Articles

Hemodynamic support in the early phase of septic shock: a review of challenges and unanswered questions

Improving sepsis support is one of the three pillars of a 2017 resolution according to the World Health Organization (WHO). Septic shock is indeed a burden issue in the intensive care units. Hemodynamic stabil...

Authors: Olivier Lesur, Eugénie Delile, Pierre Asfar and Peter Radermacher

Practical approach to diastolic dysfunction in light of the new guidelines and clinical applications in the operating room and in the intensive care

There is growing evidence both in the perioperative period and in the field of intensive care (ICU) on the association between left ventricular diastolic dysfunction (LVDD) and worse outcomes in patients. The ...

Authors: F. Sanfilippo, S. Scolletta, A. Morelli and A. Vieillard-Baron

When timing and dose of nutrition support were examined, the modified Nutrition Risk in Critically Ill (mNUTRIC) score did not differentiate high-risk patients who would derive the most benefit from nutrition support: a prospective cohort study

The timing and dose of exclusive nutrition support (ENS) have not been investigated in previous studies aimed at validating the modified Nutrition Risk in Critically Ill (mNUTRIC) score. We therefore evaluated...

Authors: Charles Chin Han Lew, Gabriel Jun Yung Wong, Ka Po Cheung, Robert J. L. Fraser, Ai Ping Chua, Mary Foong Fong Chong and Michelle Miller

Estimation of sodium and chloride storage in critically ill patients: a balance study

Nonosmotic sodium storage has been reported in animals, healthy individuals and patients with hypertension, hyperaldosteronism and end-stage kidney disease. Sodium storage has not been studied in ICU patients,...

Authors: Lara Hessels, Annemieke Oude Lansink-Hartgring, Miriam Zeillemaker-Hoekstra and Maarten W. Nijsten

Beneficial effects of antioxidant therapy in crush syndrome in a rodent model: enough evidences to be used in humans?

Authors: Patrick M. Honore, David De Bels and Herbert D. Spapen

Perioperative statin therapy in cardiac and non-cardiac surgery: a systematic review and meta-analysis of randomized controlled trials

The effects of perioperative statin therapy on clinical outcome after cardiac or non-cardiac surgery are controversial. We aimed to assess the association between perioperative statin therapy and postoperative...

Authors: Alessandro Putzu, Carolina Maria Pinto Domingues de Carvalho e Silva, Juliano Pinheiro de Almeida, Alessandro Belletti, Tiziano Cassina, Giovanni Landoni and Ludhmila Abrahao Hajjar

Predictors of survival in patients with influenza pneumonia-related severe acute respiratory distress syndrome treated with prone positioning

Patients with influenza complicated with pneumonia are at high risk of rapid progression to acute respiratory distress syndrome (ARDS). Prone positioning with longer duration and lung-protective strategies mig...

Authors: Kuo-Chin Kao, Ko-Wei Chang, Ming-Cheng Chan, Shinn-Jye Liang, Ying-Chun Chien, Han-Chung Hu, Li-Chung Chiu, Wei-Chih Chen, Wen-Feng Fang, Yu-Mu Chen, Chau-Chyun Sheu, Ming-Ju Tsai, Wann-Cherng Perng, Chung-Kan Peng, Chieh-Liang Wu, Hao-Chien Wang…

Impact of oversedation prevention in ventilated critically ill patients: a randomized trial—the AWARE study

Although oversedation has been associated with increased morbidity in ventilated critically ill patients, it is unclear whether prevention of oversedation improves mortality. We aimed to assess 90-day mortali...

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Dexmedetomidine in prevention and treatment of postoperative and intensive care unit delirium: a systematic review and meta-analysis

To determine the preventive and therapeutic effect of dexmedetomidine on intensive care unit (ICU) delirium.

Authors: Julian Flükiger, Alexa Hollinger, Benjamin Speich, Vera Meier, Janna Tontsch, Tatjana Zehnder and Martin Siegemund

Renal failure in critically ill patients, beware of applying (central venous) pressure on the kidney

The central venous pressure (CVP) is traditionally used as a surrogate of intravascular volume. CVP measurements therefore are often applied at the bedside to guide fluid administration in postoperative and cr...

Authors: Xiukai Chen, Xiaoting Wang, Patrick M. Honore, Herbert D. Spapen and Dawei Liu

Hyperoxia toxicity in septic shock patients according to the Sepsis-3 criteria: a post hoc analysis of the HYPER2S trial

Criteria for the Sepsis-3 definition of septic shock include vasopressor treatment to maintain a mean arterial pressure > 65 mmHg and a lactate concentration > 2 mmol/L. The impact of hyperoxia in patients wit...

Authors: Julien Demiselle, Martin Wepler, Clair Hartmann, Peter Radermacher, Frédérique Schortgen, Ferhat Meziani, Mervyn Singer, Valérie Seegers and Pierre Asfar

Performance of closed-loop resuscitation of haemorrhagic shock with fluid alone or in combination with norepinephrine: an experimental study

Closed-loop resuscitation can improve personalization of care, decrease workload and bring expert knowledge in isolated areas. We have developed a new device to control the administration of fluid or simultane...

Authors: Nicolas Libert, Guillaume Chenegros, Anatole Harrois, Nathalie Baudry, Gilles Cordurie, Ryad Benosman, Eric Vicaut and Jacques Duranteau

Streptococcal toxic shock syndrome in the intensive care unit

The streptococcal toxic shock syndrome is a severe complication associated with invasive infections by group A streptococci. In spite of medical progresses in the care of patients with septic shock during the ...

Authors: Marylin Schmitz, Xavier Roux, Benedikt Huttner and Jérôme Pugin

Clinical features and outcome of patients with acute respiratory failure revealing anti-synthetase or anti-MDA-5 dermato-pulmonary syndrome: a French multicenter retrospective study

Anti-synthetase (AS) and dermato-pulmonary associated with anti-MDA-5 antibodies (aMDA-5) syndromes are near one of the other autoimmune inflammatory myopathies potentially responsible for severe acute interst...

Authors: Constance Vuillard, Marc Pineton de Chambrun, Nicolas de Prost, Claude Guérin, Matthieu Schmidt, Auguste Dargent, Jean-Pierre Quenot, Sébastien Préau, Geoffrey Ledoux, Mathilde Neuville, Guillaume Voiriot, Muriel Fartoukh, Rémi Coudroy, Guillaume Dumas, Eric Maury, Nicolas Terzi…

Effects of positive end-expiratory pressure strategy in supine and prone position on lung and chest wall mechanics in acute respiratory distress syndrome

In acute respiratory distress syndrome (ARDS) patients, it has recently been proposed to set positive end-expiratory pressure (PEEP) by targeting end-expiratory transpulmonary pressure. This approach, which re...

Authors: Mehdi Mezidi, Francisco José Parrilla, Hodane Yonis, Zakaria Riad, Stephan H. Böhm, Andreas D. Waldmann, Jean-Christophe Richard, Floriane Lissonde, Romain Tapponnier, Loredana Baboi, Jordi Mancebo and Claude Guérin

High-flow nasal oxygen versus noninvasive ventilation in adult patients with cystic fibrosis: a randomized crossover physiological study

Noninvasive ventilation (NIV) is the first-line treatment of adult patients with exacerbations of cystic fibrosis (CF). High-flow nasal oxygen therapy (HFNT) might benefit patients with hypoxemia and can reduc...

Authors: Michael C. Sklar, Martin Dres, Nuttapol Rittayamai, Brent West, Domenico Luca Grieco, Irene Telias, Detajin Junhasavasdikul, Michela Rauseo, Tai Pham, Fabiana Madotto, Carolyn Campbell, Elizabeth Tullis and Laurent Brochard

Ten-year trends in intensive care admissions for respiratory infections in the elderly

The consequences of the ageing population concerning ICU hospitalisation need to be adequately described. We believe that this discussion should be disease specific. A focus on respiratory infections is of par...

Authors: Lucile Laporte, Coralie Hermetet, Youenn Jouan, Christophe Gaborit, Emmanuelle Rouve, Kimberly M. Shea, Mustapha Si-Tahar, Pierre-François Dequin, Leslie Grammatico-Guillon and Antoine Guillon

Video laryngoscopy versus direct laryngoscopy for first-attempt tracheal intubation in the general ward

Recent trials showed that video laryngoscopy (VL) did not yield higher first-attempt tracheal intubation success rate than direct laryngoscopy (DL) and was associated with higher rates of complications. Trache...

Authors: Moon Seong Baek, MyongJa Han, Jin Won Huh, Chae-Man Lim, Younsuck Koh and Sang-Bum Hong

Hypoxemia in the ICU: prevalence, treatment, and outcome

Information is limited regarding the prevalence, management, and outcome of hypoxemia among intensive care unit (ICU) patients. We assessed the prevalence and severity of hypoxemia in ICU patients and analyzed...

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Severe atypical pneumonia in critically ill patients: a retrospective multicenter study

Chlamydophila pneumoniae (CP) and Mycoplasma pneumoniae (MP) patients could require intensive care unit (ICU) admission for acute respiratory failure.

Authors: S. Valade, L. Biard, V. Lemiale, L. Argaud, F. Pène, L. Papazian, F. Bruneel, A. Seguin, A. Kouatchet, J. Oziel, S. Rouleau, N. Bele, K. Razazi, O. Lesieur, F. Boissier, B. Megarbane…

Characteristics and outcome of patients with newly diagnosed advanced or metastatic lung cancer admitted to intensive care units (ICUs)

Although patients with advanced or metastatic lung cancer have poor prognosis, admission to the ICU for management of life-threatening complications has increased over the years. Patients with newly diagnosed ...

Authors: C. Barth, M. Soares, A. C. Toffart, J. F. Timsit, G. Burghi, C. Irrazabal, N. Pattison, E. Tobar, B. F. Almeida, U. V. Silva, L. C. Azevedo, A. Rabbat, C. Lamer, A. Parrot, V. C. Souza-Dantas, F. Wallet…

Respiratory changes of the inferior vena cava diameter predict fluid responsiveness in spontaneously breathing patients with cardiac arrhythmias

Whether the respiratory changes of the inferior vena cava diameter during a deep standardized inspiration can reliably predict fluid responsiveness in spontaneously breathing patients with cardiac arrhythmia i...

Authors: Perrine Bortolotti, Delphine Colling, Vincent Colas, Benoit Voisin, Florent Dewavrin, Julien Poissy, Patrick Girardie, Maeva Kyheng, Fabienne Saulnier, Raphael Favory and Sebastien Preau

Large-volume paracentesis effects plasma disappearance rate of indo-cyanine green in critically ill patients with decompensated liver cirrhosis and intraabdominal hypertension

Ascites is a major complication of decompensated liver cirrhosis. Intraabdominal hypertension and structural alterations of parenchyma involve decisive changes in hepatosplanchnic blood flow. Clearance of indo...

Authors: Ulrich Mayr, Leonie Fahrenkrog-Petersen, Gonzalo Batres-Baires, Alexander Herner, Sebastian Rasch, Roland M. Schmid, Wolfgang Huber and Tobias Lahmer

Prediction of chronic kidney disease after acute kidney injury in ICU patients: study protocol for the PREDICT multicenter prospective observational study

Acute kidney injury (AKI) is frequent and associated with poor outcome in intensive care unit (ICU) patients. Besides the association with short- and long-term mortality, the increased risk of chronic kidney ...

Authors: Guillaume Geri, Bénédicte Stengel, Christian Jacquelinet, Philippe Aegerter, Ziad A. Massy and Antoine Vieillard-Baron

How useful are hemoglobin concentration and its variations to predict significant hemorrhage in the early phase of trauma? A multicentric cohort study

The diagnostic value of hemoglobin (Hb) for detecting a significant hemorrhage (SH) in the early phase of trauma remains controversial. The present study aimed to assess the abilities of Hb measurements taken ...

Authors: S. Figueiredo, C. Taconet, A. Harrois, S. Hamada, T. Gauss, M. Raux and J. Duranteau

Clinical impact of upper gastrointestinal endoscopy in critically ill patients with suspected bleeding

Upper gastrointestinal endoscopies’ (UGE) profitability is undisputable in patients admitted for an overt upper digestive tract bleeding. In critically ill subjects admitted for other causes, its performances ...

Authors: Sylvain Jean-Baptiste, Jonathan Messika, David Hajage, Stéphane Gaudry, Julie Barbieri, Henri Duboc, Didier Dreyfuss, Benoit Coffin and Jean-Damien Ricard

Impact of fluid challenge increase in cardiac output on the relationship between systemic and cerebral hemodynamics in severe sepsis compared to brain injury and controls

Cognitive dysfunction and delirium after ICU are frequent and may partially result from brain ischemia episodes. We hypothesized that systemic inflammation (severe sepsis or septic shock) modifies the control ...

Authors: Matthieu Le Dorze, Florian Huché, Clément Coelembier, Christophe Rabuel and Didier Payen

Estimating mean circulatory filling pressure in clinical practice: a systematic review comparing three bedside methods in the critically ill

The bedside hemodynamic assessment of the critically ill remains challenging since blood volume, arterial–venous interaction and compliance are not measured directly. Mean circulatory filling pressure (P_mcf) is t...

Authors: Marije Wijnberge, Daniko P. Sindhunata, Michael R. Pinsky, Alexander P. Vlaar, Else Ouweneel, Jos R. Jansen, Denise P. Veelo and Bart F. Geerts

Vascular complications in adult postcardiotomy cardiogenic shock patients receiving venoarterial extracorporeal membrane oxygenation

The rate, prognostic impacts, and predisposing factors of major vascular complications (MVCs) in patients underwent venoarterial extracorporeal membrane oxygenation (VA-ECMO) by surgical cut-down are poorly un...

Authors: Feng Yang, Dengbang Hou, Jinhong Wang, Yongchao Cui, Xiaomeng Wang, Zhichen Xing, Chunjing Jiang, Xing Hao, Zhongtao Du, Xiaofang Yang, Yu Jiang and Xiaotong Hou

Effectiveness of antimicrobial-coated central venous catheters for preventing catheter-related blood-stream infections with the implementation of bundles: a systematic review and network meta-analysis

Catheter-related blood-stream infections (CRBSIs) are the most common complication when using central venous catheters (CVCs). Whether coating CVCs under bundles could further reduce the incidence of CRBSIs is...

Authors: Hongliang Wang, Hongshuang Tong, Haitao Liu, Yao Wang, Ruitao Wang, Hong Gao, Pulin Yu, Yanji Lv, Shuangshuang Chen, Guiyue Wang, Miao Liu, Yuhang Li, Kaijiang Yu and Changsong Wang

The safety and efficacy of nicotine replacement therapy in the intensive care unit: a randomised controlled pilot study

Studies evaluating nicotine replacement therapy (NRT) to prevent nicotine withdrawal symptoms in ICU patients have yielded conflicting results. We performed a randomised controlled double-blind pilot study to ...

Authors: Ben de Jong, Anne Sophie Schuppers, Arriette Kruisdijk-Gerritsen, Maurits Erwin Leo Arbouw, Hubertus Laurentius Antonius van den Oever and Arthur R. H. van Zanten

Comparative effectiveness of elemental formula in the early enteral nutrition management of acute pancreatitis: a retrospective cohort study

Although enteral nutrition has become one of the standard therapies for patients with acute pancreatitis, the optimal formulae for enteral nutrition have been under debate. Elemental formula is assumed to be s...

Authors: Akira Endo, Atsushi Shiraishi, Kiyohide Fushimi, Kiyoshi Murata and Yasuhiro Otomo

Adherence to a procalcitonin-guided antibiotic treatment protocol in patients with severe sepsis and septic shock

In randomised controlled trials, procalcitonin (PCT)-guided antibiotic treatment has been proven to significantly reduce length of antibiotic therapy in intensive care unit (ICU) patients. However, concern was...

Authors: Andreas Hohn, Nina Balfer, Bernhard Heising, Sabine Hertel, Jan C. Wiemer, Marcel Hochreiter and Stefan Schröder

Carotid and femoral Doppler do not allow the assessment of passive leg raising effects

The hemodynamic effects of the passive leg raising (PLR) test must be assessed through a direct measurement of cardiac index (CI). We tested whether changes in Doppler common carotid blood flow (CBF) and commo...

Authors: Valentina Girotto, Jean-Louis Teboul, Alexandra Beurton, Laura Galarza, Thierry Guedj, Christian Richard and Xavier Monnet

Principles of fluid management and stewardship in septic shock: it is time to consider the four D’s and the four phases of fluid therapy

In patients with septic shock, the administration of fluids during initial hemodynamic resuscitation remains a major therapeutic challenge. We are faced with many open questions regarding the type, dose and ti...

Authors: Manu L. N. G. Malbrain, Niels Van Regenmortel, Bernd Saugel, Brecht De Tavernier, Pieter-Jan Van Gaal, Olivier Joannes-Boyau, Jean-Louis Teboul, Todd W. Rice, Monty Mythen and Xavier Monnet

Impact of a VAP bundle in Belgian intensive care units

In order to decrease the incidence of ventilator-associated pneumonia (VAP) in Belgium, a national campaign for implementing a VAP bundle involving assessment of sedation, cuff pressure control, oral care with...

Authors: Laurent Jadot, Luc Huyghens, Annick De Jaeger, Marc Bourgeois, Dominique Biarent, Adeline Higuet, Koen de Decker, Margot Vander Laenen, Baudewijn Oosterlynck, Patrick Ferdinande, Pascal Reper, Serge Brimioulle, Sophie Van Cromphaut, Stéphane Clement De Clety, Thierry Sottiaux and Pierre Damas

MicroDAIMON study: Microcirculatory DAIly MONitoring in critically ill patients: a prospective observational study

Until now, the prognostic value of microcirculatory alterations in critically ill patients has been mainly evaluated in highly selected subgroups. Aim of this study is to monitor the microcirculation daily in ...

Authors: Claudia Scorcella, Elisa Damiani, Roberta Domizi, Silvia Pierantozzi, Stefania Tondi, Andrea Carsetti, Silvia Ciucani, Valentina Monaldi, Mara Rogani, Benedetto Marini, Erica Adrario, Rocco Romano, Can Ince, E. Christiaan Boerma and Abele Donati

Association of intensive care unit delirium with sleep disturbance and functional disability after critical illness: an observational cohort study

In medical intensive care unit (MICU) patients, the predictors of post-discharge sleep disturbance and functional disability are poorly understood. ICU delirium is a risk factor with a plausible link to sleep ...

Authors: Marcus T. Altman, Melissa P. Knauert, Terrence E. Murphy, Amy M. Ahasic, Zeeshan Chauhan and Margaret A. Pisani

Severe metabolic acidosis after out-of-hospital cardiac arrest: risk factors and association with outcome

Metabolic acidosis is frequently observed as a consequence of global ischemia–reperfusion after out-of-hospital cardiac arrest (OHCA). We aimed to identify risk factors and assess the impact of metabolic acido...

Authors: Matthieu Jamme, Omar Ben Hadj Salem, Lucie Guillemet, Pierre Dupland, Wulfran Bougouin, Julien Charpentier, Jean-Paul Mira, Frédéric Pène, Florence Dumas, Alain Cariou and Guillaume Geri

Increase in intra-abdominal pressure during airway suctioning-induced cough after a successful spontaneous breathing trial is associated with extubation outcome

A patient’s ability to clear secretions and protect the airway with an effective cough is an important part of the pre-extubation evaluation. An increase in intra-abdominal pressure (IAP) is important in gener...

Authors: Yasuhiro Norisue, Jun Kataoka, Yosuke Homma, Takaki Naito, Junpei Tsukuda, Kentaro Okamoto, Takeshi Kawaguchi, Lonny Ashworth, Shimada Yumiko, Yuiko Hoshina, Eiji Hiraoka and Shigeki Fujitani

Skin microcirculatory reactivity assessed using a thermal challenge is decreased in patients with circulatory shock and associated with outcome

Shock states are characterized by impaired tissue perfusion and microcirculatory alterations, which are directly related to outcome. Skin perfusion can be noninvasively evaluated using skin laser Doppler (SLD)...

Authors: Diego Orbegozo, Wasineenart Mongkolpun, Gianni Stringari, Nikolaos Markou, Jacques Creteur, Jean-Louis Vincent and Daniel De Backer

Midazolam increases preload dependency during endotoxic shock in rabbits by affecting venous vascular tone

Septic patients often require sedation in intensive care unit, and midazolam is one of the most frequently used sedatives among them. But the interaction between midazolam and septic shock is not known. The ai...

Authors: Jianxiao Chen, Tao Yu, Federico Longhini, Xiwen Zhang, Songqiao Liu, Ling Liu, Yi Yang and Haibo Qiu

Data-driving methods: More than merely trendy buzzwords?

Authors: Julien Textoris, Fabio Silvio Taccone, Lara Zafrani, Antoine Guillon, Sébastien Gibot, Fabrice Uhel, Eric Azabou, Guillaume Monneret, Frédéric Pène, Nicolas de Prost and Stein Silva

Hypothermic total liquid ventilation after experimental aspiration-associated acute respiratory distress syndrome

Ultrafast cooling by total liquid ventilation (TLV) provides potent cardio- and neuroprotection after experimental cardiac arrest. However, this was evaluated in animals with no initial lung injury, whereas ou...

Authors: Jérôme Rambaud, Fanny Lidouren, Michaël Sage, Matthias Kohlhauer, Mathieu Nadeau, Étienne Fortin-Pellerin, Philippe Micheau, Luca Zilberstein, Nicolas Mongardon, Jean-Damien Ricard, Megumi Terada, Patrick Bruneval, Alain Berdeaux, Bijan Ghaleh, Hervé Walti and Renaud Tissier

Iron metabolism in critically ill patients developing anemia of inflammation: a case control study

Anemia occurring as a result of inflammatory processes (anemia of inflammation, AI) has a high prevalence in critically ill patients. Knowledge on changes in iron metabolism during the course of AI is limited,...

Authors: Margit Boshuizen, Jan M. Binnekade, Benjamin Nota, Kirsten van de Groep, Olaf L. Cremer, Pieter R. Tuinman, Janneke Horn, Marcus J. Schultz, Robin van Bruggen and Nicole P. Juffermans

Proceedings of Réanimation 2018, the French Intensive Care Society International Congress: physiotherapists’ communications

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There is more to septic shock than arterial hypotension and elevated lactate levels: another appeal to rethink current resuscitation strategies!

Authors: Martin W. Dünser and Arnaldo Dubin

My patient has received fluid. How to assess its efficacy and side effects?

Many efforts have been made to predict, before giving fluid, whether it will increase cardiac output. Nevertheless, after fluid administration, it is also essential to assess the therapeutic efficacy and to lo...

Authors: Xavier Monnet and Jean-Louis Teboul

Diaphragm function and weaning from mechanical ventilation: an ultrasound and phrenic nerve stimulation clinical study

Diaphragm dysfunction is defined by a value of twitch tracheal pressure in response to magnetic phrenic stimulation (twitch pressure) amounting to less than 11 cmH₂O. This study assessed whether this threshold or...

Authors: Martin Dres, Ewan C. Goligher, Bruno-Pierre Dubé, Elise Morawiec, Laurence Dangers, Danielle Reuter, Julien Mayaux, Thomas Similowski and Alexandre Demoule

Early goal-directed therapy using a physiological holistic view: the ANDROMEDA-SHOCK—a randomized controlled trial

Septic shock is a highly lethal condition. Early recognition of tissue hypoperfusion and its reversion are key factors for limiting progression to multiple organ dysfunction and death. Lactate-targeted resusci...

Authors: Glenn Hernández, Alexandre Biasi Cavalcanti, Gustavo Ospina-Tascón, Fernando Godinho Zampieri, Arnaldo Dubin, F. Javier Hurtado, Gilberto Friedman, Ricardo Castro, Leyla Alegría, Maurizio Cecconi, Jean-Louis Teboul and Jan Bakker