Dysphagic disorder in a cohort of COVID-19 patients: Evaluation and evolution.

Background: COVID-19 is a multisystem disease complicated by respiratory failure requiring sustanined mechanical ventilation (MV). Prolongued oro-tracheal intubation is associated to an increased risk of dysphagia and bronchial aspiration. Purpose of this study was to investigate swallowing disorders in critically ill COVID-19 patients.

Hemoadsorption Treatment with CytoSorb® in Probable Hemophagocytic Lymphohistiocytosis: A Role as Adjunctive Therapy?

Acute hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease, with an annual incidence of 1 : 800,000 people. The disease is characterized by a cytokine storm, with concomitant macrophage and natural killer (NK) cell activation; death can occur from multiple organ failure or complications such as bleeding diathesis. Therefore, HLH treatment remains a challenging one.

Low PEEP Mechanical Ventilation and PaO/FiO Ratio Evolution in COVID-19 Patients.

Invasive mechanical ventilation (IMV) is the standard treatment in critically ill COVID-19 patients with acute severe respiratory distress syndrome (ARDS). When IMV setting is extremely aggressive, especially through the application of high positive-end-expiratory respiration (PEEP) values, lung damage can occur. Until today, in COVID-19 patients, two types of ARDS were identified (L- and H-type); for the L-type, a was supposed to be preferred, but data are still missing.

Pseudoatrial Flutter: When the Problem Lies Outside the Heart.

Electrocardiogram (ECG) artifacts are a common problem in emergency medicine. Generally these artifacts are induced by movement disorders, which generate electrical interference with the ECG recording. If these disorders are not promptly recognized, consequences can lead to hospitalization and execution of unnecessary diagnostic tests, thereby increasing the costs and clinical risks such as nosocomial infections and thromboembolism.

Validation of the return of spontaneous circulation after cardiac arrest (RACA) score in two different national territories.

Background: The likelihood of return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA) is influenced by unmodifiable (gender, aetiology, location, the presence of witnesses and initial rhythm) and modifiable factors (bystander CPR and the time to EMS arrival). All of these have been included in the ROSC After Cardiac Arrest (RACA) score.

Purpose: To test the ability of the RACA score to predict the probability of ROSC in two different regions with different local resuscitation networks: the Swiss Canton Ticino and the Italian Province of Pavia.

Lay persons alerted by mobile application system initiate earlier cardio-pulmonary resuscitation: A comparison with SMS-based system notification.

Aim: We compared the time to initiation of cardiopulmonary resuscitation (CPR) by lay responders and/or first responders alerted either via Short Message Service (SMS) or by using a mobile application-based alert system (APP).

Methods: The Ticino Registry of Cardiac Arrest collects all data about out-of-hospital cardiac arrests (OHCAs) occurring in the Canton of Ticino. At the time of a bystander's call, the EMS dispatcher sends one ambulance and alerts the first-responders network made up of police officers or fire brigade equipped with an automatic external defibrillator, the so called "traditional" first responders, and - if the scene was considered safe - lay responders as well.

Comparative performance assessment of commercially available automatic external defibrillators: A simulation and real-life measurement study of hands-off time.

Purpose: Early and good quality cardiopulmonary resuscitation (CPR) and the use of automated external defibrillators (AEDs) improve cardiac arrest patients' survival. However, AED peri- and post-shock/analysis pauses may reduce CPR effectiveness.

Methods: The time performance of 12 different commercially available AEDs was tested in a manikin based scenario; then the AEDs recordings from the same tested models following the clinical use both in Pavia and Ticino were analyzed to evaluate the post-shock and post-analysis time.

Better management of out-of-hospital cardiac arrest increases survival rate and improves neurological outcome in the Swiss Canton Ticino.

Aim: To determine the incidence of out-of-hospital cardiac arrest (OHCA) fulfilling Utstein criteria in the Canton Ticino, Switzerland, the survival rate of OHCA patients and their neurological outcome.

Methods And Results: All OHCAs treated in Canton Ticino between 1 January 2005 and 31 December 2014 were followed until either death or hospital discharge. The survival and neurological outcome of those OHCA fulfilling Utstein criteria are reported.

Intraoperative three-dimensional versus two-dimensional echocardiography for left ventricular assessment.

Background: Three-dimensional (3D) transesophageal echocardiography (TEE) technology is now widely used intraoperatively in cardiac surgery. Left ventricular (LV) measurements with 3D transthoracic echocardiography correlate better with cardiac magnetic resonance measurements compared with traditional two-dimensional (2D) transthoracic echocardiography. In this study, we compared intraoperative 3D TEE against 2D TEE regarding quantitative indices of LV function.

Mitral valve replacement in pregnancy: a successful strategy for fetal survival.

The incidence of bacterial endocarditis (BE) during pregnancy is about 0.01%, while maternal and fetal mortality rates due to BE are 22% and 15%, respectively. Fetal survival is <15% until week 25 of gestation, and cesarean delivery is recommended before cardiopulmonary bypass in the third trimester.

Unusual complication after aortic valve replacement.

We present a report of a postoperative left ventricular-right atrial (LV-RA) communication after aortic valve replacement. Such intracardiac defects are rare but encountered occasionally after valve surgery. The diagnosis was made by use of transesophageal echocardiography with echo-Doppler and color-flow imaging.

Multiple valve replacement in limited access: a case report.

Nowadays minimally invasive surgery represents an accepted technique to treat heart valve disease. We report a case of surgical correction of multiple valve disease in a 61-year-old woman through a minimally invasive right anterolateral minithoracotomy. The intervention was performed under transesophageal echocardiography and videoscopic guidance.

Aortic valve replacement through a mini lateral thoracotomy with high thoracic epidural anesthesia.

Background: : Minimally invasive aortic valve surgery is usually performed through a right parasternal incision or a modification of partial sternotomy. We explored the feasibility of using a video-assisted small right lateral thoracotomy (RLT) to approach the aortic valve.

Methods: : From August 2003 to December 2004, 12 patients with aortic stenosis (9) or regurgitation (3) underwent an aortic valve replacement through an 8 cm RLT in the 4th intercostal space.

Clinical experience with adaptive support ventilation for fast-track cardiac surgery.

Objective: To evaluate adaptive support ventilation (ASV), an automatic microprocessor-controlled mode of mechanical ventilation, for the initial ventilatory management in consecutive patients eligible for early extubation after cardiac surgery.

Design: Prospective observational study.

Setting: Nonuniversity cardiac center.