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32 results on '"Ducrocq, N."'

5. Fluid challenges in intensive care: the FENICE study: a global inception cohort study

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Cecconi, M1, Hofer, C, Teboul, Jl, Pettila, V, Wilkman, E, Molnar, Z, Della Rocca, G, Aldecoa, C, Artigas, A, Jog, S, Sander, M, Spies, C, Lefrant, Jy, De Backer, D, Silva, E, Zhang, X, Ospina-tascón, G, Arias, J, Gornik, I, Benes, J, Petersen, A, Zsolt, M, Sprung, C, Koch, M, Guttormsen, Ab, Tavares, M, Pettilä, V, Mikaszewska-sokolewicz, M, Bakker, J, Parke, R, Kirov, M, Wernerman, J, Esen, F, Cecconi, M, Cannesson, M, Njimi, H, François, G, Cueto, G, Hockley, S, Ambekar, H, Laterre, Pf, Dujardin, Mf, Damas, P, Deschamps, P, Glorieux, D, Hoste, E, Miribung, M, Devriendt, J, Haentjens, L, Biston, P, Dugernier, T, Bulpa, P, Dive, A, Debaveye, Y, Franck, S, Conde, K, Morsch, R, Ramos, M, Dias, F, Mataloun, S, Mendes, C, Silva, F, Grion, C, Knibel, M, Yang, C, Xiangyu, Z, Cai, G, Ortiz, G, Ospina-tascon, G, Yepes, D, Londono Arcila Hf, Molina, F, Pereira, F, Sanchez-galvez, Hf, Benitez, F, Arias Ortiz, J, Gonzalez Rojas, M, Cavric, G, Lukic, E, Zykova, I, Freml, P, Satinsky, I, Suk, P, Novak, I, Balik, M, Szturz, P, Kratochvil, M, Bestle, M, Strange, Dg, Perner, A, Rasmussen, Bs, Hauge, J, Meldgaard, M, Toome, V, Kuitunen, A, Varila, S, Hovilehto, S, Pulkkinen, A, Kiviniemi, O, Tallgren, M, Laitio, R, Mongardon, N, Dhonneur, G, Malledant, Y, Lepouse, C, Darmon, M, Mira, Jp, Chiche, Jd, Joannes-boyau, O, Preau, S, Larche, J, Mottard, N, Bengler, C, Argaud, L, Hamzaoui, O, Desebbe, O, Burtin, P, Reignier, J, Durand, M, Guitard, Pg, Asfar, P, Guillot, M, Boulain, T, Mekontso Dessap, A, Ducrocq, N, Lakhal, K, Gregoire, C, Schmauss, M, Zacharowski, K, Meybohm, P, Treskatsch, S, Bloos, F, Van Huelst, S, Baumann, H, Kersten, A, Goldmann, A, Gkiokas, G, Dimoula, A, Kofinas, G, Anthopoulos, G, Pankotai, B, Kopitko, C, Gartner, B, Schaffer, E, Fulesdi, B, Sarkany, A, Samavedam, S, Shah, B, Dixit, S, Toraskar, K, Nandakumar, S, Goila, Ak, Nayyar, A, Patel, M, Mitra, D, Jagiasi, B, Jakkinaboina, S, Goswami, J, Ghosh, S, Hashemian, M, Mahmoodpoor, A, Breen, D, Benbenishty, J, Kuniavsky, M, Kolpak, O, Castiglione, G, Monti, G, Molin, A, Martucci, G, Panarello, G, Raineri, Sm, Pota, V, Acquarolo, A, Ploner, F, Lapichino, G, Lombardo, A, Roasio, A, Cardelino, S, Pignataro, A, Oggioni, R, Mangani, V, Parrini, V, Spadaro, S, Volta, Ca, Alampi, D, Torrente, S, Monastra, L, Marini, F, Mazzini, P, Albanese, D, Riccardi, S, Ruberto, F, Belluomo, Ac, Silvestri, R, Citerio, G, Brienza, N, Brazzi, L, Protti, A, Bottino, N, David, A, Manzoni, D, Foti, G, Numis, F, Morimatsu, H, Shimizu, K, Munster, L, Rai, V, Buttigieg, M, Pickkers, P, Mijzen, L, Kesecioglu, J, Van Duijn, D, Ormskerk, P, Beck, O, Goodson, J, King, B, Koelle, J, Kantor, S, Gomez, O, Ramos, I, Jedynak, M, Sulkowski, W, Adamik, B, Chruscikowski, M, Wadelek, J, Korzybski, J, Misiewska-kaczur, A, Piasecka-twarog, M, Fijaikowska, A, Maciejewski, D, Smiechowicz, K, Milkowska, E, Czerwinska, A, Lukaszewska, A, Wieczorek, A, Czuczwar, M, Czerwiec, A, Tamowicz, B, Branco, V, Estilita, J, Basilio, C, Diogo, C, Toma, R, Bubenek-turconi, Si, Filipescu, D, Popescu, M, Titova, J, Belskiy, V, Smetkin, A, Grigoryev, E, Pugachev, S, Gasenkampf, A, Abouelala, A, Almekhlafi, G, Rupnik, E, Garcia-delgado, H, Saez Fernandez, A, Celaya Lopez, M, Ramasco, F, Planas, K, Zavala, E, De Nadal, M, Picos, Sa, Fernandez, S, Munoz, A, Herrera Para, L, Maseda, E, Rovira, A, Monge Garcia Mi, Ferrer, R, Sole Violan, J, Garcia Nogales, X, Torrents, E, Ripolles Melchor, J, Tomás Marsilla Ji, Araujo Aguilar, P, Aguilar, G, Menor, Em, Martinez, Mc, Leal Micharet Am, Ferri Riera, C, Mosquera, D, Astola, I, Freita-ramos, S, Garcia Olivares, P, Jimenez Bartolome Mb, Fernandez Gonzalez, I, Sanchez-izquierdo, Ja, Arribas, P, Gimenez-esparzavich, C, Anglada, M, Martin, S, Weerakoon, Rk, Bendjelid, K, Fumeaux, T, Maggiorini, M, Demirkiran, O, Adanir, T, Ergin Ozcan, P, Kelebek Girgin, N, Elahi, N, Kashef, S, Alsabbah, A, Lowe, A, Wise, M, Vizcaychipi, Mp, Baht, S, Webb, S, Friis, J, Boulanger, C, Gratrix, A, Harvey, D, Ferguson, A, Espie, L, Toth-tarsoly, P, Lewis, K, Shelley, B, Thuerey, J, Przemyslaw, D, Ranganathan, M, Hormis, A, Spivey, M, Henning, J, Saveker, R, Csabi, P, Bland, M, Barrera Groba, C, Al-subaie, N, Thomson, R, Hamilton, M, Iannuccelli, F, Roberts, C, Sherwood, N, Kasipandian, V, Silversides, J, Jonas, A, Szakmany, T, Vickers, E, Richards, J, Tham, L, Williams, D, Heenen, S, Hobrok, M, Walden, A, Raj, A, Bauer, P, Kashyap, R, Tolnai, P, Kjelle, Bj, Andersen, Fh, Palo, Je, Namendys-silva, S. A., Hôpital Bicêtre, Hôpital Bicêtre-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Cecconi M., Hofer C., Teboul J.-L., Pettila V., Wilkman E., Molnar Z., Della Rocca G., Aldecoa C., Artigas A., Jog S., Sander M., Spies C., Lefrant J.-Y., De Backer D., Silva E., Zhang X., Ospina-Tascon G., Arias J., Gornik I., Benes J., Petersen A., Zsolt M., Sprung C., Koch M., Guttormsen A.B., Tavares M., Mikaszewska-Sokolewicz M., Bakker J., Parke R., Kirov M., Wernerman J., Esen F., Cannesson M., Njimi H., Francois G., Cueto G., Hockley S., Ambekar H., Laterre P.F., Dujardin M.F., Damas P., Deschamps P., Glorieux D., Hoste E., Miribung M., Devriendt J., Haentjens L., Biston P., Dugernier T., Bulpa P., Dive A., Debaveye Y., Franck S., Conde K., Morsch R., Ramos M., Dias F., Mataloun S., Mendes C., Silva F., Grion C., Knibel M., Yang C., Xiangyu Z., Cai G., Ortiz G., Yepes D., Londono Arcila H.F., Molina F., Pereira F., Sanchez-Galvez H.F., Benitez F., Arias Ortiz J., Gonzalez Rojas M., Cavric G., Lukic E., Zykova I., Freml P., Satinsky I., Suk P., Novak I., Balik M., Szturz P., Kratochvil M., Bestle M., Strange D.G., Perner A., Rasmussen B.S., Hauge J., Meldgaard M., Toome V., Kuitunen A., Varila S., Hovilehto S., Pulkkinen A., Kiviniemi O., Tallgren M., Laitio R., Mongardon N., Dhonneur G., Malledant Y., Lepouse C., Darmon M., Mira J.P., Chiche J.D., Joannes-Boyau O., Preau S., Larche J., Mottard N., Bengler C., Argaud L., Hamzaoui O., Desebbe O., Burtin P., Reignier J., Durand M., Guitard P.G., Asfar P., Guillot M., Boulain T., Mekontso Dessap A., Ducrocq N., Lakhal K., Gregoire C., Schmauss M., Zacharowski K., Meybohm P., Treskatsch S., Bloos F., van Huelst S., Baumann H., Kersten A., Goldmann A., Gkiokas G., Dimoula A., Kofinas G., Anthopoulos G., Pankotai B., Kopitko C., Gartner B., Schaffer E., Fulesdi B., Sarkany A., Samavedam S., Shah B., Dixit S., Toraskar K., Nandakumar S., Goila A.K., Nayyar A., Patel M., Mitra D., Jagiasi B., Jakkinaboina S., Goswami J., Ghosh S., Hashemian M., Mahmoodpoor A., Breen D., Benbenishty J., Kuniavsky M., Kolpak O., Castiglione G., Monti G., Molin A., Martucci G., Panarello G., Raineri S.M., Pota V., Acquarolo A., Ploner F., Lapichino G., Lombardo A., Roasio A., Cardelino S., Pignataro A., Oggioni R., Mangani V., Parrini V., Spadaro S., Volta C.A., Alampi D., Torrente S., Monastra L., Marini F., Mazzini P., Albanese D., Riccardi S., Ruberto F., Belluomo A.C., Silvestri R., Citerio G., Brienza N., Brazzi L., Protti A., Bottino N., David A., Manzoni D., Foti G., Numis F., Morimatsu H., Shimizu K., Munster L., Rai V., Buttigieg M., Pickkers P., Mijzen L., Kesecioglu J., Van Duijn D., Ormskerk P., Beck O., Goodson J., King B., Koelle J., Kantor S., Gomez O., Ramos I., Jedynak M., Sulkowski W., Adamik B., Chruscikowski M., Wadelek J., Korzybski J., Misiewska-Kaczur A., Piasecka-Twarog M., Fijaikowska A., Maciejewski D., Smiechowicz K., Milkowska E., Czerwinska A., Lukaszewska A., Wieczorek A., Czuczwar M., Czerwiec A., Tamowicz B., Branco V., Estilita J., Basilio C., Diogo C., Toma R., Bubenek-Turconi S.I., Filipescu D., Popescu M., Titova J., Belskiy V., Smetkin A., Grigoryev E., Pugachev S., Gasenkampf A., Abouelala A., Almekhlafi G., Rupnik E., Garcia-Delgado H., Saez Fernandez A., Celaya Lopez M., Ramasco F., Planas K., Zavala E., De Nadal M., Picos S.A., Fernandez S., Munoz A., Herrera Para L., Maseda E., Rovira A., Monge Garcia M.I., Ferrer R., Sole Violan J., Garcia Nogales X., Torrents E., Ripolles Melchor J., Tomas Marsilla J.I., Araujo Aguilar P., Aguilar G., Menor E.M., Martinez M.C., Leal Micharet A.M., Ferri Riera C., Mosquera D., Astola I., Freita-Ramos S., Garcia Olivares P., Jimenez Bartolome M.B., Fernandez Gonzalez I., Sanchez-Izquierdo J.A., Arribas P., Gimenez-Esparzavich C., Anglada M., Martin S., Weerakoon R.K., Bendjelid K., Fumeaux T., Maggiorini M., Demirkiran O., Adanir T., Ergin Ozcan P., Kelebek Girgin N., Elahi N., Kashef S., Alsabbah A., Lowe A., Wise M., Vizcaychipi M.P., Baht S., Webb S., Friis J., Boulanger C., Gratrix A., Harvey D., Ferguson A., Espie L., Toth-Tarsoly P., Lewis K., Shelley B., Thuerey J., Przemyslaw D., Ranganathan M., Hormis A., Spivey M., Henning J., Saveker R., Csabi P., Bland M., Barrera Groba C., Al-Subaie N., Thomson R., Hamilton M., Iannuccelli F., Roberts C., Sherwood N., Kasipandian V., Silversides J., Jonas A., Szakmany T., Vickers E., Richards J., Tham L., Williams D., Heenen S., Hobrok M., Walden A., Raj A., Bauer P., Kashyap R., Tolnai P., Kjelle B.J., Andersen F.H., Palo J.E., Namendys-Silva S.A., Cecconi, M, Hofer, C, Teboul, J, Pettila, V, Wilkman, E, Molnar, Z, Della Rocca, G, Aldecoa, C, Artigas, A, Jog, S, Sander, M, Spies, C, Lefrant, J, De Backer, D, Silva, E, Zhang, X, Ospina-Tascon, G, Arias, J, Gornik, I, Benes, J, Petersen, A, Zsolt, M, Sprung, C, Koch, M, Guttormsen, A, Tavares, M, Mikaszewska-Sokolewicz, M, Bakker, J, Parke, R, Kirov, M, Wernerman, J, Esen, F, Cannesson, M, Njimi, H, Francois, G, Cueto, G, Hockley, S, Ambekar, H, Laterre, P, Dujardin, M, Damas, P, Deschamps, P, Glorieux, D, Hoste, E, Miribung, M, Devriendt, J, Haentjens, L, Biston, P, Dugernier, T, Bulpa, P, Dive, A, Debaveye, Y, Franck, S, Conde, K, Morsch, R, Ramos, M, Dias, F, Mataloun, S, Mendes, C, Silva, F, Grion, C, Knibel, M, Yang, C, Xiangyu, Z, Cai, G, Ortiz, G, Yepes, D, Londono Arcila, H, Molina, F, Pereira, F, Sanchez-Galvez, H, Benitez, F, Arias Ortiz, J, Gonzalez Rojas, M, Cavric, G, Lukic, E, Zykova, I, Freml, P, Satinsky, I, Suk, P, Novak, I, Balik, M, Szturz, P, Kratochvil, M, Bestle, M, Strange, D, Perner, A, Rasmussen, B, Hauge, J, Meldgaard, M, Toome, V, Kuitunen, A, Varila, S, Hovilehto, S, Pulkkinen, A, Kiviniemi, O, Tallgren, M, Laitio, R, Mongardon, N, Dhonneur, G, Malledant, Y, Lepouse, C, Darmon, M, Mira, J, Chiche, J, Joannes-Boyau, O, Preau, S, Larche, J, Mottard, N, Bengler, C, Argaud, L, Hamzaoui, O, Desebbe, O, Burtin, P, Reignier, J, Durand, M, Guitard, P, Asfar, P, Guillot, M, Boulain, T, Mekontso Dessap, A, Ducrocq, N, Lakhal, K, Gregoire, C, Schmauss, M, Zacharowski, K, Meybohm, P, Treskatsch, S, Bloos, F, van Huelst, S, Baumann, H, Kersten, A, Goldmann, A, Gkiokas, G, Dimoula, A, Kofinas, G, Anthopoulos, G, Pankotai, B, Kopitko, C, Gartner, B, Schaffer, E, Fulesdi, B, Sarkany, A, Samavedam, S, Shah, B, Dixit, S, Toraskar, K, Nandakumar, S, Goila, A, Nayyar, A, Patel, M, Mitra, D, Jagiasi, B, Jakkinaboina, S, Goswami, J, Ghosh, S, Hashemian, M, Mahmoodpoor, A, Breen, D, Benbenishty, J, Kuniavsky, M, Kolpak, O, Castiglione, G, Monti, G, Molin, A, Martucci, G, Panarello, G, Raineri, S, Pota, V, Acquarolo, A, Ploner, F, Lapichino, G, Lombardo, A, Roasio, A, Cardelino, S, Pignataro, A, Oggioni, R, Mangani, V, Parrini, V, Spadaro, S, Volta, C, Alampi, D, Torrente, S, Monastra, L, Marini, F, Mazzini, P, Albanese, D, Riccardi, S, Ruberto, F, Belluomo, A, Silvestri, R, Citerio, G, Brienza, N, Brazzi, L, Protti, A, Bottino, N, David, A, Manzoni, D, Foti, G, Numis, F, Morimatsu, H, Shimizu, K, Munster, L, Rai, V, Buttigieg, M, Pickkers, P, Mijzen, L, Kesecioglu, J, Van Duijn, D, Ormskerk, P, Beck, O, Goodson, J, King, B, Koelle, J, Kantor, S, Gomez, O, Ramos, I, Jedynak, M, Sulkowski, W, Adamik, B, Chruscikowski, M, Wadelek, J, Korzybski, J, Misiewska-Kaczur, A, Piasecka-Twarog, M, Fijaikowska, A, Maciejewski, D, Smiechowicz, K, Milkowska, E, Czerwinska, A, Lukaszewska, A, Wieczorek, A, Czuczwar, M, Czerwiec, A, Tamowicz, B, Branco, V, Estilita, J, Basilio, C, Diogo, C, Toma, R, Bubenek-Turconi, S, Filipescu, D, Popescu, M, Titova, J, Belskiy, V, Smetkin, A, Grigoryev, E, Pugachev, S, Gasenkampf, A, Abouelala, A, Almekhlafi, G, Rupnik, E, Garcia-Delgado, H, Saez Fernandez, A, Celaya Lopez, M, Ramasco, F, Planas, K, Zavala, E, De Nadal, M, Picos, S, Fernandez, S, Munoz, A, Herrera Para, L, Maseda, E, Rovira, A, Monge Garcia, M, Ferrer, R, Sole Violan, J, Garcia Nogales, X, Torrents, E, Ripolles Melchor, J, Tomas Marsilla, J, Araujo Aguilar, P, Aguilar, G, Menor, E, Martinez, M, Leal Micharet, A, Ferri Riera, C, Mosquera, D, Astola, I, Freita-Ramos, S, Garcia Olivares, P, Jimenez Bartolome, M, Fernandez Gonzalez, I, Sanchez-Izquierdo, J, Arribas, P, Gimenez-Esparzavich, C, Anglada, M, Martin, S, Weerakoon, R, Bendjelid, K, Fumeaux, T, Maggiorini, M, Demirkiran, O, Adanir, T, Ergin Ozcan, P, Kelebek Girgin, N, Elahi, N, Kashef, S, Alsabbah, A, Lowe, A, Wise, M, Vizcaychipi, M, Baht, S, Webb, S, Friis, J, Boulanger, C, Gratrix, A, Harvey, D, Ferguson, A, Espie, L, Toth-Tarsoly, P, Lewis, K, Shelley, B, Thuerey, J, Przemyslaw, D, Ranganathan, M, Hormis, A, Spivey, M, Henning, J, Saveker, R, Csabi, P, Bland, M, Barrera Groba, C, Al-Subaie, N, Thomson, R, Hamilton, M, Iannuccelli, F, Roberts, C, Sherwood, N, Kasipandian, V, Silversides, J, Jonas, A, Szakmany, T, Vickers, E, Richards, J, Tham, L, Williams, D, Heenen, S, Hobrok, M, Walden, A, Raj, A, Bauer, P, Kashyap, R, Tolnai, P, Kjelle, B, Andersen, F, Palo, J, Namendys-Silva, S, De Backer, Daniel, Cecconi, M., Hofer, C., Teboul, J. -L., Pettila, V., Wilkman, E., Molnar, Z., Della Rocca, G., Aldecoa, C., Artigas, A., Jog, S., Sander, M., Spies, C., Lefrant, J. -Y., De Backer, D., Silva, E., Zhang, X., Ospina-Tascon, G., Arias, J., Gornik, I., Benes, J., Petersen, A., Zsolt, M., Sprung, C., Koch, M., Guttormsen, A. B., Tavares, M., Mikaszewska-Sokolewicz, M., Bakker, J., Parke, R., Kirov, M., Wernerman, J., Esen, F., Cannesson, M., Njimi, H., Francois, G., Cueto, G., Hockley, S., Ambekar, H., Laterre, P. F., Dujardin, M. F., Damas, P., Deschamps, P., Glorieux, D., Hoste, E., Miribung, M., Devriendt, J., Haentjens, L., Biston, P., Dugernier, T., Bulpa, P., Dive, A., Debaveye, Y., Franck, S., Conde, K., Morsch, R., Ramos, M., Dias, F., Mataloun, S., Mendes, C., Silva, F., Grion, C., Knibel, M., Yang, C., Xiangyu, Z., Cai, G., Ortiz, G., Yepes, D., Londono Arcila, H. F., Molina, F., Pereira, F., Sanchez-Galvez, H. F., Benitez, F., Arias Ortiz, J., Gonzalez Rojas, M., Cavric, G., Lukic, E., Zykova, I., Freml, P., Satinsky, I., Suk, P., Novak, I., Balik, M., Szturz, P., Kratochvil, M., Bestle, M., Strange, D. G., Perner, A., Rasmussen, B. S., Hauge, J., Meldgaard, M., Toome, V., Kuitunen, A., Varila, S., Hovilehto, S., Pulkkinen, A., Kiviniemi, O., Tallgren, M., Laitio, R., Mongardon, N., Dhonneur, G., Malledant, Y., Lepouse, C., Darmon, M., Mira, J. P., Chiche, J. D., Joannes-Boyau, O., Preau, S., Larche, J., Mottard, N., Bengler, C., Argaud, L., Hamzaoui, O., Desebbe, O., Burtin, P., Reignier, J., Durand, M., Guitard, P. G., Asfar, P., Guillot, M., Boulain, T., Mekontso Dessap, A., Ducrocq, N., Lakhal, K., Gregoire, C., Schmauss, M., Zacharowski, K., Meybohm, P., Treskatsch, S., Bloos, F., van Huelst, S., Baumann, H., Kersten, A., Goldmann, A., Gkiokas, G., Dimoula, A., Kofinas, G., Anthopoulos, G., Pankotai, B., Kopitko, C., Gartner, B., Schaffer, E., Fulesdi, B., Sarkany, A., Samavedam, S., Shah, B., Dixit, S., Toraskar, K., Nandakumar, S., Goila, A. K., Nayyar, A., Patel, M., Mitra, D., Jagiasi, B., Jakkinaboina, S., Goswami, J., Ghosh, S., Hashemian, M., Mahmoodpoor, A., Breen, D., Benbenishty, J., Kuniavsky, M., Kolpak, O., Castiglione, G., Monti, G., Molin, A., Martucci, G., Panarello, G., Raineri, S. M., Pota, V., Acquarolo, A., Ploner, F., Lapichino, G., Lombardo, A., Roasio, A., Cardelino, S., Pignataro, A., Oggioni, R., Mangani, V., Parrini, V., Spadaro, S., Volta, C. A., Alampi, D., Torrente, S., Monastra, L., Marini, F., Mazzini, P., Albanese, D., Riccardi, S., Ruberto, F., Belluomo, A. C., Silvestri, R., Citerio, G., Brienza, N., Brazzi, L., Protti, A., Bottino, N., David, A., Manzoni, D., Foti, G., Numis, F., Morimatsu, H., Shimizu, K., Munster, L., Rai, V., Buttigieg, M., Pickkers, P., Mijzen, L., Kesecioglu, J., Van Duijn, D., Ormskerk, P., Beck, O., Goodson, J., King, B., Koelle, J., Kantor, S., Gomez, O., Ramos, I., Jedynak, M., Sulkowski, W., Adamik, B., Chruscikowski, M., Wadelek, J., Korzybski, J., Misiewska-Kaczur, A., Piasecka-Twarog, M., Fijaikowska, A., Maciejewski, D., Smiechowicz, K., Milkowska, E., Czerwinska, A., Lukaszewska, A., Wieczorek, A., Czuczwar, M., Czerwiec, A., Tamowicz, B., Branco, V., Estilita, J., Basilio, C., Diogo, C., Toma, R., Bubenek-Turconi, S. I., Filipescu, D., Popescu, M., Titova, J., Belskiy, V., Smetkin, A., Grigoryev, E., Pugachev, S., Gasenkampf, A., Abouelala, A., Almekhlafi, G., Rupnik, E., Garcia-Delgado, H., Saez Fernandez, A., Celaya Lopez, M., Ramasco, F., Planas, K., Zavala, E., De Nadal, M., Picos, S. A., Fernandez, S., Munoz, A., Herrera Para, L., Maseda, E., Rovira, A., Monge Garcia, M. I., Ferrer, R., Sole Violan, J., Garcia Nogales, X., Torrents, E., Ripolles Melchor, J., Tomas Marsilla, J. I., Araujo Aguilar, P., Aguilar, G., Menor, E. M., Martinez, M. C., Leal Micharet, A. M., Ferri Riera, C., Mosquera, D., Astola, I., Freita-Ramos, S., Garcia Olivares, P., Jimenez Bartolome, M. B., Fernandez Gonzalez, I., Sanchez-Izquierdo, J. A., Arribas, P., Gimenez-Esparzavich, C., Anglada, M., Martin, S., Weerakoon, R. K., Bendjelid, K., Fumeaux, T., Maggiorini, M., Demirkiran, O., Adanir, T., Ergin Ozcan, P., Kelebek Girgin, N., Elahi, N., Kashef, S., Alsabbah, A., Lowe, A., Wise, M., Vizcaychipi, M. P., Baht, S., Webb, S., Friis, J., Boulanger, C., Gratrix, A., Harvey, D., Ferguson, A., Espie, L., Toth-Tarsoly, P., Lewis, K., Shelley, B., Thuerey, J., Przemyslaw, D., Ranganathan, M., Hormis, A., Spivey, M., Henning, J., Saveker, R., Csabi, P., Bland, M., Barrera Groba, C., Al-Subaie, N., Thomson, R., Hamilton, M., Iannuccelli, F., Roberts, C., Sherwood, N., Kasipandian, V., Silversides, J., Jonas, A., Szakmany, T., Vickers, E., Richards, J., Tham, L., Williams, D., Heenen, S., Hobrok, M., Walden, A., Raj, A., Bauer, P., Kashyap, R., Tolnai, P., Kjelle, B. J., Andersen, F. H., Palo, J. E., Namendys-Silva, S. A., Clinicum, Department of Diagnostics and Therapeutics, and Anestesiologian yksikkö

Subjects
Male, Soins intensifs réanimation, medicine.medical_treatment, Cohort Studies, Female, Humans, Middle Aged, Practice Patterns, Physicians', Critical Care, Fluid Therapy, Critical Care and Intensive Care Medicine, Practice Patterns, ESICM Trial Group, RESPONSIVENESS, Seven-Day Profile Publication, Medicine and Health Sciences, FENICE Investigators, CIRCULATORY SHOCK, intensive care, ddc:617, RENAL REPLACEMENT THERAPY, 3. Good health, OF-THE-LITERATURE, SHOCK, lipids (amino acids, peptides, and proteins), Erratum, intensive care, fluid therapy, fluids, Life Sciences & Biomedicine, CRITICALLY-ILL PATIENTS, Human, Cohort study, medicine.medical_specialty, HYDROXYETHYL STARCH 130/0.4, MEDLINE, 1117 Public Health and Health Services, NO, fluid therapy, Critical Care Medicine, CIRCULATORY, General & Internal Medicine, Intensive care, Anesthesiology, PATIENTS, medicine, cohort study, Renal replacement therapy, Intensive care medicine, Physicians', Science & Technology, CRITICALLY-ILL, business.industry, Septic shock, SEPTIC SHOCK, 1103 Clinical Sciences, 3126 Surgery, anesthesiology, intensive care, radiology, medicine.disease, Emergency & Critical Care Medicine, ARTERIAL-PRESSURE, SEVERE SEPSIS, Clinical trial, Observational study, Cohort Studie, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, TASK-FORCE
Abstract

Background: Fluid challenges (FCs) are one of the most commonly used therapies in critically ill patients and represent the cornerstone of hemodynamic management in intensive care units. There are clear benefits and harms from fluid therapy. Limited data on the indication, type, amount and rate of an FC in critically ill patients exist in the literature. The primary aim was to evaluate how physicians conduct FCs in terms of type, volume, and rate of given fluid; the secondary aim was to evaluate variables used to trigger an FC and to compare the proportion of patients receiving further fluid administration based on the response to the FC. Methods: This was an observational study conducted in ICUs around the world. Each participating unit entered a maximum of 20 patients with one FC. Results: 2213 patients were enrolled and analyzed in the study. The median [interquartile range] amount of fluid given during an FC was 500 ml (500–1000). The median time was 24 min (40–60 min), and the median rate of FC was 1000 [500–1333] ml/h. The main indication for FC was hypotension in 1211 (59 %, CI 57–61 %). In 43 % (CI 41–45 %) of the cases no hemodynamic variable was used. Static markers of preload were used in 785 of 2213 cases (36 %, CI 34–37 %). Dynamic indices of preload responsiveness were used in 483 of 2213 cases (22 %, CI 20–24 %). No safety variable for the FC was used in 72 % (CI 70–74 %) of the cases. There was no statistically significant difference in the proportion of patients who received further fluids after the FC between those with a positive, with an uncertain or with a negatively judged response. Conclusions: The current practice and evaluation of FC in critically ill patients are highly variable. Prediction of fluid responsiveness is not used routinely, safety limits are rarely used, and information from previous failed FCs is not always taken into account., SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2015
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7. Fluid challenges in intensive care: the FENICE study: A global inception cohort study

Author

Cecconi, M, Hofer, C, Teboul, J, Pettila, V, Wilkman, E, Molnar, Z, Della Rocca, G, Aldecoa, C, Artigas, A, Jog, S, Sander, M, Spies, C, Lefrant, J, De Backer, D, Silva, E, Zhang, X, Ospina-Tascon, G, Arias, J, Gornik, I, Benes, J, Petersen, A, Zsolt, M, Sprung, C, Koch, M, Guttormsen, A, Tavares, M, Mikaszewska-Sokolewicz, M, Bakker, J, Parke, R, Kirov, M, Wernerman, J, Esen, F, Cannesson, M, Njimi, H, Francois, G, Cueto, G, Hockley, S, Ambekar, H, Laterre, P, Dujardin, M, Damas, P, Deschamps, P, Glorieux, D, Hoste, E, Miribung, M, Devriendt, J, Haentjens, L, Biston, P, Dugernier, T, Bulpa, P, Dive, A, Debaveye, Y, Franck, S, Conde, K, Morsch, R, Ramos, M, Dias, F, Mataloun, S, Mendes, C, Silva, F, Grion, C, Knibel, M, Yang, C, Xiangyu, Z, Cai, G, Ortiz, G, Yepes, D, Londono Arcila, H, Molina, F, Pereira, F, Sanchez-Galvez, H, Benitez, F, Arias Ortiz, J, Gonzalez Rojas, M, Cavric, G, Lukic, E, Zykova, I, Freml, P, Satinsky, I, Suk, P, Novak, I, Balik, M, Szturz, P, Kratochvil, M, Bestle, M, Strange, D, Perner, A, Rasmussen, B, Hauge, J, Meldgaard, M, Toome, V, Kuitunen, A, Varila, S, Hovilehto, S, Pulkkinen, A, Kiviniemi, O, Tallgren, M, Laitio, R, Mongardon, N, Dhonneur, G, Malledant, Y, Lepouse, C, Darmon, M, Mira, J, Chiche, J, Joannes-Boyau, O, Preau, S, Larche, J, Mottard, N, Bengler, C, Argaud, L, Hamzaoui, O, Desebbe, O, Burtin, P, Reignier, J, Durand, M, Guitard, P, Asfar, P, Guillot, M, Boulain, T, Mekontso Dessap, A, Ducrocq, N, Lakhal, K, Gregoire, C, Schmauss, M, Zacharowski, K, Meybohm, P, Treskatsch, S, Bloos, F, van Huelst, S, Baumann, H, Kersten, A, Goldmann, A, Gkiokas, G, Dimoula, A, Kofinas, G, Anthopoulos, G, Pankotai, B, Kopitko, C, Gartner, B, Schaffer, E, Fulesdi, B, Sarkany, A, Samavedam, S, Shah, B, Dixit, S, Toraskar, K, Nandakumar, S, Goila, A, Nayyar, A, Patel, M, Mitra, D, Jagiasi, B, Jakkinaboina, S, Goswami, J, Ghosh, S, Hashemian, M, Mahmoodpoor, A, Breen, D, Benbenishty, J, Kuniavsky, M, Kolpak, O, Castiglione, G, Monti, G, Molin, A, Martucci, G, Panarello, G, Raineri, S, Pota, V, Acquarolo, A, Ploner, F, Lapichino, G, Lombardo, A, Roasio, A, Cardelino, S, Pignataro, A, Oggioni, R, Mangani, V, Parrini, V, Spadaro, S, Volta, C, Alampi, D, Torrente, S, Monastra, L, Marini, F, Mazzini, P, Albanese, D, Riccardi, S, Ruberto, F, Belluomo, A, Silvestri, R, Citerio, G, Brienza, N, Brazzi, L, Protti, A, Bottino, N, David, A, Manzoni, D, Foti, G, Numis, F, Morimatsu, H, Shimizu, K, Munster, L, Rai, V, Buttigieg, M, Pickkers, P, Mijzen, L, Kesecioglu, J, Van Duijn, D, Ormskerk, P, Beck, O, Goodson, J, King, B, Koelle, J, Kantor, S, Gomez, O, Ramos, I, Jedynak, M, Sulkowski, W, Adamik, B, Chruscikowski, M, Wadelek, J, Korzybski, J, Misiewska-Kaczur, A, Piasecka-Twarog, M, Fijaikowska, A, Maciejewski, D, Smiechowicz, K, Milkowska, E, Czerwinska, A, Lukaszewska, A, Wieczorek, A, Czuczwar, M, Czerwiec, A, Tamowicz, B, Branco, V, Estilita, J, Basilio, C, Diogo, C, Toma, R, Bubenek-Turconi, S, Filipescu, D, Popescu, M, Titova, J, Belskiy, V, Smetkin, A, Grigoryev, E, Pugachev, S, Gasenkampf, A, Abouelala, A, Almekhlafi, G, Rupnik, E, Garcia-Delgado, H, Saez Fernandez, A, Celaya Lopez, M, Ramasco, F, Planas, K, Zavala, E, De Nadal, M, Picos, S, Fernandez, S, Munoz, A, Herrera Para, L, Maseda, E, Rovira, A, Monge Garcia, M, Ferrer, R, Sole Violan, J, Garcia Nogales, X, Torrents, E, Ripolles Melchor, J, Tomas Marsilla, J, Araujo Aguilar, P, Aguilar, G, Menor, E, Martinez, M, Leal Micharet, A, Ferri Riera, C, Mosquera, D, Astola, I, Freita-Ramos, S, Garcia Olivares, P, Jimenez Bartolome, M, Fernandez Gonzalez, I, Sanchez-Izquierdo, J, Arribas, P, Gimenez-Esparzavich, C, Anglada, M, Martin, S, Weerakoon, R, Bendjelid, K, Fumeaux, T, Maggiorini, M, Demirkiran, O, Adanir, T, Ergin Ozcan, P, Kelebek Girgin, N, Elahi, N, Kashef, S, Alsabbah, A, Lowe, A, Wise, M, Vizcaychipi, M, Baht, S, Webb, S, Friis, J, Boulanger, C, Gratrix, A, Harvey, D, Ferguson, A, Espie, L, Toth-Tarsoly, P, Lewis, K, Shelley, B, Thuerey, J, Przemyslaw, D, Ranganathan, M, Hormis, A, Spivey, M, Henning, J, Saveker, R, Csabi, P, Bland, M, Barrera Groba, C, Al-Subaie, N, Thomson, R, Hamilton, M, Iannuccelli, F, Roberts, C, Sherwood, N, Kasipandian, V, Silversides, J, Jonas, A, Szakmany, T, Vickers, E, Richards, J, Tham, L, Williams, D, Heenen, S, Hobrok, M, Walden, A, Raj, A, Bauer, P, Kashyap, R, Tolnai, P, Kjelle, B, Andersen, F, Palo, J, Namendys-Silva, S, Cecconi M., Hofer C., Teboul J. -L., Pettila V., Wilkman E., Molnar Z., Della Rocca G., Aldecoa C., Artigas A., Jog S., Sander M., Spies C., Lefrant J. -Y., De Backer D., Silva E., Zhang X., Ospina-Tascon G., Arias J., Gornik I., Benes J., Petersen A., Zsolt M., Sprung C., Koch M., Guttormsen A. B., Tavares M., Mikaszewska-Sokolewicz M., Bakker J., Parke R., Kirov M., Wernerman J., Esen F., Cannesson M., Njimi H., Francois G., Cueto G., Hockley S., Ambekar H., Laterre P. F., Dujardin M. F., Damas P., Deschamps P., Glorieux D., Hoste E., Miribung M., Devriendt J., Haentjens L., Biston P., Dugernier T., Bulpa P., Dive A., Debaveye Y., Franck S., Conde K., Morsch R., Ramos M., Dias F., Mataloun S., Mendes C., Silva F., Grion C., Knibel M., Yang C., Xiangyu Z., Cai G., Ortiz G., Yepes D., Londono Arcila H. F., Molina F., Pereira F., Sanchez-Galvez H. F., Benitez F., Arias Ortiz J., Gonzalez Rojas M., Cavric G., Lukic E., Zykova I., Freml P., Satinsky I., Suk P., Novak I., Balik M., Szturz P., Kratochvil M., Bestle M., Strange D. G., Perner A., Rasmussen B. S., Hauge J., Meldgaard M., Toome V., Kuitunen A., Varila S., Hovilehto S., Pulkkinen A., Kiviniemi O., Tallgren M., Laitio R., Mongardon N., Dhonneur G., Malledant Y., Lepouse C., Darmon M., Mira J. P., Chiche J. D., Joannes-Boyau O., Preau S., Larche J., Mottard N., Bengler C., Argaud L., Hamzaoui O., Desebbe O., Burtin P., Reignier J., Durand M., Guitard P. G., Asfar P., Guillot M., Boulain T., Mekontso Dessap A., Ducrocq N., Lakhal K., Gregoire C., Schmauss M., Zacharowski K., Meybohm P., Treskatsch S., Bloos F., van Huelst S., Baumann H., Kersten A., Goldmann A., Gkiokas G., Dimoula A., Kofinas G., Anthopoulos G., Pankotai B., Kopitko C., Gartner B., Schaffer E., Fulesdi B., Sarkany A., Samavedam S., Shah B., Dixit S., Toraskar K., Nandakumar S., Goila A. K., Nayyar A., Patel M., Mitra D., Jagiasi B., Jakkinaboina S., Goswami J., Ghosh S., Hashemian M., Mahmoodpoor A., Breen D., Benbenishty J., Kuniavsky M., Kolpak O., Castiglione G., Monti G., Molin A., Martucci G., Panarello G., Raineri S. M., Pota V., Acquarolo A., Ploner F., Lapichino G., Lombardo A., Roasio A., Cardelino S., Pignataro A., Oggioni R., Mangani V., Parrini V., Spadaro S., Volta C. A., Alampi D., Torrente S., Monastra L., Marini F., Mazzini P., Albanese D., Riccardi S., Ruberto F., Belluomo A. C., Silvestri R., Citerio G., Brienza N., Brazzi L., Protti A., Bottino N., David A., Manzoni D., Foti G., Numis F., Morimatsu H., Shimizu K., Munster L., Rai V., Buttigieg M., Pickkers P., Mijzen L., Kesecioglu J., Van Duijn D., Ormskerk P., Beck O., Goodson J., King B., Koelle J., Kantor S., Gomez O., Ramos I., Jedynak M., Sulkowski W., Adamik B., Chruscikowski M., Wadelek J., Korzybski J., Misiewska-Kaczur A., Piasecka-Twarog M., Fijaikowska A., Maciejewski D., Smiechowicz K., Milkowska E., Czerwinska A., Lukaszewska A., Wieczorek A., Czuczwar M., Czerwiec A., Tamowicz B., Branco V., Estilita J., Basilio C., Diogo C., Toma R., Bubenek-Turconi S. I., Filipescu D., Popescu M., Titova J., Belskiy V., Smetkin A., Grigoryev E., Pugachev S., Gasenkampf A., Abouelala A., Almekhlafi G., Rupnik E., Garcia-Delgado H., Saez Fernandez A., Celaya Lopez M., Ramasco F., Planas K., Zavala E., De Nadal M., Picos S. A., Fernandez S., Munoz A., Herrera Para L., Maseda E., Rovira A., Monge Garcia M. I., Ferrer R., Sole Violan J., Garcia Nogales X., Torrents E., Ripolles Melchor J., Tomas Marsilla J. I., Araujo Aguilar P., Aguilar G., Menor E. M., Martinez M. C., Leal Micharet A. M., Ferri Riera C., Mosquera D., Astola I., Freita-Ramos S., Garcia Olivares P., Jimenez Bartolome M. B., Fernandez Gonzalez I., Sanchez-Izquierdo J. A., Arribas P., Gimenez-Esparzavich C., Anglada M., Martin S., Weerakoon R. K., Bendjelid K., Fumeaux T., Maggiorini M., Demirkiran O., Adanir T., Ergin Ozcan P., Kelebek Girgin N., Elahi N., Kashef S., Alsabbah A., Lowe A., Wise M., Vizcaychipi M. P., Baht S., Webb S., Friis J., Boulanger C., Gratrix A., Harvey D., Ferguson A., Espie L., Toth-Tarsoly P., Lewis K., Shelley B., Thuerey J., Przemyslaw D., Ranganathan M., Hormis A., Spivey M., Henning J., Saveker R., Csabi P., Bland M., Barrera Groba C., Al-Subaie N., Thomson R., Hamilton M., Iannuccelli F., Roberts C., Sherwood N., Kasipandian V., Silversides J., Jonas A., Szakmany T., Vickers E., Richards J., Tham L., Williams D., Heenen S., Hobrok M., Walden A., Raj A., Bauer P., Kashyap R., Tolnai P., Kjelle B. J., Andersen F. H., Palo J. E., Namendys-Silva S. A., Cecconi, M, Hofer, C, Teboul, J, Pettila, V, Wilkman, E, Molnar, Z, Della Rocca, G, Aldecoa, C, Artigas, A, Jog, S, Sander, M, Spies, C, Lefrant, J, De Backer, D, Silva, E, Zhang, X, Ospina-Tascon, G, Arias, J, Gornik, I, Benes, J, Petersen, A, Zsolt, M, Sprung, C, Koch, M, Guttormsen, A, Tavares, M, Mikaszewska-Sokolewicz, M, Bakker, J, Parke, R, Kirov, M, Wernerman, J, Esen, F, Cannesson, M, Njimi, H, Francois, G, Cueto, G, Hockley, S, Ambekar, H, Laterre, P, Dujardin, M, Damas, P, Deschamps, P, Glorieux, D, Hoste, E, Miribung, M, Devriendt, J, Haentjens, L, Biston, P, Dugernier, T, Bulpa, P, Dive, A, Debaveye, Y, Franck, S, Conde, K, Morsch, R, Ramos, M, Dias, F, Mataloun, S, Mendes, C, Silva, F, Grion, C, Knibel, M, Yang, C, Xiangyu, Z, Cai, G, Ortiz, G, Yepes, D, Londono Arcila, H, Molina, F, Pereira, F, Sanchez-Galvez, H, Benitez, F, Arias Ortiz, J, Gonzalez Rojas, M, Cavric, G, Lukic, E, Zykova, I, Freml, P, Satinsky, I, Suk, P, Novak, I, Balik, M, Szturz, P, Kratochvil, M, Bestle, M, Strange, D, Perner, A, Rasmussen, B, Hauge, J, Meldgaard, M, Toome, V, Kuitunen, A, Varila, S, Hovilehto, S, Pulkkinen, A, Kiviniemi, O, Tallgren, M, Laitio, R, Mongardon, N, Dhonneur, G, Malledant, Y, Lepouse, C, Darmon, M, Mira, J, Chiche, J, Joannes-Boyau, O, Preau, S, Larche, J, Mottard, N, Bengler, C, Argaud, L, Hamzaoui, O, Desebbe, O, Burtin, P, Reignier, J, Durand, M, Guitard, P, Asfar, P, Guillot, M, Boulain, T, Mekontso Dessap, A, Ducrocq, N, Lakhal, K, Gregoire, C, Schmauss, M, Zacharowski, K, Meybohm, P, Treskatsch, S, Bloos, F, van Huelst, S, Baumann, H, Kersten, A, Goldmann, A, Gkiokas, G, Dimoula, A, Kofinas, G, Anthopoulos, G, Pankotai, B, Kopitko, C, Gartner, B, Schaffer, E, Fulesdi, B, Sarkany, A, Samavedam, S, Shah, B, Dixit, S, Toraskar, K, Nandakumar, S, Goila, A, Nayyar, A, Patel, M, Mitra, D, Jagiasi, B, Jakkinaboina, S, Goswami, J, Ghosh, S, Hashemian, M, Mahmoodpoor, A, Breen, D, Benbenishty, J, Kuniavsky, M, Kolpak, O, Castiglione, G, Monti, G, Molin, A, Martucci, G, Panarello, G, Raineri, S, Pota, V, Acquarolo, A, Ploner, F, Lapichino, G, Lombardo, A, Roasio, A, Cardelino, S, Pignataro, A, Oggioni, R, Mangani, V, Parrini, V, Spadaro, S, Volta, C, Alampi, D, Torrente, S, Monastra, L, Marini, F, Mazzini, P, Albanese, D, Riccardi, S, Ruberto, F, Belluomo, A, Silvestri, R, Citerio, G, Brienza, N, Brazzi, L, Protti, A, Bottino, N, David, A, Manzoni, D, Foti, G, Numis, F, Morimatsu, H, Shimizu, K, Munster, L, Rai, V, Buttigieg, M, Pickkers, P, Mijzen, L, Kesecioglu, J, Van Duijn, D, Ormskerk, P, Beck, O, Goodson, J, King, B, Koelle, J, Kantor, S, Gomez, O, Ramos, I, Jedynak, M, Sulkowski, W, Adamik, B, Chruscikowski, M, Wadelek, J, Korzybski, J, Misiewska-Kaczur, A, Piasecka-Twarog, M, Fijaikowska, A, Maciejewski, D, Smiechowicz, K, Milkowska, E, Czerwinska, A, Lukaszewska, A, Wieczorek, A, Czuczwar, M, Czerwiec, A, Tamowicz, B, Branco, V, Estilita, J, Basilio, C, Diogo, C, Toma, R, Bubenek-Turconi, S, Filipescu, D, Popescu, M, Titova, J, Belskiy, V, Smetkin, A, Grigoryev, E, Pugachev, S, Gasenkampf, A, Abouelala, A, Almekhlafi, G, Rupnik, E, Garcia-Delgado, H, Saez Fernandez, A, Celaya Lopez, M, Ramasco, F, Planas, K, Zavala, E, De Nadal, M, Picos, S, Fernandez, S, Munoz, A, Herrera Para, L, Maseda, E, Rovira, A, Monge Garcia, M, Ferrer, R, Sole Violan, J, Garcia Nogales, X, Torrents, E, Ripolles Melchor, J, Tomas Marsilla, J, Araujo Aguilar, P, Aguilar, G, Menor, E, Martinez, M, Leal Micharet, A, Ferri Riera, C, Mosquera, D, Astola, I, Freita-Ramos, S, Garcia Olivares, P, Jimenez Bartolome, M, Fernandez Gonzalez, I, Sanchez-Izquierdo, J, Arribas, P, Gimenez-Esparzavich, C, Anglada, M, Martin, S, Weerakoon, R, Bendjelid, K, Fumeaux, T, Maggiorini, M, Demirkiran, O, Adanir, T, Ergin Ozcan, P, Kelebek Girgin, N, Elahi, N, Kashef, S, Alsabbah, A, Lowe, A, Wise, M, Vizcaychipi, M, Baht, S, Webb, S, Friis, J, Boulanger, C, Gratrix, A, Harvey, D, Ferguson, A, Espie, L, Toth-Tarsoly, P, Lewis, K, Shelley, B, Thuerey, J, Przemyslaw, D, Ranganathan, M, Hormis, A, Spivey, M, Henning, J, Saveker, R, Csabi, P, Bland, M, Barrera Groba, C, Al-Subaie, N, Thomson, R, Hamilton, M, Iannuccelli, F, Roberts, C, Sherwood, N, Kasipandian, V, Silversides, J, Jonas, A, Szakmany, T, Vickers, E, Richards, J, Tham, L, Williams, D, Heenen, S, Hobrok, M, Walden, A, Raj, A, Bauer, P, Kashyap, R, Tolnai, P, Kjelle, B, Andersen, F, Palo, J, Namendys-Silva, S, Cecconi M., Hofer C., Teboul J. -L., Pettila V., Wilkman E., Molnar Z., Della Rocca G., Aldecoa C., Artigas A., Jog S., Sander M., Spies C., Lefrant J. -Y., De Backer D., Silva E., Zhang X., Ospina-Tascon G., Arias J., Gornik I., Benes J., Petersen A., Zsolt M., Sprung C., Koch M., Guttormsen A. B., Tavares M., Mikaszewska-Sokolewicz M., Bakker J., Parke R., Kirov M., Wernerman J., Esen F., Cannesson M., Njimi H., Francois G., Cueto G., Hockley S., Ambekar H., Laterre P. F., Dujardin M. F., Damas P., Deschamps P., Glorieux D., Hoste E., Miribung M., Devriendt J., Haentjens L., Biston P., Dugernier T., Bulpa P., Dive A., Debaveye Y., Franck S., Conde K., Morsch R., Ramos M., Dias F., Mataloun S., Mendes C., Silva F., Grion C., Knibel M., Yang C., Xiangyu Z., Cai G., Ortiz G., Yepes D., Londono Arcila H. F., Molina F., Pereira F., Sanchez-Galvez H. F., Benitez F., Arias Ortiz J., Gonzalez Rojas M., Cavric G., Lukic E., Zykova I., Freml P., Satinsky I., Suk P., Novak I., Balik M., Szturz P., Kratochvil M., Bestle M., Strange D. G., Perner A., Rasmussen B. S., Hauge J., Meldgaard M., Toome V., Kuitunen A., Varila S., Hovilehto S., Pulkkinen A., Kiviniemi O., Tallgren M., Laitio R., Mongardon N., Dhonneur G., Malledant Y., Lepouse C., Darmon M., Mira J. P., Chiche J. D., Joannes-Boyau O., Preau S., Larche J., Mottard N., Bengler C., Argaud L., Hamzaoui O., Desebbe O., Burtin P., Reignier J., Durand M., Guitard P. G., Asfar P., Guillot M., Boulain T., Mekontso Dessap A., Ducrocq N., Lakhal K., Gregoire C., Schmauss M., Zacharowski K., Meybohm P., Treskatsch S., Bloos F., van Huelst S., Baumann H., Kersten A., Goldmann A., Gkiokas G., Dimoula A., Kofinas G., Anthopoulos G., Pankotai B., Kopitko C., Gartner B., Schaffer E., Fulesdi B., Sarkany A., Samavedam S., Shah B., Dixit S., Toraskar K., Nandakumar S., Goila A. K., Nayyar A., Patel M., Mitra D., Jagiasi B., Jakkinaboina S., Goswami J., Ghosh S., Hashemian M., Mahmoodpoor A., Breen D., Benbenishty J., Kuniavsky M., Kolpak O., Castiglione G., Monti G., Molin A., Martucci G., Panarello G., Raineri S. M., Pota V., Acquarolo A., Ploner F., Lapichino G., Lombardo A., Roasio A., Cardelino S., Pignataro A., Oggioni R., Mangani V., Parrini V., Spadaro S., Volta C. A., Alampi D., Torrente S., Monastra L., Marini F., Mazzini P., Albanese D., Riccardi S., Ruberto F., Belluomo A. C., Silvestri R., Citerio G., Brienza N., Brazzi L., Protti A., Bottino N., David A., Manzoni D., Foti G., Numis F., Morimatsu H., Shimizu K., Munster L., Rai V., Buttigieg M., Pickkers P., Mijzen L., Kesecioglu J., Van Duijn D., Ormskerk P., Beck O., Goodson J., King B., Koelle J., Kantor S., Gomez O., Ramos I., Jedynak M., Sulkowski W., Adamik B., Chruscikowski M., Wadelek J., Korzybski J., Misiewska-Kaczur A., Piasecka-Twarog M., Fijaikowska A., Maciejewski D., Smiechowicz K., Milkowska E., Czerwinska A., Lukaszewska A., Wieczorek A., Czuczwar M., Czerwiec A., Tamowicz B., Branco V., Estilita J., Basilio C., Diogo C., Toma R., Bubenek-Turconi S. I., Filipescu D., Popescu M., Titova J., Belskiy V., Smetkin A., Grigoryev E., Pugachev S., Gasenkampf A., Abouelala A., Almekhlafi G., Rupnik E., Garcia-Delgado H., Saez Fernandez A., Celaya Lopez M., Ramasco F., Planas K., Zavala E., De Nadal M., Picos S. A., Fernandez S., Munoz A., Herrera Para L., Maseda E., Rovira A., Monge Garcia M. I., Ferrer R., Sole Violan J., Garcia Nogales X., Torrents E., Ripolles Melchor J., Tomas Marsilla J. I., Araujo Aguilar P., Aguilar G., Menor E. M., Martinez M. C., Leal Micharet A. M., Ferri Riera C., Mosquera D., Astola I., Freita-Ramos S., Garcia Olivares P., Jimenez Bartolome M. B., Fernandez Gonzalez I., Sanchez-Izquierdo J. A., Arribas P., Gimenez-Esparzavich C., Anglada M., Martin S., Weerakoon R. K., Bendjelid K., Fumeaux T., Maggiorini M., Demirkiran O., Adanir T., Ergin Ozcan P., Kelebek Girgin N., Elahi N., Kashef S., Alsabbah A., Lowe A., Wise M., Vizcaychipi M. P., Baht S., Webb S., Friis J., Boulanger C., Gratrix A., Harvey D., Ferguson A., Espie L., Toth-Tarsoly P., Lewis K., Shelley B., Thuerey J., Przemyslaw D., Ranganathan M., Hormis A., Spivey M., Henning J., Saveker R., Csabi P., Bland M., Barrera Groba C., Al-Subaie N., Thomson R., Hamilton M., Iannuccelli F., Roberts C., Sherwood N., Kasipandian V., Silversides J., Jonas A., Szakmany T., Vickers E., Richards J., Tham L., Williams D., Heenen S., Hobrok M., Walden A., Raj A., Bauer P., Kashyap R., Tolnai P., Kjelle B. J., Andersen F. H., Palo J. E., and Namendys-Silva S. A.

Abstract

Background: Fluid challenges (FCs) are one of the most commonly used therapies in critically ill patients and represent the cornerstone of hemodynamic management in intensive care units. There are clear benefits and harms from fluid therapy. Limited data on the indication, type, amount and rate of an FC in critically ill patients exist in the literature. The primary aim was to evaluate how physicians conduct FCs in terms of type, volume, and rate of given fluid; the secondary aim was to evaluate variables used to trigger an FC and to compare the proportion of patients receiving further fluid administration based on the response to the FC. Methods: This was an observational study conducted in ICUs around the world. Each participating unit entered a maximum of 20 patients with one FC. Results: 2213 patients were enrolled and analyzed in the study. The median [interquartile range] amount of fluid given during an FC was 500 ml (500–1000). The median time was 24 min (40–60 min), and the median rate of FC was 1000 [500–1333] ml/h. The main indication for FC was hypotension in 1211 (59 %, CI 57–61 %). In 43 % (CI 41–45 %) of the cases no hemodynamic variable was used. Static markers of preload were used in 785 of 2213 cases (36 %, CI 34–37 %). Dynamic indices of preload responsiveness were used in 483 of 2213 cases (22 %, CI 20–24 %). No safety variable for the FC was used in 72 % (CI 70–74 %) of the cases. There was no statistically significant difference in the proportion of patients who received further fluids after the FC between those with a positive, with an uncertain or with a negatively judged response. Conclusions: The current practice and evaluation of FC in critically ill patients are highly variable. Prediction of fluid responsiveness is not used routinely, safety limits are rarely used, and information from previous failed FCs is not always taken into account.

Published
2015

14. Comparison of equipressor doses of norepinephrine, epinephrine, and phenylephrine on septic myocardial dysfunction.

Author

Ducrocq N, Kimmoun A, Furmaniuk A, Hekalo Z, Maskali F, Poussier S, Marie PY, Levy B, Ducrocq, Nicolas, Kimmoun, Antoine, Furmaniuk, Anna, Hekalo, Zerin, Maskali, Fatiha, Poussier, Sylvain, Marie, Pierre-Yves, and Levy, Bruno

Abstract

Background: Myocardial depression is a frequent event during septic shock and may mimic a cardiogenic shock state with decreased cardiac output. Nevertheless, data are scarce regarding the myocardial effects of vasopressors used to treat hypotension. In this study, the authors compared the effects of three commonly used vasopressors acting on different adrenergic receptors on myocardial function in a rodent model of septic shock, as explored with conductance catheter and positron emission tomography. Methods: Septic shock was induced in rats by peritonitis. Eighteen hours after septic insult, vasopressors were titrated to increase mean arterial pressure by 20% compared with baseline values. Results: We observed that peritonitis was associated with arterial hypotension and systolodiastolic dysfunction. Norepinephrine and epinephrine improved mean arterial pressure, cardiac output, and preload recruitable stroke work, a load-independent measure of systolic function, as well as diastolic function and ventriculoarterial coupling. Heart rate, myocardial oxygen consumption, and arrhythmia incidence were furthermore increased in the epinephrine group. Conversely, phenylephrine, a peripheral α-agonist, exhibited deleterious effects on systolodiastolic function and ventriculoarterial coupling. Conductance catheter and positron emission tomography yielded identical results with regard to myocardial function evolution under vasopressor treatment. Conclusions: Phenylephrine, a drug without β-1 effects, was associated with decreased ventricular performance and ventriculoarterial uncoupling, whereas epinephrine and norepinephrine improved global hemodynamics and myocardial function in severely hypokinetic and hypotensive experimental septic shock. Nevertheless, epinephrine was associated with increased myocardial oxygen consumption. Thus, norepinephrine appears to be a more reliable and safer strategy as a first-line therapy in this particular setting. [ABSTRACT FROM AUTHOR]

Published
2012
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16. High-dynamic-range image readout system

Author

Mathae, J. C., primary, Ducrocq, N., primary, Mazataud, E., primary, Eouzan, J. Y., primary, Heurtaux, J. C., primary, Mens, Alain, primary, Mugnier, A., primary, and Tomasini, F., primary

Published
1991
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18. Critical Illness-Related Corticosteroid Insufficiency in Cardiogenic Shock Patients: Prevalence and Prognostic Role.

Author

Ducrocq N, Biferi P, Girerd N, Latar I, Lemoine S, Perez P, Thivilier C, Levy B, and Kimmoun A

Subjects
Aged, Critical Illness, Female, Humans, Hydrocortisone blood, Male, Middle Aged, Prospective Studies, Sepsis blood, Sepsis drug therapy, Adrenal Cortex Hormones blood, Cosyntropin therapeutic use, Shock, Cardiogenic blood, Shock, Cardiogenic drug therapy
Abstract

Background: Cardiogenic shock shares with septic shock common hemodynamic features, inflammatory patterns, and most likely similar complications such as critical illness-related corticosteroid insufficiency. The aim of this study was to evaluate the prevalence of critical illness-related corticosteroid insufficiency in cardiogenic shock patients and to secondarily assess its prognostic value on 90-day mortality., Methods: A single-center prospective observational study conducted over a 3-year period and including all patients with cardiogenic shock. Main exclusion criteria were patients with prior cardiac arrest, sepsis, ongoing corticosteroid therapy, and etomidate administration. A short corticotropin test was performed in the first 24 h following admission. Serum cortisol levels were measured before (T0) and 60 min (T60) after administration of 250 μg of cosyntropin. Critical illness-related corticosteroid insufficiency was defined according to the 2017 consensus definition (basal total cortisol<10 μg·dL or a delta cortisol T60-T0<9 μg·dL) as well as the thresholds published in 2016 in cardiogenic shock patients associated with worst prognosis (basal total cortisol>29 μg·dL and delta cortisol T60-T0<17 μg·dL)., Results: Seventy-nine consecutive patients hospitalized in intensive care for cardiogenic shock met the inclusion criteria. Overall mortality was 43% at day 90. Forty-two percent had critical illness-related corticosteroid insufficiency using the 2017 consensus definition and 32% using the 2016 cardiogenic shock thresholds. Presence of critical illness-related corticosteroid insufficiency was not an independent factor associated with 90-day mortality irrespective of the thresholds used., Conclusion: Critical illness-related corticosteroid insufficiency is a frequent occurrence in medical cardiogenic shock. However, in this study, such insufficiency was not associated with prognosis.

Published
2018
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20. Moderate Hypothermia Improves Cardiac and Vascular Function in a Pig Model of Ischemic Cardiogenic Shock Treated With Veno-Arterial ECMO.

Author

Vanhuyse F, Ducrocq N, Louis H, Kattani NA, Laurent N, Joineau-Groubatch F, Falanga A, Maureira JP, Kimmoun A, Girerd N, Tran N, and Levy B

Subjects
Animals, Blotting, Western, Hemodynamics physiology, Interleukin-10 blood, Interleukin-6 blood, Norepinephrine therapeutic use, Swine, Thrombelastography, Tumor Necrosis Factor-alpha blood, Extracorporeal Membrane Oxygenation methods, Hypothermia, Induced methods, Shock, Cardiogenic therapy
Abstract

Cardiogenic shock (CS) patients treated with extracorporeal membrane oxygenation (ECMO) have severe cardiac failure, associated with ischemia-reperfusion. The use of moderate hypothermia during ischemia-reperfusion syndrome is supported by experimental data. We therefore studied the effects of moderate hypothermia on cardiac and vascular function in pig ischemic CS treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO). CS was induced in 12 anesthetized pigs by coronary ligation. After 1 h of CS, VA-ECMO was initiated and pigs were randomized to normothermia (38°C) or moderate hypothermia (34°C) during 8 h. Intrinsic cardiac function was measured using a left ventricular conductance catheter. At the end of the experiment, tissues were harvested for Western blotting. ECMO associated with norepinephrine infusion and volume resuscitation increased mean arterial pressure, mixed venous oxygen saturation as well as carotid, renal, and coronary blood flow without any differences between normothermia and hypothermia. Hypothermia was associated with less fluid and less norepinephrine infusion, lower lactate level, and higher urinary output. Vascular reactivity was superior in hypothermia comparatively to normothermia as expressed using norepinephrine dose-response curves. Pressure development during isovolumic contraction, left ventricular ejection fraction, and prerecruitable stroke work index were higher in the hypothermia group. There were no differences between normothermia and hypothermia with regard to carotid and mesenteric protein expression for iNOs, eNOS, and phospho AKt/AKt measured at the end of the experimentation. The incidence of surgical bleeding and coagulation disorders was the same in both groups. In conclusion, moderate and rapid hypothermia improves hemodynamics and cardiac and vascular function in a pig model of ischemic CS treated with ECMO.

Published
2017
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21. Beneficial Effects of Norepinephrine Alone on Cardiovascular Function and Tissue Oxygenation in a Pig Model of Cardiogenic Shock.

Author

Beurton A, Ducrocq N, Auchet T, Joineau-Groubatch F, Falanga A, Kimmoun A, Girerd N, Fay R, Vanhuyse F, Tran N, and Levy B

Subjects
Animals, Arterial Pressure drug effects, Blood Pressure drug effects, Cardiac Output drug effects, Heart Rate drug effects, Hemodynamics drug effects, Male, Oxygen Consumption drug effects, Swine, Ventricular Function, Left drug effects, Norepinephrine therapeutic use, Shock, Cardiogenic drug therapy
Abstract

Introduction: The present study was developed to investigate the effects of norepinephrine alone on hemodynamics and intrinsic cardiac function in a pig model of cardiogenic shock mimicking the clinical setting., Methods: Cardiogenic shock was induced by 1-h ligation of the left anterior descending (LAD) artery followed by reperfusion. Pigs were monitored with a Swan-Ganz catheter, a transpulmonary thermodilution catheter, and a conductance catheter placed in the left ventricle for pressure-loop measurements. Measurements were performed before LAD occlusion, 1 h after LAD occlusion, and 4 h after myocardial reperfusion., Results: Myocardial infarction and reperfusion was followed by cardiogenic shock characterized by a significant increase in heart rate and significant decreases in mean arterial pressure (MAP), mixed venous oxygen saturation (SVO2), left ventricular end-diastolic pressure (LVEDP), prerecruitable stroke work (PRSW), and cardiac power index (CPI). Lactate levels were significantly increased. The systemic vascular resistance index (SVRI) and global end-diastolic volume index (GEDVI) remained unchanged. When compared with the control group (n = 6), norepinephrine infusion (n = 6) was associated with no changes in heart rate, a significant increase in MAP, SVO2, left ventricular ejection fraction, pressure development during isovolumic contraction, SVRI, and CPI and a decrease in lactate level. Cardiac index tended to increase (P = 0.059), whereas PRSW did not change in the norepinephrine group. LVEDP and GEDVI remained unchanged., Conclusions: Norepinephrine alone is able to improve hemodynamics, cardiac function, and tissue oxygenation in a pig model of ischemic cardiogenic shock.

Published
2016
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22. Outcomes of patients admitted to intensive care units for acute manifestation of small-vessel vasculitis: a multicenter, retrospective study.

Author

Kimmoun A, Baux E, Das V, Terzi N, Talec P, Asfar P, Ehrmann S, Geri G, Grange S, Anguel N, Demoule A, Moreau AS, Azoulay E, Quenot JP, Boisramé-Helms J, Louis G, Sonneville R, Girerd N, Ducrocq N, Agrinier N, Wahl D, Puéchal X, and Levy B

Subjects
Aged, Female, France, Humans, Male, Middle Aged, Prognosis, Retrospective Studies, Hospital Mortality, Intensive Care Units statistics & numerical data, Patient Outcome Assessment, Vasculitis mortality
Abstract

Background: The outcomes of patients admitted to the intensive care unit (ICU) for acute manifestation of small-vessel vasculitis are poorly reported. The aim of the present study was to determine the mortality rate and prognostic factors of patients admitted to the ICU for acute small-vessel vasculitis., Methods: This retrospective, multicenter study was conducted from January 2001 to December 2014 in 20 ICUs in France. Patients were identified from computerized registers of each hospital using the International Classification of Diseases, Ninth Revision (ICD-9). Inclusion criteria were (1) known or highly suspected granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis, microscopic polyangiitis (respectively, ICD-9 codes M31.3, M30.1, and M31.7), or anti-glomerular basement membrane antibody disease (ICD-9 codes N08.5X-005 or M31.0+); (2) admission to the ICU for the management of an acute manifestation of vasculitis; and (3) administration of a cyclophosphamide pulse in the ICU or within 48 h before admission to the ICU. The primary endpoint was assessment of mortality rate 90 days after admission to the ICU., Results: Eighty-two patients at 20 centers were included, 94% of whom had a recent (<6 months) diagnosis of small-vessel vasculitis. Forty-four patients (54%) had granulomatosis with polyangiitis. The main reasons for admission were respiratory failure (34%) and pulmonary-renal syndrome (33%). Mechanical ventilation was required in 51% of patients, catecholamines in 31%, and renal replacement therapy in 71%. Overall mortality at 90 days was 18% and the mortality in ICU was 16 %. The main causes of death in the ICU were disease flare in 69% and infection in 31%. In univariable analysis, relevant factors associated with death in nonsurvivors compared with survivors were Simplified Acute Physiology Score II (median [interquartile range] 51 [38-82] vs. 36 [27-42], p = 0.005), age (67 years [62-74] vs. 58 years [40-68], p < 0.003), Sequential Organ Failure Assessment score on the day of cyclophosphamide administration (11 [6-12] vs. 6 [3-7], p = 0.0004), and delayed administration of cyclophosphamide (5 days [3-14] vs. 2 days [1-5], p = 0.0053)., Conclusions: Patients admitted to the ICU for management of acute small-vessel vasculitis benefit from early, aggressive intensive care treatment, associated with an 18% death rate at 90 days.

Published
2016
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23. Hemodynamic consequences of severe lactic acidosis in shock states: from bench to bedside.

Author

Kimmoun A, Novy E, Auchet T, Ducrocq N, and Levy B

Subjects
Acidosis, Lactic epidemiology, Acidosis, Lactic mortality, Carbon Dioxide adverse effects, Hospital Mortality, Humans, Shock epidemiology, Shock mortality, Sodium Bicarbonate therapeutic use, Acidosis, Lactic complications, Hemodynamics physiology, Shock complications
Abstract

Lactic acidosis is a very common biological issue for shock patients. Experimental data clearly demonstrate that metabolic acidosis, including lactic acidosis, participates in the reduction of cardiac contractility and in the vascular hyporesponsiveness to vasopressors through various mechanisms. However, the contributions of each mechanism responsible for these deleterious effects have not been fully determined and their respective consequences on organ failure are still poorly defined, particularly in humans. Despite some convincing experimental data, no clinical trial has established the level at which pH becomes deleterious for hemodynamics. Consequently, the essential treatment for lactic acidosis in shock patients is to correct the cause. It is unknown, however, whether symptomatic pH correction is beneficial in shock patients. The latest Surviving Sepsis Campaign guidelines recommend against the use of buffer therapy with pH ≥7.15 and issue no recommendation for pH levels <7.15. Furthermore, based on strong experimental and clinical evidence, sodium bicarbonate infusion alone is not recommended for restoring pH. Indeed, bicarbonate induces carbon dioxide generation and hypocalcemia, both cardiovascular depressant factors. This review addresses the principal hemodynamic consequences of shock-associated lactic acidosis. Despite the lack of formal evidence, this review also highlights the various adapted supportive therapy options that could be putatively added to causal treatment in attempting to reverse the hemodynamic consequences of shock-associated lactic acidosis.

Published
2015
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25. Efficient extra- and intracellular alkalinization improves cardiovascular functions in severe lactic acidosis induced by hemorrhagic shock.

Author

Kimmoun A, Ducrocq N, Sennoun N, Issa K, Strub C, Escanyé JM, Leclerc S, and Levy B

Subjects
Acidosis, Lactic physiopathology, Adrenergic alpha-Agonists administration & dosage, Animals, Blood Transfusion methods, Calcium administration & dosage, Disease Models, Animal, Heart physiopathology, Hydrogen-Ion Concentration drug effects, Hyperventilation therapy, Magnetic Resonance Spectroscopy methods, Male, Norepinephrine administration & dosage, Random Allocation, Rats, Rats, Wistar, Severity of Illness Index, Shock, Hemorrhagic physiopathology, Acidosis, Lactic drug therapy, Acidosis, Lactic etiology, Heart drug effects, Shock, Hemorrhagic complications, Sodium Bicarbonate therapeutic use
Abstract

Background: Lactic acidosis is associated with cardiovascular failure. Buffering with sodium bicarbonate is proposed in severe lactic acidosis. Bicarbonate induces carbon dioxide generation and hypocalcemia, both cardiovascular depressant factors. The authors thus investigated the cardiovascular and metabolic effects of an adapted sodium bicarbonate therapy, including prevention of carbon dioxide increase with hyperventilation and ionized calcium decrease with calcium administration., Methods: Lactic acidosis was induced by hemorrhagic shock. Twenty animals were randomized into five groups: (1) standard resuscitation with blood retransfusion and norepinephrine (2) adapted sodium bicarbonate therapy (3) nonadapted sodium bicarbonate therapy (4) standard resuscitation plus calcium administration (5) hyperventilation. Evaluation was focused in vivo on extracellular pH, on intracellular pH estimated by P nuclear magnetic resonance and on myocardial contractility by conductance catheter. Aortic rings and mesenteric arteries were isolated and mounted in a myograph, after which arterial contractility was measured., Results: All animals in the hyperventilation group died prematurely and were not included in the statistical analysis. When compared with sham rats, shock induced extracellular (median, 7.13; interquartile range, [0.10] vs. 7.30 [0.01]; P = 0.0007) and intracellular acidosis (7.26 [0.18] vs. 7.05 [0.13]; P = 0.0001), hyperlactatemia (7.30 [0.01] vs. 7.13 [0.10]; P = 0.0008), depressed myocardial elastance (2.87 [1.31] vs. 0.5 [0.53] mmHg/μl; P = 0.0001), and vascular hyporesponsiveness to vasoconstrictors. Compared with nonadapted therapy, adapted bicarbonate therapy normalized extracellular pH (7.03 [0.12] vs. 7.36 [0.04]; P < 0.05), increased intracellular pH to supraphysiological values, improved myocardial elastance (1.68 [0.41] vs. 0.72 [0.44] mmHg/μl; P < 0.05), and improved aortic and mesenteric vasoreactivity., Conclusions: A therapeutic strategy based on alkalinization with sodium bicarbonate along with hyperventilation and calcium administration increases pH and improves cardiovascular function.

Published
2014
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26. Prone positioning use to hasten veno-venous ECMO weaning in ARDS.

Author

Kimmoun A, Guerci P, Bridey C, Ducrocq N, Vanhuyse F, and Levy B

Subjects
Adult, Bronchoscopy methods, Central Nervous System Diseases complications, Female, Humans, Lung Diseases, Interstitial complications, Lung Diseases, Interstitial diagnostic imaging, Overweight complications, Pulmonary Atelectasis diagnostic imaging, Respiratory Distress Syndrome diagnostic imaging, Respiratory Distress Syndrome etiology, Sarcoidosis complications, Tomography, X-Ray Computed, Treatment Outcome, Extracorporeal Membrane Oxygenation methods, Lung Diseases, Interstitial drug therapy, Prone Position physiology, Pulmonary Atelectasis etiology, Pulmonary Atelectasis therapy, Respiration, Artificial methods, Respiratory Distress Syndrome therapy
Published
2013
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27. Lactate or ScvO2 as an endpoint in resuscitation of shock states?

Author

Ducrocq N, Kimmoun A, and Levy B

Subjects
Humans, Hypoxia blood, Prognosis, Shock, Septic blood, Shock, Septic therapy, Endpoint Determination, Lactic Acid blood, Oxygen blood, Resuscitation methods, Shock therapy
Abstract

In the current management of critically ill patients, variables such as blood pressure, urine output or central venous pressure guide resuscitative efforts. Unfortunately, global tissue hypoxia may persist leading to multiple organ failure and death. To address tissue well-being, indices such as central venous oxygen saturation (ScvO2) and Lactatemia are widely used and are strongly linked to outcome. Implementing these indices in haemodynamic optimization protocols have been shown to reduce morbidity and mortality in numerous studies especially in septic shock. Nevertheless, choosing one index over the other remains controversial. Herein, we review the physiology and rationale for ScvO2 and lactate monitoring. Clinical uses, evidence-based outcome implications and limitations are also examined to aid the clinician in daily practice.

Published
2013

28. Mechanisms of vascular hyporesponsiveness in septic shock.

Author

Kimmoun A, Ducrocq N, and Levy B

Subjects
Animals, Catecholamines history, Catecholamines physiology, History, 20th Century, History, 21st Century, Humans, Nitric Oxide history, Nitric Oxide physiology, Potassium Channels history, Potassium Channels physiology, Shock, Septic metabolism, Shock, Septic physiopathology, Vasopressins history, Vasopressins physiology, Shock, Septic history, Vasoconstrictor Agents history
Abstract

Purpose: To define some of the most common characteristics of vascular hyporesponsiveness to catecholamines during septic shock and outline current therapeutic approaches and future perspectives., Methods: Source data were obtained from a PubMed search of the medical literature with the following MeSH terms: Muscle, smooth, vascular/physiopathology; hypotension/etiology; shock/physiopathology; vasodilation/physiology; shock/therapy; vasoconstrictor agents., Results: NO and peroxynitrite are mainly responsible for vasoplegia and vascular hyporeactivity while COX 2 enzyme is responsible for the increase in PGI2, which also contributes to hyporeactivity. Moreover, K+ATP and BKCa channels are over-activated during septic shock and participate in hypotension. Finally, other mechanisms are involved in vascular hyporesponsiveness such as critical illness-related corticosteroid insufficiency, vasopressin depletion, dysfunction and desensitization of adrenoreceptors as well as inactivation of catecholamines by oxidation., Conclusion: In animal models, several therapeutic approaches, targeted on one particular compound have proven their efficacy in preventing or reversing vascular hyporesponsiveness to catecholamines. Unfortunately, none have been successfully tested in clinical trials. Nevertheless, very high doses of catecholamines ( > 5 μg/kg/min), hydrocortisone, terlipressin or vasopressin could represent an alternative for the treatment of refractory septic shock.

Published
2013

29. Cardiac contractile reserve parameters are related to prognosis in septic shock.

Author

Kimmoun A, Ducrocq N, Mory S, Delfosse R, Muller L, Perez P, Fay R, and Levy B

Subjects
Adult, Aged, Aged, 80 and over, Cardiotonic Agents, Female, Heart Failure blood, Heart Failure pathology, Humans, Intensive Care Units, Kaplan-Meier Estimate, Male, Middle Aged, Multivariate Analysis, Oxygen Consumption, Phosphoprotein Phosphatases blood, Shock, Septic blood, Shock, Septic pathology, Heart Failure mortality, Hemodynamics, Prognosis, Shock, Septic mortality
Abstract

Introduction: Cardiac reserve could be defined as the spontaneous magnitude from basal to maximal cardiac power under stress conditions. The aim of this study was to evaluate the prognostic value of cardiac reserve parameters in resuscitated septic shock patients., Methods: Seventy patients with septic shock were included in a prospective and observational study. Prior to inclusion, patients were resuscitated to reach a mean arterial pressure of 65-75 mmHg with an euvolemic status. General, hemodynamic, and cardiac reserve-related parameters (cardiac index, double product, and cardiac power index) were collected at inclusion and at day 1., Results: Seventy patients were included with 28-day mortality at 38.5%. Ten of the 70 patients died during the first day. In multivariate analysis, independent predictors of death were SAPS II ≥ 58 (OR: 3.36 [1.11-10.17]; P = 0.032), a high double product at inclusion (OR [95% IC]: 1.20 [1.00-1.45] per 10(3) mmHg · min; P = 0.047), and at day 1, a decrease in cardiac index (1.30 [1.08-1.56] per 0.5 L/min/m(2); P = 0.007) or cardiac power index (1.84 [1.18-2.87] per 0.1 W/m(2), P = 0.008)., Conclusion: In the first 24 hours, parameters related to cardiac reserve, such as double product and cardiac index evolution, provide crucial and easy to achieve hemodynamic physiological information, which may impact the outcome.

Published
2013
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30. New conclusive data on human myocardial dysfunction induced by acidosis.

Author

Kimmoun A, Ducrocq N, and Levy B

Subjects
Female, Humans, Male, Acidosis physiopathology, Heart physiopathology, Heart Failure physiopathology, Myocardial Contraction physiology, Receptors, Adrenergic, beta physiology
Abstract

Acidosis is one of the major consequences of hemodynamic instability in shock state patients directly associated with multiple organ failure evolution and death. Most studies on the hemodynamic consequences of acidosis have been experimental, nonhuman studies with severe acidosis, and thus far from the most common clinical situations. Schotola and colleagues offer a new approach to human failing myocardium where the authors highlight, ex vivo, the deleterious hemodynamic consequences of mild acidosis. Their work strengthens the current view of the urgent need to discover new efficient and nondeleterious therapy for the treatment of acidosis.

Published
2012
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31. [Nursing management of ventilation and sedation in patients suffering from septic shock].

Author

Bridey C, Mathieu S, Steiger M, Trari V, Lavoivre C, Ducrocq N, Levy B, Gérard A, and Augros J

Subjects
Humans, Hypnotics and Sedatives therapeutic use, Respiration, Artificial nursing, Shock, Septic nursing
Abstract

A significant number of intubated, ventilated and sedated patients suffering from septic shock develop acute respiratory distress syndrome (ARDS). The supervision by a multidisciplinary team optimises both the management of ventilation and the sedation analgesia of the patient. The nursing supervision and care related to this pathology are specific.

Published
2012

32. [The pathophysiology of septic shock].

Author

Ducrocq N, Bridey C, and Lévy B

Subjects
Humans, Shock, Septic physiopathology
Abstract

Understanding of the pathophysiology of septic shock has benefitted from recent advances. These advances enable the validation of current treatment but also the development of new therapeutic approaches.

Published
2012

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