Author: "A. Mekontso Dessap" / Database: Supplemental Index - Searchworks@Jio Institute Digital Library Search Results

Your search keyword '"A. Mekontso Dessap"' showing total 71 results

Start Over Author "A. Mekontso Dessap" Database Supplemental Index

71 results on '"A. Mekontso Dessap"'

1. Biofilm Assessment and Metagenomic Analysis of Venoarterial Extracorporeal Membrane Oxygenation Cannulas and Membrane Oxygenators

Author: Diop, Sylvain, Pons, Stéphanie, Kapandji, Natacha, Kallel, Hatem, Woerther, Paul-Louis, Mekontso-Dessap, Armand, Rodriguez, Christophe, Mongardon, Nicolas, Roujansky, Ariane, and Mounier, Roman
Abstract: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) exposes the patient to infectious complications related to the cannulas or the site of insertion. The aim of the current study was to investigate and compare the prevalence of cannula and membrane oxygenators colonization using three different methods: microbiological culture, scanning electron microscopy, and metagenomic (rRNA 16S analysis). A monocentric prospective study was conducted between December 2017 and June 2018. Consecutive patients undergoing VA-ECMO support for refractory cardiac arrest or cardiogenic shock were included. Ten patients were included with a median age of 64 (52–62) years. Venoarterial extracorporeal membrane oxygenation was inserted for refractory cardiac arrest in five (50%), cardiogenic shock in four (40%), and self-poisoning in one (10%) cases. Microbiological culture of all (8/8, 100%) membrane oxygenators was negative, whereas all (10/10, 100%) were colonized by biofilm, and eight (8/9, 89%) presented bacterial DNA. Three (3/9, 33%) arterial and venous cannulas were positive in culture and seven (7/9, 78%) were colonized by biofilm, respectively. Seven (7/9, 78%) arterial and four (4/9, 44%) venous cannulas presented bacterial DNA. Colonization of cannulas and membranes is more frequent when assessed by electron microscopy or metagenomic analysis than with culture. Membrane oxygenators are more often colonized than cannulas.
Published: 2024
Full Text: View/download PDF

2. Balance des fluides et sevrage de la ventilation mécanique

Author: Mekontso Dessap, A.
Abstract: La surcharge volémique est fréquemment rencontrée en réanimation, notamment chez les patients septiques et/ou ventilés. La surcharge volémique est associée à une prolongation de la durée de ventilation mécanique en général et du sevrage en particulier. Il s’agit d’un facteur favorisant de la dysfonction cardiovasculaire du sevrage impliqué dans l’échec de l’épreuve de ventilation spontanée et l’échec d’extubation. Une stratégie de gestion des fluides restrictive raccourcit la durée de la ventilation mécanique, y compris celle du sevrage. Volume overload is frequently encountered in intensive care unit patients, especially in patients with sepsis and/or mechanical ventilation. Volume overload is associated with a prolongation of mechanical ventilation in general and of the weaning period in particular. It is a major contributing factor to cardiovascular weaning failure, including failed spontaneous breathing trial and failed extubation. A strategy of restrictive fluid management shortens the duration of mechanical ventilation, including weaning length.
Published: 2024
Full Text: View/download PDF

3. Clinical impact of successful cardioversion for new-onset atrial fibrillation in critically ill septic patients: A preliminary study.

Author: Labbé, Vincent, Ederhy, Stephane, Legouis, David, Joffre, Jérémie, Razazi, Keyvan, Sy, Oumar, Voicu, Sebastian, Mekontso-Dessap, Armand, Cohen, Ariel, and Fartoukh, Muriel
Published: 2023
Full Text: View/download PDF

4. Effects of Standard-Dose Prophylactic, High-Dose Prophylactic, and Therapeutic Anticoagulation in Patients With Hypoxemic COVID-19 Pneumonia: The ANTICOVID Randomized Clinical Trial

Author: Labbé, Vincent, Contou, Damien, Heming, Nicholas, Megarbane, Bruno, Razazi, Keyvan, Boissier, Florence, Ait-Oufella, Hafid, Turpin, Matthieu, Carreira, Serge, Robert, Alexandre, Monchi, Mehran, Souweine, Bertrand, Preau, Sebastien, Doyen, Denis, Vivier, Emmanuel, Zucman, Noémie, Dres, Martin, Fejjal, Mohamed, Noel-Savina, Elise, Bachir, Marwa, Jaffal, Karim, Timsit, Jean-François, Picos, Santiago Alberto, Mariotte, Eric, Martis, Nihal, Juguet, William, Melica, Giovanna, Rondeau, Paul, Audureau, Etienne, and Mekontso Dessap, Armand
Abstract: IMPORTANCE: Given the high risk of thrombosis and anticoagulation-related bleeding in patients with hypoxemic COVID-19 pneumonia, identifying the lowest effective dose of anticoagulation therapy for these patients is imperative. OBJECTIVES: To determine whether therapeutic anticoagulation (TA) or high-dose prophylactic anticoagulation (HD-PA) decreases mortality and/or disease duration compared with standard-dose prophylactic anticoagulation (SD-PA), and whether TA outperforms HD-PA; and to compare the net clinical outcomes among the 3 strategies. DESIGN, SETTINGS, AND PARTICIPANTS: The ANTICOVID randomized clinical open-label trial included patients with hypoxemic COVID-19 pneumonia requiring supplemental oxygen and having no initial thrombosis on chest computer tomography with pulmonary angiogram at 23 health centers in France from April 14 to December 13, 2021. Of 339 patients randomized, 334 were included in the primary analysis—114 patients in the SD-PA group, 110 in the HD-PA, and 110 in the TA. At randomization, 90% of the patients were in the intensive care unit. Data analyses were performed from April 13, 2022, to January 3, 2023. INTERVENTIONS: Patients were randomly assigned (1:1:1) to receive either SD-PA, HD-PA, or TA with low-molecular-weight or unfractionated heparin for 14 days. MAIN OUTCOMES AND MEASURES: A hierarchical criterion of all-cause mortality followed by time to clinical improvement at day 28. Main secondary outcome was net clinical outcome at day 28 (composite of thrombosis, major bleeding, and all-cause death). RESULTS: Among the study population of 334 individuals (mean [SD] age, 58.3 [13.0] years; 226 [67.7%] men and 108 [32.3%] women), use of HD-PA and SD-PA had similar probabilities of favorable outcome (47.3% [95% CI, 39.9% to 54.8%] vs 52.7% [95% CI, 45.2% to 60.1%]; P = .48), as did TA compared with SD-PA (50.9% [95% CI, 43.4% to 58.3%] vs 49.1% [95% CI, 41.7% to 56.6%]; P = .82) and TA compared with HD-PA (53.5% [95% CI 45.8% to 60.9%] vs 46.5% [95% CI, 39.1% to 54.2%]; P = .37). Net clinical outcome was met in 29.8% of patients receiving SD-PA (20.2% thrombosis, 2.6% bleeding, 14.0% death), 16.4% receiving HD-PA (5.5% thrombosis, 3.6% bleeding, 11.8% death), and 20.0% receiving TA (5.5% thrombosis, 3.6% bleeding, 12.7% death). Moreover, HD-PA and TA use significantly reduced thrombosis compared with SD-PA (absolute difference, −14.7 [95% CI −6.2 to −23.2] and −14.7 [95% CI −6.2 to −23.2], respectively). Use of HD-PA significantly reduced net clinical outcome compared with SD-PA (absolute difference, −13.5; 95% CI −2.6 to −24.3). CONCLUSIONS AND RELEVANCE: This randomized clinical trial found that compared with SD-PA, neither HD-PA nor TA use improved the primary hierarchical outcome of all-cause mortality or time to clinical improvement in patients with hypoxemic COVID-19 pneumonia; however, HD-PA resulted in significantly better net clinical outcome by decreasing the risk of de novo thrombosis. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04808882
Published: 2023
Full Text: View/download PDF

5. Comparative outcomes of extracorporeal membrane oxygenation for COVID-19 delivered in experienced European centres during successive SARS-CoV-2 variant outbreaks (ECMO-SURGES): an international, multicentre, retrospective cohort study.

Author: Schmidt, Matthieu, Hajage, David, Landoll, Micha, Pequignot, Benjamin, Langouet, Elise, Amalric, Matthieu, Mekontso-Dessap, Armand, Chiscano-Camon, Luis, Surman, Katy, Finnerty, Dylan, Santa-Teresa, Patricia, Arcadipane, Antonio, Millán, Pablo, Roncon-Albuquerque, Roberto, Blandino-Ortiz, Aaron, Blanco-Schweizer, Pablo, Ricart, Pilar, Gimeno-Costa, Ricardo, Albacete, Carlos Luis, and Fortuna, Philip
Subjects: EXTRACORPOREAL membrane oxygenation, SARS-CoV-2, SARS-CoV-2 Delta variant, ADULT respiratory distress syndrome, HYPERLACTATEMIA, COHORT analysis
Abstract: To inform future research and practice, we aimed to investigate the outcomes of patients who received extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS) due to different variants of SARS-CoV-2. This retrospective study included consecutive adult patients with laboratory-confirmed SARS-CoV-2 infection who received ECMO for ARDS in 21 experienced ECMO centres in eight European countries (Austria, Belgium, England, France, Germany, Italy, Portugal, and Spain) between Jan 1, 2020, and Sept 30, 2021. We collected data on patient characteristics, clinical status, and management before and after the initiation of ECMO. Participants were grouped according to SARS-CoV-2 variant (wild type, alpha, delta, or other) and period of the pandemic (first [Jan 1–June 30] and second [July 1–Dec 31] semesters of 2020, and first [Jan 1–June 30] and second [July 1–Sept 30] semesters of 2021). Descriptive statistics and Kaplan-Meier survival curves were used to analyse evolving characteristics, management, and patient outcomes over the first 2 years of the pandemic, and independent risk factors of mortality were determined using multivariable Cox regression models. The primary outcome was mortality 90 days after the initiation of ECMO, with follow-up to Dec 30, 2021. ECMO was initiated in 1345 patients. Patient characteristics and management were similar for the groups of patients infected with different variants, except that those with the delta variant had a younger median age and less hypertension and diabetes. 90-day mortality was 42% (569 of 1345 patients died) overall, and 43% (297/686) in patients infected with wild-type SARS-CoV-2, 39% (152/391) in those with the alpha variant, 40% (78/195) in those with the delta variant, and 58% (42/73) in patients infected with other variants (mainly beta and gamma). Mortality was 10% higher (50%) in the second semester of 2020, when the wild-type variant was still prevailing, than in other semesters (40%). Independent predictors of mortality were age, immunocompromised status, a longer time from intensive care unit admission to intubation, need for renal replacement therapy, and higher Sequential Organ Failure Assessment haemodynamic component score, partial pressure of arterial carbon dioxide, and lactate concentration before ECMO. After adjusting for these variables, mortality was significantly higher with the delta variant than with the other variants, the wild-type strain being the reference. Although crude mortality did not differ between variants, adjusted risk of death was highest for patients treated with ECMO infected with the delta variant of SARS-CoV-2. The higher virulence and poorer outcomes associated with the delta strain might relate to higher viral load and increased inflammatory response syndrome in infected patients, reinforcing the need for a higher rate of vaccination in the population and updated selection criteria for ECMO, should a new and highly virulent strain of SARS-CoV-2 emerge in the future. Mortality was noticeably lower than in other large, multicentre series of patients who received ECMO for COVID-19, highlighting the need to concentrate resources at experienced centres. None. [ABSTRACT FROM AUTHOR]
Published: 2023
Full Text: View/download PDF

6. Comparative outcomes of extracorporeal membrane oxygenation for COVID-19 delivered in experienced European centres during successive SARS-CoV-2 variant outbreaks (ECMO-SURGES): an international, multicentre, retrospective cohort study

Author: Schmidt, Matthieu, Hajage, David, Landoll, Micha, Pequignot, Benjamin, Langouet, Elise, Amalric, Matthieu, Mekontso-Dessap, Armand, Chiscano-Camon, Luis, Surman, Katy, Finnerty, Dylan, Santa-Teresa, Patricia, Arcadipane, Antonio, Millán, Pablo, Roncon-Albuquerque, Roberto, Blandino-Ortiz, Aaron, Blanco-Schweizer, Pablo, Ricart, Pilar, Gimeno-Costa, Ricardo, Albacete, Carlos Luis, Fortuna, Philip, Schellongowski, Peter, Dauwe, Dieter, Winiszewski, Hadrien, Kimmoun, Antoine, Levy, Bruno, Hermans, Greet, Grasselli, Giacomo, Lebreton, Guillaume, Guervilly, Christophe, Martucci, Gennaro, Karagiannidis, Christian, Riera, Jordi, and Combes, Alain
Abstract: To inform future research and practice, we aimed to investigate the outcomes of patients who received extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS) due to different variants of SARS-CoV-2.
Published: 2023
Full Text: View/download PDF

7. A novel method for noninvasive estimation of respiratory effort during pressure support ventilation.

Author: Pasillas-Lépine, William, Tuffet, Samuel, Soussen, Charles, Gendreau, Ségolène, Boujelben, Mohamed Ahmed, Mekontso-Dessap, Armand, and Carteaux, Guillaume
Subjects: RESPIRATORY mechanics, VENTILATION, REAL-time computing, RESPIRATORY muscles
Abstract: This paper proposes an initial proof-of-concept validation for a method that estimates the respiratory effort during pressure support ventilation, based solely on the signals provided by a standard commercial ventilator. The study is carried out on a test bench with an Active Servo Lung 5000 mechanical simulator. The asymptotic behavior of the respiratory mechanics during expiration is exploited to analyze its identifiability (the fact that two sets of respiratory mechanics parameters necessarily generate distinct signals). Furthermore, we propose a method of estimation of the patient's respiratory muscle pressure, based on the degree of smoothness of a signal constructed from the airway pressure and flow measurements. The proposed method was validated on a commercial ventilator, under a wide range of respiratory mechanics parameters and respiratory efforts. Our approach provides a non-invasive estimation of the respiratory effort, which allows for accurately detecting over- and under-assistance. Compared to existing muscle pressure estimation methods, our approach clarifies the conditions under which the respiratory effort of a patient can be estimated and offers a simple way to compute it in real time, without using invasive devices or occlusion-based techniques. [ABSTRACT FROM AUTHOR]
Published: 2024
Full Text: View/download PDF

8. High-Dose Dexamethasone and Oxygen Support Strategies in Intensive Care Unit Patients With Severe COVID-19 Acute Hypoxemic Respiratory Failure: The COVIDICUS Randomized Clinical Trial

Author: Bouadma, Lila, Mekontso-Dessap, Armand, Burdet, Charles, Merdji, Hamid, Poissy, Julien, Dupuis, Claire, Guitton, Christophe, Schwebel, Carole, Cohen, Yves, Bruel, Cedric, Marzouk, Mehdi, Geri, Guillaume, Cerf, Charles, Mégarbane, Bruno, Garçon, Pierre, Kipnis, Eric, Visseaux, Benoit, Beldjoudi, Naima, Chevret, Sylvie, and Timsit, Jean-François
Abstract: IMPORTANCE: The benefit of high-dose dexamethasone and oxygenation strategies vs standard of care for patients with severe acute hypoxemic respiratory failure (AHRF) caused by COVID-19 pneumonia is debated. OBJECTIVES: To assess the benefit of high-dose dexamethasone compared with standard of care dexamethasone, and to assess the benefit of high-flow nasal oxygen (HFNo2) or continuous positive airway pressure (CPAP) compared with oxygen support standard of care (o2SC). DESIGN, SETTING, AND PARTICIPANTS: This multicenter, placebo-controlled randomized clinical trial was conducted in 19 intensive care units (ICUs) in France from April 2020 to January 2021. Eligible patients were consecutive ICU-admitted adults with COVID-19 AHRF. Randomization used a 2 × 3 factorial design for dexamethasone and oxygenation strategies; patients not eligible for at least 1 oxygenation strategy and/or already receiving invasive mechanical ventilation (IMV) were only randomized for dexamethasone. All patients were followed-up for 60 days. Data were analyzed from May 26 to July 31, 2021. INTERVENTIONS: Patients received standard dexamethasone (dexamethasone-phosphate 6 mg/d for 10 days [or placebo prior to RECOVERY trial results communication]) or high-dose dexamethasone (dexamethasone-phosphate 20 mg/d on days 1-5 then 10 mg/d on days 6-10). Those not requiring IMV were additionally randomized to o2SC, CPAP, or HFNo2. MAIN OUTCOMES AND MEASURES: The main outcomes were time to all-cause mortality, assessed at day 60, for the dexamethasone interventions, and time to IMV requirement, assessed at day 28, for the oxygenation interventions. Differences between intervention groups were calculated using proportional Cox models and expressed as hazard ratios (HRs). RESULTS: Among 841 screened patients, 546 patients (median [IQR] age, 67.4 [59.3-73.1] years; 414 [75.8%] men) were randomized between standard dexamethasone (276 patients, including 37 patients who received placebo) or high-dose dexamethasone (270 patients). Of these, 333 patients were randomized among o2SC (109 patients, including 56 receiving standard dexamethasone), CPAP (109 patients, including 57 receiving standard dexamethasone), and HFNo2 (115 patients, including 56 receiving standard dexamethasone). There was no difference in 60-day mortality between standard and high-dose dexamethasone groups (HR, 0.96 [95% CI, 0.69-1.33]; P = .79). There was no significant difference for the cumulative incidence of IMV criteria at day 28 among o2 support groups (o2SC vs CPAP: HR, 1.08 [95% CI, 0.71-1.63]; o2SC vs HFNo2: HR, 1.04 [95% CI, 0.69-1.55]) or 60-day mortality (o2SC vs CPAP: HR, 0.97 [95% CI, 0.58-1.61; o2SC vs HFNo2: HR, 0.89 [95% CI, 0.53-1.47]). Interactions between interventions were not significant. CONCLUSIONS AND RELEVANCE: In this randomized clinical trial among ICU patients with COVID-19–related AHRF, high-dose dexamethasone did not significantly improve 60-day survival. The oxygenation strategies in patients who were not initially receiving IMV did not significantly modify 28-day risk of IMV requirement. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04344730; EudraCT: 2020-001457-43.
Published: 2022
Full Text: View/download PDF

9. End-tidal carbon dioxide during spontaneous breathing trial to predict extubation failure: A prospective observational study

Author: May, Faten, de Prost, Nicolas, Razazi, Keyvan, Carteaux, Guillaume, and Mekontso Dessap, Armand
Abstract: Despite advances in weaning protocols, extubation failure (EF) is associated with poor outcomes. Many predictors of EF have been proposed, including hypercapnia at the end of the spontaneous breathing test (SBT). However, performing arterial blood gases at the end of SBT is not routinely recommended, whereas end-tidal carbon dioxide (EtCO2) can be routinely monitored during SBT.
Published: 2024
Full Text: View/download PDF

10. A preliminary cost-effectiveness analysis of lung protective ventilation with extra corporeal carbon dioxide removal (ECCO2R) in the management of acute respiratory distress syndrome (ARDS)

Author: Ethgen, Oliver, Goldstein, Jacques, Harenski, Kai, Mekontso Dessap, Armand, Morimont, Philippe, Quintel, Michael, and Combes, Alain
Abstract: Mechanical ventilation (MV) is the cornerstone in the management of the acute respiratory distress syndrome (ARDS). Recent research suggests that decreasing the intensity of MV using lung protective ventilation (LPV) with lower tidal volume (Vt) and driving pressure (∆P) could improve survival. Extra-corporal CO2removal (ECCO2R) precisely enables LPV by allowing lower Vt, ∆P and mechanical power while maintaining PaCO2within a physiologic range. This study evaluates the potential cost-effectiveness of ECCO2R-enabled LPV in France.
Published: 2021
Full Text: View/download PDF

11. Quantifying risk of disease due to extended-spectrum β-lactamase producing Enterobacteriaceae in patients who are colonized at ICU admission.

Author: Razazi, Keyvan, Rosman, Jérémy, Phan, Anh-Dao, Carteaux, Guillaume, Decousser, Jean-Winoc, Woerther, Paul Louis, de Prost, Nicolas, Brun-Buisson, Christian, Mekontso Dessap, Armand, and Dessap, Armand Mekontso
Subjects: ANTIBIOTICS, INTENSIVE care units, RESEARCH, RESEARCH methodology, ENTEROBACTERIACEAE diseases, MEDICAL cooperation, EVALUATION research, ENTEROBACTERIACEAE, HYDROLASES, COMPARATIVE studies, CARBAPENEMS
Abstract: Background: The prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) has globally increased and spread to the community. No clinical score is available to select carriers in whom these organisms can be empirically targeted at ICU admission.Methods: We prospectively assessed between 2009 and 2017 the prevalence of ESBL-PE infection in carriers at ICU admission. A logistic regression was used to determine independent risk factors associated with ESBL-PE infection, and to build a clinical risk score.Results: Of the 8,061 admissions over the study 7-year period, 745 (9%) patients were ESBL-PE carriers at admission, of whom 395 had infections at ICU admission including 59 (15%) who had culture-proven ESBL-PE related infection. By multivariable analysis, age >60 years, cirrhosis, being on broad-spectrum antibiotics within the past three months, urinary or intra-abdominal source of infection, and the absence of chronic pulmonary disease, were the five independent factors associated with ESBL-PE infection in carriers. A clinical risk score ranging from 0 to 7 was built based on these variables, with an area under the receiver operating characteristic curve (ROC) of 0.82 (95% CI 0.78-0.86); p <0.001. The prevalence of ESBL-PE infection for clinical risk scores of 0-1, 2-3, 4-5, or 6-7 was 0%, 4%, 26%, and 49%, respectively. The negative predictive value when Mondor ESBL risk score is <4 was 97%.Conclusion: ESBL-PE related infection was not common in carriers at ICU admission. A clinical risk score may spare ESBL-PE carriers with lower risk of ESBL-PE infection at ICU admission unnecessary empiric carbapenem therapy. [ABSTRACT FROM AUTHOR]
Published: 2020
Full Text: View/download PDF

12. Non-invasive ventilation versus high-flow nasal cannula oxygen therapy with apnoeic oxygenation for preoxygenation before intubation of patients with acute hypoxaemic respiratory failure: a randomised, multicentre, open-label trial

Author: Frat, Jean-Pierre, Ricard, Jean-Damien, Quenot, Jean-Pierre, Pichon, Nicolas, Demoule, Alexandre, Forel, Jean-Marie, Mira, Jean-Paul, Coudroy, Rémi, Berquier, Guillaume, Voisin, Benoit, Colin, Gwenhaël, Pons, Bertrand, Danin, Pierre Eric, Devaquet, Jérome, Prat, Gwenael, Clere-Jehl, Raphaël, Petitpas, Franck, Vivier, Emmanuel, Razazi, Keyvan, Nay, Mai-Anh, Souday, Vincent, Dellamonica, Jean, Argaud, Laurent, Ehrmann, Stephan, Gibelin, Aude, Girault, Christophe, Andreu, Pascal, Vignon, Philippe, Dangers, Laurence, Ragot, Stéphanie, Thille, Arnaud W, Chatellier, Delphine, Boissier, Florence, Veinstein, Anne, Robert, René, Deletage-Métreau, Céline, Olivry, Morgane, Dahyot-Fizelier, Claire, Dargent, Auguste, Large, Audrey, Begot, Emmanuelle, Mancia, Claire, Decavele, Maxence, Dres, Martin, Lehingue, Samuel, Papazian, Laurent, Paul, Marine, Marin, Nathalie, Le Meur, Matthieu, Laissy, Mohammed, Rouzé, Anaita, Nseir, Saad, Henry-Lagarrigue, Matthieu, Yehia, Aihem, Martino, Frédéric, Cerf, Charles, Bailly, Pierre, Helms, Julie, Putegnat, Jean Baptiste, Mekontso-Dessap, Armand, Boulain, Thierry, Asfar, Pierre, Cabasson, Séverin, Wallet, Florent, Klouche, Kada, Bellec, Frédéric, Chatellier, Delphine, Boissier, Florence, Veinstein, Anne, Robert, René, Deletage-Métreau, Céline, Olivry, Morgane, Decavele, Maxence, Dres, Martin, Lehingue, Samuel, Papazian, Laurent, Le Meur, Matthieu, Laissy, Mohammed, Rouzé, Anaita, Nseir, Saad, Henry-Lagarrigue, Matthieu, Yehia, Aihem, Cerf, Charles, Mekontso-Dessap, Armand, Boulain, Thierry, and Asfar, Pierre
Abstract: Non-invasive ventilation has never been compared with high-flow oxygen to determine whether it reduces the risk of severe hypoxaemia during intubation. We aimed to determine if preoxygenation with non-invasive ventilation was more efficient than high-flow oxygen in reducing the risk of severe hypoxaemia during intubation.
Published: 2019
Full Text: View/download PDF

13. Pressure-Support Ventilation vs T-Piece During Spontaneous Breathing Trials Before Extubation Among Patients at High Risk of Extubation Failure

Author: Thille, Arnaud W., Coudroy, Rémi, Nay, Mai-Anh, Gacouin, Arnaud, Demoule, Alexandre, Sonneville, Romain, Beloncle, François, Girault, Christophe, Dangers, Laurence, Lautrette, Alexandre, Levrat, Quentin, Rouzé, Anahita, Vivier, Emmanuel, Lascarrou, Jean-Baptiste, Ricard, Jean-Damien, Razazi, Keyvan, Barberet, Guillaume, Lebert, Christine, Ehrmann, Stephan, Massri, Alexandre, Bourenne, Jeremy, Pradel, Gael, Bailly, Pierre, Terzi, Nicolas, Dellamonica, Jean, Lacave, Guillaume, Robert, René, Ragot, Stéphanie, Frat, Jean-Pierre, Boissier, Florence, Chatellier, Delphine, Deletage, Céline, Guignon, Carole, Joly, Florent, Olivry, Morgane, Veinstein, Anne, Benzekri-Lefevre, Dalila, Boulain, Thierry, Muller, Grégoire, Le Tulzo, Yves, Tadié, Jean-Marc, Maamar, Adel, Demiri, Suela, Mayaux, Julien, Decavèle, Maxens, Bouadma, Lila, Dupuis, Claire, Asfar, Pierre, Pierrot, Marc, Béduneau, Gaëtan, Boyer, Déborah, Delmas, Benjamin, Puech, Bérénice, Bachoumas, Konstantinos, Soum, Edouard, Cabasson, Séverin, Hoppe, Marie-Anne, Nseir, Saad, Pouly, Olivier, Bourdin, Gaël, Rosselli, Sylvène, Le Meur, Anthony, Garret, Charlotte, Martin, Maelle, Berquier, Guillaume, Thiagarajah, Abirami, Carteaux, Guillaume, Mekontso-Dessap, Armand, Poidevin, Antoine, Dureau, Anne-Florence, Azais, Marie-Ange, Colin, Gwenhaël, Mercier, Emmanuelle, Morisseau, Marlène, Sabatier, Caroline, Picard, Walter, Gainnier, Marc, Nguyen, Thi-My-Hue, Prat, Gwenaël, Schwebel, Carole, and Buscot, Matthieu
Abstract: Spontaneous breathing trial (SBT) using a T-piece remains the most frequently performed trial before extubation in ICUs.
Published: 2020
Full Text: View/download PDF

14. Edemi polmonari

Author: Bedet, A. and Mekontso Dessap, A.
Abstract: L’edema polmonare viene classificato schematicamente, in base al suo meccanismo, in edema lesionale ed emodinamico. L’edema emodinamico (idrostatico) è secondario a un aumento della pressione idrostatica nel capillare polmonare. Il suo quadro clinico definisce l’edema acuto del polmone di tipo cardiogeno. È la forma più frequente di insufficienza cardiaca sinistra acuta. La sua incidenza è in aumento a causa dell’epidemiologia delle malattie cardiovascolari. I diuretici, i vasodilatatori e la ventilazione non invasiva sono i trattamenti di prima scelta. La ricerca e il trattamento del fattore scompensante (sindrome coronarica, aritmia, picco ipertensivo) sono essenziali. L’edema lesionale è dovuto a un’anomala permeabilità della membrana alveolocapillare e corrisponde clinicamente alla sindrome da distress respiratorio acuto. La sua incidenza è inferiore a quella dell’edema idrostatico nella popolazione generale, ma colpisce circa il 25% dei pazienti che richiedono una ventilazione in terapia intensiva ed è associata a una mortalità del 40% circa. Le sue cause sono molteplici (aggressione di origine polmonare o sistemica) e richiede una gestione eziologica e sintomatica (in generale, ventilazione assistita invasiva chiamata protettiva).
Published: 2020
Full Text: View/download PDF

15. Edema pulmonar

Author: Bedet, A. and Mekontso Dessap, A.
Abstract: El edema pulmonar se clasifica esquemáticamente según su mecanismo en edema lesional y hemodinámico. El edema hemodinámico (hidrostático) es secundario a un aumento de la presión hidrostática en el capilar pulmonar. Su cuadro clínico define el edema agudo de pulmón cardiogénico. Se trata de la forma más frecuente de insuficiencia cardíaca izquierda aguda. Su incidencia va en aumento debido a la epidemiología de las enfermedades cardiovasculares. Los diuréticos, los vasodilatadores y la ventilación no invasiva son los tratamientos de primera línea. La búsqueda y el tratamiento del factor de descompensación (síndrome coronario, arritmia, episodio hipertensivo) son primordiales. El edema lesional se debe a una permeabilidad anormal de la membrana alveolocapilar y corresponde clínicamente al síndrome de dificultad respiratoria aguda. Su incidencia es menor que la del edema hidrostático en la población general, pero afecta a alrededor del 25% de los pacientes que necesitan una ventilación en reanimación y se asocia a una mortalidad de alrededor del 40%. Sus causas son múltiples (agresión de origen pulmonar o sistémica) y requiere un tratamiento etiológico y sintomático (en general, una ventilación asistida invasiva llamada protectora).
Published: 2020
Full Text: View/download PDF

16. Incidence of bloodstream infections and predictive value of qualitative and quantitative skin cultures of patients with overlap syndrome or toxic epidermal necrolysis: A retrospective observational cohort study of 98 cases.

Author: Lecadet, Aude, Woerther, Paul-Louis, Hua, Camille, Colin, Audrey, Gomart, Camille, Decousser, Jean-Winoc, Mekontso Dessap, Armand, Wolkenstein, Pierre, Chosidow, Olivier, de Prost, Nicolas, and Ingen-Housz-Oro, Saskia
Abstract: Background: Epidermal necrolysis (EN) involving ≥10% of the body surface area (BSA) is often complicated by bacterial infections.Objective: We sought to describe the epidemiology of bloodstream infections (BSIs) in EN involving a BSA ≥10% and the diagnostic performances of skin cultures for predicting the pathogen(s) isolated from BSIs.Methods: This retrospective single-center observational study was conducted between 2009 and 2017. All patients referred at the acute phase for EN involving a BSA ≥10% were included. All clinical and bacteriologically relevant data were collected (blood and skin cultures results, number, and severity and time of BSI). Sensitivity, specificity, and predictive values of skin cultures and impact of the bacterial inoculum were investigated.Results: Of 98 patients, 46 (46.9%) had ≥1 BSI episode during the hospital stay (BSIs were caused by Staphylococcus aureus [n = 17, 36.9%] and Pseudomonas aeruginosa [n = 17, 36.9%]). Skin cultures were concordant with blood cultures in 32 cases (71.1%). The positive and negative predictive values were 57.7% and 89.4% for S aureus and 50.0% and 80.9% for P aeruginosa, respectively. BSI increased with cutaneous inoculum of S aureus.Limitations: This was a retrospective single-center design with a low total number of BSIs.Conclusion: Skin cultures for S aureus and P aeruginosa may help predict the pathogens involved in BSIs. [ABSTRACT FROM AUTHOR]
Published: 2019
Full Text: View/download PDF

17. Regional Practice Variation and Outcomes in the Standard Versus Accelerated Initiation of Renal Replacement Therapy in Acute Kidney Injury (STARRT-AKI) Trial: A Post Hoc Secondary Analysis

Author: Vaara, Suvi T., Serpa Neto, Ary, Bellomo, Rinaldo, Adhikari, Neill K. J., Dreyfuss, Didier, Gallagher, Martin, Gaudry, Stephane, Hoste, Eric, Joannidis, Michael, Pettilä, Ville, Wang, Amanda Y., Kashani, Kianoush, Wald, Ron, Bagshaw, Sean M., Ostermann, Marlies, Bagshaw, Sean M, Wald, Ron, Adhikari, Neill K.J., Bellomo, Rinaldo, Dreyfuss, Didier, Du, Bin, Gallagher, Martin P., Gaudry, Stéphane, Hoste, Eric A., Lamontagne, François, Joannidis, Michael, Liu, Kathleen D., McAuley, Daniel F., McGuinness, Shay P., Nichol, Alistair D., Ostermann, Marlies, Palevsky, Paul M., Qiu, Haibo, Pettilä, Ville, Schneider, Antoine G., Smith, Orla M., Vaara, Suvi T., Weir, Matthew, Bellomo, Rinaldo, Eastwood, Glenn M., Peck, Leah, Young, Helen, Kruger, Peter, Laurie, Gordon, Saylor, Emma, Meyer, Jason, Venz, Ellen, Wetzig, Krista, French, Craig, McGain, Forbes, Mulder, John, Fennessy, Gerard, Koottayi, Sathyajith, Bates, Samantha, Towns, Miriam, Morgan, Rebecca, Tippett, Anna, Udy, Andrew, Mason, Chris, Licari, Elisa, Gantner, Dashiell, McClure, Jason, Nichol, Alistair, McCracken, Phoebe, Board, Jasmin, Martin, Emma, Vallance, Shirley, Young, Meredith, Vladic, Chelsey, McGloughlin, Steve, Gattas, David, Buhr, Heidi, Coles, Jennifer, Hutch, Debra, Wun, James, Cole, Louise, Whitehead, Christina, Lowrey, Julie, Masters, Kristy, Gresham, Rebecca, Campbell, Victoria, Gutierrez, David, Brailsford, Jane, Forbes, Loretta, Murray, Lauren, Maguire, Teena, NiChonghaile, Martina, Orford, Neil, Bone, Allison, Elderkin, Tania, Salerno, Tania, Chimunda, Tim, Fletcher, Jason, Broadfield, Emma, Porwal, Sanjay, Knott, Cameron, Boschert, Catherine, Smith, Julie, Richardson, Angus, Hill, Dianne, Duke, Graeme, Oziemski, Peter, Cegarra, Santiago, Chan, Peter, Welsh, Deborah, Hunter, Stephanie, Roodenburg, Owen, Dyett, John, Kokotsis, Nicos, Moser, Max, Yang, Yang, Padayachee, Laven, Vetro, Joseph, Gangopadhyay, Himangsu, Kaufman, Melissa, Ghosh, Angaj, Said, Simone, Patel, Alpesh, Bihari, Shailesh, Matheson, Elisha, Jin, Xia, Shrestha, Tapaswi, Schwartz, Kate, Gallagher, Martin P., Cross, Rosalba, Cheung, Winston, Wong, Helen, Kol, Mark, Shah, Asim, Wang, Amanda Y., Endre, Zoltan, Bradford, Celia, Janin, Pierre, Finfer, Simon, Diel, Naomi, Gatward, Jonathan, Hammond, Naomi, Delaney, Anthony, Bass, Frances, Yarad, Elizabeth, Buscher, Hergen, Reynolds, Claire, Baker, Nerilee, Joannidis, Michael, Bellmann, Romuald, Peer, Andreas, Hasslacher, Julia, Koglberger, Paul, Klein, Sebastian, Zotter, Klemens, Brandtner, Anna, Finkenstedt, Armin, Ditlbacher, Adelheid, Hartig, Frank, Fries, Dietmar, Bachler, Mirjam, Schenk, Bettina, Wagner, Martin, Staudinger, Thomas, Tiller, Esther, Schellongowski, Peter, Bojic, Andja, Hoste, Eric A., Bracke, Stephanie, De Crop, Luc, Vermeiren, Daisy, Thome, Fernando, Chiella, Bianca, Fendt, Lucia, Antunes, Veronica, Maisonneuve-Rosemont, Lafrance, Jean-Philippe, Lamontagne, François, D’Aragon, Frédérick, St-Arnaud, Charles, Mayette, Michael, Carbonnaeu, Élaine, Marchand, Joannie, Masse, Marie-Hélène, Ladouceur, Marilène, Turgeon, Alexis F., Lauzier, François, Bellemare, David, Langis Francoeur, Charles, LeBlanc, Guillaume, Guilbault, Gabrielle, Grenier, Stéphanie, Cloutier, Eve, Boivin, Annick, Delisle-Thibault, Charles, Giannakouros, Panagiota, Costerousse, Olivier, Cailhier, Jean-François, Carrier, François-Martin, Ghamraoui, Ali, Lebrasseur, Martine, Benettaib, Fatna, Salamé, Maya, Boumahni, Dounia, Tung Sia, Ying, Naud, Jean-François, Roy, Isabelle, Stelfox, Henry T., Ruddell, Stacey, Manns, Braden J., Duggan, Shelley, Carney, Dominic, Barchard, Jennifer, Whitlock, Richard P., Belley-Cote, Emilie, Savija, Nevena, Sabev, Alexandra, Campbell, Troy, Creary, Thais, Devereaux, Kelson, Brodutch, Shira, Rigatto, Claudio, Paunovic, Bojan, Mooney, Owen, Glybina, Anna, Harasemiw, Oksana, Di Nella, Michelle, Harmon, John, Mehta, Navdeep, Lakatos, Louis, Haslam, Nicole, Lellouche, Francois, Simon, Mathieu, Tung, Ying, Lizotte, Patricia, Bourchard, Pierre-Alexandre, Rochwerg, Bram, Karachi, Tim, Millen, Tina, Muscedere, John, Maslove, David, Gordon Boyd, J., Sibley, Stephanie, Drover, John, Hunt, Miranda, Georgescu, Ilinca, Wax, Randy, Lenga, Ilan, Sridhar, Kavita, Steele, Andrew, Fusco, Kelly, Ghate, Taneera, Tolibas, Michael, Robinson, Holly, Weir, Matthew A., Taneja, Ravi, Ball, Ian M., Garg, Amit, Campbell, Eileen, Ovsenek, Athena, Bagshaw, Sean M., van Diepen, Sean, Baig, Nadia, Magder, Sheldon, Yao, Han, Alam, Ahsan, Campisi, Josie, MacIntyre, Erika, Rokosh, Ella, Scherr, Kimberly, Lapinsky, Stephen, Mehta, Sangeeta, Shah, Sumesh, Niven, Daniel J., Stelfox, Henry T., Ruddell, Stacey, Russell, Michael, Jim, Kym, Brown, Gillian, Oxtoby, Kerry, Hall, Adam, Benoit, Luc, Sokolowski, Colleen, Prasad, Bhanu, Rao, Jag, Giebel, Shelley, Kutsogiannis, Demetrios J., Thompson, Patricia, Thompson, Tayne, Cirone, Robert, Kavikondala, Kanthi, Soth, Mark, Clarke, France, Takaoka, Alyson, Wald, Ron, Mazer, David, Burns, Karen, Friedrich, Jan, Klein, David, Sandhu, Gyan, Santos, Marlene, Khalid, Imrana, Hodder, Jennifer, Dodek, Peter, Ayas, Najib, Alcuaz, Victoria, Suen, Gabriel, Rewa, Oleksa, Singh, Gurmeet, Norris, Sean, Gibson, Neil, Arias, Castro, Shami, Aysha, Pelletier, Celine, Adhikari, Neill K.J., Zahirieh, Alireza, Amaral, Andre, Marinoff, Nicole, Kaur, Navjot, Perez, Adic, Wang, Jane, Haljan, Gregory, Condin, Christopher, McIntyre, Lauralyn, Gomes, Brigette, Porteous, Rebecca, Watpool, Irene, Hiremath, Swapnil, Clark, Edward, Herridge, Margaret S., Backhouse, Felicity, Elizabeth Wilcox, M., Walczak, Karolina, Ki, Vincent, Sharman, Asheer, Romano, Martin, Bagshaw, Sean M., Noel Gibney, R.T., Romanovsky, Adam S., Rewa, Oleksa, McCoshen, Lorena, Baig, Nadia, Wood, Gordon, Ovakim, Daniel, Auld, Fiona, Carney, Gayle, Duan, Meili, Ji, Xiaojun, Guo, Dongchen, Qi, Zhili, Lin, Jin, Zhang, Meng, Dong, Lei, Liu, Jingfeng, Liu, Pei, Zhi, Deyuan, Bai, Guoqiang, Qiu, Yu, Yang, Ziqi, Bai, Jing, Liu, Zhuang, Zhuang, Haizhou, Wang, Haiman, Li, Jian, Zhao, Mengya, Zhou, Xiao, Shi, Xianqing, Ye, Baning, Liu, Manli, Wu, Jing, Fu, Yongjian, Long, Dali, Pan, Yu, Wang, Jinlong, Mei, Huaxian, Zhang, Songsong, Wen, Mingxiang, Yang, Enyu, Mu, Sijie, Li, Jianquan, Hu, Tingting, Qin, Bingyu, Li, Min, Wang, Cunzhen, Dong, Xin, Wang, Kaiwu, Wang, Haibo, Yang, Jianxu, Du, Bin, Wang, Chuanyao, Wang, Dongxin, Li, Nan, Yu, Zhui, Xu, Song, Yao, Lan, Hou, Guo, Liu, Zhou, Lu, Liping, Lian, Yingtao, Wang, Chunting, Zhang, Jichen, Ding, Ruiqi, Qi, Guoqing, Wang, Qizhi, Wang, Peng, Meng, Zhaoli, Chen, Man, Hu, Xiaobo, He, Xiandi, Zhao, Shibing, Hang, Lele, Li, Rui, Qin, Suhui, Lu, Kun, Dun, Shijuan, Liu, Cheng, Zhou, Qi, Chen, Zhenzhen, Mei, Jing, Zhang, Minwei, Xu, Hao, Lin, Jincan, Shi, Qindong, Fu, Lijuan, Zeng, Qinjing, Ma, Hongye, Yan, Jinqi, Gao, Lan, Liu, Hongjuan, Zhang, Lei, Li, Hao, He, Xiaona, Fan, Jingqun, Guo, Litao, Liu, Yu, Wang, Xue, Sun, Jingjing, Liu, Zhongmin, Yang, Juan, Ding, Lili, Sheng, Lulu, Liu, Xingang, Yan, Jie, Wang, Quihui, Wang, Yifeng, Zhao, Dan, Zhao, Shuangping, Hu, Chenghuan, Li, Jing, Deng, Fuxing, Qiu, Haibo, Yang, Yi, Mo, Min, Pan, Chun, Wu, Changde, Huang, Yingzi, Huang, Lili, Liu, Airan, Pettilä, Ville, Vaara, Suvi T., Korhonen, Anna-Maija, Törnblom, Sanna, Sutinen, Sari, Pettilä, Leena, Heinonen, Jonna, Lappi, Eliria, Suhonen, Taria, Karlsson, Sari, Hoppu, Sanna, Jalkanen, Ville, Kuitunen, Anne, Levoranta, Markus, Långsjö, Jaakko, Ristimäki, Sanna, Malila, Kaisa, Wootten, Anna, Varila, Simo, Järvisalo, Mikko J, Inkinen, Outi, Kentala, Satu, Leivo, Keijo, Haltia, Paivi, Dreyfuss, Didier, Ricard, Jean-Damien, Messika, Jonathan, Tiagarajah, Abirami, Emery, Malo, Dechanet, Aline, Gernez, Coralie, Roux, Damien, Martin-Lefevre, Laurent, Fiancette, Maud, Vinatier, Isabelle, Claude Lacherade, Jean, Colin, Gwenhaël, Lebert, Christine, Azais, Marie-Ange, Yehia, Aihem, Pouplet, Caroline, Henry- Lagarrigue, Matthieu, Seguin, Amélie, Crosby, Laura, Maizel, Julien, Titeca-Beauport, Dimitri, Combes, Alain, Nieszkowska, Ania, Masi, Paul, Demoule, Alexandre, Mayaux, Julien, Dres, Martin, Morawiec, Elise, Decalvele, Maxens, Demiri, Suela, Faure, Morgane, Marios, Clémence, Mallet, Maxime, Amélie Ordon, Marie, Morizot, Laura, Cantien, Marie, Pousset, François, Gaudry, Stéphane, Poirson, Florent, Cohen, Yves, Argaud, Laurent, Cour, Martin, Bitker, Laurent, Simon, Marie, Hernu, Romain, Baudry, Thomas, De La Salle, Sylvie, Robine, Adrien, Sedillot, Nicholas, Tchenio, Xavier, Bouisse, Camille, Roux, Sylvie, Barbar, Davide, Trusson, Rémi, Tamion, Fabienne, Grangé, Steven, Carpentier, Dorothée, Chevrel, Guillaume, Ensenyat-Martin, Luis, Marque, Sophie, Quenot, Jean-Pierre, Andreu, Pascal, Dargent, Auguste, Large, Audrey, Chudeau, Nicolas, Landais, Mickael, Derrien, Benoit, Christophe Callahan, Jean, Guitton, Christophe, Le Moal, Charlène, Robert, Alain, Asehnoune, Karim, Cinotti, Raphaël, Grillot, Nicolas, Demeure, Dominique, Vinsonneau, Christophe, Rahmani, Imen, Marzouk, Mehdi, Dekeyser, Thibault, Sejourne, Caroline, Verlay, Mélanie, Thevenin, Fabienne, Delecolle, Lucie, Didier Thevenin, Lens, Souweine, Bertrand, Coupez, Elisabeth, Adda, Mireille, Eraldi, Jean-Pierre, Marchalot, Antoine, De Prost, Nicolas, Mekontso Dessap, Armand, Razazi, Keyvan, Meziani, Ferhat, Boisrame-Helms, Julie, Clere-Jehl, Raphael, Delabranche, Xavier, Kummerlen, Christine, Merdji, Hamid, Monnier, Alexandra, Rabouel, Yannick, Rahmani, Hassene, Allam, Hayat, Chenaf, Samir, Franja, Vincenta, Pons, Bertrand, Carles, Michel, Martino, Frédéric, Richard, Régine, Zuber, Benjamin, Lacave, Guillaume, Lakhal, Karim, Rozec, Bertrand, Dang Van, Hoa, Boulet, Éric, Dubos, René, Fadel, Fouad, Cleophax, Cedric, Dufour, Nicolas, Grant, Caroline, Thuong, Marie, Reignier, Jean, Canet, Emmanuel, Nicolet, Laurent, Boulain, Thierry, Nay, Mai-Anh, Benzekri, Dalila, Barbier, François, Bretagnol, Anne, Kamel, Toufik, Mathonnet, Armelle, Muller, Grégoire, Skarzynski, Marie, Rossi, Julie, Pradet, Amandine, Dos Santos, Sandra, Guery, Aurore, Muller, Lucie, Felix, Luis, Bohé, Julien, Thiéry, Guillaume, Aissaoui, Nadia, Vimpere, Damien, Commeureuc, Morgane, Diehl, Jean-Luc, Guerot, Emmanuel, Liangos, Orfeas, Wittig, Monika, Zarbock, Alexander, Küllmar, Mira, van Waegeningh, Thomas, Rosenow, Nadine, Nichol, Alistair D., Brickell, Kathy, Doran, Peter, Murray, Patrick T., Landoni, Giovanni, Lembo, Rosalba, Zangrillo, Alberto, Monti, Giacomo, Tozzi, Margherita, Marzaroli, Matteo, Lombardi, Gaetano, Paternoster, Gianluca, Vitiello, Michelangelo, McGuinness, Shay, Parke, Rachael, Butler, Magdalena, Gilder, Eileen, Cowdrey, Keri-Anne, Wallace, Samantha, Hallion, Jane, Woolett, Melissa, Neal, Philippa, Duffy, Karina, Long, Stephanie, McArthur, Colin, Simmonds, Catherine, Chen, Yan, McConnochie, Rachael, Newby, Lynette, Knight, David, Henderson, Seton, Mehrtens, Jan, Morgan, Stacey, Morris, Anna, Vander Hayden, Kymbalee, Burke, Tara, Bailey, Matthew, Freebairn, Ross, Chadwick, Lesley, Park, Penelope, Rolls, Christine, Thomas, Liz, Buehner, Ulrike, Williams, Erin, Albrett, Jonathan, Kirkham, Simon, Jackson, Carolyn, Browne, Troy, Goodson, Jennifer, Jackson, David, Houghton, James, Callender, Owen, Higson, Vicki, Keet, Owen, Dominy, Clive, Young, Paul, Hunt, Anna, Judd, Harriet, Lawrence, Cassie, Olatunji, Shaanti, Robertson, Yvonne, Latimer-Bell, Charlotte, Hendry, Deborah, Mckay-Vucago, Agnes, Beehre, Nina, Lesona, Eden, Navarra, Leanlove, Robinson, Chelsea, Jang, Ryan, Junge, Andrea, Lambert, Bridget, Schneider, Antoine G., Thibault, Michel, Eckert, Philippe, Kissling, Sébastien, Polychronopoulos, Erietta, Poli, Elettra, Altarelli, Marco, Schnorf, Madeleine, Abed Mallaird, Samia, Heidegger, Claudia, Perret, Aurelie, Montillier, Philippe, Sangla, Frederic, Neils, Seigenthaller, De Watteville, Aude, Phull, Mandeep-Kaur, George, Aparna, Hussain, Nauman, Pogreban, Tatiana, Lobaz, Steve, Daniels, Alison, Cunningham, Mishell, Kerr, Deborah, Nicholson, Alice, Shanmugasundaram, Pradeep, Abrams, Judith, Manso, Katarina, Hambrook, Geraldine, McKerrow, Elizabeth, Salva, Juvy, Foulkes, Stephen, Wise, Matthew, Morgan, Matt, Brooks, Jenny, Cole, Jade, Michelle Davies, Tracy, Hill, Helen, Thomas, Emma, Vizcaychipi, Marcela, Baharlo, Behrad, Carungcong, Jaime, Costa, Patricia, Martins, Laura, Kapoor, Ritoo, Hazelton, Tracy, Moon, Angela, Musselwhite, Janine, Shelley, Ben, McCall, Philip, Ostermann, Marlies, Arbane, Gill, Bociek, Aneta, Marotti, Martina, Lim, Rosario, Campos, Sara, Grau Novellas, Neus, Cennamo, Armando, Slack, Andrew, Wyncoll, Duncan, Camporota, Luigi, Sparkes, Simon, Tilley, Rosalinde, Rattray, Austin, Moreland, Gayle, Duffy, Jane, McGonigal, Elizabeth, Hopkins, Philip, Finney, Clare, Smith, John, Noble, Harriet, Watson, Hayley, Harris, Claire-Louise, Clarey, Emma, Corcoran, Eleanor, Beck, James, Howcroft, Clare, Youngs, Nora, Wilby, Elizabeth, Ogg, Bethan, Wolverson, Adam, Lee, Sandra, Butler, Susie, Okubanjo, Maryanne, Hindle, Julia, Welters, Ingeborg, Williams, Karen, Johnson, Emily, Patrick-Heselton, Julie, Shaw, David, Waugh, Victoria, Stewart, Richard, Mwaura, Esther, Wren, Lynn, Mew, Louise, Sutherland, Sara-Beth, Adderley, Jane, Ruddy, Jim, Harkins, Margaret, Kaye, Callum, Scott, Teresa, Mitchell, Wendy, Anderson, Felicity, Willox, Fiona, Jagannathan, Vijay, Clark, Michele, Purv, Sarah, Sharman, Andrew, Meredith, Megan, Ryan, Lucy, Conner, Louise, Peters, Cecilia, Harvey, Dan, Roshdy, Ashraf, Collins, Amy, Sim, Malcolm, Henderson, Steven, Chee, Nigel, Pitts, Sally, Bowman, Katie, Dilawershah, Maria, Vamplew, Luke, Howe, Elizabeth, Rogers, Paula, Hernandez, Clara, Prendergast, Clara, Benton, Jane, Rosenberg, Alex, Forni, Lui G., Grant, Alice, Carvelli, Paula, Raithatha, Ajay, Bird, Sarah, Richardson, Max, Needham, Matthew, Hirst, Claire, Ball, Jonathan, Leaver, Susannah, Howlett, Luisa, Castro Delgado, Carlos, Farnell-Ward, Sarah, Farrah, Helen, Gray, Geraldine, Joseph, Gipsy, Robinson, Francesca, Tridente, Ascanio, Harrop, Clare, Shuker, Karen, McLaughlan, Derek, Ramsey, Judith, Meehan, Sharon, Oliver Rose, Bernd, Reece-Anthony, Rosie, Gurung, Babita, Whitehouse, Tony, Snelson, Catherine, Veenith, Tonny, Johnston, Andy, Cooper, Lauren, Carrera, Ron, Ellis, Karen, Fellows, Emma, Harkett, Samanth, Bergin, Colin, Spruce, Elaine, Despy, Liesl, Goundry, Stephanie, Dooley, Natalie, Mason, Tracy, Clark, Amy, Dignam, Gemma, Ward, Geraldine, Attwood, Ben, Parsons, Penny, Mason, Sophie, Margarson, Michael, Lord, Jenny, McGlone, Philip, Hodgson, Luke E., Chadbourn, Indra, Gomez, Raquel, Margalef, Jordi, Pretorius, Rinus, Hamshere, Alexandra, Carter, Joseph, Cahill, Hazel, Grainger, Lia, Howard, Kate, Forshaw, Greg, Guy, Zoe, Kashani, Kianoush B., Albright Jr., Robert C., Amsbaugh, Amy, Stoltenberg, Anita, Niven, Alexander S., Lynch, Matthew, O’Mara, AnnMarie, Naeem, Syed, Sharif, Sairah, McKenney Goulart, Joyce, Lynch, Matthew, O’Mara, AnnMarie, Naeem, Syed, Sharif, Sairah, McKenney Goulart, Joyce, Tolwani, Ashita, Lyas, Claretha, Latta, Laura, Bihorac, Azra, Hashemighouchani, Haleh, Efron, Philip, Ruppert, Matthew, Cupka, Julie, Kiley, Sean, Carson, Joshua, White, Peggy, Omalay, George, Brown, Sherry, Velez, Laura, Marceron, Alina, Neyra, Javier A., Carlos Aycinena, Juan, Elias, Madona, Ortiz-Soriano, Victor M., Hauschild, Caroline, and Dorfman, Robert
Published: 2024
Full Text: View/download PDF

18. Incidence, Risk Factors, and Long-Term Outcomes for Extubation Failure in ICU in Patients With Obesity

Author: De Jong, Audrey, Capdevila, Mathieu, Aarab, Yassir, Cros, Matthieu, Pensier, Joris, Lakbar, Ines, Monet, Clément, Quintard, Hervé, Cinotti, Raphael, Asehnoune, Karim, Arnal, Jean-Michel, Guitton, Christophe, Paugam-Burtz, Catherine, Abback, Paer, Mekontso-Dessap, Armand, Lakhal, Karim, Lasocki, Sigismond, Plantefeve, Gaetan, Claud, Bernard, Pottecher, Julien, Corne, Philippe, Ichai, Carole, Molinari, Nicolas, Chanques, Gerald, Papazian, Laurent, Azoulay, Elie, and Jaber, Samir
Abstract: To our knowledge, no large observational study has compared the incidence and risk factors for extubation failure within 48 h and during ICU stay in the same cohort of unselected critically ill patients with and without obesity.
Published: 2024
Full Text: View/download PDF

19. Inability of Diaphragm Ultrasound to Predict Extubation Failure

Author: Vivier, Emmanuel, Muller, Michel, Putegnat, Jean-Baptiste, Steyer, Julie, Barrau, Stéphanie, Boissier, Florence, Bourdin, Gaël, Mekontso-Dessap, Armand, Levrat, Albrice, Pommier, Christian, and Thille, Arnaud W.
Abstract: Diaphragmatic dysfunction may promote weaning difficulties in patients who are mechanically ventilated.
Published: 2019
Full Text: View/download PDF

20. A New Delayed Hemolysis Transfusion Diagnosis Score Based on Intra Vascular Hemolysis Parameters

Author: Bartolucci, Pablo, Habibi, Anoosha, Mekontso-Dessap, Armand, Adu, Emmanuel, Chadebech, Philippe, Perkins, Meghan, Bencheikh, Laura, Cambot, Marie, Rapsode, Sophia, Floch, Aline, Pirenne, France, and Kiger, Laurent
Abstract: Introduction
Published: 2023
Full Text: View/download PDF

21. A survey on the management of new onset atrial fibrillation in critically ill patients with septic shock

Author: Labbé, Vincent, Bagate, François, Cohen, Ariel, Voiriot, Guillaume, Fartoukh, Muriel, and Mekontso-Dessap, Armand
Abstract: Unlabelled TableATEArterial Thrombotic EventCHA2DS2VAScCongestive heart failure, Hypertension, Age ≥ 75 (doubled), Diabetes mellitus, prior Stroke or transient ischemic attack or thromboembolism (doubled), Vascular disease, Age 65 to 74, Sex category (female)HAS-BLEDHypertension, Abnormal renal function, Abnormal liver function, Stroke, Bleeding, Labile INR, Elderly, DrugICUIntensive Care UnitNOAFNew Onset Supraventricular Atrial Fibrillation
Published: 2021
Full Text: View/download PDF

22. A bright spinal cord

Author: Lescroart, M., Bapst, B., Dormeuil, A., and Mekontso Dessap, A.
Published: 2021
Full Text: View/download PDF

23. Understanding the Role of Neutrophil Extracellular Traps in Patients With Severe Pneumonia and ARDS

Author: Bendib, Inès, de Chaisemartin, Luc, Mekontso Dessap, Armand, Chollet-Martin, Sylvie, and de Prost, Nicolas
Published: 2019
Full Text: View/download PDF

24. Intubation et extubation du patient de réanimation

Author: Quintard, Hervé, l’Her, Erwan, Pottecher, Julien, Adnet, Frédéric, Constantin, Jean-Michel, Dejong, Audrey, Diemunsch, Pierre, Fesseau, Rose, Freynet, Anne, Girault, Christophe, Guitton, Christophe, Hamonic, Yan, Maury, Eric, Mekontso-Dessap, Armand, Michel, Fabrice, Nolent, Paul, Perbet, Sébastien, Prat, Gwenaël, Roquilly, Antoine, Tazarourte, Karim, Terzi, Nicolas, Thille, Arnaud W., Alves, Mikael, Gayat, Etienne, and Donetti, Laurence
Abstract: L’intubation et l’extubation ne sont pas des procédures sans risque en réanimation et peuvent être associées à une augmentation de la morbidité et de la mortalité. L’intubation en soins intensifs est souvent nécessaire dans des situations d’urgence pour des patients instables sur le plan respiratoire et hémodynamique. Dans ces circonstances, il s’agit d’une intervention à haut risque avec des complications mettant en jeu le pronostic vital du patient (20 à 50 %). En outre, des problèmes d’intubation difficile peuvent également être présent et donner lieu à des complications. Plusieurs nouvelles techniques, telles que la vidéolaryngoscopie, ont été développées récemment et méritent d’être positionnés dans notre arsenal technique. L’extubation est une autre période à risque, avec 10 % d’échec qui peut être associée également à un mauvais pronostic. Une meilleure compréhension des causes de ces échecs est essentielle pour optimiser le geste. En élaborant ces recommandations, les experts SFAR/SRLF ont utilisé les nouvelles données sur l’intubation et l’extubation publiées depuis une dizaine d’années pour actualiser les procédures existantes, incorporer les avancées plus récentes et proposer des algorithmes.
Published: 2018
Full Text: View/download PDF

25. Mechanisms of Thrombocytopenia During Septic Shock: A Multiplex Cluster Analysis of Endogenous Sepsis Mediators

Author: Bedet, Alexandre, Razazi, Keyvan, Boissier, Florence, Surenaud, Mathieu, Hue, Sophie, Giraudier, Stéphane, Brun-Buisson, Christian, and Mekontso Dessap, Armand
Abstract: Supplemental Digital Content is available in the text
Published: 2018
Full Text: View/download PDF

26. Prognostic Value of Relative Adrenal Insufficiency During Cardiogenic Shock: A Prospective Cohort Study With Long-Term Follow-Up

Author: Bagate, François, Lellouche, Nicolas, Lim, Pascal, Moutereau, Stephane, Razazi, Keyvan, Carteaux, Guillaume, de Prost, Nicolas, Dubois-Randé, Jean-Luc, Brun-Buisson, Christian, and Mekontso Dessap, Armand
Abstract: Supplemental Digital Content is available in the text
Published: 2017
Full Text: View/download PDF

27. Differential Effect of Targeted Temperature Management Between 32 °C and 36 °C Following Cardiac Arrest According to Initial Severity of Illness

Author: Lascarrou, Jean Baptiste, Dumas, Florence, Bougouin, Wulfran, Legriel, Stephane, Aissaoui, Nadia, Deye, Nicolas, Beganton, Frankie, Lamhaut, Lionel, Jost, Daniel, Vieillard-Baron, Antoine, Nichol, Graham, Marijon, Eloi, Jouven, Xavier, Cariou, Alain, Adnet, F., Agostinucci, J.M., Aissaoui-Balanant, N., Algalarrondo, V., Alla, F., Alonso, C., Amara, W., Annane, D., Antoine, C., Aubry, P., Azoulay, E., Beganton, F., Billon, C., Bougouin, W., Boutet, J., Bruel, C., Bruneval, P., Cariou, A., Carli, P., Casalino, E., Cerf, C., Chaib, A., Cholley, B., Cohen, Y., Combes, A., Coulaud, J.M., Da Silva, D., Das, V., Demoule, A., Denjoy, I., Deye, N., Diehl, J.L., Dinanian, S., Domanski, L., Dreyfuss, D., Dubois-Rande, J.L., Dumas, F., Duranteau, J., Empana, J.P., Extramiana, F., Fagon, J.Y., Fartoukh, M., Fieux, F., Gandjbakhch, E., Geri, G., Guidet, B., Halimi, F., Henry, P., Jabre, P., Joseph, L., Jost, D., Jouven, X., Karam, N., Lacotte, J., Lahlou-Laforet, K., Lamhaut, L., Lanceleur, A., Langeron, O., Lavergne, T., Lecarpentier, E., Leenhardt, A., Lellouche, N., Lemiale, V., Lemoine, F., Linval, F., Loeb, T., Ludes, B., Luyt, C.E., Mansencal, N., Mansouri, N., Marijon, E., Maury, E., Maxime, V., Megarbane, B., Mekontso-Dessap, A., Mentec, H., Mira, J.P., Monnet, X., Narayanan, K., Ngoyi, N., Perier, M.C., Piot, O., Plaisance, P., Plaud, B., Plu, I., Raphalen, J.H., Raux, M., Revaux, F., Ricard, J.D., Richard, C., Riou, B., Roussin, F., Santoli, F., Schortgen, F., Sharshar, T., Sideris, G., Spaulding, C., Teboul, J.L., Timsit, J.F., Tourtier, J.P., Tuppin, P., Ursat, C., Varenne, O., Vieillard-Baron, A., Voicu, S., Wahbi, K., and Waldmann, V.
Abstract: Recent guidelines have emphasized actively avoiding fever to improve outcomes in patients who are comatose following resuscitation from cardiac arrest (ie, out-of-hospital cardiac arrest). However, whether targeted temperature management between 32 °C and 36 °C (TTM32-36) can improve neurologic outcome in some patients remains debated.
Published: 2023
Full Text: View/download PDF

28. Pulmonary Vascular Dysfunction and Cor Pulmonale During Acute Respiratory Distress Syndrome in Sicklers

Author: Cecchini, Jérôme, Boissier, Florence, Gibelin, Aude, de Prost, Nicolas, Razazi, Keyvan, Carteaux, Guillaume, Galacteros, Frederic, Maitre, Bernard, Brun-Buisson, Christian, and Mekontso Dessap, Armand
Abstract: Supplemental Digital Content is available in the text
Published: 2016
Full Text: View/download PDF

29. Risk of Cross Transmission with Point-of-Care Ultrasound System: Effect of a Glass-Sealed Control Panel on Microbial Contamination

Author: Mekontso Dessap, Armand, Jansen, Chloe, Boissier, Florence, Razazi, Keyvan, de Prost, Nicolas, Michaud, Gaël, Cizeau, Florence, Ducellier, David, Abid, Shariq, Decousser, Jean-Winoc, and Brun-Buisson, Christian
Abstract: Contamination of a point-of-care ultrasound system (POCUS) mainly involved electrocardiography accessories and included pathogenic microorganisms. The use of a glass-sealed control panel significantly facilitated its cleaning and reduced its bacterial contamination compared with a standard control panel. Overall hand hygiene compliance during examinations with POCUS was poor.Infect Control Hosp Epidemiol2014;35(12):1539–1542
Published: 2014
Full Text: View/download PDF

30. Prevention of contrast-induced nephropathy by N-acetylcysteine in critically ill patients: Different definitions, different results.

Author: Chousterman, Benjamin G., Bouadma, Lila, Moutereau, Stephane, Loric, Sylvain, Alvarez-Gonzalez, Antonio, Mekontso-Dessap, Armand, Laissy, Jean-Pierre, Rahmouni, Alain, Katsahian, Sandrine, Brochard, Laurent, and Schortgen, Frédérique
Subjects: KIDNEY disease diagnosis, ACADEMIC medical centers, CRITICAL care medicine, CRITICALLY ill, GLOMERULAR filtration rate, HOSPITAL admission & discharge, KIDNEY diseases, LONGITUDINAL method, MEDICAL protocols, PATIENTS, DATA analysis, CONTRAST media, ACETYLCYSTEINE, DISEASE complications, THERAPEUTICS
Abstract: Purpose: The use of N-acetylcysteine (NAC) for preventing contrast induced nephropathy (CIN) is debated in the intensive care unit. NAC may alter the concentration of serum creatinine and interfere with CIN diagnosis. The effectiveness of NAC was evaluated with a special attention on its specific effect on creatinine levels compared to cystatin C. Methods: In a first period, we prospectively enrolled patients receiving saline and low osmolality contrast media for 140 exams in 2 intensive care units with opposite policies regarding the use of NAC. Renal impairment was defined by both the classical CIN and the "sensitive" Acute Kidney Injury Network (AKIN) (taking creatinine and diuresis) definitions. In a second period, we compared the evolution of serum creatinine and cystatin C after 23 additional contrast examinations under NAC. Results: Seventy exams with and without NAC were compared in the first period. Risk factors for CIN were similar in the two intensive care unit populations. No difference in CIN incidence was found with and without NAC, using the CIN (10/70 vs 15/70) or the AKIN (24/70 vs 22/70) definition. Interestingly, NAC seemed to reduce renal impairment when the creatinine criterion of the AKIN definition was considered alone [9% vs 21%, P = .033]. Overall, the incidence of renal impairment was 18%, 33% and 15% using the CIN definition, the AKIN, or using AKIN with creatinine alone. Serum creatinine significantly decreased after exams with NAC while cystatin C remained stable. Conclusion: The incidence of CIN does not seem to be influenced by NAC, except if small changes in creatinine only are considered. [ABSTRACT FROM AUTHOR]
Published: 2013
Full Text: View/download PDF

31. Small-bore catheter versus chest tube drainage for pneumothorax.

Author: Contou, Damien, Razazi, Keyvan, Katsahian, Sandrine, Maitre, Bernard, Mekontso-Dessap, Armand, Brun-Buisson, Christian, and Thille, Arnaud W.
Abstract: Abstract: Study Objective: The aim of the study was to compare the effectiveness of drainage via a single-lumen (5F catheter) central venous catheter (CVC) to a conventional (14-20F catheter) chest tube (CT) for the management of pneumothoraces, including primary spontaneous pneumothorax (PSP), secondary spontaneous pneumothorax (SSP), and traumatic and iatrogenic pneumothoraces. Patients: All consecutive patients admitted to the intermediate intensive care unit of a university hospital for pneumothorax were retrospectively screened over an 8-year period. Patients were preferentially treated using CT from 2003 to 2007 and using CVC from 2008 to 2010. Drainage failure was defined as the need for a second drainage procedure or for surgery. Results: Of 212 patients included, 117 (55%) had PSP, 28 (13%) had SSP associated with chronic obstructive pulmonary disease, 19 (9%) had traumatic pneumothorax, and 48 (23%) had iatrogenic pneumothorax. The failure rate was 23% in PSP, 36% in SSP, 16% in traumatic pneumothorax, and only 2% in iatrogenic pneumothorax. After adjustment, iatrogenic pneumothorax was the only factor that had an influence on drainage failure. The failure rate was similar between the 112 patients treated using CVC and the 100 patients treated using CT (18% vs 21%, P = .60). However, the durations of drainage (3.3 ± 1.9 vs 4.6 ± 2.6 days, P < .01) and of hospital stay were significantly shorter in patients treated using CVC as compared with CT. Conclusion: Our findings suggest that drainage via a catheter or via a CT is similarly effective in the management of pneumothorax. We recommend considering drainage via a small-bore catheter as a first-line treatment in patients with pneumothorax, whatever its cause. [Copyright &y& Elsevier]
Published: 2012
Full Text: View/download PDF

32. Influence of preoperative antibiotherapy on valve culture results and outcome of endocarditis requiring surgery.

Author: Mekontso Dessap, Armand, Zahar, Jean-Ralph, Voiriot, Guillaume, Ali, Firas, Aissa, Nejla, Kirsch, Matthias, and Brun-Buisson, Christian
Subjects: PREOPERATIVE care, HEART valves, TISSUE culture, HEALTH outcome assessment, ENDOCARDITIS, CARDIAC surgery, HEART disease related mortality, ANTI-infective agents, RETROSPECTIVE studies
Abstract: Summary: Objectives: Although medical–surgical therapy can reduce mortality in patients with infective endocarditis (IE), the optimal timing of surgery remains controversial. We evaluated the influence of preoperative antimicrobial therapy duration on positivity of valve culture and outcome. Methods: We retrospectively studied 94 consecutive patients admitted in our intensive care unit (ICU) and operated before completion of standard antimicrobial therapy. Results: Of 90 valves cultured, 46 were positive. In univariate analysis, time between diagnosis and surgery as well as duration of adequate therapy before surgery was shorter in patients with positive valve cultures as compared to those with negative cultures. A preoperative duration of adequate therapy ≥7 days was strongly associated with negative valve cultures (76% vs. 22%, P <0.001). Logistic regression analysis identified duration of preoperative adequate antimicrobial therapy as an independent risk factor for positive valve culture. However, there was no significant difference between patients with positive or negative valve culture regarding the occurrence of complications, ICU and hospital length of stay, hospital and long-term mortality, endocarditis relapse and reinfection, as well as treatment failure. Conclusions: Although the duration of adequate preoperative antimicrobial therapy is associated with the positivity of valve culture, the latter factor does not influence short- or long-term outcome. [Copyright &y& Elsevier]
Published: 2009
Full Text: View/download PDF

33. Vascular-wall remodeling of 3 human bypass vessels: Organ culture and smooth muscle cell properties.

Author: Mekontso-Dessap, Armand, Kirsch, Matthias, Guignambert, Christophe, Zadigue, Patricia, Adnot, Serge, Loisance, Daniel, and Eddahibi, Saadia
Subjects: SMOOTH muscle diseases, THORACIC arteries, INTERNAL thoracic artery, IMMUNOCYTOCHEMISTRY
Abstract: Objectives: Late graft occlusions after coronary artery bypass grafting have been ascribed to neointimal hyperplasia. Given the pivotal role of smooth muscle cells in the pathogenesis of neointimal hyperplasia and the phenotypic heterogeneity of smooth muscle cells across vessels, we hypothesized that differences in long-term graft patency are at least partly related to differences in smooth muscle cell properties. The aim of the present study was to compare the vascular-wall remodeling of human internal thoracic artery, radial artery, and saphenous vein bypass conduits. Methods: We evaluated the intimal thickening of the human graft segments in organ cultures (histopathology, morphometric, and immunofluorescence analyses) and assessed the properties of cultured smooth muscle cells isolated from these vessels in terms of cell proliferation (tritiated thymidine incorporation), migration (modified Boyden chamber), and collagen synthesis (tritiated proline incorporation). Results: The total vessel-wall growth index and the intimal growth index were significantly higher for saphenous vein rings than for radial artery and internal thoracic artery rings. Immunofluorescence analyses showed predominant involvement of smooth muscle cells in neointimal growth induced by organ culture of saphenous vein rings. Cell proliferation was significantly higher in saphenous vein smooth muscle cells than in radial artery smooth muscle cells and significantly higher in radial artery smooth muscle cells than in internal thoracic artery smooth muscle cells. Migration of smooth muscle cells from saphenous vein grafts was significantly greater than from internal thoracic artery or radial artery grafts. Collagen synthesis was similar in smooth muscle cells from internal thoracic artery, radial artery, and saphenous vein grafts. Conclusions: Ex vivo vascular-wall remodeling and smooth muscle cell intrinsic growth and migratory properties are dissimilar between arterial and venous grafts and might shed light on reported angiographic patency rates of these grafts. [Copyright &y& Elsevier]
Published: 2006
Full Text: View/download PDF

34. Aortic root replacement after previous surgical intervention on the aortic valve, aortic root, or ascending aorta.

Author: Kirsch, E.W. Matthias, Radu, N. Costin, Mekontso-Dessap, Armand, Hillion, Marie-Line, and Loisance, Daniel
Subjects: AORTIC valve diseases, HEART blood-vessels, MYOCARDIAL revascularization, OPERATIVE surgery
Abstract: Background: Aortic root replacement after a previous operation on the aortic valve, aortic root, or ascending aorta remains a major challenge. Methods: Records of 56 consecutive patients (44 men; mean age, 56.4 ± 13.6 years) undergoing reoperative aortic root replacement between June 1994 and June 2005 were reviewed retrospectively. Results: Reoperation was performed 9.4 ± 6.7 years after the last cardiac operation. Indications for reoperation were true aneurysm (n = 14 [25%]), false aneurysm (n = 10 [18%]), dissection or redissection (n = 9 [16%]), structural or nonstructural valve dysfunction (n = 10 [18%]), prosthetic valve-graft infection (n = 12 [21%]), and miscellaneous (n = 1 [2%]). Procedures performed were aortic root replacement (n = 47 [84%]), aortic root replacement plus mitral valve procedure (n = 5 [9%]), and aortic root replacement plus arch replacement (n = 4 [7%]). In 14 (25%) patients coronary artery bypass grafting had to be performed unexpectedly during the same procedure or immediately after the procedure to re-establish coronary perfusion. Hospital mortality reached 17.9% (n = 10). Multivariate logistic regression analysis revealed the need for unplanned perioperative coronary artery bypass grafting as the sole independent risk factor for hospital death (P = .005). Actuarial survival was 83.8% ± 4.9% at 1 month, 73.0% ± 6.3% at 1 year, and 65.7% ± 9.0% at 5 years after the operation. One patient had recurrence of endocarditis 6.7 months after the operation and required repeated homograft aortic root replacement. Conclusion: Reoperative aortic root replacement remains associated with a high postoperative mortality. The need to perform unplanned coronary artery bypass grafting during reoperative aortic root replacement is a major risk factor for hospital death. The optimal technique for coronary reconstruction in this setting remains to be debated. [Copyright &y& Elsevier]
Published: 2006
Full Text: View/download PDF

35. Golden Tracheal Secretions and Bronchoalveolar Fluid During Acute Chest Syndrome in Sickle Cell Disease.

Author: Contou, Damien, Mekontso Dessap, Armand, Carteaux, Guillaume, Brun-Buisson, Christian, Maitre, Bernard, and de Prost, Nicolas
Subjects: CEPHALOSPORINS, MACROLIDE antibiotics, BRONCHOALVEOLAR lavage, INTENSIVE care units, SICKLE cell trait, ACUTE chest syndrome, DISEASE complications, SYMPTOMS, THERAPEUTICS
Abstract: Acute chest syndrome (ACS) is the leading cause of ICU admission in patients with sickle cell disease and is characterized by golden sputum, which is commonly attributed to the presence of bilirubin. Three young consecutive patients with homozygous sickle cell disease were admitted for severe acute respiratory syndrome due to ACS. In all 3 patients, tracheal secretions and bronchoalveolar lavage fluid (BALF) showed a yellowish plasma-like stain. After normalization for the plasma-to-BAL urea ratio, BALF protein and lactate dehydrogenase levels were consistent with an exudative process. BALF bilirubin concentrations were very low, implying that the yellowish stain was not related to bilirubin content. The yellowish coloration of tracheal secretions and BALF observed during ACS appears to be related to an intense exudative process rather than to the presence of bilirubin. [ABSTRACT FROM AUTHOR]
Published: 2015
Full Text: View/download PDF

36. Atteinte bronchopulmonaire sévère au cours de la nécrolyse épidermique (syndromes de Stevens–Johnson et nécrolyse épidermique toxique)

Author: Lalevee, S., Catano, J., Oro, S., Surenaud, M., Schlemmer, F., Bendib, I., Mekontso-Dessap, A., Hue, S., and De Prost, N.
Abstract: L’atteinte pulmonaire précoce de la nécrolyse épidermique (NE, syndromes de Stevens–Johnson et nécrolyse épidermique toxique) est liée à une atteinte spécifique trachéobronchique de la maladie et peut nécessiter le recours à la ventilation mécanique (VM). En dehors des constatations endoscopiques révélant un décollement de la muqueuse trachéobronchique, la physiopathologie de cette atteinte spécifique à la phase aiguë n’a été que peu étudiée. Nous avons exploré les caractéristiques de patients nécessitant le recours à la VM à la phase aiguë de la NE.
Published: 2020
Full Text: View/download PDF

37. Eculizumab salvage therapy for delayed hemolysis transfusion reaction in sickle cell disease patients

Author: Dumas, Guillaume, Habibi, Anoosha, Onimus, Thierry, Merle, Jean-Claude, Razazi, Keyvan, Mekontso Dessap, Armand, Galactéros, Frederic, Michel, Marc, Frémeaux Bacchi, Veronique, Noizat Pirenne, France, and Bartolucci, Pablo
Published: 2016
Full Text: View/download PDF

38. Eculizumab salvage therapy for delayed hemolysis transfusion reaction in sickle cell disease patients

Author: Dumas, Guillaume, Habibi, Anoosha, Onimus, Thierry, Merle, Jean-Claude, Razazi, Keyvan, Mekontso Dessap, Armand, Galactéros, Frederic, Michel, Marc, Frémeaux Bacchi, Veronique, Noizat Pirenne, France, and Bartolucci, Pablo
Published: 2016
Full Text: View/download PDF

39. Qualité de vie et séquelles après syndromes de Stevens-Johnson et de Lyell: étude observationnelle chez 57 patients

Author: Oro, S., Alvès, A., Colin, A., Ouedraogo, R., Layese, R., Canoui-Poitrine, F., Chosidow, O., Mekontso-Dessap, A., Wolkenstein, P., and de Prost, N.
Abstract: Les séquelles sont fréquentes, multiples et parfois graves chez les patients survivant après syndrome de Stevens-Johnson (SJS) ou de Lyell. Néanmoins, très peu d’études se sont intéressées au vécu de ces séquelles et à l’impact de la maladie sur la qualité de vie (QDV) à long terme chez ces patients. Nous avons conduit une étude observationnelle chez 51 patients avec pour objectif principal de décrire le SF36 et ses composantes physique (P) et mentale (M), selon qu’il y ait eu ou non un séjour en réanimation en phase aiguë (réa/pas réa).
Published: 2019
Full Text: View/download PDF

40. BLOOD NEUTROPHIL BACTERICIDAL ACTIVITY AGAINST METHICILLIN-RESISTANT AND METHICILLIN-SENSITIVE STAPHYLOCOCCUS AUREUSDURING CARDIAC SURGERY

Author: Mekontso-Dessap, Armand, Honoré, Stéphanie, Kirsch, Matthias, Plonquet, Anne, Fernandez, Eric, Touqui, Lhousseine, Farcet, Jean-Pierre, Soussy, Claude-James, Loisance, Daniel, and Delclaux, Christophe
Abstract: Whether methicillin-resistant Staphylococcus aureus(MRSA) constitutes per sean independent risk factor for morbidity and mortality after surgery as compared with methicillin-sensitive Staphylococcus aureus(MSSA) remains a subject of debate. The aim of this study was to assess whether innate defenses against MRSA and MSSA strains are similarly impaired after cardiac surgery. Both intracellular (isolated neutrophil functions) and extracellular (plasma) defenses of 12 patients undergoing scheduled cardiac surgery were evaluated preoperatively (day 0) and postoperatively (day 3) against two MSSA strains with a low level of catalase secretion and two MRSA strains with a high level of catalase secretion, inasmuch as SA killing by neutrophils relies on oxygen-dependent mechanisms. After surgery, an increase in plasma concentration of IL-10, an anti-inflammatory cytokine able to inhibit reactive oxygen species secretion and bactericidal activity of neutrophils, was evidenced. Despite the fact that univariate analysis suggested a specific impairment of neutrophil functions against MRSA strains, two-way repeated-measures ANOVA failed to demonstrate that the effect of S. aureusphenotype was significant. On the other hand, an increase in type-II secretory phospholipase A2activity, a circulating enzyme involved in SA lysis, was evidenced and was associated with an enhancement of extracellular defenses (bactericidal activity of plasma) against MRSA. Overall, cardiac surgery and S. aureusphenotype had a significant effect on plasma bactericidal activity. Cardiac surgery was characterized by enhanced antibacterial defenses of plasma, whereas neutrophil killing properties were reduced. The overall effect of S. aureusphenotype on neutrophil functions did not seem significant.
Published: 2005
Full Text: View/download PDF

41. Usefulness of Routine Epicardial Pacing Wire Culture for Early Prediction of Poststernotomy Mediastinitis

Author: Mekontso-Dessap, Armand, Honore´, Ste´phanie, Kirsch, Matthias, Houe¨l, Re´mi, Loisance, Daniel, and Brun-Buisson, Christian
Abstract: ABSTRACTPoststernotomy mediastinitis (PSM) is one of the most serious complications of cardiac surgery, and its associated morbidity and mortality demand early recognition for emergency therapy. In this study, we investigated the usefulness of epicardial pacing wire (EPW) cultures for the prediction of PSM. Among 2,200 patients who underwent a cardiac surgical procedure at our hospital between 1 January 1999 and 31 December 2001, 82 (3.7%) had PSM; Staphylococcus aureuswas the organism (45.1%) most frequently isolated at the time of surgical debridement. EPWs from 1,607 (73.0%) patients, 73 (4.5%) of whom developed PSM, were cultured. EPW cultures from 466 (29.0%) were positive, most often (74.9%) for coagulase-negative Staphylococci. EPW cultures were truly positive in 26 cases, truly negative in 1,106 cases, falsely positive in 428 cases, and falsely negative in 47 cases (with sterile cultures in 35 cases and a culture positive for an organism different from that isolated at the time of debridement in 12 cases). EPW culture had a positive predictive value of only 5.7% and a high negative predictive value (95.9%) for the diagnosis of PSM, with an accuracy of 70.4%. However, the likelihood ratio of positive (1.27) and negative (0.89) tests indicated only small changes in pretest-to-posttest probability. Therefore, a strategy of routine culture of EPWs to predict PSM seems questionable.
Published: 2004
Full Text: View/download PDF

42. Closed drainage using Redon catheters for poststernotomy mediastinitis: results and risk factors for adverse outcome

Author: Kirsch, Matthias, Mekontso-Dessap, Armand, Houël, Rémi, Giroud, Emmanuelle, Hillion, Marie-Line, and Loisance, Daniel Y.
Abstract: Background. Several different surgical techniques have been described for the treatment of poststernotomy mediastinitis. The present study was undertaken to evaluate the midterm results of primary closed drainage using Redon catheters and to identify risk factors for adverse outcome.
Published: 2001
Full Text: View/download PDF

43. Risk factors for post-cardiopulmonary bypass vasoplegia in patients with preserved left ventricular function

Author: Mekontso-Dessap, Armand, Houël, Rémi, Soustelle, Céline, Kirsch, Matthias, Thébert, Dominique, and Loisance, Daniel Y
Abstract: Background. Although vasodilatory shock (VS) is one of the main complications of cardiopulmonary bypass (CPB), its pathophysiologic basis remains unclear. The aim of this study was to identify predisposing factors for the development of VS after CPB independent of ventricular function.
Published: 2001
Full Text: View/download PDF

44. Causes and Circumstances of Death: Analysis in 266 Sickle Cell Adult Patients

Author: Habibi, Anoosha, Ngo, Stephanie, Razazi, Keyvan, Audard, Vincent, De Luna, Gonzalo, Michel, Marc, Pirenne, France, Guillet, Henri, Kassasseya, Christian, Galactéros, Frédéric, Mekontso-Dessap, Armand, and Bartolucci, Pablo
Abstract: Introduction
Published: 2021
Full Text: View/download PDF

45. Abstract 13226: Epinephrine versus Norepinephrine in Cardiac Arrest Patients With Postresuscitation Shock

Author: Bougouin, Wulfran, Slimani, Kaci, Renaudier, Marie, Binois, Yannick, Paul, Marine, Dumas, Florence, Lamhaut, Lionel, Loeb, Thomas, Ortuno, Sofia, Deye, Nicolas, Voicu, Sebastian, BEGANTON, Frankie, jost, daniel, Mekontso-Dessap, Armand, Marijon, Eloi, JOUVEN, Xavier, Aissaoui, Nadia, and Cariou, Alain
Abstract: Backgound:Whether epinephrine or norepinephrine is preferable as the continuous intravenous vasopressor used to treat postresuscitation shock is unclear.Objectives:To compare outcomes of patients with postresuscitation shock after out-of-hospital cardiac arrest according to whether the continuous intravenous vasopressor used was epinephrine or norepinephrine.Methods:We conducted an observational multicenter study of consecutive patients managed in 2011-2018 for postresuscitation shock. The primary outcome was all-cause hospital mortality, and secondary outcomes were cardiovascular hospital mortality and unfavorable neurological outcome (Cerebral Performance Category 3 to 5). A multivariate regression analysis and a propensity score analysis were performed, as well as several sensitivity analyses.Results:Of the 766 patients included in five hospitals, 285 (37%) received epinephrine and 481 (63%) norepinephrine. All-cause hospital mortality was significantly higher in the epinephrine group (OR 2.6; 95%CI, 1.4-4.7; P=0.002). Cardiovascular hospital mortality was also higher with epinephrine (aOR 5.5; 95%CI 3.0-10.3; P<0.001), as was the proportion of patients with CPC of 3 to 5 at hospital discharge. Sensitivity analyses produced consistent results. The analysis involving adjustment on a propensity score to control for confounders showed similar findings (aOR 2.1; 95%CI 1.1-4.0; P=0.02).Conclusions:Among patients with postresuscitation shock after out-of-hospital cardiac arrest, use of epinephrine was associated with higher all-cause and cardiovascular-specific mortality, compared with norepinephrine infusion. A randomized controlled trial comparing the two vasopressors in this population is warranted.
Published: 2021
Full Text: View/download PDF

46. Causes and Circumstances of Death: Analysis in 266 Sickle Cell Adult Patients

Author: Habibi, Anoosha, Ngo, Stephanie, Razazi, Keyvan, Audard, Vincent, De Luna, Gonzalo, Michel, Marc, Pirenne, France, Guillet, Henri, Kassasseya, Christian, Galactéros, Frédéric, Mekontso-Dessap, Armand, and Bartolucci, Pablo
Abstract: Habibi: Novartis: Consultancy, Honoraria; bluebird bio: Consultancy, Honoraria, Research Funding. Audard: Addmedica: Consultancy. Michel: Novartis: Consultancy; Amgen: Consultancy; Rigel: Honoraria; Alexion: Honoraria; UCB: Honoraria; Argenx: Honoraria. Galactéros: Addmedica: Membership on an entity's Board of Directors or advisory committees. Bartolucci: INNOVHEM: Other: Co-founder; Bluebird: Consultancy, Research Funding; F. Hoffmann-La Roche Ltd: Consultancy; GBT: Consultancy; Jazz Pharma: Other: Lecture fees; AGIOS: Consultancy; Hemanext: Consultancy; Emmaus: Consultancy; Fabre Foundation: Research Funding; Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Lecture fees, Steering committee, Research Funding; Addmedica: Consultancy, Other: Lecture fees, Research Funding.
Published: 2021
Full Text: View/download PDF

47. Levosimendan added to dobutamine in acute decompensated heart failure refractory to dobutamine.

Author: Juguet, W., Faivre, L., Deguillard, C., Fard, D., Pelletier, V., Oliver, L., Damy, T., Mongardon, N., Mekontso-Dessap, A., Dubois Randé, J.L., Gallet, R., Huguet, R., and Lim, P.
Abstract: Randomised study showed that dobutamine and levosimendan have similar impact on outcome in acute decompensated heart failure (ADHF) but their combination had never been assessed. To assess the clinical impact of the combination dobutamine and levosimendan for the treatment of ADHF with low cardiac output. The study retrospectively included 89 patients (61 ± 15 years) admitted for ADHF requiring inotropic support. The first group included patients historically treated by dobutamine alone (dobutamine group, n = 42) and the second those treated by dobutamine plus levosimendan if superior vena cava oxygen saturation (ScvO 2) remained ≤ 60% after 3 days of dobutamine infusion (dobutamine-levosimendan group, n = 47). The two groups were compared in terms of changes in ScvO 2 and major cardiovascular events (MACE) at 6 months defined by death, heart transplantation or need for assistance. The dobutamine and dobutamine plus levosimendan groups had similar baseline clinical characteristics with no difference for admission cardiac index (1.7 ± 0.5 vs. 1.8 ± 0.6 L/min/m2), lactate level (3.3 ± 3.0 vs. 3.0 ± 2.1 mM/L) and ScvO 2 (49 ± 7% vs. 50 ± 9%). At day-3, the ScvO 2 target value (> 60%) was reached in 36% and 32% of patients in the dobutamine and dobutamine-levosimendan group, respectively. After adding levosimendan, 72% of the dobutamine-levosimendan-group reached the ScvO 2 target value at dobutamine weaning. At six months, 42 (47%) patients experienced MACE (n = 28 for death). MACE was less frequent in the dobutamine-levosimendan (32%) than in the dobutamine-group (64%, p = 0.003). Independent variables associated with outcome were admission systolic blood pressure and dobutamine-levosimendan strategy (OR = 0.44 [0.23-0.84], p = 0.01) (Table 1 , Fig 1). Levosimendan added to dobutamine may improve the outcome of ADHF refractory to dobutamine alone. [ABSTRACT FROM AUTHOR]
Published: 2020
Full Text: View/download PDF

48. Atteinte digestive au cours des nécrolyses épidermiques

Author: Gendreau, S., Amiot, A., Wolkenstein, P., Chosidow, O., Mekontso Dessap, A., Oro, S., and de Prost, N.
Abstract: Le syndrome de Stevens–Johnson (SJS) et la nécrolyse épidermique toxique (NET) sont des toxidermies rares mais potentiellement mortelles, caractérisées par des décollements épithéliaux cutanés et muqueux et une atteinte d’organe possiblement multiviscérale. Les lésions digestives ont été peu étudiées. Cette étude rapporte les résultats d’endoscopies digestives réalisées chez des patients atteints de SJS/NET admis en réanimation.
Published: 2018
Full Text: View/download PDF

49. Management of septic myocardial dysfunction in intensive care unit: A survey of French speaking intensivists

Author: Bedet, Alexandre, Razazi, Keyvan, Carteaux, Guillaume, de Prost, Nicolas, and Mekontso Dessap, Armand
Published: 2017
Full Text: View/download PDF

50. Insuffisance rénale aiguë au cours du syndrome de Stevens-Johnson et de la nécrolyse épidermique toxique : une étude rétrospective de 238 patients

Author: Papo, M., Valeyrie-Allanore, L., Razazi, K., Carteaux, G., Wolkenstein, P., Chosidow, O., Brun-Buisson, C., Mekontso-Dessap, A., and De Prost, N.
Abstract: La mortalité des patients présentant un syndrome de Stevens-Johnson (SJS) ou une nécrolyse épidermique toxique (NET) varie de 3 à 50 % pour les patients les plus sévères. De nombreux facteurs pronostiques ont été identifiés, notamment un score clinicobiologique, le Scorten et la nécessité d’une ventilation mécanique. La prévalence et le pronostic des patients nécessitant une épuration extrarénale (EER) n’ont jamais été étudiés.
Published: 2016
Full Text: View/download PDF

Catalog

Books, media, physical & digital resources

See catalog results

Searchworks

Select search scope, currently: Articles Catalog books, media & more in Jio Institute collections Articles journal articles & other e-resources

Search

Search Constraints

Refine your results

Search Limiters

Topic

Publication Year Range

Language

Publication Type

Journal

Database

Publisher

71 results on '"A. Mekontso Dessap"'

Search Results

Catalog

Select search scope, currently: Articles

Catalog

books, media & more in Jio Institute collections

Articles

journal articles & other e-resources