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3 results on '"Garcia Olivares P."'

1. A prospective international observational prevalence study on prone positioning of ARDS patients: the APRONET (ARDS Prone Position Network) study

Author

Guérin, C., Beuret, P., Constantin, J. M., Bellani, G., Garcia-Olivares, P., Roca, O., Meertens, J. H., Maia, P. Azevedo, Becher, T., Peterson, J., Larsson, A., Gurjar, M., Hajjej, Z., Kovari, F., Assiri, A. H., Mainas, E., Hasan, M. S., Morocho-Tutillo, D. R., Baboi, L., Chrétien, J. M., François, G., Ayzac, L., Chen, L., Brochard, L., Mercat, A., Hajjej, Zied, Sellami, Walid, Ferjani, M., Gurjar, Mohan, Assiri, Amer, Al Bshabshe, Ali, Almekhlafi, Ghaleb, Mandourah, Yasser, Hasan, Mohd Shahnaz, Rai, Vineya, Marzida, M., Corcoles Gonzalez, Virgilio, Sanchez Iniesta, Rafael, Garcia, Pablo, Garcia-Montesinos de la Peña, Manuel, Garcia Herrera, Adriana, Roca, Oriol, Garcia-de-Acilu, Marina, Masclans Enviz, Joan Ramon, Mancebo, Jordi, Heili, Sarah, Artigas Raventos, Antonio, Blanch Torra, Lluís, Roche-Campo, Ferran, Rialp, Gemma, Forteza, Catalina, Berrazueta, Ana, Martinez, Esther, Penuelas, Oscar, Jara-Rubio, Ruben, Mallat, Jihad, Thevenin, D., Zogheib, Elie, Mercat, Alain, Levrat, Albrice, Porot, Veronique, Bedock, B., Grech, Ludovic, Plantefeve, Gaetan, Badie, Julio, Besch, Guillaume, Pili-Floury, Sébastien, Guisset, Olivier, Robine, Adrien, Prat, Gwenael, Doise, Jean-Marc, Badet, Michel, Thouret, J. M., Just, Bernard, Perbet, Sébastien, Lautrette, Alexandre, Souweine, B., Chabanne, Russell, Danguy des Déserts, Marc, Rigaud, Jean-Philippe, Marchalot, Antoine, Rigaud, J. P., Bele, Nicolas, Beague, Sébastien, Hours, Sandrine, Marque, Sophie, Durand, Michel, Payen, J. F., Stoclin, Annabelle, Gaffinel, Alain, Winer, Arnaud, Chudeau, Nicolas, Tirot, Patrice, Thyrault, Martial, Paulet, Rémi, Thyrault, M., Aubrun, Frederic, Guerin, Claude, Floccard, Bernard, Rimmele, T., Argaud, Laurent, Hernu, Romain, Crozon Clauzel, Jullien, Wey, Pierre-François, Bourdin, Gael, Pommier, C., Cueuille, NadÃge, de Varax, null, Marchi, Elisa, Papazian, L., Jochmans, Sebastien, Monchi, M., Jaber, Samir, de Jong, Audrey, Moulaire, Valerie, Capron, Matthieu, Jarrige, L., Barberet, Guillaume, Lakhal, Karim, Rozec, B., Dellamonica, Jean, Robert, Alexandre, Bernardin, G., Danin, Pierre-Eric, Raucoules, M., Runge, Isabelle, Foucrier, Arnaud, Hamada, Sophie, Tesniere, Antoine, Fromentin, Mélanie, Samama, C. M., Mira, Jean-Paul, Diehl, Jean-Luc, Mekontso Dessap, Armand, Arbelot, Charlotte, Demoule, Alexandre, Roche, Anne, Similowski, T., Ricard, Jean-Damien, Gaudry, Stéphane, Dreyfuss, D., de Montmolin, Etienne, da Silva, Daniel, Verdiere, B., Ardisson, Fanny, Lemiale, Virginie, Azoulay, Elie, Bruel, Cédric, Tiercelet, Kelly, Fartoukh, Muriel, Voiriot, Guillaume, Hoffmann, Clement, Leclerc, T., Thille, Arnaud, Robert, Réné, Beuret, Pascal, Beduneau, Gaëtan, Beuzelin, Marion, Tamion, F., Morel, Jérôme, Tremblay, Aymeric, Molliex, S., Amal, Jean-Michel, Meaudre, Eric, Goutorbe, Philippe, Laffon, Marc, Gros, Antoine, Nica, Alexandru, Barjon, Genevieve, Dahyot-Fizelier, Claire, Imzi, Nadia, Gally, Josette, Real, null, Sauneuf, Bertrand, Souloy, Xavier, Girbes, Armand, Tuinman, Pieter Roel, Schultz, Marcus, Winters, Tineke, Mijzen, Lisa, Roekaerts, P. M. H. J., Vermeijden, Wytze, Beishuizen, Albertus, Trof, R., Corsten, Stijn, Kesecioglu, Jozef, Meertens, John, Dieperink, Wim, Pickers, Peter, Roovers, Noortje, Maia, Paulo, Duque, Melanie, Rua, Fernando, Pereira de Figueired, António Manuel, Ramos, Armindo, Fragoso, Elsa, Azevedo, Pilar, Gouveia, Joao, Costa E. Silva, Zélia, Silva, Goncalo, Chaves, Susana, Nobrega, J. J., Lopes, Luís, Valerio, Bernardino, Araujo, Ana Carolina, de Freitas, Paulo Telles, Bouw, Maria Jose, Melao, Maria, Granja, C., Marcal, Paulo, Fernandes, Antero, Joao, Gonçalves Pereira, Maia, Dionísio Faria, Spadaro, Savino, Volta, Carlo Alberto, Bellani, Giacomo, Citerio, G., Mauri, Tommaso, Alban, Laura, Pesenti, A., Mistraletti, Giovanni, Formenti, Paolo, Tommasino, C., Tardini, Francesca, Fumagalli, R., Colombo, Riccardo, Fossali, Tommaso, Catena, E., Todeschini, Manuel, Gnesin, Paolo, Cracchiolo, Andrea Neville, Palma, Daniela, Tetamo, R., Albiero, Daniela, Costantini, Elena, Raimondi, F., Coppadoro, Andrea, Vascotto, Ettore, Lusenti, F., Becher, Tobias, Schädler, Dirk, Weiler, N., Karagiannidis, Christian, Petersson, Johan, Konrad, D., Kawati, Rafael, Wessbergh, Joanna, Valtysson, J., Rockstroh, Matthias, Borgstrom, Sten, Larsson, Niklas, Thunberg, J., Camsooksai, Julie, Briggs, null, Kovari, Ferenc, Cuesta, J., Anwar, Sibs, O’Brien, B., Barberis, Luigi, Sturman, J., Mainas, Efstratios, Karatzas, S., Piza, Petr, Sottiaux, Thierry, Adam, J. F., Gawda, Ryszard, Gawor, Maen, Alqdah, M., Cohen, D., Brochard, Laurent, Baker, A., Ñamendys-Silva, Silvio Antonio, Garcia-Guillen, Francisco Javier, Morocho Tutillo, Diego Rolando, Jibaja Vega, Manuel, Zakalik, Graciela, Pagella, Gonzalo, Marengo, J., KARLI, Mélanie, Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Université de Lyon, 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), 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]), Hospital General Universitario 'Gregorio Marañón' [Madrid], Vall d'Hebron University Hospital [Barcelona], CIBER de Epidemiología y Salud Pública (CIBERESP), University Medical Center Groningen [Groningen] (UMCG), Centro Hospitalar do Porto, Karolinska University Hospital [Stockholm], Karolinska Institutet [Stockholm], Uppsala University, University of Malaya [Kuala Lumpur, Malaisie], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Keenan Research Centre of the Li Ka Shing Knowledge Institute [Toronto], Université d'Angers - Faculté de médecine (UA UFR Médecine), Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Other departments, Intensive Care Medicine, ACS - Diabetes & metabolism, ACS - Pulmonary hypertension & thrombosis, ACS - Microcirculation, Critical Care, 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), University of Malaya = Universiti Malaya [Kuala Lumpur, Malaisie] (UM), Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Université d'Angers (UA), Guã©rin, C, Beuret, P, Constantin, J, Bellani, G, Garcia-Olivares, P, Roca, O, Meertens, J, Maia, P, Becher, T, Peterson, J, Larsson, A, Gurjar, M, Hajjej, Z, Kovari, F, Assiri, A, Mainas, E, Hasan, M, Morocho-Tutillo, D, Baboi, L, Chrã©tien, J, Franã§ois, G, Ayzac, L, Chen, L, Brochard, L, Mercat, A, Sellami, W, Ferjani, M, Al Bshabshe, A, Almekhlafi, G, Mandourah, Y, Rai, V, Marzida, M, Corcoles Gonzalez, V, Sanchez Iniesta, R, Garcia, P, Garcia-Montesinos de la Peña, M, Garcia Herrera, A, Garcia-de-Acilu, M, Masclans Enviz, J, Mancebo, J, Heili, S, Artigas Raventos, A, Blanch Torra, L, Roche-Campo, F, Rialp, G, Forteza, C, Berrazueta, A, Martinez, E, Penuelas, O, Jara-Rubio, R, Mallat, J, Thevenin, D, Zogheib, E, Levrat, A, Porot, V, Bedock, B, Grech, L, Plantefeve, G, Badie, J, Besch, G, Pili-Floury, S, Guisset, O, Robine, A, Prat, G, Doise, J, Badet, M, Thouret, J, Just, B, Perbet, S, Lautrette, A, Souweine, B, Chabanne, R, Danguy des Déserts, M, Rigaud, J, Marchalot, A, Bele, N, Beague, S, Hours, S, Marque, S, Durand, M, Payen, J, Stoclin, A, Gaffinel, A, Winer, A, Chudeau, N, Tirot, P, Thyrault, M, Paulet, R, Aubrun, F, Guerin, C, Floccard, B, Rimmele, T, Argaud, L, Hernu, R, Crozon Clauzel, J, Wey, P, Bourdin, G, Pommier, C, Cueuille, N, de Varax, N, Marchi, E, Papazian, L, Jochmans, S, Monchi, M, Jaber, S, de Jong, A, Moulaire, V, Capron, M, Jarrige, L, Barberet, G, Lakhal, K, Rozec, B, Dellamonica, J, Robert, A, Bernardin, G, Danin, P, Raucoules, M, Runge, I, Foucrier, A, Hamada, S, Tesniere, A, Fromentin, M, Samama, C, Mira, J, Diehl, J, Mekontso Dessap, A, Arbelot, C, Demoule, A, Roche, A, Similowski, T, Ricard, J, Gaudry, S, Dreyfuss, D, de Montmolin, E, da Silva, D, Verdiere, B, Ardisson, F, Lemiale, V, Azoulay, E, Bruel, C, Tiercelet, K, Fartoukh, M, Voiriot, G, Hoffmann, C, Leclerc, T, Thille, A, Robert, R, Beduneau, G, Beuzelin, M, Tamion, F, Morel, J, Tremblay, A, Molliex, S, Amal, J, Meaudre, E, Goutorbe, P, Laffon, M, Gros, A, Nica, A, Barjon, G, Dahyot-Fizelier, C, Imzi, N, Gally, J, Real, N, Sauneuf, B, Souloy, X, Girbes, A, Tuinman, P, Schultz, M, Winters, T, Mijzen, L, Roekaerts, P, Vermeijden, W, Beishuizen, A, Trof, R, Corsten, S, Kesecioglu, J, Dieperink, W, Pickers, P, Roovers, N, Duque, M, Rua, F, Pereira de Figueired, A, Ramos, A, Fragoso, E, Azevedo, P, Gouveia, J, Costa E. Silva, Z, Silva, G, Chaves, S, Nobrega, J, Lopes, L, Valerio, B, Araujo, A, de Freitas, P, Bouw, M, Melao, M, Granja, C, Marcal, P, Fernandes, A, Joao, G, Maia, D, Spadaro, S, Volta, C, Citerio, G, Mauri, T, Alban, L, Pesenti, A, Mistraletti, G, Formenti, P, Tommasino, C, Tardini, F, Fumagalli, R, Colombo, R, Fossali, T, Catena, E, Todeschini, M, Gnesin, P, Cracchiolo, A, Palma, D, Tetamo, R, Albiero, D, Costantini, E, Raimondi, F, Coppadoro, A, Vascotto, E, Lusenti, F, Schã¤dler, D, Weiler, N, Karagiannidis, C, Petersson, J, Konrad, D, Kawati, R, Wessbergh, J, Valtysson, J, Rockstroh, M, Borgstrom, S, Larsson, N, Thunberg, J, Camsooksai, J, Briggs, N, Cuesta, J, Anwar, S, O’Brien, B, Barberis, L, Sturman, J, Karatzas, S, Piza, P, Sottiaux, T, Adam, J, Gawda, R, Gawor, M, Alqdah, M, Cohen, D, Baker, A, Ñamendys-Silva, S, Garcia-Guillen, F, Morocho Tutillo, D, Jibaja Vega, M, Zakalik, G, Pagella, G, and Marengo, J

Subjects
ARDS, RECEIVING MECHANICAL VENTILATION, Epidemiology, medicine.medical_treatment, cross-sectional studies, RESPIRATORY-DISTRESS-SYNDROME, vrouwelijk, buikligging, Critical Care and Intensive Care Medicine, respiratory distress syndrome, adult/therapy, law.invention, Positive-Pressure Respiration, Prone position, 0302 clinical medicine, Mechanical ventilation, prospectieve studies, Randomized controlled trial, law, middle aged, Medicine, FAILURE, adult/therapy, humans, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, RANDOMIZED CONTROLLED-TRIAL, respiratory distress syndrome, 3. Good health, cross-sectionele studies, ademnoodsyndroom, aged, female, SURVIVAL, middelbare leeftijd, medicine.medical_specialty, Pain medicine, positieve druk uitademing, NO, 03 medical and health sciences, male, mensen, Anesthesiology, ouderen, METAANALYSIS, business.industry, MORTALITY, 030208 emergency & critical care medicine, mannelijk, CARE, medicine.disease, prospective studies, EVOLUTION, body regions, 030228 respiratory system, Emergency medicine, Observational study, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Introduction: While prone positioning (PP) has been shown to improve patient survival in moderate to severe acute respiratory distress syndrome (ARDS) patients, the rate of application of PP in clinical practice still appears low.Aim: This study aimed to determine the prevalence of use of PP in ARDS patients (primary endpoint), the physiological effects of PP, and the reasons for not using it (secondary endpoints).Methods: The APRONET study was a prospective international 1-day prevalence study performed four times in April, July, and October 2016 and January 2017. On each study day, investigators in each ICU had to screen every patient. For patients with ARDS, use of PP, gas exchange, ventilator settings and plateau pressure (Pplat) were recorded before and at the end of the PP session. Complications of PP and reasons for not using PP were also documented. Values are presented as median (1st-3rd quartiles).Results: Over the study period, 6723 patients were screened in 141 ICUs from 20 countries (77% of the ICUs were European), of whom 735 had ARDS and were analyzed. Overall 101 ARDS patients had at least one session of PP (13.7%), with no differences among the 4 study days. The rate of PP use was 5.9% (11/187), 10.3% (41/399) and 32.9% (49/149) in mild, moderate and severe ARDS, respectively (P = 0.0001). The duration of the first PP session was 18 (16-23) hours. Measured with the patient in the supine position before and at the end of the first PP session, PaO2/FIO2 increased from 101 (76-136) to 171 (118-220) mmHg (P = 0.0001) driving pressure decreased from 14 [11-17] to 13 [10-16] cmH(2)O (P = 0.001), and Pplat decreased from 26 [23-29] to 25 [23-28] cmH(2)O (P = 0.04). The most prevalent reason for not using PP (64.3%) was that hypoxemia was not considered sufficiently severe. Complications were reported in 12 patients (11.9%) in whom PP was used (pressure sores in five, hypoxemia in two, endotracheal tube-related in two ocular in two, and a transient increase in intracranial pressure in one).Conclusions: In conclusion, this prospective international prevalence study found that PP was used in 32.9% of patients with severe ARDS, and was associated with low complication rates, significant increase in oxygenation and a significant decrease in driving pressure.

Published
2018

2. Fluid challenges in intensive care: the FENICE study: a global inception cohort study

Author

Cecconi, M1, Hofer, C, Teboul, Jl, Pettila, V, Wilkman, E, Molnar, Z, Della Rocca, G, Aldecoa, C, Artigas, A, Jog, S, Sander, M, Spies, C, Lefrant, Jy, De Backer, D, Silva, E, Zhang, X, Ospina-tascón, G, Arias, J, Gornik, I, Benes, J, Petersen, A, Zsolt, M, Sprung, C, Koch, M, Guttormsen, Ab, Tavares, M, Pettilä, V, Mikaszewska-sokolewicz, M, Bakker, J, Parke, R, Kirov, M, Wernerman, J, Esen, F, Cecconi, M, Cannesson, M, Njimi, H, François, G, Cueto, G, Hockley, S, Ambekar, H, Laterre, Pf, Dujardin, Mf, Damas, P, Deschamps, P, Glorieux, D, Hoste, E, Miribung, M, Devriendt, J, Haentjens, L, Biston, P, Dugernier, T, Bulpa, P, Dive, A, Debaveye, Y, Franck, S, Conde, K, Morsch, R, Ramos, M, Dias, F, Mataloun, S, Mendes, C, Silva, F, Grion, C, Knibel, M, Yang, C, Xiangyu, Z, Cai, G, Ortiz, G, Ospina-tascon, G, Yepes, D, Londono Arcila Hf, Molina, F, Pereira, F, Sanchez-galvez, Hf, Benitez, F, Arias Ortiz, J, Gonzalez Rojas, M, Cavric, G, Lukic, E, Zykova, I, Freml, P, Satinsky, I, Suk, P, Novak, I, Balik, M, Szturz, P, Kratochvil, M, Bestle, M, Strange, Dg, Perner, A, Rasmussen, Bs, Hauge, J, Meldgaard, M, Toome, V, Kuitunen, A, Varila, S, Hovilehto, S, Pulkkinen, A, Kiviniemi, O, Tallgren, M, Laitio, R, Mongardon, N, Dhonneur, G, Malledant, Y, Lepouse, C, Darmon, M, Mira, Jp, Chiche, Jd, Joannes-boyau, O, Preau, S, Larche, J, Mottard, N, Bengler, C, Argaud, L, Hamzaoui, O, Desebbe, O, Burtin, P, Reignier, J, Durand, M, Guitard, Pg, Asfar, P, Guillot, M, Boulain, T, Mekontso Dessap, A, Ducrocq, N, Lakhal, K, Gregoire, C, Schmauss, M, Zacharowski, K, Meybohm, P, Treskatsch, S, Bloos, F, Van Huelst, S, Baumann, H, Kersten, A, Goldmann, A, Gkiokas, G, Dimoula, A, Kofinas, G, Anthopoulos, G, Pankotai, B, Kopitko, C, Gartner, B, Schaffer, E, Fulesdi, B, Sarkany, A, Samavedam, S, Shah, B, Dixit, S, Toraskar, K, Nandakumar, S, Goila, Ak, Nayyar, A, Patel, M, Mitra, D, Jagiasi, B, Jakkinaboina, S, Goswami, J, Ghosh, S, Hashemian, M, Mahmoodpoor, A, Breen, D, Benbenishty, J, Kuniavsky, M, Kolpak, O, Castiglione, G, Monti, G, Molin, A, Martucci, G, Panarello, G, Raineri, Sm, Pota, V, Acquarolo, A, Ploner, F, Lapichino, G, Lombardo, A, Roasio, A, Cardelino, S, Pignataro, A, Oggioni, R, Mangani, V, Parrini, V, Spadaro, S, Volta, Ca, Alampi, D, Torrente, S, Monastra, L, Marini, F, Mazzini, P, Albanese, D, Riccardi, S, Ruberto, F, Belluomo, Ac, Silvestri, R, Citerio, G, Brienza, N, Brazzi, L, Protti, A, Bottino, N, David, A, Manzoni, D, Foti, G, Numis, F, Morimatsu, H, Shimizu, K, Munster, L, Rai, V, Buttigieg, M, Pickkers, P, Mijzen, L, Kesecioglu, J, Van Duijn, D, Ormskerk, P, Beck, O, Goodson, J, King, B, Koelle, J, Kantor, S, Gomez, O, Ramos, I, Jedynak, M, Sulkowski, W, Adamik, B, Chruscikowski, M, Wadelek, J, Korzybski, J, Misiewska-kaczur, A, Piasecka-twarog, M, Fijaikowska, A, Maciejewski, D, Smiechowicz, K, Milkowska, E, Czerwinska, A, Lukaszewska, A, Wieczorek, A, Czuczwar, M, Czerwiec, A, Tamowicz, B, Branco, V, Estilita, J, Basilio, C, Diogo, C, Toma, R, Bubenek-turconi, Si, Filipescu, D, Popescu, M, Titova, J, Belskiy, V, Smetkin, A, Grigoryev, E, Pugachev, S, Gasenkampf, A, Abouelala, A, Almekhlafi, G, Rupnik, E, Garcia-delgado, H, Saez Fernandez, A, Celaya Lopez, M, Ramasco, F, Planas, K, Zavala, E, De Nadal, M, Picos, Sa, Fernandez, S, Munoz, A, Herrera Para, L, Maseda, E, Rovira, A, Monge Garcia Mi, Ferrer, R, Sole Violan, J, Garcia Nogales, X, Torrents, E, Ripolles Melchor, J, Tomás Marsilla Ji, Araujo Aguilar, P, Aguilar, G, Menor, Em, Martinez, Mc, Leal Micharet Am, Ferri Riera, C, Mosquera, D, Astola, I, Freita-ramos, S, Garcia Olivares, P, Jimenez Bartolome Mb, Fernandez Gonzalez, I, Sanchez-izquierdo, Ja, Arribas, P, Gimenez-esparzavich, C, Anglada, M, Martin, S, Weerakoon, Rk, Bendjelid, K, Fumeaux, T, Maggiorini, M, Demirkiran, O, Adanir, T, Ergin Ozcan, P, Kelebek Girgin, N, Elahi, N, Kashef, S, Alsabbah, A, Lowe, A, Wise, M, Vizcaychipi, Mp, Baht, S, Webb, S, Friis, J, Boulanger, C, Gratrix, A, Harvey, D, Ferguson, A, Espie, L, Toth-tarsoly, P, Lewis, K, Shelley, B, Thuerey, J, Przemyslaw, D, Ranganathan, M, Hormis, A, Spivey, M, Henning, J, Saveker, R, Csabi, P, Bland, M, Barrera Groba, C, Al-subaie, N, Thomson, R, Hamilton, M, Iannuccelli, F, Roberts, C, Sherwood, N, Kasipandian, V, Silversides, J, Jonas, A, Szakmany, T, Vickers, E, Richards, J, Tham, L, Williams, D, Heenen, S, Hobrok, M, Walden, A, Raj, A, Bauer, P, Kashyap, R, Tolnai, P, Kjelle, Bj, Andersen, Fh, Palo, Je, Namendys-silva, S. A., Hôpital Bicêtre, Hôpital Bicêtre-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Cecconi M., Hofer C., Teboul J.-L., Pettila V., Wilkman E., Molnar Z., Della Rocca G., Aldecoa C., Artigas A., Jog S., Sander M., Spies C., Lefrant J.-Y., De Backer D., Silva E., Zhang X., Ospina-Tascon G., Arias J., Gornik I., Benes J., Petersen A., Zsolt M., Sprung C., Koch M., Guttormsen A.B., Tavares M., Mikaszewska-Sokolewicz M., Bakker J., Parke R., Kirov M., Wernerman J., Esen F., Cannesson M., Njimi H., Francois G., Cueto G., Hockley S., Ambekar H., Laterre P.F., Dujardin M.F., Damas P., Deschamps P., Glorieux D., Hoste E., Miribung M., Devriendt J., Haentjens L., Biston P., Dugernier T., Bulpa P., Dive A., Debaveye Y., Franck S., Conde K., Morsch R., Ramos M., Dias F., Mataloun S., Mendes C., Silva F., Grion C., Knibel M., Yang C., Xiangyu Z., Cai G., Ortiz G., Yepes D., Londono Arcila H.F., Molina F., Pereira F., Sanchez-Galvez H.F., Benitez F., Arias Ortiz J., Gonzalez Rojas M., Cavric G., Lukic E., Zykova I., Freml P., Satinsky I., Suk P., Novak I., Balik M., Szturz P., Kratochvil M., Bestle M., Strange D.G., Perner A., Rasmussen B.S., Hauge J., Meldgaard M., Toome V., Kuitunen A., Varila S., Hovilehto S., Pulkkinen A., Kiviniemi O., Tallgren M., Laitio R., Mongardon N., Dhonneur G., Malledant Y., Lepouse C., Darmon M., Mira J.P., Chiche J.D., Joannes-Boyau O., Preau S., Larche J., Mottard N., Bengler C., Argaud L., Hamzaoui O., Desebbe O., Burtin P., Reignier J., Durand M., Guitard P.G., Asfar P., Guillot M., Boulain T., Mekontso Dessap A., Ducrocq N., Lakhal K., Gregoire C., Schmauss M., Zacharowski K., Meybohm P., Treskatsch S., Bloos F., van Huelst S., Baumann H., Kersten A., Goldmann A., Gkiokas G., Dimoula A., Kofinas G., Anthopoulos G., Pankotai B., Kopitko C., Gartner B., Schaffer E., Fulesdi B., Sarkany A., Samavedam S., Shah B., Dixit S., Toraskar K., Nandakumar S., Goila A.K., Nayyar A., Patel M., Mitra D., Jagiasi B., Jakkinaboina S., Goswami J., Ghosh S., Hashemian M., Mahmoodpoor A., Breen D., Benbenishty J., Kuniavsky M., Kolpak O., Castiglione G., Monti G., Molin A., Martucci G., Panarello G., Raineri S.M., Pota V., Acquarolo A., Ploner F., Lapichino G., Lombardo A., Roasio A., Cardelino S., Pignataro A., Oggioni R., Mangani V., Parrini V., Spadaro S., Volta C.A., Alampi D., Torrente S., Monastra L., Marini F., Mazzini P., Albanese D., Riccardi S., Ruberto F., Belluomo A.C., Silvestri R., Citerio G., Brienza N., Brazzi L., Protti A., Bottino N., David A., Manzoni D., Foti G., Numis F., Morimatsu H., Shimizu K., Munster L., Rai V., Buttigieg M., Pickkers P., Mijzen L., Kesecioglu J., Van Duijn D., Ormskerk P., Beck O., Goodson J., King B., Koelle J., Kantor S., Gomez O., Ramos I., Jedynak M., Sulkowski W., Adamik B., Chruscikowski M., Wadelek J., Korzybski J., Misiewska-Kaczur A., Piasecka-Twarog M., Fijaikowska A., Maciejewski D., Smiechowicz K., Milkowska E., Czerwinska A., Lukaszewska A., Wieczorek A., Czuczwar M., Czerwiec A., Tamowicz B., Branco V., Estilita J., Basilio C., Diogo C., Toma R., Bubenek-Turconi S.I., Filipescu D., Popescu M., Titova J., Belskiy V., Smetkin A., Grigoryev E., Pugachev S., Gasenkampf A., Abouelala A., Almekhlafi G., Rupnik E., Garcia-Delgado H., Saez Fernandez A., Celaya Lopez M., Ramasco F., Planas K., Zavala E., De Nadal M., Picos S.A., Fernandez S., Munoz A., Herrera Para L., Maseda E., Rovira A., Monge Garcia M.I., Ferrer R., Sole Violan J., Garcia Nogales X., Torrents E., Ripolles Melchor J., Tomas Marsilla J.I., Araujo Aguilar P., Aguilar G., Menor E.M., Martinez M.C., Leal Micharet A.M., Ferri Riera C., Mosquera D., Astola I., Freita-Ramos S., Garcia Olivares P., Jimenez Bartolome M.B., Fernandez Gonzalez I., Sanchez-Izquierdo J.A., Arribas P., Gimenez-Esparzavich C., Anglada M., Martin S., Weerakoon R.K., Bendjelid K., Fumeaux T., Maggiorini M., Demirkiran O., Adanir T., Ergin Ozcan P., Kelebek Girgin N., Elahi N., Kashef S., Alsabbah A., Lowe A., Wise M., Vizcaychipi M.P., Baht S., Webb S., Friis J., Boulanger C., Gratrix A., Harvey D., Ferguson A., Espie L., Toth-Tarsoly P., Lewis K., Shelley B., Thuerey J., Przemyslaw D., Ranganathan M., Hormis A., Spivey M., Henning J., Saveker R., Csabi P., Bland M., Barrera Groba C., Al-Subaie N., Thomson R., Hamilton M., Iannuccelli F., Roberts C., Sherwood N., Kasipandian V., Silversides J., Jonas A., Szakmany T., Vickers E., Richards J., Tham L., Williams D., Heenen S., Hobrok M., Walden A., Raj A., Bauer P., Kashyap R., Tolnai P., Kjelle B.J., Andersen F.H., Palo J.E., Namendys-Silva S.A., Cecconi, M, Hofer, C, Teboul, J, Pettila, V, Wilkman, E, Molnar, Z, Della Rocca, G, Aldecoa, C, Artigas, A, Jog, S, Sander, M, Spies, C, Lefrant, J, De Backer, D, Silva, E, Zhang, X, Ospina-Tascon, G, Arias, J, Gornik, I, Benes, J, Petersen, A, Zsolt, M, Sprung, C, Koch, M, Guttormsen, A, Tavares, M, Mikaszewska-Sokolewicz, M, Bakker, J, Parke, R, Kirov, M, Wernerman, J, Esen, F, Cannesson, M, Njimi, H, Francois, G, Cueto, G, Hockley, S, Ambekar, H, Laterre, P, Dujardin, M, Damas, P, Deschamps, P, Glorieux, D, Hoste, E, Miribung, M, Devriendt, J, Haentjens, L, Biston, P, Dugernier, T, Bulpa, P, Dive, A, Debaveye, Y, Franck, S, Conde, K, Morsch, R, Ramos, M, Dias, F, Mataloun, S, Mendes, C, Silva, F, Grion, C, Knibel, M, Yang, C, Xiangyu, Z, Cai, G, Ortiz, G, Yepes, D, Londono Arcila, H, Molina, F, Pereira, F, Sanchez-Galvez, H, Benitez, F, Arias Ortiz, J, Gonzalez Rojas, M, Cavric, G, Lukic, E, Zykova, I, Freml, P, Satinsky, I, Suk, P, Novak, I, Balik, M, Szturz, P, Kratochvil, M, Bestle, M, Strange, D, Perner, A, Rasmussen, B, Hauge, J, Meldgaard, M, Toome, V, Kuitunen, A, Varila, S, Hovilehto, S, Pulkkinen, A, Kiviniemi, O, Tallgren, M, Laitio, R, Mongardon, N, Dhonneur, G, Malledant, Y, Lepouse, C, Darmon, M, Mira, J, Chiche, J, Joannes-Boyau, O, Preau, S, Larche, J, Mottard, N, Bengler, C, Argaud, L, Hamzaoui, O, Desebbe, O, Burtin, P, Reignier, J, Durand, M, Guitard, P, Asfar, P, Guillot, M, Boulain, T, Mekontso Dessap, A, Ducrocq, N, Lakhal, K, Gregoire, C, Schmauss, M, Zacharowski, K, Meybohm, P, Treskatsch, S, Bloos, F, van Huelst, S, Baumann, H, Kersten, A, Goldmann, A, Gkiokas, G, Dimoula, A, Kofinas, G, Anthopoulos, G, Pankotai, B, Kopitko, C, Gartner, B, Schaffer, E, Fulesdi, B, Sarkany, A, Samavedam, S, Shah, B, Dixit, S, Toraskar, K, Nandakumar, S, Goila, A, Nayyar, A, Patel, M, Mitra, D, Jagiasi, B, Jakkinaboina, S, Goswami, J, Ghosh, S, Hashemian, M, Mahmoodpoor, A, Breen, D, Benbenishty, J, Kuniavsky, M, Kolpak, O, Castiglione, G, Monti, G, Molin, A, Martucci, G, Panarello, G, Raineri, S, Pota, V, Acquarolo, A, Ploner, F, Lapichino, G, Lombardo, A, Roasio, A, Cardelino, S, Pignataro, A, Oggioni, R, Mangani, V, Parrini, V, Spadaro, S, Volta, C, Alampi, D, Torrente, S, Monastra, L, Marini, F, Mazzini, P, Albanese, D, Riccardi, S, Ruberto, F, Belluomo, A, Silvestri, R, Citerio, G, Brienza, N, Brazzi, L, Protti, A, Bottino, N, David, A, Manzoni, D, Foti, G, Numis, F, Morimatsu, H, Shimizu, K, Munster, L, Rai, V, Buttigieg, M, Pickkers, P, Mijzen, L, Kesecioglu, J, Van Duijn, D, Ormskerk, P, Beck, O, Goodson, J, King, B, Koelle, J, Kantor, S, Gomez, O, Ramos, I, Jedynak, M, Sulkowski, W, Adamik, B, Chruscikowski, M, Wadelek, J, Korzybski, J, Misiewska-Kaczur, A, Piasecka-Twarog, M, Fijaikowska, A, Maciejewski, D, Smiechowicz, K, Milkowska, E, Czerwinska, A, Lukaszewska, A, Wieczorek, A, Czuczwar, M, Czerwiec, A, Tamowicz, B, Branco, V, Estilita, J, Basilio, C, Diogo, C, Toma, R, Bubenek-Turconi, S, Filipescu, D, Popescu, M, Titova, J, Belskiy, V, Smetkin, A, Grigoryev, E, Pugachev, S, Gasenkampf, A, Abouelala, A, Almekhlafi, G, Rupnik, E, Garcia-Delgado, H, Saez Fernandez, A, Celaya Lopez, M, Ramasco, F, Planas, K, Zavala, E, De Nadal, M, Picos, S, Fernandez, S, Munoz, A, Herrera Para, L, Maseda, E, Rovira, A, Monge Garcia, M, Ferrer, R, Sole Violan, J, Garcia Nogales, X, Torrents, E, Ripolles Melchor, J, Tomas Marsilla, J, Araujo Aguilar, P, Aguilar, G, Menor, E, Martinez, M, Leal Micharet, A, Ferri Riera, C, Mosquera, D, Astola, I, Freita-Ramos, S, Garcia Olivares, P, Jimenez Bartolome, M, Fernandez Gonzalez, I, Sanchez-Izquierdo, J, Arribas, P, Gimenez-Esparzavich, C, Anglada, M, Martin, S, Weerakoon, R, Bendjelid, K, Fumeaux, T, Maggiorini, M, Demirkiran, O, Adanir, T, Ergin Ozcan, P, Kelebek Girgin, N, Elahi, N, Kashef, S, Alsabbah, A, Lowe, A, Wise, M, Vizcaychipi, M, Baht, S, Webb, S, Friis, J, Boulanger, C, Gratrix, A, Harvey, D, Ferguson, A, Espie, L, Toth-Tarsoly, P, Lewis, K, Shelley, B, Thuerey, J, Przemyslaw, D, Ranganathan, M, Hormis, A, Spivey, M, Henning, J, Saveker, R, Csabi, P, Bland, M, Barrera Groba, C, Al-Subaie, N, Thomson, R, Hamilton, M, Iannuccelli, F, Roberts, C, Sherwood, N, Kasipandian, V, Silversides, J, Jonas, A, Szakmany, T, Vickers, E, Richards, J, Tham, L, Williams, D, Heenen, S, Hobrok, M, Walden, A, Raj, A, Bauer, P, Kashyap, R, Tolnai, P, Kjelle, B, Andersen, F, Palo, J, Namendys-Silva, S, De Backer, Daniel, Cecconi, M., Hofer, C., Teboul, J. -L., Pettila, V., Wilkman, E., Molnar, Z., Della Rocca, G., Aldecoa, C., Artigas, A., Jog, S., Sander, M., Spies, C., Lefrant, J. -Y., De Backer, D., Silva, E., Zhang, X., Ospina-Tascon, G., Arias, J., Gornik, I., Benes, J., Petersen, A., Zsolt, M., Sprung, C., Koch, M., Guttormsen, A. B., Tavares, M., Mikaszewska-Sokolewicz, M., Bakker, J., Parke, R., Kirov, M., Wernerman, J., Esen, F., Cannesson, M., Njimi, H., Francois, G., Cueto, G., Hockley, S., Ambekar, H., Laterre, P. F., Dujardin, M. F., Damas, P., Deschamps, P., Glorieux, D., Hoste, E., Miribung, M., Devriendt, J., Haentjens, L., Biston, P., Dugernier, T., Bulpa, P., Dive, A., Debaveye, Y., Franck, S., Conde, K., Morsch, R., Ramos, M., Dias, F., Mataloun, S., Mendes, C., Silva, F., Grion, C., Knibel, M., Yang, C., Xiangyu, Z., Cai, G., Ortiz, G., Yepes, D., Londono Arcila, H. F., Molina, F., Pereira, F., Sanchez-Galvez, H. F., Benitez, F., Arias Ortiz, J., Gonzalez Rojas, M., Cavric, G., Lukic, E., Zykova, I., Freml, P., Satinsky, I., Suk, P., Novak, I., Balik, M., Szturz, P., Kratochvil, M., Bestle, M., Strange, D. G., Perner, A., Rasmussen, B. S., Hauge, J., Meldgaard, M., Toome, V., Kuitunen, A., Varila, S., Hovilehto, S., Pulkkinen, A., Kiviniemi, O., Tallgren, M., Laitio, R., Mongardon, N., Dhonneur, G., Malledant, Y., Lepouse, C., Darmon, M., Mira, J. P., Chiche, J. D., Joannes-Boyau, O., Preau, S., Larche, J., Mottard, N., Bengler, C., Argaud, L., Hamzaoui, O., Desebbe, O., Burtin, P., Reignier, J., Durand, M., Guitard, P. G., Asfar, P., Guillot, M., Boulain, T., Mekontso Dessap, A., Ducrocq, N., Lakhal, K., Gregoire, C., Schmauss, M., Zacharowski, K., Meybohm, P., Treskatsch, S., Bloos, F., van Huelst, S., Baumann, H., Kersten, A., Goldmann, A., Gkiokas, G., Dimoula, A., Kofinas, G., Anthopoulos, G., Pankotai, B., Kopitko, C., Gartner, B., Schaffer, E., Fulesdi, B., Sarkany, A., Samavedam, S., Shah, B., Dixit, S., Toraskar, K., Nandakumar, S., Goila, A. K., Nayyar, A., Patel, M., Mitra, D., Jagiasi, B., Jakkinaboina, S., Goswami, J., Ghosh, S., Hashemian, M., Mahmoodpoor, A., Breen, D., Benbenishty, J., Kuniavsky, M., Kolpak, O., Castiglione, G., Monti, G., Molin, A., Martucci, G., Panarello, G., Raineri, S. M., Pota, V., Acquarolo, A., Ploner, F., Lapichino, G., Lombardo, A., Roasio, A., Cardelino, S., Pignataro, A., Oggioni, R., Mangani, V., Parrini, V., Spadaro, S., Volta, C. A., Alampi, D., Torrente, S., Monastra, L., Marini, F., Mazzini, P., Albanese, D., Riccardi, S., Ruberto, F., Belluomo, A. C., Silvestri, R., Citerio, G., Brienza, N., Brazzi, L., Protti, A., Bottino, N., David, A., Manzoni, D., Foti, G., Numis, F., Morimatsu, H., Shimizu, K., Munster, L., Rai, V., Buttigieg, M., Pickkers, P., Mijzen, L., Kesecioglu, J., Van Duijn, D., Ormskerk, P., Beck, O., Goodson, J., King, B., Koelle, J., Kantor, S., Gomez, O., Ramos, I., Jedynak, M., Sulkowski, W., Adamik, B., Chruscikowski, M., Wadelek, J., Korzybski, J., Misiewska-Kaczur, A., Piasecka-Twarog, M., Fijaikowska, A., Maciejewski, D., Smiechowicz, K., Milkowska, E., Czerwinska, A., Lukaszewska, A., Wieczorek, A., Czuczwar, M., Czerwiec, A., Tamowicz, B., Branco, V., Estilita, J., Basilio, C., Diogo, C., Toma, R., Bubenek-Turconi, S. I., Filipescu, D., Popescu, M., Titova, J., Belskiy, V., Smetkin, A., Grigoryev, E., Pugachev, S., Gasenkampf, A., Abouelala, A., Almekhlafi, G., Rupnik, E., Garcia-Delgado, H., Saez Fernandez, A., Celaya Lopez, M., Ramasco, F., Planas, K., Zavala, E., De Nadal, M., Picos, S. A., Fernandez, S., Munoz, A., Herrera Para, L., Maseda, E., Rovira, A., Monge Garcia, M. I., Ferrer, R., Sole Violan, J., Garcia Nogales, X., Torrents, E., Ripolles Melchor, J., Tomas Marsilla, J. I., Araujo Aguilar, P., Aguilar, G., Menor, E. M., Martinez, M. C., Leal Micharet, A. M., Ferri Riera, C., Mosquera, D., Astola, I., Freita-Ramos, S., Garcia Olivares, P., Jimenez Bartolome, M. B., Fernandez Gonzalez, I., Sanchez-Izquierdo, J. A., Arribas, P., Gimenez-Esparzavich, C., Anglada, M., Martin, S., Weerakoon, R. K., Bendjelid, K., Fumeaux, T., Maggiorini, M., Demirkiran, O., Adanir, T., Ergin Ozcan, P., Kelebek Girgin, N., Elahi, N., Kashef, S., Alsabbah, A., Lowe, A., Wise, M., Vizcaychipi, M. P., Baht, S., Webb, S., Friis, J., Boulanger, C., Gratrix, A., Harvey, D., Ferguson, A., Espie, L., Toth-Tarsoly, P., Lewis, K., Shelley, B., Thuerey, J., Przemyslaw, D., Ranganathan, M., Hormis, A., Spivey, M., Henning, J., Saveker, R., Csabi, P., Bland, M., Barrera Groba, C., Al-Subaie, N., Thomson, R., Hamilton, M., Iannuccelli, F., Roberts, C., Sherwood, N., Kasipandian, V., Silversides, J., Jonas, A., Szakmany, T., Vickers, E., Richards, J., Tham, L., Williams, D., Heenen, S., Hobrok, M., Walden, A., Raj, A., Bauer, P., Kashyap, R., Tolnai, P., Kjelle, B. J., Andersen, F. H., Palo, J. E., Namendys-Silva, S. A., Clinicum, Department of Diagnostics and Therapeutics, and Anestesiologian yksikkö

Subjects
Male, Soins intensifs réanimation, medicine.medical_treatment, Cohort Studies, Female, Humans, Middle Aged, Practice Patterns, Physicians', Critical Care, Fluid Therapy, Critical Care and Intensive Care Medicine, Practice Patterns, ESICM Trial Group, RESPONSIVENESS, Seven-Day Profile Publication, Medicine and Health Sciences, FENICE Investigators, CIRCULATORY SHOCK, intensive care, ddc:617, RENAL REPLACEMENT THERAPY, 3. Good health, OF-THE-LITERATURE, SHOCK, lipids (amino acids, peptides, and proteins), Erratum, intensive care, fluid therapy, fluids, Life Sciences & Biomedicine, CRITICALLY-ILL PATIENTS, Human, Cohort study, medicine.medical_specialty, HYDROXYETHYL STARCH 130/0.4, MEDLINE, 1117 Public Health and Health Services, NO, fluid therapy, Critical Care Medicine, CIRCULATORY, General & Internal Medicine, Intensive care, Anesthesiology, PATIENTS, medicine, cohort study, Renal replacement therapy, Intensive care medicine, Physicians', Science & Technology, CRITICALLY-ILL, business.industry, Septic shock, SEPTIC SHOCK, 1103 Clinical Sciences, 3126 Surgery, anesthesiology, intensive care, radiology, medicine.disease, Emergency & Critical Care Medicine, ARTERIAL-PRESSURE, SEVERE SEPSIS, Clinical trial, Observational study, Cohort Studie, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, TASK-FORCE
Abstract

Background: Fluid challenges (FCs) are one of the most commonly used therapies in critically ill patients and represent the cornerstone of hemodynamic management in intensive care units. There are clear benefits and harms from fluid therapy. Limited data on the indication, type, amount and rate of an FC in critically ill patients exist in the literature. The primary aim was to evaluate how physicians conduct FCs in terms of type, volume, and rate of given fluid; the secondary aim was to evaluate variables used to trigger an FC and to compare the proportion of patients receiving further fluid administration based on the response to the FC. Methods: This was an observational study conducted in ICUs around the world. Each participating unit entered a maximum of 20 patients with one FC. Results: 2213 patients were enrolled and analyzed in the study. The median [interquartile range] amount of fluid given during an FC was 500 ml (500–1000). The median time was 24 min (40–60 min), and the median rate of FC was 1000 [500–1333] ml/h. The main indication for FC was hypotension in 1211 (59 %, CI 57–61 %). In 43 % (CI 41–45 %) of the cases no hemodynamic variable was used. Static markers of preload were used in 785 of 2213 cases (36 %, CI 34–37 %). Dynamic indices of preload responsiveness were used in 483 of 2213 cases (22 %, CI 20–24 %). No safety variable for the FC was used in 72 % (CI 70–74 %) of the cases. There was no statistically significant difference in the proportion of patients who received further fluids after the FC between those with a positive, with an uncertain or with a negatively judged response. Conclusions: The current practice and evaluation of FC in critically ill patients are highly variable. Prediction of fluid responsiveness is not used routinely, safety limits are rarely used, and information from previous failed FCs is not always taken into account., SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2015

3. The protective association of endogenous immunoglobulins against sepsis mortality is restricted to patients with moderate organ failure

Author

Adriele Prina-Mello, Eduardo Anton, Jesús Blanco, Rubén Herrán-Monge, Ana Rodriguez-Fernandez, Ignacio Martin-Loeches, Wysali Trapiello, Jordi Solé-Violán, Antonio Artigas, David Andaluz-Ojeda, Arturo Muriel-Bombín, Ana Loza, B. Suberviola, Jesus F. Bermejo-Martin, Pedro Merino, Ricard Ferrer, Leonardo Lorente, Pablo Garcia-Olivares, Eduardo Tamayo, Institut Català de la Salut, [Martin-Loeches I] Multidisciplinary Intensive Care Research Organization (MICRO), St. James’s University Hospitals Dublin, James’s St, Ushers, Dublin 8, Ireland. [Muriel-Bombín A] Intensive Care Department, Hospital Universitario Río Hortega de Valladolid, Calle Dulzaina, 2, 47012 Valladolid, Spain. [Ferrer R] Servei de Medicina Intensiva, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Grup de Shock, Disfunció Orgànica i Ressucitació, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. ABISS Edusepsis (AntiBiotic Intervention in Severe Sepsis), Servei de Medicina Intensiva, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Artigas A] ABISS Edusepsis (AntiBiotic Intervention in Severe Sepsis), Servei de Medicina Intensiva, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Critical Care Center, Corporacion Sanitaria Universitaria Parc Tauli, Universitat Autònoma de Barcelona, Parc Taulí 1, 08208 Sabadell, Barcelona, Spain. CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, C/Sinesio Delgado,4, 28029 Madrid, Spain. [Sole-Violan J] ABISS Edusepsis (AntiBiotic Intervention in Severe Sepsis), Servei de Medicina Intensiva, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Critical Care Medicine Service, Hospital Dr Negrin, Barranco de la Ballena, s/n, 35010 Las Palmas de Gran Canaria, Las Palmas, Spain. [Lorente L] ABISS Edusepsis (AntiBiotic Intervention in Severe Sepsis), Servei de Medicina Intensiva, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Critical Care Medicine Service, Hospital Universitario de Canarias, Carretera de Ofra, s/n, 38320 San Cristóbal de La Laguna, Santa Cruz De Tenerife, Spain. [Suberviola B] ABISS Edusepsis (AntiBiotic Intervention in Severe Sepsis), Servei de Medicina Intensiva, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Critical Care Medicine Service, Hospital Universitario Marqués de Valdecilla, Av. Valdecilla, 25, 39008 Santander, Spain. [Loza AM] ABISS Edusepsis (AntiBiotic Intervention in Severe Sepsis), Servei de Medicina Intensiva, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Critical Care Medicine Service, Hospital Nuestra Señora de Valme, Av. de Bellavista, s/n, 41014 Seville, Spain. [Garcia-Olivares P] ABISS Edusepsis (AntiBiotic Intervention in Severe Sepsis), Servei de Medicina Intensiva, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Critical Care Medicine Service, Hospital General Universitario Gregorio Marañón, Calle del Dr. Esquerdo, 46, 28007 Madrid, Spain. [Anton E] ABISS Edusepsis (AntiBiotic Intervention in Severe Sepsis), Servei de Medicina Intensiva, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Critical Care Medicine Service, Hospital de Manacor, Carretera Manacor Alcudia, s/n, 07500 Manacor, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
medicine.medical_specialty, Immunoglobulin levels, Survival, Sepsis mortality, medicine.medical_treatment, health care facilities, manpower, and services, Immunoglobulins, Endogeny, infecciones bacterianas y micosis::infección::sepsis [ENFERMEDADES], Disease, Critical Care and Intensive Care Medicine, Logistic regression, Severity, Sepsis, 03 medical and health sciences, 0302 clinical medicine, Other subheadings::Other subheadings::Other subheadings::/mortality [Other subheadings], Internal medicine, Anesthesiology, Medicine, 030212 general & internal medicine, aminoácidos, péptidos y proteínas::proteínas::proteínas sanguíneas::inmunoproteínas::inmunoglobulinas [COMPUESTOS QUÍMICOS Y DROGAS], Septicèmia - Mortalitat, Amino Acids, Peptides, and Proteins::Proteins::Blood Proteins::Immunoproteins::Immunoglobulins [CHEMICALS AND DRUGS], Otros calificadores::Otros calificadores::Otros calificadores::/mortalidad [Otros calificadores], biology, business.industry, Research, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, Immunosuppression, Retrospective cohort study, lcsh:RC86-88.9, medicine.disease, Surgery, Intravenous Immunoglobulins, biology.protein, Bacterial Infections and Mycoses::Infection::Sepsis [DISEASES], Antibody, Immunoglobulines, business
Abstract

Background: Pre-evaluation of endogenous immunoglobulin levels is a potential strategy to improve the results of intravenous immunoglobulins in sepsis, but more work has to be done to identify those patients who could benefit the most from this treatment. The objective of this study was to evaluate the impact of endogenous immunoglobulins on the mortality risk in sepsis depending on disease severity. Methods: This was a retrospective observational study including 278 patients admitted to the ICU with sepsis fulfilling the SEPSIS-3 criteria, coming from the Spanish GRECIA and ABISS-EDUSEPSIS cohorts. Patients were distributed into two groups depending on their Sequential Organ Failure Assessment score at ICU admission (SOFA < 8, n = 122 and SOFA >= 8, n = 156), and the association between immunoglobulin levels at ICU admission with mortality was studied in each group by Kaplan-Meier and multivariate logistic regression analysis. Results: ICU/hospital mortality in the SOFA < 8 group was 14.8/23.0%, compared to 30.1/35.3% in the SOFA >= 8 group. In the group with SOFA < 8, the simultaneous presence of total IgG < 407 mg/dl, IgM < 43 mg/dl and IgA < 219 mg/dl was associated with a reduction in the survival mean time of 6.6 days in the first 28 days and was a robust predictor of mortality risk either during the acute or during the post-acute phase of the disease (OR for ICU mortality: 13.79; OR for hospital mortality: 7.98). This predictive ability remained in the absence of prior immunosuppression (OR for ICU mortality: 17.53; OR for hospital mortality: 5.63). Total IgG < 407 mg/dl or IgG1 < 332 mg/dl was also an independent predictor of ICU mortality in this group. In contrast, in the SOFA >= 8 group, we found no immunoglobulin thresholds associated with neither ICU nor hospital mortality. Conclusions: Endogenous immunoglobulin levels may have a different impact on the mortality risk of sepsis patients based on their severity. In patients with moderate organ failure, the simultaneous presence of low levels of IgG, IgA and IgM was a consistent predictor of both acute and post-acute mortalities., The GRECIA study was supported by Proyectos de Investigacion en Biomedicina, Consejeria de Sanidad, JCYL (Grant Code BOCYL-D-26072010). The authors thank also Instituto de Salud Carlos III for their financial support (Grant Code EMER 07/050, ISCIII-FIS-PI12-01815). The funding agencies were not involved neither in the design of the study and collection, nor in the analysis, interpretation of data or manuscript writing.

Published
2017

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