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Article: Effectiveness of First-Line Therapy with Old and Novel Antibiotics in Ventilator-Associated Pneumonia Caused by Carbapenem-Resistant

Dalfino, Lidia / Stufano, Monica / Bavaro, Davide Fiore / Diella, Lucia / Belati, Alessandra / Stolfa, Stefania / Romanelli, Federica / Ronga, Luigi / Di Mussi, Rosa / Murgolo, Francesco / Loconsole, Daniela / Chironna, Maria / Mosca, Adriana / Montagna, Maria Teresa / Saracino, Annalisa / Grasso, Salvatore

Antibiotics (Basel, Switzerland)

2023 Volume 12, Issue 6

Abstract: Evidence-based, standard antibiotic therapy for ventilator-associated pneumonia (VAP) caused by carbapenem- ... ...

Abstract	Evidence-based, standard antibiotic therapy for ventilator-associated pneumonia (VAP) caused by carbapenem-resistant
Language	English
Publishing date	2023-06-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2681345-2
ISSN	2079-6382
ISSN	2079-6382
DOI	10.3390/antibiotics12061048
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Article: Circulating Skeletal Troponin During Weaning From Mechanical Ventilation and Their Association to Diaphragmatic Function: A Pilot Study.

Spadaro, Savino / Dalla Corte, Francesca / Scaramuzzo, Gaetano / Grasso, Salvatore / Cinnella, Gilda / Rosta, Valentina / Chiavieri, Valentina / Alvisi, Valentina / Di Mussi, Rosa / Volta, Carlo Alberto / Bellini, Tiziana / Trentini, Alessandro

Frontiers in medicine

2021 Volume 8, Page(s) 770408

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2021-12-22
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2021.770408
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Article: Case Report: Inferior Bilobectomy for Lung Cancer to Allow Weaning From Veno-Venous Extracorporeal Membrane Oxygenation.

Signore, Francesca / Brascia, Debora / Schiavone, Marcella / De Iaco, Giulia / Panza, Teodora / De Palma, Angela / Murgolo, Francesco / Civita, Antonio / Di Mussi, Rosa / Grasso, Salvatore / Marulli, Giuseppe

Frontiers in surgery

2021 Volume 8, Page(s) 736541

Abstract: In recent years, veno-venous extracorporeal membrane oxygenation (V-V ECMO) has allowed complex lung and airways resections in patients with a compromised perioperative respiratory function. In the following report, we present a case of successful ... ...

Abstract	In recent years, veno-venous extracorporeal membrane oxygenation (V-V ECMO) has allowed complex lung and airways resections in patients with a compromised perioperative respiratory function. In the following report, we present a case of successful weaning from V-V ECMO in a patient who underwent an inferior bilobectomy for lung cancer.
Language	English
Publishing date	2021-09-21
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2773823-1
ISSN	2296-875X
ISSN	2296-875X
DOI	10.3389/fsurg.2021.736541
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Article ; Online: Physiological effects of two driving pressure-based methods to set positive end-expiratory pressure during one lung ventilation.

Spadaro, Savino / Grasso, Salvatore / Karbing, Dan Stieper / Santoro, Giuseppe / Cavallesco, Giorgio / Maniscalco, Pio / Murgolo, Francesca / Di Mussi, Rosa / Ragazzi, Riccardo / Rees, Stephen Edward / Volta, Carlo Alberto / Fogagnolo, Alberto

Journal of clinical monitoring and computing

2020 Volume 35, Issue 5, Page(s) 1149–1157

Abstract: During one-lung ventilation (OLV), titrating the positive end-expiratory pressure (PEEP) to target a low driving pressure (∆P) could reduce postoperative pulmonary complications. However, it is unclear how to conduct PEEP titration: by stepwise increase ... ...

Abstract	During one-lung ventilation (OLV), titrating the positive end-expiratory pressure (PEEP) to target a low driving pressure (∆P) could reduce postoperative pulmonary complications. However, it is unclear how to conduct PEEP titration: by stepwise increase starting from zero PEEP (PEEP
MeSH term(s)	Humans ; Lung ; Lung Compliance ; One-Lung Ventilation ; Positive-Pressure Respiration ; Respiratory Mechanics
Keywords	covid19
Language	English
Publishing date	2020-08-20
Publishing country	Netherlands
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	1418733-4
ISSN	1573-2614 ; 1387-1307 ; 0748-1977
ISSN (online)	1573-2614
ISSN	1387-1307 ; 0748-1977
DOI	10.1007/s10877-020-00582-z
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Article ; Online: Individualized positive end-expiratory pressure guided by end-expiratory lung volume in early acute respiratory distress syndrome: study protocol for the multicenter, randomized IPERPEEP trial.

Trials

2022 Volume 23, Issue 1, Page(s) 63

Abstract: Background: In acute respiratory distress syndrome (ARDS), response to positive end-expiratory pressure (PEEP) is variable according to different degrees of lung recruitability. The search for a tool to individualize PEEP based on patients' individual ... ...

Abstract	Background: In acute respiratory distress syndrome (ARDS), response to positive end-expiratory pressure (PEEP) is variable according to different degrees of lung recruitability. The search for a tool to individualize PEEP based on patients' individual response is warranted. End-expiratory lung volume (EELV) assessment by nitrogen washing-washout aids bedside estimation of PEEP-induced alveolar recruitment and may therefore help titrate PEEP on patient's individual recruitability. We designed a randomized trial to test whether an individualized PEEP setting protocol driven by EELV measurement may improve a composite clinical outcome in patients with moderate-to-severe ARDS (IPERPEEP trial). Methods: IPERPEEP is an open-label, multicenter, randomized trial that will be conducted in 10 intensive care units in Italy and will enroll 132 ARDS patients showing PaO Discussion: The IPERPEEP study is a randomized trial powered to elucidate whether an individualized PEEP setting protocol based on bedside assessment of lung recruitability can improve a composite clinical outcome during moderate-to-severe ARDS. Trial registration: ClinicalTrials.gov NCT04012073 . Registered 9 July 2019.
MeSH term(s)	Humans ; Lung ; Lung Volume Measurements ; Multicenter Studies as Topic ; Positive-Pressure Respiration ; Randomized Controlled Trials as Topic ; Respiratory Distress Syndrome/diagnosis ; Respiratory Distress Syndrome/therapy ; Tidal Volume
Language	English
Publishing date	2022-01-20
Publishing country	England
Document type	Clinical Trial Protocol ; Journal Article
ZDB-ID	2040523-6
ISSN	1745-6215 ; 1468-6694 ; 1745-6215
ISSN (online)	1745-6215
ISSN	1468-6694 ; 1745-6215
DOI	10.1186/s13063-021-05993-0
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Article ; Online: Can visual inspection of the electrical activity of the diaphragm improve the detection of patient-ventilator asynchronies by pediatric critical care physicians?

DI Nardo, Matteo / Lonero, Margherita / Staffieri, Francesco / DI Mussi, Rosa / Murgolo, Francesco / Lorusso, Pantaleo / Pham, Tai / Picardo, Sergio G / Perrotta, Daniela / Cecchetti, Corrado / RavÀ, Lucilla / Grasso, Salvatore

Minerva anestesiologica

2020 Volume 87, Issue 3, Page(s) 319–324

Abstract: Background: Patient-ventilator asynchronies are challenging during pediatric mechanical ventilation. We hypothesized that monitoring the electrical activity of the diaphragm (EAdi) together with the "standard" airway opening pressure (Pao) and flow-time ...

Abstract	Background: Patient-ventilator asynchronies are challenging during pediatric mechanical ventilation. We hypothesized that monitoring the electrical activity of the diaphragm (EAdi) together with the "standard" airway opening pressure (Pao) and flow-time waveforms during pressure support ventilation would improve the ability of a cohort of critical care physicians to detect asynchronies in ventilated children. Methods: We recorded the flow, Pao and EAdi waveforms in ten consecutive patients. The recordings were split in periods of 15 s, each reproducing a ventilator screenshot. From this pool, a team of four experts selected the most representative screenshots including at least one of the three most common asynchronies (missed efforts, auto-triggering and double triggering) and split them into two versions, respectively showing or not the EAdi waveforms. The screenshots were shown in random order in a questionnaire to sixty experienced pediatric intensivists that were asked to identify any episode of patient-ventilator asynchrony. Results: Among the ten patients included in the study, only eight had EAdi tracings without artifacts and were analyzed. When the Eadi waveform was shown, the auto-triggering detection improved from 13% to 67% (P<0.0001) and the missed efforts detection improved from 43% to 95% (P<0.0001). The detection of double triggering, instead, did not improve (85% with the EAdi vs. 78% without the EAdi waveform; P=0.52). Conclusions: This single center study suggests that the EAdi waveform may improve the ability of pediatric intensivists to detect missed efforts and auto-triggering asynchronies. Further studies are required to determine the clinical implications of these findings.
MeSH term(s)	Child ; Critical Care ; Diaphragm/diagnostic imaging ; Humans ; Physicians ; Respiration, Artificial ; Ventilators, Mechanical
Language	English
Publishing date	2020-08-04
Publishing country	Italy
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	123584-9
ISSN	1827-1596 ; 0026-4717 ; 0375-9393
ISSN (online)	1827-1596
ISSN	0026-4717 ; 0375-9393
DOI	10.23736/S0375-9393.20.14543-7
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Zs.A 516: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Continuous assessment of neuro-ventilatory drive during 12 h of pressure support ventilation in critically ill patients.

Di Mussi, Rosa / Spadaro, Savino / Volta, Carlo Alberto / Bartolomeo, Nicola / Trerotoli, Paolo / Staffieri, Francesco / Pisani, Luigi / Iannuzziello, Rachele / Dalfino, Lidia / Murgolo, Francesco / Grasso, Salvatore

Critical care (London, England)

2020 Volume 24, Issue 1, Page(s) 652

Abstract: Introduction: Pressure support ventilation (PSV) should allow spontaneous breathing with a "normal" neuro-ventilatory drive. Low neuro-ventilatory drive puts the patient at risk of diaphragmatic atrophy while high neuro-ventilatory drive may causes ... ...

Abstract	Introduction: Pressure support ventilation (PSV) should allow spontaneous breathing with a "normal" neuro-ventilatory drive. Low neuro-ventilatory drive puts the patient at risk of diaphragmatic atrophy while high neuro-ventilatory drive may causes dyspnea and patient self-inflicted lung injury. We continuously assessed for 12 h the electrical activity of the diaphragm (EAdi), a close surrogate of neuro-ventilatory drive, during PSV. Our aim was to document the EAdi trend and the occurrence of periods of "Low" and/or "High" neuro-ventilatory drive during clinical application of PSV. Method: In 16 critically ill patients ventilated in the PSV mode for clinical reasons, inspiratory peak EAdi peak (EAdi Results: Within all the analyzed breaths (177.117), the neuro-ventilatory drive, as expressed by the EAdi Conclusions: We observed wide variations in EAdi amplitude and unevenly distributed "Low" and "High" neuro ventilatory drive periods during 12 h of PSV in critically ill patients. Further studies are needed to assess the possible clinical implications of our physiological findings.
MeSH term(s)	Aged ; Critical Illness/therapy ; Female ; Humans ; Intensive Care Units/organization & administration ; Intensive Care Units/statistics & numerical data ; Interactive Ventilatory Support/instrumentation ; Interactive Ventilatory Support/methods ; Italy ; Male ; Middle Aged ; Monitoring, Physiologic/instrumentation ; Monitoring, Physiologic/methods ; Monitoring, Physiologic/statistics & numerical data ; Respiration, Artificial/instrumentation ; Respiration, Artificial/methods
Keywords	covid19
Language	English
Publishing date	2020-11-20
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041406-7
ISSN	1466-609X ; 1364-8535
ISSN (online)	1466-609X
ISSN	1364-8535
DOI	10.1186/s13054-020-03357-9
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Article: High-flow oxygen therapy in tracheostomized patients at high risk of weaning failure.

Stripoli, Tania / Spadaro, Savino / Di Mussi, Rosa / Volta, Carlo Alberto / Trerotoli, Paolo / De Carlo, Francesca / Iannuzziello, Rachele / Sechi, Fabio / Pierucci, Paola / Staffieri, Francesco / Bruno, Francesco / Camporota, Luigi / Grasso, Salvatore

Annals of intensive care

2019 Volume 9, Issue 1, Page(s) 4

Abstract: Purpose: High-flow oxygen therapy delivered through nasal cannulae improves oxygenation and decreases work of breathing in critically ill patients. Little is known of the physiological effects of high-flow oxygen therapy applied to the tracheostomy ... ...

Abstract	Purpose: High-flow oxygen therapy delivered through nasal cannulae improves oxygenation and decreases work of breathing in critically ill patients. Little is known of the physiological effects of high-flow oxygen therapy applied to the tracheostomy cannula (T-HF). In this study, we compared the effects of T-HF or conventional low-flow oxygen therapy (conventional O Methods: This was a single-center, unblinded, cross-over study on fourteen patients. After disconnection from the ventilator, each patient received two 1-h periods of T-HF (T-HF1 and T-HF2) alternated with 1 h of conventional O Results: The EAdi Conclusions: In tracheostomized patients at high risk of weaning failure from mechanical ventilation, T-HF did not improve neuro-ventilatory drive, work of breathing, respiratory rate and gas exchange compared with conventional O
Language	English
Publishing date	2019-01-07
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2617094-2
ISSN	2110-5820
ISSN	2110-5820
DOI	10.1186/s13613-019-0482-2
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Article ; Online: Circulating Skeletal Troponin During Weaning From Mechanical Ventilation and Their Association to Diaphragmatic Function

Savino Spadaro / Francesca Dalla Corte / Gaetano Scaramuzzo / Salvatore Grasso / Gilda Cinnella / Valentina Rosta / Valentina Chiavieri / Valentina Alvisi / Rosa Di Mussi / Carlo Alberto Volta / Tiziana Bellini / Alessandro Trentini

Frontiers in Medicine, Vol

A Pilot Study

2021 Volume 8

Abstract: Background: Patients with acute respiratory failure (ARF) may need mechanical ventilation (MV), which can lead to diaphragmatic dysfunction and muscle wasting, thus making difficult the weaning from the ventilator. Currently, there are no biomarkers ... ...

Abstract	Background: Patients with acute respiratory failure (ARF) may need mechanical ventilation (MV), which can lead to diaphragmatic dysfunction and muscle wasting, thus making difficult the weaning from the ventilator. Currently, there are no biomarkers specific for respiratory muscle and their function can only be assessed trough ultrasound or other invasive methods. Previously, the fast and slow isoform of the skeletal troponin I (fsTnI and ssTnI, respectively) have shown to be specific markers of muscle damage in healthy volunteers. We aimed therefore at describing the trend of skeletal troponin in mixed population of ICU patients undergoing weaning from mechanical ventilation and compared the value of fsTnI and ssTnI with diaphragmatic ultrasound derived parameters.Methods: In this prospective observational study we enrolled consecutive patients recovering from acute hypoxemic respiratory failure (AHRF) within 24 h from the start of weaning. Every day an arterial blood sample was collected to measure fsTnI, ssTnI, and global markers of muscle damage, such as ALT, AST, and CPK. Moreover, thickening fraction (TF) and diaphragmatic displacement (DE) were assessed by diaphragmatic ultrasound. The trend of fsTnI and ssTnI was evaluated during the first 3 days of weaning.Results: We enrolled 62 consecutive patients in the study, with a mean age of 67 ± 13 years and 43 of them (69%) were male. We did not find significant variations in the ssTnI trend (p = 0.623), but fsTnI significantly decreased over time by 30% from Day 1 to Day 2 and by 20% from Day 2 to Day 3 (p < 0.05). There was a significant interaction effect between baseline ssTnI and DE [F(2) = 4.396, p = 0.015], with high basal levels of ssTnI being associated to a higher decrease in DE. On the contrary, the high basal levels of fsTnI at day 1 were characterized by significant higher DE at each time point.Conclusions: Skeletal muscle proteins have a distinctive pattern of variation during weaning from mechanical ventilation. At day 1, a high basal value ...
Keywords	acute hypoxemic respiratory failure ; assisted mechanical ventilation ; biomarker ; diaphragm ; diaphragmatic ultrasound ; skeletal troponin ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2021-12-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
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Article ; Online: Sterol-standardized phytopharmaceutical from ground cherry: Corticoid-like properties on human keratinocytes and fibroblasts and its effects in a randomized double-blind placebo-controlled clinical trial.

Pereda, Maria Del Carmen V / Dieamant, Gustavo / Nogueira, Cecília / Eberlin, Samara / Facchini, Gustavo / Mussi, Lilian / Polezel, Marcio A / Martins-Oliveira, Divino / Rosa, Paulo T V / Di Stasi, Luiz C

Journal of cosmetic dermatology

2018 Volume 18, Issue 5, Page(s) 1516–1528

Abstract: Background: Topical corticosteroids have been the most commonly prescribed drugs to treat skin inflammation, but their uses can lead to several adverse effects. Nowadays, new pharmacological strategies have been evaluated to improve dermatologic ... ...

Abstract	Background: Topical corticosteroids have been the most commonly prescribed drugs to treat skin inflammation, but their uses can lead to several adverse effects. Nowadays, new pharmacological strategies have been evaluated to improve dermatologic efficacy and reduce adverse effects, including natural products. Objectives: The aim of this study was to evaluate and compare the effects of a plant sterol standardized supercritical CO Methods: Both products were evaluated on the immune (IL-6, IL-10, INF-γ, TNF-α, and IL-1α), inflammatory (COX-2, LOX, PLA Results: Physalis angulata acted on the skin, modulating immune status and inflammatory response producing corticoid-like effects, but different of hydrocortisone, increased skin repair factors. The effects of phytopharmaceutical cream in the clinical trial promoted a better reduction in skin microcirculation and temperature than hydrocortisone. Conclusions: Taken together, the results indicate that sterol standardized CO
Language	English
Publishing date	2018-12-30
Publishing country	England
Document type	Journal Article
ZDB-ID	2280551-5
ISSN	1473-2165 ; 1473-2130
ISSN (online)	1473-2165
ISSN	1473-2130
DOI	10.1111/jocd.12851
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