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MULTICENTER STUDY
Jiao Liu, Yizhu Chen, Ranran Li, Zhixiong Wu, Qianghong Xu, Zhongyi Li, Djillali Annane, Huibin Feng, Sisi Huang, Jun Guo, Lidi Zhang, Xiaofei Ye, Wei Zhu, Hangxiang Du, Yong'an Liu, Tao Wang, Limin Chen, Zhenliang Wen, Jean-Louis Teboul, Dechang Chen
OBJECTIVES: Intravenous immunoglobulin (IVIG) is commonly used to treat severe COVID-19, although the clinical outcome of such treatment remains unclear. This study evaluated the effectiveness of IVIG treatment in severe COVID-19 patients. METHODS: This retrospective multicentre study evaluated 28-day mortality in severe COVID-19 patients with or without IVIG treatment. Each patient treated with IVIG was matched with one untreated patient. Logistic regression and inverse probability weighting (IPW) were used to control confounding factors...
October 2021: Clinical Microbiology and Infection
#42
JOURNAL ARTICLE
Temistocle Taccheri, Francesco Gavelli, Jean-Louis Teboul, Rui Shi, Xavier Monnet
BACKGROUND: In patients ventilated with tidal volume (Vt) < 8 mL/kg, pulse pressure variation (PPV) and, likely, the variation of distensibility of the inferior vena cava diameter (IVCDV) are unable to detect preload responsiveness. In this condition, passive leg raising (PLR) could be used, but it requires a measurement of cardiac output. The tidal volume (Vt) challenge (PPV changes induced by a 1-min increase in Vt from 6 to 8 mL/kg) is another alternative, but it requires an arterial line...
March 18, 2021: Critical Care: the Official Journal of the Critical Care Forum
#43
REVIEW
Ludhmila Abrahão Hajjar, Isabela Bispo Santos da Silva Costa, Stephanie Itala Rizk, Bruno Biselli, Brenno Rizerio Gomes, Cristina Salvadori Bittar, Gisele Queiroz de Oliveira, Juliano Pinheiro de Almeida, Mariana Vieira de Oliveira Bello, Cibele Garzillo, Alcino Costa Leme, Moizo Elena, Fernando Val, Marcela de Almeida Lopes, Marcus Vinícius Guimarães Lacerda, José Antonio Franchini Ramires, Roberto Kalil Filho, Jean-Louis Teboul, Giovanni Landoni
SARS-CoV-2, the causative agent of coronavirus disease 2019 (COVID-19), is responsible for the largest pandemic facing humanity since the Spanish flu pandemic in the early twentieth century. Since there is no specific antiviral treatment, optimized support is the most relevant factor in the patient's prognosis. In the hospital setting, the identification of high-risk patients for clinical deterioration is essential to ensure access to intensive treatment of severe conditions in a timely manner. The initial management of hypoxemia includes conventional oxygen therapy, high-flow nasal canula oxygen, and non-invasive ventilation...
February 18, 2021: Annals of Intensive Care
#44
JOURNAL ARTICLE
Julien Demiselle, Valérie Seegers, Marie Lemerle, Ferhat Meziani, Fabien Grelon, Bruno Megarbane, Nadia Anguel, Jean-Paul Mira, Pierre-François Dequin, Soizic Gergaud, Nicolas Weiss, François Legay, Yves Le Tulzo, Marie Conrad, René Robert, Frédéric Gonzalez, Christophe Guitton, Fabienne Tamion, Jean-Marie Tonnelier, Jean-Pierre Bédos, Thierry Van Der Linden, Antoine Vieillard-Baron, Eric Mariotte, Gaël Pradel, Olivier Lesieur, Jean-Damien Ricard, Fabien Hervé, Damien du Cheyron, Claude Guerin, Jean-Louis Teboul, Julie Helms, Peter Radermacher, Pierre Asfar
OBJECTIVES: Individualizing a target mean arterial pressure is challenging during the initial resuscitation of patients with septic shock. The Sepsis and Mean Arterial Pressure (SEPSISPAM) trial suggested that targeting high mean arterial pressure might reduce the occurrence of acute kidney injury among those included patients with a past history of chronic hypertension. We investigated whether the class of antihypertensive medications used before the ICU stay in chronic hypertensive patients was associated with the severity of acute kidney injury occurring after inclusion, according to mean arterial pressure target...
April 1, 2021: Critical Care Medicine
#45
JOURNAL ARTICLE
Christopher Lai, Imane Adda, Jean-Louis Teboul, Romain Persichini, Francesco Gavelli, Laurent Guérin, Xavier Monnet
OBJECTIVES: To examine the effects of prone positioning on venous return and its determinants such as mean systemic pressure and venous return resistance in patients with acute respiratory distress syndrome. DESIGN: Prospective monocentric study. SETTINGS: A 25-bed medical ICU. PATIENTS: About 22 patients with mild-to-severe acute respiratory distress syndrome in whom prone positioning was decided. INTERVENTIONS: We obtained cardiac index, mean systemic pressure, and venous return resistance (the latter two estimated through the heart-lung interactions method) before and during prone positioning...
May 1, 2021: Critical Care Medicine
#46
JOURNAL ARTICLE
Hernando Gomez, Håkon Haugaa, Daniel Escobar, Ana M Botero, Rachel Pool, Gaspar Del Rio-Pertuz, Carlos L Manrique-Caballero, Lisa Gordon, Alicia Frank, Jean-Louis Teboul, Brian S Zuckerbraun, Michael R Pinsky
Aims: We sought to investigate the relationship between macrohemodynamic resuscitation and microcirculatory parameters with the response of microcirculatory flow, tissue-specific parameters of metabolic stress and injury. We hypothesized that early resuscitation based on macrohemodynamic parameters does not prevent the development of organ dysfunction in a porcine model of endotoxemic shock, and that sublingual microcirculatory parameters are associated with markers of tissue metabolic stress and injury. Results: Both resuscitation groups had significant increases in creatinine and neutrophil gelatinase-associated lipocalin as compared with baseline...
December 10, 2021: Antioxidants & Redox Signaling
#47
JOURNAL ARTICLE
Thomas W L Scheeren, Jan Bakker, Thomas Kaufmann, Djillali Annane, Pierre Asfar, E Christiaan Boerma, Maurizio Cecconi, Michelle S Chew, Bernard Cholley, Maria Cronhjort, Daniel De Backer, Arnaldo Dubin, Martin W Dünser, Jacques Duranteau, Anthony C Gordon, Ludhmila A Hajjar, Olfa Hamzaoui, Glenn Hernandez, Vanina Kanoore Edul, Geert Koster, Giovanni Landoni, Marc Leone, Bruno Levy, Claude Martin, Alexandre Mebazaa, Xavier Monnet, Andrea Morelli, Didier Payen, Rupert M Pearse, Michael R Pinsky, Peter Radermacher, Daniel A Reuter, Yasser Sakr, Michael Sander, Bernd Saugel, Mervyn Singer, Pierre Squara, Antoine Vieillard-Baron, Philippe Vignon, Jean-Louis Vincent, Iwan C C van der Horst, Simon T Vistisen, Jean-Louis Teboul
BACKGROUND: Treatment decisions on critically ill patients with circulatory shock lack consensus. In an international survey, we aimed to evaluate the indications, current practice, and therapeutic goals of inotrope therapy in the treatment of patients with circulatory shock. METHODS: From November 2016 to April 2017, an anonymous web-based survey on the use of cardiovascular drugs was accessible to members of the European Society of Intensive Care Medicine (ESICM)...
January 29, 2021: Annals of Intensive Care
#48
JOURNAL ARTICLE
Alexandra Beurton, Francesco Gavelli, Jean-Louis Teboul, Nello De Vita, Xavier Monnet
OBJECTIVES: The end-expiratory occlusion test for assessing preload responsiveness consists in interrupting mechanical ventilation for 15 seconds at end-expiration and measuring the cardiac index changes. The perfusion index is the ratio between the pulsatile and the nonpulsatile portions of the plethysmography signal and is, in part, determined by stroke volume. We tested whether the end-expiratory occlusion-induced changes in perfusion index could detect a positive passive leg raising test, suggesting preload responsiveness...
February 1, 2021: Critical Care Medicine
#49
JOURNAL ARTICLE
Olfa Hamzaoui, Jean-Louis Teboul
No abstract text is available yet for this article.
December 2020: Critical Care Medicine
#50
JOURNAL ARTICLE
Lívia Prado, Francisco Lobo, Neymar de Oliveira, Daniela Espada, Bárbara Neves, Jean-Louis Teboul, Suzana Lobo
BACKGORUND: Current evidence suggests that intraoperative goal-directed haemodynamic therapy (GDT) should be considered for high-risk patients undergoing major gastrointestinal surgery. We aimed to evaluate if an algorithm using venoarterial carbon dioxide difference (CO2 gap) and pulse pressure variation (PPV) as therapeutic targets during GDT would decrease the major complications after gastrointestinal surgery. METHODS: This was a before-and-after study (n = 204) performed in a tertiary hospital on patients who underwent elective open major gastrointestinal surgeries...
2020: Anaesthesiology Intensive Therapy
#51
JOURNAL ARTICLE
Hanane Bouchghoul, Jean-Louis Teboul, Marie-Victoire Senat, Solène Vigoureux
BACKGROUND: The weight of social inequalities during education is a reality. Students of lower socioeconomic status may have less chance of success in higher education, particularly in medical studies. However, the role of students' socioeconomic factors, such as their parents' profession, in their success in the national ranking exam (NRE) has not been studied. Our aim was to investigate the association between socioeconomic factors and success in the national ranking exam among sixth year medical students at the Paris-Sud Faculty of Medicine...
November 2, 2020: BMC Medical Education
#52
JOURNAL ARTICLE
Jiao Liu, Lidi Zhang, Yizhu Chen, Zhixiong Wu, Xuan Dong, Jean-Louis Teboul, Sheng Zhang, Xiaofei Ye, Yongan Liu, Tao Wang, Hangxiang Du, Wenzhe Li, Dechang Chen
BACKGROUND: The outbreak of COVID-19 caused by SARS-CoV-2 has been a pandemic. The objective of our study was to explore the association between sex and clinical outcomes in patients with COVID-19. METHODS: Detailed clinical data including clinical characteristics, laboratory tests, imaging features and treatments of 1190 cases of adult patients with confirmed COVID-19 were retrospectively analyzed. Associations between sex and clinical outcomes were identified by multivariable Cox regression analysis...
September 28, 2020: Respiratory Medicine
#53
MULTICENTER STUDY
Sergi Vaquer, Denis Chemla, Jean-Louis Teboul, Umar Ahmad, Flora Cipriani, Joan Carles Oliva, Ana Ochagavia, Antonio Artigas, Francisco Baigorri, Xavier Monnet
OBJECTIVES: To evaluate the preload dependence of femoral maximal change in pressure over time (dP/dtmax) during volume expansion in preload dependent and independent critically ill patients. DESIGN: Retrospective database analysis. SETTING: Two adult polyvalent ICUs. PATIENTS: Twenty-five critically ill patients with acute circulatory failure. INTERVENTIONS: Thirty-five fluid infusions of 500 mL normal saline...
October 2020: Critical Care Medicine
#54
JOURNAL ARTICLE
Mathieu Jozwiak, Matthieu Chambaz, Pierre Sentenac, Xavier Monnet, Jean-Louis Teboul
OBJECTIVE: To investigate whether assessment of tissue oxygenation could help personalizing the mean arterial pressure (MAP) target in patients with septic shock. METHODS: We prospectively measured near-infrared spectroscopy variables in 22 patients with septic shock receiving norepinephrine with a MAP>75 mmHg within the first six hours of intensive care unit (ICU) stay for patients with community-acquired septic shock and within the first six hours of resuscitation for patients with ICU-acquired septic shock...
November 2020: Microvascular Research
#55
REVIEW
Pierre Tissières, Jean-Louis Teboul
Recent paediatric cases of acute myocarditis following a SARS-CoV-2 infection have raised the possibility of post-infective complications of COVID-19. This short editorial is reviewing current understanding of this new complication, its pathophysiology, diagnosis and therapeutic strategy.
July 23, 2020: Annals of Intensive Care
#56
JOURNAL ARTICLE
Olfa Hamzaoui, Corentin Gouëzel, Mathieu Jozwiak, Maude Millereux, Benjamin Sztrymf, Dominique Prat, Frederic Jacobs, Xavier Monnet, Pierre Trouiller, Jean-Louis Teboul
OBJECTIVE: By analogy with the classical central venous pressure rules to assess a fluid challenge, we hypothesized that an increase in central venous pressure greater than or equal to 5 cm H2O (i.e., 4 mm Hg) during passive leg raising can predict preload unresponsiveness diagnosed by the absence of increase in velocity-time integral of the left ventricular outflow tract greater than or equal to 10% during the test (negative passive leg raising test). DESIGN AND SETTINGS: Velocity-time integral was measured by transthoracic echocardiography...
August 2020: Critical Care Medicine
#57
COMMENT
Alexandra Beurton, Jean-Louis Teboul, Xavier Monnet
No abstract text is available yet for this article.
June 2020: Annals of Translational Medicine
#58
REVIEW
Rui Shi, Olfa Hamzaoui, Nello De Vita, Xavier Monnet, Jean-Louis Teboul
In addition to fluid resuscitation, the vasopressor therapy is a fundamental treatment of septic shock-induced hypotension as it aims at correcting the vascular tone depression and then at improving organ perfusion pressure. Experts' recommendations currently position norepinephrine (NE) as the first-line vasopressor in septic shock. Vasopressin and its analogues are only second-line vasopressors as strong recent evidence suggests no benefit of their early administration in spite of promising preliminary data...
June 2020: Annals of Translational Medicine
#59
REVIEW
Xavier Monnet, Jean-Louis Teboul
In patients with acute circulatory failure, the primary goal of volume expansion is to increase cardiac output. However, this expected effect is inconstant, so that in many instances, fluid administration does not result in any haemodynamic benefit. In such cases, fluid could only exert some deleterious effects. It is now well demonstrated that excessive fluid administration is harmful, especially during acute respiratory distress syndrome and in sepsis or septic shock. This is the reason why some tests and indices have been developed in order to assess "fluid responsiveness" before deciding to perform volume expansion...
June 2020: Annals of Translational Medicine
#60
EDITORIAL
Giuseppe Citerio, Jan Bakker, Laurent Brochard, Timothy G Buchman, Samir Jaber, Peter J Mazzone, Jean-Louis Teboul, Jean-Louis Vincent, Elie Azoulay
No abstract text is available yet for this article.
August 2020: Intensive Care Medicine
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