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  1. Article ; Online: Correction: Clinical performance of lung ultrasound in predicting time-dependent changes in lung aeration in ARDS patients.

    Costamagna, Andrea / Steinberg, Irene / Pivetta, Emanuele / Arina, Pietro / Veglia, Simona / Brazzi, Luca / Fanelli, Vito

    Journal of clinical monitoring and computing

    2024  

    Language English
    Publishing date 2024-03-16
    Publishing country Netherlands
    Document type Published Erratum
    ZDB-ID 1418733-4
    ISSN 1573-2614 ; 1387-1307 ; 0748-1977
    ISSN (online) 1573-2614
    ISSN 1387-1307 ; 0748-1977
    DOI 10.1007/s10877-024-01137-2
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    Zs.A 2054: Show issues Location:
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  2. Article ; Online: Pathophysiology of sepsis.

    Arina, Pietro / Singer, Mervyn

    Current opinion in anaesthesiology

    2021  Volume 34, Issue 2, Page(s) 77–84

    Abstract: Purpose of review: To provide a current overview of sepsis pathophysiology.: Recent findings: The emphasis on sepsis pathophysiology has moved away from the pathogen - the initiating factor - and instead is focussed upon the abnormal and exaggerated ... ...

    Abstract Purpose of review: To provide a current overview of sepsis pathophysiology.
    Recent findings: The emphasis on sepsis pathophysiology has moved away from the pathogen - the initiating factor - and instead is focussed upon the abnormal and exaggerated host response. Instead of targeted eradication of the infection, the host response activates or suppresses multiple downstream pathways, leading to multiple organ dysfunction.
    Summary: Sepsis represents a dysregulated host response to infection leading to organ dysfunction. Here, the pathogen triggers an initial exaggerated inflammatory-immune response that leads to activation or suppression of multiple endothelial, hormonal, bioenergetic, metabolic, immune, and other pathways. These, in turn, produce the circulatory and metabolic perturbations resulting in organ dysfunction. This review will provide an overview of underlying mechanisms and propose that these processes, whereas superficially viewed as dysfunctional, may actually be adaptive/protective in the first instance, though spilling over into maladaptation/harm depending on the magnitude of the host response.
    MeSH term(s) Energy Metabolism ; Humans ; Multiple Organ Failure ; Sepsis/physiopathology
    Language English
    Publishing date 2021-02-27
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 645203-6
    ISSN 1473-6500 ; 0952-7907
    ISSN (online) 1473-6500
    ISSN 0952-7907
    DOI 10.1097/ACO.0000000000000963
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    Zs.A 2564: Show issues Location:
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  3. Article ; Online: High-flow nasal oxygen versus conventional oxygen therapy and noninvasive ventilation in COVID-19 respiratory failure: a systematic review and network meta-analysis of randomised controlled trials.

    Pisciotta, Walter / Passannante, Alberto / Arina, Pietro / Alotaibi, Khalid / Ambler, Gareth / Arulkumaran, Nishkantha

    British journal of anaesthesia

    2024  Volume 132, Issue 5, Page(s) 936–944

    Abstract: Background: Noninvasive methods of respiratory support, including noninvasive ventilation (NIV), continuous positive airway pressure (CPAP), and high-flow nasal oxygen (HFNO), are potential strategies to prevent progression to requirement for invasive ... ...

    Abstract Background: Noninvasive methods of respiratory support, including noninvasive ventilation (NIV), continuous positive airway pressure (CPAP), and high-flow nasal oxygen (HFNO), are potential strategies to prevent progression to requirement for invasive mechanical ventilation in acute hypoxaemic respiratory failure. The COVID-19 pandemic provided an opportunity to understand the utility of noninvasive respiratory support among a homogeneous cohort of patients with contemporary management of acute respiratory distress syndrome. We performed a network meta-analysis of studies evaluating the efficacy of NIV (including CPAP) and HFNO, compared with conventional oxygen therapy (COT), in patients with COVID-19.
    Methods: PubMed, Embase, and the Cochrane library were searched in May 2023. Standard random-effects meta-analysis was used first to estimate all direct pairwise associations and the results from all studies were combined using frequentist network meta-analysis. Primary outcome was treatment failure, defined as discontinuation of HFNO, NIV, or COT despite progressive disease. Secondary outcome was mortality.
    Results: We included data from eight RCTs with 2302 patients, (756 [33%] assigned to COT, 371 [16%] to NIV, and 1175 [51%] to HFNO). The odds of treatment failure were similar for NIV (P=0.33) and HFNO (P=0.25), and both were similar to that for COT (reference category). The odds of mortality were similar for all three treatments (odds ratio for NIV vs COT: 1.06 [0.46-2.44] and HFNO vs COT: 0.97 [0.57-1.65]).
    Conclusions: Noninvasive ventilation, high-flow nasal oxygen, and conventional oxygen therapy are comparable with regards to treatment failure and mortality in COVID-19-associated acute respiratory failure.
    Prospero registration: CRD42023426495.
    MeSH term(s) Humans ; Oxygen/therapeutic use ; Noninvasive Ventilation/methods ; COVID-19/therapy ; COVID-19/etiology ; Pandemics ; Network Meta-Analysis ; Respiratory Insufficiency/therapy ; Respiratory Insufficiency/etiology ; Oxygen Inhalation Therapy/methods ; Respiratory Distress Syndrome/therapy ; Randomized Controlled Trials as Topic
    Chemical Substances Oxygen (S88TT14065)
    Language English
    Publishing date 2024-02-02
    Publishing country England
    Document type Meta-Analysis ; Systematic Review ; Journal Article ; Review
    ZDB-ID 80074-0
    ISSN 1471-6771 ; 0007-0912
    ISSN (online) 1471-6771
    ISSN 0007-0912
    DOI 10.1016/j.bja.2023.12.022
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    Uk I Zs.80: Show issues Location:
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  4. Article ; Online: Prediction of Complications and Prognostication in Perioperative Medicine: A Systematic Review and PROBAST Assessment of Machine Learning Tools.

    Arina, Pietro / Kaczorek, Maciej R / Hofmaenner, Daniel A / Pisciotta, Walter / Refinetti, Patricia / Singer, Mervyn / Mazomenos, Evangelos B / Whittle, John

    Anesthesiology

    2023  Volume 140, Issue 1, Page(s) 85–101

    MeSH term(s) Artificial Intelligence ; Bias ; Databases, Factual ; Machine Learning ; Perioperative Medicine
    Language English
    Publishing date 2023-11-09
    Publishing country United States
    Document type Journal Article ; Systematic Review
    ZDB-ID 269-0
    ISSN 1528-1175 ; 0003-3022
    ISSN (online) 1528-1175
    ISSN 0003-3022
    DOI 10.1097/ALN.0000000000004764
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  5. Article ; Online: Clinical performance of lung ultrasound in predicting time-dependent changes in lung aeration in ARDS patients.

    Costamagna, Andrea / Steinberg, Irene / Pivetta, Emanuele / Arina, Pietro / Veglia, Simona / Brazzi, Luca / Fanelli, Vito

    Journal of clinical monitoring and computing

    2022  Volume 37, Issue 2, Page(s) 473–480

    Abstract: To evaluate whether lung ultrasound is reliable bedside tool to monitor changes of lung aeration at the early and late stages of ARDS. LUS was performed in ARDS patients that underwent at least two consecutive CT scan at ICU admission and at least 1 week ...

    Abstract To evaluate whether lung ultrasound is reliable bedside tool to monitor changes of lung aeration at the early and late stages of ARDS. LUS was performed in ARDS patients that underwent at least two consecutive CT scan at ICU admission and at least 1 week after admission. Twelve fields were evaluated and graded from 0 (normal) to 3 (consolidation). Changes of LUS score in twelve fields (ΔLUS
    MeSH term(s) Humans ; Respiratory Distress Syndrome/diagnostic imaging ; Lung/diagnostic imaging ; Ultrasonography
    Language English
    Publishing date 2022-08-08
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1418733-4
    ISSN 1573-2614 ; 1387-1307 ; 0748-1977
    ISSN (online) 1573-2614
    ISSN 1387-1307 ; 0748-1977
    DOI 10.1007/s10877-022-00902-5
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    Zs.A 2054: Show issues Location:
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  6. Article ; Online: Development and translation of thiometallate sulfide donors using a porcine model of coronary occlusion and reperfusion.

    Johnson, Thomas W / Holt, James / Kleyman, Anna / Zhou, Shengyu / Sammut, Eva / Bruno, Vito Domenico / Gaupp, Charlotte / Stanzani, Giacomo / Martin, John / Arina, Pietro / Deutsch, Julia / Ascione, Raimondo / Singer, Mervyn / Dyson, Alex

    Redox biology

    2024  Volume 73, Page(s) 103167

    Abstract: Sulfide-releasing compounds reduce reperfusion injury by decreasing mitochondria-derived reactive oxygen species production. We previously characterised ammonium tetrathiomolybdate (ATTM), a clinically used copper chelator, as a sulfide donor in rodents. ...

    Abstract Sulfide-releasing compounds reduce reperfusion injury by decreasing mitochondria-derived reactive oxygen species production. We previously characterised ammonium tetrathiomolybdate (ATTM), a clinically used copper chelator, as a sulfide donor in rodents. Here we assessed translation to large mammals prior to clinical testing. In healthy pigs an intravenous ATTM dose escalation revealed a reproducible pharmacokinetic/pharmacodynamic (PK/PD) relationship with minimal adverse clinical or biochemical events. In a myocardial infarction (1-h occlusion of the left anterior descending coronary artery)-reperfusion model, intravenous ATTM or saline was commenced just prior to reperfusion. ATTM protected the heart (24-h histological examination) in a drug-exposure-dependent manner (r
    Language English
    Publishing date 2024-04-25
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2701011-9
    ISSN 2213-2317 ; 2213-2317
    ISSN (online) 2213-2317
    ISSN 2213-2317
    DOI 10.1016/j.redox.2024.103167
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  7. Article ; Online: Discriminating between CPAP success and failure in COVID-19 patients with severe respiratory failure.

    Arina, Pietro / Baso, Beatrice / Moro, Valeria / Patel, Hemani / Ambler, Gareth

    Intensive care medicine

    2020  Volume 47, Issue 2, Page(s) 237–239

    MeSH term(s) COVID-19/therapy ; Continuous Positive Airway Pressure ; Humans ; Respiratory Insufficiency/therapy
    Keywords covid19
    Language English
    Publishing date 2020-11-16
    Publishing country United States
    Document type Letter
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0340-0964 ; 0342-4642 ; 0935-1701
    DOI 10.1007/s00134-020-06304-y
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    Zs.A 1089: Show issues Location:
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  8. Article ; Online: Association Between Hypocholesterolemia and Mortality in Critically Ill Patients With Sepsis: A Systematic Review and Meta-Analysis.

    Hofmaenner, Daniel A / Arina, Pietro / Kleyman, Anna / Page Black, Lauren / Salomao, Reinaldo / Tanaka, Sébastien / Guirgis, Faheem W / Arulkumaran, Nishkantha / Singer, Mervyn

    Critical care explorations

    2023  Volume 5, Issue 2, Page(s) e0860

    Abstract: To ascertain the association between cholesterol and triglyceride levels on ICU admission and mortality in patients with sepsis.: Data sources: Systematic review and meta-analysis of published studies on PubMed and Embase.: Study selection: All ... ...

    Abstract To ascertain the association between cholesterol and triglyceride levels on ICU admission and mortality in patients with sepsis.
    Data sources: Systematic review and meta-analysis of published studies on PubMed and Embase.
    Study selection: All observational studies reporting ICU admission cholesterol and triglyceride levels in critically ill patients with sepsis were included. Authors were contacted for further data.
    Data extraction: Eighteen observational studies were identified, including 1,283 patients with a crude overall mortality of 33.3%. Data were assessed using Revman (Version 5.1, Cochrane Collaboration, Oxford, United Kingdom) and presented as mean difference (MD) with 95% CIs,
    Data synthesis: Admission levels of total cholesterol (17 studies, 1,204 patients; MD = 0.52 mmol/L [0.27-0.77 mmol/L];
    Conclusions: Mortality was associated with lower levels of total cholesterol, HDL-cholesterol, and LDL-cholesterol, but not triglyceride levels, in patients admitted to ICU with sepsis. The impact of cholesterol replacement on patient outcomes in sepsis, particularly in at-risk groups, merits investigation.
    Language English
    Publishing date 2023-02-01
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2639-8028
    ISSN (online) 2639-8028
    DOI 10.1097/CCE.0000000000000860
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  9. Article ; Online: Preoperative aerobic fitness and perioperative outcomes in patients undergoing cystectomy before and after implementation of a national lockdown.

    Tetlow, Nicholas / Dewar, Amy / Arina, Pietro / Tan, Melanie / Sridhar, Ashwin N / Kelly, John D / Arulkumaran, Nishkantha / Stephens, Robert C M / Martin, Daniel S / Moonesinghe, Suneetha R / Whittle, John

    BJA open

    2024  Volume 9, Page(s) 100255

    Abstract: Background: Lower fitness is a predictor of adverse outcomes after radical cystectomy. Lockdown measures during the COVID-19 pandemic affected daily physical activity. We hypothesised that lockdown during the pandemic was associated with a reduction in ... ...

    Abstract Background: Lower fitness is a predictor of adverse outcomes after radical cystectomy. Lockdown measures during the COVID-19 pandemic affected daily physical activity. We hypothesised that lockdown during the pandemic was associated with a reduction in preoperative aerobic fitness and an increase in postoperative complications in patients undergoing radical cystectomy.
    Methods: We reviewed routine preoperative cardiopulmonary exercise testing (CPET) data collected prior to the pandemic (September 2018 to March 2020) and after lockdown (March 2020 to July 2021) in patients undergoing radical cystectomy. Differences in CPET variables, Postoperative Morbidity Survey (POMS) data, and length of hospital stay were compared.
    Results: We identified 267 patients (85 pre-lockdown and 83 during lockdown) who underwent CPET and radical cystectomy. Patients undergoing radical cystectomy throughout lockdown had lower ventilatory anaerobic threshold (9.0 [7.9-10.9]
    Conclusions: Lockdown measures in response to the COVID-19 pandemic were associated with a reduction in fitness and an increase in postoperative morbidity among patients undergoing radical cystectomy.
    Language English
    Publishing date 2024-01-17
    Publishing country England
    Document type Journal Article
    ISSN 2772-6096
    ISSN (online) 2772-6096
    DOI 10.1016/j.bjao.2023.100255
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  10. Article ; Online: Sepsis in severe COVID-19 is rarely septic shock: a retrospective single-centre cohort study.

    Arina, Pietro / Moro, Valeria / Baso, Beatrice / Baxter-Derrington, Christopher / Singer, Mervyn

    British journal of anaesthesia

    2021  Volume 127, Issue 5, Page(s) e182–e185

    MeSH term(s) Aged ; COVID-19/complications ; COVID-19/drug therapy ; Cohort Studies ; Critical Care ; Female ; Humans ; Lactic Acid/blood ; Male ; Middle Aged ; Retrospective Studies ; Sepsis/drug therapy ; Sepsis/etiology ; Shock, Septic/drug therapy ; Shock, Septic/etiology ; Vasoconstrictor Agents/therapeutic use
    Chemical Substances Vasoconstrictor Agents ; Lactic Acid (33X04XA5AT)
    Language English
    Publishing date 2021-08-17
    Publishing country England
    Document type Letter
    ZDB-ID 80074-0
    ISSN 1471-6771 ; 0007-0912
    ISSN (online) 1471-6771
    ISSN 0007-0912
    DOI 10.1016/j.bja.2021.08.007
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