References of "MASSION, Paul"
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See detailInsulin clearance during hyper-insulinemia euglycemia therapy
Penning, Sophie ULg; MASSION, Paul ULg; Pretty, Christopher ULg et al

in Proceedings of the 11th Belgian Day on Biomedical Engineering (2012, December)

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See detailInsulin clearance during hyper-insulinemia euglycemia therapy
Penning, Sophie ULg; MASSION, Paul ULg; Pretty, Christopher ULg et al

Poster (2012, December)

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See detailSecond pilot trials of the STAR-Liege protocol for tight glycemic control in critically ill patients
Penning, Sophie ULg; Le Compte, Aaron J.; MASSION, Paul ULg et al

in BioMedical Engineering OnLine (2012)

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See detailAcute burn care : state of the art in Europe
ROUSSEAU, Anne-Françoise ULg; LEDOUX, Didier ULg; MASSION, Paul ULg et al

Poster (2012, September)

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See detailInsulin Kinetics during Hyper-Insulinemia Euglycemia Therapy (HIET)
Penning, Sophie ULg; MASSION, Paul ULg; Le Compte, Aaron J. et al

in Proceedings of the 8th IFAC Symposium on Biological and Medical Systems (2012, August)

Hyper-insulinemia euglycemia therapy (HIET) is a supra-physiological insulin dosing protocol used in acute cardiac failure to reduce dependency on inotropes to augment or generate cardiac output, and is ... [more ▼]

Hyper-insulinemia euglycemia therapy (HIET) is a supra-physiological insulin dosing protocol used in acute cardiac failure to reduce dependency on inotropes to augment or generate cardiac output, and is based on the inotropic effects of insulin at high doses up to 45-250x normal daily dose. Such high insulin doses are managed using intravenous glucose infusion to control glycemia and prevent hypoglycemia. However, both insulin dosing and glycemic control in these patients is managed ad-hoc. This research examines a selection of clinical data to determine the effect of high insulin dosing on renal clearance and insulin sensitivity, to assess the feasibility of using model-based methods to control and guide these protocols. The results show that the model and, in particular, the modeled renal clearance constant are adequate and capture measured data well, although not perfectly. Equally, insulin sensitivity over time is similar to broader critical care cohorts in level and variability, and these results are the first time they have been presented for this cohort. While more data is needed to confirm and further specify these results, it is clear that the model used is adequate for controlling HIET in a model-based framework. [less ▲]

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See detailInsulin Kinetics during Hyper-Insulinemia Euglycemia Therapy (HIET)
Penning, Sophie ULg; MASSION, Paul ULg; Le Compte, Aaron J. et al

Conference (2012, August)

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See detailPrise en charge des brûlés en phase aigue : enquête européenne.
ROUSSEAU, Anne-Françoise ULg; LEDOUX, Didier ULg; MASSION, Paul ULg et al

in Brûlures. Revue Française de Brûlologie (2012, June), XIII(2), 60

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See detailProcalcitonin usefulness for the initiation of antibiotic treatment in intensive care unit patients.
LAYIOS, Nathalie ULg; LAMBERMONT, Bernard ULg; CANIVET, Jean-Luc ULg et al

in Critical Care Medicine (2012), 40(8), 2304-9

OBJECTIVES: : To test the usefulness of procalcitonin serum level for the reduction of antibiotic consumption in intensive care unit patients. DESIGN: : Single-center, prospective, randomized controlled ... [more ▼]

OBJECTIVES: : To test the usefulness of procalcitonin serum level for the reduction of antibiotic consumption in intensive care unit patients. DESIGN: : Single-center, prospective, randomized controlled study. SETTING: : Five intensive care units from a tertiary teaching hospital. PATIENTS: : All consecutive adult patients hospitalized for > 48 hrs in the intensive care unit during a 9-month period. INTERVENTIONS: : Procalcitonin serum level was obtained for all consecutive patients suspected of developing infection either on admission or during intensive care unit stay. The use of antibiotics was more or less strongly discouraged or recommended according to the Muller classification. Patients were randomized into two groups: one using the procalcitonin results (procalcitonin group) and one being blinded to the procalcitonin results (control group). The primary end point was the reduction of antibiotic use expressed as a proportion of treatment days and of daily defined dose per 100 intensive care unit days using a procalcitonin-guided approach. Secondary end points included: a posteriori assessment of the accuracy of the infectious diagnosis when using procalcitonin in the intensive care unit and of the diagnostic concordance between the intensive care unit physician and the infectious-disease specialist. MEASUREMENTS AND MAIN RESULTS: : There were 258 patients in the procalcitonin group and 251 patients in the control group. A significantly higher amount of withheld treatment was observed in the procalcitonin group of patients classified by the intensive care unit clinicians as having possible infection. This, however, did not result in a reduction of antibiotic consumption. The treatment days represented 62.6 +/- 34.4% and 57.7 +/- 34.4% of the intensive care unit stays in the procalcitonin and control groups, respectively (p = .11). According to the infectious-disease specialist, 33.8% of the cases in which no infection was confirmed, had a procalcitonin value >1microg/L and 14.9% of the cases with confirmed infection had procalcitonin levels <0.25 microg/L. The ability of procalcitonin to differentiate between certain or probable infection and possible or no infection, upon initiation of antibiotic treatment was low, as confirmed by the receiving operating curve analysis (area under the curve = 0.69). Finally, procalcitonin did not help improve concordance between the diagnostic confidence of the infectious-disease specialist and the ICU physician. CONCLUSIONS: : Procalcitonin measuring for the initiation of antimicrobials did not appear to be helpful in a strategy aiming at decreasing the antibiotic consumption in intensive care unit patients. [less ▲]

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See detailPersistent hypocoagulability in patients with septic shock predicts greater hospital mortality: impact of impaired thrombin generation.
MASSION, Paul ULg; PETERS, Pierre ULg; LEDOUX, Didier ULg et al

in Intensive Care Medicine (2012), 38(8), 1326-35

PURPOSE: Sepsis induces hypercoagulability, hypofibrinolysis, microthrombosis, and endothelial dysfunction leading to multiple organ failure. However, not all studies reported benefit from anticoagulation ... [more ▼]

PURPOSE: Sepsis induces hypercoagulability, hypofibrinolysis, microthrombosis, and endothelial dysfunction leading to multiple organ failure. However, not all studies reported benefit from anticoagulation for patients with severe sepsis, and time courses of coagulation abnormalities in septic shock are poorly documented. Therefore, the aim of this prospective observational cohort study was to describe the coagulation profile of patients with septic shock and to determine whether alterations of the profile are associated with hospital mortality. METHODS: Thirty-nine patients with septic shock on ICU admission were prospectively included in the study. From admission to day 7, analytical coagulation tests, thrombin generation (TG) assays, and thromboelastometric analyses were performed and tested for association with survival. RESULTS: Patients with septic shock presented on admission prolongation of prothrombin time, activated partial thromboplastin time (aPTT), increased consumption of most procoagulant factors as well as both delay and deficit in TG, all compatible with a hypocoagulable state compared with reference values (P < 0.001). Time courses revealed a persistent hypocoagulability profile in non-survivors as compared with survivors. From multiple logistic regression, prolonged aPTT (P = 0.007) and persistence of TG deficit (P = 0.024) on day 3 were strong predictors of mortality, independently from disease severity scores, disseminated intravascular coagulation score, and standard coagulation tests on admission. CONCLUSIONS: Patients with septic shock present with hypocoagulability at the time of ICU admission. Persistence of hypocoagulability assessed by prolonged aPTT and unresolving deficit in TG on day 3 after onset of septic shock is associated with greater hospital mortality. [less ▲]

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See detailEnhanced insulin sensitivity variability in the first 3 days of ICU stay: Implications for TGC
Chase, Geoffrey; Le Compte, Aaron; Penning, Sophie ULg et al

Poster (2011, March)

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See detailPilot Trials of the STAR TGC Protocol in a Cardiac Surgery ICU
LeCompte, Aaron J.; Penning, Sophie ULg; Moorhead, Katherine ULg et al

in Proceedings of the 10th Annual Diabetes Technology Meeting (2010, November)

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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 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 detailTight Glycaemic control and nutrition: A comparison of two protocols
Suhaimi, F; Le Compte, AJ; Preiser, JC et al

in Proceedings of the Centre for Bio-Engineering One Day Conference 2010 (2010)

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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 detailWhat makes tight glycemic control tight? The impact of variability and nutrition in two clinical studies.
Suhaimi, Fatanah; Le Compte, Aaron; Preiser, Jean-Charles ULg et al

in Journal of Diabetes Science and Technology (2010), 4(2), 284-98

INTRODUCTION: Tight glycemic control (TGC) remains controversial while successful, consistent, and effective protocols remain elusive. This research analyzes data from two TGC trials for root causes of ... [more ▼]

INTRODUCTION: Tight glycemic control (TGC) remains controversial while successful, consistent, and effective protocols remain elusive. This research analyzes data from two TGC trials for root causes of the differences achieved in control and thus potentially in glycemic and other outcomes. The goal is to uncover aspects of successful TGC and delineate the impact of differences in cohorts. METHODS: A retrospective analysis was conducted using records from a 211-patient subset of the GluControl trial taken in Liege, Belgium, and 393 patients from Specialized Relative Insulin Nutrition Titration (SPRINT) in New Zealand. Specialized Relative Insulin Nutrition Titration targeted 4.0-6.0 mmol/liter, similar to the GluControl A (N = 142) target of 4.4-6.1 mmol/liter. The GluControl B (N = 69) target was 7.8-10.0 mmol/liter. Cohorts were matched by Acute Physiology and Chronic Health Evaluation II score and percentage males (p > .35); however, the GluControl cohort was slightly older (p = .011). Overall cohort and per-patient comparisons (median, interquartile range) are shown for (a) glycemic levels achieved, (b) nutrition from carbohydrate (all sources), and (c) insulin dosing for this analysis. Intra- and interpatient variability were examined using clinically validated model-based insulin sensitivity metric and its hour-to-hour variation. RESULTS: Cohort blood glucose were as follows: SPRINT, 5.7 (5.0-6.6) mmol/liter; GluControl A, 6.3 (5.3-7.6) mmol/liter; and GluControl B, 8.2 (6.9-9.4) mmol/liter. Insulin dosing was 3.0 (1.0-3.0), 1.5 (0.5-3), and 0.7 (0.0-1.7) U/h, respectively. Nutrition from carbohydrate (all sources) was 435.5 (259.2-539.1), 311.0 (0.0-933.1), and 622.1 (103.7-1036.8) kcal/day, respectively. Median per-patient results for blood glucose were 5.8 (5.3-6.4), 6.4 (5.9-6.9), and 8.3 (7.6-8.8) mmol/liter. Insulin doses were 3.0 (2.0-3.0), 1.5 (0.8-2.0), and 0.5 (0.0-1.0) U/h. Carbohydrate administration was 383.6 (207.4-497.7), 103.7 (0.0-829.4), and 207.4 (0.0-725.8) kcal/day. Overall, SPRINT gave approximately 2x more insulin with a 3-4x narrower, but generally non-zero, range of nutritional input to achieve equally TGC with less hypoglycemia. Specialized Relative Insulin Nutrition Titration had much less hypoglycemia (<2.2 mmol/liter), with 2% of patients, compared to GluControl A (7.7%) and GluControl B (2.9%), indicating much lower variability, with similar results for glucose levels <3.0 mmol/liter. Specialized Relative Insulin Nutrition Titration also had less hyperglycemia (>8.0 mmol/liter) than groups A and B. GluControl patients (A+B) had a approximately 2x wider range of insulin sensitivity than SPRINT. Hour-to-hour variation was similar. Hence GluControl had greater interpatient variability but similar intrapatient variability. CONCLUSION: Protocols that dose insulin blind to carbohydrate administration can suffer greater outcome glycemic variability, even if average cohort glycemic targets are met. While the cohorts varied significantly in model-assessed insulin resistance, their variability was similar. Such significant intra- and interpatient variability is a further significant cause and marker of glycemic variability in TGC. The results strongly recommended that TGC protocols be explicitly designed to account for significant intra- and interpatient variability in insulin resistance, as well as specifying or having knowledge of carbohydrate administration to minimize variability in glycemic outcomes across diverse cohorts and/or centers. [less ▲]

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See detailPneumopericarde dans les suites d'une dehiscence de sternum.
DEFRESNE, Aline ULg; Ghaye, Benoit ULg; Lando, A. et al

in Revue Médicale de Liège (2009), 64(2), 66-7

We report a case of pneumopericardium occuring after cardiac surgery. Pneumopericardium is a rare condition; trauma is the most frequent etiology. Nontraumatic causes include fistulae in relationship with ... [more ▼]

We report a case of pneumopericardium occuring after cardiac surgery. Pneumopericardium is a rare condition; trauma is the most frequent etiology. Nontraumatic causes include fistulae in relationship with the bronchial tree or oesophagus and intrapericardial gazeous production due to bacterial pericarditis. Pericardiocentesis is indicated in case of air tamponade and local infection. [less ▲]

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