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3. One-year mortality in COVID-19 is associated with patients’ comorbidities rather than pneumonia severity

Author

Novelli, Luca, Raimondi, Federico, Carioli, Greta, Carobbio, Alessandra, Pappacena, Simone, Biza, Roberta, Trapasso, Roberta, Anelli, Marisa, Amoroso, Mariangela, Allegri, Chiara, Malandrino, Luca, Imeri, Gianluca, Conti, Caterina, Beretta, Marta, Gori, Mauro, D'Elia, Emilia, Senni, Michele, Lorini, Ferdinando Luca, Rizzi, Marco, Cosentini, Roberto, Rambaldi, Alessandro, Masciulli, Arianna, Gavazzi, Antonello, Solidoro, Paolo, Sironi, Sandro, Fagiuoli, Stefano, Barbui, Tiziano, and Marco, Fabiano Di

Published
2023
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8. Outcomes of bailout use of continuous positive airway pressure in patients with severe COVID-19 respiratory failure

Author

Giannone, Alberto, primary, Piazza, Isabelle, additional, Preti, Carlo, additional, Pisano, Eleonora, additional, Ghirardi, Arianna, additional, Benetti, Alberto, additional, Fagiuoli, Stefano, additional, Lorini, Ferdinando L., additional, Rizzi, Marco, additional, Di Marco, Fabiano, additional, and Cosentini, Roberto, additional

Published
2024
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12. Severity of respiratory failure and outcome of patients needing a ventilatory support in the Emergency Department during Italian novel coronavirus SARS-CoV2 outbreak: Preliminary data on the role of Helmet CPAP and Non-Invasive Positive Pressure Ventilation

Author

Duca, Andrea, Memaj, Irdi, Zanardi, Federico, Preti, Carlo, Alesi, Andrea, Della Bella, Lorenzo, Ghezzi, Elena, Di Marco, Fabiano, Lorini, Ferdinando Luca, Venturelli, Serena, Fagiuoli, Stefano, and Cosentini, Roberto

Published
2020
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13. Assessing the heterogeneity of the impact of COVID-19 incidence on all-cause excess mortality among healthcare districts in Lombardy, Italy, to evaluate the local response to the pandemic: an ecological study

Author

Paganuzzi, Marco, primary, Nattino, Giovanni, additional, Ghilardi, Giulia Irene, additional, Costantino, Giorgio, additional, Rossi, Carlotta, additional, Cortellaro, Francesca, additional, Cosentini, Roberto, additional, Paglia, Stefano, additional, Migliori, Maurizio, additional, Mira, Antonietta, additional, and Bertolini, Guido, additional

Published
2024
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15. 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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17. Macrolide therapy is associated with lower mortality in community-acquired bacteraemic pneumonia

Author

Arnold, Forest, Peyrani, Paula, Ramirez, Julio, Ayesu, Kwabena, File, Thomas, Jr., Burdette, Steven, Blatt, Stephen, Restrepo, Marcos, Bordon, Jose, Gross, Peter, Musher, Daniel, Marrie, Thomas, Weiss, Karl, Roig, Jorge, Lode, Harmut, Welte, Tobias, Aliberti, Stephano, Blasi, Francesco, Cosentini, Roberto, Legnani, Delfino, Franzetti, Fabio, Montano, Nicola, Cervi, Giulia, Rossi, Paolo, Voza, Antonio, Ostrowsky, Belinda, Pesci, Alberto, Nava, Stefano, Viale, Pierluigi, Galavatti, Vanni, Patricia, Aruj, Dimas, Carlos, Piro, Roberto, Viscoli, Claudio, Torres, Antoni, Valenti, Vincenzo, Ojales, Daniel Portela, Bodi, Maria, Porras, Jose, Rello, Jordi, Menendez, Rosario, Stolz, Daiana, Schuetz, Philipp, Haubitz, Sebastian, Chalmers, James, Fardon, Tom, Benchetrit, Guillermo, Rodriguez, Eduardo, Corral, Jorge, Gonzalez, Jose, de Vedia, Lautaro, Lopardo, Gustavo, Luna, Carlos, Martinez, Jorge, Marzoratti, Lucia, Rodriguez, Maria, Videla, Alejandro, Saavedra, Federico, Lopez, Horacio, Gnoni, Martin, Victorio, Carlos, Riera, Fernando, Jimenez, Patricio, Fernandez, Patricia, Parada, Maria, Fuenzalida, Alejandro Díaz, Riquelme, Raul, Barros, Manuel, Luna, Juan Manuel, Toala, Ivan, Oze de Morvil, Guillermo Arbo, Fernandez, Ricardo, Aiello, Gonzalo, Alvarez, Pablo, Soca, Ana, Arteta, Federico, Delgado, Jose, Levy, Gur, Rivero, Ludwig, Rodriguez, Benito, Mirabal, Mario Perez, Mateo, Marilyn, Mendoza, Myrna, Feldman, Charles, Arnold, Forest W., Wiemken, Timothy L., Kelley, Robert, Mattingly, William A., Maurici, Rosemeri, and Ramirez, Julio A.

Published
2018
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31. The emergency department arrival mode and its relations to ED management and 30-day mortality in acute heart failure: an ancillary analysis from the EURODEM study

Author

UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service des urgences, Harjola, Pia, Tarvasmäki, Tuukka, Barletta, Cinzia, Body, Richard, Capsec, Jean, Christ, Michael, Garcia-Castrillo, Luis, Golea, Adela, Karamercan, Mehmet A., Martin, Paul-Louis, Miró, Òscar, Tolonen, Jukka, van Meer, Oene, Palomäki, Ari, Verschuren, Franck, Harjola, Veli-Pekka, Laribi, Said, Plaisance, Patrick, Dandachi, Ghanima Al, Maignan, Maxime, Pateron, Dominique, Hermand, Christelle, Tessier, Cindy, Roy, Pierre-Marie, Bucco, Lucie, Duytsche, Nicolas, Garmilla, Pablo, Carbone, Giorgio, Cosentini, Roberto, Truță, Sorana, Hrihorișan, Natalia, Cimpoeșu, Diana, Rotaru, Luciana, Petrică, Alina, Cojocaru, Mariana, Nica, Silvia, Tudoran, Rodica, Vecerdi, Cristina, Puticiu, Monica, Schönberger, Titus, Coolsma, Constant, Baggelaar, Maarten, Fransen, Noortje, van den Brand, Crispijn, Idzenga, Doutsje, Maas, Maaike, Franssen, Myriam, Staal, Charlotte Mackaij, Schutte, Lot, de Kubber, Marije, Mignot-Evers, Lisette, Penninga-Puister, Ursula, Jansen, Joyce, Kuijten, Jeroen, Bouwhuis, Marna, Reuben, Adam, Smith, Jason, Ramlakhan, Shammi, Darwent, Melanie, Gagg, James, Keating, Liza, Bongale, Santosh, Hardy, Elaine, Keep, Jeff, Jarman, Heather, Crane, Steven, Lawal, Olakunle, Hassan, Taj, Corfield, Alasdair, Reed, Matthew, Geier, Felicitas, Smolarsky, Yvonne, Blaschke, Sabine, Kill, Clemens, Jerrentrup, Andreas, Hohenstein, Christian, Rockmann, Felix, Brünnler, Tanja, Ghuysen, Alexandre, Vranckx, Marc, Ergin, Mehmet, Dundar, Zerrin D., Altuncu, Yusuf A., Arziman, Ibrahim, Avcil, Mucahit, Katirci, Yavuz, Suurmunne, Hanna, Kokkonen, Liisa, Valli, Juha, Kiljunen, Minna, Kaye, Sanna, Mäkelä, Mikko, Metsäniitty, Juhani, Vaula, Eija, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service des urgences, Harjola, Pia, Tarvasmäki, Tuukka, Barletta, Cinzia, Body, Richard, Capsec, Jean, Christ, Michael, Garcia-Castrillo, Luis, Golea, Adela, Karamercan, Mehmet A., Martin, Paul-Louis, Miró, Òscar, Tolonen, Jukka, van Meer, Oene, Palomäki, Ari, Verschuren, Franck, Harjola, Veli-Pekka, Laribi, Said, Plaisance, Patrick, Dandachi, Ghanima Al, Maignan, Maxime, Pateron, Dominique, Hermand, Christelle, Tessier, Cindy, Roy, Pierre-Marie, Bucco, Lucie, Duytsche, Nicolas, Garmilla, Pablo, Carbone, Giorgio, Cosentini, Roberto, Truță, Sorana, Hrihorișan, Natalia, Cimpoeșu, Diana, Rotaru, Luciana, Petrică, Alina, Cojocaru, Mariana, Nica, Silvia, Tudoran, Rodica, Vecerdi, Cristina, Puticiu, Monica, Schönberger, Titus, Coolsma, Constant, Baggelaar, Maarten, Fransen, Noortje, van den Brand, Crispijn, Idzenga, Doutsje, Maas, Maaike, Franssen, Myriam, Staal, Charlotte Mackaij, Schutte, Lot, de Kubber, Marije, Mignot-Evers, Lisette, Penninga-Puister, Ursula, Jansen, Joyce, Kuijten, Jeroen, Bouwhuis, Marna, Reuben, Adam, Smith, Jason, Ramlakhan, Shammi, Darwent, Melanie, Gagg, James, Keating, Liza, Bongale, Santosh, Hardy, Elaine, Keep, Jeff, Jarman, Heather, Crane, Steven, Lawal, Olakunle, Hassan, Taj, Corfield, Alasdair, Reed, Matthew, Geier, Felicitas, Smolarsky, Yvonne, Blaschke, Sabine, Kill, Clemens, Jerrentrup, Andreas, Hohenstein, Christian, Rockmann, Felix, Brünnler, Tanja, Ghuysen, Alexandre, Vranckx, Marc, Ergin, Mehmet, Dundar, Zerrin D., Altuncu, Yusuf A., Arziman, Ibrahim, Avcil, Mucahit, Katirci, Yavuz, Suurmunne, Hanna, Kokkonen, Liisa, Valli, Juha, Kiljunen, Minna, Kaye, Sanna, Mäkelä, Mikko, Metsäniitty, Juhani, and Vaula, Eija

Abstract

Background Acute heart failure patients are often encountered in emergency departments (ED) from 11% to 57% using emergency medical services (EMS). Our aim was to evaluate the association of EMS use with acute heart failure patients’ ED management and short-term outcomes. Methods This was a sub-analysis of a European EURODEM study. Data on patients presenting with dyspnoea were collected prospectively from European EDs. Patients with ED diagnosis of acute heart failure were categorized into two groups: those using EMS and those self-presenting (non- EMS). The independent association between EMS use and 30-day mortality was evaluated with logistic regression. Results Of the 500 acute heart failure patients, with information about the arrival mode to the ED, 309 (61.8%) arrived by EMS. These patients were older (median age 80 vs. 75 years, p < 0.001), more often female (56.4% vs. 42.1%, p = 0.002) and had more dementia (18.7% vs. 7.2%, p < 0.001). On admission, EMS patients had more often confusion (14.2% vs. 2.1%, p < 0.001) and higher respiratory rate (24/min vs. 21/min, p = 0.014; respiratory rate > 30/min in 17.1% patients vs. 7.5%, p = 0.005). The only difference in ED management appeared in the use of ventilatory support: 78.3% of EMS patients vs. 67.5% of non- EMS patients received supplementary oxygen (p = 0.007), and non-invasive ventilation was administered to 12.5% of EMS patients vs. 4.2% non- EMS patients (p = 0.002). EMS patients were more often hospitalized (82.4% vs. 65.9%, p < 0.001), had higher in-hospital mortality (8.7% vs. 3.1%, p = 0.014) and 30-day mortality (14.3% vs. 4.9%, p < 0.001). The use of EMS was an independent predictor of 30-day mortality (OR = 2.54, 95% CI 1.11–5.81, p = 0.027). Conclusion Most acute heart failure patients arrive at ED by EMS. These patients suffer from more severe respiratory distress and receive more often ventilatory support. EMS use is an independent predictor of 30-day mortality.

Published
2022

32. The emergency department arrival mode and its relations to ED management and 30-day mortality in acute heart failure:an ancillary analysis from the EURODEM study

Author

Harjola, Pia, Tarvasmäki, Tuukka, Barletta, Cinzia, Body, Richard, Capsec, Jean, Christ, Michael, Garcia-Castrillo, Luis, Golea, Adela, Karamercan, Mehmet A., Martin, Paul Louis, Miró, Òscar, Tolonen, Jukka, van Meer, Oene, Palomäki, Ari, Verschuren, Franck, Harjola, Veli Pekka, Laribi, Said, Plaisance, Patrick, Dandachi, Ghanima Al, Maignan, Maxime, Pateron, Dominique, Hermand, Christelle, Tessier, Cindy, Roy, Pierre Marie, Bucco, Lucie, Duytsche, Nicolas, Garmilla, Pablo, Carbone, Giorgio, Cosentini, Roberto, Truță, Sorana, Hrihorișan, Natalia, Cimpoeșu, Diana, Rotaru, Luciana, Petrica, Alina, Cojocaru, Mariana, Nica, Silvia, Tudoran, Rodica, Vecerdi, Cristina, Puticiu, Monica, Schönberger, Titus, Coolsma, Constant, Baggelaar, Maarten, Fransen, Noortje, van den Brand, Crispijn, Idzenga, Doutsje, Maas, Maaike, Franssen, Myriam, Staal, Charlotte Mackaij, Jansen, Joyce, Bouwhuis, Marna, Harjola, Pia, Tarvasmäki, Tuukka, Barletta, Cinzia, Body, Richard, Capsec, Jean, Christ, Michael, Garcia-Castrillo, Luis, Golea, Adela, Karamercan, Mehmet A., Martin, Paul Louis, Miró, Òscar, Tolonen, Jukka, van Meer, Oene, Palomäki, Ari, Verschuren, Franck, Harjola, Veli Pekka, Laribi, Said, Plaisance, Patrick, Dandachi, Ghanima Al, Maignan, Maxime, Pateron, Dominique, Hermand, Christelle, Tessier, Cindy, Roy, Pierre Marie, Bucco, Lucie, Duytsche, Nicolas, Garmilla, Pablo, Carbone, Giorgio, Cosentini, Roberto, Truță, Sorana, Hrihorișan, Natalia, Cimpoeșu, Diana, Rotaru, Luciana, Petrica, Alina, Cojocaru, Mariana, Nica, Silvia, Tudoran, Rodica, Vecerdi, Cristina, Puticiu, Monica, Schönberger, Titus, Coolsma, Constant, Baggelaar, Maarten, Fransen, Noortje, van den Brand, Crispijn, Idzenga, Doutsje, Maas, Maaike, Franssen, Myriam, Staal, Charlotte Mackaij, Jansen, Joyce, and Bouwhuis, Marna

Abstract

Background: Acute heart failure patients are often encountered in emergency departments (ED) from 11% to 57% using emergency medical services (EMS). Our aim was to evaluate the association of EMS use with acute heart failure patients’ ED management and short-term outcomes. Methods: This was a sub-analysis of a European EURODEM study. Data on patients presenting with dyspnoea were collected prospectively from European EDs. Patients with ED diagnosis of acute heart failure were categorized into two groups: those using EMS and those self-presenting (non- EMS). The independent association between EMS use and 30-day mortality was evaluated with logistic regression. Results: Of the 500 acute heart failure patients, with information about the arrival mode to the ED, 309 (61.8%) arrived by EMS. These patients were older (median age 80 vs. 75 years, p < 0.001), more often female (56.4% vs. 42.1%, p = 0.002) and had more dementia (18.7% vs. 7.2%, p < 0.001). On admission, EMS patients had more often confusion (14.2% vs. 2.1%, p < 0.001) and higher respiratory rate (24/min vs. 21/min, p = 0.014; respiratory rate > 30/min in 17.1% patients vs. 7.5%, p = 0.005). The only difference in ED management appeared in the use of ventilatory support: 78.3% of EMS patients vs. 67.5% of non- EMS patients received supplementary oxygen (p = 0.007), and non-invasive ventilation was administered to 12.5% of EMS patients vs. 4.2% non- EMS patients (p = 0.002). EMS patients were more often hospitalized (82.4% vs. 65.9%, p < 0.001), had higher in-hospital mortality (8.7% vs. 3.1%, p = 0.014) and 30-day mortality (14.3% vs. 4.9%, p < 0.001). The use of EMS was an independent predictor of 30-day mortality (OR = 2.54, 95% CI 1.11–5.81, p = 0.027). Conclusion: Most acute heart failure patients arrive at ED by EMS. These patients suffer from more severe respiratory distress and receive more often ventilatory support. EMS use is an independent predictor of 30-day mortality.

Published
2022

33. Frequency, characteristics, and outcome of patients with COVID-19 pneumonia and 'silent hypoxemia' at admission: a severity-matched analysis

Author

Novelli, L, Raimondi, F, Ghirardi, A, Galimberti, C, Biza, R, Trapasso, R, Anelli, M, Amoroso, M, Allegri, C, Imeri, G, Conti, C, Tarantini, F, Beretta, M, Gori, M, D'Elia, E, Senni, M, Solidoro, P, Lorini, F, Rizzi, M, Tebaldi, A, Barbui, T, Taurino, D, Cosentini, R, Masciulli, A, Gavazzi, A, Sironi, S, Fagiuoli, S, DI Marco, F, Novelli, Luca, Raimondi, Federico, Ghirardi, Arianna, Galimberti, Chiara, Biza, Roberta, Trapasso, Roberta, Anelli, Marisa, Amoroso, Mariangela, Allegri, Chiara, Imeri, Gianluca, Conti, Caterina, Tarantini, Francesco, Beretta, Marta, Gori, Mauro, D'Elia, Emilia, Senni, Michele, Solidoro, Paolo, Lorini, Ferdinando L, Rizzi, Marco, Tebaldi, Alessandra, Barbui, Tiziano, Taurino, Daniela, Cosentini, Roberto, Masciulli, Arianna, Gavazzi, Antonello, Sironi, Sandro, Fagiuoli, Stefano, DI Marco, Fabiano, Novelli, L, Raimondi, F, Ghirardi, A, Galimberti, C, Biza, R, Trapasso, R, Anelli, M, Amoroso, M, Allegri, C, Imeri, G, Conti, C, Tarantini, F, Beretta, M, Gori, M, D'Elia, E, Senni, M, Solidoro, P, Lorini, F, Rizzi, M, Tebaldi, A, Barbui, T, Taurino, D, Cosentini, R, Masciulli, A, Gavazzi, A, Sironi, S, Fagiuoli, S, DI Marco, F, Novelli, Luca, Raimondi, Federico, Ghirardi, Arianna, Galimberti, Chiara, Biza, Roberta, Trapasso, Roberta, Anelli, Marisa, Amoroso, Mariangela, Allegri, Chiara, Imeri, Gianluca, Conti, Caterina, Tarantini, Francesco, Beretta, Marta, Gori, Mauro, D'Elia, Emilia, Senni, Michele, Solidoro, Paolo, Lorini, Ferdinando L, Rizzi, Marco, Tebaldi, Alessandra, Barbui, Tiziano, Taurino, Daniela, Cosentini, Roberto, Masciulli, Arianna, Gavazzi, Antonello, Sironi, Sandro, Fagiuoli, Stefano, and DI Marco, Fabiano

Abstract

BACKGROUND: An aspect of COVID-19 baffling physicians is the presentation of patients with acute respiratory failure, but normal mental faculties and no perception of dyspnea (i.e. "silent hypoxemia"). The aim of this study was to investigate the frequency, characteristics, and outcome of COVID-19 patients with silent hypoxemic status and comparing them with a symptomatic severity-matched group. METHODS: This is a retrospective monocentric observational study involving all patients with PCR confirmed SARS-CoV-2 pneumonia, admitted at Papa Giovanni XXIII Hospital, Bergamo (Italy) from Emergency Department due to acute respiratory failure, during the first Italian pandemic peak (February-April 2020). RESULTS: Overall 28-day mortality in 1316 patients was 26.9%. Patients who did not report dyspnea at admission (N469, 35.6%) had a lower 28-day mortality (22.6 vs. 29.3%, P=0.009). The severity matching analysis (i.e. PaO2/FiO2 and imaging) led to the identification of two groups of 254 patients that did not differ for sex prevalence, age, BMI, smoking history, comorbidities, and PaCO2 at admission. The use of CPAP during the first 24 hours, such as the need of endotracheal intubation (ETI) during the overall admission were significantly lower in matched patients with silent hypoxemia, whereas 28-day mortality resulted similar (P=0.21). CONCLUSIONS: Lack of dyspnea is common in patients suffering from severe COVID-19 pneumonia leading to respiratory failure, since up to a third of them could be asymptomatic on admission. Dyspnea per se correlates with pneumonia severity, and prognosis. However, dyspnea loses its predictive relevance once other findings to evaluate pneumonia severity are available such as PaO2/FiO2 and imaging. Silent hypoxemic patients are less likely to receive CPAP during the first 24 hours and ETI during the hospitalization, in spite of a comparable mortality to the dyspneic ones.

Published
2022

34. Association between inhibitors of the renin-angiotensin system and lung function in elderly patients recovered from severe COVID-19

Author

Gori, M, Ghirardi, A, D'Elia, E, Imeri, G, Di Marco, F, Gavazzi, A, Carobbio, A, Balestrieri, G, Giammarresi, A, Trevisan, R, Amoroso, M, Raimondi, F, Novelli, L, Magro, B, Mangia, G, Lorini, F, Fagiuoli, S, Barbui, T, Rizzi, M, Cosentini, R, Sironi, S, Senni, M, Gori, Mauro, Ghirardi, Arianna, D'Elia, Emilia, Imeri, Gianluca, Di Marco, Fabiano, Gavazzi, Antonello, Carobbio, Alessandra, Balestrieri, Giulio, Giammarresi, Andrea, Trevisan, Roberto, Amoroso, Mariangela, Raimondi, Federico, Novelli, Luca, Magro, Bianca, Mangia, Gianpaolo, Lorini, Ferdinando L, Fagiuoli, Stefano, Barbui, Tiziano, Rizzi, Marco, Cosentini, Roberto, Sironi, Sandro, Senni, Michele, Gori, M, Ghirardi, A, D'Elia, E, Imeri, G, Di Marco, F, Gavazzi, A, Carobbio, A, Balestrieri, G, Giammarresi, A, Trevisan, R, Amoroso, M, Raimondi, F, Novelli, L, Magro, B, Mangia, G, Lorini, F, Fagiuoli, S, Barbui, T, Rizzi, M, Cosentini, R, Sironi, S, Senni, M, Gori, Mauro, Ghirardi, Arianna, D'Elia, Emilia, Imeri, Gianluca, Di Marco, Fabiano, Gavazzi, Antonello, Carobbio, Alessandra, Balestrieri, Giulio, Giammarresi, Andrea, Trevisan, Roberto, Amoroso, Mariangela, Raimondi, Federico, Novelli, Luca, Magro, Bianca, Mangia, Gianpaolo, Lorini, Ferdinando L, Fagiuoli, Stefano, Barbui, Tiziano, Rizzi, Marco, Cosentini, Roberto, Sironi, Sandro, and Senni, Michele

Published
2022

37. The emergency department arrival mode and its relations to ED management and 30-day mortality in acute heart failure

Author

Harjola, Pia, Tarvasmäki, Tuukka, Barletta, Cinzia, Body, Richard, Capsec, Jean, Christ, Michael, Garcia-Castrillo, Luis, Golea, Adela, Karamercan, Mehmet A., Martin, Paul-Louis, Miró, Òscar, Tolonen, Jukka, van Meer, Oene, Palomäki, Ari, Verschuren, Franck, Harjola, Veli-Pekka, Laribi, Said, Plaisance, Patrick, Dandachi, Ghanima Al, Maignan, Maxime, Pateron, Dominique, Hermand, Christelle, Tessier, Cindy, Roy, Pierre-Marie, Bucco, Lucie, Duytsche, Nicolas, Garmilla, Pablo, Carbone, Giorgio, Cosentini, Roberto, Truță, Sorana, Hrihorișan, Natalia, Cimpoeșu, Diana, Rotaru, Luciana, Petrică, Alina, Cojocaru, Mariana, Nica, Silvia, Tudoran, Rodica, Vecerdi, Cristina, Puticiu, Monica, Schönberger, Titus, Coolsma, Constant, Baggelaar, Maarten, Fransen, Noortje, van den Brand, Crispijn, Idzenga, Doutsje, Maas, Maaike, Franssen, Myriam, Staal, Charlotte Mackaij, Schutte, Lot, de Kubber, Marije, Mignot-Evers, Lisette, Penninga-Puister, Ursula, Jansen, Joyce, Kuijten, Jeroen, Bouwhuis, Marna, Reuben, Adam, Smith, Jason, Ramlakhan, Shammi, Darwent, Melanie, Gagg, James, Keating, Liza, Bongale, Santosh, Hardy, Elaine, Keep, Jeff, Jarman, Heather, Crane, Steven, Lawal, Olakunle, Hassan, Taj, Corfield, Alasdair, Reed, Matthew, Geier, Felicitas, Smolarsky, Yvonne, Blaschke, Sabine, Kill, Clemens, Jerrentrup, Andreas, Hohenstein, Christian, Rockmann, Felix, Brünnler, Tanja, Ghuysen, Alexandre, Vranckx, Marc, Ergin, Mehmet, Dundar, Zerrin D., Altuncu, Yusuf A., Arziman, Ibrahim, Avcil, Mucahit, Katirci, Yavuz, Suurmunne, Hanna, Kokkonen, Liisa, Valli, Juha, Kiljunen, Minna, Kaye, Sanna, Mäkelä, Mikko, Metsäniitty, Juhani, Vaula, Eija, Tampere University, Kanta-Häme Central Hospital Hämeenlinna, Clinical Medicine, Emergency Medicine, Research & Education, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service des urgences, HUS Emergency Medicine and Services, Department of Diagnostics and Therapeutics, HUS Heart and Lung Center, Clinicum, Kardiologian yksikkö, HUS Internal Medicine and Rehabilitation, Department of Medicine, HYKS erva, Päijät-Häme Welfare Consortium, and HUS Helsinki and Uusimaa Hospital District

Subjects
Arrival mode, Emergency Medical Services, EUROBSERVATIONAL RESEARCH-PROGRAM, DIAGNOSIS, Patient Admission, IN-HOSPITAL MORTALITY, PILOT, Humans, ESC GUIDELINES, Hospital Mortality, PREDICTORS, Aged, 80 and over, Heart Failure, Emergency medical services, OUTCOMES, Acute heart failure, ASSOCIATION, CARE, Prognosis, 3126 Surgery, anesthesiology, intensive care, radiology, EUROPEAN-SOCIETY, Management, Ventilatory support, Emergency Medicine, Female, Emergency Service, Hospital
Abstract

Background Acute heart failure patients are often encountered in emergency departments (ED) from 11% to 57% using emergency medical services (EMS). Our aim was to evaluate the association of EMS use with acute heart failure patients’ ED management and short-term outcomes. Methods This was a sub-analysis of a European EURODEM study. Data on patients presenting with dyspnoea were collected prospectively from European EDs. Patients with ED diagnosis of acute heart failure were categorized into two groups: those using EMS and those self-presenting (non- EMS). The independent association between EMS use and 30-day mortality was evaluated with logistic regression. Results Of the 500 acute heart failure patients, with information about the arrival mode to the ED, 309 (61.8%) arrived by EMS. These patients were older (median age 80 vs. 75 years, p p = 0.002) and had more dementia (18.7% vs. 7.2%, p p p = 0.014; respiratory rate > 30/min in 17.1% patients vs. 7.5%, p = 0.005). The only difference in ED management appeared in the use of ventilatory support: 78.3% of EMS patients vs. 67.5% of non- EMS patients received supplementary oxygen (p = 0.007), and non-invasive ventilation was administered to 12.5% of EMS patients vs. 4.2% non- EMS patients (p = 0.002). EMS patients were more often hospitalized (82.4% vs. 65.9%, p p = 0.014) and 30-day mortality (14.3% vs. 4.9%, p p = 0.027). Conclusion Most acute heart failure patients arrive at ED by EMS. These patients suffer from more severe respiratory distress and receive more often ventilatory support. EMS use is an independent predictor of 30-day mortality.

Published
2022

38. Additional file 4 of Characterization of compliance phenotypes in COVID-19 acute respiratory distress syndrome

Author

Zacchetti, Lucia, Longhi, Luca, Bianchi, Isabella, Di Matteo, Maria, Russo, Filippo, Gandini, Lucia, Manesso, Leonardo, Monti, Martina, Cosentini, Roberto, Di Marco, Fabiano, Fagiuoli, Stefano, Grazioli, Lorenzo, Gritti, Paolo, Previdi, Fabio, Senni, Michele, Ranieri, Marco, and Lorini, Luca

Abstract

Additional file 4: Table S2. Ventilator parameters, lung mechanics and gas exchanges in groups of compliance of respiratory system quartiles during the first 14 days of ICU stay.

Published
2022
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39. Additional file 6 of Characterization of compliance phenotypes in COVID-19 acute respiratory distress syndrome

Author

Zacchetti, Lucia, Longhi, Luca, Bianchi, Isabella, Di Matteo, Maria, Russo, Filippo, Gandini, Lucia, Manesso, Leonardo, Monti, Martina, Cosentini, Roberto, Di Marco, Fabiano, Fagiuoli, Stefano, Grazioli, Lorenzo, Gritti, Paolo, Previdi, Fabio, Senni, Michele, Ranieri, Marco, and Lorini, Luca

Abstract

Additional file 6: Table S4. Ventilatory setting, gas exchanges and lung mechanics during prone position, cycle-by-cycle, in the four groups of compliance of respiratory system quartiles.

Published
2022
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40. Additional file 5 of Characterization of compliance phenotypes in COVID-19 acute respiratory distress syndrome

Author

Zacchetti, Lucia, Longhi, Luca, Bianchi, Isabella, Di Matteo, Maria, Russo, Filippo, Gandini, Lucia, Manesso, Leonardo, Monti, Martina, Cosentini, Roberto, Di Marco, Fabiano, Fagiuoli, Stefano, Grazioli, Lorenzo, Gritti, Paolo, Previdi, Fabio, Senni, Michele, Ranieri, Marco, and Lorini, Luca

Abstract

Additional file 5: Table S3. Ventilatory setting, gas exchanges and lung mechanics during prone positioning in the four compliance of respiratory system quartiles.

Published
2022
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41. Additional file 7 of Characterization of compliance phenotypes in COVID-19 acute respiratory distress syndrome

Author

Zacchetti, Lucia, Longhi, Luca, Bianchi, Isabella, Di Matteo, Maria, Russo, Filippo, Gandini, Lucia, Manesso, Leonardo, Monti, Martina, Cosentini, Roberto, Di Marco, Fabiano, Fagiuoli, Stefano, Grazioli, Lorenzo, Gritti, Paolo, Previdi, Fabio, Senni, Michele, Ranieri, Marco, and Lorini, Luca

Abstract

Additional file 7: Table S5. Major complications occurred during the first 28-days of ICU stay.

Published
2022
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42. Frequency, characteristics, and outcome of patients with COVID-19 pneumonia and 'silent hypoxemia' at admission: a severity-matched analysis

Author

Novelli, Luca, Raimondi, Federico, Ghirardi, Arianna, Galimberti, Chiara, Biza, Roberta, Trapasso, Roberta, Anelli, Marisa, Amoroso, Mariangela, Allegri, Chiara, Imeri, Gianluca, Conti, Caterina, Tarantini, Francesco, Beretta, Marta, Gori, Mauro, D'Elia, Emilia, Senni, Michele, Solidoro, Paolo, Lorini, Ferdinando L, Rizzi, Marco, Tebaldi, Alessandra, Barbui, Tiziano, Taurino, Daniela, Cosentini, Roberto, Masciulli, Arianna, Gavazzi, Antonello, Sironi, Sandro, Fagiuoli, Stefano, DI Marco, Fabiano, Novelli, L, Raimondi, F, Ghirardi, A, Galimberti, C, Biza, R, Trapasso, R, Anelli, M, Amoroso, M, Allegri, C, Imeri, G, Conti, C, Tarantini, F, Beretta, M, Gori, M, D'Elia, E, Senni, M, Solidoro, P, Lorini, F, Rizzi, M, Tebaldi, A, Barbui, T, Taurino, D, Cosentini, R, Masciulli, A, Gavazzi, A, Sironi, S, Fagiuoli, S, and DI Marco, F

Subjects
Dyspnea, COVID-19, General Medicine, Hypoxia, Respiratory insufficiency
Abstract

BACKGROUND: An aspect of COVID-19 baffling physicians is the presentation of patients with acute respiratory failure, but normal mental faculties and no perception of dyspnea (i.e. "silent hypoxemia"). The aim of this study was to investigate the frequency, characteristics, and outcome of COVID-19 patients with silent hypoxemic status and comparing them with a symptomatic severity-matched group. METHODS: This is a retrospective monocentric observational study involving all patients with PCR confirmed SARS-CoV-2 pneumonia, admitted at Papa Giovanni XXIII Hospital, Bergamo (Italy) from Emergency Department due to acute respiratory failure, during the first Italian pandemic peak (February-April 2020). RESULTS: Overall 28-day mortality in 1316 patients was 26.9%. Patients who did not report dyspnea at admission (N469, 35.6%) had a lower 28-day mortality (22.6 vs. 29.3%, P=0.009). The severity matching analysis (i.e. PaO2/FiO2 and imaging) led to the identification of two groups of 254 patients that did not differ for sex prevalence, age, BMI, smoking history, comorbidities, and PaCO2 at admission. The use of CPAP during the first 24 hours, such as the need of endotracheal intubation (ETI) during the overall admission were significantly lower in matched patients with silent hypoxemia, whereas 28-day mortality resulted similar (P=0.21). CONCLUSIONS: Lack of dyspnea is common in patients suffering from severe COVID-19 pneumonia leading to respiratory failure, since up to a third of them could be asymptomatic on admission. Dyspnea per se correlates with pneumonia severity, and prognosis. However, dyspnea loses its predictive relevance once other findings to evaluate pneumonia severity are available such as PaO2/FiO2 and imaging. Silent hypoxemic patients are less likely to receive CPAP during the first 24 hours and ETI during the hospitalization, in spite of a comparable mortality to the dyspneic ones.

Published
2022

43. Additional file 3 of Characterization of compliance phenotypes in COVID-19 acute respiratory distress syndrome

Author

Zacchetti, Lucia, Longhi, Luca, Bianchi, Isabella, Di Matteo, Maria, Russo, Filippo, Gandini, Lucia, Manesso, Leonardo, Monti, Martina, Cosentini, Roberto, Di Marco, Fabiano, Fagiuoli, Stefano, Grazioli, Lorenzo, Gritti, Paolo, Previdi, Fabio, Senni, Michele, Ranieri, Marco, and Lorini, Luca

Abstract

Additional file 3: Table S1. Baseline characteristics, laboratory findings at ICU admission and additional therapies applied in the four groups of Crs quartiles.

Published
2022
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45. Epidemiology

Author

Cosentini, Roberto, Tarsia, Paolo, Blasi, Francesco, Allegra, Luigi, editor, and Blasi, Francesco, editor

Published
1995
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49. The role of helmet CPAP

Author

PIAZZA, Isabelle, primary, MARGUTTI, Eliana, additional, ROSTI, Valentina, additional, MARRA, Alessio, additional, PRETI, Carlo, additional, DUCA, Andrea, additional, and COSENTINI, Roberto, additional

Published
2022
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