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278 results on '"Giraud, Raphaël"'

1. Highly sensitive ultra-high-performance liquid chromatography coupled with tandem mass spectrometry method for the multiplex analysis of levosimendan and its metabolites OR-1855 and OR-1896 in human plasma

Author

Bertin, Stéphane, Versace, François, Mercier, Thomas, Murisier, Amarande, Sauvain, Geraldine, Haefliger, David, Girardin, François R., Perez, Maria-Helena, Giraud, Raphaël, Schneider, Antoine, Buclin, Thierry, Decosterd, Laurent A., Choong, Eva, and Livio, Françoise

Published
2025
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21. Preparedness and Reorganization of Care for Coronavirus Disease 2019 Patients in a Swiss ICU: Characteristics and Outcomes of 129 Patients

Author

Primmaz, Steve, Le Terrier, Christophe, Suh, Noémie, Ventura, François, Boroli, Filippo, Bendjelid, Karim, Cereghetti, Sara, Giraud, Raphaël, Heidegger, Claudia, Pugin, Deborah, Siegenthaler, Nils, Tassaux, Didier, Cabrol, Jean-Clément, Dolet, Nathan, Ellenberger, Christoph, Keli Barcelos, Gleicy, Licker, Marc-Joseph, Savoldelli, Georges, Schiffer, Eduardo, Gayet-Ageron, Angèle, Kaiser, Laurent, Tramèr, Martin R., and Pugin, Jérôme

Published
2020
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25. Improved Extracorporeal Cardiopulmonary Resuscitation (ECPR) Outcomes are Associated with a Restrictive Patient Selection Algorithm.

Author

Assouline, Benjamin, Mentha, Nathalie, Wozniak, Hannah, Donner, Viviane, Looyens, Carole, Suppan, Laurent, Larribau, Robert, Banfi, Carlo, Bendjelid, Karim, and Giraud, Raphaël

Subjects
PATIENT selection, CARDIOPULMONARY resuscitation, TECHNOLOGICAL innovations, ALGORITHMS, CARDIAC arrest
Abstract

Introduction: Out-of-hospital cardiac arrest (OHCA) is a leading cause of mortality. Despite decades of intensive research and several technological advancements, survival rates remain low. The integration of extracorporeal cardiopulmonary resuscitation (ECPR) has been recognized as a promising approach in refractory OHCA. However, evidence from recent randomized controlled trials yielded contradictory results, and the criteria for selecting eligible patients are still a subject of debate. Methods: This study is a retrospective analysis of refractory OHCA patients treated with ECPR. All adult patients who received ECPR, according to the hospital algorithm, from 2013 to 2021 were included. Two different algorithms were used during this period. A "permissive" algorithm was used from 2013 to mid-2016. Subsequently, a revised algorithm, more "restrictive", based on international guidelines, was implemented from mid-2016 to 2021. Key differences between the two algorithms included reducing the no-flow time from less than three minutes to zero minutes (implying that the cardiac arrests must occur in the presence of a witness with immediate CPR initiation), reducing low-flow duration from 100 to 60 min, and lowering the age limit from 65 to 55 years. The aim of this study is to compare these two algorithms (permissive (1) and restrictive (2)) to determine if the use of a restrictive algorithm was associated with higher survival rates. Results: A total of 48 patients were included in this study, with 23 treated under Algorithm 1 and 25 under Algorithm 2. A significant difference in survival rate was observed in favor of the restrictive algorithm (9% vs. 68%, p < 0.05). Moreover, significant differences emerged between algorithms regarding the no-flow time (0 (0–5) vs. 0 (0–0) minutes, p < 0.05). Survivors had a significantly shorter no-flow and low-flow time (0 (0–0) vs. 0 (0–3) minutes, p < 0.01 and 40 (31–53) vs. 60 (45–80) minutes, p < 0.05), respectively. Conclusion: The present study emphasizes that a stricter selection of OHCA patients improves survival rates in ECPR. [ABSTRACT FROM AUTHOR]

Published
2024
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40. Testbed design for in-vitro characterisation of biomimetic vocal folds

Author

Giraud, Raphaël, Yousefi-Mashouf, Hamid, Luizard, Paul, Bailly, Lucie, Orgéas, Laurent, Laval, Xavier, Henrich Bernardoni, Nathalie, GIPSA - Analyse et Modification de l'homme en mouvement : biomécanique, cognition, vocologie (GIPSA-MOVE), GIPSA Pôle Sciences des Données (GIPSA-PSD), Grenoble Images Parole Signal Automatique (GIPSA-lab), Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA)-Grenoble Images Parole Signal Automatique (GIPSA-lab), Université Grenoble Alpes (UGA), Laboratoire sols, solides, structures - risques [Grenoble] (3SR), GIPSA-Services (GIPSA-Services), Universita Degli Studi Firenze, and ANR-17-CE19-0015,MicroVoice,De la microstructure fibreuse du tissu vocal à la biomécanique phonatoire : conception d'un nouvel oscillateur biomimétique(2017)

Subjects
in vitro testbed, [SPI.ACOU]Engineering Sciences [physics]/Acoustics [physics.class-ph], self-oscillation, vocal fold, biomimetic vocal fold, [SPI.MECA.BIOM]Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph], [SHS.LANGUE]Humanities and Social Sciences/Linguistics, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing
Abstract

International audience; An in-vitro testbed was designed to study the vibromechanical behaviour of biomimetic and extensible vocal folds. The paper describes the several steps of its conception. It consists of a deformable laryngeal envelope in which stretchable vocal-fold replicas of adjustable material and structural properties can be inserted for testing. The folds are able to oscillate for a wide range of aerodynamic conditions and material elongations.

Published
2021

42. Hydrogels oscillants en interaction fluide/structure : vers le design de plis vocaux biomimétiques

Author

Yousefi-Mashouf, Hamid, Luizard, Paul, Giraud, Raphaël, Bailly, Lucie, Orgéas, Laurent, Henrich Bernardoni, Nathalie, Laboratoire sols, solides, structures - risques [Grenoble] (3SR), Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA), GIPSA - Analyse et Modification de l'homme en mouvement : biomécanique, cognition, vocologie (GIPSA-MOVE), GIPSA Pôle Sciences des Données (GIPSA-PSD), Grenoble Images Parole Signal Automatique (GIPSA-lab), Université Grenoble Alpes (UGA)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA)-Grenoble Images Parole Signal Automatique (GIPSA-lab), and ANR-17-CE19-0015,MicroVoice,De la microstructure fibreuse du tissu vocal à la biomécanique phonatoire : conception d'un nouvel oscillateur biomimétique(2017)

Subjects
hydrogels oscillants, [SPI.ACOU]Engineering Sciences [physics]/Acoustics [physics.class-ph], [SPI.MECA.BIOM]Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph], [SHS.LANGUE]Humanities and Social Sciences/Linguistics, plis vocaux, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, interaction fluide/structure
Abstract

National audience; En cas de cancers laryngés avancés, la restauration des capacités phonatoires des patients par des implants artificiels capables de mimer les vibrations des plis vocaux reste un défi scientifique, clinique et sociétal. Ce défi nécessite le développement de matériaux capables d'imiter les caractéristiques vibromécaniques des plis vocaux humains ou “cordes vocales” : capacités (i) d’endurer de grandes déformations réversibles sous chargements multiaxiaux, (ii) de vibrer dans une large gamme de fréquences fondamentales (50 à 1500 Hz). Les hydrogels sont des candidats attrayants en raison de leurs propriétés élastiques ajustables, et de leur teneur en eau comparable à celle des tissus. Cependant, leurs propriétés vibratoires restent peu étudiées à ce jour, ou dans des configurations mécaniques encore bien éloignées de la réalité physiologique. L’objectif de ce travail est d’élaborer des hydrogels aux propriétés mécaniques contrôlées, capables de reproduire les auto-oscillations caractéristiques du pli vocal humain en interaction fluide/structure.

Published
2021

43. A Dedicated Expert ECMO-Team and Strict Patient Selection Improve Survival of Patients with Severe SARS-CoV-2 ARDS Supported by VV-ECMO.

Author

Giraud, Raphaël, Wozniak, Hannah, Donner, Viviane, Looyens, Carole, Assouline, Benjamin, and Bendjelid, Karim

Subjects
*PATIENT selection, *OVERALL survival, *ADULT respiratory distress syndrome, *VENTILATOR-associated pneumonia, *COVID-19 pandemic, *PRESSURE ulcers
Abstract

The SARS-CoV-2 pandemic has overwhelmed health care systems worldwide since its first wave. Intensive care units have been under a significant amount of pressure as patients with the most severe form of the disease presented with acute respiratory distress syndrome (ARDS). A proportion of them experienced refractory acute respiratory failure and had to be supported with veno-venous extracorporeal membrane oxygenation (VV-ECMO). The present retrospective study reports the experiences of our ECMO center in the management of COVID-19 patients with refractory ARDS. Patient characteristics and outcomes are presented through the different waves of the pandemic. A cohort study was conducted on patients with refractory ARDS due to COVID-19 infection who were admitted to the intensive care unit (ICU) at the Geneva University Hospital and supported with VV-ECMO between 14 March 2020 and January 2022. The VV-ECMO implementation criteria were defined according to an institutional algorithm validated by the local crisis unit of the hospital and the Swiss Society of Intensive Care Medicine. Among the 500 ARDS patients admitted to our ICU, 41 patients with a median age of 57 (52–63) years, a body mass index (BMI) of 28 (26–32) kg/m2, and a SAPS II score of 57 (47–67), and 27 (66%) of whom were men required VV-ECMO. None of the patients were vaccinated. The time of ventilation, including noninvasive ventilation (NIV) and mechanical ventilation (MV), and the time of MV before ECMO were 7 (4–11) days and 4 (1–7) days, respectively. The time under ECMO was 20 (10–27) days. The ICU and hospital lengths of stay were 36 (21–45) days and 45 (33–69) days, respectively. The survival rate for patients on ECMO was 59%. Comparative analysis between survivors and non-survivors highlighted that survivors had a significantly shorter ventilation duration before ECMO (NIV + MV: 5.5 (1.3–9) vs. 9 (6.5–13.5) days, p = 0.0026 and MV alone: 1.6 (0.4–5.5) vs. 5.8 (5–8) days, p < 0.0001). The management of patients on ECMO by an experienced ECMO team dedicated to this activity was associated with improved survival (78% vs. 28%, p = 0.0012). Between the first wave and the following waves, patients presented with a higher incidence of ventilator-associated pneumonia (100% vs. 82%, p = 0.0325) but had better survival rates (74% vs. 35%, p = 0.024). The present study suggests that both the prompt insertion of VV-ECMO to control refractory hypoxemia and the involvement of an ECMO team improve the survival of COVID-19 patients. [ABSTRACT FROM AUTHOR]

Published
2023
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47. Extracorporeal life support in COVID‐19‐related acute respiratory distress syndrome: A EuroELSO international survey

Author

Mang, Sebastian, Kalenka, Armin, Broman, Lars Mikael, Supady, Alexander, Swol, Justyna, Danziger, Guy, Becker, André, Hörsch, Sabrina, Mertke, Thilo, Kaiser, Ralf, Bracht, Hendrik, Zotzmann, Viviane, Seiler, Frederik, Bals, Robert, Taccone, Fabio Silvio, Moerer, Onnen, Lorusso, Roberto, Bělohlávek, Jan, Muellenbach, Ralf, Lepper, Philipp, Barrett, Nicholas, Duerschmied, Daniel, Fan, Eddy, Fichtner, Falk, Haake, Hendrik, Langer, Frank, Mutlak, Haitham, Kredel, Markus, Müller, Thomas, Protti, Alessandro, Raddatz, Alexander, Spangenberg, Tobias, Staudacher, Dawid, Wehrfritz, Holger, Wengenmayer, Tobias, Westheider, Arne, Dang Van, Simon, Daubin, Cedric, Gaudard, Philippe, Godet, Thomas, Guinot, Pierre‐Grégoire, Le Guennec, Loïc, Megarbane, Bruno, Mercat, Alain, Sonneville, Romain, Zogheib, Elie, Pham, Tai, Winiszewski, Hadrien, Schellongowski, Peter, Staudinger, Thomas, Wiedemann, Dominik, Velik‐Salchner, Corinna, Joannidis, Michael, Bodenstein, Marc, Groesdonk, Heinrich Volker, Guth, Stefan, Hecker, Matthias, Husain‐Syed, Faeq, Jung, Christian, Napp, L. Christian, Natanov, Ruslan, Trummer, Georg, Treskatsch, Sascha, Welp, Henryk, Avalli, Leonello, Ball, Lorenzo, Belliato, Mirko, Bonizzoli, Manuela, Borrelli, Emma, Cavallaro, Giacomo, Franci, Andrea, Gramaticopolo, Silvia, Panigada, Mauro, Tritapepe, Luigi, Abdulaziz, Salman, Bracco, David, Alexandros, Yiorgos, Joffe, Ari, Nagpal, A. Dave, Sia, Ying, Auzinger, Georg, Zochios, Vasileios, Garcia, Alejandro, Gist, Katja, Lustbader, Dana, Yannopoulos, Demetris, Stephens, R. Scott, Tonna, Joseph, Paxton, Linda, Hirose, Hitoshi, Kim, Bo, Dalén, Magnus, Balik, Martin, Janak, David, Castillo, Luis, Bruhn, Alejandro, Socarras, Jorge Luis Alvarado, Kim, Taeyun, Kim, Hyoung Soo, Byun, Joung Hun, Mainardi, Guilherme, Mendes, Pedro, Giraud, Raphaël, Fortuna, Philip, Fukuda, Tatsuma, Maas, Jacinta, Maciejewski, Dariusz, Pandit, Deblal, Psz, Yosv, Radsel, Peter, YAN, Gangfeng, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CTC, MUMC+: MA Med Staf Spec CTC (9), RS: Carim - V04 Surgical intervention, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Service de Réanimation Médicale et Toxicologique [Hôpital Lariboisière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S_1144 / U1144)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), and MORNET, Dominique

Subjects
ARDS, Internationality, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Medicine (miscellaneous), 02 engineering and technology, 030204 cardiovascular system & hematology, extracorporeal life support, SARS‐CoV‐2, Hypoxemia, 0302 clinical medicine, Surveys and Questionnaires, Practice Patterns, Physicians', ComputingMilieux_MISCELLANEOUS, Respiratory Distress Syndrome, General Medicine, COVID‐19‐induced acute respiratory distress syndrome, 3. Good health, [SDV] Life Sciences [q-bio], SURVIVAL, medicine.symptom, Respiratory Insufficiency, endocrine system, medicine.medical_specialty, Critical Illness, 0206 medical engineering, Biomedical Engineering, Bioengineering, Extracorporeal, Biomaterials, 03 medical and health sciences, Main Text Articles, COVID‐19, medicine, Extracorporeal membrane oxygenation, Humans, survey, Main Text Article, business.industry, SARS-CoV-2, COVID-19-induced acute respiratory distress syndrome, MEMBRANE-OXYGENATION, COVID-19, extracorporeal membrane oxygenation, medicine.disease, 020601 biomedical engineering, Triage, Discontinuation, Heart failure, Life support, Emergency medicine, business
Abstract

Extracorporeal life support (ECLS) is a means to support patients with acute respiratory failure. Initially, recommendations to treat severe cases of pandemic coronavirus disease 2019 (COVID‐19) with ECLS have been restrained. In the meantime, ECLS has been shown to produce similar outcomes in patients with severe COVID‐19 compared to existing data on ARDS mortality. We performed an international email survey to assess how ECLS providers worldwide have previously used ECLS during the treatment of critically ill patients with COVID‐19. A questionnaire with 45 questions (covering, e.g., indication, technical aspects, benefit, and reasons for treatment discontinuation), mostly multiple choice, was distributed by email to ECLS centers. The survey was approved by the European branch of the Extracorporeal Life Support Organization (ELSO); 276 ECMO professionals from 98 centers in 30 different countries on four continents reported that they employed ECMO for very severe COVID‐19 cases, mostly in veno‐venous configuration (87%). The most common reason to establish ECLS was isolated hypoxemic respiratory failure (50%), followed by a combination of hypoxemia and hypercapnia (39%). Only a small fraction of patients required veno‐arterial cannulation due to heart failure (3%). Time on ECLS varied between less than 2 and more than 4 weeks. The main reason to discontinue ECLS treatment prior to patient’s recovery was lack of clinical improvement (53%), followed by major bleeding, mostly intracranially (13%). Only 4% of respondents reported that triage situations, lack of staff or lack of oxygenators, were responsible for discontinuation of ECLS support. Most ECLS physicians (51%, IQR 30%) agreed that patients with COVID‐19‐induced ARDS (CARDS) benefitted from ECLS. Overall mortality of COVID‐19 patients on ECLS was estimated to be about 55%. ECLS has been utilized successfully during the COVID‐19 pandemic to stabilize CARDS patients in hypoxemic or hypercapnic lung failure. Age and multimorbidity limited the use of ECLS. Triage situations were rarely a concern. ECLS providers stated that patients with severe COVID‐19 benefitted from ECLS., 276 ECMO professionals from 98 centers worldwide participated in this EuroELSO‐associated online survey investigating the use of ECMO for severe COVID‐19. Extracorporeal life support (ECLS) for severe COVID‐19 was used predominantly in veno‐venous configuration (87%) to treat isolated hypoxic respiratory failure (50%). Age and multimorbidity limited the use of ECLS. Overall mortality of COVID‐19 patients on ECLS was estimated to be about 55%.

Published
2021
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