1
|
Manzo-Silberman S, Martin AC, Boissier F, Hauw-Berlemont C, Aissaoui N, Lamblin N, Roubille F, Bonnefoy E, Bonello L, Elbaz M, Schurtz G, Morel O, Leurent G, Levy B, Jouve B, Harbaoui B, Vanzetto G, Combaret N, Lattucca B, Champion S, Lim P, Bruel C, Schneider F, Seronde MF, Bataille V, Gerbaud E, Puymirat E, Delmas C. Sex disparities in cardiogenic shock: Insights from the FRENSHOCK registry. J Crit Care 2024; 82:154785. [PMID: 38493531 DOI: 10.1016/j.jcrc.2024.154785] [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: 10/17/2023] [Accepted: 03/10/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Cardiogenic shock (CS) is the most severe form of acute heart failure. Discrepancies have been reported between sexes regarding delays, pathways and invasive strategies in CS complicating acute myocardial infarction. However, effect of sex on the prognosis of unselected CS remains controversial. OBJECTIVES The aim was to analyze the impact of sex on aetiology, management and prognosis of CS. METHODS The FRENSHOCK registry included all CS admitted in 49 French Intensive Care Units (ICU) and Intensive Cardiac Care Units (ICCU) between April and October 2016. RESULTS Among the 772 CS patients included, 220 were women (28.5%). Women were older, less smokers, with less history of ischemic cardiac disease (20.5% vs 33.6%) than men. At admission, women presented less cardiac arrest (5.5 vs 12.2%), less mottling (32.5 vs 41.4%) and higher LVEF (30 ± 14 vs 25 ± 13%). Women were more often managed via emergency department while men were directly admitted at ICU/ICCU. Ischemia was the most frequent trigger irrespective of sex (36.4% in women vs 38.2%) but women had less coronary angiogram and PCI (45.9% vs 54% and 24.1 vs 31.3%, respectively). We found no major difference in medication and organ support. Thirty-day mortality (26.4 vs 26.5%), transplant or permanent assist device were similar in both sexes. CONCLUSION Despite some more favorable parameters in initial presentation and no significant difference in medication and support, women shared similar poor prognosis than men. Further analysis is required to cover the lasting gap in knowledge regarding sex specificities to distinguish between differences and inequalities. NCT02703038.
Collapse
Affiliation(s)
- Stéphane Manzo-Silberman
- Sorbonne University, Institute of Cardiology- Hôpital Pitié-Salpêtrière (AP-HP), ACTION Study Group, Paris, France; Université de Paris, INSERM, Innovative Therapies in Haemostasis, 75006 Paris, France; Intensive Care Unit, Department of Cardiology, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, F-13385 Marseille, France; Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), Marseille, France; University of Lyon, CREATIS UMR5220, INSERM U1044, INSA-15 Lyon, France; AP-HP, Hôpital Universitaire Henri-Mondor, Service de Cardiologie, F-94010 Créteil, France; Bordeaux Cardio-Thoracic Research Centre, Bordeaux University, Bordeaux U1045, France; Université de Paris, 75006 Paris, France.
| | - Anne-Céline Martin
- Cardiology Department, AP HP, European Hospital Georges Pompidou, 75015, France
| | - Florence Boissier
- Service de Médecine Intensive Réanimation, Centre Hospitalo-Universitaire de Poitiers, INSERM CIC 1402 (IS-ALIVE group), Université de Poitiers, Member of FEMMIR (Femmes Médecins en Médecine Intensive Réanimation) Group for the French Intensive Care Society, Poitiers, France
| | - Caroline Hauw-Berlemont
- Medical Intensive Care Unit, European Hospital Georges Pompidou, Assistance Publique-Hôpitaux de Paris, FEMMIR (Femmes Médecins en Médecine Intensive Réanimation) Group for the French Intensive Care Society, Université Paris Cité, Paris, France
| | - Nadia Aissaoui
- Medical Intensive Care Unit, Cochin Hospital, Assistance Publique- Hôpitaux de Paris, Centre - Université de Paris, Medical School, Paris, France
| | - Nicolas Lamblin
- USIC Urgences et Centre Hémodynamique, Institut Coeur Poumon, Centre Hospitalier Universitaire Soins Intensifs de Cardiologie, CHU Lille, University of Lille, Inserm U1167, F-59000 Lille, France
| | - François Roubille
- PhyMedExp, Cardiology Department, University of Montpellier, INSERM U1046, CNRS UMR, 9214; INI-CRT, Montpellier, France
| | - Eric Bonnefoy
- Intensive Cardiac Care Unit, Lyon Brom University Hospital, Lyon, France
| | | | - Meyer Elbaz
- Intensive Cardiac Care Unit, Cardiology department, Rangueil University Hospital, 1 Avenue Jean Poulhes, Toulouse, France
| | - Guillaume Schurtz
- USIC Urgences et Centre Hémodynamique, Institut Coeur Poumon, Centre Hospitalier Universitaire Soins Intensifs de Cardiologie, CHU Lille, University of Lille, Inserm U1167, F-59000 Lille, France
| | - Olivier Morel
- Université de Strasbourg, Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, 67091 Strasbourg, France
| | - Guillaume Leurent
- Univ Rennes1, Department of Cardiology, CHU Rennes, Inserm, LTSI-UMR 1009, F-35000 Rennes, France
| | - Bruno Levy
- CHRU Nancy, Réanimation Médicale Brabois, Vandoeuvre-les Nancy, France
| | - Bernard Jouve
- Intensive Cardiac Care Unit, Department of Cardiology, CH d'Aix en Provence, Aix en Provence, Avenue des Tamaris, 13616, cedex 1, France
| | - Brahim Harbaoui
- Cardiology Department, Hôpital Croix-Rousse and Hôpital Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Gérald Vanzetto
- Department of Cardiology, Hôpital de Grenoble, 38700 La Tronche, France
| | - Nicolas Combaret
- Department of Cardiology, Clermont-Ferrand University Hospital Center, CNRS, Clermont Auvergne University, Clermont-Ferrand, France
| | - Benoit Lattucca
- Department of Cardiology, Nîmes University Hospital, Montpellier University, Nîmes, France
| | - Sébastien Champion
- Clinique de Parly 2, Ramsay Générale de Santé, 21 rue Moxouris, 78150 Le Chesnay, France
| | - Pascal Lim
- Univ Paris Est Créteil, INSERM, IMRB, F-94010 Créteil, France
| | - Cédric Bruel
- Groupe Hospitalier Saint Joseph, 185 rue Raymond Losserand, 75674 Paris, France
| | - Francis Schneider
- Médecine intensive réanimation, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg et Unistra, Faculté de Médecine, Strasbourg, France
| | | | - Vincent Bataille
- Intensive Cardiac Care Unit, Cardiology department, Rangueil University Hospital, 1 Avenue Jean Poulhes, Toulouse, France; Adimep : Association pour la Diffusion de la Médecine de Prévention, Toulouse, France
| | - Edouard Gerbaud
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut Lévêque, Pessac, France
| | - Etienne Puymirat
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Department of Cardiology, 75015 Paris, France
| | - Clément Delmas
- Intensive Cardiac Care Unit, Cardiology department, Rangueil University Hospital, 1 Avenue Jean Poulhes, Toulouse, France; Recherche Enseignement en Insuffisance cardiaque Avancée Assistance et Transplantation (REICATRA), Institut Saint Jacques, CHU de Toulouse, France.
| |
Collapse
|
2
|
Karsenty C, Touafchia A, Ladouceur M, Roubille F, Bonnefoy E, Bonello L, Leurent G, Levy B, Champion S, Lim P, Schneider F, Cariou A, Khachab H, Bourenne J, Seronde MF, Harbaoui B, Vanzetto G, Quentin C, Delabranche X, Combaret N, Morel O, Lattuca B, Leborgne L, Fillippi E, Gerbaud E, Brusq C, Bongard V, Lamblin N, Puymirat E, Delmas C. Cardiogenic shock in adults with congenital heart disease: Insights from the FRENSHOCK registry. Arch Cardiovasc Dis 2023; 116:390-396. [PMID: 37598062 DOI: 10.1016/j.acvd.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/13/2023] [Accepted: 06/19/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND Data on cardiogenic shock in adults with congenital heart disease (ACHD) are scarce. AIM We sought to describe cardiogenic shock in ACHD patients in a nationwide cardiogenic shock registry. METHODS From the multicentric FRENSHOCK registry (772 patients with cardiogenic shock from 49 French centres between April and October 2016), ACHD patients were compared with adults without congenital heart disease (non-ACHD). The primary outcome was defined by all-cause mortality, chronic ventricular assist device or heart transplantation at 1year. RESULTS Out of the 772 patients, seven (0.9%) were ACHD, who were younger (median age: 56 vs. 67years), had fewer cardiovascular risk factors, such as hypertension (14.3% vs. 47.5%) and diabetes (14.3% vs. 28.3%), and no previous ischaemic cardiopathy (0 vs. 61.5%). Right heart catheterization (57.1% vs. 15.4%), pacemakers (28.6% vs. 4.6%) and implantable cardioverter-defibrillators (28.6% vs. 4.8%) were indicated more frequently in the management of ACHD patients compared with non-ACHD patients, whereas temporary mechanical circulatory support (0 vs. 18.7%) and invasive mechanical ventilation (14.3% vs. 38.1%) were less likely to be used in ACHD patients. At 1year, the primary outcome occurred in 85.7% (95% confidence interval: 42.1-99.6) ACHD patients and 52.3% (95% confidence interval: 48.7-55.9) non-ACHD patients. Although 1-year mortality was not significantly different between ACHD patients (42.9%) and non-ACHD patients (45.4%), ventricular assist devices and heart transplantation tended to be more frequent in the ACHD group. CONCLUSIONS Cardiogenic shock in ACHD patients is rare, accounting for only 0.9% of an unselected cardiogenic shock population. Despite being younger and having fewer co-morbidities, the prognosis of ACHD patients with cardiogenic shock remains severe, and is similar to that of other patients.
Collapse
Affiliation(s)
- Clément Karsenty
- Paediatric and Adult Congenital Cardiology Unit, CHU de Toulouse, 31300 Toulouse, France; Institut Des Maladies Métaboliques et Cardiovasculaires (I2MC), Inserm U1048, 31432 Toulouse, France.
| | - Anthony Touafchia
- Intensive Cardiac Care Unit, Cardiology Department, Rangueil University Hospital, 31400 Toulouse, France
| | - Magalie Ladouceur
- Department of Cardiology, Hôpital Européen Georges-Pompidou, AP-HP, 75015 Paris, France; Université de Paris, 75006 Paris, France
| | - François Roubille
- PhyMedExp, Université de Montpellier, Inserm, CNRS, 34295 Montpellier, France; Cardiology Department, CHU de Montpellier, 34295 Montpellier, France
| | - Eric Bonnefoy
- Intensive Cardiac Care Unit, Lyon University Hospital, 69622 Bron, France
| | - Laurent Bonello
- Aix-Marseille University, 13385 Marseille, France; Intensive Care Unit, Department of Cardiology, Hôpital Nord, AP-HM, 13385 Marseille, France; Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), 13385 Marseille, France
| | - Guillaume Leurent
- Department of Cardiology, CHU de Rennes, 35000 Rennes, France; LTSI-UMR 1099, Inserm, University of Rennes 1, 35000 Rennes, France
| | - Bruno Levy
- Réanimation Médicale Brabois, CHRU Nancy, 54511 Vandœuvre-les Nancy, France
| | | | - Pascal Lim
- Université Paris-Est Créteil, Inserm, IMRB, 94010 Créteil, France; Service de Cardiologie, Hôpital Universitaire Henri-Mondor, AP-HP, 94010 Créteil, France
| | - Francis Schneider
- Médecine Intensive-Réanimation, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 67200 Strasbourg, France
| | - Alain Cariou
- Medical Intensive Care Unit, Cochin Hospital, AP-HP, 75014 Paris, France; Medical School, Centre-Université de Paris, 75014 Paris, France
| | - Hadi Khachab
- Intensive Cardiac Care Unit, Department of Cardiology, CH d'Aix-en-Provence, 13616 Aix-en-Provence, France
| | - Jeremy Bourenne
- Service de Réanimation des Urgences, CHU de la Timone 2, Aix-Marseille Université, 13385 Marseille, France
| | | | - Brahim Harbaoui
- Cardiology Department, Hôpital Croix-Rousse and Hôpital Lyon Sud, Hospices Civils de Lyon, 69004 Lyon, France; University of Lyon, CREATIS UMR 5220, Inserm U1044, INSA-15, 69100 Lyon, France
| | - Gérald Vanzetto
- Department of Cardiology, Hôpital de Grenoble, 38700 La Tronche, France
| | | | - Xavier Delabranche
- Réanimation Chirurgicale Polyvalente, Pôle Anesthésie-Réanimation Chirurgicale-Médecine Péri-opératoire, Les Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil 1, 67091 Strasbourg, France
| | - Nicolas Combaret
- Department of Cardiology, CHU de Clermont-Ferrand, CNRS, Université Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - Olivier Morel
- Pôle d'Activité Médico-Chirurgicale Cardiovasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, 67091 Strasbourg, France
| | - Benoit Lattuca
- Department of Cardiology, Nîmes University Hospital, Montpellier University, 30900 Nîmes, France
| | | | | | - Edouard Gerbaud
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut-Lévêque, 33604 Pessac, France; Bordeaux Cardio-Thoracic Research Centre, U1045, Bordeaux University, Hôpital Xavier-Arnozan, 33600 Pessac, France
| | - Clara Brusq
- Unité de Soutien Méthodologique à la Recherche (USMR), Service d'Épidémiologie Clinique et Santé Publique, CHU de Toulouse, 31300 Toulouse, France
| | - Vanina Bongard
- Unité de Soutien Méthodologique à la Recherche (USMR), Service d'Épidémiologie Clinique et Santé Publique, CHU de Toulouse, 31300 Toulouse, France
| | - Nicolas Lamblin
- Urgences et Soins Intensifs de Cardiologie, CHU de Lille, Inserm U1167, University of Lille, 59000 Lille, France
| | - Etienne Puymirat
- Department of Cardiology, Hôpital Européen Georges-Pompidou, AP-HP, 75015 Paris, France; Université de Paris, 75006 Paris, France
| | - Clément Delmas
- Paediatric and Adult Congenital Cardiology Unit, CHU de Toulouse, 31300 Toulouse, France; Institut Des Maladies Métaboliques et Cardiovasculaires (I2MC), Inserm U1048, 31432 Toulouse, France; REICATRA, Institut Saint-Jacques, CHU de Toulouse, 31059 Toulouse, France
| |
Collapse
|
3
|
Nesbitt K, Beleigoli A, Champion S, Gebremichael L, Jacob A, Du H, Hendriks J, Tirimacco R, Clark RA. Evaluating the usability of a co-designed interactive web application for cardiac rehabilitation. Eur J Cardiovasc Nurs 2022. [DOI: 10.1093/eurjcn/zvac060.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Novartis
Background/significance
The rapid development of information technology is driving the evolution of choices of modes of delivery of healthcare services. The internet is an extremely powerful tool for accessing information, and communication. However, involvement of patients in the assessment of such an intervention is crucial, and can be achieved through a person-centred approach, utilising a co-design process with the aim to increase intervention usability.
Purpose
To assess the usability of the Country Access to Cardiac Health (CATCH) Web, an interactive web application for cardiac rehabilitation (CR), co-designed with rural and remote Australians, following the co-design development phase.
Methods
The User Experience (UX) Design framework was used to co-design the web portal with CR patients through two rounds of six co-design workshops pre (n=39), and post (n=35). Participants and family members living in rural and remote areas of Australia were invited to participate based on their eligibility for CR as outlined by the National Heart Foundation of Australia. As part of the UX Design Framework the System Usability Scale (SUS) was used to measure objective feedback from participants on the website design. The SUS assesses the three core components of a products usability: effectiveness, efficiency and satisfaction using a 10 question Likert scale. Mean scores were compared between the two rounds of workshops using an independent T-Test. The mean SUS score is categorised into poor to moderate (<68), good (68-80.3) and excellent (>=80.3) and categories were compared between the two rounds of workshops through Chi-Square tests.
Results
The 35 participants in the usability workshops had a mean age of 68.6 (SD 11.2) years and 16 (47%) were female (Table 1). The majority had experienced a myocardial infarction (15, 42.8%) and had hyperlipidemia (17, 50%), heart failure (15, 44%), hypertension (14, 41%), and Type II diabetes (7, 21%). Of these participants 20 (59%) used a smart phone, 18 (58%) had access to the National Broadband Network and 20 (59%) engaged with Facebook. From the first to the second round of workshops, there was an improvement in the mean SUS scores from 66.7 (SD16.8) to 73.6 (SD 21.0); p=0.26. The proportion of participants rating it as good or excellent increased from 48.7 to 65.8%; p=0.11 (Figure1).
Conclusion
The usability testing of the interactive CATCH web application showed an improvement in the SUS rating from poor to moderate in the co-design development phase to good or excellent by most of the participants in the usability testing phase. Usability is closely related to engagement with a digital health intervention. Upcoming evaluation of this intervention will report on clinical outcomes.
Collapse
Affiliation(s)
- K Nesbitt
- Flinders University , Adelaide , Australia
| | | | - S Champion
- Flinders University , Adelaide , Australia
| | | | - A Jacob
- Flinders University , Adelaide , Australia
| | - H Du
- Flinders University , Adelaide , Australia
| | - J Hendriks
- Flinders University , Adelaide , Australia
| | - R Tirimacco
- Integrated Cardiovascular Clinical Network , Adelaide , Australia
| | - R A Clark
- Flinders University , Adelaide , Australia
| |
Collapse
|
4
|
Nesbitt K, Beleigoli A, Champion S, Gebremichael L, Du H, Foote J, Tirimacco R, Clark R. Evaluating the Useability of a Co-Designed Interactive Web Application for Cardiac Rehabilitation. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
5
|
Beleigoli A, Champion S, Tirimacco R, Govin K, Tideman P, Clark RA. How the COVID pandemic affected utilisation of cardiac rehabilitation in rural Australia? Eur J Cardiovasc Nurs 2021. [DOI: 10.1093/eurjcn/zvab060.070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Caring Futures Institute
Background
Provision of cardiac rehabilitation (CR) was disrupted in 31% of the 155 countries according to the World Health Organisation during the early months of the COVID pandemic. This might have been associated with worsening clinical outcomes and is of particular concern to patients living in rural and remote areas. In Australia, these patients have a higher prevalence of cardiovascular diseases, higher rates of adverse outcomes due to acute myocardial infarction and limited availability to regional services.
Purpose
We aimed to investigate how the COVID affected the delivery of CR services in rural and remote South Australia (SA) during the first wave of the COVID pandemic.
Methods
CR attendance, completion and waiting times in the pre-COVID period (February-July 2019) was compared to data during the first wave of COVID (February-July 2020) using data from CR services across six regional local health networks recorded in the Country Access to Cardiac Health (CATCH) database.
Results
There were 922 patients (32.2% females; mean age 69.2 years; 36.6% living in areas with high socio-economic disadvantage) referred to CR in the pre-COVID period, and 1032 patients (30.7% females; mean age 68.1 years; 35.7% living in areas with high socio-economic disadvantage) in the COVID period across the six regional areas in South Australia. Acute coronary syndrome was the main reason for referral both pre (251; 27.2%) and during COVID (273; 26.5%). The proportion of CR attendance was higher in the pre (522; 56.6%) compared to the COVID period (431, 41.8%; p < 0.001). Completion was higher pre (413, 79.1%) compared to during COVID period (205,47.6%) completed CR during the COVID period (p < 0.001). The waiting time was 35 (SD 27) days pre-COVID and 34 (SD 25) days in the COVID period (p = 0.37).
Conclusion
Our data show that attendance and completion of CR programs were significantly reduced during the COVID period in rural and remote Australia. Limited service access during the pandemic and fear to physically attend health services during the period of social and physical restrictions might have contributed to this. Telehealth-delivered CR can provide opportunities to continuity of cardiovascular care and secondary prevention during pandemic restrictions.
Collapse
Affiliation(s)
- A Beleigoli
- Flinders University, Caring Futures Institute, Adelaide, Australia
| | - S Champion
- Flinders University, Caring Futures Institute, Adelaide, Australia
| | - R Tirimacco
- Integrated Clinical Cardiovascular Network SA , Adelaide, Australia
| | - K Govin
- Flinders University, Caring Futures Institute, Adelaide, Australia
| | - P Tideman
- Integrated Clinical Cardiovascular Network SA , Adelaide, Australia
| | - RA Clark
- Flinders University, Caring Futures Institute, Adelaide, Australia
| |
Collapse
|
6
|
Delmas C, Puymirat E, Leurent G, Manzo-Silberman S, Elbaz M, Levy B, Morel O, Aissaoui N, Chevalier S, Vanzetto G, Harbaoui B, Champion S, Ternacle J, Bonello L, Combaret N, Gerbaud E, Lamblin N, Bonnefoy E, Henry P, Roubille F. Early predictive factors of 30-days mortality in cardiogenic shock: An analysis of the FRENSHOCK multicenter prospective registry. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
7
|
Delmas C, Elbaz M, Leurent G, Manzo-Silberman S, Puymirat E, Levy B, Bonello L, Ternacle J, Champion S, Aissaoui N, Seronde M, Jouve B, Morel O, Bedossa M, Shneider F, Gerbaud E, Lamblin N, Roubille F, Henry P, Bonnefoy E. Cardiogenic shock in France: What and who are we talking about? A descriptive analysis of the FRENSHOCK multicenter prospective registry. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
8
|
Champion S, Zieger L, Hemery C. Prophylaxis of postoperative nausea and vomiting after cardiac surgery in high-risk patients: A randomized controlled study. Ann Card Anaesth 2018; 21:8-14. [PMID: 29336385 PMCID: PMC5791499 DOI: 10.4103/aca.aca_122_17] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Context: The role of prophylaxis for postoperative nausea and vomiting (PONV) in cardiac surgery is under debate. Aims: To study the risk factors for PONV after cardiac surgery and the role of betamethasone with or without droperidol for its prevention. Setting and Design: Randomized open-label controlled study comparing standard care with PONV prophylaxis from February to November 2016. Methods: Five hundred and two patients with planned nonemergent cardiac surgery were included. Interventions: In the intervention arm, PONV prophylaxis (4 mg betamethasone with/without 0.625 mg droperidol) was administered in high-risk patients (two or more risk factors). Patients in the control arm were treated as per routine hospital practices. Results: Female sex, past history of PONV, and migraines were associated with a significantly increased risk of PONV, while motion sickness, smoking status, and volatile anesthetics were not. Pain and treatment with nefopam or ketoprofen were associated with an increased risk of PONV. PONV was less frequent in the active arm compared to controls (45.5% vs. 54.0%, P = 0.063; visual analogic scale 10.9 vs. 15.3 mm, P = 0.043). Among the 180 patients (35.6%) with ≥2 risk factors, prophylaxis was associated with reduced PONV (intention-to-treat: 46.8% vs. 67.8%, P = 0.0061; per-protocol: 39.2% vs. 69%, P = 0.0002). In multivariate analysis, prophylaxis was independently associated with PONV (odds ratio [OR]: 0.324, 95% confidence interval: 0.167–0.629, P = 0.0009), as were female sex, past history of PONV, and migraines (OR: 3.027, 3.031, and 2.160 respectively). No drug-related side effects were reported. Conclusion: Betamethasone with/without droperidol was effective in decreasing PONV in high risk cardiac surgical patients without any side effect.
Collapse
Affiliation(s)
- Sébastien Champion
- Intensive Care Unit, Parly 2 Clinic, Ramsay Générale de Santé, 78150 Le Chesnay, France
| | - Laëtitia Zieger
- Intensive Care Unit, Parly 2 Clinic, Ramsay Générale de Santé, 78150 Le Chesnay, France
| | - Caroline Hemery
- Intensive Care Unit, Parly 2 Clinic, Ramsay Générale de Santé, 78150 Le Chesnay, France
| |
Collapse
|
9
|
Léopold V, Gayat E, Pirracchio R, Spinar J, Parenica J, Tarvasmäki T, Lassus J, Harjola VP, Champion S, Zannad F, Valente S, Urban P, Chua HR, Bellomo R, Popovic B, Ouweneel DM, Henriques JPS, Simonis G, Lévy B, Kimmoun A, Gaudard P, Basir MB, Markota A, Adler C, Reuter H, Mebazaa A, Chouihed T. Correction to: Epinephrine and short-term survival in cardiogenic shock: an individual data meta-analysis of 2583 patients. Intensive Care Med 2018; 44:2022-2023. [DOI: 10.1007/s00134-018-5372-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
10
|
Champion S, Gaüzère BA, Vandroux D, Lefort Y. [Is it worth delivering Direct-Current Counter shock to critically ill patients with supra-ventricular tachyarrhythmia?]. Ann Cardiol Angeiol (Paris) 2018; 67:260-263. [PMID: 29945712 DOI: 10.1016/j.ancard.2018.04.003] [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: 12/21/2016] [Accepted: 04/24/2018] [Indexed: 11/24/2022]
Abstract
Supra-ventricular tachyarrhythmia and its treatment have been poorly investigated in ICU patients. AIMS To evaluate efficacy and safety of cardioversion for supra-ventricular tachyarrhythmia in the intensive care unit (ICU). PATIENTS AND METHODS Prospective inclusion of all patients who presented supra-ventricular tachyarrhythmias lasting≥30seconds in a single medico-surgical ICU, except cardiac surgery. Anti-arrhythmic drugs and/or direct-current cardioversion were administered on a liberal basis. RESULTS During the 15-month study period, 108/846 patients (12.8%) experienced supra-ventricular tachyarrhythmias. Anti-arrhythmic drugs were administered in 78 patients (72%); mostly amiodarone (92%), and/or magnesium (23%), resulting in an overall conversion rate of 68%. Direct-current cardioversion was used in 26 patients (24%), (24 patients received drug enhancement by anti-arrhythmic drugs) with an immediate 80.8%-success rate. CONCLUSION Direct-current cardioversion was associated with sustained conversion to sinus rhythm in 80.8% of ICU patients with supra-ventricular tachyarrhythmias, although most of them had already received drug enhancement.
Collapse
Affiliation(s)
- S Champion
- Service de réanimation polyvalente, hôpital Félix-Guyon, CHU de la Réunion, allée des Topazes, CS 11021, 97400 Saint-Denis, Réunion; Réanimation, clinique de Parly 2, Ramsay générale de santé, 21, rue Moxouris, 78150 Le Chesnay, France.
| | - B A Gaüzère
- Service de réanimation polyvalente, hôpital Félix-Guyon, CHU de la Réunion, allée des Topazes, CS 11021, 97400 Saint-Denis, Réunion
| | - D Vandroux
- Service de réanimation polyvalente, hôpital Félix-Guyon, CHU de la Réunion, allée des Topazes, CS 11021, 97400 Saint-Denis, Réunion
| | - Y Lefort
- Service de réanimation polyvalente, hôpital Félix-Guyon, CHU de la Réunion, allée des Topazes, CS 11021, 97400 Saint-Denis, Réunion
| |
Collapse
|
11
|
Champion S. Are Opioids Really Safe in Patients with Congestive Heart Failure? Pain Medicine 2018; 19:413-414. [DOI: 10.1093/pm/pnx221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Sébastien Champion
- Clinique de Parly 2, Ramsay Générale de Santé, 78150 Le Chesnay, France. Tel : +331 49958442; Fax : +331 49958964
| |
Collapse
|
12
|
Champion S, Belcour D, Gaüzère BA. Thrombotic thrombocytopenic purpura presenting as a severe peripartum cardiogenic shock: Role of myocardial biopsy and assist device for diagnosis and resuscitation. Eur Heart J Acute Cardiovasc Care 2017; 9:NP8-NP9. [PMID: 29105485 DOI: 10.1177/2048872617740829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We describe the case of a peripartum thrombotic thrombocytopenic purpura with fulminant cardiogenic shock treated with extracorporeal life support. Thrombotic thrombocytopenic purpura should be considered in the case of thrombotic microangiopathy with several or severe organ involvement and needs emergent treatment with plasmapheresis (with or without rituximab). In the case of cardiac involvement, aggressive treatment should be considered given the high mortality and the potential complete recovery.
Collapse
Affiliation(s)
- Sébastien Champion
- Réanimation polyvalente, Centre hospitalier universitaire de la Réunion, France.,Réanimation, clinique de Parly 2, Ramsay Générale de Santé, France
| | - Dominique Belcour
- Réanimation polyvalente, Centre hospitalier universitaire de la Réunion, France
| | | |
Collapse
|
13
|
Champion S. Extracorporeal membrane oxygenation in the therapy of cardiogenic shock (ECMO-CS): the need for a better definition of refractory cardiogenic shock. Eur J Heart Fail 2017; 20:197-198. [DOI: 10.1002/ejhf.939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 06/08/2017] [Accepted: 06/11/2017] [Indexed: 11/08/2022] Open
Affiliation(s)
- Sébastien Champion
- Réanimation, Clinique de Parly 2; Ramsay Générale de Santé; Le Chesnay France
| |
Collapse
|
14
|
Affiliation(s)
- Sébastien Champion
- Réanimation, clinique de Parly 2, Ramsay Générale de Santé, Le Chesnay, France,
| |
Collapse
|
15
|
Champion S. Stress Echocardiography: A Major Tool for Determining Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy. J Am Soc Echocardiogr 2017; 30:1042-1043. [PMID: 28797722 DOI: 10.1016/j.echo.2017.06.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Sébastien Champion
- Réanimation, Clinique de Parly 2, Ramsay Générale de Santé, Le Chesnay, France
| |
Collapse
|
16
|
Champion S. Do we need another prognostic score for cardiogenic shock patients with ECMO? Crit Care 2017; 21:168. [PMID: 28683757 PMCID: PMC5500995 DOI: 10.1186/s13054-017-1753-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 06/06/2017] [Indexed: 11/22/2022]
Affiliation(s)
- Sébastien Champion
- Réanimation, Clinique de Parly 2, Ramsay Générale de Santé, 21 rue Moxouris, 78150, Le Chesnay, France.
| |
Collapse
|
17
|
Champion S. Comment on: Ivabradine: A Review of Labeled and Off-Label Uses. Am J Cardiovasc Drugs 2016; 16:473-474. [PMID: 27743223 DOI: 10.1007/s40256-016-0198-8] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Sébastien Champion
- Réanimation, Clinique de Parly 2, Ramsay Générale de Santé, 21 rue Moxouris, 78150, Le Chesnay, France.
| |
Collapse
|
18
|
Champion S. Limited evidence of improved efficacy regarding drug eluting stents in patients with cardiogenic shock. Int J Cardiol 2016; 223:10. [PMID: 27532231 DOI: 10.1016/j.ijcard.2016.08.059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 08/03/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Sébastien Champion
- Réanimation, clinique de Parly 2, 21 rue Moxouris, 78150 Le Chesnay, France.
| |
Collapse
|
19
|
Champion S. The pursuit of a score to guide mechanical treatment of circulatory failure after cardiac arrest. J Crit Care 2016; 36:299. [PMID: 27184588 DOI: 10.1016/j.jcrc.2016.04.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 04/25/2016] [Indexed: 11/24/2022]
|
20
|
Champion S. Heterogeneous populations in non-ischaemic cardiogenic shock. Eur J Heart Fail 2016; 18:115. [DOI: 10.1002/ejhf.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 07/19/2015] [Accepted: 07/20/2015] [Indexed: 11/06/2022] Open
Affiliation(s)
- Sébastien Champion
- Réanimation polyvalente; CHU de la Réunion; route de Bellepierre 97400 Saint Denis France
| |
Collapse
|
21
|
Champion S. Takotsubo Cardiomyopathy related to Pheochromocytoma or Other Etiology Should Be Considered as Similar. Korean Circ J 2015; 45:535. [PMID: 26617659 PMCID: PMC4661372 DOI: 10.4070/kcj.2015.45.6.535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Revised: 01/16/2015] [Accepted: 04/16/2015] [Indexed: 12/16/2022] Open
|
22
|
Boukobza M, Baud FJ, Gourlain H, Champion S, Malissin I, Mégarbane B. Neuroimaging findings and follow-up in two cases of severe ethylene glycol intoxication with full recovery. J Neurol Sci 2015; 359:343-6. [PMID: 26671139 DOI: 10.1016/j.jns.2015.11.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 11/04/2015] [Accepted: 11/12/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Monique Boukobza
- Medical and Toxicological Intensive Care Unit, Assistance Publique, Hôpitaux de Paris, Groupe Hospitalier Lariboisière, Saint Louis, Paris, France.
| | - Frédéric J Baud
- Medical and Toxicological Intensive Care Unit, Assistance Publique, Hôpitaux de Paris, Groupe Hospitalier Lariboisière, Saint Louis, Paris, France; Université Paris Sorbonne Cité, Paris Diderot, Paris, France; UMR-8536, Université Paris Descartes, Paris, France.
| | - Hervé Gourlain
- Laboratory of Toxicology, Assistance Publique, Hôpitaux de Paris, Groupe Hospitalier Lariboisière, Saint Louis, Paris, France.
| | - Sébastien Champion
- Medical and Toxicological Intensive Care Unit, Assistance Publique, Hôpitaux de Paris, Groupe Hospitalier Lariboisière, Saint Louis, Paris, France.
| | - Isabelle Malissin
- Medical and Toxicological Intensive Care Unit, Assistance Publique, Hôpitaux de Paris, Groupe Hospitalier Lariboisière, Saint Louis, Paris, France.
| | - Bruno Mégarbane
- Medical and Toxicological Intensive Care Unit, Assistance Publique, Hôpitaux de Paris, Groupe Hospitalier Lariboisière, Saint Louis, Paris, France; Université Paris Sorbonne Cité, Paris Diderot, Paris, France; INSERM U1144, Paris, France.
| |
Collapse
|
23
|
Champion S. Takotsubo cardiomyopathy: Near drowning and hanging sound familiar. J Crit Care 2015; 30:1417. [PMID: 26415534 DOI: 10.1016/j.jcrc.2015.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 09/01/2015] [Accepted: 09/02/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Sébastien Champion
- Réanimation Polyvalente, CHU de la Réunion, Hôpital Félix Guyon, 97405 Saint Denis, France.
| |
Collapse
|
24
|
O'Keeffe C, Champion S, Allsop D. Demonstrating the effect of forensic firearm countermeasures: Bullet characteristics generated due to barrel modifications. Forensic Sci Int 2015; 257:13-19. [PMID: 26282508 DOI: 10.1016/j.forsciint.2015.07.034] [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: 04/17/2015] [Revised: 07/16/2015] [Accepted: 07/17/2015] [Indexed: 10/23/2022]
Abstract
Forensic awareness and the declining availability of firearms have resulted in an increase in the use of modified and re-activated firearms in crime. Although some modifications are undertaken to simply acquire a functioning firearm, others are perpetrated as a direct forensic countermeasure to prevent the association between a firearm and a crime. This article describes the effects of these modifications on bullet striation patterns imparted from the barrel to a fired bullet. The key results indicated that the investigated modifications display assessable characteristics. The use of an oversized barrel imparted striations consistent with firing with the absence of typical rifling. Subsequent or consecutively fired bullets possessed striation variations, with the first showing the least evidence of striations. The application of a choke resulted in more obvious bullet elongation compared to a smoothbore barrel. The restriction caused merging of lands and groves of the imparted rifling and obscured their usual definition. Effects of breech adaption were also characterised by observing the buckling and enlargement of the cartridge case. This deformity of the cartridge case was most evident when the barrel pressure increased due to the presence of the choke. From this study it was evident that unique characteristic impressions associated with different modifications most commonly found in criminal investigations can be utilised by a forensic expert and impart significant intelligence to an investigation.
Collapse
Affiliation(s)
- C O'Keeffe
- Cranfield Forensic Institute, Cranfield University, Defence Academy of the United Kingdom, Shrivenham SN6 8LA, United Kingdom.
| | - S Champion
- Centre for Defence Engineering, Cranfield University, Defence Academy of the United Kingdom, Shrivenham SN6 8LA, United Kingdom
| | - D Allsop
- Cranfield Forensic Institute, Cranfield University, Defence Academy of the United Kingdom, Shrivenham SN6 8LA, United Kingdom
| |
Collapse
|
25
|
Champion S. Mostly early invasive management may improve outcomes in patients with myocardial infarction and cardiogenic shock. Am J Med 2015. [PMID: 26210461 DOI: 10.1016/j.amjmed.2015.01.028] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Sébastien Champion
- Réanimation Polyvalente, CHU de la Réunion, Hôpital Félix Guyon, Saint Denis, France
| |
Collapse
|
26
|
Champion S, Deye N, Solal AC. Y a-t-il une place pour le dinitrate d’isosorbide dans l’œdème aigu pulmonaire? Therapie 2015; 70:265-71. [DOI: 10.2515/therapie/2014226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 10/25/2014] [Indexed: 11/20/2022]
|
27
|
Abstract
BACKGROUND Pentoxifylline possess antiinflammatory and rheological properties and has been tested in heart failure (HF). METHODS A comprehensive search was performed from 1980 until July 2013 in PubMed, to identify randomized controlled trials evaluating pentoxifylline versus placebo in HF, to determine impact on mortality. Search strategy is as follows: "Pentoxifylline" AND "heart" AND "trial". Study selection of six randomized controlled trials evaluating mortality as outcome. Then, we conducted a meta-analysis of randomized controlled trials versus placebo in HF. Determination of Mantel-Haenszel fixed effect and random-effect pooled odds ratios for all-cause mortality and corresponding 95% confidence intervals. RESULTS Data from a total of 221 patients with LVEF ≤40% from six randomized controlled trials were included in this analysis. Pentoxifylline 1200 mg per day was administered during 6 months, except in one study (administered during 1 month for severe acute HF). The use of pentoxifylline was not significantly associated with a reduction in mortality in HF in individual studies. The pooled data including 221 patients showed a nearly fourfold reduction in mortality (5.4% vs. 18.3%; OR 0.29; CI 0.12-0.74; P < 0.01) with homogenous results (I² 0%). CONCLUSION A meta-analysis evaluating pentoxifylline versus placebo in HF suggested a significant nearly fourfold decrease in all-cause mortality in the pentoxifylline group.
Collapse
Affiliation(s)
- Sébastien Champion
- Réanimation Médicale et Toxicologique, Hôpital Lariboisière, Paris, France
| | | | | | | | | | | |
Collapse
|
28
|
|
29
|
Champion S, Braunberger E. Surgical embolectomy for intermediate-risk acute pulmonary embolism. Interact Cardiovasc Thorac Surg 2014; 20:274-5. [PMID: 25415313 DOI: 10.1093/icvts/ivu376] [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] [Indexed: 11/14/2022] Open
Abstract
Recent series reported excellent results of surgical embolectomy in patients with acute pulmonary embolism with mortality rates of about 5-9% (range 0-13%). However, very low mortality of patients receiving medical treatment for intermediate-risk pulmonary embolism (1.5 and 2.8% at 7 and 30 days, respectively) was recently reported. Thus, we would like to challenge the indication for surgical embolectomy in the subset of intermediate-risk patients.
Collapse
Affiliation(s)
- Sébastien Champion
- Réanimation Polyvalente, Centre Hospitalier Universitaire de la Réunion, Saint Denis, France
| | - Eric Braunberger
- Chirurgie Cardiaque, Centre Hospitalier Universitaire de la Réunion, Saint Denis, France
| |
Collapse
|
30
|
Champion S, Belcour D, Vandroux D, Drouet D, Gaüzère BA, Bouchet B, Bossard G, Djouhri S, Jabot J, Champion M, Lefort Y. Stress (Tako-tsubo) cardiomyopathy in critically-ill patients. Eur Heart J Acute Cardiovasc Care 2014; 4:189-96. [PMID: 25202025 DOI: 10.1177/2048872614547686] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Stress cardiomyopathy (SC) is a transient ventricular dysfunction rarely described in the critical care setting. OBJECTIVE To evaluate the mechanisms, incidence, treatment and prognosis of SC. METHOD This is a retrospective observational study of every critically-ill patient admitted to the ICU over a period of two years. RESULTS Among 1314 patients admitted in the ICU, 20 patients (1.5%) were diagnosed with SC. A total of 249 patients experienced cardiogenic shock, whereas 8% were suffering from SC. SC was suspected because of hemodynamic impairment (80% of cases), ECG modifications (15%) and/or dyspnea (15%). SC was apical (typical Tako-tsubo) in 90% and atypical in 10% of cases. Several mechanisms or conditions may explain the occurrence of SC and are may be combined: catecholamine toxicity (45%), psychological stress, seizures or neurological impairment (35%), non-epicardial coronary ischemia (20%) and left ventricular outflow track (LVOT) obstruction (10%). SC could have indirectly caused death by worsening heart failure in three patients and arrhythmias were seen in 40% of patients. SAPS2, renal impairment, malnutrition, norepinephrine infusion and thrombocytopenia were associated with death in the univariate analysis. Catecholamines were required in 85% and intra-aortic balloon pump in 20% of patients. CONCLUSIONS SC is a rare reversible cardiac impairment in the critically-ill patient that can induce arrhythmias and cardiogenic shock. The likely mechanisms are combined: catecholamine toxicity, stress or neurological involvement and less frequently ischemia or LVOT obstruction.
Collapse
Affiliation(s)
- Sébastien Champion
- Centre Hospitalier Universitaire de La Réunion, Site Félix Guyon, Allée des Topazes, Réunion, France
| | - Dominique Belcour
- Centre Hospitalier Universitaire de La Réunion, Site Félix Guyon, Allée des Topazes, Réunion, France
| | - David Vandroux
- Centre Hospitalier Universitaire de La Réunion, Site Félix Guyon, Allée des Topazes, Réunion, France
| | - Didier Drouet
- Centre Hospitalier Universitaire de La Réunion, Site Félix Guyon, Allée des Topazes, Réunion, France
| | - Bernard A Gaüzère
- Centre Hospitalier Universitaire de La Réunion, Site Félix Guyon, Allée des Topazes, Réunion, France
| | - Bruno Bouchet
- Centre Hospitalier Universitaire de La Réunion, Site Félix Guyon, Allée des Topazes, Réunion, France
| | - Guillaume Bossard
- Centre Hospitalier Universitaire de La Réunion, Site Félix Guyon, Allée des Topazes, Réunion, France
| | - Sabina Djouhri
- Centre Hospitalier Universitaire de La Réunion, Site Félix Guyon, Allée des Topazes, Réunion, France
| | - Julien Jabot
- Centre Hospitalier Universitaire de La Réunion, Site Félix Guyon, Allée des Topazes, Réunion, France
| | | | - Yannick Lefort
- Centre Hospitalier Universitaire de La Réunion, Site Félix Guyon, Allée des Topazes, Réunion, France
| |
Collapse
|
31
|
Champion S. The double-edged sword of mechanical ventilation for patients with cardiogenic shock. Cardiol J 2014; 21:449. [PMID: 25178036 DOI: 10.5603/cj.2014.0054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 04/11/2014] [Indexed: 11/25/2022] Open
Affiliation(s)
- Sébastien Champion
- Réanimation médicale et toxicologique hôpital Lariboisière, 2 rue A. Paré, 75010 Paris, France.
| |
Collapse
|
32
|
Gaüzère BA, Malvy D, Aubry P, Brottet E, Jaffar-Bandjee MC, Filleul L, Vandroux D, Jabot J, Angue M, Belcour D, Bouchet B, Chanareille P, Gauvin T, Rakotoarisoa A, Halm A, Rakotomanga LM, Randrianarivo-Solofoniaina AE, Champion S, Lefort Y, Durasnel P, Lion F, Blondé R, Valyi L, Allyn J, Martinet O. Vingt-quatrième réunion du comité local de la Société de pathologie exotique, 18 mars 2014. Bull Soc Pathol Exot 2014; 107:199-203. [PMID: 38624281 PMCID: PMC7097729 DOI: 10.1007/s13149-014-0366-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- B.-A. Gaüzère
- CHU de La Réunion, Site Félix Guyon, Allée des Topazes, CS 11021, 97400 Saint-Denis, Réunion, France
- Centre René Labusquière, Université de Bordeaux, Bordeaux, 33076 Bordeaux, France
| | - D. Malvy
- CHU de La Réunion, Site Félix Guyon, Allée des Topazes, CS 11021, 97400 Saint-Denis, Réunion, France
| | - P. Aubry
- Centre René Labusquière, Université de Bordeaux, Bordeaux, 33076 Bordeaux, France
| | - E. Brottet
- Cellule de l’institut de veille sanitaire en Région océan Indien, Saint-Denis, Réunion, France
| | - M.-C. Jaffar-Bandjee
- Laboratoire de virologie, CHU de La Réunion, site Félix Guyon, Allée des Topazes, CS 11021, 97400 Saint-Denis, Réunion, France
| | - L. Filleul
- Cellule de l’institut de veille sanitaire en Région océan Indien, Saint-Denis, Réunion, France
| | - D. Vandroux
- CHU de La Réunion, Site Félix Guyon, Allée des Topazes, CS 11021, 97400 Saint-Denis, Réunion, France
| | - J. Jabot
- CHU de La Réunion, Site Félix Guyon, Allée des Topazes, CS 11021, 97400 Saint-Denis, Réunion, France
| | - M. Angue
- CHU de La Réunion, Site Félix Guyon, Allée des Topazes, CS 11021, 97400 Saint-Denis, Réunion, France
| | - D. Belcour
- CHU de La Réunion, Site Félix Guyon, Allée des Topazes, CS 11021, 97400 Saint-Denis, Réunion, France
| | - B. Bouchet
- CHU de La Réunion, Site Félix Guyon, Allée des Topazes, CS 11021, 97400 Saint-Denis, Réunion, France
| | - P. Chanareille
- CHU de La Réunion, Site Félix Guyon, Allée des Topazes, CS 11021, 97400 Saint-Denis, Réunion, France
| | - T. Gauvin
- CHU de La Réunion, Site Félix Guyon, Allée des Topazes, CS 11021, 97400 Saint-Denis, Réunion, France
| | - A. Rakotoarisoa
- Direction de la veille sanitaire et de la surveillance épidémiologique, Ministère de la santé publique de Madagascar, Paris, France
| | - A. Halm
- Coordonnateur FETP/Surveillance Epidémiologique et Gestion des Alertes, Commission de l’Océan Indien, Paris, France
| | - L. M. Rakotomanga
- Service de la vaccination, Ministère de la santé publique de Madagascar, Paris, France
| | - A. E. Randrianarivo-Solofoniaina
- Direction de la veille sanitaire et de la surveillance épidémiologique, Ministère de la santé publique de Madagascar, Paris, France
| | - S. Champion
- CHU de La Réunion, Site Félix Guyon, Allée des Topazes, CS 11021, 97400 Saint-Denis, Réunion, France
| | - Y. Lefort
- CHU de La Réunion, Site Félix Guyon, Allée des Topazes, CS 11021, 97400 Saint-Denis, Réunion, France
| | - P. Durasnel
- Service de réanimation, Centre hospitalier de Mayotte, BP04, 97600 Mamoudzou, Mayotte
| | - F. Lion
- Service de réanimation, Centre hospitalier de Mayotte, BP04, 97600 Mamoudzou, Mayotte
| | - R. Blondé
- Service de réanimation, Centre hospitalier de Mayotte, BP04, 97600 Mamoudzou, Mayotte
| | - L. Valyi
- Service de réanimation, Centre hospitalier de Mayotte, BP04, 97600 Mamoudzou, Mayotte
| | - J. Allyn
- CHU de La Réunion, Site Félix Guyon, Allée des Topazes, CS 11021, 97400 Saint-Denis, Réunion, France
| | - O. Martinet
- CHU de La Réunion, Site Félix Guyon, Allée des Topazes, CS 11021, 97400 Saint-Denis, Réunion, France
| |
Collapse
|
33
|
|
34
|
Champion S. Multivessel percutaneous coronary intervention for patients with cardiogenic shock should be encouraged. Crit Care Med 2014; 42:e601-e602. [PMID: 27069989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
|
35
|
Champion S. Diuretics or ultrafiltration in acute heart failure syndrome? Or two inadequate answers to the main question? Int J Cardiol 2014; 174:404-5. [PMID: 24768462 DOI: 10.1016/j.ijcard.2014.04.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 04/02/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Sébastien Champion
- Service de Réanimation Polyvalente, Centre Hospitalier Universitaire de la Réunion, 97400, Saint Denis, France.
| |
Collapse
|
36
|
Champion S, Lenclud C, Deye N. Pulmonary embolism related to central venous catheter triggered by trans-esophageal echocardiography bubble test: caught red-handed! Int J Cardiol 2014; 174:e50-1. [PMID: 24768459 DOI: 10.1016/j.ijcard.2014.04.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 04/02/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Sébastien Champion
- Réanimation Médicale et Toxicologique, Hôpital Lariboisière, 2 rue A. Paré, 75010 Paris, France.
| | - Christophe Lenclud
- Réanimation Médicale et Toxicologique, Hôpital Lariboisière, 2 rue A. Paré, 75010 Paris, France
| | - Nicolas Deye
- Réanimation Médicale et Toxicologique, Hôpital Lariboisière, 2 rue A. Paré, 75010 Paris, France
| |
Collapse
|
37
|
Champion S, Lefort Y, Gaüzère BA, Drouet D, Bouchet BJ, Bossard G, Djouhri S, Vandroux D, Mayaram K, Mégarbane B. CHADS2 and CHA2DS2-VASc scores can predict thromboembolic events after supraventricular arrhythmia in the critically ill patients. J Crit Care 2014; 29:854-8. [PMID: 24970692 DOI: 10.1016/j.jcrc.2014.05.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [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: 01/05/2014] [Revised: 05/12/2014] [Accepted: 05/17/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE Prediction of arterial thromboembolic events (ATEs) in relation to supraventricular arrhythmia (SVA) has been poorly investigated in the intensive care unit (ICU). We aimed at evaluating CHADS2 and CHA2DS2-VASc scores to predict SVA-related ATE in the ICU. METHODS We conducted a prospective observational study including all the patients except those in the postoperative course of cardiac surgery who presented SVA lasting 30 seconds or longer during their ICU stay. We looked for ATE during ICU stay, at the first and sixth month of follow-up after ICU discharge. RESULTS During the 15-month study period, 108 (12.8%) of 846 ICU patients experienced SVA with 12 SVA-related ATE occurring 6 days (3; 13) (median, 10%-90% percentiles) after SVA onset. In our SVA patients, CHADS2 score was 2 (0; 5), and CHA2DS2-VASc score 3 (0; 7). Both CHADS2 (odds ratio (OR), 1.6 [1.1; 2.4]; P = .01) and CHA2DS2-VASc scores (OR, 1.4 [1.04; 1.8]; P = .03) were significantly associated with ATE onset. However, the most accurate threshold for predicting ATE was CHADS2 score of 4 or higher. Using a multivariate analysis, only patient's history of stroke was associated with ATE onset (OR, 9.2 [2.4; 35]; P = .001). CONCLUSION CHADS2 and CHA2DS2-VASc scores are predictive of SVA-related thromboembolism in the critically ill patient.
Collapse
Affiliation(s)
- Sébastien Champion
- Service de réanimation polyvalente, CHU de la Réunion, hôpital Félix-Guyon, 97405 Saint-Denis, La Réunion, France; Réanimation Médicale et Toxicologique, Hôpital Lariboisière, Université Paris-Diderot, Paris, France.
| | - Yannick Lefort
- Service de réanimation polyvalente, CHU de la Réunion, hôpital Félix-Guyon, 97405 Saint-Denis, La Réunion, France
| | - Bernard-Alex Gaüzère
- Service de réanimation polyvalente, CHU de la Réunion, hôpital Félix-Guyon, 97405 Saint-Denis, La Réunion, France
| | - Didier Drouet
- Service de réanimation polyvalente, CHU de la Réunion, hôpital Félix-Guyon, 97405 Saint-Denis, La Réunion, France
| | - Bruno Julien Bouchet
- Service de réanimation polyvalente, CHU de la Réunion, hôpital Félix-Guyon, 97405 Saint-Denis, La Réunion, France
| | - Guillaume Bossard
- Service de réanimation polyvalente, CHU de la Réunion, hôpital Félix-Guyon, 97405 Saint-Denis, La Réunion, France
| | - Sabina Djouhri
- Service de réanimation polyvalente, CHU de la Réunion, hôpital Félix-Guyon, 97405 Saint-Denis, La Réunion, France
| | - David Vandroux
- Service de réanimation polyvalente, CHU de la Réunion, hôpital Félix-Guyon, 97405 Saint-Denis, La Réunion, France
| | - Kushal Mayaram
- Service de réanimation polyvalente, CHU de la Réunion, hôpital Félix-Guyon, 97405 Saint-Denis, La Réunion, France
| | - Bruno Mégarbane
- Réanimation Médicale et Toxicologique, Hôpital Lariboisière, Université Paris-Diderot, Paris, France; INSERM U1144, Université Paris-Descartes, Paris, France.
| |
Collapse
|
38
|
Champion S, Cleophax C, Voicu S, Sirol M, Deye N, Baud FJ. Vitamin K1 Antagonisation is not Safe in High Thromboembolic Risk Patients with Over-anticoagulation. Therapie 2014; 69:251-2. [DOI: 10.2515/therapie/2014022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 12/23/2013] [Indexed: 11/20/2022]
|
39
|
Champion S. Near-Infrared Spectroscopy with Vascular Occlusion Test May Not Be the Adequate Tool to Explore Microcirculation in Pulmonary Arterial Hypertension. Respir Care 2014; 59:e68. [DOI: 10.4187/respcare.02996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
40
|
Champion S, Gaüzère BA, Vandroux D, Bouchet BJ, Drouet D, Lefort Y. Dobutamine Infusion and Absence of Pulmonary Hypertension Are Associated with Decreased Mortality in a Cohort of 249 Patients with Cardiogenic Shock. Health (London) 2014. [DOI: 10.4236/health.2014.618277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
41
|
Affiliation(s)
- Sébastien Champion
- Réanimation Polyvalente, Centre Hospitalier Universitaire de la Réunion, Saint Denis, France
| |
Collapse
|
42
|
Champion S, Spagnoli V, Deye N, Mégarbane B, Baud F. [Cardiac impairment after hanging attempt: a preliminary descriptive study]. Ann Cardiol Angeiol (Paris) 2013; 62:259-264. [PMID: 23806859 DOI: 10.1016/j.ancard.2013.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 03/13/2013] [Indexed: 06/02/2023]
Abstract
PURPOSE OF THE STUDY Cardiomyopathy has sometimes been reported after suicide attempts by hanging. The objective of this retrospective observational study was to describe cardiac dysfunction occurring after hanging and its consequences on prognosis. PATIENTS AND METHODS Fifteen patients admitted to the intensive care unit for hanging from 1997 to 2011 were included and divided into two groups according to presence or absence of cardiac arrest at initial presentation. Cardiac dysfunction was defined by the presence of clinical, biological, electrocardiographic or echocardiographic abnormalities. RESULTS Cardiac impairment was diagnosed in nine patients over 15 (60%). Of the six patients with initial cardiac arrest, only one survived without severe neurological sequellae. Among the nine patients without cardiac arrest, eight survived and five patients (56%) had cardiac impairment, including two cases of echocardiographic aspect of Takotsubo complicated by pulmonary edema. Mortality in intensive care was significantly related to the severity of the initial neurological state assessed by the Glasgow Coma Score (OR=1.7; P=0.02), and the occurrence of cardiac arrest (OR=40; P=0.016). The presence of cardiac involvement, reversible after the acute phase in all surviving patients was not associated with increased mortality. CONCLUSION In the aftermath of hanging, predictors of mortality are the presence of impaired consciousness or initial cardiac arrest, but not the occurrence of cardiac disease.
Collapse
Affiliation(s)
- S Champion
- Service de réanimation médicale et toxicologique, CHU de Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France.
| | | | | | | | | |
Collapse
|
43
|
Champion S, Gaüzère BA, Vandroux D. Hypophosphatemia in patients with cardiogenic shock. J Crit Care 2013; 27:511. [PMID: 23062843 DOI: 10.1016/j.jcrc.2012.07.018] [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: 07/13/2012] [Accepted: 07/17/2012] [Indexed: 10/27/2022]
|
44
|
Malissin I, Baud FJ, Deveaux M, Champion S, Deye N, Megarbane B. Fatal lacosamide poisoning in relation to cardiac conduction impairment and cardiovascular failure. Clin Toxicol (Phila) 2013; 51:381-2. [PMID: 23534387 DOI: 10.3109/15563650.2013.778993] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
45
|
Champion S, Gaüzère BA, Lefor Y. Drug-Eluting Stents Should Not Be Used in ST-Elevated Myocardial Infarction With Cardiogenic Shock. ACTA ACUST UNITED AC 2012; 172:1613-4. [DOI: 10.1001/archinternmed.2012.4418] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
46
|
Champion S, Malissin I, Cleophax C, Vodovar D, Deye N, Mégarbane B, Baud FJ. Chloroquine poisoning-associated inverted Tako-tsubo cardiomyopathy. Clin Toxicol (Phila) 2012; 50:721-2. [DOI: 10.3109/15563650.2012.711477] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
47
|
Gaüzère BA, Bussienne F, Bouchet B, Jabot J, Roussiaux A, Drouet D, Djourhi S, Leauté B, Belcour D, Bossard G, Champion S, Jaffar-Bandjee MC, Belmonte O, Vilain P, Brottet E, Hoang L, Vandroux D. [Severe cases of A(H1N1)v2009 infection in Réunion Island in 2009 and 2010]. ACTA ACUST UNITED AC 2011; 104:97-104. [PMID: 21509522 PMCID: PMC7097782 DOI: 10.1007/s13149-011-0147-3] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Accepted: 02/21/2011] [Indexed: 11/21/2022]
Abstract
Dans l’hémisphère sud, La Réunion est la sentinelle des infections survenant préférentiellement au cours de l’hiver austral, susceptibles de gagner quelques mois plus tard l’hémisphère nord, telle l’infection à A(H1N1)v2009. Nous rapportons les caractéristiques des patients admis en 2009 et 2010 dans notre service de réanimation principalement pour détresse respiratoire aiguë, à la suite d’une infection à A(H1N1)v2009. Les données démographiques, cliniques, biologiques, ainsi que les traitements et le devenir des patients admis pour infection virale à A(H1N1)v2009 exclusivement confirmée par RT-PCR ont été recueillis de façon prospective. Au cours des années 2009 et 2010, 25 patients ont répondu aux critères définis d’infection à A(H1N1)v2009. L’âge médian était de 40,4 (±17,4) ans. La plupart d’entre eux (22/25) présentaient des facteurs de comorbidité: pathologies chroniques, surpoids ou obésité, grossesse, trisomie. Les principaux motifs d’admission en réanimation ont été les pneumonies virales avec tableau de syndrome de détresse respiratoire aiguë. Le recours à la ventilation artificielle a été nécessaire chez 22 des 25 patients, avec recours à des méthodes sophistiquées et réservées à quelques centres au niveau national, telles que les techniques d’oxygénation extracorporelle (ECMO) ou ventilation à haute fréquence (HFO). Au cours des deux années, 12 décès (48 %) sont survenus essentiellement dans des tableaux de défaillance multiviscérale. Au cours des hivers et automnes australs 2009 et 2010 et pendant une période de plusieurs semaines, l’infection à A(H1N1) v2009 a entraîné une surcharge d’activité notable dans les services de réanimation de La Réunion. L’échec de la campagne de vaccination, notamment des personnes à risques, a eu pour conséquence la survenue de nouveaux cas graves en 2010, notamment parmi les personnes à risques. Le recueil de ces données peut aider à la planification et à l’anticipation de la prise en charge d’autres épidémies grippales.
Collapse
Affiliation(s)
- B-A Gaüzère
- Service De Réanimation Polyvalente, Centre Hospitalier Félix-guyon, Chr Réunion, F-97405, Saint-Denis, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Raffray L, Renou F, Yvin JL, Ferrandiz D, Gerber A, Roussin C, Champion S, Drouet D, Braunberger E, Moiton MP. Thromboses extensives intracardiaques et des veines caves compliquant une maladie de Behçet. Rev Med Interne 2008. [DOI: 10.1016/j.revmed.2008.10.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
49
|
Mathonnet A, Manzo-Silberman S, Champion S, Lemiale V, Spaulding C, Varenne O, Cariou A. Left ventricular assistance by percutaneous impella recover LP 2.5™ during post resuscitation shock. Resuscitation 2008. [DOI: 10.1016/j.resuscitation.2008.03.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
50
|
Nakbi A, Champion S, Attia N, Fouchier F, Leger C, Hammami M. EFFET OF HYDROXYTYROSOL ON ROS PRODUCTION BY MACROPHAGE DIFFERENCIATED MONOCYTE THP-1. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70210-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|