0000000000163033

AUTHOR

Riccardo Ragazzi

showing 5 related works from this author

Postoperative continuous positive airway pressure to prevent pneumonia, re-intubation, and death after major abdominal surgery (PRISM): a multicentre…

2021

BackgroundRespiratory complications are an important cause of postoperative morbidity. We aimed to investigate whether continuous positive airway pressure (CPAP) administered immediately after major abdominal surgery could prevent postoperative morbidity.MethodsPRISM was an open-label, randomised, phase 3 trial done at 70 hospitals across six countries. Patients aged 50 years or older who were undergoing elective major open abdominal surgery were randomly assigned (1:1) to receive CPAP within 4 h of the end of surgery or usual postoperative care. Patients were randomly assigned using a computer-generated minimisation algorithm with inbuilt concealment. The primary outcome was a composite of…

Pulmonary and Respiratory Medicinemedicine.medical_treatmentPopulationNO03 medical and health sciences0302 clinical medicineCPAPAbdomenSettore MED/41 - ANESTESIOLOGIAIntubation IntratrachealmedicineHumansIntubation030212 general & internal medicineContinuous positive airway pressureAdverse effecteducationeducation.field_of_studyContinuous Positive Airway Pressurebusiness.industryrespiratory complications; continuous positive airway pressure; major abdominal surgeryPneumoniaMiddle Agedmedicine.diseaserespiratory tract diseasesIntratrachealPneumoniaTreatment Outcome030228 respiratory systemRespiratory failureAnesthesiaVomitingmedicine.symptomRespiratory InsufficiencyIntubationbusinessAbdominal surgery
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Intraoperative positive end-expiratory pressure and postoperative pulmonary complications: a patient-level meta-analysis of three randomised clinical…

2022

BACKGROUND: High intraoperative PEEP with recruitment manoeuvres may improve perioperative outcomes. We re-examined this question by conducting a patient-level meta-analysis of three clinical trials in adult patients at increased risk for postoperative pulmonary complications who underwent non-cardiothoracic and non-neurological surgery. METHODS: The three trials enrolled patients at 128 hospitals in 24 countries from February 2011 to February 2018. All patients received volume-controlled ventilation with low tidal volume. Analyses were performed using one-stage, two-level, mixed modelling (site as a random effect; trial as a fixed effect). The primary outcome was a composite of postoperati…

AdultLung Diseases*PEEP*postoperative pulmonary complicationsmechanical ventilationPositive-Pressure RespirationsurgeryAnesthesiology and Pain MedicinePostoperative ComplicationsTidal Volume*surgeryHumanspostoperative pulmonary complicationsPostoperative Period*mechanical ventilationmechanical ventilation; PEEP; postoperative pulmonary complications; surgery; Adult; Humans; Lung; Postoperative Complications; Postoperative Period; Randomized Controlled Trials as Topic; Tidal Volume; Lung Diseases; Positive-Pressure RespirationLungPEEPRandomized Controlled Trials as Topic
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Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

2021

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (V(T)). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients. OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference. DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries. MAIN OUTCOME MEASURES: Women and men were compared with respect to use o…

AdultMalemedicine.medical_specialtyIntra operativehealth care facilities manpower and services[SDV]Life Sciences [q-bio]Critical IllnessLas Vegas StudyArticle03 medical and health sciences0302 clinical medicine030202 anesthesiologyInternal medicineTidal VolumemedicineHumansGeneral anaesthesiaLungTidal volumeAdult; Critical Illness; Female; Humans; Lung; Male; Tidal Volume; Respiration Artificial; Sex CharacteristicsSex CharacteristicsLas vegasbusiness.industryRespirationrespiratory failure sexrespiratory systemSex differenceRespiration Artificialrespiratory tract diseasesAnesthesiology and Pain Medicine030228 respiratory systemRelative riskArtificialCohortBreathingFemaleObservational studybusinessintra-operative tidal volumecirculatory and respiratory physiology
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Protective intraoperative ventilation with higher versus lower levels of positive end-expiratory pressure in obese patients (PROBESE): study protocol…

2017

Background Postoperative pulmonary complications (PPCs) increase the morbidity and mortality of surgery in obese patients. High levels of positive end-expiratory pressure (PEEP) with lung recruitment maneuvers may improve intraoperative respiratory function, but they can also compromise hemodynamics, and the effects on PPCs are uncertain. We hypothesized that intraoperative mechanical ventilation using high PEEP with periodic recruitment maneuvers, as compared with low PEEP without recruitment maneuvers, prevents PPCs in obese patients. Methods/design The PRotective Ventilation with Higher versus Lower PEEP during General Anesthesia for Surgery in OBESE Patients (PROBESE) study is a multice…

MaleLung DiseasesTime Factors[SDV]Life Sciences [q-bio]Respiratory Medicine and Allergymedicine.medical_treatmentRESPIRATORY-DISTRESS-SYNDROMEMedicine (miscellaneous)HemodynamicsMechanical ventilation; Obesity; Positive end-expiratory pressure; Postoperative pulmonary complication; Recruitment maneuver; Medicine (miscellaneous); Pharmacology (medical)LAPAROSCOPIC BARIATRIC SURGERYLung DiseaseBody Mass Indexlaw.inventionPositive-Pressure RespirationStudy Protocol0302 clinical medicineMechanical ventilationClinical ProtocolsRandomized controlled trialRisk Factors030202 anesthesiologylawMedicine and Health SciencesClinical endpointAnesthesiaPharmacology (medical)Respiratory function030212 general & internal medicineLungLungmedicin och allergi2. Zero hungerlcsh:R5-920ddc:617Positive end-expiratory pressurerespiratory systemOperative3. Good healthTreatment OutcomeRecruitment maneuverTIDAL VOLUMESResearch DesignMechanical ventilation Positive end-expiratory pressure Recruitment maneuver Obesity Postoperative pulmonary complicationSurgical Procedures OperativeAnesthesiaBreathingFemaleErratumlcsh:Medicine (General)ALVEOLAR RECRUITMENT MANEUVERHumancirculatory and respiratory physiologymedicine.medical_specialtyTime FactorMechanical ventilation ; Obesity ; Positive end-expiratory pressure ; Postoperative pulmonary complication ; Recruitment maneuverAnesthesia GeneralLung injuryMechanical ventilation; Obesity; Positive end-expiratory pressure; Postoperative pulmonary complication; Recruitment maneuver; Body Mass Index; Clinical Protocols; Female; Humans; Intraoperative Care; Lung; Lung Diseases; Male; Obesity; Positive-Pressure Respiration; Protective Factors; Research Design; Risk Factors; Time Factors; Treatment Outcome; Anesthesia General; Surgical Procedures Operative; Medicine (miscellaneous); Pharmacology (medical)NOGENERAL-ANESTHESIADRIVING PRESSURE03 medical and health sciencesmedicineHumansddc:610ObesityClinical ProtocolGeneralProtective FactorPositive end-expiratory pressurePOSTOPERATIVE PULMONARY COMPLICATIONSMechanical ventilationSurgical ProceduresIntraoperative CareINTERNATIONAL CONSENSUSbusiness.industryRisk FactorProtective FactorsSurgeryMechanical ventilation; Obesity; Positive end-expiratory pressure; Postoperative pulmonary complication; Recruitment maneuverrespiratory tract diseasesbusinessPostoperative pulmonary complicationLUNG INJURY
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Acute respiratory failure onset in a patient with Guillain-Barré syndrome after Legionella-associated pneumonia: a case report.

2014

A 69-year-old white man was admitted because of a clinical history of persistent cough and fever. Chest x-rays showed bilateral lung infiltrates with air bronchograms, whereas the urine antigen test resulted positive for Legionella pneumophila. The next day, he was transferred to the intensive care unit and intubated because of severe renal and respiratory distress. Neurological examination revealed distal weakness and loss of deep tendon reflexes in lower extremities. Nerve conduction studies displayed severe demyelinating sensorimotor polyneuropathy, and plasmapheresis was therefore applied with mild improvement. Few weeks after, dysphagia occurred and electrophysiologic tests showed prog…

MaleRenal failuremedicine.medical_specialtymedicine.medical_treatmentNeurological examinationGBSGuillain-Barre SyndromeLegionella pneumophilamedicineHumansPlasmapheresiDiffuse alveolar damageIntensive care medicineAgedRespiratory distressmedicine.diagnostic_testGuillain-Barre syndromebusiness.industryCranial nervesPlasmapheresisGeneral Medicinemedicine.diseaseRespiratory distrePneumoniaNeurologyRespiratory failureAnesthesiaPlasmapheresisNeurology (clinical)Legionnaires' DiseaseRespiratory InsufficiencybusinessHuman
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