Search

Your search keyword '"MESH: Respiratory Distress Syndrome, Adult"' showing total 26 results
Start Over Descriptor "MESH: Respiratory Distress Syndrome, Adult"
26 results on '"MESH: Respiratory Distress Syndrome, Adult"'

1. Évaluation de l’oxygénation extra corporelle veino-veineuse dans la prise en charge de l’œdème pulmonaire post pneumonectomie

Author

moulin, charles, Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), and Christian Lamer

Subjects
MESH: Pulmonary Edema, Pneumonectomie, Oedème pulmonaire, MESH: Extracorporeal Membrane Oxygenation, MESH: Pneumonectomy, Oxygénation extracorporelle sur oxygénateur à membrane (ECMO), MESH: Respiratory Distress Syndrome, Adult, Syndrome de détresse respiratoire aiguë (SDRA), [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Post pneumonectomy pulmonary edema (PPE) is a rare but threatening complication. Recentdevelopment of veno venous extra corporeal membrane oxygenation (VVECMO) in the acute respiratorydistress syndrome (ARDS) may enhanced its prognosis. In our Department, since 2010, patients whosuffered of PPE were treated by VVECMO. The aim of this study is to evaluate the benefit of thistreatment in comparison with a control period (2004-2010) when patients were treated withconventional measures. Secondary objective was to look for all associated factors of postpneumonectomy acute respiratory failure (ARF). Method: All pneumonotomy performed in our centerbetween January 2004 and January 2018 were included. PPE was defined by: Berlin ARDS definition andthe absence of intercurrent disease. ARF was defined by the association of hypoxemia (PaO2/FiO2

Published
2019

2. Effet des différents supports d’oxygénation non invasifs sur le volume courant : une étude sur banc

Author

Maignant Haudebourg, Anne-Fleur, Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), and Guillaume Carteaux

Subjects
Détresse respiratoire aiguë, Ventilation non invasive, MESH: Respiratory Distress Syndrome, Adult, MESH: Tidal Volume, MESH: Noninvasive Ventilation, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Volume courant
Abstract

Introduction: multiple devices are available for non-invasive oxygenation support: oxygen mask, high flow nasal canula (HFNC), continuous positive airway pressure (CPAP), mask non-invasive ventilation (M-NIV) and helmet NIV (H-NIV). There are conflicted data about their respective effects during acute respiratory failure. Tidal volume is a determinant of both efficacy and safety during ventilatory support. We assessed whether the tidal volume (VT) was influenced by non-invasive oxygenation support device. Methods: this six devices were tested using the RespiSim® manikin connected to an ASL 5000® breathing simulator. Three different respiratory mechanics (normal, obstructive and restrictive) and three levels of respiratory effort (low, moderate and respiratory distress) were simulated. Results: as compared to the oxygen mask (VT=440 ± 352 mL), VT increased significantly with M-NIV (VT=690 ± 321 mL) and H-NIV (VT=652 ± 366 mL) and decreased significantly with CPAP (VT=377 ± 297 mL) and HFNC (VT=414 ± 333 mL) (p

Published
2019

3. Inhibition of the Receptor for Advanced Glycation End-Products in Acute Respiratory Distress Syndrome: A Randomised Laboratory Trial in Piglets

Author

Jules Audard, Loïc Blanchon, Christelle Gross, Vincent Sapin, Thomas Godet, Bertille Paquette, Matthieu Jabaudon, Justine Pasteur, Damien Bouvier, Raiko Blondonnet, Corinne Belville, Jean-Baptiste Joffredo, Marilyne Lavergne, Bruno Pereira, Jean-Michel Constantin, BLANCHON, LOIC, CHU Clermont-Ferrand, 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), Génétique, Reproduction et Développement (GReD), 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]), and Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
0301 basic medicine, ARDS, Swine, Receptor for Advanced Glycation End Products, lcsh:Medicine, Pharmacology, Gastroenterology, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, RAGE (receptor), Pathogenesis, 0302 clinical medicine, Interquartile range, Glycation, MESH: Animals, 050207 economics, Receptor, lcsh:Science, MESH: Swine, 0303 health sciences, Respiratory Distress Syndrome, 050208 finance, Multidisciplinary, 05 social sciences, respiratory system, 3. Good health, medicine.anatomical_structure, medicine.symptom, MESH: Oxygen, medicine.medical_specialty, MESH: Hemodynamics, Inflammation, Lung injury, Article, 03 medical and health sciences, Internal medicine, 0502 economics and business, medicine, Animals, 030304 developmental biology, Lung, business.industry, MESH: Receptor for Advanced Glycation End Products, lcsh:R, Antagonist, Hemodynamics, Oxygenation, Translational research, medicine.disease, Oxygen, Disease Models, Animal, 030104 developmental biology, 030228 respiratory system, Preclinical research, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, MESH: Respiratory Distress Syndrome, Adult, lcsh:Q, MESH: Disease Models, Animal, business, 030217 neurology & neurosurgery
Abstract

BackgroundThe receptor for advanced glycation end products (RAGE) modulates the pathogenesis of acute respiratory distress syndrome (ARDS). RAGE inhibition was recently associated with attenuated lung injury and restored alveolar fluid clearance (AFC) in a mouse model of ARDS. However, clinical translation will first require assessment of this strategy in larger animals.MethodsForty-eight anaesthetised Landrace piglets were randomised into a control group and three treatment groups. Animals allocated to treatment groups underwent orotracheal instillation of hydrochloric acid i) alone; ii) in combination with intravenous administration of a RAGE antagonist peptide (RAP), a S100P-derived peptide that prevents activation of RAGE by its ligands, or iii) in combination with intravenous administration of recombinant soluble (s)RAGE that acted as a decoy receptor. The primary outcome measure was net AFC at 4 h. Arterial oxygenation was assessed hourly for 4 h and alveolar-capillary permeability, alveolar inflammation, lung histology and lung mRNA expression of the epithelial sodium channel (α1-ENaC), α1-Na,K-ATPase and aquaporin (AQP)-5 were assessed at 4 h.FindingsTreatment with either RAP or sRAGE improved net AFC rates (median [interquartile range], 21.2 [18.8–21.7] and 19.5 [17.1–21.5] %/h, respectively, versus 12.6 [3.2–18.8] %/h in injured, untreated controls), improved oxygenation and decreased alveolar inflammation and histological evidence of tissue injury after acid-induced ARDS. RAGE inhibition also restored lung mRNA expression of α1-Na,K-ATPase and AQP-5.InterpretationRAGE inhibition restored AFC and attenuated lung injury in a piglet model of acid-induced ARDS.FundingAuvergne Regional Council, Agence Nationale de la Recherche, Direction Générale de l’Offre de Soins.Research in ContextEvidence before this studyThe acute respiratory distress syndrome (ARDS), a clinical syndrome of diffuse pulmonary oedema and inflammation, currently lacks effective therapies and is associated with high mortality and morbidity. The degrees of lung epithelial injury and of alveolar fluid clearance (AFC) impairment, as evaluated by plasma levels of soluble receptor for glycation end-products (RAGE), are major prognostic factors in ARDS and potential therapeutic targets for ongoing research. For example, targeting RAGE with recombinant sRAGE or an anti-RAGE monoclonal antibody has proven beneficial in a translational mouse model of acid-induced ARDS.Added value of this studyIn a piglet model of acid-induced ARDS, treatment with RAGE antagonist peptide or recombinant sRAGE restored AFC and attenuated the features of lung injury, thereby confirming, in the closest evolutionary model species to humans, previous evidence from rodent models that modulation of RAGE may be a therapeutic option for ARDS. Although this is an important step towards future clinical translation, future studies should assess the best methods to modulate RAGE and further confirm the safety of manipulating this pathway in patients with ARDS.

Published
2019
Full Text
View/download PDF

4. Driving pressure and acute respiratory distress syndrome in critically ill patients

Author

Blondonnet, Raiko, Joubert, Elodie, Godet, Thomas, Berthelin, Pauline, Pranal, Thibaut, Roszyk, Laurence, Chabanne, Russell, Eisenmann, Nathanael, Lautrette, Alexandre, Belville, Corinne, Cayot, Sophie, Gillart, Thierry, Souweine, Bertrand, Bouvier, Damien, Blanchon, Loïc, Sapin, Vincent, Pereira, Bruno, Constantin, Jean-Michel, Jabaudon, Matthieu, Retinoids, Development and Developmental Diseases (R2D2), Université d'Auvergne - Clermont-Ferrand I (UdA), Service d'Anésthésie Réanimation [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Service de Biochimie et Génétique Moléculaire [CHU Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Unité de soins intensifs [Clermont Ferrand], CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], Génétique, Reproduction et Développement (GReD), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), Génétique, Reproduction et Développement (GReD ), 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]), Laboratoire de Biochimie, CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand], and 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)

Subjects
MESH: Correlation of Data, MESH: Humans, MESH: Middle Aged, MESH: Adult, acute respiratory distress syndrome, driving pressure, mechanical ventilation, intensive care unit, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, MESH: Male, risk prediction, MESH: Positive-Pressure Respiration, MESH: Critical Care, MESH: Risk Factors, MESH: Critical Illness, MESH: Respiratory Distress Syndrome, Adult, MESH: Intensive Care Units, MESH: Respiration, Artificial, MESH: Female, MESH: Risk Adjustment
Abstract

International audience; Elevated driving pressure (ΔP) may be associated with increased risk of acute respiratory distress syndrome (ARDS) in patients admitted via the emergency department and with post-operative pulmonary complications in surgical patients. This study investigated the association of higher ΔP with the onset of ARDS in a high-risk, intensive care unit (ICU) population.

Published
2018
Full Text
View/download PDF

5. Recent directions in personalised acute respiratory distress syndrome medicine

Author

Matthieu Jabaudon, Vincent Sapin, Raiko Blondonnet, Thomas Godet, Jean-Michel Constantin, Jules Audard, Marianne Fournet, CHU Clermont-Ferrand, 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), Retinoids, Development and Developmental Diseases (R2D2), Université d'Auvergne - Clermont-Ferrand I (UdA), Université de Clermont-Ferrand, Laboratoire de Biologie Moléculaire de la Cellule (LBMC), École normale supérieure de Lyon (ENS de 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), Laboratoire de Biochimie, Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon

Subjects
medicine.medical_specialty, Endotype, ARDS, Point-of-care testing, Psychological intervention, MESH: Delivery of Health Care, Critical Care and Intensive Care Medicine, MESH: Precision Medicine, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Severity of illness, Medicine, Humans, 030212 general & internal medicine, Precision Medicine, Intensive care medicine, Respiratory Distress Syndrome, MESH: Humans, Acute respiratory distress syndrome, business.industry, General Medicine, Precision medicine, medicine.disease, Personalized medicine, 3. Good health, Anesthesiology and Pain Medicine, Phenotype, 030228 respiratory system, MESH: Respiratory Distress Syndrome, Adult, business, Delivery of Health Care
Abstract

International audience; Acute respiratory distress syndrome (ARDS) is heterogeneous by definition and patient response varies depending on underlying biology and their severity of illness. Although ARDS subtypes have been identified with different prognoses in past studies, the concept of phenotypes or endotypes does not extend to the clinical definition of ARDS. This has possibly hampered the development of therapeutic interventions that target select biological mechanisms of ARDS. Recently, a major advance may have been achieved as it may now be possible to identify ARDS subtypes that may confer different responses to therapy. The aim of personalised medicine is to identify, select, and test therapies that are most likely to be associated with a favourable outcome in a specific patient. Several promising approaches to ARDS subtypes capable of predicting therapeutic response, and not just prognosis, are highlighted in this perspective paper. An overview is also provided of current and future directions regarding the provision of personalised ARDS medicine. The importance of delivering the right care, at the right time, to the right patient, is emphasised.

Published
2018
Full Text
View/download PDF

6. Plasma sRAGE is independently associated with increased mortality in ARDS: a meta-analysis of individual patient data

Author

Tommaso Mauri, Bruno Pereira, Antonio Pesenti, Ognjen Gajic, Raiko Blondonnet, Michael A. Matthay, Carolyn S. Calfee, Florian Uhle, Andrea Coppadoro, Helena Brodska, Jean-Michel Constantin, Ségolène Mrozek, Christoph Lichtenstern, Vincent Sapin, Rogier M. Determann, Rolf D. Hubmayr, Tomas Drabek, Marcus J. Schultz, Marco Ranieri, Rodrigo Cartin-Ceba, Matthieu Jabaudon, CHU Clermont-Ferrand, Génétique, Reproduction et Développement (GReD), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), Retinoids, Development and Developmental Diseases (R2D2), Université d'Auvergne - Clermont-Ferrand I (UdA), Department of Anaesthesiology, Heidelberg University Hospital [Heidelberg], Mayo Clinic [Rochester], Jabaudon, M., Blondonnet, R., Pereira, B., Cartin-Ceba, R., Lichtenstern, C., Mauri, T., Determann, R.M., Drabek, T., Hubmayr, R.D., Gajic, O., Uhle, F., Coppadoro, A., Pesenti, A., Schultz, M.J., Ranieri, M.V., Brodska, H., Mrozek, S., Sapin, V., Matthay, M.A., Constantin, J.-M., Calfee, C.S., Intensive Care Medicine, AII - Inflammatory diseases, ACS - Diabetes & metabolism, ACS - Pulmonary hypertension & thrombosis, ACS - Microcirculation, and 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)

Subjects
Male, ARDS, Receptor for Advanced Glycation End Products, clinical outcome, Critical Care and Intensive Care Medicine, MESH: Tidal Volume, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, 0302 clinical medicine, MESH: Risk Factors, Risk Factors, Medicine, MESH: APACHE, randomized controlled trial (topic), Tidal volume, APACHE, Randomized Controlled Trials as Topic, Work of Breathing, Respiratory Distress Syndrome, MESH: Middle Aged, Acute respiratory distress syndrome, adult respiratory distress syndrome, respiratory system, Middle Aged, lung alveolus epithelium, Prognosis, 3. Good health, Observational Studies as Topic, medicine.anatomical_structure, MESH: Work of Breathing, Meta-analysis, Cardiology, multicenter study (topic), Biomarker (medicine), Female, medicine.medical_specialty, Prognosi, advanced glycation end product receptor, adult, MESH: Observational Studies as Topic, Lung injury, Article, lung epithelium, 03 medical and health sciences, Internal medicine, Tidal Volume, Humans, human, lung injury, Lung, Lung epithelial injury, MESH: Humans, business.industry, MESH: Receptor for Advanced Glycation End Products, 030208 emergency & critical care medicine, Odds ratio, Biomarker, medicine.disease, major clinical study, mortality, Confidence interval, MESH: Male, Receptor for advanced glycation end-products, MESH: Randomized Controlled Trials as Topic, 030228 respiratory system, protein blood level, MESH: Biomarkers, MESH: Respiratory Distress Syndrome, Adult, observational study, business, MESH: Female, Biomarkers
Abstract

Purpose: The soluble receptor for advanced glycation end-products (sRAGE) is a marker of lung epithelial injury and alveolar fluid clearance (AFC), with promising values for assessing prognosis and lung injury severity in acute respiratory distress syndrome (ARDS). Because AFC is impaired in most patients with ARDS and is associated with higher mortality, we hypothesized that baseline plasma sRAGE would predict mortality, independently of two key mediators of ventilator-induced lung injury. Methods: We conducted a meta-analysis of individual data from 746 patients enrolled in eight prospective randomized and observational studies in which plasma sRAGE was measured in ARDS articles published through March 2016. The primary outcome was 90-day mortality. Using multivariate and mediation analyses, we tested the association between baseline plasma sRAGE and mortality, independently of driving pressure and tidal volume. Results: Higher baseline plasma sRAGE [odds ratio (OR) for each one-log increment, 1.18; 95% confidence interval (CI) 1.01–1.38; P = 0.04], driving pressure (OR for each one-point increment, 1.04; 95% CI 1.02–1.07; P = 0.002), and tidal volume (OR for each one-log increment, 1.98; 95% CI 1.07–3.64; P = 0.03) were independently associated with higher 90-day mortality in multivariate analysis. Baseline plasma sRAGE mediated a small fraction of the effect of higher ΔP on mortality but not that of higher VT. Conclusions: Higher baseline plasma sRAGE was associated with higher 90-day mortality in patients with ARDS, independently of driving pressure and tidal volume, thus reinforcing the likely contribution of alveolar epithelial injury as an important prognostic factor in ARDS. Registration: PROSPERO (ID: CRD42018100241). © 2018, The Author(s).

Published
2018
Full Text
View/download PDF

7. Encou-RAGE-ing Lung Protection in Patients With Acute Respiratory Distress Syndrome Under Extracorporeal Membrane Oxygenation*

Author

Matthieu Jabaudon, Raiko Blondonnet, Jules Audard, CHU Clermont-Ferrand, Génétique, Reproduction et Développement (GReD), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), Retinoids, Development and Developmental Diseases (R2D2), Université d'Auvergne - Clermont-Ferrand I (UdA), Université de Clermont-Ferrand, and 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)

Subjects
medicine.medical_treatment, Acute respiratory distress, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Rage (emotion), 03 medical and health sciences, Extracorporeal Membrane Oxygenation, 0302 clinical medicine, MESH: Extracorporeal Membrane Oxygenation, Extracorporeal membrane oxygenation, Humans, Medicine, MESH: Lung, In patient, 030212 general & internal medicine, Lung, ComputingMilieux_MISCELLANEOUS, MESH: Respiration, Respiratory Distress Syndrome, MESH: Humans, Lung protection, business.industry, Respiration, 3. Good health, medicine.anatomical_structure, Anesthesia, MESH: Respiratory Distress Syndrome, Adult, business
Abstract

International audience

Published
2019
Full Text
View/download PDF

8. Receptor for advanced glycation end-products and ARDS prediction: a multicentre observational study

Author

Nathanael Eisenmann, Yvan Skrzypczak, Thierry Gillart, Thibaut Pranal, Vincent Sapin, Alexandre Lautrette, Bruno Pereira, Julien Pascal, Pauline Berthelin, Russell Chabanne, Matthieu Jabaudon, Laurence Roszyk, Bertrand Souweine, Sophie Cayot, Thomas Godet, Raiko Blondonnet, Loïc Blanchon, Jean-Michel Constantin, Corinne Belville, Jean-Sébastien Faure, CHU Clermont-Ferrand, Génétique, Reproduction et Développement (GReD), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Medical Biochemistry and Molecular Biology, CHU Clermont-Ferrand, Laboratoire de Biologie Moléculaire de la Cellule (LBMC), 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), Department of Perioperative Medicine, CHU Clermont-Ferrand, Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER, Unité de soins intensifs [Clermont Ferrand], CHU Clermont-Ferrand-Hôpital Gabriel Montpied, Service de Biochimie et Génétique Moléculaire [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], Institut de Chimie et Biochimie Moléculaires et Supramoléculaires (ICBMS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut de Chimie du CNRS (INC)-École Supérieure Chimie Physique Électronique de Lyon-Centre National de la Recherche Scientifique (CNRS), Service d'Anésthésie Réanimation [CHU Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], Retinoids, Development and Developmental Diseases (R2D2), Université d'Auvergne - Clermont-Ferrand I (UdA), Laboratoire de Biochimie, CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand], Université de Lyon-Université de Lyon-École Supérieure de Chimie Physique Électronique de Lyon (CPE)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), 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), and Jabaudon, Matthieu

Subjects
Male, ARDS, [SDV.MHEP.PHY] Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Receptor for Advanced Glycation End Products, lcsh:Medicine, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, 0302 clinical medicine, lcsh:Science, Prospective cohort study, MESH: Aged, Respiratory Distress Syndrome, education.field_of_study, Multidisciplinary, MESH: Middle Aged, MESH: Polymorphism, Single Nucleotide, Middle Aged, 3. Good health, Intensive Care Units, medicine.anatomical_structure, Cohort, Female, medicine.medical_specialty, Population, Single-nucleotide polymorphism, Polymorphism, Single Nucleotide, Article, 03 medical and health sciences, Intensive care, Internal medicine, medicine, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, Risk factor, education, Aged, Lung, MESH: Humans, business.industry, MESH: Receptor for Advanced Glycation End Products, lcsh:R, 030208 emergency & critical care medicine, medicine.disease, MESH: Male, 030228 respiratory system, MESH: Biomarkers, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, MESH: Respiratory Distress Syndrome, Adult, lcsh:Q, MESH: Intensive Care Units, business, MESH: Female, Biomarkers
Abstract

International audience; Acute respiratory distress syndrome (ARDS) prediction remains challenging despite available clinical scores. To assess soluble receptor for advanced glycation end-products (sRAGE), a marker of lung epithelial injury, as a predictor of ARDS in a high-risk population, adult patients with at least one ARDS risk factor upon admission to participating intensive care units (ICUs) were enrolled in a multicentre, prospective study between June 2014 and January 2015. Plasma sRAGE and endogenous secretory RAGE (esRAGE) were measured at baseline (ICU admission) and 24 hours later (day one). Four AGER candidate single nucleotide polymorphisms (SNPs) were also assayed because of previous reports of functionality (rs1800625, rs1800624, rs3134940, and rs2070600). The primary outcome was ARDS development within seven days. Of 500 patients enrolled, 464 patients were analysed, and 59 developed ARDS by day seven. Higher baseline and day one plasma sRAGE, but not esRAGE, were independently associated with increased ARDS risk. AGER SNP rs2070600 (Ser/Ser) was associated with increased ARDS risk and higher plasma sRAGE in this cohort, although confirmatory studies are needed to assess the role of AGER SNPs in ARDS prediction. These findings suggest that among at-risk ICU patients, higher plasma sRAGE may identify those who are more likely to develop ARDS. Acute respiratory distress syndrome (ARDS) still carries a high mortality rate 1,2 , and a major challenge in targeting the prevention and early treatment of ARDS is the inability to accurately predict which patients will develop the syndrome 3-6. The Lung Injury Prediction Score (LIPS) was developed to identify patients at high risk of developing ARDS; however, its positive predictive value is limited (0.14-0.23) 7. To improve prediction, one method may be to combine clinical data with plasma biomarkers that reflect the pathogenesis of ARDS such as angiopoietin-2 (Ang-2), a marker of lung endothelial injury 8. In contrast, the soluble receptor for advanced gly-cation end-products (sRAGE), a marker of lung epithelial injury 9 , may predict ARDS more accurately in selected at-risk patients, e.g. after cardiac surgery 10 , severe trauma 11 , or after major surgery 12. Soluble forms of RAGE (sRAGE) include the extracellular domain of membrane RAGE that is cleaved by proteinases 13 and endogenous secretory RAGE (esRAGE), among other forms produced by alternative splicing 14,15. sRAGE has good diagnostic value for ARDS and is associated with lung injury severity, the degree of lung epithelial injury, impaired alveolar fluid clearance, and prognosis in ARDS 16,17. Although it remains unclear whether esRAGE may be involved in ligand binding or may have any functional effects by itself, esRAGE levels were lower in the plasma and alveolar fluid from patients with ARDS than in mechanically ventilated controls without ARDS in a previous study 18. In addition, and although not yet ready for clinical use, genomic applications could facilitate better prediction

Published
2018
Full Text
View/download PDF

9. High frequency percussive ventilation increases alveolar recruitment in early acute respiratory distress syndrome: an experimental, physiological and CT scan study

Author

Thomas Godet, Emmanuel Futier, Matthieu Jabaudon, Bruno Pereira, Raiko Blondonnet, Jean-Michel Constantin, Jules Audard, Benjamin Rieu, J M Garcier, Aymeric Tremblay, CHU Clermont-Ferrand, Génétique, Reproduction et Développement (GReD), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Génétique, Reproduction et Développement (GReD ), 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]), Laboratoire de Biologie Moléculaire de la Cellule (LBMC), 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), Retinoids, Development and Developmental Diseases (R2D2), Université d'Auvergne - Clermont-Ferrand I (UdA), Université de Clermont-Ferrand, Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Institut de Chimie et Biochimie Moléculaires et Supramoléculaires (ICBMS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut de Chimie du CNRS (INC)-École Supérieure Chimie Physique Électronique de Lyon-Centre National de la Recherche Scientifique (CNRS), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), 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), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Université de Lyon-Université de Lyon-École Supérieure de Chimie Physique Électronique de Lyon (CPE)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), and BLANCHON, LOIC

Subjects
ARDS, MESH: Pulmonary Alveoli, medicine.medical_treatment, Hemodynamics, Hyperinflation, Critical Care and Intensive Care Medicine, MESH: Tidal Volume, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, 0302 clinical medicine, Mechanical ventilation, Medicine, Lung volumes, MESH: Animals, 030212 general & internal medicine, MESH: Swine, MESH: Aged, Respiratory Distress Syndrome, MESH: Statistics, Nonparametric, MESH: Middle Aged, Acute respiratory distress syndrome, lcsh:Medical emergencies. Critical care. Intensive care. First aid, respiratory system, medicine.anatomical_structure, Lung morphology, Breathing, Cardiology, MESH: Tomography, X-Ray Computed, medicine.medical_specialty, Alveolar recruitment, MESH: Arterial Pressure, MESH: Blood Gas Analysis, High-Frequency Ventilation, 03 medical and health sciences, Internal medicine, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, MESH: Lung, MESH: High-Frequency Ventilation, Lung, MESH: Humans, business.industry, Research, 030208 emergency & critical care medicine, Oxygenation, lcsh:RC86-88.9, medicine.disease, Respiration, Artificial, Alveolar hyperinflation, MESH: Male, MESH: Prospective Studies, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, MESH: Respiratory Distress Syndrome, Adult, High frequency percussive ventilation, MESH: Disease Models, Animal, business, MESH: Female
Abstract

Background High frequency percussive ventilation (HFPV) combines diffusive (high frequency mini-bursts) and convective ventilation patterns. Benefits include enhanced oxygenation and hemodynamics, and alveolar recruitment, while providing hypothetic lung-protective ventilation. No study has investigated HFPV-induced changes in lung aeration in patients with early acute respiratory distress syndrome (ARDS). Methods Eight patients with early non-focal ARDS were enrolled and five swine with early non-focal ARDS were studied in prospective computed tomography (CT) scan and animal studies, in a university-hospital tertiary ICU and an animal laboratory. Patients were optimized under conventional “open-lung” ventilation. Lung CT was performed using an end-expiratory hold (Conv) to assess lung morphology. HFPV was applied for 1 hour to all patients before new CT scans were performed with end-expiratory (HFPV EE) and end-inspiratory (HFPV EI) holds. Lung volumes were determined after software analysis. At specified time points, blood gases and hemodynamic data were collected. Recruitment was defined as a change in non-aerated lung volumes between Conv, HFPV EE and HFPV EI. The main objective was to verify whether HFPV increases alveolar recruitment without lung hyperinflation. Correlation between pleural, upper airways and HFPV-derived pressures was assessed in an ARDS swine-based model. Results One-hour HFPV significantly improved oxygenation and hemodynamics. Lung recruitment significantly rose by 12.0% (8.5–18.0%), P = 0.05 (Conv-HFPV EE) and 12.5% (9.3–16.8%), P = 0.003 (Conv-HFPV EI). Hyperinflation tended to increase by 2.0% (0.5–2.5%), P = 0.89 (Conv-HFPV EE) and 3.0% (2.5–4.0%), P = 0.27 (Conv-HFPV EI). HFPV hyperinflation correlated with hyperinflated and normally-aerated lung volumes at baseline: r = 0.79, P = 0.05 and r = 0.79, P = 0.05, respectively (Conv-HFPV EE); and only hyperinflated lung volumes at baseline: r = 0.88, P = 0.01 (Conv-HFPV EI). HFPV CT-determined tidal volumes reached 5.7 (1.1–8.1) mL.kg-1 of ideal body weight (IBW). Correlations between pleural and HFPV-monitored pressures were acceptable and end-inspiratory pleural pressures remained below 25cmH20. Conclusions HFPV improves alveolar recruitment, gas exchanges and hemodynamics of patients with early non-focal ARDS without relevant hyperinflation. HFPV-derived pressures correlate with corresponding pleural or upper airways pressures. Trial registration ClinicalTrials.gov, NCT02510105. Registered on 1 June 2015. The trial was retrospectively registered. Electronic supplementary material The online version of this article (doi:10.1186/s13054-017-1924-6) contains supplementary material, which is available to authorized users.

Published
2018
Full Text
View/download PDF

10. Reply to Riché et al.: Sevoflurane in Acute Respiratory Distress Syndrome: Are Lung Protection and Anesthesia Depth Influenced by Pulmonary Morphology?

Author

Matthieu Jabaudon, Raiko Blondonnet, Jean-Michel Constantin, Thomas Godet, Emmanuel Futier, Jean-Etienne Bazin, Retinoids, Development and Developmental Diseases (R2D2), Université d'Auvergne - Clermont-Ferrand I (UdA), 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), Laboratoire de Biologie Moléculaire de la Cellule (LBMC), École normale supérieure de Lyon (ENS de 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), Génétique, Reproduction et Développement (GReD ), Service de Médecine Intensive et Réanimation [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, CHU Clermont-Ferrand, Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, 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, Pilot Projects, Acute respiratory distress, Critical Care and Intensive Care Medicine, MESH: Anesthesia, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Sevoflurane, 03 medical and health sciences, 0302 clinical medicine, MESH: Sevoflurane, medicine, Humans, MESH: Lung, Anesthesia, Lung, ComputingMilieux_MISCELLANEOUS, Respiratory Distress Syndrome, MESH: Humans, Lung protection, business.industry, 030208 emergency & critical care medicine, MESH: Pilot Projects, 3. Good health, 030228 respiratory system, MESH: Respiratory Distress Syndrome, Adult, business, medicine.drug
Abstract

International audience

Published
2017
Full Text
View/download PDF

11. TUMOR NECROSIS FACTOR IS NOT ASSOCIATED WITH INTESTINAL ISCHEMIA/REPERFUSION-INDUCED LUNG INFLAMMATION

Author

Fernando Rodrigues Coelho, Lily Li, Jian Li, Rodrigo Guabiraba, Bernhard Ryffel, B. Boris Vargaftig, Wothan Tavares-de-Lima, Alexandre Learth Soares, Mamdouh A. Kamal, Faculdade de Ciências Farmacêuticas de Ribeirão Preto [São Paulo], Universidade de São Paulo = University of São Paulo (USP), Immunologie et Embryologie Moléculaires (IEM), Université d'Orléans (UO)-Centre National de la Recherche Scientifique (CNRS), Therakos, Real time and interoperability (TRIO), INRIA Lorraine, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire Lorrain de Recherche en Informatique et ses Applications (LORIA), Institut National de Recherche en Informatique et en Automatique (Inria)-Université Henri Poincaré - Nancy 1 (UHP)-Université Nancy 2-Institut National Polytechnique de Lorraine (INPL)-Centre National de la Recherche Scientifique (CNRS)-Université Henri Poincaré - Nancy 1 (UHP)-Université Nancy 2-Institut National Polytechnique de Lorraine (INPL)-Centre National de la Recherche Scientifique (CNRS), Fondation de la Recherche Medical (F.R.M), PhenoTec AG, Immunis SA, Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP), FAPESP (02/06606-3 03/02271-0 04/14128-0), Conselho Nacional de Pesquisa, and Universidade de São Paulo (USP)

Subjects
Male, Chemokine, Neutrophils, medicine.medical_treatment, TNF, MESH: Chemotaxis, Leukocyte, MESH: Neutrophils, pulmonary inflammation, Critical Care and Intensive Care Medicine, MESH: Mice, Knockout, ischemic tissue injury, MESH: Antibodies, Monoclonal, Mice, 0302 clinical medicine, MESH: Peroxidase, MESH: Animals, Receptor, Lung, Mice, Knockout, MESH: Cytokines, Respiratory Distress Syndrome, 0303 health sciences, biology, MESH: Toll-Like Receptor 2, Antibodies, Monoclonal, MESH: Toll-Like Receptor 4, 3. Good health, Intestines, Chemotaxis, Leukocyte, medicine.anatomical_structure, Cytokine, Reperfusion Injury, Emergency Medicine, [SDV.IMM]Life Sciences [q-bio]/Immunology, Cytokines, Tumor necrosis factor alpha, medicine.symptom, MESH: Intestines, MESH: Pneumonia, Inflammation, Granulocyte, 03 medical and health sciences, MESH: Mice, Inbred C57BL, TLR, medicine, Animals, MESH: Lung, MESH: Mice, Peroxidase, 030304 developmental biology, Tumor Necrosis Factor-alpha, business.industry, 030208 emergency & critical care medicine, Pneumonia, MESH: Male, Toll-Like Receptor 2, Mice, Inbred C57BL, Toll-Like Receptor 4, TLR2, MESH: Tumor Necrosis Factor-alpha, Immunology, biology.protein, MESH: Respiratory Distress Syndrome, Adult, MESH: Reperfusion Injury, business
Abstract

Soares, Alexandre Learth Coelho, Fernando Rodrigues Guabiraba, Rodrigo Kamal, Mamdouh Vargaftig, B Boris Li, Lily Li, Jian Tavares-de-Lima, Wothan Ryffel, Bernhard Augusta, Ga. Shock. 2010 Sep;34(3):306-13. doi: 10.1097/SHK.0b013e3181cdc585.; International audience; Intestinal ischemia-reperfusion (I/R) injury may cause acute systemic and lung inflammation. Here, we revisited the role of TNF-alpha in an intestinal I/R model in mice, showing that this cytokine is not required for the local and remote inflammatory response upon intestinal I/R injury using neutralizing TNF-alpha antibodies and TNF ligand-deficient mice. We demonstrate increased neutrophil recruitment in the lung as assessed by myeloperoxidase activity and augmented IL-6, granulocyte colony-stimulating factor, and KC levels, whereas TNF-alpha levels in serum were not increased and only minimally elevated in intestine and lung upon intestinal I/R injury. Importantly, TNF-alpha antibody neutralization neither diminished neutrophil recruitment nor any of the cytokines and chemokines evaluated. In addition, the inflammatory response was not abrogated in TNF and TNF receptors 1 and 2-deficient mice. However, in view of the damage on the intestinal barrier upon intestinal I/R with systemic bacterial translocation, we asked whether Toll-like receptor (TLR) activation is driving the inflammatory response. In fact, the inflammatory lung response is dramatically reduced in TLR2/4-deficient mice, confirming an important role of TLR receptor signaling causing the inflammatory lung response. In conclusion, endogenous TNF-alpha is not or minimally elevated and plays no role as a mediator for the inflammatory response upon ischemic tissue injury. By contrast, TLR2/4 signaling induces an orchestrated cytokine/chemokine response leading to local and remote pulmonary inflammation, and therefore disruption of TLR signaling may represent an alternative therapeutic target.

Published
2010
Full Text
View/download PDF

12. Évolution de la fonction ventriculaire droite dans les 3 premiers jours d’un syndrome de détresse respiratoire aiguë : une étude pilote

Author

Le Bot Aubry, Alix, Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), and Cyril Charron

Subjects
Échocardiographie transoesophagienne, MESH: Echocardiography, transesophageal, SDRA, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, MESH: Cor pulmonale, Coeur pulmonaire aigu, MESH: Respiratory distress syndrome, adult, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Almost 30% of the patient with acute respiratory distress syndrome (ARDS) develop an acute cor pulmonale (ACP), pejorative prognostic factor. The hemodynamic monitoring by transesophageal echocardiography (TEE) of these patients enables to diagnose ACP and adapt the treatment to limit the hemodynamics consequences. The occurrence of this right dysfunction is unknown. The purpose of our study was to report the evolution of the right ventricule (RV) function during the early hours of ARDS with miniature and disposable TEE probe. Prospective observational study of current care in 3 intensive care units. A systematic evaluation was made at H0, H6, H12, H18, H36, H48, H60 and H72 after inclusion. RV dilatation, paradoxical septum, ACP, left ventricular dysfunction, and respiratory variation of superior vena cava were recorded The hemodynamic and respiratory settings and the blood gas were also recorded as well as treatment modifications after the TEE.Twenty-eight patients were included. There were 43% of patients with ACP, with a peak at 48 hours. 71% of the patients showed RV dilatation but it seems not related with the apparition of a ACP Around half of the patients benefit from treatment modifications after TEE evaluations. ACP occurrence is frequent and not predictable which justifies a repeated TEE monitoring in the early hours of severe ARDS to optimize treatment.; Près de 30% des patients en syndrome de détresse respiratoire aigu (SDRA) développent un cœur pulmonaire aigu (CPA), facteur pronostic péjoratif. Le monitorage hémodynamique par échocardiographie transoesophagienne (ETO) permet le diagnostic et l’adaptation des thérapeutiques afin d’en limiter les conséquences. La cinétique de cette dysfonction droite est peu connue. L’objectif de notre étude était de rapporter l’évolution de la fonction ventriculaire droite au cours des 3 premiers jours du SDRA à l’aide d’une sonde d’ETO à usage unique. Étude prospective observationnelle de soins courants sur 3 centres. Une évaluation systématique était faite à H0, H6, H12, H18, H36, H48, H60 et H72 suivant l’inclusion. Étaient notés la présence d’une dilatation du ventricule droit (VD), d’un septum paradoxal, d’un CPA, d’une dysfonction ventriculaire gauche et d’une variation respiratoire de la veine cave supérieure. Les paramètres hémodynamiques, respiratoires et gazométriques et les modifications thérapeutiques après l’ETO étaient notés.Vingt-huit patients ont été inclus. On retrouve 43% de CPA avec un pic à la 48e heure. La dilatation VD est retrouvée chez 71% des patients à un moment du suivi mais ne semble pas prédire la survenue d’un CPA. Environ 1 patient sur 2 a bénéficié de modification thérapeutique à l’issue des évaluations échocardiographiques. La survenue d’un CPA est fréquente et aléatoire à la phase initiale du SDRA sévère, et justifie un monitorage ETO répété pour optimisation thérapeutique.

Published
2015

13. Hepatitis E Virus Infection after Platelet Transfusion in an Immunocompetent Trauma Patient

Author

Thomas Decaens, Thibaut Trouve-Buisson, Jean François Payen, Patricia Pouzol, Emmanuelle Loyrion, Sylvie Larrat, Grenoble Institut des Neurosciences (GIN), Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département d'Hématologie, CHU Grenoble, Institut de biologie structurale (IBS - UMR 5075 ), Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut de Recherche Interdisciplinaire de Grenoble (IRIG), Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Neuro-imagerie fonctionnelle et métabolique (ANTE-INSERM U836, équipe 5), Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), [GIN] Grenoble Institut des Neurosciences (GIN), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut de Recherche Interdisciplinaire de Grenoble (IRIG), and Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Letter, Blood transfusion, Epidemiology, Opportunistic infection, MESH: Spleen, medicine.medical_treatment, viruses, opportunistic infection, lcsh:Medicine, 030204 cardiovascular system & hematology, medicine.disease_cause, jaundice, 0302 clinical medicine, Hepatitis E virus, Medicine, Platelet, MESH: Blood Platelets, [SDV.BBM.BS]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Structural Biology [q-bio.BM], MESH: Splenic Rupture, MESH: Cholecystitis, Acute, virus diseases, Jaundice, MESH: Ribs, 3. Good health, Infectious Diseases, trauma, 030211 gastroenterology & hepatology, medicine.symptom, Microbiology (medical), MESH: Antiviral Agents, MESH: Hepatitis E virus, injury, MESH: Shock, Septic, contaminated blood products, MESH: Blood Transfusion, hepatitis E virus, Hepatitis E Virus Infection after Platelet Transfusion in an Immunocompetent Trauma Patient, blood transfusion, MESH: Splenectomy, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, Cholestasis, MESH: Ribavirin, MESH: Platelet Transfusion, lcsh:RC109-216, Letters to the Editor, Genotyping, transfusion, MESH: Humans, business.industry, MESH: Hepatitis E, lcsh:R, MESH: Blood Donors, MESH: Adult, medicine.disease, immunocompetent, MESH: Male, digestive system diseases, Platelet transfusion, HEV, Immunology, MESH: Respiratory Distress Syndrome, Adult, platelet transfusion, business, cholestasis, MESH: Antibodies, Viral
Abstract

International audience; Hepatitis E virus (HEV) infection causes acute liver disease, but severe infections are rare in immunocompetent patients. We describe a case of HEV infection in a previously healthy male trauma patient in France who received massive transfusions. Genotyping confirmed HEV in a transfused platelet pool and the donor.

Published
2017
Full Text
View/download PDF

14. Syndrome de détresse respiratoire aiguë sur hémorragie intra-alvéolaire révélant une vascularite. [Acute respiratory distress syndrome related to intra-alveolar hemorrhage revealing a vasculitis]

Author

Kerjouan, Mallorie, Gacouin, Arnaud, Gros, A., Caulet Maugendre, S., Le Tulzo, Yves, Delaval, Philippe, Jouneau, Stéphane, Service de pneumologie [Rennes] = Pneumology [Rennes], CHU Pontchaillou [Rennes], Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], Service d'anatomopathologie [Rennes], and Hôpital Pontchaillou

Subjects
MESH: Humans, MESH: Middle Aged, MESH: Pulmonary Alveoli, Syndrome de détresse respiratoire aiguë, MESH: Vasculitis, MESH: Radiography, Thoracic, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Vascularite, MESH: Bronchial Diseases, Hémorragie intra-alvéolaire, MESH: Diagnosis, Differential, Lavage broncho-alvéolaire, MESH: Respiratory Distress Syndrome, Adult, MESH: Female, MESH: Hemorrhage
Abstract

International audience; Intra-alveolar hemorrhage (IAH) could be revealed by acute respiratory failure. The classic association of hemoptysis - anemia - radiological infiltrates is suggestive and has to be confirmed by broncho-alveolar lavage with Golde score. Etiologies included immune and non-immune diseases, with specific treatment for each. We report a case of IAH revealed by acute respiratory distress syndrome and anemia (3 g/dL), related to pulmonary and cerebral vasculitis without renal involvement. The patient was efficiently treated with corticosteroids and cyclophosphamide. This case highlights the critical role of BAL cytological analysis with Golde score, and the need for a rapid and accurate diagnosis in order to guide specific treatment. If histology is needed, renal biopsy even without renal involvement, or surgical lung biopsy is possible.

Published
2012
Full Text
View/download PDF

15. High levels of circulating leukocyte microparticles are associated with better outcome in acute respiratory distress syndrome

Author

Laurent Papazian, Laurence Camoin-Jau, Christophe Guervilly, Romaric Lacroix, Antoine Roch, Françoise Dignat-George, Jean-Marie Forel, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Physiopathologie de l'Endothelium, Vascular research center of Marseille (VRCM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), This study was funded by a grant from the Association pour le Développement des Recherches Biologiques et Médicales au CHU de Marseille (ADEREM)., INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), and BMC, Ed.

Subjects
Male, Pathology, ARDS, [SDV.MHEP.PHY] Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Gastroenterology, 0302 clinical medicine, Cell-Derived Microparticles, MESH: Cell-Derived Microparticles, Leukocytes, Platelet, MESH: Treatment Outcome, MESH: Aged, Respiratory Distress Syndrome, 0303 health sciences, MESH: Middle Aged, medicine.diagnostic_test, Middle Aged, Prognosis, MESH: Case-Control Studies, 3. Good health, Treatment Outcome, Biomarker (medicine), Arterial blood, Female, Bronchoalveolar Lavage Fluid, Adult, medicine.medical_specialty, MESH: Prognosis, MESH: Leukocytes, 03 medical and health sciences, Internal medicine, medicine, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, Survival rate, Aged, 030304 developmental biology, MESH: Humans, business.industry, MESH: Bronchoalveolar Lavage Fluid, Research, Case-control study, MESH: Biological Markers, MESH: Adult, medicine.disease, MESH: Male, Bronchoalveolar lavage, Case-Control Studies, MESH: Respiratory Distress Syndrome, Adult, business, MESH: Female, Biomarkers
Abstract

International audience; INTRODUCTION: The current study has addressed the presence and the cellular origin of microparticles (MP) isolated from bronchoalveolar lavage (BAL) fluid and from blood samples from patients with acute respiratory distress syndrome (ARDS). Their prognostic interest was also investigated. METHODS: Fifty-two patients were included within the first 24 hours of ARDS. They were compared to spontaneous breathing (SB) and ventilated control (VC) groups. Bronchoalveolar lavage (BAL) and blood samples were obtained on Day 1 and Day 3 in an ARDS group. Leukocyte microparticles (LeuMP), neutrophil microparticles (NeuMP), endothelial microparticles (EMP), and platelet microparticles (PMP) were measured in arterial blood and in BAL samples by flow cytometry. Mortality from all causes was recorded at Day 28. RESULTS: All MP subpopulations were detected in BAL. However, only LeuMP and NeuMP were elevated in ARDS patients compared to the SB group (P = 0.002 for both). Among ARDS patients, higher levels of LeuMP were detected in blood (Day 1) and in BAL (Day 3) in survivors as compared with the non survivors. Circulating LeuMP >60 elements/microliter detectable on Day 1 of ARDS, was associated with a higher survival rate (odds ratio, 5.26; 95% confidence interval, 1.10 to 24.99; P = 0.037). CONCLUSIONS: The identification of the cellular origin of microparticles at the onset of ARDS has identified LeuMP as a biomarker of prognostic significance. The higher levels of LeuMP in survivors could be associated with a protective role of this MP subpopulation. This hypothesis needs further investigations.

Published
2011
Full Text
View/download PDF

16. An updated study-level meta-analysis of randomised controlled trials on proning in ARDS and acute lung injury

Author

Laurent Brochard, Fekri Abroug, Islem Ouanes, Lamia Ouanes-Besbes, Fahmi Dachraoui, ICU, Université de Monastir - University of Monastir (UM)-CHU Fattouma Bourguiba [Monastir] (HFB), INSERM U955, équipe 13, Service d'anesthésie-réanimation SAMU94-SMUR94 [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, and BMC, Ed.

Subjects
ARDS, Time Factors, Supine position, [SDV.MHEP.PHY] Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Critical Care and Intensive Care Medicine, law.invention, Prone ventilation, 0302 clinical medicine, Risk Factors, law, MESH: Risk Factors, Supine Position, Hospital Mortality, MESH: Respiration, Artificial, Randomized Controlled Trials as Topic, MESH: Treatment Outcome, Respiratory Distress Syndrome, MESH: Patient Positioning, Intensive care unit, 3. Good health, Intensive Care Units, Prone position, Treatment Outcome, MESH: Supine Position, Number needed to treat, medicine.medical_specialty, Acute Lung Injury, Lung injury, Patient Positioning, 03 medical and health sciences, Prone Position, medicine, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, MESH: Hospital Mortality, Intensive care medicine, MESH: Humans, business.industry, Research, MESH: Time Factors, MESH: Acute Lung Injury, 030208 emergency & critical care medicine, Odds ratio, MESH: Prone Position, medicine.disease, Respiration, Artificial, MESH: Randomized Controlled Trials as Topic, 030228 respiratory system, Emergency medicine, MESH: Respiratory Distress Syndrome, Adult, MESH: Intensive Care Units, business
Abstract

International audience; INTRODUCTION: In patients with acute lung injury (ALI) and/or acute respiratory distress syndrome (ARDS), recent randomised controlled trials (RCTs) showed a consistent trend of mortality reduction with prone ventilation. We updated a meta-analysis on this topic. METHODS: RCTs that compared ventilation of adult patients with ALI/ARDS in prone versus supine position were included in this study-level meta-analysis. Analysis was made by a random-effects model. The effect size on intensive care unit (ICU) mortality was computed in the overall included studies and in two subgroups of studies: those that included all ALI or hypoxemic patients, and those that restricted inclusion to only ARDS patients. A relationship between studies' effect size and daily prone duration was sought with meta-regression. We also computed the effects of prone positioning on major adverse airway complications. RESULTS: Seven RCTs (including 1,675 adult patients, of whom 862 were ventilated in the prone position) were included. The four most recent trials included only ARDS patients, and also applied the longest proning durations and used lung-protective ventilation. The effects of prone positioning differed according to the type of study. Overall, prone ventilation did not reduce ICU mortality (odds ratio = 0.91, 95% confidence interval = 0.75 to 1.2; P = 0.39), but it significantly reduced the ICU mortality in the four recent studies that enrolled only patients with ARDS (odds ratio = 0.71; 95% confidence interval = 0.5 to 0.99; P = 0.048; number needed to treat = 11). Meta-regression on all studies disclosed only a trend to explain effect variation by prone duration (P = 0.06). Prone positioning was not associated with a statistical increase in major airway complications. CONCLUSIONS: Long duration of ventilation in prone position significantly reduces ICU mortality when only ARDS patients are considered.

Published
2011
Full Text
View/download PDF

17. Year in review in Intensive Care Medicine, 2008: II. Experimental, acute respiratory failure and ARDS, mechanical ventilation and endotracheal intubation

Author

Jean Chastre, Jordi Mancebo, Duncan MacRae, Daniel De Backer, Marc Bonten, Herwig Gerlach, Haibo Zhang, Giorgio Conti, Giuseppe Citerio, Elie Azoulay, Salvatore Maurizio Maggiore, Jérôme Pugin, François Lemaire, Philipp Metnitz, Massimo Antonelli, Göran Hedenstierna, Alexandre Mebazaa, Jan Wernerman, Johan Groeneveld, Department of Intensive Care and Anesthesiology, Università cattolica del Sacro Cuore [Milano] (Unicatt), Service de réanimation médicale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Department of Medical Microbiology Julius Center for Health Sciences and Primary Care, University Medical Center [Utrecht], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Neurointensive Care Unit, Ospedale S. Gerardo, Service des Soins Intensifs, Hôpital Erasme [Bruxelles] (ULB), Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB)-Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Department of Anesthesiology, Intensive Care Medicine, and Pain Management, Vivantes-Klinikum Neukoelln, Intensive Care Medicine Unit, Free University Medical Centre, Department of Clinical Physiology, Uppsala University, Pediatric Intensive Care Unit, Royal Brompton Hospital, Hospital de la Santa Creu i Sant Pau, Service d'anesthésie - réanimation, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Department of Anesthesiology and General Intensive Care, University Hospital of Vienna, University Hospital of Geneva, Department of Anesthesiology and Intensive Care Medicine, Karolinska Institutet [Stockholm], Interdepartmental Division of Critical Care Medicine, University of Toronto, Vesin, Aurélien, Intensive care medicine, ICaR - Ischemia and repair, Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Antonelli, M, Azoulay, E, Bonten, M, Chastre, J, Citerio, G, Conti, G, De Backer, D, Lemaire, F, Gerlach, H, Groeneveld, J, Hedenstierna, G, Macrae, D, Mancebo, J, Maggiore, S, Mebazaa, A, Metnitz, P, Pugin, J, Wernerman, J, and Zhang, H

Subjects
Resuscitation, ARDS, medicine.medical_treatment, Critical Care and Intensive Care Medicine, Hypoxia-Ischemia, Brain/epidemiology, 0302 clinical medicine, Intubation, Respiratory Insufficiency/*diagnosis/epidemiology/*therapy, Sepsis/epidemiology, MESH: Respiration, Artificial, MESH: Sepsis, ComputingMilieux_MISCELLANEOUS, Respiratory Distress Syndrome, Intensive Care/*methods, ddc:617, Lung Injury, 3. Good health, Reperfusion Injury, Hypoxia-Ischemia, Brain, Acute Disease, MESH: Lung Injury, MESH: Acute Disease, Respiratory Insufficiency, Human, medicine.medical_specialty, Critical Care, Sepsi, Lung injury, Sepsis, 03 medical and health sciences, Intensive care, Anesthesiology, medicine, Intubation, Intratracheal, Humans, MESH: Intensive Care, Intensive care medicine, Lung Injury/epidemiology/therapy, Mechanical ventilation, MESH: Humans, MESH: Intubation, Intratracheal, business.industry, Reperfusion Injury/epidemiology, Intensive Care, Respiratory Distress Syndrome, Adult, Year in Review 2008, 030208 emergency & critical care medicine, medicine.disease, Respiration, Artificial, Intubation, Intratracheal/*methods, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Respiratory Distress Syndrome, Adult, MESH: Hypoxia-Ischemia, Brain, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Respiratory Distress Syndrome, Adult/epidemiology/physiopathology/*therapy, MESH: Reperfusion Injury, business, Respiration, Artificial/*methods, MESH: Respiratory Insufficiency
Abstract

Year in review in Intensive Care Medicine, 2008 : II. Experimental, acute respiratory failure and ARDS, mechanical ventilation and endotracheal intubation

Published
2009
Full Text
View/download PDF

18. Combination of two antibody fragments F(ab')(2)/Fab: an alternative for scorpion envenoming treatment

Author

Fatima Laraba-Djebari, Marie-France Martin-Eauclaire, Djelila Hammoudi-Triki, Sassia Sami-Merah, Ingénierie des protéines (IP), Université de la Méditerranée - Aix-Marseille 2-Centre National de la Recherche Scientifique (CNRS), Centre de recherche en neurobiologie - neurophysiologie de Marseille (CRN2M), and Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, MESH: Immunotherapy, medicine.medical_treatment, Venom, Scorpion stings, MESH: Amino Acid Sequence, medicine.disease_cause, MESH: Cross Reactions, MESH: Scorpion Venoms, Immunology and Allergy, MESH: Immune Sera, MESH: Animals, Leukocytosis, Respiratory Distress Syndrome, 0303 health sciences, MESH: Proteomics, 030302 biochemistry & molecular biology, MESH: Chromatography, Gel, 3. Good health, MESH: Immunoglobulin Fab Fragments, MESH: Antigens, Immunotherapy, Antibody, medicine.symptom, MESH: Rats, Androctonus australis, Immunology, Scorpion, Scorpion Venoms, Biology, Scorpions, MESH: Radioimmunoassay, Immunoglobulin Fab Fragments, 03 medical and health sciences, MESH: Mice, Inbred C57BL, biology.animal, medicine, Animals, Rats, Wistar, [SDV.BBM.BC]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Biochemistry [q-bio.BM], MESH: Chromatography, High Pressure Liquid, MESH: Mice, 030304 developmental biology, Pharmacology, MESH: Mass Spectrometry, MESH: Molecular Sequence Data, Toxin, MESH: Rats, Wistar, medicine.disease, biology.organism_classification, Molecular biology, MESH: Scorpions, MESH: Male, Rats, MESH: Heart Injuries, Disease Models, Animal, Heart Injuries, MESH: Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization, biology.protein, MESH: Respiratory Distress Syndrome, Adult, MESH: Disease Models, Animal
Abstract

International audience; Immunotherapy is the only effective treatment for scorpion stings. However the efficiency of this treatment varies depending on the forms of the antibodies and route of administration used. The antibodies are mostly injected as F(ab )(2) fragments. In this study, we investigated damage to the heart and lung tissue and the inflammatory response caused by Androctonus australis hector venom, its toxic fraction after molecular filtration or the isolated main alpha toxin (Aah II) in the presence or absence of different antibody molecules. A mixture of antibody fragments, F(ab )(2) and Fab, significantly reduced local leukocytosis, hemorrhage and inflammatory oedema induced by the A. australis hector venom and its toxins.

Published
2008
Full Text
View/download PDF

19. Circumstances of death in hospitalized patients and nurses' perceptions: French multicenter Mort-a-l'Hôpital survey

Author

Ferrand, Edouard, Jabre, Patricia, Vincent-Genod, Claire, Aubry, Régis, Badet, Michel, Badia, Philippe, Cariou, Alain, Ellien, Françoise, Gounant, Valérie, Gil, Roger, Jaber, Samir, Jay, Sylvie, Paillaud, Elena, Poulain, Philippe, Regnier, Bernard, Reignier, Jean, Socie, Gérard, Tardy, Bernard, Lemaire, François, Brun-Buisson, Christian, Marty, Jean, Renseigné, Non, Institut de Mathématiques de Jussieu (IMJ), Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Laboratoire d'Informatique pour l'Entreprise et les Systèmes de Production (LIESP), Université Lumière - Lyon 2 (UL2)-École Centrale de Lyon (ECL), Université de Lyon-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA), General ICU, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Réseau SPES, Réseau Soins Palliatifs Essonne Sud, Service d'anesthésie et de réanimation B, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), IFP Energies nouvelles (IFPEN), Bioinformatique génomique et moléculaire ((U 726)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de réanimation médicale, Hôpital les oudaries, Unité d'hématologie et de transplantation, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Groupe de recherche sur la thrombose, pharmacologie des antithrombotiques et situations à risque (GRT), Université Jean Monnet - Saint-Étienne (UJM), Physiopathologie et Thérapeutiques Respiratoires, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), DAM Île-de-France (DAM/DIF), Direction des Applications Militaires (DAM), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Groupe de recherche sur la thrombose (GRT (EA 3065)), Université Jean Monnet [Saint-Étienne] (UJM), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7)

Subjects
Male, Attitude to Death, MESH: Loneliness, Attitude of Health Personnel, Resuscitation, MESH: Attitude of Health Personnel, MESH: Social Support, Pain, MESH: Hospitalization, Nursing Staff, Hospital, MESH: Analgesics, Opioid, MESH: Nursing Staff, Hospital, MESH: Cross-Sectional Studies, MESH: Health Surveys, Professional-Family Relations, MESH: Attitude to Death, Humans, Prospective Studies, MESH: Quality of Health Care, MESH: Professional-Family Relations, Aged, Quality of Health Care, MESH: Aged, Respiratory Distress Syndrome, MESH: Humans, Loneliness, Palliative Care, Social Support, Health Surveys, MESH: Male, MESH: Prospective Studies, Analgesics, Opioid, Hospitalization, MESH: France, Cross-Sectional Studies, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, MESH: Respiratory Distress Syndrome, Adult, Female, MESH: Palliative Care, France, MESH: Pain, MESH: Resuscitation, MESH: Female
Abstract

International audience; BACKGROUND: In developed countries at present, death mostly occurs in hospitals, but the circumstances and factors associated with the quality of organization and care surrounding death are not well described. METHODS: We designed a large multicenter cross-sectional study to analyze the setting and clinical course of each patient on the day of death. We included 2750 clinical departments of 294 hospitals. Of these, 1033 departments (37.6%) of 200 hospitals (68.0%) contributed to the Mort-a-l'Hôpital survey. Data were collected prospectively by the bedside nurse of each patient within 10 days of the occurrence of death. Main outcome measures included circumstances of death in hospitalized patients; secondary outcomes, nurses' perceptions of quality of end-of-life care. RESULTS: Of the 1033 participating departments, 420 recorded no deaths during the study period and 613 declared at least 1 death. In the 3793 patients who died and were included for assessment, only 925 (24.4%) had loved ones present at the time of death; 70.1% had respiratory distress during the period before death; and only 12.0% were in pain. Written protocols for end-of-life care were available in 12.2% of participating departments. Only 35.1% of nurses judged the quality of dying and death acceptable for themselves. Principal factors significantly associated with this perception were availability of a written protocol for end-of-life care, anticipation of death, informing the family, surrogate designation, adequate control of pain, presence of family or friends at the time of death, and staff meeting with the family after the death. CONCLUSIONS: This large prospective study identifies nonoptimal circumstances of death for hospitalized patients and a number of suggestions for improvement. A combination of factors reflected in the nurses' satisfaction may improve the quality of end-of-life care.

Published
2008
Full Text
View/download PDF

20. Monitoring the capillary-alveolar leakage in an A.R.D.S. model using broncho-alveolar lavage

Author

Sam Bayat, Jean-Louis Martiel, Francis Grimbert, Raphaël Briot, Daniel Anglade, Martiel, Jean-Louis, Physiologie cardio-Respiratoire Expérimentale Théorique et Appliquée (TIMC-IMAG-PRETA), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), TIMB, and VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)

Subjects
MESH: Bronchoscopes, MESH: Pulmonary Alveoli, Physiology, Capillary action, MESH: Extravascular Lung Water, 030204 cardiovascular system & hematology, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Bronchoalveolar Lavage, MESH: Dogs, chemistry.chemical_compound, 0302 clinical medicine, MESH: Proteins, MESH: Animals, MESH: Dextrans, Respiratory Distress Syndrome, MESH: Bronchoalveolar Lavage, Dextrans, respiratory system, Dextran, medicine.anatomical_structure, Bronchoscopes, Anesthesia, Cuff, Cardiology and Cardiovascular Medicine, Fluorescein-5-isothiocyanate, Models, Biological, Broncho-alveolar lavage, 03 medical and health sciences, MESH: Fluorescein-5-isothiocyanate, Dogs, In vivo, Physiology (medical), medicine, Animals, Molecular Biology, MESH: Capillaries, Lung, business.industry, MESH: Oleic Acid, MESH: Models, Biological, Proteins, respiratory tract diseases, Capillaries, Pulmonary Alveoli, Disease Models, Animal, 030228 respiratory system, chemistry, Permeability (electromagnetism), Extravascular Lung Water, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, MESH: Respiratory Distress Syndrome, Adult, MESH: Disease Models, Animal, Nuclear medicine, business, Oleic Acid
Abstract

International audience; OBJECTIVES: We developed a modified broncho-alveolar lavage (BAL) technique in order to perform repeated measurements of capillary-alveolar leakage of a macromolecule in oleic acid (OA)-induced lung injury. METHODS: BAL was performed in anesthetized dogs in a closed lung sampling site, using a bronchoscope fitted with an inflatable cuff. Fluorescein-labeled Dextran (FITC-D70) was continuously infused and its concentration measured in plasma and BAL fluid. A two-compartment model (blood and alveoli) was used to calculate K(AB), the transport-rate coefficient of FITC-D70 from blood to alveoli. K(AB) was estimated every 15 minutes over three hours. RESULTS: K(AB), close to zero at base-line both in control (n = 3) and in OA-injured lungs (n = 7), reached a peak in permeability 30 minutes after the induction of OA injury (K(AB) = 1.43 +/- 0.31 . 10(- 3) . minutes(- 1)), followed by a slow recovery. CONCLUSIONS: We conclude that this technique allows the monitoring of capillary-alveolar transport of macromolecules in in vivo experimental models. This monitoring may prove useful to study the mechanisms of the exudative stage of acute lung injury and to test therapies aimed at slowing the alveolar accumulation of plasma proteins and procoagulant factors that contribute to alveolar fibrosis.

Published
2008
Full Text
View/download PDF

21. IL-1R1/MyD88 signaling and the inflammasome are essential in pulmonary inflammation and fibrosis in mice

Author

Sabine Charron, Vincent Lagente, Caroline Mary, Nicolas Noulin, Shizuo Akira, Isabelle Couillin, Bernhard Ryffel, Valérie F. J. Quesniaux, Silvia Schnyder-Candrian, Isabelle Guenon, Bruno Schnyder, Paméla Gasse, Immunologie et Embryologie Moléculaires (IEM), Université d'Orléans (UO)-Centre National de la Recherche Scientifique (CNRS), Détoxication et réparation tissulaire, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Biomedical Research Foundation (SBF), SBF, Matzingen, Switzerland, Department of Host Defense, Osaka University [Osaka], Centre de Recherche Claude Delorme [Jouy-en-Josas] (CRCD), Air Liquide [Siège Social], Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
MESH: Signal Transduction, MESH: Receptors, Interleukin-1 Type I, Pulmonary Fibrosis, Interleukin-1beta, MESH: Mice, Knockout, MESH: Recombinant Proteins, Mice, chemistry.chemical_compound, 0302 clinical medicine, Fibrosis, MESH: Interleukin-1beta, Pulmonary fibrosis, MESH: Animals, MESH: Sialoglycoproteins, MESH: Bone Marrow Transplantation, Bone Marrow Transplantation, Mice, Knockout, Lymphokines, Respiratory Distress Syndrome, 0303 health sciences, Antibiotics, Antineoplastic, Inflammasome, General Medicine, respiratory system, Recombinant Proteins, MESH: Bleomycin, 3. Good health, MESH: Interleukin 1 Receptor Antagonist Protein, medicine.anatomical_structure, 030220 oncology & carcinogenesis, [SDV.IMM]Life Sciences [q-bio]/Immunology, medicine.symptom, Signal transduction, Signal Transduction, Research Article, medicine.drug, MESH: Myeloid Differentiation Factor 88, MESH: Transplantation Chimera, MESH: Pneumonia, Sialoglycoproteins, Inflammation, Biology, Lung injury, Bleomycin, 03 medical and health sciences, medicine, Animals, Humans, MESH: Antibiotics, Antineoplastic, MESH: Mice, 030304 developmental biology, Receptors, Interleukin-1 Type I, Transplantation Chimera, Lung, MESH: Lymphokines, MESH: Humans, MESH: Pulmonary Fibrosis, MESH: Chronic Disease, Interleukin-8, Pneumonia, medicine.disease, respiratory tract diseases, MESH: Interleukin-8, Disease Models, Animal, Interleukin 1 Receptor Antagonist Protein, chemistry, Chronic Disease, Myeloid Differentiation Factor 88, Immunology, MESH: Respiratory Distress Syndrome, Adult, MESH: Disease Models, Animal
Abstract

The molecular mechanisms of acute lung injury resulting in inflammation and fibrosis are not well established. Here we investigate the roles of the IL-1 receptor 1 (IL-1R1) and the common adaptor for Toll/IL-1R signal transduction, MyD88, in this process using a murine model of acute pulmonary injury. Bleomycin insult results in expression of neutrophil and lymphocyte chemotactic factors, chronic inflammation, remodeling, and fibrosis. We demonstrate that these end points were attenuated in the lungs of IL-1R1- and MyD88-deficient mice. Further, in bone marrow chimera experiments, bleomycin-induced inflammation required primarily MyD88 signaling from radioresistant resident cells. Exogenous rIL-1beta recapitulated a high degree of bleomycin-induced lung pathology, and specific blockade of IL-1R1 by IL-1 receptor antagonist dramatically reduced bleomycin-induced inflammation. Finally, we found that lung IL-1beta production and inflammation in response to bleomycin required ASC, an inflammasome adaptor molecule. In conclusion, bleomycin-induced lung pathology required the inflammasome and IL-1R1/MyD88 signaling, and IL-1 represented a critical effector of pathology and therapeutic target of chronic lung inflammation and fibrosis.

Published
2007
Full Text
View/download PDF

22. Year in review in Intensive Care Medicine, 2006. II. Infections and sepsis, haemodynamics, elderly, invasive and noninvasive mechanical ventilation, weaning, ARDS

Author

Christian Richard, Philipp Metnitz, Elie Azoulay, Daniel De Backer, Herwig Gerlach, Laurent Brochard, Peter J. D. Andrews, Geoffrey J. Dobb, Jérôme Pugin, Jordi Mancebo, Massimo Antonelli, Christian Brun-Buisson, Jean-Yves Fagon, Stefano Nava, Johan Groeneveld, Duncan Macrae, Michael R. Pinsky, Peter Radermacher, Intensive Care Medicine Unit, Western General Hospital, Service de réanimation médicale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Department of Intensive Care and Anesthesiology, Università cattolica del Sacro Cuore [Milano] (Unicatt), Fonctions Cellulaires et Moleculaires de l'Appareil Respiratoire et des Vaisseaux, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service des Soins Intensifs, Hôpital Erasme [Bruxelles] (ULB), Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB)-Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB), Royal Perth Hospital, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Department of Anesthesiology, Intensive Care Medicine, and Pain Management, Vivantes-Klinikum Neukoelln, VUmc, Pediatric Intensive Care Unit, Royal Brompton Hospital, Hospital de la Santa Creu i Sant Pau, Department of Anesthesiology and General Intensive Care, University Hospital of Vienna, Fondazione S. Maugeri, University Hospital of Geneva, University of Pittsburgh Medical Center [Pittsburgh, PA, États-Unis] (UPMC), Department of Anesthesia, Universitätsklinikum Ulm - University Hospital of Ulm, Intensive Care Unit, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, and Vesin, Aurélien

Subjects
ARDS, MESH: Heart Arrest, medicine.medical_treatment, Respiratory Tract Diseases, Hemodynamics, MESH: Geriatrics, Critical Care and Intensive Care Medicine, Severe Acute Respiratory Syndrome, 0302 clinical medicine, MESH: Sepsis, ComputingMilieux_MISCELLANEOUS, MESH: Aged, Respiratory Distress Syndrome, Pulmonary Arterial Hypertension, Year in review, Acute Respiratory Distress Syndrome Patient, 3. Good health, MESH: Communicable Diseases, Ventilator Weaning, medicine.medical_specialty, Critical Care, Pain medicine, Communicable Diseases, Sepsis, 03 medical and health sciences, Anesthesiology, medicine, Weaning, Humans, MESH: Intensive Care, Intensive care medicine, Intensive Care Unit Patient, Medical Emergency Team, Aged, Mechanical ventilation, MESH: Humans, business.industry, 030208 emergency & critical care medicine, MESH: Ventilator Weaning, medicine.disease, Heart Arrest, Year in Review 2006, 030228 respiratory system, Geriatrics, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Respiratory Distress Syndrome, Adult, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Respiratory Tract Diseases, business
Abstract

This review summarizes all articles published in Intensive Care Medicine in 2006, grouped by specific topic.

Published
2007
Full Text
View/download PDF

23. Effect of surfactant on pulmonary expression of type IIA PLA(2) in an animal model of acute lung injury

Author

Lhousseine Touqui, Yong-Zheng Wu, Mounia Alaoui-El-Azher, Françoise Thouron, Monique Singer, Défense innée et inflammation, Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur [Paris], Y. Wu was supported by the Institut National de la Santé et de la Recherche Médicale (poste vert), We are grateful to B. B. Vargaftig and A. Brody for critically reading and commenting on the manuscript, Dr. J. Lefort for excellent technical assistance in measurement of Penh, and Dr. M. L. Watson (University of Bath, Bath, UK) for the gift of guinea pig recombinant TNF-α., Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Wu, Yongzheng

Subjects
Lipopolysaccharides, Male, Pathology, MESH: Macrophages, Alveolar, Physiology, Gene Expression, Cell Count, Pharmacology, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, 0302 clinical medicine, Pulmonary surfactant, MESH: Animals, Respiratory system, phospholipase, Lung, Phospholipids, 0303 health sciences, Respiratory Distress Syndrome, biology, Respiratory disease, lipopolysaccharide, MESH: Pulmonary Surfactants, 3. Good health, MESH: Group II Phospholipases A2, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Acute Disease, MESH: Acute Disease, MESH: Phospholipases A, Pulmonary alveolus, Bronchial Hyperreactivity, Bronchoalveolar Lavage Fluid, Pulmonary and Respiratory Medicine, medicine.medical_specialty, MESH: Pneumonia, MESH: Gene Expression, MESH: Biological Products, Guinea Pigs, Lung injury, Group II Phospholipases A2, Phospholipases A, MESH: Guinea Pigs, 03 medical and health sciences, Phospholipase A2, Physiology (medical), Macrophages, Alveolar, medicine, Animals, MESH: Lung, RNA, Messenger, 030304 developmental biology, MESH: RNA, Messenger, MESH: Phospholipids, Biological Products, business.industry, MESH: Bronchoalveolar Lavage Fluid, MESH: Cell Count, Tumor Necrosis Factor-alpha, MESH: Bronchial Hyperreactivity, Pulmonary Surfactants, Cell Biology, Pneumonia, medicine.disease, MESH: Male, A2alveolar macrophage, Disease Models, Animal, MESH: Tumor Necrosis Factor-alpha, Alveolar macrophage, biology.protein, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, MESH: Respiratory Distress Syndrome, Adult, MESH: Lipopolysaccharides, MESH: Disease Models, Animal, business
Abstract

We previously showed that the seminatural surfactant Curosurf inhibits the in vitro synthesis of secretory type IIA phospholipase A2 (sPLA2-IIA) in alveolar macrophages (AM). These cells are the main source of sPLA2-IIA in a guinea pig model of lipopolysaccharide (LPS)-induced acute lung injury (ALI). Here, we investigate the effect of Curosurf on the pulmonary synthesis of sPLA2-IIA in this ALI model. Our results showed that intratracheal administration of LPS (330 μg/kg) induced an increase in pulmonary expression of sPLA2-IIA, which was inhibited when animals received Curosurf (16 mg/guinea pig) 30 min or 8 h after LPS instillation. When AM were isolated from LPS-treated animals and cultured in conditioned medium, they expressed higher levels of sPLA2-IIA than AM from saline-treated animals. This ex vivo sPLA2-IIA expression was significantly reduced when guinea pigs received Curosurf 30 min after LPS instillation. Finally, we examined the effect of Curosurf on pulmonary inflammation measured 8 or 24 h after LPS administration. Curosurf instillation 30 min or 8 h after LPS reversed the increase in tumor necrosis factor-α expression, polymorphonuclear cell extravasation, and protein concentration in bronchoalveolar lavage fluids. Curosurf also decreased the bronchial reactivity induced by LPS. We conclude that Curosurf inhibits the pulmonary expression of sPLA2-IIA and exhibits palliative anti-inflammatory effects in an animal model of ALI.

Published
2002
Full Text
View/download PDF

24. Driving pressure and acute respiratory distress syndrome in critically ill patients

Author

Blondonnet, Raiko, Joubert, Elodie, Godet, Thomas, Berthelin, Pauline, Pranal, Thibaut, Roszyk, Laurence, Chabanne, Russell, Eisenmann, Nathanael, Lautrette, Alexandre, Belville, Corinne, Blanchon, Loïc, Sapin, Vincent, Jabaudon, Matthieu, Retinoids, Development and Developmental Diseases (R2D2), Université d'Auvergne - Clermont-Ferrand I (UdA), Génétique, Reproduction et Développement (GReD), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Clermont-Ferrand, Department of Perioperative Medicine, CHU Clermont-Ferrand, Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER, Génétique, Reproduction et Développement (GReD ), 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
MESH: Correlation of Data, MESH: Middle Aged, MESH: Humans, MESH: Adult, acute respiratory distress syndrome, driving pressure, mechanical ventilation, intensive care unit, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, MESH: Male, risk prediction, MESH: Positive-Pressure Respiration, MESH: Critical Care, MESH: Risk Factors, MESH: Critical Illness, MESH: Respiratory Distress Syndrome, Adult, MESH: Intensive Care Units, MESH: Respiration, Artificial, MESH: Risk Adjustment, MESH: Female
Abstract

International audience; Elevated driving pressure (ΔP) may be associated with increased risk of acute respiratory distress syndrome (ARDS) in patients admitted via the emergency department and with post-operative pulmonary complications in surgical patients. This study investigated the association of higher ΔP with the onset of ARDS in a high-risk, intensive care unit (ICU) population.

Published
1970
Full Text
View/download PDF

25. Distinct Biological Effects of Time-Controlled Adaptive Ventilation in Pulmonary and Extrapulmonary Acute Respiratory Distress Syndrome: 'One Small Step for Rats, One Giant Leap for Humans?'

Author

Jean-Michel Constantin, Matthieu Jabaudon, Raiko Blondonnet, CHU Clermont-Ferrand, Génétique, Reproduction et Développement (GReD), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), Retinoids, Development and Developmental Diseases (R2D2), Université d'Auvergne - Clermont-Ferrand I (UdA), Unité de soins intensifs [Clermont Ferrand], CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], and 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)

Subjects
MESH: Rats, Acute respiratory distress, Critical Care and Intensive Care Medicine, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, 03 medical and health sciences, 0302 clinical medicine, Animals, Humans, Medicine, MESH: Animals, MESH: Lung, 030212 general & internal medicine, MESH: Respiration, Artificial, Lung, ComputingMilieux_MISCELLANEOUS, Respiratory Distress Syndrome, MESH: Humans, business.industry, Respiration, Artificial, Rats, 3. Good health, 030228 respiratory system, Anesthesia, Breathing, MESH: Respiratory Distress Syndrome, Adult, business
Abstract

International audience

Published
1970
Full Text
View/download PDF

26. ARDS in patients with chest trauma: Better safe than sorry

Author

Matthieu Jabaudon, Raiko Blondonnet, Jean-Michel Constantin, CHU Clermont-Ferrand, Génétique, Reproduction et Développement (GReD), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), Retinoids, Development and Developmental Diseases (R2D2), Université d'Auvergne - Clermont-Ferrand I (UdA), Unité de soins intensifs [Clermont Ferrand], CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], and 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)

Subjects
ARDS, medicine.medical_specialty, Trauma networks, Thoracic Injuries, medicine.medical_treatment, Chest trauma, Critical Care and Intensive Care Medicine, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, 03 medical and health sciences, 0302 clinical medicine, Mechanical ventilation, Medicine, Humans, In patient, MESH: Respiration, Artificial, Intensive care medicine, ComputingMilieux_MISCELLANEOUS, MESH: Thoracic Injuries, MESH: Respiration, Respiratory Distress Syndrome, MESH: Humans, Acute respiratory distress syndrome, business.industry, Respiration, Prevention, 030208 emergency & critical care medicine, General Medicine, medicine.disease, Respiration, Artificial, Anesthesiology and Pain Medicine, 030228 respiratory system, MESH: Respiratory Distress Syndrome, Adult, business
Abstract

International audience

Published
1970
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results