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Declercq PL, Fournel I, Demeyere M, Berraies A, Ksiazek E, Nyunga M, Daubin C, Ampere A, Sauneuf B, Badie J, Delbove A, Nseir S, Artaud-Macari E, Bironneau V, Ramakers M, Maizel J, Miailhe AF, Lacombe B, Delberghe N, Oulehri W, Georges H, Tchenio X, Clarot C, Redureau E, Bourdin G, Federici L, Adda M, Schnell D, Bousta M, Salmon-Gandonnière C, Vanderlinden T, Plantefeve G, Delacour D, Delpierre C, Le Bouar G, Sedillot N, Beduneau G, Rivière A, Meunier-Beillard N, Gélinotte S, Rigaud JP, Labruyère M, Georges M, Binquet C, Quenot JP. Correction: Influence of socio-economic status on functional recovery after ARDS caused by SARS-CoV-2: the multicentre, observational RECOVIDS study. Intensive Care Med 2023; 49:1438-1439. [PMID: 37755457 PMCID: PMC10622337 DOI: 10.1007/s00134-023-07217-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Affiliation(s)
| | - Isabelle Fournel
- Centre d'Investigation Clinique, CHU Dijon, Dijon, France
- INSERM, CIC 1432, Module Epidémiologie Clinique, Dijon, France
| | | | | | - Eléa Ksiazek
- Centre d'Investigation Clinique, CHU Dijon, Dijon, France
- INSERM, CIC 1432, Module Epidémiologie Clinique, Dijon, France
| | - Martine Nyunga
- Service de Médecine Intensive Réanimation, CH de Roubaix, Roubaix, France
| | - Cédric Daubin
- Department of Medical Intensive Care, CHU de Caen Normandie, Caen, France
| | | | - Bertrand Sauneuf
- Service de Médecine Intensive Réanimation, CH Public du Cotentin, Cherbourg-en-Cotentin, France
| | - Julio Badie
- Service de Médecine Intensive Réanimation, Hopital Nord Franche-Comte, Trevenans, France
| | - Agathe Delbove
- Service de Réanimation Polyvalente, CHBA Vannes, Vannes, France
| | - Saad Nseir
- Service de Médecine Intensive Réanimation, CHRU Roger Salengro, Lille, France
- Inserm U1285, Univ. Lille, CNRS, UMR 8576-UGSF-Unité de Glycobiologie Structurale et Fonctionnelle, Lille, France
| | - Elise Artaud-Macari
- University of Normandie, UNIROUEN, EA3830, CHU Rouen, Department of Pneumology, Thoracic Oncology and Respiratory Intensive Care Unit, Rouen, France
| | - Vanessa Bironneau
- Service de Pneumologie, CHU Poitiers, Poitiers, France
- INSERM CIC 1402, ALIVES Research Group, Université de Poitiers, Poitiers, France
| | - Michel Ramakers
- Service de Médecine Intensive Réanimation, Centre Hospitalier Mémorial de Saint-Lô, Saint-Lô, France
| | - Julien Maizel
- Service de Médecine Intensive Réanimation, CHU d'Amiens, Amiens, France
| | | | - Béatrice Lacombe
- Service de Réanimation Polyvalente, Groupe Hospitalier Bretagne Sud, Lorient, France
| | | | - Walid Oulehri
- Service de Réanimation Chirurgicale, CHRU Strasbourg, Strasbourg, France
| | - Hugues Georges
- Service de Médecine Intensive Réanimation, CH de Tourcoing, Tourcoing, France
| | - Xavier Tchenio
- Service de Réanimation Polyvalente, Centre Hospitalier Fleyriat, Bourg en Bresse, France
| | | | - Elise Redureau
- Service de Pneumologie, CHD Vendée, La Roche-sur-Yon, France
| | - Gaël Bourdin
- Service de Réanimation Polyvalente, CH Saint Joseph Saint Luc, Lyon, France
| | - Laura Federici
- Service de Médecine Intensive Réanimation, AP-HP, Hôpital Louis Mourier, Colombes, France
| | - Mélanie Adda
- Service de Médecine Intensive Réanimation, Hôpitaux de Marseille, Hôpital Nord, Marseille, France
| | - David Schnell
- Service de Réanimation Polyvalente et USC, CH d'Angoulême, Angoulême, France
| | - Mehdi Bousta
- Service de Réanimation Médico-Chirugicale, Groupe Hospitalier du Havre, Le Havre, France
| | | | - Thierry Vanderlinden
- Intensive Care Unit, St Philibert hospital, ETHICS EA 7446, Lille Catholic University, Lille, France
| | - Gaëtan Plantefeve
- Service de Médecine Intensive Réanimation, CH d'Argenteuil, Argenteuil, France
| | - David Delacour
- Service de radiologie, Clinique du Cèdre, Bois-Guillaume, France
| | | | - Gurvan Le Bouar
- Service de Médecine Intensive Réanimation, CHES Evreux, Evreux, France
| | - Nicholas Sedillot
- Service de Réanimation Polyvalente, Centre Hospitalier Fleyriat, Bourg en Bresse, France
| | - Gaëtan Beduneau
- Normandie Univ, UNIROUEN, UR3830, CHU Rouen, Department of Medical Intensive Care, 76000, Rouen, France
| | - Antoine Rivière
- Service de Réanimation Polyvalente, CH d'Abbeville, Abbeville, France
| | - Nicolas Meunier-Beillard
- Centre d'Investigation Clinique, CHU Dijon, Dijon, France
- INSERM, CIC 1432, Module Epidémiologie Clinique, Dijon, France
| | | | - Jean-Philippe Rigaud
- Service de Médecine Intensive Réanimation, CH de Dieppe, Dieppe, France
- Espace de Réflexion Ethique de Normandie, CHU Caen, Caen, France
| | - Marie Labruyère
- Department of Intensive Care, Burgundy University Hospital, 14 rue Paul Gaffarel, B.P 77908, 21079, Dijon Cedex, France
- Lipness Team, INSERM Research Center LNC-UMR1231 and LabEx LipSTIC, University of Burgundy, Dijon, France
- INSERM CIC 1432, Clinical Epidemiology, University of Burgundy, Dijon, France
| | - Marjolaine Georges
- Department of Pulmonary Medicine and Intensive Care Unit, University Hospital, Dijon, France
| | - Christine Binquet
- Centre d'Investigation Clinique, CHU Dijon, Dijon, France
- INSERM, CIC 1432, Module Epidémiologie Clinique, Dijon, France
| | - Jean-Pierre Quenot
- Department of Intensive Care, Burgundy University Hospital, 14 rue Paul Gaffarel, B.P 77908, 21079, Dijon Cedex, France.
- Lipness Team, INSERM Research Center LNC-UMR1231 and LabEx LipSTIC, University of Burgundy, Dijon, France.
- INSERM CIC 1432, Clinical Epidemiology, University of Burgundy, Dijon, France.
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Declercq PL, Fournel I, Demeyere M, Berraies A, Ksiazek E, Nyunga M, Daubin C, Ampere A, Sauneuf B, Badie J, Delbove A, Nseir S, Artaud-Macari E, Bironneau V, Ramakers M, Maizel J, Miailhe AF, Lacombe B, Delberghe N, Oulehri W, Georges H, Tchenio X, Clarot C, Redureau E, Bourdin G, Federici L, Adda M, Schnell D, Bousta M, Salmon-Gandonnière C, Vanderlinden T, Plantefeve G, Delacour D, Delpierre C, Le Bouar G, Sedillot N, Beduneau G, Rivière A, Meunier-Beillard N, Gélinotte S, Rigaud JP, Labruyère M, Georges M, Binquet C, Quenot JP. Influence of socio-economic status on functional recovery after ARDS caused by SARS-CoV-2: the multicentre, observational RECOVIDS study. Intensive Care Med 2023; 49:1168-1180. [PMID: 37620561 PMCID: PMC10556111 DOI: 10.1007/s00134-023-07180-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 07/28/2023] [Indexed: 08/26/2023]
Abstract
PURPOSE Survivors after acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19) are at high risk of developing respiratory sequelae and functional impairment. The healthcare crisis caused by the pandemic hit socially disadvantaged populations. We aimed to evaluate the influence of socio-economic status on respiratory sequelae after COVID-19 ARDS. METHODS We carried out a prospective multicenter study in 30 French intensive care units (ICUs), where ARDS survivors were pre-enrolled if they fulfilled the Berlin ARDS criteria. For patients receiving high flow oxygen therapy, a flow ≥ 50 l/min and an FiO2 ≥ 50% were required for enrollment. Socio-economic deprivation was defined by an EPICES (Evaluation de la Précarité et des Inégalités de santé dans les Centres d'Examens de Santé - Evaluation of Deprivation and Inequalities in Health Examination Centres) score ≥ 30.17 and patients were included if they performed the 6-month evaluation. The primary outcome was respiratory sequelae 6 months after ICU discharge, defined by at least one of the following criteria: forced vital capacity < 80% of theoretical value, diffusing capacity of the lung for carbon monoxide < 80% of theoretical value, oxygen desaturation during a 6-min walk test and fibrotic-like findings on chest computed tomography. RESULTS Among 401 analyzable patients, 160 (40%) were socio-economically deprived and 241 (60%) non-deprived; 319 (80%) patients had respiratory sequelae 6 months after ICU discharge (81% vs 78%, deprived vs non-deprived, respectively). No significant effect of socio-economic status was identified on lung sequelae (odds ratio (OR), 1.19 [95% confidence interval (CI), 0.72-1.97]), even after adjustment for age, sex, most invasive respiratory support, obesity, most severe P/F ratio (adjusted OR, 1.02 [95% CI 0.57-1.83]). CONCLUSIONS In COVID-19 ARDS survivors, socio-economic status had no significant influence on respiratory sequelae 6 months after ICU discharge.
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Affiliation(s)
| | - Isabelle Fournel
- Centre d’Investigation Clinique, CHU Dijon, Dijon, France
- INSERM, CIC 1432, Module Epidémiologie Clinique, Dijon, France
| | | | | | - Eléa Ksiazek
- Centre d’Investigation Clinique, CHU Dijon, Dijon, France
- INSERM, CIC 1432, Module Epidémiologie Clinique, Dijon, France
| | - Martine Nyunga
- Service de Médecine Intensive Réanimation, CH de Roubaix, Roubaix, France
| | - Cédric Daubin
- Department of Medical Intensive Care, CHU de Caen Normandie, Caen, France
| | | | - Bertrand Sauneuf
- Service de Médecine Intensive Réanimation, CH Public du Cotentin, Cherbourg-en-Cotentin, France
| | - Julio Badie
- Service de Médecine Intensive Réanimation, Hopital Nord Franche-Comte, Trevenans, France
| | - Agathe Delbove
- Service de Réanimation Polyvalente, CHBA Vannes, Vannes, France
| | - Saad Nseir
- Service de Médecine Intensive Réanimation, CHRU Roger Salengro, Lille, France
- Inserm U1285, Univ. Lille, CNRS, UMR 8576-UGSF-Unité de Glycobiologie Structurale et Fonctionnelle, Lille, France
| | - Elise Artaud-Macari
- University of Normandie, UNIROUEN, EA3830, CHU Rouen, Department of Pneumology, Thoracic Oncology and Respiratory Intensive Care Unit, Rouen, France
| | - Vanessa Bironneau
- Service de Pneumologie, CHU Poitiers, Poitiers, France
- INSERM CIC 1402, ALIVES Research Group, Université de Poitiers, Poitiers, France
| | - Michel Ramakers
- Service de Médecine Intensive Réanimation, Centre Hospitalier Mémorial de Saint-Lô, Saint-Lô, France
| | - Julien Maizel
- Service de Médecine Intensive Réanimation, CHU d’Amiens, Amiens, France
| | | | - Béatrice Lacombe
- Service de Réanimation Polyvalente, Groupe Hospitalier Bretagne Sud, Lorient, France
| | | | - Walid Oulehri
- Service de Réanimation Chirurgicale, CHRU Strasbourg, Strasbourg, France
| | - Hugues Georges
- Service de Médecine Intensive Réanimation, CH de Tourcoing, Tourcoing, France
| | - Xavier Tchenio
- Service de Réanimation Polyvalente, Centre Hospitalier Fleyriat, Bourg en Bresse, France
| | | | - Elise Redureau
- Service de Pneumologie, CHD Vendée, La Roche-sur-Yon, France
| | - Gaël Bourdin
- Service de Réanimation Polyvalente, CH Saint Joseph Saint Luc, Lyon, France
| | - Laura Federici
- Service de Médecine Intensive Réanimation, AP-HP, Hôpital Louis Mourier, Colombes, France
| | - Mélanie Adda
- Service de Médecine Intensive Réanimation, Hôpitaux de Marseille, Hôpital Nord, Marseille, France
| | - David Schnell
- Service de Réanimation Polyvalente et USC, CH d’Angoulême, Angoulême, France
| | - Mehdi Bousta
- Service de Réanimation Médico-Chirugicale, Groupe Hospitalier du Havre, Le Havre, France
| | | | - Thierry Vanderlinden
- Intensive Care Unit, St Philibert hospital, ETHICS EA 7446, Lille Catholic University, Lille, France
| | - Gaëtan Plantefeve
- Service de Médecine Intensive Réanimation, CH d’Argenteuil, Argenteuil, France
| | - David Delacour
- Service de radiologie, Clinique du Cèdre, Bois-Guillaume, France
| | | | - Gurvan Le Bouar
- Service de Médecine Intensive Réanimation, CHES Evreux, Evreux, France
| | - Nicholas Sedillot
- Service de Réanimation Polyvalente, Centre Hospitalier Fleyriat, Bourg en Bresse, France
| | - Gaëtan Beduneau
- Normandie Univ, UNIROUEN, UR3830, CHU Rouen, Department of Medical Intensive Care, 76000 Rouen, France
| | - Antoine Rivière
- Service de Réanimation Polyvalente, CH d’Abbeville, Abbeville, France
| | - Nicolas Meunier-Beillard
- Centre d’Investigation Clinique, CHU Dijon, Dijon, France
- INSERM, CIC 1432, Module Epidémiologie Clinique, Dijon, France
| | | | - Jean-Philippe Rigaud
- Service de Médecine Intensive Réanimation, CH de Dieppe, Dieppe, France
- Espace de Réflexion Ethique de Normandie, CHU Caen, Caen, France
| | - Marie Labruyère
- Department of Intensive Care, Burgundy University Hospital, 14 rue Paul Gaffarel, B.P 77908, 21079 Dijon Cedex, France
- Lipness Team, INSERM Research Center LNC-UMR1231 and LabEx LipSTIC, University of Burgundy, Dijon, France
- INSERM CIC 1432, Clinical Epidemiology, University of Burgundy, Dijon, France
| | - Marjolaine Georges
- Department of Pulmonary Medicine and Intensive Care Unit, University Hospital, Dijon, France
| | - Christine Binquet
- Centre d’Investigation Clinique, CHU Dijon, Dijon, France
- INSERM, CIC 1432, Module Epidémiologie Clinique, Dijon, France
| | - Jean-Pierre Quenot
- Department of Intensive Care, Burgundy University Hospital, 14 rue Paul Gaffarel, B.P 77908, 21079 Dijon Cedex, France
- Lipness Team, INSERM Research Center LNC-UMR1231 and LabEx LipSTIC, University of Burgundy, Dijon, France
- INSERM CIC 1432, Clinical Epidemiology, University of Burgundy, Dijon, France
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Declercq PL, Fournel I, Demeyere M, Ksiazek E, Meunier-Beillard N, Rivière A, Clarot C, Maizel J, Schnell D, Plantefeve G, Ampere A, Daubin C, Sauneuf B, Kalfon P, Federici L, Redureau É, Bousta M, Lagache L, Vanderlinden T, Nseir S, La Combe B, Bourdin G, Monchi M, Nyunga M, Ramakers M, Oulehri W, Georges H, Salmon Gandonniere C, Badie J, Delbove A, Monnet X, Beduneau G, Artaud-Macari É, Abraham P, Delberghe N, Le Bouar G, Miailhe AF, Hraiech S, Bironneau V, Sedillot N, Hoppe MA, Barbar SD, Calcaianu GD, Dellamonica J, Terzi N, Delpierre C, Gélinotte S, Rigaud JP, Labruyère M, Georges M, Binquet C, Quenot JP. Influence of socioeconomic status on functional recovery after ARDS caused by SARS-CoV-2: a multicentre, observational study. BMJ Open 2022; 12:e057368. [PMID: 35459672 PMCID: PMC9035836 DOI: 10.1136/bmjopen-2021-057368] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Prognosis of patients with COVID-19 depends on the severity of the pulmonary affection. The most severe cases may progress to acute respiratory distress syndrome (ARDS), which is associated with a risk of long-term repercussions on respiratory function and neuromuscular outcomes. The functional repercussions of severe forms of COVID-19 may have a major impact on quality of life, and impair the ability to return to work or exercise. Social inequalities in healthcare may influence prognosis, with socially vulnerable individuals more likely to develop severe forms of disease. We describe here the protocol for a prospective, multicentre study that aims to investigate the influence of social vulnerability on functional recovery in patients who were hospitalised in intensive care for ARDS caused by COVID-19. This study will also include an embedded qualitative study that aims to describe facilitators and barriers to compliance with rehabilitation, describe patients' health practices and identify social representations of health, disease and care. METHODS AND ANALYSIS The "Functional Recovery From Acute Respiratory Distress Syndrome (ARDS) Due to COVID-19: Influence of Socio-Economic Status" (RECOVIDS) study is a mixed-methods, observational, multicentre cohort study performed during the routine follow-up of post-intensive care unit (ICU) functional recovery after ARDS. All patients admitted to a participating ICU for PCR-proven SARS-CoV-2 infection and who underwent chest CT scan at the initial phase AND who received respiratory support (mechanical or not) or high-flow nasal oxygen, AND had ARDS diagnosed by the Berlin criteria will be eligible. The primary outcome is the presence of lung sequelae at 6 months after ICU discharge, defined either by alterations on pulmonary function tests, oxygen desaturation during a standardised 6 min walk test or fibrosis-like pulmonary findings on chest CT. Patients will be considered to be socially disadvantaged if they have an "Evaluation de la Précarité et des Inégalités de santé dans les Centres d'Examen de Santé" (EPICES) score ≥30.17 at inclusion. ETHICS AND DISSEMINATION The study protocol and the informed consent form were approved by an independent ethics committee (Comité de Protection des Personnes Sud Méditerranée II) on 10 July 2020 (2020-A02014-35). All patients will provide informed consent before participation. Findings will be published in peer-reviewed journals and presented at national and international congresses. TRIAL REGISTRATION NUMBER NCT04556513.
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Affiliation(s)
| | - Isabelle Fournel
- Centre d'Investigation Clinique INSERM 1432, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - Matthieu Demeyere
- Department of Radiology, University Hospital Centre Rouen, Rouen, France
| | - Eléa Ksiazek
- Centre d'Investigation Clinique, Épidémiologie Clinique/Essais Cliniques, University Hospital Centre Dijon, Dijon, France
- Module Epidémiologie Clinique, INSERM CIC 1432, Dijon, France
| | - Nicolas Meunier-Beillard
- Centre d'Investigation Clinique, Épidémiologie Clinique/Essais Cliniques, University Hospital Centre Dijon, Dijon, France
| | - Antoine Rivière
- Service de Médecine Intensive-Réanimation, Abbeville Hospital Centre, Abbeville, France
| | - Caroline Clarot
- Service de Pneumologie, Abbeville Hospital Centre, Abbeville, France
| | - Julien Maizel
- Service de Médecine Intensive-Réanimation, University Hospital Centre Amiens-Picardie, Amiens, France
| | - David Schnell
- Service de Médecine Intensive-Réanimation, Hospital Centre Angouleme, Angouleme, France
| | - Gaetan Plantefeve
- Service de Médecine-Intensive Réanimation, Centre Hospitalier d'Argenteuil, Argenteuil, France
| | - Alexandre Ampere
- Service de Pneumologie, Hospital Centre Bethune, Bethune, France
| | - Cédric Daubin
- Department of Medical Intensive Care, CHRU de Caen, Caen, France
| | - Bertrand Sauneuf
- Service de Médecine Intensive-Réanimation, Cotentin Public Hospital Centre, Cherbourg-Octeville, France
| | - Pierre Kalfon
- Service de Médecine Intensive-Réanimation, Hospital Centre Chartres, Chartres, France
| | - Laura Federici
- Service de Médecine Intensive-Réanimation, Hôpital Louis-Mourier, Colombes, France
| | - Élise Redureau
- Service de Médecine Intensive-Réanimation, Departmental Hospital Centre La Roche-sur-Yon, La Roche-sur-Yon, France
| | - Mehdi Bousta
- Service de Réanimation Médico-Chirurgicale, Hospital Group Le Havre, Le Havre, France
| | - Laurie Lagache
- Service de Réanimation Médico-Chirurgicale, Hospital Group Le Havre, Le Havre, France
| | - Thierry Vanderlinden
- Service de Médecine Intensive-Réanimation, Hospital Group of Lille Catholic University, Lille, France
| | - Saad Nseir
- Médecine Intensive-Réanimation, Regional and University Hospital Centre Lille, Lille, France
| | - Béatrice La Combe
- Service de Réanimation Polyvalente, Groupe Hospitalier Bretagne Sud, Lorient, France
| | - Gaël Bourdin
- Service de Médecine Intensive-Réanimation, Centre Hospitalier Saint Joseph Saint Luc, Lyon, France
| | - Mehran Monchi
- Service de Médecine Intensive-Réanimation, Melun Hospital Centre, Melun, France
| | - Martine Nyunga
- Service de Médecine Intensive-Réanimation, Roubaix Hospital Center, Roubaix, France
| | - Michel Ramakers
- Service de Médecine Intensive-Réanimation, Centre Hospitalier Mémorial de Saint-Lô, Saint-Lo, France
| | - Walid Oulehri
- Service de Réanimation Chirurgicale, University Hospitals Strasbourg, Strasbourg, France
| | - Hugues Georges
- Service de Médecine Intensive-Réanimation, Hospital Centre Gustave Dron de Tourcoing, Tourcoing, France
| | | | - Julio Badie
- Service de Médecine Intensive-Réanimation, Hopital Nord Franche-Comte, Montbeliard, France
| | - Agathe Delbove
- Réanimation Polyvalente, Centre Hospitalier Bretagne Atlantique, Vannes, France
| | - Xavier Monnet
- Service de Médecine Intensive-Réanimation, University Hospitals Southern Paris, Le Kremlin-Bicetre, France
| | - Gaetan Beduneau
- Département de Réanimation Médicale, Centre Hospitalier Universitaire de Rouen, Rouen, France
| | | | - Paul Abraham
- Service d'Anesthésie-Réanimation, Groupement Hospitalier Edouard Herriot, Lyon, France
| | | | - Gurvan Le Bouar
- Service de Médecine Intensive-Réanimation, University Hospital Centre Rouen, Rouen, France
| | - Arnaud-Felix Miailhe
- Service de Médecine Intensive-Réanimation, University Hospital Centre Nantes, Nantes, France
| | - Sami Hraiech
- Service de Médecine Intensive-Réanimation, Hôpital Nord, Marseille, France
| | - Vanessa Bironneau
- Service de Pneumologie, University Hospital Centre Poitiers, Poitiers, France
| | - Nicholas Sedillot
- Réanimation Polyvalente, Hôpital Fleyriat, Centre Hospitalier de Bourg-en-Bresse, Bourg-en-Bresse, France
| | - Marie-Anne Hoppe
- Service de Médecine Intensive-Réanimation, Hospital Centre La Rochelle, La Rochelle, France
| | - Saber Davide Barbar
- Intensive Care Unit, Centre Hospitalier Universitaire de Nimes, Nimes, France
| | | | | | - Nicolas Terzi
- Service de Médecine Intensive-Réanimation, University Hospital Centre Grenoble Alpes, Grenoble, France
| | - Cyrille Delpierre
- Centre d'Epidémiologie et de Recherche en santé des POPulations (CERPOP), University of Toulouse, Toulouse, France
| | - Stéphanie Gélinotte
- Service de Médecine Intensive-Réanimation, Hospital Centre Dieppe, Dieppe, France
| | - Jean-Philippe Rigaud
- Service de Médecine Intensive-Réanimation, Hospital Centre Dieppe, Dieppe, France
| | - Marie Labruyère
- Service de Médecine Intensive-Réanimation, University Hospital Centre Dijon, Dijon, France
| | - Marjolaine Georges
- Department of Pulmonary Medicine, University Hospital, Seattle, Washington, USA
| | - Christine Binquet
- Centre d'Investigation Clinique, CHU Dijon, Dijon, France
- Clinical Epidemiology, INSERM CIC 1432, Dijon, France
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Lachkar S, Salaün M, Perrot L, Gervereau D, De Marchi M, Le Bouar G, Morisse-Pradier H, Dominique S, Piton N, Guisier F, Thiberville L. Virtual Bronchoscopy Planner and Radial-EBUS Guided Biopsy for Organizing Pneumonia Diagnosis. J Clin Med 2021; 11:jcm11010104. [PMID: 35011844 PMCID: PMC8745414 DOI: 10.3390/jcm11010104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/20/2021] [Accepted: 12/23/2021] [Indexed: 11/16/2022] Open
Abstract
Background: The diagnosis of organizing pneumonia (OP) often requires histological confirmation. The aim of this retrospective study was to evaluate the diagnostic yield and complication rate of radial endobronchial ultrasound (r-EBUS) for OP. Methods: All patients who had r-EBUS as a first diagnostic procedure for a peripheral pulmonary lesion at Rouen University Hospital, France, between April 2008 and December 2020 were included. Cases without a final diagnosis of OP or follow-up were excluded. Patients, lesions, and r-EBUS characteristics were retrospectively analyzed. Results: 2735 r-EBUS procedures were performed, and 33 cases with final OP could be analyzed. Procedures were performed under local anesthesia in 28/33 cases (85%). Among the 33 final OP cases, 17 were considered cryptogenic, and 16 secondary. The lesions were patchy alveolar opacities in 23 cases (70%), masses or pulmonary nodules in 8 cases (24%), and diffuse infiltrative opacities in 2 cases (6%). A bronchus sign on CT scan was found in all cases. In 22 cases (67%), a histopathological diagnosis was obtained from the r-EBUS samples. In 4 cases (12%), histopathological diagnosis was made by surgery, and in 7 cases (21%) the diagnosis was made based on clinical, radiological, and evolution features. An ultrasound image was found in 100% (22/22) of cases in the r-EBUS positive (r-EBUS+) group vs. 60% (6/10) in the r-EBUS negative (r-EBUS-) group, respectively (p < 0.002). The diagnostic yield of r-EBUS for OP was 67% and increased to 79% (22/28) when an ultrasound image was obtained. The median time between CT scan and r-EBUS procedure was 14 days (3–94): 11.5 days in the r-EBUS+ group and 22 days in the r-EBUS- group (p < 0.0001). No severe complications were reported. Conclusion: r-EBUS, when performed shortly after a CT scan showing a bronchus sign, is an efficient and safe technique for OP diagnosis.
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Affiliation(s)
- Samy Lachkar
- Department of Pulmonology, Thoracic Oncology and Respiratory Intensive Care & CIC-CRB 1404, Rouen University Hospital, F-76000 Rouen, France; (L.P.); (D.G.); (M.D.M.); (G.L.B.); (H.M.-P.); (S.D.)
- Correspondence:
| | - Mathieu Salaün
- EA4108 LITIS Lab, CHU Rouen, Department of Pneumology and Inserm CIC-CRB 1404, UNIROUEN, Normandie Univ, F-76000 Rouen, France; (M.S.); (F.G.); (L.T.)
| | - Loic Perrot
- Department of Pulmonology, Thoracic Oncology and Respiratory Intensive Care & CIC-CRB 1404, Rouen University Hospital, F-76000 Rouen, France; (L.P.); (D.G.); (M.D.M.); (G.L.B.); (H.M.-P.); (S.D.)
| | - Diane Gervereau
- Department of Pulmonology, Thoracic Oncology and Respiratory Intensive Care & CIC-CRB 1404, Rouen University Hospital, F-76000 Rouen, France; (L.P.); (D.G.); (M.D.M.); (G.L.B.); (H.M.-P.); (S.D.)
| | - Marielle De Marchi
- Department of Pulmonology, Thoracic Oncology and Respiratory Intensive Care & CIC-CRB 1404, Rouen University Hospital, F-76000 Rouen, France; (L.P.); (D.G.); (M.D.M.); (G.L.B.); (H.M.-P.); (S.D.)
| | - Gurvan Le Bouar
- Department of Pulmonology, Thoracic Oncology and Respiratory Intensive Care & CIC-CRB 1404, Rouen University Hospital, F-76000 Rouen, France; (L.P.); (D.G.); (M.D.M.); (G.L.B.); (H.M.-P.); (S.D.)
| | - Helene Morisse-Pradier
- Department of Pulmonology, Thoracic Oncology and Respiratory Intensive Care & CIC-CRB 1404, Rouen University Hospital, F-76000 Rouen, France; (L.P.); (D.G.); (M.D.M.); (G.L.B.); (H.M.-P.); (S.D.)
| | - Stephane Dominique
- Department of Pulmonology, Thoracic Oncology and Respiratory Intensive Care & CIC-CRB 1404, Rouen University Hospital, F-76000 Rouen, France; (L.P.); (D.G.); (M.D.M.); (G.L.B.); (H.M.-P.); (S.D.)
| | - Nicolas Piton
- Department of Cytology and Pathology, Rouen University Hospital, F-76000 Rouen, France;
| | - Florian Guisier
- EA4108 LITIS Lab, CHU Rouen, Department of Pneumology and Inserm CIC-CRB 1404, UNIROUEN, Normandie Univ, F-76000 Rouen, France; (M.S.); (F.G.); (L.T.)
| | - Luc Thiberville
- EA4108 LITIS Lab, CHU Rouen, Department of Pneumology and Inserm CIC-CRB 1404, UNIROUEN, Normandie Univ, F-76000 Rouen, France; (M.S.); (F.G.); (L.T.)
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Artaud-Macari E, Bubenheim M, Le Bouar G, Carpentier D, Grangé S, Boyer D, Béduneau G, Misset B, Cuvelier A, Tamion F, Girault C. High-flow oxygen therapy versus noninvasive ventilation: a randomised physiological crossover study of alveolar recruitment in acute respiratory failure. ERJ Open Res 2021; 7:00373-2021. [PMID: 34912882 PMCID: PMC8666576 DOI: 10.1183/23120541.00373-2021] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/10/2021] [Indexed: 11/05/2022] Open
Abstract
High-flow nasal cannula (HFNC) oxygen therapy has recently shown clinical benefits in hypoxaemic acute respiratory failure (ARF) patients, while the value of noninvasive ventilation (NIV) remains debated. The primary end-point was to compare alveolar recruitment using global end-expiratory electrical lung impedance (EELI) between HFNC and NIV. Secondary end-points compared regional EELI, lung volumes (global and regional tidal volume variation (VT)), respiratory parameters, haemodynamic tolerance, dyspnoea and patient comfort between HFNC and NIV, relative to face mask (FM). A prospective randomised crossover physiological study was conducted in patients with hypoxaemic ARF due to pneumonia. They received alternately HFNC, NIV and FM. 16 patients were included. Global EELI was 4083 with NIV and 2921 with HFNC (p=0.4). Compared to FM, NIV and HFNC significantly increased global EELI by 1810.5 (95% CI 857–2646) and 826 (95% CI 399.5–2361), respectively. Global and regional VT increased significantly with NIV compared to HFNC or FM, but not between HFNC and FM. NIV yielded a significantly higher pulse oxygen saturation/inspired oxygen fraction ratio compared to HFNC (p=0.03). No significant difference was observed between HFNC, NIV and FM for dyspnoea. Patient comfort score with FM was not significantly different than with HFNC (p=0.1), but was lower with NIV (p=0.001). This study suggests a potential benefit of HFNC and NIV on alveolar recruitment in patients with hypoxaemic ARF. In contrast with HFNC, NIV increased lung volumes, which may contribute to overdistension and its potentially deleterious effect in these patients. This study found a potential benefit of HFNC and NIV on alveolar recruitment in patients with hypoxaemic ARF, but NIV also increases lung volumes, which may give rise to overdistension, reinforcing the concept of patient self-inflicted lung injuryhttps://bit.ly/3iRcZDJ
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Affiliation(s)
- Elise Artaud-Macari
- Rouen University Hospital, Medical Intensive Care Unit, F-76000, Rouen, France.,Rouen University Hospital, Pulmonary, Thoracic Oncology and Respiratory Intensive Care Unit, F-76000, Rouen, France.,Normandie Université, UNIROUEN, EA3830, Rouen University Hospital, F-76000, Rouen, France
| | - Michael Bubenheim
- Rouen University Hospital, Dept of Clinical Research and Innovation, F-76000, Rouen, France
| | - Gurvan Le Bouar
- Rouen University Hospital, Medical Intensive Care Unit, F-76000, Rouen, France.,Rouen University Hospital, Pulmonary, Thoracic Oncology and Respiratory Intensive Care Unit, F-76000, Rouen, France
| | - Dorothée Carpentier
- Rouen University Hospital, Medical Intensive Care Unit, F-76000, Rouen, France
| | - Steven Grangé
- Rouen University Hospital, Medical Intensive Care Unit, F-76000, Rouen, France
| | - Déborah Boyer
- Rouen University Hospital, Medical Intensive Care Unit, F-76000, Rouen, France
| | - Gaëtan Béduneau
- Rouen University Hospital, Medical Intensive Care Unit, F-76000, Rouen, France.,Normandie Université, UNIROUEN, EA3830, Rouen University Hospital, F-76000, Rouen, France
| | - Benoit Misset
- Rouen University Hospital, Medical Intensive Care Unit, F-76000, Rouen, France.,Dept of Intensive Care, Liège University Hospital, Liège, Belgium
| | - Antoine Cuvelier
- Rouen University Hospital, Pulmonary, Thoracic Oncology and Respiratory Intensive Care Unit, F-76000, Rouen, France.,Normandie Université, UNIROUEN, EA3830, Rouen University Hospital, F-76000, Rouen, France
| | - Fabienne Tamion
- Rouen University Hospital, Medical Intensive Care Unit, F-76000, Rouen, France.,Normandie Université, UNIROUEN, IRIB, Inserm U 1096, Rouen University Hospital, F-76000, Rouen, France
| | - Christophe Girault
- Rouen University Hospital, Medical Intensive Care Unit, F-76000, Rouen, France.,Normandie Université, UNIROUEN, EA3830, Rouen University Hospital, F-76000, Rouen, France
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