Serena Cirio - Academia.edu (original) (raw)
Papers by Serena Cirio
Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, Jan 8, 2015
Ventilation with continuous positive airway pressure (CPAP) is the gold standard therapy for obst... more Ventilation with continuous positive airway pressure (CPAP) is the gold standard therapy for obstructive sleep apnea (OSA). However, it was recently suggested that a novel mode of ventilation, Bilevel-auto, could be equally effective in treating patients unable to tolerate CPAP. The aim of this study was to investigate the ability of Bilevel-auto to treat OSA patients whose nocturnal ventilatory disturbances are not completely corrected by CPAP. We enrolled 66 consecutive OSA patients, not responsive to (group A) or intolerant of (group B) CPAP treatment, after a full night of manual CPAP titration in a laboratory. Full polysomnography data and daytime sleepiness score were compared for each group in the three different conditions: basal, during CPAP, and during Bilevel-auto. The apnea-hypopnea index decreased significantly during CPAP in both groups; however, in the group A, there was a further significant improvement during Bilevel-auto. The same trend was observed for oxygenation...
Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo
The general aim of an ICU respiratory rehabilitation programme is to improve the patient's me... more The general aim of an ICU respiratory rehabilitation programme is to improve the patient's measured quality of life. It can be done by applying advanced therapeutic modalities in order to improve the remaining functions and to decrease the patient's dependency as well as the risks associated with an ICU admission. A number of physiological changes involve all the body systems as a consequence of a bed-rest period and play an important role in the weaning failure of ventilated patients. Inactivity muscle mass declines from the first week of ICU admission, as well as the muscle's ability to perform aerobic exercise. The respiratory muscles strength and endurance decreases, also the ventilatory pump and the cardiovascular response to exercise may be alterated. Disorientation, and disfunction of the Central Nervous System may occur. The aim of this review is to analyse the usefulness of skeletal and respiratory muscle training in improving strength, endurance and decreasing ...
Respiratory Care, 2011
BACKGROUND: The O 2 Flow Regulator (Dima, Bologna, Italy) is a new automated oxygen regulator tha... more BACKGROUND: The O 2 Flow Regulator (Dima, Bologna, Italy) is a new automated oxygen regulator that titrates the oxygen flow based on a pulse-oximetry signal to maintain a target S pO 2 . We tested the device's safety and efficacy. METHODS: We enrolled 18 subjects with chronic lung disease, exercise-induced desaturation, and on long-term oxygen therapy, in a randomized crossover study with 2 constant-work-load 15-min cycling exercise tests, starting with the patient's previously prescribed usual oxygen flow. In one test the oxygen flow was titrated manually by the respiratory therapist, and in the other test the oxygen flow was titrated by the O 2 Flow Regulator, to maintain an S pO 2 of 94%. We measured S pO 2 throughout each test, the time spent by the respiratory therapist to set the device or to manually regulate the oxygen flow, and the total number of respiratory-therapist titration interventions during the trial. RESULTS: There were no differences in symptoms or heart rate between the exercise tests. Compared to the respiratory-therapistcontrolled tests, during the O 2 Flow Regulator tests S pO 2 was significantly higher (95 ؎ 2% vs 93 ؎ 3%, P ؍ .04), significantly less time was spent below the target S pO 2 (171 ؎ 187 s vs 340 ؎ 220 s, P < .001), and the O 2 Flow Regulator tests required significantly less respiratory therapist time (5.6 ؎ 3.7 min vs 2.0 ؎ 0.1 min, P ؍ .005). CONCLUSIONS: The O 2 Flow Regulator may be a safe and effective alternative to manual oxygen titration during exercise in hypoxic patients. It provided stable S pO 2 and avoided desaturations in our subjects.
Respiratory medicine, 2006
Intrapulmonary percussive ventilation (IPV) is a ventilatory technique that delivers bursts of hi... more Intrapulmonary percussive ventilation (IPV) is a ventilatory technique that delivers bursts of high-flow respiratory gas into the lung at high rates, intended for treating acute respiratory failure and for mobilization of secretions. We performed a study, aimed at assessing the physiological response to IPV, on patients' breathing pattern, inspiratory effort, lung mechanics and tolerance to ventilation. Ten COPD patients underwent randomized trials of IPV through a face mask at different pressure/frequency combinations (1.2 bar/250 cycles/min; 1.8/250; 1.2/350; 1.8/350), separated by return to baseline (SB), using the IMP2 ventilator. In 5 patients we have also compared the physiological changes of IPV with those obtained during pressure support ventilation (PSV). Minute ventilation did not vary among the trials, but tidal volumes (VT) were significantly greater during 1.2/250, 1.2/350 and 1.8/350 compared to SB. The pressure time product of the diaphragm per minute (PTPdi/min)...
European Respiratory Journal, 2008
There is no consensus concerning the best system of humidification during long-term noninvasive m... more There is no consensus concerning the best system of humidification during long-term noninvasive mechanical ventilation (NIMV). In a technical pilot randomised crossover 12-month study, 16 patients with stable chronic hypercapnic respiratory failure received either heated humidification or heat and moisture exchanger. Compliance with long-term NIMV, airway symptoms, side-effects and number of severe acute pulmonary exacerbations requiring hospitalisation were recorded. Two patients died. Intention-to-treat statistical analysis was performed on 14 patients. No significant differences were observed in compliance with long-term NIMV, but 10 out of 14 patients decided to continue long-term NIMV with heated humidification at the end of the trial. The incidence of side-effects, except for dry throat (significantly more often present using heat and moisture exchanger), hospitalisations and pneumonia were not significantly different. In the present pilot study, the use heated humidification and heat and moisture exchanger showed similar tolerance and side-effects, but a higher number of patients decided to continue long-term noninvasive mechanical ventilation with heated humidification. Further larger studies are required in order to confirm these findings.
Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, Jan 8, 2015
Ventilation with continuous positive airway pressure (CPAP) is the gold standard therapy for obst... more Ventilation with continuous positive airway pressure (CPAP) is the gold standard therapy for obstructive sleep apnea (OSA). However, it was recently suggested that a novel mode of ventilation, Bilevel-auto, could be equally effective in treating patients unable to tolerate CPAP. The aim of this study was to investigate the ability of Bilevel-auto to treat OSA patients whose nocturnal ventilatory disturbances are not completely corrected by CPAP. We enrolled 66 consecutive OSA patients, not responsive to (group A) or intolerant of (group B) CPAP treatment, after a full night of manual CPAP titration in a laboratory. Full polysomnography data and daytime sleepiness score were compared for each group in the three different conditions: basal, during CPAP, and during Bilevel-auto. The apnea-hypopnea index decreased significantly during CPAP in both groups; however, in the group A, there was a further significant improvement during Bilevel-auto. The same trend was observed for oxygenation...
Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo
The general aim of an ICU respiratory rehabilitation programme is to improve the patient's me... more The general aim of an ICU respiratory rehabilitation programme is to improve the patient's measured quality of life. It can be done by applying advanced therapeutic modalities in order to improve the remaining functions and to decrease the patient's dependency as well as the risks associated with an ICU admission. A number of physiological changes involve all the body systems as a consequence of a bed-rest period and play an important role in the weaning failure of ventilated patients. Inactivity muscle mass declines from the first week of ICU admission, as well as the muscle's ability to perform aerobic exercise. The respiratory muscles strength and endurance decreases, also the ventilatory pump and the cardiovascular response to exercise may be alterated. Disorientation, and disfunction of the Central Nervous System may occur. The aim of this review is to analyse the usefulness of skeletal and respiratory muscle training in improving strength, endurance and decreasing ...
Respiratory Care, 2011
BACKGROUND: The O 2 Flow Regulator (Dima, Bologna, Italy) is a new automated oxygen regulator tha... more BACKGROUND: The O 2 Flow Regulator (Dima, Bologna, Italy) is a new automated oxygen regulator that titrates the oxygen flow based on a pulse-oximetry signal to maintain a target S pO 2 . We tested the device's safety and efficacy. METHODS: We enrolled 18 subjects with chronic lung disease, exercise-induced desaturation, and on long-term oxygen therapy, in a randomized crossover study with 2 constant-work-load 15-min cycling exercise tests, starting with the patient's previously prescribed usual oxygen flow. In one test the oxygen flow was titrated manually by the respiratory therapist, and in the other test the oxygen flow was titrated by the O 2 Flow Regulator, to maintain an S pO 2 of 94%. We measured S pO 2 throughout each test, the time spent by the respiratory therapist to set the device or to manually regulate the oxygen flow, and the total number of respiratory-therapist titration interventions during the trial. RESULTS: There were no differences in symptoms or heart rate between the exercise tests. Compared to the respiratory-therapistcontrolled tests, during the O 2 Flow Regulator tests S pO 2 was significantly higher (95 ؎ 2% vs 93 ؎ 3%, P ؍ .04), significantly less time was spent below the target S pO 2 (171 ؎ 187 s vs 340 ؎ 220 s, P < .001), and the O 2 Flow Regulator tests required significantly less respiratory therapist time (5.6 ؎ 3.7 min vs 2.0 ؎ 0.1 min, P ؍ .005). CONCLUSIONS: The O 2 Flow Regulator may be a safe and effective alternative to manual oxygen titration during exercise in hypoxic patients. It provided stable S pO 2 and avoided desaturations in our subjects.
Respiratory medicine, 2006
Intrapulmonary percussive ventilation (IPV) is a ventilatory technique that delivers bursts of hi... more Intrapulmonary percussive ventilation (IPV) is a ventilatory technique that delivers bursts of high-flow respiratory gas into the lung at high rates, intended for treating acute respiratory failure and for mobilization of secretions. We performed a study, aimed at assessing the physiological response to IPV, on patients' breathing pattern, inspiratory effort, lung mechanics and tolerance to ventilation. Ten COPD patients underwent randomized trials of IPV through a face mask at different pressure/frequency combinations (1.2 bar/250 cycles/min; 1.8/250; 1.2/350; 1.8/350), separated by return to baseline (SB), using the IMP2 ventilator. In 5 patients we have also compared the physiological changes of IPV with those obtained during pressure support ventilation (PSV). Minute ventilation did not vary among the trials, but tidal volumes (VT) were significantly greater during 1.2/250, 1.2/350 and 1.8/350 compared to SB. The pressure time product of the diaphragm per minute (PTPdi/min)...
European Respiratory Journal, 2008
There is no consensus concerning the best system of humidification during long-term noninvasive m... more There is no consensus concerning the best system of humidification during long-term noninvasive mechanical ventilation (NIMV). In a technical pilot randomised crossover 12-month study, 16 patients with stable chronic hypercapnic respiratory failure received either heated humidification or heat and moisture exchanger. Compliance with long-term NIMV, airway symptoms, side-effects and number of severe acute pulmonary exacerbations requiring hospitalisation were recorded. Two patients died. Intention-to-treat statistical analysis was performed on 14 patients. No significant differences were observed in compliance with long-term NIMV, but 10 out of 14 patients decided to continue long-term NIMV with heated humidification at the end of the trial. The incidence of side-effects, except for dry throat (significantly more often present using heat and moisture exchanger), hospitalisations and pneumonia were not significantly different. In the present pilot study, the use heated humidification and heat and moisture exchanger showed similar tolerance and side-effects, but a higher number of patients decided to continue long-term noninvasive mechanical ventilation with heated humidification. Further larger studies are required in order to confirm these findings.