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Your search keyword '"Gaëtan, Beduneau"' showing total 2 results
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2 results on '"Gaëtan, Beduneau"'

1. Diagnostic yield of viral multiplex PCR during acute exacerbation of COPD admitted to the intensive care unit: a pilot study

Author

Costa Salachas, Cherifa Gounane, Gaëtan Beduneau, Julien Lopinto, Matthieu Turpin, Corinne Amiel, Antoine Cuvelier, Marie Gueudin, Guillaume Voiriot, and Muriel Fartoukh

Subjects
Medicine, Science
Abstract

Abstract Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is one of the leading causes of admission to the intensive care unit, often triggered by a respiratory tract infection of bacterial or viral aetiology. Managing antibiotic therapy in this context remains a challenge. Respiratory panel molecular tests allow identifying viral aetiologies of AECOPD. We hypothesized that the systematic use of a respiratory multiplex PCR (mPCR) would help antibiotics saving in severe AECOPD. Our objectives were to describe the spectrum of infectious aetiologies of severe AECOPD, using a diagnostic approach combining conventional diagnostic tests and mPCR, and to measure antibiotics exposure. The study was bicentric, prospective, observational, and included 105 critically ill patients with a severe AECOPD of presumed infectious aetiology, in whom a respiratory mPCR with a viral panel was performed in addition to conventional microbiological tests. Altogether, the microbiological documentation rate was 50%, including bacteria alone (19%), respiratory viruses alone (16%), and mixed viruses and bacterial species (16%). The duration of antibiotic therapy was shorter in patients without documented bacterial infection (5.6 vs. 9 days; P = 0.0006). This pilot study suggests that molecular tests may help for the proper use of anti-infective treatments in critically ill patients with severe AECOPD.

Published
2024
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2. Diagnostic bronchoscopy in hematology and oncology patients with acute respiratory failure: prospective multicenter data

Author

Vincent Castelain, Elie Azoulay, Arnaud de Lassence, Benoit Renard, Didier Gruson, Sylvie Chevret, Virginie Lemiale, François Vincent, Djamel Mokart, Fabrice Bruneel, Achille Kouatchet, Ismaël Mohammedi, Delphine Moreau, Frédéric Pène, Gaëtan Beduneau, Geraldine Epinette, Benoît Schlemmer, Antoine Rabbat, and Rebecca Hamidfar

Subjects
Male, Resuscitation, medicine.medical_specialty, medicine.medical_treatment, Critical Care and Intensive Care Medicine, Bronchoalveolar Lavage, Bronchoscopy, Risk Factors, Internal medicine, Intensive care, Neoplasms, Medicine, Humans, Hospital Mortality, Prospective Studies, Practice Patterns, Physicians', Prospective cohort study, Intensive care medicine, Aged, Mechanical ventilation, Hematology, medicine.diagnostic_test, business.industry, Cancer, respiratory system, Middle Aged, medicine.disease, Hematologic Diseases, respiratory tract diseases, Causality, Bronchoalveolar lavage, Outcome and Process Assessment, Health Care, Emergency medicine, Acute Disease, Female, France, business, Respiratory Insufficiency
Abstract

To describe the diagnostic yields of test strategies with and without fiberoptic bronchoscopy and bronchoalveolar lavage (FO-BAL), as well as outcomes, in cancer patients with acute respiratory failure (ARF).Prospective observational study.Fifteen intensive care units in France.In all, 148 cancer patients, including 45 bone marrow transplant recipients (27 allogeneic, 18 autologous) with hypoxemic ARF.None.Overall, 146 causes of ARF were identified in 128 patients (97 [66.4%] pulmonary infections). The cause of ARF was identified in 50.5% of the 101 patients who underwent FO-BAL and in 66.7% of the other patients. FO-BAL was the only conclusive test in 34 (33.7%) of the 101 investigated patients. Respiratory status deterioration after FO-BAL occurred in 22 of 45 (48.9%) nonintubated patients, including 16 (35.5%) patients who required ventilatory support. Hospital mortality was 55.4% (82 deaths) overall and was not significantly different in the groups with and without FO-BAL. By multivariate analysis, mortality was affected by characteristics of the malignancy (remission, allogeneic bone marrow transplantation), cause of ARF (ARF during neutropenia recovery, cause not identified), and need for life-sustaining treatments (mechanical ventilation and vasopressors).In critically ill cancer patients with ARF, a diagnostic strategy that does not include FO-BAL may be as effective as FO-BAL without exposing the patients to respiratory status deterioration.

Published
2007

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