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2. Zooming in the plastisphere: the ecological interface for phytoplankton–plastic interactions in aquatic ecosystems

Author

Nava, V., Dar, J.Y., De Santis, V., Fehlinger, L., Pasqualini, Julia, Adekolurejo, O.A., Burri, B., Cabrerizo, M.J., Chonova, T., Cour, M., Dory, F., Drost, A.M., Figler, A., Gionchetta, G., Halabowski, D., Harvey, D.R., Manzanares-Vázquez, V., Misteli, B., Mori-Bazzano, L., Moser, V., Rotta, F., Schmid-Paech, B., Touchet, C.M., Gostyńska, J., Nava, V., Dar, J.Y., De Santis, V., Fehlinger, L., Pasqualini, Julia, Adekolurejo, O.A., Burri, B., Cabrerizo, M.J., Chonova, T., Cour, M., Dory, F., Drost, A.M., Figler, A., Gionchetta, G., Halabowski, D., Harvey, D.R., Manzanares-Vázquez, V., Misteli, B., Mori-Bazzano, L., Moser, V., Rotta, F., Schmid-Paech, B., Touchet, C.M., and Gostyńska, J.

Abstract

Phytoplankton is an essential resource in aquatic ecosystems, situated at the base of aquatic food webs. Plastic pollution can impact these organisms, potentially affecting the functioning of aquatic ecosystems. The interaction between plastics and phytoplankton is multifaceted: while microplastics can exert toxic effects on phytoplankton, plastics can also act as a substrate for colonisation. By reviewing the existing literature, this study aims to address pivotal questions concerning the intricate interplay among plastics and phytoplankton/phytobenthos and analyse impacts on fundamental ecosystem processes (e.g. primary production, nutrient cycling). This investigation spans both marine and freshwater ecosystems, examining diverse organisational levels from subcellular processes to entire ecosystems. The diverse chemical composition of plastics, along with their variable properties and role in forming the “plastisphere”, underscores the complexity of their influences on aquatic environments. Morphological changes, alterations in metabolic processes, defence and stress responses, including homoaggregation and extracellular polysaccharide biosynthesis, represent adaptive strategies employed by phytoplankton to cope with plastic-induced stress. Plastics also serve as potential habitats for harmful algae and invasive species, thereby influencing biodiversity and environmental conditions. Processes affected by phytoplankton–plastic interaction can have cascading effects throughout the aquatic food web via altered bottom-up and top-down processes. This review emphasises that our understanding of how these multiple interactions compare in impact on natural processes is far from complete, and uncertainty persists regarding whether they drive significant alterations in ecological variables. A lack of comprehensive investigation poses a risk of overlooking fundamental aspects in addressing the environmental challenges associated with widespread plastic pollution.

Published
2024

3. The Influence of Brightness on Functional Assessment by mfERG: A Study on Scaffolds Used in Retinal Cell Transplantation in Pigs

Author

Christiansen, AT, Kiilgaard, JF, Smith, M, Ejstrup, R, Wnek, GE, Prause, JU, Young, MJ, Klassen, H, Kaplan, H, and La Cour, M

Subjects
Biochemistry and Cell Biology, Biological Sciences, Neurosciences, Eye Disease and Disorders of Vision, Eye, Clinical Sciences, Biochemistry and cell biology
Abstract

To determine the effect of membrane brightness on multifocal electroretinograms (mfERGs), we implanted poly lactic-co-glycolic acid (PLGA) membranes in the subretinal space of 11 porcine eyes. We compared membranes with their native shiny white color with membranes that were stained with a blue dye (Brilliant Blue). Histological and electrophysiological evaluation of the overlying retina was carried out 6 weeks after implantation. Histologically, both white and blue membranes degraded in a spongiform manner leaving a disrupted outer retina with no preserved photoreceptor segments. Multifocal ERG revealed the white membranes to have a significantly higher P1-amplitude ratio than the blue (P = 0.027), and a correlation between brightness ratio and P1-amplitude ratio was found (r = 0.762). Based on our findings, we conclude that bright subretinal objects can produce normal mfERG amplitude ratios even when the adjacent photoreceptors are missing. Functional assessment with mfERG in scaffold implant studies should therefore be evaluated with care.

Published
2012

4. Subretinal Implantation of Electrospun, Short Nanowire, and Smooth Poly(ε-caprolactone) Scaffolds to the Subretinal Space of Porcine Eyes

Author

Christiansen, AT, Tao, SL, Smith, M, Wnek, GE, Prause, JU, Young, MJ, Klassen, H, Kaplan, HJ, la Cour, M, and Kiilgaard, JF

Subjects
Biochemistry and Cell Biology, Biological Sciences, Neurosciences, Eye Disease and Disorders of Vision, Bioengineering, Clinical Sciences, Biochemistry and cell biology
Abstract

Biodegradable scaffolds play an important adjunct role in transplantation of retinal progenitor cells (RPCs) to the subretinal space. Poly(ε-Caprolactone) (PCL) scaffolds with different modifications were subretinally implanted in 28 porcine eyes and evaluated by multifocal electroretinography (mfERG) and histology after 6 weeks of observation. PCL Short Nanowire, PCL Electrospun, and PCL Smooth scaffolds were well tolerated in the subretinal space in pigs and caused no inflammation and limited tissue disruption. PCL Short Nanowire had an average rate of preserved overlying outer retina 17% higher than PCL Electrospun and 25% higher than PCL Smooth. Furthermore, PCL Short Nanowire was found to have the most suitable degree of stiffness for surgical delivery to the subretinal space. The membrane-induced photoreceptor damage could be shown on mfERG, but the reductions in P1 amplitude were only significant for the PCL Smooth. We conclude that of the tested scaffolds, PCL Short Nanowire is the best candidate for subretinal implantation.

Published
2012

6. Cardioprotection à la phase aiguë de l’infarctus du myocarde : conditionnement ischémique, conditionnement pharmacologique et hypothermie

Author

Cour, M. and Argaud, L.

Abstract

L’infarctus du myocarde (IDM) demeure la première cause de mortalité dans le monde, alors même que le développement des procédures de revascularisation coronaire a considérablement réduit sa mortalité précoce. Les conséquences de l’IDM en termes de morbimortalité sont directement liées à la taille de l’infarctus, qui est certes due à la durée de l’occlusion coronaire mais aussi, paradoxalement, à l’importance des lésions de reperfusion. Des interventions adjuvantes de la revascularisation coronaire, telles que le conditionnement ischémique, le conditionnement pharmacologique ou encore l’hypothermie thérapeutique, pourraient limiter ces lésions de reperfusion chez l’Homme. Les premières études cliniques offrent de réelles perspectives d’amélioration de la prise en charge des patients à la phase aiguë d’un IDM. Acute myocardial infarction remains the leading cause for death and disability worldwide, whereas current reperfusion therapies of jeopardized myocardium are very effective to limit short-term mortality. Clinical adverse clinical events are substantially determined by infarct size, which depends not only on the duration of ischemia but also, paradoxically, on the severity of reperfusion injury. Besides coronary revascularization, adjuvant therapies such as ischemic conditioning, pharmacological conditioning, and mild therapeutic hypothermia could prevent reperfusion injury in humans. The first clinical studies open up real perspectives for improving management of acute myocardial infarction.

Published
2024
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9. Extracellular cold-inducible RNA-binding protein (eCIRP) comme nouveau biomarqueur d’insuffisance rénale aiguë dans un modèle murin d’ischémie-reperfusion rénale, et une cohorte d’arrêts cardiaques

Author

Schleef, M., primary, Baetz, D., additional, Pillot, B., additional, Rabeyrin, M., additional, Bidaux, G., additional, Juillard, L., additional, Guebre-Egziabher, F., additional, Argaud, L., additional, Cour, M., additional, and Lemoine, S., additional

Published
2022
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14. Recombinant human interleukin-7 reverses T cell exhaustion ex vivo in critically ill COVID-19 patients

Author

Bidar, F., Hamada, S., Gossez, M., Coudereau, R., Lopez, J., Cazalis, M. A., Tardiveau, C., Brengel-Pesce, K., Mommert, M., Buisson, M., Conti, F., Rimmele, T., Lukaszewicz, A. C., Argaud, L., Cour, M., Monneret, G., Venet, F., Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Physiopathologie de l'immunodépression associée aux réponses inflammatoires systémiques - EA 7426 (PI3), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Centre International de Recherche en Infectiologie - UMR (CIRI), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), École normale supérieure - Lyon (ENS Lyon), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Centre d'Investigation Clinique [Bron] (CIC1407), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupement Hospitalier Est [Bron], Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), RICO Study Group: Remi Pescarmona, Lorna Garnier, Christine Lombard, Magali Perret, Marine Villard, Sébastien Viel, Valérie Cheynet, Elisabeth Cerrato, Estelle Peronnet, Jean-François Llitjos, Laetitia Itah, Inesse Boussaha, Françoise Poitevin-Later, Christophe Malcus, Marine Godignon, Florent Wallet, Marie-Charlotte Delignette, Frederic Dailler, Marie Simon, Auguste Dargent, Pierre-Jean Bertrand, Neven Stevic, Marion Provent, Laurie Bignet, Valérie Cerro, Jean-Christophe Richard, Laurent Bitker, Mehdi Mezidi, Loredana Baboi., CarMeN, laboratoire, Physiopathologie de l'immunodépression associée aux réponses inflammatoires systémiques / Pathophysiology of Injury-induced Immunosuppression (PI3), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and École normale supérieure de Lyon (ENS de Lyon)

Subjects
[SDV] Life Sciences [q-bio], Exhaustion, SARS-CoV-2, Interleukin-7, [SDV]Life Sciences [q-bio], T lymphocytes, Critical Care and Intensive Care Medicine, Critically ill, Immunostimulation
Abstract

Erratum inCorrection to: Recombinant human interleukin-7 reverses T cell exhaustion ex vivo in critically ill COVID-19 patients.Bidar F, Hamada S, Gossez M, Coudereau R, Lopez J, Cazalis MA, Tardiveau C, Brengel-Pesce K, Mommert M, Buisson M, Conti F, Rimmelé T, Lukaszewicz AC, Argaud L, Cour M, Monneret G, Venet F; RICO Study Group.Ann Intensive Care. 2022 Apr 1;12(1):30. doi: 10.1186/s13613-022-01007-7.; International audience; BACKGROUND: Lymphopenia is a hallmark of severe coronavirus disease 19 (COVID-19). Similar alterations have been described in bacterial sepsis and therapeutic strategies targeting T cell function such as recombinant human interleukin 7 (rhIL-7) have been proposed in this clinical context. As COVID-19 is a viral sepsis, the objectives of this study were to characterize T lymphocyte response over time in severe COVID-19 patients and to assess the effect of ex vivo administration of rhIL-7. RESULTS: Peripheral blood mononuclear cells from COVID-19 patients hospitalized in intensive care unit (ICU) were collected at admission and after 20 days. Transcriptomic profile was evaluated through NanoString technology. Inhibitory immune checkpoints expressions were determined by flow cytometry. T lymphocyte proliferation and IFN-γ production were evaluated after ex vivo stimulation in the presence or not of rhIL-7. COVID-19 ICU patients were markedly lymphopenic at admission. Mononuclear cells presented with inhibited transcriptomic profile prevalently with impaired T cell activation pathways. CD4 + and CD8 + T cells presented with over-expression of co-inhibitory molecules PD-1, PD-L1, CTLA-4 and TIM-3. CD4 + and CD8 + T cell proliferation and IFN-γ production were markedly altered in samples collected at ICU admission. These alterations, characteristic of a T cell exhaustion state, were more pronounced at ICU admission and alleviated over time. Treatment with rhIL-7 ex vivo significantly improved both T cell proliferation and IFN-γ production in cells from COVID-19 patients. CONCLUSIONS: Severe COVID-19 patients present with features of profound T cell exhaustion upon ICU admission which can be reversed ex vivo by rhIL-7. These results reinforce our understanding of severe COVID-19 pathophysiology and opens novel therapeutic avenues to treat such critically ill patients based of immunomodulation approaches. Defining the appropriate timing for initiating such immune-adjuvant therapy in clinical setting and the pertinent markers for a careful selection of patients are now warranted to confirm the ex vivo results described so far. Trial registration ClinicalTrials.gov identifier: NCT04392401 Registered 18 May 2020, http:// clinicaltrials.gov/ct2/show/NCT04392401.

Published
2022
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18. Chronic use of inhaled corticosteroids in patients admitted for respiratory virus infections: a 6-year prospective multicenter study

Author

Luque-Paz, David, Tattevin, Pierre, Loubet, Paul, Bénézit, François, Thibault, Vincent, Lainé, Fabrice, Vanhems, Philippe, Amour, Selilah, Lina, Bruno, Duval, Xavier, L’honneur, Anne-Sophie, Fidouh, Nadhira, Vallejo, Christine, Alain, Sophie, Galtier, Florence, Foulongne, Vincent, Lagathu, Gisèle, Lenzi, Nezha, Lesieur, Zineb, Launay, Odile, Jouneau, Stéphane, Loulergue, P., Momcilovic, S., Mira, J., Marin, N., Charpentier, J., Regent, A., Kanaan, R., Dumas, F., Doumenc, B., Lachatre, M., Szwebel, T., Kansao, J., Costa, Y., Alexandra, J., Becheur, H., Belghalem, K., Bernard, J., Bleibtreu, A., Boisseau, M., Bories, R., Brugiere, O., Brunet, F., Burdet, C., Casalino, E., Caseris, M., Chansiaux, C., Chauchard, M., Chavance, P., Choquet, C., Cloppet-Fontaine, A., Colosi, L., Couset, B., Crestani, B., Crocket, F., Debit, A., Delanoe, K, Descamps, V., Dieude, P., Dossier, A., Douron, N., Dupeyrat, E., Emeyrat, N., Fernet, C., Goulenok, T., Harent, S., Jouenne, R., Justet, A., Leleu, A., Lerat, I., Lilamand, M., Mal, H., Marceau, A., Metivier, A.-C., Oplelatora, K., Papo, T., Pelletier, A.-L., Pereira, L., Pradere, P., Prommier, R, Ralainnazava, P., Ranaivoision, M., Raynaud-Simon, A., Rioux, C., Sacre, K., Verry, V., Vuong, V., Yazdapanah, Y., Houhou, N., Géraud, P., Driss, V., Maugueret, V., Crantelle, L., Agostini, C., Ray, M., Letois, F., Mura, T., Serrand, C., Noslier, S., Giordano, A., Chevassus, H., Nyiramigisha, E., Merle, C., Bourdin, A., Konaté, A., Capdevilla, X., Du Cailar, G., Terminet, A., Blain, H., Leglise, M., Le Quellec, A., Corne, P., Landreau, L., Klouche, K., Bourgeois, A., Sebbane, M., Mourad, G., Leray, H., Postil, D., Alcolea, S., Couve-Deacon, E., Rogez, S., Argaud, L., Cour, M., Hernu, R., Simon, M., Baudry, T., Tazarourte, K., Bui-Xuan, C., Fattoum, J., Valette, M., Rochas, S., Cochennec, S., Thébault, E., Revest, M., Sébillotte, M., Le Bot, A., Baldeyrou, M., Patrat-Delon, S., Cailleaux, M., Pronier, C., CHU Pontchaillou [Rennes], ARN régulateurs bactériens et médecine (BRM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Virulence Bactérienne et Infections Chroniques (VBIC), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), Hospices Civils de Lyon (HCL), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Centre d'Investigation Clinique de Limoges (CIC1435), CHU Limoges-Institut National de la Santé et de la Recherche Médicale (INSERM), Anti-infectieux : supports moléculaires des résistances et innovations thérapeutiques (RESINFIT), CHU Limoges-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), CIC Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CIC Cochin Pasteur (CIC 1417), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôtel-Dieu-Groupe hospitalier Broca-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), and This work was not funded. The study sites received funding from Sanofi Pasteur and MSD for the FLUVAC study. Vaccine producers had no role in the study design, data analysis, decision to publish or preparation of the manuscript.

Subjects
Adult, Multidisciplinary, [SDV]Life Sciences [q-bio], Respiratory Syncytial Virus Infections, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Adrenal Cortex Hormones, Virus Diseases, Respiratory Syncytial Virus, Human, Influenza, Human, Viruses, Humans, Prospective Studies, Respiratory Tract Infections
Abstract

Inhaled corticosteroids (ICS) have been associated with increased risk of pneumonia. Their impact on respiratory virus infections is unclear. We performed a post-hoc analysis of the FLUVAC cohort, a multicenter prospective cohort study of adults hospitalized with influenza-like illness (ILI) during six consecutive influenza seasons (2012–2018). All patients were tested for respiratory virus infection by multiplex PCR on nasopharyngeal swabs and/or bronchoalveolar lavage. Risk factors were identified by logistic regression analysis. Among the 2658 patients included, 537 (20.2%) were treated with ICS before admission, of whom 282 (52.5%, 282/537) tested positive for at least one respiratory virus. Patients on ICS were more likely to test positive for non-influenza respiratory viruses (25.1% vs. 19.5%, P = 0.004), especially for adenovirus (aOR 2.36, 95% CI 1.18–4.58), and respiratory syncytial virus (aOR 2.08, 95% CI 1.39–3.09). Complications were reported in 55.9% of patients on ICS (300/537), primarily pneumonia (171/535, 32%). Among patients on chronic ICS who tested positive for respiratory virus, 14.2% (40/282) were admitted to intensive care unit, and in-hospital mortality rate was 2.8% (8/282). Chronic use of ICS is associated with an increased risk of adenovirus or RSV infections in patients admitted for ILI.

Published
2021
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19. Day-90 survival in critically-ill patients with COVID-19 and hydroxychloroquine: a propensity analysis

Author

Cour, M., Amaz, C., Bohe, J., RIMMELE, T., Ovize, M., Argaud, L., Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Centre d'Investigation Clinique [Bron] (CIC1407), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupement Hospitalier Est [Bron], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), and CarMeN, laboratoire

Subjects
Coronavirus disease 2019 (COVID-19), [SDV] Life Sciences [q-bio], hydroxychloroquine (HCQ), [SDV]Life Sciences [q-bio], Original Article, acute respiratory distress syndrome, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), propensity score
Abstract

International audience; BACKGROUND: There are limited data on the effect of hydroxychloroquine on medium term outcomes in patients with coronavirus disease 2019 (COVID-19) requiring intensive care. We aimed to evaluate the effects of hydroxychloroquine on day 90 mortality in this specific population. METHODS: This retrospective, multicenter, propensity matched cohort analysis, used data of adult patients with laboratory confirmed COVID-19 admitted to 3 university affiliated intensive care units between March 7, 2020, to April 7, 2020 in Lyon, France. Patients received either hydroxychloroquine (loading dose of 400 mg twice daily at day 1 followed by 200 mg twice daily from day 2 to day 10) or standard of care without hydroxychloroquine. We compared all-cause mortality at day-90 after ICU admission between propensity score matched groups receiving hydroxychloroquine or standard of care. RESULTS: A total of 157 patients were included with a day-28 and day-90 mortality rate of 23.6% and 32.5%, respectively. The median (interquartile) age was 67 years (56-76 years), 105 (66.9%) were men, 65 (41.4%) fulfilled criteria for acute respiratory distress syndrome, and 64 (41%) received hydroxychloroquine (HCQ) for 10 days (4-10 days). In the propensity score matched cohort (59 patients in each group), day-90 mortality was 35.6% for patients who received HCQ and 23.7% for patients who did not (P=0.23). Kaplan Meier survival analysis showed no statistically significant association between HCQ therapy and mortality (P=0.20 by log-rank test). CONCLUSIONS: In this study, off-label use of HCQ in critically ill patients with COVID-19 was not associated with any significant change in medium-term prognosis, confirming results of studies in less severe patients.

Published
2021
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23. Prediction of Brain Death After Out-of-Hospital Cardiac Arrest: Development and Validation of the Brain Death After Cardiac Arrest Score

Author

Madelaine, T., Cour, M., Roy, P., Vivien, B., Charpentier, J., Dumas, F., Deye, N., Bonnefoy, E., Gueugniaud, P. Y., Coste, J., Cariou, A., Argaud, L., Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Pôle de Santé Publique [Lyon], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Cochin [AP-HP], Service des Urgences [GH Paris Saint-Joseph], Centre hospitalier Saint-Joseph [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Lariboisière-Fernand-Widal [APHP], Services de Pneumologie, Exploration Fonctionnelle Respiratoire et Cardiologie (Hôpital Louis Pradel), Hôpital Hôtel-Dieu [Paris], Unité de Soins Intensifs [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], and CarMeN, laboratoire

Subjects
[SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio], resuscitation, brain death, score, cardiac arrest
Abstract

International audience; BACKGROUND: Among patients successfully resuscitated after an out-of-hospital cardiac arrest (OHCA), 10% to 15% evolve toward brain death (BD), thus becoming potential organ donors. RESEARCH QUESTION: Is it possible to establish a score for early estimation of BD risk after OHCA? STUDY DESIGN AND METHODS: The BD after cardiac arrest (BDCA) score was developed from data available within 24 hours after OHCA from two OHCA trials: Cyclosporine in Cardiac Arrest Resuscitation and Erythropoietin After OHCA. The BDCA score was then validated in another large prospective multicenter data set. The main outcome was the occurrence of BD. Independent prognostic covariates for BD were identified using a binomial two-stage adaptive least absolute shrinkage and selection operator procedure. RESULTS: The development cohort included 569 patients alive 24 hours after OHCA, among whom 84 (14.8%) experienced BD. Independent predictors of BD used to build the BDCA score were being female (4 points), nonshockable rhythm (24 points), cardiac cause of OHCA (-6 points), neurological cause of OHCA (45 points), natremia at 24 hours (natremia in millimoles per liter minus 140 points), and vasoactive drug at admission (4 points) and at 24 hours (6 points). The area under the curve (AUC) of the BDCA score was 0.82 (95% CI, 0.77-0.86), and the discrimination value in the validation cohort (n = 487) was consistent (AUC, 0.81; 95% CI, 0.76-0.86). In the validation cohort, BD occurred in 4.0%, 20.4%, and 67.7% of patients with scores of \textless 20, 20 to 50, and \textgreater 50, respectively. INTERPRETATION: The BDCA score allows early detection of patients with a high probability of experiencing BD, which may help increase organ donation after OHCA. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov; No.: NCT01595958, and ClinicalTrials.gov; No.: NCT00999583; URL: www.clinicaltrials.gov.

Published
2021
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28. Optic nerve oxygen tension: the effects of timolol and dorzolamide

Author

Kiilgaard, J.F., Pedersen, D.B., Eysteinsson, T., La Cour, M., Bang, K., Jensen, P.K., and Stefansson, E.

Subjects
Research, Optic nerve -- Research
Abstract

Background/aims: The authors have previously reported that carbonic anhydrase inhibitors such as acetazolamide and dorzolamide raise optic nerve oxygen tension (ONP[O.sub.2]) in pigs. The purpose of the present study was [...]

Published
2004

45. Meyer-Schwickerath Lecture: Risk factors for rhegmatogenous retinal detachment

Author

la Cour, M

Subjects
ddc: 610, 610 Medical sciences, Medicine, eye diseases
Abstract

Purpose: To study the risk of rhegmatogenous retinal detachment (RRD) as a complication to intraocular surgery. Method: The Danish National Patient Register (NPR) holds information about all surgeries performed on Danish citizens since 1996, and was used a datasource for this study. The outcome [for full text, please go to the a.m. URL], 32. Internationaler Kongress der Deutschen Ophthalmochirurgen

Published
2019
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