References of "Lambermont, Bernard"
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See detailArterial dP/dtmax accurately reflects left ventricular contractility during shock when adequate vascular filling is achieved
MORIMONT, Philippe ULg; LAMBERMONT, Bernard ULg; Desaive, Thomas ULg et al

in BMC Cardiovascular Disorders (2012), 12:13

Background: Peak first derivative of femoral artery pressure (arterial dP/dt max) derived from fluid-filled catheter remains questionable to assess left ventricular (LV) contractility during shock. The ... [more ▼]

Background: Peak first derivative of femoral artery pressure (arterial dP/dt max) derived from fluid-filled catheter remains questionable to assess left ventricular (LV) contractility during shock. The aim of this study was to test if arterial dP/dt maxis reliable for assessing LV contractility during various hemodynamic conditions such as endotoxin-induced shock and catecholamine infusion.Methods: Ventricular pressure-volume data obtained with a conductance catheter and invasive arterial pressure obtained with a fluid-filled catheter were continuously recorded in 6 anaesthetized and mechanically ventilated pigs. After a stabilization period, endotoxin was infused to induce shock. Catecholamines were transiently administrated during shock. Arterial dP/dt maxwas compared to end-systolic elastance (Ees), the gold standard method for assessing LV contractility.Results: Endotoxin-induced shock and catecholamine infusion lead to significant variations in LV contractility. Overall, significant correlation (r = 0.51; p < 0.001) but low agreement between the two methods were observed. However, a far better correlation with a good agreement were observed when positive-pressure ventilation induced an arterial pulse pressure variation (PPV) ≤ 11% (r = 0.77; p < 0.001).Conclusion: While arterial dP/dt maxand Ees were significantly correlated during various hemodynamic conditions, arterial dP/dt maxwas more accurate for assessing LV contractility when adequate vascular filling, defined as PPV ≤ 11%, was achieved. © 2012 Morimont et al; licensee BioMed Central Ltd. [less ▲]

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See detailInterventricular septal rupture caused by vehicular trauma
ROBINET, Sébastien ULg; MORIMONT, Philippe ULg; LAMBERMONT, Bernard ULg et al

in Heart & Lung (2012), 41(2), 200-202

We report the case of a patient admitted at the emergency unit after a severe car accident. As ECG showed a ST segment elevation in all leads, the working diagnosis was coronary dissection. Coronary ... [more ▼]

We report the case of a patient admitted at the emergency unit after a severe car accident. As ECG showed a ST segment elevation in all leads, the working diagnosis was coronary dissection. Coronary angiography revealed a large interventricular septal rupture, confirmed by echocardiography. After discussion and as haemodynamics permitted, 6 weeks of medical observation were decided. A surgical repair was then performed, and provided a perfect repair of the shunt. We discuss about the prevalence and management of this rare traumatic complication. [less ▲]

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See detailPhysiological relevance and performance of a minimal lung model -- an experimental study in healthy and acute respiratory distress syndrome model piglets
Chiew, Y. S.; Chase, J. G.; LAMBERMONT, Bernard ULg et al

in BMC Pulmonary Medicine (2012), 12:59

Background: Mechanical ventilation (MV) is the primary form of support for acute respiratory distress syndrome (ARDS) patients. However, intra- and inter- patient-variability reduce the efficacy of ... [more ▼]

Background: Mechanical ventilation (MV) is the primary form of support for acute respiratory distress syndrome (ARDS) patients. However, intra- and inter- patient-variability reduce the efficacy of general protocols. Model-based approaches to guide MV can be patient-specific. A physiological relevant minimal model and its patient-specific performance are tested to see if it meets this objective above. Methods: Healthy anesthetized piglets weighing 24.0 kg [IQR: 21.0-29.6] underwent a step-wise PEEP increase manoeuvre from 5cmH2O to 20cmH2O. They were ventilated under volume control using Engstrom Care Station (Datex, General Electric, Finland), with pressure, flow and volume profiles recorded. ARDS was then induced using oleic acid. The data were analyzed with a Minimal Model that identifies patient-specific mean threshold opening and closing pressure (TOP and TCP), and standard deviation (SD) of these TOP and TCP distributions. The trial and use of data were approved by the Ethics Committee of the Medical Faculty of the University of Liege, Belgium.Results and discussions3 of the 9 healthy piglets developed ARDS, and these data sets were included in this study. Model fitting error during inflation and deflation, in healthy or ARDS state is less than 5.0% across all subjects, indicating that the model captures the fundamental lung mechanics during PEEP increase. Mean TOP was 42.4cmH2O [IQR: 38.2-44.6] at PEEP = 5cmH2O and decreased with PEEP to 25.0cmH2O [IQR: 21.5-27.1] at PEEP = 20cmH2O. In contrast, TCP sees a reverse trend, increasing from 10.2cmH2O [IQR: 9.0-10.4] to 19.5cmH2O [IQR: 19.0-19.7]. Mean TOP increased from average 21.2-37.4cmH2O to 30.4-55.2cmH2O between healthy and ARDS subjects, reflecting the higher pressure required to recruit collapsed alveoli. Mean TCP was effectively unchanged. Conclusion: The minimal model is capable of capturing physiologically relevant TOP, TCP and SD of both healthy and ARDS lungs. The model is able to track disease progression and the response to treatment. [less ▲]

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See detailLe débit de filtration glomérulaire est-il un déterminant de la concentration plasmatique du NGAL aux soins intensifs ?
DELANAYE, Pierre ULg; Claisse, Guillaume; Mehdi, Manoli et al

Poster (2012)

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See detailNAVA enhances tidal volume and diaphragmatic electro-myographic activity matching: a Range90 analysis of supply and demand
Moorhead, K. T.; Piquilloud, L.; LAMBERMONT, Bernard ULg et al

in Journal of Clinical Monitoring and Computing (2012)

Neurally adjusted ventilatory assist (NAVA) is a ventilation assist mode that delivers pressure in proportionality to electrical activity of the diaphragm (Eadi). Compared to pressure support ventilation ... [more ▼]

Neurally adjusted ventilatory assist (NAVA) is a ventilation assist mode that delivers pressure in proportionality to electrical activity of the diaphragm (Eadi). Compared to pressure support ventilation (PS), it improves patient-ventilator synchrony and should allow a better expression of patient's intrinsic respiratory variability. We hypothesize that NAVA provides better matching in ventilator tidal volume (Vt) to patients inspiratory demand. 22 patients with acute respiratory failure, ventilated with PS were included in the study. A comparative study was carried out between PS and NAVA, with NAVA gain ensuring the same peak airway pressure as PS. Robust coefficients of variation (CVR) for Eadi and Vt were compared for each mode. The integral of Eadi (sh{phonetic}Eadi) was used to represent patient's inspiratory demand. To evaluate tidal volume and patient's demand matching, Range90 = 5-95 % range of the Vt/sh{phonetic}Eadi ratio was calculated, to normalize and compare differences in demand within and between patients and modes. In this study, peak Eadi and sh{phonetic}Eadi are correlated with median correlation of coefficients, R > 0.95. Median sh{phonetic}Eadi, Vt, neural inspiratory time (Ti_ <br /> Neural), inspiratory time (Ti) and peak inspiratory pressure (PIP) were similar in PS and NAVA. However, it was found that individual patients have higher or smaller sh{phonetic}Eadi, Vt, Ti_ <br /> Neural, Ti and PIP. CVR analysis showed greater Vt variability for NAVA (p < 0.005). Range90 was lower for NAVA than PS for 21 of 22 patients. NAVA provided better matching of Vt to sh{phonetic}Eadi for 21 of 22 patients, and provided greater variability Vt. These results were achieved regardless of differences in ventilatory demand (Eadi) between patients and modes. © 2012 Springer Science+Business Media New York. [less ▲]

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See detailPhysiological Relevance of a Minimal Model in Healthy Pigs Lungs
Chiew, YS; Desaive, Thomas ULg; LAMBERMONT, Bernard ULg et al

in Proceedings of BMS 2012 (2012)

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See detailPerformance of lung recruitment model in healthy anesthetised pigs
Chiew, YS; LAMBERMONT, Bernard ULg; JANSSEN, Nathalie ULg et al

in Proceedings of the World Congress on Medical Physics and Biomedical Engineering 2012 (2012)

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See detailRange90 as indicator for ventilator output versus patients demand: NAVA and pressure support for non-invasively ventilated patients
Chiew, YS; Piquilloud, L.; LAMBERMONT, Bernard ULg et al

in Proceedings of the World Congress on Medical Physics and Biomedical Engineering 2012 (2012)

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See detailEstimating afterload, systemic vascular resistance and pulmonary vascular resistance in an intensive care setting
Stevenson, D; Revie, J.; Chase, JG et al

in Proceedings of BMS2012 (2012)

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See detailCardiovascular modelling and the Intensive Care Unit clinician
Desaive, Thomas ULg; LAMBERMONT, Bernard ULg; Kolh, Philippe ULg et al

in Proceedings of BMS 2012 (2012)

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See detailModel-based Monitoring of Septic Shock Treated with Large-Pore Hemofiltration Therapy
Revie; Stevenson, D; Chase, JG et al

in Proceedings of BMS 2012 (2012)

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See detailAnalysis of Aortic Energetics from Pulse Wave Examination in a Porcine Study of Septic Shock
Revie, JA; Stevenson, D; Chase, JG et al

in Prceedings of BMS 2012 (2012)

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See detailStructural model of the mitral valve included in a cardiovascular closed loop model
Paeme, Sabine ULg; Moorhead, Kate; Chase, J. Geoffrey et al

Poster (2011, December)

A minimal cardiovascular system (CVS) model including mitral valve dynamics has been previously validated in silico. However parameters of this model are difficult to link with structural and anatomical ... [more ▼]

A minimal cardiovascular system (CVS) model including mitral valve dynamics has been previously validated in silico. However parameters of this model are difficult to link with structural and anatomical components of the valve. This research describes the integration of a structural model of the mitral valve in an existing closed-loop cardiovascular system (CVS) model [less ▲]

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See detailMathematical multi-scale model of the cardiovascular system including mitral valve dynamics. Application to ischemic mitral insufficiency
Paeme, Sabine ULg; Moorhead, Katherine; Chase, J. Geoffrey et al

in BioMedical Engineering OnLine (2011), 10(1), 86

Valve dysfunction is a common cardiovascular pathology. Despite significant clinical research, there is little formal study of how valve dysfunction affects overall circulatory dynamics. Validated models ... [more ▼]

Valve dysfunction is a common cardiovascular pathology. Despite significant clinical research, there is little formal study of how valve dysfunction affects overall circulatory dynamics. Validated models would offer the ability to better understand these dynamics and thus optimize diagnosis, as well as surgical and other interventions. A cardiovascular and circulatory system (CVS) model has already been validated in silico, and in several animal model studies. It accounts for valve dynamics using Heaviside functions to simulate a physiologically accurate “open on pressure, close on flow” law. However, it does not consider real-time valve opening dynamics and therefore does not fully capture valve dysfunction, particularly where the dysfunction involves partial closure. This research describes an updated version of this previous closed-loop CVS model that includes the progressive opening of the mitral valve, and is defined over the full cardiac cycle. Simulations of the cardiovascular system with healthy mitral valve are performed, and, the global hemodynamic behaviour is studied compared with previously validated results. The error between resulting pressure-volume (PV) loops of already validated CVS model and the new CVS model that includes the progressive opening of the mitral valve is assessed and remains within typical measurement error and variability. Simulations of ischemic mitral insufficiency are also performed. Pressure-Volume loops, transmitral flow evolution and mitral valve aperture area evolution follow reported measurements in shape, amplitude and trends. The resulting cardiovascular system model including mitral valve dynamics provides a foundation for clinical validation and the study of valvular dysfunction in vivo. The overall models and results could readily be generalised to other cardiac valves. [less ▲]

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See detailMinimal cardiovascular system model including a physiological description of progressive mitral valve orifice dynamics for studying valve dysfunction
Paeme, Sabine ULg; Moorhead, Katerine; Chase, J. Geoffrey et al

in XXIIIrd congress of the International Society of Biomechanics, July 3-7, 2011 (2011, July)

This research presents a new closed-loop cardiovascular system model including a description of the progressive opening and closing dynamic of the mitral valve. Furthermore, this model includes a ... [more ▼]

This research presents a new closed-loop cardiovascular system model including a description of the progressive opening and closing dynamic of the mitral valve. Furthermore, this model includes a mathematical description of the left atrium. This new CVS model enables the study of valve dysfunction in the appropriate clinical context of the overall cardiac and circulatory hemodynamics. [less ▲]

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See detailEFFECTS OF LARGE PORE HEMOFILTRATION IN A SWINE MODEL OF FULMINANT HEPATIC FAILURE
DETRY, Olivier ULg; JANSSEN, Nathalie ULg; CHERAMY-BIEN, Jean-Paul ULg et al

in Transplant International (2011, February), 24(1), 10-10

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See detailRespiratory variability in mechanically ventilated patients
Desaive, Thomas ULg; Piquilloud, L.; Moorhead, KT et al

in Critical Care (2011), 15 (Suppl 1)

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See detailPulmonary embolism diagnostics from the driver function
Stevenson, DJ; Revie; Chase, JG et al

in Critical Care (2011), 15 (Suppl 1)

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