Impact of tapered-cuff tracheal tube on microaspiration of gastric contents in intubated critically ill patients: a multicenter cluster-randomized cross-over controlled trial.

Purpose: Studies on the impact of tapered-cuff tracheal tubes on rates of microaspiration and ventilator-associated pneumonia (VAP) in intubated patients have reported conflicting results. The aim of this study was to determine the influence of this shape of tracheal cuff on abundant microaspiration of gastric contents in critically ill patients.

Methods: All patients intubated in the intensive care unit (ICU) and requiring mechanical ventilation for at least 48 h were eligible for this multicenter cluster-randomized controlled cross-over open-label study.

Impact of combination therapy and early de-escalation on outcome of ventilator-associated pneumonia caused by Pseudomonas aeruginosa.

Background: Pseudomonas aeruginosa is a common cause of ventilator-associated pneumonia (VAP). Guidelines recommend dual coverage of P. aeruginosa, but the beneficial effect of combination therapy is controversial.

Comparison of terminal extubation and terminal weaning as mechanical ventilation withdrawal in ICU patients.

Background: Terminal extubation (TE) is applied in some Intensive Care Units (ICU) patients when a decision of withdrawal of mechanical ventilation is decided. Other units prefer terminal weaning (TW) with no removal of the endotracheal tube. We report our experience with these two procedures.

The use of static and dynamic haemodynamic parameters before volume expansion: A prospective observational study in six French intensive care units.

Objective: The aim of the present study was to determine the use of static and dynamic haemodynamic parameters for predicting fluid responsiveness prior to volume expansion (VE) in intensive care unit (ICU) patients with systemic inflammatory response syndrome (SIRS).

Methods: We conducted a prospective, multicentre, observational study in 6 French ICUs in 2012. ICU physicians were audited concerning their use of static and dynamic haemodynamic parameters before each VE performed in patients with SIRS for 6 consecutive weeks.

Impact of tracheal cuff shape on microaspiration of gastric contents in intubated critically ill patients: study protocol for a randomized controlled trial.

Background: Ventilator-associated pneumonia (VAP) is the most common infection in intubated critically ill patients. Microaspiration of the contaminated gastric and oropharyngeal secretions is the main mechanism involved in the pathophysiology of VAP. Tracheal cuff plays an important role in stopping the progression of contaminated secretions into the lower respiratory tract.

Volume expansion in the first 4 days of shock: a prospective multicentre study in 19 French intensive care units.

Purpose: To describe the current practices of volume expansion in French intensive care units (ICU).

Methods: In 19 ICUs, we prospectively observed the prescription and monitoring practices of volume expansion in consecutive adult patients with shock [sustained hypotension and/or need of vasopressor therapy, associated with at least tachycardia and/or sign (s) of hypoperfusion]. Patients were included at the time of prescription of the first fluid bolus (FB).

Wavefront kinetics of plasma oxidation of polydimethylsiloxane: limits for sub-μm wrinkling.

We investigate the surface plasma oxidation of polydimethylsiloxane (PDMS) elastomers and its implication for the morphologies attainable by wrinkling of glassy-elastomer 'bilayers'. The kinetics of glassy skin formation is found to follow a logarithmic dependence with plasma exposure time t and, for various plasma intensities I, the relevant control variable is shown to be dose (≡I × t). We model the mechanism and kinetics of glassy film formation by plasma oxidation with a frontal propagation coarse-grained model, describing the spatio-temporal evolution of a conversion order parameter (ϕ) orthogonal to the film surface.

Improvement in process of care and outcome in patients requiring intensive care unit admission for community acquired pneumonia.

Background: The present study was performed to assess the prognosis of patients admitted to the intensive care unit (ICU) for community acquired pneumonia (CAP) after implementation of new processes of care.

Methods: Two groups of patients with CAP were admitted to a 16-bed multidisciplinary ICU in an urban teaching hospital during two different periods: the years 1995-2000, corresponding to the historical group; and 2005-2010, corresponding to the intervention group. New therapeutic procedures were implemented during the period 2005-2010.

Survival in critically ill patients with acute kidney injury treated with early hemodiafiltration.

Purpose: Early renal replacement therapy (RRT) initiation should theoretically influence many physiological disorders related to acute kidney injury (AKI). Currently, there is no consensus about RRT timing in intensive care unit (ICU) patients.

Methods: We performed a retrospective analysis of all critically ill patients who received RRT in our ICU during a 3 year-period.

Should highly active antiretroviral therapy be prescribed in critically ill HIV-infected patients during the ICU stay? A retrospective cohort study.

Background: The impact of highly active antiretroviral therapy (HAART) in HIV-infected patients admitted to the intensive care unit (ICU) remains controversial. We evaluate impact of HAART prescription in HIV-infected patients admitted to the ICU of Tourcoing Hospital from January 2000 to December 2009.

Results: There were 91 admissions concerning 85 HIV-infected patients.

Severe pneumococcal pneumonia: impact of new quinolones on prognosis.

Background: Most guidelines have been proposing, for more than 15 years, a β-lactam combined with either a quinolone or a macrolide as empirical, first-line therapy of severe community acquired pneumonia (CAP) requiring ICU admission. Our goal was to evaluate the outcome of patients with severe CAP, focusing on the impact of new rather than old fluoroquinolones combined with β-lactam in the empirical antimicrobial treatments.

Methods: Retrospective study of consecutive patients admitted in a 16-bed general intensive care unit (ICU), between January 1996 and January 2009, for severe (Pneumonia Severity Index > or = 4) community-acquired pneumonia due to non penicillin-resistant Streptococcus pneumoniae and treated with a β-lactam combined with a fluoroquinolone.

Epidemiology, prognosis, and evolution of management of septic shock in a French intensive care unit: a five years survey.

Purpose. To evaluate the epidemiology, prognosis, and management of septic shock patients hospitalized in our intensive care unit (ICU). Materiel and Methods.

Resuscitation with low volume hydroxyethylstarch 130 kDa/0.4 is not associated with acute kidney injury.

Introduction: Acute kidney injury (AKI) in the ICU is associated with poorer prognosis. Hydroxyethylstarch (HES) solutions are fluid resuscitation colloids frequently used in the ICU with controversial nephrotoxic adverse effects. Our study objective was to evaluate HES impact on renal function and organ failures.

Nanostructured wrinkled surfaces for templating bionanoparticles--controlling and quantifying the degree of order.

We present a novel method to align the tobacco mosaic virus (TMV) on topographically structured surfaces. In order to gain defined patterns we use wrinkled polydimethlysiloxane (PDMS) sheets as templates. We aligned the virus with a simple spin-coating procedure on the PDMS sheet.

A lithography-free pathway for chemical microstructuring of macromolecules from aqueous solution based on wrinkling.

We report on a novel lithography-free method for obtaining chemical submicron patterns of macromolecules on flat substrates. The approach is an advancement of the well-known microcontact printing scheme: While for classical microcontact printing lithographically produced masters are needed, we show that controlled wrinkling can serve as an alternative pathway to producing such masters. These can even show submicron periodicities.

A pilot randomized study comparing high and low volume hemofiltration on vasopressor use in septic shock.

Objective: High volume hemofiltration (HVHF) has shown potential benefits in septic animals and a few reports suggested a hemodynamic improvement in humans. However, randomized studies are still lacking. Our goal was to evaluate the hemodynamic effects of HVHF in septic shock patients with acute renal failure (ARF).

Validation of a prediction rule for prognosis of severe community-acquired pneumonia.

In a previous study, we developed a prognostic prediction rule, based on nine prognostic variables, capable to estimate and to adjust the mortality rate of patients admitted in intensive care unit for severe community-acquired pneumonia. A prospective multicenter study was undertaken to evaluate the performance of this rule. Five hundred eleven patients, over a 7-year period, were studied.

Impact of thrombocytopenia on outcome of patients admitted to ICU for severe community-acquired pneumonia.

Objective: To evaluate the prevalence and the prognostic value of thrombocytopenia in patients admitted to ICU for severe community-acquired pneumonia.

Methods: Multicentre observational study was conducted in 7 ICUs in the north of France over a 19-year period (1987-2005). The primary outcome measure was the ICU mortality.