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2. Continuous Wound Infiltration of Local Anesthetics in Postoperative Pain Management: Safety, Efficacy and Current Perspectives

Author

Paladini G, Di Carlo S, Musella G, Petrucci E, Scimia P, Ambrosoli A, Cofini V, and Fusco P

Subjects
continuous wound infiltration, postoperative analgesia, postoperative pain management, local anesthetics, Medicine (General), R5-920
Abstract

Giuseppe Paladini,1 Stefano Di Carlo,2 Giuseppe Musella,1 Emiliano Petrucci,3 Paolo Scimia,4 Andrea Ambrosoli,1 Vincenza Cofini,5 Pierfrancesco Fusco3 1Department of Anesthesia, Perioperative Medicine and Intensive Care Therapy, Filippo Del Ponte Women and Children’s Hospital, ASST Sette Laghi, Varese, Italy; 2Department of Medical, Oral and Biotechnological Sciences, University of Chieti, Chieti, Italy; 3Department of Anesthesia and Intensive Care, San Salvatore Academic Hospital of L’Aquila, L’Aquila, Italy; 4Department of Anesthesia and Intensive Care, ASUR Marche AV5, San Benedetto Del Tronto, Italy; 5Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, ItalyCorrespondence: Giuseppe PaladiniDepartment of Anesthesia, Perioperative Medicine and Intensive Care Therapy, Filippo Del Ponte Women and Children’s Hospital, ASST Sette Laghi, Via F. Del Ponte 19, Varese CAP 21100, ItalyTel +39 3281477189Fax +39 0332299299Email giuseppepaladini16@gmail.comAbstract: Local infiltration and continuous infusion of surgical wound with anesthetics are parts of multimodal analgesia for postoperative pain control. The techniques, given the simplicity of execution that does not increase the timing of the intervention and does not require additional technical skills, are applied in several kinds of surgeries. The continuous wound infiltration can be used for days and a variety of continuous delivery methods can be chosen, including patient-controlled analgesia, continuous infusion or intermittent bolus. The purpose of this narrative review is to analyze the literature, in particular by researching the safety, efficacy and current perspectives of continuous wound infiltration for postoperative pain management in different surgical settings. We have identified 203 articles and 95 of these have been taken into consideration: 17 for the lower limb surgery; 7 for the upper limb surgery, 51 for the laparotomy/laparoscopic surgery of the abdominopelvic area, 13 studies regarding breast surgery and 7 for cardiothoracic surgery. The analysis of these studies reveals that the technique has a variable effectiveness based on the type of structure involved: it is better in structures rich in subcutaneous and connective tissue, while the effectiveness is limited in anatomic districts with a greater variability of innervation. However, regardless the heterogeneity of results, a general reduction in pain intensity and in opioid consumption has been observed with continuous wound infiltration: it is an excellent analgesic technique that can be included in the multimodal treatment of postoperative pain or represents a valid alternative when other options are contraindicated.Keywords: continuous wound infiltration, postoperative analgesia, postoperative pain management, local anesthetics

Published
2020

4. Association between night-time surgery and occurrence of intraoperative adverse events and postoperative pulmonary complications

Author

Kroell, W., Metzler, H., Struber, G., Wegscheider, T., Gombotz, H., Hiesmayr, M., Schmid, W., Urbanek, B., Kahn, D., Momeni, M., Pospiech, A., Lois, F., Forget, P., Grosu, I., Poelaert, J., Mossevelde, V., van Malderen, M.C., Dylst, D., Melkebeek, J.V., Beran, M., Hert, S.D., Baerdemaeker, L.D., Heyse, B., Limmen, J.V., Wyffels, P., Jacobs, T., Roels, N., Bruyne, A.D., Velde, S.V.D., Marina, J.Z., Dejana, D.O., Pernar, S., Zunic, J., Miskovic, P., Zilic, A., Kvolik, S., Ivic, D., Darija, A.V., Skiljic, S., Vinkovic, H., Oputric, I., Juricic, K., Frkovic, V., Kopic, J., Mirkovic, I., Saric, J.P., Erceg, G., Dvorscak, M.B., Branka, M.S., Pavicic, A.M., Goranovic, T., Maldini, B., Radocaj, T., Gavranovic, Z., Inga, M.B., Sehovic, M., Stourac, P., Harazim, H., Smekalova, O., Kosinova, M., Kolacek, T., Hudacek, K., Drab, M., Brujevic, J., Vitkova, K., Jirmanova, K., Volfova, I., Dzurnakova, P., Liskova, K., Dudas, R., Filipsky, R., Kafrawy, S.E., Abdelwahab, H.H., Metwally, T., Ahmed, A.R., Ahmed Mostafa, E.S., Hasan, W.F., Ahmed, A.G., Yassin, H., Magdy, M., Abdelhady, M., Mahran, M., Herodes, E., Kivik, P., Oganjan, J., Aun, A., Sormus, A., Sarapuu, K., Mall, M., Karjagin, J., Futier, E., Petit, A., Gerard, A., Marret, E., Solier, M., Jaber, S., Prades, A., Krassler, J., Merzky, S., Abreu, M.G.D., Uhlig, C., Kiss, T., Bundy, A., Bluth, T., Gueldner, A., Spieth, P., Scharffenberg, M., Thiem, D.T., Koch, T., Treschan, T., Schaefer, M., Bastin, B., Geib, J., Weiss, M., Kienbaum, P., Pannen, B., Gottschalk, A., Konrad, M., Westerheide, D., Schwerdtfeger, B., Wrigge, H., Simon, P., Reske, A., Nestler, C., Valsamidis, D., Stroumpoulis, K., Antholopoulos, G., Andreou, A., Karapanos, D., Theodoraki, K., Gkiokas, G., Tasoulis, M.K., Sidiropoulou, T., Zafeiropoulou, F., Florou, P., Pandazi, A., Tsaousi, G., Nouris, C., Pourzitaki, C., Bystritski, D., Pizov, R., Eden, A., Pesce, C.V., Campanile, A., Marrella, A., Grasso, S., Michele, M.D., Bona, F., Giacoletto, G., Sardo, E., Sottosanti, L.G.V., Solca, M., Volta, C.A., Spadaro, S., Verri, M., Ragazzi, R., Zoppellari, R., Cinnella, G., Raimondo, P., Bella, D.L., Mirabella, L., D'antini, D., Pelosi, P., Molin, A., Brunetti, I., Gratarola, A., Pellerano, G., Sileo, R., Pezzatto, S., Montagnani, L., Pasin, L., Landoni, G., Zangrillo, A., Beretta, L., Parma, A.L.D., Tarzia, V., Dossi, R., Sassone, M.E., Sances, D., Tredici, S., Spano, G., Castellani, G., Delunas, L., Peradze, S., Venturino, M., Arpino, I., Sher, S., Tommasino, C., Rapido, F., Morelli, P., Vargas, M., Servillo, G., Cortegiani, A., Raineri, S.M., Montalto, F., Russotto, V., Giarratano, A., Baciarello, M., Generali, M., Cerati, G., Leykin, Y., Bressan, F., Bartolini, V., Zamidei, L., Brazzi, L., Liperi, C., Sales, G., Pistidda, L., Severgnini, P., Brugnoni, E., Musella, G., Bacuzzi, A., Muhardri, D., Agreta, G.G., Sada, F., Bytyqi, A., Karbonskiene, A., Aukstakalniene, R., Teberaite, Z., Salciute, E., Tikuisis, R., Miliauskas, P., Jurate, S., Kontrimaviciute, E., Tomkute, G., Xuereb, J., Bezzina, M., Borg, F. Joseph, Hemmes, S., Schultz, M., Hollmann, M., Wiersma, I., Binnekade, J., Bos, L., Boer, C., Duvekot, A., Veld, B.I ‘t, Werger, A., Dennesen, P., Severijns, C., Jong, J.D., Hering, J., Beek, R.V., Ivars, S., Jammer, I.B., Breidablik, A., Hodt, K.S., Fjellanger, F., Avalos, M.V., Jannicke, M.O., Andersson, E., Amir, S.K., Molina, R., Wutai, S., Morais, E., Tareco, G., Ferreira, D., Amaral, J., Castro, M.D.L.G., Cadilha, S., Appleton, S., Parente, S., Correia, M., Martins, D., Monteirosa, A., Ricardo, A., Rodrigues, S., Horhota, L., Grintescu, I.M., Mirea, L., Grintescu, I.C., Corneci, D., Negoita, S., Dutu, M., Popescu Garotescu, I., Filipescu, D., Prodan, A.B., Droc, G., Fota, R., Popescu, M., Tomescu, D., Petcu, A.M., Tudoroiu, M.I., Moise, A., Guran, C.T., Gherghina, I., Costea, D., Cindea, I., Copotoiu, S.M., Copotoiu, R., Barsan, V., Tolcser, Z., Riciu, M., Moldovan, S.G., Veres, M., Gritsan, A., Kapkan, T., Gritsan, G., Korolkov, O., Kulikov, A., Lubnin, A., Ovezov, A., Prokoshev, P., Lugovoy, A., Anipchenko, N., Babayants, A., Komissarova, I., Zalina, K., Likhvantsev, V., Fedorov, S., Lazukic, A., Pejakovic, J., Mihajlovic, D., Kusnierikova, Z., Zelinkova, M., Bruncakova, K., Polakovicova, L., Sobona, V., Barbka, N.S., Ana, P.G., Jovanov, M., Strazisar, B., Jasmina, M.B., Vesna, N.J., Voje, M., Grynyuk, A., Kostadinov, I., Alenka, S.V., Moral, V., Unzueta, M.C., Puigbo, C., Fava, J., Canet, J., Moret, E., Nunez, M.R., Sendra, M., Brunelli, A., Rodenas, F., Monedero, P., Hidalgo, F., Yepes, M.J., Martinez-Simon, A., Abajo, A., Lisi, A., Perez, G., Martinez, R., Granell, M., Vivo, J.T., Ruiz, C.S., Andrés Ibañez, J.A.D., Pastor, E., Soro, M., Ferrando, C., Defez, M., Cesar Aldecoa, A.S., Perez, R., Rico, J., Jawad, M., Saeed, Y., Gillberg, L., Bengisun, Z.K., Kazbek, B.K., Coskunfirat, N., Boztug, N., Sanli, S., Yilmaz, M., Hadimioglu, N., Senturk, N.M., Camci, E., Kucukgoncu, S., Sungur, Z., Sivrikoz, N., Ozgen, S.U., Toraman, F., Selvi, O., Senturk, O., Yildiz, M., Kuvaki, B., Gunenc, F., Kucukguclu, S., Ozbilgin, S., Maral, J., Canli, S., Arun, O., Saltali, A., Aydogan, E., Akgun, F.N., Sanlikarip, C., Karaman, F.M., Mazur, A., Vorotyntsev, S., Rousseau, G., Barrett, C., Stancombe, L., Shelley, B., Scholes, H., Limb, J., Rafi, A., Wayman, L., Deane, J., Rogerson, D., Williams, J., Yates, S., Rogers, E., Pulletz, M., Moreton, S., Jones, S., Venkatesh, S., Burton, M., Brown, L., Goodall, C., Rucklidge, M., Fuller, D., Nadolski, M., Kusre, S., Lundberg, M., Everett, L., Nutt, H., Zuleika, M., Carvalho, P., Clements, D., Ben, C.B., Watt, P., Raymode, P., Pearse, R., Mohr, O., Raj, A., Creary, T., Chishti, A., Bell, A., Higham, C., Cain, A., Gibb, S., Mowat, S., Franklin, D., West, C., Minto, G., Boyd, N., Mills, G., Calton, E., Walker, R., Mackenzie, F., Ellison, B., Roberts, H., Chikungwa, M., Jackson, C., Donovan, A., Foot, J., Homan, E., Montgomery, J., Portch, D., Mercer, P., Palmer, J., Paddle, J., Fouracres, A., Datson, A., Andrew, A., Welch, L., Rose, A., Varma, S., Simeson, K., Rambhatla, M., Susarla, J., Marri, S., Kodaganallur, K., Das, A., Algarsamy, S., Colley, J., Davies, S., Szewczyk, M., Smith, T., Ana, F.B., Luzier, E., Almagro, A., Melo, M.V., Fernando, L., Sulemanji, D., Sprung, J., Weingarten, T., Kor, D., Scavonetto, F., Tze, Y., Gregoretti, C., Neto, A.S., Hemmes, S.N.T., Ball, L., Hollmann, M.W., Mills, G.H., Melo, M.F.V., Putensen, C., Gama de Abreu, M., and Schultz, M.J.

Published
2019
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5. The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients – a posthoc propensity score–weighted cohort analysis of the LAS VEGAS study

Author

Mazzinari, G., Serpa Neto, A., Hemmes, S. N. T., Hedenstierna, G., Jaber, S., Hiesmayr, M., Hollmann, M. W., Mills, G. H., Vidal Melo, M. F., Pearse, R. M., Putensen, C., Schmid, W., Severgnini, P., Wrigge, H., Cambronero, O. D., Ball, L., de Abreu, M. G., Pelosi, P., Schultz, M. J., Kroell, W., Metzler, H., Struber, G., Wegscheider, T., Gombotz, H., Urbanek, B., Kahn, D., Momeni, M., Pospiech, A., Lois, F., Forget, P., Grosu, I., Poelaert, J., van Mossevelde, V., van Malderen, M. -C., Dylst, D., van Melkebeek, J., Beran, M., de Hert, S., De Baerdemaeker, L., Heyse, B., Van Limmen, J., Wyffels, P., Jacobs, T., Roels, N., De Bruyne, A., van de Velde, S., Leva, B., Damster, S., Plichon, B., Juros-Zovko, M., Djonovic-Omanovic, D., Pernar, S., Zunic, J., Miskovic, P., Zilic, A., Kvolik, S., Ivic, D., Azenic-Venzera, D., Skiljic, S., Vinkovic, H., Oputric, I., Juricic, K., Frkovic, V., Kopic, J., Mirkovic, I., Karanovic, N., Carev, M., Dropulic, N., Saric, J. P., Erceg, G., Dvorscak, M. B., Mazul-Sunko, B., Pavicic, A. M., Goranovic, T., Maldini, B., Radocaj, T., Gavranovic, Z., Mladic-Batinica, I., Sehovic, M., Stourac, P., Harazim, H., Smekalova, O., Kosinova, M., Kolacek, T., Hudacek, K., Drab, M., Brujevic, J., Vitkova, K., Jirmanova, K., Volfova, I., Dzurnakova, P., Liskova, K., Dudas, R., Filipsky, R., el Kafrawy, S., Abdelwahab, H. H., Metwally, T., Abdel-Razek, A., El-Shaarawy, A. M., Hasan, W. F., Ahmed, A. G., Yassin, H., Magdy, M., Abdelhady, M., Mahran, M., Herodes, E., Kivik, P., Oganjan, J., Aun, A., Sormus, A., Sarapuu, K., Mall, M., Karjagin, J., Futier, E., Petit, A., Gerard, A., Marret, E., Solier, M., Prades, A., Krassler, J., Merzky, S., Uhlig, C., Kiss, T., Bundy, A., Bluth, T., Gueldner, A., Spieth, P., Scharffenberg, M., Thiem, D. T., Koch, T., Treschan, T., Schaefer, M., Bastin, B., Geib, J., Weiss, M., Kienbaum, P., Pannen, B., Gottschalk, A., Konrad, M., Westerheide, D., Schwerdtfeger, B., Simon, P., Reske, A., Nestler, C., Valsamidis, D., Stroumpoulis, K., Antholopoulos, G., Andreou, A., Karapanos, D., Theodoraki, K., Gkiokas, G., Tasoulis, M. -K., Sidiropoulou, T., Zafeiropoulou, F., Florou, P., Pandazi, A., Tsaousi, G., Nouris, C., Pourzitaki, C., Bystritski, D., Pizov, R., Eden, A., Pesce, C. V., Campanile, A., Marrella, A., Grasso, S., De Michele, M., Bona, F., Giacoletto, G., Sardo, E., Giancarlo, L., Sottosanti, V., Solca, M., Volta, C. A., Spadaro, S., Verri, M., Ragazzi, R., Zoppellari, R., Cinnella, G., Raimondo, P., La Bella, D., Mirabella, L., D'Antini, D., Molin, A., Brunetti, I., Gratarola, A., Pellerano, G., Sileo, R., Pezzatto, S., Montagnani, L., Pasin, L., Landoni, G., Zangrillo, A., Beretta, L., Di Parma, A. L., Tarzia, V., Dossi, R., Sassone, M. E., Sances, D., Tredici, S., Spano, G., Castellani, G., Delunas, L., Peradze, S., Venturino, M., Arpino, I., Sher, S., Tommasino, C., Rapido, F., Morelli, P., Vargas, M., Servillo, G., Cortegiani, A., Raineri, S. M., Montalto, F., Russotto, V., Giarratano, A., Baciarello, M., Generali, M., Cerati, G., Leykin, Y., Bressan, F., Bartolini, V., Zamidei, L., Brazzi, L., Liperi, C., Sales, G., Pistidda, L., Brugnoni, E., Musella, G., Bacuzzi, A., Muhardri, D., Gecaj-Gashi, A., Sada, F., Bytyqi, A., Karbonskiene, A., Aukstakalniene, R., Teberaite, Z., Salciute, E., Tikuisis, R., Miliauskas, P., Jurate, S., Kontrimaviciute, E., Tomkute, G., Xuereb, J., Bezzina, M., Borg, F. J., Hemmes, S., Schultz, M., Hollmann, M., Wiersma, I., Binnekade, J., Bos, L., Boer, C., Duvekot, A., in 't Veld, B., Werger, A., Dennesen, P., Severijns, C., De Jong, J., Hering, J., van Beek, R., Ivars, S., Jammer, I., Breidablik, A., Hodt, K. S., Fjellanger, F., Avalos, M. V., Mellin-Olsen, J., Andersson, E., Shafi-Kabiri, A., Molina, R., Wutai, S., Morais, E., Tareco, G., Ferreira, D., Amaral, J., de Lurdes Goncalves Castro, M., Cadilha, S., Appleton, S., Parente, S., Correia, M., Martins, D., Monteirosa, A., Ricardo, A., Rodrigues, S., Horhota, L., Grintescu, I. M., Mirea, L., Grintescu, I. C., Corneci, D., Negoita, S., Dutu, M., Garotescu, I. P., Filipescu, D., Prodan, A. B., Droc, G., Fota, R., Popescu, M., Tomescu, D., Petcu, A. M., Tudoroiu, M. I., Moise, A., Guran, C. -T., Gherghina, I., Costea, D., Cindea, I., Copotoiu, S. -M., Copotoiu, R., Barsan, V., Tolcser, Z., Riciu, M., Moldovan, S. G., Veres, M., Gritsan, A., Kapkan, T., Gritsan, G., Korolkov, O., Kulikov, A., Lubnin, A., Ovezov, A., Prokoshev, P., Lugovoy, A., Anipchenko, N., Babayants, A., Komissarova, I., Zalina, K., Likhvantsev, V., Fedorov, S., Lazukic, A., Pejakovic, J., Mihajlovic, D., Kusnierikova, Z., Zelinkova, M., Bruncakova, K., Polakovicova, L., Sobona, V., Novak-Supe, B., Pekle-Golez, A., Jovanov, M., Strazisar, B., Markovic-Bozic, J., Novak-Jankovic, V., Voje, M., Grynyuk, A., Kostadinov, I., Spindler-Vesel, A., Moral, V., Unzueta, M. C., Puigbo, C., Fava, J., Canet, J., Moret, E., Rodriguez Nunez, M., Sendra, M., Brunelli, A., Rodenas, F., Monedero, P., Martinez, F. H., Temino, M. J. Y., Martinez Simon, A., de Abajo Larriba, A., Lisi, A., Perez, G., Martinez, R., Granell, M., Vivo, J. T., Ruiz, C. S., de Andres Ibanez, J. A., Pastor, E., Soro, M., Ferrando, C., Defez, M., Alvares-Santullano, C. A., Perez, R., Rico, J., Jawad, M., Saeed, Y., Gillberg, L., Bengisun, Z. K., Kazbek, B. K., Coskunfirat, N., Boztug, N., Sanli, S., Yilmaz, M., Hadimioglu, N., Senturk, N. M., Camci, E., Kucukgoncu, S., Sungur, Z., Sivrikoz, N., Ozgen, S. U., Toraman, F., Selvi, O., Senturk, O., Yildiz, M., Kuvaki, B., Gunenc, F., Kucukguclu, S., Ozbilgin, S., Maral, J., Canli, S., Arun, O., Saltali, A., Aydogan, E., Akgun, F. N., Sanlikarip, C., Karaman, F. M., Mazur, A., Vorotyntsev, S., Rousseau, G., Barrett, C., Stancombe, L., Shelley, B., Scholes, H., Limb, J., Rafi, A., Wayman, L., Deane, J., Rogerson, D., Williams, J., Yates, S., Rogers, E., Pulletz, M., Moreton, S., Jones, S., Venkatesh, S., Burton, M., Brown, L., Goodall, C., Rucklidge, M., Fuller, D., Nadolski, M., Kusre, S., Lundberg, M., Everett, L., Nutt, H., Zuleika, M., Carvalho, P., Clements, D., Creagh-Brown, B., Watt, P., Raymode, P., Pearse, R., Mohr, O., Raj, A., Creary, T., Chishti, A., Bell, A., Higham, C., Cain, A., Gibb, S., Mowat, S., Franklin, D., West, C., Minto, G., Boyd, N., Mills, G., Calton, E., Walker, R., Mackenzie, F., Ellison, B., Roberts, H., Chikungwa, M., Jackson, C., Donovan, A., Foot, J., Homan, E., Montgomery, J., Portch, D., Mercer, P., Palmer, J., Paddle, J., Fouracres, A., Datson, A., Andrew, A., Welch, L., Rose, A., Varma, S., Simeson, K., Rambhatla, M., Susarla, J., Marri, S., Kodaganallur, K., Das, A., Algarsamy, S., Colley, J., Davies, S., Szewczyk, M., Smith, T., Fernandez-Bustamante, A., Luzier, E., Almagro, A., Melo, M. V., Fernando, L., Sulemanji, D., Sprung, J., Weingarten, T., Kor, D., Scavonetto, F., Tze, Y., Mazzinari G., Serpa Neto A., Hemmes S.N.T., Hedenstierna G., Jaber S., Hiesmayr M., Hollmann M.W., Mills G.H., Vidal Melo M.F., Pearse R.M., Putensen C., Schmid W., Severgnini P., Wrigge H., Cambronero O.D., Ball L., de Abreu M.G., Pelosi P., Schultz M.J., Kroell W., Metzler H., Struber G., Wegscheider T., Gombotz H., Urbanek B., Kahn D., Momeni M., Pospiech A., Lois F., Forget P., Grosu I., Poelaert J., van Mossevelde V., van Malderen M.-C., Dylst D., van Melkebeek J., Beran M., de Hert S., De Baerdemaeker L., Heyse B., Van Limmen J., Wyffels P., Jacobs T., Roels N., De Bruyne A., van de Velde S., Leva B., Damster S., Plichon B., Juros-Zovko M., Djonovic-Omanovic D., Pernar S., Zunic J., Miskovic P., Zilic A., Kvolik S., Ivic D., Azenic-Venzera D., Skiljic S., Vinkovic H., Oputric I., Juricic K., Frkovic V., Kopic J., Mirkovic I., Karanovic N., Carev M., Dropulic N., Saric J.P., Erceg G., Dvorscak M.B., Mazul-Sunko B., Pavicic A.M., Goranovic T., Maldini B., Radocaj T., Gavranovic Z., Mladic-Batinica I., Sehovic M., Stourac P., Harazim H., Smekalova O., Kosinova M., Kolacek T., Hudacek K., Drab M., Brujevic J., Vitkova K., Jirmanova K., Volfova I., Dzurnakova P., Liskova K., Dudas R., Filipsky R., el Kafrawy S., Abdelwahab H.H., Metwally T., Abdel-Razek A., El-Shaarawy A.M., Hasan W.F., Ahmed A.G., Yassin H., Magdy M., Abdelhady M., Mahran M., Herodes E., Kivik P., Oganjan J., Aun A., Sormus A., Sarapuu K., Mall M., Karjagin J., Futier E., Petit A., Gerard A., Marret E., Solier M., Prades A., Krassler J., Merzky S., Uhlig C., Kiss T., Bundy A., Bluth T., Gueldner A., Spieth P., Scharffenberg M., Thiem D.T., Koch T., Treschan T., Schaefer M., Bastin B., Geib J., Weiss M., Kienbaum P., Pannen B., Gottschalk A., Konrad M., Westerheide D., Schwerdtfeger B., Simon P., Reske A., Nestler C., Valsamidis D., Stroumpoulis K., Antholopoulos G., Andreou A., Karapanos D., Theodoraki K., Gkiokas G., Tasoulis M.-K., Sidiropoulou T., Zafeiropoulou F., Florou P., Pandazi A., Tsaousi G., Nouris C., Pourzitaki C., Bystritski D., Pizov R., Eden A., Pesce C.V., Campanile A., Marrella A., Grasso S., De Michele M., Bona F., Giacoletto G., Sardo E., Giancarlo L., Sottosanti V., Solca M., Volta C.A., Spadaro S., Verri M., Ragazzi R., Zoppellari R., Cinnella G., Raimondo P., La Bella D., Mirabella L., D'antini D., Molin A., Brunetti I., Gratarola A., Pellerano G., Sileo R., Pezzatto S., Montagnani L., Pasin L., Landoni G., Zangrillo A., Beretta L., Di Parma A.L., Tarzia V., Dossi R., Sassone M.E., Sances D., Tredici S., Spano G., Castellani G., Delunas L., Peradze S., Venturino M., Arpino I., Sher S., Tommasino C., Rapido F., Morelli P., Vargas M., Servillo G., Cortegiani A., Raineri S.M., Montalto F., Russotto V., Giarratano A., Baciarello M., Generali M., Cerati G., Leykin Y., Bressan F., Bartolini V., Zamidei L., Brazzi L., Liperi C., Sales G., Pistidda L., Brugnoni E., Musella G., Bacuzzi A., Muhardri D., Gecaj-Gashi A., Sada F., Bytyqi A., Karbonskiene A., Aukstakalniene R., Teberaite Z., Salciute E., Tikuisis R., Miliauskas P., Jurate S., Kontrimaviciute E., Tomkute G., Xuereb J., Bezzina M., Borg F.J., Hemmes S., Hollmann M., Wiersma I., Binnekade J., Bos L., Boer C., Duvekot A., in 't Veld B., Werger A., Dennesen P., Severijns C., De Jong J., Hering J., van Beek R., Ivars S., Jammer I., Breidablik A., Hodt K.S., Fjellanger F., Avalos M.V., Mellin-Olsen J., Andersson E., Shafi-Kabiri A., Molina R., Wutai S., Morais E., Tareco G., Ferreira D., Amaral J., de Lurdes Goncalves Castro M., Cadilha S., Appleton S., Parente S., Correia M., Martins D., Monteirosa A., Ricardo A., Rodrigues S., Horhota L., Grintescu I.M., Mirea L., Grintescu I.C., Corneci D., Negoita S., Dutu M., Garotescu I.P., Filipescu D., Prodan A.B., Droc G., Fota R., Popescu M., Tomescu D., Petcu A.M., Tudoroiu M.I., Moise A., Guran C.-T., Gherghina I., Costea D., Cindea I., Copotoiu S.-M., Copotoiu R., Barsan V., Tolcser Z., Riciu M., Moldovan S.G., Veres M., Gritsan A., Kapkan T., Gritsan G., Korolkov O., Kulikov A., Lubnin A., Ovezov A., Prokoshev P., Lugovoy A., Anipchenko N., Babayants A., Komissarova I., Zalina K., Likhvantsev V., Fedorov S., Lazukic A., Pejakovic J., Mihajlovic D., Kusnierikova Z., Zelinkova M., Bruncakova K., Polakovicova L., Sobona V., Novak-Supe B., Pekle-Golez A., Jovanov M., Strazisar B., Markovic-Bozic J., Novak-Jankovic V., Voje M., Grynyuk A., Kostadinov I., Spindler-Vesel A., Moral V., Unzueta M.C., Puigbo C., Fava J., Canet J., Moret E., Rodriguez Nunez M., Sendra M., Brunelli A., Rodenas F., Monedero P., Martinez F.H., Temino M.J.Y., Martinez Simon A., de Abajo Larriba A., Lisi A., Perez G., Martinez R., Granell M., Vivo J.T., Ruiz C.S., de Andres Ibanez J.A., Pastor E., Soro M., Ferrando C., Defez M., Alvares-Santullano C.A., Perez R., Rico J., Jawad M., Saeed Y., Gillberg L., Bengisun Z.K., Kazbek B.K., Coskunfirat N., Boztug N., Sanli S., Yilmaz M., Hadimioglu N., Senturk N.M., Camci E., Kucukgoncu S., Sungur Z., Sivrikoz N., Ozgen S.U., Toraman F., Selvi O., Senturk O., Yildiz M., Kuvaki B., Gunenc F., Kucukguclu S., Ozbilgin S., Maral J., Canli S., Arun O., Saltali A., Aydogan E., Akgun F.N., Sanlikarip C., Karaman F.M., Mazur A., Vorotyntsev S., Rousseau G., Barrett C., Stancombe L., Shelley B., Scholes H., Limb J., Rafi A., Wayman L., Deane J., Rogerson D., Williams J., Yates S., Rogers E., Pulletz M., Moreton S., Jones S., Venkatesh S., Burton M., Brown L., Goodall C., Rucklidge M., Fuller D., Nadolski M., Kusre S., Lundberg M., Everett L., Nutt H., Zuleika M., Carvalho P., Clements D., Creagh-Brown B., Watt P., Raymode P., Pearse R., Mohr O., Raj A., Creary T., Chishti A., Bell A., Higham C., Cain A., Gibb S., Mowat S., Franklin D., West C., Minto G., Boyd N., Mills G., Calton E., Walker R., Mackenzie F., Ellison B., Roberts H., Chikungwa M., Jackson C., Donovan A., Foot J., Homan E., Montgomery J., Portch D., Mercer P., Palmer J., Paddle J., Fouracres A., Datson A., Andrew A., Welch L., Rose A., Varma S., Simeson K., Rambhatla M., Susarla J., Marri S., Kodaganallur K., Das A., Algarsamy S., Colley J., Davies S., Szewczyk M., Smith T., Fernandez-Bustamante A., Luzier E., Almagro A., Melo M.V., Fernando L., Sulemanji D., Sprung J., Weingarten T., Kor D., Scavonetto F., Tze Y., Anesthesiology research group, Supporting clinical sciences, Anesthesiology, Guido, Mazzinari, Ary Serpa, Neto, Sabrine N, T Hemme, Goran, Hedenstierna, Samir, Jaber, Michael, Hiesmayr, Markus, W Hollmann, Gary, H Mill, Marcos, F Vidal Melo, Rupert, M Pearse, Christian, Putensen, Werner, Schmid, Paolo, Severgnini, Hermann, Wrigge, Oscar Diaz, Cambronero, Lorenzo, Ball, Marcelo Gama de, Abreu, Paolo, Pelosi, Marcus, J Schultz (LAS VEGAS study–investigator, PROtective VEntilation, Network, Clinical Trial Network of the European Society of, Anaesthesiology), Zangrillo, A, Landoni, G, Beretta, L, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Pulmonary medicine, IOO, ACS - Microcirculation, ACS - Heart failure & arrhythmias, ACS - Diabetes & metabolism, study–investigators, LAS VEGAS, NETwork, PROtective VEntilation, Anaesthesiology, Clinical Trial Network of the European Society of, Mazzinari, Guido, Serpa Neto, Ary, Hemmes, Sabrine N T, Hedenstierna, Goran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W, Mills, Gary H, Vidal Melo, Marcos F, Pearse, Rupert M, Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, Cambronero, Oscar Diaz, Ball, Lorenzo, de Abreu, Marcelo Gama, Pelosi, Paolo, Schultz, Marcus, J, Servillo, G, Vargas, M, Intensive Care Medicine, APH - Quality of Care, ACS - Pulmonary hypertension & thrombosis, Pulmonology, and APH - Global Health

Subjects
Driving pressure, Laparoscopic surgery, Laparoscopy, PEEP, Perioperative ventilation, Pneumoperitoneum, Protective ventilation, Respiratory mechanics, Lung Diseases, Male, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Cohort Studies, Positive-Pressure Respiration, Postoperative Complications, 0302 clinical medicine, 030202 anesthesiology, Abdomen, Clinical endpoint, Middle Aged, 3. Good health, Driving pressure, Laparoscopic surgery, Laparoscopy, PEEP, Perioperative ventilation, Pneumoperitoneum, Protective ventilation, Respiratory mechanics, Female, Research Article, Cohort study, Adult, medicine.medical_specialty, Anestesi och intensivvård, Anesthesia, General, NO, lcsh:RD78.3-87.3, 03 medical and health sciences, medicine, Humans, Propensity Score, Adverse effect, Aged, Retrospective Studies, Anesthesiology and Intensive Care, business.industry, Kirurgi, 030208 emergency & critical care medicine, Odds ratio, medicine.disease, Respiration, Artificial, Surgery, Anesthesiology and Pain Medicine, lcsh:Anesthesiology, Relative risk, business, Abdominal surgery
Abstract

Background It is uncertain whether the association of the intraoperative driving pressure (ΔP) with postoperative pulmonary complications (PPCs) depends on the surgical approach during abdominal surgery. Our primary objective was to determine and compare the association of time–weighted average ΔP (ΔPTW) with PPCs. We also tested the association of ΔPTW with intraoperative adverse events. Methods Posthoc retrospective propensity score–weighted cohort analysis of patients undergoing open or closed abdominal surgery in the ‘Local ASsessment of Ventilatory management during General Anaesthesia for Surgery’ (LAS VEGAS) study, that included patients in 146 hospitals across 29 countries. The primary endpoint was a composite of PPCs. The secondary endpoint was a composite of intraoperative adverse events. Results The analysis included 1128 and 906 patients undergoing open or closed abdominal surgery, respectively. The PPC rate was 5%. ΔP was lower in open abdominal surgery patients, but ΔPTW was not different between groups. The association of ΔPTW with PPCs was significant in both groups and had a higher risk ratio in closed compared to open abdominal surgery patients (1.11 [95%CI 1.10 to 1.20], P P P TW with intraoperative adverse events was also significant in both groups but had higher odds ratio in closed compared to open abdominal surgery patients (1.13 [95%CI 1.12– to 1.14], P P P Conclusions ΔP is associated with PPC and intraoperative adverse events in abdominal surgery, both in open and closed abdominal surgery. Trial registration LAS VEGAS was registered at clinicaltrials.gov (trial identifier NCT01601223).

Published
2021
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7. Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: Post-hoc analysis of LAS VEGAS study

Author

Robba, C, Hemmes, S, Serpa Neto, A, Bluth, T, Canet, J, Hiesmayr, M, Hollmann, M, Mills, G, Vidal Melo, M, Putensen, C, Jaber, S, Schmid, W, Severgnini, P, Wrigge, H, Battaglini, D, Ball, L, Gama De Abreu, M, Schultz, M, Pelosi, P, Kroell, W, Metzler, H, Struber, G, Wegscheider, T, Gombotz, H, Urbanek, B, Kahn, D, Momeni, M, Pospiech, A, Lois, F, Forget, P, Grosu, I, Poelaert, J, Van Mossevelde, V, Van Malderen, M, Dylst, D, Van Melkebeek, J, Beran, M, De Hert, S, De Baerdemaeker, L, Heyse, B, Van Limmen, J, Wyffels, P, Jacobs, T, Roels, N, De Bruyne, A, Van De Velde, S, Leva, B, Damster, S, Plichon, B, Juros-Zovko, M, Djonovic-Omanovic, D, Pernar, S, Zunic, J, Miskovic, P, Zilic, A, Kvolik, S, Ivic, D, Azenic-Venzera, D, Skiljic, S, Vinkovic, H, Oputric, I, Juricic, K, Frkovic, V, Kopic, J, Mirkovic, I, Karanovic, N, Carev, M, Dropulic, N, Saric, J, Erceg, G, Dvorscak, M, Mazul-Sunko, B, Pavicic, A, Goranovic, T, Maldini, B, Radocaj, T, Gavranovic, Z, Mladic-Batinica, I, Sehovic, M, Stourac, P, Harazim, H, Smekalova, O, Kosinova, M, Kolacek, T, Hudacek, K, Drab, M, Brujevic, J, Vitkova, K, Jirmanova, K, Volfova, I, Dzurnakova, P, Liskova, K, Dudas, R, Filipsky, R, El Kafrawy, S, Abdelwahab, H, Metwally, T, Abdel-Razek, A, El-Shaarawy, A, Hasan, W, Ahmed, A, Yassin, H, Magdy, M, Abdelhady, M, Mahran, M, Herodes, E, Kivik, P, Oganjan, J, Aun, A, Sormus, A, Sarapuu, K, Mall, M, Karjagin, J, Futier, E, Petit, A, Gerard, A, Marret, E, Solier, M, Prades, A, Krassler, J, Merzky, S, De Abreu, M, Uhlig, C, Kiss, T, Bundy, A, Gueldner, A, Spieth, P, Scharffenberg, M, Thiem, D, Koch, T, Treschan, T, Schaefer, M, Bastin, B, Geib, J, Weiss, M, Kienbaum, P, Pannen, B, Gottschalk, A, Konrad, M, Westerheide, D, Schwerdtfeger, B, Simon, P, Reske, A, Nestler, C, Valsamidis, D, Stroumpoulis, K, Antholopoulos, G, Andreou, A, Karapanos, D, Theodoraki, K, Gkiokas, G, Tasoulis, M, Sidiropoulou, T, Zafeiropoulou, F, Florou, P, Pandazi, A, Tsaousi, G, Nouris, C, Pourzitaki, C, Bystritski, D, Pizov, R, Eden, A, Pesce, C, Campanile, A, Marrella, A, Grasso, S, De Michele, M, Bona, F, Giacoletto, G, Sardo, E, Giancarlo, L, Sottosanti, V, Solca, M, Volta, C, Spadaro, S, Verri, M, Ragazzi, R, Zoppellari, R, Cinnella, G, Raimondo, P, La Bella, D, Mirabella, L, D'Antini, D, Molin, A, Brunetti, I, Gratarola, A, Pellerano, G, Sileo, R, Pezzatto, S, Montagnani, L, Pasin, L, Landoni, G, Zangrillo, A, Beretta, L, Di Parma, A, Tarzia, V, Dossi, R, Sassone, M, Sances, D, Tredici, S, Spano, G, Castellani, G, Delunas, L, Peradze, S, Venturino, M, Arpino, I, Sher, S, Tommasino, C, Rapido, F, Morelli, P, Vargas, M, Servillo, G, Cortegiani, A, Raineri, S, Montalto, F, Russotto, V, Giarratano, A, Baciarello, M, Generali, M, Cerati, G, Leykin, Y, Bressan, F, Bartolini, V, Zamidei, L, Brazzi, L, Liperi, C, Sales, G, Pistidda, L, Brugnoni, E, Musella, G, Bacuzzi, A, Muhardri, D, Gecaj-Gashi, A, Sada, F, Bytyqi, A, Karbonskiene, A, Aukstakalniene, R, Teberaite, Z, Salciute, E, Tikuisis, R, Miliauskas, P, Jurate, S, Kontrimaviciute, E, Tomkute, G, Xuereb, J, Bezzina, M, Borg, F, Wiersma, I, Binnekade, J, Bos, L, Boer, C, Duvekot, A, In 'T Veld, B, Werger, A, Dennesen, P, Severijns, C, De Jong, J, Hering, J, Van Beek, R, Ivars, S, Jammer, I, Breidablik, A, Hodt, K, Fjellanger, F, Avalos, M, Mellin-Olsen, J, Andersson, E, Shafi-Kabiri, A, Molina, R, Wutai, S, Morais, E, Tareco, G, Ferreira, D, Amaral, J, De Lurdes Goncalves Castro, M, Cadilha, S, Appleton, S, Parente, S, Correia, M, Martins, D, Monteirosa, A, Ricardo, A, Rodrigues, S, Horhota, L, Grintescu, I, Mirea, L, Corneci, D, Negoita, S, Dutu, M, Garotescu, I, Filipescu, D, Prodan, A, Droc, G, Fota, R, Popescu, M, Tomescu, D, Petcu, A, Tudoroiu, M, Moise, A, Guran, C, Gherghina, I, Costea, D, Cindea, I, Copotoiu, S, Copotoiu, R, Barsan, V, Tolcser, Z, Riciu, M, Moldovan, S, Veres, M, Gritsan, A, Kapkan, T, Gritsan, G, Korolkov, O, Kulikov, A, Lubnin, A, Ovezov, A, Prokoshev, P, Lugovoy, A, Anipchenko, N, Babayants, A, 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N. T., Serpa Neto A., Bluth T., Canet J., Hiesmayr M., Hollmann M. W., Mills G. H., Vidal Melo M. F., Putensen C., Jaber S., Schmid W., Severgnini P., Wrigge H., Battaglini D., Ball L., Gama De Abreu M., Schultz M. J., Pelosi P., Kroell W., Metzler H., Struber G., Wegscheider T., Gombotz H., Urbanek B., Kahn D., Momeni M., Pospiech A., Lois F., Forget P., Grosu I., Poelaert J., Van Mossevelde V., Van Malderen M. -C., Dylst D., Van Melkebeek J., Beran M., De Hert S., De Baerdemaeker L., Heyse B., Van Limmen J., Wyffels P., Jacobs T., Roels N., De Bruyne A., Van De Velde S., Leva B., Damster S., Plichon B., Juros-Zovko M., Djonovic-Omanovic D., Pernar S., Zunic J., Miskovic P., Zilic A., Kvolik S., Ivic D., Azenic-Venzera D., Skiljic S., Vinkovic H., Oputric I., Juricic K., Frkovic V., Kopic J., Mirkovic I., Karanovic N., Carev M., Dropulic N., Saric J. P., Erceg G., Dvorscak M. B., Mazul-Sunko B., Pavicic A. M., Goranovic T., Maldini B., Radocaj T., Gavranovic Z., Mladic-Batinica I., Sehovic M., Stourac P., Harazim H., Smekalova O., Kosinova M., Kolacek T., Hudacek K., Drab M., Brujevic J., Vitkova K., Jirmanova K., Volfova I., Dzurnakova P., Liskova K., Dudas R., Filipsky R., El Kafrawy S., Abdelwahab H. H., Metwally T., Abdel-Razek A., El-Shaarawy A. M., Hasan W. F., Ahmed A. G., Yassin H., Magdy M., Abdelhady M., Mahran M., Herodes E., Kivik P., Oganjan J., Aun A., Sormus A., Sarapuu K., Mall M., Karjagin J., Futier E., Petit A., Gerard A., Marret E., Solier M., Prades A., Krassler J., Merzky S., De Abreu M. G., Uhlig C., Kiss T., Bundy A., Gueldner A., Spieth P., Scharffenberg M., Thiem D. T., Koch T., Treschan T., Schaefer M., Bastin B., Geib J., Weiss M., Kienbaum P., Pannen B., Gottschalk A., Konrad M., Westerheide D., Schwerdtfeger B., Simon P., Reske A., Nestler C., Valsamidis D., Stroumpoulis K., Antholopoulos G., Andreou A., Karapanos D., Theodoraki K., Gkiokas G., Tasoulis M. -K., Sidiropoulou T., Zafeiropoulou F., Florou P., Pandazi A., Tsaousi G., Nouris C., Pourzitaki C., Bystritski D., Pizov R., Eden A., Pesce C. V., Campanile A., Marrella A., Grasso S., De Michele M., Bona F., Giacoletto G., Sardo E., Giancarlo L., Sottosanti V., Solca M., Volta C. A., Spadaro S., Verri M., Ragazzi R., Zoppellari R., Cinnella G., Raimondo P., La Bella D., Mirabella L., D'Antini D., Molin A., Brunetti I., Gratarola A., Pellerano G., Sileo R., Pezzatto S., Montagnani L., Pasin L., Landoni G., Zangrillo A., Beretta L., Di Parma A. L., Tarzia V., Dossi R., Sassone M. E., Sances D., Tredici S., Spano G., Castellani G., Delunas L., Peradze S., Venturino M., Arpino I., Sher S., Tommasino C., Rapido F., Morelli P., Vargas M., Servillo G., Cortegiani A., Raineri S. M., Montalto F., Russotto V., Giarratano A., Baciarello M., Generali M., Cerati G., Leykin Y., Bressan F., Bartolini V., Zamidei L., Brazzi L., Liperi C., Sales G., Pistidda L., Brugnoni E., Musella G., Bacuzzi A., Muhardri D., Gecaj-Gashi A., Sada F., Bytyqi A., Karbonskiene A., Aukstakalniene R., Teberaite Z., Salciute E., Tikuisis R., Miliauskas P., Jurate S., Kontrimaviciute E., Tomkute G., Xuereb J., Bezzina M., Borg F. J., Hemmes S., Schultz M., Hollmann M., Wiersma I., Binnekade J., Bos L., Boer C., Duvekot A., In 'T Veld B., Werger A., Dennesen P., Severijns C., De Jong J., Hering J., Van Beek R., Ivars S., Jammer I., Breidablik A., Hodt K. S., Fjellanger F., Avalos M. V., Mellin-Olsen J., Andersson E., Shafi-Kabiri A., Molina R., Wutai S., Morais E., Tareco G., Ferreira D., Amaral J., De Lurdes Goncalves Castro M., Cadilha S., Appleton S., Parente S., Correia M., Martins D., Monteirosa A., Ricardo A., Rodrigues S., Horhota L., Grintescu I. M., Mirea L., Grintescu I. C., Corneci D., Negoita S., Dutu M., Garotescu I. P., Filipescu D., Prodan A. B., Droc G., Fota R., Popescu M., Tomescu D., Petcu A. M., Tudoroiu M. I., Moise A., Guran C. -T., Gherghina I., Costea D., Cindea I., Copotoiu S. -M., Copotoiu R., Barsan V., Tolcser Z., Riciu M., Moldovan S. G., Veres M., Gritsan A., Kapkan T., Gritsan G., Korolkov O., Kulikov A., Lubnin A., Ovezov A., Prokoshev P., Lugovoy A., Anipchenko N., Babayants A., Komissarova I., Zalina K., Likhvantsev V., Fedorov S., Lazukic A., Pejakovic J., Mihajlovic D., Kusnierikova Z., Zelinkova M., Bruncakova K., Polakovicova L., Sobona V., Novak-Supe B., Pekle-Golez A., Jovanov M., Strazisar B., Markovic-Bozic J., Novak-Jankovic V., Voje M., Grynyuk A., Kostadinov I., Spindler-Vesel A., Moral V., Unzueta M. C., Puigbo C., Fava J., Moret E., Nunez M. R., Sendra M., Brunelli A., Rodenas F., Monedero P., Martinez F. H., Temino M. J. Y., Simon A. M., De Abajo Larriba A., Lisi A., Perez G., Martinez R., Granell M., Vivo J. T., Ruiz C. S., De Andres Ibanez J. A., Pastor E., Soro M., Ferrando C., Defez M., Alvares-Santullano C. A., Perez R., Rico J., Jawad M., Saeed Y., Gillberg L., Bengisun Z. K., Kazbek B. K., Coskunfirat N., Boztug N., Sanli S., Yilmaz M., Hadimioglu N., Senturk N. M., Camci E., Kucukgoncu S., Sungur Z., Sivrikoz N., Ozgen S. U., Toraman F., Selvi O., Senturk O., Yildiz M., Kuvaki B., Gunenc F., Kucukguclu S., Ozbilgin S., Maral J., Canli S., Arun O., Saltali A., Aydogan E., Akgun F. N., Sanlikarip C., Karaman F. M., Mazur A., Vorotyntsev S., Rousseau G., Barrett C., Stancombe L., Shelley B., Scholes H., Limb J., Rafi A., Wayman L., Deane J., Rogerson D., Williams J., Yates S., Rogers E., Pulletz M., Moreton S., Jones S., Venkatesh S., Burton M., Brown L., Goodall C., Rucklidge M., Fuller D., Nadolski M., Kusre S., Lundberg M., Everett L., Nutt H., Zuleika M., Carvalho P., Clements D., Creagh-Brown B., Watt P., Raymode P., Pearse R., Mohr O., Raj A., Creary T., Chishti A., Bell A., Higham C., Cain A., Gibb S., Mowat S., Franklin D., West C., Minto G., Boyd N., Mills G., Calton E., Walker R., Mackenzie F., Ellison B., Roberts H., Chikungwa M., Jackson C., Donovan A., Foot J., Homan E., Montgomery J., Portch D., Mercer P., Palmer J., Paddle J., Fouracres A., Datson A., Andrew A., Welch L., Rose A., Varma S., Simeson K., Rambhatla M., Susarla J., Marri S., Kodaganallur K., Das A., Algarsamy S., Colley J., Davies S., Szewczyk M., Smith T., Fernandez-Bustamante A., Luzier E., Almagro A., Melo M. V., Fernando L., Sulemanji D., Sprung J., Weingarten T., Kor D., Scavonetto F., Tze Y., Robba, C, Hemmes, S, Serpa Neto, A, Bluth, T, Canet, J, Hiesmayr, M, Hollmann, M, Mills, G, Vidal Melo, M, Putensen, C, Jaber, S, Schmid, W, Severgnini, P, Wrigge, H, Battaglini, D, Ball, L, Gama De Abreu, M, Schultz, M, Pelosi, P, Kroell, W, Metzler, H, Struber, G, Wegscheider, T, Gombotz, H, Urbanek, B, Kahn, D, Momeni, M, Pospiech, A, Lois, F, Forget, P, Grosu, I, Poelaert, J, Van Mossevelde, V, Van Malderen, M, Dylst, D, Van Melkebeek, J, Beran, M, De Hert, S, De Baerdemaeker, L, Heyse, B, Van Limmen, J, Wyffels, P, Jacobs, T, Roels, N, De Bruyne, A, Van De Velde, S, Leva, B, Damster, S, Plichon, B, Juros-Zovko, M, Djonovic-Omanovic, D, Pernar, S, Zunic, J, Miskovic, P, Zilic, A, Kvolik, S, Ivic, D, Azenic-Venzera, D, Skiljic, S, Vinkovic, H, Oputric, I, Juricic, K, Frkovic, V, Kopic, J, Mirkovic, I, Karanovic, N, Carev, M, Dropulic, N, Saric, J, Erceg, G, Dvorscak, M, Mazul-Sunko, B, Pavicic, A, Goranovic, T, Maldini, B, Radocaj, T, Gavranovic, Z, Mladic-Batinica, I, Sehovic, M, Stourac, P, Harazim, H, Smekalova, O, Kosinova, M, Kolacek, T, Hudacek, K, Drab, M, Brujevic, J, Vitkova, K, Jirmanova, K, Volfova, I, Dzurnakova, P, Liskova, K, Dudas, R, Filipsky, R, El Kafrawy, S, Abdelwahab, H, Metwally, T, Abdel-Razek, A, El-Shaarawy, A, Hasan, W, Ahmed, A, Yassin, H, Magdy, M, Abdelhady, M, Mahran, M, Herodes, E, Kivik, P, Oganjan, J, Aun, A, Sormus, A, Sarapuu, K, Mall, M, Karjagin, J, Futier, E, Petit, A, Gerard, A, Marret, E, Solier, M, Prades, A, Krassler, J, Merzky, S, De Abreu, M, Uhlig, C, Kiss, T, Bundy, A, Gueldner, A, Spieth, P, Scharffenberg, M, Thiem, D, Koch, T, Treschan, T, Schaefer, M, Bastin, B, Geib, J, Weiss, M, Kienbaum, P, Pannen, B, Gottschalk, A, Konrad, M, Westerheide, D, Schwerdtfeger, B, Simon, P, Reske, A, Nestler, C, Valsamidis, D, Stroumpoulis, K, Antholopoulos, G, Andreou, A, Karapanos, D, Theodoraki, K, Gkiokas, G, Tasoulis, M, Sidiropoulou, T, Zafeiropoulou, F, Florou, P, Pandazi, A, Tsaousi, G, Nouris, C, Pourzitaki, C, Bystritski, D, Pizov, R, Eden, A, Pesce, C, Campanile, A, Marrella, A, Grasso, S, De Michele, M, Bona, F, Giacoletto, G, Sardo, E, Giancarlo, L, Sottosanti, V, Solca, M, Volta, C, Spadaro, S, Verri, M, Ragazzi, R, Zoppellari, R, Cinnella, G, Raimondo, P, La Bella, D, Mirabella, L, D'Antini, D, Molin, A, Brunetti, I, Gratarola, A, Pellerano, G, Sileo, R, Pezzatto, S, Montagnani, L, Pasin, L, Landoni, G, Zangrillo, A, Beretta, L, Di Parma, A, Tarzia, V, Dossi, R, Sassone, M, Sances, D, Tredici, S, Spano, G, Castellani, G, Delunas, L, Peradze, S, Venturino, M, Arpino, I, Sher, S, Tommasino, C, Rapido, F, Morelli, P, Vargas, M, Servillo, G, Cortegiani, A, Raineri, S, Montalto, F, Russotto, V, Giarratano, A, Baciarello, M, Generali, M, Cerati, G, Leykin, Y, Bressan, F, Bartolini, V, Zamidei, L, Brazzi, L, Liperi, C, Sales, G, Pistidda, L, Brugnoni, E, Musella, G, Bacuzzi, A, Muhardri, D, Gecaj-Gashi, A, Sada, F, Bytyqi, A, Karbonskiene, A, Aukstakalniene, R, Teberaite, Z, Salciute, E, Tikuisis, R, Miliauskas, P, Jurate, S, Kontrimaviciute, E, Tomkute, G, Xuereb, J, Bezzina, M, Borg, F, Wiersma, I, Binnekade, J, Bos, L, Boer, C, Duvekot, A, In 'T Veld, B, Werger, A, Dennesen, P, Severijns, C, De Jong, J, Hering, J, Van Beek, R, Ivars, S, Jammer, I, Breidablik, A, Hodt, K, Fjellanger, F, Avalos, M, Mellin-Olsen, J, Andersson, E, Shafi-Kabiri, A, Molina, R, Wutai, S, Morais, E, Tareco, G, Ferreira, D, Amaral, J, De Lurdes Goncalves Castro, M, Cadilha, S, Appleton, S, Parente, S, Correia, M, Martins, D, Monteirosa, A, Ricardo, A, Rodrigues, S, Horhota, L, Grintescu, I, Mirea, L, Corneci, D, Negoita, S, Dutu, M, Garotescu, I, Filipescu, D, Prodan, A, Droc, G, Fota, R, Popescu, M, Tomescu, D, Petcu, A, Tudoroiu, M, Moise, A, Guran, C, Gherghina, I, Costea, D, Cindea, I, Copotoiu, S, Copotoiu, R, Barsan, V, Tolcser, Z, Riciu, M, Moldovan, S, Veres, M, Gritsan, A, Kapkan, T, Gritsan, G, Korolkov, O, Kulikov, A, Lubnin, A, Ovezov, A, Prokoshev, P, Lugovoy, A, Anipchenko, N, Babayants, A, Komissarova, I, Zalina, K, Likhvantsev, V, Fedorov, S, Lazukic, A, Pejakovic, J, Mihajlovic, D, Kusnierikova, Z, Zelinkova, M, Bruncakova, K, Polakovicova, L, Sobona, V, Novak-Supe, B, Pekle-Golez, A, Jovanov, M, Strazisar, B, Markovic-Bozic, J, Novak-Jankovic, V, Voje, M, Grynyuk, A, Kostadinov, I, Spindler-Vesel, A, Moral, V, Unzueta, M, Puigbo, C, Fava, J, Moret, E, Nunez, M, Sendra, M, Brunelli, A, Rodenas, F, Monedero, P, Martinez, F, Temino, M, Simon, A, De Abajo Larriba, A, Lisi, A, Perez, G, Martinez, R, Granell, M, Vivo, J, Ruiz, C, De Andres Ibanez, J, Pastor, E, Soro, M, Ferrando, C, Defez, M, Alvares-Santullano, C, Perez, R, Rico, J, Jawad, M, Saeed, Y, Gillberg, L, Bengisun, Z, Kazbek, B, Coskunfirat, N, Boztug, N, Sanli, S, Yilmaz, M, Hadimioglu, N, Senturk, N, Camci, E, Kucukgoncu, S, Sungur, Z, Sivrikoz, N, Ozgen, S, Toraman, F, Selvi, O, Senturk, O, Yildiz, M, Kuvaki, B, Gunenc, F, Kucukguclu, S, Ozbilgin, S, Maral, J, Canli, S, Arun, O, Saltali, A, Aydogan, E, Akgun, F, Sanlikarip, C, Karaman, F, Mazur, A, Vorotyntsev, S, Rousseau, G, Barrett, C, Stancombe, L, Shelley, B, Scholes, H, Limb, J, Rafi, A, Wayman, L, Deane, J, Rogerson, D, Williams, J, Yates, S, Rogers, E, Pulletz, M, Moreton, S, Jones, S, Venkatesh, S, Burton, M, Brown, L, Goodall, C, Rucklidge, M, Fuller, D, Nadolski, M, Kusre, S, Lundberg, M, Everett, L, Nutt, H, Zuleika, M, Carvalho, P, Clements, D, Creagh-Brown, B, Watt, P, Raymode, P, Pearse, R, Mohr, O, Raj, A, Creary, T, Chishti, A, Bell, A, Higham, C, Cain, A, Gibb, S, Mowat, S, Franklin, D, West, C, Minto, G, Boyd, N, Calton, E, Walker, R, Mackenzie, F, Ellison, B, Roberts, H, Chikungwa, M, Jackson, C, Donovan, A, Foot, J, Homan, E, Montgomery, J, Portch, D, Mercer, P, Palmer, J, Paddle, J, Fouracres, A, Datson, A, Andrew, A, Welch, L, Rose, A, Varma, S, Simeson, K, Rambhatla, M, Susarla, J, Marri, S, Kodaganallur, K, Das, A, Algarsamy, S, Colley, J, Davies, S, Szewczyk, M, Smith, T, Fernandez-Bustamante, A, Luzier, E, Almagro, A, Melo, M, Fernando, L, Sulemanji, D, Sprung, J, Weingarten, T, Kor, D, Scavonetto, F, Tze, Y, Robba C., Hemmes S. N. T., Serpa Neto A., Bluth T., Canet J., Hiesmayr M., Hollmann M. W., Mills G. H., Vidal Melo M. F., Putensen C., Jaber S., Schmid W., Severgnini P., Wrigge H., Battaglini D., Ball L., Gama De Abreu M., Schultz M. J., Pelosi P., Kroell W., Metzler H., Struber G., Wegscheider T., Gombotz H., Urbanek B., Kahn D., Momeni M., Pospiech A., Lois F., Forget P., Grosu I., Poelaert J., Van Mossevelde V., Van Malderen M. -C., Dylst D., Van Melkebeek J., Beran M., De Hert S., De Baerdemaeker L., Heyse B., Van Limmen J., Wyffels P., Jacobs T., Roels N., De Bruyne A., Van De Velde S., Leva B., Damster S., Plichon B., Juros-Zovko M., Djonovic-Omanovic D., Pernar S., Zunic J., Miskovic P., Zilic A., Kvolik S., Ivic D., Azenic-Venzera D., Skiljic S., Vinkovic H., Oputric I., Juricic K., Frkovic V., Kopic J., Mirkovic I., Karanovic N., Carev M., Dropulic N., Saric J. P., Erceg G., Dvorscak M. B., Mazul-Sunko B., Pavicic A. M., Goranovic T., Maldini B., Radocaj T., Gavranovic Z., Mladic-Batinica I., Sehovic M., Stourac P., Harazim H., Smekalova O., Kosinova M., Kolacek T., Hudacek K., Drab M., Brujevic J., Vitkova K., Jirmanova K., Volfova I., Dzurnakova P., Liskova K., Dudas R., Filipsky R., El Kafrawy S., Abdelwahab H. H., Metwally T., Abdel-Razek A., El-Shaarawy A. M., Hasan W. F., Ahmed A. G., Yassin H., Magdy M., Abdelhady M., Mahran M., Herodes E., Kivik P., Oganjan J., Aun A., Sormus A., Sarapuu K., Mall M., Karjagin J., Futier E., Petit A., Gerard A., Marret E., Solier M., Prades A., Krassler J., Merzky S., De Abreu M. G., Uhlig C., Kiss T., Bundy A., Gueldner A., Spieth P., Scharffenberg M., Thiem D. T., Koch T., Treschan T., Schaefer M., Bastin B., Geib J., Weiss M., Kienbaum P., Pannen B., Gottschalk A., Konrad M., Westerheide D., Schwerdtfeger B., Simon P., Reske A., Nestler C., Valsamidis D., Stroumpoulis K., Antholopoulos G., Andreou A., Karapanos D., Theodoraki K., Gkiokas G., Tasoulis M. -K., Sidiropoulou T., Zafeiropoulou F., Florou P., Pandazi A., Tsaousi G., Nouris C., Pourzitaki C., Bystritski D., Pizov R., Eden A., Pesce C. V., Campanile A., Marrella A., Grasso S., De Michele M., Bona F., Giacoletto G., Sardo E., Giancarlo L., Sottosanti V., Solca M., Volta C. A., Spadaro S., Verri M., Ragazzi R., Zoppellari R., Cinnella G., Raimondo P., La Bella D., Mirabella L., D'Antini D., Molin A., Brunetti I., Gratarola A., Pellerano G., Sileo R., Pezzatto S., Montagnani L., Pasin L., Landoni G., Zangrillo A., Beretta L., Di Parma A. L., Tarzia V., Dossi R., Sassone M. E., Sances D., Tredici S., Spano G., Castellani G., Delunas L., Peradze S., Venturino M., Arpino I., Sher S., Tommasino C., Rapido F., Morelli P., Vargas M., Servillo G., Cortegiani A., Raineri S. M., Montalto F., Russotto V., Giarratano A., Baciarello M., Generali M., Cerati G., Leykin Y., Bressan F., Bartolini V., Zamidei L., Brazzi L., Liperi C., Sales G., Pistidda L., Brugnoni E., Musella G., Bacuzzi A., Muhardri D., Gecaj-Gashi A., Sada F., Bytyqi A., Karbonskiene A., Aukstakalniene R., Teberaite Z., Salciute E., Tikuisis R., Miliauskas P., Jurate S., Kontrimaviciute E., Tomkute G., Xuereb J., Bezzina M., Borg F. J., Hemmes S., Schultz M., Hollmann M., Wiersma I., Binnekade J., Bos L., Boer C., Duvekot A., In 'T Veld B., Werger A., Dennesen P., Severijns C., De Jong J., Hering J., Van Beek R., Ivars S., Jammer I., Breidablik A., Hodt K. S., Fjellanger F., Avalos M. V., Mellin-Olsen J., Andersson E., Shafi-Kabiri A., Molina R., Wutai S., Morais E., Tareco G., Ferreira D., Amaral J., De Lurdes Goncalves Castro M., Cadilha S., Appleton S., Parente S., Correia M., Martins D., Monteirosa A., Ricardo A., Rodrigues S., Horhota L., Grintescu I. M., Mirea L., Grintescu I. C., Corneci D., Negoita S., Dutu M., Garotescu I. P., Filipescu D., Prodan A. B., Droc G., Fota R., Popescu M., Tomescu D., Petcu A. M., Tudoroiu M. I., Moise A., Guran C. -T., Gherghina I., Costea D., Cindea I., Copotoiu S. -M., Copotoiu R., Barsan V., Tolcser Z., Riciu M., Moldovan S. G., Veres M., Gritsan A., Kapkan T., Gritsan G., Korolkov O., Kulikov A., Lubnin A., Ovezov A., Prokoshev P., Lugovoy A., Anipchenko N., Babayants A., Komissarova I., Zalina K., Likhvantsev V., Fedorov S., Lazukic A., Pejakovic J., Mihajlovic D., Kusnierikova Z., Zelinkova M., Bruncakova K., Polakovicova L., Sobona V., Novak-Supe B., Pekle-Golez A., Jovanov M., Strazisar B., Markovic-Bozic J., Novak-Jankovic V., Voje M., Grynyuk A., Kostadinov I., Spindler-Vesel A., Moral V., Unzueta M. C., Puigbo C., Fava J., Moret E., Nunez M. R., Sendra M., Brunelli A., Rodenas F., Monedero P., Martinez F. H., Temino M. J. Y., Simon A. M., De Abajo Larriba A., Lisi A., Perez G., Martinez R., Granell M., Vivo J. T., Ruiz C. S., De Andres Ibanez J. A., Pastor E., Soro M., Ferrando C., Defez M., Alvares-Santullano C. A., Perez R., Rico J., Jawad M., Saeed Y., Gillberg L., Bengisun Z. K., Kazbek B. K., Coskunfirat N., Boztug N., Sanli S., Yilmaz M., Hadimioglu N., Senturk N. M., Camci E., Kucukgoncu S., Sungur Z., Sivrikoz N., Ozgen S. U., Toraman F., Selvi O., Senturk O., Yildiz M., Kuvaki B., Gunenc F., Kucukguclu S., Ozbilgin S., Maral J., Canli S., Arun O., Saltali A., Aydogan E., Akgun F. N., Sanlikarip C., Karaman F. M., Mazur A., Vorotyntsev S., Rousseau G., Barrett C., Stancombe L., Shelley B., Scholes H., Limb J., Rafi A., Wayman L., Deane J., Rogerson D., Williams J., Yates S., Rogers E., Pulletz M., Moreton S., Jones S., Venkatesh S., Burton M., Brown L., Goodall C., Rucklidge M., Fuller D., Nadolski M., Kusre S., Lundberg M., Everett L., Nutt H., Zuleika M., Carvalho P., Clements D., Creagh-Brown B., Watt P., Raymode P., Pearse R., Mohr O., Raj A., Creary T., Chishti A., Bell A., Higham C., Cain A., Gibb S., Mowat S., Franklin D., West C., Minto G., Boyd N., Mills G., Calton E., Walker R., Mackenzie F., Ellison B., Roberts H., Chikungwa M., Jackson C., Donovan A., Foot J., Homan E., Montgomery J., Portch D., Mercer P., Palmer J., Paddle J., Fouracres A., Datson A., Andrew A., Welch L., Rose A., Varma S., Simeson K., Rambhatla M., Susarla J., Marri S., Kodaganallur K., Das A., Algarsamy S., Colley J., Davies S., Szewczyk M., Smith T., Fernandez-Bustamante A., Luzier E., Almagro A., Melo M. V., Fernando L., Sulemanji D., Sprung J., Weingarten T., Kor D., Scavonetto F., and Tze Y.

Abstract

Background: Limited information is available regarding intraoperative ventilator settings and the incidence of postoperative pulmonary complications (PPCs) in patients undergoing neurosurgical procedures. The aim of this post-hoc analysis of the 'Multicentre Local ASsessment of VEntilatory management during General Anaesthesia for Surgery' (LAS VEGAS) study was to examine the ventilator settings of patients undergoing neurosurgical procedures, and to explore the association between perioperative variables and the development of PPCs in neurosurgical patients. Methods: Post-hoc analysis of LAS VEGAS study, restricted to patients undergoing neurosurgery. Patients were stratified into groups based on the type of surgery (brain and spine), the occurrence of PPCs and the assess respiratory risk in surgical patients in Catalonia (ARISCAT) score risk for PPCs. Results: Seven hundred eighty-four patients were included in the analysis; 408 patients (52%) underwent spine surgery and 376 patients (48%) brain surgery. Median tidal volume (VT) was 8 ml [Interquartile Range, IQR = 7.3-9] per predicted body weight; median positive end-expiratory pressure (PEEP) was 5 [3 to 5] cmH20. Planned recruitment manoeuvres were used in the 6.9% of patients. No differences in ventilator settings were found among the sub-groups. PPCs occurred in 81 patients (10.3%). Duration of anaesthesia (odds ratio, 1.295 [95% confidence interval 1.067 to 1.572]; p = 0.009) and higher age for the brain group (odds ratio, 0.000 [0.000 to 0.189]; p = 0.031), but not intraoperative ventilator settings were independently associated with development of PPCs. Conclusions: Neurosurgical patients are ventilated with low VT and low PEEP, while recruitment manoeuvres are seldom applied. Intraoperative ventilator settings are not associated with PPCs.

Published
2020

8. Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: Post-hoc analysis of LAS VEGAS study

Author

Robba C., Hemmes S. N. T., Serpa Neto A., Bluth T., Canet J., Hiesmayr M., Hollmann M. W., Mills G. H., Vidal Melo M. F., Putensen C., Jaber S., Schmid W., Severgnini P., Wrigge H., Battaglini D., Ball L., Gama De Abreu M., Schultz M. J., Pelosi P., Kroell W., Metzler H., Struber G., Wegscheider T., Gombotz H., Urbanek B., Kahn D., Momeni M., Pospiech A., Lois F., Forget P., Grosu I., Poelaert J., Van Mossevelde V., Van Malderen M. -C., Dylst D., Van Melkebeek J., Beran M., De Hert S., De Baerdemaeker L., Heyse B., Van Limmen J., Wyffels P., Jacobs T., Roels N., De Bruyne A., Van De Velde S., Leva B., Damster S., Plichon B., Juros-Zovko M., Djonovic-Omanovic D., Pernar S., Zunic J., Miskovic P., Zilic A., Kvolik S., Ivic D., Azenic-Venzera D., Skiljic S., Vinkovic H., Oputric I., Juricic K., Frkovic V., Kopic J., Mirkovic I., Karanovic N., Carev M., Dropulic N., Saric J. P., Erceg G., Dvorscak M. B., Mazul-Sunko B., Pavicic A. M., Goranovic T., Maldini B., Radocaj T., Gavranovic Z., Mladic-Batinica I., Sehovic M., Stourac P., Harazim H., Smekalova O., Kosinova M., Kolacek T., Hudacek K., Drab M., Brujevic J., Vitkova K., Jirmanova K., Volfova I., Dzurnakova P., Liskova K., Dudas R., Filipsky R., El Kafrawy S., Abdelwahab H. H., Metwally T., Abdel-Razek A., El-Shaarawy A. M., Hasan W. F., Ahmed A. G., Yassin H., Magdy M., Abdelhady M., Mahran M., Herodes E., Kivik P., Oganjan J., Aun A., Sormus A., Sarapuu K., Mall M., Karjagin J., Futier E., Petit A., Gerard A., Marret E., Solier M., Prades A., Krassler J., Merzky S., De Abreu M. G., Uhlig C., Kiss T., Bundy A., Gueldner A., Spieth P., Scharffenberg M., Thiem D. T., Koch T., Treschan T., Schaefer M., Bastin B., Geib J., Weiss M., Kienbaum P., Pannen B., Gottschalk A., Konrad M., Westerheide D., Schwerdtfeger B., Simon P., Reske A., Nestler C., Valsamidis D., Stroumpoulis K., Antholopoulos G., Andreou A., Karapanos D., Theodoraki K., Gkiokas G., Tasoulis M. -K., Sidiropoulou T., Zafeiropoulou F., Florou P., Pandazi A., Tsaousi G., Nouris C., Pourzitaki C., Bystritski D., Pizov R., Eden A., Pesce C. V., Campanile A., Marrella A., Grasso S., De Michele M., Bona F., Giacoletto G., Sardo E., Giancarlo L., Sottosanti V., Solca M., Volta C. A., Spadaro S., Verri M., Ragazzi R., Zoppellari R., Cinnella G., Raimondo P., La Bella D., Mirabella L., D'Antini D., Molin A., Brunetti I., Gratarola A., Pellerano G., Sileo R., Pezzatto S., Montagnani L., Pasin L., Landoni G., Zangrillo A., Beretta L., Di Parma A. L., Tarzia V., Dossi R., Sassone M. E., Sances D., Tredici S., Spano G., Castellani G., Delunas L., Peradze S., Venturino M., Arpino I., Sher S., Tommasino C., Rapido F., Morelli P., Vargas M., Servillo G., Cortegiani A., Raineri S. M., Montalto F., Russotto V., Giarratano A., Baciarello M., Generali M., Cerati G., Leykin Y., Bressan F., Bartolini V., Zamidei L., Brazzi L., Liperi C., Sales G., Pistidda L., Brugnoni E., Musella G., Bacuzzi A., Muhardri D., Gecaj-Gashi A., Sada F., Bytyqi A., Karbonskiene A., Aukstakalniene R., Teberaite Z., Salciute E., Tikuisis R., Miliauskas P., Jurate S., Kontrimaviciute E., Tomkute G., Xuereb J., Bezzina M., Borg F. J., Hemmes S., Schultz M., Hollmann M., Wiersma I., Binnekade J., Bos L., Boer C., Duvekot A., In 'T Veld B., Werger A., Dennesen P., Severijns C., De Jong J., Hering J., Van Beek R., Ivars S., Jammer I., Breidablik A., Hodt K. S., Fjellanger F., Avalos M. V., Mellin-Olsen J., Andersson E., Shafi-Kabiri A., Molina R., Wutai S., Morais E., Tareco G., Ferreira D., Amaral J., De Lurdes Goncalves Castro M., Cadilha S., Appleton S., Parente S., Correia M., Martins D., Monteirosa A., Ricardo A., Rodrigues S., Horhota L., Grintescu I. M., Mirea L., Grintescu I. C., Corneci D., Negoita S., Dutu M., Garotescu I. P., Filipescu D., Prodan A. B., Droc G., Fota R., Popescu M., Tomescu D., Petcu A. M., Tudoroiu M. I., Moise A., Guran C. -T., Gherghina I., Costea D., Cindea I., Copotoiu S. -M., Copotoiu R., Barsan V., Tolcser Z., Riciu M., Moldovan S. G., Veres M., Gritsan A., Kapkan T., Gritsan G., Korolkov O., Kulikov A., Lubnin A., Ovezov A., Prokoshev P., Lugovoy A., Anipchenko N., Babayants A., Komissarova I., Zalina K., Likhvantsev V., Fedorov S., Lazukic A., Pejakovic J., Mihajlovic D., Kusnierikova Z., Zelinkova M., Bruncakova K., Polakovicova L., Sobona V., Novak-Supe B., Pekle-Golez A., Jovanov M., Strazisar B., Markovic-Bozic J., Novak-Jankovic V., Voje M., Grynyuk A., Kostadinov I., Spindler-Vesel A., Moral V., Unzueta M. C., Puigbo C., Fava J., Moret E., Nunez M. R., Sendra M., Brunelli A., Rodenas F., Monedero P., Martinez F. H., Temino M. J. Y., Simon A. M., De Abajo Larriba A., Lisi A., Perez G., Martinez R., Granell M., Vivo J. T., Ruiz C. S., De Andres Ibanez J. A., Pastor E., Soro M., Ferrando C., Defez M., Alvares-Santullano C. A., Perez R., Rico J., Jawad M., Saeed Y., Gillberg L., Bengisun Z. K., Kazbek B. K., Coskunfirat N., Boztug N., Sanli S., Yilmaz M., Hadimioglu N., Senturk N. M., Camci E., Kucukgoncu S., Sungur Z., Sivrikoz N., Ozgen S. U., Toraman F., Selvi O., Senturk O., Yildiz M., Kuvaki B., Gunenc F., Kucukguclu S., Ozbilgin S., Maral J., Canli S., Arun O., Saltali A., Aydogan E., Akgun F. N., Sanlikarip C., Karaman F. M., Mazur A., Vorotyntsev S., Rousseau G., Barrett C., Stancombe L., Shelley B., Scholes H., Limb J., Rafi A., Wayman L., Deane J., Rogerson D., Williams J., Yates S., Rogers E., Pulletz M., Moreton S., Jones S., Venkatesh S., Burton M., Brown L., Goodall C., Rucklidge M., Fuller D., Nadolski M., Kusre S., Lundberg M., Everett L., Nutt H., Zuleika M., Carvalho P., Clements D., Creagh-Brown B., Watt P., Raymode P., Pearse R., Mohr O., Raj A., Creary T., Chishti A., Bell A., Higham C., Cain A., Gibb S., Mowat S., Franklin D., West C., Minto G., Boyd N., Mills G., Calton E., Walker R., Mackenzie F., Ellison B., Roberts H., Chikungwa M., Jackson C., Donovan A., Foot J., Homan E., Montgomery J., Portch D., Mercer P., Palmer J., Paddle J., Fouracres A., Datson A., Andrew A., Welch L., Rose A., Varma S., Simeson K., Rambhatla M., Susarla J., Marri S., Kodaganallur K., Das A., Algarsamy S., Colley J., Davies S., Szewczyk M., Smith T., Fernandez-Bustamante A., Luzier E., Almagro A., Melo M. V., Fernando L., Sulemanji D., Sprung J., Weingarten T., Kor D., Scavonetto F., Tze Y., Robba, C., Hemmes, S. N. T., Serpa Neto, A., Bluth, T., Canet, J., Hiesmayr, M., Hollmann, M. W., Mills, G. H., Vidal Melo, M. F., Putensen, C., Jaber, S., Schmid, W., Severgnini, P., Wrigge, H., Battaglini, D., Ball, L., Gama De Abreu, M., Schultz, M. J., Pelosi, P., Kroell, W., Metzler, H., Struber, G., Wegscheider, T., Gombotz, H., Urbanek, B., Kahn, D., Momeni, M., Pospiech, A., Lois, F., Forget, P., Grosu, I., Poelaert, J., Van Mossevelde, V., Van Malderen, M. -C., Dylst, D., Van Melkebeek, J., Beran, M., De Hert, S., De Baerdemaeker, L., Heyse, B., Van Limmen, J., Wyffels, P., Jacobs, T., Roels, N., De Bruyne, A., Van De Velde, S., Leva, B., Damster, S., Plichon, B., Juros-Zovko, M., Djonovic-Omanovic, D., Pernar, S., Zunic, J., Miskovic, P., Zilic, A., Kvolik, S., Ivic, D., Azenic-Venzera, D., Skiljic, S., Vinkovic, H., Oputric, I., Juricic, K., Frkovic, V., Kopic, J., Mirkovic, I., Karanovic, N., Carev, M., Dropulic, N., Saric, J. P., Erceg, G., Dvorscak, M. B., Mazul-Sunko, B., Pavicic, A. M., Goranovic, T., Maldini, B., Radocaj, T., Gavranovic, Z., Mladic-Batinica, I., Sehovic, M., Stourac, P., Harazim, H., Smekalova, O., Kosinova, M., Kolacek, T., Hudacek, K., Drab, M., Brujevic, J., Vitkova, K., Jirmanova, K., Volfova, I., Dzurnakova, P., Liskova, K., Dudas, R., Filipsky, R., El Kafrawy, S., Abdelwahab, H. H., Metwally, T., Abdel-Razek, A., El-Shaarawy, A. M., Hasan, W. F., Ahmed, A. G., Yassin, H., Magdy, M., Abdelhady, M., Mahran, M., Herodes, E., Kivik, P., Oganjan, J., Aun, A., Sormus, A., Sarapuu, K., Mall, M., Karjagin, J., Futier, E., Petit, A., Gerard, A., Marret, E., Solier, M., Prades, A., Krassler, J., Merzky, S., De Abreu, M. G., Uhlig, C., Kiss, T., Bundy, A., Gueldner, A., Spieth, P., Scharffenberg, M., Thiem, D. T., Koch, T., Treschan, T., Schaefer, M., Bastin, B., Geib, J., Weiss, M., Kienbaum, P., Pannen, B., Gottschalk, A., Konrad, M., Westerheide, D., Schwerdtfeger, B., Simon, P., Reske, A., Nestler, C., Valsamidis, D., Stroumpoulis, K., Antholopoulos, G., Andreou, A., Karapanos, D., Theodoraki, K., Gkiokas, G., Tasoulis, M. -K., Sidiropoulou, T., Zafeiropoulou, F., Florou, P., Pandazi, A., Tsaousi, G., Nouris, C., Pourzitaki, C., Bystritski, D., Pizov, R., Eden, A., Pesce, C. V., Campanile, A., Marrella, A., Grasso, S., De Michele, M., Bona, F., Giacoletto, G., Sardo, E., Giancarlo, L., Sottosanti, V., Solca, M., Volta, C. A., Spadaro, S., Verri, M., Ragazzi, R., Zoppellari, R., Cinnella, G., Raimondo, P., La Bella, D., Mirabella, L., D'Antini, D., Molin, A., Brunetti, I., Gratarola, A., Pellerano, G., Sileo, R., Pezzatto, S., Montagnani, L., Pasin, L., Landoni, G., Zangrillo, A., Beretta, L., Di Parma, A. L., Tarzia, V., Dossi, R., Sassone, M. E., Sances, D., Tredici, S., Spano, G., Castellani, G., Delunas, L., Peradze, S., Venturino, M., Arpino, I., Sher, S., Tommasino, C., Rapido, F., Morelli, P., Vargas, M., Servillo, G., Cortegiani, A., Raineri, S. M., Montalto, F., Russotto, V., Giarratano, A., Baciarello, M., Generali, M., Cerati, G., Leykin, Y., Bressan, F., Bartolini, V., Zamidei, L., Brazzi, L., Liperi, C., Sales, G., Pistidda, L., Brugnoni, E., Musella, G., Bacuzzi, A., Muhardri, D., Gecaj-Gashi, A., Sada, F., Bytyqi, A., Karbonskiene, A., Aukstakalniene, R., Teberaite, Z., Salciute, E., Tikuisis, R., Miliauskas, P., Jurate, S., Kontrimaviciute, E., Tomkute, G., Xuereb, J., Bezzina, M., Borg, F. J., Hemmes, S., Schultz, M., Hollmann, M., Wiersma, I., Binnekade, J., Bos, L., Boer, C., Duvekot, A., In 'T Veld, B., Werger, A., Dennesen, P., Severijns, C., De Jong, J., Hering, J., Van Beek, R., Ivars, S., Jammer, I., Breidablik, A., Hodt, K. S., Fjellanger, F., Avalos, M. V., Mellin-Olsen, J., Andersson, E., Shafi-Kabiri, A., Molina, R., Wutai, S., Morais, E., Tareco, G., Ferreira, D., Amaral, J., De Lurdes Goncalves Castro, M., Cadilha, S., Appleton, S., Parente, S., Correia, M., Martins, D., Monteirosa, A., Ricardo, A., Rodrigues, S., Horhota, L., Grintescu, I. M., Mirea, L., Grintescu, I. C., Corneci, D., Negoita, S., Dutu, M., Garotescu, I. P., Filipescu, D., Prodan, A. B., Droc, G., Fota, R., Popescu, M., Tomescu, D., Petcu, A. M., Tudoroiu, M. I., Moise, A., Guran, C. -T., Gherghina, I., Costea, D., Cindea, I., Copotoiu, S. -M., Copotoiu, R., Barsan, V., Tolcser, Z., Riciu, M., Moldovan, S. G., Veres, M., Gritsan, A., Kapkan, T., Gritsan, G., Korolkov, O., Kulikov, A., Lubnin, A., Ovezov, A., Prokoshev, P., Lugovoy, A., Anipchenko, N., Babayants, A., Komissarova, I., Zalina, K., Likhvantsev, V., Fedorov, S., Lazukic, A., Pejakovic, J., Mihajlovic, D., Kusnierikova, Z., Zelinkova, M., Bruncakova, K., Polakovicova, L., Sobona, V., Novak-Supe, B., Pekle-Golez, A., Jovanov, M., Strazisar, B., Markovic-Bozic, J., Novak-Jankovic, V., Voje, M., Grynyuk, A., Kostadinov, I., Spindler-Vesel, A., Moral, V., Unzueta, M. C., Puigbo, C., Fava, J., Moret, E., Nunez, M. R., Sendra, M., Brunelli, A., Rodenas, F., Monedero, P., Martinez, F. H., Temino, M. J. Y., Simon, A. M., De Abajo Larriba, A., Lisi, A., Perez, G., Martinez, R., Granell, M., Vivo, J. T., Ruiz, C. S., De Andres Ibanez, J. A., Pastor, E., Soro, M., Ferrando, C., Defez, M., Alvares-Santullano, C. A., Perez, R., Rico, J., Jawad, M., Saeed, Y., Gillberg, L., Bengisun, Z. K., Kazbek, B. K., Coskunfirat, N., Boztug, N., Sanli, S., Yilmaz, M., Hadimioglu, N., Senturk, N. M., Camci, E., Kucukgoncu, S., Sungur, Z., Sivrikoz, N., Ozgen, S. U., Toraman, F., Selvi, O., Senturk, O., Yildiz, M., Kuvaki, B., Gunenc, F., Kucukguclu, S., Ozbilgin, S., Maral, J., Canli, S., Arun, O., Saltali, A., Aydogan, E., Akgun, F. N., Sanlikarip, C., Karaman, F. M., Mazur, A., Vorotyntsev, S., Rousseau, G., Barrett, C., Stancombe, L., Shelley, B., Scholes, H., Limb, J., Rafi, A., Wayman, L., Deane, J., Rogerson, D., Williams, J., Yates, S., Rogers, E., Pulletz, M., Moreton, S., Jones, S., Venkatesh, S., Burton, M., Brown, L., Goodall, C., Rucklidge, M., Fuller, D., Nadolski, M., Kusre, S., Lundberg, M., Everett, L., Nutt, H., Zuleika, M., Carvalho, P., Clements, D., Creagh-Brown, B., Watt, P., Raymode, P., Pearse, R., Mohr, O., Raj, A., Creary, T., Chishti, A., Bell, A., Higham, C., Cain, A., Gibb, S., Mowat, S., Franklin, D., West, C., Minto, G., Boyd, N., Mills, G., Calton, E., Walker, R., Mackenzie, F., Ellison, B., Roberts, H., Chikungwa, M., Jackson, C., Donovan, A., Foot, J., Homan, E., Montgomery, J., Portch, D., Mercer, P., Palmer, J., Paddle, J., Fouracres, A., Datson, A., Andrew, A., Welch, L., Rose, A., Varma, S., Simeson, K., Rambhatla, M., Susarla, J., Marri, S., Kodaganallur, K., Das, A., Algarsamy, S., Colley, J., Davies, S., Szewczyk, M., Smith, T., Fernandez-Bustamante, A., Luzier, E., Almagro, A., Melo, M. V., Fernando, L., Sulemanji, D., Sprung, J., Weingarten, T., Kor, D., Scavonetto, F., Tze, Y., Anesthesiology research group, Supporting clinical sciences, Anesthesiology, Policlinico San Martino, Anaesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Largo Rosanna Benzi 8, 16131, Genoa, Italy, University of Amsterdam [Amsterdam] (UvA), Department of Anaesthesiology and Intensive Care Medicine, Pulmonary engineering group, University Hospital Carl Gustav Carus, Technische Universitat Dresden, Dresden, Germany, Division of Cardiac, Thoracic, Vascular Anaesthesia and Intensive Care, Vienna General Hospital Währinger Gürtel, Massachusetts General Hospital, Harvard Medical School, Boston, USA. 17, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Medizinische Universität Wien = Medical University of Vienna, University of Insubria, Varese, Department of Intensive Care, Academic Medical Center, Department of Intensive Care, Academic Medical Center, University of Amsterdam, IRCCS San Martino IST, Robba, Chiara, Hemmes, Sabrine N T, Serpa Neto, Ary, Bluth, Thoma, Canet, Jaume, Hiesmayr, Michael, Hollmann, M Wiersma, Mills, Gary H, Vidal Melo, Marcos F, Putensen, Christian, Jaber, Samir, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, Battaglini, Denise, Ball, Lorenzo, Gama de Abreu, Marcelo, Schultz, Marcus J, Pelosi, Paolo, Kroell W, Metzler H, Struber G, Wegscheider T, Gombotz H, Hiesmayr M, Schmid W, Urbanek B, Kahn D, Momeni M, Pospiech A, Lois F, Forget P, Grosu I, Poelaert J, van Mossevelde V, van Malderen MC, Dylst D, van Melkebeek J, Beran M, de Hert S, De Baerdemaeker L, Heyse B, Van Limmen J, Wyffels P, Jacobs T, Roels N, De Bruyne A, van de Velde S, Leva B, Damster S, Plichon B, Juros-Zovko M, Djonoviċ-Omanoviċ D, Pernar S, Zunic J, Miskovic P, Zilic A, Kvolik S, Ivic D, Azenic-Venzera D, Skiljic S, Vinkovic H, Oputric I, Juricic K, Frkovic V, Kopic J, Mirkovic I, Karanovic N, Carev M, Dropulic N, Saric JP, Erceg G, Dvorscak MB, Mazul-Sunko B, Pavicic AM, Goranovic T, Maldini B, Radocaj T, Gavranovic Z, Mladic-Batinica I, Sehovic M, Stourac P, Harazim H, Smekalova O, Kosinova M, Kolacek T, Hudacek K, Drab M, Brujevic J, Vitkova K, Jirmanova K, Volfova I, Dzurnakova P, Liskova K, Dudas R, Filipsky R, El Kafrawy S, Abdelwahab HH, Metwally T, Abdel-Razek A, El-Shaarawy AM, Hasan WF, Ahmed AG, Yassin H, Magdy M, Abdelhady M, Mahran M, Herodes E, Kivik P, Oganjan J, Aun A, Sormus A, Sarapuu K, Mall M, Karjagin J, Futier E, Petit A, Gerard A, Marret E, Solier M, Jaber S, Prades A, Krassler J, Merzky S, de Abreu MG, Uhlig C, Kiss T, Bundy A, Bluth T, Gueldner A, Spieth P, Scharffenberg M, Thiem DT, Koch T, Treschan T, Schaefer M, Bastin B, Geib J, Weiss M, Kienbaum P, Pannen B, Gottschalk A, Konrad M, Westerheide D, Schwerdtfeger B, Wrigge H, Simon P, Reske A, Nestler C, Valsamidis D, Stroumpoulis K, Antholopoulos G, Andreou A, Karapanos D, Theodoraki K, Gkiokas G, Tasoulis MK, Sidiropoulou T, Zafeiropoulou F, Florou P, Pandazi A, Tsaousi G, Nouris C, Pourzitaki C, Bystritski D, Pizov R, Eden A, Pesce CV, Campanile A, Marrella A, Grasso S, De Michele M, Bona F, Giacoletto G, Sardo E, Giancarlo L, Sottosanti V, Solca M, Volta CA, Spadaro S, Verri M, Ragazzi R, Zoppellari R, Cinnella G, Raimondo P, La Bella D, Mirabella L, D'antini D, Pelosi P, Molin A, Brunetti I, Gratarola A, Pellerano G, Sileo R, Pezzatto S, Montagnani L, Pasin L, Landoni G, Zangrillo A, Beretta L, Di Parma AL, Tarzia V, Dossi R, Sassone ME, Sances D, Tredici S, Spano G, Castellani G, Delunas L, Peradze S, Venturino M, Arpino I, Sher S, Tommasino C, Rapido F, Morelli P, Vargas M, Servillo G, Cortegiani A, Raineri SM, Montalto F, Russotto V, Giarratano A, Baciarello M, Generali M, Cerati G, Leykin Y, Bressan F, Bartolini V, Zamidei L, Brazzi L, Liperi C, Sales G, Pistidda L, Severgnini P, Brugnoni E, Musella G, Bacuzzi A, Muhardri D, Gecaj-Gashi A, Sada F, Bytyqi A, Karbonskiene A, Aukstakalniene R, Teberaite Z, Salciute E, Tikuisis R, Miliauskas P, Jurate S, Kontrimaviciute E, Tomkute G, Xuereb J, Bezzina M, Borg FJ, Hemmes S, Schultz M, Hollmann M, Wiersma I, Binnekade J, Bos L, Boer C, Duvekot A, In 't Veld B, Werger A, Dennesen P, Severijns C, De Jong J, Hering J, van Beek R, Ivars S, Jammer I, Breidablik A, Hodt KS, Fjellanger F, Avalos MV, Mellin-Olsen J, Andersson E, Shafi-Kabiri A, Molina R, Wutai S, Morais E, Tareco G, Ferreira D, Amaral J, de Lurdes Goncalves Castro M, Cadilha S, Appleton S, Parente S, Correia M, Martins D, Monteirosa A, Ricardo A, Rodrigues S, Horhota L, Grintescu IM, Mirea L, Grintescu IC, Corneci D, Negoita S, Dutu M, Garotescu IP, Filipescu D, Prodan AB, Droc G, Fota R, Popescu M, Tomescu D, Petcu AM, Tudoroiu MI, Moise A, Guran CT, Gherghina I, Costea D, Cindea I, Copotoiu SM, Copotoiu R, Barsan V, Tolcser Z, Riciu M, Moldovan SG, Veres M, Gritsan A, Kapkan T, Gritsan G, Korolkov O, Kulikov A, Lubnin A, Ovezov A, Prokoshev P, Lugovoy A, Anipchenko N, Babayants A, Komissarova I, Zalina K, Likhvantsev V, Fedorov S, Lazukic A, Pejakovic J, Mihajlovic D, Kusnierikova Z, Zelinkova M, Bruncakova K, Polakovicova L, Sobona V, Novak-Supe B, Pekle-Golez A, Jovanov M, Strazisar B, Markovic-Bozic J, Novak-Jankovic V, Voje M, Grynyuk A, Kostadinov I, Spindler-Vesel A, Moral V, Unzueta MC, Puigbo C, Fava J, Canet J, Moret E, Nunez MR, Sendra M, Brunelli A, Rodenas F, Monedero P, Martinez FH, Temino MJY, Simon AM, de Abajo Larriba A, Lisi A, Perez G, Martinez R, Granell M, Vivo JT, Ruiz CS, de Andrés Ibañez JA, Pastor E, Soro M, Ferrando C, Defez M, Alvares-Santullano CA, Perez R, Rico J, Jawad M, Saeed Y, Gillberg L, Bengisun ZK, Kazbek BK, Coskunfirat N, Boztug N, Sanli S, Yilmaz M, 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Rambhatla M, Susarla J, Marri S, Kodaganallur K, Das A, Algarsamy S, Colley J, Davies S, Szewczyk M, Smith T, Fernandez-Bustamante A, Luzier E, Almagro A, Melo MV, Fernando L, Sulemanji D, Sprung J, Weingarten T, Kor D, Scavonetto F, Tze Y., Intensive Care Medicine, ACS - Heart failure & arrhythmias, Pulmonology, ACS - Diabetes & metabolism, ACS - Pulmonary hypertension & thrombosis, ACS - Microcirculation, Robba, C, Hemmes, S, Serpa Neto, A, Bluth, T, Canet, J, Hiesmayr, M, Hollmann, M, Mills, G, Vidal Melo, M, Putensen, C, Jaber, S, Schmid, W, Severgnini, P, Wrigge, H, Battaglini, D, Ball, L, Gama De Abreu, M, Schultz, M, Pelosi, P, Kroell, W, Metzler, H, Struber, G, Wegscheider, T, Gombotz, H, Urbanek, B, Kahn, D, Momeni, M, Pospiech, A, Lois, F, Forget, P, Grosu, I, Poelaert, J, Van Mossevelde, V, Van Malderen, M, Dylst, D, Van Melkebeek, J, Beran, M, De Hert, S, De Baerdemaeker, L, Heyse, B, Van Limmen, J, Wyffels, P, Jacobs, T, Roels, N, De Bruyne, A, Van De Velde, S, Leva, B, 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Thiem, D, Koch, T, Treschan, T, Schaefer, M, Bastin, B, Geib, J, Weiss, M, Kienbaum, P, Pannen, B, Gottschalk, A, Konrad, M, Westerheide, D, Schwerdtfeger, B, Simon, P, Reske, A, Nestler, C, Valsamidis, D, Stroumpoulis, K, Antholopoulos, G, Andreou, A, Karapanos, D, Theodoraki, K, Gkiokas, G, Tasoulis, M, Sidiropoulou, T, Zafeiropoulou, F, Florou, P, Pandazi, A, Tsaousi, G, Nouris, C, Pourzitaki, C, Bystritski, D, Pizov, R, Eden, A, Pesce, C, Campanile, A, Marrella, A, Grasso, S, De Michele, M, Bona, F, Giacoletto, G, Sardo, E, Giancarlo, L, Sottosanti, V, Solca, M, Volta, C, Spadaro, S, Verri, M, Ragazzi, R, Zoppellari, R, Cinnella, G, Raimondo, P, La Bella, D, Mirabella, L, D'Antini, D, Molin, A, Brunetti, I, Gratarola, A, Pellerano, G, Sileo, R, Pezzatto, S, Montagnani, L, Pasin, L, Landoni, G, Zangrillo, A, Beretta, L, Di Parma, A, Tarzia, V, Dossi, R, Sassone, M, Sances, D, Tredici, S, Spano, G, Castellani, G, Delunas, L, Peradze, S, Venturino, M, Arpino, I, Sher, S, Tommasino, C, 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Ferrando, C, Defez, M, Alvares-Santullano, C, Perez, R, Rico, J, Jawad, M, Saeed, Y, Gillberg, L, Bengisun, Z, Kazbek, B, Coskunfirat, N, Boztug, N, Sanli, S, Yilmaz, M, Hadimioglu, N, Senturk, N, Camci, E, Kucukgoncu, S, Sungur, Z, Sivrikoz, N, Ozgen, S, Toraman, F, Selvi, O, Senturk, O, Yildiz, M, Kuvaki, B, Gunenc, F, Kucukguclu, S, Ozbilgin, S, Maral, J, Canli, S, Arun, O, Saltali, A, Aydogan, E, Akgun, F, Sanlikarip, C, Karaman, F, Mazur, A, Vorotyntsev, S, Rousseau, G, Barrett, C, Stancombe, L, Shelley, B, Scholes, H, Limb, J, Rafi, A, Wayman, L, Deane, J, Rogerson, D, Williams, J, Yates, S, Rogers, E, Pulletz, M, Moreton, S, Jones, S, Venkatesh, S, Burton, M, Brown, L, Goodall, C, Rucklidge, M, Fuller, D, Nadolski, M, Kusre, S, Lundberg, M, Everett, L, Nutt, H, Zuleika, M, Carvalho, P, Clements, D, Creagh-Brown, B, Watt, P, Raymode, P, Pearse, R, Mohr, O, Raj, A, Creary, T, Chishti, A, Bell, A, Higham, C, Cain, A, Gibb, S, Mowat, S, Franklin, D, West, C, Minto, G, Boyd, N, Calton, E, Walker, R, Mackenzie, F, Ellison, B, Roberts, H, Chikungwa, M, Jackson, C, Donovan, A, Foot, J, Homan, E, Montgomery, J, Portch, D, Mercer, P, Palmer, J, Paddle, J, Fouracres, A, Datson, A, Andrew, A, Welch, L, Rose, A, Varma, S, Simeson, K, Rambhatla, M, Susarla, J, Marri, S, Kodaganallur, K, Das, A, Algarsamy, S, Colley, J, Davies, S, Szewczyk, M, Smith, T, Fernandez-Bustamante, A, Luzier, E, Almagro, A, Melo, M, Fernando, L, Sulemanji, D, Sprung, J, Weingarten, T, Kor, D, Scavonetto, F, Tze, Y, MORNET, Dominique, and Universitá degli Studi dell’Insubria = University of Insubria [Varese] (Uninsubria)

Subjects
Lung Diseases, Male, SURGERY, medicine.medical_treatment, [SDV]Life Sciences [q-bio], RESPIRATORY-DISTRESS-SYNDROME, BRAIN-INJURY, Neurosurgical Procedures, Positive-Pressure Respiration, 0302 clinical medicine, Postoperative Complications, Mechanical ventilation, 030202 anesthesiology, Interquartile range, Medicine and Health Sciences, General anaesthesia, END-EXPIRATORY-PRESSURE, Prospective Studies, Postoperative pulmonary, Postoperative pulmonary complications, Middle Aged, 3. Good health, [SDV] Life Sciences [q-bio], Anesthesia, Female, Neurosurgery, Research Article, Pulmons Malalties, Adult, medicine.medical_specialty, complications, Lung injury, Anesthesia, General, LAS VEGAS, NO, lcsh:RD78.3-87.3, 03 medical and health sciences, Neurologia, Anesthesiology, medicine, Tidal Volume, Humans, MED/41 - ANESTESIOLOGIA, HIGH TIDAL, Aged, Intraoperative Care, Ventilators, Mechanical, Cirurgia, business.industry, 030208 emergency & critical care medicine, Odds ratio, Perioperative, Respiration, Artificial, Anesthesiology and Pain Medicine, lcsh:Anesthesiology, VOLUME, business, Postoperative pulmonary complication, LUNG INJURY
Abstract

Background Limited information is available regarding intraoperative ventilator settings and the incidence of postoperative pulmonary complications (PPCs) in patients undergoing neurosurgical procedures. The aim of this post-hoc analysis of the ‘Multicentre Local ASsessment of VEntilatory management during General Anaesthesia for Surgery’ (LAS VEGAS) study was to examine the ventilator settings of patients undergoing neurosurgical procedures, and to explore the association between perioperative variables and the development of PPCs in neurosurgical patients. Methods Post-hoc analysis of LAS VEGAS study, restricted to patients undergoing neurosurgery. Patients were stratified into groups based on the type of surgery (brain and spine), the occurrence of PPCs and the assess respiratory risk in surgical patients in Catalonia (ARISCAT) score risk for PPCs. Results Seven hundred eighty-four patients were included in the analysis; 408 patients (52%) underwent spine surgery and 376 patients (48%) brain surgery. Median tidal volume (VT) was 8 ml [Interquartile Range, IQR = 7.3–9] per predicted body weight; median positive end–expiratory pressure (PEEP) was 5 [3 to 5] cmH20. Planned recruitment manoeuvres were used in the 6.9% of patients. No differences in ventilator settings were found among the sub-groups. PPCs occurred in 81 patients (10.3%). Duration of anaesthesia (odds ratio, 1.295 [95% confidence interval 1.067 to 1.572]; p = 0.009) and higher age for the brain group (odds ratio, 0.000 [0.000 to 0.189]; p = 0.031), but not intraoperative ventilator settings were independently associated with development of PPCs. Conclusions Neurosurgical patients are ventilated with low VT and low PEEP, while recruitment manoeuvres are seldom applied. Intraoperative ventilator settings are not associated with PPCs.

Published
2020
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9. Association between night-time surgery and occurrence of intraoperative adverse events and postoperative pulmonary complications

Author

Cortegiani, A, Gregoretti, C, Neto, A, Hemmes, S, Ball, L, Canet, J, Hiesmayr, M, Hollmann, M, Mills, G, Melo, M, Putensen, C, Schmid, W, Severgnini, P, Wrigge, H, Gama de Abreu, M, Schultz, M, Pelosi, P, Kroell, W, Metzler, H, Struber, G, Wegscheider, T, Gombotz, H, Urbanek, B, Kahn, D, Momeni, M, Pospiech, A, Lois, F, Forget, P, Grosu, I, Poelaert, J, Mossevelde, V, van Malderen, M, Dylst, D, Melkebeek, J, Beran, M, Hert, S, Baerdemaeker, L, Heyse, B, Limmen, J, Wyffels, P, Jacobs, T, Roels, N, Bruyne, A, Velde, S, Marina, J, Dejana, D, Pernar, S, Zunic, J, Miskovic, P, Zilic, A, Kvolik, S, Ivic, D, Darija, A, Skiljic, S, Vinkovic, H, Oputric, I, Juricic, K, Frkovic, V, Kopic, J, Mirkovic, I, Saric, J, Erceg, G, Dvorscak, M, Branka, M, Pavicic, A, Goranovic, T, Maldini, B, Radocaj, T, Gavranovic, Z, Inga, M, Sehovic, M, Stourac, P, Harazim, H, Smekalova, O, Kosinova, M, Kolacek, T, Hudacek, K, Drab, M, Brujevic, J, Vitkova, K, Jirmanova, K, Volfova, I, Dzurnakova, P, Liskova, K, Dudas, R, Filipsky, R, Kafrawy, S, Abdelwahab, H, Metwally, T, Ahmed, A, Ahmed Mostafa, E, Hasan, W, Yassin, H, Magdy, M, Abdelhady, M, Mahran, M, Herodes, E, Kivik, P, Oganjan, J, Aun, A, Sormus, A, Sarapuu, K, Mall, M, Karjagin, J, Futier, E, Petit, A, Gerard, A, Marret, E, Solier, M, Jaber, S, Prades, A, Krassler, J, Merzky, S, Abreu, M, Uhlig, C, Kiss, T, Bundy, A, Bluth, T, Gueldner, A, Spieth, P, Scharffenberg, M, Thiem, D, Koch, T, Treschan, T, Schaefer, M, Bastin, B, Geib, J, Weiss, M, Kienbaum, P, Pannen, B, Gottschalk, A, Konrad, M, Westerheide, D, Schwerdtfeger, B, Simon, P, Reske, A, Nestler, C, Valsamidis, D, Stroumpoulis, K, Antholopoulos, G, Andreou, A, Karapanos, D, Theodorak, K, Gkiokas, G, Tasoulis, M, Sidiropoulou, T, Zafeiropoulou, F, Florou, P, Pandazi, A, Tsaousi, G, Nouris, C, Pourzitaki, C, Bystritski, D, Pizov, R, Eden, A, Pesce, C, Campanile, A, Marrella, A, Grasso, S, Michele, M, Bona, F, Giacoletto, G, Sardo, E, Sottosanti, L, Solca, M, Volta, C, Spadaro, S, 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Grynyuk, A, Kostadinov, I, Alenka, S, Moral, V, Unzueta, M, Puigbo, C, Fava, J, Moret, E, Nunez, M, Sendra, M, Brunelli, A, Rodenas, F, Monedero, P, Martinez, F, Temino, M, Simon, A, Larriba, A, Lisi, A, Perez, G, Martinez, R, Granell, M, Vivo, J, Ruiz, C, Andres Ibanez, J, Pastor, E, Soro, M, Ferrando, C, Defez, M, Cesar Aldecoa, A, Perez, R, Rico, J, Jawad, M, Saeed, Y, Gillberg, L, Bengisun, Z, Kazbek, B, Coskunfirat, N, Boztug, N, Sanli, S, Yilmaz, M, Hadimioglu, N, Senturk, N, Camci, E, Kucukgoncu, S, Sungur, Z, Sivrikoz, N, Ozgen, S, Toraman, F, Selvi, O, Senturk, O, Yildiz, M, Kuvaki, B, Gunenc, F, Kucukguclu, S, Ozbilgin, S, Maral, J, Canli, S, Arun, O, Saltali, A, Aydogan, E, Akgun, F, Sanlikarip, C, Karaman, F, Mazur, A, Vorotyntsev, S, Rousseau, G, Barrett, C, Stancombe, L, Shelley, B, Scholes, H, Limb, J, Rafi, A, Wayman, L, Deane, J, Rogerson, D, Williams, J, Yates, S, Rogers, E, Pulletz, M, Moreton, S, Jones, S, Venkatesh, S, Burton, M, Brown, L, Goodall, C, Rucklidge, M, Fuller, D, Nadolski, M, Kusre, S, Lundberg, M, Everett, L, Nutt, H, Zuleika, M, Carvalho, P, Clements, D, Ben, C, Watt, P, Raymode, P, Pearse, R, Mohr, O, Raj, A, Creary, T, Chishti, A, Bell, A, Higham, C, Cain, A, Gibb, S, Mowat, S, Franklin, D, West, C, Minto, G, Boyd, N, Calton, E, Walker, R, Mackenzie, F, Ellison, B, Roberts, H, Chikungwa, M, Jackson, C, Donovan, A, Foot, J, Homan, E, Montgomery, J, Portch, D, Mercer, P, Palmer, J, Paddle, J, Fouracres, A, Datson, A, Andrew, A, Welch, L, Rose, A, Varma, S, Simeson, K, Rambhatla, M, Susarla, J, Marri, S, Kodaganallur, K, Das, A, Algarsamy, S, Colley, J, Davies, S, Szewczyk, M, Smith, T, Ana, F, Luzier, E, Almagro, A, Fernando, L, Sulemanji, D, Sprung, J, Weingarten, T, Kor, D, Scavonetto, F, Tze, Y, Cortegiani A., Gregoretti C., Neto A. 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K., Coskunfirat N., Boztug N., Sanli S., Yilmaz M., Hadimioglu N., Senturk N. M., Camci E., Kucukgoncu S., Sungur Z., Sivrikoz N., Ozgen S. U., Toraman F., Selvi O., Senturk O., Yildiz M., Kuvaki B., Gunenc F., Kucukguclu S., Ozbilgin S., Maral J., Canli S., Arun O., Saltali A., Aydogan E., Akgun F. N., Sanlikarip C., Karaman F. M., Mazur A., Vorotyntsev S., Rousseau G., Barrett C., Stancombe L., Shelley B., Scholes H., Limb J., Rafi A., Wayman L., Deane J., Rogerson D., Williams J., Yates S., Rogers E., Pulletz M., Moreton S., Jones S., Venkatesh S., Burton M., Brown L., Goodall C., Rucklidge M., Fuller D., Nadolski M., Kusre S., Lundberg M., Everett L., Nutt H., Zuleika M., Carvalho P., Clements D., Ben C. B., Watt P., Raymode P., Pearse R., Mohr O., Raj A., Creary T., Chishti A., Bell A., Higham C., Cain A., Gibb S., Mowat S., Franklin D., West C., Minto G., Boyd N., Mills G., Calton E., Walker R., Mackenzie F., Ellison B., Roberts H., Chikungwa M., Jackson C., Donovan A., Foot J., Homan E., Montgomery J., Portch D., Mercer P., Palmer J., Paddle J., Fouracres A., Datson A., Andrew A., Welch L., Rose A., Varma S., Simeson K., Rambhatla M., Susarla J., Marri S., Kodaganallur K., Das A., Algarsamy S., Colley J., Davies S., Szewczyk M., Smith T., Ana F. B., Luzier E., Almagro A., Melo M. V., Fernando L., Sulemanji D., Sprung J., Weingarten T., Kor D., Scavonetto F., Tze Y., Cortegiani, A, Gregoretti, C, Neto, A, Hemmes, S, Ball, L, Canet, J, Hiesmayr, M, Hollmann, M, Mills, G, Melo, M, Putensen, C, Schmid, W, Severgnini, P, Wrigge, H, Gama de Abreu, M, Schultz, M, Pelosi, P, Kroell, W, Metzler, H, Struber, G, Wegscheider, T, Gombotz, H, Urbanek, B, Kahn, D, Momeni, M, Pospiech, A, Lois, F, Forget, P, Grosu, I, Poelaert, J, Mossevelde, V, van Malderen, M, Dylst, D, Melkebeek, J, Beran, M, Hert, S, Baerdemaeker, L, Heyse, B, Limmen, J, Wyffels, P, Jacobs, T, Roels, N, Bruyne, A, Velde, S, Marina, J, Dejana, D, Pernar, S, Zunic, J, Miskovic, P, Zilic, A, Kvolik, S, Ivic, D, Darija, A, Skiljic, S, Vinkovic, H, Oputric, I, Juricic, K, Frkovic, V, Kopic, J, Mirkovic, I, Saric, J, Erceg, G, Dvorscak, M, Branka, M, Pavicic, A, Goranovic, T, Maldini, B, Radocaj, T, Gavranovic, Z, Inga, M, Sehovic, M, Stourac, P, Harazim, H, Smekalova, O, Kosinova, M, Kolacek, T, Hudacek, K, Drab, M, Brujevic, J, Vitkova, K, Jirmanova, K, Volfova, I, Dzurnakova, P, Liskova, K, Dudas, R, Filipsky, R, Kafrawy, S, Abdelwahab, H, Metwally, T, Ahmed, A, Ahmed Mostafa, E, Hasan, W, Yassin, H, Magdy, M, Abdelhady, M, Mahran, M, Herodes, E, Kivik, P, Oganjan, J, Aun, A, Sormus, A, Sarapuu, K, Mall, M, Karjagin, J, Futier, E, Petit, A, Gerard, A, Marret, E, Solier, M, Jaber, S, Prades, A, Krassler, J, Merzky, S, Abreu, M, Uhlig, C, Kiss, T, Bundy, A, Bluth, T, Gueldner, A, Spieth, P, Scharffenberg, M, Thiem, D, Koch, T, Treschan, T, Schaefer, M, Bastin, B, Geib, J, Weiss, M, Kienbaum, P, Pannen, B, Gottschalk, A, Konrad, M, Westerheide, D, Schwerdtfeger, B, Simon, P, Reske, A, Nestler, C, Valsamidis, D, Stroumpoulis, K, Antholopoulos, G, Andreou, A, Karapanos, D, Theodorak, K, Gkiokas, G, Tasoulis, M, Sidiropoulou, T, Zafeiropoulou, F, Florou, P, Pandazi, A, Tsaousi, G, Nouris, C, Pourzitaki, C, Bystritski, D, Pizov, R, Eden, A, Pesce, C, Campanile, A, Marrella, A, Grasso, S, Michele, M, Bona, F, Giacoletto, G, Sardo, E, Sottosanti, L, Solca, M, Volta, C, Spadaro, S, Verri, M, Ragazzi, R, Zoppellari, R, Cinnella, G, Raimondo, P, Bella, D, Mirabella, L, D'Antini, D, Molin, A, Brunetti, I, Gratarola, A, Pellerano, G, Sileo, R, Pezzatto, S, Montagnani, L, Pasin, L, Landoni, G, Zangrillo, A, Beretta, L, Parma, A, Tarzia, V, Dossi, R, Sassone, M, Sances, D, Tredici, S, Spano, G, Castellani, G, Delunas, L, Peradze, S, Venturino, M, Arpino, I, Sher, S, Tommasino, C, Rapido, F, Morelli, P, Vargas, M, Servillo, G, Raineri, S, Montalto, F, Russotto, V, Giarratano, A, Baciarello, M, Generali, M, Cerati, G, Leykin, Y, Bressan, F, Bartolini, V, Zamidei, L, Brazzi, L, Liperi, C, Sales, G, Pistidda, L, Brugnoni, E, Musella, G, Bacuzzi, A, Muhardri, D, Agreta, G, Sada, F, Bytyqi, A, Karbonskiene, A, Aukstakalniene, R, Teberaite, Z, Salciute, E, Tikuisis, R, Miliauskas, P, Jurate, S, Kontrimaviciute, E, Tomkute, G, Xuereb, J, Bezzina, M, Borg, F, Wiersma, I, Binnekade, J, Bos, L, Boer, C, Duvekot, A, Veld, B, Werger, A, Dennesen, P, Severijns, C, Jong, J, Hering, J, Beek, R, Ivars, S, Jammer, I, Breidablik, A, Hodt, K, Fjellanger, F, Avalos, M, Jannicke, M, Andersson, E, Amir, S, Molina, R, Wutai, S, Morais, E, Tareco, G, Ferreira, D, Amaral, J, Castro, M, Cadilha, S, Appleton, S, Parente, S, Correia, M, Martins, D, Monteirosa, A, Ricardo, A, Rodrigues, S, Horhota, L, Grintescu, I, Mirea, L, Corneci, D, Negoita, S, Dutu, M, Popescu Garotescu, I, Filipescu, D, Prodan, A, Droc, G, Fota, R, Popescu, M, Tomescu, D, Petcu, A, Tudoroiu, M, Moise, A, Guran, C, Gherghina, I, Costea, D, Cindea, I, Copotoiu, S, Copotoiu, R, Barsan, V, Tolcser, Z, Riciu, M, Moldovan, S, Veres, M, Gritsan, A, Kapkan, T, Gritsan, G, Korolkov, O, Kulikov, A, Lubnin, A, Ovezov, A, Prokoshev, P, Lugovoy, A, Anipchenko, N, Babayants, A, Komissarova, I, Zalina, K, Likhvantsev, V, Fedorov, S, Lazukic, A, Pejakovic, J, Mihajlovic, D, Kusnierikova, Z, Zelinkova, M, Bruncakova, K, Polakovicova, L, Sobona, V, Barbka, N, Ana, P, Jovanov, M, Strazisar, B, Jasmina, M, Vesna, N, Voje, M, Grynyuk, A, Kostadinov, I, Alenka, S, Moral, V, Unzueta, M, Puigbo, C, Fava, J, Moret, E, Nunez, M, Sendra, M, Brunelli, A, Rodenas, F, Monedero, P, Martinez, F, Temino, M, Simon, A, Larriba, A, Lisi, A, Perez, G, Martinez, R, Granell, M, Vivo, J, Ruiz, C, Andres Ibanez, J, Pastor, E, Soro, M, Ferrando, C, Defez, M, Cesar Aldecoa, A, Perez, R, Rico, J, Jawad, M, Saeed, Y, Gillberg, L, Bengisun, Z, Kazbek, B, Coskunfirat, N, Boztug, N, Sanli, S, Yilmaz, M, Hadimioglu, N, Senturk, N, Camci, E, Kucukgoncu, S, Sungur, Z, Sivrikoz, N, Ozgen, S, Toraman, F, Selvi, O, Senturk, O, Yildiz, M, Kuvaki, B, Gunenc, F, Kucukguclu, S, Ozbilgin, S, Maral, J, Canli, S, Arun, O, Saltali, A, Aydogan, E, Akgun, F, Sanlikarip, C, Karaman, F, Mazur, A, Vorotyntsev, S, Rousseau, G, Barrett, C, Stancombe, L, Shelley, B, Scholes, H, Limb, J, Rafi, A, Wayman, L, Deane, J, Rogerson, D, Williams, J, Yates, S, Rogers, E, Pulletz, M, Moreton, S, Jones, S, Venkatesh, S, Burton, M, Brown, L, Goodall, C, Rucklidge, M, Fuller, D, Nadolski, M, Kusre, S, Lundberg, M, Everett, L, Nutt, H, Zuleika, M, Carvalho, P, Clements, D, Ben, C, Watt, P, Raymode, P, Pearse, R, Mohr, O, Raj, A, Creary, T, Chishti, A, Bell, A, Higham, C, Cain, A, Gibb, S, Mowat, S, Franklin, D, West, C, Minto, G, Boyd, N, Calton, E, Walker, R, Mackenzie, F, Ellison, B, Roberts, H, Chikungwa, M, Jackson, C, Donovan, A, Foot, J, Homan, E, Montgomery, J, Portch, D, Mercer, P, Palmer, J, Paddle, J, Fouracres, A, Datson, A, Andrew, A, Welch, L, Rose, A, Varma, S, Simeson, K, Rambhatla, M, Susarla, J, Marri, S, Kodaganallur, K, Das, A, Algarsamy, S, Colley, J, Davies, S, Szewczyk, M, Smith, T, Ana, F, Luzier, E, Almagro, A, Fernando, L, Sulemanji, D, Sprung, J, Weingarten, T, Kor, D, Scavonetto, F, Tze, Y, Cortegiani A., Gregoretti C., Neto A. S., Hemmes S. N. T., Ball L., Canet J., Hiesmayr M., Hollmann M. W., Mills G. H., Melo M. F. V., Putensen C., Schmid W., Severgnini P., Wrigge H., Gama de Abreu M., Schultz M. J., Pelosi P., Kroell W., Metzler H., Struber G., Wegscheider T., Gombotz H., Urbanek B., Kahn D., Momeni M., Pospiech A., Lois F., Forget P., Grosu I., Poelaert J., Mossevelde V., van Malderen M. C., Dylst D., Melkebeek J. V., Beran M., Hert S. D., Baerdemaeker L. D., Heyse B., Limmen J. V., Wyffels P., Jacobs T., Roels N., Bruyne A. D., Velde S. V. D., Marina J. Z., Dejana D. O., Pernar S., Zunic J., Miskovic P., Zilic A., Kvolik S., Ivic D., Darija A. V., Skiljic S., Vinkovic H., Oputric I., Juricic K., Frkovic V., Kopic J., Mirkovic I., Saric J. P., Erceg G., Dvorscak M. B., Branka M. S., Pavicic A. M., Goranovic T., Maldini B., Radocaj T., Gavranovic Z., Inga M. B., Sehovic M., Stourac P., Harazim H., Smekalova O., Kosinova M., Kolacek T., Hudacek K., Drab M., Brujevic J., Vitkova K., Jirmanova K., Volfova I., Dzurnakova P., Liskova K., Dudas R., Filipsky R., Kafrawy S. E., Abdelwahab H. H., Metwally T., Ahmed A. R., Ahmed Mostafa E. S., Hasan W. F., Ahmed A. G., Yassin H., Magdy M., Abdelhady M., Mahran M., Herodes E., Kivik P., Oganjan J., Aun A., Sormus A., Sarapuu K., Mall M., Karjagin J., Futier E., Petit A., Gerard A., Marret E., Solier M., Jaber S., Prades A., Krassler J., Merzky S., Abreu M. G. D., Uhlig C., Kiss T., Bundy A., Bluth T., Gueldner A., Spieth P., Scharffenberg M., Thiem D. T., Koch T., Treschan T., Schaefer M., Bastin B., Geib J., Weiss M., Kienbaum P., Pannen B., Gottschalk A., Konrad M., Westerheide D., Schwerdtfeger B., Simon P., Reske A., Nestler C., Valsamidis D., Stroumpoulis K., Antholopoulos G., Andreou A., Karapanos D., Theodorak K., Gkiokas G., Tasoulis M. K., Sidiropoulou T., Zafeiropoulou F., Florou P., Pandazi A., Tsaousi G., Nouris C., Pourzitaki C., Bystritski D., Pizov R., Eden A., Pesce C. V., Campanile A., Marrella A., Grasso S., Michele M. D., Bona F., Giacoletto G., Sardo E., Sottosanti L. G. V., Solca M., Volta C. A., Spadaro S., Verri M., Ragazzi R., Zoppellari R., Cinnella G., Raimondo P., Bella D. L., Mirabella L., D'antini D., Molin A., Brunetti I., Gratarola A., Pellerano G., Sileo R., Pezzatto S., Montagnani L., Pasin L., Landoni G., Zangrillo A., Beretta L., Parma A. L. D., Tarzia V., Dossi R., Sassone M. E., Sances D., Tredici S., Spano G., Castellani G., Delunas L., Peradze S., Venturino M., Arpino I., Sher S., Tommasino C., Rapido F., Morelli P., Vargas M., Servillo G., Raineri S. M., Montalto F., Russotto V., Giarratano A., Baciarello M., Generali M., Cerati G., Leykin Y., Bressan F., Bartolini V., Zamidei L., Brazzi L., Liperi C., Sales G., Pistidda L., Brugnoni E., Musella G., Bacuzzi A., Muhardri D., Agreta G. G., Sada F., Bytyqi A., Karbonskiene A., Aukstakalniene R., Teberaite Z., Salciute E., Tikuisis R., Miliauskas P., Jurate S., Kontrimaviciute E., Tomkute G., Xuereb J., Bezzina M., Borg F. J., Hemmes S., Schultz M., Hollmann M., Wiersma I., Binnekade J., Bos L., Boer C., Duvekot A., Veld B. I. '., Werger A., Dennesen P., Severijns C., Jong J. D., Hering J., Beek R. V., Ivars S., Jammer I. B., Breidablik A., Hodt K. S., Fjellanger F., Avalos M. V., Jannicke M. O., Andersson E., Amir S. K., Molina R., Wutai S., Morais E., Tareco G., Ferreira D., Amaral J., Castro M. D. L. G., Cadilha S., Appleton S., Parente S., Correia M., Martins D., Monteirosa A., Ricardo A., Rodrigues S., Horhota L., Grintescu I. M., Mirea L., Grintescu I. C., Corneci D., Negoita S., Dutu M., Popescu Garotescu I., Filipescu D., Prodan A. B., Droc G., Fota R., Popescu M., Tomescu D., Petcu A. M., Tudoroiu M. I., Moise A., Guran C. T., Gherghina I., Costea D., Cindea I., Copotoiu S. M., Copotoiu R., Barsan V., Tolcser Z., Riciu M., Moldovan S. G., Veres M., Gritsan A., Kapkan T., Gritsan G., Korolkov O., Kulikov A., Lubnin A., Ovezov A., Prokoshev P., Lugovoy A., Anipchenko N., Babayants A., Komissarova I., Zalina K., Likhvantsev V., Fedorov S., Lazukic A., Pejakovic J., Mihajlovic D., Kusnierikova Z., Zelinkova M., Bruncakova K., Polakovicova L., Sobona V., Barbka N. S., Ana P. G., Jovanov M., Strazisar B., Jasmina M. B., Vesna N. J., Voje M., Grynyuk A., Kostadinov I., Alenka S. V., Moral V., Unzueta M. C., Puigbo C., Fava J., Moret E., Nunez M. R., Sendra M., Brunelli A., Rodenas F., Monedero P., Martinez F. H., Temino M. J. Y., Simon A. M., Larriba A. D. A., Lisi A., Perez G., Martinez R., Granell M., Vivo J. T., Ruiz C. S., Andres Ibanez J. A. D., Pastor E., Soro M., Ferrando C., Defez M., Cesar Aldecoa A. S., Perez R., Rico J., Jawad M., Saeed Y., Gillberg L., Bengisun Z. K., Kazbek B. K., Coskunfirat N., Boztug N., Sanli S., Yilmaz M., Hadimioglu N., Senturk N. M., Camci E., Kucukgoncu S., Sungur Z., Sivrikoz N., Ozgen S. U., Toraman F., Selvi O., Senturk O., Yildiz M., Kuvaki B., Gunenc F., Kucukguclu S., Ozbilgin S., Maral J., Canli S., Arun O., Saltali A., Aydogan E., Akgun F. N., Sanlikarip C., Karaman F. M., Mazur A., Vorotyntsev S., Rousseau G., Barrett C., Stancombe L., Shelley B., Scholes H., Limb J., Rafi A., Wayman L., Deane J., Rogerson D., Williams J., Yates S., Rogers E., Pulletz M., Moreton S., Jones S., Venkatesh S., Burton M., Brown L., Goodall C., Rucklidge M., Fuller D., Nadolski M., Kusre S., Lundberg M., Everett L., Nutt H., Zuleika M., Carvalho P., Clements D., Ben C. B., Watt P., Raymode P., Pearse R., Mohr O., Raj A., Creary T., Chishti A., Bell A., Higham C., Cain A., Gibb S., Mowat S., Franklin D., West C., Minto G., Boyd N., Mills G., Calton E., Walker R., Mackenzie F., Ellison B., Roberts H., Chikungwa M., Jackson C., Donovan A., Foot J., Homan E., Montgomery J., Portch D., Mercer P., Palmer J., Paddle J., Fouracres A., Datson A., Andrew A., Welch L., Rose A., Varma S., Simeson K., Rambhatla M., Susarla J., Marri S., Kodaganallur K., Das A., Algarsamy S., Colley J., Davies S., Szewczyk M., Smith T., Ana F. B., Luzier E., Almagro A., Melo M. V., Fernando L., Sulemanji D., Sprung J., Weingarten T., Kor D., Scavonetto F., and Tze Y.

Abstract

Background: The aim of this post hoc analysis of a large cohort study was to evaluate the association between night-time surgery and the occurrence of intraoperative adverse events (AEs) and postoperative pulmonary complications (PPCs). Methods: LAS VEGAS (Local Assessment of Ventilatory Management During General Anesthesia for Surgery) was a prospective international 1-week study that enrolled adult patients undergoing surgical procedures with general anaesthesia and mechanical ventilation in 146 hospitals across 29 countries. Surgeries were defined as occurring during ‘daytime’ when induction of anaesthesia was between 8:00 AM and 7:59 PM, and as ‘night-time’ when induction was between 8:00 PM and 7:59 AM. Results: Of 9861 included patients, 555 (5.6%) underwent surgery during night-time. The proportion of patients who developed intraoperative AEs was higher during night-time surgery in unmatched (43.6% vs 34.1%; P<0.001) and propensity-matched analyses (43.7% vs 36.8%; P=0.029). PPCs also occurred more often in patients who underwent night-time surgery (14% vs 10%; P=0.004) in an unmatched cohort analysis, although not in a propensity-matched analysis (13.8% vs 11.8%; P=0.39). In a multivariable regression model, including patient characteristics and types of surgery and anaesthesia, night-time surgery was independently associated with a higher incidence of intraoperative AEs (odds ratio: 1.44; 95% confidence interval: 1.09–1.90; P=0.01), but not with a higher incidence of PPCs (odds ratio: 1.32; 95% confidence interval: 0.89–1.90; P=0.15). Conclusions: Intraoperative adverse events and postoperative pulmonary complications occurred more often in patients undergoing night-time surgery. Imbalances in patients’ clinical characteristics, types of surgery, and intraoperative management at night-time partially explained the higher incidence of postoperative pulmonary complications, but not the higher incidence of adverse events. Clinical trial registration: NCT0160122

Published
2019

10. Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications:LAS VEGAS - An observational study in 29 countries

Author

Schultz, Marcus J., Hemmes, Sabrine N. T., Neto, Ary Serpa, Binnekade, Jan M., Canet, Jaume, Hedenstierna, Goran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W., Mills, Gary H., Vidal Melo, Marcos F., Pearse, Rupert, Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, De Abreu, Marcelo Gama, Pelosi, Paolo, Kroell W, Metzler H, Struber G, Wegscheider T, Gombotz H, Hiesmayr M, Schmid W, Urbanek B, Leva B, Damster S, Plichon B, Kahn D, Momeni M, Pospiech A, Lois F, Forget P, Grosu I, Poelaert J, van Mossevelde V, van Malderen MC, Dylst D, van Melkebeek J, Beran M, de Hert S, De Baerdemaeker L, Heyse B, van Limmen J, Wyffels P, Jacobs T, Roels N, De Bruyne A, van de Velde S, Juros-Zovko M, Djonoviċ-Omanoviċ D, Serpa Neto A, Pernar S, Zunic J, Miskovic P, Zilic A, Kvolik S, Ivic D, Azenic-Venzera D, Skiljic S, Vinkovic H, Oputric I, Juricic K, Frkovic V, Kopic J, Mirkovic I, Karanovic N, Carev M, Dropulic N, Pavičić-Šarić J, Erceg G, Bogdanović Dvorščak M, Mazul-Sunko B, Pavicic AM, Goranovic T, Maldini B, Radocaj T, Gavranovic Z, Mladic-Batinica I, Sehovic M, Stourac P, Harazim H, Smekalova O, Kosinova M, Kolacek T, Hudacek K, Drab M, Brujevic J, Vitkova K, Jirmanova K, Volfova I, Dzurnakova P, Liskova K, Dudas R, Filipsky R, El Kafrawy S, Hosny Abdelwahab H, Metwally T, Abdel-Razek A, El-Shaarawy AM, Fathy Hasan W, Gouda Ahmed A, Yassin H, Magdy M, Abdelhady M, Mahran M, Herodes E, Kivik P, Oganjan J, Aun A, Sormus A, Sarapuu K, Mall M, Karjagin J, Futier E, Petit A, Gerard A, Marret E, Solier M, Jaber S, Prades A, Putensen C, Krassler J, Merzky S, Gama de Abreu M, Uhlig C, Kiss T, Bundy A, Bluth T, Güldner A, Spieth P, Scharffenberg M, Tran Thiem D, Koch T, Treschan T, Schaefer M, Bastin B, Geib J, Weiss M, Kienbaum P, Pannen B, Gottschalk A, Konrad M, Westerheide D, Schwerdtfeger B, Wrigge H, Simon P, Reske A, Nestler C, Valsamidis D, Stroumpoulis K, Antholopoulos G, Andreou A, Karapanos D, Theodoraki K, Gkiokas G, Tasoulis MK, Sidiropoulou T, Zafeiropoulou F, Florou P, Pandazi A, Tsaousi G, Nouris C, Pourzitaki C, Bystritski D, Pizov R, Eden A, Pesce CV, Campanile A, Marrella A, Grasso S, De Michele M, Bona F, Giacoletto G, Sardo E, Giancarlo L, Sottosanti V, Solca M, Volta CA, Spadaro S, Verri M, Ragazzi R, Zoppellari R, Cinnella G, Raimondo P, La Bella D, Mirabella L, D'antini D, Pelosi P, Molin A, Brunetti I, Gratarola A, Pellerano G, Sileo R, Pezzatto S, Montagnani L, Pasin L, Landoni G, Zangrillo A, Beretta L, Di Parma AL, Tarzia V, Dossi R, Sassone ME, Sances D, Tredici S, Spano G, Castellani G, Delunas L, Peradze S, Venturino M, Arpino I, Sher S, Tommasino C, Rapido F, Morelli P, Vargas M, Servillo G, Cortegiani A, Raineri SM, Montalto F, Russotto V, Giarratano A, Baciarello M, Generali M, Cerati G, Leykin Y, Bressan F, Bartolini V, Zamidei L, Brazzi L, Liperi C, Sales G, Pistidda L, Severgnini P, Brugnoni E, Musella G, Bacuzzi A, Muhardri D, Gecaj-Gashi A, Sada F, Bytyqi A, Karbonskiene A, Aukstakalniene R, Teberaite Z, Salciute E, Tikuisis R, Miliauskas P, Jurate S, Kontrimaviciute E, Tomkute G, Xuereb J, Bezzina M, Borg FJ, Hemmes S, Schultz M, Hollmann M, Wiersma I, Binnekade J, Bos L, Boer C, Duvekot A, In 't Veld B, Werger A, Dennesen P, Severijns C, de Jong J, Hering J, van Beek R, Ivars S, Jammer I, Breidablik A, Skirstad Hodt K, Fjellanger F, VicoAvalos M, Mellin-Olsen J, Andersson E, Shafi-Kabiri A, Molina R, Wutai S, Morais E, Tareco GR, Ferreira D, Amaral J, Gonçalves Castro ML, Cadilha S, Appleton S, Parente S, Correia M, Martins D, Monteirosa A, Ricardo A, Rodrigues S, Horhota L, Grintescu IM, Mirea L, Grintescu IC, Corneci D, Negoita S, Dutu M, Popescu Garotescu I, Filipescu D, Prodan AB, Droc G, Fota R, Popescu M, Tomescu D, Petcu AM, Tudoroiu MI, Moise A, Guran CT, Gherghina I, Costea D, Cindea I, Copotoiu SM, Copotoiu R, Barsan V, Tolcser Z, Riciu M, Moldovan GS, Veres M, Gritsan A, Kapkan T, Gritsan G, Korolkov O, Kulikov A, Lubnin A, Ovezov A, Prokoshev P, Lugovoy A, Anipchenko N, Babayants A, Komissarova I, Zalina K, Likhvantsev V, Fedorov S, Lazukic A, Pejakovic J, Mihajlovic D, Kusnierikova Z, Zelinkova M, Bruncakova K, Polakovicova L, Sobona V, Novak-Supe B, Pekle-Golez A, Jovanov M, Strazisar B, Markovic-Bozic J, Novak-Jankovic V, Voje M, Grynyuk A, Kostadinov I, Spindler-Vesel A, Moral V, Unzueta C, Puigbo C, Fava J, Canet J, Moret E, Rodriguez Nunez MN, Sendra M, Brunelli A, Rodenas F, Monedero P, Hidalgo Martinez F, Yepes Temino MJ, Marti Nez Simon A, de Abajo Larriba A, Lisi A, Perez G, Martinez R, Granell M, Tatay Vivo J, Saiz Ruiz C, de Andre S Iban Ez JA, Pastor E, Soro M, Ferrando C, Defez M, Aldecoa Alvares-Santullano C, Pere R, Rico J, Jawad M, Saeed Y, Gillberg L, Hedenstierna G, Kazak Bengisun Z, Kansu Kazbek B, Coskunfirat N, Boztug N, Sanli S, Yilmaz M, Hadimioglu N, Senturk NM, Camci E, Kucukgoncu S, Sungur Z, Sivrikoz N, Ustalar Ozgen S, Toraman F, Selvi O, Senturk O, Yildiz M, Kuvaki B, Gunenc F, Kucukguclu S, Ozbilgin SU, Maral J, Canli S, Arun O, Saltali A, Aydogan E, Akgün FN, Sanlikarip C, Mine Karaman F, Mazur A, Vorotyntsev S, Rousseau G, Barrett C, Stancombe L, Shelley B, Scholes H, Limb J, Rafi A, Wayman L, Deane J, Rogerson D, Williams J, Yates S, Rogers E, Pulletz M, Moreton S, Jones S, Venkatesh S, Burton M, Brown L, Goodall C, Rucklidge M, Fuller D, Nadolski M, Kusre S, Lundberg M, Everett L, Nutt H, Zuleika M, Carvalho P, Clements D, Creagh-Brown B, Watt P, Raymode P, Pearse R, Mohr O, Raj A, Creary T, Chishti A, Bell A, Higham C, Cain A, Gibb S, Mowat S, Franklin D, West C, Minto G, Boyd N, Mills G, Calton E, Walker R, Mackenzie F, Ellison B, Roberts H, Chikungwa M, Jackson C, Donovan A, Foot J, Homan E, Montgomery J, Portch D, Mercer P, Palmer J, Paddle J, Fouracres A, Datson A, Andrew A, Welch L, Rose A, Varma S, Simeson K, Rambhatla M, Susarla J, Marri S, Kodaganallur K, Das A, Algarsamy S, Colley J, Davies S, Szewczyk M, Smith T, Fernandez-Bustamante A, Luzier E, Almagro A, Vidal Melo M, Fernando L, Sulemanji D, Sprung J, Weingarten T, Kor D, Scavonetto F, Tze Y., Schultz, M, Hemmes, S, Neto, A, Binnekade, J, Canet, J, Hedenstierna, G, Jaber, S, Hiesmayr, M, Hollmann, M, Mills, G, Vidal Melo, M, Pearse, R, Putensen, C, Schmid, W, Severgnini, P, Wrigge, H, De Abreu, M, Pelosi, P, Kroell, W, Metzler, H, Struber, G, Wegscheider, T, Gombotz, H, Urbanek, B, Leva, B, Damster, S, Plichon, B, Kahn, D, Momeni, M, Pospiech, A, Lois, F, Forget, P, Grosu, I, Poelaert, J, van Mossevelde, V, van Malderen, M, Dylst, D, van Melkebeek, J, Beran, M, de Hert, S, De Baerdemaeker, L, Heyse, B, van Limmen, J, Wyffels, P, Jacobs, T, Roels, N, De Bruyne, A, van de Velde, S, Juros-Zovko, M, Djonovic-Omanovic, D, Pernar, S, Zunic, J, Miskovic, P, Zilic, A, Kvolik, S, Ivic, D, Azenic-Venzera, D, Skiljic, S, Vinkovic, H, Oputric, I, Juricic, K, Frkovic, V, Kopic, J, Mirkovic, I, Karanovic, N, Carev, M, Dropulic, N, Pavicic-Saric, J, Erceg, G, Bogdanovic Dvorcak, M, Mazul-Sunko, B, Pavicic, A, Goranovic, T, Maldini, B, Radocaj, T, Gavranovic, Z, Mladic-Batinica, I, Sehovic, M, Stourac, P, Harazim, H, Smekalova, O, Kosinova, M, Kolacek, T, Hudacek, K, Drab, M, Brujevic, J, Vitkova, K, Jirmanova, K, Volfova, I, Dzurnakova, P, Liskova, K, Dudas, R, Filipsky, R, El Kafrawy, S, Hosny Abdelwahab, H, Metwally, T, Abdel-Razek, A, El-Shaarawy, A, Fathy Hasan, W, Gouda Ahmed, A, Yassin, H, Magdy, M, Abdelhady, M, Mahran, M, Herodes, E, Kivik, P, Oganjan, J, Aun, A, Sormus, A, Sarapuu, K, Mall, M, Karjagin, J, Futier, E, Petit, A, Gerard, A, Marret, E, Solier, M, Prades, A, Krassler, J, Merzky, S, Uhlig, C, Kiss, T, Bundy, A, Bluth, T, Guldner, A, Spieth, P, Scharffenberg, M, Tran Thiem, D, Koch, T, Treschan, T, Schaefer, M, Bastin, B, Geib, J, Weiss, M, Kienbaum, P, Pannen, B, Gottschalk, A, Konrad, M, Westerheide, D, Schwerdtfeger, B, Simon, P, Reske, A, Nestler, C, Valsamidis, D, Stroumpoulis, K, Antholopoulos, G, Andreou, A, Karapanos, D, Theodoraki, K, Gkiokas, G, Tasoulis, M, Sidiropoulou, T, Zafeiropoulou, F, Florou, P, Pandazi, A, Tsaousi, G, Nouris, C, Pourzitaki, C, Bystritski, D, Pizov, R, Eden, A, Pesce, C, Campanile, A, Marrella, A, Grasso, S, De Michele, M, Bona, F, Giacoletto, G, Sardo, E, Giancarlo, L, Sottosanti, V, Solca, M, Volta, C, Spadaro, S, Verri, M, Ragazzi, R, Zoppellari, R, Cinnella, G, Raimondo, P, La Bella, D, Mirabella, L, D'Antini, D, Molin, A, Brunetti, I, Gratarola, A, Pellerano, G, Sileo, R, Pezzatto, S, Montagnani, L, Pasin, L, Landoni, G, Zangrillo, A, Beretta, L, Di Parma, A, Tarzia, V, Dossi, R, Sassone, M, Sances, D, Tredici, S, Spano, G, Castellani, G, Delunas, L, Peradze, S, Venturino, M, Arpino, I, Sher, S, Tommasino, C, Rapido, F, Morelli, P, Vargas, M, Servillo, G, Cortegiani, A, Raineri, S, Montalto, F, Russotto, V, Giarratano, A, Baciarello, M, Generali, M, Cerati, G, Leykin, Y, Bressan, F, Bartolini, V, Zamidei, L, Brazzi, L, Liperi, C, Sales, G, Pistidda, L, Brugnoni, E, Musella, G, Bacuzzi, A, Muhardri, D, Gecaj-Gashi, A, Sada, F, Bytyqi, A, Karbonskiene, A, Aukstakalniene, R, Teberaite, Z, Salciute, E, Tikuisis, R, Miliauskas, P, Jurate, S, Kontrimaviciute, E, Tomkute, G, Xuereb, J, Bezzina, M, Borg, F, Wiersma, I, Bos, L, Boer, C, Duvekot, A, In't Veld, B, Werger, A, Dennesen, P, Severijns, C, de Jong, J, Hering, J, van Beek, R, Ivars, S, Jammer, I, Breidablik, A, Skirstad Hodt, K, Fjellanger, F, Vicoavalos, M, Mellin-Olsen, J, Andersson, E, Shafi-Kabiri, A, Molina, R, Wutai, S, Morais, E, Tareco, G, Ferreira, D, Amaral, J, Goncalves Castro, M, Cadilha, S, Appleton, S, Parente, S, Correia, M, Martins, D, Monteirosa, A, Ricardo, A, Rodrigues, S, Horhota, L, Grintescu, I, Mirea, L, Corneci, D, Negoita, S, Dutu, M, Popescu Garotescu, I, Filipescu, D, Prodan, A, Droc, G, Fota, R, Popescu, M, Tomescu, D, Petcu, A, Tudoroiu, M, Moise, A, Guran, C, Gherghina, I, Costea, D, Cindea, I, Copotoiu, S, Copotoiu, R, Barsan, V, Tolcser, Z, Riciu, M, Moldovan, G, Veres, M, Gritsan, A, Kapkan, T, Gritsan, G, Korolkov, O, Kulikov, A, Lubnin, A, Ovezov, A, Prokoshev, P, Lugovoy, A, Anipchenko, N, Babayants, A, Komissarova, I, Zalina, K, Likhvantsev, V, Fedorov, S, Lazukic, A, Pejakovic, J, Mihajlovic, D, Kusnierikova, Z, Zelinkova, M, Bruncakova, K, Polakovicova, L, Sobona, V, Novak-Supe, B, Pekle-Golez, A, Jovanov, M, Strazisar, B, Markovic-Bozic, J, Novak-Jankovic, V, Voje, M, Grynyuk, A, Kostadinov, I, Spindler-Vesel, A, Moral, V, Unzueta, C, Puigbo, C, Fava, J, Moret, E, Rodriguez Nunez, M, Sendra, M, Brunelli, A, Rodenas, F, Monedero, P, Hidalgo Martinez, F, Yepes Temino, M, Marti Nez Simon, A, de Abajo Larriba, A, Lisi, A, Perez, G, Martinez, R, Granell, M, Tatay Vivo, J, Saiz Ruiz, C, de Andre S Iban Ez, J, Pastor, E, Soro, M, Ferrando, C, Defez, M, Aldecoa Alvares-Santullano, C, Pere, R, Rico, J, Jawad, M, Saeed, Y, Gillberg, L, Kazak Bengisun, Z, Kansu Kazbek, B, Coskunfirat, N, Boztug, N, Sanli, S, Yilmaz, M, Hadimioglu, N, Senturk, N, Camci, E, Kucukgoncu, S, Sungur, Z, Sivrikoz, N, Ustalar Ozgen, S, Toraman, F, Selvi, O, Senturk, O, Yildiz, M, Kuvaki, B, Gunenc, F, Kucukguclu, S, Ozbilgin, S, Maral, J, Canli, S, Arun, O, Saltali, A, Aydogan, E, Akgun, F, Sanlikarip, C, Mine Karaman, F, Mazur, A, Vorotyntsev, S, Rousseau, G, Barrett, C, Stancombe, L, Shelley, B, Scholes, H, Limb, J, Rafi, A, Wayman, L, Deane, J, Rogerson, D, Williams, J, Yates, S, Rogers, E, Pulletz, M, Moreton, S, Jones, S, Venkatesh, S, Burton, M, Brown, L, Goodall, C, Rucklidge, M, Fuller, D, Nadolski, M, Kusre, S, Lundberg, M, Everett, L, Nutt, H, Zuleika, M, Carvalho, P, Clements, D, Creagh-Brown, B, Watt, P, Raymode, P, Mohr, O, Raj, A, Creary, T, Chishti, A, Bell, A, Higham, C, Cain, A, Gibb, S, Mowat, S, Franklin, D, West, C, Minto, G, Boyd, N, Calton, E, Walker, R, Mackenzie, F, Ellison, B, Roberts, H, Chikungwa, M, Jackson, C, Donovan, A, Foot, J, Homan, E, Montgomery, J, Portch, D, Mercer, P, Palmer, J, Paddle, J, Fouracres, A, Datson, A, Andrew, A, Welch, L, Rose, A, Varma, S, Simeson, K, Rambhatla, M, Susarla, J, Marri, S, Kodaganallur, K, Das, A, Algarsamy, S, Colley, J, Davies, S, Szewczyk, M, Smith, T, Fernandez-Bustamante, A, Luzier, E, Almagro, A, Fernando, L, Sulemanji, D, Sprung, J, Weingarten, T, Kor, D, Scavonetto, F, Tze, Y, Schultz, M. J., Hemmes, S. N. T., Neto, A. S., Binnekade, J. M., Canet, J., Hedenstierna, G., Jaber, S., Hiesmayr, M., Hollmann, M. W., Mills, G. H., Vidal Melo, M. F., Pearse, R., Putensen, C., Schmid, W., Severgnini, P., Wrigge, H., De Abreu, M. G., Pelosi, P., Kroell, W., Metzler, H., Struber, G., Wegscheider, T., Gombotz, H., Urbanek, B., Leva, B., Damster, S., Plichon, B., Kahn, D., Momeni, M., Pospiech, A., Lois, F., Forget, P., Grosu, I., Poelaert, J., van Mossevelde, V., van Malderen, M. C., Dylst, D., van Melkebeek, J., Beran, M., de Hert, S., De Baerdemaeker, L., Heyse, B., van Limmen, J., Wyffels, P., Jacobs, T., Roels, N., De Bruyne, A., van de Velde, S., Juros-Zovko, M., Djonovic-Omanovic, D., Pernar, S., Zunic, J., Miskovic, P., Zilic, A., Kvolik, S., Ivic, D., Azenic-Venzera, D., Skiljic, S., Vinkovic, H., Oputric, I., Juricic, K., Frkovic, V., Kopic, J., Mirkovic, I., Karanovic, N., Carev, M., Dropulic, N., Pavicic-Saric, J., Erceg, G., Bogdanovic Dvorcak, M., Mazul-Sunko, B., Pavicic, A. M., Goranovic, T., Maldini, B., Radocaj, T., Gavranovic, Z., Mladic-Batinica, I., Sehovic, M., Stourac, P., Harazim, H., Smekalova, O., Kosinova, M., Kolacek, T., Hudacek, K., Drab, M., Brujevic, J., Vitkova, K., Jirmanova, K., Volfova, I., Dzurnakova, P., Liskova, K., Dudas, R., Filipsky, R., El Kafrawy, S., Hosny Abdelwahab, H., Metwally, T., Abdel-Razek, A., El-Shaarawy, A. 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V., Campanile, A., Marrella, A., Grasso, S., De Michele, M., Bona, F., Giacoletto, G., Sardo, E., Giancarlo, L., Sottosanti, V., Solca, M., Volta, C. A., Spadaro, S., Verri, M., Ragazzi, R., Zoppellari, R., Cinnella, G., Raimondo, P., La Bella, D., Mirabella, L., D'Antini, D., Molin, A., Brunetti, I., Gratarola, A., Pellerano, G., Sileo, R., Pezzatto, S., Montagnani, L., Pasin, L., Landoni, G., Zangrillo, A., Beretta, L., Di Parma, A. L., Tarzia, V., Dossi, R., Sassone, M. E., Sances, D., Tredici, S., Spano, G., Castellani, G., Delunas, L., Peradze, S., Venturino, M., Arpino, I., Sher, S., Tommasino, C., Rapido, F., Morelli, P., Vargas, M., Servillo, G., Cortegiani, A., Raineri, S. M., Montalto, F., Russotto, V., Giarratano, A., Baciarello, M., Generali, M., Cerati, G., Leykin, Y., Bressan, F., Bartolini, V., Zamidei, L., Brazzi, L., Liperi, C., Sales, G., Pistidda, L., Brugnoni, E., Musella, G., Bacuzzi, A., Muhardri, D., Gecaj-Gashi, A., Sada, F., Bytyqi, A., Karbonskiene, A., Aukstakalniene, R., Teberaite, Z., Salciute, E., Tikuisis, R., Miliauskas, P., Jurate, S., Kontrimaviciute, E., Tomkute, G., Xuereb, J., Bezzina, M., Borg, F. J., Wiersma, I., Bos, L., Boer, C., Duvekot, A., In't Veld, B., Werger, A., Dennesen, P., Severijns, C., de Jong, J., Hering, J., van Beek, R., Ivars, S., Jammer, I., Breidablik, A., Skirstad Hodt, K., Fjellanger, F., Vicoavalos, M., Mellin-Olsen, J., Andersson, E., Shafi-Kabiri, A., Molina, R., Wutai, S., Morais, E., Tareco, G. R., Ferreira, D., Amaral, J., Goncalves Castro, M. L., Cadilha, S., Appleton, S., Parente, S., Correia, M., Martins, D., Monteirosa, A., Ricardo, A., Rodrigues, S., Horhota, L., Grintescu, I. M., Mirea, L., Grintescu, I. C., Corneci, D., Negoita, S., Dutu, M., Popescu Garotescu, I., Filipescu, D., Prodan, A. B., Droc, G., Fota, R., Popescu, M., Tomescu, D., Petcu, A. M., Tudoroiu, M. I., Moise, A., Guran, C. T., Gherghina, I., Costea, D., Cindea, I., Copotoiu, S. M., Copotoiu, R., Barsan, V., Tolcser, Z., Riciu, M., Moldovan, G. S., Veres, M., Gritsan, A., Kapkan, T., Gritsan, G., Korolkov, O., Kulikov, A., Lubnin, A., Ovezov, A., Prokoshev, P., Lugovoy, A., Anipchenko, N., Babayants, A., Komissarova, I., Zalina, K., Likhvantsev, V., Fedorov, S., Lazukic, A., Pejakovic, J., Mihajlovic, D., Kusnierikova, Z., Zelinkova, M., Bruncakova, K., Polakovicova, L., Sobona, V., Novak-Supe, B., Pekle-Golez, A., Jovanov, M., Strazisar, B., Markovic-Bozic, J., Novak-Jankovic, V., Voje, M., Grynyuk, A., Kostadinov, I., Spindler-Vesel, A., Moral, V., Unzueta, C., Puigbo, C., Fava, J., Moret, E., Rodriguez Nunez, M. N., Sendra, M., Brunelli, A., Rodenas, F., Monedero, P., Hidalgo Martinez, F., Yepes Temino, M. J., Marti Nez Simon, A., de Abajo Larriba, A., Lisi, A., Perez, G., Martinez, R., Granell, M., Tatay Vivo, J., Saiz Ruiz, C., de Andre S Iban Ez, J. A., Pastor, E., Soro, M., Ferrando, C., Defez, M., Aldecoa Alvares-Santullano, C., Pere, R., Rico, J., Jawad, M., Saeed, Y., Gillberg, L., Kazak Bengisun, Z., Kansu Kazbek, B., Coskunfirat, N., Boztug, N., Sanli, S., Yilmaz, M., Hadimioglu, N., Senturk, N. M., Camci, E., Kucukgoncu, S., Sungur, Z., Sivrikoz, N., Ustalar Ozgen, S., Toraman, F., Selvi, O., Senturk, O., Yildiz, M., Kuvaki, B., Gunenc, F., Kucukguclu, S., Ozbilgin, S. U., Maral, J., Canli, S., Arun, O., Saltali, A., Aydogan, E., Akgun, F. N., Sanlikarip, C., Mine Karaman, F., Mazur, A., Vorotyntsev, S., Rousseau, G., Barrett, C., Stancombe, L., Shelley, B., Scholes, H., Limb, J., Rafi, A., Wayman, L., Deane, J., Rogerson, D., Williams, J., Yates, S., Rogers, E., Pulletz, M., Moreton, S., Jones, S., Venkatesh, S., Burton, M., Brown, L., Goodall, C., Rucklidge, M., Fuller, D., Nadolski, M., Kusre, S., Lundberg, M., Everett, L., Nutt, H., Zuleika, M., Carvalho, P., Clements, D., Creagh-Brown, B., Watt, P., Raymode, P., Mohr, O., Raj, A., Creary, T., Chishti, A., Bell, A., Higham, C., Cain, A., Gibb, S., Mowat, S., Franklin, D., West, C., Minto, G., Boyd, N., Calton, E., Walker, R., Mackenzie, F., Ellison, B., Roberts, H., Chikungwa, M., Jackson, C., Donovan, A., Foot, J., Homan, E., Montgomery, J., Portch, D., Mercer, P., Palmer, J., Paddle, J., Fouracres, A., Datson, A., Andrew, A., Welch, L., Rose, A., Varma, S., Simeson, K., Rambhatla, M., Susarla, J., Marri, S., Kodaganallur, K., Das, A., Algarsamy, S., Colley, J., Davies, S., Szewczyk, M., Smith, T., Fernandez-Bustamante, A., Luzier, E., Almagro, A., Fernando, L., Sulemanji, D., Sprung, J., Weingarten, T., Kor, D., Scavonetto, F., Tze, Y., Anesthesiology, ACS - Microcirculation, ACS - Diabetes & metabolism, Landoni, Giovanni, Zangrillo, Alberto, Beretta, Luigi, Schultz, Marcus J., Hemmes, Sabrine N.T., Neto, Ary Serpa, Binnekade, Jan M., Canet, Jaume, Hedenstierna, Goran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W., Mills, Gary H., Vidal Melo, Marcos F., Pearse, Rupert, Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, De Abreu, Marcelo Gama, Pelosi, Paolo, Kroell W, Metzler H, Struber G, Wegscheider T, Gombotz H, Hiesmayr M, Schmid W, Urbanek B, Leva B, Damster S, Plichon B, Kahn D, Momeni M, Pospiech A, Lois F, Forget P, Grosu I, Poelaert J, van Mossevelde V, van Malderen MC, Dylst D, van Melkebeek J, Beran M, de Hert S, De Baerdemaeker L, Heyse B, van Limmen J, Wyffels P, Jacobs T, Roels N, De Bruyne A, van de Velde S, Juros-Zovko M, Djonoviċ-Omanoviċ D, Serpa Neto A, Pernar S, Zunic J, Miskovic P, Zilic A, Kvolik S, Ivic D, Azenic-Venzera D, Skiljic S, Vinkovic H, Oputric I, Juricic K, Frkovic V, Kopic J, Mirkovic I, Karanovic N, Carev M, Dropulic N, Pavičić-Šarić J, Erceg G, Bogdanović Dvorščak M, Mazul-Sunko B, Pavicic AM, Goranovic T, Maldini B, Radocaj T, Gavranovic Z, Mladic-Batinica I, Sehovic M, Stourac P, Harazim H, Smekalova O, Kosinova M, Kolacek T, Hudacek K, Drab M, Brujevic J, Vitkova K, Jirmanova K, Volfova I, Dzurnakova P, Liskova K, Dudas R, Filipsky R, El Kafrawy S, Hosny Abdelwahab H, Metwally T, Abdel-Razek A, El-Shaarawy AM, Fathy Hasan W, Gouda Ahmed A, Yassin H, Magdy M, Abdelhady M, Mahran M, Herodes E, Kivik P, Oganjan J, Aun A, Sormus A, Sarapuu K, Mall M, Karjagin J, Futier E, Petit A, Gerard A, Marret E, Solier M, Jaber S, Prades A, Putensen C, Krassler J, Merzky S, Gama de Abreu M, Uhlig C, Kiss T, Bundy A, Bluth T, Güldner A, Spieth P, Scharffenberg M, Tran Thiem D, Koch T, Treschan T, Schaefer M, Bastin B, Geib J, Weiss M, Kienbaum P, Pannen B, Gottschalk A, Konrad M, Westerheide D, Schwerdtfeger B, Wrigge H, Simon P, Reske A, Nestler C, Valsamidis D, Stroumpoulis K, Antholopoulos G, Andreou A, Karapanos D, Theodoraki K, Gkiokas G, Tasoulis MK, Sidiropoulou T, Zafeiropoulou F, Florou P, Pandazi A, Tsaousi G, Nouris C, Pourzitaki C, Bystritski D, Pizov R, Eden A, Pesce CV, Campanile A, Marrella A, Grasso S, De Michele M, Bona F, Giacoletto G, Sardo E, Giancarlo L, Sottosanti V, Solca M, Volta CA, Spadaro S, Verri M, Ragazzi R, Zoppellari R, Cinnella G, Raimondo P, La Bella D, Mirabella L, D'antini D, Pelosi P, Molin A, Brunetti I, Gratarola A, Pellerano G, Sileo R, Pezzatto S, Montagnani L, Pasin L, Landoni G, Zangrillo A, Beretta L, Di Parma AL, Tarzia V, Dossi R, Sassone ME, Sances D, Tredici S, Spano G, Castellani G, Delunas L, Peradze S, Venturino M, Arpino I, Sher S, Tommasino C, Rapido F, Morelli P, Vargas M, Servillo G, Cortegiani A, Raineri SM, Montalto F, Russotto V, Giarratano A, Baciarello M, Generali M, Cerati G, Leykin Y, Bressan F, Bartolini V, Zamidei L, Brazzi L, Liperi C, Sales G, Pistidda L, Severgnini P, Brugnoni E, Musella G, Bacuzzi A, Muhardri D, Gecaj-Gashi A, Sada F, Bytyqi A, Karbonskiene A, Aukstakalniene R, Teberaite Z, Salciute E, Tikuisis R, Miliauskas P, Jurate S, Kontrimaviciute E, Tomkute G, Xuereb J, Bezzina M, Borg FJ, Hemmes S, Schultz M, Hollmann M, Wiersma I, Binnekade J, Bos L, Boer C, Duvekot A, In 't Veld B, Werger A, Dennesen P, Severijns C, de Jong J, Hering J, van Beek R, Ivars S, Jammer I, Breidablik A, Skirstad Hodt K, Fjellanger F, VicoAvalos M, Mellin-Olsen J, Andersson E, Shafi-Kabiri A, Molina R, Wutai S, Morais E, Tareco GR, Ferreira D, Amaral J, Gonçalves Castro ML, Cadilha S, Appleton S, Parente S, Correia M, Martins D, Monteirosa A, Ricardo A, Rodrigues S, Horhota L, Grintescu IM, Mirea L, Grintescu IC, Corneci D, Negoita S, Dutu M, Popescu Garotescu I, Filipescu D, Prodan AB, Droc G, Fota R, Popescu M, Tomescu D, Petcu AM, Tudoroiu MI, Moise A, Guran CT, Gherghina I, Costea D, Cindea I, Copotoiu SM, Copotoiu R, Barsan V, Tolcser Z, Riciu M, Moldovan GS, Veres M, Gritsan A, Kapkan T, Gritsan G, Korolkov O, Kulikov A, Lubnin A, Ovezov A, Prokoshev P, Lugovoy A, Anipchenko N, Babayants A, Komissarova I, Zalina K, Likhvantsev V, Fedorov S, Lazukic A, Pejakovic J, Mihajlovic D, Kusnierikova Z, Zelinkova M, Bruncakova K, Polakovicova L, Sobona V, Novak-Supe B, Pekle-Golez A, Jovanov M, Strazisar B, Markovic-Bozic J, Novak-Jankovic V, Voje M, Grynyuk A, Kostadinov I, Spindler-Vesel A, Moral V, Unzueta C, Puigbo C, Fava J, Canet J, Moret E, Rodriguez Nunez MN, Sendra M, Brunelli A, Rodenas F, Monedero P, Hidalgo Martinez F, Yepes Temino MJ, Marti Nez Simon A, de Abajo Larriba A, Lisi A, Perez G, Martinez R, Granell M, Tatay Vivo J, Saiz Ruiz C, de Andre S Iban Ez JA, Pastor E, Soro M, Ferrando C, Defez M, Aldecoa Alvares-Santullano C, Pere R, Rico J, Jawad M, Saeed Y, Gillberg L, Hedenstierna G, Kazak Bengisun Z, Kansu Kazbek B, Coskunfirat N, Boztug N, Sanli S, Yilmaz M, Hadimioglu N, Senturk NM, Camci E, Kucukgoncu S, Sungur Z, Sivrikoz N, Ustalar Ozgen S, Toraman F, Selvi O, Senturk O, Yildiz M, Kuvaki B, Gunenc F, Kucukguclu S, Ozbilgin SU, Maral J, Canli S, Arun O, Saltali A, Aydogan E, Akgün FN, Sanlikarip C, Mine Karaman F, Mazur A, Vorotyntsev S, Rousseau G, Barrett C, Stancombe L, Shelley B, Scholes H, Limb J, Rafi A, Wayman L, Deane J, Rogerson D, Williams J, Yates S, Rogers E, Pulletz M, Moreton S, Jones S, Venkatesh S, Burton M, Brown L, Goodall C, Rucklidge M, Fuller D, Nadolski M, Kusre S, Lundberg M, Everett L, Nutt H, Zuleika M, Carvalho P, Clements D, Creagh-Brown B, Watt P, Raymode P, Pearse R, Mohr O, Raj A, Creary T, Chishti A, Bell A, Higham C, Cain A, Gibb S, Mowat S, Franklin D, West C, Minto G, Boyd N, Mills G, Calton E, Walker R, Mackenzie F, Ellison B, Roberts H, Chikungwa M, Jackson C, Donovan A, Foot J, Homan E, Montgomery J, Portch D, Mercer P, Palmer J, Paddle J, Fouracres A, Datson A, Andrew A, Welch L, Rose A, Varma S, Simeson K, Rambhatla M, Susarla J, Marri S, Kodaganallur K, Das A, Algarsamy S, Colley J, Davies S, Szewczyk M, Smith T, Fernandez-Bustamante A, Luzier E, Almagro A, Vidal Melo M, Fernando L, Sulemanji D, Sprung J, Weingarten T, Kor D, Scavonetto F, Tze Y., Graduate School, ACS - Pulmonary hypertension & thrombosis, Intensive Care Medicine, AII - Amsterdam institute for Infection and Immunity, AII - Inflammatory diseases, ACS - Amsterdam Cardiovascular Sciences, ACS - Heart failure & arrhythmias, Anesthesiology research group, and Supporting clinical sciences

Subjects
Male, Pediatrics, Internationality, RESPIRATORY-DISTRESS-SYNDROME, 0302 clinical medicine, Postoperative Complications, 030202 anesthesiology, Risk Factors, Epidemiology, ABDOMINAL-SURGERY, 80 and over, Medicine and Health Sciences, General anaesthesia, Anesthesia, END-EXPIRATORY-PRESSURE, BERLIN DEFINITION, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Lung, Aged, 80 and over, Framingham Risk Score, Incidence (epidemiology), Respiration, Middle Aged, Treatment Outcome, Artificial, Female, PRACTICE PATTERNS, Human, medicine.medical_specialty, mechanical ventilation, prospective observational study, Intensive care, Anesthesia, General, NONCARDIOTHORACIC SURGERY, NO, Aged, Cross-Sectional Studies, Humans, Intraoperative Care, Respiration Disorders, Respiration, Artificial, Tidal Volume, Anesthesiology and Pain Medicine, ACUTE LUNG INJURY, 03 medical and health sciences, GENERAL-ANESTHESIA, Internal medicine, medicine, Journal Article, MED/41 - ANESTESIOLOGIA, General, Cross-Sectional Studie, business.industry, Risk Factor, Respiration Disorder, Confidence interval, PROTECTIVE MECHANICAL VENTILATION, Prospective Studie, Relative risk, MAJOR NONCARDIAC SURGERY, Postoperative Complication, business, Abdominal surgery
Abstract

BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (V T) size was 500 ml, or 7 to 9 ml kg−1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P ˂ 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P ˂ 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high V T and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome.

Published
2017
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11. Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications: LAS VEGAS - An observational study in 29 countries

Author

Schultz, M, Hemmes, S, Neto, A, Binnekade, J, Canet, J, Hedenstierna, G, Jaber, S, Hiesmayr, M, Hollmann, M, Mills, G, Vidal Melo, M, Pearse, R, Putensen, C, Schmid, W, Severgnini, P, Wrigge, H, De Abreu, M, Pelosi, P, Kroell, W, Metzler, H, Struber, G, Wegscheider, T, Gombotz, H, Urbanek, B, Leva, B, Damster, S, Plichon, B, Kahn, D, Momeni, M, Pospiech, A, Lois, F, Forget, P, Grosu, I, Poelaert, J, van Mossevelde, V, van Malderen, M, Dylst, D, van Melkebeek, J, Beran, M, de Hert, S, De Baerdemaeker, L, Heyse, B, van Limmen, J, Wyffels, P, Jacobs, T, Roels, N, De Bruyne, A, van de Velde, S, Juros-Zovko, M, Djonovic-Omanovic, D, Pernar, S, Zunic, J, Miskovic, P, Zilic, A, Kvolik, S, Ivic, D, Azenic-Venzera, D, Skiljic, S, Vinkovic, H, Oputric, I, Juricic, K, Frkovic, V, Kopic, J, Mirkovic, I, Karanovic, N, Carev, M, Dropulic, N, Pavicic-Saric, J, Erceg, G, Bogdanovic Dvorcak, M, Mazul-Sunko, B, Pavicic, A, Goranovic, T, Maldini, B, Radocaj, T, Gavranovic, Z, Mladic-Batinica, I, Sehovic, M, Stourac, P, Harazim, H, Smekalova, O, Kosinova, M, Kolacek, T, Hudacek, K, Drab, M, Brujevic, J, Vitkova, K, Jirmanova, K, Volfova, I, Dzurnakova, P, Liskova, K, Dudas, R, Filipsky, R, El Kafrawy, S, Hosny Abdelwahab, H, Metwally, T, Abdel-Razek, A, El-Shaarawy, A, Fathy Hasan, W, Gouda Ahmed, A, Yassin, H, Magdy, M, Abdelhady, M, Mahran, M, Herodes, E, Kivik, P, Oganjan, J, Aun, A, Sormus, A, Sarapuu, K, Mall, M, Karjagin, J, Futier, E, Petit, A, Gerard, A, Marret, E, Solier, M, Prades, A, Krassler, J, Merzky, S, Uhlig, C, Kiss, T, Bundy, A, Bluth, T, Guldner, A, Spieth, P, Scharffenberg, M, Tran Thiem, D, Koch, T, Treschan, T, Schaefer, M, Bastin, B, Geib, J, Weiss, M, Kienbaum, P, Pannen, B, Gottschalk, A, Konrad, M, Westerheide, D, Schwerdtfeger, B, Simon, P, Reske, A, Nestler, C, Valsamidis, D, Stroumpoulis, K, Antholopoulos, G, Andreou, A, Karapanos, D, Theodoraki, K, Gkiokas, G, Tasoulis, M, Sidiropoulou, T, Zafeiropoulou, F, Florou, P, Pandazi, A, Tsaousi, G, Nouris, C, Pourzitaki, C, Bystritski, D, Pizov, R, Eden, A, Pesce, C, Campanile, A, Marrella, A, Grasso, S, De Michele, M, Bona, F, Giacoletto, G, Sardo, E, Giancarlo, L, Sottosanti, V, Solca, M, Volta, C, Spadaro, S, Verri, M, Ragazzi, R, Zoppellari, R, Cinnella, G, Raimondo, P, La Bella, D, Mirabella, L, D'Antini, D, Molin, A, Brunetti, I, Gratarola, A, Pellerano, G, Sileo, R, Pezzatto, S, Montagnani, L, Pasin, L, Landoni, G, Zangrillo, A, Beretta, L, Di Parma, A, Tarzia, V, Dossi, R, Sassone, M, Sances, D, Tredici, S, Spano, G, Castellani, G, Delunas, L, Peradze, S, Venturino, M, Arpino, I, Sher, S, Tommasino, C, Rapido, F, Morelli, P, Vargas, M, Servillo, G, Cortegiani, A, Raineri, S, Montalto, F, Russotto, V, Giarratano, A, Baciarello, M, Generali, M, Cerati, G, Leykin, Y, Bressan, F, Bartolini, V, Zamidei, L, Brazzi, L, Liperi, C, Sales, G, Pistidda, L, Brugnoni, E, Musella, G, Bacuzzi, A, Muhardri, D, Gecaj-Gashi, A, Sada, F, Bytyqi, A, Karbonskiene, A, Aukstakalniene, R, Teberaite, Z, Salciute, E, Tikuisis, R, Miliauskas, P, Jurate, S, Kontrimaviciute, E, Tomkute, G, Xuereb, J, Bezzina, M, Borg, F, Wiersma, I, Bos, L, Boer, C, Duvekot, A, In't Veld, B, Werger, A, Dennesen, P, Severijns, C, de Jong, J, Hering, J, van Beek, R, Ivars, S, Jammer, I, Breidablik, A, Skirstad Hodt, K, Fjellanger, F, Vicoavalos, M, Mellin-Olsen, J, Andersson, E, Shafi-Kabiri, A, Molina, R, Wutai, S, Morais, E, Tareco, G, Ferreira, D, Amaral, J, Goncalves Castro, M, Cadilha, S, Appleton, S, Parente, S, Correia, M, Martins, D, Monteirosa, A, Ricardo, A, Rodrigues, S, Horhota, L, Grintescu, I, Mirea, L, Corneci, D, Negoita, S, Dutu, M, Popescu Garotescu, I, Filipescu, D, Prodan, A, Droc, G, Fota, R, Popescu, M, Tomescu, D, Petcu, A, Tudoroiu, M, Moise, A, Guran, C, Gherghina, I, Costea, D, Cindea, I, Copotoiu, S, Copotoiu, R, Barsan, V, Tolcser, Z, Riciu, M, Moldovan, G, Veres, M, Gritsan, A, Kapkan, T, Gritsan, G, Korolkov, O, Kulikov, A, Lubnin, A, Ovezov, A, Prokoshev, P, Lugovoy, A, Anipchenko, N, Babayants, A, Komissarova, I, Zalina, K, Likhvantsev, V, Fedorov, S, Lazukic, A, Pejakovic, J, Mihajlovic, D, Kusnierikova, Z, Zelinkova, M, Bruncakova, K, Polakovicova, L, Sobona, V, Novak-Supe, B, Pekle-Golez, A, Jovanov, M, Strazisar, B, Markovic-Bozic, J, Novak-Jankovic, V, Voje, M, Grynyuk, A, Kostadinov, I, Spindler-Vesel, A, Moral, V, Unzueta, C, Puigbo, C, Fava, J, Moret, E, Rodriguez Nunez, M, Sendra, M, Brunelli, A, Rodenas, F, Monedero, P, Hidalgo Martinez, F, Yepes Temino, M, Marti Nez Simon, A, de Abajo Larriba, A, Lisi, A, Perez, G, Martinez, R, Granell, M, Tatay Vivo, J, Saiz Ruiz, C, de Andre S Iban Ez, J, Pastor, E, Soro, M, Ferrando, C, Defez, M, Aldecoa Alvares-Santullano, C, Pere, R, Rico, J, Jawad, M, Saeed, Y, Gillberg, L, Kazak Bengisun, Z, Kansu Kazbek, B, Coskunfirat, N, Boztug, N, Sanli, S, Yilmaz, M, Hadimioglu, N, Senturk, N, Camci, E, Kucukgoncu, S, Sungur, Z, Sivrikoz, N, Ustalar Ozgen, S, Toraman, F, Selvi, O, Senturk, O, Yildiz, M, Kuvaki, B, Gunenc, F, Kucukguclu, S, Ozbilgin, S, Maral, J, Canli, S, Arun, O, Saltali, A, Aydogan, E, Akgun, F, Sanlikarip, C, Mine Karaman, F, Mazur, A, Vorotyntsev, S, Rousseau, G, Barrett, C, Stancombe, L, Shelley, B, Scholes, H, Limb, J, Rafi, A, Wayman, L, Deane, J, Rogerson, D, Williams, J, Yates, S, Rogers, E, Pulletz, M, Moreton, S, Jones, S, Venkatesh, S, Burton, M, Brown, L, Goodall, C, Rucklidge, M, Fuller, D, Nadolski, M, Kusre, S, Lundberg, M, Everett, L, Nutt, H, Zuleika, M, Carvalho, P, Clements, D, Creagh-Brown, B, Watt, P, Raymode, P, Mohr, O, Raj, A, Creary, T, Chishti, A, Bell, A, Higham, C, Cain, A, Gibb, S, Mowat, S, Franklin, D, West, C, Minto, G, Boyd, N, Calton, E, Walker, R, Mackenzie, F, Ellison, B, Roberts, H, Chikungwa, M, Jackson, C, Donovan, A, Foot, J, Homan, E, Montgomery, J, Portch, D, Mercer, P, Palmer, J, Paddle, J, Fouracres, A, Datson, A, Andrew, A, Welch, L, Rose, A, Varma, S, Simeson, K, Rambhatla, M, Susarla, J, Marri, S, Kodaganallur, K, Das, A, Algarsamy, S, Colley, J, Davies, S, Szewczyk, M, Smith, T, Fernandez-Bustamante, A, Luzier, E, Almagro, A, Fernando, L, Sulemanji, D, Sprung, J, Weingarten, T, Kor, D, Scavonetto, F, Tze, Y, Schultz M. J., Hemmes S. N. T., Neto A. S., Binnekade J. M., Canet J., Hedenstierna G., Jaber S., Hiesmayr M., Hollmann M. W., Mills G. H., Vidal Melo M. F., Pearse R., Putensen C., Schmid W., Severgnini P., Wrigge H., De Abreu M. G., Pelosi P., Kroell W., Metzler H., Struber G., Wegscheider T., Gombotz H., Urbanek B., Leva B., Damster S., Plichon B., Kahn D., Momeni M., Pospiech A., Lois F., Forget P., Grosu I., Poelaert J., van Mossevelde V., van Malderen M. C., Dylst D., van Melkebeek J., Beran M., de Hert S., De Baerdemaeker L., Heyse B., van Limmen J., Wyffels P., Jacobs T., Roels N., De Bruyne A., van de Velde S., Juros-Zovko M., Djonovic-Omanovic D., Pernar S., Zunic J., Miskovic P., Zilic A., Kvolik S., Ivic D., Azenic-Venzera D., Skiljic S., Vinkovic H., Oputric I., Juricic K., Frkovic V., Kopic J., Mirkovic I., Karanovic N., Carev M., Dropulic N., Pavicic-Saric J., Erceg G., Bogdanovic Dvorcak M., Mazul-Sunko B., Pavicic A. M., Goranovic T., Maldini B., Radocaj T., Gavranovic Z., Mladic-Batinica I., Sehovic M., Stourac P., Harazim H., Smekalova O., Kosinova M., Kolacek T., Hudacek K., Drab M., Brujevic J., Vitkova K., Jirmanova K., Volfova I., Dzurnakova P., Liskova K., Dudas R., Filipsky R., El Kafrawy S., Hosny Abdelwahab H., Metwally T., Abdel-Razek A., El-Shaarawy A. M., Fathy Hasan W., Gouda Ahmed A., Yassin H., Magdy M., Abdelhady M., Mahran M., Herodes E., Kivik P., Oganjan J., Aun A., Sormus A., Sarapuu K., Mall M., Karjagin J., Futier E., Petit A., Gerard A., Marret E., Solier M., Prades A., Krassler J., Merzky S., Uhlig C., Kiss T., Bundy A., Bluth T., Guldner A., Spieth P., Scharffenberg M., Tran Thiem D., Koch T., Treschan T., Schaefer M., Bastin B., Geib J., Weiss M., Kienbaum P., Pannen B., Gottschalk A., Konrad M., Westerheide D., Schwerdtfeger B., Simon P., Reske A., Nestler C., Valsamidis D., Stroumpoulis K., Antholopoulos G., Andreou A., Karapanos D., Theodoraki K., Gkiokas G., Tasoulis M. K., Sidiropoulou T., Zafeiropoulou F., Florou P., Pandazi A., Tsaousi G., Nouris C., Pourzitaki C., Bystritski D., Pizov R., Eden A., Pesce C. V., Campanile A., Marrella A., Grasso S., De Michele M., Bona F., Giacoletto G., Sardo E., Giancarlo L., Sottosanti V., Solca M., Volta C. A., Spadaro S., Verri M., Ragazzi R., Zoppellari R., Cinnella G., Raimondo P., La Bella D., Mirabella L., D'antini D., Molin A., Brunetti I., Gratarola A., Pellerano G., Sileo R., Pezzatto S., Montagnani L., Pasin L., Landoni G., Zangrillo A., Beretta L., Di Parma A. L., Tarzia V., Dossi R., Sassone M. E., Sances D., Tredici S., Spano G., Castellani G., Delunas L., Peradze S., Venturino M., Arpino I., Sher S., Tommasino C., Rapido F., Morelli P., Vargas M., Servillo G., Cortegiani A., Raineri S. M., Montalto F., Russotto V., Giarratano A., Baciarello M., Generali M., Cerati G., Leykin Y., Bressan F., Bartolini V., Zamidei L., Brazzi L., Liperi C., Sales G., Pistidda L., Brugnoni E., Musella G., Bacuzzi A., Muhardri D., Gecaj-Gashi A., Sada F., Bytyqi A., Karbonskiene A., Aukstakalniene R., Teberaite Z., Salciute E., Tikuisis R., Miliauskas P., Jurate S., Kontrimaviciute E., Tomkute G., Xuereb J., Bezzina M., Borg F. J., Wiersma I., Bos L., Boer C., Duvekot A., In't Veld B., Werger A., Dennesen P., Severijns C., de Jong J., Hering J., van Beek R., Ivars S., Jammer I., Breidablik A., Skirstad Hodt K., Fjellanger F., VicoAvalos M., Mellin-Olsen J., Andersson E., Shafi-Kabiri A., Molina R., Wutai S., Morais E., Tareco G. R., Ferreira D., Amaral J., Goncalves Castro M. L., Cadilha S., Appleton S., Parente S., Correia M., Martins D., Monteirosa A., Ricardo A., Rodrigues S., Horhota L., Grintescu I. M., Mirea L., Grintescu I. C., Corneci D., Negoita S., Dutu M., Popescu Garotescu I., Filipescu D., Prodan A. B., Droc G., Fota R., Popescu M., Tomescu D., Petcu A. M., Tudoroiu M. I., Moise A., Guran C. T., Gherghina I., Costea D., Cindea I., Copotoiu S. M., Copotoiu R., Barsan V., Tolcser Z., Riciu M., Moldovan G. S., Veres M., Gritsan A., Kapkan T., Gritsan G., Korolkov O., Kulikov A., Lubnin A., Ovezov A., Prokoshev P., Lugovoy A., Anipchenko N., Babayants A., Komissarova I., Zalina K., Likhvantsev V., Fedorov S., Lazukic A., Pejakovic J., Mihajlovic D., Kusnierikova Z., Zelinkova M., Bruncakova K., Polakovicova L., Sobona V., Novak-Supe B., Pekle-Golez A., Jovanov M., Strazisar B., Markovic-Bozic J., Novak-Jankovic V., Voje M., Grynyuk A., Kostadinov I., Spindler-Vesel A., Moral V., Unzueta C., Puigbo C., Fava J., Moret E., Rodriguez Nunez M. N., Sendra M., Brunelli A., Rodenas F., Monedero P., Hidalgo Martinez F., Yepes Temino M. J., Marti Nez Simon A., de Abajo Larriba A., Lisi A., Perez G., Martinez R., Granell M., Tatay Vivo J., Saiz Ruiz C., de Andre S Iban Ez J. A., Pastor E., Soro M., Ferrando C., Defez M., Aldecoa Alvares-Santullano C., Pere R., Rico J., Jawad M., Saeed Y., Gillberg L., Kazak Bengisun Z., Kansu Kazbek B., Coskunfirat N., Boztug N., Sanli S., Yilmaz M., Hadimioglu N., Senturk N. M., Camci E., Kucukgoncu S., Sungur Z., Sivrikoz N., Ustalar Ozgen S., Toraman F., Selvi O., Senturk O., Yildiz M., Kuvaki B., Gunenc F., Kucukguclu S., Ozbilgin S. U., Maral J., Canli S., Arun O., Saltali A., Aydogan E., Akgun F. N., Sanlikarip C., Mine Karaman F., Mazur A., Vorotyntsev S., Rousseau G., Barrett C., Stancombe L., Shelley B., Scholes H., Limb J., Rafi A., Wayman L., Deane J., Rogerson D., Williams J., Yates S., Rogers E., Pulletz M., Moreton S., Jones S., Venkatesh S., Burton M., Brown L., Goodall C., Rucklidge M., Fuller D., Nadolski M., Kusre S., Lundberg M., Everett L., Nutt H., Zuleika M., Carvalho P., Clements D., Creagh-Brown B., Watt P., Raymode P., Mohr O., Raj A., Creary T., Chishti A., Bell A., Higham C., Cain A., Gibb S., Mowat S., Franklin D., West C., Minto G., Boyd N., Calton E., Walker R., Mackenzie F., Ellison B., Roberts H., Chikungwa M., Jackson C., Donovan A., Foot J., Homan E., Montgomery J., Portch D., Mercer P., Palmer J., Paddle J., Fouracres A., Datson A., Andrew A., Welch L., Rose A., Varma S., Simeson K., Rambhatla M., Susarla J., Marri S., Kodaganallur K., Das A., Algarsamy S., Colley J., Davies S., Szewczyk M., Smith T., Fernandez-Bustamante A., Luzier E., Almagro A., Fernando L., Sulemanji D., Sprung J., Weingarten T., Kor D., Scavonetto F., Tze Y., Schultz, M, Hemmes, S, Neto, A, Binnekade, J, Canet, J, Hedenstierna, G, Jaber, S, Hiesmayr, M, Hollmann, M, Mills, G, Vidal Melo, M, Pearse, R, Putensen, C, Schmid, W, Severgnini, P, Wrigge, H, De Abreu, M, Pelosi, P, Kroell, W, Metzler, H, Struber, G, Wegscheider, T, Gombotz, H, Urbanek, B, Leva, B, Damster, S, Plichon, B, Kahn, D, Momeni, M, Pospiech, A, Lois, F, Forget, P, Grosu, I, Poelaert, J, van Mossevelde, V, van Malderen, M, Dylst, D, van Melkebeek, J, Beran, M, de Hert, S, De Baerdemaeker, L, Heyse, B, van Limmen, J, Wyffels, P, Jacobs, T, Roels, N, De Bruyne, A, van de Velde, S, Juros-Zovko, M, Djonovic-Omanovic, D, Pernar, S, Zunic, J, Miskovic, P, Zilic, A, Kvolik, S, Ivic, D, Azenic-Venzera, D, Skiljic, S, Vinkovic, H, Oputric, I, Juricic, K, Frkovic, V, Kopic, J, Mirkovic, I, Karanovic, N, Carev, M, Dropulic, N, Pavicic-Saric, J, Erceg, G, Bogdanovic Dvorcak, M, Mazul-Sunko, B, Pavicic, A, Goranovic, T, Maldini, B, Radocaj, T, Gavranovic, Z, Mladic-Batinica, I, Sehovic, M, Stourac, P, Harazim, H, Smekalova, O, Kosinova, M, Kolacek, T, Hudacek, K, Drab, M, Brujevic, J, Vitkova, K, Jirmanova, K, Volfova, I, Dzurnakova, P, Liskova, K, Dudas, R, Filipsky, R, El Kafrawy, S, Hosny Abdelwahab, H, Metwally, T, Abdel-Razek, A, El-Shaarawy, A, Fathy Hasan, W, Gouda Ahmed, A, Yassin, H, Magdy, M, Abdelhady, M, Mahran, M, Herodes, E, Kivik, P, Oganjan, J, Aun, A, Sormus, A, Sarapuu, K, Mall, M, Karjagin, J, Futier, E, Petit, A, Gerard, A, Marret, E, Solier, M, Prades, A, Krassler, J, Merzky, S, Uhlig, C, Kiss, T, Bundy, A, Bluth, T, Guldner, A, Spieth, P, Scharffenberg, M, Tran Thiem, D, Koch, T, Treschan, T, Schaefer, M, Bastin, B, Geib, J, Weiss, M, Kienbaum, P, Pannen, B, Gottschalk, A, Konrad, M, Westerheide, D, Schwerdtfeger, B, Simon, P, Reske, A, Nestler, C, Valsamidis, D, Stroumpoulis, K, Antholopoulos, G, Andreou, A, Karapanos, D, Theodoraki, K, Gkiokas, G, Tasoulis, M, Sidiropoulou, T, Zafeiropoulou, F, Florou, P, Pandazi, A, Tsaousi, G, Nouris, C, Pourzitaki, C, Bystritski, D, Pizov, R, Eden, A, Pesce, C, Campanile, A, Marrella, A, Grasso, S, De Michele, M, Bona, F, Giacoletto, G, Sardo, E, Giancarlo, L, Sottosanti, V, Solca, M, Volta, C, Spadaro, S, Verri, M, Ragazzi, R, Zoppellari, R, Cinnella, G, Raimondo, P, La Bella, D, Mirabella, L, D'Antini, D, Molin, A, Brunetti, I, Gratarola, A, Pellerano, G, Sileo, R, Pezzatto, S, Montagnani, L, Pasin, L, Landoni, G, Zangrillo, A, Beretta, L, Di Parma, A, Tarzia, V, Dossi, R, Sassone, M, Sances, D, Tredici, S, Spano, G, Castellani, G, Delunas, L, Peradze, S, Venturino, M, Arpino, I, Sher, S, Tommasino, C, Rapido, F, Morelli, P, Vargas, M, Servillo, G, Cortegiani, A, Raineri, S, Montalto, F, Russotto, V, Giarratano, A, Baciarello, M, Generali, M, Cerati, G, Leykin, Y, Bressan, F, Bartolini, V, Zamidei, L, Brazzi, L, Liperi, C, Sales, G, Pistidda, L, Brugnoni, E, Musella, G, Bacuzzi, A, Muhardri, D, Gecaj-Gashi, A, Sada, F, Bytyqi, A, Karbonskiene, A, Aukstakalniene, R, Teberaite, Z, Salciute, E, Tikuisis, R, Miliauskas, P, Jurate, S, Kontrimaviciute, E, Tomkute, G, Xuereb, J, Bezzina, M, Borg, F, Wiersma, I, Bos, L, Boer, C, Duvekot, A, In't Veld, B, Werger, A, Dennesen, P, Severijns, C, de Jong, J, Hering, J, van Beek, R, Ivars, S, Jammer, I, Breidablik, A, Skirstad Hodt, K, Fjellanger, F, Vicoavalos, M, Mellin-Olsen, J, Andersson, E, Shafi-Kabiri, A, Molina, R, Wutai, S, Morais, E, Tareco, G, Ferreira, D, Amaral, J, Goncalves Castro, M, Cadilha, S, Appleton, S, Parente, S, Correia, M, Martins, D, Monteirosa, A, Ricardo, A, Rodrigues, S, Horhota, L, Grintescu, I, Mirea, L, Corneci, D, Negoita, S, Dutu, M, Popescu Garotescu, I, Filipescu, D, Prodan, A, Droc, G, Fota, R, Popescu, M, Tomescu, D, Petcu, A, Tudoroiu, M, Moise, A, Guran, C, Gherghina, I, Costea, D, Cindea, I, Copotoiu, S, Copotoiu, R, Barsan, V, Tolcser, Z, Riciu, M, Moldovan, G, Veres, M, Gritsan, A, Kapkan, T, Gritsan, G, Korolkov, O, Kulikov, A, Lubnin, A, Ovezov, A, Prokoshev, P, Lugovoy, A, Anipchenko, N, Babayants, A, Komissarova, I, Zalina, K, Likhvantsev, V, Fedorov, S, Lazukic, A, Pejakovic, J, Mihajlovic, D, Kusnierikova, Z, Zelinkova, M, Bruncakova, K, Polakovicova, L, Sobona, V, Novak-Supe, B, Pekle-Golez, A, Jovanov, M, Strazisar, B, Markovic-Bozic, J, Novak-Jankovic, V, Voje, M, Grynyuk, A, Kostadinov, I, Spindler-Vesel, A, Moral, V, Unzueta, C, Puigbo, C, Fava, J, Moret, E, Rodriguez Nunez, M, Sendra, M, Brunelli, A, Rodenas, F, Monedero, P, Hidalgo Martinez, F, Yepes Temino, M, Marti Nez Simon, A, de Abajo Larriba, A, Lisi, A, Perez, G, Martinez, R, Granell, M, Tatay Vivo, J, Saiz Ruiz, C, de Andre S Iban Ez, J, Pastor, E, Soro, M, Ferrando, C, Defez, M, Aldecoa Alvares-Santullano, C, Pere, R, Rico, J, Jawad, M, Saeed, Y, Gillberg, L, Kazak Bengisun, Z, Kansu Kazbek, B, Coskunfirat, N, Boztug, N, Sanli, S, Yilmaz, M, Hadimioglu, N, Senturk, N, Camci, E, Kucukgoncu, S, Sungur, Z, Sivrikoz, N, Ustalar Ozgen, S, Toraman, F, Selvi, O, Senturk, O, Yildiz, M, Kuvaki, B, Gunenc, F, Kucukguclu, S, Ozbilgin, S, Maral, J, Canli, S, Arun, O, Saltali, A, Aydogan, E, Akgun, F, Sanlikarip, C, Mine Karaman, F, Mazur, A, Vorotyntsev, S, Rousseau, G, Barrett, C, Stancombe, L, Shelley, B, Scholes, H, Limb, J, Rafi, A, Wayman, L, Deane, J, Rogerson, D, Williams, J, Yates, S, Rogers, E, Pulletz, M, Moreton, S, Jones, S, Venkatesh, S, Burton, M, Brown, L, Goodall, C, Rucklidge, M, Fuller, D, Nadolski, M, Kusre, S, Lundberg, M, Everett, L, Nutt, H, Zuleika, M, Carvalho, P, Clements, D, Creagh-Brown, B, Watt, P, Raymode, P, Mohr, O, Raj, A, Creary, T, Chishti, A, Bell, A, Higham, C, Cain, A, Gibb, S, Mowat, S, Franklin, D, West, C, Minto, G, Boyd, N, Calton, E, Walker, R, Mackenzie, F, Ellison, B, Roberts, H, Chikungwa, M, Jackson, C, Donovan, A, Foot, J, Homan, E, Montgomery, J, Portch, D, Mercer, P, Palmer, J, Paddle, J, Fouracres, A, Datson, A, Andrew, A, Welch, L, Rose, A, Varma, S, Simeson, K, Rambhatla, M, Susarla, J, Marri, S, Kodaganallur, K, Das, A, Algarsamy, S, Colley, J, Davies, S, Szewczyk, M, Smith, T, Fernandez-Bustamante, A, Luzier, E, Almagro, A, Fernando, L, Sulemanji, D, Sprung, J, Weingarten, T, Kor, D, Scavonetto, F, Tze, Y, Schultz M. J., Hemmes S. N. T., Neto A. S., Binnekade J. M., Canet J., Hedenstierna G., Jaber S., Hiesmayr M., Hollmann M. W., Mills G. H., Vidal Melo M. F., Pearse R., Putensen C., Schmid W., Severgnini P., Wrigge H., De Abreu M. G., Pelosi P., Kroell W., Metzler H., Struber G., Wegscheider T., Gombotz H., Urbanek B., Leva B., Damster S., Plichon B., Kahn D., Momeni M., Pospiech A., Lois F., Forget P., Grosu I., Poelaert J., van Mossevelde V., van Malderen M. C., Dylst D., van Melkebeek J., Beran M., de Hert S., De Baerdemaeker L., Heyse B., van Limmen J., Wyffels P., Jacobs T., Roels N., De Bruyne A., van de Velde S., Juros-Zovko M., Djonovic-Omanovic D., Pernar S., Zunic J., Miskovic P., Zilic A., Kvolik S., Ivic D., Azenic-Venzera D., Skiljic S., Vinkovic H., Oputric I., Juricic K., Frkovic V., Kopic J., Mirkovic I., Karanovic N., Carev M., Dropulic N., Pavicic-Saric J., Erceg G., Bogdanovic Dvorcak M., Mazul-Sunko B., Pavicic A. M., Goranovic T., Maldini B., Radocaj T., Gavranovic Z., Mladic-Batinica I., Sehovic M., Stourac P., Harazim H., Smekalova O., Kosinova M., Kolacek T., Hudacek K., Drab M., Brujevic J., Vitkova K., Jirmanova K., Volfova I., Dzurnakova P., Liskova K., Dudas R., Filipsky R., El Kafrawy S., Hosny Abdelwahab H., Metwally T., Abdel-Razek A., El-Shaarawy A. M., Fathy Hasan W., Gouda Ahmed A., Yassin H., Magdy M., Abdelhady M., Mahran M., Herodes E., Kivik P., Oganjan J., Aun A., Sormus A., Sarapuu K., Mall M., Karjagin J., Futier E., Petit A., Gerard A., Marret E., Solier M., Prades A., Krassler J., Merzky S., Uhlig C., Kiss T., Bundy A., Bluth T., Guldner A., Spieth P., Scharffenberg M., Tran Thiem D., Koch T., Treschan T., Schaefer M., Bastin B., Geib J., Weiss M., Kienbaum P., Pannen B., Gottschalk A., Konrad M., Westerheide D., Schwerdtfeger B., Simon P., Reske A., Nestler C., Valsamidis D., Stroumpoulis K., Antholopoulos G., Andreou A., Karapanos D., Theodoraki K., Gkiokas G., Tasoulis M. K., Sidiropoulou T., Zafeiropoulou F., Florou P., Pandazi A., Tsaousi G., Nouris C., Pourzitaki C., Bystritski D., Pizov R., Eden A., Pesce C. V., Campanile A., Marrella A., Grasso S., De Michele M., Bona F., Giacoletto G., Sardo E., Giancarlo L., Sottosanti V., Solca M., Volta C. A., Spadaro S., Verri M., Ragazzi R., Zoppellari R., Cinnella G., Raimondo P., La Bella D., Mirabella L., D'antini D., Molin A., Brunetti I., Gratarola A., Pellerano G., Sileo R., Pezzatto S., Montagnani L., Pasin L., Landoni G., Zangrillo A., Beretta L., Di Parma A. L., Tarzia V., Dossi R., Sassone M. E., Sances D., Tredici S., Spano G., Castellani G., Delunas L., Peradze S., Venturino M., Arpino I., Sher S., Tommasino C., Rapido F., Morelli P., Vargas M., Servillo G., Cortegiani A., Raineri S. M., Montalto F., Russotto V., Giarratano A., Baciarello M., Generali M., Cerati G., Leykin Y., Bressan F., Bartolini V., Zamidei L., Brazzi L., Liperi C., Sales G., Pistidda L., Brugnoni E., Musella G., Bacuzzi A., Muhardri D., Gecaj-Gashi A., Sada F., Bytyqi A., Karbonskiene A., Aukstakalniene R., Teberaite Z., Salciute E., Tikuisis R., Miliauskas P., Jurate S., Kontrimaviciute E., Tomkute G., Xuereb J., Bezzina M., Borg F. J., Wiersma I., Bos L., Boer C., Duvekot A., In't Veld B., Werger A., Dennesen P., Severijns C., de Jong J., Hering J., van Beek R., Ivars S., Jammer I., Breidablik A., Skirstad Hodt K., Fjellanger F., VicoAvalos M., Mellin-Olsen J., Andersson E., Shafi-Kabiri A., Molina R., Wutai S., Morais E., Tareco G. R., Ferreira D., Amaral J., Goncalves Castro M. L., Cadilha S., Appleton S., Parente S., Correia M., Martins D., Monteirosa A., Ricardo A., Rodrigues S., Horhota L., Grintescu I. M., Mirea L., Grintescu I. C., Corneci D., Negoita S., Dutu M., Popescu Garotescu I., Filipescu D., Prodan A. B., Droc G., Fota R., Popescu M., Tomescu D., Petcu A. M., Tudoroiu M. I., Moise A., Guran C. T., Gherghina I., Costea D., Cindea I., Copotoiu S. M., Copotoiu R., Barsan V., Tolcser Z., Riciu M., Moldovan G. S., Veres M., Gritsan A., Kapkan T., Gritsan G., Korolkov O., Kulikov A., Lubnin A., Ovezov A., Prokoshev P., Lugovoy A., Anipchenko N., Babayants A., Komissarova I., Zalina K., Likhvantsev V., Fedorov S., Lazukic A., Pejakovic J., Mihajlovic D., Kusnierikova Z., Zelinkova M., Bruncakova K., Polakovicova L., Sobona V., Novak-Supe B., Pekle-Golez A., Jovanov M., Strazisar B., Markovic-Bozic J., Novak-Jankovic V., Voje M., Grynyuk A., Kostadinov I., Spindler-Vesel A., Moral V., Unzueta C., Puigbo C., Fava J., Moret E., Rodriguez Nunez M. N., Sendra M., Brunelli A., Rodenas F., Monedero P., Hidalgo Martinez F., Yepes Temino M. J., Marti Nez Simon A., de Abajo Larriba A., Lisi A., Perez G., Martinez R., Granell M., Tatay Vivo J., Saiz Ruiz C., de Andre S Iban Ez J. A., Pastor E., Soro M., Ferrando C., Defez M., Aldecoa Alvares-Santullano C., Pere R., Rico J., Jawad M., Saeed Y., Gillberg L., Kazak Bengisun Z., Kansu Kazbek B., Coskunfirat N., Boztug N., Sanli S., Yilmaz M., Hadimioglu N., Senturk N. M., Camci E., Kucukgoncu S., Sungur Z., Sivrikoz N., Ustalar Ozgen S., Toraman F., Selvi O., Senturk O., Yildiz M., Kuvaki B., Gunenc F., Kucukguclu S., Ozbilgin S. U., Maral J., Canli S., Arun O., Saltali A., Aydogan E., Akgun F. N., Sanlikarip C., Mine Karaman F., Mazur A., Vorotyntsev S., Rousseau G., Barrett C., Stancombe L., Shelley B., Scholes H., Limb J., Rafi A., Wayman L., Deane J., Rogerson D., Williams J., Yates S., Rogers E., Pulletz M., Moreton S., Jones S., Venkatesh S., Burton M., Brown L., Goodall C., Rucklidge M., Fuller D., Nadolski M., Kusre S., Lundberg M., Everett L., Nutt H., Zuleika M., Carvalho P., Clements D., Creagh-Brown B., Watt P., Raymode P., Mohr O., Raj A., Creary T., Chishti A., Bell A., Higham C., Cain A., Gibb S., Mowat S., Franklin D., West C., Minto G., Boyd N., Calton E., Walker R., Mackenzie F., Ellison B., Roberts H., Chikungwa M., Jackson C., Donovan A., Foot J., Homan E., Montgomery J., Portch D., Mercer P., Palmer J., Paddle J., Fouracres A., Datson A., Andrew A., Welch L., Rose A., Varma S., Simeson K., Rambhatla M., Susarla J., Marri S., Kodaganallur K., Das A., Algarsamy S., Colley J., Davies S., Szewczyk M., Smith T., Fernandez-Bustamante A., Luzier E., Almagro A., Fernando L., Sulemanji D., Sprung J., Weingarten T., Kor D., Scavonetto F., and Tze Y.

Abstract

Background: Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. Objectives: To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. Design: This was a prospective international 1-week observational study using the 'Assess Respiratory Risk in Surgical Patients in Catalonia risk score' (ARISCAT score) for PPC for risk stratification. Patients and Setting: Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. Main Outcome Measures: The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. Results: A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (VT) size was 500 ml, or 7 to 9 ml kg-1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH 2 O PEEP compared with 7.6% in patients at low risk of PPCs (P < 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P < 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. Conclusion: The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high VT and low PEEP levels. PPCs occur frequently in patients at i

Published
2017

17. Association between night-time surgery and occurrence of intraoperative adverse events and postoperative pulmonary complications

Author

Cortegiani, A., primary, Gregoretti, C., additional, Neto, A.S., additional, Hemmes, S.N.T., additional, Ball, L., additional, Canet, J., additional, Hiesmayr, M., additional, Hollmann, M.W., additional, Mills, G.H., additional, Melo, M.F.V., additional, Putensen, C., additional, Schmid, W., additional, Severgnini, P., additional, Wrigge, H., additional, Gama de Abreu, M., additional, Schultz, M.J., additional, Pelosi, P., additional, Kroell, W., additional, Metzler, H., additional, Struber, G., additional, Wegscheider, T., additional, Gombotz, H., additional, Urbanek, B., additional, Kahn, D., additional, Momeni, M., additional, Pospiech, A., additional, Lois, F., additional, Forget, P., additional, Grosu, I., additional, Poelaert, J., additional, Mossevelde, V., additional, van Malderen, M.C., additional, Dylst, D., additional, Melkebeek, J.V., additional, Beran, M., additional, Hert, S.D., additional, Baerdemaeker, L.D., additional, Heyse, B., additional, Limmen, J.V., additional, Wyffels, P., additional, Jacobs, T., additional, Roels, N., additional, Bruyne, A.D., additional, Velde, S.V.D., additional, Marina, J.Z., additional, Dejana, D.O., additional, Pernar, S., additional, Zunic, J., additional, Miskovic, P., additional, Zilic, A., additional, Kvolik, S., additional, Ivic, D., additional, Darija, A.V., additional, Skiljic, S., additional, Vinkovic, H., additional, Oputric, I., additional, Juricic, K., additional, Frkovic, V., additional, Kopic, J., additional, Mirkovic, I., additional, Saric, J.P., additional, Erceg, G., additional, Dvorscak, M.B., additional, Branka, M.S., additional, Pavicic, A.M., additional, Goranovic, T., additional, Maldini, B., additional, Radocaj, T., additional, Gavranovic, Z., additional, Inga, M.B., additional, Sehovic, M., additional, Stourac, P., additional, Harazim, H., additional, Smekalova, O., additional, Kosinova, M., additional, Kolacek, T., additional, Hudacek, K., additional, Drab, M., additional, Brujevic, J., additional, Vitkova, K., additional, Jirmanova, K., additional, Volfova, I., additional, Dzurnakova, P., additional, Liskova, K., additional, Dudas, R., additional, Filipsky, R., additional, Kafrawy, S.E., additional, Abdelwahab, H.H., additional, Metwally, T., additional, Ahmed, A.R., additional, Ahmed Mostafa, E.S., additional, Hasan, W.F., additional, Ahmed, A.G., additional, Yassin, H., additional, Magdy, M., additional, Abdelhady, M., additional, Mahran, M., additional, Herodes, E., additional, Kivik, P., additional, Oganjan, J., additional, Aun, A., additional, Sormus, A., additional, Sarapuu, K., additional, Mall, M., additional, Karjagin, J., additional, Futier, E., additional, Petit, A., additional, Gerard, A., additional, Marret, E., additional, Solier, M., additional, Jaber, S., additional, Prades, A., additional, Krassler, J., additional, Merzky, S., additional, Abreu, M.G.D., additional, Uhlig, C., additional, Kiss, T., additional, Bundy, A., additional, Bluth, T., additional, Gueldner, A., additional, Spieth, P., additional, Scharffenberg, M., additional, Thiem, D.T., additional, Koch, T., additional, Treschan, T., additional, Schaefer, M., additional, Bastin, B., additional, Geib, J., additional, Weiss, M., additional, Kienbaum, P., additional, Pannen, B., additional, Gottschalk, A., additional, Konrad, M., additional, Westerheide, D., additional, Schwerdtfeger, B., additional, Simon, P., additional, Reske, A., additional, Nestler, C., additional, Valsamidis, D., additional, Stroumpoulis, K., additional, Antholopoulos, G., additional, Andreou, A., additional, Karapanos, D., additional, Theodoraki, K., additional, Gkiokas, G., additional, Tasoulis, M.K., additional, Sidiropoulou, T., additional, Zafeiropoulou, F., additional, Florou, P., additional, Pandazi, A., additional, Tsaousi, G., additional, Nouris, C., additional, Pourzitaki, C., additional, Bystritski, D., additional, Pizov, R., additional, Eden, A., additional, Pesce, C.V., additional, Campanile, A., additional, Marrella, A., additional, Grasso, S., additional, Michele, M.D., additional, Bona, F., additional, Giacoletto, G., additional, Sardo, E., additional, Sottosanti, L.G.V., additional, Solca, M., additional, Volta, C.A., additional, Spadaro, S., additional, Verri, M., additional, Ragazzi, R., additional, Zoppellari, R., additional, Cinnella, G., additional, Raimondo, P., additional, Bella, D.L., additional, Mirabella, L., additional, D'antini, D., additional, Molin, A., additional, Brunetti, I., additional, Gratarola, A., additional, Pellerano, G., additional, Sileo, R., additional, Pezzatto, S., additional, Montagnani, L., additional, Pasin, L., additional, Landoni, G., additional, Zangrillo, A., additional, Beretta, L., additional, Parma, A.L.D., additional, Tarzia, V., additional, Dossi, R., additional, Sassone, M.E., additional, Sances, D., additional, Tredici, S., additional, Spano, G., additional, Castellani, G., additional, Delunas, L., additional, Peradze, S., additional, Venturino, M., additional, Arpino, I., additional, Sher, S., additional, Tommasino, C., additional, Rapido, F., additional, Morelli, P., additional, Vargas, M., additional, Servillo, G., additional, Cortegiani, A., additional, Raineri, S.M., additional, Montalto, F., additional, Russotto, V., additional, Giarratano, A., additional, Baciarello, M., additional, Generali, M., additional, Cerati, G., additional, Leykin, Y., additional, Bressan, F., additional, Bartolini, V., additional, Zamidei, L., additional, Brazzi, L., additional, Liperi, C., additional, Sales, G., additional, Pistidda, L., additional, Brugnoni, E., additional, Musella, G., additional, Bacuzzi, A., additional, Muhardri, D., additional, Agreta, G.G., additional, Sada, F., additional, Bytyqi, A., additional, Karbonskiene, A., additional, Aukstakalniene, R., additional, Teberaite, Z., additional, Salciute, E., additional, Tikuisis, R., additional, Miliauskas, P., additional, Jurate, S., additional, Kontrimaviciute, E., additional, Tomkute, G., additional, Xuereb, J., additional, Bezzina, M., additional, Borg, F. Joseph, additional, Hemmes, S., additional, Schultz, M., additional, Hollmann, M., additional, Wiersma, I., additional, Binnekade, J., additional, Bos, L., additional, Boer, C., additional, Duvekot, A., additional, Veld, B.I ‘t, additional, Werger, A., additional, Dennesen, P., additional, Severijns, C., additional, Jong, J.D., additional, Hering, J., additional, Beek, R.V., additional, Ivars, S., additional, Jammer, I.B., additional, Breidablik, A., additional, Hodt, K.S., additional, Fjellanger, F., additional, Avalos, M.V., additional, Jannicke, M.O., additional, Andersson, E., additional, Amir, S.K., additional, Molina, R., additional, Wutai, S., additional, Morais, E., additional, Tareco, G., additional, Ferreira, D., additional, Amaral, J., additional, Castro, M.D.L.G., additional, Cadilha, S., additional, Appleton, S., additional, Parente, S., additional, Correia, M., additional, Martins, D., additional, Monteirosa, A., additional, Ricardo, A., additional, Rodrigues, S., additional, Horhota, L., additional, Grintescu, I.M., additional, Mirea, L., additional, Grintescu, I.C., additional, Corneci, D., additional, Negoita, S., additional, Dutu, M., additional, Popescu Garotescu, I., additional, Filipescu, D., additional, Prodan, A.B., additional, Droc, G., additional, Fota, R., additional, Popescu, M., additional, Tomescu, D., additional, Petcu, A.M., additional, Tudoroiu, M.I., additional, Moise, A., additional, Guran, C.T., additional, Gherghina, I., additional, Costea, D., additional, Cindea, I., additional, Copotoiu, S.M., additional, Copotoiu, R., additional, Barsan, V., additional, Tolcser, Z., additional, Riciu, M., additional, Moldovan, S.G., additional, Veres, M., additional, Gritsan, A., additional, Kapkan, T., additional, Gritsan, G., additional, Korolkov, O., additional, Kulikov, A., additional, Lubnin, A., additional, Ovezov, A., additional, Prokoshev, P., additional, Lugovoy, A., additional, Anipchenko, N., additional, Babayants, A., additional, Komissarova, I., additional, Zalina, K., additional, Likhvantsev, V., additional, Fedorov, S., additional, Lazukic, A., additional, Pejakovic, J., additional, Mihajlovic, D., additional, Kusnierikova, Z., additional, Zelinkova, M., additional, Bruncakova, K., additional, Polakovicova, L., additional, Sobona, V., additional, Barbka, N.S., additional, Ana, P.G., additional, Jovanov, M., additional, Strazisar, B., additional, Jasmina, M.B., additional, Vesna, N.J., additional, Voje, M., additional, Grynyuk, A., additional, Kostadinov, I., additional, Alenka, S.V., additional, Moral, V., additional, Unzueta, M.C., additional, Puigbo, C., additional, Fava, J., additional, Moret, E., additional, Nunez, M.R., additional, Sendra, M., additional, Brunelli, A., additional, Rodenas, F., additional, Monedero, P., additional, Hidalgo, F., additional, Yepes, M.J., additional, Martinez-Simon, A., additional, Abajo, A., additional, Lisi, A., additional, Perez, G., additional, Martinez, R., additional, Granell, M., additional, Vivo, J.T., additional, Ruiz, C.S., additional, Andrés Ibañez, J.A.D., additional, Pastor, E., additional, Soro, M., additional, Ferrando, C., additional, Defez, M., additional, Cesar Aldecoa, A.S., additional, Perez, R., additional, Rico, J., additional, Jawad, M., additional, Saeed, Y., additional, Gillberg, L., additional, Bengisun, Z.K., additional, Kazbek, B.K., additional, Coskunfirat, N., additional, Boztug, N., additional, Sanli, S., additional, Yilmaz, M., additional, Hadimioglu, N., additional, Senturk, N.M., additional, Camci, E., additional, Kucukgoncu, S., additional, Sungur, Z., additional, Sivrikoz, N., additional, Ozgen, S.U., additional, Toraman, F., additional, Selvi, O., additional, Senturk, O., additional, Yildiz, M., additional, Kuvaki, B., additional, Gunenc, F., additional, Kucukguclu, S., additional, Ozbilgin, S., additional, Maral, J., additional, Canli, S., additional, Arun, O., additional, Saltali, A., additional, Aydogan, E., additional, Akgun, F.N., additional, Sanlikarip, C., additional, Karaman, F.M., additional, Mazur, A., additional, Vorotyntsev, S., additional, Rousseau, G., additional, Barrett, C., additional, Stancombe, L., additional, Shelley, B., additional, Scholes, H., additional, Limb, J., additional, Rafi, A., additional, Wayman, L., additional, Deane, J., additional, Rogerson, D., additional, Williams, J., additional, Yates, S., additional, Rogers, E., additional, Pulletz, M., additional, Moreton, S., additional, Jones, S., additional, Venkatesh, S., additional, Burton, M., additional, Brown, L., additional, Goodall, C., additional, Rucklidge, M., additional, Fuller, D., additional, Nadolski, M., additional, Kusre, S., additional, Lundberg, M., additional, Everett, L., additional, Nutt, H., additional, Zuleika, M., additional, Carvalho, P., additional, Clements, D., additional, Ben, C.B., additional, Watt, P., additional, Raymode, P., additional, Pearse, R., additional, Mohr, O., additional, Raj, A., additional, Creary, T., additional, Chishti, A., additional, Bell, A., additional, Higham, C., additional, Cain, A., additional, Gibb, S., additional, Mowat, S., additional, Franklin, D., additional, West, C., additional, Minto, G., additional, Boyd, N., additional, Mills, G., additional, Calton, E., additional, Walker, R., additional, Mackenzie, F., additional, Ellison, B., additional, Roberts, H., additional, Chikungwa, M., additional, Jackson, C., additional, Donovan, A., additional, Foot, J., additional, Homan, E., additional, Montgomery, J., additional, Portch, D., additional, Mercer, P., additional, Palmer, J., additional, Paddle, J., additional, Fouracres, A., additional, Datson, A., additional, Andrew, A., additional, Welch, L., additional, Rose, A., additional, Varma, S., additional, Simeson, K., additional, Rambhatla, M., additional, Susarla, J., additional, Marri, S., additional, Kodaganallur, K., additional, Das, A., additional, Algarsamy, S., additional, Colley, J., additional, Davies, S., additional, Szewczyk, M., additional, Smith, T., additional, Ana, F.B., additional, Luzier, E., additional, Almagro, A., additional, Melo, M.V., additional, Fernando, L., additional, Sulemanji, D., additional, Sprung, J., additional, Weingarten, T., additional, Kor, D., additional, Scavonetto, F., additional, and Tze, Y., additional

Published
2019
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24. Bone Remodeling Around Implants with Different Macro-Design Placed in Post-Extraction Sockets: A Cone-Beam Computed Tomography (CBCT) Randomized Controlled Clinical Trial (RCT).

Author

Grassi R, Silva FFVE, Musella G, Pettini F, Camolesi GCV, Coppini M, and Cantore S

Abstract

Background: Immediate post-extraction dental implants are increasingly popular, but ensuring primary stability and managing peri-implant tissues remain challenging. Implant macro-design significantly impacts stability and osseointegration. This study used Cone-beam Computed Tomography (CBCT) to evaluate changes in alveolar bone following immediate placement of two implant designs, System 2P and Dura-Vit 3P, which feature semi-conical microgeometry and apical self-tapping portions for improved stability and bone regeneration. Methods: With a 1:1 allocation ratio, the current investigation was a two-arm parallel group randomized clinical trial. Patients qualified if they required immediate dental replacements with adequate buccal bone support. Two types of implants were placed: System 2P (cylindrical shape) and Dura-Vit 3P (more conical shape, with a particular architecture of threads). Following the intervention, CBCT was performed both immediately (T1) and six months later (T2). Measurements of CBCT horizontal bone level at apical, medial, and bevel height on the palatal/lingual and vestibular sides as well as the buccal vertical gap were the primary results. Complications, implant stability quotient (ISQ), and torque insertion were evaluated. The Mann-Whitney test was used to determine time-based differences within each group, while the Wilcoxon test was used to estimate differences between groups. The impact of baseline marginal gap dimension and gingival biotype was estimated using multiple regressions. Results: Thirty patients were recruited and randomized to treatments, with two lost to follow-up. One System 2P implant failed and two patients of the Dura-Vit 3P group dropped out. At T1, the Dura-Vit 3P group exhibited a lower mean insertion torque and a higher ISQ than the System 2P group. Furthermore, the Dura-Vit 3P group showed lower bone reduction compared to System 2P at horizontal and vertical measurements with significant differences for the vestibular and palatal base and medial level ( p -values < 0.05). Regression models indicated a positive effect of thick biotypes on gap filling and dimensional bone reduction. No complications were observed in both groups. Conclusions: The Dura-Vit 3P implant exhibits high primary stability when inserted in post-extraction sites. Furthermore, this kind of implant stimulates higher bone stability on both the palatal and buccal side when compared to the System 2P implant. The present findings support the evidence that the macro-design of the Dura-Vit 3P implant promotes increased primary stability and reduces bone loss.

Published
2025
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25. Survival of dental implants placed in a postgraduate educational setting: a retrospective cohort study.

Author

Caponio VCA, Sharma A, Musella G, Perrotti V, and Quaranta A

Subjects
Humans, Retrospective Studies, Female, Male, Middle Aged, Adult, Risk Factors, Education, Dental, Graduate, Clinical Competence, Cohort Studies, Aged, Dental Implantation, Endosseous, Proportional Hazards Models, Dental Implants, Dental Restoration Failure statistics & numerical data, Smoking, Periodontitis
Abstract

Introduction: Dental implant treatment can still fail due to various factors. The aim of this retrospective cohort study was to assess the influence of operator experience in a postgraduate educational setting, as well as patient, implant, and surgical risk factors on the incidence of the dental implant failure., Methods: The dental records of 1049 implants with a mean follow-up of 794.70 days were analysed. Variables included operator experience (year of specialty study) and clinic-pathological patients' related variables. Clinic-pathological associations were explored and a Cox regression model accounted for implant survival factors., Results: Multivariate analysis revealed that a history of periodontitis and smoking were the only factors with independent prognostic value, with hazard ratios of 2.0 (95 % CI: 1.0-4.0, p = 0.048) and 1.9 (95 % CI: 1.0-3.6, p = 0.039) respectively. Conversely, despite implant treatment delivered by early career students had a higher failure rate (5.6 %) compared to advanced career students (3.7 %), this difference was statistically significant only in the univariate analysis., Conclusion: Periodontitis and smoking are independent prognostic variables, with career level potentially biasing complex case allocation to advanced students. Targeted educational interventions, including virtual reality and artificial intelligence, should be emphasized in student training. University-based implant trials must consider operator career stage., Clinical Significance: The study underscores the importance of operator experience in dental implant success. It highlights that while clinical experience influences outcomes, factors like a history of periodontitis and smoking are independent predictors of implant failure. These findings emphasize the need for targeted educational interventions to improve clinical training and patient outcomes., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2024. Published by Elsevier Ltd.)

Published
2025
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26. Oral Dysaesthetic and Perceptual Disorder, a Distinct Subset of Chronic Orofacial Pain Without Burning Symptoms: A Case-Control Study.

Author

Musella G, Canfora F, Caponio VCA, Vardas E, Kouri M, Nikitakis N, Troiano G, Aria M, D'Aniello L, Lo Muzio L, Mignogna MD, and Adamo D

Abstract

Background: According to the ICOP 2020, burning mouth syndrome (BMS) is a chronic orofacial pain disorder characterised by an intraoral burning sensation, which represents the main diagnostic criterion. However, some patients experience other symptoms such as xerostomia, taste alterations and globus, without the burning sensation (non-BMS)., Objective: This study aims to explore non-BMS as a distinct subclinical entity by comparing the classical BMS with this new group of patients in a case-control study, addressing gaps in current diagnostic criteria., Methods: 83 non-BMS patients were compared with an equal number of BMS patients matched for age and sex. Data on sociodemographic and risk factors, systemic comorbidities and drug intake, symptom patterns, psychological profiles were collected and statistically analysed., Results: No significant differences between BMS and non-BMS groups were found in sociodemographic characteristics, comorbidities, drug consumption and extraoral symptoms. Both groups reported similar symptoms patterns, with discomfort intensifying in the evening. Although oral symptoms prevalence varied, with the burning sensation exclusive to BMS patients, none of these differences reached statistical significance. Psychological assessments revealed mild depression (17 [14-19] vs. 17 [14-20], p < 0.981), mild to moderate anxiety (18 [15-21] vs. 17 [15-20.5], p < 0.767) and sleep disturbance (5 [4-7] vs. 8 [5-10], p < 0.001) in both groups., Conclusion: Non-BMS patients exhibit similarities to BMS patients yet remain unclassified under current diagnostic criteria. Therefore, we have suggested the term "Oral Dysaesthetic and Perceptual Disorder (ODPD)" to define these patients (non-BMS). This study emphasises the need to expand diagnostic criteria to better identify and manage ODPD patients., (© 2025 The Author(s). Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

Published
2025
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27. Normative percentile values for the TGMD-3 for Italian children aged 3-11+years.

Author

Walters GWM, Cooper S, Carlevaro F, Magno F, Boat R, Vagnetti R, D'Anna C, Musella G, and Magistro D

Abstract

Objectives: Sufficient gross motor skill proficiency is an essential prerequisite for the successful performance of sport-specific skills and physical activities. The Test of Gross Motor Development is the most common tool for assessing motor skills in paediatric populations, however, there is a lack of 'normative' data available against which children's scores can be compared. Normative data would enable the comparison of an individual's motor development to age-standardised norms. The aim of this study was to develop normative data for the Test of Gross Motor Development Third Edition scores for Italian children., Design: The Test of Gross Motor Development Third Edition scores from >17,000 Italian children (aged 3-11+years) were analysed to develop normative scores and percentiles., Methods: Total Test of Gross Motor Development Third Edition scores and locomotor and ball skills subscale scores were split by age and sex. Using the LMS method, based on the Box-Cox transformation, percentiles were calculated for each sex-specific age category., Results: 17,026 children were included in the analysis (n=8262 girls; n=8766 boys)., Conclusions: This is the largest sample ever used to develop normative data for the Test of Gross Motor Development and the first set of normative data for European children. This normative data can be used to identity insufficient motor skill development and aid subsequent modification of activities to nurture sufficient motor skill proficiency. This is particularly important for children in the lower percentiles given the strong associations between early childhood fundamental motor skill competence and physical activity participation in adolescence and adulthood., Competing Interests: Declaration of interest statement The authors have no conflicts of interest to declare., (Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Published
2024
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28. Biomechanical considerations of chemical structure and biosafety of current ceramic biomaterials for dentistry: review and outlook of the current state of the art.

Author

Musella G, Ballini A, Di Cosola M, Motta A, Dai Prà T, Esperouz F, Dioguardi M, Lo Muzio L, Illuzzi G, and Bizzoca ME

Subjects
Humans, Biomechanical Phenomena, Animals, Ceramics chemistry, Biocompatible Materials chemistry, Biocompatible Materials pharmacology, Dental Materials pharmacology, Dental Materials chemistry
Abstract

Biomaterial refers to any material, non-pharmaceutical or combination of substances of synthetic or natural origin used for any period independently or as part of a system for the purpose of healing, assisting the growth or replacement of tissues, organs or functions of the body. It is an unsustainable material that interacts with biological systems. Before being produced a biomaterial goes through a sequence of steps, which includes: 1) the definition of the problem that the material will be called to solve (treatment, replacement of the instrument, aesthetic reasons); 2) design of the device, composition and control of materials (mechanical properties, toxicity, biological response, corrosion resistance, interaction with proteins, cells and tissues), manufacture, sterilization and standardization; 3) control of the device (in experimental animals, in vitro) clinical studies, studies; and 4) monitor its long-term use in vivo, in vitro and in patients. Research for ceramic materials is evolving and because they can be porous or glassy, they find applications in medicine and biotechnology, as they can be used as fillers, covering materials and scaffolds. Therefore, ceramic biomaterials are widely used not only in the field of orthopedic and maxillofacial surgery but also in dentistry as for dental prostheses. Materials monitoring technologies allow us to monitor the three-dimensional development in space, as well as imperfections or micro-cracks in the ceramic.

Published
2024
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29. Therapeutic Potential of Solenopsis invicta Venom: A Scoping Review of Its Bioactive Molecules, Biological Aspects, and Health Applications.

Author

Dioguardi M, Cantore S, Sovereto D, Sanesi L, Martella A, Almasri L, Musella G, Lo Muzio L, and Ballini A

Subjects
Animals, Humans, Antineoplastic Agents pharmacology, Antineoplastic Agents chemistry, Anti-Infective Agents pharmacology, Anti-Infective Agents chemistry, Anti-Inflammatory Agents pharmacology, Anti-Inflammatory Agents chemistry, Anti-Inflammatory Agents therapeutic use, Neoplasms drug therapy, Fire Ants, Ant Venoms chemistry, Ant Venoms pharmacology, Ants
Abstract

Solenopsis invicta, a South American ant species from the Formicidae family (subfamily Myrmicinae), has recently established a stable settlement in Europe, raising public health concerns due to its venomous stings. The venom of S. invicta is rich in bioactive molecules, particularly piperidine alkaloids such as solenopsin A and peptides (Sol 1-4). These compounds have been implicated in various health applications, including antimicrobial, anti-inflammatory, and antitumour activities. While previous reviews have focused on the ecological and allergenic risks posed by S. invicta, this scoping review aims to evaluate the potential therapeutic uses of S. invicta venom by summarizing existing scientific evidence and providing a novel synthesis of recent research on its bioactive components. Furthermore, this study, by describing the unique biological aspects of S. invicta , provides an overview of its direct impact on public health, highlighting new findings on the venom's role in inhibiting bacterial biofilm formation and modulating cancer growth pathways through gene regulation. A search of databases (PubMed, Scopus, Science Direct, and Cochrane Library) identified 12,340 articles, from which 11 studies met the eligibility criteria. These studies included seven microbiological investigations and four studies on tumour cell lines and animal models. The findings suggest that S. invicta venom could inhibit biofilm formation, combat fungal infections, and suppress tumour growth. However, further research, including clinical trials, is required to fully elucidate the safety and efficacy of these bioactive molecules in human medicine, for their potential use in drug discovery to counteract several diseases, including cancer.

Published
2024
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30. Impact of cerebrovascular stroke on inflammatory periodontal indices: a systematic review with meta-analysis and trial sequential analysis of case-control studies.

Author

Dioguardi M, Bizzoca ME, Cantore S, Caloro GA, Musella G, Mastrangelo F, Lo Muzio L, and Ballini A

Abstract

Introduction: Cerebrovascular stroke, a leading cause of global morbidity and mortality, is influenced by several modifiable risk factors such as hypertension, diabetes, and smoking. Emerging evidence highlights the significant role of inflammation in stroke pathogenesis, with conditions like periodontitis potentially exacerbating this risk. The aim of this systematic review was to identify and quantify the real impact of periodontal disease in individuals with cerebral stroke through the analysis of inflammatory periodontal indices., Methods: Following PRISMA guidelines, we conducted a systematic review and meta-analysis of case-control studies assessing periodontal indices in stroke patients. Data sources included PubMed, Scopus, and Cochrane Library, with searches extended to grey literature. The review protocol was registered on PROSPERO (CRD42024529767). Studies were evaluated using the Newcastle-Ottawa Scale to assess risk of bias, and meta-analyses were conducted using Review Manager 5.4 and TSA software., Results: The review included seven case-control studies, comprising 723 stroke patients and 787 controls. Meta-analyses revealed significant differences between stroke and control groups in clinical attachment loss [MD 1.04 mm, 95% CI (0.54, 1.54)], probing pocket depth [MD 0.68 mm, 95% CI (0.31, 10.6)], and radiological bone loss (MD 2.15 mm, 95% CI [-1.58, 5.89]. These findings indicate that stroke patients exhibit worse periodontal health compared to controls, supporting a potential link between periodontal inflammation and stroke., Conclusion: This study confirms the significant impact of periodontal disease on stroke patients and highlights the importance of oral health in preventing adverse cerebrovascular events., Systematic Review Registration: PROSPERO, identifier (CRD42024529767)., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (© 2024 Dioguardi, Bizzoca, Cantore, Caloro, Musella, Mastrangelo, Lo Muzio and Ballini.)

Published
2024
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31. Knowledge, attitude and perception of Italian dental students toward HPV-related oropharyngeal cancer and vaccination: a cross-sectional study.

Author

Musella G, Liguori S, Cantile T, Adamo D, Coppola N, Canfora F, Blasi A, Mignogna M, Amato M, Caponio VCA, Mignogna MD, and Leuci S

Subjects
Humans, Cross-Sectional Studies, Female, Male, Italy, Adult, Attitude of Health Personnel, Vaccination psychology, Surveys and Questionnaires, Young Adult, Students, Dental psychology, Health Knowledge, Attitudes, Practice, Papillomavirus Infections prevention & control, Papillomavirus Infections psychology, Papillomavirus Vaccines therapeutic use, Oropharyngeal Neoplasms virology, Oropharyngeal Neoplasms psychology, Oropharyngeal Neoplasms prevention & control
Abstract

Background: Human papillomavirus (HPV) infection is a leading cause of oropharyngeal squamous cell cancer (OPSCC). This study aimed to carry out a Knowledge, Attitude and Perception survey on HPV infection, HPV+ OPSCC, and HPV vaccination among Italian dental students., Methods: Through an online self-administered questionnaire consisting of 82 questions, data on dental students' sociodemographic characteristics, knowledge, attitudes and perceptions concerning HPV+ OPSCC, infection and vaccination were acquired. A statistical analysis, based on their year of attendance (early career, from 1st to 3rd year vs. late career, from 4th to 6th year) was also conducted., Results: A total of 412 dental students completed the questionnaire. Knowledge of HPV+ OPSCC was reported by 61% of early-career students and 73% of late-career students, with high awareness of the HPV-OPSCC correlation in both groups (85% vs. 89%, respectively). The percentage of correct responses regarding HPV infection knowledge was 61% for early-career and 73% for late-career students, while vaccine knowledge was 70% and 78%, respectively. Over 90% of students acknowledged the dentist's role in educating patients about HPV and OPSCC, and attitudes toward discussing HPV and vaccination were positive. However, only about half would recommend the vaccine to either gender. Statistically significant differences were found between early- and late-career groups across all knowledge sections (p < 0.001), while no significant differences emerged for perception (p = 0.076) or attitude (p = 0.147)., Conclusions: The study reveals encouraging results but highlights significant gaps in dental students' knowledge, perceptions, and attitudes toward HPV+ OPSCC, infection, and vaccination. Addressing these gaps through targeted education and training in dental curricula could improve HPV prevention awareness and patient education, ultimately enhancing public health outcomes., (© 2024. The Author(s).)

Published
2024
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32. Tooth Loss in Periodontitis Patients-A Risk Factor for Mild Cognitive Impairment: A Systematic Review and Meta-Analysis.

Author

Agarwal B, Bizzoca ME, Musella G, De Vito D, Lo Muzio L, Ballini A, Cantore S, and Pisani F

Abstract

Background: Periodontal disease and tooth loss have been long suggested as risk factors of mild cognitive impairment. The underlying mechanisms could be systemic chronic inflammatory mediators, direct pathologic challenge to the nervous system, malnutrition and/or loss of neurosensory stimulation input causing brain atrophy. This review aimed to examine the existing literature studies linking the effect of periodontal disease and tooth loss on the development of mild cognitive impairment., Methods: A systematic review using PEO was conducted. Three electronic databases, namely Embase, Medline and DOSS (UCLan), were searched for relevant articles published up to April 2023. Google Scholar and a hand search were also conducted to ensure no relevant studies had been missed. The Newcastle-Ottawa scale was used to assess the quality of studies., Results: The findings showed that chronic periodontitis and tooth loss, both individually and in combination, led to an increased risk of mild cognitive decline in adults over 50 years. Within the limitations of this review, periodontitis and tooth loss both contribute to an increased risk of mild cognitive impairment and dementia, but the evidence so far is not strong., Conclusions: In future, more robustly designed studies investigating periodontal disease and tooth losslink with cognitive health decline are required with a longer follow-up duration.

Published
2024
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33. The literature discusses oral manifestations caused by sexually transmitted viruses: a narrative review.

Author

Motta A, Musella G, Dai Prà T, Ballini A, Dioguardi M, Bizzoca ME, Lo Muzio L, and Cantore S

Subjects
Humans, Sexually Transmitted Diseases epidemiology, Sexually Transmitted Diseases diagnosis, Mouth Diseases virology, Sexually Transmitted Diseases, Viral
Abstract

This review provides practical recommendations for dental practitioners in dealing with oral lesions associated with sexually transmitted diseases (STDs), offering clinically relevant insights to increase the awareness of these diseases in the mainstream of everyday practice. STDs are acquired through unprotected vaginal, anal or oral sex and are caused by more than 30 different types of bacteria, viruses and protozoa. Saliva, precum, semen, vaginal secretions and menstrual blood could be likely vehicles of infections and defensive barriers to infection by pathogenic microbes could be represented via intact mucosal membrane, the diluent function of saliva, and the antimicrobial action of salivary enzymes that collectively contribute to oral health and protection. STD, can directly and indirectly affect mucous membranes, manifesting with characteristic diagnostic signs and lesions. Given their potential oral manifestations, dental professionals need a comprehensive understanding of STD. The findings of this review lay a foundation for comprehending several STDs, emphasizing the importance of physicians as well dental practitioners being open to discussing sexuality issues with patients and providing appropriate therapeutic interventions.

Published
2024
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34. Cognitive profile in burning mouth syndrome versus mild cognitive impairment: A comparative study.

Author

Femminella GD, Canfora F, Musella G, Di Tella GS, Ugga L, Pecoraro G, Leuci S, Coppola N, De Lucia N, Maldonato NM, Liguori S, Aria M, D'Aniello L, Rengo G, Mignogna MD, and Adamo D

Abstract

Objectives: This study aims to assess and contrast cognitive and psychological aspects of patients with burning mouth syndrome (BMS-MCI) and geriatric patients (G-MCI) with mild cognitive impairment, focusing on potential predictors like pain, mood disorders, blood biomarkers, and age-related white matter changes (ARWMCs)., Methods: The study enrolled 40 BMS-MCI and 40 geriatric G-MCI, matching them by age, gender, and educational background. Participants underwent psychological, sleepiness, and cognitive assessment including the Mini-Mental State Exam (MMSE), Trail Making Test (TMT), Corsi Block-Tapping Task, Rey Auditory Verbal Learning Test, Copying Geometric Drawings Test, Frontal Assessment Battery, and Digit Cancellation Test., Results: G-MCI patients exhibited higher ARWMCs scores in right (p = 0.005**) and left (p < 0.001**) temporal regions, which may relate to specific neurodegenerative processes. Conversely, BMS-MCI patients showed higher levels of depression and anxiety and lower MMSE scores(p < 0.001**), also struggling more with tasks requiring processing speed and executive function, as evidenced by their higher TMT-A scores (p < 0.001**)., Conclusions: The study highlights particular deficits in global cognition and processing speed for BMS-MCI. The influence of educational background, pain levels, cholesterol, sleep disturbances, and anxiety on these cognitive assessments underscores the need for personalized therapeutic strategies addressing both cognitive and emotional aspects of MCI., (© 2024 The Author(s). Oral Diseases published by John Wiley & Sons Ltd.)

Published
2024
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35. European waste management regulations and the transition towards circular economy. A shift-and-share analysis.

Author

Agovino M, Cerciello M, Musella G, and Garofalo A

Subjects
Solid Waste, European Union, Ireland, Refuse Disposal, Waste Management
Abstract

Environmental legislation in the European Union (EU) aims to bolster the transition towards circular economy. However, a recurring limitation in EU regulations, encompassing not only environmental but also economic, social, and demographic aspects, is the lack of consideration for the unique characteristics of individual Member States when establishing common targets. The present work seeks to investigate the impact of EU waste management regulations on the attainment of circular economy objectives, taking into account national-level socio-economic and demographic characteristics. In order to do so, we employ Shift-and-Share Analysis, using data on 28 EU countries between 1995 and 2018. Our findings indicate that some Member States, namely Estonia, Finland, Hungary, Ireland, Italy, Luxembourg and Slovenia, effectively managed to align their regulatory frameworks with EU directives and create a socio-economic context where citizens and governmental bodies foster the necessary levels of cooperation. Cooperation in turn, with widespread pro-environmental attitudes on part of citizens, efficient waste management on part of specialised firms and proper oversight of waste collection activities on part of institutions, facilitated the achievement of significant circular economy goals., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Published
2024
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36. Inadvertent intra-arterial catheterisation using ultrasound guidance and endocavitary electrocardiography in a paediatric patient.

Author

Musella G, Crespi A, Apostolou G, Azzari S, and Ambrosoli AL

Subjects
Humans, Child, Infant, Ultrasonography, Interventional methods, Subclavian Vein diagnostic imaging, Arteries, Electrocardiography, Jugular Veins diagnostic imaging, Catheterization, Central Venous adverse effects, Catheterization, Central Venous methods
Abstract

Venous access in small infants is difficult and central venous catheter placed into the brachiocephalic vein is often the preferred approach. Ultrasound guided vein cannulation is standard practice and endocavitary electrocardiography is a reliable catheter tip location method. We report a not immediately recognised 2 month old case of inadvertent intra-arterial catheterisation with a 3 Fr - 8 cm catheter during right innominate vein cannulation under ultrasound guidance. Endocavitary electrocardiography showed an increased amplitude P wave with a low P/R wave ratio but further insertion of the catheter resulted in a reduction of the P wave amplitude. At ultrasound re-evaluation of the innominate vein, the catheter seemed to be inside the vessel into the proximal part of the vein, but distally appeared to surpass the vein to get into the brachiocephalic artery at the level of the bifurcation of the right common carotid artery and the right subclavian artery. Cardiac ultrasound from the suprasternal notch view identified the catheter into the aortic arch. Contrast-enhanced CT scan with 3D reconstruction confirmed the intra-arterial catheterisation and showed that the innominate vein was shifted and partially compressed but not transfixed by the catheter. The catheter was non-surgically removed uneventfully. During innominate vein cannulation the catheter cannot always be visualised into the distal tract of the vein and the maximal P wave may have a low P/R ratio; a chest X-ray can identify intra-arterial but false negative results are possible. We recommend always using a real time ultrasound tip navigation and location protocol, like the Neo-ECHOTIP protocol, to confirm the correct position of the guidewire and the catheter. If the catheter cannot be identified inside the venous system, we suggest systematically visualising the aortic arch from the suprasternal notch view and the aortic root from the parasternal view to identify arterial malposition., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Published
2024
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37. Supportive care and antiviral treatments in primary herpetic gingivostomatitis: a systematic review.

Author

Coppola N, Cantile T, Adamo D, Canfora F, Baldares S, Riccitiello F, Musella G, Mignogna MDD, and Leuci S

Subjects
Humans, Child, Delayed Diagnosis, Antiviral Agents therapeutic use, Acyclovir therapeutic use, Lidocaine therapeutic use, Randomized Controlled Trials as Topic, Stomatitis, Herpetic diagnosis, Stomatitis, Herpetic drug therapy
Abstract

Objectives: Herpes simplex virus 1 (HSV-1) is the main pathogen responsible for herpes infections. In 13-30% of the cases, primary HSV-1 leads to the primary herpetic gingivostomatitis (PHGS), often a self-limiting infection; however, it can limit the ability to drink/eat with, sometimes, the need for hospitalization. Multiple therapeutic methods have been proposed. This systematic review aims to collect and critically appraise the available evidence about the clinical management of PHGS., Materials and Methods: Literature search including three databases (PubMed, Scopus, Embase), study design, and data analysis were performed following PRISMA guidelines, according to the PICO tool (PROSPERO n° CRD42023391386). Risk of bias was assessed with RoB 2 and ROBINS-I., Results: Five studies on a total of 364 patients (average age: 7.6 years) were identified. The treatment regimens were summarized in acyclovir; acyclovir + honey; fluids and analgesic; maalox + diphenhydramine; lidocaine; chlorhexidine (CHX); CHX + ialuronic acid; CHX + Mucosyte®; antimicrobial photodynamic therapy (aPDT); topical antiviral; topical antiviral + aPDT; and others., Conclusions: Although PHGS is a disease with a high worldwide prevalence, the lack of consensus about therapeutic management indicates gaps in existing evidence. Most of the proposed treatment consists in symptomatic drugs with empiric regimens which are ineffective for the viral replication. The main limit to realize randomized clinical trial is due to the rapid onset and remission of the disease. In fact, the diagnostic delay, estimated in 72 h, decreases the effectiveness of any antiviral drugs., Clinical Relevance: Out of the five studies included in this systematic review, only one was able to provide some weak evidence that ACV is an effective treatment, improving healing of oral lesions and reducing duration of symptoms., (© 2023. The Author(s).)

Published
2023
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38. Safety and effectiveness of prilocaine for spinal anesthesia in day surgery setting: a retrospective study on a sample of 3291 patients.

Author

Ambrosoli AL, Di Carlo S, Crespi A, Severgnini P, Fedele LL, Cofini V, Necozione S, and Musella G

Abstract

Spinal anesthesia is considered safe and reliable for most surgical procedures involving the lower part of the body, but its use in the ambulatory setting requires drugs with rapid onset and regression of the motor and sensory block-like prilocaine.The purpose of this study is to retrospectively analyze data from 3291 procedures recorded in our institutional database, to better define the safety profile of spinal prilocaine and the incidence of complications and side effects.All clinical data, prospectively collected from 2011 to 2019 in an Italian tertiary hospital, of patients treated with spinal anesthesia performed with 40 mg of hyperbaric 2% prilocaine, according to our internal protocol of day surgery, were analyzed.Surgical procedures included saphenectomy (28.5%, n = 937), knee arthroscopy (26.8%, n = 882), proctologic surgery (15.16%, n = 499), and inguinal canal surgery (14.9%, n = 491).Anesthesia-related complication was represented by urinary retention (1.09%, n = 36), lipotimia (0.75%, n = 25), and postoperative nausea (0.33%, n = 11); arrhythmic events were uncommon (0.18%, n = 6). One case of persistent hypotension and 2 cases of persistent hypertension were reported.Persistent motor or sensory block (lasting more than 5 h) was experienced by 7 patients. One patient (0.03%), who underwent knee arthroscopy, experienced pelvic pain lasting for 6 h, compatible with a transient neurological symptom.Proctologic surgery was a factor associated with unplanned admission due to anesthesia-related complications (OR = 4.9; 95% CI: 2-14%).The number of complications related to the method was low as well as the need for hospitalization. This drug is valid and safe for the most performed day surgery procedures; however, further trials are needed to investigate the incidence of complications in the days following the procedure., (© 2023. Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care.)

Published
2023
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39. An After-School Football Session Transiently Improves Cognitive Function in Children.

Author

Magistro D, Cooper SB, Boat R, Carlevaro F, Magno F, Castagno C, Simon M, and Musella G

Subjects
Humans, Child, Memory, Short-Term, Cognition, Schools, Football, Soccer
Abstract

The aim of the present study was to evaluate the effect of a real-world after-school football session on subsequent cognitive function in primary school children. Following ethical approval, 100 children (aged 8−9 year) from the same after-school football club were randomly assigned to either an intervention (60 min football activity) or control (continued to rest) group. Cognitive function (selective visual attention, short term memory and long-term memory) was assessed prior to, immediately following and 45 min following the football session (and at the respective timepoints in the control group). Data were analysed via two-way (group * time) mixed methods ANOVA. The pattern of change in all domains of cognition over time, was different between the football and control groups (group * time, all p < 0.001). Specifically, performance on all cognitive tasks was greater immediately following the football session in the intervention group compared to the control group (selective visual attention, p = 0.003; short-term memory, p = 0.004; long-term memory, p < 0.001). However, there was no difference between the group 45 min following the football session (p = 0.132−0.393). These findings suggest that an after-school football session enhances cognition immediately post-activity in primary school children.

Published
2022
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40. 16 Weeks of Physically Active Mathematics and English Language Lessons Improves Cognitive Function and Gross Motor Skills in Children Aged 8-9 Years.

Author

Boat R, Cooper SB, Carlevaro F, Magno F, Bardaglio G, Musella G, and Magistro D

Subjects
Humans, Child, Problem Solving, Mathematics, Language, Motor Skills, Cognition
Abstract

The aim of the present study was to examine the effects of physically active lessons, implemented through the Mathematics and English Language curriculum, on cognitive function and gross motor skill development. Following ethical approval, 192 children aged 8-9 years were randomly allocated to an intervention group ( n = 98) or a control group ( n = 94). The intervention consisted of 8 h.wk -1 of physically active lessons, equally split between Mathematics and English Language, for 16 weeks. Cognitive function (digit span, coding and arithmetic reasoning) and gross motor skill development (TGMD-3) were assessed at baseline and follow-up. The improvement in every domain of cognitive function was greater in the intervention group compared to the control group (group * time, p = 0.008-0.023, d = 0.34-0.42). Furthermore, total TGMD-3 score (group * time, p < 0.001, d = 1.16) and both sub-scales (locomotor, p < 0.001, d = 0.63; object control, p < 0.001, d = 1.29) also improved by a greater extent in the intervention group than in the control group. These findings suggest that 16 weeks of physically active lessons, taught in both Mathematics and English Language curriculum, synergistically improved cognitive function and gross motor skill development in primary school children aged 8-9 years.

Published
2022
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41. Campania and cancer mortality: An inseparable pair? The role of environmental quality and socio-economic deprivation.

Author

Agovino M, Cerciello M, and Musella G

Subjects
Bayes Theorem, Cities, Humans, Italy epidemiology, Mortality, Socioeconomic Factors, Neoplasms
Abstract

The region of Campania in Southern Italy features high levels of socio-economic deprivation and low levels of environmental quality. A vast strand of the scientific literature has tried to verify whether poor environmental quality and widespread socio-economic deprivation might explain the high cancer mortality rates (CMRs) observed, especially in the municipalities - infamously labelled as the 'Land of Fires' - that were hit most severely by the crisis. While some studies managed to identify links between these two confounding factors and cancer mortality, the evidence is overall mixed. Interesting information may be drawn from the observation of municipal data: in spite of previous claims, some municipalities featuring high environmental quality and low socio-economic deprivation also display high CMRs, while other Campanian municipalities facing disastrous environmental and socio-economic conditions are characterised by low CMRs. These figures, in contrast to common sentiment and previous studies, need to be investigated thoroughly in order to assess the exact role of the confounding factors. In this work, we aim to identify the municipalities where confounding factors act as driving forces in the determination of high CMRs through an original multi-step analysis based on frequentist and Bayesian analysis. Pinpointing these municipalities could allow policymakers to design targeted and effective policy measures aimed at reducing cancer mortality., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Published
2021
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42. Effects of 1 Year of Lifestyle Intervention on Institutionalized Older Adults.

Author

Magistro D, Carlevaro F, Magno F, Simon M, Camp N, Kinrade N, Zecca M, and Musella G

Subjects
Aged, Aged, 80 and over, Exercise, Humans, Italy, Sedentary Behavior, Activities of Daily Living, Life Style
Abstract

The socio-economic and health consequences of our ageing population are well documented, with older adults living in long-term care facilities amongst the frailest possessing specific and significant healthcare and social care needs. These needs may be exacerbated through the sedentary behaviour which is prevalent within care home settings. Reducing sedentary time can reduce the risk of many diseases and improve functional health, implying that improvements in health may be gained by simply helping older adults substitute time spent sitting with time spent standing or in light-intensity ambulation. This study identified the impact of 1 year of lifestyle intervention in a group of older adults living in a long-term care setting in Italy. One hundred and eleven older adults (mean age, 82.37 years; SD = 10.55 years) participated in the study. Sixty-nine older adults were in the intervention group (35 without severe cognitive decline and 34 with dementia) and 42 older adults were in the control group. Data on physical functioning, basic activities of daily living (BADL) and mood were collected 4 times, before, during (every four months) and after the 1 year of intervention. The lifestyle intervention focused on improving the amount of time spent every week in active behaviour and physical activity (minimum 150 min of weekly activities). All participants completed the training program and no adverse events, related to the program, occurred. The intervention group showed steady and significant improvements in physical functioning and a stable situation in BADL and mood following the intervention in older adults with and without dementia, whilst the control group exhibited a significant decline over time. These results suggest that engagement in a physical activity intervention may benefit care home residents with and without dementia both physically and mentally, leading to improved social care and a reduced burden on healthcare services.

Published
2021
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43. Inequality and regressivity in Italian waste taxation. Is there an alternative route?

Author

Agovino M, Marchesano K, and Musella G

Subjects
Italy, Taxes, Waste Management
Abstract

The Italian financing system for waste collection and disposal services, still far from a price-based system at the national level, is similar to a real property tax system. Among other concerns, this raises equity issues. The aim of this paper is threefold. First, the structure of the waste tax in its components (i.e., fixed and variable) is analysed at the provincial level. This allows to investigate the magnitude of the two tax components in Italian provinces, while showing the differences among macro-areas in the financing system for waste collection and disposal services. Second, the regressivity (progressivity) of the tax system adopted is investigated, so as to highlight the differences among geographical areas. Third, an alternative base for the waste tax is proposed, in order to avoid regressivity and achieve higher equality. For these purposes, official data referring to 2017 are used and a Geographically Weighted Regression is implemented. The results highlight the importance of an alternative base of the waste tax to design an equal and non-regressive tax, more similar to a Pay-As-You-Throw scheme., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Published
2021
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44. Psychometric proprieties of the Test of Gross Motor Development-Third Edition in a large sample of Italian children.

Author

Magistro D, Piumatti G, Carlevaro F, Sherar LB, Esliger DW, Bardaglio G, Magno F, Zecca M, and Musella G

Subjects
Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, Italy, Male, Psychometrics, Reproducibility of Results, Translations, Child Development physiology, Locomotion physiology, Motor Skills physiology
Abstract

Objectives: The Test of Gross Motor Development-3 (TGMD-3) evaluates fundamental gross motor skills across two domains: locomotor and ball skills. This study aimed to perform a full psychometric assessment of this test in a large sample of Italian pre- and primary school children., Design: Cross-sectional and test-retest study design., Method: Children N = 5210; mean age years = 8.38, SD = 1.97; % females = 48 completed three trials, including one practice. Only the scores of the two latter 'formal' trials were recorded for the evaluation. Factorial validity and measurement invariance of TGMD-3 across age and gender groups and test-retest reliability for the overtime measure consistency were tested. Item response theory analysis further tested single items' performances., Results: Explorative and confirmatory factor analyses confirmed the two-factor structure of the TGMD-3. Multi-group confirmatory factor analyses indicated that there were no significant reductions in model adjustments between the configural, metric and structural invariance solutions for gender and age groups. Test-retest results ranged between 0.967 and 0.990 for both skill sets across age groups. Item response theory analysis using a graded response model showed low standard error and high-test information levels covering a wide spectrum range of both locomotor and ball skills., Conclusions: These results highlight the strong construct validity and reliability of the TGMD-3 to measure gross motor skills in children across gender and age groups. Item response theory analysis evidenced how the performance criteria included in this test cover a wide range of gross the motor skills spectrum. The use of TGMD-3 may inform motor development programs and support curricular decisions in schools., (Crown Copyright © 2020. Published by Elsevier Ltd. All rights reserved.)

Published
2020
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46. Postoperative analgesia and early functional recovery after day-case anterior cruciate ligament reconstruction: a randomized trial on local anesthetic delivery methods for continuous infusion adductor canal block.

Author

Ambrosoli AL, Guzzetti L, Severgnini P, Fedele LL, Musella G, Crespi A, Novario R, and Cappelleri G

Subjects
Adult, Ambulatory Surgical Procedures, Analgesics, Opioid therapeutic use, Female, Humans, Infusion Pumps, Infusions, Intravenous methods, Male, Prospective Studies, Recovery of Function, Single-Blind Method, Treatment Outcome, Young Adult, Anesthetics, Local administration & dosage, Anterior Cruciate Ligament Reconstruction adverse effects, Arthroscopy adverse effects, Nerve Block methods, Pain, Postoperative drug therapy, Ropivacaine administration & dosage
Abstract

Background: This study assessed the effects of different local anesthetic delivery techniques for continuous adductor canal block, after arthroscopic day-case anterior cruciate ligament reconstruction (ACLR)., Methods: We enrolled 80 patients to randomly receive a ropivacaine 0.2% infusion 6 mL per hour through an adductor canal catheter by an electronic pump as follow: intermittent automatic bolus (intermittent group, N.=40) versus continuous infusion (continuous group, N.=40). Patient controlled bolus was 4 mL, lock out 20 minutes. Primary endpoint was postoperative pain by a numerical rating scale (NRS), secondary endpoints were rescue local anesthetic dose, opioid consumption, and physical performance at 72 h. A P<0.05 was considered significant., Results: No difference was found between the groups in NRS, opioid consumption, and physical performance at 72 h. The intermittent group required significantly less local anesthetic than continuous group throughout the postoperative period; the median [IQR (range)] at 24 h was 149 [140-164 (140-227)] mL in the intermittent group versus 165 [147-210 (140-280)] mL in the continuous group (P=0.004). At 48 h it was 295 [284-310 (280-367)] mL in the intermittent group versus 308 [296-367 (284-500)] mL in the continuous group (P=0.002), while at 72 h it was 432 [426-450 (320-528)] mL in the intermittent group and 452 [436-487 (412-671)] mL in the continuous group respectively (P<0.001)., Conclusions: Intermittent boluses did not provide superior analgesia over continuous infusion for adductor canal block after outpatient ACLR, but significantly decreased the local anesthetic consumption. Both techniques are suitable for the early functional recovery.

Published
2019
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47. Measurement invariance of TGMD-3 in children with and without mental and behavioral disorders.

Author

Magistro D, Piumatti G, Carlevaro F, Sherar LB, Esliger DW, Bardaglio G, Magno F, Zecca M, and Musella G

Subjects
Child, Child, Preschool, Female, Humans, Male, Reproducibility of Results, Child Behavior Disorders diagnosis, Child Development physiology, Mental Disorders diagnosis, Motor Skills physiology, Neuropsychological Tests standards
Abstract

This study evaluated whether the Test of Gross Motor Development 3 (TGMD-3) is a reliable tool to compare children with and without mental and behavioral disorders across gross motor skill domains. A total of 1,075 children (aged 3-11 years), 98 with mental and behavioral disorders and 977 without (typically developing), were included in the analyses. The TGMD-3 evaluates fundamental gross motor skills of children across two domains: locomotor skills and ball skills. Two independent testers simultaneously observed children's performances (agreement over 95%). Each child completed one practice and then two formal trials. Scores were recorded only during the two formal trials. Multigroup confirmatory factor analysis tested the assumption of TGMD-3 measurement invariance across disability groups. According to the magnitude of changes in root mean square error of approximation and comparative fit index between nested models, the assumption of measurement invariance across groups was valid. Loadings of the manifest indicators on locomotor and ball skills were significant (p < .001) in both groups. Item response theory analysis showed good reliability results across locomotor and the ball skills full latent traits. The present study confirmed the factorial structure of TGMD-3 and demonstrated its feasibility across normally developing children and children with mental and behavioral disorders. These findings provide new opportunities for understanding the effect of specific intervention strategies on this population. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Published
2018
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48. Spontaneous patellar fracture in a soccer player occurred 3 years and 3 months after anterior cruciate ligament reconstruction with central third bone-patellar tendon-bone graft.

Author

Salvi AE, Metelli GP, and Musella G

Subjects
Adult, Anterior Cruciate Ligament surgery, Anterior Cruciate Ligament Injuries, Bone Screws, Bone-Patellar Tendon-Bone Grafting, Fracture Fixation, Internal methods, Fractures, Bone surgery, Humans, Male, Patella surgery, Time Factors, Fractures, Bone etiology, Patella injuries, Postoperative Complications, Soccer injuries
Published
2007
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49. Intraoperative fracture of patellar bone plug during anterior cruciate ligament reconstruction with bone-patellar tendon-bone: clinical case.

Author

Salvi AE, Metelli GP, and Musella G

Subjects
Adult, Anterior Cruciate Ligament Injuries, Bone Nails, Fractures, Bone diagnostic imaging, Humans, Imaging, Three-Dimensional, Knee Joint diagnostic imaging, Knee Joint surgery, Male, Patella diagnostic imaging, Radiography, Anterior Cruciate Ligament surgery, Bone-Patellar Tendon-Bone Grafting, Fractures, Bone etiology, Intraoperative Complications, Patella injuries
Abstract

The authors report the case of intraoperative fracture of the patellar bone plug during an operation to reconstruct an anterior cruciate ligament using bone-patellar tendon-bone. This complication, known among the problems of reconstructing the anterior cruciate ligament, is usually reported when using interference screws to block the plug at the femoral level. In the case, we describe the fracture event occurred using cross-pins. The post-operative 3D radiographic reconstruction permitted precise localisation of the position of the detached bone fragment.

Published
2007
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