Search

Your search keyword '"Giuntini, R."' showing total 200 results
Start Over Author "Giuntini, R."
200 results on '"Giuntini, R."'

1. Holistic type extension for classical propositional logic in quantum computation

Author

Freytes, H., Giuntini, R., and Sergioli, G.

Subjects
Quantum Physics
Abstract

A holistic extension of classical propositional logic is introduced in the framework of quantum computation with mixed states. The concepts of tautology and contradiction are investigated in this extensions. A special family of quantum states are investigated as particular cases of "holistic" contradiction.

Published
2019

4. Quantum Computational Logics. A Survey

Author

Chiara, M. L. Dalla, Giuntini, R., and Leporini, R.

Subjects
Quantum Physics
Abstract

Quantum computation has suggested new forms of quantum logic, called quantum computational logics. The basic semantic idea is the following: the meaning of a sentence is identified with a quregister, a system of qubits, representing a possible pure state of a compound quantum system. The generalization to mixed states, which might be useful to analyse entanglement-phenomena, is due to Gudder. Quantum computational logics represent non standard examples of unsharp quantum logic, where the non-contradiction principle is violated, while conjunctions and disjunctions are strongly non-idempotent. In this framework, any sentence of the language gives rise to a quantum tree: a kind of quantum circuit that transforms the quregister associated to the atomic subformulas of the sentence into the quregister associated to the sentence., Comment: 35 pages, 2 figures

Published
2003

5. Qubit semantics and quantum trees

Author

Chiara, M. L. Dalla, Giuntini, R., Leporini, R., and Leporati, A.

Subjects
Quantum Physics
Abstract

In the qubit semantics the \emph{meaning} of any sentence $\alpha$ is represented by a \emph{quregister}: a unit vector of the $n$--fold tensor product $\otimes^n \C^2$, where $n$ depends on the number of occurrences of atomic sentences in $\alpha$. The logic characterized by this semantics, called {\it quantum computational logic} (QCL), is {\it unsharp}, because the non-contradiction principle is violated. We show that QCL does not admit any logical truth. In this framework, any sentence $\alpha$ gives rise to a \emph{quantum tree}, consisting of a sequence of unitary operators. The quantum tree of $\alpha$ can be regarded as a quantum circuit that transforms the quregister associated to the atomic subformulas of $\alpha$ into the quregster associated to $\alpha$., Comment: 10 pages, 2 figures

Published
2002

6. An unsharp logic from quantum computation

Author

Cattaneo, G., Chiara, M. L. Dalla, Giuntini, R., and Leporini, R.

Subjects
Quantum Physics
Abstract

Logical gates studied in quantum computation suggest a natural logical abstraction that gives rise to a new form of unsharp quantum logic. We study the logical connectives corresponding to the following gates: the Toffoli gate, the NOT and the squareroot of NOT (which admit of natural physical models). This leads to a semantic characterization of a logic that we call computational quantum logic CQL.

Published
2002

7. Quantum Logic

Author

Chiara, M. L. Dalla and Giuntini, R.

Subjects
Quantum Physics
Abstract

We investigate some forms of quantum logic arising from the standard and the unsharp approach., Comment: 100 pages

Published
2001

9. Quantum computational logic

Author

Dalla Chiara, M., Giuntini, R., Greechie, R., Wójcicki, Ryszard, editor, Hendricks, Vincent F., editor, Mundici, Daniele, editor, Orłowska, Ewa, editor, Segerberg, Krister, editor, Wansing, Heinrich, editor, Dalla Chiara, M., Giuntini, R., and Greechie, R.

Published
2004
Full Text
View/download PDF

10. The Brouwer Zadeh logics

Author

Dalla Chiara, M., Giuntini, R., Greechie, R., Wójcicki, Ryszard, editor, Hendricks, Vincent F., editor, Mundici, Daniele, editor, Orłowska, Ewa, editor, Segerberg, Krister, editor, Wansing, Heinrich, editor, Dalla Chiara, M., Giuntini, R., and Greechie, R.

Published
2004
Full Text
View/download PDF

11. Partial quantum logics and Łukasiewicz’ quantum logic

Author

Dalla Chiara, M., Giuntini, R., Greechie, R., Wójcicki, Ryszard, editor, Hendricks, Vincent F., editor, Mundici, Daniele, editor, Orłowska, Ewa, editor, Segerberg, Krister, editor, Wansing, Heinrich, editor, Dalla Chiara, M., Giuntini, R., and Greechie, R.

Published
2004
Full Text
View/download PDF

12. Metalogical properties and anomalies of quantum logic

Author

Dalla Chiara, M., Giuntini, R., Greechie, R., Wójcicki, Ryszard, editor, Hendricks, Vincent F., editor, Mundici, Daniele, editor, Orłowska, Ewa, editor, Segerberg, Krister, editor, Wansing, Heinrich, editor, Dalla Chiara, M., Giuntini, R., and Greechie, R.

Published
2004
Full Text
View/download PDF

13. Sharp quantum logics

Author

Dalla Chiara, M., Giuntini, R., Greechie, R., Wójcicki, Ryszard, editor, Hendricks, Vincent F., editor, Mundici, Daniele, editor, Orłowska, Ewa, editor, Segerberg, Krister, editor, Wansing, Heinrich, editor, Dalla Chiara, M., Giuntini, R., and Greechie, R.

Published
2004
Full Text
View/download PDF

14. First-order quantum logics and quantum set theories

Author

Dalla Chiara, M., Giuntini, R., Greechie, R., Wójcicki, Ryszard, editor, Hendricks, Vincent F., editor, Mundici, Daniele, editor, Orłowska, Ewa, editor, Segerberg, Krister, editor, Wansing, Heinrich, editor, Dalla Chiara, M., Giuntini, R., and Greechie, R.

Published
2004
Full Text
View/download PDF

15. Abstract axiomatic foundations of unsharp quantum theory

Author

Dalla Chiara, M., Giuntini, R., Greechie, R., Wójcicki, Ryszard, editor, Hendricks, Vincent F., editor, Mundici, Daniele, editor, Orłowska, Ewa, editor, Segerberg, Krister, editor, Wansing, Heinrich, editor, Dalla Chiara, M., Giuntini, R., and Greechie, R.

Published
2004
Full Text
View/download PDF

16. Effect algebras and quantum MV algebras

Author

Dalla Chiara, M., Giuntini, R., Greechie, R., Wójcicki, Ryszard, editor, Hendricks, Vincent F., editor, Mundici, Daniele, editor, Orłowska, Ewa, editor, Segerberg, Krister, editor, Wansing, Heinrich, editor, Dalla Chiara, M., Giuntini, R., and Greechie, R.

Published
2004
Full Text
View/download PDF

18. Unsharp quantum logics

Author

Dalla Chiara, M., Giuntini, R., Greechie, R., Wójcicki, Ryszard, editor, Hendricks, Vincent F., editor, Mundici, Daniele, editor, Orłowska, Ewa, editor, Segerberg, Krister, editor, Wansing, Heinrich, editor, Dalla Chiara, M., Giuntini, R., and Greechie, R.

Published
2004
Full Text
View/download PDF

20. Abstract axiomatic foundations of sharp QT

Author

Dalla Chiara, M., Giuntini, R., Greechie, R., Wójcicki, Ryszard, editor, Hendricks, Vincent F., editor, Mundici, Daniele, editor, Orłowska, Ewa, editor, Segerberg, Krister, editor, Wansing, Heinrich, editor, Dalla Chiara, M., Giuntini, R., and Greechie, R.

Published
2004
Full Text
View/download PDF

21. The metalogical intractability of orthomodularity

Author

Dalla Chiara, M., Giuntini, R., Greechie, R., Wójcicki, Ryszard, editor, Hendricks, Vincent F., editor, Mundici, Daniele, editor, Orłowska, Ewa, editor, Segerberg, Krister, editor, Wansing, Heinrich, editor, Dalla Chiara, M., Giuntini, R., and Greechie, R.

Published
2004
Full Text
View/download PDF

22. An axiomatization of OL and OQL

Author

Dalla Chiara, M., Giuntini, R., Greechie, R., Wójcicki, Ryszard, editor, Hendricks, Vincent F., editor, Mundici, Daniele, editor, Orłowska, Ewa, editor, Segerberg, Krister, editor, Wansing, Heinrich, editor, Dalla Chiara, M., Giuntini, R., and Greechie, R.

Published
2004
Full Text
View/download PDF

23. To what extent is quantum ambiguity ambiguous?

Author

Dalla Chiara, M., Giuntini, R., Greechie, R., Wójcicki, Ryszard, editor, Hendricks, Vincent F., editor, Mundici, Daniele, editor, Orłowska, Ewa, editor, Segerberg, Krister, editor, Wansing, Heinrich, editor, Dalla Chiara, M., Giuntini, R., and Greechie, R.

Published
2004
Full Text
View/download PDF

24. Back to Hilbert space

Author

Dalla Chiara, M., Giuntini, R., Greechie, R., Wójcicki, Ryszard, editor, Hendricks, Vincent F., editor, Mundici, Daniele, editor, Orłowska, Ewa, editor, Segerberg, Krister, editor, Wansing, Heinrich, editor, Dalla Chiara, M., Giuntini, R., and Greechie, R.

Published
2004
Full Text
View/download PDF

28. Sigh in patients with acute hypoxemic respiratory failure and acute respiratory distress syndrome: the PROTECTION pilot randomized clinical trial

Author

Mauri, T, Foti, G, Fornari, C, Grasselli, G, Pinciroli, R, Lovisari, F, Tubiolo, D, Volta, C, Spadaro, S, Rona, R, Rondelli, E, Navalesi, P, Garofalo, E, Knafelj, R, Gorjup, V, Colombo, R, Cortegiani, A, Zhou, J, D'Andrea, R, Calamai, I, Gonzalez, A, Roca, O, Grieco, D, Jovaisa, T, Bampalis, D, Becher, T, Battaglini, D, Ge, H, Luz, M, Constantin, J, Ranieri, M, Guerin, C, Mancebo, J, Pelosi, P, Fumagalli, R, Brochard, L, Pesenti, A, Papoff, A, Di Fenza, R, Gianni, S, Spinelli, E, Lissoni, A, Abbruzzese, C, Bronco, A, Villa, S, Russotto, V, Iachi, A, Ball, L, Patroniti, N, Spina, R, Giuntini, R, Peruzzi, S, Menga, L, Fossali, T, Castelli, A, Ottolina, D, Garcia-De-Acilu, M, Santafe, M, Schadler, D, Weiler, N, Carvajal, E, Calvo, C, Neou, E, Wang, Y, Zhou, Y, Longhini, F, Bruni, A, Leonardi, M, Gregoretti, C, Ippolito, M, Milazzo, Z, Querci, L, Ranieri, S, Insom, G, Berden, J, Noc, M, Mikuz, U, Arzenton, M, Lazzeri, M, Villa, A, Barreto, B, Rios, M, Gusmao-Flores, D, Phull, M, Barnes, T, Musarat, H, Conti, S, Mauri T., Foti G., Fornari C., Grasselli G., Pinciroli R., Lovisari F., Tubiolo D., Volta C. A., Spadaro S., Rona R., Rondelli E., Navalesi P., Garofalo E., Knafelj R., Gorjup V., Colombo R., Cortegiani A., Zhou J. -X., D'Andrea R., Calamai I., Gonzalez A. V., Roca O., Grieco D. L., Jovaisa T., Bampalis D., Becher T., Battaglini D., Ge H., Luz M., Constantin J. -M., Ranieri M., Guerin C., Mancebo J., Pelosi P., Fumagalli R., Brochard L., Pesenti A., Papoff A., Di Fenza R., Gianni S., Spinelli E., Lissoni A., Abbruzzese C., Bronco A., Villa S., Russotto V., Iachi A., Ball L., Patroniti N., Spina R., Giuntini R., Peruzzi S., Menga L. S., Fossali T., Castelli A., Ottolina D., Garcia-De-Acilu M., Santafe M., Schadler D., Weiler N., Carvajal E. R., Calvo C. P., Neou E., Wang Y. -M., Zhou Y. -M., Longhini F., Bruni A., Leonardi M., Gregoretti C., Ippolito M., Milazzo Z., Querci L., Ranieri S., Insom G., Berden J., Noc M., Mikuz U., Arzenton M., Lazzeri M., Villa A., Barreto B. B., Rios M. N. O., Gusmao-Flores D., Phull M., Barnes T., Musarat H., Conti S., Mauri, T, Foti, G, Fornari, C, Grasselli, G, Pinciroli, R, Lovisari, F, Tubiolo, D, Volta, C, Spadaro, S, Rona, R, Rondelli, E, Navalesi, P, Garofalo, E, Knafelj, R, Gorjup, V, Colombo, R, Cortegiani, A, Zhou, J, D'Andrea, R, Calamai, I, Gonzalez, A, Roca, O, Grieco, D, Jovaisa, T, Bampalis, D, Becher, T, Battaglini, D, Ge, H, Luz, M, Constantin, J, Ranieri, M, Guerin, C, Mancebo, J, Pelosi, P, Fumagalli, R, Brochard, L, Pesenti, A, Papoff, A, Di Fenza, R, Gianni, S, Spinelli, E, Lissoni, A, Abbruzzese, C, Bronco, A, Villa, S, Russotto, V, Iachi, A, Ball, L, Patroniti, N, Spina, R, Giuntini, R, Peruzzi, S, Menga, L, Fossali, T, Castelli, A, Ottolina, D, Garcia-De-Acilu, M, Santafe, M, Schadler, D, Weiler, N, Carvajal, E, Calvo, C, Neou, E, Wang, Y, Zhou, Y, Longhini, F, Bruni, A, Leonardi, M, Gregoretti, C, Ippolito, M, Milazzo, Z, Querci, L, Ranieri, S, Insom, G, Berden, J, Noc, M, Mikuz, U, Arzenton, M, Lazzeri, M, Villa, A, Barreto, B, Rios, M, Gusmao-Flores, D, Phull, M, Barnes, T, Musarat, H, Conti, S, Mauri T., Foti G., Fornari C., Grasselli G., Pinciroli R., Lovisari F., Tubiolo D., Volta C. A., Spadaro S., Rona R., Rondelli E., Navalesi P., Garofalo E., Knafelj R., Gorjup V., Colombo R., Cortegiani A., Zhou J. -X., D'Andrea R., Calamai I., Gonzalez A. V., Roca O., Grieco D. L., Jovaisa T., Bampalis D., Becher T., Battaglini D., Ge H., Luz M., Constantin J. -M., Ranieri M., Guerin C., Mancebo J., Pelosi P., Fumagalli R., Brochard L., Pesenti A., Papoff A., Di Fenza R., Gianni S., Spinelli E., Lissoni A., Abbruzzese C., Bronco A., Villa S., Russotto V., Iachi A., Ball L., Patroniti N., Spina R., Giuntini R., Peruzzi S., Menga L. S., Fossali T., Castelli A., Ottolina D., Garcia-De-Acilu M., Santafe M., Schadler D., Weiler N., Carvajal E. R., Calvo C. P., Neou E., Wang Y. -M., Zhou Y. -M., Longhini F., Bruni A., Leonardi M., Gregoretti C., Ippolito M., Milazzo Z., Querci L., Ranieri S., Insom G., Berden J., Noc M., Mikuz U., Arzenton M., Lazzeri M., Villa A., Barreto B. B., Rios M. N. O., Gusmao-Flores D., Phull M., Barnes T., Musarat H., and Conti S.

Abstract

Background: Sigh is a cyclic brief recruitment maneuver: previous physiologic studies showed that its use could be an interesting addition to pressure support ventilation to improve lung elastance, decrease regional heterogeneity, and increase release of surfactant. Research Question: Is the clinical application of sigh during pressure support ventilation (PSV) feasible? Study Design and Methods: We conducted a multicenter noninferiority randomized clinical trial on adult intubated patients with acute hypoxemic respiratory failure or ARDS undergoing PSV. Patients were randomized to the no-sigh group and treated by PSV alone, or to the sigh group, treated by PSV plus sigh (increase in airway pressure to 30 cm H2O for 3 s once per minute) until day 28 or death or successful spontaneous breathing trial. The primary end point of the study was feasibility, assessed as noninferiority (5% tolerance) in the proportion of patients failing assisted ventilation. Secondary outcomes included safety, physiologic parameters in the first week from randomization, 28-day mortality, and ventilator-free days. Results: Two-hundred and fifty-eight patients (31% women; median age, 65 [54-75] years) were enrolled. In the sigh group, 23% of patients failed to remain on assisted ventilation vs 30% in the no-sigh group (absolute difference, –7%; 95% CI, –18% to 4%; P =. 015 for noninferiority). Adverse events occurred in 12% vs 13% in the sigh vs no-sigh group (P =. 852). Oxygenation was improved whereas tidal volume, respiratory rate, and corrected minute ventilation were lower over the first 7 days from randomization in the sigh vs no-sigh group. There was no significant difference in terms of mortality (16% vs 21%; P =. 337) and ventilator-free days (22 [7-26] vs 22 [3-25] days; P =. 300) for the sigh vs no-sigh group. Interpretation: Among hypoxemic intubated ICU patients, application of sigh was feasible and without increased risk.

Published
2021

29. Conclusions

Author

Dalla Chiara, M., Giuntini, R., Greechie, R., Wójcicki, Ryszard, editor, Hendricks, Vincent F., editor, Mundici, Daniele, editor, Orłowska, Ewa, editor, Segerberg, Krister, editor, Wansing, Heinrich, editor, Dalla Chiara, M., Giuntini, R., and Greechie, R.

Published
2004
Full Text
View/download PDF

40. Sigh in patients with acute hypoxemic respiratory failure and acute respiratory distress syndrome: the PROTECTION pilot randomized clinical trial

Author

Mauri T., Foti G., Fornari C., Grasselli G., Pinciroli R., Lovisari F., Tubiolo D., Volta C. A., Spadaro S., Rona R., Rondelli E., Navalesi P., Garofalo E., Knafelj R., Gorjup V., Colombo R., Cortegiani A., Zhou J. -X., D'Andrea R., Calamai I., Gonzalez A. V., Roca O., Grieco D. L., Jovaisa T., Bampalis D., Becher T., Battaglini D., Ge H., Luz M., Constantin J. -M., Ranieri M., Guerin C., Mancebo J., Pelosi P., Fumagalli R., Brochard L., Pesenti A., Papoff A., Di Fenza R., Gianni S., Spinelli E., Lissoni A., Abbruzzese C., Bronco A., Villa S., Russotto V., Iachi A., Ball L., Patroniti N., Spina R., Giuntini R., Peruzzi S., Menga L. S., Fossali T., Castelli A., Ottolina D., Garcia-De-Acilu M., Santafe M., Schadler D., Weiler N., Carvajal E. R., Calvo C. P., Neou E., Wang Y. -M., Zhou Y. -M., Longhini F., Bruni A., Leonardi M., Gregoretti C., Ippolito M., Milazzo Z., Querci L., Ranieri S., Insom G., Berden J., Noc M., Mikuz U., Arzenton M., Lazzeri M., Villa A., Barreto B. B., Rios M. N. O., Gusmao-Flores D., Phull M., Barnes T., Musarat H., Conti S., Mauri, Tommaso, Foti, Giuseppe, Fornari, Carla, Grasselli, Giacomo, Pinciroli, Riccardo, Lovisari, Federica, Tubiolo, Daniela, Volta, Carlo Alberto, Spadaro, Savino, Rona, Roberto, Rondelli, Egle, Navalesi, Paolo, Garofalo, Eugenio, Knafelj, Rihard, Gorjup, Vojka, Colombo, Riccardo, Cortegiani, Andrea, Zhou, Jian-Xin, D'Andrea, Rocco, Calamai, Italo, González, Ánxela Vidal, Roca, Oriol, Grieco, Domenico Luca, Jovaisa, Toma, Bampalis, Dimitrio, Becher, Tobia, Battaglini, Denise, Ge, Huiqing, Luz, Mariana, Constantin, Jean-Michel, Ranieri, Marco, Guerin, Claude, Mancebo, Jordi, Pelosi, Paolo, Fumagalli, Roberto, Brochard, Laurent, Pesenti, Antonio, PROTECTION collaborators: Alessandra Papoff, Raffaele Di Fenza, Stefano Gianni, Elena Spinelli, Alfredo Lissoni, Chiara Abbruzzese, Alfio Bronco, Silvia Villa, Vincenzo Russotto, Arianna Iachi, Lorenzo Ball, Nicolò Patroniti, Rosario Spina, Romano Giuntini, Simone Peruzzi, Luca Salvatore Menga, Tommaso Fossali, Antonio Castelli, Davide Ottolina, Marina García-de-Acilu, Manel Santafè, Dirk Schädler, Norbert Weiler, Emilia Rosas Carvajal, César Pérez Calvo, Evangelia Neou, Yu-Mei Wang, Yi-Min Zhou, Federico Longhini, Andrea Bruni, Mariacristina Leonardi, Cesare Gregoretti, Mariachiara Ippolito, Zelia Milazzo, Lorenzo Querci, Serena Ranieri, Giulia Insom, Jernej Berden, Marko Noc, Ursa Mikuz, Matteo Arzenton, Marta Lazzeri, Arianna Villa, Bruna Brandão Barreto, Marcos Nogueira Oliveira Rios, Dimitri Gusmao-Flores, Mandeep Phull, Tom Barnes, Hussain Musarat, Sara Conti, Mauri, T, Foti, G, Fornari, C, Grasselli, G, Pinciroli, R, Lovisari, F, Tubiolo, D, Volta, C, Spadaro, S, Rona, R, Rondelli, E, Navalesi, P, Garofalo, E, Knafelj, R, Gorjup, V, Colombo, R, Cortegiani, A, Zhou, J, D'Andrea, R, Calamai, I, Gonzalez, A, Roca, O, Grieco, D, Jovaisa, T, Bampalis, D, Becher, T, Battaglini, D, Ge, H, Luz, M, Constantin, J, Ranieri, M, Guerin, C, Mancebo, J, Pelosi, P, Fumagalli, R, Brochard, L, Pesenti, A, Papoff, A, Di Fenza, R, Gianni, S, Spinelli, E, Lissoni, A, Abbruzzese, C, Bronco, A, Villa, S, Russotto, V, Iachi, A, Ball, L, Patroniti, N, Spina, R, Giuntini, R, Peruzzi, S, Menga, L, Fossali, T, Castelli, A, Ottolina, D, Garcia-De-Acilu, M, Santafe, M, Schadler, D, Weiler, N, Carvajal, E, Calvo, C, Neou, E, Wang, Y, Zhou, Y, Longhini, F, Bruni, A, Leonardi, M, Gregoretti, C, Ippolito, M, Milazzo, Z, Querci, L, Ranieri, S, Insom, G, Berden, J, Noc, M, Mikuz, U, Arzenton, M, Lazzeri, M, Villa, A, Barreto, B, Rios, M, Gusmao-Flores, D, Phull, M, Barnes, T, Musarat, H, and Conti, S

Subjects
pressure support, ventilation, sigh, ARDS, mechanical ventilation, feasibility
Abstract

Background: Sigh is a cyclic brief recruitment manoeuvre: previous physiological studies showed that its use could be an interesting addition to pressure support ventilation to improve lung elastance, decrease regional heterogeneity and increase release of surfactant. Research question: Is the clinical application of sigh during pressure support ventilation (PSV) feasible? Study design and methods: We conducted a multi-center non-inferiority randomized clinical trial on adult intubated patients with acute hypoxemic respiratory failure or acute respiratory distress syndrome undergoing PSV. Patients were randomized to the No Sigh group and treated by PSV alone, or to the Sigh group, treated by PSV plus sigh (increase of airway pressure to 30 cmH2Ofor 3 seconds once per minute) until day 28 or death or successful spontaneous breathing trial. The primary endpoint of the study was feasibility, assessed as non-inferiority (5% tolerance) in the proportion of patients failing assisted ventilation. Secondary outcomes included safety, physiological parameters in the first week from randomization, 28-day mortality and ventilator-free days. Results: Two-hundred fifty-eight patients (31% women; median age 65 [54-75] years) were enrolled. In the Sigh group, 23% of patients failed to remain on assisted ventilation vs. 30% in the No Sigh group (absolute difference -7%, 95%CI -18% to 4%; p=0.015 for non-inferiority). Adverse events occurred in 12% vs. 13% in Sigh vs. No Sigh (p=0.852). Oxygenation was improved while tidal volume, respiratory rate and corrected minute ventilation were lower over the first 7 days from randomization in Sigh vs. No Sigh. There was no significant difference in terms of mortality (16% vs. 21%, p=0.342) and ventilator-free days (22 [7-26] vs. 22 [3-25] days, p=0.300) for Sigh vs. No Sigh. Interpretation: Among hypoxemic intubated ICU patients, application of sigh was feasible and without increased risk.

Published
2020

45. Sigh in Patients With Acute Hypoxemic Respiratory Failure and ARDS: The PROTECTION Pilot Randomized Clinical Trial

Author

Mauri, T., Foti, G., Fornari, C., Grasselli, G., Pinciroli, R., Lovisari, F., Tubiolo, D., Volta, C. A., Spadaro, S., Rona, R., Rondelli, E., Navalesi, P., Garofalo, E., Knafelj, R., Gorjup, V., Colombo, R., Cortegiani, A., Zhou, J. -X., D'Andrea, R., Calamai, I., Gonzalez, A. V., Roca, O., Grieco, D. L., Jovaisa, T., Bampalis, D., Becher, T., Battaglini, D., Ge, H., Luz, M., Constantin, J. -M., Ranieri, M., Guerin, C., Mancebo, J., Pelosi, P., Fumagalli, R., Brochard, L., Pesenti, A., Papoff, A., Di Fenza, R., Gianni, S., Spinelli, E., Lissoni, A., Abbruzzese, C., Bronco, A., Villa, S., Russotto, V., Iachi, A., Ball, L., Patroniti, N., Spina, R., Giuntini, R., Peruzzi, S., Menga, L. S., Fossali, T., Castelli, A., Ottolina, D., Garcia-De-Acilu, M., Santafe, M., Schadler, D., Weiler, N., Carvajal, E. R., Calvo, C. P., Neou, E., Wang, Y. -M., Zhou, Y. -M., Longhini, F., Bruni, A., Leonardi, M., Gregoretti, C., Ippolito, M., Milazzo, Z., Querci, L., Ranieri, S., Insom, G., Berden, J., Noc, M., Mikuz, U., Arzenton, M., Lazzeri, M., Villa, A., Barreto, B. B., Rios, M. N. O., Gusmao-Flores, D., Phull, M., Barnes, T., Musarat, H., and Conti, S.

Subjects
Male, RCT, Randomized Control Trial, VFDs, Ventilator- free days, sigh, PaO2/FiO2 ratio, Arterial Partial Pressure of O2/ Fraction of Inspired Oxygen, SpO2/FiO2 ratio, Peripheral Oxygen Saturation/ Fraction of Inspired Oxygen, Pilot Projects, ESICM, European Society of Intensive Care Medicine, NO, Positive-Pressure Respiration, ICU, Intensive Care Unit, Vt, Tidal Volume, SBT, Spontaneous Breathing Trial, Intubation, Intratracheal, Humans, PEEP, Positive End Expiratory Pressure, RR, Respiratory Rate, FiO2, Fraction of Inspired Oxygen, ARDS, feasibility, pressure support, ventilation, Aged, Female, Middle Aged, Respiratory Distress Syndrome, Respiratory Insufficiency, Respiratory Mechanics, Original Research, GEE, Generalize Estimate Equation, RASS, Richmond Agitation- Sedation Scale, ARDS, Acute Respiratory Distress Syndrome, P-SILI, Patient - Self Inflicted Lung Injury, AHRF, Acute Hypoxemic Respiratory Failure, PBW, Predicted Body Weight, PSV, Pressure Support Ventilation, SOFA, Sequence Organ Failure Assessment, Intratracheal, SAPS II, Simplified Acute Physiology Score II, SpO2, Peripheral Oxygen Saturation, PaCO2, Arterial Partial Pressure of CO2, TRALI, Transfusion-Related Acute Lung Injury, BMI, Body Mass Index, Intubation, MV, Mechanical Ventilation
Abstract

BACKGROUND: Sigh is a cyclic brief recruitment maneuver: previous physiologic studies showed that its use could be an interesting addition to pressure support ventilation to improve lung elastance, decrease regional heterogeneity, and increase release of surfactant. RESEARCH QUESTION: Is the clinical application of sigh during pressure support ventilation (PSV) feasible? STUDY DESIGN AND METHODS: We conducted a multicenter noninferiority randomized clinical trial on adult intubated patients with acute hypoxemic respiratory failure or ARDS undergoing PSV. Patients were randomized to the no-sigh group and treated by PSV alone, or to the sigh group, treated by PSV plus sigh (increase in airway pressure to 30 cm H2O for 3 s once per minute) until day 28 or death or successful spontaneous breathing trial. The primary end point of the study was feasibility, assessed as noninferiority (5% tolerance) in the proportion of patients failing assisted ventilation. Secondary outcomes included safety, physiologic parameters in the first week from randomization, 28-day mortality, and ventilator-free days. RESULTS: Two-hundred and fifty-eight patients (31% women; median age, 65 [54-75] years) were enrolled. In the sigh group, 23% of patients failed to remain on assisted ventilation vs 30% in the no-sigh group (absolute difference, -7%; 95% CI, -18% to 4%; P = .015 for noninferiority). Adverse events occurred in 12% vs 13% in the sigh vs no-sigh group (P = .852). Oxygenation was improved whereas tidal volume, respiratory rate, and corrected minute ventilation were lower over the first 7 days from randomization in the sigh vs no-sigh group. There was no significant difference in terms of mortality (16% vs 21%; P = .337) and ventilator-free days (22 [7-26] vs 22 [3-25] days; P = .300) for the sigh vs no-sigh group. INTERPRETATION: Among hypoxemic intubated ICU patients, application of sigh was feasible and without increased risk.

Published
2020

Catalog

Books, media, physical & digital resources
See catalog results