Practice of oxygenation and respiratory support during fibreoptic bronchoscopy: the OxyFOB study protocol.

Introduction: Flexible bronchoscopy (FB) is widely used for diagnostic and therapeutic procedures in pulmonary medicine. However, FB can cause respiratory and haemodynamic complications, especially in patients with pre-existing lung and/or cardiovascular comorbidities. Despite the range of oxygenation and ventilatory approaches available to prevent these risks, evidence regarding their real-world application and clinical impact is limited.

Biologic Therapy in Severe Asthma: A Phenotype-Driven and Targeted Approach.

Asthma is a highly heterogeneous respiratory disease that, in its severe forms, is characterized by persistent symptoms, frequent exacerbations, and a significant impact on patients' quality of life. Despite high-dose inhaled corticosteroids and long-acting bronchodilators, a subset of patients remains uncontrolled, necessitating advanced therapeutic strategies. The advent of biologic therapies has revolutionized the management of severe asthma, offering targeted interventions based on the underlying inflammatory endotypes, primarily T2-high and T2-low.

Impact of Cardiopulmonary Bypass Duration on the Renal Effects of Amino Acids Infusion in Cardiac Surgery Patients.

Objective: To test whether the duration of cardiopulmonary bypass (CPB) affects the nephroprotective effect of amino acids (AA) infusion in decreasing the occurrence of acute kidney injury (AKI) among cardiac surgery patients.

Design: A post hoc study of the PROTECTION multicenter randomized double-blind placebo-controlled trial aiming to assess the effect of CPB duration on the differential impact of AA infusion on both the absolute and relative risk reduction in AKI incidence by comparing medians of CPB duration and CPB duration as a continuous variable.

Setting: International, multicenter.

Efficacy of a theoretical-practical course for the ultrasound measurement of the optic nerve diameter in different healthcare operators.

Background: The measurement of the optic nerve sheath diameter (ONSD) via ultrasound is a non-invasive technique to estimate intracranial pressure. Brief training has been shown to be effective in accurately teaching the ONSD technique in specialized healthcare providers. This study evaluates the ability of medical and nursing students, Intensive Care Unit (ICU) nurses, and ICU residents to perform ONSD measurements after a brief training.

A Multinational Randomized Trial of Mega-Dose Esomeprazole as Anti-Inflammatory Agent in Sepsis.

Objectives: Proton pump inhibitors have dose-dependent immunomodulatory effects. We tested the hypothesis that mega-dose esomeprazole therapy would reduce organ dysfunction in patients with sepsis or septic shock.

Design: A multinational, randomized, double-blind, placebo-controlled clinical trial.

Retrospective Analysis of Fungal Isolations in Patients on Veno-Venous Extracorporeal Membrane Oxygenation: The Multicenter RANGER STUDY 2.0.

Veno-venous extracorporeal membrane oxygenation (V-V ECMO) represents a progressively adopted life-sustaining intervention worldwide, particularly in the management of acute respiratory distress syndrome. Nevertheless, data concerning the prognostic significance of fungal isolation in this setting remain unclear. This study aims (i) to assess the incidence of fungal infection and colonization in a homogeneous cohort of V-V ECMO patients, and (ii) to evaluate the association between fungal infection or colonization and 1-year mortality, with a focus on the impact of specific fungal species.

Risk factors for the development of hospital-acquired pneumonia in patients with carbapenem-resistant Acinetobacter baumannii respiratory colonization and the role of multisite colonization: a multicenter retrospective study.

Introduction: Carbapenem-resistant Acinetobacter baumannii (CRAB) infections are associated with high morbidity and mortality rates. Furthermore, the role of CRAB respiratory colonization, including multisite colonization, has not yet been adequately highlighted in critically ill patients.

Materials And Methods: In this retrospective multicenter study, conducted in 4 different Italian hospitals, patients with CRAB respiratory colonization +/- other site who developed or did not develop clinically significant pneumonia from December 2015 to December 2023 were enrolled.

Severe Hemodynamic Instability in a Young Pregnant Woman with Massive Pericardial Effusion and Pulmonary Embolism Secondary to Primary Mediastinal Non-Hodgkin's Lymphoma.

Lymphomas account for approximately 10% of cancers diagnosed during pregnancy, with Hodgkin's lymphoma being the most common. However, non-Hodgkin lymphomas, including primary mediastinal large B-cell lymphoma (PMBCL), also represent a significant proportion. Both mediastinal lymphomas and pregnancy develop a hypercoagulable state, increasing the risk of venous thromboembolism and massive pulmonary embolism (PE), requiring extracorporeal membrane oxygenation (ECMO).

Pirfenidone to prevent fibrosis in acute respiratory distress syndrome: The PIONEER study protocol.

Background: Pulmonary fibrosis is a major complication of the Acute Respiratory Distress Syndrome (ARDS). Pirfenidone is an approved treatment for idiopathic pulmonary fibrosis. It may attenuate ARDS-related fibrosis and decrease the need for prolonged ventilation.

Emerging biological treatments for asthma.

Introduction: Severe asthma is a chronic airway disease characterized by many pathomechanisms known as endotypes. Biological therapies targeting severe asthma endotypes have significantly improved the treatment of this disease, thus remarkably bettering patient quality of life.

Areas Covered: This review aims to describe current biological therapies for severe asthma, highlighting emerging ones.

High-frequency percussive ventilation in acute respiratory failure.

Introduction: High-frequency percussive ventilation (HFPV) is a ventilation mode characterised by high-frequency breaths. This study investigated the impact of HFPV on gas exchange and clinical outcomes in acute respiratory failure (ARF) patients during spontaneous breathing, noninvasive ventilation (NIV) and invasive mechanical ventilation (iMV).

Methods: This systematic review included randomised and nonrandomised studies up to August 2023.

Sudden Death in a Rare Case Due to Tracheo-Innominate Artery Fistula.

Tracheostomy is an essential procedure in cases of respiratory failure in patients requiring long-term ventilation or showing airway obstruction. Tracheostomy has both immediate and long-term complications. Among these, tracheo-innominate fistula is an emergency that is a rare long-term complication.

Inhaled antibiotics for treating pneumonia in invasively ventilated patients in intensive care unit: a meta-analysis of randomized clinical trials with trial sequential analysis.

Background: The use of inhaled antibiotics for treating pneumonia in invasively ventilated patients offers a direct approach, allowing for high local concentrations of the drug in the lower respiratory tract while simultaneously reducing systemic toxicity. However, the real efficacy and safety of nebulized antibiotics remain unclear. The aim of the present is to assess among critically adult patients with pneumonia and invasive ventilation, whether receiving adjuvant inhaled antibiotics improves the rate of microbiological eradication.

The Role of Adrenomedullin as a Predictive Marker of the Risk of Death and Adverse Clinical Events: A Review of the Literature.

Adrenomedullin (ADM) is a vasodilatory peptide that plays a crucial role in maintaining cardiovascular health through its various biological functions. ADM was discovered in the acidic extract of human pheochromocytoma tissue and has been recognized for its significant effects on the vascular system. The main functions of ADM include vasodilation, controlling blood pressure and maintaining vascular integrity, although its role on cardiovascular health is broader.

End-Tidal Carbon Dioxide Measurement in Out-of-Hospital Cardiac Arrest as a Predictor of Return of Spontaneous Circulation: A Literature Review.

Introduction: One of the leading causes of morbidity and mortality worldwide is out-of-hospital cardiac arrest. Early defibrillation and high-quality cardiopulmonary resuscitation (CPR) have improved survival. The main goal of CPR is to achieve return of spontaneous circulation (ROSC), which is assessed by looking for a pulse, analyzing the heart rhythm, and assessing carbon dioxide levels.

A Randomized Trial of Intravenous Amino Acids for Kidney Protection.

Background: Acute kidney injury (AKI) is a serious and common complication of cardiac surgery, for which reduced kidney perfusion is a key contributing factor. Intravenous amino acids increase kidney perfusion and recruit renal functional reserve. However, the efficacy of amino acids in reducing the occurrence of AKI after cardiac surgery is uncertain.

Persistence of SARS-CoV-2 infection and viral intra- and inter-host evolution in COVID-19 hospitalized patients.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) persistence in COVID-19 patients could play a key role in the emergence of variants of concern. The rapid intra-host evolution of SARS-CoV-2 may result in an increased transmissibility, immune and therapeutic escape which could be a direct consequence of COVID-19 epidemic currents. In this context, a longitudinal retrospective study on eight consecutive COVID-19 patients with persistent SARS-CoV-2 infection, from January 2022 to March 2023, was conducted.

Anatomo-physiological basis and applied techniques of electrical neuromodulation in chronic pain.

Chronic pain, a complex and debilitating condition, poses a significant challenge to both patients and healthcare providers worldwide. Conventional pharmacological interventions often prove inadequate in delivering satisfactory relief while carrying the risks of addiction and adverse reactions. In recent years, electric neuromodulation emerged as a promising alternative in chronic pain management.

Assessment of cephalometric parameters and correlation with the severity of the obstructive sleep apnea syndrome.

Background: In individuals diagnosed with obstructive sleep apnea syndrome (OSAS), variations in craniofacial structure have been inconsistently documented, showing differing degrees of alteration between obese and nonobese patients. In addition, sleep disturbance has also been shown to induce disequilibrium in this population of patients. This pilot observational study aimed to assess craniofacial values in obese and nonobese subpopulations of patients with OSAS and their correlation and association with the severity of OSAS.