Article
Critical Care Medicine
Christoph Boesing, Peter T. Graf, Fabian Schmitt, Manfred Thiel, Paolo Pelosi, Patricia R. M. Rocco, Thomas Luecke, Joerg Krebs
Summary: The study demonstrates that prone positioning combined with appropriate PEEP levels can increase transpulmonary pressures, improve oxygenation, and stabilize hemodynamics in patients with moderate to severe ARDS. Using a lower PEEP strategy (PEEPARDSNetwork) in conjunction with prone positioning may be an effective lung protective ventilation strategy for these patients.
Article
Anesthesiology
Severin Ramin, Matteo Arcelli, Karim Bouchdoug, Thomas Laumon, Camille Duflos, Audrey De Jong, Samir Jaber, Xavier Capdevila, Jonathan Charbit
Summary: In chest trauma patients, high APrs-ARDS was not significantly associated with an increase in mechanical ventilation duration or mortality risk.
ANAESTHESIA CRITICAL CARE & PAIN MEDICINE
(2022)
Article
Critical Care Medicine
Alvaro Mingote, Ramses Marrero Garcia, Martin Santos Gonzalez, Raquel Castejon, Clara Salas Anton, Juan Antonio Vargas Nunez, Javier Garcia-Fernandez
Summary: In this study, researchers investigated the effect of individualizing driving pressure based on pulmonary elastance on ventilatory-induced lung injury in an acute respiratory distress syndrome model. The results showed that individualized mechanical ventilation led to reduced lung inflammation and structural lung injury, without a significant impact on oxygenation.
Article
Critical Care Medicine
Peter T. Graf, Christoph Boesing, Isabel Brumm, Jonas Biehler, Kei Wieland Mueller, Manfred Thiel, Paolo Pelosi, Patricia R. M. Rocco, Thomas Luecke, Joerg Krebs
Summary: In patients with severe ARDS managed with ECMO, ultraprotective ventilation compared to apneic ventilation improved oxygenation, but increased stress, strain, and mechanical power.
JOURNAL OF INTENSIVE CARE
(2022)
Review
Physiology
Guido Musch
Summary: This review discusses four different methods to image acute lung inflammation with Positron Emission Tomography (PET), which differ in terms of the PET reporter probe, radiotracer, and the specific aspect of the inflammatory response targeted. These methods include measuring metabolic activation of inflammatory cells using 2-[F-18]fluoro-2-deoxy-D-glucose ([F-18]FDG), measuring edema and vascular permeability using H-2 O-15 and radiolabeled plasma proteins, probing expression of targets induced by inflammatory stimuli using tagged enzyme or receptor inhibitors, and developing cell-specific tracers to differentiate cell types contributing to the inflammatory response. Overall, PET imaging proves to be a versatile and quantitative tool for noninvasively measuring inflammation during acute and ventilator-induced lung injury.
FRONTIERS IN PHYSIOLOGY
(2023)
Article
Critical Care Medicine
Roberto Tonelli, Salvatore Grasso, Andrea Cortegiani, Lorenzo Ball, Ivana Castaniere, Luca Tabbi, Riccardo Fantini, Dario Andrisani, Filippo Gozzi, Antonio Moretti, Giulia Bruzzi, Linda Manicardi, Stefania Cerri, Anna Valeria Samarelli, Giulia Raineri, Francesco Murgolo, Andrea Carzoli, Rossella Di Mussi, Stefano Busani, Raffaella Rizzoni, Giacomo Grasselli, Enrico Clini, Alessandro Marchioni
Summary: This study aims to investigate the physiological effects of lung-protective ventilation in patients with AE-ILD-UIP and compare it with primary ARDS. The findings indicate that, unlike patients with primary ARDS, adjusting positive end-expiratory pressure to achieve a positive transpulmonary pressure significantly worsened lung mechanics in mechanically ventilated AE-ILD-UIP patients.
Article
Critical Care Medicine
Davide Chiumello, Matteo Bonifazi, Tommaso Pozzi, Paolo Formenti, Giuseppe Francesco Sferrazza Papa, Gabriele Zuanetti, Silvia Coppola
Summary: This study found that the effects of raising PEEP in COVID-19 ARDS patients during the early phase are highly variable and cannot be easily predicted based on respiratory system characteristics due to the heterogeneity of the disease.
Article
Physiology
Thijs A. Lilien, David M. P. Van Meenen, Marcus J. Schultz, Lieuwe D. J. Bos, Reinout A. Bem
Summary: The interest in oxygen toxicity has led to numerous studies, but there is still no consensus on the clinical impact of hyperoxia and hyperoxemia. This article explores the importance of hyperoxia-induced lung injury in current critical care practice, suggesting that it may be less important than other ventilator-related factors in patients with acute respiratory distress syndrome.
AMERICAN JOURNAL OF PHYSIOLOGY-LUNG CELLULAR AND MOLECULAR PHYSIOLOGY
(2023)
Article
Critical Care Medicine
Richard K. Albert
Summary: This Perspective summarizes the mechanisms by which continuous volume-targeted ventilation (CVTV) causes ventilator-induced lung injury (VILI) by affecting surfactant function.
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2022)
Article
Critical Care Medicine
Elias Baedorf Kassis, Henry K. Su, Alexander R. Graham, Victor Novack, Stephen H. Loring, Daniel S. Talmor
Summary: Reverse triggering is an underexplored form of dyssynchrony with important clinical implications in patients with acute respiratory distress syndrome. Different phenotypes of reverse triggering have varying effects on lung inflation and transpulmonary pressure, emphasizing the importance of understanding these events for clinical management.
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2021)
Article
Physiology
Deepak K. Agrawal, Bradford J. Smith, Peter D. Sottile, David J. Albers
Summary: This study introduces a new damaged-informed lung ventilator (DILV) model that mathematizes ventilator pressure and volume waveforms, including lung physiology, mechanical ventilation, and their interaction, to accurately simulate features of pulmonary pathophysiology and exhibit sufficient flexibility in clinical and laboratory data.
FRONTIERS IN PHYSIOLOGY
(2021)
Review
Physiology
Fernando Suarez-Sipmann, Jesus Villar, Carlos Ferrando, Juan A. Sanchez-Giralt, Gerardo Tusman
Summary: Mechanical ventilation is crucial in managing acute respiratory distress syndrome, but it can contribute to ventilation-induced lung injury. Detecting VILI, especially cyclic overdistension, is challenging due to the insensitivity of routine monitoring methods.
FRONTIERS IN PHYSIOLOGY
(2021)
Article
Critical Care Medicine
Eduardo L. Costa, Arthur S. Slutsky, Laurent J. Brochard, Roy Brower, Ary Serpa-Neto, Alexandre B. Cavalcanti, Alain Mercat, Maureen Meade, Caio C. A. Morais, Ewan Goligher, Carlos R. R. Carvalho, Marcelo B. P. Amato
Summary: This study aimed to evaluate the impact of mechanical power on mortality in ARDS patients, and found that driving pressure, respiratory rate, and mechanical power were significant predictors of mortality, with driving pressure having four times the impact on mortality compared to respiratory rate.
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2021)
Article
Anesthesiology
Jakob Wittenstein, Robert Huhle, Mark Leiderman, Marius Moebius, Anja Braune, Sebastian Tauer, Paul Herzog, Giulio Barana, Alessandra de Ferrari, Andrea Corona, Thomas Bluth, Thomas Kiss, Andreas Gueldner, Marcus J. Schultz, Patricia R. M. Rocco, Paolo Pelosi, Marcelo Gama de Abreu, Martin Scharffenberg
Summary: The study found that subject-ventilator asynchrony during spontaneous breathing did not exacerbate lung or diaphragm injury and dysfunction in experimental porcine ARDS.
BRITISH JOURNAL OF ANAESTHESIA
(2021)
Review
Critical Care Medicine
John Selickman, John J. Marini
Summary: This article discusses the potential diagnostic and therapeutic value of modifying the chest wall structure to detect end-tidal hyperinflation in the respiratory system. Recent studies have shown that limiting chest wall expansion can improve tidal compliance in certain patients with ARDS who are receiving mechanical ventilatory support.
ANNALS OF INTENSIVE CARE
(2022)
Article
Medicine, General & Internal
Gianfranco Sanson, Amedeo De Nicolo, Verena Zerbato, Ludovica Segat, Raffaella Koncan, Stefano Di Bella, Jessica Cusato, Alessandra di Masi, Andrea Palermo, Pietro Caironi, Pierlanfranco D'Agaro, Roberto Luzzati, Antonio D'Avolio
Summary: This study aimed to assess the combined role of vitamin D and albumin serum levels as predictors of COVID-19 disease progression. The results showed that patients with low albumin and low vitamin D serum levels had a significantly increased risk of disease progression. The combined evaluation of these two factors can provide a simple prognostic tool for guiding clinical decisions.
IRISH JOURNAL OF MEDICAL SCIENCE
(2023)
Letter
Respiratory System
Mattia Busana, Luigi Camporota, Luciano Gattinoni
EUROPEAN RESPIRATORY REVIEW
(2022)
Article
Critical Care Medicine
Luciano Gattinoni, Silvia Coppola, Luigi Camporota
INTENSIVE CARE MEDICINE
(2022)
Editorial Material
Critical Care Medicine
Mohamed Boussarsar, Alessandro Protti
INTENSIVE CARE MEDICINE
(2022)
Letter
Respiratory System
Mattia Busana, Luigi Camporota, Luciano Gattinoni
EUROPEAN RESPIRATORY REVIEW
(2022)
Article
Medicine, General & Internal
Giacomo Grasselli, Alberto Zanella, Eleonora Carlesso, Gaetano Florio, Arif Canakoglu, Giacomo Bellani, Nicola Bottino, Luca Cabrini, Gian Paolo Castelli, Emanuele Catena, Maurizio Cecconi, Danilo Cereda, Davide Chiumello, Andrea Forastieri, Giuseppe Foti, Marco Gemma, Riccardo Giudici, Lorenzo Grazioli, Andrea Lombardo, Ferdinando Luca Lorini, Fabiana Madotto, Alberto Mantovani, Giovanni Mistraletti, Francesco Mojoli, Silvia Mongodi, Gianpaola Monti, Stefano Muttini, Simone Piva, Alessandro Protti, Frank Rasulo, Anna Mara Scandroglio, Paolo Severgnini, Enrico Storti, Roberto Fumagalli, Antonio Pesenti
Summary: COVID-19 vaccination is associated with preventing ICU admission for COVID-19 pneumonia, with differences in baseline characteristics and outcomes between vaccinated and unvaccinated patients.
Article
Physiology
David C. Berger, Lena Zwicker, Kay Nettelbeck, Daniela Casoni, Paul Phillipp Heinisch, Hansjorg Jenni, Matthias Haenggi, Luciano Gattinoni, Kaspar F. Bachmann
Summary: Assessment of native cardiac output during extracorporeal circulation is challenging. This study evaluated a modified Fick principle for accurately measuring cardiac output under different conditions. The findings provide important insights for understanding veno-arterial extracorporeal membrane oxygenation (V-A ECMO).
AMERICAN JOURNAL OF PHYSIOLOGY-LUNG CELLULAR AND MOLECULAR PHYSIOLOGY
(2023)
Article
Anesthesiology
Simone Gattarello, Silvia Coppola, Elena Chiodaroli, Tommaso Pozzi, Luigi Camporota, Leif Saager, Davide Chiumello, Luciano Gattinoni
Summary: This study assessed lung mechanics in nonintubated patients with COVID-19 pneumonia and found that patients in the treatment escalation group had higher respiratory rate, tidal volume, and mechanical power ratio compared to the no-treatment escalation group. Mechanical power, its ratio, and pressure-rate index showed the highest association with the clinical outcome.
Editorial Material
Anesthesiology
Simone Gattarello, Luigi Camporota, Luciano Gattinoni
ANAESTHESIA CRITICAL CARE & PAIN MEDICINE
(2023)
Letter
Critical Care Medicine
Tommaso Pozzi, Francesca Collino, Serena Brusatori, Federica Romitti, Mattia Busana, Onnen Moerer, Luigi Camporota, Davide Chiumello, Silvia Coppola, Luciano Gattinoni
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2023)
Letter
Critical Care Medicine
Serena Brusatori, Carmelo Zinnato, Tommaso Pozzi, Luigi Camporota, John J. Marini, Luciano Gattinoni
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2023)
Editorial Material
Critical Care Medicine
Luciano Gattinoni, Francesca Collino, Luigi Camporota
INTENSIVE CARE MEDICINE
(2023)
Article
Physiology
Rosanna D'Albo, Federica Romitti, Luigi Camporota, Onnen Moerer, Mattia Busana, Luciano Gattinoni
Summary: The conditions of temperature, pressure, and saturation in which respiratory gas volumes are expressed are often ignored in clinical practice. This study investigates the effects of gas volume corrections on key respiratory and metabolic variables, and the possible clinical consequences. The findings suggest that gas volume corrections are mostly relevant when assessing CO2 clearance, and knowing when the appropriate corrections are needed allows for a better understanding of patients' clinical conditions and tailored treatment.
JOURNAL OF APPLIED PHYSIOLOGY
(2023)
Editorial Material
Critical Care Medicine
Luciano Gattinoni, Giuseppe Citerio, Arthur S. Slutsky
INTENSIVE CARE MEDICINE
(2023)
Review
Critical Care Medicine
Manu L. N. G. Malbrain, Pietro Caironi, Robert G. Hahn, Juan V. Llau, Marcia Mcdougall, Luis Patrao, Emily Ridley, Alan Timmins
Summary: This article discusses the importance of fluid management during hospitalization and the issues that exist, and provides specific strategies and recommendations to improve the quality and consistency of fluid management.
ANNALS OF INTENSIVE CARE
(2023)