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1. Beneficial Effect of Prone Positioning During Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019*

Author: Zaaqoq, Akram M, Barnett, Adrian G, Griffee, Matthew J, Maclaren, Graeme, Jacobs, Jeffrey P, Heinsar, Silver, Suen, Jacky Y, Bassi, Gianluigi Li, Fraser, John F, Dalton, Heidi J, Peek, Giles J, Brazzi, L, Sales, G, Montrucchio, G, and Russotto, V
Subjects: Adult, Male, Supine position, Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, Clinical Investigations, Critical Care and Intensive Care Medicine, medicine.disease_cause, Patient Positioning, law.invention, coronavirus disease 2019, Extracorporeal Membrane Oxygenation, Randomized controlled trial, law, Hospital discharge, Extracorporeal membrane oxygenation, Medicine, Humans, Hospital Mortality, Coronavirus, Probability, Respiratory Distress Syndrome, business.industry, SARS-CoV-2, Hazard ratio, COVID-19, severe acute respiratory syndrome-related coronavirus, Middle Aged, Patient Discharge, Prone position, Anesthesia, prone position, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Female, business
Abstract: Supplemental Digital Content is available in the text., OBJECTIVES: The study investigated the impact of prone positioning during venovenous extracorporeal membrane oxygenation support for coronavirus disease 2019 acute respiratory failure on the patient outcome. DESIGN: An observational study of venovenous extracorporeal membrane oxygenation patients. We used a multistate survival model to compare the outcomes of patients treated with or without prone positioning during extracorporeal membrane oxygenation, which incorporates the dynamic nature of prone positioning and adjusts for potential confounders. SETTING: Seventy-two international institutions participating in the Coronavirus Disease 2019 Critical Care Consortium international registry. PATIENTS: Coronavirus disease 2019 patients who were supported by venovenous extracorporeal membrane oxygenation during the study period. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: There were 232 coronavirus disease 2019 patients at 72 participating institutions who were supported with venovenous extracorporeal membrane oxygenation during the study period from February 16, 2020, to October 31, 2020. Proning was used in 176 patients (76%) before initiation of extracorporeal membrane oxygenation and in 67 patients (29%) during extracorporeal membrane oxygenation. Survival to hospital discharge was 33% in the extracorporeal membrane oxygenation prone group versus 22% in the extracorporeal membrane oxygenation supine group. Prone positioning during extracorporeal membrane oxygenation support was associated with reduced mortality (hazard ratio, 0.31; 95% CI, 0.14–0.68). CONCLUSIONS: Our study highlights that prone positioning during venovenous extracorporeal membrane oxygenation support for refractory coronavirus disease 2019-related acute respiratory distress syndrome is associated with reduced mortality. Given the observational nature of the study, a randomized controlled trial of prone positioning on venovenous extracorporeal membrane oxygenation is needed to confirm these findings.
Published: 2021

2. Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients From 29 Countries

Author: Russotto V., Myatra S. N., Laffey J. G., Tassistro E., Antolini L., Bauer P., Lascarrou J. B., Szuldrzynski K., Camporota L., Pelosi P., Sorbello M., Higgs A., Greif R., Putensen C., Agvald-Ohman C., Chalkias A., Bokums K., Brewster D., Rossi E., Fumagalli R., Pesenti A., Foti G., Bellani G., Hazem Abdelkarem Ahmed, Neill K J Adhikari, Kehari Agrawal, Nipun Agrawal, Hernan Aguirre-Bermeo, Christina Agvald-Öhman, Meraj Ahmad, Samareh Ajami, Shazia N Akhtar, Adnan Alghamdi, Abdulmueti Alhadi, Syed M Ali, Mohd N Ali, Anita Alias, Ghaleb Almekhlafi, Julio Alonso, Diana Alvarez Montenegro, Rubina Aman, Matthew Anstey, Irene Aragão, Eleni Arnaoutoglou, Elie Azoulay, Laura Baccari, Nishanth Baliga, Ramya Ballekatte Manjunath, Shrirang Bamane, Anna Bandert, Roland Bartholdy, Marta Basto, Vera Baturova, Philippe R Bauer, Agrippino Bellissima, Vladislav Belsky, Prashant Bendre, Annalisa Benini, Sebastien Besset, Mahuya Bhattacharyya, Piotr Bielanski, Luca Bigatello, Florence Boissier, Kristaps Bokums, Elisa Boni, Iwona Bonney, David Bowen, Alexandre Boyer, Luca Brazzi, David Brewster, Lina Broman, Alexander Browne, Cedric Bruel, Yannick Brunin, Guillermo Bugedo, Italo Calamai, Patricia Campos, Federico G Canavosio, Iacopo Cappellini, Marco Cascella, Nuno Catorze, Athanasios Chalkias, Benoit Champigneulle, Juhi Chandwani, Anne Chao, Satish Chaurasia, Rajesh Chawla, Aakanksha Chawla, Olivia Cheetham, Frank Chemouni, Lee Chew Kiok, Jung-Yien Chien, Timothy Chimunda, Ching-Tang Chiu, Fernando Chiumiento, Nai-Kuan Chou, Nicolas Chudeau, Sandra Colica, Gwenhael Colin, Jean-Michel Constantin, Damien Contou, Andrea Cortegiani, Paulo F Costa, Vasco Costa, Andrea Costamagna, Antonella Cotoia, Andrea N Cracchiolo, Petra Crone, Rui P Cunha, Renata Curić Radivojević, Amit Das, Sampat Dash, Gennaro De Pascale, Silvia De Rosa, Lorenzo Del Sorbo, Valentina Della Torre, Barbara Di Caprio, Raffaele Di Fenza, Ida Di Giacinto, Aikaterini Dimitropoulou, Marcel Dudda, Christopher Edmunds, Stefan F Ehrentraut, Nadia El-Fellah, Muhammed Elhadi, Ahmed Elhadi, Patricia Escudero-Acha, Missael Espinoza, Clelia Esposito, Fabrizio Fabretti, Daniel G Fein, Massimo Ferluga, Marco Fernandes, Alexis Ferre, Janet Ferrier, Marek Flaksa, Fernando Flores, Jesus Flores Gonzalez, Xavier E Fonseca Fuentes, Roland Francis, Daniela G Franco, Pawel Franczyk, Jean-Pierre Frat, Mikhail Furman, Maurizio Fusari, Piotr Galkin, Alice Gallo de Moraes, Renato Gammaldi, Maria F García Aguilera, Eugenio Garofalo, Tomasz Gaszynski, Jonathan Gatward, Mohamed Ghula, Angelo Giacomucci, Ilaria Giovannini, Kingsly Gnanadurai, Thomas Godet, Alberto Goffi, Gemma Goma Fernandez, Maria Gonzalez, Daira González, Alejandro González-Castro, Kadarapura N Gopalakrishna, Eric Gottesman, Alexandre Gros, Christophe Guervilly, Christophe Guitton, Manish Gupta, Kulbhusahn Gupta, Tarikul Hamid, Olfa Hamzaoui, Katrin Hannesdottir, Shahnaz Hasan, Mozaffer Hossain, Sazzad Hossein, Sami Hraiech, Chun-Kai Huang, Cameron Hypes, Soad Imhmed Alkhumsi, Motiul Islam, Muhamad A Ismail, Višnja Ivančan, Sophie Jacquier, Bharat Jagiasi, Nikhilesh Jain, Muhamad Fadhil Hadi Jamaluddin, Milosz Jankowski, Deepak Jeswani, Deepti Jeswani, Simant Jha, Laura Jones, Benjamin Jones, Mathieu Jozwiak, Aleksandra Jumić, Oliver Kamp, Ilias Karametos, Alexey Karelov, Panagiotis Katsoulis, David A Kaufman, Shuchi Kaushik, Callum T Kaye, Subba R Kesavarapu, Ala Khaled, Hapiz Khalidah, Akram Khan, Sudhir Khunteta, Detlef Kindgen-Milles, Sara V Korula, Amol Kothekar, Salman S Koul, Ditte Krog, Shih-Chi Ku, Mira Kuellmar, Lu-Cheng Kuo, Swarna D Kuragayala, Aikaterini Kyparissi, Gonzalo Labarca, John G Laffey, Jaya Lalwani, Antonio Landaverde, Jean-Baptiste Lascarrou, Andres Laserna, Chien-Chang Lee, Stephane Legriel, Andrew Lehr, Tiago Leonor, Yongxing Li, Anna Lisa Licciardi, Edward Litton, Vladimir Lomivorotov, Federico Longhini, Claudia L Lopez Nava, Luis R Loza Gallardo, Ramona Lungu, Annalisa Luzi, Wuhua Ma, Marat Magomedov, Alexandros Makris, Harish Mallapura Maheshwarappa, Tommaso Maraffi, Maria E Marcelli, Karim Mariano, Nathalie Marin, Nadezhda Marova, Maelle Martin, Mayra Martinez Gonzalez, Emilio Maseda, Fiore Mastroianni, Marijana Matas, Dubier Matos, Jessica G Maugeri, Mohd Z Mazlan, Melanie Meersch, Ranjan Meher, Tasneem H Mehesry, Maria Meirik, Armand Mekontso Dessap, Kwabena Mensah, Emmanuelle Mercier, Pavel Michalek, Abhirup Midya, Slobodan Mihaljević, Adrien Mirouse, Prasanna Mishra, Ravi Mistry, Mate Moguš, Norbaniza Mohd Nordin, Noryani Mohd Samat, Luca Montini, Giorgia Montrucchio, Valeria Moro, Diego Morocho Tutillo, Jarrod Mosier, Sircar Mrinal, Wojciech Mudyna, Grégoire Muller, Kartik Munta, Satheesh Munusamy, Stefania Musso, Stefano Muttini, Ismail Nahla Irtiza, Evi Nakou, Amit Narkhede, Joseph Nates, Moana R Nespoli, Francesca Nespoli, Artem Nikitenko, Carla Nogueira, Ross O'Grady, Yewande E Odeyemi, Annika Ohlsson, Alberto Orsello, Vijayanand Palaniswamy, Daniela M Palma, Salvatore Palmese, Jesus N Pantoja Leal, Eleni Papandreou, Metaxia Papanikolaou, Matteo Parotto, Mayur Patel, Mario Pavlek, Niccolò Pedrotti, Ngu Pei Hwa, Lorella Pelagalli, Miryam Pérez Ruiz, Elin Persson, Athanasia Petsiou, Angelo Pezzi, Sam Philip, Francois Philippard, Mariusz Piegat, Sébastien Pili-Floury, Riccardo Pinciroli, Marcia Pinto, Gael Piton, Gaetan Plantefeve, Caroline Pouplet, Sofia Pouriki, Andrea Pradella, Kumar Prashant, Christian Putensen, Alice Quayle, Lua Rahmani, Ian Randall, Banambar Ray, Adrian Regli, Syed T Reza, Jean Damien Ricard, Ivano Riva, Oriol Roca, Roberto Rona, Jon Rosell, Rebecca Rowley, Sheng-Yuan Ruan, Kay Rumschuessel, Annalisa Rundo, Pierpaolo Russo, Vincenzo Russotto, Samir Sahu, Gabriele Sales, Charlotte Salmon-Gandonnière, Nandyelly San Juan Roman, Luis Sánchez-Hurtado, Benjamin J Sandefur, Manel Santafe, Lida Santoro, Rhik Sanyal, Lakshmikanthcharan Saravanabavan, Bhagyesh Shah, Mehul Shah, Ming-Hann Shin, Monica Silva, Shannon Simpson, Ayush Sinah, Atul K Singh, Dinesh K Singh, Nitesh Singh, Lalit Singh, Lukasz Skowronski, Miguel A Sosa, Savino Spadaro, Martin Spangfors, Jesper Sperber, Rosario Spina, Anand Srivastava, Andrew Steel, Alejandro Suarez de la Rica, Singh Sujeet Kumar, Omprakash Sundrani, Nilu Sunil, Bharadwaj Suparna, Manimala R Surath, Yadullah Syed, Tamas Szakmany, Benjamin Sztrymf, Alexis Tabah, Stefano Tarantino, Maria Tileli, Hugo Tirape-Castro, Otoniel Toledo-Salinas, Jacopo Tramarin, Dimitrios Tsiftsis, Iva Tucić, Jose A Tutillo León, Lorenzo Tutino, Vijay N Tyagi, Kyriaki Vagdatli, Sneha Varkey, Maria M Vera, Magnus Von Seth, Carl Wahlstrom, Wan Mohd N Wan Hassan, Wan N Wan Ismail, Kuo-Chuan Wang, Hadrien Winiszewski, Jiayan Wu, Lun Wu, Yu-Chang Yeh, Paul Young, Gianluca Zani, Jonathan Zarka, Dawn Zhao, Diane Zlotnik, Russotto, V, Myatra, S, Laffey, J, Tassistro, E, Antolini, L, Bauer, P, Lascarrou, J, Szuldrzynski, K, Camporota, L, Pelosi, P, Sorbello, M, Higgs, A, Greif, R, Putensen, C, Agvald-Öhman, C, Chalkias, A, Bokums, K, Brewster, D, Rossi, E, Fumagalli, R, Pesenti, A, Foti, G, Bellani, G, Russotto V., Myatra S.N., Laffey J.G., Tassistro E., Antolini L., Bauer P., Lascarrou J.B., Szuldrzynski K., Camporota L., Pelosi P., Sorbello M., Higgs A., Greif R., Putensen C., Agvald-Ohman C., Chalkias A., Bokums K., Brewster D., Rossi E., Fumagalli R., Pesenti A., Foti G., Bellani G., and Hazem Abdelkarem Ahmed, Neill K J Adhikari, Kehari Agrawal, Nipun Agrawal, Hernan Aguirre-Bermeo, Christina Agvald-Öhman, Meraj Ahmad, Samareh Ajami, Shazia N Akhtar, Adnan Alghamdi, Abdulmueti Alhadi, Syed M Ali, Mohd N Ali, Anita Alias, Ghaleb Almekhlafi, Julio Alonso, Diana Alvarez Montenegro, Rubina Aman, Matthew Anstey, Irene Aragão, Eleni Arnaoutoglou, Elie Azoulay, Laura Baccari, Nishanth Baliga, Ramya Ballekatte Manjunath, Shrirang Bamane, Anna Bandert, Roland Bartholdy, Marta Basto, Vera Baturova, Philippe R Bauer, Agrippino Bellissima, Vladislav Belsky, Prashant Bendre, Annalisa Benini, Sebastien Besset, Mahuya Bhattacharyya, Piotr Bielanski, Luca Bigatello, Florence Boissier, Kristaps Bokums, Elisa Boni, Iwona Bonney, David Bowen, Alexandre Boyer, Luca Brazzi, David Brewster, Lina Broman, Alexander Browne, Cedric Bruel, Yannick Brunin, Guillermo Bugedo, Italo Calamai, Patricia Campos, Federico G Canavosio, Iacopo Cappellini, Marco Cascella, Nuno Catorze, Athanasios Chalkias, Benoit Champigneulle, Juhi Chandwani, Anne Chao, Satish Chaurasia, Rajesh Chawla, Aakanksha Chawla, Olivia Cheetham, Frank Chemouni, Lee Chew Kiok, Jung-Yien Chien, Timothy Chimunda, Ching-Tang Chiu, Fernando Chiumiento, Nai-Kuan Chou, Nicolas Chudeau, Sandra Colica, Gwenhael Colin, Jean-Michel Constantin, Damien Contou, Andrea Cortegiani, Paulo F Costa, Vasco Costa, Andrea Costamagna, Antonella Cotoia, Andrea N Cracchiolo, Petra Crone, Rui P Cunha, Renata Curić Radivojević, Amit Das, Sampat Dash, Gennaro De Pascale, Silvia De Rosa, Lorenzo Del Sorbo, Valentina Della Torre, Barbara Di Caprio, Raffaele Di Fenza, Ida Di Giacinto, Aikaterini Dimitropoulou, Marcel Dudda, Christopher Edmunds, Stefan F Ehrentraut, Nadia El-Fellah, Muhammed Elhadi, Ahmed Elhadi, Patricia Escudero-Acha, Missael Espinoza, Clelia Esposito, Fabrizio Fabretti, Daniel G Fein, Massimo Ferluga, Marco Fernandes, Alexis Ferre, Janet Ferrier, Marek Flaksa, Fernando Flores, Jesus Flores Gonzalez, Xavier E Fonseca Fuentes, Roland Francis, Daniela G Franco, Pawel Franczyk, Jean-Pierre Frat, Mikhail Furman, Maurizio Fusari, Piotr Galkin, Alice Gallo de Moraes, Renato Gammaldi, Maria F García Aguilera, Eugenio Garofalo, Tomasz Gaszynski, Jonathan Gatward, Mohamed Ghula, Angelo Giacomucci, Ilaria Giovannini, Kingsly Gnanadurai, Thomas Godet, Alberto Goffi, Gemma Goma Fernandez, Maria Gonzalez, Daira González, Alejandro González-Castro, Kadarapura N Gopalakrishna, Eric Gottesman, Alexandre Gros, Christophe Guervilly, Christophe Guitton, Manish Gupta, Kulbhusahn Gupta, Tarikul Hamid, Olfa Hamzaoui, Katrin Hannesdottir, Shahnaz Hasan, Mozaffer Hossain, Sazzad Hossein, Sami Hraiech, Chun-Kai Huang, Cameron Hypes, Soad Imhmed Alkhumsi, Motiul Islam, Muhamad A Ismail, Višnja Ivančan, Sophie Jacquier, Bharat Jagiasi, Nikhilesh Jain, Muhamad Fadhil Hadi Jamaluddin, Milosz Jankowski, Deepak Jeswani, Deepti Jeswani, Simant Jha, Laura Jones, Benjamin Jones, Mathieu Jozwiak, Aleksandra Jumić, Oliver Kamp, Ilias Karametos, Alexey Karelov, Panagiotis Katsoulis, David A Kaufman, Shuchi Kaushik, Callum T Kaye, Subba R Kesavarapu, Ala Khaled, Hapiz Khalidah, Akram Khan, Sudhir Khunteta, Detlef Kindgen-Milles, Sara V Korula, Amol Kothekar, Salman S Koul, Ditte Krog, Shih-Chi Ku, Mira Kuellmar, Lu-Cheng Kuo, Swarna D Kuragayala, Aikaterini Kyparissi, Gonzalo Labarca, John G Laffey, Jaya Lalwani, Antonio Landaverde, Jean-Baptiste Lascarrou, Andres Laserna, Chien-Chang Lee, Stephane Legriel, Andrew Lehr, Tiago Leonor, Yongxing Li, Anna Lisa Licciardi, Edward Litton, Vladimir Lomivorotov, Federico Longhini, Claudia L Lopez Nava, Luis R Loza Gallardo, Ramona Lungu, Annalisa Luzi, Wuhua Ma, Marat Magomedov, Alexandros Makris, Harish Mallapura Maheshwarappa, Tommaso Maraffi, Maria E Marcelli, Karim Mariano, Nathalie Marin, Nadezhda Marova, Maelle Martin, Mayra Martinez Gonzalez, Emilio Maseda, Fiore Mastroianni, Marijana Matas, Dubier Matos, Jessica G Maugeri, Mohd Z Mazlan, Melanie Meersch, Ranjan Meher, Tasneem H Mehesry, Maria Meirik, Armand Mekontso Dessap, Kwabena Mensah, Emmanuelle Mercier, Pavel Michalek, Abhirup Midya, Slobodan Mihaljević, Adrien Mirouse, Prasanna Mishra, Ravi Mistry, Mate Moguš, Norbaniza Mohd Nordin, Noryani Mohd Samat, Luca Montini, Giorgia Montrucchio, Valeria Moro, Diego Morocho Tutillo, Jarrod Mosier, Sircar Mrinal, Wojciech Mudyna, Grégoire Muller, Kartik Munta, Satheesh Munusamy, Stefania Musso, Stefano Muttini, Ismail Nahla Irtiza, Evi Nakou, Amit Narkhede, Joseph Nates, Moana R Nespoli, Francesca Nespoli, Artem Nikitenko, Carla Nogueira, Ross O'Grady, Yewande E Odeyemi, Annika Ohlsson, Alberto Orsello, Vijayanand Palaniswamy, Daniela M Palma, Salvatore Palmese, Jesus N Pantoja Leal, Eleni Papandreou, Metaxia Papanikolaou, Matteo Parotto, Mayur Patel, Mario Pavlek, Niccolò Pedrotti, Ngu Pei Hwa, Lorella Pelagalli, Miryam Pérez Ruiz, Elin Persson, Athanasia Petsiou, Angelo Pezzi, Sam Philip, Francois Philippard, Mariusz Piegat, Sébastien Pili-Floury, Riccardo Pinciroli, Marcia Pinto, Gael Piton, Gaetan Plantefeve, Caroline Pouplet, Sofia Pouriki, Andrea Pradella, Kumar Prashant, Christian Putensen, Alice Quayle, Lua Rahmani, Ian Randall, Banambar Ray, Adrian Regli, Syed T Reza, Jean Damien Ricard, Ivano Riva, Oriol Roca, Roberto Rona, Jon Rosell, Rebecca Rowley, Sheng-Yuan Ruan, Kay Rumschuessel, Annalisa Rundo, Pierpaolo Russo, Vincenzo Russotto, Samir Sahu, Gabriele Sales, Charlotte Salmon-Gandonnière, Nandyelly San Juan Roman, Luis Sánchez-Hurtado, Benjamin J Sandefur, Manel Santafe, Lida Santoro, Rhik Sanyal, Lakshmikanthcharan Saravanabavan, Bhagyesh Shah, Mehul Shah, Ming-Hann Shin, Monica Silva, Shannon Simpson, Ayush Sinah, Atul K Singh, Dinesh K Singh, Nitesh Singh, Lalit Singh, Lukasz Skowronski, Miguel A Sosa, Savino Spadaro, Martin Spangfors, Jesper Sperber, Rosario Spina, Anand Srivastava, Andrew Steel, Alejandro Suarez de la Rica, Singh Sujeet Kumar, Omprakash Sundrani, Nilu Sunil, Bharadwaj Suparna, Manimala R Surath, Yadullah Syed, Tamas Szakmany, Benjamin Sztrymf, Alexis Tabah, Stefano Tarantino, Maria Tileli, Hugo Tirape-Castro, Otoniel Toledo-Salinas, Jacopo Tramarin, Dimitrios Tsiftsis, Iva Tucić, Jose A Tutillo León, Lorenzo Tutino, Vijay N Tyagi, Kyriaki Vagdatli, Sneha Varkey, Maria M Vera, Magnus Von Seth, Carl Wahlstrom, Wan Mohd N Wan Hassan, Wan N Wan Ismail, Kuo-Chuan Wang, Hadrien Winiszewski, Jiayan Wu, Lun Wu, Yu-Chang Yeh, Paul Young, Gianluca Zani, Jonathan Zarka, Dawn Zhao, Diane Zlotnik
Subjects: Male, medicine.medical_specialty, Critical Illness, medicine.medical_treatment, Aged, Female, Heart Arrest, Humans, Hypotension, Hypoxia, Intensive Care Units, Intubation, Intratracheal, Logistic Models, Medical Errors, Middle Aged, Prospective Studies, Respiration, Artificial, Respiratory Insufficiency, Vasoconstrictor Agents, 01 natural sciences, NO, tracheal intubation, adverse peri-intubation events, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Intensive care, Settore MED/41 - ANESTESIOLOGIA, Medicine, Intubation, Intubation, Critical Care, 030212 general & internal medicine, 0101 mathematics, 610 Medicine & health, Prospective cohort study, business.industry, Respiration, 010102 general mathematics, Tracheal intubation, General Medicine, Intratracheal, Intubation procedure, Respiratory failure, Artificial, Emergency medicine, Airway management, business
Abstract: Importance: Tracheal intubation is one of the most commonly performed and high-risk interventions in critically ill patients. Limited information is available on adverse peri-intubation events. Objective: To evaluate the incidence and nature of adverse peri-intubation events and to assess current practice of intubation in critically ill patients. Design, Setting, and Participants: The International Observational Study to Understand the Impact and Best Practices of Airway Management in Critically Ill Patients (INTUBE) study was an international, multicenter, prospective cohort study involving consecutive critically ill patients undergoing tracheal intubation in the intensive care units (ICUs), emergency departments, and wards, from October 1, 2018, to July 31, 2019 (August 28, 2019, was the final follow-up) in a convenience sample of 197 sites from 29 countries across 5 continents. Exposures: Tracheal intubation. Main Outcomes and Measures: The primary outcome was the incidence of major adverse peri-intubation events defined as at least 1 of the following events occurring within 30 minutes from the start of the intubation procedure: cardiovascular instability (either: systolic pressure 30 minutes, new or increase need of vasopressors or fluid bolus >15 mL/kg), severe hypoxemia (peripheral oxygen saturation
Published: 2021

3. The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients – a posthoc propensity score–weighted cohort analysis of the LAS VEGAS study

Author: Mazzinari, G., Serpa Neto, A., Hemmes, S. N. T., Hedenstierna, G., Jaber, S., Hiesmayr, M., Hollmann, M. W., Mills, G. H., Vidal Melo, M. F., Pearse, R. M., Putensen, C., Schmid, W., Severgnini, P., Wrigge, H., Cambronero, O. D., Ball, L., de Abreu, M. G., Pelosi, P., Schultz, M. J., Kroell, W., Metzler, H., Struber, G., Wegscheider, T., Gombotz, H., Urbanek, B., Kahn, D., Momeni, M., Pospiech, A., Lois, F., Forget, P., Grosu, I., Poelaert, J., van Mossevelde, V., van Malderen, M. -C., Dylst, D., van Melkebeek, J., Beran, M., de Hert, S., De Baerdemaeker, L., Heyse, B., Van Limmen, J., Wyffels, P., Jacobs, T., Roels, N., De Bruyne, A., van de Velde, S., Leva, B., Damster, S., Plichon, B., Juros-Zovko, M., Djonovic-Omanovic, D., Pernar, S., Zunic, J., Miskovic, P., Zilic, A., Kvolik, S., Ivic, D., Azenic-Venzera, D., Skiljic, S., Vinkovic, H., Oputric, I., Juricic, K., Frkovic, V., Kopic, J., Mirkovic, I., Karanovic, N., Carev, M., Dropulic, N., Saric, J. P., Erceg, G., Dvorscak, M. B., Mazul-Sunko, B., Pavicic, A. M., Goranovic, T., Maldini, B., Radocaj, T., Gavranovic, Z., Mladic-Batinica, I., Sehovic, M., Stourac, P., Harazim, H., Smekalova, O., Kosinova, M., Kolacek, T., Hudacek, K., Drab, M., Brujevic, J., Vitkova, K., Jirmanova, K., Volfova, I., Dzurnakova, P., Liskova, K., Dudas, R., Filipsky, R., el Kafrawy, S., Abdelwahab, H. H., Metwally, T., Abdel-Razek, A., El-Shaarawy, A. M., Hasan, W. F., Ahmed, A. G., Yassin, H., Magdy, M., Abdelhady, M., Mahran, M., Herodes, E., Kivik, P., Oganjan, J., Aun, A., Sormus, A., Sarapuu, K., Mall, M., Karjagin, J., Futier, E., Petit, A., Gerard, A., Marret, E., Solier, M., Prades, A., Krassler, J., Merzky, S., Uhlig, C., Kiss, T., Bundy, A., Bluth, T., Gueldner, A., Spieth, P., Scharffenberg, M., Thiem, D. T., Koch, T., Treschan, T., Schaefer, M., Bastin, B., Geib, J., Weiss, M., Kienbaum, P., Pannen, B., Gottschalk, A., Konrad, M., Westerheide, D., Schwerdtfeger, B., Simon, P., Reske, A., Nestler, C., Valsamidis, D., Stroumpoulis, K., Antholopoulos, G., Andreou, A., Karapanos, D., Theodoraki, K., Gkiokas, G., Tasoulis, M. -K., Sidiropoulou, T., Zafeiropoulou, F., Florou, P., Pandazi, A., Tsaousi, G., Nouris, C., Pourzitaki, C., Bystritski, D., Pizov, R., Eden, A., Pesce, C. V., Campanile, A., Marrella, A., Grasso, S., De Michele, M., Bona, F., Giacoletto, G., Sardo, E., Giancarlo, L., Sottosanti, V., Solca, M., Volta, C. A., Spadaro, S., Verri, M., Ragazzi, R., Zoppellari, R., Cinnella, G., Raimondo, P., La Bella, D., Mirabella, L., D'Antini, D., Molin, A., Brunetti, I., Gratarola, A., Pellerano, G., Sileo, R., Pezzatto, S., Montagnani, L., Pasin, L., Landoni, G., Zangrillo, A., Beretta, L., Di Parma, A. L., Tarzia, V., Dossi, R., Sassone, M. E., Sances, D., Tredici, S., Spano, G., Castellani, G., Delunas, L., Peradze, S., Venturino, M., Arpino, I., Sher, S., Tommasino, C., Rapido, F., Morelli, P., Vargas, M., Servillo, G., Cortegiani, A., Raineri, S. M., Montalto, F., Russotto, V., Giarratano, A., Baciarello, M., Generali, M., Cerati, G., Leykin, Y., Bressan, F., Bartolini, V., Zamidei, L., Brazzi, L., Liperi, C., Sales, G., Pistidda, L., Brugnoni, E., Musella, G., Bacuzzi, A., Muhardri, D., Gecaj-Gashi, A., Sada, F., Bytyqi, A., Karbonskiene, A., Aukstakalniene, R., Teberaite, Z., Salciute, E., Tikuisis, R., Miliauskas, P., Jurate, S., Kontrimaviciute, E., Tomkute, G., Xuereb, J., Bezzina, M., Borg, F. J., Hemmes, S., Schultz, M., Hollmann, M., Wiersma, I., Binnekade, J., Bos, L., Boer, C., Duvekot, A., in 't Veld, B., Werger, A., Dennesen, P., Severijns, C., De Jong, J., Hering, J., van Beek, R., Ivars, S., Jammer, I., Breidablik, A., Hodt, K. S., Fjellanger, F., Avalos, M. V., Mellin-Olsen, J., Andersson, E., Shafi-Kabiri, A., Molina, R., Wutai, S., Morais, E., Tareco, G., Ferreira, D., Amaral, J., de Lurdes Goncalves Castro, M., Cadilha, S., Appleton, S., Parente, S., Correia, M., Martins, D., Monteirosa, A., Ricardo, A., Rodrigues, S., Horhota, L., Grintescu, I. M., Mirea, L., Grintescu, I. C., Corneci, D., Negoita, S., Dutu, M., Garotescu, I. P., Filipescu, D., Prodan, A. B., Droc, G., Fota, R., Popescu, M., Tomescu, D., Petcu, A. M., Tudoroiu, M. I., Moise, A., Guran, C. -T., Gherghina, I., Costea, D., Cindea, I., Copotoiu, S. -M., Copotoiu, R., Barsan, V., Tolcser, Z., Riciu, M., Moldovan, S. G., Veres, M., Gritsan, A., Kapkan, T., Gritsan, G., Korolkov, O., Kulikov, A., Lubnin, A., Ovezov, A., Prokoshev, P., Lugovoy, A., Anipchenko, N., Babayants, A., Komissarova, I., Zalina, K., Likhvantsev, V., Fedorov, S., Lazukic, A., Pejakovic, J., Mihajlovic, D., Kusnierikova, Z., Zelinkova, M., Bruncakova, K., Polakovicova, L., Sobona, V., Novak-Supe, B., Pekle-Golez, A., Jovanov, M., Strazisar, B., Markovic-Bozic, J., Novak-Jankovic, V., Voje, M., Grynyuk, A., Kostadinov, I., Spindler-Vesel, A., Moral, V., Unzueta, M. C., Puigbo, C., Fava, J., Canet, J., Moret, E., Rodriguez Nunez, M., Sendra, M., Brunelli, A., Rodenas, F., Monedero, P., Martinez, F. H., Temino, M. J. Y., Martinez Simon, A., de Abajo Larriba, A., Lisi, A., Perez, G., Martinez, R., Granell, M., Vivo, J. T., Ruiz, C. S., de Andres Ibanez, J. A., Pastor, E., Soro, M., Ferrando, C., Defez, M., Alvares-Santullano, C. A., Perez, R., Rico, J., Jawad, M., Saeed, Y., Gillberg, L., Bengisun, Z. K., Kazbek, B. 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M., Mazur, A., Vorotyntsev, S., Rousseau, G., Barrett, C., Stancombe, L., Shelley, B., Scholes, H., Limb, J., Rafi, A., Wayman, L., Deane, J., Rogerson, D., Williams, J., Yates, S., Rogers, E., Pulletz, M., Moreton, S., Jones, S., Venkatesh, S., Burton, M., Brown, L., Goodall, C., Rucklidge, M., Fuller, D., Nadolski, M., Kusre, S., Lundberg, M., Everett, L., Nutt, H., Zuleika, M., Carvalho, P., Clements, D., Creagh-Brown, B., Watt, P., Raymode, P., Pearse, R., Mohr, O., Raj, A., Creary, T., Chishti, A., Bell, A., Higham, C., Cain, A., Gibb, S., Mowat, S., Franklin, D., West, C., Minto, G., Boyd, N., Mills, G., Calton, E., Walker, R., Mackenzie, F., Ellison, B., Roberts, H., Chikungwa, M., Jackson, C., Donovan, A., Foot, J., Homan, E., Montgomery, J., Portch, D., Mercer, P., Palmer, J., Paddle, J., Fouracres, A., Datson, A., Andrew, A., Welch, L., Rose, A., Varma, S., Simeson, K., Rambhatla, M., Susarla, J., Marri, S., Kodaganallur, K., Das, A., Algarsamy, S., Colley, J., Davies, S., Szewczyk, M., Smith, T., Fernandez-Bustamante, A., Luzier, E., Almagro, A., Melo, M. V., Fernando, L., Sulemanji, D., Sprung, J., Weingarten, T., Kor, D., Scavonetto, F., Tze, Y., Mazzinari G., Serpa Neto A., Hemmes S.N.T., Hedenstierna G., Jaber S., Hiesmayr M., Hollmann M.W., Mills G.H., Vidal Melo M.F., Pearse R.M., Putensen C., Schmid W., Severgnini P., Wrigge H., Cambronero O.D., Ball L., de Abreu M.G., Pelosi P., Schultz M.J., Kroell W., Metzler H., Struber G., Wegscheider T., Gombotz H., Urbanek B., Kahn D., Momeni M., Pospiech A., Lois F., Forget P., Grosu I., Poelaert J., van Mossevelde V., van Malderen M.-C., Dylst D., van Melkebeek J., Beran M., de Hert S., De Baerdemaeker L., Heyse B., Van Limmen J., Wyffels P., Jacobs T., Roels N., De Bruyne A., van de Velde S., Leva B., Damster S., Plichon B., Juros-Zovko M., Djonovic-Omanovic D., Pernar S., Zunic J., Miskovic P., Zilic A., Kvolik S., Ivic D., Azenic-Venzera D., Skiljic S., Vinkovic H., Oputric I., Juricic K., Frkovic V., Kopic J., Mirkovic I., Karanovic N., Carev M., Dropulic N., Saric J.P., Erceg G., Dvorscak M.B., Mazul-Sunko B., Pavicic A.M., Goranovic T., Maldini B., Radocaj T., Gavranovic Z., Mladic-Batinica I., Sehovic M., Stourac P., Harazim H., Smekalova O., Kosinova M., Kolacek T., Hudacek K., Drab M., Brujevic J., Vitkova K., Jirmanova K., Volfova I., Dzurnakova P., Liskova K., Dudas R., Filipsky R., el Kafrawy S., Abdelwahab H.H., Metwally T., Abdel-Razek A., El-Shaarawy A.M., Hasan W.F., Ahmed A.G., Yassin H., Magdy M., Abdelhady M., Mahran M., Herodes E., Kivik P., Oganjan J., Aun A., Sormus A., Sarapuu K., Mall M., Karjagin J., Futier E., Petit A., Gerard A., Marret E., Solier M., Prades A., Krassler J., Merzky S., Uhlig C., Kiss T., Bundy A., Bluth T., Gueldner A., Spieth P., Scharffenberg M., Thiem D.T., Koch T., Treschan T., Schaefer M., Bastin B., Geib J., Weiss M., Kienbaum P., Pannen B., Gottschalk A., Konrad M., Westerheide D., Schwerdtfeger B., Simon P., Reske A., Nestler C., Valsamidis D., Stroumpoulis K., Antholopoulos G., Andreou A., Karapanos D., Theodoraki K., Gkiokas G., Tasoulis M.-K., Sidiropoulou T., Zafeiropoulou F., Florou P., Pandazi A., Tsaousi G., Nouris C., Pourzitaki C., Bystritski D., Pizov R., Eden A., Pesce C.V., Campanile A., Marrella A., Grasso S., De Michele M., Bona F., Giacoletto G., Sardo E., Giancarlo L., Sottosanti V., Solca M., Volta C.A., Spadaro S., Verri M., Ragazzi R., Zoppellari R., Cinnella G., Raimondo P., La Bella D., Mirabella L., D'antini D., Molin A., Brunetti I., Gratarola A., Pellerano G., Sileo R., Pezzatto S., Montagnani L., Pasin L., Landoni G., Zangrillo A., Beretta L., Di Parma A.L., Tarzia V., Dossi R., Sassone M.E., Sances D., Tredici S., Spano G., Castellani G., Delunas L., Peradze S., Venturino M., Arpino I., Sher S., Tommasino C., Rapido F., Morelli P., Vargas M., Servillo G., Cortegiani A., Raineri S.M., Montalto F., Russotto V., Giarratano A., Baciarello M., Generali M., Cerati G., Leykin Y., Bressan F., Bartolini V., Zamidei L., Brazzi L., Liperi C., Sales G., Pistidda L., Brugnoni E., Musella G., Bacuzzi A., Muhardri D., Gecaj-Gashi A., Sada F., Bytyqi A., Karbonskiene A., Aukstakalniene R., Teberaite Z., Salciute E., Tikuisis R., Miliauskas P., Jurate S., Kontrimaviciute E., Tomkute G., Xuereb J., Bezzina M., Borg F.J., Hemmes S., Hollmann M., Wiersma I., Binnekade J., Bos L., Boer C., Duvekot A., in 't Veld B., Werger A., Dennesen P., Severijns C., De Jong J., Hering J., van Beek R., Ivars S., Jammer I., Breidablik A., Hodt K.S., Fjellanger F., Avalos M.V., Mellin-Olsen J., Andersson E., Shafi-Kabiri A., Molina R., Wutai S., Morais E., Tareco G., Ferreira D., Amaral J., de Lurdes Goncalves Castro M., Cadilha S., Appleton S., Parente S., Correia M., Martins D., Monteirosa A., Ricardo A., Rodrigues S., Horhota L., Grintescu I.M., Mirea L., Grintescu I.C., Corneci D., Negoita S., Dutu M., Garotescu I.P., Filipescu D., Prodan A.B., Droc G., Fota R., Popescu M., Tomescu D., Petcu A.M., Tudoroiu M.I., Moise A., Guran C.-T., Gherghina I., Costea D., Cindea I., Copotoiu S.-M., Copotoiu R., Barsan V., Tolcser Z., Riciu M., Moldovan S.G., Veres M., Gritsan A., Kapkan T., Gritsan G., Korolkov O., Kulikov A., Lubnin A., Ovezov A., Prokoshev P., Lugovoy A., Anipchenko N., Babayants A., Komissarova I., Zalina K., Likhvantsev V., Fedorov S., Lazukic A., Pejakovic J., Mihajlovic D., Kusnierikova Z., Zelinkova M., Bruncakova K., Polakovicova L., Sobona V., Novak-Supe B., Pekle-Golez A., Jovanov M., Strazisar B., Markovic-Bozic J., Novak-Jankovic V., Voje M., Grynyuk A., Kostadinov I., Spindler-Vesel A., Moral V., Unzueta M.C., Puigbo C., Fava J., Canet J., Moret E., Rodriguez Nunez M., Sendra M., Brunelli A., Rodenas F., Monedero P., Martinez F.H., Temino M.J.Y., Martinez Simon A., de Abajo Larriba A., Lisi A., Perez G., Martinez R., Granell M., Vivo J.T., Ruiz C.S., de Andres Ibanez J.A., Pastor E., Soro M., Ferrando C., Defez M., Alvares-Santullano C.A., Perez R., Rico J., Jawad M., Saeed Y., Gillberg L., Bengisun Z.K., Kazbek B.K., Coskunfirat N., Boztug N., Sanli S., Yilmaz M., Hadimioglu N., Senturk N.M., Camci E., Kucukgoncu S., Sungur Z., Sivrikoz N., Ozgen S.U., Toraman F., Selvi O., Senturk O., Yildiz M., Kuvaki B., Gunenc F., Kucukguclu S., Ozbilgin S., Maral J., Canli S., Arun O., Saltali A., Aydogan E., Akgun F.N., Sanlikarip C., Karaman F.M., Mazur A., Vorotyntsev S., Rousseau G., Barrett C., Stancombe L., Shelley B., Scholes H., Limb J., Rafi A., Wayman L., Deane J., Rogerson D., Williams J., Yates S., Rogers E., Pulletz M., Moreton S., Jones S., Venkatesh S., Burton M., Brown L., Goodall C., Rucklidge M., Fuller D., Nadolski M., Kusre S., Lundberg M., Everett L., Nutt H., Zuleika M., Carvalho P., Clements D., Creagh-Brown B., Watt P., Raymode P., Pearse R., Mohr O., Raj A., Creary T., Chishti A., Bell A., Higham C., Cain A., Gibb S., Mowat S., Franklin D., West C., Minto G., Boyd N., Mills G., Calton E., Walker R., Mackenzie F., Ellison B., Roberts H., Chikungwa M., Jackson C., Donovan A., Foot J., Homan E., Montgomery J., Portch D., Mercer P., Palmer J., Paddle J., Fouracres A., Datson A., Andrew A., Welch L., Rose A., Varma S., Simeson K., Rambhatla M., Susarla J., Marri S., Kodaganallur K., Das A., Algarsamy S., Colley J., Davies S., Szewczyk M., Smith T., Fernandez-Bustamante A., Luzier E., Almagro A., Melo M.V., Fernando L., Sulemanji D., Sprung J., Weingarten T., Kor D., Scavonetto F., Tze Y., Anesthesiology research group, Supporting clinical sciences, Anesthesiology, Guido, Mazzinari, Ary Serpa, Neto, Sabrine N, T Hemme, Goran, Hedenstierna, Samir, Jaber, Michael, Hiesmayr, Markus, W Hollmann, Gary, H Mill, Marcos, F Vidal Melo, Rupert, M Pearse, Christian, Putensen, Werner, Schmid, Paolo, Severgnini, Hermann, Wrigge, Oscar Diaz, Cambronero, Lorenzo, Ball, Marcelo Gama de, Abreu, Paolo, Pelosi, Marcus, J Schultz (LAS VEGAS study–investigator, PROtective VEntilation, Network, Clinical Trial Network of the European Society of, Anaesthesiology), Zangrillo, A, Landoni, G, Beretta, L, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Pulmonary medicine, IOO, ACS - Microcirculation, ACS - Heart failure & arrhythmias, ACS - Diabetes & metabolism, study–investigators, LAS VEGAS, NETwork, PROtective VEntilation, Anaesthesiology, Clinical Trial Network of the European Society of, Mazzinari, Guido, Serpa Neto, Ary, Hemmes, Sabrine N T, Hedenstierna, Goran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W, Mills, Gary H, Vidal Melo, Marcos F, Pearse, Rupert M, Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, Cambronero, Oscar Diaz, Ball, Lorenzo, de Abreu, Marcelo Gama, Pelosi, Paolo, Schultz, Marcus, J, Servillo, G, Vargas, M, Intensive Care Medicine, APH - Quality of Care, ACS - Pulmonary hypertension & thrombosis, Pulmonology, and APH - Global Health
Subjects: Driving pressure, Laparoscopic surgery, Laparoscopy, PEEP, Perioperative ventilation, Pneumoperitoneum, Protective ventilation, Respiratory mechanics, Lung Diseases, Male, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Cohort Studies, Positive-Pressure Respiration, Postoperative Complications, 0302 clinical medicine, 030202 anesthesiology, Abdomen, Clinical endpoint, Middle Aged, 3. Good health, Driving pressure, Laparoscopic surgery, Laparoscopy, PEEP, Perioperative ventilation, Pneumoperitoneum, Protective ventilation, Respiratory mechanics, Female, Research Article, Cohort study, Adult, medicine.medical_specialty, Anestesi och intensivvård, Anesthesia, General, NO, lcsh:RD78.3-87.3, 03 medical and health sciences, medicine, Humans, Propensity Score, Adverse effect, Aged, Retrospective Studies, Anesthesiology and Intensive Care, business.industry, Kirurgi, 030208 emergency & critical care medicine, Odds ratio, medicine.disease, Respiration, Artificial, Surgery, Anesthesiology and Pain Medicine, lcsh:Anesthesiology, Relative risk, business, Abdominal surgery
Abstract: Background It is uncertain whether the association of the intraoperative driving pressure (ΔP) with postoperative pulmonary complications (PPCs) depends on the surgical approach during abdominal surgery. Our primary objective was to determine and compare the association of time–weighted average ΔP (ΔPTW) with PPCs. We also tested the association of ΔPTW with intraoperative adverse events. Methods Posthoc retrospective propensity score–weighted cohort analysis of patients undergoing open or closed abdominal surgery in the ‘Local ASsessment of Ventilatory management during General Anaesthesia for Surgery’ (LAS VEGAS) study, that included patients in 146 hospitals across 29 countries. The primary endpoint was a composite of PPCs. The secondary endpoint was a composite of intraoperative adverse events. Results The analysis included 1128 and 906 patients undergoing open or closed abdominal surgery, respectively. The PPC rate was 5%. ΔP was lower in open abdominal surgery patients, but ΔPTW was not different between groups. The association of ΔPTW with PPCs was significant in both groups and had a higher risk ratio in closed compared to open abdominal surgery patients (1.11 [95%CI 1.10 to 1.20], P P P TW with intraoperative adverse events was also significant in both groups but had higher odds ratio in closed compared to open abdominal surgery patients (1.13 [95%CI 1.12– to 1.14], P P P Conclusions ΔP is associated with PPC and intraoperative adverse events in abdominal surgery, both in open and closed abdominal surgery. Trial registration LAS VEGAS was registered at clinicaltrials.gov (trial identifier NCT01601223).
Published: 2021
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4. Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: Post-hoc analysis of LAS VEGAS study

Author: Robba C., Hemmes S. N. T., Serpa Neto A., Bluth T., Canet J., Hiesmayr M., Hollmann M. W., Mills G. H., Vidal Melo M. F., Putensen C., Jaber S., Schmid W., Severgnini P., Wrigge H., Battaglini D., Ball L., Gama De Abreu M., Schultz M. J., Pelosi P., Kroell W., Metzler H., Struber G., Wegscheider T., Gombotz H., Urbanek B., Kahn D., Momeni M., Pospiech A., Lois F., Forget P., Grosu I., Poelaert J., Van Mossevelde V., Van Malderen M. -C., Dylst D., Van Melkebeek J., Beran M., De Hert S., De Baerdemaeker L., Heyse B., Van Limmen J., Wyffels P., Jacobs T., Roels N., De Bruyne A., Van De Velde S., Leva B., Damster S., Plichon B., Juros-Zovko M., Djonovic-Omanovic D., Pernar S., Zunic J., Miskovic P., Zilic A., Kvolik S., Ivic D., Azenic-Venzera D., Skiljic S., Vinkovic H., Oputric I., Juricic K., Frkovic V., Kopic J., Mirkovic I., Karanovic N., Carev M., Dropulic N., Saric J. P., Erceg G., Dvorscak M. B., Mazul-Sunko B., Pavicic A. M., Goranovic T., Maldini B., Radocaj T., Gavranovic Z., Mladic-Batinica I., Sehovic M., Stourac P., Harazim H., Smekalova O., Kosinova M., Kolacek T., Hudacek K., Drab M., Brujevic J., Vitkova K., Jirmanova K., Volfova I., Dzurnakova P., Liskova K., Dudas R., Filipsky R., El Kafrawy S., Abdelwahab H. H., Metwally T., Abdel-Razek A., El-Shaarawy A. M., Hasan W. F., Ahmed A. G., Yassin H., Magdy M., Abdelhady M., Mahran M., Herodes E., Kivik P., Oganjan J., Aun A., Sormus A., Sarapuu K., Mall M., Karjagin J., Futier E., Petit A., Gerard A., Marret E., Solier M., Prades A., Krassler J., Merzky S., De Abreu M. G., Uhlig C., Kiss T., Bundy A., Gueldner A., Spieth P., Scharffenberg M., Thiem D. T., Koch T., Treschan T., Schaefer M., Bastin B., Geib J., Weiss M., Kienbaum P., Pannen B., Gottschalk A., Konrad M., Westerheide D., Schwerdtfeger B., Simon P., Reske A., Nestler C., Valsamidis D., Stroumpoulis K., Antholopoulos G., Andreou A., Karapanos D., Theodoraki K., Gkiokas G., Tasoulis M. -K., Sidiropoulou T., Zafeiropoulou F., Florou P., Pandazi A., Tsaousi G., Nouris C., Pourzitaki C., Bystritski D., Pizov R., Eden A., Pesce C. V., Campanile A., Marrella A., Grasso S., De Michele M., Bona F., Giacoletto G., Sardo E., Giancarlo L., Sottosanti V., Solca M., Volta C. A., Spadaro S., Verri M., Ragazzi R., Zoppellari R., Cinnella G., Raimondo P., La Bella D., Mirabella L., D'Antini D., Molin A., Brunetti I., Gratarola A., Pellerano G., Sileo R., Pezzatto S., Montagnani L., Pasin L., Landoni G., Zangrillo A., Beretta L., Di Parma A. L., Tarzia V., Dossi R., Sassone M. E., Sances D., Tredici S., Spano G., Castellani G., Delunas L., Peradze S., Venturino M., Arpino I., Sher S., Tommasino C., Rapido F., Morelli P., Vargas M., Servillo G., Cortegiani A., Raineri S. M., Montalto F., Russotto V., Giarratano A., Baciarello M., Generali M., Cerati G., Leykin Y., Bressan F., Bartolini V., Zamidei L., Brazzi L., Liperi C., Sales G., Pistidda L., Brugnoni E., Musella G., Bacuzzi A., Muhardri D., Gecaj-Gashi A., Sada F., Bytyqi A., Karbonskiene A., Aukstakalniene R., Teberaite Z., Salciute E., Tikuisis R., Miliauskas P., Jurate S., Kontrimaviciute E., Tomkute G., Xuereb J., Bezzina M., Borg F. J., Hemmes S., Schultz M., Hollmann M., Wiersma I., Binnekade J., Bos L., Boer C., Duvekot A., In 'T Veld B., Werger A., Dennesen P., Severijns C., De Jong J., Hering J., Van Beek R., Ivars S., Jammer I., Breidablik A., Hodt K. S., Fjellanger F., Avalos M. V., Mellin-Olsen J., Andersson E., Shafi-Kabiri A., Molina R., Wutai S., Morais E., Tareco G., Ferreira D., Amaral J., De Lurdes Goncalves Castro M., Cadilha S., Appleton S., Parente S., Correia M., Martins D., Monteirosa A., Ricardo A., Rodrigues S., Horhota L., Grintescu I. M., Mirea L., Grintescu I. C., Corneci D., Negoita S., Dutu M., Garotescu I. P., Filipescu D., Prodan A. B., Droc G., Fota R., Popescu M., Tomescu D., Petcu A. M., Tudoroiu M. I., Moise A., Guran C. -T., Gherghina I., Costea D., Cindea I., Copotoiu S. -M., Copotoiu R., Barsan V., Tolcser Z., Riciu M., Moldovan S. G., Veres M., Gritsan A., Kapkan T., Gritsan G., Korolkov O., Kulikov A., Lubnin A., Ovezov A., Prokoshev P., Lugovoy A., Anipchenko N., Babayants A., Komissarova I., Zalina K., Likhvantsev V., Fedorov S., Lazukic A., Pejakovic J., Mihajlovic D., Kusnierikova Z., Zelinkova M., Bruncakova K., Polakovicova L., Sobona V., Novak-Supe B., Pekle-Golez A., Jovanov M., Strazisar B., Markovic-Bozic J., Novak-Jankovic V., Voje M., Grynyuk A., Kostadinov I., Spindler-Vesel A., Moral V., Unzueta M. C., Puigbo C., Fava J., Moret E., Nunez M. R., Sendra M., Brunelli A., Rodenas F., Monedero P., Martinez F. H., Temino M. J. Y., Simon A. M., De Abajo Larriba A., Lisi A., Perez G., Martinez R., Granell M., Vivo J. T., Ruiz C. S., De Andres Ibanez J. A., Pastor E., Soro M., Ferrando C., Defez M., Alvares-Santullano C. A., Perez R., Rico J., Jawad M., Saeed Y., Gillberg L., Bengisun Z. K., Kazbek B. K., Coskunfirat N., Boztug N., Sanli S., Yilmaz M., Hadimioglu N., Senturk N. M., Camci E., Kucukgoncu S., Sungur Z., Sivrikoz N., Ozgen S. U., Toraman F., Selvi O., Senturk O., Yildiz M., Kuvaki B., Gunenc F., Kucukguclu S., Ozbilgin S., Maral J., Canli S., Arun O., Saltali A., Aydogan E., Akgun F. N., Sanlikarip C., Karaman F. M., Mazur A., Vorotyntsev S., Rousseau G., Barrett C., Stancombe L., Shelley B., Scholes H., Limb J., Rafi A., Wayman L., Deane J., Rogerson D., Williams J., Yates S., Rogers E., Pulletz M., Moreton S., Jones S., Venkatesh S., Burton M., Brown L., Goodall C., Rucklidge M., Fuller D., Nadolski M., Kusre S., Lundberg M., Everett L., Nutt H., Zuleika M., Carvalho P., Clements D., Creagh-Brown B., Watt P., Raymode P., Pearse R., Mohr O., Raj A., Creary T., Chishti A., Bell A., Higham C., Cain A., Gibb S., Mowat S., Franklin D., West C., Minto G., Boyd N., Mills G., Calton E., Walker R., Mackenzie F., Ellison B., Roberts H., Chikungwa M., Jackson C., Donovan A., Foot J., Homan E., Montgomery J., Portch D., Mercer P., Palmer J., Paddle J., Fouracres A., Datson A., Andrew A., Welch L., Rose A., Varma S., Simeson K., Rambhatla M., Susarla J., Marri S., Kodaganallur K., Das A., Algarsamy S., Colley J., Davies S., Szewczyk M., Smith T., Fernandez-Bustamante A., Luzier E., Almagro A., Melo M. V., Fernando L., Sulemanji D., Sprung J., Weingarten T., Kor D., Scavonetto F., Tze Y., Robba, C., Hemmes, S. N. T., Serpa Neto, A., Bluth, T., Canet, J., Hiesmayr, M., Hollmann, M. W., Mills, G. H., Vidal Melo, M. F., Putensen, C., Jaber, S., Schmid, W., Severgnini, P., Wrigge, H., Battaglini, D., Ball, L., Gama De Abreu, M., Schultz, M. J., Pelosi, P., Kroell, W., Metzler, H., Struber, G., Wegscheider, T., Gombotz, H., Urbanek, B., Kahn, D., Momeni, M., Pospiech, A., Lois, F., Forget, P., Grosu, I., Poelaert, J., Van Mossevelde, V., Van Malderen, M. -C., Dylst, D., Van Melkebeek, J., Beran, M., De Hert, S., De Baerdemaeker, L., Heyse, B., Van Limmen, J., Wyffels, P., Jacobs, T., Roels, N., De Bruyne, A., Van De Velde, S., Leva, B., Damster, S., Plichon, B., Juros-Zovko, M., Djonovic-Omanovic, D., Pernar, S., Zunic, J., Miskovic, P., Zilic, A., Kvolik, S., Ivic, D., Azenic-Venzera, D., Skiljic, S., Vinkovic, H., Oputric, I., Juricic, K., Frkovic, V., Kopic, J., Mirkovic, I., Karanovic, N., Carev, M., Dropulic, N., Saric, J. P., Erceg, G., Dvorscak, M. B., Mazul-Sunko, B., Pavicic, A. M., Goranovic, T., Maldini, B., Radocaj, T., Gavranovic, Z., Mladic-Batinica, I., Sehovic, M., Stourac, P., Harazim, H., Smekalova, O., Kosinova, M., Kolacek, T., Hudacek, K., Drab, M., Brujevic, J., Vitkova, K., Jirmanova, K., Volfova, I., Dzurnakova, P., Liskova, K., Dudas, R., Filipsky, R., El Kafrawy, S., Abdelwahab, H. H., Metwally, T., Abdel-Razek, A., El-Shaarawy, A. M., Hasan, W. F., Ahmed, A. G., Yassin, H., Magdy, M., Abdelhady, M., Mahran, M., Herodes, E., Kivik, P., Oganjan, J., Aun, A., Sormus, A., Sarapuu, K., Mall, M., Karjagin, J., Futier, E., Petit, A., Gerard, A., Marret, E., Solier, M., Prades, A., Krassler, J., Merzky, S., De Abreu, M. G., Uhlig, C., Kiss, T., Bundy, A., Gueldner, A., Spieth, P., Scharffenberg, M., Thiem, D. T., Koch, T., Treschan, T., Schaefer, M., Bastin, B., Geib, J., Weiss, M., Kienbaum, P., Pannen, B., Gottschalk, A., Konrad, M., Westerheide, D., Schwerdtfeger, B., Simon, P., Reske, A., Nestler, C., Valsamidis, D., Stroumpoulis, K., Antholopoulos, G., Andreou, A., Karapanos, D., Theodoraki, K., Gkiokas, G., Tasoulis, M. -K., Sidiropoulou, T., Zafeiropoulou, F., Florou, P., Pandazi, A., Tsaousi, G., Nouris, C., Pourzitaki, C., Bystritski, D., Pizov, R., Eden, A., Pesce, C. V., Campanile, A., Marrella, A., Grasso, S., De Michele, M., Bona, F., Giacoletto, G., Sardo, E., Giancarlo, L., Sottosanti, V., Solca, M., Volta, C. A., Spadaro, S., Verri, M., Ragazzi, R., Zoppellari, R., Cinnella, G., Raimondo, P., La Bella, D., Mirabella, L., D'Antini, D., Molin, A., Brunetti, I., Gratarola, A., Pellerano, G., Sileo, R., Pezzatto, S., Montagnani, L., Pasin, L., Landoni, G., Zangrillo, A., Beretta, L., Di Parma, A. L., Tarzia, V., Dossi, R., Sassone, M. E., Sances, D., Tredici, S., Spano, G., Castellani, G., Delunas, L., Peradze, S., Venturino, M., Arpino, I., Sher, S., Tommasino, C., Rapido, F., Morelli, P., Vargas, M., Servillo, G., Cortegiani, A., Raineri, S. M., Montalto, F., Russotto, V., Giarratano, A., Baciarello, M., Generali, M., Cerati, G., Leykin, Y., Bressan, F., Bartolini, V., Zamidei, L., Brazzi, L., Liperi, C., Sales, G., Pistidda, L., Brugnoni, E., Musella, G., Bacuzzi, A., Muhardri, D., Gecaj-Gashi, A., Sada, F., Bytyqi, A., Karbonskiene, A., Aukstakalniene, R., Teberaite, Z., Salciute, E., Tikuisis, R., Miliauskas, P., Jurate, S., Kontrimaviciute, E., Tomkute, G., Xuereb, J., Bezzina, M., Borg, F. J., Hemmes, S., Schultz, M., Hollmann, M., Wiersma, I., Binnekade, J., Bos, L., Boer, C., Duvekot, A., In 'T Veld, B., Werger, A., Dennesen, P., Severijns, C., De Jong, J., Hering, J., Van Beek, R., Ivars, S., Jammer, I., Breidablik, A., Hodt, K. S., Fjellanger, F., Avalos, M. V., Mellin-Olsen, J., Andersson, E., Shafi-Kabiri, A., Molina, R., Wutai, S., Morais, E., Tareco, G., Ferreira, D., Amaral, J., De Lurdes Goncalves Castro, M., Cadilha, S., Appleton, S., Parente, S., Correia, M., Martins, D., Monteirosa, A., Ricardo, A., Rodrigues, S., Horhota, L., Grintescu, I. M., Mirea, L., Grintescu, I. C., Corneci, D., Negoita, S., Dutu, M., Garotescu, I. P., Filipescu, D., Prodan, A. B., Droc, G., Fota, R., Popescu, M., Tomescu, D., Petcu, A. M., Tudoroiu, M. I., Moise, A., Guran, C. -T., Gherghina, I., Costea, D., Cindea, I., Copotoiu, S. -M., Copotoiu, R., Barsan, V., Tolcser, Z., Riciu, M., Moldovan, S. G., Veres, M., Gritsan, A., Kapkan, T., Gritsan, G., Korolkov, O., Kulikov, A., Lubnin, A., Ovezov, A., Prokoshev, P., Lugovoy, A., Anipchenko, N., Babayants, A., Komissarova, I., Zalina, K., Likhvantsev, V., Fedorov, S., Lazukic, A., Pejakovic, J., Mihajlovic, D., Kusnierikova, Z., Zelinkova, M., Bruncakova, K., Polakovicova, L., Sobona, V., Novak-Supe, B., Pekle-Golez, A., Jovanov, M., Strazisar, B., Markovic-Bozic, J., Novak-Jankovic, V., Voje, M., Grynyuk, A., Kostadinov, I., Spindler-Vesel, A., Moral, V., Unzueta, M. C., Puigbo, C., Fava, J., Moret, E., Nunez, M. R., Sendra, M., Brunelli, A., Rodenas, F., Monedero, P., Martinez, F. H., Temino, M. J. Y., Simon, A. M., De Abajo Larriba, A., Lisi, A., Perez, G., Martinez, R., Granell, M., Vivo, J. T., Ruiz, C. S., De Andres Ibanez, J. A., Pastor, E., Soro, M., Ferrando, C., Defez, M., Alvares-Santullano, C. A., Perez, R., Rico, J., Jawad, M., Saeed, Y., Gillberg, L., Bengisun, Z. K., Kazbek, B. K., Coskunfirat, N., Boztug, N., Sanli, S., Yilmaz, M., Hadimioglu, N., Senturk, N. M., Camci, E., Kucukgoncu, S., Sungur, Z., Sivrikoz, N., Ozgen, S. U., Toraman, F., Selvi, O., Senturk, O., Yildiz, M., Kuvaki, B., Gunenc, F., Kucukguclu, S., Ozbilgin, S., Maral, J., Canli, S., Arun, O., Saltali, A., Aydogan, E., Akgun, F. N., Sanlikarip, C., Karaman, F. M., Mazur, A., Vorotyntsev, S., Rousseau, G., Barrett, C., Stancombe, L., Shelley, B., Scholes, H., Limb, J., Rafi, A., Wayman, L., Deane, J., Rogerson, D., Williams, J., Yates, S., Rogers, E., Pulletz, M., Moreton, S., Jones, S., Venkatesh, S., Burton, M., Brown, L., Goodall, C., Rucklidge, M., Fuller, D., Nadolski, M., Kusre, S., Lundberg, M., Everett, L., Nutt, H., Zuleika, M., Carvalho, P., Clements, D., Creagh-Brown, B., Watt, P., Raymode, P., Pearse, R., Mohr, O., Raj, A., Creary, T., Chishti, A., Bell, A., Higham, C., Cain, A., Gibb, S., Mowat, S., Franklin, D., West, C., Minto, G., Boyd, N., Mills, G., Calton, E., Walker, R., Mackenzie, F., Ellison, B., Roberts, H., Chikungwa, M., Jackson, C., Donovan, A., Foot, J., Homan, E., Montgomery, J., Portch, D., Mercer, P., Palmer, J., Paddle, J., Fouracres, A., Datson, A., Andrew, A., Welch, L., Rose, A., Varma, S., Simeson, K., Rambhatla, M., Susarla, J., Marri, S., Kodaganallur, K., Das, A., Algarsamy, S., Colley, J., Davies, S., Szewczyk, M., Smith, T., Fernandez-Bustamante, A., Luzier, E., Almagro, A., Melo, M. V., Fernando, L., Sulemanji, D., Sprung, J., Weingarten, T., Kor, D., Scavonetto, F., Tze, Y., Anesthesiology research group, Supporting clinical sciences, Anesthesiology, Policlinico San Martino, Anaesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Largo Rosanna Benzi 8, 16131, Genoa, Italy, University of Amsterdam [Amsterdam] (UvA), Department of Anaesthesiology and Intensive Care Medicine, Pulmonary engineering group, University Hospital Carl Gustav Carus, Technische Universitat Dresden, Dresden, Germany, Division of Cardiac, Thoracic, Vascular Anaesthesia and Intensive Care, Vienna General Hospital Währinger Gürtel, Massachusetts General Hospital, Harvard Medical School, Boston, USA. 17, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Medizinische Universität Wien = Medical University of Vienna, University of Insubria, Varese, Department of Intensive Care, Academic Medical Center, Department of Intensive Care, Academic Medical Center, University of Amsterdam, IRCCS San Martino IST, Robba, Chiara, Hemmes, Sabrine N T, Serpa Neto, Ary, Bluth, Thoma, Canet, Jaume, Hiesmayr, Michael, Hollmann, M Wiersma, Mills, Gary H, Vidal Melo, Marcos F, Putensen, Christian, Jaber, Samir, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, Battaglini, Denise, Ball, Lorenzo, Gama de Abreu, Marcelo, Schultz, Marcus J, Pelosi, Paolo, Kroell W, Metzler H, Struber G, Wegscheider T, Gombotz H, Hiesmayr M, Schmid W, Urbanek B, Kahn D, Momeni M, Pospiech A, Lois F, Forget P, Grosu I, Poelaert J, van Mossevelde V, van Malderen MC, Dylst D, van Melkebeek J, Beran M, de Hert S, De Baerdemaeker L, Heyse B, Van Limmen J, Wyffels P, Jacobs T, Roels N, De Bruyne A, van de Velde S, Leva B, Damster S, Plichon B, Juros-Zovko M, Djonoviċ-Omanoviċ D, Pernar S, Zunic J, Miskovic P, Zilic A, Kvolik S, Ivic D, Azenic-Venzera D, Skiljic S, Vinkovic H, Oputric I, Juricic K, Frkovic V, Kopic J, Mirkovic I, Karanovic N, Carev M, Dropulic N, Saric JP, Erceg G, Dvorscak MB, Mazul-Sunko B, Pavicic AM, Goranovic T, Maldini B, Radocaj T, Gavranovic Z, Mladic-Batinica I, Sehovic M, Stourac P, Harazim H, Smekalova O, Kosinova M, Kolacek T, Hudacek K, Drab M, Brujevic J, Vitkova K, Jirmanova K, Volfova I, Dzurnakova P, Liskova K, Dudas R, Filipsky R, El Kafrawy S, Abdelwahab HH, Metwally T, Abdel-Razek A, El-Shaarawy AM, Hasan WF, Ahmed AG, Yassin H, Magdy M, Abdelhady M, Mahran M, Herodes E, Kivik P, Oganjan J, Aun A, Sormus A, Sarapuu K, Mall M, Karjagin J, Futier E, Petit A, Gerard A, Marret E, Solier M, Jaber S, Prades A, Krassler J, Merzky S, de Abreu MG, Uhlig C, Kiss T, Bundy A, Bluth T, Gueldner A, Spieth P, Scharffenberg M, Thiem DT, Koch T, Treschan T, Schaefer M, Bastin B, Geib J, Weiss M, Kienbaum P, Pannen B, Gottschalk A, Konrad M, Westerheide D, Schwerdtfeger B, Wrigge H, Simon P, Reske A, Nestler C, Valsamidis D, Stroumpoulis K, Antholopoulos G, Andreou A, Karapanos D, Theodoraki K, Gkiokas G, Tasoulis MK, Sidiropoulou T, Zafeiropoulou F, Florou P, Pandazi A, Tsaousi G, Nouris C, Pourzitaki C, Bystritski D, Pizov R, Eden A, Pesce CV, Campanile A, Marrella A, Grasso S, De Michele M, Bona F, Giacoletto G, Sardo E, Giancarlo L, Sottosanti V, Solca M, Volta CA, Spadaro S, Verri M, Ragazzi R, Zoppellari R, Cinnella G, Raimondo P, La Bella D, Mirabella L, D'antini D, Pelosi P, Molin A, Brunetti I, Gratarola A, Pellerano G, Sileo R, Pezzatto S, Montagnani L, Pasin L, Landoni G, Zangrillo A, Beretta L, Di Parma AL, Tarzia V, Dossi R, Sassone ME, Sances D, Tredici S, Spano G, Castellani G, Delunas L, Peradze S, Venturino M, Arpino I, Sher S, Tommasino C, Rapido F, Morelli P, Vargas M, Servillo G, Cortegiani A, Raineri SM, Montalto F, Russotto V, Giarratano A, Baciarello M, Generali M, Cerati G, Leykin Y, Bressan F, Bartolini V, Zamidei L, Brazzi L, Liperi C, Sales G, Pistidda L, Severgnini P, Brugnoni E, Musella G, Bacuzzi A, Muhardri D, Gecaj-Gashi A, Sada F, Bytyqi A, Karbonskiene A, Aukstakalniene R, Teberaite Z, Salciute E, Tikuisis R, Miliauskas P, Jurate S, Kontrimaviciute E, Tomkute G, Xuereb J, Bezzina M, Borg FJ, Hemmes S, Schultz M, Hollmann M, Wiersma I, Binnekade J, Bos L, Boer C, Duvekot A, In 't Veld B, Werger A, Dennesen P, Severijns C, De Jong J, Hering J, van Beek R, Ivars S, Jammer I, Breidablik A, Hodt KS, Fjellanger F, Avalos MV, Mellin-Olsen J, Andersson E, Shafi-Kabiri A, Molina R, Wutai S, Morais E, Tareco G, Ferreira D, Amaral J, de Lurdes Goncalves Castro M, Cadilha S, Appleton S, Parente S, Correia M, Martins D, Monteirosa A, Ricardo A, Rodrigues S, Horhota L, Grintescu IM, Mirea L, Grintescu IC, Corneci D, Negoita S, Dutu M, Garotescu IP, Filipescu D, Prodan AB, Droc G, Fota R, Popescu M, Tomescu D, Petcu AM, Tudoroiu MI, Moise A, Guran CT, Gherghina I, Costea D, Cindea I, Copotoiu SM, Copotoiu R, Barsan V, Tolcser Z, Riciu M, Moldovan SG, Veres M, Gritsan A, Kapkan T, Gritsan G, Korolkov O, Kulikov A, Lubnin A, Ovezov A, Prokoshev P, Lugovoy A, Anipchenko N, Babayants A, Komissarova I, Zalina K, Likhvantsev V, Fedorov S, Lazukic A, Pejakovic J, Mihajlovic D, Kusnierikova Z, Zelinkova M, Bruncakova K, Polakovicova L, Sobona V, Novak-Supe B, Pekle-Golez A, Jovanov M, Strazisar B, Markovic-Bozic J, Novak-Jankovic V, Voje M, Grynyuk A, Kostadinov I, Spindler-Vesel A, Moral V, Unzueta MC, Puigbo C, Fava J, Canet J, Moret E, Nunez MR, Sendra M, Brunelli A, Rodenas F, Monedero P, Martinez FH, Temino MJY, Simon AM, de Abajo Larriba A, Lisi A, Perez G, Martinez R, Granell M, Vivo JT, Ruiz CS, de Andrés Ibañez JA, Pastor E, Soro M, Ferrando C, Defez M, Alvares-Santullano CA, Perez R, Rico J, Jawad M, Saeed Y, Gillberg L, Bengisun ZK, Kazbek BK, Coskunfirat N, Boztug N, Sanli S, Yilmaz M, Hadimioglu N, Senturk NM, Camci E, Kucukgoncu S, Sungur Z, Sivrikoz N, Ozgen SU, Toraman F, Selvi O, Senturk O, Yildiz M, Kuvaki B, Gunenc F, Kucukguclu S, Ozbilgin Ş, Maral J, Canli S, Arun O, Saltali A, Aydogan E, Akgun FN, Sanlikarip C, Karaman FM, Mazur A, Vorotyntsev S, Rousseau G, Barrett C, Stancombe L, Shelley B, Scholes H, Limb J, Rafi A, Wayman L, Deane J, Rogerson D, Williams J, Yates S, Rogers E, Pulletz M, Moreton S, Jones S, Venkatesh S, Burton M, Brown L, Goodall C, Rucklidge M, Fuller D, Nadolski M, Kusre S, Lundberg M, Everett L, Nutt H, Zuleika M, Carvalho P, Clements D, Creagh-Brown B, Watt P, Raymode P, Pearse R, Mohr O, Raj A, Creary T, Chishti A, Bell A, Higham C, Cain A, Gibb S, Mowat S, Franklin D, West C, Minto G, Boyd N, Mills G, Calton E, Walker R, Mackenzie F, Ellison B, Roberts H, Chikungwa M, Jackson C, Donovan A, Foot J, Homan E, Montgomery J, Portch D, Mercer P, Palmer J, Paddle J, Fouracres A, Datson A, Andrew A, Welch L, Rose A, Varma S, Simeson K, Rambhatla M, Susarla J, Marri S, Kodaganallur K, Das A, Algarsamy S, Colley J, Davies S, Szewczyk M, Smith T, Fernandez-Bustamante A, Luzier E, Almagro A, Melo MV, Fernando L, Sulemanji D, Sprung J, Weingarten T, Kor D, Scavonetto F, Tze Y., Intensive Care Medicine, ACS - Heart failure & arrhythmias, Pulmonology, ACS - Diabetes & metabolism, ACS - Pulmonary hypertension & thrombosis, ACS - Microcirculation, Robba, C, Hemmes, S, Serpa Neto, A, Bluth, T, Canet, J, Hiesmayr, M, Hollmann, M, Mills, G, Vidal Melo, M, Putensen, C, Jaber, S, Schmid, W, Severgnini, P, Wrigge, H, Battaglini, D, Ball, L, Gama De Abreu, M, Schultz, M, Pelosi, P, Kroell, W, Metzler, H, Struber, G, Wegscheider, T, Gombotz, H, Urbanek, B, Kahn, D, Momeni, M, Pospiech, A, Lois, F, Forget, P, Grosu, I, Poelaert, J, Van Mossevelde, V, Van Malderen, M, Dylst, D, Van Melkebeek, J, Beran, M, De Hert, S, De Baerdemaeker, L, Heyse, B, Van Limmen, J, Wyffels, P, Jacobs, T, Roels, N, De Bruyne, A, Van De Velde, S, Leva, B, Damster, S, Plichon, B, Juros-Zovko, M, Djonovic-Omanovic, D, Pernar, S, Zunic, J, Miskovic, P, Zilic, A, Kvolik, S, Ivic, D, Azenic-Venzera, D, Skiljic, S, Vinkovic, H, Oputric, I, Juricic, K, Frkovic, V, Kopic, J, Mirkovic, I, Karanovic, N, Carev, M, Dropulic, N, Saric, J, Erceg, G, Dvorscak, M, Mazul-Sunko, B, Pavicic, A, Goranovic, T, Maldini, B, Radocaj, T, Gavranovic, Z, Mladic-Batinica, I, Sehovic, M, Stourac, P, Harazim, H, Smekalova, O, Kosinova, M, Kolacek, T, Hudacek, K, Drab, M, Brujevic, J, Vitkova, K, Jirmanova, K, Volfova, I, Dzurnakova, P, Liskova, K, Dudas, R, Filipsky, R, El Kafrawy, S, Abdelwahab, H, Metwally, T, Abdel-Razek, A, El-Shaarawy, A, Hasan, W, Ahmed, A, Yassin, H, Magdy, M, Abdelhady, M, Mahran, M, Herodes, E, Kivik, P, Oganjan, J, Aun, A, Sormus, A, Sarapuu, K, Mall, M, Karjagin, J, Futier, E, Petit, A, Gerard, A, Marret, E, Solier, M, Prades, A, Krassler, J, Merzky, S, De Abreu, M, Uhlig, C, Kiss, T, Bundy, A, Gueldner, A, Spieth, P, Scharffenberg, M, Thiem, D, Koch, T, Treschan, T, Schaefer, M, Bastin, B, Geib, J, Weiss, M, Kienbaum, P, Pannen, B, Gottschalk, A, Konrad, M, Westerheide, D, Schwerdtfeger, B, Simon, P, Reske, A, Nestler, C, Valsamidis, D, Stroumpoulis, K, Antholopoulos, G, Andreou, A, Karapanos, D, Theodoraki, K, Gkiokas, G, Tasoulis, M, Sidiropoulou, T, Zafeiropoulou, F, Florou, P, Pandazi, A, Tsaousi, G, Nouris, C, Pourzitaki, C, Bystritski, D, Pizov, R, Eden, A, Pesce, C, Campanile, A, Marrella, A, Grasso, S, De Michele, M, Bona, F, Giacoletto, G, Sardo, E, Giancarlo, L, Sottosanti, V, Solca, M, Volta, C, Spadaro, S, Verri, M, Ragazzi, R, Zoppellari, R, Cinnella, G, Raimondo, P, La Bella, D, Mirabella, L, D'Antini, D, Molin, A, Brunetti, I, Gratarola, A, Pellerano, G, Sileo, R, Pezzatto, S, Montagnani, L, Pasin, L, Landoni, G, Zangrillo, A, Beretta, L, Di Parma, A, Tarzia, V, Dossi, R, Sassone, M, Sances, D, Tredici, S, Spano, G, Castellani, G, Delunas, L, Peradze, S, Venturino, M, Arpino, I, Sher, S, Tommasino, C, Rapido, F, Morelli, P, Vargas, M, Servillo, G, Cortegiani, A, Raineri, S, Montalto, F, Russotto, V, Giarratano, A, Baciarello, M, Generali, M, Cerati, G, Leykin, Y, Bressan, F, Bartolini, V, Zamidei, L, Brazzi, L, Liperi, C, Sales, G, Pistidda, L, Brugnoni, E, Musella, G, Bacuzzi, A, Muhardri, D, Gecaj-Gashi, A, Sada, F, Bytyqi, A, Karbonskiene, A, Aukstakalniene, R, Teberaite, Z, Salciute, E, Tikuisis, R, Miliauskas, P, Jurate, S, Kontrimaviciute, E, Tomkute, G, Xuereb, J, Bezzina, M, Borg, F, Wiersma, I, Binnekade, J, Bos, L, Boer, C, Duvekot, A, In 'T Veld, B, Werger, A, Dennesen, P, Severijns, C, De Jong, J, Hering, J, Van Beek, R, Ivars, S, Jammer, I, Breidablik, A, Hodt, K, Fjellanger, F, Avalos, M, Mellin-Olsen, J, Andersson, E, Shafi-Kabiri, A, Molina, R, Wutai, S, Morais, E, Tareco, G, Ferreira, D, Amaral, J, De Lurdes Goncalves Castro, M, Cadilha, S, Appleton, S, Parente, S, Correia, M, Martins, D, Monteirosa, A, Ricardo, A, Rodrigues, S, Horhota, L, Grintescu, I, Mirea, L, Corneci, D, Negoita, S, Dutu, M, Garotescu, I, Filipescu, D, Prodan, A, Droc, G, Fota, R, Popescu, M, Tomescu, D, Petcu, A, Tudoroiu, M, Moise, A, Guran, C, Gherghina, I, Costea, D, Cindea, I, Copotoiu, S, Copotoiu, R, Barsan, V, Tolcser, Z, Riciu, M, Moldovan, S, Veres, M, Gritsan, A, Kapkan, T, Gritsan, G, Korolkov, O, Kulikov, A, Lubnin, A, Ovezov, A, Prokoshev, P, Lugovoy, A, Anipchenko, N, Babayants, A, Komissarova, I, Zalina, K, Likhvantsev, V, Fedorov, S, Lazukic, A, Pejakovic, J, Mihajlovic, D, Kusnierikova, Z, Zelinkova, M, Bruncakova, K, Polakovicova, L, Sobona, V, Novak-Supe, B, Pekle-Golez, A, Jovanov, M, Strazisar, B, Markovic-Bozic, J, Novak-Jankovic, V, Voje, M, Grynyuk, A, Kostadinov, I, Spindler-Vesel, A, Moral, V, Unzueta, M, Puigbo, C, Fava, J, Moret, E, Nunez, M, Sendra, M, Brunelli, A, Rodenas, F, Monedero, P, Martinez, F, Temino, M, Simon, A, De Abajo Larriba, A, Lisi, A, Perez, G, Martinez, R, Granell, M, Vivo, J, Ruiz, C, De Andres Ibanez, J, Pastor, E, Soro, M, Ferrando, C, Defez, M, Alvares-Santullano, C, Perez, R, Rico, J, Jawad, M, Saeed, Y, Gillberg, L, Bengisun, Z, Kazbek, B, Coskunfirat, N, Boztug, N, Sanli, S, Yilmaz, M, Hadimioglu, N, Senturk, N, Camci, E, Kucukgoncu, S, Sungur, Z, Sivrikoz, N, Ozgen, S, Toraman, F, Selvi, O, Senturk, O, Yildiz, M, Kuvaki, B, Gunenc, F, Kucukguclu, S, Ozbilgin, S, Maral, J, Canli, S, Arun, O, Saltali, A, Aydogan, E, Akgun, F, Sanlikarip, C, Karaman, F, Mazur, A, Vorotyntsev, S, Rousseau, G, Barrett, C, Stancombe, L, Shelley, B, Scholes, H, Limb, J, Rafi, A, Wayman, L, Deane, J, Rogerson, D, Williams, J, Yates, S, Rogers, E, Pulletz, M, Moreton, S, Jones, S, Venkatesh, S, Burton, M, Brown, L, Goodall, C, Rucklidge, M, Fuller, D, Nadolski, M, Kusre, S, Lundberg, M, Everett, L, Nutt, H, Zuleika, M, Carvalho, P, Clements, D, Creagh-Brown, B, Watt, P, Raymode, P, Pearse, R, Mohr, O, Raj, A, Creary, T, Chishti, A, Bell, A, Higham, C, Cain, A, Gibb, S, Mowat, S, Franklin, D, West, C, Minto, G, Boyd, N, Calton, E, Walker, R, Mackenzie, F, Ellison, B, Roberts, H, Chikungwa, M, Jackson, C, Donovan, A, Foot, J, Homan, E, Montgomery, J, Portch, D, Mercer, P, Palmer, J, Paddle, J, Fouracres, A, Datson, A, Andrew, A, Welch, L, Rose, A, Varma, S, Simeson, K, Rambhatla, M, Susarla, J, Marri, S, Kodaganallur, K, Das, A, Algarsamy, S, Colley, J, Davies, S, Szewczyk, M, Smith, T, Fernandez-Bustamante, A, Luzier, E, Almagro, A, Melo, M, Fernando, L, Sulemanji, D, Sprung, J, Weingarten, T, Kor, D, Scavonetto, F, Tze, Y, MORNET, Dominique, and Universitá degli Studi dell’Insubria = University of Insubria [Varese] (Uninsubria)
Subjects: Lung Diseases, Male, SURGERY, medicine.medical_treatment, [SDV]Life Sciences [q-bio], RESPIRATORY-DISTRESS-SYNDROME, BRAIN-INJURY, Neurosurgical Procedures, Positive-Pressure Respiration, 0302 clinical medicine, Postoperative Complications, Mechanical ventilation, 030202 anesthesiology, Interquartile range, Medicine and Health Sciences, General anaesthesia, END-EXPIRATORY-PRESSURE, Prospective Studies, Postoperative pulmonary, Postoperative pulmonary complications, Middle Aged, 3. Good health, [SDV] Life Sciences [q-bio], Anesthesia, Female, Neurosurgery, Research Article, Pulmons Malalties, Adult, medicine.medical_specialty, complications, Lung injury, Anesthesia, General, LAS VEGAS, NO, lcsh:RD78.3-87.3, 03 medical and health sciences, Neurologia, Anesthesiology, medicine, Tidal Volume, Humans, MED/41 - ANESTESIOLOGIA, HIGH TIDAL, Aged, Intraoperative Care, Ventilators, Mechanical, Cirurgia, business.industry, 030208 emergency & critical care medicine, Odds ratio, Perioperative, Respiration, Artificial, Anesthesiology and Pain Medicine, lcsh:Anesthesiology, VOLUME, business, Postoperative pulmonary complication, LUNG INJURY
Abstract: Background Limited information is available regarding intraoperative ventilator settings and the incidence of postoperative pulmonary complications (PPCs) in patients undergoing neurosurgical procedures. The aim of this post-hoc analysis of the ‘Multicentre Local ASsessment of VEntilatory management during General Anaesthesia for Surgery’ (LAS VEGAS) study was to examine the ventilator settings of patients undergoing neurosurgical procedures, and to explore the association between perioperative variables and the development of PPCs in neurosurgical patients. Methods Post-hoc analysis of LAS VEGAS study, restricted to patients undergoing neurosurgery. Patients were stratified into groups based on the type of surgery (brain and spine), the occurrence of PPCs and the assess respiratory risk in surgical patients in Catalonia (ARISCAT) score risk for PPCs. Results Seven hundred eighty-four patients were included in the analysis; 408 patients (52%) underwent spine surgery and 376 patients (48%) brain surgery. Median tidal volume (VT) was 8 ml [Interquartile Range, IQR = 7.3–9] per predicted body weight; median positive end–expiratory pressure (PEEP) was 5 [3 to 5] cmH20. Planned recruitment manoeuvres were used in the 6.9% of patients. No differences in ventilator settings were found among the sub-groups. PPCs occurred in 81 patients (10.3%). Duration of anaesthesia (odds ratio, 1.295 [95% confidence interval 1.067 to 1.572]; p = 0.009) and higher age for the brain group (odds ratio, 0.000 [0.000 to 0.189]; p = 0.031), but not intraoperative ventilator settings were independently associated with development of PPCs. Conclusions Neurosurgical patients are ventilated with low VT and low PEEP, while recruitment manoeuvres are seldom applied. Intraoperative ventilator settings are not associated with PPCs.
Published: 2020
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5. Association between night-time surgery and occurrence of intraoperative adverse events and postoperative pulmonary complications

Author: Cortegiani A, Gregoretti C, Neto A, Hemmes S, Ball L, Canet J, Hiesmayr M, Hollmann M, Mills G, Melo M, Putensen C, Schmid W, Severgnini P, Wrigge H, de Abreu M, Schultz M, Pelosi P, Kroell W, Metzler H, Struber G, Wegscheider T, Gombotz H, Urbanek B, Kahn D, Momeni M, Pospiech A, Lois F, Forget P, Grosu I, Poelaert J, van Mossevelde V, van Malderen M, Dylst D, van Melkebeek J, Beran M, de Hert S, De Baerdemaeker L, Heyse B, Van Limmen J, Wyffels P, Jacobs T, Roels N, De Bruyne A, van de Velde S, Leva B, Damster S, Plichon B, Juros-Zovko M, Djonovic-Omanovic D, Pernar S, Zunic J, Miskovic P, Zilic A, Kvolik S, Ivic D, Azenic-Venzera D, Skiljic S, Vinkovic H, Oputric I, Juricic K, Frkovic V, Kopic J, Mirkovic I, Karanovic N, Carev M, Dropulic N, Saric J, Erceg G, Dvorscak M, Mazul-Sunko B, Pavicic A, Goranovic T, Maldini B, Radocaj T, Gavranovic Z, Mladic-Batinica I, Sehovic M, Stourac P, Harazim H, Smekalova O, Kosinova M, Kolacek T, Hudacek K, Drab M, Brujevic J, Vitkova K, Jirmanova K, Volfova I, Dzurnakova P, Liskova K, Dudas R, Filipsky R, el Kafrawy S, Abdelwahab H, Metwally T, Abdel-Razek A, El-Shaarawy A, Hasan W, Ahmed A, Yassin H, Magdy M, Abdelhady M, Mahran M, Herodes E, Kivik P, Oganjan J, Aun A, Sormus A, Sarapuu K, Mall M, Karjagin J, Futier E, Petit A, Gerard A, Marret E, Solier M, Jaber S, Prades A, Krassler J, Merzky S, Uhlig C, Kiss T, Bundy A, Bluth T, Gueldner A, Spieth P, Scharffenberg M, Thiem D, Koch T, Treschan T, Schaefer M, Bastin B, Geib J, Weiss M, Kienbaum P, Pannen B, Gottschalk A, Konrad M, Westerheide D, Schwerdtfeger B, Simon P, Reske A, Nestler C, Valsamidis D, Stroumpoulis K, Antholopoulos G, Andreou A, Karapanos D, Theodorak K, Gkiokas G, Tasoulis M, Sidiropoulou T, Zafeiropoulou F, Florou P, Pandazi A, Tsaousi G, Nouris C, Pourzitaki C, Bystritski D, Pizov R, Eden A, Pesce C, Campanile A, Marrella A, Grasso S, De Michele M, Bona F, Giacoletto G, Sardo E, Sottosanti L, Solca M, Volta C, Spadaro S, Verri M, Ragazzi R, Zoppellari R, Cinnella G, Raimondo P, La Bella D, Mirabella L, D'antini D, Molin A, Brunetti I, Gratarola A, Pellerano G, Sileo R, Pezzatto S, Montagnani L, Pasin L, Landoni G, Zangrillo A, Beretta L, Di Parma A, Tarzia V, Dossi R, Sassone M, Sances D, Tredici S, Spano G, Castellani G, Delunas L, Peradze S, Venturino M, Arpino I, Sher S, Tommasino C, Rapido F, Morelli P, Vargas M, Servillo G, Raineri S, Montalto F, Russotto V, Giarratano A, Baciarello M, Generali M, Cerati G, Leykin Y, Bressan F, Bartolini V, Zamidei L, Brazzi L, Liperi C, Sales G, Pistidda L, Brugnoni E, Musella G, Bacuzzi A, Muhardri D, Gecaj-Gashi A, Sada F, Bytyqi A, Karbonskiene A, Aukstakalniene R, Teberaite Z, Salciute E, Tikuisis R, Miliauskas P, Jurate S, Kontrimaviciute E, Tomkute G, Xuereb J, Bezzina M, Borg F, Wiersma I, Binnekade J, Bos L, Boer C, Duvekot A, in 't Veld B, Werger A, Dennesen P, Severijns C, De Jong J, Hering J, van Beek R, Ivars S, Jammer I, Breidablik A, Hodt K, Fjellanger F, Avalos M, Mellin-Olsen J, Andersson E, Shafi-Kabiri A, Molina R, Wutai S, Morais E, Tareco G, Ferreira D, Amaral J, Castro M, Cadilha S, Appleton S, Parente S, Correia M, Martins D, Monteirosa A, Ricardo A, Rodrigues S, Horhota L, Grintescu I, Mirea L, Corneci D, Negoita S, Dutu M, Garotescu I, Filipescu D, Prodan A, Droc G, Fota R, Popescu M, Tomescu D, Petcu A, Tudoroiu M, Moise A, Guran C, Gherghina I, Costea D, Cindea I, Copotoiu S, Copotoiu R, Barsan V, Tolcser Z, Riciu M, Moldovan S, Veres M, Gritsan A, Kapkan T, Gritsan G, Korolkov O, Kulikov A, Lubnin A, Ovezov A, Prokoshev P, Lugovoy A, Anipchenko N, Babayants A, Komissarova I, Zalina K, Likhvantsev V, Fedorov S, Lazukic A, Pejakovic J, Mihajlovic D, Kusnierikova Z, Zelinkova M, Bruncakova K, Polakovicova L, Sobona V, Novak-Supe B, Pekle-Golez A, Jovanov M, Strazisar B, Markovic-Bozic J, Novak-Jankovic V, Voje M, Grynyuk A, Kostadinov I, Spindler-Vesel A, Moral V, Unzueta M, Puigbo C, Fava J, Moret E, Nunez M, Sendra M, Brunelli A, Rodenas F, Monedero P, Martinez F, Temino M, Simon A, Larriba A, Lisi A, Perez G, Martinez R, Granell M, Vivo J, Ruiz C, Ibanez J, Pastor E, Soro M, Ferrando C, Defez M, Alvares-Santullano C, Perez R, Rico J, Jawad M, Saeed Y, Gillberg L, Bengisun Z, Kazbek B, Coskunfirat N, Boztug N, Sanli S, Yilmaz M, Hadimioglu N, Senturk N, Camci E, Kucukgoncu S, Sungur Z, Sivrikoz N, Ozgen S, Toraman F, Selvi O, Senturk O, Yildiz M, Kuvaki B, Gunenc F, Kucukguclu S, Ozbilgin S, Maral J, Canli S, Arun O, Saltali A, Aydogan E, Akgun F, Sanlikarip C, Karaman F, Mazur A, Vorotyntsev S, Rousseau G, Barrett C, Stancombe L, Shelley B, Scholes H, Limb J, Rafi A, Wayman L, Deane J, Rogerson D, Williams J, Yates S, Rogers E, Pulletz M, Moreton S, Jones S, Venkatesh S, Burton M, Brown L, Goodall C, Rucklidge M, Fuller D, Nadolski M, Kusre S, Lundberg M, Everett L, Nutt H, Zuleika M, Carvalho P, Clements D, Creagh-Brown B, Watt P, Raymode P, Pearse R, Mohr O, Raj A, Creary T, Chishti A, Bell A, Higham C, Cain A, Gibb S, Mowat S, Franklin D, West C, Minto G, Boyd N, Calton E, Walker R, Mackenzie F, Ellison B, Roberts H, Chikungwa M, Jackson C, Donovan A, Foot J, Homan E, Montgomery J, Portch D, Mercer P, Palmer J, Paddle J, Fouracres A, Datson A, Andrew A, Welch L, Rose A, Varma S, Simeson K, Rambhatla M, Susarla J, Marri S, Kodaganallur K, Das A, Algarsamy S, Colley J, Davies S, Szewczyk M, Smith T, Fernandez-Bustamante A, Luzier E, Almagro A, Fernando L, Sulemanji D, Sprung J, Weingarten T, Kor D, Scavonetto F, Tze Y, LAS VEGAS Investigators, PROVE Network, European Soc Anaesthesiology, Cortegiani, A, Gregoretti, C, Neto, A, Hemmes, S, Ball, L, Canet, J, Hiesmayr, M, Hollmann, M, Mills, G, Melo, M, Putensen, C, Schmid, W, Severgnini, P, Wrigge, H, Gama de Abreu, M, Schultz, M, Pelosi, P, Kroell, W, Metzler, H, Struber, G, Wegscheider, T, Gombotz, H, Urbanek, B, Kahn, D, Momeni, M, Pospiech, A, Lois, F, Forget, P, Grosu, I, Poelaert, J, Mossevelde, V, van Malderen, M, Dylst, D, Melkebeek, 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Rapido, F, Morelli, P, Vargas, M, Servillo, G, Raineri, S, Montalto, F, Russotto, V, Giarratano, A, Baciarello, M, Generali, M, Cerati, G, Leykin, Y, Bressan, F, Bartolini, V, Zamidei, L, Brazzi, L, Liperi, C, Sales, G, Pistidda, L, Brugnoni, E, Musella, G, Bacuzzi, A, Muhardri, D, Agreta, G, Sada, F, Bytyqi, A, Karbonskiene, A, Aukstakalniene, R, Teberaite, Z, Salciute, E, Tikuisis, R, Miliauskas, P, Jurate, S, Kontrimaviciute, E, Tomkute, G, Xuereb, J, Bezzina, M, Borg, F, Wiersma, I, Binnekade, J, Bos, L, Boer, C, Duvekot, A, Veld, B, Werger, A, Dennesen, P, Severijns, C, Jong, J, Hering, J, Beek, R, Ivars, S, Jammer, I, Breidablik, A, Hodt, K, Fjellanger, F, Avalos, M, Jannicke, M, Andersson, E, Amir, S, Molina, R, Wutai, S, Morais, E, Tareco, G, Ferreira, D, Amaral, J, Castro, M, Cadilha, S, Appleton, S, Parente, S, Correia, M, Martins, D, Monteirosa, A, Ricardo, A, Rodrigues, S, Horhota, L, Grintescu, I, Mirea, L, Corneci, D, Negoita, S, Dutu, M, Popescu Garotescu, I, Filipescu, D, Prodan, A, Droc, G, Fota, R, Popescu, M, Tomescu, D, Petcu, A, Tudoroiu, M, Moise, A, Guran, C, Gherghina, I, Costea, D, Cindea, I, Copotoiu, S, Copotoiu, R, Barsan, V, Tolcser, Z, Riciu, M, Moldovan, S, Veres, M, Gritsan, A, Kapkan, T, Gritsan, G, Korolkov, O, Kulikov, A, Lubnin, A, Ovezov, A, Prokoshev, P, Lugovoy, A, Anipchenko, N, Babayants, A, Komissarova, I, Zalina, K, Likhvantsev, V, Fedorov, S, Lazukic, A, Pejakovic, J, Mihajlovic, D, Kusnierikova, Z, Zelinkova, M, Bruncakova, K, Polakovicova, L, Sobona, V, Barbka, N, Ana, P, Jovanov, M, Strazisar, B, Jasmina, M, Vesna, N, Voje, M, Grynyuk, A, Kostadinov, I, Alenka, S, Moral, V, Unzueta, M, Puigbo, C, Fava, J, Moret, E, Nunez, M, Sendra, M, Brunelli, A, Rodenas, F, Monedero, P, Martinez, F, Temino, M, Simon, A, Larriba, A, Lisi, A, Perez, G, Martinez, R, Granell, M, Vivo, J, Ruiz, C, Andres Ibanez, J, Pastor, E, Soro, M, Ferrando, C, Defez, M, Cesar Aldecoa, A, Perez, R, Rico, J, Jawad, M, Saeed, Y, Gillberg, L, Bengisun, Z, Kazbek, B, Coskunfirat, N, Boztug, N, Sanli, S, Yilmaz, M, Hadimioglu, N, Senturk, N, Camci, E, Kucukgoncu, S, Sungur, Z, Sivrikoz, N, Ozgen, S, Toraman, F, Selvi, O, Senturk, O, Yildiz, M, Kuvaki, B, Gunenc, F, Kucukguclu, S, Ozbilgin, S, Maral, J, Canli, S, Arun, O, Saltali, A, Aydogan, E, Akgun, F, Sanlikarip, C, Karaman, F, Mazur, A, Vorotyntsev, S, Rousseau, G, Barrett, C, Stancombe, L, Shelley, B, Scholes, H, Limb, J, Rafi, A, Wayman, L, Deane, J, Rogerson, D, Williams, J, Yates, S, Rogers, E, Pulletz, M, Moreton, S, Jones, S, Venkatesh, S, Burton, M, Brown, L, Goodall, C, Rucklidge, M, Fuller, D, Nadolski, M, Kusre, S, Lundberg, M, Everett, L, Nutt, H, Zuleika, M, Carvalho, P, Clements, D, Ben, C, Watt, P, Raymode, P, Pearse, R, Mohr, O, Raj, A, Creary, T, Chishti, A, Bell, A, Higham, C, Cain, A, Gibb, S, Mowat, S, Franklin, D, West, C, Minto, G, Boyd, N, Calton, E, Walker, R, Mackenzie, F, Ellison, B, Roberts, H, Chikungwa, M, Jackson, C, Donovan, A, Foot, J, Homan, E, Montgomery, J, Portch, D, Mercer, P, Palmer, J, Paddle, J, Fouracres, A, Datson, A, Andrew, A, Welch, L, Rose, A, Varma, S, Simeson, K, Rambhatla, M, Susarla, J, Marri, S, Kodaganallur, K, Das, A, Algarsamy, S, Colley, J, Davies, S, Szewczyk, M, Smith, T, Ana, F, Luzier, E, Almagro, A, Fernando, L, Sulemanji, D, Sprung, J, Weingarten, T, Kor, D, Scavonetto, F, Tze, Y, Acibadem University Dspace, Anesthesiology, Graduate School, Intensive Care Medicine, ACS - Diabetes & metabolism, ACS - Pulmonary hypertension & thrombosis, ACS - Microcirculation, ACS - Heart failure & arrhythmias, Università degli studi di Palermo - University of Palermo, University of Amsterdam [Amsterdam] (UvA), Hospital Israelita Albert Einstein [São Paulo, Brazil], IRCCS Ospedale Policlinico San Martino [Genoa, Italy], Massachusetts General Hospital [Boston], University Hospital Bonn, University Hospital Carl Gustav Carus [Dresden, Germany], Technische Universität Dresden = Dresden University of Technology (TU 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S., Hemmes, S. N. T., Ball, L., Canet, J., Hiesmayr, M., Hollmann, M. W., Mills, G. H., Melo, M. F. V., Putensen, C., Schmid, W., Severgnini, P., Wrigge, H., Gama de Abreu, M., Schultz, M. J., Pelosi, P., Kroell, W., Metzler, H., Struber, G., Wegscheider, T., Gombotz, H., Urbanek, B., Kahn, D., Momeni, M., Pospiech, A., Lois, F., Forget, P., Grosu, I., Poelaert, J., Mossevelde, V., van Malderen, M. C., Dylst, D., Melkebeek, J. V., Beran, M., Hert, S. D., Baerdemaeker, L. D., Heyse, B., Limmen, J. V., Wyffels, P., Jacobs, T., Roels, N., Bruyne, A. D., Velde, S. V. D., Marina, J. Z., Dejana, D. O., Pernar, S., Zunic, J., Miskovic, P., Zilic, A., Kvolik, S., Ivic, D., Darija, A. V., Skiljic, S., Vinkovic, H., Oputric, I., Juricic, K., Frkovic, V., Kopic, J., Mirkovic, I., Saric, J. P., Erceg, G., Dvorscak, M. B., Branka, M. S., Pavicic, A. M., Goranovic, T., Maldini, B., Radocaj, T., Gavranovic, Z., Inga, M. B., Sehovic, M., Stourac, P., Harazim, H., Smekalova, O., Kosinova, M., Kolacek, T., Hudacek, K., Drab, M., Brujevic, J., Vitkova, K., Jirmanova, K., Volfova, I., Dzurnakova, P., Liskova, K., Dudas, R., Filipsky, R., Kafrawy, S. E., Abdelwahab, H. H., Metwally, T., Ahmed, A. R., Ahmed Mostafa, E. S., Hasan, W. F., Ahmed, A. G., Yassin, H., Magdy, M., Abdelhady, M., Mahran, M., Herodes, E., Kivik, P., Oganjan, J., Aun, A., Sormus, A., Sarapuu, K., Mall, M., Karjagin, J., Futier, E., Petit, A., Gerard, A., Marret, E., Solier, M., Jaber, S., Prades, A., Krassler, J., Merzky, S., Abreu, M. G. D., Uhlig, C., Kiss, T., Bundy, A., Bluth, T., Gueldner, A., Spieth, P., Scharffenberg, M., Thiem, D. T., Koch, T., Treschan, T., Schaefer, M., Bastin, B., Geib, J., Weiss, M., Kienbaum, P., Pannen, B., Gottschalk, A., Konrad, M., Westerheide, D., Schwerdtfeger, B., Simon, P., Reske, A., Nestler, C., Valsamidis, D., Stroumpoulis, K., Antholopoulos, G., Andreou, A., Karapanos, D., Theodorak, K., Gkiokas, G., Tasoulis, M. K., Sidiropoulou, T., Zafeiropoulou, F., Florou, P., Pandazi, A., Tsaousi, G., Nouris, C., Pourzitaki, C., Bystritski, D., Pizov, R., Eden, A., Pesce, C. V., Campanile, A., Marrella, A., Grasso, S., Michele, M. D., Bona, F., Giacoletto, G., Sardo, E., Sottosanti, L. G. V., Solca, M., Volta, C. A., Spadaro, S., Verri, M., Ragazzi, R., Zoppellari, R., Cinnella, G., Raimondo, P., Bella, D. L., Mirabella, L., D'Antini, D., Molin, A., Brunetti, I., Gratarola, A., Pellerano, G., Sileo, R., Pezzatto, S., Montagnani, L., Pasin, L., Landoni, G., Zangrillo, A., Beretta, L., Parma, A. L. D., Tarzia, V., Dossi, R., Sassone, M. E., Sances, D., Tredici, S., Spano, G., Castellani, G., Delunas, L., Peradze, S., Venturino, M., Arpino, I., Sher, S., Tommasino, C., Rapido, F., Morelli, P., Vargas, M., Servillo, G., Raineri, S. M., Montalto, F., Russotto, V., Giarratano, A., Baciarello, M., Generali, M., Cerati, G., Leykin, Y., Bressan, F., Bartolini, V., Zamidei, L., Brazzi, L., Liperi, C., Sales, G., Pistidda, L., Brugnoni, E., Musella, G., Bacuzzi, A., Muhardri, D., Agreta, G. G., Sada, F., Bytyqi, A., Karbonskiene, A., Aukstakalniene, R., Teberaite, Z., Salciute, E., Tikuisis, R., Miliauskas, P., Jurate, S., Kontrimaviciute, E., Tomkute, G., Xuereb, J., Bezzina, M., Borg, F. J., Hemmes, S., Schultz, M., Hollmann, M., Wiersma, I., Binnekade, J., Bos, L., Boer, C., Duvekot, A., Veld, B. I. '., Werger, A., Dennesen, P., Severijns, C., Jong, J. D., Hering, J., Beek, R. V., Ivars, S., Jammer, I. B., Breidablik, A., Hodt, K. S., Fjellanger, F., Avalos, M. V., Jannicke, M. O., Andersson, E., Amir, S. K., Molina, R., Wutai, S., Morais, E., Tareco, G., Ferreira, D., Amaral, J., Castro, M. D. L. G., Cadilha, S., Appleton, S., Parente, S., Correia, M., Martins, D., Monteirosa, A., Ricardo, A., Rodrigues, S., Horhota, L., Grintescu, I. M., Mirea, L., Grintescu, I. C., Corneci, D., Negoita, S., Dutu, M., Popescu Garotescu, I., Filipescu, D., Prodan, A. B., Droc, G., Fota, R., Popescu, M., Tomescu, D., Petcu, A. M., Tudoroiu, M. I., Moise, A., Guran, C. T., Gherghina, I., Costea, D., Cindea, I., Copotoiu, S. M., Copotoiu, R., Barsan, V., Tolcser, Z., Riciu, M., Moldovan, S. G., Veres, M., Gritsan, A., Kapkan, T., Gritsan, G., Korolkov, O., Kulikov, A., Lubnin, A., Ovezov, A., Prokoshev, P., Lugovoy, A., Anipchenko, N., Babayants, A., Komissarova, I., Zalina, K., Likhvantsev, V., Fedorov, S., Lazukic, A., Pejakovic, J., Mihajlovic, D., Kusnierikova, Z., Zelinkova, M., Bruncakova, K., Polakovicova, L., Sobona, V., Barbka, N. S., Ana, P. G., Jovanov, M., Strazisar, B., Jasmina, M. B., Vesna, N. J., Voje, M., Grynyuk, A., Kostadinov, I., Alenka, S. V., Moral, V., Unzueta, M. C., Puigbo, C., Fava, J., Moret, E., Nunez, M. R., Sendra, M., Brunelli, A., Rodenas, F., Monedero, P., Martinez, F. H., Temino, M. J. Y., Simon, A. M., Larriba, A. D. A., Lisi, A., Perez, G., Martinez, R., Granell, M., Vivo, J. T., Ruiz, C. S., Andres Ibanez, J. A. D., Pastor, E., Soro, M., Ferrando, C., Defez, M., Cesar Aldecoa, A. S., Perez, R., Rico, J., Jawad, M., Saeed, Y., Gillberg, L., Bengisun, Z. K., Kazbek, B. K., Coskunfirat, N., Boztug, N., Sanli, S., Yilmaz, M., Hadimioglu, N., Senturk, N. M., Camci, E., Kucukgoncu, S., Sungur, Z., Sivrikoz, N., Ozgen, S. U., Toraman, F., Selvi, O., Senturk, O., Yildiz, M., Kuvaki, B., Gunenc, F., Kucukguclu, S., Ozbilgin, S., Maral, J., Canli, S., Arun, O., Saltali, A., Aydogan, E., Akgun, F. N., Sanlikarip, C., Karaman, F. M., Mazur, A., Vorotyntsev, S., Rousseau, G., Barrett, C., Stancombe, L., Shelley, B., Scholes, H., Limb, J., Rafi, A., Wayman, L., Deane, J., Rogerson, D., Williams, J., Yates, S., Rogers, E., Pulletz, M., Moreton, S., Jones, S., Venkatesh, S., Burton, M., Brown, L., Goodall, C., Rucklidge, M., Fuller, D., Nadolski, M., Kusre, S., Lundberg, M., Everett, L., Nutt, H., Zuleika, M., Carvalho, P., Clements, D., Ben, C. B., Watt, P., Raymode, P., Pearse, R., Mohr, O., Raj, A., Creary, T., Chishti, A., Bell, A., Higham, C., Cain, A., Gibb, S., Mowat, S., Franklin, D., West, C., Minto, G., Boyd, N., Mills, G., Calton, E., Walker, R., Mackenzie, F., Ellison, B., Roberts, H., Chikungwa, M., Jackson, C., Donovan, A., Foot, J., Homan, E., Montgomery, J., Portch, D., Mercer, P., Palmer, J., Paddle, J., Fouracres, A., Datson, A., Andrew, A., Welch, L., Rose, A., Varma, S., Simeson, K., Rambhatla, M., Susarla, J., Marri, S., Kodaganallur, K., Das, A., Algarsamy, S., Colley, J., Davies, S., Szewczyk, M., Smith, T., Ana, F. B., Luzier, E., Almagro, A., Melo, M. V., Fernando, L., Sulemanji, D., Sprung, J., Weingarten, T., Kor, D., Scavonetto, F., Tze, Y., Cortegiani A., Gregoretti C., Neto A.S., Hemmes S.N.T., Ball L., Canet J., Hiesmayr M., Hollmann M.W., Mills G.H., Melo M.F.V., Putensen C., Schmid W., Severgnini P., Wrigge H., Gama de Abreu M., Schultz M.J., Pelosi P., Kroell W., Metzler H., Struber G., Wegscheider T., Gombotz H., Urbanek B., Kahn D., Momeni M., Pospiech A., Lois F., Forget P., Grosu I., Poelaert J., Mossevelde V., van Malderen M.C., Dylst D., Melkebeek J.V., Beran M., Hert S.D., Baerdemaeker L.D., Heyse B., Limmen J.V., Wyffels P., Jacobs T., Roels N., Bruyne A.D., Velde S.V.D., Marina J.Z., Dejana D.O., Pernar S., Zunic J., Miskovic P., Zilic A., Kvolik S., Ivic D., Darija A.V., Skiljic S., Vinkovic H., Oputric I., Juricic K., Frkovic V., Kopic J., Mirkovic I., Saric J.P., Erceg G., Dvorscak M.B., Branka M.S., Pavicic A.M., Goranovic T., Maldini B., Radocaj T., Gavranovic Z., Inga M.B., Sehovic M., Stourac P., Harazim H., Smekalova O., Kosinova M., Kolacek T., Hudacek K., Drab M., Brujevic J., Vitkova K., Jirmanova K., Volfova I., Dzurnakova P., Liskova K., Dudas R., Filipsky R., Kafrawy S.E., Abdelwahab H.H., Metwally T., Ahmed A.R., Ahmed Mostafa E.S., Hasan W.F., Ahmed A.G., Yassin H., Magdy M., Abdelhady M., Mahran M., Herodes E., Kivik P., Oganjan J., Aun A., Sormus A., Sarapuu K., Mall M., Karjagin J., Futier E., Petit A., Gerard A., Marret E., Solier M., Jaber S., Prades A., Krassler J., Merzky S., Abreu M.G.D., Uhlig C., Kiss T., Bundy A., Bluth T., Gueldner A., Spieth P., Scharffenberg M., Thiem D.T., Koch T., Treschan T., Schaefer M., Bastin B., Geib J., Weiss M., Kienbaum P., Pannen B., Gottschalk A., Konrad M., Westerheide D., Schwerdtfeger B., Simon P., Reske A., Nestler C., Valsamidis D., Stroumpoulis K., Antholopoulos G., Andreou A., Karapanos D., Theodorak K., Gkiokas G., Tasoulis M.K., Sidiropoulou T., Zafeiropoulou F., Florou P., Pandazi A., Tsaousi G., Nouris C., Pourzitaki C., Bystritski D., Pizov R., Eden A., Pesce C.V., Campanile A., Marrella A., Grasso S., Michele M.D., Bona F., Giacoletto G., Sardo E., Sottosanti L.G.V., Solca M., Volta C.A., Spadaro S., Verri M., Ragazzi R., Zoppellari R., Cinnella G., Raimondo P., Bella D.L., Mirabella L., D'antini D., Molin A., Brunetti I., Gratarola A., Pellerano G., Sileo R., Pezzatto S., Montagnani L., Pasin L., Landoni G., Zangrillo A., Beretta L., Parma A.L.D., Tarzia V., Dossi R., Sassone M.E., Sances D., Tredici S., Spano G., Castellani G., Delunas L., Peradze S., Venturino M., Arpino I., Sher S., Tommasino C., Rapido F., Morelli P., Vargas M., Servillo G., Raineri S.M., Montalto F., Russotto V., Giarratano A., Baciarello M., Generali M., Cerati G., Leykin Y., Bressan F., Bartolini V., Zamidei L., Brazzi L., Liperi C., Sales G., Pistidda L., Brugnoni E., Musella G., Bacuzzi A., Muhardri D., Agreta G.G., Sada F., Bytyqi A., Karbonskiene A., Aukstakalniene R., Teberaite Z., Salciute E., Tikuisis R., Miliauskas P., Jurate S., Kontrimaviciute E., Tomkute G., Xuereb J., Bezzina M., Borg F.J., Hemmes S., Schultz M., Hollmann M., Wiersma I., Binnekade J., Bos L., Boer C., Duvekot A., Veld B.I.'., Werger A., Dennesen P., Severijns C., Jong J.D., Hering J., Beek R.V., Ivars S., Jammer I.B., Breidablik A., Hodt K.S., Fjellanger F., Avalos M.V., Jannicke M.O., Andersson E., Amir S.K., Molina R., Wutai S., Morais E., Tareco G., Ferreira D., Amaral J., Castro M.D.L.G., Cadilha S., Appleton S., Parente S., Correia M., Martins D., Monteirosa A., Ricardo A., Rodrigues S., Horhota L., Grintescu I.M., Mirea L., Grintescu I.C., Corneci D., Negoita S., Dutu M., Popescu Garotescu I., Filipescu D., Prodan A.B., Droc G., Fota R., Popescu M., Tomescu D., Petcu A.M., Tudoroiu M.I., Moise A., Guran C.T., Gherghina I., Costea D., Cindea I., Copotoiu S.M., Copotoiu R., Barsan V., Tolcser Z., Riciu M., Moldovan S.G., Veres M., Gritsan A., Kapkan T., Gritsan G., Korolkov O., Kulikov A., Lubnin A., Ovezov A., Prokoshev P., Lugovoy A., Anipchenko N., Babayants A., Komissarova I., Zalina K., Likhvantsev V., Fedorov S., Lazukic A., Pejakovic J., Mihajlovic D., Kusnierikova Z., Zelinkova M., Bruncakova K., Polakovicova L., Sobona V., Barbka N.S., Ana P.G., Jovanov M., Strazisar B., Jasmina M.B., Vesna N.J., Voje M., Grynyuk A., Kostadinov I., Alenka S.V., Moral V., Unzueta M.C., Puigbo C., Fava J., Moret E., Nunez M.R., Sendra M., Brunelli A., Rodenas F., Monedero P., Martinez F.H., Temino M.J.Y., Simon A.M., Larriba A.D.A., Lisi A., Perez G., Martinez R., Granell M., Vivo J.T., Ruiz C.S., Andres Ibanez J.A.D., Pastor E., Soro M., Ferrando C., Defez M., Cesar Aldecoa A.S., Perez R., Rico J., Jawad M., Saeed Y., Gillberg L., Bengisun Z.K., Kazbek B.K., Coskunfirat N., Boztug N., Sanli S., Yilmaz M., Hadimioglu N., Senturk N.M., Camci E., Kucukgoncu S., Sungur Z., Sivrikoz N., Ozgen S.U., Toraman F., Selvi O., Senturk O., Yildiz M., Kuvaki B., Gunenc F., Kucukguclu S., Ozbilgin S., Maral J., Canli S., Arun O., Saltali A., Aydogan E., Akgun F.N., Sanlikarip C., Karaman F.M., Mazur A., Vorotyntsev S., Rousseau G., Barrett C., Stancombe L., Shelley B., Scholes H., Limb J., Rafi A., Wayman L., Deane J., Rogerson D., Williams J., Yates S., Rogers E., Pulletz M., Moreton S., Jones S., Venkatesh S., Burton M., Brown L., Goodall C., Rucklidge M., Fuller D., Nadolski M., Kusre S., Lundberg M., Everett L., Nutt H., Zuleika M., Carvalho P., Clements D., Ben C.B., Watt P., Raymode P., Pearse R., Mohr O., Raj A., Creary T., Chishti A., Bell A., Higham C., Cain A., Gibb S., Mowat S., Franklin D., West C., Minto G., Boyd N., Mills G., Calton E., Walker R., Mackenzie F., Ellison B., Roberts H., Chikungwa M., Jackson C., Donovan A., Foot J., Homan E., Montgomery J., Portch D., Mercer P., Palmer J., Paddle J., Fouracres A., Datson A., Andrew A., Welch L., Rose A., Varma S., Simeson K., Rambhatla M., Susarla J., Marri S., Kodaganallur K., Das A., Algarsamy S., Colley J., Davies S., Szewczyk M., Smith T., Ana F.B., Luzier E., Almagro A., Melo M.V., Fernando L., Sulemanji D., Sprung J., Weingarten T., Kor D., Scavonetto F., Tze Y., Hemmes, Snt, Hollmann, Mw, Mills, Gh, Melo, Mfv, Schultz, Mj, on behalf of the LAS VEGAS Investigators the PROVE Network and the Clinical Trial Network of the European Society of, Anaesthesiology, Maltepe Üniversitesi, UCL - SSS/IREC - Institut de recherche expérimentale et clinique, UCL - (SLuc) Service d'anesthésiologie, and Selçuk Üniversitesi
Subjects: Lung Diseases, Postoperative Complications/epidemiology, Male, Internationality, Intraoperative Complication, medicine.medical_treatment, Settore MED/41 - Anestesiologia, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Lung Disease, Cohort Studies, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Anesteziologija i reanimatologija, 0302 clinical medicine, 030202 anesthesiology, Risk Factors, patient safety, Medicine, General anaesthesia, postoperative complication, Prospective Studies, intraoperative complications, Statistics & numerical data, Prospective cohort study, Incidence (epidemiology), Incidence, general anaesthesia, intraoperative complications, patient safety, postoperative complications, pulmonary, Middle Aged, Operative, 3. Good health, Surgical Procedures, Operative, Female, general anaesthesia, postoperative complications, pulmonary, Cohort study, Human, Adult, medicine.medical_specialty, Lung Diseases/epidemiology, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, NO, 03 medical and health sciences, Intraoperative Complications/epidemiology, After-Hours Care, Humans, MED/41 - ANESTESIOLOGIA, Adverse effect, Aged, Mechanical ventilation, Surgical Procedures, business.industry, Risk Factor, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Anesthesiology and Reanimatology, intraoperative complication, Surgery, After-Hours Care/statistics & numerical data, Anesthesiology and Pain Medicine, Clinical trial, MESH: After-hours Care / statistics & numerical data, Lung diseases / epidemiology, Surgical procedures, operative, Prospective Studie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Cohort Studie, business
Abstract: WOS: 000458513600019, PubMed: 30770054, Background: The aim of this post hoc analysis of a large cohort study was to evaluate the association between night-time surgery and the occurrence of intraoperative adverse events (AEs) and postoperative pulmonary complications (PPCs). Methods: LAS VEGAS (Local Assessment of Ventilatory Management During General Anesthesia for Surgery) was a prospective international 1-week study that enrolled adult patients undergoing surgical procedures with general anaesthesia and mechanical ventilation in 146 hospitals across 29 countries. Surgeries were defined as occurring during 'daytime' when induction of anaesthesia was between 8: 00 AM and 7: 59 PM, and as 'night-time' when induction was between 8: 00 PM and 7: 59 AM. Results: Of 9861 included patients, 555 (5.6%) underwent surgery during night-time. The proportion of patients who developed intraoperative AEs was higher during night-time surgery in unmatched (43.6% vs 34.1%; P, NIHeNHLBI [1R34HL123438]; European Society of Anaesthesiology, The LAS VEGAS study was co-funded and endorsed by the European Society of Anaesthesiology, which had no role in the study design nor data analysis and interpretation. MFVM was supported by NIHeNHLBI (1R34HL123438).
Published: 2019
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6. Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study

Author: Kirmeier E. a, Eriksson L. I. c, Lewald H. a, Jonsson Fagerlund, M. c Hoeft, A. f Hollmann, M. g Meistelman, C. e Hunter, J. M. d Ulm, K. b Blobner, M. aEmail Author, Abad Gurumeta, A. Abernethy, C. Abigail, P. Achaibar, K. Adam, E. Afshari, Agudelo Montoya, M. E. Akgün, F. N. Aletti, G. Alkış, N. Allan, K. Allan, A. Allaouchiche, B. Allcock, C. Almasy, E. Amey, I. Amigoni, M. Andersen, E. Andersson, P. Anipchenko, N. Antunes, P. Armstrong, E. Aslam, T. N. Aslin, B. Assunção, J. P. Ausserer, J. Avvai, M. Awad, Ayas Montero, B. Ayuso, M. Azevedo, P. Badarau, V. Badescu, Baiardo Redaelli, M. Baird, C. Baird, Y. Baker, T. Balaji, P. Bălan, C. Balandin, A. Balescu-Arion, C. Baliuliene, Baltasar Isabel, J. Baluch, S. N. Bandrabur, D. Bankewitz, C. Barber, K. Barbera, F. Barcraft-Barnes, H. Barletti, V. Barnett, G. Baron, K. Barros, A. Barsan, V. Bartlett, P. Batistaki, C. Baumgarten, G. Baytas, V. Beauchamp, Becerra Cayetano, I. A. Bell, S. Bellandi, M. Belletti, Belmonte Cuenca, J. Benitez-Cano, A. Beretta, L. Berger, M. Bergmann, N. Bergmark, Bermudez Lopez, M. Bernotaite, M. Beurskens, C. Bidd, H. Bifulco, F. Bignami, E. Bilic, A. Bilskiene, D. Bischoff, P. Bishop, L. Bjonness, T. Blaylock, H. Blethyn, K. Blincoe, T. Blokhin, I. Blunt, N. Boer, C. Bois, G. Bonicolini, E. Booth, J. Borecka-Kedzierska, M. Borstnar, K. Borys, M. Boselli, E. Bouvet, L. Bouwman, A. Bowen, L. Bowrey, S. Boxall, L. Božić, T. Bradley, T. Branco, T. Brazzi, L. Brazzoni, M. Brear, T. Brogly, N. Brohi, F. Broms, J. Bubliauskas, A. Bucolo, G. E. Buerkle, H. Buggy, D. Buhre, W. Bukauskas, T. Butturini, F. Byttner, Cabrera Díaz, I. Calderon, A. Calhau, R. Callejo, A. Cammu, G. Campesato, M. Can, Ö. S. Candeias, M. Cantor, A. Carise, E. Carmona, C. Carreteiro, J. Carrieri, C. Carter, A. Casal, M. Casanova, I. Cascella, M. Casero, L. M. Casiraghi, G. M. Castelo-Branco, Castro Arranz, C. Cernea, D. D. Cervantes, J. Chandler, B. Charnock, R. Chatzimicali, A. Chinery, E. Chishti, A. Chondhury, P. Christie, E. Christodoudiles, G. Ciardo, S. Cimpeanu, L. Cindea, I. Cinnella, G. Clark, S. Clayton, M. Cocu, S. Collyer, T. Colvin, C. Cope, S. Copeta, F. Copotoiu, S. -M., Correia de Barros, F. Corso, R. M. Cortegiani, A. Costa, G. Cowton, A. Cox, N. Craig, J. Cricca, V. Cronin, J. Cunha, M. Cuomo, A. Curley, K. Czuczwar, M. Dabrowska, D. Damster, Danguy des Déserts, M. Daniliuc, A. Danninger, T. Darwish, I. Dascalu, C. Davies, K. Davies, De Boer, De Flaviis, De Selincourt, G. Deana, C. Debaene, B. Debreceni, G. Dedhia, Delgado Garcia, Della Rocca, G. Delroy-Buelles, L. Desai, T. Dhillon, Di Giacinto, Di Mauro, Diaz Gomez, T. V. Dimitrovski, A. Dinic, V. Dîrzu, D. -S., Divander M. B., Dolinar J., Domingues S., Doolan J., Downes C., Dragoescu N. A., Droc G., Dum E., Dumitrescu A., Duncan L., Dzurňáková P., Eberl S., Edwards J., Edwards M., Ekelund K., Ekengren P., Elghouty E., Ellerkmann R., Ellis H., Elme A., Ernst T., Errando C. 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Livia, Männer, Olja, Marchand, Bahareh, Marcu, Alexandra, Margalef, Jordi, Margarson, Michael, Marinheiro, Lucia, Markic, Ana, Markovic Bozic, Jasmina, Marrazzo, Francesco, Martin, Jane, Martin Ayuso, Maria, Martinez, Esteher, Martino, Enrico Antonio, Martinson, Victoria, Marusic-Gaser, Katarina, Mascarenhas, Catia, Mathis, Cindy, Matsota, Paraskevi, Mavrommati, Eleni, Mazul Sunko, Branka, McCourt, Killian, McGill, Neil, McKee, Raymond, Meço, Başak Ceyda, Meier, Sonja, Melbourne, Susan, Melbybråthen, Grethe, Meli, Andrea, Melia, Aiden, Melotti, Rita Maria, Menga, Maria Rosaria, Mercer, Pauline, Merotra, Susan, Mescolini, Silvia, Metterlein, Thoma, Michalov, Martin, Michlig, Sam, Midgley, Susan, Milić, Morena, Milojevic, Milan, Miñana, Amanda, Minto, Gary, Mirabella, Lucia, Mirea, Liliana, Mittelstädt, Ludger, Moeglen, Aude, Moise, Alida, Mokini, Zhirajr, Molin, Anna, Moltó, Lui, Monea, Maria Concetta, Montalto, Francesca, Montgomery, Jane, Montgomery, Claire, Montillo, Gerardo, Moore, Sally, Moore, Faye, Moreira, Zelia, Moreno, Tania, Moreno, Ricardo, Moret, Enrique, Moreton, Sarah, Morgan, Marianne, Moro Velasco, Concepción, Morri, Davide, Moull, Alice, Moura, Fernando, Mráz, Peter, Mrozek, Katarzyna, Mukhtar, Karim, Muniyappa, Sudeshkumar, Murray, Heather, Murthy, Burra VS, Mushambi, Mary, Nadolski, Maria, Nardelli, Pasquale, Nardin, Giordano, Navarro Pérez, Rosalía, Naveiro, Andrea, Negri, Manuela, Nesek Adam, Visnja, Neskovic, Vojislava, Neuwersch, Stefan, Neves, Miriam, Nguyen, Bavinh, Ní Eochagáin, Aisling, Nicholas, Caroline, Nightingale, Jeremy, Norrie, Kylie, Novak-Jankovic, Vesna, Novakova, Andrea, Novillo, Marta, Numan, Sandra, Oduro-Dominah, Louise, Oldner, Ander, Oliveira, Isabel, Ologoiu, Daniela, Oloktsidou, Irini, O'Reilly, Rosalind, Orlando, Alessandro, Ovezov, Alexey, Ozbilgin, Sule, Paal, Peter, Padin Barreiro, Lidia, Palugniok, Ryszard, Papaioannou, Alexandra, Papapostolou, Konstantino, Paranthaman, Prabhakar, Pardey Bracho, Gilda, Parente, Suzana, Parfeni, Alexandru, Pasin, Laura, Passey, Samuel, Pastor, Ernesto, Patch, Sarah, Patil, Andan, Paunescu, Marilena-Alina, Pehboeck, Daniel, Pereira, Manuela, Pereira, Carla, Perez Caballero, Paula, Pérez García, Aníbal, Pérez Soto, Antonia, Perez Tejero, Gisela, Perez-Cerda, Francisco, Pesenti, Antonio, Petta, Rocco, Philippe, Simon, Pickering, David, Pico Veloso, Jandro, Pina, Pedro, Pinho-Oliveira, Vítor, Pinol, Santiago, Pinto, Rita, Pistidda, Laura, Pitterle, Manuela, Piwowarczyk, Paweł, Plotnikova, Olga, Pohl, Holger, Poldermann, Jorinde, Polkovicová, Lucia, Pompei, Livia, Popescu, Mihai, Popović, Radmila, Pota, Vincenzo, Potocnik, Miriam, Potręć, Beata, Potter, Alison, Pramod, Nalwaya, Prchalova, Martina, Preckel, Benedikt, Pugh, Richard, Pulletz, Mark, Radoeshki, Aleksandar, Rafi, Amir, Ragazzi, Riccardo, Raineri Santi, Maurizio, Rajamanickam, Tamiselvan, Rajput, Zahra, Ramachandran, Rajeskar, Ramasamy, Radhika, Ramessur, Suneil, Rao, Roshan, Rasmussen, Ander, Rato, André, Razaque, Usman, Real Navacerrada, M. Isabel, Reavley, Caroline, Reid, Jame, Reschreiter, Henrik, Rial, Erick, Ribas Carrasco, Patricia, Ribeiro, Sandy, Rich, Nathalie, Richardson, Lydia, Rimaitis, Kestuti, Rimaitis, Mariu, Ringvold, Else-Marie, Ripke, Fabian, Ristescu, Irina, Ritchie, Keith, Ródenas, Frederic, Rodrigues, Patrícia, Rogers, Emma, Rogerson, David, Romagnoli, Stefano, Romero, Esther, Rondovic, Goran, Rose, Bernd Oliver, Roth, Winfried, Rotter, Marie-Therese, Rousseau, Guy, Rudjord, Ander, Rueffert, Henrik, Rundgren, Malin, Rupprecht, Korbinian, Rushton, Andrew, Russotto, Vincenzo, Rypulak, Elżbieta, Ryszka, Maciej, Sà, Jacinta, Sà Couto, Paula, Saby, Sandrine, Sagic, Jelena, Saleh, Omar, Sales, Gabriele, Sánchez Sánchez, Yván, Sanghera, Sumayer, Şanli Karip, Ceren, Santiveri Papiol, Francisco Javier, Santos, Sofia, Sarno, Stephen, Saul, Daniel, Saunders, David, Savic, Nenad, Scalco, Loïc, Scanlon, Deborah, Schaller, Stefan, Schax, Christoph, Scheffer, Gert Jan, Schening, Anna, Schiavone, Vincenzo, Schmidt-Ehrenberg, Florian, Schmidt-Mutter, Catherine, Schönberg, Christina, Schopflin, Christian, Schreiber, Jan-Uwe, Schultz, Marcu, Schurig, Marlen, Scott, Carmen, Sebestian, Siby, Sehgal, Selena, Sem, Victoria, Semenas, Egidiju, Serafini, Elena, Serchan, Pashalitsa, Shields, Martin, Shobha, Ramakrishnan, Shosholcheva, Mirjana, Siamansour, Tanja, Siddaiah, Narendra, Siddiqi, Khalid, Sinclair, Rhona, Singh, Permendra, Singh, Rajendra, Sinha, Aneeta, Sinha, Ashok, Skinner, Amanda, Smee, Elizabeth, Smekalova, Olga, Smith, Neil, Smith, Thoma, Smitz, Carine, Smole, Daniel, Sojčić, Nataša, Soler Pedrola, Maria, Somanath, Sameer, Sonksen, Julian, Sorella, Maria Christina, Sörmus, Alar, Soro, Marina, Soto, Carmen, Spada, Anna, Spadaro, Savino, Spaeth, Johanne, Sparr, Harald, Spielmann, Annika, Spindler-Vesel, Alenka, Stamelos, Matthaio, Stancombe L, Liucia, Stanculescu, Andreea, Standl, Thoma, Standley, Tom, Stanek, Ondrej, Stanisavljević, Snežana, Starczewska, Malgorzata, Stäuble, Christiane, Steen, Julie, Stefan, Oana Maria, Stell, Elizabeth, Stera, Caterina, Stevens, Marku, Stoerckel, Marlène, Stošić, Biljana, Stourac, Petr, Stroumpoulis, Konstantino, Struck, Rafael, Suarez de la Rica, Alejandro, Sultanpori, Altaf, Sundara Rajan, Rajinikanth, Suying, Ong, Svensen, Christer, Swan, Louise, Syrogianni, Paulina, Sysiak, Justyna, Szederjesi, Jano, Taddei, Stefania, Tan Hao, Ern, Tanou, Virginia, Tarabová, Katarina, Tardaguila Sancho, Paula, Tarroso, Maria, Tartaglione, Marco, Taylor, Emma, Tbaily, Lee, Telford, Richard, Terenzoni, Massimo, Theodoraki, Kassiani, Thornley, Helen, Tiganiuc, Liviu, Toim, Hardo, Tomescu, Dana, Tommasino, Concezione, Toni, Jessica, Toninelli, Arturo, Toretti, Ilaria, Townley, Stephen, Trepenaitis, Dariu, Trethowan, Brian, Tsaousi, Georgia, Tsiftsi, Aikaterini, Tudor, Adrada, Turan, Güldem, Turhan, Sanem Çakar, Unic-Stojanovic, Dragana, Unterbuchner, Christoph, Unzueta, Carmen, Uranjek, Jasna, Ursic, Tomaz, Vaida, Simona, Valldeperas Ferrer, Silvia, Valldeperas Hernandez, Maria Inmaculada, Valsamidis, Dimitri, Van Beek, Rienk, Van dasselaer, Nick, Van Der Beek, Tim, Van Duivenvoorde, Yoni, van Klei, Wilton A., Van Poorter, Fran, Van Zaane, Ba, Van Zundert, Tom, Van Zyl, Rebekka, Vargas Munoz, Ana Milena, Varsani, Nimu, Vasconcelos, Pedro, Vassilakis, Georgio, Vecchiatini, Tommaso, Vecera, Lubomir, Vercauteren, Marcel, Verdouw, Ba, Verheyen, Veerle, Verri, Marco, Vicari Sottosanti, Luigi Giancarlo, Vico, Manuel, Vidal Mitjans, Patricia, Vilardi, Anna, Vissicchio, Daniela, Vitale, Giovanni, Vitković, Bibiana, Vizcaychipi, Marcela Paola, Voicu, Alexandra, Voje, Minca, Volfová, Ivana, Volta, Carlo Alberto, Von Lutterotti, Theresa, von Tiesenhausen, Anna, Vrecic-Slabe, Simona, Vukcevic, Dejan, Vukovic, Rade, Vullo, P. Agostina, Wade, Andrew, Wallberg, Hanna, Wallden, Jakob, Wallner, Johann, Walther Sturesson, Louise, Watson, Davina, Weber, Stefan, Wegiel Leskiewiq, Anna, Weller, Debbie, Wensing, Carine, Werkmann, Marku, Westberg, Henrik, Wikström, Erik, Williams, Benedict, Wilson, Robin, Wirth, Steffen, Wittmann, Maria, Wood, Laura, Wright, Stella, Zachoval, Christian, Zambon, Massimo, Zampieri, Silvia, Zampone, Salvatore, Zangrillo, Alberto, Zani, Gianluca, Zavackiene, Asta, Zieglerder, Raphael, Zonneveldt, Harry, Zsisku, Lajo, Zucker, Tom-Philipp, Żukowski, Maciej, Zuleika, Mehrun, and Zupanĕiĕ, Darja
Subjects: Pulmonary and Respiratory Medicine, pulmonary complications, muscle relaxants, Post-anaesthesia complications, Neuromuscular Blockade, pulmonary complication, muscle relaxant, neuromuscular block, postoperative pulmonary complication, business.industry, Retrospective cohort study, post-operative pulmonary complications, Neuromuscular monitoring, Neuromuscular Blocking Agents, Sugammadex, NO, Anaesthesia, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Anesthesia, Medicine, General anaesthesia, Neuromuscular Agents, 030212 general & internal medicine, MED/41 - ANESTESIOLOGIA, Prospective cohort study, business, medicine.drug
Abstract: Background: Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods: We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged ≥18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients' preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARRadj). This study is registered with ClinicalTrials.gov, number NCT01865513. Findings: Between June 16, 2014, and April 29, 2015, data from 22 803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7·6%] of 21 694); ORadj 1·86, 95% CI 1·53–2·26; ARRadj −4·4%, 95% CI −5·5 to −3·2). Only 2·3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1·31, 95% CI 1·15–1·49; ARRadj −2·6%, 95% CI −3·9 to −1·4) and the administration of reversal agents (1·23, 1·07–1·41; −1·9%, −3·2 to −0·7) were not associated with a decreased risk of postoperative pulmonary complications. Neither the choice of sugammadex instead of neostigmine for reversal (ORadj 1·03, 95% CI 0·85–1·25; ARRadj −0·3%, 95% CI −2·4 to 1·5) nor extubation at a train-of-four ratio of 0·9 or more (1·03, 0·82–1·31; −0·4%, −3·5 to 2·2) was associated with better pulmonary outcomes. Interpretation: We showed that the use of neuromuscular blocking drugs in general anaesthesia is associated with an increased risk of postoperative pulmonary complications. Anaesthetists must balance the potential benefits of neuromuscular blockade against the increased risk of postoperative pulmonary complications. Funding: European Society of Anaesthesiology.
Published: 2019
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7. Children with Covid-19 in Pediatric Emergency Departments in Italy

Author: Parri, N., Lenge, M., Buonsenso, D., Cantoni, B., Arrighini, A., Romanengo, M., Urbino, A., Da Dalt, L., Verdoni, L., Limoli, G., Musolino, A. M., Pilotto, C., La Fauci, G., Chiossi, M., Agostiniani, R., Plebani, A., Barbieri, M. A., Lanari, M., Masi, S., Giacalone, M., Leo, M. C., Falconi, M., Indolfi, G., D'Antiga, L., Mazza, A., De Martiis, D., Bertolozzi, G., Marchisio, P., Chidini, G., Calderini, E., Agostoni, C., Gori, A., Bondone, C., Dona', D., Todeschini, M., Scilipoti, M., Cogo, P., Ginocchio, F., Russotto, V. S., Biban, P., Stera, G., Margherita, M., Maiandi, S., Tubino, B., Chiaretti, A., Zampogna, S., Mazzuca, A., Parri N., Lenge M., Buonsenso D., Cantoni B., Arrighini A., Romanengo M., Urbino A., Da Dalt L., Verdoni L., Limoli G., Musolino A.M., Pilotto C., La Fauci G., Chiossi M., Agostiniani R., Plebani A., Barbieri M.A., Lanari M., Masi S., Giacalone M., Leo M.C., Falconi M., Indolfi G., D'Antiga L., Mazza A., De Martiis D., Bertolozzi G., Marchisio P., Chidini G., Calderini E., Agostoni C., Gori A., Bondone C., Dona D., Todeschini M., Scilipoti M., Cogo P., Ginocchio F., Russotto V.S., Biban P., Stera G., Margherita M., Maiandi S., Tubino B., Chiaretti A., Zampogna S., and Mazzuca A.
Subjects: Pediatric emergency, 2019-20 coronavirus outbreak, medicine.medical_specialty, China, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pneumonia, Viral, 030204 cardiovascular system & hematology, Betacoronavirus, COVID-19, Child, Humans, Italy, SARS-CoV-2, Coronavirus Infections, Emergency Service, Hospital, Pandemics, Hospital, 03 medical and health sciences, 0302 clinical medicine, Correspondence, Pandemic, medicine, Viral, 030212 general & internal medicine, Emergency Service, Betacoronaviru, business.industry, Coronavirus Infection, Pneumonia, General Medicine, Family medicine, Cohort, business, Human
Abstract: This letter describes a cohort of 100 children younger than 18 years of age with RT-PCR-confirmed Covid-19 who were assessed in 17 pediatric emergency departments in Italy. The descriptive results are compared with previously published results involving children in China and the United States.
Published: 2020
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8. Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications:LAS VEGAS - An observational study in 29 countries

Author: Schultz, Marcus J., Hemmes, Sabrine N. 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Maldini B, Radocaj T, Gavranovic Z, Mladic-Batinica I, Sehovic M, Stourac P, Harazim H, Smekalova O, Kosinova M, Kolacek T, Hudacek K, Drab M, Brujevic J, Vitkova K, Jirmanova K, Volfova I, Dzurnakova P, Liskova K, Dudas R, Filipsky R, El Kafrawy S, Hosny Abdelwahab H, Metwally T, Abdel-Razek A, El-Shaarawy AM, Fathy Hasan W, Gouda Ahmed A, Yassin H, Magdy M, Abdelhady M, Mahran M, Herodes E, Kivik P, Oganjan J, Aun A, Sormus A, Sarapuu K, Mall M, Karjagin J, Futier E, Petit A, Gerard A, Marret E, Solier M, Jaber S, Prades A, Putensen C, Krassler J, Merzky S, Gama de Abreu M, Uhlig C, Kiss T, Bundy A, Bluth T, Güldner A, Spieth P, Scharffenberg M, Tran Thiem D, Koch T, Treschan T, Schaefer M, Bastin B, Geib J, Weiss M, Kienbaum P, Pannen B, Gottschalk A, Konrad M, Westerheide D, Schwerdtfeger B, Wrigge H, Simon P, Reske A, Nestler C, Valsamidis D, Stroumpoulis K, Antholopoulos G, Andreou A, Karapanos D, Theodoraki K, Gkiokas G, Tasoulis MK, Sidiropoulou T, Zafeiropoulou F, Florou P, 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Sprung J, Weingarten T, Kor D, Scavonetto F, Tze Y., Schultz, M, Hemmes, S, Neto, A, Binnekade, J, Canet, J, Hedenstierna, G, Jaber, S, Hiesmayr, M, Hollmann, M, Mills, G, Vidal Melo, M, Pearse, R, Putensen, C, Schmid, W, Severgnini, P, Wrigge, H, De Abreu, M, Pelosi, P, Kroell, W, Metzler, H, Struber, G, Wegscheider, T, Gombotz, H, Urbanek, B, Leva, B, Damster, S, Plichon, B, Kahn, D, Momeni, M, Pospiech, A, Lois, F, Forget, P, Grosu, I, Poelaert, J, van Mossevelde, V, van Malderen, M, Dylst, D, van Melkebeek, J, Beran, M, de Hert, S, De Baerdemaeker, L, Heyse, B, van Limmen, J, Wyffels, P, Jacobs, T, Roels, N, De Bruyne, A, van de Velde, S, Juros-Zovko, M, Djonovic-Omanovic, D, Pernar, S, Zunic, J, Miskovic, P, Zilic, A, Kvolik, S, Ivic, D, Azenic-Venzera, D, Skiljic, S, Vinkovic, H, Oputric, I, Juricic, K, Frkovic, V, Kopic, J, Mirkovic, I, Karanovic, N, Carev, M, Dropulic, N, Pavicic-Saric, J, Erceg, G, Bogdanovic Dvorcak, M, Mazul-Sunko, B, Pavicic, A, Goranovic, T, Maldini, B, Radocaj, T, Gavranovic, Z, Mladic-Batinica, I, Sehovic, M, Stourac, P, Harazim, H, Smekalova, O, Kosinova, M, Kolacek, T, Hudacek, K, Drab, M, Brujevic, J, Vitkova, K, Jirmanova, K, Volfova, I, Dzurnakova, P, Liskova, K, Dudas, R, Filipsky, R, El Kafrawy, S, Hosny Abdelwahab, H, Metwally, T, Abdel-Razek, A, El-Shaarawy, A, Fathy Hasan, W, Gouda Ahmed, A, Yassin, H, Magdy, M, Abdelhady, M, Mahran, M, Herodes, E, Kivik, P, Oganjan, J, Aun, A, Sormus, A, Sarapuu, K, Mall, M, Karjagin, J, Futier, E, Petit, A, Gerard, A, Marret, E, Solier, M, Prades, A, Krassler, J, Merzky, S, Uhlig, C, Kiss, T, Bundy, A, Bluth, T, Guldner, A, Spieth, P, Scharffenberg, M, Tran Thiem, D, Koch, T, Treschan, T, Schaefer, M, Bastin, B, Geib, J, Weiss, M, Kienbaum, P, Pannen, B, Gottschalk, A, Konrad, M, Westerheide, D, Schwerdtfeger, B, Simon, P, Reske, A, Nestler, C, Valsamidis, D, Stroumpoulis, K, Antholopoulos, G, Andreou, A, Karapanos, D, Theodoraki, K, Gkiokas, G, Tasoulis, M, Sidiropoulou, T, Zafeiropoulou, F, Florou, P, Pandazi, A, Tsaousi, G, Nouris, C, Pourzitaki, C, Bystritski, D, Pizov, R, Eden, A, Pesce, C, Campanile, A, Marrella, A, Grasso, S, De Michele, M, Bona, F, Giacoletto, G, Sardo, E, Giancarlo, L, Sottosanti, V, Solca, M, Volta, C, Spadaro, S, Verri, M, Ragazzi, R, Zoppellari, R, Cinnella, G, Raimondo, P, La Bella, D, Mirabella, L, D'Antini, D, Molin, A, Brunetti, I, Gratarola, A, Pellerano, G, Sileo, R, Pezzatto, S, Montagnani, L, Pasin, L, Landoni, G, Zangrillo, A, Beretta, L, Di Parma, A, Tarzia, V, Dossi, R, Sassone, M, Sances, D, Tredici, S, Spano, G, Castellani, G, Delunas, L, Peradze, S, Venturino, M, Arpino, I, Sher, S, Tommasino, C, Rapido, F, Morelli, P, Vargas, M, Servillo, G, Cortegiani, A, Raineri, S, Montalto, F, Russotto, V, Giarratano, A, Baciarello, M, Generali, M, Cerati, G, Leykin, Y, Bressan, F, Bartolini, V, Zamidei, L, Brazzi, L, Liperi, C, Sales, G, Pistidda, L, Brugnoni, E, Musella, G, Bacuzzi, A, Muhardri, D, Gecaj-Gashi, A, Sada, F, Bytyqi, A, Karbonskiene, A, Aukstakalniene, R, Teberaite, Z, Salciute, E, Tikuisis, R, Miliauskas, P, Jurate, S, Kontrimaviciute, E, Tomkute, G, Xuereb, J, Bezzina, M, Borg, F, Wiersma, I, Bos, L, Boer, C, Duvekot, A, In't Veld, B, Werger, A, Dennesen, P, Severijns, C, de Jong, J, Hering, J, van Beek, R, Ivars, S, Jammer, I, Breidablik, A, Skirstad Hodt, K, Fjellanger, F, Vicoavalos, M, Mellin-Olsen, J, Andersson, E, Shafi-Kabiri, A, Molina, R, Wutai, S, Morais, E, Tareco, G, Ferreira, D, Amaral, J, Goncalves Castro, M, Cadilha, S, Appleton, S, Parente, S, Correia, M, Martins, D, Monteirosa, A, Ricardo, A, Rodrigues, S, Horhota, L, Grintescu, I, Mirea, L, Corneci, D, Negoita, S, Dutu, M, Popescu Garotescu, I, Filipescu, D, Prodan, A, Droc, G, Fota, R, Popescu, M, Tomescu, D, Petcu, A, Tudoroiu, M, Moise, A, Guran, C, Gherghina, I, Costea, D, Cindea, I, Copotoiu, S, Copotoiu, R, Barsan, V, Tolcser, Z, Riciu, M, Moldovan, G, Veres, M, Gritsan, A, Kapkan, T, Gritsan, G, Korolkov, O, Kulikov, A, Lubnin, A, Ovezov, A, Prokoshev, P, Lugovoy, A, Anipchenko, N, Babayants, A, Komissarova, I, Zalina, K, Likhvantsev, V, Fedorov, S, Lazukic, A, Pejakovic, J, Mihajlovic, D, Kusnierikova, Z, Zelinkova, M, Bruncakova, K, Polakovicova, L, Sobona, V, Novak-Supe, B, Pekle-Golez, A, Jovanov, M, Strazisar, B, Markovic-Bozic, J, Novak-Jankovic, V, Voje, M, Grynyuk, A, Kostadinov, I, Spindler-Vesel, A, Moral, V, Unzueta, C, Puigbo, C, Fava, J, Moret, E, Rodriguez Nunez, M, Sendra, M, Brunelli, A, Rodenas, F, Monedero, P, Hidalgo Martinez, F, Yepes Temino, M, Marti Nez Simon, A, de Abajo Larriba, A, Lisi, A, Perez, G, Martinez, R, Granell, M, Tatay Vivo, J, Saiz Ruiz, C, de Andre S Iban Ez, J, Pastor, E, Soro, M, Ferrando, C, Defez, M, Aldecoa Alvares-Santullano, C, Pere, R, Rico, J, Jawad, M, Saeed, Y, Gillberg, L, Kazak Bengisun, Z, Kansu Kazbek, B, Coskunfirat, N, Boztug, N, Sanli, S, Yilmaz, M, Hadimioglu, N, Senturk, N, Camci, E, Kucukgoncu, S, Sungur, Z, Sivrikoz, N, Ustalar Ozgen, S, Toraman, F, Selvi, O, Senturk, O, Yildiz, M, Kuvaki, B, Gunenc, F, Kucukguclu, S, Ozbilgin, S, Maral, J, Canli, S, Arun, O, Saltali, A, Aydogan, E, Akgun, F, Sanlikarip, C, Mine Karaman, F, Mazur, A, Vorotyntsev, S, Rousseau, G, Barrett, C, Stancombe, L, Shelley, B, Scholes, H, Limb, J, Rafi, A, Wayman, L, Deane, J, Rogerson, D, Williams, J, Yates, S, Rogers, E, Pulletz, M, Moreton, S, Jones, S, Venkatesh, S, Burton, M, Brown, L, Goodall, C, Rucklidge, M, Fuller, D, Nadolski, M, Kusre, S, Lundberg, M, Everett, L, Nutt, H, Zuleika, M, Carvalho, P, Clements, D, Creagh-Brown, B, Watt, P, Raymode, P, Mohr, O, Raj, A, Creary, T, Chishti, A, Bell, A, Higham, C, Cain, A, Gibb, S, Mowat, S, Franklin, D, West, C, Minto, G, Boyd, N, Calton, E, Walker, R, Mackenzie, F, Ellison, B, Roberts, H, Chikungwa, M, Jackson, C, Donovan, A, Foot, J, Homan, E, Montgomery, J, Portch, D, Mercer, P, Palmer, J, Paddle, J, Fouracres, A, Datson, A, Andrew, A, Welch, L, Rose, A, Varma, S, Simeson, K, Rambhatla, M, Susarla, J, Marri, S, Kodaganallur, K, Das, A, Algarsamy, S, Colley, J, Davies, S, Szewczyk, M, Smith, T, Fernandez-Bustamante, A, Luzier, E, Almagro, A, Fernando, L, Sulemanji, D, Sprung, J, Weingarten, T, Kor, D, Scavonetto, F, Tze, Y, Schultz, M. J., Hemmes, S. N. T., Neto, A. S., Binnekade, J. M., Canet, J., Hedenstierna, G., Jaber, S., Hiesmayr, M., Hollmann, M. W., Mills, G. H., Vidal Melo, M. F., Pearse, R., Putensen, C., Schmid, W., Severgnini, P., Wrigge, H., De Abreu, M. G., Pelosi, P., Kroell, W., Metzler, H., Struber, G., Wegscheider, T., Gombotz, H., Urbanek, B., Leva, B., Damster, S., Plichon, B., Kahn, D., Momeni, M., Pospiech, A., Lois, F., Forget, P., Grosu, I., Poelaert, J., van Mossevelde, V., van Malderen, M. C., Dylst, D., van Melkebeek, J., Beran, M., de Hert, S., De Baerdemaeker, L., Heyse, B., van Limmen, J., Wyffels, P., Jacobs, T., Roels, N., De Bruyne, A., van de Velde, S., Juros-Zovko, M., Djonovic-Omanovic, D., Pernar, S., Zunic, J., Miskovic, P., Zilic, A., Kvolik, S., Ivic, D., Azenic-Venzera, D., Skiljic, S., Vinkovic, H., Oputric, I., Juricic, K., Frkovic, V., Kopic, J., Mirkovic, I., Karanovic, N., Carev, M., Dropulic, N., Pavicic-Saric, J., Erceg, G., Bogdanovic Dvorcak, M., Mazul-Sunko, B., Pavicic, A. M., Goranovic, T., Maldini, B., Radocaj, T., Gavranovic, Z., Mladic-Batinica, I., Sehovic, M., Stourac, P., Harazim, H., Smekalova, O., Kosinova, M., Kolacek, T., Hudacek, K., Drab, M., Brujevic, J., Vitkova, K., Jirmanova, K., Volfova, I., Dzurnakova, P., Liskova, K., Dudas, R., Filipsky, R., El Kafrawy, S., Hosny Abdelwahab, H., Metwally, T., Abdel-Razek, A., El-Shaarawy, A. M., Fathy Hasan, W., Gouda Ahmed, A., Yassin, H., Magdy, M., Abdelhady, M., Mahran, M., Herodes, E., Kivik, P., Oganjan, J., Aun, A., Sormus, A., Sarapuu, K., Mall, M., Karjagin, J., Futier, E., Petit, A., Gerard, A., Marret, E., Solier, M., Prades, A., Krassler, J., Merzky, S., Uhlig, C., Kiss, T., Bundy, A., Bluth, T., Guldner, A., Spieth, P., Scharffenberg, M., Tran Thiem, D., Koch, T., Treschan, T., Schaefer, M., Bastin, B., Geib, J., Weiss, M., Kienbaum, P., Pannen, B., Gottschalk, A., Konrad, M., Westerheide, D., Schwerdtfeger, B., Simon, P., Reske, A., Nestler, C., Valsamidis, D., Stroumpoulis, K., Antholopoulos, G., Andreou, A., Karapanos, D., Theodoraki, K., Gkiokas, G., Tasoulis, M. K., Sidiropoulou, T., Zafeiropoulou, F., Florou, P., Pandazi, A., Tsaousi, G., Nouris, C., Pourzitaki, C., Bystritski, D., Pizov, R., Eden, A., Pesce, C. V., Campanile, A., Marrella, A., Grasso, S., De Michele, M., Bona, F., Giacoletto, G., Sardo, E., Giancarlo, L., Sottosanti, V., Solca, M., Volta, C. A., Spadaro, S., Verri, M., Ragazzi, R., Zoppellari, R., Cinnella, G., Raimondo, P., La Bella, D., Mirabella, L., D'Antini, D., Molin, A., Brunetti, I., Gratarola, A., Pellerano, G., Sileo, R., Pezzatto, S., Montagnani, L., Pasin, L., Landoni, G., Zangrillo, A., Beretta, L., Di Parma, A. L., Tarzia, V., Dossi, R., Sassone, M. E., Sances, D., Tredici, S., Spano, G., Castellani, G., Delunas, L., Peradze, S., Venturino, M., Arpino, I., Sher, S., Tommasino, C., Rapido, F., Morelli, P., Vargas, M., Servillo, G., Cortegiani, A., Raineri, S. M., Montalto, F., Russotto, V., Giarratano, A., Baciarello, M., Generali, M., Cerati, G., Leykin, Y., Bressan, F., Bartolini, V., Zamidei, L., Brazzi, L., Liperi, C., Sales, G., Pistidda, L., Brugnoni, E., Musella, G., Bacuzzi, A., Muhardri, D., Gecaj-Gashi, A., Sada, F., Bytyqi, A., Karbonskiene, A., Aukstakalniene, R., Teberaite, Z., Salciute, E., Tikuisis, R., Miliauskas, P., Jurate, S., Kontrimaviciute, E., Tomkute, G., Xuereb, J., Bezzina, M., Borg, F. J., Wiersma, I., Bos, L., Boer, C., Duvekot, A., In't Veld, B., Werger, A., Dennesen, P., Severijns, C., de Jong, J., Hering, J., van Beek, R., Ivars, S., Jammer, I., Breidablik, A., Skirstad Hodt, K., Fjellanger, F., Vicoavalos, M., Mellin-Olsen, J., Andersson, E., Shafi-Kabiri, A., Molina, R., Wutai, S., Morais, E., Tareco, G. R., Ferreira, D., Amaral, J., Goncalves Castro, M. L., Cadilha, S., Appleton, S., Parente, S., Correia, M., Martins, D., Monteirosa, A., Ricardo, A., Rodrigues, S., Horhota, L., Grintescu, I. M., Mirea, L., Grintescu, I. C., Corneci, D., Negoita, S., Dutu, M., Popescu Garotescu, I., Filipescu, D., Prodan, A. B., Droc, G., Fota, R., Popescu, M., Tomescu, D., Petcu, A. M., Tudoroiu, M. I., Moise, A., Guran, C. T., Gherghina, I., Costea, D., Cindea, I., Copotoiu, S. M., Copotoiu, R., Barsan, V., Tolcser, Z., Riciu, M., Moldovan, G. S., Veres, M., Gritsan, A., Kapkan, T., Gritsan, G., Korolkov, O., Kulikov, A., Lubnin, A., Ovezov, A., Prokoshev, P., Lugovoy, A., Anipchenko, N., Babayants, A., Komissarova, I., Zalina, K., Likhvantsev, V., Fedorov, S., Lazukic, A., Pejakovic, J., Mihajlovic, D., Kusnierikova, Z., Zelinkova, M., Bruncakova, K., Polakovicova, L., Sobona, V., Novak-Supe, B., Pekle-Golez, A., Jovanov, M., Strazisar, B., Markovic-Bozic, J., Novak-Jankovic, V., Voje, M., Grynyuk, A., Kostadinov, I., Spindler-Vesel, A., Moral, V., Unzueta, C., Puigbo, C., Fava, J., Moret, E., Rodriguez Nunez, M. N., Sendra, M., Brunelli, A., Rodenas, F., Monedero, P., Hidalgo Martinez, F., Yepes Temino, M. J., Marti Nez Simon, A., de Abajo Larriba, A., Lisi, A., Perez, G., Martinez, R., Granell, M., Tatay Vivo, J., Saiz Ruiz, C., de Andre S Iban Ez, J. A., Pastor, E., Soro, M., Ferrando, C., Defez, M., Aldecoa Alvares-Santullano, C., Pere, R., Rico, J., Jawad, M., Saeed, Y., Gillberg, L., Kazak Bengisun, Z., Kansu Kazbek, B., Coskunfirat, N., Boztug, N., Sanli, S., Yilmaz, M., Hadimioglu, N., Senturk, N. M., Camci, E., Kucukgoncu, S., Sungur, Z., Sivrikoz, N., Ustalar Ozgen, S., Toraman, F., Selvi, O., Senturk, O., Yildiz, M., Kuvaki, B., Gunenc, F., Kucukguclu, S., Ozbilgin, S. U., Maral, J., Canli, S., Arun, O., Saltali, A., Aydogan, E., Akgun, F. N., Sanlikarip, C., Mine Karaman, F., Mazur, A., Vorotyntsev, S., Rousseau, G., Barrett, C., Stancombe, L., Shelley, B., Scholes, H., Limb, J., Rafi, A., Wayman, L., Deane, J., Rogerson, D., Williams, J., Yates, S., Rogers, E., Pulletz, M., Moreton, S., Jones, S., Venkatesh, S., Burton, M., Brown, L., Goodall, C., Rucklidge, M., Fuller, D., Nadolski, M., Kusre, S., Lundberg, M., Everett, L., Nutt, H., Zuleika, M., Carvalho, P., Clements, D., Creagh-Brown, B., Watt, P., Raymode, P., Mohr, O., Raj, A., Creary, T., Chishti, A., Bell, A., Higham, C., Cain, A., Gibb, S., Mowat, S., Franklin, D., West, C., Minto, G., Boyd, N., Calton, E., Walker, R., Mackenzie, F., Ellison, B., Roberts, H., Chikungwa, M., Jackson, C., Donovan, A., Foot, J., Homan, E., Montgomery, J., Portch, D., Mercer, P., Palmer, J., Paddle, J., Fouracres, A., Datson, A., Andrew, A., Welch, L., Rose, A., Varma, S., Simeson, K., Rambhatla, M., Susarla, J., Marri, S., Kodaganallur, K., Das, A., Algarsamy, S., Colley, J., Davies, S., Szewczyk, M., Smith, T., Fernandez-Bustamante, A., Luzier, E., Almagro, A., Fernando, L., Sulemanji, D., Sprung, J., Weingarten, T., Kor, D., Scavonetto, F., Tze, Y., Anesthesiology, ACS - Microcirculation, ACS - Diabetes & metabolism, Landoni, Giovanni, Zangrillo, Alberto, Beretta, Luigi, Schultz, Marcus J., Hemmes, Sabrine N.T., Neto, Ary Serpa, Binnekade, Jan M., Canet, Jaume, Hedenstierna, Goran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W., Mills, Gary H., Vidal Melo, Marcos F., Pearse, Rupert, Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, De Abreu, Marcelo Gama, Pelosi, Paolo, Kroell W, Metzler H, Struber G, Wegscheider T, Gombotz H, Hiesmayr M, Schmid W, Urbanek B, Leva B, Damster S, Plichon B, Kahn D, Momeni M, Pospiech A, Lois F, Forget P, Grosu I, Poelaert J, van Mossevelde V, van Malderen MC, Dylst D, van Melkebeek J, Beran M, de Hert S, De Baerdemaeker L, Heyse B, van Limmen J, Wyffels P, Jacobs T, Roels N, De Bruyne A, van de Velde S, Juros-Zovko M, Djonoviċ-Omanoviċ D, Serpa Neto A, Pernar S, Zunic J, Miskovic P, Zilic A, Kvolik S, Ivic D, Azenic-Venzera D, Skiljic S, Vinkovic H, Oputric I, Juricic K, Frkovic V, Kopic J, Mirkovic I, Karanovic N, Carev M, Dropulic N, Pavičić-Šarić J, Erceg G, Bogdanović Dvorščak M, Mazul-Sunko B, Pavicic AM, Goranovic T, Maldini B, Radocaj T, Gavranovic Z, Mladic-Batinica I, Sehovic M, Stourac P, Harazim H, Smekalova O, Kosinova M, Kolacek T, Hudacek K, Drab M, Brujevic J, Vitkova K, Jirmanova K, Volfova I, Dzurnakova P, Liskova K, Dudas R, Filipsky R, El Kafrawy S, Hosny Abdelwahab H, Metwally T, Abdel-Razek A, El-Shaarawy AM, Fathy Hasan W, Gouda Ahmed A, Yassin H, Magdy M, Abdelhady M, Mahran M, Herodes E, Kivik P, Oganjan J, Aun A, Sormus A, Sarapuu K, Mall M, Karjagin J, Futier E, Petit A, Gerard A, Marret E, Solier M, Jaber S, Prades A, Putensen C, Krassler J, Merzky S, Gama de Abreu M, Uhlig C, Kiss T, Bundy A, Bluth T, Güldner A, Spieth P, Scharffenberg M, Tran Thiem D, Koch T, Treschan T, Schaefer M, Bastin B, Geib J, Weiss M, Kienbaum P, Pannen B, Gottschalk A, Konrad M, Westerheide D, Schwerdtfeger B, Wrigge H, Simon P, Reske A, Nestler C, Valsamidis D, Stroumpoulis K, Antholopoulos G, Andreou A, Karapanos D, Theodoraki K, Gkiokas G, Tasoulis MK, Sidiropoulou T, Zafeiropoulou F, Florou P, Pandazi A, Tsaousi G, Nouris C, Pourzitaki C, Bystritski D, Pizov R, Eden A, Pesce CV, Campanile A, Marrella A, Grasso S, De Michele M, Bona F, Giacoletto G, Sardo E, Giancarlo L, Sottosanti V, Solca M, Volta CA, Spadaro S, Verri M, Ragazzi R, Zoppellari R, Cinnella G, Raimondo P, La Bella D, Mirabella L, D'antini D, Pelosi P, Molin A, Brunetti I, Gratarola A, Pellerano G, Sileo R, Pezzatto S, Montagnani L, Pasin L, Landoni G, Zangrillo A, Beretta L, Di Parma AL, Tarzia V, Dossi R, Sassone ME, Sances D, Tredici S, Spano G, Castellani G, Delunas L, Peradze S, Venturino M, Arpino I, Sher S, Tommasino C, Rapido F, Morelli P, Vargas M, Servillo G, Cortegiani A, Raineri SM, Montalto F, Russotto V, Giarratano A, Baciarello M, Generali M, Cerati G, Leykin Y, Bressan F, Bartolini V, Zamidei L, Brazzi L, Liperi C, Sales G, Pistidda L, Severgnini P, Brugnoni E, Musella G, Bacuzzi A, Muhardri D, Gecaj-Gashi A, Sada F, Bytyqi A, Karbonskiene A, Aukstakalniene R, Teberaite Z, Salciute E, Tikuisis R, Miliauskas P, Jurate S, Kontrimaviciute E, Tomkute G, Xuereb J, Bezzina M, Borg FJ, Hemmes S, Schultz M, Hollmann M, Wiersma I, Binnekade J, Bos L, Boer C, Duvekot A, In 't Veld B, Werger A, Dennesen P, Severijns C, de Jong J, Hering J, van Beek R, Ivars S, Jammer I, Breidablik A, Skirstad Hodt K, Fjellanger F, VicoAvalos M, Mellin-Olsen J, Andersson E, Shafi-Kabiri A, Molina R, Wutai S, Morais E, Tareco GR, Ferreira D, Amaral J, Gonçalves Castro ML, Cadilha S, Appleton S, Parente S, Correia M, Martins D, Monteirosa A, Ricardo A, Rodrigues S, Horhota L, Grintescu IM, Mirea L, Grintescu IC, Corneci D, Negoita S, Dutu M, Popescu Garotescu I, Filipescu D, Prodan AB, Droc G, Fota R, Popescu M, Tomescu D, Petcu AM, Tudoroiu MI, Moise A, Guran CT, Gherghina I, Costea D, Cindea I, Copotoiu SM, Copotoiu R, Barsan V, Tolcser Z, Riciu M, Moldovan GS, Veres M, Gritsan A, Kapkan T, Gritsan G, Korolkov O, Kulikov A, Lubnin A, Ovezov A, Prokoshev P, Lugovoy A, Anipchenko N, Babayants A, Komissarova I, Zalina K, Likhvantsev V, Fedorov S, Lazukic A, Pejakovic J, Mihajlovic D, Kusnierikova Z, Zelinkova M, Bruncakova K, Polakovicova L, Sobona V, Novak-Supe B, Pekle-Golez A, Jovanov M, Strazisar B, Markovic-Bozic J, Novak-Jankovic V, Voje M, Grynyuk A, Kostadinov I, Spindler-Vesel A, Moral V, Unzueta C, Puigbo C, Fava J, Canet J, Moret E, Rodriguez Nunez MN, Sendra M, Brunelli A, Rodenas F, Monedero P, Hidalgo Martinez F, Yepes Temino MJ, Marti Nez Simon A, de Abajo Larriba A, Lisi A, Perez G, Martinez R, Granell M, Tatay Vivo J, Saiz Ruiz C, de Andre S Iban Ez JA, Pastor E, Soro M, Ferrando C, Defez M, Aldecoa Alvares-Santullano C, Pere R, Rico J, Jawad M, Saeed Y, Gillberg L, Hedenstierna G, Kazak Bengisun Z, Kansu Kazbek B, Coskunfirat N, Boztug N, Sanli S, Yilmaz M, Hadimioglu N, Senturk NM, Camci E, Kucukgoncu S, Sungur Z, Sivrikoz N, Ustalar Ozgen S, Toraman F, Selvi O, Senturk O, Yildiz M, Kuvaki B, Gunenc F, Kucukguclu S, Ozbilgin SU, Maral J, Canli S, Arun O, Saltali A, Aydogan E, Akgün FN, Sanlikarip C, Mine Karaman F, Mazur A, Vorotyntsev S, Rousseau G, Barrett C, Stancombe L, Shelley B, Scholes H, Limb J, Rafi A, Wayman L, Deane J, Rogerson D, Williams J, Yates S, Rogers E, Pulletz M, Moreton S, Jones S, Venkatesh S, Burton M, Brown L, Goodall C, Rucklidge M, Fuller D, Nadolski M, Kusre S, Lundberg M, Everett L, Nutt H, Zuleika M, Carvalho P, Clements D, Creagh-Brown B, Watt P, Raymode P, Pearse R, Mohr O, Raj A, Creary T, Chishti A, Bell A, Higham C, Cain A, Gibb S, Mowat S, Franklin D, West C, Minto G, Boyd N, Mills G, Calton E, Walker R, Mackenzie F, Ellison B, Roberts H, Chikungwa M, Jackson C, Donovan A, Foot J, Homan E, Montgomery J, Portch D, Mercer P, Palmer J, Paddle J, Fouracres A, Datson A, Andrew A, Welch L, Rose A, Varma S, Simeson K, Rambhatla M, Susarla J, Marri S, Kodaganallur K, Das A, Algarsamy S, Colley J, Davies S, Szewczyk M, Smith T, Fernandez-Bustamante A, Luzier E, Almagro A, Vidal Melo M, Fernando L, Sulemanji D, Sprung J, Weingarten T, Kor D, Scavonetto F, Tze Y., Graduate School, ACS - Pulmonary hypertension & thrombosis, Intensive Care Medicine, AII - Amsterdam institute for Infection and Immunity, AII - Inflammatory diseases, ACS - Amsterdam Cardiovascular Sciences, ACS - Heart failure & arrhythmias, Anesthesiology research group, and Supporting clinical sciences
Subjects: Male, Pediatrics, Internationality, RESPIRATORY-DISTRESS-SYNDROME, 0302 clinical medicine, Postoperative Complications, 030202 anesthesiology, Risk Factors, Epidemiology, ABDOMINAL-SURGERY, 80 and over, Medicine and Health Sciences, General anaesthesia, Anesthesia, END-EXPIRATORY-PRESSURE, BERLIN DEFINITION, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Lung, Aged, 80 and over, Framingham Risk Score, Incidence (epidemiology), Respiration, Middle Aged, Treatment Outcome, Artificial, Female, PRACTICE PATTERNS, Human, medicine.medical_specialty, mechanical ventilation, prospective observational study, Intensive care, Anesthesia, General, NONCARDIOTHORACIC SURGERY, NO, Aged, Cross-Sectional Studies, Humans, Intraoperative Care, Respiration Disorders, Respiration, Artificial, Tidal Volume, Anesthesiology and Pain Medicine, ACUTE LUNG INJURY, 03 medical and health sciences, GENERAL-ANESTHESIA, Internal medicine, medicine, Journal Article, MED/41 - ANESTESIOLOGIA, General, Cross-Sectional Studie, business.industry, Risk Factor, Respiration Disorder, Confidence interval, PROTECTIVE MECHANICAL VENTILATION, Prospective Studie, Relative risk, MAJOR NONCARDIAC SURGERY, Postoperative Complication, business, Abdominal surgery
Abstract: BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (V T) size was 500 ml, or 7 to 9 ml kg−1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P ˂ 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P ˂ 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high V T and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome.
Published: 2017
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9. Effect of Lung Recruitment and Titrated Positive End-Expiratory Pressure (PEEP) vs Low PEEP on Mortality in Patients With Acute Respiratory Distress Syndrome : a Randomized Clinical Trial

Author: Cavalcanti, A. B., Suzumura, E. A., Laranjeira, L. N., De Moraes Paisani, D., Damiani, L. P., Guimaraes, H. P., Romano, E. R., De Moraes Regenga, M., Taniguchi, L. N. T., Teixeira, C., De Oliveira, R. P., Machado, F. R., Diaz-Quijano, F. A., De Alencar Filho, M. S., Maia, I. S., Caser, E. B., De Oliveira Filho, W., De Carvalho Borges, M., De Aquino Martins, P., Matsui, M., Ospina-Tascon, G. A., Giancursi, T. S., Giraldo-Ramirez, N. D., Vieira, S. R. R., De Lima Assef, M. D. G. P., Hasan, M. S., Szczeklik, W., Rios, F., Amato, M. B. P., Berwanger, O., De Carvalho, C. R. R., Tucci, M. R., Souza Dos Santos, L., Franca de Oliveira, M. C., Peres, I., Freitas, I., Reis, H., Verissimo, A., Torres, D., Barroso, A., Semboloni Bitencourt, W., Franco, M. R., Oliveira Lage, J., Aparecida Pessoa Conde, K., Charro, F. A., Naia, A., de Brito Sobrinho, E., Lameira Verissimo, A., Barros de Oliveira, M. E., Zampieri, F., Ladeira, J. P., Cordioli, R., Diogo Sala, A., Tadahiro Ikeoka, D., Baptista Filho, M. L. A., Ray, A., Guerra de Almeida, A., Nazareno Conceicao, C., Ribeiro Salgado, D., Rosso Verdeal, J. C., Martins, G. A., Junqueira Ribeiro, L., Vilela Siqueira, H., Flavio Costa Filho, F., Adler Maccagnan Pinheiro Besen, B., Vieira Do Nascimento Martins, E., Aparecida Pereira, J., Milioli Ferreira, D., Alves Ferreira Goncalves, F., de Souza Nobrega, M., Barros Duarte, I. J., Nobre, V., Miranda Barreto Mourao, L., Gomez Ravetti, C., Scalzo, A. C., Martins De Stefano, L., Gut, A. L., Nogueira Filho, W., Gatti Cirillo, C., Ishiwaki, S., Lobo, S., Elias de Oliveira, N., Fernandes Machado, L., Sisconetto, L., Rios Vieira, S. R., Fialkow, L., Fontoura Prado, K., Franke, C., Barberena Moraes, R., Christmann Wawrzeniak, I., Rech, T. H., Parolo, E., Almeida Victorino, J., Marques Barroso, C., Marcal de Vasconcelos, M. O., Souza da Silva, R., Lesti Esteves, A. R., Camassola, A. P., Antoniazzi, R., Griebler, M., Favretto, J., Romano, M., Franz da Costa, A., Werneck, V., Miura, M. C., Farran, J., Vasconcelos, R., Isola, A., Resende, E., Goulart, R., Luzzi, S., Rea-Neto, A., de Oliveira, M. C., Bruinje Cosentino, M. F., Martins Dzivielevski, B., Reese, F. B., Ferreira da Silva, S. D., Elias Aquim, E., Girotto, F., Helenditi Fernandes Camurca Martins, R., Lima de Andrade, A., Breckenfeld Heirel, D. C., Ryoji Takatani, R., Dias de Almeida, S., Medina Matos, A., Iwamoto, T., Do Val Tavares, P. E., Valiatti, J. L., de Lucca, F. C., Fornazari, J. C., Dias Brugugnolli, I., de Araujo Nazare, M., Nascimento Loureiro, N., Vasconcelos de Sousa, G., Staffa Gonzaga da Silva, L., Dos Anjos Sad, F. C., Stucchi, E. M., Melo Silva, R., Fonseca Silva, T., Mendes Filho, S. P., Borba Pereira, T., da Silva, P. N., Martines Moralez, G., Abrantes Saraiva, S., Abrunhosa, A., Chagas, C. E. R. C., Thompson, M. M., Pinto Goncalves, C. H., de Oliveira Dias, R., Schwan Filho, F., Magalhaes Carvalho Grion, C., Mezzaroba, A. L., Festti, J., Massariol, T. C., de Souza, G. F., Martins Lima Silva, M., de Souza Andrade Neto, J., Costa, G., Souza Ribeiro, M., Coelho, M., Cruz Carbonell, R. C., de Souza Trindade, R., Valente Barbas, C. S., Domingos Correa, T., Serpa Neto, A., Santucci Cesar de Assuncao, M., Vilela Costa Pinto, B., Goncalves Libanio, P., da Silva Motta, J., Santa Maria Lucin, G., Macedo Araujo, L., Anibal Leite Barros Agostinho, T., de Andrade, K. M., da Silva, M. S., Pereira da Silva, E., Mousinho Gomes, R. L., Campos, N. M. P., Fonseca de Sousa, J., Ramos Nicolau da Costa, L., de Carvalho Fonseca Assuncao, N. S., Martins de Lima, G., Pinheiro de Oliveira, R., Gasparetto Maccari, J., de Campos Balzano, P., Tagliari, L., Metran Nascente, A. P., de Carvalho, M. A., Buttignol, M., Henn Moura, R., Vinicius Pereira, M., Alberti da Silva, G., Akemi Higo, M., Morales, M., Andrade, A. H. V., de Paiva, A. 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L., Camargo Narciso, R., Bernadete Caser, E., Falcao, J. G., Genelhu, G., Lessa Soares, F., Silva Sales, B., Rebello de Jesus, K., Correia Santos Bonomo, D., Martins Arruda, J., de Pinho, J. C., Belacho Azeredo Coutinho, J., Braga Hagreaves Ribeiro de Freitas, R., de Souza Oliveira Garcia, T., Frizera Vassallo, P., Buarque Souza de Lima, M. H., Eberhart Neto, E., Satoshi Inagaki, A., Oliveira de Paula, A. E., Amador Correia, T., Nomoto, S., Seiji Ueno Gil, F., Florizel Almeida de Araujo, M., Bezerra Lima, Z., Simoes Giancursi, T., Rejane de Lima, C., Costa, M., Osaku, E. F., Jorge, A. C., Rodrigues da Cruz, M., da Cunha, S., Silva Cavallaro Torres, K., Rocha Rodrigues da Silva, F., Lisboa de Souza, R., Osni Machado, F., Buss, E. K., Cattelan Bonorino, K., Germano, A., Bin da Silva, S. R., Herek, A., Tavares Gurgel, S. J., Sanches Laranjeira, A., Toshiyuki Tanita, M., Tibery Queiroz Cardoso, L., Osorio Guerreiro, M., Peres Bainy, M., de Oliveira Teixeira, L., Colozza Mecatti, G., Carolina Salomao, M., Ribeiro Moreira, A., Vantini Capasso Palamim, C., Deucher, R. A. O., Castro Escobar Furlan, F., Rodrigues Torres de Carvalho, F., Muniz, R., Penna Guimaraes, H., Conceicao Andrade, L., Abrahao Hajjar, L., Barbosa Gomes Galas, F. R., Pinheiro de Almeida, J., Marco, R., Peixoto, E., Hirata, F., Yen Ju, C., Bonaccorsi Fernandino, B., Lage de Assis Rocha, D., Azzi Barbosa, N., Dias Alves, J., Furtado Lamego, L., de Linhares, J. M., Ferreira Sousa, M., Ferreira de Souza, M. M., Guimaraes de Carvalho, F. L., Aparecida Leite, M., Torres, P., Bolognese, D., Lacerda, V., Cisari, G., Souza Marques, A., Amarante Costa, A., Bonin Campos, L., Lovato, W. J., Guimaraes Dantas, B., Ribeiro Campos, D., Pires Barrientto, L. 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Silva, S, Elias Aquim, E, Girotto, F, Helenditi Fernandes Camurca Martins, R, Lima de Andrade, A, Breckenfeld Heirel, D, Ryoji Takatani, R, Dias de Almeida, S, Medina Matos, A, Iwamoto, T, Do Val Tavares, P, Valiatti, J, de Lucca, F, Fornazari, J, Dias Brugugnolli, I, de Araujo Nazare, M, Nascimento Loureiro, N, Vasconcelos de Sousa, G, Staffa Gonzaga da Silva, L, Dos Anjos Sad, F, Stucchi, E, Melo Silva, R, Fonseca Silva, T, Mendes Filho, S, Borba Pereira, T, da Silva, P, Martines Moralez, G, Abrantes Saraiva, S, Abrunhosa, A, Chagas, C, Thompson, M, Pinto Goncalves, C, de Oliveira Dias, R, Schwan Filho, F, Magalhaes Carvalho Grion, C, Mezzaroba, A, Festti, J, Massariol, T, de Souza, G, Martins Lima Silva, M, de Souza Andrade Neto, J, Costa, G, Souza Ribeiro, M, Coelho, M, Cruz Carbonell, R, de Souza Trindade, R, Valente Barbas, C, Domingos Correa, T, Serpa Neto, A, Santucci Cesar de Assuncao, M, Vilela Costa Pinto, B, Goncalves Libanio, P, da Silva Motta, J, Santa Maria Lucin, G, Macedo Araujo, L, Anibal Leite Barros Agostinho, T, de Andrade, K, da Silva, M, Pereira da Silva, E, Mousinho Gomes, R, Campos, N, Fonseca de Sousa, J, Ramos Nicolau da Costa, L, de Carvalho Fonseca Assuncao, N, Martins de Lima, G, Pinheiro de Oliveira, R, Gasparetto Maccari, J, de Campos Balzano, P, Tagliari, L, Metran Nascente, A, de Carvalho, M, Buttignol, M, Henn Moura, R, Vinicius Pereira, M, Alberti da Silva, G, Akemi Higo, M, Morales, M, Andrade, A, de Paiva, A, da Silva, K, Andrioli de Araujo, P, Cordeiro de Abreu Filho, C, Abdalla, G, Loureiro Sebold, M, Moreira, R, Caldeira Filho, M, de Brito Cordeiro, R, Pfuetzenreiter, F, Costa Carvalho, L, da Silva Guimaraes, B, de Faria Cordeiro, H, Pimentel Alvim, S, Do Espirito Santo, J, Silva Maia, I, Pincelli, M, Zandonai, C, Burigo Grumann, A, Kretzer, L, Nedel, W, Manozzo Boniatti, M, Santos Pellegrini, J, da Silva Marques, L, Girardelli Baptista, W, da Silva Franco, R, Moreira de Sousa, M, de Marchi Benfica, A, Veiga de Oliveira, A, Reis, D, Morais, M, Santa Rosa Santana, H, Murilo Domingues, S, de Menezes Ferreira, C, Amado Rabelo, L, Menezes de Rezende, C, Riccio, P, Silva de Almeida, P, Rubini, P, da Graca Pasquotto de Lima Assef, M, Nardela, R, Locks Stahlhofer, L, Gatelli Noronha, C, de Azevedo Naves, S, Dias da Silva, F, Mazza, B, Longhi Simoes de Almeida, S, Mayumi Higa, R, Papacidero, C, Lima Silva, M, de Assuncao Melo, L, Miranda Mafra Oliveira, M, Matos Brito Coelho, C, Machado, J, de Souza Machado, Y, Vitor Fera, J, Dos Santos Ramos, N, Botelho Foernges, R, de Souza, R, Rutzen, W, Villasante Troncoso, E, Paiva, T, Vieira de Lacerda, N, Aires de Araujo Neto, J, de Oliveira Maia, M, Bastos de Moura, E, Brocco Magnan, G, Soares Nasrala, M, Campos Tonussi, R, Kohl Pinheiro, E, Simoes da Silva, F, Dal-Pizzol, F, Schmitz de Figueiredo, F, Ritter, C, de Vasconcellos Baldisserotto, S, Blattner, C, Saldanha Dos Santos, R, da Silva Bettega, F, Almeida Delfino Duarte, P, Tozo, T, Peliser, P, Deczka Morsch, R, Guimaraes Leal Guadalupe, E, Souza Amorim, D, Rezegue de Moraes Rego, L, Azevedo, L, Ramos, F, Pastore, L, Nery, P, Spegiorin Moreno, M, Nakad Orsatti, V, Yudi Horikawa, F, Samartino Zavanelli, G, Adrieno Westphal, G, Sperotto, G, Dadam, M, Nunes, M, Pantaleao, S, Camargo Narciso, R, Bernadete Caser, E, Falcao, J, Genelhu, G, Lessa Soares, F, Silva Sales, B, Rebello de Jesus, K, Correia Santos Bonomo, D, Martins Arruda, J, de Pinho, J, Belacho Azeredo Coutinho, J, Braga Hagreaves Ribeiro de Freitas, R, de Souza Oliveira Garcia, T, Frizera Vassallo, P, Buarque Souza de Lima, M, Eberhart Neto, E, Satoshi Inagaki, A, Oliveira de Paula, A, Amador Correia, T, Nomoto, S, Seiji Ueno Gil, F, Florizel Almeida de Araujo, M, Bezerra Lima, Z, Simoes Giancursi, T, Rejane de Lima, C, Costa, M, Osaku, E, Jorge, A, Rodrigues da Cruz, M, da Cunha, S, Silva Cavallaro Torres, K, Rocha Rodrigues da Silva, F, Lisboa de Souza, R, Osni Machado, F, Buss, E, Cattelan Bonorino, K, Germano, A, Bin da Silva, S, Herek, A, Tavares Gurgel, S, Sanches Laranjeira, A, Toshiyuki Tanita, M, Tibery Queiroz Cardoso, L, Osorio Guerreiro, M, Peres Bainy, M, de Oliveira Teixeira, L, Colozza Mecatti, G, Carolina Salomao, M, Ribeiro Moreira, A, Vantini Capasso Palamim, C, Deucher, R, Castro Escobar Furlan, F, Rodrigues Torres de Carvalho, F, Muniz, R, Penna Guimaraes, H, Conceicao Andrade, L, Abrahao Hajjar, L, Barbosa Gomes Galas, F, Pinheiro de Almeida, J, Marco, R, Peixoto, E, Hirata, F, Yen Ju, C, Bonaccorsi Fernandino, B, Lage de Assis Rocha, D, Azzi Barbosa, N, Dias Alves, J, Furtado Lamego, L, de Linhares, J, Ferreira Sousa, M, Ferreira de Souza, M, Guimaraes de Carvalho, F, Aparecida Leite, M, Torres, P, Bolognese, D, Lacerda, V, Cisari, G, Souza Marques, A, Amarante Costa, A, Bonin Campos, L, Lovato, W, Guimaraes Dantas, B, Ribeiro Campos, D, Pires Barrientto, L, Rossi Peras Americo, V, Barboza Carnevalli Bueno, T, Morales, D, Mara Gomes, T, Barbosa Cerantola, R, Hoher, J, Sa Malbouisson, L, Matheus Cadamuro, F, Bassi, E, Maia, R, Dias E Santos, J, Oliveira, C, Balzi, A, Tierno, P, Marques Andrade, G, Delascio Lopes, R, Ramos Mello, M, Vendrame, L, Ribeiro Machado, F, Baccaro Rossetti Santana, H, de Carvalho, A, Marques Ferreira Mendez, V, de Araujo Macedo Pinto, W, Dos Santos Francisco, R, Steponovicius Piedade Cruz, F, Silva de Araujo, A, Paiva de Souza, A, Teixeira Pinheiro, T, Martins Santos, T, Gontijo-Coutinho, C, Franci, D, de Carvalho-Filho, M, Ribas Rosa de Oliveira, A, Silva, J, Costa Lisboa, T, Peretti Torelly, A, Silva de Souza, A, Hadrich, M, Schwarz, P, Berto, P, Teixeira de Gois, A, Silva, M, Gessolo Lins, P, Cavalcante Lola Biazzoto, E, Dragosavac, D, Ribeiro de Carvalho, C, Passos Amato, M, Toufen, C, Ribeiro de Santis Santiago, R, Hirota, A, Rodrigues, M, Dias Chiavegato, L, Bastos Vieira, P, de Almeida, M, Barbosa, P, Pereira Santos, J, Nogueira de Paula, L, Piras, C, Giuberti, J, Siqueira da Silva, A, Conti Ramos, R, Plata Valdivieso, R, Gonzalez, H, Ortiz, M, Bautista-Rincon, D, Quinones, E, Calderon, L, Vargas, M, Pizarro, C, Orozco Levi, M, Espitia Hernandez, A, Cadavid Gutierrez, C, Giraldo Ramirez, N, Gallego, D, Naranjo Sierra, S, Ortiz, G, Esneda Rocha Gaona, M, Garay, M, Vieda, E, Bermudez, W, Castaneda, J, Cortegiani, A, Russotto, V, Raineri, S, Giarratano, A, Shahnaz Hasan, M, Rai Hakumat Rai, V, Fadhil Hadi Bin Jamaluddin, M, Afiq Syahmi Ramli, M, Gorka, J, Nowak, I, Seczynska, B, Sega, A, Paulino, C, Povoa, P, Belda, F, Ferrando, C, Carbonell, J, Puig, J, Soro, M, Nin, N, Hurtado, J, Gacel, A, Gaudin, A, Sande, L, Cavalcanti A.B., Suzumura E.A., Laranjeira L.N., De Moraes Paisani D., Damiani L.P., Guimaraes H.P., Romano E.R., De Moraes Regenga M., Taniguchi L.N.T., Teixeira C., De Oliveira R.P., Machado F.R., Diaz-Quijano F.A., De Alencar Filho M.S., Maia I.S., Caser E.B., De Oliveira Filho W., De Carvalho Borges M., De Aquino Martins P., Matsui M., Ospina-Tascon G.A., Giancursi T.S., Giraldo-Ramirez N.D., Vieira S.R.R., De Lima Assef M.D.G.P., Hasan M.S., Szczeklik W., Rios F., Amato M.B.P., Berwanger O., De Carvalho C.R.R., Tucci M.R., Souza Dos Santos L., Franca de Oliveira M.C., Peres I., Freitas I., Reis H., Verissimo A., Torres D., Barroso A., Semboloni Bitencourt W., Franco M.R., Oliveira Lage J., Aparecida Pessoa Conde K., Charro F.A., Naia A., de Brito Sobrinho E., Lameira Verissimo A., Barros de Oliveira M.E., Zampieri F., Ladeira J.P., Cordioli R., Diogo Sala A., Tadahiro Ikeoka D., Baptista Filho M.L.A., Ray A., Guerra de Almeida A., Nazareno Conceicao C., Ribeiro Salgado D., Rosso Verdeal J.C., Martins G.A., Junqueira Ribeiro L., Vilela Siqueira H., Flavio Costa Filho F., Adler Maccagnan Pinheiro Besen B., Vieira Do Nascimento Martins E., Aparecida Pereira J., Milioli Ferreira D., Alves Ferreira Goncalves F., de Souza Nobrega M., Barros Duarte I.J., Nobre V., Miranda Barreto Mourao L., Gomez Ravetti C., Scalzo A.C., Martins De Stefano L., Gut A.L., Nogueira Filho W., Gatti Cirillo C., Ishiwaki S., Lobo S., Elias de Oliveira N., Fernandes Machado L., Sisconetto L., Rios Vieira S.R., Fialkow L., Fontoura Prado K., Franke C., Barberena Moraes R., Christmann Wawrzeniak I., Rech T.H., Parolo E., Almeida Victorino J., Marques Barroso C., Marcal de Vasconcelos M.O., Souza da Silva R., Lesti Esteves A.R., Camassola A.P., Antoniazzi R., Griebler M., Favretto J., Romano M., Franz da Costa A., Werneck V., Miura M.C., Farran J., Vasconcelos R., Isola A., Resende E., Goulart R., Luzzi S., Rea-Neto A., de Oliveira M.C., Bruinje Cosentino M.F., Martins Dzivielevski B., Reese F.B., Ferreira da Silva S.D., Elias Aquim E., Girotto F., Helenditi Fernandes Camurca Martins R., Lima de Andrade A., Breckenfeld Heirel D.C., Ryoji Takatani R., Dias de Almeida S., Medina Matos A., Iwamoto T., Do Val Tavares P.E., Valiatti J.L., de Lucca F.C., Fornazari J.C., Dias Brugugnolli I., de Araujo Nazare M., Nascimento Loureiro N., Vasconcelos de Sousa G., Staffa Gonzaga da Silva L., Dos Anjos Sad F.C., Stucchi E.M., Melo Silva R., Fonseca Silva T., Mendes Filho S.P., Borba Pereira T., da Silva P.N., Martines Moralez G., Abrantes Saraiva S., Abrunhosa A., Chagas C.E.R.C., Thompson M.M., Pinto Goncalves C.H., de Oliveira Dias R., Schwan Filho F., Magalhaes Carvalho Grion C., Mezzaroba A.L., Festti J., Massariol T.C., de Souza G.F., Martins Lima Silva M., de Souza Andrade Neto J., Costa G., Souza Ribeiro M., Coelho M., Cruz Carbonell R.C., de Souza Trindade R., Valente Barbas C.S., Domingos Correa T., Serpa Neto A., Santucci Cesar de Assuncao M., Vilela Costa Pinto B., Goncalves Libanio P., da Silva Motta J., Santa Maria Lucin G., Macedo Araujo L., Anibal Leite Barros Agostinho T., de Andrade K.M., da Silva M.S., Pereira da Silva E., Mousinho Gomes R.L., Campos N.M.P., Fonseca de Sousa J., Ramos Nicolau da Costa L., de Carvalho Fonseca Assuncao N.S., Martins de Lima G., Pinheiro de Oliveira R., Gasparetto Maccari J., de Campos Balzano P., Tagliari L., Metran Nascente A.P., de Carvalho M.A., Buttignol M., Henn Moura R., Vinicius Pereira M., Alberti da Silva G., Akemi Higo M., Morales M., Andrade A.H.V., de Paiva A.P., da Silva K.S., Andrioli de Araujo P., Cordeiro de Abreu Filho C.A., Abdalla G., Loureiro Sebold M., Moreira R., Caldeira Filho M., de Brito Cordeiro R., Pfuetzenreiter F., Costa Carvalho L.F., da Silva Guimaraes B.L., de Faria Cordeiro H., Pimentel Alvim S.H., Do Espirito Santo J.A., Silva Maia I., Pincelli M., Zandonai C.L., Burigo Grumann A.C., Kretzer L.P., Nedel W., Manozzo Boniatti M., Santos Pellegrini J.A., da Silva Marques L., Girardelli Baptista W.C., da Silva Franco R.S., Moreira de Sousa M., de Marchi Benfica A.F., Veiga de Oliveira A.L., Reis D.L., Morais M.O., Santa Rosa Santana H., Murilo Domingues S., de Menezes Ferreira C., Amado Rabelo L., Menezes de Rezende C., Riccio P., Silva de Almeida P., Rubini P., da Graca Pasquotto de Lima Assef M., Nardela R., Locks Stahlhofer L., Gatelli Noronha C., de Azevedo Naves S., Dias da Silva F., Mazza B.F., Longhi Simoes de Almeida S., Mayumi Higa R., Papacidero C.H., Lima Silva M.M., de Assuncao Melo L., Miranda Mafra Oliveira M., Matos Brito Coelho C., Machado J.A., de Souza Machado Y.L., Vitor Fera J., Dos Santos Ramos N.C., Botelho Foernges R., de Souza R.R., Rutzen W., Villasante Troncoso E.M., Paiva T.K.B., Vieira de Lacerda N.M., Aires de Araujo Neto J., de Oliveira Maia M., Bastos de Moura E., Brocco Magnan G., Soares Nasrala M.L., Campos Tonussi R.L., Kohl Pinheiro E., Simoes da Silva F., Dal-Pizzol F., Schmitz de Figueiredo F., Ritter C., de Vasconcellos Baldisserotto S., Blattner C., Saldanha Dos Santos R., da Silva Bettega F., Almeida Delfino Duarte P., Tozo T.C., Peliser P., Deczka Morsch R., Guimaraes Leal Guadalupe E., Souza Amorim D., Rezegue de Moraes Rego L., Azevedo L., Ramos F., Pastore L., Nery P., Spegiorin Moreno M., Nakad Orsatti V., Yudi Horikawa F., Samartino Zavanelli G., Adrieno Westphal G., Sperotto G., Dadam M., Nunes M., Pantaleao S.L., Camargo Narciso R., Bernadete Caser E., Falcao J.G., Genelhu G., Lessa Soares F., Silva Sales B., Rebello de Jesus K., Correia Santos Bonomo D., Martins Arruda J., de Pinho J.C., Belacho Azeredo Coutinho J., Braga Hagreaves Ribeiro de Freitas R., de Souza Oliveira Garcia T., Frizera Vassallo P., Buarque Souza de Lima M.H., Eberhart Neto E., Satoshi Inagaki A., Oliveira de Paula A.E., Amador Correia T., Nomoto S., Seiji Ueno Gil F., Florizel Almeida de Araujo M., Bezerra Lima Z., Simoes Giancursi T., Rejane de Lima C., Costa M., Osaku E.F., Jorge A.C., Rodrigues da Cruz M., da Cunha S., Silva Cavallaro Torres K., Rocha Rodrigues da Silva F., Lisboa de Souza R., Osni Machado F., Buss E.K., Cattelan Bonorino K., Germano A., Bin da Silva S.R., Herek A., Tavares Gurgel S.J., Sanches Laranjeira A., Toshiyuki Tanita M., Tibery Queiroz Cardoso L., Osorio Guerreiro M., Peres Bainy M., de Oliveira Teixeira L., Colozza Mecatti G., Carolina Salomao M., Ribeiro Moreira A., Vantini Capasso Palamim C., Deucher R.A.O., Castro Escobar Furlan F., Rodrigues Torres de Carvalho F., Muniz R., Penna Guimaraes H., Conceicao Andrade L., Abrahao Hajjar L., Barbosa Gomes Galas F.R., Pinheiro de Almeida J., Marco R., Peixoto E., Hirata F., Yen Ju C., Bonaccorsi Fernandino B., Lage de Assis Rocha D., Azzi Barbosa N., Dias Alves J., Furtado Lamego L., de Linhares J.M., Ferreira Sousa M., Ferreira de Souza M.M., Guimaraes de Carvalho F.L., Aparecida Leite M., Torres P., Bolognese D., Lacerda V., Cisari G., Souza Marques A., Amarante Costa A., Bonin Campos L., Lovato W.J., Guimaraes Dantas B., Ribeiro Campos D., Pires Barrientto L.C., Rossi Peras Americo V., Barboza Carnevalli Bueno T., Morales D., Mara Gomes T., Barbosa Cerantola R., Hoher J., Sa Malbouisson L.M., Matheus Cadamuro F., Bassi E., Maia R., Dias E Santos J.A., Oliveira C., Balzi A.P., Tierno P., Marques Andrade G., Delascio Lopes R., Ramos Mello M., Vendrame L.S., Ribeiro Machado F., Baccaro Rossetti Santana H., de Carvalho A., Marques Ferreira Mendez V., de Araujo Macedo Pinto W., Dos Santos Francisco R., Steponovicius Piedade Cruz F., Silva de Araujo A., Paiva de Souza A., Teixeira Pinheiro T., Martins Santos T., Gontijo-Coutinho C.M., Franci D., de Carvalho-Filho M.A., Ribas Rosa de Oliveira A.M., Silva J.M., Costa Lisboa T., Peretti Torelly A., Silva de Souza A., Hadrich M., Schwarz P., Berto P., Teixeira de Gois A.F., Silva M., Gessolo Lins P., Cavalcante Lola Biazzoto E.P., Dragosavac D., Ribeiro de Carvalho C.R., Passos Amato M.B., Toufen C., Ribeiro de Santis Santiago R., Hirota A.S., Rodrigues M., Dias Chiavegato L., Bastos Vieira P.C., de Almeida M.M.M.F., Barbosa P.G., Pereira Santos J.R., Nogueira de Paula L., Piras C., Giuberti J., Siqueira da Silva A., Conti Ramos R., Plata Valdivieso R., Gonzalez H.H., Ortiz M., Bautista-Rincon D.F., Quinones E., Calderon L.E., Vargas M., Pizarro C., Orozco Levi M., Espitia Hernandez A.M., Cadavid Gutierrez C., Giraldo Ramirez N., Gallego D.A., Naranjo Sierra S., Ortiz G., Esneda Rocha Gaona M., Garay M., Vieda E., Bermudez W.F., Castaneda J.A., Cortegiani A., Russotto V., Raineri S.M., Giarratano A., Shahnaz Hasan M., Rai Hakumat Rai V., Fadhil Hadi Bin Jamaluddin M., Afiq Syahmi Ramli M., Gorka J., Nowak I., Seczynska B., Sega A., Paulino C., Povoa P., Belda F.J., Ferrando C., Carbonell J.A., Puig J., Soro M., Nin N., Hurtado J., Gacel A., Gaudin A., and Sande L.
Subjects: Adult, Male, ARDS, medicine.medical_specialty, acure respitatory distress syndrome, medicine.medical_treatment, mechanical ventilation, law.invention, Positive-Pressure Respiration, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Intensive care, Tidal Volume, medicine, Humans, Treatment Failure, ARDS, ventilation, PEEP, MED/41 - ANESTESIOLOGIA, PEEP, Tidal volume, Positive end-expiratory pressure, Aged, intensive care, Mechanical ventilation, Respiratory Distress Syndrome, business.industry, Hazard ratio, Pneumothorax, 030208 emergency & critical care medicine, General Medicine, Middle Aged, medicine.disease, Surgery, Intensive Care Units, Editorial, 030228 respiratory system, Anesthesia, Female, business
Abstract: Importance The effects of recruitment maneuvers and positive end-expiratory pressure (PEEP) titration on clinical outcomes in patients with acute respiratory distress syndrome (ARDS) remain uncertain. Objective To determine if lung recruitment associated with PEEP titration according to the best respiratory-system compliance decreases 28-day mortality of patients with moderate to severe ARDS compared with a conventional low-PEEP strategy. Design, Setting, and Participants Multicenter, randomized trial conducted at 120 intensive care units (ICUs) from 9 countries from November 17, 2011, through April 25, 2017, enrolling adults with moderate to severe ARDS. Interventions An experimental strategy with a lung recruitment maneuver and PEEP titration according to the best respiratory–system compliance (n = 501; experimental group) or a control strategy of low PEEP (n = 509). All patients received volume-assist control mode until weaning. Main Outcomes and Measures The primary outcome was all-cause mortality until 28 days. Secondary outcomes were length of ICU and hospital stay; ventilator-free days through day 28; pneumothorax requiring drainage within 7 days; barotrauma within 7 days; and ICU, in-hospital, and 6-month mortality. Results A total of 1010 patients (37.5% female; mean [SD] age, 50.9 [17.4] years) were enrolled and followed up. At 28 days, 277 of 501 patients (55.3%) in the experimental group and 251 of 509 patients (49.3%) in the control group had died (hazard ratio [HR], 1.20; 95% CI, 1.01 to 1.42; P = .041). Compared with the control group, the experimental group strategy increased 6-month mortality (65.3% vs 59.9%; HR, 1.18; 95% CI, 1.01 to 1.38; P = .04), decreased the number of mean ventilator-free days (5.3 vs 6.4; difference, −1.1; 95% CI, −2.1 to −0.1; P = .03), increased the risk of pneumothorax requiring drainage (3.2% vs 1.2%; difference, 2.0%; 95% CI, 0.0% to 4.0%; P = .03), and the risk of barotrauma (5.6% vs 1.6%; difference, 4.0%; 95% CI, 1.5% to 6.5%; P = .001). There were no significant differences in the length of ICU stay, length of hospital stay, ICU mortality, and in-hospital mortality. Conclusions and Relevance In patients with moderate to severe ARDS, a strategy with lung recruitment and titrated PEEP compared with low PEEP increased 28-day all-cause mortality. These findings do not support the routine use of lung recruitment maneuver and PEEP titration in these patients. Trial Registration clinicaltrials.gov Identifier:NCT01374022
Published: 2017

10. Use of Cepheid Xpert Carba-R® for Rapid Detection of Carbapenemase-Producing Bacteria in Abdominal Septic Patients Admitted to Intensive Care Unit

Author: Cortegiani, A, Russotto, V, Graziano, G, Geraci, D, Saporito, L, COCORULLO, Gianfranco, RAINERI, Santi Maurizio, Mammina, C, GIARRATANO, Antonino, SAPORITO, Laura, Cortegiani, A., Russotto, V., Graziano, G., Geraci, D., Saporito, L., Cocorullo, G., Raineri, S., Mammina, C., Giarratano, A., Cortegiani, A, Russotto, V, Graziano, G, Geraci, D, Saporito, L, Cocorullo, G, Raineri, S, Mammina, C, and Giarratano, A
Subjects: 0301 basic medicine, Male, Microbiological culture, Antibiotics, lcsh:Medicine, Artificial Gene Amplification and Extension, Pathology and Laboratory Medicine, Polymerase Chain Reaction, law.invention, Klebsiella Pneumoniae, 0302 clinical medicine, law, Klebsiella, Epidemiology, multidrug resistance, sepsis, intensive care unit, Abdomen, Medicine and Health Sciences, Medicine, 030212 general & internal medicine, lcsh:Science, Multidisciplinary, Antimicrobials, Cepheid Xpert Carba-R®, Drugs, Microbial Cultures, Middle Aged, Intensive care unit, Hospitals, Bacterial Pathogens, Intensive Care Units, Abdominal Surgery, Medical Microbiology, Female, Biological Cultures, Pathogens, Research Article, DNA, Bacterial, medicine.medical_specialty, medicine.drug_class, 030106 microbiology, Surgical and Invasive Medical Procedures, Research and Analysis Methods, Real-Time Polymerase Chain Reaction, Rapid detection, Microbiology, Sensitivity and Specificity, beta-Lactamases, 03 medical and health sciences, Antibiotic resistance, Bacterial Proteins, Enterobacteriaceae, Diagnostic Medicine, Internal medicine, Intensive care, Microbial Control, Sepsis, Drug Resistance, Bacterial, Humans, MED/41 - ANESTESIOLOGIA, Molecular Biology Techniques, Microbial Pathogens, Molecular Biology, Aged, Pharmacology, Bacteria, business.industry, lcsh:R, Organisms, Rectum, Biology and Life Sciences, Surgery, Health Care, Carbapenems, Health Care Facilities, Antibiotic Resistance, lcsh:Q, Antimicrobial Resistance, Reagent Kits, Diagnostic, business, Abdominal surgery
Abstract: Early institution of effective antibiotic therapy and source control are pivotal to improve survival of abdominal septic patients. Xpert® Carba-R is a real time polymerase chain reaction assay for rapid detection and differentiation of five genes (blaKPC, blaVIM, blaOXA-48, blaIMP-1, blaNDM) responsible for carbapenem resistance. We performed an observational study investigating the clinical usefulness and applicability of Xpert® Carba-R to detect carbapenem resistance in abdominal septic patients admitted to intensive care unit. We compared the results of Xpert® Carba-R with standard microbiological culture. We collected a set of two rectal/stomia swabs and two swabs from abdominal drainage fluid for each patient. We included 20 patients for a total of 45 comparisons between the two methods. In our clinical setting, the overall performance of Xpert® Carba-R for detection of carbapenem resistance in the presence of genes detectable and non-detectable by the method was: sensitivity 50% (95% CI 24.6-75.3); specificity 93.1% (95% CI 77.2-99.1); positive predictive value (PPV) 80% (95% CI 44.4-97.5); negative predictive value (NPV) 77.1% (95% CI 56.9-89.6). The inter-rater agreement was 0.47 (SE 0.14; 95% CI 0.20-0.74). When considering the only 5 mechanisms of resistance detected by both methods, the overall diagnostic performance was: sensitivity 100% (95% CI 69.1-100), specificity 94.2 (95% CI 80.8-99.3), PPV 83.3 (95% CI 59.6-97.9) and NPV 100% (95% CI 89.4-100). The inter-rater agreement was 0.88 (SE 0.08; 95% CI 0.71-1). Xpert® Carba-R may be considered an additional diagnostic tool for early diagnosis of carbapenem resistance in abdominal septic patients. Clinicians should be aware of their epidemiology before its introduction in the diagnostic protocol of their intensive care units.
Published: 2016

11. Management of critically ill patients with COVID-19: suggestions and instructions from the coordination of intensive care units of Lombardy

Author: Giacomo Grasselli, Gian Paolo Castelli, N Bottino, Luca Guatteri, Giuseppe Foti, Antonio Pesenti, Maurizio Cecconi, Marco Ranucci, Danilo Radrizzani, Giacomo Monti, Alberto Giannini, Nicola Latronico, Roberto Fumagalli, Thomas Langer, Stefano Muttini, Vincenzo Russotto, Foti, G., Giannini, A., Bottino, N., Castelli, G. P., Cecconi, M., Grasselli, G., Uatteri, L., Latronico, N., Langer, T., Monti, G., Muttini, S., Pesenti, A., Radrizzani, D., Ranucci, M., Russotto, V., Fumagalli, R (COVID-19 Lombardy ICU Network), Zangrillo, A, Landoni, G, Foti, G, Giannini, A, Bottino, N, Castelli, G, Cecconi, M, Grasselli, G, Guatteri, L, Latronico, N, Langer, T, Monti, G, Muttini, S, Pesenti, A, Radrizzani, D, Ranucci, M, Russotto, V, and Fumagalli, R
Subjects: medicine.medical_specialty, Respiratory distress syndrome, medicine.medical_treatment, Critical Illness, Psychological intervention, MEDLINE, law.invention, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, law, Intensive care, medicine, Humans, Continuous positive airway pressure, Intensive care medicine, Pandemics, Mechanical ventilation, business.industry, adult, COVID-19, 030208 emergency & critical care medicine, Intensive Care Units, Italy, Coronavirus, medicine.disease, Intensive care unit, Pneumonia, Anesthesiology and Pain Medicine, Respiratory failure, ARDS, business
Abstract: With 63,098 confirmed cases on 17 April 2020 and 11,384 deaths, Lombardy has been the most affected region in Italy by coronavirus disease 2019 (COVID-19). To cope with this emergency, the COVID-19 Lombardy intensive care units (ICU) network was created. The network identified the need of defining a list of clinical recommendations to standardize treatment of patients with COVID-19 admitted to Intensive Care Unit (ICU). Three core topics were identified: 1) rational use of intensive care resources; 2) ventilation strategies; 3) non-ventilatory interventions. Identification of patients who may benefit from ICU treatment is challenging. Clinicians should consider baseline performance and frailty status and they should adopt disease-specific staging tools. Continuous positive airway pressure, mainly delivered through a helmet as elective method, should be considered as initial treatment for all patients with respiratory failure associated with COVID-19. In case of persisting dyspnea and/or desaturation despite 4-6 hours of noninvasive ventilation, endotracheal intubation and invasive mechanical ventilation should be considered. In the early phase, muscle relaxant use and volume-controlled ventilation is recommended. Prone position should be performed in patients with PaOinf2/inf/FiOinf2/inf≤100 mmHg. For patients admitted to ICU with COVID-19 interstitial pneumonia, we do not recommend empiric antibiotic therapy for community-acquired pneumonia. Consultation of an infectious disease specialist is suggested before start of any antiviral therapy. In conclusion, the COVID-19 Lombardy ICU Network identified a list of best practice statements supported by the available evidence and clinical experience or identified as panel members expert opinions for the management of critically ill patients with COVID-19.
Published: 2020

12. What Healthcare Workers Should Know about Environmental Bacterial Contamination in the Intensive Care Unit

Author: Tma Fasciana, Andrea Cortegiani, Cesare Gregoretti, Santi Maurizio Raineri, Antonino Giarratano, Pasquale Iozzo, Russotto, Anna Giammanco, Russotto, V., Cortegiani, A., Fasciana, T., Iozzo, P., Raineri, S., Gregoretti, C., Giammanco, A., Giarratano, A., Russotto, V, Cortegiani, A, Fasciana, T, Iozzo, P, Raineri, S, Gregoretti, C, Giammanco, A, and Giarratano, A
Subjects: 0301 basic medicine, medicine.medical_specialty, Health Personnel, 030106 microbiology, lcsh:Medicine, Review Article, General Biochemistry, Genetics and Molecular Biology, law.invention, 03 medical and health sciences, law, Long period, Health care, medicine, Humans, Infection control, Terminal cleaning, MED/41 - ANESTESIOLOGIA, Intensive care medicine, Decontamination, Cross Infection, Infection Control, Healthcare, Environmental, Bacterial, Contamination, Intensive Care Unit, General Immunology and Microbiology, business.industry, lcsh:R, General Medicine, Contamination, Intensive care unit, Intensive Care Units, Increased risk, Equipment Contamination, Environmental Pollution, business, Human
Abstract: Intensive care unit- (ICU-) acquired infections are a major health problem worldwide. Inanimate surfaces and equipment contamination may play a role in cross-transmission of pathogens and subsequent patient colonization or infection. Bacteria contaminate inanimate surfaces and equipment of the patient zone and healthcare area, generating a reservoir of potential pathogens, including multidrug resistant species. Traditional terminal cleaning methods have limitations. Indeed patients who receive a bed from prior patient carrying bacteria are exposed to an increased risk (odds ratio 2.13, 95% confidence intervals 1.62–2.81) of being colonized and potentially infected by the same bacterial species of the previous patient. Biofilm formation, even on dry surfaces, may play a role in reducing the efficacy of terminal cleaning procedures since it enables bacteria to survive in the environment for a long period and provides increased resistance to commonly used disinfectants. No-touch methods (e.g., UV-light, hydrogen peroxide vapour) are under investigation and further studies with patient-centred outcomes are needed, before considering them the standard of terminal cleaning in ICUs. Healthcare workers should be aware of the role of environmental contamination in the ICU and consider it in the broader perspective of infection control measures and stewardship initiatives.
Published: 2017
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13. Perioperative management of obstructive sleep apnea: A systematic review

Author: Ruggero M Corso, Russotto, Davide Cattano, Cesare Gregoretti, Corso, R, Russotto, V, Gregoretti, C, Cattano, D, and Corso R. , Russotto V., Gregoretti C., Cattano, D.
Subjects: medicine.medical_specialty, Polysomnography, medicine.medical_treatment, Population, 030209 endocrinology & metabolism, Perioperative Care, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, Obstructive, Perioperative care, Sleep apnea, Sleep apnea syndromes, medicine, Intubation, Continuous positive airway pressure, MED/41 - ANESTESIOLOGIA, education, education.field_of_study, Pain, Postoperative, Sleep Apnea, Obstructive, medicine.diagnostic_test, Continuous Positive Airway Pressure, business.industry, Apnea, Perioperative, medicine.disease, respiratory tract diseases, Obstructive sleep apnea, Sleep apnea syndrome, Anesthesiology and Pain Medicine, Emergency medicine, Postoperative Complication, medicine.symptom, business, Human
Abstract: Introduction Obstructive sleep apnea (OSA) is the leading sleep disordered breathing condition, with a prevalence rate of moderate to severe OSA of approximately 10-17% in the general population. Evidence acquisition We performed an Ovid-Medline search of all articles published up to August 2016. We included all articles providing updated evidence on epidemiology, pathophysiologic mechanisms and perioperative interventions. Evidence synthesis OSA is associated with a number of comorbidities and increased perioperative risks. Although in-laboratory polysomnography represents the gold-standard for diagnosis of OSA, it is costly and time-consuming. Anesthesiologists may screen patients for OSA through one of the available questionnaires, of which the snoring, tiredness, observed apnea, high blood pressure (STOP)-Body Mass Index, age, neck circumference and gender (Bang), STOP-bang questionnaire is the most externally validated. Although its sensitivity for the identification of mild OSA patients is 83.6%, its specificity is only 56.4%. OSA patients are associated with a higher risk of both difficult ventilation and intubation. However, practice guidelines refer to available guidelines for difficult airway management. Perioperative continuous positive airway pressure use may be of benefit since it has been reported to be associated with a reduction of both respiratory and cardiovascular complications and symptom relief. When feasible, regional anesthesia techniques and a multimodal analgesia approach should be adopted to reduce intraoperative and postoperative exposure to opioids. Conclusions Preoperative screening of OSA patients is of relevance given the increased perioperative morbidity of these patients. Further studies are needed to provide conclusive data on which perioperative interventions are most effective at reducing this risk.
Published: 2018

14. Use of a real-Time training software (Laerdal QCPR®) compared to instructor-based feedback for high-quality chest compressions acquisition in secondary school students: A randomized trial

Author: Francesca Montalto, Roberta Meschis, Pasquale Iozzo, Vincenzo Russotto, Santi Maurizio Raineri, Antonino Giarratano, Dario Mariano, Vincenzo Benenati, Marinella Pugliesi, Andrea Cortegiani, Cesare Gregoretti, Cortegiani A., Russotto V., Montalto F., Iozzo P., Meschis R., Pugliesi M., Mariano D., Benenati V., Raineri S.M., Gregoretti C., Giarratano A., Cortegiani, A, Russotto, V, Montalto, F, Iozzo, P, Meschis, R, Pugliesi, M, DA ROLD, M, Benenati, V, Raineri, S, Gregoretti, C, and Giarratano, A
Subjects: Male, Australian/New Zealand, Critical Care and Emergency Medicine, medicine.medical_treatment, Social Sciences, lcsh:Medicine, 030204 cardiovascular system & hematology, Geographical locations, law.invention, 0302 clinical medicine, Primary outcome, Randomized controlled trial, Sociology, law, Heart Rate, Medicine and Health Sciences, Cardiac Arrest, Medicine, lcsh:Science, Flow Rate, Multidisciplinary, Schools, Physics, Classical Mechanics, Professions, Physical Sciences, Female, Clinical Competence, Student, Research Article, Human, Feedback system, medicine.medical_specialty, Computer and Information Sciences, Adolescent, Resuscitation, Oceania, education, Cardiology, Fluid Mechanics, Continuum Mechanics, Education, Feedback, Computer Software, 03 medical and health sciences, Humans, Cardiopulmonary resuscitation, Technical skills, MED/41 - ANESTESIOLOGIA, Trial registration, Students, business.industry, lcsh:R, Basic life support, 030208 emergency & critical care medicine, Fluid Dynamics, Cardiopulmonary Resuscitation, Heart Arrest, Clinical trial, Instructors, People and Places, Physical therapy, Population Groupings, lcsh:Q, business, Software, New Zealand
Abstract: High-quality chest compressions are pivotal to improve survival from cardiac arrest. Basic life support training of school students is an international priority. The aim of this trial was to assess the effectiveness of a real-time training software (Laerdal QCPR®) compared to a standard instructor-based feedback for chest compressions acquisition in secondary school students. After an interactive frontal lesson about basic life support and high quality chest compressions, 144 students were randomized to two types of chest compressions training: 1) using Laerdal QCPR® (QCPR group– 72 students) for real-time feedback during chest compressions with the guide of an instructor who considered software data for students’ correction 2) based on standard instructor-based feedback (SF group– 72 students). Both groups had a minimum of a 2-minute chest compressions training session. Students were required to reach a minimum technical skill level before the evaluation. We evaluated all students at 7 days from the training with a 2-minute chest compressions session. The primary outcome was the compression score, which is an overall measure of chest compressions quality calculated by the software expressed as percentage. 125 students were present at the evaluation session (60 from QCPR group and 65 from SF group). Students in QCPR group had a significantly higher compression score (median 90%, IQR 81.9–96.0) compared to SF group (median 67%, IQR 27.7–87.5), p = 0.0003. Students in QCPR group performed significantly higher percentage of fully released chest compressions (71% [IQR 24.5–99.0] vs 24% [IQR 2.5–88.2]; p = 0.005) and better chest compression rate (117.5/min [IQR 106–123.5] vs 125/min [115–135.2]; p = 0.001). In secondary school students, a training for chest compressions based on a real-time feedback software (Laerdal QCPR®) guided by an instructor is superior to instructor-based feedback training in terms of chest compression technical skill acquisition. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12616000383460
Published: 2017

15. Respiratory support techniques to avoid desaturation in critically ill patients requiring endotracheal intubation: A systematic review and meta-analysis

Author: Andrea Cortegiani, Cesare Gregoretti, Santi Maurizio Raineri, Vincenzo Russotto, Antonino Giarratano, Russotto, V., Cortegiani, A., Raineri, S., Gregoretti, C., Giarratano, A., Russotto, V, Cortegiani, A, Raineri, S, Gregoretti, C, and Giarratano, A
Subjects: Critical Care, Databases, Factual, medicine.medical_treatment, Airway management, Apneic oxygenation, Endotracheal intubation, Noninvasive ventilation, Oxygen inhalation therapy, Preoxygenation, Critical Illness, Settore MED/41 - Anestesiologia, Cochrane Library, Critical Care and Intensive Care Medicine, medicine.disease_cause, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, medicine, Intubation, Intratracheal, Intubation, Cannula, Humans, MED/41 - ANESTESIOLOGIA, Hypoxia, business.industry, 030208 emergency & critical care medicine, Respiration, Artificial, Intubation procedure, 030228 respiratory system, Meta-analysis, Anesthesia, Critical Illne, business, Respiratory Insufficiency, Nasal cannula, Human
Abstract: Purpose To evaluate which respiratory support method for critically ill patients undergoing endotracheal intubation (ETI) is associated with less desaturation. Methods We searched PubMed, Cochrane Library, Scopus and CINAHL databases. We included randomized (RCT) and non-randomized (non-RCT) studies investigating any method of respiratory support before/during ETI compared to a reference control. Results Apneic oxygenation (ApOx) was the most commonly investigated respiratory support technique for critically ill patients undergoing intubation (4 RCTs, 358 patients). Three of these studies investigated high-flow nasal cannula (HFNC) for ApOx while standard nasal cannula was used in one. Globally, ApOx was associated with higher minimum SpO2 value compared to those receiving ETI without ApOx (mean difference 2.31%, 95% CI 0.42 to 4.20, p = 0.02, I2 = 0%) but there were not significant differences between groups in severe hypoxemia and intubation related – complications. Concerning other techniques, noninvasive ventilation (NIV) was compared to bag-valve mask in only one RCT and it reduced the degree of desaturation. Conclusions ApOx was significantly associated with higher minimum SpO2 registered during the intubation procedure. Further studies are needed to increase the number of included patients and demonstrate the benefit of ApOx and of other respiratory support methods (e.g. NIV, HFNC).
Published: 2017

16. Antifungal agents for preventing fungal infections in non-neutropenic critically ill patients

Author: Massimo Attanasio, Antonino Giarratano, Andrea Cortegiani, Vincenzo Russotto, Santi Maurizio Raineri, Alessandro R Naro, Alessandra Maggiore, Cortegiani, A, Russotto, V, Maggiore, A, Attanasio, M, Naro, A, Raineri, S, Giarratano, A, Cortegiani, A., Russotto, V., Maggiore, A., Attanasio, M., Naro, A., Raineri, S., and Giarratano, A.
Subjects: Adult, medicine.medical_specialty, Antifungal drug, Mycose, intensive care medicine, law.invention, 03 medical and health sciences, Immunocompromised Host, critically ill patient, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, Amphotericin B, medicine, Humans, Antifungal Agent, Pharmacology (medical), 030212 general & internal medicine, MED/41 - ANESTESIOLOGIA, Intensive care medicine, Fluconazole, Fluconazole [therapeutic use], Randomized Controlled Trials as Topic, business.industry, fungal infection, Micafungin, 030208 emergency & critical care medicine, Publication bias, Mycoses [mortality, Clinical trial, Critical Illness [mortality], Amphotericin B [therapeutic use], Antifungal Agents [therapeutic use], prevention & control], Relative risk, Meta-analysis, Anidulafungin, Critical Illne, business, medicine.drug, Human
Abstract: Background Invasive fungal infections are important causes of morbidity and mortality among critically ill patients. Early institution of antifungal therapy is pivotal for mortality reduction. Starting a targeted antifungal therapy after culture positivity and fungi identification requires a long time. Therefore, alternative strategies (globally defined as 'untargeted antifungal treatments') for antifungal therapy institution in patients without proven microbiological evidence of fungal infections have been discussed by international guidelines. This review was originally published in 2006 and updated in 2016. This updated review provides additional evidence for the clinician dealing with suspicion of fungal infection in critically ill, non-neutropenic patients, taking into account recent findings in this field. Objectives To assess the effects of untargeted treatment with any antifungal drug (either systemic or nonabsorbable) compared to placebo or no antifungal or any other antifungal drug (either systemic or nonabsorbable) in non-neutropenic, critically ill adults and children. We assessed effectiveness in terms of total (all-cause) mortality and incidence of proven invasive fungal infections as primary outcomes. Search methods We searched the following databases to February 2015: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (OVID), and EMBASE (OVID). We also searched reference lists of identified studies and major reviews, abstracts of conference proceedings, scientific meetings and clinical trials registries. We contacted experts in the field, study authors and pharmaceutical companies as part of the search strategy. Selection criteria We included randomized controlled trials (RCTs) (irrespective of language or publication status) comparing the use of untargeted treatment with any antifungal drug (either systemic or nonabsorbable) to placebo, no antifungal, or another antifungal agent in non-neutropenic critically ill participants. Data collection and analysis Three authors independently applied selection criteria, extracted data and assessed the risk of bias. We resolved any discrepancies by discussion. We synthesized data using the random-effects model and expressed the results as risk ratios (RR) with 95% confidence intervals. We assessed overall evidence quality using the GRADE approach. Main results We included 22 studies (total of 2761 participants). Of those 22 studies, 12 were included in the original published review and 10 were newly identified. Eleven trials compared the use of fluconazole to placebo or no antifungal treatment. Three trials compared ketoconazole versus placebo. One trial compared anidulafungin with placebo. One trial compared caspofungin to placebo. Two trials compared micafungin to placebo. One trial compared amphotericin B to placebo. Two trials compared nystatin to placebo and one trial compared the effect of clotrimazole, ketoconazole, nystatin and no treatment. We found two new ongoing studies and four new studies awaiting classification. The RCTs included participants of both genders with wide age range, severity of critical illness and clinical characteristics. Funding sources from pharmaceutical companies were reported in 11 trials and one trial reported funding from a government agency. Most of the studies had an overall unclear risk of bias for key domains of this review (random sequence generation, allocation concealment, incomplete outcome data). Two studies had a high risk of bias for key domains. Regarding the other domains (blinding of participants and personnel, outcome assessment, selective reporting, other bias), most of the studies had a low or unclear risk but four studies had a high risk of bias. There was moderate grade evidence that untargeted antifungal treatment did not significantly reduce or increase total (all-cause) mortality (RR 0.93, 95% CI 0.79 to 1.09, P value = 0.36; participants = 2374; studies = 19). With regard to the outcome of proven invasive fungal infection, there was low grade evidence that untargeted antifungal treatment significantly reduced the risk (RR 0.57, 95% CI 0.39 to 0.83, P value = 0.0001; participants = 2024; studies = 17). The risk of fungal colonization was significantly reduced (RR 0.71, 95% CI 0.52 to 0.97, P value = 0.03; participants = 1030; studies = 12) but the quality of evidence was low. There was no difference in the risk of developing superficial fungal infection (RR 0.69, 95% CI 0.37 to 1.29, P value = 0.24; participants = 662; studies = 5; low grade of evidence) or in adverse events requiring cessation of treatment between the untargeted treatment group and the other group (RR 0.89, 95% CI 0.62 to 1.27, P value = 0.51; participants = 1691; studies = 11; low quality of evidence). The quality of evidence for the outcome of total (all-cause) mortality was moderate due to limitations in study design. The quality of evidence for the outcome of invasive fungal infection, superficial fungal infection, fungal colonization and adverse events requiring cessation of therapy was low due to limitations in study design, non-optimal total population size, risk of publication bias, and heterogeneity across studies. Authors' conclusions There is moderate quality evidence that the use of untargeted antifungal treatment is not associated with a significant reduction in total (all-cause) mortality among critically ill, non-neutropenic adults and children compared to no antifungal treatment or placebo. The untargeted antifungal treatment may be associated with a reduction of invasive fungal infections but the quality of evidence is low, and both the heterogeneity and risk of publication bias is high. Further high-quality RCTs are needed to improve the strength of the evidence, especially for more recent and less studied drugs (e.g. echinocandins). Future trials should adopt standardized definitions for microbiological outcomes (e.g. invasive fungal infection, colonization) to reduce heterogeneity. Emergence of resistance to antifungal drugs should be considered as outcome in studies investigating the effects of untargeted antifungal treatment to balance risks and benefit.
Published: 2016

17. Should we continue to use prediction tools to identify patients at risk of Candida spp. infection? If yes, why?

Author: Santi Maurizio Raineri, Antonino Giarratano, Vincenzo Russotto, G. Gregoretti, Andrea Cortegiani, Cortegiani A., Russotto V., Raineri S.M., Gregoretti G., Giarratano A., Cortegiani, A, Russotto, V, Raineri, S, Gregoretti, G, and Giarratano, A
Subjects: 0301 basic medicine, Candida spp, Invasive fungal infections, Sepsis, medicine.medical_specialty, Antifungal Agents, Sepsi, 030106 microbiology, Mycose, Subgroup analysis, Critical Care and Intensive Care Medicine, law.invention, 03 medical and health sciences, 0302 clinical medicine, Invasive fungal infection, Randomized controlled trial, Risk Factors, law, Intensive care, medicine, Humans, Antifungal Agent, 030212 general & internal medicine, MED/41 - ANESTESIOLOGIA, Intensive care medicine, Candida, Prophylaxis, business.industry, Incidence (epidemiology), Risk Factor, Candidiasis, medicine.disease, Confidence interval, Critical care, Fungal, Mycoses, Relative risk, Candidiasi, Invasive fungal disease, business, Research Article, Human
Abstract: Background Given the predominance of invasive fungal disease (IFD) amongst the non-immunocompromised adult critically ill population, the potential benefit of antifungal prophylaxis and the lack of generalisable tools to identify high risk patients, the aim of the current study was to describe the epidemiology of IFD in UK critical care units, and to develop and validate a clinical risk prediction tool to identify non-neutropenic, critically ill adult patients at high risk of IFD who would benefit from antifungal prophylaxis. Methods Data on risk factors for, and outcomes from, IFD were collected for consecutive admissions to adult, general critical care units in the UK participating in the Fungal Infection Risk Evaluation (FIRE) Study. Three risk prediction models were developed to model the risk of subsequent Candida IFD based on information available at three time points: admission to the critical care unit, at the end of 24 h and at the end of calendar day 3 of the critical care unit stay. The final model at each time point was evaluated in the three external validation samples. Results Between July 2009 and April 2011, 60,778 admissions from 96 critical care units were recruited. In total, 359 admissions (0.6 %) were admitted with, or developed, Candida IFD (66 % Candida albicans). At the rate of candidaemia of 3.3 per 1000 admissions, blood was the most common Candida IFD infection site. Of the initial 46 potential variables, the final admission model and the 24-h model both contained seven variables while the end of calendar day 3 model contained five variables. The end of calendar day 3 model performed the best with a c index of 0.709 in the full validation sample. Conclusions Incidence of Candida IFD in UK critical care units in this study was consistent with reports from other European epidemiological studies, but lower than that suggested by previous hospital-wide surveillance in the UK during the 1990s. Risk modeling using classical statistical methods produced relatively simple risk models, and associated clinical decision rules, that provided acceptable discrimination for identifying patients at ‘high risk’ of Candida IFD. Trial registration The FIRE Study was reviewed and approved by the Bolton NHS Research Ethics Committee (reference: 08/H1009/85), the Scotland A Research Ethics Committee (reference: 09/MRE00/76) and the National Information Governance Board (approval number: PIAG 2-10(f)/2005). Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1803-9) contains supplementary material, which is available to authorized users.
Published: 2016

18. Epidemiological characteristics, practice of ventilation, and clinical outcome in patients at risk of acute respiratory distress syndrome in intensive care units from 16 countries (PRoVENT): an international, multicentre, prospective study

Author: Ary Serpa Neto, Carmen S V Barbas, Fabienne D Simonis, Antonio Artigas-Raventós, Jaume Canet, Rogier M Determann, James Anstey, Goran Hedenstierna, Sabrine N T Hemmes, Greet Hermans, Michael Hiesmayr, Markus W Hollmann, Samir Jaber, Ignacio Martin-Loeches, Gary H Mills, Rupert M Pearse, Christian Putensen, Werner Schmid, Paolo Severgnini, Roger Smith, Tanja A Treschan, Edda M Tschernko, Marcos F V Melo, Hermann Wrigge, Marcelo Gama de Abreu, Paolo Pelosi, Marcus J Schultz, Adam Bell, Agreta Gecaj-Gashi, Ahmet Dilek, Ahmet Sukru Denker, Akut Aytulun, Peter Kienbaum, Alastair Rose, Alessandro Bacuzzi, Alexandre Biasi Cavalcanti, Alexandre Chan, Alexandre Molin, Alison Ghosh, Alistair Roy, Amanda Cowton, Amanda Skinner, Amanda Whileman, Amy McInerney, Ana Carolina Peçanha, Andrea Cortegiani, Andrej Sribar, Andrew Bentley, Andrew Corner, Angela Pinder, Anil Hormis, Anna Walker, Barry Dixon, Ben Creagh-Brown, Carlo Alberto Volta, Carlos Munhoz, Carly Brown, Carmen Scott, Caroline Wreybrown, Catherine Plowright, Charlotte Downes, Cheryl Padilla-Harris, Chloe Hughes, Christian Frey, Christian Schlegel, Christine Boyd, Christine Ryan, Christoph Muench, Christopher Smalley, Çiler Zincircioglu, Clair Harris, Claire Kaloo, Claire Matthews, Claire Miller, Claire Pegg, Clare Bullock, Clare Mellis, Claudio Piras, Colette Seasman, Cristina Santos, Daniel Beraldo, Daniel Collins, Daniel Hadfield, Daniel Hull, Daniel Prado, David Pogson, David Rogerson, David Shaw, Davide D'Antini, Dawn Trodd Denise Griffin, Debbie Weller, Deborah Smith, Deborah Wilson, Demet Aydin, Denise Donaldson, Donatella Mestria, Eduardo Di Lauro, Eliane Bernadete Caser, Elisa Seghelini, Emanuel Cirstea, Eoin Young, Erna Alberts, Evren Senturk, Farooq Brohi, Fatma Ulger, Feda Kahveci, Fernando José da Silva Ramos, Frank Van Haren, Güldem Turan, Gabriele Sales, Gayle Clifford, Gilda Cinnella, Giovana Colozza Mecatti, Giuseppe Melchionda, Gulay Eren, Hannah Crowther, Hazel Spencer, Heather Blaylock, Helen Green, Helen Robertson, Helen Rodgers, Helen Talbot, Helen Wong, Helena Barcraft-Barnes, Helga Ceunen, Henrik Reschreiter, Hulya Ulusoy, Huseyin Toman, Iain McCullagh, Ian White, Ingeborg Welters, Ingrid van den Hul, Isabela Ambrósio Gava, Isabelle Reed, Isil Kose, Israel Maia, James Limb, Jan Máca, Jane Adderly, Jane Hunt, Jane Martin, Jane Montgomery, Jane Snell, Jean Salgado, Jenny Ritzema, Jeremy Bewley, Joanne Howe, Johan Decruyenaere, Johanna Mouland, Johanna Stickley, Johannes Mellinghoff, John Criswell, John Knighton, Jonathan Cooper, Jonathan Harrison, Jonathan Paddle, Jose Augusto Santos Pellegrini, Joseph Needleman, Julian Giles, Julie Camsooksai, Julie Furneval, Julie Toms, Karen Burt, Karen Simeson, Karen Williams, Karl Blenk, Kate Turner, Katie Lynch, Katie Sweet, Keith Hugill, Kelly Matthews, Kessia Ruas, Kevin Clarkson, Kobus Preller, Kristen Joyce, Laura Ortiz-Ruiz, Laura Youds, Lee Tbaily, Lisa Barrell, Lisa Grimmer, Lokman Soyoral, Lorenzo Peluso, Lorna Murray, Lotta Niska, Louise Tonks, Lousie Fasting, Luc DeCrop, Luca Brazzi, Lucia Mirabella, Lucy Cooper, Luis Fernando Falcão, Lynn Everett, Malcolm Watters, Mandy Carnahan, Marc Bourgeois, Marcelo Luz Pereira Romano, Marco Botteri, Marcos F Vidal Melo, Maria Faulkner, Marijana Krkusek, Marina Bahl, Mark Holliday, Mark Kol, Mark Pulletz, Marta Kozlowski, Matea Bogdanovic Dvorscak, Matija Jurjevic, Matty Koopmans, Mauricio Morales, Maximilian Schaefer, Melinda Brazier, Meredith Harris, Michael Devile, Michael Kuiper, Michael Parris, Michael Sharman, Milan Kratochvil, Mohamed Ramali, Moreno Calcagnotto dos Santos, Natalie Bynorth, Natalie Wilson, Nathalie Anquez, Nathan Huneke, Nazim Dogan, Nenad Karanovic, Nicholas Tarmey, Nicolás Carreño, Nicola Fisher, Nicola Lamb, Nicola Venner, Nigel Hollister, Nur Akgun, Osman Ekinci, Owen Boyd, Pardeep Gill, Pasquale Raimondo, Pasquale Verrastro, Paul Pulak, Pauline Fitzell, Paulo Dark, Pedro Alzugaray, Perihan Ergin Özcan, Peter MacNaughton, Petr Stourac, Phil Hopkins, Pieter Roel Tuinman, Rachel Pearson, Rachel Walker, Rafaella Souza dos Santos, Raffaele Caione, Ramprasad Matsa, Rebecca Oliver, Reni Jacob, Richard Howard-Griffin, Robert BP de Wilde, Robert Plant, Robin Hollands, Rodrigo Biondi, Rola Jaafar, Rossana Avendaño, Ruth Salt, Ryan Humphries, Sérgio Felix Pinto, Sallyane Pearson, Sam Hendry, Sandeep Lakhani, Sarah Beavis, Sarah Moreton, Sarah Prudden, Sarah Thornthwaite, Savino Spadaro, Sedat Saylan, Shailaja Chenna, Shammer Gopal, Shanaz James, Sheeba Suresh, Sian Birch, Sonja Skilijic, Stefania Aguirre, Stella Metherell, Stephanie Bell, Stephanie Janes, Stephen Wright, Steve Rose, Steve Windebank, Sue Glenn, Susan Melbourne, Susan Tyson, Susannah Leaver, Tasmin Patel, Tatjana Simurina, Terri-Ann Sewell, Tiago Macruz, Tom Hatton, Tracey Evans, Ugur Goktas, Una Poultney, Unase Buyukkocak, Vanessa Linnett, Vanessa Oliveira, Vincenzo Russotto, Vlasta Klaric, Yavuz Orak, Zerrin Demirtürk, Neto, Ary Serpa, Barbas, Carmen S V, Simonis, Fabienne D, Artigas-Raventós, Antonio, Canet, Jaume, Determann, Rogier M, Anstey, Jame, Hedenstierna, Goran, Hemmes, Sabrine N T, Hermans, Greet, Hiesmayr, Michael, Hollmann, Markus W, Jaber, Samir, Martin-Loeches, Ignacio, Mills, Gary H, Pearse, Rupert M, Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Smith, Roger, Treschan, Tanja A, Tschernko, Edda M, Melo, Marcos F V, Wrigge, Hermann, de Abreu, Marcelo Gama, Pelosi, Paolo, Schultz, Marcus J, Bell A, Gecaj-Gashi A, Dilek A, Denker AS, Aytulun A, Kienbaum P, Rose A, Bacuzzi A, Cavalcanti AB, Chan A, Molin A, Ghosh A, Roy A, Cowton A, Skinner A, Whileman A, McInerney A, Peçanha AC, Cortegiani A, Sribar A, Bentley A, Corner A, Pinder A, Hormis A, Walker A, Artigas-Raventós A, Neto AS, Dixon B, Creagh-Brown B, Volta CA, Munhoz C, Brown C, Barbas CSV, Scott C, Wreybrown C, Plowright C, Downes C, Padilla-Harris C, Hughes C, Frey C, Putensen C, Schlegel C, Boyd C, Ryan C, Muench C, Smalley C, Zincircioglu Ç, Harris C, Kaloo C, Matthews C, Miller C, Pegg C, Bullock C, Mellis C, Piras C, Seasman C, Santos C, Beraldo D, Collins D, Hadfield D, Hull D, Prado D, Pogson D, Rogerson D, Shaw D, D'Antini D, Griffin DTD, Weller D, Smith D, Wilson D, Aydin D, Donaldson D, Mestria D, Tschernko EM, Lauro ED, Caser EB, Seghelini E, Cirstea E, Young E, Alberts E, Senturk E, Simonis FD, Brohi F, Ulger F, Kahveci F, da Silva Ramos FJ, Van Haren F, Turan G, Sales G, Mills GH, Mills GH, Clifford G, Cinnella G, Mecatti GC, Melchionda G, Hedenstierna G, Hermans G, Hermans G, Eren G, Crowther H, Spencer H, Blaylock H, Green H, Robertson H, Rodgers H, Talbot H, Wong H, Barcraft-Barnes H, Ceunen H, Reschreiter H, Wrigge H, Wrigge H, Ulusoy H, Toman H, McCullagh I, White I, Martin-Loeches I, Welters I, van den Hul I, Gava IA, Reed I, Kose I, Maia I, Limb J, Máca J, Adderly J, Hunt J, Martin J, Montgomery J, Snell J, Canet J, Salgado J, Ritzema J, Bewley J, Howe J, Decruyenaere J, Mouland J, Stickley J, Mellinghoff J, Criswell J, Knighton J, Cooper J, Harrison J, Paddle J, Pellegrini JAS, Needleman J, Giles J, Camsooksai J, Furneval J, Toms J, Burt K, Simeson K, Williams K, Blenk K, Turner K, Lynch K, Sweet K, Hugill K, Matthews K, Ruas K, Clarkson K, Preller K, Joyce K, Ortiz-Ruiz L, Youds L, Tbaily L, Barrell L, Grimmer L, Soyoral L, Peluso L, Murray L, Niska L, Tonks L, Fasting L, DeCrop L, Brazzi L, Mirabella L, Cooper L, Falcão LF, Everett L, Watters M, Carnahan M, Bourgeois M, Abreu MG, Romano MLP, Botteri M, Melo MFV, Melo MFV, Schultz MJ, Schultz MJ, Faulkner M, Krkusek M, Bahl M, Holliday M, Kol M, Pulletz M, Hollmann MW, Kozlowski M, Dvorscak MB, Jurjevic M, Koopmans M, Morales M, Schaefer M, Brazier M, Harris M, Devile M, Hiesmayr M, Kuiper M, Parris M, Sharman M, Kratochvil M, Ramali M, Dos Santos MC, Bynorth N, Wilson N, Anquez N, Huneke N, Dogan N, Karanovic N, Tarmey N, Carreño N, Fisher N, Lamb N, Venner N, Hollister N, Akgun N, Ekinci O, Boyd O, Pelosi P, Pelosi P, Severgnini P, Severgnini P, Gill P, Raimondo P, Verrastro P, Pulak P, Fitzell P, Dark P, Alzugaray P, Özcan PE, MacNaughton P, Stourac P, Hopkins P, Tuinman PR, Pearson R, Walker R, Santos RSD, Caione R, Matsa R, Oliver R, Jacob R, Howard-Griffin R, Wilde RB, Plant R, Hollands R, Biondi R, Smith R, Smith R, Determann RM, Jaafar R, Avendaño R, Pearse RM, Salt R, Humphries R, Pinto SF, Hemmes SNT, Pearson S, Hendry S, Jaber S, Lakhani S, Beavis S, Moreton S, Prudden S, Thornthwaite S, Spadaro S, Saylan S, Chenna S, Gopal S, James S, Suresh S, Birch S, Skilijic S, Aguirre S, Metherell S, Bell S, Janes S, Wright S, Rose S, Windebank S, Glenn S, Melbourne S, Tyson S, Leaver S, Treschan TA, Treschan TA, Patel T, Simurina T, Sewell TA, Macruz T, Hatton T, Evans T, Goktas U, Poultney U, Buyukkocak U, Linnett V, Oliveira V, Russotto V, Klaric V, Schmid W, Orak Y, Demirtürk Z., Neto, A, Barbas, C, Simonis, F, Artigas-Raventos, A, Canet, J, Determann, R, Anstey, J, Hedenstierna, G, Hemmes, S, Hermans, G, Hiesmayr, M, Hollmann, M, Jaber, S, Martin-Loeches, I, Mills, G, Pearse, R, Putensen, C, Schmid, W, Severgnini, P, Smith, R, Treschan, T, Tschernko, E, Melo, M, Wrigge, H, de Abreu, M, Pelosi, P, Schultz, M, Russotto, V, Intensive Care Medicine, Other departments, and Anesthesiology
Subjects: Male, Pediatrics, ARDS, medicine.medical_treatment, law.invention, Positive-Pressure Respiration, 0302 clinical medicine, law, Risk Factors, Prevalence, ventilator–induced lung injury, Prospective Studies, Hospital Mortality, Prospective cohort study, Tidal volume, education.field_of_study, Respiratory Distress Syndrome, Acute respiratory distress syndrome, tidal volume, ARDS, critically ill, ventilation, Middle Aged, Intensive care unit, Intensive Care Units, Critical Illne, Female, Human, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Critical Illness, Population, Intensive Care Unit, Lung injury, mechanical ventilation, NO, 03 medical and health sciences, Intensive care, medicine, Acute respiratory distress syndrome, mechanical ventilation, ventilator–induced lung injury, tidal volume, positive end–expiratory pressure, Humans, MED/41 - ANESTESIOLOGIA, education, Aged, Mechanical ventilation, business.industry, Risk Factor, Respiratory Distress Syndrome, Adult, 030208 emergency & critical care medicine, medicine.disease, Respiration, Artificial, Mechanical ventilation Acute respiratory failure Acute respiratory distress syndrome, Prospective Studie, 030228 respiratory system, Emergency medicine, positive end–expiratory pressure, business
Abstract: Background Scant information exists about the epidemiological characteristics and outcome of patients in the intensive care unit (ICU) at risk of acute respiratory distress syndrome (ARDS) and how ventilation is managed in these individuals. We aimed to establish the epidemiological characteristics of patients at risk of ARDS, describe ventilation management in this population, and assess outcomes compared with people at no risk of ARDS. Methods PRoVENT (PRactice of VENTilation in critically ill patients without ARDS at onset of ventilation) is an international, multicentre, prospective study undertaken at 119 ICUs in 16 countries worldwide. All patients aged 18 years or older who were receiving mechanical ventilation in participating ICUs during a 1-week period between January, 2014, and January, 2015, were enrolled into the study. The Lung Injury Prediction Score (LIPS) was used to stratify risk of ARDS, with a score of 4 or higher defining those at risk of ARDS. The primary outcome was the proportion of patients at risk of ARDS. Secondary outcomes included ventilatory management (including tidal volume [VT] expressed as mL/kg predicted bodyweight [PBW], and positive end-expiratory pressure [PEEP] expressed as cm H2O), development of pulmonary complications, and clinical outcomes. The PRoVENT study is registered at ClinicalTrials.gov, NCT01868321. The study has been completed. Findings Of 3023 patients screened for the study, 935 individuals fulfilled the inclusion criteria. Of these critically ill patients, 282 were at risk of ARDS (30%, 95% CI 27â33), representing 0Â·14 cases per ICU bed over a 1-week period. VTwas similar for patients at risk and not at risk of ARDS (median 7Â·6 mL/kg PBW [IQR 6Â·7â9Â·1] vs 7Â·9 mL/kg PBW [6Â·8â9Â·1]; p=0Â·346). PEEP was higher in patients at risk of ARDS compared with those not at risk (median 6Â·0 cm H2O [IQR 5Â·0â8Â·0] vs 5Â·0 cm H2O [5Â·0â7Â·0]; p
Published: 2016

19. Is it time to consider visual feedback systems the gold standard for chest compression skill acquisition?

Author: Andrea Cortegiani, Santi Maurizio Raineri, Antonino Giarratano, Vincenzo Russotto, Enrico Baldi, Enrico Contri, Cortegiani A., Russotto V., Baldi E., Contri E., Raineri S.M., Giarratano A., Cortegiani, A, Russotto, V, Baldi, E, Contri, E, Raineri, S, and Giarratano, A
Subjects: Letter, medicine.medical_treatment, Health Personnel, Visual feedback, Critical Care and Intensive Care Medicine, Dreyfus model of skill acquisition, 03 medical and health sciences, 0302 clinical medicine, Feedback, Sensory, Compression (functional analysis), Medicine, Humans, 030212 general & internal medicine, Cardiopulmonary resuscitation, Staff Development, MED/41 - ANESTESIOLOGIA, Cardiac arrest, Chest compressions, business.industry, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, Gold standard (test), lcsh:RC86-88.9, medicine.disease, Chest compression, Medical emergency, Clinical Competence, business, Human
Published: 2017
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20. Should Reinke edema be considered a contributing factor to post-extubation failure?

Author: Andrea Cortegiani, Santi Maurizio Raineri, Antonino Giarratano, Vincenzo Russotto, Cortegiani, A., Russotto, V., Raineri, S., Giarratano, A., Cortegiani, A, Russotto, V, Raineri, S, and Giarratano, A
Subjects: medicine.medical_specialty, Letter, Critical Illness, Stridor, medicine.medical_treatment, Review, Airway Extubation, Laryngeal Edema, Critical Care and Intensive Care Medicine, medicine, Humans, Intubation, Respiratory sounds, MED/41 - ANESTESIOLOGIA, Intensive care medicine, Respiratory Sounds, medicine.diagnostic_test, business.industry, Respiratory failure, Critical Illne, Airway management, airway management, anesthesia, Respiratory Sound, medicine.symptom, Respiratory Insufficiency, Airway, business, Human
Abstract: We read with interest the recently published review in Critical Care about post-extubation laryngeal edema and stridor by Pluijms et al. [1]. The review considers in detail the risk factors for post-extubation respiratory failure and describes a post-extubation algorithm for its prevention and reduction. We recently published a case report describing the occurrence of post-extubation stridor leading to post-extubation respiratory failure in a woman with a previously undiagnosed Reinke edema (RE) [2]. RE is a progressive laryngeal soft-tissue swelling. The condition typically manifests in female gender as hoarseness and as a gradually deepening voice in patients with a history of smoking, vocal cord abuse, and/or gastroesophageal reflux. Other case reports of RE complicating airway management already exist [3]. Our patient did not undergo prolonged intubation or difficult airway instrumentation. However, she presented risk factors for RE (i.e. female gender and smoking history). Notably, female gender has been reported in different studies investigating risk factors for complications following extubation which have been summarized in the review by Pluijms et al. [1]. Since our patient did not present stridor before intubation, the additional laryngeal edema due to airway management, which would have not been responsible for post-extubation failure in normal conditions, contributed to reaching the critical obstruction of airways. We believe, in accordance with other authors [4], that RE may be considered an important, underdiagnosed concomitant cause of post-extubation stridor. RE may explain why, in certain patients, a minor grade of laryngeal edema could lead to a clinically relevant reduction of airway space and post-extubation stridor. Clinical signs and risk factors for RE should be systematically assessed when clinicians deal with risks of post-extubation failure. In our opinion, when risk factors for RE are associated with difficult airway management and/or prolonged intubation, a conservative approach consisting of otolaryngology consultation, fiberoptic examination, or a neck computed tomography scan may be undertaken for a safe airway assessment and detection of a potentially critical obstruction.
Published: 2015

21. Cytokine release syndrome after CAR infusion in pediatric patients with refractory/relapsed B-ALL: is there a role for diclofenac?

Author: Sonia Bonanomi, Andrea Biondi, Laura Rachele Bettini, Giorgio Ottaviano, Roberto Rona, Sara Napolitano, Adriana Balduzzi, Attilio Rovelli, Vincenzo Russotto, Napolitano, S, Ottaviano, G, Bettini, L, Russotto, V, Bonanomi, S, Rovelli, A, Biondi, A, Rona, R, and Balduzzi, A
Subjects: Cancer Research, medicine.medical_specialty, Diclofenac, Lymphoma, B-Cell, Hematology-oncology, molecular oncology, pediatric oncology, Immunotherapy, Adoptive, Gastroenterology, Molecular oncology, Refractory, Internal medicine, medicine, Pediatric oncology, Humans, Major complication, Child, Receptor, Receptors, Chimeric Antigen, business.industry, General Medicine, Precursor Cell Lymphoblastic Leukemia-Lymphoma, medicine.disease, Cytokine release syndrome, Oncology, Cytokine Release Syndrome, business, Hematology+Oncology, medicine.drug
Abstract: Background: Cytokine release syndrome (CRS) is a major complication after chimeric-antigen receptor T-cell treatment, characterized by an uncontrolled systemic inflammatory reaction. We investigated the potential role of diclofenac in the management of CRS in five pediatric patients treated for relapsed/refractory B-lineage acute lymphoblastic leukemia. Methods In case of persistent fever with fever-free intervals shorter than 3 hours, diclofenac continuous infusion was initiated, at the starting dose of 0.5 mg/Kg/day, the lowest effective pediatric dose in our experience, possibly escalated up to 1 mg/Kg/day, as per institutional guidelines. Results: CRS occurred at a median of 20 hours (range 8–27) after tisagenlecleucel infusion. Diclofenac was started at a median of 20 hours (range 13–33) after fever onset. A mean of 3.07 febrile peaks without diclofenac and 0.95 with diclofenac were reported ( p = 0.02). Clinical benefit was achieved by hampering the progression of tachypnea and tachycardia. Despite fever control, CRS progressed in four of the five patients, and hypotension requiring vasopressors and fluid retention, as well as hypoxia, occurred. Vasopressors were followed by 1–2 doses of tocilizumab (one in patient 2 and two in patients 3, 4, and 5), plus steroids in patients 4 and 5. Conclusion: Based on a limited number of patients, diclofenac leads to better fever control, which translates into symptom relief and improvement of tachycardia, but could not prevent the progression of CRS.
Published: 2021
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22. Helmet and face mask for non-invasive respiratory support in patients with acute hypoxemic respiratory failure: A retrospective study

Author: Asia Borgo, Silvia Villa, Giuseppe Foti, Giacomo Bellani, Emanuele Rezoagli, Vincenzo Russotto, Alberto Lucchini, Stefano Gatti, Rezoagli, E, Villa, S, Gatti, S, Russotto, V, Borgo, A, Lucchini, A, Foti, G, and Bellani, G
Subjects: medicine.medical_specialty, medicine.medical_treatment, Respiratory physiology, Critical Care and Intensive Care Medicine, Helmet CPAP, 03 medical and health sciences, 0302 clinical medicine, Noninvasive respiratory support, medicine, Humans, Intubation, Prospective Studies, Prospective cohort study, Acute hypoxemic respiratory failure, Retrospective Studies, Noninvasive Ventilation, business.industry, Incidence (epidemiology), Confounding, Masks, 030208 emergency & critical care medicine, Retrospective cohort study, Length of Stay, Face mask ventilation, Respiratory Insufficiency, 030228 respiratory system, Emergency medicine, Observational study, business
Abstract: Purpose Non-invasive respiratory support could reduce the incidence of intubation in patients with Acute Hypoxemic Respiratory Failure (AHRF). The optimal interface or modality of non-invasive respiratory support is debated. We sought to evaluate the differences between patients who succeeded or failed non-invasive respiratory support, with a specific focus on the type of non-invasive respiratory support (i.e. helmet CPAP versus face mask NIV). Materials and methods In a single-center observational retrospective study, we investigated baseline, clinical characteristics and AHRF management by non-invasive respiratory support between January 2015 to December 2016. Data on gas exchange and respiratory mechanics, non-invasive respiratory support duration, ICU length of stay and mortality were collected. Results 110 patients with AHRF were included of which 41 patients (37%) were intubated. The use of helmet CPAP (p = 0.016) and a lower fluid balance (p = 0.038) were independently associated with a decreased rate of intubation after adjustment for confounders. Face mask NIV patients trended to a higher respiratory frequency at 1 h after treatment [28 (22–36) versus 24 (18–29) hours, p = 0.067], and showed a longer ICU stay (p = 0.009) compared to patients treated with helmet CPAP. Conclusions Helmet CPAP and a lower fluid balance were independent predictors of a lower intubation rate in AHRF patients in ICU. Prospective studies aimed at identifying the optimal interface and modality of non-invasive respiratory support in AHRF patients are needed.
Published: 2021
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23. Use of Cepheid Xpert Carba-R® for rapid detection of carbapenemase-producing bacteria in critically ill, abdominal surgical patients: first report of an observational study

Author: G Tricoli, Laura Saporito, Daniela Maria Geraci, Giorgio Graziano, Andrea Cortegiani, Vincenzo Russotto, P Capuano, Arash Ghodousi, Antonino Giarratano, Cortegiani, A, Russotto, V, Capuano, P, Tricoli, G, Geraci, D, Ghodousi, A, Saporito, L, Graziano, G, Giarratano, A, Cortegiani, A., Russotto, V., Capuano, P., Tricoli, G., Geraci, D., Ghodousi, A., Saporito, L., Graziano, G., and Giarratano, A.
Subjects: medicine.medical_specialty, sepsis, infection, multidrug resistance, Critically ill, business.industry, Carbapenemase producing, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, Critical Care and Intensive Care Medicine, Rapid detection, carbapenemase-producing bacteria, epheid Xpert Carba-R®, Poster Presentation, polycyclic compounds, medicine, bacteria, Observational study, MED/41 - ANESTESIOLOGIA, Intensive care medicine, business, Surgical patients
Abstract: Introduction Xpert Carba-R® (Cepheid®, USA) is a PCR-based assay for rapid (
Published: 2015

24. Short And Long-Term Complications Due To Standard And Extended Prone Position Cycles In Covid-19 Patients

Author: Nicola Barreca, Yelenia Marcolin, Giuseppe Foti, Roberto Rona, Barbara Zyberi, Alberto Lucchini, Vincenzo Russotto, Domenico Cavagnuolo, Giulia Casartelli, Giacomo Verzella, Marta Villa, Roberto Fumagalli, Lucchini, A, Russotto, V, Barreca, N, Villa, M, Casartelli, G, Marcolin, Y, Zyberi, B, Cavagnuolo, D, Verzella, G, Rona, R, Fumagalli, R, and Foti, G
Subjects: Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, Brachial Plexus injurie, Critical Care Nursing, Brachial Plexus injuries, Extended prone position, Follow-up, Pressure Sores, Prone Position, Humans, Patient Positioning, Respiration, Artificial, Retrospective Studies, SARS-CoV-2, COVID-19, Article, law.invention, law, Pressure Sore, Medicine, Mechanical ventilation, business.industry, Respiration, Sensory loss, Workload, Retrospective cohort study, Intensive care unit, Chin, Prone position, medicine.anatomical_structure, Anesthesia, Artificial, business
Abstract: Objective: To investigate short and long-term complications due to standard (≤24 hours) and extended (>24 hours) prone position in COVID-19 patients. Methods: Retrospective cohort study conducted in an Italian general intensive care unit. We enrolled patients on invasive mechanical ventilation and treated with prone positioning. We recorded short term complications from the data chart and long-term complications from the scheduled follow-up visit, three months after intensive care discharge. Results: A total of 96 patients were included in the study. Median time for each prone positioning cycle (302 cycles) was equal to 18 (16–32) hours. In 37 (38%) patients at least one cycle of extended pronation was implemented. Patients with at least one pressure sore due to prone position were 38 (40%). Patients with pressure sores showed a statistically significative difference in intensive care length of stay, mechanical ventilation days, numbers of prone position cycles, total time spent in prone position and the use of extended prone position, compared to patients without pressure sores. All lesions were low grade. Cheekbones (18%) and chin (10%) were the most affected sites. Follow-up visit, scheduled three months after intensive care discharge, was possible in 58 patients. All patients were able to have all 12 muscle groups examined using theMedical Research Council scale examination. No patient reported sensory loss or presence of neuropathic pain for upper limbs. Conclusions: Extended prone position is feasible and might reduce the workload on healthcare workers without significant increase of major prone position related complications.
Published: 2021

25. Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients-Reply

Author: John G. Laffey, Giacomo Bellani, Intube Study investigators, Vincenzo Russotto, Laffey, J, Bellani, G, and Russotto, V
Subjects: medicine.medical_specialty, Critically ill, business.industry, Respiration, medicine.medical_treatment, Critical Illness, Peri, General Medicine, Humans, Respiration, Artificial, Intubation, Intratracheal, Intratracheal, Artificial, Critical illness, medicine, Critical Illne, Intubation, business, Intensive care medicine, Human
Published: 2021

26. Tracheal intubation in the critically ill patient

Author: Giacomo Bellani, Lua S Rahmani, John G. Laffey, Vincenzo Russotto, Matteo Parotto, Russotto, V, Rahmani, L, Parotto, M, Bellani, G, and Laffey, J
Subjects: medicine.medical_specialty, Critical Care, business.industry, Critical Illness, medicine.medical_treatment, Tracheal intubation, Psychological intervention, COVID-19, Anesthesiology and Pain Medicine, Respiratory failure, intubation, artificial airway, Shock (circulatory), Intubation, Intratracheal, medicine, Humans, Intubation, Airway management, Airway Management, medicine.symptom, Respiratory Insufficiency, Adverse effect, Intensive care medicine, Airway, business
Abstract: Tracheal intubation is among the most commonly performed and high-risk procedures in critical care. Indeed, 45% of patients undergoing intubation experience at least one major peri-intubation adverse event, with cardiovascular instability being the most common event reported in 43%, followed by severe hypoxemia in 9% and cardiac arrest in 3% of cases. These peri-intubation adverse events may expose patients to a higher risk of 28-day mortality, and they are more frequently observed with an increasing number of attempts to secure the airway. The higher risk of peri-intubation complications in critically ill patients, compared with the anaesthesia setting, is the consequence of their deranged physiology (e.g. underlying respiratory failure, shock and/or acidosis) and, in this regard, airway management in critical care has been defined as "physiologically difficult". In recent years, several randomised studies have investigated the most effective preoxy-genation strategies, and evidence for the use of positive pressure ventilation in moderate-to-severe hypoxemic patients is established. On the other hand, evidence on interventions to mitigate haemodynamic collapse after intubation has been elusive. Airway management in COVID-19 patients is even more challenging because of the additional risk of infection for healthcare workers, which has influenced clinical choices in this patient group. The aim of this review is to provide an update of the evidence for intubation in critically ill patients with a focus on understanding peri-intubation risks and evaluating interventions to prevent or mitigate adverse events.
Published: 2021

27. Effect of central venous pressure on back-flow and bolus events during vasopressor syringe changeover. Comment on Br J Anaesth 2020, 125, 622-628

Author: Roberto Rona, Alberto Lucchini, Stefano Elli, Vincenzo Russotto, Russotto, V, Elli, S, Rona, R, and Lucchini, A
Subjects: Adult, Back, business.industry, Syringes, central venous pressure, Central venous pressure, critical care, critical care nursing, infusion pump, norepinephrine, shock, vasopressor, Central Venous Pressure, Critical Care, Humans, Norepinephrine, Changeover, Anesthesiology and Pain Medicine, Bolus (medicine), Anesthesia, Medicine, Infusion pump, business, Syringe
Published: 2020

28. Preoxygenation of Critically Ill Patients With Acute Hypoxemic Respiratory Failure

Author: Sheila Nainan Myatra, Giacomo Bellani, Vincenzo Russotto, Russotto, V, Myatra, S, and Bellani, G
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Acute hypoxemic respiratory failure, business.industry, Critically ill, medicine.medical_treatment, Critical Illness, MEDLINE, Critical Care and Intensive Care Medicine, Airway Management, Humans, Respiratory Insufficiency, Critical illness, medicine, Airway management, airway management, intubation, critical care, MED/41 - ANESTESIOLOGIA, Cardiology and Cardiovascular Medicine, Intensive care medicine, business
Published: 2019

29. What’s new in airway management of the critically ill

Author: Vincenzo Russotto, John G. Laffey, Sheila Nainan Myatra, Russotto, V, Myatra, S, and Laffey, J
Subjects: medicine.medical_specialty, Critically ill, business.industry, medicine.medical_treatment, Pain medicine, Critical Illness, MEDLINE, Critical Care and Intensive Care Medicine, Checklist, Anesthesiology, medicine, Intubation, Intratracheal, Intubation, Humans, Airway management, MED/41 - ANESTESIOLOGIA, Airway Management, Intensive care medicine, business
Published: 2019

30. Development of a prediction model for postoperative pneumonia: A multicentre prospective observational study

Author: Russotto, Vincenzo, Sabate, Sergi, Canet, Jaume, Langeron, Olivier, de Abreu, Marcelo Gama, Gallart, Lluis, Javier Belda, F., Pelosi, Paolo, Hoeft, Andreas, Mazo, Valentin, Leva, Brigitte, Burimi, Jonela, Halefi, Toma, Hoxha, Aleksander, Pilika, Kliti, Selmani, Imelda, Daout, Ve'ronique, Gauthier, Caroline, Kahn, David, Momeni, Mona, Watremez, Christine, Straus, Slavenka, Djonovic-manovic, Dejana, Juros-Zovko, Marina, Komen-Usljebrka, Helga, Orlic, Vlasta, Stuck, Ivana, Balakova, Lenka, Kosinova, Martina, Krikava, Ivo, Stoudek, Roman, Stourac, Petr, Zadrazilova, Katarina, Janvekar, Sanober, Karjagin, Juri, Roivassepp, Kadri, Sormus, Alar, Cuvillon, Philippe, Ibanez-Esteve, Cristina, Raux, Mathieu, Nicolas-Robin, Armelle, Winter, Andre, Brunier, Malte, Engelhard, Kristin, Feldmann, Rita Laufenberg, Lindemann, Raphaele, Mauff, Susanne, Sebastiani, Anne, Zamperoni, Camila, Kessler, Florian, Wittmann, Maria, Bluth, Thomas, Guldner, Andreas, Kiss, Thomas, Braz, Kristina, Ruszkai, Csilla, Micaglio, Massimo, Ori, Carlo, Parotto, Matteo, Persona, Paolo, Giuseppe, Coletta, Carnesecchi, Paolo, Lazzeroni, Denise, Lorenzi, Irene, Castellani, Gianluca, Sances, Daniele, Spano, Gianluca, Tredici, Stefano, Vezzoli, Dario, Brunetti, Iole, Di Noto, Anna, Gratarola, Angelo, Molin, Alexandre, Montagnani, Luca, Pellerano, Giulia, Fusari, Maurizio, Camici, Laura, Guzzetti, Luca, Marangoni, Fabio, Severgnini, Paolo, Di Mauro, Piero, Rapido, Francesca, Tommasino, Concezione, Nemme, Ieva, Nemme, Janis, Blieka, Justinas, Borodiciene, Jurgita, Budryte, Brigita, Karbonskiene, Aurika, Kiudulaite, Inga, Milieskaite, Egle, Rasimaviciute, Renata, Sireviciene, Ugne, Stasaityte, Ramune, Usas, Edgaras, Zarskiene, Giedre, Kontrimaviciute, Egle, Sipylaite, Jurate, Tomkute, Gabija, Bardea, Petra, Klop, Marco, Koch, Marc, Bozilow, Dominika, Goch, Robert, Bonifacio, Joao, Marques, Sofia, dos Santos Ralha, Tania Teresa, Alves, Daniel, Carvalho, Ines, Da Cruz Parente, Josefina Suzana, Tome, Sara, Carmona, Cristina, Costa, Miranda, Lina, Maria, Sierra, Sofia, Balcan, Alina, Cindea, Iulia, Gherghina, Viorel Ionel, Grasa, Catalin, Copotoiu, Ruxandra, Copotoiu, Sanda-Maria, Kovacs, Judit, Szederjesi, Janos, Theil, Arthur, Filipescu, Daniela, Grytsan, Alexey, Kapkan, Tatiana, Rostovtsev, Sergey, Yushkova, Anastasia, Calderon, Ricardo, Cacho, Elena, Marginet, Carolina, Monedero, Pablo, Jose Yepes, Maria, Esparza Minana, Jose Miguel, Granell Gil, Manuel, Rico Portoles, Gabriel, Lisi, Alberto, Perez, Gisela, Poch, Nuria, Arganaraz Quinteros, Mauricio Roberto, Font Bosch, Carme, Torrellardona Llobera, Jordi, Sierra, Pilar, Matute, Mercedes, Alcon Dominguez, Amalia, Jose Arguis, Maria, Belda, Isabel, Carrero, Enrique, Moreno, Jacobo, Rovira, Irene, Ubre, Marta, Castillo, Roberto, Herrero, Silvia, Ballester Lujan, Maria Teresa, Carbonell, Jose, Gencheva, Geri, Gutierrez, Andrea, Llorens, Julio, Machado, Sofia, Llobell, Francisca, Paz Martin, Daniel, Javier Garcia-Miguel, Francisco, Perez Garcia, Anibal, Company, Roque, Ahamdanech Idrissi, Aixa, del Fresno Canaveras, Josefina, Navarro Martinez, Jose Alejandro, Paya Martinez, Estefania, Sanchez Garcia, Ester, Vera Bella, Jorge, India Aldana, Inmaculada, Manuel Campos, J., Pelaez Vaamonde, Xavier, Torra, Montserrat, Arroyo, Raquel, Carlos Cabrera, Juan, Carazo Cordobes, Jesus, Rojo, Amelia, Javier Santiveri, Francisco, Gonzalez, Miriam, Jimenez, Anabel, Jimenez, Yolanda, Marti, Agnes, Moret, Enrique, Rodriguez Nunez, Monica, Velasco, Joaquin, Calderon, Adriana, Gonzalez, Matide, Gonzalez, Olga, Hermira Anchuelo, Ana, Lopez, Eloisa, Sanchez, Esther, Aznarez Zango, Blanca, Garcia Corral, Francisco Jose, Mata Mena, Esperanza, Planas Roca, Antonio, Ayala Soto, Raquel Fernandez Rocio, Quintana, Borja, Rabanal Llevot, Jose Manuel, Williams Camus, Monica Mercedes, Palacios Blanco, Alba, Largo Ruiz, Angela, Rico Feijoo, Jesus, Castellano Garijo, Elvira, Belmonte Cuenca, Julio, Bonet Binimelis, Marcos Jose, Grigorov, Ivaylo, Lluis Aguilar, Josep, De Nadal Clanchet, Miriam, Guerrero Vinas, Encarnacion, Manrique Muniz, Susana, Martin Mora, Victor, Munar Bauza, Francisca, Nunez Aguado, Sonia, Olive Vidal, Montserrat, Panos Gozalo, Maria Luisa, Sanchez Marin, Marcos, Suescun Lopez, Maria Carmen, Maino, Paolo, Yevstratov, Yevhen Eugene, Kucukgoncu, Semra, Senturk, Nuzhet Mert, Ulke, Zerrin Sungur, Russotto, V, Sabate, S, and Canet, J
Subjects: Male, medicine.medical_specialty, Prognosi, MEDLINE, Hospital mortality, Models, Biological, Risk Assessment, 03 medical and health sciences, Postoperative complications, 0302 clinical medicine, Postoperative Complications, 030202 anesthesiology, Odds Ratio, Medicine, Humans, Anesthesia, PULMONARY COMPLICATIONS, HYDROXYETHYL STARCH, HEMORRHAGIC-SHOCK, RISK, RESUSCITATION, VALIDATION, INFECTION, SCORE, Hospital Mortality, Prospective Studies, Prospective cohort study, Aged, business.industry, 030208 emergency & critical care medicine, Odds ratio, Pneumonia, Postoperative pneumonia, Surgical procedures, Middle Aged, Prognosis, respiratory tract diseases, Europe, Prospective Studie, Anesthesiology and Pain Medicine, Multicenter study, Surgical Procedures, Operative, Emergency medicine, Observational study, Female, Postoperative Complication, business, Respiratory insufficiency, Human
Abstract: BACKGROUNDPostoperative pneumonia is associated with increased morbidity, mortality and costs. Prediction models of pneumonia that are currently available are based on retrospectively collected data and administrative coding systems.OBJECTIVETo identify independent variables associated with the occurrence of postoperative pneumonia.DESIGNA prospective observational study of a multicentre cohort (Prospective Evaluation of a RIsk Score for postoperative pulmonary COmPlications in Europe database).SETTINGSixty-three hospitals in Europe.PATIENTSPatients undergoing surgery under general and/or regional anaesthesia during a 7-day recruitment period.MAIN OUTCOME MEASUREThe primary outcome was postoperative pneumonia. Definition: the need for treatment with antibiotics for a respiratory infection and at least one of the following criteria: new or changed sputum; new or changed lung opacities on a clinically indicated chest radiograph; temperature more than 38.3 °C; leucocyte count more than 12 000 μl-1.RESULTSPostoperative pneumonia occurred in 120 out of 5094 patients (2.4%). Eighty-two of the 120 (68.3%) patients with pneumonia required ICU admission, compared with 399 of the 4974 (8.0%) without pneumonia (P < 0.001). We identified five variables independently associated with postoperative pneumonia: functional status [odds ratio (OR) 2.28, 95% confidence interval (CI) 1.58 to 3.12], pre-operative SpO2 values while breathing room air (OR 0.83, 95% CI 0.78 to 0.84), intra-operative colloid administration (OR 2.97, 95% CI 1.94 to 3.99), intra-operative blood transfusion (OR 2.19, 95% CI 1.41 to 4.71) and surgical site (open upper abdominal surgery OR 3.98, 95% CI 2.19 to 7.59). The model had good discrimination (c-statistic 0.89) and calibration (Hosmer-Lemeshow P = 0.572).CONCLUSIONWe identified five variables independently associated with postoperative pneumonia. The model performed well and after external validation may be used for risk stratification and management of patients at risk of postoperative pneumonia.TRIAL REGISTRATIONNCT 01346709 (ClinicalTrials.gov).
Published: 2018

31. Obstructive sleep apnea: screening is the waiting room for preoperative testing, postoperative monitoring, and safety measures

Author: Ruggero M Corso, Cesare Gregoretti, Vincenzo Russotto, Davide Cattano, Corso R.M., Russotto V., Gregoretti C., and Cattano D.
Subjects: Sleep Apnea, Obstructive, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Polysomnography, MEDLINE, Sleep apnea, 030208 emergency & critical care medicine, medicine.disease, Obstructive sleep apnea, 03 medical and health sciences, 0302 clinical medicine, Anesthesiology and Pain Medicine, 030202 anesthesiology, Emergency medicine, medicine, Humans, Postoperative monitoring, business, Human
Abstract: N/A
Published: 2018
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32. Attitudes towards end-of-life issues in intensive care unit among Italian anesthesiologists: a nation-wide survey

Author: Santi Maurizio Raineri, Antonino Giarratano, Andrea Cortegiani, Cesare Gregoretti, Sebastiano Mercadante, Vincenzo Russotto, Cortegiani, Andrea, Russotto, Vincenzo, Raineri, Santi Maurizio, Gregoretti, Cesare, Giarratano, Antonino, Mercadante, Sebastiano, Cortegiani, A, Russotto, V, Raineri, S, Gregoretti, C, Giarratano, A, and Mercadante, S
Subjects: Adult, Male, medicine.medical_specialty, Palliative care, Pain medicine, law.invention, 03 medical and health sciences, End-of-life care, Intensive care unit, Life-sustaining treatments, 0302 clinical medicine, law, Anesthesiology, Intensive care, Surveys and Questionnaires, medicine, Surveys and Questionnaire, Humans, Life-sustaining treatment, 030212 general & internal medicine, MED/41 - ANESTESIOLOGIA, Terminal Care, business.industry, Critically ill, Nursing research, 030208 emergency & critical care medicine, Middle Aged, Anesthesiologists, Intensive Care Units, Attitude, Italy, Oncology, Family medicine, Female, Anesthesiologist, business, Human
Abstract: Background: The aim of this paper is to collect data on the practice of palliative care, withholding and withdrawal of life-sustaining therapies, and management of end of life (EOL) in Italian intensive care units (ICUs). Methods: Web-based survey among Italian anesthesiologists endorsed by the Italian Society of Anesthesiology Analgesia Reanimation and Intensive Care (SIAARTI). The survey consists of 27 close-ended and 2 open-ended questions. Results: Eight hundred and five persons responded to the full list of questions. The highest proportion of respondents was of 36â45 years of age (34%) and catholic (66%). Almost 70% of responders declared that palliative/supportive care are applied in their ICU in case of futility of intensive treatments. Decision on withdrawing/withholding of life-sustaining treatments resulted from team consensus in most cases (58%). In more than 70% of respondersâ ICUs, there is no collaboration with palliative/supportive care experts. Systematic recording of most frequent symptoms experienced by critically ill patients (e.g., pain, dyspnea, thirst) was not common. Vasopressors, extracorporeal therapies, blood component transfusions and invasive monitoring were the most commonly modified/interrupted measures in case of futility. Almost 85% of respondents have not received training in palliative/supportive care. The proportion of respondents whose institution has a palliative care team and who had training in palliative care was not homogenous across the country. Conclusions: These data suggest that training in palliative care and its clinical application should be implemented in Italy. Efforts should be made to improve and homogenize the management of dying patients in ICU.
Published: 2018

33. Respiratory mechanics in patients with acute respiratory distress syndrome

Author: Giuseppe Foti, Vincenzo Russotto, Giacomo Bellani, Russotto, V, Bellani, G, and Foti, G
Subjects: medicine.medical_specialty, ARDS, medicine.medical_treatment, Respiratory mechanics, Review Article, Respiratory physiology, Lung injury, 03 medical and health sciences, Plateau pressure, 0302 clinical medicine, 030202 anesthesiology, Medicine, Lung volumes, MED/41 - ANESTESIOLOGIA, Intensive care medicine, Mechanical ventilation, Lung, business.industry, Respiratory mechanic, acute respiratory distress syndrome (ARDS), 030208 emergency & critical care medicine, ventilator-induced lung injury (VILI), General Medicine, respiratory system, medicine.disease, medicine.anatomical_structure, Breathing, business
Abstract: Despite the recognition of its iatrogenic potential, mechanical ventilation remains the mainstay of respiratory support for patients with acute respiratory distress syndrome (ARDS). The low volume ventilation has been recognized as the only method to reduce mortality of ARDS patients and plateau pressure as the lighthouse for delivering safe ventilation. Recent investigations suggest that a ventilation based on lung mechanics (tidal ventilation tailored to the available lung volume able to receive it, i.e., driving pressure) is a successful approach to improve outcome. However, currently available bedside mechanical variables do not consider regional mechanical properties of ARDS affected lungs, which include the role of local stress risers at the boundaries of areas with different aeration. A unifying approach considers lung-related causes and ventilation-related causes of lung injury. These last may be incorporated in the mechanical power (i.e., amount of mechanical energy transferred per unit of time). Ventilation-induced lung injury (which includes the self-inflicted lung injury of a spontaneously breathing patient) can therefore be prevented by the adoption of measures promoting an increase of ventilable lung and its homogeneity and by delivering lower levels of mechanical power. Prone position promotes lung homogeneity without increasing the delivered mechanical power. This review describes the recent developments on respiratory mechanics in ARDS patients, providing both bedside and research insights from the most updated evidence.
Published: 2018

34. What Is the Most Recent Evidence on the Prevention and Early Treatment of Invasive Fungal Infections in Nonneutropenic Critically Ill Patients?

Author: Santi Maurio Raineri, Antonino Giarratano, Vincenzo Russotto, Pasquale Iozzo, Andrea Cortegiani, Cortegiani A., Russotto V., Iozzo P., Raineri S.M., and Giarratano A.
Subjects: Antifungal, medicine.medical_specialty, medicine.drug_class, Fungal sepsis, Toxicology, Critical Care and Intensive Care Medicine, law.invention, 03 medical and health sciences, High morbidity, Invasive fungal infection, 0302 clinical medicine, Randomized controlled trial, law, Intensive care, Medicine, Antifungal treatment, 030212 general & internal medicine, Intensive care medicine, Candida spp, Fungal sepsi, business.industry, Critically ill, Public Health, Environmental and Occupational Health, 030208 emergency & critical care medicine, Clinical Practice, Infectious Diseases, Systematic review, business
Abstract: Invasive fungal infections (IFIs) are associated with high morbidity and mortality in intensive care units. Candida species are the most important fungal pathogens and among the most frequent causes of infection in critically ill patients. Studies have evaluated the correlation between the onset of antifungal treatment and survival. However, definitive diagnosis of IFI is time-consuming in clinical practice. Antifungal prophylaxis and preemptive or empirical treatments are among therapeutic strategies to prevent or treat early fungal infections in selected patients. Recently, new evidence from randomized controlled trials and systematic reviews has been published. Moreover, new clinical practice guidelines from international communities are available. The aim of this review was to present updated evidence on this topic.
Published: 2017
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35. Ten important articles on noninvasive ventilation in critically ill patients and insights for the future: A report of expert opinions

Author: Paolo Pelosi, Elie Azoulay, Andrea Cortegiani, Giorgio Conti, Annalisa Carlucci, S. Jaber, Cesare Gregoretti, Massimo Antonelli, Vincenzo Russotto, Nicholas S. Hill, Alexandre Demoule, Miquel Ferrer, Paolo Navalesi, Raffaele Scala, HAL UPMC, Gestionnaire, Università degli studi di Palermo - University of Palermo, Department of Intensive Care and Anesthesiology, Università cattolica del Sacro Cuore [Milano] (Unicatt), Service de Réanimation Médicale, Hôpital Saint Louis, Paris, France, Fondazione Salvatore Maugeri-IRCCS, Università cattolica del Sacro Cuore [Piacenza e Cremona] (Unicatt), Service de Pneumologie et Réanimation Médicale [CHU Pitié-Salpêtrière] (Département ' R3S '), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Neurophysiologie Respiratoire Expérimentale et Clinique, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), Tufts Medical Center, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Università degli Studi 'Magna Graecia' di Catanzaro = University of Catanzaro (UMG), Istituto di ricovero e cura a carattere scientifico Azienda Ospedaliera Universitaria 'San Martino' (IRCCS AOU San Martino), Medicina Interna, IRCCS Policlinico San Donato, University of Milano, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Università degli Studi 'Magna Graecia' di Catanzaro [Catanzaro, Italie] (UMG), Cortegiani, A, Russotto, V, Antonelli, M, Azoulay, E, Carlucci, A, Conti, G, Demoule, A, Ferrer, M, Hill, N, Jaber, S, Navalesi, P, Pelosi, P, Scala, R, Gregoretti, C, and Hill, N S
Subjects: Research Report, medicine.medical_specialty, Exacerbation, Critical Care, CPAP, Non invasive ventilation, Respiratory failure, Critical Illness, Expert Testimony, Forecasting, Humans, Noninvasive Ventilation, Randomized Controlled Trials as Topic, Surveys and Questionnaires, Anesthesiology and Pain Medicine, Patient characteristics, Lung injury, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, law.invention, lcsh:RD78.3-87.3, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Anesthesiology, Settore MED/41 - ANESTESIOLOGIA, medicine, 030212 general & internal medicine, MED/41 - ANESTESIOLOGIA, Intensive care medicine, Critically ill, business.industry, 3. Good health, 030228 respiratory system, lcsh:Anesthesiology, Critical Illne, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Noninvasive ventilation, business, Human, Research Article
Abstract: Background Noninvasive ventilation is used worldwide in many settings. Its effectiveness has been proven for common clinical conditions in critical care such as cardiogenic pulmonary edema and chronic obstructive pulmonary disease exacerbations. Since the first pioneering studies of noninvasive ventilation in critical care in the late 1980s, thousands of studies and articles have been published on this topic. Interestingly, some aspects remain controversial (e.g. its use in de-novo hypoxemic respiratory failure, role of sedation, self-induced lung injury). Moreover, the role of NIV has recently been questioned and reconsidered in light of the recent reports of new techniques such as high-flow oxygen nasal therapy. Methods We conducted a survey among leading experts on NIV aiming to 1) identify a selection of 10 important articles on NIV in the critical care setting 2) summarize the reasons for the selection of each study 3) offer insights on the future for both clinical application and research on NIV. Results The experts selected articles over a span of 26 years, more clustered in the last 15 years. The most voted article studied the role of NIV in acute exacerbation chronic pulmonary disease. Concerning the future of clinical applications for and research on NIV, most of the experts forecast the development of innovative new interfaces more adaptable to patients characteristics, the need for good well-designed large randomized controlled trials of NIV in acute “de novo” hypoxemic respiratory failure (including its comparison with high-flow oxygen nasal therapy) and the development of software-based NIV settings to enhance patient-ventilator synchrony. Conclusions The selection made by the experts suggests that some applications of NIV in critical care are supported by solid data (e.g. COPD exacerbation) while others are still waiting for confirmation. Moreover, the identified insights for the future would lead to improved clinical effectiveness, new comparisons and evaluation of its role in still “lack of full evidence” clinical settings. Electronic supplementary material The online version of this article (10.1186/s12871-017-0409-0) contains supplementary material, which is available to authorized users.
Published: 2017
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36. Lessons from uncertainty on antifungal treatment in ICU

Author: Vincenzo Russotto, Andrea Cortegiani, Antonino Giarratano, Cortegiani, A, Russotto, V, Giarratano, A, Cortegiani, Andrea, Russotto, Vincenzo, and Giarratano, Antonino
Subjects: Antifungal, Pulmonary and Respiratory Medicine, medicine.medical_specialty, business.industry, Critically ill, medicine.drug_class, MEDLINE, 030208 emergency & critical care medicine, sepsis, fungal infection, Intensive care unit, law.invention, 03 medical and health sciences, 0302 clinical medicine, Editorial, Emergency surgery, law, Medicine, Community or, 030212 general & internal medicine, MED/41 - ANESTESIOLOGIA, business, Intensive care medicine, Letter to the Editor
Abstract: We read with great interest the Editorial from Moghnieh et al. on the EMPIRICUS trial and antifungal use in intensive care unit (ICU) (1). Authors described nicely the trial and some background evidence on untargeted antifungal treatment in non-neutropenic critically ill patients in ICU (2,3). However, we believe that some points may be further clarified. First, it may be useful to cite the study from Knitsch et al. among those evaluating empiric antifungal treatment in ICU (4). Knitsch et al. enrolled 252 critically ill patients with localized/generalized intra-abdominal infection either of community or of nosocomial origin requiring emergency surgery.
Published: 2017

37. What is the risk of acquiring bacteria from prior intensive care unit bed occupants?

Author: Antonino Giarratano, Vincenzo Russotto, Pasquale Iozzo, Cesare Gregoretti, Andrea Cortegiani, Santi Maurizio Raineri, Russotto, V, Cortegiani, A, Raineri, S, Iozzo, P, Gregoretti, C, Giarratano, A, Russotto, Vincenzo, Cortegiani, Andrea, Raineri, Santi Maurizio, Iozzo, Pasquale, Gregoretti, Cesare, and Giarratano, Antonino
Subjects: 0301 basic medicine, Risk, medicine.medical_specialty, Letter, Multi drug resistant bacteria, Sepsi, 030106 microbiology, Intensive Care Unit, Bacterial contamination, Infection, Multi-drug resistant bacteria, Sepsis, Critical Care and Intensive Care Medicine, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Patients' Room, Patients' Rooms, Anti-Bacterial Agent, Humans, Medicine, Multidrug-resistant gram-negative bacteria, MED/41 - ANESTESIOLOGIA, Intensive care medicine, Cross Infection, Infection Control, biology, business.industry, 030208 emergency & critical care medicine, medicine.disease, biology.organism_classification, Intensive care unit, Anti-Bacterial Agents, Intensive Care Units, Equipment Contamination, business, Bacteria, Human
Published: 2017

38. Uncertainty about the evidence on untargeted antifungal treatment

Author: Andrea Cortegiani, Cesare Gregoretti, Antonino Giarratano, Vincenzo Russotto, Santi Maurizio Raineri, Cortegiani, Andrea, Russotto, Vincenzo, Raineri, Santi Maurizio, Gregoretti, Cesare, Giarratano, Antonino, Cortegiani, A, Russotto, V, Raineri, S, Gregoretti, C, and Giarratano, A
Subjects: 0301 basic medicine, Antifungal, Antifungal Agents, Traditional medicine, business.industry, medicine.drug_class, Antifungal therapy, Candidaemia, Invasive fungal infections, 030106 microbiology, Uncertainty, sepsis, fungal infection, 03 medical and health sciences, 0302 clinical medicine, Invasive fungal infection, Internal Medicine, Humans, Medicine, Antifungal Agent, 030212 general & internal medicine, MED/41 - ANESTESIOLOGIA, business, Human
Abstract: N/A
Published: 2017

39. Neutrophil CD64 as a marker of infection in patients admitted to the emergency department with acute respiratory failure

Author: Santi Maurizio Raineri, Antonino Giarratano, Francesca Montalto, Grazia Foresta, Andrea Cortegiani, Russotto, Pasquale Iozzo, Cortegiani, A, Russotto, V, Montalto, F, Foresta, G, Iozzo, P, Raineri, SM, Giarratano, A, and Raineri, S
Subjects: medicine.medical_specialty, Settore MED/41 - Anestesiologia, Emergency Nursing, Acute respiratory failure, law.invention, Sepsis, law, Internal medicine, Medicine, In patient, CD64, MED/41 - ANESTESIOLOGIA, Original Research, CD64 index, business.industry, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Emergency department, lcsh:RC86-88.9, medicine.disease, Infection, Triage, Intensive care unit, acute respiratory failure, CD64, CD64 index, infection, Emergency medicine, Emergency Medicine, Differential diagnosis, business, Open Access Emergency Medicine
Abstract: Andrea Cortegiani, Vincenzo Russotto, Francesca Montalto, Grazia Foresta, Pasquale Iozzo, Santi Maurizio Raineri, Antonino Giarratano Department of Biopathology and Medical and Forensic Biotechnologies (DIBIMEF), Section of Anesthesiology, Analgesia, Emergency and Intensive Care, Policlinico “P Giaccone”, University of Palermo, Palermo, Italy Introduction: Cluster of differentiation 64 (CD64) is expressed on neutrophils during bacterial infections and sepsis. The aim of our study was to assess the CD64 expression in patients admitted to the emergency department (ED) with a triage diagnosis of acute respiratory failure (ARF) and/or dyspnea and to verify a relationship between its value and the presence of infection. Methods: We assessed neutrophil CD64 expression in peripheral blood of patients admitted to the ED with a diagnosis of ARF and/or dyspnea from September 2012 to April 2013. We measured CD64 index by flow cytometry (Leuko64™ kit) and classified patients as infected within 12 hours from admission, without an infection within 12 hours but infected within 72 hours from admission, and not infected. The primary outcome was differentiating CD64 values of patients with a diagnosis of infection within 12 hours and 72 hours from admission, from those of patients without a diagnosis of infection. The secondary outcome was verifying a relationship between CD64 values and patients' characteristics, Sequential Organ Failure Assessment score, and intensive care unit admission. Results: Of 212 patients included in the study, 40.1% were classified as infected within 12 hours from admission, 20.3% were without an infection 12 hours after admission but were infected within 72 hours, and 39.6% were not infected. The median CD64 index was higher in patients with an infection on admission (CD64 index: 3.58) than in those not considered infected (CD64 index: 1.37), P3.65 showed a sensitivity of 94.6%, a specificity of 86.8%, and an area under the receiver-operating characteristic curve of 0.952 for prediction of intensive care unit admission. Conclusion: CD64 index could represent a useful diagnostic tool for differential diagnosis of ARF in the ED. Keywords: acute respiratory failure, CD64, CD64 index, infection
Published: 2014

40. Is it time to combine untargeted antifungal strategies to reach the goal of 'early' effective treatment?

Author: Antonino Giarratano, Andrea Cortegiani, Vincenzo Russotto, Santi Maurizio Raineri, Cortegiani, A, Russotto, V, Raineri, S, Giarratano, A, and Raineri, SM
Subjects: 0301 basic medicine, medicine.medical_specialty, Antifungal Agents, 030106 microbiology, Antifungal drug, Critical Care and Intensive Care Medicine, law.invention, Goal, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, medicine, Humans, Treatment Outcome, Goals, Antifungal Agent, Stage (cooking), MED/41 - ANESTESIOLOGIA, Adverse effect, Intensive care medicine, Surrogate endpoint, business.industry, Incidence (epidemiology), 030208 emergency & critical care medicine, Retrospective cohort study, Anidulafungin, business, medicine.drug, Human
Abstract: A recently published retrospective study by Posteraro et al. [1] investigated the use of (1–3)-β-D-glucan (BDG) as a strategy for antifungal drug administration in patients at high risk of candidemia. The strategy consisted of the administration of antifungals (anidulafungin in most cases) to septic patients with a Candida score ≥ 3a nd a positive BDG result (≥80 pg/ml). This untargeted strategy led to better selection of patients, avoiding exposure to antifungals in approximately 73 % of patients with negative BDG results and leading to shortened treatment duration in another 20 % of patients. Untargeted antifungal treatments (including prophylaxis, pre-emptive and empiric approaches) are the mainstay of early invasive fungal infection (IFI) management [2]. We recently published a Cochrane systematic review investigating the effects of untargeted antifungal treatment in terms of mortality and incidence of IFI in nonneutropenic critically ill patients [3]. Notably, prophylaxis resulted in IFI reduction but it may lead to exposure to antifungals for an unacceptably high proportion of patients, with associated potential adverse effects of antifungals, increased risk of resistance and costs. On the contrary, empiric treatment showed no benefit in terms of IFI reduction and mortality. We hypothesized that this observation may be due to inclusion of patients with a more advanced disease stage [4]. Moreover, many patients receiving antifungals may not need them, leading to the observed lack of benefit. The pre-emptive strategy was less investigated, with only one published randomized controlled study included in the systematic review. According to the findings of Posteraro et al. [1], a surrogate marker-driven strategy, in association with risk factors, might represent an adequate and cost-effective approach to tailor antifungal treatment to patients who may benefit most. Is it time to abandon classic antifungal treatments to shift towards more pliant ‘early’ antifungal strategies based on risk factors and biomarkers? Data from non-randomized studies suggested that this kind of antifungal strategy might combine advantages of classic treatments with improved selection of patients and reduced exposure to antifungals, also being able to help clinicians to decide when to stop treatments [5]. There is a need for further randomized trials to answer the question of whether surrogate marker/risk factorbased antifungal strategies could be beneficial to our critically ill patients, in comparison with other (old?) untargeted treatments, in terms of efficacy, exposure to antifungals and costs.
Published: 2016

41. From bedside to bench: The missing brick for patients with fungal sepsis

Author: Andrea Cortegiani, Santi Maurizio Raineri, Vincenzo Russotto, Antonino Giarratano, Russotto, V, Cortegiani, A, Raineri, SM, Giarratano, A, and Raineri, S
Subjects: 0301 basic medicine, Adult, CD4-Positive T-Lymphocytes, Male, medicine.medical_specialty, Letter, Sepsi, 030106 microbiology, CD8-Positive T-Lymphocytes, Critical Care and Intensive Care Medicine, Communicable Disease, Sepsis, 03 medical and health sciences, 0302 clinical medicine, Immunophenotyping, Immune system, medicine, Humans, In patient, Prospective Studies, MED/41 - ANESTESIOLOGIA, Intensive care medicine, Aged, Candida, Immunosuppression Therapy, Communicable Diseases, Immune status, business.industry, Candidemia, 030208 emergency & critical care medicine, Middle Aged, medicine.disease, Phenotype, Observational study, Female, Fungal sepsis, business, Empiric treatment, Sepsis, fungal infection, Human
Abstract: We read with great interest the article by Spec et al. [1] investigating the immunophenotype of T cells from patients with Candida spp. sepsis. This is the first observational study describing the altered immune response of patients with candidemia. The authors included non-neutropenic critically ill patients with candidemia and non-septic controls, and excluded patients with human immunodeficiency virus infection, who had undergone solid or bone marrow transplantation or with other known causes of impaired immune response. The authors hypothesized that their findings may help explain why patients with fungal sepsis show a high mortality despite appropriate antifungal therapy. In our opinion, the observed T-cell exhaustion associated with candidemia may also contribute to explain the paradox of the evidence published recently about invasive fungal infection (IFI) prevention [2]. From our recently published Cochrane review [3], the use of antifungals in critically ill patients as untargeted treatment was not associated with any survival benefit despite being associated with a 45 % reduction of IFIs. When prophylactic and empiric antifungal treatments were investigated in sub-analyses, a reduction of IFIs was observed only after prophylactic administration of antifungals. We hypothesized that studies investigating empiric treatment, defined as the administration of antifungals in patients with signs/symptoms of infections at risk for IFIs, included patients with a more advanced disease process, leading to lack of any survival benefit from antifungals. We now may also speculate that poor survival of patients despite untargeted antifungal drugs may depend on their immune status. Patients treated with empiric antifungals may show an impaired immune response, which may play a causative role for reduced survival or may represent a marker of advanced disease process. Implications for future research may include potential additional mechanisms of impaired immunological function to fill the gap between bedside data and pre-clinical findings.
Published: 2016

42. Indication and Timing

Author: Andrea Cortegiani, Vincenzo Russotto, Cesare Gregoretti, Cortegiani, A., Russotto, V., and Gregoretti, C.
Subjects: Mechanical ventilation, business.industry, Sedation, medicine.medical_treatment, Incidence (epidemiology), Settore MED/41 - Anestesiologia, Percutaneous tracheostomy in Critically ill patients, medicine.disease, Intensive care unit, law.invention, Pneumonia, Respiratory failure, law, Blunt trauma, Anesthesia, medicine, Intubation, medicine.symptom, business
Abstract: Tracheostomy is performed in patients requiring prolonged mechanical ventilation aiming at avoiding the potential detrimental effect of a sustained translaryngeal intubation (e.g. laryngeal oedema, mucosal ulcerations). Potential benefits of tracheostomy in critically ill patients are improved comfort and reduced need for sedation, easier clearance of secretions and oral hygiene, and a possible faster weaning from mechanical ventilation. Controversy exists over optimal timing (early, tracheostomy placement compared with later time points) in patients with respiratory failure. Among the published randomised controlled trials, two large studies did not report a significant advantage of an early tracheostomy compared to a late procedure for the primary outcomes of incidence of ventilator-associated pneumonia and all-cause of mortality at 30 days from randomisation. In non-head injured blunt trauma patients with prolonged respiratory failure, tracheostomy placement after 7–10 days seems appropriate. This timing would avoid the potential procedural complications of an unnecessary procedure in patients with a possible shorter period of mechanical ventilation. Further investigations are needed for giving proper indication and timing of tracheostomy in selected populations (e.g. traumatic and non-traumatic neurologic injuries).
Published: 2016

43. Dying with or because of invasive fungal infection? The role of immunity exhaustion on patient outcome

Author: Andrea Cortegiani, Vincenzo Russotto, Antonino Giarratano, Cesare Gregoretti, Santi Maurizio Raineri, Cortegiani, Andrea, Russotto, Vincenzo, Raineri, Santi Maurizio, Gregoretti, Cesare, Giarratano, Antonino, Cortegiani, A, Russotto, V, Raineri, S, Gregoretti, C, and Giarratano, A
Subjects: 0301 basic medicine, Antifungal, medicine.medical_specialty, Emergency Medicine, Anesthesiology and Pain Medicine, business.industry, medicine.drug_class, 030106 microbiology, 030208 emergency & critical care medicine, medicine.disease, sepsis, fungal infection, Outcome (game theory), 03 medical and health sciences, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), Immunity, Antifungal Treatment CORTEGIANI vs. DE ROSA: DEBATE Second Round, Medicine, MED/41 - ANESTESIOLOGIA, business, Intensive care medicine
Abstract: De Rosa et al. considered clinical scores, biomarkers and their combination as useful aids for an early antifungal treatment and advocated the adoption of de-escalation therapy in an antifungal stewardship approach as a possible key for a better management of these patients. Authors considered the high burden of invasive fungal infections in terms of patient outcomes and costs and focused on current strategies for their optimization.
Published: 2016

44. Should we administer antifungal drugs before the diagnosis of invasive fungal infection in non-neutropenic critically ill patients?

Author: Santi Maurizio Raineri, Cesare Gregoretti, Antonino Giarratano, Vincenzo Russotto, Andrea Cortegiani, Cortegiani, A, Russotto, V, Raineri, S, Gregoretti, C, Giarratano, A, Cortegiani, Andrea, Russotto, Vincenzo, Raineri, Santi Maurizio, Gregoretti, Cesare, and Giarratano, Antonino
Subjects: 0301 basic medicine, medicine.medical_specialty, Emergency Medicine, Anesthesiology and Pain Medicine, Critically ill, business.industry, Antifungal drugs, Antifungal Treatment CORTEGIANI vs. DE ROSA: DEBATE First Round, 030106 microbiology, sepsis, fungal infection, Non neutropenic, 03 medical and health sciences, 0302 clinical medicine, medicine, 030212 general & internal medicine, MED/41 - ANESTESIOLOGIA, Intensive care medicine, business
Published: 2016

45. ICU-acquired infections: It is not only about the number of patients per room

Author: Santi Maurizio Raineri, Andrea Cortegiani, Antonino Giarratano, Cesare Gregoretti, Vincenzo Russotto, Russotto, Vincenzo, Cortegiani, Andrea, Gregoretti, Cesare, Raineri, Santi Maurizio, Giarratano, Antonino, Russotto, V, Cortegiani, A, Gregoretti, C, Raineri, S, and Giarratano, A
Subjects: Cross infection, medicine.medical_specialty, Cross Infection, business.industry, Intensive Care Unit, 030208 emergency & critical care medicine, Critical Care and Intensive Care Medicine, 03 medical and health sciences, Intensive Care Units, 0302 clinical medicine, Text mining, Emergency medicine, Medicine, Humans, 030212 general & internal medicine, MED/41 - ANESTESIOLOGIA, business, ICU acquired infection, sepsis, critical care, Human
Abstract: LETTER TO EDITOR
Published: 2016

46. No-touch methods of terminal cleaning in the intensive care unit: results from the first large randomized trial with patient-centred outcomes

Author: Santi Maurizio Raineri, Vincenzo Russotto, Antonino Giarratano, Cesare Gregoretti, Andrea Cortegiani, Pasquale Iozzo, Russotto, V, Cortegiani, A, Iozzo, P, Raineri, S, Gregoretti, C, Giarratano, A, Russotto, Vincenzo, Cortegiani, Andrea, Iozzo, Pasquale, Raineri, Santi Maurizio, Gregoretti, Cesare, and Giarratano, Antonino
Subjects: Cross infection, medicine.medical_specialty, Sepsi, ICU-acquired infections, Multidrug resistant organisms, Sepsis, Terminal cleaning, Intensive Care Unit, MEDLINE, Multidrug resistant organism, Critical Care and Intensive Care Medicine, Article, law.invention, 03 medical and health sciences, ICU-acquired infection, 0302 clinical medicine, Randomized controlled trial, law, medicine, Humans, 030212 general & internal medicine, Intensive care medicine, Cross Infection, business.industry, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, lcsh:RC86-88.9, medicine.disease, Intensive care unit, Intensive Care Units, Emergency medicine, business, Patient centred, Human
Abstract: N/A
Published: 2017
Full Text: View/download PDF

47. Previously undiagnosed Reinke edema as a cause of immediate postextubation inspiratory stridor

Author: Cesira Palmeri, Antonino Giarratano, Santi Maurizio Raineri, Andrea Cortegiani, Russotto, Cortegiani, A, Russotto, V, Palmeri, C, Raineri, S, Giarratano, A, and Palmeri di Villalba, C
Subjects: Reinke edema, medicine.medical_treatment, Stridor, Intensive Care Unit, Settore MED/41 - Anestesiologia, law.invention, Lesion, law, Risk Factors, otorhinolaryngologic diseases, medicine, Intubation, Intratracheal, Humans, Renike edema, Postextubation stridor, airway management, Inspiratory stridor, MED/41 - ANESTESIOLOGIA, Respiratory Sounds, Aged, Mechanical ventilation, business.industry, General Medicine, respiratory system, Laryngeal Edema, Intensive care unit, Respiration, Artificial, respiratory tract diseases, Intensive Care Units, medicine.anatomical_structure, Anesthesia, Vocal folds, Airway management, Female, medicine.symptom, Respiratory Sound, business, Human
Abstract: Reinke edema (RE) is an uncommon lesion of the vocal folds and a potential cause of complications during airway management. We report the case of a woman with previously unknown RE admitted to the intensive care unit who experienced postextubation inspiratory stridor immediately after separation from mechanical ventilation. RE should be considered among causes of postextubation stridor.
Published: 2015

48. Antifungal prophylaxis: update on an old strategy

Author: Santi Maurizio Raineri, Antonino Giarratano, Andrea Cortegiani, Vincenzo Russotto, Cortegiani, A, Russotto, V, Raineri, S, Giarratano, A, Cortegiani, A., Russotto, V., Raineri, S.M., and Giarratano, A.
Subjects: 0301 basic medicine, Microbiology (medical), Antifungal, medicine.medical_specialty, Antifungal Agents, medicine.drug_class, 030106 microbiology, Mycose, Antifungal drug, Chemoprevention, 03 medical and health sciences, 0302 clinical medicine, Medical microbiology, Internal medicine, Medicine, Antifungal Agent, Humans, MED/41 - ANESTESIOLOGIA, business.industry, 030208 emergency & critical care medicine, General Medicine, Infectious Diseases, Mycoses, business, Fluconazole, medicine.drug, Human

49. Bacterial contamination of inanimate surfaces and equipment in the intensive care unit

Author: Andrea Cortegiani, Santi Maurizio Raineri, Vincenzo Russotto, Antonino Giarratano, Russotto, V., Cortegiani, A., Raineri, S., Giarratano, A., Russotto, V, Cortegiani, A, Raineri, S, and Giarratano, A
Subjects: Pediatrics, medicine.medical_specialty, Critically ill, business.industry, media_common.quotation_subject, Patient contact, Equipment contamination, Settore MED/41 - Anestesiologia, Review, Contamination, Multidrug resistance, Critical Care and Intensive Care Medicine, Intensive care unit, law.invention, Bacterial contamination, ICU, law, Hygiene, medicine, Equipment Contamination, MED/41 - ANESTESIOLOGIA, Intensive care medicine, business, media_common
Abstract: Intensive care unit (ICU)-acquired infections are a challenging health problem worldwide, especially when caused by multidrug-resistant (MDR) pathogens. In ICUs, inanimate surfaces and equipment (e.g., bedrails, stethoscopes, medical charts, ultrasound machine) may be contaminated by bacteria, including MDR isolates. Cross-transmission of microorganisms from inanimate surfaces may have a significant role for ICU-acquired colonization and infections. Contamination may result from healthcare workers' hands or by direct patient shedding of bacteria which are able to survive up to several months on dry surfaces. A higher environmental contamination has been reported around infected patients than around patients who are only colonized and, in this last group, a correlation has been observed between frequency of environmental contamination and culture-positive body sites. Healthcare workers not only contaminate their hands after direct patient contact but also after touching inanimate surfaces and equipment in the patient zone (the patient and his/her immediate surroundings). Inadequate hand hygiene before and after entering a patient zone may result in cross-transmission of pathogens and patient colonization or infection. A number of equipment items and commonly used objects in ICU carry bacteria which, in most cases, show the same antibiotic susceptibility profiles of those isolated from patients. The aim of this review is to provide an updated evidence about contamination of inanimate surfaces and equipment in ICU in light of the concept of patient zone and the possible implications for bacterial pathogen cross-transmission to critically ill patients.

50. Medical simulation for ICU staff: does it influence safety of care?

Author: Cesare Gregoretti, Andrea Cortegiani, Vincenzo Russotto, Antonino Giarratano, Massimo Antonelli, Cortegiani, A., Russotto, V., Gregoretti, C., Giarratano, A., Antonelli, M., Cortegiani, A, Russotto, V, Gregoretti, C, Giarratano, A, and Antonelli, M
Subjects: medicine.medical_specialty, media_common.quotation_subject, education, Intensive Care Unit, MEDLINE, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Compliance (psychology), 03 medical and health sciences, 0302 clinical medicine, Medical simulation, Nursing, Multidisciplinary approach, SAFER, Anesthesiology, Settore MED/41 - ANESTESIOLOGIA, medicine, Humans, Open communication, MED/41 - ANESTESIOLOGIA, media_common, Teamwork, Intensive Care Medicine, business.industry, 030208 emergency & critical care medicine, anesthesiology, Intensive Care Units, Family medicine, Safety, business, Human
Abstract: Dear Editor, We read with great interest the article by Garrouste-Orgeas et al. entitled ‘‘Understanding medical errors and adverse events in ICU patients’’ [1]. In particular, two sentences caught our attention: ‘‘medical errors are the consequence of multiple actions of a whole chain of organizational and humans interaction...’’ and ‘‘leadership, trust, respect, open communication, non-punitive actions and coordination of behavior are essential for a multidisciplinary ICU team to provide safe care’’. In a teamworking setting like the ICU, shared knowledge and non-technical skills are pivotal to deliver a high quality of care and to reduce medical errors. Medical simulation has been demonstrated to improve knowledge, selfconfidence, non-technical skills and team performance in various settings like emergency care, trauma and anaesthesia [2, 3]. Accepting that medical error is frequent, complex and not related to a single individual behaviour, the widespread use of simulation-based learning during the last 20 years may be seen as an attempt to prevent and reduce it [4]. Targeted practice of medical simulation, based on learning-by-doing theory [5], may improve many of the factors influencing safety of care, namely ICU leadership, team work, work organization, caregiver wellbeing and awareness of error as described by the authors [1]. To know what to do, to learn and implement methods to interact with other members of the team and to deal with critical events in a safe setting are pivotal goals to achieve safer care in the ICU. However, in light of an effort to reach the goal of prevention of medical errors and adverse events in ICU, we believe that we should start to consider simulation as a core part of ICU staff training. Compliance with ethical standards

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