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https://www.readbyqxmd.com/read/29138899/correction-to-potentially-modifiable-factors-contributing-to-outcome-from-acute-respiratory-distress-syndrome-the-lung-safe-study
#1
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.
November 14, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/29134246/does-high-peep-prevent-alveolar-cycling
#2
REVIEW
M Cressoni, C Chiurazzi, D Chiumello, L Gattinoni
Acute respiratory distress syndrome (ARDS) patients need mechanical ventilation to sustain gas exchange. Animal experiments showed that mechanical ventilation with high volume/plateau pressure and no positive end-expiratory pressure (PEEP) damages healthy lungs, while low tidal volumes and the application of higher PEEP levels are protective. PEEP makes the lung homogeneous, reducing the pressure multiplication at the interface between lung units with different inflation statuses and keeps the lung open through the whole respiratory cycle, avoiding intratidal opening and closing...
November 13, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29030751/effects-of-regional-perfusion-block-in-healthy-and-injured-lungs
#3
Barbara Cambiaghi, Francesco Vasques, Onnen Mörer, Christian Ritter, Tommaso Mauri, Nils Kunze-Szikszay, Karin Holke, Francesca Collino, Giorgia Maiolo, Francesca Rapetti, Elias Schulze-Kalthoff, Tommaso Tonetti, Günter Hahn, Michael Quintel, Luciano Gattinoni
BACKGROUND: Severe hypoperfusion can cause lung damage. We studied the effects of regional perfusion block in normal lungs and in the lungs that had been conditioned by lavage with 500 ml saline and high V T (20 ml kg(-1)) ventilation. METHODS: Nineteen pigs (61.2 ± 2.5 kg) were randomized to five groups: controls (n = 3), the right lower lobe block alone (n = 3), lavage and high V T (n = 4), lung lavage, and high V T plus perfusion block of the right (n = 5) or left (n = 4) lower lobe...
October 13, 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28985479/mechanical-ventilation-in-adults-with-acute-respiratory-distress-syndrome-summary-of-the-experimental-evidence-for-the-clinical-practice-guideline
#4
Lorenzo Del Sorbo, Ewan Goligher, Daniel F McAuley, Gordon D Rubenfeld, Laurent J Brochard, Luciano Gattinoni, Arthur S Slutsky, Eddy Fan
RATIONALE: The ATS/ESICM/SCCM guidelines on mechanical ventilation in adult patients with acute respiratory distress syndrome provide treatment recommendations derived from a thorough analysis of the clinical evidence on six clinical interventions. However, each of the recommendations contains areas of uncertainty and controversy, which may affect their appropriate clinical application. OBJECTIVES: To provide a critical review of the experimental evidence surrounding the pathophysiology of ventilator-induced lung injury to help clinicians apply the clinical recommendations to individual patients...
October 6, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28948340/do-we-need-randomized-clinical-trials-in-extracorporeal-respiratory-support-no
#5
EDITORIAL
Luciano Gattinoni, Michael Quintel
No abstract text is available yet for this article.
September 25, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28899408/respiratory-support-in-patients-with-acute-respiratory-distress-syndrome-an-expert-opinion
#6
REVIEW
Davide Chiumello, Laurent Brochard, John J Marini, Arthur S Slutsky, Jordi Mancebo, V Marco Ranieri, B Taylor Thompson, Laurent Papazian, Marcus J Schultz, Marcelo Amato, Luciano Gattinoni, Alain Mercat, Antonio Pesenti, Daniel Talmor, Jean-Louis Vincent
Acute respiratory distress syndrome (ARDS) is a common condition in intensive care unit patients and remains a major concern, with mortality rates of around 30-45% and considerable long-term morbidity. Respiratory support in these patients must be optimized to ensure adequate gas exchange while minimizing the risks of ventilator-induced lung injury. The aim of this expert opinion document is to review the available clinical evidence related to ventilator support and adjuvant therapies in order to provide evidence-based and experience-based clinical recommendations for the management of patients with ARDS...
September 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28868164/who-needs-high-fio2
#7
Ozan Akca, Lorenzo Ball, F Javier Belda, Peter Biro, Andrea Cortegiani, Arieh Eden, Carlos Ferrando, Luciano Gattinoni, Zeev Goldik, Cesare Gregoretti, Thomas Hachenberg, Göran Hedenstierna, Harriet W Hopf, Thomas K Hunt, Paolo Pelosi, Motaz Qadan, Daniel I Sessler, Marina Soro, Mert Şentürk
World Health Organization and the United States Center for Disease Control have recently recommended the use of 0.8 FIO2 in all adult surgical patients undergoing general anaesthesia, to prevent surgical site infections. This recommendation has arisen several discussions: As a matter of fact, there are numerous studies with different results about the effect of FIO2 on surgical site infection. Moreover, the clinical effects of FIO2 are not limited to infection control. We asked some prominent authors about their comments regarding the recent recommendations...
August 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28828363/positive-end-expiratory-pressure-how-to-set-it-at-the-individual-level
#8
REVIEW
Luciano Gattinoni, Francesca Collino, Giorgia Maiolo, Francesca Rapetti, Federica Romitti, Tommaso Tonetti, Francesco Vasques, Michael Quintel
The positive end-expiratory pressure (PEEP), since its introduction in the treatment of acute respiratory failure, up to the 1980s was uniquely aimed to provide a viable oxygenation. Since the first application, a large debate about the criteria for selecting the PEEP levels arose within the scientific community. Lung mechanics, oxygen transport, venous admixture thresholds were all proposed, leading to PEEP recommendations from 5 up to 25 cmH2O. Throughout this period, the main concern was the hemodynamics...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28828361/driving-pressure-and-mechanical-power-new-targets-for-vili-prevention
#9
REVIEW
Tommaso Tonetti, Francesco Vasques, Francesca Rapetti, Giorgia Maiolo, Francesca Collino, Federica Romitti, Luigi Camporota, Massimo Cressoni, Paolo Cadringher, Michael Quintel, Luciano Gattinoni
Several factors have been recognized as possible triggers of ventilator-induced lung injury (VILI). The first is pressure (thus the 'barotrauma'), then the volume (hence the 'volutrauma'), finally the cyclic opening-closing of the lung units ('atelectrauma'). Less attention has been paid to the respiratory rate and the flow, although both theoretical considerations and experimental evidence attribute them a significant role in the generation of VILI. The initial injury to the lung parenchyma is necessarily mechanical and it could manifest as an unphysiological distortion of the extracellular matrix and/or as micro-fractures in the hyaluronan, likely the most fragile polymer embedded in the matrix...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28762180/optimum-support-by-high-flow-nasal-cannula-in-acute-hypoxemic-respiratory-failure-effects-of-increasing-flow-rates
#10
Tommaso Mauri, Laura Alban, Cecilia Turrini, Barbara Cambiaghi, Eleonora Carlesso, Paolo Taccone, Nicola Bottino, Alfredo Lissoni, Savino Spadaro, Carlo Alberto Volta, Luciano Gattinoni, Antonio Pesenti, Giacomo Grasselli
PURPOSE: Limited data exist on the correlation between higher flow rates of high-flow nasal cannula (HFNC) and its physiologic effects in patients with acute hypoxemic respiratory failure (AHRF). We assessed the effects of HFNC delivered at increasing flow rate on inspiratory effort, work of breathing, minute ventilation, lung volumes, dynamic compliance and oxygenation in AHRF patients. METHODS: A prospective randomized cross-over study was performed in non-intubated patients with patients AHRF and a PaO2/FiO2 (arterial partial pressure of oxygen/fraction of inspired oxygen) ratio of ≤300 mmHg...
July 31, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28701178/the-future-of-mechanical-ventilation-lessons-from-the-present-and-the-past
#11
REVIEW
Luciano Gattinoni, John J Marini, Francesca Collino, Giorgia Maiolo, Francesca Rapetti, Tommaso Tonetti, Francesco Vasques, Michael Quintel
The adverse effects of mechanical ventilation in acute respiratory distress syndrome (ARDS) arise from two main causes: unphysiological increases of transpulmonary pressure and unphysiological increases/decreases of pleural pressure during positive or negative pressure ventilation. The transpulmonary pressure-related side effects primarily account for ventilator-induced lung injury (VILI) while the pleural pressure-related side effects primarily account for hemodynamic alterations. The changes of transpulmonary pressure and pleural pressure resulting from a given applied driving pressure depend on the relative elastances of the lung and chest wall...
July 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28660933/on-the-effect-of-confined-fluid-molecular-structure-on-nonequilibrium-phase-behaviour-and-friction
#12
J P Ewen, C Gattinoni, J Zhang, D M Heyes, H A Spikes, D Dini
A detailed understanding of the behaviour of confined fluids is critical to a range of industrial applications, for example to control friction in engineering components. In this study, a combination of tribological experiments and confined nonequilibrium molecular dynamics simulations has been used to investigate the effect of base fluid molecular structure on nonequilibrium phase behaviour and friction. An extensive parameter study, including several lubricant and traction fluid molecules subjected to pressures (0...
July 21, 2017: Physical Chemistry Chemical Physics: PCCP
https://www.readbyqxmd.com/read/28504598/transpulmonary-pressure-meaning-babel-or-conceptual-evolution
#13
Luciano Gattinoni, Massimo Cressoni, Davide Chiumello, John J Marini
No abstract text is available yet for this article.
May 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28497267/understanding-blood-gas-analysis
#14
Luciano Gattinoni, Antonio Pesenti, Michael Matthay
No abstract text is available yet for this article.
May 11, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28459336/an-official-american-thoracic-society-european-society-of-intensive-care-medicine-society-of-critical-care-medicine-clinical-practice-guideline-mechanical-ventilation-in-adult-patients-with-acute-respiratory-distress-syndrome
#15
Eddy Fan, Lorenzo Del Sorbo, Ewan C Goligher, Carol L Hodgson, Laveena Munshi, Allan J Walkey, Neill K J Adhikari, Marcelo B P Amato, Richard Branson, Roy G Brower, Niall D Ferguson, Ognjen Gajic, Luciano Gattinoni, Dean Hess, Jordi Mancebo, Maureen O Meade, Daniel F McAuley, Antonio Pesenti, V Marco Ranieri, Gordon D Rubenfeld, Eileen Rubin, Maureen Seckel, Arthur S Slutsky, Daniel Talmor, B Taylor Thompson, Hannah Wunsch, Elizabeth Uleryk, Jan Brozek, Laurent J Brochard
BACKGROUND: This document provides evidence-based clinical practice guidelines on the use of mechanical ventilation in adult patients with acute respiratory distress syndrome (ARDS). METHODS: A multidisciplinary panel conducted systematic reviews and metaanalyses of the relevant research and applied Grading of Recommendations, Assessment, Development, and Evaluation methodology for clinical recommendations. RESULTS: For all patients with ARDS, the recommendation is strong for mechanical ventilation using lower tidal volumes (4-8 ml/kg predicted body weight) and lower inspiratory pressures (plateau pressure < 30 cm H2O) (moderate confidence in effect estimates)...
May 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28459332/reply-lung-recruitment-assessment
#16
Luciano Gattinoni, Massimo Cressoni, Davide Chiumello
No abstract text is available yet for this article.
May 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28418246/water-ice-analogues-of-polycyclic-aromatic-hydrocarbons-water-nanoclusters-on-cu-111
#17
Melissa L Liriano, Chiara Gattinoni, Emily A Lewis, Colin J Murphy, E Charles H Sykes, Angelos Michaelides
Water has an incredible ability to form a rich variety of structures, with 16 bulk ice phases identified, for example, as well as numerous distinct structures for water at interfaces or under confinement. Many of these structures are built from hexagonal motifs of water molecules, and indeed, for water on metal surfaces, individual hexamers of just six water molecules have been observed. Here, we report the results of low-temperature scanning tunneling microscopy experiments and density functional theory calculations which reveal a host of new structures for water-ice nanoclusters when adsorbed on an atomically flat Cu surface...
May 10, 2017: Journal of the American Chemical Society
https://www.readbyqxmd.com/read/28411114/circulating-biologically-active-adrenomedullin-bio-adm-predicts-hemodynamic-support-requirement-and-mortality-during-sepsis
#18
MULTICENTER STUDY
Pietro Caironi, Roberto Latini, Joachim Struck, Oliver Hartmann, Andreas Bergmann, Giuseppe Maggio, Marco Cavana, Gianni Tognoni, Antonio Pesenti, Luciano Gattinoni, Serge Masson
BACKGROUND: The biological role of adrenomedullin (ADM), a hormone involved in hemodynamic homeostasis, is controversial in sepsis because administration of either the peptide or an antibody against it may be beneficial. METHODS: Plasma biologically active ADM (bio-ADM) was assessed on days 1, 2, and 7 after randomization of 956 patients with sepsis or septic shock to albumin or crystalloids for fluid resuscitation in the multicenter Albumin Italian Outcome Sepsis trial...
August 2017: Chest
https://www.readbyqxmd.com/read/28331959/intensive-care-medicine-in-2050-ventilator-induced-lung-injury
#19
Luciano Gattinoni, Tommaso Tonetti, Michael Quintel
No abstract text is available yet for this article.
March 22, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28289713/th17-cells-are-refractory-to-senescence-and-retain-robust-antitumor-activity-after-long-term-ex-vivo-expansion
#20
Jacob S Bowers, Michelle H Nelson, Kinga Majchrzak, Stefanie R Bailey, Baerbel Rohrer, Andrew D M Kaiser, Carl Atkinson, Luca Gattinoni, Chrystal M Paulos
Adoptive immunotherapy for solid tumors relies on infusing large numbers of T cells to mediate successful antitumor responses in patients. While long-term rapid-expansion protocols (REPs) produce sufficient numbers of CD8(+) T cells for treatment, they also cause decline in the cell's therapeutic fitness. In contrast, we discovered that IL-17-producing CD4(+) T cells (Th17 cells) do not require REPs to expand 5,000-fold over 3 weeks. Also, unlike Th1 cells, Th17 cells do not exhibit hallmarks of senescence or apoptosis, retaining robust antitumor efficacy in vivo...
March 9, 2017: JCI Insight
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