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luciano gattinoni

John G Laffey, Giacomo Bellani, Tài Pham, Eddy Fan, Fabiana Madotto, Ednan K Bajwa, Laurent Brochard, Kevin Clarkson, Andres Esteban, Luciano Gattinoni, Frank van Haren, Leo M Heunks, Kiyoyasu Kurahashi, Jon Henrik Laake, Anders Larsson, Daniel F McAuley, Lia McNamee, Nicolas Nin, Haibo Qiu, Marco Ranieri, Gordon D Rubenfeld, B Taylor Thompson, Hermann Wrigge, Arthur S Slutsky, Antonio Pesenti
PURPOSE: To improve the outcome of the acute respiratory distress syndrome (ARDS), one needs to identify potentially modifiable factors associated with mortality. METHODS: The large observational study to understand the global impact of severe acute respiratory failure (LUNG SAFE) was an international, multicenter, prospective cohort study of patients with severe respiratory failure, conducted in the winter of 2014 in a convenience sample of 459 ICUs from 50 countries across five continents...
October 18, 2016: Intensive Care Medicine
Massimo Cressoni, Chiara Chiurazzi, Luciano Gattinoni
No abstract text is available yet for this article.
November 2016: Anesthesiology
Giacomo Bellani, John G Laffey, Tài Pham, Fabiana Madotto, Eddy Fan, Laurent Brochard, Andres Esteban, Luciano Gattinoni, Vesna Bumbasirevic, Lise Piquilloud, Frank van Haren, Anders Larsson, Daniel F McAuley, Philippe R Bauer, Yaseen M Arabi, Marco Ranieri, Massimo Antonelli, Gordon D Rubenfeld, B Taylor Thompson, Hermann Wrigge, Arthur S Slutsky, Antonio Pesenti
BACKGROUND: Non-invasive ventilation (NIV) is increasingly used in patients with Acute Respiratory Distress Syndrome (ARDS). Whether, during NIV, the categorization of ARDS severity based on the PaO2/FiO2 Berlin criteria is useful is unknown. The evidence supporting NIV use in patients with ARDS remains relatively sparse. METHODS: The Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study described the management of patients with ARDS...
October 18, 2016: American Journal of Respiratory and Critical Care Medicine
Jean-Louis Vincent, Arthur S Slutsky, Luciano Gattinoni
No abstract text is available yet for this article.
October 4, 2016: Intensive Care Medicine
Luciano Gattinoni, Tommaso Tonetti, Michael Quintel
No abstract text is available yet for this article.
September 12, 2016: Intensive Care Medicine
Michael Quintel, Tommaso Tonetti, Luciano Gattinoni
No abstract text is available yet for this article.
August 11, 2016: Intensive Care Medicine
Claudia Moeller, Carolin Fleischmann, Daniel Thomas-Rueddel, Vlasislav Vlasakov, Bram Rochwerg, Philip Theurer, Luciano Gattinoni, Konrad Reinhart, Christiane S Hartog
Gelatin is a widely used synthetic colloid resuscitation fluid. We undertook a systematic review and meta-analysis of adverse effects in randomized and nonrandomized studies comparing gelatin with crystalloid or albumin for treatment of hypovolemia. Multiple databases were searched systematically without language restrictions until August 2015. We assessed risk of bias of individual studies and certainty in evidence assessment by the Grading of Recommendations Assessment, Development, and Evaluation approach...
October 2016: Journal of Critical Care
Luca Zazzeron, Luciano Gattinoni, Pietro Caironi
PURPOSE OF REVIEW: The review focuses on fluid resuscitation of critically ill patients with either colloid or crystalloid solutions. RECENT FINDINGS: In healthy patients, the volume expanding effect of colloids is greater than that of crystalloids. However, in critically ill patients, a similar amount of crystalloids and colloids is required for fluid resuscitation, suggesting a lower efficiency of colloids when capillary permeability is increased, and endothelial glycocalyx disrupted...
October 2016: Current Opinion in Critical Care
Claude Guerin, Luciano Gattinoni
No abstract text is available yet for this article.
October 2016: Intensive Care Medicine
Luca Zazzeron, Davide Ottolina, Eleonora Scotti, Michele Ferrari, Paola Bruzzone, Silvio Sibilla, Cristina Marenghi, Luciano Gattinoni, Pietro Caironi
BACKGROUND: Although the loop-diuretic furosemide is widely employed in critically ill patients with known long-term effects on plasma electrolytes, accurate data describing its acute effects on renal electrolyte handling and the generation of plasma electrolyte alterations are lacking. We hypothesized that the long-term effects of furosemide on plasma electrolytes and acid-base depend on its immediate effects on electrolyte excretion rate and patient clinical baseline characteristics...
December 2016: Annals of Intensive Care
Thomas Langer, Alessandro Santini, Nicola Bottino, Stefania Crotti, Andriy I Batchinsky, Antonio Pesenti, Luciano Gattinoni
Venovenous extracorporeal membrane oxygenation (vv-ECMO) has been classically employed as a rescue therapy for patients with respiratory failure not treatable with conventional mechanical ventilation alone. In recent years, however, the timing of ECMO initiation has been readdressed and ECMO is often started earlier in the time course of respiratory failure. Furthermore, some centers are starting to use ECMO as a first line of treatment, i.e., as an alternative to invasive mechanical ventilation in awake, non-intubated, spontaneously breathing patients with respiratory failure ("awake" ECMO)...
June 30, 2016: Critical Care: the Official Journal of the Critical Care Forum
Tommaso Mauri, Takeshi Yoshida, Giacomo Bellani, Ewan C Goligher, Guillaume Carteaux, Nuttapol Rittayamai, Francesco Mojoli, Davide Chiumello, Lise Piquilloud, Salvatore Grasso, Amal Jubran, Franco Laghi, Sheldon Magder, Antonio Pesenti, Stephen Loring, Luciano Gattinoni, Daniel Talmor, Lluis Blanch, Marcelo Amato, Lu Chen, Laurent Brochard, Jordi Mancebo
PURPOSE: Esophageal pressure (Pes) is a minimally invasive advanced respiratory monitoring method with the potential to guide management of ventilation support and enhance specific diagnoses in acute respiratory failure patients. To date, the use of Pes in the clinical setting is limited, and it is often seen as a research tool only. METHODS: This is a review of the relevant technical, physiological and clinical details that support the clinical utility of Pes. RESULTS: After appropriately positioning of the esophageal balloon, Pes monitoring allows titration of controlled and assisted mechanical ventilation to achieve personalized protective settings and the desired level of patient effort from the acute phase through to weaning...
September 2016: Intensive Care Medicine
Luciano Gattinoni, Eleonora Carlesso, Davide Chiumello, Massimo Cressoni
No abstract text is available yet for this article.
June 1, 2016: American Journal of Respiratory and Critical Care Medicine
Alessandro Protti, Paolo Properzi, Sandra Magnoni, Alessandro Santini, Thomas Langer, Silvia Guenzani, Stefano Ferrero, Giulia Bassani, Nino Stocchetti, Luciano Gattinoni
Lactic acidosis during metformin intoxication is classically mainly attributed to diminished lactate clearance through liver gluconeogenesis. Here we studied 6 healthy, sedated and mechanically ventilated pigs to clarify whether high dose of metformin also increases skeletal muscle lactate production. Each animal had two microdialysis catheters inserted in gluteus muscles, one per side. One catheter was infused with saline (control) while the other one was infused with metformin diluted in saline (1M), both at a rate of 0...
July 25, 2016: Toxicology Letters
Luciano Gattinoni
Partial extracorporeal CO2 removal allows a decreasing tidal volume without respiratory acidosis in patients with acute respiratory distress syndrome. This, however, may be associated with worsening hypoxemia, due to several mechanisms, such as gravitational and reabsorption atelectasis, due to a decrease in mean airway pressure and a critically low ventilation-perfusion ratio, respectively. In addition, an imbalance between alveolar and artificial lung partial pressures of nitrogen may accelerate the process...
2016: Critical Care: the Official Journal of the Critical Care Forum
Alessandro Protti, Tommaso Maraffi, Marta Milesi, Emiliano Votta, Alessandro Santini, Paola Pugni, Davide T Andreis, Francesco Nicosia, Emanuela Zannin, Stefano Gatti, Valentina Vaira, Stefano Ferrero, Luciano Gattinoni
OBJECTIVE: Lungs behave as viscoelastic polymers. Harms of mechanical ventilation could then depend on not only amplitude (strain) but also velocity (strain rate) of lung deformation. Herein, we tested this hypothesis. DESIGN: Laboratory investigation. SETTING: Animal unit. SUBJECTS: Thirty healthy piglets. INTERVENTIONS: Two groups of animals were ventilated for 54 hours with matched lung strains (ratio between tidal volume and functional residual capacity) but different lung strain rates (ratio between strain and inspiratory time)...
September 2016: Critical Care Medicine
Luciano Gattinoni, Michael Quintel
The Berlin definition criteria applied at positive end-expiratory pressure (PEEP) 5 cm H2O reasonably predict lung edema and recruitabilty. To maintain viable gas exchange, the mechanical ventilation becomes progressively more risky going from mild to severe acute respiratory distress syndrome (ARDS). Tidal volume, driving pressure, flow, and respiratory rate have been identified as causes of ventilation-induced lung injury. Taken together, they represent the mechanical power applied to the lung parenchyma...
2016: Critical Care: the Official Journal of the Critical Care Forum
Alexandre Mebazaa, Pierre François Laterre, James A Russell, Andreas Bergmann, Luciano Gattinoni, Etienne Gayat, Michael O Harhay, Oliver Hartmann, Frauke Hein, Anne Louise Kjolbye, Matthieu Legrand, Roger J Lewis, John C Marshall, Gernot Marx, Peter Radermacher, Mathias Schroedter, Paul Scigalla, Wendy Gattis Stough, Joachim Struck, Greet Van den Berghe, Mehmet Birhan Yilmaz, Derek C Angus
Substantial attention and resources have been directed to improving outcomes of patients with critical illnesses, in particular sepsis, but all recent clinical trials testing various interventions or strategies have failed to detect a robust benefit on mortality. Acute heart failure is also a critical illness, and although the underlying etiologies differ, acute heart failure and sepsis are critical care illnesses that have a high mortality in which clinical trials have been difficult to conduct and have not yielded effective treatments...
2016: Journal of Intensive Care
Antonio Pesenti, Guido Musch, Daniel Lichtenstein, Francesco Mojoli, Marcelo B P Amato, Gilda Cinnella, Luciano Gattinoni, Michael Quintel
PURPOSE: Imaging has become increasingly important across medical specialties for diagnostic, monitoring, and investigative purposes in acute respiratory distress syndrome (ARDS). METHODS: This review addresses the use of imaging techniques for the diagnosis and management of ARDS as well as gaining knowledge about its pathogenesis and pathophysiology. The techniques described in this article are computed tomography, positron emission tomography, and two easily accessible imaging techniques available at the bedside-ultrasound and electrical impedance tomography (EIT)...
May 2016: Intensive Care Medicine
Eddy Fan, Luciano Gattinoni, Alain Combes, Matthieu Schmidt, Giles Peek, Dan Brodie, Thomas Muller, Andrea Morelli, V Marco Ranieri, Antonio Pesenti, Laurent Brochard, Carol Hodgson, Cecile Van Kiersbilck, Antoine Roch, Michael Quintel, Laurent Papazian
Despite expensive life-sustaining interventions delivered in the ICU, mortality and morbidity in patients with acute respiratory failure (ARF) remain unacceptably high. Extracorporeal membrane oxygenation (ECMO) has emerged as a promising intervention that may provide more efficacious supportive care to these patients. Improvements in technology have made ECMO safer and easier to use, allowing for the potential of more widespread application in patients with ARF. A greater appreciation of the complications associated with the placement of an artificial airway and mechanical ventilation has led clinicians and researchers to seek viable alternatives to providing supportive care in these patients...
May 2016: Intensive Care Medicine
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