149 results on '"Guervilly, Christophe"'
Search Results
102. Benefit-to-risk balance of bronchoalveolar lavage in the critically ill. A prospective, multicenter cohort study.
- Author
-
Kamel, Toufik, Helms, Julie, Janssen-Langenstein, Ralf, Kouatchet, Achille, Guillon, Antoine, Bourenne, Jeremy, Contou, Damien, Guervilly, Christophe, Coudroy, Rémi, Hoppe, Marie Anne, Lascarrou, Jean Baptiste, Quenot, Jean Pierre, Colin, Gwenhaël, Meng, Paris, Roustan, Jérôme, Cracco, Christophe, Nay, Mai-Anh, Boulain, Thierry, Clinical Research in Intensive Care Sepsis Group (CRICS-TRIGGERSEP), and Salmon-Gandonniere, Charlotte
- Subjects
BRONCHOALVEOLAR lavage ,CRITICALLY ill ,INTENSIVE care units ,COHORT analysis ,DECISION making ,RESEARCH ,BODY fluids ,RESEARCH methodology ,MEDICAL cooperation ,EVALUATION research ,APACHE (Disease classification system) ,CATASTROPHIC illness ,COMPARATIVE studies ,BRONCHOSCOPY ,LONGITUDINAL method - Abstract
Purpose: To assess the benefit-to-risk balance of bronchoalveolar lavage (BAL) in intensive care unit (ICU) patients.Methods: In 16 ICUs, we prospectively collected adverse events during or within 24 h after BAL and assessed the BAL input for decision making in consecutive adult patients. The occurrence of a clinical adverse event at least of grade 3, i.e., sufficiently severe to need therapeutic action(s), including modification(s) in respiratory support, defined poor BAL tolerance. The BAL input for decision making was declared satisfactory if it allowed to interrupt or initiate one or several treatments.Results: We included 483 BAL in 483 patients [age 63 years (interquartile range (IQR) 53-72); female gender: 162 (33.5%); simplified acute physiology score II: 48 (IQR 37-61); immunosuppression 244 (50.5%)]. BAL was begun in non-intubated patients in 105 (21.7%) cases. Sixty-seven (13.9%) patients reached the grade 3 of adverse event or higher. Logistic regression showed that a BAL performed by a non-experienced physician (non-pulmonologist, or intensivist with less than 10 years in the specialty or less than 50 BAL performed) was the main predictor of poor BAL tolerance in non-intubated patients [OR: 3.57 (95% confidence interval 1.04-12.35); P = 0.04]. A satisfactory BAL input for decision making was observed in 227 (47.0%) cases and was not predictable using logistic regression.Conclusions: Adverse events related to BAL in ICU patients are not infrequent nor necessarily benign. Our findings call for an extreme caution, when envisaging a BAL in ICU patients and for a mandatory accompaniment of the less experienced physicians. [ABSTRACT FROM AUTHOR]- Published
- 2020
- Full Text
- View/download PDF
103. Non-ventilatory therapies for acute respiratory distress syndrome
- Author
-
Bourenne, Jérémy, primary, Hraiech, Sami, additional, Rambaud, Romain, additional, Forel, Jean-Marie, additional, Persico, Nicolas, additional, Guervilly, Christophe, additional, and Papazian, Laurent, additional
- Published
- 2018
- Full Text
- View/download PDF
104. Impact of education and training course for ECMO patients based on high-fidelity simulation: a pilot study dedicated to ICU nurses
- Author
-
Fouilloux, Virginie, primary, Gran, Célia, additional, Guervilly, Christophe, additional, Breaud, Jean, additional, El Louali, Fedoua, additional, and Rostini, Pierre, additional
- Published
- 2018
- Full Text
- View/download PDF
105. Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome
- Author
-
Combes, Alain, primary, Hajage, David, additional, Capellier, Gilles, additional, Demoule, Alexandre, additional, Lavoué, Sylvain, additional, Guervilly, Christophe, additional, Da Silva, Daniel, additional, Zafrani, Lara, additional, Tirot, Patrice, additional, Veber, Benoit, additional, Maury, Eric, additional, Levy, Bruno, additional, Cohen, Yves, additional, Richard, Christian, additional, Kalfon, Pierre, additional, Bouadma, Lila, additional, Mehdaoui, Hossein, additional, Beduneau, Gaëtan, additional, Lebreton, Guillaume, additional, Brochard, Laurent, additional, Ferguson, Niall D., additional, Fan, Eddy, additional, Slutsky, Arthur S., additional, Brodie, Daniel, additional, and Mercat, Alain, additional
- Published
- 2018
- Full Text
- View/download PDF
106. Venovenous extracorporeal membrane oxygenation devices-related colonisations and infections
- Author
-
Thomas, Guillemette, primary, Hraiech, Sami, additional, Cassir, Nadim, additional, Lehingue, Samuel, additional, Rambaud, Romain, additional, Wiramus, Sandrine, additional, Guervilly, Christophe, additional, Klasen, Fanny, additional, Adda, Mélanie, additional, Dizier, Stéphanie, additional, Roch, Antoine, additional, Papazian, Laurent, additional, and Forel, Jean-Marie, additional
- Published
- 2017
- Full Text
- View/download PDF
107. Respiratory rate and peak inspiratory pressure, new targets from the LUNG SAFE study analysis or physiopathological artifacts?
- Author
-
Guervilly, Christophe, primary, Forel, Jean Marie, additional, and Papazian, Laurent, additional
- Published
- 2017
- Full Text
- View/download PDF
108. Effects of neuromuscular blockers on transpulmonary pressures in moderate to severe acute respiratory distress syndrome
- Author
-
Guervilly, Christophe, primary, Bisbal, Magali, additional, Forel, Jean Marie, additional, Mechati, Malika, additional, Lehingue, Samuel, additional, Bourenne, Jeremy, additional, Perrin, Gilles, additional, Rambaud, Romain, additional, Adda, Melanie, additional, Hraiech, Sami, additional, Marchi, Elisa, additional, Roch, Antoine, additional, Gainnier, Marc, additional, and Papazian, Laurent, additional
- Published
- 2016
- Full Text
- View/download PDF
109. Impact of education and training course for ECMO patients based on high-fidelity simulation: a pilot study dedicated to ICU nurses.
- Author
-
Fouilloux, Virginie, Gran, Célia, Guervilly, Christophe, Breaud, Jean, El Louali, Fedoua, and Rostini, Pierre
- Subjects
NURSING education ,CLINICAL competence ,COMPARATIVE studies ,EXTRACORPOREAL membrane oxygenation ,INTENSIVE care nursing ,T-test (Statistics) ,PILOT projects ,PRE-tests & post-tests ,DATA analysis software ,DESCRIPTIVE statistics ,ODDS ratio - Abstract
Introduction: Medical and para-medical education is one of the key points of healthcare strategy. Training and education based on high-fidelity simulation is one of the gold standards in modern healthcare institutions. We describe a model of training dedicated to ICU nurses in charge of patients with ECMO. The aim of our educational tool was to teach ICU nurses ECMO basic knowledge and skills. Methods: An ECMO Specialist Course Committee implemented the training programme. It was on two consecutive days and consisted of theoretical, practical and high-fidelity, simulation-based teaching. A content expert implemented each scenario and learning objectives were defined. Participants were assessed pre- and post-test (Group 1 and Group 2). Results: In two years, seven sessions took place and 40 volunteers were enrolled. High-fidelity, simulation-based teaching consisted of seven scenarios. There was a significant improvement in mean score between pre- and post-test. Moreover, we noticed that the basic level (pre-test) of participants was improving over the time. The mean pre-test scores of Group 2 were significantly higher than Group1. Conclusion: The implementation of education and training course for ICU nurses in charge of patients on ECMO is feasible and reliable. It improves nurse personal levels, but also shares in improving the global level of the team to which they belong. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
110. Haemophilus parahaemolyticus septic shock after aspiration pneumonia, France
- Author
-
Le Floch, Anne-Sophie, Cassir, Nadim, Hraiech, Sami, Guervilly, Christophe, Papazian, Laurent, and Rolain, Jean-Marc
- Subjects
Aspiration pneumonia -- Complications and side effects ,Hemophilus infections -- Diagnosis ,Septic shock -- Causes of ,Health - Abstract
To the Editor: Members of the genus Haemophilus are commensal bacteria of the upper respiratory tract, and H. influenzae is the main pathogen in this genus that can cause a [...]
- Published
- 2013
- Full Text
- View/download PDF
111. Type III procollagen is a reliable marker of ARDS-associated lung fibroproliferation
- Author
-
Forel, Jean-Marie, primary, Guervilly, Christophe, additional, Hraiech, Sami, additional, Voillet, François, additional, Thomas, Guillemette, additional, Somma, Claude, additional, Secq, Véronique, additional, Farnarier, Catherine, additional, Payan, Marie-Josée, additional, Donati, Stéphanie-Yannis, additional, Perrin, Gilles, additional, Trousse, Delphine, additional, Dizier, Stéphanie, additional, Chiche, Laurent, additional, Baumstarck, Karine, additional, Roch, Antoine, additional, and Papazian, Laurent, additional
- Published
- 2014
- Full Text
- View/download PDF
112. Outcome of acute respiratory distress syndrome patients treated with extracorporeal membrane oxygenation and brought to a referral center
- Author
-
Roch, Antoine, primary, Hraiech, Sami, additional, Masson, Elodie, additional, Grisoli, Dominique, additional, Forel, Jean-Marie, additional, Boucekine, Mohamed, additional, Morera, Pierre, additional, Guervilly, Christophe, additional, Adda, Mélanie, additional, Dizier, Stéphanie, additional, Toesca, Richard, additional, Collart, Fréderic, additional, and Papazian, Laurent, additional
- Published
- 2013
- Full Text
- View/download PDF
113. Haemophilus parahaemolyticusSeptic Shock after Aspiration Pneumonia, France
- Author
-
Le Floch, Anne-Sophie, primary, Cassir, Nadim, additional, Hraiech, Sami, additional, Guervilly, Christophe, additional, Papazian, Laurent, additional, and Rolain, Jean-Marc, additional
- Published
- 2013
- Full Text
- View/download PDF
114. Phenotype and Functions of Natural Killer Cells in Critically-Ill Septic Patients
- Author
-
Forel, Jean-Marie, primary, Chiche, Laurent, additional, Thomas, Guillemette, additional, Mancini, Julien, additional, Farnarier, Catherine, additional, Cognet, Céline, additional, Guervilly, Christophe, additional, Daumas, Aurélie, additional, Vély, Frédéric, additional, Xéridat, François, additional, Vivier, Eric, additional, and Papazian, Laurent, additional
- Published
- 2012
- Full Text
- View/download PDF
115. Interferon-γ production by natural killer cells and cytomegalovirus in critically ill patients*
- Author
-
Chiche, Laurent, primary, Forel, Jean-Marie, additional, Thomas, Guillemette, additional, Farnarier, Catherine, additional, Cognet, Céline, additional, Guervilly, Christophe, additional, Zandotti, Christine, additional, Vély, Frédéric, additional, Roch, Antoine, additional, Vivier, Eric, additional, and Papazian, Laurent, additional
- Published
- 2012
- Full Text
- View/download PDF
116. A strategy based on galactomannan antigen detection and PCR for invasive pulmonary aspergillosis following influenza A (H1N1) pneumonia
- Author
-
Guervilly, Christophe, primary, Roch, Antoine, additional, Ranque, Stéphane, additional, Forel, Jean-Marie, additional, Hraiech, Sami, additional, Xeridat, François, additional, Adda, Melanie, additional, and Papazian, Laurent, additional
- Published
- 2012
- Full Text
- View/download PDF
117. High-frequency oscillatory ventilation and right ventricular function
- Author
-
Guervilly, Christophe, primary and Roch, Antoine, additional
- Published
- 2012
- Full Text
- View/download PDF
118. Right ventricular function in mechanical ventilation
- Author
-
Guervilly, Christophe, primary and Roch, Antoine, additional
- Published
- 2012
- Full Text
- View/download PDF
119. Right ventricular function during high-frequency oscillatory ventilation in adults with acute respiratory distress syndrome
- Author
-
Guervilly, Christophe, primary, Forel, Jean-Marie, additional, Hraiech, Sami, additional, Demory, Didier, additional, Allardet-Servent, Jérome, additional, Adda, Mélanie, additional, Barreau-Baumstark, Karine, additional, Castanier, Matthias, additional, Papazian, Laurent, additional, and Roch, Antoine, additional
- Published
- 2012
- Full Text
- View/download PDF
120. Long-term outcome in medical patients aged 80 or over following admission to an intensive care unit
- Author
-
Roch, Antoine, primary, Wiramus, Sandrine, additional, Pauly, Vanessa, additional, Forel, Jean-Marie, additional, Guervilly, Christophe, additional, Gainnier, Marc, additional, and Papazian, Laurent, additional
- Published
- 2011
- Full Text
- View/download PDF
121. High levels of circulating leukocyte microparticles are associated with better outcome in acute respiratory distress syndrome
- Author
-
Guervilly, Christophe, primary, Lacroix, Romaric, additional, Forel, Jean-Marie, additional, Roch, Antoine, additional, Camoin-Jau, Laurence, additional, Papazian, Laurent, additional, and Dignat-George, Françoise, additional
- Published
- 2011
- Full Text
- View/download PDF
122. Significance of high levels of procalcitonin in patients with influenza A (H1N1) pneumonia
- Author
-
Guervilly, Christophe, primary, Coisel, Yanaël, additional, Botelho-Nevers, Elizabeth, additional, Dizier, Stephanie, additional, Castanier, Matthias, additional, Lepaul-Ercole, Renaud, additional, Brissy, Olivier, additional, Roch, Antoine, additional, Forel, Jean-Marie, additional, and Papazian, Laurent, additional
- Published
- 2010
- Full Text
- View/download PDF
123. Cytomegalovirus reactivation in the intensive care unit: Not a cause of late-onset ventilator-associated pneumonia
- Author
-
Chiche, Laurent, primary, Forel, Jean-Marie, additional, Roch, Antoine, additional, Guervilly, Christophe, additional, Pauly, Vanessa, additional, Allardet-Servent, Jérome, additional, Gainnier, Marc, additional, Zandotti, Christine, additional, and Papazian, Laurent, additional
- Published
- 2010
- Full Text
- View/download PDF
124. Pulmonary Capillary Blood Flow and Cardiac Output Measurement by Partial Carbon Dioxide Rebreathing in Patients with Acute Respiratory Distress Syndrome Receiving Lung Protective Ventilation
- Author
-
Allardet-Servent, Jérôme, primary, Forel, Jean-Marie, additional, Roch, Antoine, additional, Chiche, Laurent, additional, Guervilly, Christophe, additional, Bouzana, Fouad, additional, Vincent, Agnès, additional, Gainnier, Marc, additional, Loundou, Anderson, additional, and Papazian, Laurent, additional
- Published
- 2009
- Full Text
- View/download PDF
125. Active cytomegalovirus infection is common in mechanically ventilated medical intensive care unit patients*
- Author
-
Chiche, Laurent, primary, Forel, Jean-Marie, additional, Roch, Antoine, additional, Guervilly, Christophe, additional, Pauly, Vanessa, additional, Allardet-Servent, Jérôme, additional, Gainnier, Marc, additional, Zandotti, Christine, additional, and Papazian, Laurent, additional
- Published
- 2009
- Full Text
- View/download PDF
126. Fio2 and acute respiratory distress syndrome definition during lung protective ventilation*
- Author
-
Allardet-Servent, Jérôme, primary, Forel, Jean-Marie, additional, Roch, Antoine, additional, Guervilly, Christophe, additional, Chiche, Laurent, additional, Castanier, Matthias, additional, Embriaco, Nathalie, additional, Gainnier, Marc, additional, and Papazian, Laurent, additional
- Published
- 2009
- Full Text
- View/download PDF
127. Assessment of Airway Closure and Expiratory Airflow Limitation to Set Positive End-Expiratory Pressure in Morbidly Obese Patients with Acute Respiratory Distress Syndrome.
- Author
-
Mezid, Mehdi, Esnault, Pierre, Hraiech, Sami, Guervilly, Christophe, and Mezidi, Mehdi
- Subjects
ADULT respiratory distress syndrome ,TOMOGRAPHY - Published
- 2021
- Full Text
- View/download PDF
128. FI02 and acute respiratory distress syndrome definition during lung protective ventilation.
- Author
-
Allardet-Servent, Jérôme, Forel, Jean-Marie, Roch, Antoine, Guervilly, Christophe, Chiche, Laurent, Castanier, Matthias, Embriaco, Nathalie, Gainnier, Marc, and Papazian, Laurent
- Published
- 2009
- Full Text
- View/download PDF
129. Outcomes of Severe ARDS COVID-19 Patients Denied for Venovenous ECMO Support: A Prospective Observational Comparative Study.
- Author
-
Sylvestre, Aude, Forel, Jean-Marie, Textoris, Laura, Gragueb-Chatti, Ines, Daviet, Florence, Salmi, Saida, Adda, Mélanie, Roch, Antoine, Papazian, Laurent, Hraiech, Sami, and Guervilly, Christophe
- Subjects
- *
COVID-19 , *ADULT respiratory distress syndrome , *EXTRACORPOREAL membrane oxygenation - Abstract
Background: Few data are available concerning the outcome of patients denied venovenous extracorporeal membrane oxygenation (VV-ECMO) relative to severe acute respiratory distress syndrome (ARDS) due to COVID-19. Methods: We compared the 90-day survival rate of consecutive adult patients for whom our center was contacted to discuss VV-ECMO indication. Three groups of patients were created: patients for whom VV-ECMO was immediately indicated (ECMO-indicated group), patients for whom VV-ECMO was not indicated at the time of the call (ECMO-not-indicated group), and patients for whom ECMO was definitely contraindicated (ECMO-contraindicated group). Results: In total, 104 patients were referred for VV-ECMO support due to severe COVID-19 ARDS. Among them, 32 patients had immediate VV-ECMO implantation, 28 patients had no VV-ECMO indication, but 1 was assisted thereafter, and 44 patients were denied VV-ECMO for contraindication. Among the 44 patients denied, 30 were denied for advanced age, 24 for excessive prior duration of mechanical ventilation, and 16 for SOFA score >8. The 90-day survival rate was similar for the ECMO-indicated group and the ECMO-not-indicated group at 62.1 and 61.9%, respectively, whereas it was significantly lower (20.5%) for the ECMO-contraindicated group. Conclusions: Despite a low survival rate, 50% of patients were at home 3 months after being denied for VV-ECMO for severe ARDS due to COVID-19. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
130. High-frequency oscillatory ventilation and right ventricular function.
- Author
-
Kneyber, Martin C. J., van Heerde, Marc, Markhorst, Dick G., Guervilly, Christophe, and Roch, Antoine
- Published
- 2012
- Full Text
- View/download PDF
131. Right ventricular function in mechanical ventilation: It is not just about size!
- Author
-
Fichet, Jérôme, Jacobs, Frédéric M., Guervilly, Christophe, and Roch, Antoine
- Published
- 2012
- Full Text
- View/download PDF
132. Cytomegalovirus reactivation in the intensive care unit: Not a cause of late-onset ventilator-associated pneumonia.
- Author
-
Cunha, Burke A., Strollo, Stephanie, Dune, Nicole, Chiche, Laurent, Forel, Jean-Marie, Roch, Antoine, Guervilly, Christophe, Pauly, Vanessa, Allardet-Servent, Jerome, Gainnier, Marc, Zandotti, Christine, and Papazian, Laurent
- Published
- 2010
- Full Text
- View/download PDF
133. Prognostic value of respiratory compliance course on mortality in COVID-19 patients with vv-ECMO.
- Author
-
Valentin, Simon, Amalric, Mathieu, Granier, Guillaume, Pequignot, Benjamin, Guervilly, Christophe, Duarte, Kevin, Girerd, Nicolas, Levy, Bruno, Dunand, Paul, Koszutski, Matthieu, Roze, Hadrien, and Kimmoun, Antoine
- Subjects
- *
PROGNOSIS , *COVID-19 , *ADULT respiratory distress syndrome , *HOSPITAL mortality , *BODY mass index - Abstract
Background: COVID-19-associated acute respiratory distress syndrome (ARDS) supported by veno-venous extra-corporal membrane oxygenation (vv-ECMO) results in a high in-hospital mortality rate of more than 35%. However, after cannulation, no prognostic factor has been described to guide the management of these patients. The objective was to assess the association between static respiratory compliance over the first 10 days post-vv-ECMO implantation on 180-day mortality. Results: In this multicentric retrospective study in three ECMO referral centers, all patients with COVID-19-associated ARDS supported by vv-ECMO were included from 03/01/2020 to 12/31/2021. Patients were ventilated with ultra-protective settings targeting a driving pressure lower than 15 cmH2O. 122 patients were included. Median age was 59 IQR (52–64), 83 (68%) were male, with a median body mass index of 33 (28–37) kg/m2. Delay between first symptoms to vv-ECMO implantation was 16 (10–21) days. Six-month death was 48%. Over the first ten days, compliance increased in 180 day survivors [from 18 (12–25) to 20 (15–27) mL/cmH2O] compared to non-survivors [from 12 (9–20) to 10 (8–14) mL/cmH2O, p interaction < 0.0001]. A time varying multivariable Cox model found age, history of chronic lung disease, compliance from day one to day ten and sweep gas flow from day one to day ten as independent factors associated with 180-day mortality. Conclusions: In COVID-19-associated ARDS, static respiratory compliance course over the first ten days post-vv-ECMO implantation is associated with 180-day mortality. This new information may provide crucial information on the patient's prognosis for intensivists. Key points: Question: Does static respiratory compliance predict outcomes in patients with COVID-19 associated acute respiratory distress syndrome requiring vv-ECMO? Findings: In 122 included patients, static respiratory compliance course over the first ten days post vv-ECMO implantation was associated with 180-day mortality in a multicentric retrospective study. Meanings: Monitoring static respiratory compliance during the ten first days in these patients may provide crucial information on their prognosis and help intensivits for their management. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
134. Avdoralimab (Anti-C5aR1 mAb) Versus Placebo in Patients With Severe COVID-19: Results From a Randomized Controlled Trial (FOR COVID Elimination [FORCE]).
- Author
-
Carvelli, Julien, Meziani, Ferhat, Dellamonica, Jean, Cordier, Pierre-Yves, Allardet-Servent, Jerome, Fraisse, Megan, Velly, Lionel, Barbar, Saber Davide, Lehingue, Samuel, Guervilly, Christophe, Desgrouas, Maxime, Camou, Fabrice, Piperoglou, Christelle, Vely, Frederic, Demaria, Olivier, Karakunnel, Joyson, Fares, Joanna, Batista, Luciana, Rotolo, Federico, and Viotti, Julien
- Subjects
- *
COVID-19 , *RANDOMIZED controlled trials , *OXYGEN therapy , *PLACEBOS , *COMPLEMENT activation - Abstract
Objectives: Severe COVID-19 is associated with exaggerated complement activation. We assessed the efficacy and safety of avdoralimab (an anti-C5aR1 mAb) in severe COVID-19.Design: FOR COVID Elimination (FORCE) was a double-blind, placebo-controlled study.Setting: Twelve clinical sites in France (ICU and general hospitals).Patients: Patients receiving greater than or equal to 5 L oxygen/min to maintain Sp o2 greater than 93% (World Health Organization scale ≥ 5). Patients received conventional oxygen therapy or high-flow oxygen (HFO)/noninvasive ventilation (NIV) in cohort 1; HFO, NIV, or invasive mechanical ventilation (IMV) in cohort 2; and IMV in cohort 3.Interventions: Patients were randomly assigned, in a 1:1 ratio, to receive avdoralimab or placebo. The primary outcome was clinical status on the World Health Organization ordinal scale at days 14 and 28 for cohorts 1 and 3, and the number of ventilator-free days at day 28 (VFD28) for cohort 2.Measurements and Main Results: We randomized 207 patients: 99 in cohort 1, 49 in cohort 2, and 59 in cohort 3. During hospitalization, 95% of patients received glucocorticoids. Avdoralimab did not improve World Health Organization clinical scale score on days 14 and 28 (between-group difference on day 28 of -0.26 (95% CI, -1.2 to 0.7; p = 0.7) in cohort 1 and -0.28 (95% CI, -1.8 to 1.2; p = 0.6) in cohort 3). Avdoralimab did not improve VFD28 in cohort 2 (between-group difference of -6.3 (95% CI, -13.2 to 0.7; p = 0.96) or secondary outcomes in any cohort. No subgroup of interest was identified.Conclusions: In this randomized trial in hospitalized patients with severe COVID-19 pneumonia, avdoralimab did not significantly improve clinical status at days 14 and 28 (funded by Innate Pharma, ClinicalTrials.gov number, NCT04371367). [ABSTRACT FROM AUTHOR]- Published
- 2022
- Full Text
- View/download PDF
135. Effect of prone positioning on survival in adult patients receiving venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a systematic review and meta-analysis.
- Author
-
Papazian, Laurent, Schmidt, Matthieu, Hajage, David, Combes, Alain, Petit, Matthieu, Lebreton, Guillaume, Rilinger, Jonathan, Giani, Marco, Le Breton, Camille, Duburcq, Thibault, Jozwiak, Mathieu, Wengenmayer, Tobias, Roux, Damien, Parke, Rachael, Loundou, Anderson, Guervilly, Christophe, and Boyer, Laurent
- Subjects
- *
ADULT respiratory distress syndrome , *PATIENT positioning , *EXTRACORPOREAL membrane oxygenation , *CARDIOGENIC shock , *RANDOMIZED controlled trials - Abstract
Purpose: Previous studies support the potential efficacy of venovenous extracorporeal membrane oxygenation (vvECMO) for improving survival in severe acute respiratory distress syndrome (ARDS) cases. Prone positioning (PP) has been shown to improve the outcomes of moderate-to-severe ARDS patients. Few studies and no randomized controlled trials have evaluated the effect of PP performed in ECMO patients. Methods: We performed a systematic review and meta-analysis examining the effect of prone positioning for ARDS patients receiving vvECMO on survival. All authors were contacted to obtain complementary information not mentioned in the original articles. The main objective was to compare 28-day survival in vvECMO patients with PP to vvECMO patients without PP (controls). Results: Thirteen studies with a combined population of 1836 patients satisfied the inclusion criteria. PP was associated with a significant improvement in 28-day survival (503 survivors among 681 patients in the PP group [74%; 95% CI 71–77] vs. 450 survivors among 770 patients in the control group [58%, 95% CI 55–62]; RR 1.31 [95% CI 1.21–1.41]; I2 22% [95% CI 0–62%]; P < 0.0001). Survival was also improved in terms of other endpoints (60-day survival, 90-day survival, ICU survival, and hospital survival). In contrast, the duration of mechanical ventilation was increased in vvECMO patients with PP (mean difference 11.4 days [95% CI 9.2–13.5]; 0.64 [95% CI 0.50–0.78]; I2 8%; P < 0.0001). Conclusion: According to this meta-analysis, survival was improved when prone positioning was used in ARDS patients receiving vvECMO. The impact of this combination on survival should be investigated in prospective randomized controlled trials. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
136. Impact of obesity on survival in COVID-19 ARDS patients receiving ECMO: results from an ambispective observational cohort.
- Author
-
Daviet, Florence, Guilloux, Philippe, Hraiech, Sami, Tonon, David, Velly, Lionel, Bourenne, Jeremy, Porto, Alizée, Gragueb-Chatti, Inès, Bobot, Mickael, Baumstarck, Karine, Papazian, Laurent, Collart, Frédéric, Forel, Jean-Marie, and Guervilly, Christophe
- Subjects
- *
COVID-19 , *EXTRACORPOREAL membrane oxygenation , *OBESITY , *ADULT respiratory distress syndrome , *SURVIVAL rate - Abstract
Background: Since March 2020, health care systems were importantly affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak, with some patients presenting severe acute respiratory distress syndrome (ARDS), requiring extra-corporeal membrane oxygenation (ECMO). We designed an ambispective observational cohort study including all consecutive adult patients admitted to 5 different ICUs from a university hospital. The main objective was to identify the risk factors of severe COVID-19 ARDS patients supported by ECMO associated with 90-day survival. Results: Between March 1st and November 30th 2020, 76 patients with severe COVID-19 ARDS were supported by ECMO. Median (interquartile range IQR) duration of mechanical ventilation (MV) prior to ECMO was of 6 (3–10) days. At ECMO initiation, patients had a median PaO2:FiO2 of 71 mmHg (IQR 62–81), median PaCO2 of 58 mmHg (IQR 51–66) and a median arterial pH of 7.33 (IQR 7.25–7.38). Forty-five patients (59%) were weaned from ECMO. Twenty-eight day, 60-day and 90-day survival rates were, respectively, 92, 62 and 51%. In multivariate logistic regression analysis, with 2 models, one with the RESP score and one with the PRESERVE score, we found that higher BMI was associated with higher 90-day survival [odds ratio (OR): 0.775 (0.644–0.934), p = 0.007) and 0.631 (0.462–0.862), respectively]. Younger age was also associated with 90-day survival in both models [OR: 1.1354 (1.004–1.285), p = 0.044 and 1.187 (1.035–1.362), p = 0.014 respectively]. Obese patients were ventilated with higher PEEP than non-obese patients and presented slightly higher respiratory system compliance. Conclusion: In this ambispective observational cohort of COVID-19 severe ARDS supported by ECMO, obesity was an independent factor associated with improved survival at 90-day. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
137. Impact of dexamethasone on the incidence of ventilator-associated pneumonia and blood stream infections in COVID-19 patients requiring invasive mechanical ventilation: a multicenter retrospective study.
- Author
-
Gragueb-Chatti, Ines, Lopez, Alexandre, Hamidi, Dany, Guervilly, Christophe, Loundou, Anderson, Daviet, Florence, Cassir, Nadim, Papazian, Laurent, Forel, Jean-Marie, Leone, Marc, Dellamonica, Jean, and Hraiech, Sami
- Subjects
- *
COVID-19 , *VENTILATOR-associated pneumonia , *ARTIFICIAL respiration , *DEXAMETHASONE , *NOSOCOMIAL infections - Abstract
Background: Dexamethasone decreases mortality in patients with severe coronavirus disease 2019 (COVID-19) and has become the standard of care during the second wave of pandemic. Dexamethasone is an immunosuppressive treatment potentially increasing the risk of secondary hospital acquired infections in critically ill patients. We conducted an observational retrospective study in three French intensive care units (ICUs) comparing the first and second waves of pandemic to investigate the role of dexamethasone in the occurrence of ventilator-associated pneumonia (VAP) and blood stream infections (BSI). Patients admitted from March to November 2020 with a documented COVID-19 and requiring mechanical ventilation (MV) for ≥ 48 h were included. The main study outcomes were the incidence of VAP and BSI according to the use of dexamethasone. Secondary outcomes were the ventilator-free days (VFD) at day-28 and day-60, ICU and hospital length of stay and mortality. Results: Among the 151 patients included, 84 received dexamethasone, all but one during the second wave. VAP occurred in 63% of patients treated with dexamethasone (DEXA+) and 57% in those not receiving dexamethasone (DEXA−) (p = 0.43). The cumulative incidence of VAP, considering death, duration of MV and late immunosuppression as competing factors was not different between groups (p = 0.59). A multivariate analysis did not identify dexamethasone as an independent risk factor for VAP occurrence. The occurrence of BSI was not different between groups (29 vs. 30%; p = 0.86). DEXA+ patients had more VFD at day-28 (9 (0–21) vs. 0 (0–11) days; p = 0.009) and a reduced ICU length of stay (20 (11–44) vs. 32 (17–46) days; p = 0.01). Mortality did not differ between groups. Conclusions: In this cohort of COVID-19 patients requiring invasive MV, dexamethasone was not associated with an increased incidence of VAP or BSI. Dexamethasone might not explain the high rates of VAP and BSI observed in critically ill COVID-19 patients. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
138. Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients From 29 Countries
- Author
-
Russotto V., Myatra S. N., Laffey J. G., Tassistro E., Antolini L., Bauer P., Lascarrou J. B., Szuldrzynski K., Camporota L., Pelosi P., Sorbello M., Higgs A., Greif R., Putensen C., Agvald-Ohman C., Chalkias A., Bokums K., Brewster D., Rossi E., Fumagalli R., Pesenti A., Foti G., Bellani G., Hazem Abdelkarem Ahmed, Neill K J Adhikari, Kehari Agrawal, Nipun Agrawal, Hernan Aguirre-Bermeo, Christina Agvald-Öhman, Meraj Ahmad, Samareh Ajami, Shazia N Akhtar, Adnan Alghamdi, Abdulmueti Alhadi, Syed M Ali, Mohd N Ali, Anita Alias, Ghaleb Almekhlafi, Julio Alonso, Diana Alvarez Montenegro, Rubina Aman, Matthew Anstey, Irene Aragão, Eleni Arnaoutoglou, Elie Azoulay, Laura Baccari, Nishanth Baliga, Ramya Ballekatte Manjunath, Shrirang Bamane, Anna Bandert, Roland Bartholdy, Marta Basto, Vera Baturova, Philippe R Bauer, Agrippino Bellissima, Vladislav Belsky, Prashant Bendre, Annalisa Benini, Sebastien Besset, Mahuya Bhattacharyya, Piotr Bielanski, Luca Bigatello, Florence Boissier, Kristaps Bokums, Elisa Boni, Iwona Bonney, David Bowen, Alexandre Boyer, Luca Brazzi, David Brewster, Lina Broman, Alexander Browne, Cedric Bruel, Yannick Brunin, Guillermo Bugedo, Italo Calamai, Patricia Campos, Federico G Canavosio, Iacopo Cappellini, Marco Cascella, Nuno Catorze, Athanasios Chalkias, Benoit Champigneulle, Juhi Chandwani, Anne Chao, Satish Chaurasia, Rajesh Chawla, Aakanksha Chawla, Olivia Cheetham, Frank Chemouni, Lee Chew Kiok, Jung-Yien Chien, Timothy Chimunda, Ching-Tang Chiu, Fernando Chiumiento, Nai-Kuan Chou, Nicolas Chudeau, Sandra Colica, Gwenhael Colin, Jean-Michel Constantin, Damien Contou, Andrea Cortegiani, Paulo F Costa, Vasco Costa, Andrea Costamagna, Antonella Cotoia, Andrea N Cracchiolo, Petra Crone, Rui P Cunha, Renata Curić Radivojević, Amit Das, Sampat Dash, Gennaro De Pascale, Silvia De Rosa, Lorenzo Del Sorbo, Valentina Della Torre, Barbara Di Caprio, Raffaele Di Fenza, Ida Di Giacinto, Aikaterini Dimitropoulou, Marcel Dudda, Christopher Edmunds, Stefan F Ehrentraut, Nadia El-Fellah, Muhammed Elhadi, Ahmed Elhadi, Patricia Escudero-Acha, Missael Espinoza, Clelia Esposito, Fabrizio Fabretti, Daniel G Fein, Massimo Ferluga, Marco Fernandes, Alexis Ferre, Janet Ferrier, Marek Flaksa, Fernando Flores, Jesus Flores Gonzalez, Xavier E Fonseca Fuentes, Roland Francis, Daniela G Franco, Pawel Franczyk, Jean-Pierre Frat, Mikhail Furman, Maurizio Fusari, Piotr Galkin, Alice Gallo de Moraes, Renato Gammaldi, Maria F García Aguilera, Eugenio Garofalo, Tomasz Gaszynski, Jonathan Gatward, Mohamed Ghula, Angelo Giacomucci, Ilaria Giovannini, Kingsly Gnanadurai, Thomas Godet, Alberto Goffi, Gemma Goma Fernandez, Maria Gonzalez, Daira González, Alejandro González-Castro, Kadarapura N Gopalakrishna, Eric Gottesman, Alexandre Gros, Christophe Guervilly, Christophe Guitton, Manish Gupta, Kulbhusahn Gupta, Tarikul Hamid, Olfa Hamzaoui, Katrin Hannesdottir, Shahnaz Hasan, Mozaffer Hossain, Sazzad Hossein, Sami Hraiech, Chun-Kai Huang, Cameron Hypes, Soad Imhmed Alkhumsi, Motiul Islam, Muhamad A Ismail, Višnja Ivančan, Sophie Jacquier, Bharat Jagiasi, Nikhilesh Jain, Muhamad Fadhil Hadi Jamaluddin, Milosz Jankowski, Deepak Jeswani, Deepti Jeswani, Simant Jha, Laura Jones, Benjamin Jones, Mathieu Jozwiak, Aleksandra Jumić, Oliver Kamp, Ilias Karametos, Alexey Karelov, Panagiotis Katsoulis, David A Kaufman, Shuchi Kaushik, Callum T Kaye, Subba R Kesavarapu, Ala Khaled, Hapiz Khalidah, Akram Khan, Sudhir Khunteta, Detlef Kindgen-Milles, Sara V Korula, Amol Kothekar, Salman S Koul, Ditte Krog, Shih-Chi Ku, Mira Kuellmar, Lu-Cheng Kuo, Swarna D Kuragayala, Aikaterini Kyparissi, Gonzalo Labarca, John G Laffey, Jaya Lalwani, Antonio Landaverde, Jean-Baptiste Lascarrou, Andres Laserna, Chien-Chang Lee, Stephane Legriel, Andrew Lehr, Tiago Leonor, Yongxing Li, Anna Lisa Licciardi, Edward Litton, Vladimir Lomivorotov, Federico Longhini, Claudia L Lopez Nava, Luis R Loza Gallardo, Ramona Lungu, Annalisa Luzi, Wuhua Ma, Marat Magomedov, Alexandros Makris, Harish Mallapura Maheshwarappa, Tommaso Maraffi, Maria E Marcelli, Karim Mariano, Nathalie Marin, Nadezhda Marova, Maelle Martin, Mayra Martinez Gonzalez, Emilio Maseda, Fiore Mastroianni, Marijana Matas, Dubier Matos, Jessica G Maugeri, Mohd Z Mazlan, Melanie Meersch, Ranjan Meher, Tasneem H Mehesry, Maria Meirik, Armand Mekontso Dessap, Kwabena Mensah, Emmanuelle Mercier, Pavel Michalek, Abhirup Midya, Slobodan Mihaljević, Adrien Mirouse, Prasanna Mishra, Ravi Mistry, Mate Moguš, Norbaniza Mohd Nordin, Noryani Mohd Samat, Luca Montini, Giorgia Montrucchio, Valeria Moro, Diego Morocho Tutillo, Jarrod Mosier, Sircar Mrinal, Wojciech Mudyna, Grégoire Muller, Kartik Munta, Satheesh Munusamy, Stefania Musso, Stefano Muttini, Ismail Nahla Irtiza, Evi Nakou, Amit Narkhede, Joseph Nates, Moana R Nespoli, Francesca Nespoli, Artem Nikitenko, Carla Nogueira, Ross O'Grady, Yewande E Odeyemi, Annika Ohlsson, Alberto Orsello, Vijayanand Palaniswamy, Daniela M Palma, Salvatore Palmese, Jesus N Pantoja Leal, Eleni Papandreou, Metaxia Papanikolaou, Matteo Parotto, Mayur Patel, Mario Pavlek, Niccolò Pedrotti, Ngu Pei Hwa, Lorella Pelagalli, Miryam Pérez Ruiz, Elin Persson, Athanasia Petsiou, Angelo Pezzi, Sam Philip, Francois Philippard, Mariusz Piegat, Sébastien Pili-Floury, Riccardo Pinciroli, Marcia Pinto, Gael Piton, Gaetan Plantefeve, Caroline Pouplet, Sofia Pouriki, Andrea Pradella, Kumar Prashant, Christian Putensen, Alice Quayle, Lua Rahmani, Ian Randall, Banambar Ray, Adrian Regli, Syed T Reza, Jean Damien Ricard, Ivano Riva, Oriol Roca, Roberto Rona, Jon Rosell, Rebecca Rowley, Sheng-Yuan Ruan, Kay Rumschuessel, Annalisa Rundo, Pierpaolo Russo, Vincenzo Russotto, Samir Sahu, Gabriele Sales, Charlotte Salmon-Gandonnière, Nandyelly San Juan Roman, Luis Sánchez-Hurtado, Benjamin J Sandefur, Manel Santafe, Lida Santoro, Rhik Sanyal, Lakshmikanthcharan Saravanabavan, Bhagyesh Shah, Mehul Shah, Ming-Hann Shin, Monica Silva, Shannon Simpson, Ayush Sinah, Atul K Singh, Dinesh K Singh, Nitesh Singh, Lalit Singh, Lukasz Skowronski, Miguel A Sosa, Savino Spadaro, Martin Spangfors, Jesper Sperber, Rosario Spina, Anand Srivastava, Andrew Steel, Alejandro Suarez de la Rica, Singh Sujeet Kumar, Omprakash Sundrani, Nilu Sunil, Bharadwaj Suparna, Manimala R Surath, Yadullah Syed, Tamas Szakmany, Benjamin Sztrymf, Alexis Tabah, Stefano Tarantino, Maria Tileli, Hugo Tirape-Castro, Otoniel Toledo-Salinas, Jacopo Tramarin, Dimitrios Tsiftsis, Iva Tucić, Jose A Tutillo León, Lorenzo Tutino, Vijay N Tyagi, Kyriaki Vagdatli, Sneha Varkey, Maria M Vera, Magnus Von Seth, Carl Wahlstrom, Wan Mohd N Wan Hassan, Wan N Wan Ismail, Kuo-Chuan Wang, Hadrien Winiszewski, Jiayan Wu, Lun Wu, Yu-Chang Yeh, Paul Young, Gianluca Zani, Jonathan Zarka, Dawn Zhao, Diane Zlotnik, Russotto, V, Myatra, S, Laffey, J, Tassistro, E, Antolini, L, Bauer, P, Lascarrou, J, Szuldrzynski, K, Camporota, L, Pelosi, P, Sorbello, M, Higgs, A, Greif, R, Putensen, C, Agvald-Öhman, C, Chalkias, A, Bokums, K, Brewster, D, Rossi, E, Fumagalli, R, Pesenti, A, Foti, G, Bellani, G, Russotto V., Myatra S.N., Laffey J.G., Tassistro E., Antolini L., Bauer P., Lascarrou J.B., Szuldrzynski K., Camporota L., Pelosi P., Sorbello M., Higgs A., Greif R., Putensen C., Agvald-Ohman C., Chalkias A., Bokums K., Brewster D., Rossi E., Fumagalli R., Pesenti A., Foti G., Bellani G., and Hazem Abdelkarem Ahmed, Neill K J Adhikari, Kehari Agrawal, Nipun Agrawal, Hernan Aguirre-Bermeo, Christina Agvald-Öhman, Meraj Ahmad, Samareh Ajami, Shazia N Akhtar, Adnan Alghamdi, Abdulmueti Alhadi, Syed M Ali, Mohd N Ali, Anita Alias, Ghaleb Almekhlafi, Julio Alonso, Diana Alvarez Montenegro, Rubina Aman, Matthew Anstey, Irene Aragão, Eleni Arnaoutoglou, Elie Azoulay, Laura Baccari, Nishanth Baliga, Ramya Ballekatte Manjunath, Shrirang Bamane, Anna Bandert, Roland Bartholdy, Marta Basto, Vera Baturova, Philippe R Bauer, Agrippino Bellissima, Vladislav Belsky, Prashant Bendre, Annalisa Benini, Sebastien Besset, Mahuya Bhattacharyya, Piotr Bielanski, Luca Bigatello, Florence Boissier, Kristaps Bokums, Elisa Boni, Iwona Bonney, David Bowen, Alexandre Boyer, Luca Brazzi, David Brewster, Lina Broman, Alexander Browne, Cedric Bruel, Yannick Brunin, Guillermo Bugedo, Italo Calamai, Patricia Campos, Federico G Canavosio, Iacopo Cappellini, Marco Cascella, Nuno Catorze, Athanasios Chalkias, Benoit Champigneulle, Juhi Chandwani, Anne Chao, Satish Chaurasia, Rajesh Chawla, Aakanksha Chawla, Olivia Cheetham, Frank Chemouni, Lee Chew Kiok, Jung-Yien Chien, Timothy Chimunda, Ching-Tang Chiu, Fernando Chiumiento, Nai-Kuan Chou, Nicolas Chudeau, Sandra Colica, Gwenhael Colin, Jean-Michel Constantin, Damien Contou, Andrea Cortegiani, Paulo F Costa, Vasco Costa, Andrea Costamagna, Antonella Cotoia, Andrea N Cracchiolo, Petra Crone, Rui P Cunha, Renata Curić Radivojević, Amit Das, Sampat Dash, Gennaro De Pascale, Silvia De Rosa, Lorenzo Del Sorbo, Valentina Della Torre, Barbara Di Caprio, Raffaele Di Fenza, Ida Di Giacinto, Aikaterini Dimitropoulou, Marcel Dudda, Christopher Edmunds, Stefan F Ehrentraut, Nadia El-Fellah, Muhammed Elhadi, Ahmed Elhadi, Patricia Escudero-Acha, Missael Espinoza, Clelia Esposito, Fabrizio Fabretti, Daniel G Fein, Massimo Ferluga, Marco Fernandes, Alexis Ferre, Janet Ferrier, Marek Flaksa, Fernando Flores, Jesus Flores Gonzalez, Xavier E Fonseca Fuentes, Roland Francis, Daniela G Franco, Pawel Franczyk, Jean-Pierre Frat, Mikhail Furman, Maurizio Fusari, Piotr Galkin, Alice Gallo de Moraes, Renato Gammaldi, Maria F García Aguilera, Eugenio Garofalo, Tomasz Gaszynski, Jonathan Gatward, Mohamed Ghula, Angelo Giacomucci, Ilaria Giovannini, Kingsly Gnanadurai, Thomas Godet, Alberto Goffi, Gemma Goma Fernandez, Maria Gonzalez, Daira González, Alejandro González-Castro, Kadarapura N Gopalakrishna, Eric Gottesman, Alexandre Gros, Christophe Guervilly, Christophe Guitton, Manish Gupta, Kulbhusahn Gupta, Tarikul Hamid, Olfa Hamzaoui, Katrin Hannesdottir, Shahnaz Hasan, Mozaffer Hossain, Sazzad Hossein, Sami Hraiech, Chun-Kai Huang, Cameron Hypes, Soad Imhmed Alkhumsi, Motiul Islam, Muhamad A Ismail, Višnja Ivančan, Sophie Jacquier, Bharat Jagiasi, Nikhilesh Jain, Muhamad Fadhil Hadi Jamaluddin, Milosz Jankowski, Deepak Jeswani, Deepti Jeswani, Simant Jha, Laura Jones, Benjamin Jones, Mathieu Jozwiak, Aleksandra Jumić, Oliver Kamp, Ilias Karametos, Alexey Karelov, Panagiotis Katsoulis, David A Kaufman, Shuchi Kaushik, Callum T Kaye, Subba R Kesavarapu, Ala Khaled, Hapiz Khalidah, Akram Khan, Sudhir Khunteta, Detlef Kindgen-Milles, Sara V Korula, Amol Kothekar, Salman S Koul, Ditte Krog, Shih-Chi Ku, Mira Kuellmar, Lu-Cheng Kuo, Swarna D Kuragayala, Aikaterini Kyparissi, Gonzalo Labarca, John G Laffey, Jaya Lalwani, Antonio Landaverde, Jean-Baptiste Lascarrou, Andres Laserna, Chien-Chang Lee, Stephane Legriel, Andrew Lehr, Tiago Leonor, Yongxing Li, Anna Lisa Licciardi, Edward Litton, Vladimir Lomivorotov, Federico Longhini, Claudia L Lopez Nava, Luis R Loza Gallardo, Ramona Lungu, Annalisa Luzi, Wuhua Ma, Marat Magomedov, Alexandros Makris, Harish Mallapura Maheshwarappa, Tommaso Maraffi, Maria E Marcelli, Karim Mariano, Nathalie Marin, Nadezhda Marova, Maelle Martin, Mayra Martinez Gonzalez, Emilio Maseda, Fiore Mastroianni, Marijana Matas, Dubier Matos, Jessica G Maugeri, Mohd Z Mazlan, Melanie Meersch, Ranjan Meher, Tasneem H Mehesry, Maria Meirik, Armand Mekontso Dessap, Kwabena Mensah, Emmanuelle Mercier, Pavel Michalek, Abhirup Midya, Slobodan Mihaljević, Adrien Mirouse, Prasanna Mishra, Ravi Mistry, Mate Moguš, Norbaniza Mohd Nordin, Noryani Mohd Samat, Luca Montini, Giorgia Montrucchio, Valeria Moro, Diego Morocho Tutillo, Jarrod Mosier, Sircar Mrinal, Wojciech Mudyna, Grégoire Muller, Kartik Munta, Satheesh Munusamy, Stefania Musso, Stefano Muttini, Ismail Nahla Irtiza, Evi Nakou, Amit Narkhede, Joseph Nates, Moana R Nespoli, Francesca Nespoli, Artem Nikitenko, Carla Nogueira, Ross O'Grady, Yewande E Odeyemi, Annika Ohlsson, Alberto Orsello, Vijayanand Palaniswamy, Daniela M Palma, Salvatore Palmese, Jesus N Pantoja Leal, Eleni Papandreou, Metaxia Papanikolaou, Matteo Parotto, Mayur Patel, Mario Pavlek, Niccolò Pedrotti, Ngu Pei Hwa, Lorella Pelagalli, Miryam Pérez Ruiz, Elin Persson, Athanasia Petsiou, Angelo Pezzi, Sam Philip, Francois Philippard, Mariusz Piegat, Sébastien Pili-Floury, Riccardo Pinciroli, Marcia Pinto, Gael Piton, Gaetan Plantefeve, Caroline Pouplet, Sofia Pouriki, Andrea Pradella, Kumar Prashant, Christian Putensen, Alice Quayle, Lua Rahmani, Ian Randall, Banambar Ray, Adrian Regli, Syed T Reza, Jean Damien Ricard, Ivano Riva, Oriol Roca, Roberto Rona, Jon Rosell, Rebecca Rowley, Sheng-Yuan Ruan, Kay Rumschuessel, Annalisa Rundo, Pierpaolo Russo, Vincenzo Russotto, Samir Sahu, Gabriele Sales, Charlotte Salmon-Gandonnière, Nandyelly San Juan Roman, Luis Sánchez-Hurtado, Benjamin J Sandefur, Manel Santafe, Lida Santoro, Rhik Sanyal, Lakshmikanthcharan Saravanabavan, Bhagyesh Shah, Mehul Shah, Ming-Hann Shin, Monica Silva, Shannon Simpson, Ayush Sinah, Atul K Singh, Dinesh K Singh, Nitesh Singh, Lalit Singh, Lukasz Skowronski, Miguel A Sosa, Savino Spadaro, Martin Spangfors, Jesper Sperber, Rosario Spina, Anand Srivastava, Andrew Steel, Alejandro Suarez de la Rica, Singh Sujeet Kumar, Omprakash Sundrani, Nilu Sunil, Bharadwaj Suparna, Manimala R Surath, Yadullah Syed, Tamas Szakmany, Benjamin Sztrymf, Alexis Tabah, Stefano Tarantino, Maria Tileli, Hugo Tirape-Castro, Otoniel Toledo-Salinas, Jacopo Tramarin, Dimitrios Tsiftsis, Iva Tucić, Jose A Tutillo León, Lorenzo Tutino, Vijay N Tyagi, Kyriaki Vagdatli, Sneha Varkey, Maria M Vera, Magnus Von Seth, Carl Wahlstrom, Wan Mohd N Wan Hassan, Wan N Wan Ismail, Kuo-Chuan Wang, Hadrien Winiszewski, Jiayan Wu, Lun Wu, Yu-Chang Yeh, Paul Young, Gianluca Zani, Jonathan Zarka, Dawn Zhao, Diane Zlotnik
- Subjects
Male ,medicine.medical_specialty ,Critical Illness ,medicine.medical_treatment ,Aged ,Female ,Heart Arrest ,Humans ,Hypotension ,Hypoxia ,Intensive Care Units ,Intubation, Intratracheal ,Logistic Models ,Medical Errors ,Middle Aged ,Prospective Studies ,Respiration, Artificial ,Respiratory Insufficiency ,Vasoconstrictor Agents ,01 natural sciences ,NO ,tracheal intubation ,adverse peri-intubation events ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Intensive care ,Settore MED/41 - ANESTESIOLOGIA ,Medicine ,Intubation ,Intubation, Critical Care ,030212 general & internal medicine ,0101 mathematics ,610 Medicine & health ,Prospective cohort study ,business.industry ,Respiration ,010102 general mathematics ,Tracheal intubation ,General Medicine ,Intratracheal ,Intubation procedure ,Respiratory failure ,Artificial ,Emergency medicine ,Airway management ,business - Abstract
Importance: Tracheal intubation is one of the most commonly performed and high-risk interventions in critically ill patients. Limited information is available on adverse peri-intubation events. Objective: To evaluate the incidence and nature of adverse peri-intubation events and to assess current practice of intubation in critically ill patients. Design, Setting, and Participants: The International Observational Study to Understand the Impact and Best Practices of Airway Management in Critically Ill Patients (INTUBE) study was an international, multicenter, prospective cohort study involving consecutive critically ill patients undergoing tracheal intubation in the intensive care units (ICUs), emergency departments, and wards, from October 1, 2018, to July 31, 2019 (August 28, 2019, was the final follow-up) in a convenience sample of 197 sites from 29 countries across 5 continents. Exposures: Tracheal intubation. Main Outcomes and Measures: The primary outcome was the incidence of major adverse peri-intubation events defined as at least 1 of the following events occurring within 30 minutes from the start of the intubation procedure: cardiovascular instability (either: systolic pressure 30 minutes, new or increase need of vasopressors or fluid bolus >15 mL/kg), severe hypoxemia (peripheral oxygen saturation
- Published
- 2021
139. High-Frequency Oscillation for ARDS.
- Author
-
Liaudet, Lucas, McDermid, Robert C., Csányi-Fritz, Yvonne I., MacDuff, Andrew, Holland, Mat, Muellenbach, Ralf M., Kredel, Markus, Kranke, Peter, Guervilly, Christophe, Roch, Antoine, Papazian, Laurent, Ferguson, Niall D., Slutsky, Arthur S., Meade, Maureen O., and Young, Duncan
- Subjects
- *
RESPIRATORY distress syndrome , *MORTALITY , *AIRWAY (Anatomy) - Abstract
A letter to the editor is presented in response to the study "High-Frequency Oscillation in Early Acute Respiratory Distress Syndrome," by N. D. Ferguson, D. J. Cook, G. H. Guyatt et al in the February 28, 2013 issue.
- Published
- 2013
- Full Text
- View/download PDF
140. Prone positioning during extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. Not sure.
- Author
-
Abrams D, Guervilly C, and Brodie D
- Subjects
- Humans, Prone Position, Extracorporeal Membrane Oxygenation methods, Respiratory Distress Syndrome therapy, Respiratory Distress Syndrome physiopathology, Patient Positioning methods
- Published
- 2024
- Full Text
- View/download PDF
141. Prospective Multicenter Study on Early Proximal Tubular Injury in COVID-19-Related Acute Respiratory Distress Syndrome.
- Author
-
Bobot M, Heim X, Max H, Boucraut J, Simeone P, Stein C, Velly L, Bruder N, Forel JM, Hraiech S, Guervilly C, Carvelli J, Gainnier M, Mège JL, Chopinet S, Jourde-Chiche N, Papazian L, and Burtey S
- Abstract
Introduction: During COVID-19, renal impairment is associated with poor prognosis in intensive care unit (ICU). We aimed to assess the existence and incidence of early renal dysfunction and its prognostic value in patients with COVID-19-related acute respiratory distress syndrome (ARDS)., Methods: In this prospective multicenter study, patients aged over 18 years with invasive mechanical ventilation (MV) for ARDS were enrolled in 3 ICUs. Precise evaluation of renal dysfunction markers, including urinary protein electrophoresis (UPE) and quantification, was performed within 24 hours after MV onset., Results: From March 2020 to December 2021, 135 patients were enrolled as follows: 100 with COVID-19 ARDS and 35 with non-COVID-19 ARDS. UPE found more tubular dysfunction in patients with COVID-19 (68% vs. 21.4%, P < 0.0001) and more normal profiles in patients without COVID-19 (65.0% vs. 11.2%, P = 0.0003). Patients with COVID-19 significantly displayed early urinary leakage of tubular proteins such as beta-2-microglobulin (ß2m) and free light chains, tended to display acute kidney injury (AKI) more frequently (51.0% vs. 34.3%, P = 0.088), had longer MV (20 vs. 9 days, P < 0.0001) and longer ICU stay (26 vs. 15 days, P < 0.0001). In COVID-19 ARDS, leakage of free lambda light chain was associated with the onset of Kidney Disease: Improving Global Outcomes (KDIGO) ≥2 AKI (odds ratio [OR]: 1.014, 95% confidence interval [CI] 1.003-1.025, P = 0.011)., Conclusion: Patients with COVID-19-related ARDS display a proximal tubular dysfunction before the onset of AKI, which predicts AKI. Proximal tubular damage seems an important mechanism of COVID-19-induced nephropathy. Analysis of urinary proteins is a reliable noninvasive tool to assess proximal tubular dysfunction in the ICU., (© 2024 International Society of Nephrology. Published by Elsevier Inc.)
- Published
- 2024
- Full Text
- View/download PDF
142. Microvesicles Are Associated with Early Veno Venous ECMO Circuit Change during Severe ARDS: A Prospective Observational Pilot Study.
- Author
-
Guervilly C, Bousquet G, Arnaud L, Gragueb-Chatti I, Daviet F, Adda M, Forel JM, Dignat-George F, Papazian L, Roch A, Lacroix R, and Hraiech S
- Abstract
Background: Veno venous Extra Corporeal Membrane Oxygenation (vvECMO) is associated with frequent hematological ECMO-related complications needing ECMO circuit change. Microvesicles (MVs) interplay during the thrombosis-fibrinolysis process. The main objective of the study was to identify subpopulations of MVs associated with indications of early vvECMO circuit change., Methods: This is a prospective observational monocenter cohort study. Blood gas was sampled on the ECMO circuit after the membrane oxygenator to measure the PO
2 post oxy at inclusion, day 3, day 7 and the day of ECMO circuit removal. Blood samples for MV analysis were collected at inclusion, day 3, day 7 and the day of ECMO circuit removal. MV subpopulations were identified by flow cytometry., Results: Nineteen patients were investigated. Seven patients (37%) needed an ECMO circuit change for hemolysis (n = 4), a pump thrombosis with fibrinolysis (n = 1), persistent thrombocytopenia with bleeding (n = 1) and a decrease of O2 transfer (n = 1). Levels of leukocyte and endothelial MVs were significantly higher at inclusion for patients who thereafter had an ECMO circuit change ( p = 0.01 and p = 0.001). The areas under the received operating characteristics curves for LeuMVs and EndoMVs sampled the day of cannulation and the need for ECMO circuit change were 0.84 and 0.92, respectively. PO2 post oxy did not significantly change except for in one patient during the ECMO run., Conclusions: Our pilot study supports the potential interest of subpopulations of microvesicles early associated with hematological ECMO-related complications. Our results warrant further studies.- Published
- 2023
- Full Text
- View/download PDF
143. Comparative outcomes of extracorporeal membrane oxygenation for COVID-19 delivered in experienced European centres during successive SARS-CoV-2 variant outbreaks (ECMO-SURGES): an international, multicentre, retrospective cohort study.
- Author
-
Schmidt M, Hajage D, Landoll M, Pequignot B, Langouet E, Amalric M, Mekontso-Dessap A, Chiscano-Camon L, Surman K, Finnerty D, Santa-Teresa P, Arcadipane A, Millán P, Roncon-Albuquerque R Jr, Blandino-Ortiz A, Blanco-Schweizer P, Ricart P, Gimeno-Costa R, Albacete CL, Fortuna P, Schellongowski P, Dauwe D, Winiszewski H, Kimmoun A, Levy B, Hermans G, Grasselli G, Lebreton G, Guervilly C, Martucci G, Karagiannidis C, Riera J, and Combes A
- Subjects
- Adult, Humans, SARS-CoV-2, Retrospective Studies, Pandemics, COVID-19 epidemiology, COVID-19 therapy, COVID-19 etiology, Extracorporeal Membrane Oxygenation adverse effects, Respiratory Distress Syndrome
- Abstract
Background: To inform future research and practice, we aimed to investigate the outcomes of patients who received extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS) due to different variants of SARS-CoV-2., Methods: This retrospective study included consecutive adult patients with laboratory-confirmed SARS-CoV-2 infection who received ECMO for ARDS in 21 experienced ECMO centres in eight European countries (Austria, Belgium, England, France, Germany, Italy, Portugal, and Spain) between Jan 1, 2020, and Sept 30, 2021. We collected data on patient characteristics, clinical status, and management before and after the initiation of ECMO. Participants were grouped according to SARS-CoV-2 variant (wild type, alpha, delta, or other) and period of the pandemic (first [Jan 1-June 30] and second [July 1-Dec 31] semesters of 2020, and first [Jan 1-June 30] and second [July 1-Sept 30] semesters of 2021). Descriptive statistics and Kaplan-Meier survival curves were used to analyse evolving characteristics, management, and patient outcomes over the first 2 years of the pandemic, and independent risk factors of mortality were determined using multivariable Cox regression models. The primary outcome was mortality 90 days after the initiation of ECMO, with follow-up to Dec 30, 2021., Findings: ECMO was initiated in 1345 patients. Patient characteristics and management were similar for the groups of patients infected with different variants, except that those with the delta variant had a younger median age and less hypertension and diabetes. 90-day mortality was 42% (569 of 1345 patients died) overall, and 43% (297/686) in patients infected with wild-type SARS-CoV-2, 39% (152/391) in those with the alpha variant, 40% (78/195) in those with the delta variant, and 58% (42/73) in patients infected with other variants (mainly beta and gamma). Mortality was 10% higher (50%) in the second semester of 2020, when the wild-type variant was still prevailing, than in other semesters (40%). Independent predictors of mortality were age, immunocompromised status, a longer time from intensive care unit admission to intubation, need for renal replacement therapy, and higher Sequential Organ Failure Assessment haemodynamic component score, partial pressure of arterial carbon dioxide, and lactate concentration before ECMO. After adjusting for these variables, mortality was significantly higher with the delta variant than with the other variants, the wild-type strain being the reference., Interpretation: Although crude mortality did not differ between variants, adjusted risk of death was highest for patients treated with ECMO infected with the delta variant of SARS-CoV-2. The higher virulence and poorer outcomes associated with the delta strain might relate to higher viral load and increased inflammatory response syndrome in infected patients, reinforcing the need for a higher rate of vaccination in the population and updated selection criteria for ECMO, should a new and highly virulent strain of SARS-CoV-2 emerge in the future. Mortality was noticeably lower than in other large, multicentre series of patients who received ECMO for COVID-19, highlighting the need to concentrate resources at experienced centres., Funding: None., Competing Interests: Declaration of interests MS reports lecture fees from Getinge, Drager, and Xenios, outside of the submitted work. AM-D reports grants from Addmedica, Baxter, Ferring, Fisher & Paykel, and Philips, and personal fees from Air Liquide, outside of the submitted work. PSc reports lecture fees from Getinge and scientific grants from the European Society of Intensive Medicine (ESICM) and the European Commission (Horizon 2020 Fast Track to Innovation; NCT04115709), and has co-organised an ARDS fellowship for the ESICM sponsored by Medtronic. BL reports fees from Abiomed, Getinge, Baxter, Novartis, Sanofi, Amomed, and Orion, outside of the submitted work. GG has received personal fees (payment for lectures) from Getinge, Draeger Medical, Biotest, GSK, Pfizer, Fisher & Paykel, and Cook Medical, and research grants from MSD and Fisher & Paykel. CG reports fees from Xenios, outside of the submitted work. JR reports lecture fees from Werfen and Gilead, and advisory fees from Medtronic, outside of the submitted work. AC reports grants from Getinge, and personal fees from Getinge, Baxter, and Xenios, outside of the submitted work. All other authors declare no competing interests., (Copyright © 2023 Elsevier Ltd. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
144. Ultra-lung-protective ventilation and biotrauma in severe ARDS patients on veno-venous extracorporeal membrane oxygenation: a randomized controlled study.
- Author
-
Guervilly C, Fournier T, Chommeloux J, Arnaud L, Pinglis C, Baumstarck K, Boucekine M, Valera S, Sanz C, Adda M, Bobot M, Daviet F, Gragueb-Chatti I, Forel JM, Roch A, Hraiech S, Dignat-George F, Schmidt M, Lacroix R, and Papazian L
- Subjects
- Humans, Prospective Studies, Respiration, Artificial, Lung, Extracorporeal Membrane Oxygenation, Respiratory Distress Syndrome therapy
- Abstract
Background: Ultra-lung-protective ventilation may be useful during veno-venous extracorporeal membrane oxygenation (vv-ECMO) for severe acute respiratory distress syndrome (ARDS) to minimize ventilator-induced lung injury and to facilitate lung recovery. The objective was to compare pulmonary and systemic biotrauma evaluated by numerous biomarkers of inflammation, epithelial, endothelial injuries, and lung repair according to two ventilator strategies on vv-ECMO., Methods: This is a prospective randomized controlled study. Patients were randomized to receive during 48 h either ultra-lung-protective ventilation combining very low tidal volume (1-2 mL/kg of predicted body weight), low respiratory rate (5-10 cycles per minute), positive expiratory transpulmonary pressure, and 16 h of prone position or lung-protective-ventilation which followed the ECMO arm of the EOLIA trial (control group)., Results: The primary outcome was the alveolar concentrations of interleukin-1-beta, interleukin-6, interleukin-8, surfactant protein D, and blood concentrations of serum advanced glycation end products and angiopoietin-2 48 h after randomization. Enrollment was stopped for futility after the inclusion of 39 patients. Tidal volume, respiratory rate, minute ventilation, plateau pressure, and mechanical power were significantly lower in the ultra-lung-protective group. None of the concentrations of the pre-specified biomarkers differed between the two groups 48 h after randomization. However, a trend to higher 60-day mortality was observed in the ultra-lung-protective group compared to the control group (45 vs 17%, p = 0.06)., Conclusions: Despite a significant reduction in the mechanical power, ultra-lung-protective ventilation during 48 h did not reduce biotrauma in patients with vv-ECMO-supported ARDS. The impact of this ventilation strategy on clinical outcomes warrants further investigation. Trial registration Clinical trial registered with www., Clinicaltrials: gov ( NCT03918603 ). Registered 17 April 2019., (© 2022. The Author(s).)
- Published
- 2022
- Full Text
- View/download PDF
145. Delivery decision in pregnant women rescued by ECMO for severe ARDS: a retrospective multicenter cohort study.
- Author
-
Aissi James S, Guervilly C, Lesouhaitier M, Coppens A, Haddadi C, Lebreton G, Nizard J, Brechot N, Assouline B, Saura O, Levy D, Lefèvre L, Barhoum P, Chommeloux J, Hékimian G, Luyt CE, Kimmoun A, Combes A, and Schmidt M
- Subjects
- Cohort Studies, Female, Humans, Infant, Newborn, Pregnancy, Pregnant Women, Retrospective Studies, Extracorporeal Membrane Oxygenation, Respiratory Distress Syndrome therapy
- Abstract
Background: Although rarely addressed in the literature, a key question in the care of critically pregnant women with severe acute respiratory distress syndrome (ARDS), especially at the time of extracorporeal membrane oxygenation (ECMO) decision, is whether delivery might substantially improve the mother's and child's conditions. This multicenter, retrospective cohort aims to report maternal and fetal short- and long-term outcomes of pregnant women with ECMO-rescued severe ARDS according to the timing of the delivery decision taken before or after ECMO cannulation., Methods: We included critically ill women with ongoing pregnancy or within 15 days after a maternal/child-rescue-aimed delivery supported by ECMO for a severe ARDS between October 2009 and August 2021 in four ECMO centers. Clinical characteristics, critical care management, complications, and hospital discharge status for both mothers and children were collected. Long-term outcomes and premature birth complications were assessed., Results: Among 563 women on venovenous ECMO during the study period, 11 were cannulated during an ongoing pregnancy at a median (range) of 25 (21-29) gestational weeks, and 13 after an emergency delivery performed at 32 (17-39) weeks of gestation. Pre-ECMO PaO
2 /FiO2 ratio was 57 (26-98) and did not differ between the two groups. Patients on ECMO after delivery reported more major bleeding (46 vs. 18%, p = 0.05) than those with ongoing pregnancy. Overall, the maternal hospital survival was 88%, which was not different between the two groups. Four (36%) of pregnant women had a spontaneous expulsion on ECMO, and fetal survival was higher when ECMO was set after delivery (92% vs. 55%, p = 0.03). Among newborns alive, no severe preterm morbidity or long-term sequelae were reported., Conclusion: Continuation of the pregnancy on ECMO support carries a significant risk of fetal death while improving prematurity-related morbidity in alive newborns with no difference in maternal outcomes. Decisions regarding timing, place, and mode of delivery should be taken and regularly (re)assess by a multidisciplinary team in experienced ECMO centers., (© 2022. The Author(s).)- Published
- 2022
- Full Text
- View/download PDF
146. Prone positioning during venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a pooled individual patient data analysis.
- Author
-
Giani M, Rezoagli E, Guervilly C, Rilinger J, Duburcq T, Petit M, Textoris L, Garcia B, Wengenmayer T, Grasselli G, Pesenti A, Combes A, Foti G, and Schmidt M
- Subjects
- Data Analysis, Humans, Patient Positioning, Prone Position, Prospective Studies, Retrospective Studies, Extracorporeal Membrane Oxygenation, Respiratory Distress Syndrome therapy
- Abstract
Background: Prone positioning (PP) reduces mortality of patients with acute respiratory distress syndrome (ARDS). The potential benefit of prone positioning maneuvers during venovenous extracorporeal membrane oxygenation (ECMO) is unknown. The aim of this study was to evaluate the association between the use of prone positioning during extracorporeal support and ICU mortality in a pooled population of patients from previous European cohort studies., Methods: We performed a pooled individual patient data analysis of European cohort studies which compared patients treated with prone positioning during ECMO (Prone group) to "conventional" ECMO management (Supine group) in patients with severe ARDS., Results: 889 patients from five studies were included. Unadjusted ICU mortality was 52.8% in the Supine Group and 40.8% in the Prone group. At a Cox multiple regression analysis PP during ECMO was not significantly associated with a reduction of ICU mortality (HR 0.67 95% CI: 0.42-1.06). Propensity score matching identified 227 patients in each group. ICU mortality of the matched samples was 48.0% and 39.6% for patients in the Supine and Prone group, respectively (p = 0.072)., Conclusions: In a large population of ARDS patients receiving venovenous extracorporeal support, the use of prone positioning during ECMO was not significantly associated with reduced ICU mortality. The impact of this procedure will have to be definitively assessed by prospective randomized controlled trials., (© 2022. The Author(s).)
- Published
- 2022
- Full Text
- View/download PDF
147. Dissemination of extreme levels of extracellular vesicles: tissue factor activity in patients with severe COVID-19.
- Author
-
Guervilly C, Bonifay A, Burtey S, Sabatier F, Cauchois R, Abdili E, Arnaud L, Lano G, Pietri L, Robert T, Velier M, Papazian L, Albanese J, Kaplanski G, Dignat-George F, and Lacroix R
- Subjects
- Aged, Aged, 80 and over, Area Under Curve, COVID-19 complications, COVID-19 virology, Female, Fibrin Fibrinogen Degradation Products metabolism, Humans, Logistic Models, Male, Middle Aged, Pilot Projects, Plasminogen Activator Inhibitor 1 metabolism, Proportional Hazards Models, ROC Curve, Risk, SARS-CoV-2 isolation & purification, Severity of Illness Index, Thrombosis diagnosis, Thrombosis etiology, COVID-19 pathology, Extracellular Vesicles metabolism, Thromboplastin metabolism
- Abstract
Coronavirus disease 2019 (COVID-19) has become one of the biggest public health challenges of this century. Severe forms of the disease are associated with a thrombo-inflammatory state that can turn into thrombosis. Because tissue factor (TF) conveyed by extracellular vesicles (EVs) has been implicated in thrombosis, we quantified the EV-TF activity in a cohort of hospitalized patients with COVID-19 (n = 111) and evaluated its link with inflammation, disease severity, and thrombotic events. Patients with severe disease were compared with those who had moderate disease and with patients who had septic shock not related to COVID-19 (n = 218). The EV-TF activity was notably increased in patients with severe COVID-19 compared with that observed in patients with moderate COVID-19 (median, 231 [25th to 75th percentile, 39-761] vs median, 25 [25th to 75th percentile, 12-59] fM; P < .0001); EV-TF was correlated with leukocytes, D-dimer, and inflammation parameters. High EV-TF values were associated with an increased thrombotic risk in multivariable models. Compared with patients who had septic shock, those with COVID-19 were characterized by a distinct coagulopathy profile with significantly higher EV-TF and EV-fibrinolytic activities that were not counterbalanced by an increase in plasminogen activator inhibitor-1 (PAI-1). Thus, this article is the first to describe the dissemination of extreme levels of EV-TF in patients with severe COVID-19, which supports the international recommendations of systematic preventive anticoagulation in hospitalized patients and potential intensification of anticoagulation in patients with severe disease., (© 2021 by The American Society of Hematology.)
- Published
- 2021
- Full Text
- View/download PDF
148. Multidrug-resistant Pseudomonas aeruginosa and mortality in mechanically ventilated ICU patients.
- Author
-
Denis JB, Lehingue S, Pauly V, Cassir N, Gainnier M, Léone M, Daviet F, Coiffard B, Baron S, Guervilly C, Forel JM, Roch A, and Papazian L
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents therapeutic use, Female, France, Hospitals, Humans, Intensive Care Units, Male, Middle Aged, Pseudomonas aeruginosa isolation & purification, Respiration, Artificial adverse effects, Retrospective Studies, Survival Analysis, Young Adult, Anti-Bacterial Agents pharmacology, Drug Resistance, Multiple, Bacterial, Pneumonia, Ventilator-Associated microbiology, Pneumonia, Ventilator-Associated mortality, Pseudomonas Infections microbiology, Pseudomonas Infections mortality, Pseudomonas aeruginosa drug effects
- Abstract
Background: The link between bacterial resistance and prognosis remains controversial. Predominant pathogen causing ventilator-associated pneumonia (VAP) is Pseudomonas aeruginosa (Pa), which has increasingly become multidrug resistant (MDR). The aim of this study was to evaluate the relationship between MDR VAP Pa episodes and 30-day mortality., Methods: From a longitudinal prospective French multicenter database (2010-2016), Pa VAP onset and physiological data were recorded. MDR was defined as non-susceptibility to at least 1 agent in 3 or more antimicrobial categories. To analyze if MDR episodes were associated with greater in-hospital 30-day mortality, we performed a multivariate survival analysis using the multivariate nonlinear frailty model., Results: A total of 230 patients presented 286 Pa VAP. A maximum of 3 episodes per patient was observed; 73 episodes were MDR and 213 were susceptible. In the multivariate model, factors independently associated with 30-day mortality included hospitalization in the 6 months preceding the first episode (hazard ratio [HR], 2.31; 95% confidence interval [CI], 1.50-3.60; P = .0002), chronic renal failure (HR, 2.34; 95% CI, 1.15-4.77; P = .0196), and Pa VAP recurrence (HR, 2.29; 95% CI, 1.79-4.87; P = .032). Finally, MDR Pa VAP was not associated with death (HR, 0.87; 95% CI; 0.52-1.45; P = .59)., Conclusions: This study did not identify a relationship between the resistance profile of Pseudomonas aeruginosa and mortality., (Copyright © 2019 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
149. Severe metabolic or mixed acidemia on intensive care unit admission: incidence, prognosis and administration of buffer therapy. A prospective, multiple-center study.
- Author
-
Jung B, Rimmele T, Le Goff C, Chanques G, Corne P, Jonquet O, Muller L, Lefrant JY, Guervilly C, Papazian L, Allaouchiche B, and Jaber S
- Subjects
- Acidosis mortality, Aged, Buffers, Female, Humans, Incidence, Intensive Care Units, Male, Middle Aged, Patient Admission, Prognosis, Prospective Studies, Severity of Illness Index, Treatment Outcome, Acidosis drug therapy, Acidosis epidemiology, Proton Pump Inhibitors therapeutic use, Sodium Bicarbonate therapeutic use
- Abstract
Introduction: In this study, we sought describe the incidence and outcomes of severe metabolic or mixed acidemia in critically ill patients as well as the use of sodium bicarbonate therapy to treat these illnesses., Methods: We conducted a prospective, observational, multiple-center study. Consecutive patients who presented with severe acidemia, defined herein as plasma pH below 7.20, were screened. The incidence, sodium bicarbonate prescription and outcomes of either metabolic or mixed severe acidemia were analyzed., Results: Among 2, 550 critically ill patients, 200 (8%) presented with severe acidemia, and 155 (6% of the total admissions) met the inclusion criteria. Almost all patients needed mechanical ventilation and vasopressors during their ICU stay, and 20% of them required renal replacement therapy within the first 24 hours of their ICU stay. Severe metabolic or mixed acidemia was associated with a mortality rate of 57% in the ICU. Delay of acidemia recovery as opposed to initial pH value was associated with increased mortality in the ICU. The type of acidemia did not influence the decision to administer sodium bicarbonate., Conclusions: The incidence of severe metabolic or mixed acidemia in critically ill patients was 6% in the present study, and it was associated with a 57% mortality rate in the ICU. In contradistinction with the initial acid-base parameters, the rapidity of acidemia recovery was an independent risk factor for mortality. Sodium bicarbonate prescription was very heterogeneous between ICUs. Further studies assessing specific treatments may be of interest in this population.
- Published
- 2011
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.