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166 results on '"Maviglia, Riccardo"'

2. A novel risk score predicting 30-day hospital re-admission of patients with acute stroke by machine learning model

Author

Mercurio, Giovanna, Gottardelli, Benedetta, Lenkowicz, Jacopo, Patarnello, Stefano, Bellavia, Simone, Scala, Irene, Rizzo, Pierandrea, de Belvis, Antonio Giulio, Del Signore, Anna Benedetta, Maviglia, Riccardo, Bocci, Maria Grazia, Olivi, Alessandro, Franceschi, Francesco, Urbani, Andrea, Calabresi, Paolo, Valentini, Vincenzo, Antonelli, Massimo, Frisullo, Giovanni, Gottardelli, Benedetta (ORCID:0000-0002-2649-354X), Olivi, Alessandro (ORCID:0000-0002-4489-7564), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Urbani, Andrea (ORCID:0000-0001-9168-3174), Calabresi, Paolo (ORCID:0000-0003-0326-5509), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Mercurio, Giovanna, Gottardelli, Benedetta, Lenkowicz, Jacopo, Patarnello, Stefano, Bellavia, Simone, Scala, Irene, Rizzo, Pierandrea, de Belvis, Antonio Giulio, Del Signore, Anna Benedetta, Maviglia, Riccardo, Bocci, Maria Grazia, Olivi, Alessandro, Franceschi, Francesco, Urbani, Andrea, Calabresi, Paolo, Valentini, Vincenzo, Antonelli, Massimo, Frisullo, Giovanni, Gottardelli, Benedetta (ORCID:0000-0002-2649-354X), Olivi, Alessandro (ORCID:0000-0002-4489-7564), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Urbani, Andrea (ORCID:0000-0001-9168-3174), Calabresi, Paolo (ORCID:0000-0003-0326-5509), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), and Antonelli, Massimo (ORCID:0000-0003-3007-1670)

Abstract

Background: The 30-day hospital re-admission rate is a quality measure of hospital care to monitor the efficiency of the healthcare system. The hospital re-admission of acute stroke (AS) patients is often associated with higher mortality rates, greater levels of disability and increased healthcare costs. The aim of our study was to identify predictors of unplanned 30-day hospital re-admissions after discharge of AS patients and define an early re-admission risk score (RRS).Methods: This observational, retrospective study was performed on AS patients who were discharged between 2014 and 2019. Early re-admission predictors were identified by machine learning models. The performances of these models were assessed by receiver operating characteristic curve analysis.Results: Of 7599 patients with AS, 3699 patients met the inclusion criteria, and 304 patients (8.22%) were re-admitted within 30 days from discharge. After identifying the predictors of early re-admission by logistic regression analysis, RRS was obtained and consisted of seven variables: hemoglobin level, atrial fibrillation, brain hemorrhage, discharge home, chronic obstructive pulmonary disease, one and more than one hospitalization in the previous year. The cohort of patients was then stratified into three risk categories: low (RRS = 0-1), medium (RRS = 2-3) and high (RRS >3) with re-admission rates of 5%, 8% and 14%, respectively.Conclusions: The identification of risk factors for early re-admission after AS and the elaboration of a score to stratify at discharge time the risk of re-admission can provide a tool for clinicians to plan a personalized follow-up and contain healthcare costs.

Published
2024

3. Gas conditioning during helmet noninvasive ventilation: effect on comfort, gas exchange, inspiratory effort, transpulmonary pressure and patient–ventilator interaction

Author

Bongiovanni, Filippo, Grieco, Domenico Luca, Anzellotti, Gian Marco, Menga, Luca Salvatore, Michi, Teresa, Cesarano, Melania, Raggi, Valeria, De Bartolomeo, Cecilia, Mura, Benedetta, Mercurio, Giovanna, D’Arrigo, Sonia, Bello, Giuseppe, Maviglia, Riccardo, Pennisi, Mariano Alberto, and Antonelli, Massimo

Published
2021
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4. A novel risk score predicting 30‐day hospital re‐admission of patients with acute stroke by machine learning model

Author

Mercurio, Giovanna, primary, Gottardelli, Benedetta, additional, Lenkowicz, Jacopo, additional, Patarnello, Stefano, additional, Bellavia, Simone, additional, Scala, Irene, additional, Rizzo, Pierandrea, additional, de Belvis, Antonio Giulio, additional, Del Signore, Anna Benedetta, additional, Maviglia, Riccardo, additional, Bocci, Maria Grazia, additional, Olivi, Alessandro, additional, Franceschi, Francesco, additional, Urbani, Andrea, additional, Calabresi, Paolo, additional, Valentini, Vincenzo, additional, Antonelli, Massimo, additional, and Frisullo, Giovanni, additional

Published
2023
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6. Long-term outcome of COVID-19 patients treated with helmet noninvasive ventilation vs. high-flow nasal oxygen: a randomized trial

Author

Michi, Teresa, Mattana, Chiara, Menga, Luca Salvatore, Bocci, Maria Grazia, Cesarano, Melania, Rosà, Tommaso, Gualano, Maria Rosaria, Montomoli, Jonathan, Spadaro, Savino, Tosato, Matteo, Rota, Elisabetta, Landi, Francesco, Cutuli, Salvatore Lucio, Tanzarella, Eloisa S., Pintaudi, Gabriele, Piervincenzi, Edoardo, Bello, Giuseppe, Tonetti, Tommaso, Rucci, Paola, De Pascale, Gennaro, Maggiore, Salvatore M., Grieco, Domenico Luca, Conti, Giorgio, Antonelli, Massimo, Maviglia, Riccardo, Mercurio, Giovanna, De Santis, Paolo, Pennisi, Mariano Alberto, Anzellotti, Gian Marco, Torrini, Flavia, Rubino, Carlotta, Morena, Tony Christian, Gennenzi, Veronica, Postorino, Stefania, Vargas, Joel, Filetici, Nicoletta, Settanni, Donatella, Durante, Miriana, Cascarano, Laura, Di Muro, Mariangela, Scarascia, Roberta, Bitondo, Maria Maddalena, Murdolo, Martina, Mele, Alessandro, Silva, Serena, Zaccone, Carmelina, Pozzana, Francesca, Maccaglia, Alessio, Savino, Martina, Potalivo, Antonella, Ceccaroni, Francesca, Scavone, Angela, Lombardi, Gianmarco, Montini, Luca, Dell'Anna, Antonio Maria, Volta, Carlo Alberto, Ranieri, Vito M., Falò, Giulia, Carelli, Simone, Natalini, Daniele, Berardi, Cecilia, Delle Cese, Luca, Vetrugno, Luigi, Balzani, Eleonora, Null, Null, Menga, Luca S., Landi, Francesco (ORCID:0000-0002-3472-1389), Cutuli, Salvatore L., Bello, Giuseppe (ORCID:0000-0003-2648-7235), De Pascale, Gennaro (ORCID:0000-0002-8255-0676), Grieco, Domenico Luca (ORCID:0000-0002-4557-6308), Conti, Giorgio (ORCID:0000-0002-8566-9365), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Pennisi, Mariano Alberto (ORCID:0000-0001-8761-5144), Morena, Tony C., Montini, Luca (ORCID:0000-0003-4602-5134), Dell’Anna, Antonio Maria, Michi, Teresa, Mattana, Chiara, Menga, Luca Salvatore, Bocci, Maria Grazia, Cesarano, Melania, Rosà, Tommaso, Gualano, Maria Rosaria, Montomoli, Jonathan, Spadaro, Savino, Tosato, Matteo, Rota, Elisabetta, Landi, Francesco, Cutuli, Salvatore Lucio, Tanzarella, Eloisa S., Pintaudi, Gabriele, Piervincenzi, Edoardo, Bello, Giuseppe, Tonetti, Tommaso, Rucci, Paola, De Pascale, Gennaro, Maggiore, Salvatore M., Grieco, Domenico Luca, Conti, Giorgio, Antonelli, Massimo, Maviglia, Riccardo, Mercurio, Giovanna, De Santis, Paolo, Pennisi, Mariano Alberto, Anzellotti, Gian Marco, Torrini, Flavia, Rubino, Carlotta, Morena, Tony Christian, Gennenzi, Veronica, Postorino, Stefania, Vargas, Joel, Filetici, Nicoletta, Settanni, Donatella, Durante, Miriana, Cascarano, Laura, Di Muro, Mariangela, Scarascia, Roberta, Bitondo, Maria Maddalena, Murdolo, Martina, Mele, Alessandro, Silva, Serena, Zaccone, Carmelina, Pozzana, Francesca, Maccaglia, Alessio, Savino, Martina, Potalivo, Antonella, Ceccaroni, Francesca, Scavone, Angela, Lombardi, Gianmarco, Montini, Luca, Dell'Anna, Antonio Maria, Volta, Carlo Alberto, Ranieri, Vito M., Falò, Giulia, Carelli, Simone, Natalini, Daniele, Berardi, Cecilia, Delle Cese, Luca, Vetrugno, Luigi, Balzani, Eleonora, Null, Null, Menga, Luca S., Landi, Francesco (ORCID:0000-0002-3472-1389), Cutuli, Salvatore L., Bello, Giuseppe (ORCID:0000-0003-2648-7235), De Pascale, Gennaro (ORCID:0000-0002-8255-0676), Grieco, Domenico Luca (ORCID:0000-0002-4557-6308), Conti, Giorgio (ORCID:0000-0002-8566-9365), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Pennisi, Mariano Alberto (ORCID:0000-0001-8761-5144), Morena, Tony C., Montini, Luca (ORCID:0000-0003-4602-5134), and Dell’Anna, Antonio Maria

Abstract

BackgroundLong-term outcomes of patients treated with helmet noninvasive ventilation (NIV) are unknown: safety concerns regarding the risk of patient self-inflicted lung injury and delayed intubation exist when NIV is applied in hypoxemic patients. We assessed the 6-month outcome of patients who received helmet NIV or high-flow nasal oxygen for COVID-19 hypoxemic respiratory failure.MethodsIn this prespecified analysis of a randomized trial of helmet NIV versus high-flow nasal oxygen (HENIVOT), clinical status, physical performance (6-min-walking-test and 30-s chair stand test), respiratory function and quality of life (EuroQoL five dimensions five levels questionnaire, EuroQoL VAS, SF36 and Post-Traumatic Stress Disorder Checklist for the DSM) were evaluated 6 months after the enrollment.ResultsAmong 80 patients who were alive, 71 (89%) completed the follow-up: 35 had received helmet NIV, 36 high-flow oxygen. There was no inter-group difference in any item concerning vital signs (N = 4), physical performance (N = 18), respiratory function (N = 27), quality of life (N = 21) and laboratory tests (N = 15). Arthralgia was significantly lower in the helmet group (16% vs. 55%, p = 0.002). Fifty-two percent of patients in helmet group vs. 63% of patients in high-flow group had diffusing capacity of the lungs for carbon monoxide < 80% of predicted (p = 0.44); 13% vs. 22% had forced vital capacity < 80% of predicted (p = 0.51). Both groups reported similar degree of pain (p = 0.81) and anxiety (p = 0.81) at the EQ-5D-5L test; the EQ-VAS score was similar in the two groups (p = 0.27). Compared to patients who successfully avoided invasive mechanical ventilation (54/71, 76%), intubated patients (17/71, 24%) had significantly worse pulmonary function (median diffusing capacity of the lungs for carbon monoxide 66% [Interquartile range: 47-77] of predicted vs. 80% [71-88], p = 0.005) and decreased quality of life (EQ-VAS: 70 [53-70] vs. 80 [70-83], p = 0.01).ConclusionsIn

Published
2023

9. Polymyxin-B hemoperfusion in septic patients: analysis of a multicenter registry

Author

Cutuli, Salvatore Lucio, Artigas, Antonio, Fumagalli, Roberto, Monti, Gianpaola, Ranieri, Vito Marco, Ronco, Claudio, Antonelli, Massimo, Maviglia, Riccardo, Cicconi, Sandra, Silvestri, Davide, Bello, Giuseppe, Brendolan, Alessandra, Nalesso, Federico, Villa, Gianluca, Piccinni, Pasquale, Martin, Erica, Cantaluppi, Vincenzo, Vesconi, Sergio, Casella, Giampaolo, Fasanella, Egidio, Debitonto, Michele, Monza, Gianmario, Blasetti, Angelo, Coletta, Rosaria, D’Ambrosio, Michele, Cinnella, Gilda, Murino, Patrizia, Piscitelli, Eugenio, Centonze, Gaetano, Cucurachi, Marco, Altieri, Giuseppe, Leonardo, Vincenzo, Idra, Anna Sara, del Rosso, Goffredo, Polidoro, Maria, Stigliano, Nicola, Pittella, Giuseppe, Paternoster, Gianluca, Pulito, Giuseppe, Puscio, Daniela, Cingolani, Diego, Falzetti, Gabriele, Vecchiarelli, Pietro, Giunta, Francesco, Forfori, Francesco, Castiglione, Giacomo, Greco, Stefano, Capra, Carlo, Crema, Luciano, Tamayo, Leonor, Urbano, Cristina, Pezza, Brunello, Zarrillo, Nadia, di Monaco, Pasquale, Climaco, Giuseppe, de Negri, Pasquale, Modano, Pasqualina, Pagliarulo, Riccardo, Petrillo, Claudio, Stripoli, Tania, Oggioni, Roberto, Campiglia, Laura, Valletta, Anna Rita, Lugano, Manuela, Milella, Domenico, Micucci, Laura, Reist, Ursula, Ensner, Rolf, Gianbarba, Christian, Brander, Lukas, Paul, Rajib, Crawla, Rajesh, Jasujia, Sanjeev, Pande, Rajesh, Dileep, Pratibha, Sundar, Sankaran, Ganesan, Raju, Dewan, Sandeep, Nangia, Vivek, Mani, Raj Kumar, Singh, Omender, Sathe, Pracee, Sachin, Gupta, D’Costa, Pradeep M., Srivanas, Samavedam, Singh, Yogendra Pal, Doi, Kent, Taki, Fumika, Roca, Ricard Ferrer, Medina, Eduardo Romay, Gernacho, Josè, Martí, Francisco, Martinez-Ruiz, Alberto, Martinez-Sagasti, Fernando, Crespo, Rafael Zaragoza, Torti, Paola, Terzi, Valeria, and The EUPHAS 2 Collaborative Group

Published
2016
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13. Machine Learning and Antibiotic Management

Author

Maviglia, Riccardo, Michi, Teresa, Passaro, Davide, Raggi, Valeria, Bocci, Maria Grazia, Piervincenzi, Edoardo, Mercurio, Giovanna, Lucente, Monica Christine, Murri, Rita, Lucente, Monica, Murri, Rita (ORCID:0000-0003-4263-7854), Maviglia, Riccardo, Michi, Teresa, Passaro, Davide, Raggi, Valeria, Bocci, Maria Grazia, Piervincenzi, Edoardo, Mercurio, Giovanna, Lucente, Monica Christine, Murri, Rita, Lucente, Monica, and Murri, Rita (ORCID:0000-0003-4263-7854)

Abstract

Machine learning and cluster analysis applied to the clinical setting of an intensive care unit can be a valuable aid for clinical management, especially with the increasing complexity of clinical monitoring. Providing a method to measure clinical experience, a proxy for that automatic gestalt evaluation that an experienced clinician sometimes effortlessly, but often only after long, hard consideration and consultation with colleagues, relies upon for decision making, is what we wanted to achieve with the application of machine learning to antibiotic therapy and clinical monitoring in the present work. This is a single-center retrospective analysis proposing methods for evaluation of vitals and antimicrobial therapy in intensive care patients. For each patient included in the present study, duration of antibiotic therapy, consecutive days of treatment and type and combination of antimicrobial agents have been assessed and considered as single unique daily record for analysis. Each parameter, composing a record was normalized using a fuzzy logic approach and assigned to five descriptive categories (fuzzy domain sub-sets ranging from "very low" to "very high"). Clustering of these normalized therapy records was performed, and each patient/day was considered to be a pertaining cluster. The same methodology was used for hourly bed-side monitoring. Changes in patient conditions (monitoring) can lead to a shift of clusters. This can provide an additional tool for assessing progress of complex patients. We used Fuzzy logic normalization to descriptive categories of parameters as a form nearer to human language than raw numbers.

Published
2022

14. Machine Learning and Antibiotic Management

Author

Maviglia, Riccardo, primary, Michi, Teresa, additional, Passaro, Davide, additional, Raggi, Valeria, additional, Bocci, Maria Grazia, additional, Piervincenzi, Edoardo, additional, Mercurio, Giovanna, additional, Lucente, Monica, additional, and Murri, Rita, additional

Published
2022
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15. Phenotypes of Patients with COVID-19 Who Have a Positive Clinical Response to Helmet Noninvasive Ventilation

Author

Grieco, Domenico Luca, primary, Menga, Luca S., additional, Cesarano, Melania, additional, Spadaro, Savino, additional, Bitondo, Maria Maddalena, additional, Berardi, Cecilia, additional, Rosà, Tommaso, additional, Bongiovanni, Filippo, additional, Maggiore, Salvatore Maurizio, additional, Antonelli, Massimo, additional, Montomoli, Jonathan, additional, Falò, Giulia, additional, Tonetti, Tommaso, additional, Cutuli, Salvatore L., additional, Pintaudi, Gabriele, additional, Tanzarella, Eloisa S., additional, Piervincenzi, Edoardo, additional, Dell’Anna, Antonio M., additional, Delle Cese, Luca, additional, Carelli, Simone, additional, Bocci, Maria Grazia, additional, Montini, Luca, additional, Bello, Giuseppe, additional, Natalini, Daniele, additional, De Pascale, Gennaro, additional, Velardo, Matteo, additional, Volta, Carlo Alberto, additional, Ranieri, V. Marco, additional, Conti, Giorgio, additional, Maviglia, Riccardo, additional, Mercurio, Giovanna, additional, De Santis, Paolo, additional, Pennisi, Mariano Alberto, additional, Anzellotti, Gian Marco, additional, Torrini, Flavia, additional, Rubino, Carlotta, additional, Morena, Tony C., additional, Gennenzi, Veronica, additional, Postorino, Stefania, additional, Vargas, Joel, additional, Filetici, Nicoletta, additional, Settanni, Donatella, additional, Durante, Miriana, additional, Cascarano, Laura, additional, Di Muro, Mariangela, additional, Scarascia, Roberta, additional, Murdolo, Martina, additional, Mele, Alessandro, additional, Silva, Serena, additional, Zaccone, Carmelina, additional, Pozzana, Francesca, additional, Maccaglia, Alessio, additional, Savino, Martina, additional, Potalivo, Antonella, additional, Ceccaroni, Francesca, additional, Scavone, Angela, additional, Lombardi, Gianmarco, additional, and Michi, Teresa, additional

Published
2022
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16. A machine-learning parsimonious multivariable predictive model of mortality risk in patients with Covid-19

Author

Murri, Rita, Lenkowicz, Jacopo, Masciocchi, Carlotta, Iacomini, C., Fantoni, Massimo, Damiani, Andrea, Marchetti, A., Sergi, P. D. A., Arcuri, G., Cesario, Alfredo, Patarnello, S., Antonelli, Massimo, Bellantone, Rocco Domenico Alfonso, Bernabei, Roberto, Boccia, Stefania, Calabresi, Paolo, Cambieri, Andrea, Cauda, Roberto, Colosimo, Cesare, Crea, Filippo, De Maria Marchiano, Ruggero, De Stefano, Valerio, Franceschi, Francesco, Gasbarrini, Antonio, Parolini, Ornella, Richeldi, Luca, Sanguinetti, Maurizio, Urbani, Andrea, Zega, Maurizio, Scambia, Giovanni, Valentini, Vincenzo, Armuzzi, Alessandro, Barba, Marta, Baroni, Silvia, Bellesi, Silvia, Bentivoglio, Anna Rita, Biasucci, Luigi Marzio, Biscetti, Federico, Candelli, Marcello, Capalbo, Gennaro, Cattani, P., Chiusolo, Patrizia, Cingolani, Antonella, Corbo, Giuseppe Maria, Covino, Marcello, Cozzolino, A. M., D'Alfonso, Maria Elena, De Angelis, G., De Pascale, Gennaro, Frisullo, Giovanni, Gabrielli, M., Gambassi, Giovanni, Garcovich, M., Gremese, Elisa, Grieco, D. L., Iaconelli, A., Iorio, Raffaele, Landi, Francesco, Larici, Anna Rita, Liuzzo, Giovanna, Maviglia, Riccardo, Miele, Luca, Montalto, Massimo, Natale, Luigi, Nicolotti, Nicola, Ojetti, Veronica, Pompili, Maurizio, Posteraro, Brunella, Rapaccini, Gian Ludovico, Rinaldi, R., Rossi, E., Santoliquido, Angelo, Sica, Simona, Tamburrini, Enrica, Teofili, Luciana, Testa, A., Tosoni, A., Trani, Carlo, Varone, Francesco, and Verme, L. Z. D.

Subjects
Male, medicine.medical_specialty, Multivariate analysis, Science, Youden's J statistic, Rome, Cross-validation, Article, Cohort Studies, Machine Learning, Models, Internal medicine, medicine, 80 and over, Humans, Hospital Mortality, Pandemics, Aged, Aged, 80 and over, Multidisciplinary, Framingham Risk Score, Models, Statistical, business.industry, SARS-CoV-2, COVID-19, Emergency department, Statistical, Middle Aged, Blood Cell Count, Oxygen, Quartile, Risk factors, ROC Curve, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Multivariate Analysis, Absolute neutrophil count, Medicine, Female, business, Blood Chemical Analysis, Cohort study
Abstract

The COVID-19 pandemic is impressively challenging the healthcare system. Several prognostic models have been validated but few of them are implemented in daily practice. The objective of the study was to validate a machine-learning risk prediction model using easy-to-obtain parameters to help to identify patients with COVID-19 who are at higher risk of death. The training cohort included all patients admitted to Fondazione Policlinico Gemelli with COVID-19 from March 5, 2020, to November 5, 2020. Afterward, the model was tested on all patients admitted to the same hospital with COVID-19 from November 6, 2020, to February 5, 2021. The primary outcome was in-hospital case-fatality risk. The out-of-sample performance of the model was estimated from the training set in terms of Area under the Receiving Operator Curve (AUROC) and classification matrix statistics by averaging the results of fivefold cross validation repeated 3-times and comparing the results with those obtained on the test set. An explanation analysis of the model, based on the SHapley Additive exPlanations (SHAP), is also presented. To assess the subsequent time evolution, the change in paO2/FiO2 (P/F) at 48 h after the baseline measurement was plotted against its baseline value. Among the 921 patients included in the training cohort, 120 died (13%). Variables selected for the model were age, platelet count, SpO2, blood urea nitrogen (BUN), hemoglobin, C-reactive protein, neutrophil count, and sodium. The results of the fivefold cross-validation repeated 3-times gave AUROC of 0.87, and statistics of the classification matrix to the Youden index as follows: sensitivity 0.840, specificity 0.774, negative predictive value 0.971. Then, the model was tested on a new population (n = 1463) in which the case-fatality rate was 22.6%. The test model showed AUROC 0.818, sensitivity 0.813, specificity 0.650, negative predictive value 0.922. Considering the first quartile of the predicted risk score (low-risk score group), the case-fatality rate was 1.6%, 17.8% in the second and third quartile (high-risk score group) and 53.5% in the fourth quartile (very high-risk score group). The three risk score groups showed good discrimination for the P/F value at admission, and a positive correlation was found for the low-risk class to P/F at 48 h after admission (adjusted R-squared = 0.48). We developed a predictive model of death for people with SARS-CoV-2 infection by including only easy-to-obtain variables (abnormal blood count, BUN, C-reactive protein, sodium and lower SpO2). It demonstrated good accuracy and high power of discrimination. The simplicity of the model makes the risk prediction applicable for patients in the Emergency Department, or during hospitalization. Although it is reasonable to assume that the model is also applicable in not-hospitalized persons, only appropriate studies can assess the accuracy of the model also for persons at home.

Published
2021

21. COVID-19 and intestinal inflammation: Role of fecal calprotectin

Author

Abbate, Valeria, Acampora, Nicola, Addolorato, Giovanni, Agostini, Fabiana, Ainora, Maria Elena, Akacha, Karim, Amato, Elena, Andreani, Francesca, Andriollo, Gloria, Annetta, Maria Giuseppina, Annicchiarico, Brigida Eleonora, Antonelli, Mariangela, Antonucci, Gabriele, Anzellotti, Gian Marco, Armuzzi, Alessandro, Baldi, Fabiana, Barattucci, Ilaria, Barillaro, Christian, Barone, Fabiana, Bellantone, Rocco Domenico Alfonso, Bellieni, Andrea, Bello, Giuseppe, Benicchi, Andrea, Benvenuto, Francesca, Berardini, Ludovica, Berloco, Filippo, Bernabei, Roberto, Bianchi, Antonio, Biasucci, Daniele Guerino, Biasucci, Luigi Marzio, Bibbò, Stefano, Bini, Alessandra, Bisanti, Alessandra, Biscetti, Federico, Bocci, Maria Grazia, Bonadia, Nicola, Bongiovanni, Filippo, Borghetti, Alberto, Bosco, Giulia, Bosello, Silvia, Bove, Vincenzo, Bramato, Giulia, Brandi, Vincenzo, Bruni, Teresa, Bruno, Carmine, Bruno, Dario, Bungaro, Maria Chiara, Buonomo, Alessandro, Burzo, Livia, Calabrese, Angelo, Calvello, Maria Rosaria, Cambieri, Andrea, Cambise, Chiara, Cammà, Giulia, Candelli, Marcello, Canistro, Gennaro, Cantanale, Antonello, Capalbo, Gennaro, Capaldi, Lorenzo, Capone, Emanuele, Capristo, Esmeralda, Carbone, Luigi, Cardone, Silvia, Carelli, Simone, Carfì, Angelo, Carnicelli, Annamaria, Caruso, Cristiano, Casciaro, Francesco Antonio, Catalano, Lucio, Cauda, Roberto, Cecchini, Andrea Leonardo, Cerrito, Lucia, Cesarano, Melania, Chiarito, Annalisa, Cianci, Rossella, Cicchinelli, Sara, Ciccullo, Arturo, Cicetti, Marta, Ciciarello, Francesca, Cingolani, Antonella, Cipriani, Maria Camilla, Consalvo, Maria Ludovica, Coppola, Gaetano, Corbo, Giuseppe Maria, Corsello, Andrea, Costante, Federico, Costanzi, Matteo, Covino, Marcello, Crupi, Davide, Cutuli, Salvatore Lucio, D'Addio, Stefano, D'Alessandro, Alessia, D'AlfonsoD'Angelo, Maria ElenaEmanuela, D'Aversa, Francesca, Damiano, Fernando, De Berardinis, Gian Maria, De Cunzo, Tommaso, De Gaetano, Donati Katleen, De Luca, Giulio, De Matteis, Giuseppe, De Pascale, Gennaro, De Santis, Paolo, De Siena, Martina, De Vito, Francesco, Del Gatto, Valeria, Del Giacomo, Paola, Del Zompo, Fabio, Dell'Anna, Antonio Maria, Polla, Davide Della, Di Gialleonardo, Luca, Di Giambenedetto, Simona, Di Luca, Roberta, Di Maurizio, Luca, Di Muro, Mariangela, Dusina, Alex, Eleuteri, Davide, Esperide, Alessandra, Fachechi, Daniele, Faliero, Domenico, Falsiroli, Cinzia, Fantoni, Massimo, Fedele, Annalaura, Feliciani, Daniela, Ferrante, Cristina, Ferrone, Giuliano, Festa, Rossano, Fiore, Maria Chiara, Flex, Andrea, Forte, Evelina, Franceschi, Francesco, Francesconi, Alessandra, Franza, Laura, Funaro, Barbara, Fuorlo, Mariella, Fusco, Domenico, Gabrielli, Maurizio, Gaetani, Eleonora, Galletta, Claudia, Gallo, Antonella, Gambassi, Giovanni, Garcovich, Matteo, Gasbarrini, Antonio, Gasparrini, Irene, Gelli, Silvia, Giampietro, Antonella, Gigante, Laura, Giuliano, Gabriele, Giuliano, Giorgia, Giupponi, Bianca, Gremese, Elisa, Grieco, Domenico Luca, Guerrera, Manuel, Guglielmi, Valeria, Guidone, Caterina, Gullì, Antonio, Iaconelli, Amerigo, Iafrati, Aurora, Ianiro, Gianluca, Iaquinta, Angela, Impagnatiello, Michele, Inchingolo, Riccardo, Intini, Enrica, Iorio, Raffaele, Izzi, Immacolata Maria, Jovanovic, Tamara, Kadhim, Cristina, La Macchia, Rosa, La Milia, Daniele Ignazio, Landi, Francesco, Landi, Giovanni, Landi, Rosario, Landolfi, Raffaele, Leo, Massimo, Leone, Paolo Maria, Levantesi, Laura, Liguori, Antonio, Liperoti, Rosa, Lizzio, Marco Maria, Monaco, Maria Rita Lo, Locantore, Pietro, Lombardi, Francesco, Lombardi, Gianmarco, Lopetuso, Loris, Loria, Valentina, Losito, Angela Raffaella, Lucia, Mothanje Barbara Patricia, Macagno, Francesco, Macerola, Noemi, Maggi, Giampaolo, Maiuro, Giuseppe, Mancarella, Francesco, Mangiola, Francesca, Manno, Alberto, Marchesini, Debora, Maresca, Gian Marco, Marrone, Giuseppe, Martis, Ilaria, Martone, Anna Maria, Marzetti, Emanuele, Mattana, Chiara, Matteo, Maria Valeria, Maviglia, Riccardo, Mazzarella, Ada, Memoli, Carmen, Miele, Luca, Migneco, Alessio, Mignini, Irene, Milani, Alessandro, Milardi, Domenico, Montalto, Massimo, Montemurro, Giuliano, Monti, Flavia, Montini, Luca, Morena, Tony Christian, Morra, Vincenzina, Morretta, Chiara, Moschese, Davide, Murace, Celeste Ambra, Murdolo, Martina, Murri, Rita, Napoli, Marco, Nardella, Elisabetta, Natalello, Gerlando, Natalini, Daniele, Navarra, Simone Maria, Nesci, Antonio, Nicoletti, Alberto, Nicoletti, Rocco, Nicoletti, Tommaso Filippo, Nicolò, Rebecca, Nicolotti, Nicola, Nista, Enrico Celestino, Nuzzo, Eugenia, Oggiano, Marco, Ojetti, Veronica, Pagano, Francesco Cosimo, Paiano, Gianfranco, Pais, Cristina, Pallavicini, Federico, Palombo, Andrea, Paolillo, Federico, Papa, Alfredo, Papanice, Domenico, Papparella, Luigi Giovanni, Paratore, Mattia, Parrinello, Giuseppe, Pasciuto, Giuliana, Pasculli, Pierpaolo, Pecorini, Giovanni, Perniola, Simone, Pero, Erika, Petricca, Luca, Petrucci, Martina, Picarelli, Chiara, Piccioni, Andrea, Piccolo, Annalisa, Piervincenzi, Edoardo, Pignataro, Giulia, Pignataro, Raffaele, Pintaudi, Gabriele, Pisapia, Luca, Pizzoferrato, Marco, Pizzolante, Fabrizio, Pola, Roberto, Policola, Caterina, Pompili, Maurizio, Pontecorvi, Flavia, Pontecorvi, Valerio, Ponziani, Francesca, Popolla, Valentina, Porceddu, Enrica, Porfidia, Angelo, Porro, Lucia Maria, Potenza, Annalisa, Pozzana, Francesca, Privitera, Giuseppe, Pugliese, Daniela, Pulcini, Gabriele, Racco, Simona, Raffaelli, Francesca, Ramunno, Vittoria, Rapaccini, Gian Ludovico, Richeldi, Luca, Rinninella, Emanuele, Rocchi, Sara, Romanò, Bruno, Romano, Stefano, Rosa, Federico, Rossi, Laura, Rossi, Raimondo, Rossini, Enrica, Rota, Elisabetta, Rovedi, Fabiana, Rubino, Carlotta, Rumi, Gabriele, Russo, Andrea, Sabia, Luca, Salerno, Andrea, Salini, Sara, Salvatore, Lucia, Samori, Dehara, Sandroni, Claudio, Sanguinetti, Maurizio, Santarelli, Luca, Santini, Paolo, Santolamazza, Danilo, Santoliquido, Angelo, Santopaolo, Francesco, Santoro, Michele Cosimo, Sardeo, Francesco, Sarnari, Caterina, Saviano, Angela, Saviano, Luisa, Scaldaferri, Franco, Scarascia, Roberta, Schepis, Tommaso, Schiavello, Francesca, Scoppettuolo, Giancarlo, Sedda, Davide, Sessa, Flaminio, Sestito, Luisa, Settanni, Carlo, Siciliano, Matteo, Siciliano, Valentina, Sicuranza, Rossella, Simeoni, Benedetta, Simonetti, Jacopo, Smargiassi, Andrea, Soave, Paolo Maurizio, Sonnino, Chiara, Staiti, Domenico, Stella, Claudia, Stella, Leonardo, Stival, Eleonora, Taddei, Eleonora, Talerico, Rossella, Tamburello, Elio, Tamburrini, Enrica, Tanzarella, Eloisa Sofia, Tarascio, Elena, Tarli, Claudia, Tersali, Alessandra, Tilli, Pietro, Timpano, Jacopo, Torelli, Enrico, Torrini, Flavia, Tosato, Matteo, Tosoni, Alberto, Tricoli, Luca, Tritto, Marcello, Tumbarello, Mario, Tummolo, Anita Maria, Vallecoccia, Maria Sole, Valletta, Federico, Varone, Francesco, Vassalli, Francesco, Ventura, Giulio, Verardi, Lucrezia, Vetrone, Lorenzo, Vetrugno, Giuseppe, Visconti, Elena, Visconti, Felicia, Viviani, Andrea, Zaccaria, Raffaella, Zaccone, Carmelina, Zelano, Lorenzo, Dal Verme, Lorenzo Zileri, Zuccalà, Giuseppe, and Troiani, Eliana

Published
2020
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23. Thromboelastography clot strength profiles and effect of systemic anticoagulation in COVID-19 acute respiratory distress syndrome: a prospective, observational study

Author

Bocci, Maria Grazia, Maviglia, Riccardo, Consalvo, Ludovica Maria, Domenico Luca Grieco, Montini, Luca, Mercurio, Giovanna, Nardi, G, Pisapia, Luca, L Cutuli, S, Domenico, G Biasucci, Gori, Giovanni Cristiano, Rosenkranz, R, De Candia, Erica, Carelli, Simone, Daniele, Natalini, Antonelli, Massimo, and Franceschi, Francesco

Subjects
Male, Neutrophils, coronavirus, Antithrombins, blood coagulation, Fibrin Fibrinogen Degradation Products, Leukocyte Count, respiratory insufficiency, Humans, International Normalized Ratio, Lymphocyte Count, Prospective Studies, Enoxaparin, Aged, Aged, 80 and over, Respiratory Distress Syndrome, Heparin, Platelet Count, SARS-CoV-2, Settore MED/09 - MEDICINA INTERNA, Anticoagulants, COVID-19, Fibrinogen, Blood Coagulation Disorders, Middle Aged, Thrombelastography, COVID-19 Drug Treatment, Treatment Outcome, Settore MED/41, haemostasis, Female, Partial Thromboplastin Time, Blood Coagulation Tests
Abstract

Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) infection may yield a hypercoagulable state with fibrinolysis impairment. We conducted a single-center observational study with the aim of analyzing the coagulation patterns of intensive care unit (ICU) COVID-19 patients with both standard laboratory and viscoelastic tests. The presence of coagulopathy at the onset of the infection and after seven days of systemic anticoagulant therapy was investigated.Forty consecutive SARS-CoV-2 patients, admitted to the ICU of a University hospital in Italy between 29th February and 30th March 2020 were enrolled in the study, providing they fulfilled the acute respiratory distress syndrome criteria. They received full-dose anticoagulation, including Enoxaparin 0.5 mg·kg-1 subcutaneously twice a day, unfractionated Heparin 7500 units subcutaneously three times daily, or low-intensity Heparin infusion. Thromboelastographic (TEG) and laboratory parameters were measured at admission and after seven days.At baseline, patients showed elevated fibrinogen activity [rTEG-Ang 80.5° (78.7 to 81.5); TEG-ACT 78.5 sec (69.2 to 87.9)] and an increase in the maximum amplitude of clot strength [FF-MA 42.2 mm (30.9 to 49.2)]. No alterations in time of the enzymatic phase of coagulation [CKH-K and CKH-R, 1.1 min (0.85 to 1.3) and 6.6 min (5.2 to 7.5), respectively] were observed. Absent lysis of the clot at 30 minutes (LY30) was observed in all the studied population. Standard coagulation parameters were within the physiological range: [INR 1.09 (1.01 to 1.20), aPTT 34.5 sec (29.7 to 42.2), antithrombin 97.5% (89.5 to 115)]. However, plasma fibrinogen [512.5 mg·dl-1 (303.5 to 605)], and D-dimer levels [1752.5 ng·ml-1 (698.5 to 4434.5)], were persistently increased above the reference range. After seven days of full-dose anticoagulation, average TEG parameters were not different from baseline (rTEG-Ang p = 0.13, TEG-ACT p = 0.58, FF-MA p = 0.24, CK-R p = 0.19, CKH-R p = 0.35), and a persistent increase in white blood cell count, platelet count and D-dimer was observed (white blood cell count p0.01, neutrophil count p = 0.02, lymphocyte count p0.01, platelet count p = 0.130.01, D-dimer levels p= 0.02).SARS-CoV-2 patients with acute respiratory distress syndrome show elevated fibrinogen activity, high D-dimer levels and maximum amplitude of clot strength. Platelet count, fibrinogen, and standard coagulation tests do not indicate a disseminated intravascular coagulation. At seven days, thromboelastographic abnormalities persist despite full-dose anticoagulation.

Published
2020

27. High Failure Rate of Noninvasive Oxygenation Strategies in Critically Ill Subjects With Acute Hypoxemic Respiratory Failure Due to COVID-19

Author

Menga, Luca Salvatore, primary, Cese, Luca Delle, additional, Bongiovanni, Filippo, additional, Lombardi, Gianmarco, additional, Michi, Teresa, additional, Luciani, Filippo, additional, Cicetti, Marta, additional, Timpano, Jacopo, additional, Ferrante, Maria Cristina, additional, Cesarano, Melania, additional, Anzellotti, Gian Marco, additional, Rosà, Tommaso, additional, Natalini, Daniele, additional, Tanzarella, Eloisa S, additional, Cutuli, Salvatore Lucio, additional, Pintaudi, Gabriele, additional, De Pascale, Gennaro, additional, Dell'Anna, Antonio M, additional, Bello, Giuseppe, additional, Pennisi, Mariano Alberto, additional, Maggiore, Salvatore Maurizio, additional, Maviglia, Riccardo, additional, Grieco, Domenico Luca, additional, and Antonelli, Massimo, additional

Published
2021
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28. COVID-19 and intestinal inflammation: Role of fecal calprotectin

Author

Ojetti, Veronica, primary, Saviano, Angela, additional, Covino, Marcello, additional, Acampora, Nicola, additional, Troiani, Eliana, additional, Franceschi, Francesco, additional, Abbate, Valeria, additional, Addolorato, Giovanni, additional, Agostini, Fabiana, additional, Ainora, Maria Elena, additional, Akacha, Karim, additional, Amato, Elena, additional, Andreani, Francesca, additional, Andriollo, Gloria, additional, Annetta, Maria Giuseppina, additional, Annicchiarico, Brigida Eleonora, additional, Antonelli, Mariangela, additional, Antonucci, Gabriele, additional, Anzellotti, Gian Marco, additional, Armuzzi, Alessandro, additional, Baldi, Fabiana, additional, Barattucci, Ilaria, additional, Barillaro, Christian, additional, Barone, Fabiana, additional, Bellantone, Rocco Domenico Alfonso, additional, Bellieni, Andrea, additional, Bello, Giuseppe, additional, Benicchi, Andrea, additional, Benvenuto, Francesca, additional, Berardini, Ludovica, additional, Berloco, Filippo, additional, Bernabei, Roberto, additional, Bianchi, Antonio, additional, Biasucci, Daniele Guerino, additional, Biasucci, Luigi Marzio, additional, Bibbò, Stefano, additional, Bini, Alessandra, additional, Bisanti, Alessandra, additional, Biscetti, Federico, additional, Bocci, Maria Grazia, additional, Bonadia, Nicola, additional, Bongiovanni, Filippo, additional, Borghetti, Alberto, additional, Bosco, Giulia, additional, Bosello, Silvia, additional, Bove, Vincenzo, additional, Bramato, Giulia, additional, Brandi, Vincenzo, additional, Bruni, Teresa, additional, Bruno, Carmine, additional, Bruno, Dario, additional, Bungaro, Maria Chiara, additional, Buonomo, Alessandro, additional, Burzo, Livia, additional, Calabrese, Angelo, additional, Calvello, Maria Rosaria, additional, Cambieri, Andrea, additional, Cambise, Chiara, additional, Cammà, Giulia, additional, Candelli, Marcello, additional, Canistro, Gennaro, additional, Cantanale, Antonello, additional, Capalbo, Gennaro, additional, Capaldi, Lorenzo, additional, Capone, Emanuele, additional, Capristo, Esmeralda, additional, Carbone, Luigi, additional, Cardone, Silvia, additional, Carelli, Simone, additional, Carfì, Angelo, additional, Carnicelli, Annamaria, additional, Caruso, Cristiano, additional, Casciaro, Francesco Antonio, additional, Catalano, Lucio, additional, Cauda, Roberto, additional, Cecchini, Andrea Leonardo, additional, Cerrito, Lucia, additional, Cesarano, Melania, additional, Chiarito, Annalisa, additional, Cianci, Rossella, additional, Cicchinelli, Sara, additional, Ciccullo, Arturo, additional, Cicetti, Marta, additional, Ciciarello, Francesca, additional, Cingolani, Antonella, additional, Cipriani, Maria Camilla, additional, Consalvo, Maria Ludovica, additional, Coppola, Gaetano, additional, Corbo, Giuseppe Maria, additional, Corsello, Andrea, additional, Costante, Federico, additional, Costanzi, Matteo, additional, Crupi, Davide, additional, Cutuli, Salvatore Lucio, additional, D'Addio, Stefano, additional, D'Alessandro, Alessia, additional, D'AlfonsoD'Angelo, Maria ElenaEmanuela, additional, D'Aversa, Francesca, additional, Damiano, Fernando, additional, De Berardinis, Gian Maria, additional, De Cunzo, Tommaso, additional, De Gaetano, Donati Katleen, additional, De Luca, Giulio, additional, De Matteis, Giuseppe, additional, De Pascale, Gennaro, additional, De Santis, Paolo, additional, De Siena, Martina, additional, De Vito, Francesco, additional, Del Gatto, Valeria, additional, Del Giacomo, Paola, additional, Del Zompo, Fabio, additional, Dell'Anna, Antonio Maria, additional, Polla, Davide Della, additional, Di Gialleonardo, Luca, additional, Di Giambenedetto, Simona, additional, Di Luca, Roberta, additional, Di Maurizio, Luca, additional, Di Muro, Mariangela, additional, Dusina, Alex, additional, Eleuteri, Davide, additional, Esperide, Alessandra, additional, Fachechi, Daniele, additional, Faliero, Domenico, additional, Falsiroli, Cinzia, additional, Fantoni, Massimo, additional, Fedele, Annalaura, additional, Feliciani, Daniela, additional, Ferrante, Cristina, additional, Ferrone, Giuliano, additional, Festa, Rossano, additional, Fiore, Maria Chiara, additional, Flex, Andrea, additional, Forte, Evelina, additional, Francesconi, Alessandra, additional, Franza, Laura, additional, Funaro, Barbara, additional, Fuorlo, Mariella, additional, Fusco, Domenico, additional, Gabrielli, Maurizio, additional, Gaetani, Eleonora, additional, Galletta, Claudia, additional, Gallo, Antonella, additional, Gambassi, Giovanni, additional, Garcovich, Matteo, additional, Gasbarrini, Antonio, additional, Gasparrini, Irene, additional, Gelli, Silvia, additional, Giampietro, Antonella, additional, Gigante, Laura, additional, Giuliano, Gabriele, additional, Giuliano, Giorgia, additional, Giupponi, Bianca, additional, Gremese, Elisa, additional, Grieco, Domenico Luca, additional, Guerrera, Manuel, additional, Guglielmi, Valeria, additional, Guidone, Caterina, additional, Gullì, Antonio, additional, Iaconelli, Amerigo, additional, Iafrati, Aurora, additional, Ianiro, Gianluca, additional, Iaquinta, Angela, additional, Impagnatiello, Michele, additional, Inchingolo, Riccardo, additional, Intini, Enrica, additional, Iorio, Raffaele, additional, Izzi, Immacolata Maria, additional, Jovanovic, Tamara, additional, Kadhim, Cristina, additional, La Macchia, Rosa, additional, La Milia, Daniele Ignazio, additional, Landi, Francesco, additional, Landi, Giovanni, additional, Landi, Rosario, additional, Landolfi, Raffaele, additional, Leo, Massimo, additional, Leone, Paolo Maria, additional, Levantesi, Laura, additional, Liguori, Antonio, additional, Liperoti, Rosa, additional, Lizzio, Marco Maria, additional, Monaco, Maria Rita Lo, additional, Locantore, Pietro, additional, Lombardi, Francesco, additional, Lombardi, Gianmarco, additional, Lopetuso, Loris, additional, Loria, Valentina, additional, Losito, Angela Raffaella, additional, Lucia, Mothanje Barbara Patricia, additional, Macagno, Francesco, additional, Macerola, Noemi, additional, Maggi, Giampaolo, additional, Maiuro, Giuseppe, additional, Mancarella, Francesco, additional, Mangiola, Francesca, additional, Manno, Alberto, additional, Marchesini, Debora, additional, Maresca, Gian Marco, additional, Marrone, Giuseppe, additional, Martis, Ilaria, additional, Martone, Anna Maria, additional, Marzetti, Emanuele, additional, Mattana, Chiara, additional, Matteo, Maria Valeria, additional, Maviglia, Riccardo, additional, Mazzarella, Ada, additional, Memoli, Carmen, additional, Miele, Luca, additional, Migneco, Alessio, additional, Mignini, Irene, additional, Milani, Alessandro, additional, Milardi, Domenico, additional, Montalto, Massimo, additional, Montemurro, Giuliano, additional, Monti, Flavia, additional, Montini, Luca, additional, Morena, Tony Christian, additional, Morra, Vincenzina, additional, Morretta, Chiara, additional, Moschese, Davide, additional, Murace, Celeste Ambra, additional, Murdolo, Martina, additional, Murri, Rita, additional, Napoli, Marco, additional, Nardella, Elisabetta, additional, Natalello, Gerlando, additional, Natalini, Daniele, additional, Navarra, Simone Maria, additional, Nesci, Antonio, additional, Nicoletti, Alberto, additional, Nicoletti, Rocco, additional, Nicoletti, Tommaso Filippo, additional, Nicolò, Rebecca, additional, Nicolotti, Nicola, additional, Nista, Enrico Celestino, additional, Nuzzo, Eugenia, additional, Oggiano, Marco, additional, Ojetti, Veronica, additional, Pagano, Francesco Cosimo, additional, Paiano, Gianfranco, additional, Pais, Cristina, additional, Pallavicini, Federico, additional, Palombo, Andrea, additional, Paolillo, Federico, additional, Papa, Alfredo, additional, Papanice, Domenico, additional, Papparella, Luigi Giovanni, additional, Paratore, Mattia, additional, Parrinello, Giuseppe, additional, Pasciuto, Giuliana, additional, Pasculli, Pierpaolo, additional, Pecorini, Giovanni, additional, Perniola, Simone, additional, Pero, Erika, additional, Petricca, Luca, additional, Petrucci, Martina, additional, Picarelli, Chiara, additional, Piccioni, Andrea, additional, Piccolo, Annalisa, additional, Piervincenzi, Edoardo, additional, Pignataro, Giulia, additional, Pignataro, Raffaele, additional, Pintaudi, Gabriele, additional, Pisapia, Luca, additional, Pizzoferrato, Marco, additional, Pizzolante, Fabrizio, additional, Pola, Roberto, additional, Policola, Caterina, additional, Pompili, Maurizio, additional, Pontecorvi, Flavia, additional, Pontecorvi, Valerio, additional, Ponziani, Francesca, additional, Popolla, Valentina, additional, Porceddu, Enrica, additional, Porfidia, Angelo, additional, Porro, Lucia Maria, additional, Potenza, Annalisa, additional, Pozzana, Francesca, additional, Privitera, Giuseppe, additional, Pugliese, Daniela, additional, Pulcini, Gabriele, additional, Racco, Simona, additional, Raffaelli, Francesca, additional, Ramunno, Vittoria, additional, Rapaccini, Gian Ludovico, additional, Richeldi, Luca, additional, Rinninella, Emanuele, additional, Rocchi, Sara, additional, Romanò, Bruno, additional, Romano, Stefano, additional, Rosa, Federico, additional, Rossi, Laura, additional, Rossi, Raimondo, additional, Rossini, Enrica, additional, Rota, Elisabetta, additional, Rovedi, Fabiana, additional, Rubino, Carlotta, additional, Rumi, Gabriele, additional, Russo, Andrea, additional, Sabia, Luca, additional, Salerno, Andrea, additional, Salini, Sara, additional, Salvatore, Lucia, additional, Samori, Dehara, additional, Sandroni, Claudio, additional, Sanguinetti, Maurizio, additional, Santarelli, Luca, additional, Santini, Paolo, additional, Santolamazza, Danilo, additional, Santoliquido, Angelo, additional, Santopaolo, Francesco, additional, Santoro, Michele Cosimo, additional, Sardeo, Francesco, additional, Sarnari, Caterina, additional, Saviano, Luisa, additional, Scaldaferri, Franco, additional, Scarascia, Roberta, additional, Schepis, Tommaso, additional, Schiavello, Francesca, additional, Scoppettuolo, Giancarlo, additional, Sedda, Davide, additional, Sessa, Flaminio, additional, Sestito, Luisa, additional, Settanni, Carlo, additional, Siciliano, Matteo, additional, Siciliano, Valentina, additional, Sicuranza, Rossella, additional, Simeoni, Benedetta, additional, Simonetti, Jacopo, additional, Smargiassi, Andrea, additional, Soave, Paolo Maurizio, additional, Sonnino, Chiara, additional, Staiti, Domenico, additional, Stella, Claudia, additional, Stella, Leonardo, additional, Stival, Eleonora, additional, Taddei, Eleonora, additional, Talerico, Rossella, additional, Tamburello, Elio, additional, Tamburrini, Enrica, additional, Tanzarella, Eloisa Sofia, additional, Tarascio, Elena, additional, Tarli, Claudia, additional, Tersali, Alessandra, additional, Tilli, Pietro, additional, Timpano, Jacopo, additional, Torelli, Enrico, additional, Torrini, Flavia, additional, Tosato, Matteo, additional, Tosoni, Alberto, additional, Tricoli, Luca, additional, Tritto, Marcello, additional, Tumbarello, Mario, additional, Tummolo, Anita Maria, additional, Vallecoccia, Maria Sole, additional, Valletta, Federico, additional, Varone, Francesco, additional, Vassalli, Francesco, additional, Ventura, Giulio, additional, Verardi, Lucrezia, additional, Vetrone, Lorenzo, additional, Vetrugno, Giuseppe, additional, Visconti, Elena, additional, Visconti, Felicia, additional, Viviani, Andrea, additional, Zaccaria, Raffaella, additional, Zaccone, Carmelina, additional, Zelano, Lorenzo, additional, Dal Verme, Lorenzo Zileri, additional, and Zuccalà, Giuseppe, additional

Published
2020
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29. Noninvasive Ventilatory Support As First-Line Treatment For COVID-19 Critically Ill Patients With Acute Hypoxemic Respiratory Failure

Author

Menga, Luca Salvatore, primary, Cese, Luca Delle, additional, Bongiovanni, Filippo, additional, Lombardi, Gianmarco, additional, Luciani, Filippo, additional, Cicetti, Marta, additional, Timpano, Jacopo, additional, Ferrante, Maria Cristina, additional, Cesarano, Melania, additional, Tanzarella, Eloisa S., additional, Cutuli, Salvatore Lucio, additional, Pintaudi, Gabriele, additional, Pascale, Gennaro De, additional, Dell'Anna, Antonio Maria, additional, Bello, Giuseppe, additional, Maggiore, Salvatore M., additional, Maviglia, Riccardo, additional, Grieco, Domenico Luca, additional, and Antonelli, Massimo, additional

Published
2020
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30. Genetic variation at the ApoB 3' HVR minisatellite locus in Mbenzele Pygmies from the Central African Republic

Author

Destro-Bisol, Giovanni, Belledi, Michele, Capelli, Christian, Maviglia, Riccardo, and Spedini, Gabriella

Subjects
Central African Republic -- Demographic aspects, Pygmies -- Genetic aspects, Genetic polymorphisms -- Physiological aspects, Apolipoproteins -- Analysis, Genetic research -- Analysis, Biological sciences
Abstract

Research on the genetic structure of Mbenzele Pygmies of the Central African Republic is presented. Analysis of Apolipoprotein B-100 (ApoB) 3' HVR supports the hypothesis that African Pygmies are different from non-African Pygmies due to genetic diversity of ApoB 3' HVR.

Published
2000

32. Assessment of neurological manifestations in hospitalized patients with COVID-19

Author

Luigetti, M., Iorio, R., Bentivoglio, A. R., Tricoli, L., Riso, V., Marotta, J., Piano, C., Primiano, G., Zileri Del Verme, L., Lo Monaco, M. R., Calabresi, P., Abbate, Valeria, Acampora, Nicola, Addolorato, Giovanni, Agostini, Fabiana, Ainora, Maria Elena, Akacha, Karim, Amato, Elena, Andreani, Francesca, Andriollo, Gloria, Annetta, Maria Giuseppina, Annicchiarico, Brigida Eleonora, Antonelli, Mariangela, Antonucci, Gabriele, Anzellotti, Gian Marco, Armuzzi, Alessandro, Baldi, Fabiana, Barattucci, Ilaria, Barillaro, Christian, Barone, Fabiana, Bellantone, Rocco Domenico Alfonso, Bellieni, Andrea, Bello, Giuseppe, Benicchi, Andrea, Benvenuto, Francesca, Berardini, Ludovica, Berloco, Filippo, Bernabei, Roberto, Bianchi, Antonio, Biasucci, Daniele Guerino, Biasucci, Luigi Marzio, Bibbò, Stefano, Bini, Alessandra, Bisanti, Alessandra, Biscetti, Federico, Bocci, Maria Grazia, Bonadia, Nicola, Bongiovanni, Filippo, Borghetti, Alberto, Bosco, Giulia, Bosello, Silvia, Bove, Vincenzo, Bramato, Giulia, Brandi, Vincenzo, Bruni, Teresa, Bruno, Carmine, Bruno, Dario, Bungaro, Maria Chiara, Buonomo, Alessandro, Burzo, Livia, Calabrese, Angelo, Calvello, Maria Rosaria, Cambieri, Andrea, Cambise, Chiara, Cammà, Giulia, Candelli, Marcello, Canistro, Gennaro, Cantanale, Antonello, Capalbo, Gennaro, Capaldi, Lorenzo, Capone, Emanuele, Capristo, Esmeralda, Carbone, Luigi, Cardone, Silvia, Carelli, Simone, Carfì, Angelo, Carnicelli, Annamaria, Caruso, Cristiano, Casciaro, Francesco Antonio, Catalano, Lucio, Cauda, Roberto, Cecchini, Andrea Leonardo, Cerrito, Lucia, Cesarano, Melania, Chiarito, Annalisa, Cianci, Rossella, Cicchinelli, Sara, Ciccullo, Arturo, Cicetti, Marta, Ciciarello, Francesca, Cingolani, Antonella, Cipriani, Maria Camilla, Consalvo, Maria Ludovica, Coppola, Gaetano, Corbo, Giuseppe Maria, Corsello, Andrea, Costante, Federico, Costanzi, Matteo, Covino, Marcello, Crupi, Davide, Cutuli, Salvatore Lucio, DAddio, Stefano, DAlessandro, Alessia, DAlfonso, Maria Elena, DAngelo, Emanuela, DAversa, Francesca, Damiano, Fernando, De Berardinis, Gian Maria, De Cunzo, Tommaso, De Gaetano, Donati Katleen, De Luca, Giulio, De Matteis, Giuseppe, De Pascale, Gennaro, De Santis, Paolo, De Siena, Martina, De Vito, Francesco, Del Gatto, Valeria, Del Giacomo, Paola, Del Zompo, Fabio, DellAnna, Antonio Maria, Della, Polla Davide, Di Gialleonardo, Luca, Di Giambenedetto, Simona, Di Luca, Roberta, Di Maurizio, Luca, Di Muro, Mariangela, Dusina, Alex, Eleuteri, Davide, Esperide, Alessandra, Fachechi, Daniele, Faliero, Domenico, Falsiroli, Cinzia, Fantoni, Massimo, Fedele, Annalaura, Feliciani, Daniela, Ferrante, Cristina, Ferrone, Giuliano, Festa, Rossano, Fiore, Maria Chiara, Flex, Andrea, Forte, Evelina, Franceschi, Francesco, Francesconi, Alessandra, Franza, Laura, Funaro, Barbara, Fuorlo, Mariella, Fusco, Domenico, Gabrielli, Maurizio, Gaetani, Eleonora, Galletta, Claudia, Gallo, Antonella, Gambassi, Giovanni, Garcovich, Matteo, Gasbarrini, Antonio, Gasparrini, Irene, Gelli, Silvia, Giampietro, Antonella, Gigante, Laura, Giuliano, Gabriele, Giuliano, Giorgia, Giupponi, Bianca, Gremese, Elisa, Grieco, Domenico Luca, Guerrera, Manuel, Guglielmi, Valeria, Guidone, Caterina, Gullì, Antonio, Iaconelli, Amerigo, Iafrati, Aurora, Ianiro, Gianluca, Iaquinta, Angela, Impagnatiello, Michele, Inchingolo, Riccardo, Intini, Enrica, Iorio, Raffaele, Izzi, Immacolata Maria, Jovanovic, Tamara, Kadhim, Cristina, La Macchia, Rosa, La Milia, Daniele Ignazio, Landi, Francesco, Landi, Giovanni, Landi, Rosario, Landolfi, Raffaele, Leo, Massimo, Leone, Paolo Maria, Levantesi, Laura, Liguori, Antonio, Liperoti, Rosa, Lizzio, Marco Maria, Lo Monaco Maria, Rita, Locantore, Pietro, Lombardi, Francesco, Lombardi, Gianmarco, Lopetuso, Loris, Loria, Valentina, Losito, Angela Raffaella, Lucia, Mothanje Barbara Patricia, Macagno, Francesco, Macerola, Noemi, Maggi, Giampaolo, Maiuro, Giuseppe, Mancarella, Francesco, Mangiola, Francesca, Manno, Alberto, Marchesini, Debora, Maresca, Gian Marco, Marrone, Giuseppe, Martis, Ilaria, Martone, Anna Maria, Marzetti, Emanuele, Mattana, Chiara, Matteo, Maria Valeria, Maviglia, Riccardo, Mazzarella, Ada, Memoli, Carmen, Miele, Luca, Migneco, Alessio, Mignini, Irene, Milani, Alessandro, Milardi, Domenico, Montalto, Massimo, Montemurro, Giuliano, Monti, Flavia, Montini, Luca, Morena, Tony Christian, Morra, Vincenzina, Morretta, Chiara, Moschese, Davide, Murace, Celeste Ambra, Murdolo, Martina, Murri, Rita, Napoli, Marco, Nardella, Elisabetta, Natalello, Gerlando, Natalini, Daniele, Navarra, Simone Maria, Nesci, Antonio, Nicoletti, Alberto, Nicoletti, Rocco, Nicoletti, Tommaso Filippo, Nicolò, Rebecca, Nicolotti, Nicola, Nista, Enrico Celestino, Nuzzo, Eugenia, Oggiano, Marco, Ojetti, Veronica, Pagano, Francesco Cosimo, Paiano, Gianfranco, Pais, Cristina, Pallavicini, Federico, Palombo, Andrea, Paolillo, Federico, Papa, Alfredo, Papanice, Domenico, Papparella, Luigi Giovanni, Paratore, Mattia, Parrinello, Giuseppe, Pasciuto, Giuliana, Pasculli, Pierpaolo, Pecorini, Giovanni, Perniola, Simone, Pero, Erika, Petricca, Luca, Petrucci, Martina, Picarelli, Chiara, Piccioni, Andrea, Piccolo, Annalisa, Piervincenzi, Edoardo, Pignataro, Giulia, Pignataro, Raffaele, Pintaudi, Gabriele, Pisapia, Luca, Pizzoferrato, Marco, Pizzolante, Fabrizio, Pola, Roberto, Policola, Caterina, Pompili, Maurizio, Pontecorvi, Flavia, Pontecorvi, Valerio, Ponziani, Francesca, Popolla, Valentina, Porceddu, Enrica, Porfidia, Angelo, Porro, Lucia Maria, Potenza, Annalisa, Pozzana, Francesca, Privitera, Giuseppe, Pugliese, Daniela, Pulcini, Gabriele, Racco, Simona, Raffaelli, Francesca, Ramunno, Vittoria, Rapaccini, Gian Ludovico, Richeldi, Luca, Rinninella, Emanuele, Rocchi, Sara, Romanò, Bruno, Romano, Stefano, Rosa, Federico, Rossi, Laura, Rossi, Raimondo, Rossini, Enrica, Rota, Elisabetta, Rovedi, Fabiana, Rubino, Carlotta, Rumi, Gabriele, Russo, Andrea, Sabia, Luca, Salerno, Andrea, Salini, Sara, Salvatore, Lucia, Samori, Dehara, Sandroni, Claudio, Sanguinetti, Maurizio, Santarelli, Luca, Santini, Paolo, Santolamazza, Danilo, Santoliquido, Angelo, Santopaolo, Francesco, Santoro, Michele Cosimo, Sardeo, Francesco, Sarnari, Caterina, Saviano, Angela, Saviano, Luisa, Scaldaferri, Franco, Scarascia, Roberta, Schepis, Tommaso, Schiavello, Francesca, Scoppettuolo, Giancarlo, Sedda, Davide, Sessa, Flaminio, Sestito, Luisa, Settanni, Carlo, Siciliano, Matteo, Siciliano, Valentina, Sicuranza, Rossella, Simeoni, Benedetta, Simonetti, Jacopo, Smargiassi, Andrea, Soave, Paolo Maurizio, Sonnino, Chiara, Staiti, Domenico, Stella, Claudia, Stella, Leonardo, Stival, Eleonora, Taddei, Eleonora, Talerico, Rossella, Tamburello, Elio, Tamburrini, Enrica, Tanzarella, Eloisa Sofia, Tarascio, Elena, Tarli, Claudia, Tersali, Alessandra, Tilli, Pietro, Timpano, Jacopo, Torelli, Enrico, Torrini, Flavia, Tosato, Matteo, Tosoni, Alberto, Tricoli, Luca, Tritto, Marcello, Tumbarello, Mario, Tummolo, Anita Maria, Vallecoccia, Maria Sole, Valletta, Federico, Varone, Francesco, Vassalli, Francesco, Ventura, Giulio, Verardi, Lucrezia, Vetrone, Lorenzo, Vetrugno, Giuseppe, Visconti, Elena, Visconti, Felicia, Viviani, Andrea, Zaccaria, Raffaella, Zaccone, Carmelina, Zelano, Lorenzo, Zileri Dal Verme, Lorenzo, and Zuccalà, Giuseppe

Subjects
Male, Hospitalized patients, muscle, Settore M-PSI/02 - PSICOBIOLOGIA E PSICOLOGIA FISIOLOGICA, neurological disorders, 0302 clinical medicine, Hyposmia, 030212 general & internal medicine, Respiratory system, education.field_of_study, Brain Diseases, Headache, virus diseases, Neuromuscular Diseases, Middle Aged, Hospitalization, medicine.anatomical_structure, Neurology, Female, medicine.symptom, Adult, medicine.medical_specialty, SARS‐CoV2, Coronavirus disease 2019 (COVID-19), Patients, Short Communication, Anosmia, precision medicine, Population, Encephalopathy, Short Communications, Clinical Neurology, Settore MED/26, 03 medical and health sciences, COVID‐19, Internal medicine, Throat, Influenza, Human, medicine, Humans, education, Aged, Retrospective Studies, business.industry, SARS-CoV-2, COVID-19, Hypoxia (medical), medicine.disease, respiratory tract diseases, body regions, Neurology (clinical), Nervous System Diseases, business, 030217 neurology & neurosurgery
Abstract

Background and purpose The objective of this study was to assess the neurological manifestations in a series of consecutive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients, comparing their frequency with a population hospitalized in the same period for flu/respiratory symptoms, finally not related to SARS-CoV-2. Methods Patients with flu/respiratory symptoms admitted to Fondazione Policlinico Gemelli hospital from 14 March 2020 to 20 April 2020 were retrospectively enrolled. The frequency of neurological manifestations of patients with SARS-CoV-2 infection was compared with a control group. Results In all, 213 patients were found to be positive for SARS-CoV-2, after reverse transcriptase polymerase chain reaction on nasal or throat swabs, whilst 218 patients were found to be negative and were used as a control group. Regarding central nervous system manifestations, in SARS-CoV-2-positive patients a higher frequency of headache, hyposmia and encephalopathy always related to systemic conditions (fever or hypoxia) was observed. Furthermore, muscular involvement was more frequent in SARS-CoV-2 infection. Conclusions Patients with COVID-19 commonly have neurological manifestations but only hyposmia and muscle involvement seem more frequent compared with other flu diseases.

Published
2020

33. Epileptic Asystole

Author

Marca, Giacomo Della, Vollono, Catello, Bello, Giuseppe, Maviglia, Riccardo, Montini, Luca, Mazza, Salvatore, and Cianfoni, Alessandro

Published
2008

34. Physiological Comparison of High-Flow Nasal Cannula and Helmet Noninvasive Ventilation in Acute Hypoxemic Respiratory Failure

Author

Grieco, Domenico Luca, primary, Menga, Luca S., additional, Raggi, Valeria, additional, Bongiovanni, Filippo, additional, Anzellotti, Gian Marco, additional, Tanzarella, Eloisa S., additional, Bocci, Maria Grazia, additional, Mercurio, Giovanna, additional, Dell’Anna, Antonio M., additional, Eleuteri, Davide, additional, Bello, Giuseppe, additional, Maviglia, Riccardo, additional, Conti, Giorgio, additional, Maggiore, Salvatore Maurizio, additional, and Antonelli, Massimo, additional

Published
2020
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35. Physiological Comparison of High-Flow Nasal Cannula and Helmet Noninvasive Ventilation in Acute Hypoxemic Respiratory Failure

Author

Grieco, Domenico Luca, Menga, L, Raggi, V, Bongiovanni, Filippo, Anzellotti, Gm, Tanzarella, E, Bocci, Mg, Mercurio, Giovanna, Dell'Anna, Am, Eleuteri, Davide, Bello, Giuseppe, Maviglia, Riccardo, Conti, Giorgio, Maggiore, Sm, Antonelli, Massimo, Grieco DL (ORCID:0000-0002-4557-6308), Bongiovanni F, Mercurio G, Eleuteri D, Bello G (ORCID:0000-0003-2648-7235), Maviglia R, Conti G (ORCID:0000-0002-8566-9365), Antonelli M (ORCID:0000-0003-3007-1670), Grieco, Domenico Luca, Menga, L, Raggi, V, Bongiovanni, Filippo, Anzellotti, Gm, Tanzarella, E, Bocci, Mg, Mercurio, Giovanna, Dell'Anna, Am, Eleuteri, Davide, Bello, Giuseppe, Maviglia, Riccardo, Conti, Giorgio, Maggiore, Sm, Antonelli, Massimo, Grieco DL (ORCID:0000-0002-4557-6308), Bongiovanni F, Mercurio G, Eleuteri D, Bello G (ORCID:0000-0003-2648-7235), Maviglia R, Conti G (ORCID:0000-0002-8566-9365), and Antonelli M (ORCID:0000-0003-3007-1670)

Abstract

Rationale: High-flow nasal cannula (HFNC) and helmet noninvasive ventilation (NIV) are used for the management of acute hypoxemic respiratory failure.Objectives: Physiological comparison of HFNC and helmet NIV in patients with hypoxemia.Methods: Fifteen patients with hypoxemia with PaO2/FiO2 < 200 mm Hg received helmet NIV (positive end-expiratory pressure ≥ 10 cm H2O, pressure support = 10-15 cm H2O) and HFNC (50 L/min) in randomized crossover order. Arterial blood gases, dyspnea, and comfort were recorded. Inspiratory effort was estimated by esophageal pressure (Pes) swings. Pes-simplified pressure-time product and transpulmonary pressure swings were measured.Measurements and Main Results: As compared with HFNC, helmet NIV increased PaO2/FiO2 (median [interquartile range]: 255 mm Hg [140-299] vs. 138 [101-172]; P = 0.001) and lowered inspiratory effort (7 cm H2O [4-11] vs. 15 [8-19]; P = 0.001) in all patients. Inspiratory effort reduction by NIV was linearly related to inspiratory effort during HFNC (r = 0.84; P < 0.001). Helmet NIV reduced respiratory rate (24 breaths/min [23-31] vs. 29 [26-32]; P = 0.027), Pes-simplified pressure-time product (93 cm H2O ⋅ s ⋅ min-1 [43-138] vs. 200 [168-335]; P = 0.001), and dyspnea (visual analog scale 3 [2-5] vs. 8 [6-9]; P = 0.002), without affecting PaCO2 (P = 0.80) and comfort (P = 0.50). In the overall cohort, transpulmonary pressure swings were not different between treatments (NIV = 18 cm H2O [14-21] vs. HFNC = 15 [8-19]; P = 0.11), but patients exhibiting lower inspiratory effort on HFNC experienced increases in transpulmonary pressure swings with helmet NIV. Higher transpulmonary pressure swings during NIV were associated with subsequent need for intubation.Conclusions: As compared with HFNC in hypoxemic respiratory failure, helmet NIV improves oxygenation, reduces dyspnea, inspiratory effort, and simplified pressure-time product, with similar transpulmonary pressure swings, PaCO2, and comfort.

Published
2019

36. Epidemiology of intensive care unit-acquired sepsis in Italy: Results of the SPIN-UTI network

Author

Agodi, Antonella, Barchitta, M., Auxilia, F., Brusaferro, S., D'Errico, M. M., Montagna, M. T., Pasquarella, C., Tardivo, S., Arrigoni, C., Fabiani, L., Laurenti, P., Mattaliano, A. R., Orsi, G. B., Squeri, R., Torregrossa, M. V., Mura, I., Aiello, Mary Rose, Alliani, Cristina, Amatucci, Maria Rita, Antoci, Manuela, Antonelli, Massimo, Astuto, Marinella, Arnoldo, Luca, Arru, Benedetto, Baccari, Giorgio, Barbadoro, Pamela, Barbara, Andrea, Barilaro, Cynthia, Battaglia, Pietro, Bellocchi, Patrizia, Bernasconi, Mara Olga, Bianco, Aida, Bissolo, Emanuela, Bocchi, Anna, Bruno, Anna, Brusaferro, Marco, Buccheri, Margherita, Campanella, Francesca, Canino, Rosario, Cannistrà, Antonino, Carini, Santa Adele, Catalano, Sebastiano, Castellani, Paola, Castiglione, Giacomo, Coniglio, Salvatore, Consolante, Ciriaco, Conte, Carmela, Contrisciani, Roberta, Corallini, Rosy, Crollari, Patricia, Damiani, Gianfranco, Denaro, Carmelo, De Remigis, Santa, Diana, Francesca, Di Bartolo, Rosario, Di Benedetto, Antonino, Di Fabio, Gianna, Di Falco, Carlo, Digeronimo, Vito, Di Gregorio, Pietro, Distefano, Roberta, Egitto, Giovanni, Falciani, Elena, Farruggia, Patrizia, Fenaroli, Salesia, Ferlazzo, Giuseppe, Garofalo, Giuseppe, Girardis, Massimo, Giovanelli, Linda, Giubbini, Gabriele, Graceffa, Adriana, Guadagna, Antonina, Gregu, Giovanna, Ingala, Franco, Innocenzi, Ludovico, La Camera, Giuseppa, La Rosa, Maria Clara, Lesa, Lucia, Longhitano, Anna Maria, Luppino, Giuseppe, Maida, Carmelo Massimo, Manta, Giuseppe, Marino, Giovanni, Masia, Maria Dolores, Maviglia, Riccardo, Mazzetti, Magda, Maugeri, Andrea, Megna, Maria Teresa, Mella, Laura Maria, Milazzo, Marina, Milia, Mario, Minari, Caterina, Minerva, Massimo, Mordacci, Marco, Murgia, Paola, Oliveri, Pietro, Olori, Maria Patrizia, Pagliarulo, Riccardo, Palermo, Rosanna, Pandiani, Irene, Pappalardo, Federico, Papetti, Cristina, Partenza, Adolfo, Pascu, Diana, Pasculli, Marcello, Pavia, Maria, Pavone, Maria Luisa, Pellegrino, Maria Giovanna, Pelligra, Fabrizio, Pillon, Danila, Pintaudi, Sergio, Pitzoi, Lucia, Pinto, Andrea, Piotti, Paola, Pupo, Simona, Quattrocchi, Rosalba, Righi, Elena, Rigo, Alberto, Rigo, Annalisa, Romeo, Antonina, Rosa, Emilio, Rutigliano, Serafina, Sarchi, Pierangelo, Scimonello, Guglielmo, Seminerio, Antonello, Stefanini, Paolo, Sticca, Giovanna, Taddei, Stefania, Tessari, Lorella, Tetamo, Romano, Ticca, Mariantonietta, Tribastoni, Salvatore, Vallorani, Sarah, Venturoni, Federica, Vitagliano, Emilia, Vitali, Pietro, Zappone, Assunta, Zei, Ettore, Zeoli, Maria Prudenzia, Agodi A., Barchitta M., Auxilia F., Brusaferro S., D'Errico M.M., Montagna M.T., Pasquarella C., Tardivo S., Arrigoni C., Fabiani L., Laurenti P., Mattaliano A.R., Orsi G.B., Squeri R., Torregrossa M.V., Mura I., Aiello M.R., Alliani C., Amatucci M.R., Antoci M., Antonelli M., Astuto M., Arnoldo L., Arru B., Baccari G., Barbadoro P., Barbara A., Barilaro C., Battaglia P., Bellocchi P., Bernasconi M.O., Bianco A., Bissolo E., Bocchi A., Bruno A., Brusaferro M., Buccheri M., Campanella F., Canino R., Cannistra A., Carini S.A., Catalano S., Castellani P., Castiglione G., Coniglio S., Consolante C., Conte C., Contrisciani R., Corallini R., Crollari P., Damiani G., Denaro C., De Remigis S., Diana F., Di Bartolo R., Di Benedetto A., Di Fabio G., Di Falco C., Digeronimo V., Di Gregorio P., Distefano R., Egitto G., Falciani E., Farruggia P., Fenaroli S., Ferlazzo G., Garofalo G., Girardis M., Giovanelli L., Giubbini G., Graceffa A., Guadagna A., Gregu G., Ingala F., Innocenzi L., La Camera G., La Rosa M.C., Lesa L., Longhitano A.M., Luppino G., Maida C.M., Manta G., Marino G., Masia M.D., Maviglia R., Mazzetti M., Maugeri A., Megna M.T., Mella L.M., Milazzo M., Milia M., Minari C., Minerva M., Mordacci M., Murgia P., Oliveri P., Olori M.P., Pagliarulo R., Palermo R., Pandiani I., Pappalardo F., Papetti C., Partenza A., Pascu D., Pasculli M., Pavia M., Pavone M.L., Pellegrino M.G., Pelligra F., Pillon D., Pintaudi S., Pitzoi L., Pinto A., Piotti P., Pupo S., Quattrocchi R., Righi E., Rigo A., Romeo A., Rosa E., Rutigliano S., Sarchi P., Scimonello G., Seminerio A., Stefanini P., Sticca G., Taddei S., Tessari L., Tetamo R., Ticca M., Tribastoni S., Vallorani S., Venturoni F., Vitagliano E., Vitali P., Zappone A., Zei E., Zeoli M.P., Agodi, A., Barchitta, M., Auxilia, F., Brusaferro, S., D'Errico, M. M., Montagna, M. T., Pasquarella, C., Tardivo, S., Arrigoni, C., Fabiani, L., Laurenti, P., Mattaliano, A. R., Orsi, G. B., Squeri, R., Torregrossa, M. V., Mura, I., Aiello, M. R., Alliani, C., Amatucci, M. R., Antoci, M., Antonelli, M., Astuto, M., Arnoldo, L., Arru, B., Baccari, G., Barbadoro, P., Barbara, A., Barilaro, C., Battaglia, P., Bellocchi, P., Bernasconi, M. O., Bianco, A., Bissolo, E., Bocchi, A., Bruno, A., Brusaferro, M., Buccheri, M., Campanella, F., Canino, R., Cannistra, A., Carini, S. A., Catalano, S., Castellani, P., Castiglione, G., Coniglio, S., Consolante, C., Conte, C., Contrisciani, R., Corallini, R., Crollari, P., Damiani, G., Denaro, C., De Remigis, S., Diana, F., Di Bartolo, R., Di Benedetto, A., Di Fabio, G., Di Falco, C., Digeronimo, V., Di Gregorio, P., Distefano, R., Egitto, G., Falciani, E., Farruggia, P., Fenaroli, S., Ferlazzo, G., Garofalo, G., Girardis, M., Giovanelli, L., Giubbini, G., Graceffa, A., Guadagna, A., Gregu, G., Ingala, F., Innocenzi, L., La Camera, G., La Rosa, M. C., Lesa, L., Longhitano, A. M., Luppino, G., Maida, C. M., Manta, G., Marino, G., Masia, M. D., Maviglia, R., Mazzetti, M., Maugeri, A., Megna, M. T., Mella, L. M., Milazzo, M., Milia, M., Minari, C., Minerva, M., Mordacci, M., Murgia, P., Oliveri, P., Olori, M. P., Pagliarulo, R., Palermo, R., Pandiani, I., Pappalardo, F., Papetti, C., Partenza, A., Pascu, D., Pasculli, M., Pavia, M., Pavone, M. L., Pellegrino, M. G., Pelligra, F., Pillon, D., Pintaudi, S., Pitzoi, L., Pinto, A., Piotti, P., Pupo, S., Quattrocchi, R., Righi, E., Rigo, A., Romeo, A., Rosa, E., Rutigliano, S., Sarchi, P., Scimonello, G., Seminerio, A., Stefanini, P., Sticca, G., Taddei, S., Tessari, L., Tetamo, R., Ticca, M., Tribastoni, S., Vallorani, S., Venturoni, F., Vitagliano, E., Vitali, P., Zappone, A., Zei, E., and Zeoli, M. P.

Subjects
Sleep Initiation and Maintenance Disorder, Male, Time Factors, Healthcare-associated infections, Mortality, Sepsis, Surveillance, Public Health, Environmental and Occupational Health, Infectious Diseases, Diet, Mediterranean, Coffee, Health Statu, Mortality Parole chiave: Infezioni correlate all'assistenza, Mortalità, Sepsi, Sorveglianza, Academic Performance, Prevalence, Surveys and Questionnaire, Hospital Mortality, Prospective Studies, Cross Infection, Incidence, Smoking, Tryptophan, Shock, Middle Aged, Shock, Septic, Intensive Care Units, Italy, Population Surveillance, Female, Public Health, Human, Adult, Employment, Alcohol Drinking, Intensive Care Unit, Regression Analysi, Young Adult, Age Distribution, Learning, Humans, Healthcare-associated infection, Exercise, Life Style, Settore MED/42 - IGIENE GENERALE E APPLICATA, Aged, Cross-Sectional Studie, Septic, Environmental and Occupational Health, Body Weight, Length of Stay, Body Height, Prospective Studie, Quality of Life, Students, Nursing
Abstract

Background. Sepsis is the major cause of mortality from any infectious disease worldwide. Sepsis may be the result of a healthcare associated infection (HAI): the most frequent adverse events during care delivery especially in Intensive Care Units (ICUs). The main aim of the present study was to describe the epidemiology of ICU-acquired sepsis and related outcomes among patients enrolled in the framework of the Italian Nosocomial Infections Surveillance in ICUs - SPIN-UTI project. Study design. Prospective multicenter study. Methods. The SPIN-UTI network adopted the European protocols for patient-based HAI surveillance. Results. During the five editions of the SPIN-UTI project, from 2008 to 2017, 47.0% of HAIs has led to sepsis in 832 patients. Overall, 57.0% episodes were classified as sepsis, 20.5% as severe sepsis and 22.5% as septic shock. The most common isolated microorganisms from sepsis episodes were Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa. The case fatality rate increased with the severity of sepsis and the mean length of ICU-stay was significantly higher in patients with ICU-acquired sepsis than in patients without. Conclusions. Our study provides evidence that ICU-acquired sepsis occurs frequently in Italian ICU patients and is associated with a high case fatality rate and increased length of stay. However, in order to explain these findings further analyses are needed in this population of ICU patients.

Published
2018

37. Epidemiology of intensive care unit-acquired sepsis in Italy: Results of the SPIN-UTI network

Author

Agodi, A., Barchitta, M., Auxilia, F., Brusaferro, S., D'Errico, M. M., Montagna, M. T., Pasquarella, C., Tardivo, S., Arrigoni, C., Fabiani, L., Laurenti, Patrizia, Mattaliano, A. R., Orsi, G. B., Squeri, R., Torregrossa, M. V., Mura, I., Aiello, M. R., Alliani, C., Amatucci, M. R., Antoci, M., Antonelli, Massimo, Astuto, M., Arnoldo, L., Arru, B., Baccari, G., Barbadoro, P., Barbara, A., Barilaro, Cynthia, Battaglia, P., Bellocchi, Paolo, Bernasconi, M. O., Bianco, Assunta, Bissolo, E., Bocchi, A., Bruno, A., Brusaferro, M., Buccheri, M., Campanella, F., Canino, R., Cannistra, A., Carini, S. A., Catalano, S., Castellani, P., Castiglione, G., Coniglio, S., Consolante, C., Conte, Caterina, Contrisciani, R., Corallini, R., Crollari, P., Damiani, Gianfranco, Denaro, C., De Remigis, S., Diana, F., Di Bartolo, R., Di Benedetto, A., Di Fabio, G., Di Falco, C., Digeronimo, V., Di Gregorio, P., Distefano, R., Egitto, G., Falciani, E., Farruggia, P., Fenaroli, S., Ferlazzo, G., Garofalo, G., Girardis, M., Giovanelli, Laura, Giubbini, Gabriele, Graceffa, A., Guadagna, A., Gregu, G., Ingala, F., Innocenzi, L., La Camera, G., La Rosa, M. C., Lesa, L., Longhitano, A. M., Luppino, G., Maida, C. M., Manta, G., Marino, G., Masia, M. D., Maviglia, Riccardo, Mazzetti, M., Maugeri, A., Megna, M. T., Mella, L. M., Milazzo, M., Milia, M., Minari, C., Minerva, M., Mordacci, M., Murgia, P., Oliveri, P., Olori, M. P., Pagliarulo, R., Palermo, R., Pandiani, I., Pappalardo, F., Papetti, C., Partenza, A., Pascu, D., Pasculli, M., Pavia, M., Pavone, M. L., Pellegrino, Maria Gabriella, Pelligra, F., Pillon, D., Pintaudi, S., Pitzoi, L., Pinto, A., Piotti, P., Pupo, S., Quattrocchi, R., Righi, E., Rigo, A., Romeo, A., Rosa, Enrico, Rutigliano, S., Sarchi, P., Scimonello, G., Seminerio, A., Stefanini, P., Sticca, G., Taddei, S., Tessari, L., Tetamo, R., Ticca, M., Tribastoni, S., Vallorani, S., Venturoni, F., Vitagliano, E., Vitali, P., Zappone, Assunta, Zei, E., Zeoli, M. P., Laurenti P. (ORCID:0000-0002-8532-0593), Antonelli M. (ORCID:0000-0003-3007-1670), Barilaro C. (ORCID:0000-0002-6576-8921), Bellocchi P., Bianco A., Conte C., Damiani G. (ORCID:0000-0003-3028-6188), Giovanelli L. (ORCID:0009-0007-8931-6253), Giubbini G., Maviglia R., Pellegrino M. G., Rosa E., Zappone A., Agodi, A., Barchitta, M., Auxilia, F., Brusaferro, S., D'Errico, M. M., Montagna, M. T., Pasquarella, C., Tardivo, S., Arrigoni, C., Fabiani, L., Laurenti, Patrizia, Mattaliano, A. R., Orsi, G. B., Squeri, R., Torregrossa, M. V., Mura, I., Aiello, M. R., Alliani, C., Amatucci, M. R., Antoci, M., Antonelli, Massimo, Astuto, M., Arnoldo, L., Arru, B., Baccari, G., Barbadoro, P., Barbara, A., Barilaro, Cynthia, Battaglia, P., Bellocchi, Paolo, Bernasconi, M. O., Bianco, Assunta, Bissolo, E., Bocchi, A., Bruno, A., Brusaferro, M., Buccheri, M., Campanella, F., Canino, R., Cannistra, A., Carini, S. A., Catalano, S., Castellani, P., Castiglione, G., Coniglio, S., Consolante, C., Conte, Caterina, Contrisciani, R., Corallini, R., Crollari, P., Damiani, Gianfranco, Denaro, C., De Remigis, S., Diana, F., Di Bartolo, R., Di Benedetto, A., Di Fabio, G., Di Falco, C., Digeronimo, V., Di Gregorio, P., Distefano, R., Egitto, G., Falciani, E., Farruggia, P., Fenaroli, S., Ferlazzo, G., Garofalo, G., Girardis, M., Giovanelli, Laura, Giubbini, Gabriele, Graceffa, A., Guadagna, A., Gregu, G., Ingala, F., Innocenzi, L., La Camera, G., La Rosa, M. C., Lesa, L., Longhitano, A. M., Luppino, G., Maida, C. M., Manta, G., Marino, G., Masia, M. D., Maviglia, Riccardo, Mazzetti, M., Maugeri, A., Megna, M. T., Mella, L. M., Milazzo, M., Milia, M., Minari, C., Minerva, M., Mordacci, M., Murgia, P., Oliveri, P., Olori, M. P., Pagliarulo, R., Palermo, R., Pandiani, I., Pappalardo, F., Papetti, C., Partenza, A., Pascu, D., Pasculli, M., Pavia, M., Pavone, M. L., Pellegrino, Maria Gabriella, Pelligra, F., Pillon, D., Pintaudi, S., Pitzoi, L., Pinto, A., Piotti, P., Pupo, S., Quattrocchi, R., Righi, E., Rigo, A., Romeo, A., Rosa, Enrico, Rutigliano, S., Sarchi, P., Scimonello, G., Seminerio, A., Stefanini, P., Sticca, G., Taddei, S., Tessari, L., Tetamo, R., Ticca, M., Tribastoni, S., Vallorani, S., Venturoni, F., Vitagliano, E., Vitali, P., Zappone, Assunta, Zei, E., Zeoli, M. P., Laurenti P. (ORCID:0000-0002-8532-0593), Antonelli M. (ORCID:0000-0003-3007-1670), Barilaro C. (ORCID:0000-0002-6576-8921), Bellocchi P., Bianco A., Conte C., Damiani G. (ORCID:0000-0003-3028-6188), Giovanelli L. (ORCID:0009-0007-8931-6253), Giubbini G., Maviglia R., Pellegrino M. G., Rosa E., and Zappone A.

Abstract

Background. Sepsis is the major cause of mortality from any infectious disease worldwide. Sepsis may be the result of a healthcare associated infection (HAI): the most frequent adverse events during care delivery especially in Intensive Care Units (ICUs). The main aim of the present study was to describe the epidemiology of ICU-acquired sepsis and related outcomes among patients enrolled in the framework of the Italian Nosocomial Infections Surveillance in ICUs - SPIN-UTI project. Study design. Prospective multicenter study. Methods. The SPIN-UTI network adopted the European protocols for patient-based HAI surveillance. Results. During the five editions of the SPIN-UTI project, from 2008 to 2017, 47.0% of HAIs has led to sepsis in 832 patients. Overall, 57.0% episodes were classified as sepsis, 20.5% as severe sepsis and 22.5% as septic shock. The most common isolated microorganisms from sepsis episodes were Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa. The case fatality rate increased with the severity of sepsis and the mean length of ICU-stay was significantly higher in patients with ICU-acquired sepsis than in patients without. Conclusions. Our study provides evidence that ICU-acquired sepsis occurs frequently in Italian ICU patients and is associated with a high case fatality rate and increased length of stay. However, in order to explain these findings further analyses are needed in this population of ICU patients.

Published
2018

39. CO2driven endotracheal tube cuff control in critically ill patients: A randomized controlled study

Author

De Pascale, Gennaro, Pennisi, Mariano Alberto, Vallecoccia, Maria Sole, Bello, Giuseppe, Maviglia, Riccardo, Montini, Luca, Di Gravio, Valentina, Cutuli, Salvatore Lucio, Conti, Giorgio, Antonelli, Massimo, De Pascale, Gennaro (ORCID:0000-0002-8255-0676), Pennisi, Mariano Alberto (ORCID:0000-0001-8761-5144), Bello, Giuseppe (ORCID:0000-0003-2648-7235), Montini, Luca (ORCID:0000-0003-4602-5134), Conti, Giorgio (ORCID:0000-0002-8566-9365), Antonelli, Massimo (ORCID:0000-0003-3007-1670), De Pascale, Gennaro, Pennisi, Mariano Alberto, Vallecoccia, Maria Sole, Bello, Giuseppe, Maviglia, Riccardo, Montini, Luca, Di Gravio, Valentina, Cutuli, Salvatore Lucio, Conti, Giorgio, Antonelli, Massimo, De Pascale, Gennaro (ORCID:0000-0002-8255-0676), Pennisi, Mariano Alberto (ORCID:0000-0001-8761-5144), Bello, Giuseppe (ORCID:0000-0003-2648-7235), Montini, Luca (ORCID:0000-0003-4602-5134), Conti, Giorgio (ORCID:0000-0002-8566-9365), and Antonelli, Massimo (ORCID:0000-0003-3007-1670)

Abstract

Background To determine the safety and clinical efficacy of an innovative integrated airway system (AnapnoGuard1100 system) that continuously monitors and controls the cuff pressure (Pcuff), while facilitating the aspiration of subglottic secretions (SS). Methods This was a prospective, single centre, open-label, randomized, controlled feasibility and safety trial. The primary endpoint of the study was the rate of device related adverse events (AE) and serious AE (SAE) as a result of using AnapnoGuard (AG) 100 during mechanical ventilation. Secondary endpoints were: (1) mechanical complications rate (2) ICU staff satisfaction; (3) VAP occurrence; (4) length of mechanical ventilation; (5) length of Intensive Care Unit stay and mortality; (6) volume of evacuated subglottic secretions. Sixty patients were randomized to be intubated with the AG endotracheal-tube (ETT) and connected to the AG 100 system allowing Pcuff adjustment and SS aspiration; or with an ETT combined with SS drainage and Pcuff controlled manually. Results No difference in adverse events rate was identified between the groups. The use of AG system was associated with a significantly higher incidence of Pcuff determinations in the safety range (97.3% vs. 71%; p0.01) and a trend to a greater volume of aspirated SS secretions: (192.0[64 413] ml vs. 150[50 200], p = 0.19 (total)); (57.8[20 88.7] ml vs. 50[18.7 62] ml, p = 0.11 (daily)). No inter-group difference was detected using AG system vs. controls in terms of post-extubation throat pain level (0 [0 2] vs. 0 [0 3]; p = 0.7), hoarseness (42.9% vs. 75%; p = 0.55) and tracheal mucosa oedema (16.7% vs. 10%; p = 0.65). Patients enrolled in the AG group had a trend to reduced VAP risk of ventilator-associated pneumonia(VAP) (14.8% vs. 40%; p = 0.06), which were more frequently monomicrobial (25% vs. 70%; p = 0.03). No statistically significant difference was observed in duration of mechanical ventilation, ICU stay, and mortality. Conclusions The use AG 100

Published
2017

40. Taking Care of Relationships in the Intensive Care Unit: Positive Impact on Family Consent for Organ Donation

Author

Bocci, M. G, D'Alo', Ciro, Barelli, Roberta, Inguscio, Simona, Prestifilippo, Alessia, Di Paolo, S, Lochi, S, Fanfarillo, M, Grieco, Domenico Luca, Maviglia, Riccardo, Caricato, Anselmo, Mistraletti, G, Pulitano', Silvia Maria, Antonelli, Massimo, Sandroni, Claudio, D'Alo', Ciro (ORCID:0000-0003-2868-0928), Grieco, D. L (ORCID:0000-0002-4557-6308), Caricato, Anselmo (ORCID:0000-0001-5929-120X), Pulitano', Silvia Maria Modesta (ORCID:0000-0002-8496-379X), Antonelli, M (ORCID:0000-0003-3007-1670), Sandroni, Claudio (ORCID:0000-0002-8878-2611), Bocci, M. G, D'Alo', Ciro, Barelli, Roberta, Inguscio, Simona, Prestifilippo, Alessia, Di Paolo, S, Lochi, S, Fanfarillo, M, Grieco, Domenico Luca, Maviglia, Riccardo, Caricato, Anselmo, Mistraletti, G, Pulitano', Silvia Maria, Antonelli, Massimo, Sandroni, Claudio, D'Alo', Ciro (ORCID:0000-0003-2868-0928), Grieco, D. L (ORCID:0000-0002-4557-6308), Caricato, Anselmo (ORCID:0000-0001-5929-120X), Pulitano', Silvia Maria Modesta (ORCID:0000-0002-8496-379X), Antonelli, M (ORCID:0000-0003-3007-1670), and Sandroni, Claudio (ORCID:0000-0002-8878-2611)

Abstract

Background Organ donation refusal from relatives of potential donors with brain death significantly reduces organ availability. The need for organ donation has increased over time, but the shortage of available donors is the major limiting factor in transplantation. We analyzed the impact of a new systematic communication approach between medical staff and patients' relatives on the rate of consent to organ donation. Methods The study was conducted as a single-center, non-randomized, controlled, before-and-after study at an 18-bed intensive care unit (ICU) of a university hospital. We compared the rate of consent for organ donation before and after the introduction of the new communication approach. Results A total of 291 brain-dead patients were studied. The consent rate increased from 71% in the pre-intervention period (2007–2012) to 78.4% in the post-intervention period (2013–2015), with an 82.75% increase in the 2014 to 2015 period. During these periods, no significant variation of consent to organ donation was recorded at the national and regional levels. Conclusions The introduction of a new communication approach between medical staff and relatives of brain-dead patients was associated with a significant increase in the rate of consent to donation. Our results highlight the importance of empathy with relatives in the ICU. The need for organ transplants has increased over recent decades; nevertheless, the number of donors is insufficient [1]. The major factor limiting the number of donations from brain-dead potential donors is the low rate of consent from their families [2], [3], [4] and [5].

Published
2016

41. Linear and Nonlinear Heart Rate Variability Indexes in Clinical Practice

Author

Maviglia Riccardo, Bocci Maria Grazia, Calcinaro Sara, Buccelletti Francesco, Fiore Valentina, Fragnoli Chiara, Gilardi Emanuele, and Franceschi Francesco

Subjects
Male, medicine.medical_specialty, Pathology, Biological organism, Review Article, lcsh:Computer applications to medicine. Medical informatics, General Biochemistry, Genetics and Molecular Biology, Electrocardiography, Heart Rate, Internal medicine, Heart rate, medicine, Homeostasis, Humans, Heart rate variability, General Immunology and Microbiology, medicine.diagnostic_test, business.industry, Applied Mathematics, Linear model, Human heart, General Medicine, Clinical Practice, Nonlinear system, Nonlinear Dynamics, Modeling and Simulation, Linear Models, Cardiology, lcsh:R858-859.7, Female, Clinical Medicine, business
Abstract

Biological organisms have intrinsic control systems that act in response to internal and external stimuli maintaining homeostasis. Human heart rate is not regular and varies in time and such variability, also known as heart rate variability (HRV), is not random. HRV depends upon organism's physiologic and/or pathologic state. Physicians are always interested in predicting patient's risk of developing major and life-threatening complications. Understanding biological signals behavior helps to characterize patient's state and might represent a step toward a better care. The main advantage of signals such as HRV indexes is that it can be calculated in real time in noninvasive manner, while all current biomarkers used in clinical practice are discrete and imply blood sample analysis. In this paper HRV linear and nonlinear indexes are reviewed and data from real patients are provided to show how these indexes might be used in clinical practice.

Published
2012

42. Epileptic asystole

Author

Della Marca, Giacomo, Vollono, Catello, Bello, Giuseppe, Maviglia, Riccardo, Mazza, Salvatore, and Cianfoni, Alessandro

Subjects
Settore MED/26 - NEUROLOGIA, Epilepsy, Asystole
Published
2008

43. CO2 driven endotracheal tube cuff control in critically ill patients: A randomized controlled study.

Author

De Pascale, Gennaro, Pennisi, Mariano Alberto, Vallecoccia, Maria Sole, Bello, Giuseppe, Maviglia, Riccardo, Montini, Luca, Di Gravio, Valentina, Cutuli, Salvatore Lucio, Conti, Giorgio, and Antonelli, Massimo

Subjects
CRITICALLY ill patient care, PHYSIOLOGICAL effects of carbon dioxide, ENDOTRACHEAL tubes, TREATMENT effectiveness, AIRWAY (Anatomy), RANDOMIZED controlled trials
Abstract

Background: To determine the safety and clinical efficacy of an innovative integrated airway system (AnapnoGuard™ 100 system) that continuously monitors and controls the cuff pressure (Pcuff), while facilitating the aspiration of subglottic secretions (SS). Methods: This was a prospective, single centre, open-label, randomized, controlled feasibility and safety trial. The primary endpoint of the study was the rate of device related adverse events (AE) and serious AE (SAE) as a result of using AnapnoGuard (AG) 100 during mechanical ventilation. Secondary endpoints were: (1) mechanical complications rate (2) ICU staff satisfaction; (3) VAP occurrence; (4) length of mechanical ventilation; (5) length of Intensive Care Unit stay and mortality; (6) volume of evacuated subglottic secretions. Sixty patients were randomized to be intubated with the AG endotracheal-tube (ETT) and connected to the AG 100 system allowing Pcuff adjustment and SS aspiration; or with an ETT combined with SS drainage and Pcuff controlled manually. Results: No difference in adverse events rate was identified between the groups. The use of AG system was associated with a significantly higher incidence of Pcuff determinations in the safety range (97.3% vs. 71%; p<0.01) and a trend to a greater volume of aspirated SS secretions: (192.0[64–413] ml vs. 150[50–200], p = 0.19 (total)); (57.8[20–88.7] ml vs. 50[18.7–62] ml, p = 0.11 (daily)). No inter-group difference was detected using AG system vs. controls in terms of post-extubation throat pain level (0 [0–2] vs. 0 [0–3]; p = 0.7), hoarseness (42.9% vs. 75%; p = 0.55) and tracheal mucosa oedema (16.7% vs. 10%; p = 0.65). Patients enrolled in the AG group had a trend to reduced VAP risk of ventilator-associated pneumonia(VAP) (14.8% vs. 40%; p = 0.06), which were more frequently monomicrobial (25% vs. 70%; p = 0.03). No statistically significant difference was observed in duration of mechanical ventilation, ICU stay, and mortality. Conclusions: The use AG 100 system and AG tube in critically ill intubated patients is safe and effective in Pcuff control and SS drainage. Its protective role against VAP needs to be confirmed in a larger randomized trial. Trial registration: ClinicalTrials.gov . Date of registration: February 21, 2012. [ABSTRACT FROM AUTHOR]

Published
2017
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44. High dose tigecycline in critically ill patients with severe infections due to multidrug-resistant bacteria

Author

De Pascale, Gennaro, Montini, Luca, Pennisi, Mariano Alberto, Bernini, Valentina, Maviglia, Riccardo, Bello, Giuseppe, Spanu, Teresa, Tumbarello, Mario, Antonelli, Massimo, De Pascale, Gennaro (ORCID:0000-0002-8255-0676), Montini, Luca (ORCID:0000-0003-4602-5134), Pennisi, Mariano (ORCID:0000-0001-8761-5144), Bello, Giuseppe (ORCID:0000-0003-2648-7235), Spanu, Teresa (ORCID:0000-0003-1864-5184), Tumbarello, Mario (ORCID:0000-0002-9519-8552), Antonelli, Massimo (ORCID:0000-0003-3007-1670), De Pascale, Gennaro, Montini, Luca, Pennisi, Mariano Alberto, Bernini, Valentina, Maviglia, Riccardo, Bello, Giuseppe, Spanu, Teresa, Tumbarello, Mario, Antonelli, Massimo, De Pascale, Gennaro (ORCID:0000-0002-8255-0676), Montini, Luca (ORCID:0000-0003-4602-5134), Pennisi, Mariano (ORCID:0000-0001-8761-5144), Bello, Giuseppe (ORCID:0000-0003-2648-7235), Spanu, Teresa (ORCID:0000-0003-1864-5184), Tumbarello, Mario (ORCID:0000-0002-9519-8552), and Antonelli, Massimo (ORCID:0000-0003-3007-1670)

Abstract

The high incidence of multidrug-resistant (MDR) bacteria among patients admitted to ICUs has determined an increase of tigecycline (TGC) use for the treatment of severe infections. Many concerns have been raised about the efficacy of this molecule and increased dosages have been proposed. Our purpose is to investigate TGC safety and efficacy at higher than standard doses.

Published
2014

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Author

Posteraro, Brunella, De Pascale, Gennaro, Tumbarello, Mario, Torelli, Riccardo, Pennisi, Mariano, Bello, Giuseppe, Maviglia, Riccardo, Fadda, Giovanni, Sanguinetti, Maurizio, Antonelli, Massimo, Posteraro, Brunella (ORCID:0000-0002-1663-7546), De Pascale, Gennaro (ORCID:0000-0002-8255-0676), Tumbarello, Mario (ORCID:0000-0002-9519-8552), Pennisi, Mariano (ORCID:0000-0001-8761-5144), Bello, Giuseppe (ORCID:0000-0003-2648-7235), Sanguinetti, Maurizio (ORCID:0000-0002-9780-7059), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Posteraro, Brunella, De Pascale, Gennaro, Tumbarello, Mario, Torelli, Riccardo, Pennisi, Mariano, Bello, Giuseppe, Maviglia, Riccardo, Fadda, Giovanni, Sanguinetti, Maurizio, Antonelli, Massimo, Posteraro, Brunella (ORCID:0000-0002-1663-7546), De Pascale, Gennaro (ORCID:0000-0002-8255-0676), Tumbarello, Mario (ORCID:0000-0002-9519-8552), Pennisi, Mariano (ORCID:0000-0001-8761-5144), Bello, Giuseppe (ORCID:0000-0003-2648-7235), Sanguinetti, Maurizio (ORCID:0000-0002-9780-7059), and Antonelli, Massimo (ORCID:0000-0003-3007-1670)

Published
2012

46. An integrated video-analysis software system designed for movement detection and sleep analysis. Validation of a tool for the behavioural study of sleep

Author

Scatena, M, Dittoni, Serena, Maviglia, Riccardo, Frusciante, Roberto, Testani, Elisa, Vollono, Catello, Losurdo, Anna, Colicchio, Salvatore, Gnoni, Valentina, Labriola, C, Farina, B, Pennisi, Mariano, Della Marca, Giacomo, Pennisi, Mariano (ORCID:0000-0001-8761-5144), Della Marca, Giacomo (ORCID:0000-0001-6914-799X), Scatena, M, Dittoni, Serena, Maviglia, Riccardo, Frusciante, Roberto, Testani, Elisa, Vollono, Catello, Losurdo, Anna, Colicchio, Salvatore, Gnoni, Valentina, Labriola, C, Farina, B, Pennisi, Mariano, Della Marca, Giacomo, Pennisi, Mariano (ORCID:0000-0001-8761-5144), and Della Marca, Giacomo (ORCID:0000-0001-6914-799X)

Abstract

The aim of the present study was to develop and validate a software tool for the detection of movements during sleep, based on the automated analysis of video recordings. This software is aimed to detect and quantify movements and to evaluate periods of sleep and wake.

Published
2012

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Author

Posteraro, Brunella, De Pascale, Gennaro, Tumbarello, Mario, Torelli, Riccardo, Pennisi, Mariano, Bello, Giuseppe, Maviglia, Riccardo, Fadda, Guido, Sanguinetti, Maurizio, Antonelli, Massimo, Posteraro, Brunella (ORCID:0000-0002-1663-7546), De Pascale, Gennaro (ORCID:0000-0002-8255-0676), Tumbarello, Mario (ORCID:0000-0002-9519-8552), Pennisi, Mariano (ORCID:0000-0001-8761-5144), Bello, Giuseppe (ORCID:0000-0003-2648-7235), Fadda, Guido (ORCID:0000-0003-2013-7293), Sanguinetti, Maurizio (ORCID:0000-0002-9780-7059), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Posteraro, Brunella, De Pascale, Gennaro, Tumbarello, Mario, Torelli, Riccardo, Pennisi, Mariano, Bello, Giuseppe, Maviglia, Riccardo, Fadda, Guido, Sanguinetti, Maurizio, Antonelli, Massimo, Posteraro, Brunella (ORCID:0000-0002-1663-7546), De Pascale, Gennaro (ORCID:0000-0002-8255-0676), Tumbarello, Mario (ORCID:0000-0002-9519-8552), Pennisi, Mariano (ORCID:0000-0001-8761-5144), Bello, Giuseppe (ORCID:0000-0003-2648-7235), Fadda, Guido (ORCID:0000-0003-2013-7293), Sanguinetti, Maurizio (ORCID:0000-0002-9780-7059), and Antonelli, Massimo (ORCID:0000-0003-3007-1670)

Published
2011

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Author

Posteraro, Brunella, De Pascale, Gennaro, Tumbarello, Mario, Torelli, Riccardo, Pennisi, Mariano Alberto, Bello, Giuseppe, Maviglia, Riccardo, Fadda, Giovanni, Sanguinetti, Maurizio, Antonelli, Massimo, Posteraro, Brunella (ORCID:0000-0002-1663-7546), De Pascale, Gennaro (ORCID:0000-0002-8255-0676), Tumbarello, Mario (ORCID:0000-0002-9519-8552), Pennisi, Mariano (ORCID:0000-0001-8761-5144), Bello, Giuseppe (ORCID:0000-0003-2648-7235), Sanguinetti, Maurizio (ORCID:0000-0002-9780-7059), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Posteraro, Brunella, De Pascale, Gennaro, Tumbarello, Mario, Torelli, Riccardo, Pennisi, Mariano Alberto, Bello, Giuseppe, Maviglia, Riccardo, Fadda, Giovanni, Sanguinetti, Maurizio, Antonelli, Massimo, Posteraro, Brunella (ORCID:0000-0002-1663-7546), De Pascale, Gennaro (ORCID:0000-0002-8255-0676), Tumbarello, Mario (ORCID:0000-0002-9519-8552), Pennisi, Mariano (ORCID:0000-0001-8761-5144), Bello, Giuseppe (ORCID:0000-0003-2648-7235), Sanguinetti, Maurizio (ORCID:0000-0002-9780-7059), and Antonelli, Massimo (ORCID:0000-0003-3007-1670)

Published
2011

49. Decompressive craniectomy for elderly patients with traumatic brain injury: it's probably not worth the while

Author

De Bonis, Pasquale, Pompucci, Angelo, Mangiola, Annunziato, Paternoster, Giovanna, Festa, Rossano, Nucci, Carlotta Ginevra, Maviglia, Riccardo, Antonelli, Massimo, Anile, Carmelo, Pompucci, Angelo (ORCID:0000-0002-5427-9719), Mangiola, Annunziato (ORCID:0000-0002-1378-4524), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Anile, Carmelo (ORCID:0000-0002-0481-9713), De Bonis, Pasquale, Pompucci, Angelo, Mangiola, Annunziato, Paternoster, Giovanna, Festa, Rossano, Nucci, Carlotta Ginevra, Maviglia, Riccardo, Antonelli, Massimo, Anile, Carmelo, Pompucci, Angelo (ORCID:0000-0002-5427-9719), Mangiola, Annunziato (ORCID:0000-0002-1378-4524), Antonelli, Massimo (ORCID:0000-0003-3007-1670), and Anile, Carmelo (ORCID:0000-0002-0481-9713)

Abstract

Decompressive craniectomy (DC) has been regarded as an ultima ratio measure in the treatment of refractory intracranial hypertension after brain injury. Most discussion about its benefits is based on studies performed in patients who are <65 years of age. The aim of this study was to identify patients aged ≥66 years who underwent DC after traumatic brain injury (TBI), in order to assess patient outcome and to correlate the values of potential predictors of survival on prognosis. From January 2002 to December 2009, 44 patients aged ≥66 underwent DC (follow-up, 12-102 months). Potential predictors of outcome were analyzed, including age, post-resuscitation Glasgow Coma Scale (GCS) score, presence of mass lesion, Simplified Acute Physiology Score (SAPS) II, Injury Severity Score (ISS), and timing of surgical decompression. Mortality was 48% at discharge from the intensive care unit (ICU), 57% at hospital discharge, and 77% at 1-year follow-up and at last follow-up. A bad outcome Glasgow Outcome Scale Dead-Vegetative State-Severely Disabled (GOS D-VS-SD) was observed in 36/44 patients both at hospital discharge and at 1-year follow-up. Mean SAPS II was 45.2 for patients who survived and 57.3 for patients who had died (p=0.0022). Patients who survived had a higher mean post-resuscitation GCS score (p=0.02). Logistical regression analysis indicated post-resuscitation GCS score as the only independent predictive factor for outcome. None of the 22 patients with a post-resuscitation GCS score of 3-5 had a good outcome, 2/10 (20%) patients with a post-resuscitation GCS score of 6-8 and 6/12 patients (50%) with a post-resuscitation GCS score ≥9 had a good outcome.

Published
2011

50. Diurnal and nocturnal shifts do not influence non-invasive ventilation outcome.

Author

Montini, Luca, Mercurio, Giovanna, Pennisi, Mariano, Bello, Giuseppe, Maviglia, Riccardo, Caricato, Anselmo, Calabrese, Maria, Cavallaro, Fabio, Costa, Roberta, Conti, Giorgio, Antonelli, Massimo, Montini, Luca (ORCID:0000-0003-4602-5134), Pennisi, Mariano (ORCID:0000-0001-8761-5144), Bello, Giuseppe (ORCID:0000-0003-2648-7235), Caricato, Anselmo (ORCID:0000-0001-5929-120X), Conti, Giorgio (ORCID:0000-0002-8566-9365), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Montini, Luca, Mercurio, Giovanna, Pennisi, Mariano, Bello, Giuseppe, Maviglia, Riccardo, Caricato, Anselmo, Calabrese, Maria, Cavallaro, Fabio, Costa, Roberta, Conti, Giorgio, Antonelli, Massimo, Montini, Luca (ORCID:0000-0003-4602-5134), Pennisi, Mariano (ORCID:0000-0001-8761-5144), Bello, Giuseppe (ORCID:0000-0003-2648-7235), Caricato, Anselmo (ORCID:0000-0001-5929-120X), Conti, Giorgio (ORCID:0000-0002-8566-9365), and Antonelli, Massimo (ORCID:0000-0003-3007-1670)

Abstract

AIM: The aim of this study was to assess if diurnal or nocturnal shifts were independent risk factors for non-invasive ventilation (NIV) failure. METHODS: This was an observational study carried out on 18 patients of the general Intensive Care Unit in Rome. A total number of 189 consecutive patients needing mechanical ventilation for respiratory failure were prospectively enrolled: 82 were treated with NIV as a first line intervention. Of the 107 patients who were initially intubated, 59 patients were extubated; once extubation failed they were treated with NIV. NIV failure was assessed during both the day (between 7 am and 10 pm) and night shifts (between 10 pm and 7 am). RESULTS: Of the 141 total patients who received NIV, 51 experienced failure during the day shifts and 18 during the night shifts. No difference in the median day and night shift TISS-28 values were observed in any patients who failed NIV during both day and night shifts. Causes of NIV failure were similar during both diurnal and nocturnal shifts. The inability to correct gas exchanges was the main reason for failure. CONCLUSION: In a center with NIV expertise, notwithstanding nurse understaffing, diurnal and nocturnal shifts did not affect the rate of NIV failure.

Published
2010

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