Articles

Circulating bile acids predict outcome in critically ill patients

Jaundice and cholestatic hepatic dysfunction are frequent findings in critically ill patients associated with increased mortality. Cholestasis in critically ill patients is closely associated with stimulation ...

Authors: Thomas Horvatits, Andreas Drolz, Karoline Rutter, Kevin Roedl, Lies Langouche, Greet Van den Berghe, Günter Fauler, Brigitte Meyer, Martin Hülsmann, Gottfried Heinz, Michael Trauner and Valentin Fuhrmann

Are high nurse workload/staffing ratios associated with decreased survival in critically ill patients? A cohort study

Despite the central role of nurses in intensive care, a relationship between intensive care nurse workload/staffing ratios and survival has not been clearly established. We determined whether there is a thresh...

Authors: Anna Lee, Yip Sing Leo Cheung, Gavin Matthew Joynt, Czarina Chi Hung Leung, Wai-Tat Wong and Charles David Gomersall

High-flow nasal cannula to prevent postextubation respiratory failure in high-risk non-hypercapnic patients: a randomized multicenter trial

Extubation failure is associated with increased morbidity and mortality, but cannot be safely predicted or avoided. High-flow nasal cannula (HFNC) prevents postextubation respiratory failure in low-risk patients.

Authors: Rafael Fernandez, Carles Subira, Fernando Frutos-Vivar, Gemma Rialp, Cesar Laborda, Joan Ramon Masclans, Amanda Lesmes, Luna Panadero and Gonzalo Hernandez

Seawater drowning-associated pneumonia: a 10-year descriptive cohort in intensive care unit

Pneumonia is one of the major complications of drowning, but the optimal empirical antibiotic treatment is not clearly defined. Multidrug-resistant (MDR) bacteria and fungi have been identified in a recent se...

Authors: Alexandre Robert, Pierre-Éric Danin, Hervé Quintard, Nicolas Degand, Nihal Martis, Denis Doyen, Céline Pulcini, Raymond Ruimy, Carole Ichai, Gilles Bernardin and Jean Dellamonica

The protective association of endogenous immunoglobulins against sepsis mortality is restricted to patients with moderate organ failure

Pre-evaluation of endogenous immunoglobulin levels is a potential strategy to improve the results of intravenous immunoglobulins in sepsis, but more work has to be done to identify those patients who could ben...

Authors: Ignacio Martin-Loeches, Arturo Muriel-Bombín, Ricard Ferrer, Antonio Artigas, Jordi Sole-Violan, Leonardo Lorente, David Andaluz-Ojeda, Adriele Prina-Mello, Ruben Herrán-Monge, Borja Suberviola, Ana Rodriguez-Fernandez, Pedro Merino, Ana M. Loza, Pablo Garcia-Olivares, Eduardo Anton, Eduardo Tamayo…

Outcome of patients with septic shock and high-dose vasopressor therapy

Despite the dissemination of international guidelines, mortality from septic shock remains high. Norepinephrine is recommended as first-line vasopressor therapy with a target mean arterial pressure of 65 mmHg....

Authors: Thomas Auchet, Marie-Alix Regnier, Nicolas Girerd and Bruno Levy

Protocols for the obvious: Where does it start, and stop?

Protocols can be helpful in specific situations and may have show benefits in clinical trials. So-called evidence based protocols and checklists frequently remind clinicians to do the obvious, but may also co...

Authors: Armand R. J. Girbes and Paul E. Marik

Shedding light on venoarterial PCO₂ gradient

Authors: Arnaldo Dubin and Mario Omar Pozo

Diagnostic accuracy of quantitative neuromuscular ultrasound for the diagnosis of intensive care unit-acquired weakness: a cross-sectional observational study

Neuromuscular ultrasound is a noninvasive investigation, which can be easily performed at the bedside on the ICU. A reduction in muscle thickness and increase in echo intensity over time have been described in...

Authors: Esther Witteveen, Juultje Sommers, Luuk Wieske, Jonne Doorduin, Nens van Alfen, Marcus J. Schultz, Ivo N. van Schaik, Janneke Horn and Camiel Verhamme

Earlier versus later initiation of renal replacement therapy among critically ill patients with acute kidney injury: a systematic review and meta-analysis of randomized controlled trials

Although the optimal timing of initiation of renal replacement therapy (RRT) in critically ill patients with acute kidney injury has been extensively studied in the past, it is still unclear.

Authors: Tai-Shuan Lai, Chih-Chung Shiao, Jian-Jhong Wang, Chun-Te Huang, Pei-Chen Wu, Eric Chueh, Shih-Chieh Jeff Chueh, Kianoush Kashani and Vin-Cent Wu

Patients with ANCA-associated vasculitis admitted to the intensive care unit with acute vasculitis manifestations: a retrospective and comparative multicentric study

Data for ANCA-associated vasculitis (AAV) patients requiring intensive care are scarce.

Authors: Julien Demiselle, Johann Auchabie, François Beloncle, Philippe Gatault, Steven Grangé, Damien Du Cheyron, Jean Dellamonica, Sonia Boyer, Dimitri Titeca Beauport, Lise Piquilloud, Julien Letheulle, Christophe Guitton, Nicolas Chudeau, Guillaume Geri, François Fourrier, René Robert…

Long-term outcome of patients with liver cirrhosis admitted to a general intensive care unit

The prevalence of liver cirrhosis is increasing, and many patients have acute conditions requiring consideration of intensive care. This study aims to: (a) report the outcome at 12 months of patients with cirr...

Authors: Alex Warren, Charlotte R. Soulsby, Alex Puxty, Joseph Campbell, Martin Shaw, Tara Quasim, John Kinsella and Joanne McPeake

Implementation and evaluation of a paediatric nurse-driven sedation protocol in a paediatric intensive care unit

Optimal sedation and analgesia is a challenge in paediatric intensive care units (PICU) because of difficulties in scoring systems and specific metabolism inducing tolerance and withdrawal. Excessive sedation ...

Authors: Lélia Dreyfus, Etienne Javouhey, Angélique Denis, Sandrine Touzet and Fabienne Bordet

Are third-generation cephalosporins unavoidable for empirical therapy of community-acquired pneumonia in adult patients who require ICU admission? A retrospective study

Third-generation cephalosporins (3GCs) are recommended for empirical antibiotic therapy of community-acquired pneumonia (CAP) in patients requiring ICU admission. However, their extensive use could promote the...

Authors: Geoffroy Hariri, Jacques Tankovic, Pierre-Yves Boëlle, Vincent Dubée, Guillaume Leblanc, Claire Pichereau, Simon Bourcier, Naike Bigé, Jean-Luc Baudel, Arnaud Galbois, Hafid Ait-Oufella and Eric Maury

Systematic overdosing of oxa- and cloxacillin in severe infections treated in ICU: risk factors and side effects

Oxacillin and cloxacillin are the most frequently used penicillins for the treatment of severe methicillin-susceptible Staphylococcus aureus infections in intensive care units (ICUs), especially endocarditis. Int...

Authors: Mathilde Neuville, Najoua El-Helali, Eric Magalhaes, Aguila Radjou, Roland Smonig, Jean-François Soubirou, Guillaume Voiriot, Alban Le Monnier, Stéphane Ruckly, Lila Bouadma, Romain Sonneville, Jean-François Timsit and Bruno Mourvillier

Prognosis of cirrhotic patients admitted to intensive care unit: a meta-analysis

The best predictors of short- and medium-term mortality of cirrhotic patients receiving intensive care support are unknown.

Authors: Delphine Weil, Eric Levesque, Marc McPhail, Rodrigo Cavallazzi, Eleni Theocharidou, Evangelos Cholongitas, Arnaud Galbois, Heng Chih Pan, Constantine J. Karvellas, Bertrand Sauneuf, René Robert, Jérome Fichet, Gaël Piton, Thierry Thevenot, Gilles Capellier and Vincent Di Martino

Sepsis risk factors in infants with congenital diaphragmatic hernia

Congenital diaphragmatic hernia (CDH) is a rare congenital anomaly and remains among the most challenging ICU-managed disease. Beside severe pulmonary hypertension, lung hypoplasia and major abdominal surgery,...

Authors: Michaël Levy, Nolwenn Le Sache, Mostafa Mokhtari, Guy Fagherazzi, Gaelle Cuzon, Benjamin Bueno, Virginie Fouquet, Alexandra Benachi, Sergio Eleni Dit Trolli and Pierre Tissieres

Acute hyperventilation increases the central venous-to-arterial PCO₂ difference in stable septic shock patients

To evaluate the effects of acute hyperventilation on the central venous-to-arterial carbon dioxide tension difference (∆PCO₂) in hemodynamically stable septic shock patients.

Authors: Jihad Mallat, Usman Mohammad, Malcolm Lemyze, Mehdi Meddour, Marie Jonard, Florent Pepy, Gaelle Gasan, Stephanie Barrailler, Johanna Temime, Nicolas Vangrunderbeeck, Laurent Tronchon and Didier Thevenin

Persistent lymphopenia is a risk factor for ICU-acquired infections and for death in ICU patients with sustained hypotension at admission

Severely ill patients might develop an alteration of their immune system called post-aggressive immunosuppression. We sought to assess the risk of ICU-acquired infection and of mortality according to the abso...

Authors: Christophe Adrie, Maxime Lugosi, Romain Sonneville, Bertrand Souweine, Stéphane Ruckly, Jean-Charles Cartier, Maité Garrouste-Orgeas, Carole Schwebel and Jean-François Timsit

A hypoperfusion context may aid to interpret hyperlactatemia in sepsis-3 septic shock patients: a proof-of-concept study

Persistent hyperlactatemia is particularly difficult to interpret in septic shock. Besides hypoperfusion, adrenergic-driven lactate production and impaired lactate clearance are important contributors. Howeve...

Authors: Leyla Alegría, Magdalena Vera, Jorge Dreyse, Ricardo Castro, David Carpio, Carolina Henriquez, Daniela Gajardo, Sebastian Bravo, Felipe Araneda, Eduardo Kattan, Pedro Torres, Gustavo Ospina-Tascón, Jean-Louis Teboul, Jan Bakker and Glenn Hernández

Patient-important outcomes in randomized controlled trials in critically ill patients: a systematic review

Intensivists’ clinical decision making pursues two main goals for patients: to decrease mortality and to improve quality of life and functional status in survivors. Patient-important outcomes are gaining wide ...

Authors: Stéphane Gaudry, Jonathan Messika, Jean-Damien Ricard, Sylvie Guillo, Blandine Pasquet, Emeline Dubief, Tanissia Boukertouta, Didier Dreyfuss and Florence Tubach

Multi-marker approach using procalcitonin, presepsin, galectin-3, and soluble suppression of tumorigenicity 2 for the prediction of mortality in sepsis

Biomarker could be objective and reliable tools to predict mortality in sepsis. We explored the prognostic utilities of emerging biomarkers in septic patients and questioned whether adding biomarkers to the cl...

Authors: Hanah Kim, Mina Hur, Hee-Won Moon, Yeo-Min Yun and Salvatore Di Somma

Outcomes in elderly patients admitted to the intensive care unit with solid tumors

As the population ages and cancer therapies improve, there is an increased call for elderly cancer patients to be admitted to the intensive care unit (ICU). This study aimed to assess short-term survival and p...

Authors: Edouard Auclin, Anaïs Charles-Nelson, Baptiste Abbar, Emmanuel Guérot, Stéphane Oudard, Caroline Hauw-Berlemont, Constance Thibault, Alexandra Monnier, Jean-Luc Diehl, Sandrine Katsahian, Jean-Yves Fagon, Julien Taieb and Nadia Aissaoui

Sound level intensity severely disrupts sleep in ventilated ICU patients throughout a 24-h period: a preliminary 24-h study of sleep stages and associated sound levels

It is well recognized that sleep is severely disturbed in patients in intensive care units (ICU) and that this can compromise their rehabilitation potential. However, it is still difficult to objectively asses...

Authors: Maxime Elbaz, Damien Léger, Fabien Sauvet, Benoit Champigneulle, Stéphane Rio, Mélanie Strauss, Mounir Chennaoui, Christian Guilleminault and Jean Paul Mira

Diagnosis of cardiac surgery-associated acute kidney injury: differential roles of creatinine, chitinase 3-like protein 1 and neutrophil gelatinase-associated lipocalin: a prospective cohort study

A common and serious complication of cardiac surgery prompting early detection and intervention is cardiac surgery-associated acute kidney injury (CSA-AKI). Urinary chitinase 3-like protein 1 (UCHI3L1) was fou...

Authors: Jorien De Loor, Ingrid Herck, Katrien Francois, Astrid Van Wesemael, Lieve Nuytinck, Evelyne Meyer and Eric A. J. Hoste

Impact of random safety analyses on structure, process and outcome indicators: multicentre study

To assess the impact of a real-time random safety tool on structure, process and outcome indicators.

Authors: María Bodí, Iban Oliva, Maria Cruz Martín, Maria Carmen Gilavert, Carlos Muñoz, Montserrat Olona and Gonzalo Sirgo

IL-6 rs1800795 polymorphism is associated with septic shock-related death in patients who underwent major surgery: a preliminary retrospective study

Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection, being the primary cause of death from infection, especially if not recognized and treated promptly. The aim o...

Authors: Maria Angeles Jiménez-Sousa, Luz Maria Medrano, Pilar Liu, Amanda Fernández-Rodríguez, Raquel Almansa, Esther Gomez-Sanchez, Alicia Ortega, María Heredia-Rodríguez, Estefanía Gómez-Pesquera, Eduardo Tamayo and Salvador Resino

Prone positioning in acute respiratory distress syndrome after abdominal surgery: a multicenter retrospective study

The recent demonstration of prone position’s strong benefit on patient survival has rendered proning a major therapeutic intervention in severe ARDS. Uncertainties remain as to whether or not ARDS patients in...

Authors: Stéphane Gaudry, Samuel Tuffet, Anne-Claire Lukaszewicz, Christian Laplace, Noémie Zucman, Marc Pocard, Bruno Costaglioli, Simon Msika, Jacques Duranteau, Didier Payen, Didier Dreyfuss, David Hajage and Jean-Damien Ricard

Hemodynamic effects of short-term hyperoxia after coronary artery bypass grafting

Although oxygen is generally administered in a liberal manner in the perioperative setting, the effects of oxygen administration on dynamic cardiovascular parameters, filling status and cerebral perfusion have...

Authors: Hendrik J. F. Helmerhorst, Rob B. P. de Wilde, Dae Hyun Lee, Meindert Palmen, Jos R. C. Jansen, David J. van Westerloo and Evert de Jonge

Antithrombin use and 28-day in-hospital mortality among severe-burn patients: an observational nationwide study

Previous studies have suggested that antithrombin may be beneficial for treating coagulopathy in patients with severe burns. However, robust evidence for this idea is lacking. We examined the hypothesis that a...

Authors: Takashi Tagami, Hiroki Matsui, Yuuta Moroe, Reo Fukuda, Ami Shibata, Chie Tanaka, Kyoko Unemoto, Kiyohide Fushimi and Hideo Yasunaga

Epidemiology of sepsis in Catalonia: analysis of incidence and outcomes in a European setting

Up-to-date identification of local trends in sepsis incidence and outcomes is of considerable public health importance. The aim of our study was to estimate annual incidence rates and in-hospital mortality tre...

Authors: Juan Carlos Yébenes, Juan Carlos Ruiz-Rodriguez, Ricard Ferrer, Montserrat Clèries, Anna Bosch, Carol Lorencio, Alejandro Rodriguez, Xavier Nuvials, Ignacio Martin-Loeches and Antoni Artigas

Associations among left ventricular systolic function, tachycardia, and cardiac preload in septic patients

In sepsis, tachycardia may indicate low preload, adrenergic stimulation, or both. Adrenergic overstimulation is associated with septic cardiomyopathy. We sought to determine whether tachycardia was associated ...

Authors: Michael J. Lanspa, Sajid Shahul, Andrew Hersh, Emily L. Wilson, Troy D. Olsen, Eliotte L. Hirshberg, Colin K. Grissom and Samuel M. Brown

Goal-directed fluid restriction during brain surgery: a prospective randomized controlled trial

The value of goal-directed fluid therapy in neurosurgical patients, where brain swelling is a major concern, is unknown. The aim of our study was to evaluate the effect of an intraoperative goal-directed fluid...

Authors: Jinfeng Luo, Jing Xue, Jin Liu, Bin Liu, Li Liu and Guo Chen

Superior accuracy of mid-regional proadrenomedullin for mortality prediction in sepsis with varying levels of illness severity

The use of novel sepsis biomarkers has increased in recent years. However, their prognostic value with respect to illness severity has not been explored. In this work, we examined the ability of mid-regional p...

Authors: David Andaluz-Ojeda, H. Bryant Nguyen, Nicolas Meunier-Beillard, Ramón Cicuéndez, Jean-Pierre Quenot, Dolores Calvo, Auguste Dargent, Esther Zarca, Cristina Andrés, Leonor Nogales, Jose María Eiros, Eduardo Tamayo, Francisco Gandía, Jesús F. Bermejo-Martín and Pierre Emmanuel Charles

Transportation of patients on extracorporeal membrane oxygenation: a tertiary medical center experience and systematic review of the literature

Utilization of extracorporeal membrane oxygenation (ECMO) has increased worldwide, but its use remains restricted to severely ill patients, and few referral centers are properly structured to offer this suppor...

Authors: Pedro Vitale Mendes, Cesar de Albuquerque Gallo, Bruno Adler Maccagnan Pinheiro Besen, Adriana Sayuri Hirota, Raquel de Oliveira Nardi, Edzangela Vasconcelos dos Santos, Ho Yeh Li, Daniel Joelsons, Eduardo Leite Vieira Costa, Flavia Krepel Foronda, Luciano Cesar Pontes Azevedo and Marcelo Park

Relation between presence of extended-spectrum β-lactamase-producing Enterobacteriaceae in systematic rectal swabs and respiratory tract specimens in ICU patients

The choice of empirical antimicrobial therapy for pneumonia in intensive care unit (ICU) is a challenge, since pneumonia is often related to multidrug-resistant pathogens, particularly extended-spectrum β-lact...

Authors: Hélène Carbonne, Matthieu Le Dorze, Anne-Sophie Bourrel, Hélène Poupet, Claire Poyart, Emmanuelle Cambau, Jean-Paul Mira, Julien Charpentier and Rishma Amarsy

Dynamic driving pressure associated mortality in acute respiratory distress syndrome with extracorporeal membrane oxygenation

The survival predictors and optimal mechanical ventilator settings in patients with severe acute respiratory distress syndrome (ARDS) undergoing extracorporeal membrane oxygenation (ECMO) are uncertain. This s...

Authors: Li-Chung Chiu, Han-Chung Hu, Chen-Yiu Hung, Chih-Hao Chang, Feng-Chun Tsai, Cheng-Ta Yang, Chung-Chi Huang, Huang-Pin Wu and Kuo-Chin Kao

Early risk factors and the role of fluid administration in developing acute respiratory distress syndrome in septic patients

Sepsis is a major risk factor for acute respiratory distress syndrome (ARDS). However, there remains a paucity of literature examining risk factors for ARDS in septic patients early in their course. This stud...

Authors: Raghu R. Seethala, Peter C. Hou, Imoigele P. Aisiku, Gyorgy Frendl, Pauline K. Park, Mark E. Mikkelsen, Steven Y. Chang, Ognjen Gajic and Jonathan Sevransky

Clinical assessment and train-of-four measurements in critically ill patients treated with recommended doses of cisatracurium or atracurium for neuromuscular blockade: a prospective descriptive study

Despite few studies, a monitoring of a neuromuscular blockade with a train of four (TOF) is recommended in intensive care unit (ICU). Our objective was to compare the results of ulnar and facial TOF measureme...

Authors: Pierre Bouju, Jean-Marc Tadié, Nicolas Barbarot, Julien Letheulle, Fabrice Uhel, Pierre Fillatre, Guillaume Grillet, Angélique Goepp, Yves Le Tulzo and Arnaud Gacouin

Proceedings of Réanimation 2017, the French Intensive Care Society International Congress

Authors: Wulfran Bougouin, Eloi Marijon, Benjamin Planquette, Nicole Karam, Florence Dumas, David Celermajer, Daniel Jost, Lionel Lamhaut, Frankie Beganton, Alain Cariou, Guy Meyer, Xavier Jouven, Côme Bureau, Julien Charpentier, Omar Ben Hadj Salem, Lucie Guillemet…

Proceedings of Réanimation 2017, the French Intensive Care Society International Congress

Authors: Chtara Kamilia, Kais Regaieg, Najeh Baccouch, Hedi Chelly, Mabrouk Bahloul, Mounir Bouaziz, Ali Jendoubi, Ahmed Abbes, Houda Belhaouane, Oussama Nasri, Layla Jenzri, Salma Ghedira, Mohamed Houissa, Kamal Belkadi, Youness Harti, Afak Nsiri…

Invasive fungal tracheobronchitis in mechanically ventilated critically ill patients: underlying conditions, diagnosis, and outcomes

Invasive fungal tracheobronchitis (IFT) is a severe form of pulmonary fungal infection that is not limited to immunocompromised patients. Although respiratory failure is a crucial predictor of death, informati...

Authors: Chun-Yu Lin, Wei-Lun Liu, Che-Chia Chang, Hou-Tai Chang, Han-Chung Hu, Kuo-chin Kao, Ning-Hung Chen, Ying-Jen Chen, Cheng-Ta Yang, Chung-Chi Huang and George Dimopoulos

Adrenomedullin: a marker of impaired hemodynamics, organ dysfunction, and poor prognosis in cardiogenic shock

The clinical CardShock risk score, including baseline lactate levels, was recently shown to facilitate risk stratification in patients with cardiogenic shock (CS). As based on baseline parameters, however, it ...

Authors: Heli Tolppanen, Mercedes Rivas-Lasarte, Johan Lassus, Jordi Sans-Roselló, Oliver Hartmann, Matias Lindholm, Mattia Arrigo, Tuukka Tarvasmäki, Lars Köber, Holger Thiele, Kari Pulkki, Jindrich Spinar, John Parissis, Marek Banaszewski, Jose Silva-Cardoso, Valentina Carubelli…

Impact of transfusion on patients with sepsis admitted in intensive care unit: a systematic review and meta-analysis

Red blood cell transfusion (RBCT) threshold in patients with sepsis remains a matter of controversy. A threshold of 7 g/dL for stabilized patients with sepsis is commonly proposed, although debated. The aim of...

Authors: Claire Dupuis, Romain Sonneville, Christophe Adrie, Antoine Gros, Michael Darmon, Lila Bouadma and Jean-François Timsit

Patients with preexisting psychiatric disorders admitted to ICU: a descriptive and retrospective cohort study

While the psychiatric disorders are conditions frequently encountered in hospitalized patients, there are little or no data regarding the characteristics and short- and long-term outcomes in patients with pre...

Authors: Arnaud Gacouin, Adel Maamar, Pierre Fillatre, Emmanuelle Sylvestre, Margaux Dolan, Yves Le Tulzo and Jean Marc Tadié

Fluid resuscitation in human sepsis: Time to rewrite history?

Fluid resuscitation continues to be recommended as the first-line resuscitative therapy for all patients with severe sepsis and septic shock. The current acceptance of the therapy is based in part on long hist...

Authors: Liam Byrne and Frank Van Haren

Cost analysis of single-use (Ambu^® aScope™) and reusable bronchoscopes in the ICU

Flexible optical bronchoscopes are essential for management of airways in ICU, but the conventional reusable flexible scopes have three major drawbacks: high cost of repairs, need for decontamination, and poss...

Authors: S. Perbet, M. Blanquet, C. Mourgues, J. Delmas, S. Bertran, B. Longère, V. Boïko-Alaux, P. Chennell, J.-E. Bazin and J.-M. Constantin

Passive leg raise testing effectively reduces fluid administration in septic shock after correction of non-compliance to test results

Fluid resuscitation is considered a cornerstone of shock treatment, but recent data have underlined the potential hazards of fluid overload. The passive leg raise (PLR) test has been introduced as one of many ...

Authors: Arjanne Rameau, Eldert de With and Evert Christiaan Boerma

Normal saline as resuscitation fluid in critically ill patients: not dead yet!

Authors: Patrick M. Honore, Rita Jacobs and Herbert D. Spapen

Glutamine, fish oil and antioxidants in critical illness: MetaPlus trial post hoc safety analysis

The role of plasma glutamine, fish oil and antioxidants concentrations in the treatment effect of immune-modulating high-protein versus high-protein enteral nutrition on 6-month mortality in critically ill pa...

Authors: Zandrie Hofman, Sophie Swinkels and Arthur R. H. van Zanten