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3. Use of critical care resources during the first 2 weeks (February 24–March 8, 2020) of the Covid-19 outbreak in Italy

Author

Tonetti T., Grasselli G., Zanella A., Pizzilli G., Fumagalli R., Piva S., Lorini L., Iotti G., Foti G., Colombo S., Vivona L., Rossi S., Girardis M., Agnoletti V., Campagna A., Gordini G., Navalesi P., Boscolo A., Graziano A., Valeri I., Vianello A., Cereda D., Filippini C., Cecconi M., Locatelli F., Bartoletti M., Giannella M., Viale P., Antonelli M., Nava S., Pesenti A., Ranieri V. M., Albano G., Alborghetti A., Aldegheri G., Antonini B., Belgiorno N., Bellani G., Beretta E., Bonazzi S., Borelli M., Cabrini L., Carnevale L., Carnevale S., Castelli G., Catena E., Chiumello D., Coluccello A., Coppini D., Covello D., DeFilippi G., DeiPoli M., Dughi P., Gallioli G., Gnesin P., Greco S., Guatteri L., Guzzon D., Keim R., Landoni G., Langer T., Lombardo A., Marino G., Merli G., Merlo D., Mojoli F., Muttini S., Natalini G., Petrucci N., Pezzi A., Radrizzani D., Raimondi M., Riccio M., Storti E., Tavola M., Vitale G., Bosco E., Calo M. A., Danzi V., DeRosa S., Farnia A., Lazzari F., Meggiolaro M., Munari M., Saia M., Sella N., Serra E., Tiberio I., Baiocchi M., Benedetto M., Bordini M., Caramelli F., Cilloni N., DellaGiovampaola M., Fanelli A., Frascaroli G., Fusari M., Maitan S., Martino C., Melotti R. M., Merola R., Minardi F., Moro F., Nardi G., Nolli M., Pierucci E., Potalivo A., Repetti F., Salsi P., Terzitta M., Tosi M., Venturi S., Volta C. A., Zani G., Zanoni A (COVID-19 Northern Italian ICU Network), Landoni G, Tonetti, Tommaso, Grasselli, Giacomo, Zanella, Alberto, Pizzilli, Giacinto, Fumagalli, Roberto, Piva, Simone, Lorini, Luca, Iotti, Giorgio, Foti, Giuseppe, Colombo, Sergio, Vivona, Luigi, Rossi, Sandra, Girardis, Massimo, Agnoletti, Vanni, Campagna, Anselmo, Gordini, Giovanni, Navalesi, Paolo, Boscolo, Annalisa, Graziano, Alessandro, Valeri, Ilaria, Vianello, Andrea, Cereda, Danilo, Filippini, Claudia, Cecconi, Maurizio, Locatelli, Franco, Bartoletti, Michele, Giannella, Maddalena, Viale, Pierluigi, Antonelli, Massimo, Nava, Stefano, Pesenti, Antonio, Ranieri, V Marco, Tonetti, T, Grasselli, G, Zanella, A, Pizzilli, G, Fumagalli, R, Piva, S, Lorini, L, Iotti, G, Foti, G, Colombo, S, Vivona, L, Rossi, S, Girardis, M, Agnoletti, V, Campagna, A, Gordini, G, Navalesi, P, Boscolo, A, Graziano, A, Valeri, I, Vianello, A, Cereda, D, Filippini, C, Cecconi, M, Locatelli, F, Bartoletti, M, Giannella, M, Viale, P, Antonelli, M, Nava, S, Pesenti, A, Ranieri, V, Langer, T, Tonetti, T., Grasselli, G., Zanella, A., Pizzilli, G., Fumagalli, R., Piva, S., Lorini, L., Iotti, G., Foti, G., Colombo, S., Vivona, L., Rossi, S., Girardis, M., Agnoletti, V., Campagna, A., Gordini, G., Navalesi, P., Boscolo, A., Graziano, A., Valeri, I., Vianello, A., Cereda, D., Filippini, C., Cecconi, M., Locatelli, F., Bartoletti, M., Giannella, M., Viale, P., Antonelli, M., Nava, S., Pesenti, A., Ranieri, V. M., Albano, G., Alborghetti, A., Aldegheri, G., Antonini, B., Belgiorno, N., Bellani, G., Beretta, E., Bonazzi, S., Borelli, M., Cabrini, L., Carnevale, L., Carnevale, S., Castelli, G., Catena, E., Chiumello, D., Coluccello, A., Coppini, D., Covello, D., Defilippi, G., Deipoli, M., Dughi, P., Gallioli, G., Gnesin, P., Greco, S., Guatteri, L., Guzzon, D., Keim, R., Landoni, G., Langer, T., Lombardo, A., Marino, G., Merli, G., Merlo, D., Mojoli, F., Muttini, S., Natalini, G., Petrucci, N., Pezzi, A., Radrizzani, D., Raimondi, M., Riccio, M., Storti, E., Tavola, M., Vitale, G., Bosco, E., Calo, M. A., Danzi, V., Derosa, S., Farnia, A., Lazzari, F., Meggiolaro, M., Munari, M., Saia, M., Sella, N., Serra, E., Tiberio, I., Baiocchi, M., Benedetto, M., Bordini, M., Caramelli, F., Cilloni, N., Dellagiovampaola, M., Fanelli, A., Frascaroli, G., Fusari, M., Maitan, S., Martino, C., Melotti, R. M., Merola, R., Minardi, F., Moro, F., Nardi, G., Nolli, M., Pierucci, E., Potalivo, A., Repetti, F., Salsi, P., Terzitta, M., Tosi, M., Venturi, S., Volta, C. A., Zani, G., Zanoni, A (COVID-19 Northern Italian ICU Network), and Landoni, G

Subjects
medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Respiratory rate, Socio-culturale, Critical Care and Intensive Care Medicine, Acute respiratory failure, acute respiratory failure, COVID-19, ICU, non-invasive ventilation, rationing, 03 medical and health sciences, 0302 clinical medicine, Anesthesiology, Intensive care, Retrospective analysis, Medicine, 030212 general & internal medicine, Non-invasive ventilation, Rationing, Case report form, business.industry, Research, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Outbreak, lcsh:RC86-88.9, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, 030228 respiratory system, Emergency medicine, Base excess, business
Abstract

Background A Covid-19 outbreak developed in Lombardy, Veneto and Emilia-Romagna (Italy) at the end of February 2020. Fear of an imminent saturation of available ICU beds generated the notion that rationing of intensive care resources could have been necessary. Results In order to evaluate the impact of Covid-19 on the ICU capacity to manage critically ill patients, we performed a retrospective analysis of the first 2 weeks of the outbreak (February 24–March 8). Data were collected from regional registries and from a case report form sent to participating sites. ICU beds increased from 1545 to 1989 (28.7%), and patients receiving respiratory support outside the ICU increased from 4 (0.6%) to 260 (37.0%). Patients receiving respiratory support outside the ICU were significantly older [65 vs. 77 years], had more cerebrovascular (5.8 vs. 13.1%) and renal (5.3 vs. 10.0%) comorbidities and less obesity (31.4 vs. 15.5%) than patients admitted to the ICU. PaO2/FiO2 ratio, respiratory rate and arterial pH were higher [165 vs. 244; 20 vs. 24 breath/min; 7.40 vs. 7.46] and PaCO2 and base excess were lower [34 vs. 42 mmHg; 0.60 vs. 1.30] in patients receiving respiratory support outside the ICU than in patients admitted to the ICU, respectively. Conclusions Increase in ICU beds and use of out-of-ICU respiratory support allowed effective management of the first 14 days of the Covid-19 outbreak, avoiding resource rationing.

Published
2020

4. ECMO for COVID-19 patients in Europe and Israel

Author

Lorusso, R, Combes, A, Coco, V, De Piero, M, Belohlavek, J, Delnoij, T, van der Horst, I, Miranda, D, van der Linden, M, van der Heijden, J, Scholten, E, van Belle-van Haren, N, Lagrand, W, de Jong, S, Candura, D, Maas, J, van den Berg, M, Malfertheiner, M, Dreier, E, Mueller, T, Boeken, U, Akhyari, P, Lichtenberg, A, Saeed, D, Thiele, H, Baumgaertel, M, Schmitto, J, Mariani, S, Thielmann, M, Brenner, T, Benk, C, Czerny, M, Kalbhenn, J, Maier, S, Schibilsky, D, Staudacher, D, Henn, P, Iuliu, T, Muellenbach, R, Reyher, C, Rolfes, C, Zacharowski, K, Lotz, G, Sonntagbauer, M, Kersten, A, Karagiannidis, C, Schafer, S, Fichte, J, Hopf, H, Samalavicius, R, Lorini, L, Ghitti, D, Grazioli, L, Loforte, A, Baiocchi, M, Checco, E, Pacini, D, Meani, P, Cappai, A, Russo, C, Bottiroli, M, Mondino, M, Ranucci, M, Fina, D, Ballotta, A, Scandroglio, A, Zangrillo, A, Pieri, M, Nardelli, P, Fominskiy, E, Landoni, G, Fanelli, V, Brazzi, L, Montrucchio, G, Sales, G, Simonetti, U, Urbino, R, Livigni, S, Degani, A, Raffa, G, Pilato, M, Martucci, G, Arcadipane, A, Chiarini, G, Latronico, N, Cattaneo, S, Puglia, C, Reina, G, Sponga, S, Livi, U, Foti, G, Giani, M, Rona, R, Avalli, L, Bombino, M, Costa, M, Carozza, R, Donati, A, Piciche, M, Favaro, A, Salvador, L, Danzi, V, Zanin, A, Condello, I, Fiore, F, Moscarelli, M, Nasso, G, Speziale, G, Sandrelli, L, Montalto, A, Musumeci, F, Circelli, A, Gamberini, E, Russo, E, Benni, M, Agnoletti, V, Rociola, R, Milano, A, Grasso, S, Civita, A, Murgolo, F, Pilato, E, Comentale, G, Montisci, A, Alessandri, F, Tosi, A, Pugliese, F, Carelli, S, Grieco, D, Antonelli, M, Ramoni, E, Di Nardo, M, Maisano, F, Bettex, D, Weber, A, Grunenfelder, J, Consiglio, J, Hansjoerg, J, Haenggi, M, Agus, G, Doeble, T, Zenklusen, U, Bechtold, X, Stockman, B, De Backer, D, Giglioli, S, Meyns, B, Vercaemst, L, Herman, G, Meersseman, P, Vandenbriele, C, Dauwe, D, Vlasselaers, D, Raes, M, Debeuckelaere, G, Rodrigus, I, Biston, P, Piagnerelli, M, Peperstraete, H, Germay, O, Vandewiele, K, Vandeweghe, D, Witters, I, Havrin, S, Bourgeois, M, Taccone, F, Nobile, L, Lheureux, O, Brasseur, A, Creteur, J, Defraigne, J, Misset, B, Courcelle, R, Timmermans, P, Lehaen, J, Frederik, B, Riera, J, Castro, M, Gallart, E, Martinez-Martinez, M, Argudo, E, Garcia-de-Acilu, M, de Pablo Sanchez, R, Ortiz, A, Cabanes, M, Higa, K, Cassina, A, Berbel, D, Sanchez-Salado, J, Arnau, B, de Gopegui, P, Ricart, P, Sandoval, E, Veganzones, J, Millan, P, de la Sota, P, Santa Teresa, P, Alcantara, S, Alvarez, J, Gonzalez, A, Lopez, M, Gordillo, A, Naranjo-Izurieta, J, Costa, R, Albacete Moreno, C, de Ayala, J, Blanco-Schweizer, P, Andres, N, Boado, V, Martinez, J, Casal, V, Garcia, E, Martin-Villen, L, Climent, J, Pinto, L, Leprince, P, Lebreton, G, Juvin, C, Schmidt, M, Pineton, M, Folliguet, T, Saiydoun, G, Gaudard, P, Colson, P, Obadia, J, Pozzi, M, Fellahi, J, Yonis, H, Richard, J, Parasido, A, Verhoye, J, Flecher, E, Ajrhourh, L, Nesseler, N, Mansour, A, Guinot, P, Zarka, J, Besserve, P, Makhoul, M, Bolotin, G, Kassif, Y, Soufleris, D, Schellongowski, P, Bonaros, N, Krapf, C, Ebert, K, Mair, P, Kothleutner, F, Kowalewsky, M, Christensen, S, Pedersen, F, Balik, M, Blaha, J, Lips, M, Otahal, M, Camporota, L, Daly, K, Agnew, N, Barker, J, Head, L, Garcia, M, Ledot, S, Aquino, V, Lewis, R, Worthy, J, Noor, H, Scott, I, O'Brien, S, Conrick-Martin, I, Carton, E, Gillon, S, Flemming, L, Broman, L, Grins, E, Ketskalo, M, Tsarenko, S, Popugaev, K, Minin, S, Kornilov, I, Skopets, A, Kornelyuk, R, Turchaninov, A, Gorjup, V, Shelukhin, D, Dsouki, Y, Sargin, M, Kaygin, M, Liana, S, Puss, S, Soerensen, G, Magnus, R, Kanetoft, M, Watson, P, Redfors, B, Krenner, N, Velia Antonini, M, Barrett, N, Belliato, M, Davidson, M, Finney, S, Fowles, J, Halbe, M, Hennig, F, Jones, T, Smith, J, Roeleveld, P, Swol, J, Lorusso R., Combes A., Coco V. L., De Piero M. E., Belohlavek J., Delnoij T., van der Horst I., Miranda D. R., van der Linden M., van der Heijden J. J., Scholten E., van Belle-van Haren N., Lagrand W., de Jong S., Candura D., Maas J., van den Berg M. J. G., Malfertheiner M., Dreier E., Mueller T., Boeken U., Akhyari P., Lichtenberg A., Saeed D., Thiele H., Baumgaertel M., Schmitto J. D., Mariani S., Thielmann M., Brenner T., Benk C., Czerny M., Kalbhenn J., Maier S., Schibilsky D., Staudacher D. L., Henn P., Iuliu T., Muellenbach R., Reyher C., Rolfes C., Zacharowski K., Lotz G., Sonntagbauer M., Kersten A., Karagiannidis C., Schafer S., Fichte J., Hopf H. -B., Samalavicius R., Lorini L., Ghitti D., Grazioli L., Loforte A., Baiocchi M., Checco E. D., Pacini D., Meani P., Cappai A., Russo C. F., Bottiroli M., Mondino M., Ranucci M., Fina D., Ballotta A., Scandroglio A. M., Zangrillo A., Pieri M., Nardelli P., Fominskiy E., Landoni G., Fanelli V., Brazzi L., Montrucchio G., Sales G., Simonetti U., Urbino R., Livigni S., Degani A., Raffa G., Pilato M., Martucci G., Arcadipane A., Chiarini G., Latronico N., Cattaneo S., Puglia C., Reina G., Sponga S., Livi U., Foti G., Giani M., Rona R., Avalli L., Bombino M., Costa M. C., Carozza R., Donati A., Piciche M., Favaro A., Salvador L., Danzi V., Zanin A., Condello I., Fiore F., Moscarelli M., Nasso G., Speziale G., Sandrelli L., Montalto A., Musumeci F., Circelli A., Gamberini E., Russo E., Benni M., Agnoletti V., Rociola R., Milano A. D., Grasso S., Civita A., Murgolo F., Pilato E., Comentale G., Montisci A., Alessandri F., Tosi A., Pugliese F., Carelli S., Grieco D. L., Antonelli M., Ramoni E., Di Nardo M., Maisano F., Bettex D., Weber A., Grunenfelder J., Consiglio J., Hansjoerg J., Haenggi M., Agus G., Doeble T., Zenklusen U., Bechtold X., Stockman B., De Backer D., Giglioli S., Meyns B., Vercaemst L., Herman G., Meersseman P., Vandenbriele C., Dauwe D., Vlasselaers D., Raes M., Debeuckelaere G., Rodrigus I., Biston P., Piagnerelli M., Peperstraete H., Germay O., Vandewiele K., Vandeweghe D., Witters I., Havrin S., Bourgeois M., Taccone F. S., Nobile L., Lheureux O., Brasseur A., Creteur J., Defraigne J. -O., Misset B., Courcelle R., Timmermans P. J., Lehaen J., Frederik B., Riera J., Castro M. A., Gallart E., Martinez-Martinez M., Argudo E., Garcia-de-Acilu M., de Pablo Sanchez R., Ortiz A. B., Cabanes M. -P. F., Higa K. O., Cassina A. M., Berbel D. O., Sanchez-Salado J. C., Arnau B. -L., de Gopegui P. R., Ricart P., Sandoval E., Veganzones J., Millan P., de la Sota P., Santa Teresa P., Alcantara S., Alvarez J. D., Gonzalez A. V., Lopez M., Gordillo A., Naranjo-Izurieta J., Costa R. G., Albacete Moreno C. L., de Ayala J. A., Blanco-Schweizer P., Andres N. H., Boado V., Martinez J. M. N., Casal V. G., Garcia E. F., Martin-Villen L., Climent J. C., Pinto L. F., Leprince P., Lebreton G., Juvin C., Schmidt M., Pineton M., Folliguet T., Saiydoun G., Gaudard P., Colson P., Obadia J. -F., Pozzi M., Fellahi J. L., Yonis H., Richard J. C., Parasido A., Verhoye J. -P., Flecher E., Ajrhourh L., Nesseler N., Mansour A., Guinot P. -G., Zarka J., Besserve P., Makhoul M., Bolotin G., Kassif Y., Soufleris D., Schellongowski P., Bonaros N., Krapf C., Ebert K., Mair P., Kothleutner F., Kowalewsky M., Christensen S., Pedersen F. M., Balik M., Blaha J., Lips M., Otahal M., Camporota L., Daly K., Agnew N., Barker J., Head L., Garcia M., Ledot S., Aquino V., Lewis R., Worthy J., Noor H., Scott I., O'Brien S., Conrick-Martin I., Carton E., Gillon S., Flemming L., Broman L. M., Grins E., Ketskalo M., Tsarenko S., Popugaev K., Minin S., Kornilov I., Skopets A., Kornelyuk R., Turchaninov A., Gorjup V., Shelukhin D., Dsouki Y. E., Sargin M., Kaygin M. A., Liana S., Puss S., Soerensen G., Magnus R., Kanetoft M., Watson P., Redfors B., Krenner N., Velia Antonini M., Barrett N. A., Belliato M., Davidson M., Finney S., Fowles J. -A., Halbe M., Hennig F., Jones T., Pinto L., Smith J., Roeleveld P., Swol J., Lorusso, R, Combes, A, Coco, V, De Piero, M, Belohlavek, J, Delnoij, T, van der Horst, I, Miranda, D, van der Linden, M, van der Heijden, J, Scholten, E, van Belle-van Haren, N, Lagrand, W, de Jong, S, Candura, D, Maas, J, van den Berg, M, Malfertheiner, M, Dreier, E, Mueller, T, Boeken, U, Akhyari, P, Lichtenberg, A, Saeed, D, Thiele, H, Baumgaertel, M, Schmitto, J, Mariani, S, Thielmann, M, Brenner, T, Benk, C, Czerny, M, Kalbhenn, J, Maier, S, Schibilsky, D, Staudacher, D, Henn, P, Iuliu, T, Muellenbach, R, Reyher, C, Rolfes, C, Zacharowski, K, Lotz, G, Sonntagbauer, M, Kersten, A, Karagiannidis, C, Schafer, S, Fichte, J, Hopf, H, Samalavicius, R, Lorini, L, Ghitti, D, Grazioli, L, Loforte, A, Baiocchi, M, Checco, E, Pacini, D, Meani, P, Cappai, A, Russo, C, Bottiroli, M, Mondino, M, Ranucci, M, Fina, D, Ballotta, A, Scandroglio, A, Zangrillo, A, Pieri, M, Nardelli, P, Fominskiy, E, Landoni, G, Fanelli, V, Brazzi, L, Montrucchio, G, Sales, G, Simonetti, U, Urbino, R, Livigni, S, Degani, A, Raffa, G, Pilato, M, Martucci, G, Arcadipane, A, Chiarini, G, Latronico, N, Cattaneo, S, Puglia, C, Reina, G, Sponga, S, Livi, U, Foti, G, Giani, M, Rona, R, Avalli, L, Bombino, M, Costa, M, Carozza, R, Donati, A, Piciche, M, Favaro, A, Salvador, L, Danzi, V, Zanin, A, Condello, I, Fiore, F, Moscarelli, M, Nasso, G, Speziale, G, Sandrelli, L, Montalto, A, Musumeci, F, Circelli, A, Gamberini, E, Russo, E, Benni, M, Agnoletti, V, Rociola, R, Milano, A, Grasso, S, Civita, A, Murgolo, F, Pilato, E, Comentale, G, Montisci, A, Alessandri, F, Tosi, A, Pugliese, F, Carelli, S, Grieco, D, Antonelli, M, Ramoni, E, Di Nardo, M, Maisano, F, Bettex, D, Weber, A, Grunenfelder, J, Consiglio, J, Hansjoerg, J, Haenggi, M, Agus, G, Doeble, T, Zenklusen, U, Bechtold, X, Stockman, B, De Backer, D, Giglioli, S, Meyns, B, Vercaemst, L, Herman, G, Meersseman, P, Vandenbriele, C, Dauwe, D, Vlasselaers, D, Raes, M, Debeuckelaere, G, Rodrigus, I, Biston, P, Piagnerelli, M, Peperstraete, H, Germay, O, Vandewiele, K, Vandeweghe, D, Witters, I, Havrin, S, Bourgeois, M, Taccone, F, Nobile, L, Lheureux, O, Brasseur, A, Creteur, J, Defraigne, J, Misset, B, Courcelle, R, Timmermans, P, Lehaen, J, Frederik, B, Riera, J, Castro, M, Gallart, E, Martinez-Martinez, M, Argudo, E, Garcia-de-Acilu, M, de Pablo Sanchez, R, Ortiz, A, Cabanes, M, Higa, K, Cassina, A, Berbel, D, Sanchez-Salado, J, Arnau, B, de Gopegui, P, Ricart, P, Sandoval, E, Veganzones, J, Millan, P, de la Sota, P, Santa Teresa, P, Alcantara, S, Alvarez, J, Gonzalez, A, Lopez, M, Gordillo, A, Naranjo-Izurieta, J, Costa, R, Albacete Moreno, C, de Ayala, J, Blanco-Schweizer, P, Andres, N, Boado, V, Martinez, J, Casal, V, Garcia, E, Martin-Villen, L, Climent, J, Pinto, L, Leprince, P, Lebreton, G, Juvin, C, Schmidt, M, Pineton, M, Folliguet, T, Saiydoun, G, Gaudard, P, Colson, P, Obadia, J, Pozzi, M, Fellahi, J, Yonis, H, Richard, J, Parasido, A, Verhoye, J, Flecher, E, Ajrhourh, L, Nesseler, N, Mansour, A, Guinot, P, Zarka, J, Besserve, P, Makhoul, M, Bolotin, G, Kassif, Y, Soufleris, D, Schellongowski, P, Bonaros, N, Krapf, C, Ebert, K, Mair, P, Kothleutner, F, Kowalewsky, M, Christensen, S, Pedersen, F, Balik, M, Blaha, J, Lips, M, Otahal, M, Camporota, L, Daly, K, Agnew, N, Barker, J, Head, L, Garcia, M, Ledot, S, Aquino, V, Lewis, R, Worthy, J, Noor, H, Scott, I, O'Brien, S, Conrick-Martin, I, Carton, E, Gillon, S, Flemming, L, Broman, L, Grins, E, Ketskalo, M, Tsarenko, S, Popugaev, K, Minin, S, Kornilov, I, Skopets, A, Kornelyuk, R, Turchaninov, A, Gorjup, V, Shelukhin, D, Dsouki, Y, Sargin, M, Kaygin, M, Liana, S, Puss, S, Soerensen, G, Magnus, R, Kanetoft, M, Watson, P, Redfors, B, Krenner, N, Velia Antonini, M, Barrett, N, Belliato, M, Davidson, M, Finney, S, Fowles, J, Halbe, M, Hennig, F, Jones, T, Smith, J, Roeleveld, P, Swol, J, Lorusso R., Combes A., Coco V. L., De Piero M. E., Belohlavek J., Delnoij T., van der Horst I., Miranda D. R., van der Linden M., van der Heijden J. J., Scholten E., van Belle-van Haren N., Lagrand W., de Jong S., Candura D., Maas J., van den Berg M. J. G., Malfertheiner M., Dreier E., Mueller T., Boeken U., Akhyari P., Lichtenberg A., Saeed D., Thiele H., Baumgaertel M., Schmitto J. D., Mariani S., Thielmann M., Brenner T., Benk C., Czerny M., Kalbhenn J., Maier S., Schibilsky D., Staudacher D. L., Henn P., Iuliu T., Muellenbach R., Reyher C., Rolfes C., Zacharowski K., Lotz G., Sonntagbauer M., Kersten A., Karagiannidis C., Schafer S., Fichte J., Hopf H. -B., Samalavicius R., Lorini L., Ghitti D., Grazioli L., Loforte A., Baiocchi M., Checco E. D., Pacini D., Meani P., Cappai A., Russo C. F., Bottiroli M., Mondino M., Ranucci M., Fina D., Ballotta A., Scandroglio A. M., Zangrillo A., Pieri M., Nardelli P., Fominskiy E., Landoni G., Fanelli V., Brazzi L., Montrucchio G., Sales G., Simonetti U., Urbino R., Livigni S., Degani A., Raffa G., Pilato M., Martucci G., Arcadipane A., Chiarini G., Latronico N., Cattaneo S., Puglia C., Reina G., Sponga S., Livi U., Foti G., Giani M., Rona R., Avalli L., Bombino M., Costa M. C., Carozza R., Donati A., Piciche M., Favaro A., Salvador L., Danzi V., Zanin A., Condello I., Fiore F., Moscarelli M., Nasso G., Speziale G., Sandrelli L., Montalto A., Musumeci F., Circelli A., Gamberini E., Russo E., Benni M., Agnoletti V., Rociola R., Milano A. D., Grasso S., Civita A., Murgolo F., Pilato E., Comentale G., Montisci A., Alessandri F., Tosi A., Pugliese F., Carelli S., Grieco D. L., Antonelli M., Ramoni E., Di Nardo M., Maisano F., Bettex D., Weber A., Grunenfelder J., Consiglio J., Hansjoerg J., Haenggi M., Agus G., Doeble T., Zenklusen U., Bechtold X., Stockman B., De Backer D., Giglioli S., Meyns B., Vercaemst L., Herman G., Meersseman P., Vandenbriele C., Dauwe D., Vlasselaers D., Raes M., Debeuckelaere G., Rodrigus I., Biston P., Piagnerelli M., Peperstraete H., Germay O., Vandewiele K., Vandeweghe D., Witters I., Havrin S., Bourgeois M., Taccone F. S., Nobile L., Lheureux O., Brasseur A., Creteur J., Defraigne J. -O., Misset B., Courcelle R., Timmermans P. J., Lehaen J., Frederik B., Riera J., Castro M. A., Gallart E., Martinez-Martinez M., Argudo E., Garcia-de-Acilu M., de Pablo Sanchez R., Ortiz A. B., Cabanes M. -P. F., Higa K. O., Cassina A. M., Berbel D. O., Sanchez-Salado J. C., Arnau B. -L., de Gopegui P. R., Ricart P., Sandoval E., Veganzones J., Millan P., de la Sota P., Santa Teresa P., Alcantara S., Alvarez J. D., Gonzalez A. V., Lopez M., Gordillo A., Naranjo-Izurieta J., Costa R. G., Albacete Moreno C. L., de Ayala J. A., Blanco-Schweizer P., Andres N. H., Boado V., Martinez J. M. N., Casal V. G., Garcia E. F., Martin-Villen L., Climent J. C., Pinto L. F., Leprince P., Lebreton G., Juvin C., Schmidt M., Pineton M., Folliguet T., Saiydoun G., Gaudard P., Colson P., Obadia J. -F., Pozzi M., Fellahi J. L., Yonis H., Richard J. C., Parasido A., Verhoye J. -P., Flecher E., Ajrhourh L., Nesseler N., Mansour A., Guinot P. -G., Zarka J., Besserve P., Makhoul M., Bolotin G., Kassif Y., Soufleris D., Schellongowski P., Bonaros N., Krapf C., Ebert K., Mair P., Kothleutner F., Kowalewsky M., Christensen S., Pedersen F. M., Balik M., Blaha J., Lips M., Otahal M., Camporota L., Daly K., Agnew N., Barker J., Head L., Garcia M., Ledot S., Aquino V., Lewis R., Worthy J., Noor H., Scott I., O'Brien S., Conrick-Martin I., Carton E., Gillon S., Flemming L., Broman L. M., Grins E., Ketskalo M., Tsarenko S., Popugaev K., Minin S., Kornilov I., Skopets A., Kornelyuk R., Turchaninov A., Gorjup V., Shelukhin D., Dsouki Y. E., Sargin M., Kaygin M. A., Liana S., Puss S., Soerensen G., Magnus R., Kanetoft M., Watson P., Redfors B., Krenner N., Velia Antonini M., Barrett N. A., Belliato M., Davidson M., Finney S., Fowles J. -A., Halbe M., Hennig F., Jones T., Pinto L., Smith J., Roeleveld P., and Swol J.

Published
2021

5. The PROVENT-C19 registry: A study protocol for international multicenter SIAARTI registry on the use of prone positioning in mechanically ventilated patients with COVID-19 ARDS

Author

De Rosa, S., Sella, N., Rezoagli, E., Lorenzoni, G., Gregori, D., Bellani, G., Foti, G., Pettenuzzo, T., Baratto, F., Fullin, G., Papaccio, F., Peta, M., Poole, D., Toffoletto, F., Maggiore, S. M., Navales, P., Navalesi, P., Tiberio, I., Pasin, L., Godi, I., Serra, E., Zarantonello, F., Andreatta, G., Boscolo, A., Persona, P., Cattin, L., Forin, E., Boni, E., Golino, G., Danzi, V., Vetrugno, L., Cornacchia, N., Donadello, K., Gottin, L., Polati, E., Campagnolo, M., Linassi, F., Panciera, G., Garofalo, E., Bruni, A., Carlon, R., Pipitone, M., Candosin, A., Badii, F., Role, S. D., Girardis, M., Busani, S., Gamberini, E., Tartivita, C. N., Gamberini, L., Cortegiani, A., Frisella, S., Ippolito, M., Salvo, F., Greco, M., Cecconi, M., Aceto, R., Langer, T., Repishti, M., Zeduri, A., Ottolina, D., Fossali, T., Colombo, R., Predonzani, N., Ferluga, M., Blasi, S. D., Zardin, M., Vergine, S., Luccarelli, G., Tritapepe, L., Francesconi, A. G., Pagani, M., Mojoli, F., Orlando, A., Mongodi, S., Bitondo, M., Johnathan, M., Maugeri, J., Bellissima, A., Guzzardella, A., Vallecoccia, M. S., Spadaro, S., Cricca, V., Andriolo, E., Bianchin, A., Alampi, D., Rocco, M., Anchisi, S., Tenaglia, T., Nicoletti, R., Antonini, B., Zanaty, M., Mogahed, M., Ali, A., Emara, M., Abdullah, E., Awad, A. K., Abdel-Maboud, M., Hussein, A. M., Hussein, A. A. R. M., Mosleh, A. A., Ahmed, M. G., Aziz, M. G., Elsayed, A., Aldhalia, A., Elkhatid, A., Abodina, A. M., Khalleefah, A., Shalabi, L. E., Shamed, H., Bakeer, H. B., Hawad, A., Abuzaid, T., Alqandouz, R. A. S., Saliga, A. A., Haddud, A., Kredan, A. A., Shaban, M. S., Salama, A. A., Altabit, A. E. R. M., Alflite, A. O. S., Hashim, H. T., Kadhim, Q. M., Abd-Alreda, A. H., Al-Juifari, M. A., Al-Gburi, S. M., Akram, A., Laila, A., Bakri, A., Abdelmageed, A., Binnawara, M., Mohamed, M., Esaadi, H., Othman, E., Said, A., Alarabi, R., Alameen, H., Albouishi, N., Babaa, K. A., Salih, R., Elbakheet, D. E., Abuelyamen, A., Perez-Torres, D., Mattson, J., Al-Sadawi, M., Elseidy, S., De Rosa, Silvia, Sella, Nicolò, Rezoagli, Emanuele, Lorenzoni, Giulia, Gregori, Dario, Bellani, Giacomo, Foti, Giuseppe, Pettenuzzo, Tommaso, Baratto, Fabio, Fullin, Giorgio, Papaccio, Francesco, Peta, Mario, Poole, Daniele, Toffoletto, Fabio, Maggiore, Salvatore Maurizio, Navalesi, Paolo, SIAARTI Study group, Cortegiani, Andrea, Frisella, Sara, and Ippolito, Mariachiara

Subjects
Multidisciplinary, prone position, respiratory failure, COVID-19
Abstract

Background The worldwide use of prone position (PP) for invasively ventilated patients with COVID-19 is progressively increasing from the first pandemic wave in everyday clinical practice. Among the suggested treatments for the management of ARDS patients, PP was recommended in the Surviving Sepsis Campaign COVID-19 guidelines as an adjuvant therapy for improving ventilation. In patients with severe classical ARDS, some authors reported that early application of prolonged PP sessions significantly decreases 28-day and 90-day mortality. Methods and analysis Since January 2021, the COVID19 Veneto ICU Network research group has developed and implemented nationally and internationally the “PROVENT-C19 Registry”, endorsed by the Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care…’(SIAARTI). The PROVENT-C19 Registry wishes to describe 1. The real clinical practice on the use of PP in COVID-19 patients during the pandemic at a National and International level; and 2. Potential baseline and clinical characteristics that identify subpopulations of invasively ventilated patients with COVID-19 that may improve daily from PP therapy. This web-based registry will provide relevant information on how the database research tools may improve our daily clinical practice. Conclusions This multicenter, prospective registry is the first to identify and characterize the role of PP on clinical outcome in COVID-19 patients. In recent years, data emerging from large registries have been increasingly used to provide real-world evidence on the effectiveness, quality, and safety of a clinical intervention. Indeed observation-based registries could be effective tools aimed at identifying specific clusters of patients within a large study population with widely heterogeneous clinical characteristics. Trial registration The registry was registered (ClinicalTrial.Gov Trials Register NCT04905875) on May 28,2021.

Published
2022

6. Appalti pubblici

Author

Greco, G, Provenzano, P, Danzi, V, Pinotti, G, Pisani, G, Previti, L, Votta, F, Velliscig, M, Nascimbene, B, Condinanzi, M, Greco, G, Provenzano, P, Danzi, V, Pinotti, G, Pisani, G, Previti, L, Votta, F, and Velliscig, M

Subjects
Giurisprudenza, Unione europea
Published
2021

7. Lombardia

Author

Danzi, V, Pinotti, G, Pisani, G, Previti, L, Votta, F, Carullo, G, Provenzano, P, Danzi, V, Pinotti, G, Pisani, G, Previti, L, and Votta, F

Subjects
Covid-19
Published
2020

8. Static compliance and driving pressure are associated with ICU mortality in intubated COVID-19 ARDS

Author

Boscolo, A., Sella, N., Lorenzoni, G., Pasin, L., Pretto, C., Tocco, M., Tamburini, E., De Cassai, A., Rosi, P., Polati, E., Donadello, K., Gottin, L., De Rosa, S., Baratto, F., Toffoletto, F., Ranieri, V. M., Gregori, D., Navalesi, P., Valeri, I., Andreatta, G., Gandolfi, L., Gadaldi, A., Brumana, N., Forin, E., Correale, C., Pesenti, E., Fregolent, D., Pirelli, P. F., Marchesin, D., Perona, M., Franchetti, N., Della Paolera, M., Simoni, C., Falcioni, T., Tresin, A., Schiavolin, C., Schiavi, A., Vathi, S., Sartori, D., Sorgato, A., Pistollato, E., Serra, E., Pittarello, D., Tiberio, I., Bond, O., Michieletto, E., Muraro, L., Peralta, A., Persona, P., Petranzan, E., Zarantonello, F., Graziano, A., Piasentini, E., Bernardi, L., Pianon, R., Badii, F., Bosco, E., Agostini, M., Farnia, A., Peta, M., Calo, M. A., Meggiolaro, M., Lazzari, F., Martinello, I., Fullin, G., Papaccio, F., Bonato, A., Sgarabotto, C., Montacciani, F., Alessandra, P., Gagliardi, G., Ferraro, G., Ongaro, L., Baiocchi, M., Danzi, V., Zanatta, P., Marchiotto, S., Bassanini, S., Zamperini, M., Daroui, I., Linassi, F., and Pettenuzzo, T.

Subjects
Male, ARDS, Supine position, COVID-19, Driving pressure, Mechanical ventilation, Respiratory system compliance, medicine.medical_treatment, Pulmonary compliance, Critical Care and Intensive Care Medicine, Hypoxemia, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Tidal Volume, Humans, Medicine, Tidal volume, Aged, Respiratory Distress Syndrome, RC86-88.9, business.industry, Respiration, Research, Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, Middle Aged, medicine.disease, Respiration, Artificial, Intensive care unit, Intensive Care Units, Female, Intubation, Italy, 030228 respiratory system, Anesthesia, Artificial, medicine.symptom, business, Cohort study
Abstract

Background Pathophysiological features of coronavirus disease 2019-associated acute respiratory distress syndrome (COVID-19 ARDS) were indicated to be somewhat different from those described in nonCOVID-19 ARDS, because of relatively preserved compliance of the respiratory system despite marked hypoxemia. We aim ascertaining whether respiratory system static compliance (Crs), driving pressure (DP), and tidal volume normalized for ideal body weight (VT/kg IBW) at the 1st day of controlled mechanical ventilation are associated with intensive care unit (ICU) mortality in COVID-19 ARDS. Methods Observational multicenter cohort study. All consecutive COVID-19 adult patients admitted to 25 ICUs belonging to the COVID-19 VENETO ICU network (February 28th–April 28th, 2020), who received controlled mechanical ventilation, were screened. Only patients fulfilling ARDS criteria and with complete records of Crs, DP and VT/kg IBW within the 1st day of controlled mechanical ventilation were included. Crs, DP and VT/kg IBW were collected in sedated, paralyzed and supine patients. Results A total of 704 COVID-19 patients were screened and 241 enrolled. Seventy-one patients (29%) died in ICU. The logistic regression analysis showed that: (1) Crs was not linearly associated with ICU mortality (p value for nonlinearity = 0.01), with a greater risk of death for values 2O; (2) the association between DP and ICU mortality was linear (p value for nonlinearity = 0.68), and increasing DP from 10 to 14 cmH2O caused significant higher odds of in-ICU death (OR 1.45, 95% CI 1.06–1.99); (3) VT/kg IBW was not associated with a significant increase of the risk of death (OR 0.92, 95% CI 0.55–1.52). Multivariable analysis confirmed these findings. Conclusions Crs 2O was associated with ICU mortality, while DP was linearly associated with mortality. DP should be kept as low as possible, even in the case of relatively preserved Crs, irrespective of VT/kg IBW, to reduce the risk of death.

Published
2021

9. Outcomes of COVID-19 patients intubated after failure of non-invasive ventilation: a multicenter observational study

Author

Boscolo, A., Pasin, L., Sella, N., Pretto, C., Tocco, M., Tamburini, E., Rosi, P., Polati, E., Donadello, K., Gottin, L., Vianello, A., Landoni, G., Navalesi, P., Valeri, I., Andreatta, G., Gandolfi, L., Gadaldi, A., Brumana, N., Forin, E., Correale, C., Fregolent, D., Pirelli, P. F., Marchesin, D., Perona, M., Franchetti, N., Paolera, M. D., Simoni, C., Falcioni, T., Tresin, A., Schiavolin, C., Schiavi, A., Vathi, S., Sartori, D., Sorgato, A., Pistollato, E., Golino, G. L., Frigo, L., Serra, E., Pittarello, D., Tiberio, I., Bond, O., Michieletto, E., Muraro, L., Peralta, A., Persona, P., Petranzan, E., Zarantonello, F., Graziano, A., De Cassai, A., Bernardi, L., Pianon, R., Badii, F., Bosco, E., Agostini, M., Trevisiol, P., Farnia, A., Peta, M., Altafini, L., Calo, M. A., Meggiolaro, M., Lazzari, F., Martinello, I., Fullin, G., Papaccio, F., Toffoletto, F., Bonato, A., Sgarabotto, C., Baratto, F., Montacciani, F., Parnigotto, A., Gagliardi, G., Gioconda, F., Ongaro, L., Baiocchi, M., Danzi, V., De Rosa, S., Zanatta, P., Sinigaglia, E., da Ros, A., Marchiotto, S., Bassanini, S., Zamperini, M., Daroui, I., Mosaner, W., Lembo, R., Linassi, F., and Pettenuzzo, T.

Subjects
Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Respiratory distress syndrome, Outcome Assessment, Science, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Endotracheal intubation, Article, law.invention, law, Risk Factors, Outcome Assessment, Health Care, medicine, Intubation, Intratracheal, Humans, Hospital Mortality, Aged, COVID-19, Female, Intensive Care Units, Logistic Models, Middle Aged, Multivariate Analysis, Noninvasive Ventilation, Respiratory Insufficiency, SARS-CoV-2, Multidisciplinary, business.industry, Intensive care unit, Icu admission, Health Care, Intratracheal, Multicenter study, Emergency medicine, Breathing, Medicine, Observational study, business, Intubation
Abstract

IntroductionThe efficacy of non-invasive ventilation (NIV) in acute respiratory failure secondary to SARS-CoV-2 infection remains controversial. Current literature mainly examined efficacy, safety and potential predictors of NIV failure provided out of the Intensive Care Unit (ICU). On the contrary, the outcomes of ICU patients, intubated after NIV failure, remain to be explored. The aims of the present study are: 1) investigating in-hospital mortality in coronavirus disease 2019 (COVID-19) ICU patients receiving endotracheal intubation after NIV failure and 2) assessing whether the length of NIV application affects patient survival. MethodsThis observational multicenter study included all consecutive COVID-19 adult patients, admitted into the twenty-five ICUs of the COVID-19 VENETO ICU network (February-April 2020), who underwent endotracheal intubation after NIV failure. ResultsAmong the 704 patients admitted to ICU during the study period, 280 (40%) presented the inclusion criteria and were enrolled. The median age was 69 [60-76] years; 219 patients (78%) were male. In-hospital mortality was 43%. Only the length of NIV application before ICU admission (OR 2.03 (95% CI 1.06 - 4.98), p = 0.03) and age (OR 1.18 (95% CI 1.04 - 1.33), p < 0.01) were identified as independent risk factors of in-hospital mortality; whilst the length of NIV after ICU admission did not affect patient outcome. ConclusionsIn-hospital mortality of ICU patients intubated after NIV failure was 43%. Days on NIV before ICU admission and age were assessed to be potential risk factors of greater in-hospital mortality.

Published
2021

10. Appalti pubblici

Author

Nascimbene, B, Condinanzi, M, Greco, G, Provenzano, P, Danzi, V, Pinotti, G, Pisani, G, Previti, L, Votta, F, Velliscig, M, Nascimbene, B, Condinanzi, M, Greco, G, Provenzano, P, Danzi, V, Pinotti, G, Pisani, G, Previti, L, Votta, F, and Velliscig, M

Published
2021

11. Use of critical care resources during the first 2 weeks (February 24–March 8, 2020) of the Covid-19 outbreak in Italy

Author

Tonetti, T., Grasselli, G., Zanella, A., Pizzilli, G., Fumagalli, R., Piva, S., Lorini, L., Iotti, G., Foti, G., Colombo, S., Vivona, L., Rossi, S., Girardis, M., Agnoletti, V., Campagna, A., Gordini, G., Navalesi, P., Boscolo, A., Graziano, A., Valeri, I., Vianello, A., Cereda, D., Filippini, C., Cecconi, M., Locatelli, Franco, Bartoletti, M., Giannella, M., Viale, P., Antonelli, M., Nava, S., Pesenti, A., Ranieri, V. M., Albano, G., Alborghetti, A., Aldegheri, G., Antonini, B., Belgiorno, N., Bellani, G., Beretta, E., Bonazzi, S., Borelli, M., Cabrini, L., Carnevale, L., Carnevale, S., Castelli, G., Catena, E., Chiumello, D., Coluccello, A., Coppini, D., Covello, D., Defilippi, G., Deipoli, M., Dughi, P., Gallioli, G., Gnesin, P., Greco, S., Guatteri, L., Guzzon, D., Keim, R., Landoni, G., Langer, T., Lombardo, A., Marino, G., Merli, G., Merlo, D., Mojoli, F., Muttini, S., Natalini, G., Petrucci, N., Pezzi, A., Radrizzani, D., Raimondi, M., Riccio, M., Storti, E., Tavola, M., Vitale, G., Bosco, E., Calo, M. A., Danzi, V., Derosa, S., Farnia, A., Lazzari, F., Meggiolaro, M., Munari, M., Saia, M., Sella, N., Serra, E., Tiberio, I., Baiocchi, M., Benedetto, M., Bordini, M., Caramelli, F., Cilloni, N., Dellagiovampaola, M., Fanelli, A., Frascaroli, G., Fusari, M., Maitan, S., Martino, C., Melotti, R. M., Merola, R., Minardi, F., Moro, F., Nardi, G., Nolli, M., Pierucci, E., Potalivo, A., Repetti, F., Salsi, P., Terzitta, M., Tosi, M., Venturi, S., Volta, C. A., Zani, G., Zanoni, A., Locatelli F. (ORCID:0000-0002-7976-3654), Tonetti, T., Grasselli, G., Zanella, A., Pizzilli, G., Fumagalli, R., Piva, S., Lorini, L., Iotti, G., Foti, G., Colombo, S., Vivona, L., Rossi, S., Girardis, M., Agnoletti, V., Campagna, A., Gordini, G., Navalesi, P., Boscolo, A., Graziano, A., Valeri, I., Vianello, A., Cereda, D., Filippini, C., Cecconi, M., Locatelli, Franco, Bartoletti, M., Giannella, M., Viale, P., Antonelli, M., Nava, S., Pesenti, A., Ranieri, V. M., Albano, G., Alborghetti, A., Aldegheri, G., Antonini, B., Belgiorno, N., Bellani, G., Beretta, E., Bonazzi, S., Borelli, M., Cabrini, L., Carnevale, L., Carnevale, S., Castelli, G., Catena, E., Chiumello, D., Coluccello, A., Coppini, D., Covello, D., Defilippi, G., Deipoli, M., Dughi, P., Gallioli, G., Gnesin, P., Greco, S., Guatteri, L., Guzzon, D., Keim, R., Landoni, G., Langer, T., Lombardo, A., Marino, G., Merli, G., Merlo, D., Mojoli, F., Muttini, S., Natalini, G., Petrucci, N., Pezzi, A., Radrizzani, D., Raimondi, M., Riccio, M., Storti, E., Tavola, M., Vitale, G., Bosco, E., Calo, M. A., Danzi, V., Derosa, S., Farnia, A., Lazzari, F., Meggiolaro, M., Munari, M., Saia, M., Sella, N., Serra, E., Tiberio, I., Baiocchi, M., Benedetto, M., Bordini, M., Caramelli, F., Cilloni, N., Dellagiovampaola, M., Fanelli, A., Frascaroli, G., Fusari, M., Maitan, S., Martino, C., Melotti, R. M., Merola, R., Minardi, F., Moro, F., Nardi, G., Nolli, M., Pierucci, E., Potalivo, A., Repetti, F., Salsi, P., Terzitta, M., Tosi, M., Venturi, S., Volta, C. A., Zani, G., Zanoni, A., and Locatelli F. (ORCID:0000-0002-7976-3654)

Abstract

Background: A Covid-19 outbreak developed in Lombardy, Veneto and Emilia-Romagna (Italy) at the end of February 2020. Fear of an imminent saturation of available ICU beds generated the notion that rationing of intensive care resources could have been necessary. Results: In order to evaluate the impact of Covid-19 on the ICU capacity to manage critically ill patients, we performed a retrospective analysis of the first 2 weeks of the outbreak (February 24–March 8). Data were collected from regional registries and from a case report form sent to participating sites. ICU beds increased from 1545 to 1989 (28.7%), and patients receiving respiratory support outside the ICU increased from 4 (0.6%) to 260 (37.0%). Patients receiving respiratory support outside the ICU were significantly older [65 vs. 77 years], had more cerebrovascular (5.8 vs. 13.1%) and renal (5.3 vs. 10.0%) comorbidities and less obesity (31.4 vs. 15.5%) than patients admitted to the ICU. PaO2/FiO2 ratio, respiratory rate and arterial pH were higher [165 vs. 244; 20 vs. 24 breath/min; 7.40 vs. 7.46] and PaCO2 and base excess were lower [34 vs. 42 mmHg; 0.60 vs. 1.30] in patients receiving respiratory support outside the ICU than in patients admitted to the ICU, respectively. Conclusions: Increase in ICU beds and use of out-of-ICU respiratory support allowed effective management of the first 14 days of the Covid-19 outbreak, avoiding resource rationing.

Published
2020

12. Lombardia

Author

Carullo, G, Provenzano, P, Danzi, V, Pinotti, G, Pisani, G, Previti, L, Votta, F, Carullo, G, Provenzano, P, Danzi, V, Pinotti, G, Pisani, G, Previti, L, and Votta, F

Published
2020

16. Albumin replacement in patients with severe sepsis or septic shock

Author

Gattinoni L, Caironi P, Pesenti A, Fumagalli R, Tognoni G, Romero M, Latini R, Masson S, Vincent JL, Suter PM, Valsecchi MG, Santosuosso A, Cavana M, Ortu A, Gabini R, Perno S, Anelli A, Amoruso R, Ferraris S, Borelli M, Massei R, Riva I, Poli G, Papagni G, Bortone F, Mamprin F, Keim R, Brivio M, Colageo U, Mimii EP, Sangiorgi G, Siniscalchi A, Pierucci E, Giovannitti A, Gentile C, Pascucci F, Antonini B, Zummo U, Valsecchi R, Cerisara M, Trezzi T, Dossena A, Ribola A, Tamayo L, Zoppellari R, Volta CA, Mangani V, Fanfani E, Chelazzi C, Bartoli T, Parrini V, Oggioni R, Fedele A, Molin A, Berri C, Guarino A, Isetta M, Bonfiglio M, Tissino F, Silvestri L, Milanesi M, Sbrana G, Motta E, Iannaco I, Casadio MC, Pasetti GS, Palandini A, Cascione C, Puscio D, Cellai F, Boccalatte D, Silvestri S, Fausto CI, Lupo V, Zompanti V, Iacobone E, Gattari D, Ronzoni G, Beck E, Francesconi S, Colombo R, Raimondi F, Castelli A, De Gasperi A, Radrizzani D, Ferla LE, Giudici R, Bellato V, Bordone G, Gavazzeni V, Lesmo A, Ripamonti D, Vesconi S, Papoff A, Rossi A, Noto A, Pezzi A, Zanforlin G, Kandil H, Ballotta A, Bettini F, Vaghi GM, Rossi S, Pessina C, Casagrande D, Trivellato A, Costagli V, Moise G, Furla M, Marelli S, Caspani L, Panigada M, Bruzzone P, Isgrò S, Abbruzzese C, Tagliabue P, Solca M, Bonazzi M, Cattaneo A, Rossi N, Andreoni P, Pasetto A, Girardis M, Barbieri E, Piazza O, Zagara G, Bono M, Galzerano A, Garzilli T, Dentini N, Bindi M, Biancofiore G, Mercante WP, Disconzi MM, Todesco N, Lunardi S, Sani E, Carli M, Bracciotti G, Gori V, Braccini P, Maggio G, Braschi A, Bottazzi A, Iotti G, Nicora B, Salati G, Salsi P, Antonelli M, Pennisi MA, Bello G, Caccese R, D'Ambrosio M, Rocco M, Sanseverino M, Gatta A, Nastasi M, Corsi A, Facondini F, Franchi F, Mongelli P, Ferrario M, Carulli F, Del Curto S, Schiappacasse G, Dalpiaz C, Armani S, Verderosa I, Marzullo A, Tonetti F, De Piero ME, Livigni S, Fiore G, Cerutti A, Erbetta S, Napolitano R, Pastorelli M, Bona F, Debernardi F, Gallo M, Segala V, Parigi L, Perzolla D, Marson F, Chiarandini P, Cammarano C, Sermann G, De Lucia S, Frigerio A, Distaso F, Franco R, Bossi E, Laudi C, De Nardin M, Violo T, Lazzari F, Vestali A, Della Mora E, Polati E, Martini A, Cristallini S, Totaro C, Milan B, Dan M, Ruberti S, Danzi V., GIARRATANO, Antonino, RAINERI, Santi Maurizio, CORTEGIANI, Andrea, Caironi, P, Tognoni, G, Masson, S, Fumagalli, R, Pesenti, A, Romero, M, Fanizza, C, Caspani, L, Faenza, S, Grasselli, G, Iapichino, G, Antonelli, M, Parrini, V, Fiore, G, Latini, R, Gattinoni, L, Caironi P, Tognoni G, Masson S, Fumagalli R, Pesenti A, Romero M, Fanizza C, Caspani L, Faenza S, Grasselli G, Iapichino G, Antonelli M, Parrini V, Fiore G, Latini R, Gattinoni L, Vincent JL, Suter PM, Valsecchi MG, Santosuosso A, Cavana M, Ortu A, Gabini R, Perno S, Anelli A, Amoruso R, Ferraris S, Borelli M, Massei R, Riva I, Poli G, Papagni G, Bortone F, Mamprin F, Keim R, Brivio M, Colageo U, Mimii EP, Sangiorgi G, Siniscalchi A, Pierucci E, Giovannitti A, Gentile C, Pascucci F, Antonini B, Zummo U, Valsecchi R, Cerisara M, Trezzi T, Dossena A, Ribola A, Tamayo L, Zoppellari R, Volta CA, Mangani V, Fanfani E, Chelazzi C, Bartoli T, Oggioni R, Fedele A, Molin A, Berri C, Guarino A, Isetta M, Bonfiglio M, Tissino F, Silvestri L, Milanesi M, Sbrana G, Motta E, Iannaco I, Casadio MC, Pasetti GS, Palandini A, Cascione C, Puscio D, Cellai F, Boccalatte D, Silvestri S, Fausto CI, Lupo V, Zompanti V, Iacobone E, Gattari D, Ronzoni G, Beck E, Francesconi S, Colombo R, Raimondi F, Castelli A, De Gasperi A, Radrizzani D, Ferla LE, Giudici R, Bellato V, Bordone G, Gavazzeni V, Lesmo A, Ripamonti D, Vesconi S, Papoff A, Rossi A, Noto A, Pezzi A, Zanforlin G, Kandil H, Ballotta A, Bettini F, Vaghi GM, Rossi S, Pessina C, Casagrande D, Trivellato A, Costagli V, Moise G, Furla M, Marelli S, Panigada M, Bruzzone P, Isgrò S, Abbruzzese C, Tagliabue P, Solca M, Bonazzi M, Cattaneo A, Rossi N, Andreoni P, Pasetto A, Girardis M, Barbieri E, Piazza O, Giarratano A, Raineri SM, Cortegiani A, Zagara G, Bono M, Galzerano A, Garzilli T, Dentini N, Bindi M, Biancofiore G, Mercante WP, Disconzi MM, Todesco N, Lunardi S, Sani E, Carli M, Bracciotti G, Gori V, Braccini P, Maggio G, Braschi A, Bottazzi A, Iotti G, Nicora B, Salati G, Salsi P, Pennisi MA, Bello G, Caccese R, D'Ambrosio M, Rocco M, Sanseverino M, Gatta A, Nastasi M, Corsi A, Facondini F, Franchi F, Mongelli P, Ferrario M, Carulli F, Del Curto S, Schiappacasse G, Dalpiaz C, Armani S, Verderosa I, Marzullo A, Tonetti F, De Piero ME, Livigni S, Cerutti A, Erbetta S, Napolitano R, Pastorelli M, Bona F, Debernardi F, Gallo M, Segala V, Parigi L, Perzolla D, Marson F, Chiarandini P, Cammarano C, Sermann G, De Lucia S, Frigerio A, Distaso F, Franco R, Bossi E, Laudi C, De Nardin M, Violo T, Lazzari F, Vestali A, Della Mora E, Polati E, Martini A, Cristallini S, Totaro C, Milan B, Dan M, Ruberti S, and Danzi V

Subjects
Male, medicine.medical_specialty, ALBUMIN, SEPSIS, SEVERE SEPSIS, SEPTIC SHOCK, Sepsi, Serum albumin, Settore MED/41 - Anestesiologia, Aged, Albumins, Female, Humans, Isotonic Solutions, Middle Aged, Rehydration Solutions, Sepsis, Serum Albumin, Shock, Septic, Survival Rate, Treatment Outcome, Intensive care, medicine, albumin replacement, Survival rate, Isotonic Solution, Medicine (all), SEPSIS, biology, business.industry, Septic shock, Rehydration Solution, Septic, Albumin, SEPTIC SHOCK, Organ dysfunction, Shock, General Medicine, medicine.disease, Surgery, Anesthesia, Relative risk, biology.protein, medicine.symptom, business, Human
Abstract

BACKGROUND: Although previous studies have suggested the potential advantages of albumin administration in patients with severe sepsis, its efficacy has not been fully established. METHODS: In this multicenter, open-label trial, we randomly assigned 1818 patients with severe sepsis, in 100 intensive care units (ICUs), to receive either 20% albumin and crystalloid solution or crystalloid solution alone. In the albumin group, the target serum albumin concentration was 30 g per liter or more until discharge from the ICU or 28 days after randomization. The primary outcome was death from any cause at 28 days. Secondary outcomes were death from any cause at 90 days, the number of patients with organ dysfunction and the degree of dysfunction, and length of stay in the ICU and the hospital. RESULTS: During the first 7 days, patients in the albumin group, as compared with those in the crystalloid group, had a higher mean arterial pressure (P = 0.03) and lower net fluid balance (P

Published
2014

17. ECMO for COVID-19 patients in Europe and Israel

Author

Lorusso, Roberto, Combes, Alain, Coco, Valeria Lo, De Piero, Maria Elena, Belohlavek, Jan, Delnoij, Thijs, van der Horst, Iwan, Miranda, Dinis Reis, van der Linden, Marcel, van der Heijden, JJ, Scholten, Erik, van Belle-van Haren, Nicole, Lagrand, Wim, de Jong, Sytse, Candura, Dario, Maas, Jacinta, van den Berg, MJ van Gijlswijk, Malfertheiner, Maximilian, Dreier, Esther, Mueller, Thomas, Boeken, Udo, Akhyari, Payam, Lichtenberg, Artur, Saeed, Diyar, Thiele, Holger, Baumgaertel, Matthias, Schmitto, Jan D, Mariani, Silvia, Thielmann, Matthias, Brenner, Thorsten, Benk, Cristoph, Czerny, Martin, Kalbhenn, Johannes, Maier, Sven, Schibilsky, David, Staudacher, Dawid L, Henn, Philipp, Iuliu, Torje, Muellenbach, Ralf, Reyher, Christian, Rolfes, Caroline, Zacharowski, Kai, Lotz, Gosta, Sonntagbauer, Michael, Kersten, Alexander, Karagiannidis, Christian, Schafer, Simone, Fichte, Julia, Hopf, Hans-Bernd, Samalavicius, Robertas, Lorini, Luca, Ghitti, Davide, Grazioli, Lorenzo, Loforte, Antonio, Baiocchi, Massimo, Checco, Erika Dal, Pacini, Davide, Meani, Paolo, Cappai, Antioco, Russo, Claudio Francesco, Bottiroli, Maurizio, Mondino, Michele, Ranucci, Marco, Fina, Dario, Ballotta, Andrea, Scandroglio, Anna Mara, Zangrillo, Alberto, Pieri, Marina, Nardelli, Pasquale, Fominskiy, Evgeny, Landoni, Giovanni, Fanelli, Vito, Brazzi, Luca, Montrucchio, Giorgia, Sales, Gabriele, Simonetti, Umberto, Urbino, Rosario, Livigni, Sergio, Degani, Antonella, Raffa, Giuseppe, Pilato, Michele, Martucci, Gennaro, Arcadipane, Antonio, Chiarini, Giovanni, Latronico, Nicola, Cattaneo, Sergio, Puglia, Carmine, Reina, Gianfranco, Sponga, Sandro, Livi, Ugolino, Foti, Giuseppe, Giani, Marco, Rona, Roberto, Avalli, Leonello, Bombino, Michela, Costa, Maria Cristina, Carozza, Roberto, Donati, Abele, Piciche, Marco, Favaro, Alessandro, Salvador, Loris, Danzi, Vinicio, Zanin, Anita, Condello, Ignazio, Fiore, Flavio, Moscarelli, Marco, Nasso, Giuseppe, Speziale, Giuseppe, Sandrelli, Luca, Montalto, Andrea, Musumeci, Francesco, Circelli, Alessandro, Gamberini, Emiliano, Russo, Emanuele, Benni, Marco, Agnoletti, Vanni, Rociola, Ruggero, Milano, Aldo D, Grasso, Salvatore, Civita, Antonio, Murgolo, Francesco, Pilato, Emanuele, Comentale, Giuseppe, Montisci, Andrea, Alessandri, Francesco, Tosi, Antonella, Pugliese, Francesco, Carelli, Simone, Grieco, Domenico Luca, Antonelli, Massimo, Ramoni, Enrico, Di Nardo, Matteo, Maisano, Francesco, Bettex, Dominique, Weber, Alberto, Grunenfelder, Jurg, Consiglio, Jolanda, Hansjoerg, Jenni, Haenggi, Matthias, Agus, Gianluca, Doeble, Thomas, Zenklusen, Urs, Bechtold, Xavier, Stockman, Bernard, De Backer, Daniel, Giglioli, Simone, Meyns, Bart, Vercaemst, Leen, Herman, Greet, Meersseman, Philippe, Vandenbriele, Christophe, Dauwe, Dieter, Vlasselaers, Dirk, Raes, Matthias, Debeuckelaere, Gerdy, Rodrigus, Inez, Biston, Patrick, Piagnerelli, Michael, Peperstraete, Harlinde, Germay, Olivier, Vandewiele, Korneel, Vandeweghe, Dimitri, Witters, Ine, Havrin, Sven, Bourgeois, Marc, Taccone, Fabio Silvio, Nobile, Leda, Lheureux, Olivier, Brasseur, Alexandre, Creteur, Jacques, Defraigne, Jean-Olivier, Misset, Benoit, Courcelle, Romain, Timmermans, Philippe, Lehaen, Jeroen, Frederik, Bonte, Riera, Jordi, Castro, Miguel angel, Gallart, Elisabet, Martinez-Martinez, Maria, Argudo, Eduard, Garcia-de-Acilu, Marina, de Pablo Sanchez, Raul, Ortiz, Aaron Blandino, Cabanes, Mari-Paz Fuset, Higa, Karina Osorio, Cassina, Albert Miralles, Berbel, Daniel Ortiz, Sanchez-Salado, Jose Carlos, Arnau, Blasco-Lucas, de Gopegui, Pablo Ruiz, Ricart, Pilar, Sandoval, Elena, Veganzones, Javier, Millan, Pablo, de la Sota, Perez, Santa Teresa, Patricia, Alcantara, Sara, Alvarez, Jorge Duerto, Gonzalez, Anxela Vidal, Lopez, Marta, Gordillo, Antonio, Naranjo-Izurieta, Jose, Costa, Ricardo Gimeno, Albacete Moreno, Carlos L, de Ayala, Jose angel, Blanco-Schweizer, Pablo, Andres, Nicolas Hidalgo, Boado, Victoria, Martinez, Jose Maria Nunez, Casal, Vanesa Gomez, Garcia, Esperanza Fernandez, Martin-Villen, Luis, Climent, Joaquin Colomina, Pinto, Luis F, Leprince, Pascal, Lebreton, Guillaume, Juvin, Charles, Schmidt, Matthieu, Pineton, Marc, Folliguet, Thierry, Saiydoun, Gabriel, Gaudard, Philippe, Colson, Pascal, Obadia, Jean-Francois, Pozzi, Matteo, Fellahi, Jean Luc, Yonis, Hodane, Richard, Jean Christophe, Parasido, Alessandro, Verhoye, Jean-Philippe, Flecher, Erwan, Ajrhourh, Lucrezia, Nesseler, Nicolas, Mansour, Alexandre, Guinot, Pierre-Gregoire, Zarka, Jonathan, Besserve, Patricia, Makhoul, Maged, Bolotin, Gil, Kassif, Yigal, Soufleris, Dimitros, Schellongowski, Peter, Bonaros, Nikolaos, Krapf, Christoph, Ebert, Kathrin, Mair, Peter, Kothleutner, Florian, Kowalewsky, Mariusz, Christensen, Steffen, Pedersen, Finn Moller, Balik, Martin, Blaha, Jan, Lips, Michal, Otahal, Michal, Camporota, Luigi, Daly, Kathleen, Agnew, Nicola, Barker, Julian, Head, Laura, Garcia, Miguel, Ledot, Stephane, Aquino, Verna, Lewis, Rebecca, Worthy, Jennifer, Noor, Hamza, Scott, Ian, O'Brien, Serena, Conrick-Martin, Ian, Carton, Edmund, Gillon, Stuart, Flemming, Lucy, Broman, Lars Mikael, Grins, Edgars, Ketskalo, Michail, Tsarenko, Sergey, Popugaev, Konstantin, Minin, Sergei, Kornilov, Igor, Skopets, Alexander, Kornelyuk, Roman, Turchaninov, Alexandr, Gorjup, Vojka, Shelukhin, Daniil, Dsouki, Youssef El, Sargin, Murat, Kaygin, Mehmet Ali, Liana, Shestakova, Puss, Severin, Soerensen, Gro, Magnus, Rosen, Kanetoft, Mikael, Watson, Pia, Redfors, Bengt, Krenner, Niklas, Velia Antonini, M, Barrett, Nicholas A, Belliato, Mirko, Davidson, Mark, Finney, Simon, Fowles, Jo-Anne, Halbe, Maximilian, Hennig, Felix, Jones, Tim, Pinto, Luis, Smith, Jonathan, Roeleveld, Peter, Swol, Justyna, Maastricht University Medical Centre (MUMC), Maastricht University [Maastricht], Cardiovascular Research Institute Maastricht (CARIM), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), First Faculty of Medicine Charles University [Prague], Intensive Care Medicine, AII - Inflammatory diseases, ANS - Neuroinfection & -inflammation, EuroECMO COVID-19 Working Group, Euro-ELSO Steering Committee, Lorusso, Roberto, Combes, Alain, Coco, Valeria Lo, De Piero, Maria Elena, Belohlavek, Jan (EuroECMO COVID-19, Workinggroup, Euro-ELSO Steering, Committee), Zangrillo, A, Landoni, G, CTC, MUMC+: MA Med Staf Spec CTC (9), RS: Carim - V04 Surgical intervention, MUMC+: MA Alg Ond Onderz CTC (9), Lorusso, R, Combes, A, Coco, V, De Piero, M, Belohlavek, J, Delnoij, T, van der Horst, I, Miranda, D, van der Linden, M, van der Heijden, J, Scholten, E, van Belle-van Haren, N, Lagrand, W, de Jong, S, Candura, D, Maas, J, van den Berg, M, Malfertheiner, M, Dreier, E, Mueller, T, Boeken, U, Akhyari, P, Lichtenberg, A, Saeed, D, Thiele, H, Baumgaertel, M, Schmitto, J, Mariani, S, Thielmann, M, Brenner, T, Benk, C, Czerny, M, Kalbhenn, J, Maier, S, Schibilsky, D, Staudacher, D, Henn, P, Iuliu, T, Muellenbach, R, Reyher, C, Rolfes, C, Zacharowski, K, Lotz, G, Sonntagbauer, M, Kersten, A, Karagiannidis, C, Schafer, S, Fichte, J, Hopf, H, Samalavicius, R, Lorini, L, Ghitti, D, Grazioli, L, Loforte, A, Baiocchi, M, Checco, E, Pacini, D, Meani, P, Cappai, A, Russo, C, Bottiroli, M, Mondino, M, Ranucci, M, Fina, D, Ballotta, A, Scandroglio, A, Pieri, M, Nardelli, P, Fominskiy, E, Fanelli, V, Brazzi, L, Montrucchio, G, Sales, G, Simonetti, U, Urbino, R, Livigni, S, Degani, A, Raffa, G, Pilato, M, Martucci, G, Arcadipane, A, Chiarini, G, Latronico, N, Cattaneo, S, Puglia, C, Reina, G, Sponga, S, Livi, U, Foti, G, Giani, M, Rona, R, Avalli, L, Bombino, M, Costa, M, Carozza, R, Donati, A, Piciche, M, Favaro, A, Salvador, L, Danzi, V, Zanin, A, Condello, I, Fiore, F, Moscarelli, M, Nasso, G, Speziale, G, Sandrelli, L, Montalto, A, Musumeci, F, Circelli, A, Gamberini, E, Russo, E, Benni, M, Agnoletti, V, Rociola, R, Milano, A, Grasso, S, Civita, A, Murgolo, F, Pilato, E, Comentale, G, Montisci, A, Alessandri, F, Tosi, A, Pugliese, F, Carelli, S, Grieco, D, Antonelli, M, Ramoni, E, Di Nardo, M, Maisano, F, Bettex, D, Weber, A, Grunenfelder, J, Consiglio, J, Hansjoerg, J, Haenggi, M, Agus, G, Doeble, T, Zenklusen, U, Bechtold, X, Stockman, B, De Backer, D, Giglioli, S, Meyns, B, Vercaemst, L, Herman, G, Meersseman, P, Vandenbriele, C, Dauwe, D, Vlasselaers, D, Raes, M, Debeuckelaere, G, Rodrigus, I, Biston, P, Piagnerelli, M, Peperstraete, H, Germay, O, Vandewiele, K, Vandeweghe, D, Witters, I, Havrin, S, Bourgeois, M, Taccone, F, Nobile, L, Lheureux, O, Brasseur, A, Creteur, J, Defraigne, J, Misset, B, Courcelle, R, Timmermans, P, Lehaen, J, Frederik, B, Riera, J, Castro, M, Gallart, E, Martinez-Martinez, M, Argudo, E, Garcia-de-Acilu, M, de Pablo Sanchez, R, Ortiz, A, Cabanes, M, Higa, K, Cassina, A, Berbel, D, Sanchez-Salado, J, Arnau, B, de Gopegui, P, Ricart, P, Sandoval, E, Veganzones, J, Millan, P, de la Sota, P, Santa Teresa, P, Alcantara, S, Alvarez, J, Gonzalez, A, Lopez, M, Gordillo, A, Naranjo-Izurieta, J, Costa, R, Albacete Moreno, C, de Ayala, J, Blanco-Schweizer, P, Andres, N, Boado, V, Martinez, J, Casal, V, Garcia, E, Martin-Villen, L, Climent, J, Pinto, L, Leprince, P, Lebreton, G, Juvin, C, Schmidt, M, Pineton, M, Folliguet, T, Saiydoun, G, Gaudard, P, Colson, P, Obadia, J, Pozzi, M, Fellahi, J, Yonis, H, Richard, J, Parasido, A, Verhoye, J, Flecher, E, Ajrhourh, L, Nesseler, N, Mansour, A, Guinot, P, Zarka, J, Besserve, P, Makhoul, M, Bolotin, G, Kassif, Y, Soufleris, D, Schellongowski, P, Bonaros, N, Krapf, C, Ebert, K, Mair, P, Kothleutner, F, Kowalewsky, M, Christensen, S, Pedersen, F, Balik, M, Blaha, J, Lips, M, Otahal, M, Camporota, L, Daly, K, Agnew, N, Barker, J, Head, L, Garcia, M, Ledot, S, Aquino, V, Lewis, R, Worthy, J, Noor, H, Scott, I, O'Brien, S, Conrick-Martin, I, Carton, E, Gillon, S, Flemming, L, Broman, L, Grins, E, Ketskalo, M, Tsarenko, S, Popugaev, K, Minin, S, Kornilov, I, Skopets, A, Kornelyuk, R, Turchaninov, A, Gorjup, V, Shelukhin, D, Dsouki, Y, Sargin, M, Kaygin, M, Liana, S, Puss, S, Soerensen, G, Magnus, R, Kanetoft, M, Watson, P, Redfors, B, Krenner, N, Velia Antonini, M, Barrett, N, Belliato, M, Davidson, M, Finney, S, Fowles, J, Halbe, M, Hennig, F, Jones, T, Smith, J, Roeleveld, P, Swol, J, Lorusso R., Combes A., Coco V.L., De Piero M.E., and Belohlavek J, EuroECMO COVID-19 WorkingGroup, and Euro-ELSO Steering Committee, Pacini D

Subjects
2019-20 coronavirus outbreak, medicine.medical_specialty, Letter, Coronavirus disease 2019 (COVID-19), Pain medicine, medicine.medical_treatment, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), [SDV]Life Sciences [q-bio], MEDLINE, 610 Medicine & health, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, 03 medical and health sciences, Extracorporeal Membrane Oxygenation, covid, ecmo, respiratory failure, 0302 clinical medicine, Critical Care Medicine, General & Internal Medicine, Anesthesiology, medicine, Extracorporeal membrane oxygenation, Humans, Israel, ComputingMilieux_MISCELLANEOUS, Science & Technology, business.industry, COVID-19, 030208 emergency & critical care medicine, 3. Good health, Europe, Emergency medicine, Human medicine, ECMO, business, Life Sciences & Biomedicine, Human
Abstract

ispartof: INTENSIVE CARE MEDICINE vol:47 issue:3 pages:344-348 ispartof: location:United States status: published

Published
2021

18. Secondary pneumomediastinum in COVID-19 patient: A case managed with VV-ECMO.

Author

Golino G, Forin E, Boni E, Martin M, Perbellini G, Rizzello V, Toniolo A, and Danzi V

Abstract

Air leak syndrome, including pneumomediastinum (PM), pneumopericardium, pneumothorax, or subcutaneous emphysema, is primarily caused by chest trauma, cardiothoracic surgery, esophageal perforation, and mechanical ventilation. Secondary pneumomediastinum (SP) is a rare complication, with a much lower incidence reported in patients with coronavirus disease 2019 (COVID-19). Our patient was a 44-year-old nonsmoker male with a previous history of obesity (Body Mass Index [BMI] 35 kg/m 2 ), hyperthyroidism, hypokinetic cardiopathy and atrial fibrillation in treatment with flecainide, who presented to the emergency department with 6 days of fever, cough, dyspnea, and respiratory distress. The COVID-19 diagnosis was confirmed based on a polymerase chain reaction (PCR) test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). After initiation of mechanical ventilation, a chest computed tomography (CT) on the first day revealed bilateral multifocal ground-glass opacities, consolidation and an extensive SP and pneumoperitoneum. Our therapeutic strategy was initiation of veno-venous extracorporeal membrane oxygenation (VV-ECMO) as a bridge to recovery after positioning 2 drains (mediastinal and pleural), for both oxygenation and carbon dioxide clearance, to allow protective and ultra-protective ventilation to limit ventilator-induced lung injury (VILI) and the intensity of mechanical power for lung recovery. After another chest CT scan which showed a clear reduction of the PM, 2 pronation and neuromuscular relaxation cycles were also required, with improvement of gas exchange and respiratory mechanics. On the 15th day, lung function recovered and the patient was then weaned from VV-ECMO, and ultimately made a good recovery and was discharged. In conclusion, SP may be a reflection of extensive alveolar damage and should be considered as a potential predictive factor for adverse outcome in critically ill SARS-CoV2 patients., Competing Interests: The authors do not have any conflicts of interest to disclose., (© 2024 The Authors.)

Published
2024
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19. Endotoxin removal therapy with Polymyxin B immobilized fiber column: a single center experience from EUPHAS2 registry.

Author

Forin E, Lorenzoni G, Ferrer R, De Cal M, Zanella M, Marchionna N, Gregori D, Forfori F, Lorenzin A, Danzi V, Ronco C, and De Rosa S

Subjects
Humans, Critical Illness therapy, Endotoxins, Polymyxin B therapeutic use, Retrospective Studies, Hemoperfusion, Shock, Septic
Abstract

Although the precise clinical indication for initiation of PMX-HA is widely debated in the literature, a proper patient selection and timing of treatment delivery might play a critical role in the clinical course of a specific subphenotype of septic shock (endotoxic shock). In light of this view, since 2019, we have introduced in our clinical practice a diagnostic-therapeutic flowchart to select patients that can benefit the most from the treatment proposed. In addition, we reported in this study our experience of PMX-HA in a cohort of critically ill patients admitted to our intensive care unit (ICU). We analyzed a single centre, retrospective, observational web-based database (extracted from the EUPHAS2 registry) of critically ill patients admitted to the ICU between January 2016 and May 2021 who were affected by endotoxic shock. Patients were divided according to the diagnostic-therapeutic flowchart in two groups: Pre-Flowchart (Pre-F) and Post-Flowchart (Post-F). From January 2016 to May 2021, 61 patients were treated with PMX-HA out of 531 patients diagnosed with septic shock and of these, fifty patients (82%) developed AKI during their ICU stay. The most common source of infection was secondary peritonitis (36%), followed by community-acquired pneumonia (29%). Fifty-five (90%) out of 61 patients received a second PMX-HA treatment, with a statistically significant difference between the two groups (78% of the Pre-F vs. 100% of the Post-F group, p = 0.005). In both groups, between T0 and T120, the Endotoxin Activity Assay (EAA) decreased, while the SOFA score, mean arterial pressure (MAP), and Vasoactive Inotropic Score (VIS) improved with no statistically significant difference. Furthermore, when performing a propensity score matching analysis to compare mortality between the two groups, statistically significant lower ICU and 90-day mortalities were observed in the Post-F group [p = 0.016]. Although in this experienced centre data registry, PMX-HA was associated with organ function recovery, hemodynamic improvement, and current EAA level reduction in critically ill patients with endotoxic shock. Following propensity score-matched analysis, ICU mortality and 90-day mortalities were lower in the diagnostic-therapeutic flowchart group when considering two temporal groups based on strict patient selection criteria and timing to achieve PMX. Further Randomised Control Trials focused on centre selection, adequate training and a flowchart of action when assessing extracorporeal blood purification use should be performed., (© 2023. Springer Nature Limited.)

Published
2023
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20. Radiologic Imaging of the In Vivo Position of the New Supraglottic Airway Device Spritztube ® in an Adult Patient-A Case Report.

Author

De Rosa S, Sorbello M, Rigobello A, Cattin L, Iannucci G, Gennaro P, Danzi V, and Checcacci Carboni S

Abstract

Spritztube ® is a new supraglottic airway device that allows either extraglottic ventilation or orotracheal intubation with the same device. The aim of the present report is to provide the first radiologic images of the Spritztube in situ in a living human and to assess the depth of insertion and its anatomical relationships in vivo. We present the case of a 55-year-old man who was admitted to our centre to perform an interventional neuroradiological procedure. We obtained and analysed radiologic images of the head and neck of an adult patient to ascertain the position of the cuffs of the Spritztube relative to different anatomic structures. The insertion and depth of the device, correct tip positioning, effects of the distal and proximal cuffs on adjacent soft tissues, and the position of the pharyngeal cuff from the cranial to the hyoid bone were evaluated. Our report shows that Spritztube could be helpful in maintaining an adequate airway during radiologic procedures.

Published
2022
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21. Incidence of Acute Kidney Injury in Polytrauma Patients and Predictive Performance of TIMP2 × IGFBP7 Biomarkers for Early Identification of Acute Kidney Injury.

Author

Golino G, Greco M, Rigobello A, Danzi V, De Cal M, Malchiorna N, Zannella M, Navalesi P, Costa-Pinto R, Ronco C, and De Rosa S

Abstract

Background: Acute kidney injury (AKI) is a common cause of organ failure in trauma patients who survive their initial injuries. It is independently associated with increased morbidity and mortality and prolongs the length of hospital stays. The objectives of this study were to describe the incidence of early AKI and influence of risk factors in polytrauma patients and evaluate the predictive potential of TIMP2 × IGFBP7 biomarkers in this patient cohort. Methods: We conducted a retrospective cohort study of severely injured adult patients who were consecutively admitted to a multidisciplinary ICU from May 2017 to May 2019. Detailed patient data was retrieved from ICU medical records. Fluid balance, urinary output, and sCr values up to 72 h were collected. Urine samples for measuring TIMP2 × IGFBP7 concentrations were obtained and analyzed from ICU admission to 72 h. Results: Among the 153 patients eligible for analysis, 45 were included in the AKI, and 108 in the no AKI cohorts. The incidence of AKI within 72 h, based on KDIGO criteria, was 28.8%. There were no differences in ISS, type and mechanism of injury, heart rate, and systolic BP at admission between groups. Patients with early AKI were older (68 vs. 49 years, p < 0.001), obese (BMI 26.2 vs. 24.7, p < 0.048), and more likely to have previous cardiac disease (27% vs. 5.6%, p < 0.001). TIMP2 × IGFBP7 values on ICU admission were associated with subsequent AKI in patients without evidence of AKI at the time of ICU admission. They were also higher in the AKI cohort and significantly correlated with renal replacement therapy (RRT) and episodes of hypotension. Multivariable analysis confirmed age, previous cardiac disease, and NephroCheck as the variables mostly associated with AKI, with AUC 0.792. Conclusions: TIMP2 × IGFBP7 may help identify trauma patients with tubular damage that may evolve into a clinically manifested syndrome. Prospective studies of TIMP2 × IGFBP7, as a trigger for early AKI bundle care, are warranted.

Published
2022
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22. Pharmacodynamic analysis of a fluid challenge with 4 ml kg -1 over 10 or 20 min: a multicenter cross-over randomized clinical trial.

Author

Messina A, Palandri C, De Rosa S, Danzi V, Bonaldi E, Montagnini C, Baino S, Villa F, Sala F, Zito P, Negri K, Della Corte F, Cammarota G, Saderi L, Sotgiu G, Monge García MI, and Cecconi M

Subjects
Crystalloid Solutions, Humans, Prospective Studies, Stroke Volume, Fluid Therapy, Hemodynamics
Abstract

Purpose: A number of studies performed in the operating room evaluated the hemodynamic effects of the fluid challenge (FC), solely considering the effect before and after the infusion. Few studies have investigated the pharmacodynamic effect of the FC on hemodynamic flow and pressure variables. We designed this trial aiming at describing the pharmacodynamic profile of two different FC infusion times, of a fixed dose of 4 ml kg -1 ., Methods: Forty-nine elective neurosurgical patients received two consecutive FCs of 4 ml kg -1 of crystalloids in 10 (FC 10 ) or 20 (FC 20 ) minutes, in a random order. Fluid responsiveness was defined as stroke volume index increase ≥ 10%. We assessed the net area under the curve (AUC), the maximal percentage difference from baseline (d max ), time when the d max was observed (t max ), change from baseline at 1-min (d 1 ) and 5-min (d 5 ) after FC end., Results: After FC 10 and FC 20, 25 (51%) and 14 (29%) of 49 patients were classified as fluid responders (p = 0.001). With the exception of the AUCs of SAP and MAP, the AUCs of all the considered hemodynamic variables were comparable. The d max and the t max were overall comparable. In both groups, the hemodynamic effects on flow variables were dissipated within 5 min after FC end., Conclusions: The infusion time of FC administration affects fluid responsiveness, being higher for FC 10 as compared to FC 20 . The effect on flow variables of either FCs fades 5 min after the end of infusion., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

Published
2022
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23. Clinical Assessment of Continuous Hemodialysis with the Medium Cutoff EMiC®2 Membrane in Patients with Septic Shock.

Author

Ferrari F, Husain-Syed F, Milla P, Lorenzin A, Scudeller L, Sartori M, Gramaticopolo S, D'Auria L, Guglielmi A, Cornara P, De Rosa S, Zanella M, Corradi V, De Cal M, Danzi V, Giavarina D, Brendolan A, Mojoli F, Arpicco S, and Ronco C

Subjects
Humans, Critical Illness, Renal Dialysis, Albumins, Continuous Renal Replacement Therapy, Shock, Septic therapy, Shock, Septic etiology, Acute Kidney Injury therapy, Hemodiafiltration adverse effects
Abstract

Introduction: At the time of renal replacement therapy, approximately 20% of critically ill patients have septic shock. In this study, medium cutoff (MCO) continuous venovenous hemodialysis (CVVHD) was compared to high-flux membrane continuous venovenous hemodiafiltration (CVVHDF) in terms of hemodynamic improvement, efficiency, middle molecule removal, and inflammatory system activation., Methods: This is a monocenter crossover randomized study. Between December 31, 2017, and December 31, 2019, 20 patients with septic shock and stage 3 acute kidney injury (AKI) admitted to 2 Italian ICUs were enrolled. All patients underwent CVVHD with Ultraflux® EMiC®2 and CVVHDF with AV1000S® without washout. Each treatment lasted 24 h., Results: Compared to AV1000S®-CVVHDF, EMIC®2-CVVHD normalized cardiac index (β = -0.64; p = 0.02) and heart rate (β = 5.72; p = 0.01). Interleukin-8 and myeloperoxidase removal were greater with AV1000S®-CVVHDF than with EMiC®2-CVVHD (β = 0.35; p &lt; 0.001; β = 0.43; p = 0.03, respectively). Leukocytosis improved over 24 h in EMiC®2-CVVHD-treated patients (β = 4.13; p = 0.03), whereas procalcitonin levels decreased regardless of the modality (β = 0.89; p = 0.01) over a 48-h treatment period. Reduction rates, instantaneous plasmatic clearance of urea, creatinine, and β2-microglobulin were similar across modalities. β2-Microglobulin removal efficacy was greater in the EMiC®2 group (β = 0-2.88; p = 0.002), while albumin levels did not differ. Albumin was undetectable in the effluent in both treatments., Discussion: In patients with septic shock and severe AKI, the efficacy of uremic toxin removal was comparable between MCO-CVVHD and CVVHDF. Further, MCO-CVVHD was associated with improved hemodynamics. Fraction of filtration and transmembrane pressure reduction and the maintenance of equal efficacy might be the key features of CVVHD with MCO membranes in critically ill patients., (© 2022 S. Karger AG, Basel.)

Published
2022
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25. Perioperative intravenous tranexamic acid reduces blood transfusion in primary cementless total hip arthroplasty.

Author

Sandri A, Mimor BF, Ditta A, Finocchio E, Danzi V, Piccoli P, Regis D, and Magnan B

Subjects
Aged, Aged, 80 and over, Cementation, Female, Hip Prosthesis, Humans, Infusions, Intravenous, Male, Middle Aged, Prosthesis Design, Retrospective Studies, Antifibrinolytic Agents administration & dosage, Arthroplasty, Replacement, Hip adverse effects, Blood Loss, Surgical prevention & control, Blood Transfusion, Joint Diseases surgery, Tranexamic Acid administration & dosage
Abstract

Background and Aim of the Work: Blood loss and transfusion requirements are common in total hip arthroplasty. Tranexamic acid is one of the most interesting options to reduce the need for blood transfusions in a variety of surgical settings. The aim of this study was to assess the efficacy of perioperative intravenous traxexamic acid regarding blood transfusion rate and volume of transfused blood without increasing adverse events after primary elective cementless total hip arthroplasty., Methods: A comparative retrospective study was conducted in 86 healthy patients who had undergone primary cementless total hip artrhoplasty for severe joint diseases at a single institution. All surgical procedures were performed through an anterolateral Watson- Jones approach with the patient in supine position. Forty patients (TXA group) received tranexamic acid 1g as an intravenous bolus 10 minutes before skin incision and a further 1 g, diluted in 250 mL of saline solution, in continuous perfusion at 30 mL/h, following commencement of the surgery. Forty-six patients (control group) did not receive TXA. Outcome measures included BT rate, volume of transfused blood, deep vein thrombosis and occurrence of pulmonary embolism., Results: BT rate was significantly less for the TXA group (37.5%) compared with the control group (65%; p=0.011). The mean blood volume transfused was also significantly less for the TXA group (240 mL) compared with the control group (450mL; p=0.009). No adverse events occurred in any group. Conclusons: Perioperative intravenous tranexamic acid is effective in reducing blood transfusion rate and volume of transfused blood, without increasing the risk of thromboembolic events in patients undergoing primary cementless total hip arthroplasty.

Published
2019
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