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323 results on '"Munari, Marina"'

53. Effect of dexmedetomidine on hemodynamic responses to tracheal intubation: A meta-analysis with meta-regression and trial sequential analysis.

Author

De Cassai, Alessandro, primary, Boscolo, Annalisa, additional, Geraldini, Federico, additional, Zarantonello, Francesco, additional, Pettenuzzo, Tommaso, additional, Pasin, Laura, additional, Iuzzolino, Margherita, additional, Rossini, Nicolò, additional, Pesenti, Elisa, additional, Zecchino, Giovanni, additional, Sella, Nicolò, additional, Munari, Marina, additional, and Navalesi, Paolo, additional

Published
2021
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55. A practical guide to patient position and complication management in neurosurgery: a systematic qualitative review.

Author

De Cassai, Alessandro, Geraldini, Federico, Zarantonello, Francesco, Sella, Nicolò, Negro, Sebastiano, Andreatta, Giulio, Salvagno, Michele, Boscolo, Annalisa, Navalesi, Paolo, and Munari, Marina

Subjects
NEUROSURGERY, MEDICAL literature, PATIENT positioning, SUPINE position, ANESTHESIOLOGISTS, MEDICAL screening
Abstract

Adequate patient positioning is of paramount importance in neurosurgery. Complications related to the position are common and make up for more than 16% of the claims towards anaesthesiologists and neurosurgeons. This paper aims to provide the anaesthesiologist with a practical guide to avoid common pitfalls related to the patient positioning process. We performed a systematic review of the medical literature for the identification, screening, and inclusion of articles. The bibliographic search was conducted on June 1st, 2021 by two of the authors. In this review, we included articles indexed by MEDLINE, Cochrane Library, or Google Scholar. We retrieved a total of 5706 unique papers from our initial search. However, after the initial screening, 5363 papers were removed is not related to our research leaving a total of 343 papers. We examined the full text of all the 343 articles including 68 of them in the final qualitative analysis. In this review we examine the most common neurosurgical positions: supine, sitting, lateral, park-bench, prone, jack-knife, and knee-chest. For each of them, the proper positioning and related complications are described. Particular attention is given to the prevention and management of these complications, providing a practical guide for clinicians. [ABSTRACT FROM AUTHOR]

Published
2022
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59. Early management of patients with aneurysmal subarachnoid hemorrhage in a hospital without neurosurgical/neuroendovascular facilities: a consensus and clinical recommendations of the Italian Society of Anesthesia and Intensive Care (SIAARTI)

Author

Picetti, E, Berardino, M, Bertuccio, A, Bertuetti, R, Boccardi, E, Caricato, A, Castioni, C, Cenzato, M, Chieregato, A, Citerio, G, Gritti, P, Longhi, L, Martino, C, Munari, M, Rossi, S, Stocchetti, N, Zoerle, T, Rasulo, F, Robba, C, Picetti, Edoardo, Berardino, Maurizio, Bertuccio, Alessandro, Bertuetti, Rita, Boccardi, Edoardo Pietro, Caricato, Anselmo, Castioni, Carlo Alberto, Cenzato, Marco, Chieregato, Arturo, Citerio, Giuseppe, Gritti, Paolo, Longhi, Luca, Martino, Costanza, Munari, Marina, Rossi, Sandra, Stocchetti, Nino, Zoerle, Tommaso, Rasulo, Frank, Robba, Chiara, Picetti, E, Berardino, M, Bertuccio, A, Bertuetti, R, Boccardi, E, Caricato, A, Castioni, C, Cenzato, M, Chieregato, A, Citerio, G, Gritti, P, Longhi, L, Martino, C, Munari, M, Rossi, S, Stocchetti, N, Zoerle, T, Rasulo, F, Robba, C, Picetti, Edoardo, Berardino, Maurizio, Bertuccio, Alessandro, Bertuetti, Rita, Boccardi, Edoardo Pietro, Caricato, Anselmo, Castioni, Carlo Alberto, Cenzato, Marco, Chieregato, Arturo, Citerio, Giuseppe, Gritti, Paolo, Longhi, Luca, Martino, Costanza, Munari, Marina, Rossi, Sandra, Stocchetti, Nino, Zoerle, Tommaso, Rasulo, Frank, and Robba, Chiara

Abstract

Background: The immediate management of subarachnoid hemorrhage (SAH) patients in hospitals without neurosurgical/neurointerventional facilities and their transfer to a specialized center is challenging and not well covered in existing guidelines. To address these issues, we created a consensus of experts endorsed by the Italian Society of Anesthesia and Intensive Care (SIAARTI) to provide clinical guidance. Methods: A multidisciplinary consensus panel composed by 19 physicians selected for their established clinical and scientific expertise in the acute management of SAH patients with different specializations (anesthesia/intensive care, neurosurgery and interventional neuroradiology) was created. A modified Delphi approach was adopted. Results: A total of 14 statements have been discussed. Consensus was reached on 11 strong recommendations and 2 weak recommendations. In one case, where consensus could not be agreed upon, no recommendation could be provided. Conclusions: Management of SAH in a non-specialized setting and early transfer are difficult and may have a critical impact on outcome. Clinical advice, based on multidisciplinary consensus, might be helpful. Our recommendations cover most, but not all, topics of clinical relevance

Published
2021

61. Effect of a lung protective strategy for organ donors on eligibility and availability of lungs for transplantation

Author

Mascia, Luciana, Pasero, Daniela, Slutsky, Arthur S., Arguis, M. Jose, Berardino, Maurizio, Grasso, Salvatore, Munari, Marina, Boifava, Silvia, Cornara, Giuseppe, Corte, Francesco Della, Vivaldi, Nicoletta, Malacarne, Del Gaudio, Paolo, Livigni, Sergio, Zavala, Elisabeth, Filippini, Claudia, Martin, Erica L., Donadio, Pier Paolo, Mastromauro, Ilaria, and Ranieri, V. Marco

Subjects
Organ donors -- Physiological aspects, Organ donors -- Health aspects, Ventilators -- Usage, Lungs -- Transplantation, Lungs -- Methods, Lungs -- Health aspects
Abstract

The study attempts to evaluate whether the prevalence of a lung protective strategy for organ donors helps increase the eligibility and availability of lungs for transplantation. The results indicate that such a strategy was far more effective than convention strategy in making more lungs available for transplantation.

Published
2010

62. Risk Factors for General Anesthesia Conversion in Anterior Circulation Stroke Patients Undergoing Endovascular Treatment.

Author

Geraldini, Federico, De Cassai, Alessandro, Napoli, Margherita, Marini, Silvia, De Bon, Feliciana, Sergi, Massimo, Pasin, Laura, Correale, Christelle, Gabrieli, Joseph Domenico, Cester, Giacomo, Viaro, Federica, Pieroni, Alessio, Causin, Francesco, Baracchini, Claudio, Navalesi, Paolo, and Munari, Marina

Subjects
ENDOVASCULAR surgery, STROKE patients, CONSCIOUS sedation, ISCHEMIC stroke, LOCAL anesthesia, GENERAL anesthesia, BASILAR artery
Abstract

Background and Purpose: No current consensus exists on the best anesthetic management of ischemic stroke patients undergoing mechanical thrombectomy. Both conscious sedation (CS) and general anesthesia (GA) are currently considered valid anesthetic strategies, yet patients managed under CS may require emergent conversion to GA, which has been associated with worse outcomes. The aim of this study was to analyze the conversion rate and potential risk factors for GA conversion during mechanical thrombectomy. Methods: Two-hundred and twenty-seven patients with consecutive acute anterior circulation ischemic stroke treated with mechanical thrombectomy and initiated under CS or local anesthesia were included in this retrospective analysis. Conversion rate to GA was calculated, while univariate and multivariate analysis were used to identify risk factors. Results: Twenty patients (8.8%) were switched to GA. Multivariate analysis identified procedure duration (odds ratio [OR] 1.01, 95% confidence interval [CI] 1.00–1.02, p value 0.028), tandem stroke (OR 8.57, 95% CI 2.06–35.7, p value 0.003), Sequential Organ Failure Assessment (SOFA) (OR 1.76, 95% CI 1.19–2.61, p value 0.005), and number of pharmacological agents used (OR 5.76, 95% CI 2.49–13.3, p value <0.001) as independently associated with conversion to GA. Conclusion: In our study, tandem occlusion, longer endovascular procedures, SOFA, and number of pharmacological agents used predicted the risk of emergent conversion to GA in stroke patients undergoing endovascular treatment. Prospective studies investigating optimal CS strategies are deemed necessary. [ABSTRACT FROM AUTHOR]

Published
2022
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63. SARS-CoV-2 pandemic impact on traumatic brain injury epidemiology: an overview of the Veneto region

Author

MUNARI, Marina, primary, DE CASSAI, Alessandro, additional, CASARTELLI LIVIERO, Marilena, additional, ZANATTA, Paolo, additional, MARTIN, Marina A., additional, SORAGNI, Alessandra, additional, MAIORELLI, Giorgio, additional, BENETTON, Claudio, additional, DALL’ACQUA, Guido, additional, CHIOFFI, Franco, additional, and NAVALESI, Paolo, additional

Published
2021
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70. Developing an instrument for an early prediction model of long-term functional outcomes in people with acquired injuries of the central nervous system: protocol and methodological aspects

Author

Masiero, Stefano, primary, Cerrel Bazo, Humberto Antonio, additional, Rattazzi, Marcello, additional, Bernardi, Laura, additional, Munari, Marina, additional, Faggin, Elisabetta, additional, Cattelan, Manuela, additional, Pauletto, Paolo, additional, and Del Felice, Alessandra, additional

Published
2020
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72. Retrospective Analysis of a Modified Organizational Model to Guarantee CT Workflow during the COVID-19 Outbreak in the Tertiary Hospital of Padova, Italy

Author

Cester, Giacomo, primary, Giraudo, Chiara, additional, Causin, Francesco, additional, Boemo, Deris Gianni, additional, Anglani, Mariagiulia, additional, Capizzi, Alfio, additional, Carretta, Giovanni, additional, Cattelan, Annamaria, additional, Cecchin, Diego, additional, Cianci, Vito, additional, Crisanti, Andrea, additional, De Conti, Giorgio, additional, Donato, Daniele, additional, Flor, Luciano, additional, Gabrieli, Joseph-Domenico, additional, Munari, Marina, additional, Navalesi, Paolo, additional, Ponzoni, Alberto, additional, Scapellato, Maria Luisa, additional, Tiberio, Ivo, additional, Vianello, Andrea, additional, and Stramare, Roberto, additional

Published
2020
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75. Serratus anterior plane block for video-assisted thoracoscopic surgery

Author

De Cassai, Alessandro, primary, Boscolo, Annalisa, additional, Zarantonello, Francesco, additional, Piasentini, Eleonora, additional, Di Gregorio, Guido, additional, Munari, Marina, additional, Persona, Paolo, additional, Zampirollo, Stefano, additional, Zatta, Matteo, additional, and Navalesi, Paolo, additional

Published
2020
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83. Astensione vs interruzione

Author

Azzalini, Marco, Faralli, Carla, and Munari, Marina

Subjects
Azione, interruzione, trattamento sanitario, condotta, diritti della persona, relazione di cura, Settore IUS/01 - Diritto Privato
Published
2019

84. Explanation of trial sequential analysis: using a post-hoc analysis of meta-analyses published in Korean Journal of Anesthesiology.

Author

De Cassai, Alessandro, Tassone, Martina, Geraldini, Federico, Sergi, Massimo, Sella, Nicolò, Boscolo, Annalisa, and Munari, Marina

Subjects
SEQUENTIAL analysis, FALSE positive error, PERIODICAL publishing, SAMPLE size (Statistics), ANESTHESIOLOGY
Abstract

Background: Trial sequential analysis (TSA) is a recent cumulative meta-analysis method used to weigh type I and II errors and to estimate when the effect is large enough to be unaffected by further studies. The aim of this study was to illustrate possible TSA scenarios and their significance using meta-analyses published in the Korean Journal of Anesthesiology (KJA) as working material. Methods: We performed a systematic medical literature search for meta-analyses published in the KJA. TSA was performed on each main outcome, estimating the required sample size on the calculated effect size for the intervention, considering a type I error of 5% and a power of 90% or 99%. Results: Six meta-analyses with a total of ten main outcomes were included in the analysis. Seven TSAs confirmed the results of the meta-analyses. However, only three of them reached the required sample size. In the two TSAs, the cumulative z-lines were not statistically significant. One TSA boundary for effect was reached with the 90% analysis, but not with the 99% analysis. Conclusions: In TSA, a meta-analysis pooled effect may be established to assess if the cumulative sample size is large enough. TSA can be used to add strength to the conclusions of meta-analyses; however, pre-registration of the TSA protocol is of paramount importance. This study could be useful to better understand the use of TSA as an additional statistical tool to improve meta-analysis quality. [ABSTRACT FROM AUTHOR]

Published
2021
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88. Pharmacokinetics of lidocaine after bilateral ESP block.

Author

De Cassai, Alessandro, Bonanno, Claudio, Padrini, Roberto, Geraldini, Federico, Boscolo, Annalisa, Navalesi, Paolo, and Munari, Marina

Abstract

Introduction: Erector spinae plane (ESP) block is an emerging interfascial block with a wide range of indications for perioperative analgesia and chronic pain treatment. Recent studies have focused their attention on mechanisms of action of ESP block. However, the pharmacokinetics of drugs injected in ESP is, as of now, uninvestigated. The aim of this brief report is to investigate the pharmacokinetics of lidocaine in a series of 10 patients.Methods: We are reporting a case series of 10 patients undergoing bilateral ESP block for multilevel lumbar spine surgery.ESP was performed with 3.5 mg/kg of lidocaine based on ideal body weight. Lidocaine concentration was dosed at 5, 15, 30 min and at 1, 2 and 3 hours.Results: Tmax was 5 min for all the patients. Cmax ranged from 1.2 to 3.8 mg/L (mean: 2.59 mg/L). AUC0-3 was high (76%, on average) suggesting an almost complete bioavailability. Age had a negative correlation with T½ of lidocaine.Conclusions: Lidocaine pharmacokinetic after ESP block is well-described by a two-compartment model with a rapid and extensive rate of absorption. Nevertheless, its peak concentrations never exceeded the accepted toxicity limit. Elimination half-life was slightly prolonged, probably due to the advanced age of some patients. [ABSTRACT FROM AUTHOR]

Published
2021
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90. Italian COnsensus in Neuroradiological Anesthesia (ICONA)

Author

Castioni, Carlo A., Amadori, Andrea, Bilotta, Federico, Bolzon, Moreno, Barboni, Edoardo, Caricato, Anselmo, Dall'Acqua, Guido, Di Paola, Francesco, Molinari, Andrea Forastieri, Gritti, Paolo, La Rosa, Italia, Longo, Marcello, Maglione, Carla, Martorano, Pietro, Munari, Marina, Perotti, Valerio, Rasulo, Frank, Ruggiero, Maria, Santoro, Antonio, Scudeller, Luigia, Tumolo, Miriam, Mazzeo, Anna T., Caricato, Anselmo (ORCID:0000-0001-5929-120X), Perotti, Valerio (ORCID:0000-0001-9461-2101), Castioni, Carlo A., Amadori, Andrea, Bilotta, Federico, Bolzon, Moreno, Barboni, Edoardo, Caricato, Anselmo, Dall'Acqua, Guido, Di Paola, Francesco, Molinari, Andrea Forastieri, Gritti, Paolo, La Rosa, Italia, Longo, Marcello, Maglione, Carla, Martorano, Pietro, Munari, Marina, Perotti, Valerio, Rasulo, Frank, Ruggiero, Maria, Santoro, Antonio, Scudeller, Luigia, Tumolo, Miriam, Mazzeo, Anna T., Caricato, Anselmo (ORCID:0000-0001-5929-120X), and Perotti, Valerio (ORCID:0000-0001-9461-2101)

Abstract

Anesthetic management of patients undergoing endovascular procedures for treating intracranial aneurysms or cerebrovascular malformations must consider a number of specific challenges, in addition to those associated with anesthesia for other specialties. In addition to maintenance of physiological stability, manipulation of systemic and cerebral hemodynamic parameters may be required to treat any sudden unexpected catastrophic neurological events. A multidisciplinary group including neuro- and pediatric anesthesiologists, interventional neuroradiologists, neurosurgeons, and a clinical methodologist contributed to this document. This consensus working group from 21 Italian institutions identified open questions regarding the best practices for management of anesthesia during endovascular neuroradiological procedures for intracranial aneurysms and cerebrovascular malformations, and addressed these by formulating practical consensus statements. At the first meeting in November 2015, nine key areas were identified regarding choice of anesthetic, patient monitoring, hemodynamic targets, postoperative care, and the management of neuromuscular blockade, anticoagulant and/or antiplatelet therapy, and special considerations for pediatric patients. Nine subgroups were established and a medical librarian performed literature searches in the Cochrane and MEDLINE/PubMed databases for each group. Groups drafted literature summaries and provisional responses in the form of candidate consensus statements based on evidence, when possible, and clinical experience, when this was lacking. Final wording was agreed at a meeting in April 2016 and where possible evidence was graded using United States Preventive Services Task Force criteria. Consensus (defined as >90% agreement) was based on evidence, clinical experience, clinician preference, feasibility in the Italian healthcare system, and cost/benefit considerations.

Published
2017

96. Predictive value of intraoperative 5-aminolevulinic acid–induced fluorescence for detecting bone invasion in meningioma surgery

Author

Della Puppa, Alessandro, primary, Rustemi, Oriela, additional, Gioffrè, Giorgio, additional, Troncon, Irene, additional, Lombardi, Giuseppe, additional, Rolma, Giuseppe, additional, Sergi, Massimo, additional, Munari, Marina, additional, Cecchin, Diego, additional, Gardiman, Marina Paola, additional, and Scienza, Renato, additional

Published
2014
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