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https://www.readbyqxmd.com/read/29907273/extracorporeal-gas-exchange
#1
REVIEW
Onnen Moerer, Francesco Vasques, Eleonora Duscio, Francesco Cipulli, Federica Romitti, Luciano Gattinoni, Michael Quintel
Extracorporeal gas exchange is increasingly used for various indications. Among these are refractory acute respiratory failure, including the acute respiratory distress syndrome (ARDS), and the avoidance of ventilator-induced lung injury (VILI) by enabling lung-protective ventilation. Additionally, extracorporeal gas exchange allows the treatment of hypercapnic respiratory failure while helping to unload the respiratory muscles and avoid intubation and invasive ventilation, as well as facilitating weaning from the ventilator...
July 2018: Critical Care Clinics
https://www.readbyqxmd.com/read/29907269/determinants-and-prevention-of-ventilator-induced-lung-injury
#2
REVIEW
Francesco Vasques, Eleonora Duscio, Francesco Cipulli, Federica Romitti, Michael Quintel, Luciano Gattinoni
Ventilator-induced lung injury develops from interactions between the lung parenchyma and applied mechanical power. In acute respiratory distress syndrome, the lung is smaller size with an inhomogeneous structure. The same mechanical force applied on a reduced parenchyma would produce volutrauma; the concentration of mechanical forces at inhomogeneous interfaces produces atelectrauma. Higher positive end-expiratory pressures favor volutrauma and reduce atelectrauma; lower values do the opposite. Volutrauma and atelectrauma harms and benefits, however, seem to be equivalent at 5 to 15 cm H2 O...
July 2018: Critical Care Clinics
https://www.readbyqxmd.com/read/29881990/antipathy-against-sdd-is-justified-we-are-not-sure
#3
EDITORIAL
Michael Quintel, Francesco Vasques, Luciano Gattinoni
No abstract text is available yet for this article.
June 7, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29808974/inflammation-and-primary-graft-dysfunction-after-lung-transplantation-ct-pet-findings
#4
Miriam Gotti, Davide Chiumello, Massimo Cressoni, Mariateresa Guanziroli, Matteo Brioni, Bijan Safaee Fakhr, Chiara Chiurazzi, Andrea Colombo, Dario Massari, Ilaria Algieri, Caterina Lonati, Paolo Cadringher, Paolo Taccone, Marta Pizzocri, Jacopo Fumagalli, Lorenzo Rosso, Alessandro Palleschi, Riccardo Benti, Felicia Zito, Franco Valenza, Luciano Gattinoni
BACKGROUND: The leading cause of early mortality after lung transplantation is Primary Graft Dysfunction (PGD). We assessed the lung inflammation, inflation status and inhomogeneities after lung transplantation. Our purpose was to investigate the possible differences between patients who did or did not develop PGD. METHODS: We designed a prospective observational study enrolling patients who underwent a (CT-PET) study within 1 week after lung transplantation. Twenty-four patients (10 after double- and 14 after single-lung) were enrolled...
May 28, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29787743/persistence-of-central-venous-oxygen-desaturation-during-early-sepsis-is-associated-with-higher-mortality-a-retrospective-analysis-of-the-albios-trial
#5
Alessandro Protti, Serge Masson, Roberto Latini, Roberto Fumagalli, Marilena Romero, Carla Pessina, Giovanni Pasetti, Gianni Tognoni, Antonio Pesenti, Luciano Gattinoni, Pietro Caironi
BACKGROUND: Relevance of low (<70%) central venous oxygen saturation (ScvO2 ) during early sepsis has been recently questioned by three negative trials (ProCESS, ARISE and ProMISe) on early goal-directed therapy (EGDT). However, subjects included in those trials had ScvO2 at enrolment as high as 71±13%, 73±11% and 70±12%. Herein we assessed the association between ScvO2 <70% at six hours and 90-day mortality in subjects enrolled in the ALBIOS trial, focusing on those with initial ScvO2 <70%...
May 19, 2018: Chest
https://www.readbyqxmd.com/read/29746315/antithrombin-during-extracorporeal-membrane-oxygenation-in-adults-national-survey-and-retrospective-analysis
#6
Giacomo E Iapichino, Alessandro Protti, Davide T Andreis, Mauro Panigada, Andrea Artoni, Cristina Novembrino, Antonio Pesenti, Luciano Gattinoni
The impact of antithrombin replacement during extracorporeal membrane oxygenation (ECMO) in adults remains unclear. This work comprises a survey, showing that antithrombin is routinely supplemented in many Italian ECMO-Centers, and a retrospective analysis on 66 adults treated with veno-venous ECMO and unfractionated heparin at our Institution. Twenty-four to 72 h after the beginning of ECMO, antithrombin activity was ≤70% in 47/66 subjects and activated partial thromboplastin time (aPTT) ratio was <1...
May 8, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29745822/last-word-on-viewpoint-looking-beyond-macrovenitlatory-parameters-and-rethinking-ventilator-induced-lung-injury
#7
Michaela C Kollisch-Singule, Sumeet V Jain, Penny L Andrews, Joshua Satalin, Louis A Gatto, Jesús Villar, Daniel De Backer, Luciano Gattinoni, Gary F Nieman, Nader M Habashi
No abstract text is available yet for this article.
May 1, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29707275/atelectrauma-or-volutrauma-the-dilemma
#8
EDITORIAL
Francesco Cipulli, Francesco Vasques, Eleonora Duscio, Federica Romitti, Michael Quintel, Luciano Gattinoni
No abstract text is available yet for this article.
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29703925/an-innovative-approach-for-the-integration-of-proteomics-and-metabolomics-data-in-severe-septic-shock-patients-stratified-for-mortality
#9
Alice Cambiaghi, Ramón Díaz, Julia Bauzá Martinez, Antonia Odena, Laura Brunelli, Pietro Caironi, Serge Masson, Giuseppe Baselli, Giuseppe Ristagno, Luciano Gattinoni, Eliandre de Oliveira, Roberta Pastorelli, Manuela Ferrario
In this work, we examined plasma metabolome, proteome and clinical features in patients with severe septic shock enrolled in the multicenter ALBIOS study. The objective was to identify changes in the levels of metabolites involved in septic shock progression and to integrate this information with the variation occurring in proteins and clinical data. Mass spectrometry-based targeted metabolomics and untargeted proteomics allowed us to quantify absolute metabolites concentration and relative proteins abundance...
April 27, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29663042/ted-kolobow
#10
EDITORIAL
Luciano Gattinoni, Antonio Pesenti, Lorenzo Berra, Robert Bartlett
No abstract text is available yet for this article.
April 16, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29620572/energetics-and-the-root-mechanical-cause-for-ventilator-induced-lung-injury
#11
John J Marini, Luciano Gattinoni
No abstract text is available yet for this article.
June 2018: Anesthesiology
https://www.readbyqxmd.com/read/29481425/prognostic-value-of-secretoneurin-in-patients-with-severe-sepsis-and-septic-shock-data-from-the-albumin-italian-outcome-sepsis-study
#12
Helge Røsjø, Serge Masson, Pietro Caironi, Mats Stridsberg, Michela Magnoli, Geir Christensen, Gabriella Moise, Maria Cristina Urbano, Luciano Gattinoni, Antonio Pesenti, Roberto Latini, Torbjørn Omland
OBJECTIVES: Secretoneurin directly influences cardiomyocyte calcium handling, and circulating secretoneurin levels seem to improve risk prediction in patients with myocardial dysfunction by integrating information on systemic stress, myocardial function, and renal function. Accordingly, in this study, we hypothesized that secretoneurin would improve risk prediction in patients with sepsis and especially in patients with septic shock as these patients are more hemodynamically unstable...
May 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29466572/time-to-rethink-the-approach-to-treating-acute-respiratory-distress-syndrome
#13
EDITORIAL
Luciano Gattinoni, John J Marini, Michael Quintel
No abstract text is available yet for this article.
February 20, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29345967/reclassifying-acute-respiratory-distress-syndrome
#14
Giorgia Maiolo, Francesca Collino, Francesco Vasques, Francesca Rapetti, Tommaso Tonetti, Federica Romitti, Massimo Cressoni, Davide Chiumello, Onnen Moerer, Peter Herrmann, Tim Friede, Michael Quintel, Luciano Gattinoni
RATIONALE: The ratio of PaO2 to FiO2 (P/F) defines ARDS severity and suggests appropriate therapies. OBJECTIVES: We investigated 1) whether a 150 mmHg P/F threshold within the range of moderate ARDS (100-200 mmHg) would define two, more homogeneous subgroups, 2) which criteria led the clinicians to apply ECMO in severe ARDS. Methods & Measurements: At 150 mmHg P/F threshold, moderate patients were split in mild-moderate (n=50) and moderate-severe (n=55). Severe ARDS patients (FiO2 not available in 3 patients ) were split in higher (n=63) and lower-FiO2 (n=18) at 80% FiO2 threshold...
January 18, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29340875/thromboelastography-based-anticoagulation-management-during-extracorporeal-membrane-oxygenation-a-safety-and-feasibility-pilot-study
#15
Mauro Panigada, Giacomo E Iapichino, Matteo Brioni, Giovanna Panarello, Alessandro Protti, Giacomo Grasselli, Giovanna Occhipinti, Cristina Novembrino, Dario Consonni, Antonio Arcadipane, Luciano Gattinoni, Antonio Pesenti
BACKGROUND: There is no consensus on the management of anticoagulation during extracorporeal membrane oxygenation (ECMO). ECMO is currently burdened by a high rate of hemostatic complications, possibly associated with inadequate monitoring of heparin anticoagulation. This study aims to assess the safety and feasibility of an anticoagulation protocol for patients undergoing ECMO based on thromboelastography (TEG) as opposed to an activated partial thromboplastin time (aPTT)-based protocol...
January 16, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29297365/regional-physiology-of-ards
#16
REVIEW
Luciano Gattinoni, Tommaso Tonetti, Michael Quintel
The acute respiratory distress (ARDS) lung is usually characterized by a high degree of inhomogeneity. Indeed, the same lung may show a wide spectrum of aeration alterations, ranging from completely gasless regions, up to hyperinflated areas. This inhomogeneity is normally caused by the presence of lung edema and/or anatomical variations, and is deeply influenced by the gravitational forces.For any given airway pressure generated by the ventilator, the pressure acting directly on the lung (i.e., the transpulmonary pressure or lung stress) is determined by two main factors: 1) the ratio between lung elastance and the total elastance of the respiratory system (which has been shown to vary widely in ARDS patients, between 0...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29261568/platelet-drop-and-fibrinolytic-shutdown-in-patients-with-sepsis
#17
Fabrizio Semeraro, Mario Colucci, Pietro Caironi, Serge Masson, Concetta T Ammollo, Roberto Teli, Nicola Semeraro, Michela Magnoli, Giovanni Salati, Michele Isetta, Mauro Panigada, Tommaso Tonetti, Gianni Tognoni, Roberto Latini, Antonio Pesenti, Luciano Gattinoni
OBJECTIVE: Thrombocytopenia is the most common hemostatic disorder during sepsis and is associated with high mortality. We examined whether fibrinolytic changes precede incident thrombocytopenia and predict outcome in patients with severe sepsis. DESIGN: Nested study from the multicenter, randomized, controlled trial on the efficacy of albumin replacement in severe sepsis or septic shock (the Albumin Italian Outcome Sepsis trial). SETTING: Forty ICUs in Italy...
March 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29149418/randomized-multicenter-trial-of-lateral-trendelenburg-versus-semirecumbent-body-position-for-the-prevention-of-ventilator-associated-pneumonia
#18
Gianluigi Li Bassi, Mauro Panigada, Otavio T Ranzani, Alberto Zanella, Lorenzo Berra, Massimo Cressoni, Vieri Parrini, Hassan Kandil, Giovanni Salati, Paola Selvaggi, Alessandro Amatu, Miquel Sanz-Moncosi, Emanuela Biagioni, Fernanda Tagliaferri, Mirella Furia, Giovanna Mercurio, Antonietta Costa, Tullio Manca, Simone Lindau, Jaksa Babel, Marco Cavana, Chiara Chiurazzi, Joan-Daniel Marti, Dario Consonni, Luciano Gattinoni, Antonio Pesenti, Janine Wiener-Kronish, Cecilia Bruschi, Andrea Ballotta, Pierpaolo Salsi, Sergio Livigni, Giorgio Iotti, Javier Fernandez, Massimo Girardis, Maria Barbagallo, Gabriella Moise, Massimo Antonelli, Maria Luisa Caspani, Antonella Vezzani, Patrick Meybohm, Vladimir Gasparovic, Edoardo Geat, Marcelo Amato, Michael Niederman, Theodor Kolobow, Antoni Torres
PURPOSE: The lateral Trendelenburg position (LTP) may hinder the primary pathophysiologic mechanism of ventilator-associated pneumonia (VAP). We investigated whether placing patients in the LTP would reduce the incidence of VAP in comparison with the semirecumbent position (SRP). METHODS: This was a randomized, multicenter, controlled study in invasively ventilated critically ill patients. Two preplanned interim analyses were performed. Patients were randomized to be placed in the LTP or the SRP...
November 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/29146685/looking-beyond-macro-ventilatory-parameters-and-re-thinking-ventilator-induced-lung-injury
#19
Michaela C Kollisch-Singule, Sumeet V Jain, Penny L Andrews, Joshua Satalin, Louis A Gatto, Jesús Villar, Daniel De Backer, Luciano Gattinoni, Gary F Nieman, Nader M Habashi
No abstract text is available yet for this article.
November 16, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29138899/correction-to-potentially-modifiable-factors-contributing-to-outcome-from-acute-respiratory-distress-syndrome-the-lung-safe-study
#20
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
Correction to: Intensive Care Med (2016) 42:1865-1876 DOI 10.1007/s00134-016-4571-5.
January 2018: Intensive Care Medicine
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