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1. Severe varicella-zoster virus pneumonia: a multicenter cohort study.

Author: Mirouse A, Vignon P, Piron P, Robert R, Papazian L, Géri G, Blanc P, Guitton C, Guérin C, Bigé N, Rabbat A, Lefebvre A, Razazi K, Fartoukh M, Mariotte E, Bouadma L, Ricard JD, Seguin A, Souweine B, Moreau AS, Faguer S, Mari A, Mayaux J, Schneider F, Stoclin A, Perez P, Maizel J, Lafon C, Ganster F, Argaud L, Girault C, Barbier F, Lecuyer L, Lambert J, and Canet E
Subjects: Adult, Cohort Studies, Female, France, Hospital Mortality, Humans, Intensive Care Units organization & administration, Length of Stay statistics & numerical data, Male, Middle Aged, Odds Ratio, Organ Dysfunction Scores, Respiration, Artificial methods, Retrospective Studies, Herpesvirus 3, Human pathogenicity, Pneumonia complications
Abstract: Background: Pneumonia is a dreaded complication of varicella-zoster virus (VZV) infection in adults; however, the data are limited. Our objective was to investigate the clinical features, management, and outcomes of critically ill patients with VZV-related community-acquired pneumonia (VZV-CAP)., Methods: This was an observational study of patients with VZV-CAP admitted to 29 intensive care units (ICUs) from January 1996 to January 2015., Results: One hundred and two patients with VZV-CAP were included. Patients were young (age 39 years (interquartile range 32-51)) and 53 (52%) were immunocompromised. Time since respiratory symptom onset was 2 (1-3) days. There was a seasonal distribution of the disease, with more cases during spring and winter time. All but four patients presented with typical skin rash on ICU admission. Half the patients received mechanical ventilation within 1 (1-2) day following ICU admission (the ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO 2 /FiO 2 ) = 150 (80-284), 80% with acute respiratory distress syndrome (ARDS)). Sequential Organ Failure Assessment (SOFA) score on day 1 (odds ratio (OR) 1.90 (1.33-2.70); p < 0.001), oxygen flow at ICU admission (OR 1.25 (1.08-1.45); p = 0.004), and early bacterial co-infection (OR 14.94 (2.00-111.8); p = 0.009) were independently associated with the need for mechanical ventilation. Duration of mechanical ventilation was 14 (7-21) days. ICU and hospital mortality rates were 17% and 24%, respectively. All patients were treated with aciclovir and 10 received adjunctive therapy with steroids. Compared to 60 matched steroid-free controls, patients treated with steroids had a longer mechanical ventilation duration, ICU length of stay, and a similar hospital mortality, but experienced more ICU-acquired infections., Conclusions: Severe VZV-CAP is responsible for an acute pulmonary involvement associated with a significant morbidity and mortality. Steroid therapy did not influence mortality, but increased the risk of superinfection.
Published: 2017
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2. The leukocyte-stiffening property of plasma in early acute respiratory distress syndrome (ARDS) revealed by a microfluidic single-cell study: the role of cytokines and protection with antibodies.

Author: Preira P, Forel JM, Robert P, Nègre P, Biarnes-Pelicot M, Xeridat F, Bongrand P, Papazian L, and Theodoly O
Subjects: Adult, Aged, Aged, 80 and over, Antibodies immunology, Antibodies metabolism, Cell Adhesion Molecules, Cytokines metabolism, Cytokines pharmacology, Female, Humans, Lung metabolism, Male, Microfluidics methods, Middle Aged, Prospective Studies, Respiratory Distress Syndrome metabolism, Leukocytes metabolism, Plasma metabolism, Pneumonia drug therapy, Respiratory Distress Syndrome drug therapy, Respiratory Distress Syndrome pathology
Abstract: Background: Leukocyte-mediated pulmonary inflammation is a key pathophysiological mechanism involved in acute respiratory distress syndrome (ARDS). Massive sequestration of leukocytes in the pulmonary microvasculature is a major triggering event of the syndrome. We therefore investigated the potential role of leukocyte stiffness and adhesiveness in the sequestration of leukocytes in microvessels., Methods: This study was based on in vitro microfluidic assays using patient sera. Cell stiffness was assessed by measuring the entry time (ET) of a single cell into a microchannel with a 6 × 9-μm cross-section under a constant pressure drop (ΔP = 160 Pa). Primary neutrophils and monocytes, as well as the monocytic THP-1 cell line, were used. Cellular adhesiveness to human umbilical vein endothelial cells was examined using the laminar flow chamber method. We compared the properties of cells incubated with the sera of healthy volunteers (n = 5), patients presenting with acute cardiogenic pulmonary edema (ACPE; n = 6), and patients with ARDS (n = 22), of whom 13 were classified as having moderate to severe disease and the remaining 9 as having mild disease., Results: Rapid and strong stiffening of primary neutrophils and monocytes was induced within 30 minutes (mean ET >50 seconds) by sera from the ARDS group compared with both the healthy subjects and the ACPE groups (mean ET <1 second) (p < 0.05). Systematic measurements with the THP-1 cell line allowed for the establishment of a strong correlation between stiffening and the severity of respiratory status (mean ET 0.82 ± 0.08 seconds for healthy subjects, 1.6 ± 1.0 seconds for ACPE groups, 10.5 ± 6.1 seconds for mild ARDS, and 20.0 ± 8.1 seconds for moderate to severe ARDS; p < 0.05). Stiffening correlated with the cytokines interleukin IL-1β, IL-8, tumor necrosis factor TNF-α, and IL-10 but not with interferon-γ, transforming growth factor-β, IL-6, or IL-17. Strong stiffening was induced by IL-1β, IL-8, and TNF-α but not by IL-10, and incubations with sera and blocking antibodies against IL-1β, IL-8, or TNF-α significantly diminished the stiffening effect of serum. In contrast, the measurements of integrin expression (CD11b, CD11a, CD18, CD49d) and leukocyte-endothelium adhesion showed a weak and slow response after incubation with the sera of patients with ARDS (several hours), suggesting a lesser role of leukocyte adhesiveness compared with leukocyte stiffness in early ARDS., Conclusions: The leukocyte stiffening induced by cytokines in the sera of patients might play a role in the sequestration of leukocytes in the lung capillary beds during early ARDS. The inhibition of leukocyte stiffening with blocking antibodies might inspire future therapeutic strategies.
Published: 2016
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3. Outcome of acute respiratory distress syndrome patients treated with extracorporeal membrane oxygenation and brought to a referral center.

Author: Roch A, Hraiech S, Masson E, Grisoli D, Forel JM, Boucekine M, Morera P, Guervilly C, Adda M, Dizier S, Toesca R, Collart F, and Papazian L
Subjects: Adult, Comorbidity, Female, France epidemiology, Humans, Influenza, Human mortality, Influenza, Human therapy, Intensive Care Units statistics & numerical data, Male, Middle Aged, Organ Dysfunction Scores, Pneumonia etiology, Pneumonia mortality, Pneumonia therapy, Prognosis, Prospective Studies, Respiratory Distress Syndrome etiology, Risk Assessment methods, Survival Analysis, Extracorporeal Membrane Oxygenation methods, Hospital Mortality, Influenza, Human complications, Pneumonia complications, Respiratory Distress Syndrome mortality, Respiratory Distress Syndrome therapy
Abstract: Purpose: Patients with severe acute respiratory distress syndrome (ARDS) are candidates for extracorporeal membrane oxygenation (ECMO) therapy. The evaluation of organ severity is difficult in patients considered for cannulation in a distant hospital. This study was designed to identify early factors associated with hospital mortality in ARDS patients treated with ECMO and retrieved from referring hospitals., Methods: Data from 85 consecutive ARDS patients equipped with ECMO by our mobile team and consequently admitted to our ICU were prospectively collected and analyzed., Results: The main ARDS etiologies were community-acquired bacterial pneumonia (35%), influenza pneumonia (23%) (with 12 patients having been treated during the first half of the study period), and nosocomial pneumonia (14%). The median (interquartile range) time between contact from the referring hospital and patient cannulation was 3 (1-4) h. ECMO was venovenous in 77 (91%) patients. No complications occurred during transport by our mobile unit. Forty-eight patients died at the hospital (56%). Based on a multivariate logistic regression, a score including age, SOFA score, and a diagnosis of influenza pneumonia was constructed. The probability of hospital mortality following ECMO initiation was 40% in the 0-2 score class (n = 58) and 93% in the 3-4 score class (n = 27). Patients with an influenza pneumonia diagnosis and a SOFA score before ECMO of less than 12 had a mortality rate of 22%., Conclusions: Age, SOFA score, and a diagnosis of influenza may be used to accurately evaluate the risk of death in ARDS patients considered for retrieval under ECMO from distant hospitals.
Published: 2014
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4. Time to intubation is associated with outcome in patients with community-acquired pneumonia.

Author: Hraiech S, Alingrin J, Dizier S, Brunet J, Forel JM, La Scola B, Roch A, Papazian L, and Pauly V
Subjects: Adult, Aged, Anti-Infective Agents therapeutic use, Community-Acquired Infections complications, Community-Acquired Infections diagnosis, Community-Acquired Infections mortality, Female, Hospital Mortality, Humans, Male, Middle Aged, Pneumonia mortality, Prognosis, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, Community-Acquired Infections therapy, Intubation, Pneumonia therapy
Abstract: Introduction: It has been suggested that delayed intensive care unit (ICU) transfer is associated with increased mortality for patients with community-acquired pneumonia (CAP). However, ICU admission policies and patient epidemiology vary widely across the world depending on local hospital practices and organizational constraints. We hypothesized that the time from the onset of CAP symptoms to invasive mechanical ventilation could be a relevant prognostic factor., Methods: One hundred patients with a CAP and necessitating invasive mechanical ventilation were included. Prospectively collected data were retrospectively analysed. Two study groups were identified based on the time of the initiation of invasive mechanical ventilation (rapid respiratory failure requiring mechanical ventilation within 72 h of the onset of CAP and progressive respiratory failure requiring invasive mechanical ventilation 4 or more days after the onset of CAP)., Results: Excepting more COPD patients in the rapid respiratory failure group and more patients with diabetes in the progressive respiratory failure group, these patients had similar characteristics. The overall in-hospital mortality rate was 28% in the rapid respiratory failure group and 51% in the progressive respiratory failure group (P = 0.03). The ICU and the day 30 mortality rates were higher in the progressive respiratory failure group (47% vs. 23%, P = 0.02; and 37.7% vs. 21.3%, P = 0.03; respectively). After adjusting for the propensity score and other potential confounding factors, progressive respiratory failure remained associated with hospital mortality only after 12 days of invasive mechanical ventilation., Conclusions: This study suggested that the duration or delay in the time to intubation from the onset of CAP symptoms was associated with the outcomes in those patients who ultimately required invasive mechanical ventilation.
Published: 2013
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5. Serologic prevalence of amoeba-associated microorganisms in intensive care unit pneumonia patients.

Author: Bousbia S, Papazian L, Saux P, Forel JM, Auffray JP, Martin C, Raoult D, and La Scola B
Subjects: Adult, Cross Infection blood, Cross Infection microbiology, Gram-Negative Bacterial Infections blood, Gram-Negative Bacterial Infections microbiology, Gram-Positive Bacterial Infections blood, Gram-Positive Bacterial Infections microbiology, Humans, Intensive Care Units, Length of Stay, Pneumonia blood, Pneumonia microbiology, Seroepidemiologic Studies, Antibodies, Bacterial blood, Cross Infection diagnosis, Gram-Negative Bacteria isolation & purification, Gram-Negative Bacterial Infections diagnosis, Gram-Positive Bacteria isolation & purification, Gram-Positive Bacterial Infections diagnosis, Mimiviridae isolation & purification, Pneumonia diagnosis
Abstract: Background: Patients admitted to intensive care units are frequently exposed to pathogenic microorganisms present in their environment. Exposure to these microbes may lead to the development of hospital-acquired infections that complicate the illness and may be fatal. Amoeba-associated microorganisms (AAMs) are frequently isolated from hospital water networks and are reported to be associated to cases of community and hospital-acquired pneumonia., Methodology/principal Findings: We used a multiplexed immunofluorescence assay to test for the presence of antibodies against AAMs in sera of intensive care unit (ICU) pneumonia patients and compared to patients at the admission to the ICU (controls). Our results show that some AAMs may be more frequently detected in patients who had hospital-acquired pneumonia than in controls, whereas other AAMs are ubiquitously detected. However, ICU patients seem to exhibit increasing immune response to AAMs when the ICU stay is prolonged. Moreover, concomitant antibodies responses against seven different microorganisms (5 Rhizobiales, Balneatrix alpica, and Mimivirus) were observed in the serum of patients that had a prolonged ICU stay., Conclusions/significance: Our work partially confirms the results of previous studies, which show that ICU patients would be exposed to water amoeba-associated microorganisms, and provides information about the magnitude of AAM infection in ICU patients, especially patients that have a prolonged ICU stay. However, the incidence of this exposure on the development of pneumonia remains to assess.
Published: 2013
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6. Repertoire of intensive care unit pneumonia microbiota.

Author: Bousbia S, Papazian L, Saux P, Forel JM, Auffray JP, Martin C, Raoult D, and La Scola B
Subjects: Bacteria classification, Bacteria genetics, Bacteria isolation & purification, Bronchoalveolar Lavage Fluid microbiology, DNA, Ribosomal genetics, Humans, Molecular Sequence Data, Phylogeny, Intensive Care Units, Pneumonia microbiology
Abstract: Despite the considerable number of studies reported to date, the causative agents of pneumonia are not completely identified. We comprehensively applied modern and traditional laboratory diagnostic techniques to identify microbiota in patients who were admitted to or developed pneumonia in intensive care units (ICUs). During a three-year period, we tested the bronchoalveolar lavage (BAL) of patients with ventilator-associated pneumonia, community-acquired pneumonia, non-ventilator ICU pneumonia and aspiration pneumonia, and compared the results with those from patients without pneumonia (controls). Samples were tested by amplification of 16S rDNA, 18S rDNA genes followed by cloning and sequencing and by PCR to target specific pathogens. We also included culture, amoeba co-culture, detection of antibodies to selected agents and urinary antigen tests. Based on molecular testing, we identified a wide repertoire of 160 bacterial species of which 73 have not been previously reported in pneumonia. Moreover, we found 37 putative new bacterial phylotypes with a 16S rDNA gene divergence ≥ 98% from known phylotypes. We also identified 24 fungal species of which 6 have not been previously reported in pneumonia and 7 viruses. Patients can present up to 16 different microorganisms in a single BAL (mean ± SD; 3.77 ± 2.93). Some pathogens considered to be typical for ICU pneumonia such as Pseudomonas aeruginosa and Streptococcus species can be detected as commonly in controls as in pneumonia patients which strikingly highlights the existence of a core pulmonary microbiota. Differences in the microbiota of different forms of pneumonia were documented.
Published: 2012
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7. Ameba-associated microorganisms and diagnosis of nosocomial pneumonia.

Author: Berger P, Papazian L, Drancourt M, La Scola B, Auffray JP, and Raoult D
Subjects: Acanthamoeba isolation & purification, Adult, Aged, Aged, 80 and over, Amebiasis diagnosis, Amebiasis microbiology, Animals, Female, Humans, Intensive Care Units, Legionella isolation & purification, Legionella pneumophila isolation & purification, Male, Middle Aged, Pneumonia, Bacterial diagnosis, Pneumonia, Bacterial microbiology, Ventilators, Mechanical, Amoeba microbiology, Cross Infection diagnosis, Cross Infection etiology, Pneumonia diagnosis, Pneumonia etiology
Abstract: To elucidate the role of ameba-associated microorganisms (AAMs) as etiologic agents of pneumonia, we screened for Legionella spp., Parachlamydia acanthamoeba, Afipia sp., Bosea spp., Bradyrhizobium spp., Mesorhizobium amorphae, Rasbo bacterium, Azorhizobium caulinodans, Acanthamoeba polyphaga mimivirus, and conventional microorganisms in 210 pneumonia patients in intensive-care units by using culture, polymerase chain reaction, and serologic testing. These resulted in 59 diagnoses in 40 patients. AAMs and non-AAMs were implicated in 10.5% of the patients. The infectious agents were identified in 15 patients: Acanthamoeba polyphaga mimivirus, 8; Legionella pneumophila, 3; L. anisa, 1; Parachlamydia sp., 1; Bosea massiliensis, L. worsleiensis, L. quinlivanii, and L. rubrilucens, 1; and M. amorphae and R. bacterium, 1. A. polyphaga mimivirus was the fourth most common etiologic agent, with a higher seroprevalence than noted in healthy controls. This finding suggested its clinical relevance. Therefore, AAM might cause nosocomial pneumonia and should be suspected when conventional microbiologic results are negative.
Published: 2006
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8. Diagnostic workup for ARDS patients

Author: Papazian, Laurent, Calfee, Carolyn S, Chiumello, Davide, Luyt, Charles-Edouard, Meyer, Nuala J, Sekiguchi, Hiroshi, Matthay, Michael A, and Meduri, Gianfranco Umberto
Subjects: Biomedical and Clinical Sciences, Clinical Sciences, Rare Diseases, Pneumonia & Influenza, Pneumonia, Sepsis, Hematology, Infectious Diseases, Lung, Clinical Research, Acute Respiratory Distress Syndrome, Detection, screening and diagnosis, 4.1 Discovery and preclinical testing of markers and technologies, Infection, Respiratory, Good Health and Well Being, Biomarkers, Biopsy, Diagnosis, Differential, Diagnostic Imaging, Humans, Phenotype, Precision Medicine, Respiratory Distress Syndrome, ARDS, CT scan, Ultrasonography, BAL, Diffuse alveolar damage, Personalized medicine, Phenotype-endotype, Phenotype–endotype, Public Health and Health Services, Emergency & Critical Care Medicine, Clinical sciences
Abstract: Acute respiratory distress syndrome (ARDS) is defined by the association of bilateral infiltrates and hypoxaemia following an initial insult. Although a new definition has been recently proposed (Berlin definition), there are various forms of ARDS with potential differences regarding their management (ventilator settings, prone positioning use, corticosteroids). ARDS can be caused by various aetiologies, and the adequate treatment of the responsible cause is crucial to improve the outcome. It is of paramount importance to characterize the mechanisms causing lung injury to optimize both the aetiological treatment and the symptomatic treatment. If there is no obvious cause of ARDS or if a direct lung injury is suspected, bronchoalveolar lavage (BAL) should be strongly considered to identify microorganisms responsible for pneumonia. Blood samples can also help to identify microorganisms and to evaluate biomarkers of infection. If there is no infectious cause of ARDS or no other apparent aetiology is found, second-line examinations should include markers of immunologic diseases. In selected cases, open lung biopsy remains useful to identify the cause of ARDS when all other examinations remain inconclusive. CT scan is fundamental when there is a suspicion of intra-abdominal sepsis and in some cases of pneumonia. Ultrasonography is important not only in evaluating biventricular function but also in identifying pleural effusions and pneumothorax. The definition of ARDS remains clinical and the main objective of the diagnostic workup should be to be focused on identification of its aetiology, especially a treatable infection.
Published: 2016

9. Oropharyngeal and nasopharyngeal decontamination with chlorhexidine gluconate in lung cancer surgery: a randomized clinical trial

Author: D’Journo, Xavier Benoit, Falcoz, Pierre-Emmanuel, Alifano, Marco, Le Rochais, Jean-Philippe, D’Annoville, Thomas, Massard, Gilbert, Regnard, Jean Francois, Icard, Philippe, Marty-Ane, Charles, Trousse, Delphine, Doddoli, Christophe, Orsini, Bastien, Edouard, Sophie, Million, Matthieu, Lesavre, Nathalie, Loundou, Anderson, Baumstarck, Karine, Peyron, Florence, Honoré, Stephane, Dizier, Stéphanie, Charvet, Aude, Leone, Marc, Raoult, Didier, Papazian, Laurent, and Thomas, Pascal Alexandre
Published: 2018
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10. Effects of ambient air pollutants on ARDS incidence and outcome: a narrative review.

Author: Gutman, Laëtitia, Pauly, Vanessa, Papazian, Laurent, and Roch, Antoine
Subjects: AIR pollutants, ADULT respiratory distress syndrome, INTENSIVE care patients, PARTICULATE matter, PNEUMONIA
Abstract: Background: Exposure to air pollutants promotes inflammation, cancer, and mortality in chronic diseases. Acute respiratory distress syndrome (ARDS) is a common condition among intensive care unit patients and is associated with a high mortality rate. ARDS is characterized by significant lung inflammation, which can be replicated in animal models by acute exposure to high doses of various air pollutants. Recently, several clinical studies have been conducted in different countries to investigate the role of chronic or acute air pollutant exposure in enhancing both ARDS incidence and severity. Results: Chronic exposure studies have mainly been conducted in the US and France. The results of these studies suggest that some air pollutants, notably ozone, nitrogen dioxide, and particulate matter, increase susceptibility to ARDS and associated mortality. Furthermore, their impact may differ according to the cause of ARDS. A cohort study conducted in an urbanized zone in China showed that exposure to very high levels of air pollutants in the few days preceding intensive care unit admission was associated with an increased incidence of ARDS. The effects of acute exposure are more debatable regarding ARDS incidence and severity. Conclusion: There is a likely relationship between air pollutant exposure and ARDS incidence and severity. However, further studies are required to determine which pollutants are the most involved and which patients are the most affected. Due to the prevalence of ARDS, air pollutant exposure may have a significant impact and could be a key public health issue. [ABSTRACT FROM AUTHOR]
Published: 2023
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11. Extracorporeal membrane oxygenation for severe influenza A (H1N1) acute respiratory distress syndrome: a prospective observational comparative study

Author: Roch, Antoine, Lepaul-Ercole, Renaud, Grisoli, Dominique, Bessereau, Jacques, Brissy, Olivier, Castanier, Matthias, Dizier, Stephanie, Forel, Jean-Marie, Guervilly, Christophe, Gariboldi, Vlad, Collart, Frederic, Michelet, Pierre, Perrin, Gilles, Charrel, Remi, and Papazian, Laurent
Published: 2010
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12. Bacterial ventilator-associated pneumonia: bronchoalveolar lavage results are not influenced by dilution

Author: Baldesi, Olivier, Michel, Fabrice, Guervilly, Christophe, Embriaco, Nathalie, Granfond, Aliocha, La Scola, Bernard, Portugal, Henri, and Papazian, Laurent
Published: 2009
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13. Immunocompromised patients with acute respiratory distress syndrome: Secondary analysis of the LUNG SAFE database

Author: Cortegiani, Andrea, Madotto, Fabiana, Gregoretti, Cesare, Bellani, Giacomo, Laffey, John G., Pham, Tai, Van Haren, Frank, Giarratano, Antonino, Antonelli, Massimo, Pesenti, Antonio, Grasselli, Giacomo, Sula, Hektor, Nunci, Lordian, Cani, Alma, Zazu, Alan, Dellera, Christian, Insaurralde, Carolina S., Alejandro, Risso V., Daldin, Julio, Vinzio, Mauricio, Fernandez, Ruben O., Cardonnet, Luis P., Bettini, Lisandro R., Bisso, Mariano Carboni, Osman, Emilio M., Setten, Mariano G., Lovazzano, Pablo, Alvarez, Javier, Villar, Veronica, Pozo, Norberto C., Grubissich, Nicolas, Plotnikow, Gustavo A., Vasquez, Daniela N., Ilutovich, Santiago, Tiribelli, Norberto, Chena, Ariel, Pellegrini, Carlos A., Saenz, María G., Estenssoro, Elisa, Brizuela, Matias, Gianinetto, Hernan, Gomez, Pablo E., Cerrato, Valeria I., Bezzi, Marco G., Borello, Silvina A., Loiacono, Flavia A., Fernandez, Adriana M., Knowles, Serena, Reynolds, Claire, Inskip, Deborah M., Miller, Jennene J., Kong, Jing, Whitehead, Christina, Bihari, Shailesh, Seven, Aylin, Krstevski, Amanda, Rodgers, Helen J., Millar, Rebecca T., Mckenna, Toni E., Bailey, Irene M., Hanlon, Gabrielle C., Aneman, Anders, Lynch, Joan M., Azad, Raman, Neal, John, Woods, Paul W., Roberts, Brigit L., Kol, Mark R., Wong, Helen S., Riss, Katharina C., Staudinger, Thomas, Wittebole, Xavier, Berghe, Caroline, Bulpa, Pierre A., Dive, Alain M., Verstraete, Rik, Lebbinck, Herve, Depuydt, Pieter, Vermassen, Joris, Meersseman, Philippe, Ceunen, Helga, Rosa, Jonas I., Beraldo, Daniel O., Piras, Claudio, Rampinelli, Adenilton M., Nassar, Antonio P., Mataloun, Sergio, Moock, Marcelo, Thompson, Marlus M., Gonçalves, Claudio H., Antônio, Ana Carolina P., Ascoli, Aline, Biondi, Rodrigo S., Fontenele, Danielle C., Nobrega, Danielle, Sales Brunei, Vanessa M., Shindhe, Suresh, Binti Pengiran Haji Ismail, Dayangku Hajah Maizatul Aiman, Laffey, John, Beloncle, Francois, Davies, Kyle G., Cirone, Rob, Manoharan, Venika, Ismail, Mehvish, Goligher, Ewan C., Jassal, Mandeep, Nishikawa, Erin, Javeed, Areej, Curley, Gerard, Rittayamai, Nuttapol, Parotto, Matteo, Ferguson, Niall D., Mehta, Sangeeta, Knoll, Jenny, Pronovost, Antoine, Canestrini, Sergio, Bruhn, Alejandro R., Garcia, Patricio H., Aliaga, Felipe A., Farías, Pamela A., Yumha, Jacob S., Ortiz, Claudia A., Salas, Javier E., Saez, Alejandro A., Vega, Luis D., Labarca, Eduardo F., Martinez, Felipe T., Carreño, Nicolás G., Lora, Pilar, Liu, Haitao, Qiu, Haibo, Liu, Ling, Tang, Rui, Luo, Xiaoming, Youzhong, An, Zhao, Huiying, Gao, Yan, Zhai, Zhe, Zheng L., Ye, Wang, Wei, Wenwen, Li, Qingdong, Li, Zheng, Ruiqiang, Wenkui, Yu, Shen, Juanhong, Xinyu, Li, Tao, Yu, Weihua, Lu, Ya, Wu, Huang, Xiao B., Zhenyang, He, Yuanhua, Lu, Han, Hui, Zhang, Fan, Sun, Renhua, Wang, Hua, Qin, Shu H., Zhu, Bao, Zhao, Jun, Liu, Jian, Bin, Li, Liu, Jing, Zhou, Fa C., Qiong, Li, Zhang, Xing Y., Li-Xin, Zhou, Xin-Hua, Qiang, Jiang, Liangyan, Gao, Yuan, Zhao, Xian Y., Yuan, Li, Xiao L., Li, Wang, Chunting, Yao, Qingchun, Rongguo, Yu, Chen, Kai, Shao, Huanzhang, Qin, Bingyu, Huang, Qing, Zhu, Wei H., Hang, Ai, Hua, Ma X., Yimin, Li, Yonghao, Xu, Yu, Di, Ling, Long L., Qin, Tie, Wang, Shou H., Qin, Junping, Han, Yi, Zhou, Suming, Vargas, Monica, Silesky Jimenez, Juan, Rojas, Manuel A. González, Solis-Quesada, Jaime E., Ramirez-Alfaro, Christian M., Máca, Jan, Sklienka, Peter, Gjedsted, Jakob, Christiansen, Aage, Nielsen, Jonas, Villamagua, Boris, Llano, Miguel, Burtin, Philippe, Buzancais, Gautier, Beuret, Pascal, Pelletier, Nicolas, Mortaza, Satar, Mercat, Alain, Chelly, Jonathan, Jochmans, Sébastien, Terzi, Nicolas, Daubin, Cédric, Carteaux, Guillaume, de Prost, Nicolas, Chiche, Jean-Daniel, Daviaud, Fabrice, Fartoukh, Muriel, Barberet, Guillaume, Biehler, Jerome, Dellamonica, Jean, Doyen, Denis, Arnal, Jean-Michel, Briquet, Anais, Hraiech, Sami, Papazian, Laurent, Follin, Arnaud, Roux, Damien, Messika, Jonathan, Kalaitzis, Evangelos, Dangers, Laurence, Combes, Alain, Siu-Ming, Au, Béduneau, Gaetan, Carpentier, Dorothée, Zogheib, Elie, Dupont, Herve, Ricome, Sylvie, Santoli, Francesco L., Besset, Sebastien, Michel, Philippe, Gelée, Bruno, Danin, Pierre-Eric, Goubaux, Bernard, Crova, Philippe, Phan, Nga T., Berkelmans, Frantz, Badie, Julio, Tapponnier, Romain, Gally, Josette, Khebbeb, Samy, Herbrecht, Jean-Etienne, Schneider, Francis, Declercq, Pierre-Louis M., Rigaud, Jean-Philippe, Duranteau, Jacques, Harrois, Anatole, Chabanne, Russell, Marin, Julien, Bigot, Charlene, Thibault, Sandrine, Ghazi, Mohammed, Boukhazna, Messabi, Zein, Salem Ould, Richecoeur, Jack, Combaux, Daniele M., Grelon, Fabien, Moal, Charlene Le, Sauvadet, Elise, Robine, Adrien, Lemiale, Virginie, Reuter, Danielle, Dres, Martin, Demoule, Alexandre, Goldgran-Toledano, Dany, Baboi, Loredana, Guérin, Claude, Lohner, Ralph, Krabler, Jens, Schäfer, Susanne, Zacharowski, Kai, Meybohm, Patrick, Reske, Andreas, Simon, Philipp, Hopf, Hans-Bernd F., Schuetz, Michael, Baltus, Thomas, Papanikolaou, Metaxia, Papavasilopoulou, Theonymfi G., Zacharas, Giannis, Ourailogloy, Vasilis, Mouloudi, Eleni, Massa, Eleni V., Nagy, Eva, Stamou, Electra E., Kiourtzieva, Ellada, Oikonomou, Marina A., Avila, Luis, Cortez, Cesar, Citalán, Johanna E., Jog, Sameer, Sable, Safal D., Shah, Bhagyesh, Gurjar, Mohan, Baronia, Arvind K., Memon, Mohammedfaruk, Muthuchellappan, Radhakrishnan, Ramesh, Venkatapura J., Shenoy, Anitha, Unnikrishnan, Ramesh, Dixit, Subhal, Rhayakar, Rachana V., Ramakrishnan, Nagarajan, Bhardwaj, Vallish K., Mahto, Heera, Sagar, Sudha V., Palaniswamy, Vijayanand, Ganesan, Deeban, Hashemian, Seyed Mohammadreza, Jamaati, Hamidreza, Heidari, Farshad, Meaney, Edel, Nichol, Alistair, Knapman, Karl, O'Croinin, Donall, Dunne, Eimhin, Breen, Dorothy M., Clarkson, Kevin, Jaafar, Rola F., Dwyer, Rory, Amir, Fahd, Ajetunmobi, Olaitan, O'Muircheartaigh, Aogan C., Black, Colin, Treanor, Nuala, Collins, Daniel, 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, Sher, Sara, Rossi, Anna, Montini, Luca M., Casalena, Paolo, Scafetti, Sergio, Panarello, Giovanna, Occhipinti, Giovanna, Patroniti, Nicolò, Pozzi, Matteo, Biscione, Roberto, 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, Cracchiolo, Andrea, Palma, Daniela M., Raponi, Francesco, Foti, Giuseppe, Vascotto, Ettore, Coppadoro, Andrea, Brazzi, Luca, Floris, Leda, Iotti, Giorgio, Venti, Aaron, Yamaguchi, Osamu, Takagi, Shunsuke, Maeyama, Hiroki, 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, Olegs, Oss, Peteris, Haddad, Youssef, Liew, Kong, Ñamendys-Silva, Silvio A., Jarquin-Badiola, Yves D., Sanchez-Hurtado, Luis, Gomez-Flores, Saira S., Marin, Maria, Villagomez, Asisclo J., Lemus, Jordana, Fierro, Jonathan M., Cervantes, Mavy Ramirez, Mejia, Francisco Javier Flores, Dector, Dulce, Dector, Dulce M., Gonzalez, Daniel, Estrella, Claudia R., Sanchez-Medina, Jorge, Ramirez-Gutierrez, Alvaro, George, Fernando, Aguirre, Janet S., Buensuseso, Juan, Poblano, Manuel, Dendane, Tarek, Zeggwagh, Amine Ali, Balkhi, Hicham, Elkhayari, Mina, Samkaoui, Nacer, Ezzouine, Hanane, Benslama, Abdellatif, Amor, Mourad, Maazouzi, Wajdi, Cimic, Nedim, Beck, Oliver, Bruns, Monique, Schouten, Jeroen A., Rinia, Myra, Raaijmakers, Monique, Heunks, Leo, Van Wezel, Hellen M., Heines, Serge, Strauch, Ulrich, Buise, Marc, Simonis, Fabienne, Schultz, Marcus J., Goodson, Jennifer, Browne, Troy S., Navarra, Leanlove, Hunt, Anna, Hutchison, Robyn, Bailey, Mathew B., Newby, Lynette, Mcarthur, Colin, Kalkoff, Michael, Mcleod, Alex, Casement, Jonathan, Hacking, Danielle J., Andersen, Finn, Dolva, Merete S., Laake, Jon, Barratt-Due, Andreas, Noremark, Kim Andre, Søreide, Eldar, Sjøbø, Brit A., Guttormsen, Anne B., Leon Yoshido, Hector, Aguilar, Ronald Zumaran, Oscanoa, Fredy A. Montes, Alisasis, Alain, Robles, Joanne B., Pasanting-Lim, Rossini Abbie, Tan, Beatriz C., Andruszkiewicz, Pawel, Jakubowska, Karina, Coxo, Cristina, Alvarez, António, Oliveira, Bruno S., Montanha, Gustavo, Barros, Nelson C., Pereira, Carlos, Messias, António M., Monteiro, Jorge, Araujo, Ana, Catorze, Nuno T., Marum, Susan, Bouw, Maria J., Gomes, Rui, Brito, Vania A., Castro, Silvia, Estilita, Joana M., Barros, Filipa, Serra Aurelia, Isabel, Tomescu, Dana, Marcu, Alexandra, Bedreag, Ovidiu, Papurica, Marius, Corneci, Dan, Negoita, Silvius Ioan, Grigoriev, Evgeny, Gritsan, Alexey, Gazenkampf, Andrey A., Almekhlafi, Ghaleb, Albarrak, Mohamad M., Mustafa, Ghanem M., Maghrabi, Khalid, Salahuddin, Nawal, Aisa, Tharwat, Al Jabbary, Ahmed, Tabhan, Edgardo, Arabi, Yaseen M., Trinidad, Olivia A., Al Dorzi, Hasan M., Tabhan, Edgardo E., Bolon, Stefan, Smith, Oliver, Mancebo, Jordi, Aguirre-Bermeo, Hernan, Lopez-Delgado, Juan, Esteve, Francisco, Rialp, Gemma, Forteza, Catalina, de Haro, Candelaria, Artigas, Antonio, Albaiceta, Guillermo, de Cima-Iglesias, Sara, Seoane-Quiroga, Leticia, Ceniceros-Barros, Alexandra, Ruiz-Aguilar, Antonio, Claraco-Vega, Luis M., Soler, Juan Alfonso, Lorente, Maria del Carmen, Hermosa, Cecilia, Gordo, Federico, Prieto-González, Miryam, López-Messa, Juan B., Perez, Manuel, Perez, Cesar P., Allue, Raquel Montoiro, Roche-Campo, Ferran, Ibañez-Santacruz, Marco, Temprano, Susana, Pintado, Maria, de Pablo, Raul, Gómez, Pilar Ricart Aroa, Ruiz, Silvia Rodriguez, Moles, Silvia Iglesias, Jurado, Maria Teresa, Arizmendi, Alfons, Piacentini, Enrique, Franco, Nieves, Honrubia, Teresa, Cheng, Meisy Perez, Losada, Elena Perez, Blanco, Javier, Yuste, Luis J., Carbayo-Gorriz, Cecilia, Cazorla-Barranquero, Francisca G., Alonso, Javier, 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, Artiga, Maria Jose D., Penuelas, Oscar, Roser, Tomas, Olga, Moreno F., Curto, Elena Gallego, Sánchez, Rocío Manzano, Imma, Vallverdu, Elisabet, Garcia M., Claverias, Laura, Magret, Monica, Pellicer, Ana, Rodriguez, Lucia L., Sánchez-Ballesteros, Jesús, González-Salamanca, Ángela, Jimenez, Antonio, Huerta, Francisco P., Sotillo Diaz, Juan Carlos, Lopez, Esther Bermejo, Llinares Moya, David, Alfonso, Alec A. Tallet, Luis, Palazon Sanchez Eugenio, Cesar, Palazon Sanchez, Rafael, Sánchez I., Virgilio, Corcoles G., Recio, Noelia, Adamsson, Richard, Rylander, Christian C., Holzgraefe, Bernhard, Broman, Lars M., Wessbergh, Joanna, Persson, Linnea, Schiöler, Fredrik, Kedelv, Hans, Tibblin, Anna Oscarsson, Appelberg, Henrik, Hedlund, Lars, Helleberg, Johan, Eriksson, Karin, Glietsch, Rita, Larsson, Niklas, Nygren, Ingela, Nunes, Silvia, Morin, Anna-Karin, Kander, Thomas, Adolfsson, Anne, Piquilloud, Lise, Zender, Hervé, Leemann-Refondini, Corinne, Elatrous, Souheil, Bouchoucha, Slaheddine, Chouchene, Imed, Ouanes, Islem, Souissi, Asma Ben, Kamoun, Salma, Demirkiran, Oktay, Aker, Mustafa, Erbabacan, Emre, Ceylan, Ilkay, Girgin, Nermin Kelebek, Ozcelik, Menekse, Ünal, Necmettin, Meco, Basak Ceyda, Akyol, Onat, Derman, Suleyman S., Kennedy, Barry, Parhar, Ken, Srinivasa, Latha, Mcnamee, Lia, Mcauley, Danny, Hopkins, Phil, Mellis, Clare, Kakar, Vivek, Hadfield, Dan, Vercueil, Andre, Bhowmick, Kaushik, Humphreys, Sally K., Ferguson, Andrew, Mckee, Raymond, Raj, Ashok, Fawkes, Danielle A., Watt, Philip, Twohey, Linda, Jha, Rajeev, Thomas, Matthew, Morton, Alex, Kadaba, Varsha, Smith, Mark, Hormis, Anil P., Kannan, Santhana, Namih, Miriam, Reschreiter, Henrik, Camsooksai, Julie, Kumar, Alek, Rugonfalvi, Szabolcs, Nutt, Christopher, Oneill, Orla, Seasman, Colette, Dempsey, Ged, Scott, Christopher, Ellis, Helen E., Mckechnie, Stuart, Hutton, Paula J., Di Tomasso, Nora, Vitale, Michela N., Griffin, Ruth, Dean, Michael N., Cranshaw, Julius, Willett, Emma L., Ioannou, Nicholas, Gillis, Sarah, Csabi, Peter, Macfadyen, Rosaleen, Dawson, Heidi, Preez, Pieter, Williams, Alexandra J., Boyd, Owen, de Gordoa, Laura Ortiz-Ruiz, Bramall, Jon, Symmonds, Sophie, Chau, Simon, Wenham, Tim, Szakmany, Tamas, Toth-Tarsoly, Piroska, Mccalman, Katie, Alexander, Peter, Stephenson, Lorraine, Collyer, Thomas, Chapman, Rhiannon, Cooper, Raphael, Allan, Russell, Sim, Malcolm, Wrathall, David, Irvine, Donald A., Zantua, Kim, Adams, John C., Burtenshaw, Andrew, Sellors, Gareth P., Welters, Ingeborg, Williams, Karen E., Hessell, Robert, Oldroyd, Matthew G., Battle, Ceri, Pillai, Suresh, Kajtor, Istvan, Sivashanmugavel, Mageswaran, Okane, Sinead, Donnelly, Adrian, Frigyik, Aniko, Careless, Jon P., May, Martin, Stewart, Richard, Trinder, T. John, Hagan, Samantha J., Wise, Matt, Cole, Jade M., Macfie, Caroline, Dowling, Anna T., Hurtado, Javier, Nin, Nicolás, Nuñez, Edgardo, Pittini, Gustavo, Rodriguez, Ruben, Imperio, María C., Santos, Cristina, França, Ana, Ebeid, Alejandro, Deicas, Alberto, Serra, Carolina, Uppalapati, Aditya, Kamel, Ghassan, Banner-Goodspeed, Valerie, Beitler, Jeremy R., Mukkera, Satyanarayana Reddy, Kulkarni, Shreedhar, Lee, Jarone, Mesar, Tomaz, Tainter, Christopher, Shinn Iii, John O., Gomaa, Dina, Yeatts, Dale, Warren, Jessica, Lanspa, Michael, Miller, Russel R., Grissom, Colin K., Brown, Samuel M., Bauer, Philippe, Gosselin, Ryan, Kitch, Barrett T., Cohen, Jason, Beegle, Scott H., Choudry, Shazia, Gueret, Renaud, Tulaimat, Aiman, Stigler, William, Batra, Hitesh, Huff, Nidhi, Lamb, Keith, Oetting, Trevor W., Mohr, Nicholas, Judy, Claine, Saito, Shigeki, Kheir, Fayez M., Kheir, Fayez, Schlichting, Adam, Delsing, Angela, Crouch, Daniel, Elmasri, Mary, Ismail, Dina, Dreyer, Kyle, Blakeman, Thomas C., Baron, Rebecca, Grijalba, Carolina Quintana, Hou, Peter, Seethala, Raghu, Aisiku, Imo, Henderson, Galen, Frendl, Gyorgy, Hou, Sen-Kuang, Owens, Robert L., Schomer, Ashley, Bumbasirevic, Vesna, Jovanovic, Bojan, Surbatovic, Maja, Veljovic, Milic, Francois, Guy, Rabboni, Francesca, Conti, Sara, Rios, Fernando, Sottiaux, T., Depuydt, P., Lora, Fredy, Azevedo, Luciano Cesar, Fan, Eddy, Bugedo, Guillermo, Gonzalez, Marcos, Silesky, Juan, Cerny, Vladimir, Jibaja, Manuel, Wrigge, Hermann, Matamis, Dimitrios, Ranero, Jorge Luis, Amin, Pravin, Hashemian, S. M., Kurahashi, Kiyoyasu, Villagomez, Asisclo, Palo, Jose Emmanuel, do Vale Fernandes, Antero, Sandesc, Dorel, Arabi, Yaasen, Bumbasierevic, Vesna, Lorente, Jose A., Larsson, Anders, Abroug, Fekri, Mcauley, Daniel, Bajwa, Ed, Démpair, Gabriel, Cortegiani, A., Madotto, F., Gregoretti, C., Bellani, G., Laffey, J. G., Pham, T., Van Haren, F., Giarratano, A., Antonelli, M., Pesenti, A., Grasselli, G., Sula, H., Nunci, L., Cani, A., Zazu, A., Dellera, C., Insaurralde, C. S., 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., Depuydt, P., Vermassen, J., Meersseman, P., Ceunen, H., Rosa, J. I., Beraldo, D. O., Piras, C., Rampinelli, A. M., Nassar, A. P., Mataloun, S., Moock, M., Thompson, M. M., Goncalves, C. H., Antonio, A. C. P., Ascoli, A., Biondi, R. S., Fontenele, D. C., Nobrega, D., Sales Brunei, V. M., Shindhe, S., Binti Pengiran Haji Ismail, D. H. M. A., Beloncle, F., Davies, K. G., Cirone, R., Manoharan, V., Ismail, M., Goligher, E. C., Jassal, M., Nishikawa, E., Javeed, A., Curley, G., Rittayamai, N., Parotto, M., Ferguson, N. D., Mehta, S., Knoll, J., Pronovost, A., Canestrini, S., Bruhn, A. R., Garcia, P. H., Aliaga, F. A., Farias, P. A., Yumha, J. S., Ortiz, C. A., Salas, J. E., Saez, A. A., Vega, L. D., Labarca, E. F., Martinez, F. T., Carreno, N. G., Lora, P., Liu, H., Qiu, H., Liu, L., Tang, R., Luo, X., An, Y., Zhao, H., Gao, Y., Zhai, Z., Ye, Z. L., Wang, W., Li, W., Li, Q., Zheng, R., Yu, W., Shen, J., Li, X., Yu, T., Lu, W., Wu, Y. Q., Huang, X. B., He, Z., Lu, Y., Han, H., Zhang, F., Sun, R., Wang, H. X., Qin, S. H., Zhu, B. H., Zhao, J., Liu, J., Li, B., Liu, J. L., Zhou, F. C., Li, Q. J., Zhang, X. Y., Li-Xin, Z., Xin-Hua, Q., Jiang, L., Gao, Y. N., Zhao, X. Y., Li, Y. Y., Li, X. L., Wang, C., Yao, Q., Yu, R., Chen, K., Shao, H., Qin, B., Huang, Q. Q., Zhu, 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., Silesky Jimenez, J. I., Rojas, M. A. G., Solis-Quesada, J. E., Ramirez-Alfaro, C. M., Maca, J., Sklienka, P., Gjedsted, J., Christiansen, A., Nielsen, J., 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., Follin, A., Roux, D., Messika, J., Kalaitzis, E., Dangers, L., Combes, A., Au, S. -M., Beduneau, G., Carpentier, D., Zogheib, E. H., Dupont, H., Ricome, S., Santoli, F. L., Besset, S. L., Michel, P., Gelee, 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., Moal, C. L., Sauvadet, E. P., Robine, A., Lemiale, V., Reuter, D., Dres, M., Demoule, A., Goldgran-Toledano, D., Baboi, L., Guerin, C., Lohner, R., Krabler, J., Schafer, 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., Citalan, 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., Hashemian, S. M., 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., 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. 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A., 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., Heunks, L. M., Van Wezel, H. M., Heines, S. J., Strauch, U., Buise, M. P., Simonis, F. D., Schultz, M. J., 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., Laake, J. H., Barratt-Due, A., Noremark, K. L., Soreide, E., Sjobo, B. A., Guttormsen, A. B., Leon Yoshido, H. H., Aguilar, R. Z., Oscanoa, F. A. M., Alisasis, A. U., Robles, J. B., Pasanting-Lim, R. 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. 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P., Blanco, J., Yuste, L. J., Carbayo-Gorriz, C., Cazorla-Barranquero, F. G., Alonso, J. G., Alda, R. S., Algaba, A., 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., Gonzalez, R. M., Toribio, D. P., Castro, A. G., Artiga, M. J. D., Penuelas, O., Roser, T. P., Olga, M. F., Curto, E. G., Sanchez, R. M., Imma, V. P., Elisabet, G. M., Claverias, L., Magret, M., Pellicer, A. M., Rodriguez, L. L., Sanchez-Ballesteros, J., Gonzalez-Salamanca, A., Jimenez, A. G., Huerta, F. P., Sotillo Diaz, J. J., Lopez, E. B., Llinares Moya, D. D., 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., Schioler, 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., Piquilloud, L., 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., Unal, N., Meco, B. C., Akyol, O. O., Derman, S. S., Kennedy, B., Parhar, K., Srinivasa, L., Mcnamee, 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., Jha, R. R., Thomas, 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., Oneill, 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., 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., Okane, 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., Hurtado, J., Nin, N., Nunez, E., Pittini, G., Rodriguez, R., Imperio, M. C., Santos, C., Franca, 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., Tainter, C., Shinn Iii, J. O., Gomaa, D., 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., Choudry, S., Gueret, R. M., Tulaimat, A., 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., Francois, G. M., Rabboni, F., Conti, S., Rios, F., Sottiaux, T., Lora, F. S., Azevedo, L. C., Fan, E., Bugedo, G., Gonzalez, M., Silesky, J., Cerny, V., Jibaja, M., Wrigge, H., Matamis, D., Ranero, J. L., Amin, P., Clarkson, K., Kurahashi, K., Villagomez, A., Palo, J. E., do Vale Fernandes, A., Sandesc, D., Arabi, Y., Bumbasierevic, V., Lorente, J. A., Larsson, A., Abroug, F., Mcauley, D. F., Bajwa, E., Dempair, G., Intensive Care Medicine, AII - Inflammatory diseases, ACS - Diabetes & metabolism, ACS - Pulmonary hypertension & thrombosis, ACS - Microcirculation, Department of Medicine and Surgery [Monza, Italy] (Research Center on Public Health), Università degli Studi di Milano-Bicocca [Milano] (UNIMIB), Pulmonary Engineering Group, Department of Anaesthesiology and Intensive Care Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany, Sorbonne Université (SU), 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), UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (MGD) Services des soins intensifs, UCL - (SLuc) Service de soins intensifs, Cortegiani, A, Madotto, F, Gregoretti, C, Bellani, G, Laffey, J, Pham, T, Van Haren, F, Giarratano, A, Antonelli, M, Pesenti, A, Grasselli, G, Cortegiani, Andrea, Madotto, Fabiana, Gregoretti, Cesare, Bellani, Giacomo, Laffey, John G., Pham, Tai, Van Haren, Frank, Giarratano, Antonino, Antonelli, Massimo, Pesenti, Antonio, Grasselli, Giacomo, Sula, Hektor, Nunci, Lordian, Cani, Alma, Zazu, Alan, Dellera, Christian, Insaurralde, Carolina S., Alejandro, Risso V., Daldin, Julio, Vinzio, Mauricio, Fernandez, Ruben O., Cardonnet, Luis P., Bettini, Lisandro R., Bisso, Mariano Carboni, Osman, Emilio M., Setten, Mariano G., Lovazzano, Pablo, Alvarez, Javier, Villar, Veronica, Pozo, Norberto C., Grubissich, Nicola, Plotnikow, Gustavo A., Vasquez, Daniela N., Ilutovich, Santiago, Tiribelli, Norberto, Chena, Ariel, Pellegrini, Carlos A., Saenz, María G., Estenssoro, Elisa, Brizuela, Matia, Gianinetto, Hernan, Gomez, Pablo E., Cerrato, Valeria I., Bezzi, Marco G., Borello, Silvina A., Loiacono, Flavia A., Fernandez, Adriana M., Knowles, Serena, Reynolds, Claire, Inskip, Deborah M., Miller, Jennene J., Kong, Jing, Whitehead, Christina, Bihari, Shailesh, Seven, Aylin, Krstevski, Amanda, Rodgers, Helen J., Millar, Rebecca T., Mckenna, Toni E., Bailey, Irene M., Hanlon, Gabrielle C., Aneman, Ander, Lynch, Joan M., Azad, Raman, Neal, John, Woods, Paul W., Roberts, Brigit L., Kol, Mark R., Wong, Helen S., Riss, Katharina C., Staudinger, Thoma, Wittebole, Xavier, Berghe, Caroline, Bulpa, Pierre A., Dive, Alain M., Verstraete, Rik, Lebbinck, Herve, Depuydt, Pieter, Vermassen, Jori, Meersseman, Philippe, Ceunen, Helga, Rosa, Jonas I., Beraldo, Daniel O., Piras, Claudio, Rampinelli, Adenilton M., Nassar, Antonio P., Mataloun, Sergio, Moock, Marcelo, Thompson, Marlus M., Gonçalves, Claudio H., Antônio, Ana Carolina P., Ascoli, Aline, Biondi, Rodrigo S., Fontenele, Danielle C., Nobrega, Danielle, Sales Brunei, Vanessa M., Shindhe, Suresh, Binti Pengiran Haji Ismail, Dayangku Hajah Maizatul Aiman, Laffey, John, Beloncle, Francoi, Davies, Kyle G., Cirone, Rob, Manoharan, Venika, Ismail, Mehvish, Goligher, Ewan C., Jassal, Mandeep, Nishikawa, Erin, Javeed, Areej, Curley, Gerard, Rittayamai, Nuttapol, Parotto, Matteo, Ferguson, Niall D., Mehta, Sangeeta, Knoll, Jenny, Pronovost, Antoine, Canestrini, Sergio, Bruhn, Alejandro R., Garcia, Patricio H., Aliaga, Felipe A., Farías, Pamela A., Yumha, Jacob S., Ortiz, Claudia A., Salas, Javier E., Saez, Alejandro A., Vega, Luis D., Labarca, Eduardo F., Martinez, Felipe T., Carreño, Nicolás G., Lora, Pilar, Liu, Haitao, Qiu, Haibo, Liu, Ling, Tang, Rui, Luo, Xiaoming, An, Youzhong, Zhao, Huiying, Gao, Yan, Zhai, Zhe, Ye, Zheng L., Wang, Wei, Li, Wenwen, Li, Qingdong, Zheng, Ruiqiang, Yu, Wenkui, Shen, Juanhong, Li, Xinyu, Yu, Tao, Lu, Weihua, Wu, Ya, Huang, Xiao B., He, Zhenyang, Lu, Yuanhua, Han, Hui, Zhang, Fan, Sun, Renhua, Wang, Hua, Qin, Shu H., Zhu, Bao, Zhao, Jun, Liu, Jian, Li, Bin, Liu, Jing, Zhou, Fa C., Li, Qiong, Zhang, Xing Y., Li-Xin, Zhou, Xin-Hua, Qiang, Jiang, Liangyan, Gao, Yuan, Zhao, Xian Y., Li, Yuan, Li, Xiao L., Wang, Chunting, Yao, Qingchun, Yu, Rongguo, Chen, Kai, Shao, Huanzhang, Qin, Bingyu, Huang, Qing, Zhu, Wei H., Hang, Ai, Hua, Ma X., Li, Yimin, Xu, Yonghao, Di, Yu, Ling, Long L., Qin, Tie, Wang, Shou H., Qin, Junping, Han, Yi, Zhou, Suming, Vargas, Monica, Silesky Jimenez, Juan, Rojas, Manuel A. 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Hanane, Benslama, Abdellatif, Amor, Mourad, Maazouzi, Wajdi, Cimic, Nedim, Beck, Oliver, Bruns, Monique, Schouten, Jeroen A., Rinia, Myra, Raaijmakers, Monique, Heunks, Leo, Van Wezel, Hellen M., Heines, Serge, Strauch, Ulrich, Buise, Marc, Simonis, Fabienne, Schultz, Marcus J., Goodson, Jennifer, Browne, Troy S., Navarra, Leanlove, Hunt, Anna, Hutchison, Robyn, Bailey, Mathew B., Newby, Lynette, Mcarthur, Colin, Kalkoff, Michael, Mcleod, Alex, Casement, Jonathan, Hacking, Danielle J., Andersen, Finn, Dolva, Merete S., Laake, Jon, Barratt-Due, Andrea, Noremark, Kim Andre, Søreide, Eldar, Sjøbø, Brit A., Guttormsen, Anne B., Leon Yoshido, Hector, Aguilar, Ronald Zumaran, Oscanoa, Fredy A. Monte, Alisasis, Alain, Robles, Joanne B., Pasanting-Lim, Rossini Abbie, Tan, Beatriz C., Andruszkiewicz, Pawel, Jakubowska, Karina, Coxo, Cristina, Alvarez, António, Oliveira, Bruno S., Montanha, Gustavo, Barros, Nelson C., Pereira, Carlo, Messias, António M., Monteiro, Jorge, Araujo, Ana, Catorze, Nuno T., Marum, Susan, Bouw, Maria J., Gomes, Rui, Brito, Vania A., Castro, Silvia, Estilita, Joana M., Barros, Filipa, Serra Aurelia, Isabel, Tomescu, Dana, Marcu, Alexandra, Bedreag, Ovidiu, Papurica, Mariu, Corneci, Dan, Negoita, Silvius Ioan, Grigoriev, Evgeny, Gritsan, Alexey, Gazenkampf, Andrey A., Almekhlafi, Ghaleb, Albarrak, Mohamad M., Mustafa, Ghanem M., Maghrabi, Khalid, Salahuddin, Nawal, Aisa, Tharwat, Al Jabbary, Ahmed, Tabhan, Edgardo, Arabi, Yaseen M., Trinidad, Olivia A., Al Dorzi, Hasan M., Tabhan, Edgardo E., Bolon, Stefan, Smith, Oliver, Mancebo, Jordi, Aguirre-Bermeo, Hernan, Lopez-Delgado, Juan, Esteve, Francisco, Rialp, Gemma, Forteza, Catalina, de Haro, Candelaria, Artigas, Antonio, Albaiceta, Guillermo, de Cima-Iglesias, Sara, Seoane-Quiroga, Leticia, Ceniceros-Barros, Alexandra, Ruiz-Aguilar, Antonio, Claraco-Vega, Luis M., Soler, Juan Alfonso, Lorente, Maria del Carmen, Hermosa, Cecilia, Gordo, Federico, Prieto-González, Miryam, López-Messa, Juan B., Perez, Manuel, Perez, Cesar P., Allue, Raquel Montoiro, Roche-Campo, Ferran, Ibañez-Santacruz, Marco, Temprano, Susana, Pintado, Maria, de Pablo, Raul, Gómez, Pilar Ricart Aroa, Ruiz, Silvia Rodriguez, Moles, Silvia Iglesia, Jurado, Maria Teresa, Arizmendi, Alfon, Piacentini, Enrique, Franco, Nieve, Honrubia, Teresa, Cheng, Meisy Perez, Losada, Elena Perez, Blanco, Javier, Yuste, Luis J., Carbayo-Gorriz, Cecilia, Cazorla-Barranquero, Francisca G., Alonso, Javier, 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, Artiga, Maria Jose D., Penuelas, Oscar, Roser, Toma, Olga, Moreno F., Curto, Elena Gallego, Sánchez, Rocío Manzano, Imma, Vallverdu, Elisabet, Garcia M., Claverias, Laura, Magret, Monica, Pellicer, Ana, Rodriguez, Lucia L., Sánchez-Ballesteros, Jesú, González-Salamanca, Ángela, Jimenez, Antonio, Huerta, Francisco P., Sotillo Diaz, Juan Carlo, Lopez, Esther Bermejo, Llinares Moya, David, Alfonso, Alec A. Tallet, Luis, Palazon Sanchez Eugenio, Cesar, Palazon Sanchez, Rafael, Sánchez I., Virgilio, Corcoles G., Recio, Noelia, Adamsson, Richard, Rylander, Christian C., Holzgraefe, Bernhard, Broman, Lars M., Wessbergh, Joanna, Persson, Linnea, Schiöler, Fredrik, Kedelv, Han, Tibblin, Anna Oscarsson, Appelberg, Henrik, Hedlund, Lar, Helleberg, Johan, Eriksson, Karin, Glietsch, Rita, Larsson, Nikla, Nygren, Ingela, Nunes, Silvia, Morin, Anna-Karin, Kander, Thoma, Adolfsson, Anne, Piquilloud, Lise, Zender, Hervé, Leemann-Refondini, Corinne, Elatrous, Souheil, Bouchoucha, Slaheddine, Chouchene, Imed, Ouanes, Islem, Souissi, Asma Ben, Kamoun, Salma, Demirkiran, Oktay, Aker, Mustafa, Erbabacan, Emre, Ceylan, Ilkay, Girgin, Nermin Kelebek, Ozcelik, Menekse, ünal, Necmettin, Meco, Basak Ceyda, Akyol, Onat, Derman, Suleyman S., Kennedy, Barry, Parhar, Ken, Srinivasa, Latha, McNamee, Lia, McAuley, Danny, Hopkins, Phil, Mellis, Clare, Kakar, Vivek, Hadfield, Dan, Vercueil, Andre, Bhowmick, Kaushik, Humphreys, Sally K., Ferguson, Andrew, Mckee, Raymond, Raj, Ashok, Fawkes, Danielle A., Watt, Philip, Twohey, Linda, Jha, Rajeev, Thomas, Matthew, Morton, Alex, Kadaba, Varsha, Smith, Mark, Hormis, Anil P., Kannan, Santhana, Namih, Miriam, Reschreiter, Henrik, Camsooksai, Julie, Kumar, Alek, Rugonfalvi, Szabolc, Nutt, Christopher, Oneill, Orla, Seasman, Colette, Dempsey, Ged, Scott, Christopher, Ellis, Helen E., Mckechnie, Stuart, Hutton, Paula J., Di Tomasso, Nora, Vitale, Michela N., Griffin, Ruth, Dean, Michael N., Cranshaw, Juliu, Willett, Emma L., Ioannou, Nichola, Gillis, Sarah, Csabi, Peter, Macfadyen, Rosaleen, Dawson, Heidi, Preez, Pieter, Williams, Alexandra J., Boyd, Owen, de Gordoa, Laura Ortiz-Ruiz, Bramall, Jon, Symmonds, Sophie, Chau, Simon, Wenham, Tim, Szakmany, Tama, Toth-Tarsoly, Piroska, Mccalman, Katie, Alexander, Peter, Stephenson, Lorraine, Collyer, Thoma, Chapman, Rhiannon, Cooper, Raphael, Allan, Russell, Sim, Malcolm, Wrathall, David, Irvine, Donald A., Zantua, Kim, Adams, John C., Burtenshaw, Andrew, Sellors, Gareth P., Welters, Ingeborg, Williams, Karen E., Hessell, Robert, Oldroyd, Matthew G., Battle, Ceri, Pillai, Suresh, Kajtor, Istvan, Sivashanmugavel, Mageswaran, Okane, Sinead, Donnelly, Adrian, Frigyik, Aniko, Careless, Jon P., May, Martin, Stewart, Richard, Trinder, T. John, Hagan, Samantha J., Wise, Matt, Cole, Jade M., MacFie, Caroline, Dowling, Anna T., Hurtado, Javier, Nin, Nicolá, Nuñez, Edgardo, Pittini, Gustavo, Rodriguez, Ruben, Imperio, María C., Santos, Cristina, França, Ana, Ebeid, Alejandro, Deicas, Alberto, Serra, Carolina, Uppalapati, Aditya, Kamel, Ghassan, Banner-Goodspeed, Valerie, Beitler, Jeremy R., Mukkera, Satyanarayana Reddy, Kulkarni, Shreedhar, Lee, Jarone, Mesar, Tomaz, Tainter, Christopher, Shinn Iii, John O., Gomaa, Dina, Yeatts, Dale, Warren, Jessica, Lanspa, Michael, Miller, Russel R., Grissom, Colin K., Brown, Samuel M., Bauer, Philippe, Gosselin, Ryan, Kitch, Barrett T., Cohen, Jason, Beegle, Scott H., Choudry, Shazia, Gueret, Renaud, Tulaimat, Aiman, Stigler, William, Batra, Hitesh, Huff, Nidhi, Lamb, Keith, Oetting, Trevor W., Mohr, Nichola, Judy, Claine, Saito, Shigeki, Kheir, Fayez M., Kheir, Fayez, Schlichting, Adam, Delsing, Angela, Crouch, Daniel, Elmasri, Mary, Ismail, Dina, Dreyer, Kyle, Blakeman, Thomas C., Baron, Rebecca, Grijalba, Carolina Quintana, Hou, Peter, Seethala, Raghu, Aisiku, Imo, Henderson, Galen, Frendl, Gyorgy, Hou, Sen-Kuang, Owens, Robert L., Schomer, Ashley, Bumbasirevic, Vesna, Jovanovic, Bojan, Surbatovic, Maja, Veljovic, Milic, Francois, Guy, Rabboni, Francesca, Conti, Sara, Rios, Fernando, Lora, Fredy, Azevedo, Luciano Cesar, Fan, Eddy, Bugedo, Guillermo, Gonzalez, Marco, Silesky, Juan, Cerny, Vladimir, Jibaja, Manuel, Wrigge, Hermann, Matamis, Dimitrio, Ranero, Jorge Lui, Amin, Pravin, Hashemian, S.M., Kurahashi, Kiyoyasu, Villagomez, Asisclo, Palo, Jose Emmanuel, do Vale Fernandes, Antero, Sandesc, Dorel, Arabi, Yaasen, Bumbasierevic, Vesna, Lorente, Jose A., Larsson, Ander, Abroug, Fekri, McAuley, Daniel, Bajwa, Ed, and Démpair, Gabriel
Subjects: Male, ARDS, modelos logísticos, Databases, Factual, medicine.medical_treatment, [SDV]Life Sciences [q-bio], humanos, lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], Kaplan-Meier Estimate, Critical Care and Intensive Care Medicine, Acute respiratory failure, Severity of Illness Index, Cohort Studies, randomized-trial, 0302 clinical medicine, Mechanical ventilation, Risk Factors, estudios prospectivos, Epidemiology, 80 and over, icu, Medicine, Prospective Studies, Prospective cohort study, estudios de cohortes, Immunodeficiency, mediana edad, estadísticas, Aged, 80 and over, Respiratory Distress Syndrome, anciano, critically-ill patients, Respiration, resultado del tratamiento, respiración, Statistics, lcsh:Medical emergencies. Critical care. Intensive care. First aid, adulto, Middle Aged, 3. Good health, failure, Intensive Care Units, Treatment Outcome, Artificial, Cohort, prospective multicenter, Immunocompromised patients, Noninvasive ventilation, Female, Human, estimación de Kaplan-Meier, Adult, medicine.medical_specialty, Logistic Model, Intensive Care Unit, Socio-culturale, unidades de cuidados intensivos, survival, Statistics, Nonparametric, Sepsis, Databases, 03 medical and health sciences, Immunocompromised Host, Internal medicine, Immunocompromised patient, cancer, factores de riesgo, Humans, Nonparametric, índice de gravedad de la enfermedad, intensive-care-unit, Factual, Aged, business.industry, Research, Risk Factor, Respiratory Distress Syndrome, Adult, 030208 emergency & critical care medicine, lcsh:RC86-88.9, medicine.disease, Respiration, Artificial, Pneumonia, Prospective Studie, Logistic Models, 030228 respiratory system, malignancies, huésped inmunodeprimido, Cohort Studie, business
Abstract: Background: The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients. Methods: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents. Results: Of 2813 patients with ARDS, 584 (20.8%) were immunocompromised, 38.9% of whom had an unspecified cause. Pneumonia, nonpulmonary sepsis, and noncardiogenic shock were their most common risk factors for ARDS. Hospital mortality was higher in immunocompromised than in immunocompetent patients (52.4% vs 36.2%; p < 0.0001), despite similar severity of ARDS. Decisions regarding limiting life- sustaining measures were significantly more frequent in immunocompromised patients (27.1% vs 18.6%; p < 0.0001). Use of noninvasive ventilation (NIV) as first-line treatment was higher in immunocompromised patients (20.9% vs 15.9%; p = 0.0048), and immunodeficiency remained independently associated with the use of NIV after adjustment for confounders. Forty-eight percent of the patients treated with NIV were intubated, and their mortality was not different from that of the patients invasively ventilated ab initio. Conclusions: Immunosuppression is frequent in patients with ARDS, and infections are the main risk factors for ARDS in these immunocompromised patients. Their management differs from that of immunocompetent patients, particularly the greater use of NIV as first-line ventilation strategy. Compared with immunocompetent subjects, they have higher mortality regardless of ARDS severity as well as a higher frequency of limitation of life-sustaining measures. Nonetheless, nearly half of these patients survive to hospital discharge., The authors received no funding for this study. However, the LUNG SAFE study was funded and supported by the European Society of Intensive Care Medicine (ESICM; Brussels, Belgium), St. Michael's Hospital (Toronto, ON, Canada), and the University of Milano-Bicocca (Monza, Italy).
Published: 2018

14. Symptoms of Anxiety, Depression, and Peritraumatic Dissociation in Critical Care Clinicians Managing Patients with COVID-19. A Cross-Sectional Study.

Author: Azoulay, Elie, Cariou, Alain, Bruneel, Fabrice, Demoule, Alexandre, Kouatchet, Achille, Reuter, Danielle, Souppart, Virginie, Combes, Alain, Klouche, Kada, Argaud, Laurent, Barbier, François, Jourdain, Mercé, Reignier, Jean, Papazian, Laurent, Guidet, Bertrand, Géri, Guillaume, Resche-Rigon, Matthieu, Guisset, Olivier, Labbé, Vincent, and Mégarbane, Bruno
Subjects: CORONAVIRUS disease treatment, VIRAL pneumonia, RESEARCH, CROSS-sectional method, RESEARCH methodology, POST-traumatic stress disorder, MEDICAL personnel, COVID-19, EVALUATION research, MEDICAL cooperation, COMPARATIVE studies, PSYCHOLOGICAL tests, MENTAL depression, PSYCHOSOCIAL factors, DISEASE prevalence, EPIDEMICS, CRITICAL care medicine, PATIENT-family relations, ANXIETY, PSYCHOLOGICAL stress
Abstract: Rationale: Frontline healthcare providers (HCPs) during the coronavirus disease (COVID-19) pandemic are at high risk of mental morbidity.Objectives: To assess the prevalence of symptoms of anxiety, depression, and peritraumatic dissociation in HCPs.Methods: This was a cross-sectional study in 21 ICUs in France between April 20, 2020, and May 21, 2020. The Hospital Anxiety and Depression Scale and the Peritraumatic Dissociative Experience Questionnaire were used. Factors independently associated with reported symptoms of mental health disorders were identified.Measurements and Main Results: The response rate was 67%, with 1,058 respondents (median age 33 yr; 71% women; 68% nursing staff). The prevalence of symptoms of anxiety, depression, and peritraumatic dissociation was 50.4%, 30.4%, and 32%, respectively, with the highest rates in nurses. By multivariable analysis, male sex was independently associated with lower prevalence of symptoms of anxiety, depression, and peritraumatic dissociation (odds ratio of 0.58 [95% confidence interval, 0.42-0.79], 0.57 [95% confidence interval, 0.39-0.82], and 0.49 [95% confidence interval, 0.34-0.72], respectively). HCPs working in non-university-affiliated hospitals and nursing assistants were at high risk of symptoms of anxiety and peritraumatic dissociation. Importantly, we identified the following six modifiable determinants of symptoms of mental health disorders: fear of being infected, inability to rest, inability to care for family, struggling with difficult emotions, regret about the restrictions in visitation policies, and witnessing hasty end-of-life decisions.Conclusions: HCPs experience high levels of psychological burden during the COVID-19 pandemic. Hospitals, ICU directors, and ICU staff must devise strategies to overcome the modifiable determinants of adverse mental illness symptoms. [ABSTRACT FROM AUTHOR]
Published: 2020
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15. Elaboration of Consensus Clinical Endpoints to Evaluate Antimicrobial Treatment Efficacy in Future Hospital-acquired/Ventilator-associated Bacterial Pneumonia Clinical Trials.

Author: Weiss, Emmanuel, Zahar, Jean-Ralph, Alder, Jeff, Asehnoune, Karim, Bassetti, Matteo, Bonten, Marc J M, Chastre, Jean, Waele, Jan De, Dimopoulos, George, Eggimann, Philippe, Engelhardt, Marc, Ewig, Santiago, Kollef, Marin, Lipman, Jeffrey, Luna, Carlos, Martin-Loeches, Ignacio, Pagani, Leonardo, Palmer, Lucy B, Papazian, Laurent, and Poulakou, Garyphallia
Subjects: ANTI-infective agents, ARTIFICIAL respiration, CONSENSUS (Social sciences), CRITICAL care medicine, CROSS infection, DELPHI method, PHARMACEUTICAL industry, PNEUMONIA, SURVIVAL, TREATMENT effectiveness, DISEASE progression, VENTILATOR-associated pneumonia, EVALUATION
Abstract: Background Randomized clinical trials (RCTs) in hospital-acquired and ventilator-associated bacterial pneumonia (HABP and VABP, respectively) are important for the evaluation of new antimicrobials. However, the heterogeneity in endpoints used in RCTs evaluating treatment of HABP/VABP may puzzle clinicians. The aim of this work was to reach a consensus on clinical endpoints to consider in future clinical trials evaluating antimicrobial treatment efficacy for HABP/VABP. Methods Twenty-six international experts from intensive care, infectious diseases, and the pharmaceutical industry were polled using the Delphi method. Results The panel recommended a hierarchical composite endpoint including, by priority order, (1) survival at day 28, (2) mechanical ventilation–free days through day 28, and (3) clinical cure between study days 7 and 10 for VABP; and (1) survival (day 28) and (2) clinical cure (days 7–10) for HABP. Clinical cure was defined as the combination of resolution of signs and symptoms present at enrollment and improvement or lack of progression of radiological signs. More than 70% of the experts agreed to assess survival and mechanical ventilation–free days though day 28, and clinical cure between day 7 and day 10 after treatment initiation. Finally, the hierarchical order of endpoint components was reached after 3 Delphi rounds (72% agreement). Conclusions We provide a multinational expert consensus on separate hierarchical composite endpoints for VABP and HABP, and on a definition of clinical cure that could be considered for use in future HABP/VABP clinical trials. [ABSTRACT FROM AUTHOR]
Published: 2019
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16. The leukocyte-stiffening property of plasma in early acute respiratory distress syndrome (ARDS) revealed by a microfluidic single-cell study: the role of cytokines and protection with antibodies

Author: Preira, Pascal, Forel, Jean-Marie, Robert, Philippe, Nègre, Paulin, Biarnes-Pelicot, Martine, Xeridat, Francois, Bongrand, Pierre, Papazian, Laurent, Theodoly, Olivier, Laboratoire d'Immunologie [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Centre National de la Recherche Scientifique (CNRS), Adhésion et Inflammation (LAI), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Service de réanimation-Détresses Respiratoires et Infections Sévères [Hôpital Nord - APHM] (DRIS), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], The authors thank the Provence Alpes Côte d’Azur region and Capsum SAS fortheir financial support of PP’s doctoral grant, the Solvay company (LOF, Pessac,France), and F. Bedu and I. Ozerov (CINaM, CNRS UPR 3118, Marseilles, France) fortechnical support with microfabrication, Labex INFORM for financial support., Assistance Publique - Hôpitaux de Marseille (APHM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Hôpital Nord [CHU - APHM]-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), and BMC, BMC
Subjects: Adult, Male, ARDS, [SDV]Life Sciences [q-bio], Microfluidics, CD18, CD11a, Critical Care and Intensive Care Medicine, Antibodies, Plasma, 03 medical and health sciences, 0302 clinical medicine, Leukocytes, medicine, Humans, Prospective Studies, Lung, Aged, Aged, 80 and over, Respiratory Distress Syndrome, biology, Septic shock, business.industry, Research, Interleukin, 030208 emergency & critical care medicine, Pneumonia, Middle Aged, medicine.disease, 3. Good health, [SDV] Life Sciences [q-bio], medicine.anatomical_structure, Integrin alpha M, Immunology, biology.protein, Cytokines, Female, Tumor necrosis factor alpha, business, Cell Adhesion Molecules, 030215 immunology
Abstract: Background Leukocyte-mediated pulmonary inflammation is a key pathophysiological mechanism involved in acute respiratory distress syndrome (ARDS). Massive sequestration of leukocytes in the pulmonary microvasculature is a major triggering event of the syndrome. We therefore investigated the potential role of leukocyte stiffness and adhesiveness in the sequestration of leukocytes in microvessels. Methods This study was based on in vitro microfluidic assays using patient sera. Cell stiffness was assessed by measuring the entry time (ET) of a single cell into a microchannel with a 6 × 9–μm cross-section under a constant pressure drop (ΔP = 160 Pa). Primary neutrophils and monocytes, as well as the monocytic THP-1 cell line, were used. Cellular adhesiveness to human umbilical vein endothelial cells was examined using the laminar flow chamber method. We compared the properties of cells incubated with the sera of healthy volunteers (n = 5), patients presenting with acute cardiogenic pulmonary edema (ACPE; n = 6), and patients with ARDS (n = 22), of whom 13 were classified as having moderate to severe disease and the remaining 9 as having mild disease. Results Rapid and strong stiffening of primary neutrophils and monocytes was induced within 30 minutes (mean ET >50 seconds) by sera from the ARDS group compared with both the healthy subjects and the ACPE groups (mean ET Conclusions The leukocyte stiffening induced by cytokines in the sera of patients might play a role in the sequestration of leukocytes in the lung capillary beds during early ARDS. The inhibition of leukocyte stiffening with blocking antibodies might inspire future therapeutic strategies.
Published: 2015
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17. Parachlamydiaceae as rare agents of pneumonia. (Letters)

Author: Greub, Gilbert, Berger, Pierre, Papazian, Laurent, and Raoult, Didier
Subjects: Bacterial pneumonia -- Research, Pneumonia
Abstract: To the Editor: Members of the Parachlamydiaceae family are emerging intracellular bacteria living in amoebae (1,2). Serologic studies have suggested that Parachlamydia acanthamoeba might be an agent of community-acquired pneumonia [...]
Published: 2003

18. Respective impact of implementation of prevention strategies, colonization with multiresistant bacteria and antimicrobial use on the risk of early- and late-onset VAP: An analysis of the OUTCOMEREA network.

Author: Ibn Saied, Wafa, Souweine, Bertrand, Garrouste-Orgeas, Maité, Ruckly, Stéphane, Darmon, Michael, Bailly, Sébastien, Cohen, Yves, Azoulay, Elie, Schwebel, Carole, Radjou, Aguila, Kallel, Hatem, Adrie, Christophe, Dumenil, Anne-Sylvie, Argaud, Laurent, Marcotte, Guillaume, Jamali, Samir, Papazian, Laurent, Goldgran-Toledano, Dany, Bouadma, Lila, and Timsit, Jean-Francois
Subjects: VENTILATOR-associated pneumonia, MULTIDRUG resistance in bacteria, ANTI-infective agents, DISEASE progression, THERAPEUTICS, DISEASE risk factors
Abstract: Rationale: The impact of prevention strategies and risk factors for early-onset (EOP) versus late-onset (LOP) ventilator-associated pneumonia (VAP) are still debated. Objectives: To evaluate, in a multicenter cohort, the risk factors for EOP and LOP, as the evolution of prevention strategies. Methods: 7,784 patients with mechanical ventilation (MV) for at least 48 hours were selected into the multicenter prospective OUTCOMEREA database (1997–2016). VAP occurring between the 3rd and 6th day of MV defined EOP, while those occurring after defined LOPs. We used a Fine and Gray subdistribution model to take the successful extubation into account as a competing event. Measurements and main results: Overall, 1,234 included patients developed VAP (EOP: 445 (36%); LOP: 789 (64%)). Male gender was a risk factor for both EOP and LOP. Factors specifically associated with EOP were admission for respiratory distress, previous colonization with multidrug-resistant Pseudomonas aeruginosa, chest tube and enteral feeding within the first 2 days of MV. Antimicrobials administrated within the first 2 days of MV were all protective of EOP. ICU admission for COPD exacerbation or pneumonia were early risk factors for LOP, while imidazole and vancomycin use within the first 2 days of MV were protective factors. Late risk factors (between the 3rd and the 6th day of MV) were the intra-hospital transport, PAO2-FIO2<200 mmHg, vasopressor use, and known colonization with methicillin-resistant Staphylococcus aureus. Among the antimicrobials administered between the 3rd and the 6th day, fluoroquinolones were the solely protective one.Contrarily to LOP, the risk of EOP decreased across the study time periods, concomitantly with an increase in the compliance with bundle of prevention measures. Conclusion: VAP risk factors are mostly different according to the pneumonia time of onset, which should lead to differentiated prevention strategies. [ABSTRACT FROM AUTHOR]
Published: 2017
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19. Initial nutritional management during noninvasive ventilation and outcomes: a retrospective cohort study.

Author: Terzi, Nicolas, Darmon, Michael, Reignier, Jean, Ruckly, Stéphane, Garrouste-Orgeas, Maïté, Lautrette, Alexandre, Azoulay, Elie, Mourvillier, Bruno, Argaud, Laurent, Papazian, Laurent, Gainnier, Marc, Goldgran-Toledano, Dan, Jamali, Samir, Dumenil, Anne-Sylvie, Schwebel, Carole, Timsit, Jean-François, and OUTCOMEREA study group
Subjects: ARTIFICIAL respiration, DIET therapy, ENTERAL feeding, INTENSIVE care units, LONGITUDINAL method, PARENTERAL feeding, RESPIRATORY insufficiency, RETROSPECTIVE studies
Abstract: Background: Patients starting noninvasive ventilation (NIV) to treat acute respiratory failure are often unable to eat and therefore remain in the fasting state or receive nutritional support. Maintaining a good nutritional status has been reported to improve patient outcomes. In the present study, our primary objective was to describe the nutritional management of patients starting first-line NIV, and our secondary objectives were to assess potential associations between nutritional management and outcomes.Methods: Observational retrospective cohort study of a prospective database fed by 20 French intensive care units. Adult medical patients receiving NIV for more than 2 consecutive days were included and divided into four groups on the basis of nutritional support received during the first 2 days of NIV: no nutrition, enteral nutrition, parenteral nutrition only, and oral nutrition only.Results: Of the 16,594 patients admitted during the study period, 1075 met the inclusion criteria; of these, 622 (57.9%) received no nutrition, 28 (2.6%) received enteral nutrition, 74 (6.9%) received parenteral nutrition only, and 351 (32.7%) received oral nutrition only. After adjustment for confounders, enteral nutrition (vs. no nutrition) was associated with higher 28-day mortality (adjusted HR, 2.3; 95% CI, 1.2-4.4) and invasive mechanical ventilation needs (adjusted HR, 2.1; 95% CI, 1.1-4.2), as well as with fewer ventilator-free days by day 28 (adjusted relative risk, 0.7; 95% CI, 0.5-0.9).Conclusions: Nearly three-fifths of patients receiving NIV fasted for the first 2 days. Lack of feeding or underfeeding was not associated with mortality. The optimal route of nutrition for these patients needs to be investigated. [ABSTRACT FROM AUTHOR]
Published: 2017
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20. Year in review in Intensive Care Medicine 2014: III. Severe infections, septic shock, healthcare-associated infections, highly resistant bacteria, invasive fungal infections, severe viral infections, Ebola virus disease and paediatrics.

Author: Timsit, Jean-François, Perner, Anders, Bakker, Jan, Bassetti, Matteo, Benoit, Dominique, Cecconi, Maurizio, Randall Curtis, J., Doig, Gordon, Herridge, Margaret, Jaber, Samir, Joannidis, Michael, Papazian, Laurent, Peters, Mark, Singer, Pierre, Smith, Martin, Soares, Marcio, Torres, Antoni, Vieillard-Baron, Antoine, Citerio, Giuseppe, and Azoulay, Elie
Subjects: CRITICAL care medicine, SEPSIS, SEPTIC shock, PNEUMONIA, MYCOSES
Abstract: The article reports publications from intensive care on severe infections, septic shock, healthcare and ventilator associated pneumonia, highly resistant bacteria, antimicrobial therapy, invasive fungal infections, severe viral infections, Ebola virus disease and paediatrics. Topics discussed include the physiology of circulation, venous return and hypovolemia and the role of the hypothalamic-pituitary-adrenal axis (HPA) in critically ill patients.
Published: 2015
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21. Inhaled Lactonase Reduces Pseudomonas aeruginosa Quorum Sensing and Mortality in Rat Pneumonia.

Author: Hraiech, Sami, Hiblot, Julien, Lafleur, John, Lepidi, Hubert, Papazian, Laurent, Rolain, Jean-Marc, Raoult, Didier, Elias, Mikael, Silby, Mark W., Bzdrenga, Janek, Bregeon, Fabienne, and Chabriere, Eric
Subjects: LACTONASE, PSEUDOMONAS aeruginosa infections, QUORUM sensing, LABORATORY rats, HOMOSERINE dehydrogenase
Abstract: Rationale: The effectiveness of antibiotic molecules in treating Pseudomonas aeruginosa pneumonia is reduced as a result of the dissemination of bacterial resistance. The existence of bacterial communication systems, such as quorum sensing, has provided new opportunities of treatment. Lactonases efficiently quench acyl-homoserine lactone-based bacterial quorum sensing, implicating these enzymes as potential new anti-Pseudomonas drugs that might be evaluated in pneumonia. Objectives: The aim of the present study was to evaluate the ability of a lactonase called SsoPox-I to reduce the mortality of a rat P. aeruginosa pneumonia. Methods: To assess SsoPox-I-mediated quorum quenching, we first measured the activity of the virulence gene lasB, the synthesis of pyocianin, the proteolytic activity of a bacterial suspension and the formation of biofilm of a PAO1 strain grown in the presence of lactonase. In an acute lethal model of P. aeruginosa pneumonia in rats, we evaluated the effects of an early or deferred intra-tracheal treatment with SsoPox-I on the mortality, lung bacterial count and lung damage. Measurements and Primary Results: SsoPox-I decreased PAO1 lasB virulence gene activity, pyocianin synthesis, proteolytic activity and biofilm formation. The early use of SsoPox-I reduced the mortality of rats with acute pneumonia from 75% to 20%. Histological lung damage was significantly reduced but the lung bacterial count was not modified by the treatment. A delayed treatment was associated with a non-significant reduction of mortality. Conclusion: These results demonstrate the protective effects of lactonase SsoPox-I in P. aeruginosa pneumonia and open the way for a future therapeutic use. [ABSTRACT FROM AUTHOR]
Published: 2014
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22. Year in review in Intensive Care Medicine 2013: III. Sepsis, infections, respiratory diseases, pediatrics.

Author: Timsit, Jean-Francois, Citerio, Giuseppe, Bakker, Jan, Bassetti, Matteo, Benoit, Dominique, Cecconi, Maurizio, Curtis, J., Hernandez, Glenn, Herridge, Margaret, Jaber, Samir, Joannidis, Michael, Papazian, Laurent, Peters, Mark, Singer, Pierre, Smith, Martin, Soares, Marcio, Torres, Antoni, Vieillard-Baron, Antoine, and Azoulay, Elie
Subjects: CRITICAL care medicine, SEPSIS, RESPIRATORY diseases, SEPTIC shock, PNEUMONIA
Abstract: The article presents several studies on intensive care medicine published in the 2013 issue of the journal "Intensive Care Medicine," particularly on sepsis, infections, respiratory diseases, pediatric health. It cites several intensive care medicine research, including immune dysfunction during sepsis and antimicrobial dose variability, ventilator-acquired pneumonia, prognostic biomarkers in severe sepsis and septic shock, and antibiotic pharmacokinetics in severe sepsis.
Published: 2014
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23. Effect of Statin Therapy on Mortality in Patients With Ventilator-Associated Pneumonia.

Author: Papazian, Laurent, Roch, Antoine, Charles, Pierre-Emmanuel, Penot-Ragon, Christine, Perrin, Gilles, Roulier, Philippe, Goutorbe, Philippe, Lefrant, Jean-Yves, Wiramus, Sandrine, Jung, Boris, Perbet, Sé. bastien, Hernu, Romain, Nau, André., Baldesi, Olivier, Allardet-Servent, Jerome, Baumstarck, Karine, Jouve, Elisabeth, Moussa, Myriam, Hraiech, Sami, and Guervilly, Christophe
Subjects: *PNEUMONIA, *STATINS (Cardiovascular agents), *HEALTH outcome assessment, *INFECTION, *INTENSIVE care units
Abstract: IMPORTANCE Observational studies have reported that statin use may be associated with improved outcomes of various infections. Ventilator-associated pneumonia (VAP) is the most common infection in the intensive care unit (ICU) and is associated with substantial mortality. OBJECTIVE To determine whether statin therapy can decrease day-28 mortality in patients with VAP. DESIGN, SETTING, AND PARTICIPANTS Randomized, placebo-controlled, double-blind, parallel-group, multicenter trial performed in 26 intensive care units in France from January 2010 to March 2013. For power to detect an 8% absolute reduction in the day-28 mortality rate, we planned to enroll 1002 patients requiring invasive mechanical ventilation for more than 2 days and having suspected VAP, defined as a modified Clinical Pulmonary Infection Score of 5 or greater. The futility stopping rules were an absolute increase in day-28 mortality of at least 2.7% with simvastatin compared with placebo after enrollment of the first 251 patients. INTERVENTIONS Participants were randomized to receive simvastatin (60 mg) or placebo, started on the same day as antibiotic therapy and given until ICU discharge, death, or day 28. whichever occurred first. MAIN OUTCOMES AND MEASURES Primary outcome was day-28 mortality. Day-14, ICU, and hospital mortality rates were determined, as well as duration of mechanical ventilation and Sequential Organ Failure Assessment (SOFA) scores on days 3, 7, and 14. RESULTS The study was stopped for futility at the first scheduled interim analysis after enrollment of 300 patients, of whom all but 7% in the simvastatin group and 11% in the placebo group were naive to statin therapy at ICU admission. Day-28 mortality was not lower in the simvastatin group (21.2% [95% CI, 15.4% to 28.6%) than in the placebo group (15.2% [95% CI, 10.2% to 22.1%]; P = .10; hazard ratio, 1.45 [95% CI, 0.83 to 2.51]); the between-group difference was 6.0% (95% CI, -3.0% to 14.9%). In statin-naive patients, day-28 mortality was 21.5% (95% CI, 15.4% to 29.1%) with simvastatin and 13.8% (95% CI, 8.8% to 21.O%) with placebo (P = .054) (between-group difference, 7.7% [95%CI, -1.8% to 16.8%). There were no significant differences regarding day-14, ICU, or hospital mortality rates; duration of mechanical ventilation; or changes in SOFA score. CONCLUSIONS AND RELEVANCE In adults with suspected VAP0 adjunctive simvastatin therapy compared with placebo did not improve day-28 survival. These findings do not support the use of statins with the goal of improving VAP outcomes. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCTO1057758 [ABSTRACT FROM AUTHOR]
Published: 2013
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24. Routine use of Staphylococcus aureus rapid diagnostic test in patients with suspected ventilator-associated pneumonia.

Author: Leone, Marc, Malavieille, François, Papazian, Laurent, Meyssignac, Bertrand, Cassir, Nadim, Textoris, Julien, Antonini, François, La Scola, Bernard, Martin, Claude, Allaouchiche, Bernard, and Hraiech, Sami
Published: 2013
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25. 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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26. Antibacterial efficacy of inhaled squalamine in a rat model of chronic Pseudomonas aeruginosa pneumonia.

Author: Hraiech, Sami, Brégeon, Fabienne, Brunel, Jean-Michel, Rolain, Jean-Marc, Lepidi, Hubert, Andrieu, Véronique, Raoult, Didier, Papazian, Laurent, and Roch, Antoine
Subjects: SQUALAMINE, PHYSIOLOGICAL effects of antibiotics, PSEUDOMONAS aeruginosa infections, PNEUMONIA, VIRULENCE of bacteria, COLISTIN, LABORATORY rats
Abstract: Objectives Squalamine is a steroid extracted from sharks with proven in vitro antibacterial activity. We assessed its efficacy in reducing the lung bacterial load and histological lesions when given via inhalation in a rat model of chronic Pseudomonas aeruginosa pneumonia. Methods Sprague-Dawley rats were inoculated by tracheal intubation with 150 μL of a solution containing 108 cfu/mL of agar bead-embedded P. aeruginosa strain PAO1. MICs of squalamine and colistin for this strain were 2–8 and 0.5–1 mg/L, respectively. Starting the day after infection, the animals were treated twice daily with aerosolized squalamine (3 mg), colistin (160 mg) or 0.9% saline for 6 days. The bacterial load and lung histological lesions were evaluated on the seventh day. Results Aerosols of squalamine and colistin resulted in a significant reduction in median (IQR) pulmonary bacterial count compared with saline [103 (6 × 102–2 × 103), 103 (9 × 102–6 × 103) and 105 (9 × 104–2 × 105) cfu/lung, respectively; P < 0.001 for both treated groups versus saline]. The lung weight and the lung histological severity score were significantly lower in both treated groups. Conclusions In a model of chronic P. aeruginosa pneumonia, treatment twice daily with a squalamine aerosol for 6 days leads to a significant reduction in the pulmonary bacterial count and pneumonia lesions with an efficacy comparable to that of colistin. [ABSTRACT FROM PUBLISHER]
Published: 2012
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27. Ventilator-associated pneumonia and ICU mortality in severe ARDS patients ventilated according to a lung-protective strategy.

Author: Forel, Jean-Marie, Voillet, François, Pulina, Daniel, Gacouin, Arnaud, Perrin, Gilles, Barrau, Karine, Jaber, Samir, Arnal, Jean-Michel, Fathallah, Mohamed, Auquier, Pascal, Roch, Antoine, Azoulay, Elie, and Papazian, Laurent
Subjects: MECHANICAL ventilators, PNEUMONIA, ADULT respiratory distress syndrome, INTENSIVE care units, MORTALITY
Abstract: Introduction: Ventilator-associated pneumonia (VAP) may contribute to the mortality associated with acute respiratory distress syndrome (ARDS). We aimed to determine the incidence, outcome, and risk factors of bacterial VAP complicating severe ARDS in patients ventilated by using a strictly standardized lung-protective strategy.Methods: This prospective epidemiologic study was done in all the 339 patients with severe ARDS included in a multicenter randomized, placebo-controlled double-blind trial of cisatracurium besylate in severe ARDS patients. Patients with suspected VAP underwent bronchoalveolar lavage to confirm the diagnosis.Results: Ninety-eight (28.9%) patients had at least one episode of microbiologically documented bacterial VAP, including 41 (41.8%) who died in the ICU, compared with 74 (30.7%) of the 241 patients without VAP (P = 0.05). After adjustment, age and severity at baseline, but not VAP, were associated with ICU death. Cisatracurium besylate therapy within 2 days of ARDS onset decreased the risk of ICU death. Factors independently associated with an increased risk to develop a VAP were male sex and worse admission Glasgow Coma Scale score. Tracheostomy, enteral nutrition, and the use of a subglottic secretion-drainage device were protective.Conclusions: In patients with severe ARDS receiving lung-protective ventilation, VAP was associated with an increased crude ICU mortality which did not remain significant after adjustment. [ABSTRACT FROM AUTHOR]
Published: 2012
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28. Significance of high levels of procalcitonin in patients with influenza A (H1N1) pneumonia.

Author: Guervilly, Christophe, Coisel, Yanaël, Botelho-Nevers, Elizabeth, Dizier, Stephanie, Castanier, Matthias, Lepaul-Ercole, Renaud, Brissy, Olivier, Roch, Antoine, Forel, Jean-Marie, Papazian, Laurent, and Coisel, Yanaël
Subjects: BACTERIA classification, INFLUENZA complications, BACTERIA, CALCITONIN, INFLUENZA, NEUROPEPTIDES, PNEUMONIA, PROTEIN precursors, INFLUENZA A virus, H1N1 subtype
Published: 2010
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29. Advances in Mimivirus Pathogenicity.

Author: Vincent, Agnès, La Scola, Bernard, and Papazian, Laurent
Subjects: VIRUS diseases, NOSOCOMIAL infections, PNEUMONIA, GENETIC polymorphisms, NUCLEOTIDE sequence
Abstract: Viral diseases in the clinical setting have been extensively investigated. Viruses are now considered as potentially responsible for nosocomial infections, especially in intensive care unit (ICU) patients. Mimivirus is the largest virus known to date. Recent studies have suggested that Mimivirus could be responsible for both community-acquired and nosocomial pneumonia. These studies were mainly based on serologic diagnosis, which showed patients with community-acquired pneumonia have more antibodies to Mimivirus than healthy controls. Serologic evidence of Mimivirus pneumonia was also found in mechanically ventilated ICU patients. In a matched-cohort study in which ICU patients with serologic evidence of Mimivirus pneumonia were matched to ICU patients remaining seronegative for Mimivirus, positive serology was associated with an increased duration of both mechanical ventilation and ICU stay. Identification by PCR techniques remains difficult, probably because of the high level of polymorphism of nucleotide sequences of giant viruses. More studies are needed to confirm the clinical impact of Mimivirus in humans. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]
Published: 2010
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30. Detection of Plant DNA in the Bronchoalveolar Lavage of Patients with Ventilator-Associated Pneumonia.

Author: Bousbia, Sabri, Papazian, Laurent, La Scola, Bernard, and Raoult, Didier
Subjects: *DNA, *VEGETABLES, *TOBACCO, *BRONCHOALVEOLAR lavage, *NOSOCOMIAL infections, *PNEUMONIA, *WHEAT, *CUCURBITA pepo, *PATHOGENIC microorganisms, *PATIENTS
Abstract: Background: Hospital-acquired infections such as nosocomial pneumonia are a serious cause of mortality for hospitalized patients, especially for those admitted to intensive care units (ICUs). Despite the number of the studies reported to date, the causative agents of pneumonia are not completely known. Herein, we found by molecular technique that vegetable and tobacco DNA may be detected in the bronchoalveolar lavage from patients with ventilator-associated pneumonia (VAP). Methodology/Principal Findings: In the present study, we studied bronchoalveolar lavage (BAL) from patients admitted to ICUs with ventilator-associated pneumonia. BAL fluids were assessed with molecular tests, culture and blood culture. We successfully identified plant DNA in six patients out of 106 (6%) with ventilator-associated pneumonia. Inhalation was confirmed in four cases and suspected in the other two cases. Inhalation was significantly frequent in patients with plant DNA (four out of six patients) than those without plant DNA (three out of 100 patients) (P,0.001). Nicotiana tabacum chloroplast DNA was identified in three patients who were smokers (cases 2, 3 and 6). Cucurbita pepo, Morus bombycis and Triticum aestivum DNA were identified in cases 1, 4 and 5 respectively. Twenty-three different bacterial species, two viruses and five fungal species were identified from among these six patients by using molecular and culture techniques. Several of the pathogenic microorganisms identified are reported to be food-borne or tobacco plant-associated pathogens. Conclusions/Significance: Our study shows that plants DNA may be identified in the BAL fluid of pneumonia patients, especially when exploring aspiration pneumonia, but the significance of the presence of plant DNA and its role in the pathogenesis of pneumonia is unknown and remains to be investigated. However, the identification of these plants may be a potential marker of aspiration in patients with pneumonia. [ABSTRACT FROM AUTHOR]
Published: 2010
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31. Tropheryma whipplei in Patients with Pneumonia.

Author: Bousbia, Sabri, Papazian, Laurent, Auffray, Jean-Pierre, Fenollar, Florence, Martin, Claude, Wenjun Li, Chiche, Laurent, La Scola, Bernard, and Raoult, Didier
Subjects: *WHIPPLE'S disease, *PNEUMONIA, *ETIOLOGY of diseases, *DIARRHEA, *WEIGHT loss, *POLYMERASE chain reaction, *BRONCHOALVEOLAR lavage
Abstract: Tropheryma whipplei is the etiologic pathogenic agent of Whipple disease (WD), characterized by various clinical signs, such as diarrhea, weight loss, lymphadenopathy, and polyarthritis. PCR-based methods for diagnosis of WD have been developed. T. whipplei has been identified in saliva and stool samples from patients with WD and from healthy persons. T. whipplei DNA has also been found in bronchoalveolar lavage (BAL) samples of a child with pneumonia. We detected DNA of T. whipplei in 6 (3%) of 210 BAL samples collected in intensive care units by using 16S rDNA and specific quantitative PCR. We identified 4 novel genotypes of T. whipplei. In 1 case, T. whipplei was the only bacterium; in 4 others, it was associated with buccal flora. We suggest that T. whipplei should be investigated as an etiologic agent of pneumonia. [ABSTRACT FROM AUTHOR]
Published: 2010
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32. Early Antibiotic Treatment for BAL-Confirmed Ventilator-Associated Pneumonia.

Author: Michel, Fabrice, Franceschini, Bruno, Berger, Pierre, Arnal, Jean-Michel, Gainnier, Marc, Sainty, Jean-Marie, and Papazian, Laurent
Subjects: ANTIBIOTICS, PNEUMONIA, ARTIFICIAL respiration, MECHANICAL ventilators, LUNG diseases, ANTI-infective agents, RESPIRATORY therapy
Abstract: Study objectives: To test whether routine quantitative cultures of endotracheal aspirates obtained before the onset of ventilator-associated pneumonia (VAP) could help to predict the causative microorganisms and to select early appropriate antimicrobial therapy before obtaining BAL culture results. Design: Prospective observational study. Setting: French medical ICU. Patients: A total of 299 patients received mechanical ventilation for at least 48 h. Interventions: Endotracheal aspiration (EA) was performed twice weekly in all mechanically ventilated patients. A diagnosis of VAP was made by BAL culture. Only the EA performed just before the suspicion of VAP (EA-pre) were evaluated. This strategy (ie, the EA-pre-based strategy) was compared with an antibiotic therapy that would have been prescribed if the recommendations of both the American Thoracic Society (ATS) and Trouillet et al (Am J Respir Crit Care Med 1998; 157:531–539) had been applied. Measurements and results: VAP was diagnosed (by BAL culture) in 41 of the 75 patients in whom BAL was performed. Among the 41 BAL specimens that were positive for VAP, EA-pre had identified the same microorganisms (with the same antibiotic resistance patterns) in 34 cases (83%). In one case, EA-pre was not available at the time BAL was performed (a case of early-onset VAP), but the empiric antibiotic therapy was adequate. While EA-pre did not give the same results as the BAL culture, the antibiotic therapy based on the results of the EA-pre was adequate in four other cases. Finally, antibiotic therapy was delayed in only two cases. Antibiotic treatment was therefore adequate in 38 of the 40 assessable cases (95%). If the Trouillet-based strategy had been used, the antibiotic treatment would have been adequate in 34 of the 41 cases (83%; p = 0.15 [vs EA-pre strategy]). Based on the ATS classification, the antibiotic treatment would have been adequately prescribed in only 28 of the 41 cases (68%; p = 0.005 [vs EA-pre strategy]). Conclusions: Routine EA performed twice a week makes it possible to prescribe adequate antibiotic therapy (while waiting for BAL culture results) in 95% of the patients in whom a VAP is ultimately diagnosed by BAL culture. [ABSTRACT FROM AUTHOR]
Published: 2005
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33. Relationship of microbiologic diagnostic criteria to morbidity and mortality in patients with ventil

Author: Bregeon, Fabienne and Papazian, Laurent
Subjects: *BREATHING apparatus, *PNEUMONIA, *HEALTH, *MORTALITY, *PATIENTS
Abstract: Presents a study, the objective of which is to evaluate whether the mortality and the morbidity of ventilator-associated pneumonia, defined by positive result of protected specimen brush culture, was different from that defined by other methods. Design; Setting; Patients; Main outcome measures; Results; Conclusions.
Published: 1997
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34. How can earlier antibiotic efficacy be provided for ventilator-associated pneumonia without promoting bacterial resistance? Is initial monotherapy or a combination of antibiotics the right answer?

Author: Papazian, Laurent
Subjects: *PNEUMONIA treatment, *ANTIBIOTICS, *MECHANICAL ventilators, *NOSOCOMIAL infections
Abstract: The article comments on the paper "Randomized trial of combination versus monotherapy for the empiric treatment of suspected ventilator-associated pneumonia (VAP)," by D.K. Heyland and colleagues. According to the author, the paper compared monotherapy with a carbapenem with a combination therapy, carbapenem plus fluoroquinolone, in the initial treatment of patients with suspected VAP. The author notes that the study suggests that a short-term course of fluoroquinolone is secure.
Published: 2008
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35. 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. C., Nobrega, D., Sales, V. M., Shindhe, S., Ismail, D. M. A. B. P. H., Laffey, J., Beloncle, F., Davies, K. G., Cirone, R., Manoharan, V., Ismail, M., Goligher, E. C., Jassal, M., Nishikawa, E., Javeed, A., Curley, G., Rittayamai, N., Parotto, M., Ferguson, N. D., Mehta, S., Knoll, J., Pronovost, A., Canestrini, S., Bruhn, A. R., Garcia, P. H., Aliaga, F. A., Farías, P. A., Yumha, J. S., Ortiz, C. A., Salas, J. E., Saez, A. A., Vega, L. D., Labarca, E. F., Martinez, F. T., Carreño, N. G., Lora, P., Liu, H., Liu, L., Tang, R., Luo, X., An, Y., Zhao, H., Gao, Y., Zhai, Z., Ye, Z. L., Wang, W., Li, W., Li, Q., Zheng, R., Yu, W., Shen, J., Li, X., Yu, T., Lu, W., Wu, Y. Q., Huang, X. B., He, Z., Lu, Y., Han, H., Zhang, F., Sun, R., Wang, H. X., Qin, S. H., Zhu, B. H., Zhao, J., Liu, J., Li, B., Liu, J. L., Zhou, F. C., Li, Q. J., Zhang, X. Y., Li-Xin, Z., Xin-Hua, Q., Jiang, L., Gao, Y. N., Zhao, X. Y., Li, Y. Y., Li, X. L., Wang, C., Yao, Q., Yu, R., Chen, K., Shao, H., Qin, B., Huang, Q. Q., Zhu, 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. 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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. 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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.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., 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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, B, Broman, L, Wessbergh, J, Persson, L, Schiöler, F, Kedelv, H, Tibblin, A, Appelberg, H, Hedlund, L, Helleberg, J, Eriksson, K, Glietsch, R, Larsson, N, Nygren, I, Nunes, S, Morin, A, Kander, T, Adolfsson, A, Zender, H, Leemann-Refondini, C, Elatrous, S, Bouchoucha, S, Chouchene, I, Ouanes, I, Souissi, A, Kamoun, S, Demirkiran, O, Aker, M, Erbabacan, E, Ceylan, I, Girgin, N, Ozcelik, M, Ünal, N, Meco, B, Akyol, O, Derman, S, Kennedy, B, Parhar, K, Srinivasa, L, Hopkins, P, Mellis, C, Kakar, V, Hadfield, D, Vercueil, A, Bhowmick, K, Humphreys, S, Ferguson, A, Mckee, R, Raj, A, Fawkes, D, Watt, P, Twohey, L, Thomas, R, Morton, A, Kadaba, V, Smith, M, Hormis, A, Kannan, S, Namih, M, Reschreiter, H, Camsooksai, J, Kumar, A, Rugonfalvi, S, Nutt, C, O’Neill, O, Seasman, C, Dempsey, G, Scott, C, Ellis, H, Mckechnie, S, Hutton, P, Di Tomasso, N, Vitale, M, Griffin, R, Dean, M, Cranshaw, J, Willett, E, Ioannou, N, Gillis, S, Csabi, P, Macfadyen, R, Dawson, H, Preez, P, Williams, A, Boyd, O, de Gordoa, L, Bramall, J, Symmonds, S, Chau, S, Wenham, T, Szakmany, T, Toth-Tarsoly, P, Mccalman, K, Alexander, P, Stephenson, L, Collyer, T, Chapman, R, Cooper, R, Allan, R, Sim, M, Wrathall, D, Irvine, D, Zantua, K, Adams, J, Burtenshaw, A, Sellors, G, Welters, I, Williams, K, Hessell, R, Oldroyd, M, Battle, C, Pillai, S, Kajtor, I, Sivashanmugavel, M, O’Kane, S, Donnelly, A, Frigyik, A, Careless, J, May, M, Stewart, R, Trinder, T, Hagan, S, Wise, M, Cole, J, Macfie, C, Dowling, A, Nuñez, E, Pittini, G, Rodriguez, R, Imperio, M, Santos, C, França, A, Ebeid, A, Deicas, A, Serra, C, Uppalapati, A, Kamel, G, Banner-Goodspeed, V, Beitler, J, Mukkera, S, Kulkarni, S, Lee, J, Mesar, T, Shinn, J, Gomaa, D, Tainter, C, Yeatts, D, Warren, J, Lanspa, M, Miller, R, Grissom, C, Brown, S, Bauer, P, Gosselin, R, Kitch, B, Cohen, J, Beegle, S, Gueret, R, Tulaimat, A, Choudry, S, Stigler, W, Batra, H, Huff, N, Lamb, K, Oetting, T, Mohr, N, Judy, C, Saito, S, Kheir, F, Schlichting, A, Delsing, A, Crouch, D, Elmasri, M, Dreyer, K, Blakeman, T, Baron, R, Grijalba, C, Hou, P, Seethala, R, Aisiku, I, Henderson, G, Frendl, G, Hou, S, Owens, R, Schomer, A, Bumbasirevic, V, Jovanovic, B, Surbatovic, M, Veljovic, M, Madotto, Fabiana, Pham, Tài, Bellani, Giacomo, Bos, Lieuwe D., Simonis, Fabienne D., Fan, Eddy, Artigas, Antonio, Brochard, Laurent, Schultz, Marcus J., Laffey, John G., Pesenti, Antonio, Esteban, Andre, Gattinoni, Luciano, van Haren, Frank, Larsson, Ander, McAuley, Daniel F., Ranieri, Marco, Rubenfeld, Gordon, Thompson, B. 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John, Hagan, Samantha J., Wise, Matt P., Cole, Jade M., MacFie, Caroline C., Dowling, Anna T., Nin, Nicolá, Nuñez, Edgardo, Pittini, Gustavo, Rodriguez, Ruben, Imperio, María C., Santos, Cristina, França, Ana G., Ebeid, Alejandro, Deicas, Alberto, Serra, Carolina, Uppalapati, Aditya, Kamel, Ghassan, Banner-Goodspeed, Valerie M., Beitler, Jeremy R., Mukkera, Satyanarayana Reddy, Kulkarni, Shreedhar, Lee, Jarone, Mesar, Tomaz, Shinn, John O., Gomaa, Dina, Tainter, Christopher, Yeatts, Dale J., Warren, Jessica, Lanspa, Michael J., Miller, Russel R., Grissom, Colin K., Brown, Samuel M., Bauer, Philippe R., Gosselin, Ryan J., Kitch, Barrett T., Cohen, Jason E., Beegle, Scott H., Gueret, Renaud M., Tulaimat, Aiman, Choudry, Shazia, Stigler, William, Batra, Hitesh, Huff, Nidhi G., Lamb, Keith D., Oetting, Trevor W., Mohr, Nicholas M., Judy, Claine, Saito, Shigeki, Kheir, Fayez M., Kheir, Fayez, Schlichting, Adam B., Delsing, Angela, Crouch, Daniel R., Elmasri, Mary, Ismail, Dina, Dreyer, Kyle R., Blakeman, Thomas C., Baron, Rebecca M., Grijalba, Carolina Quintana, Hou, Peter C., Seethala, Raghu, Aisiku, Imo, Henderson, Galen, Frendl, Gyorgy, Hou, Sen-Kuang, Owens, Robert L., Schomer, Ashley, Bumbasirevic, Vesna, Jovanovic, Bojan, Surbatovic, Maja, Veljovic, Milic, Intensive Care Medicine, Graduate School, ACS - Heart failure & arrhythmias, AII - Inflammatory diseases, ACS - Diabetes & metabolism, ACS - Pulmonary hypertension & thrombosis, ACS - Microcirculation, Bos, L. 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C., Ferguson, N. D., Bruhn, A. R., Garcia, P. H., Aliaga, F. A., Farias, P. A., Yumha, J. S., Ortiz, C. A., Salas, J. E., Saez, A. A., Vega, L. D., Labarca, E. F., Martinez, F. T., Carreno, N. G., Ye, Z. L., Wu, Y. Q., Huang, X. B., Wang, H. X., Qin, S. H., Zhu, B. H., Liu, J. L., Zhou, F. C., Li, Q. J., Zhang, X. Y., Gao, Y. N., Zhao, X. Y., Li, Y. Y., Li, X. L., Huang, Q. Q., Zhu, W. H., Hang, A. Y., Hua, M. X., Di, Y. D., Ling, L. L., Qin, T. H., Wang, S. H., Vargas, M. P., Jimenez, J. I. S., Rojas, M. A. G., Solis-Quesada, J. E., Ramirez-Alfaro, C. M., Maca, J., Villamagua, B. G., Chiche, J. -D., Arnal, J. -M., Au, S. -M., Beduneau, G., Zogheib, E. H., Santoli, F. L., Besset, S. L., Gelee, B., Danin, P. -E., Crova, P. J., Phan, N. T., Badie, J. C., Herbrecht, J. -E., Declercq, P. -L. M., Rigaud, J. -P., Zein, S. O., Richecoeur, J. R., Combaux, D. M., Lemoal, C., Sauvadet, E. P., Guerin, C., Krassler, J., Schafer, S., Zacharowski, K. D., Reske, A. W., Hopf, H. -B. 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K., Brown, S. M., Bauer, P. R., Gosselin, R. J., Kitch, B. T., Cohen, J. E., Beegle, S. H., Gueret, R. M., Huff, N. G., Lamb, K. D., Oetting, T. W., Mohr, N. M., Kheir, F. M., Schlichting, A. B., Crouch, D. R., Dreyer, K. R., Blakeman, T. C., Baron, R. M., Grijalba, C. Q., Hou, P. C., Hou, S. -K., and Owens, R. L.
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

36. Evaluation of the diagnostic value of fluorescent in situ hybridization in a rat model of bacterial pneumonia.

Author: Atieh, Thérèse, Audoly, Gilles, Hraiech, Sami, Lepidi, Hubert, Roch, Antoine, Rolain, Jean-Marc, Raoult, Didier, Papazian, Laurent, and Brégeon, Fabienne
Subjects: *FLUORESCENCE, *IN situ hybridization, *PNEUMONIA, *BACTERIAL diseases, *LABORATORY rats, *PATHOGENIC bacteria, *BIOPSY, *LUNG surgery
Abstract: Abstract: In severe nosocomial pneumonia, the pathogenic responsibility of bacteria isolated from airways is far from certain, and a lung biopsy is sometimes performed. However, detection and identification of pathogens are frequently unachieved. Here, we developed a protocol for direct visualization of bacteria within the lung tissue using fluorescent in situ hybridization (FISH) in a rat model of Acinetobacter baumannii pneumonia. The reference positive diagnosis of bacterial pneumonia was the presence of pathological signs of pneumonia associated with the proof of bacteria or bacterial PCR products into the parenchyma. By analysis of 122 sets of slices from 26 rats and using the eubacterial probe EUB-338, our results show that FISH reached a sensitivity and a diagnostic accuracy higher than that of optic microscopy (sensitivity: 96% versus 55.4% and diagnostic accuracy: 96.7% versus 66.4%), whereas both approaches had 100% specificity. FISH could be useful especially on negative biopsies from patients with suspected infectious pneumonia. [Copyright &y& Elsevier]
Published: 2013
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37. Active cytomegalovirus infection is common in mechanically ventilated medical intensive care unit patients.

Author: Chiche, Laurent, Forel, Jean-Marie, Roch, Antoine, Guervilly, Christophe, Pauly, Vanessa, Allardet-Servent, Jérôme, Gainnier, Marc, Zandofti, Christine, and Papazian, Laurent
Subjects: *CYTOMEGALOVIRUS diseases, *CYTOMEGALIC inclusion disease, *INTENSIVE care units, *ARTIFICIAL respiration, *NOSOCOMIAL infections, *ADRENOCORTICAL hormones
Abstract: The article presents a study which assess the incidence, risk factors and outcome of active cytomegalovirus (CMV) infection to nonimmunosuppressed patients in intensive care unit (ICU). Result shows that patients with active CMV infection had longer mechanical ventilation and longer stay in ICU are at risk to develop bacterial nosocomial infections. Risk factors include enteral feeding and costicosteriod use prior to ICU admission were associated with the occurrence of active CMV infection.
Published: 2009
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38. Clinical significance of a positive serology for mimivirus in patients presenting a suspicion of ventilator-associated pneumonia.

Author: Vincent, Agnès, La Scola, Bernard, Forel, Jean-Marie, Pauly, Vanessa, Raoult, Didier, and Papazian, Laurent
Subjects: *VIRUSES, *SEROLOGY, *MORTALITY, *PNEUMONIA, *PATIENTS, *MECHANICAL ventilators, *INTENSIVE care units
Abstract: The article determines whether a positive serology for mimivirus was associated with increased morbidity and mortality in patients with a suspicion of ventilator-associated pneumonia (VAP). According to the authors, the effectiveness of matching was 94.8%. They add that patients with a positive serology for mimivirus had longer duration of mechanical ventilation and intensive care unit stay with median excesses of seven days and 10 days, respectively.
Published: 2009
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