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Jean-Louis Teboul

Maurizio Cecconi, Glenn Hernandez, Martin Dunser, Massimo Antonelli, Tim Baker, Jan Bakker, Jacques Duranteaum, Sharon Einav, A B Johan Groeneveld, Tim Harris, Sameer Jog, Flavia R Machado, Mervyn Mer, M Ignacio Monge Garcia, Sheila Nainan Myatra, Anders Perner, Jean-Louis Teboul, Jean-Louis Vincent, Daniel De Backer
An international team of experts in the field of fluid resuscitation was invited by the ESICM to form a task force to systematically review the evidence concerning fluid administration using basic monitoring. The work included a particular emphasis on pre-ICU hospital settings and resource-limited settings. The work focused on four main questions: (1) What is the role of clinical assessment to guide fluid resuscitation in shock? (2) What basic monitoring is required to perform and interpret a fluid challenge? (3) What defines a fluid challenge in terms of fluid type, ranges of volume, and rate of administration? (4) What are the safety endpoints during a fluid challenge? The expert panel found insufficient evidence to provide recommendations according to the GRADE system, and was only able to make recommendations for basic interventions, based on the available evidence and expert opinion...
November 19, 2018: Intensive Care Medicine
Olfa Hamzaoui, Jean-Louis Teboul
No abstract text is available yet for this article.
November 14, 2018: Journal of Critical Care
Mathieu Jozwiak, Xavier Monnet, Jean-Louis Teboul
Fluid administration is the first-line therapy in patients with acute circulatory failure. The main goal of fluid administration is to increase the cardiac output and ultimately the oxygen delivery. Nevertheless, the decision to administer fluids or not should be carefully considered, since half of critically ill patients are fluid unresponsive, and the deleterious effects of fluid overload clearly documented. Thus, except at the initial phase of hypovolemic or septic shock, where hypovolemia is constant and most of the patients responsive to the initial fluid resuscitation, it is of importance to test fluid responsiveness before administering fluids in critically ill patients...
September 2018: Annals of Translational Medicine
David J Lederer, Scott C Bell, Richard D Branson, James D Chalmers, Rachel Marshall, David M Maslove, David E Ost, Naresh M Punjabi, Michael Schatz, Alan R Smyth, Paul W Stewart, Samy Suissa, Alex A Adjei, Cezmi A Akdis, Elie Azoulay, Jan Bakker, Zuhair K Ballas, Philip G Bardin, Esther Barreiro, Rinaldo Bellomo, Jonathan A Bernstein, Vito Brusasco, Timothy G Buchman, Sudhansu Chokroverty, Nancy A Collop, James D Crapo, Dominic A Fitzgerald, Lauren Hale, Nicholas Hart, Felix J Herth, Theodore J Iwashyna, Gisli Jenkins, Martin Kolb, Guy B Marks, Peter Mazzone, J Randall Moorman, Thomas M Murphy, Terry L Noah, Paul Reynolds, Dieter Riemann, Richard E Russell, Aziz Sheikh, Giovanni Sotgiu, Erik R Swenson, Rhonda Szczesniak, Ronald Szymusiak, Jean-Louis Teboul, Jean-Louis Vincent
No abstract text is available yet for this article.
September 19, 2018: Annals of the American Thoracic Society
Jean-Louis Teboul, Xavier Monnet, Denis Chemla, Frédéric Michard
Fluid administration leads to a significant increase in cardiac output in only half of the intensive care unit patients. This led to the concept of assessing fluid responsiveness before infusing fluid. Pulse pressure variation, which quantifies the changes in arterial pulse pressure during mechanical ventilation, is one of the dynamic variables which can predict fluid responsiveness. The underlying hypothesis is that large respiratory changes in left ventricular stroke volume, and thus pulse pressure, occur in cases of biventricular preload responsiveness...
August 23, 2018: American Journal of Respiratory and Critical Care Medicine
Glenn Hernández, Alexandre Biasi Cavalcanti, Gustavo Ospina-Tascón, Arnaldo Dubin, Francisco Javier Hurtado, Lucas Petri Damiani, Gilberto Friedman, Ricardo Castro, Leyla Alegría, Maurizio Cecconi, Jean-Louis Teboul, Jan Bakker
BACKGROUND: ANDROMEDA-SHOCK is an international, multicenter, randomized controlled trial comparing peripheral perfusion-targeted resuscitation to lactate-targeted resuscitation in patients with septic shock in order to test the hypothesis that resuscitation targeting peripheral perfusion will be associated with lower morbidity and mortality. OBJECTIVE: To report the statistical analysis plan for the ANDROMEDA-SHOCK trial. METHODS: We describe the trial design, primary and secondary objectives, patients, methods of randomization, interventions, outcomes, and sample size...
July 30, 2018: Revista Brasileira de Terapia Intensiva
Mathieu Jozwiak, Xavier Monnet, Jean-Louis Teboul
PURPOSE OF REVIEW: Hemodynamic investigations are required in patients with shock to identify the type of shock, to select the most appropriate treatments and to assess the patient's response to the selected therapy. We discuss how to select the most appropriate hemodynamic monitoring techniques in patients with shock as well as the future of hemodynamic monitoring. RECENT FINDINGS: Over the last decades, the hemodynamic monitoring techniques have evolved from intermittent toward continuous and real-time measurements and from invasive toward less-invasive approaches...
August 2018: Current Opinion in Critical Care
Valentina Girotto, Jean-Louis Teboul, Alexandra Beurton, Laura Galarza, Thierry Guedj, Christian Richard, Xavier Monnet
BACKGROUND: The hemodynamic effects of the passive leg raising (PLR) test must be assessed through a direct measurement of cardiac index (CI). We tested whether changes in Doppler common carotid blood flow (CBF) and common femoral artery blood flow (FBF) could detect a positive PLR test (increase in CI ≥ 10%). We also tested whether CBF and FBF changes could track simultaneous changes in CI during PLR and volume expansion. In 51 cases, we measured CI (PiCCO2), CBF and FBF before and during a PLR test (one performed for CBF and another for FBF measurements) and before and after volume expansion, which was performed if PLR was positive...
May 29, 2018: Annals of Intensive Care
Jean-Louis Teboul, Maurizio Cecconi, Thomas W L Scheeren
No abstract text is available yet for this article.
June 2018: Intensive Care Medicine
Manu L N G Malbrain, Niels Van Regenmortel, Bernd Saugel, Brecht De Tavernier, Pieter-Jan Van Gaal, Olivier Joannes-Boyau, Jean-Louis Teboul, Todd W Rice, Monty Mythen, Xavier Monnet
In patients with septic shock, the administration of fluids during initial hemodynamic resuscitation remains a major therapeutic challenge. We are faced with many open questions regarding the type, dose and timing of intravenous fluid administration. There are only four major indications for intravenous fluid administration: aside from resuscitation, intravenous fluids have many other uses including maintenance and replacement of total body water and electrolytes, as carriers for medications and for parenteral nutrition...
May 22, 2018: Annals of Intensive Care
Daniel De Backer, Jan Bakker, Maurizio Cecconi, Ludhmila Hajjar, Da Wei Liu, Suzanna Lobo, Xavier Monnet, Andrea Morelli, Sheila Neinan Myatra, Azriel Perel, Michael R Pinsky, Bernd Saugel, Jean-Louis Teboul, Antoine Vieillard-Baron, Jean-Louis Vincent
While the pulmonary artery catheter (PAC) is still interesting in specific situations, there are many alternatives. A group of experts from different backgrounds discusses their respective interests and limitations of the various techniques and related measured variables. The goal of this review is to highlight the conditions in which the alternative devices will suffice and when they will not or when these alternative techniques can provide information not available with PAC. The panel concluded that it is useful to combine different techniques instead of relying on a single one and to adapt the "package" of interventions to the condition of the patient...
June 2018: Intensive Care Medicine
Xavier Monnet, Jean-Louis Teboul
Many efforts have been made to predict, before giving fluid, whether it will increase cardiac output. Nevertheless, after fluid administration, it is also essential to assess the therapeutic efficacy and to look for possible adverse effects. Like for any drug, this step should not be missed. Basically, volume expansion is aimed at improving tissue oxygenation and organ function. To assess this final result, clinical signs are often unhelpful. The increase in urine output in case of acute kidney injury is a poor marker of the kidney perfusion improvement...
April 24, 2018: Annals of Intensive Care
Glenn Hernández, Alexandre Biasi Cavalcanti, Gustavo Ospina-Tascón, Fernando Godinho Zampieri, Arnaldo Dubin, F Javier Hurtado, Gilberto Friedman, Ricardo Castro, Leyla Alegría, Maurizio Cecconi, Jean-Louis Teboul, Jan Bakker
BACKGROUND: Septic shock is a highly lethal condition. Early recognition of tissue hypoperfusion and its reversion are key factors for limiting progression to multiple organ dysfunction and death. Lactate-targeted resuscitation is the gold-standard under current guidelines, although it has several pitfalls including that non-hypoxic sources of lactate might predominate in an unknown proportion of patients. Peripheral perfusion-targeted resuscitation might provide a real-time response to increases in flow that could lead to a more timely decision to stop resuscitation, thus avoiding fluid overload and the risks of over-resuscitation...
April 23, 2018: Annals of Intensive Care
Thomas W L Scheeren, Jannis N Wicke, Jean-Louis Teboul
PURPOSE OF REVIEW: The current review attempts to demonstrate the value of several forms of carbon dioxide (CO2) gaps in resuscitation of the critically ill patient as monitor for the adequacy of the circulation, as target for fluid resuscitation and also as predictor for outcome. RECENT FINDINGS: Fluid resuscitation is one of the key treatments in many intensive care patients. It remains a challenge in daily practice as both a shortage and an overload in intravascular volume are potentially harmful...
June 2018: Current Opinion in Critical Care
Mathieu Jozwiak, Olfa Hamzaoui, Xavier Monnet, Jean-Louis Teboul
The prognosis of septic shock is tightly linked to the earliness of both appropriate antibiotic therapy and early hemodynamic resuscitation. This latter is essentially based on fluid and vasopressors administration. The step-by-step strategy, called "early goal-directed therapy" (EGDT) developed in 2001 and endorsed by the Surviving Sepsis Campaign (SSC) between 2004 and 2016 is no longer recommended. Indeed, recent multicenter randomized clinical trials showed no reduction in all-cause mortality, duration of organ support and in-hospital length of stay with EGDT in comparison with standard care...
August 2018: Minerva Anestesiologica
Can Ince, E Christiaan Boerma, Maurizio Cecconi, Daniel De Backer, Nathan I Shapiro, Jacques Duranteau, Michael R Pinsky, Antonio Artigas, Jean-Louis Teboul, Irwin K M Reiss, Cesar Aldecoa, Sam D Hutchings, Abele Donati, Marco Maggiorini, Fabio S Taccone, Glenn Hernandez, Didier Payen, Dick Tibboel, Daniel S Martin, Alexander Zarbock, Xavier Monnet, Arnaldo Dubin, Jan Bakker, Jean-Louis Vincent, Thomas W L Scheeren
PURPOSE: Hand-held vital microscopes (HVMs) were introduced to observe sublingual microcirculatory alterations at the bedside in different shock states in critically ill patients. This consensus aims to provide clinicians with guidelines for practical use and interpretation of the sublingual microcirculation. Furthermore, it aims to promote the integration of routine application of HVM microcirculatory monitoring in conventional hemodynamic monitoring of systemic hemodynamic variables...
March 2018: Intensive Care Medicine
Mathieu Jozwiak, Xavier Monnet, Jean-Louis Teboul
Monitoring cardiac output is of special interest for detecting early hemodynamic impairment and for guiding its treatment. Among the techniques that are available to monitor cardiac output, pressure waveform analysis estimates cardiac output from the shape of the arterial pressure curve. It is based on the general principle that the amplitude of the systolic part of the arterial curve is proportional to cardiac output and arterial compliance. Such an estimation of cardiac output has the advantage of being continuous and in real time...
June 2018: Anesthesia and Analgesia
Sheila Nainan Myatra, Jigeeshu Vasishtha Divatia, Natesh R Prabu, Jean-Louis Teboul
No abstract text is available yet for this article.
November 2017: Critical Care Medicine
Victor De la Puente-Diaz de Leon, Valente de Jesus Jaramillo-Rocha, Jean-Louis Teboul, Sofia Garcia-Miranda, Bernardo A Martinez-Guerra, Guillermo Dominguez-Cherit
BACKGROUND: Arterial blood pressure is the most common variable used to assess the response to a fluid challenge in routine clinical practice. The aim of this study was to evaluate the accuracy of the change in the radial artery pulse pressure (rPP) to detect the change in cardiac output after a fluid challenge in patients with septic shock. METHODS: Prospective observational study including 35 patients with septic shock in which rPP and cardiac output were measured before and after a fluid challenge with 400 mL of crystalloid solution...
January 1, 2017: Journal of Intensive Care Medicine
Jean-Louis Teboul, Jacques Duranteau, James A Russell
No abstract text is available yet for this article.
July 2018: Intensive Care Medicine
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