1
|
Hong Tuan Ha V, Jost D, Bougouin W, Joly G, Jouffroy R, Jabre P, Beganton F, Derkenne C, Lemoine S, Frédéric L, Lamhaut L, Loeb T, Revaux F, Dumas F, Trichereau J, Stibbe O, Deye N, Marijon E, Cariou A, Jouven X, Travers S. Trends in survival from out-of-hospital cardiac arrest with a shockable rhythm and its association with bystander resuscitation: a retrospective study. Emerg Med J 2023; 40:761-767. [PMID: 37640438 DOI: 10.1136/emermed-2023-213220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/08/2023] [Accepted: 08/18/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE Over 300 000 cases of out-of-hospital cardiac arrests (OHCAs) occur each year in the USA and Europe. Despite decades of investment and research, survival remains disappointingly low. We report the trends in survival after a ventricular fibrillation/pulseless ventricular tachycardia OHCA, over a 13-year period, in a French urban region, and describe the simultaneous evolution of the rescue system. METHODS We investigated four 18-month periods between 2005 and 2018. The first period was considered baseline and included patients from the randomised controlled trial 'DEFI 2005'. The three following periods were based on the Paris Sudden Death Expertise Center Registry (France). Inclusion criteria were non-traumatic cardiac arrests treated with at least one external electric shock with an automated external defibrillator from the basic life support team and resuscitated by a physician-staffed ALS team. Primary outcome was survival at hospital discharge with a good neurological outcome. RESULTS Of 21 781 patients under consideration, 3476 (16%) met the inclusion criteria. Over all study periods, survival at hospital discharge increased from 12% in 2005 to 25% in 2018 (p<0.001), and return of spontaneous circulation at hospital admission increased from 43% to 58% (p=0.004).Lay-rescuer cardiopulmonary resuscitation (CPR) and telephone CPR (T-CPR) rates increased significantly, but public defibrillator use remained limited. CONCLUSION In a two-tiered rescue system, survival from OHCA at hospital discharge doubled over a 13-year study period. Concomitantly, the system implemented an OHCA patient registry and increased T-CPR frequency, despite a consistently low rate of public defibrillator use.
Collapse
Affiliation(s)
- Vivien Hong Tuan Ha
- Prehospital Emergency Medicine Department, Paris Fire Brigade, Paris, France
| | - Daniel Jost
- Prehospital Emergency Medicine Department, Paris Fire Brigade, Paris, France
- Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), Paris, France
| | - Wulfran Bougouin
- Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), Paris, France
- Paris Descartes-Sorbonne Cité University, Paris, France
| | - Guillaume Joly
- Prehospital Emergency Medicine Department, Paris Fire Brigade, Paris, France
| | - Romain Jouffroy
- Prehospital Emergency Medicine Department, Paris Fire Brigade, Paris, France
- Service de médecine intensive et réanimation, Hôpital Universitaire Ambroise Paré, Assistance Publique-Hopitaux de Paris, Paris, France
| | - Patricia Jabre
- Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), Paris, France
- SAMU de Paris, Necker Hospital, Paris, France
| | - Frankie Beganton
- Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), Paris, France
| | - Clément Derkenne
- Prehospital Emergency Medicine Department, Paris Fire Brigade, Paris, France
| | - Sabine Lemoine
- Prehospital Emergency Medicine Department, Paris Fire Brigade, Paris, France
| | - Lemoine Frédéric
- Prehospital Emergency Medicine Department, Paris Fire Brigade, Paris, France
| | - Lionel Lamhaut
- Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), Paris, France
- SAMU de Paris, Necker Hospital, Paris, France
| | - Thomas Loeb
- SAMU 92 - Prehospital Emergency Department, Hôpital Raymond-Poincare, Garches, France
| | - François Revaux
- SAMU 94, Assistance Publique-Hopitaux de Paris, Créteil, France
| | - Florence Dumas
- Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), Paris, France
- Paris Descartes-Sorbonne Cité University, Paris, France
| | - Julie Trichereau
- Prehospital Emergency Medicine Department, Paris Fire Brigade, Paris, France
| | - Olivier Stibbe
- Prehospital Emergency Medicine Department, Paris Fire Brigade, Paris, France
| | - Nicolas Deye
- Intensive Care Unit, Lariboisière Hospital, Paris, France
- Inserm U942, Sorbonne Paris Nord University, Paris, France
| | - Eloi Marijon
- Paris Descartes-Sorbonne Cité University, Paris, France
| | - Alain Cariou
- Paris Descartes-Sorbonne Cité University, Paris, France
| | - Xavier Jouven
- Paris Descartes-Sorbonne Cité University, Paris, France
| | - Stephane Travers
- Prehospital Emergency Medicine Department, Paris Fire Brigade, Paris, France
| |
Collapse
|
2
|
Abstract
BACKGROUND Patients and their relatives often expect to be actively involved in decisions of treatment. Even during resuscitation and acute medical care, patients may want to have their relatives nearby, and relatives may want to be present if offered the possibility. The principle of family presence during resuscitation (FPDR) is a triangular relationship where the intervention of family presence affects the healthcare professionals, the relatives present, and the care of the patient involved. All needs and well-being must be balanced in the context of FPDR as the actions involving all three groups can impact the others. OBJECTIVES The primary aim of this review was to investigate how offering relatives the option to be present during resuscitation of patients affects the occurrence of post-traumatic stress disorder (PTSD)-related symptoms in the relatives. The secondary aim was to investigate how offering relatives the option to be present during resuscitation of patients affects the occurrence of other psychological outcomes in the relatives and what effect family presence compared to no family presence during resuscitation of patients has on patient morbidity and mortality. We also wanted to investigate the effect of FPDR on medical treatment and care during resuscitation. Furthermore, we wanted to investigate and report the personal stress seen in healthcare professionals and if possible describe their attitudes toward the FPDR initiative. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, PsycINFO, and CINAHL from inception to 22 March 2022 without any language limits. We also checked references and citations of eligible studies using Scopus, and searched for relevant systematic reviews using Epistomonikos. Furthermore, we searched ClinicalTrials.gov, WHO ICTRP, and ISRCTN registry for ongoing trials; OpenGrey for grey literature; and Google Scholar for additional trials (all on 22 March 2022). SELECTION CRITERIA We included randomized controlled trials of adults who have witnessed a resuscitation attempt of a patient (who was their relative) at the emergency department or in the pre-hospital emergency medical service. The participants of this review included relatives, patients, and healthcare professionals during resuscitation. We included relatives aged 18 years or older who have witnessed a resuscitation attempt of a patient (who is their relative) in the emergency department or pre-hospital. We defined relatives as siblings, parents, spouses, children, or close friends of the patient, or any other descriptions used by the study authors. There were no limitations on adult age or gender. We defined patient as a patient with cardiac arrest in need of cardiopulmonary resuscitation (CPR), a patient with a critical medical or traumatic life-threatening condition, an unconscious patient, or a patient in any other way at risk of sudden death. We included all types of healthcare professionals as described in the included studies. There were no limitations on age or gender. DATA COLLECTION AND ANALYSIS We checked titles and abstracts of studies identified by the search, and obtained the full reports of those studies deemed potentially relevant. Two review authors independently extracted data. As it was not possible to conduct meta-analyses, we synthesized data narratively. MAIN RESULTS The electronic searches yielded a total of 7292 records after deduplication. We included 2 trials (3 papers) involving a total of 595 participants: a cluster-randomized trial from 2013 involving pre-hospital emergency medical services units in France, comparing systematic offer for a relative to witness CPR with the traditional practice, and its 1-year assessment; and a small pilot study from 1998 of FPDR in an emergency department in the UK. Participants were 19 to 78 years old, and between 56% and 64% were women. PTSD was measured with the Impact of Event Scale, and the median score ranged from 0 to 21 (range 0 to 75; higher scores correspond to more severe disease). In the trial that accounted for most of the included participants (570/595), the frequency of PTSD-related symptoms was significantly higher in the control group after 3 and 12 months, and in the per-protocol analyses a significant statistical difference was found in favor of FPDR when looking at PTSD, anxiety and depression, and complicated grief after 1 year. One of the included studies also measured duration of patient resuscitation and personal stress in healthcare professionals during FPDR and found no difference between groups. Both studies had high risk of bias, and the evidence for all outcomes except one was assessed as very low certainty. AUTHORS' CONCLUSIONS There was insufficient evidence to draw any firm conclusions on the effects of FPDR on relatives' psychological outcomes. Sufficiently powered and well-designed randomized controlled trials may change the conclusions of the review in future.
Collapse
Affiliation(s)
- Monika Afzali Rubin
- Department of Anaesthesiology and Herlev ACES, Herlev Anaesthesia Critical and Emergency Care Science Unit, Copenhagen University Hospital, Herlev-Gentofte, Copenhagen, Denmark
| | | | - Suzanne Forsyth Herling
- The Neuroscience Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- University of Copenhagen, Copenhagen, Denmark
| | - Patricia Jabre
- Assistance Publique-Hôpitaux de Paris (AP-HP), SAMU (Service d'Aide Médicale Urgente) de Paris, Hôpital Universitaire Necker-Enfants Malades, Paris, France
- Cochrane Pre-hospital and Emergency Care Field, Paris, France
- Université Paris Cité, Paris Cardiovascular Research Centre (PARCC), INSERM, Integrative Epidemiology of Cardiovascular Diseases Team, Paris, France
| | - Ann Merete Møller
- Department of Anaesthesiology and Herlev ACES, Herlev Anaesthesia Critical and Emergency Care Science Unit, Copenhagen University Hospital, Herlev-Gentofte, Copenhagen, Denmark
- University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
3
|
Michelland L, Murad MH, Bougouin W, Van Der Broek M, Prokop LJ, Anys S, Perier MC, Cariou A, Empana JP, Marijon E, Jouven X, Jabre P. Association between basic life support and survival in sports-related sudden cardiac arrest: a meta-analysis. Eur Heart J 2023; 44:180-192. [PMID: 36285872 DOI: 10.1093/eurheartj/ehac586] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 12/10/2021] [Revised: 08/12/2022] [Accepted: 10/04/2022] [Indexed: 01/24/2023] Open
Abstract
AIMS To evaluate the association of basic life support with survival after sports-related sudden cardiac arrest (SR-SCA). METHODS AND RESULTS In this systematic review and meta-analysis, a search of several databases from each database inception to 31 July 2021 without language restrictions was conducted. Studies were considered eligible if they evaluated one of three scenarios in patients with SR-SCA: (i) bystander presence, (ii) bystander cardiopulmonary resuscitation (CPR), or (iii) bystander automated external defibrillator (AED) use and provided information on survival. Risk of bias was evaluated using Risk of Bias in Non-randomized Studies of Interventions. The primary outcome was survival at the longest follow up. The meta-analysis was conducted using the random-effects model. The Grading of Recommendations Assessment, Development, and Evaluations (GRADE) approach was used to rate certainty in the evidence. In total, 28 non-randomized studies were included. The meta-analysis showed significant benefit on survival in all three groups: bystander presence [odds ratio (OR) 2.55, 95% confidence interval (CI) 1.48-4.37; I2 = 25%; 9 studies-988 patients], bystander CPR (OR 3.84, 95% CI 2.36-6.25; I2 = 54%; 23 studies-2523 patients), and bystander AED use (OR 5.25, 95% CI 3.58-7.70; I2 = 16%; 19 studies-1227 patients). The GRADE certainty of evidence was judged to be moderate. CONCLUSION In patients with SR-SCA, bystander presence, bystander CPR, and bystander AED use were significantly associated with survival. These results highlight the importance of witness intervention and encourage countries to develop their first aid training policy and AED installation in sport settings.
Collapse
Affiliation(s)
- Laurianne Michelland
- Department of Emergency, Service Mobile d'Urgence et Réanimation (SMUR), Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, Montfermeil, France.,Université Paris Cité, INSERM, UMR-S970, Paris Cardiovascular Research Center, Team "Integrative Epidemiology of Cardiovascular Diseases", Paris, France
| | - Mohammad H Murad
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN, USA
| | - Wulfran Bougouin
- Université Paris Cité, INSERM, UMR-S970, Paris Cardiovascular Research Center, Team "Integrative Epidemiology of Cardiovascular Diseases", Paris, France.,Medical-Surgical Intensive Care Unit, Ramsay Générale de Santé, Hôpital Privé Jacques Cartier, 6 Avenue du Noyer Lambert, 91300 Massy, France
| | | | | | - Soraya Anys
- Université Paris Cité, INSERM, UMR-S970, Paris Cardiovascular Research Center, Team "Integrative Epidemiology of Cardiovascular Diseases", Paris, France.,Cardiology Department, Georges Pompidou European Hospital, AP-HP, 20 Rue Leblanc, 75015 Paris, France
| | - Marie-Cécile Perier
- Université Paris Cité, INSERM, UMR-S970, Paris Cardiovascular Research Center, Team "Integrative Epidemiology of Cardiovascular Diseases", Paris, France
| | - Alain Cariou
- Université Paris Cité, INSERM, UMR-S970, Paris Cardiovascular Research Center, Team "Integrative Epidemiology of Cardiovascular Diseases", Paris, France.,Medical Intensive Care Unit, Cochin Hospital, AP-HP, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Jean Philippe Empana
- Université Paris Cité, INSERM, UMR-S970, Paris Cardiovascular Research Center, Team "Integrative Epidemiology of Cardiovascular Diseases", Paris, France
| | - Eloi Marijon
- Université Paris Cité, INSERM, UMR-S970, Paris Cardiovascular Research Center, Team "Integrative Epidemiology of Cardiovascular Diseases", Paris, France.,Cardiology Department, Georges Pompidou European Hospital, AP-HP, 20 Rue Leblanc, 75015 Paris, France
| | - Xavier Jouven
- Université Paris Cité, INSERM, UMR-S970, Paris Cardiovascular Research Center, Team "Integrative Epidemiology of Cardiovascular Diseases", Paris, France.,Cardiology Department, Georges Pompidou European Hospital, AP-HP, 20 Rue Leblanc, 75015 Paris, France
| | - Patricia Jabre
- Université Paris Cité, INSERM, UMR-S970, Paris Cardiovascular Research Center, Team "Integrative Epidemiology of Cardiovascular Diseases", Paris, France.,Service d'Aide Médicale d'Urgence-SAMU de Paris, Necker-Enfants malades Hospital, AP-HP, 149 Rue de Sèvres, 75015 Paris, France
| |
Collapse
|
4
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2023. [DOI: 10.3166/afmu-2022-0474] [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: 02/23/2023]
|
5
|
Empana JP, Lerner I, Perier MC, Guibout C, Jabre P, Bailly K, Andrieu M, Climie R, van Sloten T, Vedie B, Geromin D, Marijon E, Thomas F, Danchin N, Boutouyrie P, Jouven X. Ultrasensitive Troponin I and Incident Cardiovascular Disease. Arterioscler Thromb Vasc Biol 2022; 42:1471-1481. [PMID: 36325900 DOI: 10.1161/atvbaha.122.317961] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 11/06/2022]
Abstract
BACKGROUND To examine the association of ultrasensitive cTnI (cardiac troponin I) with incident cardiovascular disease events (CVDs) in the primary prevention setting. METHODS cTnI was analyzed in the baseline plasma (2008-2012) of CVD-free volunteers from the Paris Prospective Study III using a novel ultrasensitive immunoassay (Simoa Troponin-I 2.0 Kit, Quanterix, Lexington) with a limit of detection of 0.013 pg/mL. Incident CVD hospitalizations (coronary heart disease, stroke, cardiac arrhythmias, deep venous thrombosis or pulmonary embolism, heart failure, or arterial aneurysm) were validated by critical review of the hospital records. Hazard ratios were estimated per log-transformed SD increase of cTnI in Cox models using age as the time scale. RESULTS The study population includes 9503 participants (40% women) aged 59.6 (6.3) years. cTnI was detected in 99.6% of the participants (median value=0.63 pg/mL, interquartile range, 0.39-1.09). After a median follow-up of 8.34 years (interquartile range, 8.0-10.07), 516 participants suffered 612 events. In fully adjusted analysis, higher cTnI (per 1 SD increase of log cTnI) was significantly associated with CVD events combined (hazard ratio, 1.18 [1.08-1.30]). Among all single risk factors, cTnI had the highest discrimination capacity for incident CVD events (C index=0.6349). Adding log cTnI to the SCORE 2 (Systematic Coronary Risk Evaluation) risk improved moderately discriminatory capacity (C index 0.698 versus 0.685; bootstrapped C index difference: 0.0135 [95% CI, 0.0131-0.0138]), and reclassification of the participants (categorical net reclassification index, 0.0628 [95% CI, 0.023-0.102]). Findings were consistent using the US pooled cohort risk equation. CONCLUSIONS Ultrasensitive cTnI is an independent marker of CVD events in the primary prevention setting.
Collapse
Affiliation(s)
- Jean-Philippe Empana
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (J.-P.E., I.L., M.-C.P., C.G., P.J., R.C., T.v.S., E.M., X.J.)
| | - Ivan Lerner
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (J.-P.E., I.L., M.-C.P., C.G., P.J., R.C., T.v.S., E.M., X.J.)
| | - Marie-Cécile Perier
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (J.-P.E., I.L., M.-C.P., C.G., P.J., R.C., T.v.S., E.M., X.J.)
| | - Catherine Guibout
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (J.-P.E., I.L., M.-C.P., C.G., P.J., R.C., T.v.S., E.M., X.J.)
| | - Patricia Jabre
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (J.-P.E., I.L., M.-C.P., C.G., P.J., R.C., T.v.S., E.M., X.J.)
| | - Karine Bailly
- Université Paris Cité, INSERM U1016, Cochin Institute, Platform CYBIO, France (K.B., M.A.)
| | - Muriel Andrieu
- Université Paris Cité, INSERM U1016, Cochin Institute, Platform CYBIO, France (K.B., M.A.)
| | - Rachel Climie
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (J.-P.E., I.L., M.-C.P., C.G., P.J., R.C., T.v.S., E.M., X.J.).,Menzies Institute for Medical Research, University of Tasmanian, Hobart, Australia (R.C.).,Baker Heart and Diabetes Institute, Melbourne, Australia (R.C.)
| | - Thomas van Sloten
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (J.-P.E., I.L., M.-C.P., C.G., P.J., R.C., T.v.S., E.M., X.J.).,Cardiovascular Research Institute Maastricht and Department of Internal Medicine, Maastricht University Medical Centre, the Netherlands (T.v.S.)
| | - Benoit Vedie
- AP-HP, Department of Biochemistry, Tissue and Blood Samples Biobank, Georges Pompidou European Hospital, Paris, France (B.V., D.G.)
| | - Daniela Geromin
- AP-HP, Department of Biochemistry, Tissue and Blood Samples Biobank, Georges Pompidou European Hospital, Paris, France (B.V., D.G.)
| | - Eloi Marijon
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (J.-P.E., I.L., M.-C.P., C.G., P.J., R.C., T.v.S., E.M., X.J.)
| | - Frederique Thomas
- Preventive and Clinical Investigation Center (IPC), Paris, France (F.T., N.D.)
| | - Nicolas Danchin
- Preventive and Clinical Investigation Center (IPC), Paris, France (F.T., N.D.)
| | - Pierre Boutouyrie
- Université Paris Cité, INSERM U970, Cellular, Molecular and Pathophysiological Mechanisms of Heart Failure, Paris, France (P.B.)
| | - Xavier Jouven
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (J.-P.E., I.L., M.-C.P., C.G., P.J., R.C., T.v.S., E.M., X.J.)
| |
Collapse
|
6
|
Lascarrou JB, Dumas F, Bougouin W, Legriel S, Aissaoui N, Deye N, Beganton F, Lamhaut L, Jost D, Vieillard-Baron A, Nichol G, Marijon E, Jouven X, Cariou A, Agostinucci J, Aissaoui-Balanant N, Algalarrondo V, Alla F, Alonso C, Amara W, Annane D, Antoine C, Aubry P, Azoulay E, Beganton F, Billon C, Bougouin W, Boutet J, Bruel C, Bruneval P, Cariou A, Carli P, Casalino E, Cerf C, Chaib A, Cholley B, Cohen Y, Combes A, Coulaud J, Da Silva D, Das V, Demoule A, Denjoy I, Deye N, Diehl J, Dinanian S, Domanski L, Dreyfuss D, Dubois-Rande J, Dumas F, Duranteau J, Empana J, Extramiana F, Fagon J, Fartoukh M, Fieux F, Gandjbakhch E, Geri G, Guidet B, Halimi F, Henry P, Jabre P, Joseph L, Jost D, Jouven X, Karam N, Lacotte J, Lahlou-Laforet K, Lamhaut L, Lanceleur A, Langeron O, Lavergne T, Lecarpentier E, Leenhardt A, Lellouche N, Lemiale V, Lemoine F, Linval F, Loeb T, Ludes B, Luyt C, Mansencal N, Mansouri N, Marijon E, Maury E, Maxime V, Megarbane B, Mekontso-Dessap A, Mentec H, Mira J, Monnet X, Narayanan K, Ngoyi N, Perier M, Piot O, Plaisance P, Plaud B, Plu I, Raphalen J, Raux M, Revaux F, Ricard J, Richard C, Riou B, Roussin F, Santoli F, Schortgen F, Sharshar T, Sideris G, Spaulding C, Teboul J, Timsit J, Tourtier J, Tuppin P, Ursat C, Varenne O, Vieillard-Baron A, Voicu S, Wahbi K, Waldmann V. Differential Effect of Targeted Temperature Management Between 32 °C and 36 °C Following Cardiac Arrest According to Initial Severity of Illness: Insights From Two International Data Sets. Chest 2022; 163:1120-1129. [PMID: 36445800 DOI: 10.1016/j.chest.2022.10.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 06/05/2022] [Revised: 10/10/2022] [Accepted: 10/23/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Recent guidelines have emphasized actively avoiding fever to improve outcomes in patients who are comatose following resuscitation from cardiac arrest (ie, out-of-hospital cardiac arrest). However, whether targeted temperature management between 32 °C and 36 °C (TTM32-36) can improve neurologic outcome in some patients remains debated. RESEARCH QUESTION Is there an association between the use of TTM32-36 and outcome according to severity assessed at ICU admission using a previously derived risk score? STUDY DESIGN AND METHODS Data prospectively collected in the Sudden Death Expertise Center (SDEC) registry (France) between May 2011 and December 2017 and in the Resuscitation Outcomes Consortium Continuous Chest Compressions (ROC-CCC) trial (United States and Canada) between June 2011 and May 2015 were used for this study. Severity at ICU admission was assessed through a modified version of the Cardiac Arrest Hospital Prognosis (mCAHP) score, divided into tertiles of severity. The study explored associations between TTM32-36 and favorable neurologic status at hospital discharge by using multiple logistic regression as well as in tertiles of severity for each data set. RESULTS A total of 2,723 patients were analyzed in the SDEC data set and 4,202 patients in the ROC-CCC data set. A favorable neurologic status at hospital discharge occurred in 728 (27%) patients in the French data set and in 1,239 (29%) patients in the North American data set. Among the French data set, TTM32-36 was independently associated with better neurologic outcome in the tertile of patients with low (adjusted OR, 1.63; 95% CI, 1.15-2.30; P = .006) and high (adjusted OR, 1.94; 95% CI, 1.06-3.54; P = .030) severity according to mCAHP at ICU admission. Similar results were observed in the North American data set (adjusted ORs of 1.36 [95% CI, 1.05-1.75; P = .020] and 2.42 [95% CI, 1.38-4.24; P = .002], respectively). No association was observed between TTM32-36 and outcome in the moderate groups of the two data sets. INTERPRETATION TTM32-36 was significantly associated with a better outcome in patients with low and high severity at ICU admission assessed according to the mCAHP score. Further studies are needed to evaluate individualized temperature control following out-of-hospital cardiac arrest.
Collapse
Affiliation(s)
- Jean Baptiste Lascarrou
- Université Paris Cité, INSERM, PARCC, Paris, France; Médecine Intensive Réanimation, University Hospital Center, Nantes, France; AfterROSC Network Group, Paris, France.
| | - Florence Dumas
- Université Paris Cité, INSERM, PARCC, Paris, France; Emergency Department, Cochin University Hospital, APHP, Paris, France
| | - Wulfran Bougouin
- Université Paris Cité, INSERM, PARCC, Paris, France; AfterROSC Network Group, Paris, France; Medical-Surgical Intensive Care Unit, Hopital Privé Jacques Cartier, Massy, France
| | - Stephane Legriel
- Université Paris Cité, INSERM, PARCC, Paris, France; AfterROSC Network Group, Paris, France; Medical Surgical Intensive Care Unit, Mignot Hospital, Le Chesnay, France
| | - Nadia Aissaoui
- Université Paris Cité, INSERM, PARCC, Paris, France; AfterROSC Network Group, Paris, France; Medical Intensive Care Unit, Cochin Hospital (APHP) and University of Paris, Paris, France
| | - Nicolas Deye
- AfterROSC Network Group, Paris, France; Medical Intensive Care Unit, Lariboisière University Hospital, INSERM U942, Paris, France
| | | | - Lionel Lamhaut
- AfterROSC Network Group, Paris, France; SAMU de Paris-DAR Necker University Hospital-Assistance, Paris, France
| | - Daniel Jost
- Brigade des Sapeurs-Pompiers de Paris, Paris, France
| | - Antoine Vieillard-Baron
- Medical Intensive Care Unit, Ambroise Paré University Hospital, APHP, Boulogne-Billancourt, France
| | - Graham Nichol
- University of Washington-Harborview Center for Prehospital Emergency Care, University of Washington, Seattle, WA
| | - Eloi Marijon
- Université Paris Cité, INSERM, PARCC, Paris, France
| | | | - Alain Cariou
- Université Paris Cité, INSERM, PARCC, Paris, France; AfterROSC Network Group, Paris, France; Medical Intensive Care Unit, Cochin Hospital (APHP) and University of Paris, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Empana JP, Lerner I, Perier MC, Jabre P, Andrieu M, Climie RE, Van Sloten T, Vedie B, Geromin D, Marijon E, Danchin N, Thomas F, Boutouyrie P, Jouven X. Ultra-sensitive troponin-I and incident coronary heart disease, stroke, heart failure, cardiac arrhythmias, arterial aneurysms and venous thromboembolism hospitalizations. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2289] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Cardiac troponin I (cTnI) as measured by high-sensitive assays has been related to incident cardiovascular disease events (CVD) in the community. With the advent of ultra-sensitive assays, it is now possible to detect troponin I at very low concentration, far below the classical threshold of 1.9 pg/mL. However, the clinical relevance of these low concentrations for predicting CVD is largely unknown.
Purpose
To examine the association of cTnI as low as 0.013 pg/mL with incident cardiovascular disease events (CVDs) in the primary prevention setting.
Methods
cTnI was analyzed in the baseline plasma (2008–2012) of CVD free volunteers from the Paris Prospective Study III using for the first time a novel ultra-sensitive immunoassay (Simoa Troponin-I 2.0 Kit, Quanterix, Lexington) with a limit of detection (LOD) of 0.013 pg/mL. Incident CVD hospitalizations for coronary heart disease, stroke, arrhythmias, venous thromboembolism, arterial aneurysms and heart failure were validated by critical review of the hospital records. Hazard ratios were estimated per log-transformed standard deviation (SD) increase of cTnI in Cox models using age as the time scale. The added value (gain in discriminatory capacity) of cTnI for CVD risk prediction was examined by calculating the Harell's C-index boostraped difference of the SCORE 2 risk model with and without cTnI.
Results
There were 9503 CVD free participants (40% women) aged 59.6 (6.3) years at baseline. cTnI was detected in 99.6% of the participants (median value = 0.63 pg/mL, interquartile range [IQR] 0.39–1.09). After a median follow-up of 8.34 years (IQR, 8.0–10.07), 516 participants suffered 612 events. In fully-adjusted analysis, higher cTnI (per 1 SD increase of log cTnI) was significantly associated with CVD events combined (n=516, HR= 1.21; 1.06; 1.39). In univariate Cox analysis and compared to each single established risk factor, cTnI had the highest discrimination capacity for incident CVD events (C-index=0.6349) (Figure 1). Adding log cTnI to the SCORE 2 algorithm increased significantly albeit moderately discriminatory capacity (C-index 0.698 vs. 0.685; boostraped C index difference: 0.0135 (95% CI: 0.0131; 0.0138)).
Conclusion
cTnI concentrations as measured by a novel ultra-sensitive immunoassay is associated with a significant increased risk of incident CVD events in the primary prevention setting.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): ANR: French National Research AgencyEurope: Horizon 2020
Collapse
Affiliation(s)
- J P Empana
- National Institute of Health and Medical Research (INSERM home) , Paris , France
| | - I Lerner
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - M C Perier
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - P Jabre
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - M Andrieu
- National Institute of Health and Medical Research (INSERM home) , Paris , France
| | - R E Climie
- Menzies Research Institute , Hobart , Australia
| | - T Van Sloten
- Cardiovascular Research Institute Maastricht (CARIM) , Maastricht , The Netherlands
| | - B Vedie
- Hopital Europeen Georges Pompidou-University Paris Descartes , Paris , France
| | - D Geromin
- Hopital Europeen Georges Pompidou-University Paris Descartes , Paris , France
| | - E Marijon
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - N Danchin
- Hopital Europeen Georges Pompidou-University Paris Descartes , Paris , France
| | - F Thomas
- Centre d Investigations Preventives et Cliniques , Paris , France
| | - P Boutouyrie
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - X Jouven
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| |
Collapse
|
8
|
Lvovschi V, Herkner H, Dumouchel J, Beroud S, Nekhili N, Miroux P, Auffret Y, Quay T, Smith A, Magee K, Meyran D, Jabre P. La cochrane en médecine d’urgence et en réanimation : activités et adaptation pendant la pandémie COVID-19. Méd Intensive Réa 2022. [DOI: 10.37051/mir-00108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Les activités de la Cochrane sont polymorphes et reposent toutes sur le volontariat de personnes scientifiquement indépendantes. L’approche traditionnelle de diffusion de la connaissance basée sur la publication de revues systématiques Cochrane n’est pas suffisante, en particulier en médecine d’urgence et en réanimation. Une démarche de Knowledge Translation (KT) est indispensable.
Le réseau des soins aigus et d'urgence de la Cochrane est particulièrement engagé dans cette activité via le review group Cochrane Emergency and Critical Care, qui produit des revues systématiques ciblées sur les malades en soins critiques et via le field Cochrane Pre-hospital and Emergency Care qui assure la diffusion de l’information médicale produite par la Cochrane et recense les priorités scientifiques liées au terrain. Cet article expose la méthodologie utilisée par les deux groupes car elle est standardisée et articule des étapes individuelles et collectives (pour la rédaction des revues systématiques comme pour le travail de priorisation). Une démarche active d’optimisation de la connexion entre production scientifique et terrain est indispensable dans des situations sanitaires d’exception (SSE) comme la pandémie COVID-19. Une démarche « d’Integrated Knowledge Translation » (IKT) s’est mise en place pour compléter les activités traditionnelles des groupes. Cet article fait le point sur les adaptations opérées dans ce contexte scientifique particulier.
Rendre transparente la méthodologie de travail des deux groupes Cochrane permet d’assurer leur fiabilité scientifique, y compris en SSE. Cette transparence permet également de proposer un modèle de fonctionnement reproductible dans d’autres secteurs qui nécessitent une démarche de KT et d’IKT.
Collapse
|
9
|
Lavignasse D, Lemoine S, Karam N, Gaye B, Bougouin W, Beganton F, Jabre P, Loeb T, Agostinucci JM, Dumas F, Lecarpentier E, Jost D, Cariou A, Marijon E, Empana JP, Jouven X. Does age influence out-of-hospital cardiac arrest incidence and outcomes among women? Insights from the Paris SDEC. Eur Heart J Acute Cardiovasc Care 2022; 11:293-302. [PMID: 35415752 DOI: 10.1093/ehjacc/zuac028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/15/2022] [Indexed: 06/14/2023]
Abstract
AIMS Age and sex disparities in out-of-hospital cardiac arrest (OHCA) have been described. Reproductive age may have a protected effect on females vs. males, although results are conflicting. We aimed to clarify this using the Paris Sudden Death Expertise Centre (SDEC) registry. METHODS AND RESULTS The Paris SDEC registry collects OHCAs occurring in the Greater Paris Area. We included all OHCAs of presumed cardiac causes occurring between 2013 and 2018. Patients were divided into age groups: 1-13, 13-50, 50-75, and >75 years. Sex and age disparities in OHCA incidence and outcomes were analysed using multivariable negative binomial and logistic regression models. There were 19 782 OHCAs meeting inclusion criteria: 0.37% aged 1-13 years, 12.4% aged 13-50 years, 40.4% aged 50-75 years, and 46.9% aged >75 years. Adjusted incidence rate ratios (IRRs) in females vs. males were for the youngest to the older age groups: 1.29 [95% confidence interval (CI) 0.78-2.13], 0.54 [0.49-0.59], 0.60 [0.56-0.64], and 0.75 [0.67-0.84]. At reproductive age, females were more likely than males to have a return of spontaneous circulation [adjusted odds ratio (OR) 1.60 (1.27-2.02)], to be alive at hospital admission [OR: 1.49 (1.18-1.89)]. In both sexes, patients aged 13-50 years were more likely to survive at hospital discharge than those aged 50-75 years [males: OR 1.81 (1.49-2.20), females: 2.24 (1.54-3.25)]. However, at reproductive age, no sex disparity was observed in survival at hospital discharge [OR: 1.16 (0.75-1.80)]. CONCLUSION Incidence rate ratios were similar between pre- and post-menopausal aged patients. At reproductive age, no sex disparity in survival at hospital discharge was observed, suggesting that menopausal status may not influence OHCA occurrence and prognosis.
Collapse
Affiliation(s)
- Delphine Lavignasse
- Paris Cardiovascular Research Center, University of Paris, INSERM Unit 970, 56 Leblanc street, 75015 Paris, France
| | - Sabine Lemoine
- Brigade des Sapeurs-Pompiers de Paris (BSPP), 1 place Jules Renard, 75017 Paris, France
| | - Nicole Karam
- Paris Cardiovascular Research Center, University of Paris, INSERM Unit 970, 56 Leblanc street, 75015 Paris, France
- Department of Cardiology, European Georges Pompidou Hospital, APHP, 20 Leblanc street, 75015 Paris, France
| | - Bamba Gaye
- Paris Cardiovascular Research Center, University of Paris, INSERM Unit 970, 56 Leblanc street, 75015 Paris, France
| | - Wulfran Bougouin
- Paris Cardiovascular Research Center, University of Paris, INSERM Unit 970, 56 Leblanc street, 75015 Paris, France
- Medical Surgical Intensive Care Unit, Ramsay Générale de Santé, Hôpital Privé Jacques Cartier, 6 Noyer Lambert avenue, 91300 Massy, France
| | - Frankie Beganton
- Paris Cardiovascular Research Center, University of Paris, INSERM Unit 970, 56 Leblanc street, 75015 Paris, France
| | - Patricia Jabre
- Paris Cardiovascular Research Center, University of Paris, INSERM Unit 970, 56 Leblanc street, 75015 Paris, France
- Emergency Medical Services, SAMU 75, Necker Enfants Malades Hospital, APHP, 11 rue de Sèvres, 75015 Paris, France
| | - Thomas Loeb
- Emergency Medical Services, SAMU 92, Raymond Poincaré Hospital, APHP, 104, Raymond-Poincaré boulevard, 92380 Garches, France
| | - Jean-Marc Agostinucci
- Emergency Medical Services, SAMU 93, Hôpital Avicenne, APHP, 125 Stalingrad street, 93000 Bobigny, France
| | - Florence Dumas
- Paris Cardiovascular Research Center, University of Paris, INSERM Unit 970, 56 Leblanc street, 75015 Paris, France
- Emergency Department, Cochin-Hotel-Dieu Hospital, APHP, 27 Faubourg Saint-Jacques, street 75014 Paris, France
| | - Eric Lecarpentier
- Emergency Medical Services, SAMU 94, Henri Mondor Hospital, APHP, 1 Gustave Eiffel street, 94000 Créteil, France
| | - Daniel Jost
- Department of Cardiology, European Georges Pompidou Hospital, APHP, 20 Leblanc street, 75015 Paris, France
| | - Alain Cariou
- Paris Cardiovascular Research Center, University of Paris, INSERM Unit 970, 56 Leblanc street, 75015 Paris, France
- Medical Intensive Care Unit, Hôpital Cochin Hospital, APHP, 27 Faubourg Saint-Jacques, street,75014 Paris, France
| | - Eloi Marijon
- Paris Cardiovascular Research Center, University of Paris, INSERM Unit 970, 56 Leblanc street, 75015 Paris, France
- Department of Cardiology, European Georges Pompidou Hospital, APHP, 20 Leblanc street, 75015 Paris, France
| | - Jean-Philippe Empana
- Paris Cardiovascular Research Center, University of Paris, INSERM Unit 970, 56 Leblanc street, 75015 Paris, France
| | - Xavier Jouven
- Paris Cardiovascular Research Center, University of Paris, INSERM Unit 970, 56 Leblanc street, 75015 Paris, France
- Department of Cardiology, European Georges Pompidou Hospital, APHP, 20 Leblanc street, 75015 Paris, France
| |
Collapse
|
10
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2022. [DOI: 10.3166/afmu-2022-0390] [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: 11/20/2022]
|
11
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2022. [DOI: 10.3166/afmu-2022-0378] [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: 11/20/2022]
|
12
|
Gil-Jardiné C, Jabre P, Adnet F, Nicol T, Ecollan P, Guihard B, Ferdynus C, Bocquet V, Combes X. Correction to: Incidence and factors associated with out-of-hospital peri-intubation cardiac arrest: a secondary analysis of the CURASMUR trial. Intern Emerg Med 2022; 17:619. [PMID: 35150391 DOI: 10.1007/s11739-022-02941-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Cédric Gil-Jardiné
- Department of Emergency, CHU de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux cedex, France
| | - Patricia Jabre
- AP-HP, Service d'Aide Médicale d'Urgence (SAMU) de Paris and Paris Sudden Death Expertise Center, Université Paris Descartes, Paris, France
- Department of Anesthesia and Critical Care-SAMU, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Université Paris Descartes, 149 rue de Sèvres, 75015, Paris, France
| | - Frederic Adnet
- Urgences-SAMU 93, Unite Recherche-Enseignement-Qualite, Hopital Avicenne, Bobigny, France
| | - Thomas Nicol
- Department of Anesthesia and Critical Care-SAMU, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Université Paris Descartes, 149 rue de Sèvres, 75015, Paris, France
| | - Patrick Ecollan
- Department of Anesthesia and Critical Care-SAMU, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Université Paris Descartes, 149 rue de Sèvres, 75015, Paris, France
| | - Bertrand Guihard
- Department of Emergency, CHU de la Réunion, Université de La Réunion, Réunion, France
| | - Cyril Ferdynus
- INSERM CIC 1410 Clinical and Epidemiology/CHU Réunion/Université de la Réunion, Saint-Pierre, Reunion, France
| | - Valery Bocquet
- Departement d'Informatique Clinique, Centre Hospitalier Universitaire de La Réunion Site Félix Guyon, Saint-Denis, France
| | - Xavier Combes
- Department of Emergency, CHU de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux cedex, France.
| |
Collapse
|
13
|
Gil-Jardiné C, Jabre P, Adnet F, Nicol T, Ecollan P, Guihard B, Ferdynus C, Bocquet V, Combes X. Incidence and factors associated with out-of-hospital peri-intubation cardiac arrest: a secondary analysis of the CURASMUR trial. Intern Emerg Med 2022; 17:611-617. [PMID: 35037125 DOI: 10.1007/s11739-021-02903-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/27/2021] [Indexed: 11/25/2022]
Abstract
The Incidence of peri-intubation cardiac arrest (PICA) has been rarely assessed in the out-of-hospital setting. The objectives of this study were to assess the incidence and factors associated with PICA (cardiac arrest occurring within 15 min of intubation) in an out-of-hospital emergency setting, wherein emergency physicians perform standardized airway management using a rapid sequence intubation technique in adult patients. This was a secondary analysis of the "Succinylcholine versus Rocuronium for out-of-hospital emergency intubation" (CURASMUR) trial, which compared the first attempt intubation success rate between succinylcholine and rocuronium in adult patients requiring emergency tracheal intubation for any vital distress except cardiac arrest. Enrollment occurred from January 2014 to August 2016 in 17 French out-of-hospital emergency medical units. All operators were emergency physicians. The PICA incidence was recorded and multivariable logistic regression analysis was used to identify the factors associated with its occurrence. A total of 1226 patients were included with a mean age of 55.9 ± 19 years. PICA was recorded in 35 (2.8%) patients. Multivariable analysis indicated that the occurrence of PICA was independently associated with a body mass index (BMI) > 30 kg m2 [adjusted odds ratio (aOR) 4.85; 95% confidence interval (CI) 1.82-12.90, p = 0.02], oxygen saturation (SpO2) before intubation < 90% (aOR 3.4; 95% CI 1.50-7.60, p = 0.003), difficult intubation (defined by an Intubation Difficulty Score [IDS] > 5, [aOR 3.59; 95% CI 1.82-8.08, p = 0.02], the use of rocuronium instead of succinylcholine (aOR 2.47; 95% CI 1.08-5.64, p = 0.03), post intubation hypoxaemia (aOR 2.70; 95% CI 1.05-6.95, p = 0.04), post-intubation hypotension (aOR 4.07; 95% CI 1.62-10.22, p = 0.003), and pulmonary aspiration(aOR 4.78; 95% CI 1.48-15.36, p = 0.009). Early PICA occurred in approximately 3% of cases in the out-of-hospital setting. We identified several independent risk factors for PICA, including obesity, hypoxaemia before intubation and difficult intubation.
Collapse
Affiliation(s)
- Cédric Gil-Jardiné
- Department of Emergency, CHU de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux cedex, France
| | - Patricia Jabre
- AP-HP, Service d'Aide Médicale d'Urgence (SAMU) de Paris and Paris Sudden Death Expertise Center, Université Paris Descartes, Paris, France
- Department of Anesthesia and Critical Care-SAMU, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Université Paris Descartes, 149 rue de Sèvres, 75015, Paris, France
| | - Frederic Adnet
- Urgences-SAMU 93, Unite Recherche-Enseignement-Qualite, Hopital Avicenne, Bobigny, France
| | - Thomas Nicol
- Department of Anesthesia and Critical Care-SAMU, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Université Paris Descartes, 149 rue de Sèvres, 75015, Paris, France
| | - Patrick Ecollan
- Department of Anesthesia and Critical Care-SAMU, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Université Paris Descartes, 149 rue de Sèvres, 75015, Paris, France
| | - Bertrand Guihard
- Department of Emergency, CHU de la Réunion, Université de La Réunion, Réunion, France
| | - Cyril Ferdynus
- INSERM CIC 1410 Clinical and Epidemiology/CHU Réunion/Université de la Réunion, Saint-Pierre, Reunion, France
| | - Valery Bocquet
- Departement d'Informatique Clinique, Centre Hospitalier Universitaire de La Réunion Site Félix Guyon, Saint-Denis, France
| | - Xavier Combes
- Department of Emergency, CHU de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux cedex, France.
| |
Collapse
|
14
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2022. [DOI: 10.3166/afmu-2021-0365] [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: 11/20/2022]
|
15
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Prehospital and Emergency Care. Ann Fr Med Urgence 2022. [DOI: 10.3166/afmu-2022-0409] [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: 11/20/2022]
|
16
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2022. [DOI: 10.3166/afmu-2022-0431] [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: 11/20/2022]
|
17
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2022. [DOI: 10.3166/afmu-2022-0451] [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: 11/07/2022]
|
18
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2022. [DOI: 10.3166/afmu-2022-0461] [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: 12/24/2022]
|
19
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Prehospital and Emergency Care. Ann Fr Med Urgence 2021. [DOI: 10.3166/afmu-2021-0346] [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: 11/20/2022]
|
20
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2021. [DOI: 10.3166/afmu-2021-0359] [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: 11/20/2022]
|
21
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Prehospital and Emergency Care. Ann Fr Med Urgence 2021. [DOI: 10.3166/afmu-2021-0330] [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: 11/20/2022]
|
22
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2021. [DOI: 10.3166/afmu-2021-0312] [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: 11/20/2022]
|
23
|
Anys S, Billon C, Mazzella JM, Karam N, Pechmajou L, Youssfi Y, Bellenfant F, Jost D, Jabre P, Soulat G, Bruneval P, Weizman O, Varlet E, Baudinaud P, Dumas F, Bougouin W, Cariou A, Lavergne T, Wahbi K, Jouven X, Marijon E. [Fighting against unexplained sudden death]. Ann Cardiol Angeiol (Paris) 2021; 70:129-135. [PMID: 33972104 DOI: 10.1016/j.ancard.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 03/25/2021] [Indexed: 11/18/2022]
Abstract
Sudden cardiac death, mostly related to ventricular arrhythmia, is a major public health issue, with still very poor survival at hospital discharge. Although coronary artery disease remains the leading cause, other etiologies should be systematically investigated. Exhaustive and standardized exploration is required to eventually offer specific therapeutics and management to the patient as well as his/her family members in case of inherited cardiac disease. Identification and establishing direct causality of the detected cardiac anomaly may remain challenging, underlying the need for a multidisciplinary and experimented team.
Collapse
MESH Headings
- Adult
- Age Factors
- Algorithms
- Arrhythmias, Cardiac/complications
- Arrhythmias, Cardiac/diagnosis
- Autopsy
- Cardiomyopathies/complications
- Coronary Artery Disease/complications
- Death, Sudden, Cardiac/epidemiology
- Death, Sudden, Cardiac/etiology
- Death, Sudden, Cardiac/prevention & control
- Female
- France/epidemiology
- Genetic Diseases, Inborn/complications
- Genetic Diseases, Inborn/diagnosis
- Heart Defects, Congenital/complications
- Heart Defects, Congenital/diagnosis
- Humans
- Male
- Middle Aged
- Myocardial Infarction/complications
- Registries
- Risk Factors
- Sex Factors
Collapse
Affiliation(s)
- S Anys
- Centre d'Expertise Mort Subite de Paris (Paris-CEMS), Inserm U970, 56, rue Leblanc, 75015 Paris, France; Université de Paris, 85, boulevard Saint Germain, 75006 Paris, France; Service de cardiologie, Unité de rythmologie, Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - C Billon
- Université de Paris, 85, boulevard Saint Germain, 75006 Paris, France; Service de génétique, Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - J-M Mazzella
- Service de génétique, Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - N Karam
- Centre d'Expertise Mort Subite de Paris (Paris-CEMS), Inserm U970, 56, rue Leblanc, 75015 Paris, France; Université de Paris, 85, boulevard Saint Germain, 75006 Paris, France; Service de cardiologie, Unité de cardiologie interventionnelle, Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - L Pechmajou
- Centre d'Expertise Mort Subite de Paris (Paris-CEMS), Inserm U970, 56, rue Leblanc, 75015 Paris, France; Université de Paris, 85, boulevard Saint Germain, 75006 Paris, France; Service de cardiologie, Unité de cardiologie interventionnelle, Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - Y Youssfi
- Centre d'Expertise Mort Subite de Paris (Paris-CEMS), Inserm U970, 56, rue Leblanc, 75015 Paris, France; École Polytechnique, route de Saclay, 91120 Palaiseau, France
| | - F Bellenfant
- Centre d'Expertise Mort Subite de Paris (Paris-CEMS), Inserm U970, 56, rue Leblanc, 75015 Paris, France; Unité de soins intensifs, Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - D Jost
- Centre d'Expertise Mort Subite de Paris (Paris-CEMS), Inserm U970, 56, rue Leblanc, 75015 Paris, France; Brigade de Sapeurs-Pompiers de Paris (BSPP), 1, place Jules-Renard, 75017 Paris, France
| | - P Jabre
- Centre d'Expertise Mort Subite de Paris (Paris-CEMS), Inserm U970, 56, rue Leblanc, 75015 Paris, France; Service d'aide médicale d'urgence (Samu) de Paris, Paris, France
| | - G Soulat
- Université de Paris, 85, boulevard Saint Germain, 75006 Paris, France; Service de radiologie, Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - P Bruneval
- Université de Paris, 85, boulevard Saint Germain, 75006 Paris, France; Service anatomie pathologie, Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - O Weizman
- Centre hospitalier régional universitaire de Nancy, 54511 Vandœuvre-Lès-Nancy, France
| | - E Varlet
- Centre d'Expertise Mort Subite de Paris (Paris-CEMS), Inserm U970, 56, rue Leblanc, 75015 Paris, France; Service de cardiologie, Unité de rythmologie, Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - P Baudinaud
- Centre d'Expertise Mort Subite de Paris (Paris-CEMS), Inserm U970, 56, rue Leblanc, 75015 Paris, France; Université de Paris, 85, boulevard Saint Germain, 75006 Paris, France; Service de cardiologie, Unité de rythmologie, Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - F Dumas
- Centre d'Expertise Mort Subite de Paris (Paris-CEMS), Inserm U970, 56, rue Leblanc, 75015 Paris, France; Université de Paris, 85, boulevard Saint Germain, 75006 Paris, France; Département de médecine d'urgence, Hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - W Bougouin
- Centre d'Expertise Mort Subite de Paris (Paris-CEMS), Inserm U970, 56, rue Leblanc, 75015 Paris, France; Université de Paris, 85, boulevard Saint Germain, 75006 Paris, France; Unité de soins intensifs, Hôpital privé Jacques-Cartier, Ramsay Santé, 6, avenue du Noyer-Lambert, 91300 Massy, France
| | - A Cariou
- Centre d'Expertise Mort Subite de Paris (Paris-CEMS), Inserm U970, 56, rue Leblanc, 75015 Paris, France; Université de Paris, 85, boulevard Saint Germain, 75006 Paris, France; Unité de soins intensifs, Hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - T Lavergne
- Centre d'Expertise Mort Subite de Paris (Paris-CEMS), Inserm U970, 56, rue Leblanc, 75015 Paris, France; Université de Paris, 85, boulevard Saint Germain, 75006 Paris, France; Service de cardiologie, Unité de rythmologie, Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - K Wahbi
- Centre d'Expertise Mort Subite de Paris (Paris-CEMS), Inserm U970, 56, rue Leblanc, 75015 Paris, France; Université de Paris, 85, boulevard Saint Germain, 75006 Paris, France; Service de cardiologie, hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - X Jouven
- Centre d'Expertise Mort Subite de Paris (Paris-CEMS), Inserm U970, 56, rue Leblanc, 75015 Paris, France; Université de Paris, 85, boulevard Saint Germain, 75006 Paris, France; Service de cardiologie, Unité de rythmologie, Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - E Marijon
- Centre d'Expertise Mort Subite de Paris (Paris-CEMS), Inserm U970, 56, rue Leblanc, 75015 Paris, France; Université de Paris, 85, boulevard Saint Germain, 75006 Paris, France; Service de cardiologie, Unité de rythmologie, Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
| |
Collapse
|
24
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2021. [DOI: 10.3166/afmu-2021-0304] [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: 11/20/2022]
|
25
|
Nicol T, Gil-Jardiné C, Jabre P, Adnet F, Ecollan P, Guihard B, Ferdynus C, Combes X. Incidence, Complications, and Factors Associated with Out-of-Hospital First Attempt Intubation Failure in Adult Patients: A Secondary Analysis of the CURASMUR Trial Data. PREHOSP EMERG CARE 2021; 26:280-285. [PMID: 33595420 DOI: 10.1080/10903127.2021.1891357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objectives: The objectives of this study were to evaluate first attempt intubation failure rate, its associated factors, and its related complications in out-of-hospital emergency setting, when emergency physicians perform standardized airway management using rapid sequence intubation in adult patients. Material and methods: The present study was a substudy of the Succinylcholine versus Rocuronium for out-of-hospital Emergency Intubation (CURASMUR) Trial, which compared Succinylcholine and Rocuronium used for Rapid sequence intubation. First attempt Intubation failure rate and early intubation related complications were recorded. We used multivariable logistic regression analysis to determine first intubation failure associated factors. Results: A total of 1230 patients were included with mean age of 55.9 +/- 19 years. First attempt intubation failure was recorded in 285 (23.2%) patients. The occurrence of a first attempt intubation failure was independently associated with history of ear, nose, and throat neoplasia (OR 2.20, CI 95% 1.06-4.60). Early intubation related complications were more frequent in case of first attempt intubation failure: 80 of 285 (28.4%) in patients with first attempt intubation failure and 185 of 945 (19.6%) in patients with successful first attempt intubation [OR 1.44; CI 95%, 1.11-1.87]. Conclusion: Based on a large multicenter study on out-of-hospital tracheal intubation of adult patients, we found that first attempt intubation failure rate was high and that history of ear, nose, and throat (ENT) neoplasia was an independent associated factor. Failure in first intubation attempt was associated with significantly more intubation related complications.
Collapse
|
26
|
Waldmann V, Karam N, Gaye B, Bougouin W, Dumas F, Sharifzadehgan A, Narayanan K, Kassim H, Beganton F, Jost D, Lamhaut L, Loeb T, Adnet F, Agostinucci JM, Deltour S, Revaux F, Ludes B, Voicu S, Megarbane B, Jabre P, Cariou A, Marijon E, Jouven X. Temporal Trends of Out-of-Hospital Cardiac Arrests Without Resuscitation Attempt by Emergency Medical Services. Circ Cardiovasc Qual Outcomes 2021; 14:e006626. [PMID: 33706541 DOI: 10.1161/circoutcomes.120.006626] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND Significant improvements in survival from out-of-hospital cardiac arrest (OHCA) have been reported; however, these are based only on data from OHCA in whom resuscitation is initiated by emergency medical services (EMS). We aimed to assess the characteristics and temporal trends of OHCA without resuscitation attempt by EMS. METHODS Prospective population-based study between 2011 and 2016 in the Greater Paris area (6.7 million inhabitants). All cases of OHCA were included in collaboration with EMS units, 48 different hospitals, and forensic units. RESULTS Among 15 207 OHCA (mean age 70.7±16.9 years, 61.6% male), 5486 (36.1%) had no resuscitation attempt by EMS. Factors that were independently associated with increase in likelihood of no resuscitation attempt included: age of patients (odds ratio, 1.06 per year [95% CI, 1.05-1.06], P<0.001), female sex (odds ratio, 1.21 [95% CI, 1.10-1.32], P=0.002), OHCA at home location (odds ratio, 3.38 [95%CI, 2.86-4.01], P<0.001), and absence of bystander (odds ratio, 1.94 [95% CI, 1.74-2.16], P<0.001). Overall, the annual number of OHCA increased by 9.1% (from 2923 to 3189, P=0.028). This increase was related to an increase of the annual number of OHCA without resuscitation attempt by EMS by 26.3% (from 993 to 1253, P=0.012), while the annual number of OHCA with resuscitation attempt by EMS did not significantly change (from 1930 to 1936, P=0.416). Considering only cases with resuscitation attempt, survival rate at hospital discharge increased (from 7.3% to 9.5%, P=0.02). However, when considering all OHCA, survival improvement did not reach statistical significance (from 4.8% to 5.7%, P=0.17). CONCLUSIONS We demonstrated an increase of the total number of OHCA related to an increase of the number of OHCA without resuscitation attempt by EMS. This increasing proportion of OHCA without resuscitation attempt attenuates improvement in survival rates achieved in EMS-treated patients.
Collapse
Affiliation(s)
- Victor Waldmann
- European Georges Pompidou Hospital, Cardiology Department, Paris, France (V.W., N.K., A.S., E.M., X.J.).,Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, Paris, France (V.W., N.K., B.G., W.B., F.D., A.S., K.N., H.K., F.B., A.C., E.M., X.J.).,Paris University, France (V.W., N.K., B.G., W.B., F.D., A.S., B.L., A.C., E.M., X.J.)
| | - Nicole Karam
- European Georges Pompidou Hospital, Cardiology Department, Paris, France (V.W., N.K., A.S., E.M., X.J.).,Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, Paris, France (V.W., N.K., B.G., W.B., F.D., A.S., K.N., H.K., F.B., A.C., E.M., X.J.).,Paris University, France (V.W., N.K., B.G., W.B., F.D., A.S., B.L., A.C., E.M., X.J.)
| | - Bamba Gaye
- Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, Paris, France (V.W., N.K., B.G., W.B., F.D., A.S., K.N., H.K., F.B., A.C., E.M., X.J.).,Paris University, France (V.W., N.K., B.G., W.B., F.D., A.S., B.L., A.C., E.M., X.J.)
| | - Wulfran Bougouin
- Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, Paris, France (V.W., N.K., B.G., W.B., F.D., A.S., K.N., H.K., F.B., A.C., E.M., X.J.).,Paris University, France (V.W., N.K., B.G., W.B., F.D., A.S., B.L., A.C., E.M., X.J.).,Ramsay Générale de Santé, Hôpital privé Jacques Cartier, Intensive Care Unit, Massy, France (W.B.)
| | - Florence Dumas
- Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, Paris, France (V.W., N.K., B.G., W.B., F.D., A.S., K.N., H.K., F.B., A.C., E.M., X.J.).,Paris University, France (V.W., N.K., B.G., W.B., F.D., A.S., B.L., A.C., E.M., X.J.).,Emergency Department, Cochin Hospital, Paris, France (F.D.)
| | - Ardalan Sharifzadehgan
- European Georges Pompidou Hospital, Cardiology Department, Paris, France (V.W., N.K., A.S., E.M., X.J.).,Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, Paris, France (V.W., N.K., B.G., W.B., F.D., A.S., K.N., H.K., F.B., A.C., E.M., X.J.).,Paris University, France (V.W., N.K., B.G., W.B., F.D., A.S., B.L., A.C., E.M., X.J.)
| | - Kumar Narayanan
- Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, Paris, France (V.W., N.K., B.G., W.B., F.D., A.S., K.N., H.K., F.B., A.C., E.M., X.J.).,Cardiology Department, Medicover Hospitals, Hyderabad, India (K.N.)
| | - Haoiinda Kassim
- Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, Paris, France (V.W., N.K., B.G., W.B., F.D., A.S., K.N., H.K., F.B., A.C., E.M., X.J.)
| | - Frankie Beganton
- Ramsay Générale de Santé, Hôpital privé Jacques Cartier, Intensive Care Unit, Massy, France (W.B.)
| | | | | | | | | | | | - Sandrine Deltour
- Cerebrovascular Unit, La Pitié Salpêtrière Hospital, Paris, France (S.D.)
| | | | - Bertrand Ludes
- Paris University, France (V.W., N.K., B.G., W.B., F.D., A.S., B.L., A.C., E.M., X.J.).,Cerebrovascular Unit, La Pitié Salpêtrière Hospital, Paris, France (S.D.)
| | - Sebastian Voicu
- Intensive Care Unit, Lariboisière Hospital, Paris, France (S.V., B.M.)
| | - Bruno Megarbane
- Intensive Care Unit, Lariboisière Hospital, Paris, France (S.V., B.M.)
| | | | - Alain Cariou
- Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, Paris, France (V.W., N.K., B.G., W.B., F.D., A.S., K.N., H.K., F.B., A.C., E.M., X.J.).,Paris University, France (V.W., N.K., B.G., W.B., F.D., A.S., B.L., A.C., E.M., X.J.).,Intensive Care Unit, Cochin Hospital, Paris, France (A.C.)
| | - Eloi Marijon
- European Georges Pompidou Hospital, Cardiology Department, Paris, France (V.W., N.K., A.S., E.M., X.J.).,Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, Paris, France (V.W., N.K., B.G., W.B., F.D., A.S., K.N., H.K., F.B., A.C., E.M., X.J.).,Paris University, France (V.W., N.K., B.G., W.B., F.D., A.S., B.L., A.C., E.M., X.J.)
| | - Xavier Jouven
- European Georges Pompidou Hospital, Cardiology Department, Paris, France (V.W., N.K., A.S., E.M., X.J.).,Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, Paris, France (V.W., N.K., B.G., W.B., F.D., A.S., K.N., H.K., F.B., A.C., E.M., X.J.).,Paris University, France (V.W., N.K., B.G., W.B., F.D., A.S., B.L., A.C., E.M., X.J.)
| | | |
Collapse
|
27
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2020. [DOI: 10.3166/afmu-2020-0292] [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: 11/20/2022]
|
28
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2020. [DOI: 10.3166/afmu-2020-0285] [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: 11/20/2022]
|
29
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2020. [DOI: 10.3166/afmu-2020-0247] [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: 11/20/2022]
|
30
|
Afzali Rubin M, Svensson TLG, Herling SF, Wirenfeldt Klausen T, Jabre P, Møller AM. Family presence during resuscitation. Hippokratia 2020. [DOI: 10.1002/14651858.cd013619] [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] [Indexed: 11/08/2022]
Affiliation(s)
- Monika Afzali Rubin
- Department of Anaesthesia; Herlev and Gentofte Hospital, University of Copenhagen; Herlev Denmark
- Cochrane Emergency and Critical Care; Herlev and Gentofte Hospital, University of Copenhagen; Herlev Denmark
- Cochrane Anaesthesia; Herlev and Gentofte Hospital, University of Copenhagen; Herlev Denmark
| | | | | | | | - Patricia Jabre
- Assistance Publique-Hôpitaux de Paris (AP-HP), SAMU (Service d'Aide Médicale Urgente) de Paris; Hôpital Universitaire Necker-Enfants Malades; Paris France
- Cochrane Pre-hospital and Emergency Care Field; Paris France
- Université de Paris, Paris Cardiovascular Research Centre (PARCC); INSERM, Integrative Epidemiology of Cardiovascular Diseases Team; Paris France
| | - Ann Merete Møller
- Department of Anaesthesia; Herlev and Gentofte Hospital, University of Copenhagen; Herlev Denmark
- Cochrane Emergency and Critical Care; Herlev and Gentofte Hospital, University of Copenhagen; Herlev Denmark
- Cochrane Anaesthesia; Herlev and Gentofte Hospital, University of Copenhagen; Herlev Denmark
| |
Collapse
|
31
|
Jabre P. Les PEARLS (Practical Evidence about Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2020. [DOI: 10.3166/afmu-2020-0221] [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: 11/20/2022]
|
32
|
Karam N, Jabre P, Narayanan K, Sharifzadehgan A, Perier MC, Tennenbaum J, Vandame M, Lahlou-laforet K, Jouven X, Marijon E. Psychological Support and Medical Screening of First-Degree Relatives of Sudden Cardiac Arrest Victims. JACC Clin Electrophysiol 2020; 6:586-587. [DOI: 10.1016/j.jacep.2020.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 01/31/2020] [Accepted: 02/06/2020] [Indexed: 01/01/2023]
|
33
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2020. [DOI: 10.3166/afmu-2020-0230] [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: 11/20/2022]
|
34
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2020. [DOI: 10.3166/afmu-2020-0236] [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: 11/20/2022]
|
35
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2020. [DOI: 10.3166/afmu-2019-0202] [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: 11/20/2022]
|
36
|
Guihard B, Chollet-Xémard C, Lakhnati P, Vivien B, Broche C, Savary D, Ricard-Hibon A, Marianne dit Cassou PJ, Adnet F, Wiel E, Deutsch J, Tissier C, Loeb T, Bounes V, Rousseau E, Jabre P, Huiart L, Ferdynus C, Combes X. Effect of Rocuronium vs Succinylcholine on Endotracheal Intubation Success Rate Among Patients Undergoing Out-of-Hospital Rapid Sequence Intubation: A Randomized Clinical Trial. JAMA 2019; 322:2303-2312. [PMID: 31846014 PMCID: PMC6990819 DOI: 10.1001/jama.2019.18254] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
IMPORTANCE Rocuronium and succinylcholine are often used for rapid sequence intubation, although the comparative efficacy of these paralytic agents for achieving successful intubation in an emergency setting has not been evaluated in clinical trials. Succinylcholine use has been associated with several adverse events not reported with rocuronium. OBJECTIVE To assess the noninferiority of rocuronium vs succinylcholine for tracheal intubation in out-of-hospital emergency situations. DESIGN, SETTING AND PARTICIPANTS Multicenter, single-blind, noninferiority randomized clinical trial comparing rocuronium (1.2 mg/kg) with succinylcholine (1 mg/kg) for rapid sequence intubation in 1248 adult patients needing out-of-hospital tracheal intubation. Enrollment occurred from January 2014 to August 2016 in 17 French out-of-hospital emergency medical units. The date of final follow-up was August 31, 2016. INTERVENTIONS Patients were randomly assigned to undergo tracheal intubation facilitated by rocuronium (n = 624) or succinylcholine (n = 624). MAIN OUTCOMES AND MEASURES The primary outcome was the intubation success rate on first attempt. A noninferiority margin of 7% was chosen. A per-protocol analysis was prespecified as the primary analysis. RESULTS Among 1248 patients who were randomized (mean age, 56 years; 501 [40.1%] women), 1230 (98.6%) completed the trial and 1226 (98.2%) were included in the per-protocol analysis. The number of patients with successful first-attempt intubation was 455 of 610 (74.6%) in the rocuronium group vs 489 of 616 (79.4%) in the succinylcholine group, with a between-group difference of -4.8% (1-sided 97.5% CI, -9% to ∞), which did not meet criteria for noninferiority. The most common intubation-related adverse events were hypoxemia (55 of 610 patients [9.0%]) and hypotension (39 of 610 patients [6.4%]) in the rocuronium group and hypoxemia (61 of 616 [9.9%]) and hypotension (62 of 616 patients [10.1%]) in the succinylcholine group. CONCLUSIONS AND RELEVANCE Among patients undergoing endotracheal intubation in an out-of-hospital emergency setting, rocuronium, compared with succinylcholine, failed to demonstrate noninferiority with regard to first-attempt intubation success rate. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02000674.
Collapse
Affiliation(s)
- Bertrand Guihard
- Department of Emergency, CHU de la Réunion, Allée des Topazes, Saint Denis, Réunion, France
| | - Charlotte Chollet-Xémard
- Groupe Hospitalo-Universitaire Henri Mondor, SAMU 94, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | | | - Benoit Vivien
- Department of Anesthesia & Critical Care - SAMU, Assistance Publique - Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Université Paris Descartes, Paris, France
| | - Claire Broche
- Département d'Anesthésie-Réanimation-SMUR, Hôpital Universitaire Lariboisière, AP-HP, Paris, France
| | - Dominique Savary
- Emergency Department, General Hospital of Annecy, Annecy, France
| | | | | | - Frédéric Adnet
- AP-HP, Urgences-SAMU 93, Unité Recherche-Enseignement-Qualité, Hôpital Avicenne, Bobigny, France
| | - Eric Wiel
- Univ Lille, EA 2694 - Santé Publique: Epidémiologie et Qualité des Soins, Lille, France
- French National Out-of-Hospital Cardiac Arrest Registry Research Group - Registre électronique des Arrêts Cardiaques, Lille, France
- Emergency Medicine Department and SAMU 59, Lille University Hospital, Lille, France
| | - Juliette Deutsch
- Department of Emergency Medicine, Groupe Hospitalier Broca Cochin Hôtel-Dieu, Paris, France
| | - Cindy Tissier
- Department of Emergency Medicine, University Hospital Dijon, Dijon, France
| | - Thomas Loeb
- Raymond Poincaré Hospital (APHP), SAMU 92, Paris, France
| | - Vincent Bounes
- Pôle Médecine d'Urgence, Hôpital Universitaire de Purpan, Toulouse, France
- INSERM UMR 1027, Université Paul Sabatier, Toulouse, France
| | - Emmanuel Rousseau
- Services de Médecine d’Urgence et de Réanimation, Pôle Urgence Réanimation, SAMU 77, Melun, France
| | - Patricia Jabre
- AP-HP, Service d'Aide Médicale d'Urgence (SAMU) de Paris and Paris Sudden Death Expertise Center, Université Paris Descartes, Paris, France
| | - Laetitia Huiart
- INSERM CIC 1410 Clinical and Epidemiology/ CHU Réunion/Université de la Réunion, Saint-Pierre, Reunion, France
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Cyril Ferdynus
- Departement d'Informatique Clinique, Centre Hospitalier Universitaire de La Réunion Site Félix Guyon, Saint-Denis, France
| | - Xavier Combes
- Department of Emergency, CHU de la Réunion, Université de la Réunion, Réunion, France
| |
Collapse
|
37
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2019. [DOI: 10.3166/afmu-2019-0195] [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: 11/20/2022]
|
38
|
Bougouin W, Dumas F, Lamhaut L, Marijon E, Carli P, Combes A, Pirracchio R, Aissaoui N, Karam N, Deye N, Sideris G, Beganton F, Jost D, Cariou A, Jouven X, Adnet F, Agostinucci JM, Aissaoui-Balanant N, Algalarrondo V, Alla F, Alonso C, Amara W, Annane D, Antoine C, Aubry P, Azoulay E, Beganton F, Benhamou D, Billon C, Bougouin W, Boutet J, Bruel C, Bruneval P, Cariou A, Carli P, Casalino E, Cerf C, Chaib A, Cholley B, Cohen Y, Combes A, Crahes M, Da Silva D, Das V, Demoule A, Denjoy I, Deye N, Dhonneur G, Diehl JL, Dinanian S, Domanski L, Dreyfuss D, Duboc D, Dubois-Rande JL, Dumas F, Empana JP, Extramiana F, Fartoukh M, Fieux F, Gabbas M, Gandjbakhch E, Geri G, Guidet B, Halimi F, Henry P, Hidden Lucet F, Jabre P, Jacob L, Joseph L, Jost D, Jouven X, Karam N, Kassim H, Lacotte J, Lahlou-Laforet K, Lamhaut L, Lanceleur A, Langeron O, Lavergne T, Lecarpentier E, Leenhardt A, Lellouche N, Lemiale V, Lemoine F, Linval F, Loeb T, Ludes B, Luyt CE, Maltret A, Mansencal N, Mansouri N, Marijon E, Marty J, Maury E, Maxime V, Megarbane B, Mekontso-Dessap A, Mentec H, Mira JP, Monnet X, Narayanan K, Ngoyi N, Perier MC, Piot O, Pirracchio R, Plaisance P, Plu I, Raux M, Revaux F, Ricard JD, Richard C, Riou B, Roussin F, Santoli F, Schortgen F, Sharifzadehgan A, Sideris G, Spaulding C, Teboul JL, Timsit JF, Tourtier JP, Tuppin P, Ursat C, Varenne O, Vieillard-Baron A, Voicu S, Wahbi K, Waldmann V. Extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest: a registry study. Eur Heart J 2019; 41:1961-1971. [DOI: 10.1093/eurheartj/ehz753] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 03/26/2019] [Accepted: 10/01/2019] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aims
Out-of-hospital cardiac arrest (OHCA) without return of spontaneous circulation (ROSC) despite conventional resuscitation is common and has poor outcomes. Adding extracorporeal membrane oxygenation (ECMO) to cardiopulmonary resuscitation (extracorporeal-CPR) is increasingly used in an attempt to improve outcomes.
Methods and results
We analysed a prospective registry of 13 191 OHCAs in the Paris region from May 2011 to January 2018. We compared survival at hospital discharge with and without extracorporeal-CPR and identified factors associated with survival in patients given extracorporeal-CPR. Survival was 8% in 525 patients given extracorporeal-CPR and 9% in 12 666 patients given conventional-CPR (P = 0.91). By adjusted multivariate analysis, extracorporeal-CPR was not associated with hospital survival [odds ratio (OR), 1.3; 95% confidence interval (95% CI), 0.8–2.1; P = 0.24]. By conditional logistic regression with matching on a propensity score (including age, sex, occurrence at home, bystander CPR, initial rhythm, collapse-to-CPR time, duration of resuscitation, and ROSC), similar results were found (OR, 0.8; 95% CI, 0.5–1.3; P = 0.41). In the extracorporeal-CPR group, factors associated with hospital survival were initial shockable rhythm (OR, 3.9; 95% CI, 1.5–10.3; P = 0.005), transient ROSC before ECMO (OR, 2.3; 95% CI, 1.1–4.7; P = 0.03), and prehospital ECMO implantation (OR, 2.9; 95% CI, 1.5–5.9; P = 0.002).
Conclusions
In a population-based registry, 4% of OHCAs were treated with extracorporeal-CPR, which was not associated with increased hospital survival. Early ECMO implantation may improve outcomes. The initial rhythm and ROSC may help select patients for extracorporeal-CPR.
Collapse
Affiliation(s)
- Wulfran Bougouin
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Medical-Surgical Intensive Care Unit, Ramsay Générale de Santé, Hôpital Privé Jacques Cartier, 6 Avenue du Noyer Lambert, 91300 Massy, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- AfterROSC network, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Florence Dumas
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Emergency Department, Cochin-Hotel-Dieu Hospital, APHP, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Lionel Lamhaut
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- AfterROSC network, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Intensive Care Unit - SAMU 75, Necker-Enfants-Malades Hospital, APHP, 149 Rue de Sèvres, 75015 Paris, France
| | - Eloi Marijon
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Cardiology Department, Georges Pompidou European Hospital, AP-HP, 20 Rue Leblanc, 75015 Paris, France
| | - Pierre Carli
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Intensive Care Unit - SAMU 75, Necker-Enfants-Malades Hospital, APHP, 149 Rue de Sèvres, 75015 Paris, France
| | - Alain Combes
- Medical-Surgical Intensive Care Unit, iCAN, Institute of Cardiometabolism and Nutrition, Pitié-Salpétrière Hospital, APHP, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - Romain Pirracchio
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Surgical ICU, Georges Pompidou European Hospital, AP-HP, 20 Rue Leblanc, 75015 Paris, France
| | - Nadia Aissaoui
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- AfterROSC network, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Medical ICU, Georges Pompidou European Hospital, AP-HP, 20 Rue Leblanc, 75015 Paris, France
| | - Nicole Karam
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Cardiology Department, Georges Pompidou European Hospital, AP-HP, 20 Rue Leblanc, 75015 Paris, France
| | - Nicolas Deye
- AfterROSC network, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
- Medical ICU, Lariboisière Hospital, AP-HP, 2 Rue Ambroise Paré, 75010 Paris, France
| | - Georgios Sideris
- Cardiology Department, Lariboisière Hospital, AP-HP, 2 Rue Ambroise Paré, 75010 Paris, France
| | - Frankie Beganton
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
| | - Daniel Jost
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- Brigade de Sapeurs Pompiers de Paris (BSPP), 1 Place Jules Renard, 75017 Paris, France
| | - Alain Cariou
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- AfterROSC network, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Medical Intensive Care Unit, Cochin Hospital, APHP, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Xavier Jouven
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Cardiology Department, Georges Pompidou European Hospital, AP-HP, 20 Rue Leblanc, 75015 Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2019. [DOI: 10.3166/afmu-2019-0187] [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: 11/20/2022]
|
40
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2019. [DOI: 10.3166/afmu-2019-0177] [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: 11/20/2022]
|
41
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2019. [DOI: 10.3166/afmu-2019-0156] [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: 11/20/2022]
|
42
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2019. [DOI: 10.3166/afmu-2019-0132] [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: 11/20/2022]
|
43
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2019. [DOI: 10.3166/afmu-2018-0116] [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: 11/20/2022]
|
44
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2018. [DOI: 10.3166/afmu-2018-0104] [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: 11/20/2022]
|
45
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2018. [DOI: 10.3166/afmu-2018-0095] [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: 11/20/2022]
|
46
|
Waldmann V, Karam N, Bougouin W, Gaye B, Dumas F, Sharifzadehgan A, Narayanan K, Aissaoui N, Lamhaut L, Jost D, Jabre P, Cariou A, Marijon E, Jouven X. P838Resuscitation attempt and survival after out-of-hospital cardiac arrest. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p838] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- V Waldmann
- Hôpital Européen Georges Pompidou, Université Paris Descartes, Cardiology, Paris, France
| | - N Karam
- Hôpital Européen Georges Pompidou, Université Paris Descartes, Cardiology, Paris, France
| | - W Bougouin
- Hôpital Européen Georges Pompidou, Université Paris Descartes, Cardiology, Paris, France
| | - B Gaye
- Paris Cardiovascular Research Center (PARCC), Paris, France
| | - F Dumas
- Hospital Cochin, Paris, France
| | - A Sharifzadehgan
- Hôpital Européen Georges Pompidou, Université Paris Descartes, Cardiology, Paris, France
| | - K Narayanan
- Paris Cardiovascular Research Center (PARCC), Paris, France
| | - N Aissaoui
- Hôpital Européen Georges Pompidou, Université Paris Descartes, Cardiology, Paris, France
| | - L Lamhaut
- Service d'AIde Médicale Urgente Necker, Paris, France
| | - D Jost
- Brigade des Sapeurs Pompiers de Paris, Paris, France
| | - P Jabre
- Service d'AIde Médicale Urgente Necker, Paris, France
| | | | - E Marijon
- Hôpital Européen Georges Pompidou, Université Paris Descartes, Cardiology, Paris, France
| | - X Jouven
- Hôpital Européen Georges Pompidou, Université Paris Descartes, Cardiology, Paris, France
| | | |
Collapse
|
47
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe. Ann Fr Med Urgence 2018. [DOI: 10.3166/afmu-2018-0068] [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: 11/20/2022]
|
48
|
Jabre P. Les PEARLS (Practical Evidence About Real Life Situations) du groupe Cochrane Pre-hospital and Emergency Care. Ann Fr Med Urgence 2018. [DOI: 10.3166/afmu-2018-0041] [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: 11/20/2022]
|
49
|
Abstract
BACKGROUND Necrotizing soft tissue infections (NSTIs) are severe and rapidly spreading soft tissue infections of the subcutaneous tissue, fascia, or muscle, which are mostly caused by bacteria. Associated rates of mortality and morbidity are high, with the former estimated at around 23%, and disability, sequelae, and limb loss occurring in 15% of patients. Standard management includes intravenous empiric antimicrobial therapy, early surgical debridement of necrotic tissues, intensive care support, and adjuvant therapies such as intravenous immunoglobulin (IVIG). OBJECTIVES To assess the effects of medical and surgical treatments for necrotizing soft tissue infections (NSTIs) in adults in hospital settings. SEARCH METHODS We searched the following databases up to April 2018: the Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS. We also searched five trials registers, pharmaceutical company trial results databases, and the US Food and Drug Administration and the European Medicines Agency websites. We checked the reference lists of included studies and reviews for further references to relevant randomised controlled trials (RCTs). SELECTION CRITERIA RCTs conducted in hospital settings, that evaluated any medical or surgical treatment for adults with NSTI were eligible for inclusion. Eligible medical treatments included 1) comparisons between different antimicrobials or with placebo; 2) adjuvant therapies such as intravenous immunoglobulin (IGIV) therapy compared with placebo; no treatment; or other adjuvant therapies. Eligible surgical treatments included surgical debridement compared with amputation, immediate versus delayed intervention, or comparisons of number of interventions.RCTs of hyperbaric oxygen (HBO) therapy for NSTI were ineligible because HBO is the focus of another Cochrane Review. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. The primary outcome measures were 1) mortality within 30 days, and 2) proportion of participants who experience a serious adverse event. Secondary outcomes were 1) survival time, and 2) assessment of long-term morbidity. We used GRADE to assess the quality of the evidence for each outcome. MAIN RESULTS We included three trials randomising 197 participants (62% men) who had a mean age of 55 years. One trial compared two antibiotic treatments, and two trials compared adjuvant therapies with placebo. In all trials, participants concomitantly received standard interventions, such as intravenous empiric antimicrobial therapy, surgical debridement of necrotic tissues, intensive care support, and adjuvant therapies. All trials were at risk of attrition bias and one trial was not blinded.Moxifloxacin versus amoxicillin-clavulanate One trial included 54 participants who had a NSTI; it compared a third-generation quinolone, moxifloxacin, at a dose of 400 mg given once daily, against a penicillin, amoxicillin-clavulanate, at a dose of 3 g given three times daily for at least three days, followed by 1.5 g three times daily. Duration of treatment varied from 7 to 21 days. We are uncertain of the effects of these treatments on mortality within 30 days (risk ratio (RR) 3.00, 95% confidence interval (CI) 0.39 to 23.07) and serious adverse events at 28 days (RR 0.63, 95% CI 0.30 to 1.31) because the quality of the evidence is very low.AB103 versus placebo One trial of 43 randomised participants compared two doses, 0.5 mg/kg and 0.25 mg/kg, of an adjuvant drug, a CD28 antagonist receptor (AB103), with placebo. Treatment was given via infusion pump for 10 minutes before, after, or during surgery within six hours after the diagnosis of NSTI. We are uncertain of the effects of AB103 on mortality rate within 30 days (RR of 0.34, 95% CI 0.05 to 2.16) and serious adverse events measured at 28 days (RR 1.49, 95% CI 0.52 to 4.27) because the quality of the evidence is very low.Intravenous immunoglobulin (IVIG) versus placebo One trial of 100 randomised participants assessed IVIG as an adjuvant drug, given at a dose of 25 g/day, compared with placebo, given for three consecutive days. There may be no clear difference between IVIG and placebo in terms of mortality within 30 days (RR 1.17, 95% CI 0.42 to 3.23) (low-certainty evidence), nor serious adverse events experienced in the intensive care unit (ICU) (RR 0.73 CI 95% 0.32 to 1.65) (low-certainty evidence).Serious adverse events were only described in one RCT (the IVIG versus placebo trial) and included acute kidney injury, allergic reactions, aseptic meningitis syndrome, haemolytic anaemia, thrombi, and transmissible agents.Only one trial reported assessment of long-term morbidity, but the outcome was not defined in the way we prespecified in our protocol. The trial used the Short Form Health Survey (SF36). Data on survival time were provided upon request for the trials comparing amoxicillin-clavulanate versus moxifloxacin and IVIG versus placebo. However, even with data provided, it was not possible to perform survival analysis. AUTHORS' CONCLUSIONS We found very little evidence on the effects of medical and surgical treatments for NSTI. We cannot draw conclusions regarding the relative effects of any of the interventions on 30-day mortality or serious adverse events due to the very low quality of the evidence.The quality of the evidence is limited by the very small number of trials, the small sample sizes, and the risks of bias in the included trials. It is important for future trials to clearly define their inclusion criteria, which will help with the applicability of future trial results to a real-life population.Management of NSTI participants (critically-ill participants) is complex, involving multiple interventions; thus, observational studies and prospective registries might be a better foundation for future research, which should assess empiric antimicrobial therapy, as well as surgical debridement, along with the placebo-controlled comparison of adjuvant therapy. Key outcomes to assess include mortality (in the acute phase of the condition) and long-term functional outcomes, e.g. quality of life (in the chronic phase).
Collapse
Affiliation(s)
- Camille Hua
- Hôpital Henri MondorDepartment of Dermatology51 Avenue du Maréchal de Lattre de TassignyCréteilFrance94000
| | - Romain Bosc
- Hôpital Henri MondorDepartment of Plastic, Reconstructive and Aesthetic Surgery51 Avenue du Maréchal de Lattre de TassignyCréteilFrance94000
| | - Emilie Sbidian
- Hôpital Henri MondorDepartment of Dermatology51 Avenue du Maréchal de Lattre de TassignyCréteilFrance94000
| | - Nicolas De Prost
- Hôpital Henri MondorMedical Intensive Care Unit51 Avenue du Maréchal de Lattre de TassignyCréteilFrance94000
| | - Carolyn Hughes
- The University of Nottinghamc/o Cochrane Skin GroupA103, King's Meadow CampusLenton LaneNottinghamUKNG7 2NR
| | - Patricia Jabre
- Hôpital Universitaire Necker‐Enfants MaladesAssistance Publique‐Hôpitaux de Paris (AP‐HP), SAMU (Service d'Aide Médicale Urgente) de Paris149 Rue de SèvresParisFrance75015
- Institut national de la santé et de la recherche médicale (Inserm) U970, Paris‐Centre de recherche Cardiovasculaire (PARCC), Université Paris DescartesParisFrance
| | - Olivier Chosidow
- Hôpital Henri MondorDepartment of Dermatology51 Avenue du Maréchal de Lattre de TassignyCréteilFrance94000
| | - Laurence Le Cleach
- Hôpital Henri MondorDepartment of Dermatology51 Avenue du Maréchal de Lattre de TassignyCréteilFrance94000
| | | |
Collapse
|
50
|
Bouquegneau A, Loheac C, Aubert O, Bouatou Y, Viglietti D, Empana J, Ulloa C, Hassan Murad M, Legendre C, Glotz D, Jackson AM, Zeevi A, Schaub S, Taupin J, Reed EF, Friedewald JJ, Tyan DB, Süsal C, Shapiro R, Woodle ES, Hidalgo LG, O’Leary J, Montgomery RA, Kobashigawa J, Jouven X, Jabre P, Lefaucheur C, Loupy A. Complement-activating donor-specific anti-HLA antibodies and solid organ transplant survival: A systematic review and meta-analysis. PLoS Med 2018; 15:e1002572. [PMID: 29799874 PMCID: PMC5969739 DOI: 10.1371/journal.pmed.1002572] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 04/26/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Anti-human leukocyte antigen donor-specific antibodies (anti-HLA DSAs) are recognized as a major barrier to patients' access to organ transplantation and the major cause of graft failure. The capacity of circulating anti-HLA DSAs to activate complement has been suggested as a potential biomarker for optimizing graft allocation and improving the rate of successful transplantations. METHODS AND FINDINGS To address the clinical relevance of complement-activating anti-HLA DSAs across all solid organ transplant patients, we performed a meta-analysis of their association with transplant outcome through a systematic review, from inception to January 31, 2018. The primary outcome was allograft loss, and the secondary outcome was allograft rejection. A comprehensive search strategy was conducted through several databases (Medline, Embase, Cochrane, and Scopus). A total of 5,861 eligible citations were identified. A total of 37 studies were included in the meta-analysis. Studies reported on 7,936 patients, including kidney (n = 5,991), liver (n = 1,459), heart (n = 370), and lung recipients (n = 116). Solid organ transplant recipients with circulating complement-activating anti-HLA DSAs experienced an increased risk of allograft loss (pooled HR 3.09; 95% CI 2.55-3.74, P = 0.001; I2 = 29.3%), and allograft rejection (pooled HR 3.75; 95% CI: 2.05-6.87, P = 0.001; I2 = 69.8%) compared to patients without complement-activating anti-HLA DSAs. The association between circulating complement-activating anti-HLA DSAs and allograft failure was consistent across all subgroups and sensitivity analyses. Limitations of the study are the observational and retrospective design of almost all included studies, the higher proportion of kidney recipients compared to other solid organ transplant recipients, and the inclusion of fewer studies investigating allograft rejection. CONCLUSIONS In this study, we found that circulating complement-activating anti-HLA DSAs had a significant deleterious impact on solid organ transplant survival and risk of rejection. The detection of complement-activating anti-HLA DSAs may add value at an individual patient level for noninvasive biomarker-guided risk stratification. TRIAL REGISTRATION National Clinical Trial protocol ID: NCT03438058.
Collapse
Affiliation(s)
- Antoine Bouquegneau
- Paris Translational Research Center for Organ Transplantation INSERM Unit 970, Paris, France
- Department of Nephrology, Dialysis and Transplantation, CHU de Liège, Liège, Belgium
| | - Charlotte Loheac
- Paris Translational Research Center for Organ Transplantation INSERM Unit 970, Paris, France
| | - Olivier Aubert
- Paris Translational Research Center for Organ Transplantation INSERM Unit 970, Paris, France
- Department of Kidney Transplantation, Necker Hospital, Paris Descartes University, and Assistance Publique–Hôpitaux de Paris (AP–HP), Paris, France
| | - Yassine Bouatou
- Paris Translational Research Center for Organ Transplantation INSERM Unit 970, Paris, France
- Division of Nephrology, Geneva University Hospitals, Geneva, Switzerland
| | - Denis Viglietti
- Paris Translational Research Center for Organ Transplantation INSERM Unit 970, Paris, France
- Department of Nephrology and Kidney Transplantation, Saint–Louis Hospital, Paris Diderot University, AP–HP, Paris, France
| | - Jean–Philippe Empana
- Paris Translational Research Center for Organ Transplantation INSERM Unit 970, Paris, France
| | - Camilo Ulloa
- Hospital Barros Luco Trudeau, Santiago, Chile et Clinica Alemana de Santiago, Chile
| | - Mohammad Hassan Murad
- Mayo Clinic Evidence–based Practice Center, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Christophe Legendre
- Paris Translational Research Center for Organ Transplantation INSERM Unit 970, Paris, France
- Department of Kidney Transplantation, Necker Hospital, Paris Descartes University, and Assistance Publique–Hôpitaux de Paris (AP–HP), Paris, France
| | - Denis Glotz
- Paris Translational Research Center for Organ Transplantation INSERM Unit 970, Paris, France
- Department of Nephrology and Kidney Transplantation, Saint–Louis Hospital, Paris Diderot University, AP–HP, Paris, France
| | - Annette M. Jackson
- Immunogenetics Laboratory, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Adriana Zeevi
- Department of Pathology, Surgery and Immunology at University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States of America
| | - Stephan Schaub
- Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland
| | - Jean–Luc Taupin
- Department of Immunology and Histocompatibility, CHU Paris–GH St–Louis Lariboisière, Paris, France
| | - Elaine F. Reed
- Department of Pathology and Laboratory Medicine, UCLA Immunogenetics Center, David Geffen School of Medicine, University of California, Los Angeles, California, United States of America
| | - John J. Friedewald
- Northwestern University Feinberg School of Medicine, Comprehensive Transplant Center, Division of Transplant Surgery, Chicago, Illinois, United states of America
| | - Dolly B. Tyan
- Division of Nephrology, Department of Medicine, Stanford University, Stanford, California, United States of America
| | - Caner Süsal
- Institute of Immunology, Heidelberg University, Department of Transplantation Immunology, Heidelberg, Germany
| | - Ron Shapiro
- Kidney/Pancreas Transplant Program, Mount Sinai Hospital, Recanati Miller Transplantation Institute, New York, New York, United States of America
| | - E. Steve Woodle
- Division of Transplantation, Department of Surgery, and Division of Hematology and Oncology, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
| | - Luis G. Hidalgo
- Department of Laboratory Medicine and Pathology and Alberta Transplant Applied Genomics Center, Edmonton, Alberta, Canada
| | - Jacqueline O’Leary
- Annette C. & Harold C. Simmons Transplant Institute, Baylor University Medical Center, Dallas, Texas, United States of America
| | - Robert A. Montgomery
- The NYU Transplant Institute, New York University Langone Medical Center, New York, New York, United States of America
| | - Jon Kobashigawa
- Cedars–Sinai Heart Institute, Los Angeles, California, United States of America
| | - Xavier Jouven
- Paris Translational Research Center for Organ Transplantation INSERM Unit 970, Paris, France
- Department of Cardiology and Global Health Unit European Georges Pompidou Hospital, Paris
| | - Patricia Jabre
- Paris Translational Research Center for Organ Transplantation INSERM Unit 970, Paris, France
- SAMU of Paris, Necker Hospital Paris, France
- Paris Descartes University, Paris, France
- AP–HP, Paris, France
| | - Carmen Lefaucheur
- Paris Translational Research Center for Organ Transplantation INSERM Unit 970, Paris, France
- Department of Nephrology and Kidney Transplantation, Saint–Louis Hospital, Paris Diderot University, AP–HP, Paris, France
| | - Alexandre Loupy
- Paris Translational Research Center for Organ Transplantation INSERM Unit 970, Paris, France
- Department of Kidney Transplantation, Necker Hospital, Paris Descartes University, and Assistance Publique–Hôpitaux de Paris (AP–HP), Paris, France
| |
Collapse
|