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Brevers D, Dubuisson E, Dejonghe F, Dutrieux J, Petieau M, Cheron G, Verbanck P, Foucart J. Proactive and Reactive Motor Inhibition in Top Athletes Versus Nonathletes. Percept Mot Skills 2018; 125:289-312. [PMID: 29310525 DOI: 10.1177/0031512517751751] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
We examined proactive (early restraint in preparation for stopping) and reactive (late correction to stop ongoing action) motor response inhibition in two groups of participants: professional athletes ( n = 28) and nonathletes ( n = 25). We recruited the elite athletes from Belgian national taekwondo and fencing teams. We estimated proactive and reactive inhibition with a modified version of the stop-signal task (SST) in which participants inhibited categorizing left/right arrows. The probability of the stop signal was manipulated across blocks of trials by providing probability cues from the background computer screen color (green = 0%, yellow =17%, orange = 25%, red = 33%). Participants performed two sessions of the SST, where proactive inhibition was operationalized with increased go-signal reaction time as a function of increased stop-signal probability and reactive inhibition was indicated by stop-signal reaction time latency. Athletes exhibited higher reactive inhibition performance than nonathletes. In addition, athletes exhibited higher proactive inhibition than nonathletes in Session 1 (but not Session 2) of the SST. As top-level athletes exhibited heightened reactive inhibition and were faster to reach and maintain consistent proactive motor response inhibition, these results confirm an evaluative process that can discriminate elite athleticism through a fine-grained analysis of inhibitory control.
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Affiliation(s)
- Damien Brevers
- 1 Laboratory of Psychological Medicine and Addictology, Faculty of Medicine, CHU-Brugmann, Université Libre de Bruxelles, Belgium.,2 Research in Psychology Applied to Motor Learning, Faculty of Motor Sciences, Université Libre de Bruxelles, Belgium
| | - Etienne Dubuisson
- 2 Research in Psychology Applied to Motor Learning, Faculty of Motor Sciences, Université Libre de Bruxelles, Belgium.,3 Physiotherapy Section, Haute Ecole Libre de Bruxelles Ilya Prigogine, Belgium
| | - Fabien Dejonghe
- 3 Physiotherapy Section, Haute Ecole Libre de Bruxelles Ilya Prigogine, Belgium
| | - Julien Dutrieux
- 2 Research in Psychology Applied to Motor Learning, Faculty of Motor Sciences, Université Libre de Bruxelles, Belgium
| | - Mathieu Petieau
- 4 Laboratory of Neurophysiology and Movement Biomechanics, Faculty of Motor Sciences, Université Libre de Bruxelles, Belgium
| | - Guy Cheron
- 4 Laboratory of Neurophysiology and Movement Biomechanics, Faculty of Motor Sciences, Université Libre de Bruxelles, Belgium
| | - Paul Verbanck
- 1 Laboratory of Psychological Medicine and Addictology, Faculty of Medicine, CHU-Brugmann, Université Libre de Bruxelles, Belgium.,2 Research in Psychology Applied to Motor Learning, Faculty of Motor Sciences, Université Libre de Bruxelles, Belgium
| | - Jennifer Foucart
- 2 Research in Psychology Applied to Motor Learning, Faculty of Motor Sciences, Université Libre de Bruxelles, Belgium.,3 Physiotherapy Section, Haute Ecole Libre de Bruxelles Ilya Prigogine, Belgium
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Constant AL, Mongardon N, Morelot Q, Pichon N, Grimaldi D, Bordenave L, Soummer A, Sauneuf B, Merceron S, Ricome S, Misset B, Bruel C, Schnell D, Boisramé-Helms J, Dubuisson E, Brunet J, Lasocki S, Cronier P, Bouhemad B, Carreira S, Begot E, Vandenbunder B, Dhonneur G, Jullien P, Resche-Rigon M, Bedos JP, Montlahuc C, Legriel S. Targeted temperature management after intraoperative cardiac arrest: a multicenter retrospective study. Intensive Care Med 2017; 43:485-495. [PMID: 28220232 DOI: 10.1007/s00134-017-4709-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 01/31/2017] [Indexed: 12/21/2022]
Abstract
PURPOSE Few outcome data are available about temperature management after intraoperative cardiac arrest (IOCA). We describe targeted temperature management (TTM) (32-34 °C) modalities, adverse events, and association with 1-year functional outcome in patients with IOCA. METHODS Patients admitted to 11 ICUs after IOCA in 2008-2013 were studied retrospectively. The main outcome measure was 1-year functional outcome. RESULTS Of the 101 patients [35 women and 66 men; median age, 62 years (interquartile range, 42-72)], 68 (67.3%) were ASA PS I to III and 57 (56.4%) had emergent surgery. First recorded rhythms were asystole in 44 (43.6%) patients, pulseless electrical activity in 36 (35.6%), and ventricular fibrillation/tachycardia in 20 (19.8%). Median times from collapse to cardiopulmonary resuscitation and return of spontaneous circulation (ROSC) were 0 min (0-0) and 10 min (4-20), respectively. The 30 (29.7%) patients who received TTM had an increased risk of infection (P = 0.005) but not of arrhythmia, bleeding, or metabolic/electrolyte disorders. By multivariate analysis, one or more defibrillation before ROSC was positively associated with a favorable functional outcome at 1-year (OR 3.06, 95% CI 1.05-8.95, P = 0.04) and emergency surgery was negatively associated with 1-year favorable functional outcome (OR 0.36; 95% CI 0.14-0.95, P = 0.038). TTM use was not independently associated with 1-year favorable outcome (OR 0.82; 95% CI 0.27-2.46, P = 0.72). CONCLUSIONS TTM was used in less than one-third of patients after IOCA. TTM was associated with infection but not with bleeding or coronary events in this setting. TTM did not independently predict 1-year favorable functional outcome after IOCA in this study.
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Affiliation(s)
- Anne-Laure Constant
- Medical-Surgical Intensive Care Unit, Intensive Care Department, Centre Hospitalier de Versailles-Site André Mignot, 177 rue de Versailles, 78150, Le Chesnay Cedex, France.,Department of Anesthesiology and Critical Care Medicine, Hôpital Européen Georges Pompidou, 75015, Paris, France
| | - Nicolas Mongardon
- Department of Anesthesiology and Surgical Intensive Care Units, Hôpital Henri Mondor, Assistance Publique des Hôpitaux de Paris, 51 avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France.,Faculté de médecine, Université Paris Est, 8 avenue du général Sarrail, 94000, Créteil, France.,Inserm, U955, Equipe 3 "Stratégies pharmacologiques et thérapeutiques expérimentales des insuffisances cardiaques et coronaires", 8 avenue du général Sarrail, Créteil, France
| | - Quentin Morelot
- SBIM Biostatistics and Medical information, Hôpital Saint-Louis, APHP, 1, avenue Claude Vellefaux, Paris, France.,Université Paris Diderot, Paris, France.,ECSTRA Team (Epidémiologie Clinique et Statistiques pour la Recherche en Santé), UMR 1153 INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Nicolas Pichon
- Medical-Surgical Intensive Care Unit, Centre Hospitalier Universitaire de Limoges, 2, avenue Martin-Luther-King, 87042, Limoges, France
| | - David Grimaldi
- Medical-Surgical Intensive Care Unit, Intensive Care Department, Centre Hospitalier de Versailles-Site André Mignot, 177 rue de Versailles, 78150, Le Chesnay Cedex, France
| | - Lauriane Bordenave
- Department of Anesthesiology, Institut Gustave Roussy, 39, rue Camille-Desmoulins, 94805, Villejuif Cedex, France
| | - Alexis Soummer
- Department of Intensive Care Medicine, Foch Hospital, 40 rue Worth, 92150, Suresnes, France
| | - Bertrand Sauneuf
- Pôle Anesthésie-Réanimation-SAMU, CHU de Caen, Avenue de la côte de Nacre, CS30001, 14033, Caen Cedex 9, France
| | - Sybille Merceron
- Medical-Surgical Intensive Care Unit, Intensive Care Department, Centre Hospitalier de Versailles-Site André Mignot, 177 rue de Versailles, 78150, Le Chesnay Cedex, France
| | - Sylvie Ricome
- Department of Anesthesiology and Critical Care, Assistance Publique des Hôpitaux de Paris, 100 boulevard du Général-Leclerc, 92110, Clichy la Garenne, France
| | - Benoit Misset
- Medical-Surgical Intensive Care Unit, Groupe Hospitalier Saint Joseph, 185 rue Raymond Losserand, 75614, Paris Cedex, France.,Sorbonne Paris Cité-Medical School, Paris Descartes University, Paris, France
| | - Cedric Bruel
- Medical-Surgical Intensive Care Unit, Groupe Hospitalier Saint Joseph, 185 rue Raymond Losserand, 75614, Paris Cedex, France
| | - David Schnell
- Medical Intensive Care Unit, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Julie Boisramé-Helms
- Medical Intensive Care Unit, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,EA 7293, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Faculté de médecine, Université de Strasbourg, Strasbourg, France
| | - Etienne Dubuisson
- Department of Anesthesiology, Centre Hospitalier de Versailles-Site André Mignot, 177 rue de Versailles, 78150, Le Chesnay Cedex, France
| | - Jennifer Brunet
- Pôle Anesthésie-Réanimation-SAMU, CHU de Caen, Avenue de la côte de Nacre, CS30001, 14033, Caen Cedex 9, France
| | - Sigismond Lasocki
- Pôle d'Anesthésie Réanimation, CHU d'Angers, 4 rue Larrey, 49933, Angers Cedex 9, Angers, France.,LUNAM Université, CHU d'Angers, 49933, Angers Cedex, France
| | - Pierrick Cronier
- Intensive Care Unit, Centre Hospitalier Sud-Francilien, 116 boulevard Jean Jaurès, 91106, Corbeil-Essonnes Cedex, France
| | - Belaid Bouhemad
- Department of Anesthesiology and Critical Care, Groupe Hospitalier Saint Joseph, 185 rue Raymond Losserand, 75614, Paris Cedex, France
| | - Serge Carreira
- Department of Intensive Care Medicine, Hôpital Saint-Camill, 2 rue des Pères-Camiliens, 94360, Bry-sur-Marne, France
| | - Emmanuelle Begot
- Medical-Surgical Intensive Care Unit, Centre Hospitalier Universitaire de Limoges, 2, avenue Martin-Luther-King, 87042, Limoges, France
| | - Benoit Vandenbunder
- Department of Anesthesiology, Foch Hospital, 40 rue Worth, 92150, Suresnes, France
| | - Gilles Dhonneur
- Department of Anesthesiology and Surgical Intensive Care Units, Hôpital Henri Mondor, Assistance Publique des Hôpitaux de Paris, 51 avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France.,Faculté de médecine, Université Paris Est, 8 avenue du général Sarrail, 94000, Créteil, France
| | - Philippe Jullien
- Department of Anesthesiology, Centre Hospitalier de Versailles-Site André Mignot, 177 rue de Versailles, 78150, Le Chesnay Cedex, France
| | - Matthieu Resche-Rigon
- SBIM Biostatistics and Medical information, Hôpital Saint-Louis, APHP, 1, avenue Claude Vellefaux, Paris, France.,Université Paris Diderot, Paris, France.,ECSTRA Team (Epidémiologie Clinique et Statistiques pour la Recherche en Santé), UMR 1153 INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Jean-Pierre Bedos
- Medical-Surgical Intensive Care Unit, Intensive Care Department, Centre Hospitalier de Versailles-Site André Mignot, 177 rue de Versailles, 78150, Le Chesnay Cedex, France
| | - Claire Montlahuc
- SBIM Biostatistics and Medical information, Hôpital Saint-Louis, APHP, 1, avenue Claude Vellefaux, Paris, France.,Université Paris Diderot, Paris, France.,ECSTRA Team (Epidémiologie Clinique et Statistiques pour la Recherche en Santé), UMR 1153 INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Stephane Legriel
- Medical-Surgical Intensive Care Unit, Intensive Care Department, Centre Hospitalier de Versailles-Site André Mignot, 177 rue de Versailles, 78150, Le Chesnay Cedex, France. .,Sorbonne Paris Cité-Medical School, Paris Descartes University, Paris, France. .,INSERM U970, Paris Cardiovascular Research Center, Paris, France.
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Kupersztych-Hagege E, Dubuisson E, Szekely B, Michel-Cherqui M, François Dreyfus J, Fischler M, Le Guen M. Epidural Hematoma and Abscess Related to Thoracic Epidural Analgesia: A Single-Center Study of 2,907 Patients Who Underwent Lung Surgery. J Cardiothorac Vasc Anesth 2016; 31:446-452. [PMID: 27720493 DOI: 10.1053/j.jvca.2016.07.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To report the major complications (epidural hematoma and abscess) of postoperative thoracic epidural analgesia in patients who underwent lung surgery. DESIGN Prospective, monocentric study. SETTING A university hospital. PARTICIPANTS All lung surgical patients who received postoperative thoracic epidural analgesia between November 2007 and November 2015. INTERVENTIONS Thoracic epidural analgesia for patients who underwent lung surgery. MEASUREMENTS AND MAIN RESULTS During the study period, data for 2,907 patients were recorded. The following 3 major complications were encountered: 1 case of epidural hematoma (0.34 case/1,000; 95% confidence interval 0.061-1.946), for which surgery was performed, and 2 cases of epidural abscesses (0.68 case/1,000; 95% confidence interval 0.189-2.505), which were treated medically. CONCLUSIONS The risk range of serious complications was moderate; only the patient who experienced an epidural hematoma also experienced permanent sequelae.
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Affiliation(s)
| | - Etienne Dubuisson
- Department of Anesthesiology, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Barbara Szekely
- Department of Anesthesiology, Hôpital Foch, Suresnes, France; Université Versailles Saint-Quenti- en-Yvelines, Versailles, France
| | - Mireille Michel-Cherqui
- Department of Anesthesiology, Hôpital Foch, Suresnes, France; Université Versailles Saint-Quenti- en-Yvelines, Versailles, France
| | | | - Marc Fischler
- Department of Anesthesiology, Hôpital Foch, Suresnes, France; Université Versailles Saint-Quenti- en-Yvelines, Versailles, France.
| | - Morgan Le Guen
- Department of Anesthesiology, Hôpital Foch, Suresnes, France; Université Versailles Saint-Quenti- en-Yvelines, Versailles, France
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Planquette B, Péron J, Dubuisson E, Roujansky A, Laurent V, Le Monnier A, Legriel S, Ferre A, Bruneel F, Chiles PG, Bedos JP. Antibiotics against Pseudomonas aeruginosa for COPD exacerbation in ICU: a 10-year retrospective study. Int J Chron Obstruct Pulmon Dis 2015; 10:379-88. [PMID: 25733827 PMCID: PMC4337514 DOI: 10.2147/copd.s71413] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
SUMMARY Chronic obstructive pulmonary disease (COPD) is a frequent source of hospitalization. Antibiotics are largely prescribed during COPD exacerbation. Our hypothesis is that large broad-spectrum antibiotics are more and more frequently prescribed. Our results confirm this trend and highlight that the increase in large broad-spectrum use in COPD exacerbation is largely unexplained. BACKGROUND Acute COPD exacerbation (AECOPD) is frequently due to respiratory tract infection, and the benefit of antipseudomonal antibiotics (APA) is still debated. Health care-associated pneumonia (HCAP) was defined in 2005 and requires broad-spectrum antibiotherapy. The main objectives are to describe the antibiotic use for AECOPD in intensive care unit and to identify factors associated with APA use and AECOPD prognosis. METHODS We conducted a monocentric, retrospective study on all AECOPDs in the intensive care unit treated by antibiotics for respiratory tract infection. Treatment failure (TF) was defined by death, secondary need for mechanical ventilation, or secondary systemic steroid treatment. A multivariate analysis was used to assess factors associated with APA prescription and TF. RESULTS From January 2000 to December 2011, 111 patients were included. Mean age was 69 years (±12), mean forced expiratory volume 38% of theoretic value (±13). Thirty-five (31%) patients were intubated, and 52 (47%) were treated with noninvasive ventilation. From 107 patients, 8 (7%) cases of Pseudomonas aeruginosa were documented. APAs were prescribed in 21% of patients before 2006 versus 57% after (P=0.001). TF prevalence was 31%. Risk factors for P. aeruginosa in COPD and HCAP diagnosis did not influence APA, whereas the post-2006 period was independently associated with APA prescription (odds ratio 6.2; 95% confidence interval 1.9-20.3; P=0.0013). APA did not improve TF (odds ratio 1.09; 95% confidence interval 0.37-3.2). CONCLUSION HCAP guidelines were followed by an increase in APA use in AECOPD, without an improvement in prognosis. HCAP prevalence cannot account for the increasing APA trend. Time effect reveals a drift in practices. The microbiological effect of such a drift must be evaluated.
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Affiliation(s)
- Benjamin Planquette
- Réanimation Polyvalente, Centre Hospitalier de Versailles, Le Chesnay, France ; Unité de Biostatistique Médicale, Hôpital Lyon Sud, Lyon, France ; Service de Microbiologie, Centre Hospitalier de Versailles, Le Chesnay, France ; Service de Pneumologie et de Soins Intensifs, Hôpital Européen Georges Pompidou, Université Paris René Descartes, Paris, France
| | - Julien Péron
- Unité de Biostatistique Médicale, Hôpital Lyon Sud, Lyon, France
| | - Etienne Dubuisson
- Réanimation Polyvalente, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Ariane Roujansky
- Réanimation Polyvalente, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Virginie Laurent
- Réanimation Polyvalente, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Alban Le Monnier
- Service de Microbiologie, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Stephane Legriel
- Réanimation Polyvalente, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Alexis Ferre
- Service de Pneumologie et de Soins Intensifs, Hôpital Européen Georges Pompidou, Université Paris René Descartes, Paris, France
| | - Fabrice Bruneel
- Réanimation Polyvalente, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Peter G Chiles
- Division of Pulmonary and Critical Care Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Jean P Bedos
- Réanimation Polyvalente, Centre Hospitalier de Versailles, Le Chesnay, France
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