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1. Resilience after severe critical illness: a prospective, multicentre, observational study (RESIREA)

Author

Mathieu, Alice, Reignier, Jean, Le Gouge, Amélie, Plantefeve, Gaetan, Mira, Jean-Paul, Argaud, Laurent, Asfar, Pierre, Badie, Julio, Botoc, Nicolae-Vlad, Bui, Hoang-Nam, Chatellier, Delphine, Chauvelot, Louis, Cracco, Christophe, Darmon, Michael, Delbove, Agathe, Devaquet, Jérôme, Dumont, Louis-Marie, Gontier, Olivier, Groyer, Samuel, Hourmant, Yannick, Jaber, Samir, Lambiotte, Fabien, Madeux, Benjamin, Maizel, Julien, Martinet, Olivier, Maxime, Virginie, Mercier, Emmanuelle, Nay, Mai-Anh, Nseir, Saad, Piton, Gael, Quenot, Jean-Pierre, Renault, Anne, Rigaud, Jean-Philippe, Schneider, Francis, Sirodot, Michel, Souweine, Bertrand, Tamion, Fabienne, Thévenin, Didier, Thieulot-Rolin, Nathalie, Tinturier, Francois, Tirot, Patrice, Vinatier, Isabelle, Vinsonneau, Christophe, Lascarrou, Jean-Baptiste, and Laurent, Alexandra

Published
2024
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3. Prospective comparison of prognostic scores for prediction of outcome after out-of-hospital cardiac arrest: results of the AfterROSC1 multicentric study

Author

Lascarrou, Jean Baptiste, Bougouin, Wulfran, Chelly, Jonathan, Bourenne, Jeremy, Daubin, Cedric, Lesieur, Olivier, Asfar, Pierre, Colin, Gwenhael, Paul, Marine, Chudeau, Nicolas, Muller, Gregoire, Geri, Guillaume, Jacquier, Sophier, Pichon, Nicolas, Klein, Thomas, Sauneuf, Bertrand, Klouche, Kada, Cour, Martin, Sejourne, Caroline, Annoni, Filippo, Raphalen, Jean-Herle, Galbois, Arnaud, Bruel, Cedric, Mongardon, Nicolas, Aissaoui, Nadia, Deye, Nicolas, Maizel, Julien, Dumas, Florence, Legriel, Stephane, and Cariou, Alain

Published
2023
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4. Enteral citrulline supplementation versus placebo on SOFA score on day 7 in mechanically ventilated critically ill patients: the IMMUNOCITRE randomized clinical trial

Author

Tadié, Jean-Marc, Locher, Clara, Maamar, Adel, Reignier, Jean, Asfar, Pierre, Commereuc, Morgane, Lesouhaitier, Mathieu, Gregoire, Murielle, Le Pabic, Estelle, Bendavid, Claude, Moreau, Caroline, Diehl, Jean-Luc, Gey, Alain, Tartour, Eric, Le Tulzo, Yves, Thibault, Ronan, Terzi, Nicolas, Gacouin, Arnaud, Roussel, Mikael, Delclaux, Christophe, Tarte, Karin, and Cynober, Luc

Published
2023
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5. Prophylactic platelet transfusion response in critically ill patients: a prospective multicentre observational study

Author

Reizine, Florian, Le Marec, Sarah, Le Meur, Anthony, Consigny, Maëlys, Berteau, Florian, Bodenes, Laetitia, Geslain, Marie, McQuilten, Zoe, Le Niger, Catherine, Huntzinger, Julien, Seguin, Philippe, Thibert, Jean-Baptiste, Simon, David, Reignier, Jean, Egreteau, Pierre-Yves, Tadié, Jean-Marc, Huet, Olivier, Asfar, Pierre, Ehrmann, Stephan, and Aubron, Cécile

Published
2023
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8. Valproic acid as adjuvant treatment for convulsive status epilepticus: a randomised clinical trial

Author

Sharshar, Tarek, Porcher, Raphaël, Asfar, Pierre, Grimaldi, Lamiae, Jabot, Julien, Argaud, Laurent, Lebert, Christine, Bollaert, Pierre-Edouard, Harlay, Marie Line, Chillet, Patrick, Maury, Eric, Santoli, Francois, Blanc, Pascal, Sonneville, Romain, Vu, Dinh Chuyen, Rohaut, Benjamin, Mazeraud, Aurelien, Alvarez, Jean-Claude, Navarro, Vincent, Clair, Bernard, and Outin, Hervé

Published
2023
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9. Anticoagulation strategy and safety in critically ill COVID-19 patients: a French retrospective multicentre study

Author

Lamouche-Wilquin, Pauline, Perrin, Léa, Pere, Morgane, Raymond, Matthieu, Asfar, Pierre, Darreau, Cedric, Reizine, Florian, Colin, Gwenhaël, Delbove, Agathe, Auchabie, Johann, Hourmant, Baptiste, Frérou, Aurélien, Combe, Béatrice La, Morin, Jean, Kergoat, Pierre, Lorber, Julien, Egreteau, Pierre-Yves, Souchard, Jérome, Canet, Emmanuel, and Lascarrou, Jean-Baptiste

Published
2023
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10. Prospective evaluation of the efficacy, safety, and optimal biomarker enrichment strategy for nangibotide, a TREM-1 inhibitor, in patients with septic shock (ASTONISH): a double-blind, randomised, controlled, phase 2b trial

Author

Asfar, Pierre, Nay, Mai-Anh, Guitton, Christophe, Quenot, Jean-Pierre, Tran-Van, David, Bohe, Julien, Plantefève, Gaëtan, Nseir, Saadalla, Lefrant, Jean-Yves, Monnet, Xavier, Papazian, Laurent, Vinsonneau, Christophe, Constantin, Jean-Michel, Mebazaa, Alexandre, Oueslati, Haikel, Escudero, Dolores, Martinez Sagasti, Fernando, Piacentini, Enrique, Ramirez Galleymore, Paula, Dugernier, Thierry, Fagnoul, David, Michaux, Isabelle, Seibert, Allan, Reinikainen, Matti, Grøfte, Thorbjørn, Martin-Loeches, Ignacio, Laffey, John, François, Bruno, Lambden, Simon, Fivez, Tom, Gibot, Sebastien, Derive, Marc, Grouin, Jean-Marie, Salcedo-Magguilli, Margarita, Lemarié, Jérémie, De Schryver, Nicolas, Jalkanen, Ville, Hicheur, Tarik, Garaud, Jean-Jacques, Cuvier, Valérie, Ferrer, Ricard, Bestle, Morten, Pettilä, Ville, Mira, Jean-Paul, Bouisse, Camille, Mercier, Emmanuelle, Vermassen, Joris, Huberlant, Vincent, Vinatier, Isabelle, Anguel, Nadia, Levy, Mitchell, and Laterre, Pierre-François

Published
2023
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11. Low versus standard calorie and protein feeding in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group trial (NUTRIREA-3)

Author

Contou, Damien, Pajot, Olivier, Jaubert, Paul, Marin, Nathalie, Simon, Marie, Cour, Martin, Mortaza, Satar, Souday, Vincent, Lemerle, Marie, Malfroy, Sylvain, Berdaguer Ferrari, Fernando, Rozec, Bertrand, Gruson, Didier, Sazio, Charline, Champion, Suzanne, Boissier, Florence, Veinstein, Anne, Baboi, Loredana, Richard, Jean-Christophe, Yonis, Hodane, Le Guennec, Loïc, Lefevre, Lucie, Chommeloux, Juliette, Hékimian, Guillaume, Lemiale, Virginie, Mariotte, Eric, Valade, Sandrine, Tirolien, Joanna, Fedun, Yannick, Cerf, Charles, Tachon, Guillaume, Roustan, Jérôme, Vimeux, Sylvie, Bonnivard, Michel, Anguel, Nadia, Osman, David, Asehnoune, Karim, Roquilly, Antoine, Belafia, Fouad, Conseil, Matthieu, Cisse, Moussa, Chaouki, Bouras, Espenel, Rémi, Brasse, Christine, Ena, Sébastien, Delahaye, Arnaud, Castanera, Jeremy, Dulac, Thierry, Petua, Philippe, Zerbib, Yoann, Brault, Clément, Annane, Djillali, Bounab, Rania, Heming, Nicholas, Boulain, Thierry, Jacquier, Sophie, Muller, Grégoire, Favory, Raphael, Préau, Sébastien, Poissy, Julien, Massri, Alexandre, Lissonde, Floriane, Winiszewski, Hadrien, Vieille, Thibault, Jacquier, Marine, Labruyère, Marie, Andreu, Pascal, Tadié, Jean-Marc, Bodenes, Laetitia, Combaux, Danièle, Luis, David, Marchalot, Antoine, Herbrecht, Jean-Etienne, Clere-Jehl, Raphaël, Schnell, David, Aboad, Jérôme, Bougon, David, Escudier, Etienne, Coupez, Elisabeth, Dupuis, Claire, Demailly, Zoe, Galerneau, Louis-Marie, Chelly, Jonathan, Pourcine, Franck, Van Vong, Ly, Abid, Sonia, De Montmollin, Etienne, Sonneville, Romain, Guitton, Christophe, Chudeau, Nicolas, Landais, Mickaël, Pages, Vincent, Séjourné, Caroline, Rahmani, Imen, Sbouj, Ghada, Megarbane, Bruno, Deye, Nicolas, Malissin, Isabelle, Reignier, Jean, Plantefeve, Gaetan, Mira, Jean-Paul, Argaud, Laurent, Asfar, Pierre, Aissaoui, Nadia, Badie, Julio, Botoc, Nicolae-Vlad, Brisard, Laurent, Bui, Hoang-Nam, Chatellier, Delphine, Chauvelot, Louis, Combes, Alain, Cracco, Christophe, Darmon, Michael, Das, Vincent, Debarre, Matthieu, Delbove, Agathe, Devaquet, Jérôme, Dumont, Louis-Marie, Gontier, Olivier, Groyer, Samuel, Guérin, Laurent, Guidet, Bertrand, Hourmant, Yannick, Jaber, Samir, Lambiotte, Fabien, Leroy, Christophe, Letocart, Philippe, Madeux, Benjamin, Maizel, Julien, Martinet, Olivier, Martino, Frédéric, Maxime, Virginie, Mercier, Emmanuelle, Nay, Mai-Anh, Nseir, Saad, Oziel, Johanna, Picard, Walter, Piton, Gael, Quenot, Jean-Pierre, Reizine, Florian, Renault, Anne, Richecoeur, Jack, Rigaud, Jean-Philippe, Schneider, Francis, Silva, Daniel, Sirodot, Michel, Souweine, Bertrand, Tamion, Fabienne, Terzi, Nicolas, Thévenin, Didier, Thiery, Guillaume, Thieulot-Rolin, Nathalie, Timsit, Jean-Francois, Tinturier, Francois, Tirot, Patrice, Vanderlinden, Thierry, Vinatier, Isabelle, Vinsonneau, Christophe, Voicu, Sebastian, Lascarrou, Jean-Baptiste, and Le Gouge, Amélie

Published
2023
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12. Evaluation of the efficacy and safety of TREM-1 inhibition with nangibotide in patients with COVID-19 receiving respiratory support: the ESSENTIAL randomised, double-blind trial

Author

François, Bruno, Lambden, Simon, Garaud, Jean-Jacques, Derive, Marc, Grouin, Jean-Marie, Asfar, Pierre, Darreau, Cédric, Mira, Jean-Paul, Quenot, Jean-Pierre, Lemarié, Jérémie, Mercier, Emmanuelle, Lacherade, Jean-Claude, Vinsonneau, Christophe, Fivez, Tom, Helms, Julie, Badie, Julio, Levy, Mitchell, Cuvier, Valérie, Salcedo-Magguilli, Margarita, Laszlo-Pouvreau, Anne-Lise, Laterre, Pierre-François, and Gibot, Sébastien

Published
2023
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13. Management of renal replacement therapy among adults in French intensive care units: A bedside practice evaluation

Author

Megarbane, Bruno, Lesieur, Olivier, Leloup, Maxime, Weiss, Nicolas, Tamion, Fabienne, Beuret, Pascal, Monchi, Mehran, Delcourte, Claire, Hayon, Jan, Klouche, Kada, Stoclin, Annabelle, Gibot, Sébastien, Peigne, Vincent, Mezher, Chaouki, Martino, Frédéric, Nguyen, Maxime, Kuteifan, Khaldoun, Louis, Guillaume, Rigault, Guillaume, Masuccio, Michel, Garin, Aude, Asfar, Pierre, Andrieu, Maude, Auchabie, Johann, Daviet, Florence, Lacave, Guillaume, Benhamida, Hotman, Vivet, Bérengère, Chaignat, Claire, Desgrouas, Maxime, La-Combe, Béatrice, Plouvier, Fabienne, Richard, Jean-Christophe, Haddadi, Clément, Czolnowski, Dorian, Lau, Nicolas, Jacobs, Frédéric, Thirion, Marina, Pons, Antoine, Pichon, Nicolas, Patrigeon, René-Gilles, Vieillard-Baron, Antoine, Uhel, Fabrice, Rigaud, Jean-Philippe, Bouhake, Yannis, Zagozda, Dominique, Arrestier, Romain, Vinclair, Camille, Fedou, Anne-Laure, Dargent, Auguste, Dellamonica, Jean, Rey, Brice, Gachet, Alexandre, Serie, Mathieu, Bruel, Cédric, Troger, Antoine, Berthoud, Vivien, Delbove, Agathe, Goulenok, Cyril, Bouguoin, Wulfran, Osman, David, Anguel, Nadia, Guerin, Laurent, Foucault, Camille, Preau, Sébastien, Saura, Ouriel, Boue, Yvonnick, Sedillot, Nicholas, Covin, Laetitia, Lambiotte, Fabien, Guignon, Carole, Perinel-Ragey, Sophie, Souloy, Xavier, Defaux-Chevillard, Cécile, Renault, Anne, Mme-Ngapmen, Nadège, Jourdain, Mercedes, Van Der Linden, Thierry, Levy, Clémentine, Thouy, François, Degouy, Guillaume, Jolly, Florian, Jacquier, Marine, Pecqueur, Delphine, Labruyère, Marie, Vinsonneau, Christophe, Fournel, Isabelle, and Quenot, Jean-Pierre

Published
2023
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14. Transport intrahospitalier

Author

Olivier, Pierre-Yves, primary, Demiselle, Julien, additional, Asfar, Pierre, additional, Mercat, Alain, additional, and Lerolle, Nicolas, additional

Published
2023
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15. ECMO veino-veineuse

Author

Olivier, Pierre-Yves, primary, Demiselle, Julien, additional, Asfar, Pierre, additional, Mercat, Alain, additional, and Lerolle, Nicolas, additional

Published
2023
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16. Cirrhose décompensée

Author

Olivier, Pierre-Yves, primary, Demiselle, Julien, additional, Asfar, Pierre, additional, Mercat, Alain, additional, and Lerolle, Nicolas, additional

Published
2023
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18. Intoxication au CO

Author

Olivier, Pierre-Yves, primary, Demiselle, Julien, additional, Asfar, Pierre, additional, Mercat, Alain, additional, and Lerolle, Nicolas, additional

Published
2023
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19. Microangiopathie thrombotique

Author

Olivier, Pierre-Yves, primary, Demiselle, Julien, additional, Asfar, Pierre, additional, Mercat, Alain, additional, and Lerolle, Nicolas, additional

Published
2023
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22. Feasibility Assessment of a Biomarker-Guided Kidney-Sparing Sepsis Bundle: The Limiting Acute Kidney Injury Progression In Sepsis Trial

Author

Gómez, Hernando, Zarbock, Alexander, Pastores, Stephen M., Frendl, Gyorgy, Bercker, Sven, Asfar, Pierre, Conrad, Steven A., Creteur, Jaques, Miner, James, Mira, Jean Paul, Motsch, Johan, Quenot, Jean-Pierre, Rimmelé, Thomas, Rosenberger, Peter, Vinsonneau, Christophe, Birch, Bob, Heskia, Fabienne, Textoris, Julien, Molinari, Luca, Guzzi, Louis M., Ronco, Claudio, and Kellum, John A.

Published
2023
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23. Targeted Temperature Management After In-Hospital Cardiac Arrest: An Ancillary Analysis of Targeted Temperature Management for Cardiac Arrest With Nonshockable Rhythm Trial Data

Author

Blanc, Alexiane, Colin, Gwenhael, Cariou, Alain, Merdji, Hamid, Grillet, Guillaume, Girardie, Patrick, Coupez, Elisabeth, Dequin, Pierre-François, Boulain, Thierry, Frat, Jean-Pierre, Asfar, Pierre, Pichon, Nicolas, Landais, Mickael, Plantefeve, Gaëtan, Quenot, Jean-Pierre, Chakarian, Jean-Charles, Sirodot, Michel, Legriel, Stéphane, Massart, Nicolas, Thevenin, Didier, Desachy, Arnaud, Delahaye, Arnaud, Botoc, Vlad, Vimeux, Sylvie, Martino, Frederic, Reignier, Jean, Taccone, F.S., and Lascarrou, J.B.

Published
2022
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24. Blood Pressure Targets for Adults with Vasodilatory Shock -- An Individual Patient Data Meta-Analysis.

Author

Angriman, Federico, Momenzade, Neda, Adhikari, Neill K. J., Mouncey, Paul R., Asfar, Pierre, Yarnell, Christopher J., Sean Wei Xiang Ong, Pinto, Ruxandra, Doidge, James C., Shankar-Hari, Manu, Harhay, Michael O., Masse, Marie-Hélène, Harrison, David A., Rowan, Kathryn M., Fan Li, Carter, Francis, Camirand-Lemyre, Felix, and Lamontagne, François

Abstract

Background: We sought to estimate whether a lower mean arterial blood pressure target, compared with a higher mean arterial blood pressure target, reduced 90-day all-cause mortality among critically ill adult patients with vasodilatory shock. Methods: We conducted an individual patient data meta-analysis of randomized controlled trials that evaluated the effect of distinct thresholds of mean arterial blood pressure to guide vasopressor support among critically ill adults identified in a systematic literature search. The main exposure was a lower mean arterial pressure target compared with a higher mean arterial pressure target (including usual care). The primary outcome was 90-day all-cause mortality. We used a Bayesian random effects log-binomial model to estimate risk ratios with 95% credible intervals (CrIs). Results: Between 2010 and 2019, 3352 patients were randomly assigned in three trials (SEPSISPAM, OVATION pilot trial, and 65-Trial) across 103 hospitals from the United Kingdom, France, and Canada. When compared with a higher mean arterial blood pressure target or usual care, the risk ratio for 90-day all-cause mortality associated with a lower blood pressure target was 0.93 (95% CrI, 0.76 to 1.07; low certainty, posterior probability of benefit 87%). Results were consistent across multiple secondary and sensitivity analyses, including adjustment for prognostically important baseline covariates and alternative modeling techniques. Multiple approaches to evaluate the heterogeneity of treatment effect did not identify any subgroups that may potentially benefit from higher mean arterial blood pressure targets. Conclusions: Targeting a lower mean arterial blood pressure for vasopressor therapy in critically ill patients with vasodilatory shock possibly reduced 90-day all-cause mortality. However, the certainty of evidence is low, and this analysis does not exclude the possibility that lower targets may cause harm overall. [ABSTRACT FROM AUTHOR]

Published
2025
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25. Factors associated with acute mesenteric ischemia among critically ill ventilated patients with shock: a post hoc analysis of the NUTRIREA2 trial

Author

Piton, Gaël, Le Gouge, Amélie, Boisramé-Helms, Julie, Anguel, Nadia, Argaud, Laurent, Asfar, Pierre, and Botoc, Vlad

Subjects
Medical research -- Analysis, Medicine, Experimental -- Analysis, Hemoglobin -- Analysis, Ischemia -- Analysis, Shock -- Analysis, Health care industry
Abstract

Purpose Acute mesenteric ischemia (AMI) is a rare, but life-threatening condition occurring among critically ill patients. Several factors have been associated with AMI, but the causal link is debated, most studies being retrospective. Among these factors, enteral nutrition (EN) could be associated with AMI, in particular among patients with shock. We aimed to study the factors independently associated with AMI in a post hoc analysis of the NUTRIREA-2 trial including 2410 critically ill ventilated patients with shock, randomly assigned to receive EN or parenteral nutrition (PN). Methods Post hoc analysis of the NUTRIREA-2 trial was conducted. Ventilated adults with shock were randomly assigned to receive EN or PN. AMI was assessed by computed tomography, endoscopy, or laparotomy. Factors associated with AMI were studied by univariate and multivariate analysis. Results 2410 patients from 44 French intensive care units (ICUs) were included in the study: 1202 patients in the enteral group and 1208 patients in the parenteral group. The median age was 67 [58-76] years, with 67% men, a SAPS II score of 59 [46-74], and a medical cause for ICU admission in 92.7%. AMI was diagnosed among 24 (1%) patients, mainly by computed tomography (79%) or endoscopy (38%). The mechanism of AMI was non-occlusive mesenteric ischemia (n = 12), occlusive (n = 4), and indeterminate (n = 8). The median duration between inclusion in the trial and AMI diagnosis was 4 [1-11] days. Patients with AMI were older, had a higher SAPS II score at ICU admission, had higher plasma lactate, creatinine, and ASAT concentrations and lower hemoglobin concentration, had more frequently EN, dobutamine, and CVVHDF at inclusion, developed more frequently bacteremia during ICU stay, and had higher 28-day and 90-day mortality rates compared with patients without AMI. By multivariate analysis, AMI was independently associated with EN, dobutamine use, SAPS II score [greater than or equal to] 62 and hemoglobin concentration [less than or equal to] 10.9 g/dL. Conclusion Among critically ill ventilated patients with shock, EN, dobutamine use, SAPS II score [greater than or equal to] 62 and hemoglobin [less than or equal to] 10.9 g/dL were independently associated with AMI. Among critically ill ventilated patients requiring vasopressors, EN should be delayed or introduced cautiously in case of low cardiac output requiring dobutamine and/or in case of multiple organ failure with high SAPS II score., Author(s): Gaël Piton [sup.1] [sup.56], Amélie Le Gouge [sup.2] [sup.3], Julie Boisramé-Helms [sup.4] [sup.5], Nadia Anguel [sup.6], Laurent Argaud [sup.7], Pierre Asfar [sup.8], Vlad Botoc [sup.9], Anne Bretagnol [sup.10], Laurent [...]

Published
2022
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26. Intravenous immunoglobulins in patients with COVID-19-associated moderate-to-severe acute respiratory distress syndrome (ICAR): multicentre, double-blind, placebo-controlled, phase 3 trial

Author

Mazeraud, Aurélien, Jamme, Matthieu, Mancusi, Rossella Letizia, Latroche, Claire, Megarbane, Bruno, Siami, Shidasp, Zarka, Jonathan, Moneger, Guy, Santoli, Francesco, Argaud, Laurent, Chillet, Patrick, Muller, Gregoire, Bruel, Cedric, Asfar, Pierre, Beloncle, Francois, Reignier, Jean, Vinsonneau, Christophe, Schimpf, Caroline, Amour, Julien, Goulenok, Cyril, Lemaitre, Caroline, Rohaut, Benjamin, Mateu, Philippe, De Rudnicki, Stephane, Mourvillier, Bruno, Declercq, Pierre-Louis, Schwebel, Carole, Stoclin, Annabelle, Garnier, Marc, Madeux, Benjamin, Gaudry, Stéphane, Bailly, Karine, Lamer, Christian, Aegerter, Philippe, Rieu, Christine, Sylla, Khaoussou, Lucas, Bruno, and Sharshar, Tarek

Published
2022
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27. Early steroids and ventilator-associated pneumonia in COVID-19-related ARDS

Author

Lamouche-Wilquin, Pauline, Souchard, Jérôme, Pere, Morgane, Raymond, Matthieu, Asfar, Pierre, Darreau, Cédric, Reizine, Florian, Hourmant, Baptiste, Colin, Gwenhaël, Rieul, Guillaume, Kergoat, Pierre, Frérou, Aurélien, Lorber, Julien, Auchabie, Johann, La Combe, Béatrice, Seguin, Philippe, Egreteau, Pierre-Yves, Morin, Jean, Fedun, Yannick, Canet, Emmanuel, Lascarrou, Jean-Baptiste, and Delbove, Agathe

Published
2022
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28. Effects of mean arterial pressure target on mottling and arterial lactate normalization in patients with septic shock: a post hoc analysis of the SEPSISPAM randomized trial

Author

Fage, Nicolas, Demiselle, Julien, Seegers, Valérie, Merdji, Hamid, Grelon, Fabien, Mégarbane, Bruno, Anguel, Nadia, Mira, Jean-Paul, Dequin, Pierre-François, Gergaud, Soizic, Weiss, Nicolas, Legay, François, Le Tulzo, Yves, Conrad, Marie, Coudroy, Remi, Gonzalez, Frédéric, Guitton, Christophe, Tamion, Fabienne, Tonnelier, Jean-Marie, Bedos, Jean Pierre, Van Der Linden, Thierry, Vieillard-Baron, Antoine, Mariotte, Eric, Pradel, Gaël, Lesieur, Olivier, Ricard, Jean-Damien, Hervé, Fabien, Du Cheyron, Damien, Guerin, Claude, Mercat, Alain, Teboul, Jean-Louis, Radermacher, Peter, and Asfar, Pierre

Published
2022
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29. Outcomes of mild-to-moderate postresuscitation shock after non-shockable cardiac arrest and association with temperature management: a post hoc analysis of HYPERION trial data

Author

Ziriat, Ines, Le Thuaut, Aurélie, Colin, Gwenhael, Merdji, Hamid, Grillet, Guillaume, Girardie, Patrick, Souweine, Bertrand, Dequin, Pierre-François, Boulain, Thierry, Frat, Jean-Pierre, Asfar, Pierre, Francois, Bruno, Landais, Mickael, Plantefeve, Gaëtan, Quenot, Jean-Pierre, Chakarian, Jean-Charles, Sirodot, Michel, Legriel, Stéphane, Massart, Nicolas, Thevenin, Didier, Desachy, Arnaud, Delahaye, Arnaud, Botoc, Vlad, Vimeux, Sylvie, Martino, Frederic, Reignier, Jean, Cariou, Alain, and Lascarrou, Jean Baptiste

Published
2022
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30. Relationship between corticosteroid use and incidence of ventilator-associated pneumonia in COVID-19 patients: a retrospective multicenter study

Author

Saura, Ouriel, Rouzé, Anahita, Martin-Loeches, Ignacio, Povoa, Pedro, Kreitmann, Louis, Torres, Antoni, Metzelard, Matthieu, Du Cheyron, Damien, Lambiotte, Fabien, Tamion, Fabienne, Labruyere, Marie, Boulle Geronimi, Claire, Luyt, Charles-Edouard, Nyunga, Martine, Pouly, Olivier, Thille, Arnaud W., Megarbane, Bruno, Saade, Anastasia, Magira, Eleni, Llitjos, Jean-François, Ioannidou, Iliana, Pierre, Alexandre, Reignier, Jean, Garot, Denis, Baudel, Jean-Luc, Voiriot, Guillaume, Plantefeve, Gaëtan, Morawiec, Elise, Asfar, Pierre, Boyer, Alexandre, Mekontso-Dessap, Armand, Bardaka, Fotini, Diaz, Emili, Vinsonneau, Christophe, Floch, Pierre-Edouard, Weiss, Nicolas, Ceccato, Adrian, Artigas, Antonio, Nora, David, Duhamel, Alain, Labreuche, Julien, and Nseir, Saad

Published
2022
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32. Invasive pulmonary aspergillosis among intubated patients with SARS-CoV-2 or influenza pneumonia: a European multicenter comparative cohort study

Author

Rouzé, Anahita, Lemaitre, Elise, Martin-Loeches, Ignacio, Povoa, Pedro, Diaz, Emili, Nyga, Rémy, Torres, Antoni, Metzelard, Matthieu, Du Cheyron, Damien, Lambiotte, Fabien, Tamion, Fabienne, Labruyere, Marie, Boulle Geronimi, Claire, Luyt, Charles-Edouard, Nyunga, Martine, Pouly, Olivier, Thille, Arnaud W., Megarbane, Bruno, Saade, Anastasia, Magira, Eleni, Llitjos, Jean-François, Ioannidou, Iliana, Pierre, Alexandre, Reignier, Jean, Garot, Denis, Kreitmann, Louis, Baudel, Jean-Luc, Voiriot, Guillaume, Plantefeve, Gaëtan, Morawiec, Elise, Asfar, Pierre, Boyer, Alexandre, Mekontso-Dessap, Armand, Makris, Demosthenes, Vinsonneau, Christophe, Floch, Pierre-Edouard, Marois, Clémence, Ceccato, Adrian, Artigas, Antonio, Gaudet, Alexandre, Nora, David, Cornu, Marjorie, Duhamel, Alain, Labreuche, Julien, and Nseir, Saad

Published
2022
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34. Relationship Between Obesity and Ventilator-Associated Pneumonia: A Post Hoc Analysis of the NUTRIREA2 Trial

Author

Sirodot, Michel, Bui, Hoang-Nam, Gontier, Olivier, Quenot, Jean-Pierre, Schwebel, Carole, Leray, Véronique, Rolin, Nathalie, Bellec, Frédéric, Das, Vincent, Roquilly, Antoine, Brisard, Laurent, Boulain, Thierry, Anguel, Nadia, Devaquet, Jérôme, Maxime, Virginie, Da Silva, Daniel, Canet, Emmanuel, Guidet, Bertrand, Grégoire, Charles, Martino, Frédéric, Chatelier, Delphine, Botoc, Vlad, Thiery, Guillaume, Kummerlen, Christine, Herbrecht, J-Etienne, Mercier, Emmanuelle, Letocart, Philippe, Asfar, Pierre, Ganster, Frederique, Jack, Richecoeur, Laurent, Argaud, Farid, Zerimech, Patrice, Maboudou, Nseir, Saad, Le Gouge, Amélie, Pouly, Olivier, Lascarrou, Jean-Baptiste, Lacherade, Jean-Claude, Mira, Jean-Paul, Declercq, Pierre-Louis, Piton, Gaël, Tinturier, François, Coupez, Elisabeth, Gaudry, Stéphane, Djibré, Michel, Thevenin, Didier, Balduyck, Malika, and Reignier, Jean

Published
2021
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35. Acute kidney injury in the ICU: from injury to recovery: reports from the 5th Paris International Conference.

Author

Bellomo, Rinaldo, Ronco, Claudio, Mehta, Ravindra L, Asfar, Pierre, Boisramé-Helms, Julie, Darmon, Michael, Diehl, Jean-Luc, Duranteau, Jacques, Hoste, Eric AJ, Olivier, Joannes-Boyau, Legrand, Matthieu, Lerolle, Nicolas, Malbrain, Manu LNG, Mårtensson, Johan, Oudemans-van Straaten, Heleen M, Parienti, Jean-Jacques, Payen, Didier, Perinel, Sophie, Peters, Esther, Pickkers, Peter, Rondeau, Eric, Schetz, Miet, Vinsonneau, Christophe, Wendon, Julia, Zhang, Ling, and Laterre, Pierre-François

Subjects
Acute renal failure, Anticoagulation, Biomarkers, Epidemiology, Extracorporeal epuration, Renal blood flow, Renal replacement, Therapy, Kidney Disease, Renal and urogenital, Clinical Sciences, Public Health and Health Services
Abstract

The French Intensive Care Society organized its yearly Paris International Conference in intensive care on June 18-19, 2015. The main purpose of this meeting is to gather the best experts in the field in order to provide the highest quality update on a chosen topic. In 2015, the selected theme was: "Acute Renal Failure in the ICU: from injury to recovery." The conference program covered multiple aspects of renal failure, including epidemiology, diagnosis, treatment and kidney support system, prognosis and recovery together with acute renal failure in specific settings. The present report provides a summary of every presentation including the key message and references and is structured in eight sections: (a) diagnosis and evaluation, (b) old and new diagnosis tools,

Published
2017

36. Effect of the use of an endotracheal tube and stylet versus an endotracheal tube alone on first-attempt intubation success: a multicentre, randomised clinical trial in 999 patients

Author

Jaber, Samir, Rollé, Amélie, Godet, Thomas, Terzi, Nicolas, Riu, Béatrice, Asfar, Pierre, and Bourenne, Jeremy

Subjects
Fresenius Medical Care AG & Company KGaA, Health care industry -- Usage, Clinical trials -- Usage, Health care industry
Abstract

Purpose The effect of the routine use of a stylet during tracheal intubation on first-attempt intubation success is unclear. We hypothesised that the first-attempt intubation success rate would be higher with tracheal tube + stylet than with tracheal tube alone. Methods In this multicentre randomised controlled trial, conducted in 32 intensive care units, we randomly assigned patients to tracheal tube + stylet or tracheal tube alone (i.e. without stylet). The primary outcome was the proportion of patients with first-attempt intubation success. The secondary outcome was the proportion of patients with complications related to tracheal intubation. Serious adverse events, i.e., traumatic injuries related to tracheal intubation, were evaluated. Results A total of 999 patients were included in the modified intention-to-treat analysis: 501 (50%) to tracheal tube + stylet and 498 (50%) to tracheal tube alone. First-attempt intubation success occurred in 392 patients (78.2%) in the tracheal tube + stylet group and in 356 (71.5%) in the tracheal tube alone group (absolute risk difference, 6.7; 95%CI 1.4-12.1; relative risk, 1.10; 95%CI 1.02-1.18; P = 0.01). A total of 194 patients (38.7%) in the tracheal tube + stylet group had complications related to tracheal intubation, as compared with 200 patients (40.2%) in the tracheal tube alone group (absolute risk difference, - 1.5; 95%CI - 7.5 to 4.6; relative risk, 0.96; 95%CI 0.83-1.12; P = 0.64). The incidence of serious adverse events was 4.0% and 3.6%, respectively (absolute risk difference, 0.4; 95%CI, - 2.0 to 2.8; relative risk, 1.10; 95%CI 0.59-2.06. P = 0.76). Conclusions Among critically ill adults undergoing tracheal intubation, using a stylet improves first-attempt intubation success., Author(s): Samir Jaber [sup.1] [sup.31], Amélie Rollé [sup.2], Thomas Godet [sup.3], Nicolas Terzi [sup.4], Béatrice Riu [sup.5], Pierre Asfar [sup.6], Jeremy Bourenne [sup.7], Séverin Ramin [sup.8], Virginie Lemiale [sup.9], Jean-Pierre [...]

Published
2021
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37. Process-Specific Blood Biomarkers and Outcomes in COVID-19 Versus Non-COVID-19 ARDS (APEL–COVID Study): A Prospective, Observational Cohort Study.

Author

Lesur, Olivier, Segal, Eric David, Rego, Kevin, Mercat, Alain, Asfar, Pierre, and Chagnon, Frédéric

Subjects
ADULT respiratory distress syndrome, LYSYL oxidase, LOGISTIC regression analysis, LENGTH of stay in hospitals, NEPRILYSIN
Abstract

Background: Severe acute respiratory syndrome (SARS) and acute respiratory distress syndrome (ARDS) are often considered separate clinico-radiological entities. Whether these conditions also present a single process-specific systemic biomolecular phenotype and how this relates to patient outcomes remains unknown. A prospective cohort study was conducted, including adult patients admitted to the ICU and general floors for COVID-19-related (COVID+) or non-COVID-19-related (COVID−) acute respiratory failure during the main phase of the pandemic. The primary objective was to study blood biomarkers and outcomes among different groups and severity subsets. Results: A total of 132 patients were included, as follows: 67 COVID+, 54 COVID− (with 11 matched control subjects for biomarker reference), and 58 of these patients allowed for further pre- and post-analysis. The baseline apelin (APL) levels were higher in COVID+ patients (p < 0.0001 vs. COVID− patients) and in SARS COVID+ patients (p ≤ 0.02 vs. ARDS), while the IL-6 levels were higher in ARDS COVID− patients (p ≤ 0.0001 vs. SARS). Multivariable logistic regression analyses with cohort biomarkers and outcome parameters revealed the following: (i) log-transformed neprilysin (NEP) activity was significantly higher in COVID+ patients (1.11 [95% CI: 0.4–1.9] vs. 0.37 [95% CI: 0.1–0.8], fold change (FC): 1.43 [95% CI: 1.04–1.97], p = 0.029) and in SARS patients (FC: 1.65 [95% CI: 1.05–2.6], p = 0.032 vs. non-SARS COVID+ patients, and 1.73 [95% CI: 1.19–2.5], p = 0.005 vs. ARDS COVID− patients) and (ii) higher lysyl oxidase (LOX) activity and APL levels were respectively associated with death and a shorter length of hospital stay in SARS COVID+ patients (Odds Ratios (OR): 1.01 [1.00–1.02], p = 0.05, and OR: −0.007 [−0.013–0.0001], p = 0.048). Conclusion: Process-specific blood biomarkers exhibited distinct profiles between COVID+ and COVID− patients, and across stages of severity. NEP and LOX activities, as well as APL levels, are particularly linked to COVID+ patients and their outcomes (ClinicalTrials.gov Identifier: NCT04632732). [ABSTRACT FROM AUTHOR]

Published
2024
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38. Impact of non-invasive oxygen reserve index versus standard SpO2 monitoring on peripheral oxygen saturation during endotracheal intubation in the intensive care unit: Protocol for the randomized controlled trial NESOI2.

Author

Hille, Hugo, Le Thuaut, Aurélie, Asfar, Pierre, Quelven, Quentin, Mercier, Emmanuelle, Le Meur, Anthony, Quenot, Jean-Pierre, Lemiale, Virginie, Muller, Grégoire, Cour, Martin, Ferré, Alexis, Berge, Asael, Curtiaud, Anaïs, Touron, Maxime, Plantefeve, Gaetan, Chakarian, Jean-Charles, Ricard, Jean-Damien, Colin, Gwenhael, Orieux, Arthur, and Girardie, Patrick

Subjects
OXYGEN saturation, INTENSIVE care units, TRACHEA intubation, RANDOMIZED controlled trials, CRITICALLY ill
Abstract

In critically ill patients, endotracheal intubation (ETI) is lifesaving but carries a high risk of adverse events, notably hypoxemia. Preoxygenation is performed before introducing the tube to increase the safe apnea time. Oxygenation is monitored by pulse oximeter measurement of peripheral oxygen saturation (SpO2). However, SpO2 is unreliable at the high oxygenation levels produced by preoxygenation and, in the event of desaturation, may not decrease sufficiently early to allow preventive measures. The oxygen reserve index (ORI) is a dimensionless parameter that can also be measured continuously by a fingertip monitor and reflects oxygenation in the moderate hyperoxia range. The ORI ranges from 0 to 1 when arterial oxygen saturation (PaO2) varies between 100 to 200 mmHg, as occurs during preoxygenation. No trial has assessed the potential effects of ORI monitoring to guide preoxygenation for ETI in unstable patients. We designed a multicenter, two-arm, parallel-group, randomized, superiority, open trial in 950 critically ill adults requiring ETI. The intervention consists in monitoring ORI values and using an ORI target for preoxygenation of at least 0.6 for at least 1 minute. In the control group, preoxygenation is guided by SpO2 values recorded by a standard pulse oximeter, according to the standard of care, the goal being to obtain 100% SpO2 during preoxygenation, which lasts at least 3 minutes. The standard-of-care ETI technique is used in both arms. Baseline parameters, rapid-sequence induction medications, ETI devices, and physiological data are recorded. The primary outcome is the lowest SpO2 value from laryngoscopy to 2 minutes after successful ETI. Secondary outcomes include cognitive function on day 28. Assuming a 10% standard deviation for the lowest SpO2 value in the control group, no missing data, and crossover of 5% of patients, with the bilateral alpha risk set at 0.05, including 950 patients will provide 85% power for detecting a 2% between-group absolute difference in the lowest SpO2 value. Should ORI monitoring with a target of ≥0.6 be found to increase the lowest SpO2 value during ETI, then this trial may change current practice regarding preoxygenation for ETI. Trial registration: Registered on ClinicalTrials.gov (NCT05867875) on April 27, 2023. [ABSTRACT FROM AUTHOR]

Published
2024
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39. Effects of Losartan on Patients Hospitalized for Acute COVID-19: A Randomized Controlled Trial.

Author

Tran, Karen C, Asfar, Pierre, Cheng, Matthew, Demiselle, Julien, Singer, Joel, Lee, Terry, Sweet, David, Boyd, John, Walley, Keith, Haljan, Greg, Sharif, Omar, Geri, Guillaume, Auchabie, Johann, Quenot, Jean-Pierre, Lee, Todd C, Tsang, Jennifer, Meziani, Ferhat, Lamontagne, Francois, Dubee, Vincent, and Lasocki, Sigismond

Subjects
*COMMUNICABLE diseases, *RESEARCH funding, *DRUG side effects, *HOSPITAL care, *STATISTICAL sampling, *RANDOMIZED controlled trials, *DESCRIPTIVE statistics, *ORAL drug administration, *TREATMENT duration, *HOSPITAL mortality, *ORGAN donation, *ODDS ratio, *ANGIOTENSIN receptors, *LOSARTAN, *DRUG efficacy, *RESEARCH, *INTENSIVE care units, *COMPARATIVE studies, *CONFIDENCE intervals, *LENGTH of stay in hospitals, *COVID-19, *HYPOTENSION, *EVALUATION
Abstract

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) down-regulates angiotensin-converting enzyme 2, potentially increasing angiotensin II. We hypothesized that losartan compared to usual care decreases mortality and is safe in patients hospitalized with coronavirus disease 2019 (COVID-19). We aimed to evaluate the effect of losartan versus usual care on 28-day mortality in patients hospitalized for acute COVID-19. Methods Eligibility criteria included adults admitted for acute COVID-19. Exclusion criteria were hypotension, hyperkalemia, acute kidney injury, and use of angiotensin receptor blockers (ARBs) or angiotensin-converting enzyme inhibitors within 7 days. Participants were randomized to losartan 25–100 mg/day orally for the hospital duration or 3 months or the control arm (usual care) in 29 hospitals in Canada and France. The primary outcome was 28-day mortality. Secondary outcomes were hospital mortality, organ support, and serious adverse events (SAEs). Results The trial was stopped early because of a serious safety concern with losartan. In 341 patients, any SAE and hypotension were significantly higher in the losartan versus usual care groups (any SAE: 39.8% vs 27.2%, respectively, P =.01; hypotension: 30.4% vs 15.3%, respectively, P <.001) in both ward and intensive care patients. The 28-day mortality did not differ between losartan (6.5%) versus usual care (5.9%) (odds ratio, 1.11 [95% confidence interval,.47–2.64]; P =.81), nor did organ dysfunction or secondary outcomes. Conclusions Caution is needed in deciding which patients to start or continue using ARBs in patients hospitalized with pneumonia to mitigate risk of hypotension, acute kidney injury, and other side effects. ARBs should not be added to care of patients hospitalized for acute COVID-19. Clinical Trials Registration NCT04606563. [ABSTRACT FROM AUTHOR]

Published
2024
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40. Impact of intensive prone position therapy on outcomes in intubated patients with ARDS related to COVID-19.

Author

Le Terrier, Christophe, Walter, Thaïs, Lebbah, Said, Hajage, David, Sigaud, Florian, Guérin, Claude, Desmedt, Luc, Primmaz, Steve, Joussellin, Vincent, Della Badia, Chiara, Ricard, Jean-Damien, Pugin, Jérôme, Terzi, Nicolas, COVID-ICU Group on behalf of the REVA Network and the COVID-ICU Investigators, Mercat, Alain, Asfar, Pierre, Beloncle, François, Demiselle, Julien, Pham, Tài, and Pavot, Arthur

Subjects
ADULT respiratory distress syndrome treatment, PATIENTS, ADULT respiratory distress syndrome, SECONDARY analysis, T-test (Statistics), RESEARCH funding, HOSPITAL admission & discharge, LYING down position, FISHER exact test, TREATMENT duration, TREATMENT effectiveness, DESCRIPTIVE statistics, MANN Whitney U Test, CHI-squared test, LONGITUDINAL method, KAPLAN-Meier estimator, INTENSIVE care units, ARTIFICIAL respiration, RESEARCH, SURVIVAL analysis (Biometry), BODY movement, COVID-19, CRITICAL care medicine, PROPORTIONAL hazards models
Abstract

Background: Previous retrospective research has shown that maintaining prone positioning (PP) for an average of 40 h is associated with an increase of survival rates in intubated patients with COVID-19-related acute respiratory distress syndrome (ARDS). This study aims to determine whether a cumulative PP duration of more than 32 h during the first 2 days of intensive care unit (ICU) admission is associated with increased survival compared to a cumulative PP duration of 32 h or less. Methods: This study is an ancillary analysis from a previous large international observational study involving intubated patients placed in PP in the first 48 h of ICU admission in 149 ICUs across France, Belgium and Switzerland. Given that PP is recommended for a 16-h daily duration, intensive PP was defined as a cumulated duration of more than 32 h during the first 48 h, whereas standard PP was defined as a duration equal to or less than 32 h. Patients were followed-up for 90 days. The primary outcome was mortality at day 60. An Inverse Probability Censoring Weighting (IPCW) Cox model including a target emulation trial method was used to analyze the data. Results: Out of 2137 intubated patients, 753 were placed in PP during the first 48 h of ICU admission. The intensive PP group (n = 79) had a median PP duration of 36 h, while standard PP group (n = 674) had a median of 16 h during the first 48 h. Sixty-day mortality rate in the intensive PP group was 39.2% compared to 38.7% in the standard PP group (p = 0.93). Twenty-eight-day and 90-day mortality as well as the ventilator-free days until day 28 were similar in both groups. After IPCW, there was no significant difference in mortality at day 60 between the two-study groups (HR 0.95 [0.52–1.74], p = 0.87 and HR 1.1 [0.77–1.57], p = 0.61 in complete case analysis or in multiple imputation analysis, respectively). Conclusions: This secondary analysis of a large multicenter European cohort of intubated patients with ARDS due to COVID-19 found that intensive PP during the first 48 h did not provide a survival benefit compared to standard PP. [ABSTRACT FROM AUTHOR]

Published
2024
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41. Pressure-Support Ventilation vs T-Piece During Spontaneous Breathing Trials Before Extubation Among Patients at High Risk of Extubation Failure: A Post-Hoc Analysis of a Clinical Trial

Author

Boissier, Florence, Chatellier, Delphine, Deletage, Céline, Guignon, Carole, Joly, Florent, Olivry, Morgane, Veinstein, Anne, Benzekri-Lefevre, Dalila, Boulain, Thierry, Muller, Grégoire, Le Tulzo, Yves, Tadié, Jean-Marc, Maamar, Adel, Demiri, Suela, Mayaux, Julien, Decavèle, Maxens, Bouadma, Lila, Dupuis, Claire, Asfar, Pierre, Pierrot, Marc, Béduneau, Gaëtan, Boyer, Déborah, Delmas, Benjamin, Puech, Bérénice, Bachoumas, Konstantinos, Soum, Edouard, Cabasson, Séverin, Hoppe, Marie-Anne, Nseir, Saad, Pouly, Olivier, Bourdin, Gaël, Rosselli, Sylvène, Le Meur, Anthony, Garret, Charlotte, Martin, Maelle, Berquier, Guillaume, Thiagarajah, Abirami, Carteaux, Guillaume, Mekontso-Dessap, Armand, Poidevin, Antoine, Dureau, Anne-Florence, Azais, Marie-Ange, Colin, Gwenhaël, Mercier, Emmanuelle, Morisseau, Marlène, Sabatier, Caroline, Picard, Walter, Gainnier, Marc, Nguyen, Thi-My-Hue, Prat, Gwenaël, Schwebel, Carole, Buscot, Matthieu, Thille, Arnaud W., Coudroy, Rémi, Nay, Mai-Anh, Gacouin, Arnaud, Demoule, Alexandre, Sonneville, Romain, Beloncle, François, Girault, Christophe, Dangers, Laurence, Lautrette, Alexandre, Levrat, Quentin, Rouzé, Anahita, Vivier, Emmanuel, Lascarrou, Jean-Baptiste, Ricard, Jean-Damien, Razazi, Keyvan, Barberet, Guillaume, Lebert, Christine, Ehrmann, Stephan, Massri, Alexandre, Bourenne, Jeremy, Pradel, Gael, Bailly, Pierre, Terzi, Nicolas, Dellamonica, Jean, Lacave, Guillaume, Robert, René, Ragot, Stéphanie, and Frat, Jean-Pierre

Published
2020
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42. Venoarterial extracorporeal membrane oxygenation to rescue sepsis-induced cardiogenic shock: a retrospective, multicentre, international cohort study

Author

Bréchot, Nicolas, Hajage, David, Kimmoun, Antoine, Demiselle, Julien, Agerstrand, Cara, Montero, Santiago, Schmidt, Matthieu, Luyt, Charles-Edouard, Lebreton, Guillaume, Hékimian, Guillaume, Flecher, Erwan, Zogheib, Elie, Levy, Bruno, Slutsky, Arthur S, Brodie, Daniel, Asfar, Pierre, and Combes, Alain

Published
2020
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43. Fluid administration and monitoring in ARDS: which management?

Author

Vignon, Philippe, Evrard, Bruno, Asfar, Pierre, Busana, Mattia, Calfee, Carolyn S., Coppola, Silvia, and Demiselle, Julien

Subjects
Mortality -- France -- United Kingdom, Venous pressure -- Comparative analysis -- Health aspects, Medical colleges -- Health aspects -- Comparative analysis, Acute respiratory distress syndrome -- Health aspects -- Comparative analysis, Diuretics -- Health aspects -- Comparative analysis, Company business management, Health care industry
Abstract

Modalities of fluid management in patients sustaining the acute respiratory distress syndrome (ARDS) are challenging and controversial. Optimal fluid management should provide adequate oxygen delivery to the body, while avoiding inadvertent increase in lung edema which further impairs gas exchange. In ARDS patients, positive fluid balance has been associated with prolonged mechanical ventilation, longer ICU and hospital stay, and higher mortality. Accordingly, a restrictive strategy has been compared to a more liberal approach in randomized controlled trials conducted in various clinical settings. Restrictive strategies included fluid restriction guided by the monitoring of extravascular lung water, pulmonary capillary wedge or central venous pressure, and furosemide targeted to diuresis and/or albumin replacement in hypoproteinemic patients. Overall, restrictive strategies improved oxygenation significantly and reduced duration of mechanical ventilation, but had no significant effect on mortality. Fluid management may require different approaches depending on the time course of ARDS (i.e., early vs. late period). The effects of fluid strategy management according to ARDS phenotypes remain to be evaluated. Since ARDS is frequently associated with sepsis-induced acute circulatory failure, the prediction of fluid responsiveness is crucial in these patients to avoid hemodynamically inefficient-hence respiratory detrimental-fluid administration. Specific hemodynamic indices of fluid responsiveness or mini-fluid challenges should be preferably used. Since the positive airway pressure contributes to positive fluid balance in ventilated ARDS patients, it should be kept as low as possible. As soon as the hemodynamic status is stabilized, correction of cumulated fluid retention may rely on diuretics administration or renal replacement therapy., Author(s): Philippe Vignon [sup.1] [sup.2] [sup.3] [sup.16], Bruno Evrard [sup.1] [sup.2] [sup.3], Pierre Asfar [sup.4], Mattia Busana [sup.5], Carolyn S. Calfee [sup.6], Silvia Coppola [sup.7] [sup.8] [sup.9], Julien Demiselle [sup.4], [...]

Published
2020
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44. Hypothermia vs Normothermia in Patients With Cardiac Arrest and Nonshockable Rhythm : A Meta-Analysis

Author

Taccone, Fabio Silvio, Dankiewicz, Josef, Cariou, Alain, Lilja, Gisela, Asfar, Pierre, Belohlavek, Jan, Boulain, Thierry, Colin, Gwenhael, Cronberg, Tobias, Frat, Jean-Pierre, Friberg, Hans, Grejs, Anders M., Grillet, Guillaume, Girardie, Patrick, Haenggi, Matthias, Hovdenes, Jan, Jakobsen, Janus Christian, Levin, Helena, Merdji, Hamid, Njimi, Hassane, Pelosi, Paolo, Rylander, Christian, Saxena, Manoj, Thomas, Matt, Young, Paul J., Wise, Matt P., Nielsen, Niklas, Lascarrou, Jean-Baptiste, Taccone, Fabio Silvio, Dankiewicz, Josef, Cariou, Alain, Lilja, Gisela, Asfar, Pierre, Belohlavek, Jan, Boulain, Thierry, Colin, Gwenhael, Cronberg, Tobias, Frat, Jean-Pierre, Friberg, Hans, Grejs, Anders M., Grillet, Guillaume, Girardie, Patrick, Haenggi, Matthias, Hovdenes, Jan, Jakobsen, Janus Christian, Levin, Helena, Merdji, Hamid, Njimi, Hassane, Pelosi, Paolo, Rylander, Christian, Saxena, Manoj, Thomas, Matt, Young, Paul J., Wise, Matt P., Nielsen, Niklas, and Lascarrou, Jean-Baptiste

Abstract

Importance International guidelines recommend body temperature control below 37.8 °C in unconscious patients with out-of-hospital cardiac arrest (OHCA); however, a target temperature of 33 °C might lead to better outcomes when the initial rhythm is nonshockable. Objective To assess whether hypothermia at 33 °C increases survival and improves function when compared with controlled normothermia in unconscious adults resuscitated from OHCA with initial nonshockable rhythm. Data Sources Individual patient data meta-analysis of 2 multicenter, randomized clinical trials (Targeted Normothermia after Out-of-Hospital Cardiac Arrest [TTM2; NCT02908308] and HYPERION [NCT01994772]) with blinded outcome assessors. Unconscious patients with OHCA and an initial nonshockable rhythm were eligible for the final analysis. Study Selection The study cohorts had similar inclusion and exclusion criteria. Patients were randomized to hypothermia (target temperature 33 °C) or normothermia (target temperature 36.5 to 37.7 °C), according to different study protocols, for at least 24 hours. Additional analyses of mortality and unfavorable functional outcome were performed according to age, sex, initial rhythm, presence or absence of shock on admission, time to return of spontaneous circulation, lactate levels on admission, and the cardiac arrest hospital prognosis score. Data Extraction and Synthesis Only patients who experienced OHCA and had a nonshockable rhythm with all causes of cardiac arrest were included. Variables from the 2 studies were available from the original data sets and pooled into a unique database and analyzed. Clinical outcomes were harmonized into a single file, which was checked for accuracy of numbers, distributions, and categories. The last day of follow-up from arrest was recorded for each patient. Adjustment for primary outcome and functional outcome was performed using age, gender, time to return of spontaneous circulation, and bystander cardiopulmonary resuscita

Published
2024
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47. Comparison of prognostic factors between bacteraemic and non-bacteraemic critically ill immunocompetent patients in community-acquired severe pneumococcal pneumonia: a STREPTOGENE sub-study

Author

Bellut, Hugo, Porcher, Raphael, Varon, Emmanuelle, Asfar, Pierre, Le Tulzo, Yves, Megarbane, Bruno, Mathonnet, Armelle, Dugard, Anthony, Veinstein, Anne, Ouchenir, Kader, Siami, Shidasp, Reignier, Jean, Galbois, Arnaud, Cousson, Joël, Preau, Sébastien, Baldesi, Olivier, Rigaud, Jean‑Philippe, Souweine, Bertrand, Misset, Benoit, Jacobs, Frederic, Dewavrin, Florent, Mira, Jean‑Paul, and Bedos, Jean‑Pierre

Published
2021
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48. Dangers of hyperoxia

Author

Singer, Mervyn, Young, Paul J., Laffey, John G., Asfar, Pierre, Taccone, Fabio Silvio, Skrifvars, Markus B., Meyhoff, Christian S., and Radermacher, Peter

Published
2021
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49. Current use of inotropes in circulatory shock

Author

Scheeren, Thomas W. L., Bakker, Jan, Kaufmann, Thomas, Annane, Djillali, Asfar, Pierre, Boerma, E. Christiaan, Cecconi, Maurizio, Chew, Michelle S., Cholley, Bernard, Cronhjort, Maria, De Backer, Daniel, Dubin, Arnaldo, Dünser, Martin W., Duranteau, Jacques, Gordon, Anthony C., Hajjar, Ludhmila A., Hamzaoui, Olfa, Hernandez, Glenn, Kanoore Edul, Vanina, Koster, Geert, Landoni, Giovanni, Leone, Marc, Levy, Bruno, Martin, Claude, Mebazaa, Alexandre, Monnet, Xavier, Morelli, Andrea, Payen, Didier, Pearse, Rupert M., Pinsky, Michael R., Radermacher, Peter, Reuter, Daniel A., Sakr, Yasser, Sander, Michael, Saugel, Bernd, Singer, Mervyn, Squara, Pierre, Vieillard-Baron, Antoine, Vignon, Philippe, Vincent, Jean-Louis, van der Horst, Iwan C. C., Vistisen, Simon T., and Teboul, Jean-Louis

Published
2021
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50. Norepinephrine dose and the grain of salt: a task force is needed

Author

Leone, Marc, Goyer, Isabelle, Levy, Bruno, Dünser, Martin W., Asfar, Pierre, and Jentzer, Jacob C.

Subjects
Task forces, Noradrenaline, Health care industry
Abstract

Author(s): Marc Leone [sup.1], Isabelle Goyer, Bruno Levy, Martin W. Dünser, Pierre Asfar, Jacob C. Jentzer Author Affiliations: In response to our correspondence entitled 'Dose of norepinephrine: the devil is [...]

Published
2023
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