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https://www.readbyqxmd.com/read/29600021/higher-vs-lower-peep-in-ards-just-one-part-of-the-whole
#1
EDITORIAL
Silvia Coppola, Sara Froio, Davide Chiumello
No abstract text is available yet for this article.
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29589416/conscious-sedation-in-critically-ill-patients-is-associated-with-stressors-perception-lower-than-assessed-by-caregivers
#2
Giovanni Mistraletti, Michele Umbrello, Vera Mariani, Elisabetta Carloni, Sara Miori, Martina Taverna, Giovanni Sabbatini, Paolo Formenti, Stefano Terzoni, Anne L Destrebecq, Davide Chiumello, Egidio A Moja, Gaetano Iapichino
BACKGROUND: In ICU, the stay is frequently a stressful experience. Caregivers may help to understand patients' perceptions; however, their reliability is uncertain. Despite the recent recommendations of lighter sedation targets, little is known about the impact of "conscious sedation" on ICU patients memories. Purpose of this prospective, observational study is to analyze the stress perception in consciously-sedated ICU-patients, comparing it to caregivers and staff members...
March 27, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29380581/heuristic-to-systematic-approach-to-difficult-airways-prediction-is-it-time-to-change-habits
#3
Francesco Landucci, Dario Caldiroli, Paolo Balsorano, Davide Chiumello
No abstract text is available yet for this article.
May 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29345967/reclassifying-acute-respiratory-distress-syndrome
#4
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/29332232/prone-position-in-ards-a-simple-maneuver-still-underused
#5
EDITORIAL
Davide Chiumello, Silvia Coppola, Sara Froio
No abstract text is available yet for this article.
February 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29164144/intensive-care-unit-patients-with-lower-respiratory-tract-nosocomial-infections-the-enirris-project
#6
Gennaro De Pascale, Otavio T Ranzani, Saad Nseir, Jean Chastre, Tobias Welte, Massimo Antonelli, Paolo Navalesi, Eugenio Garofalo, Andrea Bruni, Luis Miguel Coelho, Szymon Skoczynski, Federico Longhini, Fabio Silvio Taccone, David Grimaldi, Helmut J F Salzer, Christoph Lange, Filipe Froes, Antoni Artigas, Emili Díaz, Jordi Vallés, Alejandro Rodríguez, Mauro Panigada, Vittoria Comellini, Luca Fasano, Paolo M Soave, Giorgia Spinazzola, Charles-Edouard Luyt, Francisco Alvarez-Lerma, Judith Marin, Joan Ramon Masclans, Davide Chiumello, Angelo Pezzi, Marcus Schultz, Hafiz Mohamed, Menno Van Der Eerden, Roger A S Hoek, D A M P J Gommers, Marta Di Pasquale, Rok Civljak, Marko Kutleša, Matteo Bassetti, George Dimopoulos, Stefano Nava, Fernando Rios, Fernando G Zampieri, Pedro Povoa, Lieuwe D Bos, Stefano Aliberti, Antoni Torres, Ignacio Martín-Loeches
The clinical course of intensive care unit (ICU) patients may be complicated by a large spectrum of lower respiratory tract infections (LRTI), defined by specific epidemiological, clinical and microbiological aspects. A European network for ICU-related respiratory infections (ENIRRIs), supported by the European Respiratory Society, has been recently established, with the aim at studying all respiratory tract infective episodes except community-acquired ones. A multicentre, observational study is in progress, enrolling more than 1000 patients fulfilling the clinical, biochemical and radiological findings consistent with a LRTI...
October 2017: ERJ Open Research
https://www.readbyqxmd.com/read/29161936/a-morphological-and-quantitative-analysis-of-lung-ct-scan-in-patients-with-acute-respiratory-distress-syndrome-and-in-cardiogenic-pulmonary-edema
#7
Giordano Vergani, Massimo Cressoni, Francesco Crimella, Camilla L'Acqua, Erminio Sisillo, Martina Gurgitano, Alessandro Liguori, Andrea Annoni, Gianpaolo Carrafiello, Davide Chiumello
BACKGROUND: The acute respiratory distress syndrome (ARDS) and cardiogenic pulmonary edema (CPE) are both characterized by an increase in lung edema that can be measured by computed tomography (CT). The aim of this study was to compare possible differences between patients with ARDS and CPE in the morphologic pattern, the aeration, and the amount and distribution of edema within the lung. METHODS: Lung CT was performed at a mean positive end-expiratory pressure level of 5 cm H2 O in both groups...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29134246/does-high-peep-prevent-alveolar-cycling
#8
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...
February 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28951294/neurological-prognostication-during-extracorporeal-life-support-is-nse-just-another-brick-in-the-wall
#9
EDITORIAL
Michele Umbrello, Davide Chiumello
No abstract text is available yet for this article.
December 2017: Resuscitation
https://www.readbyqxmd.com/read/28899408/respiratory-support-in-patients-with-acute-respiratory-distress-syndrome-an-expert-opinion
#10
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/28828362/tidal-volume-in-acute-respiratory-distress-syndrome-how-best-to-select-it
#11
REVIEW
Michele Umbrello, Antonella Marino, Davide Chiumello
Mechanical ventilation is the type of organ support most widely provided in the intensive care unit. However, this form of support does not constitute a cure for acute respiratory distress syndrome (ARDS), as it mainly works by buying time for the lungs to heal while contributing to the maintenance of vital gas exchange. Moreover, it can further damage the lung, leading to the development of a particular form of lung injury named ventilator-induced lung injury (VILI). Experimental evidence accumulated over the last 30 years highlighted the factors associated with an injurious form of mechanical ventilation...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28631464/cognitive-resistance-towards-videolaryngoscopy%C3%A2-and-why-macintosh-refuses-to-die
#12
Francesco Landucci, Dario Caldiroli, Davide Chiumello, Aidan Byrne
No abstract text is available yet for this article.
December 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28631462/thoracic-trauma-and-acute-respiratory-distress-syndrome-mind-the-link
#13
Silvia Coppola, Davide Chiumello
No abstract text is available yet for this article.
June 14, 2017: Minerva Anestesiologica
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
#14
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/28523151/ards-onset-time-and-prognosis-is-it-a-turtle-and-rabbit-race
#15
EDITORIAL
Davide Chiumello, Antonella Marino
No abstract text is available yet for this article.
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28504598/transpulmonary-pressure-meaning-babel-or-conceptual-evolution
#16
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/28459332/reply-lung-recruitment-assessment
#17
COMMENT
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/28283699/opening-pressures-and-atelectrauma-in-acute-respiratory-distress-syndrome
#18
MULTICENTER STUDY
Massimo Cressoni, Davide Chiumello, Ilaria Algieri, Matteo Brioni, Chiara Chiurazzi, Andrea Colombo, Angelo Colombo, Francesco Crimella, Mariateresa Guanziroli, Ivan Tomic, Tommaso Tonetti, Giordano Luca Vergani, Eleonora Carlesso, Vladimir Gasparovic, Luciano Gattinoni
PURPOSE: Open lung strategy during ARDS aims to decrease the ventilator-induced lung injury by minimizing the atelectrauma and stress/strain maldistribution. We aim to assess how much of the lung is opened and kept open within the limits of mechanical ventilation considered safe (i.e., plateau pressure 30 cmH2 O, PEEP 15 cmH2 O). METHODS: Prospective study from two university hospitals. Thirty-three ARDS patients (5 mild, 10 moderate, 9 severe without extracorporeal support, ECMO, and 9 severe with it) underwent two low-dose end-expiratory CT scans at PEEP 5 and 15 cmH2 O and four end-inspiratory CT scans (from 19 to 40 cmH2 O)...
May 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28036088/current-concepts-of-ards-a-narrative-review
#19
REVIEW
Michele Umbrello, Paolo Formenti, Luca Bolgiaghi, Davide Chiumello
Acute respiratory distress syndrome (ARDS) is characterized by the acute onset of pulmonary edema of non-cardiogenic origin, along with bilateral pulmonary infiltrates and reduction in respiratory system compliance. The hallmark of the syndrome is refractory hypoxemia. Despite its first description dates back in the late 1970s, a new definition has recently been proposed. However, the definition remains based on clinical characteristic. In the present review, the diagnostic workup and the pathophysiology of the syndrome will be presented...
December 29, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27992852/paracetamol-in-fever-in-critically-ill-patients-an-update
#20
REVIEW
D Chiumello, M Gotti, G Vergani
Fever, which is arbitrary defined as an increase in body temperature above 38.3°C, can affect up to 90% of patients admitted in intensive care unit. Induction of fever is mediated by the release of pyrogenic cytokines (tumor necrosis factor α, interleukin 1, interleukin 6, and interferons). Fever is associated with increased length of stay in intensive care unit and with a worse outcome in some subgroups of patients (mainly neurocritically ill patients). Although fever can increase oxygen consumption in unstable patients, on the contrary, it can activate physiologic systems that are involved in pathogens clearance...
April 2017: Journal of Critical Care
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