Browsing by Author "Rauseo, Michela"

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    Duration of diaphragmatic inactivity after endotracheal intubation of critically ill patients
    (2021) Sklar, Michael Chaim; Damiani Rebolledo, L. Felipe; Madotto, Fabiana; Jonkman, Annemijn; Rauseo, Michela; Soliman, Ibrahim; Telias, Irene; Dubo, Sebastian; Chen, Lu; Rittayamai, Nuttapol
    Abstract Background In patients intubated for mechanical ventilation, prolonged diaphragm inactivity could lead to weakness and poor outcome. Time to resume a minimal diaphragm activity may be related to sedation practice and patient severity. Methods Prospective observational study in critically ill patients. Diaphragm electrical activity (EAdi) was continuously recorded after intubation looking for resumption of a minimal level of diaphragm activity (beginning of the first 24 h period with median EAdi > 7 µV, a threshold based on literature and correlations with diaphragm thickening fraction). Recordings were collected until full spontaneous breathing, extubation, death or 120 h. A 1 h waveform recording was collected daily to identify reverse triggering. Results Seventy-five patients were enrolled and 69 analyzed (mean age ± standard deviation 63 ± 16 years). Reasons for ventilation were respiratory (55%), hemodynamic (19%) and neurologic (20%). Eight catheter disconnections occurred. The median time for resumption of EAdi was 22 h (interquartile range 0–50 h); 35/69 (51%) of patients resumed activity within 24 h while 4 had no recovery after 5 days. Late recovery was associated with use of sedative agents, cumulative doses of propofol and fentanyl, controlled ventilation and age (older patients receiving less sedation). Severity of illness, oxygenation, renal and hepatic function, reason for intubation were not associated with EAdi resumption. At least 20% of patients initiated EAdi with reverse triggering. Conclusion Low levels of diaphragm electrical activity are common in the early course of mechanical ventilation: 50% of patients do not recover diaphragmatic activity within one day. Sedatives are the main factors accounting for this delay independently from lung or general severity. Trial Registration ClinicalTrials.gov (NCT02434016). Registered on April 27, 2015. First patients enrolled June 2015.
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    High versus low positive end-expiratory pressure during general anaesthesia for open abdominal surgery (PROVHILO trial): a multicentre randomised controlled trial
    (2014) Hemmes, Sabrine N. T.; de Abreu, Marcelo Gama; Pelosi, Paolo; Schultz, Marcus J.; Severgnini, Paolo; Hollmann, Markus W.; Binnekade, Jan M.; Wrigge, Hermann; Canet, Jaume; Hiesmayr, Michael; Schmid, Werner; Jaber, Samir; Hedenstierna, Goran; Putensen, Christian; Sessler, Daniel I.; Lachmann, Burkhard; Kacmarek, Robert M.; Slutsky, Arthur S.; De Baerdemaeker, Luc; De Hert, Stefan; Heyse, Bjorn; Van Limmen, Jurgen; Mulier, Jan-Paul; Velghe, David; Jamaer, Luc; Vandenbrande, Jeroen; Bugedo, Guillermo; Florez, Jorge; Goranovic, Tatjana; Mazul-Sunko, Branka; Bluth, Thomas; Guldner, Andreas; Kiss, Thomas; Koch, Thea; Spieth, Peter Markus; Uhlig, Christopher; Yaqub, Jonathan; Bastin, Bea; Geib, Johann; Schaefer, Maximilian S.; Weiss, Martin; Treschan, Tanja A.; Reske, Andreas W.; Simon, Philipp; Ferner, Alexander Brodhun Marion; Hartmann, Eric; Laufenberg-Feldmann, Rita; Strys, Lydia; De Robertis, Edoardo; Perilli, Valter; Proietti, Rodolfo; Amantea, Bruno; Caroleo, Santo; Tropea, Francesco; Bacuzzi, Alessandro; Vanoni, Massimo; Cinnella, Gilda; Caggianelli, Girolamo; D'Antini, Davide; La Bella, Daniela; Mollica, Giuseppina; Cortegiani, Andrea; Giarratano, Antonino; Montalto, Francesca; Raineri, Santi Maurizio; Barberis, Bruno; Celentano, Cristian; Grio, Michele; Spagnolo, Luigi; Gratarola, Angelo; Molin, Alexandre; Pellerano, Giulia; Pezzato, Stefano; Rusca, Roberta; Della Rocca, Giorgio; Bos, Lieuwe D. J.; Brunelli, Andrea; Marti, Agnes; Cegarra, Virginia; Merten, Alfred; Victoria Moral, Maria; Parera, Ana; Carmen Unzueta, Maria; Sabate, Sergi; Sierra, Pilar; Mayoral, Juan F.; Prieto, Merce; Granell Gil, Manuel; Minguez Marin, Conrado; Mills, Gary H.; Bodger, Phoebe; Melo, Marcos F. Vidal; Sulemanji, Demet; Sprung, Juraj; De Bruyne, Ann; Ongena, Patricia; Bleyl, Jorg-Uwe; Koch, Moritz; Muller, Michael; Rossel, Thomas; Saeger, Hans-Detlef; Weitz, Jurgen; Babian, Renate; Rathmann, Anna Malina; Pochert, Julia; Dathe, Mandy; Chiaravalloti, Fernando; Madia, Daniela; Pezzoli, Ivana; Caruso, Andrea; Bianco, Maria Francesca; Picicco, Francesco; Mirabella, Lucia; Rauseo, Michela; Anguilano, Romina; Palmeri, Cesira; Strano, Maria Teresa; Federico, Antonino; Pompei, Livia; Buttera, Stefania; Everingham, Kirsty; Han, Ruth; Hewson, Russell; Januszewska, Marta; Mohr, Otto; Pearse, Rupert; Raj, Ashok; Oto, Jun; Kacmarek, Robert M.; Weingarten, Toby N.
    Background The role of positive end-expiratory pressure in mechanical ventilation during general anaesthesia for surgery remains uncertain. Levels of pressure higher than 0 cm H2O might protect against postoperative pulmonary complications but could also cause intraoperative circulatory depression and lung injury from overdistension. We tested the hypothesis that a high level of positive end-expiratory pressure with recruitment manoeuvres protects against postoperative pulmonary complications in patients at risk of complications who are receiving mechanical ventilation with low tidal volumes during general anaesthesia for open abdominal surgery.