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1. Study protocol: understanding the pathophysiologic mechanisms underlying delirium in older people undergoing hip fracture surgery

Author: R. Gamberale, C. D’Orlando, S. Brunelli, R. Meneveri, P. Mazzola, G. Foti, G. Bellani, G. Zatti, D. Munegato, S. Volpato, A. Zurlo, G. Caruso, A. Andreano, M. G. Valsecchi, and G. Bellelli
Subjects: Postoperative delirium, Neuroinflammation, Sarcopenia, Biomarkers, Geriatrics, RC952-954.6
Abstract: Abstract Background Postoperative delirium (POD) is a common complication of older people undergoing hip fracture surgery, which negatively affects clinical- and healthcare-related outcomes. Unfortunately, POD pathophysiology is still largely unknown, despite previous studies showing that neuroinflammation, neuroendocrine dysfunction, increased reactive oxidative stress (ROS), and endothelial dysfunctions may be involved. There is also evidence that many of the pathophysiological mechanisms which are involved in delirium are involved in sarcopenia too. This article describes the protocol of a pilot study to evaluate the feasibility of a larger one that will explore the pathophysiological mechanisms correlating POD with sarcopenia. We will analyse whether various biomarkers reflecting neuroinflammation, ROS, neuroendocrine disorders, and microvasculature lesions will be simultaneously expressed in in the blood, cerebrospinal fluid (CSF), and muscles of patients developing POD. Methods Two centres will be involved in this study, each recruiting a convenient sample of ten older patients with hip fracture. All of them will undergo a baseline Comprehensive Geriatric Assessment, which will be used to construct a Rockwood-based Frailty Index (FI). Blood samples will be collected for each patient on the day of surgery and 1 day before. Additionally, CSF and muscle fragments will be taken and given to a biologist for subsequent analyses. The presence of POD will be assessed in each patient every morning until hospital discharge using the 4AT. Delirium subtypes and severity will be assessed using the Delirium Motor Subtype Scale-4 and the Delirium-O-Meter, respectively. We will also evaluate the patient’s functional status at discharge, using the Cumulated Ambulation Score. Discussion This study will be the first to correlate biomarkers of blood, CSF, and muscle in older patients with hip fracture.
Published: 2021
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2. ESICM LIVES 2016: part one

Author: L. Bos, L. Schouten, L. van Vught, M. Wiewel, D. Ong, O. Cremer, A. Artigas, I. Martin-Loeches, A. Hoogendijk, T. van der Poll, J. Horn, N. Juffermans, M. Schultz, N. de Prost, T. Pham, G. Carteaux, A. Mekontso Dessap, C. Brun-Buisson, E. Fan, G. Bellani, J. Laffey, A. Mercat, L. Brochard, B. Maitre, LUNG SAFE investigators and the ESICM study group, P. A. Howells, D. R. Thickett, C. Knox, D. P. Park, F. Gao, O. Tucker, T. Whitehouse, D. F. McAuley, G. D. Perkins, LUNG SAFE Investigators and the ESICM Trials Group, L. Pisani, J. P. Roozeman, F. D. Simonis, A. Giangregorio, L. R. Schouten, S. M. Van der Hoeven, A. Serpa Neto, E. Festic, A. M. Dondorp, S. Grasso, L. D. Bos, M. J. Schultz, M. Koster-Brouwer, D. Verboom, B. Scicluna, K. van de Groep, J. Frencken, M. Bonten, J. I. Ko, K. S. Kim, G. J. Suh, W. Y. Kwon, K. Kim, J. H. Shin, O. T. Ranzani, E. Prina, R. Menendez, A. Ceccato, R. Mendez, C. Cilloniz, A. Gabarrus, M. Ferrer, A. Torres, A. Urbano, L. A. Zhang, D. Swigon, F. Pike, R. S. Parker, G. Clermont, C. Scheer, S. O. Kuhn, A. Modler, M. Vollmer, C. Fuchs, K. Hahnenkamp, S. Rehberg, M. Gründling, A. Taggu, N. Darang, N. Öveges, I. László, K. Tánczos, M. Németh, G. Lebák, B. Tudor, D. Érces, J. Kaszaki, W. Huber, D. Trásy, Z. Molnár, G. Ferrara, V. S. Kanoore Edul, H. S. Canales, E. Martins, C. Canullán, G. Murias, M. O. Pozo, J. F. Caminos Eguillor, M. G. Buscetti, C. Ince, A. Dubin, H. D. Aya, A. Rhodes, N. Fletcher, R. M. Grounds, M. Cecconi, M. Jacquet-Lagrèze, M. Riche, R. Schweizer, P. Portran, W. Fornier, M. Lilot, J. Neidecker, J. L. Fellahi, A. Escoresca-Ortega, A. Gutiérrez-Pizarraya, L. Charris-Castro, Y. Corcia-Palomo, E. Fernandez-Delgado, J. Garnacho-Montero, C. Roger, L. Muller, L. Elotmani, J. Lipman, J. Y. Lefrant, J. A. Roberts, R. Muñoz-Bermúdez, M. Samper, C. Climent, F. Vasco, V. Sara, S. Luque, N. Campillo, S. Grau Cerrato, J. R. Masclans, F. Alvarez-Lerma, S. Carvalho Brugger, G. Jimenez Jimenez, M. Miralbés Torner, J. Trujillano Cabello, B. Balsera Garrido, X. Nuvials Casals, F. Barcenilla Gaite, M. Vallverdú Vidal, M. Palomar Martínez, V. Gusarov, D. Shilkin, M. Dementienko, E. Nesterova, N. Lashenkova, A. Kuzovlev, M. Zamyatin, A. Demoule, S. Carreira, S. Lavault, O. Palancca, E. Morawiec, J. Mayaux, I. Arnulf, T. Similowski, B. S. Rasmussen, R. G. Maltesen, M. Hanifa, S. Pedersen, S. R. Kristensen, R. Wimmer, M. Panigada, G. Li Bassi, T. Kolobow, A. Zanella, M. Cressoni, L. Berra, V. Parrini, H. Kandil, G. Salati, S. Livigni, A. Amatu, A. Andreotti, F. Tagliaferri, G. Moise, G. Mercurio, A. Costa, A. Vezzani, S. Lindau, J. Babel, M. Cavana, D. Consonni, A. Pesenti, L. Gattinoni, for the GRAVITY-VAP TRIAL NETWORK, P. Mansouri, F. Zand, L. Zahed, F. Dehghanrad, M. Bahrani, M. Ghorbani, B. Cambiaghi, O. Moerer, T. Mauri, N. Kunze-Szikszay, C. Ritter, M. Quintel, L. M. Vilander, M. A. Kaunisto, S. T. Vaara, V. Pettilä, FINNAKI Study Group, J. L. G. Haitsma Mulier, S. Rozemeijer, A. M. E. Spoelstra-de Man, P. E. Elbers, P. R. Tuinman, M. C. de Waard, H. M. Oudemans-van Straaten, A. M. A. Liberatore, R. B. Souza, A. M. C. R. P. F. Martins, J. C. F. Vieira, I. H. J. Koh, M. Galindo Martínez, R. Jiménez Sánchez, L. Martínez Gascón, M. D. Rodríguez Mulero, A. Ortín Freire, A. Ojados Muñoz, S. Rebollo Acebes, Á. Fernández Martínez, S. Moreno Aliaga, L. Herrera Para, J. Murcia Payá, F. Rodríguez Mulero, P. Guerci, Y. Ince, P. Heeman, B. Ergin, Z. Uz, M. Massey, R. Papatella, E. Bulent, F. Toraman, E. R. Longbottom, H. D. Torrance, H. C. Owen, C. J. Hinds, R. M. Pearse, M. J. O’Dywer, Z. Trogrlic, M. van der Jagt, H. Lingsma, H. H. Ponssen, J. F. Schoonderbeek, F. Schreiner, S. J. Verbrugge, S. Duran, T. van Achterberg, J. Bakker, D. A. M. P. J. Gommers, E. Ista, A. Krajčová, P. Waldauf, F. Duška, A. Shah, N. Roy, S. McKechnie, C. Doree, S. Fisher, S. J. Stanworth, J. F. Jensen, D. Overgaard, M. H. Bestle, D. F. Christensen, I. Egerod, The RAPIT Group, A. Pivkina, I. Zhivotneva, N. Pasko, A. Alklit, R. L. Hansen, H. Knudsen, L. B. Grode, The RAPIT group, M. Hravnak, L. Chen, A. Dubrawski, M. R. Pinsky, S. M. Parry, L. D. Knight, B. C. Connolly, C. E. Baldwin, Z. A. Puthucheary, L. Denehy, N. Hart, P. E. Morris, J. Mortimore, C. L. Granger, H. I. Jensen, R. Piers, B. Van den Bulcke, J. Malmgren, V. Metaxa, A. K. Reyners, M. Darmon, K. Rusinova, D. Talmor, A. P. Meert, L. Cancelliere, L. Zubek, P. Maia, A. Michalsen, J. Decruyenaere, E. Kompanje, S. Vanheule, E. Azoulay, S. Vansteelandt, D. Benoit, C. Ryan, D. Dawson, J. Ball, K. Noone, B. Aisling, S. Prudden, A. Ntantana, D. Matamis, S. Savvidou, M. Giannakou, M. Gouva, G. Nakos, V. Koulouras, J. Aron, G. Lumley, D. Milliken, K. Dhadwal, B. A. McGrath, S. J. Lynch, B. Bovento, G. Sharpe, E. Grainger, S. Pieri-Davies, S. Wallace, B. McGrath, M. Jung, J. Cho, H. Park, G. Suh, O. Kousha, J. Paddle, L. Gamrin Gripenberg, M. Sundström Rehal, J. Wernerman, O. Rooyackers, H. J. de Grooth, W. P. Choo, A. M. Spoelstra-de Man, E. L. Swart, L. Talan, G. Güven, N. D. Altıntas, M. Padar, G. Uusvel, L. Starkopf, J. Starkopf, A. Reintam Blaser, M. S. Kalaiselvan, A. S. Arunkumar, M. K. Renuka, R. L. Shivkumar, M. Volbeda, D. ten Kate, M. Hoekstra, J. M. van der Maaten, M. W. Nijsten, A. Komaromi, Å. Norberg, M. Smedberg, M. Mori, L. Pettersson, M. Theodorakopoulou, T. Christodoulopoulou, A. Diamantakis, F. Frantzeskaki, M. Kontogiorgi, E. Chrysanthopoulou, M. Lygnos, C. Diakaki, A. Armaganidis, K. Gundogan, E. Dogan, R. Coskun, S. Muhtaroglu, M. Sungur, T. Ziegler, M. Guven, A. Kleyman, W. Khaliq, D. Andreas, M. Singer, R. Meierhans, R. Schuepbach, I. De Brito-Ashurst, G. Sabetian, R. Nikandish, F. Hagar, M. Masjedi, B. Maghsudi, A. Vazin, E. Asadpour, K. C. Kao, L. C. Chiu, C. Y. Hung, C. H. Chang, S. H. Li, H. C. Hu, S. El Maraghi, M. Ali, D. Rageb, M. Helmy, J. Marin-Corral, C. Vilà, A. Vàzquez, I. Martín-Loeches, E. Díaz, J. C. Yébenes, A. Rodriguez, F. Álvarez-Lerma, H1N1 SEMICYUC/GETGAG Working Group, N. Varga, A. Cortina-Gutiérrez, L. Dono, M. Martínez-Martínez, C. Maldonado, E. Papiol, M. Pérez-Carrasco, R. Ferrer, K. Nweze, B. Morton, I. Welters, M. Houard, B. Voisin, G. Ledoux, S. Six, E. Jaillette, S. Nseir, S. Romdhani, R. Bouneb, D. Loghmari, N. Ben Aicha, J. Ayachi, K. Meddeb, I. Chouchène, A. Khedher, M. Boussarsar, K. S. Chan, W. L. Yu, J. Nolla, L. Vidaur, J. Bonastre, B. Suberbiola, J. E. Guerrero, H1N1 SEMICYUC/GETGAG working group, N. Ramon Coll, G. Jiménez Jiménez, J. Codina Calero, M. García, M. C. de la Torre, E. Vendrell, E. Palomera, E. Güell, M. Serra-Prat, J. F. Bermejo-Martín, J. Almirall, E. Tomas, A. Escoval, F. Froe, M. H. Vitoria Pereira, N. Velez, E. Viegas, E. Filipe, C. Groves, M. Reay, A. Ballin, F. Facchin, G. Sartori, F. Zarantonello, E. Campello, C. M. Radu, S. Rossi, C. Ori, P. Simioni, N. Umei, I. Shingo, A. C. Santos, C. Candeias, I. Moniz, R. Marçal, Z. Costa e Silva, J. M. Ribeiro, J. F. Georger, J. P. Ponthus, M. Tchir, V. Amilien, M. Ayoub, E. Barsam, G. Martucci, G. Panarello, F. Tuzzolino, G. Capitanio, V. Ferrazza, T. Carollo, L. Giovanni, A. Arcadipane, M. López Sánchez, M. A. González-Gay, F. J. Llorca Díaz, M. I. Rubio López, E. Zogheib, L. Villeret, J. Nader, M. Bernasinski, P. Besserve, T. Caus, H. Dupont, P. Morimont, S. Habran, R. Hubert, T. Desaive, F. Blaffart, N. Janssen, J. Guiot, A. Pironet, P. Dauby, B. Lambermont, T. Pettenuzzo, G. Citton, C. Kirakli, O. Ediboglu, S. Ataman, M. Yarici, F. Tuksavul, S. Keating, A. Gibson, M. Gilles, M. Dunn, G. Price, N. Young, P. Remeta, P. Bishop, M. D. Fernández Zamora, J. Muñoz-Bono, E. Curiel-Balsera, E. Aguilar-Alonso, R. Hinojosa, A. Gordillo-Brenes, J. A. Arboleda-Sánchez, ARIAM-CARDIAC SURGERY PROJECT AUTHORS, I. Skorniakov, D. Vikulova, C. Whiteley, O. Shaikh, A. Jones, M. Ostermann, L. Forni, M. Scott, J. Sahatjian, W. Linde-Zwirble, D. Hansell, P. Laoveeravat, N. Srisawat, M. Kongwibulwut, S. Peerapornrattana, N. Suwachittanont, T. O. Wirotwan, P. Chatkaew, P. Saeyub, K. Latthaprecha, K. Tiranathanagul, S. Eiam-ong, J. A. Kellum, R. E. Berthelsen, A. Perner, A. E. K. Jensen, J. U. Jensen, D. J. Gebhard, J. Price, C. E. Kennedy, A. Akcan-Arikan, Y. R. Kang, M. N. Nakamae, K. Hamed, M. M. Khaled, R. Aly Soliman, M. Sherif Mokhtar, G. Seller-Pérez, D. Arias-Verdú, E. Llopar-Valdor, I. De-Diós-Chacón, G. Quesada-García, M. E. Herrera-Gutierrez, R. Hafes, G. Carroll, P. Doherty, C. Wright, I. G. Guerra Vera, M. Ralston, M. L. Gemmell, A. MacKay, E. Black, R. I. Docking, R. Appleton, M. R. Ralston, L. Gemmell, A. Mackay, J. G. Röttgering, P. W. G. Elbers, N. Mejeni, J. Nsiala, A. Kilembe, P. Akilimali, G. Thomas, A. E. Andersson, A. M. Fagerdahl, V. Knudsen, P-INFECT, A. Ben Cheikh, Y. Hamdaoui, A. Guiga, N. Fraj, N. Sma, I. Chouchene, N. Bouafia, A. Amirian, B. Ziaian, C. Fleischmann, D. O. Thomas-Rueddel, A. Schettler, D. Schwarzkopf, A. Stacke, K. Reinhart, A. Martins, P. Sousa, G. Snell, R. Matsa, T. T. S. Paary, A. M. Cavalheiro, L. L. Rocha, C. S. Vallone, A. Tonilo, M. D. S. Lobato, D. T. Malheiro, G. Sussumo, N. M. Lucino, V. D. Rosenthal, A. Sanaei Dashti, A. Yousefipour, J. R. Goodall, M. Williamson, E. Tant, N. Thomas, C. Balci, C. Gonen, E. Haftacı, H. Gurarda, E. Karaca, B. Paldusová, I. Zýková, D. Šímová, S. Houston, L. D’Antona, J. Lloyd, V. Garnelo-Rey, M. Sosic, V. Sotosek-Tokmazic, J. Kuharic, I. Antoncic, S. Dunatov, A. Sustic, C. T. Chong, M. Sim, T. Lyovarin, F. M. Acosta Díaz, S. Narbona Galdó, M. Muñoz Garach, O. Moreno Romero, A. M. Pérez Bailón, A. Carranza Pinel, M. Colmenero, A. Gritsan, A. Gazenkampf, E. Korchagin, N. Dovbish, R. M. Lee, M. P. P. Lim, B. C. L. Lim, J. J. See, R. Assis, F. Filipe, N. Lopes, L. Pessoa, T. Pereira, N. Catorze, M. S. Aydogan, C. Aldasoro, P. Marchio, A. Jorda, M. D. Mauricio, S. Guerra-Ojeda, M. Gimeno-Raga, M. Colque-Cano, A. Bertomeu-Artecero, M. Aldasoro, S. L. Valles, D. Tonon, T. Triglia, J. C. Martin, M. C. Alessi, N. Bruder, P. Garrigue, L. Velly, S. Spina, V. Scaravilli, C. Marzorati, E. Colombo, D. Savo, A. Vargiolu, G. Cavenaghi, G. Citerio, A. H. V. Andrade, P. Bulgarelli, J. A. P. Araujo, V. Gonzalez, V. A. Souza, C. Massant, C. A. C. Abreu Filho, R. A. Morbeck, L. E. Burgo, R. van Groenendael, L. T. van Eijk, G. P. Leijte, B. Koeneman, M. Kox, P. Pickkers, A. García-de la Torre, M. de la Torre-Prados, A. Fernández-Porcel, C. Rueda-Molina, P. Nuevo-Ortega, T. Tsvetanova-Spasova, E. Cámara-Sola, A. García-Alcántara, L. Salido-Díaz, X. Liao, T. Feng, J. Zhang, X. Cao, Q. Wu, Z. Xie, H. Li, Y. Kang, M. S. Winkler, A. Nierhaus, E. Mudersbach, A. Bauer, L. Robbe, C. Zahrte, E. Schwedhelm, S. Kluge, C. Zöllner, E. Mitsi, S. H. Pennington, J. Reine, A. D. Wright, R. Parker, I. D. Welters, J. D. Blakey, G. Rajam, E. W. Ades, D. M. Ferreira, D. Wang, A. Kadioglu, S. B. Gordon, R. Koch, J. Rahamat-Langedoen, J. Schloesser, M. de Jonge, J. Bringue, R. Guillamat-Prats, E. Torrents, M. L. Martinez, M. Camprubí-Rimblas, L. Blanch, S. Y. Park, Y. B. Park, D. K. Song, S. Shrestha, S. H. Park, Y. Koh, M. J. Park, C. W. Hong, O. Lesur, D. Coquerel, X. Sainsily, J. Cote, T. Söllradl, A. Murza, L. Dumont, R. Dumaine, M. Grandbois, P. Sarret, E. Marsault, D. Salvail, M. Auger-Messier, F. Chagnon, Apelin Group, M. P. Lauretta, E. Greco, A. Dyson, S. Preau, M. Ambler, A. Sigurta, S. Saeed, L. Topcu Sarıca, N. Zibandeh, D. Genc, F. Gul, T. Akkoc, E. Kombak, L. Cinel, I. Cinel, S. J. Pollen, N. Arulkumaran, G. Warnes, D. J. Pennington, K. Brohi, M. J. O’Dwyer, H. Y. Kim, S. Na, J. Kim, Y. F. Chang, A. Chao, P. Y. Shih, C. T. Lee, Y. C. Yeh, L. W. Chen, M. Adriaanse, W. Rietdijk, S. Funcke, S. Sauerlaender, B. Saugel, H. Pinnschmidt, D. A. Reuter, R. Nitzschke, S. Perbet, C. Biboulet, A. Lenoire, D. Bourdeaux, B. Pereira, B. Plaud, J. E. Bazin, V. Sautou, A. Mebazaa, J. M. Constantin, M. Legrand, Y. Boyko, P. Jennum, M. Nikolic, H. Oerding, R. Holst, P. Toft, H. K. Nedergaard, T. Haberlandt, S. Park, S. Kim, Y. J. Cho, Y. J. Lim, A. Chan, S. Tang, S. L. Nunes, S. Forsberg, H. Blomqvist, L. Berggren, M. Sörberg, T. Sarapohja, C. J. Wickerts, J. G. M. Hofhuis, L. Rose, B. Blackwood, E. Akerman, J. Mcgaughey, M. Fossum, H. Foss, E. Georgiou, H. J. Graff, M. Kalafati, R. Sperlinga, A. Schafer, A. G. Wojnicka, P. E. Spronk, F. Khalili, R. Afshari, H. Haddad Khodaei, S. Javadpour, P. Petramfar, S. Nasimi, H. Tabei, A. Gunther, J. O. Hansen, P. Sackey, H. Storm, J. Bernhardsson, Ø. Sundin, A. Bjärtå, A. Bienert, P. Smuszkiewicz, P. Wiczling, K. Przybylowski, A. Borsuk, I. Trojanowska, J. Matysiak, Z. Kokot, M. Paterska, E. Grzeskowiak, A. Messina, E. Bonicolini, D. Colombo, G. Moro, S. Romagnoli, A. R. De Gaudio, F. Della Corte, S. M. Romano, J. A. Silversides, E. Major, E. E. Mann, A. J. Ferguson, D. F. Mcauley, J. C. Marshall, J. A. Diaz-Rodriguez, R. Silva-Medina, E. Gomez-Sandoval, N. Gomez-Gonzalez, R. Soriano-Orozco, P. L. Gonzalez-Carrillo, M. Hernández-Flores, K. Pilarczyk, J. Lubarksi, D. Wendt, F. Dusse, J. Günter, B. Huschens, E. Demircioglu, H. Jakob, A. Palmaccio, A. M. Dell’Anna, D. L. Grieco, F. Torrini, C. Iaquaniello, F. Bongiovanni, M. Antonelli, L. Toscani, D. Antonakaki, D. Bastoni, M. Jozwiak, F. Depret, J. L. Teboul, J. Alphonsine, C. Lai, C. Richard, X. Monnet, G. Demeter, I. Kertmegi, A. Hasanin, A. Lotfy, A. El-adawy, H. Nassar, S. Mahmoud, A. Abougabal, A. Mukhtar, F. Quinty, S. Habchi, A. Luzi, E. Antok, G. Hernandez, B. Lara, L. Enberg, M. Ortega, P. Leon, C. Kripper, P. Aguilera, E. Kattan, M. Lehmann, S. Sakka, B. Bein, R. M. Schmid, J. Preti, J. Creteur, A. Herpain, J. Marc, F. Trojette, S. Bar, L. Kontar, D. Titeca, J. Richecoeur, B. Gelee, N. Verrier, R. Mercier, E. Lorne, J. Maizel, M. Slama, M. E. Abdelfattah, A. Eladawy, M. A. Ali Elsayed, A. Pedraza Montenegro, E. Monares Zepeda, J. Franco Granillo, J. S. Aguirre Sánchez, G. Camarena Alejo, A. Rugerio Cabrera, A. A. Tanaka Montoya, C. Lee, F. Hatib, M. Cannesson, P. Theerawit, T. Morasert, Y. Sutherasan, G. Zani, S. Mescolini, M. Diamanti, R. Righetti, A. Scaramuzza, M. Papetti, M. Terenzoni, C. Gecele, M. Fusari, K. A. Hakim, A. Chaari, M. Ismail, A. H. Elsaka, T. M. Mahmoud, K. Bousselmi, V. Kauts, W. F. Casey, S. D. Hutchings, D. Naumann, J. Wendon, S. Watts, E. Kirkman, Z. Jian, S. Buddi, J. Settels, P. Bertini, F. Guarracino, C. Trepte, P. Richter, S. A. Haas, V. Eichhorn, J. C. Kubitz, M. S. Soliman, W. I. Hamimy, A. Z. Fouad, A. M. Mukhtar, M. Charlton, L. Tonks, L. Mclelland, T. J. Coats, J. P. Thompson, M. R. Sims, D. Williams, D. Z. Roushdy, R. A. Soliman, R. A. Nahas, M. Y. Arafa, W. T. Hung, C. C. Chiang, W. C. Huang, K. C. Lin, S. C. Lin, C. C. Cheng, P. L. Kang, S. R. Wann, G. Y. Mar, C. P. Liu, M. Lopez Carranza, H. Sancho Fernandez, J. A. Sanchez Roman, F. Lucena, A. Campanario Garcia, A. Loza Vazquez, A. Lesmes Serrano, ARIAM-SEMICYUC Registry Investigators, L. Sayagues Moreira, R. Vidal-Perez, U. Anido Herranz, J. M. Garcia Acuna, C. Pena Gil, J. L. Garcia Allut, P. Rascado Sedes, C. Martin Lopez, E. Saborido Paz, C. Galban Rodriguez, J. R. Gonzalez-Juanatey, A. Vallejo-Baez, M. V. de la Torre-Prados, ARIAM Group, R. Marharaj, K. Gervasio, M. Bottiroli, M. Mondino, D. De Caria, A. Calini, E. Montrasio, F. Milazzo, M. P. Gagliardone, A. Vallejo-Báez, ARIAM group, U. Anido, M. Cheikh-Bouhlel, M. P. R. D. L. Dela Cruz, J. M. Bernardo, F. Galfo, A. Marino, C. C. Chao, P. Hou, C. C. Hung, C. H. Chiang, Y. J. Liou, S. M. Hung, Y. S. Lin, F. Y. Kuo, K. R. Chiou, C. J. Chen, L. S. Yan, C. Y. Liu, H. H. Wang, H. L. Chen, C. K. Ho, S. Grewal, S. Gopal, C. Corbett, A. Wilson, J. Capps, W. Ayoub, A. Lomas, S. Ghani, J. Moore, D. Atkinson, M. Sharman, W. Swinnen, J. Pauwels, K. Mignolet, E. Pannier, A. Koch, T. Sarens, W. Temmerman, A. M. Elmenshawy, A. M. Fayed, M. Elboriuny, E. Hamdy, E. Zakaria, A. C. Falk, A. Petosic, K. Olafsen, H. Wøien, H. Flaatten, K. Sunde, J. J. Cáceres Agra, J. L. Santana Cabrera, J. D. Martín Santana, L. Melián Alzola, H. Rodríguez Pérez, T. Castro Pires, H. Calderón, A. Pereira, S. Castro, C. Granja, I. Norkiene, I. Urbanaviciute, G. Kezyte, D. Ringaitiene, T. Jovaisa, G. Vogel, U. B. Johansson, A. Sandgren, C. Svensen, E. Joelsson-Alm, M. A. Leite, L. D. Murbach, E. F. Osaku, C. R. L. M. Costa, M. Pelenz, N. M. Neitzke, M. M. Moraes, J. L. Jaskowiak, M. M. M. Silva, R. S. Zaponi, L. R. L. Abentroth, S. M. Ogasawara, A. C. Jorge, P. A. D. Duarte, J. Barreto, S. T. Duarte, S. Taba, D. Miglioranza, D. P. Gund, C. F. Lordani, H. Vollmer, M. Gager, C. Waldmann, A. T. Mazzeo, R. Tesio, C. Filippini, M. E. Vallero, C. Giolitti, S. Caccia, M. Medugno, T. Tenaglia, R. Rosato, I. Mastromauro, L. Brazzi, P. P. Terragni, R. Urbino, V. Fanelli, V. M. Ranieri, L. Mascia, J. Ballantyne, L. Paton, P. Perez-Teran, O. Roca, J. C. Ruiz-Rodriguez, A. Zapatero, J. Serra, S. Bianzina, P. Cornara, G. Rodi, G. Tavazzi, M. Pozzi, G. A. Iotti, F. Mojoli, A. Braschi, A. Vishnu, D. Buche, R. Pande, D. L. J. Moolenaar, F. Bakhshi-Raiez, D. A. Dongelmans, N. F. de Keizer, D. W. de Lange, I. Fuentes Fernández, D. Martínez Baño, J. L. Buendía Moreno, R. Jara Rubio, J. Scott, D. Phelan, D. Morely, J. O’Flynn, P. Stapleton, M. Lynch, B. Marsh, E. Carton, C. O’Loughlin, K. C. Cheng, M. I. Sung, M. O. Elghonemi, M. H. Saleh, T. S. Meyhoff, M. Krag, P. B. Hjortrup, M. H. Møller, T. Öhman, T. Sigmundsson, E. Redondo, M. Hallbäck, F. Suarez-Sipmann, H. Björne, C. Hällsjö Sander, KARISMA, D. Chiumello, C. Chiurazzi, M. Brioni, I. Algieri, M. Guanziroli, G. Vergani, T. Tonetti, I. Tomic, A. Colombo, F. Crimella, E. Carlesso, V. Gasparovic, R. El-Sherif, M. Abd Al-Basser, A. Raafat, A. El-Sherif, L. R. A. Schouten, O. L. Cremer, D. S. Y. Ong, G. Amoruso, G. Cinnella, L. D. J. Bos, P. Schmidle, M. Findeisen, P. Hoppmann, J. Jaitner, F. Brettner, T. Lahmer, EXODUS-investigators, G. Rajagopalan, V. Bansal, R. Frank, R. Hinds, J. Levitt, United States Critical Illness and Injury Trials Group/LIPS-B investigators, S. Siddiqui, SICM NICER Group, J. P. Gilbert, K. Sim, C. H. Wang, I. J. Li, W. R. Tang, P. Persona, A. De Cassai, M. Franco, A. Goffi, B. Llorente Ruiz, J. Lujan Varas, R. Molina Montero, C. Pintado Delgado, O. Navarrete, M. Vazquez Mezquita, E. Alonso Peces, M. A. M. Nakamura, L. A. Hajjar, F. R. B. G. Galas, T. A. Ortiz, M. B. P. Amato, L. Bitker, N. Costes, D. Le Bars, F. Lavenne, D. Mojgan, J. C. Richard, D. Massari, M. Gotti, P. Cadringher, A. Zerman, M. Türkoğlu, G. Arık, F. Yıldırım, Z. Güllü, I. Kara, N. Boyacı, B. Basarık Aydoğan, Ü. Gaygısız, K. Gönderen, G. Aygencel, M. Aydoğdu, Z. Ülger, G. Gürsel, J. Riera, C. Maldonado Toral, C. Mazo, M. Martínez, J. Baldirà, L. Lagunes, A. Roman, M. Deu, J. Rello, D. J. Levine, R. M. Mohus, Å. Askim, J. Paulsen, A. Mehl, A. T. Dewan, J. K. Damås, E. Solligård, B. O. Åsvold, Mid-Norway Sepsis Research Center, A. DeWan, O. Aktepe, A. Kara, H. Yeter, A. Topeli, M. Norrenberg, M. Devroey, H. Khader, J. C. Preiser, Z. Tang, C. Qiu, L. Tong, C. Cai, O. Apostolopoulou, J. Y. Moon, M. R. Park, I. S. Kwon, G. R. Chon, J. Y. Ahn, S. J. Kwon, Y. J. Chang, J. Y. Lee, S. Y. Yoon, J. W. Lee, The Korean Chungcheong Critical Care Research Group, M. Kostalas, J. Mckinlay, G. Kooner, G. Dudas, A. Horton, C. Kerr, N. Karanjia, B. Creagh-Brown, N. D. Altintas, S. Izdes, O. Keremoglu, A. Alkan, S. Neselioglu, O. Erel, N. Tardif, T. Gustafsson, K. N. MacEachern, M. Traille, I. Bromberg, S. E. Lapinsky, M. J. Moore, J. L. García-Garmendia, F. Villarrasa-Clemente, F. Maroto-Monserrat, O. Rufo-Tejeiro, V. Jorge-Amigo, M. Sánchez-Santamaría, C. Colón-Pallarés, A. Barrero-Almodóvar, S. Gallego-Lara, C. T. Anthon, R. B. Müller, N. Haase, K. Møller, J. Wetterslev, M. Nakanishi, A. Kuriyama, T. Fukuoka, M. A. Abd el Halim, M. H. Elsaid hafez, A. M. Moktar, H. M. Elazizy, K. Abdel Hakim, M. Elbahr, T. Mahmoud, E. Khalil, W. Casey, S. H. Zaky, A. Rizk, R. Ahmed, G. A. Ospina-Tascón, A. F. Garcia Marin, G. J. Echeverry, W. F. Bermudez, H. J. Madriñan-Navia, J. D. Valencia, E. Quiñonez, A. Marulanda, C. A. Arango-Dávila, A. Bruhn, D. De Backer, D. Orbegozo Cortes, F. Su, J. L. Vincent, L. Tullo, L. Mirabella, P. Di Molfetta, M. Dambrosio, C. Villavicencio Lujan, J. Leache irigoyen, M. Cartanya ferré, R. Carbonell García, M. Ahmed, M. El Ayashi, E. Ayman, M. Salem, S. Fathy, A. Zaghlol, M. F. Aguilar Arzapalo, Å. Valsø, T. Rustøen, I. Schou-Bredal, L. Skogstad, K. Tøien, C. Padilla, Y. Palmeiro, W. Egbaria, R. Kigli, B. Maertens, K. Blot, S. Blot, E. Santana-Santos, E. R. dos Santos, R. E. D. L. Ferretti-Rebustini, R. D. C. C. D. O. dos Santos, R. G. S. Verardino, L. A. Bortolotto, A. M. Doyle, I. Naldrett, J. Tillman, S. Price, P. Pearson, J. Greaves, D. Goodall, A. Berry, A. Richardson, G. O. Odundo, P. Omengo, P. Obonyo, N. M. Chanzu, R. Kleinpell, S. J. Sarris, P. Nedved, M. Heitschmidt, H. Ben-Ghezala, S. Snouda, S. Djobbi, N. K. J. Adhikari, D. Leasa, D. Fergusson, D. A. Mckim, J. Weblin, D. McWilliams, F. Doesburg, F. Cnossen, W. Dieperink, W. Bult, M. W. N. Nijsten, G. A. Galvez-Blanco, C. I. Olvera Guzman, J. Santos Stroud, R. Thomson, M. Llaurado-Serra, A. Lobo-Civico, M. Pi-Guerrero, I. Blanco-Sanchez, A. Piñol-Tena, C. Paños-Espinosa, Y. Alabart-Segura, B. Coloma-Gomez, A. Fernandez-Blanco, F. Braga-Dias, M. Treso-Geira, A. Valeiras-Valero, L. Martinez-Reyes, A. Sandiumenge, M. F. Jimenez-Herrera, CAPCRI Study, R. Prada, P. Juárez, R. Argandoña, J. J. Díaz, C. Sánchez Ramirez, P. Saavedra, S. Ruiz Santana, O. Obukhova, S. Kashiya, I. A. Kurmukov, A. M. Pronina, P. Simeone, L. Puybasset, G. Auzias, O. Coulon, B. Lesimple, G. Torkomian, A. Bartkowska-Sniatkowska, O. Szerkus, D. Siluk, J. Bartkowiak-Wieczorek, J. Rosada-Kurasinska, J. Warzybok, R. Kaliszan, C. Hernandez Caballero, S. Roberts, G. Isgro, D. Hall, G. Guillaume, O. Passouant, F. Dumas, W. Bougouin, B. Champigneulle, M. Arnaout, J. Chelly, J. D. Chiche, O. Varenne, J. P. Mira, E. Marijon, A. Cariou, M. Beerepoot, H. R. Touw, K. Parlevliet, C. Boer, P. W. Elbers, Á. J. Roldán Reina, Y. Corcia Palomo, R. Martín Bermúdez, L. Martín Villén, I. Palacios García, J. R. Naranjo Izurieta, J. B. Pérez Bernal, F. J. Jiménez Jiménez, Cardiac Arrest Group HUVR, F. Cota-Delgado, T. Kaneko, H. Tanaka, M. Kamikawa, R. Karashima, S. Iwashita, H. Irie, S. Kasaoka, O. Arola, R. Laitio, A. Saraste, J. Airaksinen, M. Pietilä, M. Hynninen, J. Wennervirta, M. Bäcklund, E. Ylikoski, P. Silvasti, E. Nukarinen, J. Grönlund, V. P. Harjola, J. Niiranen, K. Korpi, M. Varpula, R. O. Roine, T. Laitio, for the Xe-HYPOTHECA study group, S. Salah, B. G. Hassen, A. Mohamed Fehmi, Y. C. Hsu, J. Barea-Mendoza, C. García-Fuentes, M. Castillo-Jaramillo, H. Dominguez-Aguado, R. Viejo-Moreno, L. Terceros-Almanza, S. Bermejo Aznárez, C. Mudarra-Reche, W. Xu, M. Chico-Fernández, J. C. Montejo-González, K. Crewdson, M. Thomas, M. Merghani, L. Fenner, P. Morgan, D. Lockey, E. J. van Lieshout, B. Oomen, J. M. Binnekade, R. J. de Haan, N. P. Juffermans, M. B. Vroom, R. Algarte, L. Martínez, B. Sánchez, I. Romero, F. Martínez, S. Quintana, J. Trenado, O. Sheikh, D. Pogson, R. Clinton, F. Riccio, A. Arthur, L. Young, A. Sinclair, D. Markopoulou, K. Venetsanou, L. Filippou, E. Salla, S. Stratouli, I. Alamanos, A. H. Guirgis, R. Gutiérrez Rodriguez, M. J. Furones Lorente, I. Macias Guarasa, A. Ukere, S. Meisner, G. Greiwe, B. Opitz, D. Benten, B. Nashan, L. Fischer, C. J. C. Trepte, C. R. Behem, B. Ana, A. Vazir, D. Gibson, M. R. Hadavi, M. Riahi alam, M. R. Sasani, N. Parenti, F. Agrusta, C. Palazzi, B. Pifferi, R. Sganzerla, F. Tagliazucchi, A. Luciani, M. Möller, J. Müller-Engelmann, G. Montag, P. Adams, C. Lange, J. Neuzner, R. Gradaus, K. H. Wodack, F. Thürk, A. D. Waldmann, M. F. Grässler, S. Nishimoto, S. H. Böhm, E. Kaniusas, C. J. Trepte, M. Wallin, F. Suarez Sipman, A. Oldner, L. Colinas, R. Vicho, M. Serna, R. Cuena, A. Canabal, ECOCRITIC group, M. Etman, M. El Bahr, A. El Sakka, A. Arali, O. Bond, P. De Santis, E. Iesu, F. Franchi, S. Scolletta, F. S. Taccone, Z. Marutyan, L. Hamidova, A. Shakotko, V. Movsisyan, I. Uysupova, A. Evdokimov, S. Petrikov, F. J. Redondo Calvo, N. Bejarano, V. Baladron, R. Villazala, J. Redondo, D. Padilla, P. Villarejo, C. Gomez-Gonzalez, S. Mas-Font, A. Puppo-Moreno, M. Herrera-Gutierrez, M. Garcia-Garcia, S. Aldunate-Calvo, NEFROCON Investigators, E. P. Plata-Menchaca, X. L. Pérez-Fernández, M. Estruch, A. Betbese-Roig, P. Cárdenas Campos, M. Rojas Lora, N. D. Toapanta Gaibor, R. S. Contreras Medina, V. D. Gumucio Sanguino, E. J. Casanova, J. Sabater Riera, SIRAKI group, K. Kritmetapak, S. Peerapornratana, P. Kittiskulnam, T. Dissayabutra, P. Susantithapong, K. Praditpornsilpa, K. Tungsanga, S. Eiam-Ong, T. Winkelmann, T. Busch, J. Meixensberger, S. Bercker, E. M. Flores Cabeza, M. Sánchez Sánchez, N. Cáceres Giménez, C. Gutierrez Melón, E. Herrero de Lucas, P. Millán Estañ, M. Hernández Bernal, A. Garcia de Lorenzo y Mateos, P. A. C. Specht, M. Balik, M. Zakharchenko, F. Los, H. Brodska, C. de Tymowski, P. Augustin, M. Desmard, P. Montravers, S. N. Stapel, R. de Boer, H. M. Oudemans, A. Hollinger, T. Schweingruber, F. Jockers, M. Dickenmann, M. Siegemund, Clinical Intensive Care Research Basel, N. Runciman, L. Alban, C. Turrini, T. Sasso, T. Langer, P. Taccone, C. Marenghi, G. Grasselli, P. Wibart, T. Reginault, M. Garcia, B. Barbrel, A. Benard, C. Bader, F. Vargas, H. N. Bui, G. Hilbert, J. M. Serrano Simón, P. Carmona Sánchez, F. Ruiz Ferrón, M. García de Acilu, J. Marin, V. Antonia, L. Ruano, M. Monica, G. Hong, D. H. Kim, Y. S. Kim, J. S. Park, Y. K. Jee, Z. Yu xiang, W. Jia-xing, W. Xiao dan, N. Wen long, W. Yu, Z. Yan, X. Cheng, T. Kobayashi, Y. Onodera, R. Akimoto, A. Sugiura, H. Suzuki, M. Iwabuchi, M. Nakane, K. Kawamae, P. Carmona Sanchez, M. D. Bautista Rodriguez, M. Rodriguez Delgado, V. Martínez de Pinillos Sánchez, A. Mula Gómez, P. Beuret, C. Fortes, M. Lauer, M. Reboul, J. C. Chakarian, X. Fabre, B. Philippon-Jouve, S. Devillez, M. Clerc, N. Rittayamai, M. Sklar, M. Dres, M. Rauseo, C. Campbell, B. West, D. E. Tullis, M. Okada, N. Ahmad, M. Wood, A. Glossop, J. Higuera Lucas, A. Blandino Ortiz, D. Cabestrero Alonso, R. De Pablo Sánchez, L. Rey González, R. Costa, G. Spinazzola, A. Pizza, G. Ferrone, M. Rossi, G. Conti, H. Ribeiro, J. Alves, M. Sousa, P. Reis, C. S. Socolovsky, R. P. Cauley, J. E. Frankel, A. L. Beam, K. O. Olaniran, F. K. Gibbons, K. B. Christopher, J. Pennington, P. Zolfaghari, H. S. King, H. H. Y. Kong, H. P. Shum, W. W. Yan, C. Kaymak, N. Okumus, A. Sari, B. Erdogdu, S. Aksun, H. Basar, A. Ozcan, N. Ozcan, D. Oztuna, J. A. Malmgren, S. Lundin, K. Torén, M. Eckerström, A. Wallin, A. C. Waldenström, for the Section on Ethics of the ESICM, F. C. Riccio, A. C. P. Antonio, A. F. Leivas, F. Kenji, E. James, S. Jonnada, C. S. Gerrard, N. Jones, J. D. Salciccioli, D. C. Marshall, M. Komorowski, A. Hartley, M. C. Sykes, R. Goodson, J. Shalhoub, J. R. Fernández Villanueva, R. Fernández Garda, A. M. López Lago, E. Rodríguez Ruiz, R. Hernández Vaquero, C. Galbán Rodríguez, E. Varo Pérez, C. Hilasque, I. Oliva, G. Sirgo, M. C. Martin, M. Olona, M. C. Gilavert, M. Bodí, C. Ebm, G. Aggarwal, S. Huddart, N. Quiney, S. M. Fernandes, J. Santos Silva, J. Gouveia, D. Silva, R. Marques, H. Bento, A. Alvarez, Z. Costa Silva, D. Díaz Diaz, M. Villanova Martínez, E. Palencia Herrejon, A. Martinez de la Gandara, G. Gonzalo, M. A. Lopez, P. Ruíz de Gopegui Miguelena, C. I. Bernal Matilla, P. Sánchez Chueca, M. D. C. Rodríguez Longares, R. Ramos Abril, A. L. Ruíz Aguilar, R. Garrido López de Murillas, R. Fernández Fernández, P. Morales Laborías, M. A. Díaz Castellanos, M. E. Morales Laborías, J. Park, S. Woo, T. West, E. Powell, A. Rimmer, C. Orford, J. Williams, P. Ruiz de Gopegui Miguelena, R. S. Bourne, R. Shulman, M. Tomlin, G. H. Mills, M. Borthwick, W. Berry, D. García Huertas, F. Manzano, F. Villagrán-Ramírez, A. Ruiz-Perea, C. Rodríguez-Mejías, F. Santiago-Ruiz, M. Colmenero-Ruiz, C. König, B. Matt, A. Kortgen, C. S. Hartog, A. Wong, C. Balan, G. Barker, S. Tachaboon, J. Paratz, G. Kayambu, R. Boots, R. Vlasenko, E. Gromova, S. Loginov, M. Kiselevskiy, Y. Dolgikova, K. B. Tang, C. M. Chau, K. N. Lam, E. Gil, G. Y. Suh, C. M. Park, C. R. Chung, C. H. Lai, Y. J. Cheng, V. Colella, N. Zarrillo, M. D’Amico, F. Forfori, B. Pezza, T. Laddomada, V. Beltramelli, M. L. Pizzaballa, A. Doronzio, B. Balicco, D. Kiers, W. van der Heijden, J. Gerretsen, Q. de Mast, S. el Messaoudi, G. Rongen, M. Gomes, N. P. Riksen, Y. Kashiwagi, K. Hayashi, Y. Inagaki, S. Fujita, A. Blet, M. Sadoune, J. Lemarié, N. Bihry, R. Bern, E. Polidano, R. Merval, J. M. Launay, B. Lévy, J. L. Samuel, J. Hartmann, S. Harm, and V. Weber
Subjects: Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Published: 2016
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3. Experimental assessment of an indirect method to measure the post-combustion flue gas flow rate in waste-to-energy plant based on multi-point measurements

Author: G, Bellani, L, Lazzarini, A, Dal Pozzo, S, Moretti, M, Zattini, V, Cozzani, and A, Talamelli
Subjects: Waste Management and Disposal
Abstract: In waste-to-energy plants, the determination of the flue gas flow rate in the post-combustion section is of the utmost importance, e.g., for the verification of the compliance to the minimum residence time requirements (t
Published: 2023

4. PEEP titration is markedly affected by trunk inclination in mechanically ventilated patients with ARDS: a physiologic, cross‐over study

Author: Marrazzo, F, Spina, S, Zadek, F, Forlini, C, Bassi, G, Giudici, R, Bellani, G, Fumagalli, R, Langer, T, F. Marrazzo, S. Spina, F. Zadek, C. Forlini, G. Bassi, R. Giudici, G. Bellani, R. Fumagalli, T. Langer, Marrazzo, F, Spina, S, Zadek, F, Forlini, C, Bassi, G, Giudici, R, Bellani, G, Fumagalli, R, Langer, T, F. Marrazzo, S. Spina, F. Zadek, C. Forlini, G. Bassi, R. Giudici, G. Bellani, R. Fumagalli, and T. Langer
Published: 2023

5. Role of different driving pressure levels and respiratory rate on ventilator induced lung injury in lung injured rats undergoing mechanical ventilation

Author: Raimondi Cominesi, D, Zambelli, V, Fumagalli, R, Bellani, G, Foti, G, Rezoagli, E, D. Raimondi Cominesi, V. Zambelli, R. Fumagalli, G. Bellani, G. Foti, E. Rezoagli, Raimondi Cominesi, D, Zambelli, V, Fumagalli, R, Bellani, G, Foti, G, Rezoagli, E, D. Raimondi Cominesi, V. Zambelli, R. Fumagalli, G. Bellani, G. Foti, and E. Rezoagli
Published: 2023

6. Experimental S-PRG-Filled Composites Prevent Secondary Caries: An In-Vitro Biofilm Model

Author: A.C. Ionescu, F.I. Buhus, P. Delvecchio, V. Zambelli, G. Bellani, and E. Brambilla
Subjects: Mechanics of Materials, General Materials Science, General Dentistry
Published: 2022

7. High efficiency particulate air filters and heat & moisture exchanger filters increase positive end-expiratory pressure in helmet continuous positive airway pressure: A bench-top study

Author: E. Rezoagli, G. Coppola, L. Dezza, A. Galesi, G.P. Gallo, R. Fumagalli, G. Bellani, G. Foti, A. Lucchini, Rezoagli, E, Coppola, G, Dezza, L, Galesi, A, Gallo, G, Fumagalli, R, Bellani, G, Foti, G, and Lucchini, A
Subjects: Helmet, Pulmonary and Respiratory Medicine, HEPA, NIV, CPAP, Airway pressure, PEEP
Abstract: Background: Helmet continuous positive airway pressure (CPAP) has been widely used during the COVID-19 pandemic. Specific filters (i.e. High Efficiency Particulate Air filter: HEPA; Heat & Moisture Exchanger Filter: HMEF) were used to prevent Sars-CoV2 environmental dispersion and were connected to the CPAP helmet. However, HEPA and HMEF filters may act as resistors to expiratory gas flow and increase the levels of pressure within the hood. Methods: In a bench-top study, we investigated the levels of airway pressure generated by different HEPA and HMEF filters connected to the CPAP helmet in the absence of a Positive End Expiratory Pressure (PEEP) valve and with two levels of PEEP (5 and 10 cmH2O). All steps were performed using 3 increasing levels of gas flow (60, 80, 100 L/min). Results: The use of 8 different commercially available filters significantly increased the pressure within the hood of the CPAP helmet with or without the use of PEEP valves. On average, the increase of pressure above the set PEEP ranged from 3 cmH2O to 10 cmH2O across gas flow rates of 60 to 100 L/min. The measure of airway pressure was highly correlated between the laboratory pressure transducer and the Helmet manometer. Bias with 95% Confidence Interval of Bias between the devices was 0.7 (-2.06; 0.66) cmH2O. Conclusions: The use of HEPA and HMEF filters placed before the PEEP valve at the expiratory port of the CPAP helmet significantly increase the levels of airway pressure compared to the set level of PEEP. The manometer can detect accurately the airway pressure in the presence of HEPA and HMEF filters in the helmet CPAP and its use should considered.
Published: 2022

8. Low Skeletal Muscle Index And Myosteatosis As Predictors Of Mortality In Critically Ill Surgical Patients

Author: M. Giani, E. Rezoagli, A. Grassi, M. Porta, L. Riva, S. Famularo, A. Barbero, D. Ippolito, G. Bellani, A. Giani, and L. Gianotti
Subjects: Nutrition and Dietetics, Endocrinology, Diabetes and Metabolism
Published: 2023

9. Mechanical ventilation in patients with cardiogenic pulmonary edema: a sub-analysis of the LUNG SAFE study

Author: L., Amado-Rodriguez, R., Rodriguez-Garcia, G., Bellani, T., Pham, E., Fan, F., Madotto, J. G., Laffey, G. M., Albaiceta, Pesenti, Antonio, Brochard, Laurent, Esteban, Andre, Gattinoni, Luciano, van Haren, Frank, Larsson, Ander, Mcauley, Danielf, Ranieri, Marco, Rubenfeld, Gordon, Taylor Thompson, B, Wrigge, Hermann, S Slutsky, Arthur, Rios, Fernando, Van Haren, Frank, Sottiaux, Thierry, Depuydt, Pieter, S Lora, Fredy, Cesar Azevedo, Luciano, Bugedo, Guillermo, Qiu, Haibo, Gonzalez, Marco, Silesky, Juan, Cerny, Vladimir, Nielsen, Jona, Jibaja, Manuel, Matamis, Dimitrio, Luis Ranero, Jorge, Amin, Pravin, M Hashemian, S, Clarkson, Kevin, Kurahashi, Kiyoyasu, Villagomez, Asisclo, Ali Zeggwagh, Amine, M Heunks, Leo, Henrik Laake, Jon, Emmanuel Palo, Jose, do Vale Fernandes, Antero, Sandesc, Dorel, Arabi, Yaasen, Bumbasierevic, Vesna, Nin, Nicola, A Lorente, Jose, Piquilloud, Lise, Abroug, Fekri, Mcnamee, Lia, Hurtado, Javier, Bajwa, Ed, Démpaire, Gabriel, Sula, Hektor, Nunci, Lordian, Cani, Alma, Zazu, Alan, Dellera, Christian, S Insaurralde, Carolina, Las Lomas, Sanatorio, Isidro, San, V Alejandro, Risso, Daldin, Julio, Vinzio, Mauricio, O Fernandez, Ruben, P Cardonnet, Lui, R Bettini, Lisandro, Carboni Bisso, Mariano, M Osman, Emilio, G Setten, Mariano, Lovazzano, Pablo, Alvarez, Javier, Villar, Veronica, C Pozo, Norberto, Grubissich, Nicola, A Plotnikow, Gustavo, N Vasquez, Daniela, Ilutovich, Santiago, Tiribelli, Norberto, Chena, Ariel, A Pellegrini, Carlo, G Saenz, María, Estenssoro, Elisa, Brizuela, Matia, Gianinetto, Hernan, E Gomez, Pablo, I Cerrato, Valeria, G Bezzi, Marco, A Borello, Silvina, A Loiacono, Flavia, M Fernandez, Adriana, Knowles, Serena, Reynolds, Claire, M Inskip, Deborah, J Miller, Jennene, Kong, Jing, Whitehead, Christina, Bihari, Shailesh, Seven, Aylin, Krstevski, Amanda, J Rodgers, Helen, T Millar, Rebecca, E McKenna, Toni, M Bailey, Irene, C Hanlon, Gabrielle, Aneman, Ander, M Lynch, Joan, Azad, Raman, Neal, John, W Woods, Paul, L Roberts, Brigit, R Kol, Mark, S Wong, Helen, C Riss, Katharina, Staudinger, Thoma, Wittebole, Xavier, Berghe, 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Villamagua, Borisg, Llano, Iguel, Burtin, Philippe, Buzancais, Gautier, Beuret, Pascal, Pelletier, Nicola, Mortaza, Satar, Mercat, Alain, Chelly, Jonathan, Jochmans, Sébastien, Terzi, Nicola, Daubin, Cédric, Carteaux, Guillaume, de Prost, Nicola, Chiche, Jean-Daniel, Daviaud, Fabrice, Fartoukh, Muriel, Barberet, Guillaume, Biehler, Jerome, Dellamonica, Jean, Doyen, Deni, Arnal, Jean-Michel, Briquet, Anai, Hraiech, Sami, Papazian, Laurent, Follin, Arnaud, Roux, Damien, Messika, Jonathan, Kalaitzis, Evangelo, Dangers, Laurence, Combes, Alain, Béduneau, Gaetan, Carpentier, Dorothée, H Zogheib, Elie, Dupont, Herve, Ricome, Sylvie, Santoli, Francescol, L Besset, Sebastien, Michel, Philippe, Gelée, Bruno, Danin, Pierre-Eric, Goubaux, Bernard, J Crova, Philippe, T Phan, Nga, Berkelmans, Frantz, C Badie, Julio, Tapponnier, Romain, Gally, Josette, Khebbeb, Samy, Herbrecht, Jean-Etienne, Schneider, Franci, M Declercq, Pierreloui, Rigaud, Jean-Philippe, Duranteau, Jacque, Harrois, Anatole, Chabanne, Russell, Marin, Julien, Bigot, Charlene, Thibault, Sandrine, Ghazi, Mohammed, Boukhazna, Messabi, Ould Zein, Salem, R Richecoeur, Jack, Combaux, Danielem, Grelon, Fabien, Le Moal, Charlene, Sauvadet, Elisep, Robine, Adrien, Lemiale, Virginie, Reuter, Danielle, Dres, Martin, Demoule, Alexandre, Goldgran-Toledano, Dany, Baboi, Loredana, Guérin, Claude, Lohner, Ralph, Kraßler, Jen, Schäfer, Susanne, D Zacharowski, Kai, Meybohm, Patrick, W Reske, Andrea, Simon, Philipp, F Hopf, Hansbernd, Schuetz, Michael, Baltus, Thoma, N Papanikolaou, Metaxia, G Papavasilopoulou, Theonymfi, A Zacharas, Gianni, Ourailogloy, Vasili, K Mouloudi, Eleni, V Massa, Eleni, O Nagy, Eva, E Stamou, Electra, V Kiourtzieva, Ellada, A Oikonomou, Marina, E Avila, Lui, A Cortez, Cesar, E Citalán, Johanna, A Jog, Sameer, D Sable, Safal, Shah, Bhagyesh, Gurjar, Mohan, K Baronia, Arvind, Memon, Mohammedfaruk, Muthuchellappan, Radhakrishnan, J Ramesh, Venkatapura, Shenoy, Anitha, Unnikrishnan, Ramesh, B Dixit, 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Nicolò, Pozzi, Matteo, Biscione, Robertor, M Poli, Michela, Raimondi, Ferdinando, Albiero, Daniela, Crapelli, Giulia, Beck, Eduardo, Pota, Vincenzo, Schiavone, Vincenzo, Molin, Alexandre, Tarantino, Fabio, Monti, Giacomo, Frati, Elena, Mirabella, Lucia, Cinnella, Gilda, Fossali, Tommaso, Colombo, Riccardo, Terragni, Pierpaolo, Pattarino, Ilaria, Mojoli, Francesco, Braschi, Antonio, E Borotto, Erika, N Cracchiolo, Andrea, M Palma, Daniela, Raponi, Francesco, Foti, Giuseppe, Vascotto, Ettorer, Coppadoro, Andrea, Brazzi, Luca, Floris, Leda, A Iotti, Giorgio, Venti, Aaron, Yamaguchi, Osamu, Takagi, Shunsuke, N Maeyama, Hiroki, Watanabe, Eizo, Yamaji, Yoshihiro, Shimizu, Kazuyoshi, Shiozaki, Kyoko, Futami, Satoru, Ryosuke, Sekine, Saito, Koji, Kameyama, Yoshinobu, Ueno, Keiko, Izawa, Masayo, Okuda, Nao, Suzuki, Hiroyuki, Harasawa, Tomofumi, Nasu, Michitaka, Takada, Tadaaki, Ito, Fumihito, Nunomiya, Shin, Koyama, Kansuke, Abe, Toshikazu, Andoh, Kohkichi, Kusumoto, Kohei, Hirata, Akira, Takaba, Akihiro, Kimura, Hiroyasu, Matsumoto, Shuhei, Higashijima, Ushio, Honda, Hiroyuki, Aoki, Nobumasa, Imai, Hiroshi, Ogino, Yasuaki, Mizuguchi, Ichiko, Ichikado, Kazuya, Nitta, Kenichi, Mochizuki, Katsunori, Hashida, Tomoaki, Tanaka, Hiroyuki, Nakamura, Tomoyuki, Niimi, Daisuke, Ueda, Takeshi, Kashiwa, Yozo, Uchiyama, Akinori, Sabelnikovs, Oleg, Oss, Peteri, Haddad, Youssef, Y Liew, Kong, A Ñamendys-Silva, Silvio, Jarquin-Badiola, Yvesd, A Sanchez-Hurtado, Lui, S Gomez-Flores, Saira, C Marin, Maria, Villagomez, Asiscloj, S Lemus, Jordana, M Fierro, Jonathan, Ramirez Cervantes, Mavy, Javier Flores Mejia, Francisco, Dector, Dulce, Rojas, Alejandro, R Gonzalez, Daniel, R Estrella, Claudia, R Sanchez-Medina, Jorge, Ramirez-Gutierrez, Alvaro, G George, Fernando, S Aguirre, Janet, A Buensuseso, Juan, Poblano, Manuel, Dendane, Tarek, Balkhi, Hicham, Elkhayari, Mina, Samkaoui, Nacer, Ezzouine, Hanane, Benslama, Abdellatif, Amor, Mourad, Maazouzi, Wajdi, Cimic, Nedim, Beck, Oliver, M Bruns, Monique, A Schouten, Jeroen, Rinia, Myra, Raaijmakers, Monique, M Van Wezel, Hellen, J Heines, Serge, Strauch, Ulrich, P Buise, Marc, D Simonis, Fabienne, J Schultz, Marcu, C Goodson, Jennifer, S Browne, Troy, Navarra, Leanlove, Hunt, Anna, A Hutchison, Robyn, B Bailey, Mathew, Newby, Lynette, Mcarthur, Colin, Kalkoff, Michael, Mcleod, Alex, Casement, Jonathan, Hacking, Daniellej, H Andersen, Finn, S Dolva, Merete, H Laake, Jon, Barratt-Due, Andrea, L Noremark, Kim Andre, Søreide, Eldar, Sjøbø, Britå, Guttormsen, Anneb, H LeonYoshido, Hector, Zumaran Aguilar, Ronald, A Montes Oscanoa, Fredy, U Alisasis, Alain, B Robles, Joanne, B Pasanting-Lim, Rossini Abbie, C Tan, Beatriz, Andruszkiewicz, Pawel, Jakubowska, Karina, M Coxo, Cristina, M Alvarez, António, S Oliveira, Bruno, M Montanha, Gustavo, C Barros, Nelson, S Pereira, Carlo, M Messias, António, M Monteiro, Jorge, Araujo, Anam, Catorze, Nunot, M Marum, Susan, J Bouw, Maria, M Gomes, Rui, A Brito, Vania, Castro, Silvia, M 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Kennedy, Barry, Parhar, Ken, Srinivasa, Latha, Mcauley, Danny, Hopkins, Phil, Mellis, Clare, Kakar, Vivek, Hadfield, Dan, Vercueil, Andre, Bhowmick, Kaushik, K Humphreys, Sally, Ferguson, Andrew, Mckee, Raymond, S Raj, Ashok, A Fawkes, Danielle, Watt, Philip, Twohey, Linda, R Jha, Rajeev, Thomas, Matthew, Morton, Alex, Kadaba, Varsha, J Smith, Mark, P Hormis, Anil, G Kannan, Santhana, Namih, Miriam, Reschreiter, Henrik, Camsooksai, Julie, Kumar, Alek, Rugonfalvi, Szabolc, Nutt, Christopher, Oneill, Orla, Seasman, Colette, Dempsey, Ged, Scott, Christopherj, Ellis, Helene, Mckechnie, Stuart, Hutton, Paulaj, N Di Tomasso, Nora, N Vitale, Michela, O Griffin, Ruth, Dean, Michaeln, Cranshaw, Juliush, Willett, Emmal, Ioannou, Nichola, Gillis, Sarah, Csabi, Peter, Macfadyen, Rosaleen, Dawson, Heidi, Preez, Pieterd, J Williams, Alexandra, Boyd, Owen, Ortiz-Ruiz de Gordoa, Laura, Bramall, Jon, Symmonds, Sophie, Chau, Simonk, Wenham, Tim, Szakmany, Tama, Toth-Tarsoly, Piroska, Mccalman, Katieh, Alexander, Peter, Stephenson, Lorraine, Collyer, Thoma, Chapman, Rhiannon, Cooper, Raphael, M Allan, Russell, Sim, Malcolm, W Wrathall, David, Irvine, Donalda, S Zantua, Charing Kim, C Adams, John, J Burtenshaw, Andrew, P Sellors, Gareth, D Welters, Ingeborg, E Williams, Karen, J Hessell, Robert, G Oldroyd, Matthew, E Battle, Ceri, Pillai, Suresh, Kajtor, Istvan, Sivashanmugavel, Mageswaran, C Okane, Sinead, Donnelly, Adrian, D Frigyik, Aniko, P Careless, Jon, M May, Martin, Stewart, Richard, John Trinder, T, Hagan, Samanthaj, Cole, Jadem, C MacFie, Caroline, Dowling, Annat, Nin, Nicolá, Nuñez, Edgardo, Pittini, Gustavo, Rodriguez, Ruben, C Imperio, María, Santos, Cristina, G França, Ana, Ebeid, Alejandro, Deicas, Alberto, Serra, Carolina, Uppalapati, Aditya, Kamel, Ghassan, M BannerGoodspeed, Valerie, R Beitler, Jeremy, Reddy Mukkera, Satyanarayana, Kulkarni, Shreedhar, O Shinn Iii, John, Gomaa, Dina, Tainter, Christopher, Lee, Jarone, Mesar, Tomaz, Yeatts, Dalej, Warren, Jessica, Lanspa, Michaelj, R Miller, Russel, Grissom, Colink, Brown, Samuelm, R Bauer, Philippe, J Gosselin, Ryan, T Kitch, Barrett, E Cohen, Jason, H Beegle, Scott, Choudry, Shazia, M Gueret, Renaud, Tulaimat, Aiman, Stigler, William, Batra, Hitesh, G Huff, Nidhi, D Lamb, Keith, W Oetting, Trevor, M Mohr, Nichola, Judy, Claine, Saito, Shigeki, M Kheir, Fayez, Kheir, Fayez, B Schlichting, Adam, Delsing, Angela, R Crouch, Daniel, Elmasri, Mary, Ismail, Dina, R Dreyer, Kyle, C Blakeman, Thoma, M Baro, Rebecca, C Hou, Peter, Seethala, Raghu, Aisiku, Imo, Henderson, Galen, Frendl, Gyorgy, Hou, Sen-Kuang, Owens, Robertl, Schomer, Ashley, Rossi, Anna, Luca Montini (ORCID:0000-0003-4602-5134), L., Amado-Rodriguez, R., Rodriguez-Garcia, G., Bellani, T., Pham, E., Fan, F., Madotto, J. G., Laffey, G. M., Albaiceta, Pesenti, Antonio, Brochard, Laurent, Esteban, Andre, Gattinoni, Luciano, van Haren, Frank, Larsson, Ander, Mcauley, Danielf, Ranieri, Marco, Rubenfeld, Gordon, Taylor Thompson, B, Wrigge, Hermann, S Slutsky, Arthur, Rios, Fernando, Van Haren, Frank, Sottiaux, Thierry, Depuydt, Pieter, S Lora, Fredy, Cesar Azevedo, Luciano, Bugedo, Guillermo, Qiu, Haibo, Gonzalez, Marco, Silesky, Juan, Cerny, Vladimir, Nielsen, Jona, Jibaja, Manuel, Matamis, Dimitrio, Luis Ranero, Jorge, Amin, Pravin, M Hashemian, S, Clarkson, Kevin, Kurahashi, Kiyoyasu, Villagomez, Asisclo, Ali Zeggwagh, Amine, M Heunks, Leo, Henrik Laake, Jon, Emmanuel Palo, Jose, do Vale Fernandes, Antero, Sandesc, Dorel, Arabi, Yaasen, Bumbasierevic, Vesna, Nin, Nicola, A Lorente, Jose, Piquilloud, Lise, Abroug, Fekri, Mcnamee, Lia, Hurtado, Javier, Bajwa, Ed, Démpaire, Gabriel, Sula, Hektor, Nunci, Lordian, Cani, Alma, Zazu, Alan, Dellera, Christian, S Insaurralde, Carolina, Las Lomas, Sanatorio, Isidro, San, V 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Nicolò, Pozzi, Matteo, Biscione, Robertor, M Poli, Michela, Raimondi, Ferdinando, Albiero, Daniela, Crapelli, Giulia, Beck, Eduardo, Pota, Vincenzo, Schiavone, Vincenzo, Molin, Alexandre, Tarantino, Fabio, Monti, Giacomo, Frati, Elena, Mirabella, Lucia, Cinnella, Gilda, Fossali, Tommaso, Colombo, Riccardo, Terragni, Pierpaolo, Pattarino, Ilaria, Mojoli, Francesco, Braschi, Antonio, E Borotto, Erika, N Cracchiolo, Andrea, M Palma, Daniela, Raponi, Francesco, Foti, Giuseppe, Vascotto, Ettorer, Coppadoro, Andrea, Brazzi, Luca, Floris, Leda, A Iotti, Giorgio, Venti, Aaron, Yamaguchi, Osamu, Takagi, Shunsuke, N Maeyama, Hiroki, Watanabe, Eizo, Yamaji, Yoshihiro, Shimizu, Kazuyoshi, Shiozaki, Kyoko, Futami, Satoru, Ryosuke, Sekine, Saito, Koji, Kameyama, Yoshinobu, Ueno, Keiko, Izawa, Masayo, Okuda, Nao, Suzuki, Hiroyuki, Harasawa, Tomofumi, Nasu, Michitaka, Takada, Tadaaki, Ito, Fumihito, Nunomiya, Shin, Koyama, Kansuke, Abe, Toshikazu, Andoh, Kohkichi, Kusumoto, Kohei, Hirata, Akira, Takaba, Akihiro, Kimura, Hiroyasu, Matsumoto, Shuhei, Higashijima, Ushio, Honda, Hiroyuki, Aoki, Nobumasa, Imai, Hiroshi, Ogino, Yasuaki, Mizuguchi, Ichiko, Ichikado, Kazuya, Nitta, Kenichi, Mochizuki, Katsunori, Hashida, Tomoaki, Tanaka, Hiroyuki, Nakamura, Tomoyuki, Niimi, Daisuke, Ueda, Takeshi, Kashiwa, Yozo, Uchiyama, Akinori, Sabelnikovs, Oleg, Oss, Peteri, Haddad, Youssef, Y Liew, Kong, A Ñamendys-Silva, Silvio, Jarquin-Badiola, Yvesd, A Sanchez-Hurtado, Lui, S Gomez-Flores, Saira, C Marin, Maria, Villagomez, Asiscloj, S Lemus, Jordana, M Fierro, Jonathan, Ramirez Cervantes, Mavy, Javier Flores Mejia, Francisco, Dector, Dulce, Rojas, Alejandro, R Gonzalez, Daniel, R Estrella, Claudia, R Sanchez-Medina, Jorge, Ramirez-Gutierrez, Alvaro, G George, Fernando, S Aguirre, Janet, A Buensuseso, Juan, Poblano, Manuel, Dendane, Tarek, Balkhi, Hicham, Elkhayari, Mina, Samkaoui, Nacer, Ezzouine, Hanane, Benslama, Abdellatif, Amor, Mourad, Maazouzi, Wajdi, Cimic, Nedim, Beck, Oliver, M Bruns, Monique, A Schouten, Jeroen, Rinia, Myra, Raaijmakers, Monique, M Van Wezel, Hellen, J Heines, Serge, Strauch, Ulrich, P Buise, Marc, D Simonis, Fabienne, J Schultz, Marcu, C Goodson, Jennifer, S Browne, Troy, Navarra, Leanlove, Hunt, Anna, A Hutchison, Robyn, B Bailey, Mathew, Newby, Lynette, Mcarthur, Colin, Kalkoff, Michael, Mcleod, Alex, Casement, Jonathan, Hacking, Daniellej, H Andersen, Finn, S Dolva, Merete, H Laake, Jon, Barratt-Due, Andrea, L Noremark, Kim Andre, Søreide, Eldar, Sjøbø, Britå, Guttormsen, Anneb, H LeonYoshido, Hector, Zumaran Aguilar, Ronald, A Montes Oscanoa, Fredy, U Alisasis, Alain, B Robles, Joanne, B Pasanting-Lim, Rossini Abbie, C Tan, Beatriz, Andruszkiewicz, Pawel, Jakubowska, Karina, M Coxo, Cristina, M Alvarez, António, S Oliveira, Bruno, M Montanha, Gustavo, C Barros, Nelson, S Pereira, Carlo, M Messias, António, M Monteiro, Jorge, Araujo, Anam, Catorze, Nunot, M Marum, Susan, J Bouw, Maria, M Gomes, Rui, A Brito, Vania, Castro, Silvia, M Estilita, Joana, M Barros, Filipa, Serra, Isabelm, M Martinho, Aurelia, R Tomescu, Dana, Marcu, Alexandra, H Bedreag, Ovidiu, Papurica, Mariu, E Corneci, Dan, Ioan Negoita, Silviu, Grigoriev, Evgeny, I Gritsan, Alexey, A Gazenkampf, Andrey, Almekhlafi, Ghaleb, M Albarrak, Mohamad, M Mustafa, Ghanem, A Maghrabi, Khalid, Salahuddin, Nawal, M Aisa, Tharwat, Aljabbary, Ahmed, Tabhan, Edgardo, Arabi, Yaseenm, M Arabi, Yaseen, A Trinidad, Olivia, M Al Dorzi, Hasan, E Tabhan, Edgardo, Bumbasirevic, Vesna, Jovanovic, Bojan, Bolon, Stefan, Smith, Oliver, Mancebo, Jordi, Aguirre-Bermeo, Hernan, Lopez-Delgado, Juanc, Esteve, Francisco, Rialp, Gemma, Forteza, Catalina, De Haro, Candelaria, Artigas, Antonio, Albaiceta, Guillermom, De Cima-Iglesias, Sara, Seoane-Quiroga, Leticia, Ceniceros-Barros, Alexandra, Ruizaguilar, Antoniol, Claraco-Vega, Luism, Alfonso Soler, Juan, Del CarmenLorente, Maria, Hermosa, Cecilia, Gordo, Federico, Prietogonzález, Miryam, López-Messa, Juanb, Perez, Manuelp, Perez, Cesarp, Montoiro Allue, Raquel, Rochecampo, Ferran, Ibañez-Santacruz, Marco, Temprano, Susana, C Pintado, Maria, De Pablo, Raul, Ricart Aroa Gómez, Pilar, Rodriguez Ruiz, Silvia, Iglesias Moles, Silvia, Teresa Jurado, M, Arizmendi, Alfon, A Piacentini, Enrique, Franco, Nieve, Honrubia, Teresa, Perez Cheng, Meisy, Perez Losada, Elena, Blanco, Javier, J Yuste, Lui, Carbayo-Gorriz, Cecilia, G Cazorla-Barranquero, Francisca, G Alonso, Javier, S Alda, Rosa, Algaba, Ángela, Navarro, Gonzalo, Cereijo, Enrique, Diaz-Rodriguez, Esther, Pastor Marcos, Diego, Alvarez Montero, Laura, Herrera Para, Lui, Jimenez Sanchez, Roberto, Angel Blasco Navalpotro, Miguel, Diaz Abad, Ricardo, Montiel González, Raquel, Parrilla Toribio, Dácil, G Castro, Alejandro, D Artiga, Maria Jose, Penuelas, Oscar, P Roser, Toma, F Olga, Moreno, Gallego Curto, Elena, Manzano Sánchez, Rocío, P Imma, Vallverdu, M Elisabet, Garcia, Claverias, Laura, Magret, Monica, M Pellicer, Ana, L Rodriguez, Lucia, Sánchez-Ballesteros, Jesú, González-Salamanca, Ángela, Jimenez, Antoniog, Huerta, Franciscop, J Sotillo Diaz, Juan Carlo, Bermejo Lopez, Esther, D Llinares Moya, David, A Tallet Alfonso, Alec, Sanchez Eugenio Luis, Palazon, Sanchez Cesar, Palazon, I Rafael, Sánchez, Virgilio, Corcolesg, Recio, Noelian, O Adamsson, Richard, C Rylander, Christian, Holzgraefe, Bernhard, M Broman, Lar, Wessbergh, Joanna, Persson, Linnea, Schiöler, Fredrik, Kedelv, Han, Oscarsson Tibblin, Anna, Appelberg, Henrik, Hedlund, Lar, Helleberg, Johan, Eriksson, Karine, Glietsch, Rita, Larsson, Nikla, Nygren, Ingela, Nunes, Silvial, Morin, Anna-Karin, Kander, Thoma, Adolfsson, Anne, Zender, Hervéo, Leemann-Refondini, Corinne, Elatrous, Souheil, Bouchoucha, Slaheddine, Chouchene, Imed, Ouanes, Islem, Ben Souissi, Asma, Kamoun, Salma, Demirkiran, Oktay, Aker, Mustafa, Erbabacan, Emre, Ceylan, Ilkay, Kelebek Girgin, Nermin, Ozcelik, Menekse, Ünal, Necmettin, Ceyda Meco, Basak, Akyol, Onato, Derman, Suleyman, Kennedy, Barry, Parhar, Ken, Srinivasa, Latha, Mcauley, Danny, Hopkins, Phil, Mellis, Clare, Kakar, Vivek, Hadfield, Dan, Vercueil, Andre, Bhowmick, Kaushik, K Humphreys, Sally, Ferguson, Andrew, Mckee, Raymond, S Raj, Ashok, A Fawkes, Danielle, Watt, Philip, Twohey, Linda, R Jha, Rajeev, Thomas, Matthew, Morton, Alex, Kadaba, Varsha, J Smith, Mark, P Hormis, Anil, G Kannan, Santhana, Namih, Miriam, Reschreiter, Henrik, Camsooksai, Julie, Kumar, Alek, Rugonfalvi, Szabolc, Nutt, Christopher, Oneill, Orla, Seasman, Colette, Dempsey, Ged, Scott, Christopherj, Ellis, Helene, Mckechnie, Stuart, Hutton, Paulaj, N Di Tomasso, Nora, N Vitale, Michela, O Griffin, Ruth, Dean, Michaeln, Cranshaw, Juliush, Willett, Emmal, Ioannou, Nichola, Gillis, Sarah, Csabi, Peter, Macfadyen, Rosaleen, Dawson, Heidi, Preez, Pieterd, J Williams, Alexandra, Boyd, Owen, Ortiz-Ruiz de Gordoa, Laura, Bramall, Jon, Symmonds, Sophie, Chau, Simonk, Wenham, Tim, Szakmany, Tama, Toth-Tarsoly, Piroska, Mccalman, Katieh, Alexander, Peter, Stephenson, Lorraine, Collyer, Thoma, Chapman, Rhiannon, Cooper, Raphael, M Allan, Russell, Sim, Malcolm, W Wrathall, David, Irvine, Donalda, S Zantua, Charing Kim, C Adams, John, J Burtenshaw, Andrew, P Sellors, Gareth, D Welters, Ingeborg, E Williams, Karen, J Hessell, Robert, G Oldroyd, Matthew, E Battle, Ceri, Pillai, Suresh, Kajtor, Istvan, Sivashanmugavel, Mageswaran, C Okane, Sinead, Donnelly, Adrian, D Frigyik, Aniko, P Careless, Jon, M May, Martin, Stewart, Richard, John Trinder, T, Hagan, Samanthaj, Cole, Jadem, C MacFie, Caroline, Dowling, Annat, Nin, Nicolá, Nuñez, Edgardo, Pittini, Gustavo, Rodriguez, Ruben, C Imperio, María, Santos, Cristina, G França, Ana, Ebeid, Alejandro, Deicas, Alberto, Serra, Carolina, Uppalapati, Aditya, Kamel, Ghassan, M BannerGoodspeed, Valerie, R Beitler, Jeremy, Reddy Mukkera, Satyanarayana, Kulkarni, Shreedhar, O Shinn Iii, John, Gomaa, Dina, Tainter, Christopher, Lee, Jarone, Mesar, Tomaz, Yeatts, Dalej, Warren, Jessica, Lanspa, Michaelj, R Miller, Russel, Grissom, Colink, Brown, Samuelm, R Bauer, Philippe, J Gosselin, Ryan, T Kitch, Barrett, E Cohen, Jason, H Beegle, Scott, Choudry, Shazia, M Gueret, Renaud, Tulaimat, Aiman, Stigler, William, Batra, Hitesh, G Huff, Nidhi, D Lamb, Keith, W Oetting, Trevor, M Mohr, Nichola, Judy, Claine, Saito, Shigeki, M Kheir, Fayez, Kheir, Fayez, B Schlichting, Adam, Delsing, Angela, R Crouch, Daniel, Elmasri, Mary, Ismail, Dina, R Dreyer, Kyle, C Blakeman, Thoma, M Baro, Rebecca, C Hou, Peter, Seethala, Raghu, Aisiku, Imo, Henderson, Galen, Frendl, Gyorgy, Hou, Sen-Kuang, Owens, Robertl, Schomer, Ashley, Rossi, Anna, and Luca Montini (ORCID:0000-0003-4602-5134)
Abstract: Background: Patients with acute respiratory failure caused by cardiogenic pulmonary edema (CPE) may require mechanical ventilation that can cause further lung damage. Our aim was to determine the impact of ventilatory settings on CPE mortality. Methods: Patients from the LUNG SAFE cohort, a multicenter prospective cohort study of patients undergoing mechanical ventilation, were studied. Relationships between ventilatory parameters and outcomes (ICU discharge/hospital mortality) were assessed using latent mixture analysis and a marginal structural model. Results: From 4499 patients, 391 meeting CPE criteria (median age 70 [interquartile range 59–78], 40% female) were included. ICU and hospital mortality were 34% and 40%, respectively. ICU survivors were younger (67 [57–77] vs 74 [64–80] years, p < 0.001) and had lower driving (12 [8–16] vs 15 [11–17] cmH2O, p < 0.001), plateau (20 [15–23] vs 22 [19–26] cmH2O, p < 0.001) and peak (21 [17–27] vs 26 [20–32] cmH2O, p < 0.001) pressures. Latent mixture analysis of patients receiving invasive mechanical ventilation on ICU day 1 revealed a subgroup ventilated with high pressures with lower probability of being discharged alive from the ICU (hazard ratio [HR] 0.79 [95% confidence interval 0.60–1.05], p = 0.103) and increased hospital mortality (HR 1.65 [1.16–2.36], p = 0.005). In a marginal structural model, driving pressures in the first week (HR 1.12 [1.06–1.18], p < 0.001) and tidal volume after day 7 (HR 0.69 [0.52–0.93], p = 0.015) were related to survival. Conclusions: Higher airway pressures in invasively ventilated patients with CPE are related to mortality. These patients may be exposed to an increased risk of ventilator-induced lung injury. Trial registration Clinicaltrials.gov NCT02010073.
Published: 2022

10. Autoantibodies neutralizing type I IFNs are present in ~4% of uninfected individuals over 70 years old and account for ~20% of COVID-19 deaths

Author: Bastard, P. Gervais, A. Voyer, T.L. Rosain, J. Philippot, Q. Manry, J. Michailidis, E. Hoffmann, H.-H. Eto, S. Garcia-Prat, M. Bizien, L. Parra-Martínez, A. Yang, R. Haljasmägi, L. Migaud, M. Särekannu, K. Maslovskaja, J. De Prost, N. Tandjaoui-Lambiotte, Y. Luyt, C.-E. Amador-Borrero, B. Gaudet, A. Poissy, J. Morel, P. Richard, P. Cognasse, F. Troya, J. Trouillet-Assant, S. Belot, A. Saker, K. Garçon, P. Rivière, J.G. Lagier, J.-C. Gentile, S. Rosen, L.B. Shaw, E. Morio, T. Tanaka, J. Dalmau, D. Tharaux, P.-L. Sene, D. Stepanian, A. Megarbane, B. Triantafyllia, V. Fekkar, A. Heath, J.R. Franco, J.L. Anaya, J.-M. Solé-Violán, J. Imberti, L. Biondi, A. Bonfanti, P. Castagnoli, R. Delmonte, O.M. Zhang, Y. Snow, A.L. Holland, S.M. Biggs, C.M. Moncada-Vélez, M. Arias, A.A. Lorenzo, L. Boucherit, S. Coulibaly, B. Anglicheau, D. Planas, A.M. Haerynck, F. Duvlis, S. Nussbaum, R.L. Ozcelik, T. Keles, S. Bousfiha, A.A. El Bakkouri, J. Ramirez-Santana, C. Paul, S. Pan-Hammarström, Q. Hammarström, L. Dupont, A. Kurolap, A. Metz, C.N. Aiuti, A. Casari, G. Lampasona, V. Ciceri, F. Barreiros, L.A. Dominguez-Garrido, E. Vidigal, M. Zatz, M. Van De Beek, D. Sahanic, S. Tancevski, I. Stepanovskyy, Y. Boyarchuk, O. Nukui, Y. Tsumura, M. Vidaur, L. Tangye, S.G. Burrel, S. Duffy, D. Quintana-Murci, L. Klocperk, A. Kann, N.Y. Shcherbina, A. Lau, Y.-L. Leung, D. Coulongeat, M. Marlet, J. Koning, R. Reyes, L.F. Chauvineau-Grenier, A. Venet, F. Monneret, G. Nussenzweig, M.C. Arrestier, R. Boudhabhay, I. Baris-Feldman, H. Hagin, D. Wauters, J. Meyts, I. Dyer, A.H. Kennelly, S.P. Bourke, N.M. Halwani, R. Sharif-Askari, N.S. Dorgham, K. Sallette, J. Sedkaoui, S.M. AlKhater, S. Rigo-Bonnin, R. Morandeira, F. Roussel, L. Vinh, D.C. Ostrowski, S.R. Condino-Neto, A. Prando, C. Bondarenko, A. Spaan, A.N. Gilardin, L. Fellay, J. Lyonnet, S. Bilguvar, K. Lifton, R.P. Mane, S. Anderson, M.S. Boisson, B. Béziat, V. Zhang, S.-Y. Andreakos, E. Hermine, O. Pujol, A. Peterson, P. 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Fumado, V. Fung, K.S.C. Fusco, F. Gagro, A. Solis, B.G. Gaussem, P. Gayretli, Z. Gil-Herrera, J. Gatineau, A.G. Girona-Alarcon, M. Godinez, K.A.C. Goffard, J.-C. Gonzales, N. Gonzalez-Granado, L.I. Gonzalez-Montelongo, R. Guerder, A. Gulhan, B. Gumucio, V.D. Hanitsch, L.G. Gunst, J. Gut, M. Hadjadj, J. Hancerli, S. Hariyan, T. Hatipoglu, N. Heppekcan, D. Hernandez-Brito, E. Ho, P.-K. Holanda-Pena, M.S. Horcajada, J.P. Hraiech, S. Humbert, L. Hung, I.F.N. Iglesias, A.D. Inigo-Campos, A. Jamme, M. Arranz, M.J. Jimeno, M.-T. Jordan, I. Kanik-Yuksek, S. Kara, Y.B. Karahan, A. Karbuz, A. Yasar, K.K. Kasapcopur, O. Kashimada, K. Demirkol, Y.K. Kido, Y. Kizil, C. Kilic, A.O. Koutsoukou, A. Krol, Z.J. Ksouri, H. Kuentz, P. Kwan, A.M.C. Kwan, Y.W.M. Kwok, J.S.Y. Lam, D.S.Y. Lampropoulou, V. Lanternier, F. Le Bourgeois, F. Leo, Y.-S. Lopez, R.L. Levin, M. Levy, M. Levy, R. Li, Z. Lilleri, D. Lima, E.J.A.B. Linglart, A. Lopez-Collazo, E. Lorenzo-Salazar, J.M. Louapre, C. Lubetzki, C. Lung, K.-C. Lye, D.C. Magnone, C. Mansouri, D. Marchioni, E. Marioli, C. Marjani, M. Marques, L. Pereira, J.M. Martin-Nalda, A. Pueyo, D.M. Marzana, I. Mata-Martinez, C. Mathian, A. Matos, L.R.B. Matthews, G.V. Mayaux, J. McLaughlin-Garcia, R. Meersseman, P. Mege, J.-L. Mekontso-Dessap, A. Melki, I. Meloni, F. Meritet, J.-F. Merlani, P. Akcan, O.M. Mezidi, M. Migeotte, I. Millereux, M. Million, M. Mirault, T. Mircher, C. Mirsaeidi, M. Mizoguchi, Y. Modi, B.P. Mojoli, F. Moncomble, E. Melian, A.M. Martinez, A.M. Morange, P.-E. Mordacq, C. Morelle, G. Mouly, S.J. Munoz-Barrera, A. Nafati, C. Nagashima, S. Nakagama, Y. Neven, B. Neves, J.F. Ng, L.F.P. Ng, Y.-Y. Nielly, H. Medina, Y.N. Cuadros, E.N. Ocejo-Vinyals, J.G. Okamoto, K. Oualha, M. Ouedrani, A. Ozkaya-Parlakay, A. Pagani, M. Papadaki, M. Parizot, C. Parola, P. Pascreau, T. Paz-Artal, E. Pedraza, S. Pellecer, N.C.G. Pellegrini, S. De Diego, R.P. Perez-Fernandez, X.L. Philippe, A. Picod, A. De Chambrun, M.P. Piralla, A. Planas-Serra, L. Ploin, D. Poncelet, G. Poulakou, G. Pouletty, M.S. Pourshahnazari, P. Qiu-Chen, J.L. Quentric, P. Rambaud, T. Raoult, V. Rebillat, A.-S. Redin, C. Resmini, L. Ricart, P. Richard, J.-C. Rivet, N. Rocamora-Blanch, G. Rodero, M.P. Rodrigo, C. Rodriguez, L.A. Rodriguez-Palmero, A. Romero, C.S. Rothenbuhler, A. Roux, D. Rovina, N. Rozenberg, F. Ruch, Y. Ruiz, M. Del Prado, M.Y.R. Ruiz-Rodriguez, J.C. Sabater-Riera, J. Saks, K. Salagianni, M. Sanchez, O. Sanchez-Montalva, A. Sanchez-Ramon, S. Schidlowski, L. Schluter, A. Schmidt, J. Schmidt, M. Schuetz, C. Schweitzer, C.E. Scolari, F. Sediva, A. Seijo, L. Seminario, A.G. Seng, P. Senoglu, S. Seppanen, M. Llovich, A.S. Shahrooei, M. Siguret, V. Siouti, E. Smadja, D.M. Smith, N. Sobh, A. Soler, C. Sozeri, B. Stella, G.M. Stepanovskiy, Y. Stoclin, A. Taccone, F. Taupin, J.-L. Tavernier, S.J. Terrier, B. Thiery, G. Thorball, C. Thorn, K. Thumerelle, C. Tipu, I. Tolstrup, M. Tomasoni, G. Toubiana, J. Alvarez, J.T. Tsang, O.T.Y. Tserel, L. Tso, E.Y.K. Tucci, A. Oz, Ş.K.T. Ursini, M.V. Utsumi, T. Uzunhan, Y. Vabres, P. Valencia-Ramos, J. Van Den Rym, A.M. Vandernoot, I. Velez-Santamaria, V. Veliz, S.P.Z. Vidigal, M.C. Viel, S. Vilain, C. Vilaire-Meunier, M.E. Villar-Garcia, J. Vincent, A. Vogt, G. Voiriot, G. Volokha, A. Vuotto, F. Wauters, E. Wu, A.K.L. Wu, T.-C. Yahşi, A. Yesilbas, O. Yildiz, M. Young, B.E. Yukselmiş, U. Zecca, M. Zuccaro, V. Van Praet, J. Lambrecht, B.N. Van Braeckel, E. Bosteels, C. Hoste, L. Hoste, E. Bauters, F. De Clercq, J. Heijmans, C. Slabbynck, H. Naesens, L. Florkin, B. Boulanger, C. Vanderlinden, D. Allavena, C. Andrejak, C. Angoulvant, F. Azoulay, C. Bachelet, D. Bartoli, M. Basmaci, R. Behillill, S. Beluze, M. Benech, N. Benkerrou, D. Bhavsar, K. Bitker, L. Bouadma, L. Bouscambert-Duchamp, M. Paz, P.C. Cervantes-Gonzalez, M. Chair, A. Coelho, A. Cordel, H. Couffignal, C. D'Ortenzio, E. De Montmollin, E. Debard, A. Debray, M.-P. Desvallee, M. Diallo, A. Diouf, A. Dorival, C. Dubos, F. Eloy, P. Epaulard, O. Esposito-Farase, M. Etienne, M. Garot, D. Gault, N. Gaymard, A. Ghosn, J. Gigante, T. Gilg, M. Goehringer, F. Guedj, J. Hoctin, A. Hoffmann, I. Houas, I. Hulot, J.-S. Jaafoura, S. Kaguelidou, F. Kali, S. Kerroumi, Y. Khalil, A. Khan, C. Kimmoun, A. Laouenan, C. Laribi, S. Le, M. Le Bris, C. Le Gac, S. Le Hingrat, Q. Le Mestre, S. Le Nagard, H. Lemaignen, A. Lemee, V. Lescure, F.-X. Levy, Y. Lingas, G. Lucet, J.C. MacHado, M. Mambert, M. Manuel, A. Meziane, A. Mouquet, H. Mullaert, J. Neant, N. Noret, M. Papadopoulos, A. Paul, C. Peiffer-Smadja, N. Peigne, V. Petrov-Sanchez, V. Peytavin, G. Pham, H. Picone, O. Puechal, O. Rosa-Calatrava, M. Rossignol, B. Rossignol, P. Roy, C. Schneider, M. Su, R. Tardivon, C. Tellier, M.-C. Teoule, F. Terrier, O. Timsit, J.F. Tual, C. Vanel, N. Veislinger, A. Wiedemann, A. Danielson, J.J. Dobbs, K. Kashyap, A. Ding, L. Dalgard, C.L. Sottini, A. Quaresima, V. Quiros-Roldan, E. Rossi, C. Bettini, L.R. D'Angio, M. Beretta, I. Montagna, D. Licari, A. Marseglia, G.L. Storgaard, M. Jorgensen, S. Al-Muhsen, S. Al-Mulla, F. Arias, A.A. Bogunovic, D. Bolze, A. Brodin, P. Bryceson, Y. Bustamante, C.D. Butte, M.J. Chakravorty, S. Christodoulou, J. Constantinescu, S.N. Cooper, M.A. Desai, M. Drolet, B.A. El Baghdadi, J. Espinosa-Padilla, S. Froidure, A. Henrickson, S.E. Hsieh, E.W.Y. Husebye, E.S. Imai, K. Itan, Y. Jarvis, E.D. Karamitros, T. Ku, C.-L. Ling, Y. Lucas, C.L. Maniatis, T. Marodi, L. Milner, J.D. Mironska, K. Novelli, A. Novelli, G. Renia, L. Resnick, I. Sancho-Shimizu, V. Seppanen, M.R.J. Shahrooei, M. Slaby, O. Tayoun, A.A. Ramaswamy, S. Turvey, S.E. Furkan Uddin, K.M. Uddin, M.J. Von Bernuth, H. Zawadzki, P. Bigio, B. De La Chapelle, A. Chen, J. Chrabieh, M. Liu, D. Nemirowskaya, Y. Cruz, I.M. Materna, M. Pelet, S. Seeleuthner, Y. Thibault, C. Liu, Z. Foti, G. Bellani, G. Citerio, G. Contro, E. Pesci, A. Valsecchi, M.G. Cazzaniga, M. Batten, I. Reddy, C. McElheron, M. Noonan, C. Connolly, E. Fallon, A. Erikstrup, C. Pedersen, O.B. Sorensen, E. Mikkelsen, S. Dinh, K.M. Larsen, M.A.H. Paulsen, I.W. Von Stemann, J.H. Hansen, M.B. Annereau, J.-P. Briseno-Roa, L. Gribouval, O. Pelet, A. Alcover, A. Aschard, H. Bousso, P. Bruhns, P. Cerf-Bensussan, N. Cumano, A. D'Enfert, C. Deriano, L. Dillies, M.-A. Di Santo, J. Dromer, F. Eberl, G. Enninga, J. Gomperts-Boneca, I. Hasan, M. Hedestam, G.K. Hercberg, S. Ingersoll, M.A. Lantz, O. Kenny, R.A. Menager, M. Michel, F. Patin, E. Pellegrini, S. Rausell, A. Rieux-Laucat, F. Rogge, L. Fontes, M. Sakuntabhai, A. Schwartz, O. Schwikowski, B. Shorte, S. Tangy, F. Toubert, A. Touvier, M. Ungeheuer, M.-N. Zimmer, C. Albert, M.L. Van Agtmael, M. Algera, A.G. Appelman, B. Van Baarle, F. Bax, D. Beudel, M. Bogaard, H.J. Bomers, M. Bonta, P. Bos, L. Botta, M. De Brabander, J. De Bree, G. De Bruin, S. Buis, D.T.P. Bugiani, M. Bulle, E. Chouchane, O. Cloherty, A. Dijkstra, M. Dongelmans, D.A. Dujardin, R.W.G. Elbers, P. Fleuren, L. Geerlings, S. Geijtenbeek, T. Girbes, A. Goorhuis, B. Grobusch, M.P. Hafkamp, F. Hagens, L. Hamann, J. Harris, V. Hemke, R. Hermans, S.M. Heunks, L. Hollmann, M. Horn, J. Hovius, J.W. De Jong, M.D. Lim, E.H.T. Van Mourik, N. Nellen, J. Nossent, E.J. Paulus, F. Peters, E. Pina-Fuentes, D.A.I. Van Der Poll, T. Preckel, B. Prins, J.M. Raasveld, J. Reijnders, T. De Rotte, M.C.F.J. Schinkel, M. Schultz, M.J. Schrauwen, F.A.P. Schuurman, A. Schuurmans, J. Sigaloff, K. Slim, M.A. Smeele, P. Smit, M. Stijnis, C.S. Stilma, W. Teunissen, C. Thoral, P. Tsonas, A.M. Tuinman, P.R. Van Der Valk, M. Veelo, D. Volleman, C. De Vries, H. Vught, L.A. Van Vugt, M. Wouters, D. Zwinderman, A.H. Brouwer, M.C. Joost Wiersinga, W. Vlaar, A.P.J. Nadif, R. Goldberg, M. Ozguler, A. Henny, J. Lemonnier, S. Coeuret-Pellicer, M. Le Got, S. Tzourio, C. Dufouil, C. Soumare, A. Lachaize, M. Fievet, N. Flaig, A. Martin, F. Bonneaudeau, B. Cannet, D. Gallian, P. Jeanne, M. Perroquin, M. Hamzeh-Cognasse, H. CoV-Contact Cohort St James's Hospital, SARS CoV2 Interest group COVID Clinicians French COVID Cohort Study Group NIAID Immune Response to COVID Group Danish CHGE COVID Human Genetic Effort HGID Lab COVID-STORM Clinicians NH-COVAIR Study Group The Danish Blood Donor Study (DBDS) Imagine COVID-Group The Milieu Interieur Consortium Amsterdam UMC Covid-19 Biobank CONSTANCES cohort 3C-Dijon Study Cerba HealthCare Etablissement du Sang study group
Abstract: Circulating autoantibodies (auto-Abs) neutralizing high concentrations (10 ng/ml; in plasma diluted 1:10) of IFN-α and/or IFN-ω are found in about 10% of patients with critical COVID-19 (coronavirus disease 2019) pneumonia but not in individuals with asymptomatic infections. We detect auto-Abs neutralizing 100-fold lower, more physiological, concentrations of IFN-α and/or IFN-ω (100 pg/ml; in 1:10 dilutions of plasma) in 13.6% of 3595 patients with critical COVID-19, including 21% of 374 patients >80 years, and 6.5% of 522 patients with severe COVID-19. These antibodies are also detected in 18% of the 1124 deceased patients (aged 20 days to 99 years; mean: 70 years). Moreover, another 1.3% of patients with critical COVID-19 and 0.9% of the deceased patients have auto-Abs neutralizing high concentrations of IFN-β. We also show, in a sample of 34,159 uninfected individuals from the general population, that auto-Abs neutralizing high concentrations of IFN-α and/or IFN-ω are present in 0.18% of individuals between 18 and 69 years, 1.1% between 70 and 79 years, and 3.4% >80 years. Moreover, the proportion of individuals carrying auto-Abs neutralizing lower concentrations is greater in a subsample of 10,778 uninfected individuals: 1% of individuals 80 years. By contrast, auto-Abs neutralizing IFN-β do not become more frequent with age. Auto-Abs neutralizing type I IFNs predate SARS-CoV-2 infection and sharply increase in prevalence after the age of 70 years. They account for about 20% of both critical COVID-19 cases in the over 80s and total fatal COVID-19 cases. © 2021 The Authors, some rights reserved.
Published: 2021

11. Assessment of VILI Risk During Spontaneous Breathing and Assisted Mechanical Ventilation

Author: G. Bellani, M. Teggia-Droghi, Vincent, JL, Bellani, G, and Teggia Droghi, M
Subjects: Mechanical ventilation, medicine.medical_specialty, ARDS, VILI, Spontaneous Breathing, business.industry, medicine.medical_treatment, respiratory system, Lung injury, Pulmonary edema, medicine.disease, Plateau pressure, Internal medicine, medicine, Breathing, Cardiology, business, Tidal volume, Transpulmonary pressure
Abstract: Since the beginning of ventilatory mechanical support for the respiratory system, it was evident that if not used properly this technique could impair the clinical condition of the patient. A well-described complication is the direct damage of the ventilator to the lung parenchyma called ventilator-induced lung injury (VILI). During controlled mechanical ventilation, “protective ventilation” aimed at minimizing the harmful effects of ventilation has been shown to decrease mortality. However, in a patient with spontaneous breathing, several mechanisms can increase the VILI risk because of the active contribution of the patient’s breathing activity: uncontrolled tidal volume, inhomogeneous transpulmonary pressure, pulmonary edema, pendelluft phenomena, and patient–ventilator asynchronies. In a patient breathing spontaneously, a careful clinical evaluation is necessary in order to minimize the impact of the ventilator on the respiratory system. Many parameters are commonly used to verify the condition of the lung parenchyma and the interaction between patient and ventilator. Classic respiratory mechanics and asynchronies can be evaluated in spontaneous breathing using almost all available ventilators. Unfortunately to detect pendelluft phenomena and some asynchronies advanced monitoring devices are needed, such as electrical impedance tomography, esophageal manometry and electrical activity of the diaphragm (EAdi).
Published: 2020

12. Correction to: The Intensive Care Global Study on Severe Acute Respiratory Infection (IC-GLOSSARI): a multicenter, multinational, 14-day inception cohort study

Author: R. Di Pasquale, F. Zand, C. Chavez, P. Hopkins, G. Almekhlafi, H. Haake, A. Martinho, A. Jung, R. Montoiro Allue, T. Pellis, R. Ferrer Roca, S. Busani, A. Gordon, N. Salahuddin, F. Belda, J. Rubio Mateo-Sidron, A. Goldmann, P. Deschamps, K. Mach, J. Nentwich, F. Rubulotta, G. Lunch, A. Jonas, R. Matos, A. Carvalho, T. Vymazal, M. Guillot, D. Morocho, D. Barrios, K. Koopmans, J. Machon, D. Tomescu, X. Wu, N. Cimic, C. de Cabo, M. Kol, M. Papanikolaou, C. Aragon, S. Afonso, S. Mukkera, T. Szakmany, Z. Mitrev, A. Alsheikhly, P. Garcia Olivares, M. de la Torre-Prados, A. Donnelly, M. Girardis, V. Schiavone, N. Unni, A. Vujiaklija Brajkovic, J. van den Bosch, F. Udwadia, R. Losser, L. Bormans, J. Tomás Marsilla, F. Bloos, A. Puerto-Morlan, F. Guarracino, M. Faraz, E. Meany, K. Ravi, J. Vincent, K. Zacharowski, R. Shetty, B. Misset, V. Pota, L. Sanchez-Hurtado, B. Villamagua, C. Pierrakos, C. Nutt, S. Humphreys, P. Dennesen, M. de Groot, J. Robles, J. Meyer, W. Samaniego, Q. Zhai, L. Yu, V. Koulouras, P. Gottardo, E. Caser, M. Cecconi, S. John, I. von Osten, G. Kekstas, C. Leite Mendes, H. Jamaati, A. Raj, P. Csabi, N. Catorze, R. Gueret, F. Sifrer, G. Plantefeve, A. Macri, S. Den Boer, C. Ortiz-Leyba, M. Gurjar, J. Palo, S. Hoersch, G. Kyriazopoulos, M. Balla, Z. Kheladze, M. Hobrok, T. Nguyen, L. Srinivasa, S. Henderson, G. Dominguez, A. Maghrabi, S. Mathew, M. Blahut-Zugaj, S. Spadaro, A. Lange, K. Fiedler, L. Chao, G. Pellerano, A. Rojas, L. Brochard, S. Brett, I. Soultati, A. Albis, J. Timsit, R. Quispe Sierra, A. Pais-de-Lacerda, N. Di Tomasso, E. Scarlatescu, Y. Sakr, M. Hegazi, A. Gottschalk, N. Anguel, C. Volta, M. Alvarez, K. Psaroulis, P. Monedero, L. Fernandes, M. Niesen, G. Francois, D. Debels, M. Stotz, R. Riessen, J. Auer, E. Massa, Y. Ikeda-Maquiling, J. Izura, M. Chruscikowski, F. Franco, G. Aguilar, R. Bigornia, J. Teboul, K. Bhowmick, R. Srinivasan, J. Mallat, G. Bellani, C. Van Haren, F. Philippart, F. Honig, I. Gornik, D. Filipescu, M. Fulop, M. Albarrak, S. Behrens, E. Bermudez-Aceves, K. Schwarzkopf, N. Ramakrishnan, P. Mazzini, K. Mccalman, V. Tomic, R. Catalan, M. Giannakou, D. Molano, M. Savioli, M. Watters, X. Zhang, X. Jing, P. Araujo Aguilar, C. Joya, R. Beale, M. Garfield, A. Nichol, G. Barraza, H. Siegel, D. Gkika, L. Bouadma, T. Helmes, A. Bendtsen, R. Moreno, U. Kaisers, B. Thompson, A. Araujo, C. Teixeira, T. Hurst, M. Ostermann, T. Anguseva, I. Serra, M. Deja, J. Blanquer, A. Faltlhauser, J. Strachan, V. Corcoles Gonzalez, U. Goebel, V. Karosas, J. Wauters, F. Taccone, A. Wieczorek, C. Fernandez Gonzalez, R. Smith, A. Kübler, N. Petrucci, G. Kluge, T. Pham, U. Jaschinski, M. Vander Laenen, A. Molin, G. Barberet, M. Kuiper, C. Santos, R. Medici, J. Nielsen, S. Whittle, P. Meybohm, E. Schreurs, C. Dao, J. Bedford, R. Cardiga, G. Schatzl, M. Baumgaertel, O. Balogun, J. Gutierrez Rubio, I. Martins, G. Vlachogianni, K. Guerra, E. Novy, A. Gatta, M. Mikaszewska-Sokolewicz, B. Adamik, J. Baltazar-Torres, S. Hraech, D. Higgs, A. Ferguson, F. Cecchini, E. Zogheib, S. Dixit, M. Darmon, Z. Costa, S. O’Kane, B. Siepe, S. Ñamendys-Silva, R. Ferrer, M. Popescu, B. Floccard, O. Beck, M. Christ, F. Daviaux, N. Smalley, P. Alexander, J. Lopez-Delgado, K. Reinhart, R. Jha, J. Chiche, C. Lovesio, J. Fried, D. Rodriguez, P. Vera Aratcoz, A. Cortegiani, T. Aisa, N. Remache-Vargas, E. Salgado-Yepez, A. Olmo, E. Rupnik, M. Haap, C. Motherway, M. Sungur, R. Stoica, R. Nikandish, P. Reddy, M. Miclo, N. Chinellato, E. Mouloudi, O. O’Neill, J. Lehmke, G. Nikos, P. Bauer, M. Barger, H. Atalan, J. Ferrer Agüero, A. Bellini, G. Janssen, S. Allgaeuer, G. Strandvik, P. Simon, D. Castanares, H. Ceunen, A. Rhodes, S. Simran, S. Hashemian, A. Pravin, I. Sagoschen, E. Rezende, H. Wong, J. Sole Violan, V. Castelain, S. Raineri, K. Indraratna, E. Nives Carbonell, T. Suonsyrjä, D. Wu, G. Brescia, H. Gruber, M. Sim, T. Lazowski, C. Gonzalez, C. Dellera, J. Rajasinhe, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, and UCL - (SLuc) Service de soins intensifs
Subjects: Male, medicine.medical_specialty, Severe acute respiratory infections, Critical Care and Intensive Care Medicine, Severe Acute Respiratory Syndrome, Risk Assessment, Severity of Illness Index, Severe acute respiratory infection, Seven-Day Profile Publication, Risk Factors, Intensive care, Medicine, Humans, Hospital Mortality, Prospective Studies, Intensive care medicine, Outcome, Aged, business.industry, Age Factors, Correction, Pneumonia, Middle Aged, INCEPTION COHORT, Intensive Care Units, Female, business
Abstract: Purpose In this prospective, multicenter, 14-day inception cohort study, we investigated the epidemiology, patterns of infections, and outcome in patients admitted to the intensive care unit (ICU) as a result of severe acute respiratory infections (SARIs). Methods All patients admitted to one of 206 participating ICUs during two study weeks, one in November 2013 and the other in January 2014, were screened. SARI was defined as possible, probable, or microbiologically confirmed respiratory tract infection with recent onset dyspnea and/or fever. The primary outcome parameter was in-hospital mortality within 60 days of admission to the ICU. Results Among the 5550 patients admitted during the study periods, 663 (11.9 %) had SARI. On admission to the ICU, Gram-positive and Gram-negative bacteria were found in 29.6 and 26.2 % of SARI patients but rarely atypical bacteria (1.0 %); viruses were present in 7.7 % of patients. Organ failure occurred in 74.7 % of patients in the ICU, mostly respiratory (53.8 %), cardiovascular (44.5 %), and renal (44.6 %). ICU and in-hospital mortality rates in patients with SARI were 20.2 and 27.2 %, respectively. In multivariable analysis, older age, greater severity scores at ICU admission, and hematologic malignancy or liver disease were independently associated with an increased risk of in-hospital death, whereas influenza vaccination prior to ICU admission and adequate antibiotic administration on ICU admission were associated with a lower risk. Conclusions Admission to the ICU for SARI is common and associated with high morbidity and mortality rates. We identified several risk factors for in-hospital death that may be useful for risk stratification in these patients. Electronic supplementary material The online version of this article (doi:10.1007/s00134-015-4206-2) contains supplementary material, which is available to authorized users.
Published: 2017

13. Felines of the World : Discoveries in Taxonomic Classification and History

Author: Giovanni G. Bellani and Giovanni G. Bellani
Subjects: Felidae
Abstract: Felines of the World: Discoveries in Taxonomic Classification and History provides the most recent taxonomic, paleontological, phylogenetic and DNA advances of wild felid and domestic cat species following guidelines dictated by the IUCN SSC Cat Specialist Group. It highlights the importance of felines and their role as predators in maintaining the ecological biome balance in which they have evolved. The book delves into the anatomical, evolutionary and zoogeographic features of fossil and current felid species. Each species is described in detail, detailing its classification, habitat and biological habits. This book also presents the most updated threat and conservation status of each species. This book is an ideal resource for zoologists and paleontologists, primarily those interested in the evolution and features of extinct and extant felines. - Details the lineage, features and habits of over 40 felid species - Covers all species within the Felidae family, including lions, lynxes, pumas and domestic cats - Features detailed and colorful illustrations, diagrams and species location maps - Informs readers on endangered species, current threats and conservation efforts
Published: 2019

14. Slip velocity of large neutrally buoyant particles in turbulent flows

Author: G Bellani and E A Variano
Subjects: Science, Physics, QC1-999
Abstract: We discuss possible definitions for a stochastic slip velocity that describes the relative motion between large particles and a turbulent flow. This definition is necessary because the slip velocity used in the standard drag model fails when particle size falls within the inertial subrange of ambient turbulence. We propose two definitions, selected in part due to their simplicity: they do not require filtration of the fluid phase velocity field, nor do they require the construction of conditional averages on particle locations. A key benefit of this simplicity is that the stochastic slip velocity proposed here can be calculated equally well for laboratory, field and numerical experiments. The stochastic slip velocity allows the definition of a Reynolds number that should indicate whether large particles in turbulent flow behave (a) as passive tracers; (b) as a linear filter of the velocity field; or (c) as a nonlinear filter to the velocity field. We calculate the value of stochastic slip for ellipsoidal and spherical particles (the size of the Taylor microscale) measured in laboratory homogeneous isotropic turbulence. The resulting Reynolds number is significantly higher than 1 for both particle shapes, and velocity statistics show that particle motion is a complex nonlinear function of the fluid velocity. We further investigate the nonlinear relationship by comparing the probability distribution of fluctuating velocities for particle and fluid phases.
Published: 2012
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15. Micro-CT Analysis of Demineralization on In Vitro Cariogenic Biofilm Model

Author: A C Ionescu, V Zambelli, G Bellani, S Scolavino, M R Belluz, and E Brambilla
Published: 2018
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16. Definition and epidemiology of acute respiratory distress syndrome

Author: G. Bellani, Emanuele Rezoagli, Roberto Fumagalli, Rezoagli, E, Fumagalli, R, and Bellani, G
Subjects: 0301 basic medicine, Mechanical ventilation, medicine.medical_specialty, ARDS, business.industry, medicine.medical_treatment, General Medicine, Acute respiratory distress, Review Article, Lung injury, medicine.disease, 03 medical and health sciences, 030104 developmental biology, Epidemiology, Medicine, business, Intensive care medicine
Abstract: Fifty years ago, Ashbaugh and colleagues defined for the first time the acute respiratory distress syndrome (ARDS), one among the most challenging clinical condition of the critical care medicine. The scientific community worked over the years to generate a unified definition of ARDS, which saw its revisited version in the Berlin definition, in 2014. Epidemiologic information about ARDS is limited in the era of the new Berlin definition, and wide differences are reported among countries all over the world. Despite decades of study in the field of lung injury, ARDS is still so far under-recognized, with 2 out of 5 cases missed by clinicians. Furthermore, although advances of ventilator strategies in the management of ARDS associated with outcome improvements—such as protective mechanical ventilation, lower driving pressure, higher PEEP levels and prone positioning—ARDS appears to be undertreated and mortality remains elevated up to 40%. In this review, we cover the history that led to the current worldwide accepted Berlin definition of ARDS and we summarize the recent data regarding ARDS epidemiology.
Published: 2017

17. Assessing effort and work of breathing

Author: Antonio Pesenti, G. Bellani, Bellani, G, and Pesenti, A
Subjects: Male, medicine.medical_specialty, Diaphragm, Breathing Effort, Respiratory physiology, mechanical ventilation, Critical Care and Intensive Care Medicine, Work of breathing, Tidal Volume, medicine, Humans, MED/41 - ANESTESIOLOGIA, Intensive care medicine, Lung, Tidal volume, Work of Breathing, Pulmonary Gas Exchange, business.industry, digestive, oral, and skin physiology, Lung Injury, breathing effort, Respiration, Artificial, Diaphragm (structural system), diaphragmatic electromyogram, Critical illness, Respiratory Mechanics, Breathing, Female, business
Abstract: Purpose of Review: Spontaneous breathing has been shown to induce both positive and negative effects on the function and on injury of lungs and diaphragm during critical illness; thus, monitoring of the breathing effort generated by the patient might be valuable for a better understanding of the mechanisms of disease and to set properly ventilation. The purpose of this review is to summarize the recent findings on the different techniques available to measure the patient's breathing effort, mainly during spontaneous assisted ventilation. Recent Findings: Although esophageal pressure measurement remains the solid reference technique to quantitate the breathing effort, other tools have been developed and tested. These include the diaphragmatic electromyogram, whose voltage is linearly related to the pressure generated by the diaphragm, ultrasound, which relies on the measurement of diaphragmatic displacement or thickening, and other approaches, which derive breathing effort solely from the airway flow and pressure tracings. Summary: The development of measurement techniques and their introduction in clinical practice will allow us to understand the role of spontaneous breathing effort in the pathophysiology of lung injury and weaning failure, and how to adjust the breathing workload in an individual patient
Published: 2014

18. Tidal changes on CT and progression of ARDS

Author: Hooman Hamedani, Luca Guerra, Justin T. Clapp, Nicholas J. Tustison, Jennia Rajaei, James C. Gee, G. Bellani, Stephen Kadlecek, Natalie Meeder, Yi Xin, Brian P. Kavanagh, Maurizio Cereda, Rahim R. Rizi, Cereda, M, Xin, Y, Hamedani, H, Bellani, G, Kadlecek, S, Clapp, J, Guerra, L, Meeder, N, Rajaei, J, Tustison, N, Gee, J, Kavanagh, B, and Rizi, R
Subjects: ARDS, Time Factors, Ventilator-Induced Lung Injury, 030204 cardiovascular system & hematology, Artificial respiration, Severe Acute Respiratory Syndrome, Severity of Illness Index, law.invention, 0302 clinical medicine, law, Respiratory Distress Syndrome, Intensive care unit, 3. Good health, medicine.anatomical_structure, Inhalation, ventilator-induced lung injury, Exhalation, Cardiology, Disease Progression, Pulmonary and Respiratory Medicine, Adult, medicine.medical_specialty, Critical Care, diagnostic imaging, Lung injury, Sensitivity and Specificity, 03 medical and health sciences, Predictive Value of Tests, Internal medicine, medicine, Tidal Volume, Animals, Humans, In patient, artificial respiration, Lung, business.industry, computed tomography, Oxygenation, medicine.disease, Respiration, Artificial, Surgery, Rats, Clinical trial, Disease Models, Animal, acute lung injury, business, Tomography, X-Ray Computed, 030217 neurology & neurosurgery
Abstract: Background: Uncertain prediction of outcome in acute respiratory distress syndrome (ARDS) impedes individual patient management and clinical trial design.Objectives: To develop a radiological metric of injurious inflation derived from matched inspiratory and expiratory CT scans, calibrate it in a model of experimental lung injury, and test it in patients with ARDS.Methods: 73 anaesthetised rats (acid aspiration model) were ventilated (protective or non-protective) for up to 4 hours to generate a spectrum of lung injury. CT was performed (inspiratory and expiratory) at baseline each hour, paired inspiratory and expiratory images were superimposed and voxels tracked in sequential scans. In nine patients with ARDS, paired inspiratory and expiratory CT scans from the first intensive care unit week were analysed.Results: In experimental studies, regions of lung with unstable inflation (ie, partial or reversible airspace filling reflecting local strain) were the areas in which subsequent progression of injury was greatest in terms of progressive infiltrates (R=0.77) and impaired compliance (R=0.67, p28% in all patients who died and ≤28% in all who survived, whereas segregation of survivors versus non-survivors was not possible based on oxygenation or lung mechanics.Conclusions: A single set of superimposed inspiratory-expiratory CT scans may predict progression of lung injury and outcome in ARDS; if these preliminary results are validated, this could facilitate clinical trial recruitment and individualised care
Published: 2016

19. Imaging in acute lung injury and acute respiratory distress syndrome

Author: Antonio Pesenti, Tommaso Mauri, G. Bellani, Bellani, G, Mauri, T, and Pesenti, A
Subjects: ARDS, medicine.medical_specialty, Acute Lung Injury, Computed tomography, Acute respiratory distress, Lung injury, Critical Care and Intensive Care Medicine, Fluorodeoxyglucose F18, Electric Impedance, Animals, Humans, Medicine, MED/41 - ANESTESIOLOGIA, Diffuse alveolar damage, Ultrasonography, Respiratory Distress Syndrome, medicine.diagnostic_test, business.industry, acute respiratory distress syndrome, medicine.disease, respiratory tract diseases, PET, Positron-Emission Tomography, Radiology, Radiopharmaceuticals, Tomography, X-Ray Computed, business, CT
Abstract: Purpose of Review: The review focuses on recent achievements obtained by means of imaging techniques in clinical and experimental studies on acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Recent Findings: The review focuses on four imaging techniques: computed tomography (CT), PET, electrical impedance tomography (EIT) and ultrasound, highlighting the most recent developments for each technique. Whereas CT and ultrasound are primarily based on detection of density, EIT and PET are aimed at providing more functional data. Summary: Major improvements were recently obtained in imaging structure and several functions of the lungs, with the potential of positively impacting the clinical practice.
Published: 2012

20. NAVA: Applications and Limitations

Author: Giacomo Grasselli, Nicolò Patroniti, and G. Bellani
Subjects: medicine.medical_specialty, Work of breathing, Respiratory failure, business.industry, Internal medicine, medicine, Cardiology, Breathing, Pressure support ventilation, Respiratory system, Airway, business, Diaphragm (structural system)
Abstract: In recent years there has been an increasing interest in the use of partial ventilatory support modes not only as weaning techniques but also in the acute phases of respiratory failure. During assisted spontaneous breathing, a variable proportion of the work of breathing is provided by the ventilator, to unload the patient’s respiratory muscles [1]. Multiple ventilator modes are currently available for assisted spontaneous breathing: among these, neurally-adjusted ventilator assist (NAVA) is undergoing extensive clinical evaluation. NAVA is conceptually different from any other mode of ventilation, since the ventilator is not controlled by the ‘pneumatic’ output of respiratory muscles (i. e., a change in airway pressure or flow) but directly by the neural activity of respiratory centers, expressed by the diaphragm electromyogram (EAdi) [2].
Published: 2013

21. Pulmonary surfactant synthesis after unilateral lung injury in mice

Author: Maria Amigoni, Manuela Simonato, Luca Vedovelli, Alice Grassi, Virgilio P. Carnielli, Vanessa Zambelli, Margherita Scanziani, Paola Cogo, Giulia Lamonica, G. Bellani, Lamonica, G, Amigoni, M, Vedovelli, L, Zambelli, V, Scanziani, M, Bellani, G, Grassi, A, Simonato, M, Carnielli, V, and Cogo, P
Subjects: Male, Pathology, medicine.medical_specialty, Physiology, surfactant, Palmitates, Bronchi, Lung injury, Aspiration Pneumonitis, Mice, Pulmonary surfactant, Disaturated phosphatidylcholine, Physiology (medical), medicine, Animals, Peroxidase, Chemistry, Pulmonary Surfactants, Lung Injury, anaesthesia, respiratory system, respiratory tract diseases, acute lung injury, Murine model, disaturated phosphatidylcholine, Phosphatidylcholines, Bronchoalveolar Lavage Fluid
Abstract: Aspiration pneumonitis can lead to alveolar surfactant dysfunction. We employed a murine model of unilateral aspiration to compare surfactant synthesis in the injured (I) and noninjured (NI) contralateral lung. Mice were instilled with hydrochloric acid in the right bronchus and, after 18 h, an intraperitoneal dose of deuterated water was administered as precursor of disaturated phosphatidylcholine (DSPC)-palmitate. Selected bronchoalveolar lavage fluid (BALF) was collected at scheduled time points and lungs were removed. We measured DSPC-palmitate synthesis in lung tissue and secretion in BALF by gas chromatography-isotope ratio mass spectrometry, together with total proteins and myeloperoxidase activity (MPO) by spectrophotometry. BALF total proteins and MPO were significantly increased in the I lungs compared with NI and naïve control lungs. The DSPC pool size was significantly lower in the BALF of the I lungs compared with naïve controls. DSPC synthesis was accelerated in the I and NI lungs. DSPC secretion of the I lungs was similar to their respective naïve controls, and it was markedly lower compared with their respective NI contralateral lungs. DSPC synthesis and secretion were faster, especially in the NI lungs, compared with naïve control lungs, as a possible compensatory mechanism due to a cross-talk between the lungs triggered by inflammation, hyperventilation, and/or undetermined type II cell reaction to the injury.
Published: 2013

22. Unilateral Acid Aspiration Augments the Effects of Ventilator Lung Injury in the Contralateral Lung

Author: Lorella Fagnani, Maria Amigoni, G. Bellani, Antonio Pesenti, Francesca Farina, Margherita Scanziani, Roberto Fumagalli, Roberto Latini, Vanessa Zambelli, Amigoni, M, Bellani, G, Zambelli, V, Scanziani, M, Farina, F, Fagnani, L, Latini, R, Fumagalli, R, and Pesenti, A
Subjects: Male, Ventilator-Induced Lung Injury, medicine.medical_treatment, Acute Lung Injury, Lung injury, Pulmonary compliance, Pneumonia, Aspiration, Mice, Parenchyma, Tidal Volume, medicine, Animals, MED/41 - ANESTESIOLOGIA, Lung Compliance, Tidal volume, Mechanical ventilation, Lung, medicine.diagnostic_test, Pulmonary Gas Exchange, business.industry, Hemodynamics, Oxygenation, respiratory system, Respiration, Artificial, Mice, Inbred C57BL, Anesthesiology and Pain Medicine, Bronchoalveolar lavage, medicine.anatomical_structure, Anesthesia, Cytokines, business, Bronchoalveolar Lavage Fluid
Abstract: Background: Mechanical ventilation is necessary during acute respiratory distress syndrome, but it promotes lung injury because of the excessive stretch applied to the aerated parenchyma. The authors’ hypothesis was that after a regional lung injury, the noxious effect of mechanical ventilation on the remaining aerated parenchyma would be more pronounced. Methods: Mice, instilled with hydrochloric acid (HCl) in the right lung, was assigned to one of the following groups: mechanical ventilation with tidal volumes (VT) 25 ml/kg (HCl-VILI25, n = 12), or VT 15 ml/kg (HCl-VILI15, n = 9), or spontaneous breathing (HCl-SB, n = 14). Healthy mice were ventilated with VT 25 ml/kg (VILI25, n = 11). Arterial oxygenation, lung compliance, bronchoalveolar lavage inflammatory cells, albumin, and cytokines concentration were measured. Results: After 7 h, oxygenation and lung compliance resulted lower in HCl-VILI25 than in VILI25 (P < 0.05, 210 ± 54 vs. 479 ± 83 mmHg, and 32 ± 3.5 vs. 45 ± 4.1 µl/cm H2O, mean ± SD, respectively). After right lung injury, the left lung of HCl-VILI25 group received a greater fraction of the VT than the VILI25 group, despite an identical global VT. The number of total and polymorphonuclear cells in bronchoalveolar lavage resulted significantly higher in HCl-VILI25, compared with the other groups, in not only the right lung, but also in the left lung. The albumin content in the left lung resulted higher in HCl-VILI25 than in VILI25 (224 ± 85 vs. 33 ± 6 µg/ml; P < 0.05). Cytokines levels did not differ between groups. Conclusion: Aggressive mechanical ventilation aggravates the preexisting lung injury, which is noxious for the contralateral, not previously injured lung, possibly because of a regional redistribution of VT.
Published: 2013

23. Role of the Renin-Angiotensin System in ARDS

Author: Alice Grassi, G. Bellani, Vanessa Zambelli, Vincent, JL, Zambelli, V, Grassi, A, and Bellani, G
Subjects: chemistry.chemical_classification, medicine.medical_specialty, ARDS, Chemistry, Alveolar epithelial cell, Systemic blood pressure, medicine.disease, Renin-Angiotensin System, Endocrinology, Enzyme, Internal medicine, Renin–angiotensin system, medicine, MED/41 - ANESTESIOLOGIA, Intracellular, Homeostasis
Abstract: The renin-angiotensin system (RAS) is a powerful biological system that plays an important role in regulation of systemic blood pressure through the maintenance of fluid and salt homeostasis. It is a multifactorial system since it includes different components (Fig. 1): The first, renin, was discovered in 1898 [1], whereas the discovery of the last component, angiotensin-converting enzyme 2 (ACE 2), is relatively recent, from 2000 [2, 3]. Three kinds of RAS are known: A) circulating, B) local, and C) intracellular.
Published: 2012

24. Nonconventional support of respiration

Author: Nicolò Patroniti, Antonio Pesenti, G. Bellani, Patroniti, N, Bellani, G, and Pesenti, A
Subjects: medicine.medical_specialty, ARDS, Critical Care, medicine.medical_treatment, high frequency oscillatory ventilation, High-Frequency Ventilation, Lung injury, Î²2 agonist, Critical Care and Intensive Care Medicine, Extracorporeal, law.invention, Mechanichal ventilation, ARDS, Randomized controlled trial, law, Respiration, medicine, Extracorporeal membrane oxygenation, Prone Position, Humans, MED/41 - ANESTESIOLOGIA, Intensive care medicine, Adrenergic beta-2 Receptor Agonists, Respiratory Distress Syndrome, business.industry, High-frequency ventilation, acute respiratory distress syndrome, extracorporeal membrane oxygenation, medicine.disease, prone positioning, Prone position, Neuromuscular Blocking Agents, business
Abstract: PURPOSE OF REVIEW: Several alternative treatments have been proposed to decrease mortality of patients with acute respiratory distress syndrome (ARDS). We will discuss most recent trials and meta-analysis studies on nonconventional ventilatory and pharmacological treatments of ARDS patients. RECENT FINDINGS: Nonconventional ventilatory treatments such as prone positioning, high frequency oscillatory ventilation (HFOV), and extracorporeal membrane oxygenation (ECMO) aim to restore gas exchange while further decreasing ventilator induced lung injury. Though randomized trials failed to prove survival benefits with the use of prone positioning or HFOV, recent meta-analyses have shown, for both treatments, a decrease in mortality in the subpopulation of more severe ARDS patients. In a randomized controlled trial, referral of ARDS patients in a center with experience on ECMO was associated with an improved survival rate. Promising results come from new miniaturized extracorporeal techniques optimized for effective CO2 removal from low blood flow. These techniques should allow early application of superprotective ventilator strategies. Pharmacological treatments such as neuromuscular blocking and intravenous β2 agonist may be effective in specific times and subsets of patients. SUMMARY: Existing data suggest that some of the available nonconventional treatments may be effective in more severe ARDS patients. New techniques and drugs that should facilitate prevention or healing of lung injury are under investigation. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Published: 2011

25. Positron emission tomography in ARDS: a new look at an old syndrome

Author: G, Bellani, M, Amigoni, A, Pesenti, Bellani, G, Amigoni, M, and Pesenti, A
Subjects: Capillary Permeability, Respiratory Distress Syndrome, Positron emission tomography, Fluorodeoxyglucose F18, Nitrogen, Pulmonary Gas Exchange, Positron-Emission Tomography, Humans, Radiopharmaceuticals, acute respiratory distress syndrome, MED/41 - ANESTESIOLOGIA, Lung, Respiration, Artificial
Abstract: This is a review of some of the main findings obtained by positron emission tomography (PET) concerning the pathophysiology of acute respiratory distress syndrome (ARDS) and acute lung injury. PET (which is nowadays often combined with computed tomography) is a functional imaging technique based on the detection of a labeled molecule administered to a subject. Based on the molecule used, different lung functions can be imaged. Examples include inhaled, labeled nitrogen, which allows us to visualize regional aeration and ventilation, whereas lung perfusion has been studied by means of labeled water or by injected nitrogen dissolved in saline. With this latter technique, a global assessment of regional gas exchange is possible. Administration of [F-18]FDG facilitates the imaging of cellular metabolic activity, reflecting an acute neutrophil-sustained inflammatory process. This technique has been used in experimental ARDS and, more recently, in patients. It showed, for example, that inflammatory activity of the lungs is markedly increased even in "normally aerated" regions at levels that are, in some cases, even higher than in the non-aerated regions. (Minerva Anestesiol 2011;77:439-47)
Published: 2011

26. Helmet Continuous Positive Airway Pressure: Theory and Technology

Author: Stefano Isgrò, G. Bellani, Roberto Fumagalli, Esquinas, AM, Bellani, G, Isgro', S, and Fumagalli, R
Subjects: medicine.medical_specialty, CONTINUOUS POSITIVE AIRWAY PRESSURE, business.industry, medicine.medical_treatment, Hemodynamics, Pressure support ventilation, ACUTE RESPIRATORY FAILURE, Peak Inspiratory Flow Rate, respiratory system, respiratory tract diseases, HELMET, Internal medicine, medicine, Cardiology, Relief valve, Continuous positive airway pressure, MED/41 - ANESTESIOLOGIA, Respiratory system, Intensive care medicine, Airway, business, Active support
Abstract: Continuous positive airway pressure (CPAP) is administered to patients to maintain the airway at a selected pressure (usually named the positive end-expiratory pressure, PEEP) higher than that of the atmosphere one. PEEP application has several well-known effects on the respiratory system and hemodynamics, whose description is not among the aims of this chapter. The applied pressure is kept constant throughout the whole respiratory cycle so that intrapulmonary pressure swings around the set level. Patients can breath spontaneously at the selected pressure without any active support of inspiration; it follows that CPAP cannot be strictly considered a form of ventilation. © 2010 Springer-Verlag Berlin Heidelberg.
Published: 2010

27. Airway pressure and flow monitoring

Author: Alberto Zanella, Antonio Pesenti, G. Bellani, Zanella, A, Bellani, G, and Pesenti, A
Subjects: medicine.medical_specialty, Flow monitoring, business.industry, Ventilator-Induced Lung Injury, respiratory system, Lung injury, mechanical ventilation, Critical Care and Intensive Care Medicine, Respiration, Artificial, respiratory tract diseases, intensive care unit, Internal medicine, Cardiology, medicine, Respiratory Mechanics, Humans, MED/41 - ANESTESIOLOGIA, Airway, business, Monitoring, Physiologic
Abstract: PURPOSE OF REVIEW: We report on the evolution of airway pressure and flow monitoring from a pathophysiological tool to the cornerstone of ventilator-induced lung injury (VILI) prevention. RECENT FINDINGS: Protective ventilatory strategies are based on reduction of volume and pressures delivered to the lungs. New evidence, which will need confirmation in further studies, suggests that transpulmonary pressure (alveolar pressure minus pleural pressure), could be used to titrate both the positive end-expiratory pressure (PEEP) level and the inspiratory pressure applied by the ventilator. A limited number of animal studies are strongly supporting a role for inspiratory flow on the development of VILI.Moreover, different airway flow patterns may affect secretion movement, both global, to the alveoli or the glottis, and regional, from lower to higher compliance regions. This intra-lung transfer may be a primary mechanism for the propagation of infections and inflammatory mediators.Alternative monitoring techniques (among others) are the rapid interrupter technique, which can be used to measure airway resistance and patients' inspiratory effort and the forced oscillation technique which could become a bedside technique to estimate recruitment/derecruitment and titrate PEEP. SUMMARY: Airway pressure and flow monitoring is essential for VILI prevention and for an appropriate setting of mechanical ventilation.
Published: 2010

28. Which drugs for the control of fever in critical patients

Author: Roberto Fumagalli, G. Bellani, A. Perri, Fumagalli, R, Bellani, G, and Perri, A
Subjects: critically-ill patient, medicine.medical_specialty, Hospitalized patients, Critical Illness, Clinical Biochemistry, Internal medicine, Drug Discovery, medicine, Humans, MED/41 - ANESTESIOLOGIA, Intensive care medicine, acetaminophen, Pharmacology, fever, Critically ill, business.industry, Incidence (epidemiology), steroid, Heat losses, Analgesics, Non-Narcotic, NSAID, Acetaminophen, diclofenac, Heat generation, Etiology, Molecular Medicine, Tumor necrosis factor alpha, business, medicine.drug
Abstract: It has been estimated that nosocomial fever occurs in approximately one-third of hospitalized patients. The incidence is even higher in critically-ill patients in whom both infectious and noninfectious etiologies of fever are common. Polypeptide cytokines (endogenous pyrogens) such as interleukin-1b (IL-1b), tumor necrosis factor (TNF) and interleukin-6 (IL-6) act directly on the hypothalamus to effect a fever response by promoting an increase in heat generation and a decrease in heat loss. There is widespread acceptance that in most if not all critically ill neurologic patients fever should be treated but still it is not clear if fever per se in nonneurologic critically ill patients should be treated too. We review physical and pharmacological methods presently utilized to treat fever in critically ill patients.
Published: 2009

29. Risk factors for treatment failure in patients with severe acute cardiogenic pulmonary oedema

Author: F, Di Marco, S, Tresoldi, S, Maggiolini, A, Bozzano, G, Bellani, A, Pesenti, and R, Fumagalli
Subjects: Male, Continuous Positive Airway Pressure, Heart Diseases, Endpoint Determination, Blood Pressure, Pulmonary Edema, Carbon Dioxide, Hydrogen-Ion Concentration, Cohort Studies, Risk Factors, Data Interpretation, Statistical, Acute Disease, Intubation, Intratracheal, Humans, Regression Analysis, Female, Treatment Failure, Aged, Retrospective Studies
Abstract: Intubation is necessary in 7 to 20% of patients with severe acute cardiogenic pulmonary oedema despite optimal treatment. This study evaluated the usefulness of parameters largely available in clinical practice to predict the need for intubation in a population of acute cardiogenic pulmonary oedema patients treated with medical therapy and continuous positive airway pressure. The present retrospective cohort study involved 142 patients with severe acute cardiogenic pulmonary oedema who were admitted to coronary care or the intensive care unit of a university hospital and were treated by an in-hospital protocol. Physiological measurements and blood gas samples were evaluated at 'baseline' (just after admission), 'early' (one to three hours after beginning treatment) and 'late' (eight to 10 hours after beginning treatment). Twenty-two patients (15.5%) required intubation. A systolic blood pressure at admission lower than 140 mmHg was significantly associated with a higher risk for intubation, while hypercapnic patients or those with a reduced left ventricular ejection fraction at admission did not show a worse prognosis. A simple score based on largely available parameters (1 point for each: age78 years, systolic blood pressure140 mmHg at admission, arterial blood gas acidosis and heart rate95 bpm at early time) is proposed. The rate of intubation according to this score ranged from 0% (score of 0) to 90% (score of 3). Our study found that simple parameters available in clinical practice are significantly associated with the need for intubation in acute cardiogenic pulmonary oedema patients treated with continuous positive airway pressure and medical therapy. A simple score to evaluate the need for endotracheal intubation is proposed.
Published: 2008

30. The use of helmets to deliver non-invasive continuous positive airway pressure in hypoxemic acute respiratory failure

Author: G, Bellani, N, Patroniti, M, Greco, G, Foti, and A, Pesenti
Subjects: Adult, Continuous Positive Airway Pressure, Infant, Newborn, Masks, Equipment Design, Carbon Dioxide, Patient Acceptance of Health Care, Long-Term Care, Oxygen, Acute Disease, Humans, Equipment Failure, Child, Hypoxia, Respiratory Insufficiency, Randomized Controlled Trials as Topic
Abstract: Non-invasive continuous positive airway pressure (CPAP) is a useful tool for managing patients with acute respiratory failure. The head helmet is a relatively novel interface that is as effective as the traditionally employed face-mask in delivering CPAP and can possibly be characterized as better for the patient's tolerance and, consequently, a longer duration of treatment. This review focuses on the main properties of the helmet and the issues related to its use, as shown by the physiological and bench studies. Clinical experience, both personal and reported in the literature, for the treatment of both cardiogenic and non-cardiogenic pulmonary edema is reviewed as well.
Published: 2008

31. Auto-PEEP bei NAVA und konventioneller maschineller Atemunterstützung

Author: G. Bellani, N Patroniti, and Andrea Coppadoro
Abstract: Bei der klassischen maschinellen Atemunterstutzung entwickelt sich bei unvollstandiger Exspiration haufig ein Auto-PEEP. Um diesen intrinsischen PEEP zu uberwinden, ist eine vermehrte Atemanstrengung notwendig, was letztlich zur Erschopfung des Patienten und dem Fehlschlagen von Weaning-Versuchen fuhren kann. Eine relativ neuartige Beatmungsunterstutzung konnte hier Abhilfe bieten. Bellani et al. haben das untersucht.
Published: 2015

32. Influence of percutaneous tracheostomy on gas exchange in mechanically ventilated patients

Author: Pradella, A, Bellani, G, Abd El Aziz El Sayed Deab, S, Mauri, T, Rezoagli, E, Arrigoni, S, Leone, F, Citerio, G, Pesenti, A, A Pradella, G Bellani, S Abd El Aziz El Sayed Deab, T Mauri, E Rezoagli, S Arrigoni, F Leone, G Citerio, A Pesenti, Pradella, A, Bellani, G, Abd El Aziz El Sayed Deab, S, Mauri, T, Rezoagli, E, Arrigoni, S, Leone, F, Citerio, G, Pesenti, A, A Pradella, G Bellani, S Abd El Aziz El Sayed Deab, T Mauri, E Rezoagli, S Arrigoni, F Leone, G Citerio, and A Pesenti
Published: 2012

33. Imaging of lung inflammation during severe influenza A: H1N1

Author: Luca Guerra, G. Bellani, Antonio Pesenti, Cristina Messa, Bellani, G, Guerra, L, Pesenti, A, and Messa, M
Subjects: Resuscitation, Inflammation, ARDS, Positron Emission Tomography, influenza A-H1N1, Critical Care and Intensive Care Medicine, Severe influenza, 03 medical and health sciences, Oseltamivir, 0302 clinical medicine, Intensive care, Correspondence, medicine, MED/41 - ANESTESIOLOGIA, Acute Respiratory Distress Syndrome, 030304 developmental biology, MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA, 0303 health sciences, Lung, business.industry, Respiratory disease, Influenza a, medicine.disease, Influenza, medicine.anatomical_structure, Intensive Care Unit Stay, 030228 respiratory system, Immunology, Viral disease, medicine.symptom, business, Positron Emission Tomography
Published: 2010

34. O012 TIGHT GLYCEMIC CONTROL (TGC) AND DIMETHYLARGININES IN SEPTIC PATIENTS

Author: M. Curti, M. Giacomini, Maura Albicini, Michele Umbrello, Federico Polli, G. Iapichino, R. Paroni, V. Zona, G. Bellani, and P. Spanu
Subjects: medicine.medical_specialty, Nutrition and Dietetics, business.industry, medicine, Medicine (miscellaneous), Critical Care and Intensive Care Medicine, Intensive care medicine, business, Glycemic
Published: 2008

35. Transpulmonary Pressure at Functional Residual Capacity

Author: Antonio Pesenti, G. Bellani, Tommaso Mauri, Pesenti, A, Bellani, G, and Mauri, T
Subjects: medicine.medical_specialty, ARDS, business.industry, MEDLINE, Critical Care and Intensive Care Medicine, medicine.disease, Transpulmonary pressure, ARDS, Positive-Pressure Respiration, Functional residual capacity, Text mining, Internal medicine, Cardiology, Animals, Medicine, business, Transpulmonary pressure
Published: 2013

36. P026 DIMETHYLARGININES (ASYMMETRIC: ADMA, SYMMETRIC: SDMA) METABOLISM AND ROLE IN SEVERE SEPSIS

Author: R. Pinciroli, G. Iapichino, R. Paroni, Maura Albicini, E. Borotto, Giovanni Sabbatini, G. Mistraletti, G. Bellani, M Savioli, and P. Spanu
Subjects: Nutrition and Dietetics, business.industry, Medicine (miscellaneous), Medicine, Metabolism, Pharmacology, Critical Care and Intensive Care Medicine, business, Severe sepsis
Published: 2008

37. Reperfusion coagulopathy during human liver transplantation

Author: K G, Bellani, J A, Estrin, N L, Ascher, J S, Najarian, J, Bushman, and J J, Buckley
Subjects: Adult, Perfusion, Heparin, Humans, Blood Coagulation Disorders, Child, Intraoperative Complications, Liver Circulation, Liver Transplantation
Published: 1987

38. [Two cases of de Morsier's olfactogenital syndrome]

Author: G, Ghislanzoni, G, Bellani, and P, Lenzi
Subjects: Male, Chromosomes, Human, X, Sex Characteristics, Chromosomes, Human, Y, Hypogonadism, Prostate, Olfactory Pathways, Syndrome, Middle Aged, Hormones, 17-Ketosteroids, Olfaction Disorders, Karyotyping, Testis, Humans, Female, Follicle Stimulating Hormone, Aged
Abstract: Two cases of De Morsier's olfactogenital syndrome (complex hypogenitalism and anosmia) are presented. The first patient was of eunuchoid build and presented testicle and penile hypotrophy, depressed adrenal activity and gonad-stimulating pituitary function and distinctly below-normal urinary 17-ketosteroid values. The second subject was gynaecoid, menopausal gonadotrophic hormonal values, short urethra with no radiological signs of the prostate, and gynaecoid upper pelvic basin diameters. The karyotype pattern was normal XY in the first case and XX in the second. It is suggested that embryopathic or genetic changes, probably in the rhinencephalon, led to a direct pituitary nervous short-circuit that impeded normal FSH gonadal stimulation and hence gonadal influence on the phenotype throughout both intra- and extrauterine life, particularly at puberty.
Published: 1973

39. Early Pentraxin 3 (PTX3) Elevation Is Associated with Severity and Outcome of Severe Sepsis and Septic Shock

Author: Luciano Gattinoni, Antonio Pesenti, Andrea Pradella, Alberto Mantovani, Nicolò Patroniti, Andrea Coppadoro, G. Bellani, and Tommaso Mauri
Subjects: medicine.medical_specialty, Elevation (emotion), business.industry, Septic shock, Internal medicine, Cardiology, Medicine, PTX3, business, medicine.disease, Severe sepsis, Pentraxin-3

40. Outcome of acute hypoxaemic respiratory failure: insights from the LUNG SAFE Study

Author: Pham, Tài, Pesenti, Antonio, Bellani, Giacomo, Rubenfeld, Gordon, Fan, Eddy, Bugedo, Guillermo, Lorente, José Angel, Fernandes, Antero do Vale, Van Haren, Frank, Bruhn, Alejandro, Rios, Fernando, Esteban, Andres, Gattinoni, Luciano, Larsson, Anders, McAuley, Daniel F., Ranieri, Marco, Thompson, B. Taylor, Wrigge, Hermann, Brochard, Laurent J., Laffey, John G, Antonio Pesenti, John G Laffey, Laurent Brochard, Andres Esteban, Luciano Gattinoni, Frank van Haren, Anders Larsson, Daniel F McAuley, Marco Ranieri, Gordon Rubenfeld, B Taylor Thompson, Hermann Wrigge, Arthur S Slutsky, Giacomo Bellani, Tài Pham, Eddy Fan, Fernando Rios, Thierry Sottiaux, Pieter Depuydt, Fredy S Lora, Luciano Cesar Azevedo, Guillermo Bugedo, Haibo Qiu, Marcos Gonzalez, Juan Silesky, Vladimir Cerny, Jonas Nielsen, Manuel Jibaja, Dimitrios Matamis, Jorge Luis Ranero, Pravin Amin, S M Hashemian, Kevin Clarkson, Kiyoyasu Kurahashi, Asisclo Villagomez, Amine Ali Zeggwagh, Leo M Heunks, Jon Henrik Laake, Jose Emmanuel Palo, Antero do Vale Fernandes, Dorel Sandesc, Yaasen Arabi, Vesna Bumbasierevic, Nicolas Nin, Jose A Lorente, Lise Piquilloud, Fekri Abroug, Lia McNamee, Javier Hurtado, Ed Bajwa, Gabriel Démpaire, Hektor Sula, Lordian Nunci, Alma Cani, Alan Zazu, Christian Dellera, Carolina S Insaurralde, Risso V Alejandro, Julio Daldin, Mauricio Vinzio, Ruben O Fernandez, Luis P Cardonnet, Lisandro R Bettini, Mariano Carboni Bisso, Emilio M Osman, Mariano G Setten, Pablo Lovazzano, Javier Alvarez, Veronica Villar, Norberto C Pozo, Nicolas Grubissich, Gustavo A Plotnikow, Daniela N Vasquez, Santiago Ilutovich, Norberto Tiribelli, Ariel Chena, Carlos A Pellegrini, María G Saenz, Elisa Estenssoro, Matias Brizuela, Hernan Gianinetto, Pablo E Gomez, Valeria I Cerrato, Marco G Bezzi, Silvina A Borello, Flavia A Loiacono, Adriana M Fernandez, Serena Knowles, Claire Reynolds, Deborah M Inskip, Jennene J Miller, Jing Kong, Christina Whitehead, Shailesh Bihari, Aylin Seven, Amanda Krstevski, Helen J Rodgers, Rebecca T Millar, Toni E McKenna, Irene M Bailey, Gabrielle C Hanlon, Anders Aneman, Joan M Lynch, Raman Azad, John Neal, Paul W Woods, Brigit L Roberts, Mark R Kol, Helen S Wong, Katharina C Riss, Thomas Staudinger, Xavier Wittebole, Caroline Berghe, Pierre A Bulpa, Alain M Dive, Rik Verstraete, Herve Lebbinck, Joris Vermassen, Philippe Meersseman, Helga Ceunen, Jonas I Rosa, Daniel O Beraldo, Claudio Piras, Adenilton M Rampinelli, Antonio P Nassar Jr, Sergio Mataloun, Marcelo Moock, Marlus M Thompson, Claudio H Gonçalves, Ana Carolina P Antônio, Aline Ascoli, Rodrigo S Biondi, Danielle C Fontenele, Danielle Nobrega, Vanessa M Sales, Ahmad Yazid Bin Hj Abul Wahab, Maizatul Ismail, Suresh Shindhe, John Laffey, Francois Beloncle, Kyle G Davies, Rob Cirone, Venika Manoharan, Mehvish Ismail, Ewan C Goligher, Mandeep Jassal, Erin Nishikawa, Areej Javeed, Gerard Curley, Nuttapol Rittayamai, Matteo Parotto, Niall D Ferguson, Sangeeta Mehta, Jenny Knoll, Antoine Pronovost, Sergio Canestrini, Alejandro R Bruhn, Patricio H Garcia, Felipe A Aliaga, Pamela A Farías, Jacob S Yumha, Claudia A Ortiz, Javier E Salas, Alejandro A Saez, Luis D Vega, Eduardo F Labarca, Felipe T Martinez, Nicolás G Carreño, Pilar Lora, Haitao Liu, Ling Liu, Rui Tang, Xiaoming Luo, Youzhong An, Huiying Zhao, Yan Gao, Zhe Zhai, Zheng L Ye, Wei Wang, Wenwen Li, Qingdong Li, Ruiqiang Zheng, Wenkui Yu, Juanhong Shen, Xinyu Li, Tao Yu, Weihua Lu, Ya Q Wu, Xiao B Huang, Zhenyang He, Yuanhua Lu, Hui Han, Fan Zhang, Renhua Sun, Hua X Wang, Shu H Qin, Bao H Zhu, Jun Zhao, Jian Liu, Bin Li, Jing L Liu, Fa C Zhou, Qiong J Li, Xing Y Zhang, Zhou Li-Xin, Qiang Xin-Hua, Liangyan Jiang, Yuan N Gao, Xian Y Zhao, Yuan Y Li, Xiao L Li, Chunting Wang, Qingchun Yao, Rongguo Yu, Kai Chen, Huanzhang Shao, Bingyu Qin, Qing Q Huang, Wei H Zhu, Ai Y Hang, Ma X Hua, Yimin Li, Yonghao Xu, Yu D Di, Long L Ling, Tie H Qin, Shou H Wang, Junping Qin, Yi Han, Suming Zhou, Monica P Vargas, Juan I Silesky Jimenez, Manuel A González Rojas, Jaime E SolisQuesada, Christian M Ramirez-Alfaro, Jan Máca, Peter Sklienka, Jakob Gjedsted, Aage Christiansen, Boris G Villamagua, Iguel Llano, Philippe Burtin, Gautier Buzancais, Pascal Beuret, Nicolas Pelletier, Satar Mortaza, Alain Mercat, Jonathan Chelly, Sébastien Jochmans, Nicolas Terzi, Cédric Daubin, Guillaume Carteaux, Nicolas de Prost, Jean-Daniel Chiche, Fabrice Daviaud, Muriel Fartoukh, Guillaume Barberet, Jerome Biehler, Jean Dellamonica, Denis Doyen, Jean-Michel Arnal, Anais Briquet, Sami Hraiech, Laurent Papazian, Arnaud Follin, Damien Roux, Jonathan Messika, Evangelos Kalaitzis, Laurence Dangers, Alain Combes, Siu-Ming Au, Gaetan Béduneau, Dorothée Carpentier, Elie H Zogheib, Herve Dupont, Sylvie Ricome, Francesco L Santoli, Sebastien L Besset, Philippe Michel, Bruno Gelée, Pierre-Eric Danin, Bernard Goubaux, Philippe J Crova, Nga T Phan, Frantz Berkelmans, Julio C Badie, Romain Tapponnier, Josette Gally, Samy Khebbeb, Jean-Etienne Herbrecht, Francis Schneider, PierreLouis M Declercq, Jean-Philippe Rigaud, Jacques Duranteau, Anatole Harrois, Russell Chabanne, Julien Marin, Charlene Bigot, Sandrine Thibault, Mohammed Ghazi, Messabi Boukhazna, Salem Ould Zein, Jack R Richecoeur, Daniele M Combaux, Fabien Grelon, Charlene Le Moal, Elise P Sauvadet, Adrien Robine, Virginie Lemiale, Danielle Reuter, Martin Dres, Alexandre Demoule, Dany Goldgran-Toledano, Loredana Baboi, Claude Guérin, Ralph Lohner, Jens Kraßler, Susanne Schäfer, Kai D Zacharowski, Patrick Meybohm, Andreas W Reske, Philipp Simon, HansBernd F Hopf, Michael Schuetz, Thomas Baltus, Metaxia N Papanikolaou, Theonymfi G Papavasilopoulou, Giannis A Zacharas, Vasilis Ourailogloy, Eleni K Mouloudi, Eleni V Massa, Eva O Nagy, Electra E Stamou, Ellada V Kiourtzieva, Marina A Oikonomou, Luis E Avila, Cesar A Cortez, Johanna E Citalán, Sameer A Jog, Safal D Sable, Bhagyesh Shah, Mohan Gurjar, Arvind K Baronia, Mohammedfaruk Memon, Radhakrishnan Muthuchellappan, Venkatapura J Ramesh, Anitha Shenoy, Ramesh Unnikrishnan, Subhal B Dixit, Rachana V Rhayakar, Nagarajan Ramakrishnan, Vallish K Bhardwaj, Heera L Mahto, Sudha V Sagar, Vijayanand Palaniswamy, Deeban Ganesan, Seyed Mohammadreza Hashemian, Hamidreza Jamaati, Farshad Heidari, Edel A Meaney, Alistair Nichol, Karl M Knapman, Donall O'Croinin, Eimhin S Dunne, Dorothy M Breen, Kevin P Clarkson, Rola F Jaafar, Rory Dwyer, Fahd Amir, Olaitan O Ajetunmobi, Aogan C O'Muircheartaigh, Colin S Black, Nuala Treanor, Daniel V Collins, Wahid Altaf, Gianluca Zani, Maurizio Fusari, Savino Spadaro, Carlo A Volta, Romano Graziani, Barbara Brunettini, Salvatore Palmese, Paolo Formenti, Michele Umbrello, Andrea Lombardo, Elisabetta Pecci, Marco Botteri, Monica Savioli, Alessandro Protti, Alessia Mattei, Lorenzo Schiavoni, Andrea Tinnirello, Manuel Todeschini, Antonino Giarratano, Andrea Cortegiani, Massimo M Antonelli, Luca M Montini, Paolo Casalena, Sergio Scafetti, Giovanna Panarello, Giovanna Occhipinti, Nicolò Patroniti, Matteo Pozzi, Roberto R Biscione, Michela M Poli, Ferdinando Raimondi, Daniela Albiero, Giulia Crapelli, Eduardo Beck, Vincenzo Pota, Vincenzo Schiavone, Alexandre Molin, Fabio Tarantino, Giacomo Monti, Elena Frati, Lucia Mirabella, Gilda Cinnella, Tommaso Fossali, Riccardo Colombo, Pierpaolo Terragni, Ilaria Pattarino, Francesco Mojoli, Antonio Braschi, Erika E Borotto, Andrea N Cracchiolo, Daniela M Palma, Francesco Raponi, Giuseppe Foti, Ettore R Vascotto, Andrea Coppadoro, Luca Brazzi, Leda Floris, Giorgio A Iotti, Aaron Venti, Osamu Yamaguchi, Shunsuke Takagi, Hiroki N Maeyama, Eizo Watanabe, Yoshihiro Yamaji, Kazuyoshi Shimizu, Kyoko Shiozaki, Satoru Futami, Sekine Ryosuke, Koji Saito, Yoshinobu Kameyama, Keiko Ueno, Masayo Izawa, Nao Okuda, Hiroyuki Suzuki, Tomofumi Harasawa, Michitaka Nasu, Tadaaki Takada, Fumihito Ito, Shin Nunomiya, Kansuke Koyama, Toshikazu Abe, Kohkichi Andoh, Kohei Kusumoto, Akira Hirata, Akihiro Takaba, Hiroyasu Kimura, Shuhei Matsumoto, Ushio Higashijima, Hiroyuki Honda, Nobumasa Aoki, Hiroshi Imai, Yasuaki Ogino, Ichiko Mizuguchi, Kazuya Ichikado, Kenichi Nitta, Katsunori Mochizuki, Tomoaki Hashida, Hiroyuki Tanaka, Tomoyuki Nakamura, Daisuke Niimi, Takeshi Ueda, Yozo Kashiwa, Akinori Uchiyama, Olegs Sabelnikovs, Peteris Oss, Youssef Haddad, Kong Y Liew, Silvio A Ñamendys-Silva, Yves D Jarquin-Badiola, Luis A Sanchez-Hurtado, Saira S Gomez-Flores, Maria C Marin, Asisclo J Villagomez, Jordana S Lemus, Jonathan M Fierro, Mavy Ramirez Cervantes, Francisco Javier Flores Mejia, Dulce Dector, Alejandro Rojas, Daniel R Gonzalez, Claudia R Estrella, Jorge R Sanchez-Medina, Alvaro Ramirez-Gutierrez, Fernando G George, Janet S Aguirre, Juan A Buensuseso, Manuel Poblano, Tarek Dendane, Hicham Balkhi, Mina Elkhayari, Nacer Samkaoui, Hanane Ezzouine, Abdellatif Benslama, Mourad Amor, Wajdi Maazouzi, Nedim Cimic, Oliver Beck, Monique M Bruns, Jeroen A Schouten, Myra Rinia, Monique Raaijmakers, Hellen M van Wezel, Serge J Heines, Ulrich Strauch, Marc P Buise, Fabienne D Simonis, Marcus J Schultz, Jennifer C Goodson, Troy S Browne, Leanlove Navarra, Anna Hunt, Robyn A Hutchison, Mathew B Bailey, Lynette Newby, Colin McArthur, Michael Kalkoff, Alex Mcleod, Jonathan Casement, Danielle J Hacking, Finn H Andersen, Merete S Dolva, Jon H Laake, Andreas Barratt-Due, Kim Andre L Noremark, Eldar Søreide, Brit Å Sjøbø, Anne B Guttormsen, Hector H Leon Yoshido, Ronald Zumaran Aguilar, Fredy A Montes Oscanoa, Alain U Alisasis, Joanne B Robles, Rossini Abbie B Pasanting-Lim, Beatriz C Tan, Pawel Andruszkiewicz, Karina Jakubowska, Cristina M Coxo, António M Alvarez, Bruno S Oliveira, Gustavo M Montanha, Nelson C Barros, Carlos S Pereira, António M Messias, Jorge M Monteiro, Ana M Araujo, Nuno T Catorze, Susan M Marum, Maria J Bouw, Rui M Gomes, Vania A Brito, Silvia Castro, Joana M Estilita, Filipa M Barros, Isabel M Serra, Aurelia M Martinho, Dana R Tomescu, Alexandra Marcu, Ovidiu H Bedreag, Marius Papurica, Dan E Corneci, Silvius Ioan Negoita, Evgeny Grigoriev, Alexey I Gritsan, Andrey A Gazenkampf, Ghaleb Almekhlafi, Mohamad M Albarrak, Ghanem M Mustafa, Khalid A Maghrabi, Nawal Salahuddin, Tharwat M Aisa, Ahmed S Al Jabbary, Edgardo Tabhan, Yaseen M Arabi, Olivia A Trinidad, Hasan M Al Dorzi, Edgardo E Tabhan, Vesna Bumbasirevic, Bojan Jovanovic, Stefan Bolon, Oliver Smith, Jordi Mancebo, Hernan Aguirre-Bermeo, Juan C Lopez-Delgado, Francisco Esteve, Gemma Rialp, Catalina Forteza, Candelaria De Haro, Antonio Artigas, Guillermo M Albaiceta, Sara De Cima-Iglesias, Leticia Seoane-Quiroga, Alexandra Ceniceros-Barros, Antonio L RuizAguilar, Luis M Claraco-Vega, Juan Alfonso Soler, Maria Del Carmen Lorente, Cecilia Hermosa, Federico Gordo, Miryam PrietoGonzález, Juan B López-Messa, Manuel P Perez, Cesar P Perez, Raquel Montoiro Allue, Ferran RocheCampo, Marcos Ibañez-Santacruz, Susana TempranoSusana, Maria C Pintado, Raul De Pablo, Pilar Ricart Aroa Gómez, Silvia Rodriguez Ruiz, Silvia Iglesias Moles, Mª Teresa Jurado, Alfons Arizmendi, Enrique A Piacentini, Nieves Franco, Teresa Honrubia, Meisy Perez Cheng, Elena Perez Losada, Javier Blanco, Luis J Yuste, Cecilia Carbayo-Gorriz, Francisca G Cazorla-Barranquero, Javier G Alonso, Rosa S Alda, Ángela Algaba, Gonzalo Navarro, Enrique Cereijo, Esther Diaz-Rodriguez, Diego Pastor Marcos, Laura Alvarez Montero, Luis Herrera Para, Roberto Jimenez Sanchez, Miguel Angel Blasco Navalpotro, Ricardo Diaz Abad, Raquel Montiel González, Dácil Parrilla Toribio, Alejandro G Castro, Maria Jose D Artiga, Oscar Penuelas, Tomas P Roser, Moreno F Olga, Elena Gallego Curto, Rocío Manzano Sánchez, Vallverdu P Imma, Garcia M Elisabet, Laura Claverias, Monica Magret, Ana M Pellicer, Lucia L Rodriguez, Jesús Sánchez-Ballesteros, Ángela González-Salamanca, Antonio G Jimenez, Francisco P Huerta, Juan Carlos J Sotillo Diaz, Esther Bermejo Lopez, David D Llinares Moya, Alec A Tallet Alfonso, Palazon Sanchez Eugenio Luis, Palazon Sanchez Cesar, Sánchez I Rafael, Corcoles G Virgilio, Noelia N Recio, Christian C Rylander, Bernhard Holzgraefe, Lars M Broman, Joanna Wessbergh, Linnea Persson, Fredrik Schiöler, Hans Kedelv, Anna Oscarsson Tibblin, Henrik Appelberg, Lars Hedlund, Johan Helleberg, Karin E Eriksson, Rita Glietsch, Niklas Larsson, Ingela Nygren, Silvia L Nunes, Anna-Karin Morin, Thomas Kander, Anne Adolfsson, Hervé O Zender, Corinne Leemann-Refondini, Souheil Elatrous, Slaheddine Bouchoucha, Imed Chouchene, Islem Ouanes, Asma Ben Souissi, Salma Kamoun, Oktay Demirkiran, Mustafa Aker, Emre Erbabacan, Ilkay Ceylan, Nermin Kelebek Girgin, Menekse Ozcelik, Necmettin Ünal, Basak Ceyda Meco, Onat O Akyol, Suleyman S Derman, Barry Kennedy, Ken Parhar, Latha Srinivasa, Danny McAuley, Phil Hopkins, Clare Mellis, Vivek Kakar, Dan Hadfield, Andre Vercueil, Kaushik Bhowmick, Sally K Humphreys, Andrew Ferguson, Raymond Mckee, Ashok S Raj, Danielle A Fawkes, Philip Watt, Linda Twohey, Rajeev R Jha, Matthew Thomas, Alex Morton, Varsha Kadaba, Mark J Smith, Anil P Hormis, Santhana G Kannan, Miriam Namih, Henrik Reschreiter, Julie Camsooksai, Alek Kumar, Szabolcs Rugonfalvi, Christopher Nutt, Orla Oneill, Colette Seasman, Ged Dempsey, Christopher J Scott, Helen E Ellis, Stuart Mckechnie, Paula J Hutton, Nora N Di Tomasso, Michela N Vitale, Ruth O Griffin, Michael N 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Gazenkampf, Ghaleb Almekhlafi, Mohamad M Albarrak, Ghanem M Mustafa, Khalid A Maghrabi, Nawal Salahuddin, Tharwat M Aisa, Ahmed S Al Jabbary, Edgardo Tabhan, Yaseen M Arabi, Yaseen M Arabi, Olivia A Trinidad, Hasan M Al Dorzi, Edgardo E Tabhan, Vesna Bumbasirevic, Bojan Jovanovic, Stefan Bolon, Oliver Smith, Jordi Mancebo, Hernan Aguirre-Bermeo, Juan C Lopez-Delgado, Francisco Esteve, Gemma Rialp, Catalina Forteza, Candelaria De Haro, Antonio Artigas, Guillermo M Albaiceta, Sara De Cima-Iglesias, Leticia Seoane-Quiroga, Alexandra Ceniceros-Barros, Antonio L RuizAguilar, Luis M Claraco-Vega, Juan Alfonso Soler, Maria Del Carmen Lorente, Cecilia Hermosa, Federico Gordo, Miryam PrietoGonzález, Juan B López-Messa, Manuel P Perez, Cesar P Perez, Raquel Montoiro Allue, Ferran RocheCampo, Marcos Ibañez-Santacruz, Susana TempranoSusana, Maria C Pintado, Raul De Pablo, Pilar Ricart Aroa Gómez, Silvia Rodriguez Ruiz, Silvia Iglesias Moles, Mª Teresa Jurado, Alfons Arizmendi, Enrique A 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C Rylander, Bernhard Holzgraefe, Lars M Broman, Joanna Wessbergh, Linnea Persson, Fredrik Schiöler, Hans Kedelv, Anna Oscarsson Tibblin, Henrik Appelberg, Lars Hedlund, Johan Helleberg, Karin E Eriksson, Rita Glietsch, Niklas Larsson, Ingela Nygren, Silvia L Nunes, Anna-Karin Morin, Thomas Kander, Anne Adolfsson, Lise Piquilloud, Hervé O Zender, Corinne Leemann-Refondini, Souheil Elatrous, Slaheddine Bouchoucha, Imed Chouchene, Islem Ouanes, Asma Ben Souissi, Salma Kamoun, Oktay Demirkiran, Mustafa Aker, Emre Erbabacan, Ilkay Ceylan, Nermin Kelebek Girgin, Menekse Ozcelik, Necmettin Ünal, Basak Ceyda Meco, Onat O Akyol, Suleyman S Derman, Barry Kennedy, Ken Parhar, Latha Srinivasa, Lia McNamee, Danny McAuley, Phil Hopkins, Clare Mellis, Vivek Kakar, Dan Hadfield, Andre Vercueil, Kaushik Bhowmick, Sally K Humphreys, Andrew Ferguson, Raymond Mckee, Ashok S Raj, Danielle A Fawkes, Philip Watt, Linda Twohey, Rajeev R Jha, Matthew Thomas, Alex Morton, Varsha Kadaba, Mark J Smith, Anil P Hormis, Santhana G Kannan, Miriam Namih, Henrik Reschreiter, Julie Camsooksai, Alek Kumar, Szabolcs Rugonfalvi, Christopher Nutt, Orla Oneill, Colette Seasman, Ged Dempsey, Christopher J Scott, Helen E Ellis, Stuart Mckechnie, Paula J Hutton, Nora N Di Tomasso, Michela N Vitale, Ruth O Griffin, Michael N Dean, Julius H Cranshaw, Emma L Willett, Nicholas Ioannou, Sarah Gillis, Peter Csabi, Rosaleen Macfadyen, Heidi Dawson, Pieter D Preez, Alexandra J Williams, Owen Boyd, Laura Ortiz-Ruiz de Gordoa, Jon Bramall, Sophie Symmonds, Simon K Chau, Tim Wenham, Tamas Szakmany, Piroska Toth-Tarsoly, Katie H McCalman, Peter Alexander, Lorraine Stephenson, Thomas Collyer, Rhiannon Chapman, Raphael Cooper, Russell M Allan, Malcolm Sim, David W Wrathall, Donald A Irvine, Kim S Zantua, John C Adams, Andrew J Burtenshaw, Gareth P Sellors, Ingeborg D Welters, Karen E Williams, Robert J Hessell, Matthew G Oldroyd, Ceri E Battle, Suresh Pillai, Istvan Kajtor, Mageswaran Sivashanmugavel, Sinead C Okane, Adrian Donnelly, Aniko D Frigyik, Jon P Careless, Martin M May, Richard Stewart, T John Trinder, Samantha J Hagan, Jade M Cole, Caroline C MacFie, Anna T Dowling, Javier Hurtado, Nicolás Nin, Javier Hurtado, Edgardo Nuñez, Gustavo Pittini, Ruben Rodriguez, María C Imperio, Cristina Santos, Ana G França, Alejandro Ebeid, Alberto Deicas, Carolina Serra, Aditya Uppalapati, Ghassan Kamel, Valerie M Banner-Goodspeed, Jeremy R Beitler, Satyanarayana Reddy Mukkera, Shreedhar Kulkarni, John O Shinn Iii, Dina Gomaa, Christopher Tainter, Jarone Lee, Tomaz MesarJarone Lee, Dale J Yeatts, Jessica Warren, Michael J Lanspa, Russel R Miller, Colin K Grissom, Samuel M Brown, Philippe R Bauer, Ryan J Gosselin, Barrett T Kitch, Jason E Cohen, Scott H Beegle, Shazia Choudry, Renaud M Gueret, Aiman Tulaimat, William Stigler, Hitesh Batra, Nidhi G Huff, Keith D Lamb, Trevor W Oetting, Nicholas M Mohr, Claine Judy, Shigeki Saito, Fayez M Kheir, Fayez Kheir, Adam B Schlichting, Angela Delsing, Daniel R Crouch, Mary Elmasri, Daniel R Crouch, Dina Ismail, Kyle R Dreyer, Thomas C Blakeman, Dina Gomaa, Rebecca M Baro, Carolina Quintana Grijalba, Peter C Hou, Raghu Seethala, Imo Aisiku, Galen Henderson, Gyorgy Frendl, Sen-Kuang Hou, Robert L Owens, Ashley Schomer, Intensive Care Medicine, ACS - Diabetes & metabolism, ACS - Pulmonary hypertension & thrombosis, ACS - Microcirculation, Pham, T, Pesenti, A, Bellani, G, Rubenfeld, G, Fan, E, Bugedo, G, Lorente, J, Fernandes, A, Van Haren, F, Bruhn, A, Rios, F, Esteban, A, Gattinoni, L, Larsson, A, Mcauley, D, Ranieri, M, Thompson, B, Wrigge, H, Brochard, L, Laffey, J, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), St. Michael's Hospital, University of Toronto, Groupe de recherche clinique CARMAS, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Università degli Studi di Milano [Milano] (UNIMI), University of Milan, San Gerardo Hospital, Sunnybrook Health Sciences Center, Mount Sinai Hospital [Toronto, Canada] (MSH), Pontificia Universidad Católica de Chile (UC), University Hospital of Getafe, CIBER Enfermedades Respiratorias (CIBERES), Universidad Europea de Madrid, Hospital Garcia de Orta (EPE), Canberra Hospital, Medical School [Australian National University - ANU], Australian National University (ANU), University of Canberra, Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), University of Göttingen - Georg-August-Universität Göttingen, Uppsala University, Queen's University [Belfast] (QUB), Royal Victoria Hospital, McGill University Health Center [Montreal] (MUHC), Università degli Studi di Bologna, Massachusetts General Hospital [Boston], University Hospital Leipzig, Department of Anaesthesiology, Intensive Care and Emergency Medicine, Pain Therapy, Bergmannstrost Hospital Halle, 06112, Halle, National University of Ireland [Galway] (NUI Galway), Bayer GlaxoSmithKline, GSK Baxter International Boehringer Ingelheim Wellcome Trust, WT National Institute for Health Research, NIHR Queen's University Belfast, QUB Medical Research Council Canada, MRC European Society of Intensive Care Medicine, ESICM, Support statement: This work was supported by the European Society of Intensive Care Medicine. Funding information for this article has been deposited with the Crossref Funder Registry., Conflict of interest: T. Pham has nothing to disclose. A. Pesenti reports personal fees from Maquet, Novalung/Xenios, Baxter, Gilead and Boehringer Ingelheim, outside the submitted work. G. Bellani reports grants and personal fees from Draeger Medical, personal fees from Getinge, Hamilton, GE Healthcare, Dimar SRL, Intersurgical and Flowmeter SPA, outside the submitted work. G. Rubenfeld has nothing to disclose. E. Fan reports personal fees from ALung Technologies, Getinge and MC3 Cardiopulmonary, grants, personal fees and non-financial support from Fresenius Medical Care, outside the submitted work. G. Bugedo has nothing to disclose. J.A. Lorente has nothing to disclose. A.D. V. Fernandes has nothing to disclose. F. Van Haren has nothing to disclose. A. Bruhn has nothing to disclose. F. Rios has nothing to disclose. A. Esteban has nothing to disclose. L. Gattinoni has nothing to disclose. A. Larsson reports grants from the Swedish Heart and Lung Foundation, during the conduct of the study. D.F. McAuley reports personal fees from consultancy for GlaxoSmithKline, Boehringer Ingelheim and Bayer, outside the submitted work, in addition, his institution has received funds from grants from the UK NIHR, Wellcome Trust, Innovate UK, NI HSC R&D Division, NI Chest Heart and Stroke, and MRC, is one of four named inventors on a patent US8962032 covering the use of sialic acid-bearing nanoparticles as anti-inflammatory agents issued to his institution, The Queen’s University of Belfast (http://www.google.com/patents/US8962032), and is a Director of Research for the Intensive Care Society and NIHR EME Programme Director. M. Ranieri has nothing to disclose. B.T. Thompson reports personal fees from Bayer, Thetis and Novartis, outside the submitted work. H. Wrigge reports personal fees for consultancy from Dräger Medical, personal fees for advisory board work from Liberate Medical, grants and personal fees for lectures from InfectoPharm, personal fees for lectures from MSD and GE, outside the submitted work. L.J. Brochard reports grants from Medtronic Covidien, grants and non-financial support from Fisher Paykel, non-financial support from Air Liquide, Sentec and Philips, other (patent) from General Electric, outside the submitted work. J.G. Laffey reports grants and personal fees from Baxter, grants and non-financial support from Aerogen and Factor Biosciences, outside the submitted work., LUNG SAFE Investigators and the European Society of Intensive Care Medicine Trials Group: Antonio Pesenti, John G Laffey, Laurent Brochard, Andres Esteban, Luciano Gattinoni, Frank van Haren, Anders Larsson, Daniel F McAuley, Marco Ranieri, Gordon Rubenfeld, B Taylor Thompson, Hermann Wrigge, Arthur S Slutsky, John G Laffey, Giacomo Bellani, Tài Pham, Eddy Fan, Fernando Rios, Frank van Haren, Thierry Sottiaux, Pieter Depuydt, Fredy S Lora, Luciano Cesar Azevedo, Eddy Fan, Guillermo Bugedo, Haibo Qiu, Marcos Gonzalez, Juan Silesky, Vladimir Cerny, Jonas Nielsen, Manuel Jibaja, Tài Pham, Hermann Wrigge, Dimitrios Matamis, Jorge Luis Ranero, Pravin Amin, S M Hashemian, Kevin Clarkson, Giacomo Bellani, Kiyoyasu Kurahashi, Asisclo Villagomez, Amine Ali Zeggwagh, Leo M Heunks, Jon Henrik Laake, Jose Emmanuel Palo, Antero do Vale Fernandes, Dorel Sandesc, Yaasen Arabi, Vesna Bumbasierevic, Nicolas Nin, Jose A Lorente, Anders Larsson, Lise Piquilloud, Fekri Abroug, Daniel F McAuley, Lia McNamee, Javier Hurtado, Ed Bajwa, Gabriel Démpaire, Hektor Sula, Lordian Nunci, Alma Cani, Alan Zazu, Christian Dellera, Carolina S Insaurralde, Risso V Alejandro, Julio Daldin, Mauricio Vinzio, Ruben O Fernandez, Luis P Cardonnet, Lisandro R Bettini, Mariano Carboni Bisso, Emilio M Osman, Mariano G Setten, Pablo Lovazzano, Javier Alvarez, Veronica Villar, Norberto C Pozo, Nicolas Grubissich, Gustavo A Plotnikow, Daniela N Vasquez, Santiago Ilutovich, Norberto Tiribelli, Ariel Chena, Carlos A Pellegrini, María G Saenz, Elisa Estenssoro, Matias Brizuela, Hernan Gianinetto, Pablo E Gomez, Valeria I Cerrato, Marco G Bezzi, Silvina A Borello, Flavia A Loiacono, Adriana M Fernandez, Serena Knowles, Claire Reynolds, Deborah M Inskip, Jennene J Miller, Jing Kong, Christina Whitehead, Shailesh Bihari, Aylin Seven, Amanda Krstevski, Helen J Rodgers, Rebecca T Millar, Toni E McKenna, Irene M Bailey, Gabrielle C Hanlon, Anders Aneman, Joan M Lynch, Raman Azad, John Neal, Paul W Woods, Brigit L Roberts, Mark R Kol, Helen S Wong, Katharina C Riss, Thomas Staudinger, Xavier Wittebole, Caroline Berghe, Pierre A Bulpa, Alain M Dive, Rik Verstraete, Herve Lebbinck, Pieter Depuydt, Joris Vermassen, Philippe Meersseman, Helga Ceunen, Jonas I Rosa, Daniel O Beraldo, Claudio Piras, Adenilton M Rampinelli, Antonio P Nassar Jr, Sergio Mataloun, Marcelo Moock, Marlus M Thompson, Claudio H Gonçalves, Ana Carolina P Antônio, Aline Ascoli, Rodrigo S Biondi, Danielle C Fontenele, Danielle Nobrega, Vanessa M Sales, Ahmad Yazid Bin Hj Abul Wahab, Maizatul Ismail, Suresh Shindhe, John Laffey, Francois Beloncle, Kyle G Davies, Rob Cirone, Venika Manoharan, Mehvish Ismail, Ewan C Goligher, Mandeep Jassal, Erin Nishikawa, Areej Javeed, Gerard Curley, Nuttapol Rittayamai, Matteo Parotto, Niall D Ferguson, Sangeeta Mehta, Jenny Knoll, Antoine Pronovost, Sergio Canestrini, Alejandro R Bruhn, Patricio H Garcia, Felipe A Aliaga, Pamela A Farías, Jacob S Yumha, Claudia A Ortiz, Javier E Salas, Alejandro A Saez, Luis D Vega, Eduardo F Labarca, Felipe T Martinez, Nicolás G Carreño, Pilar Lora, Haitao Liu, Haibo Qiu, Ling Liu, Rui Tang, Xiaoming Luo, Youzhong An, Huiying Zhao, Yan Gao, Zhe Zhai, Zheng L Ye, Wei Wang, Wenwen Li, Qingdong Li, Ruiqiang Zheng, Wenkui Yu, Juanhong Shen, Xinyu Li, Tao Yu, Weihua Lu, Ya Q Wu, Xiao B Huang, Zhenyang He, Yuanhua Lu, Hui Han, Fan Zhang, Renhua Sun, Hua X Wang, Shu H Qin, Bao H Zhu, Jun Zhao, Jian Liu, Bin Li, Jing L Liu, Fa C Zhou, Qiong J Li, Xing Y Zhang, Zhou Li-Xin, Qiang Xin-Hua, Liangyan Jiang, Yuan N Gao, Xian Y Zhao, Yuan Y Li, Xiao L Li, Chunting Wang, Qingchun Yao, Rongguo Yu, Kai Chen, Huanzhang Shao, Bingyu Qin, Qing Q Huang, Wei H Zhu, Ai Y Hang, Ma X Hua, Yimin Li, Yonghao Xu, Yu D Di, Long L Ling, Tie H Qin, Shou H Wang, Junping Qin, Yi Han, Suming Zhou, Monica P Vargas, Juan I Silesky Jimenez, Manuel A González Rojas, Jaime E SolisQuesada, Christian M Ramirez-Alfaro, Jan Máca, Peter Sklienka, Jakob Gjedsted, Aage Christiansen, Jonas Nielsen, Boris G Villamagua, Iguel Llano, Philippe Burtin, Gautier Buzancais, Pascal Beuret, Nicolas Pelletier, Satar Mortaza, Alain Mercat, Jonathan Chelly, Sébastien Jochmans, Nicolas Terzi, Cédric Daubin, Guillaume Carteaux, Nicolas de Prost, Jean-Daniel Chiche, Fabrice Daviaud, Tài Pham, Muriel Fartoukh, Guillaume Barberet, Jerome Biehler, Jean Dellamonica, Denis Doyen, Jean-Michel Arnal, Anais Briquet, Sami Hraiech, Laurent Papazian, Arnaud Follin, Damien Roux, Jonathan Messika, Evangelos Kalaitzis, Laurence Dangers, Alain Combes, Siu-Ming Au, Gaetan Béduneau, Dorothée Carpentier, Elie H Zogheib, Herve Dupont, Sylvie Ricome, Francesco L Santoli, Sebastien L Besset, Philippe Michel, Bruno Gelée, Pierre-Eric Danin, Bernard Goubaux, Philippe J Crova, Nga T Phan, Frantz Berkelmans, Julio C Badie, Romain Tapponnier, Josette Gally, Samy Khebbeb, Jean-Etienne Herbrecht, Francis Schneider, PierreLouis M Declercq, Jean-Philippe Rigaud, Jacques Duranteau, Anatole Harrois, Russell Chabanne, Julien Marin, Charlene Bigot, Sandrine Thibault, Mohammed Ghazi, Messabi Boukhazna, Salem Ould Zein, Jack R Richecoeur, Daniele M Combaux, Fabien Grelon, Charlene Le Moal, Elise P Sauvadet, Adrien Robine, Virginie Lemiale, Danielle Reuter, Martin Dres, Alexandre Demoule, Dany Goldgran-Toledano, Loredana Baboi, Claude Guérin, Ralph Lohner, Jens Kraßler, Susanne Schäfer, Kai D Zacharowski, Patrick Meybohm, Andreas W Reske, Philipp Simon, HansBernd F Hopf, Michael Schuetz, Thomas Baltus, Metaxia N Papanikolaou, Theonymfi G Papavasilopoulou, Giannis A Zacharas, Vasilis Ourailogloy, Eleni K Mouloudi, Eleni V Massa, Eva O Nagy, Electra E Stamou, Ellada V Kiourtzieva, Marina A Oikonomou, Luis E Avila, Cesar A Cortez, Johanna E Citalán, Sameer A Jog, Safal D Sable, Bhagyesh Shah, Mohan Gurjar, Arvind K Baronia, Mohammedfaruk Memon, Radhakrishnan Muthuchellappan, Venkatapura J Ramesh, Anitha Shenoy, Ramesh Unnikrishnan, Subhal B Dixit, Rachana V Rhayakar, Nagarajan Ramakrishnan, Vallish K Bhardwaj, Heera L Mahto, Sudha V Sagar, Vijayanand Palaniswamy, Deeban Ganesan, Seyed Mohammadreza Hashemian, Hamidreza Jamaati, Farshad Heidari, Edel A Meaney, Alistair Nichol, Karl M Knapman, Donall O'Croinin, Eimhin S Dunne, Dorothy M Breen, Kevin P Clarkson, Rola F Jaafar, Rory Dwyer, Fahd Amir, Olaitan O Ajetunmobi, Aogan C O'Muircheartaigh, Colin S Black, Nuala Treanor, Daniel V Collins, Wahid Altaf, Gianluca Zani, Maurizio Fusari, Savino Spadaro, Carlo A Volta, Romano Graziani, Barbara Brunettini, Salvatore Palmese, Paolo Formenti, Michele Umbrello, Andrea Lombardo, Elisabetta Pecci, Marco Botteri, Monica Savioli, Alessandro Protti, Alessia Mattei, Lorenzo Schiavoni, Andrea Tinnirello, Manuel Todeschini, Antonino Giarratano, Andrea Cortegiani, Antonino Giarratano, Andrea Cortegiani, Massimo M Antonelli, Luca M Montini, Paolo Casalena, Sergio Scafetti, Giovanna Panarello, Giovanna Occhipinti, Nicolò Patroniti, Matteo Pozzi, Roberto R Biscione, Michela M Poli, Ferdinando Raimondi, Daniela Albiero, Giulia Crapelli, Eduardo Beck, Vincenzo Pota, Vincenzo Schiavone, Alexandre Molin, Fabio Tarantino, Giacomo Monti, Elena Frati, Lucia Mirabella, Gilda Cinnella, Tommaso Fossali, Riccardo Colombo, Pierpaolo Terragni, Ilaria Pattarino, Francesco Mojoli, Antonio Braschi, Erika E Borotto, Andrea N Cracchiolo, Daniela M Palma, Francesco Raponi, Giuseppe Foti, Ettore R Vascotto, Andrea Coppadoro, Luca Brazzi, Leda Floris, Giorgio A Iotti, Aaron Venti, Osamu Yamaguchi, Shunsuke Takagi, Hiroki N Maeyama, Eizo Watanabe, Yoshihiro Yamaji, Kazuyoshi Shimizu, Kyoko Shiozaki, Satoru Futami, Sekine Ryosuke, Koji Saito, Yoshinobu Kameyama, Keiko Ueno, Masayo Izawa, Nao Okuda, Hiroyuki Suzuki, Tomofumi Harasawa, Michitaka Nasu, Tadaaki Takada, Fumihito Ito, Shin Nunomiya, Kansuke Koyama, Toshikazu Abe, Kohkichi Andoh, Kohei Kusumoto, Akira Hirata, Akihiro Takaba, Hiroyasu Kimura, Shuhei Matsumoto, Ushio Higashijima, Hiroyuki Honda, Nobumasa Aoki, Hiroshi Imai, Yasuaki Ogino, Ichiko Mizuguchi, Kazuya Ichikado, Kenichi Nitta, Katsunori Mochizuki, Tomoaki Hashida, Hiroyuki Tanaka, Tomoyuki Nakamura, Daisuke Niimi, Takeshi Ueda, Yozo Kashiwa, Akinori Uchiyama, Olegs Sabelnikovs, Peteris Oss, Youssef Haddad, Kong Y Liew, Silvio A Ñamendys-Silva, Yves D Jarquin-Badiola, Luis A Sanchez-Hurtado, Saira S Gomez-Flores, Maria C Marin, Asisclo J Villagomez, Jordana S Lemus, Jonathan M Fierro, Mavy Ramirez Cervantes, Francisco Javier Flores Mejia, Dulce Dector, Alejandro Rojas, Daniel R Gonzalez, Claudia R Estrella, Jorge R Sanchez-Medina, Alvaro Ramirez-Gutierrez, Fernando G George, Janet S Aguirre, Juan A Buensuseso, Manuel Poblano, Juan A Buensuseso, Manuel Poblano, Tarek Dendane, Amine Ali Zeggwagh, Hicham Balkhi, Mina Elkhayari, Nacer Samkaoui, Hanane Ezzouine, Abdellatif Benslama, Mourad Amor, Wajdi Maazouzi, Nedim Cimic, Oliver Beck, Monique M Bruns, Jeroen A Schouten, Myra Rinia, Monique Raaijmakers, Leo M Heunks, Hellen M van Wezel, Serge J Heines, Ulrich Strauch, Marc P Buise, Fabienne D Simonis, Marcus J Schultz, Jennifer C Goodson, Troy S Browne, Leanlove Navarra, Anna Hunt, Robyn A Hutchison, Mathew B Bailey, Lynette Newby, Colin McArthur, Michael Kalkoff, Alex Mcleod, Jonathan Casement, Danielle J Hacking, Finn H Andersen, Merete S Dolva, Jon H Laake, Andreas Barratt-Due, Kim Andre L Noremark, Eldar Søreide, Brit Å Sjøbø, Anne B Guttormsen, Hector H Leon Yoshido, Ronald Zumaran Aguilar, Fredy A Montes Oscanoa, Alain U Alisasis, Joanne B Robles, Rossini Abbie B Pasanting-Lim, Beatriz C Tan, Pawel Andruszkiewicz, Karina Jakubowska, Cristina M Coxo, António M Alvarez, Bruno S Oliveira, Gustavo M Montanha, Nelson C Barros, Carlos S Pereira, António M Messias, Jorge M Monteiro, Ana M Araujo, Nuno T Catorze, Susan M Marum, Maria J Bouw, Rui M Gomes, Vania A Brito, Silvia Castro, Joana M Estilita, Filipa M Barros, Isabel M Serra, Aurelia M Martinho, Dana R Tomescu, Alexandra Marcu, Ovidiu H Bedreag, Marius Papurica, Dan E Corneci, Silvius Ioan Negoita, Evgeny Grigoriev, Alexey I Gritsan, Andrey A Gazenkampf, Ghaleb Almekhlafi, Mohamad M Albarrak, Ghanem M Mustafa, Khalid A Maghrabi, Nawal Salahuddin, Tharwat M Aisa, Ahmed S Al Jabbary, Edgardo Tabhan, Yaseen M Arabi, Yaseen M Arabi, Olivia A Trinidad, Hasan M Al Dorzi, Edgardo E Tabhan, Vesna Bumbasirevic, Bojan Jovanovic, Stefan Bolon, Oliver Smith, Jordi Mancebo, Hernan Aguirre-Bermeo, Juan C Lopez-Delgado, Francisco Esteve, Gemma Rialp, Catalina Forteza, Candelaria De Haro, Antonio Artigas, Guillermo M Albaiceta, Sara De Cima-Iglesias, Leticia Seoane-Quiroga, Alexandra Ceniceros-Barros, Antonio L RuizAguilar, Luis M Claraco-Vega, Juan Alfonso Soler, Maria Del Carmen Lorente, Cecilia Hermosa, Federico Gordo, Miryam PrietoGonzález, Juan B López-Messa, Manuel P Perez, Cesar P Perez, Raquel Montoiro Allue, Ferran RocheCampo, Marcos Ibañez-Santacruz, Susana TempranoSusana, Maria C Pintado, Raul De Pablo, Pilar Ricart Aroa Gómez, Silvia Rodriguez Ruiz, Silvia Iglesias Moles, Mª Teresa Jurado, Alfons Arizmendi, Enrique A Piacentini, Nieves Franco, Teresa Honrubia, Meisy Perez Cheng, Elena Perez Losada, Javier Blanco, Luis J Yuste, Cecilia Carbayo-Gorriz, Francisca G Cazorla-Barranquero, Javier G Alonso, Rosa S Alda, Ángela Algaba, Gonzalo Navarro, Enrique Cereijo, Esther Diaz-Rodriguez, Diego Pastor Marcos, Laura Alvarez Montero, Luis Herrera Para, Roberto Jimenez Sanchez, Miguel Angel Blasco Navalpotro, Ricardo Diaz Abad, Raquel Montiel González, Dácil Parrilla Toribio, Alejandro G Castro, Maria Jose D Artiga, Oscar Penuelas, Tomas P Roser, Moreno F Olga, Elena Gallego Curto, Rocío Manzano Sánchez, Vallverdu P Imma, Garcia M Elisabet, Laura Claverias, Monica Magret, Ana M Pellicer, Lucia L Rodriguez, Jesús Sánchez-Ballesteros, Ángela González-Salamanca, Antonio G Jimenez, Francisco P Huerta, Juan Carlos J Sotillo Diaz, Esther Bermejo Lopez, David D Llinares Moya, Alec A Tallet Alfonso, Palazon Sanchez Eugenio Luis, Palazon Sanchez Cesar, Sánchez I Rafael, Corcoles G Virgilio, Noelia N Recio, Christian C Rylander, Bernhard Holzgraefe, Lars M Broman, Joanna Wessbergh, Linnea Persson, Fredrik Schiöler, Hans Kedelv, Anna Oscarsson Tibblin, Henrik Appelberg, Lars Hedlund, Johan Helleberg, Karin E Eriksson, Rita Glietsch, Niklas Larsson, Ingela Nygren, Silvia L Nunes, Anna-Karin Morin, Thomas Kander, Anne Adolfsson, Lise Piquilloud, Hervé O Zender, Corinne Leemann-Refondini, Souheil Elatrous, Slaheddine Bouchoucha, Imed Chouchene, Islem Ouanes, Asma Ben Souissi, Salma Kamoun, Oktay Demirkiran, Mustafa Aker, Emre Erbabacan, Ilkay Ceylan, Nermin Kelebek Girgin, Menekse Ozcelik, Necmettin Ünal, Basak Ceyda Meco, Onat O Akyol, Suleyman S Derman, Barry Kennedy, Ken Parhar, Latha Srinivasa, Lia McNamee, Danny McAuley, Phil Hopkins, Clare Mellis, Vivek Kakar, Dan Hadfield, Andre Vercueil, Kaushik Bhowmick, Sally K Humphreys, Andrew Ferguson, Raymond Mckee, Ashok S Raj, Danielle A Fawkes, Philip Watt, Linda Twohey, Rajeev R Jha, Matthew Thomas, Alex Morton, Varsha Kadaba, Mark J Smith, Anil P Hormis, Santhana G Kannan, Miriam Namih, Henrik Reschreiter, Julie Camsooksai, Alek Kumar, Szabolcs Rugonfalvi, Christopher Nutt, Orla Oneill, Colette Seasman, Ged Dempsey, Christopher J Scott, Helen E Ellis, Stuart Mckechnie, Paula J Hutton, Nora N Di Tomasso, Michela N Vitale, Ruth O Griffin, Michael N Dean, Julius H Cranshaw, Emma L Willett, Nicholas Ioannou, Sarah Gillis, Peter Csabi, Rosaleen Macfadyen, Heidi Dawson, Pieter D Preez, Alexandra J Williams, Owen Boyd, Laura Ortiz-Ruiz de Gordoa, Jon Bramall, Sophie Symmonds, Simon K Chau, Tim Wenham, Tamas Szakmany, Piroska Toth-Tarsoly, Katie H McCalman, Peter Alexander, Lorraine Stephenson, Thomas Collyer, Rhiannon Chapman, Raphael Cooper, Russell M Allan, Malcolm Sim, David W Wrathall, Donald A Irvine, Kim S Zantua, John C Adams, Andrew J Burtenshaw, Gareth P Sellors, Ingeborg D Welters, Karen E Williams, Robert J Hessell, Matthew G Oldroyd, Ceri E Battle, Suresh Pillai, Istvan Kajtor, Mageswaran Sivashanmugavel, Sinead C Okane, Adrian Donnelly, Aniko D Frigyik, Jon P Careless, Martin M May, Richard Stewart, T John Trinder, Samantha J Hagan, Jade M Cole, Caroline C MacFie, Anna T Dowling, Javier Hurtado, Nicolás Nin, Javier Hurtado, Edgardo Nuñez, Gustavo Pittini, Ruben Rodriguez, María C Imperio, Cristina Santos, Ana G França, Alejandro Ebeid, Alberto Deicas, Carolina Serra, Aditya Uppalapati, Ghassan Kamel, Valerie M Banner-Goodspeed, Jeremy R Beitler, Satyanarayana Reddy Mukkera, Shreedhar Kulkarni, John O Shinn Iii, Dina Gomaa, Christopher Tainter, Jarone Lee, Tomaz MesarJarone Lee, Dale J Yeatts, Jessica Warren, Michael J Lanspa, Russel R Miller, Colin K Grissom, Samuel M Brown, Philippe R Bauer, Ryan J Gosselin, Barrett T Kitch, Jason E Cohen, Scott H Beegle, Shazia Choudry, Renaud M Gueret, Aiman Tulaimat, William Stigler, Hitesh Batra, Nidhi G Huff, Keith D Lamb, Trevor W Oetting, Nicholas M Mohr, Claine Judy, Shigeki Saito, Fayez M Kheir, Fayez Kheir, Adam B Schlichting, Angela Delsing, Daniel R Crouch, Mary Elmasri, Daniel R Crouch, Dina Ismail, Kyle R Dreyer, Thomas C Blakeman, Dina Gomaa, Rebecca M Baro, Carolina Quintana Grijalba, Peter C Hou, Raghu Seethala, Imo Aisiku, Galen Henderson, Gyorgy Frendl, Sen-Kuang Hou, Robert L Owens, Ashley Schomer, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (MGD) Services des soins intensifs, and UCL - (SLuc) Service de soins intensifs
Subjects: Pulmonary and Respiratory Medicine, ARDS, Unidades de cuidados intensivos, [SDV]Life Sciences [q-bio], medicine.medical_treatment, mechanical ventilation, NO, law.invention, 03 medical and health sciences, Tratamiento médico, 0302 clinical medicine, law, Settore MED/41 - ANESTESIOLOGIA, Insuficiencia respiratoria, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Lung, Mechanical ventilation, Respiratory Distress Syndrome, business.industry, Respiration, Incidence (epidemiology), medicine.disease, Intensive care unit, Respiration, Artificial, 3. Good health, Intensive Care Units, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], medicine.anatomical_structure, 030228 respiratory system, Respiratory failure, Heart failure, Anesthesia, Artificial, ards, business, Respiratory Insufficiency, Enfermedad
Abstract: BackgroundCurrent incidence and outcome of patients with acute hypoxaemic respiratory failure requiring mechanical ventilation in the intensive care unit (ICU) are unknown, especially for patients not meeting criteria for acute respiratory distress syndrome (ARDS).MethodsAn international, multicentre, prospective cohort study of patients presenting with hypoxaemia early in the course of mechanical ventilation, conducted during four consecutive weeks in the winter of 2014 in 459 ICUs from 50 countries (LUNG SAFE). Patients were enrolled with arterial oxygen tension/inspiratory oxygen fraction ratio ≤300 mmHg, new pulmonary infiltrates and need for mechanical ventilation with a positive end-expiratory pressure of ≥5 cmH2O. ICU prevalence, causes of hypoxaemia, hospital survival and factors associated with hospital mortality were measured. Patients with unilateral versus bilateral opacities were compared.Findings12 906 critically ill patients received mechanical ventilation and 34.9% with hypoxaemia and new infiltrates were enrolled, separated into ARDS (69.0%), unilateral infiltrate (22.7%) and congestive heart failure (CHF; 8.2%). The global hospital mortality was 38.6%. CHF patients had a mortality comparable to ARDS (44.1% versus 40.4%). Patients with unilateral-infiltrate had lower unadjusted mortality, but similar adjusted mortality compared to those with ARDS. The number of quadrants on chest imaging was associated with an increased risk of death. There was no difference in mortality comparing patients with unilateral-infiltrate and ARDS with only two quadrants involved.InterpretationMore than one-third of patients receiving mechanical ventilation have hypoxaemia and new infiltrates with a hospital mortality of 38.6%. Survival is dependent on the degree of pulmonary involvement whether or not ARDS criteria are reached.
Published: 2021

41. Numerical Assessment of a New Hydro-Pneumatic Suspension System for Motorcycles

Author: Alberto Martini, Gabriele Bellani, Cristiano Fragassa, A. Martini, G. Bellani, and C. Fragassa
Subjects: Computer science, 020209 energy, Mechanical Engineering, Work (physics), Constant speed, Numerical assessment, 02 engineering and technology, Bicycle and motorcycle dynamics, regressive suspension, 01 natural sciences, Coil spring, Hydro-pneumatic spring, Automotive engineering, motorcycle dynamics, Spring (device), 0103 physical sciences, Automotive Engineering, 0202 electrical engineering, electronic engineering, information engineering, Point (geometry), non-linear stiffne, 010301 acoustics
Abstract: This work investigates an innovative hydro-pneumatic suspension system that was recently developed for possibly enhancing the performance of wheeled road vehicles, particularly motorcycles. The device exhibits a highly non-linear behavior, and in particular a strongly regressive spring rate, due to its architecture (featuring a hydro- pneumatic spring and a coil spring arranged in series). Multibody models are implemented and simulated for a preliminary assessment of its actual benefits and/or drawbacks with respect to common suspension systems. As a starting point of the research, this work focuses on the in-plane dynamics, and in particular on a condition of straight running at constant speed. The load fluctuations on the rear wheel (grip) as well as the velocity of the suspended mass (comfort) under different road inputs at various speeds are analyzed. The numerical results confirm the hydro-pneumatic suspension system as a promising device.
Published: 2018

42. Slip velocity of large neutrally buoyant particles in turbulent flows

Author: Evan Variano, Gabriele Bellani, G Bellani, and E A Variano
Subjects: Physics, Homogeneous isotropic turbulence, Turbulence, Fluid Dynamics (physics.flu-dyn), FOS: Physical sciences, buoyant particles , turbulence, PIV, General Physics and Astronomy, Reynolds number, Physics - Fluid Dynamics, Slip (materials science), Mechanics, Physics::Fluid Dynamics, symbols.namesake, Flow velocity, Drag, symbols, Magnetosphere particle motion, Taylor microscale
Abstract: We discuss possible definitions for a stochastic slip velocity that describes the relative motion between large particles and a turbulent flow. This definition is necessary because the slip velocity used in the standard drag model fails when particle size falls within the inertial subrange of ambient turbulence. We propose two definitions, selected in part due to their simplicity: they do not require filtration of the fluid phase velocity field, nor do they require the construction of conditional averages on particle locations. A key benefit of this simplicity is that the stochastic slip velocity proposed here can be calculated equally well for laboratory, field, and numerical experiments. The stochastic slip velocity allows the definition of a Reynolds number that should indicate whether large particles in turbulent flow behave (a) as passive tracers; (b) as a linear filter of the velocity field; or (c) as a nonlinear filter to the velocity field. We calculate the value of stochastic slip for ellipsoidal and spherical particles (the size of the Taylor microscale) measured in laboratory homogeneous isotropic turbulence. The resulting Reynolds number is significantly higher than 1 for both particle shapes, and velocity statistics show that particle motion is a complex non-linear function of the fluid velocity. We further investigate the nonlinear relationship by comparing the probability distribution of fluctuating velocities for particle and fluid phases.
Published: 2012

43. Pressure support, patient effort and tidal volume: a conceptual model for a non linear interaction.

Author: Docci M, Foti G, Brochard L, and Bellani G
Subjects: Humans, Respiration, Artificial methods, Positive-Pressure Respiration methods, Tidal Volume physiology
Abstract: Pressure support ventilation (PSV) is a form of assisted ventilation which has become frequently used, with the aim of partially unloading the patient's inspiratory muscles. Both under- and over-assistance should be avoided to target a lung- and diaphragm- protective ventilation. Herein, we propose a conceptual model, supported by actual data, to describe how patient and ventilator share the generation of tidal volume (Vt) in PSV and how respiratory system compliance (Crs) affects this interaction. We describe the presence of a patient-specific range of PSV levels, within which the inspiratory effort (Pmus) is modulated, keeping Vt relatively steady on a desired value (Vt target ). This range of assistance may be considered the "adequate PSV assistance" required by the patient, while higher and lower levels may result in over- and under-assistance respectively. As we also show, the determinants of over- and under- assistance borders depend on the combination of Crs and the inspiratory effort which the patient is able to sustain over a period of time. These concepts can be applied at the bedside to understand if the level of assistance is adequate to patient's demand, focusing on the variation of relevant parameters (Vt, Pmus and pressure-muscle-index) as patient reaction to a change in the level of assistance., (© 2024. The Author(s).)
Published: 2024
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44. Identification of novel sub-phenotypes of severe ARDS requiring ECMO using latent class analysis.

Author: Nishikimi M, Ohshimo S, Bellani G, Fukumoto W, Anzai T, Liu K, Ishii J, Kyo M, Awai K, Takahashi K, and Shime N
Subjects: Humans, Male, Female, Retrospective Studies, Middle Aged, Adult, Phenotype, Aged, Hospital Mortality, Proportional Hazards Models, Extracorporeal Membrane Oxygenation methods, Extracorporeal Membrane Oxygenation statistics & numerical data, Respiratory Distress Syndrome therapy, Respiratory Distress Syndrome classification, Respiratory Distress Syndrome mortality, Respiratory Distress Syndrome physiopathology, Latent Class Analysis
Abstract: Background: Sub-phenotyping of acute respiratory distress syndrome (ARDS) could be useful for evaluating the severity of ARDS or predicting its responsiveness to given therapeutic strategies, but no studies have yet investigated the heterogeneity of patients with severe ARDS requiring veno-venous extracorporeal membrane oxygenation (V-V ECMO)., Methods: We conducted this retrospective multicenter observational study in adult patients with severe ARDS treated by V-V ECMO. We performed latent class analysis (LCA) for identifying sub-phenotypes of severe ARDS based on the radiological and clinical findings at the start of ECMO support. Multivariate Cox regression analysis was conducted to investigate the differences in mortality and association between the PEEP setting of ≥ 10 cmH 2 O and mortality by the sub-phenotypes., Results: We identified three sub-phenotypes from analysis of the data of a total of 544 patients with severe ARDS treated by V-V ECMO, as follows: Dry type (n = 185; 34%); Wet type (n = 169; 31%); and Fibrotic type (n = 190; 35%). The 90-days in-hospital mortality risk was higher in the patients with the Fibrotic type than in those with the Dry type (adjusted hazard ratio [95% confidence interval] 1.75 [1.10-2.79], p = 0.019) or the Wet type (1.50 [1.02-2.23], p = 0.042). The PEEP setting of ≥ 10 cmH 2 O during the first 3 days of ECMO decreased the 90-days in-hospital mortality risk only in patients with the Wet type, and not in those with the Dry or Fibrotic type. A significant interaction effect was observed between the Wet type and the PEEP setting of ≥ 10 cmH 2 O in relation to the 90-day in-hospital mortality (p interaction = 0.036)., Conclusions: The three sub-phenotypes showed different mortality rates and different relationships between higher PEEP settings in the early phase of V-V ECMO and patient outcomes. Our data suggest that we may need to change our management approach to patients with severe ARDS during V-V ECMO according to their clinical sub-phenotype., (© 2024. The Author(s).)
Published: 2024
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45. A multimodal characterization of cardiopulmonary resuscitation-associated lung edema.

Author: Magliocca A, Zani D, De Zani D, Castagna V, Merigo G, De Giorgio D, Fumagalli F, Zambelli V, Boccardo A, Pravettoni D, Bellani G, Richard JC, Grasselli G, Rezoagli E, and Ristagno G
Abstract: Background: Cardiopulmonary resuscitation-associated lung edema (CRALE) is a phenomenon that has been recently reported in both experimental and out-of-hospital cardiac arrest patients. We aimed to explore the respiratory and cardiovascular pathophysiology of CRALE in an experimental model of cardiac arrest undergoing prolonged manual and mechanical chest compression (CC). Oxygen delivery achieved during mechanical or manual CC were also investigated as a secondary aim, to describe CRALE evolution under different hemodynamic supports generated during CPR., Methods: Ventricular fibrillation (VF) was induced and left untreated for 5 min prior to begin cardiopulmonary resuscitation (CPR), including CC, ventilation with oxygen, epinephrine administration and defibrillation. Continuous mechanical and manual CC was performed alternating one of the two strategies every 5 min for a total of 25 min. Unsynchronized mechanical ventilation was resumed simultaneously to CC. A lung computed tomography (CT) was performed at baseline and 1 h after return of spontaneous circulation (ROSC) in surviving animals. Partitioned respiratory mechanics, gas exchange, hemodynamics, and oxygen delivery were evaluated during the experimental study at different timepoints. Lung histopathology was performed., Results: After 25 min of CPR, a marked decrease of the respiratory system compliance with reduced oxygenation and CO 2 elimination were observed in all animals. The worsening of the respiratory system compliance was driven by a significant decrease in lung compliance. The presence of CRALE was confirmed by an increased lung weight and a reduced lung aeration at the lung CT, together with a high lung wet-to-dry ratio and reduced airspace at histology. The average change in esophageal pressure during the 25-min CPR highly correlated with the severity of CRALE, i.e., lung weight increase., Conclusions: In this porcine model of cardiac arrest followed by a 25-min interval of CPR with mechanical and manual CC, CRALE was consistently present and was characterized by lung inhomogeneity with alveolar tissue and hemorrhage replacing alveolar airspace. Despite mechanical CPR is associated with a more severe CRALE, the higher cardiac output generated by the mechanical compression ultimately accounted for a greater oxygen delivery. Whether specific ventilation strategies might prevent CRALE while preserving hemodynamics remains to be proved., (© 2024. The Author(s).)
Published: 2024
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46. Impact of new lighting technology versus traditional fluorescent bulbs on sedation and delirium in the ICU.

Author: Lucchini A, Villa M, Giani M, Canzi S, Colombo S, Mapelli E, Mariani I, Rezoagli E, Foti G, and Bellani G
Abstract: Background: Critically ill patients frequently encounter disruptions in their circadian rhythms in the intensive care unit (ICU) environment. New lighting systems have been developed to enhance daytime light levels and to promote circadian alignment., Objectives: To investigate the impact of implementing an innovative lighting technology that mimics natural light and reproduce the colour of the sky., Design: Prospective, observational, non-randomized comparative trial. ICU patients were exposed to either a cutting-edge lighting system based on new technology (intervention group) or a conventional lighting system using fluorescent bulbs (control group)., Setting: An Italian intensive care unit with ten beds and five windowless rooms, thereby denying access to natural light. Three rooms had new lighting technology., Main Outcome Measures: The two groups were compared to assess the prevalence or absence of delirium and the need for sedatives during ICU stay. The secondary aim was to assess the presence of anxiety, depression, and post-traumatic stress disorder in patients at 3, 6, and 12 months after ICU discharge., Results: 86 patients were included: 52 (60 %) in the intervention group and 34 (40 %) in the control group. Seventy-nine patients (82 %) were alive at ICU discharge. Fourteen patients (16 %) developed delirium (intervention group: n = 8 [15 %] vs. control group: n = 6 [18 %] in the control group, (P=0.781). The use of sedative drugs and neuromuscular blocking agents was similar in both the groups. No differences in the incidence of anxiety, depression, or post-traumatic stress disorders were observed among patients who underwent follow-up visits., Conclusions: Compared to traditional fluorescent tube lighting, the innovative lighting system did not provide any significant benefit in reducing the frequency of delirium or the necessity for sedative medications., Implications for Clinical Practice: A single intervention, the use of lights that mimic sunny light and the sky, did not result in a statistically significant reduction in the incidence of delirium. Delirium has a multifactorial aetiology, necessitating interventions that are multifaceted and address different domains., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)
Published: 2024
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47. Respiratory Drive, Effort, and Lung-Distending Pressure during Transitioning from Controlled to Spontaneous Assisted Ventilation in Patients with ARDS: A Multicenter Prospective Cohort Study.

Author: Balzani E, Murgolo F, Pozzi M, Di Mussi R, Bartolomeo N, Simonetti U, Brazzi L, Spadaro S, Bellani G, Grasso S, and Fanelli V
Abstract: Objectives : To investigate the impact of patient characteristics and treatment factors on excessive respiratory drive, effort, and lung-distending pressure during transitioning from controlled to spontaneous assisted ventilation in patients with acute respiratory distress syndrome (ARDS). Methods : Multicenter cohort observational study of patients with ARDS at four academic intensive care units. Respiratory drive (P 0.1 ), diaphragm electrical activity (EAdi), inspiratory effort derived from EAdi (∆Pmus EAdi ) and from occlusion of airway pressure (∆Pocc) (Pmus ΔPocc ), and dynamic transpulmonary driving pressure (ΔP L,dyn ) were measured at the first transition to assisted spontaneous breathing. Results : A total of 4171 breaths were analyzed in 48 patients. P 0.1 was >3.5 cmH 2 O in 10%, EAdi PEAK > 15 µV in 29%, ∆Pmus EAdi > 15 cmH 2 O in 28%, and ΔP L,dyn > 15 cmH 2 O in 60% of the studied breaths. COVID-19 etiology of ARDS was the strongest independent risk factor for a higher proportion of breaths with excessive respiratory drive (RR 3.00 [2.43-3.71], p < 0.0001), inspiratory effort (RR 1.84 [1.58-2.15], p < 0.0001), and transpulmonary driving pressure (RR 1.48 [1.36-1.62], p < 0.0001). The P/F ratio at ICU admission, days of deep sedation, and dose of steroids were additional risk factors for vigorous inspiratory effort. Age and dose of steroids were risk factors for high transpulmonary driving pressure. Days of deep sedation (aHR 1.15 [1.07-1.24], p = 0.0002) and COVID-19 diagnosis (aHR 6.96 [1-48.5], p = 0.05) of ARDS were independently associated with composite outcome of transitioning from light to deep sedation (RASS from 0/-3 to -4/-5) or return to controlled ventilation within 48 h of spontaneous assisted breathing. Conclusions : This study identified that specific patient characteristics, including age, COVID-19-related ARDS, and P/F ratio, along with treatment factors such as the duration of deep sedation and the dosage of steroids, are independently associated with an increased likelihood of assisted breaths reaching potentially harmful thresholds of drive, effort, and lung-distending pressure during the initial transition to spontaneous assisted breathing. It is noteworthy that patients who were subjected to prolonged deep sedation under controlled mechanical ventilation, as well as those with COVID-19, were more susceptible to failing the transition from controlled to assisted breathing.
Published: 2024
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48. Using the helmet.

Author: Grassi A and Bellani G
Subjects: Humans, Head Protective Devices standards
Published: 2024
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49. Noninvasive Respiratory Support in Acute Respiratory Distress Syndrome.

Author: Lassola S, Giani M, and Bellani G
Subjects: Humans, Respiratory Distress Syndrome therapy, Respiratory Distress Syndrome physiopathology, Noninvasive Ventilation methods
Abstract: Noninvasive respiratory supports have been successfully used as an alternative to endotracheal intubation especially in patients with a milder degree of hypoxemia. In patients with acute respiratory distress syndrome (ARDS), the main goals of noninvasive oxygenation strategies are to improve oxygenation, unload the respiratory muscles, and relieve dyspnea. On the other hand, recent studies have suggested that spontaneous breathing could represent an additional mechanism of lung injury, especially in the more severe forms. The aim of this review is to describe the role of different noninvasive respiratory supports in ARDS, to optimize its use in clinical practice., Competing Interests: Disclosure G. Bellani received consultancy fees from Flowmeter SPA (Italy) and lecturing fees from Draeger Medical (Germany)., (Copyright © 2024 Elsevier Inc. All rights reserved.)
Published: 2024
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50. Epidemiology, ventilation management and outcomes of COVID-19 ARDS patients versus patients with ARDS due to pneumonia in the Pre-COVID era.

Author: van der Ven FLIM, Blok SG, Azevedo LC, Bellani G, Botta M, Estenssoro E, Fan E, Ferreira JC, Laffey JG, Martin-Loeches I, Motos A, Pham T, Peñuelas O, Pesenti A, Pisani L, Neto AS, Schultz MJ, Torres A, Tsonas AM, Paulus F, and van Meenen DMP
Subjects: Adult, Aged, Female, Humans, Male, Middle Aged, Treatment Outcome, COVID-19 mortality, COVID-19 therapy, Respiration, Artificial, Respiratory Distress Syndrome mortality, Respiratory Distress Syndrome therapy, Pneumonia complications
Abstract: Background: Ventilation management may differ between COVID-19 ARDS (COVID-ARDS) patients and patients with pre-COVID ARDS (CLASSIC-ARDS); it is uncertain whether associations of ventilation management with outcomes for CLASSIC-ARDS also exist in COVID-ARDS., Methods: Individual patient data analysis of COVID-ARDS and CLASSIC-ARDS patients in six observational studies of ventilation, four in the COVID-19 pandemic and two pre-pandemic. Descriptive statistics were used to compare epidemiology and ventilation characteristics. The primary endpoint were key ventilation parameters; other outcomes included mortality and ventilator-free days and alive (VFD-60) at day 60., Results: This analysis included 6702 COVID-ARDS patients and 1415 CLASSIC-ARDS patients. COVID-ARDS patients received lower median V T (6.6 [6.0 to 7.4] vs 7.3 [6.4 to 8.5] ml/kg PBW; p < 0.001) and higher median PEEP (12.0 [10.0 to 14.0] vs 8.0 [6.0 to 10.0] cm H 2 O; p < 0.001), at lower median ΔP (13.0 [10.0 to 15.0] vs 16.0 [IQR 12.0 to 20.0] cm H 2 O; p < 0.001) and higher median Crs (33.5 [26.6 to 42.1] vs 28.1 [21.6 to 38.4] mL/cm H 2 O; p < 0.001). Following multivariable adjustment, higher ΔP had an independent association with higher 60-day mortality and less VFD-60 in both groups. Higher PEEP had an association with less VFD-60, but only in COVID-ARDS patients., Conclusions: Our findings show important differences in key ventilation parameters and associations thereof with outcomes between COVID-ARDS and CLASSIC-ARDS., Trial Registration: Clinicaltrials.gov (identifier NCT05650957), December 14, 2022., (© 2024. The Author(s).)
Published: 2024
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