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3. Implications of early respiratory support strategies on disease progression in critical COVID-19: a matched subanalysis of the prospective RISC-19-ICU cohort

Author

Wendel Garcia, P, Aguirre-Bermeo, H, Buehler, P, Alfaro-Farias, M, Yuen, B, David, S, Tschoellitsch, T, Wengenmayer, T, Korsos, A, Fogagnolo, A, Kleger, G, Wu, M, Colombo, R, Turrini, F, Potalivo, A, Rezoagli, E, Rodriguez-Garcia, R, Castro, P, Lander-Azcona, A, Martin-Delgado, M, Lozano-Gomez, H, Ensner, R, Michot, M, Gehring, N, Schott, P, Siegemund, M, Merki, L, Wiegand, J, Jeitziner, M, Laube, M, Salomon, P, Hillgaertner, F, Dullenkopf, A, Ksouri, H, Cereghetti, S, Grazioli, S, Burkle, C, Marrel, J, Fleisch, I, Perez, M, Baltussen Weber, A, Ceruti, S, Marquardt, K, Hubner, T, Redecker, H, Studhalter, M, Stephan, M, Selz, D, Pietsch, U, Ristic, A, Heise, A, Meyer zu Bentrup, F, Franchitti Laurent, M, Fodor, P, Gaspert, T, Haberthuer, C, Colak, E, Heuberger, D, Fumeaux, T, Montomoli, J, Guerci, P, Schuepbach, R, Hilty, M, Roche-Campo, F, Algaba-Calderon, A, Apolo, J, Aslanidis, T, Babik, B, Boroli, F, Brem, J, Brenni, M, Brugger, S, Camen, G, Catena, E, Ceriani, R, Chau, I, Christ, A, Cogliati, C, Concha, P, Delahaye, G, Drvaric, I, Escos-Orta, J, Fabbri, S, Facondini, F, Filipovic, M, Gamez-Zapata, J, Gerecke, P, Gommers, D, Hillermann, T, Ince, C, Jenni-Moser, B, Jovic, M, Jurkolow, G, Klarer, A, Lambert, A, Laurent, J, Lavanchy, J, Lienhardt-Nobbe, B, Locher, P, Losser, M, Lussman, R, Magliocca, A, Margarit, A, Martinez, A, Mauri, R, Mayor-Vazquez, E, Meier, J, Moret-Bochatay, M, Murrone, M, Naon, D, Neff, T, Novy, E, Petersen, L, Pugin, J, Ramelet, A, Rilinger, J, Rimensberger, P, Sepulcri, M, Shaikh, K, Sieber, M, Simonini, M, Spadaro, S, Sridharan, G, Stahl, K, Staudacher, D, Taboada-Fraga, X, Tellez, A, Urech, S, Vitale, G, Vizmanos-Lamotte, G, Welte, T, Zalba-Etayo, B, Zellweger, N, Wendel Garcia P. D., Aguirre-Bermeo H., Buehler P. K., Alfaro-Farias M., Yuen B., David S., Tschoellitsch T., Wengenmayer T., Korsos A., Fogagnolo A., Kleger G. -R., Wu M. A., Colombo R., Turrini F., Potalivo A., Rezoagli E., Rodriguez-Garcia R., Castro P., Lander-Azcona A., Martin-Delgado M. C., Lozano-Gomez H., Ensner R., Michot M. P., Gehring N., Schott P., Siegemund M., Merki L., Wiegand J., Jeitziner M. M., Laube M., Salomon P., Hillgaertner F., Dullenkopf A., Ksouri H., Cereghetti S., Grazioli S., Burkle C., Marrel J., Fleisch I., Perez M. -H., Baltussen Weber A., Ceruti S., Marquardt K., Hubner T., Redecker H., Studhalter M., Stephan M., Selz D., Pietsch U., Ristic A., Heise A., Meyer zu Bentrup F., Franchitti Laurent M., Fodor P., Gaspert T., Haberthuer C., Colak E., Heuberger D. M., Fumeaux T., Montomoli J., Guerci P., Schuepbach R. A., Hilty M. P., Roche-Campo F., Algaba-Calderon A., Apolo J., Aslanidis T., Babik B., Boroli F., Brem J., Brenni M., Brugger S. D., Camen G., Catena E., Ceriani R., Chau I., Christ A., Cogliati C., Concha P., Delahaye G., Drvaric I., Escos-Orta J., Fabbri S., Facondini F., Filipovic M., Gamez-Zapata J., Gerecke P., Gommers D., Hillermann T., Ince C., Jenni-Moser B., Jovic M., Jurkolow G., Klarer A., Lambert A., Laurent J. -C., Lavanchy J., Lienhardt-Nobbe B., Locher P., Losser M. -R., Lussman R. F., Magliocca A., Margarit A., Martinez A., Mauri R., Mayor-Vazquez E., Meier J., Moret-Bochatay M., Murrone M., Naon D., Neff T., Novy E., Petersen L., Pugin J., Ramelet A. -S., Rilinger J., Rimensberger P. C., Sepulcri M., Shaikh K., Sieber M., Simonini M. S., Spadaro S., Sridharan G. O., Stahl K., Staudacher D. L., Taboada-Fraga X., Tellez A., Urech S., Vitale G., Vizmanos-Lamotte G., Welte T., Zalba-Etayo B., Zellweger N., Wendel Garcia, P, Aguirre-Bermeo, H, Buehler, P, Alfaro-Farias, M, Yuen, B, David, S, Tschoellitsch, T, Wengenmayer, T, Korsos, A, Fogagnolo, A, Kleger, G, Wu, M, Colombo, R, Turrini, F, Potalivo, A, Rezoagli, E, Rodriguez-Garcia, R, Castro, P, Lander-Azcona, A, Martin-Delgado, M, Lozano-Gomez, H, Ensner, R, Michot, M, Gehring, N, Schott, P, Siegemund, M, Merki, L, Wiegand, J, Jeitziner, M, Laube, M, Salomon, P, Hillgaertner, F, Dullenkopf, A, Ksouri, H, Cereghetti, S, Grazioli, S, Burkle, C, Marrel, J, Fleisch, I, Perez, M, Baltussen Weber, A, Ceruti, S, Marquardt, K, Hubner, T, Redecker, H, Studhalter, M, Stephan, M, Selz, D, Pietsch, U, Ristic, A, Heise, A, Meyer zu Bentrup, F, Franchitti Laurent, M, Fodor, P, Gaspert, T, Haberthuer, C, Colak, E, Heuberger, D, Fumeaux, T, Montomoli, J, Guerci, P, Schuepbach, R, Hilty, M, Roche-Campo, F, Algaba-Calderon, A, Apolo, J, Aslanidis, T, Babik, B, Boroli, F, Brem, J, Brenni, M, Brugger, S, Camen, G, Catena, E, Ceriani, R, Chau, I, Christ, A, Cogliati, C, Concha, P, Delahaye, G, Drvaric, I, Escos-Orta, J, Fabbri, S, Facondini, F, Filipovic, M, Gamez-Zapata, J, Gerecke, P, Gommers, D, Hillermann, T, Ince, C, Jenni-Moser, B, Jovic, M, Jurkolow, G, Klarer, A, Lambert, A, Laurent, J, Lavanchy, J, Lienhardt-Nobbe, B, Locher, P, Losser, M, Lussman, R, Magliocca, A, Margarit, A, Martinez, A, Mauri, R, Mayor-Vazquez, E, Meier, J, Moret-Bochatay, M, Murrone, M, Naon, D, Neff, T, Novy, E, Petersen, L, Pugin, J, Ramelet, A, Rilinger, J, Rimensberger, P, Sepulcri, M, Shaikh, K, Sieber, M, Simonini, M, Spadaro, S, Sridharan, G, Stahl, K, Staudacher, D, Taboada-Fraga, X, Tellez, A, Urech, S, Vitale, G, Vizmanos-Lamotte, G, Welte, T, Zalba-Etayo, B, Zellweger, N, Wendel Garcia P. D., Aguirre-Bermeo H., Buehler P. K., Alfaro-Farias M., Yuen B., David S., Tschoellitsch T., Wengenmayer T., Korsos A., Fogagnolo A., Kleger G. -R., Wu M. A., Colombo R., Turrini F., Potalivo A., Rezoagli E., Rodriguez-Garcia R., Castro P., Lander-Azcona A., Martin-Delgado M. C., Lozano-Gomez H., Ensner R., Michot M. P., Gehring N., Schott P., Siegemund M., Merki L., Wiegand J., Jeitziner M. M., Laube M., Salomon P., Hillgaertner F., Dullenkopf A., Ksouri H., Cereghetti S., Grazioli S., Burkle C., Marrel J., Fleisch I., Perez M. -H., Baltussen Weber A., Ceruti S., Marquardt K., Hubner T., Redecker H., Studhalter M., Stephan M., Selz D., Pietsch U., Ristic A., Heise A., Meyer zu Bentrup F., Franchitti Laurent M., Fodor P., Gaspert T., Haberthuer C., Colak E., Heuberger D. M., Fumeaux T., Montomoli J., Guerci P., Schuepbach R. A., Hilty M. P., Roche-Campo F., Algaba-Calderon A., Apolo J., Aslanidis T., Babik B., Boroli F., Brem J., Brenni M., Brugger S. D., Camen G., Catena E., Ceriani R., Chau I., Christ A., Cogliati C., Concha P., Delahaye G., Drvaric I., Escos-Orta J., Fabbri S., Facondini F., Filipovic M., Gamez-Zapata J., Gerecke P., Gommers D., Hillermann T., Ince C., Jenni-Moser B., Jovic M., Jurkolow G., Klarer A., Lambert A., Laurent J. -C., Lavanchy J., Lienhardt-Nobbe B., Locher P., Losser M. -R., Lussman R. F., Magliocca A., Margarit A., Martinez A., Mauri R., Mayor-Vazquez E., Meier J., Moret-Bochatay M., Murrone M., Naon D., Neff T., Novy E., Petersen L., Pugin J., Ramelet A. -S., Rilinger J., Rimensberger P. C., Sepulcri M., Shaikh K., Sieber M., Simonini M. S., Spadaro S., Sridharan G. O., Stahl K., Staudacher D. L., Taboada-Fraga X., Tellez A., Urech S., Vitale G., Vizmanos-Lamotte G., Welte T., Zalba-Etayo B., and Zellweger N.

Abstract

Background: Uncertainty about the optimal respiratory support strategies in critically ill COVID-19 patients is widespread. While the risks and benefits of noninvasive techniques versus early invasive mechanical ventilation (IMV) are intensely debated, actual evidence is lacking. We sought to assess the risks and benefits of different respiratory support strategies, employed in intensive care units during the first months of the COVID-19 pandemic on intubation and intensive care unit (ICU) mortality rates. Methods: Subanalysis of a prospective, multinational registry of critically ill COVID-19 patients. Patients were subclassified into standard oxygen therapy ≥10 L/min (SOT), high-flow oxygen therapy (HFNC), noninvasive positive-pressure ventilation (NIV), and early IMV, according to the respiratory support strategy employed at the day of admission to ICU. Propensity score matching was performed to ensure comparability between groups. Results: Initially, 1421 patients were assessed for possible study inclusion. Of these, 351 patients (85 SOT, 87 HFNC, 87 NIV, and 92 IMV) remained eligible for full analysis after propensity score matching. 55% of patients initially receiving noninvasive respiratory support required IMV. The intubation rate was lower in patients initially ventilated with HFNC and NIV compared to those who received SOT (SOT: 64%, HFNC: 52%, NIV: 49%, p = 0.025). Compared to the other respiratory support strategies, NIV was associated with a higher overall ICU mortality (SOT: 18%, HFNC: 20%, NIV: 37%, IMV: 25%, p = 0.016). Conclusion: In this cohort of critically ill patients with COVID-19, a trial of HFNC appeared to be the most balanced initial respiratory support strategy, given the reduced intubation rate and comparable ICU mortality rate. Nonetheless, considering the uncertainty and stress associated with the COVID-19 pandemic, SOT and early IMV represented safe initial respiratory support strategies. The presented findings, in

Published
2021

4. Machine learning using the extreme gradient boosting (XGBoost) algorithm predicts 5-day delta of SOFA score at ICU admission in COVID-19 patients

Author

Montomoli, J, Romeo, L, Moccia, S, Bernardini, M, Migliorelli, L, Berardini, D, Donati, A, Carsetti, A, Bocci, M, Wendel Garcia, P, Fumeaux, T, Guerci, P, Schupbach, R, Ince, C, Frontoni, E, Hilty, M, Alfaro-Farias, M, Vizmanos-Lamotte, G, Tschoellitsch, T, Meier, J, Aguirre-Bermeo, H, Apolo, J, Martinez, A, Jurkolow, G, Delahaye, G, Novy, E, Losser, M, Wengenmayer, T, Rilinger, J, Staudacher, D, David, S, Welte, T, Stahl, K, Pavlos, A, Aslanidis, T, Korsos, A, Babik, B, Nikandish, R, Rezoagli, E, Giacomini, M, Nova, A, Fogagnolo, A, Spadaro, S, Ceriani, R, Murrone, M, Wu, M, Cogliati, C, Colombo, R, Catena, E, Turrini, F, Simonini, M, Fabbri, S, Potalivo, A, Facondini, F, Gangitano, G, Perin, T, Grazia Bocci, M, Antonelli, M, Gommers, D, Rodriguez-Garcia, R, Gamez-Zapata, J, Taboada-Fraga, X, Castro, P, Tellez, A, Lander-Azcona, A, Escos-Orta, J, Martin-Delgado, M, Algaba-Calderon, A, Franch-Llasat, D, Roche-Campo, F, Lozano-Gomez, H, Zalba-Etayo, B, Michot, M, Klarer, A, Ensner, R, Schott, P, Urech, S, Zellweger, N, Merki, L, Lambert, A, Laube, M, Jeitziner, M, Jenni-Moser, B, Wiegand, J, Yuen, B, Lienhardt-Nobbe, B, Westphalen, A, Salomon, P, Drvaric, I, Hillgaertner, F, Sieber, M, Dullenkopf, A, Petersen, L, Chau, I, Ksouri, H, Sridharan, G, Cereghetti, S, Boroli, F, Pugin, J, Grazioli, S, Rimensberger, P, Burkle, C, Marrel, J, Brenni, M, Fleisch, I, Lavanchy, J, Perez, M, Ramelet, A, Weber, A, Gerecke, P, Christ, A, Ceruti, S, Glotta, A, Marquardt, K, Shaikh, K, Hubner, T, Neff, T, Redecker, H, Moret-Bochatay, M, Bentrup, F, Studhalter, M, Stephan, M, Brem, J, Gehring, N, Selz, D, Naon, D, Kleger, G, Pietsch, U, Filipovic, M, Ristic, A, Sepulcri, M, Heise, A, Franchitti Laurent, M, Laurent, J, Schuepbach, R, Heuberger, D, Buhler, P, Brugger, S, Fodor, P, Locher, P, Camen, G, Gaspert, T, Jovic, M, Haberthuer, C, Lussman, R, Colak, E, Montomoli J., Romeo L., Moccia S., Bernardini M., Migliorelli L., Berardini D., Donati A., Carsetti A., Bocci M. G., Wendel Garcia P. D., Fumeaux T., Guerci P., Schupbach R. A., Ince C., Frontoni E., Hilty M. P., Alfaro-Farias M., Vizmanos-Lamotte G., Tschoellitsch T., Meier J., Aguirre-Bermeo H., Apolo J., Martinez A., Jurkolow G., Delahaye G., Novy E., Losser M. -R., Wengenmayer T., Rilinger J., Staudacher D. L., David S., Welte T., Stahl K., Pavlos A., Aslanidis T., Korsos A., Babik B., Nikandish R., Rezoagli E., Giacomini M., Nova A., Fogagnolo A., Spadaro S., Ceriani R., Murrone M., Wu M. A., Cogliati C., Colombo R., Catena E., Turrini F., Simonini M. S., Fabbri S., Potalivo A., Facondini F., Gangitano G., Perin T., Grazia Bocci M., Antonelli M., Gommers D., Rodriguez-Garcia R., Gamez-Zapata J., Taboada-Fraga X., Castro P., Tellez A., Lander-Azcona A., Escos-Orta J., Martin-Delgado M. C., Algaba-Calderon A., Franch-Llasat D., Roche-Campo F., Lozano-Gomez H., Zalba-Etayo B., Michot M. P., Klarer A., Ensner R., Schott P., Urech S., Zellweger N., Merki L., Lambert A., Laube M., Jeitziner M. M., Jenni-Moser B., Wiegand J., Yuen B., Lienhardt-Nobbe B., Westphalen A., Salomon P., Drvaric I., Hillgaertner F., Sieber M., Dullenkopf A., Petersen L., Chau I., Ksouri H., Sridharan G. O., Cereghetti S., Boroli F., Pugin J., Grazioli S., Rimensberger P. C., Burkle C., Marrel J., Brenni M., Fleisch I., Lavanchy J., Perez M. -H., Ramelet A. -S., Weber A. B., Gerecke P., Christ A., Ceruti S., Glotta A., Marquardt K., Shaikh K., Hubner T., Neff T., Redecker H., Moret-Bochatay M., Bentrup F. Z., Studhalter M., Stephan M., Brem J., Gehring N., Selz D., Naon D., Kleger G. -R., Pietsch U., Filipovic M., Ristic A., Sepulcri M., Heise A., Franchitti Laurent M., Laurent J. -C., Schuepbach R., Heuberger D., Buhler P., Brugger S., Fodor P., Locher P., Camen G., Gaspert T., Jovic M., Haberthuer C., Lussman R. F., Colak E., Montomoli, J, Romeo, L, Moccia, S, Bernardini, M, Migliorelli, L, Berardini, D, Donati, A, Carsetti, A, Bocci, M, Wendel Garcia, P, Fumeaux, T, Guerci, P, Schupbach, R, Ince, C, Frontoni, E, Hilty, M, Alfaro-Farias, M, Vizmanos-Lamotte, G, Tschoellitsch, T, Meier, J, Aguirre-Bermeo, H, Apolo, J, Martinez, A, Jurkolow, G, Delahaye, G, Novy, E, Losser, M, Wengenmayer, T, Rilinger, J, Staudacher, D, David, S, Welte, T, Stahl, K, Pavlos, A, Aslanidis, T, Korsos, A, Babik, B, Nikandish, R, Rezoagli, E, Giacomini, M, Nova, A, Fogagnolo, A, Spadaro, S, Ceriani, R, Murrone, M, Wu, M, Cogliati, C, Colombo, R, Catena, E, Turrini, F, Simonini, M, Fabbri, S, Potalivo, A, Facondini, F, Gangitano, G, Perin, T, Grazia Bocci, M, Antonelli, M, Gommers, D, Rodriguez-Garcia, R, Gamez-Zapata, J, Taboada-Fraga, X, Castro, P, Tellez, A, Lander-Azcona, A, Escos-Orta, J, Martin-Delgado, M, Algaba-Calderon, A, Franch-Llasat, D, Roche-Campo, F, Lozano-Gomez, H, Zalba-Etayo, B, Michot, M, Klarer, A, Ensner, R, Schott, P, Urech, S, Zellweger, N, Merki, L, Lambert, A, Laube, M, Jeitziner, M, Jenni-Moser, B, Wiegand, J, Yuen, B, Lienhardt-Nobbe, B, Westphalen, A, Salomon, P, Drvaric, I, Hillgaertner, F, Sieber, M, Dullenkopf, A, Petersen, L, Chau, I, Ksouri, H, Sridharan, G, Cereghetti, S, Boroli, F, Pugin, J, Grazioli, S, Rimensberger, P, Burkle, C, Marrel, J, Brenni, M, Fleisch, I, Lavanchy, J, Perez, M, Ramelet, A, Weber, A, Gerecke, P, Christ, A, Ceruti, S, Glotta, A, Marquardt, K, Shaikh, K, Hubner, T, Neff, T, Redecker, H, Moret-Bochatay, M, Bentrup, F, Studhalter, M, Stephan, M, Brem, J, Gehring, N, Selz, D, Naon, D, Kleger, G, Pietsch, U, Filipovic, M, Ristic, A, Sepulcri, M, Heise, A, Franchitti Laurent, M, Laurent, J, Schuepbach, R, Heuberger, D, Buhler, P, Brugger, S, Fodor, P, Locher, P, Camen, G, Gaspert, T, Jovic, M, Haberthuer, C, Lussman, R, Colak, E, Montomoli J., Romeo L., Moccia S., Bernardini M., Migliorelli L., Berardini D., Donati A., Carsetti A., Bocci M. G., Wendel Garcia P. D., Fumeaux T., Guerci P., Schupbach R. A., Ince C., Frontoni E., Hilty M. P., Alfaro-Farias M., Vizmanos-Lamotte G., Tschoellitsch T., Meier J., Aguirre-Bermeo H., Apolo J., Martinez A., Jurkolow G., Delahaye G., Novy E., Losser M. -R., Wengenmayer T., Rilinger J., Staudacher D. L., David S., Welte T., Stahl K., Pavlos A., Aslanidis T., Korsos A., Babik B., Nikandish R., Rezoagli E., Giacomini M., Nova A., Fogagnolo A., Spadaro S., Ceriani R., Murrone M., Wu M. A., Cogliati C., Colombo R., Catena E., Turrini F., Simonini M. S., Fabbri S., Potalivo A., Facondini F., Gangitano G., Perin T., Grazia Bocci M., Antonelli M., Gommers D., Rodriguez-Garcia R., Gamez-Zapata J., Taboada-Fraga X., Castro P., Tellez A., Lander-Azcona A., Escos-Orta J., Martin-Delgado M. C., Algaba-Calderon A., Franch-Llasat D., Roche-Campo F., Lozano-Gomez H., Zalba-Etayo B., Michot M. P., Klarer A., Ensner R., Schott P., Urech S., Zellweger N., Merki L., Lambert A., Laube M., Jeitziner M. M., Jenni-Moser B., Wiegand J., Yuen B., Lienhardt-Nobbe B., Westphalen A., Salomon P., Drvaric I., Hillgaertner F., Sieber M., Dullenkopf A., Petersen L., Chau I., Ksouri H., Sridharan G. O., Cereghetti S., Boroli F., Pugin J., Grazioli S., Rimensberger P. C., Burkle C., Marrel J., Brenni M., Fleisch I., Lavanchy J., Perez M. -H., Ramelet A. -S., Weber A. B., Gerecke P., Christ A., Ceruti S., Glotta A., Marquardt K., Shaikh K., Hubner T., Neff T., Redecker H., Moret-Bochatay M., Bentrup F. Z., Studhalter M., Stephan M., Brem J., Gehring N., Selz D., Naon D., Kleger G. -R., Pietsch U., Filipovic M., Ristic A., Sepulcri M., Heise A., Franchitti Laurent M., Laurent J. -C., Schuepbach R., Heuberger D., Buhler P., Brugger S., Fodor P., Locher P., Camen G., Gaspert T., Jovic M., Haberthuer C., Lussman R. F., and Colak E.

Abstract

Background: Accurate risk stratification of critically ill patients with coronavirus disease 2019 (COVID-19) is essential for optimizing resource allocation, delivering targeted interventions, and maximizing patient survival probability. Machine learning (ML) techniques are attracting increased interest for the development of prediction models as they excel in the analysis of complex signals in data-rich environments such as critical care. Methods: We retrieved data on patients with COVID-19 admitted to an intensive care unit (ICU) between March and October 2020 from the RIsk Stratification in COVID-19 patients in the Intensive Care Unit (RISC-19-ICU) registry. We applied the Extreme Gradient Boosting (XGBoost) algorithm to the data to predict as a binary outcome the increase or decrease in patients’ Sequential Organ Failure Assessment (SOFA) score on day 5 after ICU admission. The model was iteratively cross-validated in different subsets of the study cohort. Results: The final study population consisted of 675 patients. The XGBoost model correctly predicted a decrease in SOFA score in 320/385 (83%) critically ill COVID-19 patients, and an increase in the score in 210/290 (72%) patients. The area under the mean receiver operating characteristic curve for XGBoost was significantly higher than that for the logistic regression model (0.86 vs. 0.69, P < 0.01 [paired t-test with 95% confidence interval]). Conclusions: The XGBoost model predicted the change in SOFA score in critically ill COVID-19 patients admitted to the ICU and can guide clinical decision support systems (CDSSs) aimed at optimizing available resources.

Published
2021

5. Implications of early respiratory support strategies on disease progression in critical COVID-19: a matched subanalysis of the prospective RISC-19-ICU cohort

Author

Wendel Garcia P. D., Aguirre-Bermeo H., Buehler P. K., Alfaro-Farias M., Yuen B., David S., Tschoellitsch T., Wengenmayer T., Korsos A., Fogagnolo A., Kleger G. -R., Wu M. A., Colombo R., Turrini F., Potalivo A., Rezoagli E., Rodriguez-Garcia R., Castro P., Lander-Azcona A., Martin-Delgado M. C., Lozano-Gomez H., Ensner R., Michot M. P., Gehring N., Schott P., Siegemund M., Merki L., Wiegand J., Jeitziner M. M., Laube M., Salomon P., Hillgaertner F., Dullenkopf A., Ksouri H., Cereghetti S., Grazioli S., Burkle C., Marrel J., Fleisch I., Perez M. -H., Baltussen Weber A., Ceruti S., Marquardt K., Hubner T., Redecker H., Studhalter M., Stephan M., Selz D., Pietsch U., Ristic A., Heise A., Meyer zu Bentrup F., Franchitti Laurent M., Fodor P., Gaspert T., Haberthuer C., Colak E., Heuberger D. M., Fumeaux T., Montomoli J., Guerci P., Schuepbach R. A., Hilty M. P., Roche-Campo F., Algaba-Calderon A., Apolo J., Aslanidis T., Babik B., Boroli F., Brem J., Brenni M., Brugger S. D., Camen G., Catena E., Ceriani R., Chau I., Christ A., Cogliati C., Concha P., Delahaye G., Drvaric I., Escos-Orta J., Fabbri S., Facondini F., Filipovic M., Gamez-Zapata J., Gerecke P., Gommers D., Hillermann T., Ince C., Jenni-Moser B., Jovic M., Jurkolow G., Klarer A., Lambert A., Laurent J. -C., Lavanchy J., Lienhardt-Nobbe B., Locher P., Losser M. -R., Lussman R. F., Magliocca A., Margarit A., Martinez A., Mauri R., Mayor-Vazquez E., Meier J., Moret-Bochatay M., Murrone M., Naon D., Neff T., Novy E., Petersen L., Pugin J., Ramelet A. -S., Rilinger J., Rimensberger P. C., Sepulcri M., Shaikh K., Sieber M., Simonini M. S., Spadaro S., Sridharan G. O., Stahl K., Staudacher D. L., Taboada-Fraga X., Tellez A., Urech S., Vitale G., Vizmanos-Lamotte G., Welte T., Zalba-Etayo B., Zellweger N., Graduate School, ACS - Atherosclerosis & ischemic syndromes, ACS - Microcirculation, AII - Inflammatory diseases, RISC-19-ICU Investigators, Wendel Garcia, P.D., Aguirre-Bermeo, H., Buehler, P.K., Alfaro-Farias, M., Yuen, B., David, S., Tschoellitsch, T., Wengenmayer, T., Korsos, A., Fogagnolo, A., Kleger, G.R., Wu, M.A., Colombo, R., Turrini, F., Potalivo, A., Rezoagli, E., Rodríguez-García, R., Castro, P., Lander-Azcona, A., Martín-Delgado, M.C., Lozano-Gómez, H., Ensner, R., Michot, M.P., Gehring, N., Schott, P., Siegemund, M., Merki, L., Wiegand, J., Jeitziner, M.M., Laube, M., Salomon, P., Hillgaertner, F., Dullenkopf, A., Ksouri, H., Cereghetti, S., Grazioli, S., Bürkle, C., Marrel, J., Fleisch, I., Perez, M.H., Baltussen Weber, A., Ceruti, S., Marquardt, K., Hübner, T., Redecker, H., Studhalter, M., Stephan, M., Selz, D., Pietsch, U., Ristic, A., Heise, A., Meyer Zu Bentrup, F., Franchitti Laurent, M., Fodor, P., Gaspert, T., Haberthuer, C., Colak, E., Heuberger, D.M., Fumeaux, T., Montomoli, J., Guerci, P., Schuepbach, R.A., Hilty, M.P., Roche-Campo, F., Algaba-Calderon, A., Apolo, J., Aslanidis, T., Babik, B., Boroli, F., Brem, J., Brenni, M., Brugger, S.D., Camen, G., Catena, E., Ceriani, R., Chau, I., Christ, A., Cogliati, C., Concha, P., Delahaye, G., Drvaric, I., Escós-Orta, J., Fabbri, S., Facondini, F., Filipovic, M., Gámez-Zapata, J., Gerecke, P., Gommers, D., Hillermann, T., Ince, C., Jenni-Moser, B., Jovic, M., Jurkolow, G., Klarer, A., Lambert, A., Laurent, J.C., Lavanchy, J., Lienhardt-Nobbe, B., Locher, P., Losser, M.R., Lussman, R.F., Magliocca, A., Margarit, A., Martínez, A., Mauri, R., Mayor-Vázquez, E., Meier, J., Moret-Bochatay, M., Murrone, M., Naon, D., Neff, T., Novy, E., Petersen, L., Pugin, J., Ramelet, A.S., Rilinger, J., Rimensberger, P.C., Sepulcri, M., Shaikh, K., Sieber, M., Simonini, M.S., Spadaro, S., Sridharan, G.O., Stahl, K., Staudacher, D.L., Taboada-Fraga, X., Tellez, A., Urech, S., Vitale, G., Vizmanos-Lamotte, G., Welte, T., Zalba-Etayo, B., Zellweger, N., Wendel Garcia, P, Aguirre-Bermeo, H, Buehler, P, Alfaro-Farias, M, Yuen, B, David, S, Tschoellitsch, T, Wengenmayer, T, Korsos, A, Fogagnolo, A, Kleger, G, Wu, M, Colombo, R, Turrini, F, Potalivo, A, Rezoagli, E, Rodriguez-Garcia, R, Castro, P, Lander-Azcona, A, Martin-Delgado, M, Lozano-Gomez, H, Ensner, R, Michot, M, Gehring, N, Schott, P, Siegemund, M, Merki, L, Wiegand, J, Jeitziner, M, Laube, M, Salomon, P, Hillgaertner, F, Dullenkopf, A, Ksouri, H, Cereghetti, S, Grazioli, S, Burkle, C, Marrel, J, Fleisch, I, Perez, M, Baltussen Weber, A, Ceruti, S, Marquardt, K, Hubner, T, Redecker, H, Studhalter, M, Stephan, M, Selz, D, Pietsch, U, Ristic, A, Heise, A, Meyer zu Bentrup, F, Franchitti Laurent, M, Fodor, P, Gaspert, T, Haberthuer, C, Colak, E, Heuberger, D, Fumeaux, T, Montomoli, J, Guerci, P, Schuepbach, R, Hilty, M, Roche-Campo, F, Algaba-Calderon, A, Apolo, J, Aslanidis, T, Babik, B, Boroli, F, Brem, J, Brenni, M, Brugger, S, Camen, G, Catena, E, Ceriani, R, Chau, I, Christ, A, Cogliati, C, Concha, P, Delahaye, G, Drvaric, I, Escos-Orta, J, Fabbri, S, Facondini, F, Filipovic, M, Gamez-Zapata, J, Gerecke, P, Gommers, D, Hillermann, T, Ince, C, Jenni-Moser, B, Jovic, M, Jurkolow, G, Klarer, A, Lambert, A, Laurent, J, Lavanchy, J, Lienhardt-Nobbe, B, Locher, P, Losser, M, Lussman, R, Magliocca, A, Margarit, A, Martinez, A, Mauri, R, Mayor-Vazquez, E, Meier, J, Moret-Bochatay, M, Murrone, M, Naon, D, Neff, T, Novy, E, Petersen, L, Pugin, J, Ramelet, A, Rilinger, J, Rimensberger, P, Sepulcri, M, Shaikh, K, Sieber, M, Simonini, M, Spadaro, S, Sridharan, G, Stahl, K, Staudacher, D, Taboada-Fraga, X, Tellez, A, Urech, S, Vitale, G, Vizmanos-Lamotte, G, Welte, T, Zalba-Etayo, B, Zellweger, N, and Intensive Care

Subjects
Male, ARDS, Time Factors, medicine.medical_treatment, Old age, Critical Care and Intensive Care Medicine, law.invention, 0302 clinical medicine, law, Oxygen therapy, Noninvasive mechanical ventilation, Intubation, 030212 general & internal medicine, Hospital Mortality, Prospective Studies, Registries, Prospective cohort study, 610 Medicine & health, Unitats de cures intensives, Intensive care units, Medical emergencies. Critical care. Intensive care. First aid, Middle Aged, Intensive care unit, Intensive Care Units, Treatment Outcome, Vellesa, High flow oxygen therapy, Disease Progression, Female, Standard oxygen therapy, medicine.medical_specialty, Respiratory Therapy, Critical Illness, NO, 03 medical and health sciences, Intensive care, medicine, Humans, Invasive mechanical ventilation, Critically ill, Patient self-inflicted lung injury, Aged, Retrospective Studies, Mechanical ventilation, COVID-19/mortality, COVID-19/therapy, Critical Illness/mortality, Critical Illness/therapy, Respiratory Therapy/methods, Respiratory Therapy/statistics & numerical data, COVID-19, Respiratory support, business.industry, RC86-88.9, Research, Retrospective cohort study, medicine.disease, Malalts en estat crític, 030228 respiratory system, Emergency medicine, business
Abstract

Background Uncertainty about the optimal respiratory support strategies in critically ill COVID-19 patients is widespread. While the risks and benefits of noninvasive techniques versus early invasive mechanical ventilation (IMV) are intensely debated, actual evidence is lacking. We sought to assess the risks and benefits of different respiratory support strategies, employed in intensive care units during the first months of the COVID-19 pandemic on intubation and intensive care unit (ICU) mortality rates. Methods Subanalysis of a prospective, multinational registry of critically ill COVID-19 patients. Patients were subclassified into standard oxygen therapy ≥10 L/min (SOT), high-flow oxygen therapy (HFNC), noninvasive positive-pressure ventilation (NIV), and early IMV, according to the respiratory support strategy employed at the day of admission to ICU. Propensity score matching was performed to ensure comparability between groups. Results Initially, 1421 patients were assessed for possible study inclusion. Of these, 351 patients (85 SOT, 87 HFNC, 87 NIV, and 92 IMV) remained eligible for full analysis after propensity score matching. 55% of patients initially receiving noninvasive respiratory support required IMV. The intubation rate was lower in patients initially ventilated with HFNC and NIV compared to those who received SOT (SOT: 64%, HFNC: 52%, NIV: 49%, p = 0.025). Compared to the other respiratory support strategies, NIV was associated with a higher overall ICU mortality (SOT: 18%, HFNC: 20%, NIV: 37%, IMV: 25%, p = 0.016). Conclusion In this cohort of critically ill patients with COVID-19, a trial of HFNC appeared to be the most balanced initial respiratory support strategy, given the reduced intubation rate and comparable ICU mortality rate. Nonetheless, considering the uncertainty and stress associated with the COVID-19 pandemic, SOT and early IMV represented safe initial respiratory support strategies. The presented findings, in agreement with classic ARDS literature, suggest that NIV should be avoided whenever possible due to the elevated ICU mortality risk.

Published
2021
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6. Rheumatische Symptome bei maligner Grunderkrankung

Author

Michot M, Lüthi U, Bargetzi M, and Röpke B

Subjects
Gynecology, medicine.medical_specialty, business.industry, Medicine, General Medicine, business, Angioimmunoblastic lymphoma
Abstract

Wir berichten über eine 75-jährige Patientin mit einer rasch progredienten AZ-Verschlechterung. Klinisch zeigte sich eine ausgeprägte Lymphadenopathie, ein auffälliges Exanthem sowie eine erhöhte Leukozytenzahl. Nach intial breiter Differenzialdiagnose konnte mittels Lymphknotenbiopsie ein angioimmunoblastisches T-Zell-Lymphom diagnostiziert werden. Auch unter Einsatz von Anthracyclinhaltiger Chemotherapie ist die Prognose des AITCL in der Regel ungünstig. Bei unserer Patientin kam aufgrund des massiv reduzierten Allgemeinzustandes eine solche Therapie nicht mehr in Frage. Sie verstarb kurz nach Hospitalisation an einer Sepsis.

Published
2012
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14. Rheumatische Symptome bei maligner Grunderkrankung.

Author

Röpke, B., Lüthi, U., Bargetzi, M., and Michot, M.

Subjects
CANCER treatment, RHEUMATISM, SYMPTOMS, LEUCOCYTOSIS, T cells, LYMPHOMAS, CANCER chemotherapy, CASE studies
Abstract

Copyright of Praxis (16618157) is the property of Aerzteverlag medinfo AG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2012
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15. Machine learning using the Extreme Gradient Boosting (XGBoost) algorithm predicts 5-day delta of SOFA score at ICU admission in COVID-19 patients

Author

Marie M. Jeitziner, Iris Drvaric, Jan Wiegand, Abele Donati, Janina Apolo, Emanuele Rezoagli, Jesús Escós-Orta, Herminia Lozano-Gómez, Mirko Brenni, Giovanni Camen, Frank Hillgaertner, Sara Moccia, Antje Heise, Alexander Dullenkopf, Michael Stephan, Can Ince, Marcus Laube, Julien Marrel, Michele Bernardini, Barbara Lienhardt-Nobbe, Hernán Aguirre-Bermeo, Alberto Fogagnolo, Dorothea M. Heuberger, Severin Urech, Reto A. Schuepbach, Andrea Glotta, Samuele Ceruti, Isabelle Fleisch, Marc P. Michot, Alice Nova, Matthias P. Hilty, Tomislav Gaspert, Gianfilippo Gangitano, Savino Spadaro, Ivan Chau, Daniele Berardini, Tiziana Perin, Andrea Westphalen, Marie-Reine Losser, Hatem Ksouri, Marie-Hélène Perez, Theodoros Aslanidis, Christoph Haberthuer, Gerardo Vizmanos-Lamotte, Jorge Gámez-Zapata, Filippo Boroli, Adriana Lambert, Serge Grazioli, Petra Salomon, Christian Bürkle, Didier Naon, Philipp Bühler, Dawid L. Staudacher, Miodrag Filipovic, Hermann Redecker, Mario Alfaro-Farias, Massimo Antonelli, Rolf Ensner, Jerome Lavanchy, Lukas Merki, Roberto Ceriani, Anette Ristic, Chiara Cogliati, Reto Andreas Schüpbach, Daniela Selz, Begoña Zalba-Etayo, Anne-Sylvie Ramelet, Thierry Fumeaux, Andrea Carsetti, Peter Gerecke, Riccardo Colombo, Marilene Franchitti Laurent, Fabrizio Turrini, Tobias Wengenmayer, Tobias Welte, Philippe Guerci, Antonella Potalivo, Lucia Migliorelli, Barna Babik, Reza Nikandish, Pedro D. Wendel Garcia, Alberto Martínez, Maria Sole Simonini, Diederik Gommers, Xiana Taboada-Fraga, Jerome Pugin, Peter C. Rimensberger, Angela Algaba-Calderon, FriederikeMeyer zu Bentrup, Agios Pavlos, Thomas Tschoellitsch, Marianne Sieber, Karim Shaikh, Nuria Zellweger, Silvio Brugger, Geoffrey Jurkolow, Anja Baltussen Weber, Maria C. Martín-Delgado, Anita Korsós, Gian-Reto Kleger, Alexander Klarer, Emmanuel Novy, Diego Franch-Llasat, Adrian Tellez, Peter Schott, Jonathan Rilinger, Andreas Christ, Bernd Yuen, Jean-Christophe Laurent, Nadine Gehring, Pedro Castro, Sascha David, Francesca Facondini, Arantxa Lander-Azcona, Maria Grazia Bocci, Maddalena Alessandra Wu, Mallory Moret-Bochatay, Sara Cereghetti, Urs Pietsch, Martina Murrone, Gauthier Delahaye, Luca Romeo, Pascal Locher, Pedro David Wendel Garcia, Michael Sepulcri, Marija Jovic, Katharina Marquardt, Emanuele Frontoni, Patricia Fodor, Emanuele Catena, Tobias Hübner, Thomas Neff, Roger F. Lussman, Matteo Giacomini, Govind Oliver Sridharan, Beatrice Jenni-Moser, Jan Brem, Michael Studhalter, Elif Colak, Raquel Rodríguez-García, Silvia Fabbri, Jens Meier, Lina Petersen, Jonathan Montomoli, Ferran Roche-Campo, Klaus Stahl, Montomoli, J, Romeo, L, Moccia, S, Bernardini, M, Migliorelli, L, Berardini, D, Donati, A, Carsetti, A, Bocci, M, Wendel Garcia, P, Fumeaux, T, Guerci, P, Schupbach, R, Ince, C, Frontoni, E, Hilty, M, Alfaro-Farias, M, Vizmanos-Lamotte, G, Tschoellitsch, T, Meier, J, Aguirre-Bermeo, H, Apolo, J, Martinez, A, Jurkolow, G, Delahaye, G, Novy, E, Losser, M, Wengenmayer, T, Rilinger, J, Staudacher, D, David, S, Welte, T, Stahl, K, Pavlos, A, Aslanidis, T, Korsos, A, Babik, B, Nikandish, R, Rezoagli, E, Giacomini, M, Nova, A, Fogagnolo, A, Spadaro, S, Ceriani, R, Murrone, M, Wu, M, Cogliati, C, Colombo, R, Catena, E, Turrini, F, Simonini, M, Fabbri, S, Potalivo, A, Facondini, F, Gangitano, G, Perin, T, Grazia Bocci, M, Antonelli, M, Gommers, D, Rodriguez-Garcia, R, Gamez-Zapata, J, Taboada-Fraga, X, Castro, P, Tellez, A, Lander-Azcona, A, Escos-Orta, J, Martin-Delgado, M, Algaba-Calderon, A, Franch-Llasat, D, Roche-Campo, F, Lozano-Gomez, H, Zalba-Etayo, B, Michot, M, Klarer, A, Ensner, R, Schott, P, Urech, S, Zellweger, N, Merki, L, Lambert, A, Laube, M, Jeitziner, M, Jenni-Moser, B, Wiegand, J, Yuen, B, Lienhardt-Nobbe, B, Westphalen, A, Salomon, P, Drvaric, I, Hillgaertner, F, Sieber, M, Dullenkopf, A, Petersen, L, Chau, I, Ksouri, H, Sridharan, G, Cereghetti, S, Boroli, F, Pugin, J, Grazioli, S, Rimensberger, P, Burkle, C, Marrel, J, Brenni, M, Fleisch, I, Lavanchy, J, Perez, M, Ramelet, A, Weber, A, Gerecke, P, Christ, A, Ceruti, S, Glotta, A, Marquardt, K, Shaikh, K, Hubner, T, Neff, T, Redecker, H, Moret-Bochatay, M, Bentrup, F, Studhalter, M, Stephan, M, Brem, J, Gehring, N, Selz, D, Naon, D, Kleger, G, Pietsch, U, Filipovic, M, Ristic, A, Sepulcri, M, Heise, A, Franchitti Laurent, M, Laurent, J, Schuepbach, R, Heuberger, D, Buhler, P, Brugger, S, Fodor, P, Locher, P, Camen, G, Gaspert, T, Jovic, M, Haberthuer, C, Lussman, R, Colak, E, Biomedical Engineering and Physics, ACS - Microcirculation, Translational Physiology, ACS - Atherosclerosis & ischemic syndromes, Graduate School, AII - Infectious diseases, and University of Zurich

Subjects
610 Medicine & health, Organ dysfunction score, Machine learning, computer.software_genre, Logistic regression, Clinical decision support system, law.invention, law, Medicine, Clinical decision support system (CDSS), Receiver operating characteristic, RC86-88.9, business.industry, Clinical decision support systems, COVID-19, Medical emergencies. Critical care. Intensive care. First aid, Extreme Gradient Boosting (XGBoost), Intensive care unit, Multiple organ failure, Cohort, Population study, SOFA score, Original Article, Artificial intelligence, 10023 Institute of Intensive Care Medicine, business, Algorithm, computer, Predictive modelling
Abstract

Background : Accurate risk stratification of critically ill patients with coronavirus disease 2019 (COVID-19) is essential for optimizing resource allocation, delivering targeted interventions, and maximizing patient survival probability. Machine learning (ML) techniques are attracting increased interest for the development of prediction models as they excel in the analysis of complex signals in data-rich environments such as critical care. Methods : We retrieved data on patients with COVID-19 admitted to an intensive care unit (ICU) between March and October 2020 from the RIsk Stratification in COVID-19 patients in the Intensive Care Unit (RISC-19-ICU) registry. We applied the Extreme Gradient Boosting (XGBoost) algorithm to the data to predict as a binary outcome the increase or decrease in patients’ Sequential Organ Failure Assessment (SOFA) score on day 5 after ICU admission. The model was iteratively cross-validated in different subsets of the study cohort. Results : The final study population consisted of 675 patients. The XGBoost model correctly predicted a decrease in SOFA score in 320/385 (83%) critically ill COVID-19 patients, and an increase in the score in 210/290 (72%) patients. The area under the mean receiver operating characteristic curve for XGBoost was significantly higher than that for the logistic regression model {0.86 vs. 0.69, P

Published
2021

16. Systemic Hemodynamics, Cardiac Mechanics, and Signaling Pathways Induced by Extracorporeal Membrane Oxygenation in a Cardiogenic Shock Model.

Author

Beurton A, Michot M, Hérion FX, Rienzo M, Oddos C, Couffinhal T, Imbault J, and Ouattara A

Subjects
Humans, Hemodynamics, Myocardium, Signal Transduction, Shock, Cardiogenic therapy, Extracorporeal Membrane Oxygenation
Abstract

Peripheral venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly being used in patients suffering from refractory cardiogenic shock (CS). Although considered life-saving, peripheral VA-ECMO may also be responsible for intracardiac hemodynamic changes, including left ventricular overload and dysfunction. Venoarterial extracorporeal membrane oxygenation may also increase myocardial wall stress and stroke work, possibly affecting the cellular cardioprotective and apoptosis signaling pathways, and thus the infarct size. To test this hypothesis, we investigated the effects of increasing the peripheral VA-ECMO blood flow (25-100% of the baseline cardiac output) on systemic and cardiac hemodynamics in a closed-chest CS model. Upon completion of the experiment, the hearts were removed for assessment of infarct size, histology, apoptosis measurements, and phosphorylation statuses of p38 and protein Kinase B (Akt), and extracellular signal-regulated kinase mitogen-activated protein kinases (ERK-MAPK). Peripheral VA-ECMO restored systemic perfusion but induced a significant and blood flow-dependent increase in left ventricular preload and afterload. Venoarterial extracorporeal membrane oxygenation did not affect infarct size but significantly decreased p38-MAPK phosphorylation and cardiac myocyte apoptosis in the border zone., Competing Interests: Disclosure: The authors have no conflicts of interest to report., (Copyright © ASAIO 2024.)

Published
2024
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17. Analysis of the Peritumoral Tissue Unveils Cellular Changes Associated with a High Risk of Recurrence.

Author

Michot A, Lagarde P, Lesluyes T, Darbo E, Neuville A, Baud J, Perot G, Bonomo I, Maire M, Michot M, Coindre JM, Le Loarer F, and Chibon F

Abstract

Background: The management of soft-tissue sarcoma (STS) relies on a multidisciplinary approach involving specialized oncological surgery combined with other adjuvant therapies to achieve optimal local disease control. Purpose and Results: Genomic and transcriptomic pseudocapsules of 20 prospective sarcomas were analyzed and revealed to be correlated with a higher risk of recurrence after surgery., Conclusions: A peritumoral environment that has been remodeled and infiltrated by M2 macrophages, and is less expressive of healthy tissue, would pose a significant risk of relapse and require more aggressive treatment strategies.

Published
2023
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18. Higher risk for influenza-associated pulmonary aspergillosis (IAPA) in asthmatic patients: A Swiss multicenter cohort study on IAPA in critically ill influenza patients.

Author

Waldeck F, Boroli F, Zingg S, Walti LN, Wendel-Garcia PD, Conen A, Pagani JL, Boggian K, Schnorf M, Siegemund M, Abed-Maillard S, Michot M, Que YA, Bättig V, Suh N, Kleger GR, and Albrich WC

Subjects
Adult, Female, Humans, Middle Aged, Male, Critical Illness, Switzerland epidemiology, Intensive Care Units, Cohort Studies, Retrospective Studies, Influenza, Human complications, Influenza, Human epidemiology, Influenza, Human diagnosis, Pulmonary Aspergillosis complications, Pulmonary Aspergillosis diagnosis, Asthma complications
Abstract

Background: Influenza-associated pulmonary aspergillosis (IAPA) is an important complication of severe influenza with high morbidity and mortality., Methods: We conducted a retrospective multicenter study in tertiary hospitals in Switzerland during 2017/2018 and 2019/2020 influenza seasons. All adults with PCR-confirmed influenza infection and treatment on intensive-care unit (ICU) for >24 h were included. IAPA was diagnosed according to previously published clinical, radiological, and microbiological criteria. We assessed risk factors for IAPA and predictors for poor outcome, which was a composite of in-hospital mortality, ICU length of stay ≥7 days, mechanical ventilation ≥7 days, or extracorporeal membrane oxygenation., Results: One hundred fifty-eight patients (median age 64 years, 45% females) with influenza were included, of which 17 (10.8%) had IAPA. Asthma was more common in IAPA patients (17% vs. 4% in non-IAPA, P = 0.05). Asthma (OR 12.0 [95% CI 2.1-67.2]) and days of mechanical ventilation (OR 1.1 [1.1-1.2]) were associated with IAPA. IAPA patients frequently required organ supportive therapies including mechanical ventilation (88% in IAPA vs. 53% in non-IAPA, P = 0.001) and vasoactive support (75% vs. 45%, P = 0.03) and had more complications including ARDS (53% vs. 26%, P = 0.04), respiratory bacterial infections (65% vs. 37%, P = 0.04), and higher ICU-mortality (35% vs. 16.4%, P = 0.05). IAPA (OR 28.8 [3.3-253.4]), influenza A (OR 3.3 [1.4-7.8]), and higher SAPS II score (OR 1.07 [1.05-1.10]) were independent predictors of poor outcome., Interpretation: High clinical suspicion, early diagnostics, and therapy are indicated in IAPA because of high morbidity and mortality. Asthma is likely an underappreciated risk factor for IAPA., (© 2022 The Authors. Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.)

Published
2023
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19. Perceptions, Knowledge, and Practices Concerning Indoor Environmental Pollution of Parents or Future Parents.

Author

Daniel L, Michot M, Esvan M, Guérin P, Chauvet G, and Pelé F

Subjects
Adolescent, Adult, Female, France, Humans, Male, Middle Aged, Pregnancy, Surveys and Questionnaires, Young Adult, Air Pollution, Indoor, Environmental Pollution, Health Knowledge, Attitudes, Practice
Abstract

Indoor pollutants can have short- and long-term health effects, especially if exposure occurs during prenatal life or early childhood. This study describe the perceptions, knowledge, and practices of adults concerning indoor environmental pollution. Adults of 18 to 45 years of age were recruited in the department of Ille-et-Vilaine (Brittany-France) in 2019 through a stratified random draw in the waiting rooms of general practitioners (GPs) ( n = 554) who completed a self-questionnaire. The 71% who had already heard of this type of pollution were older ( p = 0.001), predominantly women ( p = 0.007), not expecting a baby ( p = 0.005), and had a higher knowledge score ( p < 0.001). The average knowledge score was 6.6 ± 6.6 out of 11, which was higher for participants living in a couple and with a higher level of education ( p < 0.001). Some practices were well implemented (>80% of participants) (aeration during renovation) whereas others were insufficiently practiced (<60% of participants) (paying attention to the composition of cosmetic products). Factors associated differed depending on the frequency of integration: living in a couple and having a child for well implemented practices and educational level, knowledge level, and perception for those under implemented. Knowledge must be improved to modify perceptions and certain practices, making sure not to increase social inequalities in health., Competing Interests: The authors declare no conflicts of interest.

Published
2020
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20. [Rheumatic symptoms in a malignant disease].

Author

Röpke B, Lüthi U, Bargetzi M, and Michot M

Subjects
Aged, Biopsy, Churg-Strauss Syndrome pathology, Diagnosis, Differential, Fatal Outcome, Female, Humans, Immunoblastic Lymphadenopathy pathology, Lymph Nodes pathology, Lymphoma, T-Cell, Peripheral pathology, Paraneoplastic Syndromes pathology, Skin pathology, Churg-Strauss Syndrome diagnosis, Immunoblastic Lymphadenopathy diagnosis, Lymphoma, T-Cell, Peripheral diagnosis, Paraneoplastic Syndromes diagnosis
Abstract

We report a case of a 75 year old women with increasing deterioration of her general condition. We found a massive lymphadenopathy, an impressive exanthem and an elevation in leukocytes. After conducting a lymphnodebiopsy the diagnosis of an angioimmunoblastic T-Cell-Lymphoma was confirmed. Even with chemotherapy containing antracycline the prognosis of this disease is very poor. However this therapy couldn't be initiated because of the weak condition of the patient. She died a few days after hospitalisation.

Published
2012
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21. A fatal tick bite occurring during the course of tick-borne encephalitis vaccination.

Author

Brauchli YB, Gittermann M, Michot M, Krähenbühl S, and Gnehm HE

Subjects
Adolescent, Brain pathology, Diagnosis, Differential, Fatal Outcome, Female, Humans, Switzerland, Encephalitis, Tick-Borne, Viral Vaccines administration & dosage
Abstract

In Western Europe tick-borne encephalitis virus infections with fatal outcome are rare, especially in children. We report the case of an adolescent who died of meningoencephalitis after a tick bite that occurred between the first 2 tick-borne encephalitis vaccinations. The case demonstrates the difficulty of differentiating possible adverse events associated with the immunization from symptoms of simultaneous infection with tick-borne encephalitis virus.

Published
2008
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22. [Lemierre syndrome: diagnosis with multimodal imaging].

Author

Kos S, Kraft M, and Michot MP

Subjects
Adult, Female, Humans, Laryngoscopy, Pharyngitis diagnostic imaging, Pharyngitis pathology, Radiography, Thoracic, Sepsis diagnostic imaging, Sepsis pathology, Syndrome, Ultrasonography, Doppler, Duplex, Pharyngitis diagnosis, Sepsis diagnosis
Published
2007
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23. Hepatic veno-occlusive disease associated with immunosuppressive cyclophosphamide dosing and roxithromycin.

Author

Beltinger J, Haschke M, Kaufmann P, Michot M, Terracciano L, and Krähenbühl S

Subjects
Aged, Anemia, Hemolytic, Autoimmune drug therapy, Cyclophosphamide administration & dosage, Cyclophosphamide therapeutic use, Female, Humans, Immunosuppressive Agents administration & dosage, Immunosuppressive Agents therapeutic use, Roxithromycin administration & dosage, Roxithromycin therapeutic use, Cyclophosphamide adverse effects, Hepatic Veno-Occlusive Disease chemically induced, Immunosuppressive Agents adverse effects, Roxithromycin adverse effects
Abstract

Objective: To report on a patient developing hepatic veno-occlusive disease while being treated with immunosuppressive doses of cyclophosphamide (< or =2 mg/kg)., Case Summary: A 66-year-old woman with autoimmune hemolytic anemia developed hepatic veno-occlusive disease while being treated with immunosuppressive cyclophosphamide 100 mg/day in combination with roxithromycin (total dose 600 mg/day). After all drugs were stopped, the patient recovered within 2 weeks. The Naranjo probability scale indicated a probable relationship between veno-occlusive disease and treatment with cyclophosphamide in this patient., Discussion: Since roxithromycin inhibits CYP3A4, which is involved with cyclophosphamide metabolism, a drug-drug interaction could have been responsible. In addition, roxithromycin is an inhibitor of the drug transporter P-glycoprotein, possibly leading to accumulation of cyclophosphamide in endothelial cells. Alternatively, since cyclophosphamide has been reported to induce apoptosis, roxithromycin could have rendered endothelial cells more vulnerable for apoptosis., Conclusions: In specific patients, cyclophosphamide can be associated with hepatic veno-occlusive disease at immunosuppressive doses.

Published
2006
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25. Prevention of deep-vein thrombosis in ambulatory arthroscopic knee surgery: A randomized trial of prophylaxis with low--molecular weight heparin.

Author

Michot M, Conen D, Holtz D, Erni D, Zumstein MD, Ruflin GB, and Renner N

Subjects
Adult, Ambulatory Surgical Procedures adverse effects, Anticoagulants adverse effects, Female, Heparin, Low-Molecular-Weight adverse effects, Humans, Incidence, Male, Treatment Outcome, Venous Thrombosis epidemiology, Venous Thrombosis etiology, Anticoagulants therapeutic use, Arthroscopy adverse effects, Heparin, Low-Molecular-Weight therapeutic use, Knee surgery, Venous Thrombosis prevention & control
Abstract

Purpose: The risk of deep vein thrombosis (DVT) in patients undergoing arthroscopic knee surgery is not well known. The purpose of this study was to determine the incidence of DVT, to demonstrate the efficacy of a perioperative and postoperative prophylaxis against thromboembolism with use of low--molecular weight heparin (LMWH), and to show the safety and feasibility of LMWH administration., Type of Study: Prospective, single-blind, randomized clinical trial., Methods: There were 218 consecutive outpatients scheduled for ambulatory arthroscopic knee surgery eligible. Of these, 130 patients were randomized to a treatment group with LMWH (dalteparin: 2,500 IU less-than-or-equal70 kg and 5,000 IU >70 kg, started perioperatively and given once daily for 4 weeks; n = 66) and a control group (n = 64) with no prophylaxis. To detect DVT, all patients underwent bilateral compression ultrasonography before and 12 and 31 days after surgery., Results: Among the 130 patients studied, thromboembolism was significantly lower in the treatment than in the control group: 1 of 66 (1.5%) versus 10 of 64 (15.6%); 95% confidence interval, 7.8% to 26.8%; P =.004. Eighty percent of DVT occurred within the first 14 postoperative days. No severe side effects of LMWH were observed. Only 5% of patients refused continued subcutaneous LMWH injections., Conclusions: In patients undergoing ambulatory arthroscopic knee surgery without antithrombotic prophylaxis, the risk of DVT is high. Perioperative and postoperative prophylaxis with dalteparin is an effective and safe means of reducing this risk.

Published
2002
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