المؤلفون: Jung, Boris, Fosset, Maxime, Amalric, Matthieu, Baedorf-Kassis, Elias, O’gara, Brian, Sarge, Todd, Moulaire, Valerie, Brunot, Vincent, Bourdin, Arnaud, Molinari, Nicolas, Matecki, Stefan

المساهمون: Physiologie & médecine expérimentale du Cœur et des Muscles U 1046 (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Harvard Medical School Boston (HMS), Beth Israel Deaconess Medical Center Boston (BIDMC), Université de Montpellier (UM), IMAG

المصدر: ISSN: 2110-5820 ; Annals of Intensive Care ; https://hal.science/hal-04620826Test ; Annals of Intensive Care, 2024, 14 (1), pp.91. ⟨10.1186/s13613-024-01311-4⟩.

مصطلحات موضوعية: COPD, Mechanical ventilation, Respiratory mechanics, Sevoflurane, Volatile sedation, [SDV]Life Sciences [q-bio]

الوصف: International audience ; Abstract Background The objective was to compare sevoflurane, a volatile sedation agent with potential bronchodilatory properties, with propofol on respiratory mechanics in critically ill patients with COPD exacerbation. Methods Prospective study in an ICU enrolling critically ill intubated patients with severe COPD exacerbation and comparing propofol and sevoflurane after 1:1 randomisation. Respiratory system mechanics (airway resistance, PEEPi, trapped volume, ventilatory ratio and respiratory system compliance), gas exchange, vitals, safety and outcome were measured at inclusion and then until H48. Total airway resistance change from baseline to H48 in both sevoflurane and propofol groups was the main endpoint. Results Sixteen patients were enrolled and were sedated for 126 h(61–228) in the propofol group and 207 h(171–216) in the sevoflurane group. At baseline, airway resistance was 21.6cmH2O/l/s(19.8–21.6) in the propofol group and 20.4cmH2O/l/s(18.6–26.4) in the sevoflurane group, ( p = 0.73); trapped volume was 260 ml(176–290) in the propofol group and 73 ml(35–126) in the sevoflurane group, p = 0.02. Intrinsic PEEP was 1.5cmH2O(1–3) in both groups after external PEEP optimization. There was neither early (H4) or late (H48) significant difference in airway resistance and respiratory mechanics parameters between the two groups. Conclusions In critically ill patients intubated with COPD exacerbation, there was no significant difference in respiratory mechanics between sevoflurane and propofol from inclusion to H4 and H48.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/38888818; hal-04620826; https://hal.science/hal-04620826Test; https://hal.science/hal-04620826/documentTest; https://hal.science/hal-04620826/file/2022%20Jung%20et%20al.,%20Early%20and%20late%20effects%20.pdfTest; PUBMED: 38888818; PUBMEDCENTRAL: PMC11189368

الإتاحة: https://doi.org/10.1186/s13613-024-01311-4Test
https://hal.science/hal-04620826Test
https://hal.science/hal-04620826/documentTest
https://hal.science/hal-04620826/file/2022%20Jung%20et%20al.,%20Early%20and%20late%20effects%20.pdfTest

المؤلفون: Lecronier, Marie, Jung, Boris, Molinari, Nicolas, Pinot, Jérôme, Similowski, Thomas, Jaber, Samir, Demoule, Alexandre, Dres, Martin

المساهمون: CHU Pitié-Salpêtrière AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Neurophysiologie Respiratoire Expérimentale et Clinique (UMRS 1158), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Physiologie & médecine expérimentale du Cœur et des Muscles U 1046 (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Hôpital Arnaud de Villeneuve CHRU Montpellier, Institut Montpelliérain Alexander Grothendieck (IMAG), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Sorbonne Université (SU)

المصدر: ISSN: 2110-5820 ; Annals of Intensive Care ; https://hal.science/hal-03638172Test ; Annals of Intensive Care, 2022, 12 (1), pp.34. ⟨10.1186/s13613-022-01005-9⟩.

مصطلحات موضوعية: Diaphragm dysfunction, Mechanical ventilation, Sepsis, Sepsis-associated diaphragm dysfunction, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO]

الوصف: International audience ; Background: Whether sepsis-associated diaphragm dysfunction may improve despite the exposure of mechanical ventilation in critically ill patients is unclear. This study aims at describing the diaphragm function time course of septic and non-septic mechanically ventilated patients.Methods Secondary analysis of two prospective observational studies of mechanically ventilated patients in whom diaphragm function was assessed twice: within the 24 h after intubation and when patients were switched to pressure support mode, by measuring the endotracheal pressure in response to bilateral anterior magnetic phrenic nerve stimulation (Ptr,stim). Change in diaphragm function was expressed as the difference between Ptr,stim measured under pressure support mode and Ptr,stim measured within the 24 h after intubation. Sepsis was defined according to the Sepsis-3 international guidelines upon inclusion. In a sub-group of patients, the right hemidiaphragm thickness was measured by ultrasound.Results Ninety-two patients were enrolled in the study. Sepsis upon intubation was present in 51 (55%) patients. In septic patients, primary reason for ventilation was acute respiratory failure related to pneumonia (37/51; 73%). In non-septic patients, main reasons for ventilation were acute respiratory failure not related to pneumonia (16/41; 39%), coma (13/41; 32%) and cardiac arrest (6/41; 15%). Ptr,stim within 24 h after intubation was lower in septic patients as compared to non-septic patients: 6.3 (4.9–8.7) cmH 2 O vs. 9.8 (7.0–14.2) cmH 2 O ( p = 0.004), respectively. The median (interquartile) duration of mechanical ventilation between first and second diaphragm evaluation was 4 (2–6) days in septic patients and 3 (2–4) days in non-septic patients ( p = 0.073). Between first and second measurements, the change in Ptr,stim was + 19% (− 13–61) in septic patients and − 7% (− 40–12) in non-septic patients ( p = 0.005). In the sub-group of patients with ultrasound measurements, end-expiratory diaphragm thickness ...

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/35403916; hal-03638172; https://hal.science/hal-03638172Test; https://hal.science/hal-03638172/documentTest; https://hal.science/hal-03638172/file/2022%20Lecronier%20et%20al.,%20Severe%20but%20reversible.pdfTest; PUBMED: 35403916

الإتاحة: https://doi.org/10.1186/s13613-022-01005-9Test
https://hal.science/hal-03638172Test
https://hal.science/hal-03638172/documentTest
https://hal.science/hal-03638172/file/2022%20Lecronier%20et%20al.,%20Severe%20but%20reversible.pdfTest

المؤلفون: Aarab, Yassir, Flatres, Aurélien, Garnier, Fanny, Capdevila, Mathieu, Raynaud, F., Lacampagne, Alain, Chapeau, David, Klouche, Kada, Etienne, Pascal, Jaber, Samir, Molinari, Nicolas, Gamon, Lucie, Matecki, Stefan, Jung, Boris

المساهمون: Physiologie & médecine expérimentale du Cœur et des Muscles U 1046 (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Département d'anesthésie-réanimation Montpellier, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier)-Hôpital Gui de Chauliac CHU Montpellier, Laboratoire Charles Coulomb (L2C), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)

المصدر: ISSN: 1073-449X.

مصطلحات موضوعية: Diaphragmatic dysfunction, Diaphragmatic ultrasonography, Mechanical ventilation, Transdiaphragmatic pressure, MESH: Adult, MESH: Female, MESH: Swine, MESH: Translation Research, Biomedical, MESH: Humans, MESH: Male, MESH: Middle Aged, MESH: Animals, MESH: Biomechanical Phenomena, MESH: Biopsy, MESH: Critical Illness, MESH: Diaphragm, MESH: Elasticity Imaging Techniques, MESH: Prospective Studies, MESH: Qualitative Research, MESH: Respiration, Artificial, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract

الوصف: Rationale: Prolonged mechanical ventilation is often associated with either a decrease (known atrophy) or an increase (supposed injury) in diaphragmatic thickness. Shear wave elastography is a noninvasive technique that measures shear modulus, a surrogate of tissue stiffness and mechanical properties.Objectives: To describe changes in shear modulus (SM) during the ICU stay and the relationship with alterations in muscle thickness. To perform a comprehensive ultrasound-based characterization of histological and force production changes occurring in the diaphragm.Methods: Translational study using critically ill patients and mechanically ventilated piglets. Serial ultrasound examination of the diaphragm collecting thickness and SM was performed in both patients and piglets. Transdiaphragmatic pressure and diaphragmatic biopsies were collected in piglets.Measurements and Main Results: We enrolled 102 patients, 88 of whom were invasively mechanically ventilated. At baseline, SM was 14.3 ± 4.3 kPa and diaphragm end-expiratory thickness was 2.0 ± 0.5 mm. Decrease or increase by more than 10% from baseline was reported in 86% of the patients for thickness and in 92% of the patients for SM. An increase in diaphragmatic thickness during the stay was associated with a decrease in SM (β = −9.34 ± 4.41; P = 0.03) after multivariable analysis. In the piglet sample, a decrease in SM over 3 days of mechanical ventilation was associated with loss of force production, slow and fast fiber atrophy, and increased lipid droplets accumulation.Conclusions: Increases in diaphragm thickness during critical illness is associated with decreased tissue stiffness as demonstrated by shear wave ultrasound elastography, consistent with the development of muscle injury and weakness.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/34255974; hal-03286291; https://hal.science/hal-03286291Test; https://hal.science/hal-03286291/documentTest; https://hal.science/hal-03286291/file/2021%20Aarab%20et%20al.,%20Shear%20Wve.pdfTest; PUBMED: 34255974; WOS: 000705466800015

الإتاحة: https://doi.org/10.1164/rccm.202011-4086OCTest
https://hal.science/hal-03286291Test
https://hal.science/hal-03286291/documentTest
https://hal.science/hal-03286291/file/2021%20Aarab%20et%20al.,%20Shear%20Wve.pdfTest

المؤلفون: Dres, Martin, Jung, Boris, Molinari, Nicolas, Manna, Federico, Dubé, Bruno-Pierre, Chanques, Gerald, Similowski, Thomas, Jaber, Samir, Demoule, Alexandre

المساهمون: CHU Pitié-Salpêtrière AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles U 1046 (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Institut Montpelliérain Alexander Grothendieck (IMAG), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)

المصدر: ISSN: 1364-8535.

مصطلحات موضوعية: Magnetic stimulation, Muscles, Mechanical ventilation, Weakness, Weaning, Intensive care unit, Diaphragm, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie

الوصف: International audience ; Background: Intensive care unit (ICU)-acquired weakness (ICU-AW) and ICU-acquired diaphragm dysfunction (ICU-DD) occur frequently in mechanically ventilated (MV) patients. It is unknown whether they have different risk factors and different impacts on outcome. This study was designed to (1) describe the respective risk factors associated with ICU-AW and severe ICU-DD and (2) evaluate the respective impact of ICU-AW and severe ICU-DD on outcome.Methods: Post hoc analysis of two prospective cohort studies conducted in two ICUs. In patients mechanically ventilated for at least 24 h undergoing a first spontaneous breathing trial, severe ICU-DD was defined as diaphragm twitch pressure < 7 cmH2O and ICU-AW was defined as Medical Research Council Score < 48.Results; One hundred sixteen patients were assessed. Factors independently associated with severe ICU-DD were age, longer duration of MV, and exposure to sufentanil, and those factors associated with ICU-AW were longer duration of MV and exposure to norepinephrine. Severe ICU-DD (OR 3.56, p = 0.008), but not ICU-AW, was independently associated with weaning failure (59%). ICU-AW (OR 4.30, p = 0.033), but not severe ICU-DD, was associated with ICU mortality. Weaning failure and mortality rate were higher in patients with both severe ICU-DD and ICU-AW (86% and 39%, respectively) than in patients with either severe ICU-DD (64% and 0%) or ICU-AW (63% and 13%).Conclusion: Severe ICU-DD and ICU-AW have different risk factors and different impacts on weaning failure and mortality. The impact of the combination of ICU-DD and ICU-AW is more pronounced than their individual impact.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/31752937; hal-02377203; https://hal.science/hal-02377203Test; https://hal.science/hal-02377203/documentTest; https://hal.science/hal-02377203/file/2019%20Dres%20et%20al.,%20Respective%20contribution.pdfTest; PUBMED: 31752937

الإتاحة: https://doi.org/10.1186/s13054-019-2650-zTest
https://hal.science/hal-02377203Test
https://hal.science/hal-02377203/documentTest
https://hal.science/hal-02377203/file/2019%20Dres%20et%20al.,%20Respective%20contribution.pdfTest

المؤلفون: Demoule, Alexandre, Molinari, Nicolas, Jung, Boris, Prodanovic, Hélène, Chanques, Gerald, Matecki, Stefan, Mayaux, Julien, Similowski, Thomas, Jaber, Samir

المساهمون: Neurophysiologie Respiratoire Expérimentale et Clinique, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pitié-Salpêtrière AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Montpelliérain Alexander Grothendieck (IMAG), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Physiologie & médecine expérimentale du Cœur et des Muscles U 1046 (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier)

المصدر: ISSN: 2110-5820 ; Annals of Intensive Care ; https://hal.sorbonne-universite.fr/hal-01357795Test ; Annals of Intensive Care, 2016, 6 (75), ⟨10.1186/s13613-016-0179-8⟩.

مصطلحات موضوعية: Mechanical ventilation, Outcome, Intensive care unit, Sepsis, Phrenic nerve stimulation, Diaphragm Respiratory muscles function, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology

الوصف: 8 pages ; International audience

العلاقة: hal-01357795; https://hal.sorbonne-universite.fr/hal-01357795Test; https://hal.sorbonne-universite.fr/hal-01357795/documentTest; https://hal.sorbonne-universite.fr/hal-01357795/file/Demoule%20et%20al-AnnIntCare-2016.pdfTest; PUBMEDCENTRAL: PMC4974210

الإتاحة: https://doi.org/10.1186/s13613-016-0179-8Test
https://hal.sorbonne-universite.fr/hal-01357795Test
https://hal.sorbonne-universite.fr/hal-01357795/documentTest
https://hal.sorbonne-universite.fr/hal-01357795/file/Demoule%20et%20al-AnnIntCare-2016.pdfTest

المؤلفون: Jung, Boris, Moury, Pierre, Mahul, Martin, de Jong, Audrey, Galia, Fabrice, Prades, Albert, Albaladejo, Pierre, Chanques, Gerald, Molinari, Nicolas, Jaber, Samir

المساهمون: Physiologie & médecine expérimentale du Cœur et des Muscles U 1046 (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Département d'anesthésie-réanimation Montpellier, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier)-Hôpital Gui de Chauliac CHU Montpellier, Hôpital Saint Eloi (CHRU Montpellier), Techniques pour l'Evaluation et la Modélisation des Actions de la Santé (TIMC-IMAG-ThEMAS), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes 2016-2019 (UGA 2016-2019 )-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes 2016-2019 (UGA 2016-2019 ), Aide à la Décision pour une Médecine Personnalisé - Laboratoire de Biostatistique, Epidémiologie et Recherche Clinique - EA 2415 (AIDMP), Université Montpellier 1 (UM1)-Université de Montpellier (UM)

المصدر: ISSN: 0342-4642.

مصطلحات موضوعية: Mechanical ventilation, Respiratory muscles, Intensive care unit-acquired weakness, Weaning, Diaphragmatic dysfunction, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract

الوصف: International audience

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/26572511; hal-01780240; https://hal.umontpellier.fr/hal-01780240Test; https://hal.umontpellier.fr/hal-01780240/documentTest; https://hal.umontpellier.fr/hal-01780240/file/2016%20Jung%20%20et%20al.,%20Diaphragmatic%20dysfunction.pdfTest; PUBMED: 26572511

الإتاحة: https://doi.org/10.1007/s00134-015-4125-2Test
https://hal.umontpellier.fr/hal-01780240Test
https://hal.umontpellier.fr/hal-01780240/documentTest
https://hal.umontpellier.fr/hal-01780240/file/2016%20Jung%20%20et%20al.,%20Diaphragmatic%20dysfunction.pdfTest

المؤلفون: Mahul, Martin, Jung, Boris, Galia, Fabrice, Molinari, Nicolas, de Jong, Audrey, Coisel, Yannaël, Vaschetto, Rosanna, Matecki, Stefan, Chanques, Gerald, Brochard, Laurent, Jaber, Samir

المساهمون: Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles U 1046 (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), University of Toronto

المصدر: ISSN: 1364-8535.

مصطلحات موضوعية: Work of breathing, Weaning, Obese, Mechanical ventilation, Acute respiratory failure, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO]

الوصف: International audience

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/27784322; hal-01800609; https://hal.umontpellier.fr/hal-01800609Test; https://hal.umontpellier.fr/hal-01800609/documentTest; https://hal.umontpellier.fr/hal-01800609/file/Mahul%20et%20al-CritCare-2016.pdfTest; PUBMED: 27784322

الإتاحة: https://doi.org/10.1186/s13054-016-1457-4Test
https://hal.umontpellier.fr/hal-01800609Test
https://hal.umontpellier.fr/hal-01800609/documentTest
https://hal.umontpellier.fr/hal-01800609/file/Mahul%20et%20al-CritCare-2016.pdfTest

المؤلفون: Molinari , Nicolas, Chanez , Pascal, Roche , Nicolas, Ahmed , Engi, Vachier , Arnaud, Bourdin , Arnaud, Vachier , Isabelle

المساهمون: Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Pneumologie et Soins Intensifs Respiratoires, Université Paris Descartes - Paris 5 (UPD5)-Hôpitaux Universitaires Paris Centre, Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] ( PhyMedExp ), Centre National de la Recherche Scientifique ( CNRS ) -Université de Montpellier ( UM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Centre recherche en CardioVasculaire et Nutrition ( C2VN ), Institut National de la Recherche Agronomique ( INRA ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paris Descartes - Paris 5 ( UPD5 ) -Hôpitaux Universitaires Paris Centre, CHU Saint-Eloi-Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Montpellier ( UM ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Arnaud de Villeneuve, MORNET, Dominique, Centre recherche en CardioVasculaire et Nutrition (C2VN)

المصدر: Respiratory Research
Respiratory Research, BioMed Central, 2016, 17 (1), pp.149. ⟨10.1186/s12931-016-0469-6⟩
Respiratory Research, 2016, 17 (1), pp.149. ⟨10.1186/s12931-016-0469-6⟩
Respiratory Research, BioMed Central, 2016, 17 (1), pp.149. 〈10.1186/s12931-016-0469-6〉

مصطلحات موضوعية: Male, Time Factors, Databases, Factual, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Severity of Illness Index, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Patient Admission, Risk Factors, 030212 general & internal medicine, Hospital Mortality, Longitudinal Studies, Registries, Hospital Costs, health care economics and organizations, ComputingMilieux_MISCELLANEOUS, Aged, 80 and over, COPD, Mortality rate, Incidence (epidemiology), Incidence, Process Assessment, Health Care, Middle Aged, 3. Good health, [SDV] Life Sciences [q-bio], Treatment Outcome, Disease Progression, Female, France, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Critical Care, education, macromolecular substances, Bronchoscopies, 03 medical and health sciences, COPD exacerbation, Severity of illness, medicine, Humans, Intensive care medicine, Admissions, Aged, Mechanical ventilation, Hospitalizations, [ SDV ] Life Sciences [q-bio], business.industry, Research, COPD management, Length of Stay, medicine.disease, Respiration, Artificial, respiratory tract diseases, Pneumonia, 030228 respiratory system, Copd exacerbation, Deaths, Emergency medicine, business

الوصف: Background To examine trends in mortality, costs and in-hospital management and outcomes of severe COPD exacerbations admitted in France. Methods Patients hospitalized from 2007 to 2012 with COPD exacerbation as the primary diagnosis were identified from the exhaustive French medico-administrative hospitalizations database records. Four groups of severe COPD exacerbations were defined: hospitalisation in a general ward (GW) without acute respiratory failure (ARF), GW with ARF, ICU without invasive mechanical ventilation (MV), and ICU with MV. Results A 15.48 % increase in admissions from 113 276 in 2007 to 133 497 in 2012 was recorded. Age (+9.9 months), gender (−2.5 % of male) and length of stay (−0.29 day) slightly changed while the number of ICU admissions increased markedly (+41.78 %). In-hospital mortality rates increased (+8.06 %, p

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b1a5389d774cb80893f7c525d5ec3a10Test
https://hal.umontpellier.fr/hal-01785648/documentTest

المؤلفون: Demoule, Alexandre, Jung, Boris, Prodanovic, Hélène, Molinari, Nicolas, Chanques, Gerald, Coirault, Catherine, Matecki, Stefan, Duguet, Alexandre, Similowski, Thomas, Jaber, Samir

المساهمون: CHU Pitié-Salpêtrière AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de recherche en Myologie – U974 SU-INSERM, Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles U 1046 (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre de recherche en myologie, Université Pierre et Marie Curie - Paris 6 (UPMC)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Neurophysiologie Respiratoire Expérimentale et Clinique, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)

المصدر: ISSN: 1073-449X.

مصطلحات موضوعية: diaphragm, sepsis, mechanical ventilation, [SDV]Life Sciences [q-bio]

الوصف: International audience ; Rationale: Diaphragmatic insults occurring during intensive care unit (ICU) stays have become the focus of intense research. However, diaphragmatic abnormalities at the initial phase of critical illness remain poorly documented in humans. Objectives: To determine the incidence, risk factors, and prognostic impact of diaphragmatic impairment on ICU admission. Methods: Prospective, 6-month, observational cohort study in two ICUs. Mechanically ventilated patients were studied within 24 hours after intubation (Day 1) and 48 hours later (Day 3). Seventeen anesthetized intubated control anesthesia patients were also studied. The diaphragm was assessed by twitch tracheal pressure in response to bilateral anterior magnetic phrenic nerve stimulation (Ptr,stim). Measurements and Main Results: Eighty-five consecutive patients aged 62 (54-75) (median [interquartile range]) were evaluated (medical admission, 79%; Simplified Acute Physiology Score II, 54 [44-68]). On Day 1, Ptr, stim was 8.2 (5.9-12.3) cm H2O and 64% of patients had Ptr, stim less than 11 cm H2O. Independent predictors of low Ptr, stim were sepsis (linear regression coefficient, -3.74; standard error, 1.16; P = 0.002) and Simplified Acute Physiology Score II (linear regression coefficient, -0.07; standard error, 1.69; P = 0.03). Compared with nonsurvivors, ICU survivors had higher Ptr, stim (9.7 [6.3-13.8] vs. 7.3 [5.5-9.7] cm H2O; P = 0.004). This was also true for hospital survivors versus nonsurvivors (9.7 [6.3-13.5] vs. 7.8 [5.5-10.1] cm H2O; P = 0.004). Day 1 and Day 3 Ptr, stim were similar. Conclusions: A reduced capacity of the diaphragm to produce inspiratory pressure (diaphragm dysfunction) is frequent on ICU admission. It is associated with sepsis and disease severity, suggesting that it may represent another form of organ failure. It is associated with a poor prognosis.

العلاقة: inserm-02426547; https://inserm.hal.science/inserm-02426547Test; https://inserm.hal.science/inserm-02426547/documentTest; https://inserm.hal.science/inserm-02426547/file/Demoule%20et%20al-AJRCCM%202013.pdfTest; PRODINRA: 263619; WOS: 000321817400016

الإتاحة: https://doi.org/10.1164/rccm.201209-1668OCTest
https://inserm.hal.science/inserm-02426547Test
https://inserm.hal.science/inserm-02426547/documentTest
https://inserm.hal.science/inserm-02426547/file/Demoule%20et%20al-AJRCCM%202013.pdfTest

المؤلفون: Demoule, Alexandre, Jung, Boris, Prodanovic, Hélène, Molinari, Nicolas, Chanques, Gerald, Coirault, Catherine, Matecki, Stefan, Duguet, Alexandre, Similowski, Thomas, Jaber, Samir

المصدر: American Journal of Respiratory & Critical Care Medicine; 7/15/2013, Vol. 188 Issue 2, p213-219, 7p