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Jounieaux V, Rodenstein DO, Mahjoub Y. Letter to the Editor: Pulmonary circulation abnormalities in post-acute COVID-19 syndrome and acute vascular distress syndrome. Eur Radiol 2023:10.1007/s00330-023-10349-0. [PMID: 37947838 DOI: 10.1007/s00330-023-10349-0] [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: 05/23/2023] [Revised: 05/23/2023] [Accepted: 08/21/2023] [Indexed: 11/12/2023]
Affiliation(s)
- Vincent Jounieaux
- Respiratory Department, Amiens University Medical Centre, 1, Rond-point du Pr Cabrol, 80054, Amiens, France.
| | - Daniel O Rodenstein
- Respiratory Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Yazine Mahjoub
- Respiratory Department, Cardiac Vascular Thoracic and Respiratory Intensive Care Unit, Department of Anaesthesia and Critical Care, Amiens University Medical Centre, Amiens, France
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Taghboulit NEI, Andrejak C, Mahjoub Y, Toublanc B, Mayeux I, Delomez J, Mercier M, Leriche P, Maizel J, Dupont H, Jounieaux V, Basille D. Long-term survival comparison between the first and second waves among 265 critical COVID-19 patients admitted to the ICU: A retrospective cohort study. Respir Med Res 2023; 84:101057. [PMID: 37918184 DOI: 10.1016/j.resmer.2023.101057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/28/2023] [Accepted: 10/02/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUD Management of severe COVID-19 patients admitted to ICU considerably evolved during the first months of the pandemic. It is unclear, however, whether these changes improved long-term survival of these critically ill patients. METHODS We conducted a retrospective cohort study in adults with COVID-19 pneumonia admitted to a French ICU between February 2020 and January 2021, a timeframe that covered the first two waves of the pandemic. Primary outcome was to compare long-term survival between the first and second waves. Survival predictor were identified using a Cox proportional-hazards model. RESULTS We included 265 patients in the cohort: 140 (52.8 %) and 125 (47.2 %) belonging to the first and second waves, respectively. Baseline characteristics of the patients were similar between the two waves. During W2, use of early corticotherapy increased (86.4% vs. 17.8 %; p <0.001), as well as high-flow oxygen therapy use (68.5% vs. 37.4 %; p<0.001). Need for invasive mechanical ventilation decreased (49.6% vs. 72.9 %; p <0.001) and ICU length of stay was shorter (11 [6-22] vs 19 [8-32]days; p = 0.008). ICU mortality was 32.8 % without significant difference between waves. Survival analysis revealed that 3 variables were independently associated with a worse long-term prognosis: a higher SAPS II score (1.05 [1.04-1.06]; p<0.001), a higher age (1.05 [1.01-1.08]; p = 0.005) and admission during W2 (2.22 [1.15-4.28]; p = 0.017). DISCUSSION Despite substantial changes on management of severe COVID-19 patients, we observed a decreased long-term survival among patients admitted during the second wave. We also noted a shorter ICU length of stay.
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Affiliation(s)
- Nour-El-Imane Taghboulit
- Department of Respiratory Disease and Critical Care Unit, University Hospital Centre Amiens-Picardie, Amiens, France 1, Rue du Professeur Christian Cabrol 80054 Amiens-Cedex, France
| | - Claire Andrejak
- Department of Respiratory Disease and Critical Care Unit, University Hospital Centre Amiens-Picardie, Amiens, France 1, Rue du Professeur Christian Cabrol 80054 Amiens-Cedex, France; AGIR Unit - UR4294, University Picardie Jules Verne, 1, rue des Louvels, 80037 Amiens Cedex 1, France; RECIF Unit, University Picardie Jules Verne, 1, rue des Louvels, 80037 Amiens Cedex 1, France
| | - Yazine Mahjoub
- Department of Anesthesiology and Critical Care Medicine, University Hospital Centre Amiens-Picardie, Amiens, France 1, Rue du Professeur Christian Cabrol 80054 Amiens-Cedex, France
| | - Bénédicte Toublanc
- Department of Respiratory Disease and Critical Care Unit, University Hospital Centre Amiens-Picardie, Amiens, France 1, Rue du Professeur Christian Cabrol 80054 Amiens-Cedex, France
| | - Isabelle Mayeux
- Department of Respiratory Disease and Critical Care Unit, University Hospital Centre Amiens-Picardie, Amiens, France 1, Rue du Professeur Christian Cabrol 80054 Amiens-Cedex, France
| | - Julia Delomez
- Department of Respiratory Disease and Critical Care Unit, University Hospital Centre Amiens-Picardie, Amiens, France 1, Rue du Professeur Christian Cabrol 80054 Amiens-Cedex, France
| | - Marie Mercier
- Department of Respiratory Disease and Critical Care Unit, University Hospital Centre Amiens-Picardie, Amiens, France 1, Rue du Professeur Christian Cabrol 80054 Amiens-Cedex, France
| | - Pauline Leriche
- Department of Respiratory Disease and Critical Care Unit, University Hospital Centre Amiens-Picardie, Amiens, France 1, Rue du Professeur Christian Cabrol 80054 Amiens-Cedex, France
| | - Julien Maizel
- Intensive Care Department, University Hospital Centre Amiens-Picardie, Amiens, France 1, Rue du Professeur Christian Cabrol 80054 Amiens-Cedex, France
| | - Hervé Dupont
- Department of Anesthesiology and Critical Care Medicine, University Hospital Centre Amiens-Picardie, Amiens, France 1, Rue du Professeur Christian Cabrol 80054 Amiens-Cedex, France
| | - Vincent Jounieaux
- Department of Respiratory Disease and Critical Care Unit, University Hospital Centre Amiens-Picardie, Amiens, France 1, Rue du Professeur Christian Cabrol 80054 Amiens-Cedex, France; AGIR Unit - UR4294, University Picardie Jules Verne, 1, rue des Louvels, 80037 Amiens Cedex 1, France
| | - Damien Basille
- Department of Respiratory Disease and Critical Care Unit, University Hospital Centre Amiens-Picardie, Amiens, France 1, Rue du Professeur Christian Cabrol 80054 Amiens-Cedex, France; AGIR Unit - UR4294, University Picardie Jules Verne, 1, rue des Louvels, 80037 Amiens Cedex 1, France; RECIF Unit, University Picardie Jules Verne, 1, rue des Louvels, 80037 Amiens Cedex 1, France.
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Jounieaux V, Rodenstein DO, Mahjoub Y. Commentary: Impact of COVID-19 pneumonia on pulmonary vascular volume. Front Med (Lausanne) 2023; 10:1223819. [PMID: 37828940 PMCID: PMC10565649 DOI: 10.3389/fmed.2023.1223819] [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] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/28/2023] [Indexed: 10/14/2023] Open
Affiliation(s)
- Vincent Jounieaux
- Respiratory Department, Amiens University Medical Centre, Amiens, France
| | - Daniel O. Rodenstein
- Respiratory Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Yazine Mahjoub
- Cardiac Vascular Thoracic and Respiratory Intensive Care Unit, Department of Anaesthesia and Critical Care, Amiens University Medical Centre, Amiens, France
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Mahjoub Y, Rodenstein D, Jounieaux V. Editorial: COVID-19 related acute vascular distress syndrome: from physiopathology to treatment. Front Med (Lausanne) 2023; 10:1260309. [PMID: 37593405 PMCID: PMC10432155 DOI: 10.3389/fmed.2023.1260309] [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] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 07/24/2023] [Indexed: 08/19/2023] Open
Affiliation(s)
- Yazine Mahjoub
- Cardiac Vascular Thoracic and Respiratory Intensive Care Unit, Department of Anesthesia and Critical Care, Amiens University Medical Centre, Amiens, France
| | - Daniel Rodenstein
- Pneumology Unit, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Vincent Jounieaux
- Respiratory Department, Amiens University Medical Centre, Amiens, France
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Beyls C, Vial J, Lefebvre T, Muller C, Hanquiez T, Besserve P, Guilbart M, Haye G, Bernasinski M, Huette P, Dupont H, Abou-Arab O, Jounieaux V, Mahjoub Y. Prognostic value of right ventricular dilatation on computed tomography pulmonary angiogram for predicting adverse clinical events in severe COVID-19 pneumonia. Front Med (Lausanne) 2023; 10:1213775. [PMID: 37583421 PMCID: PMC10425267 DOI: 10.3389/fmed.2023.1213775] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/03/2023] [Indexed: 08/17/2023] Open
Abstract
Background Right ventricle dilatation (RVD) is a common complication of non-intubated COVID-19 pneumonia caused by pro-thrombotic pneumonitis, intra-pulmonary shunting, and pulmonary vascular dysfunction. In several pulmonary diseases, RVD is routinely measured on computed tomography pulmonary angiogram (CTPA) by the right ventricle-to-left ventricle (LV) diameter ratio > 1 for predicting adverse events. Objective The aim of the study was to evaluate the association between RVD and the occurrence of adverse events in a cohort of critically ill non-intubated COVID-19 patients. Methods Between February 2020 and February 2022, non-intubated patients admitted to the Amiens University Hospital intensive care unit for COVID-19 pneumonia with CTPA performed within 48 h of admission were included. RVD was defined by an RV/LV diameter ratio greater than one measured on CTPA. The primary outcome was the occurrence of an adverse event (renal replacement therapy, extracorporeal membrane oxygenation, 30-day mortality after ICU admission). Results Among 181 patients, 62% (n = 112/181) presented RVD. The RV/LV ratio was 1.10 [1.05-1.18] in the RVD group and 0.88 [0.84-0.96] in the non-RVD group (p = 0.001). Adverse clinical events were 30% and identical in the two groups (p = 0.73). In Receiving operative curves (ROC) analysis, the RV/LV ratio measurement failed to identify patients with adverse events. On multivariable Cox analysis, RVD was not associated with adverse events to the contrary to chest tomography severity score > 10 (hazards ratio = 1.70, 95% CI [1.03-2.94]; p = 0.04) and cardiovascular component (> 2) of the SOFA score (HR = 2.93, 95% CI [1.44-5.95], p = 0.003). Conclusion Right ventricle (RV) dilatation assessed by RV/LV ratio was a common CTPA finding in non-intubated critical patients with COVID-19 pneumonia and was not associated with the occurrence of clinical adverse events.
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Affiliation(s)
- Christophe Beyls
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Jeremie Vial
- Department of Radiology, Amiens University Hospital, Amiens, France
| | - Thomas Lefebvre
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Charlotte Muller
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Thomas Hanquiez
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Patricia Besserve
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Mathieu Guilbart
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Guillaume Haye
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Michael Bernasinski
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Pierre Huette
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Hervé Dupont
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Osama Abou-Arab
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Vincent Jounieaux
- Department of Pneumology, Amiens University Hospital, Amiens, France
| | - Yazine Mahjoub
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
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Basille D, Wang L, Thomsen RW, Menon J, Shetty N, Duhaut P, Andrejak C, Jounieaux V, Sørensen HT. Inhaled corticosteroids and adverse outcomes among chronic obstructive pulmonary disease patients with community-acquired pneumonia: a population-based cohort study. Front Med (Lausanne) 2023; 10:1184888. [PMID: 37554496 PMCID: PMC10405521 DOI: 10.3389/fmed.2023.1184888] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 07/10/2023] [Indexed: 08/10/2023] Open
Abstract
INTRODUCTION While inhaled corticosteroids (ICS) may increase pneumonia risk in patients with chronic obstructive pulmonary disease (COPD), the impact of ICS on pneumonia outcomes is debated. We examined whether ICS use is associated with adverse outcomes among COPD patients with community-acquired pneumonia (CAP). MATERIALS AND METHODS Population-based cohort study of all COPD patients with an incident hospitalization for CAP between 1997 and 2013 in Northern Denmark. Information on medications, COPD severity, comorbidities, complications, and death was obtained from medical databases. Adjusted risk ratios (aRRs) for pleuropulmonary complications, intensive care unit (ICU) admissions, and 30-day mortality in current and former ICS users were compared with those in non-users, using regression analyzes to handle confounding. RESULTS Of 11,368 COPD patients with CAP, 6,073 (53.4%) were current ICS users and 1,733 (15.2%) were former users. Current users had a non-significantly decreased risk of pleuropulmonary complications [2.6%; aRR = 0.82 (0.59-1.12)] compared to non-users (3.2%). This was also observed among former users [2.5%; aRR = 0.77 (0.53-1.12)]. Similarly, decreased risks of ICU admission were observed among current users [aRR = 0.77 (0.57-1.04)] and among former users [aRR = 0.81 (0.58-1.13)]. Current ICS users had significantly decreased 30-day mortality [9.1%; aRR = 0.72 (0.62-0.85)] compared to non-users (12.6%), with a stronger association observed among patients with frequent exacerbations [0.58 (0.39-0.86)]. No significant association was observed among former ICS users [0.89 (0.75-1.05)]. CONCLUSION Our results suggest a decreased risk of death with ICS use among COPD patients admitted for CAP.
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Affiliation(s)
- Damien Basille
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
- Department of Respiratory Disease and Critical Care Unit, University Hospital Centre Amiens-Picardie, Amiens, France
- AGIR Unit–UR4294, University Picardie Jules Verne, Amiens, France
- RECIF Unit, University Picardie Jules Verne, Amiens, France
| | - Lei Wang
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Reimar Wernich Thomsen
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Jyothi Menon
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Nisha Shetty
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Pierre Duhaut
- RECIF Unit, University Picardie Jules Verne, Amiens, France
- Department of Internal Medicine, University Hospital Centre Amiens-Picardie, Amiens, France
| | - Claire Andrejak
- Department of Respiratory Disease and Critical Care Unit, University Hospital Centre Amiens-Picardie, Amiens, France
- AGIR Unit–UR4294, University Picardie Jules Verne, Amiens, France
- RECIF Unit, University Picardie Jules Verne, Amiens, France
| | - Vincent Jounieaux
- Department of Respiratory Disease and Critical Care Unit, University Hospital Centre Amiens-Picardie, Amiens, France
- AGIR Unit–UR4294, University Picardie Jules Verne, Amiens, France
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
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Marchal E, Burgaud C, Jounieaux V, Leleu O. Behavior of general physicians about lung cancer screening in a French region hosting a pilot study. Respir Med Res 2023; 83:100992. [PMID: 36812773 DOI: 10.1016/j.resmer.2023.100992] [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: 09/02/2022] [Revised: 11/22/2022] [Accepted: 12/30/2022] [Indexed: 02/22/2023]
Abstract
INTRODUCTION Lung cancer is the leading cause of cancer-related death in France and has a 5-year survival rate of 20%. Recent prospective randomized controlled trials revealed that lung cancer-specific mortality decreased in patients who underwent screening using low-dose chest computed tomography (low-dose CT). The DEP KP80 pilot study conducted in 2016 showed that an organized lung cancer screening campaign involving general practitioners was feasible. MATERIAL AND METHOD We conducted a descriptive observational study of screening practices by sending a self-reported questionnaire to 1013 general practitioners practicing in the Hauts-de-France region. Our study's primary aim was to investigate the knowledge and practices of general practitioners in the Hauts-de-France region of France regarding lung cancer screening using low-dose CT. The secondary endpoint was to compare practices between general practitioners in the Somme department who had experience of experimental screening and their colleagues in the rest of the region. RESULTS The response rate was 18.8% (190 completed questionnaires). Even though 69.5% of the physicians were unaware of the potential benefits of organized low-dose CT screening for lung cancer, 76% proposed screening tests for individual patients. Despite its proven ineffectiveness, chest radiography was still the most widely recommended screening modality. Half of the physicians stated that they had already prescribed chest CT to screen for lung cancer. Additionally, only 36.3% proposed chest CT screening for patients aged over 50 years with a history of more than 30 pack-years. The physicians working in the Somme department (61% had participated in the DEP KP80 pilot study) were more aware of low-dose CT as a screening modality, and offered it significantly more than their colleagues in the other departments (61.1% vs 13.4% p<0.01). All the physicians were in favor of an organized screening program. CONCLUSION More than a third of general practitioners in the Hauts-de-France region offered for lung cancer screening using chest CT, although only 18% specified low-dose CT. Before an organized screening program can be set up, good practice guidelines must be made available about lung cancer screening.
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Affiliation(s)
- Etienne Marchal
- Department of Nuclear Medicine, CHU Amiens-Picardie, Amiens, France
| | | | - Vincent Jounieaux
- Department of Pulmonology and Thoracic Oncology, CHU Amiens-Picardie, Amiens, France
| | - Olivier Leleu
- Department of Pulmonology and Thoracic Oncology, Abbeville Hospital Center, France.
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Wallyn F, Fournier C, Jounieaux V, Basille D. [The role of endoscopy in exploration of the mediastinum, indications and results]. Rev Mal Respir 2023; 40:78-93. [PMID: 36528503 DOI: 10.1016/j.rmr.2022.12.001] [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: 07/10/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022]
Abstract
Since 2005, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has emerged as a standard pulmonological tool. The procedure is safe and well tolerated by patients, with minimal morbidity and almost no mortality. A previous review on the technique was published in 2012. However, over the last ten years, a number of new studies have been published on "benign" (sarcoidosis, tuberculosis…) as well as "malignant" diseases (lung cancer, metastases of extra-thoracic cancers, search for mutations and specific oncogenic markers…). These developments have led to expanded indications for EBUS-TBNA, with which it is indispensable to be familiar, in terms of "staging" as well as "diagnosis". In view of optimizing lymph node sampling, several publications have described and discussed EBUS exploration by means of newly available tools (biopsy forceps, larger needles…), and proposed interpretation of the images thereby produced. Given the ongoing evolution of linear EBUS, it seemed indispensable that information on this marvelous tool be updated. This review is aimed at summarizing the novel elements we have found the most important.
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Affiliation(s)
- F Wallyn
- Service endoscopie respiratoire. CHRU Lille, clinique de pneumologie, 59000 Lille, France
| | - C Fournier
- Service endoscopie respiratoire. CHRU Lille, clinique de pneumologie, 59000 Lille, France
| | - V Jounieaux
- Unité de soins continus cardio-thoracique-vasculaire-respiratoire. service de pneumologie, CHU d'Amiens-Picardie, 80054 Amiens, France
| | - D Basille
- Unité de soins continus cardio-thoracique-vasculaire-respiratoire. service de pneumologie, CHU d'Amiens-Picardie, 80054 Amiens, France.
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Beyls C, Huette P, Viart C, Mestan B, Haye G, Guilbart M, Bernasinski M, Besserve P, Leviel F, Witte Pfister A, De Dominicis F, Jounieaux V, Berna P, Dupont H, Abou-Arab O, Mahjoub Y. Mortality of COVID-19 Patients Requiring Extracorporeal Membrane Oxygenation During the Three Epidemic Waves. ASAIO J 2022; 68:1434-1442. [PMID: 36194473 DOI: 10.1097/mat.0000000000001787] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Clinical presentation and mortality of patients treated with extracorporeal membrane oxygenation (ECMO) for COVID-19 acute respiratory distress syndrome (CARDS) were different during the French epidemic waves. The management of COVID-19 patients evolved through waves as much as knowledge on that new viral disease progressed. We aimed to compare the mortality rate through the first three waves of CARDS patients on ECMO and identify associated risk factors. Fifty-four consecutive ECMO for CARDS hospitalized at Amiens University Hospital during the three waves were included. Patients were divided into three groups according to their hospitalization date. Clinical characteristics and outcomes were compared between groups. Pre-ECMO risk factors predicting 90 day mortality were evaluated using multivariate Cox regression. Among 54 ECMO (median age of 61[48-65] years), 26% were hospitalized during the first wave (n = 14/54), 26% (n = 14/54) during the second wave, and 48% (n = 26/54) during the third wave. Time from first symptoms to ECMO was higher during the second wave than the first wave. (17 [12-23] days vs. 11 [9-15]; p < 0.05). Ninety day mortality was higher during the second wave (85% vs. 43%; p < 0.05) but less during the third wave (38% vs. 85%; P < 0.05). Respiratory ECMO survival prediction score and time from symptoms onset to ECMO (HR 1.12; 95% confidence interval [CI]: 1.05-1.20; p < 0.001) were independent factors of mortality. After adjustment, time from symptoms onset to ECMO was an independent factor of 90 day mortality. Changes in CARDS management from first to second wave-induced a later ECMO cannulation from symptoms onset with higher mortality during that wave. The duration of COVID-19 disease progression could be selection criteria for initiating ECMO.
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Affiliation(s)
- Christophe Beyls
- From the Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
- Department of Thoracic Surgery, UR UPJV 7518 SSPC (Simplification of Care of Complex Surgical Patients) Research Unit, University of Picardie Jules Verne, Amiens, France
| | - Pierre Huette
- From the Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Christophe Viart
- From the Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Benjamin Mestan
- From the Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Guillaume Haye
- From the Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Mathieu Guilbart
- From the Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Michael Bernasinski
- From the Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Patricia Besserve
- From the Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Florent Leviel
- From the Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | | | | | | | - Pascal Berna
- Department of Thoracic Surgery, Clinique Pauchet, Amiens, France
| | - Hervé Dupont
- From the Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Osama Abou-Arab
- From the Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Yazine Mahjoub
- From the Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
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Beyls C, Ghesquières T, Hermida A, Booz T, Crombet M, Martin N, Huette P, Jounieaux V, Dupont H, Abou-Arab O, Mahjoub Y. Feasibility, Prediction and Association of Right Ventricular Free Wall Longitudinal Strain with 30-Day Mortality in Severe COVID-19 Pneumonia: A Prospective Study. J Clin Med 2022; 11:jcm11133629. [PMID: 35806914 PMCID: PMC9267479 DOI: 10.3390/jcm11133629] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/13/2022] [Accepted: 06/21/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction: Right ventricular (RV) systolic dysfunction (RVsD) is a common complication of coronavirus infection 2019 disease (COVID-19). The right ventricular free wall longitudinal strain parameter (RV-FWLS) is a powerful predictor of mortality. We explored the performance of RVsD parameters for predicting 30-day mortality and the association between RV-FWLS and 30-day mortality. Methods: COVID-19 patients hospitalized at Amiens University Hospital in the critical care unit with transthoracic echocardiography were included. We measured tricuspid annular plane systolic excursion (TAPSE), the RV S’ wave, RV fractional area change (RV-FAC), and RV-FWLS. The diagnostic performance of RVsD parameters as predictors for 30-day mortality was evaluated by the area under the receiver operating characteristic (ROC) curve (AUC). RVsD was defined by an RV-FWLS < 21% to explore the association between RVsD and 30-day mortality. Results: Of the 116 patients included, 20% (n = 23/116) died and 47 had a RVsD. ROC curve analysis showed that RV-FWLS failed to predict 30-day mortality, as did conventional RV parameters (all p > 0.05). TAPSE (21 (19−26) mm vs. 24 (21−27) mm; p = 0.024) and RV-FAC (40 (35−47)% vs. 47 (41−55)%; p = 0.006) were lowered in the RVsD group. In Cox analysis, RVsD was not associated with 30-day mortality (hazard ratio = 1.12, CI 95% (0.49−2.55), p = 0.78). Conclusion: In severe COVID-19 pneumonia, RV-FWLS was not associated with 30-day mortality.
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Affiliation(s)
- Christophe Beyls
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (T.G.); (T.B.); (M.C.); (P.H.); (H.D.); (O.A.-A.); (Y.M.)
- UR UPJV 7518 SSPC (Simplification of Care of Complex Surgical Patients) Research Unit, University of Picardie Jules Verne, F-80000 Amiens, France
- Correspondence:
| | - Tristan Ghesquières
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (T.G.); (T.B.); (M.C.); (P.H.); (H.D.); (O.A.-A.); (Y.M.)
| | - Alexis Hermida
- Department of Cardiology, Amiens University Hospital, F-80054 Amiens, France; (A.H.); (N.M.)
| | - Thomas Booz
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (T.G.); (T.B.); (M.C.); (P.H.); (H.D.); (O.A.-A.); (Y.M.)
| | - Maxime Crombet
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (T.G.); (T.B.); (M.C.); (P.H.); (H.D.); (O.A.-A.); (Y.M.)
| | - Nicolas Martin
- Department of Cardiology, Amiens University Hospital, F-80054 Amiens, France; (A.H.); (N.M.)
| | - Pierre Huette
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (T.G.); (T.B.); (M.C.); (P.H.); (H.D.); (O.A.-A.); (Y.M.)
- UR UPJV 7518 SSPC (Simplification of Care of Complex Surgical Patients) Research Unit, University of Picardie Jules Verne, F-80000 Amiens, France
| | - Vincent Jounieaux
- Respiratory Department, Amiens University Hospital, F-80054 Amiens, France;
| | - Hervé Dupont
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (T.G.); (T.B.); (M.C.); (P.H.); (H.D.); (O.A.-A.); (Y.M.)
- UR UPJV 7518 SSPC (Simplification of Care of Complex Surgical Patients) Research Unit, University of Picardie Jules Verne, F-80000 Amiens, France
| | - Osama Abou-Arab
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (T.G.); (T.B.); (M.C.); (P.H.); (H.D.); (O.A.-A.); (Y.M.)
| | - Yazine Mahjoub
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (T.G.); (T.B.); (M.C.); (P.H.); (H.D.); (O.A.-A.); (Y.M.)
- UR UPJV 7518 SSPC (Simplification of Care of Complex Surgical Patients) Research Unit, University of Picardie Jules Verne, F-80000 Amiens, France
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11
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Addi AA, Leleu O, Basille D, Lapôtre-Ledoux B, Auquier M, Ganry O, Berna P, Jounieaux V. Epidemiological Impact of Lung Cancer Screening by Low Dose CT Scan in the French Department of the Somme. Respir Med Res 2022; 81:100887. [DOI: 10.1016/j.resmer.2022.100887] [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: 07/31/2021] [Revised: 12/28/2021] [Accepted: 01/04/2022] [Indexed: 12/24/2022]
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Taghboulit N, Andrejak C, Mercier M, Delomez J, Carette H, Jounieaux V, Basille D. Infection grave à SARS-CoV-2 : évolution du profil des patients admis en réanimation entre les deux premières vagues. Revue des Maladies Respiratoires Actualités 2022. [PMCID: PMC8709624 DOI: 10.1016/j.rmra.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Introduction Méthodes Résultats Conclusion
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Delomez J, Mercier M, Basille D, Jounieaux V, Andrejak C. Impact de la corticothérapie systémique sur les séquelles respiratoires des infections à SARS-CoV-2. Revue des Maladies Respiratoires Actualités 2022. [PMCID: PMC8709648 DOI: 10.1016/j.rmra.2021.11.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Introduction Depuis 2019, l’épidémie de COVID-19 (infection à SARS-CoV-2) est responsable de 4 millions de décès dans le monde. Il n’existe, à ce jour, aucun traitement spécifique. La corticothérapie fait partie, depuis octobre 2020, du standard of care, suite à la publication de plusieurs études (dont la cohorte RECOVERY, NEJM 2020) montrant une amélioration significative de la survie lorsqu’elle est utilisée à la phase aiguë des pneumopathies hypoxémiantes. Cependant, peu de données sont disponibles concernant son impact sur l’atteinte résiduelle. Notre étude a donc cherché à savoir si le recours aux corticoïdes à la phase aiguë des infections à SARS-CoV-2 réduit la survenue de séquelles respiratoires à 3 mois, 6 mois et 1 an. Méthodes Il s’agit d’une étude observationnelle, rétrospective, réalisée au CHU d’Amiens entre mars et octobre 2020 concernant les patients ayant été hospitalisés dans une unité COVID. Ces patients étaient convoqués à 3 mois pour la réalisation d’un examen clinique, d’un scanner thoracique, d’explorations fonctionnelles respiratoires et d’un test de marche de 6 minutes. L’évaluation à 6 mois et 12 mois étaient optionnelles. Résultats Trois cent neuf patients ont été inclus. Parmi eux, 74 patients (23,9 %) avaient reçu une corticothérapie. À 3 mois, les patients ayant reçu une corticothérapie présentaient significativement plus de lésions en verre dépoli et une atteinte radiologique plus étendue ; ce qui n’était plus le cas à 6 mois et à 1 an. Il n’y avait pas de différence significative concernant les séquelles fonctionnelles à 3 mois comme sur le plus long terme. Conclusion Les patients ayant reçu une corticothérapie étaient peu nombreux et les plus graves, issus de la « première vague », ce qui peut expliquer les différences retrouvées lors de l’évaluation à 3 mois. Les séquelles respiratoires à 6 mois et 1 an semblent moins importantes dans le groupe ayant reçu une corticothérapie, mais le nombre de patients est insuffisant pour conclure. Cette étude n’a pas permis de mettre en évidence de différence significative à long terme entre les patients ayant reçu ou non une corticothérapie. Il semble nécessaire de poursuivre cette étude en appariant les patients sur la gravité initiale.
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Jounieaux V, Basille D, Toublanc B, Andrejak C, Rodenstein DO, Mahjoub Y. Case Reports: Bronchial Mucosal Vasculature Is Also Involved in the Acute Vascular Distress Syndrome of COVID-19. Front Med (Lausanne) 2021; 8:710992. [PMID: 34917628 PMCID: PMC8669334 DOI: 10.3389/fmed.2021.710992] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 10/27/2021] [Indexed: 11/21/2022] Open
Abstract
Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which targets the pulmonary vasculature is supposed to induce an intrapulmonary right to left shunt with an increased pulmonary blood flow. We report here what may be, to the best of our knowledge, the first videoendoscopic descriptions of an hypervascularization of the bronchial mucosa in two patients hospitalized for coronavirus disease 2019 (COVID-19) pneumonia. Cases Presentation: Two patients, 27- and 37-year-old, were addressed to our Pneumology department for suspicion of COVID-19 pneumonia. Their symptoms (fever, dry cough, and dyspnoea), associated to pulmonary ground glass opacities on thoracic CT, were highly suggestive of a COVID-19 disease despite repeated negative pharyngeal swabs RT-PCR. In both patients, bronchoscopy examination using white light was unremarkable but NBI bronchoscopy revealed a diffuse hypervascularization of the mucosa from the trachea to the sub-segmental bronchi, associated with dilated submucosal vessels. RT-PCR performed in bronchoalveolar lavage (BAL) confirmed the presence of Sars-CoV-2. Conclusions: These two case reports highlight the crucial importance of the vascular component of the viral disease. We suggest that such bronchial hypervascularization with dilated vessels contributes, at least in part, to the intrapulmonary right to left shunt that characterizes the COVID-19 related Acute Vascular Distress Syndrome (AVDS). The presence of diffuse bronchial hypervascularization in the context of COVID-19 pandemic should prompt the search for Sars-CoV-2 in BAL samples.
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Affiliation(s)
| | - Damien Basille
- Pneumology Department, University Hospital Centre, Amiens, France
| | | | - Claire Andrejak
- Pneumology Department, University Hospital Centre, Amiens, France
| | - Daniel Oscar Rodenstein
- Pneumology Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Yazine Mahjoub
- Cardiac, Thoracic-vascular and Respiratory Intensive Care Unit, Department of Anesthesia and Critical Care, University Hospital Centre, Amiens, France
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15
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Affiliation(s)
- Yazine Mahjoub
- Cardiac Vascular Thoracic and Respiratory Intensive Care Unit, Department of Anaesthesia and Intensive Care, Amiens University Medical Centre, Amiens, France.
| | - Daniel Rodenstein
- Pneumology Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Vincent Jounieaux
- Pneumology Department, Amiens University Medical Centre, Amiens, France
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Leleu O, Basille D, Auquier M, Clarot C, Hoguet E, Baud M, Lenel S, Milleron B, Berna P, Jounieaux V. Results of Second Round Lung Cancer Screening by Low-Dose CT scan - French Cohort Study (DEP-KP80). Clin Lung Cancer 2021; 23:e54-e59. [PMID: 34764039 DOI: 10.1016/j.cllc.2021.09.009] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/22/2021] [Accepted: 09/27/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Over the last few years, lung cancer screening by low-dose CT scan has demonstrated a decrease in lung cancer mortality. While this method has been in use since 2013 in the United States of America, no European country has yet implemented a systematic screening program. We hereby report the results from the second round of screening from a French cohort study. PATIENTS AND METHODS DEP KP80 is a prospective study evaluating lung cancer screening by means of three low-dose computer tomography (CT) scans at 1-year intervals in 1,307 participants, aged 55 to 74 years old, all smokers or former smokers, having quit within the last 15 years, with over 30 pack years. The results of the first round demonstrated it was possible to conduct effective screening in real-life situations. RESULTS Participation was lower in this second round than in the first (35.3% vs. 73.1%, P < .001). The rate of negative results was significantly higher and that of undetermined results lower than those produced in the first round. Overall, 75% of cancers revealed were Stage 1 and 87.5% benefitted from surgical treatment. The incidence of cancer in the second round was 2.43%. CONCLUSION As with the first round, the results of this second round confirm the feasibility and efficacy of lung cancer screening. The lower participation rate for this second round is proof of the need to improve awareness among participants and healthcare professionals of the relevance of committing to an annual screening program.
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Affiliation(s)
- Olivier Leleu
- Department of Pulmonology, Centre Hospitalier d'Abbeville, Abbeville, France.
| | | | | | - Caroline Clarot
- Department of Pulmonology, Centre Hospitalier d'Abbeville, Abbeville, France
| | - Estelle Hoguet
- Department of Pulmonology, Centre Hospitalier d'Abbeville, Abbeville, France
| | - Mickael Baud
- Department of Pulmonology, Centre Hospitalier d'Abbeville, Abbeville, France
| | - Sabrina Lenel
- Department of Pulmonology, Centre Hospitalier d'Abbeville, Abbeville, France
| | - Bernard Milleron
- Intergroupe francophone de cancérologie thoracique (IFCT), Paris, France
| | - Pascal Berna
- Department of Thoracic surgery, CHU Amiens, Amiens, France
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Jounieaux V, Mahjoub Y, El-Esper I, Rodenstein DO. The importance of lung hyperperfusion patterns in COVID-19-related AVDS. Eur J Nucl Med Mol Imaging 2021; 48:3022-3023. [PMID: 34247272 PMCID: PMC8272685 DOI: 10.1007/s00259-021-05451-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 06/03/2021] [Indexed: 02/01/2023]
Affiliation(s)
| | - Yazine Mahjoub
- Cardiac, Thoracic-Vascular and Respiratory Intensive Care Unit, Department of Anesthesia and Critical Care, University Hospital Centre, Amiens, France
| | - Isabelle El-Esper
- Nuclear Medicine Department, University Hospital Centre, Amiens, France
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Basille D, Auquier MA, Andréjak C, Rodenstein DO, Mahjoub Y, Jounieaux V. Dissociation between the clinical course and chest imaging in severe COVID-19 pneumonia: A series of five cases. Heart Lung 2021; 50:818-824. [PMID: 34271253 PMCID: PMC8241693 DOI: 10.1016/j.hrtlng.2021.06.008] [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] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 06/20/2021] [Accepted: 06/24/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Although an RT-PCR test is the "gold standard" tool for diagnosing an infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), chest imaging can be used to support a diagnosis of coronavirus disease 2019 (COVID-19) - albeit with fairly low specificity. However, if the chest imaging findings do not faithfully reflect the patient's clinical course, one can question the rationale for relying on these imaging data in the diagnosis of COVID-19. AIMS To compare clinical courses with changes over time in chest imaging findings among patients admitted to an ICU for severe COVID-19 pneumonia. METHODS We retrospectively reviewed the medical charts of all adult patients admitted to our intensive care unit (ICU) between March 1, 2020, and April 15, 2020, for a severe COVID-19 lung infection and who had a positive RT-PCR test. Changes in clinical, laboratory and radiological variables were compared, and patients with discordant changes over time (e.g. a clinical improvement with stable or worse radiological findings) were analyzed further. RESULTS Of the 46 included patients, 5 showed an improvement in their clinical status but not in their chest imaging findings. On admission to the ICU, three of the five were mechanically ventilated and the two others received high-flow oxygen therapy or a non-rebreather mask. Even though the five patients' radiological findings worsened or remained stable, the mean ± standard deviation partial pressure of arterial oxygen to the fraction of inspired oxygen (PaO2:FiO2) ratio increased significantly in all cases (from 113.2 ± 59.7 mmHg at admission to 259.8 ± 59.7 mmHg at a follow-up evaluation; p=0.043). INTERPRETATION Our results suggest that in cases of clinical improvement with worsened or stable chest imaging variables, the PaO2:FiO2 ratio might be a good marker of the resolution of COVID-19-specific pulmonary vascular insult.
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Affiliation(s)
- Damien Basille
- Pneumology Department, University Hospital Centre, Amiens, France; AGIR Unit - UR4294, University Picardie Jules Verne, Amiens, France.
| | | | - Claire Andréjak
- Pneumology Department, University Hospital Centre, Amiens, France; AGIR Unit - UR4294, University Picardie Jules Verne, Amiens, France
| | - Daniel Oscar Rodenstein
- Pneumology Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Yazine Mahjoub
- Anesthesia and Critical Care. Cardiac, Thoracic, Vascular and Respiratory Intensive Care Unit, University Hospital Centre, Amiens, France
| | - Vincent Jounieaux
- Pneumology Department, University Hospital Centre, Amiens, France; AGIR Unit - UR4294, University Picardie Jules Verne, Amiens, France
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Huette P, Abou Arab O, Jounieaux V, Guilbart M, Belhout M, Haye G, Dupont H, Beyls C, Mahjoub Y. Almitrine for COVID-19 critically ill patients – a vascular therapy for a pulmonary vascular disease: Three case reports. World J Clin Cases 2021; 9:3385-3393. [PMID: 34002149 PMCID: PMC8107903 DOI: 10.12998/wjcc.v9.i14.3385] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/31/2020] [Accepted: 01/26/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Several reports with clinical, histological and imaging data have observed the involvement of lung vascular function to explain the severe hypoxemia in coronavirus disease 2019 (COVID-19) patients. It has been hypothesized that an increased pulmonary blood flow associated with an impairment of hypoxic pulmonary vasoconstriction is responsible for an intrapulmonary shunt. COVID-19 may lead to refractory hypoxemia (PaO2/FiO2 ratio below 100 mmHg) despite mechanical ventilation and prone positioning. We hypothesized that the use of a pulmonary vasoconstrictor may help decrease the shunt and thus enhance oxygenation.
CASE SUMMARY We report our experience with three patients with refractory hypoxemia treated with almitrine to enhance oxygenation. Low dose almitrine (Vectarion®; Servier, Suresnes, France) was started at an infusion rate of 4 μg × kg/min on a central line. The PaO2/FiO2 ratio and total respiratory system compliance during almitrine infusion were measured. For the three patients, the PaO2/FiO2 ratio time-course showed a dramatic increase whereas total respiratory system compliance was unchanged. The three patients were discharged from the intensive care unit. The intensive care unit length of stay for patient 1, patient 2 and patient 3 was 30 d, 32 d and 31 d, respectively. Weaning from mechanical ventilation was performed 13 d, 18 d and 15 d after almitrine infusion for patient 1, 2 and 3, respectively. We found no deleterious effects on the right ventricular function, which was similar to previous studies on almitrine safety.
CONCLUSION Almitrine may be effective and safe to enhance oxygenation in coronavirus disease 2019 patients. Further controlled studies are required.
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Affiliation(s)
- Pierre Huette
- Department of Anaesthesia and Critical Care, Amiens Hospital University, Amiens 80000, France
| | - Osama Abou Arab
- Department of Anaesthesia and Critical Care, Amiens Hospital University, Amiens 80000, France
| | - Vincent Jounieaux
- Department of Respiratory Medicine, Amiens Hospital University, Amiens 80000, France
| | - Mathieu Guilbart
- Department of Anaesthesia and Critical Care, Amiens Hospital University, Amiens 80000, France
| | - Mohamed Belhout
- Department of Pharmacy, Amiens Hospital University, Amiens 80000, France
| | - Guillaume Haye
- Department of Anaesthesia and Critical Care, Amiens Hospital University, Amiens 80000, France
| | - Hervé Dupont
- Department of Anaesthesia and Critical Care, Amiens Hospital University, Amiens 80000, France
| | - Christophe Beyls
- Department of Anaesthesia and Critical Care, Amiens Hospital University, Amiens 80000, France
| | - Yazine Mahjoub
- Department of Anaesthesia and Critical Care, Amiens Hospital University, Amiens 80000, France
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20
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Mahjoub Y, Rodenstein DO, Jounieaux V. The hyperdynamic circulatory profile of patients with COVID-19-related acute vascular distress syndrome. Letter regarding the article 'Haemodynamic characteristics of COVID-19 patients with acute respiratory distress syndrome requiring mechanical ventilation. An invasive assessment using right heart catheterization'. Eur J Heart Fail 2021; 23:493. [PMID: 33377239 DOI: 10.1002/ejhf.2089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 12/15/2020] [Accepted: 12/25/2020] [Indexed: 12/21/2022] Open
Affiliation(s)
- Yazine Mahjoub
- Cardiac Vascular Thoracic and Respiratory Intensive Care Unit, Department of Anaesthesia and Critical Care, Amiens University Medical Centre, Amiens, France
| | - Daniel O Rodenstein
- Respiratory Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Vincent Jounieaux
- Respiratory Department, Amiens University Medical Centre, Amiens, France
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21
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Abou-Arab O, Beyls C, Khalipha A, Guilbart M, Huette P, Malaquin S, Lecat B, Macq PY, Roger PA, Haye G, Bernasinski M, Besserve P, Soriot-Thomas S, Jounieaux V, Dupont H, Mahjoub Y. Microvascular flow alterations in critically ill COVID-19 patients: A prospective study. PLoS One 2021; 16:e0246636. [PMID: 33556081 PMCID: PMC7870020 DOI: 10.1371/journal.pone.0246636] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 01/22/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Data on microcirculatory pattern of COVID-19 critically ill patients are scarce. The objective was to compare sublingual microcirculation parameters of critically ill patients according to the severity of the disease. METHODS The study is a single-center prospective study with critically ill COVID-19 patients admitted in ICU. Sublingual microcirculation was assessed by IDF microscopy within 48 hours of ICU admission. Microcirculatory flow index (MFI), proportion of perfused vessel (PPV), total vessel density (TVD), De Backer score (DBS), perfused vessel density (PVD) and heterogeneity index (HI) were assessed. Patients were divided in 2 groups (severe and critical) according to the World health organization definition. FINDINGS From 19th of March to 7th of April 2020, 43 patients were included. Fourteen patients (33%) were in the severe group and twenty-nine patients (67%) in the critical group. Patients in the critical group were all mechanically ventilated. The critical group had significantly higher values of MFI, DBS and PVD in comparison to severe group (respectively, PaCO2: 49 [44-45] vs 36 [33-37] mmHg; p<0,0001, MFI: 2.8 ± 0.2 vs 2.5 ± 0.3; p = 0.001, DBS: 12.7 ± 2.6 vs 10.8 ± 2.0 vessels mm-2; p = 0.033, PVD: 12.5 ± 3.0 vs 10.1 ± 2.4 mm.mm-2; p = 0.020). PPV, HI and TVD were similar between groups Correlation was found between microcirculatory parameters and PaCO2 levels. CONCLUSION Critical COVID-19 patients under mechanical ventilation seem to have higher red blood cell velocity than severe non-ventilated patients.
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Affiliation(s)
- Osama Abou-Arab
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
- * E-mail:
| | - Christophe Beyls
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Abdelilah Khalipha
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Mathieu Guilbart
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Pierre Huette
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Stéphanie Malaquin
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Benoit Lecat
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Pierre-Yves Macq
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Pierre Alexandre Roger
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Guillaume Haye
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Michaël Bernasinski
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Patricia Besserve
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | | | - Vincent Jounieaux
- Department of Pneumology, Amiens University Hospital, Amiens, France
| | - Hervé Dupont
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Yazine Mahjoub
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
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Abou-Arab O, Haye G, Beyls C, Huette P, Roger PA, Guilbart M, Bernasinski M, Besserve P, Trojette F, Dupont H, Jounieaux V, Mahjoub Y. Hypoxemia and prone position in mechanically ventilated COVID-19 patients: a prospective cohort study. Can J Anaesth 2021; 68:262-263. [PMID: 33146886 PMCID: PMC7640579 DOI: 10.1007/s12630-020-01844-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/17/2020] [Accepted: 10/22/2020] [Indexed: 10/25/2022] Open
Affiliation(s)
- Osama Abou-Arab
- Department of Anesthesia and Critical Care Medicine, Amiens University Medical Center, Amiens, France
| | - Guillaume Haye
- Department of Anesthesia and Critical Care Medicine, Amiens University Medical Center, Amiens, France
| | - Christophe Beyls
- Department of Anesthesia and Critical Care Medicine, Amiens University Medical Center, Amiens, France
| | - Pierre Huette
- Department of Anesthesia and Critical Care Medicine, Amiens University Medical Center, Amiens, France
| | - Pierre-Alexandre Roger
- Department of Anesthesia and Critical Care Medicine, Amiens University Medical Center, Amiens, France
| | - Mathieu Guilbart
- Department of Anesthesia and Critical Care Medicine, Amiens University Medical Center, Amiens, France
| | - Michaël Bernasinski
- Department of Anesthesia and Critical Care Medicine, Amiens University Medical Center, Amiens, France
| | - Patricia Besserve
- Department of Anesthesia and Critical Care Medicine, Amiens University Medical Center, Amiens, France
| | - Faouzi Trojette
- Department of Anesthesia and Critical Care Medicine, Amiens University Medical Center, Amiens, France
| | - Hervé Dupont
- Department of Anesthesia and Critical Care Medicine, Amiens University Medical Center, Amiens, France
| | - Vincent Jounieaux
- Respiratory Department, Amiens University Medical Center, Amiens, France
| | - Yazine Mahjoub
- Department of Anesthesia and Critical Care Medicine, Amiens University Medical Center, Amiens, France.
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Jounieaux V, Basille D, Abou-Arab O, Guillaumont MP, Andrejak C, Mahjoub Y, Rodenstein DO. Pure SARS-CoV-2 related AVDS (Acute Vascular Distress Syndrome). BMC Infect Dis 2021; 21:122. [PMID: 33509109 PMCID: PMC7841763 DOI: 10.1186/s12879-021-05805-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 01/15/2021] [Indexed: 01/04/2023] Open
Abstract
Background SARS-CoV-2 virus which targets the pulmonary vasculature is supposed to induce an intrapulmonary right to left shunt with an increased pulmonary blood flow. Such vascular injury is difficult to observe because it is hidden by the concomitant lung injury. We report here what may be, to the best of our knowledge, the first case of a pure Covid-19 related Acute Vascular Distress Syndrome (AVDS). Case presentation A 43-year-old physician, tested positive for Covid-19, was addressed to the emergency unit for severe dyspnoea and dizziness. Explorations were non informative with only a doubt regarding a sub-segmental pulmonary embolism (no ground-glass lesions or consolidations related to Covid-19 disease). Dyspnoea persisted despite anticoagulation therapy and normal pulmonary function tests. Contrast-enhanced transthoracic echocardiography was performed which revealed a moderate late right-to-left shunt. Conclusions This case report highlights the crucial importance of the vascular component of the viral disease. The intrapulmonary shunt induced by Covid-19 which remains unrecognized because generally hidden by the concomitant lung injury, can persist for a long time. Contrast-enhanced transthoracic echocardiography is the most appropriate test to propose in case of persistent dyspnoea in Covid-19 patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-05805-5.
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Affiliation(s)
| | - Damien Basille
- Pneumology Department, University Hospital Centre, Amiens, France
| | - Osama Abou-Arab
- Cardiac, Thoracic-vascular and Respiratory Intensive Care Unit, Department of Anesthesia and Critical Care, University Hospital Centre, Amiens, France
| | | | - Claire Andrejak
- Pneumology Department, University Hospital Centre, Amiens, France
| | - Yazine Mahjoub
- Cardiac, Thoracic-vascular and Respiratory Intensive Care Unit, Department of Anesthesia and Critical Care, University Hospital Centre, Amiens, France
| | - Daniel Oscar Rodenstein
- Pneumology Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
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Abou-Arab O, Haye G, Beyls C, Huette P, Roger PA, Guilbart M, Bernasinski M, Besserve P, Trojette F, Dupont H, Jounieaux V, Mahjoub Y. Correction to: Hypoxemia and prone position in mechanically ventilated COVID-19 patients: a prospective cohort study. Can J Anaesth 2020; 68:1307. [PMID: 33340066 PMCID: PMC7747773 DOI: 10.1007/s12630-020-01863-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Osama Abou-Arab
- Department of Anesthesia and Critical Care Medicine, Amiens University Medical Center, Amiens, France
| | - Guillaume Haye
- Department of Anesthesia and Critical Care Medicine, Amiens University Medical Center, Amiens, France
| | - Christophe Beyls
- Department of Anesthesia and Critical Care Medicine, Amiens University Medical Center, Amiens, France
| | - Pierre Huette
- Department of Anesthesia and Critical Care Medicine, Amiens University Medical Center, Amiens, France
| | - Pierre-Alexandre Roger
- Department of Anesthesia and Critical Care Medicine, Amiens University Medical Center, Amiens, France
| | - Mathieu Guilbart
- Department of Anesthesia and Critical Care Medicine, Amiens University Medical Center, Amiens, France
| | - Michaël Bernasinski
- Department of Anesthesia and Critical Care Medicine, Amiens University Medical Center, Amiens, France
| | - Patricia Besserve
- Department of Anesthesia and Critical Care Medicine, Amiens University Medical Center, Amiens, France
| | - Faouzi Trojette
- Department of Anesthesia and Critical Care Medicine, Amiens University Medical Center, Amiens, France
| | - Hervé Dupont
- Department of Anesthesia and Critical Care Medicine, Amiens University Medical Center, Amiens, France
| | - Vincent Jounieaux
- Respiratory Department, Amiens University Medical Center, Amiens, France
| | - Yazine Mahjoub
- Department of Anesthesia and Critical Care Medicine, Amiens University Medical Center, Amiens, France.
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Jounieaux V, Rodenstein DO, Mahjoub Y. On Happy Hypoxia and on Sadly Ignored "Acute Vascular Distress Syndrome" in Patients with COVID-19. Am J Respir Crit Care Med 2020; 202:1598-1599. [PMID: 32813543 PMCID: PMC7706160 DOI: 10.1164/rccm.202006-2521le] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abou-Arab O, Huette P, Debouvries F, Dupont H, Jounieaux V, Mahjoub Y. Inhaled nitric oxide for critically ill Covid-19 patients: a prospective study. Crit Care 2020; 24:645. [PMID: 33183348 PMCID: PMC7661015 DOI: 10.1186/s13054-020-03371-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/03/2020] [Indexed: 12/30/2022]
Affiliation(s)
- Osama Abou-Arab
- Department of Anaesthesiology and Critical Care Medicine, Amiens Picardie University Hospital, 1 rue du Professeur Christian Cabrol, 80054, Amiens, France.
| | - Pierre Huette
- Department of Anaesthesiology and Critical Care Medicine, Amiens Picardie University Hospital, 1 rue du Professeur Christian Cabrol, 80054, Amiens, France
| | - Fanny Debouvries
- Department of Anaesthesiology and Critical Care Medicine, Amiens Picardie University Hospital, 1 rue du Professeur Christian Cabrol, 80054, Amiens, France
| | - Hervé Dupont
- Department of Anaesthesiology and Critical Care Medicine, Amiens Picardie University Hospital, 1 rue du Professeur Christian Cabrol, 80054, Amiens, France
| | - Vincent Jounieaux
- Respiratory Department, Amiens Picardie University Hospital, 80054, Amiens, France
| | - Yazine Mahjoub
- Department of Anaesthesiology and Critical Care Medicine, Amiens Picardie University Hospital, 1 rue du Professeur Christian Cabrol, 80054, Amiens, France
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Basille D, Baud ME, Andrejak C, Basille-Fantinato A, Jounieaux V. Correlation between the Epworth Sleepiness Scale and the Maintenance of Wakefulness Test in Obstructive Sleep Apnea Patients Treated with Positive Airway Pressure. Respir Med Res 2020; 78:100787. [PMID: 32920453 DOI: 10.1016/j.resmer.2020.100787] [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: 02/26/2020] [Revised: 07/05/2020] [Accepted: 08/20/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Epworth sleepiness scale (ESS) is often used to evaluate the impact of treatment in patients with obstructive sleep apnea hypopnea syndrome (OSA). We aimed to evaluate the correlation between ESS and the Maintenance of Wakefulness Test (MWT) in a population of OSA patients treated with positive airway pressure (PAP). METHODS We retrospectively included all patients during a 2-year period who were diagnosed with OSA in our sleep clinic and required PAP therapy. ESS was evaluated at baseline and after PAP therapy for all patients, and all had a concomitant MWT. Correlation between final ESS, change in ESS, and MWT were evaluated using Spearman's correlation. Given that MWT is considered as the gold standard, the diagnostic performance of ESS was evaluated against MWT. RESULTS Hundred thirty-four OSA patients were included. At the time of MWT, 89.6% of the patients were compliant (PAP use ≥4hours/night), and only 9 (6.7%) had persistent sleepiness despite PAP treatment (mean sleep latency at MWT<19.4min). Moderate correlation was observed between final ESS and MWT (Spearman's correlation coefficient=-0.42), but no correlation was found between change in ESS and MWT. Diagnostic performance was as follows for final ESS: sensitivity=55.6%, specificity=84.8%, PPV=20.8%, and NPV=96.4%. CONCLUSIONS ESS was moderately correlated with MWT in a population of OSA patients compliant with PAP therapy. In this population, ESS showed poor diagnostic performance in identifying patients with persistent excessive daytime sleepiness. CLINICALTRIALS. GOV IDENTIFIER NCT03629834.
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Affiliation(s)
- D Basille
- Respiratory and Intensive Care Unit, Amiens-Picardy University Hospital, 80054 Amiens cedex 1, France.
| | - M E Baud
- Respiratory and Intensive Care Unit, Amiens-Picardy University Hospital, 80054 Amiens cedex 1, France
| | - C Andrejak
- Respiratory and Intensive Care Unit, Amiens-Picardy University Hospital, 80054 Amiens cedex 1, France
| | - A Basille-Fantinato
- Sleep and Vigilance Disorder Unit, Amiens-Picardy University Hospital, 80054 Amiens cedex 1, France
| | - V Jounieaux
- Respiratory and Intensive Care Unit, Amiens-Picardy University Hospital, 80054 Amiens cedex 1, France; Sleep and Vigilance Disorder Unit, Amiens-Picardy University Hospital, 80054 Amiens cedex 1, France
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Affiliation(s)
- Yazine Mahjoub
- Cardiac Thoracic Vascular and Respiratory Intensive Care Unit, Amiens University Medical Centre, University Hospital Centre, Amiens, France.
| | - Daniel Oscar Rodenstein
- Pneumology Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Vincent Jounieaux
- Pneumology Department, Amiens University Medical Centre, Amiens, France
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Leleu O, Vincent G, Auquier M, Basille D, Clarot C, Hoguet E, Pétigny V, Duban P, Zerkly S, Ganry O, Chauffert B, Berna P, Jounieaux V. Predictive factors for the participation of general practitioners in lung cancer screening by low-dose CT scan in the Somme department in northern France. Respir Med Res 2020; 77:95-99. [PMID: 32512523 DOI: 10.1016/j.resmer.2020.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 12/24/2019] [Accepted: 01/02/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION A study on lung cancer screening using low-dose computed tomography (DEP KP80) was conducted in the Somme department in northern France between May 2016 and December 2018. We conducted a cross-sectional survey of family physicians in that department to identify potential predictive factors for their participation in this pilot study. METHODS A survey questionnaire was sent to the 545 general practitioners (GPs) of the Somme department. This survey rendered it possible to identify the investigators who were active in the DEP KP80 study. The questionnaire's content was focused on the socio-demographic conditions of GPs, their professional practices, and their medical practice situations. RESULTS The response rate was 38% (206 completed questionnaires). Active investigators in DEP KP80 accounted for 55% (n=113) of the GPs surveyed, and non-investigators for 45% (n=93). Age, gender, or medical practice situation were not related to the active GPs' participation in DEP KP80. A multivariate analysis revealed that two factors were correlated with active participation in organized screening: (1) prescription of nicotine replacement therapy; (2) smoking history of the GP. CONCLUSIONS Securing the active involvement of family physicians and of the French regional cancer screening coordination centers seems essential for the future organization of lung cancer screening on a regional or national level. Our results demonstrate that incorporating smoking cessation support structures into the program would maximize the mechanism's potential.
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Affiliation(s)
- O Leleu
- Department of Pulmonology and Thoracic Oncology, Abbeville Hospital Center, Abbeville, France.
| | - G Vincent
- Maison Médicale, Bray-sur-Somme, France
| | - M Auquier
- Department of Radiology, CHU Amiens, Amiens, France
| | - D Basille
- Department of Pulmonology, CHU Amiens, Amiens, France
| | - C Clarot
- Department of Pulmonology and Thoracic Oncology, Abbeville Hospital Center, Abbeville, France
| | - E Hoguet
- Department of Pulmonology and Thoracic Oncology, Abbeville Hospital Center, Abbeville, France
| | | | - P Duban
- Maison Médicale, Bray-sur-Somme, France
| | - S Zerkly
- Department of Hospital Epidemiology, CHU Amiens, Amiens, France
| | - O Ganry
- Department of Hospital Epidemiology, CHU Amiens, Amiens, France
| | - B Chauffert
- Department of Medical Oncology, CHU Amiens, Amiens, France
| | - P Berna
- Department of Thoracic Surgery, CHU Amiens, Amiens, France
| | - V Jounieaux
- Department of Pulmonology, CHU Amiens, Amiens, France
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Timmerman M, Basille D, Basille-Fantinato A, Baud ME, Rebibo L, Andrejak C, Jounieaux V, Lalau JD. Short-Term Assessment of Obstructive Sleep Apnea Syndrome Remission Rate after Sleeve Gastrectomy: a Cohort Study. Obes Surg 2020; 29:3690-3697. [PMID: 31346929 DOI: 10.1007/s11695-019-04110-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Severe obesity is associated with a high prevalence of moderate-to-severe obstructive sleep apnea syndrome (OSA). Bariatric surgery has been shown to effectively reduce excess weight and comorbidities. METHODS We evaluated the remission rate of moderate-to-severe OSA (apnea-hypopnea index (AHI) ≥ 15) following sleeve gastrectomy. We performed a single-center retrospective chart review of all patients who underwent preoperative polysomnography (PSG) or polygraphy before primary sleeve gastrectomy. Patients with moderate-to-severe OSA treated by continuous positive airway pressure (CPAP) also underwent postoperative PSG. Bivariate analysis was performed to evaluate the criteria associated with remission of moderate-to-severe OSA. RESULTS From 2013 to 2018, 39 of 162 patients (24.1%) scheduled for sleeve gastrectomy (SG) presented moderate-to-severe OSA requiring CPAP. Postoperative PSG was performed in 36 patients a mean of 9.9 ± 6.1 months after SG. Mean BMI decreased from 47.4 ± 8.4 to 36.3 ± 7.1 kg/m2 (p < 0.001), and all patients reported clinical improvement of OSA symptoms. A remission of moderate-to-severe OSA was observed in 72.2% of patients with a mean decrease of AHI from 45.8 events/h to 11.3 events/h (p < 0.001). Postoperative neck circumference was the only factor associated with OSA remission. CONCLUSION SG is associated with a rapid improvement of moderate-to-severe OSA partially as a result of a reduction of neck circumference. However, the absence of correlation with excess weight loss suggests that other weight-independent factors may also be involved.
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Affiliation(s)
- Marine Timmerman
- Department of Endocrinology, Metabolic Diseases and Nutrition, University Hospital Amiens-Picardie, 80054, Amiens Cedex, France
| | - Damien Basille
- Department of Respiratory Diseases and Intensive Care Unit, University Hospital Amiens-Picardie, 80054, Amiens Cedex, France.
- AGIR Unit, University Picardie Jules Verne, 80054, Amiens Cedex, France.
| | | | - Mickaël E Baud
- Department of Respiratory Diseases and Intensive Care Unit, University Hospital Amiens-Picardie, 80054, Amiens Cedex, France
| | - Lionel Rebibo
- Department of Digestive Surgery, University Hospital Amiens-Picardie, 80054, Amiens Cedex, France
- Department of Digestive, Esogastric and Bariatric Surgery, Bichat Claude Bernard University Hospital, 46 rue Henri Huchard, F-75018, Paris, France
| | - Claire Andrejak
- Department of Respiratory Diseases and Intensive Care Unit, University Hospital Amiens-Picardie, 80054, Amiens Cedex, France
- AGIR Unit, University Picardie Jules Verne, 80054, Amiens Cedex, France
- Sleep and Vigilance Disorder Unit, University Hospital Amiens-Picardie, 80054, Amiens Cedex, France
| | - Vincent Jounieaux
- Department of Respiratory Diseases and Intensive Care Unit, University Hospital Amiens-Picardie, 80054, Amiens Cedex, France
- AGIR Unit, University Picardie Jules Verne, 80054, Amiens Cedex, France
- Sleep and Vigilance Disorder Unit, University Hospital Amiens-Picardie, 80054, Amiens Cedex, France
| | - Jean-Daniel Lalau
- Department of Endocrinology, Metabolic Diseases and Nutrition, University Hospital Amiens-Picardie, 80054, Amiens Cedex, France
- PériTox Unit, UMR-I 01, University Picardie Jules Verne, 80054, Amiens Cedex, France
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Leleu O, Basille D, Auquier M, Clarot C, Hoguet E, Pétigny V, Addi AA, Milleron B, Chauffert B, Berna P, Jounieaux V. Lung Cancer Screening by Low-Dose CT Scan: Baseline Results of a French Prospective Study. Clin Lung Cancer 2020; 21:145-152. [DOI: 10.1016/j.cllc.2019.10.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 09/06/2019] [Accepted: 10/18/2019] [Indexed: 12/24/2022]
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Lecuelle D, Basille D, Renard C, Saint F, Jounieaux V. Highly effective sirolimus therapy for abdominal lymphangioleiomyoma. Respir Med Res 2019; 75:32-34. [PMID: 31262426 DOI: 10.1016/j.resmer.2019.02.002] [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] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 02/07/2019] [Accepted: 02/11/2019] [Indexed: 10/27/2022]
Affiliation(s)
- D Lecuelle
- Departments of urology and transplantation, university hospital Amiens-Picardie, 80054 Amiens cedex 1, France
| | - D Basille
- Department of respiratory diseases and intensive care unit, university hospital Amiens-Picardie, 80054 Amiens cedex 1, France.
| | - C Renard
- Department of radiology, university hospital Amiens-Picardie, 80054 Amiens cedex 1, France
| | - F Saint
- Departments of urology and transplantation, university hospital Amiens-Picardie, 80054 Amiens cedex 1, France; Research laboratory EPROAD (EA 4669), university Picardie Jules-Verne, 80000 Amiens, France; Biobanque de Picardie, university hospital Amiens-Picardie, 80054 Amiens cedex 1, France
| | - V Jounieaux
- Department of respiratory diseases and intensive care unit, university hospital Amiens-Picardie, 80054 Amiens cedex 1, France
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Leleu O, Auquier MA, Chauffert B, Berna P, Petigny V, Ait Addi A, Basille D, Jounieaux V. Baseline results from a French pilot study on lung cancer screening by CT scan: DEP KP80. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz070.001] [Citation(s) in RCA: 1] [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: 11/14/2022] Open
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Salaün M, Guisier F, Dominique S, Genevois A, Jounieaux V, Bergot E, Thill C, Piton N, Thiberville L. In vivo probe‐based confocal laser endomicroscopy in chronic interstitial lung diseases: Specific descriptors and correlation with chest CT. Respirology 2019; 24:783-791. [DOI: 10.1111/resp.13507] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 01/23/2019] [Accepted: 01/30/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Mathieu Salaün
- Normandie UniversitéUNIROUEN Rouen France
- Department of Pulmonology and CIC‐CRB 1404Rouen University Hospital Rouen France
| | - Florian Guisier
- Normandie UniversitéUNIROUEN Rouen France
- Department of Pulmonology and CIC‐CRB 1404Rouen University Hospital Rouen France
| | - Stéphane Dominique
- Department of Pulmonology and CIC‐CRB 1404Rouen University Hospital Rouen France
| | - Anne Genevois
- Department of RadiologyRouen University Hospital Rouen France
| | | | - Emmanuel Bergot
- Department of PulmonologyCaen University Hospital Caen France
| | - Caroline Thill
- Department of BiostatisticsRouen University Hospital Rouen France
| | - Nicolas Piton
- Department of Cytology and PathologyRouen University Hospital Rouen France
| | - Luc Thiberville
- Normandie UniversitéUNIROUEN Rouen France
- Department of Pulmonology and CIC‐CRB 1404Rouen University Hospital Rouen France
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Basille D, Chevalier K, Andrejak C, Jounieaux V. Pleural transudate: pathophysiology during superior vena cava syndrome. ERJ Open Res 2019; 5:00251-2018. [PMID: 30815469 PMCID: PMC6387991 DOI: 10.1183/23120541.00251-2018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 12/21/2018] [Indexed: 11/05/2022] Open
Abstract
Pathophysiology, diagnosis and treatment of pleural transudates has widely been described in the literature [1–3]. Except for left heart failure, which requires diuretics, thoracoscopic talc pleurodesis appears to be a safe and effective therapeutic option [4–6]. We report the case of a woman who presented with a sudden pleural fluid formation from her parietal pleura during a talc pleurodesis for a recurrent transudative pleural effusion. We discuss the pathophysiology of this phenomenon. Pleural transudative effusion arises from imbalances between the hydrostatic and/or oncotic pressures. Temperature drop following talc poudrage through a spray may accentuate the pressure changes induced by superior vena cava syndrome.http://ow.ly/EpZm30nwVZj
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Jounieaux V, Rodenstein DO. Glottic patency during noninvasive ventilation in patients with chronic obstructive pulmonary disease. Respir Physiol Neurobiol 2019; 259:178. [DOI: 10.1016/j.resp.2018.09.001] [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: 08/30/2018] [Accepted: 09/06/2018] [Indexed: 10/28/2022]
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Drucbert M, Andrejak C, Jounieaux V. Syndromes de chevauchement asthme-BPCO (ACOS) : étude de la prévalence et des caractéristiques des ACOS parmi la cohorte de BPCO du CHU d’Amiens. Rev Mal Respir 2019. [DOI: 10.1016/j.rmr.2018.10.023] [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]
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Leleu O, Hoguet E, Clarot C, Baud M, Barras E, Petigny V, Benoit N, Auquier M, Chauffert B, Berna P, Jounieaux V. Preliminary results of a french pilot trial of lung cancer screening by low dose CT scan in the department of the Somme (DKP80). Lung Cancer 2018. [DOI: 10.1183/13993003.congress-2018.pa1764] [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: 11/05/2022]
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Abstract
Nontuberculous mycobacteria (NTM) are numerous, and for the vast majority of them, randomized studies are lacking and data regarding optimal treatment are limited. When Mycobacterium avium complex (MAC) and M. abscessus are excluded, the main NTM are M. xenopi, M. kansasii, M. malmoense, M. szulgai, and M. simiae. Treatment is long (at least 12 months after culture conversion according to recommendations by scientific societies) and difficult (at least three drugs are required, each of which have potential adverse events). Moreover, optimal treatment is unknown for the vast majority of NTM and efficacy of treatment is not 100%. That is why, balance between benefit and risk is fundamental. For M. xenopi, the second most common NTM isolated in Europe, treatment is classically based on macrolides or fluoroquinolones, associated with ethambutol and rifampicin. For M. kansasii, the cornerstone of treatment is rifampicin, which should be associated with two other drugs: ethambutol plus isoniazid or clarithromycin. M. malmoense, which is common in Northern Europe, can be treated by rifampicin, ethambutol, and clarithromycin and/or fluoroquinolones.
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Affiliation(s)
- Damien Basille
- Department of Respiratory Diseases, Amiens University Hospital, Amiens, France
| | - Vincent Jounieaux
- Department of Respiratory Diseases, Amiens University Hospital, Amiens, France
| | - Claire Andréjak
- Department of Respiratory Diseases, Amiens University Hospital, Amiens, France
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40
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Basille D, Thomsen RW, Madsen M, Duhaut P, Andrejak C, Jounieaux V, Sørensen HT. Nonsteroidal Antiinflammatory Drug Use and Clinical Outcomes of Community-acquired Pneumonia. Am J Respir Crit Care Med 2018; 198:128-131. [DOI: 10.1164/rccm.201802-0229le] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Damien Basille
- Aarhus University HospitalAarhus, Denmark
- University Hospital Amiens-PicardieAmiens, Franceand
- University Picardie Jules VerneAmiens, France
| | | | | | - Pierre Duhaut
- University Hospital Amiens-PicardieAmiens, Franceand
- University Picardie Jules VerneAmiens, France
| | - Claire Andrejak
- University Hospital Amiens-PicardieAmiens, Franceand
- University Picardie Jules VerneAmiens, France
| | - Vincent Jounieaux
- University Hospital Amiens-PicardieAmiens, Franceand
- University Picardie Jules VerneAmiens, France
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Voiriot G, Chalumeau M, Messika J, Basille D, Philippe B, Ricard JD, Andrejak C, Jounieaux V, Sanchez O, Fartoukh M. [Risks associated with the use of non-steroidal anti-inflammatory drugs during pneumonia]. Rev Mal Respir 2018; 35:430-440. [PMID: 29754841 DOI: 10.1016/j.rmr.2017.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 12/10/2017] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Outpatient treatment of community-acquired pneumonia (CAP) patients with non-steroidal anti-inflammatory drugs (NSAIDs) is frequent, although this is not based on clinical recommendations and there is no scientific evidence supporting better symptom relief in comparison to acetaminophen. STATE OF THE ART Experimental data suggest that NSAIDs alter the intrinsic functions of neutrophils, limit their locoregional recruitment, alter bacterial clearance and delay the resolution of inflammatory processes during acute bacterial pulmonary challenge. In hospitalized children and adults with CAP, observational data suggest a strong and independent association between the outpatient exposure to NSAIDs and the occurrence of pleuropulmonary complications (pleural empyema, excavation, and abscess). In the only study taking into account possible protopathic bias, the association still persists. Other markers of morbidity have been described, including delay in hospital management, prolonged antibiotic therapy, and higher transfer rate to an intensive care unit. PERSPECTIVES Data describing the role of self-medication and the biological mechanisms involved are needed. CONCLUSIONS Intake of NSAIDs during outpatient treatment of CAP is probably the second modifiable factor of morbidity after inadequate antibiotic therapy. In light of existing data in children and adults, health authorities should urgently reassess the risk-benefit ratio of NSAIDS in CAP.
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Affiliation(s)
- G Voiriot
- Service de réanimation médico-chirurgicale, hôpital Tenon, hôpitaux universitaires de l'Est-Parisien, Assistance publique-hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France.
| | - M Chalumeau
- Service de pédiatrie générale et maladies infectieuses, hôpital universitaire Necker-Enfants-Malades, Assistance publique-hôpitaux de Paris, 75015 Paris, France; Faculté de médecine, université Paris-Descartes-Paris-V, 75006 Paris, France
| | - J Messika
- Service de réanimation médico-chirurgicale, hôpital Louis-Mourier, hôpitaux universitaires Paris-Nord-Val-de-Seine, Assistance publique-hôpitaux de Paris, 92700 Colombes, France
| | - D Basille
- Service de pneumologie et réanimation respiratoire, centre hospitalier universitaire Amiens-Picardie, 80080 Amiens, France
| | - B Philippe
- Service de pneumologie, centre hospitalier René-Dubos, 95300 Pontoise, France
| | - J-D Ricard
- Service de réanimation médico-chirurgicale, hôpital Louis-Mourier, hôpitaux universitaires Paris-Nord-Val-de-Seine, Assistance publique-hôpitaux de Paris, 92700 Colombes, France; Faculté de médecine, université Paris-Diderot-Paris-VII, 75013 Paris, France
| | - C Andrejak
- Service de pneumologie et réanimation respiratoire, centre hospitalier universitaire Amiens-Picardie, 80080 Amiens, France; Faculté de médecine, université de Picardie-Jules-Verne, 80025 Amiens, France
| | - V Jounieaux
- Service de pneumologie et réanimation respiratoire, centre hospitalier universitaire Amiens-Picardie, 80080 Amiens, France; Faculté de médecine, université de Picardie-Jules-Verne, 80025 Amiens, France
| | - O Sanchez
- Faculté de médecine, université Paris-Descartes-Paris-V, 75006 Paris, France; Service de pneumologie, soins intensifs et endoscopies bronchiques, hôpital européen Georges-Pompidou, hôpitaux universitaires Paris-Ouest, Assistance Publique-hôpitaux de Paris, 75015 Paris, France
| | - M Fartoukh
- Service de réanimation médico-chirurgicale, hôpital Tenon, hôpitaux universitaires de l'Est-Parisien, Assistance publique-hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France; Faculté de médecine, Sorbonne université Paris, 75013 Paris, France
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Bulsei J, Leroy S, Perotin JM, Mal H, Marquette CH, Dutau H, Bourdin A, Vergnon JM, Pison C, Kessler R, Jounieaux V, Salaün M, Marceau A, Dukic S, Barbe C, Bonnaire M, Deslee G, Durand-Zaleski I. Cost-effectiveness of lung volume reduction coil treatment in patients with severe emphysema: results from the 2-year follow-up crossover REVOLENS study (REVOLENS-2 study). Respir Res 2018; 19:84. [PMID: 29743071 PMCID: PMC5941693 DOI: 10.1186/s12931-018-0796-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 03/22/2018] [Accepted: 04/29/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The REVOLENS study compared lung volume reduction coil treatment to usual care in patients with severe emphysema at 1 year, resulting in improved quality-adjusted life-year (QALY) and higher costs. Durability of the coil treatment benefit and its cost-effectiveness at 2 years are now assessed. METHODS After one year, the REVOLENS trial's usual care group patients received coil treatment (second-line coil treatment group). Costs and QALYs were assessed in both arms at 2 years and an incremental cost-effectiveness ratio in cost per QALY gained was calculated. The uncertainty of the results was estimated by probabilistic bootstrapping. RESULTS The average cost of coil treatment in both groups was estimated at €24,356. The average total cost at 2 years was €9655 higher in the first-line coil treatment group (p = 0.07) and the difference in QALY between the two groups was 0.127 (p = 0.12) in favor of first-line coil treatment group. The 2-year incremental cost-effectiveness ratio (ICER) was €75,978 / QALY. The scatter plot of the probabilistic bootstrapping had 92% of the replications in the top right-hand quadrant. CONCLUSION First-line coil treatment was more expensive but also more effective than second-line coil treatment at 2 years, with a 2-year ICER of €75,978 / QALY. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT01822795 .
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Affiliation(s)
- Julie Bulsei
- AP-HP URC Eco IdF, Unité de recherche clinique en économie de la santé d'Ile de France, Paris, France.
| | - Sylvie Leroy
- Service de Pneumologie, CHU de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France
| | | | - Hervé Mal
- Service de Pneumologie, Hôpital Universitaire Bichat, Paris, France
| | | | - Hervé Dutau
- Service d'Oncologie Thoracique, Maladies de la Plèvre, Pneumologie Interventionnelle, Hôpital Universitaire, Marseille, France
| | - Arnaud Bourdin
- Département de Pneumologie et Addictologie, PhyMedExp, INSERM U1046, CNRS UMR, Hôpital Universitaire, Montpellier, France
| | | | - Christophe Pison
- Pôle Thorax et Vaisseaux, Inserm1055, Hôpital Universitaire Grenoble Alpes, Inserm1055, Université Grenoble Alpes, Grenoble, France
| | - Romain Kessler
- Service de Pneumologie, Hôpital Universitaire, Strasbourg, France
| | | | - Mathieu Salaün
- Service de Pneumologie, Oncologie Thoracique et Soins Intensifs Respiratoires, Hôpital Universitaire, Rouen, France
| | - Armelle Marceau
- Service de Pneumologie, Hôpital Universitaire Bichat, Paris, France
| | - Sylvain Dukic
- Département de Pharmacovigilance, Hôpital Universitaire de Reims, Reims, France
| | - Coralie Barbe
- Unité d'Aide Méthodologique, Pôle Recherche et Santé Publique, Hôpital Universitaire de Reims, Reims, France
| | - Margaux Bonnaire
- Centre de Recherche et d'Investigation Clinique, Pôle Recherche et Santé Publique, Hôpital Universitaire de Reims, Reims, France
| | - Gaëtan Deslee
- Service de Pneumologie, INSERM U1250, Hôpital Universitaire, Reims, France
| | - Isabelle Durand-Zaleski
- AP-HP URC Eco IdF, Unité de recherche clinique en économie de la santé d'Ile de France, Paris, France
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Basille D, Hybiak C, Dayen C, Toublanc B, Douadi Y, Francois G, Rault I, Andrejak C, Berna P, Jounieaux V. [Endobronchial ultrasound with transbronchial needle aspiration: Evaluation of clinical practice]. Rev Mal Respir 2018; 35:305-312. [PMID: 29395562 DOI: 10.1016/j.rmr.2017.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 10/18/2016] [Accepted: 01/02/2017] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Endobronchial ultrasound with transbronchial needle aspiration (EBUS-TBNA) has undergone a large increase in France since 2007. The aim is to study the evolution of the indications for EBUS-TBNA in our region during the period 2008-2013. MATERIAL AND METHODS We conducted a retrospective observational study including all the patients who underwent an EBUS-TBNA procedure in Picardie from 2008 to 2013. The respective proportion for each indication was noted. RESULTS During the study period, 1036 EBUS-TBNA procedures were performed with a continuous increase in number (86 in 2008 versus 275 in 2013). We observed an increase in the proportion of procedures performed for a suspected diagnosis of sarcoidosis (OR=1.31; IC 95% [1.09-1.58]; P=0.005) and for the simultaneous diagnosis and staging of lung cancer (OR=1.12; IC 95% [1.02-1.24]; P=0.022). For the diagnosis of sarcoidosis, we observed an improvement in the diagnostic yield between the periods [2008-2010] and [2011-2013] (42.9% versus 72.5%). CONCLUSION A continuous increase in the number of EBUS-TBNA procedures was observed during the period 2008-2013. It was associated with a modification in practice with an increased proportion of procedures performed for the diagnosis of sarcoidosis.
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Affiliation(s)
- D Basille
- Service de pneumologie et réanimation respiratoire, CHU Amiens-Picardie, 80054 Amiens cedex 1, France.
| | - C Hybiak
- Service de pneumologie et réanimation respiratoire, CHU Amiens-Picardie, 80054 Amiens cedex 1, France
| | - C Dayen
- Service de pneumologie, maladies infectieuses et tropicales, centre hospitalier Saint-Quentin, 02321 Saint-Quentin, France
| | - B Toublanc
- Service de pneumologie et réanimation respiratoire, CHU Amiens-Picardie, 80054 Amiens cedex 1, France
| | - Y Douadi
- Service de pneumologie, maladies infectieuses et tropicales, centre hospitalier Saint-Quentin, 02321 Saint-Quentin, France
| | - G Francois
- Service de pneumologie et réanimation respiratoire, CHU Amiens-Picardie, 80054 Amiens cedex 1, France
| | - I Rault
- Service de pneumologie, maladies infectieuses et tropicales, centre hospitalier Saint-Quentin, 02321 Saint-Quentin, France
| | - C Andrejak
- Service de pneumologie et réanimation respiratoire, CHU Amiens-Picardie, 80054 Amiens cedex 1, France
| | - P Berna
- Service de chirurgie thoracique, CHU Amiens-Picardie, 80054 Amiens cedex 1, France
| | - V Jounieaux
- Service de pneumologie et réanimation respiratoire, CHU Amiens-Picardie, 80054 Amiens cedex 1, France
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Baud M, Poulet C, Andrejak C, Jounieaux V. Prise en charge de l’anémie en oncologie thoracique au CHU Amiens-Picardie. Évaluation des pratiques professionnelles entre 2014 et 2016. Rev Mal Respir 2018. [DOI: 10.1016/j.rmr.2017.10.232] [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: 11/16/2022]
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Leleu O, Auquier M, Carre O, Chauffert B, Petigny V, Trancart B, Berna P, Jounieaux V. Dépistage du cancer du poumon par scanner thoracique basse irradiation dans la Somme : résultats à 1 an. Rev Mal Respir 2018. [DOI: 10.1016/j.rmr.2017.10.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Leroy S, Benzaquen J, Mazzetta A, Marchand-Adam S, Padovani B, Israel-Biet D, Pison C, Chanez P, Cadranel J, Mazières J, Jounieaux V, Cohen C, Hofman V, Ilie M, Hofman P, Marquette CH. Circulating tumour cells as a potential screening tool for lung cancer (the AIR study): protocol of a prospective multicentre cohort study in France. BMJ Open 2017; 7:e018884. [PMID: 29282271 PMCID: PMC5770962 DOI: 10.1136/bmjopen-2017-018884] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Lung cancer (LC) is the leading cause of death from cancer. Early diagnosis of LC is of paramount importance in terms of prognosis. The health authorities of most countries do not accept screening programmes based on low-dose chest CT (LDCT), especially in Europe, because they are flawed by a high rate of false-positive results, leading to a large number of invasive diagnostic procedures. These authorities advocated further research, including companion biological tests that could enhance the effectiveness of LC screening. The present project aims to validate early diagnosis of LC by detection and characterisation of circulating tumour cells (CTCs) in a peripheral blood sample taken from a prospective cohort of persons at high-risk of LC. METHODS AND ANALYSIS The AIR Project is a prospective, multicentre, double-blinded, cohort study conducted by a consortium of 21 French university centres. The primary objective is to determine the operational values of CTCs for the early detection of LC in a cohort of asymptomatic participants at high risk for LC, that is, smokers and ex-smokers (≥30 pack-years, quitted ≤15 years), aged ≥55 years, with chronic obstructive pulmonary disease (COPD). The study participants will undergo yearly screening rounds for 3 years plus a 1-year follow-up. Each round will include LDCT plus peripheral blood sampling for CTC detection. Assuming 5% prevalence of LC in the studied population and a 10% dropout rate, a total of at least 600 volunteers will be enrolled. ETHICS AND DISSEMINATION The study sponsor is the University Hospital of Nice. The study was approved for France by the ethical committee CPP Sud-Méditerranée V and the ANSM (Ministry of Health) in July 2015. The findings of the trial will be disseminated through peer-reviewed journals and national and international conference presentations. TRIAL REGISTRATION NUMBER NCT02500693.
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Affiliation(s)
- Sylvie Leroy
- Department of Pulmonary Medicine and Thoracic Oncology, Centre Hospitalier Universitaire de Nice, Nice, France
- CNRS, INSERM, IPMC, FHU-OncoAge, Université Côte d'Azur, Valbonne, France
| | - Jonathan Benzaquen
- Department of Pulmonary Medicine and Thoracic Oncology, Centre Hospitalier Universitaire de Nice, Nice, France
- Laboratory of Clinical and Experimental Pathology, Hospital-Related Biobank (BB-0033-00025), IRCAN, FHU OncoAge, Nice, France
| | - Andrea Mazzetta
- Department of Pulmonary Medicine and Thoracic Oncology, Centre Hospitalier Universitaire de Nice, Nice, France
| | | | | | | | - Christophe Pison
- Department of Pulmonary Medicine, CHU de Grenoble, Grenoble, France
| | - Pascal Chanez
- Department of Pulmonary Medicine, CHU de Marseille, Marseille, France
| | | | - Julien Mazières
- Department of Pulmonary Medicine, CHU Toulouse, Toulouse, France
| | | | - Charlotte Cohen
- Department of Thoracic Surgery, CHU de Nice, FHU OncoAge, Nice, France
| | - Véronique Hofman
- Laboratory of Clinical and Experimental Pathology, Hospital-Related Biobank (BB-0033-00025), IRCAN, FHU OncoAge, Nice, France
| | - Marius Ilie
- Laboratory of Clinical and Experimental Pathology, Hospital-Related Biobank (BB-0033-00025), IRCAN, FHU OncoAge, Nice, France
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, Hospital-Related Biobank (BB-0033-00025), IRCAN, FHU OncoAge, Nice, France
| | - Charles Hugo Marquette
- Department of Pulmonary Medicine and Thoracic Oncology, Centre Hospitalier Universitaire de Nice, Nice, France
- Laboratory of Clinical and Experimental Pathology, Hospital-Related Biobank (BB-0033-00025), IRCAN, FHU OncoAge, Nice, France
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Zogheib E, Nyga R, Cornu M, Sendid B, Monconduit J, Jounieaux V, Maizel J, Segard C, Chouaki T, Dupont H. Prospective Observational Study on the Association Between Serum Mannose-Binding Lectin Levels and Severe Outcome in Critically Ill Patients with Pandemic Influenza Type A (H1N1) Infection. Lung 2017; 196:65-72. [PMID: 29273833 PMCID: PMC7101572 DOI: 10.1007/s00408-017-0067-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 07/08/2017] [Accepted: 11/01/2017] [Indexed: 12/18/2022]
Abstract
Background Mannose-binding lectin (MBL) plays an important role in the innate immune response. In addition to activating the complement, MBL can induce cytokine production and contribute to a deleterious inflammatory response with severe A(H1N1)pdm09 virus infection. Our aim was to determine if serum MBL levels correlate with the risk of mortality in intensive care units (ICU) patients with A(H1N1)pdm09 infection. Methods Prospective observational study was performed in ICU patients with acute respiratory distress syndrome due to influenza A(H1N1)pdm09 virus. Demographic characteristics and severity indices were recorded at ICU admission. MBL was assayed from blood drawn at influenza diagnosis within 24–48 h following the ICU admission. Outcomes were compared according to MBL levels. Results are expressed as median and interquartile range. Results Serum MBL levels were studied in 27 patients (age: 56 [IQR 29] years) with severe A(H1N1)pdm09 infection and in 70 healthy controls. Median admission SAPSII and SOFA scores were 49 [IQR 26] and 12 [IQR 5], respectively. Mortality rate after a 30-day was 37%. MBL was significantly higher in non-survivors (3741 [IQR 2336] ng/ml) vs survivors (215 [IQR 1307] ng/ml), p = 0.006, as well as control group (1814 [IQR 2250] ng/ml), p = 0.01. In contrast, MBL levels in survivors group were significantly lower than the controls group (215 [IQR 1307] ng/ml vs. 1814 [IQR 2250] ng/ml, p = 0.005). MBL cut-off > 1870 ng/ml had a sensitivity of 80% and a specificity of 88.2% for mortality [AUC = 0.82 (95% CI 0.63–0.94)]. Kaplan–Meier analysis demonstrated a strong association between MBL levels and mortality (log-rank 7.8, p = 0.005). MBL > 1870 ng/ml was independently associated with mortality (HR = 8.7, 95% CI 1.2–29.1, p = 0.007). Conclusions This study shows that baseline MBL > 1870 ng/ml is associated with higher mortality in ICU patients with severe A(H1N1)pdm09 infection.
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Affiliation(s)
- Elie Zogheib
- Cardiothoracic and Vascular Intensive Care Unit, Amiens University Hospital, Amiens, France. .,INSERM U1088, Jules Verne University of Picardy, Amiens, France.
| | - Remy Nyga
- Medical Parasitology and Mycology Department, Amiens University Hospital, Amiens, France
| | - Marjorie Cornu
- Medical Parasitology and Mycology Department, CHU, Lille, France.,INSERM U995, Team Fungal Associated Invasive & Inflammatory Diseases, Lille Inflammation Research International Center, Université de Lille, Lille, France
| | - Boualem Sendid
- Medical Parasitology and Mycology Department, CHU, Lille, France.,INSERM U995, Team Fungal Associated Invasive & Inflammatory Diseases, Lille Inflammation Research International Center, Université de Lille, Lille, France
| | - Julien Monconduit
- Respiratory Intensive Care Unit, Amiens University Hospital, Amiens, France
| | - Vincent Jounieaux
- Respiratory Intensive Care Unit, Amiens University Hospital, Amiens, France
| | - Julien Maizel
- INSERM U1088, Jules Verne University of Picardy, Amiens, France.,Medical Intensive Care Unit, Amiens University Hospital, Amiens, France
| | - Christine Segard
- Medical Virology Department, Amiens University Hospital, Amiens, France
| | - Taïeb Chouaki
- Medical Parasitology and Mycology Department, Amiens University Hospital, Amiens, France
| | - Hervé Dupont
- Cardiothoracic and Vascular Intensive Care Unit, Amiens University Hospital, Amiens, France.,INSERM U1088, Jules Verne University of Picardy, Amiens, France
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Deslée G, Leroy S, Perotin JM, Mal H, Dutau H, Bourdin A, Vergnon J, Pison C, Kessler R, Jounieaux V, Salaün M, Marceau A, Dury S, Benzaquen J, Bonnaire M, Dukic S, Barbe C, Marquette CH. Two-year follow-up after endobronchial coil treatment in emphysema: results from the REVOLENS study. Eur Respir J 2017; 50:50/6/1701740. [DOI: 10.1183/13993003.01740-2017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 09/19/2017] [Indexed: 11/05/2022]
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Basille D, De Dominicis F, Magois E, Andrejak C, Berna P, Jounieaux V. [Mediastinitis after endobronchial ultrasound-guided transbronchial needle aspiration]. Rev Mal Respir 2017; 34:1022-1025. [PMID: 28927679 DOI: 10.1016/j.rmr.2017.01.007] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 01/16/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure used for the diagnosis of mediastinal and hilar lymphadenopathy. OBSERVATION We describe a case of mediastinitis appearing 15 days after an EBUS-TBNA procedure in a 79 years old male patient. The mediastinitis was treated surgically by thoracotomy with a wide excision of infected tissue requiring transplantation of a serratus anterior muscle flap pedicled on a branch of the thoracodorsal artery. It was coupled with broad spectrum antibiotics. This medico-surgical management led to a favorable outcome. Microbiological analysis of the mediastinal collections revealed two pathogens: Streptococcus constellatus (a germ present in the normal flora of the oral cavity) and Mycobacterium tuberculosis. A standard first line quadruple antituberculous drug regimen was subsequently given to the patient. CONCLUSION This episode of Streptococcus constellatus mediastinitis was a complication of the EBUS-TBNA procedure. The operating channel of the bronchoscope had probably been contaminated when aspirating the oral cavity secretions with subsequent needle contamination and a direct bacterial inoculation during the transbronchial mediastinal puncture. The severity of such a complication justifies a medical consultation in cases of fever or chest pain following an EBUS-TBNA procedure.
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Affiliation(s)
- D Basille
- Service de pneumologie et réanimation respiratoire, CHU d'Amiens-Picardie, 80054 Amiens cedex 1, France.
| | - F De Dominicis
- Service de chirurgie thoracique, CHU d'Amiens-Picardie, 80054 Amiens cedex 1, France
| | - E Magois
- Service de pneumologie et réanimation respiratoire, CHU d'Amiens-Picardie, 80054 Amiens cedex 1, France
| | - C Andrejak
- Service de pneumologie et réanimation respiratoire, CHU d'Amiens-Picardie, 80054 Amiens cedex 1, France
| | - P Berna
- Service de chirurgie thoracique, CHU d'Amiens-Picardie, 80054 Amiens cedex 1, France
| | - V Jounieaux
- Service de pneumologie et réanimation respiratoire, CHU d'Amiens-Picardie, 80054 Amiens cedex 1, France
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Solomalalarivelo F, Poulet C, Andrejak C, Jounieaux V. Évaluation de la survie globale des patients présentant un adénocarcinome de stade avancé, selon l’existence de mutations EGFR dans 5 centres picards. Rev Mal Respir 2017. [DOI: 10.1016/j.rmr.2016.10.476] [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: 11/25/2022]
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