Massimiliano Sorbello

• MD
• Medical Doctor at University of Catania

Acquired benign tracheal stenosis represents a challenging condition characterized by narrowing of the tracheal lumen, with post-intubation and post-tracheostomy stenosis accounting for approximately 90% of acquired cases. This comprehensive review examines current treatment strategies, from conservative management to surgical reconstruction, highl...

Purpose of review This review examines the evolution of the pharmacological approach to rapid sequence induction/intubation (RSII) over the past 55 years, highlighting recent advances and contemporary perspectives on managing full-stomach patients requiring airway control. Recent findings While aspiration remains a significant concern during RSII...

Background and Objectives: Maxillofacial trauma represents a significant global health challenge with substantial physical, psychological, and socioeconomic consequences. Materials and Methods: This narrative review analyzed 112 articles published between 2000 and 2024 examining epidemiology, prevention, economics, and outcomes of maxillofacial tra...

Maxillofacial trauma constitutes one of the significant public health issues globally owing to its multifactorial etiology, ramifications, and socioeconomic burden on the world of health care. This article systematically reviews maxillofacial injury epidemiology, prevention, economic effect, and complications. The cause of such injuries is varied w...

Neurological and olfactory disturbances are increasingly recognized as potential complications of general anesthesia, particularly in vulnerable populations, such as the elderly, children, and individuals with comorbidities. Recent studies have highlighted the need for tailored anesthetic approaches in these high-risk groups to mitigate potential l...

The renal resistive index (RRI), a Doppler ultrasound-derived parameter measuring renal vascular resistance, has emerged as a promising non-invasive tool to evaluate renal hemodynamics in critically ill patients, particularly those with acute respiratory distress syndrome (ARDS) and heart failure (HF). This narrative review examines the current evi...

Asthma is a reversible clinical condition characterized by airway obstruction due to bronchial smooth muscle contraction, inflammation and a hypersecretive state. Severe asthma exacerbations (SAE) may be a part of the natural history of this condition. Patients presenting with SAE are at higher risk of recurrent attacks, often nonresponsive to medi...

Introduction: To evaluate the effectiveness of noninvasive positive pressure ventilation (NPPV) versus standard therapy in severe asthma exacerbations through meta-analysis. Methods: Nine randomized controlled trials (344 patients) were analyzed from inception to August 2024. Primary outcomes included respiratory rate, forced expiratory volume in...

The renal resistive index (RRI), a doppler ultrasound-derived parameter measuring renal vascular resistance, has emerged as a promising non-invasive tool to evaluate renal haemodynamics in critically ill patients, particularly those with Acute Respiratory Distress Syndrome (ARDS) and heart failure (HF). This review examines the current evidence for...

BACKGROUND When considering whether a patient is fit for surgery, a comprehensive patient assessment represents the first step for an anaesthetist to evaluate the risks associated with the procedure and the patient's underlying diseases, and to optimise (whenever possible) the perioperative surgical journey. These guidelines from the European Socie...

Introduction Obesity is one of the biggest modern health issues worldwide. Owing to the failure of both behavioral and pharmacological measures, the surgical approach has been established as the main conduct to follow, with bariatric surgery being one of the most effective and safe procedures. One of the bases for the optimal analgesic strategy is...

One potential complication in bariatric surgery is rhabdomyolysis, which is a condition involving muscle tissue damage that can significantly impact a patient's health. The causes of rhabdomyolysis can be broadly classified into two major categories: traumatic and non-traumatic. Early investigations into the development of intraoperative rhabdomyol...

This comprehensive review examines the role of Fenoldopam, a selective dopamine-1 receptor agonist, in preventing and treating acute kidney injury (AKI) during cardiac surgery. AKI remains a significant complication in cardiac surgery, associated with increased morbidity, mortality, and healthcare costs. The review explores Fenoldopam’s pharmacolog...

This comprehensive review examines the role of fenoldopam, a selective dopamine-1 receptor agonist, in preventing and treating acute kidney injury (AKI) during cardiac surgery. AKI remains a significant complication in cardiac surgery, associated with increased morbidity, mortality, and healthcare costs. The review explores fenoldopam's pharmacolog...

Our study aimed to provide consensus and expert clinical practice statements related to airway management in critically ill adults with a physiologically difficult airway (PDA). An international Steering Committee involving seven intensivists and one Delphi methodology expert was convened by the Society of Critical Care Anaesthesiologists (SOCCA) P...

Robotic thoracic surgery is a prominent minimally invasive approach for the treatment of various thoracic diseases. While this technique offers numerous benefits including reduced blood loss, shorter hospital stays, and less postoperative pain, effective pain management remains crucial to enhance recovery and minimize complications. This review foc...

Re-expansion pulmonary edema is a rare and potentially life-threatening complication that can occur after the rapid re-expansion of a collapsed lung due to pneumothorax or pleural effusion. It has a multifactorial pathogenesis, and risk factors for re-expansion pulmonary edema, such as chronic lung collapse, rapid re-expansion, and changes in pulmo...

The effects of tracheostomy on outcome as well as on intra or post-operative complications is yet to be defined. Admission of patients with tracheostomy to rehabilitation facility is at higher risk of suboptimal care and increased mortality. The aim of the study was to investigate ICU mortality, clinical outcome and quality of life up to 12 months...

Background: Delayed graft function (DGF) is common after kidney transplantation from deceased donors and may significantly affect post-transplant outcomes. This study aimed to evaluate whether an innovative approach, based on the administration of the intravenous prostaglandin analogue iloprost, could be beneficial in reducing the incidence of DGF...

Background: Delayed graft function (DGF) is common after kidney transplantation from de-ceased donor and may significantly affect post-transplant outcomes. This study aimed to evaluating whether an innovative approach, based on the administration of intravenous prostaglandin-analogue iloprost, could be beneficial in reducing the incidence of DGF oc...

Background: Tracheal intubation is a high-risk procedure in the critically ill, with increased intubation failure rates and a high risk of other adverse events. Videolaryngoscopy might improve intubation outcomes in this population, but evidence remains conflicting, and its impact on adverse event rates is debated.

Background: Guidelines and consensus statements recommend the use of videola-ryngoscopes (VLs) in airway management of patients with COVID-19. However, there is a lack of knowledge about which types of videolaryngoscopes are used, differences of use between countries, and how the COVID-19 pandemic influenced their use. The primary aim of this befo...

Background: Tracheal intubation is a high-risk procedure in the critically ill, with increased intubation failure rates and a high risk of other adverse events. Videolaryngoscopy might improve intubation outcomes in this population, but evidence remains conflicting, and its impact on adverse event rates is debated. Methods: This is a subanalysis...

Objective. The competency of using video laryngoscopes (VL) for double-lumen tube (DLT) endobronchial intubations can be improved with constant training as assessed by measuring the learning curves. We hypothesized that the time to DLT intubation would be reduced over the intubation attempts. Design. A crossover manikin study. Settings. University-...

Background Airway management for thoracic surgery represents a high risk setting for SARS-CoV-2 infection diffusion due to complex and invasive airway instrumentation and techniques. Results An 18-item questionnaire was submitted to the 56 members of the Thoracic subcommittee of the SIAARTI Cardio-Thoraco-Vascular Research Group to provide a snaps...

Emergency settings in obese people require tailored multidisciplinary protocols and pathways to manage these complex patients. For this reason, we would like to foresee a proficient cooperation with the UK Society for Obesity and Bariatric Anaesthesia (SOBA) and other societies: obesity is a worldwide problem, and an international and multidiscipli...

Introduction Significant concerns raise for the healthcare workers involved in airway management of patients diagnosed with coronavirus 2019 disease (COVID-19). Due to shortages of personal protective equipment (PPE), barrier enclosure systems such as aerosol box (AB) have been proposed worldwide. The aim of this study was to evaluate our experienc...

Spritztube® is a new supraglottic airway device that allows either extraglottic ventilation or orotracheal intubation with the same device. The aim of the present report is to provide the first radiologic images of the Spritztube in situ in a living human and to assess the depth of insertion and its anatomical relationships in vivo. We present the...

Recent data indicated a high incidence of inappropriate management of neuromuscular block, with a high rate of residual paralysis and relaxant-associated postoperative complications. These data are alarming in that the available neuromuscular monitoring, as well as myorelaxants and their antagonists basically allow well tolerated management of neur...

Rationale: Cardiovascular instability/collapse is a common peri-intubation event in patients who are critically ill. Objectives: To identify potentially modifiable variables associated with peri-intubation cardiovascular instability/collapse (i.e., systolic arterial pressure ,65 mm Hg [once] or ,90 mm Hg for .30 minutes; new/increased vasopressor r...

Introduction We performed a systematic review in COVID-19 mechanically ventilated (MV) patients which analysed the effect of tracheostomy timing and technique (surgical vs. percutaneous) on mortality. Secondary outcomes included intensive care unit (ICU)-and hospital-length-of-stay (LOS), decannulation from tracheostomy, duration of MV, and complic...

Across multiple disciplines undertaking airway management globally, preventable episodes of unrecognised oesophageal intubation result in profound hypoxaemia, brain injury and death. These events occur in the hands of both inexperienced and experienced practitioners. Current evidence shows that unrecognised oesophageal intubation occurs sufficientl...

The SARS-CoV-2 pandemic heavily impacted healthcare workers, increasing their physical and psychological workload. Specifically, COVID-19 patients’ airway management is definitely a challenging task regarding both severe and acute respiratory failure and the risk of contagion while performing aerosol-generating procedures. The category of anesthesi...

Background: This survey aimed to investigate routine practices and approaches of clinicians on pediatric airway in anesthesia and intensive care medicine. Methods: A 20-question multiple-choice questionnaire with the possibility to provide open text answers was developed and sent. The survey was sent to the members of European Airway Management...

Propofol sedation for advanced endoscopic procedures is a widespread technique at present, which generates controversy worldwide when anaesthetic or non-anaesthetic personnel administer this form of sedation. There is some evidence for safe administered propofol sedation by non-anaesthetic personnel in patients undergoing endoscopy procedures, but...

Rationale Cardiovascular instability/collapse is a common peri-intubation event in critically ill patients. Objectives To identify potentially modifiable variables associated with peri-intubation cardiovascular instability/collapse. Methods INTUBE was a multicenter prospective cohort study of critically ill patients undergoing tracheal intubation i...

Introduction: Significant concerns raise for the healthcare workers involved in airway management of patients diagnosed with coronavirus 2019 disease (COVID-19). Due to shortages of personal protective equipment (PPE), barrier enclosure systems such as aerosol box (AB) have been proposed worldwide. Aim of this study was to evaluate our experience u...

Airway management is a key competence and a core skill in anaesthesia, intensive care, resuscitation, and emergency medicine. Many accidents, in different settings, are still related to failure in achieving airway control, and recent evidence suggests that, equipment availability and proficient use being of utmost importance, most of the accidents...

Background: Despite several clinical index tests that are currently applied for airway assessment, unpredicted difficult laryngoscopy may still represent a serious problem in anesthesia practice. The aim of this systematic review and meta-analysis was to evaluate whether preoperative airway ultrasound can predict difficult direct laryngoscopy in a...

Obesity is associated to an increased risk of morbidity and mortality due to respiratory, cardiovascular, metabolic, and neoplastic diseases. The aim of this narrative review is to assess the physio-pathological characteristics of obese patients and how they influence the clinical approach during different emergency settings, including cardiopulmon...

The American Society of Anesthesiologists; All India Difficult Airway Association; European Airway Management Society; European Society of Anaesthesiology and Intensive Care; Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care, Learning, Teaching and Investigation Difficult Airway Group; Society for Airway Management; Soc...

Airway management, including tracheal intubation and tracheostomy, is the most commonly performed procedure in critically ill patients. The EAMS held a webinar in June 2021 focused on this subject. Vincenzo Russotto from Monza, Italy and Sheila Myatra from Mumbai, India presented the results of the "INternational observational study To Understand t...

Introduction The competency of using video laryngoscopes (VL) for double-lumen tube (DLT) endobronchial intubations can be improved with constant training as assessed by measuring the learning curves. We hypothesized that the time to DLT intubation would be reduced over the intubation attempts. Methods Forty-two novice medical students unfamiliar...

The paper describes the development of a new robotic system for guiding the intubation using a laryngoscope, separating the patient from the doctor and allowing to fully control the introduction using a small console with two joysticks. The basic mechanism derives from our ROSES, robotic system for endovascular surgery, presently going through clin...

Awake tracheal intubation remains the gold standard for managing a predicted difficult airway. There is emerging evidence that supports the use of videolaryngoscope guided awake intubation. Videolaryngoscopes have become widely available and consequently easy to use and familiar to anaesthetists, allowing for observed tube placement and fixed wide...

The novel coronavirus pandemic has radically changed the landscape of normal surgical practice. Lifesaving cancer surgery, however, remains a clinical priority, and there is an increasing need to fully define the optimal oncologic management of patients with varying stages of lung cancer, allowing prioritization of which thoracic procedures should...

( Br J Anaesth . 2020;125:e360–e361) A recent paper by Sanilipo et al, studied simulated airway management while wearing personal protective equipment. There is a need to study this issue, as personal protective equipment (PPE) can cause discomfort and potentially make airway management more challenging. PPE may do this by impairing vision, limitin...

Aspiration of gastric contents during induction of general anesthesia remains a significant cause of mortality and morbidity in anesthesia. Recent data show that pulmonary aspiration still accounts for many cases with implications on mortality despite technical and technological evolution. Practical, ethical, and methodological issues prevent high-...

In Reply We agree with Drs Bloomstone and Eckhardt that operator skill may play a major role in the success of tracheal intubation and in patient outcomes peri-intubation. In our large international cohort,¹ the first attempt at tracheal intubation was performed by a resident physician in 52% of cases. Fifty-four percent of these residents were tra...

IMPORTANCE Tracheal intubation is one of the most commonly performed and high-risk interventions in critically ill patients. Limited information is available on adverse peri-intubation events. OBJECTIVE To evaluate the incidence and nature of adverse peri-intubation events and to assess current practice of intubation in critically ill patients. DES...

Massive hematemesis could be challenging situation requiring emergency airway control and urgent surgical treatment. We report a case of difficult airway management with blind intubation through Laryngeal Mask Airway in a 56-year-old patient with massive hematemesis. After failed endoscopic attempts to stop bleeding, worsening of hemodynamics calle...

Importance: Tracheal intubation is one of the most commonly performed and high-risk interventions in critically ill patients. Limited information is available on adverse peri-intubation events. Objective: To evaluate the incidence and nature of adverse peri-intubation events and to assess current practice of intubation in critically ill patients. D...

Abstract Background Coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented pressure on healthcare system globally. Lack of high-quality evidence on the respiratory management of COVID-19-related acute respiratory failure (C-ARF) has resulted in wide variation in clinical practice. Methods Using a Delphi process, an international pane...

Faced with limited time, severely constrained resources and a lack of manpower in the face of the overwhelming numbers in Xerxes’ invading Persian Army, the Greeks strategised to halt their foe using two natural barriers which restricted movement: the Straits of Atremisium, and the narrow pass at Thermopylae. King Leonidas of Sparta led 7 000 mettl...

Background: Supraglottic airway Devices (SADs) are precious tools for airway management in both routine and rescue situations; few studies have analysed the risk factors for their difficult insertion. Methods: The aim of this study was to identify the risk factors for difficult insertion for a specific SAD, the Laryngeal Mask Airway LMA-Supreme™...

Abstract Background: Coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented pressure on healthcare system globally. Lack of high-quality evidence on the respiratory management of COVID-19-related acute respiratory failure (C-ARF) has resulted in wide variation in clinical practice. Methods: Using a Delphi process, an international p...

A novel coronavirus was identified in late 2019 as the cause of COVID-19 disease which is highly contagious. SARS-CoV2 is a single-stranded RNA, enveloped virus from the beta Coronavirus family. Intraoperative management of patients with COVID-19 is a high-risk procedure. An international attention has raised to develop recommendations for the mana...

Management of the airway is an important and challenging aspect of many clinicians' work and is a source of complications and litigation. The new edition of this popular book remains a clear, practical and highly-illustrated guide to all necessary aspects of airway management. The book has been updated throughout, to cover all changes to best pract...

Management of the airway is an important and challenging aspect of many clinicians' work and is a source of complications and litigation. The new edition of this popular book remains a clear, practical and highly-illustrated guide to all necessary aspects of airway management. The book has been updated throughout, to cover all changes to best pract...

Multiple professional groups and societies worldwide have produced airway management guidelines. These are typically targeted at the process of tracheal intubation by a particular provider group in a restricted category of patients and reflect practice preferences in a particular geographical region. The existence of multiple distinct guidelines fo...