المؤلفون: Kattan, Eduardo, Bakker, Jan, Estenssoro, Elisa, Ospina-Tascón, Gustavo Adolfo, Cavalcanti, Alexandre Biasi, Backer, Daniel De, Vieillard-Baron, Antoine, Teboul, Jean-Louis, Castro, Ricardo, Hernández, Glenn

المصدر: Revista Brasileira de Terapia Intensiva. March 2022 34(1)

مصطلحات موضوعية: Sepse, Choque séptico, Tempo de enchimento capilar, Fenótipo, Cuidados intensivos, Tempo de internação, Perfusão, Norepinefrina, Ecocardiografia, Algoritmo

الوصف: Introdução: A reversão precoce da hipoperfusão tecidual induzida é essencial para a sobrevida no choque séptico. No entanto, falta consenso sobre a melhor estratégia de ressuscitação inicial, uma vez que intervenções destinadas a toda a população com choque séptico podem produzir administração desnecessária de líquidos. Este artigo relata a justificativa, o delineamento e o plano de análise do estudo ANDROMEDA-2, que visa determinar se uma estratégia guiada por perfusão periférica, que consiste na ressuscitação guiada pelo tempo de enchimento capilar com base em fenótipos clínicos e hemodinâmicos, está associada a uma diminuição no desfecho composto de mortalidade, tempo até a interrupção ao suporte de órgãos e tempo de internação em comparação com o atendimento padrão em pacientes com choque séptico precoce (< 4 horas do diagnóstico). Metódos: O estudo ANDROMEDA-2 é um ensaio clínico randomizado controlado multinacional e multicêntrico. No grupo de intervenção, o tempo de enchimento capilar será medido a cada hora, durante 6 horas. Se estiver anormal, os pacientes serão alocados em um algoritmo, começando com a avaliação da pressão de pulso. Pacientes com pressão de pulso inferior a 40mmHg serão testados quanto à capacidade de resposta a líquidos e receberão líquidos de acordo. Em pacientes com pressão de pulso > 40mmHg, norepinefrina será titulada para manter a pressão arterial diastólica > 50mmHg. Os pacientes que não normalizarem o tempo de enchimento capilar após as etapas anteriores serão submetidos à ecocardiografia de cuidados intensivos para avaliação da disfunção cardíaca e posterior manejo. Por fim, serão realizados testes com vasopressores e inodilatadores para otimizar ainda mais a perfusão. Um tamanho de amostra de 1.500 pacientes fornecerá 88% de poder para demonstrar a superioridade da estratégia direcionada ao tempo de enchimento capilar. Conclusão: Se for demonstrado que o direcionamento ao tempo de enchimento capilar é uma estratégia melhor, os processos de atendimento na ressuscitação do choque séptico podem ser otimizados com ferramentas usadas à beira do leito.

وصف الملف: text/html

الوصول الحر: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0103-507X2022000100096Test

المؤلفون: Hajage, David, Combes, Alain, Guervilly, Christophe, Lebreton, Guillaume, Mercat, Alain, Pavot, Arthur, Nseir, Saad, Mekontso-Dessap, Armand, Mongardon, Nicolas, Mira, Jean Paul, Ricard, Jean-Damien, Beurton, Alexandra, Tachon, Guillaume, Kontar, Loay, Le Terrier, Christophe, Richard, Jean Christophe, Mégarbane, Bruno, Keogh, Ruth, Belot, Aurélien, Maringe, Camille, Leyrat, Clémence, Schmidt, Matthieu, Asfar, Pierre, Beloncle, François, Demiselle, Julien, Pham, Tài, Monnet, Xavier, Richard, Christian, Demoule, Alexandre, Dres, Martin, Mayaux, Julien, Daubin, Cédric, Descamps, Richard, Joret, Aurélie, Du Cheyron, Damien, Pene, Frédéric, Chiche, Jean-Daniel, Jozwiak, Mathieu, Jaubert, Paul, Voiriot, Guillaume, Fartoukh, Muriel, Teulier, Marion, Blayau, Clarisse, l'Her, Erwen, Aubron, Cécile, Bodenes, Laetitia, Ferriere, Nicolas, Auchabie, Johann, Le Meur, Anthony, Pignal, Sylvain, Mazzoni, Thierry, Quenot, Jean-Pierre, Andreu, Pascal, Roudau, Jean-Baptiste, Labruyère, Marie, Preau, Sebastien, Poissy, Julien, Mathieu, Daniel, Benhamida, Sarah, Paulet, Rémi, Roucaud, Nicolas, Thyrault, Martial, Daviet, Florence, Hraiech, Sami, Parzy, Gabriel, Sylvestre, Aude, Jochmans, Sébastien, Bouilland, Anne-Laure, Monchi, Mehran, Danguy Des Déserts, Marc, Mathais, Quentin, Rager, Gwendoline, Pasquier, Pierre, Reignier, Jean, Seguin, Amélie, Garret, Charlotte, Canet, Emmanuel, Dellamonica, Jean, Saccheri, Clément, Lombardi, Romain, Kouchit, Yanis, Jacquier, Sophie, Mathonnet, Armelle, Nay, Mai-Ahn, Runge, Isabelle, Martino, Frédéric, Flurin, Laure, Rolle, Amélie, Carles, Michel, Coudroy, Rémi, W. Thille, Arnaud, Frat, Jean-Pierre, Rodriguez, Maeva, Beuret, Pascal, Tientcheu, Audrey, Vincent, Arthur, Michelin, Florian, Tamion, Fabienne, Carpentier, Dorothée, Boyer, Déborah, Beduneau, Gaetan, Gissot, Valérie, Ehrmann, Stéphan, Salmon Gandonniere, Charlotte, Elaroussi, Djlali, Delbove, Agathe, Fedun, Yannick, Huntzinger, Julien, Lebas, Eddy, Kisoka, Grâce, Grégoire, Céline, Marchetta, Stella, Lambermont, Bernard, Argaud, Laurent, Baudry, Thomas, Bertrand, Pierre-Jean, Dargent, Auguste, Guitton, Christophe, Chudeau, Nicolas, Landais, Mickaël, Darreau, Cédric, Ferre, Alexis, Gros, Antoine, Lacave, Guillaume, Bruneel, Fabrice, Neuville, Mathilde, Devaquet, Jérôme, Gallot, Richard, Chelha, Riad, Galbois, Arnaud, Jallot, Anne, Chalumeau Lemoine, Ludivine, Kuteifan, Khaldoun, Pointurier, Valentin, Jandeaux, Louise-Marie, Mootien, Joy, Damoisel, Charles, Sztrymf, Benjamin, Chommeloux, Juliette, Edouard Luyt, Charles, Schortgen, Frédérique, Rusel, Leon, Jung, Camille, Gobert, Florent, Vimpere, Damien, Lamhaut, Lionel, Sauneuf, Bertrand, Charrrier, Liliane, Calus, Julien, Desmeules, Isabelle, Painvin, Benoît, Tadie, Jean-Marc, Castelain, Vincent, Michard, Baptiste, Herbrecht, Jean-Etienne, Baldacini, Mathieu, Weiss, Nicolas, Demeret, Sophie, Marois, Clémence, Rohaut, Benjamin, Moury, Pierre-Henri, Savida, Anne-Charlotte, Couadau, Emmanuel, Série, Mathieu, Alexandru, Nica, Bruel, Cédric, Fontaine, Candice, Garrigou, Sonia, Courtiade Mahler, Juliette, Leclerc, Maxime, Ramakers, Michel, Garçon, Pierre, Massou, Nicole, van Vong, Ly, Sen, Juliane, Lucas, Nolwenn, Chemouni, Franck, Stoclin, Annabelle, Avenel, Alexandre, Faure, Henri, Gentilhomme, Angélie, Ricome, Sylvie, Abraham, Paul, Monard, Céline, Textoris, Julien, Rimmele, Thomas, Montini, Florent, Lejour, Gabriel, Lazard, Thierry, Etienney, Isabelle, Kerroumi, Younes, Dupuis, Claire, Bereiziat, Marine, Coupez, Elisabeth, Thouy, François, Hoffmann, Clément, Donat, Nicolas, Chrisment, Anne, Blot, Rose-Marie, Kimmoun, Antoine, Jacquot, Audrey, Mattei, Matthieu, Levy, Bruno, Ravan, Ramin, Dopeux, Loïc, Liteaudon, Jean-Mathias, Roux, Delphine, Rey, Brice, Anghel, Radu, Schenesse, Deborah, Gevrey, Vincent, Castanera, Jermy, Petua, Philippe, Madeux, Benjamin, Hartman, Otto, Piagnerelli, Michael, Joosten, Anne, Noel, Cinderella, Biston, Patrick, Noel, Thibaut, Le Bouar, Gurvan, Boukhanza, Messabi, Demarest, Elsa, Bajolet, Marie-France, Charrier, Nathanaël, Quenet, Audrey, Zylberfajn, Cécile, Dufour, Nicolas, Mégarbane, Buno, Voicu, Sébastian, Deye, Nicolas, Malissin, Isabelle, Legay, François, Debarre, Matthieu, Barbarot, Nicolas, Fillatre, Pierre, Delord, Bertrand, Laterrade, Thomas, Saghi, Tahar, Pujol, Wilfried, Julien Cungi, Pierre, Esnault, Pierre, Cardinale, Mickael, Hong Tuan Ha, Vivien, Fleury, Grégory, Brou, Marie-Ange, Zafimahazo, Daniel, Tran-Van, David, Avargues, Patrick, Carenco, Lisa, Robin, Nicolas, Ouali, Alexandre, Houdou, Lucie, Suh, Noémie, Primmaz, Steve, Pugin, Jérome, Weiss, Emmanuel, Gauss, Tobias, Moyer, Jean-Denis, Paugam Burtz, Catherine, La Combe, Béatrice, Smonig, Rolland, Violleau, Jade, Cailliez, Pauline, Chelly, Jonathan, Marchalot, Antoine, Saladin, Cécile, Bigot, Christelle, Fayolle, Pierre-Marie, Fatséas, Jules, Ibrahim, Amr, Resiere, Dabor, Hage, Rabih, Cholet, Clémentine, Cantier, Marie, Trouiler, Pierre, Montravers, Philippe, Lortat-Jacob, Brice, Tanaka, Sebastien, Tran Dinh, Alexy, Duranteau, Jacques, Harrois, Anatole, Dubreuil, Guillaume, Werner, Marie, Godier, Anne, Hamada, Sophie, Zlotnik, Diane, Nougue, Hélène, Carteaux, Guillaume, Razazi, Keyvan, de Prost, Nicolas, Lamraoui, Meriam, Alessandri, Claire, de Roux, Quentin, de Roquetaillade, Charles, G. Chousterman, Benjamin, Mebazaa, Alexandre, Gayat, Etienne, Garnier, Marc, Pardo, Emmanuel, Satre-Buisson, Lea, Gutton, Christophe, Yvin, Elise, Marcault, Clémence, Azoulay, Elie, Darmon, Michael, Ait Oufella, Hafid, Hariri, Geoffroy, Urbina, Tomas, Mazerand, Sandie, Heming, Nicholas, Santi, Francesca, Moine, Pierre, Annane, Djillali, Bouglé, Adrien, Omar, Edris, Lancelot, Aymeric, Begot, Emmanuelle, Plantefeve, Gaétan, Contou, Damien, Mentec, Hervé, Pajot, Olivier, Faguer, Stanislas, Cointault, Olivier, Lavayssiere, Laurence, Nogier, Marie-Béatrice, Jamme, Matthieu, Pichereau, Claire, Hayon, Jan, Outin, Hervé, Dépret, François, Coutrot, Maxime, Chaussard, Maité, Guillemet, Lucie, Goffin, Pierre, Thouny, Romain, Guntz, Julien, Jadot, Laurent, Persichini, Romain, Jean-Michel, Vanessa, Georges, Hugues, Caulier, Thomas, Pradel, Gaël, Hausermann, Marie-Hélène, Nguyen-Valat, Thi My Hue, Boudinaud, Michel, Vivier, Emmanuel, Rosseli, Sylvène, Bourdin, Gaël, Pommier, Christian, Vinclair, Marc, Poignant, Simon, Mons, Sandrine, Bougouin, Wulfran, Bruna, Franklin, Maestraggi, Quentin, Roth, Christian, Bitker, Laurent, Dhelft, François, Bonnet-Chateau, Justine, Filippelli, Mathilde, Morichau-Beauchant, Tristan, Thierry, Stéphane, Le Roy, Charlotte, Saint Jouan, Mélanie, Goncalves, Bruno, Mazeraud, Aurélien, Daniel, Matthieu, Sharshar, Tarek, Cadoz, Cyril, Gaci, Rostane, Gette, Sébastien, Louis, Guillaune, Sacleux, Sophe-Caroline, Ordan, Marie-Amélie, Cravoisy, Aurélie, Conrad, Marie, Courte, Guilhem, Gibot, Sébastien, Benzidi, Younès, Casella, Claudia, Serpin, Laurent, Setti, Jean-Lou, Besse, Marie-Catherine, Bourreau, Anna, Pillot, Jérôme, Rivera, Caroline, Vinclair, Camille, Robaux, Marie-Aline, Achino, Chloé, Delignette, Marie-Charlotte, Mazard, Tessa, Aubrun, Frédéric, Bouchet, Bruno, Frérou, Aurélien, Muller, Laura, Quentin, Charlotte, Degoul, Samuel, Stihle, Xavier, Sumian, Claude, Bergero, Nicoletta, Lanaspre, Bernard, Quintard, Hervé, Marie Maiziere, Eve, Egreteau, Pierre-Yves, Leloup, Guillaume, Berteau, Florin, Cottrel, Marjolaine, Bouteloup, Marie, Jeannot, Matthieu, Blanc, Quentin, Saison, Julien, Geneau, Isabelle, Grenot, Romaric, Ouchike, Abdel, Hazera, Pascal, Masse, Anne-Lyse, Demiri, Suela, Vezinet, Corinne, Baron, Elodie, Benchetrit, Deborah, Monsel, Antoine, Trebbia, Grégoire, Schaack, Emmanuelle, Lepecq, Raphaël, Bobet, Mathieu, Vinsonneau, Christophe, Dekeyser, Thibault, Delforge, Quentin, Rahmani, Imen, Vivet, Bérengère, Paillot, Jonathan, Hierle, Lucie, Chaignat, Claire, Valette, Sarah, Her, Benoït, Brunet, Jennifier, Page, Mathieu, Boiste, Fabienne, Collin, Anthony, Bavozet, Florent, Garin, Aude, Dlala, Mohamed, Mhamdi, Kais, Beilouny, Bassem, Lavalard, Alexandra, Perez, Severine, Veber, Benoit, Guitard, Pierre-Gildas, Gouin, Philippe, Lamacz, Anna, Plouvier, Fabienne, P Delaborde, Bertrand, Kherchache, Aïssa, Chaalal, Amina, Amouretti, Marc, Freita-Ramos, Santiago, Roux, Damien, Constantin, Jean-Michel, Assefi, Mona, Lecore, Marine, Selves, Agathe, Prevost, Florian, Lamer, Christian, Shi, Ruiying, Knani, Lyes, Pili Floury, Sébastien, Vettoretti, Lucie, Levy, Michael, Marsac, Lucile, Dauger, Stéphane, Guilmin-Crépon, Sophie, Winiszewski, Hadrien, Piton, Gael, Soumagne, Thibaud, Capellier, Gilles, Putegnat, Jean-Baptiste, Bayle, Frédérique, Perrou, Maya, Thao, Ghyslaine, Géri, Guillaume, Charron, Cyril, Repessé, Xavier, Vieillard-Baron, Antoine, Guilbart, Mathieu, Roger, Pierre-Alexandre, Hinard, Sébastien, Macq, Pierre-Yves, Chaulier, Kevin, Goutte, Sylvie, Chillet, Patrick, Pitta, Anaïs, Darjent, Barbara, Bruneau, Amandine, Lasocki, Sigismond, Leger, Maxime, Gergaud, Soizic, Lemarie, Pierre, Terzi, Nicolas, Schwebel, Carole, Dartevel, Anaïs, Galerneau, Louis-Marie, Diehl, Jean-Luc, Hauw-Berlemont, Caroline, Péron, Nicolas, Guérot, Emmanuel, Mohebbi Amoli, Abolfazl, Benhamou, Michel, Deyme, Jean-Pierre, Andremont, Olivier, Lena, Diane, Cady, Julien, Causeret, Arnaud, de la Chapelle, Arnaud, Cracco, Christophe, Rouleau, Stéphane, Schnell, David, Foucault, Camille, Lory, Cécile, Chapelle, Thibault, Bruckert, Vincent, Garcia, Julie, Sahraoui, Abdlazize, Abbosh, Nathalie, Bornstain, Caroline, Pernet, Pierre, Poirson, Florent, Pasem, Ahmed, Karoubi, Philippe, Poupinel, Virginie, Gauthier, Caroline, Bouniol, François, Feuchere, Philippe, Heron, Anne, Carreira, Serge, Emery, Malo, Sophie Le Floch, Anne, Giovannangeli, Luana, Herzog, Nicolas, Giacardi, Christophe, Baudic, Thibaut, Thill, Chloé, Lebbah, Said, Palmyre, Jessica, Tubach, Florence, Bonnet, Nicolas, Ebstein, Nathan, Gaudry, Stéphane, Cohen, Yves, Noublanche, Julie, Lesieur, Olivier, Sément, Arnaud, Roca-Cerezo, Isabel, Pascal, Michel, Sma, Nesrine, Colin, Gwenhaël, Lacherade, Jean-Claude, Bionz, Gauthier, Maquigneau, Natacha, Bouzat, Pierre, Durand, Michel, Hérault, Marie-Christine, Payen, Jean-Francois

المساهمون: Unité de Glycobiologie Structurale et Fonctionnelle UMR 8576 UGSF, Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 RID-AGE, Centre Hospitalier Régional Universitaire CHU Lille CHRU Lille, Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 CIIL

مصطلحات موضوعية: extracorporeal membrane oxygenation, acute respiratory distress syndrome, COVID-19, SARS-CoV-2, emulated target trial

الوصف: Rationale: Whether patients with coronavirus disease (COVID-19) may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. Objectives: To estimate the effect of ECMO on 90-day mortality versus IMV only. Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO versus no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 < 80 or PaCO2 ⩾ 60 mm Hg). We controlled for confounding using a multivariable Cox model on the basis of predefined variables. Measurements and Main Results: A total of 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability on Day 7 from the onset of eligibility criteria (87% vs. 83%; risk difference, 4%; 95% confidence interval, 0–9%), which decreased during follow-up (survival on Day 90: 63% vs. 65%; risk difference, −2%; 95% confidence interval, −10 to 5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand and when initiated within the first 4 days of IMV and in patients who are profoundly hypoxemic. Conclusions: In an emulated trial on the basis of a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and regions with ECMO capacities specifically organized to handle high demand. ; 206;3

وصف الملف: application/octet-stream

العلاقة: American Journal of Respiratory and Critical Care Medicine; Am J Respir Crit Care Med; http://hdl.handle.net/20.500.12210/107817Test

الإتاحة: https://doi.org/20.500.12210/107817Test
https://hdl.handle.net/20.500.12210/107817Test

المؤلفون: Arrigo, Mattia, Price, Susanna, Harjola, Veli-Pekka, Huber, Lars C, SCHAUBROECK, HANNAH, Vieillard-Baron, Antoine, Mebazaa, Alexandre, Masip, Josep

المصدر: EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE ; ISSN: 2048-8726 ; ISSN: 2048-8734

مصطلحات موضوعية: Medicine and Health Sciences, Cardiology and Cardiovascular Medicine, Critical Care and Intensive Care Medicine, General Medicine, ARDS, Pulmonary embolism, Pulmonary hypertension, Increased afterload, Acute heart failure, Cardiogenic shock, Cor pulmonale, Right heart failure, Right ventricular failure

الوصف: Acute right ventricular failure secondary to acutely increased right ventricular afterload (acute cor pulmonale) is a life-threatening condition that may arise in different clinical settings. Patients at risk of developing or with manifest acute cor pulmonale usually present with an acute pulmonary disease (e.g. pulmonary embolism, pneumonia, and acute respiratory distress syndrome) and are managed initially in emergency departments and later in intensive care units. According to the clinical setting, other specialties are involved (cardiology, pneumology, internal medicine). As such, coordinated delivery of care is particularly challenging but, as shown during the COVID-19 pandemic, has a major impact on prognosis. A common framework for the management of acute cor pulmonale with inclusion of the perspectives of all involved disciplines is urgently needed. Graphical Abstract Management of acute cor pulmonale. ARDS, acute respiratory distress syndrome; LVAD, left ventricular assist device; PDE-III-I, phosphodiesterase-III inhibitors; RV, right ventricle; ECMO, extracorporeal membrane oxygenation.

وصف الملف: application/pdf

العلاقة: https://biblio.ugent.be/publication/01HQTQXMXQMBPYWC4KZ2SGR1D9Test; http://hdl.handle.net/1854/LU-01HQTQXMXQMBPYWC4KZ2SGR1D9Test; http://doi.org/10.1093/ehjacc/zuad157Test; https://biblio.ugent.be/publication/01HQTQXMXQMBPYWC4KZ2SGR1D9/file/01HS8KCHYY08MGJB56SGYX29WATest

الإتاحة: https://doi.org/10.1093/ehjacc/zuad157Test
https://biblio.ugent.be/publication/01HQTQXMXQMBPYWC4KZ2SGR1D9Test
http://hdl.handle.net/1854/LU-01HQTQXMXQMBPYWC4KZ2SGR1D9Test
https://biblio.ugent.be/publication/01HQTQXMXQMBPYWC4KZ2SGR1D9/file/01HS8KCHYY08MGJB56SGYX29WATest

المؤلفون: Millington, Scott J., Narasimhan, Mangala, Mayo, Paul H., Vieillard-Baron, Antoine

المصدر: Journal of Intensive Care Medicine ; ISSN 0885-0666 1525-1489

مصطلحات موضوعية: Critical Care and Intensive Care Medicine

الوصف: In an effort to help keep busy clinicians up to date with the latest ultrasound research, our group of experts has selected 10 influential papers from the past 12 months and provided a short summary of each. We hope to provide emergency physicians, intensivists, and other acute care providers with a succinct update concerning some key areas of ultrasound interest.

الإتاحة: https://doi.org/10.1177/08850666241233556Test

المؤلفون: Mekontso Dessap, Armand, Bagate, François, Repesse, Xavier, Blayau, Clarisse, Fartoukh, Muriel, Canoui-Poitrine, Florence, de Prost, Nicolas, Vieillard-Baron, Antoine

المساهمون: Baxter Healthcare Corporation

المصدر: Heliyon ; volume 10, issue 1, page e23878 ; ISSN 2405-8440

مصطلحات موضوعية: Multidisciplinary

الإتاحة: https://doi.org/10.1016/j.heliyon.2023.e23878Test
https://api.elsevier.com/content/article/PII:S2405844023110863?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S2405844023110863?httpAccept=text/plainTest

المؤلفون: Robba, Chiara, Wong, Adrian, Poole, Daniele, Al Tayar, Ashraf, Arntfield, Robert T., Chew, Michelle, Corradi, Francesco, Doufle, Ghislaine, Goffi, Alberto, Lamperti, Massimo, Mayo, Paul, Messina, Antonio, Mongodi, Silvia, Narasimhan, Mangala, Puppo, Corina, Sarwal, Aarti, Slama, Michel, Taccone, Fabio S., Vignon, Philippe, Vieillard-Baron, Antoine

المصدر: Intensive Care Medicine. 47(12):1347-1367

مصطلحات موضوعية: Ultrasonography, Intensive care unit, Consensus, Brain ultrasound, Echocardiography, Lung ultrasound, Abdominal ultrasound, Vascular ultrasound

الوصف: Purpose To provide consensus, and a list of experts recommendations regarding the basic skills for head-to-toe ultrasonography in the intensive care setting. Methods The Executive Committee of the European Society of Intensive Care (ESICM) commissioned the project and supervised the methodology and structure of the consensus. We selected an international panel of 19 expert clinicians-researchers in intensive care unit (ICU) with expertise in critical care ultrasonography (US), plus a non-voting methodologist. The panel was divided into five subgroups (brain, lung, heart, abdomen and vascular ultrasound) which identified the domains and generated a list of questions to be addressed by the panel. A Delphi process based on an iterative approach was used to obtain the final consensus statements. Statements were classified as a strong recommendation (84% of agreement), weak recommendation (74% of agreement), and no recommendation (less than 74%), in favor or against. Results This consensus produced a total of 74 statements (7 for brain, 20 for lung, 20 for heart, 20 for abdomen, 7 for vascular Ultrasound). We obtained strong agreement in favor for 49 statements (66.2%), 8 weak in favor (10.8%), 3 weak against (4.1%), and no consensus in 14 cases (19.9%). In most cases when consensus was not obtained, it was felt that the skills were considered as too advanced. A research agenda and discussion on training programs were implemented from the results of the consensus. Conclusions This consensus provides guidance for the basic use of critical care US and paves the way for the development of training and research projects.

وصف الملف: electronic

الوصول الحر: https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-181503Test
https://liu.diva-portal.org/smash/get/diva2:1616354/FULLTEXT01.pdfTest

المؤلفون: Tu, Guo-wei, Yin, Kanhua, Vieillard-Baron, Antoine, Dobrilovic, Nikola, Monnet, Xavier

المصدر: Frontiers Research Topics ; ISSN 1664-8714 ; ISBN 9782832511299

الإتاحة: https://doi.org/10.3389/978-2-8325-1129-9Test

المؤلفون: Lascarrou, Jean-Baptiste, Dumas, Florence, Bougouin, Wulfran, Chocron, Richard, Beganton, Frankie, Legriel, Stephane, Aissaoui, Nadia, Deye, Nicolas, Lamhaut, Lionel, Jost, Daniel, Vieillard-Baron, Antoine, Marijon, Eloi, Jouven, Xavier, Cariou, Alain, SDEC

المصدر: Critical care (London, England). 23(1)

مصطلحات موضوعية: SDEC, Humans, Treatment Outcome, Hypothermia, Induced, Registries, Logistic Models, Odds Ratio, Time Factors, Aged, Aged, 80 and over, Middle Aged, Paris, Female, Male, Out-of-Hospital Cardiac Arrest, Outcome Assessment, Health Care, Cardiac arrest, Induced hypothermia, Neurological outcome, Targeted temperature management, and over, Hypothermia, Induced, Outcome Assessment, Health Care, Medical and Health Sciences, Emergency & Critical Care Medicine

الوصف: PurposeRecent doubts regarding the efficacy may have resulted in a loss of interest for targeted temperature management (TTM) in comatose cardiac arrest (CA) patients, with uncertain consequences on outcome. We aimed to identify a change in TTM use and to assess the relationship between this change and neurological outcome.MethodsWe used Utstein data prospectively collected in the Sudden Death Expertise Center (SDEC) registry (capturing CA data from all secondary and tertiary hospitals located in the Great Paris area, France) between May 2011 and December 2017. All cases of non-traumatic OHCA patients with stable return of spontaneous circulation (ROSC) were included. After adjustment for potential confounders, we assessed the relationship between changes over time in the use of TTM and neurological recovery at discharge using the Cerebral Performance Categories (CPC) scale.ResultsBetween May 2011 and December 2017, 3925 patients were retained in the analysis, of whom 1847 (47%) received TTM. The rate of good neurological outcome at discharge (CPC 1 or 2) was higher in TTM patients as compared with no TTM (33% vs 15%, P

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/23s2x028Test

المؤلفون: Chioncel, Ovidiu, Parissis, John, Mebazaa, Alexandre, Thiele, Holger, Desch, Steffen, Bauersachs, Johann, Harjola, Veli-Pekka, Antohi, Elena-Laura, Arrigo, Mattia, Gal, Tuvia B., Celutkiene, Jelena, Collins, Sean P., DeBacker, Daniel, Iliescu, Vlad A., Jankowska, Ewa, Jaarsma, Tiny, Keramida, Kalliopi, Lainscak, Mitja, Lund, Lars H., Lyon, Alexander R., Masip, Josep, Metra, Marco, Miro, Oscar, Mortara, Andrea, Mueller, Christian, Mullens, Wilfried, Nikolaou, Maria, Piepoli, Massimo, Price, Susana, Rosano, Giuseppe, Vieillard-Baron, Antoine, Weinstein, Jean M., Anker, Stefan D., Filippatos, Gerasimos, Ruschitzka, Frank, Coats, Andrew J. S., Seferovic, Petar

المصدر: European Journal of Heart Failure. 22(8):1315-1341

مصطلحات موضوعية: Cardiogenic shock, Organ dysfunction, Mechanical circulatory support, Multidisciplinary team

الوصف: Cardiogenic shock (CS) is a complex multifactorial clinical syndrome with extremely high mortality, developing as a continuum, and progressing from the initial insult (underlying cause) to the subsequent occurrence of organ failure and death. There is a large spectrum of CS presentations resulting from the interaction between an acute cardiac insult and a patients underlying cardiac and overall medical condition. Phenotyping patients with CS may have clinical impact on management because classification would support initiation of appropriate therapies. CS management should consider appropriate organization of the health care services, and therapies must be given to the appropriately selected patients, in a timely manner, whilst avoiding iatrogenic harm. Although several consensus-driven algorithms have been proposed, CS management remains challenging and substantial investments in research and development have not yielded proof of efficacy and safety for most of the therapies tested, and outcome in this condition remains poor. Future studies should consider the identification of the new pathophysiological targets, and high-quality translational research should facilitate incorporation of more targeted interventions in clinical research protocols, aimed to improve individual patient outcomes. Designing outcome clinical trials in CS remains particularly challenging in this critical and very costly scenario in cardiology, but information from these trials is imperiously needed to better inform the guidelines and clinical practice. The goal of this review is to summarize the current knowledge concerning the definition, epidemiology, underlying causes, pathophysiology and management of CS based on important lessons from clinical trials and registries, with a focus on improving in-hospital management.

وصف الملف: electronic

الوصول الحر: https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-168514Test
https://liu.diva-portal.org/smash/get/diva2:1462216/FULLTEXT01.pdfTest

المؤلفون: Dumas, Florence, Bougouin, Wulfran, Perier, Marie Cécile, Marin, Nathalie, Goulenok, Cyril, Vieillard-Baron, Antoine, Diehl, Jean Luc, Legriel, Stéphane, Deye, Nicolas, Cronier, Pierrick, Ricôme, Sylvie, Chemouni, Frank, Mekontso Dessap, Armand, Beganton, Frankie, Marijon, Éloi, Jouven, Xavier P., Empana, Jean Philippe, Cariou, Alain

المساهمون: Hôpital Cochin AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Cité (UPCité), Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Hôpital Ambroise Paré AP-HP, Hôpital Européen Georges Pompidou APHP (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier de Versailles André Mignot (CHV), Hôpital Lariboisière-Fernand-Widal APHP, Hôpital Robert Ballanger Aulnay-sous-Bois, Grand Hôpital de l'Est Francilien (GHEF), Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Ministère des Affaires Sociales et de la Santé, (AOR 12068)

المصدر: ISSN: 2666-5204 ; Resuscitation Plus ; https://hal.science/hal-04229538Test ; Resuscitation Plus, 2023, 16, ⟨10.1016/j.resplu.2023.100460⟩.

مصطلحات موضوعية: Cardiac arrest, Coronary angiogram, Long-term outcome, Targeted temperature management, [SDV]Life Sciences [q-bio]

الوصف: International audience ; Background: While the short-term prognosis of cardiac arrest patients - nearly 250,000 new cases per year in Europe - has been extensively studied, less is known regarding the mid and long-term outcome of survivors. Objective: The aim of the DESAC study is to describe mid- and long-term survival rate and functional status of cardiac arrest survivors, and to assess the influence of pre and intra hospital therapeutic strategies on these two outcomes. Methods: Between Jul 2015 and Oct 2018, adult patients over 18 years who were discharged alive from any intensive care units (public and private hospitals) in the Ile-de-France area (Paris and suburbs, France) after a non-traumatic cardiac arrest were screened for participation in this multicentric study. Survivors were included after they signed (or the proxies) an informed consent before discharge during initial hospitalisation. We calculated that including 600 patients in total would allow an 80% power to demonstrate a 2 years survival rate difference of 10% between patients who did and those who did not receive therapeutic hypothermia after resuscitation. Pre- and in-hospital data related to the circumstances surrounding the event and to the therapeutic interventions (such as cardio-pulmonary resuscitation, defibrillation, emergent coronary revascularization, neuroprotective therapeutics) were collected. After discharge, patients were interviewed at 3 months, 6 months and every year thereafter for a minimum follow-up of 26 months and a maximum follow-up of 48 months. Information on vital status, occurrence of cardiovascular events, medications and a comprehensive assessment of the functional status (qualitive of life as assessed by the Short-Form General Health Survey (SF36) scale, activities of daily living (ADL) scale, neurological Cerebral Performance Categories (CPC) and Overall Performance Categories (OPC) scales, socio-professional activities) were collected at follow-up interviews. Discussion: The DESAC study should provide ...

العلاقة: hal-04229538; https://hal.science/hal-04229538Test; https://hal.science/hal-04229538/documentTest; https://hal.science/hal-04229538/file/1-s2.0-S2666520423001030-main.pdfTest

الإتاحة: https://doi.org/10.1016/j.resplu.2023.100460Test
https://hal.science/hal-04229538Test
https://hal.science/hal-04229538/documentTest
https://hal.science/hal-04229538/file/1-s2.0-S2666520423001030-main.pdfTest