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Annals of Intensive Care

Constance Vuillard, Marc Pineton de Chambrun, Nicolas de Prost, Claude Guérin, Matthieu Schmidt, Auguste Dargent, Jean-Pierre Quenot, Sébastien Préau, Geoffrey Ledoux, Mathilde Neuville, Guillaume Voiriot, Muriel Fartoukh, Rémi Coudroy, Guillaume Dumas, Eric Maury, Nicolas Terzi, Yacine Tandjaoui-Lambiotte, Francis Schneider, Maximilien Grall, Emmanuel Guérot, Romaric Larcher, Sylvie Ricome, Raphaël Le Mao, Gwenhaël Colin, Christophe Guitton, Lara Zafrani, Elise Morawiec, Marie Dubert, Olivier Pajot, Hervé Mentec, Gaëtan Plantefève, Damien Contou
BACKGROUND: Anti-synthetase (AS) and dermato-pulmonary associated with anti-MDA-5 antibodies (aMDA-5) syndromes are near one of the other autoimmune inflammatory myopathies potentially responsible for severe acute interstitial lung disease. We undertook a 13-year retrospective multicenter study in 35 French ICUs in order to describe the clinical presentation and the outcome of patients admitted to the ICU for acute respiratory failure (ARF) revealing AS or aMDA-5 syndromes. RESULTS: From 2005 to 2017, 47 patients (23 males; median age 60 [1st-3rd quartiles 52-69] years, no comorbidity 85%) were admitted to the ICU for ARF revealing AS (n = 28, 60%) or aMDA-5 (n = 19, 40%) syndromes...
September 11, 2018: Annals of Intensive Care
Mehdi Mezidi, Francisco José Parrilla, Hodane Yonis, Zakaria Riad, Stephan H Böhm, Andreas D Waldmann, Jean-Christophe Richard, Floriane Lissonde, Romain Tapponnier, Loredana Baboi, Jordi Mancebo, Claude Guérin
BACKGROUND: In acute respiratory distress syndrome (ARDS) patients, it has recently been proposed to set positive end-expiratory pressure (PEEP) by targeting end-expiratory transpulmonary pressure. This approach, which relies on the measurement of absolute esophageal pressure (Pes), has been used in supine position (SP) and has not been investigated in prone position (PP). Our purposes were to assess Pes-guided strategy to set PEEP in SP and in PP as compared with a PEEP/FIO2 table and to explore the early (1 h) and late (16 h) effects of PP on lung and chest wall mechanics...
September 10, 2018: Annals of Intensive Care
Michael C Sklar, Martin Dres, Nuttapol Rittayamai, Brent West, Domenico Luca Grieco, Irene Telias, Detajin Junhasavasdikul, Michela Rauseo, Tai Pham, Fabiana Madotto, Carolyn Campbell, Elizabeth Tullis, Laurent Brochard
BACKGROUND: Noninvasive ventilation (NIV) is the first-line treatment of adult patients with exacerbations of cystic fibrosis (CF). High-flow nasal oxygen therapy (HFNT) might benefit patients with hypoxemia and can reduce physiological dead space. We hypothesized that HFNT and NIV would similarly reduce work of breathing and improving breathing pattern in CF patients. Our objective was to compare the effects of HFNT versus NIV in terms of work of breathing, assessed noninvasively by the thickening fraction of the diaphragm (TFdi, measured with ultrasound), breathing pattern, transcutaneous CO2 (PtcCO2 ), hemodynamics, dyspnea and comfort...
September 5, 2018: Annals of Intensive Care
Lucile Laporte, Coralie Hermetet, Youenn Jouan, Christophe Gaborit, Emmanuelle Rouve, Kimberly M Shea, Mustapha Si-Tahar, Pierre-François Dequin, Leslie Grammatico-Guillon, Antoine Guillon
BACKGROUND: The consequences of the ageing population concerning ICU hospitalisation need to be adequately described. We believe that this discussion should be disease specific. A focus on respiratory infections is of particular interest, because it is strongly associated with old age. Our objective was to assess trends in demographics over a decade among elderly patients admitted to the ICU for acute respiratory infections. METHODS: A cross-sectional study was performed between 2006 and 2015 based on hospital discharge databases in one French region (2...
August 15, 2018: Annals of Intensive Care
S Valade, L Biard, V Lemiale, L Argaud, F Pène, L Papazian, F Bruneel, A Seguin, A Kouatchet, J Oziel, S Rouleau, N Bele, K Razazi, O Lesieur, F Boissier, B Megarbane, N Bigé, N Brulé, A S Moreau, A Lautrette, O Peyrony, P Perez, J Mayaux, E Azoulay
BACKGROUND: Chlamydophila pneumoniae (CP) and Mycoplasma pneumoniae (MP) patients could require intensive care unit (ICU) admission for acute respiratory failure. METHODS: Adults admitted between 2000 and 2015 to 20 French ICUs with proven atypical pneumonia were retrospectively described. Patients with MP were compared to Streptococcus pneumoniae (SP) pneumonia patients admitted to ICUs. RESULTS: A total of 104 patients were included, 71 men and 33 women, with a median age of 56 [44-67] years...
August 13, 2018: Annals of Intensive Care
Moon Seong Baek, MyongJa Han, Jin Won Huh, Chae-Man Lim, Younsuck Koh, Sang-Bum Hong
BACKGROUND: Recent trials showed that video laryngoscopy (VL) did not yield higher first-attempt tracheal intubation success rate than direct laryngoscopy (DL) and was associated with higher rates of complications. Tracheal intubation can be more challenging in the general ward than in the intensive care unit. This study aimed to investigate which laryngoscopy mode is associated with higher first-attempt intubation success in a general ward. METHODS: This is a retrospective study of tracheal intubations conducted at a tertiary academic hospital...
August 13, 2018: Annals of Intensive Care
(no author information available yet)
BACKGROUND: Information is limited regarding the prevalence, management, and outcome of hypoxemia among intensive care unit (ICU) patients. We assessed the prevalence and severity of hypoxemia in ICU patients and analyzed the management and outcomes of hypoxemic patients. METHODS: This is a multinational, multicenter, 1-day point prevalence study in 117 ICUs during the spring of 2016. All patients hospitalized in an ICU on the day of the study could be enrolled...
August 13, 2018: Annals of Intensive Care
C Barth, M Soares, A C Toffart, J F Timsit, G Burghi, C Irrazabal, N Pattison, E Tobar, B F Almeida, U V Silva, L C Azevedo, A Rabbat, C Lamer, A Parrot, V C Souza-Dantas, F Wallet, F Blot, G Bourdin, C Piras, J Delemazure, M Durand, J Salluh, E Azoulay, Virginie Lemiale
BACKGROUND: Although patients with advanced or metastatic lung cancer have poor prognosis, admission to the ICU for management of life-threatening complications has increased over the years. Patients with newly diagnosed lung cancer appear as good candidates for ICU admission, but more robust information to assist decisions is lacking. The aim of our study was to evaluate the prognosis of newly diagnosed unresectable lung cancer patients. METHODS: A retrospective multicentric study analyzed the outcome of patients admitted to the ICU with a newly diagnosed lung cancer (diagnosis within the month) between 2010 and 2013...
August 4, 2018: Annals of Intensive Care
Perrine Bortolotti, Delphine Colling, Vincent Colas, Benoit Voisin, Florent Dewavrin, Julien Poissy, Patrick Girardie, Maeva Kyheng, Fabienne Saulnier, Raphael Favory, Sebastien Preau
BACKGROUND: Whether the respiratory changes of the inferior vena cava diameter during a deep standardized inspiration can reliably predict fluid responsiveness in spontaneously breathing patients with cardiac arrhythmia is unknown. METHODS: This prospective two-center study included nonventilated arrhythmic patients with infection-induced acute circulatory failure. Hemodynamic status was assessed at baseline and after a volume expansion of 500 mL 4% gelatin. The inferior vena cava diameters were measured with transthoracic echocardiography using the bi-dimensional mode on a subcostal long-axis view...
August 2, 2018: Annals of Intensive Care
Ulrich Mayr, Leonie Fahrenkrog-Petersen, Gonzalo Batres-Baires, Alexander Herner, Sebastian Rasch, Roland M Schmid, Wolfgang Huber, Tobias Lahmer
BACKGROUND: Ascites is a major complication of decompensated liver cirrhosis. Intraabdominal hypertension and structural alterations of parenchyma involve decisive changes in hepatosplanchnic blood flow. Clearance of indo-cyanine green (ICG) is mainly dependent on hepatic perfusion and hepatocellular function. As a consequence, plasma disappearance rate of ICG (ICG-PDR) is rated as a useful dynamic parameter of liver function. This study primarily evaluates the impact of large-volume paracentesis (LVP) on ICG-PDR in critically ill patients with decompensated cirrhosis...
July 6, 2018: Annals of Intensive Care
S Figueiredo, C Taconet, A Harrois, S Hamada, T Gauss, M Raux, J Duranteau
BACKGROUND: The diagnostic value of hemoglobin (Hb) for detecting a significant hemorrhage (SH) in the early phase of trauma remains controversial. The present study aimed to assess the abilities of Hb measurements taken at different times throughout trauma management to identify patients with SH. METHODS: All consecutive adult trauma patients directly admitted to six French level-1 trauma centers with at least one prehospital Hb measurement were analyzed. The abilities of the following variables to identify SH (≥ 4 units of red blood cells in the first 6 h and/or death related to uncontrolled bleeding within 24 h) were determined and compared to that of shock index (SI): Hb as measured with a point-of-care (POC) device by the prehospital team on scene (POC-Hbprehosp ) and upon patient's admission to the hospital (POC-Hbhosp ), the difference between POC-Hbhosp and POC-Hbprehosp (DeltaPOC-Hb) and Hb as measured by the hospital laboratory on admission (Hb-Labhosp )...
July 6, 2018: Annals of Intensive Care
Guillaume Geri, Bénédicte Stengel, Christian Jacquelinet, Philippe Aegerter, Ziad A Massy, Antoine Vieillard-Baron
BACKGROUND: Acute kidney injury (AKI) is frequent and associated with poor outcome in intensive care unit (ICU) patients. Besides the association with short- and long-term mortality, the increased risk of chronic kidney disease (CKD) has been recently highlighted in non-ICU patients. This study aims to describe the incidence and determinants of CKD after AKI and to develop a prediction score for CKD in ICU patients. METHODS: Prospective multicenter (n = 17) observational study included 1200 ICU patients who suffered from AKI (defined by an AKIN stage ≥ 1) during their ICU stay and were discharged alive from ICU...
July 6, 2018: Annals of Intensive Care
Sylvain Jean-Baptiste, Jonathan Messika, David Hajage, Stéphane Gaudry, Julie Barbieri, Henri Duboc, Didier Dreyfuss, Benoit Coffin, Jean-Damien Ricard
BACKGROUND AND AIMS: Upper gastrointestinal endoscopies' (UGE) profitability is undisputable in patients admitted for an overt upper digestive tract bleeding. In critically ill subjects admitted for other causes, its performances have scarcely been investigated despite its broad use. We sought to question the performance of bedside UGE in intensive care unit (ICU) patients, admitted for another reason than overt bleeding. METHODS: This was a six-year (January 2007-December 2012) retrospective observational study of all UGE performed in a medico-surgical ICU...
July 4, 2018: Annals of Intensive Care
Matthieu Le Dorze, Florian Huché, Clément Coelembier, Christophe Rabuel, Didier Payen
BACKGROUND: Cognitive dysfunction and delirium after ICU are frequent and may partially result from brain ischemia episodes. We hypothesized that systemic inflammation (severe sepsis or septic shock) modifies the control of brain circulation and the relation between systemic and cerebral hemodynamic after a positive response to fluid challenge (FC). METHODS: Three groups of patients were studied if they increased stroke volume (SV) > 10% after 250 or 500 ml of crystalloids: control group: patients free of comorbidity anesthetized for orthopedic surgery; sepsis group: patients with severe sepsis or septic shock (classic definition); brain injury (BI) group: trauma brain jury or hemorrhagic stroke with no detectable systemic inflammation...
June 28, 2018: Annals of Intensive Care
Marije Wijnberge, Daniko P Sindhunata, Michael R Pinsky, Alexander P Vlaar, Else Ouweneel, Jos R Jansen, Denise P Veelo, Bart F Geerts
The bedside hemodynamic assessment of the critically ill remains challenging since blood volume, arterial-venous interaction and compliance are not measured directly. Mean circulatory filling pressure (Pmcf ) is the blood pressure throughout the vascular system at zero flow. Animal studies have shown Pmcf provides information on vascular compliance, volume responsiveness and enables the calculation of stressed volume. It is now possible to measure Pmcf at the bedside. We performed a systematic review of the current Pmcf measurement techniques and compared their clinical applicability, precision, accuracy and limitations...
June 20, 2018: Annals of Intensive Care
Feng Yang, Dengbang Hou, Jinhong Wang, Yongchao Cui, Xiaomeng Wang, Zhichen Xing, Chunjing Jiang, Xing Hao, Zhongtao Du, Xiaofang Yang, Yu Jiang, Xiaotong Hou
BACKGROUND: The rate, prognostic impacts, and predisposing factors of major vascular complications (MVCs) in patients underwent venoarterial extracorporeal membrane oxygenation (VA-ECMO) by surgical cut-down are poorly understood. The purpose of this study was to identify these parameters in adult VA-ECMO patients. METHODS: Adult postcardiotomy cardiogenic shock (PCS) patients receiving VA-ECMO by femoral surgical cut-down cannulation from January 2004 to December 2015 were enrolled in this study...
June 19, 2018: Annals of Intensive Care
Hongliang Wang, Hongshuang Tong, Haitao Liu, Yao Wang, Ruitao Wang, Hong Gao, Pulin Yu, Yanji Lv, Shuangshuang Chen, Guiyue Wang, Miao Liu, Yuhang Li, Kaijiang Yu, Changsong Wang
BACKGROUND: Catheter-related blood-stream infections (CRBSIs) are the most common complication when using central venous catheters (CVCs). Whether coating CVCs under bundles could further reduce the incidence of CRBSIs is unclear. We aimed to assess the effectiveness of implementing the use of bundles with antimicrobial-coated CVCs for preventing catheter-related blood-stream infections. METHODS: In this systematic review and network meta-analyses, we searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library in addition to the EMBASE, MEDLINE, CINAHL, and Web of Science databases for studies published before July 2017...
June 15, 2018: Annals of Intensive Care
Ben de Jong, Anne Sophie Schuppers, Arriette Kruisdijk-Gerritsen, Maurits Erwin Leo Arbouw, Hubertus Laurentius Antonius van den Oever, Arthur R H van Zanten
BACKGROUND: Studies evaluating nicotine replacement therapy (NRT) to prevent nicotine withdrawal symptoms in ICU patients have yielded conflicting results. We performed a randomised controlled double-blind pilot study to assess the safety and efficacy of NRT in critically ill patients. Mechanically ventilated patients admitted to two medical-surgical intensive care units and smoking more than 10 cigarettes per day before ICU admission were enrolled in this study. Participants were randomised to transdermal NRT (14 or 21 mg per day) or placebo until ICU discharge or day 30...
June 7, 2018: Annals of Intensive Care
Akira Endo, Atsushi Shiraishi, Kiyohide Fushimi, Kiyoshi Murata, Yasuhiro Otomo
BACKGROUND: Although enteral nutrition has become one of the standard therapies for patients with acute pancreatitis, the optimal formulae for enteral nutrition have been under debate. Elemental formula is assumed to be suitable in the treatment of patients with acute pancreatitis because it has less stimulating effects for exocrine secretions of the pancreas, simultaneously maintaining gut immunity; however, clinical studies corroborating this assumption have been scarce. METHODS: We conducted a retrospective cohort study using a Japanese national administrative database between 2010 and 2015...
June 5, 2018: Annals of Intensive Care
Andreas Hohn, Nina Balfer, Bernhard Heising, Sabine Hertel, Jan C Wiemer, Marcel Hochreiter, Stefan Schröder
BACKGROUND: In randomised controlled trials, procalcitonin (PCT)-guided antibiotic treatment has been proven to significantly reduce length of antibiotic therapy in intensive care unit (ICU) patients. However, concern was raised on low protocol adherence and high rates of overruling, and thus the value of PCT-guided treatment in real clinical life outside study conditions remains unclear. In this study, adherence to a PCT protocol to guide antibiotic treatment in patients with severe sepsis and septic shock was analysed...
June 4, 2018: Annals of Intensive Care
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