Search

Your search keyword '"Kolobow T"' showing total 313 results
Start Over Author "Kolobow T"
313 results on '"Kolobow T"'

1. Prevention of lung bacterial colonization with a leak-proof endotracheal tube cuff: An experimental animal study

Author

Rezoagli, E, Cressoni, M, Bellani, G, Grasselli, G, Pesenti, A, Kolobow, T, Zanella, A, Rezoagli E., Cressoni M., Bellani G., Grasselli G., Pesenti A. M., Kolobow T., Zanella A., Rezoagli, E, Cressoni, M, Bellani, G, Grasselli, G, Pesenti, A, Kolobow, T, Zanella, A, Rezoagli E., Cressoni M., Bellani G., Grasselli G., Pesenti A. M., Kolobow T., and Zanella A.

Abstract

BACKGROUND: Endotracheal tubes with standard polyvinyl chloride cuffs create folds on inflation into the trachea, which lead to potential leakage of subglottic secretions into the lower airways and cause lung colonization and pneumonia. The use of a double-layer prototype leak-proof cuff has shown effective prevention of the fluid leakage across the cuff. We hypothesized that the use of such a leak-proof cuff could prevent lung bacterial colonization in vivo. METHODS: To simulate patients in the ICU, 13 pigs were placed in the semirecumbent position, intubated, and mechanically ventilated for 72 h. Five animals were prospectively intubated with an endotracheal tube with a leak-proof cuff (leak-proof cuff group). Data from 8 animals previously intubated with an endotracheal tube with a standard polyvinyl chloride cuff (standard cuff group) were retrospectively analyzed. Leakage of tracheal secretions across the leak-proof cuff was tested by the macroscopic methylene blue evaluation. Arterial blood gas exchanges and microbiology were tested in all the pigs at necropsy. RESULTS: In the standard cuff group, all the pigs showed heavy bacterial colonization of the lungs after 72 h of mechanical ventilation, with an overall proportion of colonized lung lobes of 92% (44/48 lobes, 8/8 animals) compared with 27% (8/30 lobes, 5/5 animals) in the leak-proof cuff group (P <.001). These results were strengthened by the absence of methylene blue in the tracheal secretions below the leak-proof cuff. Furthermore, no hypoxemia was demonstrated in the pigs in the leak-proof cuff group after the 72-h experiment (PaO2/FIO2 change from baseline, leak-proof cuff group vs standard cuff group; median difference 332, 95% CI 41–389 mm Hg; P =.030). CONCLUSIONS: A new leak-proof cuff for endotracheal intubation prevented macroscopic leakage of subglottic secretions along the airways. This mechanism led to the reduction of lung bacterial colonization, which could contribute to the prevention

Published
2019

2. ESICM LIVES 2016: part one: Milan, Italy. 1-5 October 2016

Author

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

Published
2016
Full Text
View/download PDF

3. Pathogenic link between postextubation pneumonia and ventilator-associated pneumonia: An experimental study

Author

Rezoagli, E, Zanella, A, Cressoni, M, De Marchi, L, Kolobow, T, Berra, L, Rezoagli E., Zanella A., Cressoni M., De Marchi L., Kolobow T., Berra L., Rezoagli, E, Zanella, A, Cressoni, M, De Marchi, L, Kolobow, T, Berra, L, Rezoagli E., Zanella A., Cressoni M., De Marchi L., Kolobow T., and Berra L.

Abstract

Background: The presence of an endotracheal tube is the main cause for developing ventilator- associated pneumonia (VAP), but pneumonia can still develop in hospitalized patients after endotracheal tube removal (postextubation pneumonia [PEP]). We hypothesized that short-term intubation (24 hours) can play a role in the pathogenesis of PEP. To test such hypothesis, we initially evaluated the occurrence of lung colonization and VAP in sheep that were intubated and mechanically ventilated for 24 hours. Subsequently, we assessed the incidence of lung colonization and PEP at 48 hours after extubation in sheep previously ventilated for 24 hours. Methods: To simulate intubated intensive care unit patients placed in semirecumbent position, 14 sheep were intubated and mechanically ventilated with the head elevated 30° above horizontal. Seven of them were euthanized after 24 hours (Control Group), whereas the remaining were euthanized after being awaken, extubated, and left spontaneously breathing for 48 hours after extubation (Awake Group). Criteria of clinical diagnosis of pneumonia were tested. Microbiological evaluation was performed on autopsy in all sheep. Results: Only 1 sheep in the Control Group met the criteria of VAP after 24 hours of mechanical ventilation. However, heavy pathogenic bacteria colonization of trachea, bronchi, and lungs (range, 104-109 colony-forming unit [CFU]/g) was reported in 4 of 7 sheep (57%). In the Awake Group, 1 sheep was diagnosed with VAP and 3 developed PEP within 48 hours after extubation (42%), with 1 euthanized at 30 hours because of respiratory failure. On autopsy, 5 sheep (71%) confirmed pathogenic bacterial growth in the lower respiratory tract (range, 103-109 CFU/g). Conclusions: Twenty-four hours of intubation and mechanical ventilation in semirecumbent position leads to significant pathogenic colonization of the lower airways, which can promote the development of PEP. Strategies directed to prevent pathogenic microbiological co

Published
2017

4. 37th International Symposium on Intensive Care and Emergency Medicine (part 1 of 3)

Author

Karavana, V., Smith, I., Kanellis, G., Sigala, I., Kinsella, T., Zakynthinos, S., Liu, L., Chen, J., Zhang, X., Liu, A., Guo, F., Liu, S., Yang, Y., Qiu, H., Grimaldi, D. G., Kaya, E., Acicbe, O., Kayaalp, I., Asar, S., Dogan, M., Eren, G., Hergunsel, O., Pavelescu, D., Grintescu, I., Mirea, L., Guanziroli, M., Gotti, M., Marino, A., Cressoni, M., Vergani, G., Chiurazzi, C., Chiumello, D., Gattinoni, L., Spano, S., Massaro, F., Moustakas, A., Johansson, S., Larsson, A., Perchiazzi, G., Zhang, X. W., Guo, F. M., Chen, J. X., Xue, M., Qiu, H. B., Yang, L., Fister, M., Knafelj, R., Suzer, M. A., Kavlak, M. E., Atalan, H. K., Gucyetmez, B., Cakar, N., Weller, D., Grootendorst, A. F., Dijkstra, A., Kuijper, T. M., Cleffken, B. I., Regli, A., De Keulenaer, B., Van Heerden, P., Hadfield, D., Hopkins, P. A., Penhaligon, B., Reid, F., Hart, N., Rafferty, G. F., Grasselli, G., Mauri, T., Lazzeri, M., Carlesso, E., Cambiaghi, B., Eronia, N., Maffezzini, E., Bronco, A., Abbruzzese, C., Rossi, N., Foti, G., Bellani, G., Pesenti, A., Bassi, G. Li, Panigada, M., Ranzani, O., Kolobow, T., Zanella, A., Berra, L., Parrini, V., Kandil, H., Salati, G., Livigni, S., Amatu, A., Girardis, M., Barbagallo, M., Moise, G., Mercurio, G., Costa, A., Vezzani, A., Lindau, S., Babel, J., Cavana, M., Torres, A., Ranzani, O. T., Umbrello, M., Taverna, M., Formenti, P., Mistraletti, G., Vetrone, F., Baisi, A., Garnero, A. G., Novotni, D. N., Arnal, J. A., Urner, M., Fan, E., Dres, M., Vorona, S., Brochard, L., Ferguson, N. D., Goligher, E. C., Leung, C., Joynt, G., Wong, W., Lee, A., Gomersall, C., Poels, S., Casaer, M., Schetz, M., Van den Berghe, G., Meyfroidt, G., Holzgraefe, B., Von Kobyletzki, L. B., Cianchi, G., Becherucci, F., Batacchi, S., Cozzolino, M., Franchi, F., Di Valvasone, S., Ferraro, M. C., Peris, A., Phiphitthanaban, H., Wacharasint, P., Wongsrichanalai, V., Lertamornpong, A., Pengpinij, O., Wattanathum, A., Oer-areemitr, N., Boddi, M., Cappellini, E., Ciapetti, M., Di Lascio, G., Bonizzoli, M., Lazzeri, C., Katsin, M. L., Hurava, M. Y., Dzyadzko, A. M., Hermann, A., Schellongowski, P., Bojic, A., Riss, K., Robak, O., Lamm, W., Sperr, W., Staudinger, T., Buoninsegni, L. Tadini, Parodo, J., Ottaviano, A., Cecci, L., Corsi, E., Ricca, V., de Garibay, A. Perez Ruiz, Ende-Schneider, B., Schreiber, C., Kreymann, B., Turani, F., Resta, M., Niro, D., Castaldi, P., Boscolo, G., Gonsales, G., Martini, S., Belli, A., Zamidei, L., Falco, M., Lamas, T., Mendes, J., Galazzi, A., Benco, B., Binda, F., Masciopinto, L., Lissoni, A., Adamini, I., Thamjamrassri, T., Watcharotayangul, J., Numthavaj, P., Kongsareepong, S., Higuera, J., Cabestrero, D., Rey, L., Narváez, G., Blandino, A., Aroca, M., Saéz, S., De Pablo, R., Mohamed, A., Sklar, M., Munshi, L., Alban, L., Turrini, C., Taccone, P., Marenghi, C., Spadaro, S., Volta, C., Alonso, D. Cabestrero, González, L. Rey, Franci, A., Stocchi, G., Cappuccini, G., Socci, F., Guetti, C., Rastrelli, P., Nestorowicz, A., Glapinski, J., Fijalkowska-Nestorowicz, A., Wosko, J., Duprez, F., Bonus, T., Cuvelier, G., Mashayekhi, S., Ollieuz, S., Reychler, G., Kuchyn, I., Bielka, K., Sergienko, A., Jones, H., Day, C., Park, S. C., Yeom, S. R., Myatra, S. N., Gupta, S., Rajnala, V., Divatia, J., Silva, J. Villalobos, Olvera, O. Aguilera, Schulte, R. Cavazos, Bermudez, M. Castañeda, Zorrilla, L. Pariente, Ferretis, H. Lopez, García, K. Trejo, Balciuniene, N., Ramsaite, J., Kriukelyte, O., Krikscionaitiene, A., Tamosuitis, T., Terragni, P., Brazzi, L., Falco, D., Pistidda, L., Magni, G., Bartoletti, L., Mascia, L., Filippini, C., Ranieri, V., Kyriakoudi, A., Rovina, N., Koltsida, O., Konstantellou, E., Kardara, M., Kostakou, E., Gavriilidis, G., Vasileiadis, I., Koulouris, N., Koutsoukou, A., Van Snippenburg, W., Kröner, A., Flim, M., Buise, M., Hemler, R., Spronk, P., Noffsinger, B., Singh, B., Hockings, L., Spina, C., Magni, F., Di Giambattista, C., Vargiolu, A., Citerio, G., Scaramuzzo, G., Waldmann, A. D., Böhm, S. H., Ragazzi, R., Volta, C. A., Heines, S. J., Strauch, U., Van de Poll, M. C., Roekaerts, P. M., Bergmans, D. C., Sosio, S., Gatti, S., Punzi, V., Asta, A., Mroczka, J., Yaroshetskiy, A. I, Rezepov, N. A., Mandel, I. A., Gelfand, B. R., Ozen, E., Karakoc, E., Ayyildiz, A., Kara, S., Ekemen, S., Yelken, B. Buyukkidan, Saasouh, W., Freeman, J., Turan, A., Hajjej, Z., Sellami, W., Bousselmi, M., Samoud, W., Gharsallah, H., Labbene, I., Ferjani, M., Vetrugno, L., Barbariol, F., Forfori, F., Regeni, I., Della Rocca, G., Jansen, D., Jonkman, A., Doorduin, J., Roesthuis, L., Van der Hoeven, J., Heunks, L., Marocco, S. Arrigoni, Bottiroli, M., Pinciroli, R., Galanti, V., Calini, A., Gagliardone, M., Fumagalli, R., Ippolito, D., Sala, V. L., Meroni, V., Elbanna, M., Nassar, Y., Abdelmohsen, A., Yahia, M., Mongodi, S., Mojoli, F., Via, G., Tavazzi, G., Fava, F., Pozzi, M., Iotti, G. A., Bouhemad, B., Ruiz-Ferron, F., Simón, J. Serrano, Gordillo-Resina, M., Chica-Saez, V., Garcia, M. Ruiz, Vela-Colmenero, R., Redondo-Orts, M., Gontijo-Coutinho, C., Ozahata, T., Nocera, P., Franci, D., Santos, T., Carvalho-Filho, M., Fochi, O., Nacoti, M., Signori, D., Bonacina, D., Bonanomi, E., Bonvecchio, E., Stella, A., Roldi, E., Orlando, A., Luperto, M., Trunfio, D., Licitra, G., Martinelli, R., Vannini, D., Giuliano, G., Näslund, E., Lindberg, L. G., Lund, I., Frithiof, R., Nichols, A., Pentakota, S., Kodali, B., Pranskunas, A., Kiudulaite, I., Simkiene, J., Damanskyte, D., Pranskuniene, Z., Arstikyte, J., Vaitkaitis, D., Pilvinis, V., Brazaitis, M., Pool, R., Haugaa, H., Botero, A., Escobar, D., Maberry, D., Tønnessen, T., Zuckerbraun, B., Pinsky, M., Gomez, H., Lyons, H., Trimmings, A., Domizi, R., Scorcella, C., Damiani, E., Pierantozzi, S., Tondi, S., Monaldi, V., Carletti, A., Zuccari, S., Adrario, E., Pelaia, P., Donati, A., Kazune, S., Grabovskis, A., Volceka, K., Rubins, U., Bol, M., Suverein, M., Delnoij, T., Driessen, R., Heines, S., Delhaas, T., Vd Poll, M., Sels, J., Jozwiak, M., Chambaz, M., Sentenac, P., Richard, C., Monnet, X., Teboul, J. L., Bitar, Z., Maadarani, O., Al Hamdan, R., Huber, W., Malbrain, M., Chew, M., Mallat, J., Tagami, T., Hundeshagen, S., Wolf, S., Mair, S., Schmid, R., Aron, J., Adlam, M., Dua, G., Mu, L., Chen, L., Yoon, J., Clermont, G., Dubrawski, A., Duhailib, Z., Al Assas, K., Shafquat, A., Salahuddin, N., Donaghy, J., Morgan, P., Valeanu, L., Stefan, M., Provenchere, S., Longrois, D., Shaw, A., Mythen, M. G., Shook, D., Hayashida, D., Munson, S. H., Sawyer, A., Mariyaselvam, M., Blunt, M., Young, P., Nakwan, N., Khwannimit, B., Checharoen, P., Berger, D., Moller, P., Bloechlinger, S., Bloch, A., Jakob, S., Takala, J., Van den Brule, J. M., Stolk, R., Vinke, E., Van Loon, L. M., Pickkers, P., Van der Hoeven, J. G., Kox, M., Hoedemaekers, C. W., Werner-Moller, P., Bertini, P., Guarracino, F., Colosimo, D., Gonnella, S., Brizzi, G., Mancino, G., Baldassarri, R., Pinsky, M. R., Amitrano, D., Goslar, T., Stajer, D., Radsel, P., De Vos, R., Dijk, N. Bussink-van, Stringari, G., Cogo, G., Devigili, A., Graziadei, M. Ceola, Bresadola, E., Lubli, P., Amella, S., Marani, F., Polati, E., Gottin, L., Colinas, L., Hernández, G., Vicho, R., Serna, M., Canabal, A., Cuena, R., Gimenez, J., Mercado, P., Depret, F., Sassi, K., Herner, A., Abded, N., Elghonemi, M., Monir, A., Nikhilesh, J., Apurv, T., Uber, A. U., Grossestreuer, A., Moskowitz, A., Patel, P., Holmberg, M. J., Donnino, M. W., Graham, C. A., Hung, K., Lo, R., Leung, L. Y., Lee, K. H., Yeung, C. Y., Chan, S. Y., Trembach, N., Zabolotskikh, I., Caldas, J., Panerai, R., Camara, L., Ferreira, G., Almeida, J., de Oliveira, G. Queiroz, Jardim, J., Bor-Seng-Shu, E., Lima, M., Nogueira, R., Jatene, F., Zeferino, S., Galas, F., Robinson, T., Hajjar, L. A., Oliveira, M., Norgueira, R., Groehs, R., Ferreira-Santos, L., Oliveira, G., Hajjar, L., Ribeiro, J., Gaiotto, F., Lisboa, L., Fukushima, J., Rizk, S., Osawa, E., Franco, R., Kalil, R., Chlabicz, M., Sobkowicz, B., Kaminski, K., Kazimierczyk, R., Musial, W., Tycińska, A., Siranovic, M., Gopcevic, A., Gavranovic, Z. G., Horvat, A. H., Krolo, H., Rode, B., Videc, L., Trifi, A., Abdellatif, S., Ismail, K. Ben, Bouattour, A., Daly, F., Nasri, R., Lakhal, S. Ben, Beurton, A., Girotto, V., Galarza, L., Guedj, T., Iliæ, M. Karaman, Sakic, L., NN, V., Stojcic, L., Alphonsine, J., Lai, C., Tapanwong, N., Chuntupama, P., Hoellthaler, J., Lahmer, T., Latham, H., Bengtson, C. D., Satterwhite, L., Stites, M., Simpson, S. Q., Skladzien, T., Cicio, M., Garlicki, J., Serednicki, W., Wordliczek, J., Vargas, P., Salazar, A., Espinoza, M., Graf, J., Kongpolprom, N., Sanguanwong, N., Jonnada, S., Gerrard, C., Jones, N., Morley, T., Thorburn, P. T., Musaeva, T., Horst, S., Lipcsey, M., Kawati, R., Pikwer, A., Rasmusson, J., Castegren, M., Shilova, A., Yafarova, A., Gilyarov, M., Stojiljkovic, D. L. Loncar, Ulici, A., Reidt, S., Lam, T., Jancik, J., Ragab, D., Taema, K., Farouk, W., Saad, M., Liu, X., Uber, A., Montissol, S., Donnino, M., Andersen, L. W., Perlikos, F., Lagiou, M., Papalois, A., Kroupis, C., Toumpoulis, I., Carter, D., Sardo, S., Landoni, G., Kongsayreepong, S., Sungsiri, R., Wongsripunetit, P., Marchio, P., Guerra-Ojeda, S., Gimeno-Raga, M., Mauricio, M. D., Valles, S. L., Aldasoro, C., Jorda, A., Aldasoro, M., Vila, J. M., Borg, U. B., Neitenbach, A. M., García, M., González, P. Guijo, Romero, M. Gracia, Orduña, P. Saludes, Cano, A. Gil, Rhodes, A., Grounds, R. M., Cecconi, M., Lee, C., Hatib, F., Jian, Z., Rinehart, J., De Los Santos, J., Canales, C., Cannesson, M., García, M. I. Monge, Scheeren, T., Chantziara, V., Vassi, A., Michaloudis, G., Sanidas, E., Golemati, S., Bateman, R. M., Mokhtar, A., Omar, W., Aziz, K. Abdel, El Azizy, H., Nielsen, D. L. Lykke, Holler, J. G., Lassen, A., Eriksson, M., Strandberg, G., Capoletto, C., Nakamura, R., Risk, S., Park, C., Dias, F., D’Arrigo, N., Fortuna, F., Redaelli, S., Zerman, L., Becker, L., Serrano, T., Cotes, L., Ramos, F., Fadel, L., Coelho, F., Mendes, C., Real, J., Pedron, B., Kuroki, M., Costa, E., and Azevedo, L.

Subjects
Critical Care and Intensive Care Medicine, Meeting Abstracts
Published
2017

5. Effects of tracheal orientation on development of ventilator-associated pneumonia: An experimental study

Author

Zanella, A, Cressoni, M, Epp, M, Hoffmann, V, Stylianou, M, Kolobow, T, ZANELLA, ALBERTO, Kolobow, T., Zanella, A, Cressoni, M, Epp, M, Hoffmann, V, Stylianou, M, Kolobow, T, ZANELLA, ALBERTO, and Kolobow, T.

Abstract

Purpose: Orientation of the trachea and tracheal tube below horizontal may prevent aspiration of oropharyngeal secretions into the lungs, which is a pivotal pathway in the pathogenesis of ventilator-associated pneumonia (VAP). The incidence of VAP was evaluated in swine with orientation of trachea and tracheal tube above horizontal (model of semirecumbent position, currently recommended in patients) and below horizontal. Methods: Twenty-six mini-pigs were randomized into four groups: (A) eight mechanically ventilated with orientation of trachea 45above horizontal for 72 h. In the remaining groups (B, C, D) the trachea was oriented 10below horizontal, with (B) six mechanically ventilated for 72 h, (C) six mechanically ventilated for 72 h with enteral feeding, and (D) six mechanically ventilated for 168 h with enteral feeding. At the end of the study period, all pigs were sacrificed and the clinical diagnosis of VAP was microbiologically evaluated. No antibiotics were administered. Results: All eight pigs kept orientated with the trachea 45above horizontal developed VAP and respiratory failure (PaO2/ FiO2 = 132 ± 139 mmHg) with a median of 5.5 pulmonary lobes out of 6 colonized with average colonization of 9.3 9 107 CFU/g. None of the 18 pigs kept oriented with the trachea below horizontal developed VAP; 16 had sterile lungs, while 2, ventilated for 7 days, developed a low level of colonization. Conclusions: Orientation of the trachea above horizontal was uniformly associated with VAP and respiratory failure; positioning the trachea below horizontal consistently prevented development of VAP.© Copyright jointly held by Springer and ESICM 2012.

Published
2012

6. DEVELOPMENT OF POST EXTUBATION PNEUMONIA: ROLE OF 24 HOURS OF ENDOTRACHEAL INTUBATION AND MECHANICAL VENTILATION. AN EXPERIMENTAL STUDY

Author

Zanella, A, Rezoagli, E, Cressoni, M, Ferlicca, D, Berra, L, Kolobow, T, European Society of Intensive Care Medicine, Zanella, A, Rezoagli, E, Cressoni, M, Ferlicca, D, Berra, L, and Kolobow, T

Subjects
vantilator asociated pneumonia, post-extubation pneumonia, mechanical ventilation, MED/41 - ANESTESIOLOGIA, experimental study, endotracheal intubation
Abstract

INTRODUCTION. Tracheal intubation is a major risk factor for nosocomial pneumonia, since microaspiration of bacterial colonized secretion across the endotracheal tube cuff is considered a primary pathogenetic way for ventilator associated pneumonia (VAP). OBJECTIVES. We hypothesized that 24 h of tracheal intubation would allow the access of a conspicuous bacterial load into the lower airways to enhance the onset of pneumonia in the post extubation period. METHODS. Fourteen sheep were randomized into two groups: 1. Seven were mechanically ventilated for 24 h (control group); 2. Seven were mechanically ventilated for 24 h and then were extubated and maintained in spontaneous ventilation for 48 h (awaken group). At the end of the study all the sheep underwent to microbiology and histology of the lung. No antibiotics were administered. RESULTS. In the control group one animal developed pneumonia during mechanical ventilation while five had heavily colonized lung (median of three lobes, colonization range: 1.09E + 05–1.38E + 09). In the awaken group one animal developed pneumonia during mechanical ventilation and three developed pneumonia during the 48 h following extubation (median of 4.5 lobes, colonization range: 2.8E + 05–1.8E + 09). Two animals had sterile lungs in the control group and three in the awaken group. CONCLUSIONS. Twenty-four hours of tracheal intubation can lead to colonization of the lower airways, even without any clinical signs. This colonization can precipitate the development of pneumonia after extubation.

Published
2012

7. Glottic-modulated lung ventilation during continuous transtracheal gas insufflation: an experimental study

Author

Patroniti, N, Verweij, M, Kolobow, T, Patroniti, NA, Kolobow, T., Patroniti, N, Verweij, M, Kolobow, T, Patroniti, NA, and Kolobow, T.

Abstract

We investigated a new method of pulmonary ventilation that included a minitracheostomy, a reverse thrust catheter to deliver continuous flow of gas to the carina, and a threshold valve to avoid lung overinflation. In six lightly sedated healthy sheep, at a continuous flow of 5, 10, or 15 L/min and a threshold valve of 5, 10, 15, or 20 cm H2O, we observed a novel respiratory pattern that was characterized either by active lung inflation followed by passive and prolonged inspiratory hold (mixed pattern) or by an absence of all active inspiratory effort and only passive inflation of the lungs (passive pattern). We correlated airway pressure changes with direct visualization of the glottic opening through a fiberoptic bronchoscope. We measured airway pressures at the level of the carina, the subglottic level, and in the pleural space, and respiratory events were monitored through inductive plethysmography. An increase in continuous flow, threshold valve, or both resulted in 1) an increase in glottic breathing; 2) a decrease in respiratory rate, with a decrease in inspiratory pleural pressure excursion; or 3) an increased inspiratory/expiratory ratio and mean airway pressure. During transtracheal gas insufflation, as in this study, a novel respiratory pattern evolved that was modulated by the glottis, accompanied by a decreased effort of breathing; coughing and swallowing remained, and vocalization remained unimpaired.

Published
2003

12. DEVELOPMENT OF POST EXTUBATION PNEUMONIA: ROLE OF 24 HOURS OF ENDOTRACHEAL INTUBATION AND MECHANICAL VENTILATION. AN EXPERIMENTAL STUDY

Author

European Society of Intensive Care Medicine, Zanella, A, Rezoagli, E, Cressoni, M, Ferlicca, D, Berra, L, Kolobow, T, European Society of Intensive Care Medicine, Zanella, A, Rezoagli, E, Cressoni, M, Ferlicca, D, Berra, L, and Kolobow, T

Abstract

INTRODUCTION. Tracheal intubation is a major risk factor for nosocomial pneumonia, since microaspiration of bacterial colonized secretion across the endotracheal tube cuff is considered a primary pathogenetic way for ventilator associated pneumonia (VAP). OBJECTIVES. We hypothesized that 24 h of tracheal intubation would allow the access of a conspicuous bacterial load into the lower airways to enhance the onset of pneumonia in the post extubation period. METHODS. Fourteen sheep were randomized into two groups: 1. Seven were mechanically ventilated for 24 h (control group); 2. Seven were mechanically ventilated for 24 h and then were extubated and maintained in spontaneous ventilation for 48 h (awaken group). At the end of the study all the sheep underwent to microbiology and histology of the lung. No antibiotics were administered. RESULTS. In the control group one animal developed pneumonia during mechanical ventilation while five had heavily colonized lung (median of three lobes, colonization range: 1.09E + 05–1.38E + 09). In the awaken group one animal developed pneumonia during mechanical ventilation and three developed pneumonia during the 48 h following extubation (median of 4.5 lobes, colonization range: 2.8E + 05–1.8E + 09). Two animals had sterile lungs in the control group and three in the awaken group. CONCLUSIONS. Twenty-four hours of tracheal intubation can lead to colonization of the lower airways, even without any clinical signs. This colonization can precipitate the development of pneumonia after extubation.

Published
2012

13. Comparison of a novel Lycra endotracheal tube cuff to standard polyvinyl chloride cuff and polyurethane cuff for fluid leak prevention

Author

Kolobow, T, Cressoni, M, Epp, M, Corti, I, Cadringher, P, Zanella, A, ZANELLA, ALBERTO, Kolobow, T, Cressoni, M, Epp, M, Corti, I, Cadringher, P, Zanella, A, and ZANELLA, ALBERTO

Abstract

BACKGROUND: A high-volume low-pressure endotracheal tube (ETT) cuff forms folds along its contact with the trachea, allowing mucus leakage into the lungs. We developed a thin-walled ETT cuff made of Lycra polyurethane. METHODS: In vitro, we tested 6 of each of the new prototype Lycra cuff, the Mallinkrodt Hi-Lo ETT (polyvinyl chloride cuff), and the Kimberly-Clark Microcuff ETT (polyurethane cuff), for leakage, in an acrylic mock trachea (inner diameter 20-mm), with a cuff inflation pressure of 20 cm H2O. We poured 15 mL of methylene-blue colored water into the acrylic tube above the cuff and observed for leakage for 24 hours. RESULTS: The Lycra cuffs had no folds upon inflation in the mock trachea and completely prevented fluid leakage for 24 hours (P<.001 vs the Hi-Lo and the Microcuff). The average leakage past the Hi-Lo was 1,182±1,321 mL/h. The average leakage past the Microcuff was 1.2 ± 0.4 mL/h (P <.001 vs the Hi-Lo). CONCLUSIONS: Our Lycra cuff provided complete tracheal sealing in vitro. © 2011 Daedalus Enterprises.

Published
2011

14. Decreasing pulmonary ventilation through bicarbonate ultrafiltration: An experimental study.

Author

Cressoni, M, Zanella, A, Epp, M, Corti, I, Patroniti, N, Kolobow, T, Pesenti, A, ZANELLA, ALBERTO, PATRONITI, NICOLO' ANTONINO, PESENTI, ANTONIO MARIA, Cressoni, M, Zanella, A, Epp, M, Corti, I, Patroniti, N, Kolobow, T, Pesenti, A, ZANELLA, ALBERTO, PATRONITI, NICOLO' ANTONINO, and PESENTI, ANTONIO MARIA

Abstract

OBJECTIVE:: To demonstrate the technical feasibility of CO2 removal with a commercial hemofilter and a replacement solution containing sodium hydroxide to replace bicarbonate. DESIGN:: Prospective animal experiment in sheep. SUBJECTS:: Seven mixed-breed female sheep. INTERVENTIONS:: Blood ultrafiltrate containing half of the metabolic production of CO2 was removed with a commercial hemofilter and a replacement solution containing sodium hydroxide was given as replacement. Minute ventilation was lowered to less than half of its baseline value. Ultrafiltration was stopped at 18 hrs, and Paco2 was allowed to increase for about 1 hr; at this time, the sheep were electively killed. MEASUREMENTS AND MAIN RESULTS:: Every 6 hrs, blood was sampled from the carotid artery, the pulmonary artery, and from the extracorporeal perfusion circuit (before the hemofilter, immediately after the hemofilter, and after mixing with the replacement solution). To maintain normocapnia, minute ventilation was reduced from 3.8 +/- 0.1 L/min to 1.9 +/- 0.7 L/min; Paco2 remained near constant during the study. The average blood pH, after mixing with the replacement solution, was 7.64 +/- 0.12. One hour after the ultrafiltration had stopped, Paco2 had increased from 36.7 +/- 4.2 torr (4.9 +/- 0.6 kPa) to 59.6 +/- 9 torr (7.9 +/- 1.2 kPa) (p < .01) and blood pH had decreased from 7.317 +/- 0.041 to 7.151 +/- 0.051 (p < .01). CONCLUSION:: CO2 removal with bicarbonate ultrafiltration may be an effective treatment for patients with respiratory failure.

Published
2009

16. Lethal systemic capillary leak syndrome associated with severe ventilator-induced lung injury: an experimental study

Author

Mandava, S, Kolobow, T, Vitale, G, Foti, G, Aprigliano, M, Jones, M, Müller, E, Müller, E., FOTI, GIUSEPPE, Mandava, S, Kolobow, T, Vitale, G, Foti, G, Aprigliano, M, Jones, M, Müller, E, Müller, E., and FOTI, GIUSEPPE

Abstract

Objective: We report the evolution of severe ventilator-induced lung injury associated with lethal systemic capillary leak syndrome, when sheep were ventilated at a peak inspiratory pressure of 50 cm H2O, at a respiratory rate of 8 breaths·min-1, with an inspiratory time of 2.5 secs. Design: A prospective laboratory animal study. Setting: Experimental animal research laboratory. Subjects: Mixed breed sheep. Interventions: Sheep were anesthetized, paralyzed, and mechanically ventilated. Measurements and Main Results: This sheep model was characterized by a rapidly evolving massive anasarca, hemoconcentration, cardiac dysfunction, multiple system organ failure, and severe ventilator-induced lung injury. Cardiovascular changes and profound hemoconcentration developed within 6 hrs from the start of mechanical ventilation, along with a major decline in pulmonary compliance and deterioration in arterial blood gases. When total static lung compliance decreased to 0.15 mL (cm H2O)-1·kg-1 (7-30 hrs), the sheep were randomized to two groups. Group I received high (recruitive) positive end-expiratory pressure (9-20 cm H2O), adjusted as needed; group II received low (supportive) positive end-expiratory pressure (2-6 cm H2O). Sheep in both groups progressively deteriorated and died with cardiocirculatory failure and multiple system organ failure within 12-24 hrs from start of treatment. Conclusions: This model of lethal systemic capillary leak syndrome with multiple system organ failure differs greatly from our previous sheep model of acute ventilator-induced lung injury in which sheep were ventilated with a peak inspiratory pressure of 50 cm H2O, a respiratory rate of 4 breaths·min-1, and an inspiratory time of 1.35 secs, without inducing capillary leak syndrome. The mere change of respiratory rate from 4 to 8 breaths·min-1, with a near doubling of the inspiratory time to 2.5 secs, although maintaining eucapnia, resulted in lethal systemic capillary leak syndrome and multiple s

Published
2003

35. Long-term cardiopulmonary bypass by peripheral cannulation in a model of total heart failure. The decompression of the left heart through a percutaneous helical spring positioned within the lumen of the tricuspid and pulmonary artery valves

Author

Rossi F, Kolobow T, giuseppe foti, Borelli M, and Mandava S

Subjects
Extracorporeal Circulation, Pulmonary Valve, Cardiopulmonary Bypass, Sheep, Cardiac Output, Low, Hemodynamics, Catheterization, Electrocardiography, Catheterization, Swan-Ganz, Ventricular Fibrillation, Pressure, Animals, Heart-Assist Devices, Tricuspid Valve
Abstract

We performed long-term closed-chest cardiopulmonary bypass in an animal model of total heart failure (induced ventricular fibrillation). The extracorporeal system included a venous reservoir, a roller pump, a membrane lung, and a blood pulsator system. We cannulated the right external jugular vein for venous drainage and the right subclavian artery for arterial return. To decompress the left heart we passed by percutaneous cannulation a special helical spring mounted on a Swan-Ganz catheter (Baxter Edwards Divisions, Irvine, Calif.) and positioned it to rest within the pulmonary artery and tricuspid valves, which rendered them partly incompetent. After induced ventricular fibrillation, blood flow was raised to keep the central venous pressure at baseline values. The lungs were ventilated with 5% carbon dioxide in room air. During bypass, mean pulmonary artery pressure was 10.0 +/- 1.7 mm Hg, mean wedge pressure 11.9 +/- 1.8 mm Hg, and mean blood pressure 95.2 +/- 5.6 mm Hg. After 2 days (four animals) and 3 days (two animals) the hearts were defibrillated. There was immediate ejection from both sides of the heart. All sheep were weaned from bypass within 29 +/- 11 minutes and their lungs were ventilated with room air within 42 +/- 34 minutes. At autopsy hearts and lungs grossly appeared normal. We conclude that the percutaneous helical spring resting within right heart valves provided excellent decompression throughout the study, with full recovery of heart and lung function on defibrillation.

Published
1990

Catalog

Books, media, physical & digital resources
See catalog results