Giovanna Panarello

Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione

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Antonio Arcadipane

Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione

Gennaro Martucci

Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione

Giovanna Occhipinti

Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione

Luca Brazzi

University of Turin

Giacomo Grasselli

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

Mauro Panigada

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

Salvatore Gruttadauria

Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione

Matteo Rossetti

Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione

Fabio Tuzzolino

Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione

Antonio Artigas

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University of Oxford

907

Johns Hopkins Hospital

453

All India Institute of Medical Sciences Rishikesh

437

All India Institute of Medical Sciences Raipur

431

Inserm

376

Prince Charles Hospital

350

Istituti di Ricovero e Cura a Carattere Scientifico

266

Assistance Publique – Hôpitaux de Paris

251

Université Paris Cité

165

Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione

159

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Prone Positioning during Venovenous Extracorporeal Membrane Oxygenation in Acute Respiratory Distress Syndrome. A Multicenter Cohort Study and Propensity-matched Analysis

Annals of the American Thoracic Society (2020)

Marco Giani Gennaro Martucci Fabiana Madotto Mirko Belliato Vito Fanelli

Rationale: Prone positioning reduces mortality in patients with severe acute respiratory distress syndrome (ARDS). To date, no evidence supports the use of prone positioning (PP) during venovenous extracorporeal oxygenation (ECMO).Objectives: The aim of the study was to assess the feasibility, safety, and effect on oxygenation and lung mechanics of PP during ECMO. As a secondary exploratory aim, we assessed the association between PP and hospital mortality.Methods: We performed a multicenter retrospective cohort study in six Italian ECMO centers, including patients managed with PP during ECMO support (prone group; four centers) and patients managed in the supine position (control group; two centers). Physiological variables were analyzed at four time points (supine before PP, start of PP, end of PP, and supine after PP). The association between PP and hospital mortality was assessed by multivariate analysis and propensity score-matching.Results: A total of 240 patients were included, with 107 in the prone group and 133 in the supine group. The median duration of the 326 pronation cycles was 15 (12-18) hours. Minor reversible complications were reported in 6% of PP maneuvers. PP improved oxygenation and reduced intrapulmonary shunt. Unadjusted hospital mortality was lower in the prone group (34 vs. 50%; P = 0.017). After adjusting for covariates, PP remained significantly associated with a reduction of hospital mortality (odds ratio, 0.50; 95% confidence interval, 0.29-0.87). Sixty-six propensity score-matched patients were identified in each group. In this matched sample, patients who underwent pronation had higher ECMO duration (16 vs. 10 d; P = 0.0344) but lower hospital mortality (30% vs. 53%; P = 0.0241).Conclusions: PP during ECMO improved oxygenation and was associated with a reduction of hospital mortality.

Noninvasive Ventilation

10.1513/annalsats.202006-625oc

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Citations (87)

Amiodarone or lidocaine for cardiac arrest: A systematic review and meta-analysis

Resuscitation (2016)

Filippo Sanfilippo Carlos Corredor Cristina Santonocito Giovanna Panarello Antonio Arcadipane

Antiarrhythmic agent

10.1016/j.resuscitation.2016.07.235

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Citations (45)

[Mechanical circulatory support with veno-arterial extracorporeal membrane oxygenation in myocardial infarction-related cardiogenic shock: much ado about nothing?]

PubMed (2023)

Paolo Manca Giovanna Panarello Sergio Sciacca Manlio Cipriani

10.1714/4129.41227

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Intra-Aortic Balloon Counterpulsation in High-Risk Cardiac Patients Undergoing Noncardiac Surgery: A Case Series

Journal of Cardiothoracic and Vascular Anesthesia (2015)

Gaetano Burgio Gennaro Martucci Giovanna Panarello Maria Scarlata Federico Pastore

10.1053/j.jvca.2015.06.010

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Malignant Fibrous Histiocytoma of the Gallbladder: Case Report and Review of the Literature

The American Surgeon (2001)

Salvatore Gruttadauria Cataldo Doria Marta I. Minervini Howard R. Doyle Lucio Mandalà

Malignant fibrous histiocytoma is a soft tissue sarcoma of mesenchymal origin. It can rarely present as a primary gallbladder tumor with only five cases having been reported to date in the English literature. Here we report the sixth documented case of malignant fibrous histiocytoma of the gallbladder, and we review all other cases reported. The outcome of the visceral sarcomas is poor when compared with tumors arising from the soft tissues. The treatment of primary malignant fibrous histiocytomas of the gallbladder is surgery. However, tumor recurrence is the norm even if wide clean margins are obtained. In contrast to tumors arising from the extremities the role of adjuvant radiotherapy and chemotherapy is less clear in the case of retroperitoneal and visceral sarcomas. Our patient is still alive and free of disease 46 weeks after surgery. The fact that this is the longest survival reported to date underscores the dismal prognosis of this disease.

10.1177/000313480106700727

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Citations (14)

Identification of a Circulating miRNA Signature to Stratify Acute Respiratory Distress Syndrome Patients

Journal of Personalized Medicine (2020)

Gennaro Martucci Antonio Arcadipane Fabio Tuzzolino Giovanna Occhipinti Giovanna Panarello

There is a need to improve acute respiratory distress syndrome (ARDS) diagnosis and management, particularly with extracorporeal membrane oxygenation (ECMO), and different biomarkers have been tested to implement a precision-focused approach. We included ARDS patients on veno-venous (V-V) ECMO in a prospective observational pilot study. Blood samples were obtained before cannulation, and screened for the expression of 754 circulating microRNA (miRNAs) using high-throughput qPCR and hierarchical cluster analysis. The miRNet database was used to predict target genes of deregulated miRNAs, and the DIANA tool was used to identify significant enrichment pathways. A hierarchical cluster of 229 miRNAs (identified after quality control screening) produced a clear separation of 11 patients into two groups: considering the baseline SAPS II, SOFA, and RESP score cluster A (n = 6) showed higher severity compared to cluster B (n = 5); p values < 0.05. After analysis of differentially expressed miRNAs between the two clusters, 95 deregulated miRNAs were identified, and reduced to 13 by in silico analysis. These miRNAs target genes implicated in tissue remodeling, immune system, and blood coagulation pathways. The blood levels of 13 miRNAs are altered in severe ARDS. Further investigations will have to match miRNA results with inflammatory biomarkers and clinical data.

10.3390/jpm11010015

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Citations (13)

Continuous Renal Replacement Therapy after Liver Transplantation: Peri-Operative Associated Factors and Impact on Survival

Journal of Clinical Medicine (2022)

Gennaro Martucci Matteo Rossetti Sergio Li Petri Rossella Alduino Riccardo Volpes

Continuous renal replacement therapy (CRRT) following orthotopic liver transplantation (OLT) is usually started for multifactorial reasons, with variable incidence among series. This paper presents a single-center retrospective observational study on the early use (within one week) of CRRT after consecutive cadaveric OLT from January 2008 to December 2016. Preoperative patient characteristics and intraoperative data were collected, and patients were divided into two groups (CRRT and no CRRT) to explore the factors associated with the use of CRRT. Repeated measurements of postoperative creatinine were analyzed with generalized estimating equation (GEE) models. Among 528 OLT patients, 75 (14.2%) were treated with CRRT at least once in the first week. Patients treated with CRRT showed lower survival in a Kaplan−Meier curve (log-rank p value < 0.01). Patients treated with CRRT had a more severe preoperative profile, with a significantly higher age, MELD, BUN, creatinine, and total bilirubin, as well as a longer surgery time and a higher number of transfusions of red blood cells, plasma, and platelets (all p values < 0.05). In a stepwise multiple analysis, the following characteristics remained independently associated with the use of CRRT: the MELD score OR 1.12 (95% CL: 1.07−1.16), p value < 0.001, and the preoperative value for blood urea nitrogen OR 1.016 (95% CL: 1.010−1.023), p value < 0.001. The early use of CRRT after OLT occurred at a low rate in this large cohort; however, it was associated with worse outcomes. Apart from the preoperative severity, repeated intraoperative hypotension episodes, which were likely modifiable or preventable, were associated with the increased use of CRRT and higher postoperative creatinine.

Renal replacement therapy

Blood urea nitrogen

10.3390/jcm11133803

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Citations (4)

An Unexpected Finding Complicating Pericardial Effusion and Tamponade

Journal of Cardiothoracic and Vascular Anesthesia (2014)

Gianluca Santise Sergio Sciacca Cettina Ruperto Giovanni Gentile Giovanna Panarello

Transthoracic echocardiogram

Pericardiocentesis

10.1053/j.jvca.2014.02.009

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Citations (0)

Rounding in the Intensive Care Unit After Lung Transplantation

Organ and tissue transplantation (2024)

Giovanna Panarello Giovanna Occhipinti Matteo Rossetti

Rounding

10.1007/978-3-319-20788-9_36-1

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Liver Transplantation for Hemoperitoneum Secondary to Huge Multiple Hemangiomatosis: A Case Report of a Tele-intensive Care Unit in Deceased-Donor Management

Telemedicine Journal and e-Health (2015)

Salvatore Gruttadauria Duilio Pagano Gaetano Burgio Antonio Arcadipane Giovanna Panarello

Patients with growing and nonresectable liver hemangiomas should be followed up by a transplant center with extensive experience in complex liver disease. They could be treated on an emergency basis with orthotopic liver transplantation, with an expectation of good long-term results.We describe the case of a 37-year-old woman with liver hemangiomatosis followed up for 8 years, who presented with bleeding requiring transfusions and developed hemodynamic instability. We listed her for emergency transplant before her sister's living donor work-up could be completed. A liver from a cadaveric donor became available at a small local hospital with no experience in organ donation. Tele-intensive care unit (tele-ICU) technology was used for providing clinical data electronically to physicians, nurses, and other critical care specialists, creating medication orders, and communicating with on-site caregivers to implement changes in donor care.The recipient was transplanted on an emergency basis with a specific customization and application of the telemedicine system in the management of the organ procurement by the recipient team. Tele-ICU technology was used for providing an effective intensive care unit service, managing and stabilizing the deceased donor and allowing the procurement to be carried out uneventfully.Tele-ICU technology could be a promising resource for emergency transplantation, reducing the urgent need for a living donation and allowing prompt recipient team management of the deceased donor. Our first tele-ICU case offers early confirmation of the feasibility of the telemedicine system in deceased-donor management.

10.1089/tmj.2014.0145

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Citations (3)