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  Cumulative Time in Band (cTIB): Glycemic Level, Variability and Patient Outcome All in 1Penning, Sophie  ; ; et alin Intensive Care Medicine (2012, October), 38 (Suppl 1) Detailed reference viewed: 21 (1 ULg)Neurally adjusted ventilatory assist (NAVA) improves patient-ventilator interaction during non-invasive ventilation delivered by face mask; ; et al in Intensive Care Medicine (2012) PURPOSE: To determine if, compared to pressure support (PS), neurally adjusted ventilatory assist (NAVA) reduces patient-ventilator asynchrony in intensive care patients undergoing noninvasive ventilation ... [more ▼] PURPOSE: To determine if, compared to pressure support (PS), neurally adjusted ventilatory assist (NAVA) reduces patient-ventilator asynchrony in intensive care patients undergoing noninvasive ventilation with an oronasal face mask. METHODS: In this prospective interventional study we compared patient-ventilator synchrony between PS (with ventilator settings determined by the clinician) and NAVA (with the level set so as to obtain the same maximal airway pressure as in PS). Two 20-min recordings of airway pressure, flow and electrical activity of the diaphragm during PS and NAVA were acquired in a randomized order. Trigger delay (T(d)), the patient's neural inspiratory time (T(in)), ventilator pressurization duration (T(iv)), inspiratory time in excess (T(iex)), number of asynchrony events per minute and asynchrony index (AI) were determined. RESULTS: The study included 13 patients, six with COPD, and two with mixed pulmonary disease. T(d) was reduced with NAVA: median 35 ms (IQR 31-53 ms) versus 181 ms (122-208 ms); p = 0.0002. NAVA reduced both premature and delayed cyclings in the majority of patients, but not the median T(iex) value. The total number of asynchrony events tended to be reduced with NAVA: 1.0 events/min (0.5-3.1 events/min) versus 4.4 events/min (0.9-12.1 events/min); p = 0.08. AI was lower with NAVA: 4.9 % (2.5-10.5 %) versus 15.8 % (5.5-49.6 %); p = 0.03. During NAVA, there were no ineffective efforts, or late or premature cyclings. PaO(2) and PaCO(2) were not different between ventilatory modes. CONCLUSION: Compared to PS, NAVA improved patient ventilator synchrony during noninvasive ventilation by reducing T(d) and AI. Moreover, with NAVA, ineffective efforts, and late and premature cyclings were absent. [less ▲] Detailed reference viewed: 3 (2 ULg) Persistent hypocoagulability in patients with septic shock predicts greater hospital mortality: impact of impaired thrombin generation.MASSION, Paul ; PETERS, Pierre ; LEDOUX, Didier et alin 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 ▲] Detailed reference viewed: 27 (9 ULg)Severity of ICU-acquired pneumonia according to infectious microorganismsDAMAS, Pierre ; LAYIOS, Nathalie ; SEIDEL, Laurence et alin Intensive Care Medicine (2011), 37(7), 1128-35 Detailed reference viewed: 22 (5 ULg)Variability of insulin sensitivity for diabetics and non-diabetics during the first 3 days of ICU stay; ; et al in Intensive Care Medicine (2011), 37 (Suppl 1) Detailed reference viewed: 9 (3 ULg) Neurally Adjusted Ventilatory Assist (NAVA) improves the matching of diaphragmatic electrical activity and tidal volume in comparison to pressure support (PS); ; et al in Intensive Care Medicine (2011), 37 (Suppl 1) Detailed reference viewed: 4 (1 ULg)Pilot Trials of STAR Target to Range Glycemic ControlPenning, Sophie ; ; et alin Intensive Care Medicine (2011), 37 (Suppl 1) Detailed reference viewed: 12 (5 ULg)Safety and Performance of Stochastic Targeted (STAR) Glycemic Control of Insulin and Nutrition – First Pilot Results; ; et al in Intensive Care Medicine (2011) Detailed reference viewed: 9 (2 ULg)Dramatic reduction of postnatal growth restriction after optimizing nutrition in extremely preterm infantsSENTERRE, Thibault ; in Intensive Care Medicine (2011), 37(S2), 397 Detailed reference viewed: 11 (2 ULg)Assessment of ease of use and experience of the new paediatric triple-chamber bag for parenteral nutrition for preterm infants; ; et al in Intensive Care Medicine (2011), 37(S2), 396 Detailed reference viewed: 10 (0 ULg)Metabolic acidosis during the first 2 weeks of life in VLBW infants receiving high protein intakesSENTERRE, Thibault ; in Intensive Care Medicine (2011), 37(S2), 397 Detailed reference viewed: 10 (0 ULg)Effect of various Neurally adjusted ventilatory assist (NAVA) gains on the relationship between diaphragmatic activity (Eadi max) and tidal volume; ; Desaive, Thomas et alin Intensive Care Medicine (2010), 37 (Suppl 1) Detailed reference viewed: 1 (0 ULg)NAVA enhances ventilatory variability and diaphragmatic activity/tidal volume coupling; ; Desaive, Thomas et alin Intensive Care Medicine (2010), 36 (Suppl 2) Reduced Organ Failure with Effective Glycemic Control; ; et al in Intensive Care Medicine (2010), 36 (Suppl 2) Detailed reference viewed: 3 (0 ULg)NAVA enhances ventilatory variability and diaphragmaticactivity/tidal volume coupling; ; Desaive, Thomas et alin Intensive Care Medicine (2010), 36(2), 326-326 Detailed reference viewed: 16 (2 ULg)The long way of biomarkers: from bench to bedside.; Damas, Pierre ; PREISER, Jean-Charles in Intensive Care Medicine (2010), 36(4), 565-6 Detailed reference viewed: 7 (2 ULg)Reduced organ failure with effective glycemic control; ; et al in Intensive Care Medicine (2010), 36(2), 173-173 Detailed reference viewed: 8 (0 ULg)Time varying elastance estimation in an 8 camber cardiovascular system modelDesaive, Thomas ; ; et alin Intensive Care Medicine (2010), 36(2), 151-151 Detailed reference viewed: 16 (3 ULg)Delayed colopericardial fistula and pyopneumopericardium.JOURET, François ; ; in Intensive Care Medicine (2010), 36(3), 557-8 Detailed reference viewed: 12 (0 ULg)Model-Based Assessment of Dynamic FRC (DFRC)Desaive, Thomas ; ; et alin Intensive Care Medicine (2009), 35(suppl. 1), 52 Detailed reference viewed: 37 (10 ULg) |
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