Search

Your search keyword '"Astuto M"' showing total 17 results
Start Over Author "Astuto M" Topic humans
17 results on '"Astuto M"'

1. Acquisition of skills in critical emergency medicine: an experimental study on the SIAARTI Academy CREM experience

Author

Battaglini, D., Ionescu Maddalena, A., Caporusso, R. R., Garofalo, E., Bruni, A., Bocci, M. G., Cingolani, E., Giarratano, A., Petrini, F., Astuto, M., Barelli, A., Bressan, F., Cinnella, G., Girardis, M., Grasselli, G., Ingrassia, P. L., Menarini, M., Pelaia, P., Pelosi, P., Rocco, M., Tritapepe, L., Battaglini, Denise, Ionescu Maddalena, Alessandra, Caporusso, Roberta R, Garofalo, Eugenio, Bruni, Andrea, Bocci, Maria Grazia, Cingolani, Emiliano, Giarratano, Antonino, and Petrini, Flavia

Subjects
Professional competence, medicine.medical_specialty, Traditional learning, business.industry, Anesthesia, Education, Humans, Clinical Competence, Emergency Medicine, Anesthesiology and Pain Medicine, SIAARTI, Emergency medicine, Medicine, business
Abstract

BACKGROUND In 2019 the SIAARTI developed a seven-days course for residents, focused on critical emergency medicine (CREM) in a hostile environment, that grounds on simulation-based education and training with hands-on simulation, high-fidelity simulators and part-task trainers. This project aimed to evaluate the efficacy of this course in comparison to traditional learning programs in term of technical (TS) and non-technical (NTS) skills. We assessed the improvement in TS and NTS over time, and the ability to involve trainees in corporate activities. METHODS Three-hundred and twenty-seven trainees completed the study. Trainees were allocated into three groups: those who joined the SIAARTI-Academy-CREM course and received a study kit (SA-kit, N.=124), those who received only a study kit (kit, N.=108), and control (N.=95). Eighty-five tests were administered to investigate skills at three timepoints: T0 (baseline), T1 (post-training/kit), and T2 (four months later). RESULTS TS differed among groups (P

Published
2021

2. Pediatric Index of Mortality 2 score in Italy: a multicenter, prospective, observational study

Author

Wolfler, Andrea, Silvani, Paolo, Musicco, Massimo, Salvo, Ida, Vitale, P., Conio, A., Ottonello, G., Arena, A., Gallini, C., Gilodi, R., Osello, R., Ferrero, F., Zoia, E., Mandelli, A., Napolitano, L., Leoncino, S., Galassini, E., Codazzi, D., Baraldi, A., Molinaro, S., Santuz, P., Cogo, Paola, Pettenazzo, A., Meneghini, L., Giusti, F., Sarti, A., Iannella, E., Baroncini, S., Calamandrei, M., Messeri, A., Marano, M., Tomasello, C., Onofri, A., Ferrari, M., Piastra, M., Caresta, E., Dolcini, A., Rovella, C., Guddo, A. M., Astuto, M., Disma, N., Salvo, D., and Buono, D.

Subjects
Male, medicine.medical_specialty, Pediatrics, Adolescent, Critical Illness, Children, Mortality, Pediatric index of Mortality, Pediatric intensive care unit, Severity score, Cause of Death, Child, Child, Preschool, Female, Hospital Mortality, Humans, Infant, Infant, Newborn, Italy, Observation, Prospective Studies, Child Mortality, Hospitals, Pediatric, Intensive Care Units, Pediatric, Medicine (all), Critical Care and Intensive Care Medicine, Poison control, PIM2, law.invention, law, hemic and lymphatic diseases, Intensive care, Anesthesiology, medicine, Preschool, Prospective cohort study, Pediatric, business.industry, Newborn, Intensive care unit, Hospitals, Intensive Care Units, Observational study, business
Abstract

Objectives: To assess the performance of the Pediatric Index of Mortality (PIM) 2 score in Italian pediatric intensive care units (PICUs). Design: Prospective, observational, multicenter, 1-year study. Setting: Eighteen medical-surgical PICUs. Patients: Consecutive patients (3266) aged 0-16 years admitted between 1 March 2004 and 28 February 2005. Interventions: None. Measurements and main results: To assess the performance of the PIM2 score, discrimination and calibration measures were applied to all children admitted to the 18 PICUs, in the entire population and in different groups divided for deciles of risk, age and admission diagnosis. There was good discrimination, with an area under the receiver operating characteristic (ROC) curve of 0.89 (95% CI 0.86-0.91) and good calibration of the scoring system [non-significant differences between observed and predicted deaths when the population was stratified according to deciles of risk (chi(2) 9.86; 8 df, p = 0.26) for the whole population]. Conclusions: The PIM2 score performed well in this sample of the Italian pediatric intensive care population. It may need to be reassessed in the injury and postoperative groups in larger studies.

Published
2007

3. Video assisted trans-cervical thymectomy: a minimally invasive approach to treat non-thymomatous myasthenia gravis

Author

marcello migliore, Alongi G, Rampello L, and Astuto M

Subjects
Myasthenia Gravis, Humans, Minimally Invasive Surgical Procedures, Video-Assisted Surgery, Thymectomy
Abstract

Contemporary surgical options to remove the thymus gland include median sternotomy with extended resection or minimally invasive techniques. Transcervical thymectomy has been criticized as potentially giving a "lesser" thymectomy. We describe the trans cervical approach with telescope enhancement using a standard VATS camera. This report describes the method emphasising the excellent visualization, and discuss the pro and cons over the classic trans-cervical approach or thymectomies performed by VATS or sternotomy.

Published
2014

4. [Cerebral hemodynamics and major surgery]

Author

Dm, Romeo, Betta P, Sanges G, Di Benedetto V, Astuto M, and Mg, Romeo

Subjects
Hernia, Diaphragmatic, Male, Spectroscopy, Near-Infrared, Lymphangioma, Infant, Newborn, Brain, Intestines, Oxygen, Oxygen Consumption, Head and Neck Neoplasms, Predictive Value of Tests, Cerebrovascular Circulation, Monitoring, Intraoperative, Oxyhemoglobins, Humans, Female, Oximetry, Hypoxia, Brain, Esophageal Atresia
Abstract

Near infrared spectroscopy (NIRS) is a non invasive optical technique to assess the monitoring of oxygenation and cerebral hemodynamics. Aim of our study was to value cerebral hemodynamics during major surgery to reduce the period of possible modifications of cerebral oxygenation.Twenty-five newborns which underwent surgical intervention (8 diaphragmatic hernia, 8 esophageal atresia, 1 neck lymphangioma, 8 intestinal malformation) were studied during surgery by means of NIRS (NIRO 300), using an electrode applied to the scalp in the frontoparietal region. We monitored the Tissue Oxygenation Index (TOI) as well as the changes in concentration of total haemoglobin (tHb), oxygenated haemoglobin (O2Hb) and deoxygenated haemoglobin (HHb). The changes have been expressed as difference from the basal value recorded at the beginning of surgery.During the surgical intervention O2Hb, tHb and TOI decreased (DeltaO2Hb=-11.4+/-6.5 microM; P0.001; DeltatHb=- 7.54+/-4.3 microM, P0.05; microTOI=-12.5+/-5.5%, P0.001), and HHb increased (DeltaHHb=+4.80+/-2.30 microM, P0.001); the greatest changes occurred when the viscera were positioned into the abdomen (in diaphragmatic hernia and intestinal malformation).The present study suggests that NIRS, during major surgery, is able to monitor oxygenation and cerebral hemodynamics thus allowing a real time evaluation of some intraoperative procedure aftereffects that, if timely modified, could reduce cerebral hypoxia risks.

Published
2007

5. Preoperative evaluation in infants and children: Recommendations of the Italian Society of Pediatric and Neonatal Anesthesia and Intensive Care (SARNePI)

Author

Serafini, G., Ingelmo, P. M., Astuto, M., Baroncini, S., Borrometi, F., Bortone, L., Ceschin, C., Gentili, A., Elisabetta Lampugnani, Mangia, G., Meneghini, L., Minardi, C., Montobbio, G., Pinzoni, F., Rosina, B., Rossi, C., Sahillioglu, E., Sammartino, M., Sonzogni, R., Sonzogni, V., Tesoro, S., Tognon, C., and Zadra, N.

Subjects
Critical Care, Elective Surgical Procedures, Child, Preschool, Preoperative Care, Ambulatory care, Infant, Newborn, Humans, Infant, Child, Preoperative period, Anesthesia
Abstract

The preoperative assessment involves the process of evaluating the patient's clinical condition, which is intended to define the physical status classification, eligibility for anesthesia and the risks associated with it, thus providing elements to select the most appropriate and individualized anesthetic plan. The aim of this recommendation was provide a framework reference for the preoperative evaluation assessment of pediatric patients undergoing elective surgery or diagnostic/therapeutic procedures.We obtained evidence concerning pediatric preoperative evaluation from a systematic search of the electronic databases MEDLINE and Embase between January 1998 and February 2012. We used the format developed by the Italian Center for Evaluation of the Effectiveness of Health Care's scoring system for assessing the level of evidence and strength of recommendations.We produce a set of consensus guidelines on the preoperative assessment and on the request for preoperative tests. A review of the existing literature supporting these recommendations is provided. In reaching consensus, emphasis was placed on the level of evidence, clinical relevance and the risk/benefit ratio.Preoperative evaluation is mandatory before any diagnostic or therapeutic procedure that requires the use of anesthesia or sedation. The systematic prescription of complementary tests in children should be abandoned, and replaced by a selective and rational prescription, based on the patient history and clinical examination performed during the preoperative evaluation.

6. Methodologies for the treatment of acute and chronic nononcologic pain in children

Author

Astuto, M., Rosano, G., Rizzo, G., Nicola Disma, and Di Cataldo, A.

Subjects
Analgesics, Pain, Postoperative, regional, Acute Disease, Chronic Disease, postoperative, Humans, Pain, Pain Management, Anesthesia, Child, pain, postoperative, analgesics, anesthesia, regional, child
Abstract

Pain represents the most feared symptom of illness but for many years it has been underestimated in children. Only recently has analgesic treatment become an integral part in the assistance of ill children with acute pain, such as postoperative pain, and with chronic pain. Postoperative pain is a complication of surgery: postoperative pain prevention should replace the current theory and practice of postoperative treatment through the creation of ''pain services'' and adequate pain prevention planning. Pain prevention begins in the preoperative period, continues in the operating theaters and in the postoperative phase. A multimodal approach should employ techniques of loco-regional anesthesia using a variety of agents from opioids to nonsteroidal anti-inflammatory drugs or paracetamol. The techniques we currently use to control procedural pain are both medical and nonmedical. Nonmedical interventions such as distraction, muscular relaxation, and guided imagination for pain control are psychological techniques showing very good results in those children who must undergo various procedures. The medical treatment must guarantee both sedation and effective analgesia. Our medical approach includes local anaesthesia, conscious sedation, deep sedation, and general anaesthesia.

7. Heparin in COVID-19 patients is associated with reduced in-hospital mortality: the multicentre Italian CORIST Study

Author

Walter Ageno, Raffaele Pesavento, Marinella Astuto, Katleen de Gaetano Donati, Francesca Santilli, Filippo Aucella, Eleonora Taddei, Marianna Meschiari, Laura Scorzolini, Biagio Pinchera, Giustino Parruti, Licia Iacoviello, Andrea Vianello, Gabriella Guarnieri, Arturo Montineri, Crizia Colombo, Carlo Signorelli, Lorenzo Blandi, Raffaele De Caterina, Maria Musso, Francesco Petri, Stefano Maitan, Anna Odone, Lucia Caiano, Francesca Crosta, Lorenzo Marra, Giuseppe Patti, Emanuela Pasi, Jovana Milic, Marco Olivieri, Claudia Colomba, Francesco Maria Fusco, Claudia Ravaglia, Alexandra Virano, Carlo Torti, Samir Al Moghazi, Venerino Poletti, Riccardo Maragna, Carlo Sanrocco, Sandro Mancarella, Greta Barbieri, Arturo Ciccullo, Leonardo Grisafi, Paola Simeone, Lorenzo Menicanti, Antonella Palimodde, Gloria Maccagni, Alessandra Vergori, Daniela Niola, Marco G. Mennuni, Gianpiero D'Offizi, Claudia Marotta, Damiano D'Ardes, Vincenzo Sangiovanni, Paolo Bonfanti, Giovanni Larizza, Francesco Di Gennaro, Alessandro Mengozzi, Massimo Mapelli, Giuseppe Di Tano, Laura Carrozzi, Antonella Agodi, Francesco Menichetti, Marialaura Bonaccio, Andrea Antinori, Marco Vinceti, Armando Leone, Franco Mastroianni, Silvia Marongiu, Filippo Minutolo, Giulio Maresca, Beatrice Molena, Nausicaa Berselli, Francesco Cipollone, Massimo Fantoni, Antonella Cingolani, Giovanni Guaraldi, Raffaella Sgariglia, Piergiuseppe Agostoni, Antonio Cascio, Maria Mazzitelli, Roberta Parisi, Augusto Di Castelnuovo, Gian Battista Danzi, Luca Aiello, Roberto Vettor, Elvira Grandone, Laura Vocciante, Emauele Graziani, Cristina Mussini, Marianna Rossi, Marco Rossato, Roberto Cauda, Rosa Arboretti, Alessandro Bartoloni, Simona Costanzo, Francesco Gianfagna, Andrea Rognoni, Ferruccio Madaro, Rossella Marcucci, Pasquale Abete, Francesco Cacciatore, Ivan Gentile, Di Castelnuovo, A, Costanzo, S, Antinori, A, Berselli, N, Blandi, L, Bonaccio, M, Cauda, R, Guaraldi, G, Menicanti, L, Mennuni, M, Parruti, G, Patti, G, Santilli, F, Signorelli, C, Vergori, A, Abete, P, Ageno, W, Agodi, A, Agostoni, P, Aiello, L, Al Moghazi, S, Arboretti, R, Astuto, M, Aucella, F, Barbieri, G, Bartoloni, A, Bonfanti, P, Cacciatore, F, Caiano, L, Carrozzi, L, Cascio, A, Ciccullo, A, Cingolani, A, Cipollone, F, Colomba, C, Colombo, C, Crosta, F, Danzi, G, D'Ardes, D, de Gaetano Donati, K, Di Gennaro, F, Di Tano, G, D'Offizi, G, Fantoni, M, Fusco, F, Gentile, I, Gianfagna, F, Grandone, E, Graziani, E, Grisafi, L, Guarnieri, G, Larizza, G, Leone, A, Maccagni, G, Madaro, F, Maitan, S, Mancarella, S, Mapelli, M, Maragna, R, Marcucci, R, Maresca, G, Marongiu, S, Marotta, C, Marra, L, Mastroianni, F, Mazzitelli, M, Mengozzi, A, Menichetti, F, Meschiari, M, Milic, J, Minutolo, F, Molena, B, Montineri, A, Mussini, C, Musso, M, Niola, D, Odone, A, Olivieri, M, Palimodde, A, Parisi, R, Pasi, E, Pesavento, R, Petri, F, Pinchera, B, Poletti, V, Ravaglia, C, Rognoni, A, Rossato, M, Rossi, M, Sangiovanni, V, Sanrocco, C, Scorzolini, L, Sgariglia, R, Simeone, P, Taddei, E, Torti, C, Vettor, R, Vianello, A, Vinceti, M, Virano, A, Vocciante, L, De Caterina, R, Iacoviello, L, Danzi, G. B, De Gaetano Donati, K, Fusco, F. M, Simeone, P. G, Iacoviello, L., Di Castelnuovo, Augusto, Costanzo, Simona, Antinori, Andrea, Berselli, Nausicaa, Blandi, Lorenzo, Bonaccio, Marialaura, Cauda, Roberto, Guaraldi, Giovanni, Menicanti, Lorenzo, Mennuni, Marco, Parruti, Giustino, Patti, Giuseppe, Santilli, Francesca, Signorelli, Carlo, Vergori, Alessandra, Abete, Pasquale, Ageno, Walter, Agodi, Antonella, Agostoni, Piergiuseppe, Aiello, Luca, Al Moghazi, Samir, Arboretti, Rosa, Astuto, Marinella, Aucella, Filippo, Barbieri, Greta, Bartoloni, Alessandro, Bonfanti, Paolo, Cacciatore, Francesco, Caiano, Lucia, Carrozzi, Laura, Cascio, Antonio, Ciccullo, Arturo, Cingolani, Antonella, Cipollone, Francesco, Colomba, Claudia, Colombo, Crizia, Crosta, Francesca, Danzi, Gian Battista, D'Ardes, Damiano, de Gaetano Donati, Katleen, Di Gennaro, Francesco, Di Tano, Giuseppe, D'Offizi, Gianpiero, Fantoni, Massimo, Fusco, Francesco Maria, Gentile, Ivan, Gianfagna, Francesco, Grandone, Elvira, Graziani, Emauele, Grisafi, Leonardo, Guarnieri, Gabriella, Larizza, Giovanni, Leone, Armando, Maccagni, Gloria, Madaro, Ferruccio, Maitan, Stefano, Mancarella, Sandro, Mapelli, Massimo, Maragna, Riccardo, Marcucci, Rossella, Maresca, Giulio, Marongiu, Silvia, Marotta, Claudia, Marra, Lorenzo, Mastroianni, Franco, Mazzitelli, Maria, Mengozzi, Alessandro, Menichetti, Francesco, Meschiari, Marianna, Milic, Jovana, Minutolo, Filippo, Molena, Beatrice, Montineri, Arturo, Mussini, Cristina, Musso, Maria, Niola, Daniela, Odone, Anna, Olivieri, Marco, Palimodde, Antonella, Parisi, Roberta, Pasi, Emanuela, Pesavento, Raffaele, Petri, Francesco, Pinchera, Biagio, Poletti, Venerino, Ravaglia, Claudia, Rognoni, Andrea, Rossato, Marco, Rossi, Marianna, Sangiovanni, Vincenzo, Sanrocco, Carlo, Scorzolini, Laura, Sgariglia, Raffaella, Simeone, Paola Giustina, Taddei, Eleonora, Torti, Carlo, Vettor, Roberto, Vianello, Andrea, Vinceti, Marco, Virano, Alexandra, Vocciante, Laura, De Caterina, Raffaele, Iacoviello, Licia, Di Castelnuovo A., Costanzo S., Antinori A., Berselli N., Blandi L., Bonaccio M., Cauda R., Guaraldi G., Menicanti L., Mennuni M., Parruti G., Patti G., Santilli F., Signorelli C., Vergori A., Abete P., Ageno W., Agodi A., Agostoni P., Aiello L., Al Moghazi S., Arboretti R., Astuto M., Aucella F., Barbieri G., Bartoloni A., Bonfanti P., Cacciatore F., Caiano L., Carrozzi L., Cascio A., Ciccullo A., Cingolani A., Cipollone F., Colomba C., Colombo C., Crosta F., Danzi G.B., D'Ardes D., De Gaetano Donati K., Di Gennaro F., Di Tano G., D'Offizi G., Fantoni M., Fusco F.M., Gentile I., Gianfagna F., Grandone E., Graziani E., Grisafi L., Guarnieri G., Larizza G., Leone A., MacCagni G., Madaro F., Maitan S., Mancarella S., Mapelli M., Maragna R., Marcucci R., Maresca G., Marongiu S., Marotta C., Marra L., Mastroianni F., Mazzitelli M., Mengozzi A., Menichetti F., Meschiari M., Milic J., Minutolo F., Molena B., Montineri A., Mussini C., Musso M., Niola D., Odone A., Olivieri M., Palimodde A., Parisi R., Pasi E., Pesavento R., Petri F., Pinchera B., Poletti V., Ravaglia C., Rognoni A., Rossato M., Rossi M., Sangiovanni V., Sanrocco C., Scorzolini L., Sgariglia R., Simeone P.G., Taddei E., Torti C., Vettor R., Vianello A., Vinceti M., Virano A., Vocciante L., De Caterina R., and Iacoviello L.

Subjects
Male, medicine.medical_specialty, Settore MED/17 - Malattie Infettive, coronavirus, heparin, 030204 cardiovascular system & hematology, Lower risk, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, Clinical endpoint, medicine, Humans, Thrombophilia, 030212 general & internal medicine, Hospital Mortality, Blood Coagulation, Survival analysis, Aged, Retrospective Studies, treatment, business.industry, Heparin, Mortality rate, COVID-19,mortality, Low-Molecular-Weight, Anticoagulants, COVID-19, Retrospective cohort study, Hematology, Heparin, Low-Molecular-Weight, Middle Aged, mortality, Survival Analysis, COVID-19 Drug Treatment, coagulation activation, coronaviru, Italy, treatments, Propensity score matching, Female, business, medicine.drug
Abstract

Introduction A hypercoagulable condition was described in patients with coronavirus disease 2019 (COVID-19) and proposed as a possible pathogenic mechanism contributing to disease progression and lethality. Aim We evaluated if in-hospital administration of heparin improved survival in a large cohort of Italian COVID-19 patients. Methods In a retrospective observational study, 2,574 unselected patients hospitalized in 30 clinical centers in Italy from February 19, 2020 to June 5, 2020 with laboratory-confirmed severe acute respiratory syndrome coronavirus-2 infection were analyzed. The primary endpoint in a time-to event analysis was in-hospital death, comparing patients who received heparin (low-molecular-weight heparin [LMWH] or unfractionated heparin [UFH]) with patients who did not. We used multivariable Cox proportional-hazards regression models with inverse probability for treatment weighting by propensity scores. Results Out of 2,574 COVID-19 patients, 70.1% received heparin. LMWH was largely the most used formulation (99.5%). Death rates for patients receiving heparin or not were 7.4 and 14.0 per 1,000 person-days, respectively. After adjustment for propensity scores, we found a 40% lower risk of death in patients receiving heparin (hazard ratio = 0.60; 95% confidence interval: 0.49–0.74; E-value = 2.04). This association was particularly evident in patients with a higher severity of disease or strong coagulation activation. Conclusion In-hospital heparin treatment was associated with a lower mortality, particularly in severely ill COVID-19 patients and in those with strong coagulation activation. The results from randomized clinical trials are eagerly awaited to provide clear-cut recommendations.

Published
2021

8. Use of hydroxychloroquine in hospitalised COVID-19 patients is associated with reduced mortality: Findings from the observational multicentre Italian CORIST study

Author

Venerino Poletti, Damiano D'Ardes, Paola Simeone, Cristina Mussini, Giustino Parruti, Sandro Maccarella, Licia Iacoviello, Giulio G. Stefanini, Roberta Mussinelli, Vincenzo Sangiovanni, Paolo Bonfanti, Roberto Vettor, Andrea Vianello, Arturo Montineri, Roberto Cauda, Elvira Grandone, Maria Mazzitelli, Claudia Ravaglia, Marialaura Bonaccio, Giulio Maresca, Francesco Di Gennaro, Alessandro Mengozzi, Anna Sabena, Gian Battista Danzi, Giuseppe Di Tano, Emanuela Pasi, Ilaria Rossi, Lucia Caiano, Laura Carrozzi, Francesco Landi, Francesca Crosta, Tommaso Filippini, Francesco Menichetti, Piergiuseppe Agostoni, Andrea Madaro, Antonio Cascio, Carlo Signorelli, Michele Spinicci, Carlo Sanrocco, Enrico Guido Spinoni, Maria Musso, Alessandra Vergori, Lorenzo Marra, Giuseppe Patti, Laura Vocciante, Marco Olivieri, Francesca Santilli, Stefano Perlini, Claudia Colomba, Francesco Salinaro, Marianna Meschiari, Gabriella Guarnieri, Giampiero D'Offizi, Riccardo Maragna, Paola Del Giacomo, Giancarlo Gini, Katleen de Gaetano Donati, Andrea Antinori, Filippo Aucella, Raffaele De Caterina, Lorenzo Menicanti, Gloria Maccagni, Amedeo Venezia, Chiara Dal Pra, Carlo Andrea Pivato, Walter Ageno, Antonella Agodi, Francesco Cannata, Francesco Petri, Luca Aiello, Biagio Pinchera, Marinella Astuto, Raffaella Sgariglia, Giovanni Guaraldi, Marco Vinceti, Laura Scorzolini, Samir Al Moghazi, Armando Leone, Giovanni Veronesi, Arturo Ciccullo, Leonardo Grisafi, Francesco Cipollone, Massimo Mapelli, Greta Barbieri, Silvia Lamonica, Raffaele Bruno, Filippo Minutolo, Antonella Cingolani, Alessandro Gialluisi, Marco Rossato, Andrea Rognoni, Marianna Rossi, Claudia Marotta, Franco Mastroianni, Ilaria My, Enrico Maria Trecarichi, Anna Odone, Alessandro Bartoloni, Simona Costanzo, Francesco Cacciatore, Ivan Gentile, Massimo Rinaldi, Nausicaa Berselli, Francesco Maria Fusco, Augusto Di Castelnuovo, Lorenzo Blandi, Castelnuovo A.D., Costanzo S., Antinori A., Berselli N., Blandi L., Bruno R., Cauda R., Guaraldi G., Menicanti L., My I., Parruti G., Patti G., Perlini S., Santilli F., Signorelli C., Spinoni E., Stefanini G.G., Vergori A., Ageno W., Agodi A., Aiello L., Agostoni P., Moghazi S.A., Astuto M., Aucella F., Barbieri G., Bartoloni A., Bonaccio M., Bonfanti P., Cacciatore F., Caiano L., Cannata F., Carrozzi L., Cascio A., Ciccullo A., Cingolani A., Cipollone F., Colomba C., Crosta F., Pra C.D., Danzi G.B., D'Ardes D., Donati K.D.G., Giacomo P.D., Gennaro F.D., Di Tano G., D'Offizi G., Filippini T., Fusco F.M., Gentile I., Gialluisi A., Gini G., Grandone E., Grisafi L., Guarnieri G., Lamonica S., Landi F., Leone A., Maccagni G., Maccarella S., Madaro A., Mapelli M., Maragna R., Marra L., Maresca G., Marotta C., Mastroianni F., Mazzitelli M., Mengozzi A., Menichetti F., Meschiari M., Minutolo F., Montineri A., Mussinelli R., Mussini C., Musso M., Odone A., Olivieri M., Pasi E., Petri F., Pinchera B., Pivato C.A., Poletti V., Ravaglia C., Rinaldi M., Rognoni A., Rossato M., Rossi I., Rossi M., Sabena A., Salinaro F., Sangiovanni V., Sanrocco C., Scorzolini L., Sgariglia R., Simeone P.G., Spinicci M., Trecarichi E.M., Venezia A., Veronesi G., Vettor R., Vianello A., Vinceti M., Vocciante L., De Caterina R., Iacoviello L., Castelnuovo, A. D., Costanzo, S., Antinori, A., Berselli, N., Blandi, L., Bruno, R., Cauda, R., Guaraldi, G., Menicanti, L., My, I., Parruti, G., Patti, G., Perlini, S., Santilli, F., Signorelli, C., Spinoni, E., Stefanini, G. G., Vergori, A., Ageno, W., Agodi, A., Aiello, L., Agostoni, P., Moghazi, S. A., Astuto, M., Aucella, F., Barbieri, G., Bartoloni, A., Bonaccio, M., Bonfanti, P., Cacciatore, F., Caiano, L., Cannata, F., Carrozzi, L., Cascio, A., Ciccullo, A., Cingolani, A., Cipollone, F., Colomba, C., Crosta, F., Pra, C. D., Danzi, G. B., D'Ardes, D., Donati, K. D. G., Giacomo, P. D., Gennaro, F. D., Di Tano, G., D'Offizi, G., Filippini, T., Fusco, F. M., Gentile, I., Gialluisi, A., Gini, G., Grandone, E., Grisafi, L., Guarnieri, G., Lamonica, S., Landi, F., Leone, A., Maccagni, G., Maccarella, S., Madaro, A., Mapelli, M., Maragna, R., Marra, L., Maresca, G., Marotta, C., Mastroianni, F., Mazzitelli, M., Mengozzi, A., Menichetti, F., Meschiari, M., Minutolo, F., Montineri, A., Mussinelli, R., Mussini, C., Musso, M., Odone, A., Olivieri, M., Pasi, E., Petri, F., Pinchera, B., Pivato, C. A., Poletti, V., Ravaglia, C., Rinaldi, M., Rognoni, A., Rossato, M., Rossi, I., Rossi, M., Sabena, A., Salinaro, F., Sangiovanni, V., Sanrocco, C., Scorzolini, L., Sgariglia, R., Simeone, P. G., Spinicci, M., Trecarichi, E. M., Venezia, A., Veronesi, G., Vettor, R., Vianello, A., Vinceti, M., Vocciante, L., De Caterina, R., Iacoviello, L., Castelnuovo, A, Costanzo, S, Antinori, A, Berselli, N, Blandi, L, Bruno, R, Cauda, R, Guaraldi, G, Menicanti, L, My, I, Parruti, G, Patti, G, Perlini, S, Santilli, F, Signorelli, C, Spinoni, E, Stefanini, G, Vergori, A, Ageno, W, Agodi, A, Aiello, L, Agostoni, P, Moghazi, S, Astuto, M, Aucella, F, Barbieri, G, Bartoloni, A, Bonaccio, M, Bonfanti, P, Cacciatore, F, Caiano, L, Cannata, F, Carrozzi, L, Cascio, A, Ciccullo, A, Cingolani, A, Cipollone, F, Colomba, C, Crosta, F, Pra, C, Danzi, G, D'Ardes, D, Donati, K, Giacomo, P, Gennaro, F, Tano, G, D'Offizi, G, Filippini, T, Fusco, F, Gentile, I, Gialluisi, A, Gini, G, Grandone, E, Grisafi, L, Guarnieri, G, Lamonica, S, Landi, F, Leone, A, Maccagni, G, Maccarella, S, Madaro, A, Mapelli, M, Maragna, R, Marra, L, Maresca, G, Marotta, C, Mastroianni, F, Mazzitelli, M, Mengozzi, A, Menichetti, F, Meschiari, M, Minutolo, F, Montineri, A, Mussinelli, R, Mussini, C, Musso, M, Odone, A, Olivieri, M, Pasi, E, Petri, F, Pinchera, B, Pivato, C, Poletti, V, Ravaglia, C, Rinaldi, M, Rognoni, A, Rossato, M, Rossi, I, Rossi, M, Sabena, A, Salinaro, F, Sangiovanni, V, Sanrocco, C, Scorzolini, L, Sgariglia, R, Simeone, P, Spinicci, M, Trecarichi, E, Venezia, A, Veronesi, G, Vettor, R, Vianello, A, Vinceti, M, Vocciante, L, De Caterina, R, and Iacoviello, L

Subjects
Male, medicine.medical_specialty, 030204 cardiovascular system & hematology, Lower risk, law.invention, COVID-19, Disease severity, Hydroxychloroquine, Inflammation, Mortality, Aged, Aged, 80 and over, Female, Hospital Mortality, Humans, Italy, Middle Aged, Retrospective Studies, Treatment Outcome, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Retrospective Studie, law, Internal medicine, 80 and over, Internal Medicine, medicine, 030212 general & internal medicine, Risk factor, business.industry, Mortality rate, Retrospective cohort study, COVID-19 Drug Treatment, Propensity score matching, Commentary, Observational study, business, Human, medicine.drug
Abstract

Background Hydroxychloroquine (HCQ) was proposed as potential treatment for COVID-19. Objective We set-up a multicenter Italian collaboration to investigate the relationship between HCQ therapy and COVID-19 in-hospital mortality. Methods In a retrospective observational study, 3,451 unselected patients hospitalized in 33 clinical centers in Italy, from February 19, 2020 to May 23, 2020, with laboratory-confirmed SARS-CoV-2 infection, were analyzed. The primary end-point in a time-to event analysis was in-hospital death, comparing patients who received HCQ with patients who did not. We used multivariable Cox proportional-hazards regression models with inverse probability for treatment weighting by propensity scores, with the addition of subgroup analyses. Results Out of 3,451 COVID-19 patients, 76.3% received HCQ. Death rates (per 1,000 person-days) for patients receiving or not HCQ were 8.9 and 15.7, respectively. After adjustment for propensity scores, we found 30% lower risk of death in patients receiving HCQ (HR=0.70; 95%CI: 0.59 to 0.84; E-value=1.67). Secondary analyses yielded similar results. The inverse association of HCQ with inpatient mortality was particularly evident in patients having elevated C-reactive protein at entry. Conclusions HCQ use was associated with a 30% lower risk of death in COVID-19 hospitalized patients. Within the limits of an observational study and awaiting results from randomized controlled trials, these data do not discourage the use of HCQ in inpatients with COVID-19.

Published
2020

9. Epidemiology of intensive care unit-acquired sepsis in Italy: Results of the SPIN-UTI network

Author

Agodi, Antonella, Barchitta, M., Auxilia, F., Brusaferro, S., D'Errico, M. M., Montagna, M. T., Pasquarella, C., Tardivo, S., Arrigoni, C., Fabiani, L., Laurenti, P., Mattaliano, A. R., Orsi, G. B., Squeri, R., Torregrossa, M. V., Mura, I., Aiello, Mary Rose, Alliani, Cristina, Amatucci, Maria Rita, Antoci, Manuela, Antonelli, Massimo, Astuto, Marinella, Arnoldo, Luca, Arru, Benedetto, Baccari, Giorgio, Barbadoro, Pamela, Barbara, Andrea, Barilaro, Cynthia, Battaglia, Pietro, Bellocchi, Patrizia, Bernasconi, Mara Olga, Bianco, Aida, Bissolo, Emanuela, Bocchi, Anna, Bruno, Anna, Brusaferro, Marco, Buccheri, Margherita, Campanella, Francesca, Canino, Rosario, Cannistrà, Antonino, Carini, Santa Adele, Catalano, Sebastiano, Castellani, Paola, Castiglione, Giacomo, Coniglio, Salvatore, Consolante, Ciriaco, Conte, Carmela, Contrisciani, Roberta, Corallini, Rosy, Crollari, Patricia, Damiani, Gianfranco, Denaro, Carmelo, De Remigis, Santa, Diana, Francesca, Di Bartolo, Rosario, Di Benedetto, Antonino, Di Fabio, Gianna, Di Falco, Carlo, Digeronimo, Vito, Di Gregorio, Pietro, Distefano, Roberta, Egitto, Giovanni, Falciani, Elena, Farruggia, Patrizia, Fenaroli, Salesia, Ferlazzo, Giuseppe, Garofalo, Giuseppe, Girardis, Massimo, Giovanelli, Linda, Giubbini, Gabriele, Graceffa, Adriana, Guadagna, Antonina, Gregu, Giovanna, Ingala, Franco, Innocenzi, Ludovico, La Camera, Giuseppa, La Rosa, Maria Clara, Lesa, Lucia, Longhitano, Anna Maria, Luppino, Giuseppe, Maida, Carmelo Massimo, Manta, Giuseppe, Marino, Giovanni, Masia, Maria Dolores, Maviglia, Riccardo, Mazzetti, Magda, Maugeri, Andrea, Megna, Maria Teresa, Mella, Laura Maria, Milazzo, Marina, Milia, Mario, Minari, Caterina, Minerva, Massimo, Mordacci, Marco, Murgia, Paola, Oliveri, Pietro, Olori, Maria Patrizia, Pagliarulo, Riccardo, Palermo, Rosanna, Pandiani, Irene, Pappalardo, Federico, Papetti, Cristina, Partenza, Adolfo, Pascu, Diana, Pasculli, Marcello, Pavia, Maria, Pavone, Maria Luisa, Pellegrino, Maria Giovanna, Pelligra, Fabrizio, Pillon, Danila, Pintaudi, Sergio, Pitzoi, Lucia, Pinto, Andrea, Piotti, Paola, Pupo, Simona, Quattrocchi, Rosalba, Righi, Elena, Rigo, Alberto, Rigo, Annalisa, Romeo, Antonina, Rosa, Emilio, Rutigliano, Serafina, Sarchi, Pierangelo, Scimonello, Guglielmo, Seminerio, Antonello, Stefanini, Paolo, Sticca, Giovanna, Taddei, Stefania, Tessari, Lorella, Tetamo, Romano, Ticca, Mariantonietta, Tribastoni, Salvatore, Vallorani, Sarah, Venturoni, Federica, Vitagliano, Emilia, Vitali, Pietro, Zappone, Assunta, Zei, Ettore, Zeoli, Maria Prudenzia, Agodi A., Barchitta M., Auxilia F., Brusaferro S., D'Errico M.M., Montagna M.T., Pasquarella C., Tardivo S., Arrigoni C., Fabiani L., Laurenti P., Mattaliano A.R., Orsi G.B., Squeri R., Torregrossa M.V., Mura I., Aiello M.R., Alliani C., Amatucci M.R., Antoci M., Antonelli M., Astuto M., Arnoldo L., Arru B., Baccari G., Barbadoro P., Barbara A., Barilaro C., Battaglia P., Bellocchi P., Bernasconi M.O., Bianco A., Bissolo E., Bocchi A., Bruno A., Brusaferro M., Buccheri M., Campanella F., Canino R., Cannistra A., Carini S.A., Catalano S., Castellani P., Castiglione G., Coniglio S., Consolante C., Conte C., Contrisciani R., Corallini R., Crollari P., Damiani G., Denaro C., De Remigis S., Diana F., Di Bartolo R., Di Benedetto A., Di Fabio G., Di Falco C., Digeronimo V., Di Gregorio P., Distefano R., Egitto G., Falciani E., Farruggia P., Fenaroli S., Ferlazzo G., Garofalo G., Girardis M., Giovanelli L., Giubbini G., Graceffa A., Guadagna A., Gregu G., Ingala F., Innocenzi L., La Camera G., La Rosa M.C., Lesa L., Longhitano A.M., Luppino G., Maida C.M., Manta G., Marino G., Masia M.D., Maviglia R., Mazzetti M., Maugeri A., Megna M.T., Mella L.M., Milazzo M., Milia M., Minari C., Minerva M., Mordacci M., Murgia P., Oliveri P., Olori M.P., Pagliarulo R., Palermo R., Pandiani I., Pappalardo F., Papetti C., Partenza A., Pascu D., Pasculli M., Pavia M., Pavone M.L., Pellegrino M.G., Pelligra F., Pillon D., Pintaudi S., Pitzoi L., Pinto A., Piotti P., Pupo S., Quattrocchi R., Righi E., Rigo A., Romeo A., Rosa E., Rutigliano S., Sarchi P., Scimonello G., Seminerio A., Stefanini P., Sticca G., Taddei S., Tessari L., Tetamo R., Ticca M., Tribastoni S., Vallorani S., Venturoni F., Vitagliano E., Vitali P., Zappone A., Zei E., Zeoli M.P., Agodi, A., Barchitta, M., Auxilia, F., Brusaferro, S., D'Errico, M. M., Montagna, M. T., Pasquarella, C., Tardivo, S., Arrigoni, C., Fabiani, L., Laurenti, P., Mattaliano, A. R., Orsi, G. B., Squeri, R., Torregrossa, M. V., Mura, I., Aiello, M. R., Alliani, C., Amatucci, M. R., Antoci, M., Antonelli, M., Astuto, M., Arnoldo, L., Arru, B., Baccari, G., Barbadoro, P., Barbara, A., Barilaro, C., Battaglia, P., Bellocchi, P., Bernasconi, M. O., Bianco, A., Bissolo, E., Bocchi, A., Bruno, A., Brusaferro, M., Buccheri, M., Campanella, F., Canino, R., Cannistra, A., Carini, S. A., Catalano, S., Castellani, P., Castiglione, G., Coniglio, S., Consolante, C., Conte, C., Contrisciani, R., Corallini, R., Crollari, P., Damiani, G., Denaro, C., De Remigis, S., Diana, F., Di Bartolo, R., Di Benedetto, A., Di Fabio, G., Di Falco, C., Digeronimo, V., Di Gregorio, P., Distefano, R., Egitto, G., Falciani, E., Farruggia, P., Fenaroli, S., Ferlazzo, G., Garofalo, G., Girardis, M., Giovanelli, L., Giubbini, G., Graceffa, A., Guadagna, A., Gregu, G., Ingala, F., Innocenzi, L., La Camera, G., La Rosa, M. C., Lesa, L., Longhitano, A. M., Luppino, G., Maida, C. M., Manta, G., Marino, G., Masia, M. D., Maviglia, R., Mazzetti, M., Maugeri, A., Megna, M. T., Mella, L. M., Milazzo, M., Milia, M., Minari, C., Minerva, M., Mordacci, M., Murgia, P., Oliveri, P., Olori, M. P., Pagliarulo, R., Palermo, R., Pandiani, I., Pappalardo, F., Papetti, C., Partenza, A., Pascu, D., Pasculli, M., Pavia, M., Pavone, M. L., Pellegrino, M. G., Pelligra, F., Pillon, D., Pintaudi, S., Pitzoi, L., Pinto, A., Piotti, P., Pupo, S., Quattrocchi, R., Righi, E., Rigo, A., Romeo, A., Rosa, E., Rutigliano, S., Sarchi, P., Scimonello, G., Seminerio, A., Stefanini, P., Sticca, G., Taddei, S., Tessari, L., Tetamo, R., Ticca, M., Tribastoni, S., Vallorani, S., Venturoni, F., Vitagliano, E., Vitali, P., Zappone, A., Zei, E., and Zeoli, M. P.

Subjects
Sleep Initiation and Maintenance Disorder, Male, Time Factors, Healthcare-associated infections, Mortality, Sepsis, Surveillance, Public Health, Environmental and Occupational Health, Infectious Diseases, Diet, Mediterranean, Coffee, Health Statu, Mortality Parole chiave: Infezioni correlate all'assistenza, Mortalità, Sepsi, Sorveglianza, Academic Performance, Prevalence, Surveys and Questionnaire, Hospital Mortality, Prospective Studies, Cross Infection, Incidence, Smoking, Tryptophan, Shock, Middle Aged, Shock, Septic, Intensive Care Units, Italy, Population Surveillance, Female, Public Health, Human, Adult, Employment, Alcohol Drinking, Intensive Care Unit, Regression Analysi, Young Adult, Age Distribution, Learning, Humans, Healthcare-associated infection, Exercise, Life Style, Settore MED/42 - IGIENE GENERALE E APPLICATA, Aged, Cross-Sectional Studie, Septic, Environmental and Occupational Health, Body Weight, Length of Stay, Body Height, Prospective Studie, Quality of Life, Students, Nursing
Abstract

Background. Sepsis is the major cause of mortality from any infectious disease worldwide. Sepsis may be the result of a healthcare associated infection (HAI): the most frequent adverse events during care delivery especially in Intensive Care Units (ICUs). The main aim of the present study was to describe the epidemiology of ICU-acquired sepsis and related outcomes among patients enrolled in the framework of the Italian Nosocomial Infections Surveillance in ICUs - SPIN-UTI project. Study design. Prospective multicenter study. Methods. The SPIN-UTI network adopted the European protocols for patient-based HAI surveillance. Results. During the five editions of the SPIN-UTI project, from 2008 to 2017, 47.0% of HAIs has led to sepsis in 832 patients. Overall, 57.0% episodes were classified as sepsis, 20.5% as severe sepsis and 22.5% as septic shock. The most common isolated microorganisms from sepsis episodes were Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa. The case fatality rate increased with the severity of sepsis and the mean length of ICU-stay was significantly higher in patients with ICU-acquired sepsis than in patients without. Conclusions. Our study provides evidence that ICU-acquired sepsis occurs frequently in Italian ICU patients and is associated with a high case fatality rate and increased length of stay. However, in order to explain these findings further analyses are needed in this population of ICU patients.

Published
2018

10. Extubation in neurocritical care patients: the ENIO international prospective study

Author

Cinotti, Raphaël, Mijangos, Julio Cesar, Pelosi, Paolo, Haenggi, Matthias, Gurjar, Mohan, Schultz, Marcus J., Kaye, Callum, Godoy, Daniel Agustin, Alvarez, Pablo, Ioakeimidou, Aikaterini, Ueno, Yoshitoyo, Badenes, Rafael, Suei Elbuzidi, Abdurrahmaan Ali, Piagnerelli, Michaël, Elhadi, Muhammed, Reza, Syed Tariq, Azab, Mohammed Atef, McCredie, Victoria, Stevens, Robert D., Digitale, Jean Catherine, Fong, Nicholas, Asehnoune, Karim, Abback, Paër-sélim, Codorniu, Anaïs, Citerio, Giuseppe, Sala, Vittoria Ludovica, Astuto, Marinella, Tringali, Eleonora, Alampi, Daniela, Rocco, Monica, Maugeri, Jessica Giuseppina, Bellissima, Agrippino, Filippini, Matteo, Lazzeri, Nicoletta, Cortegiani, Andrea, Ippolito, Mariachiara, Robba, Chiara, Battaglini, Denise, Biston, Patrick, Al-Gharyani, Mohamed Fathi, Chabanne, Russell, Astier, Léo, Soyer, Benjamin, Gaugain, Samuel, Zimmerli, Alice, Pietsch, Urs, Filipovic, Miodrag, Brandi, Giovanna, Bicciato, Giulio, Serrano, Ainhoa, Monleon, Berta, van Vliet, Peter, Gerretsen, Benjamin Marcel, Ortiz-Macias, Iris Xochitl, Oto, Jun, Enomoto, Noriya, Matsuda, Tomomichi, Masui, Nobutaka, Garçon, Pierre, Zarka, Jonathan, Vermeijden, Wytze J., Cornet, Alexander Daniel, Inurrigarro, Sergio Reyes, Domínguez, Rafael Cirino Lara, Bellini, Maria Mercedes, Haedo, Maria Milagros Gomez, Lamot, Laura, Orquera, Jose, Biais, Matthieu, Georges, Delphine, Baronia, Arvind, Miranda-Ackerman, Roberto Carlos, Barbosa-Camacho, Francisco José, Porter, John, Lopez-Morales, Miguel, Geeraerts, Thomas, Compagnon, Baptiste, Pérez-Torres, David, Prol-Silva, Estefanía, Yahya, Hana Basheer, Khaled, Ala, Ghula, Mohamed, Andrea, Cracchiolo Neville, Daniela, Palma Maria, Deana, Cristian, Vetrugno, Luigi, Chavez, Manuel J. Rivera, Trujillo, Rocio Mendoza, Legros, Vincent, Brochet, Benjamin, Huet, Olivier, Geslain, Marie, van der Jagt, Mathieu, van Steenkiste, Job, Ahmed, Hazem, Coombs, Alexander Edward, Welbourne, Jessie, Pineda, Ana Alicia Velarde, Castillo, Víctor Hugo Nubert, Azab, Mohammed A., Azzam, Ahmed Y., van Meenen, David Michael Paul, Gasca, Gilberto Adrian, Arellano, Alfredo, Galicia-Espinosa, Forttino, García-Ramos, José Carlos, Yadav, Ghanshyam, Jha, Amarendra Kumar, Robert-Edan, Vincent, Rodie-Talbere, Pierre-Andre, Jain, Gaurav, Panda, Sagarika, Agarwal, Sonika, Deewan, Yashbir, Hossain, Md. Mozaffer, Papadas, Christos, Chantziara, Vasiliki, Sklavou, Chrysanthi, Hourmant, Yannick, Grillot, Nicolas, Pirracchio, Romain, Akkari, Abdelraouf, Abdelaty, Mohamed, Hashim, Ahmed, Launey, Yoann, Masseret, Elodie, Lasocki, Sigismond, Gergaud, Soizic, Mouclier, Nicolas, Saxena, Sulekha, Agrawal, Avinash, Mishra, Shakti Bedanta, Samal, Samir, Cinotti, R, Mijangos, J, Pelosi, P, Haenggi, M, Gurjar, M, Schultz, M, Kaye, C, Godoy, D, Alvarez, P, Ioakeimidou, A, Ueno, Y, Badenes, R, Suei Elbuzidi, A, Piagnerelli, M, Elhadi, M, Reza, S, Azab, M, Mccredie, V, Stevens, R, Digitale, J, Fong, N, Asehnoune, K, Abback, P, Codorniu, A, Citerio, G, Sala, V, Astuto, M, Tringali, E, Alampi, D, Rocco, M, Maugeri, J, Bellissima, A, Filippini, M, Lazzeri, N, Cortegiani, A, Ippolito, M, Robba, C, Battaglini, D, Biston, P, Al-Gharyani, M, Chabanne, R, Astier, L, Soyer, B, Gaugain, S, Zimmerli, A, Pietsch, U, Filipovic, M, Brandi, G, Bicciato, G, Serrano, A, Monleon, B, van Vliet, P, Gerretsen, B, Ortiz-Macias, I, Oto, J, Enomoto, N, Matsuda, T, Masui, N, Garcon, P, Zarka, J, Vermeijden, W, Cornet, A, Inurrigarro, S, Dominguez, R, Bellini, M, Haedo, M, Lamot, L, Orquera, J, Biais, M, Georges, D, Baronia, A, Miranda-Ackerman, R, Barbosa-Camacho, F, Porter, J, Lopez-Morales, M, Geeraerts, T, Compagnon, B, Perez-Torres, D, Prol-Silva, E, Yahya, H, Khaled, A, Ghula, M, Andrea, C, Daniela, P, Deana, C, Vetrugno, L, Chavez, M, Trujillo, R, Legros, V, Brochet, B, Huet, O, Geslain, M, van der Jagt, M, van Steenkiste, J, Ahmed, H, Coombs, A, Welbourne, J, Pineda, A, Castillo, V, Azzam, A, van Meenen, D, Gasca, G, Arellano, A, Galicia-Espinosa, F, Garcia-Ramos, J, Yadav, G, Jha, A, Robert-Edan, V, Rodie-Talbere, P, Jain, G, Panda, S, Agarwal, S, Deewan, Y, Hossain, M, Papadas, C, Chantziara, V, Sklavou, C, Hourmant, Y, Grillot, N, Pirracchio, R, Akkari, A, Abdelaty, M, Hashim, A, Launey, Y, Masseret, E, Lasocki, S, Gergaud, S, Mouclier, N, Saxena, S, Agrawal, A, Mishra, S, Samal, S, Cinotti, Raphaël, Mijangos, Julio Cesar, Pelosi, Paolo, Haenggi, Matthia, Gurjar, Mohan, Schultz, Marcus J., Kaye, Callum, Godoy, Daniel Agustin, Alvarez, Pablo, Ioakeimidou, Aikaterini, Ueno, Yoshitoyo, Badenes, Rafael, Suei Elbuzidi, Abdurrahmaan Ali, Piagnerelli, Michaël, Elhadi, Muhammed, Reza, Syed Tariq, Azab, Mohammed Atef, McCredie, Victoria, Stevens, Robert D., Digitale, Jean Catherine, Fong, Nichola, Asehnoune, Karim, Abback, Paër-sélim, Codorniu, Anaï, Citerio, Giuseppe, Sala, Vittoria Ludovica, Astuto, Marinella, Tringali, Eleonora, Alampi, Daniela, Rocco, Monica, Maugeri, Jessica Giuseppina, Bellissima, Agrippino, Filippini, Matteo, Lazzeri, Nicoletta, Cortegiani, Andrea, Ippolito, Mariachiara, Robba, Chiara, Battaglini, Denise, Biston, Patrick, Al-Gharyani, Mohamed Fathi, Chabanne, Russell, Astier, Léo, Soyer, Benjamin, Gaugain, Samuel, Zimmerli, Alice, Pietsch, Ur, Filipovic, Miodrag, Brandi, Giovanna, Bicciato, Giulio, Serrano, Ainhoa, Monleon, Berta, van Vliet, Peter, Gerretsen, Benjamin Marcel, Ortiz-Macias, Iris Xochitl, Oto, Jun, Enomoto, Noriya, Matsuda, Tomomichi, Masui, Nobutaka, Garçon, Pierre, Zarka, Jonathan, Vermeijden, Wytze J., Cornet, Alexander Daniel, Inurrigarro, Sergio Reye, Domínguez, Rafael Cirino Lara, Bellini, Maria Mercede, Haedo, Maria Milagros Gomez, Lamot, Laura, Orquera, Jose, Biais, Matthieu, Georges, Delphine, Baronia, Arvind, Miranda-Ackerman, Roberto Carlo, Barbosa-Camacho, Francisco José, Porter, John, Lopez-Morales, Miguel, Geeraerts, Thoma, Compagnon, Baptiste, Pérez-Torres, David, Prol-Silva, Estefanía, Yahya, Hana Basheer, Khaled, Ala, Ghula, Mohamed, Andrea, Cracchiolo Neville, Daniela, Palma Maria, Deana, Cristian, Vetrugno, Luigi, Chavez, Manuel J. Rivera, Trujillo, Rocio Mendoza, Legros, Vincent, Brochet, Benjamin, Huet, Olivier, Geslain, Marie, van der Jagt, Mathieu, van Steenkiste, Job, Ahmed, Hazem, Coombs, Alexander Edward, Welbourne, Jessie, Pineda, Ana Alicia Velarde, Castillo, Víctor Hugo Nubert, Azab, Mohammed A., Azzam, Ahmed Y., van Meenen, David Michael Paul, Gasca, Gilberto Adrian, Arellano, Alfredo, Galicia-Espinosa, Forttino, García-Ramos, José Carlo, Yadav, Ghanshyam, Jha, Amarendra Kumar, Robert-Edan, Vincent, Rodie-Talbere, Pierre-Andre, Jain, Gaurav, Panda, Sagarika, Agarwal, Sonika, Deewan, Yashbir, Hossain, Md. Mozaffer, Papadas, Christo, Chantziara, Vasiliki, Sklavou, Chrysanthi, Hourmant, Yannick, Grillot, Nicola, Pirracchio, Romain, Akkari, Abdelraouf, Abdelaty, Mohamed, Hashim, Ahmed, Launey, Yoann, Masseret, Elodie, Lasocki, Sigismond, Gergaud, Soizic, Mouclier, Nicola, Saxena, Sulekha, Agrawal, Avinash, Mishra, Shakti Bedanta, Samal, Samir, Intensive Care Medicine, ACS - Pulmonary hypertension & thrombosis, AII - Inflammatory diseases, ACS - Diabetes & metabolism, and ACS - Microcirculation

Subjects
Intensive Care Units, Tracheostomy, Traumatic brain injury, Extubation, Airway Extubation, Humans, Prospective Studies, Brain injury, Critical Care and Intensive Care Medicine, Intra-cranial haemorrhage, Respiration, Artificial
Abstract

Purpose: Neurocritical care patients receive prolonged invasive mechanical ventilation (IMV), but there is poor specific information in this high-risk population about the liberation strategies of invasive mechanical ventilation. Methods: ENIO (NCT03400904) is an international, prospective observational study, in 73 intensive care units (ICUs) in 18 countries from 2018 to 2020. Neurocritical care patients with a Glasgow Coma Score (GCS) ≤ 12, receiving IMV ≥ 24h, undergoing extubation attempt or tracheostomy were included. The primary endpoint was extubation failure by day 5. An extubation success prediction score was created, with 2/3 of patients randomly allocated to the training cohort and 1/3 to the validation cohort. Secondary endpoints were the duration of IMV and in-ICU mortality. Results: 1512 patients were included. Among the 1193 (78.9%) patients who underwent an extubation attempt, 231 (19.4%) failures were recorded. The score for successful extubation prediction retained 20 variables as independent predictors. The area under the curve (AUC) in the training cohort was 0.79 95% confidence interval (CI95) [0.71–0.87] and 0.71 CI95 [0.61–0.81] in the validation cohort. Patients with extubation failure displayed a longer IMV duration (14 [7–21] vs 6 [3–11] days) and a higher in-ICU mortality rate (8.7% vs 2.4%). Three hundred and nineteen (21.1%) patients underwent tracheostomy without extubation attempt. Patients with direct tracheostomy displayed a longer duration of IMV and higher in-ICU mortality than patients with an extubation attempt (success and failure). Conclusions: In neurocritical care patients, extubation failure is high and is associated with unfavourable outcomes. A score could predict extubation success in multiple settings. However, it will be mandatory to validate our findings in another prospective independent cohort.

Published
2022

11. High flow through nasal cannula in exacerbated COPD patients: a systematic review

Author

Federico Longhini, Marinella Astuto, Lara Pisani, Irene Prediletto, Pisani L., Astuto M., Prediletto I., and Longhini F.

Subjects
Pulmonary and Respiratory Medicine, Chronic obstructive pulmonary disease, High flow nasal cannula, Hypercapnia, Non-invasive ventilation, Oxygen, Positive-pressure respiration, Respiratory insufficiency, Respiratory therapy, Exacerbation, medicine.medical_treatment, medicine.disease_cause, Pulmonary Disease, Chronic Obstructive, 03 medical and health sciences, Work of breathing, 0302 clinical medicine, Respiratory Rate, Oxygen therapy, medicine, Humans, 030212 general & internal medicine, Work of Breathing, lcsh:RC705-779, COPD, Noninvasive Ventilation, business.industry, lcsh:Diseases of the respiratory system, medicine.disease, Respiratory acidosis, Treatment Outcome, medicine.anatomical_structure, 030228 respiratory system, Anesthesia, Disease Progression, Acidosis, Respiratory, Blood Gas Analysis, medicine.symptom, business, Nasal cannula, Respiratory tract
Abstract

Chronic Obstructive Pulmonary Disease (COPD) history is characterized by episodes of exacerbation of varying severity, featured by acute worsening of respiratory symptoms, commonly precipitated by respiratory tract infection. The recent ERS/ATS clinical practice guidelines strongly recommend the application of non invasive ventilation (NIV) for patients with acute respiratory failure (ARF) leading to acute or acute-on-chronic respiratory acidosis (pH 7.35) and not for those patients with acute exacerbation of COPD (AECOPD) and hypercapnia who are not acidotic. In recent years, High-Flow through Nasal Cannula (HFNC) has been introduced in the clinical practice.We designed the present systematic review of the literature to assess all effects of HFNC use reported in exacerbated COPD patients. In this setting, HFNC is able to keep PaCO2 unmodified, while oxygenation slightly deteriorates as opposed to NIV. Furthermore, the work of breathing is reduced with HFNC by a similar extent to NIV, while it increases by 40–50% during conventional oxygen therapy (COT). HFNC is also reported to be more comfortable than COT and NIV. Despite these results, little and limited evidence for improved clinical outcomes is currently available. Keywords: Chronic obstructive pulmonary disease, Oxygen, High flow nasal cannula, Non-invasive ventilation, Respiratory therapy, Respiratory insufficiency, Hypercapnia, Positive-pressure respiration

Published
2019

12. Cluster analysis identifies patients at risk of catheter-associated urinary tract infections in intensive care units: findings from the SPIN-UTI Network

Author

Francesca Moretti, Giovanni Battista Orsi, Antonella Agodi, Marina Milazzo, Riccardo Pagliarulo, Cristina Arrigoni, Raffaele Squeri, Anna Maria Longhitano, Ida Mura, MC La Rosa, Emanuela Bissolo, Salvatore Coniglio, Paola Piotti, Salesia Fenaroli, Elena Righi, Cesare Vittori, Giovanni Gallo, Massimo Girardis, Alberto Rigo, Marcello Pasculli, Franco Marinangeli, Leila Fabiani, Aida Bianco, Ennio Sicoli, Marinella Astuto, Maria Pavia, Ignazio Dei, Paolo Marco Riela, Sergio Pintaudi, Giuseppe Manta, Giacomo Castiglione, Marcello Mario D’Errico, Massimo Minerva, Stefano Tardivo, Patrizia Laurenti, Patrizia Bellocchi, Marco Brusaferro, Romano Tetamo, Abele Donati, Albino Borracino, Pierangelo Sarchi, Luca Arnoldo, R Magnano San Lio, Giorgio Scrofani, Antonino Cannistrà, Maria Carmela Riggio, Antonino Di Benedetto, Salvatore Tribastoni, Maria Concetta Monea, Maria Teresa Montagna, Martina Barchitta, A R Mattaliano, Patrizia Farruggia, Irene Pandiani, Paolo Stefanini, Franco Ingala, Silvio Brusaferro, Andrea Maugeri, C La Mastra, Rosario Massimo Di Bartolo, Alberto Carli, Giuliana Favara, Barchitta, M., Maugeri, A., Favara, G., Riela, P. M., La Mastra, C., La Rosa, M. C., Magnano San Lio, R., Gallo, G., Mura, I., Agodi, A., Salesia, F., Ennio, S., Montagna, M. T., Squeri, R., Di Bartolo, R. M., Salvatore, T., Mattaliano, A. R., Bellocchi, P., Castiglione, G., Astuto, M., Longhitano, A. M., Monea, M. C., Scrofani, G., Di Benedetto, A., Carmela, R. M., Manta, G., Tetamo, R., Dei, I., Pandiani, I., Antonino, C., Piotti, P., Girardis, M., Righi, E., Pierangelo, S., Arnoldo, L., Brusaferro, S., Coniglio, S., Albino, B., Pintaudi, S., Minerva, M., Milazzo, M., Bissolo, E., Rigo, A., Fabiani, L., Marinangeli, F., Stefanini, P., D'Errico, M. M., Donati, A., Tardivo, S., Moretti, F., Carli, A., Pagliarulo, R., Bianco, A., Pavia, M., Pasculli, M., Vittori, C., Orsi, G. B., Arrigoni, C., Laurenti, P., Ingala, F., and Farruggia, P.

Subjects
Microbiology (medical), medicine.medical_specialty, Catheters, Urinary system, medicine.medical_treatment, Catheter-associated urinary tract infection, 030501 epidemiology, Urinary catheterization, law.invention, 03 medical and health sciences, Cluster analysis, Interquartile range, law, Internal medicine, Intensive care, Sepsis, Intensive care unit, Risk factor, Cluster Analysis, Humans, Intensive Care Units, Italy, Catheter-Related Infections, Cross Infection, Urinary Tract Infections, medicine, Cluster analysi, Settore MED/42 - IGIENE GENERALE E APPLICATA, 0303 health sciences, 030306 microbiology, business.industry, Incidence (epidemiology), General Medicine, Catheter, Infectious Diseases, 0305 other medical science, business
Abstract

Background: Although preventive strategies have been proposed against catheter-associated urinary tract infections (CAUTIs) in intensive care units (ICUs), more efforts are needed to control the incidence rate. Aim: To distinguish patients according to their characteristics at ICU admission, and to identify clusters of patients at higher risk for CAUTIs. Methods: A two-step cluster analysis was conducted on 9656 patients from the Italian Nosocomial Infections Surveillance in Intensive Care Units project. Findings: Three clusters of patients were identified. Type of admission, patient origin and administration of antibiotics had the greatest weight on the clustering model. Cluster 1 comprised more patients with a medical type of ICU admission who came from the community. Cluster 2 comprised patients who were more likely to come from other wards/hospitals, and to report administration of antibiotics 48 h before or after ICU admission. Cluster 3 was similar to Cluster 2 but was characterized by a lower percentage of patients with administration of antibiotics 48 h before or after ICU admission. Patients in Clusters 1 and 2 had a longer duration of urinary catheterization [median 7 days, interquartile range (IQR) 12 days for Cluster 1; median 7 days, IQR 11 days for Cluster 2] than patients in Cluster 3 (median 6 days, IQR 8 days; P

Published
2021

13. The importance of a 'socially responsible' approach during COVID-19: the invisible heroes of science in Italy

Author

Elena Bignami, Marinella Astuto, Filippo Sanfilippo, Ferdinando Luca Lorini, Sanfilippo, F, Bignami, E, Lorini, F, and Astuto, M

Subjects
2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pneumonia, Viral, Covid19 intensive care, Critical Care and Intensive Care Medicine, Betacoronavirus, Pandemic, Humans, Medicine, Pandemics, biology, SARS-CoV-2, business.industry, Viral Epidemiology, lcsh:Medical emergencies. Critical care. Intensive care. First aid, COVID-19, lcsh:RC86-88.9, biology.organism_classification, medicine.disease, Virology, Pneumonia, Italy, Coronavirus Infections, business
Published
2020

14. Relative Analgesic Potencies of Levobupivacaine and Ropivacaine for Caudal Anesthesia in Children

Author

Pablo Ingelmo, Geoff Frawley, Susan Donath, Antonio Gullo, Marinella Astuto, Roberto Fumagalli, G. Rosano, Nicola Disma, Chris Duffy, Ingelmo, P, Frawley, G, Astuto, M, Duffy, C, Donath, S, Disma, N, Rosano, G, Fumagalli, R, and Gullo, A

Subjects
Male, medicine.medical_specialty, medicine.drug_class, Movement, caudal anesthesia, levobupivacaine, children, Analgesic, Hernia, Inguinal, Sevoflurane, Double-Blind Method, Testis, medicine, Humans, Potency, Ropivacaine, Prospective Studies, Anesthetics, Local, MED/41 - ANESTESIOLOGIA, Child, Pain Measurement, Bupivacaine, Pain, Postoperative, Dose-Response Relationship, Drug, Local anesthetic, business.industry, Infant, Amides, Surgery, Treatment Outcome, Anesthesiology and Pain Medicine, Levobupivacaine, Child, Preschool, Anesthesia, Anesthetic, Regression Analysis, business, Anesthesia, Caudal, Preanesthetic Medication, medicine.drug
Abstract

BACKGROUND: Comparing relative potency of new local anesthetics, such as levobupivacaine and ropivacaine, by the minimum local analgesic concentration model has not been described for caudal anesthesia. Therefore, we performed a prospective, randomized, double-blind study to determine the minimum local analgesic concentrations of a caudal single shot of ropivacaine and levobupivacaine in children and to describe the upper dose-response curve. METHODS: We performed a two-stage prospective, randomized, double-blind study comparing the dose-response curves of caudal ropivacaine and levobupivacaine in children. In phase 1, 80 boys were randomized to receive either ropivacaine or levobupivacaine. In the second phase a further 32 patients were randomly allocated to receive caudal anesthesia with doses designed to delineate the upper dose-response range (the 50% effective dose [ED(50)]-ED(95) range). RESULTS: There were no significant differences in ED(50) values for caudal ropivacaine and levobupivacaine. The ED(50) for levobupivacaine estimated from the Dixon Massey method was 0.069% (95% CI 0.056%-0.082%) and for ropivacaine was 0.075% (95% CI 0.058%-0.092%). Estimated by isotonic regression the ED(50) and ED(95) respectively of levobupivacaine were 0.068 (0.04-0.09) and 0.20% (95% CI 0.16%-0.24%). For ropivacaine ED 50 and ED95 were 0.066 (0.033-0.098) and 0.225% (95% CI 0.21%-0.24%). CONCLUSIONS: In children receiving one minimum alveolar anesthetic concentration of sevoflurane, there were no significant differences in the ED(50) for caudal levobupivacaine and ropivacaine. The potency ratio at ED(50) was 0.92 and 0.89 at ED(95), indicating that caudal levobupivacaine and ropivacaine have a similar potency.

Published
2009

15. The Beneficial Effects of Antioxidant Supplementation in Enteral Feeding in Critically Ill Patients: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial

Author

Ettore Crimi, Claudio Napoli, Anna Maria Molinari, Francesco Della Corte, Marinella Astuto, Vincenzo Sica, Maria Teresa Vietri, Paola Bontempo, Orlando Pignalosa, Mario Condorelli, A. Liguori, M. Cioffi, Crimi, E, Liguori, A, Condorelli, M, Cioffi, Michele, Astuto, M, Bontempo, Paola, Pignalosa, O, Vietri, Maria Teresa, Molinari, Anna Maria, Sica, V, DELLA CORTE, F, and Napoli, Claudio

Subjects
Adult, Male, medicine.medical_specialty, Antioxidant, Isoprostane, Thiobarbituric acid, Critical Illness, medicine.medical_treatment, Placebo-controlled study, Isoprostanes, medicine.disease_cause, Gastroenterology, Enteral administration, Antioxidants, chemistry.chemical_compound, Enteral Nutrition, Double-Blind Method, Internal medicine, TBARS, Humans, Medicine, Prospective Studies, Aged, business.industry, Middle Aged, Oxidative Stress, Anesthesiology and Pain Medicine, Parenteral nutrition, chemistry, Anesthesia, Female, Lipid Peroxidation, business, Oxidative stress
Abstract

We investigated whether intervention with antioxidant vitamins C and E in enteral feeding influenced oxidative stress and clinical outcome in critically ill patients. Two-hundred-sixteen patients expected to require at least 10 days of enteral feeding completed the study. One-hundred-five patients received enteral feeding supplemented with antioxidants, and 111 control patients received an isocaloric formula. Plasma lipoperoxidation (by thiobarbituric acid reactive substances [TBARS] and prostaglandin F(2alpha) isoprostane levels), low-density lipoprotein (LDL) oxidizability, and LDL tocopherol content were determined at baseline and at the end of the 10-day period. The clinical 28-day outcome was also assessed. Plasma TBARS and isoprostanes were 5.33 +/- 1.26 nM/mL and 312 +/- 68 pg/mL, respectively, before treatment and 2.42 +/- 0.61 nM/mL and 198 +/- 42 pg/mL after intervention (P < 0.01 for both comparisons). Antioxidants improved LDL resistance to oxidative stress by approximately 30% (the lag time before treatment was 87 +/- 23 min and was 118 +/- 20 min after treatment; P < 0.04). There was a significantly reduced 28-day mortality after antioxidant intervention (45.7% in the antioxidant group and 67.5% in the regular-feeding group; P < 0.05). Isoprostanes may provide a sensitive biochemical marker for dose selection in studies involving antioxidants.

Published
2004

16. Incidence of pain after craniotomy in children

Author

Fabio Mazzoleni, Laura Minguell del Lungo, Marta Somaini, Nicola Zadra, Massimo Lamperti, Anna Scolari, Valentina Benucci, Elisabetta Lampugnani, Bruno Guido Locatelli, Domenico Pietrini, Francesco Perna, Viviana Prussiani, Federica Tosi, Miriam Tumolo, Pablo Ingelmo, Alfio Bronco, Leonardo Bussolin, Matteo Rota, Catherine E. Ferland, A. Savioli, Michela Cazzaniga, Carlo Giussani, Marinella Astuto, Elena Zeimantz, Luisa Meneghini, Bronco, A, Pietrini, D, Lamperti, M, Somaini, M, Tosi, F, Minguell Del Lungo, L, Zeimantz, E, Tumolo, M, Lampugnani, E, Astuto, M, Perna, F, Zadra, N, Meneghini, L, Benucci, V, Bussolin, L, Scolari, A, Savioli, A, Locatelli, B, Prussiani, V, Cazzaniga, M, Mazzoleni, F, Giussani, C, Rota, M, Ferland, C, and Ingelmo, P

Subjects
Male, medicine.medical_specialty, pain, children, postoperative pain management, craniotomy, pain, children, analgesia, medicine.medical_treatment, Remifentanil, Risk Factors, Medicine, Humans, MED/41 - ANESTESIOLOGIA, Adverse effect, Child, Craniotomy, MED/01 - STATISTICA MEDICA, Pain Measurement, Analgesics, Pain, Postoperative, business.industry, Incidence (epidemiology), Incidence, Codeine, Infant, MED/27 - NEUROCHIRURGIA, Surgery, Anesthesiology and Pain Medicine, Italy, Anesthesia, Child, Preschool, Pediatrics, Perinatology and Child Health, FLACC scale, Morphine, Observational study, Female, business, medicine.drug
Abstract

Summary Background There is very few information regarding pain after craniotomy in children. Objectives This multicentre observational study assessed the incidence of pain after major craniotomy in children. Methods After IRB approval, 213 infants and children who were

Published
2014

17. Epidural analgesia in children: Planning, organization and development of a new program

Author

Ingelmo, P. M., Gelsumino, C., Acosta, A. P., Lopez, V., Gimenez, C., Halac, A., Lira, P., Schon, A., Spagnolo, B., Pignataro, A., Nunez, G., Gamboa, M., Buquicchio, I., marinella astuto, Fumagalli, R., Ingelmo, P, Gelsumino, C, Acosta, A, Lopez, V, Gimenez, C, Halac, A, Lira, P, Schon, A, Spagnolo, B, Pignataro, A, Nunez, G, Gamboa, M, Buquicchio, I, Astuto, M, and Fumagalli, R

Subjects
Male, Patient Care Team, Pain, Postoperative, Adolescent, Epidural analgesia, Contraindications, Argentina, Infant, Bupivacaine, Catheterization, Analgesia, Epidural, Analgesics, Opioid, Fentanyl, Treatment Outcome, children, Child, Preschool, Postoperative Nausea and Vomiting, Humans, Female, Anesthetics, Local, MED/41 - ANESTESIOLOGIA, Child
Abstract

BACKGROUND: The goal of the present work is to describe the development and results of the pediatric epidural analgesia program at the ''Hospital Nacional de Pediatria Prof. Dr. J. P. Garrahan'' in Argentina. METHODS: Patients with thoracotomy, abdominal surgery, osteotomy, amputations or severe trauma were included in the program. The program provided training to the entire staff, control and record of pain treatment and its consequences, 24 h a day availability of anesthesia staff and standard polices and procedures. RESULTS: One hundred fifty children under 16 years of age (median age 11 years, median weight 35 kg) were included in the program during the first 18 months. The median of maximum pain reported during activity was 1 (interquartile range 1 to 4 points) using the Visual Analogue Scale (VAS) or Objective Pain Scale (OPS). Eighty seven children (CI 95% 50% to 67%) presented with postoperative nausea and vomiting, urinary retention, itching, motor blockade or sedation. No patient presented with respiratory depression, hypotension, local anaesthetic toxicity, epidural catheter related infection or death during the program evaluation. The postoperative care program enabled a 98-day reduction in treatment in the intensive care unit. CONCLUSION: The safe use of pediatric epidural analgesia in general wards may require the careful selection of patients, systematic assessment by trained personnel, training of medical and nursing personnel, clear distribution of responsibilities, use of printed indications, systematic record of pain, sedation and complications, information and education of patients and parents, supply of systems for airway resuscitation and management and continuous quality control and revision of the methods.

Published
2007

Catalog

Books, media, physical & digital resources
See catalog results