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  1. Article ; Online: Neonatal respiratory support strategies for the management of extremely low gestational age infants: an Italian survey.

    Petrillo, Flavia / Gizzi, Camilla / Maffei, Gianfranco / Matassa, Piero G / Ventura, Maria Luisa / Ricci, Cinzia / Pastorino, Roberta / Vento, Giovanni

    Italian journal of pediatrics

    2019  Volume 45, Issue 1, Page(s) 44

    Abstract: Background: We aimed to survey Delivery Room and Neonatal Intensive Care Unit (NICU) respiratory strategies dedicated to the extremely low gestational age newborn (ELGAN - GA < 28 wks) in Italy.: Methods: A questionnaire was sent to 113 Italian level ...

    Abstract Background: We aimed to survey Delivery Room and Neonatal Intensive Care Unit (NICU) respiratory strategies dedicated to the extremely low gestational age newborn (ELGAN - GA < 28 wks) in Italy.
    Methods: A questionnaire was sent to 113 Italian level III centres. A lead physician and a nurse with expertise in mechanical ventilation (MV) were identified in each unit to answer. Information about those aspects of ventilatory support considered by center's staff as needing improvement was also collected.
    Results: A 100% response rate was obtained. In the Delivery Room, sustained lung inflation was performed in 74.8% of centres, and 89.2% used NCPAP. For ELGANs who need invasive MV, conventional MV was the most used strategy. Volume-targeted ventilation and High-frequency oscillatory ventilation (HFOV) were considered as primary mode in < 30% of centres. Among non-invasive strategies, NCPAP was the most utilized, followed by BiPAP, High-flow nasal cannula and nasal intermittent positive pressure ventilation. Nurses more commonly recorded in the nursing charts the ventilator's setting parameters rather than measured ones. HFOV and non-invasive ventilation were the most quoted aspects of neonatal ventilation felt as to be improved.
    Conclusion: The routine respiratory support practices in Italy showed marked variations among units. Focused interventions are largely required to improve clinical practice.
    MeSH term(s) Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Italy ; Pain Measurement/statistics & numerical data ; Practice Patterns, Nurses'/statistics & numerical data ; Practice Patterns, Physicians'/statistics & numerical data ; Pulmonary Surfactants/administration & dosage ; Respiration, Artificial/methods ; Respiration, Artificial/statistics & numerical data ; Respiratory Distress Syndrome, Newborn/therapy ; Surveys and Questionnaires
    Chemical Substances Pulmonary Surfactants
    Language English
    Publishing date 2019-04-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 2084688-5
    ISSN 1824-7288 ; 1720-8424 ; 0392-5161
    ISSN (online) 1824-7288
    ISSN 1720-8424 ; 0392-5161
    DOI 10.1186/s13052-019-0639-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Reply to Giesinger and McNamara: The Impact of Therapeutic Hypothermia on Pulmonary Hemodynamics of Meconium Aspiration Syndrome.

    De Luca, Daniele / Tingay, David G / van Kaam, Anton / Brunow de Carvalho, Werther / Valverde, Eva / Roehr, Charles Christoph / Mosca, Fabio / Matassa, Piero G / Danhaive, Olivier / Carnielli, Virgilio P / Piastra, Marco

    American journal of respiratory and critical care medicine

    2018  Volume 198, Issue 2, Page(s) 287–288

    MeSH term(s) Hemodynamics ; Humans ; Hypothermia ; Hypothermia, Induced ; Infant, Newborn ; Meconium Aspiration Syndrome ; Retrospective Studies
    Language English
    Publishing date 2018-03-27
    Publishing country United States
    Document type Letter ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.201803-0411LE
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Hypothermia and Meconium Aspiration Syndrome: International Multicenter Retrospective Cohort Study.

    De Luca, Daniele / Tingay, David G / van Kaam, Anton / Brunow de Carvalho, Werther / Valverde, Eva / Christoph Roehr, Charles / Mosca, Fabio / Matassa, Piero G / Danhaive, Olivier / Carnielli, Virgilio P / Piastra, Marco

    American journal of respiratory and critical care medicine

    2016  Volume 194, Issue 3, Page(s) 381–384

    MeSH term(s) Australia ; Brazil ; Cohort Studies ; European Union ; Female ; Humans ; Hypothermia, Induced/methods ; Infant, Newborn ; Length of Stay/statistics & numerical data ; Male ; Meconium Aspiration Syndrome/metabolism ; Meconium Aspiration Syndrome/therapy ; Oxygen/metabolism ; Respiration, Artificial/statistics & numerical data ; Retrospective Studies ; Risk Factors ; Treatment Outcome ; United States
    Chemical Substances Oxygen (S88TT14065)
    Language English
    Publishing date 2016-07-29
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.201602-0422LE
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  4. Article: Effects of early dexamethasone therapy on pulmonary fibrogenic mediators and respiratory mechanics in preterm infants.

    Vento, Giovanni / Matassa, Piero G / Ameglio, Franco / Capoluongo, Ettore / Tortorolo, Luca / Romagnoli, Costantino

    European cytokine network

    2002  Volume 13, Issue 2, Page(s) 207–214

    Abstract: Corticosteroid administration may prevent chronic lung disease in premature newborns, perhaps by modulating the synthesis of various cytokines, including those involved in fibrogenic processes. This study analyses the levels of three fibrogenic cytokines, ...

    Abstract Corticosteroid administration may prevent chronic lung disease in premature newborns, perhaps by modulating the synthesis of various cytokines, including those involved in fibrogenic processes. This study analyses the levels of three fibrogenic cytokines, namely vascular endothelial growth factor, transforming growth factor-beta 1 and basic fibroblast growth factor in tracheobronchial aspirate fluids collected from 20 premature newborns randomly assigned to the early dexamethasone group or to the control group. Furthermore, pulmonary function tests were performed on days 0 and 2 following the start of therapy. The results show that early corticosteroid administration reduces transforming growth factor-beta 1 and basic fibroblast growth factor levels, and abolishes the spontaneous vascular endothelial growth factor increase observed in untreated patients, concomitantly with significant improvement of dynamic lung compliance and shorter duration of the intubation period in the treated group of patients. Significant correlations were observed between the levels of transforming growth factor-beta 1 and vascular endothelial growth factor, indicating that the production of both these cytokines is coordinated. Finally, transforming growth factor-beta 1 ratios (day 2/day 0), representing early variations of the cytokine levels, were significantly different between treated and untreated subjects and correlated with the dynamic lung compliance ratios and the extubation day, suggesting that the downmodulation of some fibrogenic mediators may be involved in the mode of action of dexamethasone.
    MeSH term(s) Anti-Inflammatory Agents/therapeutic use ; Cytokines/blood ; Cytokines/physiology ; Dexamethasone/therapeutic use ; Gestational Age ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Pulmonary Fibrosis/prevention & control ; Respiratory Mechanics/drug effects ; Respiratory Mechanics/physiology
    Chemical Substances Anti-Inflammatory Agents ; Cytokines ; Dexamethasone (7S5I7G3JQL)
    Language English
    Publishing date 2002-04
    Publishing country France
    Document type Clinical Trial ; Controlled Clinical Trial ; Journal Article ; Multicenter Study
    ZDB-ID 1118857-1
    ISSN 1148-5493
    ISSN 1148-5493
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: HFOV in premature neonates: effects on pulmonary mechanics and epithelial lining fluid cytokines. A randomized controlled trial.

    Vento, Giovanni / Matassa, Piero G / Ameglio, Franco / Capoluongo, Ettore / Zecca, Enrico / Tortorolo, Luca / Martelli, Mara / Romagnoli, Costantino

    Intensive care medicine

    2005  Volume 31, Issue 3, Page(s) 463–470

    Abstract: Objective: Ventilation strategies for preterm neonates may influence the severity of pulmonary dysfunction and later development of chronic lung disease. The objective of this report is to compare the effects of high-frequency oscillatory ventilation ( ... ...

    Abstract Objective: Ventilation strategies for preterm neonates may influence the severity of pulmonary dysfunction and later development of chronic lung disease. The objective of this report is to compare the effects of high-frequency oscillatory ventilation (HFOV) versus synchronized intermittent mandatory ventilation (sIMV) from the points of views of biochemical and functional variables.
    Design: Randomized controlled trial.
    Setting: Third level NICU.
    Patients and participants: Forty preterm neonates with a gestational age of 24-29 weeks were randomly assigned to one of the two above-mentioned ventilation strategies within 30 min from birth.
    Measurements and results: At 1, 3, 5, and 7 days, the babies were monitored by means of ventilator indices, pulmonary function, and eight pro-inflammatory or anti-inflammatory cytokines measured in bronchoalveolar lavage fluid. The neonates assigned to the HFOV procedure benefited from early and sustained improvement in pulmonary mechanics and gas exchange-significantly higher dynamic respiratory compliance values, significantly lower expiratory airway resistance and oxygenation index values-with earlier extubation as compared to the neonates assigned to sIMV treatment, and showed significantly lower transforming growth factor-beta1 concentrations in bronchoalveolar lavage fluid.
    Conclusions: The results of this randomized clinical trial support the hypothesis that early and exclusive use of HFOV, combined with optimum volume strategy, has a beneficial effect during the acute phase of lung injury.
    MeSH term(s) Body Fluids/metabolism ; Cytokines/metabolism ; Female ; High-Frequency Ventilation ; Humans ; Infant, Newborn ; Infant, Premature, Diseases/immunology ; Infant, Premature, Diseases/physiopathology ; Infant, Premature, Diseases/therapy ; Male ; Respiration, Artificial/methods ; Respiratory Distress Syndrome, Newborn/immunology ; Respiratory Distress Syndrome, Newborn/physiopathology ; Respiratory Distress Syndrome, Newborn/therapy ; Respiratory Mechanics ; Respiratory Mucosa/immunology ; Respiratory Mucosa/metabolism ; Survival Analysis ; Transforming Growth Factor beta/metabolism ; Transforming Growth Factor beta1 ; Treatment Outcome
    Chemical Substances Cytokines ; TGFB1 protein, human ; Transforming Growth Factor beta ; Transforming Growth Factor beta1
    Language English
    Publishing date 2005-03
    Publishing country United States
    Document type Clinical Trial ; Comparative Study ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0342-4642 ; 0340-0964 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0342-4642 ; 0340-0964 ; 0935-1701
    DOI 10.1007/s00134-005-2556-x
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    Zs.A 1089: Show issues Location:
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  6. Article: Serum levels of seven cytokines in premature ventilated newborns: correlations with old and new forms of bronchopulmonary dysplasia.

    Vento, Giovanni / Capoluongo, Ettore / Matassa, Piero G / Concolino, Paola / Vendettuoli, Valentina / Vaccarella, Cinzia / Frezza, Simona / Zuppi, Cecilia / Romagnoli, Costantino / Ameglio, Franco

    Intensive care medicine

    2006  Volume 32, Issue 5, Page(s) 723–730

    Abstract: Objective: In addition to the previous classification of chronic lung disease (CLD) O2 dependency at 36 weeks of postmenstrual age, a new definition of CLD has recently been proposed: new bronchopulmonary-dysplasia (BPD). This uses total duration of O2 ... ...

    Abstract Objective: In addition to the previous classification of chronic lung disease (CLD) O2 dependency at 36 weeks of postmenstrual age, a new definition of CLD has recently been proposed: new bronchopulmonary-dysplasia (BPD). This uses total duration of O2 supplementation and positive pressure requirements to delineate three degrees of severity (mild, moderate, and severe) according to the respiratory status at 36 weeks postmenstrual age. We analyzed the balance of serum proinflammatory and profibrotic/angiogenic cytokine concentrations in relation to CLD and the new BPD definition.
    Design and setting: Descriptive study in a third-level neonatal ICU.
    Patients: Thirty-one preterm neonates with a gestational age of 24-29 weeks were studied to evaluate their serum cytokine concentration; they were previously enrolled in a randomized clinical trial to compare the effects of high-frequency oscillatory ventilation vs. intermittent mandatory ventilation in terms of pulmonary mechanics and lung cytokines. Serum samples were collected on days 1, 3, and 5 after birth until extubation to detect the levels of three proinflammatory cytokines plus four profibrotic/angiogenic cytokines, and correlations were examined to old CLD and new BPD. Ventilation treatments were distributed homogeneously between the groups and did not interfere with the results presented here.
    Results and conclusions: Old CLD development, mainly corresponding to the moderate/severe forms of new BPD, was associated with increased proinflammatory and profibrotic/angiogenic cytokines, while mild forms of new BPD were characterized only by increases in profibrotic/angiogenic cytokines, suggesting a different balance of two pathogenic mechanisms in different phases of the disease.
    MeSH term(s) Bronchopulmonary Dysplasia/physiopathology ; Cytokines/analysis ; Cytokines/blood ; Female ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Italy ; Male ; Positive-Pressure Respiration ; Premature Birth
    Chemical Substances Cytokines
    Language English
    Publishing date 2006-05
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0342-4642 ; 0340-0964 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0342-4642 ; 0340-0964 ; 0935-1701
    DOI 10.1007/s00134-006-0138-1
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  7. Article ; Online: Lung recruitment before surfactant administration in extremely preterm neonates with respiratory distress syndrome (IN-REC-SUR-E): a randomised, unblinded, controlled trial.

    Vento, Giovanni / Ventura, Maria Luisa / Pastorino, Roberta / van Kaam, Anton H / Carnielli, Virgilio / Cools, Filip / Dani, Carlo / Mosca, Fabio / Polglase, Graeme / Tagliabue, Paolo / Boni, Luca / Cota, Francesco / Tana, Milena / Tirone, Chiara / Aurilia, Claudia / Lio, Alessandra / Costa, Simonetta / D'Andrea, Vito / Lucente, Mariella /
    Nigro, Gabriella / Giordano, Lucio / Roma, Vincenzina / Villani, Paolo E / Fusco, Francesca P / Fasolato, Valeria / Colnaghi, Maria Rosa / Matassa, Piero G / Vendettuoli, Valentina / Poggi, Chiara / Del Vecchio, Antonio / Petrillo, Flavia / Betta, Pasqua / Mattia, Carmine / Garani, Giampaolo / Solinas, Agostina / Gitto, Eloisa / Salvo, Vincenzo / Gargano, Giancarlo / Balestri, Eleonora / Sandri, Fabrizio / Mescoli, Giovanna / Martinelli, Stefano / Ilardi, Laura / Ciarmoli, Elena / Di Fabio, Sandra / Maranella, Eugenia / Grassia, Carolina / Ausanio, Gaetano / Rossi, Vincenzo / Motta, Angela / Tina, Lucia G / Maiolo, Kim / Nobile, Stefano / Messner, Hubert / Staffler, Alex / Ferrero, Federica / Stasi, Ilaria / Pieragostini, Luisa / Mondello, Isabella / Haass, Cristina / Consigli, Chiara / Vedovato, Stefania / Grison, Alessandra / Maffei, Gianfranco / Presta, Giuseppe / Perniola, Roberto / Vitaliti, Marcello / Re, Maria P / De Curtis, Mario / Cardilli, Viviana / Lago, Paola / Tormena, Francesca / Orfeo, Luigi / Gizzi, Camilla / Massenzi, Luca / Gazzolo, Diego / Strozzi, Maria Chiara M / Bottino, Roberto / Pontiggia, Federica / Berardi, Alberto / Guidotti, Isotta / Cacace, Caterina / Meli, Valerio / Quartulli, Lorenzo / Scorrano, Antonio / Casati, Alessandra / Grappone, Lidia / Pillow, J Jane

    The Lancet. Respiratory medicine

    2020  Volume 9, Issue 2, Page(s) 159–166

    Abstract: Background: The importance of lung recruitment before surfactant administration has been shown in animal studies. Well designed trials in preterm infants are absent. We aimed to examine whether the application of a recruitment manoeuvre just before ... ...

    Abstract Background: The importance of lung recruitment before surfactant administration has been shown in animal studies. Well designed trials in preterm infants are absent. We aimed to examine whether the application of a recruitment manoeuvre just before surfactant administration, followed by rapid extubation (intubate-recruit-surfactant-extubate [IN-REC-SUR-E]), decreased the need for mechanical ventilation during the first 72 h of life compared with no recruitment manoeuvre (ie, intubate-surfactant-extubate [IN-SUR-E]).
    Methods: We did a randomised, unblinded, controlled trial in 35 tertiary neonatal intensive care units in Italy. Spontaneously breathing extremely preterm neonates (24 + 0 to 27 + 6 weeks' gestation) reaching failure criteria for continuous positive airway pressure within the first 24 h of life were randomly assigned (1:1) with a minimisation algorithm to IN-REC-SUR-E or IN-SUR-E using an interactive web-based electronic system, stratified by clinical site and gestational age. The primary outcome was the need for mechanical ventilation in the first 72 h of life. Analyses were done in intention-to-treat and per-protocol populations, with a log-binomial regression model correcting for stratification factors to estimate adjusted relative risk (RR). This study is registered with ClinicalTrials.gov, NCT02482766.
    Findings: Of 556 infants assessed for eligibility, 218 infants were recruited from Nov 12, 2015, to Sept 23, 2018, and included in the intention-to-treat analysis. The requirement for mechanical ventilation during the first 72 h of life was reduced in the IN-REC-SUR-E group (43 [40%] of 107) compared with the IN-SUR-E group (60 [54%] of 111; adjusted RR 0·75, 95% CI 0·57-0·98; p=0·037), with a number needed to treat of 7·2 (95% CI 3·7-135·0). The addition of the recruitment manoeuvre did not adversely affect the safety outcomes of in-hospital mortality (19 [19%] of 101 in the IN-REC-SUR-E group vs 37 [33%] of 111 in the IN-SUR-E group), pneumothorax (four [4%] of 101 vs seven [6%] of 111), or grade 3 or worse intraventricular haemorrhage (12 [12%] of 101 vs 17 [15%] of 111).
    Interpretation: A lung recruitment manoeuvre just before surfactant administration improved the efficacy of surfactant treatment in extremely preterm neonates compared with the standard IN-SUR-E technique, without increasing the risk of adverse neonatal outcomes. The reduced need for mechanical ventilation during the first 72 h of life might facilitate implementation of a non-invasive respiratory support strategy.
    Funding: None.
    MeSH term(s) Airway Extubation/methods ; Critical Care/methods ; Female ; Humans ; Infant, Extremely Premature ; Infant, Newborn ; Intensive Care Units, Neonatal ; Intubation, Intratracheal/methods ; Italy ; Lung/physiopathology ; Male ; Pulmonary Surfactants/therapeutic use ; Respiration, Artificial/statistics & numerical data ; Respiratory Distress Syndrome, Newborn/therapy ; Treatment Outcome
    Chemical Substances Pulmonary Surfactants
    Language English
    Publishing date 2020-07-17
    Publishing country England
    Document type Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 2686754-0
    ISSN 2213-2619 ; 2213-2600
    ISSN (online) 2213-2619
    ISSN 2213-2600
    DOI 10.1016/S2213-2600(20)30179-X
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