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1. Bedside POCUS during ward emergencies is associated with improved diagnosis and outcome: an observational, prospective, controlled study.

Author

Zieleskiewicz L, Lopez A, Hraiech S, Baumstarck K, Pastene B, Di Bisceglie M, Coiffard B, Duclos G, Boussuges A, Bobbia X, Einav S, Papazian L, and Leone M

Subjects
Aged, Female, France, Humans, Male, Middle Aged, Patients' Rooms organization & administration, Patients' Rooms statistics & numerical data, Point-of-Care Systems standards, Point-of-Care Systems statistics & numerical data, Prospective Studies, Statistics, Nonparametric, Ultrasonography methods, Ultrasonography statistics & numerical data, Mortality trends, Ultrasonography standards
Abstract

Background: Rapid response teams are intended to improve early diagnosis and intervention in ward patients who develop acute respiratory or circulatory failure. A management protocol including the use of a handheld ultrasound device for immediate point-of-care ultrasound (POCUS) examination at the bedside may improve team performance. The main objective of the study was to assess the impact of implementing such a POCUS-guided management on the proportion of adequate immediate diagnoses in two groups. Secondary endpoints included time to treatment and patient outcomes., Methods: A prospective, observational, controlled study was conducted in a single university hospital. Two teams alternated every other day for managing in-hospital ward patients developing acute respiratory and/or circulatory failures. Only one of the team used an ultrasound device (POCUS group)., Results: We included 165 patients (POCUS group 83, control group 82). Proportion of adequate immediate diagnoses was 94% in the POCUS group and 80% in the control group (p = 0.009). Time to first treatment/intervention was shorter in the POCUS group (15 [10-25] min vs. 34 [15-40] min, p < 0.001). In-hospital mortality rates were 17% in the POCUS group and 35% in the control group (p = 0.007), but this difference was not confirmed in the propensity score sample (29% vs. 34%, p = 0.53)., Conclusion: Our study suggests that protocolized use of a handheld POCUS device at the bedside in the ward may improve the proportion of adequate diagnosis, the time to initial treatment and perhaps also survival of ward patients developing acute respiratory or circulatory failure. Clinical Trial Registration NCT02967809. Registered 18 November 2016, https://clinicaltrials.gov/ct2/show/NCT02967809 .

Published
2021
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4. High Airway Occlusion Pressure Is Associated with Dyspnea and Increased Mortality in Critically Ill Mechanically Ventilated Patients.

Author

Le Marec, Julien, Hajage, David, Decavèle, Maxens, Schmidt, Matthieu, Laurent, Isaura, Ricard, Jean-Damien, Jaber, Samir, Azoulay, Elie, Fartoukh, Muriel, Hraiech, Sami, Mercat, Alain, Similowski, Thomas, and Demoule, Alexandre

Subjects
CRITICALLY ill, DYSPNEA, MORTALITY, AIRWAY (Anatomy), ARTIFICIAL respiration
Abstract

Rationale: Airway occlusion pressure at 100 ms (P0.1) reflects central respiratory drive. Objectives: We aimed to assess factors associated with P0.1 and whether an abnormally low or high P0.1 value is associated with higher mortality and longer duration of mechanical ventilation (MV). Methods: We performed a secondary analysis of a prospective cohort study conducted in 10 ICUs in France to evaluate dyspnea in communicative MV patients. In patients intubated for more than 24 hours, P0.1 was measured with dyspnea as soon as patients could communicate and the next day. Measurements and Main Results: Among 260 patients assessed after a median time of ventilation of 4 days, P0.1 was 1.9 (1–3.5) cm H2O at enrollment, 24% had P0.1 values >3.5 cm H2O, 37% had P0.1 values between 1.5 and 3.5 cm H2O, and 39% had P0.1 values <1.5 cm H2O. In multivariable linear regression, independent factors associated with P0.1 were the presence of dyspnea (P = 0.037), respiratory rate (P < 0.001), and PaO2 (P = 0.008). Ninety-day mortality was 33% in patients with P0.1 > 3.5 cm H2O versus 19% in those with P0.1 between 1.5 and 3.5 cm H2O and 17% in those with P0.1 < 1.5 cm H2O (P = 0.046). After adjustment for the main risk factors, P0.1 was associated with 90-day mortality (hazard ratio per 1 cm H2O, 1.19 [95% confidence interval, 1.04–1.37]; P = 0.011). P0.1 was also independently associated with a longer duration of MV (hazard ratio per 1 cm H2O, 1.10 [95% confidence interval, 1.02–1.19]; P = 0.016). Conclusions: In patients receiving invasive MV, abnormally high P0.1 values may suggest dyspnea and are associated with higher mortality and prolonged duration of MV. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Impact of Prone Position in COVID-19 Patients on Extracorporeal Membrane Oxygenation*

Author

Massart, Nicolas, Guervilly, Christophe, Mansour, Alexandre, Porto, Alizée, Flécher, Erwan, Esvan, Maxime, Fougerou, Claire, Fillâtre, Pierre, Duburcq, Thibault, Lebreton, Guillaume, Para, Marylou, Stephan, François, Hraiech, Sami, Ross, James, Schmidt, Matthieu, Vincentelli, André, Nesseler, Nicolas, CHU Pontchaillou [Rennes], Hôpital Yves LE FOLL [Saint-Brieuc], Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), Hôpital Nord [CHU - APHM], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital de la Timone [CHU - APHM] (TIMONE), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Lille, Université de Lille, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut de cardiologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Marie-Lannelongue, University of California [Davis] (UC Davis), University of California (UC), Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Extracorporeal Membrane Oxygenation for Respiratory Failure and/or Heart failure related to Severe Acute Respiratory Syndrome Coronavirus 2 (ECMOSARS) Investigators: Olivier Fouquet, Marc Pierrot, Sidney Chocron, Guillaume Flicoteaux, Philippe Mauriat, Hadrien Roze, Alexandre Ouattara, Olivier Huet, Marc-Olivier Fischer, Claire Alessandri, Raphel Bellaïche, Ophélie Constant, Quentin De Roux, André Ly, Arnaud Meffert, Jean-Claude Merle, Lucile Picard, Elena Skripkina, Thierry Folliguet, Nicolas Mongardon, Antonio Fiore, Nicolas D'ostrevy, Marie-Catherine Morgan, Maxime Nguyen, Pierre-Grégoire Guinot, Lucie Gaide-Chevronnay, Nicolas Terzi, Gwenhaël Colin, Olivier Fabre, Arash Astaneh, Justin Issard, Elie Fadel, Dominique Fabre, Antoine Girault, Iolande Ion, Jean Baptiste Menager, Delphine Mitilian, Julien Guihaire, Olaf Mercier, Jacques Thes, Jerôme Jouan, Thibault Duburcq, Valentin Loobuyck, Sabrina Manganiello, Mouhammed Moussa, Agnes Mugnier, Natacha Rousse, Olivier Desebbe, Roland Henaine, Matteo Pozzi, Jean-Luc Fellahi, Jean-Christophe Richard, Zakaria Riad, Laurent Papazian, Matthias Castanier, Charles Chanavaz, Cyril Cadoz, Sebastien Gette, Guillaume Louis, Erick Portocarrero, Philippe Gaudard, Kais Brini, Nicolas Bischoff, Antoine Kimmoun, Bruno Levy, Mathieu Mattei, Pierre Perez, Alexandre Bourdiol, Yannick Hourmant, Pierre-Joachim Mahé, Bertrand Rozec, Mickaël Vourc'h, Stéphane Aubert, Florian Bazalgette, Claire Roger, Sophie Provenchere, Pierre Jaquet, Brice Lortat-Jacob, Pierre Mordant, Patrick Nataf, Juliette Patrier, Morgan Roué, Romain Sonneville, Alexy Tran-Dinh, Paul-Henri Wicky, Charles Al Zreibi, Bernard Cholley, Yannis Guyonvarch, Sophie Hamada, Claudio Barbanti, Anatole Harrois, Astrid Bertier, Jordi Matiello, Thomas Kerforne, Corentin Lacroix, Nicolas Brechot, Juliette Chommeloux, Alain Combes, Jean Michel Constantin, Cosimo D'alessandro, Pierre Demondion, Alexandre Demoule, Martin Dres, Muriel Fartoukh, Guillaume Hekimian, Charles Juvin, Pascal Leprince, Guillaume Fadel, David Levy, Charles Edouard Luyt, Marc Pineton de Chambrun, Thibaut Schoell, Roxane Nicolas, Maud Jonas, Charles Vidal, Nicolas Allou, Salvatore Muccio, Dario Di Perna, Bruno Mourvillier, Vito-Giovanni Ruggieri, Amedeo Anselmi, Karl Bounader, Yoann Launey, Thomas Lebouvier, Alessandro Parasido, Florian Reizine, Philippe Seguin, Emmanuel Besnier, Dorothée Carpentier, Thomas Clavier, Anne Olland, Pierre-Emmanuel Falcoz, Marion Villard, Fanny Bounes, François Labaste, Vincent Minville, Antoine Guillon, Yannick Fedun, and MORNET, Dominique

Subjects
[SDV] Life Sciences [q-bio], critical care, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV]Life Sciences [q-bio], prone position, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, acute respiratory distress syndrome, extracorporeal membrane oxygenation, mechanical ventilation, Critical Care and Intensive Care Medicine, mortality
Abstract

International audience; Objectives: Prone positioning and venovenous extracorporeal membrane oxygenation (ECMO) are both useful interventions in acute respiratory distress syndrome (ARDS). Combining the two therapies is feasible and safe, but the effectiveness is not known. Our objective was to evaluate the potential survival benefit of prone positioning in venovenous ECMO patients cannulated for COVID-19-related ARDS.Design: Retrospective analysis of a multicenter cohort.Patients: Patients on venovenous ECMO who tested positive for severe acute respiratory syndrome coronavirus 2 by reverse transcriptase polymerase chain reaction or with a diagnosis on chest CT were eligible.Interventions: None.Measurements and main results: All patients on venovenous ECMO for respiratory failure in whom prone position status while on ECMO and in-hospital mortality were known were included. Of 647 patients in 41 centers, 517 were included. Median age was 55 (47-61), 78% were male and 95% were proned before cannulation. After cannulation, 364 patients (70%) were proned and 153 (30%) remained in the supine position for the whole ECMO run. There were 194 (53%) and 92 (60%) deaths in the prone and the supine groups, respectively. Prone position on ECMO was independently associated with lower in-hospital mortality (odds ratio = 0.49 [0.29-0.84]; p = 0.010). In 153 propensity score-matched pairs, mortality rate was 49.7% in the prone position group versus 60.1% in the supine position group (p = 0.085). Considering only patients alive at decannulation, propensity-matched proned patients had a significantly lower mortality rate (22.4% vs 37.8%; p = 0.029) than nonproned patients.Conclusions: Prone position may be beneficial in patients supported by venovenous ECMO for COVID-19-related ARDS but more data are needed to draw definitive conclusions.

Published
2022

7. Characteristics and outcomes of intensive care unit patients with respiratory syncytial virus compared to those with influenza infection: a multicentre matched cohort study

Author

Coussement, Julien, Zuber, Benjamin, Garrigues, Eve, Gros, Antoine, Vandueren, Charlotte, Epaillard, Nicolas, Voiriot, Guillaume, Tandjaoui-Lambiotte, Yacine, Lascarrou, Jean-Baptiste, Boissier, Florence, Lemiale, Virginie, Contou, Damien, Hraiech, Sami, Meert, Anne-Pascale, Sauneuf, Bertrand, Munting, Aline, Ricome, Sylvie, Messika, Jonathan, Muller, Gregoire, Njimi, Hassane, Grimaldi, David, UCL - SSS/IREC/MONT - Pôle Mont Godinne, and UCL - (MGD) Pathologie infectieuse

Subjects
virus diseases, RSV, mechanical ventilation, influenza, mortality, community-acquired respiratory virus
Abstract

The characteristics and outcomes of adult patients with respiratory syncytial virus (RSV) infection who require intensive care unit (ICU) admission are poorly defined. Although several studies in adults with RSV infection have been published in recent years, they did not focus specifically on critically ill patients. What are the characteristics and outcomes of adult ICU patients with RSV infection, and how do they compare to those of ICU patients with influenza infection? This retrospective, multicentre study in France and Belgium (17 sites) compared the characteristics and outcomes of adult ICU patients with RSV infection versus influenza infection between November 2011 and April 2018. Each patient with RSV infection was matched by institution and date of diagnosis with a patient with influenza infection. In-hospital mortality was compared between the two groups, with adjustment for prognostic factors in a multivariable model (sex, age, main underlying conditions, and concurrent bloodstream infection). Data from 618 patients (309 with RSV infection and 309 with influenza infection) were analysed. Patients with RSV infection were significantly more likely to have an underlying chronic respiratory condition (60.2% versus 40.1%, p

Published
2022

8. Static compliance of the respiratory system in COVID-19 related ARDS: an international multicenter study

Author

Vandenbunder, Benoit, Ehrmann, Stephan, Piagnerelli, Michael, Sauneuf, Bertrand, Serck, Nicolas, Soumagne, Thibaud, Textoris, Julien, Vinsonneau, Christophe, Aissaoui, Nadia, Blonz, Gauthier, Carbutti, Giuseppe, Courcelle, Romain, D'hondt, Alain, Gaudry, Stephane, Higny, Julien, Horlait, Geoffrey, Hraiech, Sami, Lefebvre, Laurent, Lejeune, Francois, Ly, Andre, Lascarrou, Jean-Baptiste, Grimaldi, David, COVADIS study group, Mesland, Jean-Baptiste, Service de Médecine Intensive Réanimation [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre d’Etude des Pathologies Respiratoires (CEPR), UMR 1100 (CEPR), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - SSS/DDUV - Institut de Duve, UCL - SSS/DDUV/GECE - Génétique cellulaire, UCL - (SLuc) Service de soins intensifs, and UCL - (MGD) Services des soins intensifs

Subjects
Male, ARDS, medicine.medical_specialty, animal structures, medicine.medical_treatment, Respiratory mechanics, Respiratory physiology, SARS-COV-2, Pulmonary compliance, Critical Care and Intensive Care Medicine, Logistic regression, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Mechanical ventilation, Internal medicine, medicine, otorhinolaryngologic diseases, Humans, Mortality, PEEP, Aged, Respiratory Distress Syndrome, business.industry, Research, lcsh:Medical emergencies. Critical care. Intensive care. First aid, COVID-19, 030208 emergency & critical care medicine, lcsh:RC86-88.9, Middle Aged, Plateau pressure, respiratory system, medicine.disease, 030228 respiratory system, Cohort, ICU, Breathing, Female, business, Cohort study
Abstract

BackgroundControversies exist on the nature of COVID-19 related acute respiratory distress syndrome (ARDS) in particular on the static compliance of the respiratory system (Crs). We aimed to analyze the association of Crs with outcome in COVID-19-associated ARDS, to ascertain its determinants and to describe its evolution at day-14.MethodsIn this observational multicenter cohort of patients with moderate to severe Covid-19 ARDS, Crs was measured at day-1 and day-14. Association between Crs or Crs/ideal body weight (IBW) and breathing without assistance at day-28 was analyzed with multivariable logistic regression. Determinants were ascertained by multivariable linear regression. Day-14 Crs was compared to day-1 Crs with paired t-test in patients still under controlled mechanical ventilation.ResultsThe mean Crs in 372 patients was 37.6 ± 13 mL/cmH2O, similar to as in ARDS of other causes. Multivariate linear regression identified chronic hypertension, low PaO2/FiO2ratio, low PEEP, and low tidal volume as associated with lower Crs/IBW. After adjustment on confounders, nor Crs [OR 1.0 (CI 95% 0.98–1.02)] neither Crs/IBW [OR 0.63 (CI 95% 0.13–3.1)] were associated with the chance of breathing without assistance at day-28 whereas plateau pressure was [OR 0.93 (CI 95% 0.88–0.99)]. In a subset of 108 patients, day-14 Crs decreased compared to day-1 Crs (31.2 ± 14.4 mL/cmH2O vs 37.8 ± 11.4 mL/cmH2O,p ConclusionIn a large multicenter cohort of moderate to severe COVID-19 ARDS, mean Crs was decreased below 40 mL/cmH2O and was not associated with day-28 outcome. Crs decreased between day-1 and day-14 but the decrease was not associated with day-28 outcome.

Published
2021

9. Benefits and risks of noninvasive oxygenation strategy in COVID-19: a multicenter, prospective cohort study (COVID-ICU) in 137 hospitals

Author

Schmidt, Matthieu, Demoule, Alexandre, Hajage, David, Pham, Tài, Combes, Alain, Dres, Martin, Lebbah, Said, Kimmoun, Antoine, Mercat, Alain, Beduneau, Gaëtan, Palmyre, Jessica, Prevost, Margot, Ricard, Jean-Damien, Ferré, Alexis, Fayolle, Pierre-Marie, Girault, Christophe, Pradel, Gael, Asfar, Pierre, Beloncle, François, Demiselle, Julien, Pavot, Arthur, Monnet, Xavier, Richard, Christian, Mayaux, Julien, Beurton, Alexandra, Daubin, Cédric, Descamps, Richard, Joret, Aurélie, Du Cheyron, Damien, Pene, Frédéric, Chiche, Jean-Daniel, Jozwiak, Mathieu, Jaubert, Paul, Voiriot, Guillaume, Fartoukh, Muriel, Teulier, Marion, Blayau, Clarisse, L’her, Erwen, Aubron, Cécile, Bodenes, Laetitia, Ferriere, Nicolas, Auchabie, Johann, Le Meur, Anthony, Pignal, Sylvain, Mazzoni, Thierry, Quenot, Jean-Pierre, Andreu, Pascal, Roudau, Jean-Baptiste, Labruyère, Marie, Nseir, Saad, Preau, Sébastien, Poissy, Julien, Mathieu, Daniel, Benhamida, Sarah, Paulet, Rémi, Roucaud, Nicolas, Thyrault, Martial, Daviet, Florence, Hraiech, Sami, Parzy, Gabriel, Sylvestre, Aude, Jochmans, Sébastien, Bouilland, Anne-Laure, Monchi, Mehran, Des Déserts, Marc Danguy, Mathais, Quentin, Rager, Gwendoline, Pasquier, Pierre, Jean, Reignier, Amélie, Seguin, Charlotte, Garret, Emmanuel, Canet, Dellamonica, Jean, Saccheri, Clément, Lombardi, Romain, Kouchit, Yanis, Jacquier, Sophie, Mathonnet, Armelle, Nay, Mai-Ahn, Runge, Isabelle, Martino, Frédéric, Flurin, Laure, Rolle, Amélie, Carles, Michel, Coudroy, Rémi, Thille, Arnaud, Frat, Jean-Pierre, Rodriguez, Maeva, Beuret, Pascal, Tientcheu, Audrey, Vincent, Arthur, Michelin, Florian, Tamion, Fabienne, Carpentier, Dorothée, Boyer, Déborah, Gissot, Valérie, Ehrmann, Stéphan, Gandonniere, Charlotte Salmon, Elaroussi, Djlali, Delbove, Agathe, Fedun, Yannick, Huntzinger, Julien, Lebas, Eddy, Kisoka, Grâce, Grégoire, Céline, Marchetta, Stella, Lambermont, Bernard, Argaud, Laurent, Baudry, Thomas, Bertrand, Pierre-Jean, Dargent, Auguste, Guitton, Christophe, Chudeau, Nicolas, Landais, Mickaël, Darreau, Cédric, Ferre, Alexis, Gros, Antoine, Lacave, Guillaume, Bruneel, Fabrice, Neuville, Mathilde, Devaquet, Jérôme, Tachon, Guillaume, Gallot, Richard, Chelha, Riad, Galbois, Arnaud, Jallot, Anne, Lemoine, Ludivine Chalumeau, Kuteifan, Khaldoun, Pointurier, Valentin, Jandeaux, Louise-Marie, Mootien, Joy, Damoisel, Charles, Sztrymf, Benjamin, Chommeloux, Juliette, Luyt, Charles Edouard, Schortgen, Frédérique, Rusel, Leon, Jung, Camille, Gobert, Florent, Vimpere, Damien, Lamhaut, Lionel, Sauneuf, Bertrand, Charrrier, Liliane, Calus, Julien, Desmeules, Isabelle, Painvin, Benoît, Tadie, Jean-Marc, Castelain, Vincent, Michard, Baptiste, Herbrecht, Jean-Etienne, Baldacini, Mathieu, Weiss, Nicolas, Demeret, Sophie, Marois, Clémence, Rohaut, Benjamin, Moury, Pierre-Henri, Savida, Anne-Charlotte, Couadau, Emmanuel, Série, Mathieu, Alexandru, Nica, Bruel, Cédric, Fontaine, Candice, Garrigou, Sonia, Mahler, Juliette Courtiade, Leclerc, Maxime, Ramakers, Michel, Garçon, Pierre, Massou, Nicole, van Vong, Ly, Sen, Juliane, Lucas, Nolwenn, Chemouni, Franck, Stoclin, Annabelle, Avenel, Alexandre, Faure, Henri, Gentilhomme, Angélie, Ricome, Sylvie, Abraham, Paul, Monard, Céline, Textoris, Julien, Rimmele, Thomas, Montini, Florent, Lejour, Gabriel, Lazard, Thierry, Etienney, Isabelle, Kerroumi, Younes, Dupuis, Claire, Bereiziat, Marine, Coupez, Elisabeth, Thouy, François, Hoffmann, Clément, Donat, Nicolas, Chrisment, Anne, Blot, Rose-Marie, Jacquot, Audrey, Mattei, Matthieu, Levy, Bruno, Ravan, Ramin, Dopeux, Loïc, Liteaudon, Jean-Mathias, Roux, Delphine, Rey, Brice, Anghel, Radu, Schenesse, Deborah, Gevrey, Vincent, Castanera, Jermy, Petua, Philippe, Madeux, Benjamin, Hartman, Otto, Piagnerelli, Michael, Joosten, Anne, Noel, Cinderella, Biston, Patrick, Noel, Thibaut, Bouar, Gurvan, Boukhanza, Messabi, Demarest, Elsa, Bajolet, Marie-France, Charrier, Nathanaël, Quenet, Audrey, Zylberfajn, Cécile, Dufour, Nicolas, Mégarbane, Buno, Voicu, Sqébastian, Deye, Nicolas, Malissin, Isabelle, Legay, François, Debarre, Matthieu, Barbarot, Nicolas, Fillatre, Pierre, Delord, Bertrand, Laterrade, Thomas, Saghi, Tahar, Pujol, Wilfried, Cungi, Pierre Julien, Esnault, Pierre, Cardinale, Mickael, Ha, Vivien Hong Tuan, Fleury, Grégory, Brou, Marie-Ange, Zafimahazo, Daniel, Tran-Van, David, Avargues, Patrick, Carenco, Lisa, Robin, Nicolas, Ouali, Alexandre, Houdou, Lucie, Le Terrier, Christophe, Suh, Noémie, Primmaz, Steve, Pugin, Jérome, Weiss, Emmanuel, Gauss, Tobias, Moyer, Jean-Denis, Burtz, Catherine Paugam, La Combe, Béatrice, Smonig, Rolland, Violleau, Jade, Cailliez, Pauline, Chelly, Jonathan, Marchalot, Antoine, Saladin, Cécile, Bigot, Christelle, Fatséas, Jules, Ibrahim, Amr, Resiere, Dabor, Hage, Rabih, Cholet, Clémentine, Cantier, Marie, Trouiler, Pierre, Montravers, Philippe, Lortat-Jacob, Brice, Tanaka, Sebastien, Dinh, Alexy Tran, Duranteau, Jacques, Harrois, Anatole, Dubreuil, Guillaume, Werner, Marie, Godier, Anne, Hamada, Sophie, Zlotnik, Diane, Nougue, Hélène, Mekontso-Dessap, Armand, Carteaux, Guillaume, Razazi, Keyvan, de Prost, Nicolas, Mongardon, Nicolas, Langeron, Olivier, Levesque, Eric, Attias, Arié, de Roquetaillade, Charles, Chousterman, Benjamin, Mebazaa, Alexandre, Gayat, Etienne, Garnier, Marc, Pardo, Emmanuel, Satre-Buisson, Lea, Gutton, Christophe, Yvin, Elise, Marcault, Clémence, Azoulay, Elie, Darmon, Michael, Oufella, Hafid Ait, Hariri, Geoffroy, Urbina, Tomas, Mazerand, Sandie, Heming, Nicholas, Santi, Francesca, Moine, Pierre, Annane, Djillali, Bouglé, Adrien, Omar, Edris, Lancelot, Aymeric, Begot, Emmanuelle, Plantefeve, Gaétan, Contou, Damien, Mentec, Hervé, Pajot, Olivier, Faguer, Stanislas, Cointault, Olivier, Lavayssiere, Laurence, Nogier, Marie-Béatrice, Jamme, Matthieu, Pichereau, Claire, Hayon, Jan, Outin, Hervé, Dépret, François, Coutrot, Maxime, Chaussard, Maité, Guillemet, Lucie, Goffin, Pierre, Thouny, Romain, Guntz, Julien, Jadot, Laurent, Persichini, Romain, Jean-Michel, Vanessa, Georges, Hugues, Caulier, Thomas, Pradel, Gaël, Hausermann, Marie-Hélène, Nguyen-Valat, Thi My Hue, Boudinaud, Michel, Vivier, Emmanuel, Rosseli, Sylvène, Bourdin, Gaël, Pommier, Christian, Vinclair, Marc, Poignant, Simon, Mons, Sandrine, Bougouin, Wulfran, Bruna, Franklin, Maestraggi, Quentin, Roth, Christian, Bitker, Laurent, Dhelft, François, Bonnet-Chateau, Justine, Filippelli, Mathilde, Morichau-Beauchant, Tristan, Thierry, Stéphane, Le Roy, Charlotte, Jouan, Mélanie Saint, Goncalves, Bruno, Mazeraud, Aurélien, Daniel, Matthieu, Sharshar, Tarek, Cadoz, Cyril, Gaci, Rostane, Gette, Sébastien, Louis, Guillaune, Sacleux, Sophe-Caroline, Ordan, Marie-Amélie, Cravoisy, Aurélie, Conrad, Marie, Courte, Guilhem, Gibot, Sébastien, Benzidi, Younès, Casella, Claudia, Serpin, Laurent, Setti, Jean-Lou, Besse, Marie-Catherine, Bourreau, Anna, Pillot, Jérôme, Rivera, Caroline, Vinclair, Camille, Robaux, Marie-Aline, Achino, Chloé, Delignette, Marie-Charlotte, Mazard, Tessa, Aubrun, Frédéric, Bouchet, Bruno, Frérou, Aurélien, Muller, Laura, Quentin, Charlotte, Degoul, Samuel, Stihle, Xavier, Sumian, Claude, Bergero, Nicoletta, Lanaspre, Bernard, Quintard, Hervé, Maiziere, Eve Marie, Egreteau, Pierre-Yves, Leloup, Guillaume, Berteau, Florin, Cottrel, Marjolaine, Bouteloup, Marie, Jeannot, Matthieu, Blanc, Quentin, Saison, Julien, Geneau, Isabelle, Grenot, Romaric, Ouchike, Abdel, Hazera, Pascal, Masse, Anne-Lyse, Demiri, Suela, Vezinet, Corinne, Baron, Elodie, Benchetrit, Deborah, Monsel, Antoine, Trebbia, Grégoire, Schaack, Emmanuelle, Lepecq, Raphaël, Bobet, Mathieu, Vinsonneau, Christophe, Dekeyser, Thibault, Delforge, Quentin, Rahmani, Imen, Vivet, Bérengère, Paillot, Jonathan, Hierle, Lucie, Chaignat, Claire, Valette, Sarah, Her, Benoït, Brunet, Jennifier, Page, Mathieu, Boiste, Fabienne, Collin, Anthony, Bavozet, Florent, Garin, Aude, Dlala, Mohamed, Mhamdi, Kais, Beilouny, Bassem, Lavalard, Alexandra, Perez, Severine, Veber, Benoit, Guitard, Pierre-Gildas, Gouin, Philippe, Lamacz, Anna, Plouvier, Fabienne, Delaborde, Bertrand, Kherchache, Aïssa, Chaalal, Amina, Amouretti, Marc, Freita-Ramos, Santiago, Roux, Damien, Constantin, Jean-Michel, Assefi, Mona, Lecore, Marine, Selves, Agathe, Prevost, Florian, Lamer, Christian, Shi, Ruiying, Knani, Lyes, Floury, Sébastien Pili, Vettoretti, Lucie, Levy, Michael, Marsac, Lucile, Dauger, Stéphane, Guilmin-Crépon, Sophie, Winiszewski, Hadrien, Piton, Gael, Soumagne, Thibaud, Capellier, Gilles, Putegnat, Jean-Baptiste, Bayle, Frédérique, Perrou, Maya, Thao, Ghyslaine, Géri, Guillaume, Charron, Cyril, Repessé, Xavier, Vieillard-Baron, Antoine, Guilbart, Mathieu, Roger, Pierre-Alexandre, Hinard, Sébastien, Macq, Pierre-Yves, Chaulier, Kevin, Goutte, Sylvie, Chillet, Patrick, Pitta, Anaïs, Darjent, Barbara, Bruneau, Amandine, Lasocki, Sigismond, Leger, Maxime, Gergaud, Soizic, Lemarie, Pierre, Terzi, Nicolas, Schwebel, Carole, Dartevel, Anaïs, Galerneau, Louis-Marie, Diehl, Jean-Luc, Hauw-Berlemont, Caroline, Péron, Nicolas, Guérot, Emmanuel, Amoli, Abolfazl Mohebbi, Benhamou, Michel, Deyme, Jean-Pierre, Andremont, Olivier, Lena, Diane, Cady, Julien, Causeret, Arnaud, de la Chapelle, Arnaud, Cracco, Christophe, Rouleau, Stéphane, Schnell, David, Foucault, Camille, Lory, Cécile, Chapelle, Thibault, Bruckert, Vincent, Garcia, Julie, Sahraoui, Abdlazize, Abbosh, Nathalie, Bornstain, Caroline, Pernet, Pierre, Poirson, Florent, Pasem, Ahmed, Karoubi, Philippe, Poupinel, Virginie, Gauthier, Caroline, Bouniol, François, Feuchere, Philippe, Heron, Anne, Carreira, Serge, Emery, Malo, Le Floch, Anne Sophie, Giovannangeli, Luana, Herzog, Nicolas, Giacardi, Christophe, Baudic, Thibaut, Thill, Chloé, Tubach, Florence, Bonnet, Nicolas, Ebstein, Nathan, Gaudry, Stéphane, Cohen, Yves, Noublanche, Julie, Lesieur, Olivier, Sément, Arnaud, Roca-Cerezo, Isabel, Pascal, Michel, Sma, Nesrine, Colin, Gwenhaël, Lacherade, Jean-Claude, Bionz, Gauthier, Maquigneau, Natacha, Bouzat, Pierre, Durand, Michel, Hérault, Marie-Christine, Payen, Jean-Francois, Service de Réanimation Médicale et Toxicologique [Hôpital Lariboisière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S_1144 / U1144)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), COVID-ICU group, for the REVA network, COVID-ICU investigators, and Mégarbane, Bruno

Subjects
Critical Care and Intensive Care Medicine, Acute respiratory failure, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Risk Assessment, Mechanical ventilation, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Humans, Prospective Studies, Mortality, Outcome, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Noninvasive Ventilation, Acute respiratory distress syndrome, RC86-88.9, Research, COVID-19, Medical emergencies. Critical care. Intensive care. First aid, Hospitals, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.TOX] Life Sciences [q-bio]/Toxicology, Intensive Care Units, [SDV.TOX]Life Sciences [q-bio]/Toxicology, High-flow nasal cannula, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Intubation
Abstract

Rational To evaluate the respective impact of standard oxygen, high-flow nasal cannula (HFNC) and noninvasive ventilation (NIV) on oxygenation failure rate and mortality in COVID-19 patients admitted to intensive care units (ICUs). Methods Multicenter, prospective cohort study (COVID-ICU) in 137 hospitals in France, Belgium, and Switzerland. Demographic, clinical, respiratory support, oxygenation failure, and survival data were collected. Oxygenation failure was defined as either intubation or death in the ICU without intubation. Variables independently associated with oxygenation failure and Day-90 mortality were assessed using multivariate logistic regression. Results From February 25 to May 4, 2020, 4754 patients were admitted in ICU. Of these, 1491 patients were not intubated on the day of ICU admission and received standard oxygen therapy (51%), HFNC (38%), or NIV (11%) (P P P = 0.013) but not NIV (OR 1.57, 95% CI 0.78–3.21) was associated with a reduction in oxygenation failure). Overall 90-day mortality was 21%. By multivariable analysis, HFNC was not associated with a change in mortality (OR 0.90, 95% CI 0.61–1.33), while NIV was associated with increased mortality (OR 2.75, 95% CI 1.79–4.21, P Conclusion In patients with COVID-19, HFNC was associated with a reduction in oxygenation failure without improvement in 90-day mortality, whereas NIV was associated with a higher mortality in these patients. Randomized controlled trials are needed.

Published
2021

11. Herpesviruses in Critically Ill Patients With ARDS

Author

Hraiech, Sami, Azoulay, Elie, and Papazian, Laurent

Subjects
Intensive care unit (ICU), Herpesviruses, viruses, Immunocompetent patients, Article, Herpes simples virus (HSV), Critically ill patients, Mechanical ventilation (MV), Acute respiratory distress syndrome (ARDS), Cytomegalovirus (CMV), Immunoparalysis, Mortality, Viral reactivation, Epstein Barr virus (EBV)
Abstract

Reactivation of herpsviruses, mainly HSV, CMV and EBV, are frequent among critically ill patients. Although they are not immunocompromised from a classical point of view, these patients often present an alteration of their immune system favoring viral reactivation. Seropositive patients with sepsis and under mechanical ventilation are particularly at risk. Herpesviruses have a pulmonary tropism and can be responsible for non-resolving forms of acute respiratory distress syndrome with high mortality. However, the direct causality between herpesviruses reactivation and impaired outcomes among severely ill patients remains under debate.

Published
2021

12. Characteristics and Outcomes of Patients in the ICU With Respiratory Syncytial Virus Compared With Those With Influenza Infection: A Multicenter Matched Cohort Study.

Author

Coussement, Julien, Zuber, Benjamin, Garrigues, Eve, Gros, Antoine, Vandueren, Charlotte, Epaillard, Nicolas, Voiriot, Guillaume, Tandjaoui-Lambiotte, Yacine, Lascarrou, Jean-Baptiste, Boissier, Florence, Lemiale, Virginie, Contou, Damien, Hraiech, Sami, Meert, Anne-Pascale, Sauneuf, Bertrand, Munting, Aline, Ricome, Sylvie, Messika, Jonathan, Muller, Gregoire, and Njimi, Hassane

Subjects
INFLUENZA, RESPIRATORY syncytial virus, COHORT analysis, TREATMENT effectiveness, SYMPTOMS, HOSPITAL mortality, INFLUENZA complications, INFLUENZA diagnosis, INFLUENZA epidemiology, INTENSIVE care units, RESEARCH, RESEARCH methodology, RETROSPECTIVE studies, EVALUATION research, COMPARATIVE studies, HOSPITAL care, RESPIRATORY syncytial virus infections, LONGITUDINAL method, DISEASE complications
Abstract

Background: The characteristics and outcomes of adult patients with respiratory syncytial virus (RSV) infection who require ICU admission are poorly defined. Although several studies in adults with RSV infection have been published in recent years, they did not focus specifically on patients with critical illness.Research Question: What are the characteristics and outcomes of adult patients in the ICU with RSV infection and how do they compare with those of patients in the ICU with influenza infection?Study Design and Methods: This retrospective, multicenter study in France and Belgium (17 sites) compared the characteristics and outcomes of adult patients in the ICU with RSV infection vs those with influenza infection between November 2011 and April 2018. Each patient with RSV infection was matched by institution and date of diagnosis with a patient with influenza infection. In-hospital mortality was compared between the two groups, with adjustment for prognostic factors in a multivariate model (sex, age, main underlying conditions, and concurrent bloodstream infection).Results: Data from 618 patients (309 with RSV infection and 309 with influenza infection) were analyzed. Patients with RSV infection were significantly more likely to have an underlying chronic respiratory condition (60.2% vs 40.1%; P < .001) and to be immunocompromised (35% vs 26.2%; P = .02) than patients with influenza infection. Several differences in clinical signs and biological data at diagnosis were found between the groups. In-hospital mortality was not significantly different between the two groups (23.9% in the RSV group vs 25.6% in the influenza group; P = .63), even after adjustment for prognostic factors in a multivariate model.Interpretation: Adult patients in the ICU with RSV infection differ from adult patients in the ICU with influenza in terms of comorbidities and characteristics at diagnosis. RSV infection was associated with high in-hospital mortality, approaching 25%. In multivariate analysis, RSV infection was associated with a similar odds of in-hospital death compared with influenza infection. [ABSTRACT FROM AUTHOR]

Published
2022
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13. Prevalence, Intensity, and Clinical Impact of Dyspnea in Critically Ill Patients Receiving Invasive Ventilation.

Author

Demoule, Alexandre, Hajage, David, Messika, Jonathan, Jaber, Samir, Diallo, Hassimiou, Coutrot, Maxime, Kouatchet, Achille, Azoulay, Elie, Fartoukh, Muriel, Hraiech, Sami, Beuret, Pascal, Darmon, Michael, Decavèle, Maxens, Ricard, Jean-Damien, Chanques, Gerald, Mercat, Alain, Schmidt, Matthieu, Similowski, Thomas, and REVA Network (Research Network in Mechanical Ventilation)

Subjects
INTENSIVE care units, CLINICAL trials, CATASTROPHIC illness, ARTIFICIAL respiration, DYSPNEA, DISEASE prevalence, IMPACT of Event Scale, RESEARCH funding, RESPIRATION, LONGITUDINAL method
Abstract

Rationale: Dyspnea is a traumatic experience. Only limited information is available on dyspnea in intubated critically ill patients. Objectives: Our objectives were 1) to quantify the prevalence and severity of dyspnea; and 2) to evaluate the impact of dyspnea on ICU length of stay and post-traumatic stress disorder (PTSD) 90 days after ICU discharge. Methods: This was a prospective cohort study in 10 ICUs in France. In patients intubated for more than 24 hours, dyspnea was quantified with a visual analog scale (from 0 to 10) as soon as they were able to communicate, the following day, and before spontaneous breathing trials. PTSD was defined by an Impact of Event Scale-Revised score of at least 22. Measurements and Main Results: Among the 612 patients assessed, 34% reported dyspnea, with a median dyspnea rating of 5 (interquartile range, 4-7). ICU length of stay was not significantly different between patients with versus without dyspnea (6 [3-12] and 6 [3-13] days, respectively; P = 0.781). Mortality was not different between groups. Of the 153 patients interviewed on Day 90, a higher proportion of individuals with probable PTSD was observed among patients who were dyspneic on enrollment (29% vs. 13%; P = 0.017). The density of dyspnea (number of dyspneic episodes divided by time from enrollment to extubation) was independently associated with PTSD (odds ratio, 1.07; 95% confidence interval, 1.01-1.13; P = 0.031). Conclusions: Dyspnea was frequent and intense in intubated critically ill patients. ICU length of stay was not significantly different among patients reporting dyspnea, but PTSD was more frequent at Day 90. Clinical trial registered with www.clinicaltrials.gov (NCT02336464). [ABSTRACT FROM AUTHOR]

Published
2022
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14. Preemptive ganciclovir for mechanically ventilated patients with cytomegalovirus reactivation.

Author

Papazian, Laurent, Jaber, Samir, Hraiech, Sami, Baumstarck, Karine, Cayot-Constantin, Sophie, Aissaoui, Nadia, Jung, Boris, Leone, Marc, Souweine, Bertrand, Schwebel, Carole, Bourenne, Jérémy, Allardet-Servent, Jérôme, Kamel, Toufik, Lu, Qin, Zandotti, Christine, Loundou, Anderson, Penot-Ragon, Christine, Chastre, Jean, Forel, Jean-Marie, and Luyt, Charles-Edouard

Subjects
BLOOD cell count, GANCICLOVIR, CYTOMEGALOVIRUSES, ARTIFICIAL respiration
Abstract

Background: The effect of cytomegalovirus (CMV) reactivation on the length of mechanical ventilation and mortality in immunocompetent ICU patients requiring invasive mechanical ventilation remains controversial. The main objective of this study was to determine whether preemptive intravenous ganciclovir increases the number of ventilator-free days in patients with CMV blood reactivation. Methods: This double-blind, placebo-controlled, randomized clinical trial involved 19 ICUs in France. Seventy-six adults ≥ 18 years old who had been mechanically ventilated for at least 96 h, expected to remain on mechanical ventilation for ≥ 48 h, and exhibited reactivation of CMV in blood were enrolled between February 5th, 2014, and January 23rd, 2019. Participants were randomized to receive ganciclovir 5 mg/kg bid for 14 days (n = 39) or a matching placebo (n = 37). Results: The primary endpoint was ventilator-free days from randomization to day 60. Prespecified secondary outcomes included day 60 mortality. The trial was stopped for futility based on the results of an interim analysis by the DSMB. The subdistribution hazard ratio for being alive and weaned from mechanical ventilation at day 60 for patients receiving ganciclovir (N = 39) compared with control patients (N = 37) was 1.14 (95% CI from 0.63 to 2.06; P = 0.66). The median [IQR] numbers of ventilator-free days for ganciclovir-treated patients and controls were 10 [0–51] and 0 [0–43] days, respectively (P = 0.46). Mortality at day 60 was 41% in patients in the ganciclovir group and 43% in the placebo group (P =.845). Creatinine levels and blood cells counts did not differ significantly between the two groups. Conclusions: In patients mechanically ventilated for ≥ 96 h with CMV reactivation in blood, preemptive ganciclovir did not improve the outcome. [ABSTRACT FROM AUTHOR]

Published
2021
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15. Venovenous extracorporeal membrane oxygenation devices-related colonisations and infections.

Author

Thomas, Guillemette, Hraiech, Sami, Cassir, Nadim, Lehingue, Samuel, Rambaud, Romain, Wiramus, Sandrine, Guervilly, Christophe, Klasen, Fanny, Adda, Mélanie, Dizier, Stéphanie, Roch, Antoine, Papazian, Laurent, and Forel, Jean-Marie

Subjects
*NOSOCOMIAL infections, *EXTRACORPOREAL membrane oxygenation, *INFECTION, *COLONIZATION, *ARTIFICIAL respiration, *CRITICAL care medicine, *MORTALITY, *MEDICAL device removal
Abstract

Background: Nosocomial infections occurring during extracorporeal membrane oxygenation (ECMO) support have already been reported, but few studied infections directly related to ECMO devices. This study aims to evaluate the rate of both colonisations and infections related to ECMO devices at the time of ECMO removal. Results: We included all consecutive adult patients treated with venovenous ECMO (VV-ECMO) for at least 48 h during a 34-month study. At the time of ECMO removal, blood cultures, swab cultures on insertion cannula site and intravascular cannula extremity cultures were systematically performed. Each ECMO device was classified according to the infectious status into three groups: (1) uninfected/uncolonised ECMO device, (2) ECMO device colonisation and (3) ECMO device infection. Ninety-nine patients underwent 103 VV-ECMO, representing 1472 ECMO days. The ECMO device infection rate was 9.7% (10 events), including 7 ECMO device-related bloodstream infections (6.8%). The ECMO device colonisation rate was 32% (33 events). No difference was observed between the three groups, regarding days of mechanical ventilation, ICU length of stay, ICU mortality and in-hospital mortality. We observed a longer ECMO duration in the ECMO device colonisation group as compared to the uninfected/uncolonised ECMO device group [12 (9-20 days) vs. 5 days (5-16 days), respectively, p < 0.05]. Conclusions: At the time of ECMO removal, systematic blood culture and intravascular extremity cannula culture may help to diagnose ECMO device-related infection. We reported a quite low infection rate related to ECMO device. Further studies are needed to evaluate the benefits of systematic strategies of cannula culture at the time of ECMO removal. [ABSTRACT FROM AUTHOR]

Published
2017
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16. Early Hepatic Dysfunction Is Associated with a Worse Outcome in Patients Presenting with Acute Respiratory Distress Syndrome: A Post-Hoc Analysis of the ACURASYS and PROSEVA Studies.

Author

Dizier, Stéphanie, Forel, Jean-Marie, Ayzac, Louis, Richard, Jean-Christophe, Hraiech, Sami, Lehingue, Samuel, Loundou, Anderson, Roch, Antoine, Guerin, Claude, Papazian, Laurent, and null, null

Subjects
ADULT respiratory distress syndrome, LIVER diseases, HEALTH outcome assessment, BLOOD pH, BILIRUBIN, MORTALITY, PATIENTS
Abstract

Introduction: Bilirubin is well-recognized marker of hepatic dysfunction in intensive care unit (ICU) patients. Multiple organ failure often complicates acute respiratory distress syndrome (ARDS) evolution and is associated with high mortality. The effect of early hepatic dysfunction on ARDS mortality has been poorly investigated. We evaluated the incidence and the prognostic significance of increased serum bilirubin levels in the initial phase of ARDS. Methods: The data of 805 patients with ARDS were retrospectively analysed. This population was extracted from two recent multicenter, prospective and randomised trials. Patients presenting with ARDS with a ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen < 150 mmHg measured with a PEEP ≥ 5 cm of water were included. The total serum bilirubin was measured at inclusion and at days 2, 4, 7 and 14. The primary objective was to analyse the bilirubin at inclusion according to the 90-day mortality rate. Results: The 90-day mortality rate was 33.8% (n = 272). The non-survivors were older, had higher Sepsis-related Organ Failure Assessment (SOFA) score and were more likely to have a medical diagnosis on admission than the survivors. At inclusion, the SOFA score without the liver score (10.3±2.9 vs. 9.0±3.0, p<0.0001) and the serum bilirubin levels (36.1±57.0 vs. 20.5±31.5 μmol/L, p<0.0001) were significantly higher in the non-survivors than in the survivors. Age, the hepatic SOFA score, the coagulation SOFA score, the arterial pH level, and the plateau pressure were independently associated with 90-day mortality in patients with ARDS. Conclusion: Bilirubin used as a surrogate marker of hepatic dysfunction and measured early in the course of ARDS was associated with the 90-day mortality rate. [ABSTRACT FROM AUTHOR]

Published
2015
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17. Cytomegalovirus and Herpes Simplex Virus Effect on the Prognosis of Mechanically Ventilated Patients Suspected to Have Ventilator-Associated Pneumonia.

Author

Coisel, Yannael, Bousbia, Sabri, Forel, Jean-Marie, Hraiech, Sami, Lascola, Bernard, Roch, Antoine, Zandotti, Christine, Million, Matthieu, Jaber, Samir, Raoult, Didier, and Papazian, Laurent

Subjects
CYTOMEGALOVIRUSES, HERPES simplex virus, PNEUMONIA, MORTALITY, PROGNOSIS
Abstract

Objective: Cytomegalovirus (CMV) and herpes simplex virus (HSV) are common viruses that can affect critically ill patients who are not immunocompromised. The aim of this study was to determine whether the identification of CMV and/or HSV in mechanically ventilated critically ill patients suspected of having pneumonia was associated with an increased mortality. Design: Prospective epidemiological study. Setting: Medical intensive care unit of a tertiary medical center. Patients: Ninety-three patients with suspected pneumonia. Interventions: Patients with suspected pneumonia had bronchoalveolar lavage and blood samples taken to confirm the diagnosis. Antigenemia was used to detect CMV in the blood. Bronchoalveolar lavage samples were submitted to testing using quantitative real-time Polymerase Chain Reaction. Measurements and Main Results: We identified 22 patients with a CMV infection, 26 patients with an HSV infection and 45 patients without CMV or HSV infection (control group). Mortality at day 60 was higher in patients with a CMV infection than in patients from the control group (55% vs. 20%, P<0.01). Mortality at day 60 was not significantly increased in the group with HSV infection. Duration of ICU stay and ICU mortality were significantly higher in patients with CMV infections when compared to patients from the control group, whereas ventilator free days were significantly lower in patients with CMV infections when compared to patients from the control group. Conclusions: In critically ill patients, a CMV infection is associated with an increased mortality. Further interventional studies are needed to evaluate whether treatment could improve the prognosis. [ABSTRACT FROM AUTHOR]

Published
2012
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18. Spontaneous Breathing in Acute Respiratory Distress Syndrome: Friend and Foe?

Author

Papazian, Laurent and Hraiech, Sami

Subjects
*RESPIRATION, *PARALYSIS, *LUNG injuries, *VENTILATION
Abstract

The author reflects on the application of spontaneous breathing in mechanically ventilated patients. The difference in physiology of the rabbit, and the short period of observation used in the study which compared spontaneous breathing and muscle paralysis in lung injury in rabbit models are presented as limitations. Whether the type of molecule of neuromuscular blocking agents plays a role in the beneficial effects is cited to be unknown.

Published
2013
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19. Impact of Prone Position in COVID-19 Patients on Extracorporeal Membrane Oxygenation.

Author

Massart, Nicolas, Guervilly, Christophe, Mansour, Alexandre, Porto, Alizée, Flécher, Erwan, Esvan, Maxime, Fougerou, Claire, Fillâtre, Pierre, Duburcq, Thibault, Lebreton, Guillaume, Para, Marylou, Stephan, François, Hraiech, Sami, Ross, James T., Schmidt, Matthieu, Vincentelli, André, and Nesseler, Nicolas

Subjects
*SARS-CoV-2, *PATIENT positioning, *EXTRACORPOREAL membrane oxygenation, *REVERSE transcriptase polymerase chain reaction, *COVID-19
Abstract

OBJECTIVES: Prone positioning and venovenous extracorporeal membrane oxygenation (ECMO) are both useful interventions in acute respiratory distress syndrome (ARDS). Combining the two therapies is feasible and safe, but the effectiveness is not known. Our objective was to evaluate the potential survival benefit of prone positioning in venovenous ECMO patients cannulated for COVID-19–related ARDS. DESIGN: Retrospective analysis of a multicenter cohort. PATIENTS: Patients on venovenous ECMO who tested positive for severe acute respiratory syndrome coronavirus 2 by reverse transcriptase polymerase chain reaction or with a diagnosis on chest CT were eligible. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: All patients on venovenous ECMO for respiratory failure in whom prone position status while on ECMO and in-hospital mortality were known were included. Of 647 patients in 41 centers, 517 were included. Median age was 55 (47–61), 78% were male and 95% were proned before cannulation. After cannulation, 364 patients (70%) were proned and 153 (30%) remained in the supine position for the whole ECMO run. There were 194 (53%) and 92 (60%) deaths in the prone and the supine groups, respectively. Prone position on ECMO was independently associated with lower in-hospital mortality (odds ratio = 0.49 [0.29–0.84]; p = 0.010). In 153 propensity score-matched pairs, mortality rate was 49.7% in the prone position group versus 60.1% in the supine position group (p = 0.085). Considering only patients alive at decannulation, propensity-matched proned patients had a significantly lower mortality rate (22.4% vs 37.8%; p = 0.029) than nonproned patients. CONCLUSIONS: Prone position may be beneficial in patients supported by venovenous ECMO for COVID-19–related ARDS but more data are needed to draw definitive conclusions. [ABSTRACT FROM AUTHOR]

Published
2023
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20. Resolved versus confirmed ARDS after 24 h: insights from the LUNG SAFE study

Author

Madotto, F., Pham, T., Bellani, G., Bos, L. D., Simonis, F. D., Fan, E., Artigas, A., Brochard, L., Schultz, M. J., Laffey, J. G., Pesenti, A., Esteban, A., Gattinoni, L., van Haren, F., Larsson, A., McAuley, D. F., Ranieri, M., Rubenfeld, G., Thompson, B. T., Wrigge, H., Slutsky, A. S., Rios, F., Van Haren, F., Sottiaux, T., Depuydt, P., Lora, F. S., Azevedo, L. C., Bugedo, G., Qiu, H., Gonzalez, M., Silesky, J., Cerny, V., Nielsen, J., Jibaja, M., Matamis, D., Ranero, J. L., Amin, P., Hashemian, S. M., Clarkson, K., Kurahashi, K., Villagomez, A., Zeggwagh, A. A., Heunks, L. M., Laake, J. H., Palo, J. E., do Vale Fernandes, A., Sandesc, D., Arabi, Y., Bumbasierevic, V., Nin, N., Lorente, J. A., Piquilloud, L., Abroug, F., McNamee, L., Hurtado, J., Bajwa, E., Démpaire, G., Sula, H., Nunci, L., Cani, A., Zazu, A., Dellera, C., Alejandro, R. V., Daldin, J., Vinzio, M., Fernandez, R. O., Cardonnet, L. P., Bettini, L. R., Bisso, M. C., Osman, E. M., Setten, M. G., Lovazzano, P., Alvarez, J., Villar, V., Pozo, N. C., Grubissich, N., Plotnikow, G. A., Vasquez, D. N., Ilutovich, S., Tiribelli, N., Chena, A., Pellegrini, C. A., Saenz, M. G., Estenssoro, E., Brizuela, M., Gianinetto, H., Gomez, P. E., Cerrato, V. I., Bezzi, M. G., Borello, S. A., Loiacono, F. A., Fernandez, A. M., Knowles, S., Reynolds, C., Inskip, D. M., Miller, J. J., Kong, J., Whitehead, C., Bihari, S., Seven, A., Krstevski, A., Rodgers, H. J., Millar, R. T., Mckenna, T. E., Bailey, I. M., Hanlon, G. C., Aneman, A., Lynch, J. M., Azad, R., Neal, J., Woods, P. W., Roberts, B. L., Kol, M. R., Wong, H. S., Riss, K. C., Staudinger, T., Wittebole, X., Berghe, C., Bulpa, P. A., Dive, A. M., Verstraete, R., Lebbinck, H., Vermassen, J., Meersseman, P., Ceunen, H., Rosa, J. I., Beraldo, D. O., Piras, C., Rampinelli, A. M., Nassar A. P., Jr., Mataloun, S., Moock, M., Thompson, M. M., Gonçalves, C. H., Antônio, A. C. P., Ascoli, A., Biondi, R. S., Fontenele, D. 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W.H., Hang, A.Y., Hua, M.X., Li, Y., Xu, Y., Di, Y.D., Ling, L.L., Qin, T.H., Wang, S.H., Qin, J., Han, Y., Zhou, S., Vargas, M.P., Jimenez, J.I.S., Rojas, M.A.G., Solis-Quesada, J.E., Ramirez-Alfaro, C.M., Máca, J., Sklienka, P., Gjedsted, J., Christiansen, A., Villamagua, B.G., Llano, M., Burtin, P., Buzancais, G., Beuret, P., Pelletier, N., Mortaza, S., Mercat, A., Chelly, J., Jochmans, S., Terzi, N., Daubin, C., Carteaux, G., de Prost, N., Chiche, J.-D., Daviaud, F., Fartoukh, M., Barberet, G., Biehler, J., Dellamonica, J., Doyen, D., Arnal, J.-M., Briquet, A., Hraiech, S., Papazian, L., Roux, D., Messika, J., Kalaitzis, E., Dangers, L., Combes, A., Au, S.-M., Béduneau, G., Carpentier, D., Zogheib, E.H., Dupont, H., Ricome, S., Santoli, F.L., Besset, S.L., Michel, P., Gelée, B., Danin, P.-E., Goubaux, B., Crova, P.J., Phan, N.T., Berkelmans, F., Badie, J.C., Tapponnier, R., Gally, J., Khebbeb, S., Herbrecht, J.-E., Schneider, F., Declercq, P.-L.M., Rigaud, J.-P., Duranteau, J., Harrois, A., Chabanne, R., Marin, J., Bigot, C., Thibault, S., Ghazi, M., Boukhazna, M., Zein, S.O., Richecoeur, J.R., Combaux, D.M., Grelon, F., Le Moal, C., Sauvadet, E.P., Robine, A., Lemiale, V., Reuter, D., Dres, M., Demoule, A., Goldgran-Toledano, D., Baboi, L., Guérin, C., Lohner, R., Kraßler, J., Schäfer, S., Zacharowski, K.D., Meybohm, P., Reske, A.W., Simon, P., Hopf, H.-B.F., Schuetz, M., Baltus, T., Papanikolaou, M.N., Papavasilopoulou, T.G., Zacharas, G.A., Ourailogloy, V., Mouloudi, E.K., Massa, E.V., Nagy, E.O., Stamou, E.E., Kiourtzieva, E.V., Oikonomou, M.A., Avila, L.E., Cortez, C.A., Citalán, J.E., Jog, S.A., Sable, S.D., Shah, B., Gurjar, M., Baronia, A.K., Memon, M., Muthuchellappan, R., Ramesh, V.J., Shenoy, A., Unnikrishnan, R., Dixit, S.B., Rhayakar, R.V., Ramakrishnan, N., Bhardwaj, V.K., Mahto, H.L., Sagar, S.V., Palaniswamy, V., Ganesan, D., Jamaati, H., Heidari, F., Meaney, E.A., Nichol, A., Knapman, K.M., O’Croinin, D., Dunne, E.S., Breen, D.M., Clarkson, K.P., Jaafar, R.F., Dwyer, R., Amir, F., Ajetunmobi, O.O., O’Muircheartaigh, A.C., Black, C.S., Treanor, N., Collins, D.V., Altaf, W., Zani, G., Fusari, M., Spadaro, S., Volta, C.A., Graziani, R., Brunettini, B., Palmese, S., Formenti, P., Umbrello, M., Lombardo, A., Pecci, E., Botteri, M., Savioli, M., Protti, A., Mattei, A., Schiavoni, L., Tinnirello, A., Todeschini, M., Giarratano, A., Cortegiani, A., Sher, S., Rossi, A., Antonelli, M.M., Montini, L.M., Casalena, P., Scafetti, S., Panarello, G., Occhipinti, G., Patroniti, N., Pozzi, M., Biscione, R.R., Poli, M.M., Raimondi, F., Albiero, D., Crapelli, G., Beck, E., Pota, V., Schiavone, V., Molin, A., Tarantino, F., Monti, G., Frati, E., Mirabella, L., Cinnella, G., Fossali, T., Colombo, R., Pattarino, P.T.I., Mojoli, F., Braschi, A., Borotto, E.E., Cracchiolo, A.N., Palma, D.M., Raponi, F., Foti, G., Vascotto, E.R., Coppadoro, A., Brazzi, L., Floris, L., Iotti, G.A., Venti, A., Yamaguchi, O., Takagi, S., Maeyama, H.N., Watanabe, E., Yamaji, Y., Shimizu, K., Shiozaki, K., Futami, S., Ryosuke, S., Saito, K., Kameyama, Y., Ueno, K., Izawa, M., Okuda, N., Suzuki, H., Harasawa, T., Nasu, M., Takada, T., Ito, F., Nunomiya, S., Koyama, K., Abe, T., Andoh, K., Kusumoto, K., Hirata, A., Takaba, A., Kimura, H., Matsumoto, S., Higashijima, U., Honda, H., Aoki, N., Imai, H., Ogino, Y., Mizuguchi, I., Ichikado, K., Nitta, K., Mochizuki, K., Hashida, T., Tanaka, H., Nakamura, T., Niimi, D., Ueda, T., Kashiwa, Y., Uchiyama, A., Sabelnikovs, O., Oss, P., Haddad, Y., Liew, K.Y., Ñamendys-Silva, S.A., Jarquin-Badiola, Y.D., Sanchez-Hurtado, L.A., Gomez-Flores, S.S., Marin, M.C., Villagomez, A.J., Lemus, J.S., Fierro, J.M., Cervantes, M.R., Mejia, F.J.F., Dector, D., Dector, D.M., Gonzalez, D.R., Estrella, C.R., Sanchez-Medina, J.R., Ramirez-Gutierrez, A., George, F.G., Aguirre, J.S., Buensuseso, J.A., Poblano, M., Dendane, T., Balkhi, H., Elkhayari, M., Samkaoui, N., Ezzouine, H., Benslama, A., Amor, M., Maazouzi, W., Cimic, N., Beck, O., Bruns, M.M., Schouten, J.A., Rinia, M., Raaijmakers, M., Van Wezel, H.M., Heines, S.J., Strauch, U., Buise, M.P., Goodson, J.C., Browne, T.S., Navarra, L., Hunt, A., Hutchison, R.A., Bailey, M.B., Newby, L., Mcarthur, C., Kalkoff, M., Mcleod, A., Casement, J., Hacking, D.J., Andersen, F.H., Dolva, M.S., Barratt-Due, A., Noremark, K.A.L., Søreide, E., Sjøbø, B.Å., Guttormsen, A.B., Yoshido, H.H.L., Aguilar, R.Z., Oscanoa, F.A.M., Alisasis, A.U., Robles, J.B., Pasanting-Lim, R.A.B., Tan, B.C., Andruszkiewicz, P., Jakubowska, K., Coxo, C.M., Alvarez, A.M., Oliveira, B.S., Montanha, G.M., Barros, N.C., Pereira, C.S., Messias, A.M., Monteiro, J.M., Araujo, A.M., Catorze, N.T., Marum, S.M., Bouw, M.J., Gomes, R.M., Brito, V.A., Castro, S., Estilita, J.M., Barros, F.M., Serra, I.M., Martinho, A.M., Tomescu, D.R., Marcu, A., Bedreag, O.H., Papurica, M., Corneci, D.E., Negoita, S.L., Grigoriev, E., Gritsan, A.I., Gazenkampf, A.A., Almekhlafi, G., Albarrak, M.M., Mustafa, G.M., Maghrabi, K.A., Salahuddin, N., Aisa, T.M., Jabbary, A.S.A., Tabhan, E., Arabi, Y.M., Trinidad, O.A., Dorzi, H.M.A., Tabhan, E.E., Bolon, S., Smith, O., Mancebo, J., Aguirre-Bermeo, H., Lopez-Delgado, J.C., Esteve, F., Rialp, G., Forteza, C., De Haro, C., Albaiceta, G.M., De Cima-Iglesias, S., Seoane-Quiroga, L., Ceniceros-Barros, A., Ruiz-Aguilar, A.L., Claraco-Vega, L.M., Soler, J.A., del Carmen Lorente, M., Hermosa, C., Gordo, F., Prieto-González, M., López-Messa, J.B., Perez, M.P., Perez, C.P., Allue, R.M., Roche-Campo, F., Ibañez-Santacruz, M., Temprano, S., Pintado, M.C., De Pablo, R., Gómez, P.R.A., Ruiz, S.R., Moles, S.I., Jurado, M.ªT., Arizmendi, A., Piacentini, E.A., Franco, N., Honrubia, T., Cheng, M.P., Losada, E.P., Blanco, J., Yuste, L.J., Carbayo-Gorriz, C., Cazorla-Barranquero, F.G., Alonso, J.G., Alda, R.S., Algaba, Á., Navarro, G., Cereijo, E., Diaz-Rodriguez, E., Marcos, D.P., Montero, L.A., Para, L.H., Sanchez, R.J., Navalpotro, M.A.B., Abad, R.D., González, R.M., Toribio, D.P., Castro, A.G., Artiga, M.J.D., Penuelas, O., Roser, T.P., Olga, M.F., Curto, E.G., Sánchez, R.M., Imma, V.P., Elisabet, G.M., Claverias, L., Magret, M., Pellicer, A.M., Rodriguez, L.L., Sánchez-Ballesteros, J., González-Salamanca, Á., Jimenez, A.G., Huerta, F.P., Diaz, J.C.J.S., Lopez, E.B., Moya, D.D.L., Alfonso, A.A.T., Luis, P.S.E., Cesar, P.S., Rafael, S.I., Virgilio, C.G., Recio, N.N., Adamsson, R.O., Rylander, C.C., Holzgraefe, B., Broman, L.M., Wessbergh, J., Persson, L., Schiöler, F., Kedelv, H., Tibblin, A.O., Appelberg, H., Hedlund, L., Helleberg, J., Eriksson, K.E., Glietsch, R., Larsson, N., Nygren, I., Nunes, S.L., Morin, A.-K., Kander, T., Adolfsson, A., Zender, H.O., Leemann-Refondini, C., Elatrous, S., Bouchoucha, S., Chouchene, I., Ouanes, I., Souissi, A.B., Kamoun, S., Demirkiran, O., Aker, M., Erbabacan, E., Ceylan, I., Girgin, N.K., Ozcelik, M., Ünal, N., Meco, B.C., Akyol, O.O., Derman, S.S., Kennedy, B., Parhar, K., Srinivasa, L., McAuley, D., Hopkins, P., Mellis, C., Kakar, V., Hadfield, D., Vercueil, A., Bhowmick, K., Humphreys, S.K., Ferguson, A., Mckee, R., Raj, A.S., Fawkes, D.A., Watt, P., Twohey, L., Thomas, R.R.J.M., Morton, A., Kadaba, V., Smith, M.J., Hormis, A.P., Kannan, S.G., Namih, M., Reschreiter, H., Camsooksai, J., Kumar, A., Rugonfalvi, S., Nutt, C., O’Neill, O., Seasman, C., Dempsey, G., Scott, C.J., Ellis, H.E., McKechnie, S., Hutton, P.J., Di Tomasso, N.N., Vitale, M.N., Griffin, R.O., Dean, M.N., Cranshaw, J.H., Willett, E.L., Ioannou, N., Gillis, S., Csabi, P., Macfadyen, R., Dawson, H., Preez, P.D., Williams, A.J., Boyd, O., De Gordoa, L.O.-R., Bramall, J., Symmonds, S., Chau, S.K., Wenham, T., Szakmany, T., Toth-Tarsoly, P., McCalman, K.H., Alexander, P., Stephenson, L., Collyer, T., Chapman, R., Cooper, R., Allan, R.M., Sim, M., Wrathall, D.W., Irvine, D.A., Zantua, K.S., Adams, J.C., Burtenshaw, A.J., Sellors, G.P., Welters, I.D., Williams, K.E., Hessell, R.J., Oldroyd, M.G., Battle, C.E., Pillai, S., Kajtor, I., Sivashanmugavel, M., O’Kane, S.C., Donnelly, A., Frigyik, A.D., Careless, J.P., May, M.M., Stewart, R., Trinder, T.J., Hagan, S.J., Wise, M.P., Cole, J.M., MacFie, C.C., Dowling, A.T., Nuñez, E., Pittini, G., Rodriguez, R., Imperio, M.C., Santos, C., França, A.G., Ebeid, A., Deicas, A., Serra, C., Uppalapati, A., Kamel, G., Banner-Goodspeed, V.M., Beitler, J.R., Mukkera, S.R., Kulkarni, S., Lee, J., Mesar, T., Shinn, J.O., Gomaa, D., Tainter, C., Yeatts, D.J., Warren, J., Lanspa, M.J., Miller, R.R., Grissom, C.K., Brown, S.M., Bauer, P.R., Gosselin, R.J., Kitch, B.T., Cohen, J.E., Beegle, S.H., Gueret, R.M., Tulaimat, A., Choudry, S., Stigler, W., Batra, H., Huff, N.G., Lamb, K.D., Oetting, T.W., Mohr, N.M., Judy, C., Saito, S., Kheir, F.M., Kheir, F., Schlichting, A.B., Delsing, A., Crouch, D.R., Elmasri, M., Ismail, D., Dreyer, K.R., Blakeman, T.C., Baron, R.M., Grijalba, C.Q., Hou, P.C., Seethala, R., Aisiku, I., Henderson, G., Frendl, G., Hou, S.-K., Owens, R.L., Schomer, A., Bumbasirevic, V., Jovanovic, B., Surbatovic, M., Veljovic, M., LUNG SAFE Investigators and the ESICM Trials Group, Madotto, F, Pham, T, Bellani, G, Bos, L, Simonis, F, Fan, E, Artigas, A, Brochard, L, Schultz, M, Laffey, J, Pesenti, A, Esteban, A, Gattinoni, L, van Haren, F, Larsson, A, Mcauley, D, Ranieri, M, Rubenfeld, G, Thompson, B, Wrigge, H, Slutsky, A, Rios, F, Sottiaux, T, Depuydt, P, Lora, F, Azevedo, L, Bugedo, G, Qiu, H, Gonzalez, M, Silesky, J, Cerny, V, Nielsen, J, Jibaja, M, Matamis, D, Ranero, J, Amin, P, Hashemian, S, Clarkson, K, Kurahashi, K, Villagomez, A, Zeggwagh, A, Heunks, L, Laake, J, Palo, J, Do Vale Fernandes, A, Sandesc, D, Arabi, Y, Bumbasierevic, V, Nin, N, Lorente, J, Piquilloud, L, Abroug, F, Mcnamee, L, Hurtado, J, Bajwa, E, Démpaire, G, Sula, H, Nunci, L, Cani, A, Zazu, A, Dellera, C, Alejandro, R, Daldin, J, Vinzio, M, Fernandez, R, Cardonnet, L, Bettini, L, Bisso, M, Osman, E, Setten, M, Lovazzano, P, Alvarez, J, Villar, V, Pozo, N, Grubissich, N, Plotnikow, G, Vasquez, D, Ilutovich, S, Tiribelli, N, Chena, A, Pellegrini, C, Saenz, M, Estenssoro, E, Brizuela, M, Gianinetto, H, Gomez, P, Cerrato, V, Bezzi, M, Borello, S, Loiacono, F, Fernandez, A, Knowles, S, Reynolds, C, Inskip, D, Miller, J, Kong, J, Whitehead, C, Bihari, S, Seven, A, Krstevski, A, Rodgers, H, Millar, R, Mckenna, T, Bailey, I, Hanlon, G, Aneman, A, Lynch, J, Azad, R, Neal, J, Woods, P, Roberts, B, Kol, M, Wong, H, Riss, K, Staudinger, T, Wittebole, X, Berghe, C, Bulpa, P, Dive, A, Verstraete, R, Lebbinck, H, Vermassen, J, Meersseman, P, Ceunen, H, Rosa, J, Beraldo, D, Piras, C, Rampinelli, A, Nassar, A, Mataloun, S, Moock, M, Thompson, M, Gonçalves, C, Antônio, A, Ascoli, A, Biondi, R, Fontenele, D, Nobrega, D, Sales, V, Shindhe, S, Ismail, D, Beloncle, F, Davies, K, Cirone, R, Manoharan, V, Ismail, M, Goligher, E, Jassal, M, Nishikawa, E, Javeed, A, Curley, G, Rittayamai, N, Parotto, M, Ferguson, N, Mehta, S, Knoll, J, Pronovost, A, Canestrini, S, Bruhn, A, Garcia, P, Aliaga, F, Farías, P, Yumha, J, Ortiz, C, Salas, J, Saez, A, Vega, L, Labarca, E, Martinez, F, Carreño, N, Lora, P, Liu, H, Liu, L, Tang, R, Luo, X, An, Y, Zhao, H, Gao, Y, Zhai, Z, Ye, Z, Wang, W, Li, W, Li, Q, Zheng, R, Yu, W, Shen, J, Li, X, Yu, T, Lu, W, Wu, Y, Huang, X, He, Z, Lu, Y, Han, H, Zhang, F, Sun, R, Wang, H, Qin, S, Zhu, B, Zhao, J, Liu, J, Li, B, Zhou, F, Zhang, X, Li-Xin, Z, Xin-Hua, Q, Jiang, L, Zhao, X, Li, Y, Wang, C, Yao, Q, Yu, R, Chen, K, Shao, H, Qin, B, Huang, Q, Zhu, W, Hang, A, Hua, M, Xu, Y, Di, Y, Ling, L, Qin, T, Wang, S, Qin, J, Han, Y, Zhou, S, Vargas, M, Jimenez, J, Rojas, M, Solis-Quesada, J, Ramirez-Alfaro, C, Máca, J, Sklienka, P, Gjedsted, J, Christiansen, A, Villamagua, B, Llano, M, Burtin, P, Buzancais, G, Beuret, P, Pelletier, N, Mortaza, S, Mercat, A, Chelly, J, Jochmans, S, Terzi, N, Daubin, C, Carteaux, G, de Prost, N, Chiche, J, Daviaud, F, Fartoukh, M, Barberet, G, Biehler, J, Dellamonica, J, Doyen, D, Arnal, J, Briquet, A, Hraiech, S, Papazian, L, Roux, D, Messika, J, Kalaitzis, E, Dangers, L, Combes, A, Au, S, Béduneau, G, Carpentier, D, Zogheib, E, Dupont, H, Ricome, S, Santoli, F, Besset, S, Michel, P, Gelée, B, Danin, P, Goubaux, B, Crova, P, Phan, N, Berkelmans, F, Badie, J, Tapponnier, R, Gally, J, Khebbeb, S, Herbrecht, J, Schneider, F, Declercq, P, Rigaud, J, Duranteau, J, Harrois, A, Chabanne, R, Marin, J, Bigot, C, Thibault, S, Ghazi, M, Boukhazna, M, Zein, S, Richecoeur, J, Combaux, D, Grelon, F, Le Moal, C, Sauvadet, E, Robine, A, Lemiale, V, Reuter, D, Dres, M, Demoule, A, Goldgran-Toledano, D, Baboi, L, Guérin, C, Lohner, R, Kraßler, J, Schäfer, S, Zacharowski, K, Meybohm, P, Reske, A, Simon, P, Hopf, H, Schuetz, M, Baltus, T, Papanikolaou, M, Papavasilopoulou, T, Zacharas, G, Ourailogloy, V, Mouloudi, E, Massa, E, Nagy, E, Stamou, E, Kiourtzieva, E, Oikonomou, M, Avila, L, Cortez, C, Citalán, J, Jog, S, Sable, S, Shah, B, Gurjar, M, Baronia, A, Memon, M, Muthuchellappan, R, Ramesh, V, Shenoy, A, Unnikrishnan, R, Dixit, S, Rhayakar, R, Ramakrishnan, N, Bhardwaj, V, Mahto, H, Sagar, S, Palaniswamy, V, Ganesan, D, Jamaati, H, Heidari, F, Meaney, E, Nichol, A, Knapman, K, O’Croinin, D, Dunne, E, Breen, D, Jaafar, R, Dwyer, R, Amir, F, Ajetunmobi, O, O’Muircheartaigh, A, Black, C, Treanor, N, Collins, D, Altaf, W, Zani, G, Fusari, M, Spadaro, S, Volta, C, Graziani, R, Brunettini, B, Palmese, S, Formenti, P, Umbrello, M, Lombardo, A, Pecci, E, Botteri, M, Savioli, M, Protti, A, Mattei, A, Schiavoni, L, Tinnirello, A, Todeschini, M, Giarratano, A, Cortegiani, A, Sher, S, Rossi, A, Antonelli, M, Montini, L, Casalena, P, Scafetti, S, Panarello, G, Occhipinti, G, Patroniti, N, Pozzi, M, Biscione, R, Poli, M, Raimondi, F, Albiero, D, Crapelli, G, Beck, E, Pota, V, Schiavone, V, Molin, A, Tarantino, F, Monti, G, Frati, E, Mirabella, L, Cinnella, G, Fossali, T, Colombo, R, Pattarino, P, Mojoli, F, Braschi, A, Borotto, E, Cracchiolo, A, Palma, D, Raponi, F, Foti, G, Vascotto, E, Coppadoro, A, Brazzi, L, Floris, L, Iotti, G, Venti, A, Yamaguchi, O, Takagi, S, Maeyama, H, Watanabe, E, Yamaji, Y, Shimizu, K, Shiozaki, K, Futami, S, Ryosuke, S, Saito, K, Kameyama, Y, Ueno, K, Izawa, M, Okuda, N, Suzuki, H, Harasawa, T, Nasu, M, Takada, T, Ito, F, Nunomiya, S, Koyama, K, Abe, T, Andoh, K, Kusumoto, K, Hirata, A, Takaba, A, Kimura, H, Matsumoto, S, Higashijima, U, Honda, H, Aoki, N, Imai, H, Ogino, Y, Mizuguchi, I, Ichikado, K, Nitta, K, Mochizuki, K, Hashida, T, Tanaka, H, Nakamura, T, Niimi, D, Ueda, T, Kashiwa, Y, Uchiyama, A, Sabelnikovs, O, Oss, P, Haddad, Y, Liew, K, Ñamendys-Silva, S, Jarquin-Badiola, Y, Sanchez-Hurtado, L, Gomez-Flores, S, Marin, M, Lemus, J, Fierro, J, Cervantes, M, Mejia, F, Dector, D, Gonzalez, D, Estrella, C, Sanchez-Medina, J, Ramirez-Gutierrez, A, George, F, Aguirre, J, Buensuseso, J, Poblano, M, Dendane, T, Balkhi, H, Elkhayari, M, Samkaoui, N, Ezzouine, H, Benslama, A, Amor, M, Maazouzi, W, Cimic, N, Beck, O, Bruns, M, Schouten, J, Rinia, M, Raaijmakers, M, van Wezel, H, Heines, S, Strauch, U, Buise, M, Goodson, J, Browne, T, Navarra, L, Hunt, A, Hutchison, R, Bailey, M, Newby, L, Mcarthur, C, Kalkoff, M, Mcleod, A, Casement, J, Hacking, D, Andersen, F, Dolva, M, Barratt-Due, A, Noremark, K, Søreide, E, Sjøbø, B, Guttormsen, A, Yoshido, H, Aguilar, R, Oscanoa, F, Alisasis, A, Robles, J, Pasanting-Lim, R, Tan, B, Andruszkiewicz, P, Jakubowska, K, Coxo, C, Alvarez, A, Oliveira, B, Montanha, G, Barros, N, Pereira, C, Messias, A, Monteiro, J, Araujo, A, Catorze, N, Marum, S, Bouw, M, Gomes, R, Brito, V, Castro, S, Estilita, J, Barros, F, Serra, I, Martinho, A, Tomescu, D, Marcu, A, Bedreag, O, Papurica, M, Corneci, D, Negoita, S, Grigoriev, E, Gritsan, A, Gazenkampf, A, Almekhlafi, G, Albarrak, M, Mustafa, G, Maghrabi, K, Salahuddin, N, Aisa, T, Jabbary, A, Tabhan, E, Trinidad, O, Dorzi, H, Bolon, S, Smith, O, Mancebo, J, Aguirre-Bermeo, H, Lopez-Delgado, J, Esteve, F, Rialp, G, Forteza, C, de Haro, C, Albaiceta, G, de Cima-Iglesias, S, Seoane-Quiroga, L, Ceniceros-Barros, A, Ruiz-Aguilar, A, Claraco-Vega, L, Soler, J, Del Carmen Lorente, M, Hermosa, C, Gordo, F, Prieto-González, M, López-Messa, J, Perez, M, Perez, C, Allue, R, Roche-Campo, F, Ibañez-Santacruz, M, Temprano, S, Pintado, M, de Pablo, R, Gómez, P, Ruiz, S, Moles, S, Jurado, M, Arizmendi, A, Piacentini, E, Franco, N, Honrubia, T, Cheng, M, Losada, E, Blanco, J, Yuste, L, Carbayo-Gorriz, C, Cazorla-Barranquero, F, Alonso, J, Alda, R, Algaba, Á, Navarro, G, Cereijo, E, Diaz-Rodriguez, E, Marcos, D, Montero, L, Para, L, Sanchez, R, Navalpotro, M, Abad, R, González, R, Toribio, D, Castro, A, Artiga, M, Penuelas, O, Roser, T, Olga, M, Curto, E, Sánchez, R, Imma, V, Elisabet, G, Claverias, L, Magret, M, Pellicer, A, Rodriguez, L, Sánchez-Ballesteros, J, González-Salamanca, Á, Jimenez, A, Huerta, F, Diaz, J, Lopez, E, Moya, D, Alfonso, A, Luis, P, Cesar, P, Rafael, S, Virgilio, C, Recio, N, Adamsson, R, Rylander, C, Holzgraefe, 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Khebbeb, Samy, Herbrecht, Jean-Etienne, Schneider, Franci, Declercq, Pierre-Louis M., Rigaud, Jean-Philippe, Duranteau, Jacque, Harrois, Anatole, Chabanne, Russell, Marin, Julien, Bigot, Charlene, Thibault, Sandrine, Ghazi, Mohammed, Boukhazna, Messabi, Zein, Salem Ould, Richecoeur, Jack R., Combaux, Daniele M., Grelon, Fabien, Le Moal, Charlene, Sauvadet, Elise P., Robine, Adrien, Lemiale, Virginie, Reuter, Danielle, Dres, Martin, Demoule, Alexandre, Goldgran-Toledano, Dany, Baboi, Loredana, Guérin, Claude, Lohner, Ralph, Kraßler, Jen, Schäfer, Susanne, Zacharowski, Kai D., Meybohm, Patrick, Reske, Andreas W., Simon, Philipp, Hopf, Hans-Bernd F., Schuetz, Michael, Baltus, Thoma, Papanikolaou, Metaxia N., Papavasilopoulou, Theonymfi G., Zacharas, Giannis A., Ourailogloy, Vasili, Mouloudi, Eleni K., Massa, Eleni V., Nagy, Eva O., Stamou, Electra E., Kiourtzieva, Ellada V., Oikonomou, Marina A., Avila, Luis E., Cortez, Cesar A., Citalán, Johanna E., Jog, Sameer A., Sable, Safal D., Shah, Bhagyesh, Gurjar, Mohan, Baronia, Arvind K., Memon, Mohammedfaruk, Muthuchellappan, Radhakrishnan, Ramesh, Venkatapura J., Shenoy, Anitha, Unnikrishnan, Ramesh, Dixit, Subhal B., Rhayakar, Rachana V., Ramakrishnan, Nagarajan, Bhardwaj, Vallish K., Mahto, Heera L., Sagar, Sudha V., Palaniswamy, Vijayanand, Ganesan, Deeban, Hashemian, Seyed Mohammadreza, Jamaati, Hamidreza, Heidari, Farshad, Meaney, Edel A., Nichol, Alistair, Knapman, Karl M., O’Croinin, Donall, Dunne, Eimhin S., Breen, Dorothy M., Clarkson, Kevin P., Jaafar, Rola F., Dwyer, Rory, Amir, Fahd, Ajetunmobi, Olaitan O., O’Muircheartaigh, Aogan C., Black, Colin S., Treanor, Nuala, Collins, Daniel V., Altaf, Wahid, Zani, Gianluca, Fusari, Maurizio, Spadaro, Savino, Volta, Carlo A., Graziani, Romano, Brunettini, Barbara, Palmese, Salvatore, Formenti, Paolo, Umbrello, Michele, Lombardo, Andrea, Pecci, Elisabetta, Botteri, Marco, Savioli, Monica, Protti, Alessandro, Mattei, Alessia, Schiavoni, Lorenzo, Tinnirello, Andrea, Todeschini, Manuel, Giarratano, Antonino, Cortegiani, Andrea, Sher, Sara, Rossi, Anna, Antonelli, Massimo M., Montini, Luca M., Casalena, Paolo, Scafetti, Sergio, Panarello, Giovanna, Occhipinti, Giovanna, Patroniti, Nicolò, Pozzi, Matteo, Biscione, Roberto R., Poli, Michela M., Raimondi, Ferdinando, Albiero, Daniela, Crapelli, Giulia, Beck, Eduardo, Pota, Vincenzo, Schiavone, Vincenzo, Molin, Alexandre, Tarantino, Fabio, Monti, Giacomo, Frati, Elena, Mirabella, Lucia, Cinnella, Gilda, Fossali, Tommaso, Colombo, Riccardo, Pattarino, Pierpaolo Terragni Ilaria, Mojoli, Francesco, Braschi, Antonio, Borotto, Erika E., Cracchiolo, Andrea N., Palma, Daniela M., Raponi, Francesco, Foti, Giuseppe, Vascotto, Ettore R., Coppadoro, Andrea, Brazzi, Luca, Floris, Leda, Iotti, Giorgio A., Venti, Aaron, Yamaguchi, Osamu, Takagi, Shunsuke, Maeyama, Hiroki N., Watanabe, Eizo, Yamaji, Yoshihiro, Shimizu, Kazuyoshi, Shiozaki, Kyoko, Futami, Satoru, Ryosuke, Sekine, Saito, Koji, Kameyama, Yoshinobu, Ueno, Keiko, Izawa, Masayo, Okuda, Nao, Suzuki, Hiroyuki, Harasawa, Tomofumi, Nasu, Michitaka, Takada, Tadaaki, Ito, Fumihito, Nunomiya, Shin, Koyama, Kansuke, Abe, Toshikazu, Andoh, Kohkichi, Kusumoto, Kohei, Hirata, Akira, Takaba, Akihiro, Kimura, Hiroyasu, Matsumoto, Shuhei, Higashijima, Ushio, Honda, Hiroyuki, Aoki, Nobumasa, Imai, Hiroshi, Ogino, Yasuaki, Mizuguchi, Ichiko, Ichikado, Kazuya, Nitta, Kenichi, Mochizuki, Katsunori, Hashida, Tomoaki, Tanaka, Hiroyuki, Nakamura, Tomoyuki, Niimi, Daisuke, Ueda, Takeshi, Kashiwa, Yozo, Uchiyama, Akinori, Sabelnikovs, Oleg, Oss, Peteri, Haddad, Youssef, Liew, Kong Y., Ñamendys-Silva, Silvio A., Jarquin-Badiola, Yves D., Sanchez-Hurtado, Luis A., Gomez-Flores, Saira S., Marin, Maria C., Villagomez, Asisclo J., Lemus, Jordana S., Fierro, Jonathan M., Cervantes, Mavy Ramirez, Mejia, Francisco Javier Flore, Dector, Dulce, Dector, Dulce M., Gonzalez, Daniel R., Estrella, Claudia R., Sanchez-Medina, Jorge R., Ramirez-Gutierrez, Alvaro, George, Fernando G., Aguirre, Janet S., Buensuseso, Juan A., Poblano, Manuel, Dendane, Tarek, Balkhi, Hicham, Elkhayari, Mina, Samkaoui, Nacer, Ezzouine, Hanane, Benslama, Abdellatif, Amor, Mourad, Maazouzi, Wajdi, Cimic, Nedim, Beck, Oliver, Bruns, Monique M., Schouten, Jeroen A., Rinia, Myra, Raaijmakers, Monique, van Wezel, Hellen M., Heines, Serge J., Strauch, Ulrich, Buise, Marc P., Goodson, Jennifer C., Browne, Troy S., Navarra, Leanlove, Hunt, Anna, Hutchison, Robyn A., Bailey, Mathew B., Newby, Lynette, Mcarthur, Colin, Kalkoff, Michael, Mcleod, Alex, Casement, Jonathan, Hacking, Danielle J., Andersen, Finn H., Dolva, Merete S., Laake, Jon H., Barratt-Due, Andrea, Noremark, Kim Andre L., Søreide, Eldar, Sjøbø, Brit Å., Guttormsen, Anne B., Yoshido, Hector H. Leon, Aguilar, Ronald Zumaran, Oscanoa, Fredy A. Monte, Alisasis, Alain U., Robles, Joanne B., Pasanting-Lim, Rossini Abbie B., Tan, Beatriz C., Andruszkiewicz, Pawel, Jakubowska, Karina, Coxo, Cristina M., Alvarez, António M., Oliveira, Bruno S., Montanha, Gustavo M., Barros, Nelson C., Pereira, Carlos S., Messias, António M., Monteiro, Jorge M., Araujo, Ana M., Catorze, Nuno T., Marum, Susan M., Bouw, Maria J., Gomes, Rui M., Brito, Vania A., Castro, Silvia, Estilita, Joana M., Barros, Filipa M., Serra, Isabel M., Martinho, Aurelia M., Tomescu, Dana R., Marcu, Alexandra, Bedreag, Ovidiu H., Papurica, Mariu, Corneci, Dan E., Negoita, Silvius Loan, Grigoriev, Evgeny, Gritsan, Alexey I., Gazenkampf, Andrey A., Almekhlafi, Ghaleb, Albarrak, Mohamad M., Mustafa, Ghanem M., Maghrabi, Khalid A., Salahuddin, Nawal, Aisa, Tharwat M., Jabbary, Ahmed S. Al, Tabhan, Edgardo, Arabi, Yaseen M., Trinidad, Olivia A., Dorzi, Hasan M. Al, Tabhan, Edgardo E., Bolon, Stefan, Smith, Oliver, Mancebo, Jordi, Aguirre-Bermeo, Hernan, Lopez-Delgado, Juan C., Esteve, Francisco, Rialp, Gemma, Forteza, Catalina, de Haro, Candelaria, Albaiceta, Guillermo M., de Cima-Iglesias, Sara, Seoane-Quiroga, Leticia, Ceniceros-Barros, Alexandra, Ruiz-Aguilar, Antonio L., Claraco-Vega, Luis M., Soler, Juan Alfonso, Del Carmen Lorente, Maria, Hermosa, Cecilia, Gordo, Federico, Prieto-González, Miryam, López-Messa, Juan B., Perez, Manuel P., Perez, Cesar P., Allue, Raquel Montoiro, Roche-Campo, Ferran, Ibañez-Santacruz, Marco, Temprano, Susana, Pintado, Maria C., de Pablo, Raul, Gómez, Pilar Ricart Aroa, Ruiz, Silvia Rodriguez, Moles, Silvia Iglesia, Jurado, Mª Teresa, Arizmendi, Alfon, Piacentini, Enrique A., Franco, Nieve, Honrubia, Teresa, Cheng, Meisy Perez, Losada, Elena Perez, Blanco, Javier, Yuste, Luis J., Carbayo-Gorriz, Cecilia, Cazorla-Barranquero, Francisca G., Alonso, Javier G., Alda, Rosa S., Algaba, Ángela, Navarro, Gonzalo, Cereijo, Enrique, Diaz-Rodriguez, Esther, Marcos, Diego Pastor, Montero, Laura Alvarez, Para, Luis Herrera, Sanchez, Roberto Jimenez, Navalpotro, Miguel Angel Blasco, Abad, Ricardo Diaz, González, Raquel Montiel, Toribio, Dácil Parrilla, Castro, Alejandro G., Artiga, Maria Jose D., Penuelas, Oscar, Roser, Tomas P., Olga, Moreno F., Curto, Elena Gallego, Sánchez, Rocío Manzano, Imma, Vallverdu P., Elisabet, Garcia M., Claverias, Laura, Magret, Monica, Pellicer, Ana M., Rodriguez, Lucia L., Sánchez-Ballesteros, Jesú, González-Salamanca, Ángela, Jimenez, Antonio G., Huerta, Francisco P., Diaz, Juan Carlos J. Sotillo, Lopez, Esther Bermejo, Moya, David D. Llinare, Alfonso, Alec A. 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Subjects
Male, ARDS, medicine.medical_treatment, lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], ARDS reassessment, ARDS Survival, Berlin criteria ARDS, Persisting ARDS, Critical Care and Intensive Care Medicine, assisted ventilation, 0302 clinical medicine, Risk Factors, 030212 general & internal medicine, risk factor, Adult, Tidal volume, comparative study, education.field_of_study, Respiratory Distress Syndrome, Mortality rate, Remission Induction, tidal volume, artificial ventilation, clinical trial, immunosuppressive treatment, adult respiratory distress syndrome, Middle Aged, Monte Carlo method, medicine.anatomical_structure, classification, positive end expiratory pressure, Cardiology, Disease Progression, SOFA score, disease severity, Female, Adult, medicine.medical_specialty, Population, disease classification, Article, NO, 03 medical and health sciences, remission, length of stay, Anesthesiology, Internal medicine, medicine, pneumonia, Sequential Organ Failure Assessment Score, Humans, human, education, Aged, Mechanical ventilation, hospital mortality, Lung, business.industry, Risk Factor, disease association, Respiratory Distress Syndrome, Adult, medicine.disease, major clinical study, mortality, Respiration, Artificial, breathing rate, 030228 respiratory system, disease exacerbation, business
Abstract

Purpose: To evaluate patients with resolved versus confirmed ARDS, identify subgroups with substantial mortality risk, and to determine the utility of day 2 ARDS reclassification. Methods: Our primary objective, in this secondary LUNG SAFE analysis, was to compare outcome in patients with resolved versus confirmed ARDS after 24 h. Secondary objectives included identifying factors associated with ARDS persistence and mortality, and the utility of day 2 ARDS reclassification. Results: Of 2377 patients fulfilling the ARDS definition on the first day of ARDS (day 1) and receiving invasive mechanical ventilation, 503 (24%) no longer fulfilled the ARDS definition the next day, 52% of whom initially had moderate or severe ARDS. Higher tidal volume on day 1 of ARDS was associated with confirmed ARDS [OR 1.07 (CI 1.01–1.13), P = 0.035]. Hospital mortality was 38% overall, ranging from 31% in resolved ARDS to 41% in confirmed ARDS, and 57% in confirmed severe ARDS at day 2. In both resolved and confirmed ARDS, age, non-respiratory SOFA score, lower PEEP and P/F ratio, higher peak pressure and respiratory rate were each associated with mortality. In confirmed ARDS, pH and the presence of immunosuppression or neoplasm were also associated with mortality. The increase in area under the receiver operating curve for ARDS reclassification on day 2 was marginal. Conclusions: ARDS, whether resolved or confirmed at day 2, has a high mortality rate. ARDS reclassification at day 2 has limited predictive value for mortality. The substantial mortality risk in severe confirmed ARDS suggests that complex interventions might best be tested in this population. Trial Registration: ClinicalTrials.gov NCT02010073. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature and ESICM.

Published
2018

21. National incidence rate and related mortality for acute respiratory distress syndrome in France.

Author

Papazian, Laurent, Pauly, Vanessa, Hamouda, Ilyes, Daviet, Florence, Orleans, Veronica, Forel, Jean-Marie, Roch, Antoine, Hraiech, Sami, and Boyer, Laurent

Subjects
*ADULT respiratory distress syndrome, *DEATH rate, *NOSOLOGY, *HOSPITAL mortality, *TSUTSUGAMUSHI disease
Abstract

Despite many efforts to improve mechanical ventilation strategies and the use of rescue strategies, ARDS-related mortality remains high. The primary objective of this study was to determine the incidence and 90-day mortality of ARDS patients admitted to all French ICUs following the introduction of the Berlin definition of ARDS. The data source for this nationwide cohort study was the French national hospital database (Programme de Médicalisation des Systèmes d'Information (PMSI)), which systematically collects administrative and medical information related to all patients hospitalised and hospital stays. Patient-level data were obtained from the PMSI database for all patients admitted to an ICU from the 1st of January 2017, through the 31st of December 2017. The inclusion criteria were as follows: ICU patients ≥ 18 years old with at least one International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10) diagnosis code of J80 (ARDS), either as a primary diagnosis or a secondary diagnosis, during their ICU stay. A total of 12,846 ICU adult patients with ARDS were included. The crude incidence of ARDS was 24.6 per 100,000 person-years, varying with age from 6.7 per 100,000 person-years for those 18 through 40 years of age to 51.9 per 100,000 person-years for those 68 through 76 years of age. The in-hospital mortality rate was 51.1%. Day-90 mortality (day-1 being the ICU admission) was 51.2% and increased with age from 29.0% for patients 18 through 40 years of age to 69.3% for patients 77 years of age or older (p < 0.001). Only 53.9% of the survivors were transferred home directly after hospital discharge. The incidence and mortality of ARDS in adults in France are higher than that generally reported in other countries. [ABSTRACT FROM AUTHOR]

Published
2021
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