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2. Parenteral and enteral feeding in hospitals in Italy: a national survey

Author

Braga, M, Bozzetti, F, Dionigi, P, Radrizzani, D, Iapichino, G, Salis, C, Scroccaro, G, Gelio, S, Messori, A, Tognoni, G, Zanello, M, Ferrara, F, Corti, A, Fanchini, P, Vernero, S, Congedo, R, Decicco, M, Morelli, M, Carrata, R, Laddaga, L, Lattarulo, M, Marchesi, G, Sequenza, S, Stivala, B, Lanzone, L, Sozzi, P, Raitano, A, Fiacchi, M, Pierangeli, A, Russito, G, Caporali, C, Bittasi, P, Sanna, P, Savona, G, Usai, C, Accogli, P, Selli, L, Pusceddu, P, Iasiello, G, Fazio, S, Badoino, C, Burlon, N, Lombardi, M, Bertana, P, Bartazzi, D, Paolucci, R, Tella, G, Callegari, R, Toffoletto, F, Torreggiani, L, Campo, S, Micheletti, I, Lidestri, G, Zanin, P, Giuliano, G, Chioldi, G, Perlasca, F, Grande, W, Pincelli, D, Paccagnella, A, Francesconi, R, Domeniconi, D, Bertotti, G, Campi, A, Vivarelli, R, Donati, D, Sibilla, C, Cervi, R, Vannucci, A, Tonelli, F, Bravo, M, Fusi, D, Pagani, M, Desalvo, L, Amalfitano, M, Zunino, Vanliut, M, Pirola, V, Campestrini, G, Agostini, S, Galdieri, M, Severino, A, Casula, C, Agus, G, Franceschini, L, Sarni, A, Vendrame, G, Frattini, F, Nardi, L, Valente, F, Rambelli, G, Rusconi, A, Taddei, G, Barbuscia, M, Cozzaglio, L, Regalia, E, Giudici, D, Gianotti, L, Baccari, P, Dalcin, S, Molene, V, Biffi, R, Gallitelli, L, Bianchi, G, Vecchi, G, Villa, E, Barzan, D, Mazzato, M, Pietromaggiori, F, Campisi, M, Palozzo, A, Inzalaco, M, Ricci, G, Castellucci, M, Maggiore, E, Salvadore, C, Grusovin, M, Mezzasalma, N, Maso, G, Pecorelli, O, Finco, C, Sartori, F, Buffano, G, Iacovelli, W, Ferri, T, Zermani, R, Rovati, P, Cebrelli, T, Pallavicini, F, Albertario, F, Bosco, A, Olivi, P, Paolini, P, Dalcanto, L, Marconcini, F, Lazzarini, R, Malacrida, A, Amboldi, A, Bonelli, S, Florianello, F, Borin, F, Vaghi, G, Fanelli, F, Mancini, S, Giusti, D, Nanni, G, Sannella, F, Sganga, G, Fellegara, P, Mosconi, F, Signorelli, I, Orban, D, Ceccherini, E, Orsini, A, Giuliano, P, Rosa, F, Zanella, A, Croatto, T, Toffanin, D, Binotto, F, Marcato, P, Menardo, G, Faucci, L, Spoldi, L, Marsetti, M, Dicosmo, L, Fornasetti, A, Manetti, A, Salvatore, A, Rossi, C, Rinaldi, S, Deangelis, C, Azzola, M, Conte, F, Rizzo, V, Bona, Mazzego, M, Leggieri, A, Canino, V, Pastore, V, Bosco, R, Debernardi, Disalvatore, A, Degrazia, R, Mazzon, D, Papadia, G, Toigo, G, Iscra, F, Nemez, M, Drobinz, F, Mesgez, D, Troncon, M, Bacco, A, Cattaruzzi, C, Cinque, A, Pasquetto, A, Cartei, G, Dibello, B, Miani, P, Chizzola, A, Baldassarre, M, Borga, P, Borgato, F, Scattolini, C, Laveggio, L, Franceschini, F, Turturo, F, Porretto, V, Coati, M, Nesi, L, Carner, M, Zampieri, P, Gabrielli, G, Todeschini, G, Falconi, M, Fratucello, G, Delgrossi, S, Citterio, R, Villa, C, Rivolta, A, Minuto, D, Orcalli, F, Ferrera, G, BRAGA M, BOZZETTI F, DIONIGI P, RADRIZZANI D, IAPICHINO G, SALIS C, SCROCCARO G, GELIO S, MESSORI A, TOGNONI G, ZANELLO M, FERRARA F, CORTI A, FANCHINI P, VERNERO S, CONGEDO RM, DECICCO M, MORELLI M, CARRATA R, LADDAGA L, LATTARULO M, MARCHESI G, SEQUENZA S, STIVALA B, LANZONE L, SOZZI P, RAITANO A, FIACCHI M, PIERANGELI A, RUSSITO G, CAPORALI C, BITTASI P, SANNA P, SAVONA G, USAI C, ACCOGLI P, SELLI L, PUSCEDDU P, IASIELLO G, FAZIO S, BADOINO C, BURLON N, LOMBARDI M, BERTANA P, BARTAZZI D, PAOLUCCI R, TELLA GC, CALLEGARI R, TOFFOLETTO F, TORREGGIANI L, CAMPO S, MICHELETTI I, LIDESTRI G, ZANIN P, GIULIANO G, CHIOLDI G, PERLASCA F, GRANDE W, PINCELLI D, PACCAGNELLA A, FRANCESCONI R, DOMENICONI D, BERTOTTI G, CAMPI A, VIVARELLI R, DONATI D, SIBILLA C, CERVI R, VANNUCCI A, TONELLI F, BRAVO MT, FUSI D, PAGANI M, DESALVO L, AMALFITANO ME, ZUNINO, VANLIUT MT, PIROLA V, CAMPESTRINI G, AGOSTINI S, GALDIERI MT, SEVERINO A, CASULA C, AGUS G, FRANCESCHINI L, SARNI A, VENDRAME G, FRATTINI F, NARDI L, VALENTE F, RAMBELLI G, RUSCONI A, TADDEI G, BARBUSCIA M, COZZAGLIO L, REGALIA E, GIUDICI D, GIANOTTI L, BACCARI P, DALCIN S, MOLENE V, BIFFI R, GALLITELLI L, BIANCHI G, VECCHI G, VILLA E, BARZAN D, MAZZATO M, PIETROMAGGIORI F, CAMPISI M, PALOZZO A, INZALACO M, RICCI G, CASTELLUCCI MG, MAGGIORE E, SALVADORE C, GRUSOVIN MT, MEZZASALMA N, MASO G, PECORELLI O, FINCO C, SARTORI F, BUFFANO G, IACOVELLI W, FERRI T, ZERMANI R, ROVATI P, CEBRELLI T, PALLAVICINI FB, ALBERTARIO F, BOSCO A, OLIVI P, PAOLINI P, DALCANTO L, MARCONCINI F, LAZZARINI R, MALACRIDA A, AMBOLDI A, BONELLI S, FLORIANELLO F, BORIN F, VAGHI GM, FANELLI FR, MANCINI S, GIUSTI D, NANNI G, SANNELLA F, SGANGA G, FELLEGARA P, MOSCONI F, SIGNORELLI I, ORBAN D, CECCHERINI E, ORSINI A, GIULIANO P, ROSA F, ZANELLA A, CROATTO T, TOFFANIN D, BINOTTO F, MARCATO P, MENARDO G, FAUCCI L, SPOLDI L, MARSETTI M, DICOSMO L, FORNASETTI A, MANETTI A, SALVATORE A, ROSSI C, RINALDI S, DEANGELIS C, AZZOLA M, CONTE F, RIZZO V, BONA, MAZZEGO M, LEGGIERI A, CANINO V, PASTORE V, BOSCO R, DEBERNARDI, DISALVATORE A, DEGRAZIA R, MAZZON D, PAPADIA G, TOIGO G, ISCRA F, NEMEZ M, DROBINZ F, MESGEZ D, TRONCON MG, BACCO A, CATTARUZZI C, CINQUE A, PASQUETTO A, CARTEI G, DIBELLO B, MIANI P, CHIZZOLA A, BALDASSARRE M, BORGA P, BORGATO F, SCATTOLINI C, LAVEGGIO L, FRANCESCHINI F, TURTURO F, PORRETTO V, COATI M, NESI L, CARNER M, ZAMPIERI P, GABRIELLI G, TODESCHINI G, FALCONI M, FRATUCELLO G, DELGROSSI S, CITTERIO R, VILLA C, RIVOLTA A, MINUTO D, ORCALLI F, FERRERA G, Braga, M, Bozzetti, F, Dionigi, P, Radrizzani, D, Iapichino, G, Salis, C, Scroccaro, G, Gelio, S, Messori, A, Tognoni, G, Zanello, M, Ferrara, F, Corti, A, Fanchini, P, Vernero, S, Congedo, R, Decicco, M, Morelli, M, Carrata, R, Laddaga, L, Lattarulo, M, Marchesi, G, Sequenza, S, Stivala, B, Lanzone, L, Sozzi, P, Raitano, A, Fiacchi, M, Pierangeli, A, Russito, G, Caporali, C, Bittasi, P, Sanna, P, Savona, G, Usai, C, Accogli, P, Selli, L, Pusceddu, P, Iasiello, G, Fazio, S, Badoino, C, Burlon, N, Lombardi, M, Bertana, P, Bartazzi, D, Paolucci, R, Tella, G, Callegari, R, Toffoletto, F, Torreggiani, L, Campo, S, Micheletti, I, Lidestri, G, Zanin, P, Giuliano, G, Chioldi, G, Perlasca, F, Grande, W, Pincelli, D, Paccagnella, A, Francesconi, R, Domeniconi, D, Bertotti, G, Campi, A, Vivarelli, R, Donati, D, Sibilla, C, Cervi, R, Vannucci, A, Tonelli, F, Bravo, M, Fusi, D, Pagani, M, Desalvo, L, Amalfitano, M, Zunino, Vanliut, M, Pirola, V, Campestrini, G, Agostini, S, Galdieri, M, Severino, A, Casula, C, Agus, G, Franceschini, L, Sarni, A, Vendrame, G, Frattini, F, Nardi, L, Valente, F, Rambelli, G, Rusconi, A, Taddei, G, Barbuscia, M, Cozzaglio, L, Regalia, E, Giudici, D, Gianotti, L, Baccari, P, Dalcin, S, Molene, V, Biffi, R, Gallitelli, L, Bianchi, G, Vecchi, G, Villa, E, Barzan, D, Mazzato, M, Pietromaggiori, F, Campisi, M, Palozzo, A, Inzalaco, M, Ricci, G, Castellucci, M, Maggiore, E, Salvadore, C, Grusovin, M, Mezzasalma, N, Maso, G, Pecorelli, O, Finco, C, Sartori, F, Buffano, G, Iacovelli, W, Ferri, T, Zermani, R, Rovati, P, Cebrelli, T, Pallavicini, F, Albertario, F, Bosco, A, Olivi, P, Paolini, P, Dalcanto, L, Marconcini, F, Lazzarini, R, Malacrida, A, Amboldi, A, Bonelli, S, Florianello, F, Borin, F, Vaghi, G, Fanelli, F, Mancini, S, Giusti, D, Nanni, G, Sannella, F, Sganga, G, Fellegara, P, Mosconi, F, Signorelli, I, Orban, D, Ceccherini, E, Orsini, A, Giuliano, P, Rosa, F, Zanella, A, Croatto, T, Toffanin, D, Binotto, F, Marcato, P, Menardo, G, Faucci, L, Spoldi, L, Marsetti, M, Dicosmo, L, Fornasetti, A, Manetti, A, Salvatore, A, Rossi, C, Rinaldi, S, Deangelis, C, Azzola, M, Conte, F, Rizzo, V, Bona, Mazzego, M, Leggieri, A, Canino, V, Pastore, V, Bosco, R, Debernardi, Disalvatore, A, Degrazia, R, Mazzon, D, Papadia, G, Toigo, G, Iscra, F, Nemez, M, Drobinz, F, Mesgez, D, Troncon, M, Bacco, A, Cattaruzzi, C, Cinque, A, Pasquetto, A, Cartei, G, Dibello, B, Miani, P, Chizzola, A, Baldassarre, M, Borga, P, Borgato, F, Scattolini, C, Laveggio, L, Franceschini, F, Turturo, F, Porretto, V, Coati, M, Nesi, L, Carner, M, Zampieri, P, Gabrielli, G, Todeschini, G, Falconi, M, Fratucello, G, Delgrossi, S, Citterio, R, Villa, C, Rivolta, A, Minuto, D, Orcalli, F, Ferrera, G, BRAGA M, BOZZETTI F, DIONIGI P, RADRIZZANI D, IAPICHINO G, SALIS C, SCROCCARO G, GELIO S, MESSORI A, TOGNONI G, ZANELLO M, FERRARA F, CORTI A, FANCHINI P, VERNERO S, CONGEDO RM, DECICCO M, MORELLI M, CARRATA R, LADDAGA L, LATTARULO M, MARCHESI G, SEQUENZA S, STIVALA B, LANZONE L, SOZZI P, RAITANO A, FIACCHI M, PIERANGELI A, RUSSITO G, CAPORALI C, BITTASI P, SANNA P, SAVONA G, USAI C, ACCOGLI P, SELLI L, PUSCEDDU P, IASIELLO G, FAZIO S, BADOINO C, BURLON N, LOMBARDI M, BERTANA P, BARTAZZI D, PAOLUCCI R, TELLA GC, CALLEGARI R, TOFFOLETTO F, TORREGGIANI L, CAMPO S, MICHELETTI I, LIDESTRI G, ZANIN P, GIULIANO G, CHIOLDI G, PERLASCA F, GRANDE W, PINCELLI D, PACCAGNELLA A, FRANCESCONI R, DOMENICONI D, BERTOTTI G, CAMPI A, VIVARELLI R, DONATI D, SIBILLA C, CERVI R, VANNUCCI A, TONELLI F, BRAVO MT, FUSI D, PAGANI M, DESALVO L, AMALFITANO ME, ZUNINO, VANLIUT MT, PIROLA V, CAMPESTRINI G, AGOSTINI S, GALDIERI MT, SEVERINO A, CASULA C, AGUS G, FRANCESCHINI L, SARNI A, VENDRAME G, FRATTINI F, NARDI L, VALENTE F, RAMBELLI G, RUSCONI A, TADDEI G, BARBUSCIA M, COZZAGLIO L, REGALIA E, GIUDICI D, GIANOTTI L, BACCARI P, DALCIN S, MOLENE V, BIFFI R, GALLITELLI L, BIANCHI G, VECCHI G, VILLA E, BARZAN D, MAZZATO M, PIETROMAGGIORI F, CAMPISI M, PALOZZO A, INZALACO M, RICCI G, CASTELLUCCI MG, MAGGIORE E, SALVADORE C, GRUSOVIN MT, MEZZASALMA N, MASO G, PECORELLI O, FINCO C, SARTORI F, BUFFANO G, IACOVELLI W, FERRI T, ZERMANI R, ROVATI P, CEBRELLI T, PALLAVICINI FB, ALBERTARIO F, BOSCO A, OLIVI P, PAOLINI P, DALCANTO L, MARCONCINI F, LAZZARINI R, MALACRIDA A, AMBOLDI A, BONELLI S, FLORIANELLO F, BORIN F, VAGHI GM, FANELLI FR, MANCINI S, GIUSTI D, NANNI G, SANNELLA F, SGANGA G, FELLEGARA P, MOSCONI F, SIGNORELLI I, ORBAN D, CECCHERINI E, ORSINI A, GIULIANO P, ROSA F, ZANELLA A, CROATTO T, TOFFANIN D, BINOTTO F, MARCATO P, MENARDO G, FAUCCI L, SPOLDI L, MARSETTI M, DICOSMO L, FORNASETTI A, MANETTI A, SALVATORE A, ROSSI C, RINALDI S, DEANGELIS C, AZZOLA M, CONTE F, RIZZO V, BONA, MAZZEGO M, LEGGIERI A, CANINO V, PASTORE V, BOSCO R, DEBERNARDI, DISALVATORE A, DEGRAZIA R, MAZZON D, PAPADIA G, TOIGO G, ISCRA F, NEMEZ M, DROBINZ F, MESGEZ D, TRONCON MG, BACCO A, CATTARUZZI C, CINQUE A, PASQUETTO A, CARTEI G, DIBELLO B, MIANI P, CHIZZOLA A, BALDASSARRE M, BORGA P, BORGATO F, SCATTOLINI C, LAVEGGIO L, FRANCESCHINI F, TURTURO F, PORRETTO V, COATI M, NESI L, CARNER M, ZAMPIERI P, GABRIELLI G, TODESCHINI G, FALCONI M, FRATUCELLO G, DELGROSSI S, CITTERIO R, VILLA C, RIVOLTA A, MINUTO D, ORCALLI F, and FERRERA G

Abstract

A multicentre prospective survey on the use of artificial nutrition (AN) and its complications has been carried out on 1657 hospitalised patients including 7.8% in surgical departments, 7.1% in medical departments and 59.9% in intensive care units. Gastrointestinal diseases and cancer were the most frequent pathologies among patients requiring AN. Parenteral nutrition (PN) alone was employed in 1103 (66.5%) patients. In 267 (16.1%) PN was associated with enteral nutrition (EN). 287 (17.3%) patients were fed by the enteral route alone. The average daily energy intake was 35 kcal/kg for central PN, 26 kcal/kg for peripheral PN and 33 kcal/kg for EN. The mean daily nitrogen intake was 0.19 g/kg for central PN, 0.17 g/kg for peripheral PN and 0.20 g/kg for EN. In 10% of patients PN was electrolyte free and in only 50% all the main electrolytes were added. Trace elements were added in 48% of formulations, mainly as multiple combination. Insulin was added in 61% of PN patients, while albumin was given with PN in 20% of patients. Adverse reactions were observed in 10.9% of PN patients and in 11.5% of EN patients. The most frequent complications occurring in parenterally fed patients were infections of the central venous catheter and metabolic alterations (severe electrolyte abnormalities, liver or renal dysfunction, hypo or persistent hyperglycemia). In enterally fed patients the frequent complications were abdominal distension, cramps and diarrhoea. Adverse reactions were responsible for discontinuation of AN in 2.2% of parenterally supported patients and in 5.7% of enterally fed patients.

Published
1994

3. PARENTERAL AND ENTERAL FEEDING IN HOSPITALS IN ITALY - A NATIONAL SURVEY

Author

BRAGA , MARCO, BOZZETTI F, DIONIGI P, RADRIZZANI D, IAPICHINO G, SALIS C, SCROCCARO G, GELIO S, MESSORI A, TOGNONI G, ZANELLO M, FERRARA F, CORTI A, FANCHINI P, VERNERO S, CONGEDO RM, DECICCO M, MORELLI M, CARRATA R, LADDAGA L, LATTARULO M, MARCHESI G, SEQUENZA S, STIVALA B, LANZONE L, SOZZI P, RAITANO A, FIACCHI M, PIERANGELI A, RUSSITO G, CAPORALI C, BITTASI P, SANNA P, SAVONA G, USAI C, ACCOGLI P, SELLI L, PUSCEDDU P, IASIELLO G, FAZIO S, BADOINO C, BURLON N, LOMBARDI M, BERTANA P, BARTAZZI D, PAOLUCCI R, TELLA GC, CALLEGARI R, TOFFOLETTO F, TORREGGIANI L, CAMPO S, MICHELETTI I, LIDESTRI G, ZANIN P, GIULIANO G, CHIOLDI G, PERLASCA F, GRANDE W, PINCELLI D, PACCAGNELLA A, FRANCESCONI R, DOMENICONI D, BERTOTTI G, CAMPI A, VIVARELLI R, DONATI D, SIBILLA C, CERVI R, VANNUCCI A, TONELLI F, BRAVO MT, FUSI D, PAGANI M, DESALVO L, AMALFITANO ME, ZUNINO, VANLIUT MT, PIROLA V, CAMPESTRINI G, AGOSTINI S, GALDIERI MT, SEVERINO A, CASULA C, AGUS G, FRANCESCHINI L, SARNI A, VENDRAME G, FRATTINI F, NARDI L, VALENTE F, RAMBELLI G, RUSCONI A, TADDEI G, BARBUSCIA M, COZZAGLIO L, REGALIA E, GIUDICI D, GIANOTTI L, BACCARI P, DALCIN S, MOLENE V, BIFFI R, GALLITELLI L, BIANCHI G, VECCHI G, VILLA E, BARZAN D, MAZZATO M, PIETROMAGGIORI F, CAMPISI M, PALOZZO A, INZALACO M, RICCI G, CASTELLUCCI MG, MAGGIORE E, SALVADORE C, GRUSOVIN MT, MEZZASALMA N, MASO G, PECORELLI O, FINCO C, SARTORI F, BUFFANO G, IACOVELLI W, FERRI T, ZERMANI R, ROVATI P, CEBRELLI T, PALLAVICINI FB, ALBERTARIO F, BOSCO A, OLIVI P, PAOLINI P, DALCANTO L, MARCONCINI F, LAZZARINI R, MALACRIDA A, AMBOLDI A, BONELLI S, FLORIANELLO F, BORIN F, VAGHI GM, FANELLI FR, MANCINI S, GIUSTI D, NANNI G, SANNELLA F, SGANGA G, FELLEGARA P, MOSCONI F, SIGNORELLI I, ORBAN D, CECCHERINI E, ORSINI A, GIULIANO P, ROSA F, ZANELLA A, CROATTO T, TOFFANIN D, BINOTTO F, MARCATO P, MENARDO G, FAUCCI L, SPOLDI L, MARSETTI M, DICOSMO L, FORNASETTI A, MANETTI A, SALVATORE A, ROSSI C, RINALDI S, DEANGELIS C, AZZOLA M, CONTE F, RIZZO V, BONA, MAZZEGO M, LEGGIERI A, CANINO V, PASTORE V, BOSCO R, DEBERNARDI, DISALVATORE A, DEGRAZIA R, MAZZON D, PAPADIA G, TOIGO G, ISCRA F, NEMEZ M, DROBINZ F, MESGEZ D, TRONCON MG, BACCO A, CATTARUZZI C, CINQUE A, PASQUETTO A, CARTEI G, DIBELLO B, MIANI P, CHIZZOLA A, BALDASSARRE M, BORGA P, BORGATO F, SCATTOLINI C, LAVEGGIO L, FRANCESCHINI F, TURTURO F, PORRETTO V, COATI M, NESI L, CARNER M, ZAMPIERI P, GABRIELLI G, TODESCHINI G, FALCONI, MASSIMO, FRATUCELLO G, DELGROSSI S, CITTERIO R, VILLA C, RIVOLTA A, MINUTO D, ORCALLI F, FERRERA G., Braga, Marco, Bozzetti, F, Dionigi, P, Radrizzani, D, Iapichino, G, Salis, C, Scroccaro, G, Gelio, S, Messori, A, Tognoni, G, Zanello, M, Ferrara, F, Corti, A, Fanchini, P, Vernero, S, Congedo, Rm, Decicco, M, Morelli, M, Carrata, R, Laddaga, L, Lattarulo, M, Marchesi, G, Sequenza, S, Stivala, B, Lanzone, L, Sozzi, P, Raitano, A, Fiacchi, M, Pierangeli, A, Russito, G, Caporali, C, Bittasi, P, Sanna, P, Savona, G, Usai, C, Accogli, P, Selli, L, Pusceddu, P, Iasiello, G, Fazio, S, Badoino, C, Burlon, N, Lombardi, M, Bertana, P, Bartazzi, D, Paolucci, R, Tella, Gc, Callegari, R, Toffoletto, F, Torreggiani, L, Campo, S, Micheletti, I, Lidestri, G, Zanin, P, Giuliano, G, Chioldi, G, Perlasca, F, Grande, W, Pincelli, D, Paccagnella, A, Francesconi, R, Domeniconi, D, Bertotti, G, Campi, A, Vivarelli, R, Donati, D, Sibilla, C, Cervi, R, Vannucci, A, Tonelli, F, Bravo, Mt, Fusi, D, Pagani, M, Desalvo, L, Amalfitano, Me, Zunino, Vanliut, Mt, Pirola, V, Campestrini, G, Agostini, S, Galdieri, Mt, Severino, A, Casula, C, Agus, G, Franceschini, L, Sarni, A, Vendrame, G, Frattini, F, Nardi, L, Valente, F, Rambelli, G, Rusconi, A, Taddei, G, Barbuscia, M, Cozzaglio, L, Regalia, E, Giudici, D, Gianotti, L, Baccari, P, Dalcin, S, Molene, V, Biffi, R, Gallitelli, L, Bianchi, G, Vecchi, G, Villa, E, Barzan, D, Mazzato, M, Pietromaggiori, F, Campisi, M, Palozzo, A, Inzalaco, M, Ricci, G, Castellucci, Mg, Maggiore, E, Salvadore, C, Grusovin, Mt, Mezzasalma, N, Maso, G, Pecorelli, O, Finco, C, Sartori, F, Buffano, G, Iacovelli, W, Ferri, T, Zermani, R, Rovati, P, Cebrelli, T, Pallavicini, Fb, Albertario, F, Bosco, A, Olivi, P, Paolini, P, Dalcanto, L, Marconcini, F, Lazzarini, R, Malacrida, A, Amboldi, A, Bonelli, S, Florianello, F, Borin, F, Vaghi, Gm, Fanelli, Fr, Mancini, S, Giusti, D, Nanni, G, Sannella, F, Sganga, G, Fellegara, P, Mosconi, F, Signorelli, I, Orban, D, Ceccherini, E, Orsini, A, Giuliano, P, Rosa, F, Zanella, A, Croatto, T, Toffanin, D, Binotto, F, Marcato, P, Menardo, G, Faucci, L, Spoldi, L, Marsetti, M, Dicosmo, L, Fornasetti, A, Manetti, A, Salvatore, A, Rossi, C, Rinaldi, S, Deangelis, C, Azzola, M, Conte, F, Rizzo, V, Bona, Mazzego, M, Leggieri, A, Canino, V, Pastore, V, Bosco, R, Debernardi, Disalvatore, A, Degrazia, R, Mazzon, D, Papadia, G, Toigo, G, Iscra, F, Nemez, M, Drobinz, F, Mesgez, D, Troncon, Mg, Bacco, A, Cattaruzzi, C, Cinque, A, Pasquetto, A, Cartei, G, Dibello, B, Miani, P, Chizzola, A, Baldassarre, M, Borga, P, Borgato, F, Scattolini, C, Laveggio, L, Franceschini, F, Turturo, F, Porretto, V, Coati, M, Nesi, L, Carner, M, Zampieri, P, Gabrielli, G, Todeschini, G, Falconi, Massimo, Fratucello, G, Delgrossi, S, Citterio, R, Villa, C, Rivolta, A, Minuto, D, Orcalli, F, Ferrera, G., Braga, M, Congedo, R, Tella, G, Bravo, M, Amalfitano, M, Vanliut, M, Galdieri, M, Castellucci, M, Grusovin, M, Pallavicini, F, Vaghi, G, Fanelli, F, Troncon, M, Falconi, M, and Ferrera, G

Subjects
Pediatrics, medicine.medical_specialty, Nutrition and Dietetics, business.industry, medicine.medical_treatment, Insulin, Abdominal distension, Critical Care and Intensive Care Medicine, Enteral administration, Gastroenterology, Discontinuation, Parenteral nutrition, Internal medicine, Intensive care, Medicine, enteral feeding, medicine.symptom, business, Complication, Central venous catheter
Abstract

A multicentre prospective survey on the use of artificial nutrition (AN) and its complications has been carried out on 1657 hospitalised patients including 7.8% in surgical departments, 7.1% in medical departments and 59.9% in intensive care units. Gastrointestinal diseases and cancer were the most frequent pathologies among patients requiring AN. Parenteral nutrition (PN) alone was employed in 1103 (66.5%) patients. In 267 (16.1%) PN was associated with enteral nutrition (EN). 287 (17.3%) patients were fed by the enteral route alone. The average daily energy intake was 35 kcal/kg for central PN, 26 kcal/kg for peripheral PN and 33 kcal/kg for EN. The mean daily nitrogen intake was 0.19 g/kg for central PN, 0.17 g/kg for peripheral PN and 0.20 g/kg for EN. In 10% of patients PN was electrolyte free and in only 50% all the main electrolytes were added. Trace elements were added in 48% of formulations, mainly as multiple combination. Insulin was added in 61% of PN patients, while albumin was given with PN in 20% of patients. Adverse reactions were observed in 10.9% of PN patients and in 11.5% of EN patients. The most frequent complications occurring in parenterally fed patients were infections of the central venous catheter and metabolic alterations (severe electrolyte abnormalities, liver or renal dysfunction, hypo or persistent hyperglycemia). In enterally fed patients the frequent complications were abdominal distension, cramps and diarrhoea. Adverse reactions were responsible for discontinuation of AN in 2.2% of parenterally supported patients and in 5.7% of enterally fed patients.

Published
1994

17. Surveillance of severe cutaneous drug reactions: Experience REACT-Lombardia,Sorveglianza di reazioni gravi cutanee da farmaco: L'esperienza REACT-Lombardia

Author

Gamba, C., Schroeder, J., Citterio, A., Simone Cazzaniga, Rivolta, A. L., Vighi, G., Naldi, L., Piozzi, E., Taddei, G., Reseghetti, A., Lorini, M., Di Landro, A., Manzotti, G., Accaria, F., Di Matteo, M., Fiori, A. M., Bruni, P., Pezzarossa, E., Barrosi, C., Sartori, F., Brezzi, A., Bettoni, D., Re, B., Canclini, L., Frattini, L., Fossati, S., Monina, G., Strippoli, A., Barcella, A., Corti, P., Fideli, D., Bigardi, A., Cassinerio, M., Borin, F., Cornali, A., Filippi, C., Clerici, L., Zanzottera, F., Laria, G., Lembo, G., Borroni, G., Vassallo, C., Guarnone, E., Radice, S., Clementi, E., Ragazzi, A., Antoninetti, M., Galbiati, G., Perotta, E., Curti, C., Mercuri, S. R., Ferri, C., Tosi, A., Erpoli, P., Re, E., Monti, M., Fazio, M., Motolese, E., and Malesci, A.

18. Rationale and methodology of the ICAI study, a randomised clinical trial of alprostadil in the treatment of chronic critical leg ischemia

Author

Belgrano, Ea, Nardella, L., Guala, A., Mazzucchetti, S., Marinoni, V., Calzoni, D., Bedoni, P., Confalonieri, Ma, Agus, Gb, Mondani, P., Deangelis, R., Biasi, Gm, Piglionica, MR, Abbritti, F., Agrifoglio, G., Costantini, A., DellaVedova, MR, Miglierina, L., Marrocu, R., Bragherio, G., Zanoni, Ce, Borin, F., Alderi, G., Emanuelli, G., Flandoli, C., Colzani, M., Ponti, Gb, Berra, S., Bevilacqua, A., Bocca, M., Invernizzi, C., Deangelis, E., Tacconi, A., Dangelo, F., Vaghi, M., Arzini, A., Boccalon, L., Losapio, Gm, Ambrosi, R., Briolini, F., Inzoli, MR, Lombardi, G., Tarantola, P., Zocca, N., Tenchini, P., Bruni, T., Fontanili, M., Guidetti, D., Pedeferri, G., Bordoni, Mc, Catalano, A., Visconti, W., Vedovato, F., Zucchella, M., Bittolo, Bg, Busetto, Mt, Zambon, C., Carlassara, Gb, Barbato, O., Zambelli, V., Mazzilli, G., Lino, M., Pavan, S., Pagnan, A., Visona, A., Perissinotto, C., Tonietto, G., Michelet, I., Agresta, F., Favretti, F., Burigo, E., Delazzer, L., Giansante, C., Fiotti, N., Grego, S., Mozzon, L., Gonano, N., Pfeiffer, P., Petrilli, Gl, Puzzo, A., Giuseppe Baldino, Podesta, A., Guastini, A., Traversaro, A., Zinicola, N., Baglietto, F., Arnuzzo, L., Defabritiis, A., Filippini, M., Ferrari, F., Martini, L., Testoni, P., Accorsi, F., Maurizi, P., Evangelisti, G., Roffi, A., Marzara, G., Fini, C., Coppi, G., Camparini, S., Tusini, N., Tuscano, G., Lonardi, R., Rozza, A., Botta, Gc, Villani, Lg, Pavarini, E., Campanella, P., Moratti, A., Ieran, M., Bertini, D., Pratesi, C., Narcetti, S., Corsi, C., Pollastri, M., Marrapodi, E., Melillo, E., Iabichella, Ml, Setacci, C., Sozio, G., Cao, P., Verzini, F., Mannarino, E., Pasqualini, L., Vaudo, G., Alo, F., Ioannidis, G., Spartera, C., Marino, G., Bafile, G., Anselmi, E., Maniscalco, G., Longo, P., Digiovanni, V., Colli, R., Fabbri, Mc, Bracale, G., Bernardo, B., Perretti, B., Valitutti, P., Vigliotti, G., Cimino, G., Rolli, F., Pascali, M., Sabella, G., Grilli, M., Correra, M., Palese, E., Florena, M., Cassina, I., Cumbo, P., Comande, C., Notarbartolo, A., Novo, S., Belvedere, M., Caruso, R., Verghi, F., Cavallaro, S., Martello, G., Romeo, S., Cormaci, Of, Binaghi, F., Fronteddu, P., Cannas, F., Degaetano, G., Tognoni, G., Avanzini, F., Bertele, V., Digiulio, P., Pangrazzi, J., Roncaglioni, Mc, Colombo, F., Fellin, G., Terzian, E., Coccheri, S., Delfavero, A., Geraci, E., Janzon, L., Vermylen, J., Beghi, E., Coen, D., and Turazza, F.

23. [High-flow fistula: a problem not easy to handle].

Author

Mudoni A, Cornacchiari M, Borin F, Liccardo A, Visciano B, Ponticelli MG, and Guastoni C

Subjects
Humans, Aged, Hemodynamics, Renal Dialysis adverse effects, Arteriovenous Shunt, Surgical adverse effects, Heart Failure etiology, Arteriovenous Fistula complications
Abstract

High-output cardiac failure is a well-known phenomenon of high-flow fistula in hemodialysis patients. The definition of "high flow" is varied and almost always connected to proximal arteriovenous fistulas (AVF). High flow access is a condition in which hemodynamics is affected by a greater rate of blood flow required for hemodialysis and this can compromise circulatory dynamics, particularly in the elderly in the context of pre-existing heart disease. High access flow is associated with complications like high output heart failure, pulmonary hypertension, massively dilated fistula, central vein stenosis, dialysis associated steal syndrome or distal hypoperfusion ischemic syndrome. Although there is no single agreement about the values of AVF flow volume, nor about the definition of high-flow AVF, there is no doubt that AVF flow should be considered too high if signs of cardiac failure develop. The exact threshold for defining high flow access has not been validated or universally accepted by the guidelines, although a vascular access flow rate of 1 to 1.5 l/min has been suggested. Moreover, even lower values may be indicative of relatively excessive blood flow, depending on the patient's condition. The pathophysiology contributing to this disease process is the shunting of blood from the high-resistance arterial system into the lower resistance venous system, increasing the venous return up to cardiac failure. Accurate and well-timed diagnosis of high flow arteriovenous hemodynamics by monitoring of blood flow of fistula and cardiac function is required in order to stop this process prior to cardiac failure. We present two cases of patients with high flow arteriovenous fistula with a review of the literature., (Copyright by Società Italiana di Nefrologia SIN, Rome,Italy.)

Published
2023

24. [Evaluation via ecocolordoppler before creating a vascular access for hemodyalisis: a monocentric experience].

Author

Cornacchiari M, Mudoni A, Borin F, Stasi A, Ponticelli MG, Visciano B, and Guastoni C

Subjects
Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Peritoneal Dialysis statistics & numerical data, Postoperative Complications prevention & control, Radial Artery diagnostic imaging, Radial Artery physiology, Regional Blood Flow, Subclavian Vein diagnostic imaging, Subclavian Vein physiology, Time Factors, Ulnar Artery diagnostic imaging, Ulnar Artery physiology, Vascular Patency, Arteriovenous Shunt, Surgical, Preoperative Care methods, Renal Dialysis statistics & numerical data, Ultrasonography, Doppler
Abstract

The use of a preoperative echocolordoppler improves the clinical evaluation because provides anatomical and hemodynamic information that make it an important tool in planning vascular access strategy. The preoperative ultrasound study of the vessels can significantly reduce the failure rate and the incidence of complications of vascular access. We describe the experience of our center, lasting 10-year, where the ultrasound assessment was performed in all patients before the creation of vascular access. Indeed, ultrasound reduces the rate of fistula failure and increases the utilization of fistula, allowing proper selection of vessels. In addition, the presence of the vascular access team has allowed us to achieve quite satisfactory results., (Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.)

Published
2020

25. [Clinical, ultrasound and treatment of aneurysms and pseudoaneurysms in hemodialysis vascular access].

Author

Cornacchiari M, Guastoni C, Borin F, Di Toma L, Mereghetti M, Di Lullo L, and Mudoni A

Subjects
Aneurysm etiology, Aneurysm therapy, Aneurysm, False diagnostic imaging, Aneurysm, False surgery, Diagnosis, Differential, Endovascular Procedures methods, Guidelines as Topic, Humans, Risk Factors, Treatment Outcome, Aneurysm diagnostic imaging, Aneurysm surgery, Arteriovenous Shunt, Surgical adverse effects, Renal Dialysis adverse effects, Ultrasonography, Doppler, Color
Abstract

Aneurysms (AN) and pseudoaneurysms are among the complications of vascular access. AN is a focal area of expansion, concentric or eccentric, with the wall consistency the same as all elements of the vessel wall (intima, media and adventitia). Pseudoaneurysm, or false aneurysm, is a blood harvesting without vascular wall, it is characterized by a reactive capsule of connective tissue that delimits it. The K/DOQI guidelines recommend a regular program of monitoring and surveillance of the vascular access. Color-Doppler ultrasound is considered a valuable tool in the preoperative evaluation and in the follow-up. The echo-color-Doppler surveillance plays an important role in diagnosis of aneurysm. It allows monitoring the evolution of the aneurysm, studying vessels walls, thickened because of intimal hyperplasia and to identify the presence of thrombotic material and/or calcification of the wall. Early identification of complications and the adoption of corrective measures will extend the life of the vascular access, with benefit for the patient. Moreover, it will reduce health care costs.

Published
2016

26. Vascular access teamwork.

Author

Borin F and Cornacchiari M

Subjects
Combined Modality Therapy, Cooperative Behavior, Graft Occlusion, Vascular diagnosis, Graft Occlusion, Vascular etiology, Graft Rejection diagnosis, Graft Rejection etiology, Humans, Interdisciplinary Communication, Kidney Diseases diagnosis, Male, Middle Aged, Reoperation, Thrombosis diagnosis, Thrombosis etiology, Time Factors, Treatment Outcome, Arteriovenous Shunt, Surgical adverse effects, Blood Vessel Prosthesis Implantation adverse effects, Graft Rejection therapy, Kidney Diseases therapy, Kidney Transplantation adverse effects, Patient Care Team, Renal Dialysis, Upper Extremity blood supply
Published
2015
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27. [Urokinase in a premature infant: its use in a case of right atrial thrombosis secondary to catheterization of the umbilical vein].

Author

Colnaghi C, Cazzuffi MA, Introvini P, Fornerone R, Sabatini I, Borin F, and Magni LA

Subjects
Echocardiography, Gestational Age, Heart Atria diagnostic imaging, Heart Diseases diagnostic imaging, Heart Diseases etiology, Humans, Infant, Newborn, Male, Thrombosis diagnostic imaging, Thrombosis etiology, Catheterization, Peripheral adverse effects, Heart Diseases drug therapy, Thrombolytic Therapy methods, Thrombosis drug therapy, Umbilical Veins, Urokinase-Type Plasminogen Activator administration & dosage
Abstract

Newborns with vascular catheters must be investigated by echocardiogram for intracardiac thrombosis. We report the use of urokinase to treat an asymptomatic right atrial thrombus in a 31 weeks' gestation newborn; the thrombosis occurred after placement of a catheter in the umbilical vein. We obtained a safe and successful thrombolysis using urokinase 4000 U/kg/h in continuous infusion.

Published
1995

28. Influence of blood transfusions on surgery-induced immune changes in colorectal carcinoma.

Author

Brivio F, Lissoni P, Redaelli R, Maggioni A, Rovelli F, Rescaldani R, Borin F, Erba L, and Alderi G

Subjects
Adult, Aged, Aged, 80 and over, Carcinoma pathology, Carcinoma surgery, Colorectal Neoplasms pathology, Colorectal Neoplasms surgery, Female, Humans, Leukocyte Count, Male, Middle Aged, Neoplasm Staging, Postoperative Period, Receptors, Interleukin-2 analysis, Solubility, T-Lymphocytes immunology, Blood Transfusion, Carcinoma immunology, Colorectal Neoplasms immunology, Intraoperative Care
Abstract

Perioperative blood transfusions have been shown to enhance recurrence rates in patients with operable solid tumors, perhaps by inducing immunosuppression through unknown mechanisms. Since the surgical treatment per se has been proven to induce immune alterations, the present study was carried out to evaluate the immune effect of blood transfusions on surgery-induced immune variations. The study included 27 patients with resectable colorectal carcinoma, 18 of whom received no transfusion, while the other 9 received blood transfusions in the perioperative period. Total lymphocytes, total T lymphocytes (CD3) and soluble IL-2 receptor serum levels (SIL-2R) were measured on venous blood samples collected from each patient either before or 7 days after surgery. Both in non transfused and in transfused patients, SIL-2R mean levels were significantly higher after than before surgery. Their increase was associated with a significant decrease in both lymphocytes and CD3 cells in non-transfused patients, while in the transfused ones lymphocytes and CD3 cells did not show significant changes with surgery. This study shows that blood transfusions modify the relation between changes in SIL-2R and those in lymphocyte number induced by major surgery. It remains to be understood which relation exist between these immune effects and the promoting action of blood transfusion on relapse frequency in cancer.

Published
1993

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