Affiliation: San Raffaele Scientific Institute
- Landoni G, Guarracino F, Cariello C, Franco A, Baldassarri R, Borghi G, et al. Volatile compared with total intravenous anaesthesia in patients undergoing high-risk cardiac surgery: a randomized multicentre study. Br J Anaesth. 2014;113:955-63 pubmed publisher..ClinicalTrials.gov: identifier NCT00821262. Eudra CT (2008-001752-43). ..
- Landoni G, Pasin L, Borghi G, Zangrillo A. Is time to change to halogenated drugs in cardiac surgery, what do we have to do with propofol?. Curr Pharm Des. 2014;20:5497-505 pubmed
- Landoni G, Bignami E, Oliviero F, Zangrillo A. Halogenated anaesthetics and cardiac protection in cardiac and non-cardiac anaesthesia. Ann Card Anaesth. 2009;12:4-9 pubmed..Nonetheless, evidence in non-coronary surgical settings is contradictory and will be reviewed in this paper together with the mechanisms of cardiac protection by volatile agents. ..
- Renda F, Landoni G, Trotta F, Piras D, Finco G, Felicetti P, et al. Kounis Syndrome: An analysis of spontaneous reports from international pharmacovigilance database. Int J Cardiol. 2016;203:217-20 pubmed publisher..We collected pharmacovigilance international data representing the largest case series ever published on the recently identified Kounis Syndrome. ..
- Belletti A, Castro M, Silvetti S, Greco T, Biondi Zoccai G, Pasin L, et al. The Effect of inotropes and vasopressors on mortality: a meta-analysis of randomized clinical trials. Br J Anaesth. 2015;115:656-75 pubmed publisher..Our systematic review found that inotrope/vasopressor therapy is not associated with differences in mortality in the overall population and in the majority of subsettings. ..
- Zangrillo A, Putzu A, Monaco F, Oriani A, Frau G, De Luca M, et al. Levosimendan reduces mortality in patients with severe sepsis and septic shock: A meta-analysis of randomized trials. J Crit Care. 2015;30:908-13 pubmed publisher..A large ongoing multicenter randomized trial will have to confirm these findings. ..
- Landoni G, Zambon M, Zangrillo A. Reducing perioperative myocardial infarction with anesthetic drugs and techniques. Curr Drug Targets. 2009;10:858-62 pubmed..Minor (epidural analgesia, statins, calcium antagonists and alpha(2) agonists) or doubtful (beta-blockers) results were found in non-cardiac surgery. ..
- Landoni G, Mizzi A, Biondi Zoccai G, Bignami E, Prati P, Ajello V, et al. Levosimendan reduces mortality in critically ill patients. A meta-analysis of randomized controlled studies. Minerva Anestesiol. 2010;76:276-86 pubmed..106/1093 [9.7%] in the control arm P=0.02). Levosimendan has cardioprotective effects that could result in a reduced mortality in critically ill patients. A large randomized controlled study is warranted in this setting. ..
- Silvetti S, Silvani P, Azzolini M, Dossi R, Landoni G, Zangrillo A. A systematic review on levosimendan in paediatric patients. Curr Vasc Pharmacol. 2015;13:128-33 pubmed..Side effects (e.g. hypotension) were reported. This inodilator merits to be investigated with further randomized trials focusing on clinically relevant outcomes. ..
- Landoni G, Zangrillo A, Fochi O, Maj G, Scandroglio A, Morelli A, et al. Cardiac protection with volatile anesthetics in stenting procedures. J Cardiothorac Vasc Anesth. 2008;22:543-7 pubmed publisher..73) ng/mL, and the placebo group, 0.14 (0-0.87) ng/mL (p = 0.4). Myocardial damage measured by cardiac troponin release was not reduced by the volatile anesthetic sevoflurane during interventional cardiology procedures in this study. ..
- Greco T, CalabrÃ² M, Covello R, Greco M, Pasin L, Morelli A, et al. A Bayesian network meta-analysis on the effect of inodilatory agents on mortality. Br J Anaesth. 2015;114:746-56 pubmed publisher..The sensitivity analyses performed did not produce different interpretative result. Levosimendan seems to be the most efficacious inodilator to improve survival in cardiac surgery. ..
- Renda F, Landoni G, Bertini Malgarini R, Assisi A, Azzolini M, Mucchetti M, et al. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): A National Analysis of Data from 10-Year Post-marketing Surveillance. Drug Saf. 2015;38:1211-8 pubmed publisher..This might aid understanding of the aetiology of DRESS and facilitate diagnosis. ..
- Fominskiy E, Putzu A, Monaco F, Scandroglio A, Karaskov A, Galas F, et al. Liberal transfusion strategy improves survival in perioperative but not in critically ill patients. A meta-analysis of randomised trials. Br J Anaesth. 2015;115:511-9 pubmed publisher..10; 95% CI 0.99‒1.23; P=0.07; I(2)=34%) with 3469 patients randomized in 10 trials. According to randomized published evidence, perioperative adult patients have an improved survival when receiving a liberal blood transfusion strategy. ..
- Landoni G, Fochi O, Torri G. Cardiac protection by volatile anaesthetics: a review. Curr Vasc Pharmacol. 2008;6:108-11 pubmed..Whether these cardioprotective properties also exist in non-coronary surgery settings is still controversial owing to the scarce available data. ..
- Sardo S, Osawa E, Finco G, Gomes Galas F, de Almeida J, Cutuli S, et al. Nitric Oxide in Cardiac Surgery: A Meta-Analysis of Randomized Controlled Trials. J Cardiothorac Vasc Anesth. 2018;: pubmed publisher..Large, randomized trials are needed to further assess its effect on major clinical outcomes and its cost-effectiveness. ..
- Olper L, Bignami E, Di Prima A, Albini S, Nascimbene S, Cabrini L, et al. Continuous Positive Airway Pressure Versus Oxygen Therapy in the Cardiac Surgical Ward: A Randomized Trial. J Cardiothorac Vasc Anesth. 2017;31:115-121 pubmed publisher..This was the first study that was performed in the main ward of post-surgical patients with acute respiratory failure. ..
- Nigro Neto C, Landoni G, Tardelli M. A Novel Anti-Pollution Filter for Volatile Agents During Cardiopulmonary Bypass: Preliminary Tests. J Cardiothorac Vasc Anesth. 2017;31:1218-1222 pubmed publisher..The prototype filter was considered suitable to absorb the sevoflurane, and it did not cause an overpressure to the membrane oxygenator during the test. ..
- Baiardo Redaelli M, Landoni G, Di Sanzo S, Frassoni S, Sartini C, Cabrini L, et al. Interventions affecting mortality in critically ill and perioperative patients: A systematic review of contemporary trials. J Crit Care. 2017;41:107-111 pubmed publisher..005) and NNH (p=0.02), and harm was only detected in studies from Western countries (p=0.007). These observations imply that major systematic biases exist and affect trial findings irrespective of the intervention being studied. ..
- Pieri M, Belletti A, Oriani A, Landoni G, Latib A, Mangieri A, et al. Anesthetic Management of Cardioband Implantation: Data From a Preliminary Experience and New Insights. J Cardiothorac Vasc Anesth. 2017;31:482-488 pubmed publisher..Cardioband device implantation under general anesthesia is a feasible approach when performed by skilled physicians with all the expertise and the resources of high-volume centers used to dealing with severely ill patients. ..
- Putzu A, Capelli B, Belletti A, Cassina T, Ferrari E, Gallo M, et al. Perioperative statin therapy in cardiac surgery: a meta-analysis of randomized controlled trials. Crit Care. 2016;20:395 pubmed..Future RCTs should further evaluate the safety profile of this therapy in relation to patients' outcomes and assess the more appropriate time point for discontinuation of statins before cardiac surgery. ..
- Pisano A, Landoni G, Lomivorotov V, Comis M, Gazivoda G, Conte M, et al. Worldwide Opinion on Multicenter Randomized Interventions Showing Mortality Reduction in Critically Ill Patients: A Democracy-Based Medicine Approach. J Cardiothorac Vasc Anesth. 2016;30:1386-95 pubmed publisher..The role of these interventions in affecting survival should be further investigated to reduce both the gap between evidence and clinical practice and transnational differences. ..
- Pieri M, Landoni G, Cabrini L. Noninvasive Ventilation During Endoscopic Procedures: Rationale, Clinical Use, and Devices. J Cardiothorac Vasc Anesth. 2018;32:928-934 pubmed publisher..These approaches might be further expanded in the future and possibly reduce costs, organizational requirements, and complications compared using standard management with general anesthesia. ..
- Landoni G, Pisano A, Lomivorotov V, Alvaro G, Hajjar L, Paternoster G, et al. Randomized Evidence for Reduction of Perioperative Mortality: An Updated Consensus Process. J Cardiothorac Vasc Anesth. 2017;31:719-730 pubmed publisher..Such interventions may be optimal candidates for investigation in high-quality trials and discussion in international guidelines to reduce perioperative mortality. ..
- Renda F, Marotta E, Landoni G, Belletti A, Cuconato V, Pani L. Kounis syndrome due to antibiotics: A global overview from pharmacovigilance databases. Int J Cardiol. 2016;224:406-411 pubmed publisher..Since the number of cases is low, especially considering its wide use, further analyses are needed to confirm the association. ..
- Landoni G, Pasin L, Cabrini L, Scandroglio A, Baiardo Redaelli M, Votta C, et al. Volatile Agents in Medical and Surgical Intensive Care Units: A Meta-Analysis of Randomized Clinical Trials. J Cardiothorac Vasc Anesth. 2016;30:1005-14 pubmed publisher..In this meta-analysis of randomized trials, volatile anesthetics reduced time to extubation in medical and surgical ICU patients. The results of this study should be confirmed by large and high-quality randomized controlled studies. ..
- Martino E, Winterton D, Nardelli P, Pasin L, CalabrÃ² M, Bove T, et al. The Blue Coma: The Role of Methylene Blue in Unexplained Coma After Cardiac Surgery. J Cardiothorac Vasc Anesth. 2016;30:423-7 pubmed publisher..Patients undergoing chronic SSRI therapy should not be administered methylene blue to treat vasoplegic syndrome. ..
- Landoni G, Isella F, Greco M, Zangrillo A, Royse C. Benefits and risks of epidural analgesia in cardiac surgery. Br J Anaesth. 2015;115:25-32 pubmed publisher..The use of epidural analgesia in cardiac surgery is associated with a reduction in mortality (NNT=70), and with an estimated risk of epidural haematoma of 1:3552. ..
- Likhvantsev V, Landoni G, Levikov D, Grebenchikov O, Skripkin Y, Cherpakov R. Sevoflurane Versus Total Intravenous Anesthesia for Isolated Coronary Artery Bypass Surgery With Cardiopulmonary Bypass: A Randomized Trial. J Cardiothorac Vasc Anesth. 2016;30:1221-7 pubmed publisher..8%, p = 0.03). Anesthesia with sevoflurane reduced cardiac biomarker release and length of hospital stay after CABG with cardiopulmonary bypass surgery compared with propofol-based TIVA with a possible reduction in 1-year mortality. ..
- Zangrillo A, Alvaro G, Pisano A, Guarracino F, Lobreglio R, Bradic N, et al. A randomized controlled trial of levosimendan to reduce mortality in high-risk cardiac surgery patients (CHEETAH): Rationale and design. Am Heart J. 2016;177:66-73 pubmed publisher..The results of this double-blind, placebo-controlled randomized trial may provide important insights into the management of low cardiac output in cardiac surgery. ..
- Zangrillo A, Pappalardo F, Dossi R, Di Prima A, Sassone M, Greco T, et al. Preoperative intra-aortic balloon pump to reduce mortality in coronary artery bypass graft: a meta-analysis of randomized controlled trials. Crit Care. 2015;19:10 pubmed publisher..Preoperative intra-aortic balloon pump reduces perioperative and 30-day mortality in high-risk patients undergoing elective coronary artery bypass grafting. ..
- Campanelli F, Landoni G, Cabrini L, Zangrillo A. Gender differences in septic intensive care unit patients. Minerva Anestesiol. 2018;84:504-508 pubmed publisher..Further studies are required to explain the reasons, to evaluate if a difference is present in survival rate, and to identify gender-tailored preventive measures and treatments. ..
- Landoni G, Lomivorotov V, Silvetti S, Nigro Neto C, Pisano A, Alvaro G, et al. Nonsurgical Strategies to Reduce Mortality in Patients Undergoing Cardiac Surgery: An Updated Consensus Process. J Cardiothorac Vasc Anesth. 2018;32:225-235 pubmed publisher..This list of interventions may help cardiac anesthesiologists and intensivists worldwide in their daily clinical practice and can contribute to direct future research in the field. ..
- Likhvantsev V, Landoni G, Grebenchikov O, Skripkin Y, Zabelina T, Zinovkina L, et al. Nuclear DNA as Predictor of Acute Kidney Injury in Patients Undergoing Coronary Artery Bypass Graft: A Pilot Study. J Cardiothorac Vasc Anesth. 2017;31:2080-2085 pubmed publisher..The authors found an increase of nuclear DNA in the plasma of patients who had undergone coronary artery bypass grafting, with a peak after 12 hours and an association of nuclear DNA with postoperative acute kidney injury. ..
- Putzu A, Belletti A, Cassina T, Clivio S, Monti G, Zangrillo A, et al. Vitamin D and outcomes in adult critically ill patients. A systematic review and meta-analysis of randomized trials. J Crit Care. 2017;38:109-114 pubmed publisher..In critically ill patients, vitamin D administration might be associated with a reduction in mortality without significant adverse events. A large multicenter randomized trial should conclusively confirm these findings. ..
- Pieri M, Belletti A, Monaco F, Pisano A, Musu M, Dalessandro V, et al. Outcome of cardiac surgery in patients with low preoperative ejection fraction. BMC Anesthesiol. 2016;16:97 pubmed..Accurate selection of patients, risk/benefit evaluation, and planning of surgical and anesthesiological management are mandatory to improve outcome. ..
- Belletti A, Benedetto U, Biondi Zoccai G, Leggieri C, Silvani P, Angelini G, et al. The effect of vasoactive drugs on mortality in patients with severe sepsis and septic shock. A network meta-analysis of randomized trials. J Crit Care. 2017;37:91-98 pubmed publisher..Among several regimens for pharmacological cardiovascular support in septic patients, regimens based on inodilators have the highest probability of improve survival. ..
- Landoni G, Biondi Zoccai G, Tumlin J, Bove T, De Luca M, Calabrò M, et al. Beneficial impact of fenoldopam in critically ill patients with or at risk for acute renal failure: a meta-analysis of randomized clinical trials. Am J Kidney Dis. 2007;49:56-68 pubmed..This analysis suggests that fenoldopam reduces the need for renal replacement and mortality in patients with acute kidney injury. A large, multicenter, appropriately powered trial will need to be performed to confirm these results. ..
- Landoni G, Ruggeri L, Zangrillo A. Magic bullets in cardiac anesthesia and intensive care. J Cardiothorac Vasc Anesth. 2012;26:455-8 pubmed publisher..Caring for critical patients involves making decisions based on realistic tradeoffs of clinical benefit and side effects, but too often these choices are made on the basis of extrapolations and educated guesses. ..
- Landoni G, Mizzi A, Biondi Zoccai G, Bruno G, Bignami E, Corno L, et al. Reducing mortality in cardiac surgery with levosimendan: a meta-analysis of randomized controlled trials. J Cardiothorac Vasc Anesth. 2010;24:51-7 pubmed publisher..Levosimendan has cardioprotective effects that could result in a reduced postoperative mortality. A large randomized controlled study is warranted in this setting. ..
- Landoni G, Biondi Zoccai G, Marino G, Bove T, Fochi O, Maj G, et al. Fenoldopam reduces the need for renal replacement therapy and in-hospital death in cardiovascular surgery: a meta-analysis. J Cardiothorac Vasc Anesth. 2008;22:27-33 pubmed publisher..This meta-analysis provides evidence that fenoldopam may confer significant benefits in preventing renal replacement therapy and reducing mortality in patients undergoing cardiovascular surgery. ..