References of "Ghuysen, Alexandre"
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See detailModel-Based Assessment of Right Ventricular Arterial Coupling During Septic Shock – Results With a Porcine Model
Desaive, Thomas ULg; Lambermont, Bernard ULg; Janssen, N. et al

in Proceedings of the 21st European Society of Intensive Care Medicine (ESICM) Annual Congress, September 21-24, 2008, Lisbon, Portugal (2008)

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See detailComment je traite... une intoxication au paracetamol.
Bertrand, Xavier ULg; Brasseur, Edmond ULg; Ghuysen, Alexandre ULg et al

in Revue Médicale de Liège (2008), 63(7-8), 465-8

Drug self-poisoning is a common cause of admission in ED. Among various incriminated substances, paracetamol is often implicated and presents a severe toxicity. We briefly describe the epidemiology and ... [more ▼]

Drug self-poisoning is a common cause of admission in ED. Among various incriminated substances, paracetamol is often implicated and presents a severe toxicity. We briefly describe the epidemiology and physiopathology of paracetamol self-poisoning. We then clarify the diagnostic elements, thresholds of toxicity, indications for treatment and different available therapeutic guidelines. [less ▲]

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See detailL'image du mois. Larva migrans cutanee.
Hick, Sybilla ULg; Brasseur, Edmond ULg; Ghuysen, Alexandre ULg et al

in Revue Médicale de Liège (2008), 63(9), 521-2

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See detailL'image du mois. Dissection aortique avec hemopéricarde
Secco, Daniel ULg; Brasseur, Edmond ULg; Ghuysen, Alexandre ULg et al

in Revue Médicale de Liège (2007), 62(9), 534-5

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See detailLevosimendan: Right for the right ventricle?
Lambermont, Bernard ULg; Ghuysen, Alexandre ULg; Harstein, Gary et al

in Critical Care Medicine (2007), 35(8), 1995-1996

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See detailModel-based cardiac diagnosis of pulmonary embolism
Starfinger, C.; Hann, C. E.; Chase, J. G. et al

in Computer Methods & Programs in Biomedicine (2007), 87(1), 46-60

A minimal cardiac model has been shown to accurately capture a wide range of cardiovascular system dynamics commonly seen in the intensive care unit (ICU). However, standard parameter identification ... [more ▼]

A minimal cardiac model has been shown to accurately capture a wide range of cardiovascular system dynamics commonly seen in the intensive care unit (ICU). However, standard parameter identification methods for this model are highly non-linear and non-convex, hindering real-time clinical application. An integral-based identification method that transforms the problem into a linear, convex problem, has been previously developed, but was only applied on continuous simulated data with random noise. This paper extends the method to handle discrete sets of clinical data, unmodelled dynamics, a significantly reduced data set theta requires only the minimum and maximum values of the pressure in the aorta, pulmonary artery and the volumes in the ventricles. The importance of integrals in the formulation for noise reduction is illustrated by demonstrating instability in the identification using simple derivative-based approaches. The cardiovascular system (CVS) model and parameter identification method are then clinically validated on porcine data for pulmonary embolism. Errors for the identified model are within 10% when re-simulated and compared to clinical data. All identified parameter trends match clinically expected changes. This work represents the first clinical validation of these models, methods and approach to cardiovascular diagnosis in critical care. (c) 2007 Elsevier Ireland Ltd. All rights reserved. [less ▲]

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See detailProblematique Liee aux transferts medicalises secondaires en Belgique: l'experience developpee au CHU de Liege
Brasseur, Edmond ULg; Micheels, Jean ULg; Ghuysen, Alexandre ULg et al

in Revue Médicale de Liège (2007), 62(2), 97-102

Evaluation of the aid of an emergency mobile unit to transfer monitorized patients to a University hospital, in the political context of regional care network offering highly qualified but restricted ... [more ▼]

Evaluation of the aid of an emergency mobile unit to transfer monitorized patients to a University hospital, in the political context of regional care network offering highly qualified but restricted tertiary area centres, and an open prospective study conducted over the 5 first months in 2006. The call regulation was assessed by the emergency physician of the transfer team and all missions were concluded with an evaluating report. An amount of 197 requests were taken into account from which 80 % were addressed between 8 am and 8 pm. The mean average time interval for missions was 59 minutes (base to base) and the distance covered was 20.7 km as a mean. In essence, indications for medical secondary transfer regarded patients in need for acute coronary care (42.6%), specific intensive care (26.4%) and neurosurgical interventions (19.3%). We noted that endotracheal intubation occurred in only one case. Mortality during such a transfer activity was absent. Medical transfer unit allows the development of specific high qualified network resources owing to the secondary addressee of patients. However, the weak incidence of complication questions the practice of systematic medical accompanying during such transfers. [less ▲]

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See detailCardiovascular haemodynamics and ventriculo-arterial coupling in an acute pig model of coronary ischaemia-reperfusion
Lanoye, Lieve; Segers, Patrick; Tchana-Sato, Vincent ULg et al

in Experimental Physiology (2007), 92(1), 127-137

Although reperfusion after coronary occlusion is mandatory for myocardial salvage, reperfusion may trigger a cascade of harmful events (reperfusion injury) adding to myocardial injury. We investigated ... [more ▼]

Although reperfusion after coronary occlusion is mandatory for myocardial salvage, reperfusion may trigger a cascade of harmful events (reperfusion injury) adding to myocardial injury. We investigated effects of reperfusion on left ventricular (LV) haemodynamics and ventriculo-arterial (VA) coupling in pigs following acute myocardial ischaemia induced by coronary artery occlusion. Experiments were performed in six animals, with measurements of cardiac and arterial function at baseline, after 60 min of ischaemia (T60) and after 2 (T180) and 4 h of reperfusion (T300). Ventriculo-arterial coupling was assessed using the ventriculo-arterial elastance ratio of paper, as well as using a 'stiffness coupling' and 'temporal coupling' index. Reperfusion following ischaemia (T180 versus T60) induced a progressive decline in cardiovascular function, evidenced by a decrease in mean arterial blood pressure, cardiac output and ejection fraction which was not restored at T300. Although reperfusion also induced an increase in slope of the end-systolic pressure-volume relationship (ESPVR), the ESPVR curve shifted to the right, associated with a depression of contractile function. Histology demonstrated irreversible myocardial damage at T300. The ventriculo-arterial elastance ratio and the 'stiffness coupling' index were unaffected throughout the protocol, but the 'temporal coupling' parameter indicated a relative shift between heart period and the time constant of the arterial system. It is unlikely that these alterations are attributable to ischaemic injury alone. The combination of both the stiffness and temporal coupling index may provide more information when studying ventriculo-arterial coupling than the more commonly used ventricular end-systolic stiffness/effection arterial elastance (E-es/E-a) ratio. [less ▲]

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See detailFunctional residual capacity measurement as a guide during Peep titration in ARDS
Lambermont, Bernard ULg; Ghuysen, Alexandre ULg; MOMMENS, Véronique et al

in ESICM (2007)

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See detailL'image du mois. Perforation intestinale grele sur ingestion meconnue d'un corps etranger.
Angelozzi, Valeria ULg; Brasseur, Edmond ULg; Ghuysen, Alexandre ULg et al

in Revue Médicale de Liège (2007), 62(12), 699-700

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See detailStudy of ventricular interaction during pulmonary embolism using clinical identification in a minimum cardiovascular system model.
Desaive, Thomas ULg; Ghuysen, Alexandre ULg; Lambermont, Bernard ULg et al

in Proceedings of the IEEE (2007)

Cardiovascular disturbances are difficult to diagnose and treat because of the large range of possible underlying dysfunctions combined with regulatory reflex mechanisms that can result in conflicting ... [more ▼]

Cardiovascular disturbances are difficult to diagnose and treat because of the large range of possible underlying dysfunctions combined with regulatory reflex mechanisms that can result in conflicting clinical data. Thus, medical professionals often rely on experience and intuition to optimize hemodynamics in the critically ill. This paper combines an existing minimal cardiovascular system model with an extended integral based parameter identification method to track the evolution of induced pulmonary embolism in porcine data. The model accounts for ventricular interaction dynamics and is shown to predict an increase in the right ventricle expansion index and a decrease in septum volume consistent with known physiological response to pulmonary embolism. The full range of hemodynamic responses was captured with mean prediction errors of 4.1% in the pressures and 3.1% in the volumes for 6 sets of clinical data. Pulmonary resistance increased significantly with the onset of embolism in all cases, as expected, with the percentage increase ranging from 89.98% to 261.44% of the initial state. These results are an important first step towards model-based cardiac diagnosis in the Intensive Care Unit. [less ▲]

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See detailModelling the cardiovascular system
Shaw, G. M.; Chase, J. G.; Starfinger, C. et al

in Critical Care and Resuscitation : Journal of the Australasian Academy of Critical Care Medicine (2007), 9(3), 264-269

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See detailModel-based sensor of hemodynamics in critical care
Hann, C. E.; Starfinger, C.; Chase, J. G. et al

in ICST 2007 (2007)

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See detailEffective arterial elastance as an index of pulmonary arterial load
Morimont, Philippe ULg; Lambermont, Bernard ULg; Ghuysen, Alexandre ULg et al

in European Journal of Heart Failure, Supplements (2007), 6

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See detailConfirmation of high cytokine clearance by hemofiltration with a cellulose triacetate membrane with large pores: an in vivo study
Delanaye, Pierre ULg; Lambermont, Bernard ULg; Dogné, Jean-Michel ULg et al

in International Journal of Artificial Organs (2006), 29(10), 944-948

Objective: To confirm in vivo the hypothesis that hemofiltration with a large pore membrane can achieve significant cytokine clearance. Method: We used a well-known animal model of endotoxinic shock (0.5 ... [more ▼]

Objective: To confirm in vivo the hypothesis that hemofiltration with a large pore membrane can achieve significant cytokine clearance. Method: We used a well-known animal model of endotoxinic shock (0.5 mg/kg of lipopolysaccharide from Escherichia Coli over a period of 30 mins). Six pigs were hemofiltrated for 3 hours with a large pore membrane (78 angstrom pore, 80 kDa cut off) (Sureflux FH 70, Nipro, Osaka, Japan). The ultrafiltration rate was 45 ml/kg/min. Samples were taken from arterial, venous line and in the ultrafiltrate at T120 and T240. We measured concentrations of interleukin 6, interleukin 10 and albumin. Results: At T120 and T240, the IL-6 clearances were 22 +/- 7 and 15 +/- 3 ml/min, respectively. The IL-6 sieving coefficients were 0.97 and 0.7 at T120 and T240, respectively. At T120 and T240, the IL-10 clearances were 14 +/- 4 and 10 +/- 7 ml/min, respectively. The sieving coefficients were 0.63 and 0.45 at T120 and T240, respectively. The concentrations of IL-6 and IL-10 were the same at T0 and T240. At T60 and T240, the plasmatic albumin concentrations were 24 +/- 4 g/L and 23 +/- 4 g/L, respectively ( p = 0.13). Conclusions: In this animal model of endotoxinic shock, we confirm the high cytokine clearance observed when hemofiltration is applied to a large pore membrane. The loss of albumin seems negligible. The impact of such clearances on hemodynamic stability and survival remains to be proved. [less ▲]

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See detailDissection coronaire et traumatisme thoracique ferme
Brasseur, Edmond ULg; Ghuysen, Alexandre ULg; Mommens, Véronique et al

in Annales de Cardiologie et d'Angeiologie (2006), 55(4), 233-9

The occurrence of an acute myocardial infarction after non-penetrating chest trauma is an extremely rare complication. We report a case of dissection of the left anterior descending artery in a 43 year ... [more ▼]

The occurrence of an acute myocardial infarction after non-penetrating chest trauma is an extremely rare complication. We report a case of dissection of the left anterior descending artery in a 43 year old man after being punched in the chest. Using data from a literature search relish revealed 76 cases; we review the characteristics of the pathology and its incidence. We also characterize its etiology, anatomy and path physiology. We then consider the diagnostic and therapeutic implications. [less ▲]

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See detailLarge-pore membrane hemofiltration increases cytokine clearance and improves right ventricular-vascular coupling during endotoxic shock in pigs
Lambermont, Bernard ULg; Delanaye, Pierre ULg; Dogné, Jean-Michel ULg et al

in Artificial Organs (2006), 30(7), 560-564

Hemodynamic improvement in patients suffering from both septic shock and renal failure who received hemofiltration suggested that an extrarenal epuration technique could be of interest in patients with ... [more ▼]

Hemodynamic improvement in patients suffering from both septic shock and renal failure who received hemofiltration suggested that an extrarenal epuration technique could be of interest in patients with septic shock alone. However, most of the studies using continuous venovenous hemofiltration (CVVH) in this setting evidenced neither cytokine clearance nor significant reduction in their plasma level. Lack of significant clearance was explained in part by the small size of the membrane pores. Therefore, we investigated the effects of large-pore membrane hemofiltration (LPHF) during endotoxic shock in pigs on interleukin 6 (IL-6) and interleukin 10 (IL-10) clearances, and on right ventricular (RV)-vascular coupling. Thirteen anesthetized healthy pigs weighing 20-30 kg were divided into two groups. In the Endo group (n = 6), the pigs received a 0.5-mg/kg endotoxin infusion over a period of 30 mins from T0 to T30. In the EndoHF group (n = 7), LPHF (cutoff = 80 kDa) and an ultrafiltration rate of 45 mL/kg/h were started 30 mins after the end of the endotoxin infusion, from T60 to T240. In this model of porcine endotoxic shock, LPHF was responsible for a significant clearance of IL-6 (20 mL/min) and Il-10 (14 mL/min), and for an improvement in RV-vascular coupling. [less ▲]

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