvo, I., Santagostino, R., Savoia, G., Serafini, G., Solca, M., Stella, L., Tavola, M., Torri, G., Tufano, R., Vesconi, S., Zoia, E., Zuccoli, P., Siaarti Study Group For Safety In Anesthesia, Intensive, Care, E., Calderini, A., Accorsi, E., Adrario, G., Bettelli, L., Carrani, G., Cornara, A., De Gasperi, G., Della Rocca, D., Di Castri, G., Frova, P., Gregorini, G., Iapichino, G., Landoni, G., Lombardo, E., Mondello, G. M., Paolillo, V. A., Peduto, F., Petrini, L., Piazza, S., Pierdominici, P., Pietropaoli, R., Rosi, I., Salvo, R., Santagostino, G., Savoia, G., Serafini, M., Solca, L., Stella, M., Tavola, G., Torri, Tufano, Rosalba, S., Vesconi, E., Zoia, P., Zuccoli, S. I., A., Intensive, Care, Calderini, E, Accorsi, A, Adrario, E, Bettelli, G, Carrani, L, Cornara, G, De Gasperi, A, Della Rocca, G, Di Castri, D, Frova, G, Gregorini, P, Iapichino, G, Landoni, G, Lombardo, G, Mondello, E, Paolillo, G M, Peduto, V A, Petrini, F, Piazza, L, Pierdominici, S, Pietropaoli, P, Rosi, R, Salvo, I, Santagostino, R, Savoia, G, Serafini, G, Solca, M, Stella, L, Tavola, M, Torri, G, Tufano, R, Vesconi, S, Zoia, E, and Zuccoli, P

Subjects
Medical Record, Anesthesia, Medical Records, Perioperative Care
Published
2002

8. End-of-life decision-making and quality of ICU performance: an observational study in 84 Italian units

Author

Bertolini, G, Boffelli, S, Malacarne, P, Peta, M, Marchesi, M, Barbisan, C, Tomelleri, S, Spada, S, Satolli, R, Gridelli, B, Lizzola, I, Gianni M, Mazzon D., Nasso, A, Perno, S, Cocco, L, Caracciolo, A, Di Masi, P, Moretti, M, Mazzon, D, Luise, C, Abate, C, Morigi, A, Zotti, Mc, Natalini, G, Antonini, B, Pedemonte, A, Brizio, E, Rossi, M, Ruggeri, P, Vitale, Mr, Garofalo, G, Bonaccorso, V, Cocciolo, F, Gamberini, E, Bufalini, M, Pedullà, A, Barbagli, R, Pelagatti, C, Oggioni, R, Barattini, M, Giuntini, R, Isetta, M, Cinque, E, Tavola, M, Negro, G, Ferrari, F, Chiarello, M, David, Antonio, Solca, M, Cattaneo, A, Bassini, E, Pinciroli, D, Negri, G, Ughi, L, Sicignano, A, Rotelli, S, Reineke, R, Rossi, S, Clementi, S, Bellocchio, E, Antonelli, S, Furfori, P, Guadagnucci, A, Postiglione, M, Catanzaro, P, Burgio, G, Todesco, L, Spina, T, Zava, R, Simeoni, C, Mosca, C, Bandini, M, Breschi, C, Casalini, P, Cosimati, F, Davini, D, Alampi, D, Alberti, A, Malengo, S, Tartari, S, Mastroianni, A, Perino, P, Belloni, Ug, Salcuni, R, Fiore, G, Odetto, L, Pastorelli, M, Agnelli, E, Vacca, M, Segala, V, Arbinolo, Ma, Vaj, M, Larghero, E, Vergano, M, Roncato, P, Lugano, M, Cominotti, S, Deprado, A, and Badii, F.

Subjects
Adult, Male, medicine.medical_specialty, Critical Care, Critical Illness, Decision Making, Critical Care and Intensive Care Medicine, Logistic regression, law.invention, Young Adult, law, Intensive care, medicine, Humans, Prospective Studies, Organ donation, Intensive care medicine, Critically ill, Decision-making, End-of-life, Ethics, Intensive care units, Aged, Resuscitation Orders, Aged, 80 and over, business.industry, Odds ratio, Middle Aged, Euthanasia, Passive, Intensive care unit, Confidence interval, Life Support Care, Standardized mortality ratio, Italy, Withholding Treatment, Female, Observational study, Settore SPS/07 - Sociologia Generale, Family Relations, business
Abstract

To appraise the end-of-life decision-making in several intensive care units (ICUs) and to evaluate the association between the average inclination to limit treatment and overall survival at ICU level. Prospective, multicenter, observational study, lasting 12 months. Eighty-four Italian, adult ICUs. Consecutive patients (3,793) who died in ICU or were discharged in terminal condition, in 2005. Data collection included patient description, treatment limitation and decision-makers, involvement of patients and relatives in the decision, and organ donation. A logistic regression model was used to identify predictors of treatment limitation and develop a measure of the inclination to limit treatment for each ICU. This was compared with the standardized mortality ratio, an index of the overall performance of the unit. Treatment limitation preceded 62% of deaths. In 25% of cases, nurses were involved in the decision. Half the limitations were do-not-resuscitate orders, with the remaining half almost equally split between withholding and withdrawing treatment. Units less inclined to limit treatments (odds ratio

Published
2010

9. External validation of the Simplified Acute Physiology Score (SAPS) 3 in a cohort of 28,357 patients from 147 Italian intensive care units

Author

Poole, D, Rossi, C, Anghileri, A, Giardino, M, Latronico, N, Radrizzani, D, Langer, M, Bertolini, G, Acciarri, C, Acquarolo, A, Adorni, A, Alberti, A, Alborghetti, A, Antonini, B, Archi, D, Arditi, E, Badii, F, Balata, A, Barattini, M, Barbagli, R, Barbieri, P, Baroncia, M, Bartoccini, A, Bartoli, T, Bassi, F, Beck, E, Bellato, V, Bellorini, M, Belluomo Anello, C, Benanti, C, Berardino, M, Bernasconi, Mo, Besozzi, A, Bianchin, A, Bindi, Ml, Biolino, P, Blasetti, A, Boccalatte, D, Bonaccorso, G, Bonfà, A, Bonfiglio, M, Boniotti, C, Bonizzoli, M, Bottari, V, Breschi, C, Brunori, E, Buonanno, R, Buzzetti, V, Calicchio, G, Calva, S, Capannolo, B, Caracciolo, A, Carnevale, L, Carsana, C, Casadei, E, Casagli, S, Casagrande, L, Casalini, P, Castiglione, G, Cavallo, R, Chiarello, M, Chieregato, A, Chinelli, E, Cigada, M, Coaloa, M, Colombo, R, Colombo, S, Corsini, W, Corvi, D, Cosentino, E, Costa, R, Costanzo, E, Cottignoli, T, Crema, L, Crestan, E, Da Re, D, Dal Cero, P, Dal Ferro, M, David, Antonio, De Blasi RA, De Blasio, E, De Luca, A, De Negri, P, Dei Poli, M, Del Sarto, P, Di Lorenzo, G, Di Masi, P, Di Pasquale, D, Di Serafino, G, Donato, I, Fabbri, L, Fabbri, E, Fabbri, Pg, Fabi, Mc, Faccio, L, Ferla, F, Ferri, F, Fiore, G, Fognani, G, Galeotti, E, Gamberini, E, Garelli, A, Garofalo, G, Garzilli, T, Giacopuzzi, L, Gianni, M, Giannoni, S, Giugiaro, Pm, Gorietti, A, Grassi, P, Greco, M, Guadagnucci, A, Guagliardi, C, Isetta, M, Lapolla, A, Lefons, U, Livigni, S, Madonna, R, Maestrone, C, Magatti, Mf, Maggiolo, C, Malacarne, P, Mancosu, S, Mangani, Va, Mantovani, G, Marafon, S, Martinez Escobar, R, Mastroianni, A, Mastropierro, R, Meloni, A, Messina, M, Miglioranzi, R, Molino, Fm, Morigi, A, Mosca, C, Murri, V, Nardi, G, Nascimben, E, Natalini, G, Negri, G, Negro, G, Neri, M, Nicolini, A, Nuovo, D, Odetto, L, Olivieri, C, Ortoleva, A, Pacini, Dm, Paganini, G, Paganoni, G, Palmer, M, Papiri, S, Parma, A, Parrini, V, Pastorelli, M, Pastorini, S, Pegoraro, M, Pezzi, A, Pinciroli, D, Piredda, G, Piva, S, Pizzaballa, M, Possamai, C, Postiglione, M, Potalivo, A, Pulici, M, Quattrocchi, P, Raffaeli, M, Ranzini, L, Righini, E, Rona, R, Rossi, G, Rossi, S, Rossi, M, Rottoli, F, Salcuni, R, Salvi, G, Savioli, M, Scarrone, S, Schellino, Mm, Segala, V, Segalini, Pa, Sera, G, Sforza, D, Sicignano, A, Sorbara, C, Spadini, E, Staccioli, P, Stefani, M, Sucre, Mj, Tartari, S, Tavola, M, Tetamo, R, Tibaldi, G, Tinacci, S, Todesco, L, Torta, M, Tosi, L, Tripepi, C, Ughi, L, Vaj, M, Vecchiarelli, P, Vespignani, Mg, Visconti, Mg, Vulcano, Ga, Zappa, S, Zocaro, R, and Zuccaro, F.

Subjects
Male, medicine.medical_specialty, Time Factors, genetic structures, Critical Care, Critical Illness, Critical Care and Intensive Care Medicine, law.invention, Bias, law, Predictive Value of Tests, Risk Factors, Intensive care, Anesthesiology, Outcome Assessment, Health Care, medicine, Humans, Hospital Mortality, Prospective Studies, Simplified Acute Physiology Score, Intensive care medicine, Prospective cohort study, Diagnosis-Related Groups, APACHE, Aged, Chi-Square Distribution, business.industry, Data Collection, Benchmarking, Critical care, Hospital mortality, Outcome assessment, Validation study, Discriminant Analysis, Middle Aged, Prognosis, Intensive care unit, Intensive Care Units, Logistic Models, Italy, ROC Curve, Predictive value of tests, Cohort, Calibration, Female, business, Chi-squared distribution
Abstract

To evaluate the SAPS 3 score predictive ability of hospital mortality in a large external validation cohort.Prospective observational study.A total of 28,357 patients from 147 Italian ICUs joining the Project Margherita national database of the Gruppo italiano per la Valutazione degli interventi in Terapia Intensiva (GiViTI).None.Evaluation of discrimination through ROC analysis and of overall goodness-of-fit through the Cox calibration test.Although discrimination was good, calibration turned out to be poor. The general and the South-Europe Mediterranean countries equations overestimated hospital mortality overall (SMR values 0.73 with 95% CI 0.72-0.75 for both equations) and homogeneously across risk classes. Overprediction was confirmed among important subgroups, with SMR values ranging between 0.47 and 0.82.The result strictly supported by our data is that the SAPS 3 score calibrates inadequately in a large sample of Italian ICU patients and thus should not be used for benchmarking, at least in Italian settings.

Published
2009

10. Pulmonary and chest wall mechanics in anesthetized paralyzed humans

Author

Edgardo D'Angelo, D. Bono, Edoardo Calderini, Tavola M, G. Torri, F. M. Robatto, and Joseph Milic-Emili

Subjects
Adult, Male, Thorax, medicine.medical_specialty, Supine position, Adolescent, Physiology, Respiratory physiology, Airway resistance, Physiology (medical), Internal medicine, medicine, Humans, Paralysis, Anesthesia, Respiratory system, Lung, Lung Compliance, business.industry, Airway Resistance, Interrupter Technique, Elasticity, medicine.anatomical_structure, Respiratory Mechanics, Cardiology, Female, Pulmonary Ventilation, business, Transpulmonary pressure
Abstract

Pulmonary and chest wall mechanics were studied in 18 anesthetized paralyzed supine humans by use of the technique of rapid airway occlusion during constant-flow inflation. Analysis of the changes in transpulmonary pressure after flow interruption allowed partitioning of the overall resistance of the lung (RL) into two compartments, one (Rint,L) reflecting airway resistance and the other (delta RL) representing the viscoelastic properties of the pulmonary tissues. Similar analysis of the changes in esophageal pressure indicates that chest wall resistance (RW) was due entirely to the viscoelastic properties of the chest wall tissues (delta RW = RW). In line with previous measurements of airway resistance, Rint,L increased with increasing flow and decreased with increasing volume. The opposite was true for both delta RL and delta RW. This behavior was interpreted in terms of a viscoelastic model that allowed computation of the viscoelastic constants of the lung and chest wall. This model also accounts for frequency, volume, and flow dependence of elastance of the lung and chest wall. Static and dynamic elastances, as well as delta R, were higher for the lung than for the chest wall.

Published
1991

11. 'Guidelines for completing the perioperative anesthesia record.'

Author

Edoardo Calderini, Accorsi, A., Adrario, E., Bettelli, G., Carrani, L., Cornara, G., Gasperi, A., Della Rocca, G., Di Castri, D., Frova, G., Gregorini, P., Iapichino, G., Landoni, G., Lombardo, G., Mondello, E., Paolillo, G. M., Peduto, V. A., Petrini, F., Piazza, L., Pierdominici, S., Pietropaoli, P., Rosi, R., Salvo, I., Santagostino, R., Savoia, G., Serafini, G., Solca, M., Stella, L., Tavola, M., Torri, G., Tufano, R., Vesconi, S., Zoia, E., Zuccoli, P., and Siaarti Study Group For Safety in Anesthesia and Intensive Care

Published
2002

15. Effect of PEEP on respiratory mechanics in anesthetized paralyzed humans

Author

Edoardo Calderini, D. Bono, Joseph Milic-Emili, Tavola M, and Edgardo D'Angelo

Subjects
Adult, Supine position, Adolescent, Physiology, Respiratory physiology, Models, Biological, Airway occlusion, Elastance, Positive-Pressure Respiration, Physiology (medical), Medicine, Humans, Paralysis, Anesthesia, Respiratory system, Lung Compliance, Positive end-expiratory pressure, Abdominal Muscles, Air Pressure, business.industry, Constant flow, Airway Resistance, respiratory system, Interrupter Technique, Elasticity, respiratory tract diseases, Respiratory Mechanics, business, Lung Volume Measurements
Abstract

With the use of the technique of rapid airway occlusion during constant flow inflation, respiratory mechanics were studied in eight anesthetized paralyzed supine normal humans during zero (ZEEP) and positive end-expiratory pressure (PEEP) ventilation. PEEP increased the end-expiratory lung volume by 0.49 liter. The changes in transpulmonary and esophageal pressure after flow interruption were analyzed in terms of a seven-parameter “viscoelastic” model. This allowed assessment of static lung and chest wall elastance (Est,L and Est,W), partitioning of overall resistance into airway interrupter (Rint,L) and tissue resistances (delta RL and delta RW), and computation of lung and chest wall “viscoelastic constants.” With increasing flow, Rint,L increased, whereas delta RL and delta RW decreased, as predicted by the model. Est,L, Est,W, and Rint,L decreased significantly with PEEP because of increased lung volume, whereas delta R and viscoelastic constants of lung and chest wall were independent of PEEP. The results indicate that PEEP caused a significant decrease in Rint,L, Est,L, and Est,W, whereas the dynamic tissue behavior, as reflected by delta RL and delta RW, did not change.

16. Communication and visiting policies in Italian intensive care units during the first COVID-19 pandemic wave and lockdown: a nationwide survey

Author

Langer, Thomas, Depalo, Francesca Carmela, Forlini, Clarissa, Landini, Silvia, Mezzetti, Andrea, Previtali, Paola, Monti, Gianpaola, de Toma, Carolina, Biscardi, Davide, Giannini, Alberto, Fumagalli, Roberto, Mistraletti, Giovanni, Lissoni, Barbara, De Martini, Andrea, Mareto, Nadia, Rossitto, Concetta, Zummo, Ugo, Taverna, Martina, Machieraldo, Patrizia, Navarra, Mauro, Parlanti Garbero, Massimiliano, Scaletti, Chiara, Perno, Silvia, Amendolia, Luca, Montrucchio, Giuseppe, Veliaj, Deliana, Barbarello, Giuseppe, Alesci, Maria, Bolgiaghi, Luca, Vailati, Davide, Pezzi, Angelo, Boselli, Enrico, Piccoli, Francesca, Greco, Massimiliano, Gemma, Marco, Resta, Marco, Crotti, Stefania, Bottino, Nicola, Abruzzese, Chiara, Savioli, Monica, Migliorino, Giuseppina, Muttini, Stefano, Umbrello, Michele, Borghi, Beatrice, Greco, Stefano, Dizeo, Micaela, Bottiroli, Maurizio, Mondino, Michele Giovanni, Prosepri, Manlio, Casella, Giampaolo, Curto, Francesco, Zaniboni, Matteo, Giudici, Riccardo, Gentile, Carlo, Bombino, Michela, Rona, Roberto, Cortinovis, Barbara, Benini, Annalisa, Avalli, Leonello, Tavola, Mario, Ferrario, Matteo, Preda, Roberta, Primerano, Enzo, Russo, Gianluca, Porta, Virginia, Valdambrini, Federico, Fassini, Paola, Orando, Serena, Beck, Eduardo, Pedeferri, Matteo, Cogliati, Giacomina, Testini, Denise, Moroni, Benedetta, Codeluppi, Vito, Ruggeri, Patrizia, Milanesi, Elisa, Belliato, Mirko, Besozzi, Alessandra, Riccio, Mario, Zerbi, Silvia, Corbella, Davide, Ferri, Francesco, Grazioli, Lorenzo, Bonanomi, Ezio, Giacomini, Matteo, Sacchi, Noemi, Codognola, Cristian, Ambrosini, Alessandra, Guatteri, Luca, Subert, Matteo, Castelli, Gian Paolo, Borelli, Massimo, Venier, Erica, Dittura, Loredana, Buttera, Stefania, Bigai, Roberto, Magnoni, Sandra, Rauch, Simon, Colombo, Angelo, Fullin, Giorgio, Donolato, Caterina, Cattin, Silvia, State, Veronica, Redeghieri, Enrico, Russo, Alessandro, Pastorini, Simonetta, Allena, Sandra, Munari, Marina, Turchet, Federica, Peta, Mario, De Santis, Vincenzo, Scala, Cristina, Facondini, Francesca, Marangoni, Elisabetta, Tassinati, Tania, Zanzani, Chiara, Russo, Emanuele, Marchio, Annamaria, Barbagallo, Maria, Girardis, Massimo, Taffache, Paolo, Mordacci, Marco, Vincenzi, Matteo, Pennica, Michele, Bracciotti, Giovanna, Iori, Paola, Gambi, Davide, Cappellini, Iacopo, Vegnuti, Lara, De Luca, Alessandra, Romagnoli, Stefano, Mosti, Giamila, Carla, Rossella, Roticiani, Valeria, Pelagalli, Lorella, Fuselli, Ennio, D’Avino, Emilio, De Bellis, Massimo, Gianni, Giulia, Leonardis, Francesca, Rossi, Marzia, Lorusso, Rossana, Magnanimi, Eugenia, Martelli, Sabrina, Baisi, Floriana, Balsamo, Davide, Cotticelli, Virginia, Mattei, Alessia, Farinelli, Ivano, Riccini, Teresa, Cola, Luisanna, Jorio, Antonella, Iacobone, Emanuele, Domizi, Roberta, Pizzi, Simone, Nasso, Armando, Graziani, Romano, Monaco, Anna, Manno, Manuela, Ottelio, Carla Maria, Del Rio, Michela, Serra, Antonio, Enna, Barbara, Loddo, Francesco Marco, Galbiati, Rita, Mellea, Serena, Kimberly, Michelle Brozzi, Vissani, Matteo, Romito, Francesco Massimo, Baccari, Laura, Zarrillo, Nadia, Esposito, Clelia, Murino, Patrizia, Notaro, Salvatore, Ausiello, Carmine, Marra, Annachiara, Policastro, Carmela, Cafora, Chiara, De Benedectis, Giuseppe, Di Falco, Vincenzo, Sciddurlo, Maria, Negro, Giancarlo, Vetuschi, Paolo, Recchia, Andrea, Pasquariello, Rita, Squillace, Rosalba, Ciambrone, Antonio, Bencivenga, Carmela, Camiolo, Melania, Agozzino, Cristina, Oliveri, Francesco, Notarrigo, Tiziana, Castiglione, Giacomo, Mo, Antonella, Condorelli, Laura, Favarato, Martina, Langer, T, Depalo, F, Forlini, C, Landini, S, Mezzetti, A, Previtali, P, Monti, G, de Toma, C, Biscardi, D, Giannini, A, Fumagalli, R, Mistraletti, G, Lissoni, B, De Martini, A, Mareto, N, Rossitto, C, Zummo, U, Taverna, M, Machieraldo, P, Navarra, M, Parlanti Garbero, M, Scaletti, C, Perno, S, Amendolia, L, Montrucchio, G, Veliaj, D, Barbarello, G, Alesci, M, Bolgiaghi, L, Vailati, D, Pezzi, A, Boselli, E, Piccoli, F, Greco, M, Gemma, M, Resta, M, Crotti, S, Bottino, N, Abruzzese, C, Savioli, M, Migliorino, G, Muttini, S, Umbrello, M, Borghi, B, Greco, S, Dizeo, M, Bottiroli, M, Mondino, M, Prosepri, M, Casella, G, Curto, F, Zaniboni, M, Giudici, R, Gentile, C, Bombino, M, Rona, R, Cortinovis, B, Benini, A, Avalli, L, Tavola, M, Ferrario, M, Preda, R, Primerano, E, Russo, G, Porta, V, Valdambrini, F, Fassini, P, Orando, S, Beck, E, Pedeferri, M, Cogliati, G, Testini, D, Moroni, B, Codeluppi, V, Ruggeri, P, Milanesi, E, Belliato, M, Besozzi, A, Riccio, M, Zerbi, S, Corbella, D, Ferri, F, Grazioli, L, Bonanomi, E, Giacomini, M, Sacchi, N, Codognola, C, Ambrosini, A, Guatteri, L, Subert, M, Castelli, G, Borelli, M, Venier, E, Dittura, L, Buttera, S, Bigai, R, Magnoni, S, Rauch, S, Colombo, A, Fullin, G, Donolato, C, Cattin, S, State, V, Redeghieri, E, Russo, A, Pastorini, S, Allena, S, Munari, M, Turchet, F, Peta, M, De Santis, V, Scala, C, Facondini, F, Marangoni, E, Tassinati, T, Zanzani, C, Russo, E, Marchio, A, Barbagallo, M, Girardis, M, Taffache, P, Mordacci, M, Vincenzi, M, Pennica, M, Bracciotti, G, Iori, P, Gambi, D, Cappellini, I, Vegnuti, L, De Luca, A, Romagnoli, S, Mosti, G, Carla, R, Roticiani, V, Pelagalli, L, Fuselli, E, D’Avino, E, De Bellis, M, Gianni, G, Leonardis, F, Rossi, M, Lorusso, R, Magnanimi, E, Martelli, S, Baisi, F, Balsamo, D, Cotticelli, V, Mattei, A, Farinelli, I, Riccini, T, Cola, L, Jorio, A, Iacobone, E, Domizi, R, Pizzi, S, Nasso, A, Graziani, R, Monaco, A, Manno, M, Ottelio, C, Del Rio, M, Serra, A, Enna, B, Loddo, F, Galbiati, R, Mellea, S, Kimberly, M, Vissani, M, Romito, F, Baccari, L, Zarrillo, N, Esposito, C, Murino, P, Notaro, S, Ausiello, C, Marra, A, Policastro, C, Cafora, C, De Benedectis, G, Di Falco, V, Sciddurlo, M, Negro, G, Vetuschi, P, Recchia, A, Pasquariello, R, Squillace, R, Ciambrone, A, Bencivenga, C, Camiolo, M, Agozzino, C, Oliveri, F, Notarrigo, T, Castiglione, G, Mo, A, Condorelli, L, and Favarato, M

Subjects
Adult, Pandemic, Patient-centered care, Communication, COVID-19, Professional-family relations, Intensive Care Units, Policy, Anesthesiology and Pain Medicine, Health communication, Professional-family relation, Surveys and Questionnaires, Communicable Disease Control, Intensive care units, Pandemics, Humans, Intensive care unit, Child
Abstract

Background During the first coronavirus disease 2019 (COVID-19) pandemic wave, an unprecedented number of patients with respiratory failure due to a new, highly contagious virus needed hospitalization and intensive care unit (ICU) admission. The aim of the present study was to describe the communication and visiting policies of Italian intensive care units (ICUs) during the first COVID-19 pandemic wave and national lockdown and compare these data with prepandemic conditions. Methods A national web-based survey was conducted among 290 Italian hospitals. Each ICU (active between February 24 and May 31, 2020) was encouraged to complete an individual questionnaire inquiring the hospital/ICU structure/organization, communication/visiting habits and the role of clinical psychology prior to, and during the first COVID-19 pandemic wave. Results Two hundred and nine ICUs from 154 hospitals (53% of the contacted hospitals) completed the survey (202 adult and 7 pediatric ICUs). Among adult ICUs, 60% were dedicated to COVID-19 patients, 21% were dedicated to patients without COVID-19 and 19% were dedicated to both categories (Mixed). A total of 11,102 adult patients were admitted to the participating ICUs during the study period and only approximately 6% of patients received at least one visit. Communication with family members was guaranteed daily through an increased use of electronic devices and was preferentially addressed to the same family member. Compared to the prepandemic period, clinical psychologists supported physicians more often regarding communication with family members. Fewer patients received at least one visit from family members in COVID and mixed-ICUs than in non-COVID ICUs, l (0 [0–6]%, 0 [0–4]% and 11 [2–25]%, respectively, p Conclusions Visiting policies of Italian ICUs dedicated to adult patients were markedly altered during the first COVID-19 wave. Remote communication was widely adopted as a surrogate for family meetings. New strategies to favor a family-centered approach during the current and future pandemics are warranted.

Published
2022

17. Barotrauma in mechanically ventilated patients with Coronavirus disease 2019: a survey of 38 hospitals in Lombardy, Italy

Author

Antonio Pesenti, Giacomo Bellani, Matteo Filippini, Anna Maria Vilardo, Roberto Fumagalli, Alessandro Santini, Giuseppe Foti, Maurizio Cecconi, Giacomo Grasselli, Sofia Spano, Massimiliano Greco, Thomas Langer, Pier Francesco Caruso, Fernando Frutos-Vivar, Alessandro Protti, Antonio Anzueto, Giuseppe Citerio, Martina Villa, Protti, A, Greco, M, Filippini, M, Vilardo, A, Langer, T, Tavola, M, Frutos-Vivar, F, Santini, A, Caruso, P, Spano, S, Anzueto, A, Citerio, G, Bellani, G, Foti, G, Fumagalli, R, Pesenti, A, Grasselli, G, and Cecconi, M

Subjects
Adult, Male, Critical Care, Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, law.invention, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, 030202 anesthesiology, law, Tidal Volume, Humans, Medicine, In patient, Tidal volume, Mechanical ventilation, Air Pressure, Respiratory Distress Syndrome, business.industry, Respiration, Incidence, Incidence (epidemiology), COVID-19, Outbreak, 030208 emergency & critical care medicine, Middle Aged, respiratory system, Respiration, Artificial, Intensive care unit, Anesthesiology and Pain Medicine, Barotrauma, Italy, Anesthesia, Artificial, Female, Tomography, X-Ray Computed, business, Airway
Abstract

BACKGROUND: The aim was to describe the incidence and risk factors of barotrauma in patients with the Coronavirus disease 2019 (COVID-19) on invasive mechanical ventilation, during the outbreak in our region (Lombardy, Italy). METHODS: The study was an electronic survey open from March 27th to May 2nd, 2020. Patients with COVID-19 who developed barotrauma while on invasive mechanical ventilation from 61 hospitals of the COVID-19 Lombardy Intensive Care Unit network were involved. RESULTS: The response rate was 38/61 (62%). The incidence of barotrauma was 145/2041 (7.1%; 95%-CI: 6.1-8.3%). Only a few cases occurred with ventilatory settings that may be considered non-protective such as a plateau airway pressure >35 cmH2O (2/113 [2%]), a driving airway pressure >15 cmH2O (30/113 [27%]), or a tidal volume >8 mL/kg of ideal body weight and a plateau airway pressure >30 cmH2O (12/134 [9%]). CONCLUSIONS: Within the limits of a survey, patients with COVID-19 might be at high risk for barotrauma during invasive (and allegedly lung-protective) mechanical ventilation.

Published
2021

18. Psychological Considerations in the Assessment and Treatment of Pain in Neurorehabilitation and Psychological Factors Predictive of Therapeutic Response: Evidence and Recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation

Author

Castelnuovo, Gianluca, Giusti, Emanuele M., Manzoni, Gian Mauro, Saviola, Donatella, Gatti, Arianna, Gabrielli, Samantha, Lacerenza, Marco, Pietrabissa, Giada, Cattivelli, Roberto, Spatola, Chiara A. M., Corti, Stefania, Novelli, Margherita, Villa, Valentina, Cottini, Andrea, Lai, Carlo, Pagnini, Francesco, Castelli, Lorys, Tavola, Mario, Torta, Riccardo, Arreghini, Marco, Zanini, Loredana, Brunani, Amelia, Capodaglio, Paolo, D'aniello, Guido E., Scarpina, Federica, Brioschi, Andrea, Priano, Lorenzo, Mauro, Alessandro, Riva, Giuseppe, Repetto, Claudia, Regalia, Camillo, Molinari, Enrico, Notaro, Paolo, Paolucci, Stefano, Sandrini, Giorgio, Simpson, Susan G., Wiederhold, Brenda, Tamburin, Stefano, Agostini, Michela, Alfonsi, Enrico, Aloisi, Anna Maria, Alvisi, Elena, Aprile, Irene, Armando, Michela, Avenali, Micol, Azicnuda, Eva, Barale, Francesco, Bartolo, Michelangelo, Bergamaschi, Roberto, Berlangieri, Mariangela, Berlincioni, Vanna, Berliocchi, Laura, Berra, Eliana, Berto, Giulia, Bonadiman, Silvia, Bonazza, Sara, Bressi, Federica, Brugnera, Annalisa, Brunelli, Stefano, Buzzi, Maria Gabriella, Cacciatori, Carlo, Calvo, Andrea, Cantarella, Cristina, Caraceni, Augusto, Carone, Roberto, Carraro, Elena, Casale, Roberto, Castellazzi, Paola, Castino, Adele, Cerbo, Rosanna, Chiã², Adriano, Ciotti, Cristina, Cisari, Carlo, Coraci, Daniele, Toffola, Elena Dalla, Defazio, Giovanni, De Icco, Roberto, Del Carro, Ubaldo, Dell'isola, Andrea, De Tanti, Antonio, D'ippolito, Mariagrazia, Fazzi, Elisa, Ferrari, Adriano, Ferrari, Sergio, Ferraro, Francesco, Formaglio, Fabio, Formisano, Rita, Franzoni, Simone, Gajofatto, Francesca, Gandolfi, Marialuisa, Gardella, Barbara, Geppetti, Pierangelo, Giammã², Alessandro, Gimigliano, Raffaele, Greco, Elena, Ieraci, Valentina, Invernizzi, Marco, Jacopetti, Marco, La Cesa, Silvia, Lobba, Davide, Magrinelli, Francesca, Mandrini, Silvia, Manera, Umberto, Marchettini, Paolo, Marchioni, Enrico, Mariotto, Sara, Martinuzzi, Andrea, Masciullo, Marella, Mezzarobba, Susanna, Miotti, Danilo, Modenese, Angela, Molinari, Marco, Monaco, Salvatore, Morone, Giovanni, Nappi, Rossella, Negrini, Stefano, Pace, Andrea, Padua, Luca, Pagliano, Emanuela, Palmerini, Valerio, Pazzaglia, Costanza, Pecchioli, Cristiano, Picelli, Alessandro, Porro, Carlo Adolfo, Porru, Daniele, Romano, Marcello, Roncari, Laura, Rosa, Riccardo, Saccavini, Marsilio, Sacerdote, Paola, Schenone, Angelo, Schweiger, Vittorio, Scivoletto, Giorgio, Smania, Nicola, Solaro, Claudio, Spallone, Vincenza, Springhetti, Isabella, Tassorelli, Cristina, Tinazzi, Michele, Togni, Rossella, Torre, Monica, Traballesi, Marco, Tramontano, Marco, Truini, Andrea, Tugnoli, Valeria, Turolla, Andrea, Vallies, Gabriella, Verzini, Elisabetta, Vottero, Mario, Zerbinati, Paolo, Castelnuovo, Gianluca, Giusti, Emanuele M., Manzoni, Gian Mauro, Saviola, Donatella, Gatti, Arianna, Gabrielli, Samantha, Lacerenza, Marco, Pietrabissa, Giada, Cattivelli, Roberto, Spatola, Chiara A. M., Corti, Stefania, Novelli, Margherita, Villa, Valentina, Cottini, Andrea, Lai, Carlo, Pagnini, Francesco, Castelli, Lory, Tavola, Mario, Torta, Riccardo, Arreghini, Marco, Zanini, Loredana, Brunani, Amelia, Capodaglio, Paolo, D'Aniello, Guido E., Scarpina, Federica, Brioschi, Andrea, Priano, Lorenzo, Mauro, Alessandro, Riva, Giuseppe, Repetto, Claudia, Regalia, Camillo, Molinari, Enrico, Notaro, Paolo, Paolucci, Stefano, Sandrini, Giorgio, Simpson, Susan G., Wiederhold, Brenda, Tamburin, Stefano, Agostini, Michela, Alfonsi, Enrico, Aloisi, Anna Maria, Alvisi, Elena, Aprile, Irene, Armando, Michela, Avenali, Micol, Azicnuda, Eva, Barale, Francesco, Bartolo, Michelangelo, Bergamaschi, Roberto, Berlangieri, Mariangela, Berlincioni, Vanna, Berliocchi, Laura, Berra, Eliana, Berto, Giulia, Bonadiman, Silvia, Bonazza, Sara, Bressi, Federica, Brugnera, Annalisa, Brunelli, Stefano, Buzzi, Maria Gabriella, Cacciatori, Carlo, Calvo, Andrea, Cantarella, Cristina, Caraceni, Augusto, Carone, Roberto, Carraro, Elena, Casale, Roberto, Castellazzi, Paola, Castino, Adele, Cerbo, Rosanna, Chiã², Adriano, Ciotti, Cristina, Cisari, Carlo, Coraci, Daniele, Toffola, Elena Dalla, Defazio, Giovanni, De Icco, Roberto, Del Carro, Ubaldo, Dell'Isola, Andrea, De Tanti, Antonio, D'Ippolito, Mariagrazia, Fazzi, Elisa, Ferrari, Adriano, Ferrari, Sergio, Ferraro, Francesco, Formaglio, Fabio, Formisano, Rita, Franzoni, Simone, Gajofatto, Francesca, Gandolfi, Marialuisa, Gardella, Barbara, Geppetti, Pierangelo, Giammã², Alessandro, Gimigliano, Raffaele, Greco, Elena, Ieraci, Valentina, Invernizzi, Marco, Jacopetti, Marco, La Cesa, Silvia, Lobba, Davide, Magrinelli, Francesca, Mandrini, Silvia, Manera, Umberto, Marchettini, Paolo, Marchioni, Enrico, Mariotto, Sara, Martinuzzi, Andrea, Masciullo, Marella, Mezzarobba, Susanna, Miotti, Danilo, Modenese, Angela, Molinari, Marco, Monaco, Salvatore, Morone, Giovanni, Nappi, Rossella, Negrini, Stefano, Pace, Andrea, Padua, Luca, Pagliano, Emanuela, Palmerini, Valerio, Pazzaglia, Costanza, Pecchioli, Cristiano, Picelli, Alessandro, Porro, Carlo Adolfo, Porru, Daniele, Romano, Marcello, Roncari, Laura, Rosa, Riccardo, Saccavini, Marsilio, Sacerdote, Paola, Schenone, Angelo, Schweiger, Vittorio, Scivoletto, Giorgio, Smania, Nicola, Solaro, Claudio, Spallone, Vincenza, Springhetti, Isabella, Tassorelli, Cristina, Tinazzi, Michele, Togni, Rossella, Torre, Monica, Traballesi, Marco, Tramontano, Marco, Truini, Andrea, Tugnoli, Valeria, Turolla, Andrea, Vallies, Gabriella, Verzini, Elisabetta, Vottero, Mario, Zerbinati, Paolo, Castelnuovo G., Giusti E.M., Manzoni G.M., Saviola D., Gatti A., Gabrielli S., Lacerenza M., Pietrabissa G., Cattivelli R., Spatola C.A.M., Corti S., Novelli M., Villa V., Cottini A., Lai C., Pagnini F., Castelli L., Tavola M., Torta R., Arreghini M., Zanini L., Brunani A., Capodaglio P., D'Aniello G.E., Scarpina F., Brioschi A., Priano L., Mauro A., Riva G., Repetto C., Regalia C., Molinari E., Notaro P., Paolucci S., Sandrini G., Simpson S.G., Wiederhold B., Tamburin S., Agostini M., Alfonsi E., Aloisi A.M., Alvisi E., Aprile I., Armando M., Avenali M., Azicnuda E., Barale F., Bartolo M., Bergamaschi R., Berlangieri M., Berlincioni V., Berliocchi L., Berra E., Berto G., Bonadiman S., Bonazza S., Bressi F., Brugnera A., Brunelli S., Buzzi M.G., Cacciatori C., Calvo A., Cantarella C., Caraceni A., Carone R., Carraro E., Casale R., Castellazzi P., Castino A., Cerbo R., Chio A., Ciotti C., Cisari C., Coraci D., Toffola E.D., Defazio G., De Icco R., Del Carro U., Dell'Isola A., De Tanti A., D'Ippolito M., Fazzi E., Ferrari A., Ferrari S., Ferraro F., Formaglio F., Formisano R., Franzoni S., Gajofatto F., Gandolfi M., Gardella B., Geppetti P., Giammo A., Gimigliano R., Greco E., Ieraci V., Invernizzi M., Jacopetti M., La Cesa S., Lobba D., Magrinelli F., Mandrini S., Manera U., Marchettini P., Marchioni E., Mariotto S., Martinuzzi A., Masciullo M., Mezzarobba S., Miotti D., Modenese A., Molinari M., Monaco S., Morone G., Nappi R., Negrini S., Pace A., Padua L., Pagliano E., Palmerini V., Pazzaglia C., Pecchioli C., Picelli A., Porro C.A., Porru D., Romano M., Roncari L., Rosa R., Saccavini M., Sacerdote P., Schenone A., Schweiger V., Scivoletto G., Smania N., Solaro C., Spallone V., Springhetti I., Tassorelli C., Tinazzi M., Togni R., Torre M., Traballesi M., Tramontano M., Truini A., Tugnoli V., Turolla A., Vallies G., Verzini E., Vottero M., Zerbinati P., Giusti, Emanuele M, and Simpson, Susan G

Subjects
medicine.medical_specialty, lcsh:BF1-990, Psychological intervention, Settore M-PSI/08 - PSICOLOGIA CLINICA, Review, 03 medical and health sciences, 0302 clinical medicine, psychological distress, health psychology, Chronic pain, Clinical psychology, Health psychology, Neurorehabilitation, Pain management, Psychology (all), medicine, Psychology, psychology (all), 030212 general & internal medicine, General Psychology, neurorehabilitation, business.industry, chronic pain, clinical psychology, pain management, medicine.disease, depression, pain Treatment, Settore MED/34 - Medicina Fisica e Riabilitativa, lcsh:Psychology, Migraine, Physical therapy, Anxiety, Pain catastrophizing, medicine.symptom, business, Psychosocial, 030217 neurology & neurosurgery, clinical psychology, health psychology
Abstract

Background: In order to provide effective care to patients suffering from chronic pain secondary to neurological diseases, health professionals must appraise the role of the psychosocial factors in the genesis and maintenance of this condition whilst considering how emotions and cognitions influence the course of treatment. Furthermore, it is important not only to recognize the psychological reactions to pain that are common to the various conditions, but also to evaluate how these syndromes differ with regards to the psychological factors that may be involved. As an extensive evaluation of these factors is still lacking, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) aimed to collate the evidence available across these topics. Objectives: To determine the psychological factors which are associated with or predictive of pain secondary to neurological conditions and to assess the influence of these aspects on the outcome of neurorehabilitation. Methods: Two reviews were performed. In the first, a PUBMED search of the studies assessing the association between psychological factors and pain or the predictive value of these aspects with respect to chronic pain was conducted. The included papers were then rated with regards to their methodological quality and recommendations were made accordingly. In the second study, the same methodology was used to collect the available evidence on the predictive role of psychological factors on the therapeutic response to pain treatments in the setting of neurorehabilitation. Results: The first literature search identified 1170 results and the final database included 189 articles. Factors such as depression, anxiety, pain catastrophizing, coping strategies, and cognitive functions were found to be associated with pain across the various conditions. However, there are differences between chronic musculoskeletal pain, migraine, neuropathy, and conditions associated with complex disability with regards to the psychological aspects that are involved. The second PUBMED search yielded 252 studies, which were all evaluated. Anxiety, depression, pain catastrophizing, coping strategies, and pain beliefs were found to be associated to different degrees with the outcomes of multidisciplinary programs, surgery, physical therapies, and psychological interventions. Finally, sense of presence was found to be related to the effectiveness of virtual reality as a distraction tool. Conclusions: Several psychological factors are associated with pain secondary to neurological conditions and should be acknowledged and addressed in order to effectively treat this condition. These factors also predict the therapeutic response to the neurorehabilitative interventions. Background: In order to provide effective care to patients suffering from chronic pain secondary to neurological diseases, health professionals must appraise the role of the psychosocial factors in the genesis and maintenance of this condition whilst considering how emotions and cognitions influence the course of treatment. Furthermore, it is important not only to recognize the psychological reactions to pain that are common to the various conditions, but also to evaluate how these syndromes differ with regards to the psychological factors that may be involved. As an extensive evaluation of these factors is still lacking, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) aimed to collate the evidence available across these topics. Objectives: To determine the psychological factors which are associated with or predictive of pain secondary to neurological conditions and to assess the influence of these aspects on the outcome of neurorehabilitation. Methods: Two reviews were performed. In the first, a PUBMED search of the studies assessing the association between psychological factors and pain or the predictive value of these aspects with respect to chronic pain was conducted. The included papers were then rated with regards to their methodological quality and recommendations were made accordingly. In the second study, the same methodology was used to collect the available evidence on the predictive role of psychological factors on the therapeutic response to pain treatments in the setting of neurorehabilitation. Results: The first literature search identified 1170 results and the final database included 189 articles. Factors such as depression, anxiety, pain catastrophizing, coping strategies, and cognitive functions were found to be associated with pain across the various conditions. However, there are differences between chronic musculoskeletal pain, migraine, neuropathy, and conditions associated with complex disability with regards to the psychological aspects that are involved. The second PUBMED search yielded 252 studies, which were all evaluated. Anxiety, depression, pain catastrophizing, coping strategies, and pain beliefs were found to be associated to different degrees with the outcomes of multidisciplinary programs, surgery, physical therapies, and psychological interventions. Finally, sense of presence was found to be related to the effectiveness of virtual reality as a distraction tool. Conclusions: Several psychological factors are associated with pain secondary to neurological conditions and should be acknowledged and addressed in order to effectively treat this condition. These factors also predict the therapeutic response to the neurorehabilitative interventions.

Published
2016
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