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1. Management and outcome of high-risk pulmonary embolism in intensive care units: results from a retrospective single-center analysis

Author

Colombo, C N J, primary, Guglielmi, A, additional, Caneva, L, additional, Patrini, L, additional, Rossi, F, additional, Ambrosini, E, additional, Turco, A, additional, Capra Marzani, F, additional, Scelsi, L, additional, Pagani, M, additional, Camporotondo, R, additional, Ghio, S, additional, and Tavazzi, G, additional

Published
2024
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2. Effect of a quality improvement program on compliance to the sepsis bundle in non-ICU patients: a multicenter prospective before and after cohort study

Author

Monti, G, Rezoagli, E, Calini, A, Nova, A, Marchesi, S, Nattino, G, Carrara, G, Morra, S, Cortellaro, F, Savioli, M, Capra Marzani, F, Tresoldi, M, Villa, P, Greco, S, Bonfanti, P, Spitoni, M, Vesconi, S, Caironi, P, Fumagalli, R, Monti, Gianpaola, Rezoagli, Emanuele, Calini, Angelo, Nova, Alice, Marchesi, Silvia, Nattino, Giovanni, Carrara, Greta, Morra, Sergio, Cortellaro, Francesca, Savioli, Monica, Capra Marzani, Federico, Tresoldi, Moreno, Villa, Paolo, Greco, Stefano, Bonfanti, Paolo, Spitoni, Maria Grazia, Vesconi, Sergio, Caironi, Pietro, Fumagalli, Roberto, Monti, G, Rezoagli, E, Calini, A, Nova, A, Marchesi, S, Nattino, G, Carrara, G, Morra, S, Cortellaro, F, Savioli, M, Capra Marzani, F, Tresoldi, M, Villa, P, Greco, S, Bonfanti, P, Spitoni, M, Vesconi, S, Caironi, P, Fumagalli, R, Monti, Gianpaola, Rezoagli, Emanuele, Calini, Angelo, Nova, Alice, Marchesi, Silvia, Nattino, Giovanni, Carrara, Greta, Morra, Sergio, Cortellaro, Francesca, Savioli, Monica, Capra Marzani, Federico, Tresoldi, Moreno, Villa, Paolo, Greco, Stefano, Bonfanti, Paolo, Spitoni, Maria Grazia, Vesconi, Sergio, Caironi, Pietro, and Fumagalli, Roberto

Abstract

Objective: Sepsis and septic shock are major challenges and economic burdens to healthcare, impacting millions of people globally and representing significant causes of mortality. Recently, a large number of quality improvement programs focused on sepsis resuscitation bundles have been instituted worldwide. These educational initiatives have been shown to be associated with improvements in clinical outcomes. We aimed to evaluate the impact of a multi-faceted quality implementing program (QIP) on the compliance of a “simplified 1-h bundle” (Sepsis 6) and hospital mortality of severe sepsis and septic shock patients out of the intensive care unit (ICU). Methods: Emergency departments (EDs) and medical wards (MWs) of 12 academic and non-academic hospitals in the Lombardy region (Northern Italy) were involved in a multi-faceted QIP, which included educational and organizational interventions. Patients with a clinical diagnosis of severe sepsis or septic shock according to the Sepsis-2 criteria were enrolled in two different periods: from May 2011 to November 2011 (before-QIP cohort) and from August 2012 to June 2013 (after-QIP cohort). Measurements and main results: The effect of QIP on bundle compliance and hospital mortality was evaluated in a before–after analysis. We enrolled 467 patients in the before-QIP group and 656 in the after-QIP group. At the time of enrollment, septic shock was diagnosed in 50% of patients, similarly between the two periods. In the after-QIP group, we observed increased compliance to the “simplified rapid (1 h) intervention bundle” (the Sepsis 6 bundle – S6) at three time-points evaluated (1 h, 13.7 to 18.7%, p = 0.018, 3 h, 37.1 to 48.0%, p = 0.013, overall study period, 46.2 to 57.9%, p < 0.001). We then analyzed compliance with S6 and hospital mortality in the before- and after-QIP periods, stratifying the two patients’ cohorts by admission characteristics. Adherence to the S6 bundle was increased in patients with severe sepsis in the

Published
2023

7. Extraction et évaluation de caractéristiques adaptées pour la classification du Lentigo à partir d’images de Microscopie Confocale

Author

Cendre, Romain, Mansouri, A., Marzani, F., Perrot, J-L, Cinotti, E., Cendre, Romain, Imagerie et Vision Artificielle [Dijon] (ImViA), Université de Bourgogne (UB), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), and University of Sienna

Subjects
dermatology, [INFO.INFO-AI] Computer Science [cs]/Artificial Intelligence [cs.AI], classification, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, [INFO.INFO-IM] Computer Science [cs]/Medical Imaging, lentigo, [INFO.INFO-AI]Computer Science [cs]/Artificial Intelligence [cs.AI], Reflectance Confocal Microscopy
Abstract

International audience; La détection de cancer de la peau est l’un des défis de ces dernières décennies. Par ailleurs, diverses techniques d’imagerie ont pour objectif d’aider à la reconnaissance de ces pathologies malignes en contexte clinique. La Microscopie Confocale par Réflectance est un exemple de technique d’imagerie adaptée à la détection de maladie de la peau sur laquelle nous nous basons pour la détection de Lentigo. Les travaux présentés dans cet article portent sur la classification de ces images en trois catégories : sain, bénin et malin. Dans ce but, nous proposons et évaluons deux méthodes d’extraction de caractéristiques basées sur les descripteurs d’Haralick pour l’une et sur une extraction par Réseau Neuronal Convolutif pour l’autre. Ces deux méthodes sont évaluées et comparées à un travail suggérant une approche par ondelettes, étendu à ces même catégories. D’après les résultats obtenus, l’approche par Réseau Neuronal Convolutif est la plus adaptée à cette problématique.

Published
2019

13. Evaluation of a model to improve collection of blood cultures in patients with sepsis in the emergency room.

Author

Mariani, B., Corbella, M., Seminari, E., Sacco, L., Cambieri, P., Capra Marzani, F., Martino, I. F., Bressan, M. A., Muzzi, A., Marena, C., Tinelli, C., and Marone, P.

Subjects
BLOOD testing, BLOOD diseases, SEPSIS, EMERGENCY medicine, HOSPITAL admission & discharge, PATIENTS
Abstract

Sepsis begins outside of the hospital for nearly 80% of patients and the emergency room (ER) represents the first contact with the health care system. This study evaluates a project to improve collection of blood cultures (BCs) in patients with sepsis in the ER consisting of staff education and completion of the appropriate BC pre-analytical phase. A retrospective observational study performed to analyse the data on BC collection in the ER before and after a three-phase project. The first phase (1 January to 30 June 2015) before the intervention consisted of evaluation of data on BCs routinely collected in the ER. The second phase (1 July to 31 December 2015) was the intervention phase in which educational courses on sepsis recognition and on pre-analytical phase procedures (including direct incubation) were provided to ER staff. The third phase (1 January to 30 June 2016; after the intervention) again consisted of evaluation. Before the intervention, out of 24,738 admissions to the ER, 103 patients (0.4%) were identified as septic and had BCs drawn (359 BC bottles); 19 out of 103 patients (18.4%) had positive BCs. After the intervention, out of 24,702 admissions, 313 patients (1.3%) had BCs drawn (1,242 bottles); of these, 96 (30.7%) had positive BCs. Comparing the first and third periods, an increase in the percentage of patients with BCs collected (from 0.4% to 1.3% respectively, p < 0.0001) and an increase in the percentages of patients with true-positive BCs (from 0.08% to 0.39% of all patients evaluated respectively, p < 0.0001) were observed. The isolation of bacteria by BCs increased 3.25-fold after project implementation. These results can be principally ascribed to an improved awareness of sepsis in the staff associated with improved pre-analytical phase procedures in BC collection. [ABSTRACT FROM AUTHOR]

Published
2018
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14. Repérage précis de caméras multispectrales et de scanners 3D pour le recalage de données multicapteurs appliqué à l'étude du patrimoine

Author

Simon, Camille, Schütze, R., Fachhochschule Mainz, Marzani F., Fachhochschule Mainz, Boochs, Laboratoire Electronique, Informatique et Image [UMR6306] (Le2i), Université de Bourgogne (UB)-Centre National de la Recherche Scientifique (CNRS)-École Nationale Supérieure d'Arts et Métiers (ENSAM), Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Institut für Raumbezogene Informations- und Messtechnik (i3mainz), Institut für Raumbezogene Informations- und Messtechnik, Lefevre, Marie, Laboratoire Electronique, Informatique et Image ( Le2i ), Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique ( CNRS ), and Institut für Raumbezogene Informations- und Messtechnik ( i3mainz )

Subjects
[INFO.INFO-AI] Computer Science [cs]/Artificial Intelligence [cs.AI], [INFO.INFO-CV] Computer Science [cs]/Computer Vision and Pattern Recognition [cs.CV], [INFO.INFO-CV]Computer Science [cs]/Computer Vision and Pattern Recognition [cs.CV], [ INFO.INFO-AI ] Computer Science [cs]/Artificial Intelligence [cs.AI], [ INFO.INFO-CV ] Computer Science [cs]/Computer Vision and Pattern Recognition [cs.CV], [INFO.INFO-AI]Computer Science [cs]/Artificial Intelligence [cs.AI]
Abstract

Session "Atelier V3DPAT"; National audience; Nos travaux portent sur le recalage de données multi-capteurs et spécifiquement sur la projection de textures 2D sur des modèles 3D d'objet du patrimoine en pierre. Nous nous intéressons particulièrement aux textures acquises par imagerie multispectrale mais notre technique est également adaptée à d'autres systèmes optiques d'acquisition tels que l'imagerie thermique. Les modèles 3D, eux, sont acquis par un système de projection de franges. La difficulté du recalage multicapteur vient principalement de la variation de la représentation de l'objet. Ainsi, les points saillants d'un jeu de données ne correspondent pas forcément à ceux d'une autre représentation. Il est donc difficile de trouver des correspondances entre les différents jeux de données. Par ailleurs, lorsqu'on étudie des surfaces non fermées (telles qu'un pan de mur), il y a de fortes chances que les erreurs s'additionnent plutôt que se compensent et introduisent ainsi des déformations de la surface. Nous souhaitons donc recaler les données en nous appuyant sur la position connue de chaque capteur au moment de l'acquisition. Ce repérage spatial des différents systèmes d'acquisition utilisés se fait en utilisant des techniques de photogrammétrie. Un ensemble de caméras, dites photogrammétriques, est positionné pour observer les différents capteurs pendant leur utilisation. Pour repérer précisément ces capteurs, ils sont fixés à un objet-mire qui est couvert de repères photogrammétriques. Cette technique est particulièrement adaptée à l'étude du patrimoine car les repères sont placés sur les systèmes d'acquisition et non sur l'objet d'étude. Nous décrivons toutes les étapes de calibration nécessaires au passage des images prises par les caméras photogrammétriques à la position et l'orientation de tous les capteurs dans le même repère. Des simulations nous ont permis d'estimer qu'il est possible d'évaluer la position et l'orientation d'un système d'acquisition devant une zone de 40 × 70 cm2 avec une précision angulaire de 0,1 mrad et une précision spatiale de 0,014 mm en utilisant quatre caméras photogrammétriques. En utilisant six caméras, nous pouvons repérer la position des systèmes d'acquisition devant une surface de 2 × 1.5 m2 avec une précision comparable. Ces configurations correspondent à des objets réels : un sarcophage en grès et une peinture murale. Avec nos systèmes d'acquisition, ce repérage permettra un recalage avec une précision meilleure qu'un demi-pixel multispectral.

Published
2012

15. Integration of Spatial Technologies and Semantic Web Technologies for Industrial Archaeology

Author

Karmacharya, A., Christophe CRUZ, Boochs, F., Marzani, F., Cruz, Christophe, INSTICC Press, Laboratoire Electronique, Informatique et Image ( Le2i ), Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique ( CNRS ), Institut für Raumbezogene Informations und Messtechnik ( i3mainz ), FH Mainz-http://www.fh-mainz.de, i3mainz - Institut für Raumbezogene Informations- und Messtechnik ( i3mainz ), FH Mainz, Laboratoire Electronique, Informatique et Image [UMR6306] (Le2i), Université de Bourgogne (UB)-Centre National de la Recherche Scientifique (CNRS)-École Nationale Supérieure d'Arts et Métiers (ENSAM), Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Institut für Raumbezogene Informations und Messtechnik (i3mainz), and i3mainz - Institut für Raumbezogene Informations- und Messtechnik (i3mainz)

Subjects
[INFO.INFO-AI] Computer Science [cs]/Artificial Intelligence [cs.AI], [INFO.INFO-DB]Computer Science [cs]/Databases [cs.DB], [ INFO.INFO-DB ] Computer Science [cs]/Databases [cs.DB], semantic web, spatial analysis, industrial archaeology, [INFO.INFO-DB] Computer Science [cs]/Databases [cs.DB], ontology, knowledge management, [ INFO.INFO-AI ] Computer Science [cs]/Artificial Intelligence [cs.AI], SWRL, [INFO.INFO-AI]Computer Science [cs]/Artificial Intelligence [cs.AI], OWL
Abstract

International audience; We propose a method that uses the advancement in spatial technologies from current database systems within the Semantic Web Technologies in order to enrich and to populate the knowledge of a domain defined in an OWL-DL ontology. The results of spatial operations and functions are used to populate and to enrich ontologies with new individuals and new relationships. The advantage of spatial analysis within Semantic Web technologies is the diversity of the functionalities provided by the combination of spatial operations and the rule language of the Semantic Web (SWRL). This method is applied in the industrial archaeology domain in order to enhance the knowledge management.

Published
2010

31. Advantages of a new humidification technique

Author

Via, G, primary, Olivei, M, additional, Palo, A, additional, Neri, S, additional, Ragni, G, additional, Bertolini, M, additional, Fusilli, N, additional, Capra-Marzani, F, additional, Rodi, G, additional, lotti, G, additional, and Braschi, A, additional

Published
1999
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36. Stereoscopic system for 3D reconstruction using multispectral camera and LCD projector.

Author

Lathuilière, A., Mansouri, A., Voisin, Y., Marzani, F. S., and Gouton, P.

Subjects
CAMERAS, LIQUID crystal displays, PROJECTORS, THREE-dimensional display systems, IMAGE processing
Abstract

The paper describes a stereoscopic system based on a multispectral camera and an LCD projector. The concept demonstrated consists in adding spectral information to three-dimensional (3D) scene reconstruction. These data are provided by a multispectral camera equipped with interference filters. Before use, this system must be calibrated. This starts with a geometric calibration of the stereoscopic set using a weak calibration. Next, in order to recover the surface spectral reflectance curve of the scene, one must know the spectral response of the elements in the acquisition chain from the LCD projector to the camera. Then image acquisition can begin. In order to acquire a multispectral image, the LCD projector is used to project a luminous pattern onto the scene. The projected pattern is detected in the image and labelled. The 3D position of the different parts of the luminous pattern on the scene can be obtained using triangulation. Furthermore, a spectral reflectance curve is assigned to each part, allowing easy predictions of the scene under different illuminants. Thus, the use of a multispectral camera is justified by the fact that such a system presents an advantage over the classical RGB camera by providing more complete information. [ABSTRACT FROM AUTHOR]

Published
2006
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43. Surgical treatment of chronic thromboembolic pulmonary hypertension with pulmonary endarterectomy,Terapia chirurgica dell'ipertensione polmonare cronica tromboembolica mediante endoarteriectomia polmonare

Author

D Armini, A. M., Zanotti, G., Pozzi, M., Nicolardi, S., Tramontin, C., Ruggieri, V. G., Morsolini, M., Tancredi, F., Monterosso, C., Viganò, M., Maurelli, M., Bianchi, T., Veronesi, R., Toscani, M., Dezza, C., Villani, M. A., Fuardo, M., Sottosanti, M., Braschi, A., Emmi, V., Rodi, G., Sala Gallini, G., Capra Marzani, F., Tavazzi, L., Falcone, C., Campana, C., Ghio, S., Raisaro, A., Scelsi, L., Raineri, C., Magrini, G., Aprile, C., Greco, B., Dore, R., Passera, R., Quaretti, P., Azzaretti, A., Rodolico, G., Massa Saluzzo, C., Vespro, V., Valentini, A., Pozzi, E., Cerveri, I., Zoia, M. C., Angelo Guido Corsico, Montecucco, C., Caporali, R., Epis, O., Piovella, F., Barone, M., Arbustini, E., Grasso, M., Dalla Toffola, E., Petrucci, L., Carlisi, E., Fracchia, C., Callegari, G., and Klersy, C.

47. Control of MRSA infection and colonisation in an intensive care unit by GeneOhm MRSA assay and culture methods

Author

Valle Claudia, Pasca Maria, De Vitis Debora, Marzani Federico, Emmi Vincenzo, and Marone Piero

Subjects
Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA) is one of the major nosocomial pathogens. Due to the diffusion of MRSA strains in both hospital and community settings, prevention and control strategies are receiving increased attention. Approximately 25% to 30% of the population is colonised with S. aureus and 0.2% to 7% with MRSA. The BD GeneOhm MRSA real-time PCR assay offers quicker identification of MRSA-colonised patients than do culture methods. Methods Ninety-five patients admitted to the Intensive Care Unit of IRCCS Policlinico San Matteo of Pavia (Italy) for a period > 24 h were screened for MRSA colonisation with both the culture method and the GeneOhm assay. Results Of the 246 nasal swabs collected from 95 patients, 36 samples were found to be positive by both methods (true-positive). 30% of colonised patients had developed the MRSA infection. Conclusion Our results show that the GeneOhm MRSA assay is a valuable diagnostic tool for detecting MRSA quickly in nasal swabs. This study confirms that colonisation represents a high risk factor for MRSA infection, and that good MRSA surveillance in an Intensive Care Unit is therefore an excellent way to prevent MRSA infection.

Published
2009
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50. Use of early corticosteroid therapy on ICU admission in patients affected by severe pandemic (H1N1)v influenza A infection

Author

Martin Loeches, I, Lisboa, T, Rhodes, A, Moreno, Rp, Silva, E, Sprung, C, Chiche, Jd, Barahona, D, Villabon, M, Balasini, C, Pearse, Rm, Matos, R, Rello, J, Rodriguez, A, Capuzzo, M, Reina, R, Marsh, B, Flaaten, H, Sigurdsson, G, Ivana, Z, Cerny, V, Quintel, M, Welte, T, Mayorga, M, Offenstadt, G, Guidet, B, Levin, P, Rothen, Hu, Gomersall, C, Hashemian, Sm, Katsanoulas, C, Mouloudi, H, Kapadia, F, Valentin, A, Hedenstierna, G, Perner, A, Bugedo, G, Ruokonen, E, Soriano Arandes, A, Montejo, Jc, Peñíscola, R, Hermosa, C, Gordo, F, Latour, J, Vidaur, L, Alvarez Gonzalez, M, Alvarez Rocha, L, De Pablo, A, Ferri, C, Lopez De Arbina Martinez, Cânones, C, Insausti, J, Cambronero, J, Galvan, B, Luna, J, Blancas, R, Garcia, C, Sierra, R, Fernández Dorado, F, Monedero, P, Llagunes, J, Cobo, P, Socias, A, Leon Lopez, R, Esteban, E, Lacueva, M, Magret, M, Del Nogal, F, Dinis, A, Bártolo, A, Ramos, A, Franca, C, Estevens, C, Granja, C, Fidalgo, C, Almeida, E, Lafuente, E, Rua, F, Esteves, F, Clemente, J, Nóbrega, Jj, Pereira, Jm, Moura, Jp, Silva LP, Trindade E., Telo, L, Santos, L, Pedrosa, Mj, Oliveira, M, Resende, M, Catorze, N, Coutinho, P, Ribeiro, R, Miranda, I, Cardoso, T, Branco, V, Bellani, G, Urbino, R, Peris, A, Amatu, A, Berlot, G, Marzani, Fc, Corbanese, U, David, Antonio, Chiarandini, P, Della Corte, F, Caspani, Ml, Conio, A, Mangani, V, Tetamo, R, Wolfler, A, Tappatà, G, Vivaldi, N, Bertolini, G, Pelagalli, L, Molin, A, Girardis, M, Gristin, G, Lam, A, Crabb, I, Cusack, R, Jackson, R, Veerappan, C, Whiteley, C, Ware, T, Krueper, S, Mckinstry, C, Ferguson, A, Rubulotta, F, Valencia, E, Gonzalez, S, Cevallos, V, Zazu, A, Chaparro Fresco JN, Galindez, G, Barrios, C, Lovesio, C, Villamagua, B, Cadena, M, Salgado, E, García, Mf, Paredes, G, Donnelly, M, O'Croinin, D, Bates, J, Kavanagh, N, O'Brien, B, Plant, R, Scully, M, Farragher, R, Oliveira, L, Mataloun, S, Dantas, Vs, Simvoulidis, L, Duarte, P, Grion, C, Germano, A, Laake, Jh, Helset, E, Klausen, D, Flaatten, H, Bruheim, K, Kristinsson, B, Sigurdsson, Se, Hrubý, J, Valkova, R, Janda, R, Zykova, I, Kernchen, A, Bloos, F, Rosseau, S, Krassler, J, Fischer, F, Arroyo Sanchez, A, Barrionuevo Poquet, A, Ramos Palomino, I, Rafael, F, Salasfoch, J, Dubar, G, Tonnelier, Jm, Barbar, S, Dobrzynski, M, Mignon, A, Jakobson, D, Klein, M, Segal, E, Barlavie, Y, Hersch, M, Salomón, Zs, Zender, H, Chan, K, Buckley, T, Batranovic, U, Schaffer, I, Sretkovic, J, Koulenti, D, Mouloudi, E, Clouva Molyvdas PM, Gurjar, M, Vijayan, D, Hinterholzer, G, Kulier, A, Verlaat, C, Ebel, D, Persson, J, Walther, S, Petersen, P, Swinnen, W, Collin, V, Olsen, H, Gutierrez, P, Thiery, G, Laine, H, Rumba, A, Maiyalagan, S, Bui, T., Martin-Loeches, I., Lisboa, T., Rhodes, A., Moreno, R. P., Silva, E., Sprung, C., Chiche, J. -D., Barahona, D., Villabon, M., Balasini, C., Pearse, R., Matos, R., Rello, J., Rodriguez, A., Capuzzo, M., Reina, R., Marsh, B., Flaaten, H., Sigurdsson, G., Ivana, Z., Cerny, V., Quintel, M., Welte, T., Mayorga, M., Offenstadt, G., Guidet, B., Levin, P., Rothen, H. -U., Gomersall, C., Hashemian, S. M., Katsanoulas, C., Mouloudi, H., Kapadia, F., Valentin, A., Hedenstierna, G., Perner, A., Bugedo, G., Ruokonen, E., Arandes, A. S., Montejo, J. C., Peniscola, R., Hermosa, C., Gordo, F., Latour, J., Vidaur, L., Alvarez-Gonzalez, M., Alvarez-Rocha, L., De Pablo, A., Ferri, C., De Arbina Martinez, L., Canones, C., Insausti, J., Cambronero, J., Galvan, B., Luna, J., Blancas, R., Garcia, C., Sierra, R., Dorado, F. F., Monedero, P., Llagunes, J., Cobo, P., Socias, A., Leon-Lopez, R., Esteban, E., Lacueva, M., Magret, M., Del Nogal, F., Dinis, A., Bartolo, A., Ramos, A., Franca, C., Estevens, C., Granja, C., Fidalgo, C., Almeida, E., Lafuente, E., Rua, F., Esteves, F., Clemente, J., Nobrega, J. J., Pereira, J. M., Moura, J. P., Trindade E Silva, L. P., Telo, L., Santos, L., Pedrosa, M. J., Oliveira, M., Resende, M., Catorze, N., Coutinho, P., Ribeiro, R., Moreno, R., Miranda, I., Cardoso, T., Branco, V., Bellani, G., Urbino, R., Peris, A., Amatu, A., Berlot, G., Marzani, F. C., Corbanese, U., David, A., Chiarandini, P., Corte, F. D., Caspani, M. L., Alessandra, C., Mangani, V., Tetamo, R., Wolfler, A., Tappata, G., Nicoletta, V., Bertolini, G., Pelagalli, L., Molin, A., Girardis, M., Gristin, G., Lam, A., Crabb, I., Cusack, R., Jackson, R., Veerappan, C., Whiteley, C., Ware, T., Krueper, S., Mckinstry, C., Ferguson, A., Rubulotta, F., Valencia, E., Gonzalez, S., Cevallos, V., Zazu, A., Fresco, J. N. C., Galindez, G., Barrios, C., Lovesio, C., Villamagua, B., Cadena, M., Salgado, E., Garcia, M. F., Paredes, G., Donnelly, M., O'Croinin, D., Bates, J., Kavanagh, N., O'Brien, B., Plant, R., Scully, M., Farragher, R., Oliveira, L., Mataloun, S., Dantas, V. S., Simvoulidis, L., Duarte, P., Grion, C., Germano, A., Laake, J. H., Helset, E., Klausen, D., Flaatten, H., Bruheim, K., Kristinsson, B., Sigurdsson, S. E., Hruby, J., Valkova, R., Janda, R., Zykova, I., Kernchen, A., Bloos, F., Rosseau, S., Krassler, J., Fischer, F., Arroyo-Sanchez, A., Poquet, A. B., Palomino, I. R., Rafael, F., Salasfoch, J., Dubar, G., Tonnelier, J. -M., Barbar, S., Dobrzynski, M., Mignon, A., Jakobson, D., Klein, M., Segal, E., Barlavie, Y., Hersch, M., Salomon, Z. S., Zender, H., Rothen, H. U., Chan, K., Buckley, T., Batranovic, U., Schaffer, I., Sretkovic, J., Koulenti, D., Mouloudi, E., Clouva-Molyvdas, P. -M., Gurjar, M., Vijayan, D., Hinterholzer, G., Kulier, A., Verlaat, C., Ebel, D., Persson, J., Walther, S., Petersen, P., Swinnen, W., Collin, V., Olsen, H., Gutierrez, P., Thiery, G., Laine, H., Rumba, A., Maiyalagan, S., Bui, T., Martin Loeches, I, Lisboa, T, Rhodes, A, Moreno, R, Silva, E, Sprung, C, Chiche, J, Barahona, D, Villabon, M, Balasini, C, Pearse, R, Matos, R, Rello, J, and Pesenti, A

Subjects
Registrie, Male, Original, H1N1 Influenza, Adrenal Cortex Hormone, Critical Care and Intensive Care Medicine, Severity of Illness Index, law.invention, Influenza A Virus, H1N1 Subtype, Community-acquired pneumonia, Adrenal Cortex Hormones, law, Prospective Studies, Registries, 610 Medicine & health, Prospective cohort study, H1N1 Subtype, Influenza, Acute Respiratory Distress Syndrome, Cross Infection, Likelihood Functions, COPD, Acinetobacter, Hazard ratio, Middle Aged, Likelihood Function, Intensive care unit, Europe, Intensive Care Units, Community acquired pneumonia, Corticosteroid therapy, Pandemic (H1N1)v influenza A infection, Female, Survival Analysi, Human, Adult, medicine.medical_specialty, Chronic Obstructive Pulmonary Disease, ARDS, Community acquired pneumonia, Corticosteroid therapy, Pandemic (H1N1)v influenza A infection, Intensive Care Unit, Internal medicine, Correspondence, Influenza, Human, Severity of illness, medicine, Humans, H1N1 Subtype, Intensive care medicine, Pandemics, Pandemic, business.industry, Pneumonia, Odds ratio, medicine.disease, Survival Analysis, Influenza, Asthma, Prospective Studie, business
Abstract

Introduction: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection, although relatively common, remains controversial. Methods: Prospective, observational, multicenter study from 23 June 2009 through 11 February 2010, reported in the European Society of Intensive Care Medicine (ESICM) H1N1 registry. Results: Two hundred twenty patients admitted to an intensive care unit (ICU) with completed outcome data were analyzed. Invasive mechanical ventilation was used in 155 (70.5%). Sixty-seven (30.5%) of the patients died in ICU and 75 (34.1%) whilst in hospital. One hundred twenty-six (57.3%) patients received corticosteroid therapy on admission to ICU. Patients who received corticosteroids were significantly older and were more likely to have coexisting asthma, chronic obstructive pulmonary disease (COPD), and chronic steroid use. These patients receiving corticosteroids had increased likelihood of developing hospital-acquired pneumonia (HAP) [26.2% versus 13.8%, p < 0.05; odds ratio (OR) 2.2, confidence interval (CI) 1.1-4.5]. Patients who received corticosteroids had significantly higher ICU mortality than patients who did not (46.0% versus 18.1%, p < 0.01; OR 3.8, CI 2.1-7.2). Cox regression analysis adjusted for severity and potential confounding factors identified that early use of corticosteroids was not significantly associated with mortality [hazard ratio (HR) 1.3, 95% CI 0.7-2.4, p = 0.4] but was still associated with an increased rate of HAP (OR 2.2, 95% CI 1.0-4.8, p < 0.05). When only patients developing acute respiratory distress syndrome (ARDS) were analyzed, similar results were observed. Conclusions: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection did not result in better outcomes and was associated with increased risk of superinfections. associated with mortality [hazard ratio (HR) 1.3, 95% CI 0.7-2.4, p = 0.4] but was still associated with an increased rate of HAP (OR 2.2, 95% CI 1.0-4.8, p < 0.05). When only patients developing acute respiratory distress syndrome (ARDS) were analyzed, similar results were observed. Conclusions: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection did not result in better outcomes and was associated with increased risk of superinfections. © Copyright jointly held by Springer and ESICM 2010.

Published
2011

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