Publications by authors named "Bohe J"
Article Synopsis
- The study investigates the pharmacokinetics (PK) of fluconazole in critically ill patients to identify optimal dosing regimens due to reported variability in drug response.
- A retrospective analysis included 36 critically ill and 16 non-critically ill patients, revealing that standard dosing often results in inadequate drug levels, particularly against certain pathogens.
- Findings suggest that higher loading doses are essential for meeting pharmacodynamic (PD) targets, particularly against stronger fungal infections, indicating a need for reconsideration of fluconazole use in severe cases.*
Background: Whether intensive glucose control reduces mortality in critically ill patients remains uncertain. Patient-level meta-analyses can provide more precise estimates of treatment effects than are currently available.
Methods: We pooled individual patient data from randomized trials investigating intensive glucose control in critically ill adults.
Article Synopsis
- - The study compared mortality rates and patient burden among adult ICU patients with respiratory failure due to RSV, COVID-19, seasonal influenza, and H1N1, involving a total of 807 patients.
- - Patients with RSV had more comorbidities, while those with COVID-19 presented with less severe conditions at admission, indicated by lower SAPS-II and SOFA scores.
- - Results showed that COVID-19 and H1N1 were linked to higher mortality rates compared to RSV, despite patients with RSV being more severely ill, suggesting a better overall outcome for those affected by RSV and seasonal influenza.
Purpose: The effect of renal replacement therapy (RRT) in comatose patients with acute kidney injury (AKI) remains unclear. We compared two RRT initiation strategies on the probability of awakening in comatose patients with severe AKI.
Methods: We conducted a post hoc analysis of a trial comparing two delayed RRT initiation strategies in patients with severe AKI.
Article Synopsis
- The study explores the effectiveness of hydrocortisone and fludrocortisone treatments in patients with septic shock caused by community-acquired pneumonia (CAP) compared to non-CAP cases.
- It includes data from the phase 3 APROCCHSS trial, which initially tested these treatments across multiple centers in France, focusing specifically on how they impact mortality outcomes.
- Results indicate that patients with CAP may respond differently to these treatments, and various mortality rates and recovery metrics were analyzed to determine the overall benefit of the steroid regimen.
Objective: The optimal target for blood glucose concentration in critically ill patients is unclear. We will perform a systematic review and meta-analysis with aggregated and individual patient data from randomized controlled trials, comparing intensive glucose control with liberal glucose control in critically ill adults.
Data Sources: MEDLINE®, Embase, the Cochrane Central Register of Clinical Trials, and clinical trials registries (World Health Organization, clinical trials.
Psychological resilience (the ability to thrive in adversity) may protect against mental-health symptoms in healthcare professionals during coronavirus disease (COVID-19) waves. To identify determinants of resilience in ICU staff members. In this cross-sectional survey in 21 French ICUs, staff members completed the 10-item Connor-Davidson Resilience Scale, Hospital Anxiety and Depression Scale, and Impact of Event Scale-Revised (for post-traumatic stress disorder [PTSD]).
View Article and Find Full Text PDFObjectives: The objective of this study was to compare three different approaches for estimating 30-day survival in ICU studies, considering the issue of informative censoring that occurs when patients are lost to follow-up after discharge.
Design: A comparative analysis was conducted to evaluate the effect of different approaches on the estimation of 30-day survival. Three methods were compared: the classical approach using the Kaplan-Meier (KM) estimator and Cox regression modeling, the competing risk approach using the Fine and gray model, considering censoring as a competing event, and the logistic regression approach.
Background & Aims: After a prolonged intensive care unit (ICU) stay patients experience increased mortality and morbidity. The primary aim of this study was to assess the prognostic value of nutritional status, body mass composition and muscle strength, as assessed by body mass index (BMI), bioelectrical impedance analysis (BIA), handgrip (HG) test, and that of the biological features to predict one-year survival at the end of a prolonged ICU stay.
Methods: This was a multicenter prospective observational study.
Article Synopsis
- The study evaluated mortality and factors influencing outcomes in cancer patients receiving urgent chemotherapy in the ICU of Lyon, France.
- Among the 147 patients, 77% had hematological cancers, with a 69.4% mortality rate observed within 6 months, particularly linked to solid tumors and higher SOFA scores.
- The findings suggest that urgent chemotherapy in the ICU can be viable for certain patients, especially those with hematological cancers, who often continue their conventional treatment post-ICU.
Intra-Abdominal Candidiasis (IAC) is frequent and associated with high mortality in intensive care unit (ICU) patients. Antifungal treatments may be overused due to a lack of diagnostic tools to rule out IAC. Serum 1,3-Beta-D-Glucan (BDG) concentrations are used to diagnose Candida infections, its concentration in peritoneal fluid (PF) may help to confirm or invalidate the diagnosis of IAC.
View Article and Find Full Text PDFBackground: Acute kidney injury (AKI) requiring renal replacement therapy (RRT) is a serious complication in the ICU that results in increased mortality and risk of chronic kidney disease (CKD). Some studies suggest RRT modality may have an impact on long-term renal recovery after AKI. However, other predictive factors of severe long-term CKD in ICU patients with AKI requiring RRT are unknown.
View Article and Find Full Text PDFNurse-to-nurse familiarity at work should strengthen the components of teamwork and enhance its efficiency. However, its impact on patient outcomes in critical care remains poorly investigated. To explore the role of nurse-to-nurse familiarity on inpatient deaths during ICU stay.
View Article and Find Full Text PDFBackground: Stress hyperglycemia can persist during an intensive care unit (ICU) stay and result in prolonged requirement for insulin (PRI). The impact of PRI on ICU patient outcomes is not known. We evaluated the relationship between PRI and Day 90 mortality in ICU patients without previous diabetic treatments.
View Article and Find Full Text PDFBackground: Intermittent hemodialysis (IHD) and continuous renal replacement therapy (CRRT) are the two main RRT modalities in patients with severe acute kidney injury (AKI). Meta-analyses conducted more than 10 years ago did not show survival difference between these two modalities. As the quality of RRT delivery has improved since then, we aimed to reassess whether the choice of IHD or CRRT as first modality affects survival of patients with severe AKI.
View Article and Find Full Text PDFArticle Synopsis
- - The study aimed to compare the intrinsic mortality rates and overall burden of COVID-19 versus seasonal influenza pneumonia among ICU patients in Lyon, France, from 2015 to 2021.
- - A total of 350 patients with COVID-19 and 325 with influenza were included, with the analysis focusing on mortality rates at different time intervals after ICU admission.
- - Results indicated that although COVID-19 patients were generally younger and less comorbid, the risk of death for patients with COVID-19 was significantly higher than that for those with seasonal influenza after adjusting for various medical factors.
Background: The frequency of acute kidney injury (AKI) can be as high as 50% in the intensive care unit (ICU). Despite the publication of national guidelines in France in 2015 for the use of RRT, there are no data describing the implementation of these recommendations in real-life.
Methods: We performed a nationwide survey of practices from November 15, 2019, to January 24, 2020, in France.
Purpose: Hyperglycaemia is an adaptive response to stress commonly observed in critical illness. Its management remains debated in the intensive care unit (ICU). Individualising hyperglycaemia management, by targeting the patient's pre-admission usual glycaemia, could improve outcome.
View Article and Find Full Text PDFObjectives: Prone position is used in acute respiratory distress syndrome and in coronavirus disease 2019 acute respiratory distress syndrome. However, it is unclear how responders may be identified and whether an oxygenation response improves outcome. The objective of this study was to quantify the response to prone position, describe the differences between coronavirus disease 2019 acute respiratory distress syndrome and acute respiratory distress syndrome, and explore variables associated with survival.
View Article and Find Full Text PDFPurpose: Data on aminoglycoside stewardship in critically ill septic patients with acute kidney injury (AKI) needing intermittent hemodialysis (IH) are scarce. The first objective of the study was to evaluate whether aminoglycoside administration occurs before vs after IH in the real-life management of critically ill septic patients with AKI needing IH. The second objective was to assess the delay in achieving a potential reinjection window for a second dose of aminoglycoside, which should be obtained with a postdialysis vs predialysis regimen.
View Article and Find Full Text PDFBackground: We investigated the impact of the COVID-19 crisis on mental health of professionals working in the intensive care unit (ICU) according to the intensity of the epidemic in France.
Methods: This cross-sectional survey was conducted in 77 French hospitals from April 22 to May 13 2020. All ICU frontline healthcare workers were eligible.
Purpose: Data on aminoglycoside stewardship in critically ill septic patients with acute kidney injury (AKI) needing continuous renal replacement therapy (CRRT) are scarce. The objectives of the study were to determine, during CRRT, the time window with low likelihood for safe reinjection and the proportion of inappropriate reinjection.
Methods: A post hoc observational analysis of a multicenter randomized trial comparing the risk of hemodialysis catheter infection with ethanol lock vs placebo in critically ill patients with AKI was conducted.
Article Synopsis
- The study investigated the impact of hydroxychloroquine (HCQ) on 90-day mortality in critically ill COVID-19 patients using data from three intensive care units in France.
- A total of 157 patients were analyzed, revealing a day-90 mortality rate of 35.6% for those treated with HCQ compared to 23.7% for those who received standard care, but the difference was not statistically significant.
- The findings suggest that HCQ did not significantly affect medium-term outcomes in these severely ill patients, aligning with results from studies involving less severe cases.