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1. Phenotyping COVID-19 respiratory failure in spontaneously breathing patients with AI on lung CT-scan

Author

Rezoagli, E, Xin, Y, Signori, D, Sun, W, Gerard, S, Delucchi, K, Magliocca, A, Vitale, G, Giacomini, M, Mussoni, L, Montomoli, J, Subert, M, Ponti, A, Spadaro, S, Poli, G, Casola, F, Herrmann, J, Foti, G, Calfee, C, Laffey, J, Bellani, G, Cereda, M, Lorini, F, Bonaffini, P, Cazzaniga, M, Ottaviani, I, Tavola, M, Borgo, A, Ferraris, L, Serra, F, Gatti, S, Ippolito, D, Tamagnini, B, Gatti, M, Arlotti, M, Gamberini, E, Cavagna, E, Galbiati, G, De Ponti, D, Rezoagli E., Xin Y., Signori D., Sun W., Gerard S., Delucchi K. L., Magliocca A., Vitale G., Giacomini M., Mussoni L., Montomoli J., Subert M., Ponti A., Spadaro S., Poli G., Casola F., Herrmann J., Foti G., Calfee C. S., Laffey J., Bellani G., Cereda M., Lorini F. L., Bonaffini P., Cazzaniga M., Ottaviani I., Tavola M., Borgo A., Ferraris L., Serra F., Gatti S., Ippolito D., Tamagnini B., Gatti M., Arlotti M., Gamberini E., Cavagna E., Galbiati G., De Ponti D., Rezoagli, E, Xin, Y, Signori, D, Sun, W, Gerard, S, Delucchi, K, Magliocca, A, Vitale, G, Giacomini, M, Mussoni, L, Montomoli, J, Subert, M, Ponti, A, Spadaro, S, Poli, G, Casola, F, Herrmann, J, Foti, G, Calfee, C, Laffey, J, Bellani, G, Cereda, M, Lorini, F, Bonaffini, P, Cazzaniga, M, Ottaviani, I, Tavola, M, Borgo, A, Ferraris, L, Serra, F, Gatti, S, Ippolito, D, Tamagnini, B, Gatti, M, Arlotti, M, Gamberini, E, Cavagna, E, Galbiati, G, De Ponti, D, Rezoagli E., Xin Y., Signori D., Sun W., Gerard S., Delucchi K. L., Magliocca A., Vitale G., Giacomini M., Mussoni L., Montomoli J., Subert M., Ponti A., Spadaro S., Poli G., Casola F., Herrmann J., Foti G., Calfee C. S., Laffey J., Bellani G., Cereda M., Lorini F. L., Bonaffini P., Cazzaniga M., Ottaviani I., Tavola M., Borgo A., Ferraris L., Serra F., Gatti S., Ippolito D., Tamagnini B., Gatti M., Arlotti M., Gamberini E., Cavagna E., Galbiati G., and De Ponti D.

Abstract

Background: Automated analysis of lung computed tomography (CT) scans may help characterize subphenotypes of acute respiratory illness. We integrated lung CT features measured via deep learning with clinical and laboratory data in spontaneously breathing subjects to enhance the identification of COVID-19 subphenotypes. Methods: This is a multicenter observational cohort study in spontaneously breathing patients with COVID-19 respiratory failure exposed to early lung CT within 7 days of admission. We explored lung CT images using deep learning approaches to quantitative and qualitative analyses; latent class analysis (LCA) by using clinical, laboratory and lung CT variables; regional differences between subphenotypes following 3D spatial trajectories. Results: Complete datasets were available in 559 patients. LCA identified two subphenotypes (subphenotype 1 and 2). As compared with subphenotype 2 (n = 403), subphenotype 1 patients (n = 156) were older, had higher inflammatory biomarkers, and were more hypoxemic. Lungs in subphenotype 1 had a higher density gravitational gradient with a greater proportion of consolidated lungs as compared with subphenotype 2. In contrast, subphenotype 2 had a higher density submantellar–hilar gradient with a greater proportion of ground glass opacities as compared with subphenotype 1. Subphenotype 1 showed higher prevalence of comorbidities associated with endothelial dysfunction and higher 90-day mortality than subphenotype 2, even after adjustment for clinically meaningful variables. Conclusions: Integrating lung-CT data in a LCA allowed us to identify two subphenotypes of COVID-19, with different clinical trajectories. These exploratory findings suggest a role of automated imaging characterization guided by machine learning in subphenotyping patients with respiratory failure. Trial registration: ClinicalTrials.gov Identifier: NCT04395482. Registration date: 19/05/2020.

Published
2024

2. Engineering Quantum Interference

Author

Lucci, M., Merlo, V., Ottaviani, I., Cirillo, M., Badoni, D., Campanari, V., Salina, G., Caputo, J. G., and Loukitch, L.

Subjects
Condensed Matter - Superconductivity
Abstract

A model for describing interference and diffraction of wave functions of one-dimensional Josephson array interferometers is presented. The derived expression for critical current modulations accounts for an arbitrary number of square junctions, variable distance between these, and variable size of their area. Predictions are tested on real arrays containing up to 20 equally spaced and identical junctions and on arrays shaped with peculiar geometries. Very good agreement with the modulations predicted by the model and the experimental results is obtained for all the tested configurations. It is shown that specific designs of the arrays generate significant differences in their static and dynamical (non-zero voltage) properties. The results demonstrate that the magnetic field dependence of Josephson supercurrents shows how interference and diffraction of macroscopic quantum wavefunctions can be manipulated and controlled., Comment: 5 pages, 4 figures

Published
2018
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3. Hybrid Superconducting Neutron Detectors

Author

Merlo, V., Salvato, M., Cirillo, M., Lucci, M., Ottaviani, I., Scherillo, A., Celentano, G., and Pietropaolo, A.

Subjects
Physics - Instrumentation and Detectors
Abstract

A new neutron detection concept is presented that is based on superconductive niobium (Nb) strips coated by a boron (B) layer. The working principle of the detector relies on the nuclear reaction 10B+n $\rightarrow$ $\alpha$+ 7Li , with $\alpha$ and Li ions generating a hot spot on the current-biased Nb strip which in turn induces a superconducting-normal state transition. The latter is recognized as a voltage signal which is the evidence of the incident neutron. The above described detection principle has been experimentally assessed and verified by irradiating the samples with a pulsed neutron beam at the ISIS spallation neutron source (UK). It is found that the boron coated superconducting strips, kept at a temperature T = 8 K and current-biased below the critical current Ic, are driven into the normal state upon thermal neutron irradiation. As a result of the transition, voltage pulses in excess of 40 mV are measured while the bias current can be properly modulated to bring the strip back to the superconducting state, thus resetting the detector. Measurements on the counting rate of the device are presented and the future perspectives leading to neutron detectors with unprecedented spatial resolutions and efficiency are highlighted., Comment: 8 pages 6 figures

Published
2014
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4. Characterization of Anomalous Pair Currents in Josephson Junction Networks

Author

Ottaviani, I., Lucci, M., Menditto, R., Merlo, V., Salvato, M., Mueller, M. Cirillo F., Weimann, T., Castellano, M. G., Chiarello, F., Torrioli, G., and Russo, R.

Subjects
Condensed Matter - Superconductivity
Abstract

Measurements performed on superconductive networks shaped in the form of planar graphs display anomalously large currents when specific branches are biased. The temperature dependencies of these currents evidence that their origin is due to Cooper pair hopping through the Josephson junctions connecting the superconductive islands of the array. The experimental data are discussed in terms of a theoretical model which predicts, for the system under consideration, an inhomogeneous Cooper pair distribution on the superconductive islands of the network., Comment: 10 pages and 4 figures. The paper, as it is, was submitted for publication on March 15, 2013. At the date of submission on the Archive (September 11, 2013) no feedback has yet been received from the referees

Published
2013

5. High Tc superconductivity in superlattices of insulating oxides

Author

Di Castro, D., Salvato, M., Tebano, A., Innocenti, D., Aruta, C., Prellier, W., Lebedev, O. I., Ottaviani, I., Brookes, N. B., Minola, M., Sala, M. Moretti, Mazzoli, C., Medaglia, P. G., Ghiringhelli, G., Cirillo, L. Braicovich M., and Balestrino, G.

Subjects
Condensed Matter - Superconductivity
Abstract

We report the occurrence of superconductivity, with maximum Tc = 40 K, in superlattices (SLs) based on two insulating oxides, namely CaCuO2 and SrTiO3. In these (CaCuO2)n/(SrTiO3)m SLs, the CuO2 planes belong only to CaCuO2 block, which is an antiferromagnetic insulator. Superconductivity, confined within few unit cells at the CaCuO2/SrTiO3 interface, shows up only when the SLs are grown in a highly oxidizing atmosphere, because of extra oxygen ions entering at the interfaces. Evidence is reported that the hole doping of the CuO2 planes is obtained by charge transfer from the interface layers, which act as charge reservoir., Comment: 18 pages, 8 figures

Published
2011
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6. Weak Localization and Dimensional Crossover in Carbon Nanotube Systems

Author

Salvato, M., Lucci, M., Ottaviani, I., Cirillo, M., Orlanducci, S., Toschi, F., and Terranova, M. L.

Subjects
Condensed Matter - Mesoscale and Nanoscale Physics
Abstract

We investigate the effects of magnetic and electric fields on electron wavefunction interactions in single walled carbon nanotube bundles. The magnetoresistance measurements performed at 4.2K and the dependence of the data upon the electric field, obtained by varying the bias current through the samples, reveal good agreement with weak localization theory. Recording current-voltage characteristics at different temperatures we find an ohmic non-ohmic transition which disappears above 85K. Conductance vs temperature measurements are also well explained in the framework of weak localization theory by the predicted temperature dependence of the electric field-conditioned characteristic length. This length results equal to the average bundles diameter just at T{\backcong}85K, indicating that the observed conductance transition is due to a 2D-3D crossover.

Published
2010

7. Macroscopic effects of tunneling barriers in nanotube bundles aggregates

Author

Salvato, M., Cirillo, M., Lucci, M., Orlanducci, S., Ottaviani, I., Terranova, M. L., and Toschi, F.

Subjects
Condensed Matter - Mesoscale and Nanoscale Physics, Condensed Matter - Materials Science
Abstract

We report on experiments conducted on single walled carbon nanotube bundles aligned in chains and connected through a natural contact barrier. The dependence upon the temperature of the transport properties is investigated for samples having different characteristics. Starting from two bundles separated by one barrier deposited over four contact probes, we extend the study of the transport properties to samples formed by chains of several bundles. The systematic analysis of the properties of these aggregates shows the existence of two conduction regimes in the barrier. We show that an electrical circuit taking into account serial and parallel combinations of voltages generated at the junctions between bundles models the samples consistently., Comment: 9 pages and 3 figures

Published
2009

8. Coherent Activation of Zero-Field Fiske Modes in Arrays of Josephson Junctions

Author

Ottaviani, I., Cirillo, M., Lucci, M., Merlo, V., Salvato, M., Castellano, M. G., Torrioli, G., Mueller, F., and Weimann, T.

Subjects
Condensed Matter - Superconductivity
Abstract

Series arrays of Josephson junctions show evidence of a mode in which all the junctions oscillate in synchronism on voltage resonances appearing, in zero external magnetic field, at multiples of the fundamental Fiske step spacing. The measurements show that the current amplitude of the resonances increases linearly as their voltages are summed. Investigation of the nature of the coherent mode by magnetic field responses of arrays and isolated juctions reveals that the oscillations take place in a parameter plane region where dc magnetic fields only activate boundary current and flux-quanta dynamics can take place., Comment: 12 pages and 4 figures

Published
2008

9. Charge-transport and tunneling in single-walled carbon nanotubes

Author

Salvato, M., Cirillo, M., Lucci, M., Orlanducci, S., Ottaviani, I., Terranova, M. L., and Toschi, F.

Subjects
Condensed Matter - Materials Science
Abstract

We investigate experimentally the transport properties of single-walled carbon nanotube bundles as a function of temperature and applied current over broad intervals of these variables. The analysis is performed on arrays of nanotube bundles whose axes are aligned along the direction of the externally supplied bias current. The data are found consistent with a charge transport model governed by the tunnelling between metallic regions occurring through potential barriers generated by nanotubes contact areas or bundles surfaces. Based on this model and on experimental data we describe quantitatively the dependencies of the amplitude of these barriers upon bias current and temperature., Comment: 8 pages, 4 figures. Physical Review Letters (in press)

Published
2008
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10. Prone position in intubated, mechanically ventilated patients with COVID-19: a multi-centric study of more than 1000 patients

Author

Langer, T., Brioni, M., Guzzardella, A., Carlesso, E., Cabrini, L., Castelli, G., Dalla Corte, F., De Robertis, E., Favarato, M., Forastieri, A., Forlini, C., Girardis, M., Grieco, D. L., Mirabella, L., Noseda, V., Previtali, P., Protti, A., Rona, R., Tardini, F., Tonetti, T., Zannoni, F., Antonelli, M., Foti, G., Ranieri, M., Pesenti, A., Fumagalli, R., Grasselli, G., Berselli, A., Bove, T., Calligari, P., Coloretti, I., Coluccello, A., Costantini, E., Fanelli, V., Gagliardi, G., Longhini, F., Mariani, F., Mascarello, A., Menga, L., Ottaviani, I., Pasero, D., Pedeferri, M., Pezzi, A., Servillo, G., Severgnini, P., Spadaro, S., Zambelli, V., Langer, T., Brioni, M., Guzzardella, A., Carlesso, E., Cabrini, L., Castelli, G., Dalla Corte, F., De Robertis, E., Favarato, M., Forastieri, A., Forlini, C., Girardis, M., Grieco, D. L., Mirabella, L., Noseda, V., Previtali, P., Protti, A., Rona, R., Tardini, F., Tonetti, T., Zannoni, F., Antonelli, M., Foti, G., Ranieri, M., Pesenti, A., Fumagalli, R., Grasselli, G., Berselli, A., Bove, T., Calligari, P., Coloretti, I., Coluccello, A., Costantini, E., Fanelli, V., Gagliardi, G., Longhini, F., Mariani, F., Mascarello, A., Menga, L., Ottaviani, I., Pasero, D., Pedeferri, M., Pezzi, A., Servillo, G., Severgnini, P., Spadaro, S., Zambelli, V., Langer T., Brioni M., Guzzardella A., Carlesso E., Cabrini L., Castelli G., Dalla Corte F., De Robertis E., Favarato M., Forastieri A., Forlini C., Girardis M., Grieco D.L., Mirabella L., Noseda V., Previtali P., Protti A., Rona R., Tardini F., Tonetti T., Zannoni F., Antonelli M., Foti G., Ranieri M., Pesenti A., Fumagalli R., Grasselli G., Berselli A., Bove T., Calligari P., Coloretti I., Coluccello A., Costantini E., Fanelli V., Gagliardi G., Longhini F., Mariani F., Mascarello A., Menga L., Ottaviani I., Pasero D., Pedeferri M., Pezzi A., Servillo G., Severgnini P., Spadaro S., Zambelli V., Langer, T, Brioni, M, Guzzardella, A, Carlesso, E, Cabrini, L, Castelli, G, Dalla Corte, F, De Robertis, E, Favarato, M, Forastieri, A, Forlini, C, Girardis, M, Grieco, D, Mirabella, L, Noseda, V, Previtali, P, Protti, A, Rona, R, Tardini, F, Tonetti, T, Zannoni, F, Antonelli, M, Foti, G, Ranieri, M, Pesenti, A, Fumagalli, R, and Grasselli, G

Subjects
Male, ARDS, Supine position, medicine.medical_treatment, COVID-19, Mechanical ventilation, Prone positioning, Refractory hypoxemia, Critical Care and Intensive Care Medicine, Cohort Studies, 0302 clinical medicine, Supine Position, 030212 general & internal medicine, education.field_of_study, Respiration, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Middle Aged, Prone position, Italy, Anesthesia, Practice Guidelines as Topic, Artificial, Female, Critical Care, Population, Ventilation/perfusion ratio, Patient Positioning, NO, 03 medical and health sciences, Intensive care, Settore MED/41 - ANESTESIOLOGIA, medicine, Prone Position, Humans, education, Aged, Retrospective Studies, Intubation, Respiration, Artificial, business.industry, Research, 030208 emergency & critical care medicine, lcsh:RC86-88.9, medicine.disease, Respiratory failure, business
Abstract

Background Limited data are available on the use of prone position in intubated, invasively ventilated patients with Coronavirus disease-19 (COVID-19). Aim of this study is to investigate the use and effect of prone position in this population during the first 2020 pandemic wave. Methods Retrospective, multicentre, national cohort study conducted between February 24 and June 14, 2020, in 24 Italian Intensive Care Units (ICU) on adult patients needing invasive mechanical ventilation for respiratory failure caused by COVID-19. Clinical data were collected on the day of ICU admission. Information regarding the use of prone position was collected daily. Follow-up for patient outcomes was performed on July 15, 2020. The respiratory effects of the first prone position were studied in a subset of 78 patients. Patients were classified as Oxygen Responders if the PaO2/FiO2 ratio increased ≥ 20 mmHg during prone position and as Carbon Dioxide Responders if the ventilatory ratio was reduced during prone position. Results Of 1057 included patients, mild, moderate and severe ARDS was present in 15, 50 and 35% of patients, respectively, and had a resulting mortality of 25, 33 and 41%. Prone position was applied in 61% of the patients. Patients placed prone had a more severe disease and died significantly more (45% vs. 33%, p 2/FiO2 ratio, while no change in respiratory system compliance or ventilatory ratio was observed. Seventy-eight % of the subset of 78 patients were Oxygen Responders. Non-Responders had a more severe respiratory failure and died more often in the ICU (65% vs. 38%, p = 0.047). Forty-seven % of patients were defined as Carbon Dioxide Responders. These patients were older and had more comorbidities; however, no difference in terms of ICU mortality was observed (51% vs. 37%, p = 0.189 for Carbon Dioxide Responders and Non-Responders, respectively). Conclusions During the COVID-19 pandemic, prone position has been widely adopted to treat mechanically ventilated patients with respiratory failure. The majority of patients improved their oxygenation during prone position, most likely due to a better ventilation perfusion matching. Trial registration: clinicaltrials.gov number: NCT04388670

Published
2021

11. Sustained oxygenation improvement after first prone positioning is associated with liberation from mechanical ventilation and mortality in critically ill COVID-19 patients: a cohort study

Author

Scaramuzzo G., Gamberini L., Tonetti T., Zani G., Ottaviani I., Mazzoli C. A., Capozzi C., Giampalma E., Bacchi Reggiani M. L., Bertellini E., Castelli A., Cavalli I., Colombo D., Crimaldi F., Damiani F., Fusari M., Gamberini E., Gordini G., Laici C., Lanza M. C., Leo M., Marudi A., Nardi G., Papa R., Potalivo A., Russo E., Taddei S., Consales G., Cappellini I., Ranieri V. M., Volta C. A., Guerin C., Spadaro S., Tartaglione M., Chiarini V., Buldini V., Coniglio C., Moro F., Barbalace C., Citino M., Cilloni N., Giuntoli L., Bellocchio A., Matteo E., Pizzilli G., Siniscalchi A., Tartivita C., Matteo F., Marchio A., Bacchilega I., Bernabe L., Guarino S., Mosconi E., Bissoni L., Viola L., Meconi T., Pavoni V., Pagni A., Pompa Cleta P., Cavagnino M., Malfatto A., Adduci A., Pareschi S., Melegari G., Maccieri J., Marinangeli E., Racca F., Verri M., Falo G., Marangoni E., Boni F., Felloni G., Baccarini F. D., Terzitta M., Maitan S., Becherucci F., Parise M., Masoni F., Imbriani M., Orlandi P., Monetti F., Dalpiaz G., Golfieri R., Ciccarese F., Poerio A., Muratore F., Ferrari F., Mughetti M., Franchini L., Neziri E., Miceli M., Minguzzi M. T., Mellini L., Piciucchi S., Bartolucci M., Scaramuzzo G., Gamberini L., Tonetti T., Zani G., Ottaviani I., Mazzoli C.A., Capozzi C., Giampalma E., Bacchi Reggiani M.L., Bertellini E., Castelli A., Cavalli I., Colombo D., Crimaldi F., Damiani F., Fusari M., Gamberini E., Gordini G., Laici C., Lanza M.C., Leo M., Marudi A., Nardi G., Papa R., Potalivo A., Russo E., Taddei S., Consales G., Cappellini I., Ranieri V.M., Volta C.A., Guerin C., Spadaro S., Tartaglione M., Chiarini V., Buldini V., Coniglio C., Moro F., Barbalace C., Citino M., Cilloni N., Giuntoli L., Bellocchio A., Matteo E., Pizzilli G., Siniscalchi A., Tartivita C., Matteo F., Marchio A., Bacchilega I., Bernabe L., Guarino S., Mosconi E., Bissoni L., Viola L., Meconi T., Pavoni V., Pagni A., Pompa Cleta P., Cavagnino M., Malfatto A., Adduci A., Pareschi S., Melegari G., Maccieri J., Marinangeli E., Racca F., Verri M., Falo G., Marangoni E., Boni F., Felloni G., Baccarini F.D., Terzitta M., Maitan S., Becherucci F., Parise M., Masoni F., Imbriani M., Orlandi P., Monetti F., Dalpiaz G., Golfieri R., Ciccarese F., Poerio A., Muratore F., Ferrari F., Mughetti M., Franchini L., Neziri E., Miceli M., Minguzzi M.T., Mellini L., Piciucchi S., and Bartolucci M.

Subjects
medicine.medical_specialty, Supine position, COVID19, medicine.medical_treatment, Respiratory physiology, Prone positioning, ventilatory free days, Critical Care and Intensive Care Medicine, ICU, COVID19, Prone positioning, ventilatory free days, NO, 03 medical and health sciences, 0302 clinical medicine, Anesthesiology, medicine, 030212 general & internal medicine, Mechanical ventilation, business.industry, RC86-88.9, Research, Medical emergencies. Critical care. Intensive care. First aid, Oxygenation, respiratory system, respiratory tract diseases, Prone position, 030228 respiratory system, Anesthesia, ICU, Complication, business, Cohort study
Abstract

Background Prone positioning (PP) has been used to improve oxygenation in patients affected by the SARS-CoV-2 disease (COVID-19). Several mechanisms, including lung recruitment and better lung ventilation/perfusion matching, make a relevant rational for using PP. However, not all patients maintain the oxygenation improvement after returning to supine position. Nevertheless, no evidence exists that a sustained oxygenation response after PP is associated to outcome in mechanically ventilated COVID-19 patients. We analyzed data from 191 patients affected by COVID-19-related acute respiratory distress syndrome undergoing PP for clinical reasons. Clinical history, severity scores and respiratory mechanics were analyzed. Patients were classified as responders (≥ median PaO2/FiO2 variation) or non-responders (2/FiO2 variation) based on the PaO2/FiO2 percentage change between pre-proning and 1 to 3 h after re-supination in the first prone positioning session. Differences among the groups in physiological variables, complication rates and outcome were evaluated. A competing risk regression analysis was conducted to evaluate if PaO2/FiO2 response after the first pronation cycle was associated to liberation from mechanical ventilation. Results The median PaO2/FiO2 variation after the first PP cycle was 49 [19–100%] and no differences were found in demographics, comorbidities, ventilatory treatment and PaO2/FiO2 before PP between responders (96/191) and non-responders (95/191). Despite no differences in ICU length of stay, non-responders had a higher rate of tracheostomy (70.5% vs 47.9, P = 0.008) and mortality (53.7% vs 33.3%, P = 0.006), as compared to responders. Moreover, oxygenation response after the first PP was independently associated to liberation from mechanical ventilation at 28 days and was increasingly higher being higher the oxygenation response to PP. Conclusions Sustained oxygenation improvement after first PP session is independently associated to improved survival and reduced duration of mechanical ventilation in critically ill COVID-19 patients.

Published
2021

13. Effects of High Flow Nasal Cannula on Respiratory Effort in Patients with Extra-Pulmonary Sepsis or Septic Shock: A Sub-Phenotypes Analysis

Author

Mauri, T., primary, Spinelli, E., additional, Pavlovsky, B., additional, Grieco, D.L., additional, Ottaviani, I., additional, Basile, M.C., additional, Dalla Corte, F., additional, Pintaudi, G., additional, Garofalo, E., additional, Rundo, A., additional, Volta, C.A., additional, Pesenti, A., additional, and Spadaro, S., additional

Published
2021
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14. Factors influencing liberation from mechanical ventilation in coronavirus disease 2019: multicenter observational study in fifteen Italian ICUs

Author

Gamberini, L., Tonetti, T., Spadaro, S., Zani, G., Mazzoli, C. A., Capozzi, C., Giampalma, E., Bacchi Reggiani, M. L., Bertellini, E., Castelli, A., Cavalli, I., Colombo, D., Crimaldi, F., Damiani, F., Fogagnolo, A., Fusari, M., Gamberini, E., Gordini, G., Laici, C., Lanza, M. C., Leo, M., Marudi, A., Nardi, G., Ottaviani, I., Papa, R., Potalivo, A., Russo, E., Taddei, S., Volta, C. A., Ranieri, V. M., Tartaglione, M., Chiarini, V., Buldini, V., Coniglio, C., Moro, F., Cilloni, N., Giuntoli, L., Bellocchio, A., Matteo, E., Pizzilli, G., Siniscalchi, A., Tartivita, C., Matteo, F., Marchio, A., Bacchilega, I., Bernabe, L., Guarino, S., Mosconi, G., Bissoni, L., Viola, L., Meconi, T., Pavoni, V., Pagni, A., Pompacleta, P., Cavagnino, M., Malfatto, A., Adduci, A., Pareschi, S., Melegari, G., Maccieri, J., Marinangeli, E., Racca, F., Verri, M., Falo, G., Marangoni, E., Boni, F., Felloni, G., Baccarini, F. D., Terzitta, M., Maitan, S., Imbriani, M., Orlandi, P., Dalpiaz, G., Golfieri, R., Ciccarese, F., Poerio, A., Muratore, F., Ferrari, F., Mughetti, M., Franchini, L., Neziri, E., Miceli, M., Minguzzi, M. T., Mellini, L., Piciucchi, S., Gamberini, Lorenzo, Tonetti, Tommaso, Spadaro, Savino, Zani, Gianluca, Mazzoli, Carlo Alberto, Capozzi, Chiara, Giampalma, Emanuela, Bacchi Reggiani, Maria Letizia, Bertellini, Elisabetta, Castelli, Andrea, Cavalli, Irene, Colombo, Davide, Crimaldi, Federico, Damiani, Federica, Fogagnolo, Alberto, Fusari, Maurizio, Gamberini, Emiliano, Gordini, Giovanni, Laici, Cristiana, Lanza, Maria Concetta, Leo, Mirco, Marudi, Andrea, Nardi, Giuseppe, Ottaviani, Irene, Papa, Raffaella, Potalivo, Antonella, Russo, Emanuele, Taddei, Stefania, Volta, Carlo Alberto, and Ranieri, V Marco

Subjects
medicine.medical_specialty, ARDS, medicine.medical_treatment, artificial, Outcomes, Critical Care and Intensive Care Medicine, law.invention, NO, 03 medical and health sciences, 0302 clinical medicine, Mechanical ventilation, law, Coronavirus disease 2019, Intensive care, Outcomes, mortality, Respiration, artificial, medicine, 030212 general & internal medicine, Renal replacement therapy, business.industry, Research, Respiration, Organ dysfunction, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, lcsh:RC86-88.9, medicine.disease, Intensive care unit, mortality, Respiratory failure, Emergency medicine, SOFA score, medicine.symptom, business
Abstract

Background A large proportion of patients with coronavirus disease 2019 (COVID-19) develop severe respiratory failure requiring admission to the intensive care unit (ICU) and about 80% of them need mechanical ventilation (MV). These patients show great complexity due to multiple organ involvement and a dynamic evolution over time; moreover, few information is available about the risk factors that may contribute to increase the time course of mechanical ventilation. The primary objective of this study is to investigate the risk factors associated with the inability to liberate COVID-19 patients from mechanical ventilation. Due to the complex evolution of the disease, we analyzed both pulmonary variables and occurrence of non-pulmonary complications during mechanical ventilation. The secondary objective of this study was the evaluation of risk factors for ICU mortality. Methods This multicenter prospective observational study enrolled 391 patients from fifteen COVID-19 dedicated Italian ICUs which underwent invasive mechanical ventilation for COVID-19 pneumonia. Clinical and laboratory data, ventilator parameters, occurrence of organ dysfunction, and outcome were recorded. The primary outcome measure was 28 days ventilator-free days and the liberation from MV at 28 days was studied by performing a competing risks regression model on data, according to the method of Fine and Gray; the event death was considered as a competing risk. Results Liberation from mechanical ventilation was achieved in 53.2% of the patients (208/391). Competing risks analysis, considering death as a competing event, demonstrated a decreased sub-hazard ratio for liberation from mechanical ventilation (MV) with increasing age and SOFA score at ICU admission, low values of PaO2/FiO2 ratio during the first 5 days of MV, respiratory system compliance (CRS) lower than 40 mL/cmH2O during the first 5 days of MV, need for renal replacement therapy (RRT), late-onset ventilator-associated pneumonia (VAP), and cardiovascular complications. ICU mortality during the observation period was 36.1% (141/391). Similar results were obtained by the multivariate logistic regression analysis using mortality as a dependent variable. Conclusions Age, SOFA score at ICU admission, CRS, PaO2/FiO2, renal and cardiovascular complications, and late-onset VAP were all independent risk factors for prolonged mechanical ventilation in patients with COVID-19. Trial registration NCT04411459

Published
2020

16. Engineering quantum interference

Author

Lucci, M., primary, Merlo, V., additional, Ottaviani, I., additional, Cirillo, M., additional, Badoni, D., additional, Campanari, V., additional, Salina, G., additional, Caputo, J. G., additional, and Loukitch, L., additional

Published
2018
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17. Meta-material for nuclear particle detection

Author

Merlo, V, primary, Salvato, M, additional, Lucci, M, additional, Ottaviani, I, additional, Cirillo, M, additional, Scherillo, A, additional, Schooneveld, E M, additional, Vannozzi, A, additional, Celentano, G, additional, and Pietropaolo, A, additional

Published
2016
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19. Superconducting thermal neutron detectors

Author

Merlo, V., primary, Pietropaolo, A., additional, Celentano, G., additional, Cirillo, M., additional, Lucci, M., additional, Ottaviani, I., additional, Salvato, M., additional, Scherillo, A., additional, Schooneveld, E.M., additional, and Vannozzi, A., additional

Published
2016
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21. Occurrence of a high-temperature superconducting phase in (CaCuO 2 ) n /(SrTiO 3 ) m superlattices

Author

Di Castro, D., Salvato, M., Tebano, A., Innocenti, D., Aruta, C., Prellier, Wilfrid, Lebedev, O., Ottaviani, I., Brookes, N., Minola, M., Moretti Sala, M., Mazzoli, C., Medaglia, P., Ghiringhelli, G., Braicovich, L., Cirillo, M., Balestrino, G., Università degli Studi di Roma Tor Vergata [Roma], Dipartimento di Scienze Fisiche [Naples], University of Naples Federico II = Università degli studi di Napoli Federico II, Laboratoire de cristallographie et sciences des matériaux (CRISMAT), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-École Nationale Supérieure d'Ingénieurs de Caen (ENSICAEN), Normandie Université (NU)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche sur les Matériaux Avancés (IRMA), Normandie Université (NU)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université de Rouen Normandie (UNIROUEN), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS), European Synchrotron Radiation Facility (ESRF), Politecnico di Milano [Milan] (POLIMI), Max-Planck-Institut für Extraterrestrische Physik (MPE), Università degli studi di Napoli Federico II, École Nationale Supérieure d'Ingénieurs de Caen (ENSICAEN), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Institut de Chimie du CNRS (INC), and CNR/SPIN and Dipartimento di Fisica

Subjects
[PHYS]Physics [physics], [CHIM]Chemical Sciences, [CHIM.MATE]Chemical Sciences/Material chemistry, ComputingMilieux_MISCELLANEOUS
Abstract

International audience; We report the occurrence of superconductivity, with maximum Tc=40 K, in superlattices (SLs) based on two insulating oxides, namely CaCuO2 and SrTiO3. In these (CaCuO2)n/(SrTiO3)m SLs, the CuO2 planes belong only to CaCuO2 block, which is an antiferromagnetic insulator. Superconductivity, confined within a few unit cells at the CaCuO2/SrTiO3 interface, shows up only when the SLs are grown in a highly oxidizing atmosphere, because of extra oxygen ions entering at the interfaces. The hole doping is obtained by charge transfer from the interface layers, which thus act as charge reservoir.

Published
2012

26. Hybrid superconducting neutron detectors

Author

Merlo, V., primary, Salvato, M., additional, Cirillo, M., additional, Lucci, M., additional, Ottaviani, I., additional, Scherillo, A., additional, Celentano, G., additional, and Pietropaolo, A., additional

Published
2015
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29. Tranport properties of SW and MW carbon nanotube bundles

Author

Salvato, M, Cirillo, M, Lucci, M, Orlanducci, S, Ottaviani, I, TERRANOVA PERSICHELLI, Ml, and Toschi, F

Subjects
Settore CHIM/03 - Chimica Generale e Inorganica, carbon nanotubes, charge transport, Settore FIS/01 - Fisica Sperimentale
Published
2009

40. Characterization of Thick Film of Copper Electrodeposited for Cryogenic Applications.

Author

Fava, A., Lucci, M., Faso, D., Luzzi, A., Salvato, M., Vecchione, A., Fittipaldi, R., Ottaviani, I., Colantoni, I., Tomellini, M., and Davolia, I.

Subjects
THICK films, COPPER plating, ELECTROFORMING, CRYOGENICS, COPPER films, X-ray diffraction
Abstract

We report on the characterization of electroformed copper. Different copper films have been deposited, on a brass rod, paying attention to modify only one parameter of the galvanic bath for each specimen (acidity, temperature, density of current, etc.). The samples obtained have been analyzed by residual resistivity ratio (RRR) to evaluated the electrical conductivity, with the nanoindenter to measure the hardness and the reduced modulus and with the X-ray diffraction to calculate the average dimensions of the grains. The comparative analysis of all the data gives us the set of parameters required to obtain a good electrical conductor, working at cryogenic temperatures and mechanically resistant. [ABSTRACT FROM AUTHOR]

Published
2014
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43. Health-related quality of life profiles, trajectories, persistent symptoms and pulmonary function one year after ICU discharge in invasively ventilated COVID-19 patients, a prospective follow-up study

Author

Antonio Poerio, Andrea Castelli, Sara Piciucchi, Giulia Falò, Davide Allegri, Marco Verri, Andrea Marudi, Massimiliano Mazzolini, Michele Imbriani, Loredana Franchini, Carlo Coniglio, Mirco Leo, Antonella Potalivo, Luigi Lazzari Agli, Roberta Nicali, Marco Cavagnino, Guglielmo Consales, Marina Terzitta, Harri Sintonen, Raffaella Papa, Maria Teresa Minguzzi, Cristiana Laici, Paolo Orlandi, Federica Damiani, Carlo Alberto Mazzoli, Silvia Orlando, Vito Marco Ranieri, Iacopo Cappellini, Valentina Chiarini, Elisa Marinangeli, Stefano Oldani, Virginia Buldini, Marco Tartaglione, Gianluca Zani, Lorenzo Mellini, Carlo Alberto Volta, Irene Ottaviani, Silvia Candini, Filippo Becherucci, Emanuela Giampalma, Maria Concetta Lanza, Federica Ciccarese, Irene Cavalli, Annalisa Marchio, Bruno Balbi, Fabrizio Racca, Matteo Monari, Luca Morini, Anna Malfatto, Elisabetta Bertellini, Francesco Boni, Emanuele Russo, Lorenzo Viola, Michele Valli, Savino Spadaro, Martina Ferioli, Emanuele Matteo, Giovanni Gordini, Marco Contoli, Ilaria Valentini, Chiara Tartivita, Alessia Guzzo, Lorenzo Giuntoli, Gaetano Scaramuzzo, Davide Colombo, Jessica Maccieri, Luca Bissoni, Stefano Nava, Angela Bellocchio, Patrizio Goti, Laura Bernabé, Jonathan Montomoli, Stefano Maitan, Tommaso Meconi, Angelo Senzi, Lorenzo Gamberini, Silvia Pareschi, Stefania Taddei, Angelica Venni, Fabio Ferrari, Marco Miceli, Chiara Capozzi, Elisabetta Marangoni, Lorenzo Tutino, Giulia Felloni, Antonio Siniscalchi, Giacinto Pizzilli, Francesco Muratore, Giorgia Dalpiaz, Federico Moro, Daniele Fecarotti, Vanni Agnoletti, Gabriele Melegari, Rita Golfieri, Federico Domenico Baccarini, Francesca Facondini, Patrizia Pompa Cleta, Marianna Padovani, Eva Bernardi, Tommaso Tonetti, Angelina Adduci, Federico Daniele, Anna Filomena Ferravante, Maurizio Fusari, Igor Bacchilega, Claudia Ravaglia, Nicola Cilloni, Martina Mughetti, Vittorio Pavoni, Ersenad Neziri, Irene Prediletto, Aline Pagni, Gamberini L., Mazzoli C.A., Prediletto I., Sintonen H., Scaramuzzo G., Allegri D., Colombo D., Tonetti T., Zani G., Capozzi C., Dalpiaz G., Agnoletti V., Cappellini I., Melegari G., Damiani F., Fusari M., Gordini G., Laici C., Lanza M.C., Leo M., Marudi A., Papa R., Potalivo A., Montomoli J., Taddei S., Mazzolini M., Ferravante A.F., Nicali R., Ranieri V.M., Russo E., Volta C.A., Spadaro S., Tartaglione M., Chiarini V., Buldini V., Coniglio C., Moro F., Orlando S., Fecarotti D., Cilloni N., Giuntoli L., Bellocchio A., Matteo E., Pizzilli G., Siniscalchi A., Tartivita C., Cavalli I., Castelli A., Marchio A., Bacchilega I., Bernabe L., Facondini F., Morini L., Bissoni L., Viola L., Meconi T., Pavoni V., Venni A., Pagni A., Cleta P.P., Cavagnino M., Guzzo A., Malfatto A., Adduci A., Pareschi S., Bertellini E., Maccieri J., Marinangeli E., Racca F., Verri M., Falo G., Marangoni E., Ottaviani I., Boni F., Felloni G., Baccarini F.D., Terzitta M., Maitan S., Tutino L., Senzi A., Consales G., Becherucci F., Imbriani M., Orlandi P., Candini S., Golfieri R., Ciccarese F., Poerio A., Muratore F., Ferrari F., Mughetti M., Giampalma E., Franchini L., Neziri E., Miceli M., Minguzzi M.T., Mellini L., Piciucchi S., Monari M., Valli M., Daniele F., Ferioli M., Nava S., Lazzari Agli L.A., Valentini I., Bernardi E., Balbi B., Contoli M., Padovani M., Oldani S., Ravaglia C., and Goti P.

Subjects
Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, Health-related quality of life, Population, Article, NO, Pulmonary function testing, 03 medical and health sciences, 0302 clinical medicine, Quality of life, DLCO, Acute respiratory distress syndrome, COVID-19, Dyspnea, Respiratory function tests, Internal medicine, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Survivors, education, Aged, Mechanical ventilation, Health related quality of life, education.field_of_study, Respiratory Distress Syndrome, business.industry, Middle Aged, Respiration, Artificial, Patient Discharge, humanities, 3. Good health, Intensive Care Units, 030228 respiratory system, Italy, Quality of Life, Female, business, Icu discharge, Follow-Up Studies
Abstract

Background Health-related quality of life (HRQoL) impairment is often reported among COVID-19 ICU survivors, and little is known about their long-term outcomes. We evaluated the HRQoL trajectories between 3 months and 1 year after ICU discharge, the factors influencing these trajectories and the presence of clusters of HRQoL profiles in a population of COVID-19 patients who underwent invasive mechanical ventilation (IMV). Moreover, pathophysiological correlations of residual dyspnea were tested. Methods We followed up 178 survivors from 16 Italian ICUs up to one year after ICU discharge. HRQoL was investigated through the 15D instrument. Available pulmonary function tests (PFTs) and chest CT scans at 1 year were also collected. A linear mixed-effects model was adopted to identify factors associated with different HRQoL trajectories and a two-step cluster analysis was performed to identify HRQoL clusters. Results We found that HRQoL increased during the study period, especially for the significant increase of the physical dimensions, while the mental dimensions and dyspnea remained substantially unchanged. Four main 15D profiles were identified: full recovery (47.2%), bad recovery (5.1%) and two partial recovery clusters with mostly physical (9.6%) or mental (38.2%) dimensions affected. Gender, duration of IMV and number of comorbidities significantly influenced HRQoL trajectories. Persistent dyspnea was reported in 58.4% of patients, and weakly, but significantly, correlated with both DLCO and length of IMV. Conclusions HRQoL impairment is frequent 1 year after ICU discharge, and the lowest recovery is found in the mental dimensions. Persistent dyspnea is often reported and weakly correlated with PFTs alterations. Trial registration NCT04411459.

Published
2021

44. Quality of life of COVID-19 critically ill survivors after ICU discharge: 90 days follow-up

Author

Mirco Leo, Harri Sintonen, Irene Cavalli, Vanni Agnoletti, Emanuela Giampalma, Maurizio Fusari, Cristiana Laici, Andrea Castelli, Chiara Capozzi, Irene Ottaviani, Andrea Marudi, Carlo Alberto Mazzoli, Tommaso Tonetti, Iacopo Cappellini, Stefania Taddei, Federica Damiani, Carlo Alberto Volta, Gianluca Zani, Raffaella Papa, Filippo Becherucci, Lorenzo Gamberini, Savino Spadaro, Davide Colombo, Davide Allegri, Gaetano Scaramuzzo, Antonella Potalivo, Giuseppe Nardi, Maria Concetta Lanza, Elisabetta Bertellini, Giovanni Gordini, Federico Crimaldi, Vito Marco Ranieri, Emanuele Russo, Gamberini L., Mazzoli C.A., Sintonen H., Colombo D., Scaramuzzo G., Allegri D., Tonetti T., Zani G., Capozzi C., Giampalma E., Agnoletti V., Becherucci F., Bertellini E., Castelli A., Cappellini I., Cavalli I., Crimaldi F., Damiani F., Fusari M., Gordini G., Laici C., Lanza M.C., Leo M., Marudi A., Nardi G., Ottaviani I., Papa R., Potalivo A., Ranieri V.M., Russo E., Taddei S., Volta C.A., Spadaro S., Clinicum, Harri Sintonen Research Group, and Department of Public Health

Subjects
Male, medicine.medical_specialty, ARDS, Coronavirus disease 2019 (COVID-19), Critical Illness, medicine.medical_treatment, Health-related quality of life, Coronaviru, Disease, Severity of Illness Index, Article, NO, law.invention, Quality of life, law, medicine, Humans, Survivors, Aged, Mechanical ventilation, Respiratory Distress Syndrome, Acute respiratory distress syndrome, SARS-CoV-2, business.industry, Public Health, Environmental and Occupational Health, COVID-19, 15D instrument, Coronavirus, Middle Aged, medicine.disease, Intensive care unit, Patient Discharge, humanities, Intensive Care Units, 3121 General medicine, internal medicine and other clinical medicine, Emergency medicine, Cohort, Quality of Life, Female, Icu discharge, business, Follow-Up Studies
Abstract

Purpose The onset of the coronavirus disease 19 (COVID-19) pandemic in Italy induced a dramatic increase in the need for intensive care unit (ICU) beds for a large proportion of patients affected by COVID-19-related acute respiratory distress syndrome (ARDS). The aim of the present study was to describe the health-related quality of life (HRQoL) at 90 days after ICU discharge in a cohort of COVID-19 patients undergoing invasive mechanical ventilation and to compare it with an age and sex-matched sample from the general Italian and Finnish populations. Moreover, the possible associations between clinical, demographic, social factors, and HRQoL were investigated. Methods COVID-19 ARDS survivors from 16 participating ICUs were followed up until 90 days after ICU discharge and the HRQoL was evaluated with the 15D instrument. A parallel cohort of age and sex-matched Italian population from the same geographic areas was interviewed and a third group of matched Finnish population was extracted from the Finnish 2011 National Health survey. A linear regression analysis was performed to evaluate potential associations between the evaluated factors and HRQoL. Results 205 patients answered to the questionnaire. HRQoL of the COVID-19 ARDS patients was significantly lower than the matched populations in both physical and mental dimensions. Age, sex, number of comorbidities, ARDS class, duration of invasive mechanical ventilation, and occupational status were found to be significant determinants of the 90 days HRQoL. Clinical severity at ICU admission was poorly correlated to HRQoL. Conclusion COVID-19-related ARDS survivors at 90 days after ICU discharge present a significant reduction both on physical and psychological dimensions of HRQoL measured with the 15D instrument. Trial Registration: NCT04411459. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-021-02865-7.

Published
2021

45. Occurrence of a high-temperature superconducting phase in (CaCuO2)n/(SrTi03)m superlattices.

Author

Di Castro, D., Salvato, M., Tebano, A., Innocenti, D., Aruta, C., Prellier, W., Lebedev, ?. I., Ottaviani, I., Brookes, ?. B., Minola, M., Moretti Sala, M., Mazzoli, C., Medaglia, P. G., Ghiringhelli, G., Braicovich, L., Cirillo, M., and Balestrino, G.

Subjects
*HIGH temperatures, *SUPERCONDUCTORS, *COPPER oxide, *SUPERLATTICES, *SUPERCONDUCTIVITY, *STRONTIUM compounds
Abstract

We report the occurrence of superconductivity, with maximum Tc = 40 K, in superlattices (SLs) based on two insulating oxides, namely CaCuO 2 and SrTiO 3/sub>. In these (CaCuO2)n/(SrTiOsub>3)m SLs, the CuO2 planes belong only to CaCuO2 lock, which is an antiferromagnetic insulator. Superconductivity, confined within a few unit cells at the CaCuO2/SrTi O3 interface, shows up only when the SLs are grown in a highly oxidizing atmosphere, because of extra oxygen ions entering at the interfaces. The hole doping is obtained by charge transfer from the interface layers, which thus act as charge reservoir. [ABSTRACT FROM AUTHOR]

Published
2012
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46. A Case of Takotsubo Syndrome in a Smoker-Epileptic Patient With Rhinovirus Pneumonia in the Intensive Care Unit: Could the InterTAK Criteria Be Useful?

Author

Tantillo S, Guarnera M, Benvenuti F, Ottaviani I, and Cilloni N

Abstract

Takotsubo syndrome (TS) is an acute cardiac dysfunction that typically presents hypokinesis of the apical segment of the left ventricle beyond a single coronary artery territory. The pathological mechanisms of TS remain unclear, and several possible theories have been postulated, including catecholamine excess, coronary artery spasm, microvascular dysfunction, and metabolic disturbances. Based on the etiology, a primary and secondary form is distinguished. In primary TS, acute cardiac symptoms are the primary reason for seeking acute medical care. In secondary TS, the syndrome occurs in patients already hospitalized for a medical or surgical condition. The clinical conditions most frequently associated with TS are respiratory pathologies, sepsis, neurological disease, endocrine disease, and psychiatric pathologies. The incidence of TS is poorly studied in the critically ill patient setting; furthermore, it is very difficult to determine its incidence, duration, and progression from the current literature. We present the clinical case of a secondary TS in a smoker patient with a history of epilepsy, hospitalized in the ICU for respiratory failure due to viral pneumonia, complicated with bronchospasm, highlighting the diagnostic difficulties in critically ill patients, the presence of multiple trigger factors, and the need to perform an early diagnosis for patient survival., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Tantillo et al.)

Published
2024
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47. Fasting in critical illness: the role of ketonuria - a retrospective observational study.

Author

Ottaviani I, Tantillo S, Miggiano L, Guarnera M, Menghini M, Talarico F, Mazzanti F, and Cilloni N

Abstract

Background: Metabolic acidosis is a frequent finding in patients admitted to the intensive care unit (ICU). It can be caused by prolonged fasting due to surgical procedures or by medical conditions that lead to starvation ketoacidosis (SKA). Early recognition and treatment of SKA could prevent several life-threatening complications, improving survival and reducing the ICU length of stay., Methods: We retrospectively screened all medical records of patients admitted to the ICU (Maggiore Hospital, Bologna, North Italy) from May 2022 to April 2023. We included patients aged 18 years or older who presented ketonuria detected in the urine sample., Results: We analyzed 190 patients with ketonuria at ICU admission. Postsurgical patients showed lower levels of albumin and a higher rate of shock compared to medical patients. Ketonuric patients with shock had a lower body mass index (BMI) compared to patients without shock (24 versus 26 kg/m2, respectively). There were no differences within groups regarding mortality and ICU readmission rate. Medical patients had a significantly higher ICU length of stay., Conclusions: This retrospective observational descriptive study showed that patients with ketonuria, hypoalbuminemia, and low BMI at ICU admission have high risk of hemodynamic instability and shock. Surgical patients compared to medical patients are exposed to a catabolic trigger that could worsen a state of malnutrition and induce anabolic resistance; elective and urgent surgical patients did not differ in terms of risk of shock and mortality, probably due to the activation of this catabolic pathway. Early recognition and treatment of starvation ketoacidosis and perioperative nutritional optimization could reduce incidence of hemodynamic and metabolic complications., (© 2024. The Author(s).)

Published
2024
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48. Mechanical ventilation and COPD: from pathophysiology to ventilatory management.

Author

Scaramuzzo G, Ottaviani I, Volta CA, and Spadaro S

Subjects
Humans, Lung, Respiratory Function Tests, Pulmonary Disease, Chronic Obstructive therapy, Respiration, Artificial
Abstract

In the chronic obstructive pulmonary disease (COPD), lung and chest-wall morphological alterations determine important and peculiar approaches to mechanical ventilation. Lung emphysema and reduced elastic recoil increase expiratory time, thus worsening dynamic hyperinflation, while airways chronic inflammation rises resistances and can determine distal air-trapping. Muscle wasting and fast fibers prevalence can result in weakness and in an earlier onset of muscle fatigue, prolonging the weaning process. In this narrative review, we explored the connection between altered pathophysiology and necessity for respiratory assistance in COPD, focusing on non-invasive and invasive respiratory management, lung monitoring and weaning difficulties.

Published
2022
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49. Focus on renal blood flow in mechanically ventilated patients with SARS-CoV-2: a prospective pilot study.

Author

Fogagnolo A, Grasso S, Dres M, Gesualdo L, Murgolo F, Morelli E, Ottaviani I, Marangoni E, Volta CA, and Spadaro S

Subjects
Humans, Pilot Projects, Prospective Studies, Renal Circulation, Respiration, Artificial, SARS-CoV-2, COVID-19, Respiratory Distress Syndrome therapy
Abstract

Mechanically ventilated patients with ARDS due to the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) seem particularly susceptible to AKI. Our hypothesis was that the renal blood flow could be more compromised in SARS-CoV-2 patients than in patients with "classical" ARDS. We compared the renal resistivity index (RRI) and the renal venous flow (RVF) in ARDS patients with SARS-CoV-2 and in ARDS patients due to other etiologies. Prospective, observational pilot study performed on 30 mechanically ventilated patients (15 with SARS-COV-2 ARDS and 15 with ARDS). Mechanical ventilation settings included constant-flow controlled ventilation, a tidal volume of 6 ml/kg of ideal body weight and the PEEP level titrated to the lowest driving pressure. Ultrasound Doppler measurements of RRI and RVF pattern were performed in each patient. Patients with SARS-COV-2 ARDS had higher RRI than patients with ARDS (0.71[0.67-0.78] vs 0.64[0.60-0.74], p = 0.04). RVF was not-continuous in 9/15 patients (71%) in the SARS-COV-2 ARDS group and in and 5/15 (33%) in the ARDS group (p = 0.27). A linear correlation was found between PEEP and RRI in patients with SARS-COV-2 ARDS (r 2  = 0.31; p = 0.03) but not in patients with ARDS. Occurrence of AKI was 53% in patients with SARS-COV-2 ARDS and 33% in patients with ARDS (p = 0.46). We found a more pronounced impairment in renal blood flow in mechanically ventilated patients with SARS-COV-2 ARDS, compared with patients with "classical" ARDS., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V. part of Springer Nature.)

Published
2022
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50. Respiratory Drive in Patients with Sepsis and Septic Shock: Modulation by High-flow Nasal Cannula.

Author

Mauri T, Spinelli E, Pavlovsky B, Grieco DL, Ottaviani I, Basile MC, Dalla Corte F, Pintaudi G, Garofalo E, Rundo A, Volta CA, Pesenti A, and Spadaro S

Subjects
Aged, Cohort Studies, Electric Impedance therapeutic use, Female, Humans, Intensive Care Units, Male, Middle Aged, Oxygen Inhalation Therapy instrumentation, Oxygen Inhalation Therapy methods, Sepsis physiopathology, Sepsis therapy, Cannula, Respiratory Insufficiency physiopathology, Respiratory Insufficiency therapy, Respiratory Rate physiology, Shock, Septic physiopathology, Shock, Septic therapy
Abstract

Background: Experimental and pilot clinical data suggest that spontaneously breathing patients with sepsis and septic shock may present increased respiratory drive and effort, even in the absence of pulmonary infection. The study hypothesis was that respiratory drive and effort may be increased in septic patients and correlated with extrapulmonary determinant and that high-flow nasal cannula may modulate drive and effort., Methods: Twenty-five nonintubated patients with extrapulmonary sepsis or septic shock were enrolled. Each patient underwent three consecutive steps: low-flow oxygen at baseline, high-flow nasal cannula, and then low-flow oxygen again. Arterial blood gases, esophageal pressure, and electrical impedance tomography data were recorded toward the end of each step. Respiratory effort was measured as the negative swing of esophageal pressure (ΔPes); drive was quantified as the change in esophageal pressure during the first 500 ms from start of inspiration (P0.5). Dynamic lung compliance was calculated as the tidal volume measured by electrical impedance tomography, divided by ΔPes. The results are presented as medians [25th to 75th percentile]., Results: Thirteen patients (52%) were in septic shock. The Sequential Organ Failure Assessment score was 5 [4 to 9]. During low-flow oxygen at baseline, respiratory drive and effort were elevated and significantly correlated with arterial lactate (r = 0.46, P = 0.034) and inversely with dynamic lung compliance (r = -0.735, P < 0.001). Noninvasive support by high-flow nasal cannula induced a significant decrease of respiratory drive (P0.5: 6.0 [4.4 to 9.0] vs. 4.3 [3.5 to 6.6] vs. 6.6 [4.9 to 10.7] cm H2O, P < 0.001) and effort (ΔPes: 8.0 [6.0 to 11.5] vs. 5.5 [4.5 to 8.0] vs. 7.5 [6.0 to 12.6] cm H2O, P < 0.001). Oxygenation and arterial carbon dioxide levels remained stable during all study phases., Conclusions: Patients with sepsis and septic shock of extrapulmonary origin present elevated respiratory drive and effort, which can be effectively reduced by high-flow nasal cannula., (Copyright © 2021, the American Society of Anesthesiologists. All Rights Reserved.)

Published
2021
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