References of "Preiser, Jean-Charles"
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See detailComment gérer la nutrition artificielle chez un patient diabétique ?
PAQUOT, Nicolas ULg; DE FLINES, Jenny ULg; Preiser, Jean-Charles

in Journée de développement professionnel continu de la SFNEP (2013, September 11)

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See detailInsulin Sensitivity during Hypothermia in Critically Ill Patients
Sah Pri, Azurahisham; Chase, J. Geoffrey; Le Compte, Aaron J. et al

Poster (2013, September)

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See detailClinical review: Consensus recommendations on measurement of blood glucose and reporting glycemic control in critically ill adults.
Finfer, Simon; Wernerman, Jan; Preiser, Jean-Charles et al

in Critical Care (2013), 17(3), 229

The management reporting and assessment of glycemic control lacks standardization. The use of different methods to measure the blood glucose concentration and to report the performance of insulin ... [more ▼]

The management reporting and assessment of glycemic control lacks standardization. The use of different methods to measure the blood glucose concentration and to report the performance of insulin treatment yields major disparities and complicates the interpretation and comparison of clinical trials. We convened a meeting of 16 experts plus invited observers from industry to discuss and where possible reach consensus on the most appropriate methods to measure and monitor blood glucose in critically ill patients and on how glycemic control should be assessed and reported. Where consensus could not be reached, recommendations on further research and data needed to reach consensus in the future were suggested. Recognizing their clear conflict of interest, industry observers played no role in developing the consensus or recommendations from the meeting. Consensus recommendations were agreed for the measurement and reporting of glycemic control in clinical trials and for the measurement of blood glucose in clinical practice. Recommendations covered the following areas: How should we measure and report glucose control when intermittent blood glucose measurements are used? What are the appropriate performance standards for intermittent blood glucose monitors in the ICU? Continuous or automated intermittent glucose monitoring - methods and technology: can we use the same measures for assessment of glucose control with continuous and intermittent monitoring? What is acceptable performance for continuous glucose monitoring systems? If implemented, these recommendations have the potential to minimize the discrepancies in the conduct and reporting of clinical trials and to improve glucose control in clinical practice. Furthermore, to be fit for use, glucose meters and continuous monitoring systems must match their performance to fit the needs of patients and clinicians in the intensive care setting. [less ▲]

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See detailCumulative time in band (cTIB): glycemic level, variability and patient outcome all in one
Penning, Sophie ULg; Signal, Matthew; Preiser, Jean-Charles et al

Conference (2012, October 15)

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See detailCumulative time in band: glycemic level, variability and patient outcome vs. mortality
Penning, Sophie ULg; Signal, Matthew; Preiser, Jean-Charles et al

Poster (2012, October)

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See detailCumulative Time in Band (cTIB): Glycemic Level, Variability and Patient Outcome All in 1
Penning, Sophie ULg; Signal, Matthew; Preiser, Jean-Charles et al

in Intensive Care Medicine (2012, October), 38 (Suppl 1)

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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 detailDoes Tight Glycemic Control positively impact on patient mortality?
Penning, Sophie ULg; Le Compte, Aaron J.; Signal, Matthew et al

in Critical Care (2012, March 20)

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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 detailGlycemic Variability, Hypoglycemia and Organ Failure in the Glucontrol Study
Penning, Sophie ULg; Le Compte, Aaron J.; Preiser, Jean-Charles et al

Poster (2011, December)

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

in Critical Care (2011, March)

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See detailValidation of a virtual patient and virtual trials method for accurate prediction of TGC protocol performance
Suhaimi, Fatanah; Le Compte, Aaron; Penning, Sophie ULg et al

in Critical Care (2011, March)

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See detailNutritional disorders during acute renal failure and renal replacement therapy
WIESEN, Patricia ULg; VAN OVERMEIRE, Lionel ULg; DELANAYE, Pierre ULg et al

in JPEN Journal of Parenteral & Eternal Nutrition (2011), 35

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See detailTight glycemic control in critical care - The leading role of insulin sensitivity and patient variability: A review and model-based analysis.
Chase, J. G.; Le Compte, A. J.; Suhaimi, F. et al

in Computer Methods & Programs in Biomedicine (2011)

Tight glycemic control (TGC) has emerged as a major research focus in critical care due to its potential to simultaneously reduce both mortality and costs. However, repeating initial successful TGC trials ... [more ▼]

Tight glycemic control (TGC) has emerged as a major research focus in critical care due to its potential to simultaneously reduce both mortality and costs. However, repeating initial successful TGC trials that reduced mortality and other outcomes has proven difficult with more failures than successes. Hence, there has been growing debate over the necessity of TGC, its goals, the risk of severe hypoglycemia, and target cohorts. This paper provides a review of TGC via new analyses of data from several clinical trials, including SPRINT, Glucontrol and a recent NICU study. It thus provides both a review of the problem and major background factors driving it, as well as a novel model-based analysis designed to examine these dynamics from a new perspective. Using these clinical results and analysis, the goal is to develop new insights that shed greater light on the leading factors that make TGC difficult and inconsistent, as well as the requirements they thus impose on the design and implementation of TGC protocols. A model-based analysis of insulin sensitivity using data from three different critical care units, comprising over 75,000h of clinical data, is used to analyse variability in metabolic dynamics using a clinically validated model-based insulin sensitivity metric (S(I)). Variation in S(I) provides a new interpretation and explanation for the variable results seen (across cohorts and studies) in applying TGC. In particular, significant intra- and inter-patient variability in insulin resistance (1/S(I)) is seen be a major confounder that makes TGC difficult over diverse cohorts, yielding variable results over many published studies and protocols. Further factors that exacerbate this variability in glycemic outcome are found to include measurement frequency and whether a protocol is blind to carbohydrate administration. [less ▲]

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See detailInsulin Sensitivity, Its Variability and Glycemic Outcome: A model-based analysis of the difficulty in achieving tight glycemic control in critical care
Chase, J. Geoffrey; Le Compte, Aaron J.; Preiser, Jean-Charles et al

in 18th World Congress of the International Federation of Automatic Control (IFAC) (2011)

Effective tight glycemic control (TGC) can improve outcomes in intensive care unit (ICU) <br />patients, but is difficult to achieve consistently. Glycemic level and variability, particularly early in a ... [more ▼]

Effective tight glycemic control (TGC) can improve outcomes in intensive care unit (ICU) <br />patients, but is difficult to achieve consistently. Glycemic level and variability, particularly early in a <br />patient’s stay, are a function of variability in insulin sensitivity/resistance resulting from the level and <br />evolution of stress response, and are independently associated with mortality. This study examines the <br />daily evolution of variability of insulin sensitivity in ICU patients using patient data (N = 394 patients, <br />54019 hours) from the SPRINT TGC study. Model-based insulin sensitivity (SI) was identified each hour <br />and hour-to-hour percent changes in SI were assessed for Days 1-3 individually and Day 4 Onward, as <br />well as over all days. Cumulative distribution functions (CDFs), median values, and inter-quartile points <br />(25th and 75th percentiles) are used to assess differences between groups and their evolution over time. <br />Compared to the overall (all days) distributions, ICU patients are more variable on Days 1 and 2 (p < <br />0.0001), and less variable on Days 4 Onward (p < 0.0001). Day 3 is similar to the overall cohort (p = 0.74). <br />Absolute values of SI start lower and rise for Days 1 and 2, compared to the overall cohort (all days), (p < <br />0.0001), are similar on Day 3 (p = .72) and are higher on Days 4 Onward (p < 0.0001). ICU patients have <br />lower insulin sensitivity (greater insulin resistance) and it is more variable on Days 1 and 2, compared to <br />an overall cohort on all days. This is the first such model-based analysis of its kind. Greater variability <br />with lower SI early in a patient’s stay greatly increases the difficulty in achieving and safely maintaining <br />glycemic control, reducing potential positive outcomes. Clinically, the results imply that TGC patients will <br />require greater measurement frequency, reduced reliance on insulin, and more explicit specification of <br />carbohydrate nutrition in Days 1-3 to safely minimise glycemic variability for best outcome. [less ▲]

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See detailPilot Trials of STAR Target to Range Glycemic Control
Penning, Sophie ULg; Le Compte, Aaron; Massion, Paul et al

in Intensive Care Medicine (2011), 37 (Suppl 1)

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See detailVariability of insulin sensitivity for diabetics and non-diabetics during the first 3 days of ICU stay
Pretty, Christopher G.; Le Compte, Aaron; Preiser, Jean-Charles et al

in Intensive Care Medicine (2011), 37 (Suppl 1)

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See detailVariability of insulin sensitivity for diabetics and non-diabetics during the first 3 days of ICU stay
Pretty, Christopher G.; Le Compte, Aaron; Preiser, Jean-Charles et al

Poster (2011)

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See detailPilot Trials of STAR Target to Range Glycemic Control
Penning, Sophie ULg; Le Compte, Aaron; Massion, Paul et al

Poster (2011)

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See detailGlycemic Variability, Hypoglycemia and Organ Failure in the Glucontrol Study
Penning, Sophie ULg; Le Compte, Aaron J.; Preiser, Jean-Charles et al

in 10th Belgian Day on Biomedical Engineering (2011)

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