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: 38 (19 ULg)
Clinical Significance of Exercise Pulmonary Hypertension in Secondary Mitral Regurgitation.
Lancellotti, Patrizio ; ; DULGHERU, Raluca Elena et al
in The American journal of cardiology (2015)
In patients with heart failure, exercise echocardiography can help in risk stratification and decision making. The prognostic significance of exercise pulmonary hypertension (PH) in patients with ... [more ▼]
In patients with heart failure, exercise echocardiography can help in risk stratification and decision making. The prognostic significance of exercise pulmonary hypertension (PH) in patients with secondary mitral regurgitation (MR) remains unknown. The aim of the present study was to assess the prognostic value of exercise PH in patients with secondary MR and narrow QRS intervals. From 2005 to 2012, 159 consecutive patients with secondary MR, narrow QRS intervals, left ventricular dysfunction (mean ejection fraction 36 +/- 7%), and measurable systolic pulmonary arterial pressure (SPAP) during exercise echocardiography were included. Resting and exercise PH were defined as SPAP >50 and >60 mm Hg, respectively. Exercise PH was more frequent than resting PH (40% vs 13%, p <0.0001). On multivariate logistic regression, the independent determinants of exercise PH were resting SPAP (p <0.0001), exercise MR severity (p <0.0001), and e'-wave velocity (p = 0.004). The incidence of cardiac events during follow-up was significantly higher in patients with exercise PH compared with those without exercise PH (4 years: 40 +/- 7% vs 20 +/- 5%, p <0.0001). Patients with exercise PH exhibited higher rates of cardiac events and death than those with resting PH. In a multivariate Cox proportional hazards model, exercise PH was independently associated with the occurrence of cardiac events (p <0.0001). In conclusion, in patients with secondary MR, exercise PH is determined mainly by resting SPAP, left ventricular diastolic burden, and exercise MR severity. Exercise PH is a powerful predictor of poor outcomes, with a 5.3-fold increased risk for cardiac-related death during follow-up. These results highlight the added value of exercise echocardiography in secondary MR. [less ▲]Detailed reference viewed: 13 (1 ULg)
Elevated heart rate at 24-36h after admission and in-hospital mortality in acute in non-arrhythmic heart failure.
Lancellotti, Patrizio ; ANCION, Arnaud ; et al
in International journal of cardiology (2015), 182C
BACKGROUND: Elevated resting heart rate is associated with worse outcomes in chronic heart failure (HF) but little is known about its prognostic impact in acute setting. The main aim of the present study ... [more ▼]
BACKGROUND: Elevated resting heart rate is associated with worse outcomes in chronic heart failure (HF) but little is known about its prognostic impact in acute setting. The main aim of the present study was to examine the relationship between resting heart rate obtained 24-36h after admission for acute non-arrhythmic HF and in-hospital mortality. METHODS AND RESULTS: We examined the association of heart rate with in-hospital mortality in a cohort of 712 patients admitted for acute HF. None of the patients had significant arrhythmias, required invasive ventilation, or presented with acute coronary syndrome or primary valvular disease. Forty patients (5.6%) died during the hospital stay. Those patients were significantly older (78+/-9 vs. 72+/-12years; p=0.0021), had higher heart rate (92+/-22 vs. 78+/-18bpm; p<0.0001), NT pro-BNP (p=0.0005), creatinine (p=0.023), were often diabetics (p=0.026) and had lower systolic and diastolic blood pressures (p<0.05). There was a significant graded relationship between the increase in mortality rate and tertile of heart rate (p<0.01). With multivariable analysis, age (p=0.037), heart rate (p<0.0001), diastolic blood pressure (p<0.001), prior ischemic heart disease (p=0.02) and creatinine (p=0.019) emerged as independent predictors of in-hospital mortality. After adjusting for predictors of poor prognosis, patients in the highest heart rate tertile had worst outcomes when compared with those in the lowest heart rate group (p=0.007). CONCLUSIONS: Higher heart rate 24-36h after admission for acute non-arrhythmic HF is associated with increased risk of in-hospital mortality. Early targeting of elevated heart rate might represent a complementary therapeutic challenge. [less ▲]Detailed reference viewed: 16 (2 ULg)
Recommandations européennes concernant la prise en charge de l'embolie pulmonaire.
MELISSOPOULOU, Maria ; ANCION, Arnaud ; LANCELLOTTI, Patrizio
in Revue Medicale de Liege (2014), 69(11), 594-599Detailed reference viewed: 47 (10 ULg)
Reduction in VAP incidence by subglottic secretion drainage and antibiotic consumption in ICU patients
VAN CAUWENBERGE, Isabelle ; ANCION, Arnaud ; LAMBERMONT, Bernard et al
in Intensive Care Medicine (2013), 39(Suppl 2), 465-4660898Detailed reference viewed: 52 (12 ULg)
Comment j'explore... une insuffisance cardiaque chronique
ANCION, Arnaud ; NELLESSEN, Eric ; Lancellotti, Patrizio et al
in Revue Médicale de Liège (2011)
Heart failure is defined by precise criteria associating clinical signs and cardiac abnormalities. The exploration for signs and symptoms must be associated with the systematic realization of an ... [more ▼]
Heart failure is defined by precise criteria associating clinical signs and cardiac abnormalities. The exploration for signs and symptoms must be associated with the systematic realization of an electrocardiogram, a chest X-ray and an echocardiogram to rapidly obtain the diagnosis and direct the patient to an adapted complementary clarification. Other additional tests are available (catheterization, nuclear cardiology imaging,...). The purpose is to confirm the diagnosis, to determine the aetiology and to identify factors of poor prognosis. [less ▲]Detailed reference viewed: 99 (12 ULg)