Azienda Ospedaliero Universitaria Careggi

Al fine di garantire un corretto accesso dei pazienti ai supporti extracorporei per le gravi

insufficienze d’organo è indispensabile un coordinamento con le altre realtà presenti sul

territorio nazionale, con necessità di coordinamento con:

• Centri ECMO della Rete Nazionale Respira
• Centro Trapianto Polmone e Cuore di Siena, per la destinazione finale dei pazienti suscettibili di trapianto
• CNT (Centro Nazionale Trapianti)
• OTT (Organizzazione Toscana Trapianti) per le attività di donazione a cuore fermo o a cuore battente con supporto extracorporeo

Richiesta di consulenza da parte del medico che ha in carico il paziente al medico di guardia della Terapia Intensiva di Emergenza e del Trauma (percorso respiratorio) o al medico di guardia UTIC (percorso cardiologico)

In caso di richieste di intervento per pazienti altamente instabili, ricoverati in terapie intensive di altri ospedali, per cui non è possibile il trasferimento in sicurezza con metodiche convenzionali, è possibile l’attivazione del team ECMO mobile dell’AOUC, con equipe specialistica ed ambulanza dedicata, al fine di impiantare l’ECMO nell’ospedale periferico e permettere il trasporto in sicurezza in corso di trattamento ECMO.

 L’ECMO Unit cura programmi di formazione interna per il personale delle aree ospedaliere dove vengono utilizzati i dispositivi ECMO e dove i pazienti vengono curati con questa metodica. Lo scopo di questi programmi formativi è garantire che ogni professionista abbia le competenze necessarie per gestire in modo sicuro il trattamento ECMO.

 L’ECMO unit si occupa di ricerca nelle aree di:

• ARDS (Acute Respiratory Distress Syndrome)
• Arresto cardiaco
• Donazione di organo con tecniche perfusione ECMO
• Tecniche ECMO

• Lazzeri C, Manuela B, Peris A. Out of hospital cardiac arrest and organ donation: the innovative approach for emergency physicians.Eur J Emerg Med. 2024 Feb 1;31(1):5-6.
• Lazzeri C, Bonizzoli M, Peris A. The decision-making process in out-of-hospital cardiac arrest: from complexity to opportunities. Eur J Emerg Med. 2023 Oct 1;30(5):307-308
• Peris A, Bulletti F, Lazzeri C, Bonizzoli M. Out of hospital extracorporeal cardiopulmonary resuscitation: The physiopathological rationale. Eur J Emerg Med. 2023 Oct 1;30(5):309-310.
• Lazzeri C, Manuela B, Peris A. Out of hospital cardiac arrest and organ donation: the innovative approach for emergency physicians. Eur J Emerg Med. 2023 Oct 6.
• Lazzeri C, Bonizzoli M, Batacchi S, Cianchi G, Franci A, Socci F, Chiostri M, Peris A. Echocardiography Before Extracorporeal Membrane Oxygenation in Refractory Respiratory Failure: SARS-CoV-2 Infection Versus Other Etiologies. J Cardiothorac Vasc Anesth. 2023 Jul;37(7):1208-1212
• Campi R, Pecoraro A, Sessa F, Vignolini G, Caroti L, Lazzeri C, Peris A, Serni S, Li Marzi V; University of Florence Kidney Transplantation Working Group. Outcomes of kidney transplantation from uncontrolled donors after circulatory death vs. expanded-criteria or standard-criteria donors after brain death at an Italian Academic Center: a prospective observational study. Minerva Urol Nephrol. 2023 Jun;75(3):329-342.
• Lazzeri C, Bonizzoli M, Peris A. Pre hospital interventions and organ donation in out of hospital cardiac arrest. Resuscitation. 2023 Dec;193:110002.
• Lazzeri C, Bonizzoli M, Batacchi S, Cianchi G, Chiostri M, Socci F, Peris A. Clinical Significance of Right Ventricle Echocardiographic Patterns in Critically-Ill COVID-Related Acute Respiratory Distress Syndrome “On Behalf of Protecting the Right Ventricle Network (PRORVnet)”. Angiology. 2023 Mar;74(3):268-272.
• Lazzeri C, Bonizzoli M, Batacchi S, Cianchi G, Franci A, Socci F, Chiostri M, Peris A. Right ventricle dysfunction does not predict mortality in patients with SARS-CoV-2-related acute respiratory distress syndrome on extracorporeal membrane oxygenation support. World J Cardiol. 2023 Apr 26;15(4):165-173.
• Melandro F, Basta G, Torri F, Biancofiore G, Del Turco S, Orlando F, Guarracino F, Maremmani P, Lazzeri C, Peris A, De Simone P, Ghinolfi D. Normothermic regional perfusion in liver transplantation from donation after cardiocirculatory death: Technical, biochemical, and regulatory aspects and review of literature. Artif Organs. 2022 Sep;46(9):1727-1740.
• Lazzeri C, Bonizzoli M, Batacchi S, Cianchi G, Franci N, Socci F, Peris A. Persistent Right Ventricle Dilatation in SARS-CoV-2-Related Acute Respiratory Distress Syndrome on Extracorporeal Membrane Oxygenation Support. J Cardiothorac Vasc Anesth. 2022 Jul;36(7):1956-1961.
• Voltolini L, Salvicchi A, Cianchi G, Bongiolatti S. Extracorporeal membrane oxygenation support in carinal resection for recurrent chondrosarcoma after previous distal tracheal resection. Interact Cardiovasc Thorac Surg. 2022 Jun 15;35(1):ivac148.
• Lazzeri C, Bonizzoli M, Franci A, Cianchi G, Batacchi S, Ciapetti M, Fulceri GE, Rugna M, Peris A. Out of hospital cardiac arrest and uncontrolled donation after circulatory death in a tertiary cardiac arrest center. Eur J Emerg Med. 2019 Dec 6
• Cianchi G, Lazzeri C, Bonizzoli M, Batacchi S, Di Lascio G, Ciapetti M, Franci A, Chiostri M, Peris A. Activities of an ECMO Center for Severe Respiratory Failure: ECMO Retrieval and Beyond, A 4-Year Experience. J Cardiothorac Vasc Anesth. 2019 Nov;33(11):3056-3062.
• Lazzeri C, Bonizzoli M, Cianchi G, Batacchi S, Chiostri M, Fulceri G, Peris A. Right Ventricular Hypertrophy in Refractory Acute Respiratory Distress Syndrome Treated With Venovenous Extracorporeal Membrane Oxygenation Support. J Cardiothorac Vasc Anesth. 2019 Aug 27.
• Marinoni M, Trapani S, Cianchi G. Transcranial Doppler Confirming of Brain Death in Patients Treated with Venoarterial Extracorporeal Membrane Oxygenation. ASAIO J. 2019 Jun 6
• Peris A, Lazzeri C, Cianchi G, Bonizzoli M, Batacchi S, Franci A, Rugna M, De Vito L, Ticali PF, Li Marzi V, Migliaccio ML. Implementing a donation after circulatory death program in a setting of donation after brain death activity. Minerva Anestesiol. 2018 Dec;84(12):1387-1392
• Lazzeri C, Bonizzoli M, Cianchi G, Batacchi S, Peris A. H1N1-related ARDS requiring veno-venous extracorporeal membrane oxygenation and the heart. Intensive Care Med. 2018 Dec;44(12):2307-2308
• Lazzeri C, Bonizzoli M, Cianchi G, Batacchi S, Guetti C, Cozzolino M, Bernardo P, Peris A. Right Ventricle Dysfunction and Pre Implantation Vasopressors in Refractory ARDS Supported by VV-ECMO. Heart Lung Circ. 2018 Dec;27(12):1483-1488
• Marinoni M, Cianchi G, Trapani S, Migliaccio ML, Bonizzoli M, Gucci L, Cramaro A, Gallerini A, Picciafuochi F, Valente S, Peris A. TCD and Cerebral Circulatory Arrest in VA ECMO Patients. ASAIO J. 2018 Jul/Aug;64(4):e79
• Cianchi G, Lazzeri C, Bonizzoli M, Batacchi S, Peris A. Echo-Guided Insertion of a Dual-Lumen Cannula for Venovenous Extracorporeal Membrane Oxygenation. ASAIO J. 2018 Jul 12.
• Agostini C, Stolcova M, Bernardo P, Cappelli F, Sori A, Mattesini A, Meucci F, Sorini Dini C, Cianchi G, Peris A, Di Mario C, Valente S. [Tips and tricks for using extracorporeal life support devices in the intensive cardiac care unit]. G Ital Cardiol (Rome). 2018 Jun;19(6)
• Cianchi G, Lazzeri C, Bonizzoli M, Batacchi S, Cozzolino M, Ciapetti M, Bernardo P, Franci A, Chiostri M, Peris A. The 8-Year Experience of the Florence Referral ECMO Center and Retrieval Team for Acute Respiratory Failure. J Cardiothorac Vasc Anesth. 2018 Jun;32(3):1142-1150
• Marinoni M, Cianchi G, Trapani S, Migliaccio ML, Bonizzoli M, Gucci L, Cramaro A, Gallerini A, Picciafuochi F, Valente S, Peris A. Retrospective Analysis of Transcranial Doppler Patterns in Veno-Arterial Extracorporeal Membrane Oxygenation Patients: Feasibility of Cerebral Circulatory Arrest Diagnosis. ASAIO J. 2018 Mar/Apr;64(2):175-182
• Lazzeri C, Bonizzoli M, Cianchi G, Batacchi S, Chiostri M, Fulceri GE, Buoninsegni LT, Peris A. Bilirubin in the early course of venovenous extracorporeal membrane oxygenation support for refractory ARDS. J Artif Organs. 2018 Mar;21(1):61-67
• Lazzeri C, Cianchi G, Mauri T, Pesenti A, Bonizzoli M, Batacchi S, Chiostri M, Socci F, Peris A. A novel risk score for severe ARDS patients undergoing ECMO after retrieval from peripheral hospitals. Acta Anaesthesiol Scand. 2018 Jan;62(1):38-48
• Lazzeri C, Bonizzoli M, Cianchi G, Batacchi S, Terenzi P, Cozzolino M, Bernardo P, Peris A. Lactate and Echocardiography before Veno-Venous Extracorporeal Membrane Oxygenation Support. Heart Lung Circ. 2018 Jan;27(1):99-103
• Bonizzoli M, Lazzeri C, Cianchi G, Boddi M, Cozzolino M, Di Valvasone S, Terenzi P, Batacchi S, Chiostri M, Peris A Serial Lactate Measurements as a Prognostic Tool in Venovenous Extracorporeal Membrane Oxygenation Support. Ann Thorac Surg. 2017 Mar;103(3):812-818
• Lazzeri C, Bonizzoli M, Cianchi G, Batacchi S, Terenzi P, Cozzolino M, Bernardo P, Peris A. Body mass index and echocardiography in refractory ARDS treated with veno-venous extracorporeal membrane oxygenation. J Artif Organs. 2017 Mar;20(1):50-56.
• Lazzeri C, Cianchi G, Bonizzoli M, Batacchi S, Terenzi P, Bernardo P, Valente S, Gensini GF, Peris A. Right ventricle dilation as a prognostic factor in refractory acute respiratory distress syndrome requiring veno-venous extracorporeal membrane oxygenation. Minerva Anestesiol. 2016 Oct;82(10):1043-1049
• Marinoni M, Migliaccio ML, Trapani S, Bonizzoli M, Gucci L, Cianchi G, Gallerini A, Tadini Buoninsegni L, Cramaro A, Valente S, Chiostri M, Peris A. Cerebral microemboli detected by transcranial doppler in patients treated with extracorporeal membrane oxygenation. Acta Anaesthesiol Scand. 2016 Aug;60(7):934-44.
• Lazzeri C, Cianchi G, Bonizzoli M, Batacchi S, Peris A, Gensini GF. The potential role and limitations of echocardiography in acute respiratory distress syndrome. Ther Adv Respir Dis. 2016 Apr;10(2):136-48.
• Lazzeri C, Cianchi G, Bonizzoli M, Batacchi S, Terenzi P, Bernardo P, Valente S, Gensini GF, Peris A. Pulmonary vascular dysfunction in refractory acute respiratory distress syndrome before veno-venous extracorporeal membrane oxygenation. Acta Anaesthesiol Scand. Acta Anaesthesiol Scand. 2016 Apr;60(4):485-91.
• Esquinas AM, Peris A, Gifford AH.Noninvasive Ventilation Plus Extracorporeal CO2 Removal in High-Risk Conditions: A Forthcoming Tool? Crit Care Med. 2015 Sep;43(9)
• Lazzeri C, Gensini GF, Peris A. The assessment of cardiac function in veno-venous extracorporeal membrane oxygenation: the emerging role of bedside echocardiography. Heart Lung Vessel. 2015;7(2):99-100.
• Lazzeri C, Valente S, Peris A, Gensini GF.Extracorporeal life support for out-of-hospital cardiac arrest: Part of a treatment bundle. Eur Heart J Acute Cardiovasc Care. 2015 May 12.
• Balsorano P, Ciapetti M, Cianchi G, Bonizzoli M, Migliaccio ML, Ferraro MC, Franci A, Peris A. Extracorporeal life support and multiorgan donation in a severe polytrauma patient: A case report. Int J Surg Case Rep. 2015;9:109-11.
• Peris A, Lazzeri C, Cianchi G, Bonizzoli M, Batacchi S, Bernardo P, Valente S, Gensini GF.Clinical significante of echocardiography in patients supported by venous-venous extracorporeal membrane oxygenation. J Artif Organs. 2015 Jun;18(2):99-105.
• Bonacchi M, Vannini A, Harmelin G, Batacchi S, Bugetti M, Sani G, Peris A. Inverted-Takotsubo cardiomyopathy: severe refractory heart failure in poly-traurnapatients saved by emergency extracorporeal life support. Interact Cardiovasc Thorac Surg. 2015 Mar;20(3):365-71.
• Lazzeri C, Valente S, Peris A, Gensini GF. Extracorporeal life support treatment bundle for refractory cardiac arresi. Resuscitation. 2015 Feb;87:e5-6.
• Bonacchi M, Harmelin G, Bugetti M, Sani G, Peris A. Indications of extracorporeal life support in poly-trauma. Br J Anaesth. 2014 Dec;113(6):1058-9Peris A. Systematic study of lactate in ECMO: perhaps an opportunity to strengthen the decision-making process. Minerva Anestesiol. 2014 Dec;80(12):1253-5
• Peris A, Zagli G, Bernardo P, Bonacchi M, Cozzolino M, Perretta L, Azzi A, Cianchi G. H3N2 Virus as Causative Agent of ARDS Requiring Extracorporeal Membrane Oxygenation Support. Case Rep Med. 2014;2014:560208.
• Lazzeri C, Bonizzoli M, Valente S, Cianchi G, Migliaccio ML, Gensini GF, Peris A. The role of extracorporeal membrane oxygenation in donation after circulatory death. Minerva Anestesiol. 2014 Nov;80(11):1217-27.
• Bonacchi M, Ciapetti M, Di Lascio G, Harmelin G, Sani G, Peris A. Emergent ECLS for life-threatening severe cardiac dysfunction as presentation of H1N1-flu. Anadolu Kardiyol Derg. 2014 Feb;14(1):87-90.
• Bonacchi M, Ciapetti M, Di Lascio G, Harmelin G, Sani G, Peris A. Atypical clinic presentation of pandemic influenza A successfully rescued by extracorporeal membrane oxygenation – Our experience and review of the literature. Interv Med Appl Sci. 2013 Dec;5(4):186-92.
• Lazzeri C, Bernardo P, Sori A, Innocenti L, Stefano P, Peris A, Gensini GF, Valente S. Venous-arterial extracorporeal membrane oxygenation for refractory cardiac arrest: a clinical challenge. Eur Heart J Acute Cardiovasc Care. 2013 Jun;2(2):118-26.
• Migliaccio ML, Zagli G, Cianchi G, Lazzeri C, Bonizzoli M, Cecchi A, Anichini V, Gensini GF, Peris A.Extracorporeal membrane oxygenation in brain-death organ and tissues donors: a single-centre experience. Br J Anaesth. 2013 Oct;111(4):673-4.
• Valente S, Lazzeri C, Bernardo P, Sori A, Chiostri M, Innocenti L, Stefano P, Peris A, Gensini GF.Bleeding events in refractory cardiac arrest treated with extracorporeal membrane oxygenation–a single centre experience. Resuscitation. 2013 Sep;84(9):e119.
• Pappalardo F, Pieri M, Greco T, Patroniti N, Pesenti A, Arcadipane A, Ranieri VM, Gattinoni L, Landoni G, Holzgraefe B, Beutel G, Zangrillo A; Italian ECMOnet. Predicting mortality risk in patients undergoing venovenous ECMO for ARDS due to influenza A (H1N1) pneumonia: the ECMOnet score. Intensive Care Med. 2013 Feb;39(2):275-81.
• Peris A, Biondi 5, Zagli G. Cardiopulinonary resuscitation after traumatic cardiac arrest–there are survivors: registries must speak about it. Crit Care. 2012 Sep 21;16(5):449; author reply 449.
• Bonacchi M, Spina R, Torracchi L, Harmelin G, Sani G, Peris A. Extracorporeal life support in patients with severe trauma: an advanced treatment strategy for refractory clinical settings. J Thorac Cardiovasc Surg. 2013 Jun;145(6):1617-26.
• Peris A, Zagli G, Cianchi G, Lazzeri C, Sani G, Bonizzoli M. Iliopsoas haematoma: unexpected life-threatening complication during extracorporeal membrane oxygenation support in H1N1-induced acute respiratory distress syndrome patients. Br J Anaesth. 2011 Nov;107(5):819-20.
• Patroniti N, Zangrillo A, Pappalardo F, Peris A, Cianchi G, Braschi A, lotti GA, Arcadipane A, Panarello G, Ranieri VM, Terragni P, Antonelli M, Gattinoni L, Oleari F, Pesenti A. The Italian ECMO network experience during the 2009 influenza A(H1N1) pandemic: preparation for severe respiratory emergency outbreaks. Intensive Care Med. 2011 Sep;37(9):1447-57.
• Bonacchi M, Di Lascio G, Harmelin G, Pasquini A, Peris A, Sani G. Extracorporeal membrane oxygenation for refractory, life-threatening, and herpes simplex virus 1-induced acute respiratory distress syndrome. Our experience and literature review. Am J Emerg Med. 2012 Jul;30(6):1014.e3-1014.e10.
• Ciapetti M, Cianchi G, Zagli G, Greco C, Pasquini A, Spina R, Batacchi S, Bonizzoli M, Bonacchi M, Lazzeri C, Bernardo P, Peris A. Feasibility of inter-hospital transportation using extra-corporeal membrane oxygenation (ECMO) support of patients affected by severe swine-flu(H1N1)-related ARDS. Scand J Trauma Resusc Emerg Med. 2011 May 27;19:32.
• Bonacchi M, Harmelin G, Peris A, Sani G. A novel strategy to improve systemic oxygenation in venovenous extracorporeal membrane oxygenation: the “X-configuration”. J Thorac Cardiovasc Surg. 2011 Nov;142(5):1197-204.
• Cianchi G, Bonizzoli M, Pasquini A, Bonacchi M, Zagli G, Ciapetti M, Sani G, Batacchi S, Biondi S, Bernardo P, Lazzeri C, Giovannini V, Azzi A, Abbate R, Gensini G, Peris A. Ventilatory and ECMO treatment of H1N1 -induced severe respiratory failure: results of an Italian referral ECMO center. BMC Pulm Med. 2011 Jan 11;11:2.
• Peris A, Cianchi G, Biondi S, Bonizzoli M, Pasquini A, Bonacchi M, Ciapetti, M, Zagli G, Bacci S, Lazzeri C, Bernardo P, Mascitelli E, Sani G, Gensini GF.Extracorporeal life support for management of refractory cardiac or respiratory failure: initial experience in a tertiary centre. Scand J Trauma Resusc Emerg Med. 2010 May 21;18:28.