المؤلفون: Simon Bessis, Aurélien Dinh, Sylvain Gautier, Benjamin Davido, Jonathan Levy, Christine Lawrence, Anne-Sophie Lot, Djamel Bensmail, Célia Rech, Muriel Farcy-Afif, Frédérique Bouchand, Pierre de Truchis, Jean-Louis Herrmann, Frédéric Barbot, David Orlikowski, Pierre Moine, Christian Perronne, Loïc Josseran, Hélène Prigent, Djillali Annane

المصدر: Frontiers in Public Health, Vol 10 (2022)

مصطلحات موضوعية: COVID-19 outbreak, preparedness, infection control, emerging infection, resilience, Public aspects of medicine, RA1-1270

الوصف: The COVID-19 pandemic is a unique crisis challenging healthcare institutions as it rapidly overwhelmed hospitals due to a large influx of patients. This major event forced all the components of the healthcare systems to adapt and invent new workflows. Thus, our tertiary care hospital was reorganized entirely. During the cruising phase, additional staff was allocated to a one-building organization comprising an intensive care unit (ICU), an acute care unit, a physical medicine and rehabilitation unit, and a COVID-19 screening area. The transfer of patients from a ward to another was more efficient due to these organizations and pavilion structure. The observed mortality was low in the acute care ward, except in the palliative unit. No nosocomial infection with SARS-CoV-2 was reported in any other building of the hospital since this organization was set up. This type of one-building organization, integrating all the components for comprehensive patient care, seems to be the most appropriate response to pandemics.

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fpubh.2022.709848/fullTest; https://doaj.org/toc/2296-2565Test

الوصول الحر: https://doaj.org/article/20a492f801944040a1ebedd4eb3f674dTest

المؤلفون: Nicolas Terzi, Hélène Prigent, Frédéric Lofaso

المصدر: ERJ Open Research, Vol 7, Iss 4 (2021)

مصطلحات موضوعية: Medicine

وصف الملف: electronic resource

العلاقة: http://openres.ersjournals.com/content/7/4/00490-2021.fullTest; https://doaj.org/toc/2312-0541Test

الوصول الحر: https://doaj.org/article/8ef6b96f9f2b4d458ff29425a0a1af99Test

المؤلفون: Abdallah Fayssoil, Nicolas Mansencal, Lee S. Nguyen, David Orlikowski, Hélène Prigent, Jean Bergounioux, Djillali Annane, Frédéric Lofaso

المصدر: Medicines, Vol 9, Iss 1, p 5 (2022)

مصطلحات موضوعية: cardiac surgery, diaphragm ultrasound, phrenic nerve, cardiac ICU, Medicine

الوصف: In cardiac surgery, patients are at risk of phrenic nerve injury, which leads to diaphragm dysfunction and acute respiratory failure. Diaphragm dysfunction (DD) is relatively frequent in cardiac surgery and particularly affects patients after coronary artery bypass graft. The onset of DD affects patients’ prognosis in term of weaning from mechanical ventilation and hospital length of stay. The authors present a narrative review about diaphragm physiology, techniques used to assess diaphragm function, and the clinical application of diaphragm ultrasound in patients undergoing cardiac surgery.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2305-6320/9/1/5Test; https://doaj.org/toc/2305-6320Test

الوصول الحر: https://doaj.org/article/6c0a7d19a1df43d9a047ad8e547745a2Test

المؤلفون: Marine Garguilo, Michèle Lejaille, Isabelle Vaugier, David Orlikowski, Nicolas Terzi, Frédéric Lofaso, Hélène Prigent

المصدر: PLoS ONE, Vol 11, Iss 3, p e0148673 (2016)

مصطلحات موضوعية: Medicine, Science

الوصف: BACKGROUND:Respiratory involvement in neuromuscular disorders may contribute to impaired breathing-swallowing interactions, swallowing disorders and malnutrition. We investigated whether the use of non-invasive ventilation (NIV) controlled by the patient could improve swallowing performances in a population of neuromuscular patients requiring daytime NIV. METHODS:Ten neuromuscular patients with severe respiratory failure requiring extensive NIV use were studied while swallowing without and with NIV (while ventilated with a modified ventilator allowing the patient to withhold ventilation as desired). Breathing-swallowing interactions were investigated by chin electromyography, cervical piezoelectric sensor, nasal flow recording and inductive plethysmography. Two water-bolus sizes (5 and 10ml) and a textured yogurt bolus were tested in a random order. RESULTS:NIV use significantly improved swallowing fragmentation (defined as the number of respiratory interruption of the swallowing of a single bolus) (p = 0.003) and breathing-swallowing synchronization (with a significant increase of swallows followed by an expiration) (p

وصف الملف: electronic resource

العلاقة: http://europepmc.org/articles/PMC4777441?pdf=renderTest; https://doaj.org/toc/1932-6203Test

الوصول الحر: https://doaj.org/article/9c6278ccbe8a4b15956c8b21b2aa3e18Test

المؤلفون: Matthias Boentert, Hélène Prigent, Katalin Várdi, Harrison N. Jones, Uwe Mellies, Anita K. Simonds, Stephan Wenninger, Emilia Barrot Cortés, Marco Confalonieri

المصدر: International Journal of Molecular Sciences, Vol 17, Iss 10, p 1735 (2016)

مصطلحات موضوعية: neuromuscular disorders, Pompe disease, respiratory muscle weakness, mechanical ventilation, cough assistance, Biology (General), QH301-705.5, Chemistry, QD1-999

الوصف: Pompe disease is an autosomal-recessive lysosomal storage disorder characterized by progressive myopathy with proximal muscle weakness, respiratory muscle dysfunction, and cardiomyopathy (in infants only). In patients with juvenile or adult disease onset, respiratory muscle weakness may decline more rapidly than overall neurological disability. Sleep-disordered breathing, daytime hypercapnia, and the need for nocturnal ventilation eventually evolve in most patients. Additionally, respiratory muscle weakness leads to decreased cough and impaired airway clearance, increasing the risk of acute respiratory illness. Progressive respiratory muscle weakness is a major cause of morbidity and mortality in late-onset Pompe disease even if enzyme replacement therapy has been established. Practical knowledge of how to detect, monitor and manage respiratory muscle involvement is crucial for optimal patient care. A multidisciplinary approach combining the expertise of neurologists, pulmonologists, and intensive care specialists is needed. Based on the authors’ own experience in over 200 patients, this article conveys expert recommendations for the diagnosis and management of respiratory muscle weakness and its sequelae in late-onset Pompe disease.

وصف الملف: electronic resource

العلاقة: http://www.mdpi.com/1422-0067/17/10/1735Test; https://doaj.org/toc/1422-0067Test

الوصول الحر: https://doaj.org/article/56eecea37b484bc384fa4828a35eb60cTest

المؤلفون: Abdallah Fayssoil, Nicolas Mansencal, Lee S. Nguyen, Olivier Nardi, Rabah Ben Yaou, France Leturcq, Helge Amthor, Karim Wahbi, Henri Marc Becane, Frederic Lofaso, Helene Prigent, Guillaume Bassez, Anthony Behin, Tanya Stojkovic, Bertrand Fontaine, Denis Duboc, Olivier Dubourg, Bernard Clair, Pascal Laforet, Djillali Annane, David Orlikowski

المصدر: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 12, Iss 16 (2023)

مصطلحات موضوعية: Duchenne muscular dystrophy, mortality, prognosis, right ventricle, ventilation, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Background Chronic respiratory failure and heart involvement may occur in Duchenne muscular dystrophy. We aimed to assess the prognostic value of the right ventricular (RV) systolic dysfunction in patients with Duchenne muscular dystrophy. Methods and Results We studied 90 genetically proven patients with Duchenne muscular dystrophy from 2010 to 2019, to obtain respiratory function and Doppler echocardiographic RV systolic function. Prognostic value was assessed in terms of death and cardiac events. The median age was 27.5 years, and median forced vital capacity was at 10% of the predicted value: 83 patients (92%) were on home mechanical ventilation. An RV systolic dysfunction was found in 46 patients (51%). In patients without RV dysfunction at inclusion, a left ventricular systolic dysfunction at inclusion was associated with a higher risk of developing RV dysfunction during follow‐up with an odds ratio of 4.5 (P=0.03). RV systolic dysfunction was significantly associated with cardiac events, mainly acute heart failure (62%) and cardiogenic shock (23%). In a multivariable Cox model, the adjusted hazard ratio was 4.96 (95% CI [1.09–22.6]; P=0.04). In terms of death, we found a significant difference between patients with RV dysfunction versus patients without RV dysfunction in the Kaplan–Meier curves (log‐rank P=0.045). Conclusions RV systolic dysfunction is frequently present in patients with Duchenne muscular dystrophy and is associated with increased risk of cardiac events, irrespective of left ventricular dysfunction and mechanical ventilation. Registration URL: https://www.clinicaltrials.orgTest; unique identifier: NCT02501083.

العلاقة: https://doaj.org/toc/2047-9980Test; https://doaj.org/article/02fc68b65c144097b681f168f8edc607Test

الإتاحة: https://doi.org/10.1161/JAHA.122.027231Test
https://doaj.org/article/02fc68b65c144097b681f168f8edc607Test

المؤلفون: Nicholas Heming, Robert Carlier, Helene Prigent, Ahmed Mekki, Camille Jousset, Frederic Lofaso, Xavier Ambrosi, Rania Bounab, Virginie Maxime, Arnaud Mansart, Pascal Crenn, Pierre Moine, Fabien Foltzer, Bernard Cuenoud, Tobias Konz, John Corthesy, Maurice Beaumont, Mickaël Hartweg, Claudia Roessle, Jean-Charles Preiser, Denis Breuillé, Djillali Annane

المصدر: Critical Care, Vol 26, Iss 1, Pp 1-14 (2022)

مصطلحات موضوعية: Sepsis, Critical illness, Protein balance, Intensive care unit, Nutrition, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9

الوصف: Background A defining feature of prolonged critical illness is muscle wasting, leading to impaired recovery. Supplementation with a tailored blend of amino acids may bolster the innate gut defence, promote intestinal mucosa repair and limit muscle loss. Methods This was a monocentric, randomized, double-blind, placebo-controlled study that included patients with sepsis or acute respiratory distress syndrome. Patients received a specific combination of five amino acids or placebo mixed with enteral feeding for 21 days. Markers of renal function, gut barrier structure and functionality were collected at baseline and 1, 2, 3 and 8 weeks after randomization. Muscle structure and function were assessed through MRI measurements of the anterior quadriceps volume and by twitch airway pressure. Data were compared between groups relative to the baseline. Results Thirty-five critically ill patients were randomized. The amino acid blend did not impair urine output, blood creatinine levels or creatinine clearance. Plasma citrulline levels increased significantly along the treatment period in the amino acid group (difference in means [95% CI] 5.86 [1.72; 10.00] nmol/mL P = 0.007). Alanine aminotransferase and alkaline phosphatase concentrations were lower in the amino acid group than in the placebo group at one week (ratio of means 0.5 [0.29; 0.86] (P = 0.015) and 0.73 [0.57; 0.94] (P = 0.015), respectively). Twitch airway pressure and volume of the anterior quadriceps were greater in the amino acid group than in the placebo group 3 weeks after randomization (difference in means 10.6 [0.99; 20.20] cmH20 (P = 0.035) and 3.12 [0.5; 5.73] cm3/kg (P = 0.022), respectively). Conclusions Amino acid supplementation increased plasma citrulline levels, reduced alanine aminotransferase and alkaline phosphatase levels, and improved twitch airway pressure and anterior quadriceps volume. Trial registration ClinicalTrials.gov, NCT02968836. Registered November 21, 2016.

العلاقة: https://doi.org/10.1186/s13054-022-04232-5Test; https://doaj.org/toc/1364-8535Test; https://doaj.org/article/60d1a1313e5f4b1db84d5a7ef95c2a4cTest

الإتاحة: https://doi.org/10.1186/s13054-022-04232-5Test
https://doaj.org/article/60d1a1313e5f4b1db84d5a7ef95c2a4cTest

المؤلفون: Mathieu Delorme, Antoine Leotard, Marius Lebret, Claire Lefeuvre, Anda Hazenberg, Mercedes Pallero, Annabel H. Nickol, Liam M. Hannan, Matthias Boentert, Aycan Yüksel, Wolfram Windisch, Mark E. Howard, Nicholas Hart, Peter J. Wijkstra, Hélène Prigent, Jean-Louis Pepin, Frederic Lofaso, Charles Khouri, Jean-Christian Borel

المصدر: Archivos de Bronconeumología.

مصطلحات موضوعية: Pulmonary and Respiratory Medicine

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::5769a34bd6876273d64f5b5437f8a7bdTest
https://doi.org/10.1016/j.arbres.2023.05.002Test

المؤلفون: Abdallah Fayssoil, Lee S Nguyen, Adam Ogna, Tanya Stojkovic, Paris Meng, Dominique Mompoint, Robert Carlier, Helene Prigent, Bernard Clair, Anthony Behin, Pascal Laforet, Guillaume Bassez, Pascal Crenn, David Orlikowski, Djillali Annane, Bruno Eymard, Frederic Lofaso

المصدر: PLoS ONE, Vol 14, Iss 4, p e0214288 (2019)

مصطلحات موضوعية: Medicine, Science

الوصف: Background In patients with neuromuscular disorders, assessment of respiratory function relies on forced vital capacity (FVC) measurements. Providing complementary respiratory outcomes may be useful for clinical trials. Diaphragm sniff ultrasound (US) is a noninvasive technique that can assess diaphragm function that may be affected in patients with neuromuscular disorders. Purpose We aimed to provide normal values of sniff diaphragm ultrasound, to assess the relationship between sniff diaphragm US, vital capacity (VC) and sniff nasal pressure. Additionally, we aimed to evaluate the diagnostic accuracy of sniff diaphragm US for predicting restrictive pulmonary insufficiency. Materials and methods We included patients with neuromuscular disorders that had been tested with a sniff diaphragm US and functional respiratory tests. Healthy subjects were also included to obtain normal diaphragm sniff ultrasound. We performed diaphragm tissue Doppler imaging (TDI) and time movement (TM) diaphragm echography combined with sniff maneuver. Results A total of 89 patients with neuromuscular diseases and 27 healthy subjects were included in our study. In patients, the median age was 32 years [25; 50] and the median FVC was 34% of predicted [18; 55]. Sniff diaphragm motion using TM ultrasound was significantly associated with sniff nasal pressure, both for the right hemidiaphragm (r = 0.6 p <0.0001) and the left hemidiaphragm (r = 0.63 p = 0.0008). Right sniff peak TDI velocity was also significantly associated with FVC (r = 0.72, p<0.0001) and with sniff nasal pressure (r = 0.66 p<0.0001). Sniff diaphragm ultrasound using either TM mode or TDI displayed significant accuracy for predicting FVC<60% with an area under curve (AUC) reaching 0.93 (p<0.0001) for the right sniff diaphragm ultrasound in TM mode and 0.86 (p<0.001) for right peak diaphragm TDI velocity. Conclusion Sniff diaphragm TM and TDI measures were significantly associated with sniff nasal pressure. Sniff diaphragm TM and TDI had a high level of ...

العلاقة: https://doi.org/10.1371/journal.pone.0214288Test; https://doaj.org/toc/1932-6203Test; https://doaj.org/article/a7d9a25d30e64f769eb1c4dd70adc161Test

الإتاحة: https://doi.org/10.1371/journal.pone.0214288Test
https://doaj.org/article/a7d9a25d30e64f769eb1c4dd70adc161Test

المؤلفون: Abdallah Fayssoil, Rabah Ben Yaou, Adam Ogna, Cendrine Chaffaut, France Leturcq, Olivier Nardi, Karim Wahbi, Denis Duboc, Frederic Lofaso, Helene Prigent, Bernard Clair, Pascal Crenn, Guillaume Nicolas, Pascal Laforet, Anthony Behin, Sylvie Chevret, David Orlikowski, Djillali Annane

المصدر: PLoS ONE, Vol 13, Iss 1, p e0190518 (2018)

مصطلحات موضوعية: Medicine, Science

الوصف: Duchenne muscular dystrophy (DMD) is an inherited myogenic disorder due to mutations in the dystrophin gene on chromosome Xp21.1. We designed this study to determine the prevalence of left bundle branch block (LBBB), whether there is a relationship between LBBB and genetic pattern, and to assess predictive factors for acute cardiac events and mortality in adult DMD patients.We reviewed the charts of DMD followed at the Home Mechanical Ventilation Unit of the Raymond Poincare University Hospital.A total of 121 patients, aged from 18 to 41 years have been included in our study. Median vital capacity (VC) was 12% [7; 19.5] of predicted. Almost all patients were on home mechanical ventilation (95%). LBBB was present in 15 patients (13%); among them, 10 disclosed exonic deletions. After a median follow up of 6 years, 21 patients (17%) experienced acute heart failure (AHF), 7 patients (6%) supraventricular arrhythmia, 3 patients (2.4%) ventricular tachycardia, 4 patients (3%) significant electrical disturbances. LBBB was significantly associated with cardiac events (OR = 12.7; 95%CI [3.78-42.7]; p <0.0001) and mortality (OR = 4.4; 95%CI [1.44-13.7]; p 0.009). Presence of residual dystrophin protein was not associated with significant less cardiac events. Age and LVEF were also predictive factors for cardiac events and mortality.LBBB is relatively frequent in DMD and is a major predictive factor for cardiac events and mortality. Presence of residual dystrophin protein was not associated with a lower incidence of cardiac events.

العلاقة: http://europepmc.org/articles/PMC5755816?pdf=renderTest; https://doaj.org/toc/1932-6203Test; https://doaj.org/article/b7986a31a7364b46be754655f2ea90f8Test

الإتاحة: https://doi.org/10.1371/journal.pone.0190518Test
https://doaj.org/article/b7986a31a7364b46be754655f2ea90f8Test