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2. Comprehensive Assessment of Coronary Artery Disease in Sports-Related Sudden Cardiac Arrest

Author

Karam, Nicole, Pechmajou, Louis, Dumas, Florence, Bougouin, Wulfran, Sharifzadehgan, Ardalan, Beganton, Frankie, Bonnet, Guillaume, Jost, Daniel, Lamhaut, Lionel, Varenne, Olivier, Aubry, Pierre, Sideris, Georgios, Spaulding, Christian, Cariou, Alain, Marijon, Eloi, Jouven, Xavier, Adnet, F, Agostinucci, JM, Aissaoui-Balanant, N, Algalarrondo, V, Alla, F, Alonso, C, Amara, W, Annane, D, Antoine, C, Aubry, P, Azoulay, E, Beganton, F, Benhamou, D, Bougouin, W, Bruel, C, Brun Buisson, C, Bruneval, P, Cariou, A, Carli, P, Cerf, C, Chaib, A, Chastre, J, Cholley, B, Cohen, Y, Combes, A, Cornaglia, C, Coulaud, JM, Da Silva, D, Das, V, Deye, N, Dhonneur, G, Diehl, JL, Dinanian, S, Domanski, L, Dreyfuss, D, Duboc, D, Dubois-Rande, JL, Mansencal, N, Duchateau, FX, Duguet, A, Dumas, F, Empana, JP, Extramiana, F, Fartoukh, M, Fenioux, C, Fraisse, F, Gabbas, M, Gandjbakhch, E, Guidet, B, Halimi, F, Henry, P, Hidden Lucet, F, Jabre, P, Jacob, L, Joseph, L, Jost, D, Journois, D, Jouven, X, Karam, N, Lacotte, J, Lahlou-Laforet, K, Lamhaut, L, Lanceleur, A, Langeron, O, Lanoe, V, Lavergne, T, Lecarpentier, E, Leenhardt, A, Lellouche, N, Lemiale, V, Linval, F, Loeb, T, Ludes, B, Mansouri, N, Marijon, E, Marty, J, Maury, E, Maxime, V, Mekontso-Dessaps, A, Mira, JP, Misset, B, Monnet, X, Montalescot, G, Narayanan, K, Nicolas-Robin, A, Perier, MC, Piot, O, Plu, I, Revaux, F, Ricard, JD, Richard, C, Riou, B, Rouby, JJ, Santoli, F, Schortgen, F, Sharshar, T, Sideris, G, Similowski, T, Simon, A, Spaulding, C, Steg, G, Teboul, JL, Timsit, JF, Tourtier, JP, Tuppin, P, Ursat, C, Varenne, O, Vieillard-Baron, A, Voicu, S, Wahbi, K, Waldmann, V, and Wolff, M

Published
2018
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3. Infection control in the intensive care unit: expert consensus statements for SARS-CoV-2 using a Delphi method

Author

Nasa, P, Azoulay, E, Chakrabarti, A, Divatia, JV, Jain, R, Rodrigues, C, Rosenthal, VD, Alhazzani, W, Arabi, YM, Bakker, J, Bassetti, M, De Waele, J, Dimopoulos, G, Du, B, Einav, S, Evans, L, Finfer, S, Guerin, C, Hammond, NE, Jaber, S, Kleinpell, RM, Koh, Y, Kollef, M, Levy, MM, Machado, FR, Mancebo, J, Martin-Loeches, I, Mer, M, Niederman, MS, Pelosi, P, Perner, A, Peter, JV, Phua, J, Piquilloud, L, Pletz, MW, Rhodes, A, Schultz, MJ, Singer, M, Timsit, JF, Venkatesh, B, Vincent, JL, Welte, T, and Myatra, S

Abstract

During the current COVID-19 pandemic, health-care workers and uninfected patients in intensive care units (ICUs) are at risk of being infected with SARS-CoV-2 as a result of transmission from infected patients and health-care workers. In the absence of high-quality evidence on the transmission of SARS-CoV-2, clinical practice of infection control and prevention in ICUs varies widely. Using a Delphi process, international experts in intensive care, infectious diseases, and infection control developed consensus statements on infection control for SARS-CoV-2 in an ICU. Consensus was achieved for 31 (94%) of 33 statements, from which 25 clinical practice statements were issued. These statements include guidance on ICU design and engineering, health-care worker safety, visiting policy, personal protective equipment, patients and procedures, disinfection, and sterilisation. Consensus was not reached on optimal return to work criteria for health-care workers who were infected with SARS-CoV-2 or the acceptable disinfection strategy for heat-sensitive instruments used for airway management of patients with SARS-CoV-2 infection. Well designed studies are needed to assess the effects of these practice statements and address the remaining uncertainties.

Published
2022

5. Plasma pharmacokinetics of bedaquiline administered by nasogastric tube in an intensive care unit

Author

Sayagh F, Timsit Jf, Neuville M, Minh Patrick Lê, Sinnah F, Dang E, and Gilles Peytavin

Subjects
Adult, Male, Pulmonary and Respiratory Medicine, Antitubercular Agents, law.invention, Plasma, Young Adult, chemistry.chemical_compound, Pharmacokinetics, Oral administration, law, Moxifloxacin, Tuberculosis, Multidrug-Resistant, Humans, Medicine, Diarylquinolines, Ethambutol, medicine.diagnostic_test, business.industry, Intensive care unit, Intensive Care Units, Infectious Diseases, Pharmaceutical Preparations, chemistry, Therapeutic drug monitoring, Anesthesia, Bedaquiline, business, medicine.drug, Blood sampling
Abstract

We present the case of a 21-year-old man admitted to the intensive care unit with multi-organ failure due to multidrug-resistant tuberculosis (TB). TB treatment initially comprised moxifloxacin, ethambutol, linezolid and amikacin administered intravenously. Due to suspected moxifloxacin-induced liver injury, we stopped all fluoroquinolones and switched to bedaquiline (BDQ), which is only available in tablets for oral administration. Since our patient had to be fed through a nasogastric tube (NGT), BDQ was administered after being crushed and dissolved in water; drug pharmacokinetics were studied using repeated blood sampling. Therapeutic drug monitoring showed that BDQ was detectable in blood plasma with a trough concentration above the supposed efficacy threshold, suggesting that this molecule could be administered through NGT.

Published
2020
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8. Sudden Cardiac Arrest in Young Women

Author

Weizman, Orianne, primary, Sharifzadehgan, Ardalan, additional, Bougouin, Wulfran, additional, Narayanan, Kumar, additional, Tence, Noémie, additional, Dumas, Florence, additional, Waldmann, Victor, additional, Lamhaut, Lionel, additional, Jost, Daniel, additional, Wahbi, Karim, additional, Varenne, Olivier, additional, Garcia, Rodrigue, additional, Karam, Nicole, additional, Cariou, Alain, additional, Jouven, Xavier, additional, Marijon, Eloi, additional, Agostinucci, JM, additional, Algalarrondo, V, additional, Alla, F, additional, Alonso, C, additional, Amara, W, additional, Annane, D, additional, Antoine, C, additional, Aubry, P, additional, Azoulay, E, additional, Beganton, F, additional, Benhamou, D, additional, Billon, C, additional, Bougouin, W, additional, Boutet, J, additional, Bruel, C, additional, Bruneval, P, additional, Cariou, A, additional, Carli, P, additional, Casalino, E, additional, Cerf, C, additional, Chaib, A, additional, Cholley, B, additional, Cohen, Y, additional, Combes, A, additional, Coulaud, JM, additional, Crahes, M, additional, Da Silva, D, additional, Das, V, additional, Demoule, A, additional, Denjoy, I, additional, Deye, N, additional, Dhonneur, G, additional, Diehl, JL, additional, Dinanian, S, additional, Domanski, L, additional, Dreyfuss, D, additional, Duboc, D, additional, Dubois-Rande, JL, additional, Dumas, F, additional, Empana, JP, additional, Extramiana, F, additional, Fartoukh, M, additional, Fieux, F, additional, Gabbas, M, additional, Gandjbakhch, E, additional, Geri, G, additional, Guidet, B, additional, Halimi, F, additional, Henry, P, additional, Hidden Lucet, F, additional, Jabre, P, additional, Jacob, L, additional, Joseph, L, additional, Jost, D, additional, Jouven, X, additional, Karam, N, additional, Lacotte, J, additional, Lapostolle, F, additional, Lahlou-Laforet, K, additional, Lamhaut, L, additional, Lanceleur, A, additional, Langeron, O, additional, Lavergne, T, additional, Lecarpentier, E, additional, Leenhardt, A, additional, Lellouche, N, additional, Lemiale, V, additional, Lemoine, F, additional, Linval, F, additional, Loeb, T, additional, Ludes, B, additional, Maltret, A, additional, Mansencal, N, additional, Mansouri, N, additional, Marijon, E, additional, Marty, J, additional, Maury, E, additional, Maxime, V, additional, Megarbane, B, additional, Mekontso-Dessap, A, additional, Mira, JP, additional, Monnet, X, additional, Narayanan, K, additional, Ngoyi, N, additional, Perier, MC, additional, Piot, O, additional, Plaisance, P, additional, Plu, I, additional, Raux, M, additional, Revaux, F, additional, Ricard, JD, additional, Richard, C, additional, Riou, B, additional, Roussin, F, additional, Santoli, F, additional, Schortgen, F, additional, Sharifzadehgan, A, additional, Sideris, G, additional, Spaulding, C, additional, Teboul, JL, additional, Timsit, JF, additional, Tuppin, P, additional, Ursat, C, additional, Varenne, O, additional, Vieillard-Baron, A, additional, Voicu, S, additional, Wahbi, K, additional, and Waldmann, V, additional

Published
2021
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10. Outcome of SARS-CoV-2 infection linked to MAIT cell activation and cytotoxicity: evidence for an IL-18 dependent mechanism

Author

Flament, H., primary, Rouland, M., additional, Beaudoin, L., additional, Toubal, A., additional, Bertrand, L., additional, Lebourgeois, S., additional, Gouda, Z., additional, Rousseau, C., additional, Soulard, P., additional, Hurtado-Nedelec, M., additional, Luce, S., additional, Bailly, K., additional, Andrieu, M., additional, Boitard, C., additional, Vallet-Pichard, A., additional, Gautier, JF., additional, Ajzenberg, N., additional, Terrier, B., additional, Pene, F., additional, Ghosn, J., additional, Yazdanpanah, Y., additional, Visseaux, B., additional, Descamps, D., additional, Timsit, JF., additional, Monteiro, R.C., additional, and Lehuen, A., additional

Published
2020
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11. Impact of Coronary Lesion Stability on the Benefit of Emergent Percutaneous Coronary Intervention After Sudden Cardiac Arrest

Author

Pechmajou, Louis, primary, Marijon, Eloi, additional, Varenne, Olivier, additional, Dumas, Florence, additional, Beganton, Frankie, additional, Jost, Daniel, additional, Lamhaut, Lionel, additional, Lecarpentier, Eric, additional, Loeb, Thomas, additional, Agostinucci, Jean-Marc, additional, Sideris, Georgios, additional, Riant, Elisabeth, additional, Baudinaud, Pierre, additional, Hagege, Albert, additional, Bougouin, Wulfran, additional, Spaulding, Christian, additional, Cariou, Alain, additional, Jouven, Xavier, additional, Karam, Nicole, additional, Adnet, F, additional, Algalarrondo, V, additional, Alla, F, additional, Alonso, C, additional, Amara, W, additional, Annane, D, additional, Antoine, C, additional, Aubry, P, additional, Azoulay, E, additional, Benhamou, D, additional, Billon, C, additional, Boutet, J, additional, Bruel, C, additional, Bruneval, P, additional, Carli, P, additional, Casalino, E, additional, Cerf, C, additional, Chaib, A, additional, Cholley, B, additional, Cohen, Y, additional, Combes, A, additional, Coulaud, JM, additional, Crahes, M, additional, Da Silva, D, additional, Das, V, additional, Demoule, A, additional, Denjoy, I, additional, Derkenne, C, additional, Deye, N, additional, Dhonneur, G, additional, Diehl, JL, additional, Dinanian, S, additional, Domanski, L, additional, Dreyfuss, D, additional, Duboc, D, additional, Dubois-Rande, JL, additional, Empana, JP, additional, Extramiana, F, additional, Fartoukh, M, additional, Fieux, F, additional, Frattini, B, additional, Gabbas, M, additional, Gandjbakhch, E, additional, Geri, G, additional, Guidet, B, additional, Halimi, F, additional, Henry, P, additional, Hidden-Lucet, F, additional, Jabre, P, additional, Jacob, L, additional, Joseph, L, additional, Journois, D, additional, Lacotte, J, additional, Lahlou-Laforet, K, additional, Lanceleur, A, additional, Langeron, O, additional, Lavergne, T, additional, Leenhardt, A, additional, Lellouche, N, additional, Lemiale, V, additional, Lemoine, F, additional, Linval, F, additional, Ludes, B, additional, Maltret, A, additional, Mansencal, N, additional, Mansouri, N, additional, Marty, J, additional, Maury, E, additional, Maxime, V, additional, Megarbane, B, additional, Mekontso-Dessap, A, additional, Mira, JP, additional, Monnet, X, additional, Ngoyi, N, additional, Perier, MC, additional, Piot, O, additional, Plaisance, P, additional, Plu, I, additional, Prunet, B, additional, Raux, M, additional, Revaux, F, additional, Ricard, JD, additional, Richard, C, additional, Roussin, F, additional, Santoli, F, additional, Schortgen, F, additional, Sharifzadehgan, A, additional, Teboul, JL, additional, Timsit, JF, additional, Tuppin, P, additional, Ursat, C, additional, Vieillard-Baron, A, additional, Voicu, S, additional, Wahbi, K, additional, and Waldmann, V, additional

Published
2020
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12. Immune alterations during SARS-CoV-2-related acute respiratory distress syndrome

Author

Bouadma, Lila, primary, Wiedemann, Aurélie, additional, Patrier, Juliette, additional, Surénaud, Mathieu, additional, Wicky, Paul-Henri, additional, Foucat, Emile, additional, Diehl, Jean-Luc, additional, Hejblum, Boris P., additional, Sinnah, Fabrice, additional, Montmollin, Etienne de, additional, Lacabaratz, Christine, additional, Thiébaut, Rodolphe, additional, Timsit, JF, additional, and Lévy, Yves, additional

Published
2020
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20. Fate of manuscripts rejected by Intensive Care Medicine from 2013 to 2016: a follow-up analysis

Author

Citerio, G, Deutsch, E, Sala, E, Lavillonnière, M, Perner, A, Jaber, S, Timsit, J, Azoulay, E, Citerio G, Deutsch E, Sala E, Lavillonnière M, Perner A, Jaber S, Timsit JF, Azoulay E., Citerio, G, Deutsch, E, Sala, E, Lavillonnière, M, Perner, A, Jaber, S, Timsit, J, Azoulay, E, Citerio G, Deutsch E, Sala E, Lavillonnière M, Perner A, Jaber S, Timsit JF, and Azoulay E.

Published
2018

21. Optimizing the Design and Analysis of Clinical Trials for Antibacterials Against Multidrug-resistant Organisms: A White Paper From COMBACTE's STAT-Net

Author

Kraker, MEA, Sommer, H, de Velde, Femke, Gravestock, I, Weiss, E, McAleenan, A, Nikolakopoulos, S, Amit, O, Ashton, T, Beyersmann, J, Held, L, Lovering, AM, MacGowan, AP, Mouton, Johan, Timsit, JF, Wilson, D, Wolkewitz, M, Bettiol, E, Dane, A, Harbarth, S, Kraker, MEA, Sommer, H, de Velde, Femke, Gravestock, I, Weiss, E, McAleenan, A, Nikolakopoulos, S, Amit, O, Ashton, T, Beyersmann, J, Held, L, Lovering, AM, MacGowan, AP, Mouton, Johan, Timsit, JF, Wilson, D, Wolkewitz, M, Bettiol, E, Dane, A, and Harbarth, S

Published
2018

22. International ERS/ESICM/ESCMID/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia

Author

Torres, A, Niederman, MS, Chastre, J, Ewig, S, Fernandez-Vandellos, P, Hanberger, H, Kollef, M, Bassi, GL, Luna, CM, Martin-Loeches, I, Paiva, JA, Read, RC, Rigau, D, Timsit, JF, Welte, T, and Wunderink, R

Subjects
Respiratory Medicine and Allergy, Lungmedicin och allergi
Abstract

The most recent European guidelines and task force reports on hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) were published almost 10 years ago. Since then, further randomised clinical trials of HAP and VAP have been conducted and new information has become available. Studies of epidemiology, diagnosis, empiric treatment, response to treatment, new antibiotics or new forms of antibiotic administration and disease prevention have changed old paradigms. In addition, important differences between approaches in Europe and the USA have become apparent. The European Respiratory Society launched a project to develop new international guidelines for HAP and VAP. Other European societies, including the European Society of Intensive Care Medicine and the European Society of Clinical Microbiology and Infectious Diseases, were invited to participate and appointed their representatives. The Latin American Thoracic Association was also invited. A total of 15 experts and two methodologists made up the panel. Three experts from the USA were also invited (Michael S. Niederman, Marin Kollef and Richard Wunderink). Applying the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) methodology, the panel selected seven PICO (population-intervention-comparison-outcome) questions that generated a series of recommendations for HAP/VAP diagnosis, treatment and prevention.

Published
2017

23. The Intensive Care Global Study on Severe Acute Respiratory Infection (IC-GLOSSARI): a Multicenter, Multinational, 14-Day Inception Cohort Study

Author

Sakr, Y, Ferrer, R, Reinhart1, K, Beale, R, Rhodes, A, Moreno, R, Timsit, Jf, Brochard, L, Thompson, Bt, Rezende, E, Chiche, Jd, IC GLOSSARI Investigators15, ESICM Trials Group, Spadaro, Savino, and Volta, Carlo Alberto

Subjects
Pediatrics, medicine.medical_specialty, Outcome, Pneumonia, Severe acute respiratory infections, Intensive care, HSJ UCI, MEDLINE, Severe Acute Respiratory Syndrome/diagnosis, Hospital mortality, Critical Care and Intensive Care Medicine, Risk Assessment, Severity of Illness Index, NO, 03 medical and health sciences, 0302 clinical medicine, Severe acute respiratory infection, Risk Factors, Anesthesiology, Severity of illness, Medicine, 030212 general & internal medicine, Hospital Mortality, Prospective Studies, Prospective cohort study, Aged, business.industry, Severe Acute Respiratory Syndrome/microbiology, Age Factors, Severe Acute Respiratory Syndrome/mortality, 030208 emergency & critical care medicine, Severe Acute Respiratory Syndrome/therapy, INCEPTION COHORT, Intensive Care Units, business
Abstract

PURPOSE: In this prospective, multicenter, 14-day inception cohort study, we investigated the epidemiology, patterns of infections, and outcome in patients admitted to the intensive care unit (ICU) as a result of severe acute respiratory infections (SARIs). METHODS: All patients admitted to one of 206 participating ICUs during two study weeks, one in November 2013 and the other in January 2014, were screened. SARI was defined as possible, probable, or microbiologically confirmed respiratory tract infection with recent onset dyspnea and/or fever. The primary outcome parameter was in-hospital mortality within 60 days of admission to the ICU. RESULTS: Among the 5550 patients admitted during the study periods, 663 (11.9 %) had SARI. On admission to the ICU, Gram-positive and Gram-negative bacteria were found in 29.6 and 26.2 % of SARI patients but rarely atypical bacteria (1.0 %); viruses were present in 7.7 % of patients. Organ failure occurred in 74.7 % of patients in the ICU, mostly respiratory (53.8 %), cardiovascular (44.5 %), and renal (44.6 %). ICU and in-hospital mortality rates in patients with SARI were 20.2 and 27.2 %, respectively. In multivariable analysis, older age, greater severity scores at ICU admission, and hematologic malignancy or liver disease were independently associated with an increased risk of in-hospital death, whereas influenza vaccination prior to ICU admission and adequate antibiotic administration on ICU admission were associated with a lower risk. CONCLUSIONS: Admission to the ICU for SARI is common and associated with high morbidity and mortality rates. We identified several risk factors for in-hospital death that may be useful for risk stratification in these patients.

Published
2016

24. Determinants of Procedural Pain Intensity in the Intensive Care Unit The Europain (R) Study

Author

Puntillo, KA, Max, A, Timsit, JF, Vignoud, L, Chanques, G, Robleda, G, Roche-Campo, F, Mancebo, J, Divatia, JV, Soares, M, Ionescu, DC, Grintescu, I, Vasiliu, IL, Maggiore, SM, Rusinova, K, Owczuk, R, Egerod, I, Papathanassoglou, EDE, Kyranou, M, Joynt, GM, Burghi, G, Freebairn, RC, Ho, KM, Kaarlola, A, Gerritsen, RT, Kesecioglu, J, Sulaj, MMS, Norrenberg, M, Benoit, DD, Seha, MSG, Hennein, A, Periera, FJ, Benbenishty, JS, Abroug, F, Aquilina, A, Monte, JRC, An, YZ, and Azoulay, E

Subjects
symptom assessment, prevention, analgesia
Abstract

Rationale: Intensive careunit (ICU) patients undergo several diagnostic and therapeutic procedures every day. The prevalence, intensity, and risk factors of pain related to these procedures are not well known. Objectives: To assess self-reported procedural pain intensity versus baseline pain, examine pain intensity differences across procedures, and identify risk factors for procedural pain intensity. Methods: Prospective, cross-sectional, multicenter, multinational study of pain intensity associated with 12 procedures. Data were obtained from 3,851 patients who underwent 4,812 procedures in 192 ICUs in 28 countries. Measurements and Main Results: Pain intensity on a 0-10 numeric rating scale increased significantly from baseline pain during all procedures (P < 0.001). Chest tube removal, wound drain removal, and arterial line insertion were the three most painful procedures, with median pain scores of 5 (3-7), 4.5 (2-7), and 4 (2-6), respectively. By multivariate analysis, risk factors independently associated with greater procedural pain intensity were the specific procedure; opioid administration specifically for the procedure; preprocedural pain intensity; preprocedural pain distress; intensity of the worst pain on the same day, before the procedure; and procedure not performed by a nurse. A significant ICU effect was observed, with no visible effect of country because of its absorption by the ICU effect. Some of the risk factors became nonsignificant when each procedure was examined separately. Conclusions: Knowledge of risk factors for greater procedural pain intensity identified in this study may help clinicians select interventions that are needed to minimize procedural pain.

Published
2014

25. Year in review in Intensive Care Medicine 2014: III. Severe infections, septic shock, healthcare-associated infections, highly resistant bacteria, invasive fungal infections, severe viral infections, Ebola virus disease and paediatrics

Author

Timsit, JF, Perner, A, Bakker, Jan, Bassetti, M, Benoit, D, Cecconi, M, Curtis, JR, Doig, GS, Herridge, M, Jaber, S, Joannidis, M, Papazian, L, Peters, MJ, Singer, P, Smith, M, Soares, M, Torres, A, Vieillard-Baron, A, Citerio, G, Azoulay, E, Timsit, JF, Perner, A, Bakker, Jan, Bassetti, M, Benoit, D, Cecconi, M, Curtis, JR, Doig, GS, Herridge, M, Jaber, S, Joannidis, M, Papazian, L, Peters, MJ, Singer, P, Smith, M, Soares, M, Torres, A, Vieillard-Baron, A, Citerio, G, and Azoulay, E

Published
2015

26. Year in review in Intensive Care Medicine 2014: II. ARDS, airway management, ventilation, adjuvants in sepsis, hepatic failure, symptoms assessment and management, palliative care and support for families, prognostication, organ donation, outcome, organisation and research methodology

Author

Perner, A, Citerio, G, Bakker, Jan, Bassetti, M, Benoit, D, Cecconi, M, Curtis, JR, Doig, GS, Herridge, M, Jaber, S, Joannidis, M, Papazian, L, Peters, MJ, Singer, P, Smith, M, Soares, M, Torres, A, Vieillard-Baron, A, Timsit, JF, Azoulay, E, Perner, A, Citerio, G, Bakker, Jan, Bassetti, M, Benoit, D, Cecconi, M, Curtis, JR, Doig, GS, Herridge, M, Jaber, S, Joannidis, M, Papazian, L, Peters, MJ, Singer, P, Smith, M, Soares, M, Torres, A, Vieillard-Baron, A, Timsit, JF, and Azoulay, E

Published
2015

29. Diagnosis and management of temperature abnormality in ICUs: a EUROBACT investigators' survey

Author

Niven DJ, Laupland KB, Tabah A, Vesin A, Rello J, Koulenti D, Dimopoulos G, de Waele J, Timsit JF, and EUROBACT Investigators

Abstract

Although fever and hypothermia are common abnormal physical signs observed in patients admitted to intensive care units (ICU), little data exist on their optimal management. The objective of this study was to describe contemporary practices and determinants of management of temperature abnormalities among patients admitted to ICUs.

Published
2013

34. Determinants of procedural pain intensity in the intensive care unit. The Europain® study

Author

Puntillo, Ka, Max, A, Timsit, Jf, Vignoud, L, Chanques, G, Robleda, G, Roche Campo, F, Mancebo, J, Divatia, Jv, Soares, M, Ionescu, Dc, Grintescu, Im, Vasiliu, Il, Maggiore, Salvatore Maurizio, Rusinova, K, Owczuk, R, Egerod, I, Papathanassoglou, Ed, Kyranou, M, Joynt, Gm, Burghi, G, Freebairn, Rc, Ho, Km, Kaarlola, A, Gerritsen, Rt, Kesecioglu, J, Sulaj, Mm, Norrenberg, M, Benoit, Dd, Seha, M, Hennein, A, Periera, Fj, Benbenishty, J, Abroug, Fekri, Aquilina, A, Monte, Jr, An, Y, Azoulay, E., Puntillo, Ka, Max, A, Timsit, Jf, Vignoud, L, Chanques, G, Robleda, G, Roche Campo, F, Mancebo, J, Divatia, Jv, Soares, M, Ionescu, Dc, Grintescu, Im, Vasiliu, Il, Maggiore, Salvatore Maurizio, Rusinova, K, Owczuk, R, Egerod, I, Papathanassoglou, Ed, Kyranou, M, Joynt, Gm, Burghi, G, Freebairn, Rc, Ho, Km, Kaarlola, A, Gerritsen, Rt, Kesecioglu, J, Sulaj, Mm, Norrenberg, M, Benoit, Dd, Seha, M, Hennein, A, Periera, Fj, Benbenishty, J, Abroug, Fekri, Aquilina, A, Monte, Jr, An, Y, and Azoulay, E.

Abstract

RATIONALE: Intensive care unit (ICU) patients undergo several diagnostic and therapeutic procedures every day. The prevalence, intensity, and risk factors of pain related to these procedures are not well known. OBJECTIVES: To assess self-reported procedural pain intensity versus baseline pain, examine pain intensity differences across procedures, and identify risk factors for procedural pain intensity. METHODS: Prospective, cross-sectional, multicenter, multinational study of pain intensity associated with 12 procedures. Data were obtained from 3,851 patients who underwent 4,812 procedures in 192 ICUs in 28 countries. MEASUREMENTS AND MAIN RESULTS: Pain intensity on a 0-10 numeric rating scale increased significantly from baseline pain during all procedures (P < 0.001). Chest tube removal, wound drain removal, and arterial line insertion were the three most painful procedures, with median pain scores of 5 (3-7), 4.5 (2-7), and 4 (2-6), respectively. By multivariate analysis, risk factors independently associated with greater procedural pain intensity were the specific procedure; opioid administration specifically for the procedure; preprocedural pain intensity; preprocedural pain distress; intensity of the worst pain on the same day, before the procedure; and procedure not performed by a nurse. A significant ICU effect was observed, with no visible effect of country because of its absorption by the ICU effect. Some of the risk factors became nonsignificant when each procedure was examined separately. CONCLUSIONS: Knowledge of risk factors for greater procedural pain intensity identified in this study may help clinicians select interventions that are needed to minimize procedural pain. Clinical trial registered with www.clinicaltrials.gov (NCT 01070082)

Published
2014

35. Year in review in Intensive Care Medicine 2012. II: Pneumonia and infection, sepsis, coagulation, hemodynamics, cardiovascular and microcirculation, critical care organization, imaging, ethics and legal issues

Author

Antonelli, Massimo, Bonten, M, Cecconi, M, Chastre, J, Citerio, G, Conti, Giorgio, Curtis, Jr, Hedenstierna, G, Joannidis, M, Macrae, D, Maggiore, Salvatore Maurizio, Mancebo, J, Mebazaa, A, Preiser, Jc, Rocco, P, Timsit, Jf, Wernerman, J, Zhang, H., Antonelli, Massimo (ORCID:0000-0003-3007-1670), Conti, Giorgio (ORCID:0000-0002-8566-9365), Antonelli, Massimo, Bonten, M, Cecconi, M, Chastre, J, Citerio, G, Conti, Giorgio, Curtis, Jr, Hedenstierna, G, Joannidis, M, Macrae, D, Maggiore, Salvatore Maurizio, Mancebo, J, Mebazaa, A, Preiser, Jc, Rocco, P, Timsit, Jf, Wernerman, J, Zhang, H., Antonelli, Massimo (ORCID:0000-0003-3007-1670), and Conti, Giorgio (ORCID:0000-0002-8566-9365)

Published
2013

36. Year in review in Intensive Care Medicine 2012: I. Neurology and neurointensive care, epidemiology and nephrology, biomarkers and inflammation, nutrition, experimentals

Author

Antonelli, Massimo, Bonten, M, Cecconi, M, Chastre, J, Citerio, G, Conti, Giorgio, Curtis, Jr, Hedenstierna, G, Joannidis, M, Macrae, D, Maggiore, Salvatore Maurizio, Mancebo, J, Mebazaa, A, Preiser, Jc, Rocco, P, Timsit, Jf, Wernerman, J, Zhang, H., Antonelli, Massimo (ORCID:0000-0003-3007-1670), Conti, Giorgio (ORCID:0000-0002-8566-9365), Antonelli, Massimo, Bonten, M, Cecconi, M, Chastre, J, Citerio, G, Conti, Giorgio, Curtis, Jr, Hedenstierna, G, Joannidis, M, Macrae, D, Maggiore, Salvatore Maurizio, Mancebo, J, Mebazaa, A, Preiser, Jc, Rocco, P, Timsit, Jf, Wernerman, J, Zhang, H., Antonelli, Massimo (ORCID:0000-0003-3007-1670), and Conti, Giorgio (ORCID:0000-0002-8566-9365)

Published
2013

37. Year in review in Intensive Care Medicine 2012: III. Noninvasive ventilation, monitoring and patient-ventilator interactions, acute respiratory distress syndrome, sedation, paediatrics and miscellanea

Author

Antonelli, Massimo, Bonten, M, Cecconi, M, Chastre, J, Citerio, G, Conti, Giorgio, Curtis, Jr, Hedenstierna, G, Joannidis, M, Macrae, D, Maggiore, Salvatore Maurizio, Mancebo, J, Mebazaa, A, Preiser, Jc, Rocco, P, Timsit, Jf, Wernerman, J, Zhang, H., Antonelli, Massimo (ORCID:0000-0003-3007-1670), Conti, Giorgio (ORCID:0000-0002-8566-9365), Antonelli, Massimo, Bonten, M, Cecconi, M, Chastre, J, Citerio, G, Conti, Giorgio, Curtis, Jr, Hedenstierna, G, Joannidis, M, Macrae, D, Maggiore, Salvatore Maurizio, Mancebo, J, Mebazaa, A, Preiser, Jc, Rocco, P, Timsit, Jf, Wernerman, J, Zhang, H., Antonelli, Massimo (ORCID:0000-0003-3007-1670), and Conti, Giorgio (ORCID:0000-0002-8566-9365)

Published
2013

38. Year in review in Intensive Care Medicine 2011. II. Cardiovascular, infections, pneumonia and sepsis, critical care organization and outcome, education, ultrasonography, metabolism and coagulation

Author

Antonelli, Massimo, Bonten, M, Chastre, J, Citerio, G, Conti, Giorgio, Curtis, Jr, De Backer, D, Hedenstierna, G, Joannidis, M, Macrae, D, Mancebo, J, Maggiore, Salvatore Maurizio, Mebazaa, A, Preiser, Jc, Rocco, P, Timsit, Jf, Wernerman, J, Zhang, H., Antonelli, Massimo (ORCID:0000-0003-3007-1670), Conti, Giorgio (ORCID:0000-0002-8566-9365), Antonelli, Massimo, Bonten, M, Chastre, J, Citerio, G, Conti, Giorgio, Curtis, Jr, De Backer, D, Hedenstierna, G, Joannidis, M, Macrae, D, Mancebo, J, Maggiore, Salvatore Maurizio, Mebazaa, A, Preiser, Jc, Rocco, P, Timsit, Jf, Wernerman, J, Zhang, H., Antonelli, Massimo (ORCID:0000-0003-3007-1670), and Conti, Giorgio (ORCID:0000-0002-8566-9365)

Published
2012

39. Year in review in Intensive Care Medicine 2011: III. ARDS and ECMO, weaning, mechanical ventilation, noninvasive ventilation, pediatrics and miscellanea

Author

Antonelli, Massimo, Bonten, M, Chastre, J, Citerio, G, Conti, Giorgio, Curtis, Jr, De Backer, D, Hedenstierna, G, Joannidis, M, Macrae, D, Mancebo, J, Maggiore, Salvatore Maurizio, Mebazaa, A, Preiser, Jc, Rocco, P, Timsit, Jf, Wernerman, J, Zhang, H., Antonelli, Massimo (ORCID:0000-0003-3007-1670), Conti, Giorgio (ORCID:0000-0002-8566-9365), Antonelli, Massimo, Bonten, M, Chastre, J, Citerio, G, Conti, Giorgio, Curtis, Jr, De Backer, D, Hedenstierna, G, Joannidis, M, Macrae, D, Mancebo, J, Maggiore, Salvatore Maurizio, Mebazaa, A, Preiser, Jc, Rocco, P, Timsit, Jf, Wernerman, J, Zhang, H., Antonelli, Massimo (ORCID:0000-0003-3007-1670), and Conti, Giorgio (ORCID:0000-0002-8566-9365)

Published
2012

40. Year in review in Intensive Care Medicine 2011: I. Nephrology, epidemiology, nutrition and therapeutics, neurology, ethical and legal issues, experimentals

Author

Antonelli, Massimo, Bonten, M, Chastre, J, Citerio, G, Conti, Giorgio, Curtis, Jr, De Backer, D, Hedenstierna, G, Joannidis, M, Macrae, D, Mancebo, J, Maggiore, Salvatore Maurizio, Mebazaa, A, Preiser, Jc, Rocco, P, Timsit, Jf, Wernerman, J, Zhang, H., Antonelli, Massimo (ORCID:0000-0003-3007-1670), Conti, Giorgio (ORCID:0000-0002-8566-9365), Antonelli, Massimo, Bonten, M, Chastre, J, Citerio, G, Conti, Giorgio, Curtis, Jr, De Backer, D, Hedenstierna, G, Joannidis, M, Macrae, D, Mancebo, J, Maggiore, Salvatore Maurizio, Mebazaa, A, Preiser, Jc, Rocco, P, Timsit, Jf, Wernerman, J, Zhang, H., Antonelli, Massimo (ORCID:0000-0003-3007-1670), and Conti, Giorgio (ORCID:0000-0002-8566-9365)

Published
2012

41. Prevalence and factors of intensive care unit conflicts: The conflicus study

Author

Azoulay, E, Timsit, JF, Sprung, CL, Soares, M, Rusinová, K, Lafabrie, A, Abizanda, R, Svantesson, M, Rubulotta, F, Ricou, B, Benoit, D, Heyland, D, Joynt, G, Francxais, A, Azeivedo-Maia, P, Owczuk, R, Benbenishty, J, De Vita, M, Valentin, A, Ksomos, A, Cohen, S, Kompan, L, Ho, K, Abroug, F, Kaarlola, A, Gerlach, H, Kyprianou, T, Michalsen, A, Chevret, S, Schlemmer, B, Azoulay, E, Timsit, JF, Sprung, CL, Soares, M, Rusinová, K, Lafabrie, A, Abizanda, R, Svantesson, M, Rubulotta, F, Ricou, B, Benoit, D, Heyland, D, Joynt, G, Francxais, A, Azeivedo-Maia, P, Owczuk, R, Benbenishty, J, De Vita, M, Valentin, A, Ksomos, A, Cohen, S, Kompan, L, Ho, K, Abroug, F, Kaarlola, A, Gerlach, H, Kyprianou, T, Michalsen, A, Chevret, S, and Schlemmer, B

Abstract

Rationale: Many sources of conflict exist in intensive care units (ICUs). Few studies recorded the prevalence, characteristics, and risk factors for conflicts in ICUs. Objectives: To record the prevalence, characteristics, and risk factors for conflicts in ICUs. Methods: One-day cross-sectional survey of ICU clinicians. Data on perceived conflicts in the week before the survey day were obtained from 7,498 ICU staff members (323 ICUs in 24 countries). Measurements and Main Results: Conflicts were perceived by 5,268 (71.6%) respondents. Nurse-physician conflicts were the most common (32.6%), followed by conflicts among nurses (27.3%) and staff-relative conflicts (26.6%). The most common conflict-causing behaviors were personal animosity, mistrust, and communication gaps. During end-of-life care, the main sources of perceived conflict were lack of psychological support, absence of staff meetings, and problems with the decision-making process. Conflicts perceived as severe were reported by 3,974 (53%) respondents. Job strain was significantly associated with perceiving conflicts and with greater severity of perceived conflicts. Multivariate analysis identified 15 factors associated with perceived conflicts, of which 6 were potential targets for future intervention: staff working more than 40 h/wk, more than 15 ICU beds, caring for dying patients or providing preand postmortem care within the last week, symptom control not ensured jointly by physicians and nurses, and no routine unit-level meetings. Conclusions: Over 70% of ICU workers reported perceived conflicts, which were often considered severe and were significantly associated with job strain. Workload, inadequate communication, and end-of-life care emerged as important potential targets for improvement.

Published
2009

43. Articles

Author

Timsit Jf and Chevret S

Subjects
Pulmonary and Respiratory Medicine, Estimation, business.industry, Attributable risk, Econometrics, Medicine, Critical Care and Intensive Care Medicine, business
Published
1999
Full Text
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46. Randomized Controlled Trial of Chlorhexidine Dressing and Highly Adhesive Dressing for Preventing Catheter-related Infections in Critically Ill Adults.

Author

Timsit JF, Mimoz O, Mourvillier B, Souweine B, Garrouste-Orgeas M, Alfandari S, Plantefeve G, Bronchard R, Troche G, Gauzit R, Antona M, Canet E, Bohe J, Lepape A, Vesin A, Arrault X, Schwebel C, Adrie C, Zahar JR, and Ruckly S

Abstract

Rationale: Most vascular catheter-related infections (CRIs) occur extraluminally in patients in the intensive care unit (ICU). Chlorhexidine-impregnated and strongly adherent dressings may decrease catheter colonization and CRI rates. Objectives: To determine if chlorhexidine-impregnated and strongly adherent dressings decrease catheter colonization and CRI rates. Methods: In a 2:1:1 assessor-masked randomized trial in patients with vascular catheters inserted for an expected duration of 48 hours or more in 12 French ICUs, we compared chlorhexidine dressings, highly adhesive dressings, and standard dressings from May 2010 to July 2011. Coprimary endpoints were major CRI with or without catheter-related bloodstream infection (CR-BSI) with chlorhexidine versus nonchlorhexidine dressings and catheter colonization rate with highly adhesive nonchlorhexidine versus standard nonchlorhexidine dressings. Catheter-colonization, CR-BSIs, and skin reactions were secondary endpoints. Measurements and Main Results: A total of 1,879 patients (4,163 catheters and 34,339 catheter-days) were evaluated. With chlorhexidine dressings, the major-CRI rate was 67% lower (0.7 per 1,000 vs. 2.1 per 1,000 catheter-days; hazard ratio [HR], 0.328; 95% confidence interval [CI], 0.174-0.619; P = 0.0006) and the CR-BSI rate 60% lower (0.5 per 1,000 vs. 1.3 per 1,000 catheter-days; HR, 0.402; 95% CI, 0.186-0.868; P = 0.02) than with nonchlorhexidine dressings; decreases were noted in catheter colonization and skin colonization rates at catheter removal. The contact dermatitis rate was 1.1% with and 0.29% without chlorhexidine. Highly adhesive dressings decreased the detachment rate to 64.3% versus 71.9% (P < 0.0001) and the number of dressings per catheter to two (one to four) versus three (one to five) (P < 0.0001) but increased skin colonization (P < 0.0001) and catheter colonization (HR, 1.650; 95% CI, 1.21-2.26; P = 0.0016) without influencing CRI or CR-BSI rates. Conclusions: A large randomized trial demonstrated that chlorhexidine-gel-impregnated dressings decreased the CRI rate in patients in the ICU with intravascular catheters. Highly adhesive dressings decreased dressing detachment but increased skin and catheter colonization. Clinical trial registered with www.clinicaltrials.gov (NCT 01189682). [ABSTRACT FROM AUTHOR]

Published
2012
Full Text
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48. Dressing disruption is a major risk factor for catheter-related infections.

Author

Timsit JF, Bouadma L, Ruckly S, Schwebel C, Garrouste-Orgeas M, Bronchard R, Calvino-Gunther S, Laupland K, Adrie C, Thuong M, Herault MC, Pease S, Arrault X, and Lucet JC

Abstract

OBJECTIVE: Major catheter-related infection includes catheter-related bloodstream infections and clinical sepsis without bloodstream infection resolving after catheter removal with a positive quantitative tip culture. Insertion site dressings are a major mean to reduce catheter infections by the extraluminal route. However, the importance of dressing disruptions in the occurrence of major catheter-related infection has never been studied in a large cohort of patients. DESIGN: A secondary analysis of a randomized multicenter trial was performed in order to determine the importance of dressing disruption on the risk for development of catheter-related bloodstream infection. MEASUREMENTS AND MAIN RESULTS: Among 1,419 patients (3,275 arterial or central-vein catheters) included, we identified 296 colonized catheters, 29 major catheter-related infections, and 23 catheter-related bloodstream infections. Of the 11,036 dressings changes, 7,347 (67%) were performed before the planned date because of soiling or undressing. Dressing disruption occurred more frequently in patients with higher Sequential Organ Failure Assessment scores and in patients receiving renal replacement therapies; it was less frequent in males and patients admitted for coma. Subclavian access protected from dressing disruption. Dressing cost (especially staff cost) was inversely related to the rate of disruption. The number of dressing disruptions was related to increased risk for colonization of the skin around the catheter at removal (p < .0001). The risk of major catheter-related infection and catheter-related bloodstream infection increased by more than three-fold after the second dressing disruption and by more than ten-fold if the final dressing was disrupted, independently of other risk factors of infection. CONCLUSION: Disruption of catheter dressings was common and was an important risk factor for catheter-related infections. These data support the preferential use of the subclavian insertion site and enhanced efforts to reduce dressing disruption in postinsertion bundles of care. [ABSTRACT FROM AUTHOR]

Published
2012
Full Text
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