0000000000965010

AUTHOR

Marco Ranieri

showing 12 related works from this author

Pressure support ventilation + sigh in acute hypoxemic respiratory failure patients: Study protocol for a pilot randomized controlled trial, the PROT…

2018

Background Adding cyclic short sustained inflations (sigh) to assisted ventilation yields optimizes lung recruitment, decreases heterogeneity and reduces inspiratory effort in patients with acute hypoxemic respiratory failure (AHRF). These findings suggest that adding sigh to pressure support ventilation (PSV) might decrease the risk of lung injury, shorten weaning and improve clinical outcomes. Thus, we conceived a pilot trial to test the feasibility of adding sigh to PSV (the PROTECTION study). Methods PROTECTION is an international randomized controlled trial that will be conducted in 23 intensive care units (ICUs). Patients with AHRF who have been intubated from 24 h to 7 days and under…

procedurePressure supportTime Factorsgenetic structuresbreathingmedicine.medical_treatmentMedicine (miscellaneous)Pilot Projects[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tractintensive care unitlaw.inventionPositive-Pressure RespirationStudy Protocol0302 clinical medicineMechanical ventilationRandomized controlled triallawtime factorClinical endpointpatient safetyMulticenter Studies as TopicPharmacology (medical)030212 general & internal medicinerandomized controlled trial (topic)Intervention study; Mechanical ventilation; Positive-pressure ventilation; Pressure support; Recruitment; Sigh; Ventilator-induced lung injury; Weaning; Feasibility Studies; Humans; Hypoxia; Intubation Intratracheal; Lung; Multicenter Studies as Topic; Pilot Projects; Positive-Pressure Respiration; Recovery of Function; Respiratory Insufficiency; Time Factors; Treatment Outcome; Randomized Controlled Trials as Topic; Medicine (miscellaneous); Pharmacology (medical)HypoxiaLungpathophysiologyendotracheal intubationRandomized Controlled Trials as TopicVentilator-induced lung injurylcsh:R5-920Intervention studyadultpilot studyfeasibility studytreatment outcome Feasibility Studie3. Good healthTreatment OutcomeAnesthesiapositive end expiratory pressureBreathingmulticenter study (topic)oxygenationRecruitmentlcsh:Medicine (General)Respiratory Insufficiencyrespiratory tract intubationcirculatory and respiratory physiologyHumanextubationPressure support ventilationWeaningLung injuryArticleSpontaneous breathing trialNO03 medical and health sciencesIntensive care[SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO]medicineIntubation IntratrachealHumanscontrolled studyPilot ProjectSightreatment failureMechanical ventilationhypoxemiapressure support ventilationtreatment durationbusiness.industrylung inflationrespiratory failureconvalescenceRecovery of Functionmajor clinical studymortalitywater acute respiratory failurehospital dischargeIntratracheal030228 respiratory systemrandomized controlled trialFeasibility StudiesbusinessPositive-pressure ventilationIntubationclinical protocol
researchProduct

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
researchProduct

Sepsis in head and neck cancer patients treated with chemotherapy and radiation: literature review and consensus

2015

Abstract: The reporting of infection/sepsis in chemo/radiation-treated head and neck cancer patients is sparse and the problem is underestimated. A multidisciplinary group of head and neck cancer specialists from Italy met with the aim of reaching a consensus on a clinical definition and management of infections and sepsis. The Delphi appropriateness method was used for this consensus. External expert reviewers then evaluated the conclusions carefully according to their area of expertise. The paper contains seven clusters of statements about the clinical definition and management of infections and sepsis in head and neck cancer patients, which had a consensus. Furthermore, it offers a revie…

cancer patientpathogenesipositron emission tomographyhealthcare associated infectionSettore MED/06 - Oncologia Medicapatient monitoringradiodiagnosimedicine.medical_treatmentChemotherapy; Head and neck cancer; Radiotherapy; SepsisthrombocytopeniaReviewblood cultureorgan injurymedical terminologyMedicineHead and neck cancermetabolic acidosiC reactive proteinHead and Neck Neoplasmmedical specialisttreatment withdrawalconsensus developmentHematologyclinical practicesystemic inflammatory response syndromeItalyOncologyHead and Neck Neoplasmslaboratory testthrombocytosichemically induced/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_beingchemotherapy; head and neck cancer; radiotherapy; sepsis; oncology; hematology; geriatrics and gerontologyorgan perfusionhospitalizationHumansepsis Head and Neck Neoplasmmedicine.medical_specialtySettore MED/17 - Malattie InfettiveSepsibacterium culturediagnostic approach routefluorodeoxyglucosecancer chemotherapySepsisSDG 3 - Good Health and Well-beingSepsiscancer radiotherapyfollow upChemotherapyHumansinfection riskIntensive care medicineprocalcitonin antimicrobial therapyChemotherapyRadiotherapybusiness.industrydisease predispositionHead and neck cancerlactic acidChemotherapy; Head and neck cancer; Radiotherapy; Sepsis; Humans; Italy; Head and Neck Neoplasms; Sepsis; Hematology; Oncology; Geriatrics and Gerontologymedicine.diseasemortalityDelphi studyRadiation therapyinflammationincidencehyperglycemiaHuman medicineGeriatrics and Gerontologybusiness
researchProduct

Additional file 1: of Pressure support ventilation + sigh in acute hypoxemic respiratory failure patients: study protocol for a pilot randomized cont…

2018

SPIRIT 2013 checklist: Recommended items to address in a clinical trial protocol and related documents. (DOC 121 kb)

researchProduct

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…

MaleARDSdemographyeconomicmedicine.medical_treatmentTerapéuticaair conditioningComorbidityintensive care unitdeveloped country0302 clinical medicineneuromuscular blockingmiddle agedacute myocardial-infarctionmiddle income countryProspective StudiesGeography Medicalcritically-ill patientsadultagedpriority journalrisk factorIncomegeographic-variationDeveloped countryhospitalizationprospective studyHumanPulmonary and Respiratory MedicineDeveloped Countriemedicine.medical_specialtyDeveloping countryArticle/dk/atira/pure/subjectarea/asjc/2700/274003 medical and health sciencesSíndrome respiratorio agudo graveunitsMedicalHumansIntensive care medicineDeveloping CountriesAgedhigh income countryRespiratory Distress Syndrome Adultnoninvasive ventilationAparato respiratoriomedicine.diseasemortalitymajor clinical studyProspective Studiearterial oxygen tension030228 respiratory systemARDSObservational studySociologíahealth care deliverygeographyintensive-careRisk FactorsEpidemiologyProspective cohort studyRespiratory Distress Syndromepartial pressureartificial ventilationSociología médicaMiddle Agedadult respiratory distress syndromeAged; Comorbidity; Delivery of Health Care; Developed Countries; Developing Countries; Europe; Female; Geography Medical; Humans; Income; Intensive Care Units; Male; Middle Aged; Patient Outcome Assessment; Prospective Studies; Respiratory Distress Syndrome Adult; Risk Factors; Pulmonary and Respiratory MedicineEuropeIntensive Care UnitsfemaleincomeFemaleEnfermedadinjurycohort analysigross national incomesurvivalNOmedical geographyDeveloping Countrielength of staymedicinecontrolled studyoutcome assessmentbreast-cancerMechanical ventilationdiseasebusiness.industryDeveloped Countriespatient caredeveloping country030208 emergency & critical care medicinestatistics and numerical data AgedComorbiditywinterACUTE MYOCARDIAL-INFARCTION; CRITICALLY-ILL PATIENTS; GEOGRAPHIC-VARIATION; INTENSIVE-CARE; BREAST-CANCER; MORTALITY; DISEASE; INJURY; UNITS; HOSPITALIZATIONPatient Outcome AssessmentEmergency medicineprone positiontreatment outcomebusinessDelivery of Health Care
researchProduct

Sigh in Patients With Acute Hypoxemic Respiratory Failure and ARDS

2021

Background Sigh is a cyclic brief recruitment maneuver: previous physiologic studies showed that its use could be an interesting addition to pressure support ventilation to improve lung elastance, decrease regional heterogeneity, and increase release of surfactant. Research Question Is the clinical application of sigh during pressure support ventilation (PSV) feasible? Study Design and Methods We conducted a multicenter noninferiority randomized clinical trial on adult intubated patients with acute hypoxemic respiratory failure or ARDS undergoing PSV. Patients were randomized to the no-sigh group and treated by PSV alone, or to the sigh group, treated by PSV plus sigh (increase in airway pr…

Pulmonary and Respiratory MedicineARDSbusiness.industryPressure support ventilationCritical Care and Intensive Care Medicinemedicine.diseaseSpontaneous breathing triallaw.invention03 medical and health sciences0302 clinical medicine030228 respiratory systemRandomized controlled triallawAnesthesiaBreathingMedicine030212 general & internal medicineCardiology and Cardiovascular MedicinebusinessRespiratory minute volumePositive end-expiratory pressureTidal volumeChest
researchProduct

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…

Pulmonary and Respiratory MedicineInternal Medicine SciencesKlinik TıpRESPIRATORY SYSTEMDahili Tıp BilimleriGöğüs Hastalıkları ve AllerjiCLINICAL MEDICINESağlık BilimleriClinical Medicine (MED)TıpSOLUNUM SİSTEMİMechanical ventilationN/AHealth SciencesSettore MED/41 - ANESTESIOLOGIAAkciğer ve Solunum TıbbıMedicineKlinik Tıp (MED)Chest Diseases and AllergyThe Lancet Respiratory Medicine
researchProduct

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…

MaleARDSprocedureblood oxygen tensionCritical Care and Intensive Care MedicineSeverity of Illness Indexlaw.invention0302 clinical medicinelawHospital MortalityRespiratory Distress SyndromeAcute respiratory distress syndromeadult respiratory distress syndromeMiddle AgedIntensive care unitIntensive Care Unitsmedicine.anatomical_structureTreatment Outcomepriority journalpositive end expiratory pressureNoninvasive ventilationdisease severityFemaletreatment outcome AgedNoninvasive ventilationprospective studyHumanAdultPulmonary and Respiratory Medicinemedicine.medical_specialtycohort analysiIntensive Care Unitdisease classificationAcute respiratory distressArticleNO03 medical and health sciencesacute respiratory distress syndrome; noninvasive ventilationlength of staySeverity of illnessSettore MED/41 - ANESTESIOLOGIAmedicineSequential Organ Failure Assessment ScoreHumansIn patientAcute respiratory distress syndrome; Noninvasive ventilation; Aged; Female; Hospital Mortality; Humans; Intensive Care Units; Male; Middle Aged; Respiratory Distress Syndrome Adult; Severity of Illness Index; Treatment Outcome; Noninvasive Ventilation; Pulmonary and Respiratory Medicine; Critical Care and Intensive Care MedicineIntensive care medicineoutcome assessmentAgedLungbusiness.industryRespiratory Distress Syndrome Adult030208 emergency & critical care medicinemedicine.diseasemajor clinical studymortalityrespiratory tract diseasesbreathing ratemulticenter study030228 respiratory systemincidenceObservational studyobservational studybusinessAcute respiratory distress syndrome; Noninvasive ventilation;
researchProduct

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).

Ventilator-induced lung injuryCardiogenic pulmonary edema; Driving pressure; Mechanical ventilation; Ventilator-induced lung injurylnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4]Mechanical ventilationCardiogenic pulmonary edemaSettore MED/41 - ANESTESIOLOGIADriving pressureCritical Care and Intensive Care Medicine
researchProduct

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…

Pulmonary and Respiratory MedicineARDSUnidades de cuidados intensivos[SDV]Life Sciences [q-bio]medicine.medical_treatmentmechanical ventilationNOlaw.invention03 medical and health sciencesTratamiento médico0302 clinical medicinelawSettore MED/41 - ANESTESIOLOGIAInsuficiencia respiratoriaMedicineHumans030212 general & internal medicineProspective StudiesProspective cohort studyLungMechanical ventilationRespiratory Distress SyndromeLungbusiness.industryRespirationIncidence (epidemiology)medicine.diseaseIntensive care unitRespiration Artificial3. Good healthIntensive Care Unitslnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4]medicine.anatomical_structure030228 respiratory systemRespiratory failureHeart failureAnesthesiaArtificialardsbusinessRespiratory InsufficiencyEnfermedadEuropean Respiratory Journal
researchProduct

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…

ARDSmedicine.medical_treatment030204 cardiovascular system & hematologyCritical Care and Intensive Care MedicineHyperoxemiaHypoxemialaw.inventionHypoxemia0302 clinical medicinelawFraction of inspired oxygenOxygen therapyPrevalenceMedicineHypoxiaAcute respiratory distress syndrome; Hyperoxemia; Hyperoxia; Hypoxemia; Hypoxia; Invasive mechanical ventilation; Mortality; Oxygen therapy;Respiratory Distress SyndromeHyperbaric OxygenationAcute respiratory distress syndromeRespirationlcsh:Medical emergencies. Critical care. Intensive care. First aidHyperoxemiaIntensive care unitIntensive Care UnitsAnesthesiaArtificialmedicine.symptomHumanArtificial ventilationAcute respiratory distress syndrome; Hyperoxemia; Hyperoxia; Hypoxemia; Hypoxia; Invasive mechanical ventilation; Mortality; Oxygen therapyIntensive Care UnitHyperoxiaNO03 medical and health sciencesIntensive careSettore MED/41 - ANESTESIOLOGIAHumansInvasive mechanical ventilationMortalitybusiness.industryResearchRespiratory Distress Syndrome Adultlcsh:RC86-88.9medicine.diseaseOxygen therapyRespiration Artificialrespiratory tract diseasesOxygenlnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4]030228 respiratory systembusiness
researchProduct

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 …

MaleInternationalityRespiratory Distress Syndrome Adultadult respiratory distress syndromeMiddle AgedSeverity of Illness IndexPatient Outcome AssessmentProspective StudieAnesthesiology and Pain MedicineSettore MED/41 - ANESTESIOLOGIAARDSFemaleHospital MortalityAcute Respiratory Distress SyndromeHuman
researchProduct