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4. Airway microbiota signals anabolic and catabolic remodeling in the transplanted lung

Author

Mouraux, Stéphane, primary, Bernasconi, Eric, additional, Pattaroni, Céline, additional, Koutsokera, Angela, additional, Aubert, John-David, additional, Claustre, Johanna, additional, Pison, Christophe, additional, Royer, Pierre-Joseph, additional, Magnan, Antoine, additional, Kessler, Romain, additional, Benden, Christian, additional, Soccal, Paola M., additional, Marsland, Benjamin J., additional, Nicod, Laurent P., additional, Jougon, J., additional, Velly, J.-F., additional, Rozé, H., additional, Blanchard, E., additional, Dromer, C., additional, Antoine, M., additional, Cappello, M., additional, Ruiz, M., additional, Sokolow, Y., additional, Vanden Eynden, F., additional, Van Nooten, G., additional, Barvais, L., additional, Berré, J., additional, Brimioulle, S., additional, De Backer, D., additional, Créteur, J., additional, Engelman, E., additional, Huybrechts, I., additional, Ickx, B., additional, Preiser, T.J.C., additional, Tuna, T., additional, Van Obberghe, L., additional, Vancutsem, N., additional, Vincent, J.-L., additional, De Vuyst, P., additional, Etienne, I., additional, Féry, F., additional, Jacobs, F., additional, Knoop, C., additional, Vachiéry, J.L., additional, Van den Borne, P., additional, Wellemans, I., additional, Amand, G., additional, Collignon, L., additional, Giroux, M., additional, Angelescu, D., additional, Chavanon, O., additional, Hacini, R., additional, Pirvu, A., additional, Porcu, P., additional, Albaladejo, P., additional, Allègre, C., additional, Bataillard, A., additional, Bedague, D., additional, Briot, E., additional, Casez-Brasseur, M., additional, Colas, D., additional, Dessertaine, G., additional, Durand, M., additional, Francony, G., additional, Hebrard, A., additional, Marino, M.R., additional, Oummahan, B., additional, Protar, D., additional, Rehm, D., additional, Robin, S., additional, Rossi-Blancher, M., additional, Augier, C., additional, Bedouch, P., additional, Boignard, A., additional, Bouvaist, H., additional, Briault, A., additional, Camara, B., additional, Claustre, J., additional, Chanoine, S., additional, Dubuc, M., additional, Quétant, S., additional, Maurizi, J., additional, Pavèse, P., additional, Pison, C., additional, Saint-Raymond, C., additional, Wion, N., additional, Chérion, C., additional, Grima, R., additional, Jegaden, O., additional, Maury, J.-M., additional, Tronc, F., additional, Flamens, C., additional, Paulus, S., additional, Mornex, J.-F., additional, Philit, F., additional, Senechal, A., additional, Glérant, J.-C., additional, Turquier, S., additional, Gamondes, D., additional, Chalabresse, L., additional, Thivolet-Bejui, F., additional, Barnel, C., additional, Dubois, C., additional, Tiberghien, A., additional, Le Pimpec-Barthes, F., additional, Bel, A., additional, Mordant, P., additional, Achouh, P., additional, Boussaud, V., additional, Guillemain, R., additional, Méléard, D., additional, Bricourt, M.O., additional, Cholley, B., additional, Pezella, V., additional, Brioude, G., additional, D'Journo, X.B., additional, Doddoli, C., additional, Thomas, P., additional, Trousse, D., additional, Dizier, S., additional, Leone, M., additional, Papazian, L., additional, Bregeon, F., additional, Basire, A., additional, Coltey, B., additional, Dufeu, N., additional, Dutau, H., additional, Garcia, S., additional, Gaubert, J.Y., additional, Gomez, C., additional, Laroumagne, S., additional, Nieves, A., additional, Picard, L.C., additional, Reynaud-Gaubert, M., additional, Secq, V., additional, Mouton, G., additional, Baron, O., additional, Lacoste, P., additional, Perigaud, C., additional, Roussel, J.C., additional, Danner, I., additional, Haloun, A., additional, Magnan, A., additional, Tissot, A., additional, Lepoivre, T., additional, Treilhaud, M., additional, Botturi-Cavaillès, K., additional, Brouard, S., additional, Danger, R., additional, Loy, J., additional, Morisset, M., additional, Pain, M., additional, Pares, S., additional, Reboulleau, D., additional, Royer, P.-J., additional, Fabre, D., additional, Fadel, E., additional, Mercier, O., additional, Mussot, S., additional, Stephan, F., additional, Viard, P., additional, Cerrina, J., additional, Dorfmuller, P., additional, Ghigna, S.M., additional, Hervén, Ph., additional, Le Roy Ladurie, F., additional, Le Pavec, J., additional, Thomas de Montpreville, V., additional, Lamrani, L., additional, Castier, Y., additional, Cerceau, P., additional, Augustin, P., additional, Jean-Baptiste, S., additional, Boudinet, S., additional, Montravers, P., additional, Brugière, O., additional, Dauriat, G., additional, Jébrak, G., additional, Mal, H., additional, Marceau, A., additional, Métivier, A.-C., additional, Thabut, G., additional, Lhuillier, E., additional, Dupin, C., additional, Bunel, V., additional, Falcoz, P., additional, Massard, G., additional, Santelmo, N., additional, Ajob, G., additional, Collange, O., additional, Helms, O., additional, Hentz, J., additional, Roche, A., additional, Bakouboula, B., additional, Degot, T., additional, Dory, A., additional, Hirschi, S., additional, Ohlmann-Caillard, S., additional, Kessler, L., additional, Kessler, R., additional, Schuller, A., additional, Bennedif, K., additional, Vargas, S., additional, Stauder, J., additional, Ali-Azouaou, S., additional, Bonnette, P., additional, Chapelier, A., additional, Puyo, P., additional, Sage, E., additional, Bresson, J., additional, Caille, V., additional, Cerf, C., additional, Devaquet, J., additional, Dumans-Nizard, V., additional, Felten, M.-L., additional, Fischler, M., additional, Si Larbi, A.-G., additional, Leguen, M., additional, Ley, L., additional, Liu, N., additional, Trebbia, G., additional, De Miranda, S., additional, Douvry, B., additional, Gonin, F., additional, Grenet, D., additional, Hamid, A.M., additional, Neveu, H., additional, Parquin, F., additional, Picard, C., additional, Roux, A., additional, Stern, M., additional, Bouillioud, F., additional, Cahen, P., additional, Colombat, M., additional, Dautricourt, C., additional, Delahousse, M., additional, D'Urso, B., additional, Gravisse, J., additional, Guth, A., additional, Hillaire, S., additional, Honderlick, P., additional, Lequintrec, M., additional, Longchampt, E., additional, Mellot, F., additional, Scherrer, A., additional, Temagoult, L., additional, Tricot, L., additional, Vasse, M., additional, Veyrie, C., additional, Zemoura, L., additional, Berjaud, J., additional, Brouchet, L., additional, Dahan, M., additional, Mathe, F.O., additional, Benahoua, H., additional, DaCosta, M., additional, Serres, I., additional, Merlet-Dupuy, V., additional, Grigoli, M., additional, Didier, A., additional, Murris, M., additional, Crognier, L., additional, Fourcade, O., additional, Krueger, T., additional, Ris, H.B., additional, Gonzalez, M., additional, Jolliet, Ph., additional, Marcucci, C., additional, Chollet, M., additional, Gronchi, F., additional, Courbon, C., additional, Berutto, C., additional, Manuel, O., additional, Koutsokera, A., additional, Aubert, J.-D., additional, Nicod, L.P., additional, Mouraux, S., additional, Bernasconi, E., additional, Pattaroni, C., additional, Marsland, B.J., additional, Soccal, P.M., additional, Rochat, T., additional, Lücker, L.M., additional, Hillinger, S., additional, Inci, I., additional, Weder, W., additional, Schuepbach, R., additional, Zalunardo, M., additional, Benden, C., additional, Schuurmans, M.M., additional, Gaspert, A., additional, Holzmann, D., additional, Müller, N., additional, Schmid, C., additional, Vrugt, B., additional, Fritz, A., additional, Maier, D., additional, Deplanche, K., additional, Koubi, D., additional, Ernst, F., additional, Paprotka, T., additional, Schmitt, M., additional, Wahl, B., additional, Boissel, J.-P., additional, Olivera-Botello, G., additional, Trocmé, C., additional, Toussaint, B., additional, Bourgoin-Voillard, S., additional, Sève, M., additional, Benmerad, M., additional, Siroux, V., additional, Slama, R., additional, Auffray, C., additional, Charron, D., additional, Lefaudeux, D., additional, and Pellet, J., additional

Published
2018
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5. Blood CD9+B cell, a biomarker of bronchiolitis obliterans syndrome after lung transplantation

Author

Brosseau, Carole, Danger, Richard, Durand, Maxim, Durand, Eugénie, Foureau, Aurore, Lacoste, Philippe, Tissot, Adrien, Roux, Antoine, Reynaud‐Gaubert, Martine, Kessler, Romain, Mussot, Sacha, Dromer, Claire, Brugière, Olivier, Mornex, Jean François, Guillemain, Romain, Claustre, Johanna, Magnan, Antoine, Brouard, Sophie, Jougon, J., Velly, J.‐F., Rozé, H., Blanchard, E., Antoine, M., Cappello, M., Ruiz, M., Sokolow, Y., Vanden Eynden, F, Van Nooten, G., Barvais, L., Berré, J., Brimioulle, S., De Backer, D., Créteur, J., Engelman, E, Huybrechts, I., Ickx, B., Preiser, T.J.C., Tuna, T., Van Obberghe, L., Vancutsem, N., Vincent, J.‐L., De Vuyst, P., Etienne, I., Féry, F., Jacobs, F., Knoop, C., Vachiéry, J.L., Van den Borne, P., Wellemans, I., Amand, G., Collignon, L., Giroux, M., Angelescu, D., Chavanon, O., Hacini, R., Martin, C., Pirvu, A., Porcu, P., Albaladejo, P., Allègre, C., Bataillard, A., Bedague, D., Briot, E., Casez‐Brasseur, M., Colas, D., Dessertaine, G., Francony, G., Hebrard, A., Marino, M.R., Protar, D., Rehm, D., Robin, S, Rossi‐Blancher, M., Augier, C., Bedouch, P., Boignard, A., Bouvaist, H., Briault, A., Camara, B., Chanoine, S., Dubuc, M., Quétant, S., Maurizi, J., Pavèse, P., Pison, C., Saint‐Raymond, C., Wion, N., Chérion, C., Grima, R., Jegaden, O., Maury, J.‐M., Tronc, F., Flamens, C., Paulus, S., Philit, F., Senechal, A., Glérant, J.‐C., Turquier, S., Gamondes, D., Chalabresse, L., Thivolet‐Bejui, F., Barnel, C., Dubois, C., Tiberghien, A., Pimpec‐Barthes, F., Bel, A., Mordant, P., Achouh, P., Boussaud, V., Méléard, D., Bricourt, M.O., Cholley, B., Pezella, V., Brioude, G., D'Journo, X.B., Doddoli, C., Thomas, P., Trousse, D., Dizier, S., Leone, M., Papazian, L., Bregeon, F., Coltey, B., Dufeu, N., Dutau, H., Garcia, S., Gaubert, J.Y., Gomez, C., Laroumagne, S., Mouton, G., Nieves, A., Picard, Ch., Rolain, J.M., Sampol, E., Secq, V., Perigaud, C., Roussel, J.C., Senage, T., Mugniot, A., Danner, I., Haloun, A., Abbes, S., Bry, C., Blanc, F.X., Lepoivre, T., Botturi‐Cavaillès, K., Loy, J., Bernard, M., Godard, E., Royer, P.‐J., Henrio, K., Dartevelle, Ph., Fabre, D., Fadel, E., Mercier, O., Stephan, F., Viard, P., Cerrina, J., Dorfmuller, P., Feuillet, S., Ghigna, M., Hervén, Ph., Le Roy Ladurie, F., Le Pavec, J., Thomas de Montpreville, V., Lamrani, L., Castier, Y., Mordant, P., Cerceau, P., Augustin, P., Jean‐Baptiste, S., Boudinet, S., Montravers, P., Dauriat, G., Jébrak, G., Mal, H., Marceau, A., Métivier, A.‐C., Thabut, G., Lhuillier, E., Dupin, C., Bunel, V., Falcoz, P., Massard, G., Santelmo, N., Ajob, G., Collange, O., Helms, O., Hentz, J., Roche, A., Bakouboula, B., Degot, T., Dory, A., Hirschi, S., Ohlmann‐Caillard, S., Kessler, L., Schuller, A., Bennedif, K., Vargas, S., Bonnette, P., Chapelier, A., Puyo, P., Sage, E., Bresson, J., Caille, V., Cerf, C., Devaquet, J., Dumans‐Nizard, V., Felten, M.L., Fischler, M., Si Larbi, A.G., Leguen, M., Ley, L., Liu, N., Trebbia, G., De Miranda, S., Douvry, B., Gonin, F., Grenet, D., Hamid, A.M., Neveu, H., Parquin, F., Picard, C., Stern, M., Bouillioud, F., Cahen, P., Colombat, M., Dautricourt, C., Delahousse, M., D'Urso, B., Gravisse, J., Guth, A., Hillaire, S., Honderlick, P., Lequintrec, M., Longchampt, E., Mellot, F., Scherrer, A., Temagoult, L., Tricot, L., Vasse, M., Veyrie, C., Zemoura, L., Dahan, M., Murris, M., Benahoua, H., Berjaud, J., Le Borgne Krams, A., Crognier, L., Brouchet, L., Mathe, O., Didier, A., Krueger, T., Ris, H.B., Gonzalez, M., Aubert, J.‐D., Nicod, L.P., Marsland, B.J., Berutto, T.C., Rochat, T., Soccal, P., Jolliet, Ph., Koutsokera, A., Marcucci, C., Manuel, O., Bernasconi, E., Chollet, M., Gronchi, F., Courbon, C., Hillinger, S., Inci, I., Kestenholz, P., Weder, W., Schuepbach, R., Zalunardo, M., Benden, C., Buergi, U., Huber, L.C., Isenring, B., Schuurmans, M.M., Gaspert, A., Holzmann, D., Müller, N., Schmid, C., Vrugt, B., Rechsteiner, T., Fritz, A., Maier, D., Deplanche, K., Koubi, D., Ernst, F., Paprotka, T., Schmitt, M., Wahl, B., Boissel, J.‐P., Olivera‐Botello, G., Trocmé, C., Toussaint, B., Bourgoin‐Voillard, S., Séve, M., Benmerad, M., Siroux, V., Slama, R., Auffray, C., Charron, D., Lefaudeux, D., and Pellet, J.

Abstract

Bronchiolitis obliterans syndrome is the main limitation for long‐term survival after lung transplantation. Some specific B cell populations are associated with long‐term graft acceptance. We aimed to monitor the B cell profile during early development of bronchiolitis obliterans syndrome after lung transplantation. The B cell longitudinal profile was analyzed in peripheral blood mononuclear cells from patients with bronchiolitis obliterans syndrome and patients who remained stable over 3 years of follow‐up. CD24hiCD38hitransitional B cells were increased in stable patients only, and reached a peak 24 months after transplantation, whereas they remained unchanged in patients who developed a bronchiolitis obliterans syndrome. These CD24hiCD38hitransitional B cells specifically secrete IL‐10 and express CD9. Thus, patients with a total CD9+B cell frequency below 6.6% displayed significantly higher incidence of bronchiolitis obliterans syndrome (AUC = 0.836, PPV = 0.75, NPV = 1). These data are the first to associate IL‐10‐secreting CD24hiCD38hitransitional B cells expressing CD9 with better allograft outcome in lung transplant recipients. CD9‐expressing B cells appear as a contributor to a favorable environment essential for the maintenance of long‐term stable graft function and as a new predictive biomarker of bronchiolitis obliterans syndrome–free survival. In lung transplant patients with bronchiolitis obliterans syndrome and patients who remained stable over 3 years of follow‐up, IL‐10–secreting CD24hiCD38hi transitional B cells expressing CD9 are associated with better allograft outcome, suggesting CD9‐expressing B cells as a new predictive biomarker of bronchiolitis obliterans syndrome–free survival.

Published
2019
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11. Valeurs prédictives des marqueurs physiques et biochimiques de l’œdème de reperfusion après transplantation pulmonaire

Author

Pottecher, J., primary, Roche, A.-C., additional, Dégot, T., additional, Helms, O., additional, Levy, F., additional, Hentz, J.-G., additional, Schmitt, J.-P., additional, Santelmo, N., additional, Falcoz, P.-E., additional, Geny, B., additional, Kessler, R., additional, Massard, G., additional, and Steib, A., additional

Published
2013
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12. T Cells Promote Bronchial Epithelial Cell Secretion of Matrix Metalloproteinase‐9 via a C‐C Chemokine Receptor Type 2 Pathway: Implications for Chronic Lung Allograft Dysfunction

Author

Pain, M., Royer, P.‐J., Loy, J., Girardeau, A., Tissot, A., Lacoste, P., Roux, A., Reynaud‐Gaubert, M., Kessler, R., Mussot, S., Dromer, C., Brugière, O., Mornex, J.‐F., Guillemain, R., Dahan, M., Knoop, C., Botturi, K., Pison, C., Danger, R., Brouard, S., Magnan, A., Jougon, J., Velly, J.‐F., Rozé, H., Blanchard, E., Antoine, M., Cappello, M., Souilamas, R., Ruiz, M., Sokolow, Y., Vanden Eynden, F., Van Nooten, G., Barvais, L., Berré, J., Brimioulle, S., De Backer, D., Créteur, J., Engelman, E., Huybrechts, I., Ickx, B., Preiser, T.J.C., Tuna, T., Van Obberghe, L., Vancutsem, N., Vincent, J.‐L., De Vuyst, P., Etienne, I., Féry, F., Jacobs, F., Vachiéry, J.L., Van den Borne, P., Wellemans, I., Amand, G., Collignon, L., Giroux, M., Arnaud‐Crozat, E., Bach, V., Brichon, P.‐Y., Chaffanjon, P., Chavanon, O., de Lambert, A., Fleury, J.P., Guigard, S., Hireche, K., Pirvu, A., Porcu, P., Hacini, R., Albaladejo, P., Allègre, C., Bataillard, A., Bedague, D., Briot, E., Casez‐Brasseur, M., Colas, D., Dessertaine, G., Durand, M., Francony, G., Hebrard, A., Marino, M.R., Oummahan, B., Protar, D., Rehm, D., Robin, S., Rossi‐Blancher, M., Bedouch, P., Boignard, A., Bouvaist, H., Briault, A., Camara, B., Chanoine, S., Dubuc, M., Lantuéjoul, S., Quétant, S., Maurizi, J., Pavèse, P., Saint‐Raymond, C., Wion, N., Chérion, C., Grima, R., Jegaden, O., Maury, J.‐M., Tronc, F., Flamens, C., Paulus, S., Philit, F., Senechal, A., Glérant, J.‐C., Turquier, S., Gamondes, D., Chalabresse, L., Thivolet‐Bejui, F., Barnel, C., Dubois, C., Tiberghien, A., Le Pimpec‐Barthes, F., Bel, A., Mordant, P., Achouh, P., Boussaud, V., Méléard, D., Bricourt, M.O., Cholley, B., Pezella, V., Adda, M., Badier, M., Bregeon, F., Coltey, B., D'Journo, X.B., Dizier, S., Doddoli, C., Dufeu, N., Dutau, H., Forel, J.M., Gaubert, J.Y., Gomez, C., Leone, M., Nieves, A., Orsini, B., Papazian, L., Picard, C., Roch, A., Rolain, J.M., Sampol, E., Secq, V., Thomas, P., Trousse, D., Yahyaoui, M., Baron, O., Perigaud, C., Roussel, J.C., Danner, I., Haloun, A., Lepoivre, T., Treilhaud, M., Botturi‐Cavaillès, K., Morisset, M., Pares, S., Reboulleau, D., Dartevelle, P., Fabre, D., Fadel, E., Mercier, O., Stephan, F., Viard, P., Cerrina, J., Dorfmuller, P., Feuillet, S., Ghigna, M., Hervén, P., Le Roy Ladurie, F., Le Pavec, J., Thomas de Montpreville, V., Lamrani, L., Castier, Y., Cerceau, P., Francis, F., Lesèche, G., Allou, N., Augustin, P., Boudinet, S., Desmard, M., Dufour, G., Montravers, P., Dauriat, G., Jébrak, G., Mal, H., Marceau, A., Métivier, A.‐C., Thabut, G., Ait Ilalne, B., Falcoz, P., Massard, G., Santelmo, N., Ajob, G., Collange, O., Helms, O., Hentz, J., Roche, A., Bakouboula, B., Degot, T., Dory, A., Hirschi, S., Ohlmann‐Caillard, S., Kessler, L., Schuller, A., Bennedif, K., Vargas, S., Bonnette, P., Chapelier, A., Puyo, P., Sage, E., Bresson, J., Caille, V., Cerf, C., Devaquet, J., Dumans‐Nizard, V., Felten, M.L., Fischler, M., Si Larbi, A.G., Leguen, M., Ley, L., Liu, N., Trebbia, G., De Miranda, S., Douvry, B., Gonin, F., Grenet, D., Hamid, A.M., Neveu, H., Parquin, F., Picard, C., Stern, M., Bouillioud, F., Cahen, P., Colombat, M., Dautricourt, C., Delahousse, M., D'Urso, B., Gravisse, J., Guth, A., Hillaire, S., Honderlick, P., Lequintrec, M., Longchampt, E., Mellot, F., Scherrer, A., Temagoult, L., Tricot, L., Vasse, M., Veyrie, C., Zemoura, L., Berjaud, J., Brouchet, L., Le Balle, F, Mathe, O., Benahoua, H., Didier, A., Goin, A.L., Murris, M., Crognier, L., and Fourcade, O.

Abstract

Chronic lung allograft dysfunction (CLAD) is the major limitation of long‐term survival after lung transplantation. CLADmanifests as bronchiolitis obliterans syndrome (BOS) or restrictive allograft syndrome (RAS). Alloimmune reactions and epithelial‐to‐mesenchymal transition have been suggested in BOS. However, little is known regarding the role of allogenicity in epithelial cell differentiation. Primary human bronchial epithelial cells (BECs) were treated with activated T cells in the presence or absence of transforming growth factor (TGF)‐β. The expression of epithelial and mesenchymal markers was investigated. The secretion of inflammatory cytokines and matrix metalloproteinase (MMP)‐9 was measured in culture supernatants and in plasma from lung transplant recipients (LTRs): 49 stable, 29 with BOS,and 16 with RAS. We demonstrated that C‐C motif chemokine 2 secreted by T cells supports TGF‐β–induced MMP‐9 production by BECsafter binding to C‐C chemokine receptor type 2. Longitudinal investigation in LTRsrevealed a rise in plasma MMP‐9 before CLADonset. Multivariate analysis showed that plasma MMP‐9 was independently associated with BOS(odds ratio [OR] =6.19, p = 0.002) or RAS(OR= 3.9, p = 0.024) and predicted the occurrence of CLAD12 months before the functional diagnosis. Thus, immune cells support airway remodeling through the production of MMP‐9. Plasma MMP‐9 is a potential predictive biomarker of CLAD. The authors investigate the production of matrix metalloproteinase‐9 by primary bronchial epithelial cells after interaction with activated T cells and show that plasma matrix metalloproteinase‐9 can serve as a predictor of chronic lung allograft dysfunction 12 months before clinical diagnosis.

Published
2017
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16. Deep hypophosphatemia and severe head trauma.

Author

Helms, O., Freys, G., and Pottecher, T.

Subjects
*FAMILIAL hypophosphatemia, *BRAIN death
Abstract

The authors report the case of an 18-year-old man with polytrauma, who died at the third day of its accident from brain death and who presented during his stay in the intensive care unit, a deep hypophosphatemia. Two physiopathologic mechanisms were presumed : increase of renal losses and intracellular transfer of phosphorus. Consequences, as well as the indications and the therapeutic modalities of hypophosphatemia are discussed. [Copyright &y& Elsevier]

Published
2002
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28. Increased Extravascular Lung Water and Plasma Biomarkers of Acute Lung Injury Precede Oxygenation Impairment in Primary Graft Dysfunction After Lung Transplantation.

Author

Pottecher J, Roche AC, Dégot T, Helms O, Hentz JG, Schmitt JP, Falcoz PE, Santelmo N, Levy F, Collange O, Uring-Lambert B, Bahram S, Schaeffer M, Meyer N, Geny B, Lassalle P, Diemunsch P, Massard G, Kessler R, and Steib A

Subjects
Acute Lung Injury blood, Acute Lung Injury etiology, Acute Lung Injury physiopathology, Adult, Area Under Curve, Bayes Theorem, Biomarkers blood, Disease Progression, Early Diagnosis, Female, Humans, Intercellular Adhesion Molecule-1 blood, Lung physiopathology, Male, Middle Aged, Neoplasm Proteins blood, Partial Pressure, Predictive Value of Tests, Primary Graft Dysfunction blood, Primary Graft Dysfunction etiology, Primary Graft Dysfunction physiopathology, Proteoglycans blood, Pulmonary Edema blood, Pulmonary Edema etiology, Pulmonary Edema physiopathology, ROC Curve, Receptor for Advanced Glycation End Products blood, Severity of Illness Index, Thermodilution, Time Factors, Treatment Outcome, Young Adult, Acute Lung Injury diagnosis, Extravascular Lung Water metabolism, Lung metabolism, Lung Transplantation adverse effects, Oxygen blood, Primary Graft Dysfunction diagnosis, Pulmonary Edema diagnosis
Abstract

Background: After lung transplantation (LT), early prediction of grade 3 pulmonary graft dysfunction (PGD) remains a research gap for clinicians. We hypothesized that it could be improved using extravascular lung water (EVLWi) and plasma biomarkers of acute lung injury., Methods: After institutional review board approval and informed consent, consecutive LT recipients were included. Transpulmonary thermodilution-based EVLWi, plasma concentrations of epithelial (soluble receptor for advanced glycation endproducts [sRAGE]) and endothelial biomarkers (soluble intercellular adhesion molecule-1 and endocan [full-length and cleaved p14 fragment]) were obtained before and after LT (0 [H0], 6, 12, 24, 48 and 72 hours after pulmonary artery unclamping). Grade 3 PGD was defined according to the International Society for Lung and Heart Transplantation definition, combining arterial oxygen partial pressure (PaO2)/inspired fraction of oxygen (FiO2) ratio and chest X-rays. Association of clinical risk factors, EVLWi and biomarkers with grade 3 PGD was analyzed under the Bayesian paradigm, using logistic model and areas under the receiver operating characteristic curves (AUCs)., Results: In 47 LT recipients, 10 developed grade 3 PGD, which was obvious at H6 in 8 cases. Clinical risk factors, soluble intercellular adhesion molecule-1 and endocan (both forms) were not associated with grade 3 PGD. Significant predictors of grade 3 PGD included (1) EVLWi (optimal cutoff, 13.7 mL/kg; AUC, 0.74; 95% confidence interval [CI], 0.48-0.99), (2) PaO2/FiO2 ratio (optimal cutoff, 236; AUC, 0.68; 95% CI, 0.52-0.84), and (3) sRAGE (optimal cutoff, 11 760 pg/mL; AUC, 0.66; 95% CI, 0.41-0.91) measured at H0., Conclusions: Immediate postreperfusion increases in EVLWi and sRAGE along with impaired PaO2/FiO2 ratios were early predictors of grade 3 PGD at or beyond 6 hours and may trigger early therapeutic interventions.

Published
2017
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29. Intra-operative paravertebral block for postoperative analgesia in thoracotomy patients: a randomized, double-blind, placebo-controlled study.

Author

Helms O, Mariano J, Hentz JG, Santelmo N, Falcoz PE, Massard G, and Steib A

Subjects
Adult, Aged, Analgesia, Epidural, Analgesia, Patient-Controlled, Analgesics, Opioid administration & dosage, Contraindications, Double-Blind Method, Drug Administration Schedule, Humans, Intraoperative Care methods, Middle Aged, Morphine administration & dosage, Pain Measurement methods, Pain, Postoperative etiology, Ropivacaine, Treatment Outcome, Young Adult, Amides administration & dosage, Anesthetics, Local administration & dosage, Nerve Block methods, Pain, Postoperative prevention & control, Thoracotomy adverse effects
Abstract

Objective: Epidural analgesia is the gold standard for post-thoracotomy pain relief but is contraindicated in certain patients. An alternative is paravertebral block. We investigated whether ropivacaine, administered through a paravertebral catheter placed by the surgeon, reduced postoperative pain., Methods: In a randomized double-blind study, adult patients with a paravertebral catheter placed by the thoracic surgeon after thoracotomy were randomly assigned to receive through this catheter, either a 0.1 mlkg(-1) bolus of 0.5% ropivacaine, followed by a continuous infusion of 0.1 mlkg(-1)h(-1) for 48 h, or saline at the same scheme of administration. Patients also benefited from patient-controlled analgesia with intravenous morphine (bolus 1mg, lockout time 7 min), paracetamol, and nefopam. The primary endpoint was pain intensity on a visual analog scale at rest and on coughing. Secondary endpoints were total morphine consumption and side effects during the first 48 postoperative hours. Surgeons, anesthesiologists, and all the nurses and caring staff involved in this study were blinded. Solutions of saline and ropivacaine were prepared identically by the central pharmacy, without any possible identification of the product., Results: Forty-seven patients with contraindications to epidural anesthesia were included. There were no significant differences between the groups receiving ropivacaine and saline in terms of pain severity at rest and on coughing, mean postoperative morphine consumption (45.7 mg for ropivacaine, 43.2mg in controls), and incidence of morphine-related side effects (nausea and vomiting, urinary retention, pruritus, respiratory rate, and sedation)., Conclusions: Paravertebral block using a catheter placed by the thoracic surgeon was ineffective on postoperative pain after thoracotomy and did not confirm the analgesic effect that has been observed after percutaneous catheter placement. A direct comparison of these two placement methods is required., (Copyright © 2011 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.)

Published
2011
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30. [Knot in a thoracic epidural catheter].

Author

Fischer F, Helms O, Hentz JG, and Steib A

Subjects
Adult, Analgesics, Opioid administration & dosage, Analgesics, Opioid therapeutic use, Equipment Failure, Foreign Bodies therapy, Humans, Male, Morphine administration & dosage, Morphine therapeutic use, Mouth Neoplasms surgery, Pain, Postoperative drug therapy, Analgesia, Epidural instrumentation, Catheters
Abstract

We report a case of impossible injection into a thoracic epidural catheter associated with a difficult withdrawal of this catheter after its introduction on the T3-T4 level. Thanks to a gentle and continuous traction, the catheter was finally successfully removed without being broken, but presented a simple knot at 13mm from its end. No neurological complication was observed later on. This complication happened during the introduction of the catheter at the thoracic level where anatomic conditions are less favorable for this kind of complication to happen than at the lumbar level. We have been probably confronted with a catheter taking an abnormal direction due to an anatomic structure. This case shows us that knots in an epidural catheter are also possible on the high thoracic level and that its ascent within the epidural space must happen without any resistance., (Copyright © 2010 Elsevier Masson SAS. All rights reserved.)

Published
2011
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32. [Severe hypophosphatemia and grave head trauma].

Author

Helms O, Freys G, and Pottecher T

Subjects
Adolescent, Craniocerebral Trauma blood, Fatal Outcome, Humans, Hypophosphatemia blood, Kidney metabolism, Male, Multiple Trauma blood, Norepinephrine blood, Phosphorus metabolism, Craniocerebral Trauma complications, Hypophosphatemia etiology
Abstract

The authors report the case of an 18-year-old man with polytrauma, who died at the third day of its accident from brain death and who presented during his stay in the intensive care unit, a deep hypophosphatemia. Two physiopathologic mechanisms were presumed: increase of renal losses and intracellular transfer of phosphorus. Consequences, as well as the indications and the therapeutic modalities of hypophosphatemia are discussed.

Published
2002
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