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6 results on '"PIEHR SAINT-LEGER"'

1. Therapeutic management of severe hypothermia with veno-arterial ECMO: where do we stand? Case report and review of the current literature

Author

Aurélien Ledoux and Piehr Saint Leger

Subjects
Hypothermia, Cardiac arrest, Extracorporeal membrane oxygenation, Rewarming, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background Severe accidental hypothermia is associated with high morbidity and mortality. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides an efficient rewarming method with complete cardiopulmonary support. The use of VA-ECMO for this indication has greatly improved the vital and functional prognosis of patients. Case presentation We report a case of a 46-year-old patient who was treated for severe hypothermia with a temperature of 22.4 °C along with initial cardiac arrest, whose progression was favorable after the implementation of VA-ECMO support. Two months after initial cardiac arrest, the patient was reassessed and showed signs of complete recovery with regard to his mental and physical capacities. Conclusions The recent international publications and groups of experts recommend the use of VA ECMO as the gold standard therapy to treat severe hypothermia. Therefore, it seems suitable to update the current knowledge on the topic by analysing the latest international publications. The performance of this technique calls into question ethical and economic factors. Two distinct medical teams tried to identify and regroup prognosis factors in predictive survival scores. They raise the question of the utility of these scores in clinical practice. Indeed, according to which survival rate should we proceed to prolonged resuscitation and implement VA-ECMO? Additional studies will be needed for external approval of these survival scores, and additional reflection by experts will be required.

Published
2020
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2. Saving lives by ventilating two patients with specific pressure-controlled ventilation from a single ICU-ventilator during the COVID-19 pandemic

Author

Maxence Hureau, Maaike Versyck, Sylvie Fontainre, Fabien Lambiotte, Nabil El Beki, and Piehr Saint Leger

Subjects
Anesthesiology, RD78.3-87.3, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

In late December 2019, SARS-CoV-2 was discovered, which is responsible for a new human disease called COVID-19. Among all laboratory-confirmed COVID-19 cases, 14% were hospitalized, with 2% admitted to intensive care units (ICU) with acute respiratory distress syndrome (ARDS) requiring mechanical ventilation [1]. SARS-CoV-2 has spread quickly across the world, with more than one hundred million confirmed cases and more than 2,500,000 dead. In March 2020, the Hospital of Valenciennes had to admit hundreds of COVID-19 patients, and its capacity was almost exceeded [2]. More recently, in France, thousands of critically ill patients had to be admitted to ICUs. In Europe, the next wave of COVID-19 pandemic could be more severe than the first one, and we already know that, in the case of increasing numbers of critically ill, some of them will die as a result of the unavailability of mechanical ventilators [3]. This shortage may be lessened if one ventilator could service more than one patient. The main worry is that this concept could be not useful and systematically deleterious for the patient. Some concepts have already been proposed to ventilate differently two circuits with a single ventilator, with several limitations like the lack of individualization of ventilation of each circuit [4–6]. More recently, in the face of the COVID-19 pandemic, Clarke et al. [7] described a new concept able to deliver specific ventilation for two different lung tests with a single ventilator. Again, Levin et al. [8] have recently shown that a similar concept of differential ventilation using a single ventilator with flow control valves is feasible in humans.

Published
2021
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3. Effect of non-invasive ventilation after extubation in critically ill patients with obesity in France: a multicentre, unblinded, pragmatic randomised clinical trial

Author

Audrey De Jong, Anne Bignon, François Stephan, Thomas Godet, Jean-Michel Constantin, Karim Asehnoune, Aude Sylvestre, Juliette Sautillet, Raiko Blondonnet, Martine Ferrandière, Philippe Seguin, Sigismond Lasocki, Amélie Rollé, Pierre-Marie Fayolle, Laurent Muller, Emmanuel Pardo, Nicolas Terzi, Séverin Ramin, Boris Jung, Paer-Selim Abback, Philippe Guerci, Benjamine Sarton, Hadrien Rozé, Claire Dupuis, Joel Cousson, Marion Faucher, Virginie Lemiale, Bernard Cholley, Gerald Chanques, Fouad Belafia, Helena Huguet, Emmanuel Futier, Elie Azoulay, Nicolas Molinari, Samir Jaber, AUDREY DE JONG, ANNE BIGNON, FRANÇOIS STEPHAN, THOMAS GODET, JEAN-MICHEL CONSTANTIN, KARIM ASEHNOUNE, AUDE SYLVESTRE, JULIETTE SAUTILLET, RAIKO BLONDONNET, MARTINE FERRANDIERE, PHILIPPE SEGUIN, SIGISMOND LASOCKI, AMELIE ROLLE, PIERRE-MARIE FAYOLLE, LAURENT MULLER, EMMANUEL PARDO, NICOLAS TERZI, SEVERIN RAMIN, BORIS JUNG, PAER-SELIM ABBACK, PHILIPPE GUERCI, BENJAMINE SARTON, HADRIEN ROZE, CLAIRE DUPUIS, JOEL COUSSON, MARION FAUCHER, VIRGINIE LEMIALE, BERNARD CHOLLEY, GERALD CHANQUES, FOUAD BELAFIA, HELENA HUGUET, EMMANUEL FUTIER, CLAUDINE GNIADEK, AURELIE VONARB, ALBERT PRADES, CARINE JAILLET, XAVIER CAPDEVILA, JONATHAN CHARBIT, THIBAUT GENTY, SAIDA REZAIGUIA-DELCLAUX, AUDREY IMBERT, CATHERINE PILORGE, ROMAN CALYPSO, ASTRID BOUTEAU-DURAND, MICHEL CARLES, HOSSEN MEHDAOUI, BERTRAND SOUWEINE, LAURE CALVET, MATTHIEU JABAUDON, BENJAMIN RIEU, CLARA CANDILLE, FLORIAN SIGAUD, BEATRICE RIU, LAURENT PAPAZIAN, SABINE VALERA, DJAMEL MOKART, LAURENT CHOW CHINE, MAGALI BISBAL, CAMILLE POULIQUEN, JEAN-MANUEL DE GUIBERT, MAXIME TOURRET, DAMIEN MALLET, MARC LEONE, LAURENT ZIELESKIEWICZ, JEANNE COSSIC, MONA ASSEFI, ELODIE BARON, CYRIL QUEMENEUR, ANTOINE MONSEL, MATTHIEU BIAIS, ALEXANDRE OUATTARA, ELINE BONNARDEL, SIMON MONZIOLS, MARTIN MAHUL, JEAN-YVES LEFRANT, CLAIRE ROGER, SABER BARBAR, FABIEN LAMBIOTTE, PIEHR SAINT-LEGER, CATHERINE PAUGAM, JULIEN POTTECHER, PIERRE-OLIVIER LUDES, LUCIE DARRIVERE, MARC GARNIER, ERIC KIPNIS, GILLES LEBUFFE, MATTHIAS GAROT, JEREMY FALCONE, BENJAMIN CHOUSTERMAN, MAGALI COLLET, ETIENNE GAYAT, JEAN DELLAMONICA, WILLY-SERGE MFAM, EVELINA OCHIN, MOHAMED NEBLI, NEJLA TILOUCHE, BENJAMIN MADEUX, DAVID BOUGON, YASSIR AARAB, FANNY GARNIER, ELIE AZOULAY, NICOLAS MOLINARI, and SAMIR JABER

Subjects
Pulmonary and Respiratory Medicine
Published
2023
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4. Correction to: Relationship between ventilator-associated pneumonia and mortality in COVID-19 patients: a planned ancillary analysis of the coVAPid cohort

Author

Raphael Favory, Guillaume Voiriot, Jean Luc Baudel, Anahita Rouzé, Alexandra Beurton, Mathilde Bouchereau, Anastasia Saade, Julien Poissy, Gemma Gomà, Pedro Póvoa, Piehr Saint Leger, Bruno Mégarbane, Mercé Jourdain, Claire Boulle Geronimi, Fabienne Tamion, Adrian Ceccato, Julien Labreuche, Martine Nyunga, Iliana Ioannidou, Sebastien Preau, Marie Labruyere, Saad Nseir, Matthieu Metzelard, Marc Pineton de Chambrun, Pierre Asfar, Ignacio Martin-Loeches, Louis Kreitmann, Loïc Le Guennec, Fabien Lambiotte, Alexandre Pierre, Eleni Magira, Demosthenes Makris, Thierry Van Der Linden, Alain Duhamel, Olivier Pouly, Vassiliki Tsolaki, Denis Garot, Damien du Cheyron, Antoni Torres, Jean François Llitjos, Damien Contou, Christophe Vinsonneau, Antonio Artigas, Pierre Edouard Floch, Luis Coelho, David Nora, Armand Mekontso-Dessap, Jean Reignier, Alexandre Boyer, and Arnaud W. Thille

Subjects
medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, RC86-88.9, Cohort, Emergency medicine, medicine, Ventilator-associated pneumonia, Correction, Medical emergencies. Critical care. Intensive care. First aid, Critical Care and Intensive Care Medicine, business, medicine.disease
Published
2021

5. Therapeutic management of severe hypothermia with veno-arterial ECMO: where do we stand? Case report and review of the current literature

Author

Piehr Saint Leger and Aurélien Ledoux

Subjects
Male, Resuscitation, medicine.medical_specialty, Accidental hypothermia, medicine.medical_treatment, Case Report, Hypothermia, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, 03 medical and health sciences, High morbidity, 0302 clinical medicine, Extracorporeal Membrane Oxygenation, Extracorporeal membrane oxygenation, medicine, Humans, Rewarming, Intensive care medicine, Survival rate, business.industry, Gold standard, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, lcsh:RC86-88.9, Middle Aged, Cardiac arrest, Prognosis, Heart Arrest, Clinical Practice, surgical procedures, operative, Emergency Medicine, medicine.symptom, business
Abstract

Background Severe accidental hypothermia is associated with high morbidity and mortality. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides an efficient rewarming method with complete cardiopulmonary support. The use of VA-ECMO for this indication has greatly improved the vital and functional prognosis of patients. Case presentation We report a case of a 46-year-old patient who was treated for severe hypothermia with a temperature of 22.4 °C along with initial cardiac arrest, whose progression was favorable after the implementation of VA-ECMO support. Two months after initial cardiac arrest, the patient was reassessed and showed signs of complete recovery with regard to his mental and physical capacities. Conclusions The recent international publications and groups of experts recommend the use of VA ECMO as the gold standard therapy to treat severe hypothermia. Therefore, it seems suitable to update the current knowledge on the topic by analysing the latest international publications. The performance of this technique calls into question ethical and economic factors. Two distinct medical teams tried to identify and regroup prognosis factors in predictive survival scores. They raise the question of the utility of these scores in clinical practice. Indeed, according to which survival rate should we proceed to prolonged resuscitation and implement VA-ECMO? Additional studies will be needed for external approval of these survival scores, and additional reflection by experts will be required.

Published
2020

6. Invasive pulmonary aspergillosis in COVID-19 critically ill patients: Results of a French monocentric cohort

Author

Wafa Zarrougui, Fabien Lambiotte, Nabil Elbeki, Maaike Versyck, and Piehr Saint-Leger

Subjects
Male, ARDS, beta-Glucans, medicine.medical_treatment, TA, Tracheal aspiration, Comorbidity, Invasive pulmonary aspergillosis, law.invention, Mannans, chemistry.chemical_compound, Risk Factors, law, SD, Standard deviation, Medicine, Aged, 80 and over, Respiratory Distress Syndrome, 0303 health sciences, medicine.diagnostic_test, Immunosuppression, Middle Aged, Intensive care unit, ICU, Intensive care unit, Intensive Care Units, Infectious Diseases, EORTC, European Organization for Research and Treatment of Cancer, Cohort, Female, France, BDG, Beta-D-glucan, Research Paper, IFI, Invasive fungal infection, Adult, BAL, Bronchoalveolar lavage, medicine.medical_specialty, Critical Illness, BMI, Body mass index, Opportunistic Infections, Hospitals, General, Immunocompromised Host, 03 medical and health sciences, Galactomannan, Internal medicine, ARDS, Acute respiratory distress syndrome, Humans, Infectious disease (athletes), Aged, Retrospective Studies, GM, Galactomannan, SARS-CoV-2, 030306 microbiology, business.industry, COVID-19, Galactose, Retrospective cohort study, medicine.disease, Respiration, Artificial, Bronchoalveolar lavage, chemistry, IPA, Invasive pulmonary aspergillosis, business, Biomarkers
Abstract

Introduction Coronavirus disease 2019 or COVID-19 is a new infectious disease responsible for potentially severe respiratory impairment associated with initial immunosuppression. Similarly to influenza, several authors have described a higher risk of fungal infection after COVID-19, in particular for invasive pulmonary aspergillosis. The main objective here is to define the prevalence of invasive pulmonary aspergillosis (IPA) in a cohort of COVID-19 patients with moderate to severe acute respiratory disease syndrome (ARDS). Material and methods We conducted a large monocentric retrospective study investigating all the ventilated COVID-19 patients with ARDS hospitalized at Valenciennes' general hospital, France, between March 15, 2020 and April 30, 2020. In the center a systematic IPA screening strategy was carried out for all ARDS patients, with weekly tests of serum galactomannan and beta-D-glucan. Bronchoalveolar lavage with culture and chest CT scan were performed when the serum assays were positives. Results A total of 54 patients were studied. Their median age was 65 years, and 37 of the patients (71%) were male. Two patients had chronic immunosuppression and among all the patients, only 2 non-immunocompromised presented a putative IPA during their stay. Conclusion The prevalence of IPA in this cohort of COVID-19 patients (3.7%) is not higher than what is described in the other ARDS populations in the literature. These results are however different from the previous publications on COVID-19 patients and must therefore be confirmed by larger and multicentric studies.

Published
2021
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