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MULTICENTER STUDY
Dimitri Titeca-Beauport, Momar Diouf, Delphine Daubin, Ly Van Vong, Guillaume Belliard, Cédric Bruel, Yoann Zerbib, Christophe Vinsonneau, Kada Klouche, Julien Maizel
BACKGROUND: The severity and course of sepsis-associated acute kidney injury (SA-AKI) are correlated with the mortality rate. Early detection of SA-AKI subphenotypes might facilitate the rapid provision of individualized care. PATIENTS AND METHODS: In this post-hoc analysis of a multicenter prospective study, we combined conventional kidney function variables with serial measurements of urine (tissue inhibitor of metalloproteinase-2 [TIMP-2])* (insulin-like growth factor-binding protein [IGFBP7]) at 0, 6, 12, and 24 h) and then using an unsupervised hierarchical clustering of principal components (HCPC) approach to identify different phenotypes of SA-AKI...
December 2024: Renal Failure
#2
JOURNAL ARTICLE
Thomas Rambaud, David Hajage, Didier Dreyfuss, Saïd Lebbah, Laurent Martin-Lefevre, Guillaume Louis, Sébastien Moschietto, Dimitri Titeca-Beauport, Béatrice La Combe, Bertrand Pons, Nicolas De Prost, Sébastien Besset, Alain Combes, Adrien Robine, Marion Beuzelin, Julio Badie, Guillaume Chevrel, Julien Bohe, Elisabeth Coupez, Nicolas Chudeau, Saber Barbar, Christophe Vinsonneau, Jean-Marie Forel, Didier Thevenin, Eric Boulet, Karim Lakhal, Nadia Aissaoui, Steven Grange, Marc Leone, Guillaume Lacave, Saad Nseir, Florent Poirson, Julien Mayaux, Karim Ashenoune, Guillaume Geri, Kada Klouche, Guillaume Thiery, Laurent Argaud, Bertrand Rozec, Cyril Cadoz, Pascal Andreu, Jean Reignier, Jean-Damien Ricard, Jean-Pierre Quenot, Romain Sonneville, Stéphane Gaudry
PURPOSE: The effect of renal replacement therapy (RRT) in comatose patients with acute kidney injury (AKI) remains unclear. We compared two RRT initiation strategies on the probability of awakening in comatose patients with severe AKI. METHODS: We conducted a post hoc analysis of a trial comparing two delayed RRT initiation strategies in patients with severe AKI. Patients were monitored until they had oliguria for more than 72 h and/or blood urea nitrogen higher than 112 mg/dL and then randomized to a delayed strategy (RRT initiated after randomization) or a more-delayed one (RRT initiated if complication occurred or when blood urea nitrogen exceeded 140 mg/dL)...
February 26, 2024: Intensive Care Medicine
#3
JOURNAL ARTICLE
Mickael François, Delphine Daubin, Dehbia Menouche, Antoine Gaillet, Judith Provoost, Remi Trusson, Romain Arrestier, Olivier Hequet, Jean-Christophe Richard, Olivier Moranne, Romaric Larcher, Kada Klouche
OBJECTIVES: The aim of this study was to determine, in critically ill patients treated with therapeutic plasma exchange (TPE), the incidence of adverse events as well as the incidence of secondary infections and its predictive factors. DESIGN: A multicenter retrospective cohort study of an intensive care population treated with TPE to collect adverse events and infectious complications. The characteristics of patients who developed an infection after plasma exchange were compared with those of patients who did not...
November 2023: Critical care explorations
#4
REVIEW
Kada Klouche, Vincent Brunot, Romaric Larcher, Alexandre Lautrette
Around 10% of critically ill patients suffer acute kidney injury (AKI) requiring kidney replacement therapy (KRT), with a mortality rate approaching 50%. Although most survivors achieve sufficient renal recovery to be weaned from KRT, there are no recognized guidelines on the optimal period for weaning from KRT. A systematic review was conducted using a peer-reviewed strategy, combining themes of KRT (intermittent hemodialysis, CKRT: continuous veno-venous hemo/dialysis/filtration/diafiltration, sustained low-efficiency dialysis/filtration), factors predictive of successful weaning (defined as a prolonged period without new KRT) and patient outcomes...
January 19, 2024: Journal of Clinical Medicine
#5
JOURNAL ARTICLE
Elie Azoulay, Frédéric Pochard, Laurent Argaud, Alain Cariou, Raphael Clere-Jehl, Olivier Guisset, Vincent Labbé, Fabienne Tamion, Fabrice Bruneel, Mercé Jourdain, Danielle Reuter, Kada Klouche, Achille Kouatchet, Virginie Souppart, Alexandre Lautrette, Julien Bohé, Antoine Vieillard Baron, Jean Dellamonica, Laurent Papazian, Jean Reignier, Francois Barbier, Guillaume Dumas, Nancy Kentish-Barnes
RATIONALE: Psychological resilience presents a potential protective mechanism against COVID-19-associated mental health symptoms in healthcare providers (HCPs). OBJECTIVES: to identify the determinants of HCP's resilience in intensive care unit HCPs facing the fifth pandemic wave. METHODS: Cross-sectional study in 21 ICUs. HCPs completed the CD-RISC10, HADS, and IES-R to assess resilience, symptoms of anxiety, depression and post-traumatic stress disorder (PTSD), respectively...
January 1, 2024: American Journal of Respiratory and Critical Care Medicine
#6
EDITORIAL
Kada Klouche, Xavier Monnet, Alexander Zarbock
No abstract text is available yet for this article.
December 19, 2023: Intensive Care Medicine
#7
JOURNAL ARTICLE
Romaric Larcher, Anne-Sophie Bargnoux, Stephanie Badiou, Noemie Besnard, Vincent Brunot, Delphine Daubin, Laura Platon, Racim Benomar, Matthieu Amalric, Anne-Marie Dupuy, Kada Klouche, Jean-Paul Cristol
Tubular injury is the main cause of acute kidney injury (AKI) in critically ill COVID-19 patients. Proximal tubular dysfunction (PTD) and changes in urinary biomarkers, such as NGAL, TIMP-2, and IGFBP7 product ([TIMP-2]•[IGFBP7]), could precede AKI. We conducted a prospective cohort study from 2020/03/09 to 2020/05/03, which consecutively included all COVID-19 patients who had at least one urinalysis, to assess the incidence of PTD and AKI, and the effectiveness of PTD, NGAL, and [TIMP-2]•[IGFBP7] in AKI and persistent AKI prediction using the area under the receiver operating characteristic curves (AUCs), Kaplan-Meier methodology (log-rank tests), and Cox models...
2023: Renal Failure
#8
RANDOMIZED CONTROLLED TRIAL
Lara Zafrani, Emmanuel Canet, Anouk Walter-Petrich, Bérangère Joly-Laffargue, Agnès Veyradier, Stanislas Faguer, Naïke Bigé, Laure Calvet, Julien Mayaux, Steven Grangé, Cédric Rafat, Coralie Poulain, Kada Klouche, Pierre Perez, Frédéric Pène, Claire Pichereau, Baptiste Duceau, Eric Mariotte, Sylvie Chevret, Elie Azoulay
PURPOSE: Studies have suggested benefits from magnesium sulphate in thrombotic thrombocytopenic purpura (TTP). We aimed to measure the effects of magnesium sulphate supplementation on TTP recovery. METHODS: In this multicenter, randomised, double-blind, controlled, superiority study, we enrolled adults with a clinical diagnosis of TTP. Patients were randomly allocated to receive magnesium sulphate (6 g intravenously followed by a continuous infusion of 6 g/24 h for 3 days) or placebo, in addition to the standard treatment...
November 2023: Intensive Care Medicine
#9
JOURNAL ARTICLE
Guillaume Dumas, Maxime Bertrand, Virginie Lemiale, Emmanuel Canet, François Barbier, Achille Kouatchet, Alexandre Demoule, Kada Klouche, Anne-Sophie Moreau, Laurent Argaud, Florent Wallet, Jean-Herlé Raphalen, Djamel Mokart, Fabrice Bruneel, Frédéric Pène, Elie Azoulay
BACKGROUND: Acute respiratory failure (ARF) is the leading cause of ICU admission. Viruses are increasingly recognized as a cause of pneumonia in immunocompromised patients, but epidemiologic data are scarce. We used the Groupe de Recherche en Réanimation Respiratoire en Onco-Hématologie's database (2003-2017, 72 intensive care units) to describe the spectrum of critically ill immunocompromised patients with virus-detected ARF and to report their outcomes. Then, patients with virus-detected ARF were matched based on clinical characteristics and severity (1:3 ratio) with patients with ARF from other origins...
October 13, 2023: Annals of Intensive Care
#10
JOURNAL ARTICLE
Jean Baptiste Lascarrou, Wulfran Bougouin, Jonathan Chelly, Jeremy Bourenne, Cedric Daubin, Olivier Lesieur, Pierre Asfar, Gwenhael Colin, Marine Paul, Nicolas Chudeau, Gregoire Muller, Guillaume Geri, Sophier Jacquier, Nicolas Pichon, Thomas Klein, Bertrand Sauneuf, Kada Klouche, Martin Cour, Caroline Sejourne, Filippo Annoni, Jean-Herle Raphalen, Arnaud Galbois, Cedric Bruel, Nicolas Mongardon, Nadia Aissaoui, Nicolas Deye, Julien Maizel, Florence Dumas, Stephane Legriel, Alain Cariou
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is a heterogeneous entity with multiple origins and prognoses. An early, reliable assessment of the prognosis is useful to adapt therapeutic strategy, tailor intensity of care, and inform relatives. We aimed primarily to undertake a prospective multicentric study to evaluate predictive performance of the Cardiac Arrest Prognosis (CAHP) Score as compare to historical dataset systematically collected after OHCA (Utstein style criteria). Our secondary aim was to evaluate other dedicated scores for predicting outcome after OHCA and to compare them to Utstein style criteria...
October 11, 2023: Annals of Intensive Care
#11
RANDOMIZED CONTROLLED TRIAL
Alexis Maillard, Jérôme Le Goff, Mariame Barry, Virginie Lemiale, Séverine Mercier-Delarue, Alexandre Demoule, Linda Feghoul, Samir Jaber, Kada Klouche, Achille Kouatchet, Laurent Argaud, Francois Barbier, Naike Bigé, Anne-Sophie Moreau, Emmanuel Canet, Frédéric Pène, Maud Salmona, Djamel Mokart, Elie Azoulay
BACKGROUND: In immunocompromised patients with acute respiratory failure (ARF), the clinical significance of respiratory virus detection in the nasopharynx remains uncertain. RESEARCH QUESTION: Is viral detection in nasopharyngeal swabs associated with causes and outcomes of ARF in immunocompromised patients? STUDY DESIGN AND METHODS: This preplanned post hoc analysis of a randomized controlled trial enrolled immunocompromised patients admitted to 32 ICUs for ARF between May 2016 and December 2017...
December 2023: Chest
#12
MULTICENTER STUDY
Cyrille Coustal, Juliette Vanoverschelde, Xavier Quantin, Candice Lesage, Jean-Marie Michot, Ariane Lappara, Stephane Ederhy, Eric Assenat, Maxime Faure, Nahema Issa, Olivier Lambotte, Mathieu Puyade, Olivier Dereure, Diego Tosi, Patricia Rullier, Isabelle Serre, Romaric Larcher, Kada Klouche, Gérald Chanques, Hélène Vernhet-Kovacsik, Jean-Luc Faillie, Audrey Agullo, François Roubille, Philippe Guilpain, Alexandre Thibault Jacques Maria
BACKGROUND: Immune checkpoint inhibitors (ICI) have transformed cancer treatment over the last decade. Alongside this therapeutic improvement, a new variety of side effects has emerged, called immune-related adverse events (irAEs), potentially affecting any organ. Among these irAEs, myocarditis is rare but life-threatening. METHODS: We conducted a multicenter cross-sectional retrospective study with the aim of better characterizing ICI-related myocarditis. Myocarditis diagnosis was based on the recent consensus statement of the International Cardio-Oncology Society...
May 2023: Journal for Immunotherapy of Cancer
#13
JOURNAL ARTICLE
Sarah Tournayre, Olivier Mathieu, Maxime Villiet, Noemie Besnard, Vincent Brunot, Delphine Daubin, Laura Platon, Philippe Corne, Kada Klouche, Romaric Larcher
OBJECTIVES: The use of extended intermittent infusion (EII) or continuous infusion (CI) of meropenem is recommended in intensive care unit (ICU) patients, but few data comparing these two options are available. This retrospective cohort study was conducted between 1 January 2019 and 31 March 2020 in a teaching hospital ICU. It aimed to determine the meropenem plasma concentrations achieved with CI and EII. METHODS: The study included septic patients treated with meropenem who had one or more meropenem plasma trough (Cmin) or steady-state concentration (Css) measurement(s), as appropriate...
August 2023: International Journal of Antimicrobial Agents
#14
JOURNAL ARTICLE
Romain Arrestier, Anis Chaba, Asma Mabrouki, Clément Saccheri, Emmanuel Canet, Marc Pineton de Chambrun, Annabelle Stoclin, Muriel Picard, Florent Wallet, François Perier, Matthieu Turpin, Laurent Argaud, Maxens Decavèle, Nahéma Issa, Cyril Cadoz, Kada Klouche, Johana Cohen, Djamel Mokart, Julien Grouille, Tomas Urbina, Camille Hua, Olivier Chosidow, Armand Mekontso-Dessap, Elie Azoulay, Nicolas de Prost
BACKGROUND: Necrotizing soft tissue infections (NSTIs) are rare life-threatening bacterial infections. Few data are available regarding neutropenic patients with NSTIs. Our objectives were to describe the characteristics and management of neutropenic patients with NSTIs in intensive care units (ICUs). We conducted a retrospective multicentre cohort study in 18 ICUs between 2011 and 2021. Patients admitted with NSTIs and concomitant neutropenia at diagnosis were included and compared to non-neutropenic patients with NSTIs...
April 28, 2023: Annals of Intensive Care
#15
MULTICENTER STUDY
Romain Sonneville, Etienne de Montmollin, Damien Contou, Ricard Ferrer, Mohan Gurjar, Kada Klouche, Benjamine Sarton, Sophie Demeret, Pierre Bailly, Daniel da Silva, Etienne Escudier, Loic Le Guennec, Russel Chabanne, Laurent Argaud, Omar Ben Hadj Salem, Martial Thyrault, Aurélien Frerou, Guillaume Louis, Gennaro De Pascale, Janneke Horn, Raimund Helbok, Guillaume Geri, Fabrice Bruneel, Ignacio Martin-Loeches, Fabio Silvio Taccone, Jan J De Waele, Stéphane Ruckly, Quentin Staiquly, Giuseppe Citerio, Jean-François Timsit
PURPOSE: We aimed to characterize the outcomes of patients with severe meningoencephalitis requiring intensive care. METHODS: We conducted a prospective multicenter international cohort study (2017-2020) in 68 centers across 7 countries. Eligible patients were adults admitted to the intensive care unit (ICU) with meningoencephalitis, defined by an acute onset of encephalopathy (Glasgow coma scale (GCS) score [Formula: see text] 13), a cerebrospinal fluid pleocytosis [Formula: see text] 5 cells/mm3 , and at least two of the following criteria: fever, seizures, focal neurological deficit, abnormal neuroimaging, and/or electroencephalogram...
May 2023: Intensive Care Medicine
#16
JOURNAL ARTICLE
Erwann Cariou, Romain Griffier, Arthur Orieux, Stein Silva, Stanislas Faguer, Thierry Seguin, Saad Nseir, Emmanuel Canet, Arnaud Desclaux, Bertrand Souweine, Kada Klouche, Olivier Guisset, Jerome Pillot, Walter Picard, Tahar Saghi, Pierre Delobel, Didier Gruson, Renaud Prevel, Alexandre Boyer
BACKGROUND: The rise in antimicrobial resistance is a global threat responsible for about 33,000 deaths in 2015 with a particular concern for extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) and has led to a major increase in the use of carbapenems, last-resort antibiotics. METHODS: In this retrospective propensity-weighted multicenter observational study conducted in 11 ICUs, the purpose was to assess the efficacy of non carbapenem regimen (piperacillin-tazobactam (PTZ) + aminoglycosides or 3rd-generation cephalosporin (3GC) + aminoglycosides) as empiric therapy in comparison with carbapenem in extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) urinary septic shock...
March 24, 2023: Annals of Intensive Care
#17
JOURNAL ARTICLE
Lucas Perez, Philippe Corne, Grégoire Pasquier, Céline Konecki, Meriem Sadek, Clément Le Bihan, Kada Klouche, Olivier Mathieu, Jacques Reynes, Yoann Cazaubon
Isavuconazole is a triazole antifungal agent recently recommended as first-line therapy for invasive pulmonary aspergillosis. With the COVID-19 pandemic, cases of COVID-19-associated pulmonary aspergillosis (CAPA) have been described with a prevalence ranging from 5 to 30%. We developed and validated a population pharmacokinetic (PKpop) model of isavuconazole plasma concentrations in intensive care unit patients with CAPA. Nonlinear mixed-effect modeling Monolix software were used for PK analysis of 65 plasma trough concentrations from 18 patients...
February 6, 2023: Journal of Fungi (Basel, Switzerland)
#18
JOURNAL ARTICLE
Marie Berger, Delphine Daubin, Jeremy Charriot, Kada Klouche, Vincent Le Moing, David Morquin, Laurence Halimi, Audrey Jaussent, Patrice Taourel, Maurice Hayot, Jean-Paul Cristol, Nicolas Nagot, Pierre Fesler, Camille Roubille
OBJECTIVES: The objective of this prospective, single-center study was to explore the mid-term outcomes 6 to 9 months after hospitalization in an Intensive Care Unit (ICU) for severe COVID-19 infection. METHODS: Patients systematically underwent biological tests, pulmonary function tests, chest computed tomography (CT) scan, and psychological tests. RESULTS: Among 86 patients, including 71 (82.6%) men, median age of 65.8 years (56.7; 72.4), 57 (71...
January 28, 2023: Journal of Clinical Medicine
#19
RANDOMIZED CONTROLLED TRIAL
Muriel Fartoukh, Saad Nseir, Bruno Mégarbane, Yves Cohen, Antoine Lafarge, Damien Contou, Arnaud W Thille, Louis-Marie Galerneau, Florian Reizine, Martin Cour, Kada Klouche, Jean-Christophe Navellou, Laurent Bitker, Alexandra Rousseau, Sophie Tuffet, Tabassome Simon, Guillaume Voiriot
OBJECTIVES: We aimed at assessing the efficacy and safety on antibiotic exposure of a strategy combining a respiratory multiplex PCR (mPCR) with enlarged panel and daily procalcitonin (PCT) measurements, as compared with a conventional strategy, in adult patients who were critically ill with laboratory-confirmed SARS-CoV-2 pneumonia. METHODS: This multicentre, parallel-group, open-label, randomized controlled trial enrolled patients admitted to 13 intensive care units (ICUs) in France...
June 2023: Clinical Microbiology and Infection
#20
JOURNAL ARTICLE
Jean-Christophe Gris, Florence Guillotin, Taissa Pereira Dos Santos, Mathias Chéa, Paul Loubet, Didier Laureillard, Albert Sotto, Laurent Muller, Saber Davide Barbar, Claire Roger, Jean-Yves Lefrant, Boris Jung, Kada Klouche, Thibault Mura, Isabelle Quéré, Antonia Perez-Martin
INTRODUCTION: The prognostic significance of the thrombin generation assay (TGA) with a thrombomodulin (TM) challenge in patients entering hospital with severe COVID-19 is uncertain. METHODS: We prospectively evaluated an automated TGA (aTGA) using the ST-ThromboScreen® assay and ST-Genesia® analyser in 179 patients with severe COVID-19 during their admission to 2 university hospitals. The primary outcome was early survival at Day 28 (D28). Secondary outcomes were late survival at Day 90 (D90), later transfer to an intensive care unit (ICU), and occurrence of any thrombotic complications during hospitalisation...
January 2, 2023: Thrombosis Research
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