Luca Barbano

Comparison of Three Devices Preventing Skin Damage During Facial Mask Ventilation in Acute Respiratory Failure: Multicenter Randomized Controlled Trial Protocol (3PROSNIVtrial)

Raffaele Scala, Federica Andolfi, Giulia Ottaviano, Teresa Renda et autres

In patients with acute respiratory failure (ARF) undergoing noninvasive ventilation (NIV), pressure-related skin injury is among the most frequent and clinically relevant complications. The reported prevalence of device-related pressure injuries is estimated at around 25%, while reported incidences of NIV-related facial pressure …

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Effect of nocturnal EPAP titration to abolish tidal expiratory flow limitation in COPD patients with chronic hypercapnia: a randomized, cross-over pilot study

Emanuela Zannin, Ilaria Milesi, Roberto Porta, Simona Cacciatore et autres

Abstract Background Tidal expiratory flow limitation (EFLT) promotes intrinsic PEEP (PEEPi) in patients with chronic obstructive pulmonary disease (COPD). Applying non-invasive ventilation (NIV) with an expiratory positive airway pressure (EPAP) matching PEEPi improves gas exchange, reduces work of breathing and ineffective efforts. …

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Automatic tailoring of the lowest PEEP to abolish tidal expiratory flow limitation in seated and supine COPD patients

Ilaria Milesi, Roberto Porta, Luca Barbano, Simona Cacciatore et autres

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Effects of nocturnal Non-Invasive Ventilation (NIV) with automatic tailoring of Positive End Expiratory Pressure (PEEP) on gas exchange and patient-ventilator interaction in COPD (Chronic Obstructive Pulmonary Disease)

Ilaria Milesi, Roberto Porta, Michele Vitacca, Simona Cacciatore et autres

Tidal Expiratory Flow Limitation (EFLT) promotes intrinsic PEEP (PEEPi) which increases work of breathing and patient-ventilator interaction. The application of an external PEEP adjusted to counterbalance PEEPi improves these variables. Forced oscillation technique can monitor EFLT by measuring within-breath changes in reactance …

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Overnight monitoring of lung mechanics and Tidal expiratory flow limitation (EFLT) by Forced Oscillation Technique (FOT) in Chronic Obstructive Pulmonary Disease (COPD) receiving non-invasive ventilation (NIV): the impact of sleep and posture

Ilaria Milesi, Roberto Porta, Michele Vitacca, Simona Cacciatore et autres

Tidal expiratory flow limitation (EFLT) promotes Intrinsic PEEP (PEEPi) which has detrimental effects on respiratory mechanics. FOT can monitor EFLT by measuring within-breath changes in reactance at 5Hz (ΔXRS) (Dellacà et al ERJ 2004), a breath is considered as EFL if ΔXRS …

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Prevalence and variability of use of home mechanical ventilators, positive airway pressure and oxygen devices in the Lombardy region, Italy

Michele Vitacca, Luca Barbano, Daniele Colombo, Olivia Leoni et autres

Few studies have analyzed the prevalence and accessibility of home mechanical ventilation (HMV) in Italy. We aimed to investigate the prevalence and prescription variability of HMV as well as of long-term oxygen therapy (LTOT) and continuous positive airway pressure (CPAP), in the …

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Effects of automatic tailoring of Positive End Expiratory Pressure (PEEP) by Forced Oscillation Technique (FOT) during nocturnal Non-Invasive Ventilation (NIV) in Chronic Obstructive Pulmonary Disease (COPD)

Ilaria Milesi, Roberto Porta, Simona Cacciatore, Michele Vitacca et autres

Tidal expiratory flow limitation (EFLT) promotes Intrinsic PEEP (PEEPi). Applying an external PEEP matching PEEPi reduces WoB and patient-ventilator asynchronies. FOT can monitor EFLT by measuring within-breath changes in reactance at 5Hz (ΔXRS ) (Dellacà et al ERJ 2004). FOT has been …

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Effects of posture on tidal Expiratory Flow Limitation (EFLT) and on minimum PEEP(Positive End Expiratory Pressure) able to abolish it in Chronic Obstructive Pulmonary Disease (COPD) patients

Ilaria Milesi, Raffaele L. Dellacá, Simona Cacciatore, Luca Barbano et autres

Supine position may promote EFLT in COPD leading to intrinsic PEEP. The application of PEEP during NIV is used to counterbalance its effects. Forced oscillation technique (FOT) allows a real-time automatic optimization of PEEP (APEEP) by adjusting it continuously to abolish EFLT …

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A case of obstructive sleep apnea syndrome associated with floppy eyelid syndrome: positive effect of CPAP therapy

Roberto Porta, Laura Comini, Luca Barbano, Luca Bianchi et autres

The obstructive sleep apnoea syndrome (OSAS) may be associated with several eyes disorders, among which the most common is the floppy eyelid syndrome (FES). We intended to highlight the association between OSAS and FES and evaluate the effect of FES treatment with …

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End-of-Life Discussion, Patient Understanding and Determinants of Preferences in Very Severe COPD Patients: A Multicentric Study

Annalisa Carlucci, Michele Vitacca, Alberto Malovini, Paola Pierucci et autres

Discussion about patients' end-of-life (E-o-L) preferences should be part of the routine practice. Using a semi-structured interview with a scenario-based decision, we performed a prospective multicentre study to elicit the patients' E-o-L preferences in very severe chronic obstructive pulmonary disease (COPD). We …

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Home mechanical ventilation patients: a retrospective survey to identify level of burden in real life

Michele Vitacca, Joan Escarrabill, G. Galavotti, Andrea Vianello et autres

BACKGROUND AND AIM: Home care for patients under home mechanical ventilation (HMV) may cause dramatic physical and economic burden in addition to the burden of time on family/caregivers and health care service (HCS) with difficult resource allocation decision-making. Our aims were: 1. …

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Does 6-Month Home Caregiver-Supervised Physiotherapy Improve Post-Critical Care Outcomes?

Michele Vitacca, Luca Barbano, Fabio Vanoglio, Alberto Luisa et autres

OBJECTIVE: This study aims to determine whether a 6-month home physiotherapy program can improve outcomes in critical care survivors. DESIGN: Forty-eight consecutive patients were randomized. The treatment group underwent 2 sessions/day of breathing retraining and bronchial hygiene, physical activity (mobilization, sit-to-stand gait, …

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