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1. 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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2. Body composition and muscle strength at the end of ICU stay are associated with 1-year mortality, a prospective multicenter observational study

Author

Ait Hssain, Ali, Farigon, Nicolas, Merdji, Hamid, Guelon, Dominique, Bohé, Julien, Cayot, Sophie, Chabanne, Russel, Constantin, Jean-Michel, Pereira, Bruno, Bouvier, Damien, Andant, Nicolas, Roth, Hubert, Thibault, Ronan, Sapin, Vincent, Hasselmann, Michel, Souweine, Bertrand, Cano, Noël, Boirie, Yves, and Dupuis, Claire

Published
2023
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5. Disagreement Between Clinicians and Score in Decision-Making Capacity of Critically Ill Patients*

Author

Bertrand, Pierre-Marie, Pereira, Bruno, Adda, Mireille, Timsit, Jean-François, Wolff, Michel, Hilbert, Gilles, Gruson, Didier, Garrouste-Orgeas, Maïté, Argaud, Laurent, Constantin, Jean-Michel, Chabanne, Russel, Quenot, Jean-Pierre, Bohe, Julien, Guerin, Claude, Papazian, Laurent, Jonquet, Olivier, Klouche, Kada, Delahaye, Arnaud, Riu, Beatrice, Zieleskiewicz, Laurent, Darmon, Michaël, Azoulay, Elie, Souweine, Bertrand, and Lautrette, Alexandre

Published
2019
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6. Clinical features, etiologies, and outcomes in adult patients with meningoencephalitis requiring intensive care (EURECA): an international prospective multicenter cohort study

Author

Sonneville, R, de Montmollin, E, Contou, D, Ferrer, R, Gurjar, M, Klouche, K, Sarton, B, Demeret, S, Bailly, P, da Silva, D, Escudier, E, Le Guennec, L, Chabanne, R, Argaud, L, Ben Hadj Salem, O, Thyrault, M, Frerou, A, Louis, G, De Pascale, G, Horn, J, Helbok, R, Geri, G, Bruneel, F, Martin-Loeches, I, Taccone, F, De Waele, J, Ruckly, S, Staiquly, Q, Citerio, G, Timsit, J, 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, Timsit, Jean-François, Sonneville, R, de Montmollin, E, Contou, D, Ferrer, R, Gurjar, M, Klouche, K, Sarton, B, Demeret, S, Bailly, P, da Silva, D, Escudier, E, Le Guennec, L, Chabanne, R, Argaud, L, Ben Hadj Salem, O, Thyrault, M, Frerou, A, Louis, G, De Pascale, G, Horn, J, Helbok, R, Geri, G, Bruneel, F, Martin-Loeches, I, Taccone, F, De Waele, J, Ruckly, S, Staiquly, Q, Citerio, G, Timsit, J, 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

Abstract

Purpose: We aimed to characterize the outcomes of patients with severe meningoencephalitis requiring intensive care. Methods: We conducted a prospective multicenter international cohort study (2017–2020) in 68 centers across 7 countries. Eligible patients were adults admitted to the intensive care unit (ICU) with meningoencephalitis, defined by an acute onset of encephalopathy (Glasgow coma scale (GCS) score ≤ 13), a cerebrospinal fluid pleocytosis ≥ 5 cells/mm3, and at least two of the following criteria: fever, seizures, focal neurological deficit, abnormal neuroimaging, and/or electroencephalogram. The primary endpoint was poor functional outcome at 3 months, defined by a score of three to six on the modified Rankin scale. Multivariable analyses stratified on centers investigated ICU admission variables associated with the primary endpoint. Results: Among 599 patients enrolled, 589 (98.3%) completed the 3-month follow-up and were included. Overall, 591 etiologies were identified in those patients which were categorized into five groups: acute bacterial meningitis (n = 247, 41.9%); infectious encephalitis of viral, subacute bacterial, or fungal/parasitic origin (n = 140, 23.7%); autoimmune encephalitis (n = 38, 6.4%); neoplastic/toxic encephalitis (n = 11, 1.9%); and encephalitis of unknown origin (n = 155, 26.2%). Overall, 298 patients (50.5%, 95% CI 46.6–54.6%) had a poor functional outcome, including 152 deaths (25.8%). Variables independently associated with a poor functional outcome were age > 60 years (OR 1.75, 95% CI 1.22–2.51), immunodepression (OR 1.98, 95% CI 1.27–3.08), time between hospital and ICU admission > 1 day (OR 2.02, 95% CI 1.44–2.99), a motor component on the GCS ≤ 3 (OR 2.23, 95% CI 1.49–3.45), hemiparesis/hemiplegia (OR 2.48, 95% CI 1.47–4.18), respiratory failure (OR 1.76, 95% CI 1.05–2.94), and cardiovascular failure (OR 1.72, 95% CI 1.07–2.75). In contrast, administration of a third-generation cephalosporin (OR 0.54, 95% CI 0.37–0.

Published
2023

7. AMETIS Preplanned Ancillary Study: Impact of Agitation During Mechanical Thrombectomy Under Sedation

Author

Tabillon, Caroline, Bernard, Rémy, Jacquens, Alice, Pommier, Maxime, Begard, Marc, Balança, Baptiste, Rapido, Francesca, Tavernier, Benoit, Molliex, Serge, Velly, Lionel, Verdonk, Franck, Lukaszewicz, Anne-Claire, Perrigault, Pierre-François, Albucher, Jean-François, Cognard, Christophe, Guyot, Adrien, Fernandez, Charlotte, Masgrau, Aurélie, Moreno, Ricardo, Ferrier, Anna, Jaber, Samir, Pereira, Bruno, Futier, Emmanuel, Chabanne, Russel, and Degos, Vincent

Published
2025
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8. A One-Day Prospective National Observational Study on Sedation-Analgesia of Patients with Brain Injury in French Intensive Care Units: The SEDA-BIP-ICU (Sedation-Analgesia in Brain Injury Patient in ICU) Study.

Author

Poignant, Simon, Vigué, Bernard, Balram, Patricia, Biais, Mathieu, Carillon, Romain, Cottenceau, Vincent, Dahyot-Fizelier, Claire, Degos, Vincent, Geeraerts, Thomas, Jeanjean, Patrick, Vega, Emmanuel, Lasocki, Sigismond, Espitalier, Fabien, Laffon, Marc, ANARLF and AtlanRea Network for the SEDABIP ICU Study, Gay, Samuel, de Courson, Hugues, Huet, Olivier, Laquay, Nathalie, and Chabanne, Russel

Subjects
INTENSIVE care units, TRANSCRANIAL Doppler ultrasonography, BRAIN injuries, INTRACRANIAL hypertension, SCIENTIFIC observation
Abstract

Background: Sedation/analgesia is a daily challenge faced by intensivists managing patients with brain injury (BI) in intensive care units (ICUs). The optimization of sedation in patients with BI presents particular challenges. A choice must be made between the potential benefit of a rapid clinical evaluation and the potential exacerbation of intracranial hypertension in patients with impaired cerebral compliance. In the ICU, a pragmatic approach to the use of sedation/analgesia, including the optimal titration, management of multiple drugs, and use of any type of brain monitor, is needed. Our research question was as follows: the aim of the study is to identify what is the current daily practice regarding sedation/analgesia in the management of patients with BI in the ICU in France? Methods: This study was composed of two parts. The first part was a descriptive survey of sedation practices and characteristics in 30 French ICUs and 27 academic hospitals specializing in care for patients with BI. This first step validates ICU participation in data collection regarding sedation-analgesia practices. The second part was a 1-day prospective cross-sectional snapshot of all characteristics and prescriptions of patients with BI. Results: On the study day, among the 246 patients with BI, 106 (43%) had a brain monitoring device and 74 patients (30%) were sedated. Thirty-nine of the sedated patients (53%) suffered from intracranial hypertension, 14 patients (19%) suffered from agitation and delirium, and 7 patients (9%) were sedated because of respiratory failure. Fourteen patients (19%) no longer had a formal indication for sedation. In 60% of the sedated patients, the sedatives were titrated by nurses based on sedation scales. The Richmond Agitation Sedation Scale was used in 80% of the patients, and the Behavioral Pain Scale was used in 92%. The common sedatives and opioids used were midazolam (58.1%), propofol (40.5%), and sufentanil (67.5%). The cerebral monitoring devices available in the participating ICUs were transcranial Doppler ultrasound (100%), intracranial and intraventricular pressure monitoring (93.3%), and brain tissue oxygenation (60%). Cerebral monitoring by one or more monitoring devices was performed in 62% of the sedated patients. This proportion increased to 74% in the subgroup of patients with intracranial hypertension, with multimodal cerebral monitoring in 43.6%. The doses of midazolam and sufentanil were lower in sedated patients managed based on a sedation/analgesia scale. Conclusions: Midazolam and sufentanil are frequently used, often in combination, in French ICUs instead of alternative drugs. In our study, cerebral monitoring was performed in more than 60% of the sedated patients, although that proportion is still insufficient. Future efforts should stress the use of multiple monitoring modes and adherence to the indications for sedation to improve care of patients with BI. Our study suggests that the use of sedation and analgesia scales by nurses involved in the management of patients with BI could decrease the dosages of midazolam and sufentanil administered. Updated guidelines are needed for the management of sedation/analgesia in patients with BI. [ABSTRACT FROM AUTHOR]

Published
2022
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9. Personalised mechanical ventilation tailored to lung morphology versus low positive end-expiratory pressure for patients with acute respiratory distress syndrome in France (the LIVE study): a multicentre, single-blind, randomised controlled trial

Author

Jean-Michel Constantin, Matthieu Jabaudon, Jean-Yves Lefrant, Samir Jaber, Jean-Pierre Quenot, Olivier Langeron, Martine Ferrandière, Fabien Grelon, Philippe Seguin, Carole Ichai, Benoit Veber, Bertrand Souweine, Thomas Uberti, Sigismond Lasocki, François Legay, Marc Leone, Nathanael Eisenmann, Claire Dahyot-Fizelier, Hervé Dupont, Karim Asehnoune, Achille Sossou, Gérald Chanques, Laurent Muller, Jean-Etienne Bazin, Antoine Monsel, Lucile Borao, Jean-Marc Garcier, Jean-Jacques Rouby, Bruno Pereira, Emmanuel Futier, Cayot Sophie, Godet Thomas, Guerin Renaud, Verlac Camille, Chabanne Russel, Cosserant Bernard, Blondonnet Raiko, Lautrette Alexandre, Eisenmann Nathanael, Muller Laurent, Massanet Pablo, Boutin Caroline, Barbar Saber, Roger Claire, Belafia Fouad, Cisse Moussa, Monnin Marion, Conseil Matthieu, Carr Julie, De Jong Audrey, Dargent Auguste, Andreu Pascal, Lebouvrier Thomas, Launey Yoann, Roquilly Antoine, Cinotti Raphael, Tellier Anne-Charlotte, Barbaz Mathilde, Cohen Benjamin, Lemarche Edouard, Bertrand Pierre-Marie, Arberlot Charlotte, Zieleskiewicz Laurent, Hammad Emmanuelle, Duclos Garry, Mathie Calypso, Dupont Herve, Veber Benoit, Orban Jean-Christophe, Quintard Hervé, Rimmele Thomas, Crozon-Clauzel Julien, Le Core Marinne, Grelon Fabien, Assefi Mona, Petitas Frank, Morel Jerome, Molliex Serge, Hadanou Nanadougmar, CHU Clermont-Ferrand, Service d'Anésthésie Réanimation [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, 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), 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), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de Réanimation Médicale (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Le Mans (CH Le Mans), CHU Pontchaillou [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de la Recherche Agronomique (INRA)-Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de réanimation, Centre Hospitalier Universitaire de Nice (CHU Nice)-Hôpital St Roch, Département d'anesthésie-Réanimation-Samu, CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Unité de soins intensifs [Clermont Ferrand], CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], Edouard Herriot Hospital, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), CHU de Saint-Brieuc, Service Anesthésie et Réanimation [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Pharmacologie des anti-infectieux (PHAR), Université de Poitiers-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Amiens-Picardie, Thérapeutiques cliniques et expérimentales des infections (EA 3826) (EA 3826), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Department of Anesthesiology and Critical Care Medicine, Emile-Roux general hospital, Le Puy-en-Velay, Université de Montpellier (UM), Immunologie - Immunopathologie - Immunothérapie (I3), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Unité de Biostatistiques [CHU Clermont-Ferrand], Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] (DRCI), Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Génétique, Reproduction et Développement (GReD ), 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), Department of Perioperative Medicine, CHU Clermont-Ferrand, CHU Pitié-Salpêtrière [APHP], Hopital Général, Le Mans, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Clermont-Ferrand-Hôpital Gabriel Montpied, Hospital General Saint-Brieuc, Hôpital Nord [CHU - APHM]-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Centre Régional de Lutte Contre le Cancer Jean Perrin, Centre hospitalier universitaire d'Amiens (CHU Amiens-Picardie), Service de réanimation adulte, département d'anesthésie-réanimation, CHU Clermont-Ferrand-Hôtel Dieu, Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), University Hospital of Clermont-Ferrand, Institut Pascal - Clermont Auvergne (IP), Sigma CLERMONT (Sigma CLERMONT)-Université Clermont Auvergne (UCA)-Centre National de la Recherche Scientifique (CNRS), Unité de biostatistiques, CHU Clermont-Ferrand-Hôpital Montpied, Génétique, Reproduction et Développement - Clermont Auvergne (GReD ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne (UCA)-Centre National de la Recherche Scientifique (CNRS), MORNET, Dominique, Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and 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])

Subjects
Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, ARDS, medicine.medical_treatment, [SDV]Life Sciences [q-bio], law.invention, Positive-Pressure Respiration, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, Fraction of inspired oxygen, Intensive care, medicine, Prone Position, Tidal Volume, Humans, Single-Blind Method, 030212 general & internal medicine, Prospective Studies, Precision Medicine, Lung, Positive end-expiratory pressure, Tidal volume, ComputingMilieux_MISCELLANEOUS, Proportional Hazards Models, Mechanical ventilation, Respiratory Distress Syndrome, business.industry, Hazard ratio, Middle Aged, medicine.disease, Respiration, Artificial, 3. Good health, [SDV] Life Sciences [q-bio], Intensive Care Units, Editorial Commentary, Treatment Outcome, 030228 respiratory system, Female, France, business
Abstract

The effect of personalised mechanical ventilation on clinical outcomes in patients with acute respiratory distress syndrome (ARDS) remains uncertain and needs to be evaluated. We aimed to test whether a mechanical ventilation strategy that was personalised to individual patients' lung morphology would improve the survival of patients with ARDS when compared with standard of care.We designed a multicentre, single-blind, stratified, parallel-group, randomised controlled trial enrolling patients with moderate-to-severe ARDS in 20 university or non-university intensive care units in France. Patients older than 18 years with early ARDS for less than 12 h were randomly assigned (1:1) to either the control group or the personalised group using a minimisation algorithm and stratified according to the study site, lung morphology, and duration of mechanical ventilation. Only the patients were masked to allocation. In the control group, patients received a tidal volume of 6 mL/kg per predicted bodyweight and positive end-expiratory pressure (PEEP) was selected according to a low PEEP and fraction of inspired oxygen table, and early prone position was encouraged. In the personalised group, the treatment approach was based on lung morphology; patients with focal ARDS received a tidal volume of 8 mL/kg, low PEEP, and prone position. Patients with non-focal ARDS received a tidal volume of 6 mL/kg, along with recruitment manoeuvres and high PEEP. The primary outcome was 90-day mortality as established by intention-to-treat analysis. This study is registered online with ClinicalTrials.gov, NCT02149589.From June 12, 2014, to Feb 2, 2017, 420 patients were randomly assigned to treatment. 11 patients were excluded in the personalised group and nine patients were excluded in the control group; 196 patients in the personalised group and 204 in the control group were included in the analysis. In a multivariate analysis, there was no difference in 90-day mortality between the group treated with personalised ventilation and the control group in the intention-to-treat analysis (hazard ratio [HR] 1·01; 95% CI 0·61-1·66; p=0·98). However, misclassification of patients as having focal or non-focal ARDS by the investigators was observed in 85 (21%) of 400 patients. We found a significant interaction between misclassification and randomised group allocation with respect to the primary outcome (p0·001). In the subgroup analysis, the 90-day mortality of the misclassified patients was higher in the personalised group (26 [65%] of 40 patients) than in the control group (18 [32%] of 57 patients; HR 2·8; 95% CI 1·5-5·1; p=0·012.Personalisation of mechanical ventilation did not decrease mortality in patients with ARDS, possibly because of the misclassification of 21% of patients. A ventilator strategy misaligned with lung morphology substantially increases mortality. Whether improvement in ARDS phenotyping can decrease mortality should be assessed in a future clinical trial.French Ministry of Health (Programme Hospitalier de Recherche Clinique InterRégional 2013).

Published
2019
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11. Brain Gray Matter MRI Morphometry for Neuroprognostication After Cardiac Arrest

Author

Silva, Stein, Péran, Patrice, Kerhuel, Lionel, Malagurski, Briguita, Chauveau, Nicolas, Bataille, Benoît, Lotterie, Jean Albert, Celsis, Pierre, Aubry, Florent, Citerio, Giuseppe, Jean, Betty, Chabanne, Russel, Perlbarg, Vincent, Velly, Lionel, Galanaud, Damien, Vanhaudenhuyse, Audrey, Fourcade, Olivier, Laureys, Steven, Puybasset, Louis, Service d’Anesthésie Réanimation, Imagerie cérébrale et handicaps neurologiques, Institut des sciences du cerveau de Toulouse. (ISCT), Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM), Service de neurologie [Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Neuro-Imagerie Fonctionnelle, Plasticite Cerebrale et Pathologie Neurologique, Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Neurointensive Care Unit, Ospedale S. Gerardo, Centre Hospitalier Universitaire de Clermont-Ferrand, CHU Clermont-Ferrand, Laboratoire d'Imagerie Biomédicale (LIB), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Assistance Publique - Hôpitaux de Marseille (APHM), Service de neuro-radiologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Centre de Recherches du Cyclotron [Liège] (CRC), Université de Liège, Service d'Anesthésie - Réanimation, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Coma Science Group [Liege], Johns Hopkins University School of Medicine [Baltimore], Pôle Anesthésie Réanimation [CHU de Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Toulouse Neuro Imaging Center (ToNIC), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Toulouse Mind & Brain Institut (TMBI), Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Université de Toulouse (UT)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire d'Imagerie Biomédicale [Paris] (LIB), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Toulouse (UT)-Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Silva, S, Peran, P, Kerhuel, L, Malagurski, B, Chauveau, N, Bataille, B, Lotterie, J, Celsis, P, Aubry, F, Citerio, G, Jean, B, Chabanne, R, Perlbarg, V, Velly, L, Galanaud, D, Vanhaudenhuyse, A, Fourcade, O, Laureys, S, Puybasset, L, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Service de Neuroradiologie [CHU Pitié-Salpêtrière], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
[SCCO.NEUR]Cognitive science/Neuroscience, Cardiac arrestt, prognostication, MRI, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Online Clinical Investigations, comacortical thickness, coma, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], cardiac arrest, prognosis, cortical thickness, subcortical volumetry, ComputingMilieux_MISCELLANEOUS
Abstract

Supplemental Digital Content is available in the text., Objectives: We hypothesize that the combined use of MRI cortical thickness measurement and subcortical gray matter volumetry could provide an early and accurate in vivo assessment of the structural impact of cardiac arrest and therefore could be used for long-term neuroprognostication in this setting. Design: Prospective cohort study. Setting: Five Intensive Critical Care Units affiliated to the University in Toulouse (France), Paris (France), Clermont-Ferrand (France), Liège (Belgium), and Monza (Italy). Patients: High-resolution anatomical T1-weighted images were acquired in 126 anoxic coma patients (“learning” sample) 16 ± 8 days after cardiac arrest and 70 matched controls. An additional sample of 18 anoxic coma patients, recruited in Toulouse, was used to test predictive model generalization (“test” sample). All patients were followed up 1 year after cardiac arrest. Interventions: None. Measurements and Main Results: Cortical thickness was computed on the whole cortical ribbon, and deep gray matter volumetry was performed after automatic segmentation. Brain morphometric data were employed to create multivariate predictive models using learning machine techniques. Patients displayed significantly extensive cortical and subcortical brain volumes atrophy compared with controls. The accuracy of a predictive classifier, encompassing cortical and subcortical components, has a significant discriminative power (learning area under the curve = 0.87; test area under the curve = 0.96). The anatomical regions which volume changes were significantly related to patient’s outcome were frontal cortex, posterior cingulate cortex, thalamus, putamen, pallidum, caudate, hippocampus, and brain stem. Conclusions: These findings are consistent with the hypothesis of pathologic disruption of a striatopallidal-thalamo-cortical mesocircuit induced by cardiac arrest and pave the way for the use of combined brain quantitative morphometry in this setting.

Published
2017
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12. Measurement of S100B protein: evaluation of a new prototype on a bioMérieux Vidas® 3 analyzer.

Author

Oris, Charlotte, Chabanne, Russel, Durif, Julie, Kahouadji, Samy, Brailova, Marina, Sapin, Vincent, and Bouvier, Damien

Subjects
*HOSPITAL emergency services, *MATRIX effect, *BRAIN injuries, *PROTOTYPES, *RADIATION exposure
Abstract

Background: The addition of S100B protein to guidelines for the management of mild traumatic brain injury (mTBI) decreases the amount of unnecessary computed tomography (CT) scans with a significant decrease in radiation exposure and an increase in cost savings. Both DiaSorin and Roche Diagnostics have developed automated assays for S100B determination. Recently, bioMérieux developed a prototype immunoassay for serum S100B determination. For the first time, we present the evaluation of the S100B measurement using a bioMérieux Vidas® 3 analyzer. Methods: We evaluated the matrix effects of serum and plasma, and their stability after storage at 2–8 °C, −20 °C and −80 °C. The new measurement prototype (bioMérieux) was compared with an established one (Roche Diagnostics), and a precision study was also conducted. Lastly, clinical diagnostics performance of the bioMérieux and Roche Diagnostics methods were compared for 80 patients referred to the Emergency Department for mTBI. Results: Stability after storage at 2–8 °C, −20 °C, and −80 °C and validation of the serum matrix were demonstrated. The bioMérieux analyzer was compared to the Roche Diagnostics system, and the analytical precision was found to be efficient. Clinical diagnosis performance evaluation confirmed the predictive negative value of S100B in the management of mTBI. Conclusions: The study's data are useful for interpreting serum S100B results on a bioMérieux Vidas® 3 analyzer. [ABSTRACT FROM AUTHOR]

Published
2019
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13. A multi-faceted strategy to reduce ventilation-associated mortality in brain-injured patients. The BI-VILI project: a nationwide quality improvement project.

Author

Asehnoune, Karim, Mrozek, Ségolène, Perrigault, Pierre, Seguin, Philippe, Dahyot-Fizelier, Claire, Lasocki, Sigismond, Pujol, Anne, Martin, Mathieu, Chabanne, Russel, Muller, Laurent, Hanouz, Jean, Hammad, Emmanuelle, Rozec, Bertrand, Kerforne, Thomas, Ichai, Carole, Cinotti, Raphael, Geeraerts, Thomas, Elaroussi, Djillali, Pelosi, Paolo, and Jaber, Samir

Subjects
INTENSIVE care units, VENTILATION monitoring, MULTIVARIATE analysis, PATIENTS, BRAIN injuries, RESPIRATORY insufficiency, BRAIN injury treatment, AIRWAY (Anatomy), COMPARATIVE studies, COMPUTED tomography, LONGITUDINAL method, LUNG injuries, RESEARCH methodology, MEDICAL cooperation, NONPARAMETRIC statistics, QUALITY assurance, RESEARCH, RESPIRATORY measurements, MECHANICAL ventilators, EVALUATION research, CONTROL groups, POSITIVE end-expiratory pressure, GLASGOW Coma Scale, PREVENTION
Abstract

Purpose: We assessed outcomes in brain-injured patients after implementation of a multi-faceted approach to reduce respiratory complications in intensive care units.Methods: Prospective nationwide before-after trial. Consecutive adults with acute brain injury requiring mechanical ventilation for ≥24 h in 20 French intensive care units (ICUs) were included. The management of invasive ventilation in brain-injured patients admitted between 1 July 2013 and 31 October 2013 (4 months) was monitored and analysed. After the baseline period (1 November 2013-31 December 2013), ventilator settings and decision to extubate were selected as targets to hasten weaning from invasive ventilation. During the intervention period, low tidal volume (≤7 ml/kg), moderate positive end-expiratory pressure (PEEP, 6-8 cm H2O) and an early extubation protocol were recommended. The primary endpoint was the number of days free of invasive ventilation at day 90. Comparisons were performed between the two periods and between the compliant and non-compliant groups.Results: A total of 744 patients from 20 ICUs were included (391 pre-intervention; 353 intervention). No difference in the number of invasive ventilation-free days at day 90 was observed between the two periods [71 (0-80) vs. 67 (0-80) days; P = 0.746]. Compliance with the complete set of recommendations increased from 8 (2%) to 52 (15%) patients after the intervention (P < 0.001). At day 90, the number of invasive ventilation-free days was higher in the 60 (8%) patients whose care complied with recommendations than in the 684 (92%) patients whose care deviated from recommendations [77 (66-82) and 71 (0-80) days, respectively; P = 0.03]. The mortality rate was 10% in the compliant group and 26% in the non-compliant group (P = 0.023). Both multivariate analysis [hazard ratio (HR) 1.78, 95% confidence interval (95% CI) 1.41-2.26; P < 0.001] and propensity score-adjusted analysis (HR 2.25, 95% CI 1.56-3.26, P < 0.001) revealed that compliance was an independent factor associated with the reduction in the duration of mechanical ventilation.Conclusions: Adherence to recommendations for low tidal volume, moderate PEEP and early extubation seemed to increase the number of ventilator-free days in brain-injured patients, but inconsistent adoption limited their impact. Trail registration number: NCT01885507. [ABSTRACT FROM AUTHOR]

Published
2017
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14. Transcranial Doppler to Predict Neurologic Outcome after Mild to Moderate Traumatic Brain Injury.

Author

Bouzat, Pierre, Almeras, Luc, Manhes, Pauline, Sanders, Laurence, Levrat, Albrice, David, Jean-Stephane, Cinotti, Raphael, Chabanne, Russel, Gloaguen, Aurélie, Bobbia, Xavier, Thoret, Sophie, Oujamaa, Lydia, Bosson, Jean-Luc, Payen, Jean-François, Asehnoune, Karim, Pes, Philippe, Lefrant, Jean-Yves, Mirek, Sébastien, Albasini, François, and Scrimgeour, Caron

Published
2016
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15. [Clinical-biological approaches to the spectrophotometric detection of oxyhemoglobin and bilirubin in CSF in the management of aneurysmal subarachnoid hemorrhage].

Author

Nowicki N, Allouche S, Bats ML, Bendavid C, Corbel EB, Brailova M, Brunel V, Chabanne R, Descombes G, Glady L, Guergour D, Moisset X, Morineau G, Raynor A, and Bouvier D

Subjects
Humans, Sensitivity and Specificity, Subarachnoid Hemorrhage diagnosis, Subarachnoid Hemorrhage cerebrospinal fluid, Bilirubin cerebrospinal fluid, Bilirubin analysis, Bilirubin blood, Oxyhemoglobins analysis, Oxyhemoglobins cerebrospinal fluid, Spectrophotometry methods
Abstract

The diagnosis of subarachnoid hemorrhage (SAH) is extremely important for appropriate management. Cerebral computed tomography (CT), used as the first-line investigation to detect bleeding, has excellent sensitivity if performed promptly, but its sensitivity falls sharply with the time elapsed since the onset of SAH. Oxyhemoglobin and bilirubin, the breakdown products of heme, are detectable in cerebrospinal fluid (CSF) by spectrophotometric absorption, which defines the search for xanthochromia pigment in CSF. Both parameters can be sought when imaging is negative or doubtful with a strong suspicion of SAH based on clinical signs. In this context, our working group at the Société Française de Biologie Clinique (SFBC) is proposing recommendations to provide medical biologists with support for the implementation and validation of "oxyhemoglobin and bilirubin in CSF" test and enabling them to play their part in the diagnostic process. From the pre-analytical stages through to the delivery of results, we will summarize the pitfalls to be avoided, the main decision values and different physiological and pathological profiles.

Published
2024
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16. Brain Gray Matter MRI Morphometry for Neuroprognostication After Cardiac Arrest.

Author

Silva S, Peran P, Kerhuel L, Malagurski B, Chauveau N, Bataille B, Lotterie JA, Celsis P, Aubry F, Citerio G, Jean B, Chabanne R, Perlbarg V, Velly L, Galanaud D, Vanhaudenhuyse A, Fourcade O, Laureys S, and Puybasset L

Subjects
Adult, Cerebellar Cortex diagnostic imaging, Cerebellar Cortex pathology, Coma diagnostic imaging, Coma pathology, Female, Gray Matter diagnostic imaging, Gray Matter pathology, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Prognosis, Prospective Studies, Brain diagnostic imaging, Brain pathology, Heart Arrest pathology
Abstract

Objectives: We hypothesize that the combined use of MRI cortical thickness measurement and subcortical gray matter volumetry could provide an early and accurate in vivo assessment of the structural impact of cardiac arrest and therefore could be used for long-term neuroprognostication in this setting., Design: Prospective cohort study., Setting: Five Intensive Critical Care Units affiliated to the University in Toulouse (France), Paris (France), Clermont-Ferrand (France), Liège (Belgium), and Monza (Italy)., Patients: High-resolution anatomical T1-weighted images were acquired in 126 anoxic coma patients ("learning" sample) 16 ± 8 days after cardiac arrest and 70 matched controls. An additional sample of 18 anoxic coma patients, recruited in Toulouse, was used to test predictive model generalization ("test" sample). All patients were followed up 1 year after cardiac arrest., Interventions: None., Measurements and Main Results: Cortical thickness was computed on the whole cortical ribbon, and deep gray matter volumetry was performed after automatic segmentation. Brain morphometric data were employed to create multivariate predictive models using learning machine techniques. Patients displayed significantly extensive cortical and subcortical brain volumes atrophy compared with controls. The accuracy of a predictive classifier, encompassing cortical and subcortical components, has a significant discriminative power (learning area under the curve = 0.87; test area under the curve = 0.96). The anatomical regions which volume changes were significantly related to patient's outcome were frontal cortex, posterior cingulate cortex, thalamus, putamen, pallidum, caudate, hippocampus, and brain stem., Conclusions: These findings are consistent with the hypothesis of pathologic disruption of a striatopallidal-thalamo-cortical mesocircuit induced by cardiac arrest and pave the way for the use of combined brain quantitative morphometry in this setting.

Published
2017
Full Text
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