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Hagry J, Monnet X, Mekontso-Dessap A, Chantalat C, de Prost N, Razazi K, Teboul JL, Pham T. Comprehensive assessment, pain and ventilatory management during acute complications of adult sickle cell disease: A clinical practice survey in French intensive care units. Br J Haematol 2024; 204:e37-e40. [PMID: 38553972 DOI: 10.1111/bjh.19408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 05/15/2024]
Affiliation(s)
- Julien Hagry
- Medical Intensive Care Unit, DMU CORREVE, FHU SEPSIS, CARMAS Research Group, Hôpital de Bicêtre, Hôpitaux Universitaires Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Xavier Monnet
- Medical Intensive Care Unit, DMU CORREVE, FHU SEPSIS, CARMAS Research Group, Hôpital de Bicêtre, Hôpitaux Universitaires Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Armand Mekontso-Dessap
- Medical Intensive Care Unit, Henri Mondor University Hospital, CARMAS Research Group, Créteil, France
| | - Christelle Chantalat
- Department of Internal Medicine, Bicetre University Hospital, Le Kremlin-Bicêtre, France
| | - Nicolas de Prost
- Medical Intensive Care Unit, Henri Mondor University Hospital, CARMAS Research Group, Créteil, France
| | - Keyvan Razazi
- Medical Intensive Care Unit, Henri Mondor University Hospital, CARMAS Research Group, Créteil, France
| | - Jean-Louis Teboul
- Medical Intensive Care Unit, DMU CORREVE, FHU SEPSIS, CARMAS Research Group, Hôpital de Bicêtre, Hôpitaux Universitaires Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Tài Pham
- Medical Intensive Care Unit, DMU CORREVE, FHU SEPSIS, CARMAS Research Group, Hôpital de Bicêtre, Hôpitaux Universitaires Paris-Saclay, Le Kremlin-Bicêtre, France
- Medical Intensive Care Unit, Henri Mondor University Hospital, CARMAS Research Group, Créteil, France
- Department of Internal Medicine, Bicetre University Hospital, Le Kremlin-Bicêtre, France
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm U1018, Équipe d'Épidémiologie Respiratoire intégrative, CESP, Villejuif, France
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Lopinto J, Elabbadi A, Gibelin A, Voiriot G, Fartoukh M. Infectious aetiologies of severe acute chest syndrome in sickle-cell adult patients, combining conventional microbiological tests and respiratory multiplex PCR. Sci Rep 2021; 11:4837. [PMID: 33649379 PMCID: PMC7921101 DOI: 10.1038/s41598-021-84163-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 01/27/2021] [Indexed: 02/02/2023] Open
Abstract
Acute chest syndrome (ACS) is the most serious complication of sickle cell disease. The pathophysiology of ACS may involve lower respiratory tract infection (LRTI), alveolar hypoventilation and atelectasis, bone infarcts-driven fat embolism, and in situ pulmonary artery thrombosis. One of the most challenging issues for the physicians is to diagnose LRTI as the cause of ACS. The use of a respiratory multiplex PCR (mPCR) for the diagnosis of LRTI has not been assessed in sickle-cell adult patients with ACS. To describe the spectrum of infectious aetiologies of severe ACS, using a diagnostic approach combining conventional tests and mPCR. A non-interventional monocenter prospective study involving all the consecutive sickle-cell adult patients with ACS admitted to the intensive care unit (ICU). Microbiological investigation included conventional tests and a nasopharyngeal swab for mPCR. Altogether, 36 patients were enrolled, of whom 30 (83%) had complete microbiological investigations. A bacterial microorganism, mostly Staphylococcus aureus (n = 8), was identified in 11 patients. There was no pneumonia-associated intracellular bacterial pathogen. A respiratory virus was identified in six patients. Using both conventional tests and nasopharyngeal mPCR, a microbiological documentation was obtained in half of adult ACS patients admitted to the ICU. Pyogenic bacteria, especially S. aureus, predominated.
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Affiliation(s)
- Julien Lopinto
- Assistance Publique-Hôpitaux de Paris, Service de Médecine intensive réanimation, Hôpital Tenon, 4, rue de la Chine, 75020, Paris, France.,Sorbonne Université, UFR Médecine, Paris, France
| | - Alexandre Elabbadi
- Assistance Publique-Hôpitaux de Paris, Service de Médecine intensive réanimation, Hôpital Tenon, 4, rue de la Chine, 75020, Paris, France
| | - Aude Gibelin
- Assistance Publique-Hôpitaux de Paris, Service de Médecine intensive réanimation, Hôpital Tenon, 4, rue de la Chine, 75020, Paris, France
| | - Guillaume Voiriot
- Assistance Publique-Hôpitaux de Paris, Service de Médecine intensive réanimation, Hôpital Tenon, 4, rue de la Chine, 75020, Paris, France.,Sorbonne Université, UFR Médecine, Paris, France
| | - Muriel Fartoukh
- Assistance Publique-Hôpitaux de Paris, Service de Médecine intensive réanimation, Hôpital Tenon, 4, rue de la Chine, 75020, Paris, France. .,Sorbonne Université, UFR Médecine, Paris, France.
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