A Case of Takotsubo Syndrome in a Smoker-Epileptic Patient With Rhinovirus Pneumonia in the Intensive Care Unit: Could the InterTAK Criteria Be Useful?

Takotsubo syndrome (TS) is an acute cardiac dysfunction that typically presents hypokinesis of the apical segment of the left ventricle beyond a single coronary artery territory. The pathological mechanisms of TS remain unclear, and several possible theories have been postulated, including catecholamine excess, coronary artery spasm, microvascular dysfunction, and metabolic disturbances. Based on the etiology, a primary and secondary form is distinguished.

Fasting in critical illness: the role of ketonuria - a retrospective observational study.

Background: Metabolic acidosis is a frequent finding in patients admitted to the intensive care unit (ICU). It can be caused by prolonged fasting due to surgical procedures or by medical conditions that lead to starvation ketoacidosis (SKA). Early recognition and treatment of SKA could prevent several life-threatening complications, improving survival and reducing the ICU length of stay.

Mechanical ventilation and COPD: from pathophysiology to ventilatory management.

In the chronic obstructive pulmonary disease (COPD), lung and chest-wall morphological alterations determine important and peculiar approaches to mechanical ventilation. Lung emphysema and reduced elastic recoil increase expiratory time, thus worsening dynamic hyperinflation, while airways chronic inflammation rises resistances and can determine distal air-trapping. Muscle wasting and fast fibers prevalence can result in weakness and in an earlier onset of muscle fatigue, prolonging the weaning process.

Respiratory Drive in Patients with Sepsis and Septic Shock: Modulation by High-flow Nasal Cannula.

Background: Experimental and pilot clinical data suggest that spontaneously breathing patients with sepsis and septic shock may present increased respiratory drive and effort, even in the absence of pulmonary infection. The study hypothesis was that respiratory drive and effort may be increased in septic patients and correlated with extrapulmonary determinant and that high-flow nasal cannula may modulate drive and effort.

Methods: Twenty-five nonintubated patients with extrapulmonary sepsis or septic shock were enrolled.

Calculation of Transpulmonary Pressure From Regional Ventilation Displayed by Electrical Impedance Tomography in Acute Respiratory Distress Syndrome.

Transpulmonary driving pressure (DP) corresponds to the cyclical stress imposed on the lung parenchyma during tidal breathing and, therefore, can be used to assess the risk of ventilator-induced lung injury (VILI). Its measurement at the bedside requires the use of esophageal pressure (Peso), which is sometimes technically challenging. Recently, it has been demonstrated how in an animal model of ARDS, the transpulmonary pressure (P) measured with Peso calculated with the absolute values method (P = Paw-Peso) is equivalent to the transpulmonary pressure directly measured using pleural sensors in the central-dependent part of the lung.

Management of Intraoperative Mechanical Ventilation to Prevent Postoperative Complications after General Anesthesia: A Narrative Review.

Mechanical ventilation (MV) is still necessary in many surgical procedures; nonetheless, intraoperative MV is not free from harmful effects. Protective ventilation strategies, which include the combination of low tidal volume and adequate positive end expiratory pressure (PEEP) levels, are usually adopted to minimize the ventilation-induced lung injury and to avoid post-operative pulmonary complications (PPCs). Even so, volutrauma and atelectrauma may co-exist at different levels of tidal volume and PEEP, and therefore, the physiological response to the MV settings should be monitored in each patient.

Unmatched ventilation and perfusion measured by electrical impedance tomography predicts the outcome of ARDS.

Background: In acute respiratory distress syndrome (ARDS), non-ventilated perfused regions coexist with non-perfused ventilated regions within lungs. The number of unmatched regions might reflect ARDS severity and affect the risk of ventilation-induced lung injury. Despite pathophysiological relevance, unmatched ventilation and perfusion are not routinely assessed at the bedside.

Quality of life of COVID-19 critically ill survivors after ICU discharge: 90 days follow-up.

Purpose: The onset of the coronavirus disease 19 (COVID-19) pandemic in Italy induced a dramatic increase in the need for intensive care unit (ICU) beds for a large proportion of patients affected by COVID-19-related acute respiratory distress syndrome (ARDS). The aim of the present study was to describe the health-related quality of life (HRQoL) at 90 days after ICU discharge in a cohort of COVID-19 patients undergoing invasive mechanical ventilation and to compare it with an age and sex-matched sample from the general Italian and Finnish populations. Moreover, the possible associations between clinical, demographic, social factors, and HRQoL were investigated.

Sustained oxygenation improvement after first prone positioning is associated with liberation from mechanical ventilation and mortality in critically ill COVID-19 patients: a cohort study.

Background: Prone positioning (PP) has been used to improve oxygenation in patients affected by the SARS-CoV-2 disease (COVID-19). Several mechanisms, including lung recruitment and better lung ventilation/perfusion matching, make a relevant rational for using PP. However, not all patients maintain the oxygenation improvement after returning to supine position.

Markers of endothelial and epithelial pulmonary injury in mechanically ventilated COVID-19 ICU patients.

Background: Biomarkers can be used to detect the presence of endothelial and/or alveolar epithelial injuries in case of ARDS. Angiopoietin-2 (Ang-2), soluble intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion protein-1 (VCAM-1), P-selectin and E-selectin are biomarkers of endothelial injury, whereas the receptor for advanced glycation end-products (RAGE) reflects alveolar epithelial injury. The aims of this study were to evaluate whether the plasma concentration of the above-mentioned biomarkers was different 1) in survivors and non-survivors of COVID-19-related ARDS and 2) in COVID-19-related and classical ARDS.

Focus on renal blood flow in mechanically ventilated patients with SARS-CoV-2: a prospective pilot study.

Mechanically ventilated patients with ARDS due to the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) seem particularly susceptible to AKI. Our hypothesis was that the renal blood flow could be more compromised in SARS-CoV-2 patients than in patients with "classical" ARDS. We compared the renal resistivity index (RRI) and the renal venous flow (RVF) in ARDS patients with SARS-CoV-2 and in ARDS patients due to other etiologies.

Factors influencing liberation from mechanical ventilation in coronavirus disease 2019: multicenter observational study in fifteen Italian ICUs.

Background: A large proportion of patients with coronavirus disease 2019 (COVID-19) develop severe respiratory failure requiring admission to the intensive care unit (ICU) and about 80% of them need mechanical ventilation (MV). These patients show great complexity due to multiple organ involvement and a dynamic evolution over time; moreover, few information is available about the risk factors that may contribute to increase the time course of mechanical ventilation.The primary objective of this study is to investigate the risk factors associated with the inability to liberate COVID-19 patients from mechanical ventilation.

Anodization-based process for the fabrication of all niobium nitride Josephson junction structures.

We studied the growth and oxidation of niobium nitride (NbN) films that we used to fabricate superconductive tunnel junctions. The thin films were deposited by dc reactive magnetron sputtering using a mixture of argon and nitrogen. The process parameters were optimized by monitoring the plasma with an optical spectroscopy technique.

Experimental Study of Spectral Properties of a Frenkel-Kontorova System.

We report on microwave emission from linear parallel arrays of underdamped Josephson junctions, which are described by the Frenkel-Kontorova (FK) model. Electromagnetic radiation is detected from the arrays when biased on current singularities (steps) appearing at voltages V(n)=Φ(0)(nc̅/L), where Φ(0)=2.07×10(-15)  Wb is the magnetic flux quantum, and c̅, L, and n are, respectively, the speed of light in the transmission line embedding the array, L its physical length, and n an integer.

Characterization of anomalous pair currents in Josephson junction networks.

Measurements performed on superconductive networks shaped in the form of planar graphs display anomalously large currents when specific branches are biased. The temperature dependences of these currents evidence that their origin is due to Cooper pair hopping through the Josephson junctions connecting the superconductive islands of the array. The experimental data are discussed in terms of theoretical models which predict, for the system under consideration, an inhomogeneous Cooper pair distribution on the superconductive islands of the network as a consequence of a Bose-Einstein condensation phenomenon.

Superconducting anisotropy in (CaCuO2)n/(SrTiO3)m superlattices.

The superconducting properties of (CaCuO2)n/(SrTiO3)m artificial superlattices have been investigated via transport measurements under the application of external magnetic fields. The coherence lengths in the plane of the substrate and in the direction perpendicular to it (ξab and ξc, respectively) have been measured while varying m, the thickness of the SrTiO3 block. The results show that with increasing m, i.

Low temperature conductivity of carbon nanotube aggregates.

We compare, over wide temperature ranges, the transport properties of single-wall carbon nanotubes arranged in the form of aligned arrays or in the form of fibres. The experimental data show that both the forms of aggregates present a crossover in the transport mechanism from three-dimensional hopping of the electrons between localized states at high temperature to fluctuation-induced tunnelling across potential barriers at low temperature. The role of the junctions formed between the bundles in the array and between the nanotubes inside the fibres is discussed on the basis of the experimental results.

Charge transport and tunneling in single-walled carbon nanotube bundles.

We investigate experimentally the transport properties of single-walled carbon nanotube bundles as a function of temperature and applied current over broad intervals of these variables. The analysis is performed on arrays of nanotube bundles whose axes are aligned along the direction of the externally supplied bias current. The data are found consistent with a charge transport model governed by the tunneling between metallic regions occurring through potential barriers generated by a nanotube's contact areas or bundle surfaces.