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Bevilacqua S, Pratesi C, Ostuni MF, Pecchioni A, Giacomelli E, Cerillo AG, Stefano P. Outcome analysis of synchronous carotid endarterectomy and cardiac surgery. Comparison of two anesthetic techniques after propensity score-matching. J Cardiovasc Surg (Torino) 2022; 63:445-453. [PMID: 35848868 DOI: 10.23736/s0021-9509.21.12104-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND The aim of this study was to investigate the outcome of patients undergoing synchronous carotid endarterectomy and coronary and/or other cardiac surgery. The impact of anesthesia on the outcome was examined. METHODS A retrospective single-center observational study was performed, to investigate the outcome of 127 consecutive adult patients submitted to synchronous surgery from 2011 to 2019. Cooperative patient general anesthesia for carotid endarterectomy followed by standard general anesthesia for cardiac surgery and standard general anesthesia for the whole surgery were compared after a propensity score analysis. RESULTS Primary outcomes were 30-day mortality (3.1%), incidence of stroke (3.1%), and myocardial infarction (0.8%). Agitation upon awakening, postoperative cardiac troponin I release, the increase of serum creatinine, the occurrence of acute kidney injury and the need for continuous renal replacement therapy were the secondary outcomes. A binary logistic regression revealed that cardiopulmonary bypass use, standard general anesthesia for the whole surgery and the European risk score II, were the strongest predictors of any severe postoperative complications. After propensity score matching, general anesthesia for the whole surgery was significantly correlated with the occurrence of any severe postoperative complication (P=0.038). CONCLUSIONS Synchronous surgery was performed with acceptable mortality and complication rate even in combination with other than isolated coronary surgery. Cooperative patient general anesthesia during carotid endarterectomy, was not inferior to general anesthesia in this setting.
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Affiliation(s)
- Sergio Bevilacqua
- Department of Anesthesiology and Intensive Care, Careggi University Hospital, Florence, Italy -
| | - Carlo Pratesi
- Department of Cardiothoracic and Vascular Surgery, Careggi University Hospital, Florence, Italy
| | - Michele F Ostuni
- Department of Anesthesiology and Intensive Care, Careggi University Hospital, Florence, Italy
| | - Andrea Pecchioni
- Department of Anesthesiology and Intensive Care, Careggi University Hospital, Florence, Italy
| | - Elena Giacomelli
- Department of Cardiothoracic and Vascular Surgery, Careggi University Hospital, Florence, Italy
| | - Alfredo G Cerillo
- Department of Cardiothoracic and Vascular Surgery, Careggi University Hospital, Florence, Italy
| | - Pierluigi Stefano
- Department of Cardiothoracic and Vascular Surgery, Careggi University Hospital, Florence, Italy
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2
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Lanza G, Orso M, Alba G, Bevilacqua S, Capoccia L, Cappelli A, Carrafiello G, Cernetti C, Diomedi M, Dorigo W, Faggioli G, Giannace V, Giannandrea D, Giannetta M, Lanza J, Lessiani G, Marone EM, Mazzaccaro D, Migliacci R, Nano G, Pagliariccio G, Petruzzellis M, Plutino A, Pomatto S, Pulli R, Reale N, Santalucia P, Sirignano P, Ticozzelli G, Vacirca A, Visco E. Guideline on carotid surgery for stroke prevention: updates from the Italian Society of Vascular and Endovascular Surgery. A trend towards personalized medicine. J Cardiovasc Surg (Torino) 2022; 63:471-491. [PMID: 35848869 DOI: 10.23736/s0021-9509.22.12368-2] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND This guideline (GL) on carotid surgery as updating of "Stroke: Italian guidelines for Prevention and Treatment" of the ISO-SPREAD Italian Stroke Organization-Group, has recently been published in the National Guideline System and shared with the Italian Society of Vascular and Endovascular Surgery (SICVE) and other Scientific Societies and Patient's Association. METHODS GRADE-SIGN version, AGREE quality of reporting checklist. Clinical questions formulated according to the PICO model. Recommendations developed based on clinical questions by a multidisciplinary experts' panel and patients' representatives. Systematic reviews performed for each PICO question. Considered judgements filled by assessing the evidence level, direction, and strength of the recommendations. RESULTS The panel provided indications and recommendations for appropriate, comprehensive, and individualized management of patients with carotid stenosis. Diagnostic and therapeutic processes of the best medical therapy, carotid endarterectomy (CEA), carotid stenting (CAS) according to the evidences and the judged opinions were included. Symptomatic carotid stenosis in elective and emergency, asymptomatic carotid stenosis, association with ischemic heart disease, preoperative diagnostics, types of anesthesia, monitoring in case of CEA, CEA techniques, comparison between CEA and CAS, post-surgical carotid restenosis, and medical therapy are the main topics, even with analysis of uncertainty areas for risk-benefit assessments in the individual patient (personalized medicine [PM]). CONCLUSIONS This GL updates on the main recommendations for the most appropriate diagnostic and medical-surgical management of patients with atherosclerotic carotid artery stenosis to prevent ischemic stroke. This GL also provides useful elements for the application of PM in good clinical practice.
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Affiliation(s)
- Gaetano Lanza
- Department of Vascular Surgery, IRCCS MultiMedica, Castellanza Hospital, Castellanza, Varese, Italy
| | - Massimiliano Orso
- Experimental Zooprophylactic Institute of Umbria and Marche, Perugia, Italy
| | - Giuseppe Alba
- Unit of Vascular Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Sergio Bevilacqua
- Department of Cardiac Anesthesia and Resuscitation, Careggi University Hospital, Florence, Italy
| | - Laura Capoccia
- Department of Vascular and Endovascular Surgery, Umberto I Polyclinic Hospital, Sapienza University, Rome, Italy
| | - Alessandro Cappelli
- Unit of Vascular Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Giampaolo Carrafiello
- Department of Radiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Carlo Cernetti
- Department of Cardiology and Hemodynamics, San Giacomo Apostolo Hospital, Castelfranco Veneto, Treviso, Italy
- Cardiology and Hemodynamics Unit, Ca' Foncello Hospital, Treviso, Italy
| | - Marina Diomedi
- Stroke Unit, Tor Vergata Polyclinic Hospital, Tor Vergata University, Rome, Italy
| | - Walter Dorigo
- Department of Vascular Surgery, Careggi Polyclinic Hospital, University of Florence, Florence, Italy
| | - Gianluca Faggioli
- Department of Vascular Surgery, Alma Mater Studiorum University, Bologna, Italy
| | - Vanni Giannace
- Unit of Vascular Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - David Giannandrea
- Department of Neurology, USL Umbria 1, Hospitals of Gubbio, Gualdo Tadino and Città di Castello, Perugia, Italy
| | - Matteo Giannetta
- Department of Vascular Surgery, IRCCS San Donato Hospitals, San Donato Polyclinic Hospital, Milan, Italy
| | - Jessica Lanza
- Department of Vascular Surgery, IRCCS San Martino Polyclinic Hospital, University of Genoa, Genoa, Italy -
| | - Gianfranco Lessiani
- Unit of Vascular Medicine and Diagnostics, Department of Internal Medicine, Villa Serena Hospital, Città Sant'Angelo, Pesaro, Italy
| | - Enrico M Marone
- Vascular Surgery, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Daniela Mazzaccaro
- Department of Vascular Surgery, IRCCS San Donato Hospitals, San Donato Polyclinic Hospital, Milan, Italy
| | - Rino Migliacci
- Department of Internal Medicine, Valdichiana S. Margherita Hospital, USL Toscana Sud-Est, Cortona, Arezzo, Italy
| | - Giovanni Nano
- Department of Vascular Surgery, IRCCS San Donato Hospitals, San Donato Polyclinic Hospital, Milan, Italy
| | - Gabriele Pagliariccio
- Department of Emergency Vascular Surgery, Ospedali Riuniti University of Ancona, Ancona, Italy
| | | | - Andrea Plutino
- Stroke Unit, Ospedali Riuniti Marche Nord, Ancona, Italy
| | - Sara Pomatto
- Department of Vascular Surgery, Sant'Orsola Malpighi Polyclinic Hospital, University of Bologna, Bologna, Italy
| | - Raffaele Pulli
- Department of Vascular Surgery, University of Bari, Bari, Italy
| | | | | | - Pasqualino Sirignano
- Department of Vascular and Endovascular Surgery, Umberto I Polyclinic Hospital, Sapienza University, Rome, Italy
| | - Giulia Ticozzelli
- First Department of Anesthesia and Resuscitation, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Andrea Vacirca
- Unit of Vascular Surgery, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), IRCSS Sant'Orsola Polyclinic Hospital, University of Bologna, Bologna, Italy
| | - Emanuele Visco
- Department of Cardiology and Hemodynamics, San Giacomo Apostolo Hospital, Castelfranco Veneto, Treviso, Italy
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3
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Bevilacqua S, Ticozzelli G, Orso M, Alba G, Capoccia L, Cappelli A, Cernetti C, Diomedi M, Dorigo W, Faggioli G, Giannace G, Giannandrea D, Giannetta M, Lessiani G, Marone EM, Mazzaccaro D, Migliacci R, Nano G, Pagliariccio G, Petruzzellis M, Plutino A, Pomatto S, Pulli R, Sirignano P, Vacirca A, Visco E, Moghadam SP, Lanza G, Lanza J. Anesthetic management of carotid endarterectomy: an update from Italian guidelines. J Anesth Analg Crit Care 2022; 2:24. [PMID: 37386522 PMCID: PMC10245611 DOI: 10.1186/s44158-022-00052-9] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/12/2022] [Indexed: 07/01/2023]
Abstract
BACKGROUND AND AIMS In order to systematically review the latest evidence on anesthesia, intraoperative neurologic monitoring, postoperative heparin reversal, and postoperative blood pressure management for carotid endarterectomy. The present review is based on a single chapter of the Italian Health Institute Guidelines for diagnosis and treatment of extracranial carotid stenosis and stroke prevention. METHODS AND RESULTS A systematic article review focused on the previously cited topics published between January 2016 and October 2020 has been performed; we looked for both primary and secondary studies in the extensive archive of Medline/PubMed and Cochrane library databases. We selected 14 systematic reviews and meta-analyses, 13 randomized controlled trials, 8 observational studies, and 1 narrative review. Based on this analysis, syntheses of the available evidence were shared and recommendations were indicated complying with the GRADE-SIGN version methodology. CONCLUSIONS From this up-to-date analysis, it has emerged that any type of anesthesia and neurological monitoring method is related to a better outcome after carotid endarterectomy. In addition, insufficient evidence was found to justify reversal or no-reversal of heparin at the end of surgery. Furthermore, despite a low evidence level, a suggestion for blood pressure monitoring in the postoperative period was formulated.
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Affiliation(s)
- Sergio Bevilacqua
- Department of Anesthesia, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
| | - Giulia Ticozzelli
- Anesthesiology and Intensive Care Unit, Fondazione I.R.C.C.S. Policlinico San Matteo, Pavia, Italy.
| | - Massimiliano Orso
- Società Italiana di Chirurgia Vascolare ed Endovascolare (SICVE), Roma, Italy
| | - Giuseppe Alba
- Department of Vascular Surgery, University of Siena, Siena, Italy
| | - Laura Capoccia
- Vascular and Endovascular Surgery Division, Policlinico Umberto I La Sapienza University of Rome, Rome, Italy
| | - Alessandro Cappelli
- Vascular Surgery Unit, Policlinico Le Scotte Hospital University of Siena, Siena, Italy
| | - Carlo Cernetti
- Division of Cardiology and and Interventional Hemodynamics, Ca' Foncello Hospital, Azienda USLL2 Marca Trevigiana, Treviso, Italy
| | - Marina Diomedi
- Stroke Unit, Department of Systems Medicine, Tor Vergata University Hospital, Rome, Italy
| | - Walter Dorigo
- Vascular Surgery Unit, University of Florence, Florence, Italy
| | - Gianluca Faggioli
- Vascular Surgery Unit, Policlinico Sant'Orsola, Alma Mater Studiorum University, Bologna, Italy
| | - Giovanni Giannace
- Vascular Surgery Unit, Arcispedale Snata Maria Nuova, Reggio Emilia, Italy
| | - David Giannandrea
- Stroke Unit, Neurology Department, USL Umbria 1, Cittá di Castello, Perugia, Italy
| | - Matteo Giannetta
- Vascular Surgery Unit, IRCCS Policlinico San Donato Hospital University, San Donato Milanese, Italy
| | | | - Enrico Maria Marone
- Vascular Surgery Unit, Department of Policlinico Monaza, Monza, Italy
- Pavia University, Pavia, Italy
| | - Daniela Mazzaccaro
- Vascular Surgery Unit, IRCCS Policlinico San Donato Hospital University, San Donato Milanese, Italy
| | - Rino Migliacci
- Angiology and Internal Medicine, Valdichiana S.Margherita Hospital, Cortona, Italy
| | - Giovanni Nano
- Vascular Surgery Unit, IRCCS Policlinico San Donato Hospital University, San Donato Milanese, Italy
| | | | | | | | - Sara Pomatto
- Vascular Surgery Unit, Policlinico Sant'Orsola, Alma Mater Studiorum University, Bologna, Italy
| | - Raffaele Pulli
- Vascular Surgery Unit, Policlinico Careggi Hospital University, Florence, Italy
| | - Pasqualino Sirignano
- Vascular and Endovascular Surgery Division, Sant'andrea Hospital , "La sapienza" University of Rome, Rome, Italy
| | - Andrea Vacirca
- Vascular Surgery Unit, Policlinico San'Orsola-Alma Mater Studiorum University, Bologna, Italy
| | - Emanuele Visco
- Division of Cardiology and Interventional Hemodynamic, San Giacomo Apostolo Hospital, Azienda ULSS2 Marca Trevigiana, Castelfranco Veneto, Italy
| | | | - Gaetano Lanza
- Vascular Surgery Department, Multimedica Hospital-IRCCS, Castellanza, Italy
| | - Jessica Lanza
- Vascular Surgery Department, IRCSS Ospedale Policlinico, San Martino Genova, Italy
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Bevilacqua S, Paniccia R, Galeotti I, Viappiani A, Dimizio F, Bartolozzi C, Marcucci R, Stefàno P. Rotational thromboelastometry for diagnosis of fibrinolysis induced by urokinase in an in-vitro model. Blood Coagul Fibrinolysis 2022; 33:42-50. [PMID: 34783691 DOI: 10.1097/mbc.0000000000001102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Fibrinolysis can be abnormally activated in several critical care settings but it's often misdiagnosed by standard laboratory tests. Although rotational thromboelastometry can assess the whole coagulative process, its ability to detect fibrinolysis has been questioned. Aim of this study was to investigate the ability of thromboelastometry in detecting induced fibrinolysis in an in-vitro model. Whole blood samples were taken from 18 healthy volunteers. Each sample was split and added with increasing urokinase concentrations till to reach 0, 50, 75 and 100 IU/ml. Thromboelastometry tests, extem and aptem, were performed on the obtained samples. If significant lysis at 50 IU/ml was recorded, also 10, 25 and 35 IU/ml drug concentrations were tested. No lytic effects were detected in 10 IU/ml samples. Lysis variables were the most sensitive in detecting fibrinolysis even at 25 IU/ml (P < 0.05). Clot firmness parameters were also affected by urokinase, but only at the two highest drug concentrations (P < 0.05). Extem/aptem ratio enhanced the sensitivity of these parameters only if lysis was more marked. Analysing groups of different lysis severity, the time to achieve maximum clot firmness could anticipate an ongoing fulminant or intermediate lysis with 100% sensitivity and 100% specificity (P < 0.05) when lower than 1341.5 s. Rotational thromboelastometry could detect fibrinolysis when it was induced in vitro by 25 IU/ml urokinase or more. Apart from the parameters specific for lysis, time to achieve maximum clot firmness appeared as the earliest indicator of fibrinolysis with high sensitivity and specificity especially if a more intense lysis was going on.
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Affiliation(s)
| | - Rita Paniccia
- Department of Medical and Surgical Critical Care, Thrombosis Center
| | - Ilaria Galeotti
- Department of Anesthesia, Azienda Ospedaliero Universitaria Careggi
| | - Anna Viappiani
- Department of Anesthesia, Azienda Ospedaliero Universitaria Careggi
| | - Fabio Dimizio
- Department of Anesthesia, Azienda Ospedaliero Universitaria Careggi
| | - Carlo Bartolozzi
- Department of Anesthesia, Azienda Ospedaliero Universitaria Careggi
| | | | - Pierluigi Stefàno
- Department of Medical and Surgical Critical Care, Cardiac Surgery, Azienda Ospedaliero Universitaria Careggi, Università degli Studi di Firenze, Firenze, Italy
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5
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Romeo MR, Baroni M, Berti S, Bianchi G, Margaryan R, Solinas M, Clemente A, Chiappino D, Bevilacqua S, Megaro M. Primary mitral valve regurgitation scheduled for cardiac surgery: no longer need for coronary angiography? A clinical retrospective & HTA analysis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
In patients (pts) undergoing cardiac surgery for primary mitral regurgitation (PMR), coronary angiography (CA) is always scheduled shortly before surgery to rule out significant coronary artery disease (CAD), despite this population is often young and with relatively low risk for CAD. Computed Tomography Coronary Angiography (CTCA) could be an alternative approach to evaluate coronary arteries, at least ruling out significant CAD in selected pts, due to its high negative predictive value.
Purpose
A safer, more appropriate and efficient clinical and diagnostic pathway for patients undergoing cardiac surgery for PMR by stratifying patients prior cardiac surgery according to pretest probability score (PTP) and therefore shifting imaging of epicardial coronary arteries from invasive to noninvasive in specific patients subsets.
Methods
A retrospective analysis (Jan 2014–Dec 2020) was carried out through the extraction of 7343 electronic medical records of pts who underwent cardiac valve surgery. In 1556 pts with PMR (1195 with no-CAD and 361 with CAD) a PTP was retrospectively calculated according to Genders, 2012, to stratify their risk of CAD.
A Decision oriented Health Technology Assessment (DoHTA) and a cost analysis were also performed to support the analysis results. A survey was distributed to a team of experts with a multidisciplinary background to analyze the most significant evaluation areas (Economic Aspects, Clinical Effectiveness, Safety, Innovation) and the sub-criteria related to them.
Following the Core Model Eunethta as a guideline, a Rapid Report HTA has been drawn up to identify the best solution.
Results
Patients characteristics are listed in Picture 1. Pts with normal coronary arteries showed a PTP low-to intermediate while pts with high PTP had CAD and therefore had a real pretest need for a CA (average 11 percent ± 9 in noCAD group vs 20 percent ± 14 in the CAD group). In two thirds of PMR population coronary angiography could have been avoided according to a PTP score <15 percent.
The cost analysis results were significantly lower in CTCA (1,315.00 EUR vs 180.00 EUR, CA vs CTCA respectively), The Decision Oriented HTA conducted by a multidisciplinary team showed a relevant preference for the new pathway (Picture 2) with a score of 70.23 percent of preference among the Team.
Conclusions
This new pathway, already proposed for selected pts in ESC guidelines on valve diseases (class IIA, LOE C) could be always adopted in PMR pts with low-to intermediate PTP score undergoing cardiac surgery. It could improve workflow efficiency and reduce LOS, and last but not least, avoid an invasive test, reduce radiation exposure and AKI risk in in a relatively young population
The DoHTA provided a more effective and efficient support to the decision-making process.
Funding Acknowledgement
Type of funding sources: None. Picture 1. Patients characteristics (noCAD-CAD)Picture 2. HTA Score CTCA vs CA
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Affiliation(s)
- M R Romeo
- Fondazione Toscana Gabriele Monasterio, HTA Innovation Lab, Pisa, Italy
| | - M Baroni
- Fondazione Toscana Gabriele Monasterio, Clinical Risk Management, Pisa, Italy
| | - S Berti
- Fondazione Toscana Gabriele Monasterio, Invasive Cardiology Unit, Pisa, Italy
| | - G Bianchi
- Fondazione Toscana Gabriele Monasterio, Cardiac Surgery Dpt, Pisa, Italy
| | - R Margaryan
- Fondazione Toscana Gabriele Monasterio, Cardiac Surgery Dpt, Pisa, Italy
| | - M Solinas
- Fondazione Toscana Gabriele Monasterio, Cardiac Surgery Dpt, Pisa, Italy
| | - A Clemente
- Fondazione Toscana Gabriele Monasterio, Radiology Dpt, Pisa, Italy
| | - D Chiappino
- Fondazione Toscana Gabriele Monasterio, Radiology Dpt, Pisa, Italy
| | - S Bevilacqua
- Fondazione Toscana Gabriele Monasterio, Management Control, Pisa, Italy
| | - M Megaro
- Fondazione Toscana Gabriele Monasterio, Management Control, Pisa, Italy
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Cotte L, Hocqueloux L, Lefebvre M, Pradat P, Bani-Sadr F, Huleux T, Poizot-Martin I, Pugliese P, Rey D, Cabié A, Chirouze C, Drobacheff-Thiébaut C, Foltzer A, Bouiller K, Hustache-Mathieu L, Lepiller Q, Bozon F, Babre O, Brunel AS, Muret P, Chevalier E, Jacomet C, Laurichesse H, Lesens O, Vidal M, Mrozek N, Aumeran C, Baud O, Corbin V, Goncalvez E, Mirand A, brebion A, Henquell C, Lamaury I, Fabre I, Curlier E, Ouissa R, Herrmann-Storck C, Tressieres B, Receveur MC, Boulard F, Daniel C, Clavel C, Roger PM, Markowicz S, Chellum Rungen N, Merrien D, Perré P, Guimard T, Bollangier O, Leautez S, Morrier M, Laine L, Boucher D, Point P, Cotte L, Ader F, Becker A, Boibieux A, Brochier C, Brunel-Dalmas F, Cannesson O, Chiarello P, Chidiac C, Degroodt S, Ferry T, Godinot M, Livrozet JM, Makhloufi D, Miailhes P, Perpoint T, Perry M, Pouderoux C, Roux S, Triffault-Fillit C, Valour F, Charre C, Icard V, Tardy JC, Trabaud MA, Ravaux I, Ménard A, Belkhir AY, Colson P, Dhiver C, Madrid A, Martin-Degioanni M, Meddeb L, Mokhtari M, Motte A, Raoux A, Toméi C, Tissot-Dupont H, Poizot-Martin I, Brégigeon S, Zaegel-Faucher O, Obry-Roguet V, Laroche H, Orticoni M, Soavi MJ, Ressiot E, Ducassou MJ, Jaquet I, Galie S, Colson H, Ritleng AS, Ivanova A, Debreux C, Lions C, Rojas-Rojas T, Cabié A, Abel S, Bavay J, Bigeard B, Cabras O, Cuzin L, Dupin de Majoubert R, Fagour L, Guitteaud K, Marquise A, Najioullah F, Pierre-François S, Pasquier J, Richard P, Rome K, Turmel JM, Varache C, Atoui N, Bistoquet M, Delaporte E, Le Moing V, Makinson A, Meftah N, Merle de Boever C, Montes B, Montoya Ferrer A, Tuaillon E, Reynes J, Lefèvre B, Jeanmaire E, Hénard S, Frentiu E, Charmillon A, Legoff A, Tissot N, André M, Boyer L, Bouillon MP, Delestan M, Goehringer F, Bevilacqua S, Rabaud C, May T, Raffi F, Allavena C, Aubry O, Billaud E, Biron C, Bonnet B, Bouchez S, Boutoille D, Brunet-Cartier C, Deschanvres C, Gaborit BJ, Grégoire A, Grégoire M, Grossi O, Guéry R, Jovelin T, Lefebvre M, Le Turnier P, Lecomte R, Morineau P, Reliquet V, Sécher S, Cavellec M, Paredes E, Soria A, Ferré V, André-Garnier E, Rodallec A, Pugliese P, Breaud S, Ceppi C, Chirio D, Cua E, Dellamonica P, Demonchy E, De Monte A, Durant J, Etienne C, Ferrando S, Garraffo R, Michelangeli C, Mondain V, Naqvi A, Oran N, Perbost I, Carles M, Klotz C, Maka A, Pradier C, Prouvost-Keller B, Risso K, Rio V, Rosenthal E, Touitou I, Wehrlen-Pugliese S, Zouzou G, Hocqueloux L, Prazuck T, Gubavu C, Sève A, Giaché S, Rzepecki V, Colin M, Boulard C, Thomas G, Cheret A, Goujard C, Quertainmont Y, Teicher E, Lerolle N, Jaureguiberry S, Colarino R, Deradji O, Castro A, Barrail-Tran A, Yazdanpanah Y, Landman R, Joly V, Ghosn J, Rioux C, Lariven S, Gervais A, Lescure FX, Matheron S, Louni F, Julia Z, Le GAC S, Charpentier C, Descamps D, Peytavin G, Duvivier C, Aguilar C, Alby-Laurent F, Amazzough K, Benabdelmoumen G, Bossi P, Cessot G, Charlier C, Consigny PH, Jidar K, Lafont E, Lanternier F, Leporrier J, Lortholary O, Louisin C, Lourenco J, Parize P, Pilmis B, Rouzaud C, Touam F, Valantin MA, Tubiana R, Agher R, Seang S, Schneider L, PaLich R, Blanc C, Katlama C, Bani-Sadr F, Berger JL, N’Guyen Y, Lambert D, Kmiec I, Hentzien M, Brunet A, Romaru J, Marty H, Brodard V, Arvieux C, Tattevin P, Revest M, Souala F, Baldeyrou M, Patrat-Delon S, Chapplain JM, Benezit F, Dupont M, Poinot M, Maillard A, Pronier C, Lemaitre F, Morlat C, Poisson-Vannier M, Jovelin T, Sinteff JP, Gagneux-Brunon A, Botelho-Nevers E, Frésard A, Ronat V, Lucht F, Rey D, Fischer P, Partisani M, Cheneau C, Priester M, Mélounou C, Bernard-Henry C, de Mautort E, Fafi-Kremer S, Delobel P, Alvarez M, Biezunski N, Debard A, Delpierre C, Gaube G, Lansalot P, Lelièvre L, Marcel M, Martin-Blondel G, Piffaut M, Porte L, Saune K, Robineau O, Ajana F, Aïssi E, Alcaraz I, Alidjinou E, Baclet V, Bocket L, Boucher A, Digumber M, Huleux T, Lafon-Desmurs B, Meybeck A, Pradier M, Tetart M, Thill P, Viget N, Valette M. Microelimination or Not? The Changing Epidemiology of Human Immunodeficiency Virus-Hepatitis C Virus Coinfection in France 2012–2018. Clin Infect Dis 2021; 73:e3266-e3274. [DOI: 10.1093/cid/ciaa1940] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/01/2021] [Indexed: 01/15/2023] Open
Abstract
Abstract
Background
The arrival of highly effective, well-tolerated, direct-acting antiviral agents (DAA) led to a dramatic decrease in hepatitis C virus (HCV) prevalence. Human immunodeficiency virus (HIV)-HCV–coinfected patients are deemed a priority population for HCV elimination, while a rise in recently acquired HCV infections in men who have sex with men (MSM) has been described. We describe the variations in HIV-HCV epidemiology in the French Dat’AIDS cohort.
Methods
This was a retrospective analysis of a prospective cohort of persons living with HIV (PLWH) from 2012 to 2018. We determined HCV prevalence, HCV incidence, proportion of viremic patients, treatment uptake, and mortality rate in the full cohort and by HIV risk factors.
Results
From 2012 to 2018, 50 861 PLWH with a known HCV status were followed up. During the period, HCV prevalence decreased from 15.4% to 13.5%. HCV prevalence among new HIV cases increased from 1.9% to 3.5% in MSM but remained stable in other groups. Recently acquired HCV incidence increased from 0.36/100 person-years to 1.25/100 person-years in MSM. The proportion of viremic patients decreased from 67.0% to 8.9%. MSM became the first group of viremic patients in 2018 (37.9%). Recently acquired hepatitis represented 59.2% of viremic MSM in 2018. DAA treatment uptake increased from 11.4% to 61.5%. More treatments were initiated in MSM in 2018 (41.2%) than in intravenous drug users (35.6%). In MSM, treatment at the acute phase represented 30.0% of treatments in 2018.
Conclusions
A major shift in HCV epidemiology was observed in PLWH in France from 2012 to 2018, leading to a unique situation in which the major group of HCV transmission in 2018 was MSM.
Clinical Trials Registration. NCT02898987.
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Affiliation(s)
- Laurent Cotte
- Department of Infectious Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Lyon, France
| | - Laurent Hocqueloux
- Department of Infectious Diseases, Centre Hospitalier Régional d’Orléans – La Source, Orléans, France
| | - Maeva Lefebvre
- Department of Infectious Diseases, Centre Hospitalier Universitaire Hôtel-Dieu, Nantes; Centre d’Investigation Clinique (CIC) 1413, INSERM, Nantes, France
| | - Pierre Pradat
- Center for Clinical Research, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Firouze Bani-Sadr
- Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Robert Debré Hospital, University Hospital, Reims, France
| | - Thomas Huleux
- Department of Infectious Diseases and Travel Diseases, Centre Hospitalier Gustave-Dron, Tourcoing, France
| | - Isabelle Poizot-Martin
- Immuno-Hematology Clinic, Assistance Publique–Hôpitaux de Marseille, Hôpital Sainte-Marguerite, Marseille, Aix-MarseilleUniversity–Inserm–Institut de Recherche pour le Développement (IRD), Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
| | - Pascal Pugliese
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Nice, Hôpital l’Archet, Nice, France
| | - David Rey
- HIV Infection Care Centre, Hôpitaux Universitaires, Strasbourg
| | - André Cabié
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Martinique, Fort de France, Université des Antilles EA4537, Fort de France, INSERM CIC1424, Fort-de-France, France
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7
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Stefano P, Bugetti M, Michelucci A, Del Monaco G, Popescu G, Pieragnoli P, Ricciardi G, Perrotta L, Checchi L, Rondine R, Bevilacqua S, Marchionni N. Are body mass index and age independent risk factors for new-onset atrial fibrillation after cardiac surgery regardless of left atrial size and left ventricular ejection fraction value? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Obesity, advanced age and left atrium dimensions have been linked to atrial fibrillation (AF).
Purpose
This study aimed at evidencing if the above mentioned risk factors have a role among the others in conditioning the onset of post operative AF (PoAF) in patients undergoing cardiac surgery without previous AF.
Methods
This study evaluated 249 consecutive patients undergoing coronary artery by-pass surgery either isolated or in combination with aortic or mitral valve repair/replacement, or isolated valve repair/replacement. Prior to surgery, in all patients the following data were collected: age (yrs), body mass index (BMI, kg/m2), left atrium (LA) diameter (cm), LA area (cm2), left ventricular ejection fraction (LVEF, %), the presence/absence of arterial hypertension (AH) and diabetes, creatinine (mg/dL). To detect the presence of PoAF, cardiac rhythm was continouosly recorded during the first seven postoperative days.
Results
PoAF occurred in 127 patients (51%). We compared patients with and without PoAF. Mean values (±1 SD) of continuous variables and the frequency of dicothomic ones are reported in the table. No difference was observed for sex, LA diameter, LA area, LVEF and diabetes. Instead, patients with PoAF had higher values of age, BMI, creatinine and a greater prevalence of AH. According to multivariable binary logistic analysis the independent predictors of PoAF were: age (OR = 1.05, CI 95%: 1.026–1.074, p=0.018) and BMI (OR = 1.09, CI 95%: 1.015–1.171, p=0.0001).
Conclusions
Results suggest that advanced age and a higher value of BMI could be strong risk factors for PoAF in patients who undergo cardiac surgery without previous AF. This considering that in the present population the values of LA diameter, LA area and LVEF showed no statistically significant difference between patients with and without PoAF.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- P Stefano
- Careggi University Hospital (AOUC), Florence, Italy
| | - M Bugetti
- Careggi University Hospital (AOUC), Florence, Italy
| | - A Michelucci
- Careggi University Hospital (AOUC), Florence, Italy
| | - G Del Monaco
- Careggi University Hospital (AOUC), Florence, Italy
| | - G Popescu
- Careggi University Hospital (AOUC), Florence, Italy
| | - P Pieragnoli
- Careggi University Hospital (AOUC), Florence, Italy
| | - G Ricciardi
- Careggi University Hospital (AOUC), Florence, Italy
| | - L Perrotta
- Careggi University Hospital (AOUC), Florence, Italy
| | - L Checchi
- Careggi University Hospital (AOUC), Florence, Italy
| | - R Rondine
- Careggi University Hospital (AOUC), Florence, Italy
| | - S Bevilacqua
- Careggi University Hospital (AOUC), Florence, Italy
| | - N Marchionni
- Careggi University Hospital (AOUC), Florence, Italy
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Stefàno PL, Bugetti M, Del Monaco G, Popescu G, Pieragnoli P, Ricciardi G, Perrotta L, Checchi L, Rondine R, Bevilacqua S, Fumagalli C, Marchionni N, Michelucci A. Overweight and aging increase the risk of atrial fibrillation after cardiac surgery independently of left atrial size and left ventricular ejection fraction. J Cardiothorac Surg 2020; 15:316. [PMID: 33059687 PMCID: PMC7559788 DOI: 10.1186/s13019-020-01366-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 10/05/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Body mass index (BMI), age, left atrium (LA) dimension and left ventricular ejection fraction (LVEF) have been linked to post-operative atrial fibrillation (POAF) after cardiac surgery. The aim of this study was to better define the role of these risk factors. METHODS This retrospective cohort study evaluated 249 patients (without prior atrial dysrhythmia) undergoing cardiac or aortic surgery. Prior to surgery, the following data were collected: age, BMI, LA diameter, LA area, LVEF, thyroid stimulating hormone (TSH), creatinine and the presence of arterial hypertension (AH) and diabetes. Intraoperative data such as operation time, total clamp time, cardiopulmonary bypass time, and presence of pericardial/pleural effusion were also collected. Only patients without pre- and post-surgery prophylactic anti-arrhythmic therapy were included. RESULTS Patients with (N = 127, 51%) and without POAF (N = 122, 49%) were compared. No difference was observed for sex, LA diameter, LA area, LVEF, TSH, diabetes and use of ACE inhibitors or statins prior to intervention. Moreover, no difference was observed in terms of operation time, total clamp time, cardiopulmonary bypass time, and presence of pericardial/pleural effusion. However, patients with POAF were older (70.6 ± 10.7 vs. 60.4 ± 16.4 years, p = 0.001), had higher BMI (26.8 ± 4.5 vs. 24.9 ± 3.6 kg/m2, p = 0.001), higher baseline creatinine (1.06 ± 0.91 vs. 0.88 ± 0.32 mg/dL, p = 0.038) and a higher frequency of arterial hypertension (73.2% vs. 50%, p = 0.001) and Bentall procedure (24.4% vs. 9.8%, p = 0.023). Multivariate analysis showed that the only independent predictors of POAF were age (OR = 1.05, 95%CI 1.02-1.07, p = 0.001) and BMI (OR = 1.11 95%CI 1.03-1.2,p = 0.006). CONCLUSIONS These findings suggest that advanced age and a higher BMI are strong risk factors for POAF in patients without previous AF even in the presence of comparable LA dimensions and LVEF.
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Affiliation(s)
- Pier Luigi Stefàno
- Department of Cardiothoracovascular Medicine, Careggi University Hospital (AOUC), Largo Brambilla, 3, 50134, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla, 3, Florence, 50134, Italy
| | - Marco Bugetti
- Department of Cardiothoracovascular Medicine, Careggi University Hospital (AOUC), Largo Brambilla, 3, 50134, Florence, Italy
| | - Guido Del Monaco
- Department of Cardiothoracovascular Medicine, Careggi University Hospital (AOUC), Largo Brambilla, 3, 50134, Florence, Italy
| | - Gloria Popescu
- Department of Cardiothoracovascular Medicine, Careggi University Hospital (AOUC), Largo Brambilla, 3, 50134, Florence, Italy
| | - Paolo Pieragnoli
- Department of Cardiothoracovascular Medicine, Careggi University Hospital (AOUC), Largo Brambilla, 3, 50134, Florence, Italy
| | - Giuseppe Ricciardi
- Department of Cardiothoracovascular Medicine, Careggi University Hospital (AOUC), Largo Brambilla, 3, 50134, Florence, Italy
| | - Laura Perrotta
- Department of Cardiothoracovascular Medicine, Careggi University Hospital (AOUC), Largo Brambilla, 3, 50134, Florence, Italy
| | - Luca Checchi
- Department of Cardiothoracovascular Medicine, Careggi University Hospital (AOUC), Largo Brambilla, 3, 50134, Florence, Italy
| | - Roberto Rondine
- Department of Cardiothoracovascular Medicine, Careggi University Hospital (AOUC), Largo Brambilla, 3, 50134, Florence, Italy
| | - Sergio Bevilacqua
- Department of Cardiothoracovascular Medicine, Careggi University Hospital (AOUC), Largo Brambilla, 3, 50134, Florence, Italy
| | - Carlo Fumagalli
- Department of Cardiothoracovascular Medicine, Careggi University Hospital (AOUC), Largo Brambilla, 3, 50134, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla, 3, Florence, 50134, Italy
| | - Niccolò Marchionni
- Department of Cardiothoracovascular Medicine, Careggi University Hospital (AOUC), Largo Brambilla, 3, 50134, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla, 3, Florence, 50134, Italy
| | - Antonio Michelucci
- Department of Cardiothoracovascular Medicine, Careggi University Hospital (AOUC), Largo Brambilla, 3, 50134, Florence, Italy.
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla, 3, Florence, 50134, Italy.
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Cardone C, Schettino C, Gargiulo P, Arenare L, Bevilacqua S, Buonfanti G, Giudice AD, Gimigliano A, Ribecco M, Gravina A, Perrone F, Piccirillo M. 593P Longitudinal description of clinical trials for the development of cyclin-dependent kinases inhibitors. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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10
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Bevilacqua S, Bottari V, Galeotti I. Systematic Application of Rapid Sequence Intubation With Remifentanil During COVID-19 Pandemic. Semin Cardiothorac Vasc Anesth 2020; 25:74-75. [PMID: 32664787 DOI: 10.1177/1089253220941369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this letter, the authors wonder about the need to apply some of the precautions that have been repeatedly suggested during the recent COVID-19 (coronavirus disease 19) pandemic not only to suspected or documented cases of infection but also to all the new cases entering the hospital. In this regard, orotracheal intubation has been universally recognized as a maneuver with a high risk of viral transmission. On the other hand, rapid sequence induction, which represents the gold standard for limiting the risk of transmission for health care professionals, implies side effects that can be potentially harmful for patients with impaired hemodynamics. In this regard, the authors report a particular type of rapid induction that they are performing in a systematic way during the recent pandemic in cardiac surgery patients. This is performed after the patient reaches a deep analgesic plan, thanks to the unique characteristics of the opioid remifentanil. This type of induction, already tested in vasculopathic patients who underwent carotid surgery, is characterized by great hemodynamic stability and is very advantageous, in the writer's experience, when rapid sequence induction has to be systematically applied to cardiovascular patients, especially if you only want to protect operators.
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Bevilacqua S, Mistri M, Terlizzi A, Munari C. Assessing the effectiveness of surrogates for species over time: Evidence from decadal monitoring of a Mediterranean transitional water ecosystem. Mar Pollut Bull 2018; 131:507-514. [PMID: 29886976 DOI: 10.1016/j.marpolbul.2018.04.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 04/06/2018] [Accepted: 04/18/2018] [Indexed: 06/08/2023]
Abstract
The use of higher taxa or alternative approach to species surrogacy, such as the BestAgg procedure, could represent cost-effective solutions to avoid expensive species-level identifications in monitoring activities, especially on the long term. However, whether a set of surrogates would be effective in subsequent reiteration of the same assessment remains largely unsolved. We used a long-term dataset on macro-benthic assemblages to test the hypothesis that family-level and BestAgg surrogates which are effective for a limited period of monitoring could be successfully applied to quantify community patterns also in subsequent monitoring programmes. The effectiveness of surrogates in detecting temporal variations in assemblage structure as at species level remained basically unaffected over a decade. Recognizing once and for all if species surrogacy may have a practical value for monitoring will strongly depend on future assessments of the potential of surrogates to reflect community changes and to retain this prerogative over time.
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Affiliation(s)
- S Bevilacqua
- Laboratory of Zoology and Marine Biology, Department of Biological and Environmental Sciences and Technologies, University of Salento, 73100 Lecce, Italy; CoNiSMa, Piazzale Flaminio 9, 00196 Roma, Italy.
| | - M Mistri
- Department of Chemical and Pharmaceutical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - A Terlizzi
- Department of Life Sciences, University of Trieste, 34127 Trieste, Italy; Stazione Zoologica Anton Dohrn, 80121 Napoli, Italy; CoNiSMa, Piazzale Flaminio 9, 00196 Roma, Italy
| | - C Munari
- Department of Chemical and Pharmaceutical Sciences, University of Ferrara, 44121 Ferrara, Italy
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Tiwari KK, Bevilacqua S, Aquaro G, Festa P, Ait-Ali L, Solinas M. Evaluation of Distensibility and Stiffness of Ascending Aortic Aneurysm using Magnetic Resonance Imaging. JNMA J Nepal Med Assoc 2016; 55:67-71. [PMID: 28029670] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
INTRODUCTION Magnetic resonance imaging emerging as a new tool for the diagnosis and evaluation of ascending aortic aneurysm. The aim of our study is to evaluate in vivo distensibility and pulse wave velocity of the aortic wall using functional magnetic resonance imaging technique. METHODS We enrolled 25 patients undergoing surgery for ascending aortic aneurysm and or aortic valve replacement for a period of 8 months. Preoperatively, all the patients underwent functional MRI study of the aorta. Aortic wall distensibility and pulse wave velocity of ascending aorta was evaluated. RESULTS Mean age of the patient was 66 years (66.68 ± 5.62 years) with 60% (15) male patients. More than fifty percentages of patients were smoker (52%), hypertensive (64%) and diabetic (56%). We have observed significant decrease of distensibilty in the patients with aortic diameter above 50 mm (p-0.0002). Furthermore, we have found a significant inverse correlation between aortic distensibility and pulse wave velocity (R= -0.650, R2= 0.42, p-0.0004). Similarly, we have found a significant inverse correlation between ascending aortic diameter and distensibility of the aorta (R= -0.785, R2= 0.61, p-0.00001). Statistically significant positive correlation was observed between aortic diameter and pulse wave velocity (R= 0.865, R2= 0.74, p-0.00001). CONCLUSIONS MRI measurement of aortic diameters, distensibility, and flow wave velocity is an easy, reliable and reproducible technique. Distensibility and pulse wave velocity define the elasticity of the aorta. We have observed that elasticity of aortic wall is decreased in ascending aorta aneurysm patients.
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Affiliation(s)
- K K Tiwari
- Department of Cardiothoracic and Vascular Surgery, College of Medical Sciences, Teaching Hospital, Bharatpur, Chitwan, Nepal, Department of Adult Cardiac Surgery, FTGM, G. Pasquinucci Heart Hospital, Massa, Italy
| | - S Bevilacqua
- Department of Adult Cardiac Surgery, FTGM, G. Pasquinucci Heart Hospital, Massa, Italy
| | - G Aquaro
- MRI Laboratory, FTGM, CNR, Pisa, Italy
| | - P Festa
- MRI Laboratory, FTGM, CNR, Pisa, Italy
| | - L Ait-Ali
- MRI Laboratory, FTGM, CNR, Pisa, Italy
| | - M Solinas
- Department of Adult Cardiac Surgery, FTGM, G. Pasquinucci Heart Hospital, Massa, Italy
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André M, Boyer L, Bevilacqua S, Frentiu E, Goehringer F, Hénard S, Jeanmaire E, Rabaud C, May T. VIH-23 - Bithérapies d’antirétroviraux chez des patients infectés par le VIH : efficacité et tolérance. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30568-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Fraschetti S, Guarnieri G, Gambi C, Bevilacqua S, Terlizzi A, Danovaro R. Impact of offshore gas platforms on the structural and functional biodiversity of nematodes. Mar Environ Res 2016; 115:56-64. [PMID: 26878347 DOI: 10.1016/j.marenvres.2016.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 01/29/2016] [Accepted: 02/03/2016] [Indexed: 06/05/2023]
Abstract
The Mediterranean Sea hosts hundreds of offshore gas platforms, whose activity represents a potential threat to marine ecosystems. Evidence from several studies indicates that nematodes can be highly sensitive to changes in the environmental quality. Here, we investigated the response of nematode assemblages to the presence of offshore gas platforms (located in the central Mediterranean Sea) in terms of spatial heterogeneity, structural and functional diversity. Since the effect of the investigated offshore platforms on macrofaunal assemblages were previously assessed by Terlizzi et al. (2008), the study provided also the opportunity to compare the response of different benthic compartments to the same impact related to fossil fuel extraction on marine environments. The platforms had a significant impact on nematode assemblages up to 1000 m distance from the structure. The effects were evident in term of: a) more homogeneous spatial distribution of nematode assemblages, b) increased trophic diversity of deposit feeders and c) changes in life strategies with an increase of opportunistic species in sediments closer to the platforms. Such effects seemed to be related to the dimension of the platform structures, rather than to chemical pollution or changes in food availability. These findings suggest that the platforms exert a physical alteration of the surrounding environment that is reflected by altered structural and functional traits of nematode biodiversity. The use of nematodes for monitoring the effects of the platforms only partially matched with the results obtained using macrofauna, providing further insights on potential outcomes on the functional response of marine assemblages to fossil fuel extraction.
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Affiliation(s)
- S Fraschetti
- Department of Biological and Environmental Sciences and Technology, University of Salento, CoNISMa, I-73100 Lecce, Italy.
| | - G Guarnieri
- Department of Biological and Environmental Sciences and Technology, University of Salento, CoNISMa, I-73100 Lecce, Italy
| | - C Gambi
- Department of Life and Environmental Science, Polytechnic University of Marche, Via Brecce Bianche, 60131 Ancona, Italy
| | - S Bevilacqua
- Department of Biological and Environmental Sciences and Technology, University of Salento, CoNISMa, I-73100 Lecce, Italy
| | - A Terlizzi
- Department of Biological and Environmental Sciences and Technology, University of Salento, CoNISMa, I-73100 Lecce, Italy
| | - R Danovaro
- Department of Life and Environmental Science, Polytechnic University of Marche, Via Brecce Bianche, 60131 Ancona, Italy; Stazione Zoologica Anton Dohrn, Villa Comunale, 80121 Naples, Italy
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Pinelli F, Romagnoli S, Bevilacqua S, Macchiarini P. Extracorporeal Membrane Oxygenation-Assisted Esophagectomy. J Cardiothorac Vasc Anesth 2015; 29:436-8. [DOI: 10.1053/j.jvca.2014.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Indexed: 11/11/2022]
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Rostagno C, Droandi G, Rossi A, Bevilacqua S, Romagnoli S, Montesi GF, Stefáno PL. Timing of surgery in Barlow disease. Ital J Anat Embryol 2015; 120:3-4. [PMID: 26738253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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17
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Cabral-Oliveira J, Bevilacqua S, Terlizzi A, Pardal M. Are eulittoral assemblages suitable for detecting the effects of sewage discharges in Atlantic and Mediterranean coastal areas? ACTA ACUST UNITED AC 2014. [DOI: 10.1080/11250003.2014.947336] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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18
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Romagnoli S, Ricci Z, Balsorano P, Tujjar O, Villa G, Bevilacqua S, Tofani L, De Gaudio AR. Comparison between mixed and central venous oxygen saturation in patients with severe acute heart failure after cardiac surgery: a prospective observational study. Int J Cardiol 2014; 175:566-7. [PMID: 24874913 DOI: 10.1016/j.ijcard.2014.05.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 05/12/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Stefano Romagnoli
- Department of Health Sciences, Section of Anaesthesiology, Intensive Care and Pain, University of Florence, Florence, Italy
| | - Zaccaria Ricci
- Department of Pediatric Cardiac Surgery, Bambino Gesù Children's Hospital, Rome, Italy
| | - Paolo Balsorano
- Department of Health Sciences, Section of Anaesthesiology, Intensive Care and Pain, University of Florence, Florence, Italy
| | - Omar Tujjar
- Department of Health Sciences, Section of Anaesthesiology, Intensive Care and Pain, University of Florence, Florence, Italy.
| | - Gianluca Villa
- Department of Health Sciences, Section of Anaesthesiology, Intensive Care and Pain, University of Florence, Florence, Italy
| | - Sergio Bevilacqua
- Heart and Vessels Department, Cardio-Thoracic and Vascular Anaesthesia and Intensive Care, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Lorenzo Tofani
- Department of Neurosciences, Psychology, Drug Research and Child Health - Department of Statistics, University of Florence, Florence, Italy
| | - Angelo Raffaele De Gaudio
- Department of Health Sciences, Section of Anaesthesiology, Intensive Care and Pain, University of Florence, Florence, Italy
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Rostagno C, Droandi G, Rossi A, Bevilacqua S, Romagnoli S, Montesi GF, Stefàno PL. Anatomic characteristics of bileaflet mitral valve prolapse--Barlow disease--in patients undergoing mitral valve repair. Ital J Anat Embryol 2014; 119:20-28. [PMID: 25345072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Barlow disease is a still challenging pathology for the surgeon. Aim of the present study is to report anatomic abnormalities of mitral valve in patients undergoing mitral valve repair. METHODS Between January 1st, 2007, and December 31st, 2010, 85 consecutive patients (54 men and 31 women, mean age 59 +/- 14 years--range: 28-85 years) with the features of a Barlow mitral valve disease underwent mitral repair Forty seven percent of patients were in New York Heart Association functional class III or IV. Preoperative transesophageal echocardiography was compared with anatomical findings at the moment of surgery. RESULTS Transthoracic echocardiography diagnosis of Barlow disease according to the criteria described by Carpentier was confirmed at anatomical inspection. Annular calcifications were found in 28 patients while 7 patients presented single or multiple clefts. A flail posterior mitral leaflet was detected in 32 subjects, while a flail anterior leaflet in 8. Elongation of chordae tendineae was demonstrated in 45 patients and chordal rupture in 31. All patients showed at trans esophageal echocardiography the typical features of Barlow disease. Seventy-seven (90.6%) patients had severe mitral valve regurgitation, in the remaining 9.4% it was moderate to severe. Transesophageal echocardiography failed to identify clefts in 2/7 and chordal rupture in 4/31. CONCLUSIONS bileaflet prolapse > 2 mm, billowing valve with excess tissue and thickened leaflets > or = 3 mm, and severe annular dilatation, are characteristics of Barlow disease, however the identification of the associated and complex abnormalities of mitral valve is necessary to obtain optimal valve repair.
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Cerillo AG, Murzi M, Kallushi E, Miceli A, Mariani M, Bevilacqua S, Berti S, Glauber M. 269 * PARAVALVULAR REGURGITATION AFTER TRANSCATHETER AORTIC VALVE IMPLANTATION IS A NON-PREDICTABLE COMPLICATION: A CUSUM ANALYSIS STUDY. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt372.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lo Sapio P, Gensini GF, Bevilacqua S, Chiti E, Paperetti L, Pratesi C, Romano SM. The role of ivabradine in the incidence of perioperative coronary complications in patients undergoing vascular surgery. Int J Cardiol 2013; 168:4352-3. [DOI: 10.1016/j.ijcard.2013.05.072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 05/04/2013] [Indexed: 10/26/2022]
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Gasbarri T, Bevilacqua S, Gilmanov D, Murzi M, Laws E, Del Sarto S, Rossi G, Glauber M. 287 * CUSUM CURVES FOR QUALITY CONTROL IN SURVEILLANCE OF SURGICAL SITE INFECTIONS: SINGLE-CENTRE EXPERIENCE IN 3529 PATIENTS. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt372.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Arnoux LA, Boschetti E, Bevilacqua S, May I, Demore B. CPC-139 Therapeutic Drug Monitoring For Glycopeptides and Aminoglycosides: Actual Situation and Perspectives in a French University Hospital: Abstract CPC-139 Table 1. Eur J Hosp Pharm 2013. [DOI: 10.1136/ejhpharm-2013-000276.596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Murzi M, Cerillo AG, Miceli A, Bevilacqua S, Kallushi E, Farneti P, Solinas M, Glauber M. Antegrade and retrograde arterial perfusion strategy in minimally invasive mitral-valve surgery: a propensity score analysis on 1280 patients. Eur J Cardiothorac Surg 2013; 43:e167-72. [DOI: 10.1093/ejcts/ezt043] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Romagnoli S, Ricci Z, Pinelli F, Stefàno P, Rossi A, Bevilacqua S. Spinal Cord Injury After Ascending Aorta and Aortic Arch Replacement Combined with Antegrade Stent Grafting: Role of Postoperative Cerebrospinal Fluid Drainage. J Card Surg 2012; 27:224-7. [DOI: 10.1111/j.1540-8191.2012.01430.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Giovanni Concistrè G, Farneti P, Cerillo AG, Marchi F, Chiaramonti F, Varone E, Kallushi E, Bevilacqua S, Solinas M, Miceli A, Glauber M. Sutureless aortic valve implantation in minimally invasive aortic valve replacement: an innovative approach in high-risk patients. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Murzi M, Cerillo AG, Bevilacqua S, Gilmanov D, Farneti P, Glauber M. Traversing the learning curve in minimally invasive heart valve surgery: a cumulative analysis of an individual surgeon's experience with a right minithoracotomy approach for aortic valve replacement. Eur J Cardiothorac Surg 2012; 41:1242-6. [DOI: 10.1093/ejcts/ezr230] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bevilacqua S, Demoré B, Boschetti E, Doco-Lecompte T, May I, May T, Rabaud C, Thilly N. 15 years of antibiotic stewardship policy in the Nancy Teaching Hospital. Med Mal Infect 2011; 41:532-9. [PMID: 21907511 DOI: 10.1016/j.medmal.2011.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Revised: 03/04/2011] [Accepted: 08/03/2011] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The authors report the results of a 15-year antibiotic stewardship policy in the Nancy Teaching Hospital and assess the impact of reinforcing this policy on antibiotic consumption. METHODS Antibiotic stewardship policy was initiated in the mid 90s and then reinforced from 2006 onwards. It was completed by prescription guidelines, nominative prescription of antibiotics, and an operational infectious diseases team (OIDT). The objectives were to promote antibiotic stewardship and decrease the use of extended broad spectrum or costly molecules and intravenous administration. Antibiotics consumption, as defined daily dose per 1000 patient days (DDD/1000PD) and in euros, was monitored from 2005 onwards. RESULTS Between 2005 and 2008, overall yearly cost of antibiotics dropped by 34% (-€1,308,902) and consumption in DDD/1000PD by 10%. This drop in consumption concerned all antibiotic classes. Teicoplanin prescription dropped by more than 50% and use of fluoroquinolone IV decreased by 15% in 3years. The operational team's interventions were effective since nearly 80% of suggested prescription amendments were accepted by prescribers. CONCLUSIONS This experiment shows that it is possible to implement antibiotic stewardship policy. Our results prove a significant decrease in overall consumption of antibiotic, a change in prescribing patterns, with a shift towards the use of cheaper antibiotics.
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Affiliation(s)
- S Bevilacqua
- Service des maladies infectieuses et tropicales, CHU Nancy, hôpitaux de Brabois, bâtiment P. Canton, rue du Morvan, Vandœuvre-Lès-Nancy, Nancy, France.
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Piccioni M, Monari C, Bevilacqua S, Perito S, Bistoni F, Kozel TR, Vecchiarelli A. A critical role for FcgammaRIIB in up-regulation of Fas ligand induced by a microbial polysaccharide. Clin Exp Immunol 2011; 165:190-201. [PMID: 21605112 DOI: 10.1111/j.1365-2249.2011.04415.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The microbial capsular polysaccharide glucuronoxylomannan (GXM) from the opportunistic fungus Cryptoccocus neoformans is able to alter the innate and adaptive immune response through multi-faceted mechanisms of immunosuppression. The ability of GXM to dampen the immune response involves the induction of T cell apoptosis, which is dependent on GXM-induced up-regulation of Fas ligand (FasL) on antigen-presenting cells. In this study we elucidate the mechanism exploited by GXM to induce up-regulation of FasL. We demonstrate that (i) the activation of FasL is dependent on GXM interaction with FcgammaRIIB (FcγRIIB); (ii) GXM induces activation of c-Jun NH(2) -terminal kinase (JNK) and p38 signal transduction pathways via FcγRIIB; (iii) this leads to downstream activation of c-Jun; (iv) JNK and p38 are simultaneously, but independently, activated; (v) FasL up-regulation occurs via JNK and p38 activation; and (vi) apoptosis occurs via FcγRIIB engagement with consequent JNK and p38 activation. Our results highlight a fast track to FasL up-regulation via FcγRIIB, and assign to this receptor a novel anti-inflammatory role that also accounts for induced peripheral tolerance. These results contribute to our understanding of the mechanism of immunosuppression that accompanies cryptococcosis.
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Affiliation(s)
- M Piccioni
- Microbiology Section, Department of Experimental Medicine and Biochemical Sciences, University of Perugia, Perugia, Italy
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Landoni G, Augoustides JG, Guarracino F, Santini F, Ponschab M, Pasero D, Rodseth RN, Biondi-Zoccai G, Silvay G, Salvi L, Camporesi E, Comis M, Conte M, Bevilacqua S, Cabrini L, Cariello C, Caramelli F, De Santis V, Del Sarto P, Dini D, Forti A, Galdieri N, Giordano G, Gottin L, Greco M, Maglioni E, Mantovani L, Manzato A, Meli M, Paternoster G, Pittarello D, Rana KN, Ruggeri L, Salandin V, Sangalli F, Zambon M, Zucchetti M, Bignami E, Alfieri O, Zangrillo A. Mortality reduction in cardiac anesthesia and intensive care: results of the first International Consensus Conference. Acta Anaesthesiol Scand 2011; 55:259-66. [PMID: 21288207 DOI: 10.1111/j.1399-6576.2010.02381.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
There is no consensus on which drugs/techniques/strategies can affect mortality in the perioperative period of cardiac surgery. With the aim of identifying these measures, and suggesting measures for prioritized future investigation we performed the first International Consensus Conference on this topic. The consensus was a continuous international internet-based process with a final meeting on 28 June 2010 in Milan at the Vita-Salute University. Participants included 340 cardiac anesthesiologists, cardiac surgeons, and cardiologists from 65 countries all over the world. A comprehensive literature review was performed to identify topics that subsequently generated position statements for discussion, voting, and ranking. Of the 17 major topics with a documented mortality effect, seven were subsequently excluded after further evaluation due to concerns about clinical applicability and/or study methodology. The following topics are documented as reducing mortality: administration of insulin, levosimendan, volatile anesthetics, statins, chronic β-blockade, early aspirin therapy, the use of pre-operative intra-aortic balloon counterpulsation, and referral to high-volume centers. The following are documented as increasing mortality: administration of aprotinin and aged red blood cell transfusion. These interventions were classified according to the level of evidence and effect on mortality and a position statement was generated. This International Consensus Conference has identified the non-surgical interventions that merit urgent study to achieve further reductions in mortality after cardiac surgery: insulin, intra-aortic balloon counterpulsation, levosimendan, volatile anesthetics, statins, chronic β-blockade, early aspirin therapy, and referral to high-volume centers. The use of aprotinin and aged red blood cells may result in increased mortality.
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Affiliation(s)
- G Landoni
- Department of Anesthesia and Intensive Care, Università Vita-Salute San Raffaele, Milan, Italy.
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Landoni G, Augoustides JG, Guarracino F, Santini F, Ponschab M, Pasero D, Rodseth RN, Biondi-Zoccai G, Silvay G, Salvi L, Camporesi E, Comis M, Conte M, Bevilacqua S, Cabrini L, Cariello C, Caramelli F, De Santis V, Del Sarto P, Dini D, Forti A, Galdieri N, Giordano G, Gottin L, Greco M, Maglioni E, Mantovani L, Manzato A, Meli M, Paternoster G, Pittarello D, Rana NK, Ruggeri L, Salandin V, Sangalli F, Zambon M, Zucchetti M, Bignami E, Alfieri O, Zangrillo A. Mortality reduction in cardiac anesthesia and intensive care: results of the first International Consensus Conference. HSR Proc Intensive Care Cardiovasc Anesth 2011; 3:9-19. [PMID: 23439940 PMCID: PMC3484607] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is no consensus on which drugs/techniques/strategies can affect mortality in the perioperative period of cardiac surgery. With the aim of identifying these measures, and suggesting measures for prioritized future investigation we performed the first international consensus conference on this topic. METHODS The consensus was a continuous international internet-based process with a final meeting on June 28th 2010 in Milan at the Vita-Salute University. Participants included 340 cardiac anesthesiologists, cardiac surgeons and cardiologists from 65 countries all over the world. A comprehensive literature review was performed to identify topics that subsequently generated position statements for discussion, voting and ranking. RESULTS Of the 17 major topics with a documented mortality effect, seven were subsequently excluded after further evaluation due to concerns about clinical applicability and/or study methodology. The following topics are documented as reducing mortality: administration of insulin, levosimendan, volatile anesthetics, statins, chronic beta-blockade, early aspirin therapy, the use of preoperative intra-aortic balloon counterpulsation and referral to high-volume centers. The following are documented as increasing mortality: administration of aprotinin and aged red blood cell transfusion. These interventions were classified according to the level of evidence and effect on mortality and a position statement was generated. CONCLUSION This international consensus conference has identified the non-surgical interventions that merit urgent study to achieve further reductions in mortality after cardiac surgery: insulin, intra-aortic balloon counterpulsation, levosimendan, volatile anesthetics, statins, chronic beta-blockade, early aspirin therapy, and referral to high-volume centers. The use of aprotinin and aged red blood cells may result in increased mortality.
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Affiliation(s)
- G Landoni
- Department of Anesthesia and Intensive Care, Università Vita-Salute San Raffaele, Milan, Italy
| | - J G Augoustides
- Department of Anesthesiology and Critical Care University of Pennsylvania, Philadelphia, USA
| | - F Guarracino
- Department of Cardiothoracic Anaesthesia and Intensive Care Medicine, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - F Santini
- Division of Cardiac Surgery, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - M Ponschab
- Department of Anaesthesia and Intensive Care, Trauma Hospital Linz, Linz, Austria
| | - D Pasero
- Departement of Anesthesia and Critical Care Medicine, San Giovanni Battista Hospital, University of Turin, Italy
| | - R N Rodseth
- Perioperative Research Unit, Department of Anaesthetics, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal & Department of Anaesthetics, Inkosi Albert Luthuli Central Hospital, Durban, South Africa
| | - G Biondi-Zoccai
- Division of Cardiology, University of Modena and Reggio Emilia, Modena, Italy
| | - G Silvay
- Department of Anesthesiology, The Mount of Sinai School of Medicine - New York, USA
| | - L Salvi
- Department of Anaesthesia and ICU, IRCCS Centro Cardiologico Monzino, Milan, Italy
| | - E Camporesi
- Department of Surgery/Anesthesiology; University of South Florida College of Medicine, Tampa, Florida, USA
| | - M Comis
- Department of Anesthesia and Intensive Care, Ospedale Mauriziano Umberto I di Torino, Italy
| | - M Conte
- Department of Anesthesiology and Intensive Care, Città di Lecce Hospital GVM Care & Research, Lecce, Italy
| | - S Bevilacqua
- S.O.D. Cardioanestesia, Dipartimento Cuore e Vasi, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
| | - L Cabrini
- Department of Anesthesia and Intensive Care, Università Vita-Salute San Raffaele, Milan, Italy
| | - C Cariello
- Department of Cardiothoracic Anaesthesia and Intensive Care Medicine, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - F Caramelli
- Cardiothoracic and Vascular Anesthesia and Intensive Care Unit, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - V De Santis
- Department of Anesthesiology and Intensive Care, Policlinico Umberto I - Università La Sapienza, Roma, Italy
| | - P Del Sarto
- Department of Anesthesiology and ICU, "G. Monasterio" Tuscan Foundation, "G. Pasquinucci" Heart Hospital, Massa, Italy
| | - D Dini
- S.O.D. Cardioanestesia, Dipartimento Cuore e Vasi, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
| | - A Forti
- Department of Cardiac Surgery, Intensive Care Unit, Regional Hospital Ca' Foncello, Treviso, Italy
| | - N Galdieri
- Department of Anesthesia and Intensive Care, Azienda Ospedaliera Vincenzo Monaldi, Napoli, Italy
| | - G Giordano
- Department of Anesthesiology and Intensive Care, Hesperia Hospital Modena, Modena, Italy
| | - L Gottin
- Department of Anaesthesia, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - M Greco
- Department of Anesthesia and Intensive Care, Università Vita-Salute San Raffaele, Milan, Italy
| | - E Maglioni
- Department of Anesthsiology and Intensive Care, Policlinico S. Maria alle Scotte, Siena Italy
| | - L Mantovani
- Anestesia e Rianimazione, Ospedali Riuniti di Bergamo, Italy
| | - A Manzato
- Department of Anesthesia and Intensive Care, Pres.Ospedal. Spedali Civili Brescia - Brescia, Italy
| | - M Meli
- Department of Anesthesiology and Intensive Care, Hesperia Hospital Modena, Modena, Italy
| | - G Paternoster
- Departement of Cardiovascular Anaesthesia and Intensive Care Azienda Ospedaliera San Carlo Potenza, Italy
| | - D Pittarello
- Department of Anesthesia and Intensive Care, Azienda Ospedaliera di Padova - Padova, Italy
| | - N K Rana
- Departement of Anesthesia and Critical Care Medicine, San Giovanni Battista Hospital, University of Turin, Italy
| | - L Ruggeri
- Department of Anesthesia and Intensive Care, Università Vita-Salute San Raffaele, Milan, Italy
| | - V Salandin
- Department of Cardiac Surgery, Intensive Care Unit, Regional Hospital Ca' Foncello, Treviso, Italy
| | - F Sangalli
- Cardiac Anesthesia and Intensive Care Unit, Department of Perioperative Medicine and Intensive Care, San Gerardo Hospital - University of Milan-Bicocca, Monza, Italy
| | - M Zambon
- Department of Anesthesia and Intensive Care, Università Vita-Salute San Raffaele, Milan, Italy
| | - M Zucchetti
- Department of Anesthesia and Intensive Care, Azienda Ospedaliera Papardo, Messina, Italy
| | - E Bignami
- Department of Anesthesia and Intensive Care, Università Vita-Salute San Raffaele, Milan, Italy
| | - O Alfieri
- Department of Anesthesia and Intensive Care, Università Vita-Salute San Raffaele, Milan, Italy
| | - A Zangrillo
- Department of Anesthesia and Intensive Care, Università Vita-Salute San Raffaele, Milan, Italy
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Pabari PA, Kyriacou A, Moraldo M, Unsworth B, Baruah R, Sutaria N, Hughes A, Mayet J, Francis DP, Uejima T, Loboz K, Antonini-Canterin F, Polombo C, Carerj S, Hughes A, Vinereanu D, Evangelista A, Leftheriotis G, Fraser AG, Kiotsekoglou A, Govindan M, Govind SC, Saha SK, Camm AJ, Azcarate PM, Castano S, Rodriguez-Manero M, Arraiza M, Levy B, Barba J, Rabago G, Bastarrika G, Nemes A, Takacs R, Varkonyi T, Gavaller H, Baczko I, Forster T, Wittmann T, Papp JG, Lengyel C, Varro A, Tumasyan LR, Adamyan KG, Savu O, Mieghem T, Dekoninck P, Gucciardo L, Jurcut R, Giusca S, Popescu BA, Ginghina C, Deprest J, Voigt JU, Versiero M, Galderisi M, Esposito R, Rapacciuolo A, Esposito G, Raia R, Morgillo T, Piscione F, De Simone G, Oraby MA, Maklady FA, Mohamed EM, Eraki AZ, Zaliaduonyte-Peksiene D, Tamuleviciute E, Janenaite J, Marcinkeviciene J, Mizariene V, Bucyte S, Vaskelyte J, Trifunovic D, Nedeljkovic I, Popovic D, Ostojic M, Vujisic-Tesic B, Petrovic M, Stankovic S, Sobic-Saranovic D, Banovic M, Dikic-Djordjevic A, Savino K, Lilli A, Grikstaite E, Giglio V, Bordoni E, Maragoni G, Cavallini C, Ambrosio G, Nedeljkovic I, Ostojic M, Vujisic-Tesic B, Jakovljevic B, Petrovic M, Trifunovic D, Beleslin B, Nedeljkovic M, Banovic M, Petrovic O, Moral S, Rodriguez-Palomares J, Descalzo M, Marti G, Pineda V, Mahia P, Gutierrez L, Gonzalez-Alujas T, Evangelista A, Garcia-Dorado D, Schnell F, Donal E, Thebault C, Bernard A, Corbineau H, Le Breton H, Kochanowski J, Scislo P, Piatkowski R, Roik M, Marchel M, Kosior D, Opolski G, Lesniak-Sobelga AM, Wicher-Muniak E, Kostkiewicz M, Olszowska M, Suchon E, Klimeczek P, Banys P, Pasowicz M, Tracz W, Podolec P, Moral S, Rodriguez-Palomares J, Descalzo M, Pineda V, Mahia P, Gutierrez L, Gonzalez-Alujas T, Laynez A, Evangelista A, Garcia-Dorado D, Hoefsten DE, Loegstrup BB, Norager B, Moller JE, Flyvbjerg A, Egstrup K, Streb W, Szulik M, Nowak J, Markowicz-Pawlus E, Duszanska A, Sedkowska A, Kalarus Z, Kukulski T, Spinelli L, Morisco C, Assante Di Panzillo E, Buono F, Crispo S, Trimarco B, Oraby MA, Hawary AA, Nasr GM, Fawzy MM, Faber L, Scholtz W, Boergermann J, Wiemer M, Kleikamp G, Bogunovic N, Dimitriadis Z, Gummert J, Hering D, Horstkotte D, Luca' F, Gelsomino S, Lorusso R, Caciolli S, Carella R, Bille' G, De Cicco G, Pazzagli V, Gensini GF, Borowiec A, Dabrowski R, Janas J, Kraska A, Firek B, Kowalik I, Szwed H, Marcus KA, De Korte CL, Feuth T, Thijssen JM, Kapusta L, Dahl J, Videbaek L, Poulsen MK, Pellikka PA, Veien K, Andersen LI, Haghfelt T, Moller JE, Haberka M, Mizia - Stec K, Adamczyk T, Mizia M, Chmiel A, Pysz P, Sosnowski M, Gasior Z, Trusz - Gluza M, Tendera M, Niklewski T, Wilczek K, Chodor P, Podolecki T, Frycz-Kurek A, Kukulski T, Kalarus Z, Zembala M, Yurdakul S, Yildirimturk O, Tayyareci Y, Memic K, Demiroglu ICC, Aytekin S, Garcia Alonso CJ, Ferrer Sistach E, Delgado L, Lopez Ayerbe J, Vallejo Camazon N, Gual Capllonch F, Espriu Simon M, Ruyra X, Caballero Parrilla A, Bayes Genis A, Lecuyer L, Berrebi A, Florens E, Noghin M, Huerre C, Achouh P, Zegdi R, Fabiani JN, De Chiara B, Moreo A, Musca F, De Marco F, Lobiati E, Belli O, Mauri F, Klugmann S, Caballero A, Vallejo N, Gonzalez Guardia A, Nunez Aragon R, Bosch C, Lopez Ayerbe J, Ferrer E, Pedro Botet ML, Gual F, Bayes Genis A, Cusma-Piccione M, Zito C, Oreto G, Giuffre R, Todaro MC, Barbaro CM, Lanteri S, Longordo C, Salvia J, Carerj S, Bensaid A, Gallet R, Fougeres E, Lim P, Nahum J, Deux JF, Gueret P, Teiger E, Dubois-Rande JL, Monin JL, Yurdakul S, Tayyareci Y, Yildirimturk O, Behramoglu F, Colakoglu Z, Aytekin V, Demiroglu C, Aytekin S, Gargani L, Poggianti E, Bucalo R, Rizzo M, Agrusta F, Landi P, Sicari R, Picano E, Sutandar A, Siswanto BB, Irmalita I, Harimurti G, Hayashi SY, Nascimento MM, Lindholm B, Lind B, Seeberger A, Nowak J, Pachaly MA, Riella MC, Bjallmark A, Brodin LA, Poanta L, Porojan M, Dumitrascu DL, Ikonomidis I, Tzortzis S, Lekakis J, Kremastinos DT, Paraskevaidis I, Andreadou I, Nikolaou M, Katsibri P, Anastasiou-Nana M, Maceira Gonzalez AM, Ripoll C, Cosin-Sales J, Igual B, Salazar J, Belloch V, Cosin-Aguilar J, Pennell DJ, Masaki M, Pulido JN, Yuasa T, Gillespie S, Afessa B, Brown DR, Mankad SV, Oh JK, Gurghean AL, Mihailescu AM, Tudor I, Homentcovschi C, Muraru M, Bruckner IV, Correia CE, Rodrigues B, Moreira D, Santos LF, Gama P, Dionisio O, Cabral C, Santos O, Bombardini T, Gherardi S, Arpesella G, Valente S, Calamai I, Pasanisi E, Sansoni S, Picano E, Szymanski P, Dobrowolski P, Lipczynska M, Klisiewicz A, Hoffman P, Stepowski D, Kurtz B, Grezis-Soulie G, Savoure A, Anselme F, Bauer F, Castillo J, Herszkowicz N, Ferreira C, Goscinska A, Mizia-Stec K, Gasior Z, Mizia M, Haberka M, Chmiel A, Poborski W, Azevedo O, Quelhas I, Guardado J, Fernandes M, Miranda CS, Gaspar P, Lourenco A, Medeiros R, Almeida J, L Bennani S, Algalarrondo V, Dinanian S, Guiader J, Juin C, Adams D, Slama MS, Onaindia JJ, Quintana O, Velasco S, Astigarraga E, Cacicedo A, Gonzalez J, Rodriguez I, Sadaba M, Eneriz M, Laraudogoitia Zaldumbide E, Nunez-Gil I, Luaces M, Zamorano J, Garcia Rubira JC, Vivas D, Ibanez B, Marcos Alberca P, Fernandez Golfin C, Alonso J, Macaya C, Silva Marques J, Almeida AG, Carvalho V, Jorge C, Silva D, Gato Varela M, Martins S, Brito D, Lopes MG, Tripodi E, Miserrafiti B, Montemurro V, Scali R, Tripodi P, Marchel M, Kochanowski J, Piatkowski R, Scislo P, Winkler A, Madej A, Hausmanowa-Petrusewicz I, Opolski G, Fijalkowski M, Koprowski A, Jaguszewski M, Galaska R, Taszner M, Rynkiewicz A, Citro R, Rigo F, Provenza G, Ciampi Q, Patella MM, D'andrea A, Antonini-Canterin F, Vriz O, Astarita C, Bossone E, Heggemann F, Walter TH, Kaelsch TH, Sueselbeck T, Papavassiliu TH, Borggrefe M, Haghi D, Monk-Hansen T, Have Dall C, Bisgaard Christensen S, Snoer M, Gustafsson F, Rasmusen H, Prescott E, Finocchiaro G, Pinamonti B, Merlo M, Barbati G, Di Lenarda A, Bussani R, Sinagra G, Butz T, Faber L, Lang CN, Meissner A, Plehn G, Yeni H, Langer C, Horstkotte D, Trappe HJ, Gu X, Gu XY, He YH, Li ZA, Han JC, Chen J, Gaudron P, Niemann M, Herrmann S, Hu K, Bijnens B, Hillenbrand H, Beer M, Ertl G, Weidemann F, Mazzone A, Mariani M, Foffa I, Vianello A, Del Ry S, Bevilacqua S, Andreassi MG, Glauber M, Berti S, Kochanowski J, Scislo P, Piatkowski R, Grabowski M, Roik M, Postula M, Marchel M, Kosior D, Opolski G, Dragulescu A, Van Arsdell G, Al-Radi O, Caldarone C, Mertens L, Lee KJ, Unsworth B, Casula RP, Yadav H, Baruah R, Cherian A, Sutaria N, Hughes AD, Mayet J, Francis DP, Vitarelli A, D'orazio S, Nguyen BL, Iorio G, Battaglia D, Caranci F, Padella V, Capotosto L, Alessandroni L, Barilla F, Cardin C, Hascoet S, Saudron M, Caudron G, Arnaudis B, Acar P, Sun MM, Shu XH, Pan CZ, Fang XY, Kong DH, Fang F, Zhang Q, Chan YS, Xie JM, Yip WK, Lam YY, Sanderson JE, Yu CM, Rosca M, O' Connor K, Romano G, Magne J, Calin A, Popescu BA, Muraru D, Pierard L, Ginghina C, Lancellotti P, Roushdy A, Elfiky I, El Shahid G, Elfiky A, El Sayed M, Wierzbowska-Drabik K, Chrzanowski L, Kapusta A, Plonska-Goscinak E, Krzeminska-Pakula M, Kurpesa M, Rechcinski T, Trzos E, Kasprzak JD, Ersboll MK, Valeur N, Mogensen UM, Andersen M, Moller JE, Hassager C, Sogaard P, Kober LV, Kloeckner M, Hayat D, Nahum J, Dussault C, Lellouche N, Elbaz N, Dubois-Rande JL, Gueret P, Lim P, Demopoulos A, Hatzigeorgiou G, Leontiades E, Motsi A, Karatasakis G, Athanassopoulos G, Zycinski P, Chrzanowski L, Wierzbowska-Drabik K, Kasprzak J, Vazquez Alvarez MC, Medrano Lopez C, Camino Lopez M, Granja S, Zunzunegui Martinez JL, Maroto Alvaro E, Tsai WC, Chen JY, Liu YW, Lin CC, Tsai LM, Silva Marques J, Gomes DC, Robalo Martins S, Gois MR, Ribeiro S, Nunes Diogo A, Almeida AG, Lopes MG, Zito C, Sengupta P, Di Bella G, Cusma-Piccione M, Oreto G, Caracciolo G, Longordo C, Lentini S, Carerj S, Kinova E, Zlatareva N, Goudev A, Papagiannis N, Mpouki M, Papagianni A, Vorria M, Mpenetos G, Lytra D, Papadopoulou E, Sgourakis P, Malakos J, Kyriazis J, Saha SK, Kodali V, Toole R, Govind SC, Kiotsekoglou A, Gopal AS, Celutkiene J, Rudys A, Grabauskiene V, Glaveckaite S, Sadauskiene E, Lileikiene Z, Bickauskaite N, Ciburiene E, Skorniakov V, Laucevicius A, Attenhofer Jost CH, Pfyffer M, Lindquist R, Santos JLF, Coelho ORC, Mady CM, Picard MHP, Salemi VMC, Funk L, Butz T, Lang CN, Prull MW, Plehn G, Yeni H, Meissner A, Trappe HJ, Tsai WC, Liu YW, Shih JY, Lin CC, Huang YY, Tsai LM, Lancellotti P, Donal E, Magne J, O'connor K, Moonen M, Pierard LA, Cozma DC, Mornos C, Ionac A, Petrescu L, Dragulescu D, Dan R, Popescu I, Dragulescu SI, Von Lueder TG, Hodt A, Gjerdalen GF, Andersen TE, Solberg EE, Steine K, Savu O, Van Mieghem T, Dekoninck P, Gucciardo L, Jurcut R, Giusca S, Popescu BA, Ginghina C, Deprest J, Voigt JU, Rostek M, Pikto-Pietkiewicz W, Dluzniewski M, Antoniewicz A, Poletajew S, Borowka A, Pasierski T, Malyutina SK, Ryabikov M, Ragino J, Ryabikov A, Sitia S, Tomasoni L, Atzeni F, Gianturco L, Sarzi-Puttini P, De Gennaro Colonna V, Turiel M, Uejima T, Loboz K, Vriz O, Polombo C, Carerj S, Hughes A, Vinereanu D, Gutierrez FR, Lefhtheriotis G, Fraser AG, Hurst RT, Nelson MR, Mookadam F, Thota V, Emani U, Al Harthi M, Stepanek J, Cha S, Lester SJ, Ho EMM, Hemeryck L, Hall M, Scott K, Bennett K, Mahmud A, Daly C, King G, Murphy RT, Brown AS, Teske AJ, D'Hooge J, Claus P, Rademakers F, Voigt JU, Santos L, Cortez-Dias N, Silva D, Silva Marques J, Ribeiro S, Goncalves S, Almeida Ribeiro M, Robalo Martins S, Bordalo E Sa A, Lopes MG, Teske AJ, D'Hooge J, Claus P, Rademakers F, Voigt JU, Magnino C, Marcos-Alberca P, Milan A, Nunez-Gil I, Almeria C, Caniadas V, Rodrigo JL, Perez De Isla L, Macaya C, Zamorano JL, Gustafsson U, Larsson M, Bjallmark A, Lindqvist P, Brodin L, Waldenstrom A, Roosens B, Hernot S, Droogmans S, Van Camp G, Lahoutte T, Lancellotti P, Cosyns B, Ho EMM, Scott K, Hemeryck L, Hall M, Bennett K, Mahmud A, Daly C, King G, Murphy RT, Brown AS, Rao CM, Aguglia D, Casciola G, Imbesi C, Marvelli A, Sgro M, Benedetto D, Tripepi R, Zoccali C, Benedetto FA, Muraru D, Badano LP, Cardillo M, Del Mestre L, Gianfagna P, Proclemer A, Tschernich HD, Mora B, Base E, Weber U, Dumfarth J, Mukherjee C, Skaltsiotis HS, Kaladaridis AK, Bramos DB, Kottis GK, Antoniou AA, Agrios IA, Takos DT, Vasiladiotis NV, Pamboucas KP, Toumanidis STT, Shim A, Kasprzak JD, Lipec P, Michalski B, Wozniakowski B, Stefanczyk L, Rotkiewicz A, Cameli M, Lisi M, Padeletti M, Bigio E, Bernazzali S, Tsoulpas C, Maccherini M, Henein M, Mondillo S, Garcia Lunar I, Mingo Santos S, Monivas Palomero V, Mitroi C, Beltran Correas P, Ruiz Bautista L, Muniz Lozano A, Gonzalez Gonzalez M, Pabari PA, Stegemann B, Willson K, Kyriacou A, Moraldo M, Mayet J, Hughes A, Francis DP, Zeppellini R, Iavernaro A, Zadro M, Carasi M, De Domenico R, Rigo T, Artuso E, Erente G, Ramondo A, Le TT, Huang FQ, Gu Y, Tan RS. Poster session II * Thursday 9 December 2010, 14:00-18:00. European Journal of Echocardiography 2010. [DOI: 10.1093/ejechocard/jeq138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Bevilacqua S, Romagnoli S, Ciappi F, Lazzeri C, Pratesi C. Asleep-awake-asleep technique during carotid endarterectomy. J Cardiothorac Vasc Anesth 2010; 25:580-1. [PMID: 20728376 DOI: 10.1053/j.jvca.2010.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Indexed: 11/11/2022]
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Romagnoli S, Romano SM, Bevilacqua S, Lazzeri C, Santoro G, Ciappi F, Gelsomino S, Dini D. Pulse Contour Cardiac Output Monitoring During a Complicated Percutaneous Aortic Valve Replacement. J Cardiothorac Vasc Anesth 2010; 24:303-5. [DOI: 10.1053/j.jvca.2009.03.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2008] [Indexed: 11/11/2022]
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Doco-Lecompte T, Demoré B, Burty C, Rondelot G, Scheid P, Zuck P, Simon L, Letranchant L, Robert C, Frentiu E, Petitfrère M, Simplot B, Bevilacqua S, Voltz C, Rabaud C, May T. Revue de pertinence des fluoroquinolones en Lorraine : résultats de la première évaluation. Med Mal Infect 2010; 40:106-11. [DOI: 10.1016/j.medmal.2009.08.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2009] [Accepted: 08/31/2009] [Indexed: 10/20/2022]
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Lazzeri C, Bevilacqua S, Ciappi F, Pratesi C, Gensini GF, Romagnoli S. Glucose metabolism in cardiovascular surgery. HSR Proc Intensive Care Cardiovasc Anesth 2010; 2:19-26. [PMID: 23440255 PMCID: PMC3484575] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
During the past few years, it has become evident that metabolic control is a major determinant of postoperative outcomes, not only for diabetic patients but for all patients undergoing surgery.In cardiac and vascular surgery, myocardial ischemia is a common challenge and the management of hyperglycemia should be part of the strategy aimed at optimizing cardiac protection during these types of surgery, since performed in high risk patients. Little informations are available on the relation between glucose substrate and the type of anesthesia and few studies have been performed on glucose metabolism in the perioperative risk assessment as well as on intraoperative and post surgical management of hyperglycemia in patients submitted to cardiac and vascular surgery. Evidence exists that even slight increased in glycemia are detrimental for patients (diabetic and non) elective for cardiac and vascular surgery, though the precise details of the timing of insulin therapy, the desired target serum glucose level, and the duration of therapy are so far to be completely elucidated. Anesthestiologists can therefore affect outcome by simply preserving a normal blood glucose concentration initiating in the operating room. The challenge to optimize glucose control should begin during preoperative evaluation.
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Affiliation(s)
- C Lazzeri
- Intensive Cardiac Care Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - S Bevilacqua
- Cardio Anesthesiologic Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - F Ciappi
- Cardio Anesthesiologic Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - C Pratesi
- Vascular Surgery Heart and Vessel Department, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - G F Gensini
- Intensive Cardiac Care Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - S Romagnoli
- Cardio Anesthesiologic Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
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Bianchi G, Solinas M, Bevilacqua S, Glauber M. Which patient undergoing mitral valve surgery should also have the tricuspid repair? Interact Cardiovasc Thorac Surg 2009; 9:1009-20. [DOI: 10.1510/icvts.2009.217570] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Pratesi C, Bevilacqua S, Romagnoli S, Ciappi F, dorigo W, Pratesi G, Marek J, Pulli R. PP2. Patient Cooperation During General Anesthesia for Carotid Endarterectomy. A Third Anesthetic Option. J Vasc Surg 2009. [DOI: 10.1016/j.jvs.2009.02.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Murzi M, Kallushi E, Tiwari KK, Cerillo AG, Bevilacqua S, Karimov JH, Solinas M, Glauber M. Minimally invasive mitral valve surgery through right thoracotomy in patients with patent coronary artery bypass grafts. Interact Cardiovasc Thorac Surg 2009; 9:29-32. [DOI: 10.1510/icvts.2009.203745] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Romagnoli S, Romano SM, Bevilacqua S, Ciappi F, Lazzeri C, Peris A, Dini D, Gelsomino S. Cardiac output by arterial pulse contour: reliability under hemodynamic derangements. Interact Cardiovasc Thorac Surg 2009; 8:642-6. [PMID: 19299422 DOI: 10.1510/icvts.2008.200451] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Pulse contour methods (PCM) for the measurements of cardiac output (CO) are gaining popularity in intensive care settings but their reliability during hemodynamic instability has been questioned. Pressure-recording-analytical-method (PRAM) is a newly developed uncalibrated hemodynamic monitor and its capability in measuring CO during hemodynamic instability is still under investigation. Dobutamine (2.5 and 5 microg/kg/min), vasoconstriction (arginine-vasopressin 4, 8 and 16 IU/h), hemorrhage (-10%, -20%, -35%, and -50% of the theoretical volemia), and volume resuscitation were induced in eight swine. CO by means of thermodilution (CO(ThD)), transesophageal echocardiography (CO(TEE)) and PRAM (CO(PRAM)) were contemporarily registered. R(2), bias, and percentage error were used to compare the methods. Comparison between CO(PRAM) and CO(ThD) resulted in: r(2)=0.87; bias=-0.006 l/min; precision=+/-0.87 l/min; percentage error=22.8%. Comparison between CO(PRAM) and CO(TEE) resulted in: r(2)=0.85; bias=-0.007 l/min; precision=+/-0.86 l/min; percentage error=22%. Sub-group analysis revealed disagreement between methods only during the last two steps of hemorrhage: CO(PRAM) vs. CO(ThD): r(2)=0.67, bias=-0.37 l/min, precision=+/-1.04 l/min, limits of agreement=-1.39+0.66 l/min, and percentage error=45%; CO(PRAM) vs. CO(TEE): r(2)=0.38, bias=0.4 l/min, precision=+/-1.42 l/min, limits of agreement=-0.99+1.79 l/min, and percentage error=62%. PRAM resulted to be accurate in measuring CO during hemodynamic stability, tachycardia, and vasoconstriction. When volemia was reduced by >35%, disagreement between methods was observed.
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Romagnoli S, Bevilacqua S, Lazzeri C, Ciappi F, Dini D, Pratesi C, Gensini GF, Romano SM. Most Care®: a minimally invasive system for hemodynamic monitoring powered by the Pressure Recording Analytical Method (PRAM). HSR Proc Intensive Care Cardiovasc Anesth 2009; 1:20-7. [PMID: 23439735 PMCID: PMC3484543] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
Abstract
Invasive hemodynamic monitoring is a cornerstone of the care of critically ill and hemodynamically unstable patients in both intensive care units and operating rooms. The assessment of cardiac output by means of the pulmonary artery catheter has been considered the clinical gold standard. Nevertheless, several concerns have been raised regarding its invasiveness, usefulness, and associated complica-tions. These disadvantages have led to the development, during the last years, of a number of less invasive technologies for cardiac output determination. Among them, those based on the analysis of a peripheral arterial waveform have become commonly used. Most Care(®) is a minimally invasive arterial pressure based monitor powered by the Pressure Recording Analytical Method (PRAM), the only algorithm that does not require prior calibration or pre-calculated parameters and which is based of flow. PRAM provides the measurement of the main factors of hemodynamics, such as systemic blood pressures, stroke volume, cardiac output, and vascular resistances. Moreover, dynamic indices of fluid responsiveness are continuously displayed. In the present paper, we reviewed the current literature focusing on advantages and limitations of PRAM.
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Affiliation(s)
- S Romagnoli
- Heart and Vessels Department, Cardiac and Vascular Anesthesia and Post-Cardiac Surgery Intensive Care Unit Careggi Hospital, Florence, Italy
| | - S Bevilacqua
- Heart and Vessels Department, Cardiac and Vascular Anesthesia and Post-Cardiac Surgery Intensive Care Unit Careggi Hospital, Florence, Italy
| | - C Lazzeri
- Heart and Vessels Department, Cardiac and Vascular Anesthesia and Post-Cardiac Surgery Intensive Care Unit Careggi Hospital, Florence, Italy
| | - F Ciappi
- Heart and Vessels Department, Cardiac and Vascular Anesthesia and Post-Cardiac Surgery Intensive Care Unit Careggi Hospital, Florence, Italy
| | - D Dini
- Heart and Vessels Department, Cardiac and Vascular Anesthesia and Post-Cardiac Surgery Intensive Care Unit Careggi Hospital, Florence, Italy
| | - C Pratesi
- Heart and Vessels Department, Vascular Surgery Unit, University of Florence, Careggi Hospital, Florence, Italy
| | - G F Gensini
- Heart and Vessels Department Critical Care Medicine and Surgery, University of Florence, Careggi Hospital, Florence, Italy
| | - S M Romano
- Heart and Vessels Department Critical Care Medicine and Surgery, University of Florence, Careggi Hospital, Florence, Italy
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Romagnoli S, Romano SM, Bevilacqua S, Lazzeri C, Ciappi F, Dini D, Pratesi C, Gensini GF. Hemodynamic goal-directed therapy. A review. HSR Proc Intensive Care Cardiovasc Anesth 2009; 1:54-8. [PMID: 23439079 PMCID: PMC3484536] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Patients can show arterial pressure and cardiac index within the normal range and still be in circulatory shock if oxygen and metabolic demand is increased or blood flow distribution is altered.Lactate is produced in anaerobic environment to preserve cellular integrity and physicians use its blood concentration value as a reliable marker of tissue hypoxia and energy failure.The authors review the recent literature on the importance of mixed venous oxygen saturation (SvO(2)) as an early sign of inadequate DO(2) that precede the lactate production.
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Affiliation(s)
- S Romagnoli
- Department of Cardiac and Vascular Anesthesia and Post-Surgical Intensive Care Unit, Careggi Hospital, Florence, Italy
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Caciolli S, Gelsomino S, Fradella G, Bevilacqua S, Favilli S, Gensini GF. Severe hypoplasia of the posterior mitral leaflet. Ann Thorac Surg 2008; 86:1978-9. [PMID: 19022026 DOI: 10.1016/j.athoracsur.2008.05.055] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2008] [Revised: 04/24/2008] [Accepted: 05/19/2008] [Indexed: 11/16/2022]
Abstract
A rare case of a 14-year-old child with congenital mitral insufficiency secondary to hypoplasia of the posterior leaflet is reported. Echocardiography revealed the almost complete absence of the posterior mitral leaflet, which determined massive regurgitation. At surgical inspection the posterior leaflet was almost completely absent, represented only by tags of fibrous tissue that strictly adhered to the posterior annulus with a total absence of chordae inserting into the hypoplastic leaflet. The mitral valve was successfully repaired by restrictive annuloplasty, which gained a satisfactory surface of coaptation between the anterior leaflet and the primordial posterior structure, resulting in stable valve continence.
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Affiliation(s)
- Sabina Caciolli
- Departments of Cardiac Surgery and Experimental Surgery, Careggi Hospital, Florence, Italy
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Bevilacqua S, Romagnoli S, Ciappi F, Lazzeri C, Gelsomino S, Pulli R, Pratesi C, Gensini GF. Patient cooperation during general anesthesia for combined carotid and coronary artery surgery. J Cardiothorac Vasc Anesth 2008; 23:439-40. [PMID: 18835529 DOI: 10.1053/j.jvca.2008.07.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2008] [Indexed: 11/11/2022]
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Bevilacqua S, Lazzeri C, Romagnoli S, Gelsomino S, Lorusso R, De Cicco G, Gensini GF. Unexpected severe tricuspid regurgitation after successful mitral valve repair. J Cardiothorac Vasc Anesth 2008; 23:251-2. [PMID: 18834774 DOI: 10.1053/j.jvca.2008.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2007] [Indexed: 11/11/2022]
Affiliation(s)
- Sergio Bevilacqua
- Department of Heart and Vessels, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
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47
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Frentiu E, Robert C, Letranchant L, Bevilacqua S, Villaume M, Rabaud C, May T. COL6-05 Bilan du fonctionnement d’une unité de regroupement (cohorting) de patients porteurs d’entérocoques résistants à la vancomycine en 2007. Med Mal Infect 2008. [DOI: 10.1016/s0399-077x(08)73040-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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48
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Bevilacqua S, Boschetti E, Lozniewski A, Rabaud C, May T. Policy of good use of antibiotics: example to CHU of Nancy. Med Mal Infect 2007. [DOI: 10.1016/s0399-077x(07)80013-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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49
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Braconi L, Pretelli P, Calamai G, Montesi G, Romagnoli S, Gelsomino S, Bevilacqua S, Stefàno P, Gensini GF. An unusual case of cardiac tamponade. J Cardiovasc Med (Hagerstown) 2006; 7:219-21. [PMID: 16645390 DOI: 10.2459/01.jcm.0000215277.62767.8f] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A case of a 67-year-old woman with cardiac tamponade caused by toothpick ingestion is presented. At clinical presentation, it mimicked postinfarction ventricular free wall rupture and the diagnosis was not made until the operation. Ingested toothpicks have often been reported as a cause of intestinal injuries, but in this rare case the toothpick migrated into the pericardium and caused laceration of the right coronary artery.
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Affiliation(s)
- Lucio Braconi
- Department of Cardiac Surgery, Careggi Hospital, Florence, Italy
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50
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Romagnoli S, Bevilacqua S, Gelsomino S, Pradella S, Ghilli L, Rostagno C, Gensini GF, Sorbara C. Small-Dose Recombinant Activated Factor VII (NovoSeven??) in Cardiac Surgery. Anesth Analg 2006; 102:1320-6. [PMID: 16632803 DOI: 10.1213/01.ane.0000209023.96418.e5] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Recombinant activated factor VII (rFVIIa) has been used at different doses in cardiac surgery patients. We tested the efficacy of small-dose rFVIIa in patients with intractable bleeding after cardiac surgery. The study group comprised 15 cardiac surgery patients with intractable bleeding treated with small-dose (1.2 mg) rFVIIa as a slow IV bolus at the end of complete step-by step transfusion protocol. Fifteen matched patients undergoing the same transfusion protocol in the pre-rFVIIa era represented the control group. Blood loss at the end of the transfusion protocol was a primary outcome. Median, 25th-75th 24-h blood loss percentiles were 1685 (1590-1770) mL versus 3170 (2700-3850) mL in study group and controls, respectively (P = 0.0004). Transfused red blood cells, fresh-frozen plasma, and platelets in the study group and controls were as follows: 7 (4-8) U versus 18 (12-21) U (P = 0.001); 7.5 (6-11) U versus 11 (9-15) U (P = 0.003); 0 (0-4) U versus 9 (6-13) U (P = 0.001). In addition, significant improvements of prothrombin time (P = 0.015), international normalized ratio (P = 0.006), activated partial prothrombin time (P = 0.01), and platelet count (P = 0.003) were detected in the study group versus controls. Finally, patients receiving rFVIIa showed a reduced intensive care unit length of stay (chi2 = 15.9, P = 0.0001) and had infrequent surgical re-exploration (chi2 = 16.2,P < 0.0001). Small-dose rFVIIa showed satisfactory results in cardiac patients with intractable bleeding. Further randomized studies are necessary to confirm our findings.
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