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74 results on '"Scandroglio, A M"'

1. A multicenter evaluation of external outflow graft obstruction with a fully magnetically levitated left ventricular assist device

Author

Wert, Leonhard, Stewart, Garrick C., Mehra, Mandeep R., Milwidsky, Assi, Jorde, Ulrich P., Goldstein, Daniel J., Selzman, Craig H., Stehlik, Josef, Alshamdin, Faisal D., Khaliel, Feras H., Gustafsson, Finn, Boschi, Silvia, Loforte, Antonio, Ajello, Silvia, Scandroglio, Anna M., Tučanová, Zuzana, Netuka, Ivan, Schlöglhofer, Thomas, Zimpfer, Daniel, Zijderhand, Casper F., Caliskan, Kadir, Dogan, Günes, Schmitto, Jan D., Maier, Sven, Schibilsky, David, Jawad, Khalil, Saeed, Diyar, Faerber, Gloria, Morshuis, Michiel, Hanuna, Maja, Müller, Christoph S., Mulzer, Johanna, Kempfert, Jörg, Falk, Volkmar, and Potapov, Evgenij V.

Published
2024
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2. Management of Bleeding and Hemolysis During Percutaneous Microaxial Flow Pump Support: A Practical Approach

Author

Van Edom, Charlotte J., Gramegna, Mario, Baldetti, Luca, Beneduce, Alessandro, Castelein, Thomas, Dauwe, Dieter, Frederiks, Pascal, Giustino, Gennaro, Jacquemin, Marc, Janssens, Stefan P., Panoulas, Vasileios F., Pöss, Janine, Rosenberg, Alexander, Schaubroeck, Hannah A.I., Schrage, Benedikt, Tavazzi, Guido, Vanassche, Thomas, Vercaemst, Leen, Vlasselaers, Dirk, Vranckx, Pascal, Belohlavek, Jan, Gorog, Diana A., Huber, Kurt, Mebazaa, Alexandre, Meyns, Bart, Pappalardo, Federico, Scandroglio, Anna M., Stone, Gregg W., Westermann, Dirk, Chieffo, Alaide, Price, Susanna, and Vandenbriele, Christophe

Published
2023
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3. Influence of implant strategy on the transition from temporary left ventricular assist device to durable mechanical circulatory support.

Author

Meyer, A L, Lewin, D, Billion, M, Hofmann, S, Netuka, I, Belohlavek, J, Jawad, K, Saeed, D, Schmack, B, Rojas, S V, Gummert, J, Bernhardt, A, Färber, G, Kooij, J, Meyns, B, Loforte, A, Pieri, M, Scandroglio, A M, Akhyari, P, and Szymanski, M K

Subjects
EXTRACORPOREAL membrane oxygenation, TERMINALLY ill, RENAL replacement therapy, HEART assist devices, CARDIOGENIC shock, CARDIOPULMONARY bypass
Abstract

OBJECTIVES Bridging from a temporary microaxial left ventricular assist device (tLVAD) to a durable left ventricular assist device (dLVAD) is playing an increasing role in the treatment of terminally ill patients with heart failure. Scant data exist about the best implant strategy. The goal of this study was to analyse differences in the dLVAD implant technique and effects on patient outcomes. METHODS Data from 341 patients (19 European centres) who underwent a bridge-to-bridge implant from tLVAD to dLVAD between January 2017 and October 2022 were retrospectively analysed. The outcomes of the different implant techniques with the patient on cardiopulmonary bypass, extracorporeal life support or tLVAD were compared. RESULTS A durable LVAD implant was performed employing cardiopulmonary bypass in 70% of cases (n  = 238, group 1), extracorporeal life support in 11% (n  = 38, group 2) and tLVAD in 19% (n  = 65, group 3). Baseline characteristics showed no significant differences in age (P  = 0.140), body mass index (P  = 0.388), creatinine level (P  = 0.659), the Model for End-Stage Liver Disease (MELD) score (P  = 0.190) and rate of dialysis (P  = 0.110). Group 3 had significantly fewer patients with preoperatively invasive ventilation and cardiopulmonary resuscitation before the tLVAD was implanted (P  = 0.009 and P  < 0.001 respectively). Concomitant procedures were performed more often in groups 1 and 2 compared to group 3 (24%, 37% and 5%, respectively, P  < 0.001). The 30-day mortality data showed significantly better survival after an inverse probability of treatment weighting in group 3, but the 1-year mortality showed no significant differences among the groups (P  = 0.012 and 0.581, respectively). Postoperative complications like the rate of right ventricular assist device (RVAD) implants or re-thoracotomy due to bleeding, postoperative respiratory failure and renal replacement therapy showed no significant differences among the groups. Freedom from the first adverse event like stroke, driveline infection or pump thrombosis during follow-up was not significantly different among the groups. Postoperative blood transfusions within 24 h were significantly higher in groups 1 and 2 compared to surgery on tLVAD support (P  < 0.001 and P  = 0.003, respectively). CONCLUSIONS In our analysis, the transition from tLVAD to dLVAD without further circulatory support did not show a difference in postoperative long-term survival, but a better 30-day survival was reported. The implant using only tLVAD showed a reduction in postoperative transfusion rates, without increasing the risk of postoperative stroke or pump thrombosis. In this small cohort study, our data support the hypothesis that a dLVAD implant on a tLVAD is a safe and feasible technique in selected patients. [ABSTRACT FROM AUTHOR]

Published
2024
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4. Transition from temporary microaxial left ventricular assist devices to durable mechanical circulatory support systems

Author

Lewin, D, primary, Szymanski, M K, additional, Meyer, A L, additional, Saeed, D, additional, Scandroglio, A M, additional, Akhyari, P, additional, Meyns, B, additional, Loforte, A, additional, Oezkur, M, additional, Zimpfer, D, additional, Gustafsson, F, additional, Billion, M, additional, Belohlavek, J, additional, Bernhardt, A M, additional, and Potapov, E, additional

Published
2023
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5. Pump Thrombosis

Author

Potapov, E., Kaufmann, F., Scandroglio, A. M., Pieri, M., Montalto, Andrea, editor, Loforte, Antonio, editor, Musumeci, Francesco, editor, Krabatsch, Thomas, editor, Slaughter, Mark S., editor, and Amarelli, Cristiano, With contrib. by

Published
2017
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6. Effect of Levosimendan on Renal Outcome in Cardiac Surgery Patients With Chronic Kidney Disease and Perioperative Cardiovascular Dysfunction: A Substudy of a Multicenter Randomized Trial

Author

Zangrillo, Alberto, Alvaro, Gabriele, Belletti, Alessandro, Pisano, Antonio, Brazzi, Luca, Calabrò, Maria G., Guarracino, Fabio, Bove, Tiziana, Grigoryev, Evgeny V., Monaco, Fabrizio, Boboshko, Vladimir A., Likhvantsev, Valery V., Scandroglio, Anna M., Paternoster, Gianluca, Lembo, Rosalba, Frassoni, Samuele, Comis, Marco, Pasyuga, Vadim V., Navalesi, Paolo, and Lomivorotov, Vladimir V.

Published
2018
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8. 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

9. Extracorporeal Blood Purification with CytoSorb in 359 Critically Ill Patients.

Author

Pieri, Marina, Bonizzoni, Matteo A., Belletti, Alessandro, Calabrò, Maria G., Fominskiy, Evgeny, Nardelli, Pasquale, Ortalda, Alessandro, and Scandroglio, Anna M.

Subjects
INTRA-aortic balloon counterpulsation, CRITICALLY ill, CARDIOGENIC shock, HOSPITAL mortality, INTENSIVE care units, LACTATE dehydrogenase
Abstract

Introduction: Critically ill patients with inflammatory dysregulation and organ disfunction may benefit from blood purification, although the use of this technique has not been described in large case series. We evaluated clinical outcomes and survival in high-risk intensive care unit (ICU) patients who underwent extracorporeal blood purification. Methods: 359 consecutive ICU patients treated with CytoSorb were included. Results: Main admission diagnoses were 120 (34%) refractory cardiac arrest under mechanical chest compression; 101 (28%) profound cardiogenic shock; 81 (23%) post-cardiotomy cardiogenic shock; and 37 (10%) respiratory failure. Fifteen patients (4%) were positive for SARS-CoV-2 infection. We observed 49% 30-day mortality, 57% ICU mortality, and 62% hospital mortality, all lower than the 71% mortality predicted by SAPS II and 68% predicted by SOFA score. Parameters of shock and organ failure, above all vasoactive inotropic score, reduced during CytoSorb treatment. Multivariable analysis identified SAPS II, lactate dehydrogenase, ICU stay duration, vasoactive inotropic score, lactates, intra-aortic counterpulsation on top of VA-ECMO, and total bilirubin as predictors of mortality. No CytoSorb-related complications occurred. Conclusion: CytoSorb treatment was effective in reducing laboratory parameters of shock and vasoactive inotropic score with possible survival implications in a large population of critically ill patients. [ABSTRACT FROM AUTHOR]

Published
2023
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11. A multicenter evaluation of external outflow graft obstruction with a fully magnetically levitated left ventricular assist device

Author

Wert, Leonhard, primary, Stewart, Garrick C., additional, Mehra, Mandeep R., additional, Milwidsky, Assi, additional, Jorde, Ulrich P., additional, Goldstein, Daniel J., additional, Selzman, Craig H., additional, Stehlik, Josef, additional, Alshamdin, Faisal D., additional, Khaliel, Feras H., additional, Gustafsson, Finn, additional, Boschi, Silvia, additional, Loforte, Antonio, additional, Ajello, Silvia, additional, Scandroglio, Anna M., additional, Tučanová, Zuzana, additional, Netuka, Ivan, additional, Schlöglhofer, Thomas, additional, Zimpfer, Daniel, additional, Zijderhand, Casper F., additional, Caliskan, Kadir, additional, Dogan, Günes, additional, Schmitto, Jan D., additional, Maier, Sven, additional, Schibilsky, David, additional, Jawad, Khalil, additional, Saeed, Diyar, additional, Faerber, Gloria, additional, Morshuis, Michiel, additional, Hanuna, Maja, additional, Müller, Christoph S., additional, Mulzer, Johanna, additional, Kempfert, Jörg, additional, Falk, Volkmar, additional, and Potapov, Evgenij V., additional

Published
2022
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12. Transcatheter aortic valve implantation for aortic regurgitation in patients with left ventricular assist device

Author

Ancona M. B., Moroni F., Romano V., Agricola E., Esposito A., Ajello S., De Bonis M., Cappelletti A. M., Zangrillo A., Scandroglio A. M., Montorfano M, Ancona, M. B., Moroni, F., Romano, V., Agricola, E., Esposito, A., Ajello, S., De Bonis, M., Cappelletti, A. M., Zangrillo, A., Scandroglio, A. M., and Montorfano, M

Abstract

Aortic valve regurgitation is a not negligible complication of prolonged support with continuous-flow left ventricular assist device (LVAD) and is associated with recurrence of heart failure and reduced survival. Transcatheter aortic valve implantation has been described as a feasible option in this setting, usually with self-expanding prosthesis. Giving the absence of valvular calcification, a proper prosthesis oversizing should be guaranteed in order to achieve sufficient sealing and avoid prosthesis migration or paravalvular leak. Current self-expanding prosthesis may be too small to fit aortic annulus anatomies without calcification and with the need of significant oversize. We report the first case of 32 mm balloon expandable Myval prosthesis implantation in a patient with LVAD-related aortic regurgitation. Large balloon-expandable prosthesis can be considered when a significant oversize is needed.

Published
2021

13. In-Hospital and 6-Month Outcomes of COVID-19 Patients Supported with Extracorporeal Membrane Oxygenation: The EuroECMO-COVID Multicenter Prospective Observational Study

Author

Lorusso, Roberto, primary, De Piero, Maria Elena, additional, Mariani, Silvia, additional, Di Mauro, Michele, additional, Lo Coco, Valeria, additional, Folliguet, Thierry, additional, Taccone, Fabio Silvio, additional, Camporota, Luigi, additional, van der Horst, Iwan C.C., additional, van Bussel, Bas, additional, Schnabel, Ronny M., additional, Delnoij, Thijs, additional, Swol, Justyna, additional, Wiedemann, Dominik, additional, Belliato, Mirko, additional, Broman, Lars Mikael, additional, Vuylsteke, Alain, additional, Bolotin, Gil, additional, Kassif, Yigal, additional, Scandroglio, Anna M., additional, Fanelli, Vito, additional, Gaudard, Philippe, additional, Lorini, Luca, additional, ledot, Stephane, additional, Barker, Julian, additional, Schmiady, Martin O., additional, Boeken, Udo, additional, Schibilsky, David, additional, Maier, Sven, additional, Kersten, Alexander, additional, Meyns, Bart, additional, Pozzi, Matteo, additional, Kowalewski, Mariusz, additional, Pedersen, Finn M., additional, Schellongowski, Peter, additional, Pinto, Luis F., additional, Silva, Pedro Eduardo, additional, Kornilov, Igor, additional, Kirali, Mehmet K., additional, Blandino, Aarón, additional, Vercaemst, Leen, additional, Finney, Simon, additional, Roeleveld, Peter P., additional, Di Nardo, Matteo, additional, Hennig, Felix, additional, Antonini, Velia M., additional, Davidson, Mark, additional, Jones, Tim, additional, Barrett, Nicholas, additional, Riera, Jordi, additional, Mueller, Thomas, additional, and Bělohlávek, Jan, additional

Published
2022
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16. Effect of Fenoldopam on Use of Renal Replacement Therapy Among Patients With Acute Kidney Injury After Cardiac Surgery: A Randomized Clinical Trial

Author

Bove, Tiziana, Zangrillo, Alberto, Guarracino, Fabio, Alvaro, Gabriele, Persi, Bruno, Maglioni, Enivarco, Galdieri, Nicola, Comis, Marco, Caramelli, Fabio, Pasero, Daniela C., Pala, Giovanni, Renzini, Massimo, Conte, Massimiliano, Paternoster, Gianluca, Martinez, Blanca, Pinelli, Fulvio, Frontini, Mario, Zucchetti, Maria C., Pappalardo, Federico, Amantea, Bruno, Camata, Annamaria, Pisano, Antonio, Verdecchia, Claudio, Dal Checco, Erika, Cariello, Claudia, Faita, Luana, Baldassarri, Rubia, Scandroglio, Anna M., Saleh, Omar, Lembo, Rosalba, Calabrò, Maria G., Bellomo, Rinaldo, and Landoni, Giovanni

Published
2014
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17. ECMO for COVID-19 patients in Europe and Israel

Author

Lorusso, R, Combes, A, Coco, V, De Piero, M, Belohlavek, J, Delnoij, T, van der Horst, I, Miranda, D, van der Linden, M, van der Heijden, J, Scholten, E, van Belle-van Haren, N, Lagrand, W, de Jong, S, Candura, D, Maas, J, van den Berg, M, Malfertheiner, M, Dreier, E, Mueller, T, Boeken, U, Akhyari, P, Lichtenberg, A, Saeed, D, Thiele, H, Baumgaertel, M, Schmitto, J, Mariani, S, Thielmann, M, Brenner, T, Benk, C, Czerny, M, Kalbhenn, J, Maier, S, Schibilsky, D, Staudacher, D, Henn, P, Iuliu, T, Muellenbach, R, Reyher, C, Rolfes, C, Zacharowski, K, Lotz, G, Sonntagbauer, M, Kersten, A, Karagiannidis, C, Schafer, S, Fichte, J, Hopf, H, Samalavicius, R, Lorini, L, Ghitti, D, Grazioli, L, Loforte, A, Baiocchi, M, Checco, E, Pacini, D, Meani, P, Cappai, A, Russo, C, Bottiroli, M, Mondino, M, Ranucci, M, Fina, D, Ballotta, A, Scandroglio, A, Zangrillo, A, Pieri, M, Nardelli, P, Fominskiy, E, Landoni, G, Fanelli, V, Brazzi, L, Montrucchio, G, Sales, G, Simonetti, U, Urbino, R, Livigni, S, Degani, A, Raffa, G, Pilato, M, Martucci, G, Arcadipane, A, Chiarini, G, Latronico, N, Cattaneo, S, Puglia, C, Reina, G, Sponga, S, Livi, U, Foti, G, Giani, M, Rona, R, Avalli, L, Bombino, M, Costa, M, Carozza, R, Donati, A, Piciche, M, Favaro, A, Salvador, L, Danzi, V, Zanin, A, Condello, I, Fiore, F, Moscarelli, M, Nasso, G, Speziale, G, Sandrelli, L, Montalto, A, Musumeci, F, Circelli, A, Gamberini, E, Russo, E, Benni, M, Agnoletti, V, Rociola, R, Milano, A, Grasso, S, Civita, A, Murgolo, F, Pilato, E, Comentale, G, Montisci, A, Alessandri, F, Tosi, A, Pugliese, F, Carelli, S, Grieco, D, Antonelli, M, Ramoni, E, Di Nardo, M, Maisano, F, Bettex, D, Weber, A, Grunenfelder, J, Consiglio, J, Hansjoerg, J, Haenggi, M, Agus, G, Doeble, T, Zenklusen, U, Bechtold, X, Stockman, B, De Backer, D, Giglioli, S, Meyns, B, Vercaemst, L, Herman, G, Meersseman, P, Vandenbriele, C, Dauwe, D, Vlasselaers, D, Raes, M, Debeuckelaere, G, Rodrigus, I, Biston, P, Piagnerelli, M, Peperstraete, H, Germay, O, Vandewiele, K, Vandeweghe, D, Witters, I, Havrin, S, Bourgeois, M, Taccone, F, Nobile, L, Lheureux, O, Brasseur, A, Creteur, J, Defraigne, J, Misset, B, Courcelle, R, Timmermans, P, Lehaen, J, Frederik, B, Riera, J, Castro, M, Gallart, E, Martinez-Martinez, M, Argudo, E, Garcia-de-Acilu, M, de Pablo Sanchez, R, Ortiz, A, Cabanes, M, Higa, K, Cassina, A, Berbel, D, Sanchez-Salado, J, Arnau, B, de Gopegui, P, Ricart, P, Sandoval, E, Veganzones, J, Millan, P, de la Sota, P, Santa Teresa, P, Alcantara, S, Alvarez, J, Gonzalez, A, Lopez, M, Gordillo, A, Naranjo-Izurieta, J, Costa, R, Albacete Moreno, C, de Ayala, J, Blanco-Schweizer, P, Andres, N, Boado, V, Martinez, J, Casal, V, Garcia, E, Martin-Villen, L, Climent, J, Pinto, L, Leprince, P, Lebreton, G, Juvin, C, Schmidt, M, Pineton, M, Folliguet, T, Saiydoun, G, Gaudard, P, Colson, P, Obadia, J, Pozzi, M, Fellahi, J, Yonis, H, Richard, J, Parasido, A, Verhoye, J, Flecher, E, Ajrhourh, L, Nesseler, N, Mansour, A, Guinot, P, Zarka, J, Besserve, P, Makhoul, M, Bolotin, G, Kassif, Y, Soufleris, D, Schellongowski, P, Bonaros, N, Krapf, C, Ebert, K, Mair, P, Kothleutner, F, Kowalewsky, M, Christensen, S, Pedersen, F, Balik, M, Blaha, J, Lips, M, Otahal, M, Camporota, L, Daly, K, Agnew, N, Barker, J, Head, L, Garcia, M, Ledot, S, Aquino, V, Lewis, R, Worthy, J, Noor, H, Scott, I, O'Brien, S, Conrick-Martin, I, Carton, E, Gillon, S, Flemming, L, Broman, L, Grins, E, Ketskalo, M, Tsarenko, S, Popugaev, K, Minin, S, Kornilov, I, Skopets, A, Kornelyuk, R, Turchaninov, A, Gorjup, V, Shelukhin, D, Dsouki, Y, Sargin, M, Kaygin, M, Liana, S, Puss, S, Soerensen, G, Magnus, R, Kanetoft, M, Watson, P, Redfors, B, Krenner, N, Velia Antonini, M, Barrett, N, Belliato, M, Davidson, M, Finney, S, Fowles, J, Halbe, M, Hennig, F, Jones, T, Smith, J, Roeleveld, P, Swol, J, Lorusso R., Combes A., Coco V. L., De Piero M. E., Belohlavek J., Delnoij T., van der Horst I., Miranda D. R., van der Linden M., van der Heijden J. J., Scholten E., van Belle-van Haren N., Lagrand W., de Jong S., Candura D., Maas J., van den Berg M. J. G., Malfertheiner M., Dreier E., Mueller T., Boeken U., Akhyari P., Lichtenberg A., Saeed D., Thiele H., Baumgaertel M., Schmitto J. D., Mariani S., Thielmann M., Brenner T., Benk C., Czerny M., Kalbhenn J., Maier S., Schibilsky D., Staudacher D. L., Henn P., Iuliu T., Muellenbach R., Reyher C., Rolfes C., Zacharowski K., Lotz G., Sonntagbauer M., Kersten A., Karagiannidis C., Schafer S., Fichte J., Hopf H. -B., Samalavicius R., Lorini L., Ghitti D., Grazioli L., Loforte A., Baiocchi M., Checco E. D., Pacini D., Meani P., Cappai A., Russo C. F., Bottiroli M., Mondino M., Ranucci M., Fina D., Ballotta A., Scandroglio A. M., Zangrillo A., Pieri M., Nardelli P., Fominskiy E., Landoni G., Fanelli V., Brazzi L., Montrucchio G., Sales G., Simonetti U., Urbino R., Livigni S., Degani A., Raffa G., Pilato M., Martucci G., Arcadipane A., Chiarini G., Latronico N., Cattaneo S., Puglia C., Reina G., Sponga S., Livi U., Foti G., Giani M., Rona R., Avalli L., Bombino M., Costa M. C., Carozza R., Donati A., Piciche M., Favaro A., Salvador L., Danzi V., Zanin A., Condello I., Fiore F., Moscarelli M., Nasso G., Speziale G., Sandrelli L., Montalto A., Musumeci F., Circelli A., Gamberini E., Russo E., Benni M., Agnoletti V., Rociola R., Milano A. D., Grasso S., Civita A., Murgolo F., Pilato E., Comentale G., Montisci A., Alessandri F., Tosi A., Pugliese F., Carelli S., Grieco D. L., Antonelli M., Ramoni E., Di Nardo M., Maisano F., Bettex D., Weber A., Grunenfelder J., Consiglio J., Hansjoerg J., Haenggi M., Agus G., Doeble T., Zenklusen U., Bechtold X., Stockman B., De Backer D., Giglioli S., Meyns B., Vercaemst L., Herman G., Meersseman P., Vandenbriele C., Dauwe D., Vlasselaers D., Raes M., Debeuckelaere G., Rodrigus I., Biston P., Piagnerelli M., Peperstraete H., Germay O., Vandewiele K., Vandeweghe D., Witters I., Havrin S., Bourgeois M., Taccone F. S., Nobile L., Lheureux O., Brasseur A., Creteur J., Defraigne J. -O., Misset B., Courcelle R., Timmermans P. J., Lehaen J., Frederik B., Riera J., Castro M. A., Gallart E., Martinez-Martinez M., Argudo E., Garcia-de-Acilu M., de Pablo Sanchez R., Ortiz A. B., Cabanes M. -P. F., Higa K. O., Cassina A. M., Berbel D. O., Sanchez-Salado J. C., Arnau B. -L., de Gopegui P. R., Ricart P., Sandoval E., Veganzones J., Millan P., de la Sota P., Santa Teresa P., Alcantara S., Alvarez J. D., Gonzalez A. V., Lopez M., Gordillo A., Naranjo-Izurieta J., Costa R. G., Albacete Moreno C. L., de Ayala J. A., Blanco-Schweizer P., Andres N. H., Boado V., Martinez J. M. N., Casal V. G., Garcia E. F., Martin-Villen L., Climent J. C., Pinto L. F., Leprince P., Lebreton G., Juvin C., Schmidt M., Pineton M., Folliguet T., Saiydoun G., Gaudard P., Colson P., Obadia J. -F., Pozzi M., Fellahi J. L., Yonis H., Richard J. C., Parasido A., Verhoye J. -P., Flecher E., Ajrhourh L., Nesseler N., Mansour A., Guinot P. -G., Zarka J., Besserve P., Makhoul M., Bolotin G., Kassif Y., Soufleris D., Schellongowski P., Bonaros N., Krapf C., Ebert K., Mair P., Kothleutner F., Kowalewsky M., Christensen S., Pedersen F. M., Balik M., Blaha J., Lips M., Otahal M., Camporota L., Daly K., Agnew N., Barker J., Head L., Garcia M., Ledot S., Aquino V., Lewis R., Worthy J., Noor H., Scott I., O'Brien S., Conrick-Martin I., Carton E., Gillon S., Flemming L., Broman L. M., Grins E., Ketskalo M., Tsarenko S., Popugaev K., Minin S., Kornilov I., Skopets A., Kornelyuk R., Turchaninov A., Gorjup V., Shelukhin D., Dsouki Y. E., Sargin M., Kaygin M. A., Liana S., Puss S., Soerensen G., Magnus R., Kanetoft M., Watson P., Redfors B., Krenner N., Velia Antonini M., Barrett N. A., Belliato M., Davidson M., Finney S., Fowles J. -A., Halbe M., Hennig F., Jones T., Pinto L., Smith J., Roeleveld P., Swol J., Lorusso, R, Combes, A, Coco, V, De Piero, M, Belohlavek, J, Delnoij, T, van der Horst, I, Miranda, D, van der Linden, M, van der Heijden, J, Scholten, E, van Belle-van Haren, N, Lagrand, W, de Jong, S, Candura, D, Maas, J, van den Berg, M, Malfertheiner, M, Dreier, E, Mueller, T, Boeken, U, Akhyari, P, Lichtenberg, A, Saeed, D, Thiele, H, Baumgaertel, M, Schmitto, J, Mariani, S, Thielmann, M, Brenner, T, Benk, C, Czerny, M, Kalbhenn, J, Maier, S, Schibilsky, D, Staudacher, D, Henn, P, Iuliu, T, Muellenbach, R, Reyher, C, Rolfes, C, Zacharowski, K, Lotz, G, Sonntagbauer, M, Kersten, A, Karagiannidis, C, Schafer, S, Fichte, J, Hopf, H, Samalavicius, R, Lorini, L, Ghitti, D, Grazioli, L, Loforte, A, Baiocchi, M, Checco, E, Pacini, D, Meani, P, Cappai, A, Russo, C, Bottiroli, M, Mondino, M, Ranucci, M, Fina, D, Ballotta, A, Scandroglio, A, Zangrillo, A, Pieri, M, Nardelli, P, Fominskiy, E, Landoni, G, Fanelli, V, Brazzi, L, Montrucchio, G, Sales, G, Simonetti, U, Urbino, R, Livigni, S, Degani, A, Raffa, G, Pilato, M, Martucci, G, Arcadipane, A, Chiarini, G, Latronico, N, Cattaneo, S, Puglia, C, Reina, G, Sponga, S, Livi, U, Foti, G, Giani, M, Rona, R, Avalli, L, Bombino, M, Costa, M, Carozza, R, Donati, A, Piciche, M, Favaro, A, Salvador, L, Danzi, V, Zanin, A, Condello, I, Fiore, F, Moscarelli, M, Nasso, G, Speziale, G, Sandrelli, L, Montalto, A, Musumeci, F, Circelli, A, Gamberini, E, Russo, E, Benni, M, Agnoletti, V, Rociola, R, Milano, A, Grasso, S, Civita, A, Murgolo, F, Pilato, E, Comentale, G, Montisci, A, Alessandri, F, Tosi, A, Pugliese, F, Carelli, S, Grieco, D, Antonelli, M, Ramoni, E, Di Nardo, M, Maisano, F, Bettex, D, Weber, A, Grunenfelder, J, Consiglio, J, Hansjoerg, J, Haenggi, M, Agus, G, Doeble, T, Zenklusen, U, Bechtold, X, Stockman, B, De Backer, D, Giglioli, S, Meyns, B, Vercaemst, L, Herman, G, Meersseman, P, Vandenbriele, C, Dauwe, D, Vlasselaers, D, Raes, M, Debeuckelaere, G, Rodrigus, I, Biston, P, Piagnerelli, M, Peperstraete, H, Germay, O, Vandewiele, K, Vandeweghe, D, Witters, I, Havrin, S, Bourgeois, M, Taccone, F, Nobile, L, Lheureux, O, Brasseur, A, Creteur, J, Defraigne, J, Misset, B, Courcelle, R, Timmermans, P, Lehaen, J, Frederik, B, Riera, J, Castro, M, Gallart, E, Martinez-Martinez, M, Argudo, E, Garcia-de-Acilu, M, de Pablo Sanchez, R, Ortiz, A, Cabanes, M, Higa, K, Cassina, A, Berbel, D, Sanchez-Salado, J, Arnau, B, de Gopegui, P, Ricart, P, Sandoval, E, Veganzones, J, Millan, P, de la Sota, P, Santa Teresa, P, Alcantara, S, Alvarez, J, Gonzalez, A, Lopez, M, Gordillo, A, Naranjo-Izurieta, J, Costa, R, Albacete Moreno, C, de Ayala, J, Blanco-Schweizer, P, Andres, N, Boado, V, Martinez, J, Casal, V, Garcia, E, Martin-Villen, L, Climent, J, Pinto, L, Leprince, P, Lebreton, G, Juvin, C, Schmidt, M, Pineton, M, Folliguet, T, Saiydoun, G, Gaudard, P, Colson, P, Obadia, J, Pozzi, M, Fellahi, J, Yonis, H, Richard, J, Parasido, A, Verhoye, J, Flecher, E, Ajrhourh, L, Nesseler, N, Mansour, A, Guinot, P, Zarka, J, Besserve, P, Makhoul, M, Bolotin, G, Kassif, Y, Soufleris, D, Schellongowski, P, Bonaros, N, Krapf, C, Ebert, K, Mair, P, Kothleutner, F, Kowalewsky, M, Christensen, S, Pedersen, F, Balik, M, Blaha, J, Lips, M, Otahal, M, Camporota, L, Daly, K, Agnew, N, Barker, J, Head, L, Garcia, M, Ledot, S, Aquino, V, Lewis, R, Worthy, J, Noor, H, Scott, I, O'Brien, S, Conrick-Martin, I, Carton, E, Gillon, S, Flemming, L, Broman, L, Grins, E, Ketskalo, M, Tsarenko, S, Popugaev, K, Minin, S, Kornilov, I, Skopets, A, Kornelyuk, R, Turchaninov, A, Gorjup, V, Shelukhin, D, Dsouki, Y, Sargin, M, Kaygin, M, Liana, S, Puss, S, Soerensen, G, Magnus, R, Kanetoft, M, Watson, P, Redfors, B, Krenner, N, Velia Antonini, M, Barrett, N, Belliato, M, Davidson, M, Finney, S, Fowles, J, Halbe, M, Hennig, F, Jones, T, Smith, J, Roeleveld, P, Swol, J, Lorusso R., Combes A., Coco V. L., De Piero M. E., Belohlavek J., Delnoij T., van der Horst I., Miranda D. R., van der Linden M., van der Heijden J. J., Scholten E., van Belle-van Haren N., Lagrand W., de Jong S., Candura D., Maas J., van den Berg M. J. G., Malfertheiner M., Dreier E., Mueller T., Boeken U., Akhyari P., Lichtenberg A., Saeed D., Thiele H., Baumgaertel M., Schmitto J. D., Mariani S., Thielmann M., Brenner T., Benk C., Czerny M., Kalbhenn J., Maier S., Schibilsky D., Staudacher D. L., Henn P., Iuliu T., Muellenbach R., Reyher C., Rolfes C., Zacharowski K., Lotz G., Sonntagbauer M., Kersten A., Karagiannidis C., Schafer S., Fichte J., Hopf H. -B., Samalavicius R., Lorini L., Ghitti D., Grazioli L., Loforte A., Baiocchi M., Checco E. D., Pacini D., Meani P., Cappai A., Russo C. F., Bottiroli M., Mondino M., Ranucci M., Fina D., Ballotta A., Scandroglio A. M., Zangrillo A., Pieri M., Nardelli P., Fominskiy E., Landoni G., Fanelli V., Brazzi L., Montrucchio G., Sales G., Simonetti U., Urbino R., Livigni S., Degani A., Raffa G., Pilato M., Martucci G., Arcadipane A., Chiarini G., Latronico N., Cattaneo S., Puglia C., Reina G., Sponga S., Livi U., Foti G., Giani M., Rona R., Avalli L., Bombino M., Costa M. C., Carozza R., Donati A., Piciche M., Favaro A., Salvador L., Danzi V., Zanin A., Condello I., Fiore F., Moscarelli M., Nasso G., Speziale G., Sandrelli L., Montalto A., Musumeci F., Circelli A., Gamberini E., Russo E., Benni M., Agnoletti V., Rociola R., Milano A. D., Grasso S., Civita A., Murgolo F., Pilato E., Comentale G., Montisci A., Alessandri F., Tosi A., Pugliese F., Carelli S., Grieco D. L., Antonelli M., Ramoni E., Di Nardo M., Maisano F., Bettex D., Weber A., Grunenfelder J., Consiglio J., Hansjoerg J., Haenggi M., Agus G., Doeble T., Zenklusen U., Bechtold X., Stockman B., De Backer D., Giglioli S., Meyns B., Vercaemst L., Herman G., Meersseman P., Vandenbriele C., Dauwe D., Vlasselaers D., Raes M., Debeuckelaere G., Rodrigus I., Biston P., Piagnerelli M., Peperstraete H., Germay O., Vandewiele K., Vandeweghe D., Witters I., Havrin S., Bourgeois M., Taccone F. S., Nobile L., Lheureux O., Brasseur A., Creteur J., Defraigne J. -O., Misset B., Courcelle R., Timmermans P. J., Lehaen J., Frederik B., Riera J., Castro M. A., Gallart E., Martinez-Martinez M., Argudo E., Garcia-de-Acilu M., de Pablo Sanchez R., Ortiz A. B., Cabanes M. -P. F., Higa K. O., Cassina A. M., Berbel D. O., Sanchez-Salado J. C., Arnau B. -L., de Gopegui P. R., Ricart P., Sandoval E., Veganzones J., Millan P., de la Sota P., Santa Teresa P., Alcantara S., Alvarez J. D., Gonzalez A. V., Lopez M., Gordillo A., Naranjo-Izurieta J., Costa R. G., Albacete Moreno C. L., de Ayala J. A., Blanco-Schweizer P., Andres N. H., Boado V., Martinez J. M. N., Casal V. G., Garcia E. F., Martin-Villen L., Climent J. C., Pinto L. F., Leprince P., Lebreton G., Juvin C., Schmidt M., Pineton M., Folliguet T., Saiydoun G., Gaudard P., Colson P., Obadia J. -F., Pozzi M., Fellahi J. L., Yonis H., Richard J. C., Parasido A., Verhoye J. -P., Flecher E., Ajrhourh L., Nesseler N., Mansour A., Guinot P. -G., Zarka J., Besserve P., Makhoul M., Bolotin G., Kassif Y., Soufleris D., Schellongowski P., Bonaros N., Krapf C., Ebert K., Mair P., Kothleutner F., Kowalewsky M., Christensen S., Pedersen F. M., Balik M., Blaha J., Lips M., Otahal M., Camporota L., Daly K., Agnew N., Barker J., Head L., Garcia M., Ledot S., Aquino V., Lewis R., Worthy J., Noor H., Scott I., O'Brien S., Conrick-Martin I., Carton E., Gillon S., Flemming L., Broman L. M., Grins E., Ketskalo M., Tsarenko S., Popugaev K., Minin S., Kornilov I., Skopets A., Kornelyuk R., Turchaninov A., Gorjup V., Shelukhin D., Dsouki Y. E., Sargin M., Kaygin M. A., Liana S., Puss S., Soerensen G., Magnus R., Kanetoft M., Watson P., Redfors B., Krenner N., Velia Antonini M., Barrett N. A., Belliato M., Davidson M., Finney S., Fowles J. -A., Halbe M., Hennig F., Jones T., Pinto L., Smith J., Roeleveld P., and Swol J.

Published
2021

20. Coagulation Derangements in Patients With Refractory Cardiac Arrest Treated With Extracorporeal Cardiopulmonary Resuscitation

Author

Ruggeri, L, Franco, A, Alba, A, Lembo, R, Frassoni, S, Scandroglio, A, Calabro, M, Zangrillo, A, Pappalardo, F, Ruggeri L., Franco A., Alba A. C., Lembo R., Frassoni S., Scandroglio A. M., Calabro M. G., Zangrillo A., Pappalardo F., Ruggeri, L, Franco, A, Alba, A, Lembo, R, Frassoni, S, Scandroglio, A, Calabro, M, Zangrillo, A, Pappalardo, F, Ruggeri L., Franco A., Alba A. C., Lembo R., Frassoni S., Scandroglio A. M., Calabro M. G., Zangrillo A., and Pappalardo F.

Abstract

Objective: Extracorporeal cardiopulmonary resuscitation (eCPR) with venoarterial extracorporeal membrane oxygenation (VA-ECMO) is gaining importance as a rescue therapy for refractory cardiac arrest. VA-ECMO, especially in the setting of eCPR, is plagued by hemorrhagic and thromboembolic complications. The authors’ aims were to describe the coagulation profile in refractory cardiac arrest and assess its prognostic role. Design: Single-center retrospective study. Setting: Cardiac surgical intensive care unit of a university hospital. Participants: One hundred eighty-eight patients treated with eCPR for intra-hospital and out-of-hospital refractory cardiac arrest, between 2008 and 2017. Interventions: The authors retrospectively analyzed data from the first blood sample drawn during cannulation for VA-ECMO to understand the association of coagulation parameters with survival to hospital discharge, number of blood components transfused, anticoagulation therapy, serum lactate levels, no-flow time, and low-flow time. Measurements and Main Results: Platelet count was 126 ± 79 × 109/L and in 17% of the population it was lower than 50 × 109/L, prothrombin time was 3.22 ± 4.01, activated partial thromboplastin time was 117 ± 78 seconds, fibrinogen was 186 ± 148 mg/dL, antithrombin was 47 ± 16%, and D-dimer was ≥2-fold the normal upper limit in 95% of patients. Fifty percent of patients had a disseminated intravascular coagulation (DIC) score ≥6 (52% among out-of-hospital cardiac arrest, 33% among in-hospital cardiac arrest), according to the criteria of the Japanese Society on Thrombosis and Hemostasis (2016). The median DIC score was 5.5 points (interquartile range 4-8), significantly different between survivors and nonsurvivors (4 [3-6] v 6 [4-8], p = 0.007). Every DIC score point contributed to the mortality risk (OR 1.34, 95% CI 1.09-1.67, p = 0.006). Patients with overt DIC less frequently received anticoagulants (28.6% v 55.9%, p = 0.002), started anticoagulant therapy

Published
2019

21. Immunosuppressive strategies in invasively ventilated Ards Covid-19 patients.

Author

Monti, Giacomo, Campochiaro, Corrado, Zangrillo, Alberto, Scandroglio, Anna M., Fominskiy, Evgeny, Cavalli, Giulio, Landoni, Giovanni, Beretta, Luigi, Mucci, Milena, Calabrò, Maria G., Pieri, Marina, Nardelli, Pasquale, Sartorelli, Marianna, Redaelli, Martina Baiardo, Morselli, Federica, Neto, Ary Serpa, Bellomo, Rinaldo, and Dagna, Lorenzo

Published
2021
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22. Levosimendan for Hemodynamic Support after Cardiac Surgery

Author

Landoni, Giovanni, primary, Lomivorotov, Vladimir V., additional, Alvaro, Gabriele, additional, Lobreglio, Rosetta, additional, Pisano, Antonio, additional, Guarracino, Fabio, additional, Calabrò, Maria G., additional, Grigoryev, Evgeny V., additional, Likhvantsev, Valery V., additional, Salgado-Filho, Marcello F., additional, Bianchi, Alessandro, additional, Pasyuga, Vadim V., additional, Baiocchi, Massimo, additional, Pappalardo, Federico, additional, Monaco, Fabrizio, additional, Boboshko, Vladimir A., additional, Abubakirov, Marat N., additional, Amantea, Bruno, additional, Lembo, Rosalba, additional, Brazzi, Luca, additional, Verniero, Luigi, additional, Bertini, Pietro, additional, Scandroglio, Anna M., additional, Bove, Tiziana, additional, Belletti, Alessandro, additional, Michienzi, Maria G., additional, Shukevich, Dmitriy L., additional, Zabelina, Tatiana S., additional, Bellomo, Rinaldo, additional, and Zangrillo, Alberto, additional

Published
2017
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23. Methicillin-resistant staphylococcus species in a cardiac surgical intensive care unit

Author

Pieri, M, Landoni, G, Zambon, M, Taddeo, D, Ascari, R, Costantini, M, Monaco, F, Scandroglio, A, Pappalardo, F, Bove, T, Calabro, M, Marino, G, Zangrillo, A, Pieri M., Landoni G., Zambon M., Taddeo D., Ascari R., Costantini M., Monaco F., Scandroglio A. M., Pappalardo F., Bove T., Calabro M. G., Marino G., Zangrillo A., Pieri, M, Landoni, G, Zambon, M, Taddeo, D, Ascari, R, Costantini, M, Monaco, F, Scandroglio, A, Pappalardo, F, Bove, T, Calabro, M, Marino, G, Zangrillo, A, Pieri M., Landoni G., Zambon M., Taddeo D., Ascari R., Costantini M., Monaco F., Scandroglio A. M., Pappalardo F., Bove T., Calabro M. G., Marino G., and Zangrillo A.

Abstract

Objective. Multi-drug resistant bacterial infections, in particular when Methicillin-Resistant Staphylococcus Aureus (MRSA) is involved, have become a relevant problem in both general and specialized intensive care units. The aim of this study was to identify the epidemiology of MRSA infections in a Cardiac Surgical Intensive Care Unit, to assess their impact on mortality and to identify predictors of MRSA infection and mortality in this population. Design and settings. A 7-year observational study in a cardiac surgery teaching center. Participants. Eight thousand, one hundred and sixty-two microbiological samples were obtained from 7,313 patients who underwent cardiac surgery in the study period. Interventions. None. Variables of interest and main results. Twenty-eight patients (0.38%) had MRSA infection. The most frequent site of MRSA isolation was from bronchoalveolar samples. Hospital mortality was 50% in patients with MRSA infection and 2% in patients without MRSA infection (p<0.001). Few preoperative independent predictors of MRSA infection and hospital mortality were found at multivariate analysis. Outcomes were found to be most influenced by perioperative variables. MRSA infection was the strongest predictor of mortality, with an odds ratio of 20.5 (95% CI 4.143-101.626). Conclusions. Methicillin-resistant Staphylococcus aureus infections following cardiac surgery still have a strong impact on the patients’ outcome. More efforts should be directed toward the development of new risk analysis models that might implement health care practices and might become precious instruments for infection prevention and control.

Published
2015

24. Cardiac surgery in 260 octogenarians: A case series

Author

Scandroglio, A, Finco, G, Pieri, M, Ascari, R, Calabro, M, Taddeo, D, Isella, F, Franco, A, Musu, M, Landoni, G, Alfieri, O, Zangrillo, A, Scandroglio A. M., Finco G., Pieri M., Ascari R., Calabro M. G., Taddeo D., Isella F., Franco A., Musu M., Landoni G., Alfieri O., Zangrillo A., Scandroglio, A, Finco, G, Pieri, M, Ascari, R, Calabro, M, Taddeo, D, Isella, F, Franco, A, Musu, M, Landoni, G, Alfieri, O, Zangrillo, A, Scandroglio A. M., Finco G., Pieri M., Ascari R., Calabro M. G., Taddeo D., Isella F., Franco A., Musu M., Landoni G., Alfieri O., and Zangrillo A.

Abstract

Background: The elderly undergo cardiac surgery more and more frequently, often present multiple comorbidities, assume chronic therapies, and present a unique physiology. Aim of our study was to analyze the experience of a referral cardiac surgery center with all types of cardiac surgery interventions performed in patients ≥80 years old over a six years' period. Methods: A retrospective observational study performed in a university hospital. 260 patients were included in the study (3.5% of the patients undergoing cardiac surgery in the study period). Results: Mean age was 82 ± 1.8 years. Eighty-five percent of patients underwent elective surgery, 15% unplanned surgery and 4.2% redo surgery. Intervention for aortic valve pathology and coronary artery bypass grafting were performed in 51% and 46% of the patients, respectively. Interventions involving the mitral valve were the 26% of the total, those on the tricuspid valve were 13% and those on the ascending aortic arch the 9.6%. Postoperative low output syndrome was identified in 44 patients (17%). Mortality was 3.9% and most of the patients (91%) were discharged from hospital in good clinical conditions. Hospital mortality was lower in planned vs unplanned surgery: 3.8% vs 14% respectively. Chronic obstructive pulmonary disease (OR 9.106, CI 2.275 - 36.450) was the unique independent predictor of mortality. Conclusions: Clinicians should be aware that cardiac surgery can be safely performed at all ages, that risk stratification is mandatory and that hemodynamic treatment to avoid complications is expected.

Published
2015

28. A Randomized Trial of Intravenous Amino Acids for Kidney Protection.

Author

Landoni, G., Monaco, F., Ti, L. K., Redaelli, M. Baiardo, Bradic, N., Comis, M., Kotani, Y., Brambillasca, C., Garofalo, E., Scandroglio, A. M., Viscido, C., Paternoster, G., Franco, A., Porta, S., Ferrod, F., Calabrò, M. G., Pisano, A., Vendramin, I., Barucco, G., and Federici, F.

Subjects
*AMINO acids, *CARDIOPULMONARY bypass, *ACUTE kidney failure, *AMINO group, *PHYSIOLOGIC salines, *CARDIAC surgery
Abstract

Background: Acute kidney injury (AKI) is a serious and common complication of cardiac surgery, for which reduced kidney perfusion is a key contributing factor. Intravenous amino acids increase kidney perfusion and recruit renal functional reserve. However, the efficacy of amino acids in reducing the occurrence of AKI after cardiac surgery is uncertain. Methods: In a multinational, double-blind trial, we randomly assigned adult patients who were scheduled to undergo cardiac surgery with cardiopulmonary bypass to receive an intravenous infusion of either a balanced mixture of amino acids, at a dose of 2 g per kilogram of ideal body weight per day, or placebo (Ringer's solution) for up to 3 days. The primary outcome was the occurrence of AKI, defined according to the Kidney Disease: Improving Global Outcomes creatinine criteria. Secondary outcomes included the severity of AKI, the use and duration of kidney-replacement therapy, and all-cause 30-day mortality. Results: We recruited 3511 patients at 22 centers in three countries and assigned 1759 patients to the amino acid group and 1752 to the placebo group. AKI occurred in 474 patients (26.9%) in the amino acid group and in 555 (31.7%) in the placebo group (relative risk, 0.85; 95% confidence interval [CI], 0.77 to 0.94; P = 0.002). Stage 3 AKI occurred in 29 patients (1.6%) and 52 patients (3.0%), respectively (relative risk, 0.56; 95% CI, 0.35 to 0.87). Kidney-replacement therapy was used in 24 patients (1.4%) in the amino acid group and in 33 patients (1.9%) in the placebo group. There were no substantial differences between the two groups in other secondary outcomes or in adverse events. Conclusions: Among adult patients undergoing cardiac surgery, infusion of amino acids reduced the occurrence of AKI. (Funded by the Italian Ministry of Health; PROTECTION ClinicalTrials.gov number, NCT03709264.). [ABSTRACT FROM AUTHOR]

Published
2024
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29. Argatroban anticoagulation for heparin induced thrombocytopenia in patients with ventricular assist devices

Author

Pappalardo, F., Scandroglio, A. M., Potapov, E., Stepanenko, A., Maj, G., Krabatsch, T., Alberto ZANGRILLO, Koster, A., Hetzer, R., Pappalardo, Federico, Scandroglio, Am, Potapov, E, Stepanenko, A, Maj, G, Krabatsch, T, Zangrillo, Alberto, Koster, A, and Hetzer, R.

Subjects
Adult, Male, Sulfonamides, Heparin, Incidence, Anticoagulants, Middle Aged, Postoperative Hemorrhage, Arginine, Thrombocytopenia, Postoperative Complications, Treatment Outcome, Pipecolic Acids, Thromboembolism, Feasibility Studies, Heart Transplantation, Humans, Female, Partial Thromboplastin Time, Heart-Assist Devices, Hospital Mortality, Infusions, Intravenous, Aged, Retrospective Studies
Abstract

Patients receiving implantation of ventricular assist devices (VAD) suffer a high incidence of heparin induced thrombocytopenia (HIT); the occurrence of this condition is associated with increased complications and worse outcomes. We report our experience in the management of patients who were diagnosed with HIT either before (HITpre) or after (HITpost) implantation of VAD with argatroban, a direct thrombin inhibitor.METHODS: This retrospective analysis assessed data of VAD patients diagnosed with HIT at Deutsches Herzzentrum Berlin between November 2005 and April 2009. Argatroban dose requirements, anticoagulation efficacy and adverse events (death, thromboembolism, bleeding) were recorded. Procedural success (discharge from the hospital, heart transplantation, or recovery of the failing heart) was also assessed.RESULTS: Twenty-seven patients were identified (11 HITpre, 16 HITpost). Argatroban was effective in obtaining adequate anticoagulation with a reduced dose regimen (0.02-0.42 mcg/Kg/min starting dose; 0.02-1.5 mcg/Kg/min maintenance dose). We noted 5 thromboembolic complications (18%), 6 cases of major bleeding (22%) and 5 deaths (18%), all cause composite adverse end point occurring in 40% of patients. Procedural success was obtained in 81% of patients (92% HITpre, 69% HITpost). As compared to historical controls of patients treated with lepirudin in the period 2000-2005, results were significantly improved.CONCLUSION: Argatroban anticoagulation is feasible in patients with HIT after VAD implantation, without increasing bleeding risk. Its impact in terms of survival should be reviewed also in the light of the technological improvements of assist devices.

31. Volatile Anesthetics versus Total Intravenous Anesthesia for Cardiac Surgery.

Author

Monaco, F., Lembo, R., Di Tomasso, N., Crivellari, M., Pieri, M., Beiletti, A., Scandroglio, A. M., Calabrò, M. G., Zangrillo, A., Landoni, G., Lei, C., Lozovskiy, A., Bukamal, N. A. R., Silva, F. S., Bautin, A. E., Ma, J., Farag, A. M. G. A., Uvaliev, N. S., Carollo, C., and Kunstýř, J.

Abstract

BACKGROUND Volatile (inhaled) anesthetic agents have cardioprotective effects, which might improve clinical outcomes in patients undergoing coronary-artery bypass grafting (CABG). METHODS We conducted a pragmatic, multicenter, single-blind, controlled trial at 36 centers in 13 countries. Patients scheduled to undergo elective CABG were randomly assigned to an intraoperative anesthetic regimen that included a volatile anesthetic (desflurane, isoflurane, or sevoflurane) or to total intravenous anesthesia. The primary outcome was death from any cause at 1 year. RESULTS A total of 5400 patients were randomly assigned: 2709 to the volatile anesthetics group and 2691 to the total intravenous anesthesia group. On-pump CABG was performed in 64% of patients, with a mean duration of cardiopulmonary bypass of 79 minutes. The two groups were similar with respect to demographic and clinical characteristics at baseline, the duration of cardiopulmonary bypass, and the number of grafts. At the time of the second interim analysis, the data and safety monitoring board advised that the trial should be stopped for futility. No significant difference between the groups with respect to deaths from any cause was seen at 1 year (2.8% in the volatile anesthetics group and 3.0% in the total intravenous anesthesia group; relative risk, 0.94; 95% confidence interval [CI], 0.69 to 1.29; P=0.71), with data available for 5353 patients (99.1%), or at 30 days (1.4% and 1.3%, respectively; relative risk, 1.11; 95% CI, 0.70 to 1.76), with data available for 5398 patients (99.9%). There were no significant differences between the groups in any of the secondary outcomes or in the incidence of prespecified adverse events, including myocardial infarction. CONCLUSIONS Among patients undergoing elective CABG, anesthesia with a volatile agent did not result in significantly fewer deaths at 1 year than total intravenous anesthesia. [ABSTRACT FROM AUTHOR]

Published
2019
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32. Extracorporeal cardiopulmonary resuscitation for out‐of‐hospital cardiac arrest: A systematic review and meta‐analysis of randomized and propensity score‐matched studies

Author

Tommaso Scquizzato, Alessandra Bonaccorso, Michela Consonni, Anna Mara Scandroglio, Justyna Swol, Giovanni Landoni, Alberto Zangrillo, Scquizzato, T., Bonaccorso, A., Consonni, M., Scandroglio, A. M., Swol, J., Landoni, G., and Zangrillo, A.

Subjects
extracorporeal cardiopulmonary resuscitation, Adult, Biomedical Engineering, Medicine (miscellaneous), Bioengineering, General Medicine, extracorporeal membrane oxygenation, Cardiopulmonary Resuscitation, Biomaterials, Extracorporeal Membrane Oxygenation, Treatment Outcome, Humans, out-of-hospital cardiac arrest, Propensity Score, neurological outcome, Out-of-Hospital Cardiac Arrest
Abstract

Background: In selected patients with refractory out-of-hospital cardiac arrest, extracorporeal cardiopulmonary resuscitation represents a promising approach when conventional cardiopulmonary resuscitation fails to achieve return of spontaneous circulation. This systematic review and meta-analysis aimed to compare extracorporeal cardiopulmonary resuscitation to conventional cardiopulmonary resuscitation. Methods: We searched PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials up to November 28, 2021, for randomized trials and observational studies reporting propensity score-matched data and comparing adults with out-of-hospital cardiac arrest treated with extracorporeal cardiopulmonary resuscitation with those treated with conventional cardiopulmonary resuscitation. The primary outcome was survival with favorable neurological outcome at the longest follow-up available. Secondary outcomes were survival at the longest follow-up available and survival at hospital discharge/30days. Results: We included six studies, two randomized and four propensity score-matched studies. Patients treated with extracorporeal cardiopulmonary resuscitation had higher rates of survival with favorable neurological outcome (81/584 [14%] vs. 46/593 [7.8%]; OR=2.11; 95% CI, 1.41–3.15; p&nbsp

Published
2022

33. A radiological predictor for pneumomediastinum/pneumothorax in COVID-19 ARDS patients

Author

Diego Palumbo, Alberto Zangrillo, Alessandro Belletti, Giorgia Guazzarotti, Maria Rosa Calvi, Francesca Guzzo, Renato Pennella, Giacomo Monti, Chiara Gritti, Marilena Marmiere, Margherita Rocchi, Sergio Colombo, Davide Valsecchi, Anna Mara Scandroglio, Lorenzo Dagna, Patrizia Rovere-Querini, Moreno Tresoldi, Giovanni Landoni, Francesco De Cobelli, Carolina Faustini, Nicolò Maimeri, Rosalba Lembo, Giuseppe Di Lucca, Raffaella Scotti, Maria Vittoria Lavorato, Alessandro Tomellieri, Corrado Campochiaro, Fatemeh Darvizeh, Francesca Calabrese, Roberto Mapelli, Nicola Pasculli, Giovanni Borghi, Antonella Cipriani, Maria Grazia Calabrò, Martina Crivellari, Annalisa Franco, Marina Pieri, Evgeny V. Fominskiy, Stefano Franchini, Antonio Dell'Acqua, Alessandro Marinosci, Giordano Vitali, Nicola Compagnone, Palumbo, D., Zangrillo, A., Belletti, A., Guazzarotti, G., Calvi, M. R., Guzzo, F., Pennella, R., Monti, G., Gritti, C., Marmiere, M., Rocchi, M., Colombo, S., Valsecchi, D., Scandroglio, A. M., Dagna, L., Rovere-Querini, P., Tresoldi, M., Landoni, G., De Cobelli, F., Faustini, C., Maimeri, N., Lembo, R., Di Lucca, G., Scotti, R., Lavorato, M. V., Tomellieri, A., Campochiaro, C., Darvizeh, F., Calabrese, F., Mapelli, R., Pasculli, N., Borghi, G., Cipriani, A., Calabro, M. G., Crivellari, M., Franco, A., Pieri, M., Fominskiy, E. V., Franchini, S., Dell'Acqua, A., Marinosci, A., Vitali, G., and Compagnone, N.

Subjects
ARDS, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, LR, likelihood ratio, Pneumomediastinum, Acute respiratory distress, Critical Care and Intensive Care Medicine, Article, Mechanical ventilation, Humans, Medicine, ARDS, acute respiratory distress syndrome, Mediastinal Emphysema, COVID-19, coronavirus disease 2019, PMD, pneumomediastinum, Respiratory Distress Syndrome, Chest imaging, Acute respiratory distress syndrome, SARS-CoV-2, business.industry, Tomography, X-ray computed, Pneumothorax, COVID-19, medicine.disease, PPV, positive predictive value, PNX, pneumothorax, NPV, negative predictive value, Case-Control Studies, Radiological weapon, Radiology, business
Abstract

Purpose: To determine whether Macklin effect (a linear collection of air contiguous to the bronchovascular sheath) on baseline CT imaging is an accurate predictor for subsequent pneumomediastinum (PMD)/pneumothorax (PNX) development in invasively ventilated patients with COVID-19-related acute respiratory distress syndrome (ARDS). Materials and methods: This is an observational, case-control study. From a prospectively acquired database, all consecutive invasively ventilated COVID-19 ARDS patients who underwent at least one baseline chest CT scan during the study time period (February 25th, 2020–December 31st, 2020) were identified; those who had tracheal lesion or already had PMD/PNX at the time of the first available chest imaging were excluded. Results: 37/173 (21.4%) patients enrolled had PMD/PNX; specifically, 20 (11.5%) had PMD, 10 (5.8%) PNX, 7 (4%) both. 33/37 patients with subsequent PMD/PNX had Macklin effect on baseline CT (89.2%, true positives) 8.5 days [range, 1–18] before the first actual radiological evidence of PMD/PNX. Conversely, 6/136 patients without PMD/PNX (4.4%, false positives) demonstrated Macklin effect (p < 0.001). Macklin effect yielded a sensitivity of 89.2% (95% confidence interval [CI]: 74.6–96.9), a specificity of 95.6% (95% CI: 90.6–98.4), a positive predictive value (PV) of 84.5% (95% CI: 71.3–92.3), a negative PV of 97.1% (95% CI: 74.6–96.9) and an accuracy of 94.2% (95% CI: 89.6–97.2) in predicting PMD/PNX (AUC:0.924). Conclusions: Macklin effect accurately predicts, 8.5 days in advance, PMD/PNX development in COVID-19 ARDS patients.

Published
2021

34. Left Ventricular Unloading With an IABP in Patients Undergoing Ventricular Tachycardia Ablation With ECMO Support

Author

Fabrizio Monaco, Paolo Della Bella, Alberto Zangrillo, Silvia Ajello, Anna Mara Scandroglio, Nora Di Tomasso, Elisabetta Fumagalli, Giovanni Landoni, Giulio Melisurgo, Maria Grazia Calabrò, Allegra Arata, Caterina Cecilia Lerose, Antonio Frontera, Monaco, F., Ajello, S., Calabro, M. G., Melisurgo, G., Landoni, G., Arata, A., Lerose, C. C., Fumagalli, E., Tomasso, N. D., Frontera, A., Scandroglio, A. M., Della Bella, P., and Zangrillo, A.

Subjects
medicine.medical_specialty, Heart Ventricles, medicine.medical_treatment, Catheter ablation, 030204 cardiovascular system & hematology, Ventricular tachycardia, 03 medical and health sciences, Extracorporeal Membrane Oxygenation, 0302 clinical medicine, Afterload, 030202 anesthesiology, Internal medicine, catheter ablation, Extracorporeal membrane oxygenation, Humans, Medicine, Intra-aortic balloon pump, mechanical circulatory support, Intra-Aortic Balloon Pumping, Ejection fraction, business.industry, Dilated cardiomyopathy, extracorporeal membrane oxygenation, medicine.disease, Anesthesiology and Pain Medicine, medicine.anatomical_structure, intra-aortic balloon pump, Ventricle, Tachycardia, Ventricular, Cardiology, Heart-Assist Devices, ventricular tachycardia, Cardiology and Cardiovascular Medicine, business
Abstract

Objective: The authors investigated the preprocedural predictors of postprocedural intra-aortic balloon pump (IABP) need in patients undergoing transcatheter ventricular tachycardia (VT) ablation on venoarterial (VA) extracorporeal membrane oxygenation (ECMO). Design: Observational study. Setting: Hybrid operating room and intensive care unit of a teaching hospital. Patients: Participants were 121 consecutive patients with unstable VT undergoing transcatheter ablation with VA-ECMO. Interventions: In patients with postprocedural echocardiographic, radiographic, or hemodynamic signs of increased left ventricle afterload, an IABP was positioned. Measurements and Main Results: Patients in the IABP group were more frequently on angiotensin-converting enzyme inhibitors (58% v 37%; p = 0.03) and had lower median baseline ejection fraction (25% v 28% p = 0.05), larger end-diastolic diameter (69.7 mm ± 13.0 v 65.7 mm ± 11.3; p = 0.03), and more frequent ischemic etiology as the reason for dilated cardiomyopathy (76% v 47%; p = 0.04,) when compared with patients not requiring IABP. Postoperatively, the IABP group required longer mechanical ventilation (24 hours [20-56.5] v 23 hours [15-28]; p = 0.003), intensive care unit stay (78 hours [46-174] v 48 hours [24-72]; p < 0.001), and continuous renal replacement therapy (13.3% v 1.3%; p = 0.006). By multivariate analysis, end-diastolic diameter (odds ratio [OR]:1.08; confidence interval [CI]: 1.00-1.16; p = 0.049), ischemic dilated cardiomyopathy (OR: 8.40; CI: 2.15-32.88; p = 0.002), and more-than-moderate mitral regurgitation (OR: 4.83; CI: 1.22-19.22; p = 0.025) were independent predictors of need for IABP. Conclusions: The need for an IABP to unload the left ventricle can be predicted by ventricular size, medium-severe mitral valvular defect, and ischemic etiology of the dilated cardiomyopathy.

Published
2021

35. Effect of Volatile Anesthetics on Myocardial Infarction After Coronary Artery Surgery: A Post Hoc Analysis of a Randomized Trial

Author

Zangrillo, Alberto, Lomivorotov, Vladimir, Pasyuga, Vadim, Belletti, Alessandro, Gazivoda, Gordana, Monaco, Fabrizio, Nigro Neto, Caetano, Likhvantsev, Valery, Bradic, Nikola, Lozovskiy, Andrey, Lei, Chong, Bukamal, Nazar, Santos Silva, Fernanda, Bautin, Andrey, Ma, Jun, Yen Yong, Chow, Carollo, Cristiana, Kunstyr, Jan, Wang, Chew Yin, Grigoryev, Evgeny, Riha, Hynek, Wang, Chengbin, El-Tahan, Mohamed, Scandroglio, Anna Mara, Mansor, Marzida, Lembo, Rosalba, Ponomarev, Dmitry, Lucena Bezerra, Francisco José, Ruggeri, Laura, Chernyavskiy, Alexander, Xu, Junmei, Tarasov, Dmitry, Navalesi, Paolo, Yavorovskiy, Andrey, Bove, Tiziana, Kuzovlev, Artem, Hajjar, Ludhmila, Landoni, Giovanni, MYRIAD Study Group, Zangrillo, A., Lomivorotov, V. V., Pasyuga, V. V., Belletti, A., Gazivoda, G., Monaco, F., Nigro Neto, C., Likhvantsev, V. V., Bradic, N., Lozovskiy, A., Lei, C., Bukamal, N. A. R., Silva, F. S., Bautin, A. E., Ma, J., Yong, C. Y., Carollo, C., Kunstyr, J., Wang, C. Y., Grigoryev, E. V., Riha, H., Wang, C., El-Tahan, M. R., Scandroglio, A. M., Mansor, M., Lembo, R., Ponomarev, D. N., Bezerra, F. J. L., Ruggeri, L., Chernyavskiy, A. M., Xu, J., Tarasov, D. G., Navalesi, P., Yavorovskiy, A., Bove, T., Kuzovlev, A., Hajjar, L. A., and Landoni, G.

Subjects
cancer, cardiac surgery, cardioprotection, mortality, myocardial infarction, volatile anesthetics, Myocardial Infarction, Middle Aged, Sevoflurane, Anesthesiology and Pain Medicine, Postoperative Complications, Anesthetics, Inhalation, Humans, volatile anesthetic, Coronary Artery Bypass, Cardiology and Cardiovascular Medicine, Propofol, Anesthetics, Intravenous, Aged
Abstract

Objective: To investigate the effect of volatile anesthetics on the rates of postoperative myocardial infarction (MI) and cardiac death after coronary artery bypass graft (CABG). Design: A post hoc analysis of a randomized trial. Setting: Cardiac surgical operating rooms. Participants: Patients undergoing elective, isolated CABG. Interventions: Patients were randomized to receive a volatile anesthetic (desflurane, isoflurane, or sevoflurane) or total intravenous anesthesia (TIVA). The primary outcome was hemodynamically relevant MI (MI requiring high-dose inotropic support or prolonged intensive care unit stay) occurring within 48 hours from surgery. The secondary outcome was 1-year death due to cardiac causes. Measurements and main results: A total of 5, 400 patients were enrolled between April 2014 and September 2017 (2, 709 patients randomized to the volatile anesthetics group and 2, 691 to TIVA). The mean age was 62 ± 8.4 years, and the median baseline ejection fraction was 57% (50-67), without differences between the 2 groups. Patients in the volatile group had a lower incidence of MI with hemodynamic complications both in the per- protocol (14 of 2, 530 [0.6%] v 27 of 2, 501 [1.1%] in the TIVA group ; p = 0.038) and as- treated analyses (16 of 2, 708 [0.6%] v 29 of 2, 617 [1.1%] in the TIVA group ; p = 0.039), but not in the intention-to-treat analysis (17 of 2, 663 [0.6%] v 28 of 2, 667 [1.0%] in the TIVA group ; p = 0.10). Overall, deaths due to cardiac causes were lower in the volatile group (23 of 2, 685 [0.9%] v 40 of 2, 668 [1.5%] than in the TIVA group ; p = 0.03). Conclusions: An anesthetic regimen, including volatile agents, may be associated with a lower rate of postoperative MI with hemodynamic complication in patients undergoing CABG. Furthermore, it may reduce long- term cardiac mortality.

Published
2022

36. Case Report: Nintedaninb May Accelerate Lung Recovery in Critical Coronavirus Disease 2019

Author

Cecilia Bussolari, Diego Palumbo, Evgeni Fominsky, Pasquale Nardelli, Rebecca De Lorenzo, Giordano Vitali, Francesco De Cobelli, Patrizia Rovere-Querini, Anna Mara Scandroglio, Bussolari, C., Palumbo, D., Fominsky, E., Nardelli, P., De Lorenzo, R., Vitali, G., De Cobelli, F., Rovere-Querini, P., and Scandroglio, A. M.

Subjects
Oncology, medicine.medical_specialty, ARDS, Medicine (General), Case Report, Systemic inflammation, chemistry.chemical_compound, R5-920, Growth factor receptor, Internal medicine, severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2), medicine, Respiratory function, Lung, business.industry, respiratory dysfunction, lung inflammation, Coronavirus disease (COVID-19), General Medicine, medicine.disease, Clinical trial, Pneumonia, medicine.anatomical_structure, chemistry, Medicine, Nintedanib, lung recovery, medicine.symptom, business, antifibrotic therapy
Abstract

Severe Coronavirus disease 2019 (COVID-19) is characterized by acute respiratory distress syndrome (ARDS) which may lead to long-lasting pulmonary sequelae in the survivors. COVID-19 shares common molecular signatures with interstitial lung diseases (ILDs), including pro-angiogenic and tissue-remodeling mechanisms mediated by vascular endothelial growth factor receptor (VEGF-R), fibroblast growth factor receptor (FGF-R), and platelet-derived growth factor receptor (PDGF-R). Nintedanib mainly targets these factors and is approved for ILDs. Therefore, we administered nintedanib through compassionate use to three patients with COVID-19 pneumonia requiring extra-corporeal membrane-oxygenation (ECMO). Here, we describe our experience in an attempt to explore the role of nintedanib in lung recovery in COVID-19. Three obese patients aged between 42 and 52 years were started on nintedanib due to difficulty in obtaining lung function restoration and weaning from ECMO support following the removal of orotracheal intubation (OTI). Soon after the start of the treatment, systemic inflammation and respiratory function rapidly improved and ECMO support was withdrawn. Serial chest CT scans confirmed the progressive lung amelioration, also reflected by functional tests during follow-up. Nintedanib was well-tolerated by all the three patients at the dosage used for ILDs and continued for 2–3 months based on drug availability. Although caution in interpreting events is required; it is tempting to speculate that nintedanib may have contributed to modulate lung inflammation and remodeling and to sustain lung repair. Altogether, nintedanib appears as a promising agent in patients with severe COVID-19 and delayed respiratory function recovery, for whom molecularly targeted therapies are still lacking. Clinical trials are necessary to confirm our observations.

Published
2021

37. Immunosuppressive strategies in invasively ventilated ARDS COVID-19 patients

Author

Marianna Sartorelli, Maria Grazia Calabrò, Corrado Campochiaro, Rinaldo Bellomo, Ary Serpa Neto, Alberto Zangrillo, Luigi Beretta, Giacomo Monti, Milena Mucci, Anna Mara Scandroglio, Giovanni Landoni, Pasquale Nardelli, Giulio Cavalli, Lorenzo Dagna, Federica Morselli, Martina Baiardo Redaelli, Marina Pieri, Evgeny Fominskiy, Monti, Giacomo, Campochiaro, Corrado, Zangrillo, Alberto, Scandroglio, Anna M, Fominskiy, Evgeny, Cavalli, Giulio, Landoni, Giovanni, Beretta, Luigi, Mucci, Milena, Calabrò, Maria G, Pieri, Marina, Nardelli, Pasquale, Sartorelli, Marianna, Baiardo Redaelli, Martina, Morselli, Federica, Serpa Neto, Ary, Bellomo, Rinaldo, Dagna, Lorenzo, and Intensive Care Medicine

Subjects
musculoskeletal diseases, medicine.medical_specialty, ARDS, Coronavirus disease 2019 (COVID-19), law.invention, chemistry.chemical_compound, Tocilizumab, law, Anesthesiology, Internal medicine, medicine, Humans, Prospective Studies, Prospective cohort study, Respiratory Distress Syndrome, Anakinra, SARS-CoV-2, business.industry, Respiration, Confounding, COVID-19, Bayes Theorem, medicine.disease, Intensive care unit, Intensive Care Units, Critical care, Treatment Outcome, Anesthesiology and Pain Medicine, chemistry, Artificial, Respiration, artificial, business, medicine.drug
Abstract

BACKGROUND: COVID-19 is associated with elevated levels of inflammatory cytokines. We present the characteristics and outcomes of patients treated in the Intensive Care Unit (ICU) with immunosuppressive drugs, either tocilizumab or anakinra compared with controls. METHODS: A single-center observational prospective study on ICU invasively ventilated COVID-19 patients. The primary outcome was the clinical improvement at day 28. A Bayesian framework was employed, and all analyses were adjusted for confounders. RESULTS: Sixty-one consecutive invasively ventilated patients were included, nine (14.7%) received tocilizumab and 15 (24.6%) received anakinra. Over the first seven days, tocilizumab was associated with a greater decrease in C-reactive protein (P

Published
2021

38. Predictors of Pneumothorax/Pneumomediastinum in Mechanically Ventilated COVID-19 Patients

Author

Alessandro Belletti, Giordano Vitali, Lorenzo Dagna, Francesco De Cobelli, Nicolò Maimeri, Giacomo Monti, Antonio Dell'Acqua, Diego Palumbo, Sergio Colombo, Carolina Faustini, Anna Mara Scandroglio, Alberto Zangrillo, Giorgia Guazzarotti, Rosalba Lembo, Stefano Franchini, Giovanni Landoni, Alessandro Marinosci, Junaid Mushtaq, Renato Pennella, Evgeny Fominskiy, Belletti, A., Palumbo, D., Zangrillo, A., Fominskiy, E. V., Franchini, S., Dell'Acqua, A., Marinosci, A., Monti, G., Vitali, G., Colombo, S., Guazzarotti, G., Lembo, R., Maimeri, N., Faustini, C., Pennella, R., Mushtaq, J., Landoni, G., Scandroglio, A. M., Dagna, L., and De Cobelli, F.

Subjects
ARDS, pneumothorax, medicine.medical_treatment, mechanical ventilation, 030204 cardiovascular system & hematology, barotrauma, Logistic regression, law.invention, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, law, Macklin effect, medicine, Humans, Intubation, Pneumomediastinum, Mediastinal Emphysema, Original Research, Mechanical ventilation, SARS-CoV-2, business.industry, Incidence (epidemiology), COVID-19, acute respiratory distress syndrome, medicine.disease, Respiration, Artificial, Intensive care unit, Anesthesiology and Pain Medicine, Pneumothorax, Anesthesia, business, Cardiology and Cardiovascular Medicine
Abstract

Objective To determine the incidence, predictors, and outcome of pneumothorax (PNX)/pneumomediastinum (PMD) in coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS). Design Observational study. Setting Tertiary-care university hospital. Participants One hundred sixteen consecutive critically ill, invasively ventilated patients with COVID-19 ARDS. Interventions The authors collected demographic, mechanical ventilation, imaging, laboratory, and outcome data. Primary outcome was the incidence of PNX/PMD. Multiple logistic regression analyses were performed to identify predictors of PNX/PMD. Measurements and Main Results PNX/PMD occurred in a total of 28 patients (24.1%), with 22 patients developing PNX (19.0%) and 13 developing PMD (11.2%). Mean time to development of PNX/PMD was 14 ± 11 days from intubation. The authors found no significant difference in mechanical ventilation parameters between patients who developed PNX/PMD and those who did not. Mechanical ventilation parameters were within recommended limits for protective ventilation in both groups. Ninety-five percent of patients with PNX/PMD had the Macklin effect (linear collections of air contiguous to the bronchovascular sheaths) on a baseline computed tomography scan, and tended to have a higher lung involvement at intensive care unit (ICU) admission (Radiographic Assessment of Lung Edema score 32.2 ± 13.4 v 18.7 ± 9.8 in patients without PNX/PMD, p = 0.08). Time from symptom onset to intubation and time from total bilirubin on day two after ICU admission were the only independent predictors of PNX/PMD. Mortality was 60.7% in patients who developed PNX/PMD versus 38.6% in those who did not (p = 0.04). Conclusion PNX/PMD occurs frequently in COVID-19 patients with ARDS requiring mechanical ventilation, and is associated with increased mortality. Development of PNX/PMD seems to occur despite use of protective mechanical ventilation and has a radiologic predictor sign.

Published
2021
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39. Prevalence, Characteristics, Risk Factors, and Outcomes of Invasively Ventilated COVID-19 Patients with Acute Kidney Injury and Renal Replacement Therapy

Author

Elena Moizo, Stefano Turi, Corrado Campochiaro, Alberto Zangrillo, Cristina Mattioli, Pasquale Nardelli, Paolo Silvani, Martina Crivellari, Giovanni Landoni, Marianna Sartorelli, Maria Grazia Calabrò, Fabio Ciceri, Francesco Giuseppe Nisi, Maria Luisa Azzolini, Giovanni Borghi, Marina Pieri, Antonio Dell'Acqua, Fabrizio Monaco, Martina Baiardo Redaelli, Caterina Conte, Alessandro Belletti, Ary Serpa Neto, Gabriele Valsecchi, Piera Angelillo, Evgeny Fominskiy, Cristina Barberio, Milena Mucci, Luigi Beretta, Rinaldo Bellomo, Anna Mara Scandroglio, Alfredo Ravizza, Stefano Tentori, Lorenzo Dagna, Giacomo Monti, Intensive Care Medicine, Fominskiy, E. V., Scandroglio, A. M., Monti, G., Calabro, M. G., Landoni, G., Dell'Acqua, A., Beretta, L., Moizo, E., Ravizza, A., Monaco, F., Campochiaro, C., Pieri, M., Azzolini, M. L., Borghi, G., Crivellari, M., Conte, C., Mattioli, C., Silvani, P., Mucci, M., Turi, S., Tentori, S., Baiardo Redaelli, M., Sartorelli, M., Angelillo, P., Belletti, A., Nardelli, P., Nisi, F. G., Valsecchi, G., Barberio, C., Ciceri, F., Serpa Neto, A., Dagna, L., Bellomo, R., and Zangrillo, A.

Subjects
Male, medicine.medical_specialty, Continuous Renal Replacement Therapy, Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, 030232 urology & nephrology, Hospital mortality, 030204 cardiovascular system & hematology, urologic and male genital diseases, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Prevalence, medicine, Humans, Hospital Mortality, Renal replacement therapy, Stage (cooking), Aged, Ventilators, Mechanical, Coronavirus disease 2019, SARS-CoV-2, business.industry, urogenital system, Acute kidney injury, COVID-19, Hematology, General Medicine, Middle Aged, Tertiary care hospital, medicine.disease, Respiration, Artificial, Methods observational, female genital diseases and pregnancy complications, Coronavirus, Critical care, Treatment Outcome, Nephrology, Emergency medicine, Female, business, Research Article, Healthcare system
Abstract

Background: There is no information on acute kidney injury (AKI) and continuous renal replacement therapy (CRRT) among invasively ventilated coronavirus disease 2019 (COVID-19) patients in Western healthcare systems. Objective: To study the prevalence, characteristics, risk factors and outcome of AKI and CRRT among invasively ventilated COVID-19 patients. Methods: Observational study in a tertiary care hospital in Milan, Italy. Results: Among 99 patients, 72 (75.0%) developed AKI and 17 (17.7%) received CRRT. Most of the patients developed stage 1 AKI (33 [45.8%]), while 15 (20.8%) developed stage 2 AKI and 24 (33.4%) a stage 3 AKI. Patients who developed AKI or needed CRRT at latest follow-up were older, and among CRRT treated patients a greater proportion had preexisting CKD. Hospital mortality was 38.9% for AKI and 52.9% for CRRT patients. Conclusions: Among invasively ventilated COVID-19 patients, AKI is very common and CRRT use is common. Both carry a high risk of in-hospital mortality.

Published
2021

40. Continuous infusion versus intermittent administration of meropenem in critically ill patients (MERCY): A multicenter randomized double-blind trial. Rationale and design

Author

Ingrid Marcela Pabon, Barbara Azzali, Mattia Bozzetti, Vincenzo Pota, Antonio De Sio, Andrey Yavorovskiy, Natascia D'Andrea, Rosetta Lobreglio, Andrea Della Selva, Evgeny Fominskiy, Federico Canavosio, Barbara Ferrara, Vittorio Pazzanese, Francesca Gallicchio, Nicola Pasculli, Valery Likhvantsev, Eugenio Garofalo, Sergio Colombo, Anna Mara Scandroglio, Felice Eugenio Agrò, Margherita Tozzi, Gianluca Paternoster, Francesco Corradi, Tiziana Bove, Filippo Palmesino, Elena Momesso, Luigi Vetrugno, Francesco Giuseppe Nisi, Giorgia Montrucchio, Daniela Missio, Mara Bernasconi, Giacomo Monti, Mariano Ballestra, Marco Gemma, Giovanni Marino, Silvia Ajello, Alberto Zangrillo, Rosalba Lembo, Maria Grazia Calabrò, Romina Perone, Andrea Bruni, Pavel Nogtev, Alberto Cappelletti, Gabriele Finco, Daniele Cristadoro, Leonarda Pia Cantatore, Marina Pieri, Sofia Ananiadou, Italo Calamai, Chiara Millin, A. Mattei, Luca Cabrini, Marina Petrova, Valentina Paola Plumari, Nicoletta Boffa, Davide Maraggia, Elena Moizo, Gianna Curci, Giovanni Landoni, Giuseppe Biondi-Zoccai, Giuseppe Giardina, Giacomo Iapichino, Carola Galbiati, Fabio Guarracino, Antonella Cotoia, Matteo Marzaroli, Nikola Bradic, Umberto Benedetto, Giorgio Gallioli, Fabrizio D'Ascenzo, Francesco Forfori, Fabio Toffoletto, Milena Mucci, Manuela Mainetti, Monti, G., Galbiati, C., Toffoletto, F., Calabro, M. G., Colombo, S., Ferrara, B., Giardina, G., Lembo, R., Marzaroli, M., Moizo, E., Mucci, M., Pasculli, N., Plumari, V. P., Scandroglio, A. M., Tozzi, M., Momesso, E., Boffa, N., Lobreglio, R., Montrucchio, G., Guarracino, F., Benedetto, U., Biondi-Zoccai, G., D'Ascenzo, F., D'Andrea, N., Paternoster, G., Ananiadou, S., Ballestra, M., De Sio, A., Pota, V., Cotoia, A., Della Selva, A., Bruni, A., Iapichino, G., Bradic, N., Corradi, F., Gemma, M., Nogtev, P., Petrova, M., Agro, F. E., Cabrini, L., Forfori, F., Likhvantsev, V., Bove, T., Finco, G., Landoni, G., Zangrillo, A., Ajello, S., Cappelletti, A. M., Fominskiy, E., Nisi, F. G., Pazzanese, V., Pieri, M., Canavosio, F., Palmesino, F., Bernasconi, M., Gallioli, G., Marino, G., Vetrugno, L., Millin, C., Missio, D., Gallicchio, F., Azzali, B., Bozzetti, M., Cristadoro, D., Perone, R., Cantatore, L. P., Curci, G., Pabon, I. M., Garofalo, E., Mainetti, M., Calamai, I., Maraggia, D., Mattei, A., Yavorovskiy, A., Monti, Giacomo, Galbiati, Carola, Toffoletto, Fabio, Calabrò, Maria Grazia, Colombo, Sergio, Ferrara, Barbara, Giardina, Giuseppe, Lembo, Rosalba, Marzaroli, Matteo, Moizo, Elena, Mucci, Milena, Pasculli, Nicola, Plumari, Valentina, Scandroglio, Anna Mara, Tozzi, Margherita, Momesso, Elena, Boffa, Nicoletta, Lobreglio, Rosetta, Montrucchio, Giorgia, Guarracino, Fabio, Benedetto, Umberto, Biondi-Zoccai, Giuseppe, D'Ascenzo, Fabrizio, D'Andrea, Natascia, Paternoster, Gianluca, Ananiadou, Sofia, Ballestra, Mariano, De Sio, Antonio, Pota, Vincenzo, Cotoia, Antonella, Selva, Andrea Della, Bruni, Andrea, Iapichino, Giacomo, Bradić, Nikola, Corradi, Francesco, Gemma, Marco, Nogtev, Pavel, Petrova, Marina, Agrò, Felice Eugenio, Cabrini, Luca, Forfori, Francesco, Likhvantsev, Valery, Bove, Tiziana, Finco, Gabriele, Landoni, Giovanni, and Zangrillo, Alberto

Subjects
medicine.medical_specialty, Randomization, Critical Care, Antibiotic resistance, Critical patients, Critical Illness, Population, meropenem, intermitent or continuous infusion, critically ill, Intensive care unit, Meropenem, Mortality, Multi-drug resistant pathogens, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Sepsis, medicine, Clinical endpoint, polycyclic compounds, Humans, Pharmacology (medical), 030212 general & internal medicine, education, Antibacterial agent, education.field_of_study, 030505 public health, Septic shock, business.industry, Critical patient, General Medicine, medicine.disease, Anti-Bacterial Agents, Emergency medicine, 0305 other medical science, business, medicine.drug
Abstract

Objective Meropenem is a β-lactam, carbapenem antibacterial agent with antimicrobial activity against gram-negative, gram-positive and anaerobic micro-organisms and is important in the empirical treatment of serious infections in Intensive Care Unit (ICU) patients. Multi-drug resistant gram-negative organisms, coupled with scarcity of new antibiotic classes, forced healthcare community to optimize the therapeutic potential of available antibiotics. Our aim is to investigate the effect of continuous infusion of meropenem against bolus administration, as indicated by a composite outcome of reducing death and emergence of extensive or pan drug-resistant pathogens in a population of ICU patients. Design Double blind, double dummy, multicenter randomized controlled trial (1:1 allocation ratio). Setting Tertiary and University hospitals. Interventions 600 ICU patients with sepsis or septic shock, needing by clinical judgment antibiotic therapy with meropenem, will be randomized to receive a continuous infusion of meropenem 3 g/24 h or an equal dose divided into three daily boluses (i.e. 1g q8h). Measurements The primary endpoint will be a composite outcome of reducing death and emergence of extensive or pan drug-resistant pathogens. Secondary endpoints will be death from any cause at day 90, antibiotic-free days at day 28, ICU-free days at day 28, cumulative SOFA-free (Sequential Organ Failure Assessment) score from randomization to day 28 and the two, separate, components of the primary endpoint. We expect a primary outcome reduction from 52 to 40% in the continuous infusion group. Conclusions The trial will provide evidence for choosing intermittent or continuous infusion of meropenem for critically ill patients with multi-drug resistant gram-negative infections.

Published
2021

41. Multimodality Imaging for a Challenging Left Ventricular Assist Device in Double Ventricular Aneurysm

Author

Maria Grazia Calabrò, Evgeny Fominskiy, Giulio Melisurgo, Silvia Ajello, Michele De Bonis, Anna Mara Scandroglio, Luca Baldetti, Marina Pieri, Cristina Capogrosso, Francesco Calvo, F. Pappalardo, Calvo, F., Baldetti, L., Ajello, S., Melisurgo, G., Capogrosso, C., Calabro, M. G., Pieri, M., Fominskiy, E., Pappalardo, F., De Bonis, M., and Scandroglio, A. M.

Subjects
Coronary angiography, Male, medicine.medical_specialty, hypertension, medicine.medical_treatment, Heart Ventricles, Coronary Angiography, Multimodal Imaging, Diagnosis, Differential, Aneurysm, Imaging, Three-Dimensional, Internal medicine, medicine, drug-eluting stent, Humans, Radiology, Nuclear Medicine and imaging, pulmonary edema, Heart Aneurysm, Aged, business.industry, Pulmonary edema, medicine.disease, Ventricular aneurysm, Ventricular assist device, Cardiology, aneurysm, Heart-Assist Devices, coronary angiography, Cardiology and Cardiovascular Medicine, business, Tomography, X-Ray Computed
Published
2020

42. First reorganization in Europe of a regional cardiac surgery system to deal with the coronavirus-2019 pandemic

Author

Alessandro Frigiola, Giovanni Troise, Elena Bottinelli, Benedetto Del Forno, Maurizio Roberto, Alessandro Giamberti, Fabrizio Monaco, Luca Merlino, Giulio Pompilio, Michele De Bonis, Ottavio Alfieri, Francesco Alamanni, Alessandro Triboldi, Lorenzo Menicanti, Igor Belluschi, Fulvio Edoardo Odinolfi, Alessandro Castiglioni, Germano Di Credico, Gianluca Polvani, Alberto Ambrosio, Giulio Melisurgo, Carlo De Vincentiis, Anna Mara Scandroglio, Belluschi, I., De Bonis, M., Alfieri, O., Del Forno, B., Alamanni, F., Polvani, G., Pompilio, G., Roberto, M., Merlino, L. G., Troise, G., Triboldi, A., Di Credico, G., Odinolfi, F. E., Giamberti, A., Frigiola, A., De Vincentiis, C., Menicanti, L., Monaco, F., Melisurgo, G., Scandroglio, A. M., Ambrosio, A., Bottinelli, E., and Castiglioni, A.

Subjects
Pulmonary and Respiratory Medicine, Adult, Male, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pneumonia, Viral, medicine.disease_cause, Severe Acute Respiratory Syndrome, Pandemic, medicine, Humans, Elective surgery, Intensive care medicine, Pandemics, Coronavirus, Aged, Cross Infection, Infection Control, Coronavirus disease 2019, business.industry, COVID-19, Thoracic Surgery, General Medicine, Cardiac surgery, Middle Aged, Organizational Innovation, Editorial, Italy, Elective Surgical Procedures, Surgery, Female, business, Cardiology and Cardiovascular Medicine, Coronavirus Infections
Published
2020

43. ST-Segment-Elevation Myocardial Infarction During COVID-19 Pandemic: Insights From a Regional Public Service Healthcare Hub

Author

Matteo Pagnesi, Alessandro Beneduce, Luca Baldetti, Francesco Calvo, Eustachio Agricola, Stefania Sacchi, Giovanni Landoni, Giulio Falasconi, Fabio Ciceri, Alberto Zangrillo, Mario Gramegna, Luigi Pannone, Alberto Cappelletti, Paolo G. Camici, Silvia Ajello, Giulio Melisurgo, Anna Mara Scandroglio, Vittorio Pazzanese, Francesco Moroni, Gramegna, M., Baldetti, L., Beneduce, A., Pannone, L., Falasconi, G., Calvo, F., Pazzanese, V., Sacchi, S., Pagnesi, M., Moroni, F., Ajello, S., Melisurgo, G., Agricola, E., Camici, P. G., Scandroglio, A. M., Landoni, G., Ciceri, F., Zangrillo, A., and Cappelletti, A. M.

Subjects
Male, Acute coronary syndrome, Coronavirus disease 2019 (COVID-19), Pneumonia, Viral, coronavirus, acute coronary syndrome, Betacoronavirus, Percutaneous Coronary Intervention, Health care, Pandemic, medicine, ST segment, Humans, Myocardial infarction, Prospective Studies, Registries, Pandemics, Aged, SARS-CoV-2, business.industry, pandemic, COVID-19, Outbreak, Middle Aged, medicine.disease, myocardial infarction, Italy, Public Health Practice, ST Elevation Myocardial Infarction, Public service, Female, Medical emergency, Cardiology and Cardiovascular Medicine, business, Coronavirus Infections, severe acute respiratory syndrome coronavirus 2
Abstract

Background: Coronavirus disease 2019 (COVID-19) pandemic has led to a fast and radical transformation in social, economic, and healthcare networks. COVID-19 outbreak may thus have profound indirect consequences on clinical presentation and management of patients with ST-segment–elevation myocardial infarction (STEMI). Aim of this study was to assess clinical features of patients with STEMI during COVID-19 pandemic. Methods: This single-center, prospective study from a regional public service healthcare hub in Milan included all consecutive patients with STEMI admitted to our institute from February 21 to April 1, 2020 (during COVID-19 pandemic). These patients were compared with a historical cohort of patients admitted for STEMI during the analogous time period (February 21 to April 1) in 2018 and 2019, in terms of time from symptoms onset to hospital admission, clinical characteristics, and in-hospital outcomes. Results: A total of 26 patients were admitted for STEMI during the study period, and 7 (26.9%) of these patients tested positive for severe acute respiratory syndrome coronavirus 2. On admission, medical therapy, including angiotensin-converting enzyme inhibitors and angiotensin receptor blockers use, was similar between cohorts. Median (interquartile range) time from symptoms onset to hospital admission was significantly longer in 2020 as compared to the historical cohort (15.0 [2.0–48.0] versus 2.0 [1.0–3.0] hours; P P P =0.06). In-hospital death, thromboembolism, mechanical ventilation, or hemodynamic decompensation needing inotropic or mechanical support were similar between years. Conclusions: These preliminary results from a cardiovascular regional public service healthcare hub demonstrate a significantly longer time from symptoms onset to hospital admission among patients with STEMI during COVID-19 pandemic compared with the same time period in the previous 2 years.

Published
2020

44. Levosimendan for Hemodynamic Support after Cardiac Surgery

Author

Federico Pappalardo, Tatiana S. Zabelina, Vladimir A. Boboshko, Antonio Pisano, Fabio Guarracino, Vladimir V. Lomivorotov, Alessandro Belletti, Pietro Bertini, Vadim Pasyuga, Marcello Fonseca Salgado-Filho, Rosetta Lobreglio, Rosalba Lembo, Maria G Michienzi, Tiziana Bove, Anna Mara Scandroglio, Gabriele Alvaro, Massimo Baiocchi, Marat N Abubakirov, Bruno Amantea, Giovanni Landoni, Maria Grazia Calabrò, Luca Brazzi, Rinaldo Bellomo, Dmitriy L Shukevich, Evgeny Grigoryev, Alberto Zangrillo, Luigi Verniero, Valery Likhvantsev, Alessandro Bianchi, Fabrizio Monaco, Landoni, Giovanni, Lomivorotov, Vladimir V., Alvaro, Gabriele, Lobreglio, Rosetta, Pisano, Antonio, Guarracino, Fabio, Calabrò, Maria G., Grigoryev, Evgeny V., Likhvantsev, Valery V., Salgado Filho, Marcello F., Bianchi, Alessandro, Pasyuga, Vadim V., Baiocchi, Massimo, Pappalardo, Federico, Monaco, Fabrizio, Boboshko, Vladimir A., Abubakirov, Marat N., Amantea, Bruno, Lembo, Rosalba, Brazzi, Luca, Verniero, Luigi, Bertini, Pietro, Scandroglio, Anna M., Bove, Tiziana, Belletti, Alessandro, Michienzi, Maria G., Shukevich, Dmitriy L., Zabelina, Tatiana S., Bellomo, Rinaldo, and Zangrillo, Alberto

Subjects
Male, Cardiac output, Cardiac Output, Low, Hemodynamics, 030204 cardiovascular system & hematology, law.invention, Postoperative Complications, 0302 clinical medicine, Randomized controlled trial, law, Cardiac Surgical Procedure, Infusions, Intravenou, Treatment Failure, Cardiac Output, Respiration, Medicine (all), General Medicine, Middle Aged, Hydrazone, Intensive care unit, Aged, Cardiotonic Agents, Double-Blind Method, Female, Humans, Hydrazones, Infusions, Intravenous, Length of Stay, Perioperative Period, Pyridazines, Respiration, Artificial, Stroke Volume, Cardiac Surgical Procedures, Mortality, Low, Cardiac surgery, Artificial, Cardiology, Intravenous, Pyridazine, Human, medicine.drug, Infusions, medicine.medical_specialty, Placebo, 03 medical and health sciences, Internal medicine, medicine, Cardiotonic Agent, Hemodynamic, business.industry, 030208 emergency & critical care medicine, Perioperative, Levosimendan, Postoperative Complication, business
Abstract

BACKGROUND Acute left ventricular dysfunction is a major complication of cardiac surgery and is associated with increased mortality. Meta-analyses of small trials suggest that levosimendan may result in a higher rate of survival among patients undergoing cardiac surgery. METHODS We conducted a multicenter, randomized, double-blind, placebo-controlled trial involving patients in whom perioperative hemodynamic support was indicated after cardiac surgery, according to prespecified criteria. Patients were randomly assigned to receive levosimendan (in a continuous infusion at a dose of 0.025 to 0.2 μg per kilogram of body weight per minute) or placebo, for up to 48 hours or until discharge from the intensive care unit (ICU), in addition to standard care. The primary outcome was 30-day mortality. RESULTS The trial was stopped for futility after 506 patients were enrolled. A total of 248 patients were assigned to receive levosimendan and 258 to receive placebo. There was no significant difference in 30-day mortality between the levosimendan group and the placebo group (32 patients [12.9%] and 33 patients [12.8%], respectively; absolute risk difference, 0.1 percentage points; 95% confidence interval [CI], -5.7 to 5.9; P = 0.97). There were no significant differences between the levosimendan group and the placebo group in the durations of mechanical ventilation (median, 19 hours and 21 hours, respectively; median difference, -2 hours; 95% CI, -5 to 1; P = 0.48), ICU stay (median, 72 hours and 84 hours, respectively; median difference, -12 hours; 95% CI, -21 to 2; P = 0.09), and hospital stay (median, 14 days and 14 days, respectively; median difference, 0 days; 95% CI, -1 to 2; P = 0.39). There was no significant difference between the levosimendan group and the placebo group in rates of hypotension or cardiac arrhythmias. CONCLUSIONS In patients who required perioperative hemodynamic support after cardiac surgery, low-dose levosimendan in addition to standard care did not result in lower 30-day mortality than placebo. (Funded by the Italian Ministry of Health; CHEETAH ClinicalTrials.gov number, NCT00994825.).

Published
2017

45. Clinical significance of a new Q wave after cardiac surgery

Author

Crescenzi, Giuseppe, Bove, Tiziana, Pappalardo, Federico, Scandroglio, Anna M., Landoni, Giovanni, Aletti, Giacomo, Zangrillo, Alberto, and Alfieri, Ottavio

Subjects
*ELECTROCARDIOGRAPHY, *BIOMARKERS, *MYOCARDIAL infarction, CARDIAC surgery patients
Abstract

Objective: The appearance of new Q waves on the electrocardiogram (ECG) after cardiac surgery has been traditionally considered a sign of major myocardial tissue damage. The aim of this study was to investigate the clinical significance of new Q waves appearing following cardiac surgery and to correlate them with the release of myocardial cell damage biomarkers. Methods: 206 consecutive patients undergoing cardiac surgery were prospectively evaluated. A 12 lead ECG was recorded and cardiac troponin I and creatinekinase subfraction MB assayed the day before surgery, on arrival at the intensive care Unit. 4 and 18 h postoperatively and every morning until the fifth postoperative day. Results: The incidence of new Q waves was 7.3%. Patients with isolated ECG findings had an uneventful postoperative course; on the contrary, when ECG changes were coupled with the release of myocardial necrosis biomarkers, patients had a complicated postoperative course. Conclusions: The association of a new Q wave and high levels of myocardial necrosis biomarkers is strongly associated with postoperative cardiac events. On the contrary, the isolated appearance of a new Q wave has no impact on the postoperative cardiac outcome. [Copyright &y& Elsevier]

Published
2004
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46. Early predictors of clinical outcomes of COVID-19 outbreak in Milan, Italy

Author

Maria Fazio, Giovanni Landoni, Eleonora Bossi, Stefano Franchini, Sergio Colombo, Luigi Beretta, Patrizia Rovere-Querini, Michele Carlucci, Anna Maria Scandroglio, Lorenzo Dagna, Andrea Poli, Gianvito Martino, Fabio Ciceri, Antonella Castagna, Alberto Ambrosio, Carlo Signorelli, Giacomo Monti, Caterina Conte, Massimo Clementi, Adriano Lazzarin, Francesco De Cobelli, Annalisa Ruggeri, Carlo Martinenghi, Cristina Tresoldi, Emanuele Bosi, Paolo Scarpellini, Efgeny Fominskiy, Alberto Zangrillo, Laura Galli, Moreno Tresoldi, Rebecca De Lorenzo, Massimo Locatelli, Marzia Spessot, Ciceri, F., Castagna, A., Rovere-Querini, P., De Cobelli, F., Ruggeri, A., Galli, L., Conte, C., De Lorenzo, R., Poli, A., Ambrosio, A., Signorelli, C., Bossi, E., Fazio, M., Tresoldi, C., Colombo, S., Monti, G., Fominskiy, E., Franchini, S., Spessot, M., Martinenghi, C., Carlucci, M., Beretta, L., Scandroglio, A. M., Clementi, M., Locatelli, M., Tresoldi, M., Scarpellini, P., Martino, G., Bosi, E., Dagna, L., Lazzarin, A., Landoni, G., and Zangrillo, A.

Subjects
Male, 0301 basic medicine, ARDS, RALE score, Coronary Disease, Comorbidity, Disease, Severe Acute Respiratory Syndrome, Severity of Illness Index, Infectious Disease Incubation Period, Coronary artery disease, 0302 clinical medicine, Risk Factors, Immunology and Allergy, Lymphocytes, Age Factors, Middle Aged, Hospitalization, Italy, Hypertension, Female, Coronavirus Infections, Infection, medicine.medical_specialty, Pneumonia, Viral, Immunology, Pulmonary Edema, Article, Betacoronavirus, 03 medical and health sciences, Internal medicine, Diabetes mellitus, Severity of illness, Diabetes Mellitus, medicine, Humans, Lymphocyte Count, Pandemics, Survival analysis, Aged, SARS-CoV-2, business.industry, COVID-19, Outbreak, medicine.disease, Survival Analysis, 030104 developmental biology, Kidney Failure, Chronic, business, 030215 immunology
Abstract

Background National health-system hospitals of Lombardy faced a heavy burden of admissions for acute respiratory distress syndromes associated with coronavirus disease (COVID-19). Data on patients of European origin affected by COVID-19 are limited. Methods All consecutive patients aged ≥18 years, coming from North-East of Milan's province and admitted at San Raffaele Hospital with COVID-19, between February 25th and March 24th, were reported, all patients were followed for at least one month. Clinical and radiological features at admission and predictors of clinical outcomes were evaluated. Results Of the 500 patients admitted to the Emergency Unit, 410 patients were hospitalized and analyzed: median age was 65 (IQR 56–75) years, and the majority of patients were males (72.9%). Median (IQR) days from COVID-19 symptoms onset was 8 (5–11) days. At hospital admission, fever (≥ 37.5 °C) was present in 67.5% of patients. Median oxygen saturation (SpO2) was 93% (range 60–99), with median PaO2/FiO2 ratio, 267 (IQR 184–314). Median Radiographic Assessment of Lung Edema (RALE) score was 9 (IQR 4–16). More than half of the patients (56.3%) had comorbidities, with hypertension, coronary heart disease, diabetes and chronic kidney failure being the most common. The probability of overall survival at day 28 was 66%. Multivariable analysis showed older age, coronary artery disease, cancer, low lymphocyte count and high RALE score as factors independently associated with an increased risk of mortality. Conclusion In a large cohort of COVID-19 patients of European origin, main risk factors for mortality were older age, comorbidities, low lymphocyte count and high RALE.

Published
2020

47. Effect of Levosimendan on Renal Outcome in Cardiac Surgery Patients With Chronic Kidney Disease and Perioperative Cardiovascular Dysfunction: A Substudy of a Multicenter Randomized Trial

Author

Rosalba Lembo, Evgeny Grigoryev, Anna Mara Scandroglio, Vladimir A. Boboshko, Gabriele Alvaro, Marco Comis, Fabrizio Monaco, Antonio Pisano, Fabio Guarracino, Alessandro Belletti, Alberto Zangrillo, Gianluca Paternoster, Valery V. Likhvantsev, Vladimir V. Lomivorotov, Maria Grazia Calabrò, Vadim Pasyuga, Paolo Navalesi, Luca Brazzi, Samuele Frassoni, Tiziana Bove, Zangrillo, A, Alvaro, G, Belletti, A, Pisano, A, Brazzi, L, Calabro, M, Guarracino, F, Bove, T, Grigoryev, E, Monaco, F, Boboshko, V, Likhvantsev, V, Scandroglio, A, Paternoster, G, Lembo, R, Frassoni, S, Comis, M, Pasyuga, V, Navalesi, P, Lomivorotov, V, Zangrillo, Alberto, Alvaro, Gabriele, Belletti, Alessandro, Pisano, Antonio, Brazzi, Luca, Calabrò, Maria G., Guarracino, Fabio, Bove, Tiziana, Grigoryev, Evgeny V., Monaco, Fabrizio, Boboshko, Vladimir A., Likhvantsev, Valery V., Scandroglio, Anna M., Paternoster, Gianluca, Lembo, Rosalba, Frassoni, Samuele, Comis, Marco, Pasyuga, Vadim V., Navalesi, Paolo, and Lomivorotov, Vladimir V.

Subjects
Male, Heart Valve Diseases, inotropes, 030204 cardiovascular system & hematology, Russia, Postoperative Complications, 0302 clinical medicine, Cardiac Surgical Procedure, low cardiac output syndrome, education.field_of_study, Incidence, Acute kidney injury, Middle Aged, hemodynamic support, Cardiac surgery, Heart Valve Disease, Treatment Outcome, Italy, acute kidney injury, Anesthesia, Mitral Valve, inotrope, Female, Cardiology and Cardiovascular Medicine, Brazil, cardiac surgery, Glomerular Filtration Rate, Human, medicine.drug, medicine.medical_specialty, Cardiotonic Agents, Population, Placebo, 03 medical and health sciences, levosimendan, Double-Blind Method, Intensive care, medicine, Humans, Cardiotonic Agent, Cardiac Surgical Procedures, Renal Insufficiency, Chronic, Perioperative Period, education, Simendan, Aged, Dose-Response Relationship, Drug, business.industry, 030208 emergency & critical care medicine, Levosimendan, Perioperative, medicine.disease, chronic kidney disease, mitral valve surgery, Anesthesiology and Pain Medicine, Postoperative Complication, business, Kidney disease
Abstract

Objective: Acute kidney injury (AKI) occurs frequently after cardiac surgery. Levosimendan might reduce the incidence of AKI in patients undergoing cardiac surgery. The authors investigated whether levosimendan administration could reduce AKI incidence in a high-risk cardiac surgical population. Design: Post hoc analysis of a multicenter randomized trial. Setting: Cardiac surgery operating rooms and intensive care units of 14 centers in 3 countries. Participants: The study comprised 90 patients who underwent mitral valve surgery with an estimated glomerular filtration rate

Published
2018

48. Extracorporeal membrane oxygenation to resuscitate a 14-year-old boy after 43 min drowning

Author

Tiziana Bove, Alberto Zangrillo, Carmine D. Votta, A. M. Scandroglio, R. Giacomello, M. G. Calabrò, Giovanni Landoni, F. Pappalardo, Scandroglio, A. M., Bove, T., Calabrò, M. G., Votta, C. D., Pappalardo, Federico, Giacomello, R., Landoni, Giovanni, and Zangrillo, Alberto

Subjects
medicine.medical_specialty, Injury control, business.industry, Accident prevention, medicine.medical_treatment, Poison control, 030208 emergency & critical care medicine, Electric countershock, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Surgery, 03 medical and health sciences, 0302 clinical medicine, CARDIAC THERAPY, Extracorporeal membrane oxygenation, Medicine, business
Published
2018

49. Methicillin-resistant staphylococcus species in a cardiac surgical intensive care unit

Author

Giovanni Marino, Maria Grazia Calabrò, Massimo Zambon, Fabrizio Monaco, Marco Costantini, Anna Mara Scandroglio, Roberto Ascari, Tiziana Bove, Giovanni Landoni, Alberto Zangrillo, Daiana Taddeo, Federico Pappalardo, Marina Pieri, Pieri, M, Landoni, G, Zambon, M, Taddeo, D, Ascari, R, Costantini, M, Monaco, F, Scandroglio, A, Pappalardo, F, Bove, T, Calabro, M, Marino, G, Zangrillo, A, Pieri, M., Landoni, G., Zambon, M., Taddeo, D., Ascari, R., Costantini, M., Monaco, F., Scandroglio, A. M., Pappalardo, F., Bove, T., Calabro, M. G., Marino, G., and Zangrillo, A.

Subjects
medicine.medical_specialty, Isolation (health care), Cardiac anaesthesia, Methicillin-Resistant Staphylococcus Aureu, Critical Care and Intensive Care Medicine, medicine.disease_cause, Infections, Methicillin-Resistant Staphylococcus Aureus, Internal medicine, Intensive care, Epidemiology, medicine, Infection control, Mortality, Intensive care medicine, business.industry, Odds ratio, Perioperative, Cardiac surgery, Methicillin-resistant Staphylococcus aureus, Emergency Medicine, Infection, business
Abstract

Objective. Multi-drug resistant bacterial infections, in particular when Methicillin-Resistant Staphylococcus Aureus (MRSA) is involved, have become a relevant problem in both general and specialized intensive care units. The aim of this study was to identify the epidemiology of MRSA infections in a Cardiac Surgical Intensive Care Unit, to assess their impact on mortality and to identify predictors of MRSA infection and mortality in this population. Design and settings. A 7-year observational study in a cardiac surgery teaching center. Participants. Eight thousand, one hundred and sixty-two microbiological samples were obtained from 7,313 patients who underwent cardiac surgery in the study period. Interventions. None. Variables of interest and main results. Twenty-eight patients (0.38%) had MRSA infection. The most frequent site of MRSA isolation was from bronchoalveolar samples. Hospital mortality was 50% in patients with MRSA infection and 2% in patients without MRSA infection (p

Published
2015

50. Extracorporeal membrane oxygenation to resuscitate a 14-year-old boy after 43min drowning.

Author

Scandroglio AM, Bove T, Calabrò MG, Votta CD, Pappalardo F, Giacomello R, Landoni G, and Zangrillo A

Subjects
Adolescent, Arrhythmias, Cardiac etiology, Arrhythmias, Cardiac therapy, Cardiotonic Agents therapeutic use, Combined Modality Therapy, Electric Countershock, Heart Arrest etiology, Heart Arrest therapy, Humans, Hypothermia complications, Hypothermia therapy, Intra-Aortic Balloon Pumping, Italy, Male, Extracorporeal Membrane Oxygenation, Near Drowning therapy, Resuscitation methods
Published
2018
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