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

Author

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

Abstract

Background: During the first coronavirus disease 2019 (COVID-19) pandemic wave, an unprecedented number of patients with respiratory failure due to a new, highly contagious virus needed hospitalization and intensive care unit (ICU) admission. The aim of the present study was to describe the communication and visiting policies of Italian intensive care units (ICUs) during the first COVID-19 pandemic wave and national lockdown and compare these data with prepandemic conditions. Methods: A national web-based survey was conducted among 290 Italian hospitals. Each ICU (active between February 24 and May 31, 2020) was encouraged to complete an individual questionnaire inquiring the hospital/ICU structure/organization, communication/visiting habits and the role of clinical psychology prior to, and during the first COVID-19 pandemic wave. Results: Two hundred and nine ICUs from 154 hospitals (53% of the contacted hospitals) completed the survey (202 adult and 7 pediatric ICUs). Among adult ICUs, 60% were dedicated to COVID-19 patients, 21% were dedicated to patients without COVID-19 and 19% were dedicated to both categories (Mixed). A total of 11,102 adult patients were admitted to the participating ICUs during the study period and only approximately 6% of patients received at least one visit. Communication with family members was guaranteed daily through an increased use of electronic devices and was preferentially addressed to the same family member. Compared to the prepandemic period, clinical psychologists supported physicians more often regarding communication with family members. Fewer patients received at least one visit from family members in COVID and mixed-ICUs than in non-COVID ICUs, l (0 [0-6]%, 0 [0-4]% and 11 [2-25]%, respectively, p < 0.001). Habits of pediatric ICUs were less affected by the pandemic. Conclusions: Visiting policies of Italian ICUs dedicated to adult patients were markedly altered during the first COVID-19 wave. Remote communication was wi

Published
2022

6. General anaesthesia versus local anaesthesia for carotid surgery (GALA): a multicentre, randomised controlled trial

Author

GALA Trial Collaborative Group, C Lewis, S, P Warlow, C, R Bodenham, A, Colam, B, M Rothwell, P, Torgerson, D, Dellagrammaticas, D, Horrocks, M, Liapis, C, P Banning, A, Gough, M, J Gough, M, Fraser, A, Grant, S, Hunter, J, Leigh-Brown, A, Paterson, M, Soosay, V, Young, A, Williamson, A, Dean, Z, Mazzoli, T, Ricci, S, Valenti, D, Bamford, J, Beard, J, Dearden, M, Murray, G, Ruckley, V, E Norman, P, Sedivy, P, Idla, A, Schmitz-Rixen, T, Maritati, G, Bodenham, A, Cokic, N, Doppler, W, Hlatky, P, Koelblinger, C, Raith, C, Zölss, C, Dimmitt, S, Gharbi, R, Hankey, G, Maden, A, P Mwipatayi, B, Sieunarine, K, Tan, A, Turner, G, Wesseldine, A, T M, E Davis, Audzei, P, Davidovski, I, Dedul, D, Hetsiuk, A, Kornievich, S, Gao, J, Y-G, Huang, Jing, G, H, Li, Y-J, Li, Liu, B, C-W, Liu, J-D, Wu, W, Ye, C-H, Yu, Ban, T, Buljan, K, Candrlic, K, Dapic, D, Ilijasevic, M, Istvanic, T, Kovac, B, Kvolik, S, Lehner, V, Pinotic, K, Hudorović, N, Ivanec, Z, Lovricević, I, Mazul-Sunko, B, Novotny, Z, D De Syo, Vuković, V, Biebl, O, Dolecek, L, C El Samman, Kalasova, H, Kubricht, V, Matous, P, Michalek, P, Stajnrt, M, Stern, M, Svec, M, Vitasek, P, Vrzal, J, Weiss, K, Janousek, L, Kieslichova, E, Mazarova, V, Piza, P, Vychodil, P, Dulovcova, V, Fiksa, J, Hruby, J, Maresch, M, Mathias, M, Rubes, D, Tosenovsky, P, Vidim, T, Henzl, M, Riman, J, Ziegler, Z, Drabek, P, Hrbac, T, Reguli, S, Stigler, J, Bachleda, P, Drac, P, Hudecek, M, Koutna, J, Sanak, D, Utikal, P, Goldemund, D, Gregor, Z, Pavlikova, J, Podlaha, J, Privara, M, Staffa, R, Vlachovsky, R, Barankova, L, Chlouba, V, Fiedler, J, Prazak, P, Priban, V, Wierer, A, Ellervee, T, Järve, H, Sell, A, Taba, P, Kolbassov, V, Kullamaa, S, Paavel, T, Abramishvili, N, Bokuchava, M, Kachapuridze, N, Kipiani, K, Papashvili, K, Pargalava, N, Adili, F, Dietz, A, Neidhart, G, Nentwig, G, M Sitzer, O, Beno, M, Essink-Hassels, M, Lander, K, Ruemenapf, G, Breuer, P, Heldt, R, Melichar, G, Rieper, J, H Eckstein, H, Poppert, H, Schneider, G, Andrikopoulos, V, Angel, A, Bakogiannis, K, Dermitzaki, M, Georgakis, P, Lioupis, C, Maras, D, G Moulakakis, K, Sfyroeras, G, Arato, E, Gyevnar, Z, Hardi, P, Kasza, G, Kollar, L, Menyhei, G, Pal, E, Sinay, L, Verzar, Z, Volgyi, E, S Elmakias, S, Harah, E, Kristal, K, Lebi, D, Leonty, Y, Levy, D, Milo, R, Yoffe, B, Bissi, M, Cappellini, B, Cassamali, T, Corino, L, Denkewitz, T, Ghilardi, G, Massetto, N, P Di Mauro, Tommasino, C, Bartolucci, R, Buffa, V, M Corsi, F, D'Avino, E, F Di Cesare, L Di Pirro, Lappa, A, Luzzi, S, Menichetti, A, Nesi, F, Pannone, A, Picozzi, P, Pogany, G, Rabitti, G, Severi, L, Avella, R, Biandolino, P, P Giomarelli, P, R Monfregola, M, Palasciano, G, Peccianti, V, Pieragalli, D, Setacci, C, Setacci, F, Sirignano, P, Bordoni, M, Casadei, V, Cugnasca, M, A De Troia, Geremia, L, Guffanti, P, G Lo Guercio, V Maniaci, M, Mauri, Morbidelli, A, Aletta, A, Costanzo, E, D'Arrigo, G, F Di Stefano, Lomeo, A, Maugeri, S, C Monea, M, Scardavilli, G, Scolaro, A, Aloisi, P, Ciccozzi, A, Manno, M, Marrelli, A, Martinazzo, C, Mastromarino, A, Petrassi, C, Piroli, A, Spartera, C, Ventura, M, Alessandrini, F, Carissimi, C, M Centritto, E, Cinelli, G, C De Filippo, Liberatoscioli, G, Modugno, P, Rossi, M, T Attanzio, M, Bajardi, G, Bellisi, M, Machi, P, Salemi, S, Savettieri, G, A Crea, M, V di Lazzaro, Ferrante, A, Guarneri, S, Manni, R, Snider, F, Stefanuto, C, Berardi, G, Bianchi, A, Comis, M, Cumbo, P, Fadde, M, Ferrero, E, Ferri, M, Filardo, A, Gaggiano, A, Ganzaroli, M, Labate, C, Maggio, D, Mennuti, G, Minicucci, S, Musso, A, Nessi, F, Pasquino, M, Perretta, L, Piazza, S, Verdecchia, C, Viazzo, A, Antico, A, Battan, E, Ciarlo, M, Giardini, G, G Luca Iob, Marinello, C, Piccolo, D, Bove, R, Castrucci, T, Lorido, A, Sammarco, S, Bruzzone, B, Cannata, D, Colotto, P, Finocchi, C, Giudici, N, Mambrini, S, Mazzei, R, Palombo, D, Pellegrino, A, Rousas, N, Viacava, A, Ermirio, D, Faga, D, Simoni, G, Benedetti-Valentini, F, Gabrielli, R, Garofano, R, Gossetti, B, Guerricchio, R, Irace, L, Lenzi, G, Gedins, M, Kisis, K, Krievins, D, Krustina, I, Lietuvietis, E, Malina, M, Morlata, N, Rits, J, Thor, S, Ivanova, P, Kikule, I, Liepa, V, Ligers, A, Stengrevica, N, Vnukova, N, Zvirgzdins, V, P J A, M Brouwers, H Geelkerken, R, Stam, A, M A, M Simon, T den Hoed, P, Oltmans, M, Rettig, H, F Veen, H, Zuidgeest, D, Feldo, M, Kesik, J, Kobusiewicz, W, Łatkiewicz, D, Myślinski, W, Przywara, S, Terlecki, P, Wroński, J, Zubilewicz, T, Alfonso, G, Azevedo, E, R de Albuquerque, Mansilha, A, Al-Salman, M, K Aldaif, A, A Alnasr, T, A El Dawlatly, A, Elkayali, A, M Rabee, H, Chudikova, E, Chudá, I, Dulka, T, Goldenberg, Z, Lofaj, P, Pavlikova, M, Pisar, M, Sefranek, V, Slysko, R, Tomka, J, Tóthová, Z, Zita, Z, A Cairols, M, Iborra, E, Mercadal, M, Rubio, F, Canovas, D, Cobo, L, Gimenez-Gaibar, A, Gonzalez, E, Gonzalo, B, Guilera, N, Hospedales, J, J Laso, M, Perez, J, Solanich, T, Hensater, M, Karlström, L, Kjällman, L, Rosengren, L, C-A, Ewaldsson, Gillgren, P, T-B, Käll, Konrad, P, Lindkvist, M, Nilsson, L, Takolander, R, E von Zweigbergk, Cinar, B, Coruh, T, Kurc, E, Ozsoy, D, Sargin, M, Tutkavul, K, Yekeler, I, Aksoy, M, Aksoy, S, Kurtoglu, M, Arar, C, Canbaz, S, Celik, Y, Ege, T, Ketenc, S, Sunar, H, Unal, S, Asik, I, Bengisun, U, Koksoy, C, Yucemen, N, C Berridge, D, Caldicott, L, Cooper, J, Cross, M, Ford, H, Fuller, R, Gamlin, F, Homer-Vanniasinkum, S, Howell, S, Kent, P, Lumb, A, A I, D Mavor, D J, A Scott, Shah, M, Wanklyn, P, S Budd, J, Mcateer, P, Shaw, L, Dewar, R, H Lewis, M, Potter, C, Richards, H, Roberts, R, Townsend, E, Wagle, A, Woodford, P, Hall, G, Holdsworth, R, Macleod, M, Michels, L, P A, G Sandercock, Sudlow, C, Woods, A, S Abraham, J, Bukhari, M, Bush, A, Calvey, J, Chadwick, I, Krishnaprasad, K, Oldham, T, Tomlinson, M, Vickers, A, Wilson, D, Wilson, P, Greystone, S, C Grocott, E, Hayes, W, Haynes, S, Jenkins, C, Jenkins, D, Moore, W, Nyamekye, I, Overstall, P, Riseboro, S, Williams, H, Boyle, J, Duane, D, Gaunt, M, J Kirkpatrick, P, Martin, P, E Risdall, J, Scurrah, N, L Turner, C, Varty, K, T Ferguson, I, Horsfall, S, C Mitchell, D, Robinson, S, Frankel, J, E Morris, G, Phillips, M, Sansome, A, J Sparkes, D, Williams, J, Ashton, W, Baker, S, Clark, M, G Darke, S, Dunnill, R, Hargreaves, M, Jenkinson, D, Thomson, C, White, N, D Wijesinghe, L, Bapat, P, A Barrett, J, D Blair, S, Chandrasekar, R, Lawrence, G, Lowe, D, Sangster, G, Smith, M, M Van Miert, K Das, S, Malik, O, Nel, M, Rakowicz, W, Aukett, M, Carmichael, M, Colchester, A, R Taylor, P, Wood, C, Ageed, A, J Boom, S, Ghosh, S, Godfrey, J, Hewitt-Gray, J, Mcdiarmid, I, Yousif, S, Ziarkowski, A, Al-Din, A, Carpenter, M, Ch'Ng, K, J Curley, P, Davey, R, Henderson, B, F Hossain, J, D Irvine, C, Loizou, L, Main, A, Stanners, A, Muldoon, T, V Soong, C, Wiggam, I, P Armon, M, Burrows, M, Holmes, L, K Metcalf, A, Nunn, D, Abdul-Hamid, A, Akomalafe, B, Bryce, J, Chetter, I, Samaan, A, Briley, D, Collin, J, Darby, C, Dobson, M, Foex, P, Grange, C, Handa, A, Hands, L, E Higham, H, J M, T Perkins, Sear, J, Stoneham, M, Hamilton, G, Judge, C, Morris-Vincent, P, Pegg, M, A Wilson, L, I Aldoori, M, B E, A Dafalla, Kumar, N, I F, C Hay, Jefferson, P, Muir, I, Peel, W, Rutherford, J, Sathianathan, J, Wight, S, Williams, D, Wrathall, W, Bachoo, P, Brittenden, J, Counsell, C, Patey, R, Read, J, L de Cossart, K Dimitri, S, Edwards, P, Fergusson, N, Jameson, P, Somauroo, J, Taylor, V, D Aravindan, P, Brocklehurst, I, Mirza, S, N Namushi, R, O Oshodi, T, Ruff, D, A Solomon, S, Vassallo, J, Egbe, M, Halstead, G, Onwudike, M, Putland, A, Roberts, N, A Salaman, R, Watson, D, Caine, S, Day, J, Lamont, P, J Murphy, P, Smith, F, Beacham, K, J Dorman, P, Lambert, D, Rodgers, H, Collas, D, Sarin, S, Shah, J, S Baht, H, Banks, J, Cowie, L, Gunathilagan, G, Hargroves, D, Insall, R, G Smithard, D, K Chadha, D, R Pillay, W, Rashid, J, Sayles, J, Hill, S, Lawton, G, M Lloyd, C, Marsh, A, Clarke, G, J Lonsdale, R, Venables, G, Cross, R, Lord, B, Mcilmoyle, J, Y Osman, H, Robinson, J, Chant, H, Mate, A, Sim, D, Upton, P, Thomas, D, H Wolfe, J, Mccollum, C, O'Neill, P, Bernatsky, V, Bondar, L, Karpenko, A, Mamonova, M, Muz, N, and Yavorsky, V

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Carotid endarterectomy, general anesthesia, local anesthesia, carotid surgery, Anesthesia, General, law.invention, Postoperative Complications, Randomized controlled trial, law, medicine, Humans, Carotid Stenosis, General anaesthesia, general anaesthesia, Stroke, Aged, Endarterectomy, Endarterectomy, Carotid, local anaesthesia, Intention-to-treat analysis, business.industry, General Medicine, Perioperative, Vascular surgery, medicine.disease, Surgery, Anesthesia, Female, business, Anesthesia, Local
Abstract

BACKGROUND: The effect of carotid endarterectomy in lowering the risk of stroke ipsilateral to severe atherosclerotic carotid-artery stenosis is offset by complications during or soon after surgery. We compared surgery under general anaesthesia with that under local anaesthesia because prediction and avoidance of perioperative strokes might be easier under local anaesthesia than under general anaesthesia. METHODS: We undertook a parallel group, multicentre, randomised controlled trial of 3526 patients with symptomatic or asymptomatic carotid stenosis from 95 centres in 24 countries. Participants were randomly assigned to surgery under general (n=1753) or local (n=1773) anaesthesia between June, 1999 and October, 2007. The primary outcome was the proportion of patients with stroke (including retinal infarction), myocardial infarction, or death between randomisation and 30 days after surgery. Analysis was by intention to treat. The trial is registered with Current Control Trials number ISRCTN00525237. FINDINGS: A primary outcome occurred in 84 (4.8%) patients assigned to surgery under general anaesthesia and 80 (4.5%) of those assigned to surgery under local anaesthesia; three events per 1000 treated were prevented with local anaesthesia (95% CI -11 to 17; risk ratio [RR] 0.94 [95% CI 0.70 to 1.27]). The two groups did not significantly differ for quality of life, length of hospital stay, or the primary outcome in the prespecified subgroups of age, contralateral carotid occlusion, and baseline surgical risk. INTERPRETATION: We have not shown a definite difference in outcomes between general and local anaesthesia for carotid surgery. The anaesthetist and surgeon, in consultation with the patient, should decide which anaesthetic technique to use on an individual basis. FUNDING: The Health Foundation (UK) and European Society of Vascular Surgery.

Published
2008

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

Author

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

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

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

Published
2022

14. Anticipo de jubilación en Italia: entre sustenibilidad financiera y solidaridad intergeneracional

Author

BOLOGNA, S., Baylos Grau, A., Escanciano, S., Vadillo Ruiz, J., Azor Oliver, A.G., Ballester Pastor, I., Blasco C., Diosdado P. B., Cervilla M. J., Mordillo M. A., Vidales, C., Charro Baena, P., Jover, C., del Carmen, M., Martin Munoz, M. R., Revuelta, M., Salcedo, C., Prieto, C., de Vicente, F., Aibar Bernard., J., Errandonea, E., Ulazia, E., Bernat, J., Arrieta, F, J., Bologna, S., del Carmen Burgos, M., Moreno, A., D'Avino, E., Fernandez, S., Gallego Rosada, R., Vivancos, J., Pérez, M., Dorna, E., Kahale, D., Martinez, J., Serrano, E., Vazquez, M., Portugués, F., del Prado, D., Vila Tierno, F., Bravo, C., de Lena, F., Redondo, M. G., Nebreda, C.G., Corujo, B., Mateo, C.J., Quintero Lima, M.G., Campbell, K.M., and BOLOGNA, S.

Subjects
Settore IUS/07 - Diritto Del Lavoro, Pensiones, Italia, "quota cento", sustenibilidad financiera, solidaridad intergeneracional, Pensions, Italy, "quota cento", financial sustainability, intergenerational solidarity
Abstract

The essay focuses on the recent reform of the Italian pensions system ("quota cento") and it puts in evidence the criticalities of the reform having regard to its financial sustainability and to the principle of intergenerational solidarity. El ensayo analiza la reciente reforma al sistema de pensiones italiano ("quota cento") subrayando sus criticidades desde la doble vertiente de la sustenibilidad financiera y de la solidaridad intergeneracional.

Published
2019

15. Pace e diritti umani

Author

TRUJILLO PEREZ, Isabel Ascension, Michele D'Avino e Ugo De Siervo, and Trujillo Perez, IA

Subjects
Settore IUS/20 - Filosofia Del Diritto, Pace, diritti umani, giustizia
Abstract

Si esaminano le relazioni non lineari tra pace e diritti umani nella seconda metà del Novecento. I diritti, nati con il proposito di evitare la guerra, sono diventati invece nemici della pace.

Published
2017

17. Rabtat harìr... khàlis

Author

VIVIANI, Paola, AA.VV., Maria Avino e Isabella Camera d'Afflitto, and Viviani, Paola

Published
2009

18. al-Shabah wa 'l-zanzana

Author

VIVIANI, Paola, AA.VV., Maria Avino e Isabella Camera d'Afflitto, and Viviani, Paola

Published
2008

19. al-Sadà

Author

VIVIANI, Paola, AA.VV., Maria Avino e Isabella Camera d'Afflitto, and Viviani, Paola

Published
2008

20. Asfùr al-thalg

Author

VIVIANI, Paola, AA.VV., Maria Avino e Isabella Camera d'Afflitto, and Viviani, Paola

Published
2008

21. al-Khashabah

Author

VIVIANI, Paola, AA.VV., M. Avino e I. Camera d'Afflitto, and Viviani, Paola

Published
2008

22. A Redo Percutaneous Emergency Intervention of Left Ventricular Assist Device Graft Occlusion.

Author

Stio RE, Comisso M, Paolucci L, Coletta S, Cesario V, Gioia M, Nazzaro MS, Saitto G, Contento C, D'Avino E, De Felice F, Gabrielli D, and Musumeci F

Subjects
Aged, Humans, Male, Quality of Life, Heart Failure surgery, Heart-Assist Devices
Abstract

In patients with advanced heart failure (HF), left ventricular assist devices (LVADs) have demonstrated to be effective in improving the quality of life and reducing further hospitalizations. Although uncommon, LVAD outflow graft obstruction (OGO) is a potentially life-threatening complication and percutaneous treatment has been proposed as a standard intervention strategy in such cases. We report the case of a 69 year old man admitted due to LVAD failure causing unstable HF. Past medical history included percutaneous intervention on the outflow graft with stent implantation one year before. The patient was under chronic treatment with vitamin K antagonists (VKA). Emergent percutaneous angiography was performed, showing recurrent OGO due to thrombosis located at a kinking site, distally to the previously treated segment. Using distal anchoring technique, a balloon-expandable 10 × 79 mm endoprosthesis (GORE ® Viabahn ® VBX) was effectively positioned and post-dilated. Final angiography confirmed the patency of the stent implanted one-year before. Despite the procedure succeeding in restoring LVAD function, the patient died due to septic shock ten days after. Our case suggests that recurrent OGO can be effectively treated with percutaneous redo and that long-term stent patency can be achieved with a standard antithrombotic treatment, despite further thrombotic events in other segments of the graft are still possible (especially at the kinking site). Moreover, other noncardiac conditions as infective complications, can dramatically impact the clinical course and lead to unfavorable outcomes.

Published
2022
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23. A Case of Successful Use of the "Anchoring Technique" for Percutaneous Treatment of Left Ventricular Assist Device Graft Occlusion.

Author

Stio RE, Montalto A, Intorcia A, Polizzi V, Feccia M, Musto C, Pennacchi M, Paolucci L, Stumpo R, D'Avino E, De Felice F, Gabrielli D, and Musumeci F

Subjects
Aged, Heart Ventricles, Humans, Male, Prospective Studies, Extracorporeal Membrane Oxygenation, Heart Failure surgery, Heart-Assist Devices adverse effects
Abstract

Left ventricular assist device (LVAD) obstruction can be a dramatic and life-threatening complication in patients with advanced heart failure (HF). Despite surgical redo is often required in these patients, it is associated with a high risk of periprocedural negative outcome. We report the case of a 68-year-old male with a thrombotic stenosis of the LVAD proximal outflow-graft. Following Heart Team debate, a percutaneous intervention was planned during veno-arterial Extra Corporeal Membrane Oxygenation (ECMO) assistance. To achieve the needed catheter support, we used the "distal balloon anchoring technique" through the outflow-graft and managed to implant a covered stent, rapidly restoring the flow through the LVAD. The patient was discharged without further complications. Our case shows that, in selected cases, percutaneous treatment of LVAD obstructions can be feasible, especially using advanced techniques derived from the experiences in coronary interventions and under ECMO assistance. More cases and prospective studies are mostly needed to explore long-term patency of the LVADs and clinical outcomes in these high-risk patients.

Published
2022
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24. A rare pheochromocytoma complicated by cardiogenic shock and posterior reversible encephalopathy syndrome: case report.

Author

Dominedò C, D'Avino E, Martinotti A, and Cingolani E

Abstract

Background: Pheochromocytoma is a rare catecholamine-producing tumour that classically displays clinical manifestations related to alpha-adrenergic stimulation, including paroxysmal or sustained hypertension. However, it may occasionally be complicated by life-threatening crisis, leading to refractory acute heart dysfunction in the most severe cases., Case Summary: A 28-year-old woman was admitted to intensive care unit due to hypertensive crisis causing pulmonary oedema, Takotsubo cardiomyopathy, and metabolic acidosis. Due to cardiogenic shock, she required venoarterial extracorporeal membrane oxygenation and IMPELLA implantation. A computed tomography scan revealed a 5 cm tumour of the left adrenal gland compatible with pheochromocytoma The clinical course was complicated by acute kidney injury requiring renal replacement therapy and posterior reversible encephalopathy syndrome (PRES). Pharmacological treatment with alpha lityc agents (including urapidil, dexmedetomidine, and doxazosin at maximum daily dose) and beta blockers, together with left videolaparoscopic adrenalectomy, led to progressive blood pressure control and resolution of the neurological symptoms., Discussion: Pheochromocytoma crisis turned into a potential catastrophic scenario, characterized by refractory cardiogenic shock requiring circulatory supportive devices and PRES. Alpha-antagonists and beta-blockers were the gold standard pharmacological treatment. A multidisciplinary decision-algorithm was necessary to successfully manage this complex clinical setting., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2021
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25. HIT in VAD patients: considerations.

Author

Lappa A, Picozzi P, D'Avino E, Riondino S, Menichetti A, and Musumeci F

Subjects
Dose-Response Relationship, Drug, Drug Administration Schedule, Follow-Up Studies, Heparin administration & dosage, Humans, Incidence, Risk Assessment, Thrombocytopenia epidemiology, Treatment Outcome, Heart-Assist Devices adverse effects, Heparin adverse effects, Thrombocytopenia chemically induced, Ventricular Dysfunction, Left surgery
Published
2007
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26. An on line technique to detect cardiac output variations and cardiovascular performances during abdominal aortic surgery.

Author

Clemente F, D'Avino E, Guaragno M, and Menichetti A

Subjects
Aged, Aged, 80 and over, Anesthesia, Epidural, Anesthesia, General, Equipment Design, Female, Humans, Male, Sensitivity and Specificity, Aortic Aneurysm, Abdominal surgery, Blood Pressure Monitors, Cardiac Output, Signal Processing, Computer-Assisted
Abstract

Cardiac output (CO) is a parameter usually requested to assess hemo dynamic status of patient and efficacy of therapy especially in critically ill patients. This paper, in line with other research activities and new market availability, intends to correlate a parameter derived from data already acquired in standard patient monitoring (systemic arterial pressure--Pas) in order to identify CO trends and, more generally, to obtain information on the efficiency of cardiovascular system of the patient in examination. Attention has been focussed on patients undergoing abdominal aneurysm aortic (AAA) surgery with combined anaesthesia (epidural and light general). Awake correlation was found between maximum value of Pas time derivative, max (dPas/dt), and CO measured with thermodilution method on 56 measurements on 10 patients. To evaluate further diagnostic capability of max (dPas/dt), we compare its trend with other parameters but no statistical significant results have been obtained. Therefore the target parameter can be profitably used in the examined patients to monitor CO trend and, in correlation with other parameters, as a sign of efficiency of the cardio circulatory system.

Published
2004
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27. [Anesthesia using high doses of fentanyl in coronary patients subjected to myocardial revascularization. Comparison of 2 administration methods].

Author

Tritapepe L, Cigognetti L, Brancadoro D, D'Avino E, Di Pirro L, Favaro R, and Menichetti A

Subjects
Aged, Coronary Disease surgery, Female, Humans, Male, Middle Aged, Randomized Controlled Trials as Topic, Anesthesia, Fentanyl administration & dosage, Hemodynamics drug effects, Myocardial Revascularization
Abstract

Eighteen patients to be submitted to heart surgery for myocardial revascularization have been considered. The patients were subdivided into two groups, A and B, and a high dose morphinic was administered for the induction and maintenance of the anaesthetic without further analgesic and/or narcotic supplement. The haemodynamic data obtained pointed to excellent stability in patient cardiocirculatory condition: preservation of IC within acceptable values was very interesting, owing to the fact that the high dose morphinic employed triggers very limited myocardiodepression. To conclude, the anaesthesiological techniques adopted seemed reliable and sufficiently protective with regard to exaggerated hyperdynamic responses to algogenic stimuli that trigger harmful haemodynamic conditions in coronary patients.

Published
1989

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