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Di Costanzo D, Mazza M, Ruggeri P, Blanco J, Mina B, Fiorentino G, Lazovic B, Scaramuzzo G, Esquinas A. Lung and diaphragm ultrasound in noninvasive respiratory support: A real tool or fashion? Tuberk Toraks 2023; 71:7-12. [PMID: 36912404 PMCID: PMC10795273 DOI: 10.5578/tt.20239902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 02/25/2023] [Indexed: 03/14/2023] Open
Abstract
Introduction Over the past few years, there has been an increase in lung and diaphragm ultrasound applications as a tool to evaluate the outcomes and settings of noninvasive respiratory supports. However, actual clinical practices in this field are yet to be known. The aim of this study was to investigate the current clinical utilization of ultrasound for noninvasive respiratory supports on an international level. Materials and Methods The study employed an online survey consisting of 32 items, which was sent via email to intensivists, pulmonologists, emergency medicine physicians, and other specialists with expertise in using ultrasound and/or noninvasive respiratory supports. Result We collected 52 questionnaires. The ultrasound study of diaphragm dysfunction was well-known by the majority of respondents (57.7%). Diaphragm performance was used as a weaning failure predictor (48.5%), as a predictor of noninvasive ventilation failure (38.5%) and as a tool for the ventilator settings adjustment (30.8%). In patients with acute respiratory failure, 48.1% used ultrasound to assess the damaged lung area to set up ventilatory parameters, 34.6% to monitor it after noninvasive ventilation application, and 32.7% to match it with the ventilatory settings for adjustment purposes. When administering high flow nasal cannula - oxygen therapy, 42.3% of participants used ultrasound to evaluate lung involvement and assess flow parameters. Conclusions Lung and diaphragm ultrasound is an established clinical practice to evaluate noninvasive respiratory supports outcomes and settings. Further studies are needed to evaluate the educational aspects to increase confidence and indications for its use.
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Affiliation(s)
- D. Di Costanzo
- Unit of Pulmonology and Respiratory Pathophysiology, Clinic of Medical
Sciences, Aorn Sant’Anna and San Sebastiano Hospital, Caserta, Italy
- Unit of Pulmonology, Department of Biomedical and Dental Sciences,
Messina University Faculty of Medicine, Messina, Italy
- Intensive Care Unit, Hospital Garcia de Orta, Almada, Portugal
- Clinic of Pulmonary and Critical Care, Lenox Hill Hospital, New York,
United States
- Clinic of Pathophysiology and Respiratory Rehabilitation, Monaldi Hospital
Azienda Ospedaliera Dei Colli, Napoli, Italy
- Pulmonogy Ward, University Clinical Hospital Center Zemun, Belgrade,
Serbia
- Department of Translational Medicine, Ferrara University Faculty of
Medicine, Ferrara, Italy
- Intensive Care Unit, Hospital Morales Meseguer, Murcia, Spain
| | - M. Mazza
- Unit of Pulmonology and Respiratory Pathophysiology, Clinic of Medical
Sciences, Aorn Sant’Anna and San Sebastiano Hospital, Caserta, Italy
| | - P. Ruggeri
- Unit of Pulmonology, Department of Biomedical and Dental Sciences,
Messina University Faculty of Medicine, Messina, Italy
| | - J.B. Blanco
- Intensive Care Unit, Hospital Garcia de Orta, Almada, Portugal
| | - B. Mina
- Clinic of Pulmonary and Critical Care, Lenox Hill Hospital, New York,
United States
| | - G. Fiorentino
- Clinic of Pathophysiology and Respiratory Rehabilitation, Monaldi Hospital
Azienda Ospedaliera Dei Colli, Napoli, Italy
| | - B. Lazovic
- Pulmonogy Ward, University Clinical Hospital Center Zemun, Belgrade,
Serbia
| | - G. Scaramuzzo
- Department of Translational Medicine, Ferrara University Faculty of
Medicine, Ferrara, Italy
| | - A. Esquinas
- Intensive Care Unit, Hospital Morales Meseguer, Murcia, Spain
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Di Stasi V, Rastrelli G, Inglese F, Beccaria M, Garuti M, Di Costanzo D, Spreafico F, Cervi G, Greco GF, Pecoriello A, Todisco T, Cipriani S, Maseroli E, Scavello I, Glingani C, Franchini M, Maggi M, De Donno G, Vignozzi L. Higher testosterone is associated with increased inflammatory markers in women with SARS-CoV-2 pneumonia: preliminary results from an observational study. J Endocrinol Invest 2022; 45:639-648. [PMID: 34731444 PMCID: PMC8564592 DOI: 10.1007/s40618-021-01682-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 09/21/2021] [Indexed: 01/20/2023]
Abstract
PURPOSE Objective of this study was to assess the association between testosterone (T) levels and biochemical markers in a cohort of female patients admitted for SARS-CoV-2 infection in a respiratory intensive care unit (RICU). METHODS A consecutive series of 17 women affected by SARSCoV-2 pneumonia and recovered in the RICU of the Hospital of Mantua were analyzed. Biochemical inflammatory markers as well as total testosterone (TT), calculated free T (cFT), sex hormone-binding globulin (SHBG), and luteinizing hormone (LH) were determined. RESULTS TT and cFT were significantly and positively associated with PCT, CRP, and fibrinogen as well as with a worse hospital course. We did not observe any significant association between TT and cFT with LH; conversely, both TT and cFT showed a positive correlation with cortisol. By LOWESS analysis, a linear relationship could be assumed for CRP and fibrinogen, while a threshold effect was apparent in the relationship between TT and procalcitonin, LDH and ferritin. When the TT threshold value of 1 nmol/L was used, significant associations between TT and PCT, LDH or ferritin were observed for values above this value. For LDH and ferritin, this was confirmed also in an age-adjusted model. Similar results were found for the association of cFT with the inflammatory markers with a threshold effect towards LDH and ferritin with increased LDH and ferritin levels for values above cFT 5 pmol/L. Cortisol is associated with serum inflammatory markers with similar trends observed for TT; conversely, the relationship between LH and inflammatory markers had different trends. CONCLUSION Opposite to men, in women with SARS-CoV-2 pneumonia, higher TT and cFT are associated with a stronger inflammatory status, probably related to adrenal cortex hyperactivity.
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Affiliation(s)
- V Di Stasi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Careggi Hospital, Viale Pieraccini, 6, 50134, Florence, Italy
| | - G Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Careggi Hospital, Viale Pieraccini, 6, 50134, Florence, Italy
| | - F Inglese
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Mantova, Italy
| | - M Beccaria
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Mantova, Italy
| | - M Garuti
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Mantova, Italy
| | - D Di Costanzo
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Mantova, Italy
| | - F Spreafico
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Mantova, Italy
| | - G Cervi
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Mantova, Italy
| | - G F Greco
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Mantova, Italy
| | - A Pecoriello
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Mantova, Italy
| | - T Todisco
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Careggi Hospital, Viale Pieraccini, 6, 50134, Florence, Italy
| | - S Cipriani
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Careggi Hospital, Viale Pieraccini, 6, 50134, Florence, Italy
| | - E Maseroli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Careggi Hospital, Viale Pieraccini, 6, 50134, Florence, Italy
| | - I Scavello
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Careggi Hospital, Viale Pieraccini, 6, 50134, Florence, Italy
| | - C Glingani
- Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, Mantova, Italy
| | - M Franchini
- Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, Mantova, Italy
| | - M Maggi
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Careggi Hospital, Viale Pieraccini, 6, Florence, Italy
| | - G De Donno
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Mantova, Italy
| | - L Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Careggi Hospital, Viale Pieraccini, 6, 50134, Florence, Italy.
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