Savino Spadaro
A5025581494- Respiratory Support and Mechanisms
- Intensive Care Unit Cognitive Disorders
- Cardiac Arrest and Resuscitation
- Sepsis Diagnosis and Treatment
- Cardiac, Anesthesia and Surgical Outcomes
- Hemodynamic Monitoring and Therapy
- Airway Management and Intubation Techniques
- Chronic Obstructive Pulmonary Disease (COPD) Research
- COVID-19 Clinical Research Studies
- Neonatal Respiratory Health Research
- Long-Term Effects of COVID-19
- Ultrasound in Clinical Applications
- Family and Patient Care in Intensive Care Units
- Electrical and Bioimpedance Tomography
- Abdominal Surgery and Complications
- Hip and Femur Fractures
- Anesthesia and Sedative Agents
- Nosocomial Infections in ICU
- Mechanical Circulatory Support Devices
- Blood transfusion and management
- Non-Invasive Vital Sign Monitoring
- Renal function and acid-base balance
- Thermal Regulation in Medicine
- Antibiotic Use and Resistance
- Venous Thromboembolism Diagnosis and Management
University of Ferrara
2016-2025
Arcispedale Sant'Anna
2015-2024
Iuliu Hațieganu University of Medicine and Pharmacy
2024
University Hospital Heidelberg
2024
Jagiellonian University
2024
Emergency University
2024
Heinrich Heine University Düsseldorf
2024
Düsseldorf University Hospital
2024
Heidelberg University
2024
Ospedale Sant'Anna
2017-2023
Prolonged controlled mechanical ventilation depresses diaphragmatic efficiency. Assisted modes of should improve it. We assessed the impact pressure support versus neurally adjusted ventilator assist on efficiency.Patients previously ventilated with for 72 hours or more were randomized to be 48 (n =12) ventilatory = 13). Neuro-ventilatory efficiency (tidal volume/diaphragmatic electrical activity) and neuro-mechanical (pressure generated against occluded airways/diaphragmatic measured during...
<h3>Importance</h3> High-flow nasal oxygen is recommended as initial treatment for acute hypoxemic respiratory failure and widely applied in patients with COVID-19. <h3>Objective</h3> To assess whether helmet noninvasive ventilation can increase the days free of support COVID-19 compared high-flow alone. <h3>Design, Setting, Participants</h3> Multicenter randomized clinical trial 4 intensive care units (ICUs) Italy between October December 2020, end follow-up February 11, 2021, including 109...
Mechanical ventilation can cause acute diaphragm atrophy and injury, this is associated with poor clinical outcomes. Although the importance impact of lung-protective widely appreciated well established, concept diaphragm-protective has recently emerged as a potential complementary therapeutic strategy. This Perspective, developed from discussions at meeting international experts convened by PLUG (the Pleural Pressure Working Group) European Society Intensive Care Medicine, outlines...
BackgroundCoronavirus disease 2019 (COVID-19) is associated with a high burden 10% of confirmed cases progressing towards critical illness. Nevertheless, the course and predictors mortality in critically ill patients are poorly understood.MethodsFollowing developments ICUs regions experiencing early inception pandemic, European-based, international RIsk Stratification COVID-19 Intensive Care Unit (RISC-19-ICU) registry was created to provide near real-time assessment developing illness due...
Abstract Background Biomarkers can be used to detect the presence of endothelial and/or alveolar epithelial injuries in case ARDS. Angiopoietin-2 (Ang-2), soluble intercellular adhesion molecule-1 (ICAM-1), vascular cell protein-1 (VCAM-1), P-selectin and E-selectin are biomarkers injury, whereas receptor for advanced glycation end-products (RAGE) reflects injury. The aims this study were evaluate whether plasma concentration above-mentioned was different 1) survivors non-survivors...
Defining lung recruitability is needed for safe positive end-expiratory pressure (PEEP) selection in mechanically ventilated patients. However, there no simple bedside method including both assessment of and risks overdistension as well personalized PEEP titration.
Objectives: To calculate an index (termed Pmusc/Eadi index) relating the pressure generated by respiratory muscles (Pmusc) to electrical activity of diaphragm (Eadi), during assisted mechanical ventilation and assess if is affected type level ventilator assistance. The was also used measure patient's inspiratory effort from Eadi without esophageal pressure. Design: Crossover study. Setting: One general ICU. Patients: Ten patients undergoing ventilation. Intervention: Pressure support...
The rapid shallow breathing index (RSBI), which is the ratio between respiratory rate (RR) and tidal volume (VT), one of most widely used indices to predict weaning outcome. Whereas diaphragm plays a fundamental role in generating VT, case diaphragmatic dysfunction inspiratory accessory muscles may contribute. If this occurs during trial, delayed failure likely since are more fatigable than diaphragm. Hence, we hypothesised that traditional RSBI could be implemented by substituting VT with...
The authors tested the hypothesis that during laparoscopic surgery, Trendelenburg position and pneumoperitoneum may worsen chest wall elastance, concomitantly decreasing transpulmonary pressure, a protective ventilator strategy applied after induction, by increasing would result in alveolar recruitment improvement respiratory mechanics gas exchange.In 29 consecutive patients, recruiting maneuver followed positive end-expiratory pressure 5 cm H(2)O maintained until end of surgery was...
The amount of extracorporeal carbon dioxide removal may influence respiratory drive in acute distress syndrome (ARDS) patients undergoing membrane oxygenation (ECMO). authors evaluated the effects different levels recovering from severe ARDS pressure support ventilation (PSV) and neurally adjusted ventilatory assist (NAVA).The conducted a prospective, randomized, crossover study on eight spontaneously breathing venovenous ECMO since 28 ± 20 days. To modulate extraction, gas flow (GF) was...
Assessing alveolar recruitment at different positive end-expiratory pressure (PEEP) levels is a major clinical and research interest because protective ventilation implies opening the lung without inducing overdistention. The pressure-volume (P-V) curve validated method of assessing but reflects global characteristics, changes regional level may remain undetected. aim present study was to compare, in intubated patients with acute hypoxemic respiratory failure (AHRF) distress syndrome (ARDS),...
The physiological effects of high-flow nasal cannula O2 therapy (HFNC) have been evaluated mainly in patients with hypoxemic respiratory failure. In this study, we compared the HFNC and conventional low-flow on neuroventilatory drive work breathing postextubation a background chronic obstructive pulmonary disease (COPD) who had received mechanical ventilation for hypercapnic This was single center, unblinded, cross-over study 14 COPD were recovering from an episode acute failure various...
A large proportion of patients with coronavirus disease 2019 (COVID-19) develop severe respiratory failure requiring admission to the intensive care unit (ICU) and about 80% them need mechanical ventilation (MV). These show great complexity due multiple organ involvement a dynamic evolution over time; moreover, few information is available risk factors that may contribute increase time course ventilation.The primary objective this study investigate associated inability liberate COVID-19 from...
Here, we recorded serum proteome profiles of 33 severe COVID-19 patients admitted to respiratory and intensive care units because failure. We received, for most patients, blood samples just after admission at two more later time points. With the aim predict treatment outcome, focused on proteins different in abundance between group survivors non-survivors. observed that a small panel about dozen were significantly these groups. The four structurally functionally related type-3 cystatins...
Background: Deficient interferon responses have been proposed as one of the relevant mechanisms prompting severe manifestations COVID-19. Objective: To evaluate (IFN)-α levels in a cohort COVID-19 patients relation to severity, evolution clinical and immune/inflammatory profile. Methods: This is prospective study recruiting consecutive hospitalized with respiratory failure associated SARS-COV-2 infection matched controls. After enrollment, were assessed every 7 ± 2 days for additional...
Abstract Background Prone positioning (PP) has been used to improve oxygenation in patients affected by the SARS-CoV-2 disease (COVID-19). Several mechanisms, including lung recruitment and better ventilation/perfusion matching, make a relevant rational for using PP. However, not all maintain improvement after returning supine position. Nevertheless, no evidence exists that sustained response PP is associated outcome mechanically ventilated COVID-19 patients. We analyzed data from 191...
Advanced respiratory monitoring involves several mini- or noninvasive tools, applicable at bedside, focused on assessing lung aeration and morphology, recruitment overdistention, ventilation–perfusion distribution, inspiratory effort, drive, muscle contraction, patient–ventilator asynchrony, in dealing with acute failure. Compared to a conventional approach, advanced has the potential provide more insights into pathologic modifications of induced by underlying disease, follow response...