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11. Assessment of nutritional status by monitoring quadriceps muscle layer thickness with ultrasonography in intensive care unit: an observational study

Author

Brisard, L., primary, Lakhal, K., additional, Le Thuaut, A., additional, Fresco, M., additional, Nicolet, J., additional, Lepoivre, T., additional, Demeure dit Latte, D., additional, Cinotti, R., additional, Zambon, O., additional, Nicolet, L., additional, Asehnoune, K., additional, Reigner, J., additional, and Rozec, B., additional

Published
2020
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12. Should we reconsider cefazolin for treating staphylococcal meningitis? A retrospective analysis of cefazolin and cloxacillin cerebrospinal fluid levels in patients treated for staphylococcal meningitis

Author

Le Turnier, P., primary, Gregoire, M., additional, Deslandes, G., additional, Lakhal, K., additional, Deschanvres, C., additional, Lecomte, R., additional, Talarmin, J.-P., additional, Dubée, V., additional, Bellouard, R., additional, Boutoille, D., additional, Leroy, A.-G., additional, Gaborit, B.J., additional, Raffi, Francois, additional, Boutoille, David, additional, Biron, Charlotte, additional, Lefebvre, Maeva, additional, Gaborit, Benjamin Jean, additional, Le Turnier, Paul, additional, Deschanvres, Colin, additional, Lecomte, Raphael, additional, Chauveau, Marie, additional, Asseray, Nathalie, additional, Gregoire, Matthieu, additional, Bellouard, Ronan, additional, Deslandes, Guillaume, additional, Dailly, Eric, additional, Leroy, Anne-Gaëlle, additional, Corvec, Stéphane, additional, Bémer, Pascale, additional, Caillon, Jocelyne, additional, Guillouzouic, Aurélie, additional, Lakhal, Karim, additional, Cinotti, Raphaël, additional, Canet, Emmanuel, additional, Bretonniere, Cédric, additional, Guimard, Thomas, additional, Brochard, Julia, additional, Talarmin, Jean Philippe, additional, and Katchatourian, Lydie, additional

Published
2020
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18. Fluid challenges in intensive care: the FENICE study: a global inception cohort study

Author

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

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

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

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

Author

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

Abstract

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

Published
2015

21. A prospective international observational prevalence study on prone positioning of ARDS patients: the APRONET (ARDS Prone Position Network) study

Author

Guã©rin, C, Beuret, P, Constantin, J, Bellani, G, Garcia-Olivares, P, Roca, O, Meertens, J, Maia, P, Becher, T, Peterson, J, Larsson, A, Gurjar, M, Hajjej, Z, Kovari, F, Assiri, A, Mainas, E, Hasan, M, Morocho-Tutillo, D, Baboi, L, Chrã©tien, J, Franã§ois, G, Ayzac, L, Chen, L, Brochard, L, Mercat, A, Sellami, W, Ferjani, M, Al Bshabshe, A, Almekhlafi, G, Mandourah, Y, Rai, V, Marzida, M, Corcoles Gonzalez, V, Sanchez Iniesta, R, Garcia, P, Garcia-Montesinos de la Peña, M, Garcia Herrera, A, Garcia-de-Acilu, M, Masclans Enviz, J, Mancebo, J, Heili, S, Artigas Raventos, A, Blanch Torra, L, Roche-Campo, F, Rialp, G, Forteza, C, Berrazueta, A, Martinez, E, Penuelas, O, Jara-Rubio, R, Mallat, J, Thevenin, D, Zogheib, E, Levrat, A, Porot, V, Bedock, B, Grech, L, Plantefeve, G, Badie, J, Besch, G, Pili-Floury, S, Guisset, O, Robine, A, Prat, G, Doise, J, Badet, M, Thouret, J, Just, B, Perbet, S, Lautrette, A, Souweine, B, Chabanne, R, Danguy des Déserts, M, Rigaud, J, Marchalot, A, Bele, N, Beague, S, Hours, S, Marque, S, Durand, M, Payen, J, Stoclin, A, Gaffinel, A, Winer, A, Chudeau, N, Tirot, P, Thyrault, M, Paulet, R, Aubrun, F, Guerin, C, Floccard, B, Rimmele, T, Argaud, L, Hernu, R, Crozon Clauzel, J, Wey, P, Bourdin, G, Pommier, C, Cueuille, N, de Varax, N, Marchi, E, Papazian, L, Jochmans, S, Monchi, M, Jaber, S, de Jong, A, Moulaire, V, Capron, M, Jarrige, L, Barberet, G, Lakhal, K, Rozec, B, Dellamonica, J, Robert, A, Bernardin, G, Danin, P, Raucoules, M, Runge, I, Foucrier, A, Hamada, S, Tesniere, A, Fromentin, M, Samama, C, Mira, J, Diehl, J, Mekontso Dessap, A, Arbelot, C, Demoule, A, Roche, A, Similowski, T, Ricard, J, Gaudry, S, Dreyfuss, D, de Montmolin, E, da Silva, D, Verdiere, B, Ardisson, F, Lemiale, V, Azoulay, E, Bruel, C, Tiercelet, K, Fartoukh, M, Voiriot, G, Hoffmann, C, Leclerc, T, Thille, A, Robert, R, Beduneau, G, Beuzelin, M, Tamion, F, Morel, J, Tremblay, A, Molliex, S, Amal, J, Meaudre, E, Goutorbe, P, Laffon, M, Gros, A, Nica, A, Barjon, G, Dahyot-Fizelier, C, Imzi, N, Gally, J, Real, N, Sauneuf, B, Souloy, X, Girbes, A, Tuinman, P, Schultz, M, Winters, T, Mijzen, L, Roekaerts, P, Vermeijden, W, Beishuizen, A, Trof, R, Corsten, S, Kesecioglu, J, Dieperink, W, Pickers, P, Roovers, N, Duque, M, Rua, F, Pereira de Figueired, A, Ramos, A, Fragoso, E, Azevedo, P, Gouveia, J, Costa E. Silva, Z, Silva, G, Chaves, S, Nobrega, J, Lopes, L, Valerio, B, Araujo, A, de Freitas, P, Bouw, M, Melao, M, Granja, C, Marcal, P, Fernandes, A, Joao, G, Maia, D, Spadaro, S, Volta, C, Citerio, G, Mauri, T, Alban, L, Pesenti, A, Mistraletti, G, Formenti, P, Tommasino, C, Tardini, F, Fumagalli, R, Colombo, R, Fossali, T, Catena, E, Todeschini, M, Gnesin, P, Cracchiolo, A, Palma, D, Tetamo, R, Albiero, D, Costantini, E, Raimondi, F, Coppadoro, A, Vascotto, E, Lusenti, F, Schã¤dler, D, Weiler, N, Karagiannidis, C, Petersson, J, Konrad, D, Kawati, R, Wessbergh, J, Valtysson, J, Rockstroh, M, Borgstrom, S, Larsson, N, Thunberg, J, Camsooksai, J, Briggs, N, Cuesta, J, Anwar, S, Oâ€TMBrien, B, Barberis, L, Sturman, J, Karatzas, S, Piza, P, Sottiaux, T, Adam, J, Gawda, R, Gawor, M, Alqdah, M, Cohen, D, Baker, A, Ñamendys-Silva, S, Garcia-Guillen, F, Morocho Tutillo, D, Jibaja Vega, M, Zakalik, G, Pagella, G, Marengo, J, Guérin, C., Beuret, P., Constantin, J. 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M., Just, Bernard, Perbet, Sébastien, Lautrette, Alexandre, Souweine, B., Chabanne, Russell, Danguy des Déserts, Marc, Rigaud, Jean-Philippe, Marchalot, Antoine, Rigaud, J. P., Bele, Nicolas, Beague, Sébastien, Hours, Sandrine, Marque, Sophie, Durand, Michel, Payen, J. F., Stoclin, Annabelle, Gaffinel, Alain, Winer, Arnaud, Chudeau, Nicolas, Tirot, Patrice, Thyrault, Martial, Paulet, Rémi, Thyrault, M., Aubrun, Frederic, Guerin, Claude, Floccard, Bernard, Rimmele, T., Argaud, Laurent, Hernu, Romain, Crozon Clauzel, Jullien, Wey, Pierre-François, Bourdin, Gael, Pommier, C., Cueuille, NadÃge, de Varax, null, Marchi, Elisa, Papazian, L., Jochmans, Sebastien, Monchi, M., Jaber, Samir, de Jong, Audrey, Moulaire, Valerie, Capron, Matthieu, Jarrige, L., Barberet, Guillaume, Lakhal, Karim, Rozec, B., Dellamonica, Jean, Robert, Alexandre, Bernardin, G., Danin, Pierre-Eric, Raucoules, M., Runge, Isabelle, Foucrier, Arnaud, Hamada, Sophie, Tesniere, Antoine, Fromentin, Mélanie, Samama, C. M., Mira, Jean-Paul, Diehl, Jean-Luc, Mekontso Dessap, Armand, Arbelot, Charlotte, Demoule, Alexandre, Roche, Anne, Similowski, T., Ricard, Jean-Damien, Gaudry, Stéphane, Dreyfuss, D., de Montmolin, Etienne, da Silva, Daniel, Verdiere, B., Ardisson, Fanny, Lemiale, Virginie, Azoulay, Elie, Bruel, Cédric, Tiercelet, Kelly, Fartoukh, Muriel, Voiriot, Guillaume, Hoffmann, Clement, Leclerc, T., Thille, Arnaud, Robert, Réné, Beuret, Pascal, Beduneau, Gaëtan, Beuzelin, Marion, Tamion, F., Morel, Jérà ́me, Tremblay, Aymeric, Molliex, S., Amal, Jean-Michel, Meaudre, Eric, Goutorbe, Philippe, Laffon, Marc, Gros, Antoine, Nica, Alexandru, Barjon, Genevieve, Dahyot-Fizelier, Claire, Imzi, Nadia, Gally, Josette, Real, null, Sauneuf, Bertrand, Souloy, Xavier, Girbes, Armand, Tuinman, Pieter Roel, Schultz, Marcus, Winters, Tineke, Mijzen, Lisa, Roekaerts, P. M. H. J., Vermeijden, Wytze, Beishuizen, Albertus, Trof, R., Corsten, Stijn, Kesecioglu, Jozef, Meertens, John, Dieperink, Wim, Pickers, Peter, Roovers, Noortje, Maia, Paulo, Duque, Melanie, Rua, Fernando, Pereira de Figueired, AntÃ3nio Manuel, Ramos, Armindo, Fragoso, Elsa, Azevedo, Pilar, Gouveia, Joao, Costa E. Silva, Zélia, Silva, Goncalo, Chaves, Susana, Nobrega, J. J., Lopes, Luís, Valerio, Bernardino, Araujo, Ana Carolina, de Freitas, Paulo Telles, Bouw, Maria Jose, Melao, Maria, Granja, C., Marcal, Paulo, Fernandes, Antero, Joao, Gonçalves Pereira, Maia, Dionísio Faria, Spadaro, Savino, Volta, Carlo Alberto, Bellani, Giacomo, Citerio, G., Mauri, Tommaso, Alban, Laura, Pesenti, A., Mistraletti, Giovanni, Formenti, Paolo, Tommasino, C., Tardini, Francesca, Fumagalli, R., Colombo, Riccardo, Fossali, Tommaso, Catena, E., Todeschini, Manuel, Gnesin, Paolo, Cracchiolo, Andrea Neville, Palma, Daniela, Tetamo, R., Albiero, Daniela, Costantini, Elena, Raimondi, F., Coppadoro, Andrea, Vascotto, Ettore, Lusenti, F., Becher, Tobias, Schädler, Dirk, Weiler, N., Karagiannidis, Christian, Petersson, Johan, Konrad, D., Kawati, Rafael, Wessbergh, Joanna, Valtysson, J., Rockstroh, Matthias, Borgstrom, Sten, Larsson, Niklas, Thunberg, J., Camsooksai, Julie, Briggs, null, Kovari, Ferenc, Cuesta, J., Anwar, Sibs, Oâ€TMBrien, B., Barberis, Luigi, Sturman, J., Mainas, Efstratios, Karatzas, S., Piza, Petr, Sottiaux, Thierry, Adam, J. F., Gawda, Ryszard, Gawor, Maen, Alqdah, M., Cohen, D., Brochard, Laurent, Baker, A., Ñamendys-Silva, Silvio Antonio, Garcia-Guillen, Francisco Javier, Morocho Tutillo, Diego Rolando, Jibaja Vega, Manuel, Zakalik, Graciela, Pagella, Gonzalo, Marengo, J., Guã©rin, C, Beuret, P, Constantin, J, Bellani, G, Garcia-Olivares, P, Roca, O, Meertens, J, Maia, P, Becher, T, Peterson, J, Larsson, A, Gurjar, M, Hajjej, Z, Kovari, F, Assiri, A, Mainas, E, Hasan, M, Morocho-Tutillo, D, Baboi, L, Chrã©tien, J, Franã§ois, G, Ayzac, L, Chen, L, Brochard, L, Mercat, A, Sellami, W, Ferjani, M, Al Bshabshe, A, Almekhlafi, G, Mandourah, Y, Rai, V, Marzida, M, Corcoles Gonzalez, V, Sanchez Iniesta, R, Garcia, P, Garcia-Montesinos de la Peña, M, Garcia Herrera, A, Garcia-de-Acilu, M, Masclans Enviz, J, Mancebo, J, Heili, S, Artigas Raventos, A, Blanch Torra, L, Roche-Campo, F, Rialp, G, Forteza, C, Berrazueta, A, Martinez, E, Penuelas, O, Jara-Rubio, R, Mallat, J, Thevenin, D, Zogheib, E, Levrat, A, Porot, V, Bedock, B, Grech, L, Plantefeve, G, Badie, J, Besch, G, Pili-Floury, S, Guisset, O, Robine, A, Prat, G, Doise, J, Badet, M, Thouret, J, Just, B, Perbet, S, Lautrette, A, Souweine, B, Chabanne, R, Danguy des Déserts, M, Rigaud, J, Marchalot, A, Bele, N, Beague, S, Hours, S, Marque, S, Durand, M, Payen, J, Stoclin, A, Gaffinel, A, Winer, A, Chudeau, N, Tirot, P, Thyrault, M, Paulet, R, Aubrun, F, Guerin, C, Floccard, B, Rimmele, T, Argaud, L, Hernu, R, Crozon Clauzel, J, Wey, P, Bourdin, G, Pommier, C, Cueuille, N, de Varax, N, Marchi, E, Papazian, L, Jochmans, S, Monchi, M, Jaber, S, de Jong, A, Moulaire, V, Capron, M, Jarrige, L, Barberet, G, Lakhal, K, Rozec, B, Dellamonica, J, Robert, A, Bernardin, G, Danin, P, Raucoules, M, Runge, I, Foucrier, A, Hamada, S, Tesniere, A, Fromentin, M, Samama, C, Mira, J, Diehl, J, Mekontso Dessap, A, Arbelot, C, Demoule, A, Roche, A, Similowski, T, Ricard, J, Gaudry, S, Dreyfuss, D, de Montmolin, E, da Silva, D, Verdiere, B, Ardisson, F, Lemiale, V, Azoulay, E, Bruel, C, Tiercelet, K, Fartoukh, M, Voiriot, G, Hoffmann, C, Leclerc, T, Thille, A, Robert, R, Beduneau, G, Beuzelin, M, Tamion, F, Morel, J, Tremblay, A, Molliex, S, Amal, J, Meaudre, E, Goutorbe, P, Laffon, M, Gros, A, Nica, A, Barjon, G, Dahyot-Fizelier, C, Imzi, N, Gally, J, Real, N, Sauneuf, B, Souloy, X, Girbes, A, Tuinman, P, Schultz, M, Winters, T, Mijzen, L, Roekaerts, P, Vermeijden, W, Beishuizen, A, Trof, R, Corsten, S, Kesecioglu, J, Dieperink, W, Pickers, P, Roovers, N, Duque, M, Rua, F, Pereira de Figueired, A, Ramos, A, Fragoso, E, Azevedo, P, Gouveia, J, Costa E. Silva, Z, Silva, G, Chaves, S, Nobrega, J, Lopes, L, Valerio, B, Araujo, A, de Freitas, P, Bouw, M, Melao, M, Granja, C, Marcal, P, Fernandes, A, Joao, G, Maia, D, Spadaro, S, Volta, C, Citerio, G, Mauri, T, Alban, L, Pesenti, A, Mistraletti, G, Formenti, P, Tommasino, C, Tardini, F, Fumagalli, R, Colombo, R, Fossali, T, Catena, E, Todeschini, M, Gnesin, P, Cracchiolo, A, Palma, D, Tetamo, R, Albiero, D, Costantini, E, Raimondi, F, Coppadoro, A, Vascotto, E, Lusenti, F, Schã¤dler, D, Weiler, N, Karagiannidis, C, Petersson, J, Konrad, D, Kawati, R, Wessbergh, J, Valtysson, J, Rockstroh, M, Borgstrom, S, Larsson, N, Thunberg, J, Camsooksai, J, Briggs, N, Cuesta, J, Anwar, S, Oâ€TMBrien, B, Barberis, L, Sturman, J, Karatzas, S, Piza, P, Sottiaux, T, Adam, J, Gawda, R, Gawor, M, Alqdah, M, Cohen, D, Baker, A, Ñamendys-Silva, S, Garcia-Guillen, F, Morocho Tutillo, D, Jibaja Vega, M, Zakalik, G, Pagella, G, Marengo, J, Guérin, C., Beuret, P., Constantin, J. M., Bellani, G., Garcia-Olivares, P., Roca, O., Meertens, J. H., Maia, P. Azevedo, Becher, T., Peterson, J., Larsson, A., Gurjar, M., Hajjej, Z., Kovari, F., Assiri, A. H., Mainas, E., Hasan, M. S., Morocho-Tutillo, D. R., Baboi, L., Chrétien, J. M., François, G., Ayzac, L., Chen, L., Brochard, L., Mercat, A., Hajjej, Zied, Sellami, Walid, Ferjani, M., Gurjar, Mohan, Assiri, Amer, Al Bshabshe, Ali, Almekhlafi, Ghaleb, Mandourah, Yasser, Hasan, Mohd Shahnaz, Rai, Vineya, Marzida, M., Corcoles Gonzalez, Virgilio, Sanchez Iniesta, Rafael, Garcia, Pablo, Garcia-Montesinos de la Peña, Manuel, Garcia Herrera, Adriana, Roca, Oriol, Garcia-de-Acilu, Marina, Masclans Enviz, Joan Ramon, Mancebo, Jordi, Heili, Sarah, Artigas Raventos, Antonio, Blanch Torra, Lluís, Roche-Campo, Ferran, Rialp, Gemma, Forteza, Catalina, Berrazueta, Ana, Martinez, Esther, Penuelas, Oscar, Jara-Rubio, Ruben, Mallat, Jihad, Thevenin, D., Zogheib, Elie, Mercat, Alain, Levrat, Albrice, Porot, Veronique, Bedock, B., Grech, Ludovic, Plantefeve, Gaetan, Badie, Julio, Besch, Guillaume, Pili-Floury, Sébastien, Guisset, Olivier, Robine, Adrien, Prat, Gwenael, Doise, Jean-Marc, Badet, Michel, Thouret, J. M., Just, Bernard, Perbet, Sébastien, Lautrette, Alexandre, Souweine, B., Chabanne, Russell, Danguy des Déserts, Marc, Rigaud, Jean-Philippe, Marchalot, Antoine, Rigaud, J. P., Bele, Nicolas, Beague, Sébastien, Hours, Sandrine, Marque, Sophie, Durand, Michel, Payen, J. F., Stoclin, Annabelle, Gaffinel, Alain, Winer, Arnaud, Chudeau, Nicolas, Tirot, Patrice, Thyrault, Martial, Paulet, Rémi, Thyrault, M., Aubrun, Frederic, Guerin, Claude, Floccard, Bernard, Rimmele, T., Argaud, Laurent, Hernu, Romain, Crozon Clauzel, Jullien, Wey, Pierre-François, Bourdin, Gael, Pommier, C., Cueuille, NadÃge, de Varax, null, Marchi, Elisa, Papazian, L., Jochmans, Sebastien, Monchi, M., Jaber, Samir, de Jong, Audrey, Moulaire, Valerie, Capron, Matthieu, Jarrige, L., Barberet, Guillaume, Lakhal, Karim, Rozec, B., Dellamonica, Jean, Robert, Alexandre, Bernardin, G., Danin, Pierre-Eric, Raucoules, M., Runge, Isabelle, Foucrier, Arnaud, Hamada, Sophie, Tesniere, Antoine, Fromentin, Mélanie, Samama, C. M., Mira, Jean-Paul, Diehl, Jean-Luc, Mekontso Dessap, Armand, Arbelot, Charlotte, Demoule, Alexandre, Roche, Anne, Similowski, T., Ricard, Jean-Damien, Gaudry, Stéphane, Dreyfuss, D., de Montmolin, Etienne, da Silva, Daniel, Verdiere, B., Ardisson, Fanny, Lemiale, Virginie, Azoulay, Elie, Bruel, Cédric, Tiercelet, Kelly, Fartoukh, Muriel, Voiriot, Guillaume, Hoffmann, Clement, Leclerc, T., Thille, Arnaud, Robert, Réné, Beuret, Pascal, Beduneau, Gaëtan, Beuzelin, Marion, Tamion, F., Morel, Jérà ́me, Tremblay, Aymeric, Molliex, S., Amal, Jean-Michel, Meaudre, Eric, Goutorbe, Philippe, Laffon, Marc, Gros, Antoine, Nica, Alexandru, Barjon, Genevieve, Dahyot-Fizelier, Claire, Imzi, Nadia, Gally, Josette, Real, null, Sauneuf, Bertrand, Souloy, Xavier, Girbes, Armand, Tuinman, Pieter Roel, Schultz, Marcus, Winters, Tineke, Mijzen, Lisa, Roekaerts, P. M. H. J., Vermeijden, Wytze, Beishuizen, Albertus, Trof, R., Corsten, Stijn, Kesecioglu, Jozef, Meertens, John, Dieperink, Wim, Pickers, Peter, Roovers, Noortje, Maia, Paulo, Duque, Melanie, Rua, Fernando, Pereira de Figueired, AntÃ3nio Manuel, Ramos, Armindo, Fragoso, Elsa, Azevedo, Pilar, Gouveia, Joao, Costa E. Silva, Zélia, Silva, Goncalo, Chaves, Susana, Nobrega, J. J., Lopes, Luís, Valerio, Bernardino, Araujo, Ana Carolina, de Freitas, Paulo Telles, Bouw, Maria Jose, Melao, Maria, Granja, C., Marcal, Paulo, Fernandes, Antero, Joao, Gonçalves Pereira, Maia, Dionísio Faria, Spadaro, Savino, Volta, Carlo Alberto, Bellani, Giacomo, Citerio, G., Mauri, Tommaso, Alban, Laura, Pesenti, A., Mistraletti, Giovanni, Formenti, Paolo, Tommasino, C., Tardini, Francesca, Fumagalli, R., Colombo, Riccardo, Fossali, Tommaso, Catena, E., Todeschini, Manuel, Gnesin, Paolo, Cracchiolo, Andrea Neville, Palma, Daniela, Tetamo, R., Albiero, Daniela, Costantini, Elena, Raimondi, F., Coppadoro, Andrea, Vascotto, Ettore, Lusenti, F., Becher, Tobias, Schädler, Dirk, Weiler, N., Karagiannidis, Christian, Petersson, Johan, Konrad, D., Kawati, Rafael, Wessbergh, Joanna, Valtysson, J., Rockstroh, Matthias, Borgstrom, Sten, Larsson, Niklas, Thunberg, J., Camsooksai, Julie, Briggs, null, Kovari, Ferenc, Cuesta, J., Anwar, Sibs, Oâ€TMBrien, B., Barberis, Luigi, Sturman, J., Mainas, Efstratios, Karatzas, S., Piza, Petr, Sottiaux, Thierry, Adam, J. F., Gawda, Ryszard, Gawor, Maen, Alqdah, M., Cohen, D., Brochard, Laurent, Baker, A., Ñamendys-Silva, Silvio Antonio, Garcia-Guillen, Francisco Javier, Morocho Tutillo, Diego Rolando, Jibaja Vega, Manuel, Zakalik, Graciela, Pagella, Gonzalo, and Marengo, J.

Abstract

Introduction: While prone positioning (PP) has been shown to improve patient survival in moderate to severe acute respiratory distress syndrome (ARDS) patients, the rate of application of PP in clinical practice still appears low. Aim: This study aimed to determine the prevalence of use of PP in ARDS patients (primary endpoint), the physiological effects of PP, and the reasons for not using it (secondary endpoints). Methods: The APRONET study was a prospective international 1-day prevalence study performed four times in April, July, and October 2016 and January 2017. On each study day, investigators in each ICU had to screen every patient. For patients with ARDS, use of PP, gas exchange, ventilator settings and plateau pressure (Pplat) were recorded before and at the end of the PP session. Complications of PP and reasons for not using PP were also documented. Values are presented as median (1st–3rd quartiles). Results: Over the study period, 6723 patients were screened in 141 ICUs from 20 countries (77% of the ICUs were European), of whom 735 had ARDS and were analyzed. Overall 101 ARDS patients had at least one session of PP (13.7%), with no differences among the 4 study days. The rate of PP use was 5.9% (11/187), 10.3% (41/399) and 32.9% (49/149) in mild, moderate and severe ARDS, respectively (P = 0.0001). The duration of the first PP session was 18 (16–23) hours. Measured with the patient in the supine position before and at the end of the first PP session, PaO 2 /F I O 2 increased from 101 (76–136) to 171 (118–220) mmHg (P = 0.0001) driving pressure decreased from 14 [11–17] to 13 [10–16] cmH 2 O (P = 0.001), and Pplat decreased from 26 [23–29] to 25 [23–28] cmH 2 O (P = 0.04). The most prevalent reason for not using PP (64.3%) was that hypoxemia was not considered sufficiently severe. Complications were reported in 12 patients (11.9%) in whom PP was used (pressure sores in five, hypoxemia in two, endotracheal tube-related in two ocular in two, and a transient

Published
2018

22. Should we reconsider cefazolin for treating staphylococcal meningitis? A retrospective analysis of cefazolin and cloxacillin cerebrospinal fluid levels in patients treated for staphylococcal meningitis

Author

Raffi, Francois, Boutoille, David, Biron, Charlotte, Lefebvre, Maeva, Gaborit, Benjamin Jean, Le Turnier, Paul, Deschanvres, Colin, Lecomte, Raphael, Chauveau, Marie, Asseray, Nathalie, Gregoire, Matthieu, Bellouard, Ronan, Deslandes, Guillaume, Dailly, Eric, Leroy, Anne-Gaëlle, Corvec, Stéphane, Bémer, Pascale, Caillon, Jocelyne, Guillouzouic, Aurélie, Lakhal, Karim, Cinotti, Raphaël, Canet, Emmanuel, Bretonniere, Cédric, Guimard, Thomas, Brochard, Julia, Talarmin, Jean Philippe, Katchatourian, Lydie, Le Turnier, P., Gregoire, M., Deslandes, G., Lakhal, K., Deschanvres, C., Lecomte, R., Talarmin, J.-P., Dubée, V., Bellouard, R., Boutoille, D., Leroy, A.-G., and Gaborit, B.J.

Published
2020
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27. Place de l’échographie multimodale en réanimation. Enquête de pratique dans 141 unités

Author

Meresse, Z., primary, Zieleskiewicz, L., additional, Muller, L., additional, Lakhal, K., additional, Arbelot, C., additional, Cholley, B., additional, quintard, H., additional, Michel, F., additional, Bertrand, P.-M., additional, Dupperet, S., additional, Muller, M., additional, Lefrant, J.-Y., additional, Jaber, S., additional, Martin, C., additional, and Leone, M., additional

Published
2014
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35. Noninvasive monitoring of blood pressure in the critically ill: Reliability according to the cuff site (arm, thigh, or ankle)

Author

Lakhal K, Macq C, Ehrmann S, Boulain T, and Capdevila X

Abstract

OBJECTIVE: : In the critically ill, blood pressure measurements mostly rely on automated oscillometric devices pending the intra-arterial catheter insertion or after its removal. If the arms are inaccessible, the cuff is placed at the ankle or the thigh, but this common practice has never been assessed. We evaluated the reliability of noninvasive blood pressure readings at these anatomic sites. DESIGN: : Prospective observational study. SETTING: : Medical-surgical intensive care unit. PATIENTS: : Patients carrying an arterial line with no severe occlusive arterial disease. INTERVENTION: : Each patient underwent a set of three pairs of noninvasive and intra-arterial measurements at each site (arm, ankle, thigh [if Ramsay sedation scale >4]) and, in case of circulatory failure, a second set of measurements after a cardiovascular intervention (volume expansion, change in catecholamine dosage). MEASUREMENTS AND MAIN RESULTS: : In 150 patients, whatever the cuff site, the agreement between invasive and noninvasive readings was markedly higher for mean arterial pressure than for systolic or diastolic pressure. For mean arterial pressure measurement, arm noninvasive blood pressure was reliable (mean bias of 3.4 ± 5.0 mm Hg, lower/upper limit of agreement of -6.3/13.1 mm Hg) contrary to ankle or thigh noninvasive blood pressure (mean bias of 3.1 ± 7.7 mm Hg and 5.7 ± 6.8 mm Hg and lower/upper limits of agreement of -12.1/18.3 mm Hg and -7.7/19.2 mm Hg, respectively). During acute circulatory failure (n = 83), arm noninvasive blood pressure but also ankle and thigh noninvasive blood pressure allowed a reliable detection of 1) invasive mean arterial pressure <65 mm Hg (area under the receiver operating characteristic curve of 0.98 [0.92-1], 0.93 [0.85-0.97], and 0.93 [0.85-0.98] for arm, ankle, and thigh noninvasive blood pressure, respectively); and 2) a significant (>10%) increase in invasive mean arterial pressure after a cardiovascular intervention (area under the receiver operating characteristic curve of 0.99 [0.92-1], 0.90 [0.80-0.97], and 0.96 [0.87-0.99], respectively). CONCLUSION: : In our population, arm noninvasive mean arterial pressure readings were accurate. Either the ankle or the thigh may be reliable alternatives, only to detect hypotensive and therapy-responding patients. (Crit Care Med 2012; 40:-1213). [ABSTRACT FROM AUTHOR]

Published
2012

38. A prospective international observational prevalence study on prone positioning of ARDS patients: the APRONET (ARDS Prone Position Network) study

Author

Guérin, C., Beuret, P., Constantin, J. M., Bellani, G., Garcia-Olivares, P., Roca, O., Meertens, J. H., Maia, P. Azevedo, Becher, T., Peterson, J., Larsson, A., Gurjar, M., Hajjej, Z., Kovari, F., Assiri, A. H., Mainas, E., Hasan, M. S., Morocho-Tutillo, D. R., Baboi, L., Chrétien, J. M., François, G., Ayzac, L., Chen, L., Brochard, L., Mercat, A., Hajjej, Zied, Sellami, Walid, Ferjani, M., Gurjar, Mohan, Assiri, Amer, Al Bshabshe, Ali, Almekhlafi, Ghaleb, Mandourah, Yasser, Hasan, Mohd Shahnaz, Rai, Vineya, Marzida, M., Corcoles Gonzalez, Virgilio, Sanchez Iniesta, Rafael, Garcia, Pablo, Garcia-Montesinos de la Peña, Manuel, Garcia Herrera, Adriana, Roca, Oriol, Garcia-de-Acilu, Marina, Masclans Enviz, Joan Ramon, Mancebo, Jordi, Heili, Sarah, Artigas Raventos, Antonio, Blanch Torra, Lluís, Roche-Campo, Ferran, Rialp, Gemma, Forteza, Catalina, Berrazueta, Ana, Martinez, Esther, Penuelas, Oscar, Jara-Rubio, Ruben, Mallat, Jihad, Thevenin, D., Zogheib, Elie, Mercat, Alain, Levrat, Albrice, Porot, Veronique, Bedock, B., Grech, Ludovic, Plantefeve, Gaetan, Badie, Julio, Besch, Guillaume, Pili-Floury, Sébastien, Guisset, Olivier, Robine, Adrien, Prat, Gwenael, Doise, Jean-Marc, Badet, Michel, Thouret, J. M., Just, Bernard, Perbet, Sébastien, Lautrette, Alexandre, Souweine, B., Chabanne, Russell, Danguy des Déserts, Marc, Rigaud, Jean-Philippe, Marchalot, Antoine, Rigaud, J. P., Bele, Nicolas, Beague, Sébastien, Hours, Sandrine, Marque, Sophie, Durand, Michel, Payen, J. F., Stoclin, Annabelle, Gaffinel, Alain, Winer, Arnaud, Chudeau, Nicolas, Tirot, Patrice, Thyrault, Martial, Paulet, Rémi, Thyrault, M., Aubrun, Frederic, Guerin, Claude, Floccard, Bernard, Rimmele, T., Argaud, Laurent, Hernu, Romain, Crozon Clauzel, Jullien, Wey, Pierre-François, Bourdin, Gael, Pommier, C., Cueuille, NadÃge, de Varax, null, Marchi, Elisa, Papazian, L., Jochmans, Sebastien, Monchi, M., Jaber, Samir, de Jong, Audrey, Moulaire, Valerie, Capron, Matthieu, Jarrige, L., Barberet, Guillaume, Lakhal, Karim, Rozec, B., Dellamonica, Jean, Robert, Alexandre, Bernardin, G., Danin, Pierre-Eric, Raucoules, M., Runge, Isabelle, Foucrier, Arnaud, Hamada, Sophie, Tesniere, Antoine, Fromentin, Mélanie, Samama, C. M., Mira, Jean-Paul, Diehl, Jean-Luc, Mekontso Dessap, Armand, Arbelot, Charlotte, Demoule, Alexandre, Roche, Anne, Similowski, T., Ricard, Jean-Damien, Gaudry, Stéphane, Dreyfuss, D., de Montmolin, Etienne, da Silva, Daniel, Verdiere, B., Ardisson, Fanny, Lemiale, Virginie, Azoulay, Elie, Bruel, Cédric, Tiercelet, Kelly, Fartoukh, Muriel, Voiriot, Guillaume, Hoffmann, Clement, Leclerc, T., Thille, Arnaud, Robert, Réné, Beuret, Pascal, Beduneau, Gaëtan, Beuzelin, Marion, Tamion, F., Morel, Jérôme, Tremblay, Aymeric, Molliex, S., Amal, Jean-Michel, Meaudre, Eric, Goutorbe, Philippe, Laffon, Marc, Gros, Antoine, Nica, Alexandru, Barjon, Genevieve, Dahyot-Fizelier, Claire, Imzi, Nadia, Gally, Josette, Real, null, Sauneuf, Bertrand, Souloy, Xavier, Girbes, Armand, Tuinman, Pieter Roel, Schultz, Marcus, Winters, Tineke, Mijzen, Lisa, Roekaerts, P. M. H. J., Vermeijden, Wytze, Beishuizen, Albertus, Trof, R., Corsten, Stijn, Kesecioglu, Jozef, Meertens, John, Dieperink, Wim, Pickers, Peter, Roovers, Noortje, Maia, Paulo, Duque, Melanie, Rua, Fernando, Pereira de Figueired, António Manuel, Ramos, Armindo, Fragoso, Elsa, Azevedo, Pilar, Gouveia, Joao, Costa E. Silva, Zélia, Silva, Goncalo, Chaves, Susana, Nobrega, J. J., Lopes, Luís, Valerio, Bernardino, Araujo, Ana Carolina, de Freitas, Paulo Telles, Bouw, Maria Jose, Melao, Maria, Granja, C., Marcal, Paulo, Fernandes, Antero, Joao, Gonçalves Pereira, Maia, Dionísio Faria, Spadaro, Savino, Volta, Carlo Alberto, Bellani, Giacomo, Citerio, G., Mauri, Tommaso, Alban, Laura, Pesenti, A., Mistraletti, Giovanni, Formenti, Paolo, Tommasino, C., Tardini, Francesca, Fumagalli, R., Colombo, Riccardo, Fossali, Tommaso, Catena, E., Todeschini, Manuel, Gnesin, Paolo, Cracchiolo, Andrea Neville, Palma, Daniela, Tetamo, R., Albiero, Daniela, Costantini, Elena, Raimondi, F., Coppadoro, Andrea, Vascotto, Ettore, Lusenti, F., Becher, Tobias, Schädler, Dirk, Weiler, N., Karagiannidis, Christian, Petersson, Johan, Konrad, D., Kawati, Rafael, Wessbergh, Joanna, Valtysson, J., Rockstroh, Matthias, Borgstrom, Sten, Larsson, Niklas, Thunberg, J., Camsooksai, Julie, Briggs, null, Kovari, Ferenc, Cuesta, J., Anwar, Sibs, O’Brien, B., Barberis, Luigi, Sturman, J., Mainas, Efstratios, Karatzas, S., Piza, Petr, Sottiaux, Thierry, Adam, J. F., Gawda, Ryszard, Gawor, Maen, Alqdah, M., Cohen, D., Brochard, Laurent, Baker, A., Ñamendys-Silva, Silvio Antonio, Garcia-Guillen, Francisco Javier, Morocho Tutillo, Diego Rolando, Jibaja Vega, Manuel, Zakalik, Graciela, Pagella, Gonzalo, Marengo, J., KARLI, Mélanie, Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Université de Lyon, 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), Génétique, Reproduction et Développement (GReD ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Hospital General Universitario 'Gregorio Marañón' [Madrid], Vall d'Hebron University Hospital [Barcelona], CIBER de Epidemiología y Salud Pública (CIBERESP), University Medical Center Groningen [Groningen] (UMCG), Centro Hospitalar do Porto, Karolinska University Hospital [Stockholm], Karolinska Institutet [Stockholm], Uppsala University, University of Malaya [Kuala Lumpur, Malaisie], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Keenan Research Centre of the Li Ka Shing Knowledge Institute [Toronto], Université d'Angers - Faculté de médecine (UA UFR Médecine), Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Other departments, Intensive Care Medicine, ACS - Diabetes & metabolism, ACS - Pulmonary hypertension & thrombosis, ACS - Microcirculation, Critical Care, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), University of Malaya = Universiti Malaya [Kuala Lumpur, Malaisie] (UM), Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Université d'Angers (UA), Guã©rin, C, Beuret, P, Constantin, J, Bellani, G, Garcia-Olivares, P, Roca, O, Meertens, J, Maia, P, Becher, T, Peterson, J, Larsson, A, Gurjar, M, Hajjej, Z, Kovari, F, Assiri, A, Mainas, E, Hasan, M, Morocho-Tutillo, D, Baboi, L, Chrã©tien, J, Franã§ois, G, Ayzac, L, Chen, L, Brochard, L, Mercat, A, Sellami, W, Ferjani, M, Al Bshabshe, A, Almekhlafi, G, Mandourah, Y, Rai, V, Marzida, M, Corcoles Gonzalez, V, Sanchez Iniesta, R, Garcia, P, Garcia-Montesinos de la Peña, M, Garcia Herrera, A, Garcia-de-Acilu, M, Masclans Enviz, J, Mancebo, J, Heili, S, Artigas Raventos, A, Blanch Torra, L, Roche-Campo, F, Rialp, G, Forteza, C, Berrazueta, A, Martinez, E, Penuelas, O, Jara-Rubio, R, Mallat, J, Thevenin, D, Zogheib, E, Levrat, A, Porot, V, Bedock, B, Grech, L, Plantefeve, G, Badie, J, Besch, G, Pili-Floury, S, Guisset, O, Robine, A, Prat, G, Doise, J, Badet, M, Thouret, J, Just, B, Perbet, S, Lautrette, A, Souweine, B, Chabanne, R, Danguy des Déserts, M, Rigaud, J, Marchalot, A, Bele, N, Beague, S, Hours, S, Marque, S, Durand, M, Payen, J, Stoclin, A, Gaffinel, A, Winer, A, Chudeau, N, Tirot, P, Thyrault, M, Paulet, R, Aubrun, F, Guerin, C, Floccard, B, Rimmele, T, Argaud, L, Hernu, R, Crozon Clauzel, J, Wey, P, Bourdin, G, Pommier, C, Cueuille, N, de Varax, N, Marchi, E, Papazian, L, Jochmans, S, Monchi, M, Jaber, S, de Jong, A, Moulaire, V, Capron, M, Jarrige, L, Barberet, G, Lakhal, K, Rozec, B, Dellamonica, J, Robert, A, Bernardin, G, Danin, P, Raucoules, M, Runge, I, Foucrier, A, Hamada, S, Tesniere, A, Fromentin, M, Samama, C, Mira, J, Diehl, J, Mekontso Dessap, A, Arbelot, C, Demoule, A, Roche, A, Similowski, T, Ricard, J, Gaudry, S, Dreyfuss, D, de Montmolin, E, da Silva, D, Verdiere, B, Ardisson, F, Lemiale, V, Azoulay, E, Bruel, C, Tiercelet, K, Fartoukh, M, Voiriot, G, Hoffmann, C, Leclerc, T, Thille, A, Robert, R, Beduneau, G, Beuzelin, M, Tamion, F, Morel, J, Tremblay, A, Molliex, S, Amal, J, Meaudre, E, Goutorbe, P, Laffon, M, Gros, A, Nica, A, Barjon, G, Dahyot-Fizelier, C, Imzi, N, Gally, J, Real, N, Sauneuf, B, Souloy, X, Girbes, A, Tuinman, P, Schultz, M, Winters, T, Mijzen, L, Roekaerts, P, Vermeijden, W, Beishuizen, A, Trof, R, Corsten, S, Kesecioglu, J, Dieperink, W, Pickers, P, Roovers, N, Duque, M, Rua, F, Pereira de Figueired, A, Ramos, A, Fragoso, E, Azevedo, P, Gouveia, J, Costa E. Silva, Z, Silva, G, Chaves, S, Nobrega, J, Lopes, L, Valerio, B, Araujo, A, de Freitas, P, Bouw, M, Melao, M, Granja, C, Marcal, P, Fernandes, A, Joao, G, Maia, D, Spadaro, S, Volta, C, Citerio, G, Mauri, T, Alban, L, Pesenti, A, Mistraletti, G, Formenti, P, Tommasino, C, Tardini, F, Fumagalli, R, Colombo, R, Fossali, T, Catena, E, Todeschini, M, Gnesin, P, Cracchiolo, A, Palma, D, Tetamo, R, Albiero, D, Costantini, E, Raimondi, F, Coppadoro, A, Vascotto, E, Lusenti, F, Schã¤dler, D, Weiler, N, Karagiannidis, C, Petersson, J, Konrad, D, Kawati, R, Wessbergh, J, Valtysson, J, Rockstroh, M, Borgstrom, S, Larsson, N, Thunberg, J, Camsooksai, J, Briggs, N, Cuesta, J, Anwar, S, O’Brien, B, Barberis, L, Sturman, J, Karatzas, S, Piza, P, Sottiaux, T, Adam, J, Gawda, R, Gawor, M, Alqdah, M, Cohen, D, Baker, A, Ñamendys-Silva, S, Garcia-Guillen, F, Morocho Tutillo, D, Jibaja Vega, M, Zakalik, G, Pagella, G, and Marengo, J

Subjects
ARDS, RECEIVING MECHANICAL VENTILATION, Epidemiology, medicine.medical_treatment, cross-sectional studies, RESPIRATORY-DISTRESS-SYNDROME, vrouwelijk, buikligging, Critical Care and Intensive Care Medicine, respiratory distress syndrome, adult/therapy, law.invention, Positive-Pressure Respiration, Prone position, 0302 clinical medicine, Mechanical ventilation, prospectieve studies, Randomized controlled trial, law, middle aged, Medicine, FAILURE, adult/therapy, humans, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, RANDOMIZED CONTROLLED-TRIAL, respiratory distress syndrome, 3. Good health, cross-sectionele studies, ademnoodsyndroom, aged, female, SURVIVAL, middelbare leeftijd, medicine.medical_specialty, Pain medicine, positieve druk uitademing, NO, 03 medical and health sciences, male, mensen, Anesthesiology, ouderen, METAANALYSIS, business.industry, MORTALITY, 030208 emergency & critical care medicine, mannelijk, CARE, medicine.disease, prospective studies, EVOLUTION, body regions, 030228 respiratory system, Emergency medicine, Observational study, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Introduction: While prone positioning (PP) has been shown to improve patient survival in moderate to severe acute respiratory distress syndrome (ARDS) patients, the rate of application of PP in clinical practice still appears low.Aim: This study aimed to determine the prevalence of use of PP in ARDS patients (primary endpoint), the physiological effects of PP, and the reasons for not using it (secondary endpoints).Methods: The APRONET study was a prospective international 1-day prevalence study performed four times in April, July, and October 2016 and January 2017. On each study day, investigators in each ICU had to screen every patient. For patients with ARDS, use of PP, gas exchange, ventilator settings and plateau pressure (Pplat) were recorded before and at the end of the PP session. Complications of PP and reasons for not using PP were also documented. Values are presented as median (1st-3rd quartiles).Results: Over the study period, 6723 patients were screened in 141 ICUs from 20 countries (77% of the ICUs were European), of whom 735 had ARDS and were analyzed. Overall 101 ARDS patients had at least one session of PP (13.7%), with no differences among the 4 study days. The rate of PP use was 5.9% (11/187), 10.3% (41/399) and 32.9% (49/149) in mild, moderate and severe ARDS, respectively (P = 0.0001). The duration of the first PP session was 18 (16-23) hours. Measured with the patient in the supine position before and at the end of the first PP session, PaO2/FIO2 increased from 101 (76-136) to 171 (118-220) mmHg (P = 0.0001) driving pressure decreased from 14 [11-17] to 13 [10-16] cmH(2)O (P = 0.001), and Pplat decreased from 26 [23-29] to 25 [23-28] cmH(2)O (P = 0.04). The most prevalent reason for not using PP (64.3%) was that hypoxemia was not considered sufficiently severe. Complications were reported in 12 patients (11.9%) in whom PP was used (pressure sores in five, hypoxemia in two, endotracheal tube-related in two ocular in two, and a transient increase in intracranial pressure in one).Conclusions: In conclusion, this prospective international prevalence study found that PP was used in 32.9% of patients with severe ARDS, and was associated with low complication rates, significant increase in oxygenation and a significant decrease in driving pressure.

Published
2018
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40. Incidence, Risk Factors, and Long-Term Outcomes for Extubation Failure in ICU in Patients With Obesity: A Retrospective Analysis of a Multicenter Prospective Observational Study.

Author

De Jong A, Capdevila M, Aarab Y, Cros M, Pensier J, Lakbar I, Monet C, Quintard H, Cinotti R, Asehnoune K, Arnal JM, Guitton C, Paugam-Burtz C, Abback P, Mekontso-Dessap A, Lakhal K, Lasocki S, Plantefeve G, Claud B, Pottecher J, Corne P, Ichai C, Molinari N, Chanques G, Papazian L, Azoulay E, and Jaber S

Subjects
Humans, Male, Female, Risk Factors, Middle Aged, Incidence, Aged, Prospective Studies, Retrospective Studies, Critical Illness therapy, Treatment Failure, Obesity epidemiology, Obesity complications, Airway Extubation methods, Ventilator Weaning methods, Intensive Care Units statistics & numerical data
Abstract

Background: To our knowledge, no large observational study has compared the incidence and risk factors for extubation failure within 48 h and during ICU stay in the same cohort of unselected critically ill patients with and without obesity., Research Question: What are the incidence and risk factors of extubation failure in patients with and without obesity?, Study Design and Methods: In the prospective multicenter observational Practices and Risk Factors for Weaning and Extubation Airway Failure in Adult Intensive Care Unit: A Multicenter Trial (FREEREA) study in 26 ICUs, the primary objective was to compare the incidence of extubation failure within 48 h in patients with and without obesity. Secondary objectives were to describe and to identify the independent specific risk factors for extubation failure using first a logistic regression model and second a decision tree analysis., Results: Of 1,370 extubation procedures analyzed, 288 (21%) were performed in patients with obesity and 1,082 (79%) in patients without obesity. The incidence of extubation failure within 48 h among patients with or without obesity was 23 of 288 (8.0%) vs 118 of 1,082 (11%), respectively (unadjusted OR, 0.71; 95% CI, 0.45-1.13; P = .15); alongside patients with obesity receiving significantly more noninvasive ventilation [87 of 288 (30%) vs 233 of 1,082 (22%); P = .002] and physiotherapy [165 of 288 (57%) vs 527 of 1,082 (49%); P = .02] than patients without obesity. Risk factors for extubation failure also differed according to obesity status: female sex (adjusted OR, 4.88; 95% CI, 1.61-13.9; P = .002) and agitation before extubation (adjusted OR, 6.39; 95% CI, 1.91-19.8; P = .001) in patients with obesity, and absence of strong cough before extubation (adjusted OR, 2.38; 95% CI, 1.53-3.84; P = .0002) and duration of invasive mechanical ventilation before extubation (adjusted OR, 1.03/d; 95% CI, 1.01-1.06; P = .01) in patients without obesity. The decision tree analysis found similar risk factors., Interpretation: Our findings indicate that anticipation and application of preventive measures for patients with obesity before and after extubation led to similar rates of extubation failure among patients with and without obesity., Clinical Trial Registration: ClinicalTrials.gov; No.: NCT02450669; URL: www., Clinicaltrials: gov., Competing Interests: Financial/Nonfinancial Disclosures The authors have reported to CHEST the following: S. J. reports receiving consulting fees from Drager, Medtronic, Mindray, Fresenius, Baxter, and Fisher & Paykel. A. D. J. reports receiving remuneration for presentations from Medtronic, Drager, and Fisher & Paykel. E. A. has received fees from Gilead Sciences, Alexion, Astellas, MSD, and Drager. J. Pottecher has received fees from Medtronic, Baxter, and Getinge. None declared (M. Capdevila, Y. A., M. Cros, J. Pensier, I. L., C. M., H. Q., R. C., K. A., J.-M. A., C. G., C. P.-B., P. A., A. M.-D., K. L., S. L., G. P., B. C., P. C., C. I., N. M., G. C., L. P.)., (Copyright © 2024 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)

Published
2025
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41. Clot formation risk in the clearing fluid after arterial catheter blood sampling: coagulation factors consumption over time - a prospective pilot study.

Author

Dauvergne JE, Boissier E, Rozec B, Lakhal K, and Muller D

Abstract

After blood sampling from an arterial catheter, the reinjection of the clearing fluid (a mixture of saline solution and blood) is proposed to limit blood loss. However, reinjecting clots may cause embolic complications. The primary objective was to assess fibrinogen consumption in the clearing fluid as an indicator of clot formation over time. Additionally, we searched for macroscopic clots, evaluated changes in prothrombin time, factors II and V. In this prospective observational pilot study, we enrolled adult patients in an intensive care unit with a radial artery catheter who required measurements of hemostasis parameters. We used a locally developed closed blood sampling system. Hemostasis parameters were measured in patients' pure blood (reference) and in the clearing fluid, at 2, 3, and 5 min after the complete filling of the reservoir. Thirty patients were included and 120 samples were analyzed. Fibrinogen levels decreased over time: median [interquartile range (IQR)] of 4.3 [IQR:3.1;5.9] as reference level, 3.6 [IQR:2.7;4.7] at 2 min (p < 0.001), 3.4 [IQR:2.1;4.3] at 3 min (p < 0.001) and 3.0 [IQR:1.7;4.1] g/L at 5 min (p < 0.001). No clot was macroscopically detected in any samples. An antiplatelet agent was administered in 11 (37%) patients. Unfractionated heparin anti-Xa activity was higher than 0.10 UI/ml in 17 (57%). Although no macroscopic clots were observed in the clearing fluid, its coagulation factors decreased over the 5 min following reservoir filling, indicating potential initiation of clot formation. Our findings stress the need for further studies assessing the safety of reinjecting clearing fluid as part of patient blood management., Competing Interests: Declarations. Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the ethics committee, Groupe Nantais d’Ethique dans le Domaine de la Santé (GNEDS) on December 8, 2022 (ref. 22-12-60). Oral and written information was given to the patient or his/her next of kin and their non-opposition to participate in the research was systematically sought. Consent to participate: All patients and/or their next of kin received oral and written information about data collection and their non-opposition was systematically sought. Clinical trial registration: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Published
2024
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42. Hemolysis Index, Carboxyhemoglobin, and Methemoglobin for the Early Identification of Patients at Risk for Cardiac Surgery-Associated Acute Kidney Injury.

Author

Golinvaux E, Goronflot T, Cadiet J, Senage T, Rozec B, Boissier E, Bigot-Corbel E, and Lakhal K

Subjects
Humans, Male, Female, Retrospective Studies, Aged, Middle Aged, Risk Factors, Cardiac Surgical Procedures adverse effects, Acute Kidney Injury blood, Acute Kidney Injury diagnosis, Acute Kidney Injury etiology, Acute Kidney Injury epidemiology, Carboxyhemoglobin analysis, Hemolysis physiology, Methemoglobin analysis, Biomarkers blood, Postoperative Complications blood, Postoperative Complications diagnosis, Postoperative Complications epidemiology, Postoperative Complications etiology, Early Diagnosis
Abstract

Objectives: Hemolysis is a contributor to CS-AKI. Biochemistry analyzers provide a hemolysis index to quantify in vitro hemolysis, a condition that can, for example, affect the accuracy of potassium concentration measurements. We aimed to assess whether the postoperative plasma level of the hemolysis index (HI postoperative ) could aid the early recognition of patients at risk for cardiac surgery-associated acute kidney injury (CS-AKI) and also to evaluate other hemolysis indicators: plasma carboxyhemoglobin (COHb postoperative ) and methemoglobin (MetHb postoperative )., Design: One-year retrospective study., Setting: University hospital., Participants: Patients undergoing elective cardiac surgery., Interventions: None., Measurements and Main Results: In 1090 patients, the median HI postoperative was higher in patients who developed CS-AKI compared to patients who did not (11 mg/dL [interquartile range (IQR), 5-38 mg/dL] v 7 mg/dL [IQR, 3-16 mg/dL]; p < 0.001). HI postoperative refined the early recognition of CS-AKI: the area under the precision-recall curve (AUPRC) for HI postoperative was 37% (95% confidence interval [CI], 31%-42%), whereas the AUPRC associated with no discriminative power, equal to the prevalence of CS-AKI in the whole population, was 21%. Among the 611 patients with measurements for all 3 biomarkers, the AUPRC of HI postoperative was higher than that of COHb postoperative or MetHb postoperative (+6.6% and +7.4% respectively; p < 0.0001 for both). Unlike COHb postoperative or MetHb postoperative , the incorporation of HI postoperative into a model (trained on a sample then validated in another sample) of CS-AKI early recognition significantly enhanced its performance, with a +1.9% (95% CI, 1.6%-2.1%) increase in AUPRC (p < 0.0001)., Conclusions: Elevated HI postoperative represents an early alert signal for the development of CS-AKI. Our findings support the incorporation of HI postoperative , a readily available biomarker, into predictive scores of CS-AKI., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Published
2024
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43. Noninvasive Arterial Pressure Measurements at the Lower Leg: Evaluation of the Influence of Patient Position (Semi-Recumbent or Horizontal)-A Prospective Study.

Author

Lakhal K, Audran A, Normand G, Rozec B, Boulain T, and Dauvergne JE

Abstract

Competing Interests: Financial/Nonfinancial Disclosures The authors have reported to CHEST the following: K. L. is a consultant on the Advisory Board of Philips. In addition, K. L. received, during the past 3 years, congress registration from Pfizer (once in 2022) and both congress registration and travel fees from Advanz Pharma/Correvio (once in 2021) and from AOP Health (once in 2024). B. R. received, during the past 5 years, lecture fees from Fisher&Paykel, Baxter, LFB, and Aspen, research grants from Baxter and Aguettant, and consulting fees from LFB, Aguettant, and Astra Zeneca. None declared (A. A., G. N., J. E. D., T. B.)

Published
2024
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45. Effects of induced arterial hypertension for vasospasm on unruptured and unsecured cerebral aneurysms (growth and rupture). A retrospective case-control study.

Author

Missonnier A, L'Allinec V, Constant Dit Beaufils P, Autrusseau F, Nouri A, Karakachoff M, Rozec B, Bourcier R, and Lakhal K

Subjects
Humans, Retrospective Studies, Female, Male, Middle Aged, Aged, Risk Factors, Time Factors, Arterial Pressure, Adult, Cerebral Angiography, Angiography, Digital Subtraction, Risk Assessment, Disease Progression, Case-Control Studies, Intracranial Aneurysm diagnostic imaging, Intracranial Aneurysm physiopathology, Intracranial Aneurysm complications, Aneurysm, Ruptured diagnostic imaging, Aneurysm, Ruptured physiopathology, Aneurysm, Ruptured etiology, Vasospasm, Intracranial diagnostic imaging, Vasospasm, Intracranial physiopathology, Vasospasm, Intracranial etiology, Subarachnoid Hemorrhage physiopathology, Subarachnoid Hemorrhage diagnostic imaging, Subarachnoid Hemorrhage complications, Subarachnoid Hemorrhage diagnosis, Hypertension physiopathology, Hypertension diagnosis
Abstract

Objectives: Unruptured cerebral aneurysms (UCAs) often coexist with the ruptured one but are typically left unsecured during the weeks following aneurysmal subarachnoid hemorrhage (aSAH). We compared the rate of UCAs rupture or volume growth (≥5 mm 3 ) between patients exposed to induced arterial hypertension (iHTN) for vasospasm and those not exposed (control group)., Materials and Methods: From 2013 to 2021, we retrospectively included consecutive adult patients with aSAH who had ≥1 UCA. Custom software for digital subtraction angiography (DSA) image analysis characterized UCAs volume, going beyond merely considering UCAs long axis., Results: We analyzed 118 patients (180 UCAs): 45 in the iHTN group (64 UCAs) and 73 in the control group (116 UCAs). Systolic blood pressure in the iHTN group was significantly higher than in the control group for several days after aSAH. During the 107 day-monitoring period [interquartile range(IQR):92;128], no UCA rupture occurred in either group. UCA volume analysis was performed in 44 patients (60 UCAs): none of the UCAs in the iHTN group and 3 out of 42 (7%) in the control group had a >5 mm 3 volume growth (p=0.55). Other morphologic parameters did not exhibit any variations that might indicate an increased risk of rupture in the iHTN group compared to the control group., Conclusion: iHTN did not increase the risk of rupture or volume growth of UCAs within several weeks following aSAH. These reassuring results encourage not to refrain, because of the existence of UCAs, from iHTN as an option to prevent cerebral infarction during cerebral vasospasm., Competing Interests: Declaration of competing interest Karim Lakhal has no conflict of interest in connection with the work submitted. In addition, KL received, during the past 3 years, congress registration from Pfizer (once in 2022) and both congress registration and travel fees from Advanz Pharma/Correvio (once in 2021) and AOP Health (once in 2024). Aude Missonnier has no conflict of interest in connection with the work submitted. Vincent L'Allinec has no conflict of interest in connection with the work submitted. Pacôme Constant dit Beaufils has no conflict of interest in connection with the work submitted. Florent Autrusseau has no conflict of interest in connection with the work submitted. Anass Nouri has no conflict of interest in connection with the work submitted. Matilde Karakachoff has no conflict of interest in connection with the work submitted. Bertrand Rozec has no conflict of interest in connection with the work submitted. Romain Bourcier has no conflict of interest in connection with the work submitted., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Published
2024
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46. "Finding a common definition of heparin resistance in adult cardiac surgery: Communication from the ISTH SSC Subcommittee on Perioperative and Critical Care Thrombosis and Hemostasis": comment from Boissier et al.

Author

Boissier E, Rigal JC, Rozec B, and Lakhal K

Subjects
Humans, Hemostasis drug effects, Adult, Critical Care, Perioperative Care, Heparin therapeutic use, Heparin adverse effects, Cardiac Surgical Procedures adverse effects, Thrombosis prevention & control, Thrombosis blood, Anticoagulants therapeutic use, Drug Resistance
Abstract

Competing Interests: Declaration of competing interests None of the authors have any financial or nonfinancial competing interest in connection with this study. E.B. has no conflict of interest in connection with the work submitted. In addition, E.B. received, during the past 3 years, congress registration and travel fees from Swedish Orphan Biovitrum and Takeda and lecture and consulting fees from Viatris and Aguettant. J.-C.R. has no conflict of interest in connection with the work submitted. In addition, J.-C.R. received, during the past 5 years, congress registration and travel fees from Werfen and Edwards, lecture and consulting fees from Vifor Pharma, and research grant from i-Sep. B.R. has no conflict of interest in connection with the work submitted. K.L. has no conflict of interest in connection with the work submitted. In addition, K.L. received, during the past 3 years, congress registration from Pfizer (once in 2022) and both congress registration and travel fees from Advanz Pharma/Correvio (once in 2021) and from AOP Health (once in 2024).

Published
2024
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47. Clinical evaluation of the BioFire Respiratory Pathogen Panel for the guidance of empirical antimicrobial therapy in critically ill patients with hospital-acquired pneumonia: A multicenter, quality improvement project.

Author

Poulain C, Launey Y, Bouras M, Lakhal K, Dargelos L, Crémet L, Gibaud SA, Corvec S, Seguin P, Rozec B, Asehnoune K, Feuillet F, and Roquilly A

Subjects
Adult, Humans, Critical Illness, Quality Improvement, Hospitals, Anti-Bacterial Agents therapeutic use, Anti-Infective Agents therapeutic use, Healthcare-Associated Pneumonia drug therapy
Abstract

Background: We aimed to determine whether implementing antimicrobial stewardship based on multiplex bacterial PCR examination of respiratory fluid can enhance outcomes of critically ill patients with hospital-acquired pneumonia (HAP)., Methods: We conducted a quality improvement study in two hospitals in France. Adult patients requiring invasive mechanical ventilation with a diagnosis of HAP were included. In the pre-intervention period (August 2019 to April 2020), antimicrobial therapy followed European guidelines. In the «intervention» phase (June 2020 to October 2021), treatment followed a multiplex PCR-guided protocol. The primary endpoint was a composite endpoint made of mortality on day 28, clinical cure between days 7 and 10, and duration of invasive mechanical ventilation on day 28. The primary outcome was analyzed with a DOOR strategy., Results: A total of 443 patients were included in 3 ICUs from 2 hospitals (220 pre-intervention; 223 intervention). No difference in the ranking of the primary composite outcome was found (DOOR: 50.3%; 95%CI, 49.9%-50.8%). The number of invasive mechanical ventilation-free days at day 28 was 10.0 [0.0; 19.0] in the baseline period and 9.0 [0.0; 20.0] days during the intervention period (p = 0.95). The time-to-efficient antimicrobial treatment was 0.43 ± 1.29 days before versus 0.55 ± 1.13 days after the intervention (p = 0.56)., Conclusion: Implementation of Rapid Multiplex PCR to guide empirical antimicrobial therapy for critically ill patients with HAP was not associated with better outcomes. However, adherence to stewardship was low, and the study may have had limited power to detect a clinically important difference., (Copyright © 2024. Published by Elsevier Masson SAS.)

Published
2024
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48. Risk factors for poor performance in finger cuff non-invasive monitoring of arterial pressure: A prospective multicenter study.

Author

Lakhal K, Dauvergne JE, Messet-Charriere H, Nay MA, Kamel T, Muller G, Robert-Edan V, Rozec B, Ehrmann S, Jacquier S, and Boulain T

Subjects
Humans, Blood Pressure, Prospective Studies, Reproducibility of Results, Risk Factors, Arterial Pressure, Edema
Abstract

Background: Compared to the invasive technique, non-invasive monitoring of arterial pressure favors easier and faster implementation while potentially sacrificing some reliability. This may be particularly true for the Clearsight™ system (Edwards Lifesciences), which enables continuous monitoring. We evaluated the risk factors for its poor performance., Methods: Patients with an arterial catheter and stable mean arterial pressure (MAP) over a 5-min period were included. Six pairs of invasive and Clearsight measurements of MAP were collected and the bias between the two techniques was calculated. Poor performance of the Clearsight™ system was defined as either a failure to measure and display MAP or displaying an erroneous MAP (individual bias > 5 mmHg). Fingertip perfusion was assessed using the plethysmographic perfusion index (PI) and the capillary refill time (CRT)., Results: Among 152 ICU patients (MAP of 81 ± 14 mmHg, norepinephrine in 78 [51%]), 78 (51%) experienced a poor performance of the Clearsight™ system: failure to display MAP in 19 (13%) patients, and erroneous value displayed in 59 (44%). In multivariate analysis, PI ≤ 0.85% (adjusted odds ratio [aOR] = 2.94 [95% confidence interval (95%CI):1.34;6.45]), CRT > 4 s (aOR = 5.28 [95%CI 1.39;20.05]), and the presence of hand edema (aOR = 2.06 [95%CI 1.01;4.21]) were associated with a higher likelihood of poor performance. Cardiac arrhythmia (aOR = 1.39 [95%CI 0.64;3.02]) and other tested variables were not associated with poor performance., Conclusions: Half of the included patients exhibited poor Clearsight™ system performance. Our results caution against using finger cuff arterial pressure monitoring in patients with low PI (≤0.85%), protracted CRT (>4 s), or hand edema., Registration: ClinicalTrials.gov, NCT04269382, Dr. G. Muller, February 13, 2020. https://classic., Clinicaltrials: gov/ct2/show/NCT04269382., (Copyright © 2023 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.)

Published
2024
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49. Renal replacement therapy initiation strategies in comatose patients with severe acute kidney injury: a secondary analysis of a multicenter randomized controlled trial.

Author

Rambaud T, Hajage D, Dreyfuss D, Lebbah S, Martin-Lefevre L, Louis G, Moschietto S, Titeca-Beauport D, La Combe B, Pons B, De Prost N, Besset S, Combes A, Robine A, Beuzelin M, Badie J, Chevrel G, Bohe J, Coupez E, Chudeau N, Barbar S, Vinsonneau C, Forel JM, Thevenin D, Boulet E, Lakhal K, Aissaoui N, Grange S, Leone M, Lacave G, Nseir S, Poirson F, Mayaux J, Ashenoune K, Geri G, Klouche K, Thiery G, Argaud L, Rozec B, Cadoz C, Andreu P, Reignier J, Ricard JD, Quenot JP, Sonneville R, and Gaudry S

Subjects
Humans, Proportional Hazards Models, Renal Replacement Therapy methods, Multicenter Studies as Topic, Randomized Controlled Trials as Topic, Acute Kidney Injury etiology, Coma etiology, Coma therapy
Abstract

Purpose: The effect of renal replacement therapy (RRT) in comatose patients with acute kidney injury (AKI) remains unclear. We compared two RRT initiation strategies on the probability of awakening in comatose patients with severe AKI., Methods: We conducted a post hoc analysis of a trial comparing two delayed RRT initiation strategies in patients with severe AKI. Patients were monitored until they had oliguria for more than 72 h and/or blood urea nitrogen higher than 112 mg/dL and then randomized to a delayed strategy (RRT initiated after randomization) or a more-delayed one (RRT initiated if complication occurred or when blood urea nitrogen exceeded 140 mg/dL). We included only comatose patients (Richmond Agitation-Sedation scale [RASS] < - 3), irrespective of sedation, at randomization. A multi-state model was built, defining five mutually exclusive states: death, coma (RASS < - 3), incomplete awakening (RASS [- 3; - 2]), awakening (RASS [- 1; + 1] two consecutive days), and agitation (RASS >  + 1). Primary outcome was the transition from coma to awakening during 28 days after randomization., Results: A total of 168 comatose patients (90 delayed and 78 more-delayed) underwent randomization. The transition intensity from coma to awakening was lower in the more-delayed group (hazard ratio [HR] = 0.36 [0.17-0.78]; p = 0.010). Time spent awake was 10.11 days [8.11-12.15] and 7.63 days [5.57-9.64] in the delayed and the more-delayed groups, respectively. Two sensitivity analyses were performed based on sedation status and sedation practices across centers, yielding comparable results., Conclusion: In comatose patients with severe AKI, a more-delayed RRT initiation strategy resulted in a lower chance of transitioning from coma to awakening., (© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.)

Published
2024
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50. The accuracy of intensive care nurses' interpretation of chest radiographs to recognise misplacement of endotracheal and nasogastric tubes after a single training session and comparison with residents' interpretation.

Author

Kamel T, Sauvage B, Lakhal K, Ottavy G, Janssen-Langenstein R, Jacquier M, Larrat C, Jacq G, Dauvergne JE, Maugars D, Labruyere M, Simeon V, Cugnart C, Girault C, and Boulain T

Subjects
Humans, Critical Care, Intensive Care Units, Intubation, Gastrointestinal, Intubation, Intratracheal
Abstract

Background: Misplacements of endotracheal and nasogastric tubes are frequent encounters in critically ill patients., Objectives: The purpose of this study was to assess the effectiveness of a single standardised training session on the ability of intensive care registered nurses (RNs) to recognise the misplacement of endotracheal and nasogastric tubes on bedside chest radiographs of patients in intensive care units (ICUs)., Methods: In eight French ICUs, RNs received a 110-min standardised teaching on the position of endotracheal and nasogastric tubes on chest radiographs. Their knowledge was evaluated within the subsequent weeks. For 20 chest radiographs, each with an endotracheal and nasogastric tube, RNs had to indicate whether each tube was in the proper or incorrect position. Training success was defined as >90% for the lower bound of the 95% confidence interval (95% CI) of the mean correct response rate (CRR). Residents of the participating ICUs underwent the same evaluation (without prior specific training)., Results: In total, 181 RNs were trained and evaluated and 110 residents were evaluated. The global mean CRR for RNs was 84.6% (95% CI: 83.3-85.9), significantly higher than for residents (81.4% [95% CI: 79.7-83.2]) (P < 0.0001). The mean CRR for RNs and residents was 95.9% (93.9-98.0) and 97.0% (94.7-99.3) for misplaced nasogastric tubes (P = 0.54), 86.8% (85.2-88.5) and 82.6% (79.4-85.7) (P = 0.07) for nasogastric tubes in the correct position, 86.6% (83.8-89.3) and 62.7% (57.9-67.5) for misplaced endotracheal tubes (P < 0.0001), and 79.1% (76.6-81.6) and 84.7% (82.1-87.2) for endotracheal tubes in the correct position (P = 0.01), respectively., Conclusions: The ability of trained RNs to detect tube misplacement did not reach the predetermined arbitrary level, indicating training success. Their mean CRR was higher than that for residents and was considered satisfactory for detecting misplaced nasogastric tubes. This finding is encouraging but insufficient to ensure patient safety. Transferring responsibility for reading radiographs to detect the misplacement of endotracheal tubes to intensive care RNs will need a more advanced or more in-depth teaching method., Competing Interests: Conflict of interest All authors declare that they have no financial or nonfinancial competing interests directly or indirectly related to the work submitted for publication. Karim Lakhal declares having received, during the past 3 years, congress registration fees from Sanofi Aventis (once in 2018), travel fees from MSD France (once, in 2017), Gilead Sciences (once, in 2017), Pfizer (twice, in 2019 and 2020), and Advanz Pharma/Correvio (twice, in 2020 and once in 2021). Christophe Girault reports grants and nonfinancial support from Fischer & Paykel Healthcare and ResMed Ltd outside the present study., (Copyright © 2023 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.)

Published
2023
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