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https://www.readbyqxmd.com/read/28930178/diagnostic-value-of-endotracheal-aspirates-sonication-on-ventilator-associated-pneumonia-microbiologic-diagnosis
#1
Laia Fernández-Barat, Ana Motos, Otavio T Ranzani, Gianluigi Li Bassi, Elisabet Aguilera Xiol, Tarek Senussi, Chiara Travierso, Chiara Chiurazzi, Francesco Idone, Laura Muñoz, Jordi Vila, Miquel Ferrer, Paolo Pelosi, Francesco Blasi, Massimo Antonelli, Antoni Torres
Microorganisms are able to form biofilms within respiratory secretions. Methods to disaggregate such biofilms before utilizing standard, rapid, or high throughput diagnostic technologies may aid in pathogen detection during ventilator associated pneumonia (VAP) diagnosis. Our aim was to determine if sonication of endotracheal aspirates (ETA) would increase the sensitivity of qualitative, semi-quantitative, and quantitative bacterial cultures in an animal model of pneumonia caused by Pseudomonasaeruginosa or by methicillin resistant Staphylococcusaureus (MRSA)...
September 20, 2017: Microorganisms
https://www.readbyqxmd.com/read/28868164/who-needs-high-fio2
#2
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/28861420/balanced-versus-isotonic-saline-resuscitation-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials-in-operation-rooms-and-intensive-care-units
#3
Ary Serpa Neto, Ignacio Martin Loeches, Robert B Klanderman, Raphael Freitas Silva, Marcelo Gama de Abreu, Paolo Pelosi, Marcus J Schultz
BACKGROUND: Fluid resuscitation is the cornerstone in treatment of shock, and intravenous fluid administration is the most frequent intervention in operation rooms and intensive care units (ICUs). The composition of fluids used for fluid resuscitation gained interest over the past decade, with recent focus on whether balanced solutions should be preferred over isotonic saline. METHODS: Systematic review and meta-analysis of randomized controlled trials (RCTs) comparing fluid resuscitation with a balanced solution versus isotonic saline in adult patients in operation room or ICUs...
August 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28828369/lung-imaging-how-to-get-better-look-inside-the-lung
#4
REVIEW
Lorenzo Ball, Veronica Vercesi, Federico Costantino, Karthikka Chandrapatham, Paolo Pelosi
In the last years, imaging has played a key role in the diagnosis and monitoring and critical illness, including acute respiratory distress syndrome (ARDS). Chest X-ray (CXR) and computed tomography (CT) are the conventional techniques most performed in the critically ill patients, the latter being the gold standard to assess lung aeration in ARDS patients. In addition, two bedside techniques are now gaining popularity alongside the conventional ones: lung ultrasound (LUS) and electrical impedance tomography (EIT)...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28828299/immunomodulatory-effects-of-anesthetics-in-obese-patients
#5
REVIEW
Luciana Boavista Barros Heil, Pedro Leme Silva, Paolo Pelosi, Patricia Rieken Macedo Rocco
Anesthesia and surgery have an impact on inflammatory responses, which influences perioperative homeostasis. Inhalational and intravenous anesthesia can alter immune-system homeostasis through multiple processes that include activation of immune cells (such as monocytes, neutrophils, and specific tissue macrophages) with release of pro- or anti-inflammatory interleukins, upregulation of cell adhesion molecules, and overproduction of oxidative radicals. The response depends on the timing of anesthesia, anesthetic agents used, and mechanisms involved in the development of inflammation or immunosuppression...
August 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28813446/variable-stretch-reduces-the-pro-inflammatory-response-of-alveolar-epithelial-cells
#6
Ines Rentzsch, Cíntia L Santos, Robert Huhle, Jorge M C Ferreira, Thea Koch, Christian Schnabel, Edmund Koch, Paolo Pelosi, Patricia R M Rocco, Marcelo Gama de Abreu
Mechanical ventilation has the potential to increase inflammation in both healthy and injured lungs. Several animal studies have shown that variable ventilation recruits the lungs and reduces inflammation. However, it is unclear which cellular mechanisms are involved in those findings. We hypothesized that variable stretch of LPS-stimulated alveolar epithelial cells (AECs) reduces the production of pro-inflammatory cytokines compared to non-variable stretch. AECs were subjected to non-variable or variable cyclic stretch (sinusoidal pattern), with and without LPS stimulation...
2017: PloS One
https://www.readbyqxmd.com/read/28768153/effects-of-mechanical-ventilation-on-gene-expression-profiles-in-renal-allografts-from-brain-dead-rats
#7
Maximilia C Hottenrott, Joerg Krebs, Paolo Pelosi, Thomas Luecke, Patricia R M Rocco, Carsten Sticht, Annette Breedijk, Benito Yard, Charalambos Tsagogiorgas
Pathophysiological changes of brain death (BD) are impairing distal organ function and harming potential renal allografts. Whether ventilation strategies influence the quality of renal allografts from BD donors has not been thoroughly studied. 28 adult male Wistar rats were randomly assigned to four groups: 1) no brain death (NBD) with low tidal volume/low positive endexpiratory pressure (PEEP) titrated to minimal static elastance of the respiratory system (LVT/OLPEEP); 2) NBD with high tidal volume/low PEEP (HVT/LPEEP); 3) brain death (BD) with LVT/OLPEEP; and 4) BD with HVT/LPEEP...
July 30, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28759484/impact-of-different-ventilation-strategies-on-driving-pressure-mechanical-power-and-biological-markers-during-open-abdominal-surgery-in-rats
#8
Lígia de A Maia, Cynthia S Samary, Milena V Oliveira, Cintia L Santos, Robert Huhle, Vera L Capelozzi, Marcelo M Morales, Marcus J Schultz, Marcelo G Abreu, Paolo Pelosi, Pedro L Silva, Patricia Rieken Macedo Rocco
BACKGROUND: Intraoperative mechanical ventilation may yield lung injury. To date, there is no consensus regarding the best ventilator strategy for abdominal surgery. We aimed to investigate the impact of the mechanical ventilation strategies used in 2 recent trials (Intraoperative Protective Ventilation [IMPROVE] trial and Protective Ventilation using High versus Low PEEP [PROVHILO] trial) on driving pressure (ΔPRS), mechanical power, and lung damage in a model of open abdominal surgery...
October 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28756471/the-research-agenda-for-trauma-critical-care
#9
REVIEW
Karim Asehnoune, Zsolt Balogh, Giuseppe Citerio, Andre Cap, Timothy Billiar, Nino Stocchetti, Mitchell J Cohen, Paolo Pelosi, Nicola Curry, Christine Gaarder, Russell Gruen, John Holcomb, Beverley J Hunt, Nicole P Juffermans, Mark Maegele, Mark Midwinter, Frederick A Moore, Michael O'Dwyer, Jean-François Pittet, Herbert Schöchl, Martin Schreiber, Philip C Spinella, Simon Stanworth, Robert Winfield, Karim Brohi
In this research agenda on the acute and critical care management of trauma patients, we concentrate on the major factors leading to death, namely haemorrhage and traumatic brain injury (TBI). In haemostasis biology, the results of randomised controlled trials have led to the therapeutic focus moving away from the augmentation of coagulation factors (such as recombinant factor VIIa) and towards fibrinogen supplementation and administration of antifibrinolytics such as tranexamic acid. Novel diagnostic techniques need to be evaluated to determine whether an individualised precision approach is superior to current empirical practice...
July 29, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28693606/combined-use-of-serum-1-3-%C3%AE-d-glucan-and-procalcitonin-for-the-early-differential-diagnosis-between-candidaemia-and-bacteraemia-in-intensive-care-units
#10
Daniele Roberto Giacobbe, Malgorzata Mikulska, Mario Tumbarello, Elisa Furfaro, Marzia Spadaro, Angela Raffaella Losito, Alessio Mesini, Gennaro De Pascale, Anna Marchese, Marco Bruzzone, Paolo Pelosi, Michele Mussap, Alexandre Molin, Massimo Antonelli, Brunella Posteraro, Maurizio Sanguinetti, Claudio Viscoli, Valerio Del Bono
BACKGROUND: This study aimed to assess the combined performance of serum (1,3)-β-D-glucan (BDG) and procalcitonin (PCT) for the differential diagnosis between candidaemia and bacteraemia in three intensive care units (ICUs) in two large teaching hospitals in Italy. METHODS: From June 2014 to December 2015, all adult patients admitted to the ICU who had a culture-proven candidaemia or bacteraemia, as well as BDG and PCT measured closely to the time of the index culture, were included in the study...
July 10, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28632529/respiratory-system-mechanics-during-low-versus-high-positive-end-expiratory-pressure-in-open-abdominal-surgery-a-substudy-of-provhilo-randomized-controlled-trial
#11
Davide D'Antini, Robert Huhle, Jacob Herrmann, Demet S Sulemanji, Jun Oto, Pasquale Raimondo, Lucia Mirabella, Sabrine N T Hemmes, Marcus J Schultz, Paolo Pelosi, David W Kaczka, Marcos Francisco Vidal Melo, Marcelo Gama de Abreu, Gilda Cinnella
BACKGROUND: In the 2014 PROtective Ventilation using HIgh versus LOw positive end-expiratory pressure (PROVHILO) trial, intraoperative low tidal volume ventilation with high positive end-expiratory pressure (PEEP = 12 cm H2O) and lung recruitment maneuvers did not decrease postoperative pulmonary complications when compared to low PEEP (0-2 cm H2O) approach without recruitment breaths. However, effects of intraoperative PEEP on lung compliance remain poorly understood. We hypothesized that higher PEEP leads to a dominance of intratidal overdistension, whereas lower PEEP results in intratidal recruitment/derecruitment (R/D)...
June 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28556957/increased-frequency-of-bronchiolar-histotypes-in-lung-carcinomas-associated-with-idiopathic-pulmonary-fibrosis
#12
Anna Caliò, Veronica Lever, Andrea Rossi, Eliana Gilioli, Matteo Brunelli, Alessandra Dubini, Sara Tomassetti, Sara Piciucchi, Alessia Nottegar, Giulio Rossi, Marianne Kambouchner, Alessandra Cancellieri, Mattia Barbareschi, Giuseppe Pelosi, Claudio Doglioni, Alberto Cavazza, Rodolfo Carella, Paolo Graziano, Bruno Murer, Venerino Poletti, Marco Chilosi
AIMS: The association between lung cancer and idiopathic pulmonary fibrosis (IPF) is well-known, however the significance of this association is poorly understood. Bronchiolar honeycomb cysts have been proposed as possible precursors for development of carcinoma, but limited evidence of this hypothesis is available. METHODS AND RESULTS: Thirty-three lung carcinomas arising in patients with IPF have been analyzed using a panel of immunohistochemical markers. The antibodies included pneumocyte markers (TTF1, Napsin-A, SPA1), the goblet cell marker MUC5AC, markers of basal/squamous cell differentiation (CK5/6, ΔN-p63) and markers related to enteric differentiation (CDX2, MUC2, CK20, villin)...
May 30, 2017: Histopathology
https://www.readbyqxmd.com/read/28552074/heat-and-moisture-exchangers-hmes-and-heated-humidifiers-hhs-in-adult-critically-ill-patients-a-systematic-review-meta-analysis-and-meta-regression-of-randomized-controlled-trials
#13
Maria Vargas, Davide Chiumello, Yuda Sutherasan, Lorenzo Ball, Antonio M Esquinas, Paolo Pelosi, Giuseppe Servillo
BACKGROUND: The aims of this systematic review and meta-analysis of randomized controlled trials are to evaluate the effects of active heated humidifiers (HHs) and moisture exchangers (HMEs) in preventing artificial airway occlusion and pneumonia, and on mortality in adult critically ill patients. In addition, we planned to perform a meta-regression analysis to evaluate the relationship between the incidence of artificial airway occlusion, pneumonia and mortality and clinical features of adult critically ill patients...
May 29, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28542443/effects-of-pressure-support-and-pressure-controlled-ventilation-on-lung-damage-in-a-model-of-mild-extrapulmonary-acute-lung-injury-with-intra-abdominal-hypertension
#14
Cintia L Santos, Raquel S Santos, Lillian Moraes, Cynthia S Samary, Nathane S Felix, Johnatas D Silva, Marcelo M Morales, Robert Huhle, Marcelo G Abreu, Alberto Schanaider, Pedro L Silva, Paolo Pelosi, Patricia R M Rocco
Intra-abdominal hypertension (IAH) may co-occur with the acute respiratory distress syndrome (ARDS), with significant impact on morbidity and mortality. Lung-protective controlled mechanical ventilation with low tidal volume and positive end-expiratory pressure (PEEP) has been recommended in ARDS. However, mechanical ventilation with spontaneous breathing activity may be beneficial to lung function and reduce lung damage in mild ARDS. We hypothesized that preserving spontaneous breathing activity during pressure support ventilation (PSV) would improve respiratory function and minimize ventilator-induced lung injury (VILI) compared to pressure-controlled ventilation (PCV) in mild extrapulmonary acute lung injury (ALI) with IAH...
2017: PloS One
https://www.readbyqxmd.com/read/28532465/obesity-and-survival-in-critically-ill-patients-with-acute-respiratory-distress-syndrome-a-paradox-within-the-paradox
#15
EDITORIAL
Lorenzo Ball, Ary Serpa Neto, Paolo Pelosi
No abstract text is available yet for this article.
May 3, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28528537/intraoperative-mechanical-ventilation-state-of-the-art
#16
Lorenzo Ball, Federico Costantino, Giulia Orefice, Karthikka Chandrapatham, Paolo Pelosi
Mechanical ventilation is a cornerstone of the intraoperative management of the surgical patient and is still mandatory in several surgical procedures. In the last decades, research focused on preventing postoperative pulmonary complications (PPCs), both improving risk stratification through the use of predictive scores and protecting the lung adopting so-called protective ventilation strategies. The aim of this review is to give an up-to-date overview of the currently suggested intraoperative ventilation strategies, along with their pathophysiologic rationale, with a focus on challenging conditions, such as obesity, one-lung ventilation and cardiopulmonary bypass...
May 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28512431/variable-ventilation-improved-respiratory-system-mechanics-and-ameliorated-pulmonary-damage-in-a-rat-model-of-lung-ischemia-reperfusion
#17
André Soluri-Martins, Lillian Moraes, Raquel S Santos, Cintia L Santos, Robert Huhle, Vera L Capelozzi, Paolo Pelosi, Pedro L Silva, Marcelo Gama de Abreu, Patricia R M Rocco
Lung ischemia-reperfusion injury remains a major complication after lung transplantation. Variable ventilation (VV) has been shown to improve respiratory function and reduce pulmonary histological damage compared to protective volume-controlled ventilation (VCV) in different models of lung injury induced by endotoxin, surfactant depletion by saline lavage, and hydrochloric acid. However, no study has compared the biological impact of VV vs. VCV in lung ischemia-reperfusion injury, which has a complex pathophysiology different from that of other experimental models...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28502073/early-impact-of-abdominal-compartment-syndrome-on-liver-kidney-and-lung-damage-in-a-rodent-model
#18
Ricardo Lima, Pedro L Silva, Vera L Capelozzi, Mariana G Oliveira, Maria Cristina E Santana, Fernanda F Cruz, Paolo Pelosi, Alberto Schanaider, Manu L N G Malbrain, Patricia R M Rocco
BACKGROUND: Abdominal compartment syndrome (ACS) sometimes occurs in critically ill patients following damage control surgery. The purpose of the present study was to develop a model of ACS and to evaluate its pathologic impact on liver, kidney, and lung morphology. METHODS: Twenty Wistar rats (mass 300-350 g) were randomly divided into four groups: 1) intra-abdominal hypertension (IAH): a laparotomy was performed and the abdomen packed with cotton until an intra-abdominal pressure (IAP) of 15 mm Hg was reached; 2) hypovolemia (HYPO): blood was withdrawn until a mean arterial pressure ~60 mm Hg was reached; 3) IAH + HYPO (to resemble clinical ACS); and 4) sham surgery...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28480618/beyond-chemoreception-diverse-tasks-of-soluble-olfactory-proteins-in-insects
#19
Paolo Pelosi, Immacolata Iovinella, Jiao Zhu, Guirong Wang, Francesca R Dani
Odorant-binding proteins (OBPs) and chemosensory proteins (CSPs) are regarded as carriers of pheromones and odorants in insect chemoreception. These proteins are typically located in antennae, mouth organs and other chemosensory structures; however, members of both classes of proteins have been detected recently in other parts of the body and various functions have been proposed. The best studied of these non-sensory tasks is performed in pheromone glands, where OBPs and CSPs solubilise hydrophobic semiochemicals and assist their controlled release into the environment...
May 7, 2017: Biological Reviews of the Cambridge Philosophical Society
https://www.readbyqxmd.com/read/28452241/respiratory-monitoring-in-adult-intensive-care-unit
#20
Pongdhep Theerawit, Yuda Sutherasan, Lorenzo Ball, Paolo Pelosi
The mortality of patients with respiratory failure has steadily decreased with the advancements in protective ventilation and treatment options. Although respiratory monitoring per se has not been proven to affect the mortality of critically ill patients, it plays a crucial role in patients' care, as it helps to titrate the ventilatory support. Several new monitoring techniques have recently been made available at the bedside. The goals of monitoring comprise alerting physicians to detect the change in the patients' conditions, to improve the understanding of pathophysiology to guide the diagnosis and provide cost-effective clinical management...
June 2017: Expert Review of Respiratory Medicine
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