Full Text Journal Articles by
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Immunomodulators in anesthesia.

Fernanda F Cruz, Patricia R M Rocco, Paolo Pelosi,

<h4>Purpose of review</h4>Anesthetics are known to have immunomodulatory effects. These can be detrimental, inducing immunosuppression and facilitating the development of opportunistic infections, especially when used at high doses, for prolonged periods, or in patients with preexisting immune deficiency; or beneficial, modulating the inflammatory response, particularly in critical illness and systemic ... Read more >>

Curr Opin Anaesthesiol (Current opinion in anaesthesiology)
[2021, 34(3):357-363]

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Characterization of T lymphocytes in severe COVID-19 patients.

Daniela Fenoglio, Chiara Dentone, Alessia Parodi, Antonio Di Biagio, Federica Bozzano, Antonio Vena, Marina Fabbi, Francesca Ferrera, Tiziana Altosole, Bianca Bruzzone, Mauro Giacomini, Paolo Pelosi, Andrea De Maria, Matteo Bassetti, Raffaele De Palma, Gilberto Filaci,

In this observational study, 13 patients with severe COVID-19 and 10 healthy controls were enrolled. The data concerning the analysis of circulating T cells show that, in severe COVID-19 patients, the expansion of these cell compartments is prone to induce antibody response, inflammation (CCR4+ and CCR6+ TFH) and regulation (CD8+ Treg). This pathogenic ... Read more >>

J Med Virol (Journal of medical virology)
[2021, :]

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Early Percutaneous Tracheostomy in the Coronavirus Disease 2019 Era: Shining New Light on Old Questions.

Michael J Brenner, Brendan A McGrath, Paolo Pelosi,

Crit Care Med (Critical care medicine)
[2021, 49(5):e556-e557]

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Lipocalins in arthropod chemical communication.

Jiao Zhu, Alessio Iannucci, Francesca Romana Dani, Wolfgang Knoll, Paolo Pelosi,

Lipocalins represent one of the most successful superfamilies of proteins. Most of them are extracellular carriers for hydrophobic ligands across aqueous media, but other functions have been reported. They are present in most living organisms including bacteria. In animals they have been identified in mammals, molluscs and arthropods; sequences have ... Read more >>

Genome Biol Evol (Genome biology and evolution)
[2021, :]

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Effects of distancing and pattern of breathing on the filtering capability of commercial and custom-made facial masks: An in-vitro study.

Lorenzo Ball, Stefano Alberti, Claudio Belfortini, Chiara Almondo, Chiara Robba, Denise Battaglini, Carlo Cravero, Paolo Pelosi, Valentina Caratto, Maurizio Ferretti,

<h4>Background</h4>Since the beginning of the COVID-19 pandemics, masking policies have been advocated. While masks are known to prevent transmission towards other individuals, it is unclear if different types of facial masks can protect the user from inhalation. The present study compares in-vitro different commercial and custom-made facial masks at different ... Read more >>

PLoS One (PloS one)
[2021, 16(4):e0250432]

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Safety profile of enhanced thromboprophylaxis strategies for critically ill COVID-19 patients during the first wave of the pandemic: observational report from 28 European intensive care units.

Andrea Lavinio, Ari Ercole, Denise Battaglini, Sandra Magnoni, Rafael Badenes, Fabio Silvio Taccone, Raimund Helbok, William Thomas, Paolo Pelosi, Chiara Robba, ,

<h4>Introduction</h4>Critical illness from SARS-CoV-2 infection (COVID-19) is associated with a high burden of pulmonary embolism (PE) and thromboembolic events despite standard thromboprophylaxis. Available guidance is discordant, ranging from standard care to the use of therapeutic anticoagulation for enhanced thromboprophylaxis (ET). Local ET protocols have been empirically determined and are generally ... Read more >>

Crit Care (Critical care (London, England))
[2021, 25(1):155]

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Keeping an Open Mind: Tracheostomy for Patients With Coronavirus Disease 2019.

Brendan A McGrath, Paolo Pelosi, Michael J Brenner,

Anesth Analg (Anesthesia and analgesia)
[2021, 132(5):e90-e92]

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Bronchoalveolar lavage fluid characteristics and outcomes of invasively mechanically ventilated patients with COVID-19 pneumonia in Genoa, Italy.

Chiara Dentone, Antonio Vena, Maurizio Loconte, Federica Grillo, Iole Brunetti, Emanuela Barisione, Elisabetta Tedone, Sara Mora, Antonio Di Biagio, Andrea Orsi, Andrea De Maria, Laura Nicolini, Lorenzo Ball, Daniele Roberto Giacobbe, Laura Magnasco, Emanuele Delfino, Luca Mastracci, Rosa Mangerini, Lucia Taramasso, Chiara Sepulcri, Rachele Pincino, Martina Bavastro, Matteo Cerchiaro, Malgorzata Mikulska, Bianca Bruzzone, Giancarlo Icardi, Paolo Frisoni, Angelo Gratarola, Nicolò Patroniti, Paolo Pelosi, Matteo Bassetti,

<h4>Background</h4>The primary objective of the study is to describe the cellular characteristics of bronchoalveolar lavage fluid (BALF) of COVID-19 patients requiring invasive mechanical ventilation; the secondary outcome is to describe BALF findings between survivors vs non-survivors.<h4>Materials and methods</h4>Patients positive for SARS-CoV-2 RT PCR, admitted to ICU between March and April ... Read more >>

BMC Infect Dis (BMC infectious diseases)
[2021, 21(1):353]

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Extensive activation, tissue trafficking, turnover and functional impairment of NK cells in COVID-19 patients at disease onset associates with subsequent disease severity.

Federica Bozzano, Chiara Dentone, Carola Perrone, Antonio Di Biagio, Daniela Fenoglio, Alessia Parodi, Malgorzata Mikulska, Bianca Bruzzone, Daniele Roberto Giacobbe, Antonio Vena, Lucia Taramasso, Laura Nicolini, Nicolò Patroniti, Paolo Pelosi, Angelo Gratarola, Raffaele De Palma, Gilberto Filaci, Matteo Bassetti, Andrea De Maria, ,

The SARS-CoV-2 infection causes severe respiratory involvement (COVID-19) in 5-20% of patients through initial immune derangement, followed by intense cytokine production and vascular leakage. Evidence of immune involvement point to the participation of T, B, and NK cells in the lack of control of virus replication leading to COVID-19. NK ... Read more >>

PLoS Pathog (PLoS pathogens)
[2021, 17(4):e1009448]

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Ten things you need to know about intensive care unit management of mechanically ventilated patients with COVID-19.

Chiara Robba, Denise Battaglini, Lorenzo Ball, Paolo Pelosi, Patricia R M Rocco,

<b>Introduction:</b> The ongoing pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has posed important challenges for clinicians and health-care systems worldwide.<b>Areas covered:</b> The aim of this manuscript is to provide brief guidance for intensive care unit management of mechanically ventilated patients with COVID-19 based on the literature and our ... Read more >>

Expert Rev Respir Med (Expert review of respiratory medicine)
[2021, :1-10]

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Individualized versus Fixed Positive End-expiratory Pressure for Intraoperative Mechanical Ventilation in Obese Patients: A Secondary Analysis.

Philipp Simon, Felix Girrbach, David Petroff, Nadja Schliewe, Gunther Hempel, Mirko Lange, Thomas Bluth, Marcelo Gama de Abreu, Alessandro Beda, Marcus J Schultz, Paolo Pelosi, Andreas W Reske, Hermann Wrigge, ,

<h4>Background</h4>General anesthesia may cause atelectasis and deterioration in oxygenation in obese patients. The authors hypothesized that individualized positive end-expiratory pressure (PEEP) improves intraoperative oxygenation and ventilation distribution compared to fixed PEEP.<h4>Methods</h4>This secondary analysis included all obese patients recruited at University Hospital of Leipzig from the multicenter Protective Intraoperative Ventilation with ... Read more >>

Anesthesiology (Anesthesiology)
[2021, :]

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Early effects of ventilatory rescue therapies on systemic and cerebral oxygenation in mechanically ventilated COVID-19 patients with acute respiratory distress syndrome: a prospective observational study.

Chiara Robba, Lorenzo Ball, Denise Battaglini, Danilo Cardim, Emanuela Moncalvo, Iole Brunetti, Matteo Bassetti, Daniele R Giacobbe, Antonio Vena, Nicolò Patroniti, Patricia R M Rocco, Basil F Matta, Paolo Pelosi, ,

<h4>Background</h4>In COVID-19 patients with acute respiratory distress syndrome (ARDS), the effectiveness of ventilatory rescue strategies remains uncertain, with controversial efficacy on systemic oxygenation and no data available regarding cerebral oxygenation and hemodynamics.<h4>Methods</h4>This is a prospective observational study conducted at San Martino Policlinico Hospital, Genoa, Italy. We included adult COVID-19 patients ... Read more >>

Crit Care (Critical care (London, England))
[2021, 25(1):111]

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International multicentre observational study to evaluate the association between perioperative red blood cell transfusions and 1-year mortality after major cancer surgery (ARCA-1): study design, statistical analysis plan and study protocol.

Juan Cata, Maria Ramirez, Patrice Forget, Lee-Lynn Chen, Oscar Diaz-Cambronero, Wankun Chen, Matthew A Warner, Adriana Knopfelmacher Couchonal, Paolo Pelosi, Luis Cuellar, German Corrales, Carlos Romero, Francisco Lobo, Leif Saager, Jorge Castro Tapia, Roy Kiberenge, Lei Feng, Ary Serpa Neto,

<h4>Introduction</h4>Blood transfusion is still common in patients undergoing major cancer surgery. Blood transfusion can be associated with poor prognosis in patients with cancer. Perioperative Care in the Cancer Patient -1 (ARCA-1) aims to assess in a large cohort of patients the current incidence, pattern of practice and associations between perioperative ... Read more >>

BMJ Open (BMJ open)
[2021, 11(3):e043453]

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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.

Guido Mazzinari, Ary Serpa Neto, Sabrine N T Hemmes, Goran Hedenstierna, Samir Jaber, Michael Hiesmayr, Markus W Hollmann, Gary H Mills, 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, , , ,

<h4>Background</h4>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 (ΔP<sub>TW</sub>) with PPCs. We also tested the association of ΔP<sub>TW</sub> with ... Read more >>

BMC Anesthesiol (BMC anesthesiology)
[2021, 21(1):84]

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Expert consensus statements for the management of COVID-19-related acute respiratory failure using a Delphi method.

Prashant Nasa, Elie Azoulay, Ashish K Khanna, Ravi Jain, Sachin Gupta, Yash Javeri, Deven Juneja, Pradeep Rangappa, Krishnaswamy Sundararajan, Waleed Alhazzani, Massimo Antonelli, Yaseen M Arabi, Jan Bakker, Laurent J Brochard, Adam M Deane, Bin Du, Sharon Einav, Andrés Esteban, Ognjen Gajic, Samuel M Galvagno, Claude Guérin, Samir Jaber, Gopi C Khilnani, Younsuck Koh, Jean-Baptiste Lascarrou, Flavia R Machado, Manu L N G Malbrain, Jordi Mancebo, Michael T McCurdy, Brendan A McGrath, Sangeeta Mehta, Armand Mekontso-Dessap, Mervyn Mer, Michael Nurok, Pauline K Park, Paolo Pelosi, John V Peter, Jason Phua, David V Pilcher, Lise Piquilloud, Peter Schellongowski, Marcus J Schultz, Manu Shankar-Hari, Suveer Singh, Massimiliano Sorbello, Ravindranath Tiruvoipati, Andrew A Udy, Tobias Welte, Sheila N Myatra,

<h4>Background</h4>Coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented pressure on healthcare system globally. Lack of high-quality evidence on the respiratory management of COVID-19-related acute respiratory failure (C-ARF) has resulted in wide variation in clinical practice.<h4>Methods</h4>Using a Delphi process, an international panel of 39 experts developed clinical practice statements on the ... Read more >>

Crit Care (Critical care (London, England))
[2021, 25(1):106]

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Ventilator Weaning and Discontinuation Practices for Critically Ill Patients.

Karen E A Burns, Leena Rizvi, Deborah J Cook, Gerald Lebovic, Peter Dodek, Jesús Villar, Arthur S Slutsky, Andrew Jones, Farhad N Kapadia, David J Gattas, Scott K Epstein, Paolo Pelosi, Kallirroi Kefala, Maureen O Meade, ,

<h4>Importance</h4>Although most critically ill patients receive invasive mechanical ventilation (IMV), few studies have characterized how IMV is discontinued in practice.<h4>Objective</h4>To describe practice variation in IMV discontinuation internationally, associations between initial discontinuation events and outcomes, and factors associated with the use of select discontinuation strategies and failed initial spontaneous breathing trials ... Read more >>

JAMA (JAMA)
[2021, 325(12):1173-1184]

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Evolution Over Time of Ventilatory Management and Outcome of Patients With Neurologic Disease.

Eva E Tejerina, Paolo Pelosi, Chiara Robba, Oscar Peñuelas, Alfonso Muriel, Deisy Barrios, Fernando Frutos-Vivar, Konstantinos Raymondos, Bin Du, Arnaud W Thille, Fernando Ríos, Marco González, Lorenzo Del-Sorbo, Maria Del Carmen Marín, Bruno Valle Pinheiro, Marco Antonio Soares, Nicolas Nin, Salvatore M Maggiore, Andrew Bersten, Pravin Amin, Nahit Cakar, Gee Young Suh, Fekri Abroug, Manuel Jibaja, Dimitros Matamis, Amine Ali Zeggwagh, Yuda Sutherasan, Antonio Anzueto, Andrés Esteban, ,

<h4>Objectives</h4>To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality.<h4>Design</h4>Secondary analysis of three prospective, observational, multicenter studies.<h4>Setting</h4>Cohort studies conducted in 2004, 2010, and 2016.<h4>Patients</h4>Adult patients who received mechanical ventilation for more than 12 hours.<h4>Interventions</h4>None.<h4>Measurements ... Read more >>

Crit Care Med (Critical care medicine)
[2021, :]

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Computed tomography assessment of PEEP-induced alveolar recruitment in patients with severe COVID-19 pneumonia.

Lorenzo Ball, Chiara Robba, Lorenzo Maiello, Jacob Herrmann, Sarah E Gerard, Yi Xin, Denise Battaglini, Iole Brunetti, Giuseppe Minetti, Sara Seitun, Antonio Vena, Daniele Roberto Giacobbe, Matteo Bassetti, Patricia R M Rocco, Maurizio Cereda, Lucio Castellan, Nicolò Patroniti, Paolo Pelosi, ,

<h4>Background</h4>There is a paucity of data concerning the optimal ventilator management in patients with COVID-19 pneumonia; particularly, the optimal levels of positive-end expiratory pressure (PEEP) are unknown. We aimed to investigate the effects of two levels of PEEP on alveolar recruitment in critically ill patients with severe COVID-19 pneumonia.<h4>Methods</h4>A single-center ... Read more >>

Crit Care (Critical care (London, England))
[2021, 25(1):81]

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Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients From 29 Countries.

Vincenzo Russotto, Sheila Nainan Myatra, John G Laffey, Elena Tassistro, Laura Antolini, Philippe Bauer, Jean Baptiste Lascarrou, Konstanty Szuldrzynski, Luigi Camporota, Paolo Pelosi, Massimiliano Sorbello, Andy Higgs, Robert Greif, Christian Putensen, Christina Agvald-Öhman, Athanasios Chalkias, Kristaps Bokums, David Brewster, Emanuela Rossi, Roberto Fumagalli, Antonio Pesenti, Giuseppe Foti, Giacomo Bellani, ,

<h4>Importance</h4>Tracheal intubation is one of the most commonly performed and high-risk interventions in critically ill patients. Limited information is available on adverse peri-intubation events.<h4>Objective</h4>To evaluate the incidence and nature of adverse peri-intubation events and to assess current practice of intubation in critically ill patients.<h4>Design, setting, and participants</h4>The International Observational Study ... Read more >>

JAMA (JAMA)
[2021, 325(12):1164-1172]

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Ten golden rules for individualized mechanical ventilation in acute respiratory distress syndrome

Denise Battaglini, Marco Sottano, Lorenzo Ball, Chiara Robba, Patricia R.M. Rocco, Paolo Pelosi,

Considerable progress has been made over the last decades in the management of acute respiratory distress syndrome (ARDS). Mechanical ventilation(MV) remains the cornerstone of supportive therapy for ARDS. Lung-protective MV minimizes the risk of ventilator-induced lung injury (VILI) and improves survival. Several parameters contribute to the risk of VILI and ... Read more >>

(Journal of Intensive Medicine)
[2021, :]

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Novel Synthetic and Natural Therapies for Traumatic Brain Injury.

Denise Battaglini, Dorota Siwicka-Gieroba, Patricia Rm Rocco, Fernanda Ferreira Cruz, Pedro Leme Silva, Wojciech Dabrowski, Iole Brunetti, Nicolò Patroniti, Paolo Pelosi, Chiara Robba,

Traumatic brain injury (TBI) is a major cause of disability and death worldwide. The initial mechanical insult results in tissue and vascular disruption with hemorrhages and cellular necrosis that is followed by a dynamic secondary brain damage that presumably results in additional destruction of the brain. In order to minimize ... Read more >>

Curr Neuropharmacol (Current neuropharmacology)
[2021, :]

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Molecular Epidemiological Investigation of a Nosocomial Cluster of C. auris: Evidence of Recent Emergence in Italy and Ease of Transmission during the COVID-19 Pandemic.

Vincenzo Di Pilato, Giulia Codda, Lorenzo Ball, Daniele Roberto Giacobbe, Edward Willison, Malgorzata Mikulska, Laura Magnasco, Francesca Crea, Antonio Vena, Paolo Pelosi, Matteo Bassetti, Anna Marchese,

<i>Candida auris</i> is an emerging MDR pathogen raising major concerns worldwide. In Italy, it was first and only identified in July 2019 in our hospital (San Martino Hospital, Genoa), where infection or colonization cases have been increasingly recognized during the following months. To gain insights into the introduction, transmission dynamics, ... Read more >>

J Fungi (Basel) (Journal of fungi (Basel, Switzerland))
[2021, 7(2):]

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Impact of positive biphasic pressure during low and high inspiratory efforts in Pseudomonas aeruginosa-induced pneumonia.

Daniela G da Cruz, Raquel F de Magalhães, Gisele A Padilha, Mariana C da Silva, Cassia L Braga, Adriana R Silva, Cassiano F Gonçalves de Albuquerque, Vera L Capelozzi, Cynthia S Samary, Paolo Pelosi, Patricia R M Rocco, Pedro L Silva,

<h4>Background</h4>During pneumonia, normal alveolar areas coexist adjacently with consolidated areas, and high inspiratory efforts may predispose to lung damage. To date, no study has evaluated different degrees of effort during Biphasic positive airway pressure (BIVENT) on lung and diaphragm damage in experimental pneumonia, though largely used in clinical setting. We ... Read more >>

PLoS One (PloS one)
[2021, 16(2):e0246891]

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Use of Neuromuscular Blocking Agents in Mechanically Ventilated Patients with COVID-19: A Propensity Score Analysis

Gianluigi Li Bassi, Kristen Gibbons, Jacky Suen, Heidi Dalton, Nicole White, Amanda Corley, Samuel Hinton, Simon Forsyth, John Laffey, Daniel Brodie, Aidan Burrell, Eddy Fan, Robert Bartlett, Antoni Torres, Davide Chiumello, Alyaa Elhazmi, Carol Hodgson, Shingo Ichiba, Carlos Luna, Srinivas Murthy, Alistair Nichol, Pauline Yeung Ng, Mark Ogino, Mauro Panigada, Antonio Pesenti, John Fraser,

Background: Neuromuscular blocking agents (NMBA) have been previously used in patients with acute respiratory distress syndrome (ARDS). It is unknown if NMBA are useful in COVID-19 patients who require invasive mechanical ventilation (IMV). Methods: We investigated use of NMBA in COVID-19 patients on IMV from&amp;nbsp;February 1 to November&amp;nbsp;24, 2020, in ... Read more >>

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Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study.

Sunny G Nijbroek, Liselotte Hol, Pien Swart, Sabrine N T Hemmes, Ary Serpa Neto, Jan M Binnekade, Goran Hedenstierna, Samir Jaber, Michael Hiesmayr, Markus W Hollmann, Gary H Mills, Marcos F Vidal Melo, Christian Putensen, Werner Schmid, Paolo Severgnini, Hermann Wrigge, Marcelo Gama de Abreu, Paolo Pelosi, Marcus J Schultz, ,

<h4>Background</h4>One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.<h4>Objectives</h4>The aim of this study was to determine whether a sex difference in use of LTVV also ... Read more >>

Eur J Anaesthesiol (European journal of anaesthesiology)
[2021, :]

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