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1. 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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2. Early Changes Over Time in the Radiographic Assessment of Lung Edema Score Are Associated With Survival in ARDS

Author

Souweine, Bertrand, Eisenmann, Nathanael, Quenot, Jean-Pierre, Seguin, Philippe, Asehnoune, Karim, Lasocki, Sigismond, Ferrandiere, Martine, Sossou, Achile, Langeron, Olivier, Leone, Marc, Dupont, Herve, Veber, Benoit, Ichai, Carole, Rimmelé, Thomas, Legay, François, Grelon, Fabien, Dahyot-Fizelier, Claire, Cayot, Sophie, Godet, Thomas, Guerin, Renaud, Verlhac, Camille, Chabanne, Russell, Cosserant, Bernard, Blondonnet, Raiko, Lautrette, Alexandre, Muller, Laurent, Massanet, Pablo, Boutin, Caroline, Barbar, Saber, Roger, Claire, Belafia, Fouad, Cisse, Moussa, Monnin, Marion, Conseil, Matthieu, Carr, Julie, De Jong, Audrey, Chanques, Gérald, Dargent, Auguste, Crozon, Thomas, Clauzel, Julien, Le Core, Marinne, Andreu, Pascal, Lebouvrier, Thomas, Launey, Yoann, Roquilly, Antoine, Cinotti, Raphael, Tellier, Anne-Charlotte, Barbaz, Mathilde, Cohen, Benjamin, Lemarche, Edouard, Bertrand, Pierre-Marie, Arbelot, Charlotte, Zieleskiewicz, Laurent, Hammad, Emmanuelle, Duclos, Garry, Calypso, Mathieu, Orban, Jean-Christophe, Quintard, Hervé, Assefi, Mona, Morel, Jerome, Molliex, Serge, Petitas, Frank, Nanadougmar, Hadanou, Jabaudon, Matthieu, Audard, Jules, Pereira, Bruno, Jaber, Samir, Lefrant, Jean-Yves, Futier, Emmanuel, Lambert, Céline, Bazin, Jean-Etienne, Bastarache, Julie A., Constantin, Jean-Michel, and Ware, Lorraine B.

Published
2020
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4. Sodium bicarbonate therapy for patients with severe metabolic acidaemia in the intensive care unit (BICAR-ICU): a multicentre, open-label, randomised controlled, phase 3 trial

Author

Jaber, Samir, de Jong, Audrey, Belafia, Fouad, Chanques, Gérald, Monnin, Marion, Delay, Jean-Marc, Cissé, Moussa, Geniez, Marie, Conseil, Matthieu, Souche, Bruno, Paugam, Catherine, Abback, Paër-Sélim, Futier, Emmanuel, Constantin, Jean Michel, Lefrant, Jean-Yves, Muller, Laurent, Lasocki, Sigismond, Lescot, Thomas, Pottecher, Julien, Noll, Eric, Demoule, Alexandre, Morawiec, Elise, Ferrandière, Martine, Asehnoune, Karim, Roquilly, Antoine, Dellamonica, Jean, Robert, Alexandre, Velly, Lionel, Triglia, Thibaut, Brunot, Vincent, Molinari, Nicolas, Mechati, Malika, Arnal, Jean-Michel, Durand-Gasselin, Jacques, Demoly, Didier, Hraiech, Sami, Papazian, Laurent, Gilles, Vincent, Rimmelé, Thomas, Riu, Béatrice, Cougot, Pierre, Fourcade, Olivier, Seguin, Philippe, Charbit, Jonathan, Capdevila, Xavier, Leone, Marc, Zieleskiewicz, Laurent, Ichai, Carole, Orban, Jean Christophe, Darmon, Michael, Azoulay, Elie, Lemiale, Virginie, Zafrani, Lara, Debbat, Karim, Mimoz, Oliver, Guérin, Claude, Kipnis, Eric, Constantin, Jean-Michel, Bertet, Helena, Klouche, Kada, and Jung, Boris

Published
2018
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6. Immediate interruption of sedation compared with usual sedation care in critically ill postoperative patients (SOS-Ventilation): a randomised, parallel-group clinical trial

Author

Chanques, Gerald, Conseil, Matthieu, Prades, Albert, Carr, Julie, Jung, Boris, Belafia, Fouad, Cissé, Moussa, Delay, Jean-Marc, De Jong, Audrey, Verzilli, Daniel, Clavieras, Noémie, Jaber, Samir, Mercier, Grégoire, Molinari, Nicolas, Mathieu, Emmanuelle, Bertet, Héléna, Roger, Claire, Muller, Laurent, Lefrant, Jean-Yves, Boutin, Caroline, Constantin, Jean-Michel, Futier, Emmanuel, Cayot, Sophie, Perbet, Sébastien, Jabaudon, Matthieu, and de Jong, Audrey

Published
2017
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7. Low versus standard calorie and protein feeding in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group trial (NUTRIREA-3)

Author

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

Published
2023
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8. High-Flow Versus VenturiMask Oxygen Therapy to Prevent Reintubation in Hypoxemic Patients after Extubation: A Multicenter Randomized Clinical Trial

Author

Maggiore, Salvatore Maurizio, primary, Jaber, Samir, additional, Grieco, Domenico Luca, additional, Mancebo, Jordi, additional, Zakynthinos, Spyros, additional, Demoule, Alexandre, additional, Ricard, Jean-Damien, additional, Navalesi, Paolo, additional, Vaschetto, Rosanna, additional, Hraiech, Sami, additional, Klouche, Kada, additional, Frat, Jean-Pierre, additional, Lemiale, Virginie, additional, Fanelli, Vito, additional, Chanques, Gerald, additional, Natalini, Daniele, additional, Ischaki, Eleni, additional, Reuter, Danielle, additional, Morán, Indalecio, additional, La Combe, Béatrice, additional, Longhini, Federico, additional, De Gaetano, Andrea, additional, Ranieri, V. Marco, additional, Brochard, Laurent J., additional, Antonelli, Massimo, additional, Aarab, Yassir, additional, Azoulay, Elie, additional, Belafia, Fouad, additional, Berquier, Guillaume, additional, Conseil, Matthieu, additional, Costamagna, Andrea, additional, Dangers, Laurence, additional, Jong, Audrey De, additional, Delemazure, Julie, additional, Corte, Francesco Della, additional, Dell’Atti, Ivan, additional, Gaudry, Stèphane, additional, Grossi, Francesca, additional, Iovino, Giovanni Carmine, additional, Jean-Baptiste, Sylvain, additional, Laissi, Mohammed, additional, Larcher, Romaric, additional, Meur, Matthieu Le, additional, Leclaire, Clèment, additional, Lopez, Paula Andrea, additional, Malachias, Sotirios M., additional, Matteo, Marilena, additional, Mayaux, Julienne, additional, Messika, Jonathan, additional, Monet, Clement, additional, Morawiec, Elise, additional, Papazian, Laurent, additional, Parrilla, Francisco, additional, Platon, Laura, additional, Roux, Damien, additional, Santantonio, Maria Teresa, additional, Suarez, Juan Carlos, additional, Tanzarella, Eloisa Sofia, additional, Toni, Flavia, additional, and Vetrugno, Luigi, additional

Published
2022
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10. Apnoeic oxygenation via high-flow nasal cannula oxygen combined with non-invasive ventilation preoxygenation for intubation in hypoxaemic patients in the intensive care unit: the single-centre, blinded, randomised controlled OPTINIV trial

Author

Jaber, Samir, Monnin, Marion, Girard, Mehdi, Conseil, Matthieu, Cisse, Moussa, Carr, Julie, and Mahul, Martin

Subjects
Hospital patients -- Comparative analysis -- Health aspects, Health care industry
Abstract

Purpose High-flow nasal cannula oxygen (HFNC) has the potential to provide apnoeic oxygenation. We decided to assess in a proof-of-concept study whether the addition of HFNC to non-invasive ventilation (NIV) could reduce oxygen desaturation during intubation, compared with NIV alone for preoxygenation, in severely hypoxaemic intensive care unit (ICU) patients with respiratory failure. Methods We conducted a randomised, controlled, single-centre trial with assessor-blinded outcome assessment in patients admitted to the ICU. Hypoxaemic patients requiring orotracheal intubation for respiratory failure were randomised to receive preoxygenation using HFNC [flow = 60 L/min, fraction of inspired oxygen (FiO.sub.2) = 100 %] combined with NIV (pressure support = 10 cmH.sub.2O, positive end-expiratory pressure = 5 cmH.sub.2O, FiO.sub.2 = 100 %) in the intervention group or NIV alone in the reference group prior to intubation. The primary outcome was the lowest oxygen saturation (SpO.sub.2) during the intubation procedure. Secondary outcomes were intubation-related complications and ICU mortality. Results Between July 2015 and February 2016, we randomly assigned 25 and 24 patients to the intervention and reference groups, respectively. In both groups the main reasons for respiratory failure were pneumonia and ARDS. During the intubation procedure, the lowest SpO.sub.2 values were significantly higher in the intervention group than in the reference group [100 (95-100) % vs. 96 (92-99) %, p = 0.029]. After exclusion of two patients from analysis for protocol violation, no (0 %) patients in the intervention group and five (21 %) patients in the reference group had SpO.sub.2 below 80 % (p = 0.050). We recorded no significant difference between the groups in intubation-related complications or ICU mortality. Conclusions A novel strategy for preoxygenation in hypoxaemic patients, adding HFNC for apnoeic oxygenation to NIV prior to orotracheal intubation, may be more effective in reducing the severity of oxygen desaturation than the reference method using NIV alone., Author(s): Samir Jaber [sup.1] [sup.2], Marion Monnin [sup.1], Mehdi Girard [sup.1], Matthieu Conseil [sup.1], Moussa Cisse [sup.1], Julie Carr [sup.1], Martin Mahul [sup.1], Jean Marc Delay [sup.1], Fouad Belafia [sup.1], [...]

Published
2016
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11. Video laryngoscopy versus direct laryngoscopy for orotracheal intubation in the intensive care unit: a systematic review and meta-analysis

Author

De Jong, Audrey, Molinari, Nicolas, Conseil, Matthieu, Coisel, Yannael, Pouzeratte, Yvan, Belafia, Fouad, and Jung, Boris

Subjects
Medical research -- Comparative analysis -- Usage, Medicine, Experimental -- Comparative analysis -- Usage, Laryngoscopy -- Comparative analysis -- Usage, Hospital patients -- Care and treatment, Health care industry
Abstract

Purpose Single studies of video laryngoscopy (VL) use for airway management in intensive care unit (ICU) patients have produced controversial findings. The aim of this study was to critically review the literature to investigate whether VL reduces difficult orotracheal intubation (OTI) rate, first-attempt success, and complications related to intubation in ICU patients, compared to standard therapy, defined as direct laryngoscopy (DL). Methods We performed a systematic review and meta-analysis of randomized controlled trials, as well as prospective and retrospective observational studies, by searching PubMed, EMBASE, and bibliographies of articles retrieved. We screened for relevant studies that enrolled adults in whom the trachea was intubated in the ICU and compared VL to DL. We included studies reporting at least one clinical outcome of interest to perform a meta-analysis. We generated pooled odd ratios (OR) across studies. The primary outcome measure was difficult OTI. The secondary outcomes were first-attempt success, Cormack 3/4 grades, and complications related to intubation (severe hypoxemia, severe cardiovascular collapse, airway injury, esophageal intubation). Results Nine trials with a total of 2,133 participants (1,067 in DL and 1,066 in VL) were included in the current analysis. Compared to DL, VL reduced the risk of difficult OTI [OR 0.29 (95 % confidence interval (CI) 0.20-0.44, p < 0.001)], Cormack 3/4 grades [OR 0.26 (95 % CI 0.17-0.41, p < 0.001)], and esophageal intubation [0.14 (95 % CI 0.02-0.81, p = 0.03)] and increased the first-attempt success [OR 2.07 (95 % CI 1.35-3.16, p < 0.001)]. No statistically significant difference was found for severe hypoxemia, severe cardiovascular collapse or airway injury. Conclusions These results suggest that VL could be useful in airway management of ICU patients., Author(s): Audrey De Jong [sup.1], Nicolas Molinari [sup.2] [sup.3], Matthieu Conseil [sup.1], Yannael Coisel [sup.1], Yvan Pouzeratte [sup.1], Fouad Belafia [sup.1], Boris Jung [sup.1] [sup.3], Gérald Chanques [sup.1] [sup.3], Samir [...]

Published
2014
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12. Long-Term Outcome of Severe Metabolic Acidemia in ICU Patients, a BICAR-ICU Trial Post Hoc Analysis.

Author

Bendiab, Eddine, Garnier, Fanny, Soler, Marion, Fosset, Maxime, Jaber, Samir, Molinari, Nicolas, Jung, Boris, de Jong, Audrey, Belafia, Fouad, Chanques, Gérald, Monnin, Marion, Delay, Jean-Marc, Cissé, Moussa, Geniez, Marie, Conseil, Matthieu, Souche, Bruno, Paugam, Catherine, Abback, Paër-Sélim, Futier, Emmanuel, and Michel Constantin, Jean

Published
2023
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13. Implementation of a combo videolaryngoscope for intubation in critically ill patients: a before-after comparative study

Author

De Jong, Audrey, Clavieras, Noémie, Conseil, Matthieu, Coisel, Yannael, Moury, Pierre-Henri, Pouzeratte, Yvan, and Cisse, Moussa

Subjects
Intensive care units -- Services, Laryngoscopy -- Methods, Critically ill -- Care and treatment, Health care industry
Abstract

Purpose Airway management in intensive care unit (ICU) patients is challenging. The main objective of this study was to compare the incidence of difficult laryngoscopy and/or difficult intubation between a combo videolaryngoscope and the standard Macintosh laryngoscope in critically ill patients. Methods In the context of the implementation of a quality-improvement process for airway management, we performed a prospective interventional monocenter before-after study which evaluated a new combo videolaryngoscope. The primary outcome was the incidence of difficult laryngoscopy (defined by Cormack grade 3-4) and/or difficult intubation (more than two attempts). The secondary outcomes were the severe life-threatening complications related to intubation in ICU and the rate of difficult intubation in cases of predicted difficult intubation evaluated by a specific score (MACOCHA score [greater than or equal to]3). Results Two hundred and ten non-selected consecutive intubation procedures were included, 140 in the standard laryngoscope group and 70 in the combo videolaryngoscope group. The incidence of difficult laryngoscopy and/or difficult intubation was 16 % in the laryngoscope group vs. 4 % in the combo videolaryngoscope group (p = 0.01). The severe life-threatening complications related to intubation did not differ between groups (16 vs. 14 %, p = 0.79). Among the 32 patients with a MACOCHA score [greater than or equal to]3, there were significantly more patients with difficult intubation in the standard laryngoscope group in comparison to the combo videolaryngoscope group [12/23 (57 %) vs. 0/9 (0 %), p < 0.01]. Conclusions The systematic use of a combo videolaryngoscope in ICU was associated with a decreased incidence of difficult laryngoscopy and/or difficult intubation., Author(s): Audrey De Jong [sup.1] , Noémie Clavieras [sup.1] , Matthieu Conseil [sup.1] , Yannael Coisel [sup.1] , Pierre-Henri Moury [sup.1] , Yvan Pouzeratte [sup.1] , Moussa Cisse [sup.1] , [...]

Published
2013
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14. Noninvasive mechanical ventilation in patients having declined tracheal intubation

Author

Azoulay, Élie, Kouatchet, Achille, Jaber, Samir, Lambert, Jérôme, Meziani, Ferhat, Schmidt, Matthieu, Schnell, David, Mortaza, Satar, Conseil, Matthieu, Tchenio, Xavier, Herbecq, Patrick, Andrivet, Pierre, Guerot, Emmanuel, Lafabrie, Ariane, Perbet, Sébastien, Camous, Laurent, Janssen-Langenstein, Ralf, Collet, François, Messika, Jonathan, Legriel, Stéphane, Fabre, Xavier, Guisset, Olivier, Touati, Samia, Kilani, Sarah, Alves, Michael, Mercat, Alain, Similowski, Thomas, Papazian, Laurent, Meert, Anne-Pascale, Chevret, Sylvie, Schlemmer, Benoît, Brochard, Laurent, and Demoule, Alexandre

Published
2013
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15. Early Changes Over Time in the Radiographic Assessment of Lung Edema Score Are Associated With Survival in ARDS

Author

Jabaudon, Matthieu, primary, Audard, Jules, additional, Pereira, Bruno, additional, Jaber, Samir, additional, Lefrant, Jean-Yves, additional, Blondonnet, Raiko, additional, Godet, Thomas, additional, Futier, Emmanuel, additional, Lambert, Céline, additional, Bazin, Jean-Etienne, additional, Bastarache, Julie A., additional, Constantin, Jean-Michel, additional, Ware, Lorraine B., additional, Souweine, Bertrand, additional, Eisenmann, Nathanael, additional, Quenot, Jean-Pierre, additional, Seguin, Philippe, additional, Asehnoune, Karim, additional, Lasocki, Sigismond, additional, Ferrandiere, Martine, additional, Sossou, Achile, additional, Langeron, Olivier, additional, Leone, Marc, additional, Dupont, Herve, additional, Veber, Benoit, additional, Ichai, Carole, additional, Rimmelé, Thomas, additional, Legay, François, additional, Grelon, Fabien, additional, Dahyot-Fizelier, Claire, additional, Cayot, Sophie, additional, Guerin, Renaud, additional, Verlhac, Camille, additional, Chabanne, Russell, additional, Cosserant, Bernard, additional, Lautrette, Alexandre, additional, Muller, Laurent, additional, Massanet, Pablo, additional, Boutin, Caroline, additional, Barbar, Saber, additional, Roger, Claire, additional, Belafia, Fouad, additional, Cisse, Moussa, additional, Monnin, Marion, additional, Conseil, Matthieu, additional, Carr, Julie, additional, De Jong, Audrey, additional, Chanques, Gérald, additional, Dargent, Auguste, additional, Crozon, Thomas, additional, Clauzel, Julien, additional, Le Core, Marinne, additional, Andreu, Pascal, additional, Lebouvrier, Thomas, additional, Launey, Yoann, additional, Roquilly, Antoine, additional, Cinotti, Raphael, additional, Tellier, Anne-Charlotte, additional, Barbaz, Mathilde, additional, Cohen, Benjamin, additional, Lemarche, Edouard, additional, Bertrand, Pierre-Marie, additional, Arbelot, Charlotte, additional, Zieleskiewicz, Laurent, additional, Hammad, Emmanuelle, additional, Duclos, Garry, additional, Calypso, Mathieu, additional, Orban, Jean-Christophe, additional, Quintard, Hervé, additional, Assefi, Mona, additional, Morel, Jerome, additional, Molliex, Serge, additional, Petitas, Frank, additional, and Nanadougmar, Hadanou, additional

Published
2020
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16. Combination of Monocyte Human Leukocyte Antigen-DR and β-d-Glucan for the Early Diagnosis of Invasive Candida Infection in Critically Ill Patients: A Proof of Concept Study

Author

Jung, Boris, primary, Bihan, Clément Le, additional, Portales, Pierre, additional, Bourgeois, Nathalie, additional, Vincent, Thierry, additional, Lachaud, Laurence, additional, Chanques, Gerald, additional, Conseil, Matthieu, additional, Corne, Philippe, additional, Massanet, Pablo, additional, Timsit, Jean François, additional, and Jaber, Samir, additional

Published
2020
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17. 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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18. Medical Versus Surgical ICU Obese Patient Outcome: A Propensity-Matched Analysis to Resolve Clinical Trial Controversies

Author

De Jong, Audrey, primary, Verzilli, Daniel, additional, Sebbane, Mustapha, additional, Monnin, Marion, additional, Belafia, Fouad, additional, Cisse, Moussa, additional, Conseil, Matthieu, additional, Carr, Julie, additional, Jung, Boris, additional, Chanques, Gérald, additional, Molinari, Nicolas, additional, and Jaber, Samir, additional

Published
2018
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19. Sepsis is associated with a preferential diaphragmatic atrophy: a critically ill patient study using tridimensional computed tomography

Author

Jung, Boris, Nougaret, Stephanie, Conseil, Matthieu, Coisel, Yannaël, Futier, Emmanuel, Chanques, Gerald, Molinari, Nicolas, Lacampagne, Alain, Matecki, Stefan, Jaber, Samir, 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 d'Anésthésie Réanimation [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Aide à la Décision pour une Médecine Personnalisé - Laboratoire de Biostatistique, Epidémiologie et Recherche Clinique - EA 2415 (AIDMP), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Passerieux, Emilie, and Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Adult, Aged, 80 and over, Male, [SDV.MHEP.PHY] Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Critical Illness, Diaphragm, Cone-Beam Computed Tomography, Middle Aged, musculoskeletal system, Muscular Atrophy, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Sepsis, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Humans, Female, Aged, Retrospective Studies
Abstract

International audience; Background:: Diaphragm and psoas are affected during sepsis in animal models. Whether diaphragm or limb muscle is preferentially affected during sepsis in the critically ill remains unclear.Methods:: Retrospective secondary analysis study including 40 patients, comparing control (n = 17) and critically ill patients, with (n = 14) or without sepsis (n = 9). Diaphragm volume, psoas volume, and cross-sectional area of the skeletal muscles at the third lumbar vertebra were measured during intensive care unit (ICU) stay using tridimensional computed tomography scan volumetry. Diaphragm strength was evaluated using magnetic phrenic nerve stimulation. The primary endpoint was the comparison between diaphragm and peripheral muscle volume kinetics during the ICU stay among critically ill patients, with or without sepsis.Results:: Upon ICU admission, neither diaphragm nor psoas muscle volumes were significantly different between critically ill and control patients (163 ± 53 cm3 vs. 197 ± 82 cm3 for the diaphragm, P = 0.36, and 272 ± 116 cm3 vs. to 329 ± 166 cm3 for the psoas, P = 0.31). Twenty-five (15 to 36) days after admission, diaphragm volume decreased by 11 ± 13% in nonseptic and by 27 ± 12% in septic patients, P = 0.01. Psoas volume decreased by 11 ± 10% in nonseptic and by 19 ± 13% in septic patients, P = 0.09. Upon ICU admission, diaphragm strength was correlated with diaphragm volume and was lower in septic (6.2 cm H2O [5.6 to 9.3]) than that in nonseptic patients (13.2 cm H2O [12.3 to 15.6]), P = 0.01.Conclusions:: During the ICU stay, both diaphragm and psoas volumes decreased. In septic patients, the authors report for the first time in humans preferential diaphragm atrophy compared with peripheral muscles.

Published
2014
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20. Differential Perceptions of Noninvasive Ventilation in Intensive Care among Medical Caregivers, Patients, and Their Relatives

Author

Schmidt, Matthieu, primary, Boutmy-Deslandes, Emmanuelle, additional, Perbet, Sébastien, additional, Mongardon, Nicolas, additional, Dres, Martin, additional, Razazi, Keyvan, additional, Guerot, Emmanuel, additional, Terzi, Nicolas, additional, Andrivet, Pierre, additional, Alves, Mikael, additional, Sonneville, Romain, additional, Cracco, Christophe, additional, Peigne, Vincent, additional, Collet, Francois, additional, Sztrymf, Benjamin, additional, Rafat, Cedric, additional, Reuter, Danielle, additional, Fabre, Xavier, additional, Labbe, Vincent, additional, Tachon, Guillaume, additional, Minet, Clémence, additional, Conseil, Matthieu, additional, Azoulay, Elie, additional, Similowski, Thomas, additional, and Demoule, Alexandre, additional

Published
2016
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23. Prospective Randomized Crossover Study of a New Closed-loop Control System versus Pressure Support during Weaning from Mechanical Ventilation

Author

Clavieras, Noémie, primary, Wysocki, Marc, additional, Coisel, Yannael, additional, Galia, Fabrice, additional, Conseil, Matthieu, additional, Chanques, Gerald, additional, Jung, Boris, additional, Arnal, Jean-Michel, additional, Matecki, Stefan, additional, Molinari, Nicolas, additional, and Jaber, Samir, additional

Published
2013
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24. Noninvasive mechanical ventilation in patients having declined tracheal intubation

Author

Azoulay, Élie, primary, Kouatchet, Achille, additional, Jaber, Samir, additional, Lambert, Jérôme, additional, Meziani, Ferhat, additional, Schmidt, Matthieu, additional, Schnell, David, additional, Mortaza, Satar, additional, Conseil, Matthieu, additional, Tchenio, Xavier, additional, Herbecq, Patrick, additional, Andrivet, Pierre, additional, Guerot, Emmanuel, additional, Lafabrie, Ariane, additional, Perbet, Sébastien, additional, Camous, Laurent, additional, Janssen-Langenstein, Ralf, additional, Collet, François, additional, Messika, Jonathan, additional, Legriel, Stéphane, additional, Fabre, Xavier, additional, Guisset, Olivier, additional, Touati, Samia, additional, Kilani, Sarah, additional, Alves, Michael, additional, Mercat, Alain, additional, Similowski, Thomas, additional, Papazian, Laurent, additional, Meert, Anne-Pascale, additional, Chevret, Sylvie, additional, Schlemmer, Benoît, additional, Brochard, Laurent, additional, and Demoule, Alexandre, additional

Published
2012
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25. Video laryngoscopy versus direct laryngoscopy for orotracheal intubation in the intensive care unit: a systematic review and meta-analysis.

Author

Jong, Audrey, Molinari, Nicolas, Conseil, Matthieu, Coisel, Yannael, Pouzeratte, Yvan, Belafia, Fouad, Jung, Boris, Chanques, Gérald, and Jaber, Samir

Subjects
LARYNGOSCOPY, ENDOTRACHEAL tubes, CRITICAL care medicine, LARYNX examination, INTENSIVE care units
Abstract

Purpose: Single studies of video laryngoscopy (VL) use for airway management in intensive care unit (ICU) patients have produced controversial findings. The aim of this study was to critically review the literature to investigate whether VL reduces difficult orotracheal intubation (OTI) rate, first-attempt success, and complications related to intubation in ICU patients, compared to standard therapy, defined as direct laryngoscopy (DL). Methods: We performed a systematic review and meta-analysis of randomized controlled trials, as well as prospective and retrospective observational studies, by searching PubMed, EMBASE, and bibliographies of articles retrieved. We screened for relevant studies that enrolled adults in whom the trachea was intubated in the ICU and compared VL to DL. We included studies reporting at least one clinical outcome of interest to perform a meta-analysis. We generated pooled odd ratios (OR) across studies. The primary outcome measure was difficult OTI. The secondary outcomes were first-attempt success, Cormack 3/4 grades, and complications related to intubation (severe hypoxemia, severe cardiovascular collapse, airway injury, esophageal intubation). Results: Nine trials with a total of 2,133 participants (1,067 in DL and 1,066 in VL) were included in the current analysis. Compared to DL, VL reduced the risk of difficult OTI [OR 0.29 (95 % confidence interval (CI) 0.20-0.44, p < 0.001)], Cormack 3/4 grades [OR 0.26 (95 % CI 0.17-0.41, p < 0.001)], and esophageal intubation [0.14 (95 % CI 0.02-0.81, p = 0.03)] and increased the first-attempt success [OR 2.07 (95 % CI 1.35-3.16, p < 0.001)]. No statistically significant difference was found for severe hypoxemia, severe cardiovascular collapse or airway injury. Conclusions: These results suggest that VL could be useful in airway management of ICU patients. [ABSTRACT FROM AUTHOR]

Published
2014
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26. Implementation of a combo videolaryngoscope for intubation in critically ill patients: a before-after comparative study.

Author

Jong, Audrey, Clavieras, Noémie, Conseil, Matthieu, Coisel, Yannael, Moury, Pierre-Henri, Pouzeratte, Yvan, Cisse, Moussa, Belafia, Fouad, Jung, Boris, Chanques, Gérald, Molinari, Nicolas, and Jaber, Samir

Subjects
LARYNGOSCOPY, AIRWAY (Anatomy), TRACHEA intubation, LARYNX examination, CRITICALLY ill, INTENSIVE care units, PHYSIOLOGY
Abstract

Purpose: Airway management in intensive care unit (ICU) patients is challenging. The main objective of this study was to compare the incidence of difficult laryngoscopy and/or difficult intubation between a combo videolaryngoscope and the standard Macintosh laryngoscope in critically ill patients. Methods: In the context of the implementation of a quality-improvement process for airway management, we performed a prospective interventional monocenter before-after study which evaluated a new combo videolaryngoscope. The primary outcome was the incidence of difficult laryngoscopy (defined by Cormack grade 3-4) and/or difficult intubation (more than two attempts). The secondary outcomes were the severe life-threatening complications related to intubation in ICU and the rate of difficult intubation in cases of predicted difficult intubation evaluated by a specific score (MACOCHA score ≥3). Results: Two hundred and ten non-selected consecutive intubation procedures were included, 140 in the standard laryngoscope group and 70 in the combo videolaryngoscope group. The incidence of difficult laryngoscopy and/or difficult intubation was 16 % in the laryngoscope group vs. 4 % in the combo videolaryngoscope group ( p = 0.01). The severe life-threatening complications related to intubation did not differ between groups (16 vs. 14 %, p = 0.79). Among the 32 patients with a MACOCHA score ≥3, there were significantly more patients with difficult intubation in the standard laryngoscope group in comparison to the combo videolaryngoscope group [12/23 (57 %) vs. 0/9 (0 %), p < 0.01]. Conclusions: The systematic use of a combo videolaryngoscope in ICU was associated with a decreased incidence of difficult laryngoscopy and/or difficult intubation. [ABSTRACT FROM AUTHOR]

Published
2013
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