LRU – CRITICAL CARE

Steering Committee

• Prof. Dr. med. Paolo Merlani: Head DAC OCL, Lugano
• Dr med. Michael Llamas, Head DAC ODL, Locarno
• Dr med. Marco Grischott, Head DAC OBV, Mendrisio
• PD Dr. med. Andrea Saporito: Head DAC ORBV & Head Anesthesiology, ORBV Bellinzona
• Dr.ssa med. Roberta Petrino: Head of Emergency Department (ED), OCL Lugano
• Loris Bonetti, RN PhD: Head Nursing Research Competence Centre, EOC Bellinzona
• Prof. Dr. med. Alberto Pagnamenta

The Department of Anesthesiology, Emergency and Intensive Care Medicine of the Ente Ospedaliero Cantonale (“Dipartimento Area Critica”: DAC-EOC) is a functional Department. Each of the four public hospitals of the EOC has his own DAC. The four local DACs make up the DAC-EOC. Each local DAC is headed by a local Director. The DAC-EOC coordinates and facilitates the integration and the collaboration among the four local DACs for patients’ care, innovation and for research purposes. The DAC-EOC is responsible for the didactic module “Critical Care Medicine” for the Medical Master School (third semester) of the Faculty of Biomedical Sciences of the Università della Svizzera italiana (USI). Furthermore, it supports medical students for their master’s and/or doctoral thesis. In 2022 a Local Research Unit (LRU) for the entire DAC-EOC has been established and headed by a staff physician of the Department. The Steering Committee of the LRU of the DAC-EOC includes the four Directors of the local DACs and one representative per specialty. The main aim of the LRU is to support any researcher/investigator from study conception to manuscript submission in peer review journals. Each specialty: Anesthesiology, Emergency Medicine and Intensive Care Medicine manage their own research projects as both monocentric and multicentric trials in collaboration with other Swiss and foreign research centers. We support nursing research, in accordance with the Swiss Society of Intensive Care Medicine, which is the only nursing/medical society in Switzerland. Our LRU is not responsible for the fundraising of the DAC. One of the purposes of the LRU of the DAC-EOC is to encourage common projects among the different Services of the Department and especially regarding the transition of care (interdisciplinary and interprofessional projects). Quality-improvements studies and especially process-improvements trials are still scarce in medicine and especially in the acute care setting.

Different topics are currently investigated by the DAC-EOC, and thereafter we mention the most relevant:

• Diagnostic accuracy of Point of Care Ultrasound in different clinical settings, especially in Anesthesiology and Intensive Care Medicine
• Cost-effectiveness analysis in Anesthesiology
• Perioperative transfusion’s strategies
• Use of different analgetic regimen and analgetic procedures in the post-operative setting
• Treatment strategies for chronic pain syndromes
• Impact of the COVID-19 pandemic on the occurrence of different complications (herpes simplex recurrence) in the ICU population
• Best practice for the care of mild traumatic brain injury in the Emergency Department (ED)
• Communication practices in the ED for outpatients

Different projects are working in progress. Here a selection of the most promising: optimization of the time to transfer for patients from the ED to the ICU and identification of barriers; use of artificial intelligence and machine learning techniques for the early identification of nosocomial infections; strategies to improve communication’s skills of ED doctors; impact of delayed transfer of patients from the ward to the ICU.