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Antoine Vieillard Baron

Xavier Repessé, Alix Aubry, Antoine Vieillard-Baron
Acute respiratory distress syndrome (ARDS) remains associated with a poor outcome despite recent major therapeutic advances. Forecasting the outcome of patients suffering from such a syndrome is of a crucial interest and many scores have been proposed, all suffering from limits responsible for important discrepancies. Authors try to elaborate simple, routine and reliable scores but most of them do not consider hemodynamics yet acknowledged as a major determinant of outcome. This article aims at reminding the approach of scoring in ARDS and at deeply describing the most recently published one in order to highlight their main pitfall, which is to forget the hemodynamics...
August 2016: Journal of Thoracic Disease
Anders Aneman, Antoine Vieillard-Baron
No abstract text is available yet for this article.
August 20, 2016: Intensive Care Medicine
Philippe Vignon, Xavier Repessé, Antoine Vieillard-Baron, Eric Maury
Acute respiratory failure (ARF) is a leading indication for performing critical care ultrasonography (CCUS) which, in these patients, combines critical care echocardiography (CCE) and chest ultrasonography. CCE is ideally suited to guide the diagnostic work-up in patients presenting with ARF since it allows the assessment of left ventricular filling pressure and pulmonary artery pressure, and the identification of a potential underlying cardiopathy. In addition, CCE precisely depicts the consequences of pulmonary vascular lesions on right ventricular function and helps in adjusting the ventilator settings in patients sustaining moderate-to-severe acute respiratory distress syndrome...
August 15, 2016: Critical Care: the Official Journal of the Critical Care Forum
Alexis Paternot, Xavier Repessé, Antoine Vieillard-Baron
Pulmonary vascular dysfunction is associated with ARDS and leads to increased right-ventricular afterload and eventually right-ventricular failure, also called acute cor pulmonale. Interest in acute cor pulmonale and its negative impact on outcome in patients with ARDS has grown in recent years. Right-ventricular function in these patients should be closely monitored, and this is helped by the widespread use of echocardiography in intensive care units. Because mechanical ventilation may worsen right-ventricular failure, the interaction between the lungs and the right ventricle appears to be a key factor in the ventilation strategy...
October 2016: Respiratory Care
Anthony S McLean, Fabio S Taccone, Antoine Vieillard-Baron
No abstract text is available yet for this article.
October 2016: Intensive Care Medicine
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
Laurent Guérin, Antoine Vieillard-Baron
Echocardiography is a noninvasive and accurate tool used in the intensive care unit to assess cardiac function and monitor hemodynamics in shocked patients. During severe sepsis or septic shock, several mechanisms can lead to hemodynamic failure and have to be quickly and precisely diagnosed to propose adequate, personalized, and timely hemodynamic therapy. Echocardiography truly provides intensivists with this diagnostic possibility, whether or not there is fluid responsiveness, cardiac dysfunction, or persistent vasoplegia...
June 2016: Clinics in Chest Medicine
Gwénaël Prat, Cyril Charron, Xavier Repesse, Pierre Coriat, Pierre Bailly, Erwan L'her, Antoine Vieillard-Baron
BACKGROUND: Our aim was to evaluate the impact of a computerized echocardiographic simulator on the learning curve for transesophageal echocardiography (TEE) hemodynamic assessment of ventilated patients in the ICU. METHODS: We performed a prospective study in two university hospital medical ICUs. Using our previously validated skill assessment scoring system (/40 points), we compared learning curves obtained with (interventional group, n = 25 trainees) and without (control group, n = 31 trainees) use of a simulator in the training...
December 2016: Annals of Intensive Care
Xavier Repessé, Cyril Charron, Antoine Vieillard-Baron
PURPOSE OF REVIEW: The right ventricle (RV) plays a pivotal role during respiratory failure because of its high sensitivity to small loading changes during inspiration. Both RVs, preload and afterload, are altered during inspiration, either in spontaneous breathing or during mechanical ventilation. Some clinical situations especially affect RV load during inspiration, for example acute asthma and acute respiratory distress syndrome. The aim of this review is to explain and to summarize the different mechanisms leading to RV failure in these situations...
June 2016: Current Opinion in Critical Care
Veli-Pekka Harjola, Alexandre Mebazaa, Jelena Čelutkienė, Dominique Bettex, Hector Bueno, Ovidiu Chioncel, Maria G Crespo-Leiro, Volkmar Falk, Gerasimos Filippatos, Simon Gibbs, Adelino Leite-Moreira, Johan Lassus, Josep Masip, Christian Mueller, Wilfried Mullens, Robert Naeije, Anton Vonk Nordegraaf, John Parissis, Jillian P Riley, Arsen Ristic, Giuseppe Rosano, Alain Rudiger, Frank Ruschitzka, Petar Seferovic, Benjamin Sztrymf, Antoine Vieillard-Baron, Mehmet Birhan Yilmaz, Stavros Konstantinides
Acute right ventricular (RV) failure is a complex clinical syndrome that results from many causes. Research efforts have disproportionately focused on the failing left ventricle, but recently the need has been recognized to achieve a more comprehensive understanding of RV anatomy, physiology, and pathophysiology, and of management approaches. Right ventricular mechanics and function are altered in the setting of either pressure overload or volume overload. Failure may also result from a primary reduction of myocardial contractility owing to ischaemia, cardiomyopathy, or arrhythmia...
March 2016: European Journal of Heart Failure
Guy Meyer, Antoine Vieillard-Baron, Benjamin Planquette
The aim of this narrative review is to summarize for intensivists or any physicians managing "severe" pulmonary embolism (PE) the main recent advances or recommendations in the care of patients including risk stratification, diagnostic algorithm, hemodynamic management in the intensive care unit (ICU), recent data regarding the use of thrombolytic treatment and retrievable vena cava filters and finally results of direct oral anticoagulants. Thanks to the improvements achieved in the risk stratification of patients with PE, a better therapeutic approach is now recommended from diagnosis algorithm and indication to admission in ICU to indication of thrombolysis and general hemodynamic support in patients with shock...
December 2016: Annals of Intensive Care
Armand Mekontso Dessap, Florence Boissier, Cyril Charron, Emmanuelle Bégot, Xavier Repessé, Annick Legras, Christian Brun-Buisson, Philippe Vignon, Antoine Vieillard-Baron
RATIONALE: Increased right ventricle (RV) afterload during acute respiratory distress syndrome (ARDS) may induce acute cor pulmonale (ACP). OBJECTIVES: To determine the prevalence and prognosis of ACP and build a clinical risk score for the early detection of ACP. METHODS: This was a prospective study in which 752 patients with moderate-to-severe ARDS receiving protective ventilation were assessed using transesophageal echocardiography in 11 intensive care units...
May 2016: Intensive Care Medicine
Xavier Repessé, Cyril Charron, Antoine Vieillard-Baron
PURPOSE OF REVIEW: Circulatory failure is a frequent complication during acute respiratory distress syndrome (ARDS) and is associated with a poor outcome. This review aims at clarifying the mechanisms of circulatory failure during ARDS. RECENT FINDINGS: For the past decades, the right ventricle (RV) has gained a crucial interest since many authors confirmed the high incidence of acute cor pulmonale during ARDS and showed a potential role of the acute cor pulmonale in the poor outcome of ARDS patients...
February 2016: Current Opinion in Critical Care
Xavier Repessé, Antoine Vieillard-Baron
No abstract text is available yet for this article.
October 2015: American Journal of Physiology. Heart and Circulatory Physiology
Romain Jouffroy, Vincent Caille, Stéphane Perrot, Antoine Vieillard-Baron, Olivier Dubourg, Nicolas Mansencal
Previous studies have noted reversible cardiac dysfunction during marathon races, but few data are available concerning ultradistance trail running. The aim of this study was to assess echocardiographic parameters during ultradistance trail running. We performed an observational study in 66 participants to the 80-km Ecotrail of Paris Ile de France. All subjects had echocardiographic examinations before the race and on arrival, and 28 of them underwent serial echocardiographic examinations during the race (21 and 53 km)...
October 15, 2015: American Journal of Cardiology
Xavier Repessé, Cyril Charron, Julia Fink, Alain Beauchet, Florian Deleu, Michel Slama, Guillaume Belliard, Antoine Vieillard-Baron
Mean systemic filling pressure (Pmsf) is a major determinant of venous return. Its value is unknown in critically ill patients (ICU). Our objectives were to report Pmsf in critically ill patients and to look for its clinical determinants, if any. We performed a prospective study in 202 patients who died in the ICU with a central venous and/or arterial catheter. One minute after the heart stopped beating, intravascular pressures were recorded in the supine position after ventilator disconnection. Parameters at admission, during the ICU stay, and at the time of death were prospectively collected...
September 2015: American Journal of Physiology. Heart and Circulatory Physiology
Anders Perner, Antoine Vieillard-Baron, Jan Bakker
No abstract text is available yet for this article.
September 2015: Intensive Care Medicine
Jean-François Timsit, Anders Perner, Jan Bakker, Matteo Bassetti, Dominique Benoit, Maurizio Cecconi, J Randall Curtis, Gordon S Doig, Margaret Herridge, Samir Jaber, Michael Joannidis, Laurent Papazian, Mark J Peters, Pierre Singer, Martin Smith, Marcio Soares, Antoni Torres, Antoine Vieillard-Baron, Giuseppe Citerio, Elie Azoulay
No abstract text is available yet for this article.
April 2015: Intensive Care Medicine
Paul Mayo, Armand Mekontso Dessap, Antoine Vieillard-Baron
No abstract text is available yet for this article.
March 2015: Intensive Care Medicine
Paul Mayo, Armand Mekontso Dessap, Armand Mekontso Dessap, Antoine Vieillard-Baron
No abstract text is available yet for this article.
June 2015: Intensive Care Medicine
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