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1. Study protocol: understanding the pathophysiologic mechanisms underlying delirium in older people undergoing hip fracture surgery

Author

R. Gamberale, C. D’Orlando, S. Brunelli, R. Meneveri, P. Mazzola, G. Foti, G. Bellani, G. Zatti, D. Munegato, S. Volpato, A. Zurlo, G. Caruso, A. Andreano, M. G. Valsecchi, and G. Bellelli

Subjects
Postoperative delirium, Neuroinflammation, Sarcopenia, Biomarkers, Geriatrics, RC952-954.6
Abstract

Abstract Background Postoperative delirium (POD) is a common complication of older people undergoing hip fracture surgery, which negatively affects clinical- and healthcare-related outcomes. Unfortunately, POD pathophysiology is still largely unknown, despite previous studies showing that neuroinflammation, neuroendocrine dysfunction, increased reactive oxidative stress (ROS), and endothelial dysfunctions may be involved. There is also evidence that many of the pathophysiological mechanisms which are involved in delirium are involved in sarcopenia too. This article describes the protocol of a pilot study to evaluate the feasibility of a larger one that will explore the pathophysiological mechanisms correlating POD with sarcopenia. We will analyse whether various biomarkers reflecting neuroinflammation, ROS, neuroendocrine disorders, and microvasculature lesions will be simultaneously expressed in in the blood, cerebrospinal fluid (CSF), and muscles of patients developing POD. Methods Two centres will be involved in this study, each recruiting a convenient sample of ten older patients with hip fracture. All of them will undergo a baseline Comprehensive Geriatric Assessment, which will be used to construct a Rockwood-based Frailty Index (FI). Blood samples will be collected for each patient on the day of surgery and 1 day before. Additionally, CSF and muscle fragments will be taken and given to a biologist for subsequent analyses. The presence of POD will be assessed in each patient every morning until hospital discharge using the 4AT. Delirium subtypes and severity will be assessed using the Delirium Motor Subtype Scale-4 and the Delirium-O-Meter, respectively. We will also evaluate the patient’s functional status at discharge, using the Cumulated Ambulation Score. Discussion This study will be the first to correlate biomarkers of blood, CSF, and muscle in older patients with hip fracture.

Published
2021
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2. ESICM LIVES 2016: part one

Author

L. Bos, L. Schouten, L. van Vught, M. Wiewel, D. Ong, O. Cremer, A. Artigas, I. Martin-Loeches, A. Hoogendijk, T. van der Poll, J. Horn, N. Juffermans, M. Schultz, N. de Prost, T. Pham, G. Carteaux, A. Mekontso Dessap, C. Brun-Buisson, E. Fan, G. Bellani, J. Laffey, A. Mercat, L. Brochard, B. Maitre, LUNG SAFE investigators and the ESICM study group, P. A. Howells, D. R. Thickett, C. Knox, D. P. Park, F. Gao, O. Tucker, T. Whitehouse, D. F. McAuley, G. D. Perkins, LUNG SAFE Investigators and the ESICM Trials Group, L. Pisani, J. P. Roozeman, F. D. Simonis, A. Giangregorio, L. R. Schouten, S. M. Van der Hoeven, A. Serpa Neto, E. Festic, A. M. Dondorp, S. Grasso, L. D. Bos, M. J. Schultz, M. Koster-Brouwer, D. Verboom, B. Scicluna, K. van de Groep, J. Frencken, M. Bonten, J. I. Ko, K. S. Kim, G. J. Suh, W. Y. Kwon, K. Kim, J. H. Shin, O. T. Ranzani, E. Prina, R. Menendez, A. Ceccato, R. Mendez, C. Cilloniz, A. Gabarrus, M. Ferrer, A. Torres, A. Urbano, L. A. Zhang, D. Swigon, F. Pike, R. S. Parker, G. Clermont, C. Scheer, S. O. Kuhn, A. Modler, M. Vollmer, C. Fuchs, K. Hahnenkamp, S. Rehberg, M. Gründling, A. Taggu, N. Darang, N. Öveges, I. László, K. Tánczos, M. Németh, G. Lebák, B. Tudor, D. Érces, J. Kaszaki, W. Huber, D. Trásy, Z. Molnár, G. Ferrara, V. S. Kanoore Edul, H. S. Canales, E. Martins, C. Canullán, G. Murias, M. O. Pozo, J. F. Caminos Eguillor, M. G. Buscetti, C. Ince, A. Dubin, H. D. Aya, A. Rhodes, N. Fletcher, R. M. Grounds, M. Cecconi, M. Jacquet-Lagrèze, M. Riche, R. Schweizer, P. Portran, W. Fornier, M. Lilot, J. Neidecker, J. L. Fellahi, A. Escoresca-Ortega, A. Gutiérrez-Pizarraya, L. Charris-Castro, Y. Corcia-Palomo, E. Fernandez-Delgado, J. Garnacho-Montero, C. Roger, L. Muller, L. Elotmani, J. Lipman, J. Y. Lefrant, J. A. Roberts, R. Muñoz-Bermúdez, M. Samper, C. Climent, F. Vasco, V. Sara, S. Luque, N. Campillo, S. Grau Cerrato, J. R. Masclans, F. Alvarez-Lerma, S. Carvalho Brugger, G. Jimenez Jimenez, M. Miralbés Torner, J. Trujillano Cabello, B. Balsera Garrido, X. Nuvials Casals, F. Barcenilla Gaite, M. Vallverdú Vidal, M. Palomar Martínez, V. Gusarov, D. Shilkin, M. Dementienko, E. Nesterova, N. Lashenkova, A. Kuzovlev, M. Zamyatin, A. Demoule, S. Carreira, S. Lavault, O. Palancca, E. Morawiec, J. Mayaux, I. Arnulf, T. Similowski, B. S. Rasmussen, R. G. Maltesen, M. Hanifa, S. Pedersen, S. R. Kristensen, R. Wimmer, M. Panigada, G. Li Bassi, T. Kolobow, A. Zanella, M. Cressoni, L. Berra, V. Parrini, H. Kandil, G. Salati, S. Livigni, A. Amatu, A. Andreotti, F. Tagliaferri, G. Moise, G. Mercurio, A. Costa, A. Vezzani, S. Lindau, J. Babel, M. Cavana, D. Consonni, A. Pesenti, L. Gattinoni, for the GRAVITY-VAP TRIAL NETWORK, P. Mansouri, F. Zand, L. Zahed, F. Dehghanrad, M. Bahrani, M. Ghorbani, B. Cambiaghi, O. Moerer, T. Mauri, N. Kunze-Szikszay, C. Ritter, M. Quintel, L. M. Vilander, M. A. Kaunisto, S. T. Vaara, V. Pettilä, FINNAKI Study Group, J. L. G. Haitsma Mulier, S. Rozemeijer, A. M. E. Spoelstra-de Man, P. E. Elbers, P. R. Tuinman, M. C. de Waard, H. M. Oudemans-van Straaten, A. M. A. Liberatore, R. B. Souza, A. M. C. R. P. F. Martins, J. C. F. Vieira, I. H. J. Koh, M. Galindo Martínez, R. Jiménez Sánchez, L. Martínez Gascón, M. D. Rodríguez Mulero, A. Ortín Freire, A. Ojados Muñoz, S. Rebollo Acebes, Á. Fernández Martínez, S. Moreno Aliaga, L. Herrera Para, J. Murcia Payá, F. Rodríguez Mulero, P. Guerci, Y. Ince, P. Heeman, B. Ergin, Z. Uz, M. Massey, R. Papatella, E. Bulent, F. Toraman, E. R. Longbottom, H. D. Torrance, H. C. Owen, C. J. Hinds, R. M. Pearse, M. J. O’Dywer, Z. Trogrlic, M. van der Jagt, H. Lingsma, H. H. Ponssen, J. F. Schoonderbeek, F. Schreiner, S. J. Verbrugge, S. Duran, T. van Achterberg, J. Bakker, D. A. M. P. J. Gommers, E. Ista, A. Krajčová, P. Waldauf, F. Duška, A. Shah, N. Roy, S. McKechnie, C. Doree, S. Fisher, S. J. Stanworth, J. F. Jensen, D. Overgaard, M. H. Bestle, D. F. Christensen, I. Egerod, The RAPIT Group, A. Pivkina, I. Zhivotneva, N. Pasko, A. Alklit, R. L. Hansen, H. Knudsen, L. B. Grode, The RAPIT group, M. Hravnak, L. Chen, A. Dubrawski, M. R. Pinsky, S. M. Parry, L. D. Knight, B. C. Connolly, C. E. Baldwin, Z. A. Puthucheary, L. Denehy, N. Hart, P. E. Morris, J. Mortimore, C. L. Granger, H. I. Jensen, R. Piers, B. Van den Bulcke, J. Malmgren, V. Metaxa, A. K. Reyners, M. Darmon, K. Rusinova, D. Talmor, A. P. Meert, L. Cancelliere, L. Zubek, P. Maia, A. Michalsen, J. Decruyenaere, E. Kompanje, S. Vanheule, E. Azoulay, S. Vansteelandt, D. Benoit, C. Ryan, D. Dawson, J. Ball, K. Noone, B. Aisling, S. Prudden, A. Ntantana, D. Matamis, S. Savvidou, M. Giannakou, M. Gouva, G. Nakos, V. Koulouras, J. Aron, G. Lumley, D. Milliken, K. Dhadwal, B. A. McGrath, S. J. Lynch, B. Bovento, G. Sharpe, E. Grainger, S. Pieri-Davies, S. Wallace, B. McGrath, M. Jung, J. Cho, H. Park, G. Suh, O. Kousha, J. Paddle, L. Gamrin Gripenberg, M. Sundström Rehal, J. Wernerman, O. Rooyackers, H. J. de Grooth, W. P. Choo, A. M. Spoelstra-de Man, E. L. Swart, L. Talan, G. Güven, N. D. Altıntas, M. Padar, G. Uusvel, L. Starkopf, J. Starkopf, A. Reintam Blaser, M. S. Kalaiselvan, A. S. Arunkumar, M. K. Renuka, R. L. Shivkumar, M. Volbeda, D. ten Kate, M. Hoekstra, J. M. van der Maaten, M. W. Nijsten, A. Komaromi, Å. Norberg, M. Smedberg, M. Mori, L. Pettersson, M. Theodorakopoulou, T. Christodoulopoulou, A. Diamantakis, F. Frantzeskaki, M. Kontogiorgi, E. Chrysanthopoulou, M. Lygnos, C. Diakaki, A. Armaganidis, K. Gundogan, E. Dogan, R. Coskun, S. Muhtaroglu, M. Sungur, T. Ziegler, M. Guven, A. Kleyman, W. Khaliq, D. Andreas, M. Singer, R. Meierhans, R. Schuepbach, I. De Brito-Ashurst, G. Sabetian, R. Nikandish, F. Hagar, M. Masjedi, B. Maghsudi, A. Vazin, E. Asadpour, K. C. Kao, L. C. Chiu, C. Y. Hung, C. H. Chang, S. H. Li, H. C. Hu, S. El Maraghi, M. Ali, D. Rageb, M. Helmy, J. Marin-Corral, C. Vilà, A. Vàzquez, I. Martín-Loeches, E. Díaz, J. C. Yébenes, A. Rodriguez, F. Álvarez-Lerma, H1N1 SEMICYUC/GETGAG Working Group, N. Varga, A. Cortina-Gutiérrez, L. Dono, M. Martínez-Martínez, C. Maldonado, E. Papiol, M. Pérez-Carrasco, R. Ferrer, K. Nweze, B. Morton, I. Welters, M. Houard, B. Voisin, G. Ledoux, S. Six, E. Jaillette, S. Nseir, S. Romdhani, R. Bouneb, D. Loghmari, N. Ben Aicha, J. Ayachi, K. Meddeb, I. Chouchène, A. Khedher, M. Boussarsar, K. S. Chan, W. L. Yu, J. Nolla, L. Vidaur, J. Bonastre, B. Suberbiola, J. E. Guerrero, H1N1 SEMICYUC/GETGAG working group, N. Ramon Coll, G. Jiménez Jiménez, J. Codina Calero, M. García, M. C. de la Torre, E. Vendrell, E. Palomera, E. Güell, M. Serra-Prat, J. F. Bermejo-Martín, J. Almirall, E. Tomas, A. Escoval, F. Froe, M. H. Vitoria Pereira, N. Velez, E. Viegas, E. Filipe, C. Groves, M. Reay, A. Ballin, F. Facchin, G. Sartori, F. Zarantonello, E. Campello, C. M. Radu, S. Rossi, C. Ori, P. Simioni, N. Umei, I. Shingo, A. C. Santos, C. Candeias, I. Moniz, R. Marçal, Z. Costa e Silva, J. M. Ribeiro, J. F. Georger, J. P. Ponthus, M. Tchir, V. Amilien, M. Ayoub, E. Barsam, G. Martucci, G. Panarello, F. Tuzzolino, G. Capitanio, V. Ferrazza, T. Carollo, L. Giovanni, A. Arcadipane, M. López Sánchez, M. A. González-Gay, F. J. Llorca Díaz, M. I. Rubio López, E. Zogheib, L. Villeret, J. Nader, M. Bernasinski, P. Besserve, T. Caus, H. Dupont, P. Morimont, S. Habran, R. Hubert, T. Desaive, F. Blaffart, N. Janssen, J. Guiot, A. Pironet, P. Dauby, B. Lambermont, T. Pettenuzzo, G. Citton, C. Kirakli, O. Ediboglu, S. Ataman, M. Yarici, F. Tuksavul, S. Keating, A. Gibson, M. Gilles, M. Dunn, G. Price, N. Young, P. Remeta, P. Bishop, M. D. Fernández Zamora, J. Muñoz-Bono, E. Curiel-Balsera, E. Aguilar-Alonso, R. Hinojosa, A. Gordillo-Brenes, J. A. Arboleda-Sánchez, ARIAM-CARDIAC SURGERY PROJECT AUTHORS, I. Skorniakov, D. Vikulova, C. Whiteley, O. Shaikh, A. Jones, M. Ostermann, L. Forni, M. Scott, J. Sahatjian, W. Linde-Zwirble, D. Hansell, P. Laoveeravat, N. Srisawat, M. Kongwibulwut, S. Peerapornrattana, N. Suwachittanont, T. O. Wirotwan, P. Chatkaew, P. Saeyub, K. Latthaprecha, K. Tiranathanagul, S. Eiam-ong, J. A. Kellum, R. E. Berthelsen, A. Perner, A. E. K. Jensen, J. U. Jensen, D. J. Gebhard, J. Price, C. E. Kennedy, A. Akcan-Arikan, Y. R. Kang, M. N. Nakamae, K. Hamed, M. M. Khaled, R. Aly Soliman, M. Sherif Mokhtar, G. Seller-Pérez, D. Arias-Verdú, E. Llopar-Valdor, I. De-Diós-Chacón, G. Quesada-García, M. E. Herrera-Gutierrez, R. Hafes, G. Carroll, P. Doherty, C. Wright, I. G. Guerra Vera, M. Ralston, M. L. Gemmell, A. MacKay, E. Black, R. I. Docking, R. Appleton, M. R. Ralston, L. Gemmell, A. Mackay, J. G. Röttgering, P. W. G. Elbers, N. Mejeni, J. Nsiala, A. Kilembe, P. Akilimali, G. Thomas, A. E. Andersson, A. M. Fagerdahl, V. Knudsen, P-INFECT, A. Ben Cheikh, Y. Hamdaoui, A. Guiga, N. Fraj, N. Sma, I. Chouchene, N. Bouafia, A. Amirian, B. Ziaian, C. Fleischmann, D. O. Thomas-Rueddel, A. Schettler, D. Schwarzkopf, A. Stacke, K. Reinhart, A. Martins, P. Sousa, G. Snell, R. Matsa, T. T. S. Paary, A. M. Cavalheiro, L. L. Rocha, C. S. Vallone, A. Tonilo, M. D. S. Lobato, D. T. Malheiro, G. Sussumo, N. M. Lucino, V. D. Rosenthal, A. Sanaei Dashti, A. Yousefipour, J. R. Goodall, M. Williamson, E. Tant, N. Thomas, C. Balci, C. Gonen, E. Haftacı, H. Gurarda, E. Karaca, B. Paldusová, I. Zýková, D. Šímová, S. Houston, L. D’Antona, J. Lloyd, V. Garnelo-Rey, M. Sosic, V. Sotosek-Tokmazic, J. Kuharic, I. Antoncic, S. Dunatov, A. Sustic, C. T. Chong, M. Sim, T. Lyovarin, F. M. Acosta Díaz, S. Narbona Galdó, M. Muñoz Garach, O. Moreno Romero, A. M. Pérez Bailón, A. Carranza Pinel, M. Colmenero, A. Gritsan, A. Gazenkampf, E. Korchagin, N. Dovbish, R. M. Lee, M. P. P. Lim, B. C. L. Lim, J. J. See, R. Assis, F. Filipe, N. Lopes, L. Pessoa, T. Pereira, N. Catorze, M. S. Aydogan, C. Aldasoro, P. Marchio, A. Jorda, M. D. Mauricio, S. Guerra-Ojeda, M. Gimeno-Raga, M. Colque-Cano, A. Bertomeu-Artecero, M. Aldasoro, S. L. Valles, D. Tonon, T. Triglia, J. C. Martin, M. C. Alessi, N. Bruder, P. Garrigue, L. Velly, S. Spina, V. Scaravilli, C. Marzorati, E. Colombo, D. Savo, A. Vargiolu, G. Cavenaghi, G. Citerio, A. H. V. Andrade, P. Bulgarelli, J. A. P. Araujo, V. Gonzalez, V. A. Souza, C. Massant, C. A. C. Abreu Filho, R. A. Morbeck, L. E. Burgo, R. van Groenendael, L. T. van Eijk, G. P. Leijte, B. Koeneman, M. Kox, P. Pickkers, A. García-de la Torre, M. de la Torre-Prados, A. Fernández-Porcel, C. Rueda-Molina, P. Nuevo-Ortega, T. Tsvetanova-Spasova, E. Cámara-Sola, A. García-Alcántara, L. Salido-Díaz, X. Liao, T. Feng, J. Zhang, X. Cao, Q. Wu, Z. Xie, H. Li, Y. Kang, M. S. Winkler, A. Nierhaus, E. Mudersbach, A. Bauer, L. Robbe, C. Zahrte, E. Schwedhelm, S. Kluge, C. Zöllner, E. Mitsi, S. H. Pennington, J. Reine, A. D. Wright, R. Parker, I. D. Welters, J. D. Blakey, G. Rajam, E. W. Ades, D. M. Ferreira, D. Wang, A. Kadioglu, S. B. Gordon, R. Koch, J. Rahamat-Langedoen, J. Schloesser, M. de Jonge, J. Bringue, R. Guillamat-Prats, E. Torrents, M. L. Martinez, M. Camprubí-Rimblas, L. Blanch, S. Y. Park, Y. B. Park, D. K. Song, S. Shrestha, S. H. Park, Y. Koh, M. J. Park, C. W. Hong, O. Lesur, D. Coquerel, X. Sainsily, J. Cote, T. Söllradl, A. Murza, L. Dumont, R. Dumaine, M. Grandbois, P. Sarret, E. Marsault, D. Salvail, M. Auger-Messier, F. Chagnon, Apelin Group, M. P. Lauretta, E. Greco, A. Dyson, S. Preau, M. Ambler, A. Sigurta, S. Saeed, L. Topcu Sarıca, N. Zibandeh, D. Genc, F. Gul, T. Akkoc, E. Kombak, L. Cinel, I. Cinel, S. J. Pollen, N. Arulkumaran, G. Warnes, D. J. Pennington, K. Brohi, M. J. O’Dwyer, H. Y. Kim, S. Na, J. Kim, Y. F. Chang, A. Chao, P. Y. Shih, C. T. Lee, Y. C. Yeh, L. W. Chen, M. Adriaanse, W. Rietdijk, S. Funcke, S. Sauerlaender, B. Saugel, H. Pinnschmidt, D. A. Reuter, R. Nitzschke, S. Perbet, C. Biboulet, A. Lenoire, D. Bourdeaux, B. Pereira, B. Plaud, J. E. Bazin, V. Sautou, A. Mebazaa, J. M. Constantin, M. Legrand, Y. Boyko, P. Jennum, M. Nikolic, H. Oerding, R. Holst, P. Toft, H. K. Nedergaard, T. Haberlandt, S. Park, S. Kim, Y. J. Cho, Y. J. Lim, A. Chan, S. Tang, S. L. Nunes, S. Forsberg, H. Blomqvist, L. Berggren, M. Sörberg, T. Sarapohja, C. J. Wickerts, J. G. M. Hofhuis, L. Rose, B. Blackwood, E. Akerman, J. Mcgaughey, M. Fossum, H. Foss, E. Georgiou, H. J. Graff, M. Kalafati, R. Sperlinga, A. Schafer, A. G. Wojnicka, P. E. Spronk, F. Khalili, R. Afshari, H. Haddad Khodaei, S. Javadpour, P. Petramfar, S. Nasimi, H. Tabei, A. Gunther, J. O. Hansen, P. Sackey, H. Storm, J. Bernhardsson, Ø. Sundin, A. Bjärtå, A. Bienert, P. Smuszkiewicz, P. Wiczling, K. Przybylowski, A. Borsuk, I. Trojanowska, J. Matysiak, Z. Kokot, M. Paterska, E. Grzeskowiak, A. Messina, E. Bonicolini, D. Colombo, G. Moro, S. Romagnoli, A. R. De Gaudio, F. Della Corte, S. M. Romano, J. A. Silversides, E. Major, E. E. Mann, A. J. Ferguson, D. F. Mcauley, J. C. Marshall, J. A. Diaz-Rodriguez, R. Silva-Medina, E. Gomez-Sandoval, N. Gomez-Gonzalez, R. Soriano-Orozco, P. L. Gonzalez-Carrillo, M. Hernández-Flores, K. Pilarczyk, J. Lubarksi, D. Wendt, F. Dusse, J. Günter, B. Huschens, E. Demircioglu, H. Jakob, A. Palmaccio, A. M. Dell’Anna, D. L. Grieco, F. Torrini, C. Iaquaniello, F. Bongiovanni, M. Antonelli, L. Toscani, D. Antonakaki, D. Bastoni, M. Jozwiak, F. Depret, J. L. Teboul, J. Alphonsine, C. Lai, C. Richard, X. Monnet, G. Demeter, I. Kertmegi, A. Hasanin, A. Lotfy, A. El-adawy, H. Nassar, S. Mahmoud, A. Abougabal, A. Mukhtar, F. Quinty, S. Habchi, A. Luzi, E. Antok, G. Hernandez, B. Lara, L. Enberg, M. Ortega, P. Leon, C. Kripper, P. Aguilera, E. Kattan, M. Lehmann, S. Sakka, B. Bein, R. M. Schmid, J. Preti, J. Creteur, A. Herpain, J. Marc, F. Trojette, S. Bar, L. Kontar, D. Titeca, J. Richecoeur, B. Gelee, N. Verrier, R. Mercier, E. Lorne, J. Maizel, M. Slama, M. E. Abdelfattah, A. Eladawy, M. A. Ali Elsayed, A. Pedraza Montenegro, E. Monares Zepeda, J. Franco Granillo, J. S. Aguirre Sánchez, G. Camarena Alejo, A. Rugerio Cabrera, A. A. Tanaka Montoya, C. Lee, F. Hatib, M. Cannesson, P. Theerawit, T. Morasert, Y. Sutherasan, G. Zani, S. Mescolini, M. Diamanti, R. Righetti, A. Scaramuzza, M. Papetti, M. Terenzoni, C. Gecele, M. Fusari, K. A. Hakim, A. Chaari, M. Ismail, A. H. Elsaka, T. M. Mahmoud, K. Bousselmi, V. Kauts, W. F. Casey, S. D. Hutchings, D. Naumann, J. Wendon, S. Watts, E. Kirkman, Z. Jian, S. Buddi, J. Settels, P. Bertini, F. Guarracino, C. Trepte, P. Richter, S. A. Haas, V. Eichhorn, J. C. Kubitz, M. S. Soliman, W. I. Hamimy, A. Z. Fouad, A. M. Mukhtar, M. Charlton, L. Tonks, L. Mclelland, T. J. Coats, J. P. Thompson, M. R. Sims, D. Williams, D. Z. Roushdy, R. A. Soliman, R. A. Nahas, M. Y. Arafa, W. T. Hung, C. C. Chiang, W. C. Huang, K. C. Lin, S. C. Lin, C. C. Cheng, P. L. Kang, S. R. Wann, G. Y. Mar, C. P. Liu, M. Lopez Carranza, H. Sancho Fernandez, J. A. Sanchez Roman, F. Lucena, A. Campanario Garcia, A. Loza Vazquez, A. Lesmes Serrano, ARIAM-SEMICYUC Registry Investigators, L. Sayagues Moreira, R. Vidal-Perez, U. Anido Herranz, J. M. Garcia Acuna, C. Pena Gil, J. L. Garcia Allut, P. Rascado Sedes, C. Martin Lopez, E. Saborido Paz, C. Galban Rodriguez, J. R. Gonzalez-Juanatey, A. Vallejo-Baez, M. V. de la Torre-Prados, ARIAM Group, R. Marharaj, K. Gervasio, M. Bottiroli, M. Mondino, D. De Caria, A. Calini, E. Montrasio, F. Milazzo, M. P. Gagliardone, A. Vallejo-Báez, ARIAM group, U. Anido, M. Cheikh-Bouhlel, M. P. R. D. L. Dela Cruz, J. M. Bernardo, F. Galfo, A. Marino, C. C. Chao, P. Hou, C. C. Hung, C. H. Chiang, Y. J. Liou, S. M. Hung, Y. S. Lin, F. Y. Kuo, K. R. Chiou, C. J. Chen, L. S. Yan, C. Y. Liu, H. H. Wang, H. L. Chen, C. K. Ho, S. Grewal, S. Gopal, C. Corbett, A. Wilson, J. Capps, W. Ayoub, A. Lomas, S. Ghani, J. Moore, D. Atkinson, M. Sharman, W. Swinnen, J. Pauwels, K. Mignolet, E. Pannier, A. Koch, T. Sarens, W. Temmerman, A. M. Elmenshawy, A. M. Fayed, M. Elboriuny, E. Hamdy, E. Zakaria, A. C. Falk, A. Petosic, K. Olafsen, H. Wøien, H. Flaatten, K. Sunde, J. J. Cáceres Agra, J. L. Santana Cabrera, J. D. Martín Santana, L. Melián Alzola, H. Rodríguez Pérez, T. Castro Pires, H. Calderón, A. Pereira, S. Castro, C. Granja, I. Norkiene, I. Urbanaviciute, G. Kezyte, D. Ringaitiene, T. Jovaisa, G. Vogel, U. B. Johansson, A. Sandgren, C. Svensen, E. Joelsson-Alm, M. A. Leite, L. D. Murbach, E. F. Osaku, C. R. L. M. Costa, M. Pelenz, N. M. Neitzke, M. M. Moraes, J. L. Jaskowiak, M. M. M. Silva, R. S. Zaponi, L. R. L. Abentroth, S. M. Ogasawara, A. C. Jorge, P. A. D. Duarte, J. Barreto, S. T. Duarte, S. Taba, D. Miglioranza, D. P. Gund, C. F. Lordani, H. Vollmer, M. Gager, C. Waldmann, A. T. Mazzeo, R. Tesio, C. Filippini, M. E. Vallero, C. Giolitti, S. Caccia, M. Medugno, T. Tenaglia, R. Rosato, I. Mastromauro, L. Brazzi, P. P. Terragni, R. Urbino, V. Fanelli, V. M. Ranieri, L. Mascia, J. Ballantyne, L. Paton, P. Perez-Teran, O. Roca, J. C. Ruiz-Rodriguez, A. Zapatero, J. Serra, S. Bianzina, P. Cornara, G. Rodi, G. Tavazzi, M. Pozzi, G. A. Iotti, F. Mojoli, A. Braschi, A. Vishnu, D. Buche, R. Pande, D. L. J. Moolenaar, F. Bakhshi-Raiez, D. A. Dongelmans, N. F. de Keizer, D. W. de Lange, I. Fuentes Fernández, D. Martínez Baño, J. L. Buendía Moreno, R. Jara Rubio, J. Scott, D. Phelan, D. Morely, J. O’Flynn, P. Stapleton, M. Lynch, B. Marsh, E. Carton, C. O’Loughlin, K. C. Cheng, M. I. Sung, M. O. Elghonemi, M. H. Saleh, T. S. Meyhoff, M. Krag, P. B. Hjortrup, M. H. Møller, T. Öhman, T. Sigmundsson, E. Redondo, M. Hallbäck, F. Suarez-Sipmann, H. Björne, C. Hällsjö Sander, KARISMA, D. Chiumello, C. Chiurazzi, M. Brioni, I. Algieri, M. Guanziroli, G. Vergani, T. Tonetti, I. Tomic, A. Colombo, F. Crimella, E. Carlesso, V. Gasparovic, R. El-Sherif, M. Abd Al-Basser, A. Raafat, A. El-Sherif, L. R. A. Schouten, O. L. Cremer, D. S. Y. Ong, G. Amoruso, G. Cinnella, L. D. J. Bos, P. Schmidle, M. Findeisen, P. Hoppmann, J. Jaitner, F. Brettner, T. Lahmer, EXODUS-investigators, G. Rajagopalan, V. Bansal, R. Frank, R. Hinds, J. Levitt, United States Critical Illness and Injury Trials Group/LIPS-B investigators, S. Siddiqui, SICM NICER Group, J. P. Gilbert, K. Sim, C. H. Wang, I. J. Li, W. R. Tang, P. Persona, A. De Cassai, M. Franco, A. Goffi, B. Llorente Ruiz, J. Lujan Varas, R. Molina Montero, C. Pintado Delgado, O. Navarrete, M. Vazquez Mezquita, E. Alonso Peces, M. A. M. Nakamura, L. A. Hajjar, F. R. B. G. Galas, T. A. Ortiz, M. B. P. Amato, L. Bitker, N. Costes, D. Le Bars, F. Lavenne, D. Mojgan, J. C. Richard, D. Massari, M. Gotti, P. Cadringher, A. Zerman, M. Türkoğlu, G. Arık, F. Yıldırım, Z. Güllü, I. Kara, N. Boyacı, B. Basarık Aydoğan, Ü. Gaygısız, K. Gönderen, G. Aygencel, M. Aydoğdu, Z. Ülger, G. Gürsel, J. Riera, C. Maldonado Toral, C. Mazo, M. Martínez, J. Baldirà, L. Lagunes, A. Roman, M. Deu, J. Rello, D. J. Levine, R. M. Mohus, Å. Askim, J. Paulsen, A. Mehl, A. T. Dewan, J. K. Damås, E. Solligård, B. O. Åsvold, Mid-Norway Sepsis Research Center, A. DeWan, O. Aktepe, A. Kara, H. Yeter, A. Topeli, M. Norrenberg, M. Devroey, H. Khader, J. C. Preiser, Z. Tang, C. Qiu, L. Tong, C. Cai, O. Apostolopoulou, J. Y. Moon, M. R. Park, I. S. Kwon, G. R. Chon, J. Y. Ahn, S. J. Kwon, Y. J. Chang, J. Y. Lee, S. Y. Yoon, J. W. Lee, The Korean Chungcheong Critical Care Research Group, M. Kostalas, J. Mckinlay, G. Kooner, G. Dudas, A. Horton, C. Kerr, N. Karanjia, B. Creagh-Brown, N. D. Altintas, S. Izdes, O. Keremoglu, A. Alkan, S. Neselioglu, O. Erel, N. Tardif, T. Gustafsson, K. N. MacEachern, M. Traille, I. Bromberg, S. E. Lapinsky, M. J. Moore, J. L. García-Garmendia, F. Villarrasa-Clemente, F. Maroto-Monserrat, O. Rufo-Tejeiro, V. Jorge-Amigo, M. Sánchez-Santamaría, C. Colón-Pallarés, A. Barrero-Almodóvar, S. Gallego-Lara, C. T. Anthon, R. B. Müller, N. Haase, K. Møller, J. Wetterslev, M. Nakanishi, A. Kuriyama, T. Fukuoka, M. A. Abd el Halim, M. H. Elsaid hafez, A. M. Moktar, H. M. Elazizy, K. Abdel Hakim, M. Elbahr, T. Mahmoud, E. Khalil, W. Casey, S. H. Zaky, A. Rizk, R. Ahmed, G. A. Ospina-Tascón, A. F. Garcia Marin, G. J. Echeverry, W. F. Bermudez, H. J. Madriñan-Navia, J. D. Valencia, E. Quiñonez, A. Marulanda, C. A. Arango-Dávila, A. Bruhn, D. De Backer, D. Orbegozo Cortes, F. Su, J. L. Vincent, L. Tullo, L. Mirabella, P. Di Molfetta, M. Dambrosio, C. Villavicencio Lujan, J. Leache irigoyen, M. Cartanya ferré, R. Carbonell García, M. Ahmed, M. El Ayashi, E. Ayman, M. Salem, S. Fathy, A. Zaghlol, M. F. Aguilar Arzapalo, Å. Valsø, T. Rustøen, I. Schou-Bredal, L. Skogstad, K. Tøien, C. Padilla, Y. Palmeiro, W. Egbaria, R. Kigli, B. Maertens, K. Blot, S. Blot, E. Santana-Santos, E. R. dos Santos, R. E. D. L. Ferretti-Rebustini, R. D. C. C. D. O. dos Santos, R. G. S. Verardino, L. A. Bortolotto, A. M. Doyle, I. Naldrett, J. Tillman, S. Price, P. Pearson, J. Greaves, D. Goodall, A. Berry, A. Richardson, G. O. Odundo, P. Omengo, P. Obonyo, N. M. Chanzu, R. Kleinpell, S. J. Sarris, P. Nedved, M. Heitschmidt, H. Ben-Ghezala, S. Snouda, S. Djobbi, N. K. J. Adhikari, D. Leasa, D. Fergusson, D. A. Mckim, J. Weblin, D. McWilliams, F. Doesburg, F. Cnossen, W. Dieperink, W. Bult, M. W. N. Nijsten, G. A. Galvez-Blanco, C. I. Olvera Guzman, J. Santos Stroud, R. Thomson, M. Llaurado-Serra, A. Lobo-Civico, M. Pi-Guerrero, I. Blanco-Sanchez, A. Piñol-Tena, C. Paños-Espinosa, Y. Alabart-Segura, B. Coloma-Gomez, A. Fernandez-Blanco, F. Braga-Dias, M. Treso-Geira, A. Valeiras-Valero, L. Martinez-Reyes, A. Sandiumenge, M. F. Jimenez-Herrera, CAPCRI Study, R. Prada, P. Juárez, R. Argandoña, J. J. Díaz, C. Sánchez Ramirez, P. Saavedra, S. Ruiz Santana, O. Obukhova, S. Kashiya, I. A. Kurmukov, A. M. Pronina, P. Simeone, L. Puybasset, G. Auzias, O. Coulon, B. Lesimple, G. Torkomian, A. Bartkowska-Sniatkowska, O. Szerkus, D. Siluk, J. Bartkowiak-Wieczorek, J. Rosada-Kurasinska, J. Warzybok, R. Kaliszan, C. Hernandez Caballero, S. Roberts, G. Isgro, D. Hall, G. Guillaume, O. Passouant, F. Dumas, W. Bougouin, B. Champigneulle, M. Arnaout, J. Chelly, J. D. Chiche, O. Varenne, J. P. Mira, E. Marijon, A. Cariou, M. Beerepoot, H. R. Touw, K. Parlevliet, C. Boer, P. W. Elbers, Á. J. Roldán Reina, Y. Corcia Palomo, R. Martín Bermúdez, L. Martín Villén, I. Palacios García, J. R. Naranjo Izurieta, J. B. Pérez Bernal, F. J. Jiménez Jiménez, Cardiac Arrest Group HUVR, F. Cota-Delgado, T. Kaneko, H. Tanaka, M. Kamikawa, R. Karashima, S. Iwashita, H. Irie, S. Kasaoka, O. Arola, R. Laitio, A. Saraste, J. Airaksinen, M. Pietilä, M. Hynninen, J. Wennervirta, M. Bäcklund, E. Ylikoski, P. Silvasti, E. Nukarinen, J. Grönlund, V. P. Harjola, J. Niiranen, K. Korpi, M. Varpula, R. O. Roine, T. Laitio, for the Xe-HYPOTHECA study group, S. Salah, B. G. Hassen, A. Mohamed Fehmi, Y. C. Hsu, J. Barea-Mendoza, C. García-Fuentes, M. Castillo-Jaramillo, H. Dominguez-Aguado, R. Viejo-Moreno, L. Terceros-Almanza, S. Bermejo Aznárez, C. Mudarra-Reche, W. Xu, M. Chico-Fernández, J. C. Montejo-González, K. Crewdson, M. Thomas, M. Merghani, L. Fenner, P. Morgan, D. Lockey, E. J. van Lieshout, B. Oomen, J. M. Binnekade, R. J. de Haan, N. P. Juffermans, M. B. Vroom, R. Algarte, L. Martínez, B. Sánchez, I. Romero, F. Martínez, S. Quintana, J. Trenado, O. Sheikh, D. Pogson, R. Clinton, F. Riccio, A. Arthur, L. Young, A. Sinclair, D. Markopoulou, K. Venetsanou, L. Filippou, E. Salla, S. Stratouli, I. Alamanos, A. H. Guirgis, R. Gutiérrez Rodriguez, M. J. Furones Lorente, I. Macias Guarasa, A. Ukere, S. Meisner, G. Greiwe, B. Opitz, D. Benten, B. Nashan, L. Fischer, C. J. C. Trepte, C. R. Behem, B. Ana, A. Vazir, D. Gibson, M. R. Hadavi, M. Riahi alam, M. R. Sasani, N. Parenti, F. Agrusta, C. Palazzi, B. Pifferi, R. Sganzerla, F. Tagliazucchi, A. Luciani, M. Möller, J. Müller-Engelmann, G. Montag, P. Adams, C. Lange, J. Neuzner, R. Gradaus, K. H. Wodack, F. Thürk, A. D. Waldmann, M. F. Grässler, S. Nishimoto, S. H. Böhm, E. Kaniusas, C. J. Trepte, M. Wallin, F. Suarez Sipman, A. Oldner, L. Colinas, R. Vicho, M. Serna, R. Cuena, A. Canabal, ECOCRITIC group, M. Etman, M. El Bahr, A. El Sakka, A. Arali, O. Bond, P. De Santis, E. Iesu, F. Franchi, S. Scolletta, F. S. Taccone, Z. Marutyan, L. Hamidova, A. Shakotko, V. Movsisyan, I. Uysupova, A. Evdokimov, S. Petrikov, F. J. Redondo Calvo, N. Bejarano, V. Baladron, R. Villazala, J. Redondo, D. Padilla, P. Villarejo, C. Gomez-Gonzalez, S. Mas-Font, A. Puppo-Moreno, M. Herrera-Gutierrez, M. Garcia-Garcia, S. Aldunate-Calvo, NEFROCON Investigators, E. P. Plata-Menchaca, X. L. Pérez-Fernández, M. Estruch, A. Betbese-Roig, P. Cárdenas Campos, M. Rojas Lora, N. D. Toapanta Gaibor, R. S. Contreras Medina, V. D. Gumucio Sanguino, E. J. Casanova, J. Sabater Riera, SIRAKI group, K. Kritmetapak, S. Peerapornratana, P. Kittiskulnam, T. Dissayabutra, P. Susantithapong, K. Praditpornsilpa, K. Tungsanga, S. Eiam-Ong, T. Winkelmann, T. Busch, J. Meixensberger, S. Bercker, E. M. Flores Cabeza, M. Sánchez Sánchez, N. Cáceres Giménez, C. Gutierrez Melón, E. Herrero de Lucas, P. Millán Estañ, M. Hernández Bernal, A. Garcia de Lorenzo y Mateos, P. A. C. Specht, M. Balik, M. Zakharchenko, F. Los, H. Brodska, C. de Tymowski, P. Augustin, M. Desmard, P. Montravers, S. N. Stapel, R. de Boer, H. M. Oudemans, A. Hollinger, T. Schweingruber, F. Jockers, M. Dickenmann, M. Siegemund, Clinical Intensive Care Research Basel, N. Runciman, L. Alban, C. Turrini, T. Sasso, T. Langer, P. Taccone, C. Marenghi, G. Grasselli, P. Wibart, T. Reginault, M. Garcia, B. Barbrel, A. Benard, C. Bader, F. Vargas, H. N. Bui, G. Hilbert, J. M. Serrano Simón, P. Carmona Sánchez, F. Ruiz Ferrón, M. García de Acilu, J. Marin, V. Antonia, L. Ruano, M. Monica, G. Hong, D. H. Kim, Y. S. Kim, J. S. Park, Y. K. Jee, Z. Yu xiang, W. Jia-xing, W. Xiao dan, N. Wen long, W. Yu, Z. Yan, X. Cheng, T. Kobayashi, Y. Onodera, R. Akimoto, A. Sugiura, H. Suzuki, M. Iwabuchi, M. Nakane, K. Kawamae, P. Carmona Sanchez, M. D. Bautista Rodriguez, M. Rodriguez Delgado, V. Martínez de Pinillos Sánchez, A. Mula Gómez, P. Beuret, C. Fortes, M. Lauer, M. Reboul, J. C. Chakarian, X. Fabre, B. Philippon-Jouve, S. Devillez, M. Clerc, N. Rittayamai, M. Sklar, M. Dres, M. Rauseo, C. Campbell, B. West, D. E. Tullis, M. Okada, N. Ahmad, M. Wood, A. Glossop, J. Higuera Lucas, A. Blandino Ortiz, D. Cabestrero Alonso, R. De Pablo Sánchez, L. Rey González, R. Costa, G. Spinazzola, A. Pizza, G. Ferrone, M. Rossi, G. Conti, H. Ribeiro, J. Alves, M. Sousa, P. Reis, C. S. Socolovsky, R. P. Cauley, J. E. Frankel, A. L. Beam, K. O. Olaniran, F. K. Gibbons, K. B. Christopher, J. Pennington, P. Zolfaghari, H. S. King, H. H. Y. Kong, H. P. Shum, W. W. Yan, C. Kaymak, N. Okumus, A. Sari, B. Erdogdu, S. Aksun, H. Basar, A. Ozcan, N. Ozcan, D. Oztuna, J. A. Malmgren, S. Lundin, K. Torén, M. Eckerström, A. Wallin, A. C. Waldenström, for the Section on Ethics of the ESICM, F. C. Riccio, A. C. P. Antonio, A. F. Leivas, F. Kenji, E. James, S. Jonnada, C. S. Gerrard, N. Jones, J. D. Salciccioli, D. C. Marshall, M. Komorowski, A. Hartley, M. C. Sykes, R. Goodson, J. Shalhoub, J. R. Fernández Villanueva, R. Fernández Garda, A. M. López Lago, E. Rodríguez Ruiz, R. Hernández Vaquero, C. Galbán Rodríguez, E. Varo Pérez, C. Hilasque, I. Oliva, G. Sirgo, M. C. Martin, M. Olona, M. C. Gilavert, M. Bodí, C. Ebm, G. Aggarwal, S. Huddart, N. Quiney, S. M. Fernandes, J. Santos Silva, J. Gouveia, D. Silva, R. Marques, H. Bento, A. Alvarez, Z. Costa Silva, D. Díaz Diaz, M. Villanova Martínez, E. Palencia Herrejon, A. Martinez de la Gandara, G. Gonzalo, M. A. Lopez, P. Ruíz de Gopegui Miguelena, C. I. Bernal Matilla, P. Sánchez Chueca, M. D. C. Rodríguez Longares, R. Ramos Abril, A. L. Ruíz Aguilar, R. Garrido López de Murillas, R. Fernández Fernández, P. Morales Laborías, M. A. Díaz Castellanos, M. E. Morales Laborías, J. Park, S. Woo, T. West, E. Powell, A. Rimmer, C. Orford, J. Williams, P. Ruiz de Gopegui Miguelena, R. S. Bourne, R. Shulman, M. Tomlin, G. H. Mills, M. Borthwick, W. Berry, D. García Huertas, F. Manzano, F. Villagrán-Ramírez, A. Ruiz-Perea, C. Rodríguez-Mejías, F. Santiago-Ruiz, M. Colmenero-Ruiz, C. König, B. Matt, A. Kortgen, C. S. Hartog, A. Wong, C. Balan, G. Barker, S. Tachaboon, J. Paratz, G. Kayambu, R. Boots, R. Vlasenko, E. Gromova, S. Loginov, M. Kiselevskiy, Y. Dolgikova, K. B. Tang, C. M. Chau, K. N. Lam, E. Gil, G. Y. Suh, C. M. Park, C. R. Chung, C. H. Lai, Y. J. Cheng, V. Colella, N. Zarrillo, M. D’Amico, F. Forfori, B. Pezza, T. Laddomada, V. Beltramelli, M. L. Pizzaballa, A. Doronzio, B. Balicco, D. Kiers, W. van der Heijden, J. Gerretsen, Q. de Mast, S. el Messaoudi, G. Rongen, M. Gomes, N. P. Riksen, Y. Kashiwagi, K. Hayashi, Y. Inagaki, S. Fujita, A. Blet, M. Sadoune, J. Lemarié, N. Bihry, R. Bern, E. Polidano, R. Merval, J. M. Launay, B. Lévy, J. L. Samuel, J. Hartmann, S. Harm, and V. Weber

Subjects
Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Published
2016
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3. PEEP titration is markedly affected by trunk inclination in mechanically ventilated patients with ARDS: a physiologic, cross‐over study

Author

Marrazzo, F, Spina, S, Zadek, F, Forlini, C, Bassi, G, Giudici, R, Bellani, G, Fumagalli, R, Langer, T, F. Marrazzo, S. Spina, F. Zadek, C. Forlini, G. Bassi, R. Giudici, G. Bellani, R. Fumagalli, T. Langer, Marrazzo, F, Spina, S, Zadek, F, Forlini, C, Bassi, G, Giudici, R, Bellani, G, Fumagalli, R, Langer, T, F. Marrazzo, S. Spina, F. Zadek, C. Forlini, G. Bassi, R. Giudici, G. Bellani, R. Fumagalli, and T. Langer

Published
2023

4. Role of different driving pressure levels and respiratory rate on ventilator induced lung injury in lung injured rats undergoing mechanical ventilation

Author

Raimondi Cominesi, D, Zambelli, V, Fumagalli, R, Bellani, G, Foti, G, Rezoagli, E, D. Raimondi Cominesi, V. Zambelli, R. Fumagalli, G. Bellani, G. Foti, E. Rezoagli, Raimondi Cominesi, D, Zambelli, V, Fumagalli, R, Bellani, G, Foti, G, Rezoagli, E, D. Raimondi Cominesi, V. Zambelli, R. Fumagalli, G. Bellani, G. Foti, and E. Rezoagli

Published
2023

5. High efficiency particulate air filters and heat & moisture exchanger filters increase positive end-expiratory pressure in helmet continuous positive airway pressure: A bench-top study

Author

E. Rezoagli, G. Coppola, L. Dezza, A. Galesi, G.P. Gallo, R. Fumagalli, G. Bellani, G. Foti, A. Lucchini, Rezoagli, E, Coppola, G, Dezza, L, Galesi, A, Gallo, G, Fumagalli, R, Bellani, G, Foti, G, and Lucchini, A

Subjects
Helmet, Pulmonary and Respiratory Medicine, HEPA, NIV, CPAP, Airway pressure, PEEP
Abstract

Background: Helmet continuous positive airway pressure (CPAP) has been widely used during the COVID-19 pandemic. Specific filters (i.e. High Efficiency Particulate Air filter: HEPA; Heat & Moisture Exchanger Filter: HMEF) were used to prevent Sars-CoV2 environmental dispersion and were connected to the CPAP helmet. However, HEPA and HMEF filters may act as resistors to expiratory gas flow and increase the levels of pressure within the hood. Methods: In a bench-top study, we investigated the levels of airway pressure generated by different HEPA and HMEF filters connected to the CPAP helmet in the absence of a Positive End Expiratory Pressure (PEEP) valve and with two levels of PEEP (5 and 10 cmH2O). All steps were performed using 3 increasing levels of gas flow (60, 80, 100 L/min). Results: The use of 8 different commercially available filters significantly increased the pressure within the hood of the CPAP helmet with or without the use of PEEP valves. On average, the increase of pressure above the set PEEP ranged from 3 cmH2O to 10 cmH2O across gas flow rates of 60 to 100 L/min. The measure of airway pressure was highly correlated between the laboratory pressure transducer and the Helmet manometer. Bias with 95% Confidence Interval of Bias between the devices was 0.7 (-2.06; 0.66) cmH2O. Conclusions: The use of HEPA and HMEF filters placed before the PEEP valve at the expiratory port of the CPAP helmet significantly increase the levels of airway pressure compared to the set level of PEEP. The manometer can detect accurately the airway pressure in the presence of HEPA and HMEF filters in the helmet CPAP and its use should considered.

Published
2022

6. Mechanical ventilation in patients with cardiogenic pulmonary edema: a sub-analysis of the LUNG SAFE study

Author

L., Amado-Rodriguez, R., Rodriguez-Garcia, G., Bellani, T., Pham, E., Fan, F., Madotto, J. G., Laffey, G. M., Albaiceta, Pesenti, Antonio, Brochard, Laurent, Esteban, Andre, Gattinoni, Luciano, van Haren, Frank, Larsson, Ander, Mcauley, Danielf, Ranieri, Marco, Rubenfeld, Gordon, Taylor Thompson, B, Wrigge, Hermann, S Slutsky, Arthur, Rios, Fernando, Van Haren, Frank, Sottiaux, Thierry, Depuydt, Pieter, S Lora, Fredy, Cesar Azevedo, Luciano, Bugedo, Guillermo, Qiu, Haibo, Gonzalez, Marco, Silesky, Juan, Cerny, Vladimir, Nielsen, Jona, Jibaja, Manuel, Matamis, Dimitrio, Luis Ranero, Jorge, Amin, Pravin, M Hashemian, S, Clarkson, Kevin, Kurahashi, Kiyoyasu, Villagomez, Asisclo, Ali Zeggwagh, Amine, M Heunks, Leo, Henrik Laake, Jon, Emmanuel Palo, Jose, do Vale Fernandes, Antero, Sandesc, Dorel, Arabi, Yaasen, Bumbasierevic, Vesna, Nin, Nicola, A Lorente, Jose, Piquilloud, Lise, Abroug, Fekri, Mcnamee, Lia, Hurtado, Javier, Bajwa, Ed, Démpaire, Gabriel, Sula, Hektor, Nunci, Lordian, Cani, Alma, Zazu, Alan, Dellera, Christian, S Insaurralde, Carolina, Las Lomas, Sanatorio, Isidro, San, V Alejandro, Risso, Daldin, Julio, Vinzio, Mauricio, O Fernandez, Ruben, P Cardonnet, Lui, R Bettini, Lisandro, Carboni Bisso, Mariano, M Osman, Emilio, G Setten, Mariano, Lovazzano, Pablo, Alvarez, Javier, Villar, Veronica, C Pozo, Norberto, Grubissich, Nicola, A Plotnikow, Gustavo, N Vasquez, Daniela, Ilutovich, Santiago, Tiribelli, Norberto, Chena, Ariel, A Pellegrini, Carlo, G Saenz, María, Estenssoro, Elisa, Brizuela, Matia, Gianinetto, Hernan, E Gomez, Pablo, I Cerrato, Valeria, G Bezzi, Marco, A Borello, Silvina, A Loiacono, Flavia, M Fernandez, Adriana, Knowles, Serena, Reynolds, Claire, M Inskip, Deborah, J Miller, Jennene, Kong, Jing, Whitehead, Christina, Bihari, Shailesh, Seven, Aylin, Krstevski, Amanda, J Rodgers, Helen, T Millar, Rebecca, E McKenna, Toni, M Bailey, Irene, C Hanlon, Gabrielle, Aneman, Ander, M Lynch, Joan, Azad, Raman, Neal, John, W Woods, Paul, L Roberts, Brigit, R Kol, Mark, S Wong, Helen, C Riss, Katharina, Staudinger, Thoma, Wittebole, Xavier, Berghe, Caroline, A Bulpa, Pierre, M Dive, Alain, Verstraete, Rik, Lebbinck, Herve, Vermassen, Jori, Meersseman, Philippe, Ceunen, Helga, Rosa, Jonasi, O Beraldo, Daniel, Piras, Claudio, M Rampinelli, Adenilton, P Nassar Jr, Antonio, Mataloun, Sergio, Moock, Marcelo, Thompson, Marlusm, H Gonçalves, Claudio, P Antônio, Ana Carolina, Ascoli, Aline, S Biondi, Rodrigo, C Fontenele, Danielle, Nobrega, Danielle, M Sales, Vanessa, Yazid BinHJAbul Wahab, Ahmad, Ismail, Maizatul, Shindhe, Suresh, Laffey, John, Beloncle, Francoi, G Davies, Kyle, Cirone, Rob, Manoharan, Venika, Ismail, Mehvish, C Goligher, Ewan, Jassal, Mandeep, Nishikawa, Erin, Javeed, Areej, Curley, Gerard, Rittayamai, Nuttapol, Parotto, Matteo, D Ferguson, Niall, Mehta, Sangeeta, Knoll, Jenny, Pronovost, Antoine, Canestrini, Sergio, R Bruhn, Alejandro, H Garcia, Patricio, A Aliaga, Felipe, A Farías, Pamela, S Yumha, Jacob, A Ortiz, Claudia, E Salas, Javier, A Saez, Alejandro, D Vega, Lui, F Labarca, Eduardo, T Martinez, Felipe, G Carreño, Nicolá, Lora, Pilar, Liu, Haitao, Liu, Ling, Tang, Rui, Luo, Xiaoming, An, Youzhong, Zhao, Huiying, Gao, Yan, Zhai, Zhe, L Ye, Zheng, Wang, Wei, Li, Wenwen, Li, Qingdong, Zheng, Ruiqiang, Yu, Wenkui, Shen, Juanhong, Li, Xinyu, Yu, Tao, Lu, Weihua, Q Wu, Ya, B Huang, Xiao, He, Zhenyang, Lu, Yuanhua, Han, Hui, Zhang, Fan, Sun, Renhua, X Wang, Hua, H Qin, Shu, H Zhu, Bao, Zhao, Jun, Liu, Jian, Li, Bin, L Liu, Jing, C Zhou, Fa, J Li, Qiong, Y Zhang, Xing, Li-Xin, Zhou, Xin-Hua, Qiang, Jiang, Liangyan, N Gao, Yuan, Y Zhao, Xian, Y Li, Yuan, L Li, Xiao, Wang, Chunting, Yao, Qingchun, Yu, Rongguo, Chen, Kai, Shao, Huanzhang, Qin, Bingyu, Q Huang, Qing, H Zhu, Wei, Y Hang, Ai, X Hua, Ma, Li, Yimin, Xu, Yonghao, D Di, Yu, L Ling, Long, H Qin, Tie, Wang, Shouh, Qin, Junping, Han, Yi, Zhou, Suming, P Vargas, Monica, I Silesky Jimenez, Juan, A González Rojas, Manuel, E SolisQuesada, Jaime, Ramirez-Alfaro, Christianm, Máca, Jan, Sklienka, Peter, Gjedsted, Jakob, Christiansen, Aage, Villamagua, Borisg, Llano, Iguel, Burtin, Philippe, Buzancais, Gautier, Beuret, Pascal, Pelletier, Nicola, Mortaza, Satar, Mercat, Alain, Chelly, Jonathan, Jochmans, Sébastien, Terzi, Nicola, Daubin, Cédric, Carteaux, Guillaume, de Prost, Nicola, Chiche, Jean-Daniel, Daviaud, Fabrice, Fartoukh, Muriel, Barberet, Guillaume, Biehler, Jerome, Dellamonica, Jean, Doyen, Deni, Arnal, Jean-Michel, Briquet, Anai, Hraiech, Sami, Papazian, Laurent, Follin, Arnaud, Roux, Damien, Messika, Jonathan, Kalaitzis, Evangelo, Dangers, Laurence, Combes, Alain, Béduneau, Gaetan, Carpentier, Dorothée, H Zogheib, Elie, Dupont, Herve, Ricome, Sylvie, Santoli, Francescol, L Besset, Sebastien, Michel, Philippe, Gelée, Bruno, Danin, Pierre-Eric, Goubaux, Bernard, J Crova, Philippe, T Phan, Nga, Berkelmans, Frantz, C Badie, Julio, Tapponnier, Romain, Gally, Josette, Khebbeb, Samy, Herbrecht, Jean-Etienne, Schneider, Franci, M Declercq, Pierreloui, Rigaud, Jean-Philippe, Duranteau, Jacque, Harrois, Anatole, Chabanne, Russell, Marin, Julien, Bigot, Charlene, Thibault, Sandrine, Ghazi, Mohammed, Boukhazna, Messabi, Ould Zein, Salem, R Richecoeur, Jack, Combaux, Danielem, Grelon, Fabien, Le Moal, Charlene, Sauvadet, Elisep, Robine, Adrien, Lemiale, Virginie, Reuter, Danielle, Dres, Martin, Demoule, Alexandre, Goldgran-Toledano, Dany, Baboi, Loredana, Guérin, Claude, Lohner, Ralph, Kraßler, Jen, Schäfer, Susanne, D Zacharowski, Kai, Meybohm, Patrick, W Reske, Andrea, Simon, Philipp, F Hopf, Hansbernd, Schuetz, Michael, Baltus, Thoma, N Papanikolaou, Metaxia, G Papavasilopoulou, Theonymfi, A Zacharas, Gianni, Ourailogloy, Vasili, K Mouloudi, Eleni, V Massa, Eleni, O Nagy, Eva, E Stamou, Electra, V Kiourtzieva, Ellada, A Oikonomou, Marina, E Avila, Lui, A Cortez, Cesar, E Citalán, Johanna, A Jog, Sameer, D Sable, Safal, Shah, Bhagyesh, Gurjar, Mohan, K Baronia, Arvind, Memon, Mohammedfaruk, Muthuchellappan, Radhakrishnan, J Ramesh, Venkatapura, Shenoy, Anitha, Unnikrishnan, Ramesh, B Dixit, Subhal, Rhayakar, Rachanav, Ramakrishnan, Nagarajan, Bhardwaj, Vallishk, Mahto, Heeral, V Sagar, Sudha, Palaniswamy, Vijayanand, Ganesan, Deeban, Mohammadreza Hashemian, Seyed, Jamaati, Hamidreza, Heidari, Farshad, A Meaney, Edel, Nichol, Alistair, M Knapman, Karl, O'Croinin, Donall, Dunne, Eimhin, M Breen, Dorothy, P Clarkson, Kevin, F Jaafar, Rola, Dwyer, Rory, Amir, Fahd, O Ajetunmobi, Olaitan, C O'Muircheartaigh, Aogan, Black, Colin, Treanor, Nuala, V Collins, Daniel, Altaf, Wahid, Zani, Gianluca, Fusari, Maurizio, Spadaro, Savino, A Volta, Carlo, Graziani, Romano, Brunettini, Barbara, Palmese, Salvatore, Formenti, Paolo, Umbrello, Michele, Lombardo, Andrea, Pecci, Elisabetta, Botteri, Marco, Savioli, Monica, Protti, Alessandro, Mattei, Alessia, Schiavoni, Lorenzo, Tinnirello, Andrea, Todeschini, Manuel, Giarratano, Antonino, Cortegiani, Andrea, Sher, Sara, M Antonelli, Massimo, Montini, Luca, Casalena, Paolo, Scafetti, Sergio, Panarello, Giovanna, Occhipinti, Giovanna, Patroniti, Nicolò, Pozzi, Matteo, Biscione, Robertor, M Poli, Michela, Raimondi, Ferdinando, Albiero, Daniela, Crapelli, Giulia, Beck, Eduardo, Pota, Vincenzo, Schiavone, Vincenzo, Molin, Alexandre, Tarantino, Fabio, Monti, Giacomo, Frati, Elena, Mirabella, Lucia, Cinnella, Gilda, Fossali, Tommaso, Colombo, Riccardo, Terragni, Pierpaolo, Pattarino, Ilaria, Mojoli, Francesco, Braschi, Antonio, E Borotto, Erika, N Cracchiolo, Andrea, M Palma, Daniela, Raponi, Francesco, Foti, Giuseppe, Vascotto, Ettorer, Coppadoro, Andrea, Brazzi, Luca, Floris, Leda, A Iotti, Giorgio, Venti, Aaron, Yamaguchi, Osamu, Takagi, Shunsuke, N Maeyama, Hiroki, Watanabe, Eizo, Yamaji, Yoshihiro, Shimizu, Kazuyoshi, Shiozaki, Kyoko, Futami, Satoru, Ryosuke, Sekine, Saito, Koji, Kameyama, Yoshinobu, Ueno, Keiko, Izawa, Masayo, Okuda, Nao, Suzuki, Hiroyuki, Harasawa, Tomofumi, Nasu, Michitaka, Takada, Tadaaki, Ito, Fumihito, Nunomiya, Shin, Koyama, Kansuke, Abe, Toshikazu, Andoh, Kohkichi, Kusumoto, Kohei, Hirata, Akira, Takaba, Akihiro, Kimura, Hiroyasu, Matsumoto, Shuhei, Higashijima, Ushio, Honda, Hiroyuki, Aoki, Nobumasa, Imai, Hiroshi, Ogino, Yasuaki, Mizuguchi, Ichiko, Ichikado, Kazuya, Nitta, Kenichi, Mochizuki, Katsunori, Hashida, Tomoaki, Tanaka, Hiroyuki, Nakamura, Tomoyuki, Niimi, Daisuke, Ueda, Takeshi, Kashiwa, Yozo, Uchiyama, Akinori, Sabelnikovs, Oleg, Oss, Peteri, Haddad, Youssef, Y Liew, Kong, A Ñamendys-Silva, Silvio, Jarquin-Badiola, Yvesd, A Sanchez-Hurtado, Lui, S Gomez-Flores, Saira, C Marin, Maria, Villagomez, Asiscloj, S Lemus, Jordana, M Fierro, Jonathan, Ramirez Cervantes, Mavy, Javier Flores Mejia, Francisco, Dector, Dulce, Rojas, Alejandro, R Gonzalez, Daniel, R Estrella, Claudia, R Sanchez-Medina, Jorge, Ramirez-Gutierrez, Alvaro, G George, Fernando, S Aguirre, Janet, A Buensuseso, Juan, Poblano, Manuel, Dendane, Tarek, Balkhi, Hicham, Elkhayari, Mina, Samkaoui, Nacer, Ezzouine, Hanane, Benslama, Abdellatif, Amor, Mourad, Maazouzi, Wajdi, Cimic, Nedim, Beck, Oliver, M Bruns, Monique, A Schouten, Jeroen, Rinia, Myra, Raaijmakers, Monique, M Van Wezel, Hellen, J Heines, Serge, Strauch, Ulrich, P Buise, Marc, D Simonis, Fabienne, J Schultz, Marcu, C Goodson, Jennifer, S Browne, Troy, Navarra, Leanlove, Hunt, Anna, A Hutchison, Robyn, B Bailey, Mathew, Newby, Lynette, Mcarthur, Colin, Kalkoff, Michael, Mcleod, Alex, Casement, Jonathan, Hacking, Daniellej, H Andersen, Finn, S Dolva, Merete, H Laake, Jon, Barratt-Due, Andrea, L Noremark, Kim Andre, Søreide, Eldar, Sjøbø, Britå, Guttormsen, Anneb, H LeonYoshido, Hector, Zumaran Aguilar, Ronald, A Montes Oscanoa, Fredy, U Alisasis, Alain, B Robles, Joanne, B Pasanting-Lim, Rossini Abbie, C Tan, Beatriz, Andruszkiewicz, Pawel, Jakubowska, Karina, M Coxo, Cristina, M Alvarez, António, S Oliveira, Bruno, M Montanha, Gustavo, C Barros, Nelson, S Pereira, Carlo, M Messias, António, M Monteiro, Jorge, Araujo, Anam, Catorze, Nunot, M Marum, Susan, J Bouw, Maria, M Gomes, Rui, A Brito, Vania, Castro, Silvia, M Estilita, Joana, M Barros, Filipa, Serra, Isabelm, M Martinho, Aurelia, R Tomescu, Dana, Marcu, Alexandra, H Bedreag, Ovidiu, Papurica, Mariu, E Corneci, Dan, Ioan Negoita, Silviu, Grigoriev, Evgeny, I Gritsan, Alexey, A Gazenkampf, Andrey, Almekhlafi, Ghaleb, M Albarrak, Mohamad, M Mustafa, Ghanem, A Maghrabi, Khalid, Salahuddin, Nawal, M Aisa, Tharwat, Aljabbary, Ahmed, Tabhan, Edgardo, Arabi, Yaseenm, M Arabi, Yaseen, A Trinidad, Olivia, M Al Dorzi, Hasan, E Tabhan, Edgardo, Bumbasirevic, Vesna, Jovanovic, Bojan, Bolon, Stefan, Smith, Oliver, Mancebo, Jordi, Aguirre-Bermeo, Hernan, Lopez-Delgado, Juanc, Esteve, Francisco, Rialp, Gemma, Forteza, Catalina, De Haro, Candelaria, Artigas, Antonio, Albaiceta, Guillermom, De Cima-Iglesias, Sara, Seoane-Quiroga, Leticia, Ceniceros-Barros, Alexandra, Ruizaguilar, Antoniol, Claraco-Vega, Luism, Alfonso Soler, Juan, Del CarmenLorente, Maria, Hermosa, Cecilia, Gordo, Federico, Prietogonzález, Miryam, López-Messa, Juanb, Perez, Manuelp, Perez, Cesarp, Montoiro Allue, Raquel, Rochecampo, Ferran, Ibañez-Santacruz, Marco, Temprano, Susana, C Pintado, Maria, De Pablo, Raul, Ricart Aroa Gómez, Pilar, Rodriguez Ruiz, Silvia, Iglesias Moles, Silvia, Teresa Jurado, M, Arizmendi, Alfon, A Piacentini, Enrique, Franco, Nieve, Honrubia, Teresa, Perez Cheng, Meisy, Perez Losada, Elena, Blanco, Javier, J Yuste, Lui, Carbayo-Gorriz, Cecilia, G Cazorla-Barranquero, Francisca, G Alonso, Javier, S Alda, Rosa, Algaba, Ángela, Navarro, Gonzalo, Cereijo, Enrique, Diaz-Rodriguez, Esther, Pastor Marcos, Diego, Alvarez Montero, Laura, Herrera Para, Lui, Jimenez Sanchez, Roberto, Angel Blasco Navalpotro, Miguel, Diaz Abad, Ricardo, Montiel González, Raquel, Parrilla Toribio, Dácil, G Castro, Alejandro, D Artiga, Maria Jose, Penuelas, Oscar, P Roser, Toma, F Olga, Moreno, Gallego Curto, Elena, Manzano Sánchez, Rocío, P Imma, Vallverdu, M Elisabet, Garcia, Claverias, Laura, Magret, Monica, M Pellicer, Ana, L Rodriguez, Lucia, Sánchez-Ballesteros, Jesú, González-Salamanca, Ángela, Jimenez, Antoniog, Huerta, Franciscop, J Sotillo Diaz, Juan Carlo, Bermejo Lopez, Esther, D Llinares Moya, David, A Tallet Alfonso, Alec, Sanchez Eugenio Luis, Palazon, Sanchez Cesar, Palazon, I Rafael, Sánchez, Virgilio, Corcolesg, Recio, Noelian, O Adamsson, Richard, C Rylander, Christian, Holzgraefe, Bernhard, M Broman, Lar, Wessbergh, Joanna, Persson, Linnea, Schiöler, Fredrik, Kedelv, Han, Oscarsson Tibblin, Anna, Appelberg, Henrik, Hedlund, Lar, Helleberg, Johan, Eriksson, Karine, Glietsch, Rita, Larsson, Nikla, Nygren, Ingela, Nunes, Silvial, Morin, Anna-Karin, Kander, Thoma, Adolfsson, Anne, Zender, Hervéo, Leemann-Refondini, Corinne, Elatrous, Souheil, Bouchoucha, Slaheddine, Chouchene, Imed, Ouanes, Islem, Ben Souissi, Asma, Kamoun, Salma, Demirkiran, Oktay, Aker, Mustafa, Erbabacan, Emre, Ceylan, Ilkay, Kelebek Girgin, Nermin, Ozcelik, Menekse, Ünal, Necmettin, Ceyda Meco, Basak, Akyol, Onato, Derman, Suleyman, Kennedy, Barry, Parhar, Ken, Srinivasa, Latha, Mcauley, Danny, Hopkins, Phil, Mellis, Clare, Kakar, Vivek, Hadfield, Dan, Vercueil, Andre, Bhowmick, Kaushik, K Humphreys, Sally, Ferguson, Andrew, Mckee, Raymond, S Raj, Ashok, A Fawkes, Danielle, Watt, Philip, Twohey, Linda, R Jha, Rajeev, Thomas, Matthew, Morton, Alex, Kadaba, Varsha, J Smith, Mark, P Hormis, Anil, G Kannan, Santhana, Namih, Miriam, Reschreiter, Henrik, Camsooksai, Julie, Kumar, Alek, Rugonfalvi, Szabolc, Nutt, Christopher, Oneill, Orla, Seasman, Colette, Dempsey, Ged, Scott, Christopherj, Ellis, Helene, Mckechnie, Stuart, Hutton, Paulaj, N Di Tomasso, Nora, N Vitale, Michela, O Griffin, Ruth, Dean, Michaeln, Cranshaw, Juliush, Willett, Emmal, Ioannou, Nichola, Gillis, Sarah, Csabi, Peter, Macfadyen, Rosaleen, Dawson, Heidi, Preez, Pieterd, J Williams, Alexandra, Boyd, Owen, Ortiz-Ruiz de Gordoa, Laura, Bramall, Jon, Symmonds, Sophie, Chau, Simonk, Wenham, Tim, Szakmany, Tama, Toth-Tarsoly, Piroska, Mccalman, Katieh, Alexander, Peter, Stephenson, Lorraine, Collyer, Thoma, Chapman, Rhiannon, Cooper, Raphael, M Allan, Russell, Sim, Malcolm, W Wrathall, David, Irvine, Donalda, S Zantua, Charing Kim, C Adams, John, J Burtenshaw, Andrew, P Sellors, Gareth, D Welters, Ingeborg, E Williams, Karen, J Hessell, Robert, G Oldroyd, Matthew, E Battle, Ceri, Pillai, Suresh, Kajtor, Istvan, Sivashanmugavel, Mageswaran, C Okane, Sinead, Donnelly, Adrian, D Frigyik, Aniko, P Careless, Jon, M May, Martin, Stewart, Richard, John Trinder, T, Hagan, Samanthaj, Cole, Jadem, C MacFie, Caroline, Dowling, Annat, Nin, Nicolá, Nuñez, Edgardo, Pittini, Gustavo, Rodriguez, Ruben, C Imperio, María, Santos, Cristina, G França, Ana, Ebeid, Alejandro, Deicas, Alberto, Serra, Carolina, Uppalapati, Aditya, Kamel, Ghassan, M BannerGoodspeed, Valerie, R Beitler, Jeremy, Reddy Mukkera, Satyanarayana, Kulkarni, Shreedhar, O Shinn Iii, John, Gomaa, Dina, Tainter, Christopher, Lee, Jarone, Mesar, Tomaz, Yeatts, Dalej, Warren, Jessica, Lanspa, Michaelj, R Miller, Russel, Grissom, Colink, Brown, Samuelm, R Bauer, Philippe, J Gosselin, Ryan, T Kitch, Barrett, E Cohen, Jason, H Beegle, Scott, Choudry, Shazia, M Gueret, Renaud, Tulaimat, Aiman, Stigler, William, Batra, Hitesh, G Huff, Nidhi, D Lamb, Keith, W Oetting, Trevor, M Mohr, Nichola, Judy, Claine, Saito, Shigeki, M Kheir, Fayez, Kheir, Fayez, B Schlichting, Adam, Delsing, Angela, R Crouch, Daniel, Elmasri, Mary, Ismail, Dina, R Dreyer, Kyle, C Blakeman, Thoma, M Baro, Rebecca, C Hou, Peter, Seethala, Raghu, Aisiku, Imo, Henderson, Galen, Frendl, Gyorgy, Hou, Sen-Kuang, Owens, Robertl, Schomer, Ashley, Rossi, Anna, Luca Montini (ORCID:0000-0003-4602-5134), L., Amado-Rodriguez, R., Rodriguez-Garcia, G., Bellani, T., Pham, E., Fan, F., Madotto, J. G., Laffey, G. M., Albaiceta, Pesenti, Antonio, Brochard, Laurent, Esteban, Andre, Gattinoni, Luciano, van Haren, Frank, Larsson, Ander, Mcauley, Danielf, Ranieri, Marco, Rubenfeld, Gordon, Taylor Thompson, B, Wrigge, Hermann, S Slutsky, Arthur, Rios, Fernando, Van Haren, Frank, Sottiaux, Thierry, Depuydt, Pieter, S Lora, Fredy, Cesar Azevedo, Luciano, Bugedo, Guillermo, Qiu, Haibo, Gonzalez, Marco, Silesky, Juan, Cerny, Vladimir, Nielsen, Jona, Jibaja, Manuel, Matamis, Dimitrio, Luis Ranero, Jorge, Amin, Pravin, M Hashemian, S, Clarkson, Kevin, Kurahashi, Kiyoyasu, Villagomez, Asisclo, Ali Zeggwagh, Amine, M Heunks, Leo, Henrik Laake, Jon, Emmanuel Palo, Jose, do Vale Fernandes, Antero, Sandesc, Dorel, Arabi, Yaasen, Bumbasierevic, Vesna, Nin, Nicola, A Lorente, Jose, Piquilloud, Lise, Abroug, Fekri, Mcnamee, Lia, Hurtado, Javier, Bajwa, Ed, Démpaire, Gabriel, Sula, Hektor, Nunci, Lordian, Cani, Alma, Zazu, Alan, Dellera, Christian, S Insaurralde, Carolina, Las Lomas, Sanatorio, Isidro, San, V Alejandro, Risso, Daldin, Julio, Vinzio, Mauricio, O Fernandez, Ruben, P Cardonnet, Lui, R Bettini, Lisandro, Carboni Bisso, Mariano, M Osman, Emilio, G Setten, Mariano, Lovazzano, Pablo, Alvarez, Javier, Villar, Veronica, C Pozo, Norberto, Grubissich, Nicola, A Plotnikow, Gustavo, N Vasquez, Daniela, Ilutovich, Santiago, Tiribelli, Norberto, Chena, Ariel, A Pellegrini, Carlo, G Saenz, María, Estenssoro, Elisa, Brizuela, Matia, Gianinetto, Hernan, E Gomez, Pablo, I Cerrato, Valeria, G Bezzi, Marco, A Borello, Silvina, A Loiacono, Flavia, M Fernandez, Adriana, Knowles, Serena, Reynolds, Claire, M Inskip, Deborah, J Miller, Jennene, Kong, Jing, Whitehead, Christina, Bihari, Shailesh, Seven, Aylin, Krstevski, Amanda, J Rodgers, Helen, T Millar, Rebecca, E McKenna, Toni, M Bailey, Irene, C Hanlon, Gabrielle, Aneman, Ander, M Lynch, Joan, Azad, Raman, Neal, John, W Woods, Paul, L Roberts, Brigit, R Kol, Mark, S Wong, Helen, C Riss, Katharina, Staudinger, Thoma, Wittebole, Xavier, Berghe, Caroline, A Bulpa, Pierre, M Dive, Alain, Verstraete, Rik, Lebbinck, Herve, Vermassen, Jori, Meersseman, Philippe, Ceunen, Helga, Rosa, Jonasi, O Beraldo, Daniel, Piras, Claudio, M Rampinelli, Adenilton, P Nassar Jr, Antonio, Mataloun, Sergio, Moock, Marcelo, Thompson, Marlusm, H Gonçalves, Claudio, P Antônio, Ana Carolina, Ascoli, Aline, S Biondi, Rodrigo, C Fontenele, Danielle, Nobrega, Danielle, M Sales, Vanessa, Yazid BinHJAbul Wahab, Ahmad, Ismail, Maizatul, Shindhe, Suresh, Laffey, John, Beloncle, Francoi, G Davies, Kyle, Cirone, Rob, Manoharan, Venika, Ismail, Mehvish, C Goligher, Ewan, Jassal, Mandeep, Nishikawa, Erin, Javeed, Areej, Curley, Gerard, Rittayamai, Nuttapol, Parotto, Matteo, D Ferguson, Niall, Mehta, Sangeeta, Knoll, Jenny, Pronovost, Antoine, Canestrini, Sergio, R Bruhn, Alejandro, H Garcia, Patricio, A Aliaga, Felipe, A Farías, Pamela, S Yumha, Jacob, A Ortiz, Claudia, E Salas, Javier, A Saez, Alejandro, D Vega, Lui, F Labarca, Eduardo, T Martinez, Felipe, G Carreño, Nicolá, Lora, Pilar, Liu, Haitao, Liu, Ling, Tang, Rui, Luo, Xiaoming, An, Youzhong, Zhao, Huiying, Gao, Yan, Zhai, Zhe, L Ye, Zheng, Wang, Wei, Li, Wenwen, Li, Qingdong, Zheng, Ruiqiang, Yu, Wenkui, Shen, Juanhong, Li, Xinyu, Yu, Tao, Lu, Weihua, Q Wu, Ya, B Huang, Xiao, He, Zhenyang, Lu, Yuanhua, Han, Hui, Zhang, Fan, Sun, Renhua, X Wang, Hua, H Qin, Shu, H Zhu, Bao, Zhao, Jun, Liu, Jian, Li, Bin, L Liu, Jing, C Zhou, Fa, J Li, Qiong, Y Zhang, Xing, Li-Xin, Zhou, Xin-Hua, Qiang, Jiang, Liangyan, N Gao, Yuan, Y Zhao, Xian, Y Li, Yuan, L Li, Xiao, Wang, Chunting, Yao, Qingchun, Yu, Rongguo, Chen, Kai, Shao, Huanzhang, Qin, Bingyu, Q Huang, Qing, H Zhu, Wei, Y Hang, Ai, X Hua, Ma, Li, Yimin, Xu, Yonghao, D Di, Yu, L Ling, Long, H Qin, Tie, Wang, Shouh, Qin, Junping, Han, Yi, Zhou, Suming, P Vargas, Monica, I Silesky Jimenez, Juan, A González Rojas, Manuel, E SolisQuesada, Jaime, Ramirez-Alfaro, Christianm, Máca, Jan, Sklienka, Peter, Gjedsted, Jakob, Christiansen, Aage, Villamagua, Borisg, Llano, Iguel, Burtin, Philippe, Buzancais, Gautier, Beuret, Pascal, Pelletier, Nicola, Mortaza, Satar, Mercat, Alain, Chelly, Jonathan, Jochmans, Sébastien, Terzi, Nicola, Daubin, Cédric, Carteaux, Guillaume, de Prost, Nicola, Chiche, Jean-Daniel, Daviaud, Fabrice, Fartoukh, Muriel, Barberet, Guillaume, Biehler, Jerome, Dellamonica, Jean, Doyen, Deni, Arnal, Jean-Michel, Briquet, Anai, Hraiech, Sami, Papazian, Laurent, Follin, Arnaud, Roux, Damien, Messika, Jonathan, Kalaitzis, Evangelo, Dangers, Laurence, Combes, Alain, Béduneau, Gaetan, Carpentier, Dorothée, H Zogheib, Elie, Dupont, Herve, Ricome, Sylvie, Santoli, Francescol, L Besset, Sebastien, Michel, Philippe, Gelée, Bruno, Danin, Pierre-Eric, Goubaux, Bernard, J Crova, Philippe, T Phan, Nga, Berkelmans, Frantz, C Badie, Julio, Tapponnier, Romain, Gally, Josette, Khebbeb, Samy, Herbrecht, Jean-Etienne, Schneider, Franci, M Declercq, Pierreloui, Rigaud, Jean-Philippe, Duranteau, Jacque, Harrois, Anatole, Chabanne, Russell, Marin, Julien, Bigot, Charlene, Thibault, Sandrine, Ghazi, Mohammed, Boukhazna, Messabi, Ould Zein, Salem, R Richecoeur, Jack, Combaux, Danielem, Grelon, Fabien, Le Moal, Charlene, Sauvadet, Elisep, Robine, Adrien, Lemiale, Virginie, Reuter, Danielle, Dres, Martin, Demoule, Alexandre, Goldgran-Toledano, Dany, Baboi, Loredana, Guérin, Claude, Lohner, Ralph, Kraßler, Jen, Schäfer, Susanne, D Zacharowski, Kai, Meybohm, Patrick, W Reske, Andrea, Simon, Philipp, F Hopf, Hansbernd, Schuetz, Michael, Baltus, Thoma, N Papanikolaou, Metaxia, G Papavasilopoulou, Theonymfi, A Zacharas, Gianni, Ourailogloy, Vasili, K Mouloudi, Eleni, V Massa, Eleni, O Nagy, Eva, E Stamou, Electra, V Kiourtzieva, Ellada, A Oikonomou, Marina, E Avila, Lui, A Cortez, Cesar, E Citalán, Johanna, A Jog, Sameer, D Sable, Safal, Shah, Bhagyesh, Gurjar, Mohan, K Baronia, Arvind, Memon, Mohammedfaruk, Muthuchellappan, Radhakrishnan, J Ramesh, Venkatapura, Shenoy, Anitha, Unnikrishnan, Ramesh, B Dixit, Subhal, Rhayakar, Rachanav, Ramakrishnan, Nagarajan, Bhardwaj, Vallishk, Mahto, Heeral, V Sagar, Sudha, Palaniswamy, Vijayanand, Ganesan, Deeban, Mohammadreza Hashemian, Seyed, Jamaati, Hamidreza, Heidari, Farshad, A Meaney, Edel, Nichol, Alistair, M Knapman, Karl, O'Croinin, Donall, Dunne, Eimhin, M Breen, Dorothy, P Clarkson, Kevin, F Jaafar, Rola, Dwyer, Rory, Amir, Fahd, O Ajetunmobi, Olaitan, C O'Muircheartaigh, Aogan, Black, Colin, Treanor, Nuala, V Collins, Daniel, Altaf, Wahid, Zani, Gianluca, Fusari, Maurizio, Spadaro, Savino, A Volta, Carlo, Graziani, Romano, Brunettini, Barbara, Palmese, Salvatore, Formenti, Paolo, Umbrello, Michele, Lombardo, Andrea, Pecci, Elisabetta, Botteri, Marco, Savioli, Monica, Protti, Alessandro, Mattei, Alessia, Schiavoni, Lorenzo, Tinnirello, Andrea, Todeschini, Manuel, Giarratano, Antonino, Cortegiani, Andrea, Sher, Sara, M Antonelli, Massimo, Montini, Luca, Casalena, Paolo, Scafetti, Sergio, Panarello, Giovanna, Occhipinti, Giovanna, Patroniti, Nicolò, Pozzi, Matteo, Biscione, Robertor, M Poli, Michela, Raimondi, Ferdinando, Albiero, Daniela, Crapelli, Giulia, Beck, Eduardo, Pota, Vincenzo, Schiavone, Vincenzo, Molin, Alexandre, Tarantino, Fabio, Monti, Giacomo, Frati, Elena, Mirabella, Lucia, Cinnella, Gilda, Fossali, Tommaso, Colombo, Riccardo, Terragni, Pierpaolo, Pattarino, Ilaria, Mojoli, Francesco, Braschi, Antonio, E Borotto, Erika, N Cracchiolo, Andrea, M Palma, Daniela, Raponi, Francesco, Foti, Giuseppe, Vascotto, Ettorer, Coppadoro, Andrea, Brazzi, Luca, Floris, Leda, A Iotti, Giorgio, Venti, Aaron, Yamaguchi, Osamu, Takagi, Shunsuke, N Maeyama, Hiroki, Watanabe, Eizo, Yamaji, Yoshihiro, Shimizu, Kazuyoshi, Shiozaki, Kyoko, Futami, Satoru, Ryosuke, Sekine, Saito, Koji, Kameyama, Yoshinobu, Ueno, Keiko, Izawa, Masayo, Okuda, Nao, Suzuki, Hiroyuki, Harasawa, Tomofumi, Nasu, Michitaka, Takada, Tadaaki, Ito, Fumihito, Nunomiya, Shin, Koyama, Kansuke, Abe, Toshikazu, Andoh, Kohkichi, Kusumoto, Kohei, Hirata, Akira, Takaba, Akihiro, Kimura, Hiroyasu, Matsumoto, Shuhei, Higashijima, Ushio, Honda, Hiroyuki, Aoki, Nobumasa, Imai, Hiroshi, Ogino, Yasuaki, Mizuguchi, Ichiko, Ichikado, Kazuya, Nitta, Kenichi, Mochizuki, Katsunori, Hashida, Tomoaki, Tanaka, Hiroyuki, Nakamura, Tomoyuki, Niimi, Daisuke, Ueda, Takeshi, Kashiwa, Yozo, Uchiyama, Akinori, Sabelnikovs, Oleg, Oss, Peteri, Haddad, Youssef, Y Liew, Kong, A Ñamendys-Silva, Silvio, Jarquin-Badiola, Yvesd, A Sanchez-Hurtado, Lui, S Gomez-Flores, Saira, C Marin, Maria, Villagomez, Asiscloj, S Lemus, Jordana, M Fierro, Jonathan, Ramirez Cervantes, Mavy, Javier Flores Mejia, Francisco, Dector, Dulce, Rojas, Alejandro, R Gonzalez, Daniel, R Estrella, Claudia, R Sanchez-Medina, Jorge, Ramirez-Gutierrez, Alvaro, G George, Fernando, S Aguirre, Janet, A Buensuseso, Juan, Poblano, Manuel, Dendane, Tarek, Balkhi, Hicham, Elkhayari, Mina, Samkaoui, Nacer, Ezzouine, Hanane, Benslama, Abdellatif, Amor, Mourad, Maazouzi, Wajdi, Cimic, Nedim, Beck, Oliver, M Bruns, Monique, A Schouten, Jeroen, Rinia, Myra, Raaijmakers, Monique, M Van Wezel, Hellen, J Heines, Serge, Strauch, Ulrich, P Buise, Marc, D Simonis, Fabienne, J Schultz, Marcu, C Goodson, Jennifer, S Browne, Troy, Navarra, Leanlove, Hunt, Anna, A Hutchison, Robyn, B Bailey, Mathew, Newby, Lynette, Mcarthur, Colin, Kalkoff, Michael, Mcleod, Alex, Casement, Jonathan, Hacking, Daniellej, H Andersen, Finn, S Dolva, Merete, H Laake, Jon, Barratt-Due, Andrea, L Noremark, Kim Andre, Søreide, Eldar, Sjøbø, Britå, Guttormsen, Anneb, H LeonYoshido, Hector, Zumaran Aguilar, Ronald, A Montes Oscanoa, Fredy, U Alisasis, Alain, B Robles, Joanne, B Pasanting-Lim, Rossini Abbie, C Tan, Beatriz, Andruszkiewicz, Pawel, Jakubowska, Karina, M Coxo, Cristina, M Alvarez, António, S Oliveira, Bruno, M Montanha, Gustavo, C Barros, Nelson, S Pereira, Carlo, M Messias, António, M Monteiro, Jorge, Araujo, Anam, Catorze, Nunot, M Marum, Susan, J Bouw, Maria, M Gomes, Rui, A Brito, Vania, Castro, Silvia, M Estilita, Joana, M Barros, Filipa, Serra, Isabelm, M Martinho, Aurelia, R Tomescu, Dana, Marcu, Alexandra, H Bedreag, Ovidiu, Papurica, Mariu, E Corneci, Dan, Ioan Negoita, Silviu, Grigoriev, Evgeny, I Gritsan, Alexey, A Gazenkampf, Andrey, Almekhlafi, Ghaleb, M Albarrak, Mohamad, M Mustafa, Ghanem, A Maghrabi, Khalid, Salahuddin, Nawal, M Aisa, Tharwat, Aljabbary, Ahmed, Tabhan, Edgardo, Arabi, Yaseenm, M Arabi, Yaseen, A Trinidad, Olivia, M Al Dorzi, Hasan, E Tabhan, Edgardo, Bumbasirevic, Vesna, Jovanovic, Bojan, Bolon, Stefan, Smith, Oliver, Mancebo, Jordi, Aguirre-Bermeo, Hernan, Lopez-Delgado, Juanc, Esteve, Francisco, Rialp, Gemma, Forteza, Catalina, De Haro, Candelaria, Artigas, Antonio, Albaiceta, Guillermom, De Cima-Iglesias, Sara, Seoane-Quiroga, Leticia, Ceniceros-Barros, Alexandra, Ruizaguilar, Antoniol, Claraco-Vega, Luism, Alfonso Soler, Juan, Del CarmenLorente, Maria, Hermosa, Cecilia, Gordo, Federico, Prietogonzález, Miryam, López-Messa, Juanb, Perez, Manuelp, Perez, Cesarp, Montoiro Allue, Raquel, Rochecampo, Ferran, Ibañez-Santacruz, Marco, Temprano, Susana, C Pintado, Maria, De Pablo, Raul, Ricart Aroa Gómez, Pilar, Rodriguez Ruiz, Silvia, Iglesias Moles, Silvia, Teresa Jurado, M, Arizmendi, Alfon, A Piacentini, Enrique, Franco, Nieve, Honrubia, Teresa, Perez Cheng, Meisy, Perez Losada, Elena, Blanco, Javier, J Yuste, Lui, Carbayo-Gorriz, Cecilia, G Cazorla-Barranquero, Francisca, G Alonso, Javier, S Alda, Rosa, Algaba, Ángela, Navarro, Gonzalo, Cereijo, Enrique, Diaz-Rodriguez, Esther, Pastor Marcos, Diego, Alvarez Montero, Laura, Herrera Para, Lui, Jimenez Sanchez, Roberto, Angel Blasco Navalpotro, Miguel, Diaz Abad, Ricardo, Montiel González, Raquel, Parrilla Toribio, Dácil, G Castro, Alejandro, D Artiga, Maria Jose, Penuelas, Oscar, P Roser, Toma, F Olga, Moreno, Gallego Curto, Elena, Manzano Sánchez, Rocío, P Imma, Vallverdu, M Elisabet, Garcia, Claverias, Laura, Magret, Monica, M Pellicer, Ana, L Rodriguez, Lucia, Sánchez-Ballesteros, Jesú, González-Salamanca, Ángela, Jimenez, Antoniog, Huerta, Franciscop, J Sotillo Diaz, Juan Carlo, Bermejo Lopez, Esther, D Llinares Moya, David, A Tallet Alfonso, Alec, Sanchez Eugenio Luis, Palazon, Sanchez Cesar, Palazon, I Rafael, Sánchez, Virgilio, Corcolesg, Recio, Noelian, O Adamsson, Richard, C Rylander, Christian, Holzgraefe, Bernhard, M Broman, Lar, Wessbergh, Joanna, Persson, Linnea, Schiöler, Fredrik, Kedelv, Han, Oscarsson Tibblin, Anna, Appelberg, Henrik, Hedlund, Lar, Helleberg, Johan, Eriksson, Karine, Glietsch, Rita, Larsson, Nikla, Nygren, Ingela, Nunes, Silvial, Morin, Anna-Karin, Kander, Thoma, Adolfsson, Anne, Zender, Hervéo, Leemann-Refondini, Corinne, Elatrous, Souheil, Bouchoucha, Slaheddine, Chouchene, Imed, Ouanes, Islem, Ben Souissi, Asma, Kamoun, Salma, Demirkiran, Oktay, Aker, Mustafa, Erbabacan, Emre, Ceylan, Ilkay, Kelebek Girgin, Nermin, Ozcelik, Menekse, Ünal, Necmettin, Ceyda Meco, Basak, Akyol, Onato, Derman, Suleyman, Kennedy, Barry, Parhar, Ken, Srinivasa, Latha, Mcauley, Danny, Hopkins, Phil, Mellis, Clare, Kakar, Vivek, Hadfield, Dan, Vercueil, Andre, Bhowmick, Kaushik, K Humphreys, Sally, Ferguson, Andrew, Mckee, Raymond, S Raj, Ashok, A Fawkes, Danielle, Watt, Philip, Twohey, Linda, R Jha, Rajeev, Thomas, Matthew, Morton, Alex, Kadaba, Varsha, J Smith, Mark, P Hormis, Anil, G Kannan, Santhana, Namih, Miriam, Reschreiter, Henrik, Camsooksai, Julie, Kumar, Alek, Rugonfalvi, Szabolc, Nutt, Christopher, Oneill, Orla, Seasman, Colette, Dempsey, Ged, Scott, Christopherj, Ellis, Helene, Mckechnie, Stuart, Hutton, Paulaj, N Di Tomasso, Nora, N Vitale, Michela, O Griffin, Ruth, Dean, Michaeln, Cranshaw, Juliush, Willett, Emmal, Ioannou, Nichola, Gillis, Sarah, Csabi, Peter, Macfadyen, Rosaleen, Dawson, Heidi, Preez, Pieterd, J Williams, Alexandra, Boyd, Owen, Ortiz-Ruiz de Gordoa, Laura, Bramall, Jon, Symmonds, Sophie, Chau, Simonk, Wenham, Tim, Szakmany, Tama, Toth-Tarsoly, Piroska, Mccalman, Katieh, Alexander, Peter, Stephenson, Lorraine, Collyer, Thoma, Chapman, Rhiannon, Cooper, Raphael, M Allan, Russell, Sim, Malcolm, W Wrathall, David, Irvine, Donalda, S Zantua, Charing Kim, C Adams, John, J Burtenshaw, Andrew, P Sellors, Gareth, D Welters, Ingeborg, E Williams, Karen, J Hessell, Robert, G Oldroyd, Matthew, E Battle, Ceri, Pillai, Suresh, Kajtor, Istvan, Sivashanmugavel, Mageswaran, C Okane, Sinead, Donnelly, Adrian, D Frigyik, Aniko, P Careless, Jon, M May, Martin, Stewart, Richard, John Trinder, T, Hagan, Samanthaj, Cole, Jadem, C MacFie, Caroline, Dowling, Annat, Nin, Nicolá, Nuñez, Edgardo, Pittini, Gustavo, Rodriguez, Ruben, C Imperio, María, Santos, Cristina, G França, Ana, Ebeid, Alejandro, Deicas, Alberto, Serra, Carolina, Uppalapati, Aditya, Kamel, Ghassan, M BannerGoodspeed, Valerie, R Beitler, Jeremy, Reddy Mukkera, Satyanarayana, Kulkarni, Shreedhar, O Shinn Iii, John, Gomaa, Dina, Tainter, Christopher, Lee, Jarone, Mesar, Tomaz, Yeatts, Dalej, Warren, Jessica, Lanspa, Michaelj, R Miller, Russel, Grissom, Colink, Brown, Samuelm, R Bauer, Philippe, J Gosselin, Ryan, T Kitch, Barrett, E Cohen, Jason, H Beegle, Scott, Choudry, Shazia, M Gueret, Renaud, Tulaimat, Aiman, Stigler, William, Batra, Hitesh, G Huff, Nidhi, D Lamb, Keith, W Oetting, Trevor, M Mohr, Nichola, Judy, Claine, Saito, Shigeki, M Kheir, Fayez, Kheir, Fayez, B Schlichting, Adam, Delsing, Angela, R Crouch, Daniel, Elmasri, Mary, Ismail, Dina, R Dreyer, Kyle, C Blakeman, Thoma, M Baro, Rebecca, C Hou, Peter, Seethala, Raghu, Aisiku, Imo, Henderson, Galen, Frendl, Gyorgy, Hou, Sen-Kuang, Owens, Robertl, Schomer, Ashley, Rossi, Anna, and Luca Montini (ORCID:0000-0003-4602-5134)

Abstract

Background: Patients with acute respiratory failure caused by cardiogenic pulmonary edema (CPE) may require mechanical ventilation that can cause further lung damage. Our aim was to determine the impact of ventilatory settings on CPE mortality. Methods: Patients from the LUNG SAFE cohort, a multicenter prospective cohort study of patients undergoing mechanical ventilation, were studied. Relationships between ventilatory parameters and outcomes (ICU discharge/hospital mortality) were assessed using latent mixture analysis and a marginal structural model. Results: From 4499 patients, 391 meeting CPE criteria (median age 70 [interquartile range 59–78], 40% female) were included. ICU and hospital mortality were 34% and 40%, respectively. ICU survivors were younger (67 [57–77] vs 74 [64–80] years, p < 0.001) and had lower driving (12 [8–16] vs 15 [11–17] cmH2O, p < 0.001), plateau (20 [15–23] vs 22 [19–26] cmH2O, p < 0.001) and peak (21 [17–27] vs 26 [20–32] cmH2O, p < 0.001) pressures. Latent mixture analysis of patients receiving invasive mechanical ventilation on ICU day 1 revealed a subgroup ventilated with high pressures with lower probability of being discharged alive from the ICU (hazard ratio [HR] 0.79 [95% confidence interval 0.60–1.05], p = 0.103) and increased hospital mortality (HR 1.65 [1.16–2.36], p = 0.005). In a marginal structural model, driving pressures in the first week (HR 1.12 [1.06–1.18], p < 0.001) and tidal volume after day 7 (HR 0.69 [0.52–0.93], p = 0.015) were related to survival. Conclusions: Higher airway pressures in invasively ventilated patients with CPE are related to mortality. These patients may be exposed to an increased risk of ventilator-induced lung injury. Trial registration Clinicaltrials.gov NCT02010073.

Published
2022

7. Autoantibodies neutralizing type I IFNs are present in ~4% of uninfected individuals over 70 years old and account for ~20% of COVID-19 deaths

Author

Bastard, P. Gervais, A. Voyer, T.L. Rosain, J. Philippot, Q. Manry, J. Michailidis, E. Hoffmann, H.-H. Eto, S. Garcia-Prat, M. Bizien, L. Parra-Martínez, A. Yang, R. Haljasmägi, L. Migaud, M. Särekannu, K. Maslovskaja, J. De Prost, N. Tandjaoui-Lambiotte, Y. Luyt, C.-E. Amador-Borrero, B. Gaudet, A. Poissy, J. Morel, P. Richard, P. Cognasse, F. Troya, J. Trouillet-Assant, S. Belot, A. Saker, K. Garçon, P. Rivière, J.G. Lagier, J.-C. Gentile, S. Rosen, L.B. Shaw, E. Morio, T. Tanaka, J. Dalmau, D. Tharaux, P.-L. Sene, D. Stepanian, A. Megarbane, B. Triantafyllia, V. Fekkar, A. Heath, J.R. Franco, J.L. Anaya, J.-M. Solé-Violán, J. Imberti, L. Biondi, A. Bonfanti, P. Castagnoli, R. Delmonte, O.M. Zhang, Y. Snow, A.L. Holland, S.M. Biggs, C.M. Moncada-Vélez, M. Arias, A.A. Lorenzo, L. Boucherit, S. Coulibaly, B. Anglicheau, D. Planas, A.M. Haerynck, F. Duvlis, S. Nussbaum, R.L. Ozcelik, T. Keles, S. Bousfiha, A.A. El Bakkouri, J. Ramirez-Santana, C. Paul, S. Pan-Hammarström, Q. Hammarström, L. Dupont, A. Kurolap, A. Metz, C.N. Aiuti, A. Casari, G. Lampasona, V. Ciceri, F. Barreiros, L.A. Dominguez-Garrido, E. Vidigal, M. Zatz, M. Van De Beek, D. Sahanic, S. Tancevski, I. Stepanovskyy, Y. Boyarchuk, O. Nukui, Y. Tsumura, M. Vidaur, L. Tangye, S.G. Burrel, S. Duffy, D. Quintana-Murci, L. Klocperk, A. Kann, N.Y. Shcherbina, A. Lau, Y.-L. Leung, D. Coulongeat, M. Marlet, J. Koning, R. Reyes, L.F. Chauvineau-Grenier, A. Venet, F. Monneret, G. Nussenzweig, M.C. Arrestier, R. Boudhabhay, I. Baris-Feldman, H. Hagin, D. Wauters, J. Meyts, I. Dyer, A.H. Kennelly, S.P. Bourke, N.M. Halwani, R. Sharif-Askari, N.S. Dorgham, K. Sallette, J. Sedkaoui, S.M. AlKhater, S. Rigo-Bonnin, R. Morandeira, F. Roussel, L. Vinh, D.C. Ostrowski, S.R. Condino-Neto, A. Prando, C. Bondarenko, A. Spaan, A.N. Gilardin, L. Fellay, J. Lyonnet, S. Bilguvar, K. Lifton, R.P. Mane, S. Anderson, M.S. Boisson, B. Béziat, V. Zhang, S.-Y. Andreakos, E. Hermine, O. Pujol, A. Peterson, P. Mogensen, T.H. Rowen, L. Mond, J. Debette, S. De Lamballerie, X. Duval, X. Mentré, F. Zins, M. Soler-Palacin, P. Colobran, R. Gorochov, G. Solanich, X. Susen, S. Martinez-Picado, J. Raoult, D. Vasse, M. Gregersen, P.K. Piemonti, L. Rodríguez-Gallego, C. Notarangelo, L.D. Su, H.C. Kisand, K. Okada, S. Puel, A. Jouanguy, E. Rice, C.M. Tiberghien, P. Zhang, Q. Cobat, A. Abel, L. Casanova, J.-L. Alavoine, L. Behillil, S. Burdet, C. Charpentier, C. Dechanet, A. Descamps, D. Ecobichon, J.-L. Enouf, V. Frezouls, W. Houhou, N. Kafif, O. Lehacaut, J. Letrou, S. Lina, B. Lucet, J.-C. Manchon, P. Nouroudine, M. Piquard, V. Quintin, C. Thy, M. Tubiana, S. Van Der Werf, S. Vignali, V. Visseaux, B. Yazdanpanah, Y. Chahine, A. Waucquier, N. Migaud, M.-C. Deplanque, D. Djossou, F. Mergeay-Fabre, M. Lucarelli, A. Demar, M. Bruneau, L. Gerardin, P. Maillot, A. Payet, C. Laviolle, B. Laine, F. Paris, C. Desille-Dugast, M. Fouchard, J. Malvy, D. Nguyen, D. Pistone, T. Perreau, P. Gissot, V. Le Goas, C. Montagne, S. Richard, L. Chirouze, C. Bouiller, K. Desmarets, M. Meunier, A. Lefevre, B. Jeulin, H. Legrand, K. Lomazzi, S. Tardy, B. Gagneux-Brunon, A. Bertholon, F. Botelho-Nevers, E. Christelle, K. Nicolas, L. Roufai, L. Amat, K. Couffin-Cadiergues, S. Esperou, H. Hendou, S. Townsend, L. Cheallaigh, C.N. Bergin, C. Martin-Loeches, I. Dunne, J. Conlon, N. O'Farrelly, C. Abad, J. Accordino, G. Achille, C. Aguilera-Albesa, S. Aguilo-Cucurull, A. Ozkan, E.A. Darazam, I.A. Albisures, J.A.R. Aldave, J.C. Ramos, M.A. Khan, T.A. Aliberti, A. Nadji, S.A. Alkan, G. AlKhater, S.A. Allardet-Servent, J. Allende, L.M. Alonso-Arias, R. Alshahrani, M.S. Alsina, L. Alyanakian, M.-A. Borrero, B.A. Amoura, Z. Antoli, A. Aubart, M. Auguet, T. Avramenko, I. Aytekin, G. Azot, A. Bahram, S. Bajolle, F. Baldanti, F. Baldolli, A. Ballester, M. Feldman, H.B. Barrou, B. Barzaghi, F. Basso, S. Bayhan, G.I. Bezrodnik, L. Bilbao, A. Blanchard-Rohner, G. Blanco, I. Blandinieres, A. Blazquez-Gamero, D. Bleibtreu, A. Bloomfield, M. Bolivar-Prados, M. Borghesi, A. Borie, R. Botdhlo-Nevers, E. Bousquet, A. Boutolleau, D. Bouvattier, C. Bravais, J. Briones, M.L. Brunner, M.-E. Bruno, R. Bueno, M.R.P. Bukhari, H. Bustamante, J. Agra, J.J.C. Capra, R. Carapito, R. Carrabba, M. Casasnovas, C. Caseris, M. Cassaniti, I. Castelle, M. Castelli, F. De Vera, M.C. Castro, M.V. Catherinot, E. Celik, J.B. Ceschi, A. Chalumeau, M. Charbit, B. Cheng, M.P. Clave, P. Clotet, B. Codina, A. Cohen, Y. Comarmond, C. Combes, A. Comoli, P. Corsico, A.G. Coşkuner, T. Cvetkovski, A. Cyrus, C. Danion, F. Darley, D.R. Das, V. Dauby, N. Dauger, S. De Munter, P. De Pontual, L. Dehban, A. Delplancq, G. Demoule, A. Desguerre, I. Di Sabatino, A. Diehl, J.-L. Dobbelaere, S. Dubost, C. Ekwall, O. Bozdemir, Ş.E. Elnagdy, M.H. Emiroglu, M. Endo, A. Erdeniz, E.H. Aytekin, S.E. Lasa, M.P.E. Euvrard, R. Fabio, G. Faivre, L. Falck, A. Fartoukh, M. Faure, M. Arquero, M.F. Ferrer, R. Ferreres, J. Flores, C. Francois, B. Fumado, V. Fung, K.S.C. Fusco, F. Gagro, A. Solis, B.G. Gaussem, P. Gayretli, Z. Gil-Herrera, J. Gatineau, A.G. Girona-Alarcon, M. Godinez, K.A.C. Goffard, J.-C. Gonzales, N. Gonzalez-Granado, L.I. Gonzalez-Montelongo, R. Guerder, A. Gulhan, B. Gumucio, V.D. Hanitsch, L.G. Gunst, J. Gut, M. Hadjadj, J. Hancerli, S. Hariyan, T. Hatipoglu, N. Heppekcan, D. Hernandez-Brito, E. Ho, P.-K. Holanda-Pena, M.S. Horcajada, J.P. Hraiech, S. Humbert, L. Hung, I.F.N. Iglesias, A.D. Inigo-Campos, A. Jamme, M. Arranz, M.J. Jimeno, M.-T. Jordan, I. Kanik-Yuksek, S. Kara, Y.B. Karahan, A. Karbuz, A. Yasar, K.K. Kasapcopur, O. Kashimada, K. Demirkol, Y.K. Kido, Y. Kizil, C. Kilic, A.O. Koutsoukou, A. Krol, Z.J. Ksouri, H. Kuentz, P. Kwan, A.M.C. Kwan, Y.W.M. Kwok, J.S.Y. Lam, D.S.Y. Lampropoulou, V. Lanternier, F. Le Bourgeois, F. Leo, Y.-S. Lopez, R.L. Levin, M. Levy, M. Levy, R. Li, Z. Lilleri, D. Lima, E.J.A.B. Linglart, A. Lopez-Collazo, E. Lorenzo-Salazar, J.M. Louapre, C. Lubetzki, C. Lung, K.-C. Lye, D.C. Magnone, C. Mansouri, D. Marchioni, E. Marioli, C. Marjani, M. Marques, L. Pereira, J.M. Martin-Nalda, A. Pueyo, D.M. Marzana, I. Mata-Martinez, C. Mathian, A. Matos, L.R.B. Matthews, G.V. Mayaux, J. McLaughlin-Garcia, R. Meersseman, P. Mege, J.-L. Mekontso-Dessap, A. Melki, I. Meloni, F. Meritet, J.-F. Merlani, P. Akcan, O.M. Mezidi, M. Migeotte, I. Millereux, M. Million, M. Mirault, T. Mircher, C. Mirsaeidi, M. Mizoguchi, Y. Modi, B.P. Mojoli, F. Moncomble, E. Melian, A.M. Martinez, A.M. Morange, P.-E. Mordacq, C. Morelle, G. Mouly, S.J. Munoz-Barrera, A. Nafati, C. Nagashima, S. Nakagama, Y. Neven, B. Neves, J.F. Ng, L.F.P. Ng, Y.-Y. Nielly, H. Medina, Y.N. Cuadros, E.N. Ocejo-Vinyals, J.G. Okamoto, K. Oualha, M. Ouedrani, A. Ozkaya-Parlakay, A. Pagani, M. Papadaki, M. Parizot, C. Parola, P. Pascreau, T. Paz-Artal, E. Pedraza, S. Pellecer, N.C.G. Pellegrini, S. De Diego, R.P. Perez-Fernandez, X.L. Philippe, A. Picod, A. De Chambrun, M.P. Piralla, A. Planas-Serra, L. Ploin, D. Poncelet, G. Poulakou, G. Pouletty, M.S. Pourshahnazari, P. Qiu-Chen, J.L. Quentric, P. Rambaud, T. Raoult, V. Rebillat, A.-S. Redin, C. Resmini, L. Ricart, P. Richard, J.-C. Rivet, N. Rocamora-Blanch, G. Rodero, M.P. Rodrigo, C. Rodriguez, L.A. Rodriguez-Palmero, A. Romero, C.S. Rothenbuhler, A. Roux, D. Rovina, N. Rozenberg, F. Ruch, Y. Ruiz, M. Del Prado, M.Y.R. Ruiz-Rodriguez, J.C. Sabater-Riera, J. Saks, K. Salagianni, M. Sanchez, O. Sanchez-Montalva, A. Sanchez-Ramon, S. Schidlowski, L. Schluter, A. Schmidt, J. Schmidt, M. Schuetz, C. Schweitzer, C.E. Scolari, F. Sediva, A. Seijo, L. Seminario, A.G. Seng, P. Senoglu, S. Seppanen, M. Llovich, A.S. Shahrooei, M. Siguret, V. Siouti, E. Smadja, D.M. Smith, N. Sobh, A. Soler, C. Sozeri, B. Stella, G.M. Stepanovskiy, Y. Stoclin, A. Taccone, F. Taupin, J.-L. Tavernier, S.J. Terrier, B. Thiery, G. Thorball, C. Thorn, K. Thumerelle, C. Tipu, I. Tolstrup, M. Tomasoni, G. Toubiana, J. Alvarez, J.T. Tsang, O.T.Y. Tserel, L. Tso, E.Y.K. Tucci, A. Oz, Ş.K.T. Ursini, M.V. Utsumi, T. Uzunhan, Y. Vabres, P. Valencia-Ramos, J. Van Den Rym, A.M. Vandernoot, I. Velez-Santamaria, V. Veliz, S.P.Z. Vidigal, M.C. Viel, S. Vilain, C. Vilaire-Meunier, M.E. Villar-Garcia, J. Vincent, A. Vogt, G. Voiriot, G. Volokha, A. Vuotto, F. Wauters, E. Wu, A.K.L. Wu, T.-C. Yahşi, A. Yesilbas, O. Yildiz, M. Young, B.E. Yukselmiş, U. Zecca, M. Zuccaro, V. Van Praet, J. Lambrecht, B.N. Van Braeckel, E. Bosteels, C. Hoste, L. Hoste, E. Bauters, F. De Clercq, J. Heijmans, C. Slabbynck, H. Naesens, L. Florkin, B. Boulanger, C. Vanderlinden, D. Allavena, C. Andrejak, C. Angoulvant, F. Azoulay, C. Bachelet, D. Bartoli, M. Basmaci, R. Behillill, S. Beluze, M. Benech, N. Benkerrou, D. Bhavsar, K. Bitker, L. Bouadma, L. Bouscambert-Duchamp, M. Paz, P.C. Cervantes-Gonzalez, M. Chair, A. Coelho, A. Cordel, H. Couffignal, C. D'Ortenzio, E. De Montmollin, E. Debard, A. Debray, M.-P. Desvallee, M. Diallo, A. Diouf, A. Dorival, C. Dubos, F. Eloy, P. Epaulard, O. Esposito-Farase, M. Etienne, M. Garot, D. Gault, N. Gaymard, A. Ghosn, J. Gigante, T. Gilg, M. Goehringer, F. Guedj, J. Hoctin, A. Hoffmann, I. Houas, I. Hulot, J.-S. Jaafoura, S. Kaguelidou, F. Kali, S. Kerroumi, Y. Khalil, A. Khan, C. Kimmoun, A. Laouenan, C. Laribi, S. Le, M. Le Bris, C. Le Gac, S. Le Hingrat, Q. Le Mestre, S. Le Nagard, H. Lemaignen, A. Lemee, V. Lescure, F.-X. Levy, Y. Lingas, G. Lucet, J.C. MacHado, M. Mambert, M. Manuel, A. Meziane, A. Mouquet, H. Mullaert, J. Neant, N. Noret, M. Papadopoulos, A. Paul, C. Peiffer-Smadja, N. Peigne, V. Petrov-Sanchez, V. Peytavin, G. Pham, H. Picone, O. Puechal, O. Rosa-Calatrava, M. Rossignol, B. Rossignol, P. Roy, C. Schneider, M. Su, R. Tardivon, C. Tellier, M.-C. Teoule, F. Terrier, O. Timsit, J.F. Tual, C. Vanel, N. Veislinger, A. Wiedemann, A. Danielson, J.J. Dobbs, K. Kashyap, A. Ding, L. Dalgard, C.L. Sottini, A. Quaresima, V. Quiros-Roldan, E. Rossi, C. Bettini, L.R. D'Angio, M. Beretta, I. Montagna, D. Licari, A. Marseglia, G.L. Storgaard, M. Jorgensen, S. Al-Muhsen, S. Al-Mulla, F. Arias, A.A. Bogunovic, D. Bolze, A. Brodin, P. Bryceson, Y. Bustamante, C.D. Butte, M.J. Chakravorty, S. Christodoulou, J. Constantinescu, S.N. Cooper, M.A. Desai, M. Drolet, B.A. El Baghdadi, J. Espinosa-Padilla, S. Froidure, A. Henrickson, S.E. Hsieh, E.W.Y. Husebye, E.S. Imai, K. Itan, Y. Jarvis, E.D. Karamitros, T. Ku, C.-L. Ling, Y. Lucas, C.L. Maniatis, T. Marodi, L. Milner, J.D. Mironska, K. Novelli, A. Novelli, G. Renia, L. Resnick, I. Sancho-Shimizu, V. Seppanen, M.R.J. Shahrooei, M. Slaby, O. Tayoun, A.A. Ramaswamy, S. Turvey, S.E. Furkan Uddin, K.M. Uddin, M.J. Von Bernuth, H. Zawadzki, P. Bigio, B. De La Chapelle, A. Chen, J. Chrabieh, M. Liu, D. Nemirowskaya, Y. Cruz, I.M. Materna, M. Pelet, S. Seeleuthner, Y. Thibault, C. Liu, Z. Foti, G. Bellani, G. Citerio, G. Contro, E. Pesci, A. Valsecchi, M.G. Cazzaniga, M. Batten, I. Reddy, C. McElheron, M. Noonan, C. Connolly, E. Fallon, A. Erikstrup, C. Pedersen, O.B. Sorensen, E. Mikkelsen, S. Dinh, K.M. Larsen, M.A.H. Paulsen, I.W. Von Stemann, J.H. Hansen, M.B. Annereau, J.-P. Briseno-Roa, L. Gribouval, O. Pelet, A. Alcover, A. Aschard, H. Bousso, P. Bruhns, P. Cerf-Bensussan, N. Cumano, A. D'Enfert, C. Deriano, L. Dillies, M.-A. Di Santo, J. Dromer, F. Eberl, G. Enninga, J. Gomperts-Boneca, I. Hasan, M. Hedestam, G.K. Hercberg, S. Ingersoll, M.A. Lantz, O. Kenny, R.A. Menager, M. Michel, F. Patin, E. Pellegrini, S. Rausell, A. Rieux-Laucat, F. Rogge, L. Fontes, M. Sakuntabhai, A. Schwartz, O. Schwikowski, B. Shorte, S. Tangy, F. Toubert, A. Touvier, M. Ungeheuer, M.-N. Zimmer, C. Albert, M.L. Van Agtmael, M. Algera, A.G. Appelman, B. Van Baarle, F. Bax, D. Beudel, M. Bogaard, H.J. Bomers, M. Bonta, P. Bos, L. Botta, M. De Brabander, J. De Bree, G. De Bruin, S. Buis, D.T.P. Bugiani, M. Bulle, E. Chouchane, O. Cloherty, A. Dijkstra, M. Dongelmans, D.A. Dujardin, R.W.G. Elbers, P. Fleuren, L. Geerlings, S. Geijtenbeek, T. Girbes, A. Goorhuis, B. Grobusch, M.P. Hafkamp, F. Hagens, L. Hamann, J. Harris, V. Hemke, R. Hermans, S.M. Heunks, L. Hollmann, M. Horn, J. Hovius, J.W. De Jong, M.D. Lim, E.H.T. Van Mourik, N. Nellen, J. Nossent, E.J. Paulus, F. Peters, E. Pina-Fuentes, D.A.I. Van Der Poll, T. Preckel, B. Prins, J.M. Raasveld, J. Reijnders, T. De Rotte, M.C.F.J. Schinkel, M. Schultz, M.J. Schrauwen, F.A.P. Schuurman, A. Schuurmans, J. Sigaloff, K. Slim, M.A. Smeele, P. Smit, M. Stijnis, C.S. Stilma, W. Teunissen, C. Thoral, P. Tsonas, A.M. Tuinman, P.R. Van Der Valk, M. Veelo, D. Volleman, C. De Vries, H. Vught, L.A. Van Vugt, M. Wouters, D. Zwinderman, A.H. Brouwer, M.C. Joost Wiersinga, W. Vlaar, A.P.J. Nadif, R. Goldberg, M. Ozguler, A. Henny, J. Lemonnier, S. Coeuret-Pellicer, M. Le Got, S. Tzourio, C. Dufouil, C. Soumare, A. Lachaize, M. Fievet, N. Flaig, A. Martin, F. Bonneaudeau, B. Cannet, D. Gallian, P. Jeanne, M. Perroquin, M. Hamzeh-Cognasse, H. CoV-Contact Cohort St James's Hospital, SARS CoV2 Interest group COVID Clinicians French COVID Cohort Study Group NIAID Immune Response to COVID Group Danish CHGE COVID Human Genetic Effort HGID Lab COVID-STORM Clinicians NH-COVAIR Study Group The Danish Blood Donor Study (DBDS) Imagine COVID-Group The Milieu Interieur Consortium Amsterdam UMC Covid-19 Biobank CONSTANCES cohort 3C-Dijon Study Cerba HealthCare Etablissement du Sang study group

Abstract

Circulating autoantibodies (auto-Abs) neutralizing high concentrations (10 ng/ml; in plasma diluted 1:10) of IFN-α and/or IFN-ω are found in about 10% of patients with critical COVID-19 (coronavirus disease 2019) pneumonia but not in individuals with asymptomatic infections. We detect auto-Abs neutralizing 100-fold lower, more physiological, concentrations of IFN-α and/or IFN-ω (100 pg/ml; in 1:10 dilutions of plasma) in 13.6% of 3595 patients with critical COVID-19, including 21% of 374 patients >80 years, and 6.5% of 522 patients with severe COVID-19. These antibodies are also detected in 18% of the 1124 deceased patients (aged 20 days to 99 years; mean: 70 years). Moreover, another 1.3% of patients with critical COVID-19 and 0.9% of the deceased patients have auto-Abs neutralizing high concentrations of IFN-β. We also show, in a sample of 34,159 uninfected individuals from the general population, that auto-Abs neutralizing high concentrations of IFN-α and/or IFN-ω are present in 0.18% of individuals between 18 and 69 years, 1.1% between 70 and 79 years, and 3.4% >80 years. Moreover, the proportion of individuals carrying auto-Abs neutralizing lower concentrations is greater in a subsample of 10,778 uninfected individuals: 1% of individuals 80 years. By contrast, auto-Abs neutralizing IFN-β do not become more frequent with age. Auto-Abs neutralizing type I IFNs predate SARS-CoV-2 infection and sharply increase in prevalence after the age of 70 years. They account for about 20% of both critical COVID-19 cases in the over 80s and total fatal COVID-19 cases. © 2021 The Authors, some rights reserved.

Published
2021

8. Correction to: The Intensive Care Global Study on Severe Acute Respiratory Infection (IC-GLOSSARI): a multicenter, multinational, 14-day inception cohort study

Author

R. Di Pasquale, F. Zand, C. Chavez, P. Hopkins, G. Almekhlafi, H. Haake, A. Martinho, A. Jung, R. Montoiro Allue, T. Pellis, R. Ferrer Roca, S. Busani, A. Gordon, N. Salahuddin, F. Belda, J. Rubio Mateo-Sidron, A. Goldmann, P. Deschamps, K. Mach, J. Nentwich, F. Rubulotta, G. Lunch, A. Jonas, R. Matos, A. Carvalho, T. Vymazal, M. Guillot, D. Morocho, D. Barrios, K. Koopmans, J. Machon, D. Tomescu, X. Wu, N. Cimic, C. de Cabo, M. Kol, M. Papanikolaou, C. Aragon, S. Afonso, S. Mukkera, T. Szakmany, Z. Mitrev, A. Alsheikhly, P. Garcia Olivares, M. de la Torre-Prados, A. Donnelly, M. Girardis, V. Schiavone, N. Unni, A. Vujiaklija Brajkovic, J. van den Bosch, F. Udwadia, R. Losser, L. Bormans, J. Tomás Marsilla, F. Bloos, A. Puerto-Morlan, F. Guarracino, M. Faraz, E. Meany, K. Ravi, J. Vincent, K. Zacharowski, R. Shetty, B. Misset, V. Pota, L. Sanchez-Hurtado, B. Villamagua, C. Pierrakos, C. Nutt, S. Humphreys, P. Dennesen, M. de Groot, J. Robles, J. Meyer, W. Samaniego, Q. Zhai, L. Yu, V. Koulouras, P. Gottardo, E. Caser, M. Cecconi, S. John, I. von Osten, G. Kekstas, C. Leite Mendes, H. Jamaati, A. Raj, P. Csabi, N. Catorze, R. Gueret, F. Sifrer, G. Plantefeve, A. Macri, S. Den Boer, C. Ortiz-Leyba, M. Gurjar, J. Palo, S. Hoersch, G. Kyriazopoulos, M. Balla, Z. Kheladze, M. Hobrok, T. Nguyen, L. Srinivasa, S. Henderson, G. Dominguez, A. Maghrabi, S. Mathew, M. Blahut-Zugaj, S. Spadaro, A. Lange, K. Fiedler, L. Chao, G. Pellerano, A. Rojas, L. Brochard, S. Brett, I. Soultati, A. Albis, J. Timsit, R. Quispe Sierra, A. Pais-de-Lacerda, N. Di Tomasso, E. Scarlatescu, Y. Sakr, M. Hegazi, A. Gottschalk, N. Anguel, C. Volta, M. Alvarez, K. Psaroulis, P. Monedero, L. Fernandes, M. Niesen, G. Francois, D. Debels, M. Stotz, R. Riessen, J. Auer, E. Massa, Y. Ikeda-Maquiling, J. Izura, M. Chruscikowski, F. Franco, G. Aguilar, R. Bigornia, J. Teboul, K. Bhowmick, R. Srinivasan, J. Mallat, G. Bellani, C. Van Haren, F. Philippart, F. Honig, I. Gornik, D. Filipescu, M. Fulop, M. Albarrak, S. Behrens, E. Bermudez-Aceves, K. Schwarzkopf, N. Ramakrishnan, P. Mazzini, K. Mccalman, V. Tomic, R. Catalan, M. Giannakou, D. Molano, M. Savioli, M. Watters, X. Zhang, X. Jing, P. Araujo Aguilar, C. Joya, R. Beale, M. Garfield, A. Nichol, G. Barraza, H. Siegel, D. Gkika, L. Bouadma, T. Helmes, A. Bendtsen, R. Moreno, U. Kaisers, B. Thompson, A. Araujo, C. Teixeira, T. Hurst, M. Ostermann, T. Anguseva, I. Serra, M. Deja, J. Blanquer, A. Faltlhauser, J. Strachan, V. Corcoles Gonzalez, U. Goebel, V. Karosas, J. Wauters, F. Taccone, A. Wieczorek, C. Fernandez Gonzalez, R. Smith, A. Kübler, N. Petrucci, G. Kluge, T. Pham, U. Jaschinski, M. Vander Laenen, A. Molin, G. Barberet, M. Kuiper, C. Santos, R. Medici, J. Nielsen, S. Whittle, P. Meybohm, E. Schreurs, C. Dao, J. Bedford, R. Cardiga, G. Schatzl, M. Baumgaertel, O. Balogun, J. Gutierrez Rubio, I. Martins, G. Vlachogianni, K. Guerra, E. Novy, A. Gatta, M. Mikaszewska-Sokolewicz, B. Adamik, J. Baltazar-Torres, S. Hraech, D. Higgs, A. Ferguson, F. Cecchini, E. Zogheib, S. Dixit, M. Darmon, Z. Costa, S. O’Kane, B. Siepe, S. Ñamendys-Silva, R. Ferrer, M. Popescu, B. Floccard, O. Beck, M. Christ, F. Daviaux, N. Smalley, P. Alexander, J. Lopez-Delgado, K. Reinhart, R. Jha, J. Chiche, C. Lovesio, J. Fried, D. Rodriguez, P. Vera Aratcoz, A. Cortegiani, T. Aisa, N. Remache-Vargas, E. Salgado-Yepez, A. Olmo, E. Rupnik, M. Haap, C. Motherway, M. Sungur, R. Stoica, R. Nikandish, P. Reddy, M. Miclo, N. Chinellato, E. Mouloudi, O. O’Neill, J. Lehmke, G. Nikos, P. Bauer, M. Barger, H. Atalan, J. Ferrer Agüero, A. Bellini, G. Janssen, S. Allgaeuer, G. Strandvik, P. Simon, D. Castanares, H. Ceunen, A. Rhodes, S. Simran, S. Hashemian, A. Pravin, I. Sagoschen, E. Rezende, H. Wong, J. Sole Violan, V. Castelain, S. Raineri, K. Indraratna, E. Nives Carbonell, T. Suonsyrjä, D. Wu, G. Brescia, H. Gruber, M. Sim, T. Lazowski, C. Gonzalez, C. Dellera, J. Rajasinhe, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, and UCL - (SLuc) Service de soins intensifs

Subjects
Male, medicine.medical_specialty, Severe acute respiratory infections, Critical Care and Intensive Care Medicine, Severe Acute Respiratory Syndrome, Risk Assessment, Severity of Illness Index, Severe acute respiratory infection, Seven-Day Profile Publication, Risk Factors, Intensive care, Medicine, Humans, Hospital Mortality, Prospective Studies, Intensive care medicine, Outcome, Aged, business.industry, Age Factors, Correction, Pneumonia, Middle Aged, INCEPTION COHORT, Intensive Care Units, Female, business
Abstract

Purpose In this prospective, multicenter, 14-day inception cohort study, we investigated the epidemiology, patterns of infections, and outcome in patients admitted to the intensive care unit (ICU) as a result of severe acute respiratory infections (SARIs). Methods All patients admitted to one of 206 participating ICUs during two study weeks, one in November 2013 and the other in January 2014, were screened. SARI was defined as possible, probable, or microbiologically confirmed respiratory tract infection with recent onset dyspnea and/or fever. The primary outcome parameter was in-hospital mortality within 60 days of admission to the ICU. Results Among the 5550 patients admitted during the study periods, 663 (11.9 %) had SARI. On admission to the ICU, Gram-positive and Gram-negative bacteria were found in 29.6 and 26.2 % of SARI patients but rarely atypical bacteria (1.0 %); viruses were present in 7.7 % of patients. Organ failure occurred in 74.7 % of patients in the ICU, mostly respiratory (53.8 %), cardiovascular (44.5 %), and renal (44.6 %). ICU and in-hospital mortality rates in patients with SARI were 20.2 and 27.2 %, respectively. In multivariable analysis, older age, greater severity scores at ICU admission, and hematologic malignancy or liver disease were independently associated with an increased risk of in-hospital death, whereas influenza vaccination prior to ICU admission and adequate antibiotic administration on ICU admission were associated with a lower risk. Conclusions Admission to the ICU for SARI is common and associated with high morbidity and mortality rates. We identified several risk factors for in-hospital death that may be useful for risk stratification in these patients. Electronic supplementary material The online version of this article (doi:10.1007/s00134-015-4206-2) contains supplementary material, which is available to authorized users.

Published
2017

9. Slip velocity of large neutrally buoyant particles in turbulent flows

Author

G Bellani and E A Variano

Subjects
Science, Physics, QC1-999
Abstract

We discuss possible definitions for a stochastic slip velocity that describes the relative motion between large particles and a turbulent flow. This definition is necessary because the slip velocity used in the standard drag model fails when particle size falls within the inertial subrange of ambient turbulence. We propose two definitions, selected in part due to their simplicity: they do not require filtration of the fluid phase velocity field, nor do they require the construction of conditional averages on particle locations. A key benefit of this simplicity is that the stochastic slip velocity proposed here can be calculated equally well for laboratory, field and numerical experiments. The stochastic slip velocity allows the definition of a Reynolds number that should indicate whether large particles in turbulent flow behave (a) as passive tracers; (b) as a linear filter of the velocity field; or (c) as a nonlinear filter to the velocity field. We calculate the value of stochastic slip for ellipsoidal and spherical particles (the size of the Taylor microscale) measured in laboratory homogeneous isotropic turbulence. The resulting Reynolds number is significantly higher than 1 for both particle shapes, and velocity statistics show that particle motion is a complex nonlinear function of the fluid velocity. We further investigate the nonlinear relationship by comparing the probability distribution of fluctuating velocities for particle and fluid phases.

Published
2012
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10. Definition and epidemiology of acute respiratory distress syndrome

Author

G. Bellani, Emanuele Rezoagli, Roberto Fumagalli, Rezoagli, E, Fumagalli, R, and Bellani, G

Subjects
0301 basic medicine, Mechanical ventilation, medicine.medical_specialty, ARDS, business.industry, medicine.medical_treatment, General Medicine, Acute respiratory distress, Review Article, Lung injury, medicine.disease, 03 medical and health sciences, 030104 developmental biology, Epidemiology, Medicine, business, Intensive care medicine
Abstract

Fifty years ago, Ashbaugh and colleagues defined for the first time the acute respiratory distress syndrome (ARDS), one among the most challenging clinical condition of the critical care medicine. The scientific community worked over the years to generate a unified definition of ARDS, which saw its revisited version in the Berlin definition, in 2014. Epidemiologic information about ARDS is limited in the era of the new Berlin definition, and wide differences are reported among countries all over the world. Despite decades of study in the field of lung injury, ARDS is still so far under-recognized, with 2 out of 5 cases missed by clinicians. Furthermore, although advances of ventilator strategies in the management of ARDS associated with outcome improvements—such as protective mechanical ventilation, lower driving pressure, higher PEEP levels and prone positioning—ARDS appears to be undertreated and mortality remains elevated up to 40%. In this review, we cover the history that led to the current worldwide accepted Berlin definition of ARDS and we summarize the recent data regarding ARDS epidemiology.

Published
2017

11. Tidal changes on CT and progression of ARDS

Author

Hooman Hamedani, Luca Guerra, Justin T. Clapp, Nicholas J. Tustison, Jennia Rajaei, James C. Gee, G. Bellani, Stephen Kadlecek, Natalie Meeder, Yi Xin, Brian P. Kavanagh, Maurizio Cereda, Rahim R. Rizi, Cereda, M, Xin, Y, Hamedani, H, Bellani, G, Kadlecek, S, Clapp, J, Guerra, L, Meeder, N, Rajaei, J, Tustison, N, Gee, J, Kavanagh, B, and Rizi, R

Subjects
ARDS, Time Factors, Ventilator-Induced Lung Injury, 030204 cardiovascular system & hematology, Artificial respiration, Severe Acute Respiratory Syndrome, Severity of Illness Index, law.invention, 0302 clinical medicine, law, Respiratory Distress Syndrome, Intensive care unit, 3. Good health, medicine.anatomical_structure, Inhalation, ventilator-induced lung injury, Exhalation, Cardiology, Disease Progression, Pulmonary and Respiratory Medicine, Adult, medicine.medical_specialty, Critical Care, diagnostic imaging, Lung injury, Sensitivity and Specificity, 03 medical and health sciences, Predictive Value of Tests, Internal medicine, medicine, Tidal Volume, Animals, Humans, In patient, artificial respiration, Lung, business.industry, computed tomography, Oxygenation, medicine.disease, Respiration, Artificial, Surgery, Rats, Clinical trial, Disease Models, Animal, acute lung injury, business, Tomography, X-Ray Computed, 030217 neurology & neurosurgery
Abstract

Background: Uncertain prediction of outcome in acute respiratory distress syndrome (ARDS) impedes individual patient management and clinical trial design.Objectives: To develop a radiological metric of injurious inflation derived from matched inspiratory and expiratory CT scans, calibrate it in a model of experimental lung injury, and test it in patients with ARDS.Methods: 73 anaesthetised rats (acid aspiration model) were ventilated (protective or non-protective) for up to 4 hours to generate a spectrum of lung injury. CT was performed (inspiratory and expiratory) at baseline each hour, paired inspiratory and expiratory images were superimposed and voxels tracked in sequential scans. In nine patients with ARDS, paired inspiratory and expiratory CT scans from the first intensive care unit week were analysed.Results: In experimental studies, regions of lung with unstable inflation (ie, partial or reversible airspace filling reflecting local strain) were the areas in which subsequent progression of injury was greatest in terms of progressive infiltrates (R=0.77) and impaired compliance (R=0.67, p28% in all patients who died and ≤28% in all who survived, whereas segregation of survivors versus non-survivors was not possible based on oxygenation or lung mechanics.Conclusions: A single set of superimposed inspiratory-expiratory CT scans may predict progression of lung injury and outcome in ARDS; if these preliminary results are validated, this could facilitate clinical trial recruitment and individualised care

Published
2016

12. Pulmonary surfactant synthesis after unilateral lung injury in mice

Author

Maria Amigoni, Manuela Simonato, Luca Vedovelli, Alice Grassi, Virgilio P. Carnielli, Vanessa Zambelli, Margherita Scanziani, Paola Cogo, Giulia Lamonica, G. Bellani, Lamonica, G, Amigoni, M, Vedovelli, L, Zambelli, V, Scanziani, M, Bellani, G, Grassi, A, Simonato, M, Carnielli, V, and Cogo, P

Subjects
Male, Pathology, medicine.medical_specialty, Physiology, surfactant, Palmitates, Bronchi, Lung injury, Aspiration Pneumonitis, Mice, Pulmonary surfactant, Disaturated phosphatidylcholine, Physiology (medical), medicine, Animals, Peroxidase, Chemistry, Pulmonary Surfactants, Lung Injury, anaesthesia, respiratory system, respiratory tract diseases, acute lung injury, Murine model, disaturated phosphatidylcholine, Phosphatidylcholines, Bronchoalveolar Lavage Fluid
Abstract

Aspiration pneumonitis can lead to alveolar surfactant dysfunction. We employed a murine model of unilateral aspiration to compare surfactant synthesis in the injured (I) and noninjured (NI) contralateral lung. Mice were instilled with hydrochloric acid in the right bronchus and, after 18 h, an intraperitoneal dose of deuterated water was administered as precursor of disaturated phosphatidylcholine (DSPC)-palmitate. Selected bronchoalveolar lavage fluid (BALF) was collected at scheduled time points and lungs were removed. We measured DSPC-palmitate synthesis in lung tissue and secretion in BALF by gas chromatography-isotope ratio mass spectrometry, together with total proteins and myeloperoxidase activity (MPO) by spectrophotometry. BALF total proteins and MPO were significantly increased in the I lungs compared with NI and naïve control lungs. The DSPC pool size was significantly lower in the BALF of the I lungs compared with naïve controls. DSPC synthesis was accelerated in the I and NI lungs. DSPC secretion of the I lungs was similar to their respective naïve controls, and it was markedly lower compared with their respective NI contralateral lungs. DSPC synthesis and secretion were faster, especially in the NI lungs, compared with naïve control lungs, as a possible compensatory mechanism due to a cross-talk between the lungs triggered by inflammation, hyperventilation, and/or undetermined type II cell reaction to the injury.

Published
2013

13. Role of the Renin-Angiotensin System in ARDS

Author

Alice Grassi, G. Bellani, Vanessa Zambelli, Vincent, JL, Zambelli, V, Grassi, A, and Bellani, G

Subjects
chemistry.chemical_classification, medicine.medical_specialty, ARDS, Chemistry, Alveolar epithelial cell, Systemic blood pressure, medicine.disease, Renin-Angiotensin System, Endocrinology, Enzyme, Internal medicine, Renin–angiotensin system, medicine, MED/41 - ANESTESIOLOGIA, Intracellular, Homeostasis
Abstract

The renin-angiotensin system (RAS) is a powerful biological system that plays an important role in regulation of systemic blood pressure through the maintenance of fluid and salt homeostasis. It is a multifactorial system since it includes different components (Fig. 1): The first, renin, was discovered in 1898 [1], whereas the discovery of the last component, angiotensin-converting enzyme 2 (ACE 2), is relatively recent, from 2000 [2, 3]. Three kinds of RAS are known: A) circulating, B) local, and C) intracellular.

Published
2012

14. Influence of percutaneous tracheostomy on gas exchange in mechanically ventilated patients

Author

Pradella, A, Bellani, G, Abd El Aziz El Sayed Deab, S, Mauri, T, Rezoagli, E, Arrigoni, S, Leone, F, Citerio, G, Pesenti, A, A Pradella, G Bellani, S Abd El Aziz El Sayed Deab, T Mauri, E Rezoagli, S Arrigoni, F Leone, G Citerio, A Pesenti, Pradella, A, Bellani, G, Abd El Aziz El Sayed Deab, S, Mauri, T, Rezoagli, E, Arrigoni, S, Leone, F, Citerio, G, Pesenti, A, A Pradella, G Bellani, S Abd El Aziz El Sayed Deab, T Mauri, E Rezoagli, S Arrigoni, F Leone, G Citerio, and A Pesenti

Published
2012

15. Imaging of lung inflammation during severe influenza A: H1N1

Author

Luca Guerra, G. Bellani, Antonio Pesenti, Cristina Messa, Bellani, G, Guerra, L, Pesenti, A, and Messa, M

Subjects
Resuscitation, Inflammation, ARDS, Positron Emission Tomography, influenza A-H1N1, Critical Care and Intensive Care Medicine, Severe influenza, 03 medical and health sciences, Oseltamivir, 0302 clinical medicine, Intensive care, Correspondence, medicine, MED/41 - ANESTESIOLOGIA, Acute Respiratory Distress Syndrome, 030304 developmental biology, MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA, 0303 health sciences, Lung, business.industry, Respiratory disease, Influenza a, medicine.disease, Influenza, medicine.anatomical_structure, Intensive Care Unit Stay, 030228 respiratory system, Immunology, Viral disease, medicine.symptom, business, Positron Emission Tomography
Published
2010

16. Outcome of acute hypoxaemic respiratory failure: insights from the LUNG SAFE Study

Author

Pham, Tài, Pesenti, Antonio, Bellani, Giacomo, Rubenfeld, Gordon, Fan, Eddy, Bugedo, Guillermo, Lorente, José Angel, Fernandes, Antero do Vale, Van Haren, Frank, Bruhn, Alejandro, Rios, Fernando, Esteban, Andres, Gattinoni, Luciano, Larsson, Anders, McAuley, Daniel F., Ranieri, Marco, Thompson, B. Taylor, Wrigge, Hermann, Brochard, Laurent J., Laffey, John G, Antonio Pesenti, John G Laffey, Laurent Brochard, Andres Esteban, Luciano Gattinoni, Frank van Haren, Anders Larsson, Daniel F McAuley, Marco Ranieri, Gordon Rubenfeld, B Taylor Thompson, Hermann Wrigge, Arthur S Slutsky, Giacomo Bellani, Tài Pham, Eddy Fan, Fernando Rios, Thierry Sottiaux, Pieter Depuydt, Fredy S Lora, Luciano Cesar Azevedo, Guillermo Bugedo, Haibo Qiu, Marcos Gonzalez, Juan Silesky, Vladimir Cerny, Jonas Nielsen, Manuel Jibaja, Dimitrios Matamis, Jorge Luis Ranero, Pravin Amin, S M Hashemian, Kevin Clarkson, Kiyoyasu Kurahashi, Asisclo Villagomez, Amine Ali Zeggwagh, Leo M Heunks, Jon Henrik Laake, Jose Emmanuel Palo, Antero do Vale Fernandes, Dorel Sandesc, Yaasen Arabi, Vesna Bumbasierevic, Nicolas Nin, Jose A Lorente, Lise Piquilloud, Fekri Abroug, Lia McNamee, Javier Hurtado, Ed Bajwa, Gabriel Démpaire, Hektor Sula, Lordian Nunci, Alma Cani, Alan Zazu, Christian Dellera, Carolina S Insaurralde, Risso V Alejandro, Julio Daldin, Mauricio Vinzio, Ruben O Fernandez, Luis P Cardonnet, Lisandro R Bettini, Mariano Carboni Bisso, Emilio M Osman, Mariano G Setten, Pablo Lovazzano, Javier Alvarez, Veronica Villar, Norberto C Pozo, Nicolas Grubissich, Gustavo A Plotnikow, Daniela N Vasquez, Santiago Ilutovich, Norberto Tiribelli, Ariel Chena, Carlos A Pellegrini, María G Saenz, Elisa Estenssoro, Matias Brizuela, Hernan Gianinetto, Pablo E Gomez, Valeria I Cerrato, Marco G Bezzi, Silvina A Borello, Flavia A Loiacono, Adriana M Fernandez, Serena Knowles, Claire Reynolds, Deborah M Inskip, Jennene J Miller, Jing Kong, Christina Whitehead, Shailesh Bihari, Aylin Seven, Amanda Krstevski, Helen J Rodgers, Rebecca T Millar, Toni E McKenna, Irene M Bailey, Gabrielle C Hanlon, Anders Aneman, Joan M Lynch, Raman Azad, John Neal, Paul W Woods, Brigit L Roberts, Mark R Kol, Helen S Wong, Katharina C Riss, Thomas Staudinger, Xavier Wittebole, Caroline Berghe, Pierre A Bulpa, Alain M Dive, Rik Verstraete, Herve Lebbinck, Joris Vermassen, Philippe Meersseman, Helga Ceunen, Jonas I Rosa, Daniel O Beraldo, Claudio Piras, Adenilton M Rampinelli, Antonio P Nassar Jr, Sergio Mataloun, Marcelo Moock, Marlus M Thompson, Claudio H Gonçalves, Ana Carolina P Antônio, Aline Ascoli, Rodrigo S Biondi, Danielle C Fontenele, Danielle Nobrega, Vanessa M Sales, Ahmad Yazid Bin Hj Abul Wahab, Maizatul Ismail, Suresh Shindhe, John Laffey, Francois Beloncle, Kyle G Davies, Rob Cirone, Venika Manoharan, Mehvish Ismail, Ewan C Goligher, Mandeep Jassal, Erin Nishikawa, Areej Javeed, Gerard Curley, Nuttapol Rittayamai, Matteo Parotto, Niall D Ferguson, Sangeeta Mehta, Jenny Knoll, Antoine Pronovost, Sergio Canestrini, Alejandro R Bruhn, Patricio H Garcia, Felipe A Aliaga, Pamela A Farías, Jacob S Yumha, Claudia A Ortiz, Javier E Salas, Alejandro A Saez, Luis D Vega, Eduardo F Labarca, Felipe T Martinez, Nicolás G Carreño, Pilar Lora, Haitao Liu, Ling Liu, Rui Tang, Xiaoming Luo, Youzhong An, Huiying Zhao, Yan Gao, Zhe Zhai, Zheng L Ye, Wei Wang, Wenwen Li, Qingdong Li, Ruiqiang Zheng, Wenkui Yu, Juanhong Shen, Xinyu Li, Tao Yu, Weihua Lu, Ya Q Wu, Xiao B Huang, Zhenyang He, Yuanhua Lu, Hui Han, Fan Zhang, Renhua Sun, Hua X Wang, Shu H Qin, Bao H Zhu, Jun Zhao, Jian Liu, Bin Li, Jing L Liu, Fa C Zhou, Qiong J Li, Xing Y Zhang, Zhou Li-Xin, Qiang Xin-Hua, Liangyan Jiang, Yuan N Gao, Xian Y Zhao, Yuan Y Li, Xiao L Li, Chunting Wang, Qingchun Yao, Rongguo Yu, Kai Chen, Huanzhang Shao, Bingyu Qin, Qing Q Huang, Wei H Zhu, Ai Y Hang, Ma X Hua, Yimin Li, Yonghao Xu, Yu D Di, Long L Ling, Tie H Qin, Shou H Wang, Junping Qin, Yi Han, Suming Zhou, Monica P Vargas, Juan I Silesky Jimenez, Manuel A González Rojas, Jaime E SolisQuesada, Christian M Ramirez-Alfaro, Jan Máca, Peter Sklienka, Jakob Gjedsted, Aage Christiansen, Boris G Villamagua, Iguel Llano, Philippe Burtin, Gautier Buzancais, Pascal Beuret, Nicolas Pelletier, Satar Mortaza, Alain Mercat, Jonathan Chelly, Sébastien Jochmans, Nicolas Terzi, Cédric Daubin, Guillaume Carteaux, Nicolas de Prost, Jean-Daniel Chiche, Fabrice Daviaud, Muriel Fartoukh, Guillaume Barberet, Jerome Biehler, Jean Dellamonica, Denis Doyen, Jean-Michel Arnal, Anais Briquet, Sami Hraiech, Laurent Papazian, Arnaud Follin, Damien Roux, Jonathan Messika, Evangelos Kalaitzis, Laurence Dangers, Alain Combes, Siu-Ming Au, Gaetan Béduneau, Dorothée Carpentier, Elie H Zogheib, Herve Dupont, Sylvie Ricome, Francesco L Santoli, Sebastien L Besset, Philippe Michel, Bruno Gelée, Pierre-Eric Danin, Bernard Goubaux, Philippe J Crova, Nga T Phan, Frantz Berkelmans, Julio C Badie, Romain Tapponnier, Josette Gally, Samy Khebbeb, Jean-Etienne Herbrecht, Francis Schneider, PierreLouis M Declercq, Jean-Philippe Rigaud, Jacques Duranteau, Anatole Harrois, Russell Chabanne, Julien Marin, Charlene Bigot, Sandrine Thibault, Mohammed Ghazi, Messabi Boukhazna, Salem Ould Zein, Jack R Richecoeur, Daniele M Combaux, Fabien Grelon, Charlene Le Moal, Elise P Sauvadet, Adrien Robine, Virginie Lemiale, Danielle Reuter, Martin Dres, Alexandre Demoule, Dany Goldgran-Toledano, Loredana Baboi, Claude Guérin, Ralph Lohner, Jens Kraßler, Susanne Schäfer, Kai D Zacharowski, Patrick Meybohm, Andreas W Reske, Philipp Simon, HansBernd F Hopf, Michael Schuetz, Thomas Baltus, Metaxia N Papanikolaou, Theonymfi G Papavasilopoulou, Giannis A Zacharas, Vasilis Ourailogloy, Eleni K Mouloudi, Eleni V Massa, Eva O Nagy, Electra E Stamou, Ellada V Kiourtzieva, Marina A Oikonomou, Luis E Avila, Cesar A Cortez, Johanna E Citalán, Sameer A Jog, Safal D Sable, Bhagyesh Shah, Mohan Gurjar, Arvind K Baronia, Mohammedfaruk Memon, Radhakrishnan Muthuchellappan, Venkatapura J Ramesh, Anitha Shenoy, Ramesh Unnikrishnan, Subhal B Dixit, Rachana V Rhayakar, Nagarajan Ramakrishnan, Vallish K Bhardwaj, Heera L Mahto, Sudha V Sagar, Vijayanand Palaniswamy, Deeban Ganesan, Seyed Mohammadreza Hashemian, Hamidreza Jamaati, Farshad Heidari, Edel A Meaney, Alistair Nichol, Karl M Knapman, Donall O'Croinin, Eimhin S Dunne, Dorothy M Breen, Kevin P Clarkson, Rola F Jaafar, Rory Dwyer, Fahd Amir, Olaitan O Ajetunmobi, Aogan C O'Muircheartaigh, Colin S Black, Nuala Treanor, Daniel V Collins, Wahid Altaf, Gianluca Zani, Maurizio Fusari, Savino Spadaro, Carlo A Volta, Romano Graziani, Barbara Brunettini, Salvatore Palmese, Paolo Formenti, Michele Umbrello, Andrea Lombardo, Elisabetta Pecci, Marco Botteri, Monica Savioli, Alessandro Protti, Alessia Mattei, Lorenzo Schiavoni, Andrea Tinnirello, Manuel Todeschini, Antonino Giarratano, Andrea Cortegiani, Massimo M Antonelli, Luca M Montini, Paolo Casalena, Sergio Scafetti, Giovanna Panarello, Giovanna Occhipinti, Nicolò Patroniti, Matteo Pozzi, Roberto R Biscione, Michela M Poli, Ferdinando Raimondi, Daniela Albiero, Giulia Crapelli, Eduardo Beck, Vincenzo Pota, Vincenzo Schiavone, Alexandre Molin, Fabio Tarantino, Giacomo Monti, Elena Frati, Lucia Mirabella, Gilda Cinnella, Tommaso Fossali, Riccardo Colombo, Pierpaolo Terragni, Ilaria Pattarino, Francesco Mojoli, Antonio Braschi, Erika E Borotto, Andrea N Cracchiolo, Daniela M Palma, Francesco Raponi, Giuseppe Foti, Ettore R Vascotto, Andrea Coppadoro, Luca Brazzi, Leda Floris, Giorgio A Iotti, Aaron Venti, Osamu Yamaguchi, Shunsuke Takagi, Hiroki N Maeyama, Eizo Watanabe, Yoshihiro Yamaji, Kazuyoshi Shimizu, Kyoko Shiozaki, Satoru Futami, Sekine Ryosuke, Koji Saito, Yoshinobu Kameyama, Keiko Ueno, Masayo Izawa, Nao Okuda, Hiroyuki Suzuki, Tomofumi Harasawa, Michitaka Nasu, Tadaaki Takada, Fumihito Ito, Shin Nunomiya, Kansuke Koyama, Toshikazu Abe, Kohkichi Andoh, Kohei Kusumoto, Akira Hirata, Akihiro Takaba, Hiroyasu Kimura, Shuhei Matsumoto, Ushio Higashijima, Hiroyuki Honda, Nobumasa Aoki, Hiroshi Imai, Yasuaki Ogino, Ichiko Mizuguchi, Kazuya Ichikado, Kenichi Nitta, Katsunori Mochizuki, Tomoaki Hashida, Hiroyuki Tanaka, Tomoyuki Nakamura, Daisuke Niimi, Takeshi Ueda, Yozo Kashiwa, Akinori Uchiyama, Olegs Sabelnikovs, Peteris Oss, Youssef Haddad, Kong Y Liew, Silvio A Ñamendys-Silva, Yves D Jarquin-Badiola, Luis A Sanchez-Hurtado, Saira S Gomez-Flores, Maria C Marin, Asisclo J Villagomez, Jordana S Lemus, Jonathan M Fierro, Mavy Ramirez Cervantes, Francisco Javier Flores Mejia, Dulce Dector, Alejandro Rojas, Daniel R Gonzalez, Claudia R Estrella, Jorge R Sanchez-Medina, Alvaro Ramirez-Gutierrez, Fernando G George, Janet S Aguirre, Juan A Buensuseso, Manuel Poblano, Tarek Dendane, Hicham Balkhi, Mina Elkhayari, Nacer Samkaoui, Hanane Ezzouine, Abdellatif Benslama, Mourad Amor, Wajdi Maazouzi, Nedim Cimic, Oliver Beck, Monique M Bruns, Jeroen A Schouten, Myra Rinia, Monique Raaijmakers, Hellen M van Wezel, Serge J Heines, Ulrich Strauch, Marc P Buise, Fabienne D Simonis, Marcus J Schultz, Jennifer C Goodson, Troy S Browne, Leanlove Navarra, Anna Hunt, Robyn A Hutchison, Mathew B Bailey, Lynette Newby, Colin McArthur, Michael Kalkoff, Alex Mcleod, Jonathan Casement, Danielle J Hacking, Finn H Andersen, Merete S Dolva, Jon H Laake, Andreas Barratt-Due, Kim Andre L Noremark, Eldar Søreide, Brit Å Sjøbø, Anne B Guttormsen, Hector H Leon Yoshido, Ronald Zumaran Aguilar, Fredy A Montes Oscanoa, Alain U Alisasis, Joanne B Robles, Rossini Abbie B Pasanting-Lim, Beatriz C Tan, Pawel Andruszkiewicz, Karina Jakubowska, Cristina M Coxo, António M Alvarez, Bruno S Oliveira, Gustavo M Montanha, Nelson C Barros, Carlos S Pereira, António M Messias, Jorge M Monteiro, Ana M Araujo, Nuno T Catorze, Susan M Marum, Maria J Bouw, Rui M Gomes, Vania A Brito, Silvia Castro, Joana M Estilita, Filipa M Barros, Isabel M Serra, Aurelia M Martinho, Dana R Tomescu, Alexandra Marcu, Ovidiu H Bedreag, Marius Papurica, Dan E Corneci, Silvius Ioan Negoita, Evgeny Grigoriev, Alexey I Gritsan, Andrey A Gazenkampf, Ghaleb Almekhlafi, Mohamad M Albarrak, Ghanem M Mustafa, Khalid A Maghrabi, Nawal Salahuddin, Tharwat M Aisa, Ahmed S Al Jabbary, Edgardo Tabhan, Yaseen M Arabi, Olivia A Trinidad, Hasan M Al Dorzi, Edgardo E Tabhan, Vesna Bumbasirevic, Bojan Jovanovic, Stefan Bolon, Oliver Smith, Jordi Mancebo, Hernan Aguirre-Bermeo, Juan C Lopez-Delgado, Francisco Esteve, Gemma Rialp, Catalina Forteza, Candelaria De Haro, Antonio Artigas, Guillermo M Albaiceta, Sara De Cima-Iglesias, Leticia Seoane-Quiroga, Alexandra Ceniceros-Barros, Antonio L RuizAguilar, Luis M Claraco-Vega, Juan Alfonso Soler, Maria Del Carmen Lorente, Cecilia Hermosa, Federico Gordo, Miryam PrietoGonzález, Juan B López-Messa, Manuel P Perez, Cesar P Perez, Raquel Montoiro Allue, Ferran RocheCampo, Marcos Ibañez-Santacruz, Susana TempranoSusana, Maria C Pintado, Raul De Pablo, Pilar Ricart Aroa Gómez, Silvia Rodriguez Ruiz, Silvia Iglesias Moles, Mª Teresa Jurado, Alfons Arizmendi, Enrique A Piacentini, Nieves Franco, Teresa Honrubia, Meisy Perez Cheng, Elena Perez Losada, Javier Blanco, Luis J Yuste, Cecilia Carbayo-Gorriz, Francisca G Cazorla-Barranquero, Javier G Alonso, Rosa S Alda, Ángela Algaba, Gonzalo Navarro, Enrique Cereijo, Esther Diaz-Rodriguez, Diego Pastor Marcos, Laura Alvarez Montero, Luis Herrera Para, Roberto Jimenez Sanchez, Miguel Angel Blasco Navalpotro, Ricardo Diaz Abad, Raquel Montiel González, Dácil Parrilla Toribio, Alejandro G Castro, Maria Jose D Artiga, Oscar Penuelas, Tomas P Roser, Moreno F Olga, Elena Gallego Curto, Rocío Manzano Sánchez, Vallverdu P Imma, Garcia M Elisabet, Laura Claverias, Monica Magret, Ana M Pellicer, Lucia L Rodriguez, Jesús Sánchez-Ballesteros, Ángela González-Salamanca, Antonio G Jimenez, Francisco P Huerta, Juan Carlos J Sotillo Diaz, Esther Bermejo Lopez, David D Llinares Moya, Alec A Tallet Alfonso, Palazon Sanchez Eugenio Luis, Palazon Sanchez Cesar, Sánchez I Rafael, Corcoles G Virgilio, Noelia N Recio, Christian C Rylander, Bernhard Holzgraefe, Lars M Broman, Joanna Wessbergh, Linnea Persson, Fredrik Schiöler, Hans Kedelv, Anna Oscarsson Tibblin, Henrik Appelberg, Lars Hedlund, Johan Helleberg, Karin E Eriksson, Rita Glietsch, Niklas Larsson, Ingela Nygren, Silvia L Nunes, Anna-Karin Morin, Thomas Kander, Anne Adolfsson, Hervé O Zender, Corinne Leemann-Refondini, Souheil Elatrous, Slaheddine Bouchoucha, Imed Chouchene, Islem Ouanes, Asma Ben Souissi, Salma Kamoun, Oktay Demirkiran, Mustafa Aker, Emre Erbabacan, Ilkay Ceylan, Nermin Kelebek Girgin, Menekse Ozcelik, Necmettin Ünal, Basak Ceyda Meco, Onat O Akyol, Suleyman S Derman, Barry Kennedy, Ken Parhar, Latha Srinivasa, Danny McAuley, Phil Hopkins, Clare Mellis, Vivek Kakar, Dan Hadfield, Andre Vercueil, Kaushik Bhowmick, Sally K Humphreys, Andrew Ferguson, Raymond Mckee, Ashok S Raj, Danielle A Fawkes, Philip Watt, Linda Twohey, Rajeev R Jha, Matthew Thomas, Alex Morton, Varsha Kadaba, Mark J Smith, Anil P Hormis, Santhana G Kannan, Miriam Namih, Henrik Reschreiter, Julie Camsooksai, Alek Kumar, Szabolcs Rugonfalvi, Christopher Nutt, Orla Oneill, Colette Seasman, Ged Dempsey, Christopher J Scott, Helen E Ellis, Stuart Mckechnie, Paula J Hutton, Nora N Di Tomasso, Michela N Vitale, Ruth O Griffin, Michael N Dean, Julius H Cranshaw, Emma L Willett, Nicholas Ioannou, Sarah Gillis, Peter Csabi, Rosaleen Macfadyen, Heidi Dawson, Pieter D Preez, Alexandra J Williams, Owen Boyd, Laura Ortiz-Ruiz de Gordoa, Jon Bramall, Sophie Symmonds, Simon K Chau, Tim Wenham, Tamas Szakmany, Piroska Toth-Tarsoly, Katie H McCalman, Peter Alexander, Lorraine Stephenson, Thomas Collyer, Rhiannon Chapman, Raphael Cooper, Russell M Allan, Malcolm Sim, David W Wrathall, Donald A Irvine, Kim S Zantua, John C Adams, Andrew J Burtenshaw, Gareth P Sellors, Ingeborg D Welters, Karen E Williams, Robert J Hessell, Matthew G Oldroyd, Ceri E Battle, Suresh Pillai, Istvan Kajtor, Mageswaran Sivashanmugavel, Sinead C Okane, Adrian Donnelly, Aniko D Frigyik, Jon P Careless, Martin M May, Richard Stewart, T John Trinder, Samantha J Hagan, Jade M Cole, Caroline C MacFie, Anna T Dowling, Nicolás Nin, Edgardo Nuñez, Gustavo Pittini, Ruben Rodriguez, María C Imperio, Cristina Santos, Ana G França, Alejandro Ebeid, Alberto Deicas, Carolina Serra, Aditya Uppalapati, Ghassan Kamel, Valerie M Banner-Goodspeed, Jeremy R Beitler, Satyanarayana Reddy Mukkera, Shreedhar Kulkarni, John O Shinn Iii, Dina Gomaa, Christopher Tainter, Jarone Lee, Tomaz MesarJarone Lee, Dale J Yeatts, Jessica Warren, Michael J Lanspa, Russel R Miller, Colin K Grissom, Samuel M Brown, Philippe R Bauer, Ryan J Gosselin, Barrett T Kitch, Jason E Cohen, Scott H Beegle, Shazia Choudry, Renaud M Gueret, Aiman Tulaimat, William Stigler, Hitesh Batra, Nidhi G Huff, Keith D Lamb, Trevor W Oetting, Nicholas M Mohr, Claine Judy, Shigeki Saito, Fayez M Kheir, Fayez Kheir, Adam B Schlichting, Angela Delsing, Daniel R Crouch, Mary Elmasri, Dina Ismail, Kyle R Dreyer, Thomas C Blakeman, Rebecca M Baro, Carolina Quintana Grijalba, Peter C Hou, Raghu Seethala, Imo Aisiku, Galen Henderson, Gyorgy Frendl, Sen-Kuang Hou, Robert L Owens, Ashley Schomer, Pham, Tài, Pesenti, Antonio, Bellani, Giacomo, Rubenfeld, Gordon, Fan, Eddy, Bugedo, Guillermo, Lorente, José Angel, Fernandes, Antero do Vale, Van Haren, Frank, Bruhn, Alejandro, Rios, Fernando, Esteban, Andre, Gattinoni, Luciano, Larsson, Ander, McAuley, Daniel F., Ranieri, Marco, Thompson, B. Taylor, Wrigge, Hermann, Brochard, Laurent J., Laffey, John G, Antonio Pesenti, John G Laffey, Laurent Brochard, Andres Esteban, Luciano Gattinoni, Frank van Haren, Anders Larsson, Daniel F McAuley, Marco Ranieri, Gordon Rubenfeld, B Taylor Thompson, Hermann Wrigge, Arthur S Slutsky, John G Laffey, Giacomo Bellani, Tài Pham, Eddy Fan, Fernando Rios, Frank van Haren, Thierry Sottiaux, Pieter Depuydt, Fredy S Lora, Luciano Cesar Azevedo, Eddy Fan, Guillermo Bugedo, Haibo Qiu, Marcos Gonzalez, Juan Silesky, Vladimir Cerny, Jonas Nielsen, Manuel Jibaja, Tài Pham, Hermann Wrigge, Dimitrios Matamis, Jorge Luis Ranero, Pravin Amin, S M Hashemian, Kevin Clarkson, Giacomo Bellani, Kiyoyasu Kurahashi, Asisclo Villagomez, Amine Ali Zeggwagh, Leo M Heunks, Jon Henrik Laake, Jose Emmanuel Palo, Antero do Vale Fernandes, Dorel Sandesc, Yaasen Arabi, Vesna Bumbasierevic, Nicolas Nin, Jose A Lorente, Anders Larsson, Lise Piquilloud, Fekri Abroug, Daniel F McAuley, Lia McNamee, Javier Hurtado, Ed Bajwa, Gabriel Démpaire, Hektor Sula, Lordian Nunci, Alma Cani, Alan Zazu, Christian Dellera, Carolina S Insaurralde, Risso V Alejandro, Julio Daldin, Mauricio Vinzio, Ruben O Fernandez, Luis P Cardonnet, Lisandro R Bettini, Mariano Carboni Bisso, Emilio M Osman, Mariano G Setten, Pablo Lovazzano, Javier Alvarez, Veronica Villar, Norberto C Pozo, Nicolas Grubissich, Gustavo A Plotnikow, Daniela N Vasquez, Santiago Ilutovich, Norberto Tiribelli, Ariel Chena, Carlos A Pellegrini, María G Saenz, Elisa Estenssoro, Matias Brizuela, Hernan Gianinetto, Pablo E Gomez, Valeria I Cerrato, Marco G Bezzi, Silvina A Borello, Flavia A Loiacono, Adriana M Fernandez, Serena Knowles, Claire Reynolds, Deborah M Inskip, Jennene J Miller, Jing Kong, Christina Whitehead, Shailesh Bihari, Aylin Seven, Amanda Krstevski, Helen J Rodgers, Rebecca T Millar, Toni E McKenna, Irene M Bailey, Gabrielle C Hanlon, Anders Aneman, Joan M Lynch, Raman Azad, John Neal, Paul W Woods, Brigit L Roberts, Mark R Kol, Helen S Wong, Katharina C Riss, Thomas Staudinger, Xavier Wittebole, Caroline Berghe, Pierre A Bulpa, Alain M Dive, Rik Verstraete, Herve Lebbinck, Pieter Depuydt, Joris Vermassen, Philippe Meersseman, Helga Ceunen, Jonas I Rosa, Daniel O Beraldo, Claudio Piras, Adenilton M Rampinelli, Antonio P Nassar Jr, Sergio Mataloun, Marcelo Moock, Marlus M Thompson, Claudio H Gonçalves, Ana Carolina P Antônio, Aline Ascoli, Rodrigo S Biondi, Danielle C Fontenele, Danielle Nobrega, Vanessa M Sales, Ahmad Yazid Bin Hj Abul Wahab, Maizatul Ismail, Suresh Shindhe, John Laffey, Francois Beloncle, Kyle G Davies, Rob Cirone, Venika Manoharan, Mehvish Ismail, Ewan C Goligher, Mandeep Jassal, Erin Nishikawa, Areej Javeed, Gerard Curley, Nuttapol Rittayamai, Matteo Parotto, Niall D Ferguson, Sangeeta Mehta, Jenny Knoll, Antoine Pronovost, Sergio Canestrini, Alejandro R Bruhn, Patricio H Garcia, Felipe A Aliaga, Pamela A Farías, Jacob S Yumha, Claudia A Ortiz, Javier E Salas, Alejandro A Saez, Luis D Vega, Eduardo F Labarca, Felipe T Martinez, Nicolás G Carreño, Pilar Lora, Haitao Liu, Haibo Qiu, Ling Liu, Rui Tang, Xiaoming Luo, Youzhong An, Huiying Zhao, Yan Gao, Zhe Zhai, Zheng L Ye, Wei Wang, Wenwen Li, Qingdong Li, Ruiqiang Zheng, Wenkui Yu, Juanhong Shen, Xinyu Li, Tao Yu, Weihua Lu, Ya Q Wu, Xiao B Huang, Zhenyang He, Yuanhua Lu, Hui Han, Fan Zhang, Renhua Sun, Hua X Wang, Shu H Qin, Bao H Zhu, Jun Zhao, Jian Liu, Bin Li, Jing L Liu, Fa C Zhou, Qiong J Li, Xing Y Zhang, Zhou Li-Xin, Qiang Xin-Hua, Liangyan Jiang, Yuan N Gao, Xian Y Zhao, Yuan Y Li, Xiao L Li, Chunting Wang, Qingchun Yao, Rongguo Yu, Kai Chen, Huanzhang Shao, Bingyu Qin, Qing Q Huang, Wei H Zhu, Ai Y Hang, Ma X Hua, Yimin Li, Yonghao Xu, Yu D Di, Long L Ling, Tie H Qin, Shou H Wang, Junping Qin, Yi Han, Suming Zhou, Monica P Vargas, Juan I Silesky Jimenez, Manuel A González Rojas, Jaime E SolisQuesada, Christian M Ramirez-Alfaro, Jan Máca, Peter Sklienka, Jakob Gjedsted, Aage Christiansen, Jonas Nielsen, Boris G Villamagua, Iguel Llano, Philippe Burtin, Gautier Buzancais, Pascal Beuret, Nicolas Pelletier, Satar Mortaza, Alain Mercat, Jonathan Chelly, Sébastien Jochmans, Nicolas Terzi, Cédric Daubin, Guillaume Carteaux, Nicolas de Prost, Jean-Daniel Chiche, Fabrice Daviaud, Tài Pham, Muriel Fartoukh, Guillaume Barberet, Jerome Biehler, Jean Dellamonica, Denis Doyen, Jean-Michel Arnal, Anais Briquet, Sami Hraiech, Laurent Papazian, Arnaud Follin, Damien Roux, Jonathan Messika, Evangelos Kalaitzis, Laurence Dangers, Alain Combes, Siu-Ming Au, Gaetan Béduneau, Dorothée Carpentier, Elie H Zogheib, Herve Dupont, Sylvie Ricome, Francesco L Santoli, Sebastien L Besset, Philippe Michel, Bruno Gelée, Pierre-Eric Danin, Bernard Goubaux, Philippe J Crova, Nga T Phan, Frantz Berkelmans, Julio C Badie, Romain Tapponnier, Josette Gally, Samy Khebbeb, Jean-Etienne Herbrecht, Francis Schneider, PierreLouis M Declercq, Jean-Philippe Rigaud, Jacques Duranteau, Anatole Harrois, Russell Chabanne, Julien Marin, Charlene Bigot, Sandrine Thibault, Mohammed Ghazi, Messabi Boukhazna, Salem Ould Zein, Jack R Richecoeur, Daniele M Combaux, Fabien Grelon, Charlene Le Moal, Elise P Sauvadet, Adrien Robine, Virginie Lemiale, Danielle Reuter, Martin Dres, Alexandre Demoule, Dany Goldgran-Toledano, Loredana Baboi, Claude Guérin, Ralph Lohner, Jens Kraßler, Susanne Schäfer, Kai D Zacharowski, Patrick Meybohm, Andreas W Reske, Philipp Simon, HansBernd F Hopf, Michael Schuetz, Thomas Baltus, Metaxia N Papanikolaou, Theonymfi G Papavasilopoulou, Giannis A Zacharas, Vasilis Ourailogloy, Eleni K Mouloudi, Eleni V Massa, Eva O Nagy, Electra E Stamou, Ellada V Kiourtzieva, Marina A Oikonomou, Luis E Avila, Cesar A Cortez, Johanna E Citalán, Sameer A Jog, Safal D Sable, Bhagyesh Shah, Mohan Gurjar, Arvind K Baronia, Mohammedfaruk Memon, Radhakrishnan Muthuchellappan, Venkatapura J Ramesh, Anitha Shenoy, Ramesh Unnikrishnan, Subhal B Dixit, Rachana V Rhayakar, Nagarajan Ramakrishnan, Vallish K Bhardwaj, Heera L Mahto, Sudha V Sagar, Vijayanand Palaniswamy, Deeban Ganesan, Seyed Mohammadreza Hashemian, Hamidreza Jamaati, Farshad Heidari, Edel A Meaney, Alistair Nichol, Karl M Knapman, Donall O'Croinin, Eimhin S Dunne, Dorothy M Breen, Kevin P Clarkson, Rola F Jaafar, Rory Dwyer, Fahd Amir, Olaitan O Ajetunmobi, Aogan C O'Muircheartaigh, Colin S Black, Nuala Treanor, Daniel V Collins, Wahid Altaf, Gianluca Zani, Maurizio Fusari, Savino Spadaro, Carlo A Volta, Romano Graziani, Barbara Brunettini, Salvatore Palmese, Paolo Formenti, Michele Umbrello, Andrea Lombardo, Elisabetta Pecci, Marco Botteri, Monica Savioli, Alessandro Protti, Alessia Mattei, Lorenzo Schiavoni, Andrea Tinnirello, Manuel Todeschini, Antonino Giarratano, Andrea Cortegiani, Massimo M Antonelli, Luca M Montini, Paolo Casalena, Sergio Scafetti, Giovanna Panarello, Giovanna Occhipinti, Nicolò Patroniti, Matteo Pozzi, Roberto R Biscione, Michela M Poli, Ferdinando Raimondi, Daniela Albiero, Giulia Crapelli, Eduardo Beck, Vincenzo Pota, Vincenzo Schiavone, Alexandre Molin, Fabio Tarantino, Giacomo Monti, Elena Frati, Lucia Mirabella, Gilda Cinnella, Tommaso Fossali, Riccardo Colombo, Pierpaolo Terragni, Ilaria Pattarino, Francesco Mojoli, Antonio Braschi, Erika E Borotto, Andrea N Cracchiolo, Daniela M Palma, Francesco Raponi, Giuseppe Foti, Ettore R Vascotto, Andrea Coppadoro, Luca Brazzi, Leda Floris, Giorgio A Iotti, Aaron Venti, Osamu Yamaguchi, Shunsuke Takagi, Hiroki N Maeyama, Eizo Watanabe, Yoshihiro Yamaji, Kazuyoshi Shimizu, Kyoko Shiozaki, Satoru Futami, Sekine Ryosuke, Koji Saito, Yoshinobu Kameyama, Keiko Ueno, Masayo Izawa, Nao Okuda, Hiroyuki Suzuki, Tomofumi Harasawa, Michitaka Nasu, Tadaaki Takada, Fumihito Ito, Shin Nunomiya, Kansuke Koyama, Toshikazu Abe, Kohkichi Andoh, Kohei Kusumoto, Akira Hirata, Akihiro Takaba, Hiroyasu Kimura, Shuhei Matsumoto, Ushio Higashijima, Hiroyuki Honda, Nobumasa Aoki, Hiroshi Imai, Yasuaki Ogino, Ichiko Mizuguchi, Kazuya Ichikado, Kenichi Nitta, Katsunori Mochizuki, Tomoaki Hashida, Hiroyuki Tanaka, Tomoyuki Nakamura, Daisuke Niimi, Takeshi Ueda, Yozo Kashiwa, Akinori Uchiyama, Olegs Sabelnikovs, Peteris Oss, Youssef Haddad, Kong Y Liew, Silvio A Ñamendys-Silva, Yves D Jarquin-Badiola, Luis A Sanchez-Hurtado, Saira S Gomez-Flores, Maria C Marin, Asisclo J Villagomez, Jordana S Lemus, Jonathan M Fierro, Mavy Ramirez Cervantes, Francisco Javier Flores Mejia, Dulce Dector, Alejandro Rojas, Daniel R Gonzalez, Claudia R Estrella, Jorge R Sanchez-Medina, Alvaro Ramirez-Gutierrez, Fernando G George, Janet S Aguirre, Juan A Buensuseso, Manuel Poblano, Juan A Buensuseso, Manuel Poblano, Tarek Dendane, Amine Ali Zeggwagh, Hicham Balkhi, Mina Elkhayari, Nacer Samkaoui, Hanane Ezzouine, Abdellatif Benslama, Mourad Amor, Wajdi Maazouzi, Nedim Cimic, Oliver Beck, Monique M Bruns, Jeroen A Schouten, Myra Rinia, Monique Raaijmakers, Leo M Heunks, Hellen M van Wezel, Serge J Heines, Ulrich Strauch, Marc P Buise, Fabienne D Simonis, Marcus J Schultz, Jennifer C Goodson, Troy S Browne, Leanlove Navarra, Anna Hunt, Robyn A Hutchison, Mathew B Bailey, Lynette Newby, Colin McArthur, Michael Kalkoff, Alex Mcleod, Jonathan Casement, Danielle J Hacking, Finn H Andersen, Merete S Dolva, Jon H Laake, Andreas Barratt-Due, Kim Andre L Noremark, Eldar Søreide, Brit Å Sjøbø, Anne B Guttormsen, Hector H Leon Yoshido, Ronald Zumaran Aguilar, Fredy A Montes Oscanoa, Alain U Alisasis, Joanne B Robles, Rossini Abbie B Pasanting-Lim, Beatriz C Tan, Pawel Andruszkiewicz, Karina Jakubowska, Cristina M Coxo, António M Alvarez, Bruno S Oliveira, Gustavo M Montanha, Nelson C Barros, Carlos S Pereira, António M Messias, Jorge M Monteiro, Ana M Araujo, Nuno T Catorze, Susan M Marum, Maria J Bouw, Rui M Gomes, Vania A Brito, Silvia Castro, Joana M Estilita, Filipa M Barros, Isabel M Serra, Aurelia M Martinho, Dana R Tomescu, Alexandra Marcu, Ovidiu H Bedreag, Marius Papurica, Dan E Corneci, Silvius Ioan Negoita, Evgeny Grigoriev, Alexey I Gritsan, Andrey A Gazenkampf, Ghaleb Almekhlafi, Mohamad M Albarrak, Ghanem M Mustafa, Khalid A Maghrabi, Nawal Salahuddin, Tharwat M Aisa, Ahmed S Al Jabbary, Edgardo Tabhan, Yaseen M Arabi, Yaseen M Arabi, Olivia A Trinidad, Hasan M Al Dorzi, Edgardo E Tabhan, Vesna Bumbasirevic, Bojan Jovanovic, Stefan Bolon, Oliver Smith, Jordi Mancebo, Hernan Aguirre-Bermeo, Juan C Lopez-Delgado, Francisco Esteve, Gemma Rialp, Catalina Forteza, Candelaria De Haro, Antonio Artigas, Guillermo M Albaiceta, Sara De Cima-Iglesias, Leticia Seoane-Quiroga, Alexandra Ceniceros-Barros, Antonio L RuizAguilar, Luis M Claraco-Vega, Juan Alfonso Soler, Maria Del Carmen Lorente, Cecilia Hermosa, Federico Gordo, Miryam PrietoGonzález, Juan B López-Messa, Manuel P Perez, Cesar P Perez, Raquel Montoiro Allue, Ferran RocheCampo, Marcos Ibañez-Santacruz, Susana TempranoSusana, Maria C Pintado, Raul De Pablo, Pilar Ricart Aroa Gómez, Silvia Rodriguez Ruiz, Silvia Iglesias Moles, Mª Teresa Jurado, Alfons Arizmendi, Enrique A Piacentini, Nieves Franco, Teresa Honrubia, Meisy Perez Cheng, Elena Perez Losada, Javier Blanco, Luis J Yuste, Cecilia Carbayo-Gorriz, Francisca G Cazorla-Barranquero, Javier G Alonso, Rosa S Alda, Ángela Algaba, Gonzalo Navarro, Enrique Cereijo, Esther Diaz-Rodriguez, Diego Pastor Marcos, Laura Alvarez Montero, Luis Herrera Para, Roberto Jimenez Sanchez, Miguel Angel Blasco Navalpotro, Ricardo Diaz Abad, Raquel Montiel González, Dácil Parrilla Toribio, Alejandro G Castro, Maria Jose D Artiga, Oscar Penuelas, Tomas P Roser, Moreno F Olga, Elena Gallego Curto, Rocío Manzano Sánchez, Vallverdu P Imma, Garcia M Elisabet, Laura Claverias, Monica Magret, Ana M Pellicer, Lucia L Rodriguez, Jesús Sánchez-Ballesteros, Ángela González-Salamanca, Antonio G Jimenez, Francisco P Huerta, Juan Carlos J Sotillo Diaz, Esther Bermejo Lopez, David D Llinares Moya, Alec A Tallet Alfonso, Palazon Sanchez Eugenio Luis, Palazon Sanchez Cesar, Sánchez I Rafael, Corcoles G Virgilio, Noelia N Recio, Christian C Rylander, Bernhard Holzgraefe, Lars M Broman, Joanna Wessbergh, Linnea Persson, Fredrik Schiöler, Hans Kedelv, Anna Oscarsson Tibblin, Henrik Appelberg, Lars Hedlund, Johan Helleberg, Karin E Eriksson, Rita Glietsch, Niklas Larsson, Ingela Nygren, Silvia L Nunes, Anna-Karin Morin, Thomas Kander, Anne Adolfsson, Lise Piquilloud, Hervé O Zender, Corinne Leemann-Refondini, Souheil Elatrous, Slaheddine Bouchoucha, Imed Chouchene, Islem Ouanes, Asma Ben Souissi, Salma Kamoun, Oktay Demirkiran, Mustafa Aker, Emre Erbabacan, Ilkay Ceylan, Nermin Kelebek Girgin, Menekse Ozcelik, Necmettin Ünal, Basak Ceyda Meco, Onat O Akyol, Suleyman S Derman, Barry Kennedy, Ken Parhar, Latha Srinivasa, Lia McNamee, Danny McAuley, Phil Hopkins, Clare Mellis, Vivek Kakar, Dan Hadfield, Andre Vercueil, Kaushik Bhowmick, Sally K Humphreys, Andrew Ferguson, Raymond Mckee, Ashok S Raj, Danielle A Fawkes, Philip Watt, Linda Twohey, Rajeev R Jha, Matthew Thomas, Alex Morton, Varsha Kadaba, Mark J Smith, Anil P Hormis, Santhana G Kannan, Miriam Namih, Henrik Reschreiter, Julie Camsooksai, Alek Kumar, Szabolcs Rugonfalvi, Christopher Nutt, Orla Oneill, Colette Seasman, Ged Dempsey, Christopher J Scott, Helen E Ellis, Stuart Mckechnie, Paula J Hutton, Nora N Di Tomasso, Michela N Vitale, Ruth O Griffin, Michael N Dean, Julius H Cranshaw, Emma L Willett, Nicholas Ioannou, Sarah Gillis, Peter Csabi, Rosaleen Macfadyen, Heidi Dawson, Pieter D Preez, Alexandra J Williams, Owen Boyd, Laura Ortiz-Ruiz de Gordoa, Jon Bramall, Sophie Symmonds, Simon K Chau, Tim Wenham, Tamas Szakmany, Piroska Toth-Tarsoly, Katie H McCalman, Peter Alexander, Lorraine Stephenson, Thomas Collyer, Rhiannon Chapman, Raphael Cooper, Russell M Allan, Malcolm Sim, David W Wrathall, Donald A Irvine, Kim S Zantua, John C Adams, Andrew J Burtenshaw, Gareth P Sellors, Ingeborg D Welters, Karen E Williams, Robert J Hessell, Matthew G Oldroyd, Ceri E Battle, Suresh Pillai, Istvan Kajtor, Mageswaran Sivashanmugavel, Sinead C Okane, Adrian Donnelly, Aniko D Frigyik, Jon P Careless, Martin M May, Richard Stewart, T John Trinder, Samantha J Hagan, Jade M Cole, Caroline C MacFie, Anna T Dowling, Javier Hurtado, Nicolás Nin, Javier Hurtado, Edgardo Nuñez, Gustavo Pittini, Ruben Rodriguez, María C Imperio, Cristina Santos, Ana G França, Alejandro Ebeid, Alberto Deicas, Carolina Serra, Aditya Uppalapati, Ghassan Kamel, Valerie M Banner-Goodspeed, Jeremy R Beitler, Satyanarayana Reddy Mukkera, Shreedhar Kulkarni, John O Shinn Iii, Dina Gomaa, Christopher Tainter, Jarone Lee, Tomaz MesarJarone Lee, Dale J Yeatts, Jessica Warren, Michael J Lanspa, Russel R Miller, Colin K Grissom, Samuel M Brown, Philippe R Bauer, Ryan J Gosselin, Barrett T Kitch, Jason E Cohen, Scott H Beegle, Shazia Choudry, Renaud M Gueret, Aiman Tulaimat, William Stigler, Hitesh Batra, Nidhi G Huff, Keith D Lamb, Trevor W Oetting, Nicholas M Mohr, Claine Judy, Shigeki Saito, Fayez M Kheir, Fayez Kheir, Adam B Schlichting, Angela Delsing, Daniel R Crouch, Mary Elmasri, Daniel R Crouch, Dina Ismail, Kyle R Dreyer, Thomas C Blakeman, Dina Gomaa, Rebecca M Baro, Carolina Quintana Grijalba, Peter C Hou, Raghu Seethala, Imo Aisiku, Galen Henderson, Gyorgy Frendl, Sen-Kuang Hou, Robert L Owens, Ashley Schomer, Intensive Care Medicine, ACS - Diabetes & metabolism, ACS - Pulmonary hypertension & thrombosis, ACS - Microcirculation, Pham, T, Pesenti, A, Bellani, G, Rubenfeld, G, Fan, E, Bugedo, G, Lorente, J, Fernandes, A, Van Haren, F, Bruhn, A, Rios, F, Esteban, A, Gattinoni, L, Larsson, A, Mcauley, D, Ranieri, M, Thompson, B, Wrigge, H, Brochard, L, Laffey, J, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), St. Michael's Hospital, University of Toronto, Groupe de recherche clinique CARMAS, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Università degli Studi di Milano [Milano] (UNIMI), University of Milan, San Gerardo Hospital, Sunnybrook Health Sciences Center, Mount Sinai Hospital [Toronto, Canada] (MSH), Pontificia Universidad Católica de Chile (UC), University Hospital of Getafe, CIBER Enfermedades Respiratorias (CIBERES), Universidad Europea de Madrid, Hospital Garcia de Orta (EPE), Canberra Hospital, Medical School [Australian National University - ANU], Australian National University (ANU), University of Canberra, Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), University of Göttingen - Georg-August-Universität Göttingen, Uppsala University, Queen's University [Belfast] (QUB), Royal Victoria Hospital, McGill University Health Center [Montreal] (MUHC), Università degli Studi di Bologna, Massachusetts General Hospital [Boston], University Hospital Leipzig, Department of Anaesthesiology, Intensive Care and Emergency Medicine, Pain Therapy, Bergmannstrost Hospital Halle, 06112, Halle, National University of Ireland [Galway] (NUI Galway), Bayer GlaxoSmithKline, GSK Baxter International Boehringer Ingelheim Wellcome Trust, WT National Institute for Health Research, NIHR Queen's University Belfast, QUB Medical Research Council Canada, MRC European Society of Intensive Care Medicine, ESICM, Support statement: This work was supported by the European Society of Intensive Care Medicine. Funding information for this article has been deposited with the Crossref Funder Registry., Conflict of interest: T. Pham has nothing to disclose. A. Pesenti reports personal fees from Maquet, Novalung/Xenios, Baxter, Gilead and Boehringer Ingelheim, outside the submitted work. G. Bellani reports grants and personal fees from Draeger Medical, personal fees from Getinge, Hamilton, GE Healthcare, Dimar SRL, Intersurgical and Flowmeter SPA, outside the submitted work. G. Rubenfeld has nothing to disclose. E. Fan reports personal fees from ALung Technologies, Getinge and MC3 Cardiopulmonary, grants, personal fees and non-financial support from Fresenius Medical Care, outside the submitted work. G. Bugedo has nothing to disclose. J.A. Lorente has nothing to disclose. A.D. V. Fernandes has nothing to disclose. F. Van Haren has nothing to disclose. A. Bruhn has nothing to disclose. F. Rios has nothing to disclose. A. Esteban has nothing to disclose. L. Gattinoni has nothing to disclose. A. Larsson reports grants from the Swedish Heart and Lung Foundation, during the conduct of the study. D.F. McAuley reports personal fees from consultancy for GlaxoSmithKline, Boehringer Ingelheim and Bayer, outside the submitted work, in addition, his institution has received funds from grants from the UK NIHR, Wellcome Trust, Innovate UK, NI HSC R&D Division, NI Chest Heart and Stroke, and MRC, is one of four named inventors on a patent US8962032 covering the use of sialic acid-bearing nanoparticles as anti-inflammatory agents issued to his institution, The Queen’s University of Belfast (http://www.google.com/patents/US8962032), and is a Director of Research for the Intensive Care Society and NIHR EME Programme Director. M. Ranieri has nothing to disclose. B.T. Thompson reports personal fees from Bayer, Thetis and Novartis, outside the submitted work. H. Wrigge reports personal fees for consultancy from Dräger Medical, personal fees for advisory board work from Liberate Medical, grants and personal fees for lectures from InfectoPharm, personal fees for lectures from MSD and GE, outside the submitted work. L.J. Brochard reports grants from Medtronic Covidien, grants and non-financial support from Fisher Paykel, non-financial support from Air Liquide, Sentec and Philips, other (patent) from General Electric, outside the submitted work. J.G. Laffey reports grants and personal fees from Baxter, grants and non-financial support from Aerogen and Factor Biosciences, outside the submitted work., LUNG SAFE Investigators and the European Society of Intensive Care Medicine Trials Group: Antonio Pesenti, John G Laffey, Laurent Brochard, Andres Esteban, Luciano Gattinoni, Frank van Haren, Anders Larsson, Daniel F McAuley, Marco Ranieri, Gordon Rubenfeld, B Taylor Thompson, Hermann Wrigge, Arthur S Slutsky, John G Laffey, Giacomo Bellani, Tài Pham, Eddy Fan, Fernando Rios, Frank van Haren, Thierry Sottiaux, Pieter Depuydt, Fredy S Lora, Luciano Cesar Azevedo, Eddy Fan, Guillermo Bugedo, Haibo Qiu, Marcos Gonzalez, Juan Silesky, Vladimir Cerny, Jonas Nielsen, Manuel Jibaja, Tài Pham, Hermann Wrigge, Dimitrios Matamis, Jorge Luis Ranero, Pravin Amin, S M Hashemian, Kevin Clarkson, Giacomo Bellani, Kiyoyasu Kurahashi, Asisclo Villagomez, Amine Ali Zeggwagh, Leo M Heunks, Jon Henrik Laake, Jose Emmanuel Palo, Antero do Vale Fernandes, Dorel Sandesc, Yaasen Arabi, Vesna Bumbasierevic, Nicolas Nin, Jose A Lorente, Anders Larsson, Lise Piquilloud, Fekri Abroug, Daniel F McAuley, Lia McNamee, Javier Hurtado, Ed Bajwa, Gabriel Démpaire, Hektor Sula, Lordian Nunci, Alma Cani, Alan Zazu, Christian Dellera, Carolina S Insaurralde, Risso V Alejandro, Julio Daldin, Mauricio Vinzio, Ruben O Fernandez, Luis P Cardonnet, Lisandro R Bettini, Mariano Carboni Bisso, Emilio M Osman, Mariano G Setten, Pablo Lovazzano, Javier Alvarez, Veronica Villar, Norberto C Pozo, Nicolas Grubissich, Gustavo A Plotnikow, Daniela N Vasquez, Santiago Ilutovich, Norberto Tiribelli, Ariel Chena, Carlos A Pellegrini, María G Saenz, Elisa Estenssoro, Matias Brizuela, Hernan Gianinetto, Pablo E Gomez, Valeria I Cerrato, Marco G Bezzi, Silvina A Borello, Flavia A Loiacono, Adriana M Fernandez, Serena Knowles, Claire Reynolds, Deborah M Inskip, Jennene J Miller, Jing Kong, Christina Whitehead, Shailesh Bihari, Aylin Seven, Amanda Krstevski, Helen J Rodgers, Rebecca T Millar, Toni E McKenna, Irene M Bailey, Gabrielle C Hanlon, Anders Aneman, Joan M Lynch, Raman Azad, John Neal, Paul W Woods, Brigit L Roberts, Mark R Kol, Helen S Wong, Katharina C Riss, Thomas Staudinger, Xavier Wittebole, Caroline Berghe, Pierre A Bulpa, Alain M Dive, Rik Verstraete, Herve Lebbinck, Pieter Depuydt, Joris Vermassen, Philippe Meersseman, Helga Ceunen, Jonas I Rosa, Daniel O Beraldo, Claudio Piras, Adenilton M Rampinelli, Antonio P Nassar Jr, Sergio Mataloun, Marcelo Moock, Marlus M Thompson, Claudio H Gonçalves, Ana Carolina P Antônio, Aline Ascoli, Rodrigo S Biondi, Danielle C Fontenele, Danielle Nobrega, Vanessa M Sales, Ahmad Yazid Bin Hj Abul Wahab, Maizatul Ismail, Suresh Shindhe, John Laffey, Francois Beloncle, Kyle G Davies, Rob Cirone, Venika Manoharan, Mehvish Ismail, Ewan C Goligher, Mandeep Jassal, Erin Nishikawa, Areej Javeed, Gerard Curley, Nuttapol Rittayamai, Matteo Parotto, Niall D Ferguson, Sangeeta Mehta, Jenny Knoll, Antoine Pronovost, Sergio Canestrini, Alejandro R Bruhn, Patricio H Garcia, Felipe A Aliaga, Pamela A Farías, Jacob S Yumha, Claudia A Ortiz, Javier E Salas, Alejandro A Saez, Luis D Vega, Eduardo F Labarca, Felipe T Martinez, Nicolás G Carreño, Pilar Lora, Haitao Liu, Haibo Qiu, Ling Liu, Rui Tang, Xiaoming Luo, Youzhong An, Huiying Zhao, Yan Gao, Zhe Zhai, Zheng L Ye, Wei Wang, Wenwen Li, Qingdong Li, Ruiqiang Zheng, Wenkui Yu, Juanhong Shen, Xinyu Li, Tao Yu, Weihua Lu, Ya Q Wu, Xiao B Huang, Zhenyang He, Yuanhua Lu, Hui Han, Fan Zhang, Renhua Sun, Hua X Wang, Shu H Qin, Bao H Zhu, Jun Zhao, Jian Liu, Bin Li, Jing L Liu, Fa C Zhou, Qiong J Li, Xing Y Zhang, Zhou Li-Xin, Qiang Xin-Hua, Liangyan Jiang, Yuan N Gao, Xian Y Zhao, Yuan Y Li, Xiao L Li, Chunting Wang, Qingchun Yao, Rongguo Yu, Kai Chen, Huanzhang Shao, Bingyu Qin, Qing Q Huang, Wei H Zhu, Ai Y Hang, Ma X Hua, Yimin Li, Yonghao Xu, Yu D Di, Long L Ling, Tie H Qin, Shou H Wang, Junping Qin, Yi Han, Suming Zhou, Monica P Vargas, Juan I Silesky Jimenez, Manuel A González Rojas, Jaime E SolisQuesada, Christian M Ramirez-Alfaro, Jan Máca, Peter Sklienka, Jakob Gjedsted, Aage Christiansen, Jonas Nielsen, Boris G Villamagua, Iguel Llano, Philippe Burtin, Gautier Buzancais, Pascal Beuret, Nicolas Pelletier, Satar Mortaza, Alain Mercat, Jonathan Chelly, Sébastien Jochmans, Nicolas Terzi, Cédric Daubin, Guillaume Carteaux, Nicolas de Prost, Jean-Daniel Chiche, Fabrice Daviaud, Tài Pham, Muriel Fartoukh, Guillaume Barberet, Jerome Biehler, Jean Dellamonica, Denis Doyen, Jean-Michel Arnal, Anais Briquet, Sami Hraiech, Laurent Papazian, Arnaud Follin, Damien Roux, Jonathan Messika, Evangelos Kalaitzis, Laurence Dangers, Alain Combes, Siu-Ming Au, Gaetan Béduneau, Dorothée Carpentier, Elie H Zogheib, Herve Dupont, Sylvie Ricome, Francesco L Santoli, Sebastien L Besset, Philippe Michel, Bruno Gelée, Pierre-Eric Danin, Bernard Goubaux, Philippe J Crova, Nga T Phan, Frantz Berkelmans, Julio C Badie, Romain Tapponnier, Josette Gally, Samy Khebbeb, Jean-Etienne Herbrecht, Francis Schneider, PierreLouis M Declercq, Jean-Philippe Rigaud, Jacques Duranteau, Anatole Harrois, Russell Chabanne, Julien Marin, Charlene Bigot, Sandrine Thibault, Mohammed Ghazi, Messabi Boukhazna, Salem Ould Zein, Jack R Richecoeur, Daniele M Combaux, Fabien Grelon, Charlene Le Moal, Elise P Sauvadet, Adrien Robine, Virginie Lemiale, Danielle Reuter, Martin Dres, Alexandre Demoule, Dany Goldgran-Toledano, Loredana Baboi, Claude Guérin, Ralph Lohner, Jens Kraßler, Susanne Schäfer, Kai D Zacharowski, Patrick Meybohm, Andreas W Reske, Philipp Simon, HansBernd F Hopf, Michael Schuetz, Thomas Baltus, Metaxia N Papanikolaou, Theonymfi G Papavasilopoulou, Giannis A Zacharas, Vasilis Ourailogloy, Eleni K Mouloudi, Eleni V Massa, Eva O Nagy, Electra E Stamou, Ellada V Kiourtzieva, Marina A Oikonomou, Luis E Avila, Cesar A Cortez, Johanna E Citalán, Sameer A Jog, Safal D Sable, Bhagyesh Shah, Mohan Gurjar, Arvind K Baronia, Mohammedfaruk Memon, Radhakrishnan Muthuchellappan, Venkatapura J Ramesh, Anitha Shenoy, Ramesh Unnikrishnan, Subhal B Dixit, Rachana V Rhayakar, Nagarajan Ramakrishnan, Vallish K Bhardwaj, Heera L Mahto, Sudha V Sagar, Vijayanand Palaniswamy, Deeban Ganesan, Seyed Mohammadreza Hashemian, Hamidreza Jamaati, Farshad Heidari, Edel A Meaney, Alistair Nichol, Karl M Knapman, Donall O'Croinin, Eimhin S Dunne, Dorothy M Breen, Kevin P Clarkson, Rola F Jaafar, Rory Dwyer, Fahd Amir, Olaitan O Ajetunmobi, Aogan C O'Muircheartaigh, Colin S Black, Nuala Treanor, Daniel V Collins, Wahid Altaf, Gianluca Zani, Maurizio Fusari, Savino Spadaro, Carlo A Volta, Romano Graziani, Barbara Brunettini, Salvatore Palmese, Paolo Formenti, Michele Umbrello, Andrea Lombardo, Elisabetta Pecci, Marco Botteri, Monica Savioli, Alessandro Protti, Alessia Mattei, Lorenzo Schiavoni, Andrea Tinnirello, Manuel Todeschini, Antonino Giarratano, Andrea Cortegiani, Antonino Giarratano, Andrea Cortegiani, Massimo M Antonelli, Luca M Montini, Paolo Casalena, Sergio Scafetti, Giovanna Panarello, Giovanna Occhipinti, Nicolò Patroniti, Matteo Pozzi, Roberto R Biscione, Michela M Poli, Ferdinando Raimondi, Daniela Albiero, Giulia Crapelli, Eduardo Beck, Vincenzo Pota, Vincenzo Schiavone, Alexandre Molin, Fabio Tarantino, Giacomo Monti, Elena Frati, Lucia Mirabella, Gilda Cinnella, Tommaso Fossali, Riccardo Colombo, Pierpaolo Terragni, Ilaria Pattarino, Francesco Mojoli, Antonio Braschi, Erika E Borotto, Andrea N Cracchiolo, Daniela M Palma, Francesco Raponi, Giuseppe Foti, Ettore R Vascotto, Andrea Coppadoro, Luca Brazzi, Leda Floris, Giorgio A Iotti, Aaron Venti, Osamu Yamaguchi, Shunsuke Takagi, Hiroki N Maeyama, Eizo Watanabe, Yoshihiro Yamaji, Kazuyoshi Shimizu, Kyoko Shiozaki, Satoru Futami, Sekine Ryosuke, Koji Saito, Yoshinobu Kameyama, Keiko Ueno, Masayo Izawa, Nao Okuda, Hiroyuki Suzuki, Tomofumi Harasawa, Michitaka Nasu, Tadaaki Takada, Fumihito Ito, Shin Nunomiya, Kansuke Koyama, Toshikazu Abe, Kohkichi Andoh, Kohei Kusumoto, Akira Hirata, Akihiro Takaba, Hiroyasu Kimura, Shuhei Matsumoto, Ushio Higashijima, Hiroyuki Honda, Nobumasa Aoki, Hiroshi Imai, Yasuaki Ogino, Ichiko Mizuguchi, Kazuya Ichikado, Kenichi Nitta, Katsunori Mochizuki, Tomoaki Hashida, Hiroyuki Tanaka, Tomoyuki Nakamura, Daisuke Niimi, Takeshi Ueda, Yozo Kashiwa, Akinori Uchiyama, Olegs Sabelnikovs, Peteris Oss, Youssef Haddad, Kong Y Liew, Silvio A Ñamendys-Silva, Yves D Jarquin-Badiola, Luis A Sanchez-Hurtado, Saira S Gomez-Flores, Maria C Marin, Asisclo J Villagomez, Jordana S Lemus, Jonathan M Fierro, Mavy Ramirez Cervantes, Francisco Javier Flores Mejia, Dulce Dector, Alejandro Rojas, Daniel R Gonzalez, Claudia R Estrella, Jorge R Sanchez-Medina, Alvaro Ramirez-Gutierrez, Fernando G George, Janet S Aguirre, Juan A Buensuseso, Manuel Poblano, Juan A Buensuseso, Manuel Poblano, Tarek Dendane, Amine Ali Zeggwagh, Hicham Balkhi, Mina Elkhayari, Nacer Samkaoui, Hanane Ezzouine, Abdellatif Benslama, Mourad Amor, Wajdi Maazouzi, Nedim Cimic, Oliver Beck, Monique M Bruns, Jeroen A Schouten, Myra Rinia, Monique Raaijmakers, Leo M Heunks, Hellen M van Wezel, Serge J Heines, Ulrich Strauch, Marc P Buise, Fabienne D Simonis, Marcus J Schultz, Jennifer C Goodson, Troy S Browne, Leanlove Navarra, Anna Hunt, Robyn A Hutchison, Mathew B Bailey, Lynette Newby, Colin McArthur, Michael Kalkoff, Alex Mcleod, Jonathan Casement, Danielle J Hacking, Finn H Andersen, Merete S Dolva, Jon H Laake, Andreas Barratt-Due, Kim Andre L Noremark, Eldar Søreide, Brit Å Sjøbø, Anne B Guttormsen, Hector H Leon Yoshido, Ronald Zumaran Aguilar, Fredy A Montes Oscanoa, Alain U Alisasis, Joanne B Robles, Rossini Abbie B Pasanting-Lim, Beatriz C Tan, Pawel Andruszkiewicz, Karina Jakubowska, Cristina M Coxo, António M Alvarez, Bruno S Oliveira, Gustavo M Montanha, Nelson C Barros, Carlos S Pereira, António M Messias, Jorge M Monteiro, Ana M Araujo, Nuno T Catorze, Susan M Marum, Maria J Bouw, Rui M Gomes, Vania A Brito, Silvia Castro, Joana M Estilita, Filipa M Barros, Isabel M Serra, Aurelia M Martinho, Dana R Tomescu, Alexandra Marcu, Ovidiu H Bedreag, Marius Papurica, Dan E Corneci, Silvius Ioan Negoita, Evgeny Grigoriev, Alexey I Gritsan, Andrey A Gazenkampf, Ghaleb Almekhlafi, Mohamad M Albarrak, Ghanem M Mustafa, Khalid A Maghrabi, Nawal Salahuddin, Tharwat M Aisa, Ahmed S Al Jabbary, Edgardo Tabhan, Yaseen M Arabi, Yaseen M Arabi, Olivia A Trinidad, Hasan M Al Dorzi, Edgardo E Tabhan, Vesna Bumbasirevic, Bojan Jovanovic, Stefan Bolon, Oliver Smith, Jordi Mancebo, Hernan Aguirre-Bermeo, Juan C Lopez-Delgado, Francisco Esteve, Gemma Rialp, Catalina Forteza, Candelaria De Haro, Antonio Artigas, Guillermo M Albaiceta, Sara De Cima-Iglesias, Leticia Seoane-Quiroga, Alexandra Ceniceros-Barros, Antonio L RuizAguilar, Luis M Claraco-Vega, Juan Alfonso Soler, Maria Del Carmen Lorente, Cecilia Hermosa, Federico Gordo, Miryam PrietoGonzález, Juan B López-Messa, Manuel P Perez, Cesar P Perez, Raquel Montoiro Allue, Ferran RocheCampo, Marcos Ibañez-Santacruz, Susana TempranoSusana, Maria C Pintado, Raul De Pablo, Pilar Ricart Aroa Gómez, Silvia Rodriguez Ruiz, Silvia Iglesias Moles, Mª Teresa Jurado, Alfons Arizmendi, Enrique A Piacentini, Nieves Franco, Teresa Honrubia, Meisy Perez Cheng, Elena Perez Losada, Javier Blanco, Luis J Yuste, Cecilia Carbayo-Gorriz, Francisca G Cazorla-Barranquero, Javier G Alonso, Rosa S Alda, Ángela Algaba, Gonzalo Navarro, Enrique Cereijo, Esther Diaz-Rodriguez, Diego Pastor Marcos, Laura Alvarez Montero, Luis Herrera Para, Roberto Jimenez Sanchez, Miguel Angel Blasco Navalpotro, Ricardo Diaz Abad, Raquel Montiel González, Dácil Parrilla Toribio, Alejandro G Castro, Maria Jose D Artiga, Oscar Penuelas, Tomas P Roser, Moreno F Olga, Elena Gallego Curto, Rocío Manzano Sánchez, Vallverdu P Imma, Garcia M Elisabet, Laura Claverias, Monica Magret, Ana M Pellicer, Lucia L Rodriguez, Jesús Sánchez-Ballesteros, Ángela González-Salamanca, Antonio G Jimenez, Francisco P Huerta, Juan Carlos J Sotillo Diaz, Esther Bermejo Lopez, David D Llinares Moya, Alec A Tallet Alfonso, Palazon Sanchez Eugenio Luis, Palazon Sanchez Cesar, Sánchez I Rafael, Corcoles G Virgilio, Noelia N Recio, Christian C Rylander, Bernhard Holzgraefe, Lars M Broman, Joanna Wessbergh, Linnea Persson, Fredrik Schiöler, Hans Kedelv, Anna Oscarsson Tibblin, Henrik Appelberg, Lars Hedlund, Johan Helleberg, Karin E Eriksson, Rita Glietsch, Niklas Larsson, Ingela Nygren, Silvia L Nunes, Anna-Karin Morin, Thomas Kander, Anne Adolfsson, Lise Piquilloud, Hervé O Zender, Corinne Leemann-Refondini, Souheil Elatrous, Slaheddine Bouchoucha, Imed Chouchene, Islem Ouanes, Asma Ben Souissi, Salma Kamoun, Oktay Demirkiran, Mustafa Aker, Emre Erbabacan, Ilkay Ceylan, Nermin Kelebek Girgin, Menekse Ozcelik, Necmettin Ünal, Basak Ceyda Meco, Onat O Akyol, Suleyman S Derman, Barry Kennedy, Ken Parhar, Latha Srinivasa, Lia McNamee, Danny McAuley, Phil Hopkins, Clare Mellis, Vivek Kakar, Dan Hadfield, Andre Vercueil, Kaushik Bhowmick, Sally K Humphreys, Andrew Ferguson, Raymond Mckee, Ashok S Raj, Danielle A Fawkes, Philip Watt, Linda Twohey, Rajeev R Jha, Matthew Thomas, Alex Morton, Varsha Kadaba, Mark J Smith, Anil P Hormis, Santhana G Kannan, Miriam Namih, Henrik Reschreiter, Julie Camsooksai, Alek Kumar, Szabolcs Rugonfalvi, Christopher Nutt, Orla Oneill, Colette Seasman, Ged Dempsey, Christopher J Scott, Helen E Ellis, Stuart Mckechnie, Paula J Hutton, Nora N Di Tomasso, Michela N Vitale, Ruth O Griffin, Michael N Dean, Julius H Cranshaw, Emma L Willett, Nicholas Ioannou, Sarah Gillis, Peter Csabi, Rosaleen Macfadyen, Heidi Dawson, Pieter D Preez, Alexandra J Williams, Owen Boyd, Laura Ortiz-Ruiz de Gordoa, Jon Bramall, Sophie Symmonds, Simon K Chau, Tim Wenham, Tamas Szakmany, Piroska Toth-Tarsoly, Katie H McCalman, Peter Alexander, Lorraine Stephenson, Thomas Collyer, Rhiannon Chapman, Raphael Cooper, Russell M Allan, Malcolm Sim, David W Wrathall, Donald A Irvine, Kim S Zantua, John C Adams, Andrew J Burtenshaw, Gareth P Sellors, Ingeborg D Welters, Karen E Williams, Robert J Hessell, Matthew G Oldroyd, Ceri E Battle, Suresh Pillai, Istvan Kajtor, Mageswaran Sivashanmugavel, Sinead C Okane, Adrian Donnelly, Aniko D Frigyik, Jon P Careless, Martin M May, Richard Stewart, T John Trinder, Samantha J Hagan, Jade M Cole, Caroline C MacFie, Anna T Dowling, Javier Hurtado, Nicolás Nin, Javier Hurtado, Edgardo Nuñez, Gustavo Pittini, Ruben Rodriguez, María C Imperio, Cristina Santos, Ana G França, Alejandro Ebeid, Alberto Deicas, Carolina Serra, Aditya Uppalapati, Ghassan Kamel, Valerie M Banner-Goodspeed, Jeremy R Beitler, Satyanarayana Reddy Mukkera, Shreedhar Kulkarni, John O Shinn Iii, Dina Gomaa, Christopher Tainter, Jarone Lee, Tomaz MesarJarone Lee, Dale J Yeatts, Jessica Warren, Michael J Lanspa, Russel R Miller, Colin K Grissom, Samuel M Brown, Philippe R Bauer, Ryan J Gosselin, Barrett T Kitch, Jason E Cohen, Scott H Beegle, Shazia Choudry, Renaud M Gueret, Aiman Tulaimat, William Stigler, Hitesh Batra, Nidhi G Huff, Keith D Lamb, Trevor W Oetting, Nicholas M Mohr, Claine Judy, Shigeki Saito, Fayez M Kheir, Fayez Kheir, Adam B Schlichting, Angela Delsing, Daniel R Crouch, Mary Elmasri, Daniel R Crouch, Dina Ismail, Kyle R Dreyer, Thomas C Blakeman, Dina Gomaa, Rebecca M Baro, Carolina Quintana Grijalba, Peter C Hou, Raghu Seethala, Imo Aisiku, Galen Henderson, Gyorgy Frendl, Sen-Kuang Hou, Robert L Owens, Ashley Schomer, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (MGD) Services des soins intensifs, and UCL - (SLuc) Service de soins intensifs

Subjects
Pulmonary and Respiratory Medicine, ARDS, Unidades de cuidados intensivos, [SDV]Life Sciences [q-bio], medicine.medical_treatment, mechanical ventilation, NO, law.invention, 03 medical and health sciences, Tratamiento médico, 0302 clinical medicine, law, Settore MED/41 - ANESTESIOLOGIA, Insuficiencia respiratoria, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Lung, Mechanical ventilation, Respiratory Distress Syndrome, business.industry, Respiration, Incidence (epidemiology), medicine.disease, Intensive care unit, Respiration, Artificial, 3. Good health, Intensive Care Units, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], medicine.anatomical_structure, 030228 respiratory system, Respiratory failure, Heart failure, Anesthesia, Artificial, ards, business, Respiratory Insufficiency, Enfermedad
Abstract

BackgroundCurrent incidence and outcome of patients with acute hypoxaemic respiratory failure requiring mechanical ventilation in the intensive care unit (ICU) are unknown, especially for patients not meeting criteria for acute respiratory distress syndrome (ARDS).MethodsAn international, multicentre, prospective cohort study of patients presenting with hypoxaemia early in the course of mechanical ventilation, conducted during four consecutive weeks in the winter of 2014 in 459 ICUs from 50 countries (LUNG SAFE). Patients were enrolled with arterial oxygen tension/inspiratory oxygen fraction ratio ≤300 mmHg, new pulmonary infiltrates and need for mechanical ventilation with a positive end-expiratory pressure of ≥5 cmH2O. ICU prevalence, causes of hypoxaemia, hospital survival and factors associated with hospital mortality were measured. Patients with unilateral versus bilateral opacities were compared.Findings12 906 critically ill patients received mechanical ventilation and 34.9% with hypoxaemia and new infiltrates were enrolled, separated into ARDS (69.0%), unilateral infiltrate (22.7%) and congestive heart failure (CHF; 8.2%). The global hospital mortality was 38.6%. CHF patients had a mortality comparable to ARDS (44.1% versus 40.4%). Patients with unilateral-infiltrate had lower unadjusted mortality, but similar adjusted mortality compared to those with ARDS. The number of quadrants on chest imaging was associated with an increased risk of death. There was no difference in mortality comparing patients with unilateral-infiltrate and ARDS with only two quadrants involved.InterpretationMore than one-third of patients receiving mechanical ventilation have hypoxaemia and new infiltrates with a hospital mortality of 38.6%. Survival is dependent on the degree of pulmonary involvement whether or not ARDS criteria are reached.

Published
2021

17. Numerical Assessment of a New Hydro-Pneumatic Suspension System for Motorcycles

Author

Alberto Martini, Gabriele Bellani, Cristiano Fragassa, A. Martini, G. Bellani, and C. Fragassa

Subjects
Computer science, 020209 energy, Mechanical Engineering, Work (physics), Constant speed, Numerical assessment, 02 engineering and technology, Bicycle and motorcycle dynamics, regressive suspension, 01 natural sciences, Coil spring, Hydro-pneumatic spring, Automotive engineering, motorcycle dynamics, Spring (device), 0103 physical sciences, Automotive Engineering, 0202 electrical engineering, electronic engineering, information engineering, Point (geometry), non-linear stiffne, 010301 acoustics
Abstract

This work investigates an innovative hydro-pneumatic suspension system that was recently developed for possibly enhancing the performance of wheeled road vehicles, particularly motorcycles. The device exhibits a highly non-linear behavior, and in particular a strongly regressive spring rate, due to its architecture (featuring a hydro- pneumatic spring and a coil spring arranged in series). Multibody models are implemented and simulated for a preliminary assessment of its actual benefits and/or drawbacks with respect to common suspension systems. As a starting point of the research, this work focuses on the in-plane dynamics, and in particular on a condition of straight running at constant speed. The load fluctuations on the rear wheel (grip) as well as the velocity of the suspended mass (comfort) under different road inputs at various speeds are analyzed. The numerical results confirm the hydro-pneumatic suspension system as a promising device.

Published
2018

18. Slip velocity of large neutrally buoyant particles in turbulent flows

Author

Evan Variano, Gabriele Bellani, G Bellani, and E A Variano

Subjects
Physics, Homogeneous isotropic turbulence, Turbulence, Fluid Dynamics (physics.flu-dyn), FOS: Physical sciences, buoyant particles , turbulence, PIV, General Physics and Astronomy, Reynolds number, Physics - Fluid Dynamics, Slip (materials science), Mechanics, Physics::Fluid Dynamics, symbols.namesake, Flow velocity, Drag, symbols, Magnetosphere particle motion, Taylor microscale
Abstract

We discuss possible definitions for a stochastic slip velocity that describes the relative motion between large particles and a turbulent flow. This definition is necessary because the slip velocity used in the standard drag model fails when particle size falls within the inertial subrange of ambient turbulence. We propose two definitions, selected in part due to their simplicity: they do not require filtration of the fluid phase velocity field, nor do they require the construction of conditional averages on particle locations. A key benefit of this simplicity is that the stochastic slip velocity proposed here can be calculated equally well for laboratory, field, and numerical experiments. The stochastic slip velocity allows the definition of a Reynolds number that should indicate whether large particles in turbulent flow behave (a) as passive tracers; (b) as a linear filter of the velocity field; or (c) as a nonlinear filter to the velocity field. We calculate the value of stochastic slip for ellipsoidal and spherical particles (the size of the Taylor microscale) measured in laboratory homogeneous isotropic turbulence. The resulting Reynolds number is significantly higher than 1 for both particle shapes, and velocity statistics show that particle motion is a complex non-linear function of the fluid velocity. We further investigate the nonlinear relationship by comparing the probability distribution of fluctuating velocities for particle and fluid phases.

Published
2012

19. Pressure support, patient effort and tidal volume: a conceptual model for a non linear interaction.

Author

Docci M, Foti G, Brochard L, and Bellani G

Subjects
Humans, Respiration, Artificial methods, Positive-Pressure Respiration methods, Tidal Volume physiology
Abstract

Pressure support ventilation (PSV) is a form of assisted ventilation which has become frequently used, with the aim of partially unloading the patient's inspiratory muscles. Both under- and over-assistance should be avoided to target a lung- and diaphragm- protective ventilation. Herein, we propose a conceptual model, supported by actual data, to describe how patient and ventilator share the generation of tidal volume (Vt) in PSV and how respiratory system compliance (Crs) affects this interaction. We describe the presence of a patient-specific range of PSV levels, within which the inspiratory effort (Pmus) is modulated, keeping Vt relatively steady on a desired value (Vt target ). This range of assistance may be considered the "adequate PSV assistance" required by the patient, while higher and lower levels may result in over- and under-assistance respectively. As we also show, the determinants of over- and under- assistance borders depend on the combination of Crs and the inspiratory effort which the patient is able to sustain over a period of time. These concepts can be applied at the bedside to understand if the level of assistance is adequate to patient's demand, focusing on the variation of relevant parameters (Vt, Pmus and pressure-muscle-index) as patient reaction to a change in the level of assistance., (© 2024. The Author(s).)

Published
2024
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20. Identification of novel sub-phenotypes of severe ARDS requiring ECMO using latent class analysis.

Author

Nishikimi M, Ohshimo S, Bellani G, Fukumoto W, Anzai T, Liu K, Ishii J, Kyo M, Awai K, Takahashi K, and Shime N

Subjects
Humans, Male, Female, Retrospective Studies, Middle Aged, Adult, Phenotype, Aged, Hospital Mortality, Proportional Hazards Models, Extracorporeal Membrane Oxygenation methods, Extracorporeal Membrane Oxygenation statistics & numerical data, Respiratory Distress Syndrome therapy, Respiratory Distress Syndrome classification, Respiratory Distress Syndrome mortality, Respiratory Distress Syndrome physiopathology, Latent Class Analysis
Abstract

Background: Sub-phenotyping of acute respiratory distress syndrome (ARDS) could be useful for evaluating the severity of ARDS or predicting its responsiveness to given therapeutic strategies, but no studies have yet investigated the heterogeneity of patients with severe ARDS requiring veno-venous extracorporeal membrane oxygenation (V-V ECMO)., Methods: We conducted this retrospective multicenter observational study in adult patients with severe ARDS treated by V-V ECMO. We performed latent class analysis (LCA) for identifying sub-phenotypes of severe ARDS based on the radiological and clinical findings at the start of ECMO support. Multivariate Cox regression analysis was conducted to investigate the differences in mortality and association between the PEEP setting of ≥ 10 cmH 2 O and mortality by the sub-phenotypes., Results: We identified three sub-phenotypes from analysis of the data of a total of 544 patients with severe ARDS treated by V-V ECMO, as follows: Dry type (n = 185; 34%); Wet type (n = 169; 31%); and Fibrotic type (n = 190; 35%). The 90-days in-hospital mortality risk was higher in the patients with the Fibrotic type than in those with the Dry type (adjusted hazard ratio [95% confidence interval] 1.75 [1.10-2.79], p = 0.019) or the Wet type (1.50 [1.02-2.23], p = 0.042). The PEEP setting of ≥ 10 cmH 2 O during the first 3 days of ECMO decreased the 90-days in-hospital mortality risk only in patients with the Wet type, and not in those with the Dry or Fibrotic type. A significant interaction effect was observed between the Wet type and the PEEP setting of ≥ 10 cmH 2 O in relation to the 90-day in-hospital mortality (p interaction  = 0.036)., Conclusions: The three sub-phenotypes showed different mortality rates and different relationships between higher PEEP settings in the early phase of V-V ECMO and patient outcomes. Our data suggest that we may need to change our management approach to patients with severe ARDS during V-V ECMO according to their clinical sub-phenotype., (© 2024. The Author(s).)

Published
2024
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21. A multimodal characterization of cardiopulmonary resuscitation-associated lung edema.

Author

Magliocca A, Zani D, De Zani D, Castagna V, Merigo G, De Giorgio D, Fumagalli F, Zambelli V, Boccardo A, Pravettoni D, Bellani G, Richard JC, Grasselli G, Rezoagli E, and Ristagno G

Abstract

Background: Cardiopulmonary resuscitation-associated lung edema (CRALE) is a phenomenon that has been recently reported in both experimental and out-of-hospital cardiac arrest patients. We aimed to explore the respiratory and cardiovascular pathophysiology of CRALE in an experimental model of cardiac arrest undergoing prolonged manual and mechanical chest compression (CC). Oxygen delivery achieved during mechanical or manual CC were also investigated as a secondary aim, to describe CRALE evolution under different hemodynamic supports generated during CPR., Methods: Ventricular fibrillation (VF) was induced and left untreated for 5 min prior to begin cardiopulmonary resuscitation (CPR), including CC, ventilation with oxygen, epinephrine administration and defibrillation. Continuous mechanical and manual CC was performed alternating one of the two strategies every 5 min for a total of 25 min. Unsynchronized mechanical ventilation was resumed simultaneously to CC. A lung computed tomography (CT) was performed at baseline and 1 h after return of spontaneous circulation (ROSC) in surviving animals. Partitioned respiratory mechanics, gas exchange, hemodynamics, and oxygen delivery were evaluated during the experimental study at different timepoints. Lung histopathology was performed., Results: After 25 min of CPR, a marked decrease of the respiratory system compliance with reduced oxygenation and CO 2 elimination were observed in all animals. The worsening of the respiratory system compliance was driven by a significant decrease in lung compliance. The presence of CRALE was confirmed by an increased lung weight and a reduced lung aeration at the lung CT, together with a high lung wet-to-dry ratio and reduced airspace at histology. The average change in esophageal pressure during the 25-min CPR highly correlated with the severity of CRALE, i.e., lung weight increase., Conclusions: In this porcine model of cardiac arrest followed by a 25-min interval of CPR with mechanical and manual CC, CRALE was consistently present and was characterized by lung inhomogeneity with alveolar tissue and hemorrhage replacing alveolar airspace. Despite mechanical CPR is associated with a more severe CRALE, the higher cardiac output generated by the mechanical compression ultimately accounted for a greater oxygen delivery. Whether specific ventilation strategies might prevent CRALE while preserving hemodynamics remains to be proved., (© 2024. The Author(s).)

Published
2024
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22. Respiratory Drive, Effort, and Lung-Distending Pressure during Transitioning from Controlled to Spontaneous Assisted Ventilation in Patients with ARDS: A Multicenter Prospective Cohort Study.

Author

Balzani E, Murgolo F, Pozzi M, Di Mussi R, Bartolomeo N, Simonetti U, Brazzi L, Spadaro S, Bellani G, Grasso S, and Fanelli V

Abstract

Objectives : To investigate the impact of patient characteristics and treatment factors on excessive respiratory drive, effort, and lung-distending pressure during transitioning from controlled to spontaneous assisted ventilation in patients with acute respiratory distress syndrome (ARDS). Methods : Multicenter cohort observational study of patients with ARDS at four academic intensive care units. Respiratory drive (P 0.1 ), diaphragm electrical activity (EAdi), inspiratory effort derived from EAdi (∆Pmus EAdi ) and from occlusion of airway pressure (∆Pocc) (Pmus ΔPocc ), and dynamic transpulmonary driving pressure (ΔP L,dyn ) were measured at the first transition to assisted spontaneous breathing. Results : A total of 4171 breaths were analyzed in 48 patients. P 0.1 was >3.5 cmH 2 O in 10%, EAdi PEAK > 15 µV in 29%, ∆Pmus EAdi > 15 cmH 2 O in 28%, and ΔP L,dyn > 15 cmH 2 O in 60% of the studied breaths. COVID-19 etiology of ARDS was the strongest independent risk factor for a higher proportion of breaths with excessive respiratory drive (RR 3.00 [2.43-3.71], p < 0.0001), inspiratory effort (RR 1.84 [1.58-2.15], p < 0.0001), and transpulmonary driving pressure (RR 1.48 [1.36-1.62], p < 0.0001). The P/F ratio at ICU admission, days of deep sedation, and dose of steroids were additional risk factors for vigorous inspiratory effort. Age and dose of steroids were risk factors for high transpulmonary driving pressure. Days of deep sedation (aHR 1.15 [1.07-1.24], p = 0.0002) and COVID-19 diagnosis (aHR 6.96 [1-48.5], p = 0.05) of ARDS were independently associated with composite outcome of transitioning from light to deep sedation (RASS from 0/-3 to -4/-5) or return to controlled ventilation within 48 h of spontaneous assisted breathing. Conclusions : This study identified that specific patient characteristics, including age, COVID-19-related ARDS, and P/F ratio, along with treatment factors such as the duration of deep sedation and the dosage of steroids, are independently associated with an increased likelihood of assisted breaths reaching potentially harmful thresholds of drive, effort, and lung-distending pressure during the initial transition to spontaneous assisted breathing. It is noteworthy that patients who were subjected to prolonged deep sedation under controlled mechanical ventilation, as well as those with COVID-19, were more susceptible to failing the transition from controlled to assisted breathing.

Published
2024
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23. Epidemiology, ventilation management and outcomes of COVID-19 ARDS patients versus patients with ARDS due to pneumonia in the Pre-COVID era.

Author

van der Ven FLIM, Blok SG, Azevedo LC, Bellani G, Botta M, Estenssoro E, Fan E, Ferreira JC, Laffey JG, Martin-Loeches I, Motos A, Pham T, Peñuelas O, Pesenti A, Pisani L, Neto AS, Schultz MJ, Torres A, Tsonas AM, Paulus F, and van Meenen DMP

Subjects
Adult, Aged, Female, Humans, Male, Middle Aged, Treatment Outcome, COVID-19 mortality, COVID-19 therapy, Respiration, Artificial, Respiratory Distress Syndrome mortality, Respiratory Distress Syndrome therapy, Pneumonia complications
Abstract

Background: Ventilation management may differ between COVID-19 ARDS (COVID-ARDS) patients and patients with pre-COVID ARDS (CLASSIC-ARDS); it is uncertain whether associations of ventilation management with outcomes for CLASSIC-ARDS also exist in COVID-ARDS., Methods: Individual patient data analysis of COVID-ARDS and CLASSIC-ARDS patients in six observational studies of ventilation, four in the COVID-19 pandemic and two pre-pandemic. Descriptive statistics were used to compare epidemiology and ventilation characteristics. The primary endpoint were key ventilation parameters; other outcomes included mortality and ventilator-free days and alive (VFD-60) at day 60., Results: This analysis included 6702 COVID-ARDS patients and 1415 CLASSIC-ARDS patients. COVID-ARDS patients received lower median V T (6.6 [6.0 to 7.4] vs 7.3 [6.4 to 8.5] ml/kg PBW; p < 0.001) and higher median PEEP (12.0 [10.0 to 14.0] vs 8.0 [6.0 to 10.0] cm H 2 O; p < 0.001), at lower median ΔP (13.0 [10.0 to 15.0] vs 16.0 [IQR 12.0 to 20.0] cm H 2 O; p < 0.001) and higher median Crs (33.5 [26.6 to 42.1] vs 28.1 [21.6 to 38.4] mL/cm H 2 O; p < 0.001). Following multivariable adjustment, higher ΔP had an independent association with higher 60-day mortality and less VFD-60 in both groups. Higher PEEP had an association with less VFD-60, but only in COVID-ARDS patients., Conclusions: Our findings show important differences in key ventilation parameters and associations thereof with outcomes between COVID-ARDS and CLASSIC-ARDS., Trial Registration: Clinicaltrials.gov (identifier NCT05650957), December 14, 2022., (© 2024. The Author(s).)

Published
2024
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24. Phenotyping COVID-19 respiratory failure in spontaneously breathing patients with AI on lung CT-scan.

Author

Rezoagli E, Xin Y, Signori D, Sun W, Gerard S, Delucchi KL, Magliocca A, Vitale G, Giacomini M, Mussoni L, Montomoli J, Subert M, Ponti A, Spadaro S, Poli G, Casola F, Herrmann J, Foti G, Calfee CS, Laffey J, Bellani G, and Cereda M

Subjects
Humans, Female, Male, Middle Aged, Aged, Cohort Studies, Adult, COVID-19 diagnostic imaging, COVID-19 physiopathology, Tomography, X-Ray Computed methods, Phenotype, Lung diagnostic imaging, Lung physiopathology, Respiratory Insufficiency diagnostic imaging, Respiratory Insufficiency etiology, Respiratory Insufficiency physiopathology
Abstract

Background: Automated analysis of lung computed tomography (CT) scans may help characterize subphenotypes of acute respiratory illness. We integrated lung CT features measured via deep learning with clinical and laboratory data in spontaneously breathing subjects to enhance the identification of COVID-19 subphenotypes., Methods: This is a multicenter observational cohort study in spontaneously breathing patients with COVID-19 respiratory failure exposed to early lung CT within 7 days of admission. We explored lung CT images using deep learning approaches to quantitative and qualitative analyses; latent class analysis (LCA) by using clinical, laboratory and lung CT variables; regional differences between subphenotypes following 3D spatial trajectories., Results: Complete datasets were available in 559 patients. LCA identified two subphenotypes (subphenotype 1 and 2). As compared with subphenotype 2 (n = 403), subphenotype 1 patients (n = 156) were older, had higher inflammatory biomarkers, and were more hypoxemic. Lungs in subphenotype 1 had a higher density gravitational gradient with a greater proportion of consolidated lungs as compared with subphenotype 2. In contrast, subphenotype 2 had a higher density submantellar-hilar gradient with a greater proportion of ground glass opacities as compared with subphenotype 1. Subphenotype 1 showed higher prevalence of comorbidities associated with endothelial dysfunction and higher 90-day mortality than subphenotype 2, even after adjustment for clinically meaningful variables., Conclusions: Integrating lung-CT data in a LCA allowed us to identify two subphenotypes of COVID-19, with different clinical trajectories. These exploratory findings suggest a role of automated imaging characterization guided by machine learning in subphenotyping patients with respiratory failure., Trial Registration: ClinicalTrials.gov Identifier: NCT04395482. Registration date: 19/05/2020., (© 2024. The Author(s).)

Published
2024
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25. Humidification during Invasive and Non-Invasive Ventilation: A Starting Tool Kit for Correct Setting.

Author

Re R, Lassola S, De Rosa S, and Bellani G

Subjects
Humans, Humidifiers, Respiration, Artificial instrumentation, Humidity, Noninvasive Ventilation instrumentation
Abstract

The humidification process of medical gases plays a crucial role in both invasive and non-invasive ventilation, aiming to mitigate the complications arising from bronchial dryness. While passive humidification systems (HME) and active humidification systems are prevalent in routine clinical practice, there is a pressing need for further evaluation of their significance. Additionally, there is often an incomplete understanding of the operational mechanisms of these devices. The current review explores the historical evolution of gas conditioning in clinical practice, from early prototypes to contemporary active and passive humidification systems. It also discusses the physiological principles underlying humidity regulation and provides practical guidance for optimizing humidification parameters in both invasive and non-invasive ventilation modalities. The aim of this review is to elucidate the intricate interplay between temperature, humidity, and patient comfort, emphasizing the importance of individualized approaches to gas conditioning.

Published
2024
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26. The "ZEEP-PEEP test" to evaluate the response to positive end-expiratory pressure delivered by helmet: A prospective physiologic study.

Author

Giani M, Fumagalli B, Cipulli F, Rezoagli E, Pozzi M, Fumagalli D, Fumagalli L, Ferrari K, Rona R, Bellani G, Lucchini A, and Foti G

Abstract

Introduction: The improvement in oxygenation after helmet application in hypoxemic patients may be explained by the alveolar recruitment obtained with positive end expiratory pressure (PEEP) or by the administration of a more accurate inspiratory fraction of oxygen (F i O 2 ). We have designed the "ZEEP-PEEP test", capable to distinguish between the F i O 2 -related or PEEP-related oxygenation improvement. Our primary aim was to describe the use of this test during helmet CPAP to assess the oxygenation improvement attributable to PEEP application., Material and Methods: We performed a prospective physiological study including adult critically ill patients. Respiratory and hemodynamic parameters were recorded before helmet application (PRE step), after helmet application without PEEP (ZEEP step) and after the application of the PEEP valve (PEEP step), while maintaining a constant FiO 2 . We defined as "PEEP responders" patients showing a PaO 2 /FiO 2 ratio improvement ≥10% after PEEP application., Results: 93 patients were enrolled. Compared to the PRE step, PaO2/FiO2 ratio was significantly improved during helmet CPAP both at ZEEP and PEEP step (189 ± 55, 219 ± 74 and 241 ± 82 mmHg, respectively, p < 0.01). Both PEEP responders (41%) and non-responders showed a significant improvement of PaO2/FiO2 ratio after the application of helmet at ZEEP, PEEP responders also showed a significant improvement of oxygenation after PEEP application (208 ± 70 vs 267 ± 85, p < 0.01)., Conclusions: Helmet CPAP improved oxygenation. This improvement was not only due to the PEEP effect, but also to the increase of the effective inspired FiO 2 . Performing the ZEEP-PEEP test may help to identify patients who benefit from PEEP., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier Ltd.)

Published
2024
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27. The use of extracorporeal blood purification therapies and sequential extracorporeal support in patients with septic shock (EROICASS): a study protocol for a national, non-interventional, observational multicenter, prospective study.

Author

De Rosa S, Ferrari F, Greco M, Pota V, Umbrello M, Cotoia A, Pasin L, Nalesso F, Paternoster G, Villa G, Lassola S, Miori S, Sanna A, Cantaluppi V, Marengo M, Valente F, Fiorentino M, Brunori G, Bellani G, and Giarratano A

Abstract

Background: Septic shock, a critical condition characterized by organ failure, presents a substantial mortality risk in intensive care units (ICUs), with the 28-day mortality rate possibly reaching 40%. Conventional management of septic shock typically involves the administration of antibiotics, supportive care for organ dysfunction, and, if necessary, surgical intervention to address the source of infection. In recent decades, extracorporeal blood purification therapies (EBPT) have emerged as potential interventions aimed at modulating the inflammatory response and restoring homeostasis in patients with sepsis. Likewise, sequential extracorporeal therapy in sepsis (SETS) interventions offer comprehensive organ support in the setting of multiple organ dysfunction syndrome (MODS). The EROICASS study will assess and describe the utilization of EBPT in patients with septic shock. Additionally, we will evaluate the potential association between EBPT treatment utilization and 90-day mortality in septic shock cases in Italy., Methods: The EROICASS study is a national, non-interventional, multicenter observational prospective cohort study. All consecutive patients with septic shock at participating centers will be prospectively enrolled, with data collection extending from intensive care unit (ICU) admission to hospital discharge. Variables including patient demographics, clinical parameters, EBPT/SETS utilization, and outcomes will be recorded using a web-based data capture system. Statistical analyses will encompass descriptive statistics, hypothesis testing, multivariable regression models, and survival analysis to elucidate the associations between EBPT/SETS utilization and patient outcomes., Conclusions: The EROICASS study provides valuable insights into the utilization and outcomes of EBPT and SETS in septic shock management. Through analysis of usage patterns and clinical data, this study aims to guide treatment decisions and enhance patient care. The implications of these findings may impact clinical guidelines, potentially improving survival rates and patient outcomes in septic shock cases., (© 2024. The Author(s).)

Published
2024
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28. Successful Versus Failed Transition From Controlled Ventilation to Pressure Support Ventilation in COVID-19 Patients: A Retrospective Cohort Study.

Author

Polo Friz M, Rezoagli E, Safaee Fakhr B, Florio G, Carlesso E, Giudici R, Forlini C, Tardini F, Langer T, Laratta M, Casella G, Forastieri Molinari A, Protti A, Cecconi M, Cabrini L, Biagioni E, Berselli A, Mirabella L, Tonetti T, De Robertis E, Grieco DL, Antonelli M, Citerio G, Fumagalli R, Foti G, Zanella A, Grasselli G, and Bellani G

Abstract

Objectives: In patients with COVID-19 respiratory failure, controlled mechanical ventilation (CMV) is often necessary during the acute phases of the disease. Weaning from CMV to pressure support ventilation (PSV) is a key objective when the patient's respiratory functions improve. Limited evidence exists regarding the factors predicting a successful transition to PSV and its impact on patient outcomes., Design: Retrospective observational cohort study., Setting: Twenty-four Italian ICUs from February 2020 to May 2020., Patients: Mechanically ventilated ICU patients with COVID-19-induced respiratory failure., Intervention: The transition period from CMV to PSV was evaluated. We defined it as "failure of assisted breathing" if the patient returned to CMV within the first 72 hours., Measurements and Main Results: Of 1260 ICU patients screened, 514 were included. Three hundred fifty-seven patients successfully made the transition to PSV, while 157 failed. Pao 2 /Fio 2 ratio before the transition emerged as an independent predictor of a successful shift (odds ratio 1.00; 95% CI, 0.99-1.00; p = 0.003). Patients in the success group displayed a better trend in Pao 2 /Fio 2 , Paco 2 , plateau and peak pressure, and pH level. Subjects in the failure group exhibited higher ICU mortality (hazard ratio 2.08; 95% CI, 1.42-3.06; p < 0.001), an extended ICU length of stay (successful vs. failure 21 ± 14 vs. 27 ± 17 d; p < 0.001) and a longer duration of mechanical ventilation (19 ± 18 vs. 24 ± 17 d, p = 0.04)., Conclusions: Our study emphasizes that the Pao 2 /Fio 2 ratio was the sole independent factor associated with a failed transition from CMV to PSV. The unsuccessful transition was associated with worse outcomes., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.)

Published
2024
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30. Feasibility of Setting the Tidal Volume Based on End-Expiratory Lung Volume: A Pilot Clinical Study.

Author

Grassi A, Teggia-Droghi M, Borgo A, Szudrinsky K, and Bellani G

Abstract

Objectives: To assess the feasibility of setting the tidal volume (TV) as 25% of the actual aerated lung volume (rather than on ideal body weight) in patients with Acute Respiratory Distress Syndrome (ARDS)., Design: Physiologic prospective single-center pilot study., Setting: Medical ICU specialized in the care of patients with ARDS., Patients: Patients with moderate-severe ARDS deeply sedated or paralyzed, undergoing controlled mechanical ventilation with a ventilator able to measure the end-expiratory lung volume (EELV) with a washin, washout technique., Interventions: Three-phase study (baseline, strain-selected TV setting, ventilation with strain-selected TV for 24 hr). The TV was calculated as 25% of the measured EELV minus the static strain due to the applied positive end-expiratory pressure., Measurements and Main Results: Gas exchanges and respiratory mechanics were measured and compared in each phase. In addition, during the TV setting phase, driving pressure (DP) and lung strain (TV/EELV) were measured at different TVs to assess the correlation between the two measurements. The maintenance of the set strain-selected TV for 24 hours was safe and feasible in 76% of the patients enrolled. Three patients dropped out from the study because of the need to set a respiratory rate higher than 35 breaths per minute to avoid respiratory acidosis. The DP of the respiratory system was a satisfactory surrogate for strain in this population., Conclusions: In our population of 17 patients with moderate to severe ARDS, setting TV based on the actual lung size was feasible. DP was a reliable surrogate of strain in these patients, and DP less than or equal to 8 cm H 2 O corresponded to a strain less than 0.25., Competing Interests: Dr. Bellani received lecturing or consultancy fees from Draeger Medical, Getinge, Siare Engineering International Group s.r.l., and Flowmeter SPA. The remaining authors have disclosed that they do not have any potential conflict of interest., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.)

Published
2024
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31. High efficiency particulate air filters and heat & moisture exchanger filters increase positive end-expiratory pressure in helmet continuous positive airway pressure: A bench-top study.

Author

Rezoagli E, Coppola G, Dezza L, Galesi A, Gallo GP, Fumagalli R, Bellani G, Foti G, and Lucchini A

Subjects
Humans, Hot Temperature, Pandemics, RNA, Viral, Continuous Positive Airway Pressure, Air Filters
Abstract

Background: Helmet continuous positive airway pressure (CPAP) has been widely used during the COVID-19 pandemic. Specific filters (i.e. High Efficiency Particulate Air filter: HEPA; Heat & Moisture Exchanger Filter: HMEF) were used to prevent Sars-CoV2 environmental dispersion and were connected to the CPAP helmet. However, HEPA and HMEF filters may act as resistors to expiratory gas flow and increase the levels of pressure within the hood., Methods: In a bench-top study, we investigated the levels of airway pressure generated by different HEPA and HMEF filters connected to the CPAP helmet in the absence of a Positive End Expiratory Pressure (PEEP) valve and with two levels of PEEP (5 and 10 cmH 2 O). All steps were performed using 3 increasing levels of gas flow (60, 80, 100 L/min)., Results: The use of 8 different commercially available filters significantly increased the pressure within the hood of the CPAP helmet with or without the use of PEEP valves. On average, the increase of pressure above the set PEEP ranged from 3 cmH 2 O to 10 cmH 2 O across gas flow rates of 60 to 100 L/min. The measure of airway pressure was highly correlated between the laboratory pressure transducer and the Helmet manometer. Bias with 95% Confidence Interval of Bias between the devices was 0.7 (-2.06; 0.66) cmH 2 O., Conclusions: The use of HEPA and HMEF filters placed before the PEEP valve at the expiratory port of the CPAP helmet significantly increase the levels of airway pressure compared to the set level of PEEP. The manometer can detect accurately the airway pressure in the presence of HEPA and HMEF filters in the helmet CPAP and its use should considered., Competing Interests: Conflict of interest The authors declare they have no conflict of interest., (Copyright © 2022 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.)

Published
2024
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32. Individual response in patient's effort and driving pressure to variations in assistance during pressure support ventilation.

Author

Docci M, Rezoagli E, Teggia-Droghi M, Coppadoro A, Pozzi M, Grassi A, Bianchi I, Foti G, and Bellani G

Abstract

Background: During Pressure Support Ventilation (PSV) an inspiratory hold allows to measure plateau pressure (Pplat), driving pressure (∆P), respiratory system compliance (Crs) and pressure-muscle-index (PMI), an index of inspiratory effort. This study aims [1] to assess systematically how patient's effort (estimated with PMI), ∆P and tidal volume (Vt) change in response to variations in PSV and [2] to confirm the robustness of Crs measurement during PSV., Methods: 18 patients recovering from acute respiratory failure and ventilated by PSV were cross-randomized to four steps of assistance above (+ 3 and + 6 cmH 2 O) and below (-3 and -6 cmH 2 O) clinically set PS. Inspiratory and expiratory holds were performed to measure Pplat, PMI, ∆P, Vt, Crs, P0.1 and occluded inspiratory airway pressure (Pocc). Electromyography of respiratory muscles was monitored noninvasively from body surface (sEMG)., Results: As PSV was decreased, Pplat (from 20.5 ± 3.3 cmH 2 O to 16.7 ± 2.9, P < 0.001) and ∆P (from 12.5 ± 2.3 to 8.6 ± 2.3 cmH 2 O, P < 0.001) decreased much less than peak airway pressure did (from 21.7 ± 3.8 to 9.7 ± 3.8 cmH2O, P < 0.001), given the progressive increase of patient's effort (PMI from -1.2 ± 2.3 to 6.4 ± 3.2 cmH 2 O) in line with sEMG of the diaphragm (r = 0.614; P < 0.001). As ∆P increased linearly with Vt, Crs did not change through steps (P = 0.119)., Conclusion: Patients react to a decrease in PSV by increasing inspiratory effort-as estimated by PMI-keeping Vt and ∆P on a desired value, therefore, limiting the clinician's ability to modulate them. PMI appears a valuable index to assess the point of ventilatory overassistance when patients lose control over Vt like in a pressure-control mode. The measurement of Crs in PSV is constant-likely suggesting reliability-independently from the level of assistance and patient's effort., (© 2023. The Author(s).)

Published
2023
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33. Indoleamine 2,3-Dioxygenase Deletion to Modulate Kynurenine Pathway and to Prevent Brain Injury after Cardiac Arrest in Mice.

Author

Magliocca A, Perego C, Motta F, Merigo G, Micotti E, Olivari D, Fumagalli F, Lucchetti J, Gobbi M, Mandelli A, Furlan R, Skrifvars MB, Latini R, Bellani G, Ichinose F, and Ristagno G

Subjects
Animals, Mice, Kynurenine, Diffusion Tensor Imaging, Water, Indoleamine-Pyrrole 2,3,-Dioxygenase genetics, Brain Injuries
Abstract

Background: The catabolism of the essential amino acid tryptophan to kynurenine is emerging as a potential key pathway involved in post-cardiac arrest brain injury. The aim of this study was to evaluate the effects of the modulation of kynurenine pathway on cardiac arrest outcome through genetic deletion of the rate-limiting enzyme of the pathway, indoleamine 2,3-dioxygenase., Methods: Wild-type and indoleamine 2,3-dioxygenase-deleted (IDO-/-) mice were subjected to 8-min cardiac arrest. Survival, neurologic outcome, and locomotor activity were evaluated after resuscitation. Brain magnetic resonance imaging with diffusion tensor and diffusion-weighted imaging sequences was performed, together with microglia and macrophage activation and neurofilament light chain measurements., Results: IDO-/- mice showed higher survival compared to wild-type mice (IDO-/- 11 of 16, wild-type 6 of 16, log-rank P = 0.036). Neurologic function was higher in IDO-/- mice than in wild-type mice after cardiac arrest (IDO-/- 9 ± 1, wild-type 7 ± 1, P = 0.012, n = 16). Indoleamine 2,3-dioxygenase deletion preserved locomotor function while maintaining physiologic circadian rhythm after cardiac arrest. Brain magnetic resonance imaging with diffusion tensor imaging showed an increase in mean fractional anisotropy in the corpus callosum (IDO-/- 0.68 ± 0.01, wild-type 0.65 ± 0.01, P = 0.010, n = 4 to 5) and in the external capsule (IDO-/- 0.47 ± 0.01, wild-type 0.45 ± 0.01, P = 0.006, n = 4 to 5) in IDO-/- mice compared with wild-type ones. Increased release of neurofilament light chain was observed in wild-type mice compared to IDO-/- (median concentrations [interquartile range], pg/mL: wild-type 1,138 [678 to 1,384]; IDO-/- 267 [157 to 550]; P < 0.001, n = 3 to 4). Brain magnetic resonance imaging with diffusion-weighted imaging revealed restriction of water diffusivity 24 h after cardiac arrest in wild-type mice; indoleamine 2,3-dioxygenase deletion prevented water diffusion abnormalities, which was reverted in IDO-/- mice receiving l-kynurenine (apparent diffusion coefficient, μm2/ms: wild-type, 0.48 ± 0.07; IDO-/-, 0.59 ± 0.02; IDO-/- and l-kynurenine, 0.47 ± 0.08; P = 0.007, n = 6)., Conclusions: The kynurenine pathway represents a novel target to prevent post-cardiac arrest brain injury. The neuroprotective effects of indoleamine 2,3-dioxygenase deletion were associated with preservation of brain white matter microintegrity and with reduction of cerebral cytotoxic edema., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Anesthesiologists.)

Published
2023
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34. Identifying Trauma Patients in Need for Emergency Surgery in the Prehospital Setting: The Prehospital Prediction of In-Hospital Emergency Treatment (PROPHET) Study.

Author

Isgrò S, Giani M, Antolini L, Giudici R, Valsecchi MG, Bellani G, Chiara O, Bassi G, Latronico N, Cabrini L, Fumagalli R, Chieregato A, Sammartano F, Sechi G, Zoli A, Pagliosa A, Palo A, Valoti O, Carlucci M, Benini A, and Foti G

Abstract

Prehospital field triage often fails to accurately identify the need for emergent surgical or non-surgical procedures, resulting in inefficient resource utilization and increased costs. This study aimed to analyze prehospital factors associated with the need for emergent procedures (such as surgery or interventional angiography) within 6 h of hospital admission. Additionally, our goal was to develop a prehospital triage tool capable of estimating the likelihood of requiring an emergent procedure following hospital admission. We conducted a retrospective observational study, analyzing both prehospital and in-hospital data obtained from the Lombardy Trauma Registry. We conducted a multivariable logistic regression analysis to identify independent predictors of emergency procedures within the first 6 h from admission. Subsequently, we developed and internally validated a triage score composed of factors associated with the probability of requiring an emergency procedure. The study included a total of 3985 patients, among whom 295 (7.4%) required an emergent procedure within 6 h. Age, penetrating injury, downfall, cardiac arrest, poor neurological status, endotracheal intubation, systolic pressure, diastolic pressure, shock index, respiratory rate and tachycardia were identified as predictors of requiring an emergency procedure. A triage score generated from these predictors showed a good predictive power (AUC of the ROC curve: 0.81) to identify patients requiring an emergent surgical or non-surgical procedure within 6 h from hospital admission. The proposed triage score might contribute to predicting the need for immediate resource availability in trauma patients.

Published
2023
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35. Effects of CPAP and FiO 2 on respiratory effort and lung stress in early COVID-19 pneumonia: a randomized, crossover study.

Author

Giosa L, Collins PD, Sciolla M, Cerrone F, Di Blasi S, Macrì MM, Davicco L, Laguzzi A, Gorgonzola F, Penso R, Steinberg I, Muraccini M, Perboni A, Russotto V, Camporota L, Bellani G, and Caironi P

Abstract

Background: in COVID-19 acute respiratory failure, the effects of CPAP and FiO 2 on respiratory effort and lung stress are unclear. We hypothesize that, in the compliant lungs of early Sars-CoV-2 pneumonia, the application of positive pressure through Helmet-CPAP may not decrease respiratory effort, and rather worsen lung stress and oxygenation when compared to higher FiO 2 delivered via oxygen masks., Methods: In this single-center (S.Luigi Gonzaga University-Hospital, Turin, Italy), randomized, crossover study, we included patients receiving Helmet-CPAP for early (< 48 h) COVID-19 pneumonia without additional cardiac or respiratory disease. Healthy subjects were included as controls. Participants were equipped with an esophageal catheter, a non-invasive cardiac output monitor, and an arterial catheter. The protocol consisted of a random sequence of non-rebreather mask (NRB), Helmet-CPAP (with variable positive pressure and FiO 2 ) and Venturi mask (FiO 2 0.5), each delivered for 20 min. Study outcomes were changes in respiratory effort (esophageal swing), total lung stress (dynamic + static transpulmonary pressure), gas-exchange and hemodynamics., Results: We enrolled 28 COVID-19 patients and 7 healthy controls. In all patients, respiratory effort increased from NRB to Helmet-CPAP (5.0 ± 3.7 vs 8.3 ± 3.9 cmH 2 O, p < 0.01). However, Helmet's pressure decreased by a comparable amount during inspiration (- 3.1 ± 1.0 cmH 2 O, p = 0.16), therefore dynamic stress remained stable (p = 0.97). Changes in static and total lung stress from NRB to Helmet-CPAP were overall not significant (p = 0.07 and p = 0.09, respectively), but showed high interpatient variability, ranging from - 4.5 to + 6.1 cmH 2 O, and from - 5.8 to + 5.7 cmH 2 O, respectively. All findings were confirmed in healthy subjects, except for an increase in dynamic stress (p < 0.01). PaO 2 decreased from NRB to Helmet-CPAP with FiO 2 0.5 (107 ± 55 vs 86 ± 30 mmHg, p < 0.01), irrespective of positive pressure levels (p = 0.64). Conversely, with Helmet's FiO 2 0.9, PaO 2 increased (p < 0.01), but oxygen delivery remained stable (p = 0.48) as cardiac output decreased (p = 0.02). When PaO 2 fell below 60 mmHg with VM, respiratory effort increased proportionally (p < 0.01, r = 0.81)., Conclusions: In early COVID-19 pneumonia, Helmet-CPAP increases respiratory effort without altering dynamic stress, while the effects upon static and total stress are variable, requiring individual assessment. Oxygen masks with higher FiO 2 provide better oxygenation with lower respiratory effort. Trial registration Retrospectively registered (13-May-2021): clinicaltrials.gov (NCT04885517), https://clinicaltrials.gov/ct2/show/NCT04885517 ., (© 2023. La Société de Réanimation de Langue Francaise = The French Society of Intensive Care (SRLF).)

Published
2023
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36. Safety and Effectiveness of Intensive Treatments Administered Outside the Intensive Care Unit to Hematological Critically Ill Patients: An Intensive Care without Walls Trial.

Author

Vergnano B, Signori D, Benini A, Calcinati S, Bettini F, Verga L, Borin LM, Cavalca F, Gambacorti-Passerini C, Bellani G, and Foti G

Abstract

Historically, the admission of hematological patients in the ICU shortly after the start of a critical illness is associated with better survival rates. Early intensive interventions administered by MET could play a role in the management of hematological critically ill patients, eventually reducing the ICU admission rate. In this retrospective and monocentric study, we evaluate the safety and effectiveness of intensive treatments administered by the MET in a medical ward frame. The administered interventions were mainly helmet CPAP and pharmacological cardiovascular support. Frequent reassessment by the MET at least every 8 to 12 h was guaranteed. We analyzed data from 133 hematological patients who required MET intervention. In-hospital mortality was 38%; mortality does not increase in patients not immediately transferred to the ICU. Only three patients died without a former admission to the ICU; in these cases, mortality was not related to the acute illness. Moreover, 37% of patients overcame the critical episode in the hematological ward. Higher SOFA and MEWS scores were associated with a worse survival rate, while neutropenia and pharmacological immunosuppression were not. The MET approach seems to be safe and effective. SOFA and MEWS were confirmed to be effective tools for prognostication.

Published
2023
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37. Efficacy and adverse events profile of videolaryngoscopy in critically ill patients: subanalysis of the INTUBE study.

Author

Russotto V, Lascarrou JB, Tassistro E, Parotto M, Antolini L, Bauer P, Szułdrzyński K, Camporota L, Putensen C, Pelosi P, Sorbello M, Higgs A, Greif R, Grasselli G, Valsecchi MG, Fumagalli R, Foti G, Caironi P, Bellani G, Laffey JG, and Myatra SN

Subjects
Humans, Intubation, Intratracheal adverse effects, Intubation, Intratracheal methods, Laryngoscopy adverse effects, Laryngoscopy methods, Prospective Studies, Critical Illness therapy, Laryngoscopes
Abstract

Background: Tracheal intubation is a high-risk procedure in the critically ill, with increased intubation failure rates and a high risk of other adverse events. Videolaryngoscopy might improve intubation outcomes in this population, but evidence remains conflicting, and its impact on adverse event rates is debated., Methods: This is a subanalysis of a large international prospective cohort of critically ill patients (INTUBE Study) performed from 1 October 2018 to 31 July 2019 and involving 197 sites from 29 countries across five continents. Our primary aim was to determine the first-pass intubation success rates of videolaryngoscopy. Secondary aims were characterising (a) videolaryngoscopy use in the critically ill patient population and (b) the incidence of severe adverse effects compared with direct laryngoscopy., Results: Of 2916 patients, videolaryngoscopy was used in 500 patients (17.2%) and direct laryngoscopy in 2416 (82.8%). First-pass intubation success was higher with videolaryngoscopy compared with direct laryngoscopy (84% vs 79%, P=0.02). Patients undergoing videolaryngoscopy had a higher frequency of difficult airway predictors (60% vs 40%, P<0.001). In adjusted analyses, videolaryngoscopy increased the probability of first-pass intubation success, with an OR of 1.40 (95% confidence interval [CI] 1.05-1.87). Videolaryngoscopy was not significantly associated with risk of major adverse events (odds ratio 1.24, 95% CI 0.95-1.62) or cardiovascular events (odds ratio 0.78, 95% CI 0.60-1.02)., Conclusions: In critically ill patients, videolaryngoscopy was associated with higher first-pass intubation success rates, despite being used in a population at higher risk of difficult airway management. Videolaryngoscopy was not associated with overall risk of major adverse events., Clinical Trial Registration: NCT03616054., (Copyright © 2023 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.)

Published
2023
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38. Validation of a tool for estimating clinician recognition of ARDS using data from the international LUNG SAFE study.

Author

Bechel MA, Madotto F, Pah AR, Bellani G, Laffey JG, Pham T, Amaral LAN, and Weiss CH

Abstract

Under-recognition of acute respiratory distress syndrome (ARDS) by clinicians is an important barrier to adoption of evidence-based practices such as low tidal volume ventilation. The burden created by the COVID-19 pandemic makes it even more critical to develop scalable data-driven tools to improve ARDS recognition. The objective of this study was to validate a tool for accurately estimating clinician ARDS recognition rates using discrete clinical characteristics easily available in electronic health records. We conducted a secondary analysis of 2,705 ARDS and 1,261 non-ARDS hypoxemic patients in the international LUNG SAFE cohort. The primary outcome was validation of a tool that estimates clinician ARDS recognition rates from health record data. Secondary outcomes included the relative impact of clinical characteristics on tidal volume delivery and clinician documentation of ARDS. In both ARDS and non-ARDS patients, greater height was associated with lower standardized tidal volume (mL/kg PBW) (ARDS: adjusted β = -4.1, 95% CI -4.5 --3.6; non-ARDS: β = -7.7, 95% CI -8.8 --6.7, P<0.00009 [where α = 0.01/111 with the Bonferroni correction]). Standardized tidal volume has already been normalized for patient height, and furthermore, height was not associated with clinician documentation of ARDS. Worsening hypoxemia was associated with both increased clinician documentation of ARDS (β = -0.074, 95% CI -0.093 --0.056, P<0.00009) and lower standardized tidal volume (β = 1.3, 95% CI 0.94-1.6, P<0.00009) in ARDS patients. Increasing chest imaging opacities, plateau pressure, and clinician documentation of ARDS also were associated with lower tidal volume in ARDS patients. Our EHR-based data-driven approach using height, gender, ARDS documentation, and lowest standardized tidal volume yielded estimates of clinician ARDS recognition rates of 54% for mild, 63% for moderate, and 73% for severe ARDS. Our tool replicated clinician-reported ARDS recognition in the LUNG SAFE study, enabling the identification of ARDS patients at high risk of being unrecognized. Our approach can be generalized to other conditions for which there is a need to increase adoption of evidence-based care., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: JL received consulting fees from Baxter Healthcare and Glaxosmithkline. The remaining authors have declared that no competing interests exist., (Copyright: © 2023 Bechel et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Published
2023
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39. High-stress surgery in severely frail patients: a case report of personalized and multidisciplinary shared decision-making.

Author

Sanna A, Miori S, Lassola S, Umbrello M, De Rosa S, and Bellani G

Abstract

We report the case of a 65-year-old severely disabled man diagnosed with advanced renal neoplasm who was scheduled for major urologic surgery. Through a multidisciplinary approach, a shared decision-making process and mutual listening of all the health professionals involved, it was decided not to have major surgery due to the high risk of worsening the patient's health and quality of life., (© 2023. Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care.)

Published
2023
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41. PEEP Titration Is Markedly Affected by Trunk Inclination in Mechanically Ventilated Patients with COVID-19 ARDS: A Physiologic, Cross-Over Study.

Author

Marrazzo F, Spina S, Zadek F, Forlini C, Bassi G, Giudici R, Bellani G, Fumagalli R, and Langer T

Abstract

Background: Changing trunk inclination affects lung function in patients with ARDS. However, its impacts on PEEP titration remain unknown. The primary aim of this study was to assess, in mechanically ventilated patients with COVID-19 ARDS, the effects of trunk inclination on PEEP titration. The secondary aim was to compare respiratory mechanics and gas exchange in the semi-recumbent (40° head-of-the-bed) and supine-flat (0°) positions following PEEP titration., Methods: Twelve patients were positioned both at 40° and 0° trunk inclination (randomized order). The PEEP associated with the best compromise between overdistension and collapse guided by Electrical Impedance Tomography (PEEP EIT ) was set. After 30 min of controlled mechanical ventilation, data regarding respiratory mechanics, gas exchange, and EIT parameters were collected. The same procedure was repeated for the other trunk inclination., Results: PEEP EIT was lower in the semi-recumbent than in the supine-flat position (8 ± 2 vs. 13 ± 2 cmH 2 O, p < 0.001). A semi-recumbent position with optimized PEEP resulted in higher PaO 2 :FiO 2 (141 ± 46 vs. 196 ± 99, p = 0.02) and a lower global inhomogeneity index (46 ± 10 vs. 53 ± 11, p = 0.008). After 30 min of observation, a loss of aeration (measured by EIT) was observed only in the supine-flat position (-153 ± 162 vs. 27 ± 203 mL, p = 0.007)., Conclusions: A semi-recumbent position is associated with lower PEEP EIT and results in better oxygenation, less derecruitment, and more homogenous ventilation compared to the supine-flat position.

Published
2023
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42. Assessment of Inspiratory Effort in Spontaneously Breathing COVID-19 ARDS Patients Undergoing Helmet CPAP: A Comparison between Esophageal, Transdiaphragmatic and Central Venous Pressure Swing.

Author

Lassola S, Miori S, Sanna A, Menegoni I, De Rosa S, Bellani G, and Umbrello M

Abstract

Introduction: The clinical features of COVID-19 are highly variable. It has been speculated that the progression across COVID-19 may be triggered by excessive inspiratory drive activation. The aim of the present study was to assess whether the tidal swing in central venous pressure (ΔCVP) is a reliable estimate of inspiratory effort., Methods: Thirty critically ill patients with COVID-19 ARDS underwent a PEEP trial (0-5-10 cmH 2 O) during helmet CPAP. Esophageal (ΔPes) and transdiaphragmatic (ΔPdi) pressure swings were measured as indices of inspiratory effort. ΔCVP was assessed via a standard venous catheter. A low and a high inspiratory effort were defined as ΔPes ≤ 10 and  >15 cmH2O, respectively., Results: During the PEEP trial, no significant changes in ΔPes (11 [6-16] vs. 11 [7-15] vs. 12 [8-16] cmH2O, p = 0.652) and in ΔCVP (12 [7-17] vs. 11.5 [7-16] vs. 11.5 [8-15] cmH2O, p = 0.918) were detected. ΔCVP was significantly associated with ΔPes (marginal R 2 0.87, p < 0.001). ΔCVP recognized both low (AUC-ROC curve 0.89 [0.84-0.96]) and high inspiratory efforts (AUC-ROC curve 0.98 [0.96-1])., Conclusions: ΔCVP is an easily available a reliable surrogate of ΔPes and can detect a low or a high inspiratory effort. This study provides a useful bedside tool to monitor the inspiratory effort of spontaneously breathing COVID-19 patients.

Published
2023
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44. Physical manoeuvres in patients with ARDS and low compliance: bedside approaches to detect lung hyperinflation and optimise mechanical ventilation.

Author

Rezoagli E, Bastia L, Brochard L, and Bellani G

Subjects
Humans, Positive-Pressure Respiration, Lung, Lung Compliance, Tidal Volume, Respiration, Artificial, Respiratory Distress Syndrome diagnosis, Respiratory Distress Syndrome therapy
Abstract

Competing Interests: Conflict of interest: All authors have no conflict of interest to disclose in relation to this work.

Published
2023
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46. Hospital Memories and Six-Month Psychological Outcome: A Prospective Study in Critical Ill Patients with COVID-19 Respiratory Failure.

Author

Pozzi M, Ripa C, Meroni V, Ferlicca D, Annoni A, Villa M, Strepparava MG, Rezoagli E, Piva S, Lucchini A, Bellani G, Foti G, and The Monza Follow-Up Study Group

Abstract

ICU survivors suffer from various long-term physical and psychological impairments. Memories from the critical illness may influence long-term psychological outcome. In particular, the role of ICU memories in COVID-19 critically ill patients is unknown. In a prospective observational study, we aimed to investigate patients' memories from the experience of critical illness and their association with a six-month psychological outcome involving quality of life evaluation. Patients' memories were investigated with ICU Memory tool, while psychological outcome and quality of life were evaluated by means of a battery of validated questionnaires during an in-person interview at the follow-up clinic. 149 adult patients were enrolled. 60% retained memories from pre-ICU days spent on a general ward, while 70% reported memories from the in-ICU period. Delusional memories (i.e., memories of facts that never happened) were reported by 69% of patients. According to a multivariable analysis, the lack of pre-ICU memories was an independent predictor of worse psychological outcomes in terms of anxiety, depression and Post-traumatic Stress Disorder (PTDS). Factors associated with long-term outcome in ICU survivors are not still fully understood and patients' experience during the day spent before ICU admission may be associated with psychological sequelae.

Published
2023
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47. Treatment with levosimendan in an experimental model of early ventilator-induced diaphragmatic dysfunction.

Author

Zambelli V, Murphy EJ, Delvecchio P, Rizzi L, Fumagalli R, Rezoagli E, and Bellani G

Abstract

Introduction: Mechanical ventilation (MV) is a life-saving approach in critically ill patients. However, it may affect the diaphragmatic structure and function, beyond the lungs. Levosimendan is a calcium sensitizer widely used in clinics to improve cardiac contractility in acute heart failure patients. In vitro studies have demonstrated that levosimendan increased force-generating capacity of the diaphragm in chronic obstructive pulmonary disease patients. Thus the aim of this study was to evaluate the effects of levosimendan administration in an animal model of ventilator-induced diaphragmatic dysfunction (VIDD) on muscle contraction and diaphragm muscle cell viability., Methods: Sprague-Dawley rats underwent prolonged MV (5 hours). VIDD+Levo group received a starting bolus of levosimendan immediately after intratracheal intubation and then an intravenous infusion of levosimendan throughout the study. Diaphragms were collected for ex vivo contractility measurement (with electric stimulation), histological analysis and Western blot analysis. Healthy rats were used as the control., Results: Levosimendan treatment maintained an adequate mean arterial pressure during the entire experimental protocol, preserved levels of autophagy-related proteins (LC3BI and LC3BII) and the muscular cell diameter demonstrated by histological analysis. Levosimendan did not affect the diaphragmatic contraction or the levels of proteins involved in the protein degradation (atrogin)., Conclusions: Our data suggest that levosimendan preserves muscular cell structure (cross-sectional area) and muscle autophagy after 5 hours of MV in a rat model of VIDD. However, levosimendan did not improve diaphragm contractile efficiency., Competing Interests: Conflict of interest: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023, The Authors.)

Published
2023
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48. Incidence, Risk Factors, and Consequences of Post-Traumatic Stress Disorder Symptoms in Survivors of COVID-19-Related ARDS.

Author

Miori S, Sanna A, Lassola S, Cicolini E, Zanella R, Magnoni S, De Rosa S, Bellani G, and Umbrello M

Subjects
Humans, Quality of Life psychology, Prospective Studies, Incidence, Intensive Care Units, Survivors psychology, Risk Factors, Stress Disorders, Post-Traumatic epidemiology, Stress Disorders, Post-Traumatic etiology, Stress Disorders, Post-Traumatic diagnosis, COVID-19 epidemiology, COVID-19 complications, Respiratory Distress Syndrome epidemiology, Respiratory Distress Syndrome etiology
Abstract

Purpose: To assess the prevalence of symptoms of Post-Traumatic Stress Disorder (PTSD) in survivors of COVID-19 Acute Respiratory Distress Syndrome that needed ICU care; to investigate risk factors and their impact on the Health-Related Quality of life (HR-QoL). Materials and Methods: This multicenter, prospective, observational study included all patients who were discharged from the ICU. Patients were administered the European Quality of Life 5 Dimensions 5 Level Version (EQ-5D-5L) questionnaire, the Short-Form Health Survey 36Version 2 (SF-36v2), a socioeconomic question set and the Impact of Event Scale-Revised (IES-R) to assess PTSD. Results: The multivariate logistic regression model found that an International Standard Classification of Education Score (ISCED) higher than 2 (OR 3.42 (95% CI 1.28-9.85)), monthly income less than EUR 1500 (OR 0.36 (95% CI 0.13-0.97)), and more than two comorbidities (OR 4.62 (95% CI 1.33-16.88)) are risk factors for developing PTSD symptoms. Patients with PTSD symptoms are more likely to present a worsening in their quality of life as assessed by EQ-5D-5L and SF-36 scales. Conclusion: The main factors associated with the development of PTSD-related symptoms were a higher education level, a lower monthly income, and more than two comorbidities. Patients who developed symptoms of PTSD reported a significantly lower Health-Related Quality of life as compared to patients without PTSD. Future research areas should be oriented toward recognizing potential psychosocial and psychopathological variables capable of influencing the quality of life of patients discharged from the intensive care unit to better recognize the prognosis and longtime effects of diseases.

Published
2023
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49. Prognostic Performance of Bedside Lung Ultrasound Score (LUSS) and ROX Index in Hypoxemic Respiratory Failure Due to COVID-19.

Author

Nova A, Rezoagli E, Eronia N, Benini A, Scognamiglio A, Foti G, and Bellani G

Abstract

Background: Noninvasive ventilation, mainly helmet CPAP, was widely used during the COVID-19 pandemic, even outside of intensive care units. Both the ROX index and the LUS score (LUSS) have been proposed as tools to predict negative outcomes in patients with hypoxemia treated with noninvasive ventilation (NIV) outside of ICUs. We aim to evaluate whether the combination of LUSS with the ROX index improves the predictive performance of these indices in patients with hypoxemia due to COVID-19 pneumonia, treated with NIV outside of ICUs. Methods: This is a monocentric prospective observational study conducted at the university teaching hospital Fondazione IRCCS San Gerardo dei Tintori (Monza, Italy) from February to April 2021. LUSS and ROX were collected at the same time in noninvasively ventilated patients outside of the ICU. An LUS exam was performed by 3 emergency medicine attending physicians with at least 5 years' experience in point-of-care ultrasonography using a 12-zone system. To evaluate the accuracy of the prognostic indices in predicting a composite outcome (endotracheal intubation and mortality), ROC curves were used. A logistic multivariable model was used to explore the predictors of the composite outcome of endotracheal intubation and in-hospital mortality. An unadjusted Kaplan-Meier analysis was used to explore the association with the composite outcome of survival without invasive mechanical ventilation at the 30-day follow-up by stratifying the 3 indices by their best cut-offs. Results: A total of 79 patients were included in the statistical analysis and stratified into 2 groups based on the presence of a negative outcome, which was reported in 24 patients out of 79 (30%). A great proportion of patients (66 patients-84%) were treated with helmet CPAP. All three indices (LUSS, ROX and LUSS/ROX) were independently associated with negative outcomes in the multivariable analyses. Although the comparison between the AUROC of LUSS or ROX versus LUSS/ROX did not reveal a statistically significant difference, we observed a trend toward a higher accuracy for predicting negative outcomes using the LUSS/ROX index as compared to using LUSS. With the Kaplan-Maier approach, all three indices stratified by the best cut-off reported a significant association with the outcome of 30-day survival without mechanical ventilation. Conclusions: A multimodal noninvasive approach that combines ultrasound (i.e., LUSS) and a bedside clinical evaluation (i.e., the ROX index) may help clinicians to predict outcomes and to identify patients who would benefit the most from invasive respiratory support.

Published
2023
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50. Editorial: Lung monitoring in respiratory failure.

Author

Rezoagli E, Chen L, and Bellani G

Abstract

Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Published
2023
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