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16 results on '"Contou, Damien"'

1. Hematological features and alternate diagnoses in critically ill thrombotic antiphospholipid syndrome patients

Author

Azoulay, Levi-Dan, Frapard, Thomas, Larcher, Romaric, Pène, Frédéric, Argaud, Laurent, Mayaux, Julien, Jamme, Matthieu, Coudroy, Remi, Mathian, Alexis, Gibelin, Aude, Azoulay, Elie, Tandjaoui-Lambiotte, Yacine, Dargent, Auguste, Beloncle, François-Michel, Raphalen, Jean-Herlé, Bréchot, Nicolas, de Prost, Nicolas, Devaquet, Jérôme, Contou, Damien, Gaugain, Samuel, Trouiller, Pierre, Grangé, Steven, Ledochowski, Stanislas, Lemarie, Jérémie, Faguer, Stanislas, Degos, Vincent, Frere, Corinne, Quentric, Paul, Moyon, Quentin, Luyt, Charles-Edouard, Combes, Alain, Amoura, Zahir, and Pineton de Chambrun, Marc

Published
2024
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3. COVID-19 associated pulmonary aspergillosis in critically-ill patients: a prospective multicenter study in the era of Delta and Omicron variants

Author

Bay, Pierre, Audureau, Etienne, Préau, Sébastien, Favory, Raphaël, Guigon, Aurélie, Heming, Nicholas, Gault, Elyanne, Pham, Tài, Chaghouri, Amal, Turpin, Matthieu, Morand-Joubert, Laurence, Jochmans, Sébastien, Pitsch, Aurélia, Meireles, Sylvie, Contou, Damien, Henry, Amandine, Joseph, Adrien, Chaix, Marie-Laure, Uhel, Fabrice, Roux, Damien, Descamps, Diane, Emery, Malo, Garcia-Sanchez, Claudio, Levy, David, Burrel, Sonia, Mayaux, Julien, Kimmoun, Antoine, Hartard, Cédric, Pène, Frédéric, Rozenberg, Flore, Gaudry, Stéphane, Brichler, Ségolène, Guillon, Antoine, Handala, Lynda, Tamion, Fabienne, Moisan, Alice, Daix, Thomas, Hantz, Sébastien, Delamaire, Flora, Thibault, Vincent, Souweine, Bertrand, Henquell, Cecile, Picard, Lucile, Botterel, Françoise, Rodriguez, Christophe, Dessap, Armand Mekontso, Pawlotsky, Jean-Michel, Fourati, Slim, and de Prost, Nicolas

Published
2024
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4. Clinical features, etiologies, and outcomes in adult patients with meningoencephalitis requiring intensive care (EURECA): an international prospective multicenter cohort study

Author

Sonneville, Romain, de Montmollin, Etienne, Contou, Damien, Ferrer, Ricard, Gurjar, Mohan, Klouche, Kada, Sarton, Benjamine, Demeret, Sophie, Bailly, Pierre, da Silva, Daniel, Escudier, Etienne, Le Guennec, Loic, Chabanne, Russel, Argaud, Laurent, Ben Hadj Salem, Omar, Thyrault, Martial, Frerou, Aurélien, Louis, Guillaume, De Pascale, Gennaro, Horn, Janneke, Helbok, Raimund, Geri, Guillaume, Bruneel, Fabrice, Martin-Loeches, Ignacio, Taccone, Fabio Silvio, De Waele, Jan J., Ruckly, Stéphane, Staiquly, Quentin, Citerio, Giuseppe, and Timsit, Jean-François

Published
2023
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5. Accuracy of clinicians’ ability to predict the need for renal replacement therapy: a prospective multicenter study

Author

Sitbon, Alexandre, Darmon, Michael, Geri, Guillaume, Jaubert, Paul, Lamouche-Wilquin, Pauline, Monet, Clément, Le Fèvre, Lucie, Baron, Marie, Harlay, Marie-Line, Bureau, Côme, Joannes-Boyau, Olivier, Dupuis, Claire, Contou, Damien, Lemiale, Virginie, Simon, Marie, Vinsonneau, Christophe, Blayau, Clarisse, Jacobs, Frederic, and Zafrani, Lara

Published
2022
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7. Acute cholangitis in intensive care units: clinical, biological, microbiological spectrum and risk factors for mortality: a multicenter study

Author

Lavillegrand, Jean-Rémi, Mercier-Des-Rochettes, Emmanuelle, Baron, Elodie, Pène, Frédéric, Contou, Damien, Favory, Raphael, Préau, Sébastien, Galbois, Arnaud, Molliere, Chloé, Miailhe, Arnaud-Félix, Reignier, Jean, Monchi, Mehran, Pichereau, Claire, Thietart, Sara, Vieille, Thibault, Piton, Gael, Preda, Gabriel, Abdallah, Idriss, Camus, Marine, Maury, Eric, Guidet, Bertrand, Dumas, Guillaume, and Ait-Oufella, Hafid

Published
2021
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8. Mucormycosis in intensive care unit: surgery is a major prognostic factor in patients with hematological malignancy

Author

Claustre, Johanna, Larcher, Romaric, Jouve, Thomas, Truche, Anne-Sophie, Nseir, Saad, Cadiet, Julien, Zerbib, Yoann, Lautrette, Alexandre, Constantin, Jean-Michel, Charles, Pierre-Emmanuel, Daubin, Cedric, Coudroy, Remi, Dellamonica, Jean, Argaud, Laurent, Phelouzat, Pierre, Contou, Damien, Pocquet, Juliette, Voiriot, Guillaume, Navellou, Jean-Christophe, Lavagne, Pierre, Durand, Michel, Cornet, Muriel, Schwebel, Carole, and Terzi, Nicolas

Published
2020
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9. Respiratory multiplex PCR and procalcitonin to reduce antibiotic exposure in severe SARS-CoV-2 pneumonia: a multicenter randomised controlled trial

Author

Fartoukh, Muriel, Nseir, Saad, Mégarbane, Bruno, Cohen, Yves, Lafarge, Antoine, Contou, Damien, Thille, Arnaud, Galerneau, Louis-Marie, Reizine, Florian, Cour, Martin, Klouche, Kada, Navellou, Jean-Christophe, Bitker, Laurent, Rousseau, Alexandra, Tuffet, Sophie, Simon, Tabassome, Voiriot, Guillaume, Elabbadi, Alexandre, Turpin, Matthieu, Verdet, Charlotte, Préau, Sébastien, Wallet, Frédéric, Loiez, Caroline, Voicu, Sebastian, Jacquier, Hervé, Tandjaoui-Lambiotte, Yacine, Jaureguy, Françoise, Alloui, Chakib, Azoulay, Elie, Bercot, Béatrice, Plantefeve, Gaëtan, Claudinon-Courpon, Aurore, Henry, Amandine, Pichon, Maxime, Schwebel, Carole, Tadié, Jean-Marc, Auger, Gabriel, Argaud, Laurent, Chabchoub, Malek, Kolenda, Camille, Vandenesch, François, Godreuil, Sylvain, Piton, Gael, Jeannot, Kay, Danjou, William, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Unité de Glycobiologie Structurale et Fonctionnelle - UMR 8576 (UGSF), Université de Lille-Centre National de la Recherche Scientifique (CNRS), Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S_1144 / U1144)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Hypoxie et PhysioPathologie (HP2), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), CHU Pontchaillou [Rennes], Hospices Civils de Lyon (HCL), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP), Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 (CIIL), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Microenvironment and B-cells: Immunopathology,Cell Differentiation, and Cancer (MOBIDIC), Université de Rennes (UR)-Etablissement français du sang [Rennes] (EFS Bretagne)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM), Laboratoire Chrono-environnement (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), and The study was sponsored by Assistance Publique – Hôpitaux de Paris (Délégation à la Recherche Clinique et à l’Innovation), and funded by a grant from the Fondation de l’AP-HP (Project Code: APHP200392/EUDRACT no: 2020-001324-33).

Subjects
Microbiology (medical), Randomised controlled trial, Infectious Diseases, [SDV]Life Sciences [q-bio], Antibiotics use, Intensive care unit, General Medicine, Multiplex PCR, Covid-19
Abstract

International audience; Objectives: We aimed at assessing the efficacy and safety on antibiotics exposure of a strategy combining a respiratory multiplex PCR (mPCR) with enlarged panel and daily procalcitonin (PCT) measurements, as compared with a conventional strategy, in critically ill adult patients with laboratory-confirmed SARS-CoV-2 pneumonia.Methods: This multicentre, parallel-group, open-label, randomised controlled trial enrolled patients admitted to 13 intensive care units (ICU) in France. Patients were assigned (1:1) to the control strategy, where antibiotic streamlining remained at the discretion of the physicians, or interventional strategy, consisting of using mPCR and daily PCT measurements within the first seven days of randomisation to streamline initial antibiotic therapy, with antibiotic continuation encouraged when PCT was > 1 ng/mL and discouraged if < 1 ng/mL or decreased by 80% from baseline. All patients underwent conventional microbiological tests and cultures. The primary end-point was antibiotic-free days at day 28.Results: Between April 20st and November 23st 2020, 194 patients were randomised, of whom 191 were retained in the intention-to-treat analysis. Respiratory bacterial coinfection was detected in 48.4% (45/93) and 21.4% (21/98) in the interventional and control group, respectively. The number of antibiotic-free days was 12.0 (0.0; 25.0) and 14.0 (0.0; 24.0) days, respectively (difference -2.0, (95% CI -10.6 to 6.6), P=0.89). Superinfection rates were high (51.6% and 48.5%, respectively). Mortality rates and ICU lengths of stay did not differ between groups.Conclusion: In severe SARS-CoV-2 pneumonia, the mPCR/PCT algorithm strategy did not affect 28-day antibiotics exposure nor the major clinical outcomes, as compared with routine practice.

Published
2023
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11. In-Hospital Mortality-Associated Factors of Thrombotic Antiphospholipid Syndrome Patients Requiring Intensive Care Unit Admission

Author

Pineton De Chambrun, Marc, Larcher, R., Pène, Frédéric, Argaud, Laurent, Mayaux, Julien, Jamme, Matthieu, Coudroy, Rémi, Mathian, Alexis, Gibelin, Aude, Azoulay, Elie, Tandjaoui-Lambiotte, Yacine, Dargent, Auguste, Beloncle, François-Michel, Raphalen, Jean-Herlé, Couteau-Chardon, Amélie, De Prost, Nicolas, Devaquet, Jérôme, Contou, Damien, Gaugain, Samuel, Trouiller, Pierre, Grange, Steven, Ledochowski, Stanislas, Lemarié, Jérémie, Faguer, Stanislas, Degos, Vincent, Luyt, Charles-Edouard, Combes, Alain, Amoura, Zahir, Centre National de Référence du Lupus Systémique, Syndrome des Anticorps Anti-phospholipides et Maladies Auto-immunes Systémiques Rares [CHU Pitié Salpêtrière], Service de Médecine Interne 2, maladies auto-immunes et systémiques [CHU Pitié-Salpêtrière], Institut E3M [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Institut E3M [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Université Paris Descartes - Paris 5 (UPD5), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHI Poissy-Saint-Germain, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre d'Immunologie et des Maladies Infectieuses (CIMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), CHU Tenon [AP-HP], Hopital Saint-Louis [AP-HP] (AP-HP), Service de Réanimation Médico-Chirurgicale [Avicenne], Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], Service de Réanimation Médicale (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHU Necker - Enfants Malades [AP-HP], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Service de réanimation médicale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service d'anesthésie-réanimation SAMU94-SMUR94 [Mondor], Hôpital Lariboisière-Fernand-Widal [APHP], Hôpital Antoine Béclère, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de soins intensifs [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de Réanimation Médicale [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHU Toulouse [Toulouse], Neuroprotection du Cerveau en Développement / Promoting Research Oriented Towards Early Cns Therapies (PROTECT), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases [IHU ICAN], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut E3M [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre d'Immunologie et de Maladies Infectieuses (CIMI), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de Rangueil, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut E3M [CHU Pitié-Salpêtrière], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
systemic lupus erythematosus, catastrophic antiphospholipid syndrome, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, intensive care unit, antiphospholipid syndrome, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Background: The antiphospholipid syndrome (APS) is a systemic autoimmune disease defined by thrombotic events that can require ICU admission because of organ dysfunction related to macrovascular and/or microvascular thrombosis. Critically ill patients with thrombosis and APS were studied to gain insight into their prognoses and in-hospital mortality-associated factors.Methods: This French national, multicenter, retrospective study included all patients with APS and any new thrombotic manifestations admitted to 24 ICUs (January 2000-September 2018).Results: During the study period, 134 patients (male/female ratio, 0.4) with 152 APS episodes were admitted to the ICU (mean age at admission, 46.0 ± 15.1 years). In-hospital mortality of their 134 last episodes was 35 of 134 (26.1%). The Cox multivariable model retained certain factors (hazard ratio [95% CI]: age ≥ 40 years, 11.4 [3.1-41.5], P < .0001; mechanical ventilation, 11.0 [3.3-37], P < .0001; renal replacement therapy, 2.9 [1.3-6.3], P = .007; and in-ICU anticoagulation, 0.1 [0.03-0.3], P < .0001) as independently associated with in-hospital mortality. For the subgroup of definite/probable catastrophic APS, the Cox bivariable model (including the Simplified Acute Physiology Score II score) retained double therapy (corticosteroids + anticoagulant, 0.2 [0.07-0.6]; P = .005) but not triple therapy (corticosteroids + anticoagulant + IV immunoglobulins or plasmapheresis: hazard ratio, 0.3 [0.1-1.1]; P = .07) as independently associated with in-hospital mortality.Conclusions: In-ICU anticoagulation was the only APS-specific treatment independently associated with survival for all patients. Double therapy was independently associated with better survival of patients with definite/probable catastrophic APS. In these patients, further studies are needed to determine the role of triple therapy.

Published
2019
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12. Description and predictive factors of infection in patients with chronic kidney disease admitted to the critical care unit.

Author

Contou, Damien, d'Ythurbide, Géraldine, Messika, Jonathan, Ridel, Christophe, Parrot, Antoine, Djibré, Michel, Hertig, Alexandre, Rondeau, Eric, and Fartoukh, Muriel

Abstract

Summary: Objectives: To describe the spectrum of infection and multidrug-resistant bacterial colonization, and to identify early predictors of infection in patients with chronic kidney disease (CKD) admitted to the critical care unit (CCU). Methods: A 7-month observational prospective single-centre study in a French university hospital. Results: 791 patients were admitted to the CCU, 135 of whom (17%) had severe CKD. Among these, 41 (30%) were infected on admission. Infection was microbiologically documented in 32 patients (78%), of which 7 (22%) were related to Pseudomonas aeruginosa. There was no infection related to extended-spectrum β-lactamase-producing enterobacteriaceae despite a 12% carriage rate on admission. A temperature ≥37.6 °C and a leukocyte count >12.000/mm3 were specific but poorly sensitive of infection (91% and 80%, and 45% and 39%, respectively). Using the threshold of 0.85 ng/ml, procalcitonin was a strong independent predictor of infection on admission (OR 12.8, 95% CI 4.4–37.3). Age (≥60 years) and the cause of CKD were two other predictors. Conclusions: Infection accounts for one-third of CCU admissions in CKD patients, with a high prevalence of P. aeruginosa. The usual diagnostic criteria are inaccurate for diagnosing infection in this population. A procalcitonin ≥0.85 ng/ml might be helpful for early identifying CKD patients with infection. [Copyright &y& Elsevier]

Published
2014
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13. Long-term health-related quality of life of critically ill patients with haematological malignancies: a prospective observational multicenter study.

Author

Ehooman, Franck, Biard, Lucie, Lemiale, Virginie, Contou, Damien, de Prost, Nicolas, Mokart, Djamel, Pène, Frédéric, Kouatchet, Achille, Mayaux, Julien, Demoule, Alexandre, Vincent, François, Nyunga, Martine, Bruneel, Fabrice, Rabbat, Antoine, Lebert, Christine, Perez, Pierre, Meert, Anne-Pascale, Benoit, Dominique, Hamidfar, Rebecca, and Darmon, Michael

Subjects
CRITICALLY ill, QUALITY of life, HEMATOLOGIC malignancies
Abstract

Background: Although outcomes of critically ill patients with haematological malignancies (HMs) have been fully investigated in terms of organ failure and mortality, data are scarce on health-related quality of life (HRQOL) in this population. We aim to assess post-intensive care unit (ICU) burden and HRQOL of critically ill patients with HMs and to identify risk factors for quality-of-life (QOL) impairment.Results: In total, 1011 patients with HMs who required ICU admission in 17 ICUs in France and Belgium were included in the study; 278 and 117 patients were evaluated for QOL at 3 months and 1 year, respectively, after ICU discharge. HRQOL was determined by applying the interview form of the Short Form 36 (SF-36) questionnaire. Psychological distress symptoms were evaluated using the Hospital Anxiety Depression Score (HADS) and the Impact of Event Scale (IES). In-hospital mortality rates at 3 months and 1 year were, respectively, 39.1, 50.7 and 57.2%, respectively. At 3 months, median [IQR] physical and mental component summary scores (PCS and MCS) (SF-36) were 37 [28-46] and 51 [45-58], respectively. PCS was lower in ICU patients with HMs when compared to general ICU septic patients (52 [5-13], p = 0.00001). The median combined HAD score was 8 [5-13], and the median IES score was 8 [3-16]. However, recovery during the first year after ICU discharge was not consistent in all dimensions of HRQOL. Three months after ICU discharge, the maximum daily Sequential Organ Failure Assessment score and status of the underlying malignancy at ICU admission were significantly associated with MCS impairment (− 0.54 points [95% CI − 0.99; − 0.1], p = 0.018 and − 4.83 points [95% CI − 8.44; − 1.22], p = 0.009, respectively).Conclusion: HRQOL is strongly impaired in critically ill patients with HMs at 3 months and 1 year after ICU discharge. Organ failure and disease status are strongly associated with QOL. The kinetic evaluation of QOL at 3 months and 1 year offers the opportunity to focus on QOL aspects that may be improved by therapeutic interventions during the first year after ICU discharge. [ABSTRACT FROM AUTHOR]

Published
2019
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14. Early Identification of Acute Respiratory Distress Syndrome in the Absence of Positive Pressure Ventilation: Implications for Revision of the Berlin Criteria for Acute Respiratory Distress Syndrome.

Author

Coudroy, Rémi, Frat, Jean-Pierre, Boissier, Florence, Contou, Damien, Robert, René, and Thille, Arnaud W.

Subjects
*ADULT respiratory distress syndrome, *ARTIFICIAL respiration, *PULMONARY edema, *MORTALITY, *CRITICALLY ill
Abstract

Objectives: To assess whether patients breathing spontaneously under standard oxygen could be recognized early as acute respiratory distress syndrome patients according to the current Berlin definition.Design: A post hoc analysis from two prospective studies.Setting: Twenty-three French ICUs.Patients: All patients admitted for acute hypoxemic respiratory failure and treated with noninvasive ventilation were analyzed. Patients with cardiogenic pulmonary edema, acute exacerbation of chronic obstructive pulmonary disease, or hypercapnia were excluded.Interventions: None.Measurements and Main Results: The PaO2/FIO2 ratio was estimated at admission under standard oxygen and then under noninvasive ventilation 1 hour after initiation and within the first 24 hours. Among the 219 patients treated with noninvasive ventilation for acute hypoxemic respiratory failure, 180 (82%) had bilateral infiltrates including 161 patients with PaO2/FIO2 less than or equal to 300 mm Hg under standard oxygen. Among them, 127 were treated with positive end-expiratory pressure of at least 5 cm H2O, and 120 (94%) fulfilled criteria for acute respiratory distress syndrome within the first 24 hours. The mortality rate of patients with bilateral infiltrates and PaO2/FIO2 less than or equal to 300 mm Hg under standard oxygen was 29%, a rate very close to that of intubated patients with acute respiratory distress syndrome in the Berlin definition.Conclusions: Almost all patients with pulmonary bilateral infiltrates and a PaO2/FIO2 less than or equal to 300 mm Hg under standard oxygen fulfilled the acute respiratory distress syndrome criteria under noninvasive ventilation within the first 24 hours. Their mortality rate was similar to that reported in the Berlin definition of acute respiratory distress syndrome. Therefore, spontaneous breathing patients with the acute respiratory distress syndrome criteria could be identified early without positive pressure ventilation. [ABSTRACT FROM AUTHOR]

Published
2018
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15. Prevalence, characteristics and outcome of cardiac manifestations in critically-ill antiphospholipid syndrome patients.

Author

Azoulay, Lévi-Dan, Pineton de Chambrun, Marc, Larcher, Romaric, Pène, Frédéric, Argaud, Laurent, Mayaux, Julien, Jamme, Matthieu, Coudroy, Remi, Mathian, Alexis, Gibelin, Aude, Azoulay, Elie, Tandjaoui-Lambiotte, Yacine, Dargent, Auguste, Beloncle, François, Raphalen, Jean-Herlé, Troger, Antoine, de Prost, Nicolas, Devaquet, Jérôme, Contou, Damien, and Gaugain, Samuel

Subjects
*ANTIPHOSPHOLIPID syndrome, *CARDIAC magnetic resonance imaging, *INTENSIVE care patients, *PHOSPHOLIPID antibodies, *VENTRICULAR ejection fraction
Abstract

Antiphospholipid syndrome (APS) is a rare autoimmune disease defined by thrombotic events occurring in patients with persistent antiphospholipid antibodies. Cardiac manifestations in critically-ill APS patients are poorly investigated. We conducted a study to assess the prevalence, the characteristics and the prognosis of cardiac manifestations in thrombotic APS patients admitted to intensive care unit (ICU). A French, national, multicentre, retrospective study, conducted, from January 2000 to September 2018, including all APS patients admitted to 24 participating centres' ICUs with any new thrombotic (arterial, venous or microvascular) manifestation. Cardiac manifestations were defined as any new cardiac abnormalities relying on clinical examination, cardiac biomarkers, echocardiography, cardiac magnetic resonance (CMR) and coronarography. One hundred and thirty-six patients (female 72%) were included. Mean age at ICU admission was 46 ± 15years. Cardiac manifestations were present in 71 patients (53%). In patients with cardiac involvement, median left ventricular ejection fraction (LVEF) was 40% [28–55], troponin was elevated in 93% patients, coronary angiogram (n = 19, 27%) disclosing a coronary obstruction in 21%. CMR (n = 21) was abnormal in all cases, with late gadolinium enhancement in 62% of cases. Cardiac manifestations were associated with a non-significant increase of mortality (32% vs. 19%, p = 0.08). After 1-year follow-up, median LVEF was 57% [44–60] in patients with cardiac involvement. Cardiac involvement is frequent in critically-ill thrombotic APS patients and may be associated to more severe outcome. Increased awareness on this rare cause of myocardial infarction with or without obstructive coronary artery is urgently needed. [Display omitted] • Cardiac manifestations occurs in 53% critically-ill thrombotic APS patients. • Half patients with cardiac involvement have proven or suspected MINOCAs. • Patients with cardiac involvement tend to have a worse outcome. [ABSTRACT FROM AUTHOR]

Published
2022
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16. CAPS criteria fail to identify most severely-ill thrombotic antiphospholipid syndrome patients requiring intensive care unit admission.

Author

Pineton de Chambrun, Marc, Larcher, Romaric, Pène, Frédéric, Argaud, Laurent, Demoule, Alexandre, Jamme, Matthieu, Coudroy, Remi, Mathian, Alexis, Gibelin, Aude, Azoulay, Elie, Tandjaoui-Lambiotte, Yacine, Dargent, Auguste, Beloncle, François-Michel, Raphalen, Jean-Herlé, Couteau-Chardon, Amélie, de Prost, Nicolas, Devaquet, Jérôme, Contou, Damien, Gaugain, Samuel, and Trouiller, Pierre

Subjects
*ANTIPHOSPHOLIPID syndrome, *INTENSIVE care units, *INTENSIVE care patients, *SYSTEMIC lupus erythematosus, *HOSPITAL admission & discharge
Abstract

Catastrophic antiphospholipid syndrome (CAPS), the most severe manifestation of antiphospholipid syndrome (APS), is characterised by simultaneous thromboses in multiple organs. Diagnosing CAPS can be challenging but its early recognition and management is crucial for a favourable outcome. This study was undertaken to evaluate the frequencies, distributions and ability to predict mortality of "definite/probable" or "no-CAPS" categories of thrombotic APS patients requiring admission to the intensive care unit (ICU). This French national multicentre retrospective study, conducted from January 2000 to September 2018, included all APS patients with any new thrombotic manifestation(s) admitted to 24 ICUs. One hundred and thirty-four patients (male/female ratio: 0.4; mean age at admission: 45.4 ± 15.0 years), who experienced 152 CAPS episodes, required ICU admission. The numbers of definite, probable or no-CAPS episodes, respectively, were: 11 (7.2%), 60 (39.5%) and 81 (53.3%). No histopathological proof of microvascular thrombosis was the most frequent reason for not being classified as definite CAPS. Overall, 35/152 (23.0%) episodes were fatal, with comparable rates for definite/probable CAPS and no CAPS (23% vs. 28.8% respectively, p = 0.4). The Kaplan–Meier curve of estimated probability of survival showed no between-group survival difference (log-rank test p = 0.5). Conclusions : In this study , CAPS criteria were not associated with mortality of thrombotic APS patients requiring ICU admission. Further studies are need evaluate the adequacy of CAPS criteria for critically-ill APS patients. • CAPS is the most severe APS manifestation. • Distributions of CAPS criteria in critically-ill APS patients is unknown. • Less than half of critically-ill APS patients have definite/probable CAPS. • CAPS criteria failed to predict death of thrombotic APS patients in ICU admission. [ABSTRACT FROM AUTHOR]

Published
2019
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