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1. Thoracic epidural analgesia in intensive care unit patients with acute pancreatitis: the EPIPAN multicenter randomized controlled trial

Author

Jabaudon, Matthieu, Genevrier, Alexandra, Jaber, Samir, Windisch, Olivier, Bulyez, Stéphanie, Laterre, Pierre-François, Escudier, Etienne, Sossou, Achille, Guerci, Philippe, Bertrand, Pierre-Marie, Danin, Pierre-Eric, Bonnassieux, Martin, Bühler, Leo, Heidegger, Claudia Paula, Chabanne, Russell, Godet, Thomas, Roszyk, Laurence, Sapin, Vincent, Futier, Emmanuel, Pereira, Bruno, and Constantin, Jean-Michel

Published
2023
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4. Elevated Plasma Levels of sRAGE Are Associated With Nonfocal CT-Based Lung Imaging in Patients With ARDS: A Prospective Multicenter Study

Author

Mrozek, Segolene, Jabaudon, Matthieu, Jaber, Samir, Paugam-Burtz, Catherine, Lefrant, Jean-Yves, Rouby, Jean-Jacques, Asehnoune, Karim, Allaouchiche, Bernard, Baldesi, Olivier, Leone, Marc, Lu, Qin, Bazin, Jean-Etienne, Roszyk, Laurence, Sapin, Vincent, Futier, Emmanuel, Pereira, Bruno, and Constantin, Jean-Michel

Published
2016
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6. Additional file 3 of Thoracic epidural analgesia in intensive care unit patients with acute pancreatitis: the EPIPAN multicenter randomized controlled trial

Author

Jabaudon, Matthieu, Genevrier, Alexandra, Jaber, Samir, Windisch, Olivier, Bulyez, Stéphanie, Laterre, Pierre-François, Escudier, Etienne, Sossou, Achille, Guerci, Philippe, Bertrand, Pierre-Marie, Danin, Pierre-Eric, Bonnassieux, Martin, Bühler, Leo, Heidegger, Claudia Paula, Chabanne, Russell, Godet, Thomas, Roszyk, Laurence, Sapin, Vincent, Futier, Emmanuel, Pereira, Bruno, and Constantin, Jean-Michel

Abstract

Additional file 3. CONSORT checklist.

Published
2023
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7. Additional file 2 of Thoracic epidural analgesia in intensive care unit patients with acute pancreatitis: the EPIPAN multicenter randomized controlled trial

Author

Jabaudon, Matthieu, Genevrier, Alexandra, Jaber, Samir, Windisch, Olivier, Bulyez, Stéphanie, Laterre, Pierre-François, Escudier, Etienne, Sossou, Achille, Guerci, Philippe, Bertrand, Pierre-Marie, Danin, Pierre-Eric, Bonnassieux, Martin, Bühler, Leo, Heidegger, Claudia Paula, Chabanne, Russell, Godet, Thomas, Roszyk, Laurence, Sapin, Vincent, Futier, Emmanuel, Pereira, Bruno, and Constantin, Jean-Michel

Abstract

Additional file 2. Research protocols and analysis plans.

Published
2023
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8. Additional file 1 of Thoracic epidural analgesia in intensive care unit patients with acute pancreatitis: the EPIPAN multicenter randomized controlled trial

Author

Jabaudon, Matthieu, Genevrier, Alexandra, Jaber, Samir, Windisch, Olivier, Bulyez, Stéphanie, Laterre, Pierre-François, Escudier, Etienne, Sossou, Achille, Guerci, Philippe, Bertrand, Pierre-Marie, Danin, Pierre-Eric, Bonnassieux, Martin, Bühler, Leo, Heidegger, Claudia Paula, Chabanne, Russell, Godet, Thomas, Roszyk, Laurence, Sapin, Vincent, Futier, Emmanuel, Pereira, Bruno, and Constantin, Jean-Michel

Abstract

Additional file 1. List of investigators and additional details.

Published
2023
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10. Effects of a recruitment maneuver on plasma levels of soluble RAGE in patients with diffuse acute respiratory distress syndrome: a prospective randomized crossover study

Author

Jabaudon, Matthieu, Hamroun, Nacim, Roszyk, Laurence, Guérin, Renaud, Bazin, Jean-Etienne, Sapin, Vincent, and Pereira, Bruno

Subjects
Medical research, Medicine, Experimental, Respiratory distress syndrome -- Care and treatment, Acute respiratory distress syndrome -- Care and treatment, Cisatracurium, Health care industry
Abstract

Purpose The soluble form of the receptor for advanced glycation end-products (sRAGE) is a promising marker for epithelial dysfunction, but it has not been fully characterized as a biomarker of acute respiratory distress syndrome (ARDS). Whether sRAGE could inform on the response to ventilator settings has been poorly investigated, and whether a recruitment maneuver (RM) may influence plasma sRAGE remains unknown. Methods Twenty-four patients with moderate/severe, nonfocal ARDS were enrolled in this prospective monocentric crossover study and randomized into a 'RM-SHAM' group when a 6-h-long RM sequence preceded a 6-h-long sham evaluation period, or a 'SHAM-RM' group (inverted sequences). Protective ventilation was applied, and RM consisted of the application of 40 cmH.sub.2O airway pressure for 40 s. Arterial blood was sampled for gas analyses and sRAGE measurements, 5 min pre-RM (or 40-s-long sham period), 5, 30 min, 1, 4, and 6 h after the RM (or 40-s-long sham period). Results Mean PaO.sub.2/FiO.sub.2, tidal volume, PEEP, and plateau pressure were 125 mmHg, 6.8 ml/kg (ideal body weight), and 13 and 26 cmH.sub.2O, respectively. Median baseline plasma sRAGE levels were 3,232 pg/ml. RM induced a significant decrease in sRAGE (-1,598 ± 859 pg/ml) in 1 h (p = 0.043). At 4 and 6 h post-RM, sRAGE levels increased back toward baseline values. Pre-RM sRAGE was associated with RM-induced oxygenation improvement (AUC 0.84). Conclusions We report the first kinetics study of plasma sRAGE after RM in ARDS. Our findings reinforce the value of plasma sRAGE as a biomarker of ARDS., Author(s): Matthieu Jabaudon [sup.1] [sup.2], Nacim Hamroun [sup.1], Laurence Roszyk [sup.2] [sup.3], Renaud Guérin [sup.1], Jean-Etienne Bazin [sup.1], Vincent Sapin [sup.2] [sup.3], Bruno Pereira [sup.4], Jean-Michel Constantin [sup.1] [sup.2] Author [...]

Published
2015
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14. Added value of serial bio-adrenomedullin measurement in addition to lactate for the prognosis of septic patients admitted to ICU

Author

Blet, Alice, De Roquetaillade, Charles, Hartmann, Oliver, Struck, Joachim, Mebazaa, Alexandre, Chousterman, Benjamin Glenn, Laterre, Pierre François, Berghe, Caroline, Dujardin, Marie France, Renard, Suzanne, Wittebole, Xavier, Collienne, Christine, Zapatero, Diego Castanares, Dugernier, Thierry, Vinetti, Marco, De Schryver, Nicolas, Thirifays, Anne, Mairesse, Jacques, Huberlant, Vincent, Petre, Hélène, Buelens, Isabelle, Henin, Pierre, Trine, Hugues, Laurent, Yves, Sébastien, Loix, Geukens, Paul, Kehl, Laurent, François, Bruno, Vignon, Philippe, Pichon, Nicolas, Begot, Emmanuelle, Fedou, Anne Laure, Chapellas, Catherine, Galy, Antoine, Rodier, Nicolas, Baudrillart, Ludmilla, Nouaille, Michelle, Laleu, Séverine, Mancia, Claire, Daix, Thomas, Bourzeix, Paul, Herafa, Isabelle, Duchambon, Anne Aurore, Lascarrou, Jean Baptiste, Fiancette, Maud, Colin, Gwenhael, Henry-Lagarrigue, Matthieu, Lacherade, Jean Claude, Lebert, Christine, Martin-Levfèvre, Laurent, Vinatier, Isabelle, Yehia, Aihem, Bachoumas, Konstantinos, Joret, Aurélie, Reignier, Jean, Rousseau, Cécille, Maquigneau, Natacha, Alcourt, Yolaine, Zinzonni, Vanessa Erragne, Deschamps, Angélique, Robert, Angelina, Mercier, Emmanuelle, Simeon-Vieules, Véronique, Aubrey, Aurélie, Mabilat, Christine, Garot, Denis, Ehrmann, Stephan, Legras, Annick, Jouan, Youenn, Dequin, Pierre François, Guillon, Antoine, Bodet-Contentin, Laetitia, Rouve, Emmannuelle, Salmon, Charlotte, Brick, Lysiane, Massat, Stéphanie, Desachy, Arnaud, Fally, Marie Anne, Robin, Laurence, Cracco, Christophe, Lafon, Charles, Calvat, Sylvie, Rouleau, Stéphane, Schnell, David, Lasocki, Sigismond, Fesard, Philippe, Leblanc, Damien, Bouhours, Guillaume, Chassier, Claire, Conte, Mathieu, Gaillard, Thomas, Denou, Floriane, Kerymel, Mathieu, Guyon, Marion, Loiez, Anthéa, Lebreton, Stéphanie, Meziani, Ferhat, Allam, Hayat, Chenaf, Samir, Rahmani, Hassène, Heenen, Sarah, Kummerlen, Christine, Delabranche, Xavier, Boivin, Alexandra, Clere-Jehl, Raphaël, Rabouël, Yannick, Pottecher, Julien, Bayer, Sophie, Metzger, Catherine, Hecketsweiler, Stéphane, Ludes, Pierre Olivier, Besancenot, Hortense, Dhif, Nadia, Freys, Guy, Lessinger, Jean Marc, Launoy, Anne, Ruimy, Aude, Meyer, Alain, Szozot, M., Deye, Nicolas, Gayat, Etienne, Fournier, Marie Céline, Abroug, Sarra, Louadah, Badr, Feliot, Elodie, Voicu, Sebastian, Malissin, Isabelle, Megarbane, Bruno, Manivet, Philippe, Victori, Gardianot, Kelly, Da Silva, La Foucher, Béatrice, Pierre, Valérie, Kerdjana, Lamia, Beeken, Thomas, Goury, Antoine, Garcon, Pierre, Gaugain, Samuel, Huot, Benjamin, Barthelemy, Romain, Soyer, Benjamin, Jacob, Laurent, Legrand, Matthieu, Fourniar, Marie Céline, Bonnet, Francine, Legall, Chloé, Oueslati, Haikel, Cupaciu, Alexandru, Manivat, Philippe, Louadeh, Badr, Sonneville, Romain, Letrou, Sophie, Bouadma, Lila, Mourvillier, Bruno, Deiler, Véronique, Magalhaes, Eric, Neuville, Mathilde, Timsit, Jean François, Radjou, Aguila, Gaudry, Stéphane, Dubief, Emeline, Messika, Jonathan, La Combe, Béatrice, Roux, Damien, Berquier, Guillaume, Laissi, Mohamed, Ricard, Jean Damien, Constantin, Jean Michel, Perbet, Sebastien, Delmas, Julie, Pascal, Julien, Cayot, Sophie, Guerin, Renaud, Jabaudon, Matthieu, Roszyk, Laurence, Rolhion, Christine, Bourdier, Justine, Lematte, Mathilde, Gouhier, Charlène, Verlhac, Camille, Godet, Thomas, Radji, Sophiano, Caumon, Elodie, Thibault, Sandrine, Marx, Nikolaus, Schuerholz, Tobias, Pezechk, Jessica, Feld, Florian, Brülls, Christian, Beeker, Thorben, Simon, Tim Philipp, Deisz, Robert, Schindler, Achim, Meier, Bianca, Janisch, Thorsten, Hohn, Andreas, Schedler, Dirk, Wetsch, Wolfgang, Schröder, Daniel, Meier-Hellmann, Andreas, Lucht, Alexander, Henker, Robert, Römmer, Magdalena, Meinig, Torsten, Zacharowski, Kai D., Meybohm, Patrick, Lindau, Simone, Mutlak, Haitham, Kluge, Stefan, Ringeis, Grit, Füllekrug, Birgit, Singer, Brigitte, Nierhaus, Axel, Bangert, Katrin, De Heer, Geraldine, Frings, Daniel, Fuhrmann, Valentin, Müller, Jakob, Schreiber, Jörg, Sensen, Barbara, Siedler, Stephanie, Siewecke, Annekatrin, Söffker, Gerold, Wichmann, Dominic, Kerinn, Mélanie, Jaschinski, Ulrich, Kreuser, Ilse, Zanquila, Marlene, Kortgen, Andreas, Bloos, Frank, Gonnert, Falk, Thomas-Rüddel, Daniel, Haucke, Anja, Kolanos, Steffi, Kohlberg, Karina Knuhr, Bloos, Petra, Schwope, Katrin, Di Somma, Salvatore, Rossella, Marino, Russo, Veronica, Simona, Santarelli, Bartoli, Christopher, Navarin, Sylvia, Bongiovanni, Cristina, Orru, Michela, Quatrocchi, Daniela, Zoccoli, Giada, Varchetta, Antonella, Antonelli, Massimo, De Pascale, Gennaro, Vallecoccia, Maria Sole, Cutuli, Salvatore Lucio, Digravio, Valentina, Quattrochi, Daniela, D'Arrigo, Sonia, Leone, Filippo Elvino, Beishuizen, Bert, Rinket, Martin, Border, Natalie, Bos-Burgmeijer, Mariska, Braad, Astrid, Papendorp, S., Vermeijden, J., Pickkers, Peter, Van De A, Marieke, Van Wezel, Helen, Heunks, Leo, Bordar, Natalie, Luijten-Arts, Chantal, Hoedemaekers, Astrid, Van Der Hoeven, Hans, Roovers, Noortje, Hemelaar, Pleun, Intensive care medicine, ACS - Pulmonary hypertension & thrombosis, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, and UCL - (SLuc) Service de soins intensifs

Subjects
Male, medicine.medical_specialty, Multiple Organ Failure, MEDLINE, lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], Critical Care and Intensive Care Medicine, Sepsis, 03 medical and health sciences, Adrenomedullin, 0302 clinical medicine, Belgium, Germany, medicine, Research Letter, Humans, Lactic Acid, Hospital Mortality, Prospective Studies, Prospective cohort study, Aged, Netherlands, Proportional Hazards Models, Chi-Square Distribution, business.industry, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, lcsh:RC86-88.9, Length of Stay, Middle Aged, medicine.disease, Prognosis, Shock, Septic, Survival Analysis, 3. Good health, Hospitalization, Patient Outcome Assessment, Intensive Care Units, 030228 respiratory system, Italy, Shock (circulatory), Emergency medicine, Female, France, medicine.symptom, business, Biomarkers
Abstract

Adrenomedullin (ADM) regulates vascular tone and endothelial permeability during sepsis. Levels of circulating biologically active ADM (bio-ADM) show an inverse relationship with blood pressure and a direct relationship with vasopressor requirement. In the present prospective observational multinational Adrenomedullin and Outcome in Sepsis and Septic Shock 1 (, AdrenOSS-1) study, we assessed relationships between circulating bio-ADM during the initial intensive care unit (ICU) stay and short-term outcome in order to eventually design a biomarker-guided randomized controlled trial.AdrenOSS-1 was a prospective observational multinational study. The primary outcome was 28-day mortality. Secondary outcomes included organ failure as defined by Sequential Organ Failure Assessment (SOFA) score, organ support with focus on vasopressor/inotropic use, and need for renal replacement therapy. AdrenOSS-1 included 583 patients admitted to the ICU with sepsis or septic shock.Circulating bio-ADM levels were measured upon admission and at day 2. Median bio-ADM concentration upon admission was 80.5 pg/ml [IQR 41.5-148.1 pg/ml]. Initial SOFA score was 7 [IQR 5-10], and 28-day mortality was 22%. We found marked associations between bio-ADM upon admission and 28-day mortality (unadjusted standardized HR 2.3 [CI 1.9-2.9]; adjusted HR 1.6 [CI 1.1-2.5]) and between bio-ADM levels and SOFA score (p0.0001). Need of vasopressor/inotrope, renal replacement therapy, and positive fluid balance were more prevalent in patients with a bio-ADM70 pg/ml upon admission than in those with bio-ADM ≤ 70 pg/ml. In patients with bio-ADM70 pg/ml upon admission, decrease in bio-ADM below 70 pg/ml at day 2 was associated with recovery of organ function at day 7 and better 28-day outcome (9.5% mortality). By contrast, persistently elevated bio-ADM at day 2 was associated with prolonged organ dysfunction and high 28-day mortality (38.1% mortality, HR 4.9, 95% CI 2.5-9.8).AdrenOSS-1 shows that early levels and rapid changes in bio-ADM estimate short-term outcome in sepsis and septic shock. These data are the backbone of the design of the biomarker-guided AdrenOSS-2 trial.ClinicalTrials.gov, NCT02393781 . Registered on March 19, 2015.

Published
2020

15. Design and Rationale of the Sevoflurane for Sedation in Acute Respiratory Distress Syndrome (SESAR) Randomized Controlled Trial.

Author

Blondonnet, Raiko, Simand, Laure-Anne, Vidal, Perine, Borao, Lucile, Bourguignon, Nathalie, Morand, Dominique, Bernard, Lise, Roszyk, Laurence, Audard, Jules, Godet, Thomas, Monsel, Antoine, Garnier, Marc, Quesnel, Christophe, Bazin, Jean-Etienne, Sapin, Vincent, Bastarache, Julie A., Ware, Lorraine B., Hughes, Christopher G., Pandharipande, Pratik P., and Ely, E. Wesley

Abstract

Preclinical studies have shown that volatile anesthetics may have beneficial effects on injured lungs, and pilot clinical data support improved arterial oxygenation, attenuated inflammation, and decreased lung epithelial injury in patients with acute respiratory distress syndrome (ARDS) receiving inhaled sevoflurane compared to intravenous midazolam. Whether sevoflurane is effective in improving clinical outcomes among patients with ARDS is unknown, and the benefits and risks of inhaled sedation in ARDS require further evaluation. Here, we describe the SESAR (Sevoflurane for Sedation in ARDS) trial designed to address this question. SESAR is a two-arm, investigator-initiated, multicenter, prospective, randomized, stratified, parallel-group clinical trial with blinded outcome assessment designed to test the efficacy of sedation with sevoflurane compared to intravenous propofol in patients with moderate to severe ARDS. The primary outcome is the number of days alive and off the ventilator at 28 days, considering death as a competing event, and the key secondary outcome is 90 day survival. The planned enrollment is 700 adult participants at 37 French academic and non-academic centers. Safety and long-term outcomes will be evaluated, and biomarker measurements will help better understand mechanisms of action. The trial is funded by the French Ministry of Health, the European Society of Anaesthesiology, and Sedana Medical. [ABSTRACT FROM AUTHOR]

Published
2022
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16. Assessment of a Novel Method for Non-invasive Sampling of the Distal Airspace in Acute Respiratory Distress Syndrome Patients Receiving Inhaled Sedation with Sevoflurane: the ANAISS Study Protocol

Author

Tronche, Pierre-Antoine, primary, Lalande, Robin, additional, Blondonnet, Raiko, additional, Roszyk, Laurence, additional, Zhai, Ruoyang, additional, Morand, Dominique, additional, Pereira, Bruno, additional, Sapin, Vincent, additional, Malinovsky, Jean-Marc, additional, Mourvillier, Bruno, additional, Constantin, Jean-Michel, additional, Cousson, Joël, additional, and Jabaudon, Matthieu, additional

Published
2020
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18. Driving pressure and acute respiratory distress syndrome in critically ill patients

Author

Blondonnet, Raiko, Joubert, Elodie, Godet, Thomas, Berthelin, Pauline, Pranal, Thibaut, Roszyk, Laurence, Chabanne, Russell, Eisenmann, Nathanael, Lautrette, Alexandre, Belville, Corinne, Cayot, Sophie, Gillart, Thierry, Souweine, Bertrand, Bouvier, Damien, Blanchon, Loïc, Sapin, Vincent, Pereira, Bruno, Constantin, Jean-Michel, Jabaudon, Matthieu, Retinoids, Development and Developmental Diseases (R2D2), Université d'Auvergne - Clermont-Ferrand I (UdA), Service d'Anésthésie Réanimation [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Service de Biochimie et Génétique Moléculaire [CHU Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Unité de soins intensifs [Clermont Ferrand], CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], Génétique, Reproduction et Développement (GReD), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), Génétique, Reproduction et Développement (GReD ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Laboratoire de Biochimie, CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand], and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)

Subjects
MESH: Correlation of Data, MESH: Humans, MESH: Middle Aged, MESH: Adult, acute respiratory distress syndrome, driving pressure, mechanical ventilation, intensive care unit, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, MESH: Male, risk prediction, MESH: Positive-Pressure Respiration, MESH: Critical Care, MESH: Risk Factors, MESH: Critical Illness, MESH: Respiratory Distress Syndrome, Adult, MESH: Intensive Care Units, MESH: Respiration, Artificial, MESH: Female, MESH: Risk Adjustment
Abstract

International audience; Elevated driving pressure (ΔP) may be associated with increased risk of acute respiratory distress syndrome (ARDS) in patients admitted via the emergency department and with post-operative pulmonary complications in surgical patients. This study investigated the association of higher ΔP with the onset of ARDS in a high-risk, intensive care unit (ICU) population.

Published
2018

19. Circulating adrenomedullin estimates survival and reversibility of organ failure in sepsis: the prospective observational multinational Adrenomedullin and Outcome in Sepsis and Septic Shock-1 (AdrenOSS-1) study

Author

Mebazaa, Alexandre, Geven, Christopher, Bergmann, Andreas, Massat, Stéphanie, Desachy, Arnaud, Fally, Marie Anne, Robin, Laurence, Cracco, Christophe, Lafon, Charles, Calvat, Sylvie, Rouleau, Stéphane, Schnell, David, Lasocki, Sigismond, Antonelli, Massimo, Fesard, Philippe, Leblanc, Damien, Bouhours, Guillaume, Chassier, Claire, Conte, Mathieu, Gaillard, Thomas, Denou, Floriane, Kerymel, Mathieu, Guyon, Marion, Loiez, Anthéa, Beishuizen, Albertus, Lebreton, Stéphanie, Meziani, Ferhat, Allam, Hayat, Chenaf, Samir, Rahmani, Hassène, Heenen, Sarah, Kummerlen, Christine, Delabranche, Xavier, Boivin, Alexandra, Clere-Jehl, Raphaël, Constantin, Jean-Michel, Rabouël, Yannick, Pottecher, Julien, Bayer, Sophie, Metzger, Catherine, Hecketsweiler, Stéphane, Ludes, Pierre Olivier, Besancenot, Hortense, Dhif, Nadia, Freys, Guy, Lessinger, Jean-Marc, Damoisel, Charles, Launoy, Anne, Ruimy, Aude, Meyer, Alain, Szozot, M., Deye, Nicolas, Gayat, Etienne, Fournier, Marie-Céline, Abroug, Sarra, Louadah, Badr, Feliot, Elodie, Voicu, Sebastian, Malissin, I., Megarbane, Bruno, Manivet, Philippe, Victori, Gardianot, Kelly, Da Silva, La Foucher, Béatrice, Pierre, Valérie, Kerdjana, Lamia, Di Somma, Salvatore, Beeken, Thomas, Goury, Antoine, Garcon, Pierre, Gaugain, Samuel, Chousterman, Benjamin Glen, Huot, Benjamin, Barthelemy, Romain, Soyer, Benjamin, Jacob, Laurent, Legrand, Matthieu, Dugernier, Thierry, Bonnet, Francine, Legall, Chloé, Oueslati, Haikel, Cupaciu, Alexandru, Sonneville, Romain, Letrou, Sophie, Bouadma, Lila, François, Bruno, Mourvillier, Bruno, Deiler, Véronique, Magalhaes, Eric, Neuville, Mathilde, Timsit, Jean-François, Radjou, Aguila, Gaudry, Stéphane, Dubief, Emeline, Messika, Jonathan, La Combe, Béatrice, Gaudry, Stephane, Roux, Damien, Berquier, Guillaume, Laissi, Mohamed, Ricard, Jean-Damien, Perbet, Sebastien, Delmas, Julie, Pascal, Julien, Cayot, Sophie, Guerin, Renaud, Hollinger, Alexa, Huberlant, Vincent, Jabaudon, Matthieu, Roszyk, Laurence, Rolhion, Christine, Bourdier, Justine, Lematte, Mathilde, Gouhier, Charlène, Verlhac, Camille, Godet, Thomas, Radji, Sophiano, Caumon, Elodie, Lascarrou, Jean-Baptiste, Thibault, Sandrine, Marx, Nikolaus, Schuerholz, Tobias, Pezechk, Jessica, Feld, Florian, Brülls, Christian, Beeker, Thorben, Simon, Tim-Philipp, Deisz, Robert, Schindler, Achim, Marx, Gernot, Meier, Bianca, Janisch, Thorsten, Hohn, Andreas, Schedler, Dirk, Wetsch, Wolfgang, Schröder, Daniel, Meier-Hellmann, Andreas, Lucht, Alexander, Henker, Robert, Römmer, Magdalena, Mercier, Emmanuelle, Meinig, Torsten, Zacharowski, Kai D., Meybohm, Patrick, Lindau, Simone, Mutlak, Haitham, Kluge, Stefan, Ringeis, Grit, Füllekrug, Birgit, Singer, Brigitte, Nierhaus, Axel, Bangert, Katrin, de Heer, Geraldine, Frings, Daniel, Fuhrmann, Valentin, Müller, Jakob, Schreiber, Jörg, Sensen, Barbara, Siedler, Stephanie, Siewecke, Annekatrin, Söffker, Gerold, Pickkers, Peter, Wichmann, Dominic, Kerinn, Mélanie, Jaschinski, Ulrich, Kreuser, Ilse, Zanquila, Marlene, Kortgen, Andreas, Bloos, Frank, Gonnert, Falk, Thomas-Rüddel, Daniel, Haucke, Anja, Kolanos, Steffi, Kohlberg, Karina Knuhr, Bloos, Petra, Schwope, Katrin, Rossella, Marino, Russo, Veronica, Simona, Santarelli, Bartoli, Christopher, Navarin, Sylvia, Bongiovanni, Cristina, Orru, Michela, Quatrocchi, Daniela, Zoccoli, Giada, Varchetta, Antonella, de Pascale, Gennaro, Vallecoccia, Maria Sole, Cutuli, Salvatore Lucio, Digravio, Valentina, Laterre, Pierre-François, Quattrochi, Daniela, D'Arrigo, Sonia, Leone, Filippo Elvino, Beishuizen, Bert, Rinket, Martin, Border, Natalie, Bos-Burgmeijer, Mariska, Braad, Astrid, Papendorp, S., Cornet, Alexander, AdrenOSS-1 study investigators, Vermeijden, J., Trof, Ronald J., van de A, Marieke, Van Wezel, Helen, Heunks, Leo, Luijten-Arts, Chantal, Hoedemaekers, Astrid, van der Hoeven, Hans, Wittebole, Xavier, Laterre, Pierre François, Roovers, Noortje, Hemelaar, Pleun, Berghe, Caroline, Dujardin, Marie-France, Renard, Suzanne, Collienne, Christine, Zapatero, Diego Castanares, Vinetti, Marco, De Schryver, Nicolas, Thirifays, Anne, Mairesse, Jacques, Petre, Hélène, Buelens, Isabelle, Henin, Pierre, Trine, Hugues, Laurent, Yves, Sébastien, Loix, Geukens, Paul, Blet, Alice, Kehl, Laurent, Vignon, Philippe, Pichon, Nicolas, Begot, Emmanuelle, Fedou, Anne-Laure, Chapellas, Catherine, Galy, Antoine, Rodier, Nicolas, Baudrillart, Ludmilla, Nouaille, Michelle, Laleu, Séverine, Mancia, Claire, Daix, Thomas, Bourzeix, Paul, Herafa, Isabelle, Duchambon, Anne-Aurore, Lascarrou, Jean Baptiste, Fiancette, Maud, Colin, Gwenhael, Hartmann, Oliver, Henry-Lagarrigue, Matthieu, Lacherade, Jean-Claude, Lebert, Christine, Martin-Levèvre, Laurent, Vinatier, Isabelle, Yehia, Aihem, Bachoumas, Konstantinos, Joret, Aurélie, Reignier, Jean, Rousseau, Cécille, Scigalla, Paul, Maquigneau, Natacha, Alcourt, Yolaine, Zinzonni, Vanessa Erragne, Deschamps, Angélique, Robert, Angelina, Simeon-Vieules, Véronique, Aubrey, Aurélie, Mabilat, Christine, Garot, Denis, Struck, Joachim, Ehrmann, Stephan, Legras, Annick, Manikikian, Jouan, Youenn, Dequin, Pierre François, Guillon, Antoine, Bodet-Contentin, Laetitia, Rouve, Emmannuelle, Salmon, Charlotte, Brick, Lysiane, Department of Anaesthesiology and Critical Care and Burn Unit, St-Louis Hospital, Service de biochimie INSERM UMR-S942, Hôpital Lariboisière-APHP, Université Paris Diderot - Paris 7 (UPD7), Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal, Biomarqueurs CArdioNeuroVASCulaires (BioCANVAS), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Cliniques universitaires St Luc [Bruxelles], Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Adrenomed AG, Service de Médecine Intensive et Réanimation [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Génétique, Reproduction et Développement (GReD), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Department of Intensive Care, St-Pierre Hospital, Centre d'Investigation Clinique de Limoges (CIC1435), CHU Limoges-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Réanimation Médico-Chirurgicale [Avicenne], Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], Service de réanimation médicale [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Rheinisch-Westfälische Technische Hochschule Aachen (RWTH), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Hôpital Saint-Louis, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Radboud university [Nijmegen], Hôpital Bichat - Claude Bernard, Université Catholique de Louvain = Catholic University of Louvain (UCL), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Physiopathologie Cardiovasculaire et Mitochondriale (MITOVASC), Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Intensive care medicine, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Limoges, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Rheinisch-Westfälische Technische Hochschule Aachen University (RWTH), Radboud University [Nijmegen], and MitoVasc - Physiopathologie Cardiovasculaire et Mitochondriale (MITOVASC)

Subjects
Male, medicine.medical_treatment, [SDV]Life Sciences [q-bio], lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Medical and Health Sciences, law.invention, Adrenomedullin, 0302 clinical medicine, Belgium, law, Germany, Medicine, Hospital Mortality, Prospective Studies, Netherlands, Outcome, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Hematology, Middle Aged, Prognosis, Shock, Septic, Intensive care unit, 3. Good health, Hospitalization, Intensive Care Units, Infectious Diseases, Italy, Anesthesia, outcome, biomarker, Female, SOFA score, France, medicine.symptom, Infection, Multiple Organ Failure, Sepsis, 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, Clinical Research, Biomarker, Sepsis-2, Sepsis-3, Aged, Biomarkers, Chi-Square Distribution, Humans, Length of Stay, Patient Outcome Assessment, Proportional Hazards Models, Survival Analysis, Settore MED/41 - ANESTESIOLOGIA, AdrenOSS-1 study investigators, Lactic Acid, Renal replacement therapy, business.industry, Septic shock, Research, Inflammatory and immune system, Organ dysfunction, 030208 emergency & critical care medicine, lcsh:RC86-88.9, medicine.disease, Emergency & Critical Care Medicine, Good Health and Well Being, Blood pressure, business
Abstract

Background Adrenomedullin (ADM) regulates vascular tone and endothelial permeability during sepsis. Levels of circulating biologically active ADM (bio-ADM) show an inverse relationship with blood pressure and a direct relationship with vasopressor requirement. In the present prospective observational multinational Adrenomedullin and Outcome in Sepsis and Septic Shock 1 (, AdrenOSS-1) study, we assessed relationships between circulating bio-ADM during the initial intensive care unit (ICU) stay and short-term outcome in order to eventually design a biomarker-guided randomized controlled trial. Methods AdrenOSS-1 was a prospective observational multinational study. The primary outcome was 28-day mortality. Secondary outcomes included organ failure as defined by Sequential Organ Failure Assessment (SOFA) score, organ support with focus on vasopressor/inotropic use, and need for renal replacement therapy. AdrenOSS-1 included 583 patients admitted to the ICU with sepsis or septic shock. Results Circulating bio-ADM levels were measured upon admission and at day 2. Median bio-ADM concentration upon admission was 80.5 pg/ml [IQR 41.5–148.1 pg/ml]. Initial SOFA score was 7 [IQR 5–10], and 28-day mortality was 22%. We found marked associations between bio-ADM upon admission and 28-day mortality (unadjusted standardized HR 2.3 [CI 1.9–2.9]; adjusted HR 1.6 [CI 1.1–2.5]) and between bio-ADM levels and SOFA score (p < 0.0001). Need of vasopressor/inotrope, renal replacement therapy, and positive fluid balance were more prevalent in patients with a bio-ADM > 70 pg/ml upon admission than in those with bio-ADM ≤ 70 pg/ml. In patients with bio-ADM > 70 pg/ml upon admission, decrease in bio-ADM below 70 pg/ml at day 2 was associated with recovery of organ function at day 7 and better 28-day outcome (9.5% mortality). By contrast, persistently elevated bio-ADM at day 2 was associated with prolonged organ dysfunction and high 28-day mortality (38.1% mortality, HR 4.9, 95% CI 2.5–9.8). Conclusions AdrenOSS-1 shows that early levels and rapid changes in bio-ADM estimate short-term outcome in sepsis and septic shock. These data are the backbone of the design of the biomarker-guided AdrenOSS-2 trial. Trial registration ClinicalTrials.gov, NCT02393781. Registered on March 19, 2015. Electronic supplementary material The online version of this article (10.1186/s13054-018-2243-2) contains supplementary material, which is available to authorized users.

Published
2018

22. Receptor for advanced glycation end-products and ARDS prediction: a multicentre observational study

Author

Jabaudon, Matthieu, primary, Berthelin, Pauline, additional, Pranal, Thibaut, additional, Roszyk, Laurence, additional, Godet, Thomas, additional, Faure, Jean-Sébastien, additional, Chabanne, Russell, additional, Eisenmann, Nathanael, additional, Lautrette, Alexandre, additional, Belville, Corinne, additional, Blondonnet, Raiko, additional, Cayot, Sophie, additional, Gillart, Thierry, additional, Pascal, Julien, additional, Skrzypczak, Yvan, additional, Souweine, Bertrand, additional, Blanchon, Loic, additional, Sapin, Vincent, additional, Pereira, Bruno, additional, and Constantin, Jean-Michel, additional

Published
2018
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23. Clinical and Biological Predictors of Plasma Levels of Soluble RAGE in Critically Ill Patients: Secondary Analysis of a Prospective Multicenter Observational Study

Author

Pranal, Thibaut, primary, Pereira, Bruno, additional, Berthelin, Pauline, additional, Roszyk, Laurence, additional, Godet, Thomas, additional, Chabanne, Russell, additional, Eisenmann, Nathanael, additional, Lautrette, Alexandre, additional, Belville, Corinne, additional, Blondonnet, Raiko, additional, Cayot, Sophie, additional, Gillart, Thierry, additional, Skrzypczak, Yvan, additional, Souweine, Bertrand, additional, Bouvier, Damien, additional, Blanchon, Loic, additional, Sapin, Vincent, additional, Constantin, Jean-Michel, additional, and Jabaudon, Matthieu, additional

Published
2018
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24. Epidural analgesia in critically ill patients with acute pancreatitis: the multicentre randomised controlled EPIPAN study protocol

Author

UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service de soins intensifs, Bulyez, Stéphanie, Pereira, Bruno, Caumon, Elodie, Imhoff, Etienne, Roszyk, Laurence, Bernard, Lise, Bühler, Leo, Heidegger, Claudia, Jaber, Samir, Lefrant, Jean-Yves, Chabanne, Russell, Bertrand, Pierre-Marie, Laterre, Pierre-François, Guerci, Philippe, Danin, Pierre-Eric, Escudier, Etienne, Sossou, Achille, Morand, Dominique, Sapin, Vincent, Constantin, Jean-Michel, Jabaudon, Matthieu, EPIPAN Study Group, AzuRea network, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service de soins intensifs, Bulyez, Stéphanie, Pereira, Bruno, Caumon, Elodie, Imhoff, Etienne, Roszyk, Laurence, Bernard, Lise, Bühler, Leo, Heidegger, Claudia, Jaber, Samir, Lefrant, Jean-Yves, Chabanne, Russell, Bertrand, Pierre-Marie, Laterre, Pierre-François, Guerci, Philippe, Danin, Pierre-Eric, Escudier, Etienne, Sossou, Achille, Morand, Dominique, Sapin, Vincent, Constantin, Jean-Michel, Jabaudon, Matthieu, EPIPAN Study Group, and AzuRea network

Abstract

BACKGROUND: Acute pancreatitis (AP) is associated with high morbidity and mortality in its most severe forms. Most patients with severe AP require intubation and invasive mechanical ventilation, frequently for more than 7 days, which is associated with the worst outcome. Recent increasing evidence from preclinical and clinical studies support the beneficial effects of epidural analgesia (EA) in AP, such as increased gut barrier function and splanchnic, pancreatic and renal perfusion, decreased liver damage and inflammatory response, and reduced mortality. Because recent studies suggest that EA might be a safe procedure in the critically ill, we sought to determine whether EA reduced AP-associated respiratory failure and other major clinical outcomes in patients with AP. METHODS AND ANALYSIS: The Epidural Analgesia for Pancreatitis (EPIPAN) trial is an investigator-initiated, prospective, multicentre, randomised controlled two-arm trial with assessor-blinded outcome assessment. The EPIPAN trial will randomise 148 patients with AP requiring admission to an intensive care unit (ICU) to receive EA (with patient-controlled epidural administration of ropivacaine and sufentanil) combined with standard care based on current recommendations on the treatment of AP (interventional group), or standard care alone (reference group). The primary outcome is the number of ventilator-free days at day 30. Secondary outcomes include main complications of AP (eg, organ failure and mortality, among others), levels of biological markers of systemic inflammation, epithelial lung injury, renal failure, and healthcare-associated costs. ETHICS AND DISSEMINATION: The study was approved by the appropriate ethics committee (CPP Sud-Est VI). Informed consent is required. If the combined application of EA and standard care proves superior to standard care alone in patients with AP in the ICU, the use of EA may become standard practice in experienced centres, thereby decreasing potential complicati

Published
2017

25. RAGE inhibition reduces acute lung injury in mice

Author

Blondonnet, Raiko, primary, Audard, Jules, additional, Belville, Corinne, additional, Clairefond, Gael, additional, Lutz, Jean, additional, Bouvier, Damien, additional, Roszyk, Laurence, additional, Gross, Christelle, additional, Lavergne, Marilyne, additional, Fournet, Marianne, additional, Blanchon, Loic, additional, Vachias, Caroline, additional, Damon-Soubeyrand, Christelle, additional, Sapin, Vincent, additional, Constantin, Jean-Michel, additional, and Jabaudon, Matthieu, additional

Published
2017
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26. Epidural analgesia in critically ill patients with acute pancreatitis: the multicentre randomised controlled EPIPAN study protocol

Author

Bulyez, Stéphanie, primary, Pereira, Bruno, additional, Caumon, Elodie, additional, Imhoff, Etienne, additional, Roszyk, Laurence, additional, Bernard, Lise, additional, Bühler, Leo, additional, Heidegger, Claudia, additional, Jaber, Samir, additional, Lefrant, Jean-Yves, additional, Chabanne, Russell, additional, Bertrand, Pierre-Marie, additional, Laterre, Pierre-François, additional, Guerci, Philippe, additional, Danin, Pierre-Eric, additional, Escudier, Etienne, additional, Sossou, Achille, additional, Morand, Dominique, additional, Sapin, Vincent, additional, Constantin, Jean-Michel, additional, and Jabaudon, Matthieu, additional

Published
2017
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27. Driving pressure and acute respiratory distress syndrome in critically ill patients.

Author

Joubert, Elodie, Godet, Thomas, Berthelin, Pauline, Pranal, Thibaut, Chabanne, Russell, Cayot, Sophie, Gillart, Thierry, Blondonnet, Raiko, Constantin, Jean‐Michel, Jabaudon, Matthieu, Belville, Corinne, Roszyk, Laurence, Bouvier, Damien, Sapin, Vincent, Blanchon, Loic, Eisenmann, Nathanael, Lautrette, Alexandre, Souweine, Bertrand, and Pereira, Bruno

Subjects
RESPIRATORY distress syndrome, INTENSIVE care units, LUNG injury treatment, VASOPRESSIN, MECHANICAL ventilators
Abstract

Background and objective: Elevated driving pressure (ΔP) may be associated with increased risk of acute respiratory distress syndrome (ARDS) in patients admitted via the emergency department and with post‐operative pulmonary complications in surgical patients. This study investigated the association of higher ΔP with the onset of ARDS in a high‐risk, intensive care unit (ICU) population. Methods: This is a secondary analysis of a prospective multicentre observational study. Data for this ancillary study were obtained from intubated adult patients with at least one ARDS risk factor upon ICU admission enrolled in a previous multicentre observational study. Patients were followed up for the development of ARDS within 7 days (primary outcome). Univariate and multivariate analyses tested the association between ΔP (measured at ICU admission (baseline) or 24 h later (day 1)) and the development of ARDS. Results: A total of 221 patients were included in this study, among whom 34 (15%) developed ARDS within 7 days. These patients had higher baseline ΔP than those who did not (mean ± SD: 12.5 ± 3.1 vs 9.8 ± 3.4 cm H2O, respectively, P = 0.0001). The association between baseline ΔP and the risk of developing ARDS was robust to adjustment for baseline tidal volume, positive‐end expiratory pressure, illness severity, serum lactate and sepsis, pneumonia, severe trauma and shock as primary ARDS risk factors (odds ratio: 1.20; 95% CI: 1.03–1.41; P = 0.02). The same results were found with day 1 ΔP. Conclusion: Among at‐risk ICU patients, higher ΔP may identify those who are more likely to develop ARDS. The driving pressure at admission to the intensive care unit in intubated patients under controlled ventilation identifies patients with clinical risk factor(s), who develop acute respiratory distress syndrome within 7 days. See relatedEditorial [ABSTRACT FROM AUTHOR]

Published
2019
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29. Soluble Forms and Ligands of the Receptor for Advanced Glycation End-Products in Patients with Acute Respiratory Distress Syndrome: An Observational Prospective Study

Author

Jabaudon, Matthieu, primary, Blondonnet, Raiko, additional, Roszyk, Laurence, additional, Pereira, Bruno, additional, Guérin, Renaud, additional, Perbet, Sébastien, additional, Cayot, Sophie, additional, Bouvier, Damien, additional, Blanchon, Loic, additional, Sapin, Vincent, additional, and Constantin, Jean-Michel, additional

Published
2015
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30. Changes in Plasma Soluble Receptor for Advanced Glycation End-Products Are Associated with Survival in Patients with Acute Respiratory Distress Syndrome.

Author

Jabaudon, Matthieu, Pereira, Bruno, Laroche, Erwan, Roszyk, Laurence, Blondonnet, Raiko, Audard, Jules, Godet, Thomas, Futier, Emmanuel, Bazin, Jean-Etienne, Sapin, Vincent, Bastarache, Julie A., Ware, Lorraine B., Constantin, Jean-Michel, and Chiumello, Davide

Subjects
ADULT respiratory distress syndrome, ADVANCED glycation end-products, PROGNOSIS
Abstract

The plasma soluble receptor for advanced glycation end-products (sRAGE) is a marker of lung epithelial injury with prognostic value when measured at baseline in acute respiratory distress syndrome (ARDS). However, whether changes in plasma sRAGE could inform prognosis in ARDS remains unknown. In this secondary analysis of the Lung Imaging for Ventilator Setting in ARDS (LIVE) multicenter randomized controlled trial, which evaluated a personalized ventilation strategy tailored to lung morphology, plasma sRAGE was measured upon study entry (baseline) and on days one, two, three, four and six. The association between changes in plasma sRAGE over time and 90-day survival was evaluated. Higher baseline plasma sRAGE (HR per-one log increment, 1.53; 95% CI, 1.16–2.03; p = 0.003) and an increase in sRAGE over time (HR for each one-log increment in plasma sRAGE per time unit, 1.01; 95% CI, 1.01–1.02; p < 10−3) were both associated with increased 90-day mortality. Each 100-unit increase in the plasma sRAGE level per unit of time increased the risk of death at day 90 by 1% in joint modeling. Plasma sRAGE increased over time when a strategy of maximal alveolar recruitment was applied in patients with focal ARDS. Current findings suggest that the rate of change in plasma sRAGE over time is associated with 90-day survival and could be helpful as a surrogate outcome in ARDS. [ABSTRACT FROM AUTHOR]

Published
2021
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31. Driving pressure and acute respiratory distress syndrome in critically ill patients.

Author

Blondonnet R, Joubert E, Godet T, Berthelin P, Pranal T, Roszyk L, Chabanne R, Eisenmann N, Lautrette A, Belville C, Cayot S, Gillart T, Souweine B, Bouvier D, Blanchon L, Sapin V, Pereira B, Constantin JM, and Jabaudon M

Subjects
Adult, Correlation of Data, Critical Care methods, Female, Humans, Intensive Care Units statistics & numerical data, Male, Middle Aged, Risk Adjustment, Risk Factors, Critical Illness therapy, Positive-Pressure Respiration adverse effects, Positive-Pressure Respiration methods, Respiration, Artificial adverse effects, Respiration, Artificial methods, Respiratory Distress Syndrome etiology
Abstract

Background and Objective: Elevated driving pressure (ΔP) may be associated with increased risk of acute respiratory distress syndrome (ARDS) in patients admitted via the emergency department and with post-operative pulmonary complications in surgical patients. This study investigated the association of higher ΔP with the onset of ARDS in a high-risk, intensive care unit (ICU) population., Methods: This is a secondary analysis of a prospective multicentre observational study. Data for this ancillary study were obtained from intubated adult patients with at least one ARDS risk factor upon ICU admission enrolled in a previous multicentre observational study. Patients were followed up for the development of ARDS within 7 days (primary outcome). Univariate and multivariate analyses tested the association between ΔP (measured at ICU admission (baseline) or 24 h later (day 1)) and the development of ARDS., Results: A total of 221 patients were included in this study, among whom 34 (15%) developed ARDS within 7 days. These patients had higher baseline ΔP than those who did not (mean ± SD: 12.5 ± 3.1 vs 9.8 ± 3.4 cm H 2 O, respectively, P = 0.0001). The association between baseline ΔP and the risk of developing ARDS was robust to adjustment for baseline tidal volume, positive-end expiratory pressure, illness severity, serum lactate and sepsis, pneumonia, severe trauma and shock as primary ARDS risk factors (odds ratio: 1.20; 95% CI: 1.03-1.41; P = 0.02). The same results were found with day 1 ΔP., Conclusion: Among at-risk ICU patients, higher ΔP may identify those who are more likely to develop ARDS., (© 2018 Asian Pacific Society of Respirology.)

Published
2019
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