Critical emergency medicine unit: a new model to mitigate critically ill patient boarding in emergency department.

Background: Boarding of critically ill patients in the emergency department (ED) is an emerging problem that increases mortality. We have developed a "CREM Unit (critical emergency medicine unit)" led by an anesthetist-intensivist who manages critical patients directly in the ED. This study aims to assess whether the CREM Unit is an effective model for mitigating the boarding of critical patients in the ED and the impact of this on mortality.

A narrative review of glucagon-like peptide-1 receptor agonists prior to deep sedation or general anesthesia.

Glucagon-like peptide-1 receptor agonists are a class of drugs that mimic a natural incretin hormone released by the intestine after meals, and they are well-suited for treating type 2 diabetes. Glucagon-like peptide-1 receptor agonists also lead to satiety and appetite reduction through action on the brain's appetite regulation centers, leading to weight loss in obese patients. However, because glucagon-like peptide-1 receptor agonists work to slow gastric emptying, a safety concern has been raised in patients undergoing deep sedation or general anesthesia regarding gastric aspiration, and considering their long half-life in the blood, they are difficult to manage in the perioperative period.

Lung ultrasound and supine chest X-ray use in modern adult intensive care: mapping 30 years of advancement (1993-2023).

In critically ill patients with acute respiratory failure, thoracic images are essential for evaluating the nature, extent and progression of the disease, and for clinical management decisions. For this purpose, computed tomography (CT) is the gold standard. However, transporting patients to the radiology suite and exposure to ionized radiation limit its use.

Artificial intelligence and telemedicine in the field of anaesthesiology, intensive care and pain medicine: A European survey.

Background: The potential role of artificial intelligence in enhancing human life and medical practice is under investigation but the knowledge of the topic among healthcare providers is under-investigated.

Objectives: To investigate knowledge of artificial intelligence in physicians working in the field of anaesthesiology, intensive care, and pain medicine. As secondary outcomes, we investigated the main concerns on the implementation of artificial intelligence.

Diaphragm ultrasound evaluation during weaning from mechanical ventilation in COVID-19 patients: a pragmatic, cross-section, multicenter study.

Background: Diaphragmatic dysfunction is a major factor responsible for weaning failure in patients that underwent prolonged invasive mechanical ventilation for acute severe respiratory failure from COVID-19. This study hypothesizes that ultrasound measured diaphragmatic thickening fraction (DTF) could provide corroborating information for weaning COVID-19 patients from mechanical ventilation.

Methods: This was an observational, pragmatic, cross-section, multicenter study in 6 Italian intensive care units.

Lung Ultrasound Signs and Their Correlation With Clinical Symptoms in COVID-19 Pregnant Women: The "PINK-CO" Observational Study.

Objective: To analyze the application of lung ultrasound (LUS) diagnostic approach in obstetric patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and compare LUS score and symptoms of the patients.

Design: A single-center observational retrospective study from October 31, 2020 to March 31, 2021.

Setting: Department of Ob/Gyn at the University-Hospital of Udine, Italy.

Italian Society of Anesthesia, Analgesia, Resuscitation, and Intensive Care expert consensus statement on the use of lung ultrasound in critically ill patients with coronavirus disease 2019 (ITACO).

Background: To produce statements based on the available evidence and an expert consensus (as members of the Lung Ultrasound Working Group of the Italian Society of Analgesia, Anesthesia, Resuscitation, and Intensive Care, SIAARTI) on the use of lung ultrasound for the management of patients with COVID-19 admitted to the intensive care unit.

Methods: A modified Delphi method was applied by a panel of anesthesiologists and intensive care physicians expert in the use of lung ultrasound in COVID-19 intensive critically ill patients to reach a consensus on ten clinical questions concerning the role of lung ultrasound in the following: COVID-19 diagnosis and monitoring (with and without invasive mechanical ventilation), positive end expiratory pressure titration, the use of prone position, the early diagnosis of pneumothorax- or ventilator-associated pneumonia, the process of weaning from invasive mechanical ventilation, and the need for radiologic chest imaging.

Results: A total of 20 statements were produced by the panel.

Level of Diffusion and Training of Lung Ultrasound during the COVID-19 Pandemic - A National Online Italian Survey (ITALUS) from the Lung Ultrasound Working Group of the Italian Society of Anesthesia, Analgesia, Resuscitation, and Intensive Care (SIAARTI).

Purpose:  The goal of this survey was to describe the use and diffusion of lung ultrasound (LUS), the level of training received before and during the COVID-19 pandemic, and the clinical impact LUS has had on COVID-19 cases in intensive care units (ICU) from February 2020 to May 2020.

Materials And Methods:  The Italian Lung Ultrasound Survey (ITALUS) was a nationwide online survey proposed to Italian anesthesiologists and intensive care physicians carried out after the first wave of the COVID-19 pandemic. It consisted of 27 questions, both quantitative and qualitative.

Lung ultrasound for the early diagnosis of COVID-19 pneumonia: an international multicenter study.

Purpose: To analyze the application of a lung ultrasound (LUS)-based diagnostic approach to patients suspected of COVID-19, combining the LUS likelihood of COVID-19 pneumonia with patient's symptoms and clinical history.

Methods: This is an international multicenter observational study in 20 US and European hospitals. Patients suspected of COVID-19 were tested with reverse transcription-polymerase chain reaction (RT-PCR) swab test and had an LUS examination.

The COVID-19 Worsening Score (COWS)-a predictive bedside tool for critical illness.

Objectives: To evaluate the accuracy of a new COVID-19 prognostic score based on lung ultrasound (LUS) and previously validated variables in predicting critical illness.

Methods: We conducted a single-center retrospective cohort development and internal validation study of the COVID-19 Worsening Score (COWS), based on a combination of the previously validated COVID-GRAM score (GRAM) variables and LUS. Adult COVID-19 patients admitted to the emergency department (ED) were enrolled.

Diaphragmatic thickening fraction as a potential predictor of response to continuous positive airway pressure ventilation in Covid-19 pneumonia: A single-center pilot study.

Background: In a variable number of Covid-19 patients with acute respiratory failure, non-invasive breathing support strategies cannot provide adequate oxygenation, thus making invasive mechanical ventilation necessary. Factors predicting this unfavorable outcome are unknown, but we hypothesized that diaphragmatic weakness may contribute.

Methods: We prospectively analyzed the data of 27 consecutive patients admitted to the general Intensive Care Unit (ICU) from March 19, 2020, to April 20, 2020 and submitted to continuous positive airway pressure (CPAP) before considering invasive ventilation.

Our Italian experience using lung ultrasound for identification, grading and serial follow-up of severity of lung involvement for management of patients with COVID-19.

Lung ultrasound (LU) has rapidly become a tool for assessment of patients stricken by the novel coronavirus 2019 (COVID-19). Over the past two and a half months (January, February, and first half of March 2020) we have used this modality for identification of lung involvement along with pulmonary severity in patients with suspected or documented COVID-19 infection. Use of LU has helped us in clinical decision making and reduced the use of both chest x-rays and computed tomography (CT).

"Sigmoid diverticulitis mimicking cholecystitis" a clinical challenge.

Diverticular disease is a common disorder and its incidence increases with ageing. Pathophysiology is multifactorial. Lifestyle, including smoking, alcohol intake, decreased dietary fibres and lack of physical activity, plays a predominant role.

An easier and safe affair, pleural drainage with ultrasound in critical patient: a technical note.

Thoracic ultrasound is a powerful diagnostic imaging technique for pleural space disorders. In addition to visualising pleural effusion, thoracic ultrasound also helps clinicians to identify the best puncture site and to guide the drainage insertion procedure. Thoracic ultrasound is essential during these invasive manoeuvres to increase safety and decrease potential life-threatening complications.

The Sierra Leone Ultrasound Rainbow4Africa Project (SLURP): an observational study of ultrasound effectiveness in developing countries.

Background: Diagnostic tools available in low-income countries are often really basic even if patients can be as sick as those of the richer countries. Point-of-care ultrasound could be a solution for this problem. We studied the impact of ultrasound at the Holy Spirit Hospital, Makeni, Sierra Leone.

Lung Ultrasound-Implemented Diagnosis of Acute Decompensated Heart Failure in the ED: A SIMEU Multicenter Study.

Background: Lung ultrasonography (LUS) has emerged as a noninvasive tool for the differential diagnosis of pulmonary diseases. However, its use for the diagnosis of acute decompensated heart failure (ADHF) still raises some concerns. We tested the hypothesis that an integrated approach implementing LUS with clinical assessment would have higher diagnostic accuracy than a standard workup in differentiating ADHF from noncardiogenic dyspnea in the ED.

Semi-quantification of pneumothorax volume by lung ultrasound.

Background: Lung ultrasound (LUS) may accurately diagnose pneumothorax. However, there is uncertainty about its usefulness in the quantification of pneumothorax size. To determine the ability of LUS in the semi-quantification of pneumothorax volume, we compared the projection of the lung point (LP) with the pneumothorax volume measured by computerized tomography (CT) and the interpleural distance on chest radiography (CXR).