Publications by authors named "Tavazzi G"
Aims: This study aimed to investigate incidence and predictors of weaning failure and in-hospital death after successful weaning from veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in patients with cardiogenic shock (CS).
Methods And Results: Overall, 685 patients with CS treated with VA-ECMO from 23 tertiary care centres in 7 countries were analysed (median age 57 [interquartile range 49-66] years, 542 [79.1%] male, median lactate 7.
The future for cardiogenic shock management: insights from the leaders of the European Society of Cardiology.
Eur Heart J Acute Cardiovasc Care
December 2024
Article Synopsis
- A reversal of timing between early diastolic velocity (e') and mitral inflow (E) occurs with high left atrial pressure, but its potential application for assessing right atrial pressure has not been studied previously.
- In a study comparing patients with pre-capillary pulmonary hypertension to healthy volunteers, it was found that the interval (T) is prolonged in those with pulmonary hypertension.
- Strong correlations between T and measured right atrial pressure, along with a high predictive value for identifying elevated pressures, suggest T could be a valuable tool in understanding the cardiac function in pulmonary hypertension.
Article Synopsis
- The study aimed to identify echocardiographic indicators that could predict the success of weaning patients from veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and their survival after the procedure.
- It involved 76 patients undergoing V-A ECMO due to cardiogenic shock, measuring various echocardiographic parameters before and during the weaning process.
- Key findings highlighted that parameters like total isovolumic time (t-IVT), mitral annular plane systolic excursion (MAPSE), and left ventricular output velocity-time integral (LVOT VTI) were strong predictors of successful weaning and survival, whereas the left ventricular ejection fraction (LVEF) was not a reliable
Echodynamics or pulmonary artery catheter dynamics? Should they be mutually exclusive?
Eur Heart J Acute Cardiovasc Care
September 2024
Imaging in acute percutaneous mechanical circulatory support in adults: a clinical consensus statement of the Association for Acute CardioVascular Care (ACVC) of the ESC, the European Association of Cardiovascular Imaging (EACVI) of the ESC and the European branch of the Extracorporeal Life Support Organization (EuroELSO).
Eur Heart J Cardiovasc Imaging
November 2024
Article Synopsis
- The use of temporary mechanical circulatory support (tMCS) in patients with cardiogenic shock has grown, primarily guided by observational studies and expert opinions.
- Imaging plays a crucial role in every stage of patient care, from diagnosis to monitoring and eventual weaning from support.
- This manuscript presents expert consensus and practical guidelines on the use of imaging in conjunction with tMCS, emphasizing evidence-based practices and current best standards.
Aims: To describe the use and the relation to outcome of different ventilation strategies in a contemporary, large, prospective registry of cardiogenic shock patients.
Methods And Results: Among 657 patients enrolled from March 2020 to November 2023, 198 (30.1%) received oxygen therapy (OT), 96 (14.
Background: The cardiac manifestations of COVID-19 have been described in patients with acute respiratory distress syndrome (ARDS) admitted to intensive care unit (ICU). The presence and impact of right ventricular (RV) diastolic function and performance has not been studied in this population yet. We describe the prevalence of RV diastolic dysfunction, assessed by the pulmonary valve pre-ejection A wave (PV A wave), and the RV systo-diastolic interaction, using the RV total isovolumic time (t-IVT), in COVID-19 ARDS.
View Article and Find Full Text PDFThis review aims to enhance the comprehension and management of cardiopulmonary interactions in critically ill patients with cardiovascular disease undergoing mechanical ventilation. Highlighting the significance of maintaining a delicate balance, this article emphasizes the crucial role of adjusting ventilation parameters based on both invasive and noninvasive monitoring. It provides recommendations for the induction and liberation from mechanical ventilation.
View Article and Find Full Text PDFBackground: Observational data suggest that the subset of patients with heart failure related CS (HF-CS) now predominate critical care admissions for CS. There are no dedicated HF-CS randomised control trials completed to date which reliably inform clinical practice or clinical guidelines. We sought to identify aspects of HF-CS care where both consensus and uncertainty may exist to guide clinical practice and future clinical trial design, with a specific focus on HF-CS due to acute decompensated chronic HF.
View Article and Find Full Text PDFBackground: the epidemiology of cardiogenic shock has evolved over the years: in the last decades an increasing prevalence of cardiogenic shock related to acute decompensated heart failure was observed. Therefore, treatment bundles should be updated according to the underlying pathophysiology. No data exist regarding the diagnostic/therapeutic strategies in general intensive care units.
View Article and Find Full Text PDFArticle Synopsis
- - The study aims to standardize antithrombotic management practices for patients on percutaneous mechanical circulatory support (pMCS), as bleeding and clotting issues significantly affect patient outcomes during procedures like veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and Impella™ use.
- - An online survey targeting European clinicians was conducted, gathering 105 responses from 26 countries, revealing that most clinicians followed local anticoagulation protocols, primarily using unfractionated heparin (UFH), but there was notable variation in anticoagulant targets and monitoring practices.
- - The findings indicate considerable inconsistency in antithrombotic practices across responding institutions, which may lead to different rates of
Article Synopsis
- VA-ECMO is a type of machine that helps people whose hearts can't pump blood properly, but researchers aren't sure if it's really helpful or safe yet.
- Some studies show it might help after heart emergencies but others don't agree, especially for certain heart problems.
- More research is being done to find out who might benefit the most from VA-ECMO and how to use it better.
Answer: Severe bronchospasm-a lung-brain-heart interaction.
Eur Heart J Acute Cardiovasc Care
March 2024
Background: Recent data indicate that end-of-life management for patients affected by acute decompensated heart failure in cardiac intensive care units is aggressive, with late or no engagement of palliative care teams.
Objective: To assess current palliative care and end-of-life practices in a contemporary Italian multicenter registry of patients with cardiogenic shock due to acute decompensated heart failure.
Methods: A survey-based approach was used to collect data on palliative care and end-of-life management practices.
Question: Severe bronchospasm-a lung-brain-heart interaction?
Eur Heart J Acute Cardiovasc Care
March 2024
Article Synopsis
- * Women with HF-CS tend to be older, have fewer prior heart issues, and lower rates of severe heart dysfunction compared to men, yet both genders received similar treatments.
- * Despite ranking equally in treatment use, the 30-day mortality rates were also comparable between sexes (around 53% for women and 51% for men), suggesting the need for further investigation into sex-specific treatment strategies.
Article Synopsis
- The study discusses a rare lung disease in nine children linked to a genetic deficiency of the CCR2 receptor, leading to conditions like pulmonary alveolar proteinosis (PAP) and increased vulnerability to infections.
- This deficiency is characterized by loss-of-function variants, affecting the migration and signaling of immune cells, particularly monocytes, due to a lack of response to CCL-2, a chemokine essential for these processes.
- Elevated levels of CCL-2 in the blood serve as a diagnostic marker for identifying children with unexplained respiratory issues or recurrent infections, indicating the importance of CCR2 in lung health and immune response.
Cardiogenic shock (CS) portends a dismal prognosis if hypoperfusion triggers uncontrolled inflammatory and metabolic derangements. We sought to investigate metabolomic profiles and temporal changes in IL6, Ang-2, and markers of glycocalyx perturbation from admission to discharge in eighteen patients with heart failure complicated by CS (HF-CS). Biological samples were collected from 18 consecutive HF-CS patients at admission (T0), 48 h after admission (T1), and at discharge (T2).
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