Author: "Sébastien Perbet" - Searchworks@Jio Institute Digital Library Search Results

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103 results on '"Sébastien Perbet"'

1. Experts’ guidelines of intubation and extubation of the ICU patient of French Society of Anaesthesia and Intensive Care Medicine (SFAR) and French-speaking Intensive Care Society (SRLF)

Author: Hervé Quintard, Erwan l’Her, Julien Pottecher, Frédéric Adnet, Jean-Michel Constantin, Audrey De Jong, Pierre Diemunsch, Rose Fesseau, Anne Freynet, Christophe Girault, Christophe Guitton, Yann Hamonic, Eric Maury, Armand Mekontso-Dessap, Fabrice Michel, Paul Nolent, Sébastien Perbet, Gwenael Prat, Antoine Roquilly, Karim Tazarourte, Nicolas Terzi, Arnaud W. Thille, Mikael Alves, Etienne Gayat, and Laurence Donetti
Subjects: Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Abstract Background Intubation and extubation of ventilated patients are not risk-free procedures in the intensive care unit (ICU) and can be associated with morbidity and mortality. Intubation in the ICU is frequently required in emergency situations for patients with an unstable cardiovascular or respiratory system. Under these circumstances, it is a high-risk procedure with life-threatening complications (20–50%). Moreover, technical problems can also give rise to complications and several new techniques, such as videolaryngoscopy, have been developed recently. Another risk period is extubation, which fails in approximately 10% of cases and is associated with a poor prognosis. A better understanding of the cause of failure is essential to improve success procedure. Results and conclusion In constructing these guidelines, the SFAR/SRLF experts have made use of new data on intubation and extubation in the ICU from the last decade to update existing procedures, incorporate more recent advances and propose algorithms.
Published: 2019
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2. Soluble Forms and Ligands of the Receptor for Advanced Glycation End-Products in Patients with Acute Respiratory Distress Syndrome: An Observational Prospective Study.

Author: Matthieu Jabaudon, Raiko Blondonnet, Laurence Roszyk, Bruno Pereira, Renaud Guérin, Sébastien Perbet, Sophie Cayot, Damien Bouvier, Loic Blanchon, Vincent Sapin, and Jean-Michel Constantin
Subjects: Medicine, Science
Abstract: The main soluble form of the receptor for advanced glycation end-products (sRAGE) is elevated during acute respiratory distress syndrome (ARDS). However other RAGE isoforms and multiple ligands have been poorly reported in the clinical setting, and their respective contribution to RAGE activation during ARDS remains unclear. Our goal was therefore to describe main RAGE isoforms and ligands levels during ARDS.30 ARDS patients and 30 mechanically ventilated controls were prospectively included in this monocenter observational study. Arterial, superior vena cava and alveolar fluid levels of sRAGE, endogenous-secretory RAGE (esRAGE), high mobility group box-1 protein (HMGB1), S100A12 and advanced glycation end-products (AGEs) were measured in duplicate ELISA on day 0, day 3 and day 6. In patients with ARDS, baseline lung morphology was assessed with computed tomography.ARDS patients had higher arterial, central venous and alveolar levels of sRAGE, HMGB1 and S100A12, but lower levels of esRAGE and AGEs, than controls. Baseline arterial sRAGE, HMGB1 and S100A12 were correlated with nonfocal ARDS (AUC 0.79, 0.65 and 0.63, respectively). Baseline arterial sRAGE, esRAGE, S100A12 and AGEs were associated with severity as assessed by PaO2/FiO2.This is the first kinetics study of levels of RAGE main isoforms and ligands during ARDS. Elevated sRAGE, HMGB1 and S100A12, with decreased esRAGE and AGEs, were found to distinguish patients with ARDS from those without. Our findings should prompt future studies aimed at elucidating RAGE/HMGB1/S100A12 axis involvement in ARDS.clinicaltrials.gov Identifier: NCT01270295.
Published: 2015
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3. Lung Postmortem Autopsy Revealing Extramedullary Involvement in Multiple Myeloma Causing Acute Respiratory Distress Syndrome

Author: Aurélie Ravinet, Sébastien Perbet, Romain Guièze, Richard Lemal, Renaud Guérin, Guillaume Gayraud, Jugurtha Aliane, Aymeric Tremblay, Julien Pascal, Albane Ledoux, Carine Chaleteix, Pierre Dechelotte, Jacques-Olivier Bay, Jean-Etienne Bazin, and Jean-Michel Constantin
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
Abstract: Pulmonary involvement with multiple myeloma is rare. We report the case of a 61-year-old man with past medical history of chronic respiratory failure with emphysema, and a known multiple myeloma (Durie and Salmon stage III B and t(4;14) translocation). Six months after diagnosis and first line of treatment, he presented acute dyspnea with interstitial lung disease. Computed tomography showed severe bullous emphysema and diffuse, patchy, multifocal infiltrations bilaterally with nodular character, small bilateral pleural effusions, mediastinal lymphadenopathy, and a known lytic lesion of the 12th vertebra. He was treated with piperacillin-tazobactam, amikacin, oseltamivir, and methylprednisolone. Finally, outcome was unfavourable. Postmortem analysis revealed diffuse and nodular infracentimetric infiltration of the lung parenchyma by neoplastic plasma cells. Physicians should be aware that acute respiratory distress syndrome not responding to treatment of common causes could be a manifestation of the disease, even with negative BAL or biopsy and could be promptly treated with salvage therapy.
Published: 2014
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4. Plasma levels of sRAGE, loss of aeration and weaning failure in ICU patients: a prospective observational multicenter study.

Author: Matthieu Jabaudon, Sébastien Perbet, Bruno Pereira, Alexis Soummer, Laurence Roszyk, Renaud Guérin, Emmanuel Futier, Qin Lu, Jean-Etienne Bazin, Vincent Sapin, Jean-Jacques Rouby, and Jean-Michel Constantin
Subjects: Medicine, Science
Abstract: Postextubation distress after a successful spontaneous breathing trial (SBT) is associated with increased morbidity and mortality. Lung ultrasound determination of changes in lung aeration predicts weaning failure. It remains unknown whether this derecruitment is related to alveolar epithelial dysfunction or not.To verify whether lung alveolar type I epithelial cell injury marker sRAGE (soluble form of the receptor for advanced glycation end-products) is predictive of postextubation distress and weaning failure or not, and to verify whether plasma sRAGE levels can be related to lung derecruitment during the process of weaning from mechanical ventilation or not. INTERVENTIONS MEASUREMENTS: 88 patients from 2 intensive care units were included in this observational prospective study. Plasma sRAGE levels were measured in duplicate by ELISA before, at the end of a 60-minute SBT, and 4 hours after extubation. To quantify lung aeration, a lung ultrasound score was calculated.34% of extubated patients experienced postextubation distress. Patients with or without postextubation distress had comparable sRAGE levels before SBT, after SBT, and 4 hours after extubation. In patients with postextubation distress, sRAGE levels were not predictive of the need for mechanical ventilation. sRAGE levels were not associated with lung aeration as assessed by echography. Patients who succeeded SBT (86%) and those who failed (14%) had no differences in sRAGE levels, before (median 1111 vs 1021 pg/mL, p = 0,87) and at the end of SBT (1165 vs 1038 pg/mL, p = 0.74).Plasma levels of sRAGE do not predict postextubation distress or SBT failure/success in patients weaning from mechanical ventilation. Lung aeration loss during a successful weaning trial predicts postextubation distress, but may not be evaluable by plasma levels of sRAGE, a marker of alveolar type I epithelial cell injury.ClinicalTrials.gov NCT01098773.
Published: 2013
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5. Low Molecular Weight Heparin Induced Skin Necrosis without Platelet Fall Revealing Immunoallergic Heparin Induced Thrombocytopenia

Author: Thomas Godet, Sébastien Perbet, Aurélien Lebreton, Guillaume Gayraud, Sophie Cayot, Aymeric Tremblay, Aurélie Ravinet, Sébastien Christophe, Renaud Guérin, Julien Pascal, Matthieu Jabaudon, Amr Hassan, Anne-Françoise Sapin, Jean-Etienne Bazin, and Jean-Michel Constantin
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
Abstract: Low molecular weight heparins (LMWH) are commonly used in the ICU setting for thromboprophylaxis as well as curative decoagulation as required during renal replacement therapy (RRT). A rare adverse event revealing immunoallergic LMWH induced thrombopenia (HIT) is skin necrosis at injection sites. We report the case of a patient presenting with skin necrosis witnessing an HIT after RRT, without thrombocytopenia. The mechanism remains unclear. Anti-PF4/heparin antibodies, functional tests (HIPA and/or SRA), and skin biopsy are of great help to evaluate differential diagnosis with a low pretest probability 4T’s score.
Published: 2013
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6. Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Author: Tài, Pham, Leo, Heunk, Giacomo, Bellani, Fabiana, Madotto, Irene, Aragao, Gaëtan, Beduneau, Ewan C, Goligher, Giacomo, Grasselli, Jon Henrik, Laake, Jordi, Mancebo, Oscar, Peñuela, Lise, Piquilloud, Antonio, Pesenti, Hannah, Wunsch, Frank, van Haren, Laurent, Brochard, John G, Laffey, Abrough, Fekri, P Acharya, Subhash, Amin, Pravin, Arabi, Yaseen, Aragao, Irene, Bauer, Philippe, Beduneau, Gaëtan, Beitler, Jeremy, Berkius, Johan, Bugedo, Guillermo, Camporota, Luigi, Cerny, Vladimir, Cho, Young-Jae, Clarkson, Kevin, Estenssoro, Elisa, Goligher, Ewan, Grasselli, Giacomo, Gritsan, Alexey, Mohammadreza Hashemian, Seyed, Hermans, Greet, M Heunks, Leo, Jovanovic, Bojan, Kurahashi, Kiyoyasu, Henrik Laake, Jon, Matamis, Dimitrio, Moerer, Onnen, Molnar, Zsolt, Ozyilmaz, Ezgi, Panka, Bernardo, Papali, Alfred, Peñuelas, Óscar, Perbet, Sébastien, Piquilloud, Lise, Qiu, Haibo, Abdel Razek, Assem, Rittayamai, Nuttapol, Roldan, Rollin, Serpa Neto, Ary, Szuldrzynski, Konstanty, Talmor, Daniel, Tomescu, Dana, Van Haren, Frank, Villagomez, Asisclo, Ali Zeggwagh, Amine, Abe, Toshikazu, Aboshady, Abdelrhman, Acampo-de Jong, Melanie, Acharya, Subhash, Adderley, Jane, Adiguzel, Nalan, Kumar Agrawal, Vijay, Aguilar, Gerardo, Aguirre, Gaston, Aguirre-Bermeo, Hernan, Ahlström, Björn, Akbas, Türkay, Akker, Mustafa, Al Sadeh, Ghamdan, Alamri, Sultan, Algaba, Angela, Ali, Muneeb, Aliberti, Anna, Manuel Allegue, Jose, Alvarez, Diana, Amador, Joaquin, H Andersen, Finn, Ansari, Sharique, Apichatbutr, Yutthana, Apostolopoulou, Olympia, Arellano, Daniel, Arica, Mestanza, Arikan, Huseyin, Arinaga, Koichi, Arnal, Jean-Michel, Asano, Kengo, Asín-Corrochano, Marta, Milagrito Avalos Cabrera, Jesu, Avila Fuentes, Silvia, Aydemir, Semih, Aygencel, Gulbin, Azevedo, Luciano, Bacakoglu, Feza, Badie, Julio, Baedorf Kassis, Elia, Bai, Gabriela, Balaraj, Govindan, Ballico, Bruno, Banner-Goodspeed, Valerie, Banwarie, Preveen, Barbieri, Rosella, Baronia, Arvind, Barrett, Jonathan, Barrot, Loïc, Emilio Barrueco-Francioni, Jesu, Barry, Jeffrey, Bawangade, Harshal, Beavis, Sarah, Beck, Eduardo, Beehre, Nina, Belenguer Muncharaz, Alberto, Bellani, Giacomo, Belliato, Mirko, Bellissima, Agrippino, Beltramelli, Rodrigo, Ben Souissi, Asma, Benitez-Cano, Adela, Benlamin, Mohamed, Benslama, Abdellatif, Bento, Lui, Benvenuti, Daniela, Bernabe, Laura, Bersten, Andrew, Berta, Giacomo, Bertini, Pietro, Bertram-Ralph, Elliot, Besbes, Mohamed, Roberto Bettini, Lisandro, Beuret, Pascal, Bewley, Jeremy, Bezzi, Marco, Bhakhtiani, Lakshay, Bhandary, Rakesh, Bhowmick, Kaushik, Bihari, Shailesh, Bissett, Bernie, Blythe, David, Bocher, Simon, Boedjawan, Narain, M Bojanowski, Christine, Boni, Elisa, Boraso, Sabrina, Borelli, Massimo, Borello, Silvina, Borislavova, Margarita, J Bosma, Karen, Bottiroli, Maurizio, Boyd, Owen, Bozbay, Suha, Briva, Arturo, Brochard, Laurent, Bruel, Cédric, Bruni, Andrea, Buehner, Ulrike, Bulpa, Pierre, Burt, Karen, Buscot, Mathieu, Buttera, Stefania, Cabrera, Jorge, Caccese, Roberta, Caironi, Pietro, Canchos Gutierrez, Ivan, Canedo, Nancy, Cani, Alma, Cappellini, Iacopo, Carazo, Jesu, Pablo Cardonnet, Lui, Carpio, David, Carriedo, Demetrio, Carrillo, Ramón, Carvalho, João, Caser, Eliana, Castelli, Antonio, Castillo Quintero, Manuel, Castro, Heloisa, Catorze, Nuno, Cengiz, Melike, Cereijo, Enrique, Ceunen, Helga, Chaintoutis, Christo, Chang, Youjin, Chaparro, Gustavogcha, Chapman, Carmel, Chau, Simon, Eugenia Chavez, Cecilia, Chelazzi, Cosimo, Chelly, Jonathan, Chemouni, Frank, Chen, Kai, Chena, Ariel, Chiarandini, Paolo, Chilton, Phil, Chiumello, Davide, Chou-Lie, Yvette, Chudeau, Nicola, Cinel, Ismail, Cinnella, Gilda, Clark, Michele, Clark, Thoma, Clementi, Stefano, Coaguila, Lui, Jaspe Codecido, Alexi, Collins, Amy, Colombo, Riccardo, Conde, Juan, Consales, Guglielmo, Cook, Tim, Coppadoro, Andrea, Cornejo, Rodrigo, Cortegiani, Andrea, Coxo, Cristina, Neville Cracchiolo, Andrea, Crespo Ramirez, Mónica, Crova, Philippe, Cruz, José, Cubattoli, Lucia, Çukurova, Zafer, Curto, Francesco, Czempik, Piotr, D'Andrea, Rocco, da Silva Ramos, Fernando, Dangers, Laurence, Danguy des Déserts, Marc, Danin, Pierre-Eric, Dantas, Fabianne, Daubin, Cédric, Dawei, Wu, de Haro, Candelaria, de Jesus Montelongo, Felipe, De Mendoza, Diego, de Pablo, Raúl, De Pascale, Gennaro, De Rosa, Silvia, Decavèle, Maxen, Declercq, Pierre-Loui, Deicas, Alberto, Del Carmen Campos Moreno, María, Dellamonica, Jean, Delmas, Benjamin, Demirkiran, Oktay, Demirkiran, Hilmi, Dendane, Tarek, di Mussi, Rossella, Diakaki, Chrysi, Diaz, Anatilde, Diaz, Willy, Dikmen, Yalim, Dimoula, Aikaterini, Doble, Patricia, Doha, Nagwa, Domingos, Guilherme, Dres, Martin, Dries, David, Duggal, Abhijit, Duke, Graeme, Dunts, Pavel, Dybwik, Knut, Dykyy, Maksym, Eckert, Philippe, Efe, Serdar, Elatrous, Souheil, Elay, Gülseren, S Elmaryul, Abubaker, Elsaadany, Mohamed, Elsayed, Hany, Elsayed, Samar, Emery, Malo, Ena, Sébastien, Eng, Kevin, A Englert, Joshua, Erdogan, Elif, Ergin Ozcan, Perihan, Eroglu, Ege, Escobar, Miguel, Esen, Figen, Esen Tekeli, Arzu, Esquivel, Alejandro, Esquivel Gallegos, Helbert, Ezzouine, Hanane, Facchini, Alberto, Faheem, Mohammad, Fanelli, Vito, Fernanda Farina, Maria, Fartoukh, Muriel, Fehrle, Lutz, Feng, Feng, Feng, Yufeng, Fernandez, Irene, Fernandez, Borja, Lorena Fernandez-Rodriguez, Maria, Ferrando, Carlo, João Ferreira da Silva, Maria, Ferreruela, Mireia, Ferrier, Janet, Jesús Flamm Zamorano, Matia, Flood, Laura, Floris, Leda, Fluckiger, Martin, Forteza, Catalina, Fortunato, Antonella, Frans, Eric, Frattari, Antonella, Fredes, Sebastian, Frenzel, Tim, Fumagalli, Roberto, Andres Furche, Mariano, Fusari, Maurizio, Fysh, Edward, Luis Galeas-Lopez, Juan, Galerneau, Louis-Marie, Garcia, Analía, Fernanda Garcia, María, Garcia, Elisabet, Garcia Olivares, Pablo, Garlicki, Jaroslaw, Garnero, Aude, Garofalo, Eugenio, Gautam, Prabha, Gazenkampf, Andrey, Gelinotte, Stéphanie, Gelormini, Domenico, Ghrenassia, Etienne, Giacomucci, Angelo, Giannoni, Robert, Gigante, Andrea, Glober, Nancy, Gnesin, Paolo, Gollo, Yari, Gomaa, Dina, Gomero Paredes, Rosita, Gomes, Rui, Alejandro Gomez, Raúl, Gomez, Oscar, Gomez, Aroa, Gondim, Louise, Gonzalez, Manuel, Gonzalez, Isabel, Gonzalez-Castro, Alejandro, Gordillo Romero, Orlando, Gordo, Federico, Gouin, Philippe, Graf Santos, Jerónimo, Grainne, Rooney, Grando, Matilde, Granov Grabovica, Sanja, Grasso, Salvatore, Grasso, Rinaldo, Grimmer, Lisa, Grissom, Colin, Gu, Qing, Guan, Xiang-Dong, Guarracino, Fabio, Guasch, Neu, Guatteri, Luca, Gueret, Renaud, Guérin, Claude, Guerot, Emmanuel, Guitard, Pierre-Gilda, Gül, Fethi, Gumus, Ayca, Gurjar, Mohan, Gutierrez, Patricia, Hachimi, Abdelhamid, Hadzibegovic, Adi, Hagan, Samantha, Hammel, Clare, Han Song, Joo, Hanlon, Gabrielle, Heines, Serge, Henriksson, Johanna, Herbrecht, Jean-Etienne, Omar Heredia Orbegoso, Gabriel, Hermon, Andrew, Hernandez, Rosana, Hernandez, Carmen, Herrera, Lui, Herrera-Gutierrez, Manuel, Heunks, Leo, Hidalgo, Juan, Hill, Dianne, Holmquist, Dagmar, Homez, Marcela, Hongtao, Xia, Hormis, Anil, Horner, Daniel, Carmen Hornos, M, Hou, Meihong, House, Stacy, Housni, Brahim, Hugill, Keith, Humphreys, Sally, Humbert, Loui, Hunter, Stephanie, Hwa Young, Lee, Iezzi, Nicola, Ilutovich, Santiago, Inal, Volkan, Innes, Richard, Ioannides, Panagioti, Antonio Iotti, Giorgio, Ippolito, Mariachiara, Irie, Hiromasa, Iriyama, Hiroki, Itagaki, Taiga, Izura, Javier, Izza, Santiago, Jabeen, Rakhshanda, Jamaati, Hamidreza, Jamadarkhana, Sunil, Jamoussi, Amira, Jankowski, Milosz, Alberto Jaramillo, Lui, Jeon, Kyeongman, Jeong Lee, Seok, Jeswani, Deepak, Jha, Simant, Jiang, Liangyan, Jing, Chen, Jochmans, Sébastien, Anders Johnstad, Bror, Jongmin, Lee, Joret, Aurélie, Junhasavasdikul, Detajin, Teresa Jurado, Maria, Kam, Elisa, Kamohara, Hidenobu, Kane, Caroline, Kara, Iskender, Karakurt, Sait, Karnjanarachata, Cherdkiat, Kataoka, Jun, Katayama, Shinshu, Kaushik, Shuchi, Kelebek Girgin, Nermin, Kerr, Kathryn, Kerslake, Ian, Khairnar, Prakash, Khalid, Abidi, Khan, Akram, K Khanna, Ashish, Khorasanee, Reza, Kienhorst, Dieneke, Kirakli, Cenk, Knafelj, Rihard, Kol Kol, Mark, Kongpolprom, Napplika, Kopitko, Csaba, Korkmaz Ekren, Pervin, Kubisz-Pudelko, Agnieszka, Kulcsar, Zoltan, Kumasawa, Junji, Kuriyama, Akira, Kutchak, Fernanda, Labarca, Eduardo, Labat, Françoise, Laborda, César, Alberto Laca Barrera, Manuel, Lagache, Laurie, Landaverde Lopez, Antonio, Lanspa, Michael, Lascari, Valeria, Le Meur, Matthieu, Hwan Lee, Su, Ju Lee, Young, Lee, Jinwoo, Lee, Won-Yeon, Lee, Jarone, Legernaes, Terje, Leiner, Tamaa, Lemiale, Virginie, Leonor, Tiago, M Lepper, Philipp, Li, Dahuan, Li, Hongbin, Li, Oleg, Raquel Lima, Ana, Lind, Dan, Litton, Edward, Liu, Ning, Liu, Ling, Liu, Jialin, Llitjos, Jean-Françoi, Llorente, Beatriz, Lopez, Rodolfo, Elizabeth Lopez, Claudia, Lopez Nava, Claudia, Lovazzano, Pablo, Lu, Min, Lucchese, Francesca, Lugano, Manuela, Lugo Goytia, Gustavo, Luo, Hua, Lynch, Ceri, Macheda, Sebastiano, Hugo Madrigal Robles, Victor, Maurizio Maggiore, Salvatore, Magret Iglesias, Mònica, Malaga, Peter, Mallapura Maheswarappa, Harish, Malpartida, Guillermo, Malyarchikov, Andrey, Mansson, Helena, Manzano, Anaid, Marey, Ismael, Marin, Nathalie, Del Carmen Marin, Maria, Markman, Eliana, Martin, Felix, Martin, Alex, Martin Dal Gesso, Cristina, Martinez, Felipe, Martínez-Fidalgo, Conchita, Martin-Loeches, Ignacio, Mas, Arantxa, Masaaki, Sakuraya, Maseda, Emilio, Massa, Eleni, Mattsson, Anna, Maugeri, Jessica, Mccredie, Victoria, Mccullough, Jame, Mcguinness, Shay, Mckown, Andrew, Medve, László, Mei, Chengqing, Mellado Artigas, Ricard, Mendes, Vitor, Khalaf Ebraheim Mervat, Mohamed, Michaux, Isabelle, Mikhaeil, Michael, Milagros, Olga, Milet, Igor, Teresa Millan, Maria, Minwei, Zhang, Mirabella, Lucia, Mishra, Sanghamitra, Mistraletti, Giovanni, Mochizuki, Katsunori, Moghal, Arif, Mojoli, Francesco, Molin, Alexandre, Montiel, Raquel, Montini, Luca, Monza, Gianmario, Mora Aznar, Maria, Morakul, Sunthiti, Morales, Maria, Moreno Torres, Daniel, Rolando Morocho Tutillo, Diego, Motherway, Catherine, Mouhssine, Doumiri, Mouloudi, Eleni, Muñoz, Tapia, Munoz de Cabo, Carlo, Mustafa, Mohamed, Muthuchellappan, Radhakrishnan, Muthukrishnan, Muraleekrishnan, Muttini, Stefano, Nagata, Isao, Nahar, Dick, Nakanishi, Misuzu, Nakayama, Izumi, Antonio Namendys-Silva, Silvio, Nanchal, Rahul, Nandakumar, Sivakumar, Nasi, Alessandra, Nasir, Kamal, Navalesi, Paolo, Naz Aslam, Tayyba, Nga Phan, Thuy, Nichol, Alistair, Niiyama, Shuhei, Nikolakopoulou, Sofia, Nikolic, Elena, Nitta, Kenichi, Noc, Marko, Nonas, Stephanie, Nseir, Saad, Nur Soyturk, Ayse, Obata, Yukako, Oeckler, Richard, Oguchi, Moe, Ohshimo, Shinichiro, Oikonomou, Marina, Ojados, Agueda, Teresa Oliveira, Maria, Oliveira Filho, Wilson, Oliveri, Carlo, Olmos, Aitor, Omura, Kazuya, Cristina Orlandi, Maria, Orsenigo, Francesca, Ortiz-Ruiz De Gordoa, Laura, Ota, Kei, Ovalle Olmos, Rainier, Öveges, Nándo, Oziemski, Peter, Ozkan Kuscu, Ozlem, Özyilmaz, Ezgi, Pachas Alvarado, Fernando, Pagella, Gonzalo, Palaniswamy, Vijayanand, Luis Palazon Sanchez, Eugenio, Palmese, Salvatore, Pan, Guojun, Pan, Wensen, Papanikolaou, Metaxia, Papavasilopoulou, Theonymfi, Parekh, Ameet, Parke, Rachael, J Parrilla, Francisco, Parrilla, Dácil, Pasha, Taha, Pasin, Laura, Patão, Lui, Patel, Mayur, Patel, Grisma, Kumar Pati, Basanta, Patil, Jayaprakash, Pattnaik, Saroj, Paul, Daniel, Pavesi, Maurizio, Alejandra Pavlotsky, Vanesa, Paz, Graciela, Paz, Enrique, Pecci, Elisabetta, Pellegrini, Carlo, Gabriela Peña Padilla, Andrea, Perchiazzi, Gaetano, Pereira, Tiago, Pereira, Vera, Perez, Manuel, Perez Calvo, Cesar, Perez Cheng, Meisy, Perez Maita, Ronald, Pérez-Araos, Rodrigo, Perez-Teran, Purificación, Perez-Torres, David, Perkins, Gavin, Persona, Paolo, Petnak, Tananchai, Petrova, Marina, Pham, Tai, Philippart, Françoi, Picetti, Edoardo, Pierucci, Elisabetta, Piervincenzi, Edoardo, Pinciroli, Riccardo, Pintado, Maria-Consuelo, Piraino, Thoma, Piras, Stephanie, Piras, Claudio, Pirompanich, Pattarin, Pisani, Luigi, Platas, Enrique, Plotnikow, Gustavo, Porras, Willy, Porta, Virginia, Portilla, Mariana, Portugal, José, Povoa, Pedro, Prat, Gwenael, Pratto, Romina, Preda, Gabriel, Prieto, Isidro, Prol-Silva, Estefania, Pugh, Richard, Qi, Yupeng, Qian, Chuanyun, Qin, Tiehe, Qu, Hongping, Quintana, Teobaldo, Quispe Sierra, Rosari, Quispe Soto, Rocio, Rabbani, Raihan, Rabee, Mohamed, Rabie, Ahmed, Augusta Rahe Pereira, Maria, Rai, Ashish, Raj Ashok, Sundar, Rajab, Mostafa, Ramdhani, Navin, Ramey, Elizabeth, Ranieri, Marco, Rathod, Darshana, Ray, Banambar, Mahmud Redwanul Huq, Shihan, Regli, Adrian, Reina, Rosa, Resano Sarmiento, Natalia, Reynaud, Faustine, Rialp, Gemma, Ricart, Pilar, Rice, Todd, Richardson, Angu, Rieder, Marcelo, Rinket, Martin, Rios, Fernando, Risso Vazquez, Alejandro, Riva, Ivano, Rivette, Monaly, Roca, Oriol, Roche-Campo, Ferran, Rodriguez, Covadonga, Rodriguez, Gabriel, Rodriguez Gonzalez, Daniel, Yanina Rodriguez Tucto, Xandra, Rogers, Angela, Elena Romano, María, Rørtveit, Linda, Rose, Alastair, Roux, Damien, Rouze, Anahita, Nahuel Rubatto Birri, Paolo, Ruilan, Wang, Ruiz Robledo, Aldana, Luis Ruiz-Aguilar, Antonio, Sadahiro, Tomohito, Saez, Ignacio, Sagardia, Judith, Saha, Rajnish, Saha, Rohit, Saiphoklang, Narongkorn, Saito, Shigeki, Salem, Maie, Sales, Gabriele, Salgado, Patricia, Samavedam, Sriniva, Sami Mebazaa, Mhamed, Samuelsson, Line, San Juan Roman, Nandyelly, Sanchez, Patricia, Sanchez-Ballesteros, Jesu, Sandoval, Yazcitk, Sani, Emanuele, Santos, Martin, Santos, Carla, Sanui, Masamitsu, Saravanabavan, Lakshmikanthcharan, Sari, Sema, Sarkany, Agne, Sauneuf, Bertrand, Savioli, Monica, Sazak, Hilal, Scano, Riccardo, Schneider, Franci, Schortgen, Frédérique, J Schultz, Marcu, Leonie Schwarz, Gabriele, Seçkin Yücesoy, Faruk, Seely, Andrew, Seiler, Frederik, Seker Tekdos, Yasemin, Seok Chan, Kim, Serano, Luca, Serednicki, Wojciech, Setten, Mariano, Shah, Asim, Shah, Bhagyesh, Shang, You, Shanmugasundaram, Pradeep, Shapovalov, Konstantin, Shebl, Eman, Shiga, Takuya, Shime, Nobuaki, Shin, Phil, Short, Jack, Shuhua, Chen, Siddiqui, Sughrat, Ignacio Silesky Jimenez, Juan, Silva, Daniel, Silva Sales, Betania, Simons, Koen, Ågot Sjøbø, Brit, Slessor, David, Smiechowicz, Jakub, Smischney, Nathan, Smith, Paul, Smith, Tim, Smith, Mark, Snape, Sarah, Snyman, Lindi, Soetens, Filiep, Sook Hong, Kyung, Ángel Sosa Medellin, Miguel, Soto, Giovanna, Souloy, Xavier, Sousa, Elsa, Sovatzis, Stefania, Sozutek, Didem, Spadaro, Savino, Spagnoli, Marco, Spångfors, Martin, Spittle, Nick, Spivey, Mike, Stapleton, Andrew, Stefanovic, Branislava, Stephenson, Lorraine, Stevenson, Elizabeth, Strand, Kristian, Teresa Strano, Maria, Straus, Slavenka, Sun, Chenliang, Sun, Rongqing, Sundaram, Venkat, Sunpark, Tai, Surlemont, Elisabeth, Sutherasan, Yuda, Szabo, Zsuzsanna, Tainter, Christopher, Takaba, Akihiro, Tallott, 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Maseda, Eleni Massa, Anna Mattsson, Jessica Maugeri, Victoria McCredie, James McCullough, Shay McGuinness, Andrew McKown, László Medve, Chengqing Mei, Ricard Mellado Artigas, Vitor Mendes, Mohamed Khalaf Ebraheim Mervat, Isabelle Michaux, Michael Mikhaeil, Olga Milagros, Igor Milet, Maria Teresa Millan, Zhang Minwei, Lucia Mirabella, Sanghamitra Mishra, Giovanni Mistraletti, Katsunori Mochizuki, Arif Moghal, Francesco Mojoli, Alexandre Molin, Raquel Montiel, Luca Montini (ORCID:0000-0003-4602-5134), Gianmario Monza, Maria Mora Aznar, Sunthiti Morakul, Maria Morales, Daniel Moreno Torres, Diego Rolando Morocho Tutillo, Catherine Motherway, Doumiri Mouhssine, Eleni Mouloudi, Tapia Muñoz, Carlos Munoz de Cabo, Mohamed Mustafa, Radhakrishnan Muthuchellappan, Muraleekrishnan Muthukrishnan, Stefano Muttini, Isao Nagata, Dick Nahar, Misuzu Nakanishi, Izumi Nakayama, Silvio Antonio Namendys-Silva, Rahul Nanchal, Sivakumar Nandakumar, Alessandra Nasi, Kamal Nasir, Paolo Navalesi, Tayyba Naz 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Kassis, Gabriela Bai, Govindan Balaraj, Bruno Ballico, Valerie Banner-Goodspeed, Preveen Banwarie, Rosella Barbieri, Arvind Baronia, Jonathan Barrett, Loïc Barrot, Jesus Emilio Barrueco-Francioni, Jeffrey Barry, Harshal Bawangade, Sarah Beavis, Eduardo Beck, Nina Beehre, Alberto Belenguer Muncharaz, Giacomo Bellani, Mirko Belliato, Agrippino Bellissima, Rodrigo Beltramelli, Asma Ben Souissi, Adela Benitez-Cano, Mohamed Benlamin, Abdellatif Benslama, Luis Bento, Daniela Benvenuti, Laura Bernabe, Andrew Bersten, Giacomo Berta, Pietro Bertini, Elliot Bertram-Ralph, Mohamed Besbes, Lisandro Roberto Bettini, Pascal Beuret, Jeremy Bewley, Marco Bezzi, Lakshay Bhakhtiani, Rakesh Bhandary, Kaushik Bhowmick, Shailesh Bihari, Bernie Bissett, David Blythe, Simon Bocher, Narain Boedjawan, Christine M Bojanowski, Elisa Boni, Sabrina Boraso, Massimo Borelli, Silvina Borello, Margarita Borislavova, Karen J Bosma, Maurizio Bottiroli, Owen Boyd, Suha Bozbay, Arturo Briva, Laurent Brochard, Cédric Bruel, Andrea Bruni, Ulrike Buehner, Pierre Bulpa, Karen Burt, Mathieu Buscot, Stefania Buttera, Jorge Cabrera, Roberta Caccese, Pietro Caironi, Ivan Canchos Gutierrez, Nancy Canedo, Alma Cani, Iacopo Cappellini, Jesus Carazo, Luis Pablo Cardonnet, David Carpio, Demetrio Carriedo, Ramón Carrillo, João Carvalho, Eliana Caser, Antonio Castelli, Manuel Castillo Quintero, Heloisa Castro, Nuno Catorze, Melike Cengiz, Enrique Cereijo, Helga Ceunen, Christos Chaintoutis, Youjin Chang, Gustavogcha Chaparro, Carmel Chapman, Simon Chau, Cecilia Eugenia Chavez, Cosimo Chelazzi, Jonathan Chelly, Frank Chemouni, Kai Chen, Ariel Chena, Paolo Chiarandini, Phil Chilton, Davide Chiumello, Yvette Chou-Lie, Nicolas Chudeau, Ismail Cinel, Gilda Cinnella, Michele Clark, Thomas Clark, Stefano Clementi, Luis Coaguila, Alexis Jaspe Codecido, Amy Collins, Riccardo Colombo, Juan Conde, Guglielmo Consales, Tim Cook, Andrea Coppadoro, Rodrigo Cornejo, Andrea Cortegiani, Cristina Coxo, Andrea Neville Cracchiolo, Mónica Crespo Ramirez, Philippe Crova, José Cruz, Lucia Cubattoli, Zafer Çukurova, Francesco Curto, Piotr Czempik, Rocco D'Andrea, Fernando da Silva Ramos, Laurence Dangers, Marc Danguy des Déserts, Pierre-Eric Danin, Fabianne Dantas, Cédric Daubin, Wu Dawei, Candelaria de Haro, Felipe de Jesus Montelongo, Diego De Mendoza, Raúl de Pablo, Gennaro De Pascale, Silvia De Rosa, Maxens Decavèle, Pierre-Louis Declercq, Alberto Deicas, María Del Carmen Campos Moreno, Jean Dellamonica, Benjamin Delmas, Oktay Demirkiran, Hilmi Demirkiran, Tarek Dendane, Rossella di Mussi, Chrysi Diakaki, Anatilde Diaz, Willy Diaz, Yalim Dikmen, Aikaterini Dimoula, Patricia Doble, Nagwa Doha, Guilherme Domingos, Martin Dres, David Dries, Abhijit Duggal, Graeme Duke, Pavel Dunts, Knut Dybwik, Maksym Dykyy, Philippe Eckert, Serdar Efe, Souheil Elatrous, Gülseren Elay, Abubaker S Elmaryul, Mohamed Elsaadany, Hany Elsayed, Samar Elsayed, Malo Emery, Sébastien Ena, Kevin Eng, Joshua A Englert, Elif Erdogan, Perihan Ergin Ozcan, Ege Eroglu, Miguel Escobar, Figen Esen, Arzu Esen Tekeli, Alejandro Esquivel, Helbert Esquivel Gallegos, Hanane Ezzouine, Alberto Facchini, Mohammad Faheem, Vito Fanelli, Maria Fernanda Farina, Muriel Fartoukh, Lutz Fehrle, Feng Feng, Yufeng Feng, Irene Fernandez, Borja Fernandez, Maria Lorena Fernandez-Rodriguez, Carlos Ferrando, Maria João Ferreira da Silva, Mireia Ferreruela, Janet Ferrier, Matias Jesús Flamm Zamorano, Laura Flood, Leda Floris, Martin Fluckiger, Catalina Forteza, Antonella Fortunato, Eric Frans, Antonella Frattari, Sebastian Fredes, Tim Frenzel, Roberto Fumagalli, Mariano Andres Furche, Maurizio Fusari, Edward Fysh, Juan Luis Galeas-Lopez, Louis-Marie Galerneau, Analía Garcia, María Fernanda Garcia, Elisabet Garcia, Pablo Garcia Olivares, Jaroslaw Garlicki, Aude Garnero, Eugenio Garofalo, Prabha Gautam, Andrey Gazenkampf, Stéphanie Gelinotte, Domenico Gelormini, Etienne Ghrenassia, Angelo Giacomucci, Robert Giannoni, Andrea Gigante, Nancy Glober, Paolo Gnesin, Yari Gollo, Dina Gomaa, Rosita Gomero Paredes, Rui Gomes, Raúl Alejandro Gomez, Oscar Gomez, Aroa Gomez, Louise Gondim, Manuel Gonzalez, Isabel Gonzalez, Alejandro Gonzalez-Castro, Orlando Gordillo Romero, Federico Gordo, Philippe Gouin, Jerónimo Graf Santos, Rooney Grainne, Matilde Grando, Sanja Granov Grabovica, Salvatore Grasso, Rinaldo Grasso, Lisa Grimmer, Colin Grissom, Qing Gu, Xiang-Dong Guan, Fabio Guarracino, Neus Guasch, Luca Guatteri, Renaud Gueret, Claude Guérin, Emmanuel Guerot, Pierre-Gildas Guitard, Fethi Gül, Ayca Gumus, Mohan Gurjar, Patricia Gutierrez, Abdelhamid Hachimi, Adi Hadzibegovic, Samantha Hagan, Clare Hammel, Joo Han Song, Gabrielle Hanlon, Serge Heines, Johanna Henriksson, Jean-Etienne Herbrecht, Gabriel Omar Heredia Orbegoso, Andrew Hermon, Rosana Hernandez, Carmen Hernandez, Luis Herrera, Manuel Herrera-Gutierrez, Leo Heunks, Juan Hidalgo, Dianne Hill, Dagmar Holmquist, Marcela Homez, Xia Hongtao, Anil Hormis, Daniel Horner, M Carmen Hornos, Meihong Hou, Stacy House, Brahim Housni, Keith Hugill, Sally Humphreys, Louis Humbert, Stephanie Hunter, Lee Hwa Young, Nicolas Iezzi, Santiago Ilutovich, Volkan Inal, Richard Innes, Panagiotis Ioannides, Giorgio Antonio Iotti, Mariachiara Ippolito, Hiromasa Irie, Hiroki Iriyama, Taiga Itagaki, Javier Izura, Santiago Izza, Rakhshanda Jabeen, Hamidreza Jamaati, Sunil Jamadarkhana, Amira Jamoussi, Milosz Jankowski, Luis Alberto Jaramillo, Kyeongman Jeon, Seok Jeong Lee, Deepak Jeswani, Simant Jha, Liangyan Jiang, Chen Jing, Sébastien Jochmans, Bror Anders Johnstad, Lee Jongmin, Aurélie Joret, Detajin Junhasavasdikul, Maria Teresa Jurado, Elisa Kam, Hidenobu Kamohara, Caroline Kane, Iskender Kara, Sait Karakurt, Cherdkiat Karnjanarachata, Jun Kataoka, Shinshu Katayama, Shuchi Kaushik, Nermin Kelebek Girgin, Kathryn Kerr, Ian Kerslake, Prakash Khairnar, Abidi Khalid, Akram Khan, Ashish K Khanna, Reza Khorasanee, Dieneke Kienhorst, Cenk Kirakli, Rihard Knafelj, Mark Kol Kol, Napplika Kongpolprom, Csaba Kopitko, Pervin Korkmaz Ekren, Agnieszka Kubisz-Pudelko, Zoltan Kulcsar, Junji Kumasawa, Akira Kuriyama, Fernanda Kutchak, Eduardo Labarca, Françoise Labat, César Laborda, Manuel Alberto Laca Barrera, Laurie Lagache, Antonio Landaverde Lopez, Michael Lanspa, Valeria Lascari, Matthieu Le Meur, Su Hwan Lee, Young Ju Lee, Jinwoo Lee, Won-Yeon Lee, Jarone Lee, Terje Legernaes, Tamaas Leiner, Virginie Lemiale, Tiago Leonor, Philipp M Lepper, Dahuan Li, Hongbin Li, Oleg Li, Ana Raquel Lima, Dan Lind, Edward Litton, Ning Liu, Ling Liu, Jialin Liu, Jean-François Llitjos, Beatriz Llorente, Rodolfo Lopez, Claudia Elizabeth Lopez, Claudia Lopez Nava, Pablo Lovazzano, Min Lu, Francesca Lucchese, Manuela Lugano, Gustavo Lugo Goytia, Hua Luo, Ceri Lynch, Sebastiano Macheda, Victor Hugo Madrigal Robles, Salvatore Maurizio Maggiore, Mònica Magret Iglesias, Peter Malaga, Harish Mallapura Maheswarappa, Guillermo Malpartida, Andrey Malyarchikov, Helena Mansson, Anaid Manzano, Ismael Marey, Nathalie Marin, Maria Del Carmen Marin, Eliana Markman, Felix Martin, Alex Martin, Cristina Martin Dal Gesso, Felipe Martinez, Conchita Martínez-Fidalgo, Ignacio Martin-Loeches, Arantxa Mas, Sakuraya Masaaki, Emilio Maseda, Eleni Massa, Anna Mattsson, Jessica Maugeri, Victoria McCredie, James McCullough, Shay McGuinness, Andrew McKown, László Medve, Chengqing Mei, Ricard Mellado Artigas, Vitor Mendes, Mohamed Khalaf Ebraheim Mervat, Isabelle Michaux, Michael Mikhaeil, Olga Milagros, Igor Milet, Maria Teresa Millan, Zhang Minwei, Lucia Mirabella, Sanghamitra Mishra, Giovanni Mistraletti, Katsunori Mochizuki, Arif Moghal, Francesco Mojoli, Alexandre Molin, Raquel Montiel, Luca Montini (ORCID:0000-0003-4602-5134), Gianmario Monza, Maria Mora Aznar, Sunthiti Morakul, Maria Morales, Daniel Moreno Torres, Diego Rolando Morocho Tutillo, Catherine Motherway, Doumiri Mouhssine, Eleni Mouloudi, Tapia Muñoz, Carlos Munoz de Cabo, Mohamed Mustafa, Radhakrishnan Muthuchellappan, Muraleekrishnan Muthukrishnan, Stefano Muttini, Isao Nagata, Dick Nahar, Misuzu Nakanishi, Izumi Nakayama, Silvio Antonio Namendys-Silva, Rahul Nanchal, Sivakumar Nandakumar, Alessandra Nasi, Kamal Nasir, Paolo Navalesi, Tayyba Naz Aslam, Thuy Nga Phan, Alistair Nichol, Shuhei Niiyama, Sofia Nikolakopoulou, Elena Nikolic, Kenichi Nitta, Marko Noc, Stephanie Nonas, Saad Nseir, Ayse Nur Soyturk, Yukako Obata, Richard Oeckler, Moe Oguchi, Shinichiro Ohshimo, Marina Oikonomou, Agueda Ojados, Maria Teresa Oliveira, Wilson Oliveira Filho, Carlo Oliveri, Aitor Olmos, Kazuya Omura, Maria Cristina Orlandi, Francesca Orsenigo, Laura Ortiz-Ruiz De Gordoa, Kei Ota, Rainier Ovalle Olmos, Nándo Öveges, Peter Oziemski, Ozlem Ozkan Kuscu, Ezgi Özyilmaz, Fernando Pachas Alvarado, Gonzalo Pagella, Vijayanand Palaniswamy, Eugenio Luis Palazon Sanchez, Salvatore Palmese, Guojun Pan, Wensen Pan, Metaxia Papanikolaou, Theonymfi Papavasilopoulou, Ameet Parekh, Rachael Parke, Francisco J Parrilla, Dácil Parrilla, Taha Pasha, Laura Pasin, Luis Patão, Mayur Patel, Grisma Patel, Basanta Kumar Pati, Jayaprakash Patil, Saroj Pattnaik, Daniel Paul, Maurizio Pavesi, Vanesa Alejandra Pavlotsky, Graciela Paz, Enrique Paz, Elisabetta Pecci, Carlos Pellegrini, Andrea Gabriela Peña Padilla, Gaetano Perchiazzi, Tiago Pereira, Vera Pereira, Manuel Perez, Cesar Perez Calvo, Meisy Perez Cheng, Ronald Perez Maita, Rodrigo Pérez-Araos, Purificación Perez-Teran, David Perez-Torres, Gavin Perkins, Paolo Persona, Tananchai Petnak, Marina Petrova, Tai Pham, François Philippart, Edoardo Picetti, Elisabetta Pierucci, Edoardo Piervincenzi, Riccardo Pinciroli, Maria-Consuelo Pintado, Thomas Piraino, Stephanie Piras, Claudio Piras, Pattarin Pirompanich, Luigi Pisani, Enrique Platas, Gustavo Plotnikow, Willy Porras, Virginia Porta, Mariana Portilla, José Portugal, Pedro Povoa, Gwenael Prat, Romina Pratto, Gabriel Preda, Isidro Prieto, Estefania Prol-Silva, Richard Pugh, Yupeng Qi, Chuanyun Qian, Tiehe Qin, Hongping Qu, Teobaldo Quintana, Rosari Quispe Sierra, Rocio Quispe Soto, Raihan Rabbani, Mohamed Rabee, Ahmed Rabie, Maria Augusta Rahe Pereira, Ashish Rai, Sundar Raj Ashok, Mostafa Rajab, Navin Ramdhani, Elizabeth Ramey, Marco Ranieri, Darshana Rathod, Banambar Ray, Shihan Mahmud Redwanul Huq, Adrian Regli, Rosa Reina, Natalia Resano Sarmiento, Faustine Reynaud, Gemma Rialp, Pilar Ricart, Todd Rice, Angus Richardson, Marcelo Rieder, Martin Rinket, Fernando Rios, Alejandro Risso Vazquez, Ivano Riva, Monaly Rivette, Oriol Roca, Ferran Roche-Campo, Covadonga Rodriguez, Gabriel Rodriguez, Daniel Rodriguez Gonzalez, Xandra Yanina Rodriguez Tucto, Angela Rogers, María Elena Romano, Linda Rørtveit, Alastair Rose, Damien Roux, Anahita Rouze, Paolo Nahuel Rubatto Birri, Wang Ruilan, Aldana Ruiz Robledo, Antonio Luis Ruiz-Aguilar, Tomohito Sadahiro, Ignacio Saez, Judith Sagardia, Rajnish Saha, Rohit Saha, Narongkorn Saiphoklang, Shigeki Saito, Maie Salem, Gabriele Sales, Patricia Salgado, Srinivas Samavedam, Mhamed Sami Mebazaa, Line Samuelsson, Nandyelly San Juan Roman, Patricia Sanchez, Jesus Sanchez-Ballesteros, Yazcitk Sandoval, Emanuele Sani, Martin Santos, Carla Santos, Masamitsu Sanui, Lakshmikanthcharan Saravanabavan, Sema Sari, Agnes Sarkany, Bertrand Sauneuf, Monica Savioli, Hilal Sazak, Riccardo Scano, Francis Schneider, Frédérique Schortgen, Marcus J Schultz, Gabriele Leonie Schwarz, Faruk Seçkin Yücesoy, Andrew Seely, Frederik Seiler, Yasemin Seker Tekdos, Kim Seok Chan, Luca Serano, Wojciech Serednicki, Mariano Setten, Asim Shah, Bhagyesh Shah, You Shang, Pradeep Shanmugasundaram, Konstantin Shapovalov, Eman Shebl, Takuya Shiga, Nobuaki Shime, Phil Shin, Jack Short, Chen Shuhua, Sughrat Siddiqui, Juan Ignacio Silesky Jimenez, Daniel Silva, Betania Silva Sales, Koen Simons, Brit Ågot Sjøbø, David Slessor, Jakub Smiechowicz, Nathan Smischney, Paul Smith, Tim Smith, Mark Smith, Sarah Snape, Lindi Snyman, Filiep Soetens, Kyung Sook Hong, Miguel Ángel Sosa Medellin, Giovanna Soto, Xavier Souloy, Elsa Sousa, Stefania Sovatzis, Didem Sozutek, Savino Spadaro, Marco Spagnoli, Martin Spångfors, Nick Spittle, Mike Spivey, Andrew Stapleton, Branislava Stefanovic, Lorraine Stephenson, Elizabeth Stevenson, Kristian Strand, Maria Teresa Strano, Slavenka Straus, Chenliang Sun, Rongqing Sun, Venkat Sundaram, Tai SunPark, Elisabeth Surlemont, Yuda Sutherasan, Zsuzsanna Szabo, Christopher Tainter, Akihiro Takaba, Mandy Tallott, Tamasato Tamasato, Zhanhong Tang, Viratch Tangsujaritvijit, Leandro Taniguchi, Daisuke Taniguchi, Fabio Tarantino, Krittika Teerapuncharoen, Susana Temprano, Pierpaolo Terragni, Nicolas Terzi, Anand Thakur, Pongdhep Theerawit, Arnaud W Thille, Matt Thomas, Poungrat Thungtitigul, Martial Thyrault, Nejla Tilouch, Karina Timenetsky, Juna Tirapu, Manuel Todeschini, Roser Tomas, Christian Tomaszewski, Tommaso Tonetti, Alexandre Tonnelier, John Trinder, Konlawij Trongtrakul, Jonathon Truwit, Betty Tsuei, Aiman Tulaimat, Sema Turan, Melda Turkoglu, Sanjeev Tyagi, Alejandro Ubeda, Federica Vagginelli, María Florencia Valenti, Imma Vallverdu, Alisha Van Axel, Ingrid van den Hul, Hans van der Hoeven, Nardo Van Der Meer, Marc Vanhoof, Mónica Vargas-Ordoñez, Rosanna Vaschetto, Ettore Vascotto, Maria Vatsik, Ana Vaz, Antonia Vazquez-Sanchez, Sara Ventura, Jan Wytze Vermeijden, Anxela Vidal, Jocyelle Vieira, Bruno Vilela Costa Pinto, Ana Villagra, Cristina Villegas Succar, Ole Georg Vinorum, Giovanni Vitale, Ramesh Vj, Ana Vochin, Guillaume Voiriot, Carlo Alberto Volta, Magnus von Seth, Maazouzi Wajdi, Don Walsh, Shouhong Wang, Gabriel Wardi, Nils Christian Ween-Velken, Bi-Lin Wei, Dolf Weller, Deborah Welsh, Ingeborg Welters, Michael Wert, Simon Whiteley, Elizabeth Wilby, Erin Williams, Karen Williams, Antoinette Wilson, Jadwiga Wojtas, Jin Won Huh, David Wrathall, Christopher Wright, Jian-Feng Wu, Guo Xi, Zheng-Jiang Xing, Hongyang Xu, Kotaro Yamamoto, Jie Yan, Julio Yáñez, Xiaobo Yang, Elliot Yates, Ozlem Yazicioglu Mocin, Zhenglong Ye, Fatma Yildirim, Norifumi Yoshida, Hector Higo Leon Yoshido, Bo Young Lee, Rongguo Yu, Gong Yu, Tao Yu, Boyun Yuan, Nadwipa Yuangtrakul, Tetsuya Yumoto, Xie Yun, Graciela Zakalik, Ahmad Zaki, Begoña Zalba-Etayo, Massimo Zambon, Bin Zang, Gianluca Zani, Jonathan Zarka, Simone Maria Zerbi, Avsar Zerman, Harald Zetterquist, Jiuzhi Zhang, Hongwen Zhang, Wei Zhang, Guoxiu Zhang, Weixin Zhang, Hongsheng Zhao, Jia Zheng, Bin Zhu, and Ronald Zumaran
Abstract: Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 d
Published: 2023

7. Lung Ultrasound in Emergency and Critically Ill Patients

Author: Yuzhi Gao, Jie Lv, Wang Chunyao, Felippe Leopoldo Dexheimer Neto, Julio Neves, J. J. Rouby, Jean-Michel Constantin, Hélène Brisson, Fabiola Prior Caltabellotta, Luis Malbouisson, Jorge Salluh, Charlotte Arbelot, Du Bin, Antoine Monsel, Sébastien Perbet, Romain Deransy, Mao Zhang, Youzhong An, Emidio J. S. Lima, Carmen Silvia Valente Barbas, and Andres Cebey
Subjects: medicine.medical_specialty, Critically ill, business.industry, Ultrasound, MEDLINE, 030208 emergency & critical care medicine, 030204 cardiovascular system & hematology, Lung ultrasound, Basic skills, 03 medical and health sciences, 0302 clinical medicine, Anesthesiology and Pain Medicine, Intensive care, medicine, Medical physics, Prospective cohort study, business, Competence (human resources)
Abstract: Background Lung ultrasound is increasingly used in critically ill patients as an alternative to bedside chest radiography, but the best training method remains uncertain. This study describes a training curriculum allowing trainees to acquire basic competence. Methods This multicenter, prospective, and educational study was conducted in 10 Intensive Care Units in Brazil, China, France and Uruguay. One hundred residents, respiratory therapists, and critical care physicians without expertise in transthoracic ultrasound (trainees) were trained by 18 experts. The main study objective was to determine the number of supervised exams required to get the basic competence, defined as the trainees’ ability to adequately classify lung regions with normal aeration, interstitial–alveolar syndrome, and lung consolidation. An initial 2-h video lecture provided the rationale for image formation and described the ultrasound patterns commonly observed in critically ill and emergency patients. Each trainee performed 25 bedside ultrasound examinations supervised by an expert. The progression in competence was assessed every five supervised examinations. In a new patient, 12 pulmonary regions were independently classified by the trainee and the expert. Results Progression in competence was derived from the analysis of 7,330 lung regions in 2,562 critically ill and emergency patients. After 25 supervised examinations, 80% of lung regions were adequately classified by trainees. The ultrasound examination mean duration was 8 to 10 min in experts and decreased from 19 to 12 min in trainees (after 5 vs. 25 supervised examinations). The median training duration was 52 (42, 82) days. Conclusions A training curriculum including 25 transthoracic ultrasound examinations supervised by an expert provides the basic skills for diagnosing normal lung aeration, interstitial–alveolar syndrome, and consolidation in emergency and critically ill patients. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New
Published: 2020
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8. Intrahospital Trauma Flowcharts - cognitive aids for intrahospital trauma management from the French Society of Anaesthesia and Intensive Care Medicine and the French Society of Emergency Medicine

Author: Tobias Gauss, Hervé Quintard, Benjamin Bijok, Guillaume Bouhours, Thomas Clavier, Fabrice Cook, Hugues de Courson, Jean-Stéphane David, Caroline Duracher-Gout, Delphine Garrigue, Thomas Geeraerts, Sophie Hamada, Olivier Joannes-Boyau, Romain Jouffroy, Antoine Lamblin, Olivier Langeron, Pierre Lanot, Sigismond Lasocki, Marc Leone, Sébastien Mirek, Laurent Muller, Pierre Pasquier, Bertrand Prunet, Sébastien Perbet, Mathieu Raux, Justin Richards, Claire Roger, Antoine Roquilly, Emmanuel Weiss, Pierre Bouzat, Julien Pottecher, Bordeaux population health (BPH), and Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Anesthesiology and Pain Medicine, Traumatic Brain Injury, Resuscitation, Cognitive aid, Shock, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, General Medicine, Guideline, Damage Control, Critical Care and Intensive Care Medicine, Trauma
Published: 2022
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9. Urgence vitale intra-hospitalière : état des lieux en 2018

Author: Pierre Bouzat, Laurent Ducros, Guillaume Bouhours, Delphine Garigue, Julien Pottecher, Bertrand Prunet, Sébastien Perbet, Fabrice Cook, Claire Roger, Tobias Gauss, Antoine Lamblin, Pierre Michelet, Xavier Bobbia, and Romain Jouffroy
Subjects: 03 medical and health sciences, 0302 clinical medicine, Anesthesiology and Pain Medicine, 030212 general & internal medicine, 030204 cardiovascular system & hematology
Abstract: Resume Objectif En France, la prise en charge des urgences vitales intra-hospitalieres (UVIH) est peu connue malgre des recommandations d’experts de 2004. Cette etude visait a decrire l’organisation de leur prise en charge dans les hopitaux universitaires (HU). Methodes En 2017, une enquete descriptive, multicentrique, basee sur un questionnaire comportant 27 questions envoye par voie electronique au chef de service d’anesthesie reanimation a ete conduite. Resultats Trente-huit (sur 52) reponses (73 %) ont ete recueillies et analysees. La plupart des HU ont declare disposer d’une procedure UVIH : applicable a toutes les UVIH pour 29 (76 %) et uniquement dediee a l’arret cardiaque pour 8 HU (21 %). Un numero de telephone dedie existe dans 35 HU (92 %). L’interlocuteur est principalement le SAMU pour 11 (29 %), les urgences pour 6 (16 %) et la reanimation pour 5 HU (13 %). L’interlocuteur differe selon l’heure et/ou le service demandeur pour 22 HU (58 %). L’intervention de l’equipe de reponse aux urgences vitales intra-hospitalieres (ERUVIH) est realisee exclusivement par l’equipe des urgences dans 6 (16 %), de reanimation dans 5 (13 %) et variable dans 26 HU (74 %). L’ERUVIH est composee d’un medecin senior dans 36 (95 %), d’un interne dans 30 (79 %), d’un infirmier dans 32 (84 %) et d’un aide-soignant dans 16 HU (42 %). Conclusion Une procedure UVIH et un numero de telephone dedie existent dans la majorite des HU francais. Alors qu’un medecin senior est implique dans la plupart des ERUVIH, de grandes disparites subsistent dans la constitution de cette derniere entre les urgences, l’anesthesie reanimation et la reanimation.
Published: 2019
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10. Minimal alveolar concentration for deep sedation (MAC-DS) in intensive care unit patients sedated with sevoflurane: A physiological study

Author: Thomas Godet, Bruno Pereira, Franck Verdonk, Arthur James, Florian Blanchard, Jean-Etienne Bazin, Sébastien Perbet, Jean-Michel Constantin, Céline Lambert, Groupe de recherche clinique en anesthésie réanimation médecine périopératoire [CHU Pitié-Salpétrière] (GRC ARPE), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Pôle de Médecine Périopératoire [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Service d'Anesthésie réanimation [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Unité de Biostatistiques [CHU Clermont-Ferrand], and Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] (DRCI)
Subjects: Male, Icu patients, Critical Care, Sedation, medicine.medical_treatment, Critical Illness, [SDV]Life Sciences [q-bio], Clinical scale, Critical Care and Intensive Care Medicine, Sevoflurane, law.invention, 03 medical and health sciences, 0302 clinical medicine, Consciousness Monitors, Interquartile range, law, medicine, Humans, Hypnotics and Sedatives, 030212 general & internal medicine, Prospective Studies, Aged, Mechanical ventilation, business.industry, Volatile anesthetic, 030208 emergency & critical care medicine, General Medicine, Middle Aged, Intensive care unit, Respiration, Artificial, Pulmonary Alveoli, Anesthesiology and Pain Medicine, Anesthesia, Anesthetics, Inhalation, Female, medicine.symptom, Deep Sedation, business, medicine.drug
Abstract: Volatile anaesthetic agents, especially sevoflurane, could be an alternative for sedating ICU patients. In the operating theatre, volatile anaesthetic agents are monitored using minimal alveolar concentration (MAC). In ICU, MAC may be used to assess sedation level and may replace clinical scale especially when they are unusable. Therefore, we sought to investigate the minimal sevoflurane end-tidal concentration to achieved deep sedation in critical ill patients: MAC-deep sedation (MAC-DS).In a prospective interventional study, we included patients with a Richmond Assessment Sedation Score (RASS) of 0 without any sedation. We stepwise increased sevoflurane concentration level before assessing for deep sedation (RASS≤-3). MAC-DS was defined as the minimal sevoflurane MAC fraction or sevoflurane expiratory fraction (FeSevo) to get 90% and 95% of patients in deep sedation (MAC-DS 90 and MAC-DS 95, respectively).Between June and November 2014, 30 patients were included (median age=60 years [interquartile range: 47-69]). Increasing sevoflurane MAC was correlated with a decrease in RASS values (r=-0.83, P0.001). MAC-DS 90 and MAC-DS 95 were achieved at 0.42 MAC (CI 95 [0.38-0.46]) and 0.46 MAC (CI 95 [0.42-0.51]), respectively. FeSevo to achieve MAC-DS 90 and MAC-DS 95 was 0.72 (CI 95 [0.65-0.79]) and 0.80 (CI 95 [0.72-0.89]), respectively.In this physiological study involving 30 ICU patients, MAC-DS, end-tidal sevoflurane concentration to get 95% of patients in deep sedation determined over more than 500 observations, is achieved at 0.8% of expired fraction of sevoflurane or at 0.5 age-adjusted MAC.
Published: 2020
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11. Low doses of ketamine reduce delirium but not opiate consumption in mechanically ventilated and sedated ICU patients: A randomised double-blind control trial

Author: Renaud Guérin, Emmanuel Futier, Christian Chartier, Bruno Pereira, Sébastien Perbet, Thomas Godet, Sophie Cayot, Matthieu Jabaudon, Jean-Etienne Bazin, Jean-Michel Constantin, Franck Verdonk, and Dominique Morand
Subjects: Mechanical ventilation, business.industry, Sedation, medicine.medical_treatment, Remifentanil, 030208 emergency & critical care medicine, Context (language use), General Medicine, Perioperative, Critical Care and Intensive Care Medicine, Intensive care unit, law.invention, 03 medical and health sciences, 0302 clinical medicine, Anesthesiology and Pain Medicine, law, Anesthesia, Medicine, Delirium, Ketamine, 030212 general & internal medicine, medicine.symptom, business, medicine.drug
Abstract: Context Low doses of ketamine are commonly used to decrease opiates tolerance, hyperalgesia and delirium in perioperative theatre but these properties have never been studied in intensive care unit (ICU) patients. Purpose To determine the impact of ketamine infusion on opiates consumption when added to standard care in ICU patients requiring sedation for mechanical ventilation. Methods Patients admitted in a general ICU of a university hospital and undergoing mechanical ventilation (n = 162) with nurse-driven sedation protocol were randomly assigned into ketamine (2 mg/kg/h) or placebo in a double-blinded control trial. Patients were assessed for sedation and analgesia levels, opiates consumption and delirium (using the Confusion Assessment Method for ICU). Results Daily consumption of remifentanil (7.9 ± 1.0 vs. 9.3 ± 1.0 μg/kg/h, P = 0.548) and increase in remifentanil doses required for equianalgesia (0.107 ± 0.17 and 0.11 ± 0.18 μg/kg/min, P = 0.78) were not different between ketamine and control groups. The incidence was higher in the placebo group 30/82 (37%) than in the ketamine group 17/80 (21%) (P = 0.03). The duration of delirium was lower in ketamine group (5.3 ± 4.7 vs. 2.8 ± 3 days, P = 0.005). Mortality rates, ventilator-free days and ICU length of stay (LOS) were non-statistically different in both groups. Conclusions When the best practices of sedation (nurse-driven sedation, a consistent light-to-moderate sedation level, and delirium monitoring) are used for all patients, the addition of low doses of ketamine does not decrease opiate consumption but reduces delirium incidence and its duration in medico-surgical ICU patients with no effect on mortality rate and ICU LOS.
Published: 2018
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12. Intubation et extubation du patient de réanimation

Author: Hervé Quintard, Erwan l’Her, Julien Pottecher, Frédéric Adnet, Jean-Michel Constantin, Audrey Dejong, Pierre Diemunsch, Rose Fesseau, Anne Freynet, Christophe Girault, Christophe Guitton, Yan Hamonic, Eric Maury, Armand Mekontso-Dessap, Fabrice Michel, Paul Nolent, Sébastien Perbet, Gwenaël Prat, Antoine Roquilly, Karim Tazarourte, Nicolas Terzi, Arnaud W. Thille, Mikael Alves, Etienne Gayat, and Laurence Donetti
Subjects: Anesthesiology and Pain Medicine
Published: 2018
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13. Training for Lung Ultrasound Score Measurement in Critically Ill Patients

Author: Jean-Jacques Rouby, Charlotte Arbelot, Yuzhi Gao, Mao Zhang, Jie Lv, Youzhong An, Wang Chunyao, Du Bin, Carmen Silvia Valente Barbas, Felippe Leopoldo Dexheimer Neto, Fabiola Prior Caltabeloti, Emidio Lima, Andres Cebey, Sébastien Perbet, Jean-Michel Constantin, Hélène Brisson, Romain Deransy, Corinne Vezinet, Pierre Garçon, Nabil El Hadj Kacem, Denis Lemesle, Antoine Monsel, Qin Lu, Olivier Langeron, Frédérick Gay, Bruno Lucena, Luiz Malbouisson, Maria José Carvalho Carmona, Julio Neves, Paulo de Tarso Roth Dalcin, Guilherme de Paula Pinto Schettino, Alberto Biestro, Davi Cristovao, and Jorge Salluh
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Critically ill, business.industry, MEDLINE, 030208 emergency & critical care medicine, Critical Care and Intensive Care Medicine, Lung ultrasound, 03 medical and health sciences, 0302 clinical medicine, Text mining, 030228 respiratory system, Correspondence, medicine, Intensive care medicine, business
Published: 2018
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14. Outcomes in 886 Critically Ill Patients After Near-Hanging Injury

Author: Candice Belony, Guillaume Schnell, Caroline Durant, Gwenaëlle Jacq, Pascal Beuret, Emmanuelle Noel, Olivier Lesieur, Sébastien Perbet, Lucie Biard, Christophe Guitton, Nicolas Deye, Thomas Geeraerts, Pauline Moriss, Pierrick Cronier, Nicolas Girard, Charles Cerf, Cédric Daubin, Charlene Leparq, Guillaume Thiery, Elie Azoulay, Alexis Soummer, Pierre Kalfon, Jean Pierre Quenot, Michael Darmon, Quentin de Roux, Gwenhael Colin, Julien Mayaux, Adriaan Prisacariu, Cécile Carre, Abdelkader Ouchenir, Michael Piagnerelli, Laurent Argaud, François Vincent, Maleka Schenck, Vincent Das, Alain Cariou, Marc Danguy Des Déserts, Matthieu Resche-Rigon, Jonathan Chelly, Auguste Dargent, Sébastien Cavelot, Charlotte Martin, Stein Silva, Thibaut Baudic, Thomas Rossignol, Philippe Vignon, Marie Salvetti, Alexandre Demoule, Marc A. Simon, Bruno Mégarbane, Hamid Merdji, Bertrand Sauneuf, Frédéric Jacobs, Louise de Charentenay, Martin Cour, Delphine Bachelet, Bernard Cholley, Marine Paul, Ferhat Meziani, Nicolas Mongardon, Segolene Couraud, Stéphane Legriel, Nicolas Pichon, Jean-Baptiste Lascarrou, Centre Hospitalier de Versailles André Mignot (CHV), Groupe Hospitalier du Havre, Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], CHU Limoges, AfterROSC Network Group [Paris], Les Hôpitaux Universitaires de Strasbourg (HUS), Centre Hospitalier Sud Francilien, CH Evry-Corbeil, Génétique, Reproduction et Développement (GReD), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Hôpital Hôtel-Dieu de Nantes - Centre Hospitalier Universitaire de Nantes (Hôpital Hôtel-Dieu de Nantes - CHU de Nantes), Centre Hospitalier Le Mans (CH Le Mans), Hopital saint louis (LA ROCHELLE - Hôpital Saint Louis), CH La Rochelle, Hospices Civils de Lyon (HCL), Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Nanomédecine Régénérative (NanoRegMed), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'anesthésie-réanimation, hôpital Purpan, CHU Toulouse [Toulouse], Intensive Care Unit, Groupe Hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77000, Melun, Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital d'Instruction des Armées Clermont Tonnerre, Service de Santé des Armées, Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), CHU bobigny, Centre Hospitalier Intercommunal André Grégoire [Montreuil] (CHI André Gregoire), Hopital Saint-Louis [AP-HP] (AP-HP), Hôpital Foch [Suresnes], Hôpital de la Pitié-Salpêtrière, Centre Hospitalier de Roanne, Hôpital Louis Pasteur [Chartres], Centre Hospitalier Public du Cotentin (CHPC), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), CHU Henri Mondor, Equipe 2 : ECSTRA - Epidémiologie Clinique, STatistique, pour la Recherche en Santé (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, 12/17, FUNDING/SUPPORT: This study was supported by the Délégation à la Recherche Clinique et à l’Innovation de Versailles, the non-profit publicly funded research agency for the Versailles Hospital, Versailles, France [Grant 12/17]., CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon (CHD Vendée), Pôle Anesthésie Réanimation [CHU de Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CH Centre Hospitalier Public du Cotentin (CHPC), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S_1144 / U1144)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), CCSD, Accord Elsevier, Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), and CHU Henri Mondor [Créteil]
Subjects: Pulmonary and Respiratory Medicine, Adult, Male, medicine.medical_specialty, Multivariate analysis, near-hanging, medicine.medical_treatment, Critical Illness, [SDV]Life Sciences [q-bio], Suicide, Attempted, coma, Critical Care and Intensive Care Medicine, cardiopulmonary resuscitation, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Belgium, Interquartile range, Medicine, Humans, Glasgow Coma Scale, 030212 general & internal medicine, Cardiopulmonary resuscitation, Hospital Mortality, Retrospective Studies, Coma, business.industry, Glasgow Outcome Scale, Retrospective cohort study, Prognosis, Survival Analysis, Patient Discharge, 3. Good health, Heart Arrest, [SDV] Life Sciences [q-bio], Functional Status, 030228 respiratory system, SAPS II, Emergency medicine, ICU, outcome, CPR, Female, France, medicine.symptom, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; Background: Near-hanging experiences are life-threatening events about which few data are available. Research Question: What are the outcomes and early predictors of hospital mortality in critically ill patients who have undergone a near-hanging experience? Study Design and Methods: Adult patients who were resuscitated successfully after suicidal near-hanging injury admitted to 31 university or university-affiliated ICUs in France and Belgium between 1992 and 2014 were studied retrospectively. Patients were identified by searching the hospital databases for International Statistical Classification of Diseases and Related Health Problems, 9th and 10th revisions, codes and hospital charts for hanging. Logistic multivariate regression was performed to identify factors associated vital and functional outcomes at hospital discharge as the primary end points. Secondary outcomes were evaluation of temporal trends and identification of predictors of hospital mortality. Results: Of the 886 patients (181 women and 705 men; median age, 43 years; interquartile range, 34-52 years), 266 (30.0%) had attempted suicide previously, 600 (67.7%) had a diagnosed mental illness, and 55 (6.2%) attempted hanging while hospitalized. Median time from hanging awareness to unhanging was 0 min (interquartile range [IQR], 0-0; range, 0-82 min). Median Glasgow Coma Scale score was 3 (IQR, 3-5) at ICU admission. Hanging induced cardiac arrest in 450 of 886 patients (50.8%). Overall, 497 of 886 patients (56.1%) were alive at hospital discharge, including 479 of 497 patients (96.4%) with a favorable neurocognitive outcome (defined as a Glasgow Outcome Scale score of 4 or 5). By multivariate analysis, factors associated with hospital mortality were hanging-induced cardiac arrest (OR, 19.50; 95% CI, 7.21-60.90; P < .00001) and findings at ICU admission of glycemia level > 1.4 g/L (OR, 4.34; 95% CI, 1.82-10.81; P = .0007) and of lactate level > 3.5 mmol/L (OR, 9.98; 95% CI, 4.17-25.36; P < .00001). Interpretation: The findings from this large multicenter retrospective cohort emphasize the very high mortality after hanging injury chiefly because of hanging-induced cardiac arrest. However, patients who survive near-hanging experiences achieve excellent neurocognitive recovery. Studies of early neuroprotective strategies for patients who have undergone near-hanging experiences are warranted. Trial Registry: ClinicalTrials.gov; No.: NCT04096976; URL: www.clinicaltrials.gov
Published: 2020
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15. Ketamine infusion for sedation in ICU, response to Dr Mion

Author: Jean-Michel Constantin, Thomas Godet, and Sébastien Perbet
Subjects: business.industry, Sedation, Conscious Sedation, Delirium, General Medicine, Critical Care and Intensive Care Medicine, Respiration, Artificial, Intensive Care Units, Anesthesiology and Pain Medicine, Double-Blind Method, Anesthesia, medicine, Humans, Ketamine, medicine.symptom, business, medicine.drug
Published: 2019

16. Differential Perceptions of Noninvasive Ventilation in Intensive Care among Medical Caregivers, Patients, and Their Relatives

Author: Elie Azoulay, Keyvan Razazi, Emmanuelle Boutmy-Deslandes, Thomas Similowski, Alexandre Demoule, Vincent Labbé, Nicolas Mongardon, Romain Sonneville, Xavier Fabre, Vincent Peigne, Cédric Rafat, Nicolas Terzi, Clémence Minet, Emmanuel Guerot, Mikael Alves, Benjamin Sztrymf, Christophe Cracco, Sébastien Perbet, Martin Dres, Guillaume Tachon, François Collet, Danielle Reuter, Matthieu Schmidt, Pierre Andrivet, and Matthieu Conseil
Subjects: medicine.medical_specialty, business.industry, MEDLINE, Workload, Intensive care unit, law.invention, 03 medical and health sciences, 0302 clinical medicine, Anesthesiology and Pain Medicine, 030228 respiratory system, Interquartile range, law, Anesthesiology, Intensive care, medicine, Anxiety, 030212 general & internal medicine, medicine.symptom, business, Intensive care medicine, Prospective cohort study
Abstract: Background Noninvasive ventilation (NIV) requires a close “partnership” between a conscious patient and the patient’s caregivers. Specific perceptions of NIV stakeholders and their impact have been poorly described to date. The objectives of this study were to compare the perceptions of NIV by intensive care unit (ICU) physicians, nurses, patients, and their relatives and to explore factors associated with caregivers’ willingness to administer NIV and patients’ and relatives’ anxiety in relation to NIV. Methods This is a prospective, multicenter questionnaire-based study. Results Three hundred and eleven ICU physicians, 752 nurses, 396 patients, and 145 relatives from 32 ICUs answered the questionnaire. Nurses generally reported more negative feelings and more frequent regrets about providing NIV (median score, 3; interquartile range, [1 to 5] vs. 1 [1 to 5]; P < 0.0001) compared to ICU physicians. Sixty-four percent of ICU physicians and only 32% of nurses reported a high level of willingness to administer NIV, which was independently associated with NIV case-volume and workload. A high NIV session–related level of anxiety was observed in 37% of patients and 45% of relatives. “Dyspnea during NIV,” “long NIV session,” and “the need to have someone at the bedside” were identified as independent risk factors of high anxiety in patients. Conclusions Lack of willingness of caregivers to administer NIV and a high level of anxiety of patients and relatives in relation to NIV are frequent in the ICU. Most factors associated with low willingness to administer NIV by nurses or anxiety in patients and relatives may be amenable to change. Interventional studies are now warranted to evaluate how to reduce these risk factors and therefore contribute to better management of a potentially traumatic experience. (Anesthesiology 2016; 124:1347-59)
Published: 2016
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17. Sevoflurane for procedural sedation in critically ill patients: A pharmacokinetic comparative study between burn and non-burn patients

Author: Sébastien Perbet, Claire Biboulet, Jean-Marie Launay, Daniel Bourdeaux, Malha Sadoune, Alexandre Mebazaa, Valérie Sautou, Pascal Houzé, Matthieu Legrand, Alexandre Lenoire, Jean-Etienne Bazin, Benoit Plaud, Bruno Pereira, Jean-Michel Constantin, Génétique, Reproduction et Développement (GReD), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Médecine Intensive et Réanimation [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Service Pharmacie [CHU Clermont-Ferrand], CHU Louise Michel [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Department of Anaesthesiology and Critical Care and Burn Unit, St-Louis Hospital, service de Biostatistiques, DRCI, Service de biochimie INSERM UMR-S942, Hôpital Lariboisière-APHP, Université Paris Diderot - Paris 7 (UPD7), Department of biochemistry, Lariboisière hospital, Institut de Chimie de Clermont-Ferrand (ICCF), SIGMA Clermont (SIGMA Clermont)-Institut de Chimie du CNRS (INC)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Department of Pharmacology, St-Louis hospital, 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), CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand], and CHU Clermont-Ferrand-CHU Louise Michel [Clermont-Ferrand]
Subjects: Adult, Male, Critical Care, Propanols, Sedation, Critical Illness, [SDV]Life Sciences [q-bio], Conscious Sedation, Critical Care and Intensive Care Medicine, Kidney Function Tests, Sevoflurane, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Pharmacokinetics, Lipocalin-2, Intensive care, medicine, Humans, Prospective Studies, Aged, Volume of distribution, Aged, 80 and over, Critically ill, business.industry, Distribution volume, 030208 emergency & critical care medicine, General Medicine, Acute Kidney Injury, Middle Aged, Respiration, Artificial, 3. Good health, Pharmacokinetic analysis, Anesthesiology and Pain Medicine, Metabolism, 030228 respiratory system, Anesthesia, Toxicity, Anesthetics, Inhalation, Female, medicine.symptom, business, Burns, medicine.drug, Half-Life
Abstract: International audience; BackgroundSevoflurane has anti-inflammatory proprieties and short lasting effects making it of interest for procedural sedation in critically ill patients. We evaluated the pharmacokinetics of sevoflurane and metabolites in severely ill burn patients and controls. The secondary objective was to assess potential kidney injury.MethodsProspective interventional study in a burn and a surgical intensive care unit; 24 mechanically ventilated critically ill patients (12 burns, 12 controls) were included. The sevoflurane was administered with an expired fraction target of 2% during short-term procedural sedation. Plasma concentrations of sevoflurane, hexafluoroisopropanolol (HFIP) and free fluoride ions were recorded at different times. Kinetic Pro (Wgroupe, France) was used for pharmacokinetic analysis. Kidney injury was assessed with neutrophil gelatinase-associated lipocalin (NGAL).ResultsThe mean total burn surface area was 36 ± 11%. The average plasma concentration of sevoflurane was 70.4 ± 37.5 mg·L−1 in burns and 57.2 ± 28.1 mg·L−1 in controls at the end of the procedure (P = 0.58). The volume of distribution was higher (46.8 ± 7.2 vs 22.2 ± 2.50 L, P < 0.001), and the drug half-life longer in burns (1.19 ± 0.28 h vs 0.65 ± 0.04 h, P < 0.0001). Free metabolite HFIP was higher in burns. Plasma fluoride was not different between burns and controls. NGAL did not rise after procedures.ConclusionWe observed an increased volume of distribution, slower elimination rate, and altered metabolism of sevoflurane in burn patients compared to controls. Repeated use for procedural sedation in burn patients needs further evaluation. No renal toxicity was detected.
Published: 2018
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18. Experts' guidelines of intubation and extubation of the ICU patient of French Society of Anaesthesia and Intensive Care Medicine (SFAR) and French-speaking Intensive Care Society (SRLF) : In collaboration with the pediatric Association of French-speaking Anaesthetists and Intensivists (ADARPEF), French-speaking Group of Intensive Care and Paediatric emergencies (GFRUP) and Intensive Care physiotherapy society (SKR)

Author: Hervé Quintard, Sébastien Perbet, Laurence Donetti, Audrey De Jong, Christophe Guitton, Arnaud W. Thille, Pierre Diemunsch, Gwenaël Prat, Paul Nolent, Frédéric Adnet, Jean-Michel Constantin, Nicolas Terzi, Julien Pottecher, Armand Mekontso-Dessap, Antoine Roquilly, Yann Hamonic, Erwan L'Her, Eric Maury, Karim Tazarourte, Christophe Girault, Mikael Alves, Fabrice Michel, Rose Fesseau, Anne Freynet, and Etienne Gayat
Subjects: medicine.medical_specialty, Poor prognosis, business.industry, medicine.medical_treatment, Research, MEDLINE, 030208 emergency & critical care medicine, Critical Care and Intensive Care Medicine, Emergency situations, Intensive care unit, 3. Good health, law.invention, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, law, Anesthesiology, Intensive care, medicine, Intubation, Intensive care medicine, business
Abstract: Background Intubation and extubation of ventilated patients are not risk-free procedures in the intensive care unit (ICU) and can be associated with morbidity and mortality. Intubation in the ICU is frequently required in emergency situations for patients with an unstable cardiovascular or respiratory system. Under these circumstances, it is a high-risk procedure with life-threatening complications (20–50%). Moreover, technical problems can also give rise to complications and several new techniques, such as videolaryngoscopy, have been developed recently. Another risk period is extubation, which fails in approximately 10% of cases and is associated with a poor prognosis. A better understanding of the cause of failure is essential to improve success procedure. Results and conclusion In constructing these guidelines, the SFAR/SRLF experts have made use of new data on intubation and extubation in the ICU from the last decade to update existing procedures, incorporate more recent advances and propose algorithms.
Published: 2018

19. Dyspnea in patients receiving noninvasive ventilation for acute respiratory failure: prevalence, risk factors and prognostic impact – a prospective observational study

Author: Matthieu Resche-Rigon, Laurence Dangers, Alexandre Demoule, Ferhat Meziani, Thomas Similowski, Sébastien Perbet, Achille Kouatchet, Elie Azoulay, Claire Montlahuc, Samir Jaber, Neurophysiologie Respiratoire Expérimentale et Clinique, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), CHU Pitié-Salpêtrière [APHP], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Urgences médicales, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), PRES Université Nantes Angers Le Mans (UNAM), Service d'anesthésie et de réanimation B, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Mitochondries, stress oxydant et protection musculaire (Strasbourg), Mitochondrie, stress oxydant et protection musculaire (MSP), Université de Strasbourg (UNISTRA)-Université de Strasbourg (UNISTRA), Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), CHU Clermont-Ferrand, Département de l'information médicale et de la biostatistique [AP-HP Hôpital Saint-Louis], AP-HP Hôpital Saint-Louis, Hôpital Saint-Louis, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7), Equipe 2 : ECSTRA - Epidémiologie Clinique, STatistique, pour la Recherche en Santé (CRESS - U1153), Université Paris Diderot - Paris 7 (UPD7)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Pneumologie et Réanimation Médicale [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Université Paris-Sorbonne (UP4), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), and Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)
Subjects: Pulmonary and Respiratory Medicine, Mechanical ventilation, medicine.medical_specialty, Respiratory rate, business.industry, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Odds ratio, Intensive care unit, 3. Good health, law.invention, respiratory tract diseases, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Interquartile range, law, Emergency medicine, Severity of illness, medicine, 030212 general & internal medicine, Prospective cohort study, business, ComputingMilieux_MISCELLANEOUS, Cohort study
Abstract: Dyspnoea is a frequent and intense symptom in intubated patients, but little attention has been paid to dyspnoea during noninvasive mechanical ventilation in the intensive care unit (ICU).The objectives of this study were to quantify the prevalence, intensity and prognostic impact of dyspnoea in patients receiving noninvasive ventilation (NIV) for acute respiratory failure (ARF) based on secondary analysis of a prospective observational cohort study in patients who received ventilatory support for ARF in 54 ICUs in France and Belgium. Dyspnoea was measured by a modified Borg scale.Among the 426 patients included, the median (interquartile range) dyspnoea score was 4 (3-5) on admission and 3 (2-4) after the first NIV session (p=0.001). Dyspnoea intensity ≥4 after the first NIV session was associated with the Sequential Organ Failure Assessment Score (odds ratio (OR) 1.12, p=0.001), respiratory rate (OR 1.03, p=0.032), anxiety (OR 1.92, p=0.006), leaks (OR 2.5, p=0.002) and arterial carbon dioxide tension (OR 0.98, p=0.025). Dyspnoea intensity ≥4 was independently associated with NIV failure (OR 2.41, p=0.001) and mortality (OR 2.11, p=0.009), but not with higher post-ICU burden and altered quality of life.Dyspnoea is frequent and intense in patients receiving NIV for ARF and is associated with a higher risk of NIV failure and poorer outcome.
Published: 2018
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20. Strategic proposal for a national trauma system in France

Author: Delphine Garrigue, Guillaume de Saint Maurice, Jérôme Tonetti, Marc Leone, Benjamin Bijok, Jean François Payen, Groupe d’intérêt en traumatologie grave, Thomas Geeraerts, Romain Pirracchio, Isabelle Plenier, Sandrine Barbois, Julio Abba, Catherine Paugam-Burtz, Jonathan Charbit, Sébastien Perbet, Catherine Arvieux, Julien Picard, Abdel Nadji, Bruno Riou, Paul Balandraud, Sébastien Mirek, Sylvain Rigal, Pierre-Francois Wey, Frédéric Thony, Dominique Savary, Hicham Kobeiter, Thierry Secheresse, Jacques Duranteau, Xavier Bobbia, François-Xavier Ageron, Pierre Bouzat, Jean-Stéphane David, Karim Tazarourte, Pierre Albaladejo, Julien Ghelfi, Anatole Harrois, Albrice Levrat, Sophie Hamada, Julien Pottecher, Christophe Tresallet, Fabrice Cook, Julien Frandon, Tobias Gauss, Clinic of Abdominal, Thoracic and Vascular Surgery, Laveran Military Hospital, Marseille, France, parent, Biotop, Service d'anesthésie-réanimation, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Techniques pour l'Evaluation et la Modélisation des Actions de la Santé (TIMC-IMAG-ThEMAS), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), CHU Grenoble, Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes (UGA), Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de Soins Intensifs [Mondor], Hôpital Henri Mondor, Service d'anesthésie-réanimation [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Microcirculation, bioénergétique, inflammation et insuffisance circulatoire aiguë (URCT), Université Paris-Sud - Paris 11 (UP11)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris 13 (UP13)-Université Sorbonne Paris Cité (USPC), Fédération des Urgences - SAMU 59, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Toulouse [Toulouse], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Service d'anesthésie - réanimation chirurgicale [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital Beaujon, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon, Unité Générale de Soins Intensifs, Hôpital d'Estaing, Service d'Anesthésie-Réanimation [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Mitochondries, stress oxydant et protection musculaire (Strasbourg), Mitochondrie, stress oxydant et protection musculaire (MSP), Université de Strasbourg (UNISTRA)-Université de Strasbourg (UNISTRA), Clinic of Traumatology and Orthopaedics, Percy Military Hospital, Clamart, France, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [APHP], Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois], Laboratoire de Recherche sur les Apprentissages en Contexte (LaRAC), Centre d’enseignement par simulation (CEnSIM), Urgences Médicales, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Service central de radiologie et d'imagerie médicale, CHU Grenoble-Hôpital Michallon, Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Service de chirurgie générale d'endocrinologie [CHU Pitié–Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Institut franco-allemand de recherches de Saint-Louis (ISL), DGA-Matériaux et nanosciences d'Alsace, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Grenoble Institut des Neurosciences (GIN), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpitaux Universitaires Paris Nord Val de Seine, Académie de Médecine Militaire Française [Ecole du Val-de-Grâce, Paris], Ecole du Val-de-Grâce [Paris, France], Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Centre Hospitalier Universitaire [Grenoble] (CHU), CHU Lille, Hôpital Lapeyronie [Montpellier] (CHU), Université de Montpellier (UM), CHU Henri Mondor, Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital d'instruction des Armées Percy, Service de Santé des Armées, Université Paris-Saclay, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Hôpitaux Universitaires Paris Sud, Toulouse Neuro Imaging Center (ToNIC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Toulouse [Toulouse], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Nord [CHU - APHM], Université Paris Diderot - Paris 7 (UPD7), CHU Clermont-Ferrand, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris Descartes - Paris 5 (UPD5), Université Sorbonne Paris Cité (USPC), CHU Strasbourg, Hôpital de Hautepierre [Strasbourg], Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases [IHU ICAN], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Health Service and Performance Research (HESPER), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Hospices Civils de Lyon (HCL), Hôpital Edouard Herriot [CHU - HCL], Service de Chirurgie Générale, Viscérale et Endocrinienne [CHU Pitié-Sapêtrière], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire International de Neuroimagerie et Modélisation (Linem), Université Pierre et Marie Curie - Paris 6 (UPMC)-Université de Montréal (UdeM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital d'Instruction des Armées Desgenettes, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Université Paris 13 (UP13)-Université Paris-Sud - Paris 11 (UP11)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Université de Strasbourg (UNISTRA), and Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: National Health Programs, education, Strategy, Certification, Guidelines, Critical Care and Intensive Care Medicine, Trauma, [SHS]Humanities and Social Sciences, 03 medical and health sciences, 0302 clinical medicine, Trauma Centers, 030202 anesthesiology, Trauma Trauma system Guidelines Strategy Organisation, Medicine, Humans, Road map, Registries, Implementation, Data collection, Education, Medical, business.industry, Major trauma, Rehabilitation, 030208 emergency & critical care medicine, Trauma system, General Medicine, medicine.disease, Triage, Anesthesiology and Pain Medicine, Organisation, Scale (social sciences), Wounds and Injuries, Medical emergency, France, business, Trauma surgery, Delivery of Health Care
Abstract: International audience; In this road map for trauma in France, we focus on the main challenges for system implementation, surgical and radiology training and upon innovative training techniques. Regarding system organisation: procedures for triage, designation and certification of trauma centres are mandatory to implement trauma networks on a national scale. Data collection with registries must be created, with a core dataset defined and applied through all registries. Regarding surgical and radiology training, diagnostic-imaging processes should be standardised and the role of the interventional radiologist within the trauma team and the trauma network should be clearly defined. Education in surgery for trauma is crucial and recent changes in medical training in France will promote trauma surgery as a specific sub-specialty. Innovative training techniques should be implemented and be based on common objectives, scenarios and evaluation, so as to improve individual and team performances. The group formulated 14 proposals that should help to structure and improve major trauma management in France over the next 10 years.
Published: 2018
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21. Erratum to 'Intubation and extubation of the ICU patient' [Anaesth. Crit. Care Pain Med. 36 (5) (2017) 327-341]

Author: Nicolas Terzi, Y. Hamonic, M. Alves, A. Freynet, Karim Tazarourte, Etienne Gayat, Christophe Girault, A. De Jong, Jean-Michel Constantin, Arnaud W. Thille, Julien Pottecher, Pierre Diemunsch, L. Donetti, P. Nolent, Frédéric Adnet, Armand Mekontso-Dessap, Antoine Roquilly, Sébastien Perbet, Eric Maury, Christophe Guitton, Fabrice Michel, R. Fesseau, Erwan L'Her, Gwenaël Prat, and Hervé Quintard
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, General Medicine, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, Anesthesiology and Pain Medicine, 030202 anesthesiology, Emergency medicine, Medicine, Intubation, 030212 general & internal medicine, business
Published: 2018

22. Ventilation non-invasive dans la période postopératoire

Author: Jean-Etienne Bazin, Emmanuel Futier, and Sébastien Perbet
Subjects: business.industry, Emergency Medicine, Medicine, Emergency Nursing, business
Published: 2015
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23. Cost analysis of single-use (Ambu® aScope™) and reusable bronchoscopes in the ICU

Author: S. Bertran, V. Boïko-Alaux, M. Blanquet, C. Mourgues, J E Bazin, B. Longère, Sébastien Perbet, J. Delmas, P. Chennell, Jean-Michel Constantin, Génétique, Reproduction et Développement (GReD), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), 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), and SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)
Subjects: [SDV]Life Sciences [q-bio], Airway management, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, Medicine, 030212 general & internal medicine, Bronchoscopes, health care economics and organizations, Single use, Scope (project management), Health professionals, business.industry, Research, Fiberscope, Medico-economic analysis, University hospital, medicine.disease, 3. Good health, Percutaneous tracheostomy, 030228 respiratory system, Cost analysis, Medical emergency, business
Abstract: Background Flexible optical bronchoscopes are essential for management of airways in ICU, but the conventional reusable flexible scopes have three major drawbacks: high cost of repairs, need for decontamination, and possible transmission of infectious agents. The main objective of this study was to measure the cost of bronchoalveolar lavage (BAL) and percutaneous tracheostomy (PT) using reusable bronchoscopes and single-use bronchoscopes in an ICU of an university hospital. The secondary objective was to compare the satisfaction of healthcare professionals with reusable and single-use bronchoscopes. Methods The study was performed between August 2009 and July 2014 in a 16-bed ICU. All BAL and PT procedures were performed by experienced healthcare professionals. Cost analysis was performed considering ICU and hospital organization. Healthcare professional satisfaction with single-use and reusable scopes was determined based on eight factors. Sensitivity analysis was performed by applying discount rates (0, 3, and 5%) and by simulation of six situations based on different assumptions. Results At a discount rate of 3%, the costs per BAL for the two reusable scopes were 188.86€ (scope 1) and 185.94€ (scope 2), and the costs per PT for the reusable scope 1 and scope 2 and single-use scopes were 1613.84€, 410.24€, and 204.49€, respectively. The cost per procedure for the reusable scopes depended on the number of procedures performed, maintenance costs, and decontamination costs. Healthcare professionals were more satisfied with the third-generation single-use Ambu® aScope™. Conclusions The cost per procedure for the single-use scope was not superior to that for reusable scopes. The choice of single-use or reusable bronchoscopes in an ICU should consider the frequency of procedures and the number of bronchoscopes needed. Electronic supplementary material The online version of this article (doi:10.1186/s13613-016-0228-3) contains supplementary material, which is available to authorized users.
Published: 2017
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24. Intubation and extubation of the ICU patient

Author: Karim Tazarourte, Christophe Girault, Antoine Roquilly, M. Alves, Y. Hamonic, Sébastien Perbet, A. Freynet, L. Donetti, Armand Mekontso-Dessap, Christophe Guitton, R. Fesseau, Frédéric Adnet, Jean-Michel Constantin, Erwan L'Her, Eric Maury, Arnaud W. Thille, Gwenaël Prat, Nicolas Terzi, A. De Jong, Julien Pottecher, Fabrice Michel, Pierre Diemunsch, P. Nolent, Etienne Gayat, Hervé Quintard, Institut de pharmacologie moléculaire et cellulaire (IPMC), Université Nice Sophia Antipolis (... - 2019) (UNS), Université Côte d'Azur (UCA)-Université Côte d'Azur (UCA)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Nice (CHU Nice), CHRU Brest - Service de Réanimation Médicale (CHU - BREST - Réa Med), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Hôpital de Hautepierre [Strasbourg], Hôpital avicenne, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris 13 (UP13)-Hôpital Avicenne, Biomarqueurs CArdioNeuroVASCulaires (BioCANVAS), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Estaing [Clermont-Ferrand], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Groupe de Recherche sur le Handicap Ventilatoire (GRHV), CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institute for Research and Innovation in Biomedicine (IRIB), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier universitaire de Nantes (CHU Nantes), Service de Réanimation Médicale [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), 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), Hôpital de la Timone [CHU - APHM] (TIMONE), CHU Gabriel Montpied (CHU), CHU Clermont-Ferrand, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Health Service and Performance Research (HESPER), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Hypoxie et physiopathologies cardiovasculaire et respiratoire, Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Grenoble, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Centre hospitalier universitaire de Poitiers (CHU Poitiers), CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHI Poissy-Saint-Germain, Hôpital Lariboisière, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7), Centre National de la Recherche Scientifique (CNRS)-Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université Côte d'Azur (UCA), Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-CHU Rouen, Normandie Université (NU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, CHU Gabriel Montpied [Clermont-Ferrand], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Avicenne, Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rouen Normandie (UNIROUEN), Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Centre National de la Recherche Scientifique (CNRS)-Université Côte d'Azur (UCA), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hypoxie : Physiopathologie Respiratoire et Cardiovasculaire (HP2 ), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])
Subjects: Adult, medicine.medical_specialty, Critical Care, medicine.medical_treatment, MEDLINE, Critical Care and Intensive Care Medicine, Intensive Care Units, Pediatric, 03 medical and health sciences, 0302 clinical medicine, Intubation, Intratracheal, Medicine, Intubation, Humans, Child, ComputingMilieux_MISCELLANEOUS, Aged, business.industry, 030208 emergency & critical care medicine, General Medicine, Guideline, Middle Aged, Intensive Care Units, Anesthesiology and Pain Medicine, 030228 respiratory system, Emergency medicine, Airway Extubation, Patient Care, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience
Published: 2017
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25. Prevalence and Prognosis Impact of Patient-Ventilator Asynchrony in Early Phase of Weaning according to Two Detection Methods

Author: Marc Clavel, Nicolas Terzi, Achille Kouatchet, Camille Rolland-Debord, Sébastien Perbet, Tymothée Poitou, Alexandre Demoule, Thomas Similowski, Lisa Belin, and Côme Bureau
Subjects: Male, medicine.medical_specialty, Pressure support ventilation, law.invention, Positive-Pressure Respiration, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Interquartile range, law, Risk Factors, Internal medicine, medicine, Neurally adjusted ventilatory assist, Prevalence, Weaning, Humans, Interactive Ventilatory Support, Aged, business.industry, 030208 emergency & critical care medicine, Middle Aged, Prognosis, Respiration, Artificial, Asynchrony (computer programming), Diaphragm (structural system), Anesthesiology and Pain Medicine, 030228 respiratory system, Cardiology, Female, France, business, Early phase, Ventilator Weaning
Abstract: Background Patient–ventilator asynchrony is associated with a poorer outcome. The prevalence and severity of asynchrony during the early phase of weaning has never been specifically described. The authors’ first aim was to evaluate the prognosis impact and the factors associated with asynchrony. Their second aim was to compare the prevalence of asynchrony according to two methods of detection: a visual inspection of signals and a computerized method integrating electromyographic activity of the diaphragm. Methods This was an ancillary study of a multicenter, randomized controlled trial comparing neurally adjusted ventilatory assist to pressure support ventilation. Asynchrony was quantified at 12, 24, 36, and 48 h after switching from controlled ventilation to a partial mode of ventilatory assistance according to the two methods. An asynchrony index greater than or equal to 10% defined severe asynchrony. Results A total of 103 patients ventilated for a median duration of 5 days (interquartile range, 3 to 9 days) were included. Whatever the method used for quantification, severe patient–ventilator asynchrony was not associated with an alteration of the outcome. No factor was associated with severe asynchrony. The prevalence of asynchrony was significantly lower when the quantification was based on flow and pressure than when it was based on the electromyographic activity of the diaphragm at 0.3 min–1 (interquartile range, 0.2 to 0.8 min–1) and 4.7 min–1 (interquartile range, 3.2 to 7.7 min–1; P < 0.0001), respectively. Conclusions During the early phase of weaning in patients receiving a partial ventilatory mode, severe patient–ventilator asynchrony was not associated with adverse clinical outcome, although the prevalence of patient–ventilator asynchrony varies according to the definitions and methods used for detection.
Published: 2017

26. Enteral Feeding and Noninvasive Ventilation

Author: Sébastien Perbet, Lionel Bouvet, and Jean-Michel Constantin
Subjects: Mechanical ventilation, COPD, medicine.medical_specialty, Exacerbation, business.industry, medicine.medical_treatment, Airway obstruction, medicine.disease, Enteral administration, Pneumonia, Parenteral nutrition, medicine, Airway, business, Intensive care medicine
Abstract: In the last decades, noninvasive ventilation (NIV) has been increasingly applied in a growing number of acute care settings and conditions for prevention or treatment of acute respiratory failure (ARF). Its efficacy has been evaluated in several randomized trials, and it is currently considered a first-line treatment in some common conditions such as chronic obstructive pulmonary disease (COPD) exacerbation, cardiogenic pulmonary edema, pneumonia in immunosuppressed patients, and postoperative ARF [1]. However, so far its benefit on survival has not yet been demonstrated for many indications, and its utilization is more and more challenging at least for ARF; physicians’ daily use of NIV in acute care setting and the question of nutritional support for patients on NIV remain a hot topic. Early enteral nutrition (EN) is recommended for mechanically ventilated patients in several studies and guidelines [2]. Enteral nutrition reportedly reduces the duration of mechanical ventilation and hospitalization and enhances patient survival. However, the effects of early EN on NIV have not been investigated extensively. In addition, EN has shown adverse effects, including critical ones. Patients receiving NIV may experience various complications, including airway problems (vomiting, increased sputum, mucus plugging, and atelectasis) and other problems (discomfort, pneumothorax, hypotension, cardiac rhythm disturbances, and anxiety). Enteral nutrition may worsen these complications, especially airway complications, possibly leading to critical problems, such as pneumonia and airway obstruction. Moreover, unlike for invasive ventilation, no methods of airway protection have been established for NIV. Despite the advantages of EN in patients with acute respiratory failure, the effects of EN in patients receiving NIV have not been clarified. Only one study directly related to this topic has been published [3]. In this monocentric retrospective study, the authors analyzed 107 patients over 8 years admitted in their ICU for ARF treated by NIV, 60 with EN and 47 without. The rate of airway complications was significantly higher (53% vs. 32%, P = 0.03), and the median NIV duration was significantly longer (16 vs. 8 days, P = 0.02) in subjects who received EN than in those who did not. No difference in hospital or overall mortality was shown. They concluded that among subjects receiving NIV, EN was associated with increased risk of airway complications but did not affect mortality. Because no conclusion could be drawn from this study, and in the absence of ongoing RCT, a physiological approach must be proposed for daily practice in ICU setting.
Published: 2017
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27. Immediate interruption of sedation compared with usual sedation care in critically ill postoperative patients (SOS-Ventilation): a randomised, parallel-group clinical trial

Author: Gerald Chanques, Matthieu Conseil, Claire Roger, Jean-Michel Constantin, Albert Prades, Julie Carr, Laurent Muller, Boris Jung, Fouad Belafia, Moussa Cissé, Jean-Marc Delay, Audrey de Jong, Jean-Yves Lefrant, Emmanuel Futier, Grégoire Mercier, Nicolas Molinari, Samir Jaber, Audrey De Jong, Daniel Verzilli, Noémie Clavieras, Emmanuelle Mathieu, Héléna Bertet, Caroline Boutin, Sophie Cayot, Sébastien Perbet, Matthieu Jabaudon, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), CHU Clermont-Ferrand, Service de Soins Intensifs et Anesthésiologie, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-CHU Saint-Eloi, Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), Université Montpellier 1 (UM1)-Université de Montpellier (UM), 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]), Centre d'Etudes Politiques de l'Europe Latine (CEPEL), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Institut Montpelliérain Alexander Grothendieck (IMAG), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Saint Eloi (CHRU Montpellier), and 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)
Subjects: Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, Time Factors, Critical Care, medicine.medical_treatment, Sedation, Critical Illness, Conscious Sedation, Minimisation (clinical trials), [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Drug Administration Schedule, 03 medical and health sciences, 0302 clinical medicine, Tracheotomy, Intensive care, medicine, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, Hypnotics and Sedatives, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Aged, Mechanical ventilation, Postoperative Care, business.industry, Organ dysfunction, 030208 emergency & critical care medicine, Middle Aged, Respiration, Artificial, 3. Good health, Surgery, Clinical trial, Intensive Care Units, Anesthesia, Female, medicine.symptom, business, Abdominal surgery
Abstract: Summary Background Avoidance of excessive sedation and subsequent prolonged mechanical ventilation in intensive care units (ICUs) is recommended, but no data are available for critically ill postoperative patients. We hypothesised that in such patients stopping sedation immediately after admission to the ICU could reduce unnecessary sedation and improve patient outcomes. Methods We did a randomised, parallel-group, clinical trial at three ICUs in France. Stratified randomisation with minimisation (1:1 via a restricted web platform) was used to assign eligible patients (aged ≥18 years, admitted to an ICU after abdominal surgery, and expected to require at least 12 h of mechanical ventilation because of a critical illness defined by a Sequential Organ Failure Assessment score >1 for any organ, but without severe acute respiratory distress syndrome or brain injury) to usual sedation care provided according to recommended practices (control group) or to immediate interruption of sedation (intervention group). The primary outcome was the time to successful extubation (defined as the time from randomisation to the time of extubation [or tracheotomy mask] for at least 48 h). All patients who underwent randomisation (except for those who were excluded after randomisation) were included in the intention-to-treat analysis. This study is registered with ClinicalTrials.gov, number NCT01486121. Findings Between Dec 2, 2011, and Feb 27, 2014, 137 patients were randomly assigned to the control (n=68) or intervention groups (n=69). In the intention-to-treat analysis, time to successful extubation was significantly lower in the intervention group than in the control group (median 8 h [IQR 4–36] vs 50 h [29–93], group difference −33·6 h [95% CI −44·9 to −22·4]; p Interpretation Immediate interruption of sedation in critically ill postoperative patients with organ dysfunction who were admitted to the ICU after abdominal surgery improved outcomes compared with usual sedation care. These findings support interruption of sedation in these patients following transfer from the operating room. Funding Delegation a la Recherche Clinique et a l'Innovation du Groupement de Cooperation Sanitaire de la Mission d'Enseignement, de Recherche, de Reference et d'Innovation (DRCI-GCS-MERRI) de Montpellier-Nimes.
Published: 2017
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28. Comparison of video-based learning and lecture-based learning for training of ultrasound-guided central venous catheterization: a randomized controlled trial

Author: H. Boby, Bruno Pereira, Pierre-Marie Bertrand, Sébastien Perbet, S. Bertran, and A Lautrette
Subjects: medicine.medical_specialty, Catheterization, Central Venous, 020205 medical informatics, Venous catheterization, Critical Care, Video Recording, 02 engineering and technology, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Anesthesiology, 0202 electrical engineering, electronic engineering, information engineering, Medicine, Humans, Learning, Single-Blind Method, 030212 general & internal medicine, Prospective Studies, Ultrasonography, Interventional, Video recording, Video based learning, business.industry, Teaching, Internship and Residency, Ultrasound guided, Anesthesiology and Pain Medicine, Physical therapy, Clinical Competence, Ultrasonography, Clinical competence, business
Published: 2017

29. Impact of the Anesthetic Conserving Device on Respiratory Parameters and Work of Breathing in Critically Ill Patients under Light Sedation with Sevoflurane

Author: Russell Chabanne, Bruno Pereira, Emmanuel Futier, Samir Jaber, Nordine Ait Ben Said, Sébastien Perbet, Jean-Michel Constantin, and Jean-Etienne Bazin
Subjects: Adult, Male, Methyl Ethers, Critical Illness, Sedation, Remifentanil, Richmond Agitation-Sedation Scale, Sevoflurane, law.invention, Work of breathing, law, medicine, Humans, Hypnotics and Sedatives, Prospective Studies, Aged, Work of Breathing, business.industry, Middle Aged, Respiration, Artificial, Intensive care unit, Anesthesiology and Pain Medicine, Anesthesia, Respiratory Mechanics, Breathing, Female, medicine.symptom, business, Respiratory minute volume, medicine.drug
Abstract: Background:Sevoflurane sedation in the intensive care unit is possible with a special heat and moisture exchanger called the Anesthetic Conserving Device (ACD) (AnaConDa®; Sedana Medical AB, Uppsala, Sweden). The ACD, however, may corrupt ventilatory mechanics when used during the weaning process of intensive care unit patients. The authors compared the ventilatory effects of light-sedation with sevoflurane administered with the ACD and those of classic management, consisting of a heated humidifier and intravenous sedation, in intensive care unit patients receiving pressure-support ventilation.Methods:Fifteen intensive care unit patients without chronic pulmonary disease were included. A target Richmond Agitation Sedation Scale level of −1/−2 was obtained with intravenous remifentanil (baseline 1-condition). Two successive interventions were tested: replacement of the heated humidifier by the ACD without sedation change (ACD-condition) and sevoflurane with the ACD with an identical target level (ACD-sevoflurane-condition). Patients finally returned to baseline (baseline 2-condition). Work of breathing, ventilatory patterns, blood gases, and tolerance were recorded. A steady state of 30 min was achieved for each experimental condition.Results:ACD alone worsened ventilatory parameters, with significant increases in work of breathing (from 1.7 ± 1.1 to 2.3 ± 1.2 J/l), minute ventilation, P0,1, intrinsic positive end-expiratory pressure (from 1.3 ± 2.6 to 4.7 ± 4.2 cm H2O), inspiratory pressure swings, and decreased patient comfort. Sevoflurane normalized work of breathing (from 2.3 ± 1.2 to 1.8 ± 1 J/l), intrinsic positive end-expiratory pressure (from 4.7 ± 4.2 to 1.8 ± 2 cm H2O), inspiratory pressure swings, other ventilatory parameters, and patient tolerance.Conclusions:ACD increases work of breathing and worsens ventilatory parameters. Sevoflurane use via the ACD (for a light-sedation target) normalizes respiratory parameters. In this patient’s population, light-sedation with sevoflurane and the ACD may be possible during the weaning process.
Published: 2014
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30. Repeated early hemofiltration filters clotting and heparin-induced thrombocytopenia in ICU

Author: Jean-Michel Constantin, Thomas Godet, Sébastien Perbet, Anne-Françoise Sapin, and Aurélien Lebreton
Subjects: Male, Methicillin-Resistant Staphylococcus aureus, Serotonin, medicine.medical_specialty, Time Factors, Scoring system, Critical Care, medicine.medical_treatment, Health Informatics, Critical Care and Intensive Care Medicine, Severity of Illness Index, Recurrence, Heparin-induced thrombocytopenia, Anesthesiology, Hemofiltration, medicine, Humans, Platelet activation, Blood Coagulation, Aged, 80 and over, Heparin, Platelet Count, business.industry, Hemodynamics, Thrombosis, Staphylococcal Infections, Platelet Activation, medicine.disease, Thrombocytopenia, Surgery, Pre- and post-test probability, Intensive Care Units, Anesthesiology and Pain Medicine, Immunoglobulin G, Anesthesia, business, medicine.drug
Abstract: Repeated early hemofiltration filter clotting are real thrombotic events. Diagnosis of heparin-induced thrombocytopenia (HIT) in this setting in ICU remains difficult. We describe two cases of repeated early hemofiltration filters clotting in ICU and to evaluate their impact on the probability test 4T’s score and diagnosis of HIT. Two patients undergoing at least three repeated early hemofiltration clotting filters in
Published: 2014
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31. Utilisation de la voie intraosseuse chez l’adulte en France en 2012

Author: Sébastien Perbet, Jean-Michel Constantin, S. Colomb, B. Abbal, Jean-Etienne Bazin, Stephan Ehrmann, and B. Pereira
Subjects: Anesthesiology and Pain Medicine, General Medicine
Abstract: Resume Objectif Evaluer les connaissances theoriques et pratiques sur les catheters intraosseux (CIO) chez l’adulte en France en 2012. Type d’etude Etude observationnelle descriptive transversale nationale de type enquete d’opinion et de pratique. Materiels et methodes Un courriel, avec un lien vers un questionnaire automatise en ligne, a ete adresse aux medecins et internes en poste dans les services d’anesthesie, de reanimation et de medecine d’urgence de France. Les questions posees portaient sur les connaissances theoriques et l’experience pratique de l’utilisation de dispositifs intraosseux. Resultats Sur les 1359 reponses obtenues, 396 (29 %) praticiens avaient deja utilise un CIO, principalement en cas d’ACR (68 %). L’assurance des operateurs et la proportion de medecins ayant deja pose un CIO augmentaient avec les annees d’experience. Les raisons justifiant le non-recours a cette voie etaient principalement l’absence de difficulte a la pose d’une voie veineuse peripherique (77 %) et la meconnaissance du materiel et de la technique (32 %). Plus de la moitie (n = 753 [55 %]) des praticiens avaient recu une formation et 90 % (n = 265) des medecins non formes la jugeaient necessaire. Les systemes motorises etaient majoritairement utilises (71 %). Conclusion Seulement 29 % des praticiens francais interroges declaraient avoir deja mis en place un CIO. Avec l’avenement des dispositifs les plus recents, une formation theorique et pratique s’avere indispensable pour l’essor de la technique.
Published: 2014
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32. Trachéotomies en réanimation et devenir des patients : enquête déclarative nationale

Author: Raiko Blondonnet, S. Kauffmann, Sébastien Perbet, R. Chabanne, T. Godet, J. Pascal, and B. Pereira
Subjects: Anesthesiology and Pain Medicine, General Medicine
Abstract: Resume Objectifs La tracheotomie est une procedure frequente en reanimation, mais le devenir post-reanimation des patients est peu documente. Nous avons realise une enquete declarative de pratique aupres de reanimateurs francais exercant en reanimation polyvalente et a orientation neurologique concernant les patients tracheotomises en reanimation et leur devenir post-reanimation. Type d’etude Etude observationnelle descriptive transversale nationale de type enquete d’opinion et de pratique. Materiel et methodes Un courriel a ete adresse a deux medecins de chaque reanimation francaise identifiee. Le questionnaire comprenait des donnees demographiques et relevait les pratiques concernant les indications, la technique et la gestion post-reanimation. Resultats Cent quarante-huit reponses de praticiens de services differents ont ete obtenues dont 15 % de neuroreanimateurs. Il n’y avait pas de difference entre reanimateurs polyvalents et neuroreanimateurs concernant le recours declare a la tracheotomie (10 ± 13 % vs 20 ± 22 % ; p = 0,05) et le delai de realisation (majoritairement entre j10 et j21). Les indications rapportees etaient les echecs de sevrage respiratoire et dysfonctions ventilatoires d’origine neurologique. La technique declaree etait majoritairement percutanee. Seulement 48 % des praticiens declaraient parvenir a sevrer la canule. Des difficultes pour le transfert post-reanimation etaient retrouvees 4 fois sur 5. Quatre-vingt-neuf pour cent des medecins interroges estimaient que cette prise en charge pourrait etre amelioree. Conclusion Les tracheotomies sont frequentes, majoritairement realisees par voie percutanee. Les indications et delais declares correspondent aux recommandations. Les difficultes ressenties de prise en charge et de gestion post-reanimation sont importantes a l’echelon national.
Published: 2014
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33. Epidemiology and outcome predictors in 450 patients with hanging-induced cardiac arrest: a retrospective study

Author: Marie Salvetti, Guillaume Schnell, Nicolas Pichon, Maleka Schenck, Pierrick Cronier, Sebastien Perbet, Jean-Baptiste Lascarrou, Christophe Guitton, Olivier Lesieur, Laurent Argaud, Gwenhael Colin, Bernard Cholley, Jean-Pierre Quenot, Hamid Merdji, Thomas Geeraerts, Michael Piagnerelli, Gwenaelle Jacq, Marine Paul, Jonathan Chelly, Louise de Charentenay, Nicolas Deye, Marc Danguy des Déserts, Guillaume Thiery, Marc Simon, Vincent Das, Frederic Jacobs, Charles Cerf, Julien Mayaux, Pascal Beuret, Abdelkader Ouchenir, Antoine Lafarge, Bertrand Sauneuf, Cedric Daubin, Alain Cariou, Stein Silva, and Stephane Legriel
Subjects: near-hanging, intensive care unit, coma/therapy, outcome, cardiopulmonary resuscitation, Neurology. Diseases of the nervous system, RC346-429
Abstract: BackgroundCardiac arrest is the most life-threatening complication of attempted suicide by hanging. However, data are scarce on its characteristics and outcome predictors.MethodsThis retrospective observational multicentre study in 31 hospitals included consecutive adults admitted after cardiac arrest induced by suicidal hanging. Factors associated with in-hospital mortality were identified by multivariate logistic regression with multiple imputations for missing data and adjusted to the temporal trends over the study period.ResultsOf 450 patients (350 men, median age, 43 [34–52] years), 305 (68%) had a psychiatric history, and 31 (6.9%) attempted hanging while hospitalized. The median time from unhanging to cardiopulmonary resuscitation was 0 [0–5] min, and the median time to return of spontaneous circulation (ROSC) was 20 [10–30] min. Seventy-nine (18%) patients survived to hospital discharge. Three variables were independently associated with higher in-hospital mortality: time from collapse or unhanging to ROSC>20 min (odds ratio [OR], 4.71; 95% confidence intervals [95%CIs], 2.02–10.96; p = 0.0004); glycaemia >1.4 g/L at admission (OR, 6.38; 95%CI, 2.60–15.66; p < 0.0001); and lactate >3.5 mmol/L at admission (OR, 6.08; 95%CI, 1.71–21.06; p = 0.005). A Glasgow Coma Scale (GCS) score of >5 at admission was associated with lower in-hospital mortality (OR, 0.009; 95%CI, 0.02–0.37; p = 0.0009).ConclusionIn patients with hanging-induced cardiac arrest, time from collapse or unhanging to return of spontaneous circulation, glycaemia, arterial lactate, and coma depth at admission were independently associated with survival to hospital discharge. Knowledge of these risk factors may help guide treatment decisions in these patients at high risk of hospital mortality.
Published: 2023
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34. Lung ultrasonography for assessment of oxygenation response to prone position ventilation in ARDS

Author: Coralie Vigne, Jean-Jacques Rouby, Emmanuelle Hammad, Sébastien Perbet, Olivier Langeron, Alexandre Noel, Qin Lu, Eric Peytel, Laurent Papazian, Laurent Muller, Claude Martin, Belaid Bouhemad, Alice Baldovini, Marc Leone, Laurent Zieleskiewicz, Malik Haddam, Jean-Michel Constantin, François Antonini, Jean-Louis Golmard, Christophe Guervilly, Charlotte Arbelot, Samuel Lehingue, Service Anesthésie et Réanimation [Hôpital Nord - APHM], Aix Marseille Université ( AMU ) -Assistance Publique - Hôpitaux de Marseille ( APHM ) - Hôpital Nord [CHU - APHM], Unité Générale de Soins Intensifs, Hôpital d'Estaing, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes ( URMITE ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR48, INSB-INSB-Centre National de la Recherche Scientifique ( CNRS ), CHU Pitié-Salpêtrière [APHP], Université Pierre et Marie Curie - Paris 6 ( UPMC ), Hôpital d'Instruction des Armées Laveran, Hôpital d'instruction des armées Laveran, Multidisciplinary intensive care unit, UFR des Sciences de Santé (Université de Bourgogne), Université de Bourgogne ( UB ), Service d'anesthésie - réanimation chirurgicale [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Département de Biostatistiques [Paris], Assistance publique - Hôpitaux de Paris (AP-HP), Études des Structures, des Processus d’Adaptation et des Changements de l’Espace ( ESPACE ), Université Nice Sophia Antipolis ( UNS ), Université Côte d'Azur ( UCA ) -Université Côte d'Azur ( UCA ) -Université d'Avignon et des Pays de Vaucluse ( UAPV ) -Aix Marseille Université ( AMU ) -Centre National de la Recherche Scientifique ( CNRS ), Centre interdisciplinaire de recherche en biologie ( CIRB ), Collège de France ( CdF ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Département anesthésie et réanimation, CHU Clermont-Ferrand-Hôpital d'Estaing, Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 (UPMC), Université de Bourgogne (UB), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Études des Structures, des Processus d’Adaptation et des Changements de l’Espace (ESPACE), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Avignon Université (AU)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Service d'Anésthésie Réanimation [CHU Clermont-Ferrand], Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), and Université Nice Sophia Antipolis (1965 - 2019) (UNS)
Subjects: ARDS, Supine position, Critical Care and Intensive Care Medicine, 03 medical and health sciences, Prone position, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, medicine, Prospective cohort study, Lung, Lung ultrasound, Acute respiratory distress syndrome, business.industry, 030208 emergency & critical care medicine, Oxygenation, medicine.disease, [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, medicine.anatomical_structure, 030228 respiratory system, Anesthesia, Predictive value of tests, Breathing, Recruitment, business
Abstract: IF 12.015; International audience; Prone position (PP) improves oxygenation and outcome of acute respiratory distress syndrome (ARDS) patients with a PaO2/FiO(2) ratio < 150 mmHg. Regional changes in lung aeration can be assessed by lung ultrasound (LUS). Our aim was to predict the magnitude of oxygenation response after PP using bedside LUS. We conducted a prospective multicenter study that included adult patients with severe and moderate ARDS. LUS data were collected at four time points: 1 h before (baseline) and 1 h after turning the patient to PP, 1 h before and 1 h after turning the patient back to the supine position. Regional lung aeration changes and ultrasound reaeration scores were assessed at each time. Overdistension was not assessed. Fifty-one patients were included. Oxygenation response after PP was not correlated with a specific LUS pattern. The patients with focal and non-focal ARDS showed no difference in global reaeration score. With regard to the entire PP session, the patients with non-focal ARDS had an improved aeration gain in the anterior areas. Oxygenation response was not associated with aeration changes. No difference in PaCO2 change was found according to oxygenation response or lung morphology. In ARDS patients with a PaO2/FiO(2) ratio aecurrency sign150 mmHg, bedside LUS cannot predict oxygenation response after the first PP session. At the bedside, LUS enables monitoring of aeration changes during PP.
Published: 2016
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35. Effect of non-invasive oxygenation strategies in immunocompromised patients with severe acute respiratory failure: a post-hoc analysis of a randomised trial

Author: Thierry Boulain, Christophe Girault, Laurent Brochard, Arnaud W. Thille, Gwenaël Prat, Alain Mercat, Jean-Damien Ricard, Rémi Coudroy, René Robert, Stéphanie Ragot, Sébastien Perbet, Alexandre Demoule, Jean-Pierre Frat, Service de Réanimation, Hôpital Jean Bernard, CHU de Poitiers, Poitiers, France, Immunologie antivirale systémique et cérébrale, Université Paris-Sud - Paris 11 (UP11)-IFR93-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Rouen, Normandie Université (NU), Groupe de Recherche sur le Handicap Ventilatoire (GRHV), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institute for Research and Innovation in Biomedicine (IRIB), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Unité Générale de Soins Intensifs, CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, CHRU Brest - Service de Réanimation Médicale (CHU - BREST - Réa Med), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Réanimation Polyvalente, Hôpital de la source, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier universitaire de Poitiers (CHU Poitiers), CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Poitiers - Faculté de Médecine et de Pharmacie, Université de Poitiers, Réanimation Médicale, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Physiologie respiratoire, Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-CHU Rouen, and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, medicine.medical_treatment, Neutropenia, medicine.disease_cause, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Oxygen therapy, Intensive care, medicine, Intubation, ComputingMilieux_MISCELLANEOUS, business.industry, 030208 emergency & critical care medicine, medicine.disease, Cannula, 3. Good health, Surgery, 030228 respiratory system, Respiratory failure, Anesthesia, business, Nasal cannula
Abstract: Summary Background The use of non-invasive ventilation is controversial in immunocompromised patients with acute respiratory failure, whereas the use of high-flow nasal cannula oxygen therapy is growing as an alternative to standard oxygen. We aimed to compare outcomes of immunocompromised patients with acute respiratory failure treated with standard oxygen with those treated with high-flow nasal cannula oxygen alone or high-flow nasal cannula oxygen associated with non-invasive ventilation. Methods We did a post-hoc subgroup analysis in a subset of immunocompromised patients with non-hypercapnic acute respiratory failure from a multicentre, randomised, controlled trial. In the trial, patients from 23 intensive care units in France and Belgium were randomly assigned (1:1:1) to receive either standard oxygen, high-flow nasal cannula alone, or non-invasive ventilation interspaced with high-flow nasal cannula between non-invasive ventilation sessions (non-invasive ventilation group). Patients with profound neutropenia, acute-on-chronic respiratory failure, cardiogenic pulmonary oedema, shock, or altered consciousness were excluded. The primary outcome was the proportion of patients who required endotracheal intubation within 28 days after randomisation. Findings Of the 82 immunocompromised patients, 30 were treated with standard oxygen, 26 with high-flow nasal cannula alone, and 26 with non-invasive ventilation plus interspaced high-flow nasal cannula. 8 (31%) of 26 patients treated with high-flow nasal cannula alone, 13 (43%) of 30 patients treated with standard oxygen, and 17 (65%) of 26 patients treated with non-invasive ventilation required intubation at 28 days (p=0·04). Odds ratios (ORs) for intubation were higher in patients treated with non-invasive ventilation than in those treated with high-flow nasal cannula: OR 4·25 (95% CI 1·33–13·56). ORs were not significantly different between patients treated with high-flow nasal cannula alone and standard oxygen: OR 1·72 (0·57–5·18). After multivariable logistic regression, the two factors independently associated with endotracheal intubation and mortality were age and use of non-invasive ventilation as first-line therapy. Interpretation Non-invasive ventilation might be associated with an increased risk of intubation and mortality and should be used cautiously in immunocompromised patients with acute hypoxaemic respiratory failure. Funding French Ministry of Health, the French societies of intensive care (Societe de Reanimation de Langue Francaise, SRLF) and pneumology (Societe de Pneumologie de Langue Francaise, SPLF), La Mutuelle de Poitiers, AADAIRC (Association pour l'Assistance a Domicile Aux Insuffisants Respiratoires Chroniques), and Fisher&Paykel Healthcare.
Published: 2016
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36. Urine sodium concentration to predict fluid responsiveness in oliguric ICU patients: a prospective multicenter observational study

Author: Jean-Yves Lefrant, Michael Darmon, Marc Leone, Jean-Michel Constantin, Philippe Guerci, Claire Roger, Brigitte Le Cam, Sabri Soussi, Etienne Gayat, Véronique Maurel, Axelle Ferry, Sébastien Perbet, Matthieu Legrand, Biomarqueurs CArdioNeuroVASCulaires (BioCANVAS), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Anesthésie et Soins Intensifs, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Université Paris Diderot - Paris 7 (UPD7), Unité Générale de Soins Intensifs, CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), Université Montpellier 1 (UM1)-Université de Montpellier (UM), CSE, Centre européen de sociologie et de science politique (CESSP), Université Paris 1 Panthéon-Sorbonne (UP1)-École des hautes études en sciences sociales (EHESS)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-École des hautes études en sciences sociales (EHESS)-Centre National de la Recherche Scientifique (CNRS), Faculté de Médecine [Nancy], Université de Lorraine (UL), Service d'Anésthésie Réanimation [CHU Clermont-Ferrand], Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), INSB-INSB-Centre National de la Recherche Scientifique (CNRS), and COMBE, Isabelle
Subjects: Male, Cardiac output, medicine.medical_specialty, Fractional excretion of sodium, Urology, Oliguria, Fluid responsiveness, Natriuresis, Urine, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Urine sodium, Excretion, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, medicine, Humans, Arterial Pressure, Prospective Studies, Urine output, Aged, business.industry, Research, Sodium, Acute kidney injury, 030208 emergency & critical care medicine, Middle Aged, medicine.disease, Surgery, Intensive Care Units, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Fluid Therapy, Female, medicine.symptom, Isotonic Solutions, business
Abstract: International audience; Background: Oliguria is one of the leading triggers of fluid loading in patients in the intensive care unit (ICU). The purpose of this study was to assess the predictive value of urine Na+ (uNa(+)) and other routine urine biomarkers for cardiac fluid responsiveness in oliguric ICU patients. Methods: We conducted a prospective multicenter observational study in five university ICUs. Patients with urine output (UO) 65 mmHg received a fluid challenge. Cardiac fluid responsiveness was defined by an increase in stroke volume >15 % after fluid challenge. Urine and plasma biochemistry samples were examined before fluid challenge. We examined renal fluid responsiveness (defined as UO >0.5 ml/kg/h for 3 consecutive hours) after fluid challenge as a secondary endpoint. Results: Fifty-four patients (age 51 +/- 37 years, Simplified Acute Physiology Score II score 40 +/- 20) were included. Most patients (72 %) were not cardiac responders (CRs), and 50 % were renal responders (RRs) to fluid challenge. Patient characteristics were similar between CRs and cardiac nonresponders. uNa(+) (37 +/- 38 mmol/L vs 25 +/- 75 mmol/L, p = 0.44) and fractional excretion of sodium (FENa+) (2.27 +/- 2.5 % vs 2.15 +/- 5.0 %, p = 0.94) were not statistically different between those who did and those who did not respond to the fluid challenge. Areas under the receiver operating characteristic (AUROC) curves were 0.51 (95 % CI 0.35-0.68) and 0.56 (95 % CI 0.39-0.73) for uNa(+) and FENa+, respectively. Fractional excretion of urea had an AUROC curve of 0.70 (95 % CI 0.54-0.86, p = 0.03) for CRs. Baseline UO was higher in RRs than in renal nonresponders (1.07 +/- 0.78 ml/kg/3 h vs 0.65 +/- 0.53 ml/kg/3 h, p = 0.01). The AUROC curve for RRs was 0.65 (95 % CI 0.53-0.78) for uNa(+). Conclusions: In the present study, most oliguric patients were not CRs and half were not renal responders to fluid challenge. Routine urinary biomarkers were not predictive of fluid responsiveness in oliguric normotensive ICU patients.
Published: 2016
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37. Differential Perceptions of Noninvasive Ventilation in Intensive Care among Medical Caregivers, Patients, and Their Relatives: A Multicenter Prospective Study-The PARVENIR Study

Author: Matthieu, Schmidt, Emmanuelle, Boutmy-Deslandes, Sébastien, Perbet, Nicolas, Mongardon, Martin, Dres, Keyvan, Razazi, Emmanuel, Guerot, Nicolas, Terzi, Pierre, Andrivet, Mikael, Alves, Romain, Sonneville, Christophe, Cracco, Vincent, Peigne, Francois, Collet, Benjamin, Sztrymf, Cedric, Rafat, Danielle, Reuter, Xavier, Fabre, Vincent, Labbe, Guillaume, Tachon, Clémence, Minet, Matthieu, Conseil, Elie, Azoulay, Thomas, Similowski, and Alexandre, Demoule
Subjects: Adult, Male, Inpatients, Noninvasive Ventilation, Critical Care, Attitude of Health Personnel, Nurses, Intensive Care Units, Physicians, Surveys and Questionnaires, Humans, Family, Female, Prospective Studies, Respiratory Insufficiency
Abstract: Noninvasive ventilation (NIV) requires a close "partnership" between a conscious patient and the patient's caregivers. Specific perceptions of NIV stakeholders and their impact have been poorly described to date. The objectives of this study were to compare the perceptions of NIV by intensive care unit (ICU) physicians, nurses, patients, and their relatives and to explore factors associated with caregivers' willingness to administer NIV and patients' and relatives' anxiety in relation to NIV.This is a prospective, multicenter questionnaire-based study.Three hundred and eleven ICU physicians, 752 nurses, 396 patients, and 145 relatives from 32 ICUs answered the questionnaire. Nurses generally reported more negative feelings and more frequent regrets about providing NIV (median score, 3; interquartile range, [1 to 5] vs. 1 [1 to 5]; P0.0001) compared to ICU physicians. Sixty-four percent of ICU physicians and only 32% of nurses reported a high level of willingness to administer NIV, which was independently associated with NIV case-volume and workload. A high NIV session-related level of anxiety was observed in 37% of patients and 45% of relatives. "Dyspnea during NIV," "long NIV session," and "the need to have someone at the bedside" were identified as independent risk factors of high anxiety in patients.Lack of willingness of caregivers to administer NIV and a high level of anxiety of patients and relatives in relation to NIV are frequent in the ICU. Most factors associated with low willingness to administer NIV by nurses or anxiety in patients and relatives may be amenable to change. Interventional studies are now warranted to evaluate how to reduce these risk factors and therefore contribute to better management of a potentially traumatic experience. (Anesthesiology 2016; 124:1347-59).
Published: 2016

38. Net alveolar fluid clearance is associated with lung morphology phenotypes in acute respiratory distress syndrome

Author: Sébastien Perbet, Loïc Blanchon, Sophie Cayot, Raiko Blondonnet, Vincent Sapin, Emmanuel Futier, Damien Bouvier, Matthieu Jabaudon, Jean Lutz, Thomas Godet, Jean-Michel Constantin, Renaud Guérin, Laurence Roszyk, Jean-Etienne Bazin, CHU Clermont-Ferrand, Retinoids, Development and Developmental Diseases (R2D2), Université d'Auvergne - Clermont-Ferrand I (UdA), Service de Biochimie et Génétique Moléculaire [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], Génétique, Reproduction et Développement (GReD), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de soins intensifs [Clermont Ferrand], CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], Service d'Anésthésie Réanimation [CHU Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, 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]), Laboratoire de Biochimie, CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand], and 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)
Subjects: Male, ARDS, Endotype, Pathology, medicine.medical_specialty, Peak Expiratory Flow Rate, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Permeability, Capillary Permeability, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Internal medicine, Tidal Volume, medicine, Humans, Prospective Studies, Diffuse alveolar damage, Lung, Aged, Respiratory Distress Syndrome, COPD, business.industry, General Medicine, Oxygenation, Middle Aged, respiratory system, medicine.disease, respiratory tract diseases, Oxygen, Pulmonary Alveoli, Prone position, Anesthesiology and Pain Medicine, medicine.anatomical_structure, Phenotype, 030228 respiratory system, Alveolar epithelium, Lung morphology, Pulmonary oedema, Cardiology, Female, Alveolar fluid clearance, Tomography, X-Ray Computed, business
Abstract: Background The acute respiratory distress syndrome (ARDS) is a heterogeneous syndrome that encompasses multiple phenotypes, e.g. with regards to lung morphology as assessed by computed tomography (CT). Focal or non-focal lung morphology may influence the response to positive end-expiratory pressure (PEEP), recruitment manoeuvres and prone position. Lung morphology has been hypothesized to be associated with alveolar fluid clearance (AFC), thus explaining various responses to such therapeutic interventions; however, this hypothesis has not been specifically studied in humans. Methods We measured net AFC rates in 30 patients with ARDS as a secondary data analysis of a prospective single-centre study. Net AFC rates were compared between patients with focal ARDS and those with non-focal ARDS, as assessed by lung CT-scans. Results Net AFC rates were significantly lower in patients with non-focal ARDS (n = 23; median [interquartile range], 1.5 [0–5.5] %/h) as compared to those with focal ARDS (n = 7; 10.3 [4.5–15] %/h) (P = 0.01). The area under the receiver-operating characteristic curve when net AFC rates were used to differentiate the presence from absence of non-focal ARDS was 0.93 (95% confidence interval, 0.81–1). Tidal volumes and PEEP levels differed between focal and non-focal ARDS patients, but there was no difference in arterial oxygenation or in alveolar-capillary permeability. Conclusions Non-focal lung morphology may be characterized by a functional endotype consistent with marked AFC impairment. Despite study limitations and the need for validating studies in larger cohorts, such novel findings may reinforce our understanding of the association between ARDS phenotypes and therapeutic responses.
Published: 2016
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39. Efficacy and safety of sedation with dexmedetomidine in critical care patients: A meta-analysis of randomized controlled trials

Author: Aurelien Momon, Sébastien Perbet, Sophie Cayot, Jean François Payen, Bernard De Jonghe, Bruno Perreira, Jean-Michel Constantin, Gerald Chanques, Jean Mantz, CHU Clermont-Ferrand, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris Descartes - Paris 5 (UPD5), Université Sorbonne Paris Cité (USPC), Service d'Anesthésie-Réanimation [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hôpital Michallon, CHI Poissy-Saint-Germain, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), and Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)
Subjects: Sedation, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, law.invention, 03 medical and health sciences, 0302 clinical medicine, Mechanical ventilation, Randomized controlled trial, law, medicine, Humans, Hypnotics and Sedatives, Dexmedetomidine, ComputingMilieux_MISCELLANEOUS, Randomized Controlled Trials as Topic, business.industry, Delirium, 030208 emergency & critical care medicine, General Medicine, Intensive care unit, 3. Good health, Meta-analysis, Critical care, Anesthesiology and Pain Medicine, Anesthesia, Midazolam, medicine.symptom, business, Propofol, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, medicine.drug
Abstract: Introduction Dexmedetomidine may help physicians target a low level of sedation. Unfortunately, the impact of dexmedetomidine on major endpoints remains unclear in intensive care unit (ICU). Material and methods To evaluate the association between dexmedetomidine use with efficacy and safety outcomes, two reviewers independently identified randomized controlled trials comparing dexmedetomidine with other sedative agents in non-post-cardiac surgery critically ill patients in the PubMed and Cochrane databases. Random effects models were considered if heterogeneity was detected using the DerSimonian and Laird estimation method. Statistical heterogeneity between results was assessed by examining forest plots, confidence intervals (CI) and by using the I 2 statistic. The risk of bias was assessed using the risk of bias tool. Results This meta-analysis included 1994 patients from 16 randomized controlled trials. Comparators were lorazepam, midazolam and propofol. Dexmedetomidine was associated with a reduction in ICU length of stays (WMD = −0.304; 95% CI [−0.477, −0.132]; P = 0.001), mechanical ventilation duration (WMD = −0.313, 95% CI [−0.523, −0.104]; P = 0.003) and delirium incidence (RR = 0.812, 95% CI [0.680, 0.968]; P = 0.020). Dexmedetomidine is also associated with an increase in the incidence of bradycardia (RR = 1.947, 95% CI [1.387, 2.733]; P = 0.001) and hypotension (RR = 1.264; 95% CI [1.013, 1.576]; P = 0.038). Conclusions and relevance In this first meta-analysis including only randomized controlled trials related to ICU patients, dexmedetomidine was associated with a 48 h reduction in ICU length of stay, mechanical ventilation duration and delirium occurrence despite a significant heterogeneity among studies. Dexmedetomidine was also associated with an increase in bradycardia and hypotension.
Published: 2016
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40. Noninvasive mechanical ventilation in patients having declined tracheal intubation

Author: Samir Jaber, Michael Alves, Laurent Papazian, Ralf Janssen-Langenstein, David Schnell, Sébastien Perbet, Matthieu Schmidt, Sarah Kilani, François Collet, Laurent Camous, Pierre Andrivet, Laurent Brochard, Stéphane Legriel, Samia Touati, Thomas Similowski, Anne-Pascale Meert, Xavier Fabre, Olivier Guisset, Satar Mortaza, Emmanuel Guerot, Achille Kouatchet, Benoit Schlemmer, Patrick Herbecq, Xavier Tchenio, Alain Mercat, Elie Azoulay, Ariane Lafabrie, Matthieu Conseil, Sylvie Chevret, Ferhat Meziani, Jonathan Messika, Jérôme Lambert, Alexandre Demoule, and Barthel, Ingrid
Subjects: Male, medicine.medical_specialty, Palliative care, medicine.medical_treatment, Anxiety, Critical Care and Intensive Care Medicine, Cohort Studies, Stress Disorders, Post-Traumatic, Treatment Refusal, Intensive care, Anesthesiology, [SDV.BBM] Life Sciences [q-bio]/Biochemistry, Molecular Biology, Intubation, Intratracheal, medicine, Humans, Intubation, Prospective Studies, Prospective cohort study, [SDV.BC] Life Sciences [q-bio]/Cellular Biology, ComputingMilieux_MISCELLANEOUS, Aged, Aged, 80 and over, Mechanical ventilation, Noninvasive Ventilation, Depression, business.industry, Tracheal intubation, Middle Aged, Anesthesia, Quality of Life, Female, Respiratory Insufficiency, business, Cohort study
Abstract: Noninvasive ventilation (NIV) is a treatment option in patients with acute respiratory failure who are good candidates for intensive care but have declined tracheal intubation. The aim of our study was to report outcomes after NIV in patients with a do-not-intubate (DNI) order.Prospective observational cohort study in all patients who received NIV for acute respiratory failure in 54 ICUs in France and Belgium, in 2010/2011.Goals of care, comfort, and vital status were assessed daily. On day 90, a telephone interview with patients and relatives recorded health-related quality of life (HRQOL), posttraumatic stress disorder-related symptoms, and symptoms of anxiety and depression. Post-ICU burden was compared between DNI patients and patients receiving NIV with no treatment-limitation decisions (TLD). Of 780 NIV patients, 574 received NIV with no TLD, and 134 had DNI orders. Hospital mortality was 44 % in DNI patients and 12 % in the no-TLD group. Mortality in the DNI group was lowest in COPD patients compared to other patients in the DNI group (34 vs. 51 %, P = 0.01). In the DNI group, HRQOL showed no significant decline on day 90 compared to baseline; day-90 data of patients and relatives did not differ from those in the no-TLD group.Do-not-intubate status was present among one-fifth of ICU patients who received NIV. DNI patients who were alive on day 90 experienced no decrease in HRQOL compared to baseline. The prevalences of anxiety, depression, and PTSD-related symptoms in these patients and their relatives were similar to those seen after NIV was used as part of full-code management (clinicaltrial.govNCT01449331).
Published: 2012
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41. Management of HSV-1 encephalitis due to reactivation of HSV-1 during late pregnancy

Author: M. Bonnin, C. Chartier, G. Mage, Nicolas Bourdel, Sébastien Perbet, X. Tran, Jean-Etienne Bazin, D. Da Ines, J. Pascal, and Jean-Michel Constantin
Subjects: Adult, Photophobia, Pregnancy Trimester, Third, viruses, Acyclovir, Herpesvirus 1, Human, medicine.disease_cause, Antiviral Agents, Polymerase Chain Reaction, Diagnosis, Differential, Pregnancy, medicine, Humans, Pregnancy Complications, Infectious, Neck stiffness, Eclampsia, business.industry, Brain, Obstetrics and Gynecology, Meningoencephalitis, medicine.disease, Magnetic Resonance Imaging, Anesthesiology and Pain Medicine, Herpes simplex virus, Anesthesia, Vomiting, Female, Virus Activation, Encephalitis, Herpes Simplex, medicine.symptom, business, Encephalitis, Follow-Up Studies
Abstract: A previously healthy 31-year-old G4P2 woman at 33 weeks of gestation was admitted as an emergency with a pyrexia of 39°C, vomiting, headache and neck stiffness associated with photophobia, phonophobia and visual and auditory symptoms. There were no heraldic signs of eclampsia. Polymerase chain reaction and testing for herpes simplex virus in the cerebrospinal fluid diagnosed herpes simplex-1 meningoencephalitis. Following acyclovir, the clinical course improved. Spontaneous vaginal delivery occurred at 39 weeks of gestation with epidural analgesia using ropivacaine. Mother and child were neurologically normal and healthy 15 months later. Early administration of acyclovir is essential to reduce the risk of neurological complications. After treatment and a negative polymerase chain reaction for herpes simplex virus in the cerebrospinal fluid, epidural analgesia with local anesthetic and sufentanil is possible.
Published: 2012
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42. Early-Onset Pneumonia after Cardiac Arrest

Author: Nicolas Mongardon, Bruno Mourvillier, Olivier Varenne, Cédric Bruel, Jean-Paul Mira, Virginie Lemiale, Michel Wolff, Florence Dumas, Alain Cariou, Pierre Carli, and Sébastien Perbet
Subjects: Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Time Factors, Accidental hypothermia, Critical Care and Intensive Care Medicine, Hypothermia, Induced, Risk Factors, Intensive care, Odds Ratio, medicine, Humans, Hospitals, Teaching, Intensive care medicine, Aged, Retrospective Studies, Early onset, business.industry, Incidence (epidemiology), Pneumonia, Ventilator-Associated, Retrospective cohort study, Pneumonia, Odds ratio, Length of Stay, Middle Aged, Hypothermia, Prognosis, medicine.disease, Heart Arrest, Intensive Care Units, Multivariate Analysis, Emergency medicine, Female, France, medicine.symptom, business
Abstract: Although frequent, little is known about early-onset pneumonia that occurs in the postresuscitation period. Although induced hypothermia is recommended as a method of improving neurological outcome, its influence on the occurrence of early-onset pneumonia is not well defined.To describe the incidence, risk factors, causative agents, and impact on outcome of early-onset pneumonia occurring within 3 days after out-of-hospital cardiac arrest (OHCA).Retrospective analysis of a large cohort study of all patients successfully resuscitated after OHCA and admitted from July 2002 to March 2008 in two medical intensive care units (ICUs). Patients who presented accidental hypothermia or a known pneumonia before OHCA, or patients who died within the first 24 hours, were excluded.During this 6-year period, 845 patients were admitted after OHCA, and 641 consecutive patients were included. A total of 500 patients (78%) were treated with therapeutic hypothermia. In the first 3 days, 419 (65%) presented early-onset pneumonia. Multivariate analysis disclosed therapeutic hypothermia as the single independent risk factor of early-onset pneumonia (odds ratio, 1.90; 95% confidence interval, 1.28-2.80; P = 0.001). Early-onset pneumonia increased length of mechanical ventilation (5.7 ± 5.9 vs. 4.7 ± 6.2 d; P = 0.001) and ICU stay (7.9 ± 7.2 versus 6.7 ± 7.6 d; P = 0.001), but did not influence incidence of ventilator-associated pneumonia (P = 0.25), favorable neurologic outcome (P = 0.35), or ICU mortality (P = 0.26).After OHCA, therapeutic hypothermia is associated with an increased risk of early-onset pneumonia. This complication was associated with prolonged respiratory support and ICU stay, but did not significantly influence ICU mortality.
Published: 2011
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43. Anesthésie pour électroconvulsivothérapie : résultats d’une enquête dans les CHU

Author: D. Gonzalez, F. Dissait, Sébastien Perbet, A.-S. Bellocq, and S. Colomb
Subjects: Gynecology, medicine.medical_specialty, Anesthesiology and Pain Medicine, Guideline adherence, business.industry, medicine, General Medicine, business
Abstract: Resume Objectif Evaluer la prise en charge anesthesique des patients qui beneficient d’une electroconvulsivotherapie (ECT) au sein des centres hospitaliers universitaires (CHU). Type d’etude Enquete nationale dans les CHU par internet. Materiels et methodes Un courriel a ete adresse aux chefs de service d’anesthesie-reanimation des CHU de France metropolitaine afin qu’ils identifient un praticien referent par centre, auquel un questionnaire informatise a ensuite ete transmis. Les questions posees portaient sur le volume et l’organisation de l’activite, la prise en charge pre-, per- et post-anesthesique des patients beneficiant d’une ECT. Resultats Sur les 33 sites realisant des ECT, 28 (85 %) ont repondu. La consultation d’anesthesie etait systematique au moins 48 heures avant le debut du traitement, mais la visite pre-anesthesique n’etait effectuee que dans 32 % des centres. Un electrocardiogramme systematique etait realise chez 89 % des patients. Dans quatre centres (25 %), la curarisation n’etait pas systematique. Le propofol etait l’hypnotique le plus utilise (82 %), devant l’etomidate (11 %) et le thiopental (7 %). Dans deux CHU, les praticiens declaraient ne pas utiliser de protection buccale. Le psychiatre n’etait present que dans 71 % des cas. L’electroencephalogramme continu n’etait enregistre que dans 45 % des centres. Conclusion Les recommandations, bien qu’anciennes, restent d’actualite et pourraient etre mises a jour. Elles ne sont pas toujours suivies par les equipes. La formation medicale continue doit etre encouragee pour une meilleure connaissance de tous les facteurs interferant entre l’anesthesie et l’ECT.
Published: 2011
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44. Utilisation des curares en médecine préhospitalière : enquête de pratique dans les Smur de la région Sud-Est

Author: Sébastien Perbet, R. Chabanne, S. Colomb, and D. Gonzalez
Subjects: Gynecology, medicine.medical_specialty, Anesthesiology and Pain Medicine, business.industry, medicine, General Medicine, business
Abstract: Resume Objectif Evaluer l’utilisation des curares dans les Services mobiles d’urgence-reanimation (Smur) adultes. Type d’etude Enquete telephonique de pratique. Materiel et methodes Une enquete a ete conduite en 2009 aupres de tous les Smur adultes de la region Sud-Est. Un medecin sortant par centre a ete interroge a l’aide d’un questionnaire standardise comprenant des donnees demographiques, les modalites d’induction anesthesique, et d’utilisation des curares non depolarisants et de la succinylcholine. Resultats La totalite ( n = 86) des Smur de la region a ete interrogee. La succinylcholine etait utilisee dans 98 % des inductions en sequence rapide. Les curares non depolarisants n’etaient jamais utilises par 38 % et n’etaient pas disponibles dans 21 % des Smur. Parmi les praticiens les utilisant, les curares non depolarisants etaient peu prescrits par 79 % (chez moins d’un quart des patients intubes). Ils etaient utilises dans plus de 50 % des cas de desadaptation du ventilateur par 27 % des declarants, d’hyperpression des voies aeriennes (23 %), d’asthme aigu grave (23 %), de suspicion d’hypertension intracrânienne (22 %), d’hypoxemie refractaire (16 %), d’hypothermie therapeutique (10 %). Les limitations a leur prescription etaient la faible incidence des indications et le manque de formation. L’atracurium et le cisatracurium etaient les plus utilises. Les posologies exactes n’etaient connues que par 18 % des praticiens. Aucun ne monitorait la curarisation. Conclusion Cette enquete met en evidence l’utilisation tres frequente de la succinylcholine dans l’induction en sequence rapide et la faible utilisation des curares non depolarisants et pour des indications ciblees. Un effort de formation devrait etre entrepris pour ameliorer l’utilisation de ces medicaments d’anesthesie par les medecins transporteurs.
Published: 2011
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45. Infectious complications in out-of-hospital cardiac arrest patients in the therapeutic hypothermia era*

Author: Nicolas Mongardon, Julien Charpentier, Hélène Poupet, Frédéric Pène, Jean-Daniel Chiche, Sébastien Perbet, Alain Cariou, Virginie Lemiale, Jean-Paul Mira, and Florence Dumas
Subjects: Male, medicine.medical_specialty, Resuscitation, Critical Care, Infections, Critical Care and Intensive Care Medicine, Out of hospital cardiac arrest, Cohort Studies, Hypothermia, Induced, Intensive care, Epidemiology, medicine, Humans, Intensive care medicine, Aged, Retrospective Studies, business.industry, Incidence, Retrospective cohort study, Length of Stay, Middle Aged, Hypothermia, Female, medicine.symptom, business, Complication, Out-of-Hospital Cardiac Arrest, Cohort study
Abstract: Infectious complications are frequently reported in critically ill patients, especially after cardiac arrest. Recent and widespread use of therapeutic hypothermia has raised concerns about increased septic complications, but no specific reappraisal has been performed. We investigated the infectious complications in cardiac arrest survivors and assessed their impact on morbidity and long-term outcome.Retrospective review of a prospectively acquired intensive care unit database.A 24-bed medical intensive care unit in a French university hospital.Between March 2004 and March 2008, consecutive patients admitted for management of resuscitated out-of-hospital cardiac arrest were considered. Patients dying within 24 hrs were excluded. All patients' files were reviewed to assess the development of infection.None.Of the 537 patients admitted after cardiac arrest, 421 were included and 281 patients (67%) presented 373 infectious complications. Pneumonia was the most frequent (318 episodes), followed by bloodstream infections (35 episodes) and catheter-related infections (11 episodes). When grouped together, Gram-negative bacteria were the most frequently isolated infectious germs (64%), but the main pathogen detected was Staphylococcus aureus (57 occurrences). Both application itself (83 vs. 73%; p = .02) and duration (1244 vs. 1176 mins; p = .05) of therapeutic hypothermia were significantly more frequent in infected patients. Infection was associated with increased mechanical ventilation duration (6 [2-9] vs. 3 [2-5.5] days; p.001) and intensive care unit length of stay (7 [4-10] vs. 3 [2-7] days; p.001). Nonetheless, there was no impact on intensive care unit mortality (174 [62%] vs. 92 [66%] patients; p = .45) or on favorable neurologic outcome (cerebral performance category 1-2, 102 [36%] vs. 47 [34%] patients; p = .58).Infectious complications are frequent after cardiac arrest and may be even more frequent after therapeutic hypothermia. Despite increase in care costs, long-term and clinically relevant outcomes do not seem to be impaired. This should not discourage the use of therapeutic hypothermia in cardiac arrest survivors.
Published: 2011
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46. Soluble form of the receptor for advanced glycation end products is a marker of acute lung injury but not of severe sepsis in critically ill patients*

Author: Sébastien Perbet, Vincent Sapin, Jean-Michel Constantin, Laurence Roszyk, Elodie Chalus, Emmanuel Futier, Matthieu Jabaudon, Christian Chartier, Renaud Guérin, Jean-Etienne Bazin, Sophie Cayot-Constantin, Ségolène Mrozek, and Antoine Petit
Subjects: Glycation End Products, Advanced, Male, Resuscitation, medicine.medical_specialty, Critical Illness, Acute Lung Injury, Lung injury, Critical Care and Intensive Care Medicine, Gastroenterology, Statistics, Nonparametric, law.invention, law, Sepsis, Intensive care, Internal medicine, medicine, Humans, Prospective Studies, Diffuse alveolar damage, Lung, Aged, Academic Medical Centers, Respiratory Distress Syndrome, Respiratory distress, Septic shock, business.industry, Respiratory disease, Middle Aged, medicine.disease, Respiration, Artificial, Shock, Septic, Intensive care unit, Surgery, Intensive Care Units, Female, business, Biomarkers
Abstract: Objectives: Levels of the soluble form of the receptor for advanced glycation end products (sRAGE) are elevated during acute lung injury. However, it is not known whether this increase is linked to its involvement in alveolar epithelium injury or in systemic inflammation. Whether sRAGE is a marker of acute lung injury and acute respiratory distress syndrome, regardless of associated severe sepsis or septic shock, remains unknown in the intensive care unit setting. Design: Prospective, observational, clinical study. Setting: Intensive care unit of an academic medical center. Patients: A total of 64 consecutive subjects, divided into four groups: acute lung injury/acute respiratory distress syndrome (n = 15); acute lung injury/acute respiratory distress syndrome plus severe sepsis/septic shock (n = 18); severe sepsis/septic shock (n = 16); and mechanically ventilated controls (n = 15). Interventions: None. Measurements and Main Results: Plasma sRAGE levels were measured at baseline and on days 3, 6, and 28 (or at intensive care unit discharge, whichever occurred first). Baseline plasma levels of sRAGE were significantly higher in patients with acute lung injury/ acute respiratory distress syndrome, with (median, 2951 pg/mL) or without (median, 3761 pg/mL) severe sepsis, than in patients with severe sepsis (median, 488 pg/mL) only and in mechanically ventilated controls (median, 525 pg/mL). Levels of sRAGE were correlated with acute lung injury/acute respiratory distress syndrome severity and decreased over time but were not associated with outcome. Lower baseline plasma sRAGE was associated with focal loss of aeration based on computed tomography lung morphology. Conclusions: sRAGE levels were elevated during acute lung injury/acute respiratory distress syndrome, regardless of the presence or absence of severe sepsis. The plasma level of sRAGE was correlated with clinical and radiographic severity in acute respiratory distress syndrome patients and decreased over time, suggesting resolution of the injury to the alveolar epithelium. Further study is warranted to test the clinical utility of this biomarker in managing such patients and to better understand its relationship with lung morphology during acute lung injury/acute respiratory distress syndrome.
Published: 2011
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47. Évaluation des motivations de choix et de leur cursus d’apprentissage par les internes d’anesthésie-réanimation : enquête nationale

Author: Samir Jaber, N. Eisenmann, Jean-Etienne Bazin, Jean-Michel Constantin, S. Colomb, A. Soummer, and Sébastien Perbet
Subjects: Anesthesiology and Pain Medicine, Political science, General Medicine, Humanities, Anesthesie reanimation
Abstract: Resume Introduction La duree de l’internat d’anesthesie-reanimation (AR) est passee de quatre a cinq ans en 2002 en France. L’AR est une specialite de mieux en mieux choisie par rapport aux specialites medicales et chirurgicales. Nous avons realise une enquete nationale par questionnaire sur l’evaluation de leur formation theorique et pratique de l’internat par les internes d’AR francais. Materiel et methodes Un questionnaire (donnees demographiques, motivations du choix, cursus) a ete envoye aux 1422 internes inscrits depuis 2002 dans chaque inter-region. Resultats Au total, 562 questionnaires (40 %) ont ete renvoyes. Les internes sont âges en moyenne de 28 ± 2 ans, 46 % sont des femmes, en moyenne en sixieme semestre [extremes : 1–10]. La specialite AR etait le premier choix de specialite pour 90 % et la ville d’internat obtenue etait le premier choix de ville pour 73 %. Les internes declarent que leur lieu d’installation sera choisi principalement sur des criteres de qualite de vie. Ainsi, 97 % referaient le meme choix de specialite. La formation en anesthesie locoregionale (ALR) et la prise en charge de l’intubation difficile a ete estimee bonne ou correcte par 53 et 62 % des internes. La formation theorique a ete jugee correcte par 31 % et bonne par 53 % des repondeurs et la formation pratique a ete estimee correcte par 25 % et bonne par 61 % des internes. Discussion L’AR est desormais une specialite qui repond a un choix positif. Le choix de l’AR par les etudiants en fin de cursus medical est conforte par l’enseignement et l’exercice de la specialite au cours de l’internat. La formation globale est jugee satisfaisante dans l’ensemble. Les internes souhaiteraient un approfondissement dans certains domaines (echographie, ALR, lecture critique d’articles, redaction medicale) et une evaluation de cette formation pratique par des simulations. Conclusion Les internes d’AR semblent dans l’ensemble satisfaits de leur parcours de formation et referaient le meme choix de specialite.
Published: 2010
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48. Impact de la sophrologie sur la tolérance des séances de ventilation non invasive chez des patients en insuffisance respiratoire aiguë

Author: C. Chartier, R. Guérin, S. Cayot-Constantin, Jean-Etienne Bazin, E. Futier, V. Gignac, H. Fabrègue, Sébastien Perbet, F. Bannier, and Jean-Michel Constantin
Subjects: Gynecology, medicine.medical_specialty, Anesthesiology and Pain Medicine, business.industry, Acute respiratory insufficiency, medicine, Acute respiratory failure, Sophrology, General Medicine, Positive-Pressure Respiration, Pain management, business
Abstract: Resume Objectifs La prise en charge par ventilation non invasive (VNI) des patients en insuffisance respiratoire aigue (IRA) est grevee d’un grand nombre d’echecs dus a l’inconfort de la technique, a la sensation de gene respiratoire et a la douleur. L’objet de cette etude etait d’evaluer l’efficacite de la sophrologie, pour ameliorer les conditions de realisation de la VNI. Patients et methodes Il s’agit d’une etude prospective, randomisee et controlee, incluant des patients en IRA hypoxemiante. Des la premiere seance de VNI, ils beneficiaient soit de la realisation d’une seance de sophrologie pendant les 30 premieres minutes de ventilation (groupe S), soit de la presence de la meme infirmiere qui realisait un accompagnement « standard » pendant 30 minutes (groupe T). Les donnees hemodynamiques et ventilatoires etaient enregistrees en continu, la douleur, la sensation de gene respiratoire et l’inconfort etaient mesures sur une echelle numerique visuelle. Resultats Trente patients ont ete inclus dans l’etude, 27 ont pu etre analyses. Chaque patient a beneficie en moyenne de quatre seances de VNI. Il n’existait pas de difference significative dans les deux groupes en termes d’amelioration des echanges gazeux. Il existait une difference significative en termes de reduction de la gene respiratoire (−76 %), de l’inconfort (−60 %) et de diminution de la douleur (−40 %) en faveur de la sophrologie (p Conclusion La sophrologie constitue une aide pour la realisation des seances de VNI chez les patients en IRA.
Published: 2009
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49. Ventilation non-invasive pour oedème pulmonaire attribué aux tocolytiques lors du travail d’une grossesse gémellaire

Author: Sébastien Perbet, Marie Vignaud, Jean-Michel Constantin, Sylvain Chanséaume, Marie Zenut, Denis Gallot, Jean-Etienne Bazin, and Franck Bolandard
Subjects: medicine.medical_specialty, Anesthesiology and Pain Medicine, business.industry, Anesthesiology, Anesthesia, Medicine, General Medicine, LUNG EDEMA, business
Abstract: Objectif : Nous decrivons l’interet et la bonne tolerance de la ventilation non-invasive lors d’un oedeme pulmonaire attribue aux medicaments tocolytiques durant le travail d’une grossesse gemellaire.
Published: 2008
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50. Tolérance de la caspofongine chez les patients de réanimation : étude prospective

Author: Sébastien Perbet, C. Chartier, Jean-Michel Constantin, E. Futier, L. Roszyk, R. Guérin, Jean-Etienne Bazin, Vincent Sapin, F. Bannier, and S. Cayot-Constantin
Subjects: Gynecology, medicine.medical_specialty, Anesthesiology and Pain Medicine, business.industry, Medicine, General Medicine, business
Abstract: Resume Introduction La caspofongine a montre une efficacite et une tolerance remarquable lors de candidoses profondes ou d’aspergilloses chez les sujets neutropeniques ou non. Le but de cette etude etait d’evaluer la tolerance de la caspofongine chez les patients de reanimation. Patients et methode Sur une periode de 36 mois, 1430 patients ont ete admis dans le service de reanimation et entres dans une base de donnee saisie prospectivement. Tous les effets secondaires cliniques ou biologiques rapportes dans les etudes multicentriques ont ete recherches. Les patients ont ete stratifies en deux groupes, selon que la fonction hepatique etait normale ou alteree a la mise en route du traitement. Resultats Un traitement par caspofongine a ete instaure chez 73 patients (5,1 %). Dans ce groupe de patients, 58 % etaient immunodeprimes. Les causes de l’immunosuppression etaient une hemopathie maligne dans 30 % des cas et une transplantation d’organe dans 20 %. L’IGS2 etait plus eleve (51 ± 20 versus 44 ± 20 ; p Conclusion Ces donnees confirment la tres bonne tolerance de la caspofongine, notamment chez les patients les plus graves.
Published: 2008
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