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25 results on '"Pizza, Alessandro"'

7. Noninvasive Ventilation in a Pediatric Trauma Center: A Cohort Study.

Author

Piastra, Marco, De Bellis, Andrea, Morena, Tony C., De Luca, Daniele, Pezza, Lucilla, Pizza, Alessandro, Genovese, Orazio, Mancino, Aldo, Picconi, Enzo, and Conti, Giorgio

Subjects
NONINVASIVE ventilation, TRACHEA intubation, CRITICAL care medicine, RESPIRATORY insufficiency, PEDIATRIC intensive care
Abstract

Objective: To determine whether non-invasive ventilation (NIV) can avoid the need for tracheal intubation and/or reduce the duration of invasive ventilation (IMV) in previously intubated patients admitted to the pediatric intensive care unit (PICU) and developing acute hypoxemic respiratory failure (AHRF) after major traumatic injury. Study Design: A single center observational cohort study. Setting: Pediatric ICU in a University Hospital (tertiary referral Pediatric Trauma Centre) Population: During the 48-month study period, 276 patients (median age 6.4 years) with trauma were admitted to PICU; among 86 of them, who suffered from AHRF and received ventilation (IMV and/or NIV) for more than 12 hrs, 32 patients (median age 8.5 years) were treated with NIV. Inclusion/Exclusion Criteria: Inclusion criteria: at least 12 hours of NIV; exclusion criteria: patients with facial trauma or congenital malformations; patients receiving IMV <12 hours or perioperative ventilation. Measurements and Results: Among NIV patients, 27 (84,3%) were previously on IMV, while 5 (15,6%) could be managed exclusively with NIV. In patients with post-extubation respiratory distress, NIV was successful in 88.4% of cases. Before starting NIV, P/F ratio was 242.7 ± 71. After 8 hours of NIV treatment, a significant oxygenation improvement (PaO2/ FiO2 = 354.3 ± 81; p = 0.0002) was found, with no significant changes in carbon dioxide levels. A trend toward increasing ventilation-free time has been evidenced; NIV resulted feasible and generally well tolerated. Conclusions: AHRF in trauma patients is multifactorial and may be due to many reasons, such as lung contusion, aspiration of blood or gastric contents. Systemic inflammatory response and transfusions may also contribute to hypoxia. Our pilot study strongly suggests that NIV can be applied in post-traumatic AHRF: it may successfully reduce the time of both invasive ventilation and deep sedation. Further data from controlled studies are needed to assess the advantage of NIV in pediatric trauma. [ABSTRACT FROM AUTHOR]

Published
2022
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9. Clinical Outcomes and Prognostic Factors for Spontaneous Intracerebral Hemorrhage in Pediatric ICU: A 12-Year Experience

Author

Piastra, Marco, De Luca, Daniele, Genovese, Orazio, Tosi, Federica, Caliandro, Francesca, Zorzi, Giulia, Massimi, Luca, Visconti, Federico, Pizza, Alessandro, Biasucci, Daniele Guerino, Conti, Giorgio, Piastra, Marco (ORCID:0000-0002-3144-8970), Biasucci, Daniele G, Conti, Giorgio (ORCID:0000-0002-8566-9365), Piastra, Marco, De Luca, Daniele, Genovese, Orazio, Tosi, Federica, Caliandro, Francesca, Zorzi, Giulia, Massimi, Luca, Visconti, Federico, Pizza, Alessandro, Biasucci, Daniele Guerino, Conti, Giorgio, Piastra, Marco (ORCID:0000-0002-3144-8970), Biasucci, Daniele G, and Conti, Giorgio (ORCID:0000-0002-8566-9365)

Abstract

Clinical Outcomes and Prognostic Factors for Spontaneous Intracerebral Hemorrhage in Pediatric ICU: A 12-Year Experience

Published
2019

10. Targeting zero catheter-related bloodstream infections in pediatric intensive care unit: a retrospective matched case-control study

Author

Biasucci, Daniele G, Pittiruti, Mauro, Taddei, Alessandra, Picconi, Enzo, Pizza, Alessandro, Celentano, Davide, Piastra, Marco, Scoppettuolo, Giancarlo, Conti, Giorgio, Pittiruti, Mauro (ORCID:0000-0003-4541-7566), Piastra, Marco (ORCID:0000-0002-3144-8970), Conti, Giorgio (ORCID:0000-0002-8566-9365), Biasucci, Daniele G, Pittiruti, Mauro, Taddei, Alessandra, Picconi, Enzo, Pizza, Alessandro, Celentano, Davide, Piastra, Marco, Scoppettuolo, Giancarlo, Conti, Giorgio, Pittiruti, Mauro (ORCID:0000-0003-4541-7566), Piastra, Marco (ORCID:0000-0002-3144-8970), and Conti, Giorgio (ORCID:0000-0002-8566-9365)

Abstract

Targeting zero catheter-related bloodstream infections in pediatric intensive care unit: a retrospective matched case-control study

Published
2018

12. Clinical Outcomes and Prognostic Factors for Spontaneous Intracerebral Hemorrhage in Pediatric ICU: A 12-Year Experience

Author

Piastra, Marco, primary, De Luca, Daniele, additional, Genovese, Orazio, additional, Tosi, Federica, additional, Caliandro, Francesca, additional, Zorzi, Giulia, additional, Massimi, Luca, additional, Visconti, Federico, additional, Pizza, Alessandro, additional, Biasucci, Daniele G, additional, and Conti, Giorgio, additional

Published
2017
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15. Bedside monitoring of cerebral blood flow in traumatic bilateral internal carotid artery injury

Author

Piastra, Marco, Pizza, Alessandro, Toni, Flavia, Conti, Giorgio, Piastra, Marco (ORCID:0000-0002-3144-8970), Conti, Giorgio (ORCID:0000-0002-8566-9365), Piastra, Marco, Pizza, Alessandro, Toni, Flavia, Conti, Giorgio, Piastra, Marco (ORCID:0000-0002-3144-8970), and Conti, Giorgio (ORCID:0000-0002-8566-9365)

Abstract

Bedside monitoring of cerebral blood flow in traumatic bilateral internal carotid artery injury

Published
2017

16. Targeting zero catheter-related bloodstream infections in pediatric intensive care unit: a retrospective matched case-control study

Author

Biasucci, Daniele Guerino, Pittiruti, Mauro, Taddei, Alessandra, Picconi, Enzo, Pizza, Alessandro, Celentano, Davide, Piastra, Marco, Scoppettuolo, Giancarlo, Conti, Giorgio, Biasucci, Daniele G, Pittiruti, Mauro (ORCID:0000-0003-4541-7566), Piastra, Marco (ORCID:0000-0002-3144-8970), Conti, Giorgio (ORCID:0000-0002-8566-9365), Biasucci, Daniele Guerino, Pittiruti, Mauro, Taddei, Alessandra, Picconi, Enzo, Pizza, Alessandro, Celentano, Davide, Piastra, Marco, Scoppettuolo, Giancarlo, Conti, Giorgio, Biasucci, Daniele G, Pittiruti, Mauro (ORCID:0000-0003-4541-7566), Piastra, Marco (ORCID:0000-0002-3144-8970), and Conti, Giorgio (ORCID:0000-0002-8566-9365)

Abstract

catheter related bloodstream infections

Published
2017

17. Early versus late tracheostomy in pediatric intensive care unit: Does it matter? A 6-year experience

Author

Pizza, Alessandro, Picconi, Enzo, Piastra, Marco, Genovese, Orazio, Biasucci, Daniele Guerino, Conti, Giorgio, Piastra, Marco (ORCID:0000-0002-3144-8970), Biasucci, Daniele G., Conti, Giorgio (ORCID:0000-0002-8566-9365), Pizza, Alessandro, Picconi, Enzo, Piastra, Marco, Genovese, Orazio, Biasucci, Daniele Guerino, Conti, Giorgio, Piastra, Marco (ORCID:0000-0002-3144-8970), Biasucci, Daniele G., and Conti, Giorgio (ORCID:0000-0002-8566-9365)

Abstract

BACKGROUND: The aim of this study is to examine the clinical data of children who underwent tracheostomy during their stay in Pediatric Intensive Care Unit (PICU), in order to describe the relationship between the timing of tracheostomy, the length of PICU stay and the occurrence of ventilator-associated pneumonia (VA P). METHODS: This is a retrospective cohort study that collects all patients undergoing tracheostomy during their PICU stay over a six-year period. Data collection included PICU length of stay, days of intubation, days of mechanical ventilation, primary indication for tracheostomy, information about VA P and decannulations. The early tracheostomy group was defined as patients who had ten or fewer days of continuous ventilation, whereas the late tracheostomy group had more than ten days of continuous ventilation. RESULTS: A significant decrease in the rate of VAP incidence was noticed in the early tracheostomy group vs. late group (P=0.004, OR=0.39, 95% CI : 0.18-0.85). No differences were observed about decannulation, need of long-term ventilation and death rate. Significant decreases of days of mechanical ventilation and PICU stay were found in subgroup of patients who underwent early tracheostomy and were decannulated within 18 months. CONCLUSIONS: No standard timing for tracheostomy placement has been established in the pediatric population. Early tracheostomy can shorten the days of ventilation and hospitalization in PICU and reduce the incidence of VA P, but further studies are needed to identify patient categories in which it can be of benefit.

Published
2017

18. Clinical Outcomes and Prognostic Factors for Spontaneous Intracerebral Hemorrhage in Pediatric ICU: A 12-Year Experience

Author

Piastra, Marco, De Luca, Daniele, Genovese, Orazio, Tosi, Federica, Caliandro, Francesca, Zorzi, Giulia, Massimi, Luca, Visconti, Federico, Pizza, Alessandro, Biasucci, Daniele Guerino, Conti, Giorgio, Piastra, Marco (ORCID:0000-0002-3144-8970), Biasucci, Daniele G, Conti, Giorgio (ORCID:0000-0002-8566-9365), Piastra, Marco, De Luca, Daniele, Genovese, Orazio, Tosi, Federica, Caliandro, Francesca, Zorzi, Giulia, Massimi, Luca, Visconti, Federico, Pizza, Alessandro, Biasucci, Daniele Guerino, Conti, Giorgio, Piastra, Marco (ORCID:0000-0002-3144-8970), Biasucci, Daniele G, and Conti, Giorgio (ORCID:0000-0002-8566-9365)

Abstract

prognostic factors for spontaneous intracranial haemorrhage

Published
2017

20. Successful therapeutic hypothermia for children surviving near-hanging

Author

Piastra, Marco, Pizza, Alessandro, Biasucci, Daniele Guerino, Morena, T. C., Marzano, Laura, De Luca, Daniele, Genovese, Orazio, Bolzon, M., Betto, C., Conti, Giorgio, Piastra, M. (ORCID:0000-0002-3144-8970), Pizza, A., Biasucci, D. G., Marzano, L., De Luca, D., Genovese, O., Conti, G. (ORCID:0000-0002-8566-9365), Piastra, Marco, Pizza, Alessandro, Biasucci, Daniele Guerino, Morena, T. C., Marzano, Laura, De Luca, Daniele, Genovese, Orazio, Bolzon, M., Betto, C., Conti, Giorgio, Piastra, M. (ORCID:0000-0002-3144-8970), Pizza, A., Biasucci, D. G., Marzano, L., De Luca, D., Genovese, O., and Conti, G. (ORCID:0000-0002-8566-9365)

Abstract

Successful therapeutic hypothermia for children surviving near-hanging

Published
2016

21. Bedside Monitoring of Cerebral Blood Flow in Traumatic Bilateral Internal Carotid Artery Injury

Author

Piastra, Marco, Pizza, Alessandro, Toni, Flavia, Conti, Giorgio, Piastra, Marco (ORCID:0000-0002-3144-8970), Conti, Giorgio (ORCID:0000-0002-8566-9365), Piastra, Marco, Pizza, Alessandro, Toni, Flavia, Conti, Giorgio, Piastra, Marco (ORCID:0000-0002-3144-8970), and Conti, Giorgio (ORCID:0000-0002-8566-9365)

Abstract

The aim of this study was to describe the Bedside Monitoring of Cerebral Blood Flow in Traumatic Bilateral Internal Carotid Artery Injury

Published
2016

22. Validation of the Glycemic Stress Index in Pediatric Neurosurgical Intensive Care

Author

Piastra, Marco, Pizza, Alessandro, Tosi, Federica, Mensi, Sonia, Massimi, Luca, De Bellis, Andrea, Biasucci, Daniele Guerino, Luca, Ersilia, Conti, Giorgio, De Luca, Daniele, Piastra, Marco (ORCID:0000-0002-3144-8970), Conti, Giorgio (ORCID:0000-0002-8566-9365), Piastra, Marco, Pizza, Alessandro, Tosi, Federica, Mensi, Sonia, Massimi, Luca, De Bellis, Andrea, Biasucci, Daniele Guerino, Luca, Ersilia, Conti, Giorgio, De Luca, Daniele, Piastra, Marco (ORCID:0000-0002-3144-8970), and Conti, Giorgio (ORCID:0000-0002-8566-9365)

Abstract

Validation of the Glycemic Stress Index in Pediatric Neurosurgical Intensive Care

Published
2016

24. How to make the axillary vein larger? Effect of 90° abduction of the arm to facilitate ultrasound-guided axillary vein puncture

Author

Pittiruti, Mauro, Biasucci, Daniele Guerino, La Greca, Antonio, Pizza, Alessandro, Scoppettuolo, Giancarlo, Pittiruti, Mauro (ORCID:0000-0003-4541-7566), La Greca, Antonio (ORCID:0000-0002-7587-7427), Pittiruti, Mauro, Biasucci, Daniele Guerino, La Greca, Antonio, Pizza, Alessandro, Scoppettuolo, Giancarlo, Pittiruti, Mauro (ORCID:0000-0003-4541-7566), and La Greca, Antonio (ORCID:0000-0002-7587-7427)

Abstract

PURPOSE: Placement of central venous catheters by the infraclavicular route can be achieved by ultrasound-guided puncture of the axillary vein. However, in some cases, the axillary vein may be difficult to puncture because it is too deep or too small or because it is collapsing significantly during breathing. The objective of this observational study was to determine the effect of 90° abduction of the arm associated with forward position of the shoulder on axillary vein diameters. MATERIAL AND METHODS: In a group of 30 healthy volunteers and in a group of 40 patients during spontaneous breathing, we used ultrasound to examine the axillary vein, visualizing it in short axis, with the arm at 0° and at 90° abduction, pushing the shoulder forward. RESULTS: The axillary vein was easily identified in 100% of subjects, with relevant variability in terms of depth from the skin, diameter, and tendency to collapse during inspiration. Significant increase of axillary vein diameters was found after 90° abduction in 52 of the 70 cases studied. CONCLUSION: These findings suggest that a 90° abduction of the arm, particularly if associated with a forward position of the shoulder, facilitates the visualization of the axillary vein, making its ultrasound-guided venipuncture easier.

Published
2015

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