Despite randomized controlled trials with favorable results, few intensive care units (ICUs) implemented selective decontamination (SD) for ICU-acquired infection prevention. We aimed to evaluate, SD implementation and associated-effects in a large network of French ICUs. This study was conducted using the healthcare-associated infection surveillance cohort “REA-REZO” involving...
Capillary leakage is common in critical illness and can lead to intravascular hypovolemia and edema. Fluid balance, however, is crucial to optimize cardiac preload, vascular filling and tissue perfusion. Intravenously administered fluids are rapidly distributed to the extravascular spaces and further increase edema with consecutive harm for impeded wound healing, weakness...
Fulminant myocarditis (FM) is a severe condition primarily triggered by viruses. Anti-RNA polymerase III autoantibodies (RNApol3) which are typically found in patients with severe systemic sclerosis, have been reported in patients with influenza-related FM. Our objective is to provide additional insight into RNApol3-associated FM. We retrospectively included all patients admitted...
Alterations in the classical Renin-Angiotensin Aldosterone System (RAAS) have been described during septic shock and are associated with patient outcomes. Since the alternative RAAS has also been reported to be altered in critically ill patients, and given that the RAAS can be modulated by specific therapeutics, such as angiotensin II, understanding its pathophysiology is of...
Acute encephalopathy in the ICU poses significant diagnostic, therapeutic, and prognostic challenges. Standardized expert guidelines on acute encephalopathy are needed to improve diagnostic methods, therapeutic decisions, and prognostication. The experts conducted a review of the literature, analysed it according to the GRADE (Grading of Recommendation, Assessment, Development...
Only few data regarding epidemiology and management of ECMO cannula-related infections (ECMO-CRIs) exist. The aim of our study was to describe their epidemiology and prognosis, and to evaluate factors associated with outcome. We performed a multicenter retrospective study in 12 European ICUs, including patients with ECMO-CRI, defined as a clinical suspicion plus a positive...
The purpose of this study was to identify the main greenhouse gas (GHG) emitting activities or products among the medical devices (MD) and medicines used in a polyvalent Intensive Care Unit (ICU). A pragmatic eco-audit was conducted in a 21-beds polyvalent ICU, in Saint-Brieuc, Bretagne, France. It consisted of estimating GHG emissions of products or activities, considering...
Hemoptysis is a life-threatening event in the course of lung cancer (LC). The management of the most severe episodes of hemoptysis include medical measures and vascular interventional radiology (VIR). There are few data on initial clinical and radiological features associated with early bleeding recurrence, and its prognostic significance. A monocenter retrospective study...
Antimicrobial stewardship (AMS) for ventilator-associated pneumonia (VAP) in carriers of extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) presents significant challenges. The abundance of ESBL-E rectal carriage has emerged as a potentially valuable tool for predicting ESBL-E-related VAP. This single-center, retrospective study was conducted between October 2019...
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) offers an immediate and effective mechanical cardio-circulatory support for critically ill patients with refractory cardiogenic shock or selected refractory cardiac arrest. As fluid therapy is routinely performed as a component of initial hemodynamic resuscitation of ECMO supported patients, this narrative review intends...
The aim of this study was to investigate whether high-dose intravenous vitamin C (HDIVC) could decrease the mortality rate within 28 days among patients moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP). In this randomized, placebo-controlled trial, patients diagnosed with predicted MSAP or SAP within 72 h of symptom onset were enrolled to receive...
This study aimed to evaluate the association of end-of-life decisions and time to death in a global cohort of critically ill patients who participated in the international study on end-of-life practices in intensive care units (ICU) (Ethicus-2 study). A post hoc analysis was conducted on data from a worldwide observational study that prospectively recruited adult ICU patients who...
Survivors of critical illness endure long-lasting physical and mental challenges. Despite the persistence of poor sleep quality in a considerable proportion of patients at the 12-month follow-up, studies with assessments exceeding this period are limited. We aimed to investigate the trajectory of sleep over the 24 months following critical illness. Observational, prospective...
The relative contribution of the different components of mechanical power to mortality is a subject of debate and has not been studied in COVID-19. The aim of this study is to evaluate both the total and the relative impact of each of the components of mechanical power on mortality in a well-characterized cohort of patients with COVID-19-induced acute respiratory failure...
Several artificial intelligence (AI)-driven tools have emerged for the hemodynamic evaluation of critically ill and surgical patients. This article provides an overview of current developments and potential clinical applications of machine learning (ML) for blood pressure measurements, hypotension prediction, hemodynamic profiling, and echocardiography. ML algorithms have shown...
This narrative review aims to describe the epidemiology and aetiologies of thrombocytopenia in critically ill patients, the bleeding risk assessment in thrombocytopenic patients, and provide an update on platelet transfusion indications. Thrombocytopenia is a common disorder in critically ill patients. The classic definition relies on an absolute platelet count below 150 × 109/L...
Some ICU patients remain critically ill despite reversal of the original admission diagnosis, driven by a cascade of events resulting in new and persistent organ failure. Secondary infections and systemic inflammation are important components of this cascade and may be visualised using [18F]FDG PET/CT. The aim of this dual centre retrospective study was to assess the ability of...
Prone positioning of patients with COVID-19 undergoing invasive mechanical ventilation (IMV) is widely used, but evidence of efficacy remains sparse. The COVID-19 Critical Care Consortium has generated one of the largest global datasets on the management and outcomes of critically ill COVID-19 patients. This prospective cohort study investigated the association between prone...
Prone position has been diffusely applied in mechanically ventilated COVID-19 patients. Our aim is ascertaining the association between the physiologic response and the length of the first cycle of prone position and intensive care unit (ICU) mortality. International registry including COVID-19 adult patients who underwent prone positioning. We measured the difference for...
The optimal timing for initiating vasopressor therapy in patients with septic shock remains unclear. This study aimed to assess the impact of early versus late vasopressor initiation on clinical outcomes. A systematic review and meta-analysis were conducted by searching PubMed, Embase, and Cochrane databases. Studies comparing early and late vasopressor administration in septic...
Acute kidney injury (AKI) is common in critically ill patients and is associated with increased morbidity and mortality. Its complications often require renal replacement therapy (RRT). Invasive mechanical ventilation (IMV) and infections are considered risk factors for the occurrence of AKI. The use of IMV and non-invasive ventilation (NIV) has changed over the course of the...