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Burgel PR, Paillasseur JL, Durieu I, Reynaud-Gaubert M, Hamidfar R, Murris-Espin M, Danner-Boucher I, Chiron R, Leroy S, Douvry B, Grenet D, Mely L, Ramel S, Moncouquiol S, Burnet E, Ouaalaya EH, Sogni P, Da Silva J, Martin C. Multisystemic Effects of Elexacaftor-Tezacaftor-Ivacaftor in Adults with Cystic Fibrosis and Advanced Lung Disease. Ann Am Thorac Soc 2024. [PMID: 38579175 DOI: 10.1513/annalsats.202312-1065oc] [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] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/04/2024] [Indexed: 04/07/2024] Open
Abstract
RATIONALE Limited data exist on safety and effectiveness of elexacaftor-tezacaftor-ivacaftor (ETI) in people with cystic fibrosis (pwCF) and advanced lung disease. OBJECTIVE To evaluate the effects of ETI in an unselected population of pwCF and advanced lung disease. METHODS A prospective observational study, including all adults, aged 18 years and older, with a percent predicted FEV1 (ppFEV1)≤ 40 who initiated ETI from December 2019 to June 2021 in France was conducted. PwCF were followed until August 8th, 2022. RESULTS ETI was initiated in 434 pwCF with a median [interquartile range, IQR] ppFEV1=30 [25; 35], including 27 with severe CF liver disease and 183 with diabetes. PwCF were followed for a median [IQR] 587 [396; 728] days after ETI initiation. Discontinuation of ETI occurred in 12 (2.8%) pwCF and was mostly due to lung transplantation (n=5) or death (n=4). Absolute increase in ppFEV1 by a mean +14.2% (95% CI, 13.1-15.4) occurred at 1 month and persisted throughout the study. Increase in ppFEV1 in the younger age quartile was almost twice that of the oldest quartile (P<0.001); body mass index <18.5 kg/m2 was found in 38.6% at initiation vs. 11.3% at 12 months (P=0.0001). Increase in serum concentrations of vitamin A and E, but not 25OHD3, was observed. Significant reduction in the % of pwCF using oxygen therapy, noninvasive ventilation, nutritional support, inhaled and systemic therapies (including antibiotics) were observed; insulin was discontinued in 12% of diabetics. CONCLUSION ETI is safe in pwCF and advanced lung disease with multisystem pulmonary and extrapulmonary benefits.
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Affiliation(s)
| | | | - Isabelle Durieu
- Hospices Civils de Lyon, 26900, Service de médecine interne, Pierre Bénite, Auvergne-Rhône-Alpes , France
| | | | - Rebecca Hamidfar
- Centre Hospitalier Universitaire de Grenoble-Alpes, Service Hospitalo-Universitaire de Pneumologie et Physiologie, Pôle Thorax et Vaisseaux, , La Tronche, France
| | - Marlène Murris-Espin
- Centre Hospitalier Universitaire de Toulouse, 36760, Pulmonology, Toulouse, Midi-Pyrénées, France
| | | | | | - Sylvie Leroy
- University Hospital of Nice, Service de Pneumologie, Nice, France
| | - Benoit Douvry
- Centre Hospitalier Intercommunal de Creteil, 26949, Creteil, Île-de-France, France
| | | | | | | | | | - Espérie Burnet
- Cochin hospital, APHP, Respiratory Medicine, Paris, France
| | | | | | | | - Clémence Martin
- Groupe Hospitalier Cochin-Hotel Dieu, AP-HP, Pulmonary Department and Adult CF Centre, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
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Hamidfar R, Murris-Espin M, Mahot M, Abouly R, Gauchez H, Jacques S, Joffray E, Arnol N, Morin L, Leroy S, Borel JC. Feasibility of home initiation of an airway clearance device (SIMEOX) by telecare in people with non-cystic fibrosis bronchiectasis: a pilot study. BMJ Open Respir Res 2023; 10:e001722. [PMID: 37524523 PMCID: PMC10391802 DOI: 10.1136/bmjresp-2023-001722] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/20/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Mucociliary clearance is a cornerstone of the management of people with non-cystic fibrosis bronchiectasis (NCFB). SIMEOX, an innovative device, could facilitate autonomous airway clearance, but its use requires specific training. We hypothesised that telecare would be an effective means to train people with NCFB in the handling of device and to monitor and promote device adherence. OBJECTIVES (1) To evaluate frequency of use of the SIMEOX for 10 weeks after telecare training. (2) To assess user satisfaction and clinical efficacy of the SIMEOX+telecare. METHODS Multicentre, prospective, pilot study in adults with NCFB. A SIMEOX was provided to each participant at inclusion. Physiotherapists performed telecare sessions the first 2 weeks (3-5 sessions) for device training and every 10 days to reinforce motivation and provide technical support. RESULTS 22 individuals were included, 21 analysed (38% male; mean±SD age 53±18 years; Bronchiectasis Severity Index 6.6±3.5). Fourteen participants (66.7%; 95% CI 43.1% to 84.5%) performed ≥3 SIMEOX sessions/week (self-reported adherence, primary outcome). Median (Q1; Q3) number of self-reported sessions/week for the whole group was 3.7 (1.8; 5.7). Adherence including web registration was 80.9%. At week 12, participant satisfaction rating was 9.0 (7.9; 10.0) on a 10-point visual analogue scale; respiratory function did not change but quality of life improved (COPD Assessment Test score -4.7, 95% CI -7.7 to -1.6, p=0.023; St Georges Respiratory Questionnaire -5.8, 95% CI -10.8 to -0.9, p=0.005). CONCLUSION Adherence to and satisfaction with the SIMEOX airway clearance device supported by telecare were high in people with NCFB. The clinical efficacy needs to be confirmed in a randomised controlled trial. TRIAL REGISTRATION NUMBER NCT04742270.
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Affiliation(s)
- Rebecca Hamidfar
- Service de Pneumologie-CRCM adulte Hôpital Michallon, Grenoble Alpes University Hospital, Grenoble, France
| | - Marlene Murris-Espin
- Service de Pneumologie-CRCM adulte Hôpital Larrey, CHU Toulouse, Toulouse, France
| | | | | | | | | | | | | | | | - Sylvie Leroy
- Service de Pneumologie-CRCM adulte Hôpital Pasteur, CHU Nice, Nice, France
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3
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Corvol H, de Miranda S, Dehillotte C, Lemonnier L, Chiron R, Danner-Boucher I, Hamidfar R, Houdouin V, Macey J, Marguet C, Murris-Espin M, Reynaud Q, Reix P, Gaubert MR, Kemgang A, Burgel PR. Cumulative Incidence and Risk Factors for Severe COVID-19 in French People with Cystic Fibrosis. Clin Infect Dis 2022; 75:2135-2144. [PMID: 35475917 PMCID: PMC9129125 DOI: 10.1093/cid/ciac333] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/08/2022] [Accepted: 04/25/2022] [Indexed: 11/30/2022] Open
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections are closely monitored in people with cystic fibrosis (pwCF), with a special emphasis on severe cases. Previous studies used hospitalization rates as proxy for severity. Methods We evaluated data from coronavirus disease 2019 (COVID-19) cases diagnosed in French pwCF followed in one of the 47 French CF center over the first year of the pandemic. Objective criteria were applied for defining severity (e.g., respiratory failure and/or death). Data were compared to those from all French pwCF using the French CF Registry. Results As of April 30, 2021, 223 pwCF were diagnosed with COVID-19, with higher risks in adults (≥18 years, odds ratio [OR] = 2.52, 95% confidence interval [CI] = 1.82-3.48) and post-transplant individuals (OR = 2.68, 95% CI = 1.98-3.63). Sixty (26.9%) patients were hospitalized, with an increased risk in post-transplant individuals (OR = 4.74, 95% CI = 2.49-9.02). In 34 (15%) cases, COVID-19 was considered severe; 28/60 (46.7%) hospitalizations occurred in patients without objective criteria of severity. Severe cases occurred mostly in adults (85.3%) and post-transplant pwCF (61.8%, OR = 6.02, 95% CI = 2.77-13.06). In non-transplanted pwCF, risk factors for severity included low lung function (median ppFEV1 54.6% vs. 75.1%, OR = 1.04, 95% CI = 1.01-1.08) and CF-associated diabetes (OR = 3.26, 95% CI = 1.02-10.4). While most cases recovered without sequelae (n = 204, 91.5%), 16 (13%) were followed for possible sequelae, and three post-transplant females died. Conclusions Severe COVID-19 cases occurred infrequently during the first year of the pandemic in French pwCF. Non-transplanted adults with severe respiratory disease or diabetes and post-transplant individuals were at risk for severe COVID-19. Thus, specific preventive measures should be proposed.
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Affiliation(s)
- Harriet Corvol
- Pediatric Respiratory Department and Pediatric CF Center, Assistance Publique Hôpitaux de Paris (APHP), Hôpital Trousseau, Paris, France.,Sorbonne Université, Centre de Recherche Saint-Antoine, Paris, France
| | - Sandra de Miranda
- Pulmonology Department and CF Center, Hôpital Foch, Suresnes, France
| | | | | | - Raphael Chiron
- CF Center, Hôpital Arnaud de Villeneuve, CHU de Montpellier, Montpellier, France
| | - Isabelle Danner-Boucher
- Pulmonology Department and Adult CF Center, Institut du Thorax, CHU de Nantes, Nantes, France
| | | | - Véronique Houdouin
- Pediatric Pulmonology Department and Pediatric CF Center, APHP, Hôpital Robert Debré, Paris, France
| | - Julie Macey
- Respiratory Medicine and CF Center, CHU de Bordeaux, Bordeaux, France
| | - Christophe Marguet
- Pediatric Respiratory Disease and CF Center, CIC Inserm 1404, Inserm U3111, FHU RESPIR, Rouen University Hospital, Rouen, France
| | - Marlène Murris-Espin
- CF Center and Service de Pneumologie Pôle des Voies Respiratoires, CHU de Toulouse, Toulouse, France
| | - Quitterie Reynaud
- Internal Medicine Department and adult CF center, Hospices Civils de Lyon, Research on Healthcare Performance (RESHAPE), INSERM U1290, Université de Lyon, Lyon, France.,ERN-Lung CF Network, Frankfurt, Germany
| | - Philippe Reix
- Pediatric CF Center, Hospices Civils de Lyon, UMR 5558 CNRS Equipe EMET, Université Claude Bernard Lyon 1, Lyon, France
| | - Martine Reynaud Gaubert
- Respiratory Medicine and adult CF center, Assistance Publique Hôpitaux de Marseille, Aix-Marseille Université UM63, Institut de Recherche pour le Développement, Marseille, France
| | - Astrid Kemgang
- Sorbonne Université, Centre de Recherche Saint-Antoine, Paris, France
| | - Pierre-Régis Burgel
- Respiratory Medicine and National Reference CF Center, AP-HP, Hôpital Cochin, Paris, France.,Université de Paris, Institut Cochin, Inserm U-1016, Paris, France.,ERN-Lung CF Network, Frankfurt, Germany
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Abbas A, Abdukahil SA, Abdulkadir NN, Abe R, Abel L, Absil L, Acharya S, Acker A, Adachi S, Adam E, Adrião D, Ageel SA, Ahmed S, Ain Q, Ainscough K, Aisa T, Ait Hssain A, Ait Tamlihat Y, Akimoto T, Akmal E, Al Qasim E, Alalqam R, Alam T, Al-dabbous T, Alegesan S, Alegre C, Alessi M, Alex B, Alexandre K, Al-Fares A, Alfoudri H, Ali I, Ali Shah N, Alidjnou KE, Aliudin J, Alkhafajee Q, Allavena C, Allou N, Altaf A, Alves J, Alves JM, Alves R, Amaral M, Amira N, Ammerlaan H, Ampaw P, Andini R, Andrejak C, Angheben A, Angoulvant F, Ansart S, Anthonidass S, Antonelli M, Antunes de Brito CA, Anwar KR, Apriyana A, Arabi Y, Aragao I, Arali R, Arancibia F, Araujo C, Arcadipane A, Archambault P, Arenz L, Arlet JB, Arnold-Day C, Aroca A, Arora L, Arora R, Artaud-Macari E, Aryal D, Asaki M, Asensio A, Ashley E, Ashraf M, Ashraf S, Asim M, Assie JB, Asyraf A, Atique A, Attanyake AMUL, Auchabie J, Aumaitre H, Auvet A, Azemar L, Azoulay C, Bach B, Bachelet D, Badr C, Baig N, Baillie JK, Baird JK, Bak E, Bakakos A, Bakar NA, Bal A, Balakrishnan M, Balan V, Bani-Sadr F, Barbalho R, Barbosa NY, Barclay WS, Barnett SU, Barnikel M, Barrasa H, Barrelet A, Barrigoto C, Bartoli M, Bartone C, Baruch J, Bashir M, Basmaci R, Basri MFH, Bastos D, Battaglini D, Bauer J, Bautista Rincon DF, Bazan Dow D, Bedossa A, Bee KH, Behilill S, Beishuizen A, Beljantsev A, Bellemare D, Beltrame A, Beltrão BA, Beluze M, Benech N, Benjiman LE, Benkerrou D, Bennett S, Bento L, Berdal JE, Bergeaud D, Bergin H, Bernal Sobrino JL, Bertoli G, Bertolino L, Bessis S, Betz A, Bevilcaqua S, Bezulier K, Bhatt A, Bhavsar K, Bianchi I, Bianco C, Bidin FN, Bikram Singh M, Bin Humaid F, Bin Kamarudin MN, Bissuel F, Biston P, Bitker L, Blanco-Schweizer P, Blier C, Bloos F, Blot M, Blumberg L, Boccia F, Bodenes L, Bogaarts A, Bogaert D, Boivin AH, Bolze PA, Bompart F, Bonfasius A, Borges D, Borie R, Bosse HM, Botelho-Nevers E, Bouadma L, Bouchaud O, Bouchez S, Bouhmani D, Bouhour D, Bouiller K, Bouillet L, Bouisse C, Boureau AS, Bourke J, Bouscambert M, Bousquet A, Bouziotis J, Boxma B, Boyer-Besseyre M, Boylan M, Bozza FA, Brack M, Braconnier A, Braga C, Brandenburger T, Brás Monteiro F, Brazzi L, Breen D, Breen P, Breen P, Brett S, Brickell K, Broadley T, Browne A, Browne S, Brozzi N, Brusse-Keizer M, Buchtele N, Buesaquillo C, Bugaeva P, Buisson M, Burhan E, Burrell A, Bustos IG, Butnaru D, Cabie A, Cabral S, Caceres E, Cadoz C, Callahan M, Calligy K, Calvache JA, Cam J, Campana V, Campbell P, Campisi J, Canepa C, Cantero M, Caraux-Paz P, Cárcel S, Cardellino CS, Cardoso F, Cardoso F, Cardoso N, Cardoso S, Carelli S, Carlier N, Carmoi T, Carney G, Carpenter C, Carqueja I, Carret MC, Carrier FM, Carroll I, Carson G, Carton E, Casanova ML, Cascão M, Casey S, Casimiro J, Cassandra B, Castañeda S, Castanheira N, Castor-Alexandre G, Castrillón H, Castro I, Catarino A, Catherine FX, Cattaneo P, Cavalin R, Cavalli GG, Cavayas A, Ceccato A, Cervantes-Gonzalez M, Chair A, Chakveatze C, Chan A, Chand M, Chantalat Auger C, Chapplain JM, Chas J, Chaudary M, Chávez Iñiguez JS, Chen A, Chen YS, Cheng MP, Cheret A, Chiarabini T, Chica J, Chidambaram SK, Chin-Tho L, Chirouze C, Chiumello D, Cho HJ, Cho SM, Cholley B, Chopin MC, Chow TS, Chow YP, Chua HJ, Chua J, Cidade JP, Cisneros Herreros JM, Citarella BW, Ciullo A, Clarke E, Clarke J, Claure Del Granado R, Clohisey S, Cobb JP, Coca N, Codan C, Cody C, Coelho A, Coles M, Colin G, Collins M, Colombo SM, Combs P, Connolly J, Connor M, Conrad A, Contreras S, Conway E, Cooke GS, Copland M, Cordel H, Corley A, Cormican S, Cornelis S, Cornet AD, Corpuz AJ, Cortegiani A, Corvaisier G, Costigan E, Couffignal C, Couffin-Cadiergues S, Courtois R, Cousse S, Cregan R, Crepy D'Orleans C, Croonen S, Crowl G, Crump J, Cruz C, Cruz Berm JL, Cruz Rojo J, Csete M, Cucino A, Cullen A, Cullen C, Cummings M, Curley G, Curlier E, Curran C, Custodio P, da Silva Filipe A, Da Silveira C, Dabaliz AA, Dagens A, Dahly D, Dalton H, Dalton J, Daly S, D'Amico F, Daneman N, Daniel C, Dankwa EA, Dantas J, D’Aragon F, de Boer M, de Loughry G, de Mendoza D, De Montmollin E, de Oliveira França RF, de Pinho Oliveira AI, De Rosa R, de Silva T, de Vries P, Deacon J, Dean D, Debard A, DeBenedictis B, Debray MP, DeCastro N, Dechert W, Deconninck L, Decours R, Defous E, Delacroix I, Delaveuve E, Delavigne K, Delfos NM, Deligiannis I, Dell'Amore A, Delmas C, Delobel P, Delsing C, Demonchy E, Denis E, Deplanque D, Depuydt P, Desai M, Descamps D, Desvallée M, Dewayanti S, Diallo A, Diamantis S, Dias A, Diaz P, Diaz R, Diaz Diaz JJ, Didier K, Diehl JL, Dieperink W, Dimet J, Dinot V, Diop F, Diouf A, Dishon Y, Dixit D, Djossou F, Docherty AB, Doherty H, Dondorp AM, Dong A, Donnelly CA, Donnelly M, Donohue C, Donohue S, Donohue Y, Doran C, Doran P, Dorival C, D'Ortenzio E, Douglas JJ, Douma R, Dournon N, Downer T, Downey J, Downing M, Drake T, Driscoll A, Dryden M, Duarte Fonseca C, Dubee V, Dubos F, Ducancelle A, Duculan T, Dudman S, Duggal A, Dunand P, Dunning J, Duplaix M, Durante-Mangoni E, Durham III L, Dussol B, Duthoit J, Duval X, Dyrhol-Riise AM, Ean SC, Echeverria-Villalobos M, Egan S, Eira C, El Sanharawi M, Elapavaluru S, Elharrar B, Ellerbroek J, Eloy P, Elshazly T, Elyazar I, Enderle I, Endo T, Eng CC, Engelmann I, Enouf V, Epaulard O, Escher M, Esperatti M, Esperou H, Esposito-Farese M, Estevão J, Etienne M, Ettalhaoui N, Everding AG, Evers M, Fabre I, Fabre M, Faheem A, Fahy A, Fairfield CJ, Fakar Z, Faria P, Farooq A, Farrar JJ, Farshait N, Fateena H, Fatoni AZ, Faure K, Favory R, Fayed M, Feely N, Feeney L, Fernandes J, Fernandes M, Fernandes S, Ferrand FX, Ferrand Devouge E, Ferrão J, Ferraz M, Ferreira B, Ferreira S, Ferrer-Roca R, Ferriere N, Ficko C, Figueiredo-Mello C, Fiorda J, Flament T, Flateau C, Fletcher T, Florio LL, Flynn B, Flynn D, Foley C, Foley J, Fomin V, Fonseca T, Fontela P, Forsyth S, Foster D, Foti G, Fourn E, Fowler RA, Fraher DM, Franch-Llasat D, Fraser C, Fraser JF, Freire MV, Freitas Ribeiro A, Friedrich C, Fritz R, Fry S, Fuentes N, Fukuda M, Gaborieau V, Gaci R, Gagliardi M, Gagnard JC, Gagné N, Gagneux-Brunon A, Gaião S, Gail Skeie L, Gallagher P, Gallego Curto E, Gamble C, Gani Y, Garan A, Garcia R, García Barrio N, Garcia-Diaz J, Garcia-Gallo E, Garimella N, Garot D, Garrait V, Gauli B, Gault N, Gavin A, Gavrylov A, Gaymard A, Gebauer J, Geraud E, Gerbaud Morlaes L, Germano N, ghisulal PK, Ghosn J, Giani M, Giaquinto C, Gibson J, Gigante T, Gilg M, Gilroy E, Giordano G, Girvan M, Gissot V, Gitahi J, Giwangkancana G, Glikman D, Glybochko P, Gnall E, Goco G, Goehringer F, Goepel S, Goffard JC, Goh JY, Golob J, Gomes R, Gomez K, Gómez-Junyent J, Gominet M, Gonzalez A, Gordon P, Gordon A, Gorenne I, Goubert L, Goujard C, Goulenok T, Grable M, Graf J, Grandin EW, Granier P, Grasselli G, Grazioli L, Green CA, Greene C, Greenhalf W, Greffe S, Grieco DL, Griffee M, Griffiths F, Grigoras I, Groenendijk A, Grosse Lordemann A, Gruner H, Gu Y, Guarracino F, Guedj J, Guego M, Guellec D, Guerguerian AM, Guerreiro D, Guery R, Guillaumot A, Guilleminault L, Guimarães de Castro M, Guimard T, Haalboom M, Haber D, Habraken H, Hachemi A, Hadri N, Haidash O, Haider S, Haidri F, Hakak S, Hall A, Hall M, Halpin S, Hamer A, Hamers R, Hamidfar R, Hammond T, Han LY, Haniffa R, Hao KW, Hardwick H, Harrison EM, Harrison J, Harrison SBE, Hartman A, Hashmi J, Hashmi M, Hayat M, Hayes A, Hays L, Heerman J, Heggelund L, Hendry R, Hennessy M, Henriquez A, Hentzien M, Herekar F, Hernandez-Montfort J, Herr D, Hershey A, Hesstvedt L, Hidayah A, Higgins D, Higgins E, HigginsOKeeffe G, Hinchion R, Hinton S, Hiraiwa H, Hitoto H, Ho A, Ho YB, Hoctin A, Hoffmann I, Hoh WH, Hoiting O, Holt R, Holter JC, Horby P, Horcajada JP, Hoshino K, Hoshino K, Houas I, Hough CL, Houltham S, Hsu JMY, Hulot JS, Hussain I, Ijaz S, Illes HG, Imbert P, Imran M, Imran Sikander R, Inácio H, Infante Dominguez C, Ing YS, Iosifidis E, Ippolito M, Isgett S, Ishani PGPI, Isidoro T, Ismail N, Isnard M, Itai J, Ito A, Ivulich D, Jaafar D, Jaafoura S, Jabot J, Jackson C, Jamieson N, Jaquet P, Jassat W, Jaud-Fischer C, Jaureguiberry S, Javidfar J, Jawad I, Jaworsky D, Jayakumar D, Jego F, Jelani AM, Jenum S, Jimbo-Sotomayor R, Job VDP, Joe OY, Jorge García RN, Joseph C, Joseph M, Joshi S, Jourdain M, Jouvet P, June J, Jung A, Jung H, Juzar D, Kafif O, Kaguelidou F, Kaisbain N, Kaleesvran T, Kali S, Kalicinska A, Kalomoiri S, Kamal S, Kamaluddin MAA, Kamaruddin ZAC, Kamarudin N, Kandamby DH, Kandel C, Kang KY, Kant R, Kanwal D, Kanyawati D, Karki B, Karpayah P, Karsies T, Kartsonaki C, Kasugai D, Kataria A, Katz K, Kaur A, Kaur Johal S, Kawasaki T, Kay C, Keane H, Keating S, Kellam P, Kelly A, Kelly A, Kelly C, Kelly N, Kelly S, Kelly Y, Kelsey M, Kennedy R, Kennon K, Kernan M, Kerroumi Y, Keshav S, Kestelyn E, Khalid I, Khalid O, Khalil A, Khan C, Khan I, Khanal S, Kho ME, Khoo D, Khoo R, Khoo S, Khoso N, Kiat KH, Kida Y, Kiiza P, Kildal AB, Kim JB, Kimmoun A, Kindgen-Milles D, King A, Kitamura N, Klenerman P, Klont R, Kloumann Bekken G, Knight S, Kobbe R, Kodippily C, Kohns Vasconcelos M, Koirala S, Komatsu M, Korten V, Kosgei C, Kpangon A, Krawczyk K, Krishnan S, Krishnan V, Kruglova O, Kumar A, Kumar D, Kumar G, Kumar M, Kumar Vecham P, Kuriakose D, Kurtzman E, Kusumastuti NP, Kutsogiannis D, Kutsyna G, Kyriakoulis K, Lachatre M, Lacoste M, Laffey JG, Lagrange M, Laine F, Lairez O, Lakhey S, Lalueza A, Lambert M, Lamontagne F, Langelot-Richard M, Langlois V, Lantang EY, Lanza M, Laouénan C, Laribi S, Lariviere D, Lasry S, Latif N, Launay O, Laureillard D, Lavie-Badie Y, Law A, Lawrence C, Lawrence T, Le M, Le Bihan C, Le Bris C, Le Falher G, Le Fevre L, Le Hingrat Q, Le Maréchal M, Le Mestre S, Le Moal G, Le Moing V, Le Nagard H, Le Turnier P, Leal E, Leal Santos M, Lee BH, Lee HG, Lee J, Lee SH, Lee TC, Lee YL, Leeming G, Lefebvre B, Lefebvre L, Lefevre B, LeGac S, Lelievre JD, Lellouche F, Lemaignen A, Lemee V, Lemeur A, Lemmink G, Lene HS, Lennon J, León R, Leone M, Leone M, Lepiller Q, Lescure FX, Lesens O, Lesouhaitier M, Lester-Grant A, Levy B, Levy Y, Levy-Marchal C, Lewandowska K, L'Her E, Li Bassi G, Liang J, Liaquat A, Liegeon G, Lim KC, Lim WS, Lima C, Lina B, Lina L, Lind A, Lingas G, Lion-Daolio S, Lissauer S, Liu K, Livrozet M, Lizotte P, Loforte A, Lolong N, Loon LC, Lopes D, Lopez-Colon D, Loschner AL, Loubet P, Loufti B, Louis G, Lourenco S, Lovelace-Macon L, Low LL, Lowik M, Loy JS, Lucet JC, Lumbreras Bermejo C, Luna CM, Lungu O, Luong L, Luque N, Luton D, Lwin N, Lyons R, Maasikas O, Mabiala O, MacDonald S, MacDonald S, Machado M, Macheda G, Macias Sanchez J, Madhok J, Maestro de la Calle G, Mahieu R, Mahy S, Maia AR, Maier LS, Maillet M, Maitre T, Malfertheiner M, Malik N, Mallon P, Maltez F, Malvy D, Manda V, Mandei JM, Mandelbrot L, Manetta F, Mangal K, Mankikian J, Manning E, Manuel A, Maria Sant`Ana Malaque C, Marino D, Marino F, Markowicz S, Maroun Eid C, Marques A, Marquis C, Marsh B, Marsh L, Marshal M, Marshall J, Martelli CT, Martin DA, Martin E, Martin-Blondel G, Martinelli A, Martin-Loeches I, Martinot M, Martin-Quiros A, Martins A, Martins J, Martins N, Martins Rego C, Martucci G, Martynenko O, Marwali EM, Marzukie M, Masa Jimenez JF, Maslove D, Maslove D, Mason P, Mason S, Masood S, Masood S, Mat Nor B, Matan M, Mateus Fernandes H, Mathew M, Mathieu D, Mattei M, Matulevics R, Maulin L, Maxwell M, Maynar J, Mazzoni T, Mc Sweeney L, McAndrew L, McArthur C, McCarthy A, McCarthy A, McCloskey C, McConnochie R, McDermott S, McDonald SE, McElroy A, McElwee S, McEneany V, McEvoy N, McGeer A, McKay C, McKeown J, McLean KA, McNally P, McNicholas B, McPartlan E, Meaney E, Mear-Passard C, Mechlin M, Meher M, Mehkri O, Mele F, Melo L, Memon K, Mendes JJ, Menkiti O, Menon K, Mentré F, Mentzer AJ, Mercier E, Mercier N, Merckx A, Mergeay-Fabre M, Mergler B, Merson L, Mesquita A, Metwally O, Meybeck A, Meyer D, Meynert AM, Meysonnier V, Meziane A, Mezidi M, Michelagnoli G, Michelanglei C, Michelet I, Mihelis E, Mihnovit V, Miranda-Maldonado H, Misnan NA, Mohamed NNE, Mohamed TJ, Moin A, Molina D, Molinos E, Molloy B, Mone M, Monteiro A, Montes C, Montrucchio G, Moore S, Moore SC, Morales Cely L, Moro L, Morocho Tutillo DR, Morton B, Motherway C, Motos A, Mouquet H, Mouton Perrot C, Moyet J, Mudara C, Mufti AK, Muh NY, Muhamad D, Mullaert J, Muller F, Müller KE, Munblit D, Muneeb S, Munir N, Munshi L, Murphy A, Murphy A, Murphy L, Murris M, Murthy S, Musaab H, Muyandy G, Myrodia DM, N N, Nagpal D, Nagrebetsky A, Narasimhan M, Narayanan N, Nasim Khan R, Nazerali-Maitland A, Neant N, Neb H, Nekliudov NA, Nelwan E, Neto R, Neumann E, Neves B, Ng PY, Nghi A, Nguyen D, Ni Choileain O, Ni Leathlobhair N, Nichol A, Nitayavardhana P, Nonas S, Noordin NAM, Noret M, Norharizam NFI, Norman L, Notari A, Noursadeghi M, Nowicka K, Nowinski A, Nseir S, Nunez JI, Nurnaningsih N, Nyamankolly E, O Brien F, O'Callaghan A, Occhipinti G, OConnor D, O'Donnell M, Ogston T, Ogura T, Oh TH, O'Halloran S, O'Hearn K, Ohshimo S, Oldakowska A, Oliveira J, Oliveira L, Olliaro PL, O'Neil C, Ong DS, Ong JY, Oosthuyzen W, Opavsky A, Openshaw P, Orakzai S, Orozco-Chamorro CM, Orquera A, Ortoleva J, Osatnik J, O'Shea L, O'Sullivan M, Othman SZ, Ouamara N, Ouissa R, Owyang C, Oziol E, Pabasara HMU, Pagadoy M, Pages J, Palacios A, Palacios M, Palmarini M, Panarello G, Panda PK, Paneru H, Pang LH, Panigada M, Pansu N, Papadopoulos A, Parke R, Parker M, Parra B, Parrini V, Pasha T, Pasquier J, Pastene B, Patauner F, Patel J, Pathmanathan MD, Patrão L, Patricio P, Patrier J, Patterson L, Pattnaik R, Paul C, Paul M, Paulos J, Paxton WA, Payen JF, Peariasamy K, Pedrera Jiménez M, Peek GJ, Peelman F, Peiffer-Smadja N, Peigne V, Pejkovska M, Pelosi P, Peltan ID, Pereira R, Perez D, Periel L, Perpoint T, Pesenti A, Pestre V, Petrou L, Petrov-Sanchez V, Pettersen FO, Peytavin G, Pharand S, Piagnerelli M, Picard W, Picone O, Piero MD, Pierobon C, Piersma D, Pimentel C, Pinto R, Pires C, Pironneau I, Piroth L, Pius R, Piva S, Plantier L, Plotkin D, Png HS, Poissy J, Pokeerbux R, Pokorska-Spiewak M, Poli S, Pollakis G, Ponscarme D, Popielska J, Post AM, Postma DF, Povoa P, Póvoas D, Powis J, Prapa S, Preau S, Prebensen C, Preiser JC, Prinssen A, Pritchard MG, Priyadarshani GDD, Proença L, Pudota S, Puéchal O, Pujo Semedi B, Pulicken M, Puntoni M, Purcell G, Quesada L, Quinones-Cardona V, Quirós González V, Quist-Paulsen E, Quraishi M, Rabaa M, Rabaud C, Rabindrarajan E, Rafael A, Rafiq M, Ragazzo G, Rahman AKHA, Rahman RA, Rahutullah A, Rainieri F, Rajahram GS, Rajapakse N, Ralib A, Ramakrishnan N, Ramanathan K, Ramli AA, Rammaert B, Ramos GV, Rana A, Rangappa R, Ranjan R, Rapp C, Rashan A, Rashan T, Rasheed G, Rasmin M, Rätsep I, Rau C, Ravi T, Raza A, Real A, Rebaudet S, Redl S, Reeve B, Rehan A, Rehman A, Reid L, Reid L, Reikvam DH, Reis R, Rello J, Remppis J, Remy M, Ren H, Renk H, Resende L, Resseguier AS, Revest M, Rewa O, Reyes LF, Reyes T, Ribeiro MI, Richardson D, Richardson D, Richier L, Ridzuan SNAA, Riera J, Rios AL, Rishu A, Rispal P, Risso K, Rivera Nuñez MA, Rizer N, Robb D, Robba C, Roberto A, Roberts S, Robertson DL, Robineau O, Roche-Campo F, Rodari P, Rodeia S, Rodriguez Abreu J, Roessler B, Roger C, Roger PM, Roilides E, Rojek A, Romaru J, Roncon-Albuquerque Jr R, Roriz M, Rosa-Calatrava M, Rose M, Rosenberger D, Rossanese A, Rossetti M, Rossignol B, Rossignol P, Rousset S, Roy C, Roze B, Rusmawatiningtyas D, Russell CD, Ryan M, Ryan M, Ryckaert S, Rygh Holten A, Saba I, Sadaf S, Sadat M, Sahraei V, Saint-Gilles M, Sakiyalak P, Salahuddin N, Salazar L, Saleem J, Saleem J, Sales G, Sallaberry S, Salmon Gandonniere C, Salvator H, Sanchez O, Sánchez Choez X, Sanchez de Oliveira K, Sanchez-Miralles A, Sancho-Shimizu V, Sandhu G, Sandhu Z, Sandrine PF, Sandulescu O, Santos M, Sarfo-Mensah S, Sarmento Banheiro B, Sarmiento ICE, Sarton B, Satyapriya S, Satyawati R, Saviciute E, Savio R, Savvidou P, Saw YT, Schaffer J, Schermer T, Scherpereel A, Schneider M, Schroll S, Schwameis M, Schwartz G, Scott JT, Scott-Brown J, Sedillot N, Seitz T, Selvanayagam J, Selvarajoo M, Semaille C, Semple MG, Senian RB, Senneville E, Sepulveda C, Sequeira F, Sequeira T, Serpa Neto A, Serrano Balazote P, Shadowitz E, Shahidan SA, Shahnaz Hasan M, Shamsah M, Shankar A, Sharjeel S, Sharma P, Shaw CA, Shaw V, Shi H, Shiban N, Shiekh M, Shiga T, Shime N, Shimizu H, Shimizu K, Shimizu N, Shindo N, Shrapnel S, Shum HP, Si Mohammed N, Siang NY, Sibiude J, Siddiqui A, Sigfrid L, Sillaots P, Silva C, Silva MJ, Silva R, Sim Lim Heng B, Sin WC, Singh BC, Singh P, Sitompul PA, Sivam K, Skogen V, Smith S, Smood B, Smyth C, Smyth M, Smyth M, Snacken M, So D, Soh TV, Solis M, Solomon J, Solomon T, Somers E, Sommet A, Song MJ, Song R, Song T, Song Chia J, Sonntagbauer M, Soom AM, Sotto A, Soum E, Sousa AC, Sousa M, Sousa Uva M, Souza-Dantas V, Sperry A, Spinuzza E, Sri Darshana BPSR, Sriskandan S, Stabler S, Staudinger T, Stecher SS, Steinsvik T, Stienstra Y, Stiksrud B, Stolz E, Stone A, Streinu-Cercel A, Streinu-Cercel A, Strudwick S, Stuart A, Stuart D, Subekti D, Suen G, Suen JY, Sukumar P, Sultana A, Summers C, Supic D, Suppiah D, Surovcová M, Suwarti S, Svistunov AA, Syahrin S, Syrigos K, Sztajnbok J, Szuldrzynski K, Tabrizi S, Taccone FS, Tagherset L, Taib SM, Talarek E, Taleb S, Talsma J, Tampubolon ML, Tan KK, Tan LV, Tan YC, Tanaka C, Tanaka H, Tanaka T, Taniguchi H, Tanveer H, Taqdees H, Taqi A, Tardivon C, Tattevin P, Taufik MA, Tawfik H, Tedder RS, Tee TY, Teixeira J, Tejada S, Tellier MC, Teoh SK, Teotonio V, Téoulé F, Terpstra P, Terrier O, Terzi N, Tessier-Grenier H, Tey A, Thabit AAM, Tham ZD, Thangavelu S, Thibault V, Thiberville SD, Thill B, Thirumanickam J, Thompson S, Thomson D, Thomson EC, Thurai SRT, Thuy DB, Thwaites RS, Tierney P, Tieroshyn V, Timashev PS, Timsit JF, Tirupakuzhi Vijayaraghavan BK, Tissot N, Toh JZY, Toki M, Tolppa T, Tonby K, Tonnii SL, Torres A, Torres M, Torres Santos-Olmo RM, Torres-Zevallos H, Towers M, Trapani T, Traynor D, Treoux T, Trieu HT, Tripathy S, Tromeur C, Trontzas I, Trouillon T, Truong J, Tual C, Tubiana S, Tuite H, Turmel JM, Turtle LC, Tveita A, Twardowski P, Uchiyama M, Udayanga PGI, Udy A, Ullrich R, Umer Z, Uribe A, Usman A, Vajdovics C, Val-Flores L, Valle AL, Valran A, Van de Velde S, van den Berge M, van der Feltz M, van der Valk P, Van Der Vekens N, Van der Voort P, Van Der Werf S, van Dyk M, van Gulik L, Van Hattem J, van Lelyveld S, van Netten C, Van Twillert G, van Veen I, Vanel N, Vanoverschelde H, Varghese P, Varrone M, Vasudayan SR, Vauchy C, Vaughan H, Veeran S, Veislinger A, Vencken S, Ventura S, Verbon A, Vidal JE, Vieira C, Vijayan D, Villanueva JA, Villar J, Villeneuve PM, Villoldo A, Vinh Chau NV, Visseaux B, Visser H, Vitiello C, Vonkeman H, Vuotto F, Wahab NH, Wahab SA, Wahid NA, Wainstein M, Wan Muhd Shukeri WF, Wang CH, Webb SA, Wei J, Weil K, Wen TP, Wesselius S, West TE, Wham M, Whelan B, White N, Wicky PH, Wiedemann A, Wijaya SO, Wille K, Willems S, Williams V, Wils EJ, Wing Yiu N, Wong C, Wong TF, Wong XC, Wong YS, Xian GE, Xian LS, Xuan KP, Xynogalas I, Yacoub S, Yakop SRBM, Yamazaki M, Yazdanpanah Y, Yee Liang Hing N, Yelnik C, Yeoh CH, Yerkovich S, Yokoyama T, Yonis H, Yousif O, Yuliarto S, Zaaqoq A, Zabbe M, Zacharowski K, Zahid M, Zahran M, Zaidan NZB, Zambon M, Zambrano M, Zanella A, Zawadka K, Zaynah N, Zayyad H, Zoufaly A, Zucman D. The value of open-source clinical science in pandemic response: lessons from ISARIC. Lancet Infect Dis 2021; 21:1623-1624. [PMID: 34619109 PMCID: PMC8489876 DOI: 10.1016/s1473-3099(21)00565-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/16/2021] [Indexed: 12/31/2022]
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Bisbal M, Darmon M, Saillard C, Mallet V, Mouliade C, Lemiale V, Benoit D, Pene F, Kouatchet A, Demoule A, Vincent F, Nyunga M, Bruneel F, Lebert C, Renault A, Meert AP, Hamidfar R, Jourdain M, Azoulay E, Mokart D. Hepatic dysfunction impairs prognosis in critically ill patients with hematological malignancies: A post-hoc analysis of a prospective multicenter multinational dataset. J Crit Care 2020; 62:88-93. [PMID: 33310587 DOI: 10.1016/j.jcrc.2020.11.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 09/09/2020] [Revised: 11/26/2020] [Accepted: 11/30/2020] [Indexed: 11/15/2022]
Abstract
PURPOSE Hyperbilirubinemia is frequent in patients with hematological malignancies admitted to the intensive care unit (ICU). Literature about hepatic dysfunction (HD) in this context is scarce. METHODS We investigated the prognostic impact of HD analyzing a prospective multicenter cohort of 893 critically ill hematology patients. Two groups were defined: patients with HD (total bilirubin ≥33 μmol/L at ICU admission) and patients without HD. RESULTS Twenty one percent of patients were found to have HD at ICU admission. Cyclosporine, antimicrobials before ICU admission, abdominal symptoms, ascites, history of liver disease, neutropenia, increased serum creatinine and myeloma were independently associated with HD. Etiology remained undetermined in 73% of patients. Hospital mortality was 56.3% and 36.3% respectively in patients with and without HD (p < 0.0001). Prognostic factors independently associated with hospital mortality in HD group were, performance status >1 (OR = 2.07, 95% CI = 1.49-2.87, p < 0.0001), invasive mechanical ventilation (OR = 3.92, 95% CI = 2.69-5.71, p < 0.0001), renal replacement therapy (OR = 1.74, 95% CI = 1.22-2.47, p = 0.002), vasoactive drug (OR = 1.81, 95% CI = 1.21-2.71, p = 0.004) and SOFA score without bilirubin level at ICU admission (OR = 1.09, 95% CI = 1.04-1.14, p < 0.0001). CONCLUSIONS HD is common, underestimated, infrequently investigated, and is associated with impaired outcome in critically ill hematology patients. HD should be considered upon ICU admission and managed as other organ dysfunctions.
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Affiliation(s)
- Magali Bisbal
- Intensive Care Unit, Institut Paoli Calmettes, Marseille, France.
| | - Michael Darmon
- Medical Intensive Care Unit, Saint Louis Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Paris Diderot Sorbonne University, Paris, France
| | - Colombe Saillard
- Departement of Hematology, Institut Paoli-Calmettes, Marseille, France
| | - Vincent Mallet
- Departement of Hepatology, Cochin Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Université de Paris, Paris, France
| | - Charlotte Mouliade
- Departement of Hepatology, Cochin Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Université de Paris, Paris, France
| | - Virginie Lemiale
- Medical Intensive Care Unit, Saint Louis Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Paris Diderot Sorbonne University, Paris, France
| | | | - Frederic Pene
- Medical Intensive Care Unit, Cochin Hospital, Assistance Publique - Hôpitaux de Paris (APHP) and University Paris Descartes, Paris, France
| | - Achille Kouatchet
- Medical Intensive Care Unit, Angers Teaching Hospital, Angers, France
| | - Alexandre Demoule
- Intensive Care Unit, Pitié Salpêtrière Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Université de Paris, Paris, France
| | | | | | - Fabrice Bruneel
- Intensive Care Unit, Versailles Hospital, Versailles, France
| | - Christine Lebert
- Intensive Care Unit, La Roche-sur-Yon Hospital, La Roche-sur-Yon, France
| | - Anne Renault
- Intensive Care Unit, Brest Hospital, Brest, France
| | | | - Rebecca Hamidfar
- Intensive Care Unit, Grenoble Teaching Hospital, Grenoble, France
| | - Merce Jourdain
- Intensive Care Unit, Roger Salengro Hospital, CHU, Lille, France
| | - Elie Azoulay
- Medical Intensive Care Unit, Saint Louis Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Paris Diderot Sorbonne University, Paris, France
| | - Djamel Mokart
- Intensive Care Unit, Institut Paoli Calmettes, Marseille, France
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Raëth J, Tomio A, Eugene A, Mouffak A, Durand M, Hamidfar R, Pison C, Pluchart H, Mounayar AL. Immunosuppression in a lung transplant recipient with COVID-19? Lessons from an early case. Respir Med Res 2020; 78:100782. [PMID: 32801101 PMCID: PMC7833068 DOI: 10.1016/j.resmer.2020.100782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/09/2020] [Accepted: 07/23/2020] [Indexed: 11/03/2022]
Affiliation(s)
- J Raëth
- Pôle thorax et vaisseaux, service hospitalier universitaire pneumologie, CHU Grenoble Alpes, Grenoble, France; Université Grenoble Alpes, Grenoble, France
| | - A Tomio
- Pôle thorax et vaisseaux, service hospitalier universitaire pneumologie, CHU Grenoble Alpes, Grenoble, France; Université Grenoble Alpes, Grenoble, France
| | - A Eugene
- Université Grenoble Alpes, Grenoble, France; Pôle pharmacie, CHU Grenoble Alpes, Grenoble, France
| | - A Mouffak
- Université Grenoble Alpes, Grenoble, France; Centre régional de pharmacovigilance, centre hospitalier universitaire Grenoble-Alpes, 38000 Grenoble, France
| | - M Durand
- Pôle anesthésie réanimation, CHU Grenoble Alpes, Grenoble, France
| | - R Hamidfar
- Pôle thorax et vaisseaux, service hospitalier universitaire pneumologie, CHU Grenoble Alpes, Grenoble, France
| | - C Pison
- Pôle thorax et vaisseaux, service hospitalier universitaire pneumologie, CHU Grenoble Alpes, Grenoble, France; Université Grenoble Alpes, Grenoble, France.
| | - H Pluchart
- Université Grenoble Alpes, Grenoble, France; Pôle pharmacie, CHU Grenoble Alpes, Grenoble, France; TIMC-IMAG UMR5525/ThEMAS, CNRS, université Grenoble Alpes, Grenoble, France
| | - A L Mounayar
- Pôle urgence médecine aiguë, service des maladies infectieuses et tropicales, CHU Grenoble Alpes, Grenoble, France
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Garrouste-Orgeas M, Flahault C, Vinatier I, Rigaud JP, Thieulot-Rolin N, Mercier E, Rouget A, Grand H, Lesieur O, Tamion F, Hamidfar R, Renault A, Parmentier-Decrucq E, Monseau Y, Argaud L, Bretonnière C, Lautrette A, Badié J, Boulet E, Floccard B, Forceville X, Kipnis E, Soufir L, Valade S, Bige N, Gaffinel A, Hamzaoui O, Simon G, Thirion M, Bouadma L, Large A, Mira JP, Amdjar-Badidi N, Jourdain M, Jost PH, Maxime V, Santoli F, Ruckly S, Vioulac C, Leborgne MA, Bellalou L, Fasse L, Misset B, Bailly S, Timsit JF. Effect of an ICU Diary on Posttraumatic Stress Disorder Symptoms Among Patients Receiving Mechanical Ventilation: A Randomized Clinical Trial. JAMA 2019; 322:229-239. [PMID: 31310299 PMCID: PMC6635906 DOI: 10.1001/jama.2019.9058] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [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: 12/14/2022]
Abstract
IMPORTANCE Keeping a diary for patients while they are in the intensive care unit (ICU) might reduce their posttraumatic stress disorder (PTSD) symptoms. OBJECTIVES To assess the effect of an ICU diary on the psychological consequences of an ICU hospitalization. DESIGN, SETTING, AND PARTICIPANTS Assessor-blinded, multicenter, randomized clinical trial in 35 French ICUs from October 2015 to January 2017, with follow-up until July 2017. Among 2631 approached patients, 709 adult patients (with 1 family member each) who received mechanical ventilation within 48 hours after ICU admission for at least 2 days were eligible, 657 were randomized, and 339 were assessed 3 months after ICU discharge. INTERVENTIONS Patients in the intervention group (n = 355) had an ICU diary filled in by clinicians and family members. Patients in the control group (n = 354) had usual ICU care without an ICU diary. MAIN OUTCOMES AND MEASURES The primary outcome was significant PTSD symptoms, defined as an Impact Event Scale-Revised (IES-R) score greater than 22 (range, 0-88; a higher score indicates more severe symptoms), measured in patients 3 months after ICU discharge. Secondary outcomes, also measured at 3 months and compared between groups, included significant PTSD symptoms in family members; significant anxiety and depression symptoms in patients and family members, based on a Hospital Anxiety and Depression Scale score greater than 8 for each subscale (range, 0-42; higher scores indicate more severe symptoms; minimal clinically important difference, 2.5); and patient memories of the ICU stay, reported with the ICU memory tool. RESULTS Among 657 patients who were randomized (median [interquartile range] age, 62 [51-70] years; 126 women [37.2%]), 339 (51.6%) completed the trial. At 3 months, significant PTSD symptoms were reported by 49 of 164 patients (29.9%) in the intervention group vs 60 of 175 (34.3%) in the control group (risk difference, -4% [95% CI, -15% to 6%]; P = .39). The median (interquartile range) IES-R score was 12 (5-25) in the intervention group vs 13 (6-27) in the control group (difference, -1.47 [95% CI, -1.93 to 4.87]; P = .38). There were no significant differences in any of the 6 prespecified comparative secondary outcomes. CONCLUSIONS AND RELEVANCE Among patients who received mechanical ventilation in the ICU, the use of an ICU diary filled in by clinicians and family members did not significantly reduce the number of patients who reported significant PTSD symptoms at 3 months. These findings do not support the use of ICU diaries for preventing PTSD symptoms. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02519725.
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Affiliation(s)
- Maité Garrouste-Orgeas
- Infection, Antimicrobials, Modelling, Evolution (IAME), UMR 1137, INSERM, Paris Diderot University, Department of Biostatistics - HUPNVS. - AP-HP, UFR de Médecine - Bichat University Hospital, Paris, France
- Department of Biostatistics, Outcomerea, Paris, France
- Medical unit, French British Hospital, Levallois-Perret, France
| | - Cécile Flahault
- LPPS-EA4057, Laboratory of Psychopathology and Health Process, Paris Descartes University, Paris, France
| | - Isabelle Vinatier
- Medical ICU, Les Oudaries Hospital, La Roche-sur-Yon, Vendée, France
| | | | | | - Emmanuelle Mercier
- CRICS-TRIGGERSEP group, Medical-Surgical ICU, Tours University Hospital, Tours, France
| | - Antoine Rouget
- Medical-Surgical ICU, Rangueil University Hospital, Toulouse, France
| | - Hubert Grand
- Medical-Surgical ICU, Hospital Robert Boulin, Libourne, France
| | | | - Fabienne Tamion
- Medical ICU, University Medical Center, Rouen, France
- INSERM U-1096, University of Rouen, Rouen, France
| | - Rebecca Hamidfar
- Medical ICU, Albert Michallon University Hospital, Grenoble, France
| | - Anne Renault
- Medical ICU, La Cavale Blanche University Hospital, Brest, France
| | | | | | - Laurent Argaud
- Medical ICU, Edouard Herriot University Hospital, Lyon, France
| | - Cédric Bretonnière
- Medical ICU, Nantes University Hospital, Nantes, France
- EA3826, Laboratory of Clinical and Experimental Therapeutics of Infections, University of Nantes, Nantes, France
| | - Alexandre Lautrette
- Medical ICU, Gabriel-Montpied University Hospital, Clermont Ferrand, France
- LMGE UMR CNRS 6023, University of Clermont-Ferrand, Clermont Ferrand, France
| | - Julio Badié
- Medical-Surgical ICU, General Hospital Belfort-Montbéliard, Belfort, France
| | - Eric Boulet
- Medical ICU, Beaumont General Hospital, Beaumont, France
| | - Bernard Floccard
- Medical ICU, Hospices Civils de Lyon, Edouard Herriot University Hospital, Lyon, France
| | - Xavier Forceville
- Medical-Surgical ICU, Great Hospital of East Francilien, Meaux, France
| | - Eric Kipnis
- Surgical ICU, Lille University Hospital, Lille, France
| | - Lilia Soufir
- Medical-Surgical ICU, Saint Joseph Hospital Network, Paris, France
| | | | - Naike Bige
- Medical ICU, Saint Antoine University Hospital, Paris, France
| | - Alain Gaffinel
- Medical-Surgical ICU, Gustave Roussy Cancer Campus, Villejuif, France
| | - Olfa Hamzaoui
- Medical Surgical ICU, University Hospital Paris -Sud, Beclère University Hospital, Clamart, France
| | - Georges Simon
- Medical-Surgical ICU, General Hospital, Troyes, France
| | - Marina Thirion
- Medical-Surgical ICU, General Hospital Victor Dupouy, Argenteuil, France
| | - Lila Bouadma
- Infection, Antimicrobials, Modelling, Evolution (IAME), UMR 1137, INSERM, Paris Diderot University, Department of Biostatistics - HUPNVS. - AP-HP, UFR de Médecine - Bichat University Hospital, Paris, France
- Medical ICU, Bichat University Hospital, Paris, France
| | - Audrey Large
- Medical ICU, François Mitterrand University Hospital, Dijon, France
| | - Jean-Paul Mira
- Medical ICU, Cochin University Hospital, Paris Centre Hospital Group, AP-HP, Paris, France
| | | | - Mercé Jourdain
- Group of medical ICUs, Lille University Hospital, Lille, France
- Lille University, Inserm U1190, Lille, France
| | - Paul-Henri Jost
- Surgical ICU, Henri Mondor University Hospital, Créteil, France
| | - Virginie Maxime
- Medical ICU, Raymond Poincaré University Hospital, Garches, France
| | - François Santoli
- Medical ICU, General Hospital Robert Ballanger, Aulnay-Sous-Bois, France
| | | | - Christel Vioulac
- LPPS-EA4057, Laboratory of Psychopathology and Health Process, Paris Descartes University, Paris, France
| | - Marie Annick Leborgne
- LPPS-EA4057, Laboratory of Psychopathology and Health Process, Paris Descartes University, Paris, France
| | - Lucie Bellalou
- LPPS-EA4057, Laboratory of Psychopathology and Health Process, Paris Descartes University, Paris, France
| | - Léonor Fasse
- LPPS-EA4057, Laboratory of Psychopathology and Health Process, Paris Descartes University, Paris, France
| | - Benoit Misset
- Medical ICU, University Medical Center, Rouen, France
| | - Sébastien Bailly
- Infection, Antimicrobials, Modelling, Evolution (IAME), UMR 1137, INSERM, Paris Diderot University, Department of Biostatistics - HUPNVS. - AP-HP, UFR de Médecine - Bichat University Hospital, Paris, France
- Grenoble Alpes University, INSERM, University hospital Grenoble Alpes, HP2, Grenoble, France
| | - Jean-François Timsit
- Infection, Antimicrobials, Modelling, Evolution (IAME), UMR 1137, INSERM, Paris Diderot University, Department of Biostatistics - HUPNVS. - AP-HP, UFR de Médecine - Bichat University Hospital, Paris, France
- Department of Biostatistics, Outcomerea, Paris, France
- Medical ICU, Bichat University Hospital, Paris, France
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8
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Ehooman F, Biard L, Lemiale V, Contou D, de Prost N, Mokart D, Pène F, Kouatchet A, Mayaux J, Demoule A, Vincent F, Nyunga M, Bruneel F, Rabbat A, Lebert C, Perez P, Meert AP, Benoit D, Hamidfar R, Darmon M, Azoulay E, Zafrani L. Long-term health-related quality of life of critically ill patients with haematological malignancies: a prospective observational multicenter study. Ann Intensive Care 2019; 9:2. [PMID: 30612249 PMCID: PMC6320707 DOI: 10.1186/s13613-018-0478-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 12/24/2018] [Indexed: 12/18/2022] Open
Abstract
Background Although outcomes of critically ill patients with haematological malignancies (HMs) have been fully investigated in terms of organ failure and mortality, data are scarce on health-related quality of life (HRQOL) in this population. We aim to assess post-intensive care unit (ICU) burden and HRQOL of critically ill patients with HMs and to identify risk factors for quality-of-life (QOL) impairment. Results In total, 1011 patients with HMs who required ICU admission in 17 ICUs in France and Belgium were included in the study; 278 and 117 patients were evaluated for QOL at 3 months and 1 year, respectively, after ICU discharge. HRQOL was determined by applying the interview form of the Short Form 36 (SF-36) questionnaire. Psychological distress symptoms were evaluated using the Hospital Anxiety Depression Score (HADS) and the Impact of Event Scale (IES). In-hospital mortality rates at 3 months and 1 year were, respectively, 39.1, 50.7 and 57.2%, respectively. At 3 months, median [IQR] physical and mental component summary scores (PCS and MCS) (SF-36) were 37 [28–46] and 51 [45–58], respectively. PCS was lower in ICU patients with HMs when compared to general ICU septic patients (52 [5–13], p = 0.00001). The median combined HAD score was 8 [5–13], and the median IES score was 8 [3–16]. However, recovery during the first year after ICU discharge was not consistent in all dimensions of HRQOL. Three months after ICU discharge, the maximum daily Sequential Organ Failure Assessment score and status of the underlying malignancy at ICU admission were significantly associated with MCS impairment (− 0.54 points [95% CI − 0.99; − 0.1], p = 0.018 and − 4.83 points [95% CI − 8.44; − 1.22], p = 0.009, respectively). Conclusion HRQOL is strongly impaired in critically ill patients with HMs at 3 months and 1 year after ICU discharge. Organ failure and disease status are strongly associated with QOL. The kinetic evaluation of QOL at 3 months and 1 year offers the opportunity to focus on QOL aspects that may be improved by therapeutic interventions during the first year after ICU discharge. Electronic supplementary material The online version of this article (10.1186/s13613-018-0478-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Franck Ehooman
- Medical ICU, Saint-Louis Teaching Hospital, 1 Avenue Claude Vellefaux, 75010, Paris, France
| | - Lucie Biard
- Biostatistics Department, Saint-Louis Teaching Hospital, Paris, France
| | - Virginie Lemiale
- Medical ICU, Saint-Louis Teaching Hospital, 1 Avenue Claude Vellefaux, 75010, Paris, France
| | - Damien Contou
- Medical ICU, Henri Mondor Teaching Hospital, Paris, France.,ICU, Albert Michallon University Hospital, Grenoble, France.,ICU, Saint-Etienne University Hospital, Saint-Etienne, France
| | - Nicolas de Prost
- Medical ICU, Henri Mondor Teaching Hospital, Paris, France.,ICU, Albert Michallon University Hospital, Grenoble, France.,ICU, Saint-Etienne University Hospital, Saint-Etienne, France
| | - Djamel Mokart
- Medical ICU, Henri Mondor Teaching Hospital, Paris, France
| | | | | | - Julien Mayaux
- Medical ICU, Angers Teaching Hospital, Angers, France
| | | | | | | | | | | | | | | | | | - Dominique Benoit
- Service soins intensifs et urgences oncologiques, Institut Jules Bordet, Brussels, Belgium
| | | | - Michael Darmon
- ICU, Albert Michallon University Hospital, Grenoble, France
| | - Elie Azoulay
- Medical ICU, Saint-Louis Teaching Hospital, 1 Avenue Claude Vellefaux, 75010, Paris, France
| | - Lara Zafrani
- Medical ICU, Saint-Louis Teaching Hospital, 1 Avenue Claude Vellefaux, 75010, Paris, France.
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9
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Mignard X, Biard L, Lemiale V, Mokart D, Pène F, Kouatchet A, Mayaux J, Vincent F, Nyunga M, Bruneel F, Rabbat A, Lebert C, Perez P, Meert AP, Benoit D, Hamidfar R, Darmon M, Azoulay E, Zafrani L. Granulocyte colony-stimulating factor and respiratory status of critically ill neutropenic patients with hematologic malignancies. Leuk Lymphoma 2018; 60:1156-1163. [PMID: 30277108 DOI: 10.1080/10428194.2018.1516874] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
In patients with hematologic malignancies, respiratory status may deteriorate during neutropenia recovery. This multicenter, observational study aims to evaluate granulocyte colony-stimulating factor (G-CSF) impact on respiratory status in critically ill neutropenic patients. Among 1011 critically ill patients with hematologic malignancies, 288 were neutropenic and included in this study. 201 (70%) did not receive G-CSF at day 1 or 2. After propensity score matching for the probability of receiving G-CSF at day 1 or 2, there was no association between G-CSF and respiratory deterioration at day 14 (OR =1.19; 95%CI (0.57-2.51); p = .64). Additional sensitivity analysis in patients admitted for acute respiratory failure showed similar results (OR =1.34; 95%CI (0.5-3.59); p = .57). Among patients who recovered from neutropenia, 75% experienced respiratory deterioration during neutropenia recovery. This study confirms that neutropenia recovery is a situation at risk of respiratory deterioration. However, whether G-CSF is an aggravating factor cannot be supported by our results.
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Affiliation(s)
- Xavier Mignard
- a Medical ICU , Saint-Louis Teaching Hospital , Paris , France
| | - Lucie Biard
- b Department of Biostatistics , Saint-Louis Teaching Hospital , Paris , France
| | | | - Djamel Mokart
- c ICU , Paoli Calmette Institute , Marseille , France
| | | | | | - Julien Mayaux
- f Medical ICU , Pitié-Salpétrière Teaching Hospital , Paris , France
| | | | | | | | - Antoine Rabbat
- j Respiratory Unit , Cochin Teaching Hospital , Paris , France
| | | | - Pierre Perez
- l ICU , Brabois Teaching Hospital , Nancy , France
| | - Anne-Pascale Meert
- m Service soins intensifs et urgences oncologiques , Institut Jules Bordet , Brussels , Belgium
| | | | - Rebecca Hamidfar
- o ICU , Albert Michallon University Hospital , Grenoble , France
| | - Michael Darmon
- p ICU , Saint-Etienne University Hospital , Saint-Etienne , France
| | - Elie Azoulay
- a Medical ICU , Saint-Louis Teaching Hospital , Paris , France
| | - Lara Zafrani
- a Medical ICU , Saint-Louis Teaching Hospital , Paris , France
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10
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Mirouse A, Resche-Rigon M, Lemiale V, Mokart D, Kouatchet A, Mayaux J, Vincent F, Nyunga M, Bruneel F, Rabbat A, Lebert C, Perez P, Renault A, Meert AP, Benoit D, Hamidfar R, Jourdain M, Darmon M, Azoulay E, Pène F. Red blood cell transfusion in the resuscitation of septic patients with hematological malignancies. Ann Intensive Care 2017; 7:62. [PMID: 28608137 PMCID: PMC5468360 DOI: 10.1186/s13613-017-0292-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Accepted: 06/02/2017] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Indications for red blood cell (RBC) transfusion in septic acute circulatory failure remain unclear. We addressed the practices and the prognostic impact of RBC transfusion in the early resuscitation of severe sepsis and septic shock in patients with hematological malignancies. METHODS We performed a retrospective analysis of a prospectively collected database of patients with hematological malignancies who required intensive care unit (ICU) admission in 2010-2011. Patients with a main admission diagnosis of severe sepsis or septic shock were included in the present study. We assessed RBC transfusion during the first two days as part of initial resuscitation. RESULTS Among the 1011 patients of the primary cohort, 631 (62.4%) were admitted to the ICU for severe sepsis (55%) or septic shock (45%). Among them, 210 (33.3%) patients received a median of 2 [interquartile 1-3] packed red cells during the first 48 h. Hemoglobin levels were lower in transfused patients at days 1 and 2 and became similar to those of non-transfused patients at day 3. Early RBC transfusion was more likely in patients with myeloid neoplasms and neutropenia. Transfused patients displayed more severe presentations as assessed by higher admission SOFA scores and blood lactate levels and the further requirements for organ failure supports. RBC transfusion within the first two days was associated with higher day 7 (20.5 vs. 13.3%, p = 0.02), in-ICU (39 vs. 25.2%, p < 0.001) and in-hospital (51 vs. 36.6%, p < 0.001) mortality rates. RBC transfusion remained independently associated with increased in-hospital mortality in multivariate logistic regression (OR 1.52 [1.03-2.26], p = 0.03) and propensity score-adjusted (OR 1.64 [1.05-2.57], p = 0.03) analysis. CONCLUSIONS RBC transfusion is commonly used in the early resuscitation of septic patients with hematological malignancies. Although it was preferentially provided to the most severe patients, we found it possibly associated with an increased risk of death.
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Affiliation(s)
- Adrien Mirouse
- Réanimation médicale, hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP) and Université Paris Descartes, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Matthieu Resche-Rigon
- Département de biostatistiques, Hôpital Saint-Louis, AP-HP and Université Paris Diderot, Paris, France
| | - Virginie Lemiale
- Réanimation médicale, Hôpital Saint-Louis, AP-HP and Université Paris Diderot, Paris, France
| | - Djamel Mokart
- Département d’anesthésie-réanimation, Institut Paoli-Calmettes, Marseille, France
| | - Achille Kouatchet
- Réanimation médicale et médecine hyperbare, CHU d’Angers, Angers, France
| | - Julien Mayaux
- Réanimation médicale, Hôpital de la Pitié-Salpêtrière, AP-HP and Université Pierre et Marie Curie, Paris, France
| | - François Vincent
- Réanimation polyvalente, Centre Hospitalier Intercommunal, Montfermeil, France
| | | | - Fabrice Bruneel
- Réanimation polyvalente, Hôpital André Mignot, Le Chesnay, France
| | - Antoine Rabbat
- Unité de soins intensifs respiratoires, Hôpital Cochin, AP-HP and Université Paris Descartes, Paris, France
| | - Christine Lebert
- Réanimation polyvalente, Centre Hospitalier Départemental, La Roche-sur-Yon, France
| | - Pierre Perez
- Réanimation médicale, Hôpital Brabois, Nancy, France
| | - Anne Renault
- Réanimation médicale, Centre Hospitalier de Brest, Brest, France
| | - Anne-Pascale Meert
- Service des soins intensifs et urgences oncologiques, Institut Jules Bordet, Brussels, Belgium
| | | | | | - Mercé Jourdain
- Université de Lille and Réanimation Polyvalente, CHU de Lille, Lille, France
| | - Michaël Darmon
- Réanimation médicale, Centre Hospitalier de Saint-Etienne, Saint-Etienne, France
| | - Elie Azoulay
- Réanimation médicale, Hôpital Saint-Louis, AP-HP and Université Paris Diderot, Paris, France
| | - Frédéric Pène
- Réanimation médicale, hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP) and Université Paris Descartes, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - on behalf of the Groupe de Recherche sur la Réanimation Respiratoire en Onco-Hématologie (Grrr-OH)
- Réanimation médicale, hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP) and Université Paris Descartes, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France
- Département de biostatistiques, Hôpital Saint-Louis, AP-HP and Université Paris Diderot, Paris, France
- Réanimation médicale, Hôpital Saint-Louis, AP-HP and Université Paris Diderot, Paris, France
- Département d’anesthésie-réanimation, Institut Paoli-Calmettes, Marseille, France
- Réanimation médicale et médecine hyperbare, CHU d’Angers, Angers, France
- Réanimation médicale, Hôpital de la Pitié-Salpêtrière, AP-HP and Université Pierre et Marie Curie, Paris, France
- Réanimation polyvalente, Centre Hospitalier Intercommunal, Montfermeil, France
- Centre Hospitalier de Roubaix, Roubaix, France
- Réanimation polyvalente, Hôpital André Mignot, Le Chesnay, France
- Unité de soins intensifs respiratoires, Hôpital Cochin, AP-HP and Université Paris Descartes, Paris, France
- Réanimation polyvalente, Centre Hospitalier Départemental, La Roche-sur-Yon, France
- Réanimation médicale, Hôpital Brabois, Nancy, France
- Réanimation médicale, Centre Hospitalier de Brest, Brest, France
- Service des soins intensifs et urgences oncologiques, Institut Jules Bordet, Brussels, Belgium
- Ghent University Hospital, Ghent, Belgium
- Réanimation médicale, CHU Grenoble-Alpes, Grenoble, France
- Université de Lille and Réanimation Polyvalente, CHU de Lille, Lille, France
- Réanimation médicale, Centre Hospitalier de Saint-Etienne, Saint-Etienne, France
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11
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Perolat R, Stephanov O, Mounier A, Thiebaut A, Pirvu A, Hamidfar R, Ferretti G. Signe du halo inversé chez un patient neutropénique fébrile. Rev Mal Respir 2017; 34:778-781. [DOI: 10.1016/j.rmr.2016.08.007] [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] [Received: 06/02/2016] [Accepted: 08/29/2016] [Indexed: 10/20/2022]
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12
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Contejean A, Lemiale V, Resche-Rigon M, Mokart D, Pène F, Kouatchet A, Mayaux J, Vincent F, Nyunga M, Bruneel F, Rabbat A, Perez P, Meert AP, Benoit D, Hamidfar R, Darmon M, Jourdain M, Renault A, Schlemmer B, Azoulay E. Increased mortality in hematological malignancy patients with acute respiratory failure from undetermined etiology: a Groupe de Recherche en Réanimation Respiratoire en Onco-Hématologique (Grrr-OH) study. Ann Intensive Care 2016; 6:102. [PMID: 27783381 PMCID: PMC5080277 DOI: 10.1186/s13613-016-0202-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Accepted: 10/11/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Acute respiratory failure (ARF) is the most frequent complication in patients with hematological malignancies and is associated with high morbidity and mortality. ARF etiologies are numerous, and despite extensive diagnostic workflow, some patients remain with undetermined ARF etiology. METHODS This is a post-hoc study of a prospective multicenter cohort performed on 1011 critically ill hematological patients. Relationship between ARF etiology and hospital mortality was assessed using a multivariable regression model adjusting for confounders. RESULTS This study included 604 patients with ARF. All patients underwent noninvasive diagnostic tests, and a bronchoscopy and bronchoalveolar lavage (BAL) was performed in 155 (25.6%). Definite diagnoses were classified into four exclusive etiological categories: pneumonia (44.4%), non-infectious diagnoses (32.6%), opportunistic infection (10.1%) and undetermined (12.9%), with corresponding hospital mortality rates of 40, 35, 55 and 59%, respectively. Overall hospital mortality was 42%. By multivariable analysis, factors associated with hospital mortality were invasive pulmonary aspergillosis (OR 7.57 (95% CI 3.06-21.62); p < 0.005), use of invasive mechanical ventilation (OR 1.65 (95% CI 1.07-2.55); p = 0.02), a SOFA score >7 (OR 3.32 (95% CI 2.15-5.15); p < 0.005) and an undetermined ARF etiology (OR 2.92 (95% CI 1.71-5.07); p < 0.005). CONCLUSIONS In patients with hematological malignancies and ARF, up to 13% remain with undetermined ARF etiology despite comprehensive diagnostic workup. Undetermined ARF etiology is independently associated with hospital mortality. Studies to guide second-line diagnostic strategies are warranted. ClinicalTrials.Gov NCT01172132.
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Affiliation(s)
| | | | | | - Djamel Mokart
- Réanimation, Institut Paoli Calmettes, Marseille, France.,Medical Intensive Care Unit, Hôpital Saint-Louis, ECSTRA Team, Biostatistics and Clinical Epidemiology, UMR 1153 (Center of Epidemiology And Biostatistics Sorbonne Paris Cité, CRESS), INSERM, Université Paris Diderot Sorbonne, 1, Avenue Claude Vellefaux, 75010, Paris, France
| | - Frédéric Pène
- Réanimation médicale, Hôpital Cochin, APHP, Paris, France
| | - Achille Kouatchet
- Service de Reanimation Médicale et Médecine Hyperbare, CHU Angers, Angers, France
| | - Julien Mayaux
- Service de Pneumologie et Réanimation, Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France
| | - François Vincent
- Réanimation polyvalente, Hôpital Avicenne, APHP, Bobigny, France
| | - Martine Nyunga
- Réanimation polyvalente, Hôpital V.Provo, Roubaix, France
| | - Fabrice Bruneel
- Réanimation polyvalente, Hôpital de Versailles, Le Chesnay, France
| | - Antoine Rabbat
- Réanimation médicale, Hôpital Cochin, APHP, Paris, France
| | - Pierre Perez
- Réanimation médicale, Hôpital Brabois, Nancy, France
| | - Anne-Pascale Meert
- Service des Soins Intensifs Medico-Chirurgicaux et Oncologie Thoracique, Institut Jules Bordet, Brussels, Belgium
| | | | | | - Michael Darmon
- Réanimation polyvalente, CHU de Saint-Etienne, Saint-Piest-en-Jarrez, France
| | | | - Anne Renault
- Réanimation et Urgences Médicales, CHU de la Cavale Blanche, Brest, France
| | | | - Elie Azoulay
- Réanimation médicale, Hôpital Saint Louis, APHP, Paris, France. .,Medical Intensive Care Unit, Hôpital Saint-Louis, ECSTRA Team, Biostatistics and Clinical Epidemiology, UMR 1153 (Center of Epidemiology And Biostatistics Sorbonne Paris Cité, CRESS), INSERM, Université Paris Diderot Sorbonne, 1, Avenue Claude Vellefaux, 75010, Paris, France.
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13
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Sivakumar S, Taccone FS, Desai KA, Lazaridis C, Skarzynski M, Sekhon M, Henderson W, Griesdale D, Chapple L, Deane A, Williams L, Strickland R, Lange K, Heyland D, Chapman M, Rowland MJ, Garry P, Westbrook J, Corkill R, Antoniades CA, Pattinson KT, Fatania G, Strong AJ, Myers RB, Lazaridis C, Jermaine CM, Robertson CS, Rusin CG, Hofmeijer J, Sondag L, Tjepkema-Cloostermans MC, Beishuizen A, Bosch FH, van Putten MJAM, Carteron L, Patet C, Solari D, Oddo M, Ali MA, Dias C, Almeida R, Vaz-Ferreira A, Silva J, Monteiro E, Cerejo A, Rocha AP, Elsayed AA, Abougabal AM, Beshey BN, Alzahaby KM, Pozzebon S, Ortiz AB, Cristallini S, Lheureux O, Brasseur A, Vincent JL, Creteur J, Taccone FS, Hravnak M, Yousef K, Chang Y, Crago E, Friedlander RM, Abdelmonem SA, Tahon SA, Helmy TA, Meligy HS, Puig F, Dunn-Siegrist I, Pugin J, Gupta S, Govil D, Srinivasan S, Patel SJ, N JK, Gupta A, Tomar DS, Shafi M, Harne R, Arora DP, Talwar N, Mazumdar S, Papakrivou EE, Makris D, Manoulakas E, Tsolaki B, Karadodas B, Zakynthinos E, Garcia IP, Martin AD, Encinares VS, Ibañez MP, Montero JG, Labrador G, Cangueiro TC, Poulose V, Koh J, Kam JW, Yeter H, Stepinska J, Pérez AG, Ordoñez PF, Giribet A, Cuervo MAA, Cuervo RA, Esteban MAR, Fraile LI, Mittelbrum CP, Albaiceta GM, Kara A, Koeze J, Keus F, Dieperink W, van der Horst ICC, van Meurs M, Zijlstra JG, Roberts S, Caballero CH, Isgro G, Hall D, Aktepe O, Beitland S, Trøseid AMS, Brusletto BS, Waldum-Grevbo BE, Berg JP, Sunde K, Huertas DG, Manzano F, Quintana MMJ, Osuna A, Topeli A, Santiago-Ruiz F, Rodríguez-Mejías C, Wangensteen R, Jamaati HR, Masjedi M, Zand F, Hashemian SMR, Sabetian G, Abbasi G, Khaloo V, Tsolakoglou I, Tabei SH, Kafilzadeh A, Bakhodaei HH, Diaz JA, Silva R, Garcia DJ, Luis E, Gomez MN, Soriano R, Gonzalez PL, Intas G, Ibrahim IA, Rafik MM, Al-Ansary AM, Algendi MA, Ali AA, Fuhrmann V, Roedl K, Horvatits T, Drolz A, Rutter K, Stergiannis P, Benten D, Kluwe J, Siedler S, Kluge S, Adedugbe I, Bird GT, Kennedy RM, Sharma S, Butler MB, Yugi G, Kolaros AA, Haroon BA, Witter T, Khaliq W, Singer M, Havaldar AA, Krishna B, Sriram S, Espinoza EDV, Pozo MO, Edul VSK, Chalari E, Furche M, Motta MF, Vazquez AR, Birri PNR, Ince C, Dubin A, Dogliotti A, Ramos A, Lovesio C, Delile E, Athanasiadou E, Nevière R, Thiébaut PA, Maupoint J, Mulder P, Coquerel D, Renet S, do Rego JC, Rieusset J, Richard V, Tamion F, Martika A, Khaliq W, Andreis DT, Singer M, Smit B, Smulders YM, de Waard MC, van Straaten HMO, Girbes ARJ, Eringa EC, Man AMESD, Fildisis G, Alegría L, Soto D, Luengo C, Gomez J, Jarufe N, Bruhn A, Castro R, Kattan E, Tapia P, Rebolledo R, Faivre V, Achurra P, Ospina-Tascón G, Bakker J, Hernández G, Bertini P, Guarracino F, Baldassarri R, Pinsky MR, Alegría L, Vera M, Mengelle C, Dreyse J, Carpio D, Henriquez C, Gajardo D, Bravo S, Castro R, Ospina-Tascón G, Bakker J, Hernández G, Kim S, Favier B, Lee M, Park SY, So S, Lee H, Kačar MB, Kačar SM, Uddin I, Belhaj AM, Aydın MA, Avsec D, Payen D, Kapuağası A, Kaymak Ç, Kovach L, Şencan İ, Meço B, Özçelik M, Ünal N, Lazaridis C, Jenni-Moser B, Jeitziner MM, Poppe A, Galassi MS, Sales FL, de Moraes KCL, Batista CL, Júnior JADS, Marcari TB, Lobato R, Castro CSAA, de Souza LM, Rodrigues FFP, Winkler MS, Correa NG, Pelegrini AM, Eid RAC, Timenetsky KT, Cazati D, Lobato M, Diniz PS, Rocha LL, Cavalheiro AM, Lucinio NM, Mudersbach E, Santos ER, Norrenberg M, Gleize A, Preiser JC, Simón IF, Carmona SA, Valhonrat IL, Domínguez JP, Abellán AN, Almudévar PM, Schreiber J, Dávila F, Rubio JJ, Ramos AJ, Reina ÁJR, López NP, Pérez MA, Apolo DXC, Villén LM, López FMP, García IP, Wruck ML, Izurieta JRN, Guerrero JJE, Calvert S, Quint M, Adeniji K, Young R, Shevill DD, Robertson E, Garside P, Walter E, Schwedhelm E, Isotti P, De Vecchi MM, Perduca AE, Negro A, Villa G, Manara DF, Cabrini L, Zangrillo A, Frencken JF, van Baal L, Kluge S, Peelen LM, Donker DW, Horn J, van der Poll T, van Klei WA, Bonten MJM, Cremer OL, Menard CE, Kumar A, Rimmer E, Zöllner 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Karanjia ND, Forni LG, Creagh-Brown BC, Bossy M, Nyman M, Tailor A, Creagh-Brown B, D’Antini D, Spadaro S, Valentino F, Sollitto F, Cinnella G, Mirabella L, Calvo FJR, Bejarano N, Padilla D, Baladron V, Villajero P, Villazala R, Redondo J, Yuste AS, Liu J, Shen F, Teboul JL, Anguel N, Beurton A, Bezaz N, Richard C, Monnet X, Fossali T, Colombo R, Ottolina D, Rossetti M, Mazzucco C, Marchi A, Porta A, Catena E, Tollisen KH, Andersen GØ, Heyerdahl F, Jacobsen D, de Waard MC, Girbes ARJ, van IJzendoorn MCO, Buter H, Kingma WP, Navis GJ, Boerma EC, Rulisek J, Balik M, Zacharov S, Kim HS, Jeon SJ, Namgung H, Lee E, Lee E, Cho YJ, Lee YJ, Huang A, Cioccari L, Luethi N, Mårtensson J, Bellomo R, Forsberg M, Edman G, Höjer J, Forsberg S, Freile MTC, Hidalgo FN, Molina JAM, Lecumberri R, Rosselló AF, Travieso PM, Leon GT, Sanchez JG, Frias LS, Rosello DB, Verdejo JAG, Serrano JAN, Winterwerp D, van Galen T, Vazin A, Karimzade I, Zand A, Ozen E, Ekemen S, Akcan A, Sen E, Yelken BB, Kureshi N, Fenerty L, Thibault-Halman G, Erdogan M, Walling S, Green RS, Clarke DB, Briassoulis P, Kalimeris K, Ntzouvani A, Nomikos T, Papaparaskeva K, Politi E, Kostopanagiotou G, Crewdson K, Rehn M, Weaver A, Brohi K, Lockey D, Wright S, Thomas K, Baker C, Mansfield L, Stafford V, Wade C, Watson G, Bryant A, Chadwick T, Shen J, Wilkinson J, Furneval J, Henderson A, Hugill K, Howard P, Roy A, Bonner S, Baudouin S, Ramírez CS, Escalada SH, Viera MAH, Santana MC, Balcázar LC, Monroy NS, Campelo FA, Vázquez CFL, Santana PS, Santana SR, Carteron L, Patet C, Quintard H, Solari D, Bouzat P, Oddo M, Wollersheim T, Malleike J, Haas K, Carbon N, Schneider J, Birchmeier C, Fielitz J, Spuler S, Weber-Carstens S, Enseñat L, Pérez-Madrigal A, Saludes P, Proença L, Gruartmoner G, Espinal C, Mesquida J, Huber W, Eckmann M, Elkmann F, Gruber A, Lahmer T, Mayr U, Herner A, Schellnegger R, Schneider J, Schmid RM, Ayoub W, Samy W, Esmat A, Battah A, Mukhtar S, Mongkolpun W, Cortés DO, Cordeiro CPR, Vincent JL, Creteur J, Funcke S, Groesdonk H, Saugel B, Wagenpfeil G, Wagenpfeil S, Reuter DA, Fernandez MM, Fernandez R, Magret M, González-Castro A, Bouza MT, Ibañez M, García C, Balerdi B, Mas A, Arauzo V, Añón JM, Ruiz F, Ferreres J, Tomás R, Alabert M, Tizón AI, Altaba S, Llamas N, Goligher EC, Fan E, Herridge M, Vorona S, Sklar M, Dres M, Rittayamai N, Lanys A, Urrea C, Tomlinson G, Reid WD, Rubenfeld GD, Kavanagh BP, Brochard LJ, Ferguson ND, Neto AS, de Abreu MG, Pelosi P, Schultz MJ, Guérin C, Papazian L, Reignier J, Ayzac L, Loundou A, Forel JM, Rolland-Debord C, Bureau C, Poitou T, Clavel M, Perbet S, Terzi N, Kouatchet A, Similowski T, Demoule A, Hunfeld N, Trogrlic Z, Ladage S, Osse RJ, Koch B, Rietdijk W, Devlin J, van der Jagt M, Picetti E, Ceccarelli P, Mensi F, Malchiodi L, Risolo S, Rossi I, Antonini MV, Servadei F, Caspani ML, Roquilly A, Lasocki S, Seguin P, Geeraerts T, Perrigault PF, Dahyot-Fizelier C, Paugam-Burtz C, Cook F, Cinotti R, dit Latte DD, Mahe PJ, Fortuit C, Feuillet F, Asehnoune K, Marzorati C, Spina S, Scaravilli V, Vargiolu A, Riva M, Giussani C, Sganzerla E, Citerio G, Barbadillo S, de Molina FJG, Álvarez-Lerma F, Rodríguez A, Zakharkina T, Martin-Loeches I, Matamoros S, Povoa P, Torres A, Kastelijn J, Hofstra JJ, de Jong M, Schultz M, Sterk P, Artigas A, Bos LJ, Moreau AS, Martin-Loeches I, Povoa P, Salluh J, Rodriguez A, Nseir S, de Jong E, van Oers JA, Beishuizen A, Girbes ARJ, Nijsten MWN, de Lange DW, Bonvicini D, Labate D, Benacchio L, Olivieri A, Pizzirani E, Lopez-Delgado JC, Gonzalez-Romero M, Fuentes-Mila V, Berbel-Franco D, Romera-Peregrina I, Martinez-Pascual A, Perez-Sanchez J, Abellan-Lencina R, Ávila-Espinoza RE, Moreno-Gonzalez G, Sbraga F, Griffiths S, Grocott MPW, Creagh-Brown B, Doyle J, Wilkerson P, Soon Y, Huddart S, Dickinson M, Riga A, Zuleika A, Miyamoto K, Kawazoe Y, Morimoto T, Yamamoto T, Fuke A, Hashimoto A, Koami H, Beppu S, Katayama Y, Ito M, Ohta Y, Yamamura H, Rygård SL, Holst LB, Wetterslev J, Johansson PI, Perner A, Soliman IW, de Lange DW, van Dijk D, van Delden JJM, Cremer OL, Slooter AJC, Peelen LM, McWilliams D, Snelson C, Neves AD, Loudet CI, Busico M, Vazquez D, Villalba D, Veronesi M, Lischinsky A, López FJL, Mori LB, Plotnikow G, Díaz A, Giannasi S, Hernandez R, Krzisnik L, Cecotti C, Viola L, Lopez R, Sottile JP, Benavent G, Estenssoro E, Chen CM, Lai CC, Cheng KC, Chou W, Chan KS, Roeker LE, Horkan CM, Gibbons FK, Christopher KB, Weijs PJM, Mogensen KM, Rawn JD, Robinson MK, Christopher KB, Tang Z, Qiu C, Ouyang B, Cai C, Guan X, Regueira T, Cea L, Carlos SJ, Elisa B, Puebla C, Vargas A, Poulsen MK, Thomsen LP, Kjærgaard S, Rees SE, Karbing DS, Wollersheim T, Frank S, Müller MC, Carbon NM, Skrypnikov V, Pickerodt PA, Falk R, Mahlau A, Weber-Carstens S, Lee A, Inglis R, Morgan R, Barker G, Kamata K, Abe T, Saitoh D, Tokuda Y, Green RS, Butler MB, Erdogan M, Hwa HT, Gil LJ, Vaquero RH, Rodriguez-Ruiz E, Lago AL, Allut JLG, Gestal AE, Gonzalez MAG, Thomas-Rüddel DO, Schwarzkopf D, Fleischmann C, Reinhart K, Suwanpasu S, Sattayasomboon Y, Filho NMF, Oliveira JCA, Ballalai CS, De Lucia CV, Araponga GP, Veiga LN, Silva CS, Garrido ME, Ramos BB, Ricaldi EF, Gomes SS, Gemmell L, MacKay A, Wright C, Docking RI, Doherty P, Black E, Stenhouse P, Plummer MP, Finnis ME, Phillips LK, Kar P, Bihari S, Biradar V, Moodie S, Horowitz M, Shaw JE, Deane AM, Yatabe T, Inoue S, Sakaguchi M, Egi M, Abdelhamid YA, Plummer MP, Finnis ME, Phillips LK, Kar P, Bihari S, Biradar V, Moodie S, Horowitz M, Shaw JE, Deane AM, Hokka M, Egi M, Mizobuchi S, Kar P, Plummer M, Abdelhamid YA, Giersch E, Summers M, Hatzinikolas S, Heller S, Chapman M, Jones K, Horowitz M, Deane A, Schweizer R, Jacquet-Lagreze M, Portran P, Junot S, Allaouchiche B, Fellahi JL, Guerci P, Ergin B, Kapucu A, Ince C, Cioccari L, Luethi N, Crisman M, Bellomo R, Mårtensson J, Shinotsuka CR, Fagnoul D, Brasseur A, Orbegozo D, Vincent JL, Preiser JC, Preiser JC, Lheureux O, Thooft A, Brimioulle S, Vincent JL, Iwasaka H, Tahara S, Nagamine M, Ichigatani A, Cabrera AR, Zepeda EM, Granillo JF, Sánchez JSA, Montoya AAT, Montenegro AP, Blanco GAG, Robles CMC, Drolz A, Horvatits T, Roedl K, Rutter K, Kluge S, Funk GC, Schneeweiss B, Fuhrmann V, Sabetian G, Pooresmaeel F, Zand F, Ghaffaripour S, Farbod A, Tabei H, Taheri L, Anandanadesan R, Metaxa V, Teixeira C, Pereira SM, Hernández-Marrero P, Carvalho AS, Beckmann M, Hartog CS, Schwarzkopf D, Raadts A, Robertsen A, Førde R, Skaga NO, Helseth E, Honeybul S, Ho K, Lopez PM, Gonzalez MN, Ortega PN, Sola EC, Spasova T, de la Torre-Prados MV, Kopecky O, Rusinova K, Waldauf P, Cepeplikova Z, Balik M, Domínguez JP, Almudevar PM, Carmona SA, Muñoz JJR, Castañeda DP, Abellán AN, Villamizar PR, Ramos JV, Pérez LP, Lucendo AP, Ejarque MC, Estella A, Camps VL, Martín MC, Masnou N, Barbosa S, Varela A, Palma I, Cristina L, Nunes E, Pereira I, Campello G, Granja C, Pande R, Pandey M, Varghese S, Chanu M, Van Dam MJ, Ter Braak EWMT, Estella A, Gracia M, Viciana R, Recuerda M, Fontaiña LP, Tharmalingam B, Kovari F, Rose L, Mcginlay M, Amin R, Burns K, Connolly B, Hart N, Jouvet P, Katz S, Leasa D, Mawdsley C, Mcauley D, Schultz M, Blackwood B, Denham S, Worrall R, Arshad M, Isherwood P, Khadjibaev A, Sabirov D, Rosstalnaya A, Parpibaev F, Sharipova V, Blanco GAG, Guzman CIO, Sánchez JSA, Granillo JF, Gupta S, Govil D, Srinivasan S, Patel SJ, N JK, Gupta A, Shafi M, Tomar DS, Harne R, Arora DP, Talwar N, Mazumdar S, Cha YS, Lee SJ, Tyagi N, Rajput RK, Taneja S, Singh VK, Sharma SC, Mittal S, Rao BK, Ayachi J, Fraj N, Romdhani S, Khedher A, Meddeb K, Sma N, Azouzi A, Bouneb R, Chouchene I, El Ghardallou M, Boussarsar M, Jennings R, Walter E, Ribeiro JM, Moniz I, Marçal R, Santos AC, Candeias C, e Silva ZC, Gomez SEZ, Nieto ORP, Gonzalez JAC, Cuellar AIV, Mildh H, Pettilä V, Korhonen AM, Karlsson S, Ala-Kokko T, Reinikainen M, Vaara ST, Zaleska-Kociecka M, Grabowski M, Dąbrowski M, Wozniak S, Piotrowska K, Banaszewski M, Imiela J. ESICM LIVES 2016: part two. Intensive Care Med Exp 2016. [PMCID: PMC5042923 DOI: 10.1186/s40635-016-0099-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Zhao Y, Garnaud C, Brenier-Pinchart MP, Thiébaut-Bertrand A, Saint-Raymond C, Camara B, Hamidfar R, Cognet O, Maubon D, Cornet M, Perlin DS. Direct Molecular Diagnosis of Aspergillosis and CYP51A Profiling from Respiratory Samples of French Patients. Front Microbiol 2016; 7:1164. [PMID: 27524978 PMCID: PMC4965478 DOI: 10.3389/fmicb.2016.01164] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 07/13/2016] [Indexed: 11/21/2022] Open
Abstract
Background: Microbiological diagnosis of aspergillosis and triazole resistance is limited by poor culture yield. To better estimate this shortcoming, we compared culture and molecular detection of A. fumigatus in respiratory samples from French patients at risk for aspergillosis. Methods: A total of 97 respiratory samples including bronchoalveolar lavages (BAL), bronchial aspirates (BA), tracheal aspirates, sputa, pleural fluids, and lung biopsy were collected from 33 patients having invasive aspergillosis (n = 12), chronic pulmonary aspergillosis (n = 3), allergic bronchopulmonary aspergillosis (n = 7), or colonization (n = 11) and 28 controls. Each specimen was evaluated by culture, pan-Aspergillus qPCR, and CYP51A PCR and sequencing. Results: One A. flavus and 19 A. fumigatus with one multiazole resistant strain (5.3%) were cultured from 20 samples. Culture positivity was 62.5, 75, 42.9, and 15.8% in ABPA, CPA, IA, and colonized patients, respectively. Aspergillus detection rate was significantly higher by pan-Aspergillus qPCR than by culture in IA (90.5 vs. 42.9%; P < 0.05) and colonization group (73.7 vs. 15.8%; P < 0.05). The CYP51A PCR found one TR34/L98H along with 5 novel cyp51A mutations (4 non-synonymous and 1 promoter mutations), yet no association can be established currently between these novel mutations and azole resistance. The analysis of 11 matched pairs of BA and BAL samples found that 9/11 BA carried greater fungal load than BAL and CYP51A detection was more sensitive in BA than in BAL. Conclusion: Direct molecular detection of Aspergillus spp. and azole resistance markers are useful adjunct tools for comprehensive aspergillosis diagnosis. The observed superior diagnostic value of BAs to BAL fluids warrants more in-depth study.
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Affiliation(s)
- Yanan Zhao
- New Jersey Medical School, Public Health Research Institute, Rutgers Biomedical and Health Sciences Newark, NJ, USA
| | - Cécile Garnaud
- Laboratoire de Parasitologie-Mycologie, Institut de Biologie et Pathologie, Centre Hospitalier Universitaire Grenoble AlpesGrenoble, France; Laboratoire TIMC-IMAG-TheREx, UMR 5525 Centre National de la Recherche Scientifique, Université Grenoble AlpesGrenoble, France
| | - Marie-Pierre Brenier-Pinchart
- Laboratoire de Parasitologie-Mycologie, Institut de Biologie et Pathologie, Centre Hospitalier Universitaire Grenoble AlpesGrenoble, France; Institut Albert Bonniot, Centre National de la Recherche Scientifique UMR 5309, Institut National de la Santé et de la Recherche Médicale U1209, Université Grenoble-AlpesGrenoble, France
| | - Anne Thiébaut-Bertrand
- Laboratoire TIMC-IMAG-TheREx, UMR 5525 Centre National de la Recherche Scientifique, Université Grenoble AlpesGrenoble, France; Clinique Universitaire d'Hématologie, Centre Hospitalier Universitaire Grenoble AlpesGrenoble, France
| | - Christel Saint-Raymond
- Clinique Universitaire de Pneumologie, Centre Hospitalier Universitaire Grenoble Alpes Grenoble, France
| | - Boubou Camara
- Clinique Universitaire de Pneumologie, Centre Hospitalier Universitaire Grenoble Alpes Grenoble, France
| | - Rebecca Hamidfar
- Réanimation Médicale, Centre Hospitalier Universitaire Grenoble Alpes Grenoble, France
| | - Odile Cognet
- Laboratoire de Parasitologie-Mycologie, Institut de Biologie et Pathologie, Centre Hospitalier Universitaire Grenoble Alpes Grenoble, France
| | - Danièle Maubon
- Laboratoire de Parasitologie-Mycologie, Institut de Biologie et Pathologie, Centre Hospitalier Universitaire Grenoble AlpesGrenoble, France; Laboratoire TIMC-IMAG-TheREx, UMR 5525 Centre National de la Recherche Scientifique, Université Grenoble AlpesGrenoble, France
| | - Muriel Cornet
- Laboratoire de Parasitologie-Mycologie, Institut de Biologie et Pathologie, Centre Hospitalier Universitaire Grenoble AlpesGrenoble, France; Laboratoire TIMC-IMAG-TheREx, UMR 5525 Centre National de la Recherche Scientifique, Université Grenoble AlpesGrenoble, France
| | - David S Perlin
- New Jersey Medical School, Public Health Research Institute, Rutgers Biomedical and Health Sciences Newark, NJ, USA
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Darmon M, Vincent F, Canet E, Mokart D, Pène F, Kouatchet A, Mayaux J, Nyunga M, Bruneel F, Rabbat A, Lebert C, Perez P, Renault A, Meert AP, Benoit D, Hamidfar R, Jourdain M, Schlemmer B, Chevret S, Lemiale V, Azoulay E. Acute kidney injury in critically ill patients with haematological malignancies: results of a multicentre cohort study from the Groupe de Recherche en Réanimation Respiratoire en Onco-Hématologie. Nephrol Dial Transplant 2016; 30:2006-13. [PMID: 26597921 DOI: 10.1093/ndt/gfv372] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Cancer patients are at high risk for acute kidney injury (AKI), which is associated with high morbidity and mortality. We sought to appraise the incidence, risk factors, and outcome of AKI in a large multicentre cohort study of critically ill patients with haematological malignancies. METHODS We used a retrospective analysis of a prospectively collected database. The study was carried out in 17 university or university-affiliated centres in France and Belgium between 2010 and 2012. AKI was defined according to the Acute Kidney Injury Network (AKIN) definition. RESULTS Of the 1011 patients admitted into the intensive care unit (ICU) during the study period, 1009 were included in this study. According to the AKIN definition, 671 patients (66.5%) developed an AKI during their ICU stay, of which 258 patients (38.4%) were AKI stage 1, 75 patients (11.2%) AKI stage 2 and 338 patients (50.4%) AKI stage 3. After adjustment for confounders, main adverse risk factors of AKI were older age, severity [non-renal Sequential Organ Failure Assessment (SOFA)], history of hypertension, tumour lysis syndrome, exposure to nephrotoxic agents and myeloma. Hospital mortality was 44.3% in patients with AKI and 25.4% in patients without AKI (P < 0.0001). After adjustment for confounders, AKI was independently associated with hospital mortality [OR 1.65 (95% CI 1.19-2.29)]. Overall, 271 patients required renal replacement therapy (RRT), of whom 57.2% died during their hospital stay as compared with 31.2% (P < 0.0001) in those not requiring RRT. CONCLUSION Two-thirds of critically ill patients with haematological malignancies developed AKI. Hospital mortality in this population of patients developing AKI or requiring RRT is close to that in general ICU population.
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Affiliation(s)
| | | | | | | | | | | | - Julien Mayaux
- Pitié-Salpétrière University Hospital, Paris, France
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Lemiale V, Mokart D, Resche-Rigon M, Pène F, Mayaux J, Faucher E, Nyunga M, Girault C, Perez P, Guitton C, Ekpe K, Kouatchet A, Théodose I, Benoit D, Canet E, Barbier F, Rabbat A, Bruneel F, Vincent F, Klouche K, Loay K, Mariotte E, Bouadma L, Moreau AS, Seguin A, Meert AP, Reignier J, Papazian L, Mehzari I, Cohen Y, Schenck M, Hamidfar R, Darmon M, Demoule A, Chevret S, Azoulay E. Effect of Noninvasive Ventilation vs Oxygen Therapy on Mortality Among Immunocompromised Patients With Acute Respiratory Failure: A Randomized Clinical Trial. JAMA 2015; 314:1711-9. [PMID: 26444879 DOI: 10.1001/jama.2015.12402] [Citation(s) in RCA: 221] [Impact Index Per Article: 24.6] [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: 12/13/2022]
Abstract
IMPORTANCE Noninvasive ventilation has been recommended to decrease mortality among immunocompromised patients with hypoxemic acute respiratory failure. However, its effectiveness for this indication remains unclear. OBJECTIVE To determine whether early noninvasive ventilation improved survival in immunocompromised patients with nonhypercapnic acute hypoxemic respiratory failure. DESIGN, SETTING, AND PARTICIPANTS Multicenter randomized trial conducted among 374 critically ill immunocompromised patients, of whom 317 (84.7%) were receiving treatment for hematologic malignancies or solid tumors, at 28 intensive care units (ICUs) in France and Belgium between August 12, 2013, and January 2, 2015. INTERVENTIONS Patients were randomly assigned to early noninvasive ventilation (n = 191) or oxygen therapy alone (n = 183). MAIN OUTCOMES AND MEASURES The primary outcome was day-28 mortality. Secondary outcomes were intubation, Sequential Organ Failure Assessment score on day 3, ICU-acquired infections, duration of mechanical ventilation, and ICU length of stay. RESULTS At randomization, median oxygen flow was 9 L/min (interquartile range, 5-15) in the noninvasive ventilation group and 9 L/min (interquartile range, 6-15) in the oxygen group. All patients in the noninvasive ventilation group received the first noninvasive ventilation session immediately after randomization. On day 28 after randomization, 46 deaths (24.1%) had occurred in the noninvasive ventilation group vs 50 (27.3%) in the oxygen group (absolute difference, -3.2 [95% CI, -12.1 to 5.6]; P = .47). Oxygenation failure occurred in 155 patients overall (41.4%), 73 (38.2%) in the noninvasive ventilation group and 82 (44.8%) in the oxygen group (absolute difference, -6.6 [95% CI, -16.6 to 3.4]; P = .20). There were no significant differences in ICU-acquired infections, duration of mechanical ventilation, or lengths of ICU or hospital stays. CONCLUSIONS AND RELEVANCE Among immunocompromised patients admitted to the ICU with hypoxemic acute respiratory failure, early noninvasive ventilation compared with oxygen therapy alone did not reduce 28-day mortality. However, study power was limited. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01915719.
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Affiliation(s)
| | | | | | | | - Julien Mayaux
- Service de Pneumologie Et Réanimation Médicale, AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Paris, France
| | | | | | - Christophe Girault
- Medical Intensive Care Unit, Charles Nicolle University Hospital-Rouen University, Rouen, France
| | - Pierre Perez
- Centre Hospitalier Universitaire-Nancy, Nancy, France
| | | | | | | | | | | | | | - François Barbier
- Medical Intensive Care Unit, La Source Hospital-CHR Orleans, Orléans, France
| | | | - Fabrice Bruneel
- Intensive Care Unit, Hopital Andre Mignot-Le Chesnay, Paris, France
| | | | - Kada Klouche
- Lapeyronie University Hospital, Montpellier, France
| | - Kontar Loay
- Centre Hospitalier Universitaire-Amiens, Amiens, France
| | | | | | | | | | | | - Jean Reignier
- Réanimation Médicale, Centre Hospitalier Universitaire-Nantes, Nantes, France
| | | | | | - Yves Cohen
- Hôpital d'Avicenne, APHP, Bobigny, France
| | | | - Rebecca Hamidfar
- The Centre Hospitalier Universitaire de Grenoble, Grenoble, France
| | - Michael Darmon
- Medical-Surgical ICU, Saint-Etienne University Hospital, Saint-Etienne, France
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Schmidt M, Sonneville R, Schnell D, Bigé N, Hamidfar R, Mongardon N, Castelain V, Razazi K, Marty A, Vincent F, Dres M, Gaudry S, Luyt CE, Das V, Micol JB, Demoule A, Mayaux J. Clinical features and outcomes in patients with disseminated toxoplasmosis admitted to intensive care: a multicenter study. Clin Infect Dis 2013; 57:1535-41. [PMID: 23994819 DOI: 10.1093/cid/cit557] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [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: 02/07/2023] Open
Abstract
BACKGROUND Characteristics and outcomes of adult patients with disseminated toxoplasmosis admitted to the intensive care unit (ICU) have rarely been described. METHODS We performed a retrospective study on consecutive adult patients with disseminated toxoplasmosis who were admitted from January 2002 through December 2012 to the ICUs of 14 university-affiliated hospitals in France. Disseminated toxoplasmosis was defined as microbiological or histological evidence of disease affecting >1 organ in immunosuppressed patients. Isolated cases of cerebral toxoplasmosis were excluded. Clinical data on admission and risk factors for 60-day mortality were collected. RESULTS Thirty-eight patients were identified during the study period. Twenty-two (58%) had received an allogeneic hematopoietic stem cell transplant (median, 61 [interquartile range {IQR}, 43-175] days before ICU admission), 4 (10%) were solid organ transplant recipients, and 10 (27%) were infected with human immunodeficiency virus (median CD4 cell count, 14 [IQR, 6-33] cells/µL). The main indications for ICU admission were acute respiratory failure (89%) and shock (53%). The 60-day mortality rate was 82%. Allogeneic hematopoietic stem cell transplant (hazard ratio [HR] = 2.28; 95% confidence interval [CI], 1.05-5.35; P = .04) and systolic cardiac dysfunction (HR = 3.54; 95% CI, 1.60-8.10; P < .01) within 48 hours of ICU admission were associated with mortality. CONCLUSIONS Severe disseminated toxoplasmosis leading to ICU admission has a poor prognosis. Recipients of allogeneic hematopoietic stem cell transplant appear to have the highest risk of mortality. We identified systolic cardiac dysfunction as a major determinant of outcome. Strategies aimed at preventing this fatal opportunistic infection may improve outcomes.
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Affiliation(s)
- Matthieu Schmidt
- Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie et Réanimation Médicale
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Azoulay E, Mokart D, Pène F, Lambert J, Kouatchet A, Mayaux J, Vincent F, Nyunga M, Bruneel F, Laisne LM, Rabbat A, Lebert C, Perez P, Chaize M, Renault A, Meert AP, Benoit D, Hamidfar R, Jourdain M, Darmon M, Schlemmer B, Chevret S, Lemiale V. Outcomes of Critically Ill Patients With Hematologic Malignancies: Prospective Multicenter Data From France and Belgium—A Groupe de Recherche Respiratoire en Réanimation Onco-Hématologique Study. J Clin Oncol 2013; 31:2810-8. [DOI: 10.1200/jco.2012.47.2365] [Citation(s) in RCA: 410] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose Patients with hematologic malignancies are increasingly admitted to the intensive care unit (ICU) when life-threatening events occur. We sought to report outcomes and prognostic factors in these patients. Patients and Methods Ours was a prospective, multicenter cohort study of critically ill patients with hematologic malignancies. Health-related quality of life (HRQOL) and disease status were collected after 3 to 6 months. Results Of the 1,011 patients, 38.2% had newly diagnosed malignancies, 23.1% were in remission, and 24.9% had received hematopoietic stem-cell transplantations (HSCT, including 145 allogeneic). ICU admission was mostly required for acute respiratory failure (62.5%) and/or shock (42.3%). On day1, 733 patients (72.5%) received life-supporting interventions. Hospital, day-90, and 1-year survival rates were 60.7%, 52.5%, and 43.3%, respectively. By multivariate analysis, cancer remission and time to ICU admission less than 24 hours were associated with better hospital survival. Poor performance status, Charlson comorbidity index, allogeneic HSCT, organ dysfunction score, cardiac arrest, acute respiratory failure, malignant organ infiltration, and invasive aspergillosis were associated with higher hospital mortality. Mechanical ventilation (47.9% of patients), vasoactive drugs (51.2%), and dialysis (25.9%) were associated with mortality rates of 60.5%, 57.5%, and 59.2%, respectively. On day 90, 80% of survivors had no HRQOL alterations (physical and mental health similar to that of the overall cancer population). After 6 months, 80% of survivors had no change in treatment intensity compared with similar patients not admitted to the ICU, and 80% were in remission. Conclusion Critically ill patients with hematologic malignancies have good survival, disease control, and post-ICU HRQOL. Earlier ICU admission is associated with better survival.
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Affiliation(s)
- Elie Azoulay
- Elie Azoulay, Jérôme Lambert, Louise-Marie Laisne, Marine Chaize, Benoit Schlemmer, Sylvie Chevret, and Virginie Lemiale, Saint-Louis Hospital; Frédéric Pène, Cochin Hospital; Julien Mayaux, Pitié-Salpétrière Hospital; Antoine Rabbat, Hôtel Dieu Hospital, Paris; Djamel Mokart, Institut Paoli Calmette, Marseille; Achille Kouatchet, Centre Hospitalier Universitaire Hospital, Angers; François Vincent, Avicenne Hospital, Bobigny; Martine Nyunga, Victor Provo Hospital, Roubaix; Fabrice Bruneel, Mignot
| | - Djamel Mokart
- Elie Azoulay, Jérôme Lambert, Louise-Marie Laisne, Marine Chaize, Benoit Schlemmer, Sylvie Chevret, and Virginie Lemiale, Saint-Louis Hospital; Frédéric Pène, Cochin Hospital; Julien Mayaux, Pitié-Salpétrière Hospital; Antoine Rabbat, Hôtel Dieu Hospital, Paris; Djamel Mokart, Institut Paoli Calmette, Marseille; Achille Kouatchet, Centre Hospitalier Universitaire Hospital, Angers; François Vincent, Avicenne Hospital, Bobigny; Martine Nyunga, Victor Provo Hospital, Roubaix; Fabrice Bruneel, Mignot
| | - Frédéric Pène
- Elie Azoulay, Jérôme Lambert, Louise-Marie Laisne, Marine Chaize, Benoit Schlemmer, Sylvie Chevret, and Virginie Lemiale, Saint-Louis Hospital; Frédéric Pène, Cochin Hospital; Julien Mayaux, Pitié-Salpétrière Hospital; Antoine Rabbat, Hôtel Dieu Hospital, Paris; Djamel Mokart, Institut Paoli Calmette, Marseille; Achille Kouatchet, Centre Hospitalier Universitaire Hospital, Angers; François Vincent, Avicenne Hospital, Bobigny; Martine Nyunga, Victor Provo Hospital, Roubaix; Fabrice Bruneel, Mignot
| | - Jérôme Lambert
- Elie Azoulay, Jérôme Lambert, Louise-Marie Laisne, Marine Chaize, Benoit Schlemmer, Sylvie Chevret, and Virginie Lemiale, Saint-Louis Hospital; Frédéric Pène, Cochin Hospital; Julien Mayaux, Pitié-Salpétrière Hospital; Antoine Rabbat, Hôtel Dieu Hospital, Paris; Djamel Mokart, Institut Paoli Calmette, Marseille; Achille Kouatchet, Centre Hospitalier Universitaire Hospital, Angers; François Vincent, Avicenne Hospital, Bobigny; Martine Nyunga, Victor Provo Hospital, Roubaix; Fabrice Bruneel, Mignot
| | - Achille Kouatchet
- Elie Azoulay, Jérôme Lambert, Louise-Marie Laisne, Marine Chaize, Benoit Schlemmer, Sylvie Chevret, and Virginie Lemiale, Saint-Louis Hospital; Frédéric Pène, Cochin Hospital; Julien Mayaux, Pitié-Salpétrière Hospital; Antoine Rabbat, Hôtel Dieu Hospital, Paris; Djamel Mokart, Institut Paoli Calmette, Marseille; Achille Kouatchet, Centre Hospitalier Universitaire Hospital, Angers; François Vincent, Avicenne Hospital, Bobigny; Martine Nyunga, Victor Provo Hospital, Roubaix; Fabrice Bruneel, Mignot
| | - Julien Mayaux
- Elie Azoulay, Jérôme Lambert, Louise-Marie Laisne, Marine Chaize, Benoit Schlemmer, Sylvie Chevret, and Virginie Lemiale, Saint-Louis Hospital; Frédéric Pène, Cochin Hospital; Julien Mayaux, Pitié-Salpétrière Hospital; Antoine Rabbat, Hôtel Dieu Hospital, Paris; Djamel Mokart, Institut Paoli Calmette, Marseille; Achille Kouatchet, Centre Hospitalier Universitaire Hospital, Angers; François Vincent, Avicenne Hospital, Bobigny; Martine Nyunga, Victor Provo Hospital, Roubaix; Fabrice Bruneel, Mignot
| | - François Vincent
- Elie Azoulay, Jérôme Lambert, Louise-Marie Laisne, Marine Chaize, Benoit Schlemmer, Sylvie Chevret, and Virginie Lemiale, Saint-Louis Hospital; Frédéric Pène, Cochin Hospital; Julien Mayaux, Pitié-Salpétrière Hospital; Antoine Rabbat, Hôtel Dieu Hospital, Paris; Djamel Mokart, Institut Paoli Calmette, Marseille; Achille Kouatchet, Centre Hospitalier Universitaire Hospital, Angers; François Vincent, Avicenne Hospital, Bobigny; Martine Nyunga, Victor Provo Hospital, Roubaix; Fabrice Bruneel, Mignot
| | - Martine Nyunga
- Elie Azoulay, Jérôme Lambert, Louise-Marie Laisne, Marine Chaize, Benoit Schlemmer, Sylvie Chevret, and Virginie Lemiale, Saint-Louis Hospital; Frédéric Pène, Cochin Hospital; Julien Mayaux, Pitié-Salpétrière Hospital; Antoine Rabbat, Hôtel Dieu Hospital, Paris; Djamel Mokart, Institut Paoli Calmette, Marseille; Achille Kouatchet, Centre Hospitalier Universitaire Hospital, Angers; François Vincent, Avicenne Hospital, Bobigny; Martine Nyunga, Victor Provo Hospital, Roubaix; Fabrice Bruneel, Mignot
| | - Fabrice Bruneel
- Elie Azoulay, Jérôme Lambert, Louise-Marie Laisne, Marine Chaize, Benoit Schlemmer, Sylvie Chevret, and Virginie Lemiale, Saint-Louis Hospital; Frédéric Pène, Cochin Hospital; Julien Mayaux, Pitié-Salpétrière Hospital; Antoine Rabbat, Hôtel Dieu Hospital, Paris; Djamel Mokart, Institut Paoli Calmette, Marseille; Achille Kouatchet, Centre Hospitalier Universitaire Hospital, Angers; François Vincent, Avicenne Hospital, Bobigny; Martine Nyunga, Victor Provo Hospital, Roubaix; Fabrice Bruneel, Mignot
| | - Louise-Marie Laisne
- Elie Azoulay, Jérôme Lambert, Louise-Marie Laisne, Marine Chaize, Benoit Schlemmer, Sylvie Chevret, and Virginie Lemiale, Saint-Louis Hospital; Frédéric Pène, Cochin Hospital; Julien Mayaux, Pitié-Salpétrière Hospital; Antoine Rabbat, Hôtel Dieu Hospital, Paris; Djamel Mokart, Institut Paoli Calmette, Marseille; Achille Kouatchet, Centre Hospitalier Universitaire Hospital, Angers; François Vincent, Avicenne Hospital, Bobigny; Martine Nyunga, Victor Provo Hospital, Roubaix; Fabrice Bruneel, Mignot
| | - Antoine Rabbat
- Elie Azoulay, Jérôme Lambert, Louise-Marie Laisne, Marine Chaize, Benoit Schlemmer, Sylvie Chevret, and Virginie Lemiale, Saint-Louis Hospital; Frédéric Pène, Cochin Hospital; Julien Mayaux, Pitié-Salpétrière Hospital; Antoine Rabbat, Hôtel Dieu Hospital, Paris; Djamel Mokart, Institut Paoli Calmette, Marseille; Achille Kouatchet, Centre Hospitalier Universitaire Hospital, Angers; François Vincent, Avicenne Hospital, Bobigny; Martine Nyunga, Victor Provo Hospital, Roubaix; Fabrice Bruneel, Mignot
| | - Christine Lebert
- Elie Azoulay, Jérôme Lambert, Louise-Marie Laisne, Marine Chaize, Benoit Schlemmer, Sylvie Chevret, and Virginie Lemiale, Saint-Louis Hospital; Frédéric Pène, Cochin Hospital; Julien Mayaux, Pitié-Salpétrière Hospital; Antoine Rabbat, Hôtel Dieu Hospital, Paris; Djamel Mokart, Institut Paoli Calmette, Marseille; Achille Kouatchet, Centre Hospitalier Universitaire Hospital, Angers; François Vincent, Avicenne Hospital, Bobigny; Martine Nyunga, Victor Provo Hospital, Roubaix; Fabrice Bruneel, Mignot
| | - Pierre Perez
- Elie Azoulay, Jérôme Lambert, Louise-Marie Laisne, Marine Chaize, Benoit Schlemmer, Sylvie Chevret, and Virginie Lemiale, Saint-Louis Hospital; Frédéric Pène, Cochin Hospital; Julien Mayaux, Pitié-Salpétrière Hospital; Antoine Rabbat, Hôtel Dieu Hospital, Paris; Djamel Mokart, Institut Paoli Calmette, Marseille; Achille Kouatchet, Centre Hospitalier Universitaire Hospital, Angers; François Vincent, Avicenne Hospital, Bobigny; Martine Nyunga, Victor Provo Hospital, Roubaix; Fabrice Bruneel, Mignot
| | - Marine Chaize
- Elie Azoulay, Jérôme Lambert, Louise-Marie Laisne, Marine Chaize, Benoit Schlemmer, Sylvie Chevret, and Virginie Lemiale, Saint-Louis Hospital; Frédéric Pène, Cochin Hospital; Julien Mayaux, Pitié-Salpétrière Hospital; Antoine Rabbat, Hôtel Dieu Hospital, Paris; Djamel Mokart, Institut Paoli Calmette, Marseille; Achille Kouatchet, Centre Hospitalier Universitaire Hospital, Angers; François Vincent, Avicenne Hospital, Bobigny; Martine Nyunga, Victor Provo Hospital, Roubaix; Fabrice Bruneel, Mignot
| | - Anne Renault
- Elie Azoulay, Jérôme Lambert, Louise-Marie Laisne, Marine Chaize, Benoit Schlemmer, Sylvie Chevret, and Virginie Lemiale, Saint-Louis Hospital; Frédéric Pène, Cochin Hospital; Julien Mayaux, Pitié-Salpétrière Hospital; Antoine Rabbat, Hôtel Dieu Hospital, Paris; Djamel Mokart, Institut Paoli Calmette, Marseille; Achille Kouatchet, Centre Hospitalier Universitaire Hospital, Angers; François Vincent, Avicenne Hospital, Bobigny; Martine Nyunga, Victor Provo Hospital, Roubaix; Fabrice Bruneel, Mignot
| | - Anne-Pascale Meert
- Elie Azoulay, Jérôme Lambert, Louise-Marie Laisne, Marine Chaize, Benoit Schlemmer, Sylvie Chevret, and Virginie Lemiale, Saint-Louis Hospital; Frédéric Pène, Cochin Hospital; Julien Mayaux, Pitié-Salpétrière Hospital; Antoine Rabbat, Hôtel Dieu Hospital, Paris; Djamel Mokart, Institut Paoli Calmette, Marseille; Achille Kouatchet, Centre Hospitalier Universitaire Hospital, Angers; François Vincent, Avicenne Hospital, Bobigny; Martine Nyunga, Victor Provo Hospital, Roubaix; Fabrice Bruneel, Mignot
| | - Dominique Benoit
- Elie Azoulay, Jérôme Lambert, Louise-Marie Laisne, Marine Chaize, Benoit Schlemmer, Sylvie Chevret, and Virginie Lemiale, Saint-Louis Hospital; Frédéric Pène, Cochin Hospital; Julien Mayaux, Pitié-Salpétrière Hospital; Antoine Rabbat, Hôtel Dieu Hospital, Paris; Djamel Mokart, Institut Paoli Calmette, Marseille; Achille Kouatchet, Centre Hospitalier Universitaire Hospital, Angers; François Vincent, Avicenne Hospital, Bobigny; Martine Nyunga, Victor Provo Hospital, Roubaix; Fabrice Bruneel, Mignot
| | - Rebecca Hamidfar
- Elie Azoulay, Jérôme Lambert, Louise-Marie Laisne, Marine Chaize, Benoit Schlemmer, Sylvie Chevret, and Virginie Lemiale, Saint-Louis Hospital; Frédéric Pène, Cochin Hospital; Julien Mayaux, Pitié-Salpétrière Hospital; Antoine Rabbat, Hôtel Dieu Hospital, Paris; Djamel Mokart, Institut Paoli Calmette, Marseille; Achille Kouatchet, Centre Hospitalier Universitaire Hospital, Angers; François Vincent, Avicenne Hospital, Bobigny; Martine Nyunga, Victor Provo Hospital, Roubaix; Fabrice Bruneel, Mignot
| | - Mercé Jourdain
- Elie Azoulay, Jérôme Lambert, Louise-Marie Laisne, Marine Chaize, Benoit Schlemmer, Sylvie Chevret, and Virginie Lemiale, Saint-Louis Hospital; Frédéric Pène, Cochin Hospital; Julien Mayaux, Pitié-Salpétrière Hospital; Antoine Rabbat, Hôtel Dieu Hospital, Paris; Djamel Mokart, Institut Paoli Calmette, Marseille; Achille Kouatchet, Centre Hospitalier Universitaire Hospital, Angers; François Vincent, Avicenne Hospital, Bobigny; Martine Nyunga, Victor Provo Hospital, Roubaix; Fabrice Bruneel, Mignot
| | - Michael Darmon
- Elie Azoulay, Jérôme Lambert, Louise-Marie Laisne, Marine Chaize, Benoit Schlemmer, Sylvie Chevret, and Virginie Lemiale, Saint-Louis Hospital; Frédéric Pène, Cochin Hospital; Julien Mayaux, Pitié-Salpétrière Hospital; Antoine Rabbat, Hôtel Dieu Hospital, Paris; Djamel Mokart, Institut Paoli Calmette, Marseille; Achille Kouatchet, Centre Hospitalier Universitaire Hospital, Angers; François Vincent, Avicenne Hospital, Bobigny; Martine Nyunga, Victor Provo Hospital, Roubaix; Fabrice Bruneel, Mignot
| | - Benoit Schlemmer
- Elie Azoulay, Jérôme Lambert, Louise-Marie Laisne, Marine Chaize, Benoit Schlemmer, Sylvie Chevret, and Virginie Lemiale, Saint-Louis Hospital; Frédéric Pène, Cochin Hospital; Julien Mayaux, Pitié-Salpétrière Hospital; Antoine Rabbat, Hôtel Dieu Hospital, Paris; Djamel Mokart, Institut Paoli Calmette, Marseille; Achille Kouatchet, Centre Hospitalier Universitaire Hospital, Angers; François Vincent, Avicenne Hospital, Bobigny; Martine Nyunga, Victor Provo Hospital, Roubaix; Fabrice Bruneel, Mignot
| | - Sylvie Chevret
- Elie Azoulay, Jérôme Lambert, Louise-Marie Laisne, Marine Chaize, Benoit Schlemmer, Sylvie Chevret, and Virginie Lemiale, Saint-Louis Hospital; Frédéric Pène, Cochin Hospital; Julien Mayaux, Pitié-Salpétrière Hospital; Antoine Rabbat, Hôtel Dieu Hospital, Paris; Djamel Mokart, Institut Paoli Calmette, Marseille; Achille Kouatchet, Centre Hospitalier Universitaire Hospital, Angers; François Vincent, Avicenne Hospital, Bobigny; Martine Nyunga, Victor Provo Hospital, Roubaix; Fabrice Bruneel, Mignot
| | - Virginie Lemiale
- Elie Azoulay, Jérôme Lambert, Louise-Marie Laisne, Marine Chaize, Benoit Schlemmer, Sylvie Chevret, and Virginie Lemiale, Saint-Louis Hospital; Frédéric Pène, Cochin Hospital; Julien Mayaux, Pitié-Salpétrière Hospital; Antoine Rabbat, Hôtel Dieu Hospital, Paris; Djamel Mokart, Institut Paoli Calmette, Marseille; Achille Kouatchet, Centre Hospitalier Universitaire Hospital, Angers; François Vincent, Avicenne Hospital, Bobigny; Martine Nyunga, Victor Provo Hospital, Roubaix; Fabrice Bruneel, Mignot
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Minet C, Bonadona A, Tabah A, Karkas A, Mescam L, Schwebel C, Hamidfar R, Pison C, Saint-Raymond C, Faure O, Salameire D, Timsit JF. Mucormycose disséminée d’évolution favorable chez une greffée pulmonaire. Rev Mal Respir 2009; 26:998-1002. [DOI: 10.1016/s0761-8425(09)73337-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Fricker‐Hidalgo H, Bulabois C, Brenier‐Pinchart M, Hamidfar R, Garban F, Brion J, Timsit J, Cahn J, Pelloux H. Diagnosis of Toxoplasmosis after Allogeneic Stem Cell Transplantation: Results of DNA Detection and Serological Techniques. Clin Infect Dis 2009; 48:e9-e15. [DOI: 10.1086/595709] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Bosson JL, Pernod G, Joubin E, Hamidfar R, Bricault I, Hugon V, Seinturier C, Satger B, Pison C, Vuillez JP, Carpentier PH, Carpentier F, Polack B, Rodiere M, Ferretti GR. Non-conform diagnostic management of pulmonary embolism suspected patients is responsible for a higher risk of thrombotic event occurrence. ACTA ACUST UNITED AC 2007; 32:15-22. [PMID: 17321710 DOI: 10.1016/j.jmv.2007.01.098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2006] [Accepted: 01/09/2007] [Indexed: 11/25/2022]
Abstract
The aim of this 3-month follow-up prospective pragmatic study was to evaluate the implementation of a pulmonary embolism (PE) diagnostic strategy in clinical practice. One thousand and one hundred thirty-four consecutive in- and outpatients with clinically suspected PE were enrolled into a sequential diagnostic algorithm in which vascular medical unit plays a pivotal role in advising physicians and suggesting the most appropriate tests according to the diagnostic algorithm. In this observational study, patients that followed the proposed work-up were attributed to a so-called "conform group". Patients in whom diagnostic work-up was not according to protocol were attributed to a "non-conform group". Nine hundred and ninety-seven patients (87.9%) had a conform work-up, and 137 patients a non-conform work-up according to the proposed diagnostic algorithm. The non-conform work-up directly increased in relation to the age of the referred patients. PE was ruled out in 907 (80%) patients of whom 787 (86.8%) were in the conform group. Of the 797 patients who did not receive anticoagulant drugs, follow-up was obtained in 792 (99.4%). Among these patients, the incidence of acute thromboembolic events during the 3-month follow-up period was different in the group of patients that had a conform work-up (1%, [95% CI, 0.5-2.1%]) from the non-conform group patients (4.5%, [95% CI, 2-10.2%]. Therefore patients from the non-conform group have an independent increased risk to develop a thromboembolic event during the follow-up, adjusted odds ratio 3.3 [1.1-10, 95% CI]. Therefore we demonstrated that a non-conform diagnostic management strategy is associated with a higher risk of thrombotic event occurrence.
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Affiliation(s)
- J L Bosson
- Center of Clinical Investigation, CHU de Grenoble, BP 217, 38043 Grenoble cedex 9, France
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Boignard A, Bonadona A, Hamidfar R, Pavese P, Bouvaist H, Hammer L, Rey I, Schwebel C, Vanzetto G, Barnoud D. [Cardiogenic shock due to acute myocarditis complicating leptospirosis]. Arch Mal Coeur Vaiss 2006; 99:251-4. [PMID: 16618030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
A 48 year old man was admitted to the intensive care unit with septicaemic shock associated with febrile jaundice and anuric renal failure. Within hours, he developed cardiogenic shock with multi-organ failure due to an acute myocarditis refractory to catecholamines and requiring intra-aortic balloon pumping. The diagnosis was an ictero-haemorrhagic leptospirosis, the outcome of which was finally favourable. Myocarditis is an underestimated complication of leptospirosis because it is often symptomless. The main signs are arrhythmias, conduction defects and ST-T wave abnormalities which have little clinical expression. The disease may progress and is sometimes fatal. Leptospirosis myocarditis should therefore be carefully considered because of its potential severity and its reversibility with appropriate antibiotic therapy and also the necessity of initial management in a specific infrastructure.
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Affiliation(s)
- A Boignard
- Unité de réanimation médicale, Fédération des maladies cardiovasculaire et thoraciques, CHU de Grenoble, BP 217, 38043 Grenoble 9
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Fourneret-Vivier A, Lebeau B, Mallaret MR, Brenier-Pinchart MP, Brion JP, Pinel C, Garban F, Pison C, Hamidfar R, Plantaz D, Pelloux H, Grillot R. Hospital-wide prospective mandatory surveillance of invasive aspergillosis in a French teaching hospital (2000-2002). J Hosp Infect 2005; 62:22-8. [PMID: 16257084 DOI: 10.1016/j.jhin.2005.06.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2003] [Accepted: 06/03/2005] [Indexed: 10/25/2022]
Abstract
A multidisciplinary working group devoted to epidemiological surveillance of invasive aspergillosis (IA) was created in January 2000 in Grenoble University Hospital. This article presents the results of a three-year IA surveillance. The multidisciplinary working group surveyed all hospitalized patients, and the mycology laboratory detected most suspected IA cases. Cases were reviewed monthly by the Aspergillosis Committee, and were classified according to international consensus criteria. Possible nosocomial acquisition was determined. Among the 490 alerts, 74 IA cases were observed: six proven cases (8%), 36 (49%) probable cases and 32 (43%) possible cases. The incidence was 4.4 (95% CI 3.4-5.4) IA/100 000 patient-days. Among the proven and probable IA cases, we observed 10 nosocomial cases and six cases of undetermined origin. No cases were noted in the protected rooms in the haematology unit. Only one cluster of cases (three nosocomial cases) was detected in the haematology unit. Forty-three percent of cases (N=32) were hospitalized in the haematology unit, and all other cases were hospitalized elsewhere. This three-year survey found a high rate of non-nosocomial IA cases and a high frequency of IA cases hospitalized in units other than haematology. Thus, this study shows the importance of IA surveillance in haematology units and all high-risk units.
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Affiliation(s)
- A Fourneret-Vivier
- Infection Control Unit, Grenoble University Hospital, Grenoble Cedex 9, France
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Hamidfar R, Arbib F, Ferretti G, Pison C, Brambilla C. [A case of febrile hemoptysis]. Rev Mal Respir 1999; 16:398-9. [PMID: 10472652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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