Daniele Bonacina - Academia.edu (original) (raw)
Papers by Daniele Bonacina
Clinical Case Reports, Mar 25, 2018
This report describes the successful use of a new intervention to improve respiratory mechanics a... more This report describes the successful use of a new intervention to improve respiratory mechanics and gas exchange in a relatively homogeneous group of infants with severe bronchiolitis-induced PARDS after failure of conventional treatment. These results may open a new interesting area of research and management for PARDS patients.
Critical Care, Jun 1, 2012
It is a pleasure to announce the 2nd Innsbruck Hypothermia Symposium. We are very happy that Crit... more It is a pleasure to announce the 2nd Innsbruck Hypothermia Symposium. We are very happy that Critical Care has agreed to publish extended abstracts submitted by invited renowned scientists from all over the world; that is, Europe, the Americas, Asia. Neuroprotection-potentially achieved by targeted temperature management (that is, therapeutic hypothermia or prophylactic controlled normothermia)-is essential in emergency and acute care management of various severe neurologic and cardiologic diseases. Beyond neuroprotection-for this aim, therapeutic hypothermia has been established after resuscitation of patients with cardiac arrest due to a shockable arrhythmia and in neonatal asphyxic encephalopathytherapeutic hypothermia and prophylactic controlled normothermia have been published in single case reports, retrospective, open, but also in prospective randomised controlled trials in many other emergency disciplines in which both neuroprotection and protection of other organs and tissues are the target of our therapeutic endeavours. The Medical University Innsbruck, Austria, is happy to organise this conference on temperature management, therapeutic hypothermia and prophylactic normothermia respectively, to be held in Portoroz, Slovenia. In accordance with the first Meeting on Hypothermia, which was held in Miami, Florida, USA (CHilling At the Beach), we are proud to suggest the acronym CHAB standing for take Care for Heart And Brain, characterising the major target organs of therapeutic and, possibly also, prophylactic temperature management. Again, we have been able to gather most renowned scientists, neurointensivists and intensivists, emergency physicians, cardiologists and other specialists to cover the entire scientific and clinical spectrum of emergency temperature management, technical aspects of cooling and management of potential complications including shivering, but also temperature management in neurology, neurosurgery, intensive care medicine, in the operation theatre, cardiology, infectious diseases, and so forth. Beyond that we cross borders and discuss hypothermia and intracranial pressure, pharmacodynamics in hypothermic patients and the influence of hypothermia onto pharmacokinetics/pharmacodynamics, hypothermia in refractory status epilepticus or heat stroke, hypothermia and advanced neuromonitoring, hypothermia and nutrition, shivering and the critical issue of rewarming, amongst other topics. The aim of this symposium is to enhance the knowledge on temperature management, increase the readiness and stimulate the preparedness to institute therapeutic hypothermia and/or prophylactic controlled normothermia, respectively, in patients in need of tissue and organ A2 Therapeutic hypothermia: the rationale
F1000Research, Mar 28, 2017
<p>Data are separately shown for Study A and B.</p>*<p>-p<0.05, **-p<0.01... more <p>Data are separately shown for Study A and B.</p>*<p>-p<0.05, **-p<0.01, ***, p<0.001 vs. baseline; † - p<0.05, †† - p<0.01, †††, p<0.001 vs. slow breathing.</p><p>Sp<sub>O2</sub>, blood oxygen saturation; p<sub>tO2</sub>– transcutaneous oxygen partial pressure; pt<sub>CO2</sub>– transcutaneous CO<sub>2</sub> partial pressure; Et<sub>CO2</sub>– end tidal CO<sub>2</sub> pressure in the exhaled air; SBP – systolic blood pressure; DBP – diastolic blood pressure; PP – pulse pressure; HR – heart rate; sPAP – systolic pulmonary artery pressure; RF – respiratory frequency; Vt – tidal volume; VE – minute ventilation; VA – alveolar volume; Dl<sub>CO</sub> - pulmonary CO diffusion; TFC – thoracic fluid content.</p
Objectives: To evaluate the effects of two different levels of positive end-expiratory pressure (... more Objectives: To evaluate the effects of two different levels of positive end-expiratory pressure (PEEP) during helmet continuous positive airway pressure (HCPAP) support on the intubation rate in infants with bronchiolitis admitted to pediatric intensive care units (PICUs). Design: Multicentric prospective, randomized, open clinical trial. Setting: Four tertiary PICUs in Italy. Participants: Infants admitted to PICUs due to severe bronchiolitis and requiring respiratory support. Interventions: The enrolled patients were randomly assigned one of two PEEP levels for HCPAP support: high (P10 group: 10 cmH O) or low (P5 group: 5 cmH O). Measurements and Main Results: In total, 64 patients were randomly assigned to the P10 group, and 60 to the P5 group. The intubation rate was 9/60 (15%) and 9/64 (14%) in P5 and P10 groups (OR 0.94, 95% CI 0.36-2.46, p=0.99). Of the patients in the P5 group, 47 (78%) were escalated to a PEEP level of 10 cmH O. PEEP level was not associated to intubation r...
European Respiratory Journal, Sep 1, 2012
Pediatric Pulmonology, Apr 19, 2019
Objectives: We sought to compare gas exchange, respiratory mechanics, and asynchronies during pre... more Objectives: We sought to compare gas exchange, respiratory mechanics, and asynchronies during pressure support ventilation (PSV), sigh adjunct to PSV (PSV SIGH), and neurally adjusted ventilatory assist (NAVA) in hypoxemic infants after cardiac surgery.
BMC Pulmonary Medicine
Background Coronavirus disease 2019-associated acute respiratory distress syndrome (COVID-19 ARDS... more Background Coronavirus disease 2019-associated acute respiratory distress syndrome (COVID-19 ARDS) seems to differ from the “classic ARDS”, showing initial significant hypoxemia in the face of relatively preserved compliance and evolving later in a scenario of poorly compliant lungs. We tested the hypothesis that in patients with COVID-19 ARDS, the initial value of static compliance of respiratory system (Crs) (1) depends on the previous duration of the disease (i.e., the fewer days of illness, the higher the Crs and vice versa) and (2) identifies different lung patterns of time evolution and response to prone positioning. Methods This was a single-center prospective observational study. We enrolled consecutive mechanically ventilated patients with a diagnosis of COVID-19 who met ARDS criteria, admitted to intensive care unit (ICU). Patients were divided in four groups based on quartiles of initial Crs. Relationship between Crs and the previous duration of the disease was evaluated....
Introduction Some evidence indicates that exogenous surfactant therapy may be effective in infant... more Introduction Some evidence indicates that exogenous surfactant therapy may be effective in infants with acute viral bronchiolitis, even though more confirmatory data are needed. To date, no large multicentre trials have evaluated the effectiveness and safety of exogenous surfactant in severe cases of bronchiolitis requiring invasive mechanical ventilation (IMV). Methods and analysis This is a multicentre randomised, placebo-controlled, double-blind study, performed in 19 Italian paediatric intensive care units (PICUs). Eligible participants are infants under the age of 12 months hospitalised in a PICU, suffering from severe acute hypoxaemic bronchiolitis, requiring IMV. We adopted a more restrictive definition of bronchiolitis, including only infants below 12 months of age, to maintain the population as much homogeneous as possible. The primary outcome is to evaluate whether exogenous surfactant therapy (Curosurf, Chiesi Pharmaceuticals, Italy) is effective compared with placebo (ai...
Giornale italiano di cardiologia, 2009
... Maurizio Bussotti1, Piergiuseppe Agostoni1, Daniele Bonacina1, Grzegorz Bilo2,3, Katarzjina S... more ... Maurizio Bussotti1, Piergiuseppe Agostoni1, Daniele Bonacina1, Grzegorz Bilo2,3, Katarzjina Styczkiewicz2,4, Andrea Faini2,3, Gianluca Caldara2,3, Pietro ... perfusione persisteva sino ad un li-vello moderato mentre le limitazioni di diffusione peggio-ravano progressivamente ...
BACKGROUND Despite significant improvements in surgical techniques and medical care, thrombotic c... more BACKGROUND Despite significant improvements in surgical techniques and medical care, thrombotic complications still represent the primary cause of early graft failure and re-transplantation following paediatric liver transplantation. There is still no standardized approach for thrombosis prevention. MATERIALS AND METHODS The study aimed to evaluate the effectiveness of early intravenous unfractionated heparin started 12 hours postoperatively at 10 UI/kg per hour and used a retrospective "before and after" design to compare the incidence of early thrombotic complications prior to (2002-2010) and after (2011-2016) the introduction of heparin in our institute. RESULTS From 2002 to 2016, 479 paediatric patients received liver transplantation in our institution with an overall survival rate over one year of 0.91 (95% CI: 0.87-0.94). Of 365 eligible patients, 244 did not receive heparin while 121 did receive heparin. We reported a lower incidence of venous thrombosis (VT) in the...
Intensive Care Medicine
A 42-day-old infant was admitted to our pediatric intensive care unit (PICU) for respiratory dist... more A 42-day-old infant was admitted to our pediatric intensive care unit (PICU) for respiratory distress. The complete blood count analysis showed an important lymphocytosis (38.48 × 109/L); the peripheral blood smear evaluation revealed small and deeply clefted lymphocytes with mature chromatin morphology suggestive of Bordetella pertussis infection (Fig. 1a–d). Azithromycin was started. Two days later microbiologists confirmed the diagnosis by real-time polymerase chain reaction (PCR). The infant was supported with invasive mechanical ventilation and extracorporeal membrane oxygenation (ECMO) because of the persistence of severe hypoxia and pulmonary hypertension; nevertheless, he developed progressive multiorgan failure and died on the 5th day following admission. Bordetella pertussis is a vaccine-preventable cause of infectious disease, often unrecognized, with a high mortality in infants worldwide, even in areas with high immunization coverage. Severe cases present extreme leukocytosis, refractory hypoxemia, and pulmonary hypertension with a fulminant course: despite ECMO support, mortality remains as high as 70%. Recent findings suggest that pre-ECMO leukodepletion may confer a survival advantage. The recognition of the typical
Pediatric Pulmonology
We sought to compare gas exchange, respiratory mechanics, and asynchronies during pressure suppor... more We sought to compare gas exchange, respiratory mechanics, and asynchronies during pressure support ventilation (PSV), sigh adjunct to PSV (PSV SIGH), and neurally adjusted ventilatory assist (NAVA) in hypoxemic infants after cardiac surgery.
Clinical Case Reports
This report describes the successful use of a new intervention to improve respiratory mechanics a... more This report describes the successful use of a new intervention to improve respiratory mechanics and gas exchange in a relatively homogeneous group of infants with severe bronchiolitis-induced PARDS after failure of conventional treatment. These results may open a new interesting area of research and management for PARDS patients.
Blood transfusion = Trasfusione del sangue, Jan 8, 2017
In a Bergamo hospital deeply strained by the Covid-19 pandemic, exhausted clinicians reflect on h... more In a Bergamo hospital deeply strained by the Covid-19 pandemic, exhausted clinicians reflect on how to prepare for the next outbreak.
Clinical Case Reports, Mar 25, 2018
This report describes the successful use of a new intervention to improve respiratory mechanics a... more This report describes the successful use of a new intervention to improve respiratory mechanics and gas exchange in a relatively homogeneous group of infants with severe bronchiolitis-induced PARDS after failure of conventional treatment. These results may open a new interesting area of research and management for PARDS patients.
Critical Care, Jun 1, 2012
It is a pleasure to announce the 2nd Innsbruck Hypothermia Symposium. We are very happy that Crit... more It is a pleasure to announce the 2nd Innsbruck Hypothermia Symposium. We are very happy that Critical Care has agreed to publish extended abstracts submitted by invited renowned scientists from all over the world; that is, Europe, the Americas, Asia. Neuroprotection-potentially achieved by targeted temperature management (that is, therapeutic hypothermia or prophylactic controlled normothermia)-is essential in emergency and acute care management of various severe neurologic and cardiologic diseases. Beyond neuroprotection-for this aim, therapeutic hypothermia has been established after resuscitation of patients with cardiac arrest due to a shockable arrhythmia and in neonatal asphyxic encephalopathytherapeutic hypothermia and prophylactic controlled normothermia have been published in single case reports, retrospective, open, but also in prospective randomised controlled trials in many other emergency disciplines in which both neuroprotection and protection of other organs and tissues are the target of our therapeutic endeavours. The Medical University Innsbruck, Austria, is happy to organise this conference on temperature management, therapeutic hypothermia and prophylactic normothermia respectively, to be held in Portoroz, Slovenia. In accordance with the first Meeting on Hypothermia, which was held in Miami, Florida, USA (CHilling At the Beach), we are proud to suggest the acronym CHAB standing for take Care for Heart And Brain, characterising the major target organs of therapeutic and, possibly also, prophylactic temperature management. Again, we have been able to gather most renowned scientists, neurointensivists and intensivists, emergency physicians, cardiologists and other specialists to cover the entire scientific and clinical spectrum of emergency temperature management, technical aspects of cooling and management of potential complications including shivering, but also temperature management in neurology, neurosurgery, intensive care medicine, in the operation theatre, cardiology, infectious diseases, and so forth. Beyond that we cross borders and discuss hypothermia and intracranial pressure, pharmacodynamics in hypothermic patients and the influence of hypothermia onto pharmacokinetics/pharmacodynamics, hypothermia in refractory status epilepticus or heat stroke, hypothermia and advanced neuromonitoring, hypothermia and nutrition, shivering and the critical issue of rewarming, amongst other topics. The aim of this symposium is to enhance the knowledge on temperature management, increase the readiness and stimulate the preparedness to institute therapeutic hypothermia and/or prophylactic controlled normothermia, respectively, in patients in need of tissue and organ A2 Therapeutic hypothermia: the rationale
F1000Research, Mar 28, 2017
<p>Data are separately shown for Study A and B.</p>*<p>-p<0.05, **-p<0.01... more <p>Data are separately shown for Study A and B.</p>*<p>-p<0.05, **-p<0.01, ***, p<0.001 vs. baseline; † - p<0.05, †† - p<0.01, †††, p<0.001 vs. slow breathing.</p><p>Sp<sub>O2</sub>, blood oxygen saturation; p<sub>tO2</sub>– transcutaneous oxygen partial pressure; pt<sub>CO2</sub>– transcutaneous CO<sub>2</sub> partial pressure; Et<sub>CO2</sub>– end tidal CO<sub>2</sub> pressure in the exhaled air; SBP – systolic blood pressure; DBP – diastolic blood pressure; PP – pulse pressure; HR – heart rate; sPAP – systolic pulmonary artery pressure; RF – respiratory frequency; Vt – tidal volume; VE – minute ventilation; VA – alveolar volume; Dl<sub>CO</sub> - pulmonary CO diffusion; TFC – thoracic fluid content.</p
Objectives: To evaluate the effects of two different levels of positive end-expiratory pressure (... more Objectives: To evaluate the effects of two different levels of positive end-expiratory pressure (PEEP) during helmet continuous positive airway pressure (HCPAP) support on the intubation rate in infants with bronchiolitis admitted to pediatric intensive care units (PICUs). Design: Multicentric prospective, randomized, open clinical trial. Setting: Four tertiary PICUs in Italy. Participants: Infants admitted to PICUs due to severe bronchiolitis and requiring respiratory support. Interventions: The enrolled patients were randomly assigned one of two PEEP levels for HCPAP support: high (P10 group: 10 cmH O) or low (P5 group: 5 cmH O). Measurements and Main Results: In total, 64 patients were randomly assigned to the P10 group, and 60 to the P5 group. The intubation rate was 9/60 (15%) and 9/64 (14%) in P5 and P10 groups (OR 0.94, 95% CI 0.36-2.46, p=0.99). Of the patients in the P5 group, 47 (78%) were escalated to a PEEP level of 10 cmH O. PEEP level was not associated to intubation r...
European Respiratory Journal, Sep 1, 2012
Pediatric Pulmonology, Apr 19, 2019
Objectives: We sought to compare gas exchange, respiratory mechanics, and asynchronies during pre... more Objectives: We sought to compare gas exchange, respiratory mechanics, and asynchronies during pressure support ventilation (PSV), sigh adjunct to PSV (PSV SIGH), and neurally adjusted ventilatory assist (NAVA) in hypoxemic infants after cardiac surgery.
BMC Pulmonary Medicine
Background Coronavirus disease 2019-associated acute respiratory distress syndrome (COVID-19 ARDS... more Background Coronavirus disease 2019-associated acute respiratory distress syndrome (COVID-19 ARDS) seems to differ from the “classic ARDS”, showing initial significant hypoxemia in the face of relatively preserved compliance and evolving later in a scenario of poorly compliant lungs. We tested the hypothesis that in patients with COVID-19 ARDS, the initial value of static compliance of respiratory system (Crs) (1) depends on the previous duration of the disease (i.e., the fewer days of illness, the higher the Crs and vice versa) and (2) identifies different lung patterns of time evolution and response to prone positioning. Methods This was a single-center prospective observational study. We enrolled consecutive mechanically ventilated patients with a diagnosis of COVID-19 who met ARDS criteria, admitted to intensive care unit (ICU). Patients were divided in four groups based on quartiles of initial Crs. Relationship between Crs and the previous duration of the disease was evaluated....
Introduction Some evidence indicates that exogenous surfactant therapy may be effective in infant... more Introduction Some evidence indicates that exogenous surfactant therapy may be effective in infants with acute viral bronchiolitis, even though more confirmatory data are needed. To date, no large multicentre trials have evaluated the effectiveness and safety of exogenous surfactant in severe cases of bronchiolitis requiring invasive mechanical ventilation (IMV). Methods and analysis This is a multicentre randomised, placebo-controlled, double-blind study, performed in 19 Italian paediatric intensive care units (PICUs). Eligible participants are infants under the age of 12 months hospitalised in a PICU, suffering from severe acute hypoxaemic bronchiolitis, requiring IMV. We adopted a more restrictive definition of bronchiolitis, including only infants below 12 months of age, to maintain the population as much homogeneous as possible. The primary outcome is to evaluate whether exogenous surfactant therapy (Curosurf, Chiesi Pharmaceuticals, Italy) is effective compared with placebo (ai...
Giornale italiano di cardiologia, 2009
... Maurizio Bussotti1, Piergiuseppe Agostoni1, Daniele Bonacina1, Grzegorz Bilo2,3, Katarzjina S... more ... Maurizio Bussotti1, Piergiuseppe Agostoni1, Daniele Bonacina1, Grzegorz Bilo2,3, Katarzjina Styczkiewicz2,4, Andrea Faini2,3, Gianluca Caldara2,3, Pietro ... perfusione persisteva sino ad un li-vello moderato mentre le limitazioni di diffusione peggio-ravano progressivamente ...
BACKGROUND Despite significant improvements in surgical techniques and medical care, thrombotic c... more BACKGROUND Despite significant improvements in surgical techniques and medical care, thrombotic complications still represent the primary cause of early graft failure and re-transplantation following paediatric liver transplantation. There is still no standardized approach for thrombosis prevention. MATERIALS AND METHODS The study aimed to evaluate the effectiveness of early intravenous unfractionated heparin started 12 hours postoperatively at 10 UI/kg per hour and used a retrospective "before and after" design to compare the incidence of early thrombotic complications prior to (2002-2010) and after (2011-2016) the introduction of heparin in our institute. RESULTS From 2002 to 2016, 479 paediatric patients received liver transplantation in our institution with an overall survival rate over one year of 0.91 (95% CI: 0.87-0.94). Of 365 eligible patients, 244 did not receive heparin while 121 did receive heparin. We reported a lower incidence of venous thrombosis (VT) in the...
Intensive Care Medicine
A 42-day-old infant was admitted to our pediatric intensive care unit (PICU) for respiratory dist... more A 42-day-old infant was admitted to our pediatric intensive care unit (PICU) for respiratory distress. The complete blood count analysis showed an important lymphocytosis (38.48 × 109/L); the peripheral blood smear evaluation revealed small and deeply clefted lymphocytes with mature chromatin morphology suggestive of Bordetella pertussis infection (Fig. 1a–d). Azithromycin was started. Two days later microbiologists confirmed the diagnosis by real-time polymerase chain reaction (PCR). The infant was supported with invasive mechanical ventilation and extracorporeal membrane oxygenation (ECMO) because of the persistence of severe hypoxia and pulmonary hypertension; nevertheless, he developed progressive multiorgan failure and died on the 5th day following admission. Bordetella pertussis is a vaccine-preventable cause of infectious disease, often unrecognized, with a high mortality in infants worldwide, even in areas with high immunization coverage. Severe cases present extreme leukocytosis, refractory hypoxemia, and pulmonary hypertension with a fulminant course: despite ECMO support, mortality remains as high as 70%. Recent findings suggest that pre-ECMO leukodepletion may confer a survival advantage. The recognition of the typical
Pediatric Pulmonology
We sought to compare gas exchange, respiratory mechanics, and asynchronies during pressure suppor... more We sought to compare gas exchange, respiratory mechanics, and asynchronies during pressure support ventilation (PSV), sigh adjunct to PSV (PSV SIGH), and neurally adjusted ventilatory assist (NAVA) in hypoxemic infants after cardiac surgery.
Clinical Case Reports
This report describes the successful use of a new intervention to improve respiratory mechanics a... more This report describes the successful use of a new intervention to improve respiratory mechanics and gas exchange in a relatively homogeneous group of infants with severe bronchiolitis-induced PARDS after failure of conventional treatment. These results may open a new interesting area of research and management for PARDS patients.
Blood transfusion = Trasfusione del sangue, Jan 8, 2017
In a Bergamo hospital deeply strained by the Covid-19 pandemic, exhausted clinicians reflect on h... more In a Bergamo hospital deeply strained by the Covid-19 pandemic, exhausted clinicians reflect on how to prepare for the next outbreak.