References of "LAMBERMONT, Bernard"
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See detailA mathematical model of respiration under protective ventilation and extracorporeal CO2 removal therapy
Habran, Simon ULiege; Desaive, Thomas ULiege; MORIMONT, Philippe ULiege et al

Conference (2017, September 27)

The aim of the present study is to build a mathematical model of the respiratory system connected to an extracorporeal CO2 removal device (ECCO2RD) to optimize the gas exchanges efficiency. The model must ... [more ▼]

The aim of the present study is to build a mathematical model of the respiratory system connected to an extracorporeal CO2 removal device (ECCO2RD) to optimize the gas exchanges efficiency. The model must be simple enough to provide rapid solutions and to estimate specific parameters from available clinical data. But it also must be complex enough to be able to simulate the respiratory system when protective ventilation is used and when this system is assisted by an ECCO2RD. [less ▲]

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See detailMathematical modeling of extracorporeal CO2 removal therapy. A validation carried out on ten pigs
Habran, Simon ULiege; Desaive, Thomas ULiege; MORIMONT, Philippe ULiege et al

in Medical & Biological Engineering & Computing (2017)

The extracorporeal CO2 removal device (ECCO2RD) is used in clinics to treat patients suffering from respiratory failures like acute respiratory distress syn- drome (ARDS) or chronic obstructive pulmonary ... [more ▼]

The extracorporeal CO2 removal device (ECCO2RD) is used in clinics to treat patients suffering from respiratory failures like acute respiratory distress syn- drome (ARDS) or chronic obstructive pulmonary disease (COPD). The aim of this device is to decarboxylate blood externally with low blood flow. A mathematical model is proposed to describe protective ventilation, ARDS, and an extracorporeal CO2 removal therapy (ECCO2RT). The sim- ulations are compared with experimental data carried out on ten pigs. The results show a good agreement between the mathematical simulations and the experimental data, which provides a nice validation of the model. This model is thus able to predict the decrease of PCO2 during ECCO2RT for different blood flows across the extracorporeal lung support. [less ▲]

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See detailThe added value of plasma or urinary NGAL concentrations in clinical practice
Gregoire, Emilien ULiege; Claisse, Guillaume; GUIOT, Julien ULiege et al

Poster (2017, January 13)

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See detailGeneralisability of a Virtual Trials Method for Glycaemic Control in Intensive Care.
Dickson, Jennifer L.; Stewart, Kent W.; Pretty, Christopher G. et al

in IEEE transactions on bio-medical engineering (2017)

BACKGROUND: Elevated blood glucose (BG) concentrations (Hyperglycaemia) are a common complication in critically ill patients. Insulin therapy is commonly used to treat hyperglycaemia, but metabolic ... [more ▼]

BACKGROUND: Elevated blood glucose (BG) concentrations (Hyperglycaemia) are a common complication in critically ill patients. Insulin therapy is commonly used to treat hyperglycaemia, but metabolic variability often results in poor BG control and low BG (hypoglycaemia). OBJECTIVE: This paper presents a model-based virtual trial method for glycaemic control protocol design, and evaluates its generalisability across different populations. METHODS: Model-based insulin sensitivity (SI) was used to create virtual patients from clinical data from three different ICUs in New Zealand, Hungary, and Belgium. Glycaemic results from simulation of virtual patients under their original protocol (self-simulation) and protocols from other units (cross-simulation) were compared. RESULTS: Differences were found between the three cohorts in median SI and inter-patient variability in SI. However, hour-to-hour intra-patient variability in SI was found to be consistent between cohorts. Self and cross-simulation results were found to have overall similarity and consistency, though results may differ in the first 24-48 hours due to different cohort starting BG and underlying SI. CONCLUSIONS AND SIGNIFICANCE: Virtual patients and the virtual trial method were found to be generalisable across different ICUs. This virtual trial method is useful for in silico protocol design and testing, given an understanding of the underlying assumptions and limitations of this method. [less ▲]

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See detailMinimally invasive estimation of ventricular dead space volume through use of Frank-Starling curves.
Davidson, Shaun; Pretty, Chris; Pironet, Antoine et al

in PLoS ONE (2017), 12(4), 0176302

This paper develops a means of more easily and less invasively estimating ventricular dead space volume (Vd), an important, but difficult to measure physiological parameter. Vd represents a subject and ... [more ▼]

This paper develops a means of more easily and less invasively estimating ventricular dead space volume (Vd), an important, but difficult to measure physiological parameter. Vd represents a subject and condition dependent portion of measured ventricular volume that is not actively participating in ventricular function. It is employed in models based on the time varying elastance concept, which see widespread use in haemodynamic studies, and may have direct diagnostic use. The proposed method involves linear extrapolation of a Frank-Starling curve (stroke volume vs end-diastolic volume) and its end-systolic equivalent (stroke volume vs end-systolic volume), developed across normal clinical procedures such as recruitment manoeuvres, to their point of intersection with the y-axis (where stroke volume is 0) to determine Vd. To demonstrate the broad applicability of the method, it was validated across a cohort of six sedated and anaesthetised male Pietrain pigs, encompassing a variety of cardiac states from healthy baseline behaviour to circulatory failure due to septic shock induced by endotoxin infusion. Linear extrapolation of the curves was supported by strong linear correlation coefficients of R = 0.78 and R = 0.80 average for pre- and post- endotoxin infusion respectively, as well as good agreement between the two linearly extrapolated y-intercepts (Vd) for each subject (no more than 7.8% variation). Method validity was further supported by the physiologically reasonable Vd values produced, equivalent to 44.3-53.1% and 49.3-82.6% of baseline end-systolic volume before and after endotoxin infusion respectively. This method has the potential to allow Vd to be estimated without a particularly demanding, specialised protocol in an experimental environment. Further, due to the common use of both mechanical ventilation and recruitment manoeuvres in intensive care, this method, subject to the availability of multi-beat echocardiography, has the potential to allow for estimation of Vd in a clinical environment. [less ▲]

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See detailEffect of citrate anticoagulation on CO2 extraction during low flow extracorporeal veno-venous CO2 removal therapy
MORIMONT, Philippe ULiege; Habran, Simon ULiege; Hubert, Romain et al

in Intensive Care Medicine Experimental (2016), 4

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See detailA Comparison between four Techniques to Measure Cardiac Output
Pironet, Antoine ULiege; Dauby, Pierre ULiege; Chase, J. Geoffrey et al

in Proceedings of the 38th International Conference of the IEEE Engineering in Medicine and Biology Society (2016, August 17)

Cardiac output is an important variable when monitoring hemodynamic status. In particular, changes in cardiac output represent the goal of several circulatory management therapies. Unfortunately, cardiac ... [more ▼]

Cardiac output is an important variable when monitoring hemodynamic status. In particular, changes in cardiac output represent the goal of several circulatory management therapies. Unfortunately, cardiac output is very difficult to estimate, either in experimental or clinical settings. The goal of this work is to compare four techniques to measure cardiac output: pressure-volume catheter, aortic flow probe, thermodilution, and the PiCCO monitor. These four techniques were simultaneously used during experiments of fluid and endotoxin administration on 7 pigs. Findings show that, first, each individual technique is precise, with a relative coefficient of repeatability lower than 7 %. Second, 1 cardiac output estimate provided by any technique relates poorly to the estimates from the other 3, even if there is only small bias between the techniques. Third, changes in cardiac output detected by one technique are only detected by the others in 62 to 100 % of cases. This study confirms the difficulty of obtaining a reliable clinical cardiac output measurement. Therefore, several measurements using different techniques should be performed, if possible, and all such should be treated with caution. [less ▲]

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See detailA Comparison between four Techniques to Measure Cardiac Output
Pironet, Antoine ULiege; Dauby, Pierre ULiege; Chase, J. Geoffrey et al

Poster (2016, August 17)

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See detailImportance of Metabolism Variations in a Model of Extracorporeal Carbon Dioxide Removal
Habran, Simon ULiege; Desaive, Thomas ULiege; MORIMONT, Philippe ULiege et al

in Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society (2016)

Extracorporeal CO2 Removal device is used in clinics when a patient suffers from a pulmonary insufficiency like Acute Respiratory Distress Syndrome and allows to decarboxylate blood externally. In this ... [more ▼]

Extracorporeal CO2 Removal device is used in clinics when a patient suffers from a pulmonary insufficiency like Acute Respiratory Distress Syndrome and allows to decarboxylate blood externally. In this work, a model of the respiratory system coupled with such a device is proposed to analyze the decrease of CO2 partial pressure in blood. To validate the model, some parameters are estimated thanks to experimental data. Metabolism is a crucial parameter and we show that its time evolution must be taken into account in order to have correct CO2 partial pressure simulations in arteries and in veins. [less ▲]

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See detailSize of cannula for extracorporeal CO2 removal therapies
Habran, Simon ULiege; Desaive, Thomas ULiege; MORIMONT, Philippe ULiege et al

Conference (2015, November 26)

Extracorporeal CO2 removal devices (ECCO2R) can be used in clinics to decarboxylate blood externally for patients suffering from pulmonary insufficiencies like acute respiratory distress syndrome. In this ... [more ▼]

Extracorporeal CO2 removal devices (ECCO2R) can be used in clinics to decarboxylate blood externally for patients suffering from pulmonary insufficiencies like acute respiratory distress syndrome. In this work, we propose a model of the respiratory system coupled with such a device to analyze the decrease of CO2 partial pressure in the blood as a function of the blood flow through the device. Thanks to this information, the size of the cannulae can be optimized. [less ▲]

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See detailModel-Based Stressed Blood Volume is an Index of Fluid Responsiveness
Pironet, Antoine ULiege; Dauby, Pierre ULiege; Chase, J. Geoffrey et al

Conference (2015, September 01)

Fluid therapy is frequently used to manage acute circulatory failure. This therapy aims to restore cardiac output by fluid administration, which increases the quantity of fluid in the circulation. However ... [more ▼]

Fluid therapy is frequently used to manage acute circulatory failure. This therapy aims to restore cardiac output by fluid administration, which increases the quantity of fluid in the circulation. However, it has been shown to be effective only in certain cases, leading to the need for indices of fluid responsiveness. Total stressed blood volume has recently been shown to be such an index of fluid responsiveness. However, the current methods to determine this parameter require specific procedures. In this work, a more straightforward method is developed using data available in the intensive care unit. A simple three-chamber cardiovascular system model is used, of which total stressed blood volume is a parameter. All model parameters (including total stressed blood volume) are adjusted to pig experimental data during fluid administrations. The resulting value of total stressed blood volume is always negatively associated with the relative change in cardiac output after fluid administration. This finding confirms that total stressed blood volume is an index of fluid responsiveness. Another finding of this study is that the response curves are subject-specific. The method developed in this work can be applied to humans, since the data required is typically available in an intensive care unit. [less ▲]

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See detailModel-Based Stressed Blood Volume is an Index of Fluid Responsiveness
Pironet, Antoine ULiege; Dauby, Pierre ULiege; Chase, J. Geoffrey et al

in IFAC PapersOnLine (2015, September)

Fluid therapy is frequently used to manage acute circulatory failure. This therapy aims to restore cardiac output by fluid administration, which increases the quantity of fluid in the circulation. However ... [more ▼]

Fluid therapy is frequently used to manage acute circulatory failure. This therapy aims to restore cardiac output by fluid administration, which increases the quantity of fluid in the circulation. However, it has been shown to be effective only in certain cases, leading to the need for indices of fluid responsiveness. Total stressed blood volume has recently been shown to be such an index of fluid responsiveness. However, the current methods to determine this parameter require specific procedures. In this work, a more straightforward method is developed using data available in the intensive care unit. A simple three-chamber cardiovascular system model is used, of which total stressed blood volume is a parameter. All model parameters (including total stressed blood volume) are adjusted to pig experimental data during fluid administrations. The resulting value of total stressed blood volume is always negatively associated with the relative change in cardiac output after fluid administration. This finding confirms that total stressed blood volume is an index of fluid responsiveness. Another finding of this study is that the response curves are subject-specific. The method developed in this work can be applied to humans, since the data required is typically available in an intensive care unit. [less ▲]

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See detailMathematical modeling of extracorporeal CO2 removal
Habran, Simon ULiege; Dauby, Pierre ULiege; Desaive, Thomas ULiege et al

Poster (2015, August)

Extra¬cor¬poreal CO2 removal devices (ECCO2R) can be used in clinics to decarboxylate blood externally for patients suffering from pulmonary insufficiencies like acute respiratory distress syndrome. In ... [more ▼]

Extra¬cor¬poreal CO2 removal devices (ECCO2R) can be used in clinics to decarboxylate blood externally for patients suffering from pulmonary insufficiencies like acute respiratory distress syndrome. In this work, a model of the respiratory system coupled with such a device is proposed to analyze the decrease of CO2 partial pressure in blood as a function of blood flow through the device. This model provides a mathematical tool which could help clinicians to choose the optimal settings of ECCO2R. [less ▲]

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See detailMolding thrombus of an ECMO cannula floating in the right atrium.
MORIMONT, Philippe ULiege; LAMBERMONT, Bernard ULiege; GARSPARD, Valérie ULiege et al

in Intensive Care Medicine (2015)

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See detailThe relation between global end-diastolic volume and left ventricular end-diastolic volume
Pironet, Antoine ULiege; MORIMONT, Philippe ULiege; Kamoi, Shun et al

Poster (2015, March)

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See detailVeno-venous extracorporeal CO2 removal improves pulmonary hemodynamics in a porcine ARDS model
MORIMONT, Philippe ULiege; GUIOT, Julien ULiege; Desaive, Thomas ULiege et al

in Acta Anaesthesiologica Scandinavica (2015)

BACKGROUND: Protective lung ventilation is recommended in patients with acute respiratory distress syndrome (ARDS) to minimize additional injuries to the lung. However, hypercapnic acidosis resulting from ... [more ▼]

BACKGROUND: Protective lung ventilation is recommended in patients with acute respiratory distress syndrome (ARDS) to minimize additional injuries to the lung. However, hypercapnic acidosis resulting from ventilation at lower tidal volume enhances pulmonary hypertension and might induce right ventricular (RV) failure. We investigated if extracorporeal veno-venous CO2 removal therapy could have beneficial effects on pulmonary circulation and RV function. METHODS: This study was performed on an experimental model of ARDS obtained in eight anaesthetized pigs connected to a volume-cycled ventilator. A micromanometer-tipped catheter was inserted into the main pulmonary artery and an admittance micromanometer-tipped catheter was inserted into the right ventricle. RV-arterial coupling was derived from RV pressure-volume loops. ARDS was obtained by repeated bronchoalveolar lavage. Protective ventilation was then achieved, and the pigs were connected to a pump-driven extracorporeal membrane oxygenator (PALP, Maquet, Germany) in order to achieve CO2 removal. RESULTS: ARDS induced severe hypercapnic acidosis. Systolic pulmonary artery pressure significantly increased from 29.6 ± 1.8 to 43.9 ± 2.0 mmHg (P < 0.001). After the PALP was started, acidosis was corrected and normocarbia was maintained despite protective ventilation. Pulmonary artery pressure significantly decreased to 31.6 ± 3.2 mmHg (P < 0.001) and RV-arterial coupling significantly improved (RV-arterial coupling index = 1.03 ± 0.33 vs. 0.55 ± 0.41, P < 0.05). CONCLUSION: Veno-venous CO2 removal therapy enabled protective ventilation while maintaining normocarbia during ARDS. CO2 removal decreased pulmonary hypertension and improved RV function. This technique may be an effective lung- and RV-protective adjunct to mechanical ventilation. [less ▲]

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See detailUpdate on the Role of Extracorporeal CO2 Removal as An Adjunct to Mechanical Ventilation in ARDS.
MORIMONT, Philippe ULiege; BATCHINSKY, Andriy; LAMBERMONT, Bernard ULiege

in Vincent, Jean-Louis (Ed.) Annual Update in Intensive Care and Emergency Médicine 2015 (2015)

Veno-venous CO2 removal therapy enabled protective ventilation while maintaining normocarbia during ARDS. CO2 removal decreased pulmonary hypertension and improved RV function. This technique may be an ... [more ▼]

Veno-venous CO2 removal therapy enabled protective ventilation while maintaining normocarbia during ARDS. CO2 removal decreased pulmonary hypertension and improved RV function. This technique may be an effective lung- and RV- protective adjunct to mechanical ventilation. [less ▲]

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