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3 results on '"Luca Tabbì"'

1. Ventilatory support and mechanical properties of the fibrotic lung acting as a 'squishy ball'

Author

Alessandro, Marchioni, Tonelli, Roberto, Giulio, Rossi, Paolo, Spagnolo, Fabrizio, Luppi, Cerri, Stefania, Elisabetta, Cocconcelli, Pellegrino, Maria Rosaria, Davide, Campana, Riccardo, Fantini, Luca, Tabbì, Castaniere, Ivana, Lorenzo, Ball, Malbrain, Manu L. N. G., Paolo, Pelosi, Clini, Enrico, Marchioni, A, Tonelli, R, Rossi, G, Spagnolo, P, Luppi, F, Cerri, S, Cocconcelli, E, Pellegrino, M, Fantini, R, Tabbi, L, Castaniere, I, Ball, L, Malbrain, M, Pelosi, P, Clini, E, Supporting clinical sciences, and Intensive Care

Subjects
Artificial ventilation, medicine.medical_specialty, ARDS, Interstitial lung diseases, Exacerbation, medicine.medical_treatment, Interstitial lung disease, Review, mechanical ventilation, Respiratory failure, Lung injury, Critical Care and Intensive Care Medicine, 03 medical and health sciences, Mechanical ventilation, 0302 clinical medicine, Acute respiratory distress syndrome, Ventilator-induced lung injury, interstitial lung diseases, Medicine, Intensive care medicine, Medicine(all), Lung, business.industry, lcsh:Medical emergencies. Critical care. Intensive care. First aid, respiratory failure, 030208 emergency & critical care medicine, lcsh:RC86-88.9, ventilator-induced lung injury, acute respiratory distress syndrome, respiratory system, medicine.disease, respiratory tract diseases, medicine.anatomical_structure, 030228 respiratory system, business, interstitial lung diseases, acute respiratory distress syndrome, respiratory failure, mechanical ventilation, ventilator-induced lung injury
Abstract

Protective ventilation is the cornerstone of treatment of patients with the acute respiratory distress syndrome (ARDS); however, no studies have yet established the best ventilatory strategy to adopt when patients with acute exacerbation of interstitial lung disease (AE-ILD) are admitted to the intensive care unit. Due to the severe impairment of the respiratory mechanics, the fibrotic lung is at high risk of developing ventilator-induced lung injury, regardless of the lung fibrosis etiology. The purpose of this review is to analyze the effects of mechanical ventilation in AE-ILD and to increase the knowledge on the characteristics of fibrotic lung during artificial ventilation, introducing the concept of “squishy ball lung”. The role of positive end-expiratory pressure is discussed, proposing a “lung resting strategy” as opposed to the “open lung approach”. The review also discusses the practical management of AE-ILD patients discussing illustrative clinical cases.

Published
2020

2. Serial ultrasound assessment of diaphragmatic function and clinical outcome in patients with amyotrophic lateral sclerosis

Author

Riccardo, Fantini, Tonelli, Roberto, Castaniere, Ivana, Luca, Tabbì, Pellegrino, Maria Rosaria, Cerri, Stefania, Francesco, Livrieri, Francesco, Giaroni, Marco, Monelli, Ruggieri, Valentina, Nicola, Fini, Mandrioli, Jessica, Clini, Enrico, and Alessandro, Marchioni

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Vital capacity, medicine.medical_treatment, Diaphragm, Vital Capacity, Diaphragmatic breathing, Kaplan-Meier Estimate, Respiratory failure, Diaphragm dysfunction, Time-to-Treatment, ultrasound, diaphragmatic function, Noninvasive ventilation, ALS, Diaphragm ultrasound, FEV1/FVC ratio, Mechanical ventilation, Internal medicine, medicine, Humans, Respiratory function, Lung volumes, Prospective Studies, Tidal volume, Aged, Ultrasonography, lcsh:RC705-779, Noninvasive Ventilation, business.industry, Amyotrophic Lateral Sclerosis, lcsh:Diseases of the respiratory system, Middle Aged, Linear Models, Cardiology, Female, Respiratory Insufficiency, business, Research Article
Abstract

Background Diaphragmatic assessment by ultrasound (US) is a non-invasive and useful method in the clinical management of patients with Amyotrophic Lateral Sclerosis (ALS). The aim of our observational study was to evaluate the impact of serial assessment of the diaphragmatic function by US on long-term outcomes in a series of patients suffering from ALS and to correlate US indices of diaphragmatic function and respiratory function tests with these outcomes. Methods A cohort of 39 consecutive patients has been followed up to 24 months. Both lung volume (forced vital capacity, FVC) and diaphragmatic pressure generating capacity (by sniff inspiratory nasal pressure (SNIP) and by both US thickening fraction, ΔTdi, and the ratio of the thickening fraction between tidal volume and maximal lung capacity, ΔTmax) were recorded at baseline and every 3 months. Parameters were then correlated with outcomes (nocturnal hypoventilation, daily hypercapnia, start of ventilatory support (NIV), and death at 1 year) over time. Results The occurrence of ΔTmax > 0.75 increased the risk to start NIV (HR = 5.6, p = 0.001) and to die (HR = 3.7, p = 0.0001) compared with patients maintaining lower values. Moreover, compared with the occurrence of FVC 0.75 appeared slightly better correlated with NIV commencement within 6 months. Conclusions Serial diaphragmatic assessment by ultrasound is a useful and accurate method to predict the initiation of NIV earlier in patients with ALS. Electronic supplementary material The online version of this article (10.1186/s12890-019-0924-5) contains supplementary material, which is available to authorized users.

Published
2019

3. Ultrasound-assessed diaphragmatic impairment is a predictor of outcomes in patients with acute exacerbation of chronic obstructive pulmonary disease undergoing noninvasive ventilation

Author

Enrico Clini, Ivana Castaniere, Luca Tabbì, Alessandro Marchioni, Valentina Ruggieri, Francesco Giaroni, Matteo Fontana, Roberto Tonelli, Riccardo Fantini, Andrea Viani, and Stefania Cerri

Subjects
Male, medicine.medical_specialty, Acute exacerbation of chronic obstructive pulmonary disease, medicine.medical_treatment, Diaphragm, Population, Diaphragmatic breathing, Kaplan-Meier Estimate, Respiratory failure, Critical Care and Intensive Care Medicine, Statistics, Nonparametric, Cohort Studies, Pulmonary Disease, Chronic Obstructive, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Diagnosis, Ultrasound, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, education, Tidal volume, APACHE, Aged, Ultrasonography, Aged, 80 and over, Mechanical ventilation, Simplified Acute Physiology Score, education.field_of_study, business.industry, Research, lcsh:Medical emergencies. Critical care. Intensive care. First aid, lcsh:RC86-88.9, medicine.disease, Patient Outcome Assessment, Diaphragmatic dysfunction, Intensive Care Units, Italy, 030228 respiratory system, Cardiology, Arterial blood, Female, business, Noninvasive ventilation, Transdiaphragmatic pressure
Abstract

Background Ultrasound (US) evaluation of diaphragmatic dysfunction (DD) has proved to be a reliable technique in critical care. In this single-center prospective study, we investigated the impact of US-assessed DD on noninvasive ventilation (NIV) failure in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and its correlation with the transdiaphragmatic pressure assessed using the invasive sniff maneuver (Pdi sniff). Methods A population of 75 consecutive patients with AECOPD with hypercapnic acidosis admitted to our respiratory intensive care unit (RICU) were enrolled. Change in diaphragm thickness (ΔTdi)

Published
2018

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