Publications by authors named "Azoulay E"

Background: Cancer patients who are exposed to sepsis and had previous chemotherapy may have increased severity. Among chemotherapeutic agents, anthracyclines have been associated with cardiac toxicity. Like other chemotherapeutic agents, they may cause endothelial toxicity.

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Purpose: Invasive pulmonary aspergillosis (IPA) is a life-threatening opportunistic infection in immunocompromised patients. The diagnosis is often made late, with mortality reaching 90% when mechanical ventilation is needed. We sought to develop and validate a risk prediction model for the diagnosis of IPA.

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Background: To describe the use of life-sustaining therapies and mortality in patients with acute leukemia admitted to the intensive care unit (ICU).

Methods: The PubMed database was searched from January 1st, 2000 to July 1st, 2023. All studies including adult critically ill patients with acute leukemia were included.

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Background: Sepsis-associated encephalopathy (SAE) may be worsened by early systemic insults. We aimed to investigate the association of early systemic insults with outcomes of critically ill patients with severe SAE.

Methods: We performed a retrospective analysis using data from the French OUTCOMEREA prospective multicenter database.

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Purpose: Advances in therapeutic care are leading to an increase in the number of patients living with overt immunosuppression. These patients are at risk of cytomegalovirus (CMV) infection and disease that can lead to or develop during ICU admission. This manuscript aims to describe the clinical presentation, risk factors, and management of CMV infection and disease in this patient population.

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Introduction: Patients with acute myeloid leukemia (AML) are at high risk of developing life-threatening complications. It is estimated that a quarter of adult patients diagnosed with AML will require admission to the intensive care unit (ICU) at least once during their disease. Acute respiratory failure (ARF) is the main reason for ICU admission and is associated with high mortality rates, depending on the etiology of ARF.

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Background: The incidence of invasive fungal infections is increasing in immune-competent and immune-compromised patients. An examination of the recent literature related to the treatment of fungal infections was performed to address two clinical questions. First, in patients with proven or probable invasive pulmonary aspergillosis, should combination therapy with a mold-active triazole plus echinocandin be administered vs.

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Article Synopsis
  • The ESICM Green Paper addresses the importance of environmental sustainability in intensive care units (ICUs) and proposes actionable strategies to reduce their ecological impact.
  • A task force of experts assessed key areas for improvement and refined their strategies through a series of meetings and drafts.
  • The paper emphasizes the need for energy efficiency, waste reduction, and education among healthcare professionals to ensure that high-quality patient care and sustainability go hand in hand.
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  • Mental health issues among healthcare professionals in ICUs are serious, with burnout rates reaching up to 50%, and factors affecting burnout include communication and support systems.
  • The 'Hello Bundle' intervention was created to combat burnout by enhancing social interactions and team cohesion, using elements like posters, email reminders, and daily greetings.
  • A cluster randomized controlled trial will assess the effectiveness of the 'Hello Bundle', involving around 7,300 participants from various ICUs, comparing burnout levels before and after the intervention.
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The European Society of Intensive Care Medicine (ESICM) has developed evidence-based recommendations and expert opinions about end-of-life (EoL) and palliative care for critically ill adults to optimize patient-centered care, improving outcomes of relatives, and supporting intensive care unit (ICU) staff in delivering compassionate and effective EoL and palliative care. An international multi-disciplinary panel of clinical experts, a methodologist, and representatives of patients and families examined key domains, including variability across countries, decision-making, palliative-care integration, communication, family-centered care, and conflict management. Eight evidence-based recommendations (6 of low level of evidence and 2 of high level of evidence) and 19 expert opinions were presented.

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Purpose: During the initial phase of the pandemic, healthcare professionals faced difficulties due to the limited availability of comprehensive learning resources on managing patients affected with coronavirus disease 2019 (COVID-19). The COVID-19 Skills Preparation Course (C19_SPACE) was tailored to meet the overwhelming demand for specialized training. The primary objective of this study was to assess the efficacy and impact of this program on enhancing clinical knowledge and to identify factors affecting this improvement.

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  • Immune effector cell-associated neurotoxicity syndrome (ICANS) is a serious complication of CD19-targeted CAR T-cell therapy, and early prediction of patients at risk is crucial for tailored management.
  • Elevated serum neurofilament light chain (NfL) levels are linked to the severity of ICANS, with higher levels indicating greater neuroaxonal injury.
  • In a study of 150 patients, those with elevated NfL (>75 pg/mL at leukapheresis or >58 pg/mL at infusion) were significantly more likely to develop severe ICANS, suggesting that NfL could be a vital predictive marker for neurotoxicity in CAR T-cell therapy.
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The complement system is a set of over 50 proteins that constitutes an essential part of the innate immune system. Complement system activation involves an organized proteolytic cascade. Overactivation of complement system activation is the main pathogenic mechanism of several diseases and contributes to the manifestations of many other conditions.

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  • Many cancer patients and people with weakened immune systems face a higher risk of serious infections because their bodies can't fight germs as well.
  • Factors like age, other health problems, and the type and stage of cancer can make them even more vulnerable to severe conditions like septic shock.
  • To improve survival rates, it's important to quickly identify infections and provide specialized care, using new technologies and teamwork among healthcare providers.
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Background: To our knowledge, no large observational study has compared the incidence and risk factors for extubation failure within 48 h and during ICU stay in the same cohort of unselected critically ill patients with and without obesity.

Research Question: What are the incidence and risk factors of extubation failure in patients with and without obesity?

Study Design And Methods: In the prospective multicenter observational Practices and Risk Factors for Weaning and Extubation Airway Failure in Adult Intensive Care Unit: A Multicenter Trial (FREEREA) study in 26 ICUs, the primary objective was to compare the incidence of extubation failure within 48 h in patients with and without obesity. Secondary objectives were to describe and to identify the independent specific risk factors for extubation failure using first a logistic regression model and second a decision tree analysis.

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Purpose: For the first time in France, a randomised controlled trial was conducted to evaluate the impact of a nurse facilitator on family psychological symptoms. We sought to explore the implementation of the intervention, how it was experienced by clinicians, as well as the barriers and facilitators to implementing the change.

Methods: We conducted qualitative semi-structured interviews with intensive care unit (ICU) clinicians and facilitators involved in the trial.

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Background: The underrepresentation of women in leadership remains a pervasive issue, prompting a critical examination of support mechanisms within professional settings. Previous studies have identified challenges women face, ranging from limited visibility to barriers to career advancement. This survey aims to investigate perceptions regarding the effectiveness of women's leadership programs, mentoring initiatives, and a specialized communication course.

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In this image, the autors reinterprate "The Thinker" from Auguste Rodin to transfer knowledge about dengue fever, which can range from flu-like illness to severe hemorrhagic fever. By fostering awareness and understanding of dengue fever, we strive to empower individuals and communities in the ongoing fight against dengue and other infectious threats.

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Background: The accuracy of a diagnostic test depends on its intrinsic characteristics and the disease incidence. This study aims to depict post-test probability of Pneumocystis pneumonia (PJP), according to results of PCR and Beta-D-Glucan (BDG) tests in patients with acute respiratory failure (ARF).

Materials And Methods: Diagnostic performance of PCR and BDG was extracted from literature.

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