380 results on '"Pineton de Chambrun, Marc"'
Search Results
102. In-Hospital Mortality-Associated Factors of Thrombotic Antiphospholipid Syndrome Patients Requiring Intensive Care Unit Admission
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Pineton De Chambrun, Marc, Larcher, R., Pène, Frédéric, Argaud, Laurent, Mayaux, Julien, Jamme, Matthieu, Coudroy, Rémi, Mathian, Alexis, Gibelin, Aude, Azoulay, Elie, Tandjaoui-Lambiotte, Yacine, Dargent, Auguste, Beloncle, François-Michel, Raphalen, Jean-Herlé, Couteau-Chardon, Amélie, De Prost, Nicolas, Devaquet, Jérôme, Contou, Damien, Gaugain, Samuel, Trouiller, Pierre, Grange, Steven, Ledochowski, Stanislas, Lemarié, Jérémie, Faguer, Stanislas, Degos, Vincent, Luyt, Charles-Edouard, Combes, Alain, Amoura, Zahir, Centre National de Référence du Lupus Systémique, Syndrome des Anticorps Anti-phospholipides et Maladies Auto-immunes Systémiques Rares [CHU Pitié Salpêtrière], Service de Médecine Interne 2, maladies auto-immunes et systémiques [CHU Pitié-Salpêtrière], Institut E3M [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Institut E3M [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Université Paris Descartes - Paris 5 (UPD5), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHI Poissy-Saint-Germain, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre d'Immunologie et des Maladies Infectieuses (CIMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), CHU Tenon [AP-HP], Hopital Saint-Louis [AP-HP] (AP-HP), Service de Réanimation Médico-Chirurgicale [Avicenne], Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], Service de Réanimation Médicale (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHU Necker - Enfants Malades [AP-HP], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Service de réanimation médicale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service d'anesthésie-réanimation SAMU94-SMUR94 [Mondor], Hôpital Lariboisière-Fernand-Widal [APHP], Hôpital Antoine Béclère, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de soins intensifs [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de Réanimation Médicale [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHU Toulouse [Toulouse], Neuroprotection du Cerveau en Développement / Promoting Research Oriented Towards Early Cns Therapies (PROTECT), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases [IHU ICAN], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut E3M [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre d'Immunologie et de Maladies Infectieuses (CIMI), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de Rangueil, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], 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 E3M [CHU Pitié-Salpêtrière], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
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systemic lupus erythematosus ,catastrophic antiphospholipid syndrome ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,intensive care unit ,antiphospholipid syndrome ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience; Background: The antiphospholipid syndrome (APS) is a systemic autoimmune disease defined by thrombotic events that can require ICU admission because of organ dysfunction related to macrovascular and/or microvascular thrombosis. Critically ill patients with thrombosis and APS were studied to gain insight into their prognoses and in-hospital mortality-associated factors.Methods: This French national, multicenter, retrospective study included all patients with APS and any new thrombotic manifestations admitted to 24 ICUs (January 2000-September 2018).Results: During the study period, 134 patients (male/female ratio, 0.4) with 152 APS episodes were admitted to the ICU (mean age at admission, 46.0 ± 15.1 years). In-hospital mortality of their 134 last episodes was 35 of 134 (26.1%). The Cox multivariable model retained certain factors (hazard ratio [95% CI]: age ≥ 40 years, 11.4 [3.1-41.5], P < .0001; mechanical ventilation, 11.0 [3.3-37], P < .0001; renal replacement therapy, 2.9 [1.3-6.3], P = .007; and in-ICU anticoagulation, 0.1 [0.03-0.3], P < .0001) as independently associated with in-hospital mortality. For the subgroup of definite/probable catastrophic APS, the Cox bivariable model (including the Simplified Acute Physiology Score II score) retained double therapy (corticosteroids + anticoagulant, 0.2 [0.07-0.6]; P = .005) but not triple therapy (corticosteroids + anticoagulant + IV immunoglobulins or plasmapheresis: hazard ratio, 0.3 [0.1-1.1]; P = .07) as independently associated with in-hospital mortality.Conclusions: In-ICU anticoagulation was the only APS-specific treatment independently associated with survival for all patients. Double therapy was independently associated with better survival of patients with definite/probable catastrophic APS. In these patients, further studies are needed to determine the role of triple therapy.
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- 2019
103. Monitoring disease activity in systemic lupus erythematosus with single-molecule array digital ELISA quantification of serum interferon-α
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Mathian, Alexis, Mouries-Martin, Suzanne, Dorgham, Karim, Devilliers, Herve, Barnabei, Laura, Ben Salah, Elyès, Cohen-Aubart, Fleur, Garrido Castillo, Laura, Haroche, Julien, Hie, Miguel, Pineton de Chambrun, Marc, Miyara, Makoto, Sterlin, Delphine, Pha, Micheline, Lê Thi Huong, Du, Rieux-Laucat, Frédéric, Rozenberg, Flore, Gorochov, Guy, Amoura, Zahir, Centre d'Immunologie et de Maladies Infectieuses (CIMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Centre National de Référence du Lupus Systémique, Syndrome des Anticorps Anti-phospholipides et Maladies Auto-immunes Systémiques Rares [CHU Pitié Salpêtrière], Service de Médecine Interne 2, maladies auto-immunes et systémiques [CHU Pitié-Salpêtrière], Institut E3M [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], 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 E3M [CHU Pitié-Salpêtrière], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Médecine Interne (SOC 1 et SOC 2) [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), 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), Imagine - Institut des maladies génétiques (IMAGINE - U1163), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Virologie [CHU Cochin], Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Institut E3M [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Direction Générale de l'Organisation des Soins (DGOS)-Université de Bourgogne (UB), Centre d'Immunologie et des Maladies Infectieuses (CIMI), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and université de Bourgogne, LNC
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Simoa ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,Systemic lupus erythematosus ,interferon-alpha ,biomarker ,skin and connective tissue diseases ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
IF 7.873; International audience; ObjectivesNo simple or standardized assay is available to quantify interferon‐α (IFNα) in routine clinical practice. Single‐molecule–array (Simoa) digital enzyme‐linked immunosorbent assay (ELISA) technology enables direct IFNα quantification at fg/mL concentrations. This study was undertaken to assess IFNα digital ELISA diagnostic performances to monitor systemic lupus erythematosus (SLE) activity.MethodsIFNα concentrations in serum samples from 150 consecutive SLE patients in a cross‐sectional study were determined with digital ELISA and a functional biological activity assay (bioassay). According to their SELENA–SLEDAI flare composite, patients were divided into groups with inactive (SLEDAI 0), and into groups with no flare or mild/moderate flare or severe flare.ResultsBased on healthy blood donors, the abnormal serum‐IFNα level threshold value was 136 fg/mL. Next, using receiver operating characteristics curves for an SLE‐patient series, widely heterogeneous for disease activity and organ involvement, the threshold IFNα value associated with active disease was determined to be 266 fg/mL. The digital ELISA‐assessed serum‐IFNα level was a better biomarker of disease activity than the Farr test: its specificity, likelihood ratio for positive results and positive‐predictive value better discerned active SLE or flare from inactive patients. The digital ELISA was more sensitive than the bioassay to detect low‐abnormal serum‐IFNα concentrations and patients with low disease activity.ConclusionDirect serum‐IFNα determination with a highly sensitive assay might improve monitoring of clinical SLE activity and selection of the best candidates for anti‐IFNα treatment.
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104. Ultrasensitive serum interferon-α quantification during SLE remission identifies patients at risk for relapse
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Mathian, Alexis, primary, Mouries-Martin, Suzanne, additional, Dorgham, Karim, additional, Devilliers, Hervé, additional, Yssel, Hans, additional, Garrido Castillo, Laura, additional, Cohen-Aubart, Fleur, additional, Haroche, Julien, additional, Hié, Miguel, additional, Pineton de Chambrun, Marc, additional, Miyara, Makoto, additional, Pha, Micheline, additional, Rozenberg, Flore, additional, Gorochov, Guy, additional, and Amoura, Zahir, additional
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- 2019
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105. CAPS criteria fail to identify most severely-ill thrombotic antiphospholipid syndrome patients requiring intensive care unit admission
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Pineton de Chambrun, Marc, primary, Larcher, Romaric, additional, Pène, Frédéric, additional, Argaud, Laurent, additional, Demoule, Alexandre, additional, Jamme, Matthieu, additional, Coudroy, Remi, additional, Mathian, Alexis, additional, Gibelin, Aude, additional, Azoulay, Elie, additional, Tandjaoui-Lambiotte, Yacine, additional, Dargent, Auguste, additional, Beloncle, François-Michel, additional, Raphalen, Jean-Herlé, additional, Couteau-Chardon, Amélie, additional, de Prost, Nicolas, additional, Devaquet, Jérôme, additional, Contou, Damien, additional, Gaugain, Samuel, additional, Trouiller, Pierre, additional, Grangé, Steven, additional, Ledochowski, Stanislas, additional, Lemarie, Jérémie, additional, Faguer, Stanislas, additional, Degos, Vincent, additional, Combes, Alain, additional, Luyt, Charles-Edouard, additional, and Amoura, Zahir, additional
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- 2019
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106. Achieving lupus low-disease activity and remission states under belimumab in refractory systemic lupus erythematosus: time and organ involvement matter
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Sbeih, Nabiha, primary, Mathian, Alexis, additional, Pineton de Chambrun, Marc, additional, Lhote, Raphael, additional, Zahr, Noël, additional, Pha, Micheline, additional, Cohen-Aubart, Fleur, additional, Haroche, Julien, additional, Hié, Miguel, additional, Jouffroy, Sophie, additional, Benameur, Neila, additional, Devilliers, Hervé, additional, and Amoura, Zahir, additional
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- 2019
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107. Handling shock in idiopathic systemic capillary leak syndrome (Clarkson’s disease): less is more—comment
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Pineton de Chambrun, Marc, primary, Mathian, Alexis, additional, Combes, Alain, additional, Luyt, Charles-Edouard, additional, and Amoura, Zahir, additional
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- 2019
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108. Safety and effectiveness of transjugular renal biopsy for systemic lupus erythematosus and antiphospholipid antibody syndrome patients taking antithrombotics
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Nielly, Hubert, primary, Mathian, Alexis, additional, Cazenave, Maud, additional, Izzedine, Hassan, additional, Haroche, Julien, additional, Cohen-Aubart, Fleur, additional, Hie, Miguel, additional, Miyara, Makoto, additional, Pineton de Chambrun, Marc, additional, Benameur, Neila, additional, Hausfater, Pierre, additional, Pha, Micheline, additional, Boutin-Lê Thi Huong, Du, additional, Rouvier, Philippe, additional, Brocheriou, Isabelle, additional, Cluzel, Philippe, additional, and Amoura, Zahir, additional
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- 2019
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109. Monitoring Disease Activity in Systemic Lupus Erythematosus With Single‐Molecule Array Digital Enzyme‐Linked Immunosorbent Assay Quantification of Serum Interferon‐α
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Mathian, Alexis, primary, Mouries‐Martin, Suzanne, additional, Dorgham, Karim, additional, Devilliers, Hervé, additional, Barnabei, Laura, additional, Ben Salah, Elyès, additional, Cohen‐Aubart, Fleur, additional, Garrido Castillo, Laura, additional, Haroche, Julien, additional, Hie, Miguel, additional, Pineton de Chambrun, Marc, additional, Miyara, Makoto, additional, Sterlin, Delphine, additional, Pha, Micheline, additional, Lê Thi Huong, Du, additional, Rieux‐Laucat, Frédéric, additional, Rozenberg, Flore, additional, Gorochov, Guy, additional, and Amoura, Zahir, additional
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- 2019
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110. Clinical and immunological features of antiphospholipid syndrome in the elderly: a retrospective national multicentre study
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Grimaud, Felix, primary, Yelnik, Cecile, additional, Pineton de Chambrun, Marc, additional, Amoura, Zahir, additional, Arnaud, Laurent, additional, Costedoat Chalumeau, Nathalie, additional, Hachulla, Eric, additional, Lambert, Marc, additional, Roriz, Mélanie, additional, Sibilia, Jean, additional, Papo, Thomas, additional, and Sacre, Karim, additional
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- 2019
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111. Adding Azathioprine to Remission-Induction Glucocorticoids for Eosinophilic Granulomatosis With Polyangiitis (Churg-Strauss), Microscopic Polyangiitis, or Polyarteritis Nodosa Without Poor Prognosis Factors
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Puechal, Xavier, Pagnoux, Christian, Baron, Gabriel, Quemeneur, Thomas, Néel, Antoine, Agard, Christian, Lifermann, François, Liozon, Eric, Ruivard, Marc, Godmer, Pascal, Limal, Nicolas, Mekinian, Arsène, Papo, Thomas, Ruppert, Anne, Bourgarit, Anne, Bienvenu, Boris, Geffray, Loïc, Saraux, Luc, Diot, Elisabeth, Crestani, Bruno, Delbrel, Xavier, Sailler, Laurent, Cohen, Pascal, Le Guern, Véronique, Terrier, Benjamin, Groh, Matthieu, Le Jeunne, Claire, Mouthon, Luc, Ravaud, Philippe, Guillevin, Loïc, Pineton de Chambrun, Marc, Luyt, Charles-Edouard, Beloncle, Francois, Gousseff, Marie, Mauhin, Wladimir, Argaud, Laurent, Ledochowski, Stanislas, Moreau, Anne-Sophie, Sonneville, Romain, Verdière, Bruno, Merceron, Sybille, Zappella, Nathalie, Landais, Mickael, Contou, Damien, Demoule, Alexandre, Paulus, Sylvie, Souweine, Bertrand, Lecomte, Bernard, Vieillard-Baron, Antoine, Terzi, Nicolas, Azoulay, Elie, Friolet, Raymond, Puidupin, Marc, Devaquet, Jérôme, Mazou, Jean-Marc, Fédun, Yannick, Mira, Jean-Paul, Raphalen, Jean-Herlé, Combes, Alain, Amoura, Zahir, Lega, Jean-Christophe, Lambert, Marc, Rivière, Sophie, Dossier, Antoine, Lhote, François, Blaison, Gilles, Alric, Laurent, Saadoun, David, Graveleau, Julie, Soubrier, Martin, Lecomte, Marie-Josée, Christides, Christine, Bosseray, Annick, Lévesque, Hervé, Viallard, François, Tieulie, Nathalie, Lovey, Pierre-Yves, Le Moal, Sylvie, Bibes, Béatrice, Malizia, Giuseppe, Abgueguen, Pierre, Liferman, François, Ninet, Jacques, Hatron, Pierre-Yves, Hot, Arnaud, Hernu, Romain, de La Salle, Sylvie, Similowski, Thomas, Haroche, Julien, Boileau, Julien, Hanslik, Thomas, Bulte, Caroline, Talasczka, Aline, Hachulla, Eric, Decaux, Olivier, Ibouanga, Florent, Arnulf, Bertrand, Benedit, Marc, Maalouf, Assaad, Moulin, Bruno, Cohen-Aubart, Fleur, Pha, Micheline, Rivard, Georges-Etienne, Rondeau, Eric, Debourdeau, Philippe, Presne, Claire, Andrieu, Maude, Len Abad, Oscar, Devilliers, Hervé, Rogers, Alister, Hie, Miguel, Mathian, Alexis, Heidelberger, Valentine, Ingen-Housz-Oro, Saskia, Marquet, Alicia, Mahevas, Matthieu, Bessis, Didier, Bouillet, Laurence, Caux, Frédéric, Chapelon-Abric, Catherine, Debarbieux, Sebastien, Delaporte, Emmanuel, Duval-Modeste, Anne-Bénédicte, Fain, Olivier, Joly, Pascal, Marchand-Adam, Marc, Monfort, Jean-Benoît, Noel, Nicolas, Passeron, Thierry, Sarrot-Reynauld, Françoise, Verrot, Denis, Bouvry, Diane, Fardet, Laurence, Chosidow, Olivier, Sève, Pascal, Valeyre, Dominique, Moreau, Sophie, Centre Hospitalier Le Mans (CH Le Mans), Service de médecine interne et centre de référence des maladies rares [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), Département de Médecine Interne (VALENCIENNES - Med Int), CH Valenciennes, Service de médecine interne [Nantes], Université de Nantes (UN)-Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Service de Médecine Interne [Dax], Centre Hospitalier de Dax, Service de Médecine interne A et polyclinique médicale [CHU Limoges], CHU Limoges, CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Service de médecine interne [CHU Bretagnes Atlantique], CHU Bretagnes Atlantique, Service de rhumatologie [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Department of Internal Medicine, Université Paris Diderot - Paris 7 (UPD7), Centre d'Immunologie et de Maladies Infectieuses (CIMI), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Médecine interne, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Physiopathologie et Epidemiologie de l'Insuffisance Respiratoire, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Médecine Interne [Pau], Centre hospitalier de Pau, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Immunologie - Immunopathologie - Immunothérapeutique (I3), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service des maladies infectieuses et tropicales, Université Paris Diderot - Paris 7 (UPD7)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Chirurgie Orthopédique et traumatique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Centre de référence pour les vascularites nécrosantes et la sclérodermie systémique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Faculté de Médecine-pôle de Médecine Interne, CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Réanimation Médicale et de Médecine Hyperbare [Angers], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP), Centre de recherche en myologie, Université Pierre et Marie Curie - Paris 6 (UPMC)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Ecole Polytechnique Fédérale de Lausanne (EPFL), Hôpital Bichat - Claude Bernard, Service de soins intensifs, Centre Hospitalier de Versailles André Mignot (CHV), Service de réanimation médicale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Neurophysiologie Respiratoire Expérimentale et Clinique, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Microorganismes : Génome et Environnement (LMGE), Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Centre National de la Recherche Scientifique (CNRS)-Université d'Auvergne - Clermont-Ferrand I (UdA), Médecine générale, Service de réanimation medico-chirurgicale [CHU Raymond-Poincaré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Service de réanimation médicale [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), Medical ICU, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Service d'anesthésie-réanimation SAMU94-SMUR94 [Mondor], Institut Cochin (UMR_S567 / UMR 8104), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Immunité et Infection, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Centre National de la Recherche Scientifique (CNRS), Hôpital pasteur [Colmar], Service de Medecine Interne, CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Centre hospitalier de Saint-Nazaire, Clinique de médecine interne, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Service de Médecine Interne [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Hôpital l'Archet, Service des maladies infectieuses et tropicales [CHU Angers], Médecine Interne Dax (MEDECINE INTERNE), Hopital, Service de Médecine Interne, Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service de médecine interne [Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Pneumologie et Réanimation Médicale [CHU Pitié-Salpêtrière] (Département ' R3S '), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de médecine interne [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Department of Clinical Immunology, CHU Strasbourg, CHU Pontchaillou [Rennes], Service d'hématologie biologique, Service de néphrologie, Service de médecine interne et d'immunologie clinique [CHU Pitié-Salpêtrière], Service d'Hématologie-Oncologie, Hôpital Ste-Justine, Département d'Oncologie (Dep Oncol - AVIGNON), Institut Ste Catherine, Service de Néphrologie - Médecine Interne, CHU Amiens-Picardie-hôpital Sud, Service de Médecine Interne (SOC 1 et SOC 2) [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHU Henri Mondor, Service de Médecine Interne [Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Centre de référence maladie rare des cytopénies auto-immunes de l'adulte-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de Dermatologie, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de dermatologie [Avicenne], Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13), Service de Dermatologie, Centre Hospitalier Sud, Hospices Civils, Lyon, Service de dermatologie (CHRU de Lille), Service de dermatologie [Rouen], Service de médecine interne, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Jean Verdier [AP-HP], Commissariat à l'énergie atomique et aux énergies alternatives - Laboratoire d'Electronique et de Technologie de l'Information (CEA-LETI), Direction de Recherche Technologique (CEA) (DRT (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), Equipe 12, Centre Hospitalier Universitaire de Nice (CHU Nice)-Hôpital l'Archet-Centre Hospitalier Universitaire de Nice (CHU Nice)-Hôpital l'Archet-Centre méditerranéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA)-Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA), Service de pneumologie [Avicenne], Service de médecine interne [Saint-Antoine], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Epidemiology in Dermatology and Evaluation in Therapeutics (EpiDermE), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Centre de recherche en Myologie – U974 SU-INSERM, Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Université d'Auvergne - Clermont-Ferrand I (UdA)-Centre National de la Recherche Scientifique (CNRS), 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), Service Médecine interne [CHU Toulouse], Pôle Inflammation, infection, immunologie et loco-moteur [CHU Toulouse] (Pôle I3LM Toulouse), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Henri Mondor [Créteil], Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA)-Université Nice Sophia Antipolis (1965 - 2019) (UNS), Hôpital Ambroise Paré [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR113-Université Pierre et Marie Curie - Paris 6 (UPMC), Service de Département de médecine interne et immunologie clinique [CHU Pitié-Salpêtrière] (DMIIC), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université Côte d'Azur (UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université Côte d'Azur (UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Service de médecine interne [CHU Saint-Antoine]
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[SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system ,[SDV]Life Sciences [q-bio] ,ComputingMilieux_MISCELLANEOUS ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience
- Published
- 2017
112. Contrast‐enhanced Doppler echography to assess position of the distal leg perfusion line in patients on venoarterial extracorporeal membrane oxygenation: A preliminary study
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Pineton de Chambrun, Marc, primary, Combes, Alain, additional, and Hekimian, Guillaume, additional
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- 2018
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113. Sjögren’s syndrome: state of the art on clinical practice guidelines
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Romão, Vasco C, primary, Talarico, Rosaria, additional, Scirè, Carlo Alberto, additional, Vieira, Ana, additional, Alexander, Tobias, additional, Baldini, Chiara, additional, Gottenberg, Jacques-Eric, additional, Gruner, Heidi, additional, Hachulla, Eric, additional, Mouthon, Luc, additional, Orlandi, Martina, additional, Pamfil, Cristina, additional, Pineton de Chambrun, Marc, additional, Taglietti, Marco, additional, Toplak, Natasa, additional, van Daele, Paul, additional, van Laar, Jacob M, additional, Bombardieri, Stefano, additional, Schneider, Matthias, additional, Smith, Vanessa, additional, Cutolo, Maurizio, additional, Mosca, Marta, additional, and Mariette, Xavier, additional
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- 2018
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114. The place of extracorporeal life support in cardiogenic shock.
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de Chambrun, Marc Pineton, Bréchot, Nicolas, Combes, Alain, and Pineton de Chambrun, Marc
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- 2020
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115. Withdrawal of low-dose prednisone in SLE patients with a clinically quiescent disease for more than 1 year: a randomised clinical trial.
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Mathian, Alexis, Pha, Micheline, Haroche, Julien, Cohen-Aubart, Fleur, Hié, Miguel, de Chambrun, Marc Pineton, Thi Huong Du Boutin, Makoto Miyara, Gorochov, Guy, Yssel, Hans, Cherin, Patrick, Devilliers, Hervé, Amoura, Zahir, Pineton de Chambrun, Marc, Boutin, Thi Huong Du, and Miyara, Makoto
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DISEASE relapse prevention ,GLUCOCORTICOIDS ,RESEARCH ,RESEARCH methodology ,EVALUATION research ,MEDICAL cooperation ,TREATMENT effectiveness ,COMPARATIVE studies ,RANDOMIZED controlled trials ,SEVERITY of illness index ,DRUG therapy ,PREDNISONE ,SYSTEMIC lupus erythematosus ,PASSIVE euthanasia - Abstract
Objectives: To compare the efficacy to prevent flares of maintenance versus withdrawal of 5 mg/day prednisone in systemic lupus erythematosus (SLE) patients with clinically quiescent disease.Methods: A monocentric, 12-month, superiority, open-label, randomised (1:1) controlled trial was conducted with 61 patients continuing 5 mg/day prednisone and 63 stopping it. Eligibility criteria were SLE patients who, during the year preceding the inclusion, had a clinically inactive disease and a stable SLE treatment including 5 mg/day prednisone. The primary endpoint was the proportion of patient experiencing a flare defined with the SELENA-SLEDAI flare index (SFI) at 52 weeks. Secondary endpoints included time to flare, flare severity according to SFI and British Isles Lupus Assessment Group (BILAG) index and increase in the Systemic Lupus International Collaborating Clinics (SLICC) damage index (SDI).Results: Proportion of patients experiencing a flare was significantly lower in the maintenance group as compared with the withdrawal group (4 patients vs 17; RR 0.2 (95% CI 0.1 to 0.7), p=0.003). Maintenance of 5 mg prednisone was superior with respect to time to first flare (HR 0.2; 95% CI 0.1 to 0.6, p=0.002), occurrence of mild/moderate flares using the SFI (3 patients vs 12; RR 0.2 (95% CI 0.1 to 0.8), p=0.012) and occurrence of moderate/severe flares using the BILAG index (1 patient vs 8; RR 0.1 (95% CI 0.1 to 0.9), p=0.013). SDI increase and adverse events were similar in the two treatment groups. Subgroup analyses of the primary endpoint by predefined baseline characteristics did not show evidence of a different clinical response.Conclusion: Maintenance of long term 5 mg prednisone in SLE patients with inactive disease prevents relapse.Trial Registration Number: NCT02558517; Results. [ABSTRACT FROM AUTHOR]- Published
- 2020
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116. Who? When? Where? How? Still the alpha and omega of extracorporeal cardiopulmonary resuscitation
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Pineton de Chambrun, Marc and Combes, Alain
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- 2022
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117. Myocardial dysfunction is frequent in systemic capillary-leak syndrome (Clarkson disease) severe episodes
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Pineton de Chambrun, Marc, primary, Mathian, Alexis, additional, Luyt, Charles-Edouard, additional, Combes, Alain, additional, and Amoura, Zahir, additional
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- 2018
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118. Appraising the Real-Life Need for Extracorporeal Membrane Oxygenation during the COVID-19 Pandemic.
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de Chambrun, Pineton, Brodie, Daniel, Combes, Alain, and Pineton de Chambrun, Marc
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EXTRACORPOREAL membrane oxygenation ,ADULT respiratory distress syndrome ,COVID-19 ,MORTALITY ,CRITICAL care medicine ,HOSPITAL care - Abstract
The article discusses the study "Extracorporeal Membrane Oxygenation for COVID-19-Associated Severe Acute Respiratory Distress Syndrome in Chile: A Nationwide Incidence and Cohort Study" by R. A. Diaz, J. Graf, C. Ruiz and colleagues, that was published within the issue. Topics covered include prevalence of acute respiratory distress syndrome (ARDS), mortality rate, and median duration of extracorporeal membrane oxygenation, intensive care unit (ICU) and hospital length of stay.
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- 2021
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119. Extracorporeal Membrane Oxygenation instead of Invasive Mechanical Ventilation in a Patient with Severe COVID-19-associated Acute Respiratory Distress Syndrome.
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Schmidt, Matthieu, Pineton de Chambrun, Marc, Lebreton, Guillaume, Hékimian, Guillaume, Chommeloux, Juliette, Bréchot, Nicolas, Barhoum, Petra, Lefevre, Lucie, Juvin, Charles, Molle, Julie, Luyt, Charles-Edouard, Combes, Alain, and de Chambrun, Marc Pineton
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EXTRACORPOREAL membrane oxygenation ,ADULT respiratory distress syndrome ,ARTIFICIAL respiration - Published
- 2021
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120. The Clinical Picture of Severe Systemic Capillary-Leak Syndrome Episodes Requiring ICU Admission
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Pineton de Chambrun, Marc, primary, Luyt, Charles-Edouard, additional, Beloncle, François, additional, Gousseff, Marie, additional, Mauhin, Wladimir, additional, Argaud, Laurent, additional, Ledochowski, Stanislas, additional, Moreau, Anne-Sophie, additional, Sonneville, Romain, additional, Verdière, Bruno, additional, Merceron, Sybille, additional, Zappella, Nathalie, additional, Landais, Mickael, additional, Contou, Damien, additional, Demoule, Alexandre, additional, Paulus, Sylvie, additional, Souweine, Bertrand, additional, Lecomte, Bernard, additional, Vieillard-Baron, Antoine, additional, Terzi, Nicolas, additional, Azoulay, Elie, additional, Friolet, Raymond, additional, Puidupin, Marc, additional, Devaquet, Jérôme, additional, Mazou, Jean-Marc, additional, Fedun, Yannick, additional, Mira, Jean-Paul, additional, Raphalen, Jean-Herlé, additional, Combes, Alain, additional, and Amoura, Zahir, additional
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- 2017
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121. Reversible Severe Eosinophilic Endomyocardial Fibrosis During Pregnancy
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Pineton de Chambrun, Marc, Charron, Philippe, Vauthier-Brouzes, Danièle, Cluzel, Philippe, Haroche, Julien, Kahn, Jean-Emmanuel, Amoura, Zahir, and Aubart, Fleur Cohen
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Adult ,Heart Failure ,Endomyocardial Fibrosis ,Pregnancy ,Azathioprine ,Hypereosinophilic Syndrome ,Humans ,Prednisone ,Female ,Clinical Case Report ,biological phenomena, cell phenomena, and immunity ,reproductive and urinary physiology ,Immunosuppressive Agents ,Research Article - Abstract
Idiopathic hypereosinophilic syndrome (HES) is a condition of unknown origin characterized by clinical manifestations attributable to eosinophilia and eosinophilic infiltration of tissues. Cardiac involvement is rare and threatening accounting for 33% to 43% of death in HES. Management of pregnant patients with HES is challenging and have rarely been reported, particularly in the setting of heart failure. We here report on the case of a 29-year-old woman with HES who developed severe endomyocardial fibrosis with heart failure during pregnancy. Outcome was favorable under treatment with prednisone and azathioprine. This case illustrates a favorable outcome of endomyocardial fibrosis during pregnancy.
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- 2015
122. Transvenous Renal Biopsy of Critically Ill Patients: Safety and Diagnostic Yield.
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de Chambrun, Marc Pineton, Cluzel, Philippe, Brocheriou, Isabelle, Bréchot, Nicolas, Hékimian, Guillaume, Turki, Mohamed-Wafik, Franchineau, Guillaume, Rouvier, Philippe, Bourcier, Simon, Bureau, Côme, Nieszkowska, Ania, Le Guennec, Loïc, Mathian, Alexis, Amoura, Zahir, Schmidt, Matthieu, Combes, Alain, Luyt, Charles-Edouard, Guennec, Loïc Le, and Pineton de Chambrun, Marc
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- 2019
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123. Achieving lupus low-disease activity and remission states under belimumab in refractory systemic lupus erythematosus: time and organ involvement matter.
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Sbeih, Nabiha, Mathian, Alexis, Pineton de Chambrun, Marc, Lhote, Raphael, Zahr, Noël, Pha, Micheline, Cohen-Aubart, Fleur, Haroche, Julien, Hié, Miguel, Jouffroy, Sophie, Benameur, Neila, Devilliers, Hervé, and Amoura, Zahir
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- 2020
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124. The eclipse sign as a radiological presentation of neurosarcoidosis.
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Pineton de Chambrun, Marc, Galanaud, Damien, Haroche, Julien, Amoura, Zahir, and Cohen Aubart, Fleur
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ECLIPSES , *SARCOIDOSIS , *GADOLINIUM , *GRANULOMA - Abstract
Neurosarcoidosis is a rare inflammatory neurological condition. We describe a challenging radiological presentation of neurosarcoidosis. The eclipse sign refers to hypo T1-weighted parenchymal or leptomeningeal images surrounded by circular gadolinium enhancement. The eclipse sign was identified in 3 out of 46 patients with histologically-proven neurosarcoidosis. The eclipse sign may correspond to necrotizing parenchymal or leptomeningeal granuloma. This sign expands the spectrum of radiological presentations of neurosarcoidosis. [ABSTRACT FROM AUTHOR]
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- 2020
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125. Severe Viral Myopericarditis With Autoantibodies Directed Against RNA Polymerase III.
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Pineton de Chambrun, Marc, Charuel, Jean-Luc, Hékimian, Guillaume, Lifermann, François, Mathian, Alexis, Cohen-Aubart, Fleur, Melki, Isabelle, Luyt, Charles-Edouard, Combes, Alain, and Amoura, Zahir
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RNA polymerases , *AUTOANTIBODIES , *EXTRACORPOREAL membrane oxygenation , *CARDIOMYOPATHIES , *PERICARDITIS , *TRANSFERASES - Abstract
Only 2 of the 11 patients had definite systemic sclerosis according to the American College of Rheumatology and European League Against Rheumatism 2013 classification system, and those 2 patients had mild phenotypes. For example, some patients with systemic sclerosis have chronic fibrotic cardiomyopathy, but acute myocarditis occurs uncommonly and is limited to patients with systemic sclerosis who have borderline forms with inflammatory myositis or systemic lupus erythematosus. Finally, none of the 20 patients with severe influenza-related acute respiratory distress syndrome had antibodies against RNApol3, which suggests that influenza itself does not provoke antibodies against RNApol3. [Extracted from the article]
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- 2020
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126. Idiopathic lung fibrosis and anti myeloperoxidase glomerulonephritis: the tree that hides the forest
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Pineton de Chambrun, Marc, primary, Nunes, Hilario, additional, Brochériou, Isabelle, additional, and Hertig, Alexandre, additional
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- 2015
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127. Mechanical circulatory devices in acute heart failure.
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de Chambrun, Marc Pineton, Breéchot, Nicolas, Combes, Alain, Pineton de Chambrun, Marc, and Bréchot, Nicolas
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- 2018
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128. Lung positron emission tomography with FDG in patients with haematological malignancies and acute respiratory failure
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Pineton De Chambrun, Marc, primary, Lemiale, Virginie, additional, and Azoulay, Élie, additional
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- 2015
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129. La surexpression des chimiokines CXC contrôlant la migration des neutrophiles est prédictive du risque de décès chez les patients souffrant de cirrhose décompensée
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Weiss, Emmanuel, primary, Rautou, Pierre-Emmanuel, additional, Fasseu, Magali, additional, Giabicani, Mikhaël, additional, Pineton de Chambrun, Marc, additional, Durand, François, additional, Lotersztajn, Sophie, additional, Moreau, Richard, additional, and Paugam-Burtz, Catherine, additional
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- 2015
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130. La voie de l’interféron (IFN)-β est inhibée à plusieurs niveaux dans les cellules immunitaires cirrhotiques
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Weiss, Emmanuel, primary, Rautou, Pierre-Emmanuel, additional, Fasseu, Magali, additional, Giabicani, Mikhaël, additional, Pineton de Chambrun, Marc, additional, Durand, François, additional, Lotersztajn, Sophie, additional, Moreau, Richard, additional, and Paugam-Burtz, Catherine, additional
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- 2015
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131. Venoarterial extracorporeal membrane oxygenation for refractory cardiogenic shock post-cardiac arrest.
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de Chambrun, Marc Pineton, Bréchot, Nicolas, Lebreton, Guillaume, Schmidt, Matthieu, Hekimian, Guillaume, Demondion, Pierre, Trouillet, Jean-Louis, Leprince, Pascal, Chastre, Jean, Combes, Alain, Luyt, Charles-Edouard, and Pineton de Chambrun, Marc
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CARDIOGENIC shock ,EXTRACORPOREAL membrane oxygenation ,CARDIAC arrest ,CARDIOPULMONARY resuscitation ,INTENSIVE care units ,THERAPEUTICS - Abstract
Purpose: To describe the characteristics, outcomes, and risk factors associated with poor outcome of venoarterial extracorporeal membrane oxygenation (VA-ECMO)-treated patients with refractory shock post-cardiac arrest.Methods: We retrospectively analyzed data collected prospectively (March 2007-January 2015) in a 26-bed tertiary hospital intensive care unit. All patients implanted with VA-ECMO for refractory cardiogenic shock after successful resuscitation from cardiac arrest were included. Refractory cardiac arrest patients, given VA-ECMO under cardiopulmonary resuscitation, were excluded.Results: Ninety-four patients received VA-ECMO for refractory shock post-cardiac arrest. Their hospital and 12-month survival rates were 28 and 27 %, respectively. All 1-year survivors were cerebral performance category 1. Multivariable analysis retained INR >2.4 (OR 4.9; 95 % CI 1.4-17.2), admission SOFA score >14 (OR 5.3; 95 % CI 1.7-16.5), and shockable rhythm (OR 0.3; 95 % CI 0.1-0.9) as independent predictors of hospital mortality, but not SAPS II, out-of-hospital cardiac arrest score, or other cardiac arrest variables. Only 10 % of patients with an admission SOFA score >14 survived, whereas 50 % of those with scores ≤14 were alive at 1 year. Restricting the analysis to the 67 patients with out-of-hospital cardiac arrest of coronary cause yielded similar results.Conclusion: Among 94 patients implanted with VA-ECMO for refractory cardiogenic shock post-cardiac arrest resuscitation, the 24 (27 %) 1-year survivors had good neurological outcomes, but survival was significantly better for patients with admission SOFA scores <14, shockable rhythm, and INR ≤2.4. VA-ECMO might be considered a rescue therapy for patients with refractory cardiogenic shock post-cardiac arrest resuscitation. [ABSTRACT FROM AUTHOR]- Published
- 2016
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132. New insights into the pathogenesis of Behçet's disease
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Pineton de Chambrun, Marc, primary, Wechsler, Bertrand, additional, Geri, Guillaume, additional, Cacoub, Patrice, additional, and Saadoun, David, additional
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- 2012
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133. Response to: 'Presence of anti-phospholipid antibodies in COVID-19: a case series study' by Amezcua-Guerra .
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Mathian, Alexis, De Chambrun, Marc Pineton, Combes, Alain, Amoura, Zahir, and Pineton De Chambrun, Marc
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- 2021
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134. Antibiotic stewardship in the ICU: time to shift into overdrive.
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Mokrani, David, Chommeloux, Juliette, Pineton de Chambrun, Marc, Hékimian, Guillaume, and Luyt, Charles-Edouard
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MULTIDRUG-resistant tuberculosis , *ANTIMICROBIAL stewardship , *INTENSIVE care units , *DISEASE risk factors , *DRUG resistance in bacteria - Abstract
Antibiotic resistance is a major health problem and will be probably one of the leading causes of deaths in the coming years. One of the most effective ways to fight against resistance is to decrease antibiotic consumption. Intensive care units (ICUs) are places where antibiotics are widely prescribed, and where multidrug-resistant pathogens are frequently encountered. However, ICU physicians may have opportunities to decrease antibiotics consumption and to apply antimicrobial stewardship programs. The main measures that may be implemented include refraining from immediate prescription of antibiotics when infection is suspected (except in patients with shock, where immediate administration of antibiotics is essential); limiting empiric broad-spectrum antibiotics (including anti-MRSA antibiotics) in patients without risk factors for multidrug-resistant pathogens; switching to monotherapy instead of combination therapy and narrowing spectrum when culture and susceptibility tests results are available; limiting the use of carbapenems to extended-spectrum beta-lactamase-producing Enterobacteriaceae, and new beta-lactams to difficult-to-treat pathogen (when these news beta-lactams are the only available option); and shortening the duration of antimicrobial treatment, the use of procalcitonin being one tool to attain this goal. Antimicrobial stewardship programs should combine these measures rather than applying a single one. ICUs and ICU physicians should be at the frontline for developing antimicrobial stewardship programs. [ABSTRACT FROM AUTHOR]
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- 2023
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135. Thrombolysis before venoarterial ECMO for high-risk pulmonary embolism: a retrospective cohort study.
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Levy, David, Saura, Ouriel, Passarelli, Maria Teresa, Lucenteforte, Manuela, Lebreton, Guillaume, Bougle, Adrien, Monsel, Antoine, Ortuno, Sofia, Benitha, Yoël, Hammoudi, Nadjib, Assouline, Benjamin, Petit, Matthieu, Gautier, Melchior, Le Fevre, Lucie, Pineton de Chambrun, Marc, Juvin, Charles, Chommeloux, Juliette, Luyt, Charles-Edouard, Hékimian, Guillaume, and Leprince, Pascal
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INTENSIVE care units , *HOSPITAL admission & discharge , *PULMONARY hypertension , *LOG-rank test , *QUALITY of life - Abstract
Purpose: Despite systemic thrombolysis, a few patients with high-risk pulmonary embolism (PE) remain hemodynamically unstable. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is a considerable lifesaving therapy but systemic thrombolysis before cannulation could carry a high risk of hemorrhage and alter the prognosis. Methods: Between June 2012 and June 2023, we retrospectively analyzed from three intensive care units in Sorbonne University, ECMO-related complications and 90-day mortality for high-risk PE patients who received ECMO without previous systemic thrombolysis compared to those cannulated after systemic thrombolysis failure. Hospital discharge survivors were assessed for long-term health-related quality of life and echocardiographic evaluations. Results: 72 high-risk PE patients [median age 48 (37–61) years, Simplified Acute Physiology Score II (SAPS II) 74 (60–85)] were placed on VA-ECMO for 5 (5–7) days. 31 (43%) patients underwent pre-ECMO thrombolysis (thrombolysis ECMO group, T +) compared to 41 patients (57%, no thrombolysis ECMO group, T−). There was more pre-ECMO cardiac arrest in the thrombolysis ECMO group (94% vs. 67%, p = 0.02). Ninety-day survival was not different between groups (39% vs 46%, log-rank test, p = 0.31). There was no difference in severe hemorrhages (61% vs 59%, p = 1). Twenty-five over 28 patients attended follow-up at a median time of 69 (52–95) months. Long-term quality of life was acceptable and none of them experienced chronic thromboembolic pulmonary hypertension. Conclusions: Ninety-day survival and bleeding events rates did not differ in patients treated with VA-ECMO after systemic thrombolysis compared to those who were not. Recent systemic thrombolysis, as a single parameter, should not be considered as a contraindication for VA-ECMO in high-risk PE. [ABSTRACT FROM AUTHOR]
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- 2024
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136. Contrast‐enhanced Doppler echography to assess position of the distal leg perfusion line in patients on venoarterial extracorporeal membrane oxygenation: A preliminary study.
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Pineton de Chambrun, Marc, Combes, Alain, and Hekimian, Guillaume
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EXTRACORPOREAL membrane oxygenation , *FEMORAL artery - Published
- 2019
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137. The Consequences Of COVID-19 Pandemic On Patients With Monoclonal Gammopathy Associated Systemic Capillary-Leak Syndrome (Clarkson’s disease)
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Pineton de Chambrun, Marc, Moyon, Quentin, Faguer, Stanislas, Urbanski, Geoffrey, Mathian, Alexis, Zucman, Noémie, Werner, Marie, Luyt, Charles-Edouard, Verlicchi, Franco, and Amoura, Zahir
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- 2021
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138. ECMO induces early alterations in coagulation and fibrinolysis profiles in COVID-19 patients with acute respiratory distress syndrome.
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Hékimian, Guillaume, Masi, Paul, Lejeune, Manon, Lebreton, Guillaume, Chommeloux, Juliette, Desnos, Cyrielle, Pineton De Chambrun, Marc, Martin-Toutain, Isabelle, Nieszkowska, Ania, Bréchot, Nicolas, Schmidt, Matthieu, Leprince, Pascal, Luyt, Charles-Edouard, Combes, Alain, and Frère, Corinne
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- 2021
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139. Venoarterial extracorporeal membrane oxygenation in immunocompromised patients with cardiogenic shock: a cohort study and propensity-weighted analysis.
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Moyon, Quentin, Triboulet, Félicien, Reuter, Jean, Lebreton, Guillaume, Dorget, Amandine, Para, Marylou, Chommeloux, Juliette, Stern, Jules, Pineton de Chambrun, Marc, Hékimian, Guillaume, Luyt, Charles-Edouard, Combes, Alain, Sonneville, Romain, and Schmidt, Matthieu
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CARDIOGENIC shock , *EXTRACORPOREAL membrane oxygenation , *IMMUNOCOMPROMISED patients , *HIV infections , *COHORT analysis , *INTENSIVE care units - Abstract
Purpose: The outcomes of immunocompromised patients with cardiogenic shock treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO) are seldom documented, making ECMO candidacy decisions challenging. This study aims (1) to report outcomes of immunocompromised patients treated with VA-ECMO, (2) to identify pre-ECMO predictors of 90-day mortality, (3) to assess the impact of immunodepression on 90-day mortality, and (4) to describe the main ECMO-related complications. Methods: This is a retrospective, propensity-weighted study conducted in two French experienced ECMO centers. Results: From January 2006 to January 2022, 177 critically ill immunocompromised patients (median (interquartile range, IQR) age 49 (32–60) years) received VA-ECMO. The main causes of immunosuppression were long-term corticosteroids/immunosuppressant treatment (29%), hematological malignancy (26%), solid organ transplant (20%), and solid tumor (13%). Overall 90-day and 1-year mortality were 70% (95% confidence interval (CI) 63–77%) and 75% (95% CI 65–79%), respectively. Older age and higher pre-ECMO lactate were independently associated with 90-day mortality. Across immunodepression causes, 1-year mortality ranged from 58% for patients with infection by human immunodeficiency virus (HIV) or asplenia, to 89% for solid organ transplant recipients. Hemorrhagic and infectious complications affected 39% and 54% of patients, while more than half the stay in intensive care unit (ICU) was spent on antibiotics. In a propensity score-weighted model comparing the 177 patients with 942 non-immunocompromised patients experiencing cardiogenic shock on VA-ECMO, immunocompromised status was independently associated with a higher 90-day mortality (odds ratio 2.53, 95% CI 1.72–3.79). Conclusion: Immunocompromised patients undergoing VA-ECMO treatment face an unfavorable prognosis, with higher 90-day mortality compared to non-immunocompromised patients. This underscores the necessity for thorough evaluation and careful selection of ECMO candidates within this frail population. [ABSTRACT FROM AUTHOR]
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- 2024
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140. Severe infections requiring intensive care unit admission in patients receiving ibrutinib for hematological malignancies: a groupe de recherche respiratoire en réanimation onco-hématologique (GRRR-OH) study.
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Baucher, Louise, Lemiale, Virginie, Joseph, Adrien, Wallet, Florent, Pineton de Chambrun, Marc, Ferré, Alexis, Lombardi, Romain, Platon, Laura, Contejean, Adrien, Fuseau, Charline, Calvet, Laure, Pène, Frédéric, Kouatchet, Achille, Mokart, Djamel, Azoulay, Elie, and Lafarge, Antoine
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OPPORTUNISTIC infections , *INTENSIVE care units , *STATISTICS , *RESEARCH , *RESPIRATORY insufficiency , *CRITICALLY ill , *PNEUMOCYSTIS pneumonia , *CRYPTOCOCCOSIS , *CANCER chemotherapy , *EARLY warning score , *MULTIVARIATE analysis , *ANTINEOPLASTIC agents , *RETROSPECTIVE studies , *PATIENTS , *QUANTITATIVE research , *MANN Whitney U Test , *FISHER exact test , *TREATMENT duration , *SEVERITY of illness index , *PROTEIN-tyrosine kinase inhibitors , *TREATMENT effectiveness , *CANCER patients , *QUALITATIVE research , *ASPERGILLOSIS , *ARTIFICIAL respiration , *HOSPITAL mortality , *COMPARATIVE studies , *HOSPITAL care , *HEMATOLOGIC malignancies , *SYMPTOMS , *DESCRIPTIVE statistics , *MYCOSES , *VIRUS diseases , *KAPLAN-Meier estimator , *LYMPHOPROLIFERATIVE disorders , *DATA analysis software , *ALGORITHMS , *LONGITUDINAL method , *ACUTE diseases , *DISEASE complications - Abstract
Background: In the last decade, Ibrutinib has become the standard of care in the treatment of several lymphoproliferative diseases such as chronic lymphocytic leukemia (CLL) and several non-Hodgkin lymphoma. Beyond Bruton tyrosine kinase inhibition, Ibrutinib shows broad immunomodulatory effects that may promote the occurrence of infectious complications, including opportunistic infections. The infectious burden has been shown to vary by disease status, neutropenia, and prior therapy but data focusing on severe infections requiring intensive care unit (ICU) admission remain scarce. We sought to investigate features and outcomes of severe infections in a multicenter cohort of 69 patients receiving ibrutinib admitted to 10 French intensive care units (ICU) from 1 January 2015 to 31 December 2020. Results: Median time from ibrutinib initiation was 6.6 [3–18] months. Invasive fungal infections (IFI) accounted for 19% (n = 13/69) of severe infections, including 9 (69%; n = 9/13) invasive aspergillosis, 3 (23%; n = 3/13) Pneumocystis pneumonia, and 1 (8%; n = 1/13) cryptococcosis. Most common organ injury was acute respiratory failure (ARF) (71%; n = 49/69) and 41% (n = 28/69) of patients required mechanical ventilation. Twenty (29%; n = 20/69) patients died in the ICU while day-90 mortality reached 55% (n = 35/64). In comparison with survivors, decedents displayed more severe organ dysfunctions (SOFA 7 [5–11] vs. 4 [3–7], p = 0.004) and were more likely to undergo mechanical ventilation (68% vs. 31%, p = 0.010). Sixty-three ibrutinib-treated patients were matched based on age and underlying malignancy with 63 controls receiving conventional chemotherapy from an historic cohort. Despite a higher median number of prior chemotherapy lines (2 [1–2] vs. 0 [0–2]; p < 0.001) and higher rates of fungal [21% vs. 8%, p = 0.001] and viral [17% vs. 5%, p = 0.027] infections in patients receiving ibrutinib, ICU (27% vs. 38%, p = 0.254) and day-90 mortality (52% vs. 48%, p = 0.785) were similar between the two groups. Conclusion: In ibrutinib-treated patients, severe infections requiring ICU admission were associated with a dismal prognosis, mostly impacted by initial organ failures. Opportunistic agents should be systematically screened by ICU clinicians in this immunocompromised population. [ABSTRACT FROM AUTHOR]
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- 2023
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141. Necrotizing soft tissue infections in critically ill neutropenic patients: a French multicentre retrospective cohort study.
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Arrestier, Romain, Chaba, Anis, Mabrouki, Asma, Saccheri, Clément, Canet, Emmanuel, Pineton de Chambrun, Marc, Stoclin, Annabelle, Picard, Muriel, Wallet, Florent, Perier, François, Turpin, Matthieu, Argaud, Laurent, Decavèle, Maxens, Issa, Nahéma, Cadoz, Cyril, Klouche, Kada, Cohen, Johana, Mokart, Djamel, Grouille, Julien, and Urbina, Tomas
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SOFT tissue infections , *GRANULOCYTE-colony stimulating factor , *FEBRILE neutropenia , *AGRANULOCYTOSIS , *CRITICALLY ill , *INTENSIVE care patients , *PROPENSITY score matching - Abstract
Background: Necrotizing soft tissue infections (NSTIs) are rare life-threatening bacterial infections. Few data are available regarding neutropenic patients with NSTIs. Our objectives were to describe the characteristics and management of neutropenic patients with NSTIs in intensive care units (ICUs). We conducted a retrospective multicentre cohort study in 18 ICUs between 2011 and 2021. Patients admitted with NSTIs and concomitant neutropenia at diagnosis were included and compared to non-neutropenic patients with NSTIs. The relationship between therapeutic interventions and outcomes was assessed using Cox regression and propensity score matching. Results: 76 neutropenic patients were included and compared to 165 non-neutropenic patients. Neutropenic patients were younger (54 ± 14 vs 60 ± 13 years, p = 0.002) and had less lower limb (44.7% vs 70.9%, p < 0.001) and more abdomino-perineal NSTIs (43.4% vs 18.8%, p < 0.001). Enterobacterales and non-fermenting gram-negative bacteria were the most frequently isolated microorganisms in neutropenic patients. In-hospital mortality was significantly higher in neutropenic than in non-neutropenic patients (57.9% vs 28.5%, p < 0.001). Granulocyte colony-stimulating factor (G-CSF) administration was associated with a lower risk of in-hospital mortality in univariable Cox (hazard ratio (HR) = 0.43 95% confidence interval (CI) [0.23–0.82], p = 0.010) and multivariable Cox (adjusted HR = 0.46 95% CI [0.22–0.94], p = 0.033) analyses and after overlap propensity score weighting (odds ratio = 0.25 95% CI [0.09; 0.68], p = 0.006). Conclusions: Critically ill neutropenic patients with NSTIs present different clinical and microbiological characteristics and are associated with a higher hospital mortality than non-neutropenic patients. G-CSF administration was associated with hospital survival. [ABSTRACT FROM AUTHOR]
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- 2023
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142. Herpesviridae lung reactivation and infection in patients with severe COVID-19 or influenza virus pneumonia: a comparative study.
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Luyt, Charles-Edouard, Burrel, Sonia, Mokrani, David, Pineton de Chambrun, Marc, Luyt, Domitille, Chommeloux, Juliette, Guiraud, Vincent, Bréchot, Nicolas, Schmidt, Matthieu, Hekimian, Guillaume, Combes, Alain, and Boutolleau, David
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- *
INFLUENZA , *COVID-19 , *LUNG infections , *HERPESVIRUSES , *INFLUENZA A virus , *INFLUENZA viruses - Abstract
Background: Lung reactivations of Herpesviridae, herpes simplex virus (HSV) and cytomegalovirus (CMV) have been reported in COVID-19 patients. Whether or not those viral reactivations are more frequent than in other patients is not known. Methods: Retrospective monocentric cohort study of 145 patients with severe COVID-19 pneumonia requiring invasive mechanical ventilation and who were tested for HSV and CMV in bronchoalveolar lavage performed during fiberoptic bronchoscopy for ventilator-associated pneumonia suspicion. Rates of HSV and CMV lung reactivations, and HSV bronchopneumonitis were assessed and compared with an historical cohort of 89 patients with severe influenza pneumonia requiring invasive mechanical ventilation. Results: Among the 145 COVID-19 patients included, 50% and 42% had HSV and CMV lung reactivations, respectively, whereas among the 89 influenza patients, 63% and 28% had HSV and CMV lung reactivations, respectively. Cumulative incidence of HSV lung reactivation (taking into account extubation and death as competing events) was higher in influenza than in COVID-19 patients (p = 0.03), whereas the rate of HSV bronchopneumonitis was similar in both groups (31% and 25%, respectively). Cumulative incidence of CMV lung reactivation (taking into account extubation and death as competing events) was similar in COVID-19 and influenza patients (p = 0.07). Outcomes of patients with HSV or CMV lung reactivations were similar to that of patients without, whatever the underlying conditions, i.e., in COVID-19 patients, in influenza patients, or when all patients were grouped. Conclusions: HSV and CMV lung reactivations are frequent in COVID-19 patients, but not more frequent than in patients with influenza-associated severe pneumonia, despite a higher severity of illness at intensive care unit admission of the latter and a longer duration of mechanical ventilation of the former. Although no impact on outcome of HSV and CMV lung reactivations was detected, the effect of antiviral treatment against these Herpesviridae remains to be determined in these patients. [ABSTRACT FROM AUTHOR]
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- 2022
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143. In-ICU-acquired infections in flare-up systemic rheumatic disease patients receiving immunosuppressant.
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Assan, Florence, Bay, Pierre, Mathian, Alexis, Hekimian, Guillaume, Bréchot, Nicolas, Quentric, Paul, Moyon, Quentin, Schmidt, Matthieu, Cohen-Aubart, Fleur, Haroche, Julien, Amoura, Zahir, Luyt, Charles-Edouard, Combes, Alain, and Pineton de Chambrun, Marc
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RHEUMATISM , *ARTIFICIAL respiration , *INTENSIVE care units , *RENAL replacement therapy , *NOSOCOMIAL infections - Abstract
Objectives: Systemic rheumatic diseases (SRDs) are a group of inflammatory disorders that can need intensive care unit (ICU) admission during a flare-up, requiring administration of immunosuppressants. We undertook this study to determine the frequency, outcome, and occurrence associated factors of infections in flare-up SRD patients receiving immunosuppressant. Methods: Monocenter, a retrospective study including SRD patients admitted to ICU for a flare-up requiring immunosuppressant from 2004 to 2019. The primary endpoint was in-ICU-acquired infections. Results: Ninety-eight patients (female/male ratio: 1.6; mean age at admission: 39.5 ± 17.4 years) were admitted to the ICU for a SRD flare-up, inaugural in 61.2% cases. A specific treatment was given to every patient: corticosteroids 100%, cyclophosphamide 45.9%, plasma exchange 46.9%. Ninety-five infections occurred in 35 (36%) patients mainly pneumonias. The overall in-hospital mortality was 17.3%, and 46% of patients with a nosocomial infection died during their ICU stay. The logistic regression multivariable model retained renal replacement therapy and mechanical ventilation as independent predictors of infection. Conclusion: In-ICU-acquired infection in SRD flare-up is a frequent event associated with organ failures but not with in-ICU use of immunosuppressants. These data suggest that the fear of infection should not withhold a careful in-ICU use of immunosuppressive drugs. Key Points • In-ICU infections are frequent in flare-up systemic rheumatic disease patients. • Infections are associated with increased mortality. • Cyclophosphamide given in ICU was not independently associated with infection. • Severe neutropenia occurred in 27% of patients receiving cyclophosphamide in ICU. [ABSTRACT FROM AUTHOR]
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- 2022
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144. Mechanical ventilation settings during weaning from venovenous extracorporeal membrane oxygenation.
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Passarelli MT, Petit M, Garberi R, Lebreton G, Luyt CE, Pineton De Chambrun M, Chommeloux J, Hékimian G, Rezoagli E, Foti G, Combes A, Giani M, and Schmidt M
- Abstract
Background: The optimal timing of weaning from venovenous extracorporeal membrane oxygenation (VV ECMO) and its modalities have been rarely studied., Methods: Retrospective, multicenter cohort study over 7 years in two tertiary ICUs, high-volume ECMO centers in France and Italy. Patients with ARDS on ECMO and successfully weaned from VV ECMO were classified based on their mechanical ventilation modality during the sweep gas-off trial (SGOT) with either controlled mechanical ventilation or spontaneous breathing (i.e. pressure support ventilation). The primary endpoint was the time to successful weaning from mechanical ventilation within 90 days post-ECMO weaning., Results: 292 adult patients with severe ARDS were weaned from controlled ventilation, and 101 were on spontaneous breathing during SGOT. The 90-day probability of successful weaning from mechanical ventilation was not significantly different between the two groups (sHR [95% CI], 1.23 [0.84-1.82]). ECMO-related complications were not statistically different between patients receiving these two mechanical ventilation strategies. After adjusting for covariates, older age, higher pre-ECMO sequential organ failure assessment score, pneumothorax, ventilator-associated pneumonia, and renal replacement therapy, but not mechanical ventilation modalities during SGOT, were independently associated with a lower probability of successful weaning from mechanical ventilation after ECMO weaning., Conclusions: Time to successful weaning from mechanical ventilation within 90 days post-ECMO was not associated with the mechanical ventilation strategy used during SGOT. Further research is needed to assess the optimal ventilation strategy during weaning off VV ECMO and its impact on short- and long-term outcomes., (© 2024. The Author(s).)
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- 2024
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145. Hematological features and alternate diagnoses in critically ill thrombotic antiphospholipid syndrome patients.
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Azoulay LD, Frapard T, Larcher R, Pène F, Argaud L, Mayaux J, Jamme M, Coudroy R, Mathian A, Gibelin A, Azoulay E, Tandjaoui-Lambiotte Y, Dargent A, Beloncle FM, Raphalen JH, Bréchot N, de Prost N, Devaquet J, Contou D, Gaugain S, Trouiller P, Grangé S, Ledochowski S, Lemarie J, Faguer S, Degos V, Frere C, Quentric P, Moyon Q, Luyt CE, Combes A, Amoura Z, and Pineton de Chambrun M
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- Humans, Female, Middle Aged, Male, Retrospective Studies, Adult, Thrombosis etiology, Intensive Care Units, France epidemiology, Hospital Mortality, Anemia blood, Anemia complications, Anemia etiology, ADAMTS13 Protein blood, Platelet Count, Antiphospholipid Syndrome complications, Antiphospholipid Syndrome blood, Critical Illness, Thrombocytopenia complications, Thrombocytopenia blood, Thrombotic Microangiopathies blood, Thrombotic Microangiopathies etiology, Thrombotic Microangiopathies complications
- Abstract
Objectives: Severe thrombotic antiphospholipid syndrome (APS) frequently affects the kidney, heart, and central nervous system. The precise frequency, clinical picture, differential diagnoses, and outcome of APS-related hematological involvement are lacking, especially in patients requiring ICU admission. This study aimed to describe the hematological manifestations associated with critically ill thrombotic APS patients and catastrophic antiphospholipid syndrome., Methods: This French, national, multicenter, retrospective study, conducted, from January 2000 to September 2018, included all APS patients admitted to 24 participating centers' ICUs with any new thrombotic manifestation. The prevalence of hematological manifestations and their associated outcomes were studied., Results: One hundred and thirty-four patients, female 72%, median [IQR] age 45 [34-56] years, with 152 episodes were included. Anemia was present in 95% of episodes and thrombocytopenia in 93%. The lowest values for hemoglobin and platelets were 7.1 [6.3-8.8] g/dL and 38 [21-60] g/L, respectively. The lowest platelet count below 20 g/L was significantly associated with a higher in-ICU mortality rate (50%, p < 0.0001). A thrombotic microangiopathy syndrome (TMA) syndrome was seen in 16 patients (12%) and was associated with higher in-hospital mortality (p = 0.05). Median ADAMTS-13 levels were 44% [27-74]. Anti-ADAMTS13 antibodies were tested in 11 patients and found negative in all. A suspicion of heparin-induced thrombocytopenia (HIT) was raised in 66 patients but only four patients were classified as definite HIT. Disseminated intravascular coagulation (DIC) was seen in 51% of patients., Conclusion: Thrombocytopenia is very frequent in severe APS patients and may be related to TMA, HIT, or DIC. Deciphering the mechanisms of thrombocytopenia is decisive in CAPS patients. Key Points • Thrombocytopenia is the hallmark laboratory finding in CAPS. • A complete thrombotic microangiopathy pattern is infrequent in CAPS patients. • Alternate diagnoses of CAPS, especially heparin-induced thrombocytopenia, need to be adequately investigated., (© 2024. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)
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- 2024
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146. Incidence and outcomes of prosthetic valve thrombosis during peripheral extracorporeal membrane oxygenation.
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Danial P, Zamorano C, Carillion A, Barreda E, Laali M, Demondion P, D'Alessandro C, Bouglé A, Pineton De Chambrun M, Combes A, Leprince P, and Lebreton G
- Abstract
Objectives: In the context of postcardiotomy cardiogenic shock (PCCS) following valve replacement surgery, it may be necessary to implant a peripheral veno-arterial extracorporeal membrane oxygenation (pVA-ECMO). This procedure, however, carries a risk of prosthetic valve thrombosis. The aim of this retrospective study was to describe the incidence and outcomes of prosthetic valve thrombosis after VA-ECMO support for PCCS and to report the associated risk factors., Methods: All consecutive adult patients who received pVA-ECMO for PCCS following a valve replacement procedure between January 2015 and October 2019 in our institution were included in this retrospective study. Outcome variables were prosthetic valve thrombosis, 30-day and hospital survival, pVA-ECMO-associated adverse events and surgery-related adverse events., Results: During the 4-year study period, 549 patients received pVA-ECMO for PCCS. Among them, 152 had undergone a valve replacement procedure and 9 of these developed prosthetic valve thrombosis. The incidence of valve thrombosis at 30 days was 7.5 ± 2%. The cumulative Incidence of prosthetic valve thrombosis was significantly lower with pVA-ECMO + IABP versus VA-ECMO alone (1.4 ± 1.4% vs 13.7 ± 4.7%, p = 0.021, respectively). Intra-aortic balloon pump use associated with pVA-ECMO (versus pVA-ECMO alone) was an independent protective factor against hospital death (OR = 0.180 [0.068-0.478], p = 0.001)., Conclusions: After PCCS following valve replacement surgery, peripheral femoro-femoral VA-ECMO is associated with a low risk of acute valve thrombosis especially when associated with an IABP., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
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- 2024
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147. Bleeding complications, coagulation disorders, and their management in acute myocardial infarction-related cardiogenic shock rescued by veno-arterial ECMO: A retrospective cohort study.
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Masi P, Gendreau S, Moyon Q, Leguyader M, Lebreton G, Ropers J, Dangers L, Sitruk S, Bréchot N, Pineton de Chambrun M, Chommeloux J, Schmidt M, Luyt CE, Leprince P, Combes A, Frere C, and Hékimian G
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- Humans, Female, Male, Retrospective Studies, Middle Aged, Aged, Risk Factors, Blood Coagulation Disorders etiology, Blood Coagulation Disorders therapy, Platelet Aggregation Inhibitors therapeutic use, Shock, Cardiogenic therapy, Shock, Cardiogenic etiology, Shock, Cardiogenic mortality, Extracorporeal Membrane Oxygenation adverse effects, Myocardial Infarction complications, Myocardial Infarction therapy, Hemorrhage therapy, Hemorrhage etiology
- Abstract
Purpose: Management of dual antiplatelet therapy (DAPT) in patients on venoarterial-extracorporeal membrane (VA-ECMO) after acute myocardial infarction (AMI) is challenging. Our objective was to describe the frequency, management and outcomes of severe bleeding complications and determine their occurrence risk factors., Material and Methods: We conducted a retrospective observational cohort study including post-AMI cardiogenic shock patients requiring VA-ECMO. Severe bleeding was defined based on the Bleeding Academic Research Consortium classification. We calculated multivariable Fine-Gray models to assess factors associated with risk of severe bleeding., Results: From January 2015 to July 2019, 176 patients received VA-ECMO after AMI and 132 patients were included. Sixty-five (49%) patients died. Severe bleeding occurred in 39% of cases. Severe thrombocytopenia (< 50 G/L) and hypofibrinogenemia (<1,5 g/L) occurred in respectively 31% and 19% of patients. DAPT was stopped in 32% of patients with a 6% rate of stent thrombosis. Anticoagulation was stopped in 39% of patients. Using a multivariate competing risk model, female sex, time on ECMO, troponin at admission and Impella® implantation were independently associated with severe bleeding., Conclusions: Bleeding complications and coagulation disorders were frequent and severe in patients on VA-ECMO after AMI, leading of antiplatelet therapy withdrawal in one third of patients., Competing Interests: Declaration of competing interest Matthieu Schmidt reports lecture fees from Getinge, Drager and Xenios outside the submitted work. Alain Combes reports grants from Getinge, personal fees from Getinge, Baxter and Xenios outside the submitted work. Charles Edouard Luyt reported personal fees from Bayer Healthcare, Carmat, Faron, Merck Sharp & Dohme, ThermoFischer Brahms, and Biomérieux; and grants from Bayer Healthcare outside the submitted work. Guillaume Lebreton reports lecture fees from Livanova and Abiomed, outside of the submitted work. The other authors declare that they have no conflicts of interest related to the purpose of this manuscript., (Copyright © 2023. Published by Elsevier Inc.)
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- 2024
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148. Antiphospholipid Patients Admitted in the Intensive Care Unit: What Must The Rheumatologist Know?
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Moyon Q, Mathian A, Papo M, Combes A, Amoura Z, and Pineton de Chambrun M
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- Humans, Anticoagulants therapeutic use, Antibodies, Antiphospholipid blood, Antibodies, Antiphospholipid immunology, Plasma Exchange, Critical Illness, Antiphospholipid Syndrome diagnosis, Antiphospholipid Syndrome complications, Antiphospholipid Syndrome therapy, Intensive Care Units
- Abstract
Purpose of the Review: Antiphospholipid syndrome (APS) is a rare systemic autoimmune disorder that can escalate into a 'thrombotic storm' called the catastrophic antiphospholipid syndrome (CAPS), frequently requiring ICU admission for multiple organ failure. This review aims to offer insight and recent evidence on critically-ill APS patients., Recent Findings: The CAPS classification criteria define this condition as the involvement of at least three organs/systems/tissues within less than a week, caused by small vessel thrombosis, in patients with elevated antiphospholipid antibodies levels. These criteria do not encompass the full spectrum of critically-ill thrombotic APS patients and they need to be cautiously used for the bedside diagnosis of CAPS. Thrombocytopenia is the laboratory hallmark of CAPS, sometimes dropping below 20G/L, but a complete thrombotic microangiopathy pattern is infrequent. Anticoagulation is the pivotal treatment for APS and CAPS, associated with improved outcome. Triple therapy - the combination of anticoagulation, high-dose corticosteroids, and either plasma exchange or intravenous immunoglobulins - remains the standard treatment for CAPS patients. Eculizumab, an anti-C5 monoclonal antibody, may be useful in refractory patients. Despite significant progress, CAPS mortality rate remains high. Its diagnosis and management are complex, requiring a close multidisciplinary cross talk between APS specialists and intensivists., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2024
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149. Isoproterenol improves hemodynamics and right ventricle-pulmonary artery coupling after heart transplantation.
- Author
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Levy D, Saura O, Lucenteforte M, Collado Lledó E, Demondion P, Hammoudi N, Assouline B, Petit M, Gautier M, Le Fevre L, Pineton de Chambrun M, Coutance G, Berg E, Chommeloux J, Schmidt M, Luyt CE, Lebreton G, Leprince P, Hékimian G, and Combes A
- Subjects
- Humans, Middle Aged, Male, Female, Retrospective Studies, Adult, Aged, Heart Failure physiopathology, Heart Failure drug therapy, Dobutamine pharmacology, Treatment Outcome, Heart Rate drug effects, Recovery of Function, Cardiotonic Agents pharmacology, Isoproterenol pharmacology, Heart Transplantation adverse effects, Pulmonary Artery physiopathology, Pulmonary Artery drug effects, Ventricular Function, Right drug effects, Hemodynamics drug effects, Ventricular Dysfunction, Right physiopathology, Ventricular Dysfunction, Right etiology
- Abstract
Right ventricular failure (RVF) is a major cause of early mortality after heart transplantation (HT). Isoproterenol (Iso) has chronotropic, inotropic, and vasodilatory properties, which might improve right ventricle function in this setting. We aimed to investigate the hemodynamic effects of isoproterenol on patients with post-HT RVF. We conducted a 1-yr retrospective observational study including patients receiving isoproterenol (Iso) and dobutamine for early RVF after HT. A comprehensive multiparametric hemodynamic evaluation was performed successively three times: no isoproterenol, low doses: 0.025 µg/kg/min, and high doses: 0.05 µg/kg/min (henceforth, respectively, called no Iso, low Iso, and high Iso). From June 2022 to June 2023, 25 patients, median [interquartile range (IQR) 25-75] age 54 [38-61] yr, were included. Before isoproterenol was introduced, all patients received dobutamine, and 15 (60%) were on venoarterial extracorporeal membrane oxygenation (VA-ECMO). Isoproterenol significantly increased heart rate from 84 [77-99] (no Iso) to 91 [88-106] (low Iso) and 102 [90-122] beats/min (high Iso, P < 0.001). Similarly, cardiac index rose from 2.3 [1.4-3.1] to 2.7 [1.8-3.4] and 3 [1.9-3.7] L/min/m
2 ( P < 0.001) with a concomitant increase in indexed stroke volume (28 [17-34] to 31 [20-34] and 33 [23-35] mL/m2 , P < 0.05). Effective pulmonary arterial elastance and pressures were not modified by isoproterenol. Pulmonary vascular resistance (PVR) tended to decrease from 2.9 [1.4-3.6] to 2.3 [1.3-3.5] wood units (WU), P = 0.06. Right ventricular ejection fraction/systolic pulmonary artery pressure (sPAP) evaluating right ventricle-pulmonary artery (RV-PA) coupling increased after isoproterenol from 0.8 to 0.9 and 1%·mmHg-1 ( P = 0.001). In conclusion, in post-HT RVF, isoproterenol exhibits chronotropic and inotropic effects, thereby improving RV-PA coupling and resulting in a clinically relevant increase in the cardiac index. NEW & NOTEWORTHY This study offers a detailed and comprehensive hemodynamic investigation at the bedside, illustrating the favorable impact of isoproterenol on right ventricular-pulmonary arterial coupling and global hemodynamics. It elucidates the physiological effects of an underused inotropic strategy in a critical clinical scenario. By enhancing cardiac hemodynamics, isoproterenol has the potential to expedite right ventricular recovery and mitigate primary graft dysfunction, thereby reducing the duration of mechanical support and intensive care unit stay posttransplantation.- Published
- 2024
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150. Ceftazidime/avibactam serum concentration in patients on ECMO.
- Author
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Curtiaud A, Petit M, Chommeloux J, Pineton de Chambrun M, Hekimian G, Schmidt M, Combes A, and Luyt CE
- Subjects
- Humans, Male, Female, Retrospective Studies, Middle Aged, Adult, Aged, Pseudomonas aeruginosa drug effects, Microbial Sensitivity Tests, Enterobacteriaceae drug effects, Ceftazidime pharmacokinetics, Ceftazidime administration & dosage, Ceftazidime therapeutic use, Ceftazidime blood, Azabicyclo Compounds pharmacokinetics, Azabicyclo Compounds administration & dosage, Azabicyclo Compounds therapeutic use, Azabicyclo Compounds blood, Drug Combinations, Anti-Bacterial Agents pharmacokinetics, Anti-Bacterial Agents administration & dosage, Anti-Bacterial Agents therapeutic use, Anti-Bacterial Agents blood, Extracorporeal Membrane Oxygenation
- Abstract
Objectives: The use of extracorporeal membrane oxygenation (ECMO) may alter blood levels of several drugs, including antibiotics, leading to under dosing of these drugs and thus to potential treatment failure. No data exist on pharmacokinetics of new antimicrobial, in particular ceftazidime/avibactam. We therefore perform this study to evaluate ceftazidime/avibactam blood levels in ECMO patients and find factors associated with underdosing., Methods: Retrospective observational study of patients on ECMO having received ceftazidime/avibactam and in whom trough blood levels of ceftazidime and avibactam were available. Main outcome measurement was the number of patients with ceftazidime and avibactam blood levels above predefined cut-off values, derived from the European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints for Enterobacteriaceae and Pseudomonas aeruginosa, namely 8 mg/L for ceftazidime and 4 mg/L for avibactam, and explored factors associated with underdosing., Results: Twenty-three ceftazidime/avibactam trough levels were available in 14 ECMO patients, all of them having received veno-venous ECMO for SARS-CoV-2-associated pneumonia. Although ceftazidime levels were above 8 mg/L in all except one patient, nine (39%) of the avibactam dosages were below 4 mg/L. Increased renal clearance (creatinine clearance > 130 mL/min) was the main factor associated with under dosing, since 7 out of the 10 dosages below the predefined cut-offs were measured in patients with this condition., Conclusions: In ECMO patients receiving ceftazidime/avibactam, ceftazidime and avibactam serum levels are above EUCAST breakpoints in most cases, justifying the use of normal dosing in ECMO patients. Increased renal clearance may lead to ceftazidime and avibactam under dosing., (© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
- Published
- 2024
- Full Text
- View/download PDF
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