Articles

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

Authors:

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

Point-of-care ultrasonography in Brazilian intensive care units: a national survey

Point-of-care ultrasonography (POCUS) has recently become a useful tool that intensivists are incorporating into clinical practice. However, the incorporation of ultrasonography in critical care in developing ...

Authors: José Augusto Santos Pellegrini, Ricardo Luiz Cordioli, Ana Cristina Burigo Grumann, Patrícia Klarmann Ziegelmann and Leandro Utino Taniguchi

De-escalation of antifungal treatment in critically ill patients with suspected invasive Candida infection: incidence, associated factors, and safety

Antifungal treatment is common in critically ill patients, but only a small proportion of patients receiving antifungals have a proven fungal infection. However, antifungal treatment has side effects such as t...

Authors: Karim Jaffal, Julien Poissy, Anahita Rouze, Sébastien Preau, Boualem Sendid, Marjorie Cornu and Saad Nseir

Acid–base status and its clinical implications in critically ill patients with cirrhosis, acute-on-chronic liver failure and without liver disease

Acid–base disturbances are frequently observed in critically ill patients at the intensive care unit. To our knowledge, the acid–base profile of patients with acute-on-chronic liver failure (ACLF) has not been...

Authors: Andreas Drolz, Thomas Horvatits, Kevin Roedl, Karoline Rutter, Richard Brunner, Christian Zauner, Peter Schellongowski, Gottfried Heinz, Georg-Christian Funk, Michael Trauner, Bruno Schneeweiss and Valentin Fuhrmann

The prognostic impact of abdominal surgery in cancer patients with neutropenic enterocolitis: a systematic review and meta-analysis, on behalf the Groupe de Recherche en Réanimation Respiratoire du patient d’Onco-Hématologie (GRRR-OH)

Neutropenic enterocolitis (NE) is a diagnostic and therapeutic challenge associated with high mortality rates, with controversial opinions on its optimal management. Physicians are usually reluctant to select ...

Authors: Colombe Saillard, Lara Zafrani, Michael Darmon, Magali Bisbal, Laurent Chow-Chine, Antoine Sannini, Jean-Paul Brun, Jacques Ewald, Olivier Turrini, Marion Faucher, Elie Azoulay and Djamel Mokart

Biological scoring system for early prediction of acute bowel ischemia after cardiac surgery: the PALM score

Bowel ischemia is a life-threatening emergency defined as an inadequate vascular perfusion leading to bowel inflammation resulting from impaired colonic/small bowel blood supply. Main issue for physicians rega...

Authors: Elie Zogheib, Cyril Cosse, Charles Sabbagh, Simon Marx, Thierry Caus, Marc Henry, Joseph Nader, Mathurin Fumery, Michael Bernasinski, Patricia Besserve, Faouzi Trojette, Cedric Renard, Pierre Duhaut, Said Kamel, Jean-Marc Regimbeau and Hervé Dupont

A novel sampling method to detect airborne influenza and other respiratory viruses in mechanically ventilated patients: a feasibility study

Respiratory viruses circulate constantly in the ambient air. The risk of opportunistic infection from these viruses can be increased in mechanically ventilated patients. The present study evaluates the feasibi...

Authors: Alicia B. Mitchell, Benjamin Tang, Maryam Shojaei, Lachlan S. Barnes, Marek Nalos, Brian G. Oliver and Anthony S. McLean

Mortality and detailed characteristics of pre-ICU qSOFA-negative patients with suspected sepsis: an observational study

Recent studies have suggested that quick Sequential Organ Failure Assessment (qSOFA) scores have limited utility in early prognostication in high-mortality populations. The purpose of this study was to investi...

Authors: Izumi Nakayama, Junichi Izawa, Hideyuki Mouri, Tetsuhisa Kitamura and Junji Shiotsuka

Hyperchloraemia in sepsis

Chloride represents—quantitatively—the most prevalent, negatively charged, strong plasma electrolyte. Control of chloride concentration is a probable major mechanism for regulating the body’s acid–base balance...

Authors: Christos Filis, Ioannis Vasileiadis and Antonia Koutsoukou

Nucleated red blood cells as predictors of mortality in patients with acute respiratory distress syndrome (ARDS): an observational study

Nucleated red blood cells (NRBCs) in critically ill patients are associated with increased mortality and poor outcome. The aim of the present study was to evaluate the predictive value of NRBCs in patients wit...

Authors: Mario Menk, Lena Giebelhäuser, Gerald Vorderwülbecke, Martina Gassner, Jan A. Graw, Björn Weiss, Mathias Zimmermann, Klaus-D. Wernecke and Steffen Weber-Carstens

Removal of totally implanted venous access ports for suspected infection in the intensive care unit: a multicenter observational study

While no data support this practice, international guidelines recommend the removal of totally implanted venous access ports (TIVAPs) in patients with suspicion of TIVAP-related bloodstream infection admitted ...

Authors: Marie Lecronier, Sandrine Valade, Naike Bigé, Nicolas de Prost, Damien Roux, David Lebeaux, Eric Maury, Elie Azoulay, Alexandre Demoule and Martin Dres

In-hospital and day-120 survival of critically ill solid cancer patients after discharge of the intensive care units: results of a retrospective multicenter study—A Groupe de recherche respiratoire en réanimation en Onco–Hématologie (Grrr-OH) study

To assess outcomes at hospital discharge and day-120 after intensive care unit (ICU) discharge among patients with solid cancer admitted to ICU and to identify characteristics associated with in-hospital and d...

Authors: François Vincent, Marcio Soares, Djamel Mokart, Virginie Lemiale, Fabrice Bruneel, Marouane Boubaya, Frédéric Gonzalez, Yves Cohen, Elie Azoulay and Michaël Darmon

Potentially modifiable respiratory variables contributing to outcome in ICU patients without ARDS: a secondary analysis of PRoVENT

The majority of critically ill patients do not suffer from acute respiratory distress syndrome (ARDS). To improve the treatment of these patients, we aimed to identify potentially modifiable factors associated...

Authors: Fabienne D. Simonis, Carmen S. V. Barbas, Antonio Artigas-Raventós, Jaume Canet, Rogier M. Determann, James Anstey, Goran Hedenstierna, Sabrine N. T. Hemmes, Greet Hermans, Michael Hiesmayr, Markus W. Hollmann, Samir Jaber, Ignacio Martin-Loeches, Gary H. Mills, Rupert M. Pearse, Christian Putensen…

Quality of life and life satisfaction are severely impaired in patients with long-term invasive ventilation following ICU treatment and unsuccessful weaning

Health-related quality of life (HRQL), life satisfaction, living conditions, patients’ attitudes towards life and death, expectations, beliefs and unmet needs are all poorly understood aspects associated with ...

Authors: Sophie Emilia Huttmann, Friederike Sophie Magnet, Christian Karagiannidis, Jan Hendrik Storre and Wolfram Windisch

Tracheotomy in the intensive care unit: guidelines from a French expert panel

Tracheotomy is widely used in intensive care units, albeit with great disparities between medical teams in terms of frequency and modality. Indications and techniques are, however, associated with variable lev...

Authors: Jean Louis Trouillet, Olivier Collange, Fouad Belafia, François Blot, Gilles Capellier, Eric Cesareo, Jean-Michel Constantin, Alexandre Demoule, Jean-Luc Diehl, Pierre-Grégoire Guinot, Franck Jegoux, Erwan L’Her, Charles-Edouard Luyt, Yazine Mahjoub, Julien Mayaux, Hervé Quintard…

Occurrence of marked sepsis-induced immunosuppression in pediatric septic shock: a pilot study

While the process of sepsis-induced immunosuppression is now well described in adults, very little information is available on immune functions in pediatric sepsis. The current study investigated this in child...

Authors: Solenn Remy, Karine Kolev-Descamps, Morgane Gossez, Fabienne Venet, Julie Demaret, Etienne Javouhey and Guillaume Monneret

Predictors of response to fixed-dose vasopressin in adult patients with septic shock

Vasopressin is often utilized for hemodynamic support in patients with septic shock. However, the most appropriate patient to initiate therapy in is unknown. This study was conducted to determine factors assoc...

Authors: Gretchen L. Sacha, Simon W. Lam, Abhijit Duggal, Heather Torbic, Stephanie N. Bass, Sarah C. Welch, Robert S. Butler and Seth R. Bauer

The prognostic value of bispectral index and suppression ratio monitoring after out-of-hospital cardiac arrest: a prospective observational study

We investigated the ability of bispectral index (BIS) monitoring to predict poor neurological outcome in out-of-hospital cardiac arrest (OHCA) patients fully treated according to guidelines.

Authors: Ward Eertmans, Cornelia Genbrugge, Margot Vander Laenen, Willem Boer, Dieter Mesotten, Jo Dens, Frank Jans and Cathy De Deyne

The 2014 updated version of the Confusion Assessment Method for the Intensive Care Unit compared to the 5th version of the Diagnostic and Statistical Manual of Mental Disorders and other current methods used by intensivists

One third of patients admitted to an intensive care unit (ICU) will develop delirium. However, delirium is under-recognized by bedside clinicians without the use of delirium screening tools, such as the Intens...

Authors: Gérald Chanques, E. Wesley Ely, Océane Garnier, Fanny Perrigault, Anaïs Eloi, Julie Carr, Christine M. Rowan, Albert Prades, Audrey de Jong, Sylvie Moritz-Gasser, Nicolas Molinari and Samir Jaber

Correction to: Blood platelets and sepsis pathophysiology: A new therapeutic prospect in critically ill patients?

Upon publication of the original article [1], it was noticed that the title was incorrect. Instead of ‘critical’, it should read ‘critically’, and therefore, the correct title should be.

Authors: Antoine Dewitte, Sébastien Lepreux, Julien Villeneuve, Claire Rigothier, Christian Combe, Alexandre Ouattara and Jean Ripoche

The effect of multidisciplinary extracorporeal membrane oxygenation team on clinical outcomes in patients with severe acute respiratory failure

The Extracorporeal Life Support Organization (ELSO) has suggested that extracorporeal membrane oxygenation (ECMO) patients should be managed by a multidisciplinary team. However, there are limited data on the ...

Authors: Soo Jin Na, Chi Ryang Chung, Hee Jung Choi, Yang Hyun Cho, Kiick Sung, Jeong Hoon Yang, Gee Young Suh and Kyeongman Jeon

Duration of acute kidney injury in critically ill patients

Duration of acute kidney injury (AKI) has been recognized a risk factor for adverse outcomes following AKI. We sought to examine the relationship of AKI duration and recurrent AKI with short-term outcomes in c...

Authors: Christine K. Federspiel, Theis S. Itenov, Kala Mehta, Raymond K. Hsu, Morten H. Bestle and Kathleen D. Liu

Use of speckle-tracking strain in preload-dependent patients, need for cautious interpretation!

In critical patients, left ventricular ejection fraction and fractional shortening are used to reflect left ventricular systolic function. An emerging technique, two-dimensional-strain echocardiography, allows...

Authors: C. Nafati, M. Gardette, M. Leone, L. Reydellet, V. Blasco, A. Lannelongue, F. Sayagh, S. Wiramus, F. Antonini, J. Albanèse and L. Zieleskiewicz

Impaired aspirin-mediated platelet function inhibition in resuscitated patients with acute myocardial infarction treated with therapeutic hypothermia: a prospective, observational, non-randomized single-centre study

The majority of resuscitated patients present with underlying cardiac disease, and out of these myocardial infarction is most common. Immediate interventional treatment is recommended and routinely requires du...

Authors: Florian Prüller, Oliver Leopold Milke, Lukasz Bis, Friedrich Fruhwald, Daniel Scherr, Philipp Eller, Sascha Pätzold, Siegfried Altmanninger-Sock, Peter Rainer, Jolanta Siller-Matula and Dirk von Lewinski

Fluid therapy and outcome: a prospective observational study in 65 German intensive care units between 2010 and 2011

Outcome data on fluid therapy in critically ill patients from randomised controlled trials may be different from data obtained by observational studies under “real-life” conditions. We conducted this prospecti...

Authors: Christian Ertmer, Bernhard Zwißler, Hugo Van Aken, Michael Christ, Fabian Spöhr, Axel Schneider, Robert Deisz and Matthias Jacob

Acute kidney injury epidemiology, risk factors, and outcomes in critically ill patients 16–25 years of age treated in an adult intensive care unit

Most studies of acute kidney injury (AKI) have focused on older adults, and little is known about AKI in young adults (16–25 years) that are cared for in an adult intensive care unit (ICU). We analyzed data fr...

Authors: Dana Y. Fuhrman, Sandra Kane-Gill, Stuart L. Goldstein, Priyanka Priyanka and John A. Kellum

Lung volumes and lung volume recruitment in ARDS: a comparison between supine and prone position

The use of positive end-expiratory pressure (PEEP) and prone position (PP) is common in the management of severe acute respiratory distress syndrome patients (ARDS). We conducted this study to analyze the vari...

Authors: Hernan Aguirre-Bermeo, Marta Turella, Maddalena Bitondo, Juan Grandjean, Stefano Italiano, Olimpia Festa, Indalecio Morán and Jordi Mancebo

Sodium lactate improves renal microvascular thrombosis compared to sodium bicarbonate and 0.9% NaCl in a porcine model of endotoxic shock: an experimental randomized open label controlled study

Sodium lactate seemed to improve fluid balance and avoid fluid overload. The objective of this study was to determine if these beneficial effects can be at least partly explained by an improvement in dissemina...

Authors: Thibault Duburcq, Arthur Durand, Antoine Tournoys, Viviane Gnemmi, Valery Gmyr, François Pattou, Mercedes Jourdain, Fabienne Tamion, Emmanuel Besnier, Sebastien Préau, Erika Parmentier-Decrucq, Daniel Mathieu, Julien Poissy and Raphaël Favory

Plasma microRNAs levels are different between pulmonary and extrapulmonary ARDS patients: a clinical observational study

Mesenchymal stem cells (MSC) obviously alleviate the damage of the structure and function of pulmonary vascular endothelial cells (VEC). The therapeutic effects of MSC are significantly different between pulmo...

Authors: Yi Zheng, Song-qiao Liu, Qin Sun, Jian-feng Xie, Jing-yuan Xu, Qing Li, Chun Pan, Ling Liu and Ying-zi Huang

Acute kidney injury in major abdominal surgery: incidence, risk factors, pathogenesis and outcomes

Acute kidney injury (AKI) is a common complication in patients undergoing major abdominal surgery. Various recent studies using modern standardized classifications for AKI reported a variable incidence of AKI ...

Authors: Joana Gameiro, José Agapito Fonseca, Marta Neves, Sofia Jorge and José António Lopes

Assessment of fluid responsiveness in spontaneously breathing patients: a systematic review of literature

Patients who increase stoke volume or cardiac index more than 10 or 15% after a fluid challenge are usually considered fluid responders. Assessment of fluid responsiveness prior to volume expansion is critical...

Authors: Renato Carneiro de Freitas Chaves, Thiago Domingos Corrêa, Ary Serpa Neto, Bruno de Arruda Bravim, Ricardo Luiz Cordioli, Fabio Tanzillo Moreira, Karina Tavares Timenetsky and Murillo Santucci Cesar de Assunção

Delayed cerebral thrombosis complicating pneumococcal meningitis: an autopsy study

Delayed cerebral thrombosis (DCT) is a devastating cerebrovascular complication in patients with excellent initial recovery of pneumococcal meningitis. The aetiology is unknown, but direct bacterial invasion, ...

Authors: Joo-Yeon Engelen-Lee, Matthijs C. Brouwer, Eleonora Aronica and Diederik van de Beek

The effect of a medication reconciliation program in two intensive care units in the Netherlands: a prospective intervention study with a before and after design

Medication errors occur frequently in the intensive care unit (ICU) and during care transitions. Chronic medication is often temporarily stopped at the ICU. Unfortunately, when the patient improves, the restar...

Authors: Liesbeth B. E. Bosma, Nicole G. M. Hunfeld, Rogier A. M. Quax, Edmé Meuwese, Piet H. G. J. Melief, Jasper van Bommel, SiokSwan Tan, Maaike J. van Kranenburg and Patricia M. L. A. van den Bemt