Cardiovascular research

Intensive Care and Anesthesia

Head

Alberto Zangrillo

The Anesthesia and Intensive Care Unit of IRCCS Ospedale San Raffaele in Milan is leader in Italy and worldwide for the treatment of critically ill patients. We deliver the safest, most effective, evidence-based care to critically ill patients requiring attention for decompensated heart failure, cardiothoracic surgery, multiple organ failure, acute respiratory failure, sepsis, resuscitation of in-hospital and out-of-hospital cardiac arrest, major trauma and organ donation.

Our group is staffed by a multidisciplinary team of clinicians, nurses, biostatisticians, bioengineer and support staff working together to deliver the best care to our patients. Our Unit has a well-established and recognized national and international reputation for its clinical research activity attracting the smartest and most ambitious minds to our team by offering first-class education, research and innovation.

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Research activity

In our dedicated center in Milan we conduct cutting edge research to drive forward advances in anesthesia and critical care medicine. Our multidisciplinary and collaborative research group includes some of the most productive researchers sharing the same goal: reducing mortality in the intensive care unit and in the perioperative period towards better survival and outcomes.

We provide the latest evidences related to life-threatening acute and chronic conditions, from basic science to clinical trials and outcomes research. Our group is highly skilled and specialized in designing randomized clinical trials, observational studies and performing systematic reviews and meta-analysis. Many of these research projects are recognized nationally and internationally and include the study of advanced circulatory and ventilatory supports, treatment of acute cardiac failure, non-invasive ventilation, cardiac protection by halogenates, organ protection, treatment of sepsis, sedation, resuscitation and brain protection after cardiac arrest, and in-hospital and pre-hospital emergencies.

selected publications

Landoni G, Lomivorotov VV, Alvaro G, Lobreglio R, Pisano A, Guarracino F, Calabrò MG, Grigoryev EV, Likhvantsev VV, Salgado-Filho MF, Bianchi A, Pasyuga VV, Baiocchi M, Pappalardo F, Monaco F, Boboshko VA, Abubakirov MN, Amantea B, Lembo R, Brazzi L, Verniero L, Bertini P, Scandroglio AM, Bove T, Belletti A, Michienzi MG, Shukevich DL, Zabelina TS, Bellomo R, Zangrillo A; CHEETAH Study Group. Levosimendan for Hemodynamic Support after Cardiac Surgery. N Engl J Med. 2017 May 25;376(21):2021-2031.

Graham MM, Sessler DI, Parlow JL, Biccard BM, Guyatt G, Leslie K, Chan MTV, Meyhoff CS, Xavier D, Sigamani A, Kumar PA, Mrkobrada M, Cook DJ, Tandon V, Alvarez-Garcia J, Villar JC, Painter TW15, Landoni G, Fleischmann E, Lamy A, Whitlock R, Le Manach Y, Aphang-Lam M, Cata JP, Gao P, Terblanche NCS, Ramana PV, Jamieson KA, Bessissow A, Mendoza GR, Ramirez S2, Diemunsch PA2, Yusuf S, Devereaux P. Aspirin in Patients With Previous Percutaneous Coronary Intervention Undergoing Noncardiac Surgery. Ann Intern Med. 2018 Feb 20;168(4):237-244.

Bove T, Zangrillo A, Guarracino F, Alvaro G, Persi B, Maglioni E, Galdieri N, Comis M, Caramelli F, Pasero DC, Pala G, Renzini M, Conte M, Paternoster G, Martinez B, Pinelli F, Frontini M, Zucchetti MC, Pappalardo F, Amantea B, Camata A, Pisano A, Verdecchia C, Dal Checco E, Cariello C, Faita L, Baldassarri R, Scandroglio AM, Saleh O, Lembo R, Calabrò MG, Bellomo R, Landoni G. Effect of fenoldopam on use of renal replacement therapy among patients with acute kidney injury after cardiac surgery: a randomized clinical trial. JAMA. 2014 Dec 3;312(21):2244-53.

Crescenti A, Borghi G, Bignami E, Bertarelli G, Landoni G, Casiraghi GM, Briganti A, Montorsi F, Rigatti P, Zangrillo A. Intraoperative use of tranexamic acid to reduce transfusion rate in patients undergoing radical retropubic prostatectomy: double blind, randomised, placebo controlled trial. BMJ. 2011 Oct 19;343:d5701.

Bove T, Landoni G, Calabrò MG, Aletti G, Marino G, Cerchierini E, Crescenzi G, Zangrillo A. Renoprotective action of fenoldopam in high-risk patients undergoing cardiac surgery: a prospective, double-blind, randomized clinical trial. Circulation. 2005 Jun 21;111(24):3230-5.

Scandroglio AM, Bove T, Calabrò MG, Votta CD, Pappalardo F, Giacomello R, Landoni G, Zangrillo A. Extracorporeal membrane oxygenation to resuscitate a 14-year-old boy after 43min drowning. Med Intensiva. 2018 Nov;42(8):509-510.

Monaco F, Belletti A, Bove T, Landoni G, Zangrillo A. Extracorporeal Membrane Oxygenation: Beyond Cardiac Surgery and Intensive Care Unit: Unconventional Uses and Future Perspectives. J Cardiothorac Vasc Anesth. 2018 Aug;32(4):1955-1970.

Pappalardo F, Ajello S, Greco M, Celińska-Spodar M, De Bonis M, Zangrillo A, Montisci A. Contemporary applications of intra-aortic balloon counterpulsation for cardiogenic shock: a "real world" experience. J Thorac Dis. 2018 Apr;10(4):2125-2134.

Landoni G, Lomivorotov V, Silvetti S, Nigro Neto C, Pisano A, Alvaro G, Hajjar LA, Paternoster G, Riha H, Monaco F, Szekely A, Lembo R, Aslan NA, Affronti G, Likhvantsev V, Amarelli C, Fominskiy E, Baiardo Redaelli M, Putzu A, Baiocchi M, Ma J, Bono G, Camarda V, Covello RD, Di Tomasso N, Labonia M, Leggieri C, Lobreglio R, Monti G, Mura P, Scandroglio AM, Pasero D, Turi S, Roasio A, Votta CD, Saporito E, Riefolo C, Sartini C, Brazzi L, Bellomo R, Zangrillo A. Nonsurgical Strategies to Reduce Mortality in Patients Undergoing Cardiac Surgery: An Updated Consensus Process. J Cardiothorac Vasc Anesth. 2018 Feb;32(1):225-235.

Sartini C, Lomivorotov V, Pieri M, Delgado JCL, Baiardo Redaelli M, Hajjar L, Pisano A, Likhvantsev V, Fominskiy E, Bradic N, Cabrini L, Novikov M, Avancini D, Riha H, Lembo R, Gazivoda G, Paternoster G, Wang C, Tamà S, Alvaro G, Wang CY, Roasio A, Ruggeri L, Yong CY, Pasero D, Severi L, Pasin L, Mancino G, Mura P, Musu M, Spadaro S, Conte M, Lobreglio R, Silvetti S, Votta CD, Belletti A, Di Fraja D, Corradi F, Brusasco C, Saporito E, D'Amico A, Sardo S, Ortalda A, Riefolo C, Fabrizio M, Zangrillo A, Bellomo R, Landoni G. A Systematic Review and International Web-Based Survey of Randomized Controlled Trials in the Perioperative and Critical Care Setting: Interventions Reducing Mortality. J Cardiothorac Vasc Anesth. 2018 Nov 22. pii: S1053-0770(18)31044-9.

Sousa-Uva M, Head SJ, Milojevic M, Collet JP, Landoni G, Castella M, Dunning J, Gudbjartsson T, Linker NJ, Sandoval E, Thielmann M, Jeppsson A, Landmesser U. 2017 EACTS Guidelines on perioperative medication in adult cardiac surgery. Eur J Cardiothorac Surg. 2018 Jan 1;53(1):5-33.

Landoni, G., Lomivorotov, V. V., Nigro Neto, C., Monaco, F., Pasyuga, V. V., Bradic, N., … Zangrillo, A. Volatile Anesthetics versus Total Intravenous Anesthesia for Cardiac Surgery. New England Journal of Medicine, NEJMoa1816476, 2019

Myles PS, Smith JA, Forbes A, Silbert B, Jayarajah M, Painter T, Cooper DJ, Marasco S, McNeil J, Bussières JS, McGuinness S, Byrne K, Chan MT, Landoni G, Wallace S; ATACAS Investigators of the ANZCA Clinical Trials Network. Tranexamic Acid in Patients Undergoing Coronary-Artery Surgery. N Engl J Med. 2017 Jan 12;376(2):136-148. Erratum in: N Engl J Med. 2018 Feb 22;378(8):782.

Devereaux PJ, Mrkobrada M, Sessler DI, Leslie K, Alonso-Coello P, Kurz A, Villar JC, Sigamani A, Biccard BM, Meyhoff CS, Parlow JL, Guyatt G, Robinson A, Garg AX, Rodseth RN, Botto F, Lurati Buse G, Xavier D, Chan MT, Tiboni M, Cook D, Kumar PA, Forget P, Malaga G, Fleischmann E, Amir M, Eikelboom J, Mizera R, Torres D, Wang CY, VanHelder T, Paniagua P, Berwanger O, Srinathan S, Graham M, Pasin L, Le Manach Y, Gao P, Pogue J, Whitlock R, Lamy A, Kearon C, Baigent C, Chow C, Pettit S, Chrolavicius S, Yusuf S; POISE-2 Investigators. Aspirin in patients undergoing noncardiac surgery. N Engl J Med. 2014 Apr 17;370(16):1494-503Select item 24679061

Devereaux PJ, Sessler DI, Leslie K, Kurz A, Mrkobrada M, Alonso-Coello P, Villar JC, Sigamani A, Biccard BM, Meyhoff CS, Parlow JL, Guyatt G, Robinson A, Garg AX, Rodseth RN, Botto F, Lurati Buse G, Xavier D, Chan MT, Tiboni M, Cook D, Kumar PA, Forget P, Malaga G, Fleischmann E, Amir M, Eikelboom J, Mizera R, Torres D, Wang CY, Vanhelder T, Paniagua P, Berwanger O, Srinathan S, Graham M, Pasin L, Le Manach Y, Gao P, Pogue J, Whitlock R, Lamy A, Kearon C, Chow C, Pettit S, Chrolavicius S, Yusuf S; POISE-2 Investigators. Clonidine in patients undergoing noncardiac surgery. N Engl J Med. 2014 Apr 17;370(16):1504-13.