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101. High-flow nasal oxygen alone or alternating with non-invasive ventilation in critically ill immunocompromised patients with acute respiratory failure: a randomised controlled trial

Author

Coudroy, Rémi, primary, Frat, Jean-Pierre, additional, Ehrmann, Stephan, additional, Pène, Frédéric, additional, Decavèle, Maxens, additional, Terzi, Nicolas, additional, Prat, Gwenaël, additional, Garret, Charlotte, additional, Contou, Damien, additional, Gacouin, Arnaud, additional, Bourenne, Jeremy, additional, Girault, Christophe, additional, Vinsonneau, Christophe, additional, Dellamonica, Jean, additional, Labro, Guylaine, additional, Jochmans, Sébastien, additional, Herbland, Alexandre, additional, Quenot, Jean-Pierre, additional, Devaquet, Jérôme, additional, Benzekri, Dalila, additional, Vivier, Emmanuel, additional, Nseir, Saad, additional, Colin, Gwenhaël, additional, Thevenin, Didier, additional, Grasselli, Giacomo, additional, Bougon, David, additional, Assefi, Mona, additional, Guérin, Claude, additional, Lherm, Thierry, additional, Kouatchet, Achille, additional, Ragot, Stephanie, additional, Thille, Arnaud W, additional, Delphine, Chatellier, additional, Anne, Veinstein, additional, Florence, Boissier, additional, Faustine, Reynaud, additional, Maeva, Rodriguez, additional, Florent, Joly, additional, François, Arrivé, additional, Victor, De Roubin, additional, René, Robert, additional, Laetitia, Bodet-Contentin, additional, Charlotte, Salmon Gandonnière, additional, Emmanuelle, Mercier, additional, Paul, Jaubert, additional, Nathalie, Marin, additional, Marine, Paul, additional, Morgane, Faure, additional, Suela, Demiri, additional, Alexandre, Demoule, additional, Clara, Candille, additional, Anaïs, Dartevel, additional, Florian, Sigaud, additional, Vanessa, Jean Michel, additional, Raphaël, Le Mao, additional, Pierre, Bailly, additional, Amélie, Seguin, additional, Jean-Baptiste, Lascarrou, additional, Emmanuel, Canet, additional, Gaëtan, Plantefève, additional, Radj, Cally, additional, Joanna, Tirolien, additional, Adel, Maamar, additional, Benoit, Painvin, additional, Julien, Carvelli, additional, Marc, Gainnier, additional, Gaëtan, Béduneau, additional, Dorothée, Carpentier, additional, Dominique, Malacrino, additional, Mehdi, Marzouk, additional, Clément, Saccheri, additional, Nicolas, Mahr, additional, Pauline, Soulier, additional, Quentin, Levrat, additional, Pascal, Andreu, additional, David, Cortier, additional, and Mai Anh, Nay, additional

Published
2022
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103. Noninvasive Oxygenation in Patients with Acute Respiratory Failure: Current Perspectives

Author

Frat,Jean-Pierre, Le Pape,Sylvain, Coudroy,Rémi, and Thille,Arnaud W

Subjects
International Journal of General Medicine
Abstract

Jean-Pierre Frat,1,2 Sylvain Le Pape,1 Rémi Coudroy,1,2 Arnaud W Thille1,2 1Centre Hospitalier Universitaire de Poitiers, Médecine Intensive Réanimation, Poitiers, France; 2Centre d’Investigation Clinique 1402 ALIVE, INSERM, Université de Poitiers, Poitiers, FranceCorrespondence: Jean-Pierre Frat, Centre Hospitalier Universitaire de Poitiers, Médecine Intensive Réanimation, 2 rue la Milétrie, Poitiers, 86021, France, Tel +33549444007, Email jean-pierre.frat@chu-poitiers.frPurpose of Review: High-flow nasal oxygen and noninvasive ventilation are two alternative strategies to standard oxygen in the management of acute respiratory failure.Discussion: Although high-flow nasal oxygen has gained major popularity in ICUs due to its simplicity of application, good comfort for patients, efficiency in improving oxygenation and promising results in patients with acute hypoxemic respiratory failure, further large clinical trials are needed to confirm its superiority over standard oxygen. Non-invasive ventilation may have deleterious effects, especially in patients exerting strong inspiratory efforts, and no current recommendations support its use in this setting. Protective non-invasive ventilation using higher levels of positive-end expiratory pressure, more prolonged sessions and other interfaces such as the helmet may have beneficial physiological effects leading to it being proposed as alternative to high-flow nasal oxygen in acute hypoxemic respiratory failure. By contrast, non-invasive ventilation is the first-line strategy of oxygenation in patients with acute exacerbation of chronic lung disease, while high-flow nasal oxygen could be an alternative to non-invasive ventilation after partial reversal of respiratory acidosis. Questions remain about the target populations and non-invasive oxygen strategy representing the best alternative to standard oxygen in acute hypoxemic respiratory failure. As concerns acute on-chronic-respiratory failure, the place of high-flow nasal oxygen remains to be evaluated.Keywords: noninvasive ventilation, high-flow nasal oxygen, respiratory insufficiency, acute respiratory failure

Published
2022

104. Noninvasive respiratory support following extubation in critically ill adults:a systematic review and network meta-analysis

Author

Fernando, Shannon M., Tran, Alexandre, Sadeghirad, Behnam, Burns, Karen E. A., Fan, Eddy, Brodie, Daniel, Munshi, Laveena, Goligher, Ewan C., Cook, Deborah J., Fowler, Robert A., Herridge, Margaret S., Cardinal, Pierre, Jaber, Samir, Moller, Morten Hylander, Thille, Arnaud W., Ferguson, Niall D., Slutsky, Arthur S., Brochard, Laurent J., Seely, Andrew J. E., Rochwerg, Bram, Fernando, Shannon M., Tran, Alexandre, Sadeghirad, Behnam, Burns, Karen E. A., Fan, Eddy, Brodie, Daniel, Munshi, Laveena, Goligher, Ewan C., Cook, Deborah J., Fowler, Robert A., Herridge, Margaret S., Cardinal, Pierre, Jaber, Samir, Moller, Morten Hylander, Thille, Arnaud W., Ferguson, Niall D., Slutsky, Arthur S., Brochard, Laurent J., Seely, Andrew J. E., and Rochwerg, Bram

Abstract

Purpose Systematic review and network meta-analysis to investigate the efficacy of noninvasive respiratory strategies, including noninvasive positive pressure ventilation (NIPPV) and high-flow nasal cannula (HFNC), in reducing extubation failure among critically ill adults. Methods We searched databases from inception through October 2021 for randomized controlled trials (RCTs) evaluating noninvasive respiratory support therapies (NIPPV, HFNC, conventional oxygen therapy, or a combination of these) following extubation in critically ill adults. Two reviewers performed screening, full text review, and extraction independently. The primary outcome of interest was reintubation. We used GRADE to rate the certainty of our findings. Results We included 36 RCTs (6806 patients). Compared to conventional oxygen therapy, NIPPV (OR 0.65 [95% CI 0.52-0.82]) and HFNC (OR 0.63 [95% CI 0.45-0.87]) reduced reintubation (both moderate certainty). Sensitivity analyses showed that the magnitude of the effect was highest in patients with increased baseline risk of reintubation. As compared to HFNC, no difference in incidence of reintubation was seen with NIPPV (OR 1.04 [95% CI 0.78-1.38], low certainty). Compared to conventional oxygen therapy, neither NIPPV (OR 0.8 [95% CI 0.61-1.04], moderate certainty) or HFNC (OR 0.9 [95% CI 0.66-1.24], low certainty) reduced short-term mortality. Consistent findings were demonstrated across multiple subgroups, including high- and low-risk patients. These results were replicated when evaluating noninvasive strategies for prevention (prophylaxis), but not in rescue (application only after evidence of deterioration) situations. Conclusions Our findings suggest that both NIPPV and HFNC reduced reintubation in critically ill adults, compared to conventional oxygen therapy. NIPPV did not reduce incidence of reintubation when compared to HFNC. These findings support the preventative application of noninvasive respiratory support strategies to mitigate

Published
2022

106. Beneficial Effects of Noninvasive Ventilation after Extubation in Obese or Overweight Patients: A Post Hoc Analysis of a Randomized Clinical Trial

Author

Thille, Arnaud W., primary, Coudroy, Rémi, additional, Nay, Mai-Anh, additional, Gacouin, Arnaud, additional, Decavèle, Maxens, additional, Sonneville, Romain, additional, Beloncle, François, additional, Girault, Christophe, additional, Dangers, Laurence, additional, Lautrette, Alexandre, additional, Levrat, Quentin, additional, Rouzé, Anahita, additional, Vivier, Emmanuel, additional, Lascarrou, Jean-Baptiste, additional, Ricard, Jean-Damien, additional, Mekontso-Dessap, Armand, additional, Barberet, Guillaume, additional, Lebert, Christine, additional, Ehrmann, Stephan, additional, Massri, Alexandre, additional, Bourenne, Jeremy, additional, Pradel, Gael, additional, Bailly, Pierre, additional, Terzi, Nicolas, additional, Dellamonica, Jean, additional, Lacave, Guillaume, additional, Robert, René, additional, Frat, Jean-Pierre, additional, Ragot, Stéphanie, additional, Boissier, Florence, additional, Chatellier, Delphine, additional, Deletage, Céline, additional, Guignon, Carole, additional, Joly, Florent, additional, Olivry, Morgane, additional, Veinstein, Anne, additional, Benzekri-Lefevre, Dalila, additional, Boulain, Thierry, additional, Muller, Grégoire, additional, Le Tulzo, Yves, additional, Tadié, Jean-Marc, additional, Maamar, Adel, additional, Demiri, Suela, additional, Mayaux, Julien, additional, Demoule, Alexandre, additional, Bouadma, Lila, additional, Dupuis, Claire, additional, Asfar, Pierre, additional, Pierrot, Marc, additional, Béduneau, Gaëtan, additional, Boyer, Déborah, additional, Delmas, Benjamin, additional, Puech, Bérénice, additional, Bachoumas, Konstantinos, additional, Soum, Edouard, additional, Cabasson, Séverin, additional, Hoppe, Marie-Anne, additional, Nseir, Saad, additional, Pouly, Olivier, additional, Bourdin, Gaël, additional, Rosselli, Sylvène, additional, Le Meur, Anthony, additional, Garret, Charlotte, additional, Martin, Maelle, additional, Berquier, Guillaume, additional, Thiagarajah, Abirami, additional, Carteaux, Guillaume, additional, Razazi, Keyvan, additional, Poidevin, Antoine, additional, Dureau, Anne-Florence, additional, Azais, Marie-Ange, additional, Colin, Gwenhaël, additional, Mercier, Emmanuelle, additional, Morisseau, Marlène, additional, Sabatier, Caroline, additional, Picard, Walter, additional, Gainnier, Marc, additional, Nguyen, Thi-My-Hue, additional, Prat, Gwenaël, additional, Schwebel, Carole, additional, and Buscot, Matthieu, additional

Published
2022
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107. Invasive pulmonary aspergillosis among intubated patients with SARS-CoV-2 or influenza pneumonia: a European multicenter comparative cohort study

Author

Rouze, Anahita Lemaitre, Elise Martin-Loeches, Ignacio and Povoa, Pedro Diaz, Emili Nyga, Remy Torres, Antoni and Metzelard, Matthieu Du Cheyron, Damien Lambiotte, Fabien and Tamion, Fabienne Labruyere, Marie Geronimi, Claire Boulle and Luyt, Charles-Edouard Nyunga, Martine Pouly, Olivier Thille, Arnaud W. Megarbane, Bruno Saade, Anastasia Magira, Eleni and Llitjos, Jean-Francois Ioannidou, Iliana Pierre, Alexandre and Reignier, Jean Garot, Denis Kreitmann, Louis Baudel, Jean-Luc Voiriot, Guillaume Plantefeve, Gaetan Morawiec, Elise Asfar, Pierre Boyer, Alexandre Mekontso-Dessap, Armand and Makris, Demosthenes Vinsonneau, Christophe Floch, Pierre-Edouard Marois, Clemence Ceccato, Adrian Artigas, Antonio Gaudet, Alexandre Nora, David Cornu, Marjorie and Duhamel, Alain Labreuche, Julien Nseir, Saad CoVAPid Study Grp

Subjects
skin and connective tissue diseases, respiratory tract diseases
Abstract

Background: Recent multicenter studies identified COVID-19 as a risk factor for invasive pulmonary aspergillosis (IPA). However, no large multicenter study has compared the incidence of IPA between COVID-19 and influenza patients. Objectives: To determine the incidence of putative IPA in critically ill SARS-CoV-2 patients, compared with influenza patients. Methods: This study was a planned ancillary analysis of the coVAPid multicenter retrospective European cohort. Consecutive adult patients requiring invasive mechanical ventilation for > 48 h for SARS-CoV-2 pneumonia or influenza pneumonia were included. The 28-day cumulative incidence of putative IPA, based on Blot definition, was the primary outcome. IPA incidence was estimated using the Kalbfleisch and Prentice method, considering extubation (dead or alive) within 28 days as competing event. Results: A total of 1047 patients were included (566 in the SARS-CoV-2 group and 481 in the influenza group). The incidence of putative IPA was lower in SARS-CoV-2 pneumonia group (14, 2.5%) than in influenza pneumonia group (29, 6%), adjusted cause-specific hazard ratio (cHR) 3.29 (95% CI 1.53-7.02, p= 0.0006). When putative IPA and Aspergillus respiratory tract colonization were combined, the incidence was also significantly lower in the SARS-CoV-2 group, as compared to influenza group (4.1% vs. 10.2%), adjusted cHR 3.21 (95% CI 1.88-5.46, p < 0.0001). In the whole study population, putative IPA was associated with significant increase in 28-day mortality rate, and length of ICU stay, compared with colonized patients, or those with no IPA or Aspergillus colonization. Conclusions: Overall, the incidence of putative IPA was low. Its incidence was significantly lower in patients with SARS-CoV-2 pneumonia than in those with influenza pneumonia.

Published
2022

108. Additional file 1 of Invasive pulmonary aspergillosis among intubated patients with SARS-CoV-2 or influenza pneumonia: a European multicenter comparative cohort study

Author

Rouz��, Anahita, Lemaitre, Elise, Martin-Loeches, Ignacio, Povoa, Pedro, Diaz, Emili, Nyga, R��my, Torres, Antoni, Metzelard, Matthieu, Du Cheyron, Damien, Lambiotte, Fabien, Tamion, Fabienne, Labruyere, Marie, Boulle Geronimi, Claire, Luyt, Charles-Edouard, Nyunga, Martine, Pouly, Olivier, Thille, Arnaud W., Megarbane, Bruno, Saade, Anastasia, Magira, Eleni, Llitjos, Jean-Fran��ois, Ioannidou, Iliana, Pierre, Alexandre, Reignier, Jean, Garot, Denis, Kreitmann, Louis, Baudel, Jean-Luc, Voiriot, Guillaume, Plantefeve, Ga��tan, Morawiec, Elise, Asfar, Pierre, Boyer, Alexandre, Mekontso-Dessap, Armand, Makris, Demosthenes, Vinsonneau, Christophe, Floch, Pierre-Edouard, Marois, Cl��mence, Ceccato, Adrian, Artigas, Antonio, Gaudet, Alexandre, Nora, David, Cornu, Marjorie, Duhamel, Alain, Labreuche, Julien, and Nseir, Saad

Subjects
Data_FILES
Abstract

Additional file 1. Further details on methods and results.

Published
2022
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109. Additional file 1 of Relationship between corticosteroid use and incidence of ventilator-associated pneumonia in COVID-19 patients: a retrospective multicenter study

Author

Saura, Ouriel, Rouzé, Anahita, Martin-Loeches, Ignacio, Povoa, Pedro, Kreitmann, Louis, Torres, Antoni, Metzelard, Matthieu, Du Cheyron, Damien, Lambiotte, Fabien, Tamion, Fabienne, Labruyere, Marie, Boulle Geronimi, Claire, Luyt, Charles-Edouard, Nyunga, Martine, Pouly, Olivier, Thille, Arnaud W., Megarbane, Bruno, Saade, Anastasia, Magira, Eleni, Llitjos, Jean-François, Ioannidou, Iliana, Pierre, Alexandre, Reignier, Jean, Garot, Denis, Baudel, Jean-Luc, Voiriot, Guillaume, Plantefeve, Gaëtan, Morawiec, Elise, Asfar, Pierre, Boyer, Alexandre, Mekontso-Dessap, Armand, Bardaka, Fotini, Diaz, Emili, Vinsonneau, Christophe, Floch, Pierre-Edouard, Weiss, Nicolas, Ceccato, Adrian, Artigas, Antonio, Nora, David, Duhamel, Alain, Labreuche, Julien, and Nseir, Saad

Abstract

Additional file 1. Supplementary e-figures and e-tables.

Published
2022
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114. Awake prone positioning for COVID-19 acute hypoxaemic respiratory failure: a randomised, controlled, multinational, open-label meta-trial

Author

Ehrmann, Stephan, primary, Li, Jie, additional, Ibarra-Estrada, Miguel, additional, Perez, Yonatan, additional, Pavlov, Ivan, additional, McNicholas, Bairbre, additional, Roca, Oriol, additional, Mirza, Sara, additional, Vines, David, additional, Garcia-Salcido, Roxana, additional, Aguirre-Avalos, Guadalupe, additional, Trump, Matthew W, additional, Nay, Mai-Anh, additional, Dellamonica, Jean, additional, Nseir, Saad, additional, Mogri, Idrees, additional, Cosgrave, David, additional, Jayaraman, Dev, additional, Masclans, Joan R, additional, Laffey, John G, additional, Tavernier, Elsa, additional, Elshafei, Ahmad A, additional, Scott, Brady J, additional, Weiss, Tyler, additional, Kaur, Ramandeep, additional, Harnois, Lauren J, additional, Miller, Amanda, additional, Cerda, Flor, additional, Klein, Andrew, additional, Burd, Jacob R, additional, Posa-Kearney, Kathleen, additional, Trump, Matthew, additional, Jackson, Julie, additional, Oetting, Trevor, additional, Greenwood, Mark, additional, Hazel, Lindsay, additional, Kingery, Lisa, additional, Morris, Lindsey, additional, Moon, Joon Yong, additional, Garnett, Julianne, additional, Jia, Shijing, additional, Nelson, Kristine, additional, Giacomini, Camilla, additional, Laffey, John, additional, Brennan, Aoife, additional, Judge, Conor, additional, Kernan, Maeve, additional, Kelly, Claire, additional, Ranjan, Ritika, additional, Casey, Siobhan, additional, O'Connell, Kevin, additional, Newell, Evelyn, additional, Gallagher, David, additional, Nichol, Alistair, additional, Curley, Ger, additional, Estrada, Miguel Ibarra, additional, García-Salcido, Roxana, additional, Vargas-Obieta, Alexandra, additional, Aguirre-Díaz, Sara A, additional, Alcántar-Vallín, Luz, additional, Alvarado-Padilla, Montserrat, additional, Chávez-Peña, Quetzalcóatl, additional, López-Pulgarín, José A, additional, Mijangos-Méndez, Julio C, additional, Marín-Rosales, Miguel, additional, García-Alvarado, Jorge E, additional, Baltazar-González, Oscar G, additional, González-Guerrero, Maura C, additional, Gutiérrez Ramírez, Paola G, additional, Gilman, Sean, additional, Plamondon, Patrice, additional, Roy, Rachel, additional, Shahin, Jason, additional, Ragoshai, Raham, additional, Kaur, Aasmine, additional, Campisi, Josie, additional, Dahine, Joseph, additional, Perron, Stefanie, additional, Achouri, Slimane, additional, Racette, Ronald, additional, Kulenkamp, Anne, additional, Pacheco, Andrés, additional, García-de-Acilu, Marina, additional, Dot, Irene, additional, Bodet-Contentin, Laetitia, additional, Garot, Denis, additional, Ehrmann, Stephan, additional, Mercier, Emmanuelle, additional, Salmon Gandonnière, Charlotte, additional, Morisseau, Marlène, additional, Jouan, Youenn, additional, Darwiche, Walid, additional, Legras, Annick, additional, Guillon, Antoine, additional, Dequin, Pierre-François, additional, Tellier, Anne-Charlotte, additional, Reignier, Jean, additional, Lascarrou, Jean-Baptiste, additional, Seguin, Amélie, additional, Desmedt, Luc, additional, Canet, Emmanuel, additional, Guitton, Christophe, additional, Marnai, Rémy, additional, Callahan, Jean-Christophe, additional, Landais, Mickaël, additional, Chudeau, Nicolas, additional, Darreau, Cédric, additional, Tirot, Patrice, additional, Saint Martin, Marjorie, additional, Le Moal, Charlene, additional, Muller, Grégoire, additional, Jacquier, Sophie, additional, Prat, Gwenaël, additional, Bailly, Pierre, additional, Ferrière, Nicola, additional, Thille, Arnaud W, additional, Frat, Jean-Pierre, additional, Saccheri, Clément, additional, Buscot, Matthieu, additional, Plantefève, Gaëtan, additional, Contou, Damien, additional, Roux, Damien, additional, Ricard, Jean-Damien, additional, Federici, Laura, additional, Zucman, Noémie, additional, Freita Ramos, Santiago, additional, Amouretti, Marc, additional, Besset, Sébastien, additional, Gernez, Coralie, additional, Delbove, Agathe, additional, Voiriot, Guillaume, additional, Elabbadi, Alexandre, additional, Fartoukh, Muriel, additional, Préau, Sébastien, additional, Favory, Raphaël, additional, Pierre, Alexandre, additional, Sement, Arnaud, additional, Terzi, Nicolas, additional, Sigaud, Florian, additional, Candille, Clara, additional, Turbil, Emanuele, additional, Maizel, Julien, additional, Brault, Clément, additional, Zerbib, Yoan, additional, Joret, Aurélie, additional, Daubin, Cédric, additional, Lefebvre, Laurent, additional, Giraud, Alais, additional, Auvet, Adrien, additional, Vinsonneau, Christophe, additional, Marzouk, Mehdi, additional, Quenot, Jean-Pierre, additional, Andreu, Pascal, additional, Labruyère, Marie, additional, Roudaut, Jean-Baptiste, additional, Aptel, François, additional, Boyer, Alexandre, additional, Boyer, Philippe, additional, Lacherade, Jean-Claude, additional, Hille, Hugo, additional, Bouteloup, Marie, additional, Jeannot, Matthieu, additional, Feller, Marc, additional, Grillet, Guillaume, additional, Levy, Bruno, additional, and Kimmoun, Antoine, additional

Published
2021
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115. Noninvasive respiratory support following extubation in critically ill adults: a systematic review and network meta-analysis

Author

Fernando, Shannon M., primary, Tran, Alexandre, additional, Sadeghirad, Behnam, additional, Burns, Karen E. A., additional, Fan, Eddy, additional, Brodie, Daniel, additional, Munshi, Laveena, additional, Goligher, Ewan C., additional, Cook, Deborah J., additional, Fowler, Robert A., additional, Herridge, Margaret S., additional, Cardinal, Pierre, additional, Jaber, Samir, additional, Møller, Morten Hylander, additional, Thille, Arnaud W., additional, Ferguson, Niall D., additional, Slutsky, Arthur S., additional, Brochard, Laurent J., additional, Seely, Andrew J. E., additional, and Rochwerg, Bram, additional

Published
2021
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117. High-Flow Oxygen through Nasal Cannula in Acute Hypoxemic Respiratory Failure

Author

Frat, Jean-Pierre, Thille, Arnaud W., Mercat, Alain, Girault, Christophe, Ragot, Stéphanie, Perbet, Sébastien, Prat, Gwénael, Boulain, Thierry, Morawiec, Elise, Cottereau, Alice, Devaquet, Jérôme, Nseir, Saad, Razazi, Keyvan, Mira, Jean-Paul, Argaud, Laurent, Chakarian, Jean-Charles, Ricard, Jean-Damien, Wittebole, Xavier, Chevalier, Stéphanie, Herbland, Alexandre, Fartoukh, Muriel, Constantin, Jean-Michel, Tonnelier, Jean-Marie, Pierrot, Marc, Mathonnet, Armelle, Béduneau, Gaëtan, Delétage-Métreau, Céline, Richard, Jean-Christophe M., Brochard, Laurent, and Robert, René

Published
2015
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118. a planned ancillary analysis of the coVAPid cohort

Author

Nseir, Saad, Martin-Loeches, Ignacio, Povoa, Pedro, Metzelard, Matthieu, Du Cheyron, Damien, Lambiotte, Fabien, Tamion, Fabienne, Labruyere, Marie, Makris, Demosthenes, Boulle Geronimi, Claire, Pinetonde Chambrun, Marc, Nyunga, Martine, Pouly, Olivier, Mégarbane, Bruno, Saade, Anastasia, Gomà, Gemma, Magira, Eleni, Llitjos, Jean François, Torres, Antoni, Ioannidou, Iliana, Pierre, Alexandre, Coelho, Luis, Reignier, Jean, Garot, Denis, Kreitmann, Louis, Baudel, Jean Luc, Voiriot, Guillaume, Contou, Damien, Beurton, Alexandra, Asfar, Pierre, Boyer, Alexandre, Thille, Arnaud W., Mekontso-Dessap, Armand, Tsolaki, Vassiliki, Vinsonneau, Christophe, Floch, Pierre Edouard, Le Guennec, Loïc, Ceccato, Adrian, Artigas, Antonio, Bouchereau, Mathilde, Labreuche, Julien, Duhamel, Alain, Rouzé, Anahita, and NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)

Subjects
COVID-19, Ventilator-associated pneumonia, Mortality, Critical Care and Intensive Care Medicine, respiratory tract diseases
Abstract

Funding: This study was supported in part by a grant from the French government through the «Programme Investissement d’Avenir» (I-SITE ULNE) managed by the Agence Nationale de la Recherche (coVAPid project). The funders of the study had no role in the study design, data collection, analysis, or interpreta tion, writing of the report, or decision to submit for publication. BACKGROUND: Patients with SARS-CoV-2 infection are at higher risk for ventilator-associated pneumonia (VAP). No study has evaluated the relationship between VAP and mortality in this population, or compared this relationship between SARS-CoV-2 patients and other populations. The main objective of our study was to determine the relationship between VAP and mortality in SARS-CoV-2 patients. METHODS: Planned ancillary analysis of a multicenter retrospective European cohort. VAP was diagnosed using clinical, radiological and quantitative microbiological criteria. Univariable and multivariable marginal Cox's regression models, with cause-specific hazard for duration of mechanical ventilation and ICU stay, were used to compare outcomes between study groups. Extubation, and ICU discharge alive were considered as events of interest, and mortality as competing event. FINDINGS: Of 1576 included patients, 568 were SARS-CoV-2 pneumonia, 482 influenza pneumonia, and 526 no evidence of viral infection at ICU admission. VAP was associated with significantly higher risk for 28-day mortality in SARS-CoV-2 (adjusted HR 1.70 (95% CI 1.16-2.47), p = 0.006), and influenza groups (1.75 (1.03-3.02), p = 0.045), but not in the no viral infection group (1.07 (0.64-1.78), p = 0.79). VAP was associated with significantly longer duration of mechanical ventilation in the SARS-CoV-2 group, but not in the influenza or no viral infection groups. VAP was associated with significantly longer duration of ICU stay in the 3 study groups. No significant difference was found in heterogeneity of outcomes related to VAP between the 3 groups, suggesting that the impact of VAP on mortality was not different between study groups. INTERPRETATION: VAP was associated with significantly increased 28-day mortality rate in SARS-CoV-2 patients. However, SARS-CoV-2 pneumonia, as compared to influenza pneumonia or no viral infection, did not significantly modify the relationship between VAP and 28-day mortality. CLINICAL TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov, number NCT04359693. publishersversion published

Published
2021

121. ERS clinical practice guidelines: high-flow nasal cannula in acute respiratory failure

Author

Oczkowski, Simon, primary, Ergan, Begüm, additional, Bos, Lieuwe, additional, Chatwin, Michelle, additional, Ferrer, Miguel, additional, Gregoretti, Cesare, additional, Heunks, Leo, additional, Frat, Jean-Pierre, additional, Longhini, Federico, additional, Nava, Stefano, additional, Navalesi, Paolo, additional, Ozsancak Uğurlu, Aylin, additional, Pisani, Lara, additional, Renda, Teresa, additional, Thille, Arnaud W., additional, Winck, João Carlos, additional, Windisch, Wolfram, additional, Tonia, Thomy, additional, Boyd, Jeanette, additional, Sotgiu, Giovanni, additional, and Scala, Raffaele, additional

Published
2021
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122. Early Bacterial Identification among Intubated Patients with COVID-19 or Influenza Pneumonia: A European Multicenter Comparative Clinical Trial

Author

Rouzé, Anahita, primary, Martin-Loeches, Ignacio, additional, Povoa, Pedro, additional, Metzelard, Matthieu, additional, Du Cheyron, Damien, additional, Lambiotte, Fabien, additional, Tamion, Fabienne, additional, Labruyere, Marie, additional, Boulle Geronimi, Claire, additional, Nieszkowska, Ania, additional, Nyunga, Martine, additional, Pouly, Olivier, additional, Thille, Arnaud W., additional, Megarbane, Bruno, additional, Saade, Anastasia, additional, Diaz, Emili, additional, Magira, Eleni, additional, Llitjos, Jean-François, additional, Cilloniz, Catia, additional, Ioannidou, Iliana, additional, Pierre, Alexandre, additional, Reignier, Jean, additional, Garot, Denis, additional, Kreitmann, Louis, additional, Baudel, Jean-Luc, additional, Fartoukh, Muriel, additional, Plantefeve, Gaëtan, additional, Beurton, Alexandra, additional, Asfar, Pierre, additional, Boyer, Alexandre, additional, Mekontso-Dessap, Armand, additional, Makris, Demosthenes, additional, Vinsonneau, Christophe, additional, Floch, Pierre-Edouard, additional, Weiss, Nicolas, additional, Ceccato, Adrian, additional, Artigas, Antonio, additional, Bouchereau, Mathilde, additional, Duhamel, Alain, additional, Labreuche, Julien, additional, Nseir, Saad, additional, Poissy, Julien, additional, Favory, Raphaël, additional, Preau, Sébastien, additional, Jourdain, Mercè, additional, Boyd, Sean, additional, Coelho, Luis, additional, Cuchet, Pierre, additional, Zarrougui, Wafa, additional, Boyer, Déborah, additional, Quenot, Jean-Pierre, additional, Imouloudene, Mehdi, additional, Luyt, Charles-Edouard, additional, van der Linden, Thierry, additional, Bardin, Justine, additional, Voicu, Sebastian, additional, Azoulay, Elie, additional, Goma, Gemma, additional, Pene, Frédéric, additional, Torres, Antoni, additional, Thevenin, Didier, additional, Ehrmann, Stéphan, additional, Argaud, Laurent, additional, Guidet, Bertrand, additional, Voiriot, Guillaume, additional, Contou, Damien, additional, Le Marec, Julien, additional, Demiselle, Julien, additional, Meguerditchian, David, additional, Razazi, Keyvan, additional, Tsolaki, Vassiliki, additional, Sejourne, Caroline, additional, Brunin, Guillaume, additional, Le Guennec, Loïc, additional, and Morales, Luis, additional

Published
2021
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123. Driving Pressure is a Risk Factor for ARDS in Mechanically Ventilated Subjects Without ARDS

Author

Roca, Oriol, primary, Peñuelas, Oscar, additional, Muriel, Alfonso, additional, García-de-Acilu, Marina, additional, Laborda, César, additional, Sacanell, Judit, additional, Riera, Jordi, additional, Raymondos, Konstantinos, additional, Du, Bin, additional, Thille, Arnaud W, additional, Ríos, Fernando, additional, González, Marco, additional, del-Sorbo, Lorenzo, additional, del Carmen Marín, Maria, additional, Soares, Marco Antonio, additional, Pinheiro, Bruno Valle, additional, Nin, Nicolas, additional, Maggiore, Salvatore M, additional, Bersten, Andrew, additional, Amin, Pravin, additional, Çakar, Nahit, additional, Suh, Gee Young, additional, Abroug, Fekri, additional, Jibaja, Manuel, additional, Matamis, Dimitros, additional, Zeggwagh, Amine Ali, additional, Sutherasan, Yuda, additional, Anzueto, Antonio, additional, Esteban, Andrés, additional, and Frutos-Vivar, Fernando, additional

Published
2021
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131. Management and outcome of mechanically ventilated patients after cardiac arrest

Author

Sutherasan, Yuda, Peñuelas, Oscar, Muriel, Alfonso, Vargas, Maria, Frutos-Vivar, Fernando, Brunetti, Iole, Raymondos, Konstantinos, D’Antini, Davide, Nielsen, Niklas, Ferguson, Niall D, Böttiger, Bernd W, Thille, Arnaud W, Davies, Andrew R, Hurtado, Javier, Rios, Fernando, Apezteguía, Carlos, Violi, Damian A, Cakar, Nahit, González, Marco, Du, Bin, Kuiper, Michael A, Soares, Marco Antonio, Koh, Younsuck, Moreno, Rui P, Amin, Pravin, Tomicic, Vinko, Soto, Luis, Bülow, Hans-Henrik, Anzueto, Antonio, Esteban, Andrés, and Pelosi, Paolo

Published
2015
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132. Patient--ventilator asynchrony during non-invasive ventilation for acute respiratory failure: a multicenter study

Author

Vignaux, Laurence, Vargas, Frederic, Roeseler, Jean, Tassaux, Didier, Thille, Arnaud W., Kossowsky, Michel P., Brochard, Laurent, and Jolliet, Philippe

Subjects
Acute respiratory distress syndrome -- Care and treatment, Artificial respiration -- Health aspects, Health care industry
Abstract

Byline: Laurence Vignaux (1), Frederic Vargas (2,3,4), Jean Roeseler (5), Didier Tassaux (1), Arnaud W. Thille (2,3,4), Michel P. Kossowsky (6), Laurent Brochard (2,3,4), Philippe Jolliet (1,7) Keywords: Noninvasive ventilation; Mechanical ventilation; Patient--ventilator interaction; Asynchrony Abstract: Objective To determine the prevalence of patient--ventilator asynchrony in patients receiving non-invasive ventilation (NIV) for acute respiratory failure. Design Prospective multicenter observation study. Setting Intensive care units in three university hospitals. Methods Patients consecutively admitted to ICU were included. NIV, performed with an ICU ventilator, was set by the clinician. Airway pressure, flow, and surface diaphragmatic electromyography were recorded continuously for 30 min. Asynchrony events and the asynchrony index (AI) were determined from visual inspection of the recordings and clinical observation. Results A total of 60 patients were included, 55% of whom were hypercapnic. Auto-triggering was present in 8 (13%) patients, double triggering in 9 (15%), ineffective breaths in 8 (13%), premature cycling 7 (12%) and late cycling in 14 (23%). An AI > 10%, indicating severe asynchrony, was present in 26 patients (43%), whose median (25--75 IQR) AI was 26 (15--54%). A significant correlation was found between the magnitude of leaks and the number of ineffective breaths and severity of delayed cycling. Multivariate analysis indicated that the level of pressure support and the magnitude of leaks were weakly, albeit significantly, associated with an AI > 10%. Patient comfort scale was higher in pts with an AI < 10%. Conclusion Patient--ventilator asynchrony is common in patients receiving NIV for acute respiratory failure. Our results suggest that leaks play a major role in generating patient--ventilator asynchrony and discomfort, and point the way to further research to determine if ventilator functions designed to cope with leaks can reduce asynchrony in the clinical setting. Author Affiliation: (1) Service des Soins Intensifs, Hopitaux universitaires de Geneve, Geneva, Switzerland (2) Reanimation Medicale, AP-HP, Centre Hospitalier Albert Chenevier-Henri-Mondor, Creteil, France (3) INSERM U 841, Creteil, France (4) Universite Paris 12, Creteil, France (5) Service des Soins Intensifs, Cliniques Universitaires St.-Luc, Brussels, Belgium (6) Service de Medecine de Premier Recours, Hopitaux universitaires de Geneve, Geneva, Switzerland (7) Service des Soins Intensifs, Hopital Cantonal Universitaire, 1211, Geneva 14, Switzerland Article History: Registration Date: 16/01/2009 Received Date: 13/05/2008 Accepted Date: 12/12/2008 Online Date: 29/01/2009 Article note: This study was presented in abstract form at the 2008 Annual Meeting of the American Thoracic Society. Electronic supplementary material The online version of this article (doi: 10.1007/s00134-009-1416-5) contains supplementary material, which is available to authorized users.

Published
2009

133. Additional file 1 of Relationship between ventilator-associated pneumonia and mortality in COVID-19 patients: a planned ancillary analysis of the coVAPid cohort

Author

Nseir, Saad, Martin-Loeches, Ignacio, Povoa, Pedro, Metzelard, Matthieu, Du Cheyron, Damien, Lambiotte, Fabien, Tamion, Fabienne, Labruyere, Marie, Makris, Demosthenes, Boulle Geronimi, Claire, Pinetonde Chambrun, Marc, Nyunga, Martine, Pouly, Olivier, Mégarbane, Bruno, Saade, Anastasia, Gomà, Gemma, Magira, Eleni, Llitjos, Jean-François, Torres, Antoni, Ioannidou, Iliana, Pierre, Alexandre, Coelho, Luis, Reignier, Jean, Garot, Denis, Kreitmann, Louis, Baudel, Jean-Luc, Voiriot, Guillaume, Contou, Damien, Beurton, Alexandra, Asfar, Pierre, Boyer, Alexandre, Thille, Arnaud W., Mekontso-Dessap, Armand, Tsolaki, Vassiliki, Vinsonneau, Christophe, Floch, Pierre-Edouard, Le Guennec, Loïc, Ceccato, Adrian, Artigas, Antonio, Bouchereau, Mathilde, Labreuche, Julien, Duhamel, Alain, and Rouzé, Anahita

Subjects
Data_FILES
Abstract

Additional file 1. Online supplementay data.

Published
2021
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134. Additional file 1 of Role of sleep on respiratory failure after extubation in the ICU

Author

Thille, Arnaud W., Barrau, Stephanie, Beuvon, Clément, Marie, Damien, Reynaud, Faustine, Bardin, Justine, Pépin-Lehalleur, Adrien, Bironneau, Vanessa, Meurice, Jean-Claude, Coudroy, Rémi, Frat, Jean-Pierre, Robert, René, Rault, Christophe, and Drouot, Xavier

Abstract

Additional file 1: Table S1. Comparison of patients who required reintubation in the ICU and those who succeeded extubation.

Published
2021
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135. Additional file 1 of Non-invasive ventilation versus high-flow nasal oxygen for postextubation respiratory failure in ICU: a post-hoc analysis of a randomized clinical trial

Author

Thille, Arnaud W., Monseau, Grégoire, Coudroy, Rémi, Nay, Mai-Anh, Gacouin, Arnaud, Decavèle, Maxens, Sonneville, Romain, Beloncle, François, Girault, Christophe, Dangers, Laurence, Lautrette, Alexandre, Levrat, Quentin, Rouzé, Anahita, Vivier, Emmanuel, Lascarrou, Jean-Baptiste, Ricard, Jean-Damien, Razazi, Keyvan, Barberet, Guillaume, Lebert, Christine, Ehrmann, Stephan, Massri, Alexandre, Bourenne, Jeremy, Pradel, Gael, Bailly, Pierre, Terzi, Nicolas, Dellamonica, Jean, Lacave, Guillaume, Robert, René, Ragot, Stéphanie, and Frat, Jean-Pierre

Subjects
health care facilities, manpower, and services
Abstract

Additional file 1. Comparison between patients who were discharged alive from ICU and those who died in ICUs after post-extubation respiratory failure.

Published
2021
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136. Task Force report: ERS Clinical Practice Guidelines: high-flow nasal cannula in acute respiratory failure

Author

Oczkowski, Simon, Ergan, Begüm, Bos, Lieuwe, Chatwin, Michelle, Ferrer, Miguel, Gregoretti, Cesare, Heunks, Leo, Frat, Jean-Pierre, Longhini, Federico, Nava, Stefano, Navalesi, Paolo, Uğurlu, Aylin Ozsancak, Pisani, Lara, Renda, Teresa, Thille, Arnaud W, Winck, João Carlos, Windisch, Wolfram, Tonia, Thomy, Boyd, Jeanette, Sotgiu, Giovanni, and Scala, Raffaele

Subjects
610 Medicine & health, 360 Social problems & social services
Abstract

BACKGROUND High-flow nasal cannula (HFNC) has become a frequently used non-invasive form of respiratory support in acute settings, however evidence supporting its use has only recently emerged. These guidelines provide evidence-based recommendations for the use of HFNC alongside other noninvasive forms of respiratory support in adults with acute respiratory failure (ARF). MATERIALS AND METHODOLOGY The European Respiratory Society Task Force panel included expert clinicians and methodologists in pulmonology and intensive care medicine. The Task Force used the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methods to summarise evidence and develop clinical recommendations for the use of HFNC alongside conventional oxygen therapy (COT) and non-invasive ventilation (NIV) for the management of adults in acute settings with ARF. RESULTS The Task Force developed 8 conditional recommendations, suggesting using: 1) HFNC over COT in hypoxemic ARF, 2) HFNC over NIV in hypoxemic ARF, 3)HFNC over COT during breaks from NIV, 4) either HFNC or COT in post-operative patients at low risk of pulmonary complications, 5) either HFNC or NIV in post-operative patients at high risk of pulmonary complications, 6) HFNC over COT in non-surgical patients at low risk of extubation failure, 7) NIV over HFNC for patients at high risk of extubation failure unless there are relative or absolute contraindications to NIV, 8) trialling NIV prior to use of HFNC in patients with chronic obstructive pulmonary disease (COPD) and hypercapnic ARF. CONCLUSIONS HFNC is a valuable intervention in adults with ARF. These conditional recommendations can assist clinicians in choosing the most appropriate form of non-invasive respiratory support to provide to patients in different acute settings.

Published
2021
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137. Additional file 1 of Prediction of extubation outcome in critically ill patients: a systematic review and meta-analysis

Author

Torrini, Flavia, Gendreau, S��gol��ne, Morel, Johanna, Carteaux, Guillaume, Thille, Arnaud W., Antonelli, Massimo, and Mekontso Dessap, Armand

Abstract

Additional file 1: Table S1. Variables excluded because of missing data. Figure S1. Forest plots for variables statistically significantly associated with extubation failure. Table S2. Subgroup analyses by intensive care unit type. Figure S2. Heatmap of natural log transformation of odd ratios (LnOR) for extubation failure, according to ICU type. Table S3. Sensitivity analysis focusing on studies defining extubation failure as death or reintubation, whatever the delay. Table S4. Sensitivity analysis focusing on studies defining extubation failure at 48 h. Figure S3. Individual risk of bias in the included studies. Figure S4. Forest plot for the 26 variables significantly associated with extubation failure, assessed by multivariate meta-analysis for multiple factors.

Published
2021
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138. Early Bacterial Identification among Intubated Patients with COVID-19 or Influenza Pneumonia: A European Multicenter Comparative Clinical Trial

Author

Rouze, Anahita Martin-Loeches, Ignacio Povoa, Pedro and Metzelard, Matthieu Du Cheyron, Damien Lambiotte, Fabien and Tamion, Fabienne Labruyere, Marie Geronimi, Claire Boulle and Nieszkowska, Ania Nyunga, Martine Pouly, Olivier Thille, Arnaud W. Megarbane, Bruno Saade, Anastasia Diaz, Emili and Magira, Eleni Llitjos, Jean-Francois Cilloniz, Catia and Ioannidou, Iliana Pierre, Alexandre Reignier, Jean Garot, Denis Kreitmann, Louis Baudel, Jean-Luc Fartoukh, Muriel and Plantefeve, Gaetan Beurton, Alexandra Asfar, Pierre Boyer, Alexandre Mekontso-Dessap, Armand Makris, Demosthenes and Vinsonneau, Christophe Floch, Pierre-Edouard Weiss, Nicolas and Ceccato, Adrian Artigas, Antonio Bouchereau, Mathilde and Duhamel, Alain Labreuche, Julien Nseir, Saad CoVAPid Study Grp

Subjects
virus diseases, respiratory tract diseases
Abstract

Rationale: Early empirical antimicrobial treatment is frequently prescribed to critically ill patients with coronavirus disease (COVID-19) based on Surviving Sepsis Campaign guidelines. Objectives: We aimed to determine the prevalence of early bacterial identification in intubated patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia, as compared with influenza pneumonia, and to characterize its microbiology and impact on outcomes. Methods: A multicenter retrospective European cohort was performed in 36 ICUs. All adult patients receiving invasivemechanical ventilation.48 hours were eligible if they had SARS-CoV-2 or influenza pneumonia at ICU admission. Bacterial identification was defined by a positive bacterial culture within 48 hours after intubation in endotracheal aspirates, BAL, blood cultures, or a positive pneumococcal or legionella urinary antigen test. Measurements and Main Results: A total of 1,050 patients were included (568 in SARS-CoV-2 and 482 in influenza groups). The prevalence of bacterial identification was significantly lower in patients with SARS-CoV-2 pneumonia compared with patients with influenza pneumonia (9.7 vs. 33.6%; unadjusted odds ratio, 0.21; 95% confidence interval [CI], 0.15-0.30; adjusted odds ratio, 0.23; 95% CI, 0.16-0.33; P, 0.0001). Gram-positive cocci were responsible for 58% and 72% of coinfection in patients with SARS-CoV-2 and influenza pneumonia, respectively. Bacterial identification was associated with increased adjusted hazard ratio for 28-day mortality in patients with SARS-CoV-2 pneumonia (1.57; 95% CI, 1.01-2.44; P = 0.043). However, no significant difference was found in the heterogeneity of outcomes related to bacterial identification between the two study groups, suggesting that the impact of coinfection on mortality was not different between patients with SARS-CoV-2 and influenza. Conclusions: Bacterial identification within 48 hours after intubation is significantly less frequent in patients with SARSCoV-2 pneumonia than patients with influenza pneumonia.

Published
2021

139. Additional file 1 of Noninvasive ventilation vs. high-flow nasal cannula oxygen for preoxygenation before intubation in patients with obesity: a post hoc analysis of a randomized controlled trial

Author

Rodriguez, Maeva, Ragot, Stéphanie, Coudroy, Rémi, Quenot, Jean-Pierre, Vignon, Philippe, Forel, Jean-Marie, Demoule, Alexandre, Mira, Jean-Paul, Ricard, Jean-Damien, Nseir, Saad, Colin, Gwenhael, Pons, Bertrand, Danin, Pierre-Eric, Devaquet, Jérome, Prat, Gwenael, Merdji, Hamid, Petitpas, Franck, Vivier, Emmanuel, Mekontso-Dessap, Armand, Nay, Mai-Anh, Asfar, Pierre, Dellamonica, Jean, Argaud, Laurent, Ehrmann, Stephan, Fartoukh, Muriel, Girault, Christophe, Robert, René, Thille, Arnaud W., and Frat, Jean-Pierre

Subjects
nervous system, musculoskeletal, neural, and ocular physiology, macromolecular substances, circulatory and respiratory physiology, respiratory tract diseases
Abstract

Additional file 1: Table S1. Comparison of characteristics in patients with and without severe hypoxemia during intubation procedure. Table S2. Multivariable logistic regression analyses of factors associated with severe hypoxemia during intubation procedure. Table S3. Comparison of Characteristics in Patients with Obesity and Severe Hypoxemia during Intubation Procedure. Table S4. Multivariable logistic regression analyses of factors associated with severe hypoxemia during intubation procedure in patients with obesity.

Published
2021
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140. Relationship between ventilator-associated pneumonia and mortality in COVID-19 patients: a planned ancillary analysis of the coVAPid cohort (vol 25, 177, 2021)

Author

Nseir, Saad Martin-Loeches, Ignacio Povoa, Pedro Metzelard, Matthieu Du Cheyron, Damien Lambiotte, Fabien Tamion, Fabienne Labruyere, Marie Makris, Demosthenes Boulle Geronimi, Claire Pinetonde Chambrun, Marc Nyunga, Martine and Pouly, Olivier Megarbane, Bruno Saade, Anastasia Goma, Gemma and Magira, Eleni Llitjos, Jean-Francois Torres, Antoni and Ioannidou, Iliana Pierre, Alexandre Coelho, Luis Reignier, Jean Garot, Denis Kreitmann, Louis Baudel, Jean-Luc and Voiriot, Guillaume Contou, Damien Beurton, Alexandra Asfar, Pierre Boyer, Alexandre Thille, Arnaud W. Mekontso-Dessap, Armand Tsolaki, Vassiliki Vinsonneau, Christophe Floch, Pierre-Edouard Le Guennec, Loic Ceccato, Adrian Artigas, Antonio Bouchereau, Mathilde Labreuche, Julien Duhamel, Alain Rouze, Anahita CoVAPid Study Grp

Published
2021

143. Continuous enteral nutrition compared with a maximal gastric vacuity strategy at the time of extubation in the intensive care unit: protocol for a non-inferiority cluster randomised trial (the Ambroisie Project)

Author

Landais, Mickael, primary, Nay, Mai-Anh, additional, Auchabie, Johann, additional, Hubert, Noemie, additional, Rebion, Anne, additional, Robert, Alain, additional, Giraudeau, Bruno, additional, Reignier, Jean, additional, Thille, Arnaud W, additional, Tavernier, Elsa, additional, and Ehrmann, Stephan, additional

Published
2021
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144. Multicenter International Cohort Validation of a Modified Sequential Organ Failure Assessment Score Using the Richmond Agitation-sedation Scale.

Author

Rakhit, Shayan, Wang, Li, Lindsell, Christopher J., Hosay, Morgan A., Stewart, James W., Owen, Gary D., Frutos-Vivar, Fernando, Pen~uelas, Oscar, Esteban, Andre´s, Anzueto, Antonio R., Raymondos, Konstantinos, Rios, Fernando, Thille, Arnaud W., Gonza´lez, Marco, Du, Bin, Maggiore, Salvatore M., Matamis, Dimitrios, Abroug, Fekri, Amin, Pravin, and Zeggwagh, Amine A.

Abstract

Objective: In a multicenter, international cohort, we aimed to validate a modified Sequential Organ Failure Assessment (mSOFA) using the Richmond Agitation-Sedation Scale, hypothesized as comparable to the Glasgow Coma Scale (GCS)-based Sequential Organ Failure Assessment (SOFA). Summary Background Data: The SOFA score, whose neurologic component is based on the GCS, can predict intensive care unit (ICU) mortality. But, GCS is often missing in lieu of other assessments, such as the also reliable and validated Richmond Agitation Sedation Scale (RASS). Single-center data suggested an RASS-based SOFA (mSOFA) predicted ICU mortality. Methods: Our nested cohort within the prospective 2016 Fourth International Study of Mechanical Ventilation contains 4120 ventilated patients with daily RASS and GCS assessments (20,023 patient-days, 32 countries). We estimated GCS from RASS via a proportional odds model without adjustment. ICU mortality logistic regression models and c-statistics were constructed using SOFA (measured GCS) and mSOFA (measured RASS-estimated GCS), adjusted for age, sex, body-mass index, region (Europe, USA-Canada, Latin America, Africa, Asia, Australia-New Zealand), and postoperative status (medical/surgical). Results: Cohort-wide, the mean SOFA=9.4+/−2.8 and mean mSOFA = 10.0+/−2.3, with ICU mortality = 31%. Mean SOFA and mSOFA similarly predicted ICU mortality (SOFA: AUC = 0.784, 95% CI = 0.769–0.799; mSOFA: AUC = 0.778, 95% CI = 0.763–0.793, P = 0.139). Across models, other predictors of mortality included higher age, female sex, medical patient, and African region (all P < 0.001). Conclusions: We present the first SOFA modification with RASS in a "real-world" international cohort. Estimating GCS from RASS preserves predictive validity of SOFA to predict ICU mortality. Alternative neurologic measurements like RASS can be viably integrated into severity of illness scoring systems like SOFA. [ABSTRACT FROM AUTHOR]

Published
2022
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145. Evolution Over Time of Ventilatory Management and Outcome of Patients With Neurologic Disease*

Author

Tejerina, Eva E., Pelosi, Paolo, Robba, Chiara, Penuelas, Oscar, Muriel, Alfonso, Barrios, Deisy, Frutos-Vivar, Fernando, Raymondos, Konstantinos, Du, Bin, Thille, Arnaud W., Rios, Fernando, Gonzalez, Marco, del-Sorbo, Lorenzo, del Carmen Marin, Maria, Pinheiro, Bruno Valle, Soares, Marco Antonio, Nin, Nicolas, Maggiore, Salvatore M., Bersten, Andrew, Amin, Pravin, Cakar, Nahit, Suh, Gee Young, Abroug, Fekri, Jibaja, Manuel, Matamis, Dimitros, Zeggwagh, Amine Ali, Sutherasan, Yuda, Anzueto, Antonio, Esteban, Andres, VENTILA Group, Bergmans, Dennis, Heines, Serge, Tejerina, Eva E., Pelosi, Paolo, Robba, Chiara, Penuelas, Oscar, Muriel, Alfonso, Barrios, Deisy, Frutos-Vivar, Fernando, Raymondos, Konstantinos, Du, Bin, Thille, Arnaud W., Rios, Fernando, Gonzalez, Marco, del-Sorbo, Lorenzo, del Carmen Marin, Maria, Pinheiro, Bruno Valle, Soares, Marco Antonio, Nin, Nicolas, Maggiore, Salvatore M., Bersten, Andrew, Amin, Pravin, Cakar, Nahit, Suh, Gee Young, Abroug, Fekri, Jibaja, Manuel, Matamis, Dimitros, Zeggwagh, Amine Ali, Sutherasan, Yuda, Anzueto, Antonio, Esteban, Andres, VENTILA Group, Bergmans, Dennis, and Heines, Serge

Abstract

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p < 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p < 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p < 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the

Published
2021

146. Propensity-Adjusted Comparison of Mortality of Elderly Versus Very Elderly Ventilated Patients

Author

Medische Staf Intensive Care, NVIC bedrijfsvoering, Brain, Infection & Immunity, Wernly, Bernhard, Bruno, Raphael Romano, Frutos-Vivar, Fernando, Peñuelas, Oscar, Rezar, Richard, Raymondos, Konstantinos, Muriel, Alfonso, Du, Bin, Thille, Arnaud W, Ríos, Fernando, González, Marco, Del-Sorbo, Lorenzo, Marín, Maria Del Carmen, Pinheiro, Bruno Valle, Soares, Marco Antonio, Nin, Nicolas, Maggiore, Salvatore M, Bersten, Andrew, Kelm, Malte, Amin, Pravin, Cakar, Nahit, Young Suh, Gee, Abroug, Fekri, Jibaja, Manuel, Matamis, Dimitros, Zeggwagh, Amine Ali, Sutherasan, Yuda, Guidet, Bertrand, De Lange, Dylan W, Beil, Michael, Svri, Sigal, van Heerden, Vernon, Flaatten, Hans, Anzueto, Antonio, Osmani, Venet, Esteban, Andrés, Jung, Christian, Medische Staf Intensive Care, NVIC bedrijfsvoering, Brain, Infection & Immunity, Wernly, Bernhard, Bruno, Raphael Romano, Frutos-Vivar, Fernando, Peñuelas, Oscar, Rezar, Richard, Raymondos, Konstantinos, Muriel, Alfonso, Du, Bin, Thille, Arnaud W, Ríos, Fernando, González, Marco, Del-Sorbo, Lorenzo, Marín, Maria Del Carmen, Pinheiro, Bruno Valle, Soares, Marco Antonio, Nin, Nicolas, Maggiore, Salvatore M, Bersten, Andrew, Kelm, Malte, Amin, Pravin, Cakar, Nahit, Young Suh, Gee, Abroug, Fekri, Jibaja, Manuel, Matamis, Dimitros, Zeggwagh, Amine Ali, Sutherasan, Yuda, Guidet, Bertrand, De Lange, Dylan W, Beil, Michael, Svri, Sigal, van Heerden, Vernon, Flaatten, Hans, Anzueto, Antonio, Osmani, Venet, Esteban, Andrés, and Jung, Christian

Published
2021

148. High risk of pulmonary embolism in acute respiratory distress syndrome related to COVID-19: an observational controlled-cohort study

Author

de Roubin, Victor, primary, Reynaud, Faustine, additional, Coudroy, Rémi, additional, Rodriguez, Maeva, additional, Monseau, Grégoire, additional, Joly, Florent, additional, Bardin, Justine, additional, Boissier, Florence, additional, Chatellier, Delphine, additional, Veinstein, Anne, additional, Robert, René, additional, Frat, Jean-Pierre, additional, and Thille, Arnaud W., additional

Published
2021
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149. Propensity-Adjusted Comparison of Mortality of Elderly Versus Very Elderly Ventilated Patients

Author

Wernly, Bernhard, primary, Bruno, Raphael Romano, additional, Frutos-Vivar, Fernando, additional, Peñuelas, Oscar, additional, Rezar, Richard, additional, Raymondos, Konstantinos, additional, Muriel, Alfonso, additional, Du, Bin, additional, Thille, Arnaud W, additional, Ríos, Fernando, additional, González, Marco, additional, del-Sorbo, Lorenzo, additional, Marín, Maria del Carmen, additional, Pinheiro, Bruno Valle, additional, Soares, Marco Antonio, additional, Nin, Nicolas, additional, Maggiore, Salvatore M, additional, Bersten, Andrew, additional, Kelm, Malte, additional, Amin, Pravin, additional, Cakar, Nahit, additional, Young Suh, Gee, additional, Abroug, Fekri, additional, Jibaja, Manuel, additional, Matamis, Dimitros, additional, Zeggwagh, Amine Ali, additional, Sutherasan, Yuda, additional, Guidet, Bertrand, additional, De Lange, Dylan W, additional, Beil, Michael, additional, Svri, Sigal, additional, van Heerden, Vernon, additional, Flaatten, Hans, additional, Anzueto, Antonio, additional, Osmani, Venet, additional, Esteban, Andrés, additional, and Jung, Christian, additional

Published
2021
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150. Evolution Over Time of Ventilatory Management and Outcome of Patients With Neurologic Disease*

Author

Tejerina, Eva E., primary, Pelosi, Paolo, additional, Robba, Chiara, additional, Peñuelas, Oscar, additional, Muriel, Alfonso, additional, Barrios, Deisy, additional, Frutos-Vivar, Fernando, additional, Raymondos, Konstantinos, additional, Du, Bin, additional, Thille, Arnaud W., additional, Ríos, Fernando, additional, González, Marco, additional, del-Sorbo, Lorenzo, additional, Marín, Maria del Carmen, additional, Valle Pinheiro, Bruno, additional, Soares, Marco Antonio, additional, Nin, Nicolas, additional, Maggiore, Salvatore M., additional, Bersten, Andrew, additional, Amin, Pravin, additional, Cakar, Nahit, additional, Young Suh, Gee, additional, Abroug, Fekri, additional, Jibaja, Manuel, additional, Matamis, Dimitros, additional, Ali Zeggwagh, Amine, additional, Sutherasan, Yuda, additional, Anzueto, Antonio, additional, and Esteban, Andrés, additional

Published
2021
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