Marco Vergano

Marco Vergano
Ospedale San Giovanni Bosco · Anesthesia and Intensive Care Unit

MD

About

31
Publications
5,450
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Introduction
Consultant, Department of Anesthesia and Intensive Care, San Giovanni Bosco Hospital, Turin, Italy. Chair of the Ethics Section, Italian College of Anesthesia and Intensive Care Medicine (SIAARTI). Main clinical and research interests: End-of-Life Care, Clinical Ethics, Determination of Death and Organ Donation.

Publications

Publications (31)
Article
Donation after circulatory death (DCD) is a valuable option for the procurement of organs for transplantation. In Italy, organ procurement after controlled DCD is legally and ethically conceivable within the current legislative framework. However, although formal impediments do not exist, the health care team is faced with many obstacles that may h...
Article
Full-text available
As of March 6, 2020, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) issued a series of recommendations and relevant ethical considerations to better inform the clinicians involved in the care of critically-ill COVID-19 patients, in a setting where a disproportionate number of patients requiring life-sustain...
Article
Full-text available
The burning ethical question raised by the COVID-19 pandemic is how to deal fairly and ethically with a large number of patients simultaneously becoming critically unwell. Across the world, in both developed and developing countries, health systems are grappling with the possibility or the reality that the demand for intensive medical care will out...
Article
Full-text available
Prolonged warm ischemia time (WIT) has a negative prognostic value in liver transplantation (LT) using grafts procured after circulatory death (DCD). To assess the value of abdominal normothermic regional perfusion (A-NRP) associated with dual hypothermic oxygenated machine perfusion (D-HOPE) in controlled DCD LT, prospectively collected data on LT...
Article
Full-text available
Since the lockdown because of the pandemic, family members have been prohibited from visiting their loved ones in hospital. While it is clearly complicated to implement protocols for the admission of family members, we believe precise strategic goals are essential and operational guidance is needed on how to achieve them. Even during the pandemic,...
Article
Full-text available
Importance: During the SARS-CoV-2 pandemic, a complete physical isolation has been worldwide introduced. The impossibility of visiting their loved ones during the hospital stay causes additional distress for families: in addition to the worries about clinical recovery, they may feel exclusion and powerlessness, anxiety, depression, mistrust in the...
Chapter
Healthcare crises, like the COVID-19 pandemic, can lead to a pronounced national-and sometimes supranational-discrepancy between the need for medical care and the ability of the healthcare systems to provide such care. Such need can, among others, consist of personnel, pharmaceuticals, equipment, nutrition, transportation capacity, or reinforcement...
Preprint
Full-text available
In late February and early March 2020, Italy became the European epicenter of the COVID-19 pandemic. Despite increasingly stringent containment measures enforced by the government, the health system faced an enormous pressure, and extraordinary efforts were made in order to increase overall hospital beds’ availability and especially ICU capacity. N...
Article
Full-text available
How did Italy face the issue of allocating beds in Intensive Care Units and ventilators during the COVID-19 outbreak? At the beginning of the epidemic, the Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care issued recommendations that sparked a heated debate. Later, the National Bioethics Committee, the ethical advisory board...
Article
According to current vital statistics suicide appears as a growing public health problem in most Western countries. However, suicide is rarely discussed in scientific journals, possibly because of a persisting moral stigma. As a consequence, the diverse bases of suicidal behavior are little understood while the role of Chronic-Degenerative Terminal...
Article
Full-text available
On February 21st, 2020 the first case of severe acute respiratory syndrome due to the coronavirus 2 (SARS-CoV-2) causing the CoViD-19 disease, was identified in Italy. In the following days, despite the restrictive public health measures aimed to avoid the infection's spread, the number of cases increased. As of March 8th, 2020, Italy is the 2nd mo...
Article
Full-text available
Western countries are today experiencing a profound mutation of their immigration policies. Integration and hospitality have been taken over by closure and rejections. The policy of "closed ports" gained ground as never before. Traditionally, hospitals have imposed rules and restrictions to patients and visitors, ruling and limiting the space and t...
Book
Full-text available
ELS - Ethical Life Support Strumenti etici per decidere in Medicina Nella pratica clinica è frequente imbattersi in situazioni che presentano una valenza etica, e non sempre si è preparati ad affrontarle o si è pienamente consapevoli dei valori in base ai quali si agisce. Questo libro si propone di fornire gli strumenti adeguati per far fronte a...
Article
Full-text available
In the last decades, mortality from severe acute illnesses has considerably declined thanks to the advances in intensive care medicine. Meanwhile, critical care physicians realized that life-sustaining treatments (LST) may not be appropriate for every patient, and end-of-life care in the Intensive Care Unit (ICU) started to receive growing attentio...
Chapter
This chapter's objectives are to present the main bioethical problems associated with the management of renal replacement therapy (RRT) in critically ill patients; to discuss a strategy, based on moral principles, for guiding the decision-making process; to present a protocol to guide a practical possible approach to difficult decisions in critical...
Article
Full-text available
Clinical ethics if often perceived as an intuitive understanding of what is right versus wrong. This is insufficient for healthcare workers in general, but particularly for anesthesiologists and intensivists, who often must weigh up complex and emergent life or death decisions and subsequently justify these decisions to their team and patients, as...
Conference Paper
Full-text available
Italy is among the first European countries in terms of number of deceased donors. However, the striking majority of donated organs comes from donations after brain death, and experience with donation after cardiac death (DCD) is still limited to few istitutions. Implementation of a comprehensive approach to organ donation for the patients dying in...
Article
Full-text available
In comparison with some other European countries, such as Germany, Spain, France, and UK, Italy has not adopted an end of life legislation yet. From a clinical point of view, today there is in western countries a sound evidence supporting that the best scientific and ethical approach to end of life issues is based on four fundamental principles: sh...
Article
Full-text available
In comparison with some other European countries, such as Germany, Spain, France, and UK, Italy has not adopted an end of life legislation yet. From a clinical point of view, today there is in western countries a sound evidence supporting that the best scientific and ethical approach to end of life issues is based on four fundamental principles: sh...
Article
The culture of organ and tissue donation is not particularly well established among the general population, who often receive incorrect, incomplete information. Unfortunately, even among health workers not directly involved in the field of transplantation (laypersons), there is a poor level of knowledge concerning the underlying principles, mechani...
Article
Full-text available
Extracorporeal lung assist, an extreme resource in patients with acute respiratory failure (ARF), is expanding its indications since knowledge about ventilator-induced lung injury has increased and protective ventilation has become the standard in ARF. A prospective study on seven adult sheep was conducted to quantify carbon dioxide (CO2) removal a...
Article
The case of a decompression sickness in woman, diving to 26 meter depth is reported. The patient was helped by instructor's computer (error!) and she presented risk factors for embolic disease (obesity, smoke, estroprogestinic therapy). She presented with many symptoms of decompression sickness during immersion and during re-ascent (headache, verti...

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