Showing papers by "Massimo Antonelli published in 2002"
TL;DR: The use of NPPV in patients with chronic obstructive pulmonary disease and acute respiratory failure requiring ventilatory support after failure of medical treatment avoided ETI in 48% of the patients, had the same ICU mortality as conventional treatment and, at 1-year follow-up was associated with fewer patients readmitted to the hospital or requiring for long-term oxygen supplementation.
Abstract:
Objective. We conducted a randomized prospective study comparing noninvasive positive pressure ventilation (NPPV) with conventional mechanical ventilation via endotracheal intubation (ETI) in a group of patients with chronic obstructive pulmonary disease who failed standard medical treatment in the emergency ward after initial improvement and met predetermined criteria for ventilatory support.
Design and setting. Prospective randomized study in a university hospital 13-bed general ICU.
Patients. Forty-nine patients were randomly assigned to receive NPPV (n=23) or conventional ventilation (n=26).
Results. both NPPV and conventional ventilation significantly improved gas exchanges. The two groups had similar length of ICU stay, number of days on mechanical ventilation, overall complications, ICU mortality, and hospital mortality. In the NPPV group 11 (48%) patients avoided intubation, survived, and had a shorter duration of ICU stay than intubated patients. One year following hospital discharge the NPPV group had fewer patients readmitted to the hospital (65% vs. 100%) or requiring de novo permanent oxygen supplementation (0% vs. 36%).
Conclusions. The use of NPPV in patients with chronic obstructive pulmonary disease and acute respiratory failure requiring ventilatory support after failure of medical treatment avoided ETI in 48% of the patients, had the same ICU mortality as conventional treatment and, at 1-year follow-up was associated with fewer patients readmitted to the hospital or requiring for long-term oxygen supplementation. An editorial regarding this article can be found in the same issue (http://dx.doi.org/10.1007/s00134-002-1503-3).
338 citations
TL;DR: NPSV by helmet successfully treated hypoxemic ARF, with better tolerance and fewer complications than facial mask NPSV.
Abstract: Objective To assess the efficacy of noninvasive pressure support ventilation (NPSV) using a new special helmet as first-line intervention to treat patients with hypoxemic acute respiratory failure (ARF), in comparison to NPSV using standard facial mask. Design and setting Prospective clinical pilot investigation with matched control group in three intensive care units of university hospitals. Patients and methods Thirty-three consecutive patients without chronic obstructive pulmonary disease and with hypoxemic ARF (defined as severe dyspnea at rest, respiratory rate >30 breaths/min, PaO2:FiO2 Results The 33 patients and the 66 controls had similar characteristics at baseline. Both groups improved oxygenation after NPSV. Eight patients (24%) in the helmet group and 21 patients (32%) in the facial mask group (p = .3) failed NPSV and were intubated. No patients failed NPSV because of intolerance of the technique in the helmet group in comparison with 8 patients (38%) in the mask group (p = .047). Complications related to the technique (skin necrosis, gastric distension, and eye irritation) were fewer in the helmet group compared with the mask group (no patients vs. 14 patients (21%), p = .002). The helmet allowed the continuous application of NPSV for a longer period of time (p = .05). Length of stay in the intensive care unit, intensive care, and hospital mortality were not different. Conclusions NPSV by helmet successfully treated hypoxemic ARF, with better tolerance and fewer complications than facial mask NPSV.
269 citations
01 Aug 2002-Nuclear Instruments & Methods in Physics Research Section A-accelerators Spectrometers Detectors and Associated Equipment
TL;DR: The Drift Chamber for the KLOE experiment at the Frascati φ-factory, DAΦNE, is described in this article, together with a description of the track reconstruction program and of the calibration procedures.
Abstract: The design and construction of the large Drift Chamber for the KLOE experiment at the Frascati φ-factory, DAΦNE, are described. The relevant aspects of the various elements of the detector are reviewed together with a description of the track reconstruction program and of the calibration procedures. The performance of the detector based on measurements with cosmic rays and with e+e− colliding beams during DAΦNE commissioning is presented.
262 citations
21 Nov 2002-Nuclear Instruments & Methods in Physics Research Section A-accelerators Spectrometers Detectors and Associated Equipment
TL;DR: The KLOE calorimeter as mentioned in this paper is a fine lead-scintillating fiber sampling calorometer with an energy resolution of 5.4% and a time resolution of 56 ps/E (GeV).
Abstract: The KLOE calorimeter is a fine lead-scintillating fiber sampling calorimeter. We describe in the following the calibration procedures and the calorimeter performances obtained after 3 years of data taking. We get an energy resolution for electromagnetic showers of 5.4%/ E (GeV) and a time resolution of 56 ps/ E (GeV) . We also present a measurement of efficiency for low-energy photons.
257 citations
TL;DR: It is stressed that ARF is common in the ICU (56% of all patients) and that a number of extrapulmonary factors are related to the risk of development of ARF and to mortality rate in these patients.
198 citations
TL;DR: In patients with severe hypoxemia, NPPV is superior to conventional oxygen supplementation in preventing gas-exchange deterioration during FOB with better hemodynamic tolerance.
156 citations
TL;DR: The PM significantly reduced skin breakdown while improving patient comfort, compared to the CMs, in a randomized study of patients with acute respiratory failure during non-invasive ventilation.
Abstract: Objective: To evaluate patient comfort, skin breakdown and eye irritation when comparing a prototype face mask (PM) and conventional face masks (CMs) during non-invasive ventilation. Setting and design: Eight centers (intensive or intermediate care units). Multicenter randomized study. Populations: Patients with acute respiratory failure of different etiologies. Interventions: Patients were randomized to CMs or PM when ventilation was expected to last at least 12 consecutive hours a day for two consecutive days. Patient comfort, skin breakdown and eye irritation, assessed by means of standardized scoring systems, were measured after 24 and 48 h and before discontinuing ventilation. Results: Hundred ninety-four patients were randomized. Forty-seven patients were finally enrolled: PM (24) and CMs (23). Ventilator settings were similar in the two groups at the beginning of the treatment and after 24 and 48 h. Skin breakdown was significantly higher in the CMs group over the study period (p<0.001). Patient comfort was higher in the PM group after 24 and 48 h (p=0.008 and p<0.001, respectively). Eye irritation was absent in both groups after 24 h and did not differ significantly after 48 h (p=0.539). Before ventilation was discontinued skin breakdown and patient comfort were significantly higher in the CMs group, when compared to the PM group (p<0.001 and p=0.003, respectively). Eye irritation was slightly higher in the PM versus CMs group (p=0.21). The time on ventilation was not significantly different between the two groups (p=0.830). Conclusion: The PM significantly reduced skin breakdown while improving patient comfort, compared to the CMs.
153 citations
TL;DR: The authors measured the branching ratio of φ mesons with the KLOE detector using a sample of ∼5×10 7 φ decays and fit the two-pion mass spectrum to models to disentangle contributions from various sources.
133 citations
TL;DR: In this paper, a search for charginos nearly mass degenerate with the lightest neutralino was performed with the data collected by the ALEPH detector at LEP, at centre-of-mass energies between 189 and 209 GeV, corresponding to an integrated luminosity of 628 pb(-1).
124 citations
TL;DR: In this paper, the branching ratio of the Frascati φ -factory was measured with the KLOE detector using a sample of ∼5×10 7 φ mesons.
104 citations
TL;DR: In this article, a search for selectron, smuon and stau pair production is performed with the data collected by the ALEPH detector at LEP at centre-of-mass energies up to 209 GeV.
TL;DR: The final results of the ALEPH search for the Standard Model Higgs boson at LEP, with data collected in the year 2000 at centre-of-mass energies up to 209 GeV, are presented in this article.
Journal Article•
TL;DR: The closed-suction system can be helpful in limiting environmental, personnel and patient contamination and in preventing the loss of lung volume and the alveolar derecruitment associated with standard suctioning in the severely hypoxemic patients.
Abstract: Airway suctioning is classically performed with the disconnection of the patient from the ventilator and the introduction of the suction catheter into the endotracheal tube. Alternatively, it can be accomplished with a closed suctioning system included in the ventilatory circuit, allowing to introduce the suction catheter into the airways without disconnecting the patient from the ventilator. The closed-suction system has some advantages compared to the conventional, open-suction technique. It can be helpful in limiting environmental, personnel and patient contamination and in preventing the loss of lung volume and the alveolar derecruitment associated with standard suctioning in the severely hypoxemic patients. However, the impact of the closed system on ventilator-associated pneumonia as well as its cost-effectiveness and the influence of such devices with ventilatory support remain to be assessed.
TL;DR: Low doses of remifentanil can be useful in critically-ill patients in order to achieve calm and sedation and can inhibit respiratory drive and require controlled mechanical ventilation.
Abstract: Purpose
To study the analgesic and sedative effects of remifentanil in critically-ill patients.
TL;DR: In this paper, the results of searches for selectrons, charginos and neutralinos performed with the data collected by the ALEPH detector at LEP at centre-of-mass energies up to 209 GeV are interpreted in the framework of the Minimal Supersymmetric extension of the Standard Model with R-parity conservation.
TL;DR: In this article, the radiative decays φ→ηγ, φ →η′γ selecting π+π−γγγ final state in a sample of ∼5×107 φ-mesons produced at the Frascati φfactory DAΦNE were measured.
TL;DR: In this article, an upper bound on the branching ratio of single top production was derived for the ALEPH data at center-of-mass energies between 204 and 209 GeV.
TL;DR: In this paper, a search for the pseudoscalar meson eta_b is performed in two-photon interactions at LEP~2 with an integrated luminosity of 699 pb^-1 collected at e+e-center-of-mass energies from 181 GeV to 209 GeV.
TL;DR: In this paper, the KLOE detector at the DA Φ NE e + e − collider was used to measure the ratio R S π = 2.236±0.003 stat ± 0.015 syst.
TL;DR: The purely leptonic decays Ds -> tau nu and Ds-> mu nu were studied in a sample of four million hadronic Z decays collected with the ALEPH detector at the LEP e+e-collider from 1991 to 1995 as mentioned in this paper.
TL;DR: In this paper, a measurement of the branching ratio BR (K S →π ± e ∓ ν (ν)) performed using the KLOE detector is presented. But this measurement is limited to a sample of ∼5×10 6 K S -tagged events.
TL;DR: In this article, the authors measured the production rates of the orbitally excited Ds** mesons, Ds1 and Ds2*, with the 4.1 million hadronic Z decays recorded by the ALEPH detector during 1991-1995.
TL;DR: In this paper, a search for events with a photon pair arising from the decay of a Higgs boson produced in association with a fermion pair, is performed in 893 pb(-1) of data recorded by the ALEPH detector at LEP at centre-of-mass energies up to 209 GeV.
TL;DR: In this paper, a search for the Higgsstrahlung process e+e−→HZ is carried out, covering decays of a Higgs boson into any quark pair, a gluon pair or a tau pair.
TL;DR: In this paper, the authors measured the production of the η and ω(782) mesons in the π+π−π0 decay mode in hadronic Z decays and compared to model predictions.
TL;DR: In this paper, a measurement of the inclusive semileptonic branching ratios of b hadrons produced in Z decay is presented, using four million hadronic events collected by the ALEPH detector from 1991 to 1995.
Abstract: A measurement of the inclusive semileptonic branching ratios of b hadrons produced in Z decay is presented, using four million hadronic events collected by the ALEPH detector from 1991 to 1995. Electrons and muons are selected opposite to b-tagged hemispheres. Two different methods are explored to distinguish the contributions from direct $\bl$ and cascade $\bcl$ dec ays to the total lepton yield. One is based on the lepton transverse momentum spectrum, the other makes use of the correlation between the charge of the lepton and charge estimators built from tracks in the opposite hemisphere of the event. The latter method reduces the dependence on the modelling of semileptonic b decays. The results obtained by averaging the two techniques are BR(b->l) = 0.1070 +- 0.0010 +- 0.0023 +- 0.0026 BR(b->c->l) = 0.0818 +- 0.0015 +- 0.0022 + 0.0022 -0.0014
TL;DR: Evaluating the effects of alfentanil on respiratory system mechanics in a group of ASA I patients ventilated mechanically during general anesthesia found respiratory system compliance and the different subcomponents of respiratory system resistances were within normal limits and did not vary after alfENTanil administration.
Abstract: Several experimental and clinical studies have demonstrated a direct bronchoconstrictor effect of opioids on smooth bronchial musculature followingiv administration. The aim of this study was to evaluate the effects of alfentanil on respiratory system mechanics in a group of ASA I patients ventilated mechanically during general anesthesia. Twenty consecutive ASA I patients (ten men and ten women) scheduled for general surgery interventions were studied (mean age 45.4 ± 9.9 yr, mean weight 61.9 ± 6.7 kg). Exclusion criteria were a history of chronic obstructive pulmonary disease, asthma or other pulmonary disease, atopy, wheezes, smoking and age below 18 yr. Subjects were randomly divided in two groups: Group A, receiving alfentanil at a 15 μg·kg−1 dose and Group B receiving alfentanil at a 30 μg·kg−1 dose. Respiratory mechanic variables were acquired at baseline (T0) and after three, ten and 15 min (T1, T2 and T3, respectively). We compared the basal values to the values measured at each time interval; basal values, prior to drug administration, served as control for each patient. P values < 0.05 were considered statistically significant. We did not observe significant differences in respiratory mechanic variables after the administration of alfentanil, 15 and 30 μg·kg−1. More specifically, respiratory system compliance and the different subcomponents of respiratory system resistances (i.e., maximum, minimum and delta resistance of respiratory system) were within normal limits and did not vary after alfentanil administration. No respiratory adverse effect was reported after alfentaniliv administration.
TL;DR: In ASA I spontaneously breathing patients, the pre‐operative administration of low doses of alfentanil can initially reduce the respiratory centre activity leading to a reduction in minute volume and Sao2, and it is recommended that careful monitoring of cardio‐respiratory function in ASA I patients, following the administration of al fentanin is recommended.
Abstract: The aim of this study was to assess the short-term effects of the administration of low doses of alfentanil on respiratory drive and respiratory pattern. We studied 17 ASA I patients scheduled for minor surgery or endoscopic procedures. During spontaneous ventilation, Respiratory Rate, Tidal Volume, Total Respiratory Cycle, Inspiratory and Expiratory Time, Mean Inspiratory Flow, P0.1, S(a)O(2) and EtCO(2) were all measured. The inspired oxygen concentration was 21% and measurements were made at baseline, 5 min (T1), 10 min (T2) and 15 min (T3) following an intravenous bolus injection 10 microg.kg(-1) alfentanil. The administration of alfentanil produced a significant (p < 0.05) reduction in S(a)O(2), minute volume and P0.1. In ASA I spontaneously breathing patients, the pre-operative administration of low doses of alfentanil can initially reduce the respiratory centre activity leading to a reduction in minute volume and S(a)O(2). We therefore recommend careful monitoring of cardio-respiratory function in ASA I patients, following the administration of alfentanil.
TL;DR: The findings suggest that acid-base abnormalities, particularly metabolic acidosis, markedly affect blood capacity of transporting CO2 and may worsen tissue hypercarbia associated with hypoperfusion.
Abstract: Objective.To investigate the effects of some acid-base abnormalities on blood capacity of transporting CO2.