Emanuele Rezoagli

Emanuele Rezoagli
Università degli Studi di Milano-Bicocca | UNIMIB · School of Medicine and Surgery

MD PhD

About

110
Publications
20,044
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
1,541
Citations
Education
July 2012 - July 2017
Università degli Studi di Milano-Bicocca
Field of study
  • Anesthesia, Critical Care and Pain Medicine
September 2004 - July 2010
Università degli Studi dell'Insubria
Field of study
  • Medicine and Surgery

Publications

Publications (110)
Article
Full-text available
Background External chest-wall compression (ECC) is sometimes used in ARDS patients despite lack of evidence. It is currently unknown whether this practice has any clinical benefit in patients with COVID-19 ARDS (C-ARDS) characterized by a respiratory system compliance ( C rs ) < 35 mL/cmH 2 O. Objectives To test if an ECC with a 5 L-bag in low-co...
Article
Full-text available
Background The impact of underlying comorbidities on the clinical presentation, management and outcomes in patients with ARDS is poorly understood and deserves further investigation. Objectives We examined these issue in patients with ARDS enrolled in the L arge observational study to UNderstand the Global impact of Severe Acute respiratory Failur...
Article
Full-text available
Nitric oxide (NO) is a key molecule in the biology of human life. NO is involved in the physiology of organ viability and in the pathophysiology of organ dysfunction, respectively. In this narrative review, we aimed at elucidating the mechanisms behind the role of NO in the respiratory and cardio-cerebrovascular systems, in the presence of a health...
Article
Full-text available
Background: It remains elusive how the characteristics, the course of disease, the clinical management and the outcomes of critically ill COVID-19 patients admitted to intensive care units (ICU) worldwide have changed over the course of the pandemic. Methods: Prospective, observational registry constituted by 90 ICUs across 22 countries worldwid...
Article
Full-text available
Background Helmet continuous positive airway pressure (CPAP) has been widely used during the COVID-19 pandemic. Specific filters (i.e. High Efficiency Particulate Air filter: HEPA; Heat & Moisture Exchanger Filter: HMEF) were used to prevent Sars-CoV2 environmental dispersion and were connected to the CPAP helmet. However, HEPA and HMEF filters may...
Article
Background Lesion segmentation is a critical step in medical image analysis, and methods to identify pathology without time-intensive manual labeling of data are of utmost importance during a pandemic and in resource-constrained healthcare settings. Here, we describe a method for fully automated segmentation and quantification of pathological COVID...
Article
Acute respiratory distress syndrome (ARDS) is a severe form of respiratory failure burden by high hospital mortality. No specific pharmacologic treatment is currently available and its ventilatory management is a key strategy to allow reparative and regenerative lung tissue processes. Unfortunately, a poor management of mechanical ventilation can i...
Article
Full-text available
β-glucans are a large class of complex polysaccharides with bioactive properties, including immune modulation. Natural sources of these compounds include yeast, oats, barley, mushrooms, and algae. Yeast is abundant in various processes, including fermentation, and they are often discarded as waste products. The production of biomolecules from waste...
Article
Background Low muscle mass and other specific body composition indexes, assessed by computed tomography (CT), are associated with adverse outcomes after elective surgery, such as an increased risk of postoperative complications and higher mortality. However, limited information is available about the role of these indexes on short- and long-term ou...
Article
Full-text available
Background The physiological and prognostical significance of accessory and expiratory muscles activation is unknown during a spontaneous breathing trial (SBT). We hypothesized that, in patients experiencing weaning failure, accessory and expiratory muscles are activated to cope with an increased respiratory workload. Purpose To describe accessory...
Article
Inhaled nitric oxide (iNO) acts as a selective pulmonary vasodilator and it is currently approved by the FDA for the treatment of persistent pulmonary hypertension of the newborn. iNO has been demonstrated to effectively decrease pulmonary artery pressure and improve oxygenation, while decreasing extracorporeal life support use in hypoxic newborns...
Article
Background Two acute respiratory distress syndrome (ARDS) subphenotypes (hyperinflammatory and hypoinflammatory) with distinct clinical and biological features and differential treatment responses have been identified using latent class analysis (LCA) in seven individual cohorts. To facilitate bedside identification of subphenotypes, clinical class...
Article
Full-text available
Background: Prone positioning (PP) reduces mortality of patients with acute respiratory distress syndrome (ARDS). The potential benefit of prone positioning maneuvers during venovenous extracorporeal membrane oxygenation (ECMO) is unknown. The aim of this study was to evaluate the association between the use of prone positioning during extracorpor...
Article
Background Prone positioning (PP) reduces mortality of patients with acute respiratory distress syndrome (ARDS). The potential benefit of prone positioning maneuvers during venovenous extracorporeal membrane oxygenation (ECMO) is unknown. The aim of this study was to evaluate the association between the use of prone positioning during extracorporea...
Article
Full-text available
Background Uncertainty about the optimal respiratory support strategies in critically ill COVID-19 patients is widespread. While the risks and benefits of noninvasive techniques versus early invasive mechanical ventilation (IMV) are intensely debated, actual evidence is lacking. We sought to assess the risks and benefits of different respiratory su...
Article
Acute respiratory distress syndrome (ARDS) is the most common form of acute severe hypoxemic respiratory failure in the critically ill with a hospital mortality of 40%. Alveolar inflammation is one of the hallmarks for this disease. β-Glucans are polysaccharides isolated from a variety of natural sources including mushrooms, with documented immune...
Article
Full-text available
Introduction: Acute respiratory distress syndrome (ARDS) is an acute form of diffuse lung injury characterized by (i) an intense inflammatory response, (ii) increased pulmonary vascular permeability, and (iii) the loss of respiratory pulmonary tissue. In this article we explore the therapeutic potential of hexarelin, a synthetic hexapeptide growth...
Article
Objectives The exhaled CO2 signal provides guidance during cardiopulmonary resuscitation. The Airway opening index (AOI) has been recently used to quantify chest-compression (CC) induced expired CO2 oscillations. We aimed to determine whether levels of intrathoracic pressures developed during CC or parameters related to lung structure may affect AO...
Article
Full-text available
β-glucans are complex polysaccharides that are found in several plants and foods, including mushrooms. β-glucans display an array of potentially therapeutic properties.
Article
Background and Purpose Cerebral vein thrombosis (CVT) incidence is estimated to be >10 per 1 000 000 per year. Few population-based studies investigating case-fatality rates (CFRs) and pyogenic/nonpyogenic CVT incidence are available. We assessed trends in CVT incidence between 2002 and 2012, as well as adjusted in-hospital CFRs and incidence of ho...
Preprint
Full-text available
Background Low muscle mass and other specific body composition indexes, assessed by computed tomography (CT), are associated with adverse outcomes after elective surgery, such as an increased risk of postoperative complications and higher mortality. However, limited information is available about the role of these indexes on short- and long-term ou...
Preprint
Full-text available
Background Low muscle mass and other specific body composition indexes, assessed by computed tomography (CT), are associated with adverse outcomes after elective surgery, such as an increased risk of postoperative complications and higher mortality. However, limited information is available about the role of these indexes on short- and long-term ou...
Article
Objective:to describe our clinical experience using Electrical Impedance Tomography (EIT) in the management of mechanical ventilation in patients with acute respiratory failure and to determine to which extent EIT-guided PEEP setting differed from clinically set values.Approach:a retrospective, observational cohort study performed in a hub centre f...
Article
Purpose Non-invasive respiratory support could reduce the incidence of intubation in patients with Acute Hypoxemic Respiratory Failure (AHRF). The optimal interface or modality of non-invasive respiratory support is debated. We sought to evaluate the differences between patients who succeeded or failed non-invasive respiratory support, with a speci...
Article
Full-text available
Background To determine the frequency of, and factors associated with, death in hospital following ICU discharge to the ward. Methods The Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE study was an international, multicenter, prospective cohort study of patients with severe respiratory failure, conduc...
Article
The global aquaculture industry has surpassed capture fishing to achieve goals of economic and environmental sustainability. This intensification, albeit extremely beneficial, has limitations with regard to the cultured animals, including infections, pollution and stress. This can lead to an increase in disease and mortality rates not experienced i...
Article
Italy was the first western country facing an outbreak of coronavirus disease 2019 (COVID-19). The first Italian patient diagnosed with COVID-19 was admitted, on Feb. 20, 2020, to the intensive care unit (ICU) in Codogno (Lodi, Lombardy, Italy), and the number of reported positive cases increased to 36 in the next 24 hours, and then exponentially f...
Article
Full-text available
Background: Cardiac surgery with cardiopulmonary bypass (CPB) is associated with a high risk of postoperative acute kidney injury (AKI). Due to limitations of current diagnostic strategies, we sought to determine whether free hemoglobin (fHb) ratio (ie, levels of fHb at the end of CPB divided by baseline fHb) could predict AKI after on-pump cardia...
Article
Full-text available
The purpose of this study was to develop a fully-automated segmentation algorithm, robust to various density enhancing lung abnormalities, to facilitate rapid quantitative analysis of computed tomography images. A polymorphic training approach is proposed, in which both specifically labeled left and right lungs of humans with COPD, and nonspecifica...
Article
Rationale: Treatment with non-invasive ventilation (NIV) in COVID-19 is frequent. Shortage of Intensive care unit (ICU) beds led clinicians to deliver NIV also outside intensive care units (ICUs). Data about the use of NIV in COVID-19 is limited. Objective: To describe the prevalence and clinical characteristics of patients with COVID-19 treated w...
Article
Full-text available
β-glucans are complex polysaccharides that are found in several plants and foods, including mushrooms. β-glucans display an array of potentially therapeutic properties. β-glucans have metabolic and gastro-intestinal effects, modulating the gut microbiome, altering lipid and glucose metabolism, reducing cholesterol, leading to their investigation as...
Conference Paper
Full-text available
Introduction/Background Cervical cancer (CC) is described as cancer that occurs in the cells located in the cervix. Each year, more than 500,000 women are diagnosed with CC and the disease results in over 300,000 deaths across the world. Infection by high-risk oncogenic subtypes of human papillomavirus (HPV); HPV16 and HPV18, is the cause for almos...
Article
Full-text available
This study was performed to develop an adjuvant therapy in the form of a self-administered vaginal tablet regimen for the localized delivery of chemotherapeutic drugs. This therapy will help to reduce relapse by eradicating cancerous cells in the margin of cervical tumors. The vaginal tablet is a very common formulation that is easy to manufacture,...
Preprint
Full-text available
The purpose of this study was to develop a fully-automated segmentation algorithm, robust to various density enhancing lung abnormalities, to facilitate rapid quantitative analysis of computed tomography images. A polymorphic training approach is proposed, in which both specifically labeled left and right lungs of humans with COPD, and nonspecifica...
Article
The purpose of this study was to develop a fully-automated segmentation algorithm, robust to various density enhancing lung abnormalities, to facilitate rapid quantitative analysis of computed tomography images. A polymorphic training approach is proposed, in which both specifically labeled left and right lungs of humans with COPD, and nonspecifica...
Article
Highlights • This is a secondary analysis stratified by sex of the CEVETIS that enrolled patients with a first event of CVT. • The female-to-male distribution ratio of CVT in the CEVETIS population was 3:1. • Infections, cranial trauma and unprovoked CVT were more frequent in males than in females. • VTE recurrence in other sites was twice as high...
Article
Rationale: Cardiopulmonary Resuscitation is the cornerstone of cardiac arrest (CA) treatment. However, lung injuries associated with it have been reported. Objectives: To assess 1) the presence and characteristics of lung abnormalities induced by Cardiopulmonary Resuscitation and 2) the role of mechanical and manual chest compression (CC) in its d...
Preprint
Full-text available
Background: To determine the frequency of, and factors associated with, death in hospital following ICU discharge. Methods: The Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study was an international, multicenter, prospective cohort study of patients with severe respiratory failure, condu...
Preprint
Full-text available
Background: To determine the frequency of, and factors associated with, death in hospital following ICU discharge to the ward. Methods: The Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study was an international, multicenter, prospective cohort study of patients with severe respiratory fa...
Preprint
Full-text available
Background: To determine the frequency of, and factors associated with, death in hospital following ICU discharge to the ward. Methods: The Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study was an international, multicenter, prospective cohort study of patients with severe respiratory fa...
Preprint
Full-text available
Background: To determine the frequency of, and factors associated with, death in hospital following ICU discharge to the ward. Methods: The Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study was an international, multicenter, prospective cohort study of patients with severe respiratory fa...
Article
Full-text available
ARDS, first described in 1967, is the commonest form of acute severe hypoxemic respiratory failure. Despite considerable advances in our knowledge regarding the pathophysiology of ARDS, insights into the biologic mechanisms of lung injury and repair, and advances in supportive care, particularly ventilatory management, there remains no effective ph...
Article
Background Considerable variability exists regarding CO2 management in early ARDS, with the impact of arterial CO2 tension on management and outcomes poorly understood. Research Question To determine the prevalence and impact of hypo- and hypercapnia on the management and outcomes of patients with early ARDS enrolled in the Large observational stu...
Article
Full-text available
Coronavirus pneumonia is accompanied by rapid virus replication, where a large number of inflammatory cell infiltration and cytokine storm may lead to acute lung injury, acute respiratory distress syndrome (ARDS) and death. The uncontrolled release of pro-inflammatory cytokines, including interleukin (IL)-1β and IL-6, is associated with ARDS. This...
Article
Full-text available
Background Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods In this secondary...
Article
Background: Adjunctive strategies are an important part of the management of acute respiratory distress syndrome (ARDS). However, their application in clinical practice remains inconsistent. Research question: We wished to determine the frequency and patterns of use of adjunctive strategies in patients with moderate-severe ARDS (P/F ratio < 150)...
Chapter
Arterial CO2 tension (PaCO2) represents a balance between CO2 production and elimination via the lungs, and in health is maintained within a tight range (3.5–4.5 kPa). Traditional approaches to CO2 management in the critically ill focused on maintaining tidal and minute ventilation to avoid the risks of hypercapnia. The demonstration that high lung...
Chapter
Acute Respiratory Distress Syndrome (ARDS) is a complex and debilitating disease of the lungs, which continues to have a high mortality rate and huge disease burden on patients. Incidence is rising, possibly due to greater awareness leading to more diagnoses rather than a change in the underlying rate. It arises from multiple etiologies, though pat...
Article
RATIONALE: Acidemia is a severe condition among critically ill patients. Despite lack of evidence, sodium bicarbonate is frequently used to correct pH. However, its administration is burdened by several side effects. We hypothesized that the reduction of plasma chloride concentration could be an alternative strategy to correct acidemia. OBJECTIVES:...
Article
Rationale We wished to determine the influence of sex on the management and outcomes in acute respiratory distress syndrome (ARDS) patients in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE). Methods We assessed the effect of sex on mortality, length of stay (LOS) and duration of invasi...
Article
Full-text available
Introduction Postoperative acute kidney injury (AKI) is a common complication in cardiac surgery. Levels of intravascular haemolysis are strongly associated with postoperative AKI and with prolonged (>90 min) use of cardiopulmonary bypass (CPB). Ferrous plasma haemoglobin released into the circulation acts as a scavenger of nitric oxide (NO) produc...
Article
We report the clinical case of a septic patient with antiphospholipid syndrome who developed ischemia in all 4 limbs, despite a normal systemic blood pressure. Prolonged coagulation times suggested a hemorrhagic diathesis, requiring transfusion of fresh-frozen plasma and discontinuation of heparin infusion. In contrast, the study of the viscoelasti...
Poster
Rationale: Acute Respiratory Distress Syndrome (ARDS) is characterized by an acute lung inflammatory process. This results in lung parenchyma injury and promotes activation of the immune system with the up-regulation of pro-inflammatory cytokines. β-glucans - a diverse group of polysaccharides - have been reported to have immune-modulating properti...
Poster
Abstract: Cervical cancer is the third most common cancer in women in the world. Prevention and diagnosis is essential to prevent the cancer progressing. Disulfiram and 5-Fluorouracil are two anti-cancer drugs. The aim of this study was to determine the cytotoxic effects of two anti-cancer drugs on the cervical cancer line Caski cells. To determine...
Article
Objectives: To understand the impact of mild-moderate and severe acute kidney injury in patients with acute respiratory distress syndrome. Design: Secondary analysis of the "Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure", an international prospective cohort study of patients with severe respiratory...