0000000001276195

AUTHOR

Riccardo Fantini

showing 9 related works from this author

Nasal pressure swings as the measure of inspiratory effort in spontaneously breathing patients with de novo acute respiratory failure.

2022

Abstract Background Excessive inspiratory effort could translate into self-inflicted lung injury, thus worsening clinical outcomes of spontaneously breathing patients with acute respiratory failure (ARF). Although esophageal manometry is a reliable method to estimate the magnitude of inspiratory effort, procedural issues significantly limit its use in daily clinical practice. The aim of this study is to describe the correlation between esophageal pressure swings (ΔPes) and nasal (ΔPnos) as a potential measure of inspiratory effort in spontaneously breathing patients with de novo ARF. Methods From January 1, 2021, to September 1, 2021, 61 consecutive patients with ARF (83.6% related to COVID…

Self-inflicted lung injuryCritical Care and Intensive Care MedicineAcute respiratory failureself-inflicted lung injuryNon-invasive Mechanical ventilationesophageal pressure swingsacute respiratory failure non-invasive mechanical ventilation esophageal pressure swings nasal pressure swings endotracheal intubation COVID-19 respiratory monitoring inspiratory effort self-inflicted lung injuryHumansInspiratory effortendotracheal intubationEsophageal pressure swingsAcute respiratory failure Non-invasive Mechanical ventilation Esophageal pressure swings Nasal pressure swings Endotracheal intubation COVID-19 Respiratory monitoring Inspiratory effort Self-inflicted lung injuryRespiratory Distress Syndromeacute respiratory failurenon-invasive mechanical ventilationNoninvasive VentilationRespiratory monitoringCOVID-19Endotracheal intubationRespiration ArtificialAcute respiratory failure; COVID-19; Endotracheal intubation; Esophageal pressure swings; Inspiratory effort; Nasal pressure swings; Non-invasive Mechanical ventilation; Respiratory monitoring; Self-inflicted lung injuryNasal pressure swingsnasal pressure swingsrespiratory monitoringRespiratory Insufficiencyinspiratory effortCritical care (London, England)
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High flow nasal therapy versus noninvasive ventilation as initial ventilatory strategy in COPD exacerbation: a multicenter non-inferiority randomized…

2020

Abstract Background The efficacy and safety of high flow nasal therapy (HFNT) in patients with acute hypercapnic exacerbation of chronic obstructive pulmonary disease (AECOPD) are unclear. Our aim was to evaluate the short-term effect of HFNT versus NIV in patients with mild-to-moderate AECOPD, with the hypothesis that HFNT is non-inferior to NIV on CO2 clearance after 2 h of treatment. Methods We performed a multicenter, non-inferiority randomized trial comparing HFNT and noninvasive ventilation (NIV) in nine centers in Italy. Patients were eligible if presented with mild-to-moderate AECOPD (arterial pH 7.25–7.35, PaCO2 ≥ 55 mmHg before ventilator support). Primary endpoint was the mean di…

MaleExacerbationEquivalence Trials as TopicCritical Care and Intensive Care MedicineAcute respiratory failurelaw.invention03 medical and health sciencesPulmonary Disease Chronic Obstructive0302 clinical medicineRandomized controlled triallawClinical endpointmedicineHumansCannulaAcute respiratory failure; Chronic obstructive pulmonary disease; High flow nasal cannula; High flow nasal therapy; Noninvasive ventilation030212 general & internal medicineHigh flow nasal therapyAgedCOPDbusiness.industryResearchhigh flow oxygen therapy high flow nasal cannula noninvasive ventilation COPD carbon dioxide acute respiratory failureChronic obstructive pulmonary diseaselcsh:Medical emergencies. Critical care. Intensive care. First aidOxygen Inhalation Therapylcsh:RC86-88.9Middle Agedmedicine.diseaseSymptom Flare UpConfidence intervalHigh flow nasal cannula030228 respiratory systemItalyAnesthesiaBreathingNoninvasive ventilationFemaleHigh flowbusinessNoninvasive ventilationHuman
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Accuracy of Nasal Pressure Swing to Predict Failure of High-Flow Nasal Oxygen in Patients with Acute Hypoxemic Respiratory Failure

2023

In a real-life cohort of patients with AHRF undergoing HFNO, ΔPnose showed excellent accuracy in predicting early failure, similar of that displayed by ROX. Giving that the decision to upgrade to NIV or MV was based on clinical variables, the high accuracy of ROX in predicting failure of HFNO is not surprising. The similar accuracy of ΔPnose (the only measurement that remained blinded to our clinical decision), strengthened the association with outcome, avoiding incorporation bias.

Pulmonary and Respiratory Medicineself-inflicted lung injuryacute respiratory failurenon-invasive mechanical ventilationhigh flow nasal cannulaesophageal pressure swingshigh flow nasal cannulaacute respiratory failure high flow nasal cannula non-invasive mechanical ventilation esophageal pressure swings nasal pressure swings respiratory monitoring inspiratory effort self-inflicted lung injurynasal pressure swingsCritical Care and Intensive Care MedicineAcute respiratory failurerespiratory monitoringinspiratory effort
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Microbiological testing of adults hospitalised with community-acquired pneumonia: an international study

2018

This study aimed to describe real-life microbiological testing of adults hospitalised with community-acquired pneumonia (CAP) and to assess concordance with the 2007 Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) and 2011 European Respiratory Society (ERS) CAP guidelines. This was a cohort study based on the Global Initiative for Methicillin-resistant Staphylococcus aureus Pneumonia (GLIMP) database, which contains point-prevalence data on adults hospitalised with CAP across 54 countries during 2015. In total, 3702 patients were included. Testing was performed in 3217 patients, and included blood culture (71.1%), sputum culture (61.8%), Legionella urinary anti…

0301 basic medicinePulmonary and Respiratory Medicinemedicine.medical_specialtycommunity-acquired pneumoniaCommunity-acquired pneumoniaPatients4Concordance030106 microbiologyRespiratory Systemlcsh:MedicineSettore MED/10 - Malattie Dell'Apparato RespiratorioGUIDELINESPneumònia adquirida a la comunitatSputum cultureSerology03 medical and health sciences0302 clinical medicineCommunity-acquired pneumoniaInternal medicinemedicineMANAGEMENTBlood culture030212 general & internal medicinePOPULATIONpneumonia Methicillin-resistant Staphylococcus aureus PneumoniaScience & Technologymedicine.diagnostic_testbusiness.industryMORTALITYlcsh:RMicrobiologia mèdicaOriginal ArticlesGuidelinePneumoniaMedical microbiologymedicine.diseaseMicrobiologicalETIOLOGYPneumoniaDiagnostic testingREQUIRING HOSPITALIZATIONbusinessLife Sciences & BiomedicineCohort studyERJ Open Research
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Aspiration Risk Factors, Microbiology, and Empiric Antibiotics for Patients Hospitalized With Community-Acquired Pneumonia

2021

Background: Aspiration community-acquired pneumonia (ACAP) and community-acquired pneumonia (CAP) in patients with aspiration risk factors (AspRFs) are infections associated with anaerobes, but limited evidence suggests their pathogenic role. Research Question: What are the aspiration risk factors, microbiology patterns, and empiric anti-anaerobic use in patients hospitalized with CAP? Study Design and Methods: This is a secondary analysis of GLIMP, an international, multicenter, point-prevalence study of adults hospitalized with CAP. Patients were stratified into three groups: (1) ACAP, (2) CAP/AspRF+ (CAP with AspRF), and (3) CAP/AspRF- (CAP without AspRF). Data on demographics, comorbidi…

MalePulmonary and Respiratory Medicinemedicine.drug_classAspiration riskAntibioticsNursing home residentSettore MED/10 - Malattie Dell'Apparato RespiratorioCritical Care and Intensive Care MedicineMicrobiologyanaerobic; aspiration; bacteria; pneumonia; risk factors.Cohort Studies03 medical and health sciences0302 clinical medicineCommunity-acquired pneumoniaTaverneAnti-Bacterial AgentmedicineHumanspneumoniarisk factors.Community-Acquired Infection030212 general & internal medicinebacteriaStrokeAgedAged 80 and overaspirationbusiness.industryRespiratory AspirationMiddle Agedmedicine.diseaseAntibiotic coverageAnti-Bacterial AgentsCommunity-Acquired InfectionsHospitalizationPneumonia030228 respiratory systemRisk factorsrisk factoranaerobicFemaleUnderweightmedicine.symptombusinessCardiology and Cardiovascular Medicine
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Global initiative for meticillin-resistant Staphylococcus aureus pneumonia (GLIMP): an international, observational cohort study

2016

BACKGROUND: Antibiotic resistance is a major global health problem and pathogens such as meticillin-resistant Staphylococcus aureus (MRSA) have become of particular concern in the management of lower respiratory tract infections. However, few data are available on the worldwide prevalence and risk factors for MRSA pneumonia. We aimed to determine the point prevalence of MRSA pneumonia and identify specific MRSA risk factors in community-dwelling patients hospitalised with pneumonia.METHODS: We did an international, multicentre study of community-dwelling, adult patients admitted to hospital with pneumonia who had microbiological tests taken within 24 h of presentation. We recruited investig…

Maleantibiotic resistancePrevalenceMRSAmedicine.disease_causepneumonia; antibiotic resistance; staphylococcus aureus; MRSAGlobal HealthCohort Studies0302 clinical medicineCommunity-acquired pneumoniaRisk FactorsRetrospective StudiePrevalenceCommunity-Acquired Infection030212 general & internal medicineeducation.field_of_studyCross InfectionRespiratory tract infectionsMethicillin-Resistant Staphylococcus aureuStaphylococcal InfectionsHospitalsCommunity-Acquired InfectionsInfectious DiseasesInfectious diseasesFemaleHumanMethicillin-Resistant Staphylococcus aureusstaphylococcus aureusmedicine.medical_specialtyPopulationAdmissionstaphylococcus aureuSettore MED/10 - Malattie Dell'Apparato Respiratorio03 medical and health sciencesHospitalInternal medicinemedicineHumanspneumoniaRisk factoreducationIntensive care medicineStaphylococcal InfectionRetrospective StudiesAgedbusiness.industryRisk FactorOdds ratioPneumoniamedicine.diseaseMethicillin-resistant Staphylococcus aureusPneumonia030228 respiratory systemMethicillin ResistanceCohort Studiebusiness
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Bacterial etiology of community-acquired pneumonia in immunocompetent hospitalized patients and appropriateness of empirical treatment recommendation…

2020

An accurate knowledge of the epidemiology of community-acquired pneumonia (CAP) is key for selecting appropriate antimicrobial treatments. Very few etiological studies assessed the appropriateness of empiric guideline recommendations at a multinational level. This study aims at the following: (i) describing the bacterial etiologic distribution of CAP and (ii) assessing the appropriateness of the empirical treatment recommendations by clinical practice guidelines (CPGs) for CAP in light of the bacterial pathogens diagnosed as causative agents of CAP. Secondary analysis of the GLIMP, a point-prevalence international study which enrolled adults hospitalized with CAP in 2015. The analysis was l…

Male0301 basic medicineMicrobiology (medical)medicine.medical_specialtyCommunity-acquired pneumonia030106 microbiologyAntimicrobial treatmentPrevalenceGuidelineSettore MED/10 - Malattie Dell'Apparato RespiratorioGuidelinesGlobal Healthmedicine.disease_causeImmunocompromised Host03 medical and health sciences0302 clinical medicineMedical microbiologyCommunity-acquired pneumoniaInternal medicineEpidemiologyStreptococcus pneumoniaePneumonia BacterialPrevalenceHumansMedicine030212 general & internal medicinePractice Patterns Physicians'AgedAged 80 and overbusiness.industryCorrectionGeneral MedicineGuidelineMiddle Agedmedicine.diseaseAnti-Bacterial AgentsCommunity-Acquired InfectionsHospitalizationPneumoniaInfectious DiseasesStreptococcus pneumoniaePractice Guidelines as TopicPseudomonas aeruginosaEtiologyOriginal ArticleFemaleGuideline Adherencebusiness
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Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised Patients

2018

Abstract Background The correct management of immunocompromised patients with pneumonia is debated. We evaluated the prevalence, risk factors, and characteristics of immunocompromised patients coming from the community with pneumonia. Methods We conducted a secondary analysis of an international, multicenter study enrolling adult patients coming from the community with pneumonia and hospitalized in 222 hospitals in 54 countries worldwide. Risk factors for immunocompromise included AIDS, aplastic anemia, asplenia, hematological cancer, chemotherapy, neutropenia, biological drug use, lung transplantation, chronic steroid use, and solid tumor. Results At least 1 risk factor for immunocompromis…

0301 basic medicineMalePediatricsEtiologyMultidrug-resistant pathogenMRSAPneumocystis pneumoniaPneumònia adquirida a la comunitatHOSPITALIZED-PATIENTS0302 clinical medicineCommunity-acquired pneumoniaRisk FactorsPrevalenceMedicine030212 general & internal medicinePNEUMOCYSTIS PNEUMONIAArticles and CommentariesAged 80 and overRespiratory tract infectionsAnemia AplasticMiddle Aged3. Good healthCommunity-Acquired InfectionsEuropeInfectious DiseasesImmunocompromise; Microbiology; MRSA; Multidrug-resistant pathogens; PneumoniaEtiologiaHematologic NeoplasmsFemaleBLOOD-STREAM INFECTIONSLung TransplantationMicrobiology (medical)medicine.medical_specialtyAsiaNeutropeniaCommunity-acquired pneumonia030106 microbiologyRESPIRATORY-TRACT INFECTIONSHematologic NeoplasmsSettore MED/10 - Malattie Dell'Apparato RespiratorioTRANSPLANT RECIPIENTSDISEASES-SOCIETYMicrobiology03 medical and health sciencesImmunocompromised HostPneumonia BacterialMANAGEMENTHumanspneumoniaBACTERIAL PNEUMONIAImmunocompromiseAgedAcquired Immunodeficiency Syndromebusiness.industrymicrobiologyBacterial pneumoniaAustraliaPneumoniamedicine.diseaseMultidrug-resistant pathogensPneumoniamultidrug-resistant pathogensMycosesBacteremiaAfricaEtiologyRISK-FACTORSimmunocompromiseAmericasbusinessClinical Infectious Diseases
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Additional file 1 of Nasal pressure swings as the measure of inspiratory effort in spontaneously breathing patients with de novo acute respiratory fa…

2022

Additional file 1: eTable 1. Esophageal and nasal pressure swings according to acute respiratory failure etiology. Data are presented as median and interquartile ranges (IQR). eFigure 1. Pearson���s R showing correlations between ��Pes and ��Pnos at 24 hours after splitting the study population according to the NRS received. eFigure 2. Bland-Altman analysis assessing the agreement between ��Pes measured with esophageal manometry and estimated based on ��Pnos (��Pes, estimated) and computed as k����Pnos, where k is the average ratio of ��Pes to ��Pnos measured at baseline. At T2 Bland-Altman methods showed a bias of 0.1 cmH2O and 95% limits of agreement, LoA, from ���2.0 to 2.1 cmH2O (95.1% …

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