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51. Lung transplantation for COVID-19-associated ARDS

Author: Pierre Mordant, Alexy Tran-Dinh, Jonathan Messika, and Matthieu Schmidt
Subjects: Pulmonary and Respiratory Medicine, 2019-20 coronavirus outbreak, ARDS, medicine.medical_specialty, Respiratory Distress Syndrome, Coronavirus disease 2019 (COVID-19), business.industry, SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), medicine.medical_treatment, MEDLINE, COVID-19, medicine.disease, Respiration, Artificial, Correspondence, medicine, Lung transplantation, Humans, business, Intensive care medicine, Lung Transplantation
Published: 2021

52. Quel effectif médical dans les services de réanimation et surveillance continue en France ? Une position du syndicat des médecins réanimateurs des hôpitaux publics

Author: Jean-Philippe Rigaud, Nicolas Terzi, Jean-Luc Chagnon, Benoit Misset, Hervé Outin, Olivier Lesieur, Djillali Annane, Jean Luc Diehl, Jonathan Messika, Samia Touati, Laetitia Bodet-Contentin, Didier Dreyfuss, Didier Thevenin, and A. Sement
Subjects: Emergency Medicine, Emergency Nursing
Published: 2019
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53. An Index Combining Respiratory Rate and Oxygenation to Predict Outcome of Nasal High-Flow Therapy

Author: Manuel Samper, Jean Pierre Frat, Jonathan Messika, Joan R. Masclans, Oriol Roca, Marina García-de-Acilu, Berta Caralt, Benjamin Sztrymf, Jean-Damien Ricard, and Gonzalo Hernández
Subjects: Male, Pulmonary and Respiratory Medicine, Letter, Respiratory rate, Critical Care and Intensive Care Medicine, medicine.disease_cause, Catheterization, Cohort Studies, 03 medical and health sciences, Extracorporeal Membrane Oxygenation, 0302 clinical medicine, Respiratory Rate, Humans, Medicine, Acute respiratory failure, In patient, Prospective Studies, 030212 general & internal medicine, Diagnostic Techniques and Procedures, Aged, Noninvasive Ventilation, Acute hypoxemic respiratory failure, business.industry, Oxygen Inhalation Therapy, Pneumonia, Oxygenation, Middle Aged, medicine.disease, Data Accuracy, 030228 respiratory system, Anesthesia, Practice Guidelines as Topic, Female, Blood Gas Analysis, business, High flow, Nasal cannula
Abstract: Rationale: One important concern during high-flow nasal cannula (HFNC) therapy in patients with acute hypoxemic respiratory failure is to not delay intubation.Objectives: To validate the diagnostic...
Published: 2019
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54. Compared Efficacy of Four Preoxygenation Methods for Intubation in the ICU

Author: Jean-Paul Mira, Gwenhael Colin, Arthur Bailly, Emmanuelle Mercier, Elie Azoulay, Thierry Boulain, Benoit Champigneulle, Virginie Lemiale, Raphaël Clere-Jehl, Jonathan Messika, Jean-Damien Ricard, Julie Helms, Pierre-François Dequin, Jean-Baptiste Lascarrou, Toufik Kamel, Jean Reignier, and Aurélie Le Thuaut
Subjects: medicine.medical_specialty, genetic structures, Relative efficacy, business.industry, medicine.medical_treatment, MEDLINE, 030208 emergency & critical care medicine, Endotracheal intubation, Retrospective cohort study, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Severe hypoxemia, Emergency medicine, Retrospective analysis, medicine, Intubation, Adverse effect, business
Abstract: Objectives:Severe hypoxemia is the most common serious adverse event during endotracheal intubation. Preoxygenation is performed routinely as a preventive measure. The relative efficacy of the various available preoxygenation devices is unclear. Here, our objective was to assess associations between
Published: 2019
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55. Pneumonia-SpecificEscherichia coliwith Distinct Phylogenetic and Virulence Profiles, France, 2012–2014

Author: Romain Fernandes, Vincent Fihman, Typhaine Billard-Pomares, Béatrice La Combe, Achille Kouatchet, Erick Denamur, Sandra Bourdon, Julien Goret, Matthieu Eveillard, Frédéric Wallet, Jean-Damien Ricard, Olivier Clermont, Julien Bador, Sigismond Lasocki, Karim Lakhal, Laurence Armand-Lefevre, Nicolas de Prost, Stéphane Corvec, Jonathan Messika, Jean Reignier, Service de Réanimation Médico-Chirurgicale [Hôpital Louis Mourier], Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)
Subjects: 0301 basic medicine, Epidemiology, virulence factors, lcsh:Medicine, medicine.disease_cause, Virulence factor, Nosocomial infection, 0302 clinical medicine, Public Health Surveillance, bacteria, Escherichia coli Infections, Phylogeny, Phylotype, Virulence, Phylogenetic tree, Anti-Bacterial Agents, 3. Good health, Infectious Diseases, Pathovar, France, Pneumonia (non-human), Microbiology (medical), 030231 tropical medicine, 030106 microbiology, Microbial Sensitivity Tests, Biology, Serogroup, History, 21st Century, lcsh:Infectious and parasitic diseases, Microbiology, respiratory infections, ventilator-associated pneumonia, 03 medical and health sciences, Antibiotic resistance, Drug Resistance, Bacterial, Pneumonia, Bacterial, Escherichia coli, medicine, pneumonia, Humans, lcsh:RC109-216, antimicrobial resistance, Research, lcsh:R, biology.organism_classification, medicine.disease, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Molecular Typing, Pneumonia-Specific Escherichia coli with Distinct Phylogenetic and Virulence Profiles, France, 2012–2014, Genes, Bacterial
Abstract: International audience; In a prospective, nationwide study in France of Escherichia coli responsible for pneumonia in patients receiving mechanical ventilation, we determined E. coli antimicrobial susceptibility, phylotype, O-type, and virulence factor gene content. We compared 260 isolates with those of 2 published collections containing commensal and bacteremia isolates. The preponderant phylogenetic group was B2 (59.6%), and the predominant sequence type complex (STc) was STc73. STc127 and STc141 were overrepresented and STc95 underrepresented in pneumonia isolates compared with bacteremia isolates. Pneumonia isolates carried higher proportions of virulence genes sfa/foc, papGIII, hlyC, cnf1, and iroN compared with bacteremia isolates. Virulence factor gene content and antimicrobial drug resistance were higher in pneumonia than in commensal isolates. Genomic and phylogenetic characteristics of E. coli pneumonia isolates from critically ill patients indicate that they belong to the extraintestinal pathogenic E. coli pathovar but have distinguishable lung-specific traits.
Published: 2019
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56. Clinical assessment of scannographic markers for sarcopenia in lung transplant candidates

Author: Nathalie Zappella, Garance Vaillant, Loukbi Saker, Elie Kantor, Pierre Mordant, Jonathan Messika, Vincent Bunel, Antoine Khalil, Alexy Tran Dinh, and Philippe Montravers
Subjects: Pulmonary and Respiratory Medicine, Sarcopenia, Humans, Reproducibility of Results, Pilot Projects, Lung Transplantation, Retrospective Studies
Abstract: The selection of patients for lung transplantation is difficult. An aspect of the patient's general condition and frailty can be assessed by measuring the surface area of certain muscles on CT. Indeed, sarcopenia, assessed by measuring the area of psoas muscles on scannographic sections has already been shown to be associated with poor outcomes in lung transplant and other major surgeries and could thus be helpful to evaluate candidates to lung transplant. However, it is not routinely performed by radiologists. As a pilot study, we compared the reliability of computerized tomography scan assessment for sarcopenia by clinicians with that of radiologists.We conducted a retrospective single-centre study in which preoperative abdominal CT scans of lung transplant patients from 2014 to 2018 were analysed to assess sarcopenia by measuring the surface areas (mmWe performed a double reading of 200 scans. The clinicians 'measurements were comparable to those of the radiologists for the psoas and paraspinal muscles but not for the diaphragm pillars.CT measurement of psoas and paraspinal muscle areas by clinicians appears reliable and feasible in routine practice and could be used in the evaluation of lung transplant candidates.
Published: 2022
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57. Antiplatelet Drugs and Risk of Bleeding After Bedside Pleural Procedures: A National Multicenter Cohort Study

Author: Jean-Jacques Quiot, Thomas Similowski, Nicolas Terzi, Elise Morawiec, Jonathan Giovannelli, Laurence Dangers, Xavier Dhalluin, Mathilde Neuville, Cécile Chenivesse, Nathalie Bautin, Jonathan Messika, Christophe Cracco, Isabelle Huet, Mikael Alves, Gilles Mangiapan, Corinne Appere-de Vecchi, Naïke Bigé, Gaetan Beduneau, CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Neurophysiologie Respiratoire Expérimentale et Clinique, Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Service de Réanimation Médico-Chirurgicale [Hôpital Louis Mourier], Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 (CIIL), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Neurophysiologie Respiratoire Expérimentale et Clinique (UMRS 1158), CHU Lille, Lille Inflammation Research International Center - U 995 (LIRIC), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHI Créteil, CHU Saint-Antoine [AP-HP], Centre hospitalier intercommunal de Poissy/Saint-Germain-en-Laye - CHIPS [Poissy], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Centre Hospitalier d'Angoulême (CH Angoulême), CHU Rouen, Normandie Université (NU), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service de Pneumologie [Roubaix], Centre hospitalier de Roubaix, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), and Centre Hospitalier Victor Dupouy
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Antiplatelet drug, thoracentesis, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Thoracentesis, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, Hematoma, bleeding risk, medicine, antiplatelet drug, 030212 general & internal medicine, Embolization, closed pleural biopsy, Univariate analysis, business.industry, medicine.disease, Hemothorax, Thrombosis, 3. Good health, Surgery, 030228 respiratory system, chest tube insertion, pleural procedure, Cardiology and Cardiovascular Medicine, business, Cohort study
Abstract: International audience; Background: The decision-making on antiplatelet drug withdrawal or continuation before performing a pleural procedure is based on the balance between the risk of bleeding associated with the antiplatelet therapy and the risk of arterial thrombosis due to its interruption. Knowledge on antiplatelet therapy-associated risk of bleeding after pleural procedures is lacking.Research question: Is the risk of bleeding associated with antiplatelet drugs increased in patients undergoing pleural procedures?Study design and methods: We conducted a French multicenter cohort study in 19 centers. The main outcome was the occurrence of bleeding, defined as hematoma, hemoptysis, or hemothorax, during the 24 h following a pleural procedure. Serious bleeding events were defined as bleeding requiring blood transfusion, respiratory support, endotracheal intubation, embolization, or surgery, or as death.Results: A total of 1,124 patients was included (men, 66%; median age, 62.6 ± 27.7 years), of whom 182 were receiving antiplatelet therapy and 942 were not. Fifteen patients experienced a bleeding event, including eight serious bleeding events. The 24-h incidence of bleeding was 3.23% (95% CI, 1.08%-5.91%) in the antiplatelet group and 0.96% (95% CI, 0.43%-1.60%) in the control group. The occurrence of bleeding events was significantly associated with antiplatelet therapy in univariate analysis (OR, 3.44; 95% CI, 1.14-9.66; P = .021) and multivariate analysis (OR, 4.13; 95% CI, 1.01-17.03; P = .044) after adjusting for demographic data and the main risk factors for bleeding. Likewise, antiplatelet therapy was significantly associated with serious bleeding in univariate analysis (OR, 8.61; 95% CI, 2.09-42.3; P = .003) and multivariate analysis (OR, 7.27; 95% CI, 1.18-56.1; P = .032) after adjusting for the number of risk factors for bleeding.Interpretation: Antiplatelet therapy was associated with an increased risk of post-pleural procedure bleeding and serious bleeding. Future guidelines should take into account these results for patient safety.
Published: 2021
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58. Clinical Applications of High-Flow Nasal Cannula in Acute Hypoxemic Respiratory Failure

Author: Jonathan Messika, Damien Marie, Jean-Damien Ricard, and Jean-Pierre Frat
Subjects: Respiratory rate, business.industry, medicine.medical_treatment, Emergency department, Oxygenation, medicine.disease_cause, Intensive care unit, law.invention, Intubation procedure, law, Oxygen therapy, Anesthesia, Medicine, Intubation, business, Nasal cannula
Abstract: The use of high-flow nasal cannula oxygen therapy is spreading in intensive care unit in patients with acute respiratory failure. It is based on benefits of high-flow oxygen reported by a randomized controlled trial comparing high-flow oxygen with standard oxygen and noninvasive ventilation in patients having acute hypoxemic respiratory failure. Mortality and intubation rates reduced especially in severe patients treated with high-flow oxygen as compared with the other two strategies. For patients treated early for acute respiratory failure in the emergency department physiological parameters improved with a decrease in respiratory rate and an improvement in oxygenation with a better comfort as compared with standard oxygen. These results led to the use of high-flow oxygen as an alternative to standard oxygen in patients with acute hypoxemic respiratory failure; however future studies should confirm the superiority of high-flow oxygen. Indeed, a recent large randomized controlled trial in immunocompromised patients with acute respiratory failure reported no difference between high-flow oxygen and standard oxygen in terms of mortality and intubation rates. Before ongoing intubation, patients with acute hypoxemic respiratory failure should have preoxygenation rather with noninvasive ventilation than high-flow oxygen to avoid severe hypoxemia and secure intubation procedure.
Published: 2021
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59. Airway complications in lung transplant recipients with telomere‐related interstitial lung disease

Author: Souheil El-Chemaly, Romain Lazor, Jérôme Le Pavec, Aurélie Le Borgne, Jean François Mornex, A. Roux, Raphael Borie, Antoine Froidure, Sandrine Hirschi, Hilary J. Goldberg, Andrew M. Courtwright, Martine Reynaud-Gaubert, Sébastien Quétant, Bina Choi, Jonathan Messika, Mathilde Phillips Houlbracq, Brigham & Women’s Hospital [Boston] (BWH), Harvard Medical School [Boston] (HMS), Physiopathologie et Epidémiologie des Maladies Respiratoires (PHERE (UMR_S_1152 / U1152)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Hospital of the University of Pennsylvania (HUP), Perelman School of Medicine, University of Pennsylvania-University of Pennsylvania, Infections Virales et Pathologie Comparée - UMR 754 (IVPC), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hospices Civils de Lyon (HCL), Centre de Référence des Maladies Pulmonaires Rares, Les Hôpitaux Universitaires de Strasbourg (HUS), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre Chirurgical Marie Lannelongue (CCML), Service Hospitalier Universitaire Pneumologie-Physiologie [CHU Grenoble Alpes] (Pôle Thorax et Vaisseaux), Centre Hospitalier Universitaire [Grenoble] (CHU), Université Catholique de Louvain = Catholic University of Louvain (UCL), Lausanne University Hospital, Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), École pratique des hautes études (EPHE), ROSSI, Sabine, UCL - (SLuc) Service de pneumologie, and UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie
Subjects: medicine.medical_specialty, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, medicine.medical_treatment, Population, Constriction, Pathologic, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, telomerase, Internal medicine, medicine, lung transplantation, Humans, Lung transplantation, education, Lung, Retrospective Studies, Transplantation, education.field_of_study, telomere, pulmonary fibrosis, business.industry, Interstitial lung disease, Retrospective cohort study, Odds ratio, respiratory system, medicine.disease, Transplant Recipients, respiratory tract diseases, Stenosis, Cohort, Female, Lung Diseases, Interstitial, business
Abstract: International audience; Introduction Patients with short telomere-related interstitial lung disease (ILD) have worse outcomes after lung transplantation. We hypothesized that post-transplant airway complications, including dehiscence and bronchial stenosis, would be more common in the short telomere ILD lung transplant population. Methods We conducted a multi-institutional (Brigham and Women's Hospital, Groupe de Transplantation de la SPLF) retrospective cohort study of 63 recipients between 2009 and 2019 with ILD and short telomeres, compared to 4359 recipients from the Scientific Registry of Transplant Recipients with ILD and no known telomeropathy. Results In the short telomere cohort, six recipients (9.5%) developed dehiscence and nine recipients (14.3%) developed stenosis, compared to 60 (1.4%) and 149 (3.4%) in the control, respectively. After adjusting for age, sex, and bilaterality, the presence of short telomeres was associated with higher odds of dehiscence (odds ratio (OR) = 8.24, 95% confidence interval (CI) = 3.34 20.29, p < .001) and stenosis (OR = 4.63, 95% CI 2.21 9.69, p < .001). Conclusion The association between the presence of short telomeres and post-transplant dehiscence and stenosis suggest that airway complications may be a contributor to increased morbidity and mortality in patients with telomere-related ILD.
Published: 2021
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60. Aspiration Risk Factors, Microbiology, and Empiric Antibiotics for Patients Hospitalized With Community-Acquired Pneumonia

Author: Judith Marin-Corral, Sergi Pascual-Guardia, Francesco Amati, Stefano Aliberti, Joan R Masclans, Nilam Soni, Alejandro Rodriguez, Oriol Sibila, Francisco Sanz, Giovanni Sotgiu, Antonio Anzueto, Katerina Dimakou, Roberta Petrino, Ewoudt van de Garde, Marcos I Restrepo, GLIMP investigators, Patricia Karina Aruj, Silvia Attorri, Enrique Barimboim, Juan Pablo Caeiro, María I Garzón, Victor Hugo Cambursano, V H Dr Cazaux A Adrian Ceccato, Julio Chertcoff, Florencia Lascar, Fernando Di Tulio, Ariel Cordon Díaz, Lautaro de Vedia, Maria Cristina Ganaha, Sandra Lambert, Gustavo Lopardo, Carlos M Luna, Alessio Gerardo Malberti, Nora Morcillo, Silvina Tartara, Claudia Pensotti, Betiana Pereyra, Pablo Gustavo Scapellato, Juan Pablo Stagnaro, Sonali Shah, Felix Lötsch, Florian Thalhammer, Kurt Anseeuw, Camille A Francois, Eva Van Braeckel, Jean Louis Vincent, Marcel Zannou Djimon, Jules Bashi, Roger Dodo, Simone Aranha Nouér, Peter Chipev, Milena Encheva, Darina Miteva, Diana Petkova, Adamou Dodo Balkissou, Eric Walter Pefura Yone, Bertrand Hugo Mbatchou Ngahane, Ning Shen, Jin-Fu Xu, Carlos Andres Bustamante Rico, Ricardo Buitrago, Fernando Jose Pereira Paternina, Jean-Marie Kayembe Ntumba, Vesna Vladic Carevic, Marko Jakopovic, Mateja Jankovic, Zinka Matkovic, Ivan Mitrecic, Marie-Laure Bouchy Jacobsson, Anette Bro Christensen, Uffe Christian Heitmann Bødtger, Christian Niels Meyer, Andreas Vestergaard Jensen, Gertrud Baunbæk-Knudsen, Pelle Trier Petersen, Stine Andersen, Ibrahim El-Said Abd El-Wahhab, Nesreen Elsayed Morsy, Hanaa Shafiek, Eman Sobh, Kedir Abdella Abdulsemed, Fabrice Bertrand, Christian Brun-Buisson, Etienne de Montmollin, Muriel Fartoukh, Jonathan Messika, Pierre Tattevin, Abdo Khoury, Bernard Ebruke, Michael Dreher, Martin Kolditz, Matthias Meisinger, Mathias W Pletz, Stefan Hagel, Jan Rupp, Tom Schaberg, Marc Spielmanns, Petra Creutz, Norton Suttorp, Beatrice Siaw-Lartey, Dimosthenis Papapetrou, Evdoxia Tsigou, Dimitrios Ampazis, Evangelos Kaimakamis, Mohit Bhatia, Raja Dhar, George D'Souza, Rajiv Garg, Parvaiz A Koul, P A Mahesh, B S Jayaraj, Kiran Vishnu Narayan, Hirennappa B Udnur, Shashi Bhaskara Krishnamurthy, Surya Kant, Rajesh Swarnakar, Sneha Limaye, Sundeep Salvi, Keihan Golshani, Vera M Keatings, Ignacio Martin-Loeches, Yasmin Maor, Jacob Strahilevitz, Paola Faverio, Salvatore Battaglia, Maria Carrabba, Piero Ceriana, Marco Confalonieri, Antonella d'Arminio Monforte, Bruno Del Prato, Marino De Rosa, Riccardo Fantini, Giuseppe Fiorentino, Maria Antonia Gammino, Francesco Menzella, Giuseppe Milani, Stefano Nava, Gerardo Palmiero, Barbra Gabrielli, Paolo Rossi, Claudio Sorino, Gundi Steinhilber, Alessandro Zanforlin, Ospedale San Luca, Fabio Franzetti, Manuela Carugati, Manuela Morosi, Elisa Monge, Mauro Carone, Vincenzo Patella, Simone Scarlata, Andrea Comel, Kiyoyasu Kurahashi, Zeina Aoun Bacha, Daniel Barajas Ugalde, Omar Ceballos Zuñiga, José F Villegas, Milic Medenica, Deebya Raj Mihsra, Poojan Shrestha, Elliott Ridgeon, Babatunde Ishola Awokola, Ogonna N O Adefuye Bolanle Olufunlola, Segaolu Olumide, Kingsley N Ukwaja, Muhammad Irfan, Lukasz Minarowski, Skoczyński Szymon, Felipe Froes, Pedro Leuschner, Mariana Meireles, Cláudia Ferrão, João Neves, Abel Salazar, Sofia B Ravara, Victoria Brocovschii, Doina Rusu, Cristina Toma, Daniela Chirita, Carmen Mihaela Dorobat, Alexei Birkun, Anna Kaluzhenina, Abdullah Almotairi, Zakeya Abdulbaqi Ali Bukhary, Jameela Edathodu, Amal Fathy, Abdullah Mushira Abdulaziz Enani, Nazik Eltayeb Mohamed, Jawed Ulhadi Memon, Abdelhaleem Bella, Serbia Nada Bogdanović, Branislava Milenkovic, Dragica Pesut, Luis Borderìas, Noel Manuel Bordon Garcia, Hugo Cabello Alarcón, Catia Cilloniz, Antoni Torres, Vicens Diaz-Brito, Xavier Casas, Alicia Encabo González, Maria Luisa Fernández-Almira, Medicina Interna, Miguel Gallego, Inmaculada Gaspar-GarcÍa, Juan González Del Castillo, Patricia Javaloyes Victoria, Elena Laserna Martínez, Rosa Malo de Molina, Pedro J Marcos, Rosario Menéndez, Ana Pando-Sandoval, Cristina Prat Aymerich, Alicia Lacoma de la Torre, Ignasi García-Olivé, Jordi Rello, Silvia Moyano, Ana Rodrigo-Troyano, Jordi Solé-Violán, Ane Uranga, Job Fm van Boven, Ester Vendrell Torra, Jordi Almirall Pujol, Charles Feldman, Ho Kee Yum, Inje Univ Arnauld Attannon Fiogbe, Ferdaous Yangui, Semra Bilaceroglu, Izmir Dr Levent Dalar, Ufuk Yilmaz, Artemii Bogomolov, Naheed Elahi, Devesh J Dhasmana, Andrew Feneley, Adam T Hill, Banu Rudran, Silvia Ruiz-Buitrago, Marion Campbell, Paul Whitaker, Alexander Youzguin, Anika Singanayagam, C Hancock, David Villafuerte, Karen S Allen, Veronica Brito, Jessica Dietz, Claire E Dysart, Susan M Kellie, Clement J Ricardo A Franco-Sadud, Garnet Meier, Mina Gaga, Thomas L Holland, Stephen P Bergin, Fayez Kheir, Mark Landmeier, Manuel Lois, Girish B Nair, Hemali Patel, Katherine Reyes, William Rodriguez-Cintron, Shigeki Saito, Julio Noda, Cecilia I Hinojosa, Stephanie M Levine, Luis F Reyes, Luis F Angel, K Scott Whitlow, John Hipskind, Kunal Sukhija, Vicken Totten, Richard G Wunderink, Ray D Shah, Kondwelani John Mateyo, Lorena Noriega, Ezequiel Alvarado, Mohamed Aman, Lucía Labra, Marin-Corral J., Pascual-Guardia S., Amati F., Aliberti S., Masclans J.R., Soni N., Rodriguez A., Sibila O., Sanz F., Sotgiu G., Anzueto A., Dimakou K., Petrino R., van de Garde E., Restrepo M.I., Aruj P.K., Attorri S., Barimboim E., Caeiro J.P., Garzon M.I., Cambursano V.H., Adrian Ceccato V.H.D.C.A., Chertcoff J., Lascar F., Di Tulio F., Diaz A.C., de Vedia L., Ganaha M.C., Lambert S., Lopardo G., Luna C.M., Malberti A.G., Morcillo N., Tartara S., Pensotti C., Pereyra B., Scapellato P.G., Stagnaro J.P., Shah S., Lotsch F., Thalhammer F., Anseeuw K., Francois C.A., Van Braeckel E., Vincent J.L., Djimon M.Z., Bashi J., Dodo R., Nouer S.A., Chipev P., Encheva M., Miteva D., Petkova D., Balkissou A.D., Pefura Yone E.W., Mbatchou Ngahane B.H., Shen N., Xu J.-F., Bustamante Rico C.A., Buitrago R., Pereira Paternina F.J., Kayembe Ntumba J.-M., Carevic V.V., Jakopovic M., Jankovic M., Matkovic Z., Mitrecic I., Bouchy Jacobsson M.-L., Christensen A.B., Heitmann Bodtger U.C., Meyer C.N., Jensen A.V., Baunbaek-knudsen G., Petersen P.T., Andersen S., El-Said Abd El-Wahhab I., Morsy N.E., Shafiek H., Sobh E., Abdulsemed K.A., Bertrand F., Brun-Buisson C., de Montmollin E., Fartoukh M., Messika J., Tattevin P., Khoury A., Ebruke B., Dreher M., Kolditz M., Meisinger M., Pletz M.W., Hagel S., Rupp J., Schaberg T., Spielmanns M., Creutz P., Suttorp N., Siaw-Lartey B., Papapetrou D., Tsigou E., Ampazis D., Kaimakamis E., Bhatia M., Dhar R., D'Souza G., Garg R., Koul P.A., Mahesh P.A., Jayaraj B.S., Narayan K.V., Udnur H.B., Krishnamurthy S.B., Kant S., Swarnakar R., Limaye S., Salvi S., Golshani K., Keatings V.M., Martin-Loeches I., Maor Y., Strahilevitz J., Faverio P., Battaglia S., Carrabba M., Ceriana P., Confalonieri M., Monforte A.D., Del Prato B., De Rosa M., Fantini R., Fiorentino G., Gammino M.A., Menzella F., Milani G., Nava S., Palmiero G., Gabrielli B., Rossi P., Sorino C., Steinhilber G., Zanforlin A., San Luca O., Franzetti F., Carugati M., Morosi M., Monge E., Carone M., Patella V., Scarlata S., Comel A., Kurahashi K., Bacha Z.A., Ugalde D.B., Zuniga O.C., Villegas J.F., Medenica M., Mihsra D.R., Shrestha P., Ridgeon E., Awokola B.I., Adefuye Bolanle Olufunlola O.N.O., Olumide S., Ukwaja K.N., Irfan M., Minarowski L., Szymon S., Froes F., Leuschner P., Meireles M., Ferrao C., Neves J., Abel Salazar, Ravara S.B., Brocovschii V., Rusu D., Toma C., Chirita D., Dorobat C.M., Birkun A., Kaluzhenina A., Almotairi A., Ali Bukhary Z.A., Edathodu J., Fathy A., Abdulaziz Enani A.M., Mohamed N.E., Memon J.U., Bella A., Bogdanovic S.N., Milenkovic B., Pesut D., Borderias L., Bordon Garcia N.M., Alarcon H.C., Cilloniz C., Torres A., Diaz-Brito V., Casas X., Gonzalez A.E., Fernandez-Almira M.L., Interna M., Gallego M., Gaspar-GarcIa I., Gonzalez del Castillo J., Victoria P.J., Martinez E.L., Malo de Molina R., Marcos P.J., Menendez R., Pando-Sandoval A., Aymerich C.P., Lacoma de la Torre A., Garcia-Olive I., Rello J., Moyano S., Rodrigo-Troyano A., Sole-Violan J., Uranga A., van Boven J.F., Torra E.V., Pujol J.A., Feldman C., Yum H.K., Arnauld Attannon Fiogbe I.U., Yangui F., Bilaceroglu S., Levent Dalar I.D., Yilmaz U., Bogomolov A., Elahi N., Dhasmana D.J., Feneley A., Hill A.T., Rudran B., Ruiz-Buitrago S., Campbell M., Whitaker P., Youzguin A., Singanayagam A., Hancock C., Villafuerte D., Allen K.S., Brito V., Dietz J., Dysart C.E., Kellie S.M., Ricardo A. Franco-Sadud C.J., Meier G., Gaga M., Holland T.L., Bergin S.P., Kheir F., Landmeier M., Lois M., Nair G.B., Patel H., Reyes K., Rodriguez-Cintron W., Saito S., Noda J., Hinojosa C.I., Levine S.M., Reyes L.F., Angel L.F., Whitlow K.S., Hipskind J., Sukhija K., Totten V., Wunderink R.G., Shah R.D., Mateyo K.J., Noriega L., Alvarado E., Aman M., Labra L., Marin-Corral, Judith, Pascual-Guardia, Sergi, Amati, Francesco, Aliberti, Stefano, R Masclans, Joan, Soni, Nilam, Rodriguez, Alejandro, Sibila, Oriol, Sanz, Francisco, Sotgiu, Giovanni, Anzueto, Antonio, Dimakou, Katerina, Petrino, Roberta, van de Garde, Ewoudt, I Restrepo, Marco, Investigators, Glimp, Karina Aruj, Patricia, Attorri, Silvia, Barimboim, Enrique, Pablo Caeiro, Juan, I Garzón, María, Hugo Cambursano, Victor, A Adrian Ceccato, V H Dr Cazaux, Chertcoff, Julio, Lascar, Florencia, Di Tulio, Fernando, Cordon Díaz, Ariel, de Vedia, Lautaro, Cristina Ganaha, Maria, Lambert, Sandra, Lopardo, Gustavo, M Luna, Carlo, Gerardo Malberti, Alessio, Morcillo, Nora, Tartara, Silvina, Pensotti, Claudia, Pereyra, Betiana, Gustavo Scapellato, Pablo, Pablo Stagnaro, Juan, Shah, Sonali, Lötsch, Felix, Thalhammer, Florian, Anseeuw, Kurt, A Francois, Camille, Van Braeckel, Eva, Louis Vincent, Jean, Zannou Djimon, Marcel, Bashi, Jule, Dodo, Roger, Aranha Nouér, Simone, Chipev, Peter, Encheva, Milena, Miteva, Darina, Petkova, Diana, Dodo Balkissou, Adamou, Walter Pefura Yone, Eric, Hugo Mbatchou Ngahane, Bertrand, Shen, Ning, Xu, Jin-Fu, Andres Bustamante Rico, Carlo, Buitrago, Ricardo, Jose Pereira Paternina, Fernando, Kayembe Ntumba, Jean-Marie, Vladic Carevic, Vesna, Jakopovic, Marko, Jankovic, Mateja, Matkovic, Zinka, Mitrecic, Ivan, Bouchy Jacobsson, Marie-Laure, Bro Christensen, Anette, Christian Heitmann Bødtger, Uffe, Niels Meyer, Christian, Vestergaard Jensen, Andrea, Baunbæk-Knudsen, Gertrud, Trier Petersen, Pelle, Andersen, Stine, El-Said Abd El-Wahhab, Ibrahim, Elsayed Morsy, Nesreen, Shafiek, Hanaa, Sobh, Eman, Abdella Abdulsemed, Kedir, Bertrand, Fabrice, Brun-Buisson, Christian, de Montmollin, Etienne, Fartoukh, Muriel, Messika, Jonathan, Tattevin, Pierre, Khoury, Abdo, Ebruke, Bernard, Dreher, Michael, Kolditz, Martin, Meisinger, Matthia, W Pletz, Mathia, Hagel, Stefan, Rupp, Jan, Schaberg, Tom, Spielmanns, Marc, Creutz, Petra, Suttorp, Norton, Siaw-Lartey, Beatrice, Papapetrou, Dimostheni, Tsigou, Evdoxia, Ampazis, Dimitrio, Kaimakamis, Evangelo, Bhatia, Mohit, Dhar, Raja, D'Souza, George, Garg, Rajiv, A Koul, Parvaiz, A Mahesh, P, S Jayaraj, B, Vishnu Narayan, Kiran, B Udnur, Hirennappa, Bhaskara Krishnamurthy, Shashi, Kant, Surya, Swarnakar, Rajesh, Limaye, Sneha, Salvi, Sundeep, Golshani, Keihan, M Keatings, Vera, Martin-Loeches, Ignacio, Maor, Yasmin, Strahilevitz, Jacob, Faverio, Paola, Battaglia, Salvatore, Carrabba, Maria, Ceriana, Piero, Confalonieri, Marco, d'Arminio Monforte, Antonella, Del Prato, Bruno, De Rosa, Marino, Fantini, Riccardo, Fiorentino, Giuseppe, Antonia Gammino, Maria, Menzella, Francesco, Milani, Giuseppe, Nava, Stefano, Palmiero, Gerardo, Gabrielli, Barbra, Rossi, Paolo, Sorino, Claudio, Steinhilber, Gundi, Zanforlin, Alessandro, San Luca, Ospedale, Franzetti, Fabio, Carugati, Manuela, Morosi, Manuela, Monge, Elisa, Carone, Mauro, Patella, Vincenzo, Scarlata, Simone, Comel, Andrea, Kurahashi, Kiyoyasu, Aoun Bacha, Zeina, Barajas Ugalde, Daniel, Ceballos Zuñiga, Omar, F Villegas, José, Medenica, Milic, Raj Mihsra, Deebya, Shrestha, Poojan, Ridgeon, Elliott, Ishola Awokola, Babatunde, O Adefuye Bolanle Olufunlola, Ogonna N, Olumide, Segaolu, N Ukwaja, Kingsley, Irfan, Muhammad, Minarowski, Lukasz, Szymon, Skoczyński, Froes, Felipe, Leuschner, Pedro, Meireles, Mariana, Ferrão, Cláudia, Neves, João, Salazar, Abel, B Ravara, Sofia, Brocovschii, Victoria, Rusu, Doina, Toma, Cristina, Chirita, Daniela, Mihaela Dorobat, Carmen, Birkun, Alexei, Kaluzhenina, Anna, Almotairi, Abdullah, Abdulbaqi Ali Bukhary, Zakeya, Edathodu, Jameela, Fathy, Amal, Mushira Abdulaziz Enani, Abdullah, Eltayeb Mohamed, Nazik, Ulhadi Memon, Jawed, Bella, Abdelhaleem, Nada Bogdanović, Serbia, Milenkovic, Branislava, Pesut, Dragica, Borderìas, Lui, Manuel Bordon Garcia, Noel, Cabello Alarcón, Hugo, Cilloniz, Catia, Torres, Antoni, Diaz-Brito, Vicen, Casas, Xavier, Encabo González, Alicia, Luisa Fernández-Almira, Maria, Interna, Medicina, Gallego, Miguel, Gaspar-GarcÍa, Inmaculada, González Del Castillo, Juan, Javaloyes Victoria, Patricia, Laserna Martínez, Elena, Malo de Molina, Rosa, J Marcos, Pedro, Menéndez, Rosario, Pando-Sandoval, Ana, Prat Aymerich, Cristina, Lacoma de la Torre, Alicia, García-Olivé, Ignasi, Rello, Jordi, Moyano, Silvia, Rodrigo-Troyano, Ana, Solé-Violán, Jordi, Uranga, Ane, Fm van Boven, Job, Vendrell Torra, Ester, Almirall Pujol, Jordi, Feldman, Charle, Kee Yum, Ho, Univ Arnauld Attannon Fiogbe, Inje, Yangui, Ferdaou, Bilaceroglu, Semra, Dr Levent Dalar, Izmir, Yilmaz, Ufuk, Bogomolov, Artemii, Elahi, Naheed, J Dhasmana, Devesh, Feneley, Andrew, T Hill, Adam, Rudran, Banu, Ruiz-Buitrago, Silvia, Campbell, Marion, Whitaker, Paul, Youzguin, Alexander, Singanayagam, Anika, Hancock, C, Villafuerte, David, S Allen, Karen, Brito, Veronica, Dietz, Jessica, E Dysart, Claire, M Kellie, Susan, A Franco-Sadud, Clement J Ricardo, Meier, Garnet, Gaga, Mina, L Holland, Thoma, P Bergin, Stephen, Kheir, Fayez, Landmeier, Mark, Lois, Manuel, B Nair, Girish, Patel, Hemali, Reyes, Katherine, Rodriguez-Cintron, William, Saito, Shigeki, Noda, Julio, I Hinojosa, Cecilia, M Levine, Stephanie, F Reyes, Lui, F Angel, Lui, Scott Whitlow, K, Hipskind, John, Sukhija, Kunal, Totten, Vicken, G Wunderink, Richard, D Shah, Ray, John Mateyo, Kondwelani, Noriega, Lorena, Alvarado, Ezequiel, Aman, Mohamed, Labra, Lucía, Marin-Corral, J, Pascual-Guardia, S, Amati, F, Aliberti, S, Masclans, J, Soni, N, Rodriguez, A, Sibila, O, Sanz, F, Sotgiu, G, Anzueto, A, Dimakou, K, Petrino, R, van de Garde, E, Restrepo, M, Aruj, P, Attorri, S, Barimboim, E, Caeiro, J, Garzon, M, Cambursano, V, Adrian Ceccato, V, Chertcoff, J, Lascar, F, Di Tulio, F, Diaz, A, de Vedia, L, Ganaha, M, Lambert, S, Lopardo, G, Luna, C, Malberti, A, Morcillo, N, Tartara, S, Pensotti, C, Pereyra, B, Scapellato, P, Stagnaro, J, Shah, S, Lotsch, F, Thalhammer, F, Anseeuw, K, Francois, C, Van Braeckel, E, Vincent, J, Djimon, M, Bashi, J, Dodo, R, Nouer, S, Chipev, P, Encheva, M, Miteva, D, Petkova, D, Balkissou, A, Pefura Yone, E, Mbatchou Ngahane, B, Shen, N, Xu, J, Bustamante Rico, C, Buitrago, R, Pereira Paternina, F, Kayembe Ntumba, J, Carevic, V, Jakopovic, M, Jankovic, M, Matkovic, Z, Mitrecic, I, Bouchy Jacobsson, M, Christensen, A, Heitmann Bodtger, U, Meyer, C, Jensen, A, Baunbaek-knudsen, G, Petersen, P, Andersen, S, El-Said Abd El-Wahhab, I, Morsy, N, Shafiek, H, Sobh, E, Abdulsemed, K, Bertrand, F, Brun-Buisson, C, de Montmollin, E, Fartoukh, M, Messika, J, Tattevin, P, Khoury, A, Ebruke, B, Dreher, M, Kolditz, M, Meisinger, M, Pletz, M, Hagel, S, Rupp, J, Schaberg, T, Spielmanns, M, Creutz, P, Suttorp, N, Siaw-Lartey, B, Papapetrou, D, Tsigou, E, Ampazis, D, Kaimakamis, E, Bhatia, M, Dhar, R, D'Souza, G, Garg, R, Koul, P, Mahesh, P, Jayaraj, B, Narayan, K, Udnur, H, Krishnamurthy, S, Kant, S, Swarnakar, R, Limaye, S, Salvi, S, Golshani, K, Keatings, V, Martin-Loeches, I, Maor, Y, Strahilevitz, J, Faverio, P, Battaglia, S, Carrabba, M, Ceriana, P, Confalonieri, M, Monforte, A, Del Prato, B, De Rosa, M, Fantini, R, Fiorentino, G, Gammino, M, Menzella, F, Milani, G, Nava, S, Palmiero, G, Gabrielli, B, Rossi, P, Sorino, C, Steinhilber, G, Zanforlin, A, San Luca, O, Franzetti, F, Carugati, M, Morosi, M, Monge, E, Carone, M, Patella, V, Scarlata, S, Comel, A, Kurahashi, K, Bacha, Z, Ugalde, D, Zuniga, O, Villegas, J, Medenica, M, Mihsra, D, Shrestha, P, Ridgeon, E, Awokola, B, Adefuye Bolanle Olufunlola, O, Olumide, S, Ukwaja, K, Irfan, M, Minarowski, L, Szymon, S, Froes, F, Leuschner, P, Meireles, M, Ferrao, C, Neves, J, Abel, S, Ravara, S, Brocovschii, V, Rusu, D, Toma, C, Chirita, D, Dorobat, C, Birkun, A, Kaluzhenina, A, Almotairi, A, Ali Bukhary, Z, Edathodu, J, Fathy, A, Abdulaziz Enani, A, Mohamed, N, Memon, J, Bella, A, Bogdanovic, S, Milenkovic, B, Pesut, D, Borderias, L, Bordon Garcia, N, Alarcon, H, Cilloniz, C, Torres, A, Diaz-Brito, V, Casas, X, Gonzalez, A, Fernandez-Almira, M, Interna, M, Gallego, M, Gaspar-GarcIa, I, Gonzalez del Castillo, J, Victoria, P, Martinez, E, Malo de Molina, R, Marcos, P, Menendez, R, Pando-Sandoval, A, Aymerich, C, Lacoma de la Torre, A, Garcia-Olive, I, Rello, J, Moyano, S, Rodrigo-Troyano, A, Sole-Violan, J, Uranga, A, van Boven, J, Torra, E, Pujol, J, Feldman, C, Yum, H, Arnauld Attannon Fiogbe, I, Yangui, F, Bilaceroglu, S, Levent Dalar, I, Yilmaz, U, Bogomolov, A, Elahi, N, Dhasmana, D, Feneley, A, Hill, A, Rudran, B, Ruiz-Buitrago, S, Campbell, M, Whitaker, P, Youzguin, A, Singanayagam, A, Villafuerte, D, Allen, K, Brito, V, Dietz, J, Dysart, C, Kellie, S, Ricardo, A, Meier, G, Gaga, M, Holland, T, Bergin, S, Kheir, F, Landmeier, M, Lois, M, Nair, G, Patel, H, Reyes, K, Rodriguez-Cintron, W, Saito, S, Noda, J, Hinojosa, C, Levine, S, Reyes, L, Angel, L, Whitlow, K, Hipskind, J, Sukhija, K, Totten, V, Wunderink, R, Shah, R, Mateyo, K, Noriega, L, Alvarado, E, Aman, M, and Labra, L
Subjects: Male, Pulmonary and Respiratory Medicine, medicine.drug_class, Aspiration risk, Antibiotics, Nursing home resident, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Critical Care and Intensive Care Medicine, Microbiology, anaerobic, aspiration, bacteria, pneumonia, risk factors, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Community-acquired pneumonia, Taverne, Anti-Bacterial Agent, medicine, Humans, Community-Acquired Infection, 030212 general & internal medicine, Stroke, Aged, Aged, 80 and over, business.industry, Respiratory Aspiration, Middle Aged, medicine.disease, Antibiotic coverage, Anti-Bacterial Agents, Community-Acquired Infections, Hospitalization, Pneumonia, 030228 respiratory system, Risk factors, risk factor, Female, Underweight, medicine.symptom, business, Cardiology and Cardiovascular Medicine
Abstract: Background: Aspiration community-acquired pneumonia (ACAP) and community-acquired pneumonia (CAP) in patients with aspiration risk factors (AspRFs) are infections associated with anaerobes, but limited evidence suggests their pathogenic role. Research Question: What are the aspiration risk factors, microbiology patterns, and empiric anti-anaerobic use in patients hospitalized with CAP? Study Design and Methods: This is a secondary analysis of GLIMP, an international, multicenter, point-prevalence study of adults hospitalized with CAP. Patients were stratified into three groups: (1) ACAP, (2) CAP/AspRF+ (CAP with AspRF), and (3) CAP/AspRF- (CAP without AspRF). Data on demographics, comorbidities, microbiological results, and anti-anaerobic antibiotics were analyzed in all groups. Patients were further stratified in severe and nonsevere CAP groups. Results: We enrolled 2,606 patients with CAP, of which 193 (7.4%) had ACAP. Risk factors independently associated with ACAP were male, bedridden, underweight, a nursing home resident, and having a history of stroke, dementia, mental illness, and enteral tube feeding. Among non-ACAP patients, 1,709 (70.8%) had CAP/AspRF+ and 704 (29.2%) had CAP/AspRF-. Microbiology patterns including anaerobes were similar between CAP/AspRF-, CAP/AspRF+ and ACAP (0.0% vs 1.03% vs 1.64%). Patients with severe ACAP had higher rates of total gram-negative bacteria (64.3% vs 44.3% vs 33.3%, P =.021) and lower rates of total gram-positive bacteria (7.1% vs 38.1% vs 50.0%, P 50% in all groups) independent of AspRFs or ACAP received specific or broad-spectrum anti-anaerobic coverage antibiotics. Interpretation: Hospitalized patients with ACAP or CAP/AspRF+ had similar anaerobic flora compared with patients without aspiration risk factors. Gram-negative bacteria were more prevalent in patients with severe ACAP. Despite having similar microbiological flora between groups, a large proportion of CAP patients received anti-anaerobic antibiotic coverage.
Published: 2021

61. Outpatient management of primary spontaneous pneumothorax

Author: A. Salé, Yann Bazin, Laurent Sohier, Mallorie Kerjouan, Jean-Damien Ricard, Constance Vuillard, Jonathan Messika, Stéphane Jouneau, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), CHU Pontchaillou [Rennes], Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Pontchaillou, Hôpital Broussais, Groupe Hospitalier Bretagne Sud (GHBS), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Physiopathologie et Epidémiologie des Maladies Respiratoires (PHERE (UMR_S_1152 / U1152)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), CCSD, Accord Elsevier, Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Biopsy, Fine-Needle, Conservative Treatment, Risk Assessment, One-way valve, 03 medical and health sciences, 0302 clinical medicine, Cost Savings, Primary spontaneous pneumothorax, Outpatients, Ambulatory Care, Humans, Medicine, 030212 general & internal medicine, Intensive care medicine, Monitoring, Physiologic, business.industry, Outpatient management, Pneumothorax, food and beverages, Conservative strategies, Patient Preference, Needle aspiration, Tension pneumothorax, 3. Good health, [SDV] Life Sciences [q-bio], Treatment Outcome, 030228 respiratory system, Chest Tubes, Cost of treatment, Drainage, Active treatment, business
Abstract: International audience; The outpatient management of primary spontaneous pneumothorax (PSP) is still debated. The risk of a tension pneumothorax is used to justify active treatment like chest-tube drainage, although outpatient management can reduce both the time in hospital and the cost of treatment. It is also likely to be the patient’s choice. This report is a reappraisal of the situations for which outpatient management, by monitoring alone, or using minimally invasive techniques, can be considered.
Published: 2021
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62. Objective structured clinical examinations (OSCEs) for students’ training and assessment in the French respiratory medicine departments in 2021: An overview

Author: Etienne-Marie Jutant, Lucile Sesé, Maxime Patout, Jonathan Messika, Bernard Maître, Thomas Gille, and Maeva Zysman
Subjects: Pulmonary and Respiratory Medicine, Students, Medical, Pulmonary Medicine, Humans, Clinical Competence, Educational Measurement, Physical Examination
Abstract: Medical professional performances can be assessed by objective structured clinical examinations (OSCEs) where medical trainees go through a series of simulated clinical situations. OSCEs are now the gold standard for the assessment of medical students' competence during their training. In France, the first national OSCEs will take place in May 2024 and respiratory teachers will be involved in this reform and will use OSCEs for students' training and assessment in respiratory medicine. Students training regarding this final OSCE may vary across medical faculties and may impact students' results. Therefore, we aimed to provide a national overview of OSCE's training performed by respiratory teachers and their interest in developing a common French databank of OSCEs.We conducted a national anonymous online survey among the members of the French college of respiratory teachers (CEP), from 2021 February the 15th to 2021 June the 15th. The survey consisted of 32 questions.Among 118 French pulmonologists teachers, 52 (45%) responded to the survey. We received a response from at least one of each of the French Medical Universities. Twenty-two (42%) had received specific training on how to conduct an OSCE. Twenty-eight (54%) of respondents used OSCEs for training purposes and 24 (46%) for assessment purposes, for less than 1 year in more than half of the participants. The average satisfaction scores out of 10 about OSCEs was 7.3 ± 1.7 for training and 7.4 ± 1.5 for students' assessment. Respondents were willing (8.9 ± 1.8 out of ten) to develop a common databank to share OSCEs subjects in respiratory medicine in France.This survey confirms heterogeneity in the training and the use of OSCEs among French respiratory teachers. However, a common national databank could be a useful tool to reduce these disparities.
Published: 2022
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63. Résultats précoces de la transplantation pulmonaire chez les patients âgés de 65 ans et plus

Author: Yves Castier, Philippe Montravers, A. Avramenko-Bouvier, Hervé Mal, Cendrine Godet, Arnaud Roussel, Pierre Mordant, Pierre Cerceau, Jonathan Messika, Vincent Bunel, G. Weisenburger, Quentin Pellenc, Gilles Jebrak, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord, Physiopathologie et Epidémiologie des Maladies Respiratoires (PHERE (UMR_S_1152 / U1152)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), CCSD, Accord Elsevier, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)
Subjects: Pulmonary and Respiratory Medicine, Pediatrics, medicine.medical_specialty, Lung, business.industry, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Primary Graft Dysfunction, Disease, 030204 cardiovascular system & hematology, Single Lung Transplantation, Single Center, 3. Good health, [SDV] Life Sciences [q-bio], 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, 030228 respiratory system, 030220 oncology & carcinogenesis, Medicine, Lung transplantation, In patient, 030212 general & internal medicine, business, Survival rate
Abstract: Resume Introduction Le nombre des transplantations pulmonaires realisees dans le monde n’a cesse d’augmenter au fil du temps. A mesure de l’experience accumulee, l’âge est passe d’une contre-indication absolue a une contre-indication relative. Nous rapportons ici notre premiere experience avec les receveurs âges de 65 ans et plus. Methodes Toutes les transplantations pulmonaires entre janvier 2014 et mars 2019 chez les patients âges de 65 ans et plus ont ete retrospectivement analysees a partir d’une base de donnees prospective. Resultats Vingt-cinq patients âges de 65 ans et plus ont ete transplantes durant la periode de l'etude parmi les 241 patients transplantes a l'hopital Bichat (Paris). Les indications etaient les pathologies interstitielles (72 %) et les troubles ventilatoires obstructifs (28 %). Les transplantations etaient mono-pulmonaires dans 80 % des cas. Seize patients ont necessite une assistance circulatoire par ECMO veino-arterielle peripherique en peroperatoire. Les complications precoces ont ete dominees par la defaillance primaire du greffon grade 3 (12 %) et le rejet cellulaire (20 %). La survie globale a un an a ete de 76 %. Conclusion Les resultats precoces de cette courte serie monocentrique et retrospective sont encourageants et nous permettent de continuer a proposer l’acces a la transplantation chez les patients âges de 65 ans et plus sous reserve d’une selection rigoureuse.
Published: 2020
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64. Reply to Yan and Muller, 'Captisol and GS-704277, but Not GS-441524, Are Credible Mediators of Remdesivir’s Nephrotoxicity'

Author: Quentin Le Hingrat, Jean-François Timsit, Pierre Jaquet, Christine Le Beller, Laurent Massias, Hervé Mal, Gilles Peytavin, Diane Descamps, Benoit Visseaux, Minh Patrick Lê, Vincent Bunel, Paul-Henri Wicky, and Jonathan Messika
Subjects: 2019-20 coronavirus outbreak, Adenosine, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Nephrotoxicity, 03 medical and health sciences, Renal Dialysis, Medicine, Humans, Pharmacology (medical), Pyrroles, Furans, Letter to the Editor, Lung, Pandemics, Pharmacology, 0303 health sciences, Alanine, 030306 microbiology, business.industry, SARS-CoV-2, Triazines, beta-Cyclodextrins, COVID-19, Virology, Adenosine Monophosphate, Transplant Recipients, Infectious Diseases, business, Neuroglia, Lung Transplantation
Abstract: We thank Yan VC and Muller FL (1) for taking their valuable time to comment on our article.….
Published: 2020

65. COVID-19 in Lung Transplant Recipients

Author: Nicolas Carlier, Adrien Tissot, Martine Reynaud-Gaubert, Benjamin Renaud-Picard, Xavier Demant, Sacha Mussot, Ana Nieves, Christel Saint Raymond, Sandrine Hirschi, Philippine Eloy, Aurélie Le Borgne, Jonathan Messika, Marie-Pierre Debray, Véronique Boussaud, Agathe Sénéchal, Jean-François Mornex, Loïc Falque, Jérôme Le Pavec, L. Beaumont, Hervé Mal, Jacques Jougon, Antoine Roux, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), INSERM UMR1152, Service de Pneumologie et Transplantation Pulmomaire, Hôpital Bichat - Claude Bernard, Assistance Publique - Hôpitaux de Paris (AP-HP), Département d’Epidémiologie et Recherche Clinique [AP-HP Hôpital Bichat - Claude Bernard] (CIC‑EC 1425), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Les Hôpitaux Universitaires de Strasbourg (HUS), Aix Marseille Université (AMU), Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France, «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, Le Plessis-Robinson, hôpital Louis-Pradel, CHU de Lyon, 69500 Bron, France., Centre Hospitalier Universitaire [Grenoble] (CHU), AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Foch [Suresnes], Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Infections Virales et Pathologie Comparée - UMR 754 (IVPC), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre Hospitalier Universitaire Grenoble Alpes (CHU Grenoble Alpes), CHU Toulouse [Toulouse], École pratique des hautes études (EPHE), and HAL UVSQ, Équipe
Subjects: Adult, Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], medicine.medical_treatment, 030230 surgery, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Internal medicine, Humans, Medicine, Lung transplantation, Letters to the Editor, Survival rate, Retrospective Studies, Univariate analysis, Transplantation, SARS-CoV-2, business.industry, COVID-19, Retrospective cohort study, Middle Aged, medicine.disease, Intensive care unit, Transplant Recipients, 3. Good health, [SDV] Life Sciences [q-bio], Intensive Care Units, Pneumonia, Cohort, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Female, 030211 gastroenterology & hepatology, business, Immunosuppressive Agents, Lung Transplantation, Cohort study
Abstract: International audience; BACKGROUND: A concern about the susceptibility of immunocompromised patients to the worldwide pandemic of coronavirus disease 2019 (COVID-19) has been raised. We aimed at describing COVID-19 infections in the French cohort of lung transplant (LT) patients. METHODS: Multicenter nationwide cohort study of all LT recipients with COVID-19 diagnosed from March 1 to May 19, 2020. Recipient main characteristics and their management were retrieved. Hospitalization characteristics, occurrence of complications and survival were analyzed. RESULTS: Thirty-five LT patients with a COVID-19 infection were included. Median age was 50.4 (40.6-62.9) years, 16 (45.7%) were female, and 80% were double-LT recipients. Infection was community-acquired in 25 (71.4%). Thirty-one (88.6%) required hospitalization, including 13 (41.9%) in the intensive care unit. The main symptoms of COVID-19 were fever, cough, and diarrhea, present in 71.4%, 54.3%, and 31.4% of cases, respectively. Extension of pneumonia on chest CT was moderate to severe in 51.4% of cases. Among the 13 critically ill patients, 7 (53.9%) received invasive mechanical ventilation. Thrombotic events occurred in 4 patients. Overall survival rate was 85.7% after a median follow-up of 50 days (41.0-56.5). Four of 5 nonsurvivors had had bronchial complications or intensification of immunosuppression in the previous weeks. On univariate analysis, overweight was significantly associated with risk of death (odds ratio, 16.0; 95% confidence interval, 1.5-170.6; P = 0.02). CONCLUSIONS: For the 35 LT recipients with COVID-19, the presentation was severe, requiring hospitalization in most cases, with a survival rate of 85.7%. Copyright
Published: 2020
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66. Removal of Remdesivir’s Metabolite GS-441524 by Hemodialysis in a Double Lung Transplant Recipient with COVID-19

Author: Quentin Le Hingrat, Pierre Jaquet, Paul Henri Wicky, Minh Patrick Lê, Gilles Peytavin, Jean-François Timsit, Hervé Mal, Benoit Visseaux, Vincent Bunel, Jonathan Messika, Diane Descamps, and Laurent Massias
Subjects: medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, Metabolite, remdesivir, Urine, Antiviral Agents, Gastroenterology, law.invention, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Pharmacokinetics, In vivo, law, Internal medicine, medicine, Lung transplantation, Pharmacology (medical), 030212 general & internal medicine, Pharmacology, 0303 health sciences, hemodialysis, 030306 microbiology, business.industry, Intensive care unit, Infectious Diseases, chemistry, Hemodialysis, business, pharmacokinetics
Abstract: Remdesivir has reported efficacy against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vitro and in vivo. Drug-drug interactions limit therapeutic options in transplant patients. Remdesivir and its metabolite GS-441524 are excreted principally in urine. In intensive care unit (ICU) settings, in which multiple-organ dysfunctions can occur rapidly, hemodialysis may be a viable option for maintaining remdesivir treatment, while improving tolerance, by removing both remdesivir’s metabolite (GS-441524) and sulfobutylether β-cyclodextrin sodium (SEBCD)., Remdesivir has reported efficacy against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vitro and in vivo. Drug-drug interactions limit therapeutic options in transplant patients. Remdesivir and its metabolite GS-441524 are excreted principally in urine. In intensive care unit (ICU) settings, in which multiple-organ dysfunctions can occur rapidly, hemodialysis may be a viable option for maintaining remdesivir treatment, while improving tolerance, by removing both remdesivir’s metabolite (GS-441524) and sulfobutylether β-cyclodextrin sodium (SEBCD). Additional studies may prove informative, particularly in the evaluations of therapeutic options for coronavirus disease 2019 (COVID-19).
Published: 2020
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67. Impact of panelists' experience on script concordance test scores of medical students

Author: Jennifer Truchot, Sylvie Chevret, Pierre-Emmanuel Cailleaux, Jonathan Messika, Mariana Mirabel, Victoria Tea, Alice Hutin, David Calvet, Raphael Borie, Yousrah Baadj, Adrien Albaladejo, David Lebeaux, Martin Flamant, Alexandre Meunier, Xavier Treton, Damien Roux, Olivier Peyrony, and Clémence Martin
Subjects: Medical knowledge, medicine.medical_specialty, Students, Medical, 020205 medical informatics, Wilcoxon signed-rank test, Concordance, lcsh:Medicine, 02 engineering and technology, Statistics, Nonparametric, Education, 03 medical and health sciences, 0302 clinical medicine, 0202 electrical engineering, electronic engineering, information engineering, medicine, Humans, 030212 general & internal medicine, Experience level, Medical student, Median score, Medical education, lcsh:LC8-6691, Script concordance test, lcsh:Special aspects of education, business.industry, lcsh:R, Clinical reasoning, Uncertainty, General Medicine, Panelist, Test (assessment), Large cohort, Physical therapy, Clinical Competence, Educational Measurement, business, Research Article
Abstract: Background The evaluation process of French medical students will evolve in the next few years in order to improve assessment validity. Script concordance testing (SCT) offers the possibility to assess medical knowledge alongside clinical reasoning under conditions of uncertainty. In this study, we aimed at comparing the SCT scores of a large cohort of undergraduate medical students, according to the experience level of the reference panel. Methods In 2019, the authors developed a 30-item SCT and sent it to experts with varying levels of experience. Data analysis included score comparisons with paired Wilcoxon rank sum tests and concordance analysis with Bland & Altman plots. Results A panel of 75 experts was divided into three groups: 31 residents, 21 non-experienced physicians (NEP) and 23 experienced physicians (EP). Among each group, random samples of N = 20, 15 and 10 were selected. A total of 985 students from nine different medical schools participated in the SCT examination. No matter the size of the panel (N = 20, 15 or 10), students’ SCT scores were lower with the NEP group when compared to the resident panel (median score 67.1 vs 69.1, p p N = 15 and 67.7 vs 68.4, p N = 10) and with EP compared to NEP (65.4 vs 67.1, p p p Conclusions Even though student SCT scores differed statistically according to the expert panels, these differences were rather weak. These results open the possibility of including less-experienced experts in panels for the evaluation of medical students.
Published: 2020

68. Antiplatelet Drugs and Risk of Bleeding After Bedside Pleural Procedures: A National Multicenter Cohort Study

Author: Laurence, Dangers, Jonathan, Giovannelli, Gilles, Mangiapan, Mikael, Alves, Naïke, Bigé, Jonathan, Messika, Elise, Morawiec, Mathilde, Neuville, Christophe, Cracco, Gaëtan, Béduneau, Nicolas, Terzi, Isabelle, Huet, Xavier, Dhalluin, Nathalie, Bautin, Jean-Jacques, Quiot, Corinne, Appere-de Vecchi, Thomas, Similowski, and Cécile, Chenivesse
Subjects: Adult, Male, Risk, Biopsy, Thoracentesis, Hemorrhage, Middle Aged, Pleural Diseases, Cohort Studies, Chest Tubes, Humans, Female, France, Platelet Aggregation Inhibitors, Aged
Abstract: The decision-making on antiplatelet drug withdrawal or continuation before performing a pleural procedure is based on the balance between the risk of bleeding associated with the antiplatelet therapy and the risk of arterial thrombosis due to its interruption. Knowledge on antiplatelet therapy-associated risk of bleeding after pleural procedures is lacking.Is the risk of bleeding associated with antiplatelet drugs increased in patients undergoing pleural procedures?We conducted a French multicenter cohort study in 19 centers. The main outcome was the occurrence of bleeding, defined as hematoma, hemoptysis, or hemothorax, during the 24 h following a pleural procedure. Serious bleeding events were defined as bleeding requiring blood transfusion, respiratory support, endotracheal intubation, embolization, or surgery, or as death.A total of 1,124 patients was included (men, 66%; median age, 62.6 ± 27.7 years), of whom 182 were receiving antiplatelet therapy and 942 were not. Fifteen patients experienced a bleeding event, including eight serious bleeding events. The 24-h incidence of bleeding was 3.23% (95% CI, 1.08%-5.91%) in the antiplatelet group and 0.96% (95% CI, 0.43%-1.60%) in the control group. The occurrence of bleeding events was significantly associated with antiplatelet therapy in univariate analysis (OR, 3.44; 95% CI, 1.14-9.66; P = .021) and multivariate analysis (OR, 4.13; 95% CI, 1.01-17.03; P = .044) after adjusting for demographic data and the main risk factors for bleeding. Likewise, antiplatelet therapy was significantly associated with serious bleeding in univariate analysis (OR, 8.61; 95% CI, 2.09-42.3; P = .003) and multivariate analysis (OR, 7.27; 95% CI, 1.18-56.1; P = .032) after adjusting for the number of risk factors for bleeding.Antiplatelet therapy was associated with an increased risk of post-pleural procedure bleeding and serious bleeding. Future guidelines should take into account these results for patient safety.
Published: 2020

69. Strengths of the French end-of-life Law as Well as its Shortcomings in Handling Intractable Disputes Between Physicians and Families

Author: Virginie Fouilloux, Anahita Rouzé, Claire-Marie Barbier, Noël Boussard, Jonathan Messika, Fabrice Michel, Henry Silverman, Saad Nseir, Claude Guérin, Didier Dreyfuss, Hodane Yonis, Jean-Damien Ricard, Stéphane Gaudry, Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord, Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord
Subjects: Adult, Male, Adolescent, media_common.quotation_subject, [SDV]Life Sciences [q-bio], Treatment withdrawal, 030204 cardiovascular system & hematology, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Reading (process), Intensive care, Stress (linguistics), Humans, 030212 general & internal medicine, health care economics and organizations, ComputingMilieux_MISCELLANEOUS, Aged, media_common, Aged, 80 and over, Terminal Care, Jurisdiction, Infant, 16. Peace & justice, Dissent and Disputes, Intensive care unit, Intensive Care Units, Issues, ethics and legal aspects, Withholding Treatment, Female, France, Psychology
Abstract: French end-of-life law aims at protecting patients from unreasonable treatments, but has been used to force caregivers to prolong treatments deemed unreasonable. We describe six cases (five intensive care unit patients including two children) where families disagreed with a decision to withdraw treatments and sued medical teams. An emergent inquiry was instigated by the families. In two cases, the court rejected the families' inquiries. In two cases, the families appealed the decision, and in both the first jurisdiction decision was confirmed, compelling caregivers to pursue treatments, even though they deemed them unreasonable. We discuss how this law may be perverted. Legal procedures may result in the units' disorganisation and give rise to caregivers' stress. Families' requests may be subtended by religious beliefs. French end-of-life law has benefits in theoretically constraining physicians to withhold or withdraw disproportionate therapies. These cases underline some caveats and the perverse effects of its literal reading.
Published: 2020
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70. Etiologies and Outcomes of Acute Respiratory Failure in Solid Organ Transplant Recipients: Insight Into the EFRAIM Multicenter Cohort

Author: Elie Azoulay, Sylvie Chevret, Miia Valkonen, Jonathan Messika, Efraim investigators, Gastón Burghi, Hervé Mal, Emmanuel Canet, François Barbier, Jordi Rello, Sangeeta Mehta, Achille Kouatchet, Djamel Mokart, Victoria Metaxa, Lene B. Nielsen, Marcio Soares, Luca Montini, Virginie Lemiale, Andry Van de Louw, Peter Pickkers, Frédéric Pène, Philippe R. Bauer, Peter Schellongowski, Michael Darmon, Lara Zafrani, Fabio Silvio Taccone, Massimo Antonelli, Fabrice Bruneel, Ignacio Martin Loeches, Anne Sophie Moreau, Andreas Barratt-Due, HUS Perioperative, Intensive Care and Pain Medicine, Anestesiologian yksikkö, Department of Diagnostics and Therapeutics, University of Helsinki, and Helsinki University Hospital Area
Subjects: Male, Etiologies, medicine.medical_treatment, lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], THERAPY, OXYGEN, law.invention, Cohort Studies, 0302 clinical medicine, Postoperative Complications, law, Medicine, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, medicine.diagnostic_test, BRONCHOSCOPY, Middle Aged, Intensive care unit, 3. Good health, medicine.anatomical_structure, Cohort, Female, Respiratory Insufficiency, Etiologies, Outcomes, Acute Respiratory Failure, Cohort study, medicine.medical_specialty, Outcomes, NONINVASIVE VENTILATION, 03 medical and health sciences, IMMUNOCOMPROMISED PATIENTS, HEMATOLOGY, All institutes and research themes of the Radboud University Medical Center, Internal medicine, Settore MED/41 - ANESTESIOLOGIA, Humans, PULMONARY COMPLICATIONS, Chirurgie, Aged, Mechanical ventilation, Transplantation, Lung, business.industry, Organ Transplantation, 3126 Surgery, anesthesiology, intensive care, radiology, Transplantation d'organes, Transplant Recipients, ONCOLOGY PATIENTS, Bronchoalveolar lavage, 030228 respiratory system, INTUBATION, 13. Climate action, Etiology, Surgery, business, Acute Respiratory Failure
Abstract: Background: Respiratory complications of solid organ transplant (SOT) are a diagnostic and therapeutic challenge when requiring intensive care unit (ICU) admission. We aimed at describing this challenge in a prospective cohort of SOT recipients admitted in the ICU. Methods: In this post hoc analysis of an international cohort of immunocompromised patients admitted in the ICU for an acute respiratory failure, we analyzed all SOT recipients and compared their severity, etiologic diagnosis, prognosis, and outcome according to the performance of an invasive diagnostic strategy (encompassing a fiber-optic bronchoscopy and bronchoalveolar lavage), the type of transplanted organ, and the need of invasive ventilation at day 1. Results: Among 1611 patients included in the primary study, 142 were SOT recipients (kidney, n = 73; 51.4%; lung, n = 33; 23.2%; liver, n = 29; 20.4%; heart, n = 7; 4.9%). Lung transplant recipients were younger than other SOT recipients, and severity did not differ across type of received organ. An invasive diagnostic strategy was more frequently performed in lung transplant recipients with a trend toward a higher rate of bacterial etiology in lung than kidney transplant recipients. Overall ICU survival of SOT recipients was 75.4%. Invasive diagnostic strategy, type of transplanted organ, and need of invasive mechanical ventilation at day 1 did not affect ICU prognosis. Conclusions: ICU management of hypoxemic acute respiratory failure in SOT recipients translated into a low ICU mortality rate, whatever the transplanted organ or the acute respiratory failure cause. The post-ICU burden of acute respiratory failure SOT recipients remains to be investigated., SCOPUS: ar.j, info:eu-repo/semantics/published
Published: 2020
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71. Etiologies and Outcomes of Acute Respiratory Failure in Solid Organ Transplant Recipients: Insight Into the EFRAIM Multicenter Cohort

Author: 1, Jonathan Messika, 2, Michael Darmon, 3, Hervé Mal, 4, Peter Pickker, 5, Marcio Soare, 6, Emmanuel Canet, 7, Jordi Rello, R Bauer 8, Philippe, 9, Andry van de Louw, 2, Virginie Lemiale, Silvio Taccone 10, Fabio, Martin Loeches 11, Ignacio, Schellongowski 12, Peter, Mehta 13, Sangeeta, Antonelli, Massimo, Kouatchet 15, Achille, Barratt-Due 16, Andrea, Valkonen 17, Miia, Bruneel 18, Fabrice, Pène 19, Frédéric, Metaxa 20, Victoria, Sophie Moreau 21, Anne, Burghi 22, Gaston, Montini, Luca, Barbier 23, Françoi, B Nielsen 24, Lene, Mokart 25, Djamel, Chevret 26, Sylvie, 2, Lara Zafrani, 2, Elie Azoulay, Investigators and the Nine-I Study Group, Efraim, Massimo Antonelli (ORCID:0000-0003-3007-1670), Luca Montini 15 (ORCID:0000-0003-4602-5134), 1, Jonathan Messika, 2, Michael Darmon, 3, Hervé Mal, 4, Peter Pickker, 5, Marcio Soare, 6, Emmanuel Canet, 7, Jordi Rello, R Bauer 8, Philippe, 9, Andry van de Louw, 2, Virginie Lemiale, Silvio Taccone 10, Fabio, Martin Loeches 11, Ignacio, Schellongowski 12, Peter, Mehta 13, Sangeeta, Antonelli, Massimo, Kouatchet 15, Achille, Barratt-Due 16, Andrea, Valkonen 17, Miia, Bruneel 18, Fabrice, Pène 19, Frédéric, Metaxa 20, Victoria, Sophie Moreau 21, Anne, Burghi 22, Gaston, Montini, Luca, Barbier 23, Françoi, B Nielsen 24, Lene, Mokart 25, Djamel, Chevret 26, Sylvie, 2, Lara Zafrani, 2, Elie Azoulay, Investigators and the Nine-I Study Group, Efraim, Massimo Antonelli (ORCID:0000-0003-3007-1670), and Luca Montini 15 (ORCID:0000-0003-4602-5134)
Abstract: Background: Respiratory complications of solid organ transplant (SOT) are a diagnostic and therapeutic challenge when requiring intensive care unit (ICU) admission. We aimed at describing this challenge in a prospective cohort of SOT recipients admitted in the ICU. Methods: In this post hoc analysis of an international cohort of immunocompromised patients admitted in the ICU for an acute respiratory failure, we analyzed all SOT recipients and compared their severity, etiologic diagnosis, prognosis, and outcome according to the performance of an invasive diagnostic strategy (encompassing a fiber-optic bronchoscopy and bronchoalveolar lavage), the type of transplanted organ, and the need of invasive ventilation at day 1. Results: Among 1611 patients included in the primary study, 142 were SOT recipients (kidney, n = 73; 51.4%; lung, n = 33; 23.2%; liver, n = 29; 20.4%; heart, n = 7; 4.9%). Lung transplant recipients were younger than other SOT recipients, and severity did not differ across type of received organ. An invasive diagnostic strategy was more frequently performed in lung transplant recipients with a trend toward a higher rate of bacterial etiology in lung than kidney transplant recipients. Overall ICU survival of SOT recipients was 75.4%. Invasive diagnostic strategy, type of transplanted organ, and need of invasive mechanical ventilation at day 1 did not affect ICU prognosis. Conclusions: ICU management of hypoxemic acute respiratory failure in SOT recipients translated into a low ICU mortality rate, whatever the transplanted organ or the acute respiratory failure cause. The post-ICU burden of acute respiratory failure SOT recipients remains to be investigated.
Published: 2020

72. Constipation in critical care patients: both timing and duration matter

Author: Pierre Trouiller, Dominique Prat, Benjamin Sztrymf, Frédéric Jacobs, Jean-Damien Ricard, Jonathan Messika, Nadège Demars, Maude Millereux, Olfa Hamzaoui, and Corentin Gouezel
Subjects: Male, Pediatrics, medicine.medical_specialty, Time Factors, Constipation, Critical Care, Health Status, medicine.medical_treatment, 03 medical and health sciences, Patient Admission, 0302 clinical medicine, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Simplified Acute Physiology Score, Defecation, Prospective cohort study, Aged, Mechanical ventilation, Hepatology, business.industry, Gastroenterology, 030208 emergency & critical care medicine, Mean age, Length of Stay, Middle Aged, Prognosis, Respiration, Artificial, Icu admission, Intensive Care Units, Duration (music), Female, France, medicine.symptom, Gastrointestinal Motility, business
Abstract: Objective Most of the studies have defined constipation as a period without stool after ICU admission. We aimed to test the impact of both duration and timing of infrequent defecation in critical care patients. Patients and methods We performed a prospective, bi-center, observational study. Patients were divided into three subgroups: 'not constipated', '3-5 days', and 'at least 6 days' (longest period without stool passage, respectively, shorter than 3 days, 3-5 days, and ≥6 days). Furthermore, 'early' constipated patients were defined as those for whom the longest time to stool passage occurred just after ICU admission, whereas for 'late' constipated patients the longest period without stool occurred later during ICU stay. Results A total of 182 patients were included: the mean age was 67.2 years (54.4-78.9 years), 80 were women, and simplified acute physiology score II was 42 (34-52). In all, 42 (23.1%), 82 (45.1%), and 58 (31.8%) belonged to the nonconstipated, 3-5 days, or greater than or equal to 6 days subgroup of patients, respectively. Time spent under mechanical ventilation and ICU length of stay was longer in the greater than or equal to 6 days subgroups as compared with both other subgroups. ICU stay was longer in the 3-5 days subgroup as compared with the not constipated patients. Furthermore, the late patients of the greater than or equal to 6 days subgroups exhibited worse survival as compared with all other patients. Conclusion Both timing and duration of infrequent defecation seem to have an impact on critical care patient's outcome, and should therefore be included in the diagnostic criteria.
Published: 2018
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73. Risques associés à la prise d’anti-inflammatoires non stéroïdiens au cours de la pneumonie

Author: Olivier Sanchez, B. Philippe, Claire Andrejak, Jonathan Messika, Damien Basille, Martin Chalumeau, Muriel Fartoukh, Vincent Jounieaux, Guillaume Voiriot, and Jean-Damien Ricard
Subjects: Pulmonary and Respiratory Medicine, Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, 030228 respiratory system, business.industry, Pleural empyema, medicine, Iatrogenic disease, 030212 general & internal medicine, medicine.disease, business
Abstract: Resume Introduction Le traitement ambulatoire de la pneumonie aigue communautaire (PAC) utilise frequemment les anti-inflammatoires non steroidiens (AINS), en dehors de toute recommandation et alors qu’aucune donnee scientifique ne soutient leur benefice symptomatique par rapport au paracetamol. Etat des connaissances Des donnees experimentales suggerent que les AINS perturbent les fonctions intrinseques des polynucleaires neutrophiles, limitent leur recrutement locoregional, alterent la clairance bacterienne et retardent la resolution du processus inflammatoire au cours de l’agression pulmonaire aigue bacterienne. Au cours des PAC de l’enfant et de l’adulte necessitant une hospitalisation, des donnees observationnelles rapportent une association forte et independante entre l’exposition aux AINS et la survenue de complications pleuro-pulmonaires (empyeme pleural, excavation, abces). Dans la seule etude ou un biais protopathique est pris en compte, cette association persiste. D’autres marqueurs de morbidite ont ete decrits, incluant un retard a la prise en charge hospitaliere, une duree d’antibiotherapie allongee et un taux de transfert en reanimation majore. Perspectives Des donnees eclairant les mecanismes biologiques impliques sont attendues. Conclusions L’administration d’AINS au cours du traitement ambulatoire de la PAC constitue probablement le deuxieme facteur modifiable de morbidite apres l’antibiotherapie inadaptee. Les donnees existantes incitent a une reevaluation urgente du rapport benefice-risque de ces molecules par les autorites de sante.
Published: 2018
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74. Underreporting of End-of-Life Decisions in Critical Care Trials: A Call to Modify the Consolidated Standards of Reporting Trials Statement

Author: Florence Tubach, Jean-Damien Ricard, Stéphane Gaudry, Jonathan Messika, S Guillo, Didier Dreyfuss, and David Hajage
Subjects: Male, Research Report, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Critical Care, Statement (logic), Clinical Decision-Making, Alternative medicine, MEDLINE, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, Clinical decision making, medicine, Humans, 030212 general & internal medicine, Mortality, Mortality trends, Randomized Controlled Trials as Topic, Publishing, Terminal Care, Medical education, business.industry, Consolidated Standards of Reporting Trials, 030208 emergency & critical care medicine, United States, Intensive Care Units, Withholding Treatment, Female, Periodicals as Topic, business
Published: 2018
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75. Enteral versus parenteral early nutrition in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2)

Author: Jean Reignier, Julie Boisramé-Helms, Laurent Brisard, Jean-Baptiste Lascarrou, Ali Ait Hssain, Nadia Anguel, Laurent Argaud, Karim Asehnoune, Pierre Asfar, Frédéric Bellec, Vlad Botoc, Anne Bretagnol, Hoang-Nam Bui, Emmanuel Canet, Daniel Da Silva, Michael Darmon, Vincent Das, Jérôme Devaquet, Michel Djibre, Frédérique Ganster, Maité Garrouste-Orgeas, Stéphane Gaudry, Olivier Gontier, Claude Guérin, Bertrand Guidet, Christophe Guitton, Jean-Etienne Herbrecht, Jean-Claude Lacherade, Philippe Letocart, Frédéric Martino, Virginie Maxime, Emmanuelle Mercier, Jean-Paul Mira, Saad Nseir, Gael Piton, Jean-Pierre Quenot, Jack Richecoeur, Jean-Philippe Rigaud, René Robert, Nathalie Rolin, Carole Schwebel, Michel Sirodot, François Tinturier, Didier Thévenin, Bruno Giraudeau, Amélie Le Gouge, Hervé Dupont, Marc Pierrot, François Beloncle, Danièle Combaux, Romain Mercier, Hadrien Winiszewski, Gilles Capellier, Gilles Hilbert, Didier Gruson, Pierre Kalfon, Bertrand Souweine, Elizabeth Coupez, Jean-Damien Ricard, Jonathan Messika, François Bougerol, Pierre-Louis Declercq, Auguste Dargent, Audrey Large, Djillali Annane, Bernard Clair, Agnès Bonadona, Rebecca Hamidfar, Christian Richard, Mathieu Henry-Lagarrigue, Ahiem Yehia Yehia, Johanna Temime, Stephanie Barrailler, Raphaël Favory, Erika Parmentier-Decrucq, Mercé Jourdain, Loredana Baboi, Marie Simon, Thomas Baudry, Mehran Monchi, Jérôme Roustan, Patrick Bardou, Alice Cottereau, Philippe Guiot, Noelle Brule, Mickael Landais, Antoine Roquilly, Thierry Boulain, Dalila Benzekri, Benoit Champigneulle, Jalel Tahiri, Gabriel Preda, Benoit Misset, Virginie Lemiale, Lara Zafrani, Muriel Fartoukh, Guillaume Thiéry, Delphine Chatellier, Rémi Coudroy, Renaud Chouquer, Samuel Gay, Christine Brasse, Arnaud Delahaye, Luis Ferreira, Régine Vermesch, Stéphanie Chevalier, Charlotte Quentin, Quentin Maestraggi, Francis Schneider, Ferhat Meziani, Charles Cerf, Grégoire Trebbia, Charlotte Salmon-Gandonnière, Laetitia Bodet-Contentin, Service d'anesthésie et réanimation chirurgicale [Nantes], Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Service de Réanimation Médicale [Strasbourg], Les Hôpitaux Universitaires de Strasbourg (HUS), Stress vasculaire et tissulaire en transplantation : microparticules et environnement, Université de Strasbourg (UNISTRA), Service de réanimation médicale [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Service d'Anésthésie Réanimation [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Groupement Hospitalier - Hôpital Edouard Herriot, Service de Réanimation Médicale, Hospices Civils de Lyon (HCL), Service de médecine intensive - réanimation et médecine hyperbare [CHU Angers], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Service de réanimation et de surveillance continue [CH Mautauban], Centre hospitalier de Montauban, Service de réanimation (CH Saint-Malo), Centre hospitalier de Saint-Malo, Service de Réanimation Polyvalente - CHR d’Orleans, Service de Réanimation Médicale [CHU Bordeaux], CHU Bordeaux [Bordeaux]-Hôpital Pellegrin, Service d’anesthésie-réanimation [AP-HP Hôpital Saint-Louis], Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), réanimation et soins continus [CH Saint-Denis], Centre Hospitalier de Saint-Denis [Ile-de-France], Service des Urgences et de Réanimation Médicale (Urg - SAINT ETIENNE), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Service de réanimation polyvalente [Hôpital Foch, Suresnes], Hôpital Foch [Suresnes], Service de Réanimation et USC Médico-Chirurgicale = Médecine intensive réanimation [CHU Tenon], CHU Tenon [AP-HP], Service de réanimation chirurgicale [Centre Hospitalier Emile Muller, Mulhouse], Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA)-Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Soins Intensifs [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Le Mans (CH Le Mans), Biomatériaux et Bioingénierie (BB), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Matériaux et nanosciences d'Alsace (FMNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Service de réanimation (CH La Roche-sur-Yon), Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon (CHD Vendée), Service de Réanimation Médicale (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Laboratoire d'Excellence : Lipoprotéines et Santé : prévention et Traitement des maladies Inflammatoires et du Cancer (LabEx LipSTIC), Institut National de la Recherche Agronomique (INRA)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université Paris-Sud - Paris 11 (UP11)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut Gustave Roussy (IGR)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM)-Fédération Francophone de la Cancérologie Digestive, FFCD-Université de Montpellier (UM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service de Réanimation, Hôpital Jean Bernard, CHU de Poitiers, Poitiers, France, Radiopharmaceutiques biocliniques (LRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre d’Investigation Clinique [Tours] CIC 1415 (CIC ), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC - Tours, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Réanimation Médicale, CHU Gabriel Montpied, CHU de Clermont-Ferrand, France, AP-HP Hôpital Saint-Louis, Service de réanimation et USC médico-chirurgicale [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Tenon [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université de Strasbourg (UNISTRA)-Matériaux et nanosciences d'Alsace, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon, Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Recherche Agronomique (INRA)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université Paris-Sud - Paris 11 (UP11)-École pratique des hautes études (EPHE)-Institut Gustave Roussy (IGR)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc (CRLCC - CGFL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Fédération Francophone de la Cancérologie Digestive, FFCD-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Etablissement français du sang [Bourgogne-France-Comté] (EFS [Bourgogne-France-Comté])-Centre National de la Recherche Scientifique (CNRS)-Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Université de Franche-Comté (UFC)-Université de Montpellier (UM), Radiopharmaceutiques biocliniques, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), CIC Tours, Hôpital Bretonneau-Université de Tours-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Réanimation et USC Médico-Chirurgicale [CHU Tenon], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut Gustave Roussy (IGR)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM)-Fédération Francophone de la Cancérologie Digestive, FFCD-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Centre National de la Recherche Scientifique (CNRS)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), Université de Strasbourg (UNISTRA)-Matériaux et nanosciences d'Alsace (FMNGE), Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôtel-Dieu-Centre hospitalier universitaire de Nantes ( CHU Nantes ), Université de Strasbourg ( UNISTRA ), Centre hospitalier universitaire de Nantes ( CHU Nantes ), Hospices Civils de Lyon ( HCL ), CHU Angers, CH Saint-Denis, Service des Urgences et de Réanimation Médicale ( Urg - SAINT ETIENNE ), Centre Hospitalier Universitaire de Saint-Etienne ( CHU de Saint-Etienne ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Tenon [APHP], Centre Hospitalier Emile Muller [Mulhouse] ( CH E.Muller Mulhouse ), Groupe Hospitalier de Territoire Haute Alsace ( GHTHA ) -Groupe Hospitalier de Territoire Haute Alsace ( GHTHA ), Infection, Antimicrobiens, Modélisation, Evolution ( IAME ), Université Paris 13 ( UP13 ) -Université Paris Diderot - Paris 7 ( UPD7 ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Centre Hospitalier Le Mans, Biomatériaux et Bioingénierie, Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Matériaux et nanosciences d'Alsace, Université de Strasbourg ( UNISTRA ) -Université de Haute-Alsace (UHA) Mulhouse - Colmar ( Université de Haute-Alsace (UHA) ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Strasbourg ( UNISTRA ) -Université de Haute-Alsace (UHA) Mulhouse - Colmar ( Université de Haute-Alsace (UHA) ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Lipides - Nutrition - Cancer [Dijon - U1231] ( LNC ), Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire d'Excellence : Lipoprotéines et Santé : prévention et Traitement des maladies Inflammatoires et du Cancer ( LabEx LipSTIC ), Institut National de la Recherche Agronomique ( INRA ) -Université Montpellier 2 - Sciences et Techniques ( UM2 ) -Université Paris-Sud - Paris 11 ( UP11 ) -École pratique des hautes études ( EPHE ) -Institut Gustave Roussy ( IGR ) -Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ) -Université de Bourgogne ( UB ) -Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ) -Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Fédération Francophone de la Cancérologie Digestive, FFCD-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Etablissement français du sang [Bourgogne-France-Comté] ( EFS [Bourgogne-France-Comté] ) -Centre National de la Recherche Scientifique ( CNRS ) -Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université de Franche-Comté ( UFC ), Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hôpital Bretonneau-Université de Tours-CHRU Tours-Institut National de la Santé et de la Recherche Médicale ( INSERM ), and CHRU Tours-Institut National de la Santé et de la Recherche Médicale ( INSERM )
Subjects: Adult, Male, Parenteral Nutrition, Pediatrics, medicine.medical_specialty, Time Factors, Critical Care, Secondary infection, Enteral feeding, Clinical nutrition, Enteral administration, law.invention, 03 medical and health sciences, Enteral Nutrition, 0302 clinical medicine, Randomized controlled trial, law, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, Humans, Vasoconstrictor Agents, Medicine, Cumulative incidence, Hospital Mortality, 030212 general & internal medicine, Nutritional support, Aged, Acute critical illness, business.industry, Malnutrition, Hazard ratio, Shock, 030208 emergency & critical care medicine, General Medicine, Length of Stay, Middle Aged, Interim analysis, Respiration, Artificial, The enteral route, 3. Good health, Treatment Outcome, Parenteral nutrition, Female, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; BackgroundWhether the route of early feeding affects outcomes of patients with severe critical illnesses is controversial. We hypothesised that outcomes were better with early first-line enteral nutrition than with early first-line parenteral nutrition.MethodsIn this randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2 trial) done at 44 French intensive-care units (ICUs), adults (18 years or older) receiving invasive mechanical ventilation and vasopressor support for shock were randomly assigned (1:1) to either parenteral nutrition or enteral nutrition, both targeting normocaloric goals (20–25 kcal/kg per day), within 24 h after intubation. Randomisation was stratified by centre using permutation blocks of variable sizes. Given that route of nutrition cannot be masked, blinding of the physicians and nurses was not feasible. Patients receiving parenteral nutrition could be switched to enteral nutrition after at least 72 h in the event of shock resolution (no vasopressor support for 24 consecutive hours and arterial lactate
Published: 2018
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76. Infinitix-BOS Trial: Multi-Center, Randomised, Double-Blind Placebo-Controlled Trial of Nintedanib in Lung Transplant Recipients with Bronchiolitis Obliterans Syndrome (BOS) Grade 0-p and Grade 1-2

Author: C. Macey, G. Dauriat, C. Saint Raymond, Adrian Crutu, a. Briault, O. Brugière, Benjamin Coiffard, L. Beaumont, Anne-Françoise Roux, G. Weisenburger, J. Le Pavec, Martine Reynaud-Gaubert, A. Hamid, b. Renaud Picard, Christophe Pison, Clément Picard, c. Bon, Sandrine Hirschi, Tristan Dégot, Xavier Demant, Vincent Bunel, Jonathan Messika, and B. Coltey
Subjects: Pulmonary and Respiratory Medicine, Transplantation, medicine.medical_specialty, Lung, business.industry, medicine.medical_treatment, Placebo-controlled study, Bronchiolitis obliterans, medicine.disease, Placebo, humanities, law.invention, chemistry.chemical_compound, medicine.anatomical_structure, chemistry, Randomized controlled trial, Bronchiolitis, law, Internal medicine, medicine, Lung transplantation, Surgery, Nintedanib, Cardiology and Cardiovascular Medicine, business
Abstract: Purpose Lung transplantation (TxP) is now a validated treatment of end-stage pulmonary diseases, but long-term survival are still hampered by the development of chronic allograft dysfunction (CLAD) affecting> 50% of patients. Bronchiolitis obliterans syndrome/obliterative bronchiolitis (BOS/OB) is the most common manifestation of CLAD. Survival after onset of BOS is poor ( Methods A phase III clinical randomized trial to assess the efficacy of Nintedanib in LTx recipients with BOS.Inclusion criteria: n=80 LTx recipients with BOS 0p-1-2, with a decline of FEV1> 200ml within the previous year.Primary Objective: to assess Nintedanib efficacy in the reduction of the rate of decline of FEV1 (forced expiratory volume in 1 sec) at a dose of 150 mg twice daily (bid) compared to placebo over 6 months. Secondary Objectives: to assess Nintedanib efficacy and tolerance in the treatment of BOS 0p-1-2, based on the change over 6 months of : 6WT, QOL, BOS grade/graft failure, O2 saturation, KL-6, SPD, VEGF, PDGF parameters, and tolerance. Results The trial was started in December 2019 among 8 french LTx centers (Hopital Foch, Bichat, HEGP/Cochin, Marie-Lannelongue, Marseille, Bordeaux, Strasbourg, and Grenoble), for a total duration of inclusion anticipated at 36 months. On October 15th 2020, 14 patients were already included. Conclusion Infinitix-BOS is the first therapeutic randomized trial testing the efficacy of nintedanib in LTx recipients with BOS. In case of demonstrated effectiveness of Nintedanib, the benefit for LTx patients with BOS seems high in terms of stabilization of lung function and enhancement of survival.
Published: 2021
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77. Coping strategies, anxiety and depression related to the COVID-19 pandemic in lung transplant candidates and recipients. Results from a monocenter series

Author: Armelle Marceau, G. Weisenburger, Philippe Montravers, Gilles Jebrak, Pierre Mordant, Alexy Tran-Dinh, Malika Hammouda, Alice Savary, Vincent Bunel, Tiphaine Goletto, Lucie Genet, Jonathan Messika, Hervé Mal, Yves Castier, Chahine Medraoui, and Cendrine Godet
Subjects: Pulmonary and Respiratory Medicine, Coping (psychology), medicine.medical_treatment, Coping strategy, Anxiety, Hospital Anxiety and Depression Scale, Article, HADS, Hospital Anxiety and Depression Scale, LT, lung transplantation, Interquartile range, Adaptation, Psychological, Pandemic, medicine, Humans, Lung transplantation, Pandemics, Depression (differential diagnoses), Retrospective Studies, COVID-19, coronavirus disease 2019, Lung, SARS-CoV-2, Depression, business.industry, COVID-19, CISS, Coping Inventory for Stressful Situations, Middle Aged, Cross-Sectional Studies, medicine.anatomical_structure, Female, medicine.symptom, business, Clinical psychology
Abstract: Background The COVID-19 pandemic has been associated with an increase in anxiety and depression symptoms in people. We investigated the impact of the pandemic on coping strategies and anxiety and depression in lung transplantation (LT) recipients and patients with end-stage chronic lung disease awaiting LT. Methods We retrospectively investigated coping strategies by using the Coping Inventory for Stressful Situations questionnaire and anxiety and depression symptoms by the Hospital Anxiety and Depression scale in 115 LT candidates and recipients. Results Overall, 63 participants (20 women; median age 59 years [interquartile range 52–65]) answered one or both questionnaires (49 LT recipients and 14 LT candidates). The preferred coping strategy was task-focused for 51 (86.4%) participants, with no difference between LT recipients and candidates nor according to the main anamnestic and clinical data. Eleven patients had suspected or proven depression symptoms, and 18 had suspected or proven anxiety symptoms. Coping strategies related to COVID-19 did not differ by presence of anxiety or depression symptoms. Conclusion In the current pandemic, healthcare professionals should consider these results to provide relevant psychological help to these fragile populations and promote a systematic and wide multidisciplinary assessment of LT recipients and candidates.
Published: 2021
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78. Essai multicentrique, randomisé double aveugle contre placebo, évaluant l’efficacité du Nintedanib dans le traitement du syndrome de bronchiolite oblitérante grade 0-p et grade 1-2 chez les patients transplantés pulmonaires

Author: L. Beaumont, C. Macey, Xavier Demant, O. Brugière, Y. Maurer, G. Dauriat, C. Couffignal, C. Saint Raymond, Vincent Bunel, R. Antoine, Martine Reynaud-Gaubert, Adrian Crutu, Benjamin Renaud-Picard, B. Coltey, Jonathan Messika, Christophe Pison, G. Weisenburger, A. Briot, Tristan Dégot, Sandrine Hirschi, c. Bon, J. Le Pavec, S. Makhlouf, and Clément Picard
Subjects: Pulmonary and Respiratory Medicine
Abstract: Introduction La survie apres transplantation pulmonaire (TxP) reste limitee par la survenue d’une dysfunction chronique pulmonaire (CLAD), qui touche > 50 % des greffes. La forme obstructive de CLAD, bronchiolite obliterante (BO)/syndrome de BO (SBO), est le phenotype le plus frequent de CLAD (80% des cas). Les lesions de BO semblent dues a des agressions repetees de l’epithelium bronchique avec developpement d’une cicatrice fibreuse. Il n’existe actuellement pas de traitement demontre pour stabiliser le SBO. Le role crucial de la dysfonction de reparation fibrotique est demontre dans la BO via le remodellage bronchique, l’augmentation de matrice extra-cellulaire, la transition epithelio-mesenchymateuse, l’augmentation des facteurs de croissance PDGF, VEGF, FGF, IGF- Le TKI Nintedanib, demontre efficace dans la fibrose pulmonaire idiopathique, et qui cible ces facteurs de croissance, est une molecule candidate. Un essai therapeutique testant le nintedanib dans la BOS post-TxP a debute en France fin 2019. Methodes Essai multicentrique, randomise double aveugle contre placebo, evaluant l’efficacite du Nintedanib dans le traitement du syndrome de bronchiolite obliterante grade 0-p et grade 1-2 chez les patients greffes pulmonaires. Criteres d’inclusion: BOS 0-p, 1, 2 et forme mixte de CLAD (criteres ISHLT). Objectif principal: evaluer l’efficacite du nintedanib sur la reduction du taux de declin du VEMS dans le SBO post-TxP (150 mg × 2/j versus placebo pendant 6 mois (± 100 mg × 2/j si effets secondaires). Objectifs secondaires: evaluer l’efficacite du nintedanib sur l’evolution de: 6WT, QOL (SGRQ); mesures repetees VEMS; grade BOS; Saturation O2; ainsi que frequence des effets secondaires, et evolution de parametres sanguins KL-6, SPD, VEGF, PDGF. Resultats L’essai a ete ouvert entre dec 2019 et mars 2020 parmi 8 centres de greffe en France (Hopital Foch, Bichat, HEGP/Cochin, Marie-Lannelongue, Marseille, Bordeaux, Strasbourg et Grenoble), pour une duree d’inclusion prevue de 36 mois. Au 31/08/2020, 7 patients greffes ont ete inclus dans 3 centres. Afin d’augmenter le nombre de patients eligibles, une modification du protocole du 2/07/2020, permet d’inclure desormais les patients avec BOS grade 0-p et les regreffes. Conclusion InfinitixBOS est le 1er essai therapeutique randomise controle evaluant l’efficacite du Nintedanib dans les formes obstructives/mixtes de CLAD. En cas de demonstration d’une efficacite sur la fonction pulmonaire, le benefice au patient est eleve au vu de la frequence du SBO.
Published: 2021
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79. Progression rapide de la fibrose du poumon natif associée à une infection virale sévère après transplantation monopulmonaire pour fibrose

Author: S. Najem, C. Medraoui, Vincent Bunel, Yves Castier, Lila Bouadma, G. Weisenburger, Jonathan Messika, Tiphaine Goletto, Raphael Borie, Hervé Mal, Cendrine Godet, Pierre Mordant, and S. Decaux
Subjects: Pulmonary and Respiratory Medicine
Abstract: Introduction Un inconvenient majeur de la transplantation monopulmonaire (TMP) est que le poumon natif reste expose a des complications se developpant en son sein (infection, hemoptysie, pneumothorax, neoplasie). En cas de TMP pour fibrose pulmonaire, on assiste en general a une aggravation progressive des lesions de fibrose du natif au fil du temps, sans consequence notable sur l’hematose. Methodes Nous presentons les cas de 2 patients qui, dans les suites de TMP pour fibrose pulmonaire idiopathique (FPI), ont developpe a l’occasion d’une infection virale severe une progression rapide de la fibrose du cote natif. Resultats Il s’agissait du patient A : 65 ans, TMP 7 mois plus tot, ayant developpe au decours des 6 mois de prophylaxie anti-CMV une primo-infection CMV (D+/R − ) sous la forme d’une maladie a CMV avec PCR > 0 et atteinte gastrique sans signes de pneumonie a CMV ; et du patient B, 62 ans, TMP 4 mois plus tot, ayant developpe une infection a COVID-19 nosocomiale en avril 2020. Les caracteristiques communes a ces 2 patients sont les suivantes : apparition en quelques jours d’une insuffisance respiratoire aigue hypoxemiante (avec transfert en reanimation et prescription d’oxygenotherapie a haut debit dans les 2 cas), en parallele avec une opacification TDM du poumon natif (verre depoli surajoute a la fibrose), avec au niveau du poumon greffe une absence d’anomalies chez le patient A et des lesions de verre depoli COVID-19 beaucoup moins marquees que sur le natif ; contexte d’infection virale severe en cours ; negativite de tout le bilan infectieux en dehors de l’infection virale en cours ; amelioration tres progressive de l’hypoxemie sur quelques semaines mais persistance de l’opacite du poumon natif avec aggravation nette des lesions de fibrose (majoration du rayon de miel, perte de volume nette). Notre hypothese est que : – le mecanisme conduisant a la progression rapide de la fibrose sur le natif est une agression virale directe sur un parenchyme deja atteint, responsable d’une exacerbation aigue de FPI ; – la severite de l’atteinte pulmonaire du poumon natif a conduit a des anomalies majeures des rapports ventilation/perfusion au sein du natif ; – l’amelioration progressive de l’etat respiratoire etait principalement liee a une baisse progressive de la perfusion vers le poumon natif au fil du temps plutot qu’a un traitement antiviral. Conclusion Une infection virale severe peut conduire a une aggravation rapide des lesions de fibrose du natif apres TMP pour FPI.
Published: 2021
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80. Pseudomonas aeruginosa eradication after lung transplantation: is it the tip of the iceberg?

Author: Vincent Bunel, Hervé Mal, Jonathan Messika, G. Weisenburger, and Cendrine Godet
Subjects: Pulmonary and Respiratory Medicine, Lung, business.industry, Pseudomonas aeruginosa, medicine.medical_treatment, Organ dysfunction, respiratory system, medicine.disease_cause, respiratory tract diseases, Persistence (computer science), medicine.anatomical_structure, Immunology, Medicine, Lung transplantation, Respiratory system, medicine.symptom, business
Abstract: Is respiratory Pseudomonas aeruginosa infection or persistence in lung transplant recipients an early marker of an emerging chronic lung organ dysfunction? Or its by-product?https://bit.ly/3nyPHlW
Published: 2021
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81. Terminal weaning or immediate extubation for withdrawing mechanical ventilation in critically ill patients (the ARREVE observational study)

Author: Anne Claire Hyacinthe, Olivier Lesieur, Antoine Roquilly, Jérôme Devaquet, Anne Renault, Philippe Mateu, Sebastien Jochmans, François Brenas, Isabelle Vinatier, Olivier Guisset, Alexandre Boyer, Alice Cottereau, Jean Philippe Rigaud, Ségolène Robin, Juliette Audibert, Djillali Annane, Frédérique Ganster, Jean Reignier, Mercé Jourdain, Nancy Kentish-Barnes, Maité Garrouste-Orgeas, Patrice Tirot, Jonathan Messika, Bruno Giraudeau, Paul Morin-Longuet, Xavier Repessé, Bruno Mégarbane, Bénédicte Philippon-Jouve, Simon Bourcier, Didier Thevenin, Jeremy Bourenne, Vincent Das, François Barbier, Mélanie Adda, Elie Azoulay, Emmanuelle Mercier, Guillaume Grillet, Patrick Bardou, Amélie Le Gouge, Alexandre Lautrette, Jean Pierre Quenot, Fabien Lion, René Robert, Nicolas Lerolle, Arnaud Desachy, Amélie Seguin, M. Feissel, Sybille Merceron, Rebecca Hamidfar-Roy, Institut Français de Recherche pour l'Exploitation de la Mer - Brest ( IFREMER ), Institut Français de Recherche pour l'Exploitation de la Mer ( IFREMER ), Epidémiologie, santé publique et développement, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR99-ISPED, Service de réanimation médicale, Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Université de Tours, COIITSS Study Investigators, Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP Hôpital Raymond Poincaré [Garches], Institut de Recherche en Horticulture et Semences ( IRHS ), Université d'Angers ( UA ) -Institut National de la Recherche Agronomique ( INRA ) -AGROCAMPUS OUEST, Service de Réanimation Médico-Chirurgicale [CH Montauban], CH Montauban, Institut Pierre Louis d'Epidémiologie et de Santé Publique ( iPLESP ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ), Service de Réanimation Médicale [CHU Bordeaux], CHU Bordeaux [Bordeaux]-Hôpital Pellegrin, Service d'anesthésie-réanimation SAMU94-SMUR94 [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Service de Réanimation, Maladies Infectieuses, Centre Hospitalier de Belfort-Montbéliard, Service de réanimation Médicale, CHU Strasbourg, Epidémiologie pronostique des cancers et affections graves, Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hôpital St-André, Réanimation, CHU Bordeaux [Bordeaux], Clinique de réanimation médicale, Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-Hôpital Albert Michallon, Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Unité de soins intensifs [Clermont Ferrand], CHU Clermont-Ferrand-Hôpital Gabriel Montpied, Réanimation Médicale, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Laboratoire Ethique Politique et Santé ( EA 4569 ), Université Paris Descartes - Paris 5 ( UPD5 ), Neuropsychopharmacologie des addictions. Vulnérabilité et variabilité expérimentale et clinique ( NAVVEC (UM 81) ), Université Paris Diderot - Paris 7 ( UPD7 ) -Institut des sciences du Médicament -Toxicologie - Chimie - Environnement ( IFR71 ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Ecole Nationale Supérieure de Chimie de Paris- Chimie ParisTech-PSL ( ENSCP ) -Centre National de la Recherche Scientifique ( CNRS ) -Institut de Recherche pour le Développement ( IRD ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Ecole Nationale Supérieure de Chimie de Paris- Chimie ParisTech-PSL ( ENSCP ) -Centre National de la Recherche Scientifique ( CNRS ) -Institut de Recherche pour le Développement ( IRD ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Service de soins intensifs, Centre Hospitalier de Versailles (CHV), Réanimation médicale, CHU Bretonneau, Hopital Louis Mourier - AP-HP [Colombes], Service de Réanimation Médicale (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Equipe LIPNESS (LNC - U1231) ( LIPNESS ), Lipides - Nutrition - Cancer [Dijon - U1231] ( LNC ), Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre d'Investigation Clinique 1432 (Dijon) - Module Plurithématique : Périnatalité Cancérologie Handicap et Ophtalmologie ( CIC-P803 ), Université de Bourgogne ( UB ) -Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hôpital Ambroise Paré, Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Assistance publique - Hôpitaux de Paris (AP-HP), Thérapeutiques Cliniques et Expérimentales des Infections, Université de Nantes ( UN ), Service de réanimation médicale [Caen], Université de Caen Normandie ( UNICAEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -CHU Caen, Service de biostatistiques et information médicale [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris]-Université Paris Diderot - Paris 7 ( UPD7 ), Université de Nantes - Faculté de médecine et des techniques médicales ( UN Médecine ), Service de réanimation médicale [CHU Nantes], Centre hospitalier universitaire de Nantes ( CHU Nantes ), MethodS in Patients-centered outcomes and HEalth ResEarch (SPHERE), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Université de Nantes (UN)-Université de Nantes (UN), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, and Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM )
Subjects: Male, Time Factors, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Anxiety, Critical Care and Intensive Care Medicine, Stress Disorders, Post-Traumatic, Mechanical ventilation, 0302 clinical medicine, Personnel, 80 and over, Medicine, Prospective Studies, 030212 general & internal medicine, Stress Disorders, Aged, 80 and over, Depression, Pain scale, Middle Aged, 3. Good health, Intensive Care Units, Anesthesia, Female, medicine.symptom, Ventilator Weaning, Adult, Critical Illness, Airway Extubation, Hospital, 03 medical and health sciences, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, Humans, Weaning, Family, Aged, Ethics, Chi-Square Distribution, Job strain, business.industry, Treatment limitation, 030208 emergency & critical care medicine, Immediate extubation, Length of Stay, Airway obstruction, medicine.disease, Complicated grief, Personnel, Hospital, Critical care, Post-Traumatic, Terminal weaning, Grief, business
Abstract: International audience; PURPOSE: The relative merits of immediate extubation versus terminal weaning for mechanical ventilation withdrawal are controversial, particularly regarding the experience of patients and relatives. METHODS: This prospective observational multicentre study (ARREVE) was done in 43 French ICUs to compare terminal weaning and immediate extubation, as chosen by the ICU team. Terminal weaning was a gradual decrease in the amount of ventilatory assistance and immediate extubation was extubation without any previous decrease in ventilatory assistance. The primary outcome was posttraumatic stress symptoms (Impact of Event Scale Revised, IES-R) in relatives 3~months after the death. Secondary outcomes were complicated grief, anxiety, and depression symptoms in relatives; comfort of patients during the dying process; and job strain in staff. RESULTS: We enrolled 212 (85.5%) relatives of 248 patients with terminal weaning and 190 relatives (90.5%) of 210 patients with immediate extubation. Immediate extubation was associated with airway obstruction and a higher mean Behavioural Pain Scale score compared to terminal weaning. In relatives, IES-R scores after 3~months were not significantly different between groups (31.9~±~18.1 versus 30.5~±~16.2, respectively; adjusted difference, -1.9; 95% confidence interval, -5.9 to 2.1; p~=~0.36); neither were there any differences in complicated grief, anxiety, or depression scores. Assistant nurses had lower job strain scores in the immediate extubation group. CONCLUSIONS: Compared to terminal weaning, immediate extubation was not associated with differences in psychological welfare of relatives when each method constituted standard practice in the ICU where it was applied. Patients had more airway obstruction and gasps with immediate extubation. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01818895.
Published: 2017
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82. Costs associated with community acquired pneumonia in France

Author: Patrick Petitpretz, Pierre Bonnin, Henri Laurichesse, J. Gaillat, Jean-Damien Ricard, Christian Chidiac, Bruno Detournay, Grèce Saba, Luiz Flavio Andrade, Gérard de Pouvourville, Jonathan Messika, and Hajnal-Gabriela Illes
Subjects: Adult, Male, 0301 basic medicine, medicine.medical_specialty, Pediatrics, Multivariate analysis, 030106 microbiology, Economics, Econometrics and Finance (miscellaneous), Context (language use), Young Adult, 03 medical and health sciences, 0302 clinical medicine, Community-acquired pneumonia, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Hospital Costs, health care economics and organizations, Average cost, Aged, Aged, 80 and over, Health economics, Descriptive statistics, business.industry, Health Policy, Pneumonia, Length of Stay, Middle Aged, medicine.disease, Community-Acquired Infections, Hospitalization, Emergency medicine, Pneumococcal pneumonia, Female, France, business
Abstract: Pneumocost is a prospective study that aimed at documenting the costs of the management of patients hospitalized with a pneumococcal pneumonia and the post-discharge costs during a 6-month period in the French context. Billing data were used to document hospital costs. Resource use during the follow-up period was collected through phone interviews at month 1, 3 and 6. Descriptive statistics and multivariate analyses were performed. We used generalized linear models with log-link functions to estimate parameters associated with hospital and follow-up costs of patients. Five hundred twenty-four patients were enrolled in 40 public centers from October 2011 to April 2014. Average age was 63 (SD 17); 55.0% of them were male. Average length of stay was 15 days (SD 23). Average cost of stay for the French Sickness Fund was €7293 (SD €7363). Average cost of follow-up was €1242 (SD €3000) and decreased steadily through time. When controlling for patient’s socioeconomic characteristics, severity of disease and hospital stay, results showed a concave relationship between hospital costs and age. Obesity, the severity of the disease and comorbidities were associated with constantly increasing inpatient costs. Concerning follow-up costs, we found the same concave relationship with age, while gender, a history of pneumonia and severity of the disease were the most important predictors of high costs after discharge. Pneumocost is the first French study providing a robust estimation of the cost of managing invasive pneumococcal pneumonia in the French context.
Published: 2017
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83. Identification radiographique de la position des sondes d’alimentation entérales par les infirmières de réanimation : expérience prospective bicentrique

Author: Benjamin Sztrymf, Jean-Damien Ricard, E. Touré, B. Guyon, Jonathan Messika, D. Coadic, Y. Martin, Pierre Trouiller, and V. David
Subjects: business.industry, Emergency Medicine, Medicine, Emergency Nursing, business
Published: 2018
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84. Use of high flow nasal cannula for preoxygenation and apneic oxygenation during intubation

Author: Camille Le Breton, Juliette Bernier, Baptiste Gaborieau, Jean-Damien Ricard, and Jonathan Messika
Subjects: Male, medicine.medical_treatment, Critical Illness, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Intubation, Intratracheal, Medicine, Intubation, Cannula, Humans, Acute respiratory failure, In patient, Respiratory system, Administration, Intranasal, Aged, Apneic oxygenation, business.industry, Oxygen Inhalation Therapy, 030208 emergency & critical care medicine, General Medicine, Middle Aged, Intention to Treat Analysis, Oxygen, Editorial Commentary, Intensive Care Units, 030228 respiratory system, Respiratory failure, Anesthesia, Female, business, High flow, Nasal cannula
Abstract: Preoxygenation with high-flow therapy by nasal cannulae (HFNC) is now widespread in the intensive care unit (ICU). However, no large randomized study has assessed its relevance in non-severely hypoxemic patients. In a randomized controlled trial (PROTRACH study), we aimed to evaluate preoxygenation with HFNC vs. standard bag-valve mask oxygenation (SMO) in non-severely hypoxemic patients during rapid sequence intubation (RSI) in the ICU.Randomized controlled trial including non-severely hypoxemic patients requiring intubation in the ICU. Patients received preoxygenation by HFNC or SMO during RSI. HFNC was maintained throughout the intubation procedure whereas SMO was removed to perform laryngoscopy. The primary outcome was the lowest pulse oximetry (SpOA total of 192 patients were randomized. In the intent-to-treat analysis, 184 patients (HFNC n = 95; SMO n = 89), the median [IQR] lowest SpOCompared with SMO, preoxygenation with HFNC in the ICU did not improve the lowest SpOClinical trial Submission: 7 March 2016. Registry name: Benefits of high-flow nasal cannulae oxygen for preoxygenation during intubation in non-severely hypoxemic patients: the PROTRACH study. Clinicaltrials.gov identifier: NCT02700321. Eudra CT: 2015-A00145-44. CPP: 15/13-975 (Comité de protection des personnes de Rennes). URL registry: https://clinicaltrials.gov/ct2/show/record/NCT02700321 .
Published: 2019

85. High-Flow Nasal Oxygen Therapy Outside the Intensive Care Setting: How Safe Is Safe Enough?

Author: Jonathan Messika and Jean-Damien Ricard
Subjects: Pulmonary and Respiratory Medicine, Oxygen inhalation therapy, Critical Care, medicine.medical_treatment, chemistry.chemical_element, Critical Care and Intensive Care Medicine, Oxygen, 03 medical and health sciences, 0302 clinical medicine, Inspiratory flow, Oxygen therapy, Intensive care, Medicine, Cannula, Humans, business.industry, Oxygen Inhalation Therapy, General Medicine, Intensive Care Units, 030228 respiratory system, chemistry, Anesthesia, business, High flow
Abstract: Oxygen interface choices have recently been broadened with the arrival of high-flow nasal canula (HFNC) oxygen therapy. HFNC avoids several drawbacks of low-flow interfaces:[1][1]–[3][2] the FIO2 can be precisely adjusted, with a flow that better matches patient's inspiratory flow demand; the
Published: 2019

86. Sedation practice and discomfort during withdrawal of mechanical ventilation in critically ill patients at end-of-life: a post-hoc analysis of a multicenter study

Author: Olivier Guisset, Emmanuelle Mercier, Mélanie Adda, Jean Reignier, René Robert, Isabelle Vinatier, Arnaud W. Thille, Jonathan Messika, Anne Renault, Anne-Claire Hyacinthe, Simon Bourcier, Amélie Le Gouge, Juliette Audibert, Olivier Lesieur, Mercé Jourdain, Alexandre Boyer, Nancy Kentish-Barnes, Elie Azoulay, François Barbier, Nicolas Lerolle, Jeremy Bourenne, Jérôme Devaquet, and Guillaume Grillet
Subjects: medicine.medical_specialty, Sedation, medicine.medical_treatment, Critical Illness, Critical Care and Intensive Care Medicine, law.invention, law, Anesthesiology, Post-hoc analysis, Medicine, Humans, Hypnotics and Sedatives, Prospective Studies, Mechanical ventilation, business.industry, Incidence (epidemiology), Pain scale, Intensive care unit, Respiration, Artificial, Death, Intensive Care Units, Anesthesia, Midazolam, medicine.symptom, business, medicine.drug
Abstract: Little is known on the incidence of discomfort during the end-of-life of intensive care unit (ICU) patients and the impact of sedation on such discomfort. The aim of this study was to assess the incidence of discomfort events according to levels of sedation. Post-hoc analysis of an observational prospective multicenter study comparing immediate extubation vs. terminal weaning for end-of-life in ICU patients. Discomforts including gasps, significant bronchial obstruction or high behavioural pain scale score, were prospectively assessed by nurses from mechanical ventilation withdrawal until death. Level of sedation was assessed using the Richmond Agitation–Sedation Scale (RASS) and deep sedation was considered for a RASS − 5. Psychological disorders in family members were assessed up until 12 months after the death. Among the 450 patients included in the original study, 226 (50%) experienced discomfort after mechanical ventilation withdrawal. Patients with discomfort received lower doses of midazolam and equivalent morphine, and were less likely to have deep sedation than patients without discomfort (59% vs. 79%, p
Published: 2019

87. 'You helped me keep my head above water'—experience of bereavement research after loss of a loved one in the ICU: insights from the ARREVE study

Author: Bénédicte Philippon-Jouve, Djillali Annane, Alexandre Lautrette, Jean-Pierre Quenot, Nicolas Lerolle, Jean Reignier, Jonathan Messika, Paul Morin-Longuet, Alexandre Boyer, Xavier Repessé, Amélie Seguin, Elie Azoulay, Maité Garrouste-Orgeas, Emmanuelle Mercier, Fabien Lion, Nancy Kentish-Barnes, Vincent Das, François Barbier, Sebastien Jochmans, Olivier Lesieur, Alice Cottereau, Isabelle Vinatier, Anne Renault, François Brenas, Frédérique Ganster, Guillaume Grillet, Didier Thevenin, Ségolène Robin, Jeremy Bourenne, Patrick Bardou, Bruno Mégarbane, Juliette Audibert, Olivier Guisset, Rebecca Hamidfar-Roy, Patrice Tirot, Jérôme Devaquet, Philippe Mateu, Antoine Roquilly, Mélanie Adda, Jean-Philippe Rigaud, Anne-Claire Hyacinthe, Mercé Jourdain, Arnaud Desachy, Simon Bourcier, Sybille Merceron, M. Feissel, René Robert, Alexandra Laurent, Amélie Le Gouge, Laboratoire de psychologie : dynamiques relationnelles et processus identitaires [Dijon] (PSY-DREPI), Université de Bourgogne (UB)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre hospitalier universitaire de Nantes (CHU Nantes), Université de Nantes (UN), Centre d’Investigation Clinique [Tours] CIC 1415 (CIC ), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Intercommunal André Grégoire [Montreuil] (CHI André Gregoire), Service de réanimation-Détresses Respiratoires et Infections Sévères [Hôpital Nord - APHM] (DRIS), Hôpital Nord [CHU - APHM]-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), 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, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Hôpital Ambroise Paré [AP-HP], Infection et inflammation (2I), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Réanimation polyvalente [Chartres], Hôpital Louis Pasteur [Chartres], Centre Hospitalier Régional d'Orléans (CHRO), Centre hospitalier de Montauban, Service de Réanimation Médicale [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital Pellegrin, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Service d'anesthésie-réanimation SAMU94-SMUR94 [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Réanimation et Maladies Infectieuses, Site de Belfort-CH Belfort-Montbéliard, Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques (HIFIH), Université d'Angers (UA), Medical-Surgical ICU, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Hôpital Saint Joseph, CHU Pontchaillou [Rennes], CHU Bordeaux [Bordeaux], Clinique de réanimation médicale, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Pôle Anesthésie Réanimation, CHU Grenoble-Hôpital Michallon, Hôpital Salengro, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Unité de soins intensifs [Clermont Ferrand], CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Laboratoire Microorganismes : Génome et Environnement (LMGE), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Laboratoire d'éthique médicale et médecine légale (LEM), Université Paris Descartes - Paris 5 (UPD5)-Réseau Inserm de Recherche en éthique médicale, Bureau de Recherches Géologiques et Minières (BRGM) (BRGM), Université Pierre et Marie Curie - Paris 6 (UPMC), Service de soins intensifs, Centre Hospitalier de Versailles André Mignot (CHV), Réanimation médicale, CHU Bretonneau, Service de Réanimation Médico-Chirurgicale [Hôpital Louis Mourier], Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Réanimation Médicale (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), De la Préhistoire à l'Actuel : Culture, Environnement et Anthropologie (PACEA), Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS), Service de réanimation médicale [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre de recherche en éducation de Nantes (CREN), Le Mans Université (UM)-Université de Nantes - UFR Lettres et Langages (UFRLL), Université de Nantes (UN)-Université de Nantes (UN), Service de réanimation médicale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Service de Réanimation, Hôpital Jean Bernard, CHU de Poitiers, Poitiers, France, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), CH Belfort-Montbéliard-Site de Belfort, Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Université de Nantes - UFR Lettres et Langages (UFRLL), Université de Nantes (UN)-Université de Nantes (UN)-Le Mans Université (UM), CIC-CHU Tours, CHU Marseille, General Intensive Care Medicine, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP Hôpital Raymond Poincaré [Garches], FUNDP, Université de Namur [Namur], Service d'Anesthésie-Réanimation [CHU Limoges], CHU Limoges, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5)-Hôpital Saint Joseph, CHU Clermont-Ferrand-Hôpital Gabriel Montpied, Laboratoire Microorganismes : Génome et Environnement - Clermont Auvergne (LMGE), Université Clermont Auvergne (UCA)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier de Versailles (CHV), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hopital Louis Mourier - AP-HP [Colombes], Hôpital Ambroise Paré, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Normandie Université (NU), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Centre National de la Recherche Scientifique (CNRS)-Université de Bordeaux (UB), Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Centre hospitalier de Montauban (CH Montauban), CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Adult, Male, Attitude to Death, media_common.quotation_subject, [SHS.PSY]Humanities and Social Sciences/Psychology, Context (language use), Critical Care and Intensive Care Medicine, [SDV.MP.PRO]Life Sciences [q-bio]/Microbiology and Parasitology/Protistology, 03 medical and health sciences, 0302 clinical medicine, Nursing, Emotional distress, Surveys and Questionnaires, 030225 pediatrics, Humans, Medicine, Family, 030212 general & internal medicine, Social isolation, Qualitative Research, ComputingMilieux_MISCELLANEOUS, Aged, media_common, business.industry, Social Support, Middle Aged, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Intensive Care Units, Hospice Care, Emotional Adjustments, Female, Psychological resilience, Thematic analysis, medicine.symptom, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Meaning (linguistics), Qualitative research
Abstract: Bereavement research has helped to improve end-of-life practices in the ICU. However, few studies have explored bereaved relatives experience of research participation in this context. We aimed to explore the experience of bereaved relatives’ participation in the ARREVE study which included three telephone follow-up calls to complete several quantitative tools. Volunteer relatives who participated in the 12-month follow-up call completed a questionnaire about research participation that included ten open-ended questions so that respondents could use their own words and thoughts. These open-ended questions were analyzed using qualitative analysis that examines themes within the data. 175/311 relatives completed the questionnaire. Three themes were derived from the thematic analysis: (1) struggling: reactivation of emotional distress associated with the ICU experience and the loss is frequent, specifically during the 1st follow-up call. (2) Resilience: as time goes by, research participation becomes increasingly positive. The calls are a help both in giving meaning to the relatives’ experience and in accepting the loss. (3) Recognition: research calls can compensate for the absence of support during bereavement. Although some emotional difficulties must be acknowledged, bereavement research is overall associated with benefits, by facilitating emotional adjustments, meaning-making and resilience. Lack of support and social isolation during bereavement are frequent experiences, revealing that support strategies for bereaved relatives should be developed after the loss of a loved one in the ICU.
Published: 2019
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88. Longer symptom onset to aspiration time predicts success of needle aspiration in primary spontaneous pneumothorax

Author: Jean-Damien Ricard, Nicolas Javaud, Fadia Dib, Didier Dreyfuss, Myriam Chemouny, Jonathan Messika, Constance Vuillard, Jallal Achamlal, Damien Roux, and Stéphane Gaudry
Subjects: Pulmonary and Respiratory Medicine, Adult, Male, Time Factors, Thoracentesis, Chest tube insertion, law.invention, Time-to-Treatment, Primary outcome, law, Medicine, Humans, Symptom onset, Prospective Studies, Trial registration, Prospective cohort study, Retrospective Studies, business.industry, Pneumothorax, Primary spontaneous pneumothorax, medicine.disease, Intensive care unit, Treatment Outcome, Anesthesia, Chest Tubes, Female, business
Abstract: BackgroundNeedle aspiration (NA) is recommended as first-line treatment of primary spontaneous pneumothorax (PSP). We aimed to assess NA success and the effect of a longer symptom onset to NA time.MethodsA discovery phase was retrospectively conducted in the intensive care unit of Louis Mourier Hospital (January 2000 to December 2011) followed by a prospective validation cohort (January 2012 to August 2015). The primary outcome was immediate NA success defined by the absence of need for chest tube insertion within 24 hours of the procedure.ResultsIn the discovery phase, 130 patients were admitted for PSP and 98 had NA as first-line treatment (75%). The immediate success rate of NA was 34.7% and was higher when it was performed ≥48 hours after symptom onset (57.7% vs 25%; p=0.004). In the prospective cohort, 87 patients were admitted for PSP; 71 (82%) had NA as first-step treatment. The immediate success rate was 40.8%. NA was more successful when it was performed after 48 hours of symptoms’ onset (34.5% vs 7.1%; p=0.005). A delay between the first symptom and NA procedure ≥48 hours was associated with a higher success of NA (OR=13.54; 95% CI 1.37 to 133). A smaller pneumothorax estimated by Light’s index was associated with NA success (OR=0.95; 95% CI 0.92 to 0.98). To what extent some of these pneumothoraces would have had a spontaneous resolution remains unknown.ConclusionWhen managing PSP with NA, a longer symptom onset to NA time was associated with NA success.Trial registration numberNCT02528734.
Published: 2019

89. Use of anti‐CMV immunoglobulins in lung transplant recipients: The French experience.

Author: Charlotte, Roy, François, Parquin, Jonathan, Messika, Véronique, Boussaud, Olivier, Brugière, Tristan, Degot, Séverine, Feuillet, Jérôme, Lepavec, Adrien, Tissot, Claire, Dromer, Espérie, Burnet, Eve, Camps, and Antoine, Roux
Subjects: LUNG transplantation, IMMUNOGLOBULINS, CYTOMEGALOVIRUS diseases, CLINICAL indications, DISEASE relapse
Abstract: Rational: Pending the authorization of new anti‐CMV drugs with fewer adverse effects, exploring the possibilities offered by CMV immunoglobulins (CMVIG) seems necessary. In France, access to CMVIG requires official authorization by the national Health authority and is restricted to second line rescue therapy for CMV infection/disease. The aim of this multicenter retrospective study is to describe the indications and clinical situations that justified its use in France. Methods: A multicenter retrospective study included 22 lung transplant patients over a 3‐year period. Data on clinical indication, tolerance and efficacy were collected. Results: The main indication for CMVIG initiation, which was documented in 17 of them (82%) was complex clinical situations resulting from side effects to antiviral drug. CMVIG indication was documented as treatment for 15 patients (68%) and as a secondary prophylaxis for 7 patients (32%). Only one side effect (pruritus during infusion with no anaphylactic symptoms) attributable to CMVIG was reported. After CMVIG initiation, no recurrence of infection or disease was observed during a median follow‐up of 174 (12–682) days after treatment initiation for respectively 68% and 66% of the patients. Conclusion: This study describes an unusual indication of CMVIG use as a last resort treatment in complex situations, based on clinical needs. CMVIG could be useful to change the course of CMV infection with minimal adverse effects or comorbidity. [ABSTRACT FROM AUTHOR]
Published: 2021
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90. Infections à Corynébactéries non diphtériques et complications bronchiques après transplantation pulmonaire – une étude cas-témoin

Author: Cendrine Godet, G. Weisenburger, N. Grall, Pierre Mordant, A. Tran Dinh, A. Sandot, Jonathan Messika, Gilles Jebrak, Vincent Bunel, and Hervé Mal
Subjects: 0301 basic medicine, Pulmonary and Respiratory Medicine, 03 medical and health sciences, 0302 clinical medicine, 030106 microbiology, 030212 general & internal medicine
Abstract: Introduction L’association entre infection ou colonisation a corynebacterie non diphterique (CND) et complications anastomotiques bronchiques apres transplantation pulmonaire (TP) a ete soulevee [1] . Methodes Il s’agit d’une etude retrospective, monocentrique. Les patients TP avec CND isolee sur un prelevement respiratoire profond (juillet 2014–decembre 2018) ont ete inclus et compares a une serie appariee de notre cohorte. L’objectif principal est de decrire le lien entre l’isolement d’une CND sur un prelevement respiratoire profond et la survenue de complications bronchiques (fistule bronchique ou stenose necessitant une dilatation endoscopique ou un stent) apres TP. Les objectifs secondaires sont de decrire les facteurs associes a l’isolement d’une CND et le pronostic a long terme. Resultats Une CND a ete isolee chez 59 patients transplantes sur la periode, dans un delai median de 128 jours (34–517) apres TP. L’espece la plus frequemment isolee etait C. striatum pour 42 patients (71%). Parmi ces 59 patients, 34 (58%) avaient des signes cliniques d’infection pulmonaire basse, 25 (42%) avaient au moins une autre espece bacterienne au seuil (Pseudomonas aeruginosa pour n = 10), et la CND etait associee a une autre espece bacterienne infra-seuil ou une flore oropharyngee chez 33 autres. Des signes d’ischemie bronchiques existaient a l’isolement de la CND chez 27 patients (46%); 20 (34%) avaient un stent bronchique. La survenue prealable d’un rejet humoral etait associee a l’isolement d’une CND (27% vs 8%; p = 0,01). Les patients infectes ou colonises a CND ont developpe significativement plus de complications bronchiques (72% vs 28%; p = 0,003), plus de dysfonction chronique du greffon (27% vs 6,7%, p = 0,006) que les temoins. La mortalite a un an ne differait pas significativement (29% vs 39%). Conclusion Dans cette serie monocentrique de patients TP, l’isolement d’une CND etait associe a une plus grande frequence de complications bronchiques. La causalite des CND dans la survenue de ces complications reste a determiner.
Published: 2021
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91. Quels sont les critères de jugements importants pour le patient en transplantation pulmonaire ? Une revue systématique de la littérature

Author: Cendrine Godet, Hervé Mal, Pierre Mordant, A. Tran-Dinh, G. Weisenburger, Jonathan Messika, S. Gaudry, N. Gault, Vincent Bunel, Anne-Françoise Roux, Tiphaine Goletto, and C. Medraoui
Subjects: Pulmonary and Respiratory Medicine, 03 medical and health sciences, 0302 clinical medicine, 030212 general & internal medicine, 030204 cardiovascular system & hematology
Abstract: Introduction Les criteres de jugements (CJ) importants pour le patient (patient-important outcomes [PIO]) sont definis comme des caracteristiques ou variables qui refletent la facon dont le patient ressent, fonctionne ou survit [1] . L’importance de la necessite de prise en compte de ces PIO emerge dans la recherche medicale, afin de replacer le patient au cœur de la recherche. La mortalite est insuffisante comme CJ en transplantation pulmonaire (TP) [2] . La place des PIO dans ce domaine n’a jamais ete evaluee. L’objectif de cette etude est de realiser un etat des lieux de l’utilisation des PIO dans la litterature de TP. Methodes Revue systematique de la litterature internationale de 2018–2019 sur 3 bases de donnees (PubMed, Embase et Cochrane). Inclusion de toutes les etudes, prospectives ou retrospectives sur base de donnees, incluant exclusivement ou majoritairement des patients TP. Enregistrement PROSPERO CRD42020163425. Resultats Parmi 859 references retrouvees, 150 articles ont ete selectionnes apres une double lecture independante sur titres et abstracts, et 79 inclus sur texte entier. Cinquante-trois (67 %) etaient des etudes prospectives, dont 13 (16 %) des essais randomises. Les etudes observationnelles en representaient 72 % (n = 57). Au moins un PIO etait utilise dans 41 (52 %) etudes (dont 26 prospectives et 6 essais randomises). Ce PIO etait le CJ principal de 26 etudes (32 %). Dans la moitie des cas (n = 13), il s’agissait de la mortalite. Au moins un PIO etait evalue en CJ secondaire dans 30 (38 %) etudes, dont la mortalite pour 19 (63 %) d’entre elles. Seules 32 (41 %) etudes (15 prospectives, 8 interventionnelles, 4 randomisees) evaluaient un PIO autre que la mortalite. La qualite de vie etait ce PIO dans 6 etudes (CJ principal pour 2 etudes et CJ secondaire pour 4). Conclusion Les PIO sont des criteres de jugements principaux dans moins d’1/3 des etudes publiees en TP. Les aspects autres que la mortalite sont insuffisamment pris en compte. L’elaboration d’un « core-outcome set » de PIO en TP est necessaire afin de mesurer le benefice ressenti par les patients des interventions testees dans la recherche sur ce domaine.
Published: 2021
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92. Antifibrosants: risque post-opératoire chez les patients transplantés pour une fibrose pulmonaire idiopathique

Author: Pierre Mordant, Hervé Mal, Gaëlle Dauriat, Ana Nieves, Cendrine Godet, Sandrine Hirschi, J. Le Pavec, Jean-François Mornex, E. Moncomble, Raphael Borie, Clément Picard, Tristan Dégot, Vincent Bunel, G. Weisenburger, Jonathan Messika, and Martine Reynaud-Gaubert
Subjects: Pulmonary and Respiratory Medicine
Abstract: Introduction La transplantation (TxP) est le seul traitement curatif de la fibrose pulmonaire idiopathique (FPI). Des traitements antifibrosants (pirfenidone et nintedanib), qui ralentissent l’evolution de la maladie, ont ete developpes recemment. Ils pourraient augmenter le risque de complications post-operatoires lors de la TxP des patients traites. L’objectif de cette etude etait d’evaluer l’association entre la prise d’un traitement antifibrosant et les complications apres une TxP. Methodes Il s’agit d’une etude retrospective multicentrique francaise, ayant inclus des patients atteints de FPI et ayant beneficie d’une TxP entre 2011 et 2018. Nous avons compare l’incidence des complications post operatoires (complications bronchiques et hemorragiques) et la survie des patients ayant recu ou non des antifibrosants au minimum un mois avant la TxP. Resultats Parmi les 205 patients inclus, 57 (27,8%) ont recu un traitement antifibrosant: pirfenidone pour 36 patients (63%) et nintedanib pour 21 patients (37%). La duree mediane de traitement antifibrosant avant la TxP etait de 532 jours. Il n’y avait pas de difference entre les deux groupes dans la survenue de complications anastomotiques bronchiques (p = 0,90), hemorragiques (p = 0,14) ou de cicatrisation cutanee (p = 0,65). La mortalite a 90 jours post-TxP dans le groupe traite etait significativement inferieure (7%) a celle du groupe controle (18,2%, p = 0,04). La mortalite a 30 jours post-TxP des deux groupes ne differait pas (p = 0,18). Le groupe traite presentait egalement moins de dysfonction primaire du greffon (DPG) (29,8%) que le groupe controle (43,2%, p = 0,01). Conclusion Les antifibrosants ne sont pas associes a une augmentation du risque de complications post-TxP et peuvent donc etre utilises sans risque avant la transplantation. Leur utilisation semble etre associee a une diminution de la DPG et de la mortalite a 90 jours. Cette difference de mortalite, deja rapportee par une equipe australienne [1] , devra cependant etre confirmee par d’autres etudes.
Published: 2021
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93. Predicting success of high-flow nasal cannula in pneumonia patients with hypoxemic respiratory failure: The utility of the ROX index

Author: Oriol Roca, Berta Caralt, Jonathan Messika, Marina García-de-Acilu, Benjamin Sztrymf, Jean-Damien Ricard, and Joan R. Masclans
Subjects: Mechanical ventilation, Respiratory rate, medicine.diagnostic_test, business.industry, medicine.medical_treatment, 030208 emergency & critical care medicine, Critical Care and Intensive Care Medicine, medicine.disease, medicine.disease_cause, Hypoxemia, 03 medical and health sciences, Pneumonia, Pulse oximetry, 0302 clinical medicine, 030228 respiratory system, Oxygen therapy, Fraction of inspired oxygen, Anesthesia, medicine, medicine.symptom, business, Nasal cannula
Abstract: Purpose The purpose of the study is to describe early predictors and to develop a prediction tool that accurately identifies the need for mechanical ventilation (MV) in pneumonia patients with hypoxemic acute respiratory failure (ARF) treated with high-flow nasal cannula (HFNC). Materials and methods This is a 4-year prospective observational 2-center cohort study including patients with severe pneumonia treated with HFNC. High-flow nasal cannula failure was defined as need for MV. ROX index was defined as the ratio of pulse oximetry/fraction of inspired oxygen to respiratory rate. Results One hundred fifty-seven patients were included, of whom 44 (28.0%) eventually required MV (HFNC failure). After 12 hours of HFNC treatment, the ROX index demonstrated the best prediction accuracy (area under the receiver operating characteristic curve 0.74 [95% confidence interval, 0.64-0.84]; P Conclusions In patients with ARF and pneumonia, the ROX index can identify patients at low risk for HFNC failure in whom therapy can be continued after 12 hours.
Published: 2016
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94. Bacteriophage LM33_P1, a fast-acting weapon against the pandemic ST131-O25b:H4Escherichia coliclonal complex

Author: Béatrice La Combe, Erick Denamur, Jonathan Messika, Varun Khanna, Sara Dion, Laurent Debarbieux, Nicolas Dufour, Jean-Damien Ricard, Olivier Clermont, Biologie Moléculaire du Gène chez les Extrêmophiles (BMGE), Institut Pasteur [Paris] (IP), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Réanimation Médico-Chirurgicale [Hôpital Louis Mourier], Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Bioinformatique, Biostatistique et Biologie Intégrative (C3BI), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Hôpitaux Universitaires Paris Nord Val de Seine, This project was supported by a joint research grant from both Institut Pasteur and Assistance Publique–Hôpitaux de Paris (Programme Transversal de Recherche #417 and Poste d′Accueil pour praticien hospitalier)., Institut Pasteur [Paris], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), and Debarbieux, Laurent
Subjects: 0301 basic medicine, Microbiology (medical), antibiotic resistance, phage therapy, Genotype, Phage therapy, medicine.drug_class, medicine.medical_treatment, 030106 microbiology, Antibiotics, Population, Virulence, Genome, Viral, Biology, medicine.disease_cause, Coliphages, extended spectrum beta-lactamase, Microbiology, T131 -O25b:H4, Bacteriophage, Mice, 03 medical and health sciences, Antibiotic resistance, Escherichia coli, medicine, Animals, Pharmacology (medical), education, Escherichia coli Infections, Pharmacology, education.field_of_study, Microbial Viability, 23 bacteriophage, Sequence Analysis, DNA, biology.organism_classification, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Virology, 3. Good health, Disease Models, Animal, Infectious Diseases, [SDV.MP.BAC] Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Bacteria
Abstract: International audience; OBJECTIVES:Amongst the highly diverse Escherichia coli population, the ST131-O25b:H4 clonal complex is particularly worrisome as it is associated with a high level of antibiotic resistance. The lack of new antibiotics, the worldwide continuous increase of infections caused by MDR bacteria and the need for narrow-spectrum antimicrobial agents have revived interest in phage therapy. In this article, we describe a virulent bacteriophage, LM33_P1, which specifically infects O25b strains, and provide data related to its therapeutic potential.METHODS:A large panel of E. coli strains (n = 283) was used to assess both the specificity and the activity of bacteriophage LM33_P1. Immunology, biochemistry and genetics-based methods confirmed this specificity. Virology methods and sequencing were used to characterize this bacteriophage in vitro, while three relevant mouse models were employed to show its in vivo efficacy.RESULTS: Bacteriophage LM33_P1 exclusively infects O25b E. coli strains with a 70% coverage on sequence types associated with high antibiotic resistance (ST131 and ST69). This specificity is due to an interaction with the LPS mediated by an original tail fibre. LM33_P1 also has exceptional intrinsic properties with a high adsorption constant and produces over 300 virions per cell in
Published: 2016
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95. Constipation en réanimation : physiopathologie, définition, valeur pronostique, prise en charge

Author: Dominique Prat, Jonathan Messika, M. Le Meur, Benjamin Sztrymf, and Jean-Damien Ricard
Subjects: Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, Constipation, business.industry, Emergency Medicine, medicine, 030208 emergency & critical care medicine, 030212 general & internal medicine, Emergency Nursing, medicine.symptom, business
Abstract: Les symptomes gastro-intestinaux sont frequents et varies chez les patients de reanimation. La physiopathologie de la motricite digestive est complexe et influencee par les agressions habituellement identifiees chez des patients de reanimation, mais aussi par differentes therapeutiques. La definition de la constipation est variable du fait de criteres diagnostiques differents dans les etudes et d’une estimation difficile liee au contexte. Cela participe a la variabilite de l’incidence rapportee de ce trouble. La valeur pronostique est egalement sujette a debats, et il reste impossible de determiner avec exactitude si la constipation est une entite morbide a part entiere ou un reflet de la severite des patients qui en souffrent. De nombreux travaux retrouvent cependant une influence de la constipation sur la duree de ventilation mecanique et la duree de sejour en reanimation. La prise en charge n’est pas codifiee, et l’identification du mecanisme physiopathologique pourrait avoir un interet dans l’efficacite du traitement, dont la nature, le delai d’initiation et les objectifs therapeutiques restent a definir precisement.
Published: 2016
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96. Constipation incidence and impact in medical critical care patients

Author: Matthieu Lemeur, Frédéric Jacobs, Jérôme Fichet, Dominique Prat, Jonathan Messika, A. Avenel, Benjamin Sztrymf, and Jean-Damien Ricard
Subjects: Male, Pediatrics, medicine.medical_specialty, Time Factors, Constipation, Critical Care, Critical Illness, Sedation, Population, Kaplan-Meier Estimate, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Risk Factors, Humans, Medicine, Hospital Mortality, Prospective Studies, 030212 general & internal medicine, Defecation, Prospective cohort study, education, Aged, education.field_of_study, Hepatology, business.industry, Incidence, Incidence (epidemiology), Gastroenterology, 030208 emergency & critical care medicine, Length of Stay, Middle Aged, Respiration, Artificial, Intensive Care Units, SAPS II, Predictive value of tests, Female, France, medicine.symptom, business
Abstract: Background Constipation incidence and impact remain controversial in the ICU. This may depend on the definition criterion used in the previous studies on the field. We aimed to determine the frequency and significance of constipation according to its definition criterion. Methods This is a prospective observational study. Adult patients without a cause of transit time modification and laxative intake within the first 3 days were screened. Constipation was defined by a first stool passage occurring after 3 days of ICU stay. Thereafter, we identified two subgroups of patients: absence of stool passage more than 3 days but less than 6 days (3-day subgroup), and no stool passage for 6 days or more (6-day subgroup). Survival, length of stay and time spent under mechanical ventilation (MV) were compared according to constipation status. Results Among 189 included patients [age 60.8 (49.5-74.2) years, SAPS II 44 (34-53)], 98 (51.9%) exhibited constipation (3-day subgroup n=53, 6-day subgroup n=45). Constipated patients were more likely to receive MV, sedation, vasopressors, enteral nutrition and neuromuscular blocking agents. ICU length of stay and time spent under MV was longer in the 6-day subgroup but not in the 3-day subgroup of patients. Conclusion With regard to outcomes, defining constipation by the absence of stool passage less than 6 days after ICU admission does not identify a specific subset of population. Further studies on the management of this condition should focus on these 'long-term' constipated patients.
Published: 2016
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97. High-flow nasal oxygen for bronchoalveolar lavage in acute respiratory failure patients

Author: Béatrice La Combe, Didier Dreyfuss, Muriel Fartoukh, Bernard Maitre, Vincent Labbé, Jean-Damien Ricard, Keyvan Razazi, Jonathan Messika, and Benjamin Sztrymf
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, chemistry.chemical_element, Oxygen, 03 medical and health sciences, 0302 clinical medicine, Bronchoscopy, otorhinolaryngologic diseases, medicine, Acute respiratory failure, medicine.diagnostic_test, business.industry, 030208 emergency & critical care medicine, Oxygenation, respiratory system, Hypoxia (medical), respiratory tract diseases, Surgery, Bronchoalveolar lavage, 030228 respiratory system, Multicenter study, chemistry, Anesthesia, medicine.symptom, business, High flow
Abstract: HFNC is an effective and safe method of oxygenation during nasal bronchoscopy with BAL in hypoxaemic ARF patients http://ow.ly/XAmtZ
Published: 2016
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98. Oropharyngeal colonization: epidemiology, treatment and ventilator-associated pneumonia prevention

Author: Jonathan Messika, Béatrice La Combe, and Jean-Damien Ricard
Subjects: medicine.medical_specialty, business.industry, Chlorhexidine, Antimicrobial peptides, Ventilator-associated pneumonia, 030208 emergency & critical care medicine, General Medicine, Review Article, medicine.disease, 03 medical and health sciences, Pneumonia, 0302 clinical medicine, Clinical research, Internal medicine, Epidemiology, medicine, Colonization, 030212 general & internal medicine, Urothelium, business, medicine.drug
Abstract: Oropharyngeal (OP) colonization and ventilator-associated pneumonia (VAP) mechanisms are tightly linked. A significant within-population variation in OP colonization has been described, with its composition being dependent from patients’ severity. For instance, healthy subjects have a very low rate in Gram-negative bacteria (GNB) colonization, while its rate rises in comorbid patients, reaching high proportions in ICU patients. Various factors can be put forward to explain the modifications of hospital acquired OP. ICU patients might suffer from underlying diseases; the gastric reflux induced by the presence of nasogastric tubes and the patients’ position influences OP colonization; salivary composition might influence OP content, as it modulates bacterial adhesion and induces reversible bacterial changes enhancing bacterial binding. The transition from OP colonization to VAP has been shown in numerous studies, with the digestive tract acting as a filter, or as a reservoir. Some therapies have been investigated to modulate OP colonization, in order to reduce the risk for VAP. Among those, mammalian antimicrobial peptides have been shown effective in reducing GNB colonization in healthy subjects, but failed in preventing VAP in ICU patients. The widely used chlorhexidine was tested in numerous trials. Data on its efficacy are conflicting, and meta-analyses yield discordant results. Above all, several drawbacks have aroused: a poor tolerance of concentrated solutions; an increased risk of death in the less severe patients; and a reduced susceptibility towards chlorhexidine of number of VAP pathogens. Proanthocyanidins, used to prevent Escherichia coli adhesion to the urothelium, have been tested in mice model of pneumonia with interesting results. Some complementary data are needed before moving to clinical research. Future research paths should include a reappraisal of OP colonization; finding better formulations for chlorhexidine; define the best populations to target oral decontamination and developing other strategies to prevent and treat OP colonization.
Published: 2018

99. Tranexamic Acid Inhalations in Nonmassive Hemoptysis: A Word of Caution

Author: Jonathan, Messika, Dominique, Prat, and Benjamin, Sztrymf
Subjects: Hemoptysis, Tranexamic Acid, Humans, Antifibrinolytic Agents
Published: 2018

100. Health related quality of life in patients with community-acquired pneumococcal pneumonia in France

Author: Grèce Saba, Luiz Flavio Andrade, Hajnal-Gabriela Illes, Patrick Petitpretz, Jonathan Messika, Bruno Detournay, Pierre Bonnin, Gérard de Pouvourville, Henri Laurichesse, J. Gaillat, Christian Chidiac, Jean-Damien Ricard, ESSEC Business School, Essec Business School, Ecologie et Evolution des Microorganismes (EEM), Université Paris Diderot - Paris 7 (UPD7)-Université Paris 13 (UP13)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service des Maladies Infectieuses, Centre Hospitalier de la Région d'Annecy (Pringy), Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Immunité infection vaccination (I2V), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-IFR128-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des Maladies Infectieuses et Tropicales [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, and ESSEC
Subjects: Male, Time Factors, Lung infection, [SDV]Life Sciences [q-bio], Severity of Illness Index, Health problems, 0302 clinical medicine, Surveys and Questionnaires, Activities of Daily Living, Prospective Studies, 030212 general & internal medicine, Aged, 80 and over, 030503 health policy & services, Age Factors, General Medicine, Middle Aged, CAP, 3. Good health, Community-Acquired Infections, Pneumococcal pneumonia, lcsh:R858-859.7, Female, France, 0305 other medical science, Adult, Quality of life, medicine.medical_specialty, lcsh:Computer applications to medicine. Medical informatics, Young Adult, 03 medical and health sciences, Quality of life (healthcare), EQ-5D, medicine, Humans, In patient, Intensive care medicine, Aged, Health related quality of life, business.industry, Research, Public Health, Environmental and Occupational Health, Pneumonia, Length of Stay, Pneumonia, Pneumococcal, medicine.disease, respiratory tract diseases, Tobit model, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Background Community Acquired Pneumococcal Pneumonia is a lung infection that causes serious health problems and can lead to complications and death. The aim of this study was to observe and analyze health related quality of life after a hospital episode for patients with community acquired pneumococcal pneumonia in France. Methods A total of 524 individuals were enrolled prospectively in the study and were followed for 12 months after hospital discharge. Presence of streptococcus pneumoniae was confirmed by microbiological sampling. Quality of life was reported at four different points of time with the EQ-5D-3 L health states using the French reference tariff. Complete data on all four periods was available for 269 patients. We used descriptive and econometric analysis to assess quality of life over time during follow-up, and to identify factors that impact the utility indexes and their evolution through time. We used Tobit panel data estimators to deal with the bounded nature of utility values. Results Average age of patients was 63 and 55% of patients were men. Negative predictors of quality of life were the severity of the initial event, history of pneumonia, smokers, age and being male. On average, quality of life improved in the first 6 months after discharge and stabilized beyond. At month 1, mean utility index was 0.53 (SD: 0.34) for men and 0.45 (SD: 0.34) for women, versus mean of 0.69 (SD: 0.33) and 0.70 (SD: 0.35) at Month 12. “Usual activities” was the dimension the most impacted by the disease episode. Utilities for men were significantly higher than for women, although male patients were more severe. Individuals over 85 years old did not improve quality of life during follow-up, and quality of life did not improve or deteriorated for 34% of patients. We found that length of hospital stay was negatively correlated with quality of life immediately after discharge. Conclusion This study provides with evidence that quality of life after an episode of community acquired pneumococcal pneumonia improves overall until the sixth month after hospital discharge, but older patients with previous history of pneumonia may not experience health gains after the initial episode.
Published: 2018
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