Vitamin D status after a high dose of cholecalciferol in healthy and burn subjects
ROUSSEAU, Anne-Françoise ; DAMAS, Pierre ; LEDOUX, Didier et al
in Burns : Journal of the International Society for Burn Injuries (in press)
Background: Burn patients are at risk of vitamin D (VD) deficiency and may benefit from its pleiotropic effects as soon as acute phase. Aim of this observational study was to assess effects of a ... [more ▼]
Background: Burn patients are at risk of vitamin D (VD) deficiency and may benefit from its pleiotropic effects as soon as acute phase. Aim of this observational study was to assess effects of a cholecalciferol (VD3) bolus on VD status in adult burn patients (Group B, GB) after admission, compared to healthy subjects (Group H, GH). Methods: Both groups received an oral dose of 100,000 IU VD3. Blood samples were collected before (D0) and 7 days (D7) after bolus to measure 250H-D, 1,25(OH)2-D, parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23). Albumin (ALB) and VD binding protein (DBP) were measured and used to calculate free 25OH-D level. Data were expressed as median (min–max) or proportions. Results: A total of 49 subjects were included: 29 in GH and 20 in GB. At D0, prevalence of VD deficiency was higher in GB: 25OH-D was 21.5 (10.1–46.3) ng/ml in GH vs 11 (1.8–31.4) ng/ml in GB. DBP and ALB were lower in GB. At D7, DBP was stable in both groups while ALB decreased in GB. 25OH-D increased by 66.6 (13.5–260.3)% in GH. In GB, changes in 25OH-D extended from 36.7% to 333.3% with a median increase of 33.1%. Similar changes were observed in each group for free 25OH-D. High FGF23 levels were observed in GB. Conclusions: This study highlighted the differences in VD status and in response to a high dose VD3 in burn patients when compared to healthy patients. Pitfalls in VD status assessment are numerous during acute burn care: 25OH-D measurement needs cautious interpretation and interest of free 25OH-D is still questionable. They should not prevent burn patients to receive VD supplements during acute care. Higher doses than general recommendations should probably be considered. [less ▲]Detailed reference viewed: 10 (7 ULg)
effects of cholecaciferol supplementation and optimized calcium intakes on vitamin D status, muscle strength and bone health: a one-year pilot randomized controlled trial in adults with severe burns
ROUSSEAU, Anne-Françoise ; FOIDART-DESSALLE, Marguerite ; LEDOUX, Didier et al
in Burns : Journal of the International Society for Burn Injuries (2015), 41(2), 317-325
Objective: Burn patients are at risk of hypovitaminosis D and osteopenia or sarcopenia. Vitamin D pleiotropic effects may influence bone and muscle health. The aim of this pilot study was to assess ... [more ▼]
Objective: Burn patients are at risk of hypovitaminosis D and osteopenia or sarcopenia. Vitamin D pleiotropic effects may influence bone and muscle health. The aim of this pilot study was to assess effects of a cholecalciferol (VD3) supplementation and an optimized calcium (Ca) regimen on vitamin D (VD) status, bone and muscle health during sequelar stage of burn injury. Design: Monocentric randomized controlled trial. Methods: Fifteen adults with thermal burns dating from 2 to 5 years were randomized into two groups. For 12 months, they either received a quarterly IM injection of 200,000 IU VD3 and daily oral Ca (Group D) or placebo (Group P). VD status and bone remodeling markers were assessed every 3 months. Knee muscle strength and bone mineral density were, respectively, assessed using isokinetic dynamometry and dual X-ray absorptiometry at initiation (M0) and completion (M12) of the protocol. Results: Of all the patients, 66% presented with VD deficiency and 53% (with 3 men <40 y) were considered osteopenic at inclusion. After one year, calcidiol levels significantly increased in Group D to reach 40 (37–61) ng/ml. No significant change in bone health was observed in both groups while Group D significantly improved quadriceps strength when tested at high velocity. Conclusions: This VD3 supplementation was safe and efficient to correct hypovitaminosis D in burn adults. When combined with optimized Ca intakes, it demonstrated positive effects on muscle health but not on bone health. A high prevalence of hypovitaminosis D and osteopenia in these patients, as well as their wide range of muscle performances, seem to be worrying when considering rehabilitation and quality of life. [less ▲]Detailed reference viewed: 21 (6 ULg)
Modelled target attainment after meropenem infusion in patients with severe nosocomial pneumonia: the PROMESSE study.
FRIPPIAT, Frédéric ; ; Seidel, Laurence et al
in Journal of Antimicrobial Chemotherapy (2015)
OBJECTIVES: The objective of this study was to propose an optimal treatment regimen of meropenem in critically ill patients with severe nosocomial pneumonia. PATIENTS AND METHODS: Among 55 patients in ... [more ▼]
OBJECTIVES: The objective of this study was to propose an optimal treatment regimen of meropenem in critically ill patients with severe nosocomial pneumonia. PATIENTS AND METHODS: Among 55 patients in intensive care treated with 1 g of meropenem every 8 h for severe nosocomial pneumonia, 30 were assigned to intermittent infusion (II; over 0.5 h) and 25 to extended infusion (EI; over 3 h) groups. Based on plasma and epithelial lining fluid (ELF) concentrations determined at steady-state, pharmacokinetic modelling and Monte Carlo simulations were undertaken to assess the probability of attaining drug concentrations above the MIC for 40%-100% of the time between doses (%T > 1-fold and 4-fold MIC), for 1 or 2 g administered by either method. RESULTS: Penetration ratio, measured by the ELF/plasma ratio of AUCs, was statistically higher in the EI group than in the II group (mean ± SEM: 0.29 ± 0.030 versus 0.20 ± 0.033, P = 0.047). Considering a maximum susceptibility breakpoint of 2 mg/L, all dosages and modes of infusions achieved 40%-100% T > 1-fold MIC in plasma, but none did so in ELF, and only the 2 g dose over EI achieved 40%-100% T > 4-fold MIC in plasma. CONCLUSIONS: The optimum regimen to treat severe nosocomial pneumonia was 2 g of meropenem infused over 3 h every 8 h. This regimen achieved the highest pharmacodynamic targets both in plasma and in ELF. [less ▲]Detailed reference viewed: 18 (2 ULg)
Prevention of ventilator-associated pneumonia and ventilator-associated conditions: A randomized controlled trial with subglottic secretion suctioning
DAMAS, Pierre ; FRIPPIAT, Frédéric ; ANCION, Arnaud et al
in Critical Care Medicine (2015), 43(1), 22-30Detailed reference viewed: 26 (12 ULg)
Use of a pediatric oxygenator integrated in a veno-venous hemofiltration circuit to remove CO2 : a case report in a severe burn patient with refractory hypercapnia.
ROUSSEAU, Anne-Françoise ; DAMAS, Pierre ; RENWART, Ludovic et al
in Burns : Journal of the International Society for Burn Injuries (2014), 40(7), 57-60Detailed reference viewed: 11 (1 ULg)
INCIDENCE AND RISK FACTORS FOR EARLY RENAL DYSFUNCTION AFTER LIVER TRANSPLANTATION
WIESEN, Patricia ; ; VAN CAUWENBERGE, Isabelle et al
in Intensive Care Medicine (2014, October), 40(S1), 1740628
INTRODUCTION. Renal dysfunction often occurred after liver transplantation. OBJECTIVES. The aim of the study was to determine its incidence and its risk factors in a clinical series at the University ... [more ▼]
INTRODUCTION. Renal dysfunction often occurred after liver transplantation. OBJECTIVES. The aim of the study was to determine its incidence and its risk factors in a clinical series at the University Hospital of Liege, Belgium. METHODS. Orthotopic liver transplantations performed from January 2006 until Sep- tember 2012 were retrospectively reviewed (n = 187). Patients, with no renal replacement therapy (RRT) before transplantation were classified in four groups according to their highest creatinine plasma level during the first postoperative week. First group had a cre- atinine level below 12 mg/l, the second group between 12 and 20 mg/l, the third group between 20 and 35 mg/l, and the fourth above 35 mg/l. In addition, patients who needed RRT during the first week after transplantation were also classified in the fourth group. Preoperative and perioperative parameters were tested as risk factors: age, sex, body mass index (BMI), length of hospital preoperative stay, prior bacterial infection within one month, preoperative ascites, preoperative treatment with ß-blocker, converting enzyme inhibitor, or non steroidal antiinflammatory drugs, preoperative creatinine and bilirubine level, postop- erative lactate level, need for postoperative vasopressive drugs, surgical revision, mechanical ventilation for more than 24 h, postoperative peaks in bilirubine and transam- inase levels, postoperative hemoglobin level, amount of perioperative blood transfusions, type of immunosuppression. Univariate and multivariate analysis were performed using logistic ordinal regression method. RESULTS. There were 78 patients in group 1 (41.7 %), 46 in group 2 (24.6 %), 38 in group 3 (20.3 %) and 25 in group 4 (13.4 %). Eighteen patients required RRT: 13 (7 %) during the first week after transplantation (group 4), the 5 others after the first week after transplan- tation (2 in group 1 and 2, and 1 in group 3). There were 7 (3.7 %) early deaths within 28 days after transplantation. Using univariate analysis, the severity of renal dysfunction was correlated with presence of ascites and prior bacterial infection, preoperative bilirubin and creatinine level, need for surgical revision, use of vasopressor, postoperative mechanical ventilation, postoperative bilirubine, transaminase, and hemoglobin levels. The need for transfusion of each type of products also affected renal dysfunction. The ordinal logistic analysis pointed out the BMI (OR = 1.1, p = 0.004), preoperative creatinine level (OR = 11.1, p \ 0.0001), use of vasopressor (OR = 3.31, p = 0.0002), maximal postop- erative bilirubine level (OR = 1.44, p = 0.044) and minimal postoperative hemoglobin level (OR 0.059 p = 0.0005). CONCLUSIONS. More than half of liver transplanted patients experienced some degree of early renal dysfunction after transplantation. Risk factors are preoperative renal dysfunction, and mainly perioperative circulatory instability requiring the use of vasopressor and post- operative anemia. [less ▲]Detailed reference viewed: 13 (0 ULg)
Evaluation of Temocillin for treatment of nosocomial infections
LAYIOS, Nathalie ; CIUTEA, Mirela ; et al
Poster (2014, September)Detailed reference viewed: 34 (13 ULg)
Effect of gamma-hydroxybutyrate on keratinocytes proliferation: a preliminary prospective controlled study in severe burn patients.
ROUSSEAU, Anne-Françoise ; ; et al
in International Journal of Critical Illness and Injury Science (2014), 4(2), 108-113Detailed reference viewed: 23 (10 ULg)
Detection of decreased glomerular filtration rate in intensive care units: serum cystatin C versus serum creatinine
DELANAYE, Pierre ; CAVALIER, Etienne ; et al
in BMC Nephrology (2014), 15(9), 1471-2369Detailed reference viewed: 16 (5 ULg)
Does comfort therapy during controlled donation after circulatory death shorten the life of potential donors?
LEDOUX, Didier ; DELBOUILLE, Marie-Hélène ; DE ROOVER, Arnaud et al
in Clinical transplantation (2014), 28(1), 47-51
INTRODUCTION: Controlled donation after circulatory death (DCD) remains ethically controversial. The authors developed a controlled DCD protocol in which comfort therapy is regularly used. The aim of this ... [more ▼]
INTRODUCTION: Controlled donation after circulatory death (DCD) remains ethically controversial. The authors developed a controlled DCD protocol in which comfort therapy is regularly used. The aim of this study was to determine whether this policy shortens the DCD donors' life. METHODS: The authors retrospectively analyzed prospectively collected data on patients proposed for DCD at the University Hospital of Liege, Belgium, over a 56-month period. The survival duration of these patients, defined as duration between the time of proposal for DCD and the time of circulatory arrest, was compared between patients who actually donated organs and those who did not. RESULTS: About 128 patients were considered for controlled DCD and 54 (43%) became donors. Among the 74 non-donor patients, 34 (46%) objected to organ donation, 38 patients (51%) were denied by the transplant team for various medical reasons, and two potential DCD donors did not undergo procurement due to logistical and organizational reasons. The survival durations were similar in the DCD donor and non-donor groups. No non-donor patient survived. CONCLUSIONS: Survival of DCD donors is not shortened when compared with non-donor patients. These data support the ethical and respectful approach to potential DCD donors in the authors' center, including regular comfort therapy. [less ▲]Detailed reference viewed: 33 (8 ULg)
Catastrophic antiphospholipid syndrome : case reports and review of the literature
; LAYIOS, Nathalie ; DAMAS, Pierre
in Acta Anaesthesiologica Belgica (2014), 65Detailed reference viewed: 12 (3 ULg)
Effect of optimized cholecalciferol and calcium intakes on bone mineral density: a randomized controlled trial in adult burns during sequelae stage.
ROUSSEAU, Anne-Françoise ; FOIDART-DESSALLE, Marguerite ; REMY, Christophe et al
in Nutrients (2014), 6Detailed reference viewed: 13 (5 ULg)
Effect of cholecalciferol recommended daily allowances on vitamin D status and fibroblast growth factor-23: an observational study in acute burn patients.
ROUSSEAU, Anne-Françoise ; DAMAS, Pierre ; LEDOUX, Didier et al
in Burns : Journal of the International Society for Burn Injuries (2014), 40(5), 865-70Detailed reference viewed: 11 (5 ULg)
Critical care and vitamin D status assessment: What about immunoassays and calculated free 25OH-D?
ROUSSEAU, Anne-Françoise ; DAMAS, Pierre ; JANSSENS, Marc et al
in Clinica Chimica Acta (2014), 437Detailed reference viewed: 12 (1 ULg)
Towards targeted early burn care: lessons from a European survey.
ROUSSEAU, Anne-Françoise ; MASSION, Paul ; LAUNGANI, Alexis et al
in Journal of Burn Care & Research (2014), 35Detailed reference viewed: 9 (1 ULg)
Vitamin D status during acute phase of burn injury : is 25(OH)D measurement an accurate marker ?
ROUSSEAU, Anne-Françoise ; DAMAS, Pierre ; LEDOUX, Didier et al
in Nutrients (2014), 6Detailed reference viewed: 10 (2 ULg)
DONATION AFTER CIRCULATORY DEATH INCREASES THE CADAVERIC DONOR POOL
; DE ROOVER, Arnaud ; SQUIFFLET, Jean-Paul et al
in Transplant International (2013, December), 26(S2), 54-101
Background: There is a controversy on the possibility to increase the organ donor pool by donation-after-circulatory-death (DCD) and the possible decrease in donation-after-brain-death (DBD) by DCD ... [more ▼]
Background: There is a controversy on the possibility to increase the organ donor pool by donation-after-circulatory-death (DCD) and the possible decrease in donation-after-brain-death (DBD) by DCD programs. Our aim is to report the DCD experience at the University Hospital of Liege, Belgium, from 2002 through 2012, in a donor region of about 1 million inhabitants. Methods: The prospective organ donor and recipient databases were retrospectively reviewed. Results: 94 and 331 procurements were performed from controlled DCD and DBD donors in the time period, respectively. DCD donors contributed to 22.1% of the deceased donor (DD) organ procurement activity from Jan 2002 to Dec 2012, and up to one-third annually since 2009. DCD liver and kidneys contributed 23.7% and 24.2% of the DD liver and kidney transplantation activity, respectively. There was no decrease of the DBD procurement in the study period. In 2012, overall 54 DD were procured in the Liege region, reaching a high procurement activity.Conclusions: Controlled DCD donors are a valuable source of transplantable liver and kidney grafts, and in our experience do not adversely affect DBD organ procurement activity. [less ▲]Detailed reference viewed: 80 (6 ULg)
Hypovitaminose D du patient brûlé : une équation à plusieurs inconnues.
ROUSSEAU, Anne-Françoise ; LEDOUX, Didier ; DAMAS, Pierre et al
in Revue Médicale de Liège (2013), 68(11), 574-578Detailed reference viewed: 33 (9 ULg)
Nursing adherence on ventilator care bundle in a burn unit.
DEPAYE, Nicolas ; ROUSSEAU, Anne-Françoise ; LAPORT, Virginie et al
Conference (2013, September 30)Detailed reference viewed: 46 (7 ULg)