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Abstract Background and Aims Over the past decades, the number of cardiac patients (e.g., with advanced heart failure or existing cardiovascular comorbidities that expose them to a heightened risk of acute cardiovascular decompensation) requiring noncardiac surgery is rising. For this patient population, potentially curative surgical treatments may be denied due to their prohibitive perioperative risk. Around 30% of patients undergoing general thoracic surgery experience cardiovascular complications of varying severity that may ultimately result in refractory heart failure and/or hemodynamic instability. In both these scenarios, perioperative implantation of temporary mechanical circulatory support (tMCS) may improve patient outcomes by both expanding preoperative surgical eligibility criteria and enabling safer management of unexpected periprocedural complications. This scoping review seeks to summarize the current existing evidence on the role of tMCS for cardiac assistance in thoracic surgery and provide a thorough overview. Methods We will perform a scoping review adhering to the Joanna Briggs Institute (JBI) methodology and the extension for Scoping Reviews of the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis checklist (PRISMA). We will carry out a comprehensive search of several online databases to identify studies on the perioperative implantation of tMCS in patients undergoing thoracic surgery to provide cardiac assistance either due to their heightened preoperative cardiac risk (pre‐emptive tMCS) or for acute cardiac failure due to inherent surgical complications (bail‐out tMCS). Standardized forms will be employed to perform data charting and extraction. Results Retrieved studies will be presented through a narrative synthesis following initial categorization, supplemented by descriptive statistical analyses of quantitative data if adequate inter‐study homogeneity is observed and further complemented by figures and tables. Conclusion The planned scoping review aims to assess the safety and feasibility of perioperative implantation of tMCS in patients undergoing thoracic surgery either to mitigate their heightened cardiovascular risk or as a rescue strategy in the event of life‐threatening surgical complications. It will identify knowledge gaps, offer direction for future research, and improve clinical practices within the field.

Hirsch-index, better known as, H-index is an important bibliometric index for Italian critical care physicians.Aim of our study was to collect the H-index of all Italian critical care academic physicians and compare it with the Italian Ministry of University and Research thresholds necessary to be eligible as Professor, and to investigate potential gender disparities in such bibliometric indices.Materials and Methods. We collected all the names of academic ICU physicians on June 24th, 2023 from the official Italian Ministry of University and Research website. We added non-academic ICU physicians searching on Scopus or among academic physicians’ collaborators. Minimum thresholds to be eligible as Professor were identified through the official Italian Ministry of University and Research website. Median H-index of men and women were compared.Results. The total number of included physicians was 237 (46 Full Professors, 88 Associate Professors, 79 Researchers and 22 Non-academic physicians). Minimum threshold to be eligible as Associate Professor was 6 and to be eligible as Full Professor was 13. The median H-index in men versus women in every subgroup was: Full Professors (38 [27-49] vs 29 [21-34]), Associate Professors (25 [18-32] vs 22 [18-28]), Researchers (12 [7-21] vs 9 [6-16]) and Non-academic physicians (27 [25-37] vs 26 [25-29]).Conclusion. Current median H-index of Italian academic ICU physicians is considerably greater than minimum thresholds released by the Italian Ministry of University and Research to be eligible as Professor. Gender gap in bibliometric indices of academic ICU physicians remains.

Introduction: Data on out-of-hospital cardiac arrest (OHCA) is limited in Italy, and there has never been a comprehensive systematic appraisal of the available evidence. Therefore, this review aims to explore the incidence, characteristics, and outcome of OHCA in Italy. Methods: We systematically searched PubMed, Embase, Google Scholar, ResearchGate, and conference proceedings up to September 23, 2022. Studies investigating OHCA in Italy and reporting at least one outcome related to cardiac arrest were considered eligible. The primary outcome was survival at the longest follow-up available. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal tool. A random-effects model proportion meta-analysis was performed to calculate the pooled outcomes with 95% confidence interval (CI). Results: We included 42 studies (43,042 patients) from 13 of the 20 Italian regions published between 1995 and 2022. Only five studies were deemed to be at low risk of bias. The overall average incidences of OHCA attended by emergency medical services and with resuscitation attempted were 86 (range: 10–190) and 55 (range: 6–108) per 100,000 populations per year, respectively. Survival at the longest follow-up available was 9.0% (95% CI, 6.7–12%; 30 studies and 15,195 patients) in the overall population, 25% (95% CI, 21–30%; 16 studies and 2,863 patients) among patients with shockable rhythms, 28% (95% CI, 20–37%; 8 studies and 1,292 patients) among the Utstein comparator group. Favourable neurological outcome was 5.0% (95% CI, 3.6–6.6%; 16 studies and 9,675 patients). Return of spontaneous circulation was achieved in 19% (95% CI, 16–23%; 40 studies and 30,875 patients) of cases. Bystanders initiated cardiopulmonary resuscitation in 26% (95% CI, 21–32%; 33 studies and 23,491 patients) of cases but only in 3.2% (95% CI, 1.9–4.9%; 9 studies and 8,508 patients) with an automated external defibrillator. The mean response time was 10.2 (95% CI, 8.9–11.4; 25 studies and 23,997 patients) minutes. Conclusions: Survival after OHCA in Italy occurred in one of every ten patients. Bystanders initiated cardiopulmonary resuscitation in only one-third of cases, rarely with a defibrillator. Different areas of the country collected data, but an essential part of the population was not included. There was high heterogeneity and large variation in outcomes results and reporting, limiting the confidence in the estimates of incidence and outcome. Creating and maintaining a nationwide registry is a priority.