13 results on '"Filetici N"'
Search Results
2. Long-term outcome of COVID-19 patients treated with helmet noninvasive ventilation vs. high-flow nasal oxygen: a randomized trial
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Michi T., Mattana C., Menga L. S., Bocci M. G., Cesarano M., Rosa T., Gualano M. R., Montomoli J., Spadaro S., Tosato M., Rota E., Landi F., Cutuli S. L., Tanzarella E. S., Pintaudi G., Piervincenzi E., Bello G., Tonetti T., Rucci P., De Pascale G., Maggiore S. M., Grieco D. L., Conti G., Antonelli M., Maviglia R., Mercurio G., De Santis P., Pennisi M. A., Anzellotti G. M., Torrini F., Rubino C., Morena T. C., Gennenzi V., Postorino S., Vargas J., Filetici N., Settanni D., Durante M., Cascarano L., Di Muro M., Scarascia R., Bitondo M. M., Murdolo M., Mele A., Silva S., Zaccone C., Pozzana F., Maccaglia A., Savino M., Potalivo A., Ceccaroni F., Scavone A., Lombardi G., Montini L., Dell'Anna A. M., Volta C. A., Ranieri V. M., Falo G., Carelli S., Natalini D., Berardi C., Delle Cese L., Vetrugno L., Balzani E., Michi T., Mattana C., Menga L.S., Bocci M.G., Cesarano M., Rosa T., Gualano M.R., Montomoli J., Spadaro S., Tosato M., Rota E., Landi F., Cutuli S.L., Tanzarella E.S., Pintaudi G., Piervincenzi E., Bello G., Tonetti T., Rucci P., De Pascale G., Maggiore S.M., Grieco D.L., Conti G., Antonelli M., Maviglia R., Mercurio G., De Santis P., Pennisi M.A., Anzellotti G.M., Torrini F., Rubino C., Morena T.C., Gennenzi V., Postorino S., Vargas J., Filetici N., Settanni D., Durante M., Cascarano L., Di Muro M., Scarascia R., Bitondo M.M., Murdolo M., Mele A., Silva S., Zaccone C., Pozzana F., Maccaglia A., Savino M., Potalivo A., Ceccaroni F., Scavone A., Lombardi G., Montini L., Dell'Anna A.M., Volta C.A., Ranieri V.M., Falo G., Carelli S., Natalini D., Berardi C., Delle Cese L., Vetrugno L., and Balzani E.
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Helmet ,COVID-19 ,Acute respiratory failure ,High-flow nasal oxygen ,Noninvasive ventilation ,Patient self-inflicted lung injury (P-SILI) - Abstract
Background: Long-term outcomes of patients treated with helmet noninvasive ventilation (NIV) are unknown: safety concerns regarding the risk of patient self-inflicted lung injury and delayed intubation exist when NIV is applied in hypoxemic patients. We assessed the 6-month outcome of patients who received helmet NIV or high-flow nasal oxygen for COVID-19 hypoxemic respiratory failure. Methods: In this prespecified analysis of a randomized trial of helmet NIV versus high-flow nasal oxygen (HENIVOT), clinical status, physical performance (6-min-walking-test and 30-s chair stand test), respiratory function and quality of life (EuroQoL five dimensions five levels questionnaire, EuroQoL VAS, SF36 and Post-Traumatic Stress Disorder Checklist for the DSM) were evaluated 6months after the enrollment. Results: Among 80 patients who were alive, 71 (89%) completed the follow-up: 35 had received helmet NIV, 36 high-flow oxygen. There was no inter-group difference in any item concerning vital signs (N = 4), physical performance (N = 18), respiratory function (N = 27), quality of life (N = 21) and laboratory tests (N = 15). Arthralgia was significantly lower in the helmet group (16% vs. 55%, p = 0.002). Fifty-two percent of patients in helmet group vs. 63% of patients in high-flow group had diffusing capacity of the lungs for carbon monoxide < 80% of predicted (p = 0.44); 13% vs. 22% had forced vital capacity < 80% of predicted (p = 0.51). Both groups reported similar degree of pain (p = 0.81) and anxiety (p = 0.81) at the EQ-5D-5L test; the EQ-VAS score was similar in the two groups (p = 0.27). Compared to patients who successfully avoided invasive mechanical ventilation (54/71, 76%), intubated patients (17/71, 24%) had significantly worse pulmonary function (median diffusing capacity of the lungs for carbon monoxide 66% [Interquartile range: 47–77] of predicted vs. 80% [71–88], p = 0.005) and decreased quality of life (EQ-VAS: 70 [53–70] vs. 80 [70–83], p = 0.01). Conclusions: In patients with COVID-19 hypoxemic respiratory failure, treatment with helmet NIV or high-flow oxygen yielded similar quality of life and functional outcome at 6months. The need for invasive mechanical ventilation was associated with worse outcomes. These data indicate that helmet NIV, as applied in the HENIVOT trial, can be safely used in hypoxemic patients. Trial registration Registered on clinicaltrials.gov NCT04502576 on August 6, 2020
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- 2023
3. High‐volume patient‐controlled epidural vs. programmed intermittent epidural bolus for labour analgesia: a randomised controlled study.
- Author
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Roofthooft, E., Filetici, N., Van Houwe, M., Van Houwe, P., Barbé, A., Fieuws, S., Rex, S., Wong, C. A., and Van de Velde, M.
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PATIENT-controlled analgesia , *EPIDURAL analgesia , *ANALGESIA , *PATIENT satisfaction , *SUFENTANIL - Abstract
Summary: The aim of neuraxial analgesia is to achieve excellent pain relief with the fewest adverse effects. The most recently introduced technique for epidural analgesia maintenance is the programmed intermittent epidural bolus. In a recent study, we compared this with patient‐controlled epidural analgesia without a background infusion and found that a programmed intermittent epidural bolus was associated with less breakthrough pain, lower pain scores, higher local anaesthetic consumption and comparable motor block. However, we had compared 10 ml programmed intermittent epidural boluses with 5 ml patient‐controlled epidural analgesia boluses. To overcome this potential limitation, we designed a randomised, multicentre non‐inferiority trial using 10 ml boluses in each group. The primary outcome was the incidence of breakthrough pain and total analgesic intake. Secondary outcomes included motor block; pain scores; patient satisfaction; and obstetric and neonatal outcomes. The trial was considered positive if two endpoints were met: non‐inferiority of patient‐controlled epidural analgesia with respect to breakthrough pain; and superiority of patient‐controlled epidural analgesia with respect to local anaesthetic consumption. A total of 360 nulliparous women were allocated randomly to patient‐controlled epidural analgesia‐only or programmed intermittent epidural bolus groups. The patient‐controlled group received 10 ml boluses of ropivacaine 0.12% with sufentanil 0.75 μg.ml‐1; the programmed intermittent group received 10 ml boluses supplemented by 5 ml patient‐controlled boluses. The lockout period was 30 min in each group and the maximum allowed hourly local anaesthetic/opioid consumption was identical between the groups. Breakthrough pain was similar between groups (11.2% patient controlled vs. 10.8% programmed intermittent, p = 0.003 for non‐inferiority). Total ropivacaine consumption was lower in the PCEA–group (mean difference 15.3 mg, p < 0.001). Motor block, patient satisfaction scores and maternal and neonatal outcomes were similar across both groups. In conclusion, patient‐controlled epidural analgesia is non‐inferior to programmed intermittent epidural bolus if equal volumes of patient‐controlled epidural analgesia are used to maintain labour analgesia and superior with respect to local anaesthetic consumption. [ABSTRACT FROM AUTHOR]
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- 2023
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4. B5 High-volume PCEA versus PIEB for labour analgesia: a randomised, double-blind, two-center, non-inferiority study in nulliparous women investigating quality of pain relief
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Filetici, N, primary, Roofthooft, E, additional, Rex, S, additional, Wong, CA, additional, and Van de Velde, M, additional
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- 2022
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5. The place of dexmedetomidine light sedation in patients with acute brain injury
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Carelli, Simone, De Pascale, Gennaro, Filetici, Nicoletta, Bocci, Maria Grazia, Maresca, Gian Marco, Cutuli, S. L., Pizzo, Cecilia Maria, Bello, Giuseppe, Montini, Luca, Caricato, Anselmo, Conti, Giorgio, Antonelli, Massimo, Carelli S., De Pascale G. (ORCID:0000-0002-8255-0676), Filetici N., Bocci M. G., Maresca G. M., Pizzo C. M., Bello G. (ORCID:0000-0003-2648-7235), Montini L. (ORCID:0000-0003-4602-5134), Caricato A. (ORCID:0000-0001-5929-120X), Conti G. (ORCID:0000-0002-8566-9365), Antonelli M. (ORCID:0000-0003-3007-1670), Carelli, Simone, De Pascale, Gennaro, Filetici, Nicoletta, Bocci, Maria Grazia, Maresca, Gian Marco, Cutuli, S. L., Pizzo, Cecilia Maria, Bello, Giuseppe, Montini, Luca, Caricato, Anselmo, Conti, Giorgio, Antonelli, Massimo, Carelli S., De Pascale G. (ORCID:0000-0002-8255-0676), Filetici N., Bocci M. G., Maresca G. M., Pizzo C. M., Bello G. (ORCID:0000-0003-2648-7235), Montini L. (ORCID:0000-0003-4602-5134), Caricato A. (ORCID:0000-0001-5929-120X), Conti G. (ORCID:0000-0002-8566-9365), and Antonelli M. (ORCID:0000-0003-3007-1670)
- Abstract
An individualized titration of sedative and analgesic drugs is pivotal in the late phase management of acute brain injury (ABI) patients, when weaning from mechanical ventilation (MV) needs to be implemented [1]. Due to its pharmacologic profile, dexmedetomidine (Dex) represents a drug of choice in such setting. Nevertheless, its use in ABI patients has been recently debated mainly as a consequence of its hemodynamic effects [2, 3]. The present study aimed to evaluate clinical outcomes and safety profile of Dex administration in this patients’ category. We retrospectively analysed prospectively collected data on the main clinical features and adverse events observed during light sedation with dexmedetomidine (Dex-LS) in ICU patients with ABI. Light sedation was defined by the maintenance of a Richmond Agitation and Sedation Scale (RASS) score between 1 and − 2. The rate of potential side effects during Dex-LS was compared with the 6-h period before Dex initiation (see Additional file 1 for further details). Dexmedetomidine has been administered safely in our population of ABI patients. Dex infusion rate and duration were comparable with those previously described [2, 3]. The rate of systemic arterial hypotension was consistent with available findings [2, 3] and lower compared with the pre-infusion period. The 23% rate of bradycardia takes place in the wide range of occurrence reported in ABI patients [2]. Nevertheless, bradycardia never imposed dexmedetomidine interruption. These findings should be interpreted in the light of the relatively young age and low severity scores of our population, where Dex was frequently co-infused with other sedatives or opioids. Neither seizure rate nor intracranial pressure increased during Dex-LS, supporting the clinical absence of Dex impact on cerebral physiology [4]. During Dex-LS, the majority of patients were weaned from MV, including more than half who previously failed a weaning attempt. These observations are in line with th
- Published
- 2019
6. Epidemiology of intra-abdominal infection and sepsis in critically ill patients: 'AbSeS', a multinational observational cohort study and ESICM Trials Group Project
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Carelli, Simone, De Pascale, Gennaro, Filetici, Nicoletta, Bocci, Maria Grazia, Maresca, Gian Marco, Cutuli, S. L., Pizzo, Cecilia Maria, Bello, Giuseppe, Montini, Luca, Caricato, Anselmo, Conti, Giorgio, Antonelli, Massimo, Carelli S., De Pascale G. (ORCID:0000-0002-8255-0676), Filetici N., Bocci M. G., Maresca G. M., Pizzo C. M., Bello G. (ORCID:0000-0003-2648-7235), Montini L. (ORCID:0000-0003-4602-5134), Caricato A. (ORCID:0000-0001-5929-120X), Conti G. (ORCID:0000-0002-8566-9365), Antonelli M. (ORCID:0000-0003-3007-1670), Carelli, Simone, De Pascale, Gennaro, Filetici, Nicoletta, Bocci, Maria Grazia, Maresca, Gian Marco, Cutuli, S. L., Pizzo, Cecilia Maria, Bello, Giuseppe, Montini, Luca, Caricato, Anselmo, Conti, Giorgio, Antonelli, Massimo, Carelli S., De Pascale G. (ORCID:0000-0002-8255-0676), Filetici N., Bocci M. G., Maresca G. M., Pizzo C. M., Bello G. (ORCID:0000-0003-2648-7235), Montini L. (ORCID:0000-0003-4602-5134), Caricato A. (ORCID:0000-0001-5929-120X), Conti G. (ORCID:0000-0002-8566-9365), and Antonelli M. (ORCID:0000-0003-3007-1670)
- Abstract
PURPOSE: To describe the epidemiology of intra-abdominal infection in an international cohort of ICU patients according to a new system that classifies cases according to setting of infection acquisition (community-acquired, early onset hospital-acquired, and late-onset hospital-acquired), anatomical disruption (absent or present with localized or diffuse peritonitis), and severity of disease expression (infection, sepsis, and septic shock). METHODS: We performed a multicenter (n = 309), observational, epidemiological study including adult ICU patients diagnosed with intra-abdominal infection. Risk factors for mortality were assessed by logistic regression analysis. RESULTS: The cohort included 2621 patients. Setting of infection acquisition was community-acquired in 31.6%, early onset hospital-acquired in 25%, and late-onset hospital-acquired in 43.4% of patients. Overall prevalence of antimicrobial resistance was 26.3% and difficult-to-treat resistant Gram-negative bacteria 4.3%, with great variation according to geographic region. No difference in prevalence of antimicrobial resistance was observed according to setting of infection acquisition. Overall mortality was 29.1%. Independent risk factors for mortality included late-onset hospital-acquired infection, diffuse peritonitis, sepsis, septic shock, older age, malnutrition, liver failure, congestive heart failure, antimicrobial resistance (either methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Gram-negative bacteria, or carbapenem-resistant Gram-negative bacteria) and source control failure evidenced by either the need for surgical revision or persistent inflammation. CONCLUSION: This multinational, heterogeneous cohort of ICU patients with intra-abdominal infection revealed that setting of infection acquisition, anatomical disruption, and severity of disease expression are disease-specific phenotypic characteristics associated with outco
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- 2019
7. ESRA19-0181 Erector spine plane block for laparoscopic gynecologic oncologic surgery: a case series of 10 patients
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Frassanito, L, primary, Sonnino, C, additional, Germini, P, additional, Scorzoni, M, additional, Ciancia, M, additional, Giuri, PP, additional, Toni, F, additional, De Martino, S, additional, Olivieri, C, additional, Cantale, A, additional, Settanni, D, additional, Filetici, N, additional, and Draisci, G, additional
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- 2019
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8. Pericapsular nerve block for analgesia in a pregnant patient with hip fracture.
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Frassanito L, Filetici N, Canistro G, Zanfini BA, Catarci S, and Draisci G
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- Humans, Female, Pregnancy, Adult, Analgesia methods, Pregnancy Complications, Analgesia, Obstetrical methods, Nerve Block methods, Hip Fractures surgery
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- 2024
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9. Personalized Predictive Hemodynamic Management for Gynecologic Oncologic Surgery: Feasibility of Cost-Benefit Derivatives of Digital Medical Devices.
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Frassanito L, Di Bidino R, Vassalli F, Michnacs K, Giuri PP, Zanfini BA, Catarci S, Filetici N, Sonnino C, Cicchetti A, Arcuri G, and Draisci G
- Abstract
Background: Intraoperative hypotension is associated with increased perioperative complications, hospital length of stay (LOS) and healthcare expenditure in gynecologic surgery. We tested the hypothesis that the adoption of a machine learning-based warning algorithm (hypotension prediction index-HPI) might yield an economic advantage, with a reduction in adverse outcomes that outweighs the costs for its implementation as a medical device., Methods: A retrospective-matched cohort cost-benefit Italian study in gynecologic surgery was conducted. Sixty-six female patients treated with standard goal-directed therapy (GDT) were matched in a 2:1 ratio with thirty-three patients treated with HPI based on ASA status, diagnosis, procedure, surgical duration and age., Results: The most relevant contributor to medical costs was operating room occupation (46%), followed by hospital stay (30%) and medical devices (15%). Patients in the HPI group had EURO 300 greater outlay for medical devices without major differences in total costs (GDT 5425 (3505, 8127), HPI 5227 (4201, 7023) p = 0.697). A pre-specified subgroup analysis of 50% of patients undergoing laparotomic surgery showed similar medical device costs and total costs, with a non-significant saving of EUR 1000 in the HPI group (GDT 8005 (5961, 9679), HPI 7023 (5227, 11,438), p = 0.945). The hospital LOS and intensive care unit stay were similar in the cohorts and subgroups., Conclusions: Implementation of HPI is associated with a scenario of cost neutrality, with possible economic advantage in high-risk settings.
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- 2023
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10. Real Evidence and Misconceptions about Malignant Hyperthermia in Children: A Narrative Review.
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Frassanito L, Sbaraglia F, Piersanti A, Vassalli F, Lucente M, Filetici N, Zanfini BA, Catarci S, and Draisci G
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Malignant hyperthermia is a rare but life-threatening pharmacogenetic disorder triggered by exposure to specific anesthetic agents. Although this occurrence could affect virtually any patient during the perioperative time, the pediatric population is particularly vulnerable, and it has a five-fold higher incidence in children compared to adults. In the last few decades, synergistic efforts among leading anesthesiology, pediatrics, and neurology associations have produced new evidence concerning the diagnostic pathway, avoiding unnecessary testing and limiting false diagnoses. However, a personalized approach and an effective prevention policy focused on clearly recognizing the high-risk population, defining perioperative trigger-free hospitalization, and rapid activation of supportive therapy should be improved. Based on epidemiological data, many national scientific societies have produced consistent guidelines, but many misconceptions are common among physicians and healthcare workers. This review shall consider all these aspects and summarize the most recent updates.
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- 2023
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11. Noninvasive hypotension Prediction Index versus continuous blood pressure monitoring and intraoperative hypotension.
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Frassanito L, Giuri PP, Vassalli F, Piersanti A, Zanfini BA, Catarci S, Olivieri C, DE Martino S, Santantonio MT, Filetici N, and Draisci G
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- Humans, Blood Pressure physiology, Blood Pressure Determination, Monitoring, Physiologic, Hypotension diagnosis, Hypotension etiology
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- 2023
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12. Maternal sepsis.
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Filetici N, Van de Velde M, Roofthooft E, and Devroe S
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- Critical Illness, Female, Humans, Pregnancy, Pre-Eclampsia, Pregnancy Complications, Infectious diagnosis, Pregnancy Complications, Infectious epidemiology, Pregnancy Complications, Infectious therapy, Sepsis diagnosis, Sepsis therapy, Shock, Septic diagnosis, Shock, Septic therapy
- Abstract
Maternal sepsis is a life-threatening condition defined as organ dysfunction resulting from infection that can arise during pregnancy, childbirth, postabortion, or in the postpartum period. Validated diagnostic criteria of maternal sepsis and septic shock may reduce the impact of this condition on maternal health worldwide, but the lack of consensus on adequate tools due to the overlap between physiological adaptations that occur during pregnancy and signs and symptoms of infection and sepsis can delay both diagnosis and treatment. In the absence of evidence-based guidelines for obstetric populations, the WHO recommends the use of the "Surviving Sepsis Campaign" sepsis protocols for maternal care adapted to the local obstetric population. Interventions within the first hour from diagnosis have been proposed in 2021 to emphasize the state of emergency of a maternal sepsis. This review will highlight the utility of standardized diagnostic criteria, the implemented approaches for the prevention and treatment of maternal infections, and the strategies for early management of critically ill parturients., Competing Interests: Declaration of competing interest Professor Van de Velde is a consultant for Smiths Medical and MSD and has received lecture fees for AstraZeneca, Baxter, Smiths Medical, BBraun, Abbvie, Kimberley Clarck, and Fresenius, and a research grant from Air Liquide. The other authors have no conflicts of interest to declare., (Copyright © 2022 Elsevier Ltd. All rights reserved.)
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- 2022
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13. The place of dexmedetomidine light sedation in patients with acute brain injury.
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Carelli S, De Pascale G, Filetici N, Bocci MG, Maresca GM, Cutuli SL, Pizzo CM, Bello G, Montini L, Caricato A, Conti G, and Antonelli M
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- Conscious Sedation, Humans, Hypnotics and Sedatives, Brain Injuries, Dexmedetomidine
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- 2019
- Full Text
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