Panoramica

Postdoctoral Training 11/2011 – 02/2012 Intern Medicine, Surgery, Primary Care University of Milan-San Raffaele, Italy 01/2013 – 12/2013 Research Fellow Cardiovascular and Metabolic Sciences San Raffaele Hospital, Italy 11/2015 – 10/2020 Resident Anesthesia, Critical Care and Pain Medicine University of Milan-Bicocca, Italy 10/2019 – 06/2022 Research Fellow Critical Care Medicine Massachusetts General Hospital 07/2022 – 06/2023 Fellow Advanced Perioperative Ultrasound and Clinical Anesthesia Beth Israel Deaconess Medical Center 07/2023 – Resident Anesthesia Beth Israel Deaconess Medical Center Other Professional Positions 12/2011 – 10/2012 Volunteer General Medicine, Diabetology and Endocrinology San Raffaele Hospital, Italy 03/2012 – 10/2015 Volunteer Diabetes Research Institute San Raffaele Hospital, Italy 07/2012 – 09/2013 Locum Physician Infirmary Banca Popolare di Milano, Italy 11/2012 – 10/2015 Attending Physician General Medicine, Diabetology and Endocrinology San Raffaele Hospital, Italy 06/2013 – 10/2015 Attending Physician Ophthalmology San Raffaele Hospital, Italy 06/2014 – 10/2015 Clinical Monitor Cardiovascular and Metabolic Sciences San Raffaele Hospital, Italy Committee Service Regional 10/2018 – 10/2020 Executive Member Monitoring Board for Graduate Medical Evaluation Government of Lombardy Region, Italy Local 08/2023 – 06/2024 Executive Member Education, Quality Improvement and Professionalism Leadership Committee Beth Israel Deaconess Medical Center 08/2024 – Executive Member Greening the OR working Group Beth Israel Deaconess Medical Center 08/2024 – Member Safety Committee, Department of Anesthesia Beth Israel Deaconess Medical Center 05/2025 – Social Media Cha Residency Program Social Media, Department of Anesthesia Beth Israel Deaconess Medical Center Professional Societies 2012 – Board of Physicians, Surgeons and Dentists, Province of Milan Member 2017 – European Society of Intensive Care Medicine Member 2018 – Italian Society of Anaesthesia, Analgesia, Reanimation and Intensive Care (SIAARTI) Member 2020 – American Association for the Advancement of Science Member 2020 – American Thoracic Society Member 2022 – American Medical Association Member 2023 – American Society of Anesthesiologists Member Editorial Activities Ad hoc Reviewer British Medical Journal Case Reports Nitric Oxide PLOS One Report of Local Teaching and Training Formal Teaching of Residents, Clinical Fellows and Research Fellows 2022 – 2023 Vascular anesthesia rotation junior supervisor Anesthesia Residents Beth Israel Deaconess Medical Center 10 hours / week 2022 – 2023 Vascular anesthesia skills and core competencies checkoff instructor for Anesthesia Residents Beth Israel Deaconess Medical Center 48 hours / year (biweekly 2-hour sessions) 2022 – 2023 Skills session preparator and instructor for Anesthesia Residents (CA-1) Beth Israel Deaconess Medical Center 84 hours / year (monthly 7-hour sessions) 2022 – 2023 Skill session preparator and instructor for Nephrology Fellows Beth Israel Deaconess Medical Center 4 hours / year (yearly session) Other Mentored Trainees and Faculty Summer 2019 Sara Mastinu, MD Career Stage: Intensive Care Unit Elective while sixth year MD candidate University of Milan-Bicocca, Milan, Italy Mentoring Role: Co-supervisor (with Dr. Riccardo Pinciroli) Accomplishment: Data analysis, thesis preparation, dissertation, and graduation. Matched in Radiology Residency at the University of Milan, Italy 04/2020 – 07/2021 Grant Larson, MD Career Stage: Research Assistant, Massachusetts General Hospital, Boston, MA, USA Mentoring Role: Supervisor (with Dr. Lorenzo Berra) Accomplishment: Actively participated in two clinical trials – MD at Geisel School of Medicine, Dartmouth – Matched in Anesthesia Residency at Beth Israel Deaconess Medical Center 06/2022 – 07/2022 Nicolette Duong, MPH, MBA, Doctor of Osteopathic Medicine Candidate at Kansas City University, Kansas City, KS, USA Career Stage: FAER Summer Student at Massachusetts General Hospital, Boston, MA, USA Mentoring Role: Supervisor (with Dr. Lorenzo Berra) Accomplishment: Lab skill development, performance of experiments, data analysis, manuscript preparation and submission Local Invited Presentations No presentations below were sponsored by outside entities 2020 Hemolysis and the Protective Role of Nitric Oxide / Grand Rounds Department of Anesthesia, Critical Care and Pain Medicine, VA Boston Report of Clinical Activities and Innovations Practice Activities 2011 – 2012 Internal Medicine, Surgery, Family Medicine; Intern San Raffaele Hospital, Italy 5 days/week 2012 – 2015 General Medicine, Diabetology and Endocrinology; Attending Physician (Internal Medicine) San Raffaele Hospital, Italy 2 days/week 2012 – 2013 Infirmary; Locum Physician Banca Popolare di Milano, Italy 3 days/week 2013 – 2015 Ophthalmology; Attending Physician (Internal Medicine) San Raffaele Hospital, Italy 6 days/week 2015 – 2016 Anesthesia, Critical Care and Pain Medicine; Resident Niguarda Hospital, Italy 6 days/week 2015 – 2018 Anesthesia, Critical Care and Pain Medicine; Resident San Gerardo Hospital, Italy 6 days/week 2018 – 2019 Anesthesia, Critical Care and Pain Medicine; Resident Niguarda Hospital, Italy 6 days/week 2022 – 2023 Anesthesia, Critical Care and Pain Medicine; Fellow Beth Israel Deaconess Medical Center 6 days/week 2023 – Anesthesia, Critical Care and Pain Medicine; Resident Beth Israel Deaconess Medical Center 6 days/week Report of Scholarship Peer-Reviewed Scholarship in print or other media Research Investigations 1. Balzano G, Dugnani E, Pasquale V, Capretti G, Radaelli MG, Garito T, Stratta G, Nini A, Di Fenza R, Castoldi R, Staudacher C, Reni M, Scavini M, Doglioni C, Piemonti L. Clinical signature and pathogenetic factors of diabetes associated with pancreas disease (T3cDM): a prospective observational study in surgical patients. Acta Diabetol. 2014 Oct;51(5):801-11 2. Gibson LE, Di Fenza R, Berra L, Bittner EA, Chang MG. Transthoracic Echocardiography in Prone Patients With Acute Respiratory Distress Syndrome: A Feasibility Study. Crit Care Explor. 2020 Aug 7;2(8):e0179. 3. Safaee Fakhr B, Wiegand SB, Pinciroli R, Gianni S, Morais CCA, Ikeda T, Miyazaki Y, Marutani E, Di Fenza R, Larson GM, Parcha V, Gibson LE, Chang MG, Arora P, Carroll RW, Kacmarek RM, Ichinose F, Barth WH Jr, Kaimal A, Hohmann EL, Zapol WM, Berra L. High Concentrations of Nitric Oxide Inhalation Therapy in Pregnant Patients With Severe Coronavirus Disease 2019 (COVID-19). Obstet Gynecol. 2020 Dec;136(6):1109-1113. 4. Pinciroli R, Traeger L, Fischbach A, Gianni S, Morais CCA, Fakhr BS, Di Fenza R, Robinson D, Carroll R, Zapol WM, Berra L. A Novel Inhalation Mask System to Deliver High Concentrations of Nitric Oxide Gas in Spontaneously Breathing Subjects. J Vis Exp. 2021 May 4;(171). 5. Gibson LE, Di Fenza R, Lang M, Capriles MI, Li MD, Kalpathy-Cramer J, Little BP, Arora P, Mueller AL, Ichinose F, Bittner EA, Berra L, G Chang M. Right Ventricular Strain Is Common in Intubated COVID-19 Patients and Does Not Reflect Severity of Respiratory Illness. J Intensive Care Med. 2021 Aug;36(8):900-909. 6. Safaee Fakhr B, Di Fenza R, Gianni S, Wiegand SB, Miyazaki Y, Araujo Morais CC, Gibson LE, Chang MG, Mueller AL, Rodriguez-Lopez JM, Ackman JB, Arora P, Scott LK, Bloch DB, Zapol WM, Carroll RW, Ichinose F, Berra L; Nitric Oxide Study Investigators. Inhaled high dose nitric oxide is a safe and effective respiratory treatment in spontaneous breathing hospitalized patients with COVID-19 pneumonia. Nitric Oxide. 2021 Nov 1;116:7-13 7. Fischbach A, Wiegand SB, Zazzeron L, Traeger L, Di Fenza R, Bagchi A, Farinelli WA, Franco W, Korupolu S, Arens J, Grassi L, Zadek F, Bloch DB, Rox Anderson R, Zapol WM. Veno-venous extracorporeal blood phototherapy increases the rate of carbon monoxide (CO) elimination in CO-poisoned pigs. Lasers Surg Med. 2022 Feb;54(2):256-267 8. Gianni S, Di Fenza R, Morais CCA, Fakhr BS, Mueller AL, Yu B, Carroll RW, Ichinose F, Zapol WM, Berra L. High-Dose Nitric Oxide From Pressurized Cylinders and Nitric Oxide Produced by an Electric Generator From Air. Respir Care. 2022 Feb;67(2):201-208. 9. Chirinos JD, Turco IS, Di Fenza R, Gianni S, Larson GM, Swingle JF, Akeju O, Berra L. Patient hesitancy in perioperative clinical trial enrollment during the COVID-19 pandemic. PLoS One. 2023 Jan 17;18(1):e0279643 10. Di Fenza R, Shetty NS, Gianni S, Parcha V, Giammatteo V, Safaee Fakhr B, Tornberg D, Wall O, Harbut P, Lai PS, Li JZ, Paganoni S, Cenci S, Mueller AL, Houle TT, Akeju O, Bittner EA, Bose S, Scott LK MD, Carroll RW, Ichinose F, Hedenstierna M, Arora P, Berra L. High-Dose Inhaled Nitric Oxide in Acute Hypoxemic Respiratory Failure due to COVID-19: A Multicenter Phase 2 Trial. Am J Respir Crit Care Med. 2023 Sep 29. 11. Morais CCA, Alcala G, De Santis Santiago RR, Valsecchi C, Diaz E, Wanderley H, Fakhr BS, Di Fenza R, Gianni S, Foote S, Chang MG, Bittner EA, Carroll RW, Costa ELV, Amato MBP, Berra L. Pronation Reveals a Heterogeneous Response of Global and Regional Respiratory Mechanics in Patients With Acute Hypoxemic Respiratory Failure. Crit Care Explor. 2023 Oct 2;5(10):e0983. 12. Yunus RA, Saeed S, Levy N, Di Fenza R, Sharkey A, Pobywajlo S, Liang P, Schermerhorn M, Mahmood F, Matyal R, Neves S. A Multidisciplinary Protocolized Approach for Ruptured Abdominal Aortic Aneurysm Management: A Retrospective before-after Study. J Cardiothorac Vasc Anesth. 2024 Mar 38(3): 755-7 Other peer-reviewed scholarship 1. D'Addio F, Vergani A, Di Fenza R, Tezza S, Bassi R, Fiorina P. Novel immunological aspects of pediatric kidney transplantation [Ita]. G Ital Nefrol. 2012 Jan-Feb;29(1):44-8. 2. Petrelli, A., Di Fenza, R., Carvello, M., Gatti, F., Secchi, A., Fiorina, P., 2012. Strategies to Reverse Endothelial Progenitor Cell Dysfunction in Diabetes. Experimental Diabetes Research 2012, 1–9 3. Safaee Fakhr B, Araujo Morais CC, De Santis Santiago RR, Di Fenza R, Gibson LE, Restrepo PA, Chang MG, Bittner EA, Pinciroli R, Fintelmann FJ, Kacmarek RM, Berra L. Bedside monitoring of lung perfusion by electrical impedance tomography in the time of COVID-19. Br J Anaesth. 2020 Nov;125(5):e434-e436. 4. Morais CCA, Safaee Fakhr B, De Santis Santiago RR, Di Fenza R, Marutani E, Gianni S, Pinciroli R, Kacmarek RM, Berra L. Bedside Electrical Impedance Tomography Unveils Respiratory "Chimera" in COVID-19. Am J Respir Crit Care Med. 2021 Jan 1;203(1):120-121. 5. Balakrishna A, Di Fenza R, Morais CCA, Imber DA, Arora P, Kacmarek RM, De Santis Santiago R, Berra L. Reply to Mezidi et al.: Assessment of Airway Closure and Expiratory Airflow Limitation to Set Positive End-Expiratory Pressure in Morbidly Obese Patients with Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med. 2021 Feb 1;203(3):392-394 6. Di Fenza R, Yu B, Carroll RW, Berra L. Chemiluminescence-based Assays for Detection of Nitric Oxide and its Derivatives from Autoxidation and Nitrosated Compounds. J Vis Exp. 2022 Feb 16;(180). 7. Hao D, Low S, Di Fenza R, Shenoy ES, Ananian L, Prout LA, La Vita CJ, Berra L. Prone Positioning of Intubated Patients with an Elevated Body-Mass Index. NEJM. 2022 Apr 7;386(14):e34 Scholarship without named authorship 1. Mauri T, Foti G, Fornari C, Grasselli G, Pinciroli R, Lovisari F, Tubiolo D, Volta CA, Spadaro S, Rona R, Rondelli E, Navalesi P, Garofalo E, Knafelj R, Gorjup V, Colombo R, Cortegiani A, Zhou JX, D'Andrea R, Calamai I, Vidal González Á, Roca O, Grieco DL, Jovaisa T, Bampalis D, Becher T, Battaglini D, Ge H, Luz M, Constantin JM, Ranieri M, Guerin C, Mancebo J, Pelosi P, Fumagalli R, Brochard L, Pesenti A; PROTECTION Trial Collaborators. Sigh in Patients With Acute Hypoxemic Respiratory Failure and ARDS: The PROTECTION Pilot Randomized Clinical Trial. Chest. 2021 Apr;159(4):1426-1436. 2. Russotto V, Myatra SN, Laffey JG, Tassistro E, Antolini L, Bauer P, Lascarrou JB, Szuldrzynski K, Camporota L, Pelosi P, Sorbello M, Higgs A, Greif R, Putensen C, Agvald-Öhman C, Chalkias A, Bokums K, Brewster D, Rossi E, Fumagalli R, Pesenti A, Foti G, Bellani G; INTUBE Study Investigators. Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients From 29 Countries. JAMA. 2021 Mar 23;325(12):1164-1172. 3. De Santis Santiago R, Teggia Droghi M, Fumagalli J, Marrazzo F, Florio G, Grassi LG, Gomes S, Morais CCA, Ramos OPS, Bottiroli M, Pinciroli R, Imber DA, Bagchi A, Shelton K, Sonny A, Bittner EA, Amato MBP, Kacmarek RM, Berra L; Lung Rescue Team Investigators. High Pleural Pressure Prevents Alveolar Overdistension and Hemodynamic Collapse in Acute Respiratory Distress Syndrome with Class III Obesity. A Clinical Trial. Am J Respir Crit Care Med. 2021 Mar 1;203(5):575-584. doi: 10.1164/rccm.201909-1687OC. Non-peer reviewed scholarship in print or other media: Proceedings of meetings or other non-peer reviewed scholarship 1. Lei C, Su B, Dong H, Bellavia A, Di Fenza R, Safaee Fakhr B, Gianni S, Grassi LG, Kacmarek R, Araujo Morais CC, Pinciroli R, Vassena E, Berra L. Protocol of a randomized controlled trial testing inhaled Nitric Oxide in mechanically ventilated patients with severe acute respiratory syndrome in COVID-19 (SARS-CoV-2). medRxiv [Preprint]. 2020 Mar 13:2020.03. 2. Lei C, Su B, Dong H, Fakhr BS, Grassi LG, Di Fenza R, Gianni S, Pinciroli R, Vassena E, Morais CCA, Bellavia A, Spina S, Kacmarek R, Berra L. Protocol for a randomized controlled trial testing inhaled nitric oxide therapy in spontaneously breathing patients with COVID-19. medRxiv [Preprint]. 2020 Mar 13:2020.03. 3. Gianni, S, Fakhr, BS, Morais CCA, Di Fenza R, Larson GM, Pinciroli R, Houle T, Mueller AL, Bellavia A, Kacmarek R, Carroll RW, Berra L. Nitric oxide gas inhalation to prevent COVID-2019 in healthcare providers. medRxiv [Preprint]. 2020.04. 4. Di Fenza R, Gay H, Favarato M, Fontana I, Fumagalli R. Pronation Technique in ARDS Patients. AboutOpen. 2020 Jul 15; 7(1):21-23 Reviews, chapters, monographs and editorials 1. Di Fenza R, Fiorina P. (2010). Physical Activity and Inflammation. In L. Luzi (Ed.), Cellular Physiology and Metabolism of Physical Exercise (pp. 99-108). Milan: Springer-Verlag. 2. Trevisani A, Tezza S, Di Fenza R, Bassi R, Fiorina P. (2011). The use of stem cells in type 1 diabetes [Ita] [Monograph]. G It Diabetol Metab, 31 (3)(141-149). 3. Di Fenza R, Citerio G. (2018). Electrolyte disturbances and endocrinal care. In H. Prabhakar, C. Mahajan, I. Kapoor (Ed.), Essentials of Anesthesia for Neurotrauma (pp. 295-316). Boca Raton: Taylor & Francis Group. 4. Di Fenza R, Berra L. (2019). Other Parenchymal Disease and Pulmonary Edema. In A. Sonny, E.A. Bittner, R.J. Horvath, S.M. Berg (Ed.), Critical Care Medicine Review: 1000 Questions and Answers (pp. 216-221). Philadelphia: Wolters Kluwer. Thesis 1. Di Fenza R. Reversal of diabetic enteropathy associated with intestinal nerve regeneration in uremic type 1 diabetic patients after kidney-pancreas transplantation. Milan (Italy), University of Milan-San Raffaele; 2011 2. Di Fenza R. The Acute Effects of High Dose Inhaled Nitric Oxide in Patients with Critical COVID-19. Boston, MA, University of Milan-Bicocca; 2020 Abstracts, Poster Presentations and Exhibits Presented at Professional Meetings 1. Petrelli A, Carvello M, Di Fenza R, D’Addio F, Markmann FJ, Secchi A, Fiorina P. Targeting IL21/IL21R pathway as a novel strategy to prolong graft survival in allogenic islet transplantation. In G Ital Nefrol 2011; 28 (S52): S6-S12. Presented at the 2011 SIN Meeting, Genoa, Italy 2. Perra S, Lattuada G, Ragogna F, Di Fenza R, Dellerma N, Martucci F, Manzoni G, Devecchi E, Maurizio L, Hulshof T, Perseghin G. Effects of Italian breakfasts on appetite [Ita]. 2016. Presented at the 22nd AMD-SID Congress, Coccaglio, Italy 3. Fior G, Monti G, Pinciroli R, Guarnieri M, Di Fenza R, Previtali E, Bettini F, Ferrari C, Checchi S, Giudici R, Bassi G, De Angelis A, Fumagalli R. Direct admission to referral center versus transfer: differences in fluid resuscitation [Ita]. 2018. Presented at the 23rd SIUST Congress, Verona, Italy. 4. Bielli A, Torri S, Lepera V, Piazza A, Comandatore F, Travi G, Di Fenza R, Vismara CS, Perno F. Hypermucoviscous Klebsiella pneumoniae: a new and dangerous pathogen isolated in four patients in Italy. 2019. Presented at the 29th ECCMID Congress, Amsterdam, The Netherlands. 5. Di Fenza R, Guarnieri M, Pinciroli R, Gay H, Bielli A, Orcese, CA, Fumagalli R. A case of septic shock and multiorgan failure with ARDS caused by hypervirulent Klebsiella Pneumoniae in a patient with severe chest trauma. 2019. Presented at the 30th SMART, Milan, Italy. 6. Di Fenza R, Gibson LE, Parcha V, Capriles MI, Arora P, Chang MG, Berra L. Hemodynamic response to inhaled nitric oxide in intubated patients with severe COVID-19 infection. 2020. Presented at the MGH Clinical Research Day, Boston, MA. 7. Safaee Fakhr B, Wiegand SB, Gianni S, Morais CCA, Ikeda T, Miyazaki Y, Marutani E, Di Fenza R, Larson GM, Berra L. Breathing Nitric Oxide at High Dose in Severe-critical COVID-19 during Pregnancy: a case series. 2020. Presented at the MGH DACCPM Research Night, Boston, MA 8. Gibson LE, Di Fenza R, Lang M, Capriles MI, Li MD, Kalpathy-Cramer J, Little BP, Bittner EA, Berra L, Chang MG. Right ventricular strain is common in intubated COVID-19 patients and does not reflect severity of respiratory illness. 2020. Presented at the MGH DACCPM Research Night, Boston, MA. 9. Safaee Fakhr B, Di Fenza R, Gianni S, Wiegand SB, Marutani E, Miyazaki Y, Ikeda T, Morais CCA, Gibson LE, Berra L. Breathing Nitric Oxide at High Dose in Mild-Moderate, non-intubated, COVID-19 patients: preliminary analysis of aa randomized clinical trial. 2020. Presented at the MGH DACCPM Research Night, Boston, MA. 10. Morais CA, Alcala GC, Santiago RR, Wanderley H, Diaz Delgado E, Di Fenza R, Safaee Fakhr B, Gianni S, Kacmarek R, Berra L. Titration of mechanical ventilation in supine compared to prone position reveals different respiratory mechanics behavior in COVID-19 patients. In Am J Respir Crit Care Med 2021; 203:A2606. Presented at the MGH DACCPM Research Night, Boston, MA 11. Safaee Fakhr B, Di Fenza R, Gianni S, Wiegand S, Miyazaki Y, Morais CA, Gibson L, Chang, M, Mueller A, Rodriguez-Lopez J, Ackman J, Arora P, Scott L, Bloch D, Zapol WM, Carroll R, Ichinose F, Berra L. “Safety and Efficacy of Inhaled High-Dose Nitric Oxide in Non-Intubated Patients with COVID-19 Pneumonia”. In Chest 2022 Jun; 161 (6): A93. Presented at the CHEST Congress, Bologna, Italy, 2022. 12. Duong N, Di Fenza R, Winterton D, Cenci S, Buehl T, Medeiros k, Capriles M, Yu B, Ichinose F, Berra L. Administration of nitric oxide in cardiac surgical patients with impaired endothelial function to prevent postoperative acute kidney injury. 2022. Presented at the ASA Annual Meeting, New Orleans, LO 13. Yunus R, Levy N, Saeed S, Sohail M, Di Fenza R, Khan Am Rehman T, Matyal R. Impact of Case Experience and Training on Process Outcomes and Safety of Patients with Ruptured Abdominal Aortic Aneurysm. 2023. Presented at the BIDMC Anesthesia Week Research Night, Boston, MA 14. Gibson LE, Di Fenza R, De Santis Santiago R, Chang MG, Berra L. Reduction in Right Ventricular Afterload with Nitric Oxide Predicts Survival in COVID-19 ARDS. 2024 Presented at the Society of Critical Care Medicine Congress, Phoenix, AZ