0000000000076210
AUTHOR
Giacomo Bellani
showing 30 related works from this author
Albumin replacement therapy in immunocompromised patients with sepsis - Secondary analysis of the ALBIOS trial
2021
Abstract Background The best fluid replacement strategy and the role of albumin in immunocompromised patients with sepsis is unclear. Methods We performed a secondary analysis of immunocompromised patients enrolled in the ALBIOS trial which randomized patients with severe sepsis or septic shock to receive either 20% albumin (target 30 g per liter or more) and crystalloid or crystalloid alone during ICU stay. Results Of 1818 patients originally enrolled, 304 (16.4%) were immunocompromised. One-hundred-thirty-nine (45.7%) patients were randomized in the albumin while 165 (54.2%) in the crystalloid group. At 90 days, 69 (49.6%) in the albumin group and 89 (53.9%) in the crystalloids group died…
Geo-economic variations in epidemiology, patterns of care, and outcomes in patients with acute respiratory distress syndrome: insights from the LUNG …
2017
Background Little information is available about the geo-economic variations in demographics, management, and outcomes of patients with acute respiratory distress syndrome (ARDS). We aimed to characterise the effect of these geo-economic variations in patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE). Methods LUNG SAFE was done during 4 consecutive weeks in winter, 2014, in a convenience sample of 459 intensive-care units in 50 countries across six continents. Inclusion criteria were admission to a participating intensive-care unit (including transfers) within the enrolment window and receipt of invasive or non…
Outcome of acute hypoxaemic respiratory failure: insights from the LUNG SAFE Study
2020
BackgroundCurrent incidence and outcome of patients with acute hypoxaemic respiratory failure requiring mechanical ventilation in the intensive care unit (ICU) are unknown, especially for patients not meeting criteria for acute respiratory distress syndrome (ARDS).MethodsAn international, multicentre, prospective cohort study of patients presenting with hypoxaemia early in the course of mechanical ventilation, conducted during four consecutive weeks in the winter of 2014 in 459 ICUs from 50 countries (LUNG SAFE). Patients were enrolled with arterial oxygen tension/inspiratory oxygen fraction ratio ≤300 mmHg, new pulmonary infiltrates and need for mechanical ventilation with a positive end-e…
Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome: Insights from the LUNG SAFE study
2020
Abstract Background Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence o…
Impact of Early Acute Kidney Injury on Management and Outcome in Patients With Acute Respiratory Distress Syndrome: A Secondary Analysis of a Multice…
2019
Contains fulltext : 208648.pdf (Publisher’s version ) (Closed access) OBJECTIVES: To understand the impact of mild-moderate and severe acute kidney injury in patients with acute respiratory distress syndrome. DESIGN: Secondary analysis of the "Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure", an international prospective cohort study of patients with severe respiratory failure. SETTING: Four-hundred fifty-nine ICUs from 50 countries across five continents. SUBJECTS: Patients with a glomerular filtration rate greater than 60 mL/min/1.73 m prior to admission who fulfilled criteria of acute respiratory distress syndrome on day 1 and day 2 of acute …
Higher levels of IgA and IgG at sepsis onset are associated with higher mortality: results from the Albumin Italian Outcome Sepsis (ALBIOS) trial
2021
Abstract Background The role of intravenous immunoglobulins (IVIG) during sepsis is controversial, as different trials on IVIG have observed inconsistent survival benefits. We aimed to elucidate the possible association and clinical significance between circulating levels of immunoglobulins. Methods In a subset of 956 patients with severe sepsis and septic shock of the multicentre, open-label RCT ALBIOS, venous blood samples were serially collected 1, 2, and 7 days after enrolment (or at ICU discharge, whichever came first). IgA, IgG and IgM concentrations were assayed in all patients on day 1 and in a subgroup of 150 patients on days 2 and 7. Ig concentrations were measured employing a tur…
Additional file 12: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
Table S8. Patientsâ characteristics and clinical endpoints of immunocompromised (study) patients, according to the cause of immunosuppression (known, unknown). (PDF 79Â kb)
Additional file 1: of Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 count…
2018
Table S1. Additional baseline characteristics in patients with tracheostomy and no tracheostomy (n = 2377). BMI, body mass index; ICU, intensive care unit; ER, emergency room; COPD, chronic obstructive pulmonary disease; NYHA, New York heart association; AHRF, Acute hypoxemic respiratory failure; ARDS, acute respiratory distress syndrome; TRALI, transfusion-related acute lung injury; A/C, assist control; PC, pressure control; BIPAP, bilevel positive airway pressure APRV, airway pressure release ventilation; SIMV, synchronized intermittent mandatory ventilation, PRVC, pressure-regulated volume control; PSV, pressure support ventilation; HFO, high-frequency oscillation; CPAP, continuous posit…
Additional file 11: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
Table S7. Patient characteristics and clinical endpoints of immunocompetent patients, according to the type of ventilatory support. (PDF 88Â kb)
Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute resp…
2022
Contains fulltext : 252214.pdf (Publisher’s version ) (Open Access) BACKGROUND: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. METHODS: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to defi…
Additional file 8: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
Figure S2. This figure shows a Kaplan-Meier curve for hospital survival of immunocompromised patients according to the ventilation subgroup. This figure shows a Kaplan-Meier curve for hospital survival of immunocompromised patients according to the ventilation subgroup. Mortality is defined as mortality at hospital discharge or at 90Â days after onset of acute hypoxemic respiratory failure, whichever event occurred first. We assumed that patients discharged alive from the hospital before 90Â days were alive on day 90. Type of ventilator support: IMV Patients invasively ventilated from day 1, independently of the type of support received after the eventual extubation; NIV Patients treated ex…
Additional file 4: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
Table S3. Ventilator settings during the first day of ARDS in the immunocompetent (Control) and immunocompromised (Study) groups. This table shows ventilator settings during the first day of ARDS in the immunocompetent (Control) and immunocompromised (Study) groups. (PDF 50Â kb)
Additional file 1 of Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome: insights from the LUNG SAFE study
2020
Additional file 1. Online Methodology and eTables. Expanded Methods and Materials. eTable 1: Comorbidities and risk factors in study population (n = 2005), stratified by arterial oxygenation on day 1. eTable 2. Characteristics of patients with sustained normoxemia and sustained hyperoxemia. eTable 3: Characteristics at ARDS onset and clinical outcomes in matched sample (n = 354) of patients with sustained normoxemia and with sustained hyperoxemia. eTable 4. Characteristics at ARDS onset and clinical outcomes in matched sample (n = 646) of patients with normoxemia and with excess oxygen use at day 1.
Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE)
2023
Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventila…
Additional file 2: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
Table S1. Patient characteristics of immunocompromised patients according to the type of ventilator support. This table shows patient characteristics, including comorbidities, ARDS risk factors, and illness severity at ARDS onset of immunocompromised patients according to the type of ventilator support. (PDF 74Â kb)
Additional file 1 of Higher levels of IgA and IgG at sepsis onset are associated with higher mortality: results from the Albumin Italian Outcome Seps…
2021
Additional file 1: Table S1. Patient characteristics by IgA groups. Table S2. Patient characteristics by IgG groups.Table S3. Patient characteristics by IgM groups.Table S4. Plasma concentrations of IgA, IgG & IgM on day 1, 2 & 7 by day 1 levels.Table S5. Patient characteristics by 90-day survival.
Immunocompromised patients with acute respiratory distress syndrome: Secondary analysis of the LUNG SAFE database
2018
Background: The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients. Methods: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents. Results: Of 2813 patients with ARDS, 584 (20.8%) were immunocompromised, 38.9% of whom had an unspecified cause. Pneumonia, nonpulmonary sepsis, and noncardiog…
Validation and utility of ARDS subphenotypes identified by machine-learning models using clinical data: an observational, multicohort, retrospective …
2022
Item does not contain fulltext BACKGROUND: Two acute respiratory distress syndrome (ARDS) subphenotypes (hyperinflammatory and hypoinflammatory) with distinct clinical and biological features and differential treatment responses have been identified using latent class analysis (LCA) in seven individual cohorts. To facilitate bedside identification of subphenotypes, clinical classifier models using readily available clinical variables have been described in four randomised controlled trials. We aimed to assess the performance of these models in observational cohorts of ARDS. METHODS: In this observational, multicohort, retrospective study, we validated two machine-learning clinical classifie…
Additional file 6: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
Table S6. Ventilator settings during the first day of ARDS in immunocompetent (Control) and immunocompromised (Study) patients, stratified by the type of ventilatory support (IMV, NIV, NIV failure). (PDF 60Â kb)
Noninvasive Ventilation of Patients with Acute Respiratory Distress Syndrome: Insights from the LUNG SAFE Study
2016
Rationale: Noninvasive ventilation (NIV) is increasingly used in patients with acute respiratory distress syndrome (ARDS). The evidence supporting NIV use in patients with ARDS remains relatively sparse.Objectives: To determine whether, during NIV, the categorization of ARDS severity based on the PaO2/FiO2 Berlin criteria is useful.Methods: The LUNG SAFE (Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure) study described the management of patients with ARDS. This substudy examines the current practice of NIV use in ARDS, the utility of the PaO2/FiO2 ratio in classifying patients receiving NIV, and the impact of NIV on outcome.Measurements and Main…
Mechanical ventilation in patients with cardiogenic pulmonary edema: a sub-analysis of the LUNG SAFE study
2022
Supported by Centro de Investigación Biomédica en Red (CIBER)‑Enfermedades respiratorias, Madrid, Spain (CB17/06/00021) and Fundación para el Fomento en Asturias de la Investigación Científica aplicada y la tecnología (FICYT, AYUD2021/52014). RRG is the recipient of a grant from Instituto de Salud Carlos III, Madrid, Spain (CM20/00083).
Additional file 1: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
List of LUNG SAFE investigators. Names and affiliations of the LUNG SAFE investigators. (PDF 172Â kb)
Additional file 7: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
Figure S1. Kaplan-Meier curve for hospital survival in immunocompromised patients according to ARDS severity. Kaplan-Meier curve for hospital survival in immunocompromised patients according to ARDS severity. Mortality is defined as mortality at hospital discharge or at 90Â days after onset of acute hypoxemic respiratory failure, whichever event occurred first. We assumed that patients discharged alive from the hospital before 90Â days were alive on day 90. Severity of ARDS was evaluated at the day of onset according to the Berlin definition. Note: The number of patients reported in the bottom of figure is referred to as the end of the corresponding day. (PDF 402Â kb)
Additional file 3: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
Table S2. Factors associated with the use of noninvasive ventilation. Multivariate logistic regression model describing the factors associated with the use of noninvasive ventilation. (PDF 49Â kb)
Additional file 10: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
Table S9. The most important factors leading to death in the ICU in immunocompetent and immunocompromised patients. (PDF 44Â kb)
Additional file 5: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
Table S4. Adjunctive measures/therapies during at least one day during follow-up in immunocompetent and immunocompromised patients. This table shows the proportions of adjunctive measures/therapies during at least one day during follow-up in immunocompetent and immunocompromised patients. (PDF 97Â kb)
Outcomes of Patients Presenting with Mild Acute Respiratory Distress Syndrome: Insights from the LUNG SAFE Study
2019
Editor's Perspective What We Already Know about This Topic Hospital mortality in acute respiratory distress syndrome is approximately 40%, but mortality and trajectory in "mild" acute respiratory distress syndrome (classified only since 2012) are unknown, and many cases are not detected What This Article Tells Us That Is New Approximately 80% of cases of mild acute respiratory distress syndrome persist or worsen in the first week; in all cases, the mortality is substantial (30%) and is higher (37%) in those in whom the acute respiratory distress syndrome progresses Background: Patients with initial mild acute respiratory distress syndrome are often underrecognized and mistakenly considered …
Additional file 1 of Death in hospital following ICU discharge: insights from the LUNG SAFE study
2021
Additional file 1. Supplemental Results.
Additional file 9: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
Table S5. Factors associated with hospital mortality in immunocompromised patients. Multivariate logistic regression model describing the factors associated with hospital mortality in immunocompromised patients. (PDF 49Â kb)
Additional file 2: of Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 count…
2018
Table S2 compares outcomes between early (within 7 days of ICU admission) and late (8 days and later) thoracotomy (n = 280). SD, standard deviation; ICU, intensive care unit; Q1–Q3; 25%–75% interquartile. Missing data: days of mechanical ventilation = 37; days of mechanical ventilation in patient alive at hospital discharge (90 days) = 139; length of ICU stay in patient alive at ICU discharge (90 days) = 58; length of hospital stay = 19; length of hospital stay in patient alive at ICU discharge (90 days) = 87; ICU, 28-day, 60-day, and 90-day mortality = 1. Participants were adult patients (≥ 18 years) with severe or moderate ARDS who received mechanical ventilation and had tracheostomy. Par…