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Start Over Author "Navalesi, P" Publisher biomed central
44 results on '"Navalesi, P"'

1. Retrospective ANalysis of multi-drug resistant Gram-nEgative bacteRia on veno-venous extracorporeal membrane oxygenation. The multicenter RANGER STUDY

Author

Boscolo, Annalisa, Bruni, Andrea, Giani, Marco, Garofalo, Eugenio, Sella, Nicolò, Pettenuzzo, Tommaso, Bombino, Michela, Palcani, Matteo, Rezoagli, Emanuele, Pozzi, Matteo, Falcioni, Elena, Pistollato, Elisa, Biamonte, Eugenio, Murgolo, Francesco, D’Arrigo, Graziella, Gori, Mercedes, Tripepi, Giovanni Luigi, Gottin, Leonardo, Longhini, Federico, Grasso, Salvatore, Navalesi, Paolo, and Foti, Giuseppe

Published
2024
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3. Effects of non-invasive respiratory support in post-operative patients: a systematic review and network meta-analysis

Author

Pettenuzzo, Tommaso, Boscolo, Annalisa, Pistollato, Elisa, Pretto, Chiara, Giacon, Tommaso Antonio, Frasson, Sara, Carbotti, Francesco Maria, Medici, Francesca, Pettenon, Giovanni, Carofiglio, Giuliana, Nardelli, Marco, Cucci, Nicolas, Tuccio, Clara Letizia, Gagliardi, Veronica, Schiavolin, Chiara, Simoni, Caterina, Congedi, Sabrina, Monteleone, Francesco, Zarantonello, Francesco, Sella, Nicolò, De Cassai, Alessandro, and Navalesi, Paolo

Published
2024
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5. Gram-negative bacterial colonizations before bilateral lung transplant. The impact of ‘targeted’ versus ‘standard’ surgical prophylaxis

Author

Congedi, Sabrina, Peralta, Arianna, Muraro, Luisa, Biscaro, Martina, Pettenuzzo, Tommaso, Sella, Nicolò, Crociani, Silvia, Tagne, Arméla Anne-Sabine, Caregnato, Ida, Monteleone, Francesco, Rossi, Elisa, Roca, Gabriella, Manfrin, Silvia, Marinello, Serena, Mazzitelli, Maria, Dell’Amore, Andrea, Cattelan, Annamaria, Rea, Federico, Navalesi, Paolo, and Boscolo, Annalisa

Published
2024
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10. A pragmatic, open-label, multi-center, randomized controlled clinical trial on the rotational use of interfaces vs standard of care in patients treated with noninvasive positive pressure ventilation for acute hypercapnic respiratory failure: the ROTAtional-USE of interface STUDY (ROTA-USE STUDY)

Author

Vaschetto, Rosanna, Gregoretti, Cesare, Scotti, Lorenza, De Vita, Nello, Carlucci, Annalisa, Cortegiani, Andrea, Crimi, Claudia, Mattei, Alessio, Scala, Raffaele, Rocca, Eduardo, Longhini, Federico, Cammarota, Gianmaria, Misseri, Giovanni, Dal Molin, Alberto, Scolletta, Sabino, Nava, Stefano, Maggiore, Salvatore Maurizio, and Navalesi, Paolo

Published
2023
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15. Individualized positive end-expiratory pressure guided by end-expiratory lung volume in early acute respiratory distress syndrome: study protocol for the multicenter, randomized IPERPEEP trial

Author

Grieco, Domenico Luca, Maggiore, Salvatore Maurizio, Bellani, Giacomo, Spadaro, Savino, Spinelli, Elena, Tonetti, Tommaso, Menga, Luca S., Pozzi, Marco, Battaglini, Denise, Di Mussi, Rosa, Bruni, Andrea, De Gaetano, Andrea, Iovino, Carmine Giovanni, Brioni, Matteo, Mojoli, Francesco, Foti, Giuseppe, Volta, Carlo Aberto, Pelosi, Paolo, Navalesi, Paolo, Grasso, Salvatore, Ranieri, V. Marco, and Antonelli, Massimo

Published
2022
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21. Correction to: Effects of early extubation followed by noninvasive ventilation versus standard extubation on the duration of invasive mechanical ventilation in hypoxemic non-hypercapnic patients: a systematic review and individual patient data meta-analysis of randomized controlled trials

Author

Vaschetto, Rosanna, Pecere, Alessandro, Perkins, Gavin D., Mistry, Dipesh, Cammarota, Gianmaria, Longhini, Federico, Ferrer, Miguel, Pletsch-Assunção, Renata, Carron, Michele, Moretto, Francesca, Qiu, Haibo, Della Corte, Francesco, Barone-Adesi, Francesco, and Navalesi, Paolo

Published
2021
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22. Effects of early extubation followed by noninvasive ventilation versus standard extubation on the duration of invasive mechanical ventilation in hypoxemic non-hypercapnic patients: a systematic review and individual patient data meta-analysis of randomized controlled trials

Author

Vaschetto, Rosanna, Pecere, Alessandro, Perkins, Gavin D., Mistry, Dipesh, Cammarota, Gianmaria, Longhini, Federico, Ferrer, Miguel, Pletsch-Assunção, Renata, Carron, Michele, Moretto, Francesca, Qiu, Haibo, Della Corte, Francesco, Barone-Adesi, Francesco, and Navalesi, Paolo

Published
2021
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26. Italian Society of Anesthesia, Analgesia, Resuscitation, and Intensive Care expert consensus statement on the use of lung ultrasound in critically ill patients with coronavirus disease 2019 (ITACO)

Author

Vetrugno, Luigi, Mojoli, Francesco, Cortegiani, Andrea, Bignami, Elena Giovanna, Ippolito, Mariachiara, Orso, Daniele, Corradi, Francesco, Cammarota, Gianmaria, Mongodi, Silvia, Boero, Enrico, Iacovazzo, Carmine, Vargas, Maria, Poole, Daniele, Biasucci, Daniele Guerino, Persona, Paolo, Bove, Tiziana, Ball, Lorenzo, Chiumello, Davide, Forfori, Francesco, de Robertis, Edoardo, Pelosi, Paolo, Navalesi, Paolo, Giarratano, Antonino, and Petrini, Flavia

Published
2021
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27. Effect of awake prone position on diaphragmatic thickening fraction in patients assisted by noninvasive ventilation for hypoxemic acute respiratory failure related to novel coronavirus disease

Author

Cammarota, Gianmaria, Rossi, Elisa, Vitali, Leonardo, Simonte, Rachele, Sannipoli, Tiziano, Anniciello, Francesco, Vetrugno, Luigi, Bignami, Elena, Becattini, Cecilia, Tesoro, Simonetta, Azzolina, Danila, Giacomucci, Angelo, Navalesi, Paolo, and De Robertis, Edoardo

Published
2021
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28. Noninvasive respiratory support outside the intensive care unit for acute respiratory failure related to coronavirus-19 disease: a systematic review and meta-analysis

Author

Cammarota, Gianmaria, Esposito, Teresa, Azzolina, Danila, Cosentini, Roberto, Menzella, Francesco, Aliberti, Stefano, Coppadoro, Andrea, Bellani, Giacomo, Foti, Giuseppe, Grasselli, Giacomo, Cecconi, Maurizio, Pesenti, Antonio, Vitacca, Michele, Lawton, Tom, Ranieri, V. Marco, Di Domenico, Sandro Luigi, Resta, Onofrio, Gidaro, Antonio, Potalivo, Antonella, Nardi, Giuseppe, Brusasco, Claudia, Tesoro, Simonetta, Navalesi, Paolo, Vaschetto, Rosanna, and De Robertis, Edoardo

Published
2021
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34. High-flow nasal therapy versus noninvasive ventilation in COPD patients with mild-to-moderate hypercapnic acute respiratory failure: study protocol for a noninferiority randomized clinical trial

Author

Cortegiani, Andrea, Longhini, Federico, Carlucci, Annalisa, Scala, Raffaele, Groff, Paolo, Bruni, Andrea, Garofalo, Eugenio, Taliani, Maria Rita, Maccari, Uberto, Vetrugno, Luigi, Lupia, Enrico, Misseri, Giovanni, Comellini, Vittoria, Giarratano, Antonino, Nava, Stefano, Navalesi, Paolo, and Gregoretti, Cesare

Published
2019
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36. Pressure support ventilation + sigh in acute hypoxemic respiratory failure patients: study protocol for a pilot randomized controlled trial, the PROTECTION trial

Author

Mauri, Tommaso, Foti, Giuseppe, Fornari, Carla, Constantin, Jean-Michel, Guerin, Claude, Pelosi, Paolo, Ranieri, Marco, Conti, Sara, Tubiolo, Daniela, Rondelli, Egle, Lovisari, Federica, Fossali, Tommaso, Spadaro, Savino, Grieco, Domenico Luca, Navalesi, Paolo, Calamai, Italo, Becher, Tobias, Roca, Oriol, Wang, Yu-Mei, Knafelj, Rihard, Cortegiani, Andrea, Mancebo, Jordi, Brochard, Laurent, Pesenti, Antonio, and for the Protection Study Group

Published
2018
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37. Early short course of neuromuscular blocking agents in patients with COVID-19 ARDS: a propensity score analysis

Author

Li Bassi, G., Gibbons, K., Suen, J. Y., Dalton, H. J., White, N., Corley, A., Shrapnel, S., Hinton, S., Forsyth, S., Laffey, J. G., Fan, E., Fanning, J. P., Panigada, M., Bartlett, R., Brodie, D., Burrell, A., Chiumello, D., Elhazmi, A., Esperatti, M., Grasselli, G., Hodgson, C., Ichiba, S., Luna, C., Marwali, E., Merson, L., Murthy, S., Nichol, A., Ogino, M., Pelosi, P., Torres, A., P. Y., Ng, Fraser, J. F., Al-Dabbous, T., Alfoudri, H., Shamsah, M., Elapavaluru, S., Berg, A., Horn, C., Mayasi, Y., Schroll, S., Meyer, D., Velazco, J., Ploskanych, L., Fikes, W., Bagewadi, R., Dao, M., White, H., Ehlers, A., Shalabi-McGuire, M., Witt, T., Grazioli, L., Lorini, L., Grandin, E. W., Nunez, J., Reyes, T., Obriain, D., Hunter, S., Ramanan, M., Affleck, J., Veerendra, H. H., Rai, S., Russell-Brown, J., Nourse, M., Joseph, M., Mitchell, B., Tenzer, M., Abe, R., Cho, H. J., Jeong, I. S., Rahman, N., Kakar, V., Brozzi, N., Mehkri, O., Krishnan, S., Duggal, A., Houltham, S., Graf, J., Diaz, R., Orrego, R., Delgado, C., Gonzalez, J., Sanchez, M. S., Piagnerelli, M., Sarrazin, J. V., Zabert, A. /P. G., Espinosa, L., Delgado, P., Delgado, V., Rincon, D. F. B., Yanten, A. M. M., Duque, M. B., Al-Hudaib, A., Callahan, M., Taufik, M. A., Wardoyo, E. Y., Gunawan, M., Trisnaningrum, N. S., Irawany, V., Rayhan, M., Pesenti, A., Zanella, A., Leone, M., Coppola, S., Colombo, S., Antonelli, M., Carelli, S., Grieco, D. L., Asaki, M., Hoshino, K., Salazar, L., Duarte, L., Laffey, J., Mcnicholas, B., Cosgrave, D., Mccaffrey, J., Bone, A., Hakeem, Y., Winearls, J., Tallott, M., Thomson, D., Arnold-Day, C., Cupido, J., Fanie, Z., Miller, M., Seymore, L., van Straaten, D., Hssain, A. A., Aliudin, J., Alqahtani, A. -R., Mohamed, K., Mohamed, A., Tan, D., Villanueva, J., Zaqout, A., Kurtzman, E., Ademi, A., Dobrita, A., El Aoudi, K., Segura, J., Giwangkancana, G., Ohshimo, S., Hitoshi, S., Osatnik, J., Joosten, A., Yang, M., Motos, A., Arancibia, F., Williams, V., Noel, A., Luque, N., Trung, T. H., Yacoub, S., Fantini, M., Garcia, R. N. J., Alvarez, E. C., Greti, A., Ceccato, A., Sanchez, A., Vazquez, A. L., Roche-Campo, F., Franch-Llasat, D., Tuazon, D., Amato, M., Cassimiro, L., Pola, F., Ribeiro, F., Fonseca, G., Dalton, H., Desai, M., Osborn, E., Deeb, H., Arcadipane, A., Martucci, G., Panarello, G., Vitiello, C., Bianco, C., Occhipinti, G., Rossetti, M., Cuffaro, R., Cho, S. -M., Shimizu, H., Moriyama, N., Kim, J. -B., Kitamura, N., Gebauer, J., Yokoyama, T., Al-Fares, A., Buabbas, S., Alamad, E., Alawadhi, F., Alawadi, K., Tanaka, H., Hashimoto, S., Yamazaki, M., T. -H., Oh, Epler, M., Forney, C., Kruse, L., Feister, J., Williamson, J., Grobengieser, K., Gnall, E., Golden, S., Caroline, M., Shapiro, T., Karaj, C., Thome, L., Sher, L., Vanderland, M., Welch, M., Mcdermott, S., Brain, M., Mineall, S., Kimura, D., Brazzi, L., Sales, G., Ogston, T., Nagpal, D., Fischer, K., Lorusso, R., Rangappa, R., Appu, A., Carton, E. G., Sen, A., Palacios, A., Rainey, D., Samoukoviv, G., Campisi, J., Durham, L., Neumann, E., Seefeldt, C., Falcucci, O., Emmrich, A., Guy, J., Johns, C., Potzner, K., Zimmermann, C., Espinal, A., Buchtele, N., Schwameis, M., Stecher, S. -S., Singh, D., Barnikel, M., Arenz, L., Zaaqoq, A., Galloway, L. A., Merley, C., Csete, M., Quesada, L., Saba, I., Kasugai, D., Hiraiwa, H., Tanaka, T., Purnama, Y., Dewayanti, S. R., Ardiyan, Juzar, D. A., Siagian, D., Chen, Y. -S., Ratsep, I., Oigus, G., Erikson, K., Post, A. -M., Enneveer, L., Sillaots, P., Manetta, F., Mihelis, E., Sarmiento, I. C., Narasimhan, M., Varrone, M., Komats, M., Garcia-Diaz, J., Harmon, C., Satyapriya, S. V., Bhatt, A., Mokadam, N. A., Uribe, A., Gonzalez, A., Shi, H., Mckeown, J., Pasek, J., Fiorda, J., Echeverria, M., Moreno, R., Zakhary, B., Cavana, M., Cucino, A., Foti, G., Giani, M., Russotto, V., Castagna, V., Dellamore, A., Navalesi, P., Shum, H. -P., Vuysteke, A., Usman, A., Acker, A., Smood, B., Mergler, B., Sertic, F., Subramanian, M., Sperry, A., Rizer, N., Burhan, E., Rasmin, M., Akmal, E., Sitompul, F., Lolong, N., Naivedh, B., Erickson, S., Barrett, P., Dean, D., Daugherty, J., Loforte, A., Khan, I., Abraar Quraishi, M., Desantis, O., So, D., Kandamby, D., Mandei, J. M., Natanael, H., Yudhalantang, E., Lantang, A., Wijaya, S. O., Jung, A., Ng, G., W. Y., Ng, Fang, S., Tabah, A., Ratcliffe, M., Duroux, M., Adachi, S., Nakao, S., Blanco, P., Prieto, A., Sanchez, J., Nicholson, M., Butt, W., Serratore, A., Delzoppo, C., Janin, P., Yarad, E., Totaro, R., Coles, J., Pujo, B., Balk, R., Vissing, A., Kapania, E., Hays, J., Fox, S., Yantosh, G., Mishin, P., Yuliarto, S., Hari Santoso, K., Djajalaksana, S., Fatoni, A. Z., Fukuda, M., Liu, K., Battaglini, D., Jimenez, J. F. M., Bastos, D., Gaiao, S., Rusmawatiningtyas, D., Buchner, J., Cho, Y. -J., Lee, S. H., Kawasaki, T., Munshi, L., Sakiyalak, P., Nitayavardhana, P., Seitz, T., Arora, R., Kent, D., Marino, D., Parwar, S., Cheng, A., Miller, J., Fujitani, S., Shimizu, N., Madhok, J., Owyang, C., Buscher, H., Reynolds, C., Maasikas, O., Beljantsev, A., Mihnovits, V., Akimoto, T., Aizawa, M., Horibe, K., Onodera, R., Young, M., George, T., Shekar, K., Mcguinness, N., Irvine, L., Flynn, B., Endo, T., Sugiyama, K., Shimizu, K., Exconde, K., Lussier, L., Lotz, G., Malfertheiner, M., Maier, L., Dreier, E., Kusumastuti, N. P., Mccloskey, C., Dabaliz, A. -A., Elshazly, T. B., Smith, J., Szuldrzynski, K. S., Bielanski, P., Wille, K., Parhar, K. K. S., Fiest, K. M., Codan, C., Shahid, A., Fayed, M., Evans, T., Garcia, R., Gutierrez, A., Song, T., Rose, R., Bennett, S., Richardson, D., Peek, G., Arora, L., Rappapport, K., Rudolph, K., Sibenaller, Z., Stout, L., Walter, A., Herr, D., Vedadi, N., Thompson, S., Sindt, L., Rajnic, S., Ewald, C., Hoffman, J., Ying, X., Kennedy, R., Griffee, M., Ciullo, A., Kida, Y., Roca, R. F., Riera, J. I., Contreras, S., Alegre, C., Kay, C., Fischer, I., Renner, E., Taniguci, H., Fraser, J., Bassi, G. L., Suen, J., Barnett, A., Pearse, I., Abbate, G., Hassan, H., Heinsar, S., Karnik, V. A., Ki, K., Oneill, H. F., Obonyo, N., Pimenta, L. P., Reid, J. D., Sato, K., Vuorinen, A., Wildi, K. S., Wood, E. S., Yerkovich, S., Lee, J., Plotkin, D., Citarella, B. W., Hartley, E., Lubis, B., Ikeyama, T., Bhaskar, B., Jung, J. -S., Mcguinness, S., Eastwood, G., Marta, S. R., Guarracino, F., Gerle, S., Coxon, E., Claro, B., Loverde, D., Patil, N., Parrini, V., Mcbride, A., Negaard, K., Ratsch, A., Abdelaziz, A., Uribe, J. D., Peris, A., Sanders, M., Emerson, D., Kamal, M., Povoa, P., Francis, R., Cherif, A., Joseph, S., Di Nardo, M., Heard, M., Kyle, K., Blackwell, R. A., Biston, P., Jeong, H. W., Smith, R., Prawira, Y., Montrucchio, G., Garcia, A. H., Salterain, N., Meyns, B., Moreno, M., Walia, R., Mehta, A., Schweda, A., Supriatna, M., Kirakli, C., Williams, M., Kim, K. H., Assad, A., Giraldo, E., Karolak, W., Balik, M., Pocock, E., Gajkowski, E., Masafumi, K., Barrett, N., Takeyama, Y., Park, S., Amin, F., Andriyani, F. M., Sudakevych, S., Vera, M., Cornejo, R., Schwarz, P., Mardini, A. C., de Paula, T., Neto, A. S., Villoldo, A., Colafranceschi, A. S., Iglesias, A. U., Granjean, J., Melro, L. M. G., Romualdo, G. F., Gaia, D., Souza, H., Galas, F., Mendiluce, R. M., Sosa, A., Martinez, I., Kurosawa, H., Salgado, J., Hugi-MayrCharbonneau, B. E., Barzilai, V. S., Monteiro, V., de Souza, R. R., Harper, M., Suzuki, H., Adams, C., Brieva, J., Nyale, G., Eltatar, F. S., Fatani, J., Baeissa, H., Masri, A. A., Rabie, A., Hui, M. Y., Yamane, M., Jung, H., Margaret, A. M., Nacpil, N., Ruck, K., Bakken, R., Jara, C., Felton, T., Berra, L., Shah, B., Chakraborty, A., Cardona, M., Capatos, G., Akkanti, B., Orija, A., Jain, H., Ito, A., Housni, B., Low, S., Iihara, K., Chavez, J., Ramanathan, K., Zabert, G., Naidoo, K., Seppelt, I., Vandyk, M., Macdonald, S., Mcgregor, R., Siebenaler, T., Flynn, H., Lofton, K., Aokage, T., Shigemitsu, K., Moscatelli, A., Fiorentino, G., Baumgaertel, M., Mba, S. E., Assy, J., Hutahaean, A., Roush, H., Sichting, K. A., Alessandri, F., Burns, D., Salt, G., Garabedian, C. P., Millar, J., Sim, M., Mattke, A., Mcauley, D., Tadili, J., Frenzel, T., Bar-Lavie, Y., Ortiz, A. B., Stone, J., Attokaran, A., Farquharson, M., Patel, B., Gunning, D., Baillie, K., Watson, P., Tamai, K., Sajinadiyasa, G. K., Kanyawati, D., Salgado, M., Sassine, A., Yudo, B., Mccaul, S., Lee, B., Lee, S. M., Afek, A., Iwashita, Y., Semedi, B. P., Metiva, J., Van Belle, N., Martin-Loeches, I., Ivatt, L., Woon, C. Y., Kang, H. M., Smith, T., James, E., Al-Rawas, N., Iwasaki, Y., King-Chung, K. C., Gudzenko, V., Hugi-Mayr, B., Taccone, F., Perdhana, F., Lamarche, Y., Ribeiro, J. M., Bradic, N., Van den Bossche, K., Lansink, O., Singh, G., Debeuckelaere, G., Stelfox, H. T., Yi, C., Elia, J., Tribble, T., Shankar, S., Padmanabhan, R., Hallinan, B., Paoletti, L., Leyva, Y., Fykuda, T., Badulak, J., Koch, J., Hackman, A., Janowaik, L., Hernandez, D., Osofsky, J., Donadello, K., Lawang, A., Fine, J., Davidson, B., Vazquez, A. O. R., COVID-19 Critical Care Consortium, and Consortium, COVID-19 Critical Care

Subjects
Male, Respiratory Distress Syndrome, COVID-19, Intensive care unit, Mechanical ventilation, Neuromuscular blocking agent, SARS-CoV-2, Aged, Female, Humans, Intensive Care Units, Middle Aged, Propensity Score, Respiration, Artificial, Neuromuscular Blocking Agents, Respiration, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Settore MED/41 - Anestesiologia, Critical Care and Intensive Care Medicine, COVID-19 Drug Treatment, Artificial, Human medicine
Abstract

Background The role of neuromuscular blocking agents (NMBAs) in coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS) is not fully elucidated. Therefore, we aimed to investigate in COVID-19 patients with moderate-to-severe ARDS the impact of early use of NMBAs on 90-day mortality, through propensity score (PS) matching analysis. Methods We analyzed a convenience sample of patients with COVID-19 and moderate-to-severe ARDS, admitted to 244 intensive care units within the COVID-19 Critical Care Consortium, from February 1, 2020, through October 31, 2021. Patients undergoing at least 2 days and up to 3 consecutive days of NMBAs (NMBA treatment), within 48 h from commencement of IMV were compared with subjects who did not receive NMBAs or only upon commencement of IMV (control). The primary objective in the PS-matched cohort was comparison between groups in 90-day in-hospital mortality, assessed through Cox proportional hazard modeling. Secondary objectives were comparisons in the numbers of ventilator-free days (VFD) between day 1 and day 28 and between day 1 and 90 through competing risk regression. Results Data from 1953 patients were included. After propensity score matching, 210 cases from each group were well matched. In the PS-matched cohort, mean (± SD) age was 60.3 ± 13.2 years and 296 (70.5%) were male and the most common comorbidities were hypertension (56.9%), obesity (41.1%), and diabetes (30.0%). The unadjusted hazard ratio (HR) for death at 90 days in the NMBA treatment vs control group was 1.12 (95% CI 0.79, 1.59, p = 0.534). After adjustment for smoking habit and critical therapeutic covariates, the HR was 1.07 (95% CI 0.72, 1.61, p = 0.729). At 28 days, VFD were 16 (IQR 0–25) and 25 (IQR 7–26) in the NMBA treatment and control groups, respectively (sub-hazard ratio 0.82, 95% CI 0.67, 1.00, p = 0.055). At 90 days, VFD were 77 (IQR 0–87) and 87 (IQR 0–88) (sub-hazard ratio 0.86 (95% CI 0.69, 1.07; p = 0.177). Conclusions In patients with COVID-19 and moderate-to-severe ARDS, short course of NMBA treatment, applied early, did not significantly improve 90-day mortality and VFD. In the absence of definitive data from clinical trials, NMBAs should be indicated cautiously in this setting.

Published
2022
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42. Pressure support ventilation + sigh in acute hypoxemic respiratory failure patients: study protocol for a pilot randomized controlled trial, the PROTECTION trial

Author

Mauri, T, Foti, G, Fornari, C, Constantin, J, Guerin, C, Pelosi, P, Ranieri, M, Conti, S, Tubiolo, D, Rondelli, E, Lovisari, F, Fossali, T, Spadaro, S, Grieco, D, Navalesi, P, Calamai, I, Becher, T, Roca, O, Wang, Y, Knafelj, R, Cortegiani, A, Mancebo, J, Brochard, L, Pesenti, A, Grasselli, G, Spinelli, E, Abbruzzese, C, Rona, R, Bronco, A, Villa, S, Gianni, S, Papoff, A, Pinciroli, R, Colombo, R, Sproccati, C, Mandelli, P, Villa, F, Patroniti, N, Brunetti, I, Ball, L, Volta, C, Lazzeri, M, Maragoni, E, Eleuteri, D, Bello, G, Dell'Anna, A, Garofalo, E, Bruni, A, Biamonte, E, D'Andrea, R, Querci, L, Pierucci, E, Spina, R, Mori, I, Tomeo, F, Mercat, A, Beloncle, F, Jochmans, S, Mazerand, S, Baboi, L, Yonis, H, Jabaudon, M, Godet, T, Jovaisa, T, Barnes, T, Tariq, U, Weiler, N, Schädler, D, Frerichs, I, García-de-Acilu, M, Vidal, A, Rosas, E, Calvo, C, Zhou, J, Karagiannis, S, Zisopoulou, V, Staikos, I, Noc, M, Fister, M, Radsel, P, Gregoretti, C, Sabella, I, Raineri, S, Mauri, Tommaso, Foti, Giuseppe, Fornari, Carla, Constantin, Jean-Michel, Guerin, Claude, Pelosi, Paolo, Ranieri, Marco, Conti, Sara, Tubiolo, Daniela, RONDELLI, EGLE ROSALIA, Lovisari, Federica, Fossali, Tommaso, Spadaro, Savino, Grieco, Domenico Luca, Navalesi, Paolo, Calamai, Italo, Becher, Tobias, Roca, Oriol, Wang, Yu-Mei, Knafelj, Rihard, Cortegiani, Andrea, Mancebo, Jordi, Brochard, Laurent, Pesenti, Antonio, Volta, CA, dell'Anna, A, Calvo, CP, Zhou, JX, Raineri, SM, Mauri, T, Foti, G, Fornari, C, Constantin, J, Guerin, C, Pelosi, P, Ranieri, M, Conti, S, Tubiolo, D, Rondelli, E, Lovisari, F, Fossali, T, Spadaro, S, Grieco, D, Navalesi, P, Calamai, I, Becher, T, Roca, O, Wang, Y, Knafelj, R, Cortegiani, A, Mancebo, J, Brochard, L, Pesenti, A, Grasselli, G, Spinelli, E, Abbruzzese, C, Rona, R, Bronco, A, Villa, S, Gianni, S, Papoff, A, Pinciroli, R, Colombo, R, Sproccati, C, Mandelli, P, Villa, F, Patroniti, N, Brunetti, I, Ball, L, Volta, C, Lazzeri, M, Maragoni, E, Eleuteri, D, Bello, G, Dell'Anna, A, Garofalo, E, Bruni, A, Biamonte, E, D'Andrea, R, Querci, L, Pierucci, E, Spina, R, Mori, I, Tomeo, F, Mercat, A, Beloncle, F, Jochmans, S, Mazerand, S, Baboi, L, Yonis, H, Jabaudon, M, Godet, T, Jovaisa, T, Barnes, T, Tariq, U, Weiler, N, Schädler, D, Frerichs, I, García-de-Acilu, M, Vidal, A, Rosas, E, Calvo, C, Zhou, J, Karagiannis, S, Zisopoulou, V, Staikos, I, Noc, M, Fister, M, Radsel, P, Gregoretti, C, Sabella, I, Raineri, S, Mauri, Tommaso, Foti, Giuseppe, Fornari, Carla, Constantin, Jean-Michel, Guerin, Claude, Pelosi, Paolo, Ranieri, Marco, Conti, Sara, Tubiolo, Daniela, RONDELLI, EGLE ROSALIA, Lovisari, Federica, Fossali, Tommaso, Spadaro, Savino, Grieco, Domenico Luca, Navalesi, Paolo, Calamai, Italo, Becher, Tobias, Roca, Oriol, Wang, Yu-Mei, Knafelj, Rihard, Cortegiani, Andrea, Mancebo, Jordi, Brochard, Laurent, Pesenti, Antonio, Volta, CA, dell'Anna, A, Calvo, CP, Zhou, JX, and Raineri, SM

Abstract

BACKGROUND: Adding cyclic short sustained inflations (sigh) to assisted ventilation yields optimizes lung recruitment, decreases heterogeneity and reduces inspiratory effort in patients with acute hypoxemic respiratory failure (AHRF). These findings suggest that adding sigh to pressure support ventilation (PSV) might decrease the risk of lung injury, shorten weaning and improve clinical outcomes. Thus, we conceived a pilot trial to test the feasibility of adding sigh to PSV (the PROTECTION study). METHODS: PROTECTION is an international randomized controlled trial that will be conducted in 23 intensive care units (ICUs). Patients with AHRF who have been intubated from 24 h to 7 days and undergoing PSV from 4 to 24 h will be enrolled. All patients will first undergo a 30-min sigh test by adding sigh to clinical PSV for 30 min to identify early oxygenation responders. Then, patients will be randomized to PSV or PSV + sigh until extubation, ICU discharge, death or day 28. Sigh will be delivered as a 3-s pressure control breath delivered once per minute at 30 cmH2O. Standardized protocols will guide ventilation settings, switch back to controlled ventilation, use of rescue treatments, performance of spontaneous breathing trial, extubation and reintubation. The primary endpoint of the study will be to verify the feasibility of PSV + sigh evaluated through reduction of failure to remain on assisted ventilation during the first 28 days in the PSV + sigh group versus standard PSV (15 vs. 22%). Failure will be defined by switch back to controlled ventilation for more than 24 h or use of rescue treatments or reintubation within 48 h from elective extubation. Setting the power to 80% and first-risk order to 5%, the computed size of the trial is 129 patients per arm. DISCUSSION: PROTECTION is a pilot randomized controlled trial testing the feasibility of adding sigh to PSV. If positive, it will provide physicians with an effective addition to standard PSV for lung protection, a

Published
2018

43. Ten important articles on noninvasive ventilation in critically ill patients and insights for the future: A report of expert opinions.

Author

Cortegiani, A., Russotto, V., Gregoretti, C., Scala, R., Navalesi, P., Pelosi, P., Antonelli, M., Conti, G., Azoulay, E., Carlucci, A., Demoule, A., Ferrer, M., Hill, N. S., and Jaber, S.

Subjects
RESPIRATORY insufficiency treatment, PATIENTS, SERIAL publications, CRITICAL care medicine, CRITICALLY ill, DIFFUSION of innovations, REPORT writing, SURVEYS, VENTILATION, CONTINUOUS positive airway pressure, PULMONOLOGISTS
Abstract

Background: Noninvasive ventilation is used worldwide in many settings. Its effectiveness has been proven for common clinical conditions in critical care such as cardiogenic pulmonary edema and chronic obstructive pulmonary disease exacerbations. Since the first pioneering studies of noninvasive ventilation in critical care in the late 1980s, thousands of studies and articles have been published on this topic. Interestingly, some aspects remain controversial (e.g. its use in de-novo hypoxemic respiratory failure, role of sedation, self-induced lung injury). Moreover, the role of NIV has recently been questioned and reconsidered in light of the recent reports of new techniques such as high-flow oxygen nasal therapy. Methods: We conducted a survey among leading experts on NIV aiming to 1) identify a selection of 10 important articles on NIV in the critical care setting 2) summarize the reasons for the selection of each study 3) offer insights on the future for both clinical application and research on NIV. Results: The experts selected articles over a span of 26 years, more clustered in the last 15 years. Themost voted article studied the role of NIV in acute exacerbation chronic pulmonary disease. Concerning the future of clinical applications for and research on NIV, most of the experts forecast the development of innovative new interfaces more adaptable to patients characteristics, the need for good well-designed large randomized controlled trials of NIV in acute "de novo" hypoxemic respiratory failure (including its comparison with high-flow oxygen nasal therapy) and the development of software-based NIV settings to enhance patient-ventilator synchrony. Conclusions: The selection made by the experts suggests that some applications of NIV in critical care are supported by solid data (e.g. COPD exacerbation) while others are still waiting for confirmation. Moreover, the identified insights for the future would lead to improved clinical effectiveness, new comparisons and evaluation of its role in still "lack of full evidence" clinical settings. [ABSTRACT FROM AUTHOR]

Published
2017
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44. Clinical outcomes of patients treated with intravenous zanamivir for severe influenza A(H1N1)pdm09 infection: a case report series.

Author

Torti C, Mazzitelli M, Longhini F, Garofalo E, Bruni A, Giancotti A, Barreca GS, Quirino A, Liberto MC, Serapide F, Matera G, Trecarichi EM, and Navalesi P

Subjects
Humans, Influenza, Human physiopathology, Influenza, Human virology, Antiviral Agents therapeutic use, Influenza A Virus, H1N1 Subtype, Influenza, Human drug therapy, Zanamivir therapeutic use
Abstract

Background: Intravenous (IV) zanamivir could be a suitable alternative for the treatment of severe influenza A(H1N1)pdm09 infection in patients who are unable to take oral or inhaled medication, for example, those on mechanical ventilation and extracorporeal membrane oxygenation (ECMO). However, data on the clinical outcomes of such patients is limited., Case Presentation: We report the clinical outcomes of four patients who were admitted at the intensive care unit during the 2017-2018 influenza season with severe sepsis (SOFA score > 11) and acute respiratory distress syndrome requiring ECMO and mechanical ventilation. Two patients were immune-compromised. The A(H1N1)pdm09 genome was confirmed by polymerase chain reaction (PCR) on nasopharyngeal specimen swabs prior to administration of IV zanamivir at a dose of 600 mg twice daily. Weekly qualitative PCR analysis was done to monitor viral clearance, with zanamivir treatment being discontinued upon receipt of negative results. In addition, the patients were managed for concomitant multidrug-resistant bacterial infections, with infection resolution confirmed with blood cultures. The median time for zanamivir treatment was 10 days (IQR 10-17). The clinical outcome was favourable with all four patients surviving and improving clinically. All four patients achieved viral clearance of A(H1N1)pdm09 genome, and resolution of multidrug-resistant bacterial infections., Conclusions: IV zanamivir could be a good therapeutic option in patients with severe influenza A(H1N1)pdm09 infection who are unable to take oral or aerosolised antiviral medication. We recommend prospective randomized control trials to support this hypothesis.

Published
2019
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