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1. International normalized ratio self-testing and self-management: improving patient outcomes

Author

Pozzi M, Mitchell J, Henaine AM, Hanna N, Safi O, and Henaine R

Subjects
oral anticoagulation, vitamin K antagonists, international normalized ratio, INR self-management, INR self-testing, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Matteo Pozzi,1 Julia Mitchell,2 Anna Maria Henaine,3 Najib Hanna,4 Ola Safi,4 Roland Henaine2 1Department of Adult Cardiac Surgery, “Louis Pradel” Cardiologic Hospital, Lyon, France; 2Department of Congenital Cardiac Surgery, “Louis Pradel” Cardiologic Hospital, Lyon, France; 3Clinical Pharmacology Unit, Lebanese University, Beirut, Lebanon; 4Pediatric Unit, “Hotel Dieu de France” Hospital, Saint Joseph University, Beirut, Lebanon Abstract: Long term oral anti-coagulation with vitamin K antagonists is a risk factor of hemorrhagic or thromebomlic complications. Periodic laboratory testing of international normalized ratio (INR) and a subsequent dose adjustment are therefore mandatory. The use of home testing devices to measure INR has been suggested as a potential way to improve the comfort and compliance of the patients and their families, the frequency of monitoring and, finally, the management and safety of long-term oral anticoagulation. In pediatric patients, increased doses to obtain and maintain the therapeutic target INR, more frequent adjustments and INR testing, multiple medication, inconstant nutritional intake, difficult venepunctures, and the need to go to the laboratory for testing (interruption of school and parents’ work attendance) highlight those difficulties. After reviewing the most relevant published studies of self-testing and self-management of INR for adult patients and children on oral anticoagulation, it seems that these are valuable and effective strategies of INR control. Despite an unclear relationship between INR control and clinical effects, these self-strategies provide a better control of the anticoagulant effect, improve patients and their family quality of life, and are an appealing solution in term of cost-effectiveness. Structured education and knowledge evaluation by trained health care professionals is required for children, to be able to adjust their dose treatment safely and accurately. However, further data are necessary in order to best define those patients who might better benefit from this multidisciplinary approach. Keywords: oral anticoagulation, vitamin K antagonists, international normalized ratio, INR self-management, INR self-testing

Published
2016

3. Extracorporeal cardio-pulmonary resuscitation in a patient with missed diagnosis of sodium nitrite intoxication

Author

Gaiani, F, Giani, M, Vergnano, B, Sardella, J, Cappellini, F, Casati, M, Pozzi, M, Foti, G, Gaiani F., Giani M., Vergnano B., Sardella J., Cappellini F., Casati M., Pozzi M., Foti G., Gaiani, F, Giani, M, Vergnano, B, Sardella, J, Cappellini, F, Casati, M, Pozzi, M, Foti, G, Gaiani F., Giani M., Vergnano B., Sardella J., Cappellini F., Casati M., Pozzi M., and Foti G.

Abstract

Introduction: Critical poisoning with sodium nitrite (NaNO2) can present challenges in promptly identifying and managing acute methemoglobinemia. Case report: We report the case of an overt self-intoxication by an initially unknown agent, leading to cardiac arrest. Despite prodromal signs of cyanosis, coma, desaturation, and hypotension, methemoglobinemia went unrecognized during extracorporeal cardiopulmonary resuscitation (ECPR) as the point-of-care test failed to provide methemoglobin levels, leading to untreated methemoglobinemia. The blood flowing through the oxygenator notably maintained the same brown colour. Return of spontaneous circulation was never achieved, and the patient was declared dead after 60 min of unsuccessful resuscitation. Cause of death by means of NaNO2 voluntary ingestion was later clarified and confirmed by postmortem finding of elevated nitrite and nitrate concentration. Conclusions: This case highlights the risk of failure of ECPR in the context of cardiac arrest due to methemoglobinemia, emphasizing the critical need for prompt recognition of the causative agent and early administration of antidotes.

Published
2024

4. Perfusion deficits may underlie lung and kidney injury in severe COVID-19 disease: insights from a multicenter international cohort study

Author

Nova, A, Mcnicholas, B, Magliocca, A, Laffey, M, Zambelli, V, Mariani, I, Atif, M, Giacomini, M, Vitale, G, Rona, R, Foti, G, Laffey, J, Rezoagli, E, O'Connor, A, Giani, M, Pozzi, M, Coppadoro, A, Sordi, S, Crippa, I, Nova A., McNicholas B., Magliocca A., Laffey M., Zambelli V., Mariani I., Atif M., Giacomini M., Vitale G., Rona R., Foti G., Laffey J., Rezoagli E., O'Connor A., Giani M., Pozzi M., Coppadoro A., Sordi S., Crippa I. A., Nova, A, Mcnicholas, B, Magliocca, A, Laffey, M, Zambelli, V, Mariani, I, Atif, M, Giacomini, M, Vitale, G, Rona, R, Foti, G, Laffey, J, Rezoagli, E, O'Connor, A, Giani, M, Pozzi, M, Coppadoro, A, Sordi, S, Crippa, I, Nova A., McNicholas B., Magliocca A., Laffey M., Zambelli V., Mariani I., Atif M., Giacomini M., Vitale G., Rona R., Foti G., Laffey J., Rezoagli E., O'Connor A., Giani M., Pozzi M., Coppadoro A., Sordi S., and Crippa I. A.

Abstract

Background: Lung perfusion defects, mainly due to endothelial and coagulation activation, are a key contributor to COVID-19 respiratory failure. COVID-19 patients may also develop acute kidney injury (AKI) because of renal perfusion deficit. We aimed to explore AKI-associated factors and the independent prediction of standardized minute ventilation (MV)—a proxy of alveolar dead space—on AKI onset and persistence in COVID-19 mechanically ventilated patients. Methods: This is a multicenter observational cohort study. We enrolled 157 COVID-19 patients requiring mechanical ventilation and intensive care unit (ICU) admission. We collected clinical information, ventilation, and laboratory data. AKI was defined by the 2012 KDIGO guidelines and classified as transient or persistent according to serum creatinine criteria persistence within 48 h. Ordered univariate and multivariate logistic regression analyses were employed to identify variables associated with AKI onset and persistence. Results: Among 157 COVID-19 patients on mechanical ventilation, 47% developed AKI: 10% had transient AKI, and 37% had persistent AKI. The degree of hypoxia was not associated with differences in AKI severity. Across increasing severity of AKI groups, despite similar levels of paCO2, we observed an increased MV and standardized MV, a robust proxy of alveolar dead space. After adjusting for other clinical and laboratory covariates, standardized MV remained an independent predictor of AKI development and persistence. d-dimer levels were higher in patients with persistent AKI. Conclusions: In critically ill COVID-19 patients with respiratory failure, increased wasted ventilation is independently associated with a greater risk of persistent AKI. These hypothesis-generating findings may suggest that perfusion derangements may link the pathophysiology of both wasted ventilation and acute kidney injury in our population.

Published
2024

5. One-year survival and Quality of Life of first wave COVID-19 invasively ventilated patients in Lombardy, Italy

Author

Lorini, L, Labanca, R, Bugada, D, Cazzaniga, S, D'Amico, F, Grazioli, L, Marmiere, M, Novelli, L, Pozzi, M, Rona, R, Giani, M, Bellin, V, Lucchini, A, Raimondi, F, Rocchi, M, Salvioni, M, Foti, G, Landoni, G, Andreossi, M, Annoni, A, Azzolini, M, Baiardo Redaelli, M, Belletti, A, Belmonte, G, Benigni, A, Benini, A, Bonfanti, P, Borghi, G, Butovska, L, Cadone Ughi, E, Calabria, M, Celona, S, Ciceri, F, Consalvo, L, Farina, A, Ferlicca, D, Finazzi, S, Fominskiy, E, Grieco, S, Guzzo, F, Landini, S, Lo-Catelli, S, Lorini, A, Lorini, G, Magri, F, Manildo, E, Nava, C, Ortalda, A, Palumbo, D, Real, G, Rezoagli, E, Ripa, C, Saracino, M, Sosio, S, Trocchia, R, Villa, M, Zangrillo, A, Lorini L. F., Labanca R., Bugada D., Cazzaniga S., D'Amico F., Grazioli L., Marmiere M., Novelli L., Pozzi M., Rona R., Giani M., Bellin V., Lucchini A., Raimondi F., Rocchi M., Salvioni M. T., Foti G., Landoni G., Andreossi M., Annoni A., Azzolini M. L., Baiardo Redaelli M., Belletti A., Belmonte G., Benigni A., Benini A., Bonfanti P., Borghi G., Butovska L., Cadone Ughi E., Calabria M., Celona S., Ciceri F., Consalvo L., Farina A., Ferlicca D., Finazzi S., Fominskiy E. V., Grieco S., Guzzo F., Landini S., Lo-Catelli S., Lorini A., Lorini G., Magri F., Manildo E., Nava C., Ortalda A., Palumbo D., Real G., Rezoagli E., Ripa C., Saracino M., Sosio S., Trocchia R., Villa M., Zangrillo A., Lorini, L, Labanca, R, Bugada, D, Cazzaniga, S, D'Amico, F, Grazioli, L, Marmiere, M, Novelli, L, Pozzi, M, Rona, R, Giani, M, Bellin, V, Lucchini, A, Raimondi, F, Rocchi, M, Salvioni, M, Foti, G, Landoni, G, Andreossi, M, Annoni, A, Azzolini, M, Baiardo Redaelli, M, Belletti, A, Belmonte, G, Benigni, A, Benini, A, Bonfanti, P, Borghi, G, Butovska, L, Cadone Ughi, E, Calabria, M, Celona, S, Ciceri, F, Consalvo, L, Farina, A, Ferlicca, D, Finazzi, S, Fominskiy, E, Grieco, S, Guzzo, F, Landini, S, Lo-Catelli, S, Lorini, A, Lorini, G, Magri, F, Manildo, E, Nava, C, Ortalda, A, Palumbo, D, Real, G, Rezoagli, E, Ripa, C, Saracino, M, Sosio, S, Trocchia, R, Villa, M, Zangrillo, A, Lorini L. F., Labanca R., Bugada D., Cazzaniga S., D'Amico F., Grazioli L., Marmiere M., Novelli L., Pozzi M., Rona R., Giani M., Bellin V., Lucchini A., Raimondi F., Rocchi M., Salvioni M. T., Foti G., Landoni G., Andreossi M., Annoni A., Azzolini M. L., Baiardo Redaelli M., Belletti A., Belmonte G., Benigni A., Benini A., Bonfanti P., Borghi G., Butovska L., Cadone Ughi E., Calabria M., Celona S., Ciceri F., Consalvo L., Farina A., Ferlicca D., Finazzi S., Fominskiy E. V., Grieco S., Guzzo F., Landini S., Lo-Catelli S., Lorini A., Lorini G., Magri F., Manildo E., Nava C., Ortalda A., Palumbo D., Real G., Rezoagli E., Ripa C., Saracino M., Sosio S., Trocchia R., Villa M., and Zangrillo A.

Abstract

BACKGROUND: Lombardy was the epicenter of the first coronavirus disease 2019 (COVID-19) outbreak in western countries. The outbreak began in February 2020 and rapidly disseminated throughout the region. ICU beds were vastly insufficient and clinical knowledge of disease was poor at that time. Unfortunately, data on long-term mortality, morbidity, and Quality of Life are scarce and controversial. The aim of this study was to evaluate 1-year survival, Quality of Life, and functional recovery in patients with COVID-19 admitted to Intensive Care Units. METHODS: All COVID-19 patients invasively ventilated and successfully discharged from 3 important academic hospitals in Lombardy were evaluated. Evaluations were performed by qualified medical staff and monitoring over time was performed by telephone call. Functional, cognitive, and psychological outcomes were explored using validated questionnaires. Selected patients were offered a follow-up chest computed tomography (CT) scan. RESULTS: Four hundred twenty-seven patients were invasively ventilated and 268 (63%) were successfully discharged. Out of these 268 patients, 266 (99%) were alive at one year with no patient loss during follow-up. Very severe or severe dyspnea was reported by 7% of patients, while most patients (84%) did not experience dyspnea at rest. A small proportion of patients (17%) reported severe anxiety/depression. Good Quality of Life was reported by 64% of survivors. In patients complaining of dyspnea on exertion, fibrotic-like changes were observed at chest CT scans in 32/37 (86%) and 7/11 (63%) patients who underwent CT at 3 months and 1 year, respectively. CONCLUSIONS: COVID-19 patients discharged from the hospital after invasive ventilation had excellent one-year survival and good overall recovery and Quality of Life.

Published
2024

6. Retrospective ANalysis of multi-drug resistant Gram-nEgative bacteRia on veno-venous extracorporeal membrane oxygenation. The multicenter RANGER STUDY

Author

Boscolo, A, Bruni, A, Giani, M, Garofalo, E, Sella, N, Pettenuzzo, T, Bombino, M, Palcani, M, Rezoagli, E, Pozzi, M, Falcioni, E, Pistollato, E, Biamonte, E, Murgolo, F, D'Arrigo, G, Gori, M, Tripepi, G, Gottin, L, Longhini, F, Grasso, S, Navalesi, P, Foti, G, Boscolo A., Bruni A., Giani M., Garofalo E., Sella N., Pettenuzzo T., Bombino M., Palcani M., Rezoagli E., Pozzi M., Falcioni E., Pistollato E., Biamonte E., Murgolo F., D'Arrigo G., Gori M., Tripepi G. L., Gottin L., Longhini F., Grasso S., Navalesi P., Foti G., Boscolo, A, Bruni, A, Giani, M, Garofalo, E, Sella, N, Pettenuzzo, T, Bombino, M, Palcani, M, Rezoagli, E, Pozzi, M, Falcioni, E, Pistollato, E, Biamonte, E, Murgolo, F, D'Arrigo, G, Gori, M, Tripepi, G, Gottin, L, Longhini, F, Grasso, S, Navalesi, P, Foti, G, Boscolo A., Bruni A., Giani M., Garofalo E., Sella N., Pettenuzzo T., Bombino M., Palcani M., Rezoagli E., Pozzi M., Falcioni E., Pistollato E., Biamonte E., Murgolo F., D'Arrigo G., Gori M., Tripepi G. L., Gottin L., Longhini F., Grasso S., Navalesi P., and Foti G.

Abstract

Background: Veno-venous extracorporeal membrane oxygenation (V-V ECMO) is a rapidly expanding life-support technique worldwide. The most common indications are severe hypoxemia and/or hypercapnia, unresponsive to conventional treatments, primarily in cases of acute respiratory distress syndrome. Concerning potential contraindications, there is no mention of microbiological history, especially related to multi-drug resistant (MDR) bacteria isolated before V-V ECMO placement. Our study aims to investigate: (i) the prevalence and incidence of MDR Gram-negative (GN) bacteria in a cohort of V-V ECMOs; (ii) the risk of 1-year mortality, especially in the case of predetected MDR GN bacteria; and (iii) the impact of annual hospital V-V ECMO volume on the probability of acquiring MDR GN bacteria. Methods: All consecutive adults admitted to the Intensive Care Units of 5 Italian university-affiliated hospitals and requiring V-V ECMO were screened. Exclusion criteria were age < 18 years, pregnancy, veno-arterial or mixed ECMO-configuration, incomplete records, survival < 24 h after V-V ECMO. A standard protocol of microbiological surveillance was applied and MDR profiles were identified using in vitro susceptibility tests. Cox-proportional hazards models were applied for investigating mortality. Results: Two hundred and seventy-nine V-V ECMO patients (72% male) were enrolled. The overall MDR GN bacteria percentage was 50%: 21% (n.59) detected before and 29% (n.80) after V-V ECMO placement. The overall 1-year mortality was 42%, with a higher risk observed in predetected patients (aHR 2.14 [1.33–3.47], p value 0.002), while not in ‘V-V ECMO-acquired MDR GN bacteria’ group (aHR 1.51 [0.94–2.42], p value 0.090), as compared to ‘non-MDR GN bacteria’ group (reference). Same findings were found considering only infections. A larger annual hospital V-V ECMO volume was associated with a lower probability of acquiring MDR GN bacteria during V-V ECMO course (aOR 0.91

Published
2024

7. Novel insights into the management of rheumatoid arthritis: one year in review 2024

Author

Molteni, E, Adinolfi, A, Bondi, V, Delvino, P, Sakellariou, G, Trentanni, C, Ughi, N, Pozzi, M, Scire, C, Molteni E., Adinolfi A., Bondi V., Delvino P., Sakellariou G., Trentanni C., Ughi N., Pozzi M. R., Scire C. A., Molteni, E, Adinolfi, A, Bondi, V, Delvino, P, Sakellariou, G, Trentanni, C, Ughi, N, Pozzi, M, Scire, C, Molteni E., Adinolfi A., Bondi V., Delvino P., Sakellariou G., Trentanni C., Ughi N., Pozzi M. R., and Scire C. A.

Abstract

New evidence from 2023 has slightly shifted some perspectives on rheumatoid arthritis (RA) management. Glucocorticoids have reaffirmed their role as bridging therapy, while novel studies on JAK inhibitors have examined efficacy, mechanism of action, and their potential in high-risk populations, bolstering our understanding with real-world data. Additionally, among treatment strategies, achieving low disease activity has emerged as comparable to achieving remission in the long term, and new insights have been gained regarding tapering both biological and conventional synthetic DMARDs. Furthermore, novel approaches have been proposed for managing difficult-to-treat RA and pre-RA. In this paper, the reviewers aim to present the most relevant studies published during the last year in the field of RA management.

Published
2024

8. Pulmonary shunt in critical care: a practical approach with clinical scenarios.

Author

Raimondi Cominesi, D, Forcione, M, Pozzi, M, Giani, M, Foti, G, Rezoagli, E, Cipulli, F, Raimondi Cominesi D., Forcione M., Pozzi M., Giani M., Foti G., Rezoagli E., Cipulli F., Raimondi Cominesi, D, Forcione, M, Pozzi, M, Giani, M, Foti, G, Rezoagli, E, Cipulli, F, Raimondi Cominesi D., Forcione M., Pozzi M., Giani M., Foti G., Rezoagli E., and Cipulli F.

Abstract

Background: Pulmonary shunt refers to the passage of venous blood into the arterial blood system bypassing the alveoli-blood gas exchange. Pulmonary shunt is defined by a drop in the physiologic coupling of lung ventilation and lung perfusion. This may consequently lead to respiratory failure. Main body: The pulmonary shunt assessment is often neglected. From a mathematical point of view, pulmonary shunt can be assessed by estimating the degree of mixing between oxygenated and deoxygenated blood. To compute the shunt, three key components are analyzed: the oxygen (O2) content in the central venous blood before gas exchange, the calculated O2 content in the pulmonary capillaries after gas exchange, and the O2 content in the arterial system, after the mixing of shunted and non-shunted blood. Computing the pulmonary shunt becomes of further importance in patients on extracorporeal membrane oxygenation (ECMO), as arterial oxygen levels may not directly reflect the gas exchange of the native lung. Conclusion: In this review, the shunt analysis and its practical clinical applications in different scenarios are discussed by using an online shunt simulator.

Published
2024

9. Long term outcome in patients treated with veno-venous extracorporeal membrane oxygenation: A prospective observational study

Author

Lucchini, A, Villa, M, Giani, M, Andreossi, M, Alessandra, V, Vigo, V, Gatti, S, Ferlicca, D, Teggia Droghi, M, Rezoagli, E, Foti, G, Pozzi, M, Lucchini A., Villa M., Giani M., Andreossi M., Alessandra V., Vigo V., Gatti S., Ferlicca D., Teggia Droghi M., Rezoagli E., Foti G., Pozzi M., Lucchini, A, Villa, M, Giani, M, Andreossi, M, Alessandra, V, Vigo, V, Gatti, S, Ferlicca, D, Teggia Droghi, M, Rezoagli, E, Foti, G, Pozzi, M, Lucchini A., Villa M., Giani M., Andreossi M., Alessandra V., Vigo V., Gatti S., Ferlicca D., Teggia Droghi M., Rezoagli E., Foti G., and Pozzi M.

Abstract

Introduction: Over the last few decades, the use of veno-venous extracorporeal membrane oxygenation (VV-ECMO) support for severe respiratory failure has increased. Aim: This study aimed to assess the long-term outcomes of patients treated with VV-ECMO for respiratory failure. Methods: We performed a single-centre prospective evaluation of patients on VV-ECMO who were successfully discharged from the intensive care unit of an Italian University Hospital between January 2018 and May 2021. The enrolled patients underwent follow-up evaluations at 6 and 12 months after ICU discharge. The follow-up team performed psychological and functional assessments using the following instruments: Hospital Anxiety and Depression Scale (HADS), Post-traumatic Stress Disorder Symptom Severity Scale (PTSS-10), Euro Quality Five Domains Five Levels (EQ-5L-5D), and 6-minute walk test. Results: We enrolled 33 patients who were evaluated at a follow-up clinic. The median patient age was 51 years (range: 45–58 years). The median duration of VV-ECMO support was 12 (9–19) days and the length of ICU stay was 23 (18–42) days. A HADS score higher than 14 was reported in 8 (24 %) and 7 (21 %) patients at the six- and twelve-month visit, respectively. PTSS-10 total score ≥ 35 points was present in three (9 %) and two (6 %) patients at the six- and twelve-month examination. The median EQ-5L-5D-VAS was respectively 80 (80–90) and 87.5 (70–95). The PTSS-10 score significantly decreased from six to 12 months in COVID-19 survivors (p = 0.024). Conclusions: In this cohort of patients treated with VV-ECMO, cognitive and psychological outcomes were good and comparable to those of patients with Adult Respiratory Distress Syndrome (ARDS) managed without ECMO. Implications for clinical practice: The findings of this study confirm the need for long-term follow-up and rehabilitation programs for every ICU survivor after discharge. COVID-19 survivors treated with VV-ECMO had outcomes comparable to those reported

Published
2024

10. The “ZEEP-PEEP test” to evaluate the response to positive end-expiratory pressure delivered by helmet: A prospective physiologic study

Author

Giani, M, Fumagalli, B, Cipulli, F, Rezoagli, E, Pozzi, M, Fumagalli, D, Fumagalli, L, Ferrari, K, Rona, R, Bellani, G, Lucchini, A, Foti, G, Giani M., Fumagalli B., Cipulli F., Rezoagli E., Pozzi M., Fumagalli D., Fumagalli L., Ferrari K., Rona R., Bellani G., Lucchini A., Foti G., Giani, M, Fumagalli, B, Cipulli, F, Rezoagli, E, Pozzi, M, Fumagalli, D, Fumagalli, L, Ferrari, K, Rona, R, Bellani, G, Lucchini, A, Foti, G, Giani M., Fumagalli B., Cipulli F., Rezoagli E., Pozzi M., Fumagalli D., Fumagalli L., Ferrari K., Rona R., Bellani G., Lucchini A., and Foti G.

Abstract

Introduction: The improvement in oxygenation after helmet application in hypoxemic patients may be explained by the alveolar recruitment obtained with positive end expiratory pressure (PEEP) or by the administration of a more accurate inspiratory fraction of oxygen (FiO2). We have designed the “ZEEP-PEEP test”, capable to distinguish between the FiO2-related or PEEP-related oxygenation improvement. Our primary aim was to describe the use of this test during helmet CPAP to assess the oxygenation improvement attributable to PEEP application. Material and methods: We performed a prospective physiological study including adult critically ill patients. Respiratory and hemodynamic parameters were recorded before helmet application (PRE step), after helmet application without PEEP (ZEEP step) and after the application of the PEEP valve (PEEP step), while maintaining a constant FiO2. We defined as “PEEP responders” patients showing a PaO2/FiO2 ratio improvement ≥10% after PEEP application. Results: 93 patients were enrolled. Compared to the PRE step, PaO2/FiO2 ratio was significantly improved during helmet CPAP both at ZEEP and PEEP step (189 ± 55, 219 ± 74 and 241 ± 82 mmHg, respectively, p < 0.01). Both PEEP responders (41%) and non-responders showed a significant improvement of PaO2/FiO2 ratio after the application of helmet at ZEEP, PEEP responders also showed a significant improvement of oxygenation after PEEP application (208 ± 70 vs 267 ± 85, p < 0.01). Conclusions: Helmet CPAP improved oxygenation. This improvement was not only due to the PEEP effect, but also to the increase of the effective inspired FiO2. Performing the ZEEP-PEEP test may help to identify patients who benefit from PEEP.

Published
2024

11. Characteristics of long COVID after two years of follow-up in a previously hospitalized population

Author

Cogliandro, V, Squillace, N, Rossi, E, Ferrara, M, Monzani, A, Pozzi, M, Salvarani, V, Valagussa, L, Caramma, I, Cappelletti, A, Bonaffini, L, Ferrarese, C, Foti, G, Lettino, M, Luppi, F, Strepparava, M, Bellelli, G, Bonfanti, P, Ferrara, MC, Caramma, IC, Strepparava, MG, Cogliandro, V, Squillace, N, Rossi, E, Ferrara, M, Monzani, A, Pozzi, M, Salvarani, V, Valagussa, L, Caramma, I, Cappelletti, A, Bonaffini, L, Ferrarese, C, Foti, G, Lettino, M, Luppi, F, Strepparava, M, Bellelli, G, Bonfanti, P, Ferrara, MC, Caramma, IC, and Strepparava, MG

Published
2024

12. Effect of Helmet CPAP on Tidal Volume Assessed by Bioelectrical Impedance

Author

Giani, M, Rezoagli, E, Raimondi Cominesi, D, Moretto, L, Fumagalli, B, Cipulli, F, Lucchini, A, Pozzi, M, Foti, G, Giani, Marco, Rezoagli, Emanuele, Raimondi Cominesi, Davide, Moretto, Lorenza, Fumagalli, Benedetta, Cipulli, Francesco, Lucchini, Alberto, Pozzi, Matteo, Foti, Giuseppe, Giani, M, Rezoagli, E, Raimondi Cominesi, D, Moretto, L, Fumagalli, B, Cipulli, F, Lucchini, A, Pozzi, M, Foti, G, Giani, Marco, Rezoagli, Emanuele, Raimondi Cominesi, Davide, Moretto, Lorenza, Fumagalli, Benedetta, Cipulli, Francesco, Lucchini, Alberto, Pozzi, Matteo, and Foti, Giuseppe

Published
2024

13. Il servizio civile come pratica di educazione non formale: il nodo della certificazione delle competenze

Author

Aglieri, M, Bonometti, S, Cadei, L, Mesa, D, Pozzi, M, Serrelli, M, Mesa, Diego, Diego Mesa (ORCID:0000-0003-0491-4988), Aglieri, M, Bonometti, S, Cadei, L, Mesa, D, Pozzi, M, Serrelli, M, Mesa, Diego, and Diego Mesa (ORCID:0000-0003-0491-4988)

Abstract

Seguendo questa linea interpretativa, si propone un approfondimento delle competenze del SC intese come fenomeno multilivello emergente dell’azione dei diversi attori dentro il “campo” delineato dal contesto socio-culturale e strutturale del sistema del SC. Infine si affrontano i nodi riguardanti la certificazione delle competenze in relazione alle caratteristiche del SC e alla normativa attuale. Nelle conclusioni vengono prese in considerazione le acquisizioni emerse rispetto agli interrogativi posti.

Published
2024

14. Cohort Enrichment Strategies for Progressive Interstitial Lung Disease in Systemic Sclerosis From European Scleroderma Trials and Research

Author

Hoffmann-Vold A. -M., Brunborg C., Airo P., Ananyeva L. P., Czirjak L., Guiducci S., Hachulla E., Li M., Mihai C., Riemekasten G., Sfikakis P. P., Valentini G., Kowal-Bielecka O., Allanore Y., Distler O., Vacca A., Giollo A., Balbir-Gurman A., Gheorghiu A. M., Marcoccia A., Herrick A., Radic M., Stamenkovic B., Anic B., Granel B., Ribi C., Selmi C. F., Carlos de la Puente M., de Souza Muller C., Denton C., Kayser C., Tanaseanu C. -M., Majewski D., Rimar D., Krasowska D., Veale D., Walker U., Kerzberg E., Rezus E., Zanatta E., Siegert E., De Langhe E., Oksel F., Ingegnoli F., Cantatore F. P., Szucs G., Cuomo G., Seskute G., Litinsky V., Castellvi I., Morovic-Vergles J., Sibilia J., Henes J., Solanki K., Perdan-Pirkmajer K., Herrmann K., Saketkoo L. A., Stamp L., Mouthon L., Salvador M. J., Pozzi M. R., Uprus M., Vanthuyne M., Engelhart M., Kohm M., Iudici M., Inanc M., Fathi N., Pamuk N., Garcia de la Pena Lefebv P., Carreira P. E., Bancel D. F., Moroncini L., Montecucco C., Ancuta C., Sunderkotter C., Muller-Ladner U., Rosato E., Kucharz E. J., Iannone F., Del Galdo F., Poormoghim H., Kotter I., Distler J., Cutolo M., Tikly M., Damjanov N., Hunzelmann N., Vlachoyiannopoulos P., Hasler P., Sarzi Puttini P., Wiland P., Becvar R., Yavuz S., Zdrojewski Z., Pellerito R., Foti R., Ionescu R. M., Adler S., Kahl S., Moiseev S., Stebbings S., Rednic S., Negrini S., Heitmann S., Ullman S., Agachi S., Martin T., Schmeiser T., Riccieri V., Smith V., Bernardino V., Ortiz-Santamaria V., Hsu V. M., Abdel Atty Mohamed W. A., Hoffmann-Vold, A. -M., Brunborg, C., Airo, P., Ananyeva, L. P., Czirjak, L., Guiducci, S., Hachulla, E., Li, M., Mihai, C., Riemekasten, G., Sfikakis, P. P., Valentini, G., Kowal-Bielecka, O., Allanore, Y., Distler, O., Vacca, A., Giollo, A., Balbir-Gurman, A., Gheorghiu, A. M., Marcoccia, A., Herrick, A., Radic, M., Stamenkovic, B., Anic, B., Granel, B., Ribi, C., Selmi, C. F., Carlos de la Puente, M., de Souza Muller, C., Denton, C., Kayser, C., Tanaseanu, C. -M., Majewski, D., Rimar, D., Krasowska, D., Veale, D., Walker, U., Kerzberg, E., Rezus, E., Zanatta, E., Siegert, E., De Langhe, E., Oksel, F., Ingegnoli, F., Cantatore, F. P., Szucs, G., Cuomo, G., Seskute, G., Litinsky, V., Castellvi, I., Morovic-Vergles, J., Sibilia, J., Henes, J., Solanki, K., Perdan-Pirkmajer, K., Herrmann, K., Saketkoo, L. A., Stamp, L., Mouthon, L., Salvador, M. J., Pozzi, M. R., Uprus, M., Vanthuyne, M., Engelhart, M., Kohm, M., Iudici, M., Inanc, M., Fathi, N., Pamuk, N., Garcia de la Pena Lefebv, P., Carreira, P. E., Bancel, D. F., Moroncini, L., Montecucco, C., Ancuta, C., Sunderkotter, C., Muller-Ladner, U., Rosato, E., Kucharz, E. J., Iannone, F., Del Galdo, F., Poormoghim, H., Kotter, I., Distler, J., Cutolo, M., Tikly, M., Damjanov, N., Hunzelmann, N., Vlachoyiannopoulos, P., Hasler, P., Sarzi Puttini, P., Wiland, P., Becvar, R., Yavuz, S., Zdrojewski, Z., Pellerito, R., Foti, R., Ionescu, R. M., Adler, S., Kahl, S., Moiseev, S., Stebbings, S., Rednic, S., Negrini, S., Heitmann, S., Ullman, S., Agachi, S., Martin, T., Schmeiser, T., Riccieri, V., Smith, V., Bernardino, V., Ortiz-Santamaria, V., Hsu, V. M., and Abdel Atty Mohamed, W. A.

Subjects
interstitial lung disease, Pulmonary and Respiratory Medicine, enrichment, systemic sclerosis, clinical trial, Cardiology and Cardiovascular Medicine, Critical Care and Intensive Care Medicine
Abstract

BACKGROUND: Enrichment strategies from clinical trials for progressive systemic sclerosis-associated interstitial lung disease (SSc-ILD) have not been tested in a real-life cohort.RESEARCH QUESTION: Do enrichment strategies for progressive ILD impact efficacy, repre-sentativeness, and feasibility in patients with SSc-ILD from the European Scleroderma Trials and Research (EUSTAR) database?STUDY DESIGN AND METHODS: We applied the inclusion criteria of major recent SSc-ILD trials (Study of the Efficacy and Safety of Tocilizumab in Participants With Systemic Sclerosis [focuSSced], Scleroderma Lung Study II [SLS II], and Safety and Efficacy of Nintedanib in Systemic Sclerosis [SENSCIS]) and assessed progressive ILD, which was defined as absolute change in FVC and as significant progression (FVC decline $10%). Data were compared with all patients and with patients who did not fulfill any inclusion criteria. RESULTS: In total, 2,258 patients with SSc-ILD were included: 31.2% of the patients met SENSCIS criteria; 5.8% of the patients met SLS II criteria; 1.6% of the patients met focuSSced criteria, and 67.7% (1,529) of the patients did not meet any criteria. In the first 12 + 3 months, the absolute FVC decline in all patients and in patients who fulfilled criteria from SENSCIS was -0.1%, in patients who fulfilled criteria from focuSSced was -3.7%, and in patients who fulfilled criteria from SLS II was 2.3%, with accompanying more progressors in focuSSced. The patient populations that fulfilled the different study inclusion criteria significantly differed in various clinical parameters. In the second 12-month period, SENSCIS-enriched patients had a further absolute FVC% decline as described for the total cohort. In contrast, patients who fulfilled the focuSSced and SLS II criteria showed numeric improvement of lung function. There were no significant associations of enrichment criteria and ILD progression.INTERPRETATION: The application of enrichment criteria from previous clinical trials showed enrichment for progression with variable success, which led to selected patient populations reducing feasibility of recruitment. These findings are important for future clinical trial design and interpretation of the results of published trials.CHEST 2023; 163(3):586-598

Published
2023

15. Long-Term Physical, Cognitive, and Psychological Outcomes in Severe COVID-19 Patients Managed with Extracorporeal Membrane Oxygenation: A Prospective Study

Author

Pozzi, M, Giani, M, Andreossi, M, Annoni, A, Villa, M, Bellin, V, Ferlicca, D, Piva, S, Rona, R, Avalli, L, Lucchini, A, Foti, G, Pozzi M., Giani M., Andreossi M., Annoni A., Villa M., Bellin V., Ferlicca D., Piva S., Rona R., Avalli L., Lucchini A., Foti G., Pozzi, M, Giani, M, Andreossi, M, Annoni, A, Villa, M, Bellin, V, Ferlicca, D, Piva, S, Rona, R, Avalli, L, Lucchini, A, Foti, G, Pozzi M., Giani M., Andreossi M., Annoni A., Villa M., Bellin V., Ferlicca D., Piva S., Rona R., Avalli L., Lucchini A., and Foti G.

Abstract

Extracorporeal membrane oxygenation (ECMO) has been used in highly selected COVID-19 patients with severe respiratory failure. Scarce data exist on long-term outcomes of these patients. We performed a single-center prospective evaluation of consecutive COVID-19 ECMO patients successfully discharged from the intensive care unit between February 2020 and January 2022. Physical, cognitive and psychological outcome was assessed at 3, 6, and 12 months by in-person evaluation. All the 34 discharged patients (median age 49 years old) were alive at one year, and 25 of them were evaluated at the follow-up clinic. 67% of patients had muscle weakness, with improvement over time (p = 0.032). The percentage of patients able to return to work progressively increased, up to 86% at 1 year. 23% of patients experienced fatigue. Participation restriction improved over time for both physical (p = 0.050) and emotional (p = 0.005) problems. Cognitive impairment, anxiety, and depression occurred in 29%, 29%, and 23% of patients, respectively, with no changes over time. Health-related quality of life was good. In conclusion, COVID-19 ECMO patients suffer from significant long-term sequelae. However, multidimensional outcomes continued to improve over the follow-up time.

Published
2023

16. In-hospital and 6-month outcomes in patients with COVID-19 supported with extracorporeal membrane oxygenation (EuroECMO-COVID): a multicentre, prospective observational study

Author

Lorusso, R, De Piero, M, Mariani, S, Di Mauro, M, Folliguet, T, Taccone, F, Camporota, L, Swol, J, Wiedemann, D, Belliato, M, Broman, L, Vuylsteke, A, Kassif, Y, Scandroglio, A, Fanelli, V, Gaudard, P, Ledot, S, Barker, J, Boeken, U, Maier, S, Kersten, A, Meyns, B, Pozzi, M, Pedersen, F, Schellongowski, P, Kirali, K, Barrett, N, Riera, J, Mueller, T, Belohlavek, J, Lo Coco, V, Van der Horst, I, Van Bussel, B, Schnabel, R, Delnoij, T, Bolotin, G, Lorini, L, Schmiady, M, Schibilsky, D, Kowalewski, M, Pinto, L, Silva, P, Kornilov, I, Blandino Ortiz, A, Vercaemst, L, Finney, S, Roeleveld, P, Di Nardo, M, Hennig, F, Antonini, M, Davidson, M, Jones, T, Staudinger, T, Mair, P, Kilo, J, Krapf, C, Erbert, K, Peer, A, Bonaros, N, Kotheletner, F, Krenner Mag, N, Shestakova, L, Hermans, G, Dauwe, D, Meersseman, P, Stockman, B, Nobile, L, Lhereux, O, Nrasseurs, A, Creuter, J, De Backer, D, Giglioli, S, Michiels, G, Foulon, P, Raes, M, Rodrigus, I, Allegaert, M, Jorens, P, Debeucklare, G, Piagnerelli, M, Biston, P, Peperstraete, H, Vandewiele, K, Germay, O, Vandeweghe, D, Havrin, S, Bourgeois, M, Lagny, M, Alois, G, Lavios, N, Misset, B, Courcelle, R, Timmermans, P, Yilmaz, A, Vantomout, M, Lehaen, J, Jassen, A, Guterman, H, Strauven, M, Lormans, P, Verhamme, B, Vandewaeter, C, Bonte, F, Vionne, D, Balik, M, Blaha, J, Lips, M, Othal, M, Bursa, F, Spacek, R, Christensen, S, Jorgensen, V, Sorensen, M, Madsen, S, Puss, S, Beljantsev, A, Saiydoun, G, Fiore, A, Colson, P, Bazalgette, F, Capdevila, X, Kollen, S, Muller, L, Obadia, J, Dubien, P, Ajrhourh, L, Guinot, P, Zarka, J, Besserve, P, Malfertheiner, M, Dreier, E, Heinze, B, Akhyari, P, Lichtenberg, A, Aubin, H, Assman, A, Saeed, D, Thiele, H, Baumgaertel, M, Schmitto, J, Ruslan, N, Haverich, A, Thielmann, M, Brenner, T, Ruhpawar, A, Benk, C, Czerny, M, Staudacher, D, Beyersdorf, F, Kalbhenn, J, Henn, P, Popov, A, Iuliu, T, Muellenbach, R, Reyher, C, Rolfes, C, Lotz, G, Sonntagbauer, M, Winkels, H, Fichte, J, Stohr, R, Kalverkamp, S, Karagiannidis, C, Schafer, S, Svetlitchny, A, Hopf, H, Jarczak, D, Groesdonk, H, Rommer, M, Hirsch, J, Kaehny, C, Soufleris, D, Gavriilidis, G, Pontikis, K, Kyriakopoulou, M, Kyriakoudi, A, O'Brien, S, Conrick-Martin, I, Carton, E, Makhoul, M, Ben-Ari, J, Hadash, A, Kogan, A, Kassif Lerner, R, Abu-Shakra, A, Matan, M, Balawona, A, Kachel, E, Altshuler, R, Galante, O, Fuchs, L, Almog, Y, Ishay, Y, Lichter, Y, Gal-oz, A, Carmi, U, Nini, A, Soroksky, A, Dekel, H, Rozman, Z, Tayem, E, Ilgiyaev, E, Hochman, Y, Miltau, D, Rapoport, A, Eden, A, Kompanietz, D, Yousif, M, Golos, M, Grazioli, L, Ghitti, D, Loforte, A, Di Luca, D, Baiocchi, M, Pacini, D, Cappai, A, Meani, P, Mondino, M, Russo, C, Ranucci, M, Fina, D, Cotza, M, Ballotta, A, Landoni, G, Nardelli, P, Fominski, E, Brazzi, L, Montrucchio, G, Sales, G, Simonetti, U, Livigni, S, Silengo, D, Arena, G, Sovatzis, S, Degani, A, Riccardi, M, Milanesi, E, Raffa, G, Martucci, G, Arcadipane, A, Panarello, G, Chiarini, G, Cattaneo, S, Puglia, C, Benussi, S, Foti, G, Giani, M, Bombino, M, Costa, M, Rona, R, Avalli, L, Donati, A, Carozza, R, Gasparri, F, Carsetti, A, Piciche, M, Marinello, A, Danzi, V, Zanin, A, Condello, I, Fiore, F, Moscarelli, M, Nasso, G, Speziale, G, Sandrelli, L, Montalto, A, Musumeci, F, Circelli, A, Russo, E, Agnoletti, V, Rociola, R, Milano, A, Pilato, E, Comentale, G, Montisci, A, Alessandri, F, Tosi, A, Pugliese, F, Giordano, G, Carelli, S, Grieco, D, Dell'Anna, A, Antonelli, M, Ramoni, E, Zulueta, J, Del Giglio, M, Petracca, S, Bertini, P, Guarracino, F, De Simone, L, Angeletti, P, Forfori, F, Taraschi, F, Quintiliani, V, Samalavicius, R, Jankuviene, A, Scupakova, N, Urbonas, K, Kapturauskas, J, Soerensen, G, Suwalski, P, Linhares Santos, L, Marques, A, Miranda, M, Teixeira, S, Salgueiro, A, Pereira, F, Ketskalo, M, Tsarenko, S, Shilova, A, Afukov, I, Popugaev, K, Minin, S, Shelukhin, D, Malceva, O, Gleb, M, Skopets, A, Kornelyuk, R, Kulikov, A, Okhrimchuk, V, Turchaninov, A, Petrushin, M, Sheck, A, Mekulov, A, Ciryateva, S, Urusov, D, Gorjup, V, Golicnik, A, Goslar, T, Ferrer, R, Martinez-Martinez, M, Argudo, E, Palmer, N, De Pablo Sanchez, R, Juan Higuera, L, Arnau Blasco, L, Marquez, J, Sbraga, F, Fuset, M, De Gopegui, P, Claraco, L, De Ayala, J, Peiro, M, Ricart, P, Martinez, S, Chavez, F, Fabra, M, Sandoval, E, Toapanta, D, Carraminana, A, Tellez, A, Ososio, J, Milan, P, Rodriguez, J, Andoni, G, Gutierrez, C, Perez de la Sota, E, Eixeres-Esteve, A, Garcia-Maellas, M, Gutierrez-Gutierrez, J, Arboleda-Salazar, R, Santa Teresa, P, Jaspe, A, Garrido, A, Castaneda, G, Alcantara, S, Martinez, N, Perez, M, Villanueva, H, Vidal Gonzalez, A, Paez, J, Santon, A, Perez, C, Lopez, M, Rubio Lopez, M, Gordillo, A, Naranjo-Izurieta, J, Munoz, J, Alcalde, I, Onieva, F, Gimeno Costa, R, Perez, F, Madrid, I, Gordon, M, Albacete Moreno, C, Perez, D, Lopez, N, Martinenz, D, Blanco-Schweizer, P, Diez, C, Prieto, A, Renedo, G, Bustamante, E, Cicuendez, R, Citores, R, Boado, V, Garcia, K, Voces, R, Domezain, M, Nunez Martinez, J, Vicente, R, Martin, D, Andreu, A, Gomez Casal, V, Chico, I, Menor, E, Vara, S, Gamacho, J, Perez-Chomon, H, Javier Gonzales, F, Barrero, I, Martin-Villen, L, Fernandez, E, Mendoza, M, Navarro, J, Colomina Climent, J, Gonzales-Perez, A, Muniz-Albaceita, G, Amado, L, Rodriguez, R, Ruiz, E, Eiras, M, Grins, E, Magnus, R, Kanetoft, M, Eidevald, M, Watson, P, Vogt, P, Steiger, P, Aigner, T, Weber, A, Grunefelder, J, Kunz, M, Grapow, M, Aymard, T, Reser, D, Agus, G, Consiglio, J, Haenggi, M, Hansjoerg, J, Iten, M, Doeble, T, Zenklusen, U, Bechtold, X, Faedda, G, Iafrate, M, Rohjer, A, Bergamaschi, L, Maessen, J, Reis Miranda, D, Endeman, H, Gommers, D, Meuwese, C, Maas, J, Van Gijlswijk, M, Van Berg, R, Candura, D, Van der Linden, M, Kant, M, Van der Heijden, J, Scholten, E, Van Belle-van Haren, N, Lagrand, W, Vlaar, A, De Jong, S, Cander, B, Sargin, M, Ugur, M, Kaygin, M, Daly, K, Agnew, N, Head, L, Kelly, L, Anoma, G, Russell, C, Aquino, V, Scott, I, Flemming, L, Gillon, S, Moore, O, Gelandt, E, Auzinger, G, Patel, S, Loveridge, R, Lorusso R., De Piero M. E., Mariani S., Di Mauro M., Folliguet T., Taccone F. S., Camporota L., Swol J., Wiedemann D., Belliato M., Broman L. M., Vuylsteke A., Kassif Y., Scandroglio A. M., Fanelli V., Gaudard P., Ledot S., Barker J., Boeken U., Maier S., Kersten A., Meyns B., Pozzi M., Pedersen F. M., Schellongowski P., Kirali K., Barrett N., Riera J., Mueller T., Belohlavek J., Lo Coco V., Van der Horst I. C. C., Van Bussel B. C. T., Schnabel R. M., Delnoij T., Bolotin G., Lorini L., Schmiady M. O., Schibilsky D., Kowalewski M., Pinto L. F., Silva P. E., Kornilov I., Blandino Ortiz A., Vercaemst L., Finney S., Roeleveld P. P., Di Nardo M., Hennig F., Antonini M. V., Davidson M., Jones T. J., Staudinger T., Mair P., Kilo J., Krapf C., Erbert K., Peer A., Bonaros N., Kotheletner F., Krenner Mag N., Shestakova L., Hermans G., Dauwe D., Meersseman P., Stockman B., Nobile L., Lhereux O., Nrasseurs A., Creuter J., De Backer D., Giglioli S., Michiels G., Foulon P., Raes M., Rodrigus I., Allegaert M., Jorens P., Debeucklare G., Piagnerelli M., Biston P., Peperstraete H., Vandewiele K., Germay O., Vandeweghe D., Havrin S., Bourgeois M., Lagny M. -G., Alois G., Lavios N., Misset B., Courcelle R., Timmermans P. J., Yilmaz A., Vantomout M., Lehaen J., Jassen A., Guterman H., Strauven M., Lormans P., Verhamme B., Vandewaeter C., Bonte F., Vionne D., Balik M., Blaha J., Lips M., Othal M., Bursa F., Spacek R., Christensen S., Jorgensen V., Sorensen M., Madsen S. A., Puss S., Beljantsev A., Saiydoun G., Fiore A., Colson P., Bazalgette F., Capdevila X., Kollen S., Muller L., Obadia J. -F., Dubien P. -Y., Ajrhourh L., Guinot P. G., Zarka J., Besserve P., Malfertheiner M. V., Dreier E., Heinze B., Akhyari P., Lichtenberg A., Aubin H., Assman A., Saeed D., Thiele H., Baumgaertel M., Schmitto J. D., Ruslan N., Haverich A., Thielmann M., Brenner T., Ruhpawar A., Benk C., Czerny M., Staudacher D. L., Beyersdorf F., Kalbhenn J., Henn P., Popov A. -F., Iuliu T., Muellenbach R., Reyher C., Rolfes C., Lotz G., Sonntagbauer M., Winkels H., Fichte J., Stohr R., Kalverkamp S., Karagiannidis C., Schafer S., Svetlitchny A., Hopf H. -B., Jarczak D., Groesdonk H., Rommer M., Hirsch J., Kaehny C., Soufleris D., Gavriilidis G., Pontikis K., Kyriakopoulou M., Kyriakoudi A., O'Brien S., Conrick-Martin I., Carton E., Makhoul M., Ben-Ari J., Hadash A., Kogan A., Kassif Lerner R., Abu-Shakra A., Matan M., Balawona A., Kachel E., Altshuler R., Galante O., Fuchs L., Almog Y., Ishay Y. S., Lichter Y., Gal-oz A., Carmi U., Nini A., Soroksky A., Dekel H., Rozman Z., Tayem E., Ilgiyaev E., Hochman Y., Miltau D., Rapoport A., Eden A., Kompanietz D., Yousif M., Golos M., Grazioli L., Ghitti D., Loforte A., Di Luca D., Baiocchi M., Pacini D., Cappai A., Meani P., Mondino M., Russo C. F., Ranucci M., Fina D., Cotza M., Ballotta A., Landoni G., Nardelli P., Fominski E. V., Brazzi L., Montrucchio G., Sales G., Simonetti U., Livigni S., Silengo D., Arena G., Sovatzis S. S., Degani A., Riccardi M., Milanesi E., Raffa G., Martucci G., Arcadipane A., Panarello G., Chiarini G., Cattaneo S., Puglia C., Benussi S., Foti G., Giani M., Bombino M., Costa M. C., Rona R., Avalli L., Donati A., Carozza R., Gasparri F., Carsetti A., Piciche M., Marinello A., Danzi V., Zanin A., Condello I., Fiore F., Moscarelli M., Nasso G., Speziale G., Sandrelli L., Montalto A., Musumeci F., Circelli A., Russo E., Agnoletti V., Rociola R., Milano A. D., Pilato E., Comentale G., Montisci A., Alessandri F., Tosi A., Pugliese F., Giordano G., Carelli S., Grieco D. L., Dell'Anna A. M., Antonelli M., Ramoni E., Zulueta J., Del Giglio M., Petracca S., Bertini P., Guarracino F., De Simone L., Angeletti P. M., Forfori F., Taraschi F., Quintiliani V. N., Samalavicius R., Jankuviene A., Scupakova N., Urbonas K., Kapturauskas J., Soerensen G., Suwalski P., Linhares Santos L., Marques A., Miranda M., Teixeira S., Salgueiro A., Pereira F., Ketskalo M., Tsarenko S., Shilova A., Afukov I., Popugaev K., Minin S., Shelukhin D., Malceva O., Gleb M., Skopets A., Kornelyuk R., Kulikov A., Okhrimchuk V., Turchaninov A., Petrushin M., Sheck A., Mekulov A., Ciryateva S., Urusov D., Gorjup V., Golicnik A., Goslar T., Ferrer R., Martinez-Martinez M., Argudo E., Palmer N., De Pablo Sanchez R., Juan Higuera L., Arnau Blasco L., Marquez J. A., Sbraga F., Fuset M. P., De Gopegui P. R., Claraco L. M., De Ayala J. A., Peiro M., Ricart P., Martinez S., Chavez F., Fabra M., Sandoval E., Toapanta D., Carraminana A., Tellez A., Ososio J., Milan P., Rodriguez J., Andoni G., Gutierrez C., Perez de la Sota E., Eixeres-Esteve A., Garcia-Maellas M. T., Gutierrez-Gutierrez J., Arboleda-Salazar R., Santa Teresa P., Jaspe A., Garrido A., Castaneda G., Alcantara S., Martinez N., Perez M., Villanueva H., Vidal Gonzalez A., Paez J., Santon A., Perez C., Lopez M., Rubio Lopez M. I., Gordillo A., Naranjo-Izurieta J., Munoz J., Alcalde I., Onieva F., Gimeno Costa R., Perez F., Madrid I., Gordon M., Albacete Moreno C. L., Perez D., Lopez N., Martinenz D., Blanco-Schweizer P., Diez C., Prieto A., Renedo G., Bustamante E., Cicuendez R., Citores R., Boado V., Garcia K., Voces R., Domezain M., Nunez Martinez J. M., Vicente R., Martin D., Andreu A., Gomez Casal V., Chico I., Menor E. M., Vara S., Gamacho J., Perez-Chomon H., Javier Gonzales F., Barrero I., Martin-Villen L., Fernandez E., Mendoza M., Navarro J., Colomina Climent J., Gonzales-Perez A., Muniz-Albaceita G., Amado L., Rodriguez R., Ruiz E., Eiras M., Grins E., Magnus R., Kanetoft M., Eidevald M., Watson P., Vogt P. R., Steiger P., Aigner T., Weber A., Grunefelder J., Kunz M., Grapow M., Aymard T., Reser D., Agus G., Consiglio J., Haenggi M., Hansjoerg J., Iten M., Doeble T., Zenklusen U., Bechtold X., Faedda G., Iafrate M., Rohjer A., Bergamaschi L., Maessen J., Reis Miranda D., Endeman H., Gommers D., Meuwese C., Maas J., Van Gijlswijk M. J., Van Berg R. N., Candura D., Van der Linden M., Kant M., Van der Heijden J. J., Scholten E., Van Belle-van Haren N., Lagrand W. K., Vlaar A. P., De Jong S., Cander B., Sargin M., Ugur M., Kaygin M. A., Daly K., Agnew N., Head L., Kelly L., Anoma G., Russell C., Aquino V., Scott I., Flemming L., Gillon S., Moore O., Gelandt E., Auzinger G., Patel S., Loveridge R., Lorusso, R, De Piero, M, Mariani, S, Di Mauro, M, Folliguet, T, Taccone, F, Camporota, L, Swol, J, Wiedemann, D, Belliato, M, Broman, L, Vuylsteke, A, Kassif, Y, Scandroglio, A, Fanelli, V, Gaudard, P, Ledot, S, Barker, J, Boeken, U, Maier, S, Kersten, A, Meyns, B, Pozzi, M, Pedersen, F, Schellongowski, P, Kirali, K, Barrett, N, Riera, J, Mueller, T, Belohlavek, J, Lo Coco, V, Van der Horst, I, Van Bussel, B, Schnabel, R, Delnoij, T, Bolotin, G, Lorini, L, Schmiady, M, Schibilsky, D, Kowalewski, M, Pinto, L, Silva, P, Kornilov, I, Blandino Ortiz, A, Vercaemst, L, Finney, S, Roeleveld, P, Di Nardo, M, Hennig, F, Antonini, M, Davidson, M, Jones, T, Staudinger, T, Mair, P, Kilo, J, Krapf, C, Erbert, K, Peer, A, Bonaros, N, Kotheletner, F, Krenner Mag, N, Shestakova, L, Hermans, G, Dauwe, D, Meersseman, P, Stockman, B, Nobile, L, Lhereux, O, Nrasseurs, A, Creuter, J, De Backer, D, Giglioli, S, Michiels, G, Foulon, P, Raes, M, Rodrigus, I, Allegaert, M, Jorens, P, Debeucklare, G, Piagnerelli, M, Biston, P, Peperstraete, H, Vandewiele, K, Germay, O, Vandeweghe, D, Havrin, S, Bourgeois, M, Lagny, M, Alois, G, Lavios, N, Misset, B, Courcelle, R, Timmermans, P, Yilmaz, A, Vantomout, M, Lehaen, J, Jassen, A, Guterman, H, Strauven, M, Lormans, P, Verhamme, B, Vandewaeter, C, Bonte, F, Vionne, D, Balik, M, Blaha, J, Lips, M, Othal, M, Bursa, F, Spacek, R, Christensen, S, Jorgensen, V, Sorensen, M, Madsen, S, Puss, S, Beljantsev, A, Saiydoun, G, Fiore, A, Colson, P, Bazalgette, F, Capdevila, X, Kollen, S, Muller, L, Obadia, J, Dubien, P, Ajrhourh, L, Guinot, P, Zarka, J, Besserve, P, Malfertheiner, M, Dreier, E, Heinze, B, Akhyari, P, Lichtenberg, A, Aubin, H, Assman, A, Saeed, D, Thiele, H, Baumgaertel, M, Schmitto, J, Ruslan, N, Haverich, A, Thielmann, M, Brenner, T, Ruhpawar, A, Benk, C, Czerny, M, Staudacher, D, Beyersdorf, F, Kalbhenn, J, Henn, P, Popov, A, Iuliu, T, Muellenbach, R, Reyher, C, Rolfes, C, Lotz, G, Sonntagbauer, M, Winkels, H, Fichte, J, Stohr, R, Kalverkamp, S, Karagiannidis, C, Schafer, S, Svetlitchny, A, Hopf, H, Jarczak, D, Groesdonk, H, Rommer, M, Hirsch, J, Kaehny, C, Soufleris, D, Gavriilidis, G, Pontikis, K, Kyriakopoulou, M, Kyriakoudi, A, O'Brien, S, Conrick-Martin, I, Carton, E, Makhoul, M, Ben-Ari, J, Hadash, A, Kogan, A, Kassif Lerner, R, Abu-Shakra, A, Matan, M, Balawona, A, Kachel, E, Altshuler, R, Galante, O, Fuchs, L, Almog, Y, Ishay, Y, Lichter, Y, Gal-oz, A, Carmi, U, Nini, A, Soroksky, A, Dekel, H, Rozman, Z, Tayem, E, Ilgiyaev, E, Hochman, Y, Miltau, D, Rapoport, A, Eden, A, Kompanietz, D, Yousif, M, Golos, M, Grazioli, L, Ghitti, D, Loforte, A, Di Luca, D, Baiocchi, M, Pacini, D, Cappai, A, Meani, P, Mondino, M, Russo, C, Ranucci, M, Fina, D, Cotza, M, Ballotta, A, Landoni, G, Nardelli, P, Fominski, E, Brazzi, L, Montrucchio, G, Sales, G, Simonetti, U, Livigni, S, Silengo, D, Arena, G, Sovatzis, S, Degani, A, Riccardi, M, Milanesi, E, Raffa, G, Martucci, G, Arcadipane, A, Panarello, G, Chiarini, G, Cattaneo, S, Puglia, C, Benussi, S, Foti, G, Giani, M, Bombino, M, Costa, M, Rona, R, Avalli, L, Donati, A, Carozza, R, Gasparri, F, Carsetti, A, Piciche, M, Marinello, A, Danzi, V, Zanin, A, Condello, I, Fiore, F, Moscarelli, M, Nasso, G, Speziale, G, Sandrelli, L, Montalto, A, Musumeci, F, Circelli, A, Russo, E, Agnoletti, V, Rociola, R, Milano, A, Pilato, E, Comentale, G, Montisci, A, Alessandri, F, Tosi, A, Pugliese, F, Giordano, G, Carelli, S, Grieco, D, Dell'Anna, A, Antonelli, M, Ramoni, E, Zulueta, J, Del Giglio, M, Petracca, S, Bertini, P, Guarracino, F, De Simone, L, Angeletti, P, Forfori, F, Taraschi, F, Quintiliani, V, Samalavicius, R, Jankuviene, A, Scupakova, N, Urbonas, K, Kapturauskas, J, Soerensen, G, Suwalski, P, Linhares Santos, L, Marques, A, Miranda, M, Teixeira, S, Salgueiro, A, Pereira, F, Ketskalo, M, Tsarenko, S, Shilova, A, Afukov, I, Popugaev, K, Minin, S, Shelukhin, D, Malceva, O, Gleb, M, Skopets, A, Kornelyuk, R, Kulikov, A, Okhrimchuk, V, Turchaninov, A, Petrushin, M, Sheck, A, Mekulov, A, Ciryateva, S, Urusov, D, Gorjup, V, Golicnik, A, Goslar, T, Ferrer, R, Martinez-Martinez, M, Argudo, E, Palmer, N, De Pablo Sanchez, R, Juan Higuera, L, Arnau Blasco, L, Marquez, J, Sbraga, F, Fuset, M, De Gopegui, P, Claraco, L, De Ayala, J, Peiro, M, Ricart, P, Martinez, S, Chavez, F, Fabra, M, Sandoval, E, Toapanta, D, Carraminana, A, Tellez, A, Ososio, J, Milan, P, Rodriguez, J, Andoni, G, Gutierrez, C, Perez de la Sota, E, Eixeres-Esteve, A, Garcia-Maellas, M, Gutierrez-Gutierrez, J, Arboleda-Salazar, R, Santa Teresa, P, Jaspe, A, Garrido, A, Castaneda, G, Alcantara, S, Martinez, N, Perez, M, Villanueva, H, Vidal Gonzalez, A, Paez, J, Santon, A, Perez, C, Lopez, M, Rubio Lopez, M, Gordillo, A, Naranjo-Izurieta, J, Munoz, J, Alcalde, I, Onieva, F, Gimeno Costa, R, Perez, F, Madrid, I, Gordon, M, Albacete Moreno, C, Perez, D, Lopez, N, Martinenz, D, Blanco-Schweizer, P, Diez, C, Prieto, A, Renedo, G, Bustamante, E, Cicuendez, R, Citores, R, Boado, V, Garcia, K, Voces, R, Domezain, M, Nunez Martinez, J, Vicente, R, Martin, D, Andreu, A, Gomez Casal, V, Chico, I, Menor, E, Vara, S, Gamacho, J, Perez-Chomon, H, Javier Gonzales, F, Barrero, I, Martin-Villen, L, Fernandez, E, Mendoza, M, Navarro, J, Colomina Climent, J, Gonzales-Perez, A, Muniz-Albaceita, G, Amado, L, Rodriguez, R, Ruiz, E, Eiras, M, Grins, E, Magnus, R, Kanetoft, M, Eidevald, M, Watson, P, Vogt, P, Steiger, P, Aigner, T, Weber, A, Grunefelder, J, Kunz, M, Grapow, M, Aymard, T, Reser, D, Agus, G, Consiglio, J, Haenggi, M, Hansjoerg, J, Iten, M, Doeble, T, Zenklusen, U, Bechtold, X, Faedda, G, Iafrate, M, Rohjer, A, Bergamaschi, L, Maessen, J, Reis Miranda, D, Endeman, H, Gommers, D, Meuwese, C, Maas, J, Van Gijlswijk, M, Van Berg, R, Candura, D, Van der Linden, M, Kant, M, Van der Heijden, J, Scholten, E, Van Belle-van Haren, N, Lagrand, W, Vlaar, A, De Jong, S, Cander, B, Sargin, M, Ugur, M, Kaygin, M, Daly, K, Agnew, N, Head, L, Kelly, L, Anoma, G, Russell, C, Aquino, V, Scott, I, Flemming, L, Gillon, S, Moore, O, Gelandt, E, Auzinger, G, Patel, S, Loveridge, R, Lorusso R., De Piero M. E., Mariani S., Di Mauro M., Folliguet T., Taccone F. S., Camporota L., Swol J., Wiedemann D., Belliato M., Broman L. M., Vuylsteke A., Kassif Y., Scandroglio A. M., Fanelli V., Gaudard P., Ledot S., Barker J., Boeken U., Maier S., Kersten A., Meyns B., Pozzi M., Pedersen F. M., Schellongowski P., Kirali K., Barrett N., Riera J., Mueller T., Belohlavek J., Lo Coco V., Van der Horst I. C. C., Van Bussel B. C. T., Schnabel R. M., Delnoij T., Bolotin G., Lorini L., Schmiady M. O., Schibilsky D., Kowalewski M., Pinto L. F., Silva P. E., Kornilov I., Blandino Ortiz A., Vercaemst L., Finney S., Roeleveld P. P., Di Nardo M., Hennig F., Antonini M. V., Davidson M., Jones T. J., Staudinger T., Mair P., Kilo J., Krapf C., Erbert K., Peer A., Bonaros N., Kotheletner F., Krenner Mag N., Shestakova L., Hermans G., Dauwe D., Meersseman P., Stockman B., Nobile L., Lhereux O., Nrasseurs A., Creuter J., De Backer D., Giglioli S., Michiels G., Foulon P., Raes M., Rodrigus I., Allegaert M., Jorens P., Debeucklare G., Piagnerelli M., Biston P., Peperstraete H., Vandewiele K., Germay O., Vandeweghe D., Havrin S., Bourgeois M., Lagny M. -G., Alois G., Lavios N., Misset B., Courcelle R., Timmermans P. J., Yilmaz A., Vantomout M., Lehaen J., Jassen A., Guterman H., Strauven M., Lormans P., Verhamme B., Vandewaeter C., Bonte F., Vionne D., Balik M., Blaha J., Lips M., Othal M., Bursa F., Spacek R., Christensen S., Jorgensen V., Sorensen M., Madsen S. A., Puss S., Beljantsev A., Saiydoun G., Fiore A., Colson P., Bazalgette F., Capdevila X., Kollen S., Muller L., Obadia J. -F., Dubien P. -Y., Ajrhourh L., Guinot P. G., Zarka J., Besserve P., Malfertheiner M. V., Dreier E., Heinze B., Akhyari P., Lichtenberg A., Aubin H., Assman A., Saeed D., Thiele H., Baumgaertel M., Schmitto J. D., Ruslan N., Haverich A., Thielmann M., Brenner T., Ruhpawar A., Benk C., Czerny M., Staudacher D. L., Beyersdorf F., Kalbhenn J., Henn P., Popov A. -F., Iuliu T., Muellenbach R., Reyher C., Rolfes C., Lotz G., Sonntagbauer M., Winkels H., Fichte J., Stohr R., Kalverkamp S., Karagiannidis C., Schafer S., Svetlitchny A., Hopf H. -B., Jarczak D., Groesdonk H., Rommer M., Hirsch J., Kaehny C., Soufleris D., Gavriilidis G., Pontikis K., Kyriakopoulou M., Kyriakoudi A., O'Brien S., Conrick-Martin I., Carton E., Makhoul M., Ben-Ari J., Hadash A., Kogan A., Kassif Lerner R., Abu-Shakra A., Matan M., Balawona A., Kachel E., Altshuler R., Galante O., Fuchs L., Almog Y., Ishay Y. S., Lichter Y., Gal-oz A., Carmi U., Nini A., Soroksky A., Dekel H., Rozman Z., Tayem E., Ilgiyaev E., Hochman Y., Miltau D., Rapoport A., Eden A., Kompanietz D., Yousif M., Golos M., Grazioli L., Ghitti D., Loforte A., Di Luca D., Baiocchi M., Pacini D., Cappai A., Meani P., Mondino M., Russo C. F., Ranucci M., Fina D., Cotza M., Ballotta A., Landoni G., Nardelli P., Fominski E. V., Brazzi L., Montrucchio G., Sales G., Simonetti U., Livigni S., Silengo D., Arena G., Sovatzis S. S., Degani A., Riccardi M., Milanesi E., Raffa G., Martucci G., Arcadipane A., Panarello G., Chiarini G., Cattaneo S., Puglia C., Benussi S., Foti G., Giani M., Bombino M., Costa M. C., Rona R., Avalli L., Donati A., Carozza R., Gasparri F., Carsetti A., Piciche M., Marinello A., Danzi V., Zanin A., Condello I., Fiore F., Moscarelli M., Nasso G., Speziale G., Sandrelli L., Montalto A., Musumeci F., Circelli A., Russo E., Agnoletti V., Rociola R., Milano A. D., Pilato E., Comentale G., Montisci A., Alessandri F., Tosi A., Pugliese F., Giordano G., Carelli S., Grieco D. L., Dell'Anna A. M., Antonelli M., Ramoni E., Zulueta J., Del Giglio M., Petracca S., Bertini P., Guarracino F., De Simone L., Angeletti P. M., Forfori F., Taraschi F., Quintiliani V. N., Samalavicius R., Jankuviene A., Scupakova N., Urbonas K., Kapturauskas J., Soerensen G., Suwalski P., Linhares Santos L., Marques A., Miranda M., Teixeira S., Salgueiro A., Pereira F., Ketskalo M., Tsarenko S., Shilova A., Afukov I., Popugaev K., Minin S., Shelukhin D., Malceva O., Gleb M., Skopets A., Kornelyuk R., Kulikov A., Okhrimchuk V., Turchaninov A., Petrushin M., Sheck A., Mekulov A., Ciryateva S., Urusov D., Gorjup V., Golicnik A., Goslar T., Ferrer R., Martinez-Martinez M., Argudo E., Palmer N., De Pablo Sanchez R., Juan Higuera L., Arnau Blasco L., Marquez J. A., Sbraga F., Fuset M. P., De Gopegui P. R., Claraco L. M., De Ayala J. A., Peiro M., Ricart P., Martinez S., Chavez F., Fabra M., Sandoval E., Toapanta D., Carraminana A., Tellez A., Ososio J., Milan P., Rodriguez J., Andoni G., Gutierrez C., Perez de la Sota E., Eixeres-Esteve A., Garcia-Maellas M. T., Gutierrez-Gutierrez J., Arboleda-Salazar R., Santa Teresa P., Jaspe A., Garrido A., Castaneda G., Alcantara S., Martinez N., Perez M., Villanueva H., Vidal Gonzalez A., Paez J., Santon A., Perez C., Lopez M., Rubio Lopez M. I., Gordillo A., Naranjo-Izurieta J., Munoz J., Alcalde I., Onieva F., Gimeno Costa R., Perez F., Madrid I., Gordon M., Albacete Moreno C. L., Perez D., Lopez N., Martinenz D., Blanco-Schweizer P., Diez C., Prieto A., Renedo G., Bustamante E., Cicuendez R., Citores R., Boado V., Garcia K., Voces R., Domezain M., Nunez Martinez J. M., Vicente R., Martin D., Andreu A., Gomez Casal V., Chico I., Menor E. M., Vara S., Gamacho J., Perez-Chomon H., Javier Gonzales F., Barrero I., Martin-Villen L., Fernandez E., Mendoza M., Navarro J., Colomina Climent J., Gonzales-Perez A., Muniz-Albaceita G., Amado L., Rodriguez R., Ruiz E., Eiras M., Grins E., Magnus R., Kanetoft M., Eidevald M., Watson P., Vogt P. R., Steiger P., Aigner T., Weber A., Grunefelder J., Kunz M., Grapow M., Aymard T., Reser D., Agus G., Consiglio J., Haenggi M., Hansjoerg J., Iten M., Doeble T., Zenklusen U., Bechtold X., Faedda G., Iafrate M., Rohjer A., Bergamaschi L., Maessen J., Reis Miranda D., Endeman H., Gommers D., Meuwese C., Maas J., Van Gijlswijk M. J., Van Berg R. N., Candura D., Van der Linden M., Kant M., Van der Heijden J. J., Scholten E., Van Belle-van Haren N., Lagrand W. K., Vlaar A. P., De Jong S., Cander B., Sargin M., Ugur M., Kaygin M. A., Daly K., Agnew N., Head L., Kelly L., Anoma G., Russell C., Aquino V., Scott I., Flemming L., Gillon S., Moore O., Gelandt E., Auzinger G., Patel S., and Loveridge R.

Abstract

Background: Extracorporeal membrane oxygenation (ECMO) has been widely used in patients with COVID-19, but uncertainty remains about the determinants of in-hospital mortality and data on post-discharge outcomes are scarce. The aims of this study were to investigate the variables associated with in-hospital outcomes in patients who received ECMO during the first wave of COVID-19 and to describe the status of patients 6 months after ECMO initiation. Methods: EuroECMO-COVID is a prospective, multicentre, observational study developed by the European Extracorporeal Life Support Organization. This study was based on data from patients aged 16 years or older who received ECMO support for refractory COVID-19 during the first wave of the pandemic—from March 1 to Sept 13, 2020—at 133 centres in 21 countries. In-hospital mortality and mortality 6 months after ECMO initiation were the primary outcomes. Mixed-Cox proportional hazards models were used to investigate associations between patient and management-related variables (eg, patient demographics, comorbidities, pre-ECMO status, and ECMO characteristics and complications) and in-hospital deaths. Survival status at 6 months was established through patient contact or institutional charts review. This study is registered with ClinicalTrials.gov, NCT04366921, and is ongoing. Findings: Between March 1 and Sept 13, 2020, 1215 patients (942 [78%] men and 267 [22%] women; median age 53 years [IQR 46–60]) were included in the study. Median ECMO duration was 15 days (IQR 8–27). 602 (50%) of 1215 patients died in hospital, and 852 (74%) patients had at least one complication. Multiorgan failure was the leading cause of death (192 [36%] of 528 patients who died with available data). In mixed-Cox analyses, age of 60 years or older, use of inotropes and vasopressors before ECMO initiation, chronic renal failure, and time from intubation to ECMO initiation of 4 days or more were associated with higher in-hospital mortality. 613 patients

Published
2023

17. Airway Closure in Patients With Cardiogenic Pulmonary Edema as a Cause of Driving Pressure Overestimation: The “Uncorking Effect”

Author

Pozzi, M, Raimondi Cominesi, D, Giani, M, Avalli, L, Foti, G, Brochard, L, Bellani, G, Rezoagli, E, Pozzi M., Raimondi Cominesi D., Giani M., Avalli L., Foti G., Brochard L. J., Bellani G., Rezoagli E., Pozzi, M, Raimondi Cominesi, D, Giani, M, Avalli, L, Foti, G, Brochard, L, Bellani, G, Rezoagli, E, Pozzi M., Raimondi Cominesi D., Giani M., Avalli L., Foti G., Brochard L. J., Bellani G., and Rezoagli E.

Abstract

Airway closure is an underestimated phenomenon reported in hypoxemic respiratory failure under mechanical ventilation, during cardiac arrest, and in patients who are obese. Because airway and alveolar pressure are not communicating, it leads to an overestimation of driving pressure and an underestimation of respiratory system compliance. Airway closure also favors denitrogenation atelectasis. To date, it has been described mainly in patients with ARDS and those with obesity. We describe three cases of airway closure in patients with hydrostatic pulmonary edema caused by cardiogenic shock, highlighting its resolution in a limited period of time (24 h) as pulmonary edema resolved. The waveforms show a biphasic reopening that we refer to as the "uncorking effect". The detection of airway closure may require setting positive end-expiratory pressure at or above the airway opening pressure to avoid the overestimation of driving pressure.

Published
2023

18. The frail patient undergoing cardiac surgery: lessons learned and future perspectives

Author

Pozzi, M, Mariani, S, Scanziani, M, Passolunghi, D, Bruni, A, Finazzi, A, Lettino, M, Foti, G, Bellelli, G, Marchetto, G, Pozzi M., Mariani S., Scanziani M., Passolunghi D., Bruni A., Finazzi A., Lettino M., Foti G., Bellelli G., Marchetto G., Pozzi, M, Mariani, S, Scanziani, M, Passolunghi, D, Bruni, A, Finazzi, A, Lettino, M, Foti, G, Bellelli, G, Marchetto, G, Pozzi M., Mariani S., Scanziani M., Passolunghi D., Bruni A., Finazzi A., Lettino M., Foti G., Bellelli G., and Marchetto G.

Abstract

Frailty is a geriatric condition characterized by the reduction of the individual's homeostatic reserves. It determines an increased vulnerability to endogenous and exogenous stressors and can lead to poor outcomes. It is an emerging concept in perioperative medicine, since an increasing number of patients undergoing surgical interventions are older and the traditional models of care seem to be inadequate to satisfy these patients' emerging clinical needs. Nowadays, the progressive technical and clinical improvements allow to offer cardiac operations to an older, sicker and frail population. For these reasons, a multidisciplinary team involving cardiac surgeons, clinical cardiologists, anesthesiologists, and geriatricians, is often needed to assess, select and provide tailored care to these high-risk frail patients to optimize clinical outcomes. There is unanimous agreement that frailty assessment may capture the individual's biological decline and the heterogeneity in risk profile for poor health-related outcomes among people of the same age. However, since commonly used preoperative scores for cardiac surgery fail to capture frailty, a specific preoperative assessment with dedicated tools is warranted to correctly recognize, measure and quantify frailty in these patients. On the contrary, pre-operative and post-operative interventions can reduce the risk of complications and support patient recovery promoting surgical resilience. Minimally invasive cardiac procedures aim to reduce surgical trauma and may be associated with better clinical outcome in this specific sub-group of high-risk patients. Among postoperative adverse events, the occurrence of delirium represents a risk factor for several unfavorable outcomes including mortality and subsequent cognitive decline. Its presence should be carefully recognized, triggering an adequate, evidence based, treatment. There is evidence, from several cross-section and longitudinal studies, that frailty and delirium may fr

Published
2023

19. Adjuvant capecitabine in triple negative breast cancer patients with residual disease after neoadjuvant treatment: real-world evidence from CaRe, a multicentric, observational study

Author

Di Lisa, F, Krasniqi, E, Pizzuti, L, Barba, M, Cannita, K, De Giorgi, U, Borella, F, Foglietta, J, Cariello, A, Ferro, A, Picardo, E, Mitidieri, M, Sini, V, Stani, S, Tonini, G, Santini, D, La Verde, N, Gambaro, A, Grassadonia, A, Tinari, N, Garrone, O, Sarobba, G, Livi, L, Meattini, I, D'Auria, G, Vergati, M, Gamucci, T, Pistelli, M, Berardi, R, Risi, E, Giotta, F, Lorusso, V, Rinaldi, L, Artale, S, Cazzaniga, M, Zustovich, F, Cappuzzo, F, Landi, L, Torrisi, R, Scagnoli, S, Botticelli, A, Michelotti, A, Fratini, B, Saltarelli, R, Paris, I, Muratore, M, Cassano, A, Gianni, L, Gaspari, V, Veltri, E, Zoratto, F, Fiorio, E, Fabbri, M, Mazzotta, M, Ruggeri, E, Pedersini, R, Valerio, M, Filomeno, L, Minelli, M, Scavina, P, Raffaele, M, Astone, A, De Vita, R, Pozzi, M, Riccardi, F, Greco, F, Moscetti, L, Giordano, M, Maugeri-Sacca, M, Zennaro, A, Botti, C, Pelle, F, Cappelli, S, Cavicchi, F, Vizza, E, Sanguineti, G, Tomao, F, Cortesi, E, Marchetti, P, Tomao, S, Speranza, I, Sperduti, I, Ciliberto, G, Vici, P, Di Lisa F. S., Krasniqi E., Pizzuti L., Barba M., Cannita K., De Giorgi U., Borella F., Foglietta J., Cariello A., Ferro A., Picardo E., Mitidieri M., Sini V., Stani S., Tonini G., Santini D., La Verde N., Gambaro A. R., Grassadonia A., Tinari N., Garrone O., Sarobba G., Livi L., Meattini I., D'Auria G., Vergati M., Gamucci T., Pistelli M., Berardi R., Risi E., Giotta F., Lorusso V., Rinaldi L., Artale S., Cazzaniga M. E., Zustovich F., Cappuzzo F., Landi L., Torrisi R., Scagnoli S., Botticelli A., Michelotti A., Fratini B., Saltarelli R., Paris I., Muratore M., Cassano A., Gianni L., Gaspari V., Veltri E. M., Zoratto F., Fiorio E., Fabbri M. A., Mazzotta M., Ruggeri E. M., Pedersini R., Valerio M. R., Filomeno L., Minelli M., Scavina P., Raffaele M., Astone A., De Vita R., Pozzi M., Riccardi F., Greco F., Moscetti L., Giordano M., Maugeri-Sacca M., Zennaro A., Botti C., Pelle F., Cappelli S., Cavicchi F., Vizza E., Sanguineti G., Tomao F., Cortesi E., Marchetti P., Tomao S., Speranza I., Sperduti I., Ciliberto G., Vici P., Di Lisa, F, Krasniqi, E, Pizzuti, L, Barba, M, Cannita, K, De Giorgi, U, Borella, F, Foglietta, J, Cariello, A, Ferro, A, Picardo, E, Mitidieri, M, Sini, V, Stani, S, Tonini, G, Santini, D, La Verde, N, Gambaro, A, Grassadonia, A, Tinari, N, Garrone, O, Sarobba, G, Livi, L, Meattini, I, D'Auria, G, Vergati, M, Gamucci, T, Pistelli, M, Berardi, R, Risi, E, Giotta, F, Lorusso, V, Rinaldi, L, Artale, S, Cazzaniga, M, Zustovich, F, Cappuzzo, F, Landi, L, Torrisi, R, Scagnoli, S, Botticelli, A, Michelotti, A, Fratini, B, Saltarelli, R, Paris, I, Muratore, M, Cassano, A, Gianni, L, Gaspari, V, Veltri, E, Zoratto, F, Fiorio, E, Fabbri, M, Mazzotta, M, Ruggeri, E, Pedersini, R, Valerio, M, Filomeno, L, Minelli, M, Scavina, P, Raffaele, M, Astone, A, De Vita, R, Pozzi, M, Riccardi, F, Greco, F, Moscetti, L, Giordano, M, Maugeri-Sacca, M, Zennaro, A, Botti, C, Pelle, F, Cappelli, S, Cavicchi, F, Vizza, E, Sanguineti, G, Tomao, F, Cortesi, E, Marchetti, P, Tomao, S, Speranza, I, Sperduti, I, Ciliberto, G, Vici, P, Di Lisa F. S., Krasniqi E., Pizzuti L., Barba M., Cannita K., De Giorgi U., Borella F., Foglietta J., Cariello A., Ferro A., Picardo E., Mitidieri M., Sini V., Stani S., Tonini G., Santini D., La Verde N., Gambaro A. R., Grassadonia A., Tinari N., Garrone O., Sarobba G., Livi L., Meattini I., D'Auria G., Vergati M., Gamucci T., Pistelli M., Berardi R., Risi E., Giotta F., Lorusso V., Rinaldi L., Artale S., Cazzaniga M. E., Zustovich F., Cappuzzo F., Landi L., Torrisi R., Scagnoli S., Botticelli A., Michelotti A., Fratini B., Saltarelli R., Paris I., Muratore M., Cassano A., Gianni L., Gaspari V., Veltri E. M., Zoratto F., Fiorio E., Fabbri M. A., Mazzotta M., Ruggeri E. M., Pedersini R., Valerio M. R., Filomeno L., Minelli M., Scavina P., Raffaele M., Astone A., De Vita R., Pozzi M., Riccardi F., Greco F., Moscetti L., Giordano M., Maugeri-Sacca M., Zennaro A., Botti C., Pelle F., Cappelli S., Cavicchi F., Vizza E., Sanguineti G., Tomao F., Cortesi E., Marchetti P., Tomao S., Speranza I., Sperduti I., Ciliberto G., and Vici P.

Abstract

Background: In triple negative breast cancer patients treated with neoadjuvant chemotherapy, residual disease at surgery is the most relevant unfavorable prognostic factor. Current guidelines consider the use of adjuvant capecitabine, based on the results of the randomized CREATE-X study, carried out in Asian patients and including a small subset of triple negative tumors. Thus far, evidence on Caucasian patients is limited, and no real-world data are available. Methods: We carried out a multicenter, observational study, involving 44 oncologic centres. Triple negative breast cancer patients with residual disease, treated with adjuvant capecitabine from January 2017 through June 2021, were recruited. We primarily focused on treatment tolerability, with toxicity being reported as potential cause of treatment discontinuation. Secondarily, we assessed effectiveness in the overall study population and in a subset having a minimum follow-up of 2 years. Results: Overall, 270 patients were retrospectively identified. The 50.4% of the patients had residual node positive disease, 7.8% and 81.9% had large or G3 residual tumor, respectively, and 80.4% a Ki-67 >20%. Toxicity-related treatment discontinuation was observed only in 10.4% of the patients. In the whole population, at a median follow-up of 15 months, 2-year disease-free survival was 62%, 2 and 3-year overall survival 84.0% and 76.2%, respectively. In 129 patients with a median follow-up of 25 months, 2-year disease-free survival was 43.4%, 2 and 3-year overall survival 78.0% and 70.8%, respectively. Six or more cycles of capecitabine were associated with more favourable outcomes compared with less than six cycles. Conclusion: The CaRe study shows an unexpectedly good tolerance of adjuvant capecitabine in a real-world setting, although effectiveness appears to be lower than that observed in the CREATE-X study. Methodological differences between the two studies impose significant limits to comparability concerning ef

Published
2023

20. Hospital Memories and Six-Month Psychological Outcome: A Prospective Study in Critical Ill Patients with COVID-19 Respiratory Failure

Author

Pozzi, M, Ripa, C, Meroni, V, Ferlicca, D, Annoni, A, Villa, M, Strepparava, M, Rezoagli, E, Piva, S, Lucchini, A, Bellani, G, Foti, G, Pozzi M., Ripa C., Meroni V., Ferlicca D., Annoni A., Villa M., Strepparava M. G., Rezoagli E., Piva S., Lucchini A., Bellani G., Foti G., Pozzi, M, Ripa, C, Meroni, V, Ferlicca, D, Annoni, A, Villa, M, Strepparava, M, Rezoagli, E, Piva, S, Lucchini, A, Bellani, G, Foti, G, Pozzi M., Ripa C., Meroni V., Ferlicca D., Annoni A., Villa M., Strepparava M. G., Rezoagli E., Piva S., Lucchini A., Bellani G., and Foti G.

Abstract

ICU survivors suffer from various long-term physical and psychological impairments. Memories from the critical illness may influence long-term psychological outcome. In particular, the role of ICU memories in COVID-19 critically ill patients is unknown. In a prospective observational study, we aimed to investigate patients' memories from the experience of critical illness and their association with a six-month psychological outcome involving quality of life evaluation. Patients' memories were investigated with ICU Memory tool, while psychological outcome and quality of life were evaluated by means of a battery of validated questionnaires during an in-person interview at the follow-up clinic. 149 adult patients were enrolled. 60% retained memories from pre-ICU days spent on a general ward, while 70% reported memories from the in-ICU period. Delusional memories (i.e., memories of facts that never happened) were reported by 69% of patients. According to a multivariable analysis, the lack of pre-ICU memories was an independent predictor of worse psychological outcomes in terms of anxiety, depression and Post-traumatic Stress Disorder (PTDS). Factors associated with long-term outcome in ICU survivors are not still fully understood and patients' experience during the day spent before ICU admission may be associated with psychological sequelae.

Published
2023

22. Inhaled Nitric Oxide in Acute Respiratory Distress Syndrome Subsets: Rationale and Clinical Applications

Author

Redaelli, S, Pozzi, M, Giani, M, Magliocca, A, Fumagalli, R, Foti, G, Berra, L, Rezoagli, E, Redaelli S., Pozzi M., Giani M., Magliocca A., Fumagalli R., Foti G., Berra L., Rezoagli E., Redaelli, S, Pozzi, M, Giani, M, Magliocca, A, Fumagalli, R, Foti, G, Berra, L, Rezoagli, E, Redaelli S., Pozzi M., Giani M., Magliocca A., Fumagalli R., Foti G., Berra L., and Rezoagli E.

Abstract

Acute respiratory distress syndrome (ARDS) is a life-threatening condition, characterized by diffuse inflammatory lung injury. Since the coronavirus disease 2019 (COVID-19) pandemic spread worldwide, the most common cause of ARDS has been the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Both the COVID-19-associated ARDS and the ARDS related to other causes - also defined as classical ARDS - are burdened by high mortality and morbidity. For these reasons, effective therapeutic interventions are urgently needed. Among them, inhaled nitric oxide (iNO) has been studied in patients with ARDS since 1993 and it is currently under investigation. In this review, we aim at describing the biological and pharmacological rationale of iNO treatment in ARDS by elucidating similarities and differences between classical and COVID-19 ARDS. Thereafter, we present the available evidence on the use of iNO in clinical practice in both types of respiratory failure. Overall, iNO seems a promising agent as it could improve the ventilation/perfusion mismatch, gas exchange impairment, and right ventricular failure, which are reported in ARDS. In addition, iNO may act as a viricidal agent and prevent lung hyperinflammation and thrombosis of the pulmonary vasculature in the specific setting of COVID-19 ARDS. However, the current evidence on the effects of iNO on outcomes is limited and clinical studies are yet to demonstrate any survival benefit by administering iNO in ARDS.

Published
2023

23. Individual response in patient’s effort and driving pressure to variations in assistance during pressure support ventilation

Author

Docci, M, Rezoagli, E, Teggia-Droghi, M, Coppadoro, A, Pozzi, M, Grassi, A, Bianchi, I, Foti, G, Bellani, G, Docci M., Rezoagli E., Teggia-Droghi M., Coppadoro A., Pozzi M., Grassi A., Bianchi I., Foti G., Bellani G., Docci, M, Rezoagli, E, Teggia-Droghi, M, Coppadoro, A, Pozzi, M, Grassi, A, Bianchi, I, Foti, G, Bellani, G, Docci M., Rezoagli E., Teggia-Droghi M., Coppadoro A., Pozzi M., Grassi A., Bianchi I., Foti G., and Bellani G.

Abstract

Background: During Pressure Support Ventilation (PSV) an inspiratory hold allows to measure plateau pressure (Pplat), driving pressure (∆P), respiratory system compliance (Crs) and pressure-muscle-index (PMI), an index of inspiratory effort. This study aims [1] to assess systematically how patient’s effort (estimated with PMI), ∆P and tidal volume (Vt) change in response to variations in PSV and [2] to confirm the robustness of Crs measurement during PSV. Methods: 18 patients recovering from acute respiratory failure and ventilated by PSV were cross-randomized to four steps of assistance above (+ 3 and + 6 cmH2O) and below (-3 and -6 cmH2O) clinically set PS. Inspiratory and expiratory holds were performed to measure Pplat, PMI, ∆P, Vt, Crs, P0.1 and occluded inspiratory airway pressure (Pocc). Electromyography of respiratory muscles was monitored noninvasively from body surface (sEMG). Results: As PSV was decreased, Pplat (from 20.5 ± 3.3 cmH2O to 16.7 ± 2.9, P < 0.001) and ∆P (from 12.5 ± 2.3 to 8.6 ± 2.3 cmH2O, P < 0.001) decreased much less than peak airway pressure did (from 21.7 ± 3.8 to 9.7 ± 3.8 cmH2O, P < 0.001), given the progressive increase of patient’s effort (PMI from -1.2 ± 2.3 to 6.4 ± 3.2 cmH2O) in line with sEMG of the diaphragm (r = 0.614; P < 0.001). As ∆P increased linearly with Vt, Crs did not change through steps (P = 0.119). Conclusion: Patients react to a decrease in PSV by increasing inspiratory effort—as estimated by PMI—keeping Vt and ∆P on a desired value, therefore, limiting the clinician’s ability to modulate them. PMI appears a valuable index to assess the point of ventilatory overassistance when patients lose control over Vt like in a pressure-control mode. The measurement of Crs in PSV is constant—likely suggesting reliability—independently from the level of assistance and patient’s effort.

Published
2023

26. T2D triggers distinct cardiac transcriptomic signatures in patients with severe aortic stenosis

Author

Cherpaz, M, primary, Meugnier, E, additional, Seillier, G, additional, Le Dantec, G, additional, Bergerot, C, additional, Pozzi, M, additional, Pierrard, R, additional, Chalabreysse, L, additional, May, C, additional, Farhat, F, additional, Vola, M, additional, Obadia, J F, additional, Amaz, C, additional, Paillard, M, additional, and Thibault, H, additional

Published
2023
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30. Hospital Memories and Six-Month Psychological Outcome: A Prospective Study in Critical Ill Patients with COVID-19 Respiratory Failure

Author

Pozzi M., Ripa C., Meroni V., Ferlicca D., Annoni A., Villa M., Strepparava M. G., Rezoagli E., Piva S., Lucchini A., Bellani G., Foti G., Pozzi, M, Ripa, C, Meroni, V, Ferlicca, D, Annoni, A, Villa, M, Strepparava, M, Rezoagli, E, Piva, S, Lucchini, A, Bellani, G, and Foti, G

Subjects
long-term outcome, psychological outcome, PIC syndrome, ARDS, COVID-19 pneumonia, M-PSI/08 - PSICOLOGIA CLINICA, MED/41 - ANESTESIOLOGIA, ICU memorie
Abstract

ICU survivors suffer from various long-term physical and psychological impairments. Memories from the critical illness may influence long-term psychological outcome. In particular, the role of ICU memories in COVID-19 critically ill patients is unknown. In a prospective observational study, we aimed to investigate patients' memories from the experience of critical illness and their association with a six-month psychological outcome involving quality of life evaluation. Patients' memories were investigated with ICU Memory tool, while psychological outcome and quality of life were evaluated by means of a battery of validated questionnaires during an in-person interview at the follow-up clinic. 149 adult patients were enrolled. 60% retained memories from pre-ICU days spent on a general ward, while 70% reported memories from the in-ICU period. Delusional memories (i.e., memories of facts that never happened) were reported by 69% of patients. According to a multivariable analysis, the lack of pre-ICU memories was an independent predictor of worse psychological outcomes in terms of anxiety, depression and Post-traumatic Stress Disorder (PTDS). Factors associated with long-term outcome in ICU survivors are not still fully understood and patients' experience during the day spent before ICU admission may be associated with psychological sequelae.

Published
2023

31. ‘Coming together to awaken our democracy’: Examining precursors of emergent social identity and collective action among activists and non-activists in the 2019–2020 ‘Chile despertó’ protests

Author

Pozzi, M, Passini, S, Chayinska, M, Morselli, D, Ellena, A, Wlodarczyk, A, Pistoni, C, Pozzi M., Passini S., Chayinska M., Morselli D., Ellena A. M., Wlodarczyk A., Pistoni C., Pozzi, M, Passini, S, Chayinska, M, Morselli, D, Ellena, A, Wlodarczyk, A, Pistoni, C, Pozzi M., Passini S., Chayinska M., Morselli D., Ellena A. M., Wlodarczyk A., and Pistoni C.

Abstract

By integrating the insights from social identity research on collective action, this article examines the social-psychological mechanisms behind the emergence of the 2019–20 ‘Chile despertó’ social movement, a major Latin American revolt against the government's price hikes. Using survey data collected among Chilean activists (N = 549) and non-activists (i.e., members of broader society, N = 234), we analyse two major explanatory collective action frameworks: that is, the social identity model of collective action (SIMCA) and the encapsulation model of the social identity of collective action (EMSICA). Multi-group SEM with latent variables revealed that the EMSICA was slightly better suited as compared to SIMCA to explain collective action on behalf of newly formed collective identities. As concerns prosocial disobedience, these attitudes predicted collective action intentions indirectly through social identification among both activists and non-activists. The indirect effects of moral outrage were found to be more pronounced in non-activists, whereas perceived collective efficacy had stronger direct mobilizing effects among activists. The discussion highlights the importance of studying individuals' prosocial disobedience attitudes within social identity models of collective action. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.

Published
2022

32. Arterio-venous fistula causing acute right heart failure: A rare complication of veno-arterial extracorporeal membrane oxygenation

Author

Scanziani, M, Pozzi, M, Rovere, A, Rezoagli, E, Avalli, L, Foti, G, Scanziani M., Pozzi M., Rovere A., Rezoagli E., Avalli L., Foti G., Scanziani, M, Pozzi, M, Rovere, A, Rezoagli, E, Avalli, L, Foti, G, Scanziani M., Pozzi M., Rovere A., Rezoagli E., Avalli L., and Foti G.

Abstract

Introduction: Vascular complications are a major issue in V-A ECMO and can affect long term outcome. Among these, Artero-Venous (AV) fistulas may lead to right heart failure. Case History: A 73-years patient supported with V-A ECMO for post-cardiotomy biventricular failure developed right heart failure after V-A ECMO decannulation, requiring V-A ECMO recannulation. The presence of an AV femoral fistula was incidentally revealed during femoral vein cannulation, from which oxygenated blood was unexpectedly drawn. The angiographic assessment confirmed the presence of a fistula between superficial femoral artery and vein, at the site of the first venous ECMO cannulation. This was caused by the venous cannula that inadvertently passed across the artery and created an AV fistula that was opened by the venous cannula removal. The exclusion of the endovascular fistula allowed the right heart failure resolution. Conclusions: In the presence of right heart failure after recent vascular manipulation, AV fistula should be ruled out.

Published
2022

33. Individualized positive end-expiratory pressure guided by end-expiratory lung volume in early acute respiratory distress syndrome: study protocol for the multicenter, randomized IPERPEEP trial

Author

Grieco, D, Maggiore, S, Bellani, G, Spadaro, S, Spinelli, E, Tonetti, T, Menga, L, Pozzi, M, Battaglini, D, Di Mussi, R, Bruni, A, De Gaetano, A, Iovino, C, Brioni, M, Mojoli, F, Foti, G, Volta, C, Pelosi, P, Navalesi, P, Grasso, S, Ranieri, V, Antonelli, M, Grieco D. L., Maggiore S. M., Bellani G., Spadaro S., Spinelli E., Tonetti T., Menga L. S., Pozzi M., Battaglini D., Di Mussi R., Bruni A., De Gaetano A., Iovino C. G., Brioni M., Mojoli F., Foti G., Volta C. A., Pelosi P., Navalesi P., Grasso S., Ranieri V. M., Antonelli M., Grieco, D, Maggiore, S, Bellani, G, Spadaro, S, Spinelli, E, Tonetti, T, Menga, L, Pozzi, M, Battaglini, D, Di Mussi, R, Bruni, A, De Gaetano, A, Iovino, C, Brioni, M, Mojoli, F, Foti, G, Volta, C, Pelosi, P, Navalesi, P, Grasso, S, Ranieri, V, Antonelli, M, Grieco D. L., Maggiore S. M., Bellani G., Spadaro S., Spinelli E., Tonetti T., Menga L. S., Pozzi M., Battaglini D., Di Mussi R., Bruni A., De Gaetano A., Iovino C. G., Brioni M., Mojoli F., Foti G., Volta C. A., Pelosi P., Navalesi P., Grasso S., Ranieri V. M., and Antonelli M.

Abstract

BACKGROUND: In acute respiratory distress syndrome (ARDS), response to positive end-expiratory pressure (PEEP) is variable according to different degrees of lung recruitability. The search for a tool to individualize PEEP based on patients' individual response is warranted. End-expiratory lung volume (EELV) assessment by nitrogen washing-washout aids bedside estimation of PEEP-induced alveolar recruitment and may therefore help titrate PEEP on patient's individual recruitability. We designed a randomized trial to test whether an individualized PEEP setting protocol driven by EELV measurement may improve a composite clinical outcome in patients with moderate-to-severe ARDS (IPERPEEP trial). METHODS: IPERPEEP is an open-label, multicenter, randomized trial that will be conducted in 10 intensive care units in Italy and will enroll 132 ARDS patients showing PaO2/FiO2 ratio ≤ 150 mmHg within 24 h from endotracheal intubation while on mechanical ventilation with PEEP 5 cmH2O. To standardize lung volumes at study initiation, all patients will undergo mechanical ventilation with tidal volume of 6 ml/kg of predicted body weight and PEEP set to obtain a plateau pressure within 28 and 30 cmH2O for 30 min (EXPRESS PEEP). Afterwards, a 5-step decremental PEEP trial will be conducted (EXPRESS PEEP to PEEP 5 cmH2O), and EELV will be measured at each step. Recruitment-to-inflation ratio will be calculated for each PEEP range from EELV difference. Patients will be then randomized to receive mechanical ventilation with PEEP set according to the optimal recruitment observed in the PEEP trial (IPERPEEP arm) trial or to achieve a plateau pressure of 28-30 cmH2O (control arm, EXPRESS strategy). In both groups, tidal volume size, use of prone positioning and neuromuscular blocking agents, and weaning from PEEP and from mechanical ventilation will be standardized. The primary endpoint of the study is a composite clinical outcome incorporating in-ICU mortality, 60-day ventilator-free days

Published
2022

35. Vignettes: Controlled Mechanical Ventilation

Author

Bellani, G, Pozzi, M, Rezoagli, E, Pozzi M., Bellani G., Rezoagli E., Bellani, G, Pozzi, M, Rezoagli, E, Pozzi M., Bellani G., and Rezoagli E.

Abstract

In the following two chapters (“Controlled modes of mechanical ventilation” and “Assisted modes of mechanical ventilation”) 24 clinical vignettes representing some figurative examples of two main clinical circumstances that physicians may face up in their daily clinical practice in the Intensive Care Unit about the ventilation management are collected.

Published
2022

36. Vignettes: Assisted Mechanical Ventilation

Author

Bellani, G, Pozzi, M, Rezoagli, E, Pozzi M., Bellani G., Rezoagli E., Bellani, G, Pozzi, M, Rezoagli, E, Pozzi M., Bellani G., and Rezoagli E.

Abstract

In this second chapter about clinical vignettes, we represented 14 noninvasive ventilation scenarios about assisted modes of mechanical ventilation, and we highlighted different approaches on lung monitoring and to how detect common ventilator asynchronies.

Published
2022

38. Transcatheter Pulmonary Valve Implantation in Carcinoid Heart Disease

Author

Flagiello, M., Pozzi, M., Francois, L., Al Harthy, A., Forestier, J., Boccalini, S., Rioufol, G., Walter, T., Obadia, J. F., Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Research on Healthcare Performance (RESHAPE - Inserm U1290 - UCBL1), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Edouard Herriot [CHU - HCL], Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and CarMeN, laboratoire

Subjects
[SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio], Transcatheter pulmonary valve implantation, General Medicine, Cardiology and Cardiovascular Medicine, Carcinoid heart desease
Abstract

International audience; Carcinoid heart disease is a rare condition affecting mostly tricuspid and pulmonary valves causing right-sided heart failure. Surgical valve replacement is the mainstay of treatment when patients become symptomatic and/or in the presence of right heart remodeling. We present a case of severe pulmonary valve regurgitation secondary to carcinoid heart disease occurring 4 years after a surgical tricuspid replacement, successfully treated with direct transcatheter pulmonary valve implantation without pre-stenting.

Published
2022

40. Psicologia Sociale

Author

Myers, D. G., Twenge, J. M., Marta, Elena, Pozzi, Maura, Marta, E. (ORCID:0000-0002-2119-5148), Pozzi, M. (ORCID:0000-0003-2849-9344), Myers, D. G., Twenge, J. M., Marta, Elena, Pozzi, Maura, Marta, E. (ORCID:0000-0002-2119-5148), and Pozzi, M. (ORCID:0000-0003-2849-9344)

Abstract

Il manuale di Psicologia sociale di Myers et al. offre un panorama esaustivo della disciplina, illustrando in modo dettagliato le teorie e presentando gli esiti di esperimenti classici e ricerche contemporanee. L’obiettivo degli Autori è stato quello di realizzare un testo solido dal punto di vista scientifico, ma anche caldo dal punto di vista umano, rigoroso nella rendicontazione di ricerche e teorie, ma anche stimolante e provocatorio dal punto di vista intellettuale e culturale. I capitoli, suddivisi secondo la consolidata articolazione della psicologia sociale, offrono molti esempi di applicazione concreta della disciplina e dei suoi risultati di ricerca. In questa quarta edizione italiana, riveduta e aggiornata, sono stati inseriti i risultati di recenti ricerche, riorganizzati contenuti per renderli ancora più fruibili ed è stato aggiunto un nuovo capitolo di grande rilevanza sociale, ovvero la transizione ecologica. Anche in questa edizione, come nella precedente, nella presentazione dei contenuti e degli esempi sono stati tenuti in considerazione i 17 obiettivi di Agenda 2030. Il volume si offre come strumento di avvicinamento alla disciplina per gli studenti e le studentesse dei corsi di laurea in cui è presente un insegnamento di Psicologia sociale e anche per tutti coloro che hanno interesse e desiderio di comprendere i processi interpersonali e sociali che si verificano nella vita quotidiana delle persone nei loro ambienti di vita.

Published
2023

41. Long-term physical impairments in survivors of COVID-19-associated ARDS compared with classic ARDS: A two-center study

Author

Piva, S, Pozzi, M, Bellani, G, Peli, E, Gitti, N, Lucchini, A, Bertoni, M, Goffi, A, Marshall, J, Calza, S, Rasulo, F, Foti, G, Latronico, N, Piva, Simone, Pozzi, Matteo, Bellani, Giacomo, Peli, Elena, Gitti, Nicola, Lucchini, Alberto, Bertoni, Michele, Goffi, Alberto, Marshall, John C, Calza, Stefano, Rasulo, Francesco A, Foti, Giuseppe, Latronico, Nicola, Piva, S, Pozzi, M, Bellani, G, Peli, E, Gitti, N, Lucchini, A, Bertoni, M, Goffi, A, Marshall, J, Calza, S, Rasulo, F, Foti, G, Latronico, N, Piva, Simone, Pozzi, Matteo, Bellani, Giacomo, Peli, Elena, Gitti, Nicola, Lucchini, Alberto, Bertoni, Michele, Goffi, Alberto, Marshall, John C, Calza, Stefano, Rasulo, Francesco A, Foti, Giuseppe, and Latronico, Nicola

Abstract

Purpose: This work aimed to compare physical impairment in survivors of classic ARDS compared with COVID-19-associated ARDS (CARDS) survivors.Material and methods: This is a prospective observational cohort study on 248 patients with CARDS and compared them with a historical cohort of 48 patients with classic ARDS. Physical performance was evaluated at 6 and 12 months after ICU discharge, using the Medical Research Council Scale (MRCss), 6-min walk test (6MWT), handgrip dynamometry (HGD), and fatigue severity score (FSS). We also assessed activities of daily living (ADLs) using the Barthel index.Results: At 6 months, patients with classic ARDS had lower HGD (estimated difference [ED]: 11.71 kg, p < 0.001; ED 31.9% of predicted value, p < 0.001), 6MWT distance (ED: 89.11 m, p < 0.001; ED 12.96% of predicted value, p = 0.032), and more frequent significant fatigue (OR 0.35, p = 0.046). At 12 months, patients with classic ARDS had lower HGD (ED: 9.08 kg, p = 0.0014; ED 25.9% of predicted value, p < 0.001) and no difference in terms of 6MWT and fatigue. At 12 months, patients with classic ARDS improved their MRCss (ED 2.50, p = 0.006) and HGD (ED: 4.13 kg, p = 0.002; ED 9.45% of predicted value, p = 0.005), while those with CARDS did not. Most patients in both groups regained independence in ADLs at 6 months. COVID-19 diagnosis was a significant independent predictor of better HGD (p < 0.0001) and 6MWT performance (p = 0.001), and lower prevalence of fatigue (p = 0.018).Conclusions: Both classic ARDS and CARDS survivors experienced long-term impairments in physical functioning, confirming that post-intensive care syndrome remains a major legacy of critical illness. Surprisingly, however, persisting disability was more common in survivors of classic ARDS than in CARDS survivors. In fact, muscle strength measured with HGD was reduced in survivors of classic ARDS compared to CARDS patients at both 6 and 12 months. The 6MWT was reduced and fatigue was more co

Published
2023

42. La Generazione Z e il Positive Youth Development

Author

Marta, E., Martinez Damia, S., Pozzi, Maura, Ellena, Adriano Mauro, Pozzi M. (ORCID:0000-0003-2849-9344), Ellena A. M. (ORCID:0000-0002-4464-7792), Marta, E., Martinez Damia, S., Pozzi, Maura, Ellena, Adriano Mauro, Pozzi M. (ORCID:0000-0003-2849-9344), and Ellena A. M. (ORCID:0000-0002-4464-7792)

Abstract

Il capitolo analizza le differenze di genere, titolo di studio e provenienza geografica dei giovani appartenenti alla GenZ rispetto alle traiettorie di sviluppo positive descritte dal Positive Youth Development.

Published
2023

43. Cutting-edge technology and automation in the pathology laboratory

Author

Munari, E, Scarpa, A, Cima, L, Pozzi, M, Pagni, F, Vasuri, F, Marletta, S, Dei Tos, A, Eccher, A, Dei Tos, AP, Munari, E, Scarpa, A, Cima, L, Pozzi, M, Pagni, F, Vasuri, F, Marletta, S, Dei Tos, A, Eccher, A, and Dei Tos, AP

Abstract

One of the goals of pathology is to standardize laboratory practices to increase the precision and effectiveness of diagnostic testing, which will ultimately enhance patient care and results. Standardization is crucial in the domains of tissue processing, analysis, and reporting. To enhance diagnostic testing, innovative technologies are also being created and put into use. Furthermore, although problems like algorithm training and data privacy issues still need to be resolved, digital pathology and artificial intelligence are emerging in a structured manner. Overall, for the field of pathology to advance and for patient care to be improved, standard laboratory practices and innovative technologies must be adopted. In this paper, we describe the state-of-the-art of automation in pathology laboratories in order to lead technological progress and evolution. By anticipating laboratory needs and demands, the aim is to inspire innovation tools and processes as positively transformative support for operators, organizations, and patients.

Published
2023

44. Exposure to environmental pollutants and attention-deficit/hyperactivity disorder: an overview of systematic reviews and meta-analyses

Author

Rosi, E, Crippa, A, Pozzi, M, De Francesco, S, Fioravanti, M, Mauri, M, Molteni, M, Morello, L, Tosti, L, Metruccio, F, Clementi, E, Nobile, M, Rosi, Eleonora, Crippa, Alessandro, Pozzi, Marco, De Francesco, Stefano, Fioravanti, Mariachiara, Mauri, Maddalena, Molteni, Massimo, Morello, Luisa, Tosti, Luca, Metruccio, Francesca, Clementi, Emilio, Nobile, Maria, Rosi, E, Crippa, A, Pozzi, M, De Francesco, S, Fioravanti, M, Mauri, M, Molteni, M, Morello, L, Tosti, L, Metruccio, F, Clementi, E, Nobile, M, Rosi, Eleonora, Crippa, Alessandro, Pozzi, Marco, De Francesco, Stefano, Fioravanti, Mariachiara, Mauri, Maddalena, Molteni, Massimo, Morello, Luisa, Tosti, Luca, Metruccio, Francesca, Clementi, Emilio, and Nobile, Maria

Abstract

Although heritability estimates suggest a role for genetic components, environmental risk factors have been described as relevant in the etiology of attention deficit/hyperactivity disorder (ADHD). Several studies have investigated the role of toxicological pollution, i.e., air pollution, heavy metals, POPs, and phthalates. Clear evidence for association of ADHD and environmental factors has not been provided yet. To answer this, we have assessed all available systematic reviews and meta-analyses that focused on the association between pollutant exposure and either ADHD diagnosis or symptoms. More than 1800 studies were screened of which 14 found eligible. We found evidence of a significant role for some pollutants, in particular heavy metals and phthalates, in the increased risk of developing ADHD symptoms. However, at the current stage, data from existing literature also do not allow to weight the role of the different environmental pollutants. We also offer a critical examination of the reviews/meta-analyses and provide indications for future studies in this field. PROSPERO registration: CRD42022341496.

Published
2023

45. Dedizione ad una causa. Leadership e cultura organizzativa delle aziende eccellenti.

Author

V. Coda, Gallo, Rosanna, Pozzi, Maura, Capretti, P., Bondesan, E., De Nigris, Marco, Pistoni, Carlo, Gallo R., Pozzi M. (ORCID:0000-0003-2849-9344), De Nigris M., Pistoni C. (ORCID:0000-0002-6314-121X), V. Coda, Gallo, Rosanna, Pozzi, Maura, Capretti, P., Bondesan, E., De Nigris, Marco, Pistoni, Carlo, Gallo R., Pozzi M. (ORCID:0000-0003-2849-9344), De Nigris M., and Pistoni C. (ORCID:0000-0002-6314-121X)

Abstract

IL capitolo analizza le imprese italiane eccellenti evidenziando le culture organizzative e lo stile di leadership non chè i valori dei fondatori e del manangment

Published
2023

46. Engagement: il circolo virtuoso di una reciproca scelta.

Author

V. Coda, Colli, A., Pozzi, Maura, Federici, M., Pozzi M. (ORCID:0000-0003-2849-9344), V. Coda, Colli, A., Pozzi, Maura, Federici, M., and Pozzi M. (ORCID:0000-0003-2849-9344)

Abstract

Il capitolo evidenzia il rapporto che dovrebbe instaurarsi tra imprenditore e manager per assicurare che l'impresa funzioni. La ricerca evidenzia come nelle imprese eccellenti il manager sia considerato uno di famiglia ma allo stesso tempo sia una persona alla quale si lascia lo spazio di vita, familiare e professionale. inoltre il manager è libero di sperimentare le proprie competenze senza la paura di sbagliare ed essere licenziato.

Published
2023

47. Embeddedness. Il rapporto con gli stakeholder e il territorio nelle imprese eccellenti.

Author

V. Coda, Zattoni, A., Pozzi, Maura, Perugini, M., Pozzi M. (ORCID:0000-0003-2849-9344), V. Coda, Zattoni, A., Pozzi, Maura, Perugini, M., and Pozzi M. (ORCID:0000-0003-2849-9344)

Abstract

Il capitolo evidenzia una ricerca su un campione di imprese eccellenti per definire le chiavi del successo nel rapporto con il proprio territorio.

Published
2023

48. A multidisciplinary approach to screen the post-COVID-19 conditions

Author

Squillace, N, Cogliandro, V, Rossi, E, Bellelli, G, Pozzi, M, Luppi, F, Lettino, M, Strepparava, M, Ferrarese, C, Pollastri, E, Ricci, E, Bonfanti, P, Squillace, Nicola, Cogliandro, Viola, Rossi, Emanuela, Bellelli, Giuseppe, Pozzi, Matteo, Luppi, Fabrizio, Lettino, Maddalena, Strepparava, Maria Grazia, Ferrarese, Carlo, Pollastri, Ester, Ricci, Elena, Bonfanti, Paolo, Squillace, N, Cogliandro, V, Rossi, E, Bellelli, G, Pozzi, M, Luppi, F, Lettino, M, Strepparava, M, Ferrarese, C, Pollastri, E, Ricci, E, Bonfanti, P, Squillace, Nicola, Cogliandro, Viola, Rossi, Emanuela, Bellelli, Giuseppe, Pozzi, Matteo, Luppi, Fabrizio, Lettino, Maddalena, Strepparava, Maria Grazia, Ferrarese, Carlo, Pollastri, Ester, Ricci, Elena, and Bonfanti, Paolo

Abstract

BACKGROUND: Post-COronaVIrus Disease 2019 (COVID-19) conditions (PCC) include multiple symptoms afflicting different organs and systems. To evaluate the frequency and type of them, we described our multidisciplinary approach with preliminary results of the first enrolled patients. METHODS: We included patients aged ≥ 18 years with hospital admission for confirmed SARS-CoV-2 infection. Symptoms were grouped in five macro groups hereafter referred to as "Symptoms Category" (SC): respiratory SC (dyspnoea or cough), neurological SC (peripheral neuropathies, headache, impaired mobility, behavioural disorders), psychological SC (sleep disorders, mood disorders), muscular SC (arthromyalgia, asthenia), other SC (fever, alopecia, diarrhoea, weight loss, smell and taste alterations, sexual dysfunctions). SC were evaluated at discharge and at follow-up. Association between patients' characteristics and presence of SC at follow up was estimated by a logistic multivariable regression model. RESULTS: From June 2020 to July 2021, we followed up 361 patients: 128 (35.5%) who were previously admitted to Intensive Care Unit (ICU) and 233 patients to ordinary department. The median length of hospital stay was 20 days (Inter-Quartile-Range 13-32). Most patients (317/361, 87.8%) were still symptomatic at discharge, with one third referring three or more SC. At follow up, 67.3% (243/361) of patients still complained at least one SC. Moreover, 159 patients (44%) developed at least one new involved SC during follow up: 116 (72.9%) one SC, 39 (24.5%) two SC, 4 (2.5%) three or more SC. At follow up visit 130 of 361 (36%) were still with SC developed during follow up. At multivariable analysis presence of any SC at follow-up was associated with male gender (Odds Ratio [OR] 3.23, Confidence Interval [CI] 95% 1.46-7.15), ICU admission (OR 2.78, CI 95% 1.29-5.96) and presence of SC at discharge (OR 14.39, CI 95% 6.41-32.32). CONCLUSIONS: In our sample of patients with severe COVID-19, we found t

Published
2023

49. Azione collettiva e movimenti dal basso

Author

T. Mannarini, Pozzi, Maura, Pistoni, Carlo, Pozzi M. (ORCID:0000-0003-2849-9344), Pistoni C (ORCID:0000-0002-6314-121X), T. Mannarini, Pozzi, Maura, Pistoni, Carlo, Pozzi M. (ORCID:0000-0003-2849-9344), and Pistoni C (ORCID:0000-0002-6314-121X)

Abstract

Il capitolo descriv ei principali approcci teorici allo studio dell'azione collettiva e dei movimenti dal basso in chiave di psicologia di comunità.

Published
2023

50. ESICM LIVES 2016: part three: Milan, Italy. 1–5 October 2016

Author

Velasquez, T., Mackey, G., Lusk, J., Kyle, U. G., Fontenot, T., Marshall, P., Shekerdemian, L. S., Coss-Bu, J. A., Nishigaki, A., Yatabe, T., Tamura, T., Yamashita, K., Yokoyama, M., Ruiz-Rodriguez, J. C., Encina, B., Belmonte, R., Troncoso, I., Tormos, P., Riveiro, M., Baena, J., Sanchez, A., Bañeras, J., Cordón, J., Duran, N., Ruiz, A., Caballero, J., Nuvials, X., Riera, J., Serra, J., Rutten, A. M. F., van Ieperen, S. N. M., Der Kinderen, E. P. H. M., Van Logten, T., Kovacikova, L., Skrak, P., Zahorec, M., Kyle, U. G., Akcan-Arikan, A., Silva, J. C., Mackey, G., Lusk, J., Goldsworthy, M., Shekerdemian, L. S., Coss-Bu, J. A., Wood, D., Harrison, D., Parslow, R., Davis, P., Pappachan, J., Goodwin, S., Ramnarayan, P., Chernyshuk, S., Yemets, H., Zhovnir, V., Pulitano’, S. M., De Rosa, S., Mancino, A., Villa, G., Tosi, F., Franchi, P., Conti, G., Patel, B., Khine, H., Shah, A., Sung, D., Singer, L., Haghbin, S., Inaloo, S., Serati, Z., Idei, M., Nomura, T., Yamamoto, N., Sakai, Y., Yoshida, T., Matsuda, Y., Yamaguchi, Y., Takaki, S., Yamaguchi, O., Goto, T., Longani, N., Medar, S., Abdel-Aal, I. R., El Adawy, A. S., Mohammed, H. M. E. H., Mohamed, A. N., Parry, S. M., Knight, L. D., Denehy, L., De Morton, N., Baldwin, C. E., Sani, D., Kayambu, G., da Silva, V. Z. M., Phongpagdi, P., Puthucheary, Z. A., Granger, C. L., Rydingsward, J. E., Horkan, C. M., Christopher, K. B., McWilliams, D., Jones, C., Reeves, E., Atkins, G., Snelson, C., Aitken, L. M., Rattray, J., Kenardy, J., Hull, A. M., Ullman, A., Le Brocque, R., Mitchell, M., Davis, C., Macfarlane, B., Azevedo, J. C., Rocha, L. L., De Freitas, F. F. M., Cavalheiro, A. M., Lucinio, N. M., Lobato, M. S., Ebeling, G., Kraegpoeth, A., Laerkner, E., De Brito-Ashurst, I., White, C., Gregory, S., Forni, L. G., Flowers, E., Curtis, A., Wood, C. A., Siu, K., Venkatesan, K., Muhammad, J. B. H., Ng, L., Seet, E., Baptista, N., Escoval, A., Tomas, E., Agrawal, R., Mathew, R., Varma, A., Dima, E., Charitidou, E., Perivolioti, E., Pratikaki, M., Vrettou, C., Giannopoulos, A., Zakynthinos, S., Routsi, C., Atchade, E., Houzé, S., Jean-Baptiste, S., Thabut, G., Genève, C., Tanaka, S., Lortat-Jacob, B., Augustin, P., Desmard, M., Montravers, P., de Molina, F. J. González, Barbadillo, S., Alejandro, R., Álvarez-Lerma, F., Vallés, J., Catalán, R. M., Palencia, E., Jareño, A., Granada, R. M., Ignacio, M. L., Cui, N., Liu, D., Wang, H., Su, L., Qiu, H., Li, R., Jaffal, K., Rouzé, A., Poissy, J., Sendid, B., Nseir, S., Paramythiotou, E., Rizos, M., Frantzeskaki, F., Antoniadou, A., Vourli, S., Zerva, L., Armaganidis, A., Riera, J., Gottlieb, J., Greer, M., Wiesner, O., Martínez, M., Acuña, M., Rello, J., Welte, T., Atchade, E., Mignot, T., Houzé, S., Jean-Baptiste, S., Thabut, G., Lortat-Jacob, B., Tanaka, S., Augustin, P., Desmard, M., Montravers, P., Soussi, S., Dudoignon, E., Ferry, A., Chaussard, M., Benyamina, M., Alanio, A., Touratier, S., Chaouat, M., Lafaurie, M., Mimoun, M., Mebazaa, A., Legrand, M., Sheils, M. A., Patel, C., Mohankumar, L., Akhtar, N., Noriega, S. K. Pacheco, Aldana, N. Navarrete, León, J. L. Ávila, Baquero, J. Durand, Bernal, F. Fernández, Ahmadnia, E., Hadley, J. S., Millar, M., Hall, D., Hewitt, H., Yasuda, H., Sanui, M., Komuro, T., Kawano, S., Andoh, K., Yamamoto, H., Noda, E., Hatakeyama, J., Saitou, N., Okamoto, H., Kobayashi, A., Takei, T., Matsukubo, S., Rotzel, H. B., Lázaro, A. Serrano, Prada, D. Aguillón, Gimillo, M. Rodriguez, Barinas, O. Diaz, Cortes, M. L. Blasco, Franco, J. Ferreres, Roca, J. M. Segura, Carratalá, A., Gonçalves, B., Turon, R., Mendes, A., Miranda, F., Mata, P. J., Cavalcanti, D., Melo, N., Lacerda, P., Kurtz, P., Righy, C., Rosario, L. E. de la Cruz, Lesmes, S. P. Gómez, Romero, J. C. García, Herrera, A. N. García, Pertuz, E. D. Díaz, Sánchez, M. J. Gómez, Sanz, E. Regidor, Hualde, J. Barado, Hernández, A. Ansotegui, Irazabal, J. M. Guergué, Spatenkova, V., Bradac, O., Suchomel, P., Urli, T., Lazzeri, E. Heusch, Aspide, R., Zanello, M., Perez-Borrero, L., Garcia-Alvarez, J. M., Arias-Verdu, M. D., Aguilar-Alonso, E., Rivera-Fernandez, R., Mora-Ordoñez, J., De La Fuente-Martos, C., Castillo-Lorente, E., Guerrero-Lopez, F., Lesmes, S. P. Gómez, Rosario, L. E. De la Cruz, Pertuz, E. D. Díaz, Hernández, A. Ansotegui, Romero, J. C. García, Sánchez, M. J. Gómez, Herrera, A. N. García, Ramírez, J. Roldán, Sanz, E. Regidor, Hualde, J. Barado, León, J. P. Tirapu, Navarro-Guillamón, L., Cordovilla-Guardia, S., Iglesias-Santiago, A., Guerrero-López, F., Fernández-Mondéjar, E., Vidal, A., Perez, M., Juez, A., Arias, N., Colino, L., Perez, J. L., Pérez, H., Calpe, P., Alcala, M. A., Robaglia, D., Perez, C., Lan, S. K., Cunha, M. M., Moreira, T., Santos, F., Lafuente, E., Fernandes, M. J., Silva, J. G., Rosario, L. E. de la Cruz, Lesmes, S. P. Gómez, Herrera, A. N. García, Romero, J. C. García, Pertuz, E. D. Díaz, Sánchez, M. J. Gómez, Sanz, E. Regidor, Echeverría, J. G. Armando, Hernández, A. Ansotegui, Hualde, J. Barado, Podlepich, V., Sokolova, E., Alexandrova, E., Lapteva, K., Kurtz, P., Shuinotsuka, C., Rabello, L., Vianna, G., Reis, A., Cairus, C., Salluh, J., Bozza, F., Torres, J. C. Barrios, Araujo, N. J. Fernández, García-Olivares, P., Keough, E., Dalorzo, M., Tang, L. K., De Sousa, I., Díaz, M., Marcos-Zambrano, L. J., Guerrero, J. E., Gomez, S. E. Zamora, Lopez, G. D. Hernandez, Cuellar, A. I. Vazquez, Nieto, O. R. Perez, Gonzalez, J. A. Castanon, Bhasin, D., Rai, S., Singh, H., Gupta, O., Bhattal, M. K., Sampley, S., Sekhri, K., Nandha, R., Aliaga, F. A., Olivares, F., Appiani, F., Farias, P., Alberto, F., Hernández, A., Pons, S., Sonneville, R., Bouadma, L., Neuville, M., Mariotte, E., Radjou, A., Lebut, J., Chemam, S., Voiriot, G., Dilly, M. P., Mourvillier, B., Dorent, R., Nataf, P., Wolff, M., Timsit, J. F., Ediboglu, O., Ataman, S., Ozkarakas, H., Kirakli, C., Vakalos, A., Avramidis, V., Obukhova, O., Kurmukov, I. A., Kashiya, S., Golovnya, E., Baikova, V. N., Ageeva, T., Haritydi, T., Kulaga, E. V., Rios-Toro, J. J., Perez-Borrero, L., Aguilar-Alonso, E., Arias-Verdu, M. D., Garcia-Alvarez, J. M., Lopez-Caler, C., De La Fuente-Martos, C., Rodriguez-Fernandez, S., Sanchez-Orézzoli, M. Gomez, Martin-Gallardo, F., Nikhilesh, J., Joshi, V., Villarreal, E., Ruiz, J., Gordon, M., Quinza, A., Gimenez, J., Piñol, M., Castellanos, A., Ramirez, P., Jeon, Y. D., Jeong, W. Y., Kim, M. H., Jeong, I. Y., Ahn, M. Y., Ahn, J. Y., Han, S. H., Choi, J. Y., Song, Y. G., Kim, J. M., Ku, N. S., Shah, H., Kellner, F., Rezai, F., Mistry, N., Yodice, P., Ovnanian, V., Fless, K., Handler, E., Alejos, R. Martínez, Romeu, J. D. Martí, Antón, D. González, Quinart, A., Martí, A. Torres, Llaurado-Serra, M., Lobo-Civico, A., Ventura-Rosado, A., Piñol-Tena, A., Pi-Guerrero, M., Paños-Espinosa, C., Peralvo-Bernat, M., Marine-Vidal, J., Gonzalez-Engroba, R., Montesinos-Cerro, N., Treso-Geira, M., Valeiras-Valero, A., Martinez-Reyes, L., Sandiumenge, A., Jimenez-Herrera, M. F., Helyar, S., Riozzi, P., Noon, A., Hallows, G., Cotton, H., Keep, J., Hopkins, P. A., Taggu, A., Renuka, S., Sampath, S., Rood, P. J. T., Frenzel, T., Verhage, R., Bonn, M., Pickkers, P., van der Hoeven, J. G., van den Boogaard, M., Corradi, F., Melnyk, L., Moggia, F., Pienovi, R., Adriano, G., Brusasco, C., Mariotti, L., Lattuada, M., Bloomer, M. J., Coombs, M., Ranse, K., Endacott, R., Maertens, B., Blot, K., Blot, S., Amerongen, M. P. van Nieuw, van der Heiden, E. S., Twisk, J. W. R., Girbes, A. R. J., Spijkstra, J. J., Riozzi, P., Helyar, S., Cotton, H., Hallows, G., Noon, A., Bell, C., Peters, K., Feehan, A., Keep, J., Hopkins, P. A., Churchill, K., Hawkins, K., Brook, R., Paver, N., Endacott, R., Maistry, N., van Wijk, A., Rouw, N., van Galen, T., Evelein-Brugman, S., Taggu, A., Krishna, B., Sampath, S., Putzu, A., Fang, M., Berto, M. Boscolo, Belletti, A., Cassina, T., Cabrini, L., Mistry, M., Alhamdi, Y., Welters, I., Abrams, S. T., Toh, C. H., Han, H. S., Gil, E. M., Lee, D. S., Park, C. M., Winder-Rhodes, S., Lotay, R., Doyle, J., Ke, M. W., Huang, W. C., Chiang, C. H., Hung, W. T., Cheng, C. C., Lin, K. C., Lin, S. C., Chiou, K. R., Wann, S. R., Shu, C. W., Kang, P. L., Mar, G. Y., Liu, C. P., Dubó, S., Aquevedo, A., Jibaja, M., Berrutti, D., Labra, C., Lagos, R., García, M. F., Ramirez, V., Tobar, M., Picoita, F., Peláez, C., Carpio, D., Alegría, L., Hidalgo, C., Godoy, K., Bakker, J., Hernández, G., Sadamoto, Y., Katabami, K., Wada, T., Ono, Y., Maekawa, K., Hayakawa, M., Sawamura, A., Gando, S., Marin-Mateos, H., Perez-Vela, J. L., Garcia-Gigorro, R., Peiretti, M. A. Corres, Lopez-Gude, M. J., Chacon-Alves, S., Renes-Carreño, E., Montejo-González, J. C., Parlevliet, K. L., Touw, H. R. W., Beerepoot, M., Boer, C., Elbers, P. W. G., Tuinman, P. R., Abdelmonem, S. A., Helmy, T. A., El Sayed, I., Ghazal, S., Akhlagh, S. H., Masjedi, M., Hozhabri, K., Kamali, E., Zýková, I., Paldusová, B., Sedlák, P., Morman, D., Youn, A. M., Ohta, Y., Sakuma, M., Bates, D., Morimoto, T., Su, P. L., Chang, W. Y., Lin, W. C., Chen, C. W., Facchin, F., Zarantonello, F., Panciera, G., De Cassai, A., Venrdramin, A., Ballin, A., Tonetti, T., Persona, P., Ori, C., Del Sorbo, L., Rossi, S., Vergani, G., Cressoni, M., Chiumello, D., Chiurazzi, C., Brioni, M., Algieri, I., Tonetti, T., Guanziroli, M., Colombo, A., Tomic, I., Colombo, A., Crimella, F., Carlesso, E., Gasparovic, V., Gattinoni, L., Neto, A. Serpa, Schmidt, M., Pham, T., Combes, A., de Abreu, M. Gama, Pelosi, P., Schultz, M. J., Katira, B. H., Engelberts, D., Giesinger, R. 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2016
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