0000000000528904
AUTHOR
Monica Rocco
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…
Age and Multimorbidity Predict Death Among COVID-19 Patients: Results of the SARS-RAS Study of the Italian Society of Hypertension
Several factors have been proposed to explain the high death rate of the coronavirus disease 2019 (COVID-19) outbreak, including hypertension and hypertension-related treatment with Renin Angiotensin System inhibitors. Also, age and multimorbidity might be confounders. No sufficient data are available to demonstrate their independent role. We designed a cross-sectional, observational, multicenter, nationwide survey in Italy to verify whether renin-angiotensin system inhibitors are related to COVID-19 severe outcomes. We analyzed information from Italian patients diagnosed with COVID-19, admitted in 26 hospitals. One thousand five hundred ninety-one charts (male, 64.1%; 66±0.4 years) were r…
Extubation in neurocritical care patients: the ENIO international prospective study
Purpose: Neurocritical care patients receive prolonged invasive mechanical ventilation (IMV), but there is poor specific information in this high-risk population about the liberation strategies of invasive mechanical ventilation. Methods: ENIO (NCT03400904) is an international, prospective observational study, in 73 intensive care units (ICUs) in 18 countries from 2018 to 2020. Neurocritical care patients with a Glasgow Coma Score (GCS) ≤ 12, receiving IMV ≥ 24 h, undergoing extubation attempt or tracheostomy were included. The primary endpoint was extubation failure by day 5. An extubation success prediction score was created, with 2/3 of patients randomly allocated to the training cohort …
Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study (Intensive Care Medicine, (2021), 47, 2, (160-169), 10.1007/s00134-020-06234-9)
The original version of this article unfortunately contained a mistake. The members of the ESICM Trials Group Collaborators were not shown in the article but only in the ESM. The full list of collaborators is shown below. The original article has been corrected.
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 …
Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study
Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231…
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…
Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study.
Purpose: In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. Methods: We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. Results: 2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters…
ROAD project: Robotics for assisted diving
The activities associated to underwater diving are of great importance in many areas. In the second half of the last century, diving technologies have greatly progressed, but diving is still characterized by significant risks, especially for professional divers who works at high depth, and limited practicability. The use of robotic systems and automatic procedures would allow, as in other situations where safety is of concern (for example, in case of hazardous works or in relation to hostile environments), a reliable monitoring and assessment of the physiological conditions of human operators during their activities. Moving from currently available technologies in underwater robotics, the R…
Evolution Over Time of Ventilatory Management and Outcome of Patients With Neurologic Disease
OBJECTIVES: 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. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need fo…
Propofol sedation reduces diaphragm activity in spontaneously breathing patients: ultrasound assessment.
BACKGROUND: The diaphragm is the most important respiratory muscle in humans, and the close relationship between inspired volume and diaphragmatic movement in normal subjects has led to investigations into diaphragmatic activity using ultrasound, during spontaneous breathing and sedative drug infusion. METHODS: A total of 36 consecutive patients undergoing diagnostic procedures under deep propofol sedation were studied. Ultrasound measurements included the following: diaphragmatic thickening end-inspiration (TEI) and endexpiration (TEE). Diaphragmatic thickening fraction (DTF) was calculated from [(TEI TEE) / TEE] at various time points (at T0 basal; at T1 during propofol infusion; at T2 aw…
Different epidemiology of bloodstream infections in COVID-19 compared to non-COVID-19 critically ill patients: a descriptive analysis of the Eurobact II study
Funder: European society of Intensive Care Medicine
Utilization of mechanical power and associations with clinical outcomes in brain injured patients: a secondary analysis of the extubation strategies in neuro-intensive care unit patients and associations with outcome (ENIO) trial
Background: There is insufficient evidence to guide ventilatory targets in acute brain injury (ABI). Recent studies have shown associations between mechanical power (MP) and mortality in critical care populations. We aimed to describe MP in ventilated patients with ABI, and evaluate associations between MP and clinical outcomes. Methods: In this preplanned, secondary analysis of a prospective, multi-center, observational cohort study (ENIO, NCT03400904), we included adult patients with ABI (Glasgow Coma Scale ≤ 12 before intubation) who required mechanical ventilation (MV) ≥ 24 h. Using multivariable log binomial regressions, we separately assessed associations between MP on hospital day (H…