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1. Can Biomarkers Correctly Predict Ventilator-associated Pneumonia in Patients Treated With Targeted Temperature Management After Cardiac Arrest? An Exploratory Study of the Multicenter Randomized Antibiotic (ANTHARTIC) Study

Author: Nicolas Deye, MD, PhD, Amelie Le Gouge, MSc, Bruno François, MD, Camille Chenevier-Gobeaux, MD, PhD, Thomas Daix, MD, Hamid Merdji, MD, PhD, Alain Cariou, MD, PhD, Pierre-François Dequin, MD, PhD, Christophe Guitton, MD, Bruno Mégarbane, MD, PhD, Jacques Callebert, PharmD, PhD, Bruno Giraudeau, PhD, Alexandre Mebazaa, MD, PhD, Nicolas Vodovar, PhD, for the Clinical Research in Intensive Care and Sepsis-TRIal Group for Global Evaluation and Research in SEPsis (TRIGGERSEP) Network and the ANtibiotherapy during Therapeutic HypothermiA to pRevenT Infectious Complications (ANTHARTIC) Study Group, Arnaud Desachy, Christophe Cracco, Laurence Robin, Marie Anne Fally, David Schnell, Olivier Baudin, Charles Lafon, Philippe Petua, Stéphane Rouleau, Cyrille Nowak, Gaétan Plantefeve, Hervé Mentec, Olivier Pajot, Damien Contou, Jo-Anna Tirolien, Constance Vuillard, Cécile Zylberfajn, Nadile Ali, Dieudonne Kilendo, Olivia Chauvel, Elias Karam, Pascal Chevallier, Dorothée Ducoux, Fabrice Raymond, Christophe Gellis, Jean-Pierre Quenot, Thérèse Devaux, Audrey Large, Sébastien Mortreux, Pierre-Emmanuel Charles, Sébastien Prin, Jean-Baptiste Roudaut, Pascal Andreu, Auguste Dargent, Nora Perrot, Audrey Massard, Solenne Villot, Corinne Pernot, Bruno Francois, Thomas Daix, Philippe Vignon, Nicolas Pichon, Celine Gonzalez, Nicolas Rodier, Jean François Mary, Ludmila Baudrillart, Christine Vallejo, Emmanuelle Begot, Claire Mancia, Michelle Nouaille, Cécile Duchiron, Sandrine Naturel, Marie-Anne De Vinzellles, Hélène Beacco, Thierry Boulain, Chantal Brossard, Armelle Mathonnet, Dalila Benzekri-Lefevre, Anne Bretagnol, Isabelle Runge, François Barbier, Grégoire Muller, Mai-Anh Nay, Julie Rossi, Lucie Muller, Sophie Tollec, Alain Cariou, Nathalie Marin, Camille Chenevier-Gobeaux, Michel Arnaout, Omar Ben Hadj Salem, Wulfran Bougouin, Simon Bourcier, Benoit Champigneulle, Matthieu Jamme, Alexis Ferre, Guillaume Geri, Frédéric Pene, Julien Charpentier, Jean-Daniel Chiche, Lucie Guillemet, Jean-Paul Mira, Marine Paul, Nicolas Deye, Bruno Megarbane, Alexandre Mebazaa, Isabelle Malissin, Sebastian Voicu, Nicolas Vodovar, Jacques Callebert, Claire Pernin, Lydia Suarez, Philippe Manivet, Dominique Vodovar, Anthony Checinski, Lamia Kerdjana, Pierre Garcon, Antoine Goury, Catherine Fauvaux, Salamata Agne, Nahima Gueblaoui, Aude Jacob, Loic Chimot, Catherine Huchet, Nadège Lacoste, Pierre-Henri Dessalles, Mélanie Saint-Leger, Yannick Monseau, Marie Heil, Ferhat Meziani, Hamid Merdji, DrKhoury, Samir Chenaf, Christine Kummerlen, Yannick Rabouel, Hayat Allam, Anne Hutt-Clauss, Alexandra Monnier, Pierre-François Dequin, Christine Mabilat, Emmanuelle Rouve, Charlotte Salmon-Gandonnière, Denis Garot, Youen Jouan, Stephan Ehrmann, Antoine Guillon, Laetitia Bodet–Contentin, Emmanuelle Mercier, Julie Mankikian, Stéphane Legriel, MrSébastien Cavelot, Christophe Guitton, Charlotte Garret, Cédric Bretonniere, Laurent Nicolat, Noëlle Brule, and Olivier Zambon
Subjects: Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: IMPORTANCE:. Ventilator-associated pneumonia (VAP) frequently occurs in patients with cardiac arrest. Diagnosis of VAP after cardiac arrest remains challenging, while the use of current biomarkers such as C-reactive protein (CRP) or procalcitonin (PCT) is debated. OBJECTIVES:. To evaluate biomarkers’ impact in helping VAP diagnosis after cardiac arrest. DESIGN, SETTING, AND PARTICIPANTS:. This is a prospective ancillary study of the randomized, multicenter, double-blind placebo-controlled ANtibiotherapy during Therapeutic HypothermiA to pRevenT Infectious Complications (ANTHARTIC) trial evaluating the impact of antibiotic prophylaxis to prevent VAP in out-of-hospital patients with cardiac arrest secondary to shockable rhythm and treated with therapeutic hypothermia. An adjudication committee blindly evaluated VAP according to predefined clinical, radiologic, and microbiological criteria. All patients with available biomarker(s), sample(s), and consent approval were included. MAIN OUTCOMES AND MEASURES:. The main endpoint was to evaluate the ability of biomarkers to correctly diagnose and predict VAP within 48 hours after sampling. The secondary endpoint was to study the combination of two biomarkers in discriminating VAP. Blood samples were collected at baseline on day 3. Routine and exploratory panel of inflammatory biomarkers measurements were blindly performed. Analyses were adjusted on the randomization group. RESULTS:. Among 161 patients of the ANTHARTIC trial with available biological sample(s), patients with VAP (n = 33) had higher body mass index and Acute Physiology and Chronic Health Evaluation II score, more unwitnessed cardiac arrest, more catecholamines, and experienced more prolonged therapeutic hypothermia duration than patients without VAP (n = 121). In univariate analyses, biomarkers significantly associated with VAP and showing an area under the curve (AUC) greater than 0.70 were CRP (AUC = 0.76), interleukin (IL) 17A and 17C (IL17C) (0.74), macrophage colony-stimulating factor 1 (0.73), PCT (0.72), and vascular endothelial growth factor A (VEGF-A) (0.71). Multivariate analysis combining novel biomarkers revealed several pairs with p value of less than 0.001 and odds ratio greater than 1: VEGF-A + IL12 subunit beta (IL12B), Fms-related tyrosine kinase 3 ligands (Flt3L) + C–C chemokine 20 (CCL20), Flt3L + IL17A, Flt3L + IL6, STAM-binding protein (STAMBP) + CCL20, STAMBP + IL6, CCL20 + 4EBP1, CCL20 + caspase-8 (CASP8), IL6 + 4EBP1, and IL6 + CASP8. Best AUCs were observed for CRP + IL6 (0.79), CRP + CCL20 (0.78), CRP + IL17A, and CRP + IL17C. CONCLUSIONS AND RELEVANCE:. Our exploratory study shows that specific biomarkers, especially CRP combined with IL6, could help to better diagnose or predict early VAP occurrence in cardiac arrest patients.
Published: 2024
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2. Non-intubated COVID-19 patients despite high levels of supplemental oxygen

Author: Samuel Chosidow, Gaëtan Plantefève, Megan Fraissé, Hervé Mentec, Radj Cally, and Damien Contou
Subjects: SARS-CoV-2, COVID-19, ICU, ARDS, Mechanical ventilation, Tracheal intubation, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Published: 2021
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3. Comparison between first and second wave among critically ill COVID-19 patients admitted to a French ICU: no prognostic improvement during the second wave?

Author: Damien Contou, Megan Fraissé, Olivier Pajot, Jo-Anna Tirolien, Hervé Mentec, and Gaëtan Plantefève
Subjects: SARS-CoV-2, COVID-19, France, Corticoids, ICU, Mortality, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Published: 2021
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4. Eosinophilia in critically ill COVID-19 patients: a French monocenter retrospective study

Author: Megan Fraissé, Elsa Logre, Hervé Mentec, Radj Cally, Gaëtan Plantefève, and Damien Contou
Subjects: Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Published: 2020
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5. Bacterial and viral co-infections in patients with severe SARS-CoV-2 pneumonia admitted to a French ICU

Author: Damien Contou, Aurore Claudinon, Olivier Pajot, Maïté Micaëlo, Pascale Longuet Flandre, Marie Dubert, Radj Cally, Elsa Logre, Megan Fraissé, Hervé Mentec, and Gaëtan Plantefève
Subjects: COVID-19, SARS-CoV-2, Bacteria, Co-infection, Staphylococcus aureus, Streptococcus pneumoniae, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Abstract Background Data on the prevalence of bacterial and viral co-infections among patients admitted to the ICU for acute respiratory failure related to SARS-CoV-2 pneumonia are lacking. We aimed to assess the rate of bacterial and viral co-infections, as well as to report the most common micro-organisms involved in patients admitted to the ICU for severe SARS-CoV-2 pneumonia. Patients and methods In this monocenter retrospective study, we reviewed all the respiratory microbiological investigations performed within the first 48 h of ICU admission of COVID-19 patients (RT-PCR positive for SARS-CoV-2) admitted for acute respiratory failure. Results From March 13th to April 16th 2020, a total of 92 adult patients (median age: 61 years, 1st–3rd quartiles [55–70]; males: n = 73/92, 79%; baseline SOFA: 4 [3–7] and SAPS II: 31 [21–40]; invasive mechanical ventilation: n = 83/92, 90%; ICU mortality: n = 45/92, 49%) were admitted to our 40-bed ICU for acute respiratory failure due to SARS-CoV-2 pneumonia. Among them, 26 (28%) were considered as co-infected with a pathogenic bacterium at ICU admission with no co-infection related to atypical bacteria or viruses. The distribution of the 32 bacteria isolated from culture and/or respiratory PCRs was as follows: methicillin-sensitive Staphylococcus aureus (n = 10/32, 31%), Haemophilus influenzae (n = 7/32, 22%), Streptococcus pneumoniae (n = 6/32, 19%), Enterobacteriaceae (n = 5/32, 16%), Pseudomonas aeruginosa (n = 2/32, 6%), Moraxella catarrhalis (n = 1/32, 3%) and Acinetobacter baumannii (n = 1/32, 3%). Among the 24 pathogenic bacteria isolated from culture, 2 (8%) and 5 (21%) were resistant to 3rd generation cephalosporin and to amoxicillin–clavulanate combination, respectively. Conclusions We report on a 28% rate of bacterial co-infection at ICU admission of patients with severe SARSCoV-2 pneumonia, mostly related to Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae and Enterobacteriaceae. In French patients with confirmed severe SARSCoV-2 pneumonia requiring ICU admission, our results encourage the systematic administration of an empiric antibiotic monotherapy with a 3rd generation cephalosporin, with a prompt de-escalation as soon as possible. Further larger studies are needed to assess the real prevalence and the predictors of co-infection together with its prognostic impact on critically ill patients with severe SARS-CoV-2 pneumonia.
Published: 2020
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6. Thrombotic and hemorrhagic events in critically ill COVID-19 patients: a French monocenter retrospective study

Author: Megan Fraissé, Elsa Logre, Olivier Pajot, Hervé Mentec, Gaëtan Plantefève, and Damien Contou
Subjects: SARS-CoV-2, COVID-19, Thrombosis, Pulmonary embolism, D-dimers, ARDS, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Published: 2020
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7. Amikacin pharmacokinetic/pharmacodynamic in intensive care unit: a prospective database

Author: Elsa Logre, Maya Enser, Sébastien Tanaka, Marie Dubert, Aurore Claudinon, Nathalie Grall, Hervé Mentec, Philippe Montravers, and Olivier Pajot
Subjects: Pharmacokinetic, Pharmacodynamic, Amikacin, Intensive care unit, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Abstract Background Aminoglycosides have a concentration-dependent therapeutic effect when peak serum concentration (C max) reaches eight to tenfold the minimal inhibitory concentration (MIC). With an amikacin MIC of 8 mg/L, the C max should be 64–80 mg/L. This objective is based on clinical breakpoints and not on measured MIC. This study aimed to assess the proportion of patients achieving the pharmacokinetic/pharmacodynamic (PK/PD) target C max/MIC ≥ 8 using the measured MIC in critically ill patients treated for documented Gram-negative bacilli (GNB) infections. Methods Retrospective analysis from February 2016 to December 2017 of a prospective database conducted in 2 intensive care units (ICU). All patients with documented severe GNB infections treated with amikacin (single daily dose of 25 mg/kg of total body weight (TBW)) with both MIC and C max measurements at first day of treatment (D1) were included. Results are expressed in n (%) or median [min–max]. Results 93 patients with 98 GNB-documented infections were included. The median C max was 55.2 mg/L [12.2–165.7] and the median MIC was 2 mg/L [0.19–16]. C max/MIC ratio ≥ 8 was achieved in 87 patients (88.8%) while a C max ≥ 64 mg/L was achieved in only 38 patients (38.7%). Overall probability of PK/PD target attainment was 93%. No correlation was found between C max/MIC ratio and clinical outcome at D8 and D28. Conclusion According to PK/PD parameters observed in our study, single daily dose of amikacin 25 mg/kg of TBW appears to be sufficient in most critically ill patients treated for severe GNB infections.
Published: 2020
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8. Empirical Antibiotic Therapy for Gram-Negative Bacilli Ventilator-Associated Pneumonia: Observational Study and Pharmacodynamic Assessment

Author: Olivier Pajot, Karim Lakhal, Jérome Lambert, Antoine Gros, Cédric Bruel, Thierry Boulain, Denis Garot, Vincent Das, Jean François Timsit, Charles Cerf, Bertrand Souweine, Cendrine Chaffaut, Hervé Mentec, Jean Ralph Zahar, Jean Paul Mira, and Vincent Jullien
Subjects: VAP, pharmacokinetics, pharmacodynamics, intensive care unit, Therapeutics. Pharmacology, RM1-950
Abstract: Background: Strong evidence suggests a correlation between pharmacodynamics (PD) index and antibiotic efficacy while dose adjustment should be considered in critically ill patients due to modified pharmacokinetic (PK) parameters and/or higher minimum inhibitory concentrations (MICs). This study aimed to assess pharmacodynamic (PD) target attainment considering both antibiotics serum concentrations and measured MICs in these patients. Method: A multicentric prospective open-label trial conducted in 11 French ICUs involved patients with Gram-negative bacilli (GNB) ventilator-associated pneumonia (VAP) confirmed by quantitative cultures. Results: We included 117 patients. Causative GNBs were P. aeruginosa (40%), Enterobacter spp. (23%), E. coli (20%), and Klebsiella spp. (16%). Hence, 117 (100%) patients received β-lactams, 65 (58%) aminoglycosides, and two (1.5%) fluoroquinolones. For β-lactams, 83% of the patients achieved a Cmin/MIC > 1 and 70% had a Cmin/MIC > 4. In the case of high creatinine clearance (CrCL > 100 mL/min/1.73 m2), 70.4% of the patients achieved a Cmin/MIC ratio > 1 versus 91% otherwise (p = 0.041), and 52% achieved a Cmin/MIC ratio > 4 versus 81% (p = 0.018). For aminoglycosides, 94% of the patients had a Cmax/MIC ratio > 8. Neither β-lactams nor aminoglycosides PK/PD parameters were associated clinical outcomes, but our data suggest a correlation between β-lactams Cmin/MIC and microbiological success. Conclusion: In our ICU patients treated for GNB VAP, using recommended antibiotic dosage led in most cases to PK/PD targets attainment for aminoglycosides and β-lactams. High creatinine clearance should encourage clinicians to focus on PK/PD issues.
Published: 2022
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9. Journal club in an ICU: rate and factors associated with practice-changing articles. Analysis of 1712 articles read over a 13-year period (2007–2019)

Author: Damien Contou, Marina Thirion, Olivier Pajot, Gaëtan Plantefève, and Hervé Mentec
Subjects: Journal Club, Medical Journal, Continuing medical education, Intensive Care, Practice-changing article, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Published: 2020
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10. Pulmonary embolism or thrombosis in ARDS COVID-19 patients: A French monocenter retrospective study.

Author: Damien Contou, Olivier Pajot, Radj Cally, Elsa Logre, Megan Fraissé, Hervé Mentec, and Gaëtan Plantefève
Subjects: Medicine, Science
Abstract: Hypercoagulability and endotheliopathy reported in patients with coronavirus disease 2019 (COVID-19) combined with strict and prolonged immobilization inherent to deep sedation and administration of neuromuscular blockers for Acute Respiratory Distress Syndrome (ARDS) may expose critically ill COVID-19 patients to an increased risk of venous thrombosis and pulmonary embolism (PE). We aimed to assess the rate and to describe the clinical features and the outcomes of ARDS COVID-19 patients diagnosed with PE during ICU stay. From March 13th to April 24th 2020, a total of 92 patients (median age: 61 years, 1st-3rd quartiles [55-70]; males: n = 73/92, 79%; baseline SOFA: 4 [3-7] and SAPS II: 31 [21-40]; invasive mechanical ventilation: n = 83/92, 90%; ICU mortality: n = 45/92, 49%) were admitted to our 41-bed COVID-19 ICU for ARDS due to COVID-19. Among them, 26 patients (n = 26/92, 28%) underwent a Computed Tomography Pulmonary Angiography which revealed PE in 16 (n = 16/26, 62%) of them, accounting for 17% (n = 16/92) of the whole cohort. PE was bilateral in 3 (19%) patients and unilateral in 13 (81%) patients. The most proximal thrombus was localized in main (n = 4, 25%), lobar (n = 2, 12%) or segmental (n = 10, 63%) pulmonary artery. Most of the thrombi (n = 13/16, 81%) were located in a parenchymatous condensation. Only three of the 16 patients (19%) had lower limb venous thrombosis on Doppler ultrasound. Three patients were treated with alteplase and anticoagulation (n = 3/16, 19%) while the 13 others (n = 13/16, 81%) were treated with anticoagulation alone. ICU mortality was higher in patients with PE compared to that of patients without PE (n = 11/16, 69% vs. n = 2/10, 20%; p = 0.04). The low rate of lower limb venous thrombosis together with the high rate of distal pulmonary thrombus argue for a local immuno-thrombotic process associated with the classic embolic process. Further larger studies are needed to assess the real prevalence and the risk factors of pulmonary embolism/thrombosis together with its prognostic impact on critically ill patients with COVID-19.
Published: 2020
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11. Clinical features and outcome of patients with acute respiratory failure revealing anti-synthetase or anti-MDA-5 dermato-pulmonary syndrome: a French multicenter retrospective study

Author: Constance Vuillard, Marc Pineton de Chambrun, Nicolas de Prost, Claude Guérin, Matthieu Schmidt, Auguste Dargent, Jean-Pierre Quenot, Sébastien Préau, Geoffrey Ledoux, Mathilde Neuville, Guillaume Voiriot, Muriel Fartoukh, Rémi Coudroy, Guillaume Dumas, Eric Maury, Nicolas Terzi, Yacine Tandjaoui-Lambiotte, Francis Schneider, Maximilien Grall, Emmanuel Guérot, Romaric Larcher, Sylvie Ricome, Raphaël Le Mao, Gwenhaël Colin, Christophe Guitton, Lara Zafrani, Elise Morawiec, Marie Dubert, Olivier Pajot, Hervé Mentec, Gaëtan Plantefève, and Damien Contou
Subjects: Inflammatory myositis, Interstitial lung disease, ARDS, Acute respiratory failure, Diagnosis, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Abstract Background Anti-synthetase (AS) and dermato-pulmonary associated with anti-MDA-5 antibodies (aMDA-5) syndromes are near one of the other autoimmune inflammatory myopathies potentially responsible for severe acute interstitial lung disease. We undertook a 13-year retrospective multicenter study in 35 French ICUs in order to describe the clinical presentation and the outcome of patients admitted to the ICU for acute respiratory failure (ARF) revealing AS or aMDA-5 syndromes. Results From 2005 to 2017, 47 patients (23 males; median age 60 [1st–3rd quartiles 52–69] years, no comorbidity 85%) were admitted to the ICU for ARF revealing AS (n = 28, 60%) or aMDA-5 (n = 19, 40%) syndromes. Muscular, articular and cutaneous manifestations occurred in 11 patients (23%), 14 (30%) and 20 (43%) patients, respectively. Seventeen of them (36%) had no extra-pulmonary manifestations. C-reactive protein was increased (139 [40–208] mg/L), whereas procalcitonine was not (0.30 [0.12–0.56] ng/mL). Proportion of patients with creatine kinase ≥ 2N was 20% (n = 9/47). Forty-two patients (89%) had ARDS, which was severe in 86%, with a rate of 17% (n = 8/47) of extra-corporeal membrane oxygenation requirement. Proportion of patients who received corticosteroids, cyclophosphamide, rituximab, intravenous immunoglobulins and plasma exchange were 100%, 72%, 15%, 21% and 17%, respectively. ICU and hospital mortality rates were 45% (n = 21/47) and 51% (n = 24/47), respectively. Patients with aMDA-5 dermato-pulmonary syndrome had a higher hospital mortality than those with AS syndrome (n = 16/19, 84% vs. n = 8/28, 29%; p = 0.001). Conclusions Intensivists should consider inflammatory myopathies as a cause of ARF of unknown origin. Extra-pulmonary manifestations are commonly lacking. Mortality is high, especially in aMDA-5 dermato-pulmonary syndrome.
Published: 2018
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12. Impact of Resident Rotations on Critically Ill Patient Outcomes: Results of a French Multicenter Observational Study.

Author: Benjamin G Chousterman, Romain Pirracchio, Bertrand Guidet, Philippe Aegerter, Hervé Mentec, and CUB-REA network
Subjects: Medicine, Science
Abstract: PURPOSE:The impact of resident rotation on patient outcomes in the intensive care unit (ICU) has been poorly studied. The aim of this study was to address this question using a large ICU database. METHODS:We retrospectively analyzed the French CUB-REA database. French residents rotate every six months. Two periods were compared: the first (POST) and fifth (PRE) months of the rotation. The primary endpoint was ICU mortality. The secondary endpoints were the length of ICU stay (LOS), the number of organ supports, and the duration of mechanical ventilation (DMV). The impact of resident rotation was explored using multivariate regression, classification tree and random forest models. RESULTS:262,772 patients were included between 1996 and 2010 in the database. The patient characteristics were similar between the PRE (n = 44,431) and POST (n = 49,979) periods. Multivariate analysis did not reveal any impact of resident rotation on ICU mortality (OR = 1.01, 95% CI = 0.94; 1.07, p = 0.91). Based on the classification trees, the SAPS II and the number of organ failures were the strongest predictors of ICU mortality. In the less severe patients (SAPS II
Published: 2016
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13. Non-intubated COVID-19 patients despite high levels of supplemental oxygen

Author: Radj Cally, Samuel Chosidow, Hervé Mentec, Megan Fraissé, Gaëtan Plantefève, and Damien Contou
Subjects: ARDS, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Supplemental oxygen, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), medicine.medical_treatment, Critical Care and Intensive Care Medicine, Acute respiratory failure, Tachypnea, Mechanical ventilation, medicine, Research Letter, Humans, Noninvasive Ventilation, business.industry, SARS-CoV-2, RC86-88.9, Tracheal intubation, Oxygen Inhalation Therapy, COVID-19, Medical emergencies. Critical care. Intensive care. First aid, medicine.disease, Respiration, Artificial, Oxygen, Anesthesia, ICU, medicine.symptom, business, Respiratory Insufficiency
Published: 2021

14. Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis

Author: David Hajage, Alain Combes, Christophe Guervilly, Guillaume Lebreton, Alain Mercat, Arthur Pavot, Saad Nseir, Armand Mekontso-Dessap, Nicolas Mongardon, Jean Paul Mira, Jean-Damien Ricard, Alexandra Beurton, Guillaume Tachon, Loay Kontar, Christophe Le Terrier, Jean Christophe Richard, Bruno Mégarbane, Ruth H. Keogh, Aurélien Belot, Camille Maringe, Clémence Leyrat, Matthieu Schmidt, Pierre Asfar, François Beloncle, Julien Demiselle, Tài Pham, Xavier Monnet, Christian Richard, Alexandre Demoule, Martin Dres, Julien Mayaux, Cédric Daubin, Richard Descamps, Aurélie Joret, Damien Du Cheyron, Frédéric Pene, Jean-Daniel Chiche, Mathieu Jozwiak, Paul Jaubert, Guillaume Voiriot, Muriel Fartoukh, Marion Teulier, Clarisse Blayau, Erwen L'Her, Cécile Aubron, Laetitia Bodenes, Nicolas Ferriere, Johann Auchabie, Anthony Le Meur, Sylvain Pignal, Thierry Mazzoni, Jean-Pierre Quenot, Pascal Andreu, Jean-Baptiste Roudau, Marie Labruyère, Sébastien Preau, Julien Poissy, Daniel Mathieu, Sarah Benhamida, Rémi Paulet, Nicolas Roucaud, Martial Thyrault, Florence Daviet, Sami Hraiech, Gabriel Parzy, Aude Sylvestre, Sébastien Jochmans, Anne-Laure Bouilland, Mehran Monchi, Marc Danguy des Déserts, Quentin Mathais, Gwendoline Rager, Pierre Pasquier, Jean Reignier, Amélie Seguin, Charlotte Garret, Emmanuel Canet, Jean Dellamonica, Clément Saccheri, Romain Lombardi, Yanis Kouchit, Sophie Jacquier, Armelle Mathonnet, Mai-Ahn Nay, Isabelle Runge, Frédéric Martino, Laure Flurin, Amélie Rolle, Michel Carles, Rémi Coudroy, Arnaud W. Thille, Jean-Pierre Frat, Maeva Rodriguez, Pascal Beuret, Audrey Tientcheu, Arthur Vincent, Florian Michelin, Fabienne Tamion, Dorothée Carpentier, Déborah Boyer, Gaetan Beduneau, Valérie Gissot, Stéphan Ehrmann, Charlotte Salmon Gandonniere, Djlali Elaroussi, Agathe Delbove, Yannick Fedun, Julien Huntzinger, Eddy Lebas, Grâce Kisoka, Céline Grégoire, Stella Marchetta, Bernard Lambermont, Laurent Argaud, Thomas Baudry, Pierre-Jean Bertrand, Auguste Dargent, Christophe Guitton, Nicolas Chudeau, Mickaël Landais, Cédric Darreau, Alexis Ferre, Antoine Gros, Guillaume Lacave, Fabrice Bruneel, Mathilde Neuville, Jérôme Devaquet, Richard Gallot, Riad Chelha, Arnaud Galbois, Anne Jallot, Ludivine Chalumeau Lemoine, Khaldoun Kuteifan, Valentin Pointurier, Louise-Marie Jandeaux, Joy Mootien, Charles Damoisel, Benjamin Sztrymf, Juliette Chommeloux, Charles Edouard Luyt, Frédérique Schortgen, Leon Rusel, Camille Jung, Florent Gobert, Damien Vimpere, Lionel Lamhaut, Bertrand Sauneuf, Liliane Charrrier, Julien Calus, Isabelle Desmeules, Benoît Painvin, Jean-Marc Tadie, Vincent Castelain, Baptiste Michard, Jean-Etienne Herbrecht, Mathieu Baldacini, Nicolas Weiss, Sophie Demeret, Clémence Marois, Benjamin Rohaut, Pierre-Henri Moury, Anne-Charlotte Savida, Emmanuel Couadau, Mathieu Série, Nica Alexandru, Cédric Bruel, Candice Fontaine, Sonia Garrigou, Juliette Courtiade Mahler, Maxime Leclerc, Michel Ramakers, Pierre Garçon, Nicole Massou, Ly Van Vong, Juliane Sen, Nolwenn Lucas, Franck Chemouni, Annabelle Stoclin, Alexandre Avenel, Henri Faure, Angélie Gentilhomme, Sylvie Ricome, Paul Abraham, Céline Monard, Julien Textoris, Thomas Rimmele, Florent Montini, Gabriel Lejour, Thierry Lazard, Isabelle Etienney, Younes Kerroumi, Claire Dupuis, Marine Bereiziat, Elisabeth Coupez, François Thouy, Clément Hoffmann, Nicolas Donat, Anne Chrisment, Rose-Marie Blot, Antoine Kimmoun, Audrey Jacquot, Matthieu Mattei, Bruno Levy, Ramin Ravan, Loïc Dopeux, Jean-Mathias Liteaudon, Delphine Roux, Brice Rey, Radu Anghel, Deborah Schenesse, Vincent Gevrey, Jermy Castanera, Philippe Petua, Benjamin Madeux, Otto Hartman, Michael Piagnerelli, Anne Joosten, Cinderella Noel, Patrick Biston, Thibaut Noel, Gurvan LE Bouar, Messabi Boukhanza, Elsa Demarest, Marie-France Bajolet, Nathanaël Charrier, Audrey Quenet, Cécile Zylberfajn, Nicolas Dufour, Buno Mégarbane, Sébastian Voicu, Nicolas Deye, Isabelle Malissin, François Legay, Matthieu Debarre, Nicolas Barbarot, Pierre Fillatre, Bertrand Delord, Thomas Laterrade, Tahar Saghi, Wilfried Pujol, Pierre Julien Cungi, Pierre Esnault, Mickael Cardinale, Vivien Hong Tuan Ha, Grégory Fleury, Marie-Ange Brou, Daniel Zafimahazo, David Tran-Van, Patrick Avargues, Lisa Carenco, Nicolas Robin, Alexandre Ouali, Lucie Houdou, Noémie Suh, Steve Primmaz, Jérome Pugin, Emmanuel Weiss, Tobias Gauss, Jean-Denis Moyer, Catherine Paugam Burtz, Béatrice La Combe, Rolland Smonig, Jade Violleau, Pauline Cailliez, Jonathan Chelly, Antoine Marchalot, Cécile Saladin, Christelle Bigot, Pierre-Marie Fayolle, Jules Fatséas, Amr Ibrahim, Dabor Resiere, Rabih Hage, Clémentine Cholet, Marie Cantier, Pierre Trouiler, Philippe Montravers, Brice Lortat-Jacob, Sebastien Tanaka, Alexy Tran Dinh, Jacques Duranteau, Anatole Harrois, Guillaume Dubreuil, Marie Werner, Anne Godier, Sophie Hamada, Diane Zlotnik, Hélène Nougue, Guillaume Carteaux, Keyvan Razazi, Nicolas De Prost, Meriam Lamraoui, Claire Alessandri, Quentin de Roux, Charles de Roquetaillade, Benjamin G. Chousterman, Alexandre Mebazaa, Etienne Gayat, Marc Garnier, Emmanuel Pardo, Lea Satre-Buisson, Christophe Gutton, Elise Yvin, Clémence Marcault, Elie Azoulay, Michael Darmon, Hafid Ait Oufella, Geoffroy Hariri, Tomas Urbina, Sandie Mazerand, Nicholas Heming, Francesca Santi, Pierre Moine, Djillali Annane, Adrien Bouglé, Edris Omar, Aymeric Lancelot, Emmanuelle Begot, Gaétan Plantefeve, Damien Contou, Hervé Mentec, Olivier Pajot, Stanislas Faguer, Olivier Cointault, Laurence Lavayssiere, Marie-Béatrice Nogier, Matthieu Jamme, Claire Pichereau, Jan Hayon, Hervé Outin, François Dépret, Maxime Coutrot, Maité Chaussard, Lucie Guillemet, Pierre Goffin, Romain Thouny, Julien Guntz, Laurent Jadot, Romain Persichini, Vanessa Jean-Michel, Hugues Georges, Thomas Caulier, Gaël Pradel, Marie-Hélène Hausermann, Thi My Hue Nguyen-Valat, Michel Boudinaud, Emmanuel Vivier, Sylvène Rosseli, Gaël Bourdin, Christian Pommier, Marc Vinclair, Simon Poignant, Sandrine Mons, Wulfran Bougouin, Franklin Bruna, Quentin Maestraggi, Christian Roth, Laurent Bitker, François Dhelft, Justine Bonnet-Chateau, Mathilde Filippelli, Tristan Morichau-Beauchant, Stéphane Thierry, Charlotte Le Roy, Mélanie Saint Jouan, Bruno Goncalves, Aurélien Mazeraud, Matthieu Daniel, Tarek Sharshar, Cyril Cadoz, Rostane Gaci, Sébastien Gette, Guillaune Louis, Sophe-Caroline Sacleux, Marie-Amélie Ordan, Aurélie Cravoisy, Marie Conrad, Guilhem Courte, Sébastien Gibot, Younès Benzidi, Claudia Casella, Laurent Serpin, Jean-Lou Setti, Marie-Catherine Besse, Anna Bourreau, Jérôme Pillot, Caroline Rivera, Camille Vinclair, Marie-Aline Robaux, Chloé Achino, Marie-Charlotte Delignette, Tessa Mazard, Frédéric Aubrun, Bruno Bouchet, Aurélien Frérou, Laura Muller, Charlotte Quentin, Samuel Degoul, Xavier Stihle, Claude Sumian, Nicoletta Bergero, Bernard Lanaspre, Hervé Quintard, Eve Marie Maiziere, Pierre-Yves Egreteau, Guillaume Leloup, Florin Berteau, Marjolaine Cottrel, Marie Bouteloup, Matthieu Jeannot, Quentin Blanc, Julien Saison, Isabelle Geneau, Romaric Grenot, Abdel Ouchike, Pascal Hazera, Anne-Lyse Masse, Suela Demiri, Corinne Vezinet, Elodie Baron, Deborah Benchetrit, Antoine Monsel, Grégoire Trebbia, Emmanuelle Schaack, Raphaël Lepecq, Mathieu Bobet, Christophe Vinsonneau, Thibault Dekeyser, Quentin Delforge, Imen Rahmani, Bérengère Vivet, Jonathan Paillot, Lucie Hierle, Claire Chaignat, Sarah Valette, Benoït Her, Jennifier Brunet, Mathieu Page, Fabienne Boiste, Anthony Collin, Florent Bavozet, Aude Garin, Mohamed Dlala, Kais Mhamdi, Bassem Beilouny, Alexandra Lavalard, Severine Perez, Benoit Veber, Pierre-Gildas Guitard, Philippe Gouin, Anna Lamacz, Fabienne Plouvier, Bertrand P Delaborde, Aïssa Kherchache, Amina Chaalal, Marc Amouretti, Santiago Freita-Ramos, Damien Roux, Jean-Michel Constantin, Mona Assefi, Marine Lecore, Agathe Selves, Florian Prevost, Christian Lamer, Ruiying Shi, Lyes Knani, Sébastien Pili Floury, Lucie Vettoretti, Michael Levy, Lucile Marsac, Stéphane Dauger, Sophie Guilmin-Crépon, Hadrien Winiszewski, Gael Piton, Thibaud Soumagne, Gilles Capellier, Jean-Baptiste Putegnat, Frédérique Bayle, Maya Perrou, Ghyslaine Thao, Guillaume Géri, Cyril Charron, Xavier Repessé, Antoine Vieillard-Baron, Mathieu Guilbart, Pierre-Alexandre Roger, Sébastien Hinard, Pierre-Yves Macq, Kevin Chaulier, Sylvie Goutte, Patrick Chillet, Anaïs Pitta, Barbara Darjent, Amandine Bruneau, Sigismond Lasocki, Maxime Leger, Soizic Gergaud, Pierre Lemarie, Nicolas Terzi, Carole Schwebel, Anaïs Dartevel, Louis-Marie Galerneau, Jean-Luc Diehl, Caroline Hauw-Berlemont, Nicolas Péron, Emmanuel Guérot, Abolfazl Mohebbi Amoli, Michel Benhamou, Jean-Pierre Deyme, Olivier Andremont, Diane Lena, Julien Cady, Arnaud Causeret, Arnaud De La Chapelle, Christophe Cracco, Stéphane Rouleau, David Schnell, Camille Foucault, Cécile Lory, Thibault Chapelle, Vincent Bruckert, Julie Garcia, Abdlazize Sahraoui, Nathalie Abbosh, Caroline Bornstain, Pierre Pernet, Florent Poirson, Ahmed Pasem, Philippe Karoubi, Virginie Poupinel, Caroline Gauthier, François Bouniol, Philippe Feuchere, Anne Heron, Serge Carreira, Malo Emery, Anne Sophie Le Floch, Luana Giovannangeli, Nicolas Herzog, Christophe Giacardi, Thibaut Baudic, Chloé Thill, Said Lebbah, Jessica Palmyre, Florence Tubach, Nicolas Bonnet, Nathan Ebstein, Stéphane Gaudry, Yves Cohen, Julie Noublanche, Olivier Lesieur, Arnaud Sément, Isabel Roca-Cerezo, Michel Pascal, Nesrine Sma, Gwenhaël Colin, Jean-Claude Lacherade, Gauthier Bionz, Natacha Maquigneau, Pierre Bouzat, Michel Durand, Marie-Christine Hérault, Jean-Francois Payen, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Nord [CHU - APHM], Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Université Paris-Saclay, CHU Lille, Hôpital Henri Mondor, Groupe de recherche clinique CARMAS [Créteil] (UPEC/Faculté de Médecine de Créteil), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Descartes - Paris 5 (UPD5), Hôpital Louis Mourier - AP-HP [Colombes], Hôpital Foch [Suresnes], CHU Amiens-Picardie, Geneva University Hospital (HUG), Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Hôpital Lariboisière-Fernand-Widal [APHP], London School of Hygiene and Tropical Medicine (LSHTM), RICHARD, Jean-Christophe, Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Pulmonary and Respiratory Medicine, Adult, Respiratory Distress Syndrome, SARS-CoV-2, [SDV]Life Sciences [q-bio], acute respiratory distress syndrome (ARDS), COVID-19, extracorporeal membrane oxygenation, Critical Care and Intensive Care Medicine, Cohort Studies, [SDV] Life Sciences [q-bio], emulated target trial, acute respiratory distress syndrome, Treatment Outcome, surgical procedures, operative, Humans, Retrospective Studies
Abstract: International audience; Rationale: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown.Objectives: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2
Published: 2022

15. Relying on pulse oximetry to avoid hypoxaemia and hyperoxia: A multicentre prospective cohort study in patients with circulatory failure

Author: Thierry Boulain, Mai-Anh Nay, Pierre-François Dequin, Jean-Baptiste Lascarrou, Philippe Vignon, Toufik Kamel, Grégoire Muller, Stephan Ehrmann, Olivier Baudin, Sylvie Calvat, Christophe Cracco, Arnault Desachy, Charles Lafon, Emmanuelle Boitrou, Arnaud Follin, Hervé Mentec, Olivier Pajot, Gaëtan Plantefève, Marina Thirion, Rémi Bruyère, Jean-Pierre Quenot, Konstantinos Bachoumas, Maud Fiancette, Jean Claude Lacherade, Christine Lebert, Laurent Martin-Lefèvre, Jean Reignier, Isabelle Vinatier, Aihem Yehia, Emmanuelle Begot, Remy Bellier, Marc Clavel, Bruno François, Antoine Galy, Nicolas Pichon, Patrick Bardou, Frédéric Bellec, Michel Bonnivard, Anne Marco, Jérôme Roustan, Sylvie Vimeux, Anne Bretagnol, Armelle Mathonnet, Nicolas Bercault, François Réminiac, Isabelle Runge, Marie Skarzynski, Delphine Chatellier, Rémi Coudroy, Jean-Pierre Frat, Véronique Goudet, René Robert, Anne Veinstein, Vlad Botoc, Stéphanie Chevalier, François Collet, Jean-Paul Gouello, Julie Badin, Antoine Guillon, Annick Legras, Elodie Masseret, Emmanuelle Mercier, and Patrice Talec
Subjects: Emergency Nursing, Critical Care Nursing
Abstract: The purpose of this study was to assess the predictive performance of pulse oximetry (SpOSpOFive hundred seventy-one patients (mean [standard deviation] Simplified Acute Physiology Score II: 58.7 [20.1]; mechanically ventilated 75.6%) with 2643 available SaO
Published: 2022

16. Frailty is associated with long-term outcome in patients with sepsis who are over 80 years old: results from an observational study in 241 European ICUs

Author: Nigel White, Jenny Lord, Angela Prado Mira, Ala Khaled, Hubert Hymczak, Kristian Strand, Lenneke E M Haas, Mirosław Czuczwar, Lettie van den Berg, Pieter De Buysscher, Małgorzata Lipińska-Gediga, Simon Dubler, Michel Djibré, Ignacio Martin-Loeches, Georgina Randell, Diederik Gommers, Jose Maia, Patrick Meybohm, Wojciech Gola, Lina De Geer, Tom Lawton, Jonas Juul Pedersen, Isabel Amorim Ferreira, Kristina Fuest, Marcus Franz, McDonald Mupudzi, Kounougeri Aikaterini, Zoi Aidoni, Anastasia Koutsikou, Joakim Sivik, Hans Flaatten, Catia Cilloniz, Paweł Zatorski, Sally Humphreys, Henrik Westberg, Eva Rice, Peter de Jager, Helder Filipe, Stefania Brusa, Maria Faulkner, Jan Stefaniak, Cyril Charron, Nuno Candeias, Sten Walther, Nathalie Rolin, Muhammed Elhadi, Marta Serwa, Sebastian Allgäuer, Thomas Elkmann, Philipp Eller, Jean-Luc Chagnon, Gonzalo Navarro Velasco, Raimund Helbok, Catherine Motherway, Dorota Studzińska, Alan Pope, Ahmed Tarek, Cristina Sousa, Natalia Kozera, Michael Horacek, Camilla Brorsson, Tom Dormans, Nuno Catorze, Michael Joannidis, Andrea Neville Cracchiolo, Walter Swinnen, Oscar Hoiting, Africa Lores, Dominic Spray, Vladislav Belskiy, Marijana Mikačić, Rachel Savine, Tim Rahmel, Christoffer Sølling, Fredrik Schiöler, Henning Ebelt, Urszula Kościuczuk, Marek Pietruszko, Alexander D Cornet, Vasiiios Zidianakis, Bogdan Raitsiou, Ana Rita Santos, Nick Spittle Nick Spittle, Jan Peter Jensen, Alena Breidablik Alena Breidablik, Wojciech Szczeklik, Joerg C. Schefold, Karin Kleiven Thiringer, Alexandre Fernandes Pinto, Antoine Romen, Ingeborg D Welters, Nikolaas de Neve, Joanne Jones, Carole Boulanger, Ciaran Hart, Georgios Papathanakos, Jessica Nauska, Gaspar Eixarch, Pål Klepstad, Wesal Ali Belkhair, Ximena Watson, Brian Marsh, Emmanuel Guerot, Michael W. Schuster, Julie North, Bartosz Kudlinski, Alessandro Morandi, Stefan Schering, Fotios Tsimpoukas, Mercedes Ibarz, Ioannis Koutsodimitropoulos, Maurizio Cecconi, David Perez-Torres, Stephan Steiner, Agnieszka Kubisz-Pudelko, Johan Berkius, Phillipa Wakefield, Joanna Zorska, Anne-Karin Rime, Jacobo Bacariza Blanco, Reni Jacob, Guillaume Besch, Jane Evans, Mathilde Hummelmose Enevoldsen, Jasper Haringman, Xavier Valette, Pierre Garçon, Waldemar Cyrankiewicz, Megan Lea-Hagerty, Jason Cupitt, Yolanda Baird, Eberhard Barth, Stylliani Kourelea, Christine Cramer, Gerardo Aguilar, Christophe Vinsonneau, Maud Mousset Hovaere, Hans Frank Strietzel, Patricia Jimeno Cubero, René Schmutz, Aristide Morigi, Jonathan Ball, Raphael Romano Bruno, Kirsti Tøien, Ahmed Elhadi, Susan Dowling, Antonio Artigas, Aleksandra Biernacka, Clare Bolger, Italo Calamai, Dorthe Ørsnes, Giorgos Marinakis, Amy Collins, Leila Hergafi, Didier Thevenin, Michael Spivey, Bård E S Dahle, Willem Dieperink, Lucie Vettoretti, Vryza Konstantinia, Tasioudis Polychronis, Laura Ortiz-Ruiz De Gordoa, Julien Maizel, Louise Bell, Nicholas Love, Christian Frey, Joanna Solek-Pastuszka, Richard Pugh, Stefan J. Schaller, Hervé Mentec, Mercedes Ibarz Villamayor, Ritoo Kapoor, W. Khaliq, Gemma Gomà, Patrick Morgan, Finn H. Andersen, Madhu Balasubramaniam, Irina Grecu, Filippo Boroli, Saad Nseir, Mariusz Piechota, Ana M. Fernandes, Katarzyna Cwyl, Elli Niki Flioni, Jørund Langørgen, Kiran Salaunkey, Jean-Pierre Quenot, Philippe Burtin, Michael Reay, Ryszard Gawda, Ariane Boumendil, Anders Bastiansen, Hazem Ahmed, Evangelia Neou, Ihor Yovenko, Rik T Gerritsen, Bente Jannestad, Tarkeshwari Mane, Richard Innes, Kelly Tiercelet, Christian Jung, Rui Moreno, Maciej Zukowski, Dariusz Maciejewski, Dylan W. de Lange, Jeremy Henning, Paweł Nasiłowski, Estefania Prol-Silva, Tilemachos Zafeiridis, Lukasz J Krzych, Jérémy Rosman, Tobias Graf, Sonia López-Cuenca, Marcela Vizcaychipi, Jeremy Castaneray, Steve Rose, Vongayi Ogbeide, Arnaud Galbois, Yuriy Nalapko, Sandra Oeyen, Joke Nollet, Ismail Yıldız, Chris Read, Philippe Eckert, Ashok Raj, Anita Slapgard, Anna Kluzik, Mirosław Ziętkiewicz, Christian Rabe, Guillaume Savary, Noemí Llamas Fernández, João Teles Carvalho, Nikoletta Rovina, Jakob Edelberg Thomsen, Britt Sjøbøe, Andreas Husted, Jean-Philippe Rigaud, Bertrand Guidet, Piotr Galkin, Marián Irazábal Jaimes, Anders Sjöqvist, Paweł Sendur, Thorben Dieck, A. Vakalos, Enver Rodriguez, Jesper Fjølner, Eva van Boven, Inês Barros, Susannah Leaver, Patricia Williams, Messika Messika, Emilio Maseda, Michael Hahn, Teresa Tomasa, and Critical Care
Subjects: Aging, medicine.medical_specialty, intensive care units, 80 jaar en ouder, Comorbidity, frailty, elderly, law.invention, Sepsis, sepsis, 03 medical and health sciences, intensive care afdelingen, 0302 clinical medicine, law, Intensive care, kwetsbaarheid, sterfte, ouderen, medicine, 80 and over, Humans, 030212 general & internal medicine, Hospital Mortality, Prospective Studies, Prospective cohort study, business.industry, Mortality rate, Hazard ratio, 030208 emergency & critical care medicine, General Medicine, medicine.disease, Intensive care unit, mortality, aged, Emergency medicine, SOFA score, Geriatrics and Gerontology, business, aged, 80 and over
Abstract: Background Sepsis is one of the most frequent reasons for acute intensive care unit (ICU) admission of very old patients and mortality rates are high. However, the impact of pre-existing physical and cognitive function on long-term outcome of ICU patients ≥ 80 years old (very old intensive care patients (VIPs)) with sepsis is unclear. Objective To investigate both the short- and long-term mortality of VIPs admitted with sepsis and assess the relation of mortality with pre-existing physical and cognitive function. Design Prospective cohort study. Setting 241 ICUs from 22 European countries in a six-month period between May 2018 and May 2019. Subjects Acutely admitted ICU patients aged ≥80 years with sequential organ failure assessment (SOFA) score ≥ 2. Methods Sepsis was defined according to the sepsis 3.0 criteria. Patients with sepsis as an admission diagnosis were compared with other acutely admitted patients. In addition to patients’ characteristics, disease severity, information about comorbidity and polypharmacy and pre-existing physical and cognitive function were collected. Results Out of 3,596 acutely admitted VIPs with SOFA score ≥ 2, a group of 532 patients with sepsis were compared to other admissions. Predictors for 6-month mortality were age (per 5 years): Hazard ratio (HR, 1.16 (95% confidence interval (CI), 1.09–1.25, P 4): HR, 1.34 (95% CI, 1.18–1.51, P Conclusions There is substantial long-term mortality in VIPs admitted with sepsis. Frailty, age and disease severity were identified as predictors of long-term mortality in VIPs admitted with sepsis.
Published: 2021

17. Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Author: Labeau, Sonia O, Afonso, Elsa, Benbenishty, Julie, Blackwood, Bronagh, Boulanger, Carole, Brett, Stephen J, Calvino-Gunther, Silvia, Chaboyer, Wendy, Coyer, Fiona, Deschepper, Mieke, François, Guy, Honore, Patrick M, Jankovic, Radmilo, Khanna, Ashish K, Llaurado-Serra, Mireia, Lin, Frances, Rose, Louise, Rubulotta, Francesca, Saager, Leif, Williams, Ged, Blot, Stijn I, Dritan, Muzha, Antoni Margarit Ribas, Fernando, Lipovesty, Cecilia, Loudet, Fiona, Coyer, Philipp, Eller, Nafseen, Mostafa, Patrick, M Honoré, Vanesa Mercado Telleria, Jasmina, Smajic, Paula Cristina Nogueira, Khalid Mahmood Khan Nafees, Romuald, Hentchoya, Louise, Rose, Javiera, Soledad, Frances, Lin, Yenny, Cardenas, Amylkar Garay Reyes, Alan, Sustic, Meropi, Mpouzika, Tamas, Vymazal, Hanne Irene Jensen, Hernan, Aguirre-Bermeo, Liivi, Maddison, Maija, Valta, Silvia, Calvino-Gunther, Frank, Bloos, Faustina Excel Adipa, Vasilios, Koulouras, Judy, Enamorado, Zsuzsann, Ágoston, Hrönn, Birgisdóttir, Amit, Gupta, Mohan, Gurjar, Bram, Kilapong, Seyed Mohammadreza Hashemian, Ignacio, Martin-Loeches, Julie, Benbenishty, Andrea, Cortegiani, Kelly, Fletcher, Yoshiro, Hayashi, Wangari, Waweru-Siika, Khalid, Abidi, Sang-Min, Lee, Burhan, Hadri, Mihails, Dolgusevs, Fayez François Abillama, Tomas, Jovaisa, Cyril, Thix, Muhammed, Elhadi, Basri Mat Nor, Shanti, Ratnam, Mohd Zulfakar Mazlan, Sundaresan, Maiyalagan, Luis, Sánchez-Hurtado, Adrian, Belii, Mendsaikhan, Naranpurev, Prabha, Gautam, Dylan De Lange, Rachael, Parke, Rose Ekama Ilesanmi, Mirjana, Shosholcheva, Antonija, Petosic, Ranveig, Lind, Madiha Hashmi Ffarcsi, Javier, Bogarin, Aaron Mark Hernandez, Malgorzata, Mikaszewska-Sokolewicz, Bruno, Sousa, Dana, Tomescu, Dorel, Sandesc, Theogene, Twagirumugabe, Vitaly, Gusarov, Maie, Ebaid, Radmilo, Jankovic, Gari, Slobodianiuk, Andrea, Martonova, Rihard, Knafelj, Mervyn, Mer, Emilio, Maseda, Bernardo, Panka, Joerg, C Schefold, Eva, Joelsson-Alm, Konlawij, Trongtrakul, Lorna, Merritt-Charles, Lamia Ouanes Besbes, Yalım, Dikmen, Lesia, Zgrzheblovska, Mark, Fielding, Francesca, Rubulotta, Ashish, K Khanna, Leif, Saager, Ingrid von der Osten, Alban, Greca, Alma, Cani, Nordian, Xhindi, Genci, Hyska, Antonio Margarit Ribas, Susana, Pinto, Paulo, Alves, Romina, Esposito, Emanuel, Valgolio, John Thomas Sanchez Minope, Antonio, Abdala, Maria, Ayala, Silvina, Bravo, Ana, Bantar, Patricia, Delgado, Gustavo, Badariotti, Fernando, Lipovestky, Ana, Diaz, Pablo, Saul, Mariano, Setten, Alejandra, Aucapina, Ysica, Acosta, Victor, Gonzalez, Luis, Camputaro, Fernando, Baccaro, Robert, Villa, Marcela, Mastantuono, Emiliano, Dean, Oscar Fernández Rostello, Patricia, Brizuela, Julio Ricardo Bartoli, Matias, Guereschi, Cristian, Quiroga, Sofia, Putruele, Paula, Villegas, Veronica, Curilen, Ruben, Fernandez, Mariangeles Gabriela Nocheretti, Rosana Gabriela Escalante, Cecilia Inés Loudet, Silvia, Fernandez, Ana Laura Gonzalez, Gustavo Andres Alvarez, Federico, Iglesias, Silvia, Chaparro, Graciela, 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Michael, Isanan, Marta, Tubacka, Przemyslaw, Jasiewicz, Miroslaw, Czuczwar, Michal, Borys, Aleksandra, Gutysz-Wojnicka, Lidia, Glinka, Ryszard, Gawda, Jan, Bilawicz, Paula, Cabrita, João, Vieira, Margarida Ferreira Figueiredo, Cristiana Mota Pinheiro, Nelson, Antunes, Laura, Pedro, Fatima, Ferreira, Isabel, Parente, Maria, Varela, Fatima, Fernandes, Claudia, Martins, Abel, Viveiros, Raquel, Cavaco, Clara Santa Rita, Sofia, Dias, Ana Margarida Feranandes, Pedro, Silva, Catarina, Nunes, João, Cabral, Filpe, Pires, Hilaryano, Ferreira, Jacinta, Santos, Vitor Manuel Vaz Pinto, Bruno Miguel Bispo, Amelia, Ferreira, Elena, Molinos, Estevão, Lafuente, Ricardo, Gregorio, Humberto, Costa, Ângela, Lima, Susana, Ferreira, Vanda, Seromenho, Eulália, Luis, Idália, Valerio, Helena, Cesar, Ana, Tavares, Ahmed Subhy Alsheikhly, Saeed, Mahmood, Catalin Traian Guran, Alida, Moise, Daniela Carmen Filipescu, Mihail, Luchian, Mihai, Popescu, Monica Adriana Scutariu, Cristina, Petrisor, Natalia, Hagau, 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Slobodianiuk, Daria, Rabarova, Danca, Lančaričová, Janko, Vlaovic, Matjaž, Groznik, Milica, Lukic, Janja, Perme, Maja, Sostaric, Nejc, Umek, Tomislav, Mirkovic, Simon, Dolenc, Misa, Fister, Nika, Zorko, Andrej, Markota, Nomhle Princess Yeni, Phumele, Jali, Shelley, Schmollgruber, Muhommed Ridwaan Syed, Nivisha, Parag, Robert, Wise, Maria, Galiana, José Alejandro Navarro, Ana María De Pablo, Patricia, Albert, Pilar, Martinez, Yolanda, Mendiara, Barbara, Garcia, Ana Alabart Llinas, Marilyn, Riveiro, Elisabet, Gallart, Alba, Riera, Miquel, Sanz, Swagotika, Salo, Miguel Angel Gimenez Lajara, Montserrat Venturas Nieto, Rosa, Garcia, José Manuel Garcia Pena, Maria Carmen Gorgolas, Maria Aranzazu Isasi, Rafael, Sierra, Federico, Gordo, Isabel, Conejo, Vicent, Salvà-Costa, Carolina, Garzón-Tovar, Sara, Lospitao, Rafael, Gonzalez, Pedro, Gutierrez, Mercè, Girona, Jordi, Adamuz, Pablo Garcia Olivares, José Peral Gutierrez de Ceballos, Celia, Tirado, Irene De Wit, Ana Belén Curto Polo, Maria Del Mar Diaz Salcedo, Javier, Ripolles-Melchor, Eugenio, Martinez-Hurtado, Jorge Duerto Alvarez, María Luisa Bravo Arcas, Juan Ignacio Torres Gonzalez, Ana Belén Sánchez de la Ventana, Pablo Lopez-Arcas Calleja, Raquel Garcia Alvarez, Purificacion Sanchez Zamora, Alvaro Ortega Guerrero, Rosario, Cosano, Jonathan, Perez-Vacas, Margarita, Campos-Perez, Emma Moreno Barreiro, Losune Cano Sanchez, Monica Garcia Diaz, Raquel, Jimenez, Lorena Del Rio Cabajo, Daniel Sancho Muriel, Helena Fernandez Alonso, Ana Wensell Fernández, Isabel Santín Piñan, Guillermo Muñiz Albaiceta, Maria Cristina Iglesias Fernandez, Francisco Javier Saenz Abos, Pablo, Monedero, Ramon Molina Chueca, Lydia Gallego Aguirre, Silvia Call Manosa, Carmen Partera Luque, Neus, Calpe, Monica Recio Losilla, Meritxell Tapia Fores, Olga, Farre, Oscar, Fernandez, M Del Rosario Villar Redondo, Donaldo, S Arteta Arteta, Maria Angeles Hurtado Sanchez, Cristina Paños Espinosa, Laura Martinez Reyes, Laura Claramunt Domenech, Carmen Velasco Guillén, Josep Trenado Alvarez, Mercedes Del Cotillo, Jesus Emilio Barrueco-Francioni, Belen Burgos Conde, Maria Pilar Sogues Blanco, Maria Luisa Blasco, Ana Isabel Clement, Clara, Hurtado, Luz Coronado Sanz, David, Perez-Torres, Estefanía, Prol-Silva, Jorge, Pereira, Iván Areán González, Anastasio Espejo Cano, Cesar Rodriguez Nuñez, Inmaculada Lorenzo Fernadez, Alejandra Azahara Marguello Fernandez, Rosa Del Bosque Diez, Badiola, Hilario, Begoña, Zalba-Etayo, Ana, Pascual-Bielsa, Preveen, Banwarie, Dick, Nahar, Alisha van Axel, Naraindath, N Boedjawan, Erika Backlund Jansson, Ann-Sofie, Malvemyr, Lotta, Johansson, Ulla, Sandberg, Catarina, Tingsvik, Gunilla, Mattsson, Gun, Löf, Martin, Spångfors, Mona, Ringdal, Sebastian, Geijer, Lotti, Orvelius, Mia, Hylen, Caroline, Lagerhäll, Eva, Åkerman, Viveca Hamback Hellkvist, Ulrica, Mickelsson, Ewa, Wahlbom, Ing-Marie, Larsson, Ewa, Wallin, Filippo, Boroli, Solenne, Ory, Margaret Lynn Jong, Alexander, Dullenkopf, Martin, Lang, Yvan, Fleury, Marianne, Maus, Nawfel, Ben-Hamouda, Anne, Fishman, Mei Yu Hsu, Shu Chuan Chang, Konlawij, Trongtratul, Chaiwut, Sawawiboon, Sunthiti, Morakul, Bodin, Khwannimit, Keevan, Singh, Dale, Ventour, Dianne, Figaro-Barclay, Sasha, Sankar-Maharaj, Mhamed Sami Mebazaa, Salma, Kamoun, Souheil, Elatrous, Lamia, Besbes, Fekri, Abroug, Walid, Naija, Youssef Zied Elhechmi, Walid, Sellami, Zied, Hajjej, Takoua, Merhabene, Imen, Talik, Ozlem Ozkan Kuscu, Ozcengiz, Dilek, Avşar, Zerman, Hayriye Cankar Dal, Sema, Turan, Semih, Aydemir, Hakan, Yilmaz, Duygu Kayar Calili, Seval, İzdes, Melike, Cengiz, Ayça, Gümüş, Banu, Taşdemir, Ali, Kağnıcı, Mustafa, Ay, Serap Avcı Ay, Gulbahar, Caliskan, Turkay, Akbas, Abidin Oner Balbay, Serdar, Efe, Volkan, Inal, Gülseren, Elay, Pınar, Karabacak, Boğaç, Özserezli, Evren, Şentürk, Oktay, Demirkiran, Suha, Bozbay, Elif, Erdogan, Mustafa, Akker, Nebia, Peker, Asu, Ozgultekin, Sibel Ocak Serin, Can, Turan, Gulsah, Karaoren, Senay, Goksu, Sait, Karakurt, Huseyin, Arikan, Fethi, Gül, İsmail, Cinel, Iskender, Kara, Hasan Nabi Undar, Yesim Serife Bayraktar, Jale Bengi Çelik, Murat Emre Tokur, Demet Tok Aydin, İsmail, Yildiz, Beysim, Özcan, Başar, Erdivanli, Ahmet, Eroglu, Devrim, Akdağ, Nurdan, Ünlü, Adonis, Dungca, Ashwaq, Ali, Bindu, Thankamma, Paul Eric Reyes, Sini, John, Ajitha, Rajendran, Fatima Kasem El Ahmad, Kathleen Ann Smiley, Susanna, Hojden, Mia Thorning Miller, Vishnu Das Sasidharan Nair, Maria Gracia San Antonio, Khaled Al Qawasmeh, Sabah Abu Shawish, Hilary, Twiggs, Ines, Rosado, Volodymyr, Babych, Faye, Morren, Charlotte, Young, Nicola, Vaughan-Jones, Stephanie, Harris, Karen, Burns, Carmel, Georgiev, Rosina, Shayamano, Ian, Kerslake, Peter, Creber, Ana, Vochin, Catherine, O'Brien, Paul, Caddell, Samantha, Hagan, Mandy, Hughes, Tomasz, Torlinski, James, Sherwin, Santhana, Kannan, Amber, Markham, Richard, Lebon, Jason, Cupitt, Julius, Cranshaw, Nigel, White, Victoria, Marriott, Wendy, Milner, Casiano Barrera Groba, Joao, Azoia, Petra, 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A.S., Goller, S., Afonso, E., Larina, E., Labeau, Sonia O. 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[0000-0003-2145-0345], Apollo - University of Cambridge Repository, Critical Care, Labeau S.O., Afonso E., Benbenishty J., Blackwood B., Boulanger C., Brett S.J., Calvino-Gunther S., Chaboyer W., Coyer F., Deschepper M., Francois G., Honore P.M., Jankovic R., Khanna A.K., Llaurado-Serra M., Lin F., Rose L., Rubulotta F., Saager L., Williams G., Blot S.I., Muzha D., Ribas A.M., Lipovesty F., Loudet C., Eller P., Mostafa N., Telleria V.M., Smajic J., Nogueira P.C., Nafees K.M.K., Hentchoya R., Soledad J., Cardenas Y., Reyes A.G., Sustic A., Mpouzika M., Vymazal T., Jensen H.I., Aguirre-Bermeo H., Maddison L., Valta M., Bloos F., Adipa F.E., Koulouras V., Enamorado J., Agoston Z., Birgisdottir H., Gupta A., Gurjar M., Kilapong B., Hashemian S.M., Martin-Loeches I., Cortegiani A., Fletcher K., Hayashi Y., Waweru-Siika W., Abidi K., Lee S.-M., Hadri B., Dolgusevs M., Abillama F.F., Jovaisa T., Thix C., Elhadi M., Nor B.M., Ratnam S., Mazlan M.Z., Maiyalagan S., Sanchez-Hurtado L., Belii A., 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N.N., Jansson E.B., Malvemyr A.-S., Johansson L., Sandberg U., Tingsvik C., Mattsson G., Lof G., Spangfors M., Ringdal M., Geijer S., Orvelius L., Hylen M., Lagerhall C., Akerman E., Hellkvist V.H., Mickelsson U., Wahlbom E., Larsson I.-M., Wallin E., Boroli F., Ory S., Jong M.L., Dullenkopf A., Lang M., Fleury Y., Maus M., Ben-Hamouda N., Fishman A., Hsu M.Y., Chang S.C., Trongtratul K., Sawawiboon C., Morakul S., Khwannimit B., Singh K., Ventour D., Figaro-Barclay D., Sankar-Maharaj S., Mebazaa M.S., Kamoun S., Elatrous S., Besbes L., Abroug F., Naija W., Elhechmi Y.Z., Sellami W., Hajjej Z., Merhabene T., Talik I., Kuscu O.O., Dilek O., Zerman A., Dal H.C., Turan S., Aydemir S., Yilmaz H., Calili D.K., Izdes S., Cengiz M., Gumus A., Tasdemir B., Kagnici A., Ay M., Ay S.A., Caliskan G., Akbas T., Balbay A.O., Efe S., Inal V., Elay G., Karabacak P., Ozserezli B., Senturk E., Demirkiran O., Bozbay S., Erdogan E., Akker M., Peker N., Ozgultekin A., Serin S.O., Turan C., Karaoren G., Goksu S., Karakurt S., Arikan H., Gul F., Cinel I., Kara I., Undar H.N., Bayraktar Y.S., Celik J.B., Tokur M.E., Aydin D.T., Yildiz I., Ozcan B., Erdivanli B., Eroglu A., Akdag D., Unlu N., Dungca A., Ali A., Thankamma B., Reyes P.E., John S., Rajendran A., Ahmad F.K.E., Smiley K.A., Hojden S., Miller M.T., Das Sasidharan Nair V., Antonio M.G.S., Qawasmeh K.A., Shawish S.A., Twiggs H., Rosado I., Babych V., Morren F., Young C., Vaughan-Jones N., Harris S., Burns K., Georgiev C., Shayamano R., Kerslake I., Creber P., Vochin A., O'Brien C., Caddell P., Hagan S., Hughes M., Torlinski T., Sherwin J., Kannan S., Markham A., Lebon R., Cupitt J., Cranshaw J., White N., Marriott V., Milner W., Groba C.B., Azoia J., Polgarova P., George S., Kapoor R., Lynch C., Fox N., Cranmer K., Llewellym T., Matthews K., Maltby L., Ibao J., Boulton K., Jarman R., Baxter K., Raj A.S., Moghal A., White J., Barrowcliffe S., Pulletz M., Ganeshalingam V., Baruah R., Baker H., Woods J., Ei P.P., Ogbeide V., Hayden P., Hughes J., Balasubramanian M., Salberg A., Saha R., Holmquist D., Derbyshire C., Smith N., Stones E., Ademokun J., Legorburo M.S., North S., Brett C., Jaundoo H., Craig J., Whiteley S., Howcroft C., Wilby L., Delve P., Shaw D., Williams K., Welters I.D., McMullen J., Brett S., Flores L., Trueman-Dawkins T., Templeton M., Adams J., Prowle J., Byers H., McDonnell A., Rose B.O., Reece-Anthony R., Mendes L., Vizcaychipi M., Bull R., Lacaden G., Santiago E., Delgado C.C., Farnell-Ward S., Thorpe E., Somerville J., Williams A., Cummings D., Derrick H., Brumwell S., Randell C., McCann N., Aves E., Berry G., Szakmany T., Gunter U., Pulak P., Sarkar N., Wright K., Gomes V., Jones J., Palfrey R., Camsooksai J., Lewis A., Eneas A., Tridente A., Barr L., Thomas B., Parkin E., Horner D., Frey C., Bench S., Baumber R., Broadhurst P., Jackson M., Williams L., Clark M., Paddle J., Bean S., Buckley S., Palfreeman C., Liu S., Allison N., Attwood B., Parsons P., Houghton V., Turner S.J., Higgins D., Bielskute E., Horrigan N., Jacob R., Habgood K., Zaki A., Collins A., Lord J., Ramiro C., Kubisz-Pudelko A., Kotze M., Williams H., Iovenko I., Tsarev A., Briva A., Mendez G., Napolitano L., Teig M., Rodriguez G.E., Ben-Jacob T., Potestio C., Eng T., Mahanes D., Khanna A., Duggal A., Nananmori M., Lois M., Karamchandani K., Bealer C., Barefield C., Terry D., Fivecoat P., Idowu O., Cata J., Clesi T., Peterson J., Hatton K., Dhaliwal J., Mueller D., Tao J., Eltorai A.S., Pastores S.M., Remor N., Salazar J., Barkas D., Joffe A., Barnes C., Sona C., Schallom M., Short J., Lorenzo J., Von Der Osten I., Borkowska M., Demarre L., Pleitinckx V., Xing C., Debue A.-S., Goller S., Larina E., Labeau, S. O., Blackwood, B., Brett, S. J., Deschepper, M., Francois, G., Honore, P. M., Khanna, A. K., Williams, G., Blot, S. I., Ribas, A. M., Telleria, V. M., Nogueira, P. C., Nafees, K. M. K., Reyes, A. G., Jensen, H. I., Adipa, F. E., Agoston, Z., Hashemian, S. M., Lee, S. -M., Abillama, F. F., Nor, B. M., Mazlan, M. Z., Sanchez-Hurtado, L., De lange, D., Ilesanmi, R. E., Ffarcsi, M. H., Hernandez, A. M., Schefold, J. C., Besbes, L. O., Minope, J. T. S., Rostello, O. F., Bartoli, J. R., Nocheretti, M. G., Escalante, R. G., Loudet, C. I., Gonzalez, A. L., Alvarez, G. A., Campos, P. A., Fonseca, I. P., Alvarez, G. M., Bascary, C. A., del Valle Gimenez, G., Bertoletti, F. P., Bonsignore, P. J. M., Fernandez, M. A., Leslie, G. D., Mclucas, A., Jacquet, L. -M., de Almeida, A. O., Jorge, S. A., Schmidt, R. C., Garcia, P. C., Ronchini, A. L. V., Manap, N. B. A., Laizner, A. M., Mcquirter, M., Kampayana, B. S., Sepulveda, M. I., Zamorano, M. J. F., Zhao, R. H., Hu, L. P., Jiao, Q. F., Wang, H. Y., Xia, C. J., Insu, L., Zhu, J. Y., Zhu, J. F., Huang, R. F., Wang, L. L., Song, J. H., Liu, X. M., Li, Z. S., Li, L. C., Zeng, J. M., Hu, X. C., Wang, R. X., Tak, P. S., Ho, S. W., Jiang, Q. X., Huang, L. P., Liu, X. L., Jiang, J. H., Gong, Y. Y., Lei, D. H., Bi, A. P., Zhao, H. M., Cao, Z. Q., Wu, S. F., Tian, X. F., Feng, Z. X., Liu, X. Z., Jiang, Z. X., Wang, G. X., Hu, R. L., Li, X. Q., Yu, Z. J., Yang, Y. X., Gama, L. M. S., Hernandez, J. S., Ochoa, M. -E., Reyes, A. J. G., Filipovic-Grcic, I., Vukovic, A., Pecenkovic, S., Suput, A., Radivojevic, R. C., Culjak, H., Adam, V. N., Pedersen, K. R., Kjaergard, I. E., Kodal, A. M., Hansen, T. C. B., Pedersen, A. S. B., Thomsen, T. D., Frandsen, T. M., Bliksted, I. A., Tamayo, L. M., Tutillo, D. R. M., Hurtado, C. V., Garcia, M. F., Kutimets, M., Lofqvist, C., Sakki, J. -K., Valta, M. A., Plantefeve, G., Deserts, M. D., Gunther, S. C., Timsit, J. -F., Farkas, J. -C., Bosl, K., Schuppel, S., Stubner, A., Osei, I. P., Kusi-Appiah, A. -C., Yakubu, Y. H., Patsiou, E. -C., Stalika, K. M. M., Enamorado, J. E., Jonasdottir, R. J., Lestari, M. I., Finn, D. O. C. R., Mcpherson, S., Ghioldi, D. M., Bruno, A. V., Maggiore, S. M., Volta, C. A., Taibi, M. R., Tranello, F. P., Giusti, G. D., Martin, M. A., Correia, M. C., Kim, J. H., Kim, K. C., Bae, J. -M., Park, S. Y., Park, T. S., Lee, H. B., Kim, S. C., Chee, H. K., Huh, J. W., Sim, Y. S., Ahn, J. -J., Kang, B. J., Lee, W. -Y., Lee, S. J., Feghaly, M. E., Belkhair, W. A., Tababa, O. W. E., Alkhumsi, S. I. R., Alshrif, A. I., Aboufray, A. A., Triki, A. R., Zahra, H. B., Al-Alawi, M. M. S., Ghula, M. A. A., Bahrin, L. K. K., Deva, S. R., Rahim, A. H. A., Hassan, W. N. W., Ismail, W. N. W., Ali, M. N., Khoo, T. M., Samat, N. M., Tong, J. M. G., Adib, N. A. N., Nor, M. B. M., Sulaiman, S. R., Foong, K. W., Hua, N. P., Zermeno, J. M., Nava, C. L. L., Nandyelly, S. J. R., Sanchez-Hurtado, L. A., Nava, L. P. A., Herrera, J. G., de Anda, G. F. V., Namendys-Silva, S. A., Romero-Gonzalez, J. P., Sosa, M. A., de Molina Serrano, J. I. R., Iburrigarro, S. R., Padilla, N. R. C., Pineda, A. A. V., Villafuerte, M. V. E., Herrera, M. O. G., Subedi, N. B., Pathak, S. D., Vermeijden, J. W., Gerritsen, R. T., Fijen, J. -W., Adejumo, P. O., Sankey, B. J., Olsen, B. F., Jensen, K. D., Johansen, B. F., Finnstrom, I. J., Skorstad, E. M., Lunde, G. A., Akselsen, G. R., Monstad, K. R., Hogvall, L., Malmin, S. K., Andersen, M. H., Hargott, R. F., de Jesus Ortiz, A., Cabral, D. M. B., Rivas, J. C., Moreira, M. L., Ellazar, C. G., Cerezo, F. D., Palo, J. E., Aperocho, C. A. J., Figueiredo, M. F., Pinheiro, C. M., Rita, C. S., Feranandes, A. M., Pinto, V. M. V., Bispo, B. M., Lima, A., Alsheikhly, A. S., Guran, C. T., Filipescu, D. C., Scutariu, M. A., Ebaid, M. S., Velickovic, D., Rajkovic, M., Stanojevic, M., Turcan, A., Lancaricova, D., Yeni, N. P., Syed, M. R., Navarro, J. A., De Pablo, A. M., Llinas, A. A., Lajara, M. A. G., Nieto, M. V., Pena, J. M. G., Gorgolas, M. C., Isasi, M. A., Salva-Costa, V., Garzon-Tovar, C., Olivares, P. G., de Ceballos, J. P. G., Polo, A. B. C., del Mar Diaz Salcedo, M., Alvarez, J. D., Arcas, M. L. B., Gonzalez, J. I. T., de la Ventana, A. B. S., Calleja, P. L. -A., Alvarez, R. G., Zamora, P. S., Guerrero, A. O., Barreiro, E. M., Sanchez, L. C., Diaz, M. G., Muriel, D. S., Alonso, H. F., Fernandez, A. W., Pinan, I. S., Albaiceta, G. M., Fernandez, M. C. I., Abos, F. J. S., Chueca, R. M., Aguirre, L. G., Manosa, S. C., Luque, C. P., Losilla, M. R., Fores, M. T., del Rosario Villar Redondo, M., Arteta Arteta, D. S., Sanchez, M. A. H., Espinosa, C. P., Reyes, L. M., Domenech, L. C., Guillen, C. V., Alvarez, J. T., del Cotillo, M., Barrueco-Francioni, J. E., Conde, B. B., Blanco, M. P. S., Blasco, M. L., Clement, A. I., Sanz, L. C., Gonzalez, I. A., Cano, A. E., Nunez, C. R., Fernadez, I. L., Fernandez, A. A. M., Boedjawan, N. N., Jansson, E. B., Malvemyr, A. -S., Lof, G., Spangfors, M., Lagerhall, C., Akerman, E., Hellkvist, V. H., Larsson, I. -M., Jong, M. L., Hsu, M. Y., Chang, S. C., Mebazaa, M. S., Elhechmi, Y. Z., Kuscu, O. O., Dal, H. C., Calili, D. K., Izdes, S., Gumus, A., Tasdemir, B., Kagnici, A., Ay, S. A., Balbay, A. O., Ozserezli, B., Senturk, E., Serin, S. O., Gul, F., Cinel, I., Undar, H. N., Bayraktar, Y. S., Celik, J. B., Tokur, M. E., Aydin, D. T., Yildiz, I., Ozcan, B., Akdag, D., Unlu, N., Reyes, P. E., Ahmad, F. K. E., Smiley, K. A., Miller, M. T., Antonio, M. G. S., Qawasmeh, K. A., Shawish, S. A., Groba, C. B., Raj, A. S., Ei, P. P., Legorburo, M. S., Welters, I. D., Mcmullen, J., Mcdonnell, A., Rose, B. O., Delgado, C. C., Mccann, N., Turner, S. J., Rodriguez, G. E., Eltorai, A. S., Pastores, S. M., Demarre, L., and Debue, A. -S.
Subjects: Male, Original, medicine.medical_treatment, artificial, Critical Care and Intensive Care Medicine, Medical and Health Sciences, Pressure ulcer, law.invention, Decubitus epidemiology, ICU, Morbidity, Mortality, Outcome, Pressure injury, Risk factors, Adult, Aged, Hospital Mortality, Humans, Patient Discharge, Prevalence, Risk Factors, Intensive Care Units, Respiration, Artificial, 0302 clinical medicine, decubitus epidemiology, pressure injury, pressure ulcer, outcome, risk factors, morbidity, mortality, law, Medicine and Health Sciences, adults, Medicine, Simplified Acute Physiology Score, icu, ziekenhuissterfte, Immunodeficiency, intensive care, European Society of Intensive Care Medicine (ESICM) Trials Group Collaborators, mannen, volwassenen, COST, Intensive care unit, STATE, ULCERS, Underweight, medicine.symptom, Life Sciences & Biomedicine, Human, medicine.medical_specialty, risicofactoren, Decubitus epidemiology, ICU, Pressure injury, Pressure ulcer, Outcome, Risk factors, Morbidity, Mortality, pressure injuries, Intensive Care Unit, prevalentie, NO, 1117 Public Health and Health Services, DecubICUs Study Team, 03 medical and health sciences, Critical Care Medicine, Anesthesiology, General & Internal Medicine, Health Sciences, ouderen, Mechanical ventilation, Science & Technology, business.industry, decubitus, Risk Factor, 030208 emergency & critical care medicine, 1103 Clinical Sciences, Odds ratio, medicine.disease, Emergency & Critical Care Medicine, Confidence interval, 030228 respiratory system, Emergency medicine, kunstmatige ademhaling, RISK-FACTORS, business, respiration
Abstract: Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347, Funder: Flemish Society for Critical Care Nurses, Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score < 19, ICU stay > 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat.
Published: 2021
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18. Comparison between first and second wave among critically ill COVID-19 patients admitted to a French ICU: no prognostic improvement during the second wave?

Author: Hervé Mentec, Megan Fraissé, Gaëtan Plantefève, Jo-Anna Tirolien, Damien Contou, and Olivier Pajot
Subjects: Male, 2019-20 coronavirus outbreak, ARDS, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Critical Illness, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Critical Care and Intensive Care Medicine, Research Letter, Corticoids, medicine, Humans, Mortality, Intensive care medicine, Aged, SARS-CoV-2, Critically ill, business.industry, lcsh:Medical emergencies. Critical care. Intensive care. First aid, COVID-19, lcsh:RC86-88.9, Middle Aged, Prognosis, medicine.disease, Hospitalization, Intensive Care Units, ICU, Critical illness, Female, France, business
Published: 2021

19. 'Early' and 'delayed' intubation of COVID-19 patients: Different definitions, different populations

Author: Samuel Chosidow, Damien Contou, Megan Fraissé, Olivier Pajot, Hervé Mentec, Radj Cally, and Gaëtan Plantefève
Subjects: Pulmonary and Respiratory Medicine, SARS-CoV-2, Intubation, Intratracheal, COVID-19, Humans, Respiratory Insufficiency
Published: 2022

20. Eosinophilia in critically ill COVID-19 patients: a French monocenter retrospective study

Author: Damien Contou, Gaëtan Plantefève, Radj Cally, Elsa Logre, Hervé Mentec, and Megan Fraissé
Subjects: Male, 2019-20 coronavirus outbreak, Pediatrics, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Critical Illness, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pneumonia, Viral, Critical Care and Intensive Care Medicine, Eosinophilia, Research Letter, medicine, Humans, Pandemics, Aged, Retrospective Studies, Critically ill, business.industry, Incidence, Incidence (epidemiology), lcsh:Medical emergencies. Critical care. Intensive care. First aid, COVID-19, Retrospective cohort study, lcsh:RC86-88.9, Middle Aged, Intensive Care Units, Critical illness, Female, France, medicine.symptom, Coronavirus Infections, business
Published: 2020

21. Bacterial and viral co-infections in patients with severe SARS-CoV-2 pneumonia admitted to a French ICU

Author: Megan Fraissé, Maïté Micaëlo, Elsa Logre, Pascale Longuet Flandre, Hervé Mentec, Damien Contou, Gaëtan Plantefève, Aurore Claudinon, Olivier Pajot, Marie Dubert, and Radj Cally
Subjects: Staphylococcus aureus, medicine.medical_specialty, Atypical bacteria, medicine.drug_class, Antibiotics, Critical Care and Intensive Care Medicine, medicine.disease_cause, Haemophilus influenzae, Moraxella catarrhalis, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Streptococcus pneumoniae, medicine, 030212 general & internal medicine, 0303 health sciences, Bacteria, biology, SARS-CoV-2, 030306 microbiology, business.industry, Research, lcsh:Medical emergencies. Critical care. Intensive care. First aid, COVID-19, lcsh:RC86-88.9, medicine.disease, biology.organism_classification, Co-infection, Acinetobacter baumannii, Pneumonia, SAPS II, business
Abstract: Background Data on the prevalence of bacterial and viral co-infections among patients admitted to the ICU for acute respiratory failure related to SARS-CoV-2 pneumonia are lacking. We aimed to assess the rate of bacterial and viral co-infections, as well as to report the most common micro-organisms involved in patients admitted to the ICU for severe SARS-CoV-2 pneumonia. Patients and methods In this monocenter retrospective study, we reviewed all the respiratory microbiological investigations performed within the first 48 h of ICU admission of COVID-19 patients (RT-PCR positive for SARS-CoV-2) admitted for acute respiratory failure. Results From March 13th to April 16th 2020, a total of 92 adult patients (median age: 61 years, 1st–3rd quartiles [55–70]; males: n = 73/92, 79%; baseline SOFA: 4 [3–7] and SAPS II: 31 [21–40]; invasive mechanical ventilation: n = 83/92, 90%; ICU mortality: n = 45/92, 49%) were admitted to our 40-bed ICU for acute respiratory failure due to SARS-CoV-2 pneumonia. Among them, 26 (28%) were considered as co-infected with a pathogenic bacterium at ICU admission with no co-infection related to atypical bacteria or viruses. The distribution of the 32 bacteria isolated from culture and/or respiratory PCRs was as follows: methicillin-sensitive Staphylococcus aureus (n = 10/32, 31%), Haemophilus influenzae (n = 7/32, 22%), Streptococcus pneumoniae (n = 6/32, 19%), Enterobacteriaceae (n = 5/32, 16%), Pseudomonas aeruginosa (n = 2/32, 6%), Moraxella catarrhalis (n = 1/32, 3%) and Acinetobacter baumannii (n = 1/32, 3%). Among the 24 pathogenic bacteria isolated from culture, 2 (8%) and 5 (21%) were resistant to 3rd generation cephalosporin and to amoxicillin–clavulanate combination, respectively. Conclusions We report on a 28% rate of bacterial co-infection at ICU admission of patients with severe SARSCoV-2 pneumonia, mostly related to Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae and Enterobacteriaceae. In French patients with confirmed severe SARSCoV-2 pneumonia requiring ICU admission, our results encourage the systematic administration of an empiric antibiotic monotherapy with a 3rd generation cephalosporin, with a prompt de-escalation as soon as possible. Further larger studies are needed to assess the real prevalence and the predictors of co-infection together with its prognostic impact on critically ill patients with severe SARS-CoV-2 pneumonia.
Published: 2020

22. Journal club in an ICU: rate and factors associated with practice-changing articles. Analysis of 1712 articles read over a 13-year period (2007–2019)

Author: Marina Thirion, Gaëtan Plantefève, Hervé Mentec, Damien Contou, and Olivier Pajot
Subjects: medicine.medical_specialty, Journal Club, business.industry, Practice-changing article, Intensive Care, lcsh:Medical emergencies. Critical care. Intensive care. First aid, lcsh:RC86-88.9, Continuing medical education, Critical Care and Intensive Care Medicine, Anesthesiology, Intensive care, Family medicine, medicine, Medical journal, Journal club, business, Letter to the Editor, Medical Journal, Period (music)
Published: 2020

23. Thrombotic and hemorrhagic events in critically ill COVID-19 patients: a French monocenter retrospective study

Author: Olivier Pajot, Damien Contou, Hervé Mentec, Megan Fraissé, Gaëtan Plantefève, and Elsa Logre
Subjects: Male, medicine.medical_specialty, ARDS, Patients, Critical Illness, Pneumonia, Viral, D-dimers, Hemorrhage, Critical Care and Intensive Care Medicine, law.invention, law, Intensive care, medicine, Research Letter, Humans, Dosing, Pandemics, Aged, Retrospective Studies, business.industry, SARS-CoV-2, Incidence, Pulmonary embolism, lcsh:Medical emergencies. Critical care. Intensive care. First aid, COVID-19, Retrospective cohort study, Thrombosis, lcsh:RC86-88.9, Middle Aged, medicine.disease, Intensive care unit, Patient Discharge, Intensive Care Units, Pneumonia, Emergency medicine, Female, France, Coronavirus Infections, business
Abstract: Patients admitted to the intensive care unit (ICU) for coronavirus disease 2019 (COVID-19), following an infection by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), seem to have an increased risk of thrombotic events (TE), both arterial and venous [1–3]. Even in the absence of high level of evidence, some centers have consequently modified their pharmacological thromboprophylaxis strategy toward intermediate or full-dose (therapeutic) preemptive anticoagulation (rather than prophylactic dosing) for routine care of COVID-19 patients [2, 4], exposing them to a higher risk of hemorrhagic events (HE). Our aim was to assess the rates and to describe each TE and HE occurring in critically ill COVID-19 patients admitted to our ICU.
Published: 2020

24. Association of systemic secondary brain insults and outcome in patients with convulsive status epilepticus: A post hoc study of a randomized controlled trial

Author: Bruno Mégarbane, Christophe Guitton, Jonathan Chelly, Matthieu Resche-Rigon, Hervé Mentec, Cendrine Chaffaut, Candice Fontaine, Jean-Yves Lefrant, Aicha Hamdi, Ferhat Meziani, Virginie Lemiale, Stéphane Legriel, Maleka Schenck, Alain Cariou, Thomas Geeraerts, Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre hospitalier Saint-Joseph [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hopital Saint-Louis [AP-HP] (AP-HP), Service de biostatistique et information médicale de l’hôpital Saint Louis (Equipe ECSTRA) (SBIM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut national du cancer [Boulogne] (INCA)-Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP), Centre Hospitalier de Melun, Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, Centre Hospitalier Le Mans (CH Le Mans), Hôpital de Hautepierre [Strasbourg], Hôpital Lariboisière-Fernand-Widal [APHP], Centre Hospitalier Victor Dupouy, AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPC)
Subjects: Male, Fever, Population, Glasgow Outcome Scale, law.invention, Hypercapnia, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, Status Epilepticus, Randomized controlled trial, law, Hypothermia, Induced, Intensive care, Clinical endpoint, Medicine, Humans, 030212 general & internal medicine, education, Hypoxia, Aged, Randomized Controlled Trials as Topic, education.field_of_study, business.industry, Brain, Odds ratio, Middle Aged, medicine.disease, Respiration, Artificial, 3. Good health, Blood pressure, Anesthesia, Female, Neurology (clinical), Hypotension, business, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: ObjectiveTo evaluate the association between systemic factors (mean arterial blood pressure, arterial partial pressures of carbon dioxide and oxygen, body temperature, natremia, and glycemia) on day 1 and neurologic outcomes 90 days after convulsive status epilepticus.MethodsThis was a post hoc analysis of the Evaluation of Therapeutic Hypothermia in Convulsive Status Epilepticus in Adults in Intensive Care (HYBERNATUS) multicenter open-label controlled trial, which randomized 270 critically ill patients with convulsive status epilepticus requiring mechanical ventilation to therapeutic hypothermia (32°C–34°C for 24 hours) plus standard care or standard care alone between March 2011 and January 2015. The primary endpoint was a Glasgow Outcome Scale score of 5, defining a favorable outcome, 90 days after convulsive status epilepticus.ResultsThe 172 men and 93 women had a median age of 57 years (45–68 years). Among them, 130 (49%) had a history of epilepsy, and 59 (29%) had a primary brain insult. Convulsive status epilepticus was refractory in 86 (32%) patients, and total seizure duration was 67 minutes (35–120 minutes). The 90-day outcome was unfavorable in 126 (48%) patients. In multivariate analysis, none of the systemic secondary brain insults were associated with outcome; achieving an unfavorable outcome was associated with age >65 years (odds ratio [OR] 2.17, 95% confidence interval [CI] 1.20–3.85; p = 0.01), refractory convulsive status epilepticus (OR 2.00, 95% CI 1.04–3.85; p = 0.04), primary brain insult (OR 2.00, 95% CI 1.02–4.00; p = 0.047), and no bystander-witnessed seizure onset (OR 2.49, 95% CI 1.05–5.59; p = 0.04).ConclusionsIn our population, systemic secondary brain insults were not associated with outcome in critically ill patients with convulsive status epilepticus.ClinicalTrials.gov identifierNCT01359332.
Published: 2020

25. Amikacin pharmacokinetic/pharmacodynamic in intensive care unit: a prospective database

Author: Aurore Claudinon, Hervé Mentec, Maya Enser, Olivier Pajot, Elsa Logre, Sébastien Tanaka, Philippe Montravers, Nathalie Grall, Marie Dubert, Univ, Réunion, Service de réanimation (CH d'Argenteuil), Centre Hospitalier Victor Dupouy, Diabète athérothrombose et thérapies Réunion Océan Indien (DéTROI), Université de La Réunion (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'anesthésie - réanimation chirurgicale [CHU Bichat], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Services de Maladies Infectieuses et Tropicales [CHU Bichat], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de microbiologie [CHU Bichat], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Nord Val de Seine, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de La Réunion (UR), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP)
Subjects: medicine.medical_specialty, [SDV]Life Sciences [q-bio], Cmax, Pharmacokinetic, Critical Care and Intensive Care Medicine, Gastroenterology, law.invention, 03 medical and health sciences, Minimum inhibitory concentration, 0302 clinical medicine, Pharmacokinetics, law, Intensive care, Internal medicine, Medicine, Intensive care unit, Amikacin, 0303 health sciences, Pharmacodynamic, 030306 microbiology, business.industry, Research, Therapeutic effect, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, lcsh:RC86-88.9, 3. Good health, [SDV] Life Sciences [q-bio], Pharmacodynamics, business, medicine.drug
Abstract: Background Aminoglycosides have a concentration-dependent therapeutic effect when peak serum concentration (Cmax) reaches eight to tenfold the minimal inhibitory concentration (MIC). With an amikacin MIC of 8 mg/L, the Cmax should be 64–80 mg/L. This objective is based on clinical breakpoints and not on measured MIC. This study aimed to assess the proportion of patients achieving the pharmacokinetic/pharmacodynamic (PK/PD) target Cmax/MIC ≥ 8 using the measured MIC in critically ill patients treated for documented Gram-negative bacilli (GNB) infections. Methods Retrospective analysis from February 2016 to December 2017 of a prospective database conducted in 2 intensive care units (ICU). All patients with documented severe GNB infections treated with amikacin (single daily dose of 25 mg/kg of total body weight (TBW)) with both MIC and Cmax measurements at first day of treatment (D1) were included. Results are expressed in n (%) or median [min–max]. Results 93 patients with 98 GNB-documented infections were included. The median Cmax was 55.2 mg/L [12.2–165.7] and the median MIC was 2 mg/L [0.19–16]. Cmax/MIC ratio ≥ 8 was achieved in 87 patients (88.8%) while a Cmax ≥ 64 mg/L was achieved in only 38 patients (38.7%). Overall probability of PK/PD target attainment was 93%. No correlation was found between Cmax/MIC ratio and clinical outcome at D8 and D28. Conclusion According to PK/PD parameters observed in our study, single daily dose of amikacin 25 mg/kg of TBW appears to be sufficient in most critically ill patients treated for severe GNB infections.
Published: 2020

26. Right upper lobe pulmonary edema

Author: Hervé Mentec, Damien Contou, Shanta Valainathan, and Olivier Pajot
Subjects: medicine.medical_specialty, business.industry, Pain medicine, Pulmonary Edema, Critical Care and Intensive Care Medicine, Pulmonary edema, medicine.disease, Radiography, Anesthesia, Anesthesiology, Medicine, Humans, Right upper lobe, business, Lung
Published: 2019

27. Clinical features and outcome of patients with acute respiratory failure revealing anti-synthetase or anti-MDA-5 dermato-pulmonary syndrome: a French multicenter retrospective study

Author: Guillaume Dumas, Nicolas Terzi, Emmanuel Guerot, Romaric Larcher, Christophe Guitton, Jean-Pierre Quenot, Marc Pineton de Chambrun, Yacine Tandjaoui-Lambiotte, Damien Contou, Marie Dubert, Gwenhael Colin, Gaëtan Plantefève, Nicolas de Prost, Matthieu Schmidt, Sylvie Ricome, Elise Morawiec, Claude Guérin, Eric Maury, Mathilde Neuville, Hervé Mentec, Raphaël Le Mao, Guillaume Voiriot, Olivier Pajot, Maximilien Grall, Sebastien Preau, Lara Zafrani, Geoffrey Ledoux, Constance Vuillard, Rémi Coudroy, Auguste Dargent, Muriel Fartoukh, Francis Schneider, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de réanimation médicale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de Réanimation Médicale, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Université de Lyon, Lyon, France, Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), CHU Pitié-Salpêtrière [AP-HP], Service de Réanimation Médicale (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université de Lille-UNICANCER, Reanimation Médicale et Infectieuse [Bichat], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bichat-Claude Bernard, Centre hospitalier universitaire de Poitiers (CHU Poitiers), CHU Saint-Antoine [AP-HP], Service de Réanimation Médicale [CHU Grenoble], CHU Grenoble, Service de Réanimation Médico-Chirurgicale [Avicenne], Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Réanimation Médicale [Strasbourg], Les Hôpitaux Universitaires de Strasbourg (HUS), Service de réanimation médicale [CHU Rouen], Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de réanimation médicale [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), CHRU Brest - Service de Réanimation Médicale (CHU - BREST - Réa Med), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre Hospitalier Le Mans (CH Le Mans), Service de Réanimation Médicale, Hôpital Saint Louis, Paris, France, Immunologie clinique [CHU St-Louis], Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Victor Dupouy, Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Réanimation Médicale [CHU Pitié-Salpétrière], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Lille Nord de France (COMUE)-UNICANCER, Service de Réanimation et USC Médico-Chirurgicale [CHU Tenon], Service de Réanimation Médicale [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Université Paris 13 (UP13)-Hôpital Avicenne [AP-HP], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Pneumologie et Réanimation Médicale [CHU Pitié-Salpêtrière] (Département ' R3S '), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Service de Réanimation et USC Médico-Chirurgicale = Médecine intensive réanimation [CHU Tenon]
Subjects: medicine.medical_specialty, ARDS, Cyclophosphamide, Interstitial lung disease, Critical Care and Intensive Care Medicine, Acute respiratory failure, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Anesthesiology, Diagnosis, medicine, 030203 arthritis & rheumatology, Inflammatory myositis, biology, business.industry, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Retrospective cohort study, lcsh:RC86-88.9, medicine.disease, Comorbidity, 3. Good health, 030228 respiratory system, biology.protein, Creatine kinase, Rituximab, business, medicine.drug
Abstract: IF 3.771; International audience; BackgroundAnti-synthetase (AS) and dermato-pulmonary associated with anti-MDA-5 antibodies (aMDA-5) syndromes are near one of the other autoimmune inflammatory myopathies potentially responsible for severe acute interstitial lung disease. We undertook a 13-year retrospective multicenter study in 35 French ICUs in order to describe the clinical presentation and the outcome of patients admitted to the ICU for acute respiratory failure (ARF) revealing AS or aMDA-5 syndromes.ResultsFrom 2005 to 2017, 47 patients (23 males; median age 60 [1st–3rd quartiles 52–69] years, no comorbidity 85%) were admitted to the ICU for ARF revealing AS (n = 28, 60%) or aMDA-5 (n = 19, 40%) syndromes. Muscular, articular and cutaneous manifestations occurred in 11 patients (23%), 14 (30%) and 20 (43%) patients, respectively. Seventeen of them (36%) had no extra-pulmonary manifestations. C-reactive protein was increased (139 [40–208] mg/L), whereas procalcitonine was not (0.30 [0.12–0.56] ng/mL). Proportion of patients with creatine kinase ≥ 2N was 20% (n = 9/47). Forty-two patients (89%) had ARDS, which was severe in 86%, with a rate of 17% (n = 8/47) of extra-corporeal membrane oxygenation requirement. Proportion of patients who received corticosteroids, cyclophosphamide, rituximab, intravenous immunoglobulins and plasma exchange were 100%, 72%, 15%, 21% and 17%, respectively. ICU and hospital mortality rates were 45% (n = 21/47) and 51% (n = 24/47), respectively. Patients with aMDA-5 dermato-pulmonary syndrome had a higher hospital mortality than those with AS syndrome (n = 16/19, 84% vs. n = 8/28, 29%; p = 0.001).ConclusionsIntensivists should consider inflammatory myopathies as a cause of ARF of unknown origin. Extra-pulmonary manifestations are commonly lacking. Mortality is high, especially in aMDA-5 dermato-pulmonary syndrome.
Published: 2018

28. Images in Anesthesiology: Diagnosis of Atrial Tachycardia with Transesophageal Echocardiography

Author: Damien Contou, Jean-Pierre Laforêt, Jo-Anna Tirolien, and Hervé Mentec
Subjects: Tachycardia, Male, Tachycardia, Ectopic Atrial, medicine.medical_specialty, Hemorrhage, 03 medical and health sciences, Electrocardiography, 0302 clinical medicine, Anesthesiology, Internal medicine, medicine, Humans, Atrial tachycardia, medicine.diagnostic_test, business.industry, 030208 emergency & critical care medicine, Middle Aged, Shock, Septic, Anesthesiology and Pain Medicine, 030228 respiratory system, Shock (circulatory), Cardiology, medicine.symptom, business, Echocardiography, Transesophageal
Published: 2018

29. Perivalvular Mitral Abscess Fistulised to the Pericardial Cavity Revealing Staphylococcal Endocarditis

Author: Damien Contou, Gaëtan Plantefève, Anthony Chauvat, Hervé Mentec, Thomas Garaud, Olivier Andremont, and Paul Desaint
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Staphylococcus aureus, 030204 cardiovascular system & hematology, Pericardial effusion, Pericardial Effusion, 03 medical and health sciences, 0302 clinical medicine, Intensive care, medicine, Endocarditis, Pericardium, Humans, 030212 general & internal medicine, Abscess, Aged, business.industry, Pericardial cavity, Pericardial fluid, Endocarditis, Bacterial, Staphylococcal Infections, medicine.disease, Surgery, medicine.anatomical_structure, Echocardiography, Infective endocarditis, Mitral Valve, Female, Cardiology and Cardiovascular Medicine, business, Tomography, X-Ray Computed
Abstract: Background Fistula to the pericardial cavity is a very rare complication of perivalvular abscess during infective endocarditis, with Staphylococcus aureus being the most commonly associated microorganism. Methods We report a fatal septic shock due to a mitral endocarditis revealed by a myocardial abscess fistulised toward the pericardial cavity. Results A 66-year-old female without previous valvular disease was admitted to intensive care for severe sepsis. A few hours after admission, an unexpected cardiac arrest occurred. Chest computed tomographic-scan and transoesophageal echocardiography revealed a pericardial effusion due to a perivalvular mitral abscess fistulised toward the pericardial cavity. Despite prompt management including surgical debridement and appropriate antibiotics, death occurred 36hours after intensive care admission. All blood cultures as well as native mitral valve and pericardial fluid grew methicillin-sensitive Staphylococcus aureus . Conclusions Intensivists should consider this rare complication in patients with staphylococcal infective endocarditis and perivalvular abscess.
Published: 2017

30. Echocardiography to predict tolerance to negative fluid balance in acute respiratory distress syndrome/acute lung injury

Author: Jérôme Allyn, Mathieu Desmard, Omar Daoud, Nicolas Allou, Marc Dib, Hervé Mentec, Parvine Tashk, Philippe Montravers, and Guillaume Dufour
Subjects: Male, ARDS, Acute Lung Injury, Lung injury, Critical Care and Intensive Care Medicine, Inferior vena cava, Predictive Value of Tests, Fraction of inspired oxygen, medicine, Humans, Prospective Studies, Pulmonary wedge pressure, APACHE, Aged, Respiratory Distress Syndrome, business.industry, Acute kidney injury, Odds ratio, Middle Aged, Water-Electrolyte Balance, medicine.disease, Respiratory Function Tests, Intensive Care Units, medicine.vein, Echocardiography, Anesthesia, Female, business, Fluid balance
Abstract: Purpose In acute respiratory distress syndrome (ARDS) and acute lung injury (ALI), a conservative fluid management strategy improves lung function but could jeopardize extrapulmonary organ perfusion. The objective was to evaluate the diagnostic accuracy of echocardiography to predict tolerance of negative fluid balance (NFB) in patients with ARDS/ALI. Materials and Methods A prospective and observational study in an adult intensive care unit of a university hospital was conducted. All hemodynamically stable patients with ARDS/ALI were included. Echocardiography was performed before NFB and again after 24 hours. Tolerance of NFB was evaluated by the presence of hypotension, acute kidney injury, or need for fluid expansion. The 2 patient groups (tolerating and not tolerating NFB) were compared. Results Forty-five patients were included. Median age (Q1-Q3) was 58 (52-66) years, and the ratio of partial pressure of arterial oxygen to the fraction of inspired oxygen was 205 (163-258) mm Hg. Negative fluid balance was 1950 (1200-2200) mL within 24 hours in the tolerant group. Complications of NFB were observed in 35% cases. After univariate and multivariate logistic regression analyzes, 2 criteria was independently associates with poor tolerance: mitral inflow E wave to early diastolic mitral annulus velocities ratio (E/Ea ratio; odds ratio, 2.02 [1.02-4.02]; P = .04) and weight gain (odds ratio, 1.2 [1.03-1.4]; P = .02). The area under receiver operating characteristic curves was 0.74 for E/Ea and 0.77 for weight gain. Conclusions The ratio of E/Ea accurately predicted tolerance of NFB in patients with ARDS/ALI.
Published: 2013

31. Prévention des complications pulmonaires après chirurgie aortique : évaluation de la ventilation non invasive prophylactique périopératoire

Author: Ali Benabdesselam, Mohamed Bouayad, Jean-Claude Couffinhal, Hervé Mentec, Patrick Bagan, and Alain Landais
Subjects: Gynecology, medicine.medical_specialty, business.industry, medicine, Electrical and Electronic Engineering, business, Atomic and Molecular Physics, and Optics
Abstract: Objectifs Les complications pulmonaires sont rencontrees frequemment, dans environ 40% des cas apres chirurgie aortique chez le malade atteint d’une broncho-pneumopathie chronique obstructive (BPCO). Les facteurs aggravant de survenue de ces complications sont un tabagisme cumule superieur ou egal a 40 paquets/annee (PA) et une chirurgie pour le traitement d’anevrismes. Le but de notre etude prospective a ete d’evaluer l’impact d’une preparation par VNI pre- et postoperatoire sur la fonction respiratoire chez des malades a haut risque pulmonaire. Materiel et methodes Entre septembre 2007 et mai 2010, 30 malades ont ete inclus dans l’etude. Les criteres d’inclusion etaient : le sexe masculin, les malades atteints d’une BPCO avec un tabagisme superieur ou egal a 40 PA, une chirurgie aortique pour pathologie anevrismale +/− occlusive. Quatorze malades sur 15 ont effectivement realise la preparation avant et apres chirurgie selon le protocole etabli (groupe VNI). Nous avons compare le taux de complications respiratoires et la duree moyenne d’hospitalisation en soins intensifs avec le groupe controle non VNI (15 malades). Resultats L’âge moyen, la severite de la BPCO selon la classification de la Societe de Pneumologie de Langue Francaise, la duree operatoire et les pertes sanguines etaient comparables dans les deux groupes. En revanche, le nombre de complications pulmonaires etaient significativement inferieure dans le groupe VNI (0/14, 0% versus 5/14, 33%, p = 0,004). La duree d’hospitalisation en soins intensifs etait plus courte dans le groupe VNI (2,5 versus 6,5 jours, p Conclusion Les resultats preliminaires sont encourageants, en faveur d’une preparation pulmonaire avant chirurgie aortique par VNI a domicile et poursuivie en postoperatoire chez les malades ayant une BPCO. Ces resultats incitent a proposer une etude multicentrique pour valider ces premieres constatations.
Published: 2011

32. Upper digestive intolerance during enteral nutrition in critically ill patients: Frequency, risk factors, and complications

Author: Hervé Dupont, Frédérique Ponche, Gérard Bleichner, Pascale Cani, Maria Bocchetti, and Hervé Mentec
Subjects: Adult, Male, medicine.medical_specialty, Gastrointestinal Diseases, Critical Illness, Aspiration pneumonia, Critical Care and Intensive Care Medicine, Risk Assessment, Enteral administration, law.invention, Enteral Nutrition, Risk Factors, law, Intensive care, Confidence Intervals, medicine, Humans, Prospective Studies, Risk factor, Intensive care medicine, Prospective cohort study, Aged, Chi-Square Distribution, business.industry, Incidence, Middle Aged, Prognosis, medicine.disease, Intensive care unit, Survival Rate, Intensive Care Units, Logistic Models, Parenteral nutrition, Multivariate Analysis, Female, Risk assessment, business
Abstract: To study the frequency of and risk factors for increased gastric aspirate volume (GAV) and upper digestive intolerance and their complications during enteral nutrition (EN) in critically ill patients.Prospective observational study.Intensive care unit (ICU) in a general hospital.A total of 153 patients with nasogastric tube feeding.None.Upper digestive intolerance was considered when GAV was between 150 and 500 mL at two consecutive measurements, when it was500 mL, or when vomiting occurred. Forty-nine patients (32%; 95% confidence interval [CI], 25%-42%) presented increased GAV after a median EN duration of 2 days (range, 1-16 days), and 70 patients (46%; 95% CI, 38%-54%) presented upper digestive intolerance. Independent risk factors for high GAV were GAV20 mL before the start of EN (odds ratio [OR], 2.16; 95% CI, 1.11-4.18; p =.02), GAV100 mL during EN (OR, 1.49; 95% CI, 1.01-2.19; p.05), sedation during EN (OR, 1.78; 95% CI, 1.17-2.71; p =.007), use of catecholamines during EN (OR, 1.81; 95% CI, 1.21-2.70; p =.004). Complications related to high GAV were a lower feed intake (15 +/- 7 vs. 19 +/- 8 kcal/kg/day; p =.0004) and vomiting (53% vs. 23%; p =.0002). Complications related to upper digestive intolerance were the development of pneumonia (43% vs. 24%; p =.01), a longer ICU stay (23 +/- 21 vs. 15 +/- 16 days; p =.007), and a higher ICU mortality (41% vs. 25%; p =.03), even after adjustment for Simplified Acute Physiology Score II (OR, 1.48; 95% CI, 1.04-2.10; p =.028).In ICU patients receiving nasogastric tube feeding, high gastric aspirate volume was frequent, occurred early, and was more frequent in patients with sedation or catecholamines. High gastric aspirate volume was an early marker of upper digestive intolerance, which was associated with a higher incidence of nosocomial pneumonia, a longer ICU stay, and a higher ICU mortality.
Published: 2001

33. Impact of appropriateness of initial antibiotic therapy on the outcome of ventilator-associated pneumonia

Author: Hervé Dupont, Hervé Mentec, Jean-Pierre Sollet, and Gérard Bleichner
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, Population, Critical Care and Intensive Care Medicine, Statistics, Nonparametric, Intensive care, Internal medicine, Severity of illness, Pneumonia, Bacterial, medicine, Humans, Hospital Mortality, education, Retrospective Studies, Antibacterial agent, Mechanical ventilation, Cross Infection, education.field_of_study, business.industry, Ventilator-associated pneumonia, Retrospective cohort study, Length of Stay, Middle Aged, medicine.disease, Respiration, Artificial, Anti-Bacterial Agents, Surgery, Intensive Care Units, Logistic Models, Treatment Outcome, SAPS II, Female, business
Abstract: Objectives: To evaluate the impact of appropriate initial antibiotic therapy (AB) on the outcome of ventilator-associated pneumonia (VAP). Design: Retrospective study (1992–97). Patients and methods: Episodes of VAP diagnosed on both clinical and microbiological criteria after ≥48 h of mechanical ventilation (MV). Initial AB was considered appropriate when all significant organisms were susceptible to at least one of the antibiotics started after distal bronchial sampling. Antibiotic treatment was modified within 48 h when susceptibility testing was available. Outcome was recorded at the ICU and hospital discharge. Results: One hundred and eleven patients were included (SAPS II=48±18, age=62±14 years, mean duration of MV before VAP=12±9 days). Initial AB was appropriate in 55 patients (49.5%). No difference between appropriate initial AB and inappropriate initial AB was found concerning severity indices at the time of VAP diagnosis. ICU length of stay was shorter with appropriate initial AB than with inappropriate initial AB for survivors (12±11 days vs 20±24 days, P=0.01). Crude hospital mortality tended to be lower with appropriate initial AB than with inappropriate initial AB (47.3% vs 60.7%, odds ratio=1.72, 95% CI=0.81–3.7). Relative crude mortality reduction with appropriate initial AB was 22%, 95% CI=–10% to 45%. Conclusion: Inappropriate initial AB of VAP during the first 48 h increased ICU length of stay after VAP diagnosis and tended to increase crude hospital mortality despite equal severity of illness at the time of VAP diagnosis, when compared to appropriate initial AB in a population of 111 ICU patients.
Published: 2000

34. Short-term effect of inhaled nitric oxide and prone positioning on gas exchange in patients with severe acute respiratory distress syndrome

Author: Lisiane Fierobe, Christine Cheval, Jean-François Timsit, Hervé Dupont, Hervé Mentec, and Pierre Moine
Subjects: Adult, Male, ARDS, Time Factors, Adolescent, Lung injury, Nitric Oxide, Critical Care and Intensive Care Medicine, Severity of Illness Index, law.invention, Hypoxemia, Positive-Pressure Respiration, Predictive Value of Tests, law, Administration, Inhalation, Prone Position, medicine, Humans, Simplified Acute Physiology Score, APACHE, Aged, Retrospective Studies, Respiratory Distress Syndrome, Inhalation, Pulmonary Gas Exchange, business.industry, Free Radical Scavengers, Middle Aged, medicine.disease, Combined Modality Therapy, Intensive care unit, Bronchodilator Agents, Oxygen, Systemic inflammatory response syndrome, Prone position, Anesthesia, Female, Blood Gas Analysis, medicine.symptom, business
Abstract: Objective: To compare the short-term effects of inhaled nitric oxide (NO) and prone positioning in improving oxygenation in acute respiratory distress syndrome (ARDS). Methods: Charts of consecutive ARDS patients (lung injury score >2) during a 2-yr period, tested for both inhaled NO and prone positioning efficacy were retrospectively reviewed. Variations in the Pao 2 /Flo 2 ratio induced by inhaled NO and prone positioning were evaluated. Measurements and Main Results: Twenty-seven patients (age, 42 ± 17 yrs) were included. Simplified Acute Physiology Score II was 45 ± 14. Mortality rate in the intensive care unit was 63%. The causes of ARDS were pneumonia (n = 14), extra-lung infection (n = 5), and noninfectious systemic inflammatory response syndrome (n = 8). Lung injury score was 2.7 ± 0.3. At baseline, before the initiation of inhaled NO, the Pao 2 /Flo 2 ratio was 97 ± 46 torr and before prone positioning, 92 ± 26 torr. Variations in the Pao 2 /Flo 2 ratio were lower at start of NO therapy (11 ± 4 ppm) than that observed at prone positioning initiation (23 ± 31 vs. 62 ± 78 torr, p 15 torr was associated with prone positioning in 16 patients (59%) and with NO inhalation in 13 patients (48%) (not significant). An increase in variations in the Pao 2 /Flo 2 ratio of >15 torr was associated with both techniques in only six patients (22%). There was no correlation between the response to prone positioning and the response to inhaled NO (r 2 =.005; p =.73). Conclusions: Prone positioning improves hypoxemia significantly better than does inhaled NO. The response to one technique is not predictive of the response to the other technique.
Published: 2000

35. Prevalence, etiologies and outcome of the acute respiratory distress syndrome among hypoxemic ventilated patients

Author: Didier Dreyfuss, Jean Carlet, Christian Brun-Buisson, Hervé Mentec, Jean-Yves Fagon, E Roupie, Jean Chastre, Laurent Brochard, Eric Lepage, Marc Wysocki, and François Lemaire
Subjects: Mechanical ventilation, Artificial ventilation, ARDS, medicine.medical_specialty, Septic shock, business.industry, medicine.medical_treatment, Mortality rate, Lung injury, Critical Care and Intensive Care Medicine, medicine.disease, Surgery, Intensive care, Anesthesia, medicine, business, Prospective cohort study
Abstract: Objective: To evaluate the prevalence and outcome of the acute respiratory distress syndrome (ARDS) among patients requiring mechanical ventilation. Design: A prospective, multi-institutional, initial cohort study including 28-day follow-up. Settings: Thirty-six French intensive care units (ICUs) from a working group of the French Intensive Care Society (SRLF). Patients: All the patients entering the ICUs during a 14-day period were screened prospectively. Hypoxemic patients, defined as having a PaO2/FIO2 ratio (P/F) of 300 mmHg or less and receiving mechanical ventilation, were classified into three groups, according to the Consensus Conference on ARDS: group 1 refers to ARDS (P/F: 200 mmHg or less and bilateral infiltrates on the chest X-ray); group 2 to acute lung injury (ALI) without having criteria for ARDS (200 < P/F ≤ 300 mmHg and bilateral infiltrates) and group 3 to patients with P/F of 300 mmHg or less but having exclusion criteria from the previous groups. Results: Nine hundred seventy-six patients entered the ICUs during the study period, 43 % of them being mechanically ventilated and 213 (22 %) meeting the criteria for one of the three groups. Among all the ICU admissions, ARDS, ALI and group 3 patients amounted, respectively, to 6.9 % (67), 1.8 % (17) and 13.3 % (129) of the patients, and represented 31.5 %, 8.1 % and 60.2 % of the hypoxemic, ventilated patients. The overall mortality rate was 41 % and was significantly higher in ARDS patients than in the others (60 % vs 31 % p < 0.01). In group 3, 42 patients had P/F less than 200 mmHg associated with unilateral lung injury; mortality was significantly lower (40.5 %) than in the ARDS group. In the whole group of hypoxemic, ventilated patients, septic shock and severity indices but not oxygenation indices were significantly associated with mortality, while the association with immunosuppression revealed only a trend (p = 0.06). Conclusions: In this survey we found that very few patients fulfilled the ALI non-ARDS criteria and that the mortality of the group with ARDS was high.
Published: 1999

36. Traitement du portage nasal de Staphylococcus aureus par la mupirocine nasale et prévention des infections acquises en réanimation. Etude multicentrique contrôlée

Author: M. Ossart, P. Legrand, A. Boillot, Jean-Pierre Sollet, J.L. Ricome, Hervé Mentec, Y. Michel-Briand, Christian Brun-Buisson, A. Rauss, F. Le Turdu, A. Boisivon, and F. Eb
Subjects: Infectious Diseases
Abstract: Resume L'objectif de ce travail est d'evaluer l'efficacite du traitement par la mupirocine nasale des malades porteurs de Staphylococcus aureus, hospitalises en reanimation, et son effet sur l'incidence des infections nosocomiales. Malades et methodes : l'etude est multicentrique (5 unites de reanimation medicales ou polyvalentes d'hopitaux universitaires ou affilies), ouverte et comparative sur le mode sequentiel, avec deux periodes successives, de 18 (controle) et 16 semaines (traitement par la mupirocine nasale). Tous les patients hospitalises pendant au moins 48 h et ayant un score de gravite simplifie >6 ont ete suivis. Des ecouvillonnages nasaux ont ete obtenus a l'admission et tous les 4 jours pendant les 2 premieres semaines du sejour, puis toutes les semaines. Les patients trouves porteurs de S. aureus etaient traites pendant la deuxieme periode par la mupirocine nasale pendant 5 jours. Resultats : un portage nasal de S. aureus etait detecte chez 225/546 (41 %) des patients pendant la periode controle, dont 152 (28 %) des l'admission et 95 (17,4 %) secondairement (>4j.); une infection a S. aureus est survenue chez 57 (10,4 %) d'entre eux, dont 35 (6 %) ayant un portage nasal secondairement acquis. Durant la periode ou les porteurs etaient traites, un portage nasal etait detecte chez 159/463 malades (34,4 %, p=0.03), dont 107 (23 %) a l'admission et 59 (12,8 %, p=0.04) secondairement. Une eradication du portage nasal a ete obtenue par la mupirocine chez 78/95 patients evaluables; une infection a S. aureus est cependant survenue chez 35 (7,6 %, p=0.12) malades, associee chez 25 (5,4 %) a un portage nasal secondaire. Les isolats resistants a la meticilline (SAMR) representaient 56 % et 49 % de l'ensemble des S. aureus respectivement pendant les deux periodes, dont 32 % et 33 % des souches isolees a l'admission et 88 % et 76 % (p
Published: 1994

37. L'échocardiographie transœsophagienne en réanimation

Author: P. Vignon, P. Guéret, and Hervé Mentec
Subjects: business.industry, Medicine, Critical Care and Intensive Care Medicine, business
Published: 1994

38. Intérêt de la fibrinolyse intrapleurale dans le traitement des pleurésies purulentes et parapneumoniques compliquées

Author: L. Brochard, R. Boiteau, L. Donetti, J.-F. Loriferne, François Lemaire, and Hervé Mentec
Subjects: Critical Care and Intensive Care Medicine
Abstract: Resume Le drainage pleural est un element determinant du traitement des pleuresies sero-fibrineuses parapneumoniques et purulentes, permettant d'evacuer le foyer infectieux et de prevenir les sequelles fonctionnelles. Lorsque les caracteristiques du liquide pleural empechent un drainage efficace, avant de recourir a l'evacuation chirurgicale, certains auteurs ont propose le recours a la fibrinolyse intrapleurale. Nous rapportons cinq observations personnelles dans lesquelles la fibrinolyse intrapleurale, par injection, eventuellement repetee, de 250 000 unites de streptokinase, a permis un drainage efficace de deux pleuresies purulentes et de trois pleuresies parapneumoniques compliquees. La fibrinolyse intrapleurale s'avere une technique simple a mettre en œuvre, efficace, bien toleree, n'entrainant ni reactions allergiques, ni fibrinolyse systemique, ni complications hemorragiques. Elle semble donc pouvoir etre proposee en cas de drainage difficile alors que le drain est bien en place, et peut eviter de recourir a la chirurgie.
Published: 1994

39. A long-term clinical evaluation of autoflow during assist-controlled ventilation: a randomized controlled trial

Author: Sigismond Lasocki, Hervé Mentec, Mathieu Desmard, Gaëtan Plantefève, and Françoise Labat
Subjects: Adult, Male, Time Factors, Respiratory rate, Sedation, medicine.medical_treatment, law.invention, Randomized controlled trial, Respiratory Rate, Interquartile range, law, medicine, Humans, Hypnotics and Sedatives, Lead (electronics), Aged, Mechanical ventilation, Aged, 80 and over, business.industry, Middle Aged, Respiration, Artificial, Anesthesiology and Pain Medicine, Anesthesia, Ventilation (architecture), Female, medicine.symptom, business, Respiratory minute volume
Abstract: BACKGROUND: Many new mechanical ventilation modes are proposed without any clinical evaluation. "Dual-controlled" modes, such as AutoFlow™, are supposed to improve patient-ventilator interfacing and could lead to fewer alarms. We performed a long-term clinical evaluation of the efficacy and safety of AutoFlow during assist-controlled ventilation, focusing on ventilator alarms. METHODS: Forty-two adult patients, receiving mechanical ventilation for more than 2 days with a Drager Evita 4 ventilator were randomized to conventional (n = 21) or AutoFlow (n = 21) assist-controlled ventilation. Sedation was given using a nurse-driven protocol. Ventilator-generated alarms were exhaustively recorded from the ventilator logbook with a computer. Daily blood gases and ventilation outcome were recorded. RESULTS: A total of 403 days of mechanical ventilation were studied and 45,022 alarms were recorded over a period of 8074 hours. The course of respiratory rate, minute ventilation, F IO2 , positive end-expiratory pressure, Pa O2 /F IO2 , Pa CO2 , and pH and doses and duration of sedation did not differ between the 2 groups. Outcome (duration of mechanical ventilation, ventilator-associated pneumonia, course of Sequential Organ Failure Assessment score, or death) was not different between the 2 groups. The number of alarms per hour was lower with AutoFlow assist-controlled ventilation: 3.3 [1.5 to 17] versus 9.1 [5 to 19], P < 0.0001 (median [quartile range]). In multivariate analysis, a low alarm rate was associated with activation of AutoFlow and a higher midazolam dose. CONCLUSIONS: This first long-term clinical evaluation of the AutoFlow mode demonstrated its safety with regard to gas exchange and patient outcome. AutoFlow also allowed a very marked reduction in the number of ventilator alarms.
Published: 2010

40. Prevention of pulmonary complications after aortic surgery: evaluation of prophylactic noninvasive perioperative ventilation

Author: Mohamed Bouayad, Ali Benabdesselam, Alain Landais, Jean-Claude Couffinhal, Hervé Mentec, and Patrick Bagan
Subjects: Lung Diseases, Male, medicine.medical_specialty, Time Factors, Respiratory rate, Aortic Diseases, Risk Assessment, Severity of Illness Index, Perioperative Care, Pulmonary Disease, Chronic Obstructive, Aneurysm, Risk Factors, Intensive care, medicine, Humans, Respiratory function, Prospective Studies, Prospective cohort study, Aorta, Aged, Aged, 80 and over, business.industry, Smoking, General Medicine, Perioperative, Length of Stay, Middle Aged, medicine.disease, Aortic surgery, Respiration, Artificial, Surgery, Intensive Care Units, Treatment Outcome, Anesthesia, Case-Control Studies, Breathing, France, Cardiology and Cardiovascular Medicine, business, Vascular Surgical Procedures
Abstract: Background In 40% of the cases, pulmonary complications are encountered after aortic surgery in patients suffering from chronic obstructive broncho-pneumopathy (COBP). The factors aggravating the occurrence of these complications are cumulated tobacco addiction of ≥40 packets per year and surgery for aneurysm. The aim of our prospective study was to evaluate the effect of pre- and postoperative noninvasive ventilation (NIV) preparation on the respiratory function of patients presenting with high pulmonary risks. Methods Between September 2007 and May 2010, 30 patients were included in the present study. Inclusions criteria were male gender, patients suffering from COBP with tobacco addiction of ≥40 packets per year, and aortic surgery for aneurysm with or without occlusive lesions. In all, 14 of the 15 patients had effectively performed the preparation before and after surgery according to a fixed protocol (NIV group). We compared the respiratory rate complications and the mean hospital length of stay in intensive care with the non-NIV control group (15 patients). Results Mean age, severity of COBP according to the classification of the French Society for Pneumology, surgery duration, and blood losses were comparable between the two groups. Conversely, pulmonary complications were significantly lower in the NIV group (0/14 [0%] vs. 5/15 [33%], p = 0.004). Hospital length of stay in intensive care was shorter in the NIV group (2.5 vs. 6.5 days, p 0.001). Conclusion Preliminary results are encouraging, in favor of pulmonary preparation before aortic surgery with NIV at home, and carried on postoperatively in hospital for patients with COBP. These results prompt us to propose a multicenter study to validate these first observations.
Published: 2010

41. Evaluation of the Binax NOW Streptococcus pneumoniae urinary antigen assay in intensive care patients hospitalized for pneumonia

Author: Sigismond Lasocki, Aymeric Restoux, Françoise Le Turdu, Gérard Bleichner, Jean-Pierre Sollet, Agnès Scanvic, and Hervé Mentec
Subjects: Adult, Male, medicine.medical_specialty, Population, Critical Care and Intensive Care Medicine, medicine.disease_cause, Sensitivity and Specificity, Internal medicine, Intensive care, Positive predicative value, Anesthesiology, Streptococcus pneumoniae, medicine, Humans, Intensive care medicine, education, Aged, Retrospective Studies, Aged, 80 and over, Immunoassay, education.field_of_study, Antigens, Bacterial, Chromatography, business.industry, Retrospective cohort study, Middle Aged, Pneumonia, Pneumococcal, medicine.disease, Anti-Bacterial Agents, Community-Acquired Infections, Pneumonia, Pneumococcal pneumonia, Female, business
Abstract: To evaluate the diagnostic performance of Binax Now S. pneumoniae urinary antigen rapid immunochromatographic membrane test (ICT) for patients with suspicion of community-acquired pneumonia hospitalized in intensive care and to assess the impact of prior antibiotics on its diagnostic performance. Retrospective study in a medicosurgical ICU in a 700-bed general hospital. Charts of patients with ICT performed (result blinded) were reviewed between May 2002 and July 2004. ICT has been performed in 140 of the 1,006 patients hospitalized in the unit; two-thirds had received antibiotics prior to admission. Diagnosis of pneumonia was made according to usual criteria. All patients had at least one microbiological test. Pneumonia diagnosis confirmed in 108 patients including 32 pneumococcal. ICT was positive in 23 of 32 patients with pneumococcal pneumonia, in 11 of 108 without, and in none of the 32 patients without pneumonia, resulting in sensitivity, specificity, and positive and negative predictive values of, respectively: 72%, 90%, 68% and 92%. Positive likelihood ratios were comparable among patients with or without prior antibiotics (respectively 6 and 12 for 7 in the overall population). This first clinical evaluation of ICT in intensive care patients hospitalized for suspicion of community-acquired pneumonia, demonstrated performance in accordance with published data even in the case of prior antibiotics. Its clinical interest and impact on antibiotics policy remain to be refined.
Published: 2005

42. Blind and bronchoscopic sampling methods in suspected ventilator-associated pneumonia. A multicentre prospective study

Author: E. Varon, Françoise Le Turdu, Gérard Bleichner, Laetitia May-Michelangeli, Antoine Rabbat, and Hervé Mentec
Subjects: Male, medicine.medical_specialty, endocrine system diseases, medicine.medical_treatment, Biopsy, Critical Care and Intensive Care Medicine, Bronchoalveolar Lavage, Sensitivity and Specificity, Intensive care, Bronchoscopy, medicine, Pneumonia, Bacterial, Humans, Prospective Studies, Prospective cohort study, Aged, Mechanical ventilation, medicine.diagnostic_test, Bacteria, business.industry, Respiratory disease, Ventilator-associated pneumonia, Pneumonia, respiratory system, Middle Aged, medicine.disease, Respiration, Artificial, respiratory tract diseases, Surgery, Trachea, Catheter, Intensive Care Units, Bronchoalveolar lavage, Phenazines, Female, Gentian Violet, business, Bronchoalveolar Lavage Fluid
Abstract: To compare four sampling methods: blind tracheal aspirate (blind TA), blind protected telescoping catheter (blind PTC), bronchoscopic PTC and bronchoscopic bronchoalveolar lavage (bronchoscopic BAL), for diagnosis of ventilator-associated pneumonia (VAP).Prospective multicentre study.Five intensive care units in France.Sixty-three patients with mechanical ventilation for more than 48 h, no recent antibiotic change (72 h) and suspected nosocomial pneumonia.All patients underwent the four sampling methods. Direct examination and quantitative cultures of the four specimens were performed.Visible secretions expelled from the catheter were present 40 times (63%) for blind PTC and 45 times (71%) for bronchoscopic PTC. After exclusion of 11 uncertain cases, 34 VAP were diagnosed. Direct examination of PTC (either blind or bronchoscopic) did not differ from direct examination of bronchoscopic BAL in predicting VAP diagnosis and in guiding initial antibiotic treatment correctly. Compared to that of bronchoscopic BAL (0.98), the area under receiver operating characteristics (ROC) curve was smaller for blind TA (0.78, p=0.002), blind PTC (0.83, p=0.009) and bronchoscopic PTC (0.85, p=0.01). When samples with visible secretions expelled from the catheter were considered, blind and bronchoscopic PTC had areas under ROC curve close to that of bronchoscopic BAL (0.90, p=0.22 and 0.91, p=0.27, respectively).Blind PTC appears to be a good alternative to bronchoscopic sampling for VAP diagnosis, provided that the sample contains visible secretions expelled from the catheter.
Published: 2003

43. Frequency of bacteremia associated with transesophageal echocardiography in intensive care unit patients: a prospective study of 139 patients

Author: Bernard Cholley, Sylvie Terre, Eric Roupie, Hervé Mentec, Philippe Vignon, Christian Brun-Buisson, François Lemaire, and Patrick Legrand
Subjects: Adult, Male, medicine.medical_specialty, Critical Care, medicine.medical_treatment, Bacteremia, Critical Care and Intensive Care Medicine, law.invention, law, Intensive care, medicine, Confidence Intervals, Humans, Blood culture, Prospective Studies, Prospective cohort study, Aged, Mechanical ventilation, Aged, 80 and over, Chi-Square Distribution, medicine.diagnostic_test, Bacteria, business.industry, Incidence, Middle Aged, medicine.disease, Intensive care unit, Surgery, Anesthesia, Female, Netilmicin, Complication, business, Echocardiography, Transesophageal, medicine.drug
Abstract: Objective : To determine the occurrence rate of bacteremia associated with transesophageal echocardiography in intensive care unit (ICU) patients. Design : A prospective study of 139 patients undergoing transesophageal echocardiography. Setting : The medical ICU of a tertiary referral teaching hospital. Patients : One hundred thirty-nine ICU patients (mean age 58 yrs) who underwent transesophageal echocardiography. Interventions : Blood samples were systematically drawn for aerobic and anaerobic culture at the following times : before (blood culture 1), at the end of (blood culture 2), and 30 mins after (blood culture 3) transesophageal echocardiography examinations. Measurements and Main Results : The mean duration of transesophageal echocardiography was 35 mins (range 7 to 120). One hundred thirty-four patients received mechanical ventilation; 125 patients had a nasogastric tube. Fifty-one patients had one or more underlying conditions that usually justify antimicrobial prophylaxis of bacterial endocarditis before high-risk procedures. Fifty-six patients did not receive any antibiotic treatment at the time of transesophageal echocardiography. In 114 patients, the three blood cultures were negative. In six patients, transesophageal echocardiography was performed during a preexisting bacteremia. A contamination (only one positive blood culture of the three sampling times) with coagulase-negative staphylococci occurred in four patients at blood culture 1, five patients at blood culture 2, and six patients at blood culture 3. Contamination with Corynebacterium species occurred in two patients at blood culture 2. In one patient receiving cefotaxime and netilmicin, blood culture 1 was sterile and blood cultures 2 and 3 yielded coagulase-negative staphylococci. In one patient receiving no antibiotic treatment, blood culture 1 was sterile and blood cultures 2 and 3 yielded Enterococcus faecalis. None of these two patients received a specific antibiotic treatment or developed any secondary septic focus. Conclusions : The overall frequency of bacteremia induced by transesophageal echocardiography in ICU patients was 1.4% (two of 139 patients) (95% confidence interval 0.2% to 5.1%). The frequency did not differ whether patients received antibiotics before transesophageal echocardiography (one [1.2%] of 83 patients) or not (one [1.8%] of 56 patients) (p = .96). Therefore, routine antimicrobial prophylaxis does not appear justified before transesophageal echocardiography in ICU patients. (Crit Care Med 1995 ; 23 :1194-1199)
Published: 1995

44. Cytomegalovirus colitis in HIV-1-infected patients: a prospective research in 55 patients

Author: Jean-Louis Vildé, Claudie Marche, Martine Harzic, Catherine Leport, Jacques Leport, and Hervé Mentec
Subjects: Human cytomegalovirus, Adult, Male, medicine.medical_specialty, Pathology, Opportunistic infection, Immunology, Cytomegalovirus colitis, Retinitis, Colonoscopy, Gastroenterology, Betaherpesvirinae, Risk Factors, Internal medicine, medicine, Immunology and Allergy, Humans, Prospective Studies, Viremia, Colitis, biology, medicine.diagnostic_test, AIDS-Related Opportunistic Infections, business.industry, virus diseases, Middle Aged, biology.organism_classification, medicine.disease, Ulcerative colitis, Infectious Diseases, Cytomegalovirus Infections, Cytomegalovirus Retinitis, HIV-1, Female, business, Follow-Up Studies
Abstract: OBJECTIVE To determine criteria for the diagnosis of cytomegalovirus (CMV) colitis and to analyse stages of the course and prognosis of CMV colonic involvement in HIV-1-infected patients. DESIGN Prospective search for CMV colonic involvement with systematic biopsies to search for CMV intranuclear inclusion bodies and for CMV culture. The evolution of CMV colonic involvement was estimated using further coloscopies and autopsy. SETTING Infectious diseases department in a tertiary referral teaching hospital in Paris, France. PARTICIPANTS Fifty-five consecutive patients with HIV-1 infection, who had not previously received anti-CMV drugs, and who had at least one coloscopy performed. RESULTS According to initial coloscopy, colitis, either ulcerative or inflammatory, was found in nine (16%) out of the 55 patients, CMV intranuclear inclusions were present in the colon of four (7%) patients, and colonic cultures were positive for CMV in 15 (27%) patients. The results of the initial coloscopy showed a positive correlation between endoscopic colitis (either ulcerative or inflammatory), CMV inclusions and positive CMV culture from colonic biopsies. The absence of endoscopic ulcerative lesions had a 98% (49 out of 50) negative predictive value for recording CMV inclusions in the colon (95% confidence interval, 89-100). CMV inclusions were recorded in three out of five ulcerative colitis. Male homosexuality, HIV-1 infection stages IVB, C1, D or E, according to the Centers for Disease Control and Prevention classification, CD4 lymphocyte count < 200 x 10(6)/l and CMV viraemia also correlated positively with CMV colonic involvement. During the observation period (mean, 7.3 months), the estimated incidence of CMV colitis according to coloscopic studies was 13%. Deterioration in condition was the most frequent spontaneous evolution of CMV colonic infection, whereas anti-CMV treatment resulted in an improvement. Ulcerative lesions occurred earlier in patients with colonic CMV inclusions or positive colonic CMV culture than in patients without CMV colonic involvement at the initial coloscopy. CMV colitis occurred late in the course of HIV-1 infection, on average 4 months before death. The presence of CMV inclusions was an indicator of poor prognosis with earlier occurrence of CMV viraemia and retinitis and no survival after 9 months. CONCLUSIONS These results confirm that the colon is a target organ for CMV in HIV-1-infected patients. Coloscopy should be used to diagnose CMV colitis, because of the close correlation between endoscopic and histological data (i.e., intranuclear inclusions). This combination allows us to propose an evolutive staging of CMV colonic involvement and provide stratification criteria to assess the efficacy of anti-CMV drugs.
Published: 1994

45. Unilateral pulmonary edema related to massive mitral insufficiency

Author: Hervé Mentec, Stéphane Legriel, and Benjamin Tremey
Subjects: Resuscitation, medicine.medical_specialty, business.industry, Respiratory disease, MEDLINE, Mitral Valve Insufficiency, Pulmonary Edema, General Medicine, medicine.disease, Pulmonary edema, Surgery, Diagnosis, Differential, Lung disease, Anesthesia, Intensive care, Emergency Medicine, Humans, Medicine, Female, LUNG EDEMA, business, Aged
Published: 2006

46. Status epilepticus during acute hypercapnia: a case report

Author: Hervé Mentec and Stéphane Legriel
Subjects: medicine.medical_specialty, business.industry, Pain medicine, Anesthesiology, Emergency medicine, medicine, MEDLINE, Status epilepticus, medicine.symptom, Critical Care and Intensive Care Medicine, business, Hypercapnia
Published: 2004

47. Mechanical ventilation in ARDS

Author: G. Chatte, Dominique Robert, D. M. Medelros, H. Hmouda, Rolf Rossaint, B. Langevin, B. Kuhlen, F. Lopez, Eric Roupie, Konrad J. Falke, N. Bloch, M. R. P. Amato, Carlos Roberto Ribeiro de Carvalho, Jm Dubois, M. Rousset, Laurent Brochard, Jm Sab, François Lemaire, K Falke, T. Grüning, Michele Dambrosio, T. Lherm, C. A. Lin, Csv Barbas, A. Tenaillon, E. Valente, K. Lewandowski, K. Slama, P. Gaussorgues, D. Pappert, A. Carneiro, R. Boiteau, Hervé Mentec, and M. Sirodot
Subjects: Mechanical ventilation, medicine.medical_specialty, ARDS, business.industry, medicine.medical_treatment, Pain medicine, Critical Care and Intensive Care Medicine, medicine.disease, Prone position, Anesthesiology, Emergency medicine, Medicine, Lung volumes, business
Published: 1992

48. Cardiovascular assessment II

Author: L. Andriolo, R. Oltra, A. Felices Nieto, F. Merlo, F. J. Ortega Vinuesa, H. Dan, B. Allaria, H. Brock, M. Guerrero de Mier, J. M. Palencia, V. Reina, Hervé Mentec, J. Lopez, E. Weiss, M. Pavon Garcia, S. Terré, J. Gimenez Raurell, B. Rapf, L. Lacquaniti, D. Pittarello, Patrick Legrand, E. Sansone, B. Brunetti, F. Kern, Adolfo Cabadés, M. Ruano, J. M. Cruz Fernández, Raffaele Bonato, G. DeFilippi, L. Fayos, S. Necsk, A. Rigoli, V. Palacios, H. Chromy, and J. E. Belenguer
Subjects: medicine.medical_specialty, business.industry, Anesthesiology, Pain medicine, Emergency medicine, medicine, Critical Care and Intensive Care Medicine, business
Published: 1992

49. Characteristics, management, and prognosis of elderly patients with COVID-19 admitted in the ICU during the first wave: insights from the COVID-ICU study

Author: Dres, Martin, Hajage, David, Lebbah, Said, Kimmoun, Antoine, Pham, Tai, Béduneau, Gaëtan, Combes, Alain, Mercat, Alain, Guidet, Bertrand, Demoule, Alexandre, Schmidt, Matthieu, Neurophysiologie Respiratoire Expérimentale et Clinique (UMRS 1158), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Hôpital Bicêtre, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Groupe de Recherche sur le Handicap Ventilatoire et Neurologique (GRHVN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Rouen, Normandie Université (NU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Université d'Angers (UA), CHU Saint-Antoine [AP-HP], COVID-ICU investigators: Alain Mercat, Pierre Asfar, François Beloncle, Julien Demiselle, Tài Pham, Arthur Pavot, Xavier Monnet, Christian Richard, Alexandre Demoule, Martin Dres, Julien Mayaux, Alexandra Beurton, Cédric Daubin, Richard Descamps, Aurélie Joret, Damien Du Cheyron, Frédéric Pene, Jean-Daniel Chiche, Mathieu Jozwiak, Paul Jaubert, Guillaume Voiriot, Muriel Fartoukh, Marion Teulier, Clarisse Blayau, Erwen L'Her, Cécile Aubron, Laetitia Bodenes, Nicolas Ferriere, Johann Auchabie, Anthony Le Meur, Sylvain Pignal, Thierry Mazzoni, Jean-Pierre Quenot, Pascal Andreu, Jean-Baptiste Roudau, Marie Labruyère, Saad Nseir, Sébastien Preau, Julien Poissy, Daniel Mathieu, Sarah Benhamida, Rémi Paulet, Nicolas Roucaud, Martial Thyrault, Florence Daviet, Sami Hraiech, Gabriel Parzy, Aude Sylvestre, Sébastien Jochmans, Anne-Laure Bouilland, Mehran Monchi, Marc Danguy des Déserts, Quentin Mathais, Gwendoline Rager, Pierre Pasquier, Reignier Jean, Seguin Amélie, Garret Charlotte, Canet Emmanuel, Jean Dellamonica, Clément Saccheri, Romain Lombardi, Yanis Kouchit, Sophie Jacquier, Armelle Mathonnet, Mai-AhnNay, Isabelle Runge, Frédéric Martino, Laure Flurin, Amélie Rolle, Michel Carles, Rémi Coudroy, Arnaud W Thille, Jean-Pierre Frat, Maeva Rodriguez, Pascal Beuret, Audrey Tientcheu, Arthur Vincent, Florian Michelin, Marie Anne Melone, Maxime Gauzi, Arnaud Guilbert, Geoffrey Kouadri, Valérie Gissot, Stéphan Ehrmann, Charlotte Salmon Gandonniere, Djlali Elaroussi, Agathe Delbove, Yannick Fedun, Julien Huntzinger, Eddy Lebas, Grâce Kisoka, Céline Grégoire, Stella Marchetta, Bernard Lambermont, Laurent Argaud, Thomas Baudry, Pierre-Jean Bertrand, Auguste Dargent, Christophe Guitton, Nicolas Chudeau, Mickaël Landais, Cédric Darreau, Alexis Ferre, Antoine Gros, Guillaume Lacave, Fabrice Bruneel, Mathilde Neuville, Jérôme Devaquet, Guillaume Tachon, Richard Gallot, Riad Chelha, Arnaud Galbois, Anne Jallot, Ludivine Chalumeau Lemoine, Khaldoun Kuteifan, Valentin Pointurier, Louise-Marie Jandeaux, Joy Mootien, Charles Damoisel, Benjamin Sztrymf, Matthieu Schmidt, Alain Combes, Juliette Chommeloux, Charles Edouard Luyt, Frédérique Schortgen, Leon Rusel, Camille Jung, Florent Gobert, Damien Vimpere, Lionel Lamhaut, Bertrand Sauneuf, Liliane Charrrier, Julien Calus, Isabelle Desmeules, Benoît Painvin, Jean-Marc Tadie, Vincent Castelain, Baptiste Michard, Jean-Etienne Herbrecht, Mathieu Baldacini, Nicolas Weiss, Sophie Demeret, Clémence Marois, Benjamin Rohaut, Pierre-Henri Moury, Anne-Charlotte Savida, Emmanuel Couadau, Mathieu Série, Nica Alexandru, Cédric Bruel, Candice Fontaine, Sonia Garrigou, Juliette Courtiade Mahler, Maxime Leclerc, Michel Ramakers, Pierre Garçon, Nicole Massou, Ly Van Vong, Juliane Sen, Nolwenn Lucas, Franck Chemouni, Annabelle Stoclin, Alexandre Avenel, Henri Faure, Angélie Gentilhomme, Sylvie Ricome, Paul Abraham, Céline Monard, Julien Textoris, Thomas Rimmele, Florent Montini, Gabriel Lejour, Thierry Lazard, Isabelle Etienney, Younes Kerroumi, Claire Dupuis, Marine Bereiziat, Elisabeth Coupez, François Thouy, Clémet Hoffmann, Nicolas Donat, Violaine Muller, Thibault Martinez, Antoine Kimmoun, Audrey Jacquot, Matthieu Mattei, Bruno Levy, Ramin Ravan, Loïc Dopeux, Jean-Mathias Liteaudon, Delphine Roux, Brice Rey, Radu Anghel, Deborah Schenesse, Vincent Gevrey, Jermy Castanera, Philippe Petua, Benjamin Madeux, Otto Hartman, Michael Piagnerelli, Anne Joosten, Cinderella Noel, Patrick Biston, Thibaut Noel, Gurvan L E Bouar, Messabi Boukhanza, Elsa Demarest, Marie-France Bajolet, Nathanaël Charrier, Audrey Quenet, Cécile Zylberfajn, Nicolas Dufour, Buno Mégarbane, SqébastianVoicu, Nicolas Deye, Isabelle Malissin, François Legay, Matthieu Debarre, Nicolas Barbarot, Pierre Fillatre, Bertrand Delord, Thomas Laterrade, Tahar Saghi, Wilfried Pujol, Pierre Julien Cungi, Pierre Esnault, Mickael Cardinale, Vivien Hong Tuan Ha, Grégory Fleury, Marie-Ange Brou, Daniel Zafimahazo, David Tran-Van, Patrick Avargues, Lisa Carenco, Nicolas Robin, Alexandre Ouali, Lucie Houdou, Christophe Le Terrier, Noémie Suh, Steve Primmaz, Jérome Pugin, Emmanuel Weiss, Tobias Gauss, Jean-Denis Moyer, Catherine Paugam Burtz, Béatrice La Combe, Rolland Smonig, Jade Violleau, Pauline Cailliez, Jonathan Chelly, Antoine Marchalot, Cécile Saladin, Christelle Bigot, Pierre-Marie Fayolle, Jules Fatséas, Amr Ibrahim, Dabor Resiere, Rabih Hage, Clémentine Cholet, Marie Cantier, Pierre Trouiler, Philippe Montravers, Brice Lortat-Jacob, Sebastien Tanaka, Alexy Tran Dinh, Jacques Duranteau, Anatole Harrois, Guillaume Dubreuil, Marie Werner, Anne Godier, Sophie Hamada, Diane Zlotnik, Hélène Nougue, Armand Mekontso-Dessap, Guillaume Carteaux, Keyvan Razazi, Nicolas De Prost, Nicolas Mongardon, Olivier Langeron, Eric Levesque, Arié Attias, Charles de Roquetaillade, Benjamin G Chousterman, Alexandre Mebazaa, Etienne Gayat, Marc Garnier, Emmanuel Pardo, Lea Satre-Buisson, Christophe Gutton, Elise Yvin, Clémence Marcault, Elie Azoulay, Michael Darmon, Hafid Ait Oufella, Geoffroy Hariri, Tomas Urbina, Sandie Mazerand, Nicholas Heming, Francesca Santi, Pierre Moine, Djillali Annane, Adrien Bouglé, Edris Omar, Aymeric Lancelot, Emmanuelle Begot, Gaétan Plantefeve, Damien Contou, Hervé Mentec, Olivier Pajot, Stanislas Faguer, Olivier Cointault, Laurence Lavayssiere, Marie-Béatrice Nogier, Matthieu Jamme, Claire Pichereau, Jan Hayon, Hervé Outin, François Dépret, Maxime Coutrot, Maité Chaussard, Lucie Guillemet, Pierre Goffin, Romain Thouny, Julien Guntz, Laurent Jadot, Romain Persichini, Vanessa Jean-Michel, Hugues Georges, Thomas Caulier, Gaël Pradel, Marie-Hélène Hausermann, ThiMy Hue Nguyen-Valat, Michel Boudinaud, Emmanuel Vivier, Sylvène Rosseli, Gaël Bourdin, Christian Pommier, Marc Vinclair, Simon Poignant, Sandrine Mons, Wulfran Bougouin, Franklin Bruna, Quentin Maestraggi, Christian Roth, Laurent Bitker, François Dhelft, Justine Bonnet-Chateau, Mathilde Filippelli, Tristan Morichau-Beauchant, Stéphane Thierry, Charlotte Le Roy, Mélanie Saint Jouan, Bruno Goncalves, Aurélien Mazeraud, Matthieu Daniel, Tarek Sharshar, Cyril Cadoz, RostaneGaci, Sébastien Gette, Guillaune Louis, Sophe-Caroline Sacleux, Marie-Amélie Ordan, Aurélie Cravoisy, Marie Conrad, Guilhem Courte, Sébastien Gibot, Younès Benzidi, Claudia Casella, Laurent Serpin, Jean-Lou Setti, Marie-Catherine Besse, Anna Bourreau, Jérôme Pillot, Caroline Rivera, Camille Vinclair, Marie-Aline Robaux, Chloé Achino, Marie-Charlotte Delignette, Tessa Mazard, Frédéric Aubrun, Bruno Bouchet, Aurélien Frérou, Laura Muller, Charlotte Quentin, Samuel Degoul, Xavier Stihle, Claude Sumian, Nicoletta Bergero, Bernard Lanaspre, Hervé Quintard, Eve Marie Maiziere, Pierre-Yves Egreteau, Guillaume Leloup, Florin Berteau, Marjolaine Cottrel, Marie Bouteloup, Matthieu Jeannot, Quentin Blanc, Julien Saison, Isabelle Geneau, Romaric Grenot, Abdel Ouchike, Pascal Hazera, Anne-Lyse Masse, Suela Demiri, Corinne Vezinet, Elodie Baron, Deborah Benchetrit, Antoine Monsel, Grégoire Trebbia, Emmanuelle Schaack, Raphaël Lepecq, Mathieu Bobet, Christophe Vinsonneau, Thibault Dekeyser, Quentin Delforge, Imen Rahmani, Bérengère Vivet, Jonathan Paillot, Lucie Hierle, Claire Chaignat, Sarah Valette, Benoït Her, Jennifier Brunet, Mathieu Page, Fabienne Boiste, Anthony Collin, Florent Bavozet, Aude Garin, Mohamed Dlala, Kais Mhamdi, Bassem Beilouny, Alexandra Lavalard, Severine Perez, Benoit Veber, Pierre-Gildas Guitard, Philippe Gouin, Anna Lamacz, Fabienne Plouvier, Bertrand P Delaborde, Aïssa Kherchache, Amina Chaalal, Jean-Damien Ricard, Marc Amouretti, Santiago Freita-Ramos, Damien Roux, Jean-Michel Constantin, Mona Assefi, Marine Lecore, Agathe Selves, Florian Prevost, Christian Lamer, Ruiying Shi, Lyes Knani, Sébastien PiliFloury, Lucie Vettoretti, Michael Levy, Lucile Marsac, Stéphane Dauger, Sophie Guilmin-Crépon, Hadrien Winiszewski, Gael Piton, Thibaud Soumagne, Gilles Capellier, Jean-Baptiste Putegnat, Frédérique Bayle, Maya Perrou, Ghyslaine Thao, Guillaume Géri, Cyril Charron, Xavier Repessé, Antoine Vieillard-Baron, Mathieu Guilbart, Pierre-Alexandre Roger, Sébastien Hinard, Pierre-Yves Macq, Kevin Chaulier, Sylvie Goutte, Patrick Chillet, Anaïs Pitta, Barbara Darjent, Amandine Bruneau, Sigismond Lasocki, Maxime Leger, Soizic Gergaud, Pierre Lemarie, Nicolas Terzi, Carole Schwebel, Anaïs Dartevel, Louis-Marie Galerneau, Jean-Luc Diehl, Caroline Hauw-Berlemont, Nicolas Péron, Emmanuel Guérot, Abolfazl Mohebbi Amoli, Michel Benhamou, Jean-Pierre Deyme, Olivier Andremont, Diane Lena, Julien Cady, Arnaud Causeret, Arnaud De La Chapelle, Christophe Cracco, Stéphane Rouleau, David Schnell, Camille Foucault, Cécile Lory, Thibault Chapelle, Vincent Bruckert, Julie Garcia, Abdlazize Sahraoui, Nathalie Abbosh, Caroline Bornstain, Pierre Pernet, Florent Poirson, Ahmed Pasem, Philippe Karoubi, Virginie Poupinel, Caroline Gauthier, François Bouniol, Philippe Feuchere, Florent Bavozet, Anne Heron, Serge Carreira, Malo Emery, Anne Sophie Le Floch, Luana Giovannangeli, Nicolas Herzog, Christophe Giacardi, Thibaut Baudic, Chloé Thill, Said Lebbah, Jessica Palmyre, Florence Tubach, David Hajage, Nicolas Bonnet, Nathan Ebstein, Stéphane Gaudry, Yves Cohen, Julie Noublanche, Olivier Lesieur, Arnaud Sément, Isabel Roca-Cerezo, Michel Pascal, Nesrine Sma, Gwenhaël Colin, Jean-Claude Lacherade, Gauthier Bionz, Natacha Maquigneau, Pierre Bouzat, Michel Durand, Marie-Christine Hérault, Jean-Francois Payen, and dres, martin
Subjects: [SDV] Life Sciences [q-bio], Acute respiratory distress syndrome, Frailty, [SDV]Life Sciences [q-bio], Old patients, COVID-19, Intensive care unit, Mortality, Intubation
Abstract: International audience; Abstract Background The COVID-19 pandemic is a heavy burden in terms of health care resources. Future decision-making policies require consistent data on the management and prognosis of the older patients (> 70 years old) with COVID-19 admitted in the intensive care unit (ICU). Methods Characteristics, management, and prognosis of critically ill old patients (> 70 years) were extracted from the international prospective COVID-ICU database. A propensity score weighted-comparison evaluated the impact of intubation upon admission on Day-90 mortality. Results The analysis included 1199 (28% of the COVID-ICU cohort) patients (median [interquartile] age 74 [72–78] years). Fifty-three percent, 31%, and 16% were 70–74, 75–79, and over 80 years old, respectively. The most frequent comorbidities were chronic hypertension (62%), diabetes (30%), and chronic respiratory disease (25%). Median Clinical Frailty Scale was 3 (2–3). Upon admission, the PaO 2 /FiO 2 ratio was 154 (105–222). 740 (62%) patients were intubated on Day-1 and eventually 938 (78%) during their ICU stay. Overall Day-90 mortality was 46% and reached 67% among the 193 patients over 80 years old. Mortality was higher in older patients, diabetics, and those with a lower PaO 2 /FiO 2 ratio upon admission, cardiovascular dysfunction, and a shorter time between first symptoms and ICU admission. In propensity analysis, early intubation at ICU admission was associated with a significantly higher Day-90 mortality (42% vs 28%; hazard ratio 1.68; 95% CI 1.24–2.27; p
Published: 2021

50. Management and outcomes in critically ill nonagenarian versus octogenarian patients

Author: Bruno, Raphael Romano, Wernly, Bernhard, Kelm, Malte, Boumendil, Ariane, Morandi, Alessandro, Andersen, Finn H., Artigas, Antonio, Finazzi, Stefano, Cecconi, Maurizio, Christensen, Steffen, Faraldi, Loredana, Lichtenauer, Michael, Muessig, Johanna M., Marsh, Brian, Moreno, Rui, Oeyen, Sandra, Öhman, Christina Agvald, Pinto, Bernardo Bollen, Soliman, Ivo W., Szczeklik, Wojciech, Valentin, Andreas, Watson, Ximena, Leaver, Susannah, Boulanger, Carole, Walther, Sten, Schefold, Joerg C., Joannidis, Michael, Nalapko, Yuriy, Elhadi, Muhammed, Fjølner, Jesper, Zafeiridis, Tilemachos, De Lange, Dylan W., Guidet, Bertrand, Flaatten, Hans, Jung, Christian, Eller, Philipp, Helbok, Raimund, Schmutz, René, Nollet, Joke, de Neve, Nikolaas, Buysscher, Pieter De, Swinnen, Walter, Mikačić, Marijana, Bastiansen, Anders, Husted, Andreas, Dahle, Bård E.S., Cramer, Christine, Sølling, Christoffer, Heinrich Heine Universität Düsseldorf = Heinrich Heine University [Düsseldorf], Paracelsus Medizinische Privatuniversität = Paracelsus Medical University (PMU), Karolinska Institutet [Stockholm], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), the Handmaids of Charity Nursing Home / Casa di Cura Ancelle della Carità [Cremona, Italia], NTNU [Ålesund], Hospital Universitari Parc Taulí [Sabadell, Spain] (HUPT), CIBER de Epidemiología y Salud Pública (CIBERESP), RCCS–Istituto di Ricerche Farmacologiche 'Mario Negri [Bergamo, Italy], Clinical Research Center for Rare Diseases 'Aldo e Cele Daccò' [Bergamo, Italy], Humanitas University [Milan] (Hunimed), Aarhus University Hospital, ASST Great Metropolitan Niguarda / ASST Grande Ospedale Metropolitano Niguarda [Milan, Italia], Mater Misericordiae University Hospital (The Mater Hospital), NOVA Medical School - Faculdade de Ciências Médicas (NMS), Universidade Nova de Lisboa = NOVA University Lisbon (NOVA), Ghent University Hospital, Karolinska University Hospital [Stockholm], Geneva University Hospitals and Geneva University, Utrecht University [Utrecht], Uniwersytet Jagielloński w Krakowie = Jagiellonian University (UJ), Cardinal Schwarzenberg Hospital [Pongau, Austria] (CSH), St George’s University Hospitals, Royal Devon and Exeter NHS Foundation Trust [UK], Linköping university hospital, University of Bern, Innsbruck Medical University = Medizinische Universität Innsbruck (IMU), European Wellness International [Luhansk, Ukraine] (EWI), Alkhums Hospital [Tripoli, Libya] (AH), University Hospital of Larissa, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), University of Bergen (UiB), Haukeland University Hospital, VIP2 study group: Michael Joannidis, Philipp Eller, Raimund Helbok, René Schmutz, Joke Nollet, Nikolaas de Neve, Pieter De Buysscher, Sandra Oeyen, Walter Swinnen, Marijana Mikačić, Anders Bastiansen, Andreas Husted, Bård E S Dahle, Christine Cramer, Christoffer Sølling, Dorthe Ørsnes, Jakob Edelberg Thomsen, Jonas Juul Pedersen, Mathilde Hummelmose Enevoldsen, Thomas Elkmann, Agnieszka Kubisz-Pudelko, Alan Pope, Amy Collins, Ashok S Raj, Carole Boulanger, Christian Frey, Ciaran Hart, Clare Bolger, Dominic Spray, Georgina Randell, Helder Filipe, Ingeborg D Welters, Irina Grecu, Jane Evans, Jason Cupitt, Jenny Lord, Jeremy Henning, Joanne Jones, Jonathan Ball, Julie North, Kiran Salaunkey, Laura Ortiz-Ruiz De Gordoa, Louise Bell, Madhu Balasubramaniam, Marcela Vizcaychipi, Maria Faulkner, Mc Donald Mupudzi, Megan Lea-Hagerty, Michael Reay, Michael Spivey, Nicholas Love, Nick Spittle Nick Spittle, Nigel White, Patricia Williams, Patrick Morgan, Phillipa Wakefield, Rachel Savine, Reni Jacob, Richard Innes, Ritoo Kapoor, Sally Humphreys, Steve Rose, Susan Dowling, Susannah Leaver, Tarkeshwari Mane, Tom Lawton, Vongayi Ogbeide, Waqas Khaliq, Yolanda Baird, Antoine Romen, Arnaud Galbois, Bertrand Guidet, Christophe Vinsonneau, Cyril Charron, Didier Thevenin, Emmanuel Guerot, Guillaume Besch, Guillaume Savary, Hervé Mentec, Jean-Luc Chagnon, Jean-Philippe Rigaud, Jean-Pierre Quenot, Jeremy Castanera, Jérémy Rosman, Julien Maizel, Kelly Tiercelet, Lucie Vettoretti, Maud Mousset Hovaere, Messika Messika, Michel Djibré, Nathalie Rolin, Philippe Burtin, Pierre Garcon, Saad Nseir, Xavier Valette, Christian Rabe, Eberhard Barth, Henning Ebelt, Kristina Fuest, Marcus Franz, Michael Horacek, Michael Schuster, Patrick Meybohm, Raphael Romano Bruno, Sebastian Allgäuer, Simon Dubler, Stefan J Schaller, Stefan Schering, Stephan Steiner, Thorben Dieck, Tim Rahmel, Tobias Graf, Anastasia Koutsikou, Aristeidis Vakalos, Bogdan Raitsiou, Elli Niki Flioni, Evangelia Neou, Fotios Tsimpoukas, Georgios Papathanakos, Giorgos Marinakis, Ioannis Koutsodimitropoulos, Kounougeri Aikaterini, Nikoletta Rovina, Stylliani Kourelea, Polychronis Tasioudis, Vasiiios Zidianakis, Vryza Konstantinia, Zoi Aidoni, Brian Marsh, Catherine Motherway, Chris Read, Ignacio Martin-Loeches, Andrea Neville Cracchiolo, Aristide Morigi, Italo Calamai, Stefania Brusa, Ahmed Elhadi, Ahmed Tarek, Ala Khaled, Hazem Ahmed, Wesal Ali Belkhair, Alexander D Cornet, Diederik Gommers, Dylan W De Lange, Eva van Boven, Jasper Haringman, Lenneke Haas, Lettie van den Berg, Oscar Hoiting, Peter de Jager, Rik T Gerritsen, Tom Dormans, Willem Dieperink, Alena Breidablik Alena Breidablik, Anita Slapgard, Anne-Karin Rime, Bente Jannestad, Britt Sjøbøe, Eva Rice, Finn H Andersen, Hans Frank Strietzel, Jan Peter Jensen, Jørund Langørgen, Kirsti Tøien, Kristian Strand, Michael Hahn, Pål Klepstad, Aleksandra Biernacka, Anna Kluzik, Bartosz Kudlinski, Dariusz Maciejewski, Dorota Studzińska, Hubert Hymczak, Jan Stefaniak, Joanna Solek-Pastuszka, Joanna Zorska, Katarzyna Cwyl, Lukasz J Krzych, Maciej Zukowski, Małgorzata Lipińska-Gediga, Marek Pietruszko, Mariusz Piechota, Marta Serwa, Miroslaw Czuczwar, Mirosław Ziętkiewicz, Natalia Kozera, Paweł Nasiłowski, Paweł Sendur, Paweł Zatorski, Piotr Galkin, Ryszard Gawda, Urszula Kościuczuk, Waldemar Cyrankiewicz, Wojciech Gola, Alexandre Fernandes Pinto, Ana Margarida Fernandes, Ana Rita Santos, Cristina Sousa, Inês Barros, Isabel Amorim Ferreira, Jacobo Bacariza Blanco, João Teles Carvalho, Jose Maia, Nuno Candeias, Nuno Catorze, Vladislav Belskiy, Africa Lores, Angela Prado Mira, Catia Cilloniz, David Perez-Torres, Emilio Maseda, Enver Rodriguez, Estefania Prol-Silva, Gaspar Eixarch, Gemma Gomà, Gerardo Aguilar, Gonzalo Navarro Velasco, Marián Irazábal Jaimes, Mercedes Ibarz Villamayor, Noemí Llamas Fernández, Patricia Jimeno Cubero, Sonia López-Cuenca, Teresa Tomasa, Anders Sjöqvist, Camilla Brorsson, Fredrik Schiöler, Henrik Westberg, Jessica Nauska, Joakim Sivik, Johan Berkius, Karin Kleiven Thiringer, Lina De Geer, Sten Walther, Filippo Boroli, Joerg C Schefold, Leila Hergafi, Philippe Eckert, Ismail Yıldız, Ihor Yovenko, Yuriy Nalapko, Richard Pugh, Malbec, Odile, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Mater Misericordiae University Hospital [Dublin] (The Mater Hospital), Jagiellonian University Medical College / Uniwersytet Jagielloński Collegium Medicum [Krakow, Poland], Innsbruck Medical University [Austria] (IMU), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), and Intensive Care
Subjects: Aged, 80 and over, Octogenarians, Critical Care, Frailty, Omvårdnad, Research, Critical Illness, [SDV]Life Sciences [q-bio], 610 Medicine & health, Nursing, Cohort Studies, Hospitalization, [SDV] Life Sciences [q-bio], Critical Illness/therapy, Nonagenarians, Humans, Intensive care medicine, Geriatrics and Gerontology, Outcome
Abstract: Funding Information: This study was endorsed by the ESICM. Free support for running the electronic database and was granted from the dep. of Epidemiology, University of Aarhus, Denmark. Financial support for creation of the e-CRF and maintenance of the database was possible from a grant (open project support) by Western Health region in Norway) 2018 who also funded the participating Norwegian ICUs. DRC Ile de France and URC Est helped conducting VIP2 in France. Open Access funding enabled and organized by Projekt DEAL. Publisher Copyright: © 2021, The Author(s). Background: Intensive care unit (ICU) patients age 90 years or older represent a growing subgroup and place a huge financial burden on health care resources despite the benefit being unclear. This leads to ethical problems. The present investigation assessed the differences in outcome between nonagenarian and octogenarian ICU patients. Methods: We included 7900 acutely admitted older critically ill patients from two large, multinational studies. The primary outcome was 30-day-mortality, and the secondary outcome was ICU-mortality. Baseline characteristics consisted of frailty assessed by the Clinical Frailty Scale (CFS), ICU-management, and outcomes were compared between octogenarian (80–89.9 years) and nonagenarian (> 90 years) patients. We used multilevel logistic regression to evaluate differences between octogenarians and nonagenarians. Results: The nonagenarians were 10% of the entire cohort. They experienced a higher percentage of frailty (58% vs 42%; p < 0.001), but lower SOFA scores at admission (6 + 5 vs. 7 + 6; p < 0.001). ICU-management strategies were different. Octogenarians required higher rates of organ support and nonagenarians received higher rates of life-sustaining treatment limitations (40% vs. 33%; p < 0.001). ICU mortality was comparable (27% vs. 27%; p = 0.973) but a higher 30-day-mortality (45% vs. 40%; p = 0.029) was seen in the nonagenarians. After multivariable adjustment nonagenarians had no significantly increased risk for 30-day-mortality (aOR 1.25 (95% CI 0.90–1.74; p = 0.19)). Conclusion: After adjustment for confounders, nonagenarians demonstrated no higher 30-day mortality than octogenarian patients. In this study, being age 90 years or more is no particular risk factor for an adverse outcome. This should be considered– together with illness severity and pre-existing functional capacity - to effectively guide triage decisions. Trial registration: NCT03134807 and NCT03370692. publishersversion published
Published: 2021

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