Impact of the Organizational Model Adopted during the COVID-19 Pandemic on the Perceived Safety of Intensive Care Unit Staff

Conoscenti, Elena; Campanella, Maria; Sala, Antonino; Stefano, María Cristina Di; Vinci, Dario; Lombardo, R.; Arena, Giuseppe; Ginestra, Angelo; Fiolo, Rosario; Tuzzolino, Fabio; Ippolito, Alessia; Enea, Giuseppe; Luca, Angelo

doi:10.3390/jcm11061487

Cited by 7 publications

(9 citation statements)

References 18 publications

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“…Differently from typical ARDS, in COVID-19, the lung compliance system does not deteriorate rapidly, but gas-exchange impairment and hypoxia predominantly occur due to micro-thrombosis, dead space, and low V/Q lung regions. Associated thrombi can result as expressions of an altered coagulation cascade, which is common in COVID-19 [3]. Severe COVID-19 pneumonia shares several histological and imaging features with non-COVID-19 ARDS since both are characterized by inflammatory lung injury, progressive parenchymal stiffening and consolidation, alveolar and airway collapse, altered vascular permeability, and a pathological picture of diffuse alveolar damage [4].…”

Section: Covid-19 Ards and Treatment By Surfactant Administrationmentioning

confidence: 99%

“…Coronavirus disease 2019 (COVID- 19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was declared a pandemic by the World Health Organization (WHO) on 11 March 2020 [1][2][3]. As of 27 May 2022, there have been 524,878,064 confirmed cases of COVID-19, including 6,283,119 deaths, reported to the WHO [1].…”

Section: Introductionmentioning

confidence: 99%

“…As of 27 May 2022, there have been 524,878,064 confirmed cases of COVID-19, including 6,283,119 deaths, reported to the WHO [1]. COVID-19 causes both pneumonia and acute respiratory distress syndrome (ARDS) [3][4][5][6][7]. The SARS-CoV-2 virus uses the angiotensin-converting enzyme 2 (ACE2) receptor, in conjunction with serine protease TMPRSS2, expressed by alveolar type II (ATII) cells, as one of the SARS-CoV-2 target cells, to enter into the ATII pneumocytes [8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Severe COVID-19 ARDS Treated by Bronchoalveolar Lavage with Diluted Exogenous Pulmonary Surfactant as Salvage Therapy: In Pursuit of the Holy Grail?

Ruaro

Confalonieri

Pozzan

et al. 2022

JCM

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Background: Severe pneumonia caused by coronavirus disease 2019 (COVID-19) is characterized by inflammatory lung injury, progressive parenchymal stiffening and consolidation, alveolar and airway collapse, altered vascular permeability, diffuse alveolar damage, and surfactant deficiency. COVID-19 causes both pneumonia and acute respiratory distress syndrome (COVID-19 ARDS). COVID-19 ARDS is characterized by severe refractory hypoxemia and high mortality. Despite extensive research, the treatment of COVID-19 ARDS is far from satisfactory. Some treatments are recommended for exhibiting some clinically positive impacts on COVID-19 patients although there are already several drugs in clinical trials, some of which are already demonstrating promising results in addressing COVID-19. Few studies have demonstrated beneficial effects in non-COVID-19 ARDS treatment of exogenous surfactant, and there is no evidence-based, proven method for the procedure of surfactant administration. Aim: The aim of this work is to underline the key role of ATII cells and reduced surfactant levels in COVID-19 ARDS and to emphasize the rational basis for exogenous surfactant therapy in COVID-19 ARDS, providing insights for future research. Methods: In this article, we describe and support via the literature the decision to administer large volumes of surfactant to two patients via bronchoalveolar lavage to maximize its distribution in the respiratory tract. Results: In this study, we report on two cases of COVID-19 ARDS in patients who have been successfully treated with diluted surfactants by bronchoalveolar lavage, followed by a low-dose bolus of surfactant. Conclusion: Combining the administration of diluted, exogenous pulmonary surfactant via bronchoalveolar lavage along with the standard therapy for SARS-COV-2-induced ARDS may be a promising way of improving the management of ARDS.

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Section: Covid-19 Ards and Treatment By Surfactant Administrationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Severe COVID-19 ARDS Treated by Bronchoalveolar Lavage with Diluted Exogenous Pulmonary Surfactant as Salvage Therapy: In Pursuit of the Holy Grail?

Ruaro

Confalonieri

Pozzan

et al. 2022

JCM

View full text Add to dashboard Cite

show abstract

“…According to World Health Organization statistics, by June 2022 there were over 532 million confirmed cases of coronavirus disease 2019 (COVID-19) and more than 6 million confirmed deaths [ 1 ]. The health, social, and economic consequences of this pandemic on the population are enormous and have created a worldwide tragedy [ 2 ]. Even after two years, the global severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic does not wane and remains a huge medical challenge.…”

Section: Introductionmentioning

confidence: 99%

Elevated Transaminases as Predictors of COVID-19 Pneumonia Severity

et al. 2022

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Background: This study aimed to calculate the frequency of elevated liver enzymes in hospitalized patients with coronavirus disease 2019 (COVID-19) infection and to test if liver enzyme biochemistry levels on admission could predict the computed tomography (CT) scan severity score of bilateral interstitial pneumonia. Methods: This single-center study comprised of 323 patients including their demographic data, laboratory analyses, and radiological findings. All the information was taken from electronic health records, followed by statistical analysis. Results: Out of 323 patients, 115 of them (35.60%) had aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) over 40 U/L on admission. AST was the best predictor of CT scan severity score of bilateral interstitial pneumonia (R2 = 0.313, Adjusted R2 = 0.299). CT scan severity score in the peak of the infection could be predicted with the value of AST, neutrophils, platelets, and monocytes count (R2 = 0.535, Adjusted R2 = 0.495). Conclusion: AST, neutrophils, platelets, and monocytes count on admission can account for almost half (49.5%) of the variability in CT scan severity score at peak of the disease, predicting the extensiveness of interstitial pneumonia related to COVID-19 infection. Liver enzymes should be closely monitored in order to stratify COVID-19 patients with a higher risk of developing severe forms of the disease and to plan the beforehand step-up treatment.

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“…Due to the exposure risk, many routine procedures were burdened by an extraordinary rise in technical difficulties and safety issues. In their paper [ 1 ], Conoscenti et al explored the impact of an organizational model adopted during the pandemic on the perceived safety of the ICU staff. In the context of an Italian hospital with a COVID-19 dedicated intensive care unit, a bundle of organizational, technical, and structural interventions aimed at the protection of the staff was perceived as appropriate by more than 90% of the respondents.…”

mentioning

confidence: 99%