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Friedrich O, Reid MB, Van den Berghe G, Vanhorebeek I, Hermans G, Rich MM, Larsson L. The Sick and the Weak: Neuropathies/Myopathies in the Critically Ill. Physiol Rev 2015; 95:1025-109. [PMID: 26133937 PMCID: PMC4491544 DOI: 10.1152/physrev.00028.2014] [Citation(s) in RCA: 231] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Critical illness polyneuropathies (CIP) and myopathies (CIM) are common complications of critical illness. Several weakness syndromes are summarized under the term intensive care unit-acquired weakness (ICUAW). We propose a classification of different ICUAW forms (CIM, CIP, sepsis-induced, steroid-denervation myopathy) and pathophysiological mechanisms from clinical and animal model data. Triggers include sepsis, mechanical ventilation, muscle unloading, steroid treatment, or denervation. Some ICUAW forms require stringent diagnostic features; CIM is marked by membrane hypoexcitability, severe atrophy, preferential myosin loss, ultrastructural alterations, and inadequate autophagy activation while myopathies in pure sepsis do not reproduce marked myosin loss. Reduced membrane excitability results from depolarization and ion channel dysfunction. Mitochondrial dysfunction contributes to energy-dependent processes. Ubiquitin proteasome and calpain activation trigger muscle proteolysis and atrophy while protein synthesis is impaired. Myosin loss is more pronounced than actin loss in CIM. Protein quality control is altered by inadequate autophagy. Ca(2+) dysregulation is present through altered Ca(2+) homeostasis. We highlight clinical hallmarks, trigger factors, and potential mechanisms from human studies and animal models that allow separation of risk factors that may trigger distinct mechanisms contributing to weakness. During critical illness, altered inflammatory (cytokines) and metabolic pathways deteriorate muscle function. ICUAW prevention/treatment is limited, e.g., tight glycemic control, delaying nutrition, and early mobilization. Future challenges include identification of primary/secondary events during the time course of critical illness, the interplay between membrane excitability, bioenergetic failure and differential proteolysis, and finding new therapeutic targets by help of tailored animal models.
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Affiliation(s)
- O Friedrich
- Institute of Medical Biotechnology, Department of Chemical and Biological Engineering, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany; College of Health and Human Performance, University of Florida, Gainesville, Florida; Clinical Department and Laboratory of Intensive Care Medicine, Division of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium; Department of Neuroscience, Cell Biology and Physiology, Wright State University, Dayton, Ohio; and Department of Physiology and Pharmacology, Department of Clinical Neuroscience, Clinical Neurophysiology, Karolinska Institutet, Stockholm, Sweden
| | - M B Reid
- Institute of Medical Biotechnology, Department of Chemical and Biological Engineering, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany; College of Health and Human Performance, University of Florida, Gainesville, Florida; Clinical Department and Laboratory of Intensive Care Medicine, Division of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium; Department of Neuroscience, Cell Biology and Physiology, Wright State University, Dayton, Ohio; and Department of Physiology and Pharmacology, Department of Clinical Neuroscience, Clinical Neurophysiology, Karolinska Institutet, Stockholm, Sweden
| | - G Van den Berghe
- Institute of Medical Biotechnology, Department of Chemical and Biological Engineering, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany; College of Health and Human Performance, University of Florida, Gainesville, Florida; Clinical Department and Laboratory of Intensive Care Medicine, Division of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium; Department of Neuroscience, Cell Biology and Physiology, Wright State University, Dayton, Ohio; and Department of Physiology and Pharmacology, Department of Clinical Neuroscience, Clinical Neurophysiology, Karolinska Institutet, Stockholm, Sweden
| | - I Vanhorebeek
- Institute of Medical Biotechnology, Department of Chemical and Biological Engineering, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany; College of Health and Human Performance, University of Florida, Gainesville, Florida; Clinical Department and Laboratory of Intensive Care Medicine, Division of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium; Department of Neuroscience, Cell Biology and Physiology, Wright State University, Dayton, Ohio; and Department of Physiology and Pharmacology, Department of Clinical Neuroscience, Clinical Neurophysiology, Karolinska Institutet, Stockholm, Sweden
| | - G Hermans
- Institute of Medical Biotechnology, Department of Chemical and Biological Engineering, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany; College of Health and Human Performance, University of Florida, Gainesville, Florida; Clinical Department and Laboratory of Intensive Care Medicine, Division of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium; Department of Neuroscience, Cell Biology and Physiology, Wright State University, Dayton, Ohio; and Department of Physiology and Pharmacology, Department of Clinical Neuroscience, Clinical Neurophysiology, Karolinska Institutet, Stockholm, Sweden
| | - M M Rich
- Institute of Medical Biotechnology, Department of Chemical and Biological Engineering, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany; College of Health and Human Performance, University of Florida, Gainesville, Florida; Clinical Department and Laboratory of Intensive Care Medicine, Division of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium; Department of Neuroscience, Cell Biology and Physiology, Wright State University, Dayton, Ohio; and Department of Physiology and Pharmacology, Department of Clinical Neuroscience, Clinical Neurophysiology, Karolinska Institutet, Stockholm, Sweden
| | - L Larsson
- Institute of Medical Biotechnology, Department of Chemical and Biological Engineering, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany; College of Health and Human Performance, University of Florida, Gainesville, Florida; Clinical Department and Laboratory of Intensive Care Medicine, Division of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium; Department of Neuroscience, Cell Biology and Physiology, Wright State University, Dayton, Ohio; and Department of Physiology and Pharmacology, Department of Clinical Neuroscience, Clinical Neurophysiology, Karolinska Institutet, Stockholm, Sweden
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Borel AL, Schwebel C, Planquette B, Vésin A, Garrouste-Orgeas M, Adrie C, Clec'h C, Azoulay E, Souweine B, Allaouchiche B, Goldgran-Toledano D, Jamali S, Darmon M, Timsit JF. Initiation of nutritional support is delayed in critically ill obese patients: a multicenter cohort study. Am J Clin Nutr 2014; 100:859-66. [PMID: 25080456 DOI: 10.3945/ajcn.114.088187] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND A high catabolic rate characterizes the acute phase of critical illness. Guidelines recommend an early nutritional support, regardless of the previous nutritional status. OBJECTIVE We aimed to assess whether the nutritional status of patients, which was defined by the body mass index (BMI) at admission in an intensive care unit (ICU), affected the time of nutritional support initiation. DESIGN We conducted a cohort study that reported a retrospective analysis of a multicenter ICU database (OUTCOMEREA) by using data prospectively entered from January 1997 to October 2012. Patients who needed orotracheal intubation within the first 72 h and >3 d were included. RESULTS Data from 3257 ICU stays were analyzed. The delay before feeding was different according to BMI groups (P = 0.035). The delay was longer in obese patients [BMI (in kg/m²) ≥30; n = 663] than in other patients with either low weight (BMI <20; n = 501), normal weight (BMI ≥20 and <25; n = 1135), or overweight (BMI ≥25 and <30; n = 958). The association between nutritional status and a delay in nutrition initiation was independent of potential confounding factors such as age, sex, and diabetes or other chronic diseases. In comparison with normal weight, the adjusted RR (95% CI) associated with a delayed nutrition initiation was 0.92 (0.86, 0.98) for patients with low weight, 1.00 (0.94, 1.05) for overweight patients, and 1.06 (1.00, 1.12) for obese patients (P = 0.004). CONCLUSIONS The initiation of nutritional support was delayed in obese ICU patients. Randomized controlled trials that address consequences of early compared with delayed beginnings of nutritional support in critically ill obese patients are needed.
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Affiliation(s)
- Anne-Laure Borel
- From the Endocrinology Department (A-LB) and Medical Intensive Care Unit (ICU) (CS and J-FT), Grenoble University Hospital, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM) U1042, Grenoble, France (A-LB), the Grenoble Alpes University, Grenoble, France (A-LB and CS); the Medical Surgical ICU, André Mignot Hospital, Versailles-Le Chesnay, France (BP); the Integrated Research Center INSERM U823, Grenoble, France (AV and J-FT); the Medical Surgical ICU, Saint-Joseph Hospital, Paris, France (MG-O); the ICU, Delafontaine Hospital, Saint Denis, France (CA); Physiology, Cochin University Hospital, Paris, France (CA), the ICU, Avicenne University Hospital, Bobigny, France (CC); the Medical ICU, Saint-Louis University Hospital, Paris, France (EA); the Medical ICU, Gabriel-Montpied University Hospital, Clermont-Ferrand, France (BS); the Surgical ICU, Edouard Herriot Hospital, Lyon, France (BA); the ICU, Gonesse Hospital, Gonesse, France (DG-T); the ICU, Dourdan Hospital, Dourdan, France (SJ); the Medical ICU, Saint-Etienne University Hospital, Saint-Etienne, France (MD); the Medical and Infectious Diseases ICU, Paris Diderot University/Bichat Hospital, Paris, France (J-FT); and the Unité mixte de Recherche 1137, Infection, Antimicrobials, Modelling, Evolution Team 5, Decision Sciences in Infectious Diseases, Control and Care INSERM/Paris Diderot, Sorbonne Paris Cité University, Paris, France (MG-O and J-FT)
| | - Carole Schwebel
- From the Endocrinology Department (A-LB) and Medical Intensive Care Unit (ICU) (CS and J-FT), Grenoble University Hospital, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM) U1042, Grenoble, France (A-LB), the Grenoble Alpes University, Grenoble, France (A-LB and CS); the Medical Surgical ICU, André Mignot Hospital, Versailles-Le Chesnay, France (BP); the Integrated Research Center INSERM U823, Grenoble, France (AV and J-FT); the Medical Surgical ICU, Saint-Joseph Hospital, Paris, France (MG-O); the ICU, Delafontaine Hospital, Saint Denis, France (CA); Physiology, Cochin University Hospital, Paris, France (CA), the ICU, Avicenne University Hospital, Bobigny, France (CC); the Medical ICU, Saint-Louis University Hospital, Paris, France (EA); the Medical ICU, Gabriel-Montpied University Hospital, Clermont-Ferrand, France (BS); the Surgical ICU, Edouard Herriot Hospital, Lyon, France (BA); the ICU, Gonesse Hospital, Gonesse, France (DG-T); the ICU, Dourdan Hospital, Dourdan, France (SJ); the Medical ICU, Saint-Etienne University Hospital, Saint-Etienne, France (MD); the Medical and Infectious Diseases ICU, Paris Diderot University/Bichat Hospital, Paris, France (J-FT); and the Unité mixte de Recherche 1137, Infection, Antimicrobials, Modelling, Evolution Team 5, Decision Sciences in Infectious Diseases, Control and Care INSERM/Paris Diderot, Sorbonne Paris Cité University, Paris, France (MG-O and J-FT)
| | - Benjamin Planquette
- From the Endocrinology Department (A-LB) and Medical Intensive Care Unit (ICU) (CS and J-FT), Grenoble University Hospital, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM) U1042, Grenoble, France (A-LB), the Grenoble Alpes University, Grenoble, France (A-LB and CS); the Medical Surgical ICU, André Mignot Hospital, Versailles-Le Chesnay, France (BP); the Integrated Research Center INSERM U823, Grenoble, France (AV and J-FT); the Medical Surgical ICU, Saint-Joseph Hospital, Paris, France (MG-O); the ICU, Delafontaine Hospital, Saint Denis, France (CA); Physiology, Cochin University Hospital, Paris, France (CA), the ICU, Avicenne University Hospital, Bobigny, France (CC); the Medical ICU, Saint-Louis University Hospital, Paris, France (EA); the Medical ICU, Gabriel-Montpied University Hospital, Clermont-Ferrand, France (BS); the Surgical ICU, Edouard Herriot Hospital, Lyon, France (BA); the ICU, Gonesse Hospital, Gonesse, France (DG-T); the ICU, Dourdan Hospital, Dourdan, France (SJ); the Medical ICU, Saint-Etienne University Hospital, Saint-Etienne, France (MD); the Medical and Infectious Diseases ICU, Paris Diderot University/Bichat Hospital, Paris, France (J-FT); and the Unité mixte de Recherche 1137, Infection, Antimicrobials, Modelling, Evolution Team 5, Decision Sciences in Infectious Diseases, Control and Care INSERM/Paris Diderot, Sorbonne Paris Cité University, Paris, France (MG-O and J-FT)
| | - Aurélien Vésin
- From the Endocrinology Department (A-LB) and Medical Intensive Care Unit (ICU) (CS and J-FT), Grenoble University Hospital, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM) U1042, Grenoble, France (A-LB), the Grenoble Alpes University, Grenoble, France (A-LB and CS); the Medical Surgical ICU, André Mignot Hospital, Versailles-Le Chesnay, France (BP); the Integrated Research Center INSERM U823, Grenoble, France (AV and J-FT); the Medical Surgical ICU, Saint-Joseph Hospital, Paris, France (MG-O); the ICU, Delafontaine Hospital, Saint Denis, France (CA); Physiology, Cochin University Hospital, Paris, France (CA), the ICU, Avicenne University Hospital, Bobigny, France (CC); the Medical ICU, Saint-Louis University Hospital, Paris, France (EA); the Medical ICU, Gabriel-Montpied University Hospital, Clermont-Ferrand, France (BS); the Surgical ICU, Edouard Herriot Hospital, Lyon, France (BA); the ICU, Gonesse Hospital, Gonesse, France (DG-T); the ICU, Dourdan Hospital, Dourdan, France (SJ); the Medical ICU, Saint-Etienne University Hospital, Saint-Etienne, France (MD); the Medical and Infectious Diseases ICU, Paris Diderot University/Bichat Hospital, Paris, France (J-FT); and the Unité mixte de Recherche 1137, Infection, Antimicrobials, Modelling, Evolution Team 5, Decision Sciences in Infectious Diseases, Control and Care INSERM/Paris Diderot, Sorbonne Paris Cité University, Paris, France (MG-O and J-FT)
| | - Maité Garrouste-Orgeas
- From the Endocrinology Department (A-LB) and Medical Intensive Care Unit (ICU) (CS and J-FT), Grenoble University Hospital, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM) U1042, Grenoble, France (A-LB), the Grenoble Alpes University, Grenoble, France (A-LB and CS); the Medical Surgical ICU, André Mignot Hospital, Versailles-Le Chesnay, France (BP); the Integrated Research Center INSERM U823, Grenoble, France (AV and J-FT); the Medical Surgical ICU, Saint-Joseph Hospital, Paris, France (MG-O); the ICU, Delafontaine Hospital, Saint Denis, France (CA); Physiology, Cochin University Hospital, Paris, France (CA), the ICU, Avicenne University Hospital, Bobigny, France (CC); the Medical ICU, Saint-Louis University Hospital, Paris, France (EA); the Medical ICU, Gabriel-Montpied University Hospital, Clermont-Ferrand, France (BS); the Surgical ICU, Edouard Herriot Hospital, Lyon, France (BA); the ICU, Gonesse Hospital, Gonesse, France (DG-T); the ICU, Dourdan Hospital, Dourdan, France (SJ); the Medical ICU, Saint-Etienne University Hospital, Saint-Etienne, France (MD); the Medical and Infectious Diseases ICU, Paris Diderot University/Bichat Hospital, Paris, France (J-FT); and the Unité mixte de Recherche 1137, Infection, Antimicrobials, Modelling, Evolution Team 5, Decision Sciences in Infectious Diseases, Control and Care INSERM/Paris Diderot, Sorbonne Paris Cité University, Paris, France (MG-O and J-FT)
| | - Christophe Adrie
- From the Endocrinology Department (A-LB) and Medical Intensive Care Unit (ICU) (CS and J-FT), Grenoble University Hospital, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM) U1042, Grenoble, France (A-LB), the Grenoble Alpes University, Grenoble, France (A-LB and CS); the Medical Surgical ICU, André Mignot Hospital, Versailles-Le Chesnay, France (BP); the Integrated Research Center INSERM U823, Grenoble, France (AV and J-FT); the Medical Surgical ICU, Saint-Joseph Hospital, Paris, France (MG-O); the ICU, Delafontaine Hospital, Saint Denis, France (CA); Physiology, Cochin University Hospital, Paris, France (CA), the ICU, Avicenne University Hospital, Bobigny, France (CC); the Medical ICU, Saint-Louis University Hospital, Paris, France (EA); the Medical ICU, Gabriel-Montpied University Hospital, Clermont-Ferrand, France (BS); the Surgical ICU, Edouard Herriot Hospital, Lyon, France (BA); the ICU, Gonesse Hospital, Gonesse, France (DG-T); the ICU, Dourdan Hospital, Dourdan, France (SJ); the Medical ICU, Saint-Etienne University Hospital, Saint-Etienne, France (MD); the Medical and Infectious Diseases ICU, Paris Diderot University/Bichat Hospital, Paris, France (J-FT); and the Unité mixte de Recherche 1137, Infection, Antimicrobials, Modelling, Evolution Team 5, Decision Sciences in Infectious Diseases, Control and Care INSERM/Paris Diderot, Sorbonne Paris Cité University, Paris, France (MG-O and J-FT)
| | - Christophe Clec'h
- From the Endocrinology Department (A-LB) and Medical Intensive Care Unit (ICU) (CS and J-FT), Grenoble University Hospital, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM) U1042, Grenoble, France (A-LB), the Grenoble Alpes University, Grenoble, France (A-LB and CS); the Medical Surgical ICU, André Mignot Hospital, Versailles-Le Chesnay, France (BP); the Integrated Research Center INSERM U823, Grenoble, France (AV and J-FT); the Medical Surgical ICU, Saint-Joseph Hospital, Paris, France (MG-O); the ICU, Delafontaine Hospital, Saint Denis, France (CA); Physiology, Cochin University Hospital, Paris, France (CA), the ICU, Avicenne University Hospital, Bobigny, France (CC); the Medical ICU, Saint-Louis University Hospital, Paris, France (EA); the Medical ICU, Gabriel-Montpied University Hospital, Clermont-Ferrand, France (BS); the Surgical ICU, Edouard Herriot Hospital, Lyon, France (BA); the ICU, Gonesse Hospital, Gonesse, France (DG-T); the ICU, Dourdan Hospital, Dourdan, France (SJ); the Medical ICU, Saint-Etienne University Hospital, Saint-Etienne, France (MD); the Medical and Infectious Diseases ICU, Paris Diderot University/Bichat Hospital, Paris, France (J-FT); and the Unité mixte de Recherche 1137, Infection, Antimicrobials, Modelling, Evolution Team 5, Decision Sciences in Infectious Diseases, Control and Care INSERM/Paris Diderot, Sorbonne Paris Cité University, Paris, France (MG-O and J-FT)
| | - Elie Azoulay
- From the Endocrinology Department (A-LB) and Medical Intensive Care Unit (ICU) (CS and J-FT), Grenoble University Hospital, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM) U1042, Grenoble, France (A-LB), the Grenoble Alpes University, Grenoble, France (A-LB and CS); the Medical Surgical ICU, André Mignot Hospital, Versailles-Le Chesnay, France (BP); the Integrated Research Center INSERM U823, Grenoble, France (AV and J-FT); the Medical Surgical ICU, Saint-Joseph Hospital, Paris, France (MG-O); the ICU, Delafontaine Hospital, Saint Denis, France (CA); Physiology, Cochin University Hospital, Paris, France (CA), the ICU, Avicenne University Hospital, Bobigny, France (CC); the Medical ICU, Saint-Louis University Hospital, Paris, France (EA); the Medical ICU, Gabriel-Montpied University Hospital, Clermont-Ferrand, France (BS); the Surgical ICU, Edouard Herriot Hospital, Lyon, France (BA); the ICU, Gonesse Hospital, Gonesse, France (DG-T); the ICU, Dourdan Hospital, Dourdan, France (SJ); the Medical ICU, Saint-Etienne University Hospital, Saint-Etienne, France (MD); the Medical and Infectious Diseases ICU, Paris Diderot University/Bichat Hospital, Paris, France (J-FT); and the Unité mixte de Recherche 1137, Infection, Antimicrobials, Modelling, Evolution Team 5, Decision Sciences in Infectious Diseases, Control and Care INSERM/Paris Diderot, Sorbonne Paris Cité University, Paris, France (MG-O and J-FT)
| | - Bertrand Souweine
- From the Endocrinology Department (A-LB) and Medical Intensive Care Unit (ICU) (CS and J-FT), Grenoble University Hospital, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM) U1042, Grenoble, France (A-LB), the Grenoble Alpes University, Grenoble, France (A-LB and CS); the Medical Surgical ICU, André Mignot Hospital, Versailles-Le Chesnay, France (BP); the Integrated Research Center INSERM U823, Grenoble, France (AV and J-FT); the Medical Surgical ICU, Saint-Joseph Hospital, Paris, France (MG-O); the ICU, Delafontaine Hospital, Saint Denis, France (CA); Physiology, Cochin University Hospital, Paris, France (CA), the ICU, Avicenne University Hospital, Bobigny, France (CC); the Medical ICU, Saint-Louis University Hospital, Paris, France (EA); the Medical ICU, Gabriel-Montpied University Hospital, Clermont-Ferrand, France (BS); the Surgical ICU, Edouard Herriot Hospital, Lyon, France (BA); the ICU, Gonesse Hospital, Gonesse, France (DG-T); the ICU, Dourdan Hospital, Dourdan, France (SJ); the Medical ICU, Saint-Etienne University Hospital, Saint-Etienne, France (MD); the Medical and Infectious Diseases ICU, Paris Diderot University/Bichat Hospital, Paris, France (J-FT); and the Unité mixte de Recherche 1137, Infection, Antimicrobials, Modelling, Evolution Team 5, Decision Sciences in Infectious Diseases, Control and Care INSERM/Paris Diderot, Sorbonne Paris Cité University, Paris, France (MG-O and J-FT)
| | - Bernard Allaouchiche
- From the Endocrinology Department (A-LB) and Medical Intensive Care Unit (ICU) (CS and J-FT), Grenoble University Hospital, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM) U1042, Grenoble, France (A-LB), the Grenoble Alpes University, Grenoble, France (A-LB and CS); the Medical Surgical ICU, André Mignot Hospital, Versailles-Le Chesnay, France (BP); the Integrated Research Center INSERM U823, Grenoble, France (AV and J-FT); the Medical Surgical ICU, Saint-Joseph Hospital, Paris, France (MG-O); the ICU, Delafontaine Hospital, Saint Denis, France (CA); Physiology, Cochin University Hospital, Paris, France (CA), the ICU, Avicenne University Hospital, Bobigny, France (CC); the Medical ICU, Saint-Louis University Hospital, Paris, France (EA); the Medical ICU, Gabriel-Montpied University Hospital, Clermont-Ferrand, France (BS); the Surgical ICU, Edouard Herriot Hospital, Lyon, France (BA); the ICU, Gonesse Hospital, Gonesse, France (DG-T); the ICU, Dourdan Hospital, Dourdan, France (SJ); the Medical ICU, Saint-Etienne University Hospital, Saint-Etienne, France (MD); the Medical and Infectious Diseases ICU, Paris Diderot University/Bichat Hospital, Paris, France (J-FT); and the Unité mixte de Recherche 1137, Infection, Antimicrobials, Modelling, Evolution Team 5, Decision Sciences in Infectious Diseases, Control and Care INSERM/Paris Diderot, Sorbonne Paris Cité University, Paris, France (MG-O and J-FT)
| | - Dany Goldgran-Toledano
- From the Endocrinology Department (A-LB) and Medical Intensive Care Unit (ICU) (CS and J-FT), Grenoble University Hospital, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM) U1042, Grenoble, France (A-LB), the Grenoble Alpes University, Grenoble, France (A-LB and CS); the Medical Surgical ICU, André Mignot Hospital, Versailles-Le Chesnay, France (BP); the Integrated Research Center INSERM U823, Grenoble, France (AV and J-FT); the Medical Surgical ICU, Saint-Joseph Hospital, Paris, France (MG-O); the ICU, Delafontaine Hospital, Saint Denis, France (CA); Physiology, Cochin University Hospital, Paris, France (CA), the ICU, Avicenne University Hospital, Bobigny, France (CC); the Medical ICU, Saint-Louis University Hospital, Paris, France (EA); the Medical ICU, Gabriel-Montpied University Hospital, Clermont-Ferrand, France (BS); the Surgical ICU, Edouard Herriot Hospital, Lyon, France (BA); the ICU, Gonesse Hospital, Gonesse, France (DG-T); the ICU, Dourdan Hospital, Dourdan, France (SJ); the Medical ICU, Saint-Etienne University Hospital, Saint-Etienne, France (MD); the Medical and Infectious Diseases ICU, Paris Diderot University/Bichat Hospital, Paris, France (J-FT); and the Unité mixte de Recherche 1137, Infection, Antimicrobials, Modelling, Evolution Team 5, Decision Sciences in Infectious Diseases, Control and Care INSERM/Paris Diderot, Sorbonne Paris Cité University, Paris, France (MG-O and J-FT)
| | - Samir Jamali
- From the Endocrinology Department (A-LB) and Medical Intensive Care Unit (ICU) (CS and J-FT), Grenoble University Hospital, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM) U1042, Grenoble, France (A-LB), the Grenoble Alpes University, Grenoble, France (A-LB and CS); the Medical Surgical ICU, André Mignot Hospital, Versailles-Le Chesnay, France (BP); the Integrated Research Center INSERM U823, Grenoble, France (AV and J-FT); the Medical Surgical ICU, Saint-Joseph Hospital, Paris, France (MG-O); the ICU, Delafontaine Hospital, Saint Denis, France (CA); Physiology, Cochin University Hospital, Paris, France (CA), the ICU, Avicenne University Hospital, Bobigny, France (CC); the Medical ICU, Saint-Louis University Hospital, Paris, France (EA); the Medical ICU, Gabriel-Montpied University Hospital, Clermont-Ferrand, France (BS); the Surgical ICU, Edouard Herriot Hospital, Lyon, France (BA); the ICU, Gonesse Hospital, Gonesse, France (DG-T); the ICU, Dourdan Hospital, Dourdan, France (SJ); the Medical ICU, Saint-Etienne University Hospital, Saint-Etienne, France (MD); the Medical and Infectious Diseases ICU, Paris Diderot University/Bichat Hospital, Paris, France (J-FT); and the Unité mixte de Recherche 1137, Infection, Antimicrobials, Modelling, Evolution Team 5, Decision Sciences in Infectious Diseases, Control and Care INSERM/Paris Diderot, Sorbonne Paris Cité University, Paris, France (MG-O and J-FT)
| | - Michael Darmon
- From the Endocrinology Department (A-LB) and Medical Intensive Care Unit (ICU) (CS and J-FT), Grenoble University Hospital, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM) U1042, Grenoble, France (A-LB), the Grenoble Alpes University, Grenoble, France (A-LB and CS); the Medical Surgical ICU, André Mignot Hospital, Versailles-Le Chesnay, France (BP); the Integrated Research Center INSERM U823, Grenoble, France (AV and J-FT); the Medical Surgical ICU, Saint-Joseph Hospital, Paris, France (MG-O); the ICU, Delafontaine Hospital, Saint Denis, France (CA); Physiology, Cochin University Hospital, Paris, France (CA), the ICU, Avicenne University Hospital, Bobigny, France (CC); the Medical ICU, Saint-Louis University Hospital, Paris, France (EA); the Medical ICU, Gabriel-Montpied University Hospital, Clermont-Ferrand, France (BS); the Surgical ICU, Edouard Herriot Hospital, Lyon, France (BA); the ICU, Gonesse Hospital, Gonesse, France (DG-T); the ICU, Dourdan Hospital, Dourdan, France (SJ); the Medical ICU, Saint-Etienne University Hospital, Saint-Etienne, France (MD); the Medical and Infectious Diseases ICU, Paris Diderot University/Bichat Hospital, Paris, France (J-FT); and the Unité mixte de Recherche 1137, Infection, Antimicrobials, Modelling, Evolution Team 5, Decision Sciences in Infectious Diseases, Control and Care INSERM/Paris Diderot, Sorbonne Paris Cité University, Paris, France (MG-O and J-FT)
| | - Jean-François Timsit
- From the Endocrinology Department (A-LB) and Medical Intensive Care Unit (ICU) (CS and J-FT), Grenoble University Hospital, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM) U1042, Grenoble, France (A-LB), the Grenoble Alpes University, Grenoble, France (A-LB and CS); the Medical Surgical ICU, André Mignot Hospital, Versailles-Le Chesnay, France (BP); the Integrated Research Center INSERM U823, Grenoble, France (AV and J-FT); the Medical Surgical ICU, Saint-Joseph Hospital, Paris, France (MG-O); the ICU, Delafontaine Hospital, Saint Denis, France (CA); Physiology, Cochin University Hospital, Paris, France (CA), the ICU, Avicenne University Hospital, Bobigny, France (CC); the Medical ICU, Saint-Louis University Hospital, Paris, France (EA); the Medical ICU, Gabriel-Montpied University Hospital, Clermont-Ferrand, France (BS); the Surgical ICU, Edouard Herriot Hospital, Lyon, France (BA); the ICU, Gonesse Hospital, Gonesse, France (DG-T); the ICU, Dourdan Hospital, Dourdan, France (SJ); the Medical ICU, Saint-Etienne University Hospital, Saint-Etienne, France (MD); the Medical and Infectious Diseases ICU, Paris Diderot University/Bichat Hospital, Paris, France (J-FT); and the Unité mixte de Recherche 1137, Infection, Antimicrobials, Modelling, Evolution Team 5, Decision Sciences in Infectious Diseases, Control and Care INSERM/Paris Diderot, Sorbonne Paris Cité University, Paris, France (MG-O and J-FT)
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