10 results on '"Votta, CD"'
Search Results
2. Tracheal intubation in critically ill patients: a comprehensive systematic review of randomized trials
- Author
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Cabrini, L, Landoni, G, Radaelli, MB, Saleh, O, Votta, CD, Fominskiy, E, Putzu, A, Snak de Souza, CD, Antonelli, M, Bellomo, R, Pelosi, P, Zangrillo, A, Cabrini, L, Landoni, G, Radaelli, MB, Saleh, O, Votta, CD, Fominskiy, E, Putzu, A, Snak de Souza, CD, Antonelli, M, Bellomo, R, Pelosi, P, and Zangrillo, A more...
- Abstract
BACKGROUND: We performed a systematic review of randomized controlled studies evaluating any drug, technique or device aimed at improving the success rate or safety of tracheal intubation in the critically ill. METHODS: We searched PubMed, BioMed Central, Embase and the Cochrane Central Register of Clinical Trials and references of retrieved articles. Finally, pertinent reviews were also scanned to detect further studies until May 2017. The following inclusion criteria were considered: tracheal intubation in adult critically ill patients; randomized controlled trial; study performed in Intensive Care Unit, Emergency Department or ordinary ward; and work published in the last 20 years. Exclusion criteria were pre-hospital or operating theatre settings and simulation-based studies. Two investigators selected studies for the final analysis. Extracted data included first author, publication year, characteristics of patients and clinical settings, intervention details, comparators and relevant outcomes. The risk of bias was assessed with the Cochrane Collaboration's Risk of Bias tool. RESULTS: We identified 22 trials on use of a pre-procedure check-list (1 study), pre-oxygenation or apneic oxygenation (6 studies), sedatives (3 studies), neuromuscular blocking agents (1 study), patient positioning (1 study), video laryngoscopy (9 studies), and post-intubation lung recruitment (1 study). Pre-oxygenation with non-invasive ventilation (NIV) and/or high-flow nasal cannula (HFNC) showed a possible beneficial role. Post-intubation recruitment improved oxygenation, while ramped position increased the number of intubation attempts and thiopental had negative hemodynamic effects. No effect was found for use of a checklist, apneic oxygenation (on oxygenation and hemodynamics), videolaryngoscopy (on number and length of intubation attempts), sedatives and neuromuscular blockers (on hemodynamics). Finally, videolaryngoscopy was associated with severe adverse effects in multiple trial more...
- Published
- 2018
Catalog
3. Remote Ischemic Preconditioning and Cardiac Surgery
- Author
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Derek Hausenloy, Kai Zacharowski, Nana-Maria Wagner, Patrick Meybohm, Derek Yellon, Giovanni LANDONI, Landoni, Giovanni, Baiardo Redaelli, M, and Votta, Cd
- Subjects
Male ,medicine.medical_specialty ,business.industry ,MEDLINE ,General Medicine ,030204 cardiovascular system & hematology ,Cardiac surgery ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,Postoperative Complications ,Anesthesia ,Internal medicine ,Cardiology ,medicine ,Ischemic preconditioning ,Humans ,Female ,030212 general & internal medicine ,Coronary Artery Bypass ,Cardiac Surgical Procedures ,business ,Ischemic Preconditioning - Published
- 2016
4. Volatile Agents in Medical and Surgical Intensive Care Units: A Meta-Analysis of Randomized Clinical Trials
- Author
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Giovanni Landoni, Carmine D. Votta, Anna Mara Scandroglio, Mattia Bellandi, Alberto Zangrillo, Laura Pasin, Giovanni Borghi, Martina Baiardo Redaelli, Luca Cabrini, Landoni, Giovanni, Pasin, L, Cabrini, L, Scandroglio, Am, Baiardo Redaelli, M, Votta, Cd, Bellandi, M, Borghi, G, and Zangrillo, Alberto more...
- Subjects
medicine.medical_specialty ,Critical Care ,Sedation ,critically ill ,anesthesia ,intensive care ,mechanical ventilation ,sedation ,volatile agents ,Airway Extubation ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Intensive care ,medicine ,Humans ,030212 general & internal medicine ,Intensive care medicine ,Randomized Controlled Trials as Topic ,business.industry ,030208 emergency & critical care medicine ,Intensive care unit ,Clinical trial ,Intensive Care Units ,Anesthesiology and Pain Medicine ,Strictly standardized mean difference ,Meta-analysis ,Anesthetics, Inhalation ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
OBJECTIVE:To comprehensively assess published randomized peer-reviewed studies related to volatile agents used for sedation in intensive care unit (ICU) settings, with the hypothesis that volatile agents could reduce time to extubation in adult patients.DESIGN:Systematic review and meta-analysis of randomized trials.SETTING:Intensive care units.PARTICIPANTS:Critically ill patients.INTERVENTIONS:None.MEASUREMENTS AND MAIN RESULTS:The BioMedCentral, PubMed, Embase, and Cochrane Central Register databases of clinical trials were searched systematically for studies on volatile agents used in the ICU setting. Articles were assessed by trained investigators, and divergences were resolved by consensus. Inclusion criteria included random allocation to treatment (volatile agents versus any intravenous comparator, with no restriction on dose or time of administration) in patients requiring mechanical ventilation in the ICU. Twelve studies with 934 patients were included in the meta-analysis. The use of halogenated agents reduced the time to extubation (standardized mean difference = -0.78 [-1.01 to -0.55] hours; p for effect more...
- Published
- 2016
5. Prolonged transesophageal echocardiography during percutaneous closure of the left atrial appendage without general anesthesia: the utility of the Janus mask
- Author
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Paolo Della Bella, Alberto Zangrillo, Patrizio Mazzone, Nicola Villari, Fabrizio Monaco, Carmine D. Votta, Zangrillo, Alberto, Mazzone, P, Votta, Cd, Villari, N, Della Bella, P, and Monaco, F.
- Subjects
medicine.medical_specialty ,Percutaneous ,Sedation ,Operative Time ,Remifentanil ,Echocardiography, Three-Dimensional ,030204 cardiovascular system & hematology ,Anesthesia, General ,03 medical and health sciences ,0302 clinical medicine ,030202 anesthesiology ,Anesthesiology ,Atrial Fibrillation ,medicine ,Humans ,Atrial Appendage ,Stroke ,Aged ,Aged, 80 and over ,business.industry ,Masks ,Atrial fibrillation ,General Medicine ,medicine.disease ,Anesthesiology and Pain Medicine ,Treatment Outcome ,Anesthesia ,Midazolam ,medicine.symptom ,Deep Sedation ,business ,Propofol ,Echocardiography, Transesophageal ,medicine.drug - Abstract
PURPOSE:Left atrial appendage (LAA) closure is an interventional procedure increasingly used to prevent stroke in patients with permanent atrial fibrillation and contraindications to anticoagulation therapy. As this procedure requires a relatively immobile patient and performance of continuous and prolonged transesophageal echocardiography (TEE), it is usually performed under general anesthesia. In this case series, we describe the feasibility of prolonged TEE for percutaneous LAA closure using a new noninvasive ventilation device that can avoid the need for endotracheal intubation and general anesthesia.CLINICAL FEATURES:Percutaneous LAA closure was performed under deep sedation in three elderly patients with permanent atrial fibrillation. Sedation was obtained with a combination of midazolam, propofol, and remifentanil. Continuous intraoperative TEE was performed through the port of the newly available Janus mask (Biomedical Srl; Florence, Italy), allowing for noninvasive ventilation (pressure support = 12-16 cm H2O; positive end-expiratory pressure = 7 cm H2O; FIO2 = 0.3) in these spontaneously breathing patients. The total procedure times ranged from 75-90 min. The patients reported excellent satisfaction with the sedation received in terms of discomfort experienced during the procedure, capacity to recall the procedure, and comfort with the mask. The operators also rated the procedural conditions as excellent.CONCLUSION:Deep sedation with noninvasive ventilation may be a reasonable and safe alternative to general endotracheal anesthesia in patients requiring prolonged TEE for noninvasive cardiac procedures, including LAA closure more...
6. Characteristics, treatment, outcomes and cause of death of invasively ventilated patients with COVID-19 ARDS in Milan, Italy.
- Author
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Zangrillo A, Beretta L, Scandroglio AM, Monti G, Fominskiy E, Colombo S, Morselli F, Belletti A, Silvani P, Crivellari M, Monaco F, Azzolini ML, Reineke R, Nardelli P, Sartorelli M, Votta CD, Ruggeri A, Ciceri F, De Cobelli F, Tresoldi M, Dagna L, Rovere-Querini P, Serpa Neto A, Bellomo R, and Landoni G more...
- Subjects
- Age Factors, Aged, Betacoronavirus, COVID-19, Cause of Death, Coronavirus Infections therapy, Female, Humans, Hypertension complications, Italy, Male, Middle Aged, Pandemics, Pneumonia, Viral therapy, Respiratory Distress Syndrome therapy, Respiratory Distress Syndrome virology, Risk Factors, SARS-CoV-2, Coronavirus Infections mortality, Pneumonia, Viral mortality, Respiration, Artificial, Respiratory Distress Syndrome mortality
- Abstract
Objective: Describe characteristics, daily care and outcomes of patients with coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS)., Design: Case series of 73 patients., Setting: Large tertiary hospital in Milan., Participants: Mechanically ventilated patients with confirmed COVID-19 admitted to the intensive care unit (ICU) between 20 February and 2 April 2020., Main Outcome Measures: Demographic and daily clinical data were collected to identify predictors of early mortality., Results: Of the 73 patients included in the study, most were male (83.6%), the median age was 61 years (interquartile range [IQR], 54-69 years), and hypertension affected 52.9% of patients. Lymphocytopenia (median, 0.77 x 10
3 per mm3 ; IQR, 0.58-1.00 x 103 per mm3 ), hyperinflammation with C-reactive protein (median, 184.5 mg/dL; IQR, 108.2-269.1 mg/dL) and pro-coagulant status with D-dimer (median, 10.1 μg/m; IQR, 5.0-23.8 μg/m) were present. Median tidal volume was 6.7 mL/kg (IQR, 6.0-7.5 mL/kg), and median positive end-expiratory pressure was 12 cmH2 O (IQR, 10-14 cmH2 O). In the first 3 days, prone positioning (12-16 h) was used in 63.8% of patients and extracorporeal membrane oxygenation in five patients (6.8%). After a median follow-up of 19.0 days (IQR, 15.0-27.0 days), 17 patients (23.3%) had died, 23 (31.5%) had been discharged from the ICU, and 33 (45.2%) were receiving invasive mechanical ventilation in the ICU. Older age (odds ratio [OR], 1.12; 95% CI, 1.04-1.22; P = 0.004) and hypertension (OR, 6.15; 95% CI, 1.75-29.11; P = 0.009) were associated with mortality, while early improvement in arterial partial pressure of oxygen (PaO2 ) to fraction of inspired oxygen (FiO2 ) ratio was associated with being discharged alive from the ICU ( P = 0.002 for interaction)., Conclusions: Despite multiple advanced critical care interventions, COVID-19 ARDS was associated with prolonged ventilation and high short term mortality. Older age and pre-admission hypertension were key mortality risk factors., Trial Registration: ClinicalTrials.gov identifier: NCT04318366. more...- Published
- 2020
7. Correction to: Tracheal intubation in critically ill patients: a comprehensive systematic review of randomized trials.
- Author
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Cabrini L, Landoni G, Baiardo Redaelli M, Saleh O, Votta CD, Fominskiy E, Putzu A, de Souza CDS, Antonelli M, Bellomo R, Pelosi P, and Zangrillo A
- Abstract
In the publication of this article [1], there was an error in a contributors Family Name. This has now been updated in the original article.
- Published
- 2019
- Full Text
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8. Awake Fiberoptic Intubation Protocols in the Operating Room for Anticipated Difficult Airway: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
- Author
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Cabrini L, Baiardo Redaelli M, Ball L, Filippini M, Fominskiy E, Pintaudi M, Putzu A, Votta CD, Sorbello M, Antonelli M, Landoni G, Pelosi P, and Zangrillo A
- Subjects
- Analgesics, Opioid therapeutic use, Anesthesia, Local, Dexmedetomidine therapeutic use, Humans, Hypnotics and Sedatives, Midazolam therapeutic use, Patient Safety, Propofol therapeutic use, Randomized Controlled Trials as Topic, Risk, Treatment Outcome, Wakefulness, Clinical Protocols, Fiber Optic Technology, Intubation, Intratracheal adverse effects, Intubation, Intratracheal methods, Operating Rooms
- Abstract
Awake fiberoptic intubation is one of the recommended strategies for surgical patients with anticipated difficult airway, especially when concurrent difficult ventilation is expected. We performed the first systematic review of randomized controlled trials assessing different protocols for awake fiberoptic intubation in anticipated difficult airway, including studies investigating elective awake fiberoptic intubation for scheduled surgery; randomized controlled trials comparing different methods for performing awake fiberoptic intubation; and adult patients with anticipated difficult airway. We excluded studies in the nonoperating theater settings, randomized controlled trials comparing awake fiberoptic intubation with other techniques, and studies based on simulation. Primary outcomes were success rate and death; secondary outcomes were major adverse events. Thirty-seven randomized controlled trials evaluating 2045 patients and 4 areas were identified: premedication, local anesthesia, sedation, and ancillary techniques to facilitate awake fiberoptic intubation. Quality of evidence was moderate-low and based on small-sampled randomized controlled trials. Overall, 12 of 2045 intubation failures (0.59%) and 7 of 2045 severe adverse events (0.34%) occurred, with no permanent consequences or death. All evaluated methods to achieve local anesthesia performed similarly well. No differences were observed in success rate with different sedatives. Dexmedetomidine resulted in fewer desaturation episodes compared to propofol and opioids with or without midazolam (relative risk, 0.51 [95% CI, 0.28-0.95]; P = .03); occurrence of desaturation was similar with remifentanil versus propofol, while incidence of apnoea was lower with sevoflurane versus propofol (relative risk, 0.43 [95% CI, 0.22-0.81]; P = .01). A high degree of efficacy and safety was observed with minimal differences among different protocols; dexmedetomidine might offer a better safety profile compared to other sedatives. more...
- Published
- 2019
- Full Text
- View/download PDF
9. Tracheal intubation in critically ill patients: a comprehensive systematic review of randomized trials.
- Author
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Cabrini L, Landoni G, Baiardo Redaelli M, Saleh O, Votta CD, Fominskiy E, Putzu A, Snak de Souza CD, Antonelli M, Bellomo R, Pelosi P, and Zangrillo A
- Subjects
- Adult, Cannula trends, Critical Illness therapy, Emergency Service, Hospital organization & administration, Humans, Intensive Care Units organization & administration, Laryngoscopy methods, Noninvasive Ventilation methods, Noninvasive Ventilation standards, Randomized Controlled Trials as Topic, Respiration, Artificial methods, Respiration, Artificial standards, Intubation, Intratracheal methods, Intubation, Intratracheal standards
- Abstract
Background: We performed a systematic review of randomized controlled studies evaluating any drug, technique or device aimed at improving the success rate or safety of tracheal intubation in the critically ill., Methods: We searched PubMed, BioMed Central, Embase and the Cochrane Central Register of Clinical Trials and references of retrieved articles. Finally, pertinent reviews were also scanned to detect further studies until May 2017. The following inclusion criteria were considered: tracheal intubation in adult critically ill patients; randomized controlled trial; study performed in Intensive Care Unit, Emergency Department or ordinary ward; and work published in the last 20 years. Exclusion criteria were pre-hospital or operating theatre settings and simulation-based studies. Two investigators selected studies for the final analysis. Extracted data included first author, publication year, characteristics of patients and clinical settings, intervention details, comparators and relevant outcomes. The risk of bias was assessed with the Cochrane Collaboration's Risk of Bias tool., Results: We identified 22 trials on use of a pre-procedure check-list (1 study), pre-oxygenation or apneic oxygenation (6 studies), sedatives (3 studies), neuromuscular blocking agents (1 study), patient positioning (1 study), video laryngoscopy (9 studies), and post-intubation lung recruitment (1 study). Pre-oxygenation with non-invasive ventilation (NIV) and/or high-flow nasal cannula (HFNC) showed a possible beneficial role. Post-intubation recruitment improved oxygenation
, while ramped position increased the number of intubation attempts and thiopental had negative hemodynamic effects. No effect was found for use of a checklist, apneic oxygenation (on oxygenation and hemodynamics), videolaryngoscopy (on number and length of intubation attempts), sedatives and neuromuscular blockers (on hemodynamics). Finally, videolaryngoscopy was associated with severe adverse effects in multiple trials., Conclusions: The limited available evidence supports a beneficial role of pre-oxygenation with NIV and HFNC before intubation of critically ill patients. Recruitment maneuvers may increase post-intubation oxygenation. Ramped position increased the number of intubation attempts; thiopental had negative hemodynamic effects and videolaryngoscopy might favor adverse events. more...- Published
- 2018
- Full Text
- View/download PDF
10. Two Different Endoscopic Procedures Made Feasible by the Janus Mask in a High-Risk Patient.
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Beccaria P, Votta CD, Lucchetta L, Silvetti S, Agostoni M, and Zangrillo A
- Abstract
The Janus mask is a full face mask designed for providing noninvasive ventilation (NIV) during any kind of upper endoscopies (e.g., fiber-optic bronchoscopy, gastrointestinal endoscopy, and transesophageal echocardiography). Due to its unique conformation, its use can be considered for both elective and urgent endoscopic procedures in high-risk patients. In this case report, we present a patient with acute respiratory failure who underwent two consecutive different endoscopic procedures (fiber-optic bronchoscopy and gastrointestinal endoscopy) during continuous positive airway pressure support by means of this novel NIV mask, thus avoiding tracheal intubation and at the same time, improving his respiratory condition., Competing Interests: There are no conflicts of interest. more...
- Published
- 2017
- Full Text
- View/download PDF
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