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  1. Article ; Online: D-dimer and bleeding during ECMO: the chicken and the egg?

    Giani, Marco / Panigada, Mauro

    Intensive care medicine

    2023  Volume 49, Issue 12, Page(s) 1567–1568

    MeSH term(s) Animals ; Chickens ; Extracorporeal Membrane Oxygenation/adverse effects ; Hemorrhage/etiology ; Hemorrhage/therapy ; Fibrin Fibrinogen Degradation Products ; Retrospective Studies
    Chemical Substances fibrin fragment D ; Fibrin Fibrinogen Degradation Products
    Language English
    Publishing date 2023-11-14
    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/s00134-023-07265-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1089: Show issues Location:
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  2. Article ; Online: Correction: Rapid multiplex PCR panels for the management of ventilator-associated pneumonia: pondering strengths and weaknesses.

    Tomasello, Mara / Mangioni, Davide / Panigada, Mauro / Matinato, Caterina / Bandera, Alessandra

    Intensive care medicine

    2024  

    Language English
    Publishing date 2024-04-02
    Publishing country United States
    Document type Published Erratum
    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/s00134-024-07394-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Rapid multiplex PCR panels for the management of ventilator-associated pneumonia: pondering strengths and weaknesses.

    Tomasello, Mara / Mangioni, Davide / Panigada, Mauro / Matinato, Caterina / Bandera, Alessandra

    Intensive care medicine

    2024  

    Language English
    Publishing date 2024-03-18
    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/s00134-024-07375-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Hemoglobin Concentration and Viscoelastic Tests: Remember to Consider Fibrinogen and Platelets.

    Meli, Andrea / Grasselli, Giacomo / Panigada, Mauro

    Critical care medicine

    2023  Volume 51, Issue 5, Page(s) e122–e123

    MeSH term(s) Blood Platelets ; Fibrinogen ; Hemostatics ; Blood Coagulation ; Hemoglobins ; Adenosine Diphosphate/pharmacology
    Chemical Substances Fibrinogen (9001-32-5) ; Hemostatics ; Hemoglobins ; Adenosine Diphosphate (61D2G4IYVH)
    Language English
    Publishing date 2023-04-13
    Publishing country United States
    Document type Research Support, Non-U.S. Gov't ; Letter ; Comment
    ZDB-ID 197890-1
    ISSN 1530-0293 ; 0090-3493
    ISSN (online) 1530-0293
    ISSN 0090-3493
    DOI 10.1097/CCM.0000000000005799
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1261: Show issues Location:
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  5. Article ; Online: A Reminder of Organizational Safety in the ICU in 2022.

    Panigada, Mauro / Zoumprouli, Argyro / Bilotta, Federico

    Critical care medicine

    2022  Volume 50, Issue 11, Page(s) e802–e803

    MeSH term(s) Intensive Care Units ; Organizational Culture
    Language English
    Publishing date 2022-10-13
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 197890-1
    ISSN 1530-0293 ; 0090-3493
    ISSN (online) 1530-0293
    ISSN 0090-3493
    DOI 10.1097/CCM.0000000000005612
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1261: Show issues Location:
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  6. Article ; Online: Agreement between the thromboelastography reaction time parameter using fresh and citrated whole blood during extracorporeal membrane oxygenation with Teg®5000 and Teg®6s.

    De Falco, Stefano / Meli, Andrea / Caccioppola, Alessio / Grasselli, Giacomo / Panigada, Mauro

    Perfusion

    2024  Volume 39, Issue 1_suppl, Page(s) 77S–80S

    Abstract: Purpose: We aimed at assessing the correlation between TEG reaction time (TEG-R) in citrated and fresh blood samples with TEG5000 and TEG 6S during heparin administration in patients with and without ECMO support.: Materials and methods: Paired ... ...

    Abstract Purpose: We aimed at assessing the correlation between TEG reaction time (TEG-R) in citrated and fresh blood samples with TEG5000 and TEG 6S during heparin administration in patients with and without ECMO support.
    Materials and methods: Paired TEG5000 (fresh and citrated whole blood, kaolin and kaolin-heparinase) and TEG6S (citrated whole blood) samples were obtained, together with standard coagulation laboratory tests. Bland-Altman analysis and Lin's concordance correlation coefficient were used to assess agreement.
    Results: Thirteen consecutive ECMO patients and eight consecutive non-ECMO patients were enrolled and TEG was performed for a total of 84 paired samples. ECMO patients received 19.2 (12.6-25.8) U/kg/h of heparin. Five of the non-ECMO patients did not receive heparin, two of them received a very low prophylactic dose (1.6 and 2.9 IU/kg/h, respectively), and one of them 13.1 U/kg/h of heparin. Using TEG®5000, TEG-R was 21.0 (-23.4; 65.5) min longer on fresh compared to citrated blood in patients receiving heparin while only 1.58 (-5.5; 8.7) min longer in patients not-receiving heparin. These differences were reverted by heparinase.
    Conclusions: Using citrated-recalcified blood to perform TEG might lead to underestimation of the effect of heparin.
    Language English
    Publishing date 2024-04-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 645038-6
    ISSN 1477-111X ; 0267-6591
    ISSN (online) 1477-111X
    ISSN 0267-6591
    DOI 10.1177/02676591231223085
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    Zs.A 2424: Show issues Location:
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  7. Article ; Online: Nosocomial Pneumonia in the Mechanically Ventilated Patient.

    Fanning, Jonathon / Panigada, Mauro / Li Bassi, Gianluigi

    Seminars in respiratory and critical care medicine

    2022  Volume 43, Issue 3, Page(s) 426–439

    Abstract: Ventilator-associated pneumonia (VAP) is a common complication occurring in critically ill patients who are mechanically ventilated and is the leading cause of nosocomial infection-related death. Etiologic agents for VAP widely differ based on the ... ...

    Abstract Ventilator-associated pneumonia (VAP) is a common complication occurring in critically ill patients who are mechanically ventilated and is the leading cause of nosocomial infection-related death. Etiologic agents for VAP widely differ based on the population of intensive care unit patients, duration of hospital stay, and prior antimicrobial therapy. VAP due to multidrug-resistant pathogens is associated with the highest morbidity and mortality, likely due to delays in appropriate antimicrobial treatment. International guidelines are currently available to guide diagnostic and therapeutic strategies. VAP can be prevented through various pharmacological and non-pharmacological interventions, which are more effective when grouped as bundles. When VAP is clinically suspected, diagnostic strategies should include early collection of respiratory samples to guide antimicrobial therapy. Empirical treatment should be based on the most likely etiologic microorganisms and antibiotics likely to be active against these microorganisms. Response to therapy should be reassessed after 3 to 5 days and antimicrobials adjusted or de-escalated to reduce the burden of the disease. Finally, considering that drug resistance is increasing worldwide, several novel antibiotics are being tested to efficiently treat VAP in the coming decades.
    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Critical Illness ; Cross Infection/drug therapy ; Cross Infection/epidemiology ; Cross Infection/etiology ; Humans ; Intensive Care Units ; Pneumonia, Ventilator-Associated/diagnosis ; Pneumonia, Ventilator-Associated/drug therapy ; Pneumonia, Ventilator-Associated/epidemiology ; Respiration, Artificial/adverse effects
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2022-06-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1183617-9
    ISSN 1098-9048 ; 1069-3424
    ISSN (online) 1098-9048
    ISSN 1069-3424
    DOI 10.1055/s-0042-1749448
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1555: Show issues Location:
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  8. Article ; Online: Ventilator-associated pneumonia among SARS-CoV-2 acute respiratory distress syndrome patients.

    Fumagalli, Jacopo / Panigada, Mauro / Klompas, Michael / Berra, Lorenzo

    Current opinion in critical care

    2022  Volume 28, Issue 1, Page(s) 74–82

    Abstract: Purpose of review: We conducted a systematic literature review to summarize the available evidence regarding the incidence, risk factors, and clinical characteristics of ventilator-associated pneumonia (VAP) in patients undergoing mechanical ventilation ...

    Abstract Purpose of review: We conducted a systematic literature review to summarize the available evidence regarding the incidence, risk factors, and clinical characteristics of ventilator-associated pneumonia (VAP) in patients undergoing mechanical ventilation because of acute respiratory distress syndrome secondary to SARS-CoV-2 infection (C-ARDS).
    Recent findings: Sixteen studies (6484 patients) were identified. Bacterial coinfection was uncommon at baseline (<15%) but a high proportion of patients developed positive bacterial cultures thereafter leading to a VAP diagnosis (range 21-64%, weighted average 50%). Diagnostic criteria varied between studies but most signs of VAP have substantial overlap with the signs of C-ARDS making it difficult to differentiate between bacterial colonization versus superinfection. Most episodes of VAP were associated with Gram-negative bacteria. Occasional cases were also attributed to herpes virus reactivations and pulmonary aspergillosis. Potential factors driving high VAP incidence rates include immunoparalysis, prolonged ventilation, exposure to immunosuppressants, understaffing, lapses in prevention processes, and overdiagnosis.
    Summary: Covid-19 patients who require mechanical ventilation for ARDS have a high risk (>50%) of developing VAP, most commonly because of Gram-negative bacteria. Further work is needed to elucidate the disease-specific risk factors for VAP, strategies for prevention, and how best to differentiate between bacterial colonization versus superinfection.
    MeSH term(s) COVID-19 ; Humans ; Overdiagnosis ; Pneumonia, Ventilator-Associated/epidemiology ; Respiration, Artificial ; Respiratory Distress Syndrome/epidemiology ; Respiratory Distress Syndrome/etiology ; SARS-CoV-2
    Language English
    Publishing date 2022-02-22
    Publishing country United States
    Document type Journal Article ; Systematic Review
    ZDB-ID 1235629-3
    ISSN 1531-7072 ; 1070-5295
    ISSN (online) 1531-7072
    ISSN 1070-5295
    DOI 10.1097/MCC.0000000000000908
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Microbiological colonization of healthcare workers' mobile phones in a tertiary-level Italian intensive care unit.

    Galazzi, Alessandro / Panigada, Mauro

    Intensive & critical care nursing

    2019  Volume 53, Page(s) 112

    MeSH term(s) Cell Phone ; Health Personnel ; Humans ; Intensive Care Units
    Language English
    Publishing date 2019-03-27
    Publishing country Netherlands
    Document type Letter ; Comment
    ZDB-ID 1105892-4
    ISSN 1532-4036 ; 0964-3397
    ISSN (online) 1532-4036
    ISSN 0964-3397
    DOI 10.1016/j.iccn.2019.03.005
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  10. Article ; Online: The role of inflammation and antithrombin supplementation on thromboelastographic parameters during veno-venous ECMO for respiratory failure.

    Meli, Andrea / De Falco, Stefano / Novembrino, Cristina / Boscolo Anzoletti, Massimo / Arcadipane, Antonio / Panarello, Giovanna / Occhipinti, Giovanna / Grasselli, Giacomo / Panigada, Mauro

    Perfusion

    2024  Volume 39, Issue 1_suppl, Page(s) 66S–76S

    Abstract: Introduction: Extracorporeal membrane oxygenation (ECMO) may act as a driver or propagator of systemic inflammation. In turn, cytokine release can modify thromboelastographic (TEG) tests which are commonly used for anticoagulation monitoring. In this ... ...

    Abstract Introduction: Extracorporeal membrane oxygenation (ECMO) may act as a driver or propagator of systemic inflammation. In turn, cytokine release can modify thromboelastographic (TEG) tests which are commonly used for anticoagulation monitoring. In this context, antithrombin (AT) supplementation might further modify TEG.
    Methods: This is a pre-specified sub-study of the "Randomized Controlled Trial of Antithrombin Supplementation During Extracorporeal Membrane Oxygenation" study (investigator-initiated, randomized, single-blind, two-arm trial) conducted in two Italian ECMO referral ICUs. Adult patients requiring vv-ECMO for respiratory failure and undergoing unfractioned heparin (UFH) administration were enrolled and randomized whether to receive AT supplementation. Plasma samples for cytokine assay (IL-8, IL-10, IL-6, IL-1β, TNF-α and Pro-ADM) and heparinase TEG were collected from every patient before ECMO start, 24 h and 72 h after ECMO start, before ECMO removal, and 7 days after ECMO removal or upon ICU discharge whichever happened first. AT concentration, coagulation and clinical data were collected before ECMO start and at pre-fixed time points.
    Results: Thirty-nine patients were enrolled (21 treatments, 18 controls). TEG-R had a weak-to-moderate positive correlation with IL-8, IL-6, IL-10 and TNF-α and a moderate positive correlation with Pro-ADM. TEG-ANG showed a weak negative correlation with IL-8, IL-6 and TNF-α, while TEG-MA negatively correlated with IL-8, TNF-α and Pro-ADM. AT supplementation seemed to modify the association between TEG-MA and IL-8, IL-10 and Pro-ADM; conversely, AT did not affect the relationship among TEG-R or TEG-ANG and the studied cytokines.
    Conclusions: High concentrations of systemic cytokines correlated with longer reaction times and decreased angle and amplitude at TEG, suggesting that an increase in inflammation is related with hypocoagulability as revealed by thromboelastography.
    Language English
    Publishing date 2024-04-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 645038-6
    ISSN 1477-111X ; 0267-6591
    ISSN (online) 1477-111X
    ISSN 0267-6591
    DOI 10.1177/02676591241237637
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