Giuliano Lo Bianco, Adnan Al-Kaisy, Silvia Natoli, Alaa Abd-Elsayed, Georgios Matis, Alfonso Papa, Leonardo Kapural, Peter Staats
{"title":"Neuromodulation in chronic pain management: addressing persistent doubts in spinal cord stimulation.","authors":"Giuliano Lo Bianco, Adnan Al-Kaisy, Silvia Natoli, Alaa Abd-Elsayed, Georgios Matis, Alfonso Papa, Leonardo Kapural, Peter Staats","doi":"10.1186/s44158-024-00219-6","DOIUrl":"https://doi.org/10.1186/s44158-024-00219-6","url":null,"abstract":"","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"5 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"One-year outcome and quality of life of patients with subarachnoid hemorrhage admitted to intensive care unit: a single-center retrospective pilot study.","authors":"Bergamini Carlo, Brogi Etrusca, Salvigni Sara, Romoli Michele, Bini Giovanni, Venditto Alessandra, Lafe Elvis, D'Andrea Marcello, Tosatto Luigino, Ruggiero Maria, Agnoletti Vanni, Russo Emanuele","doi":"10.1186/s44158-024-00223-w","DOIUrl":"10.1186/s44158-024-00223-w","url":null,"abstract":"<p><p>Patients admitted to intensive care unit (ICU) after non-traumatic subarachnoid hemorrhage (SAH) represent a group with distinctive characteristics and few data are available on long-term outcome in this population. We conducted a single-center retrospective study in an Italian intensive care unit. All patients with non-traumatic SAH (ICD-9-CM Diagnosis Code 430) admitted to ICU were included. Disability and quality of life were evaluated via telephone interview after 12-15 months after initial bleeding using GOSE and EuroQoL, respectively. Baseline and clinical course characteristics were analyzed to evaluate relation with poor outcome defined as GOSE ≤ 3. Final population consisted of 38 patients. Twenty-four patients (63.2%) had favorable outcome (GOSE ≥ 4). Among 29 patients (76.3%) who survived at 1 year, median EQ-5D Index was 0.743 (IQR 0.287), while median EQ-VAS was 74.79 (IQR 18.5). Median EQ-5D Index and median EQ-VAS were higher among patients with favorable outcome (EQ-5D Index p = 0.037, EQ-VAS p = 0.003). Among baseline characteristics, only HH scale showed a significant relation with disability at one year (p = 0.033). Between complications occurred during ICU-stay only early HICP was related with unfavorable outcome (p = 0.028). Higher HH scale and early HICP were related with unfavorable outcome. Among patients with unfavorable outcome, quality of life has a broad range of variability, and this result should be taken into account when reporting patient-centered outcomes.</p>","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"5 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ciltius, Altius, Fortius! Our Olympic games: simulation training for potential casualties massive influx during Paris 2024!","authors":"Myriam Lamamri, Raphaëlle David, Emmanuel Weiss, Mathilde Holleville","doi":"10.1186/s44158-024-00220-z","DOIUrl":"10.1186/s44158-024-00220-z","url":null,"abstract":"","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"5 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Manuel Alberto Guerrero-Gutiérrez, Rafael Alfonso Reyes-Monge, Ignacio Rodríguez-Guevara, Diego Escarramán-Martínez, Orlando Rubén Pérez-Nieto
{"title":"Analgosedation in patients with acute respiratory failure on noninvasive ventilation: is it truly safe?","authors":"Manuel Alberto Guerrero-Gutiérrez, Rafael Alfonso Reyes-Monge, Ignacio Rodríguez-Guevara, Diego Escarramán-Martínez, Orlando Rubén Pérez-Nieto","doi":"10.1186/s44158-024-00221-y","DOIUrl":"10.1186/s44158-024-00221-y","url":null,"abstract":"","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"4 1","pages":"84"},"PeriodicalIF":0.0,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tommaso Pettenuzzo, Honoria Ocagli, Nicolò Sella, Alessandro De Cassai, Francesco Zarantonello, Sabrina Congedi, Maria Vittoria Chiaruttini, Elisa Pistollato, Marco Nardelli, Martina Biscaro, Mara Bassi, Giordana Coniglio, Eleonora Faccioli, Federico Rea, Dario Gregori, Paolo Navalesi, Annalisa Boscolo
{"title":"Intraoperative extracorporeal support for lung transplant: a systematic review and network meta-analysis.","authors":"Tommaso Pettenuzzo, Honoria Ocagli, Nicolò Sella, Alessandro De Cassai, Francesco Zarantonello, Sabrina Congedi, Maria Vittoria Chiaruttini, Elisa Pistollato, Marco Nardelli, Martina Biscaro, Mara Bassi, Giordana Coniglio, Eleonora Faccioli, Federico Rea, Dario Gregori, Paolo Navalesi, Annalisa Boscolo","doi":"10.1186/s44158-024-00214-x","DOIUrl":"10.1186/s44158-024-00214-x","url":null,"abstract":"<p><strong>Background: </strong>In the last decades, veno-arterial extracorporeal membrane oxygenation (V-A ECMO) has been gaining in popularity for intraoperative support during lung transplant (LT), being advocated for routinely use also in uncomplicated cases. Compared to off-pump strategy and, secondarily, to traditional cardiopulmonary bypass (CPB), V-A ECMO seems to offer a better hemodynamic stability and oxygenation, while data regarding blood product transfusions, postoperative recovery, and mortality remain unclear. This systematic review and network meta-analysis aims to evaluate the comparative efficacy and safety of V-A ECMO and CPB as compared to OffPump strategy during LT.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across multiple databases (PubMed Embase, Cochrane, Scopus) and was updated in February 2024. A Bayesian network meta-analysis (NMA), with a fixed-effect approach, was performed to compare outcomes, such as intraoperative needing of blood products, invasive mechanical ventilation (IMV) duration, intensive care unit (ICU) length of stay (LOS), surgical duration, needing of postoperative ECMO, and mortality, across different supports (i.e., intraoperative V-A (default (d) or rescue (r)) ECMO, CPB, or OffPump).</p><p><strong>Findings: </strong>Twenty-seven observational studies (6113 patients) were included. As compared to OffPump surgery, V-A ECMOd, V-A ECMOr, and CPB recorded a higher consumption of all blood products, longer IMV durations, prolonged ICU LOS, surgical duration, and higher mortalities. Comparing different extracorporeal supports, V-A ECMOd and, secondarily, V-A ECMOr overperformed CPB in nearly all above mentioned outcomes, except for RBC transfusions. The lowest rate of postoperative ECMO was recorded after OffPump surgery, while no differences were found comparing different extracorporeal supports. Finally, older age, male gender, and body mass index ≥ 25 kg/m<sup>2</sup> negatively impacted on RBC transfusions, ICU LOS, surgical duration, need of postoperative ECMO, and mortality, regardless of the intraoperative extracorporeal support investigated.</p><p><strong>Interpretation: </strong>This comparative network meta-analysis highlights that OffPump overperformed ECMO and CPB in all outcomes of interest, while, comparing different extracorporeal supports, V-A ECMOd and, secondarily, V-A ECMOr overperformed CPB in nearly all above mentioned outcomes, except for RBC transfusions. Older age, male gender, and higher BMI negatively affect several outcomes across different intraoperative strategies, regardless of the intraoperative extracorporeal support investigated. Future prospective studies are necessary to optimize and standardize the intraoperative management of LT.</p>","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"4 1","pages":"81"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maurizio Marchesini, Giulia Topi, Cesare Bonezzi, Laura Demartini
{"title":"Amitriptyline-perphenazine therapy for persistent idiopathic facial pain: translational perspectives from a retrospective study.","authors":"Maurizio Marchesini, Giulia Topi, Cesare Bonezzi, Laura Demartini","doi":"10.1186/s44158-024-00217-8","DOIUrl":"10.1186/s44158-024-00217-8","url":null,"abstract":"<p><strong>Background: </strong>Persistent idiopathic facial pain (PIFP) can be challenging, both in its diagnosis, which appears to be purely exclusionary, and in its treatment, which currently lacks a gold standard. Amitriptyline is considered a first-line therapy, although not always effective. Recent insights into the role of dopamine in facial pain suggest that a novel therapeutic approach could target the dopamine system.</p><p><strong>Methods: </strong>This study aimed to retrospectively evaluate the efficacy of treatment with amitriptyline-perphenazine association in patients with severe PIFP. Thirty-one patients were given a regimen dose of amitriptyline-perphenazine at dosages ranging between 10/2 and 20/4 mg and were then retrospectively analyzed. We evaluated the following outcomes, referred to the last week prior to follow-up visits: NRS score for pain intensity (minimum, maximum, and average), the number of attacks, and SF-36 questionnaire for quality of life. Comparisons were made between pre- and post-treatment.</p><p><strong>Results: </strong>Thirty-one patients over 35 were screened. At baseline, average NRS was 5 ± 0.93 (CI 95%: 4.6-5.3), and the median number of breakthrough episodes over last week was 5 ± 1.57 (CI 95%: 4-6) with a maximum NRS = 9 ± 0.89 (CI 95%: 8-9). After treatment, average NRS was 4.1 ± 0.93 (CI 95%: 3.8-4.5; p < 0.001), maximum NRS was 6.1 ± 1.60 (CI 95%: 5.5-6.6), and the median number of attacks was 4 ± 0.99 (IC 95%: 3-4) (p < 0.001). Regarding SF-36 questionnaire, the most improved parameters were quality of life related to pain (25.89 ± 12.48 vs 31.19 ± 13.44; p < 0.001) and physical function (69.56 ± 17.84 vs 84.17 ± 20.99; p < 0.001).</p><p><strong>Conclusion: </strong>Despite limitations, the pain scores, the frequency of the attacks, and quality of life were found to be significantly improved after treatment. Although results are not broad based given the small sample size, the combination of amitriptyline and perphenazine may be an effective and well-tolerated treatment in patients with PIFP. It is abundantly clear that dopaminergic pathways play a key role in pain modulation, yet the underlying mechanisms have not been fully understood, requiring further investigation.</p>","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"4 1","pages":"83"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Samiullah Shaikh, Umm E Salma Shabbar Banatwala, Paranshi Desai, Muhammad Arham Khan, Rimsha Bint-E-Hina, Sidra Samad, Muhammad Hamza Sikandari, Ali Nawaz, Rana Ijaz, Shayan Asmat, Abeer Fatima, Harim Mirza, Noor Mahal Azam, Qurat Ul Ain Muhammad, Satesh Kumar, Mahima Khatri
{"title":"Analgesic efficacy and safety of erector spinae plane block versus serratus anterior plane block in breast surgery-a meta-analysis and systematic review of randomized controlled trials.","authors":"Samiullah Shaikh, Umm E Salma Shabbar Banatwala, Paranshi Desai, Muhammad Arham Khan, Rimsha Bint-E-Hina, Sidra Samad, Muhammad Hamza Sikandari, Ali Nawaz, Rana Ijaz, Shayan Asmat, Abeer Fatima, Harim Mirza, Noor Mahal Azam, Qurat Ul Ain Muhammad, Satesh Kumar, Mahima Khatri","doi":"10.1186/s44158-024-00218-7","DOIUrl":"10.1186/s44158-024-00218-7","url":null,"abstract":"<p><strong>Background: </strong>Mastectomy and breast-conserving surgery are key interventions for breast cancer, a leading cause of cancer-related mortality in women. Many undergoing breast surgery experience postoperative pain compromising their functionality and quality of life. While multiple pain management strategies are available, evidence comparing the erector spinae (ESPB) and serratus anterior plane blocks (SAPB) for improving post-surgical pain management in breast cancer surgery patients is limited. Therefore, we investigated the efficacy and safety of these two regional anesthesia techniques.</p><p><strong>Methods: </strong>After PROSPERO registration, we systematically searched PubMed, Google Scholar, and Cochrane Library until May 2024. Risk ratios (RR) were calculated for dichotomous outcomes and standard mean differences (SMD) or mean differences (MD) were computed for continuous data. RevMan Review Manager 5.4.1 was used for the data analysis and generation of forest plots as well as funnel plots. The Cochrane Risk of Bias tool 2.0 (18) and Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) guidelines were used to appraise and evaluate the evidence (19).</p><p><strong>Results: </strong>A total of 9 randomized control trials enrolling 550 patients were included. Static pain scores at 0, 6, 8, 12, and 24 h after surgery, dynamic pain scores computed at 0, 8, 12, and 24 h after surgery and area under the curve (AUC) static pain score at all time points between 0 and 24 h (SMD (HKSJ 95% CI) - 0.27 [- 0.99, 0.45]) did not significantly vary with either plane block. Postoperative morphine consumption in the first 24 h and the number of patients requesting analgesia were significantly greater in those receiving SAPB [MD: - 1.41 (95% C.I. - 2.70, - 0.13), p = 0.03] and [RR: 1.28 (95% C.I. 1.00, 1.63), p = 0.05], respectively. The time to first postoperative analgesic use was significantly greater among those administered ESPB [MD: 1.55 h, (95% C.I. 1.02, 2.09), p < 0.01]. Patient satisfaction scores and the incidence of nausea and vomiting were similar across both groups.</p><p><strong>Conclusions: </strong>While pain scores with either block are comparable, ESPB reduces postoperative morphine consumption and may be the favorable option in breast cancer patients undergoing surgery.</p>","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"4 1","pages":"82"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fabio Sbaraglia, Simona Gaudino, Eloisa Tiberi, Federica Maiellare, Giorgia Spinazzola, Rossella Garra, Filomena Della Sala, Daniela Maria Micci, Rosellina Russo, Francesca Riitano, Giuseppe Ferrara, Giovanni Vento, Marco Rossi
{"title":"Deep sedation in lateral position for preterm infants during cerebral magnetic resonance imaging: a pilot study.","authors":"Fabio Sbaraglia, Simona Gaudino, Eloisa Tiberi, Federica Maiellare, Giorgia Spinazzola, Rossella Garra, Filomena Della Sala, Daniela Maria Micci, Rosellina Russo, Francesca Riitano, Giuseppe Ferrara, Giovanni Vento, Marco Rossi","doi":"10.1186/s44158-024-00216-9","DOIUrl":"10.1186/s44158-024-00216-9","url":null,"abstract":"<p><strong>Introduction: </strong>Respiratory adverse events are common during the sedation of preterm babies, often needing active airway support. During magnetic resonance imaging, this occurrence could extend the acquisition time, with a negative impact on the thermic and metabolic homeostasis. The aim of the study is to verify if lying in a lateral position instead of supine could improve the safe quality of sedation, without worsening the quality of imaging.</p><p><strong>Methods: </strong>This study was performed as a single-center, prospective study at a university-affiliated tertiary care center. A consultant provided deep sedation with sevoflurane 3-4% delivered by an external mask, in the lateral decubitus position. All patients were evaluated for the incidence of apnea and desaturation, quality of imaging obtained, the timing of imaging acquisition, and thermic and metabolic homeostasis.</p><p><strong>Results: </strong>We enrolled 23 consecutive preterm babies born < 37 weeks gestational age, candidates for sedation for elective brain magnetic resonance imaging. All patients completed the radiological procedure in 30 min (SD ± 6.39 min) without complications requiring exam interruption. Only one patient (4%) experienced a transient desaturation, while 2 neonates (9%) showed apnea lasting > 20 s. On average, there was a 1 °C decrease in body temperature and full enteral feeding was resumed within 1.5 h. Neuroradiologists rated the quality of the images obtained as high.</p><p><strong>Conclusions: </strong>Lateral lying seems to be a viable option for sedated preterm babies during magnetic resonance imaging with a low risk of intervention for apnea and a reduced impact on thermic and metabolic homeostasis. Quality of imaging would be preserved maintaining correct scheduling of standard care.</p><p><strong>Trial registration: </strong>The study was registered at www.</p><p><strong>Clinicaltrials: </strong>gov before enrollment (NCT05776238 on December, 21th 2023).</p>","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"4 1","pages":"80"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elena Bignami, Michele Russo, Roberto Lanza, Valentina Bellini
{"title":"Navigating the integration of large language models in healthcare: challenges, opportunities, and implications under the EU AI Act.","authors":"Elena Bignami, Michele Russo, Roberto Lanza, Valentina Bellini","doi":"10.1186/s44158-024-00215-w","DOIUrl":"10.1186/s44158-024-00215-w","url":null,"abstract":"","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"4 1","pages":"79"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francesca Izzo, Rosanna I Comoretto, Angela Amigoni, Marco Daverio, Elena Zoia, Veronica Diotto, Francesco Sacco, Claudio Nettuno, Anna Tessari, Enzo Picconi, Maria Cristina Mondardini, Gaia Milvia Bregant, Andrea Wolfler, Dario Gregori, Anna Camporesi
{"title":"Severe bronchiolitis before and after the COVID-19 pandemic: a retrospective database analysis by the Italian Network of PICU study group (TIPNet).","authors":"Francesca Izzo, Rosanna I Comoretto, Angela Amigoni, Marco Daverio, Elena Zoia, Veronica Diotto, Francesco Sacco, Claudio Nettuno, Anna Tessari, Enzo Picconi, Maria Cristina Mondardini, Gaia Milvia Bregant, Andrea Wolfler, Dario Gregori, Anna Camporesi","doi":"10.1186/s44158-024-00210-1","DOIUrl":"10.1186/s44158-024-00210-1","url":null,"abstract":"<p><strong>Background: </strong>The first post-COVID-19 pandemic year demonstrated an unusual bronchiolitis epidemic in both hemispheres and has been attributed to the removal of barriers implemented during SARS-CoV-2 infection. Several countries reported an increase in respiratory syncytial virus (RSV) bronchiolitis, with more hospitalizations and a greater need for respiratory support. We aimed to evaluate the consequences of the COVID-19 pandemic on the epidemiology and management of severe bronchiolitis in pediatric intensive care units (PICUs) in Italy.</p><p><strong>Methods: </strong>Multicenter, retrospective, cohort database analysis. All children younger than 24 months admitted to 7 PICUs from October 2017 to April 2023 diagnosed with bronchiolitis were included. We compared patients from pre-COVID and post-COVID eras, excluding patients from the 2020-2021 season due to low numbers. Logistic regression models were used to assess the impact of the pre-/post-COVID period on the need for invasive ventilation.</p><p><strong>Results: </strong>Seven hundred fifteen patients were admitted to PICU during the study period, 451 patients pre-COVID and 251 patients post-COVID. Patients in the post-COVID group were older, had more comorbidities, and had higher Pediatric Index of Mortality scores at admission but the need for respiratory support was not significantly different. There was high variability in bronchiolitis management across centers. Presenting pre-COVID was protective against the risk of mechanical ventilation, adjusted for age and disease severity at admission (OR 0.38, 95% CI 0.16-0.89), while RSV infection increased the risk of intubation (OR 2.49, 95% CI 1.1-5.63).</p><p><strong>Conclusions: </strong>PICUs have faced an unexpected peak of significantly more severe cases of bronchiolitis after the COVID-19 pandemic, which did not require increased respiratory support.</p>","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"4 1","pages":"78"},"PeriodicalIF":0.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}