0000000000215109
AUTHOR
Elena Bignami
Postoperative continuous positive airway pressure to prevent pneumonia, re-intubation, and death after major abdominal surgery (PRISM): a multicentre, open-label, randomised, phase 3 trial.
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…
MOESM1 of Comparisons of two diaphragm ultrasound-teaching programs: a multicenter randomized controlled educational study
Additional file 1. Theoretical test.
Level of Diffusion and Training of Lung Ultrasound during the COVID-19 Pandemic - A National Online Italian Survey (ITALUS) from the Lung Ultrasound Working Group of the Italian Society of Anesthesia, Analgesia, Resuscitation, and Intensive Care (SIAARTI)
The goal of this survey was to describe the use and diffusion of lung ultrasound (LUS), the level of training received before and during the COVID-19 pandemic, and the clinical impact LUS has had on COVID-19 cases in intensive care units (ICU) from February 2020 to May 2020. The Italian Lung Ultrasound Survey (ITALUS) was a nationwide online survey proposed to Italian anesthesiologists and intensive care physicians carried out after the first wave of the COVID-19 pandemic. It consisted of 27 questions, both quantitative and qualitative. 807 responded to the survey. The median previous LUS experience was 3 years (IQR 1.0-6.0). 473 (60.9 %) reported having attended at least one training cour…
Burnout in Cardiac Anesthesiologists: Results From a National Survey in Italy
Objective There is increasing burnout incidence among medical disciplines, and physicians working in emergency settings seem at higher risk. Cardiac anesthesiology is a stressful anesthesiology subspecialty dealing with high-risk patients. The authors hypothesized a high risk of burnout in cardiac anesthesiologists. Design National survey conducted on burnout. Setting Italian cardiac centers. Participants Cardiac anesthesiologists. Interventions The authors administered via email an anonymous questionnaire divided into 3 parts. The first 2 parts evaluated workload and private life. The third part consisted of the Maslach Burnout Inventory test with its 3 constituents: high emotional exhaust…
Long-term placement of continuous popliteal nerve block catheter for management of a wounded patient in a combat field environment: a case report
Costantino Fontana,1 Monica Rocco,2 Luigi Vetrugno,3 Elena Bignami41Anesthesia and Intensive Care Unit, Sapienza University of Rome, Rome, Italy; 2Intensive Care Unit and Anesthesia, Ospedale S. Andrea Rome, Rome, Italy; 3Anesthesia and Intensive Care Clinic, University-Hospital of Udine, Udine, Italy; 4Intensive Care Unit and Anestehsia, Università degli Studi di Parma, Parma, ItalyCorrespondence: Costantino FontanaAnesthesia and Intensive Care Unit, Sapienza University of Rome, Policlinico Militare di Roma, Piazza Celimontana n. 50, Roma 00184, ItalyEmail cosfontana@gmail.comAbstract: Continuous peripheral nerve block is a relevant part of multimodal treatment of postoperative …
Comparisons of two diaphragm ultrasound-teaching programs: a multicenter randomized controlled educational study
Abstract Background This study aims to ascertain whether (1) an educational program is sufficient to achieve adequate Diaphragm Ultrasound (DUS) assessments on healthy volunteers and (2) combining a video tutorial with a practical session is more effective in making learners capable to obtain accurate DUS measurements, as opposed to sole video tutorial. Results We enrolledstep 1: 172 volunteers naïve to ultrasound. After watching a video tutorial, a questionnaire was administered and considered to be passed when at least 70% of the questions were correctly answered. Course participants who passed the theoretical test were randomized to either intervention or control group. Learners randomiz…
COVID-19 … What are drugs and strategies now?
From February 2019 the World faces the Covid19 pandemic. The data in our possession are still insufficient to effectively combat this pathology. The gold standard for diagnosis remains molecular testing, while clinical and instrumental and serological diagnostics are highly nonspecific leading to a slowdown in the battle against covid19.[3] Can Artificial Intelligence (AI) and Machine Learning (ML) help us? The use of large databases to cross-reference data to stratify the diagnostic scores, to quickly differentiate a critical Covid-19 patient from a non-critical one is the challenge of the future. All to achieve better management of resources in the field and a more effective therapeutic a…
Long-term placement of continuous popliteal nerve block catheter for management of a wounded patient in a combat field environment: a case report.
Costantino Fontana,1 Monica Rocco,2 Luigi Vetrugno,3 Elena Bignami41Anesthesia and Intensive Care Unit, Sapienza University of Rome, Rome, Italy; 2Intensive Care Unit and Anesthesia, Ospedale S. Andrea Rome, Rome, Italy; 3Anesthesia and Intensive Care Clinic, University-Hospital of Udine, Udine, Italy; 4Intensive Care Unit and Anestehsia, Università degli Studi di Parma, Parma, ItalyCorrespondence: Costantino FontanaAnesthesia and Intensive Care Unit, Sapienza University of Rome, Policlinico Militare di Roma, Piazza Celimontana n. 50, Roma 00184, ItalyEmail cosfontana@gmail.comAbstract: Continuous peripheral nerve block is a relevant part of multimodal treatment of postoperative pain…
Postoperative pain management in non-traumatic emergency general surgery: WSES-GAIS-SIAARTI-AAST guidelines
Abstract Background Non-traumatic emergency general surgery involves a heterogeneous population that may present with several underlying diseases. Timeous emergency surgical treatment should be supplemented with high-quality perioperative care, ideally performed by multidisciplinary teams trained to identify and handle complex postoperative courses. Uncontrolled or poorly controlled acute postoperative pain may result in significant complications. While pain management after elective surgery has been standardized in perioperative pathways, the traditional perioperative treatment of patients undergoing emergency surgery is often a haphazard practice. The present recommended pain management g…
Italian Society of Anesthesia, Analgesia, Resuscitation, and Intensive Care expert consensus statement on the use of lung ultrasound in critically ill patients with coronavirus disease 2019 (ITACO)
Abstract Background To produce statements based on the available evidence and an expert consensus (as members of the Lung Ultrasound Working Group of the Italian Society of Analgesia, Anesthesia, Resuscitation, and Intensive Care, SIAARTI) on the use of lung ultrasound for the management of patients with COVID-19 admitted to the intensive care unit. Methods A modified Delphi method was applied by a panel of anesthesiologists and intensive care physicians expert in the use of lung ultrasound in COVID-19 intensive critically ill patients to reach a consensus on ten clinical questions concerning the role of lung ultrasound in the following: COVID-19 diagnosis and monitoring (with and without i…
Good clinical practice for the use of vasopressor and inotropic drugs in critically ill patients: state-of-the-science and expert consensus
Vasopressors and inotropic agents are widely used in critical care. However, strong evidence supporting their use in critically ill patients is lacking in many clinical scenarios. Thus, the Italian Society of Anesthesia and Intensive Care (SIAARTI) promoted a project aimed to provide indications for good clinical practice on the use of vasopressors and inotropes, and on the management of critically ill patients with shock. A panel of 16 experts in the field of intensive care medicine and hemodynamics has been established. Systematic review of the available literature was performed based on PICO questions. Basing on available evidence, the panel prepared a summary of evidences and then wrote…