References of "Damas, Pierre"
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See detailHepatic dysfunction or failure and ICU-acquired infection
HUBERLANT, Vincent; LEDOUX, Didier ULg; MASSION, Paul ULg et al

in Newsletter SIZ, special issue, Abstracts Spring Meeting (2010, June 25)

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See detailAntibiotic consumption and bacterial resistance
ZAOUI, Kuider; MELIN, Pierrette ULg; CHRISTIAENS, Geneviève ULg et al

in Newsletter SIZ, special issue, abstracts Spring Meeting (2010, June 25)

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See detailMesure du volume de fin d'expiration (VFE) en cours de ventilation contrôlée après chirurgie cardiaque
MARCHAL, Vanessa; SOTTIAUX, Thierry; PUJOL, B et al

in Réanimation (2010), 19(Suppl 1), 180325

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See detailHepatic dysfunction or failure favours ICU-acquired infections
MASSION, Paul ULg; LEDOUX, Didier ULg; DAMAS, Pierre ULg

in Intensive Care Medicine (2010), 36(Suppl 2), 2560681

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See detailRenal replacement therapy is an independent risk factor for mortality in critically ill patients with acute kidney injury
Elseviers, M. M.; Lins, Robert L; Van der Niepen, Patricia et al

in Critical Care (2010), 14(6), 221

INTRODUCTION: Outcome studies in patients with acute kidney injury (AKI) have focused on differences between modalities of renal replacement therapy (RRT). The outcome of conservative treatment, however ... [more ▼]

INTRODUCTION: Outcome studies in patients with acute kidney injury (AKI) have focused on differences between modalities of renal replacement therapy (RRT). The outcome of conservative treatment, however, has never been compared with RRT. METHODS: Nine Belgian intensive care units (ICUs) included all adult patients consecutively admitted with serum creatinine >2 mg/dl. Included treatment options were conservative treatment and intermittent or continuous RRT. Disease severity was determined using the Stuivenberg Hospital Acute Renal Failure (SHARF) score. Outcome parameters studied were mortality, hospital length of stay and renal recovery at hospital discharge. RESULTS: Out of 1,303 included patients, 650 required RRT (58% intermittent, 42% continuous RRT). Overall results showed a higher mortality (43% versus 58%) as well as a longer ICU and hospital stay in RRT patients compared to conservative treatment. Using the SHARF score for adjustment of disease severity, an increased risk of death for RRT compared to conservative treatment of RR = 1.75 (95% CI: 1.4 to 2.3) was found. Additional correction for other severity parameters (Acute Physiology And Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA)), age, type of AKI and clinical conditions confirmed the higher mortality in the RRT group. CONCLUSIONS: The SHARF study showed that the higher mortality expected in AKI patients receiving RRT versus conservative treatment can not only be explained by a higher disease severity in the RRT group, even after multiple corrections. A more critical approach to the need for RRT in AKI patients seems to be arranted [less ▲]

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See detailThe long way of biomarkers: from bench to bedside.
Zhang, Haibo; Damas, Pierre ULg; PREISER, Jean-Charles ULg

in Intensive Care Medicine (2010), 36(4), 565-6

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See detailL’ECMO (ExtraCorporeal Membrane Oxygenation) aux soins intensifs : intérêt chez le patient en choc cardiogénique réfractaire, en hypoxémie réfractaire ou en arrêt cardiaque.
Massion, Paul ULg; Ledoux, Didier ULg; Piret, S. et al

in Revue Médicale de Liège (2010), 65

ExtraCorporeal Membrane Oxygenation (ECMO) is a cardiopulmonary assistance device able to support patients in cardiac arrest, refractory cardiogenic shock or refractory hypoxemia otherwise sentenced to ... [more ▼]

ExtraCorporeal Membrane Oxygenation (ECMO) is a cardiopulmonary assistance device able to support patients in cardiac arrest, refractory cardiogenic shock or refractory hypoxemia otherwise sentenced to death. Recent technical progresses, early indication decision, bedside multidisciplinary implant, specific complications screening and echocardiographic weaning testing are crucial points to allow success of this exceptional technique. [less ▲]

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See detailHyperacute graft rejection during heart transplantation for giant cell myocarditis: A case report.
Mutijima, E.; Delbecque, Katty ULg; Defraigne, Jean-Olivier ULg et al

in Pathology - Research & Practice (2010), 15(206), 411-4

We report the case of a patient with giant cell myocarditis who was bridged to transplantation with mechanical circulatory support and developed a fatal perioperative hyperacute rejection. The patient had ... [more ▼]

We report the case of a patient with giant cell myocarditis who was bridged to transplantation with mechanical circulatory support and developed a fatal perioperative hyperacute rejection. The patient had received abundant transfusions that had raised her anti-HLA antibody titers. The cross-match test was positive. No pre-transplantation immunosuppressive therapy had been administered given concomitant infection. The severity and acuteness of the rejection in this case likely reflect the combined effect of preformed anti-HLA antibodies in the context of an active organ-specific immune process at the time of transplantation. This case raises the questions of the need for intensive immunosuppressive therapy before transplantation in giant cell myocarditis and of the management of patients with positive cross-match in the context of a giant cell myocarditis. [less ▲]

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See detailLes prélèvements à coeur arrêté: une source d'organes trop souvent oubliée?
Detry, Olivier ULg; De Roover, Arnaud ULg; Damas, Pierre ULg et al

in Hospitals.be (2010), 8(1), 7-12

La transplantation est aujourd’hui victime de son succès. Les procédures de prélèvement à coeur arrêté se doivent de respecter les règles d’éthique et les dispositions légales en la matière. La pénurie ... [more ▼]

La transplantation est aujourd’hui victime de son succès. Les procédures de prélèvement à coeur arrêté se doivent de respecter les règles d’éthique et les dispositions légales en la matière. La pénurie relative d’organes sera partiellement comblée lorsqu’elles seront appliquées dans une majorité d'hôpitaux du pays. [less ▲]

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See detailLiver transplantation from controlled donation after cardiac death (DCD) donors: a single center experience
Detry, Olivier ULg; Veys, Caroline; Seydel, Benoît ULg et al

in Liver Transplantation (2009, July), 15(7), 180-181

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See detailLiver transplant donation after cardiac death : experience at the University of Liège
Detry, Olivier ULg; Seydel, Benoît ULg; Delbouille, Marie-Hélène ULg et al

in Transplantation Proceedings (2009), 41(2), 582-4

Aim: Donation after cardiac death (DCD) has been proposed to partly overcome the organ donor shortage. In liver transplantation, the additional warm ischemia linked to DCD procurement may promote higher ... [more ▼]

Aim: Donation after cardiac death (DCD) has been proposed to partly overcome the organ donor shortage. In liver transplantation, the additional warm ischemia linked to DCD procurement may promote higher rate of primary non-function and ischemic type biliary lesions. In this study we reviewed the results of DCD liver transplantation at the University of Liège. Patients and Methods: From 2003 to 2007, 13 controlled DCD liver transplantations were consecutively performed. The records of all donors and recipients were retrospectively reviewed, particularly evaluating the outcome and the occurrence of biliary complications. Mean follow-up was 25 months. Results: Mean donor age was 51 years and their mean intensive care stay was 5.4 days. Mean time between ventilation arrest and cardiac arrest was 9.3 min. Mean time between cardiac arrest and arterial flush was 7.7 min. No touch period was 2 to 5 min. Mean graft cold ischemia was 295 min and mean suture warm ischemia was 38 min. Postoperatively there was no primary non-function. Mean peak transaminase was 2,546 UI/ml. Patient and graft survival was 100% at one year. Two patients (15%) developed graft main bile duct stenosis and underwent endoscopic management. No patient developed symptomatic intrahepatic bile duct strictures or needed retransplantation in the follow-up. Conclusions: The experience of the transplantation department of the University of Liege confirms that controlled DCD donors may be a valuable source of transplantable liver grafts, in case of short procurement warm ischemia and short transplant cold ischemia. [less ▲]

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See detailResults of liver transplantation from controlled donation after cardiac death (DCD) donors: a single center experience
Detry, Olivier ULg; Seydel, Benoît ULg; Veys, C. et al

in Acta Gastro-Enterologica Belgica (2009, January), 72(1), 25

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See detailIntermittent versus continuous renal replacement therapy for acute kidney injury patients admitted to the intensive care unit: results of a randomized clinical trial.
Lins, Robert L; Elseviers, Monique M; Van der Niepen, Patricia et al

in Nephrology Dialysis Transplantation (2009), 24(2), 512-8

BACKGROUND: There is uncertainty on the effect of different dialysis modalities for the treatment of patients with acute kidney injury (AKI), admitted to the intensive care unit (ICU). This controlled ... [more ▼]

BACKGROUND: There is uncertainty on the effect of different dialysis modalities for the treatment of patients with acute kidney injury (AKI), admitted to the intensive care unit (ICU). This controlled clinical trial performed in the framework of the multicentre SHARF 4 study (Stuivenberg Hospital Acute Renal Failure) aimed to investigate the outcome in patients with AKI, stratified according to severity of disease and randomized to different treatment options. METHODS: This was a multicentre prospective randomized controlled trial with stratification according to severity of disease expressed by the SHARF score. ICU patients were eligible for inclusion when serum creatinine was >2 mg/dL, and RRT was initiated. The selected patients were randomized to intermittent (IRRT) or continuous renal replacement therapy (CRRT). RESULTS: A total of 316 AKI patients were randomly assigned to IRRT (n = 144) or CRRT (n = 172). The mean age was 66 (range 18-96); 59% were male. Intention-to-treat analysis revealed a mortality of 62.5% in IRRT compared to 58.1% in CRRT (P = 0.430). No difference between IRRT and CRRT could be observed in the duration of ICU stay or hospital stay. In survivors, renal recovery at hospital discharge was comparable between both groups. Multivariate analysis, including the SHARF score, APACHE II and SOFA scores for correction of disease severity, showed no difference in mortality between both treatment modalities. This result was confirmed in pre-specified subgroup analysis (elderly, patients with sepsis, heart failure, ventilation) and after exclusion of possible confounders (early mortality, delayed ICU admission). CONCLUSIONS: Modality of RRT, either CRRT or IRRT, had no impact on the outcome in ICU patients with AKI. Both modalities need to be considered as complementary in the treatment of AKI (Clinical Trial: SHARF 4, NCT00322933, http://ClinicalTrials.gov). [less ▲]

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See detailLe sepsis, réponse adaptée ou non à l’infection?
Damas, Pierre ULg

in Réanimation (2009), 18(4), 277-281

Sepsis, severe sepsis and septic shock were thought to be provoked by an overwhelming inflammation in response to an infectious process. This was documented in several animal studies. However, in human ... [more ▼]

Sepsis, severe sepsis and septic shock were thought to be provoked by an overwhelming inflammation in response to an infectious process. This was documented in several animal studies. However, in human sepsis, excess of inflammation is hard to be observed. Compartimentalization of the host response rather favors a systemic anti-inflammatory climate. Clinical situations are complex: on one hand, virulence factors of microorganisms can directly harm the host tissues, divert the defence mechanisms or distract the control mechanisms of the host, preventing the normal interaction of endogenous mediators. On the other hand, septic shock mostly occurs in patients experiencing previous organic or functional vital failures before the development of infection. The vulnerability of the patient appears therefore to be a key point in the severity of the disease. Enhancing the host defence mechanisms rather than inhibiting the inflammatory reaction may become a preferential option. [less ▲]

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See detailSAPS 3 admission score: an external validation in a general intensive care population
Ledoux, Didier ULg; Canivet, Jean-Luc ULg; Preiser, Jean-Charles ULg et al

in Intensive Care Medicine (2008)

OBJECTIVES: To validate the SAPS 3 admission score in an independent general intensive care case mix and to compare its performances with the APACHE II and the SAPS II scores. DESIGN: Cohort observational ... [more ▼]

OBJECTIVES: To validate the SAPS 3 admission score in an independent general intensive care case mix and to compare its performances with the APACHE II and the SAPS II scores. DESIGN: Cohort observational study. SETTING: A 26-bed general ICU from a Tertiary University Hospital. PATIENTS AND PARTICIPANTS: Eight hundred and fifty-one consecutive patients admitted to the ICU over an 8-month period. Of these patients, 49 were readmissions, leaving 802 patients for further analysis. INTERVENTION: None. MEASUREMENTS AND RESULTS: APACHE II, SAPS II and SAPS 3 variables were prospectively collected; scores and their derived probability of death were calculated according to their original manuscript description. The discriminative power was assessed using the area under the ROC curve (AUROC) and calibration was verified with the Hosmer-Lemeshow goodness-of-fit test. The AUROC of the APACHE II model (AUROC = 0.823) was significantly lower than those of the SAPS II (AUROC = 0.850) and SAPS 3 models (AUROC = 0.854) (P = 0.038). The calibration of the APACHE II model (P = 0.037) and of the SAPS 3 global model (P = 0.035) appeared unsatisfactory. On the contrary, both SAPS II model and SAPS 3 model customised for Central and Western Europe had a good calibration. However, in our study case mix, SAPS II model tended to overestimate the probability of death. CONCLUSION: In this study, the SAPS 3 admission score and its prediction model customised for Central and Western Europe was more discriminative and better calibrated than APACHE II, but it was not significantly better than the SAPS II. [less ▲]

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See detailCyclic appearance of left ventricular outflow tract dynamic obstruction during mechanical ventilation: evidence for a preload dependent phenomenon.
Canivet, Jean-Luc ULg; Lancellotti, Patrizio ULg; Radermecker, Marc ULg et al

in Journal of Intensive Care Medicine (2008), 23(4), 281-4

The cyclic appearance of dynamic left ventricular outflow tract obstruction during mechanical ventilation, according to the phasic changes in preload, is described in this article. Hemodialysis-induced ... [more ▼]

The cyclic appearance of dynamic left ventricular outflow tract obstruction during mechanical ventilation, according to the phasic changes in preload, is described in this article. Hemodialysis-induced fluid removal resulted in preload dependence as evidenced by the pulse pressure variation in a 56-year-old critically ill patient. The clinical picture was suggestive of myocardial failure. Transthoracic echocardiography disclosed dynamic left ventricular outflow tract obstruction associated with systolic anterior motion of the mitral valve. Progressive fluid restitution resulted in a parallel decrease in both the degree of dynamic obstruction and pulse pressure variation. During fluid loading, dynamic obstruction disappeared at first during the inspiratory phase of intermittent positive pressure ventilation corresponding to the phasic increase in left ventricular preload. Further fluid loading resulted in the disappearance of dynamic obstruction during both inspiratory and expiratory phase of intermittent positive pressure ventilation. This is the first reported case clearly relating left ventricular outflow tract dynamic obstruction to preload dependence during mechanical ventilation in a critically ill patient without predisposing anatomical factor. [less ▲]

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