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Zapata L, Guía C, Gómez R, García-Paredes T, Colinas L, Portugal-Rodriguez E, Rodado I, Leache I, Fernández-Ferreira A, Hermosilla-Semikina I, Roche-Campo F. Clinical presentation and outcomes of acute heart failure in the critically ill patient: A prospective, observational, multicentre study. Med Intensiva 2022. [DOI: 10.1016/j.medin.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Concha P, Treso-Geira M, Esteve-Sala C, Prades-Berengué C, Domingo-Marco J, Roche-Campo F. Invasive mechanical ventilation and prolonged prone position during the COVID-19 pandemic. Med Intensiva 2021; 46:161-163. [PMID: 34969651 PMCID: PMC8673827 DOI: 10.1016/j.medine.2021.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 12/02/2022]
Affiliation(s)
- P Concha
- Servicio de Medicina Intensiva, Hospital Verge de la Cinta, Tortosa, Tarragona, Spain
| | - M Treso-Geira
- Servicio de Medicina Intensiva, Hospital Verge de la Cinta, Tortosa, Tarragona, Spain
| | - C Esteve-Sala
- Servicio de Medicina Intensiva, Hospital Verge de la Cinta, Tortosa, Tarragona, Spain
| | - C Prades-Berengué
- Servicio de Medicina Intensiva, Hospital Verge de la Cinta, Tortosa, Tarragona, Spain
| | - J Domingo-Marco
- Servicio de Medicina Intensiva, Hospital Verge de la Cinta, Tortosa, Tarragona, Spain
| | - F Roche-Campo
- Servicio de Medicina Intensiva, Hospital Verge de la Cinta, Tortosa, Tarragona, Spain.
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Wendel-Garcia PD, Roche-Campo F, Mancebo J. Positive end-expiratory pressure, or the perennial conundrum surrounding lung recruitment. Med Intensiva 2021; 45:513-515. [PMID: 34839882 DOI: 10.1016/j.medine.2021.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 08/22/2021] [Indexed: 12/16/2022]
Affiliation(s)
- P D Wendel-Garcia
- Institute of Intensive Care Medicine, University Hospital of Zurich, Zurich, Switzerland
| | - F Roche-Campo
- Intensive Care Dept, Hospital de Tortosa Verge de la Cinta, Tortosa, Tarragona, Spain
| | - J Mancebo
- Intensive Care Dept, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
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Wendel-Garcia PD, Roche-Campo F, Mancebo J. Positive end-expiratory pressure, or the perennial conundrum surrounding lung recruitment. Med Intensiva 2021; 45:S0210-5691(21)00183-2. [PMID: 34548184 DOI: 10.1016/j.medin.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 08/22/2021] [Indexed: 12/16/2022]
Affiliation(s)
- P D Wendel-Garcia
- Institute of Intensive Care Medicine, University Hospital of Zurich, Zurich, Switzerland
| | - F Roche-Campo
- Intensive Care Dept, Hospital de Tortosa Verge de la Cinta, Tortosa, Tarragona, Spain
| | - J Mancebo
- Intensive Care Dept, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
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Franch-Llasat D, Mayor-Vázquez E, Pedregosa-Díaz J, Herrero-Redondo M, Ortin-Font X, Roche-Campo F. [e-Thrombosis in the COVID-19 era: collateral effects of confinement]. Med Intensiva 2021; 45:122-124. [PMID: 38620599 PMCID: PMC7473011 DOI: 10.1016/j.medin.2020.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 07/31/2020] [Accepted: 08/13/2020] [Indexed: 10/26/2022]
Affiliation(s)
- D Franch-Llasat
- Servicio de Medicina intensiva. Hospital Verge de la Cinta, Tortosa, Tarragona, España
| | - E Mayor-Vázquez
- Servicio de Medicina intensiva. Hospital Verge de la Cinta, Tortosa, Tarragona, España
| | - J Pedregosa-Díaz
- Servicio de Laboratorio Clínico ICS Camp de Tarragona i Terres de l'Ebre, Tarragona, España
| | - M Herrero-Redondo
- Servicio de Radiodiagnóstico. Unidad IDI-Terres de l'Ebre. Hospital Verge de la Cinta, Tortosa, Tarragona, España
| | - X Ortin-Font
- Servicio de Hematología. Hospital Verge de la Cinta, Tortosa, Tarragona, España
| | - F Roche-Campo
- Servicio de Medicina intensiva. Hospital Verge de la Cinta, Tortosa, Tarragona, España
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Concha P, Treso-Geira M, Esteve-Sala C, Prades-Berengué C, Domingo-Marco J, Roche-Campo F. Invasive mechanical ventilation and prolonged prone position during the COVID-19 pandemic. Med Intensiva 2021; 46:S0210-5691(21)00001-2. [PMID: 33551113 PMCID: PMC7832806 DOI: 10.1016/j.medin.2021.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 11/24/2022]
Affiliation(s)
- P Concha
- Servicio de Medicina Intensiva, Hospital Verge de la Cinta, Tortosa, Tarragona, España
| | - M Treso-Geira
- Servicio de Medicina Intensiva, Hospital Verge de la Cinta, Tortosa, Tarragona, España
| | - C Esteve-Sala
- Servicio de Medicina Intensiva, Hospital Verge de la Cinta, Tortosa, Tarragona, España
| | - C Prades-Berengué
- Servicio de Medicina Intensiva, Hospital Verge de la Cinta, Tortosa, Tarragona, España
| | - J Domingo-Marco
- Servicio de Medicina Intensiva, Hospital Verge de la Cinta, Tortosa, Tarragona, España
| | - F Roche-Campo
- Servicio de Medicina Intensiva, Hospital Verge de la Cinta, Tortosa, Tarragona, España.
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Darreau C, Martino F, Saint-Martin M, Jacquier S, Hamel JF, Nay MA, Terzi N, Ledoux G, Roche-Campo F, Camous L, Pene F, Balzer T, Bagate F, Lorber J, Bouju P, Marois C, Robert R, Gaudry S, Commereuc M, Debarre M, Chudeau N, Labroca P, Merouani K, Egreteau PY, Peigne V, Bornstain C, Lebas E, Benezit F, Vally S, Lasocki S, Robert A, Delbove A, Lerolle N. Use, timing and factors associated with tracheal intubation in septic shock: a prospective multicentric observational study. Ann Intensive Care 2020; 10:62. [PMID: 32449053 PMCID: PMC7245631 DOI: 10.1186/s13613-020-00668-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [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] [Received: 01/10/2020] [Accepted: 04/22/2020] [Indexed: 01/20/2023] Open
Abstract
Background No recommendation exists about the timing and setting for tracheal intubation and mechanical ventilation in septic shock. Patients and methods This prospective multicenter observational study was conducted in 30 ICUs in France and Spain. All consecutive patients presenting with septic shock were eligible. The use of tracheal intubation was described across the participating ICUs. A multivariate analysis was performed to identify parameters associated with early intubation (before H8 following vasopressor onset). Results Eight hundred and fifty-nine patients were enrolled. Two hundred and nine patients were intubated early (24%, range 4.5–47%), across the 18 centers with at least 20 patients included. The cumulative intubation rate during the ICU stay was 324/859 (38%, range 14–65%). In the multivariate analysis, seven parameters were significantly associated with early intubation and ranked as follows by decreasing weight: Glasgow score, center effect, use of accessory respiratory muscles, lactate level, vasopressor dose, pH and inability to clear tracheal secretions. Global R-square of the model was only 60% indicating that 40% of the variability of the intubation process was related to other parameters than those entered in this analysis. Conclusion Neurological, respiratory and hemodynamic parameters only partially explained the use of tracheal intubation in septic shock patients. Center effect was important. Finally, a vast part of the variability of intubation remained unexplained by patient characteristics. Trial registration Clinical trials NCT02780466, registered on May 23, 2016. https://clinicaltrials.gov/ct2/show/NCT02780466?term=intubatic&draw=2&rank=1.
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Affiliation(s)
- C Darreau
- Medical and Surgical Intensive Care Unit, Le Mans Hospital, Le Mans, France
| | - F Martino
- Medical and Surgical Intensive Care Unit, Guadeloupe University Hospital, Les Abymes, Guadeloupe, France
| | - M Saint-Martin
- Medical and Surgical Intensive Care Unit, Le Mans Hospital, Le Mans, France
| | - S Jacquier
- Medical Intensive Care Unit, Tours University Hospital, Tours, France
| | - J F Hamel
- Methodology and Statistics Department, Angers University Hospital, Angers, France
| | - M A Nay
- Medical Intensive Care Unit, Orleans Regional Hospital, Orléans, France
| | - N Terzi
- Medical Intensive Care Unit, Grenoble University Hospital, La Tronche, France
| | - G Ledoux
- Medical and Surgical Intensive Care Unit, Lille University Hospital, Lille, France
| | - F Roche-Campo
- Intensive Care Unit, Hospital Verge de la Cinta, Tortosa, Spain
| | - L Camous
- Medical Intensive Care Unit, Bicêtre Hospital, AP-HP, Paris, France
| | - F Pene
- Medical Intensive Care Unit, Cochin Hospital, AP-HP, Paris, France
| | - T Balzer
- Medical Intensive Care Unit, Brest University Hospital, Brest, France
| | - F Bagate
- Medical Intensive Care Unit, Henri Mondor Hospital, AP-HP, Paris, France
| | - J Lorber
- Medical and Surgical Intensive Care Unit, La-Roche-sur-Yon Hospital, La Roche-sur-Yon, France
| | - P Bouju
- Medical and Surgical Intensive Care Unit, Sud Bretagne Hospital, Lorient, France
| | - C Marois
- Medical Intensive Care Unit, Pitié-Salpétrière Hospital, AP-HP, Paris, France
| | - R Robert
- Medical Intensive Care Unit, Poitiers University Hospital, Poitiers, France
| | - S Gaudry
- Medical Intensive Care Unit, Louis Mourier Hospital, AP-HP, Colombes, France
| | - M Commereuc
- Medical Intensive Care Unit, Georges Pompidou European Hospital, AP-HP, Paris, France
| | - M Debarre
- Medical and Surgical Intensive Care Unit, Saint Brieuc Hospital, Saint Brieuc, France
| | - N Chudeau
- Medical and Surgical Intensive Care Unit, Le Mans Hospital, Le Mans, France
| | - P Labroca
- Medical Intensive Care Unit, Nancy University Central Hospital, Nancy, France
| | - K Merouani
- Medical and Surgical Intensive Care Unit, Alençon Hospital, Alençon, France
| | - P Y Egreteau
- Medical and Surgical Intensive Care Unit, Morlaix Hospital, Morlaix, France
| | - V Peigne
- Medical and Surgical Intensive Care Unit, Métropole Savoie Hospital, Chambéry, France
| | - C Bornstain
- Medical Intensive Care Unit, Le Raincy-Montfermeil Hospital, Montfermeil, France
| | - E Lebas
- Medical and Surgical Intensive Care Unit, Bretagne Atlantique Hospital, Vannes, France
| | - F Benezit
- Medical and Surgical Intensive Care Unit, Rennes University Hospital, Rennes, France
| | - S Vally
- Medical and Surgical Intensive Care Unit, Martinique University Hospital, Fort-de-France, Martinique, France
| | - S Lasocki
- Surgical Intensive Care Unit, Angers University Hospital, Angers, France
| | - A Robert
- Medical Intensive Care Unit, Nice University Hospital, Nice, France
| | - A Delbove
- Medical Intensive Care Unit, Nantes University Hospital, Nantes, France
| | - N Lerolle
- Medical Intensive Care Unit, Angers University Hospital, Angers, France.
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Ruiz-Ramos J, Vidal-Cortés P, Díaz-Lamas A, Reig-Valero R, Roche-Campo F, Del Valle-Ortiz M, Nuvials-Casals X, Ortiz-Piquer M, Andaluz-Ojeda D, Tamayo-Lomas L, Blasco-Navalpotro MA, Rodriguez-Aguirregabiria M, Aguado J, Ramirez P. Ventilator-associated pneumonia by methicillin-susceptible Staphylococcus aureus: do minimum inhibitory concentrations to vancomycin and daptomycin matter? Eur J Clin Microbiol Infect Dis 2017; 36:1569-1575. [PMID: 28378244 DOI: 10.1007/s10096-017-2970-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 03/16/2017] [Indexed: 01/21/2023]
Abstract
The use of vancomycin minimum inhibitory concentration (MIC) as an outcome predictor in patients with methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia has become an important topic for debate in the last few years. Given these previous results, we decided to investigate whether MICs to vancomycin or daptomycin had any effect on the evolution of patients with ventilator-associated pneumonia (VAP) due to MSSA. An observational, retrospective, multicenter study was conducted among patients with MSSA VAP. We analyzed the relationship between vancomycin and daptomycin MICs and early clinical response (72 h), 30-day mortality, intensive care unit (ICU) length of stay (LOS), and duration on mechanical ventilation. Univariate and multivariate analyses were performed. Sixty-six patients from 12 centers were included. Twenty-six patients (39%) had an infection due to MSSA strains with a vancomycin MIC ≥1.5 μg/mL. Daptomycin MIC was determined in 58 patients, of whom 17 (29%) had an MIC ≥1.0 μg/mL. Ten patients (15%) did not respond to first-line treatment. Only daptomycin MIC ≥1.0 μg/mL had a significant association [odds ratio (OR): 30.00; 95% confidence interval (CI): 2.91-60.41] with early treatment failure. The 30-day mortality was 12% (n = 8). Any variable was associated with mortality in the multivariate analysis. None of the variables studied were associated with ICU LOS or duration on mechanical ventilation. In patients with MSSA VAP, vancomycin MIC does not influence the response to antibiotic treatment or the 30-day mortality. Daptomycin MIC was directly related to early treatment failure.
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Affiliation(s)
- J Ruiz-Ramos
- Intensive Care Unit, Instituto de Investigación Sanitaria La Fe, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - P Vidal-Cortés
- Intensive Care Unit, Complexo Hospitalario Universitario de Ourense, Ourense, Spain
| | - A Díaz-Lamas
- Intensive Care Unit, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - R Reig-Valero
- Intensive Care Unit, Hospital Universitario General de Castellón, Castellón, Spain
| | - F Roche-Campo
- Intensive Care Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - M Del Valle-Ortiz
- Intensive Care Unit, Hospital Universitario de Burgos, Burgos, Spain
| | - X Nuvials-Casals
- Intensive Care Unit, Hospital Universitari Arnau de Vilanova, Lleida, Spain
- Institut de Recerca Biomèdica (IRB Lleida), Lleida, Spain
| | - M Ortiz-Piquer
- Intensive Care Unit, Hospital Lucus Augusti, Lugo, Spain
| | - D Andaluz-Ojeda
- Intensive Care Unit, Hospital Clínico Universitario Valladolid, Valladolid, Spain
| | - L Tamayo-Lomas
- Intensive Care Unit, Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain
| | | | | | - J Aguado
- Infectious Disease Department, University Hospital 12 de Octubre, Madrid, Spain
| | - P Ramirez
- Intensive Care Unit, Hospital Universitario y Politécnico La Fe, Avenida Fernando Abril Martorell n°106, 46026, Valencia, Spain.
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Robleda G, Roche-Campo F, Membrilla-Martínez L, Fernández-Lucio A, Villamor-Vázquez M, Merten A, Gich I, Mancebo J, Català-Puigbó E, Baños J. Evaluación del dolor durante la movilización y la aspiración endotraqueal en pacientes críticos. Med Intensiva 2016; 40:96-104. [DOI: 10.1016/j.medin.2015.03.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Revised: 03/11/2015] [Accepted: 03/14/2015] [Indexed: 12/15/2022]
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Badia SG, Batet S, Italiano S, Roche-Campo F, Antonijoan R. Sleep quality in Intensive Care Unit. Sleep Med 2013. [DOI: 10.1016/j.sleep.2013.11.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Aguirre-Bermeo H, Bottiroli M, Italiano S, Roche-Campo F, Santos JA, Alonso M, Mancebo J. [Pressure support ventilation and proportional assist ventilation during weaning from mechanical ventilation]. Med Intensiva 2013; 38:363-70. [PMID: 24144679 DOI: 10.1016/j.medin.2013.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Revised: 08/07/2013] [Accepted: 08/28/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To compare tolerance, duration of mechanical ventilation (MV) and clinical outcomes during weaning from MV in patients subjected to either pressure support ventilation (PSV) or proportional assist ventilation (PAV). DESIGN A prospective, observational study was carried out. SETTING Intensive Care Unit. PATIENTS A total of 40 consecutive subjects were allocated to either the PSV or the PAV group until each group contained 20 patients. Patients were included in the study when they met the criteria to begin weaning and the attending physician decided to initiate the weaning process. The physician selected the modality and set the ventilatory parameters. INTERVENTIONS None. VARIABLES OF INTEREST Demographic data, respiratory mechanics, ventilatory parameters, duration of MV, and clinical outcomes (reintubation, tracheostomy, mortality). RESULTS Baseline characteristics were similar in both groups. No significant differences were observed between the PSV and PAV groups in terms of the total duration of MV (10 [5-18] vs. 9 [7-19] days; P=.85), reintubation (5 [31%] vs. 3 [19%]; P=.69), or mortality (4 [20%] vs. 5 [25%] deaths; P=1). Eight patients (40%) in the PSV group and 6 patients (30%) in the PAV group (P=.74) required a return to volume assist-control ventilation due to clinical deterioration. CONCLUSIONS Tolerance, duration of MV and clinical outcomes during weaning from mechanical ventilation were similar in PSV and PAV.
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Affiliation(s)
- H Aguirre-Bermeo
- Servicio de Medicina Intensiva, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona (UAB), Barcelona, España; Servicio de Medicina Intensiva, Hospital Sant Joan de Reus, Reus, Tarragona, España.
| | - M Bottiroli
- Servicio de Medicina Intensiva, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona (UAB), Barcelona, España; Anestesia e Rianimazione 3, Ospedale Niguarda Ca' Granda, Milán, Italia
| | - S Italiano
- Servicio de Medicina Intensiva, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona (UAB), Barcelona, España; Servicio de Medicina Intensiva, Hospital Verge de la Cinta, Tortosa, Tarragona, España
| | - F Roche-Campo
- Servicio de Medicina Intensiva, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona (UAB), Barcelona, España; Servicio de Medicina Intensiva, Hospital Sant Joan de Reus, Reus, Tarragona, España
| | - J A Santos
- Servicio de Medicina Intensiva, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona (UAB), Barcelona, España
| | - M Alonso
- Servicio de Farmacología Clínica, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona (UAB), Barcelona, España
| | - J Mancebo
- Servicio de Medicina Intensiva, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona (UAB), Barcelona, España
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Bitondo MM, Aguirre-Bermeo HM, Moccaldo A, De Santis P, Bernini V, Tersali A, Italiano S, Grieco DL, Idone FA, Grandjean J, Roche-Campo F, Antonelli M, Mancebo Cortes J, Maggiore SM. Patient-ventilator asynchrony during conventional or automated pressure support ventilation in difficult-to-wean patients. Crit Care 2012. [PMCID: PMC3363544 DOI: 10.1186/cc10733] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Roche-Campo F, Aguirre-Bermeo H, Mancebo J. Glucocorticoids in the treatment of acute respiratory distress syndrome. Réanimation 2012; 21:391-398. [PMID: 32288728 PMCID: PMC7117829 DOI: 10.1007/s13546-011-0316-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Accepted: 10/03/2011] [Indexed: 12/02/2022]
Abstract
Acute respiratory distress syndrome (ARDS) is characterized by local inflammation and an intense systemic inflammatory reaction. Glucocorticoid administration has been suggested due to their anti-inflammatory properties. However, results from the initial studies of glucocorticoids in ARDS, which evaluated high-dose and short-term treatments, were negative. More recent studies have evaluated the effect of lower doses of glucocorticoids administered over longer periods, but the results thus far have been inconclusive.
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Affiliation(s)
- F. Roche-Campo
- Servei de Medicina Intensiva, Hospital de Sant Pau, Barcelona, Espagne
| | - H. Aguirre-Bermeo
- Servei de Medicina Intensiva, Hospital de Sant Pau, Barcelona, Espagne
| | - J. Mancebo
- Servei de Medicina Intensiva, Hospital de Sant Pau, Barcelona, Espagne
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Roche-Campo F, Mancebo J. Implications of a comprehensive clinical approach in the treatment of critically-ill patients requiring mechanical ventilation. Minerva Anestesiol 2011; 77:477-479. [PMID: 21540799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Cuquemelle E, Soulis F, Villers D, Roche-Campo F, Ara Somohano C, Fartoukh M, Kouatchet A, Mourvillier B, Dellamonica J, Picard W, Schmidt M, Boulain T, Brun-Buisson C. Can procalcitonin help identify associated bacterial infection in patients with severe influenza pneumonia? A multicentre study. Intensive Care Med 2011; 37:796-800. [PMID: 21369807 PMCID: PMC7080069 DOI: 10.1007/s00134-011-2189-1] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2010] [Accepted: 11/27/2010] [Indexed: 11/27/2022]
Abstract
Purpose To determine whether procalcitonin (PCT) levels could help discriminate isolated viral from mixed (bacterial and viral) pneumonia in patients admitted to the intensive care unit (ICU) during the A/H1N1v2009 influenza pandemic. Methods A retrospective observational study was performed in 23 French ICUs during the 2009 H1N1 pandemic. Levels of PCT at admission were compared between patients with confirmed influenzae A pneumonia associated or not associated with a bacterial co-infection. Results Of 103 patients with confirmed A/H1N1 infection and not having received prior antibiotics, 48 (46.6%; 95% CI 37–56%) had a documented bacterial co-infection, mostly caused by Streptococcus pneumoniae (54%) or Staphylococcus aureus (31%). Fifty-two patients had PCT measured on admission, including 19 (37%) having bacterial co-infection. Median (range 25–75%) values of PCT were significantly higher in patients with bacterial co-infection: 29.5 (3.9–45.3) versus 0.5 (0.12–2) μg/l (P < 0.01). For a cut-off of 0.8 μg/l or more, the sensitivity and specificity of PCT for distinguishing isolated viral from mixed pneumonia were 91 and 68%, respectively. Alveolar condensation combined with a PCT level of 0.8 μg/l or more was strongly associated with bacterial co-infection (OR 12.9, 95% CI 3.2–51.5; P < 0.001). Conclusions PCT may help discriminate viral from mixed pneumonia during the influenza season. Levels of PCT less than 0.8 μg/l combined with clinical judgment suggest that bacterial infection is unlikely.
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Affiliation(s)
- E Cuquemelle
- Service de Réanimation médicale, Medical Intensive Care Unit, Université Paris-Est Créteil, Créteil, France
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Roche-Campo F, Mozota-Duarte J, Trigeros-Martín J, López-Jurado I, Freile-García E, Pina-Leita I. Embolismo gaseoso cerebral por accidente de buceo. Med Intensiva 2005. [DOI: 10.1016/s0210-5691(05)74234-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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