Publications by authors named "Bruno Riou"

Background: This study examined 1071 adult primary kidney transplants from the French-controlled donation after the circulatory determination of death (cDCD) program, which uses normothermic regional perfusion (NRP), and involves short cold ischemia times (CIT) and constrained asystole times differing by donor age.

Methods: Logistic regression identified risk factors for primary nonfunction (PNF), delayed graft function (DGF), and graft failure.

Results: Risk factors for PNF included donor hypertension, admission for ischemic vascular stroke, and HLA DR mismatches.

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  • A study examined in-hospital mortality in older COVID-19 patients (aged ≥ 75) during the Omicron wave compared to previous waves from March 2020 to January 2022, using data from 38 hospitals in Greater Paris.
  • Out of 195,084 hospitalized patients, 19,909 older patients were included, revealing an overall mortality rate of 22%, which dropped to 17% during the Omicron wave.
  • Findings indicated that older patients faced significantly lower mortality and decreased risk of ICU admission during the Omicron wave (Wave 5) than during earlier waves (Waves 1-3).
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Importance: Optimal transfusion strategies in traumatic hemorrhage are unknown. Reports suggest a beneficial effect of 4-factor prothrombin complex concentrate (4F-PCC) on blood product consumption.

Objective: To investigate the efficacy and safety of 4F-PCC administration in patients at risk of massive transfusion.

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  • Sepsis is a serious condition caused by infection that can lead to problems in organs, including making muscles weaker in very sick patients.
  • Researchers studied muscle samples from patients with sepsis and compared them to other sick groups to understand the changes happening in the muscles during septic shock.
  • They found that certain important processes in the body's energy production and fat breakdown were less active in sepsis patients, which might be causing muscle issues.
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Background: Severe hypoxemia in patients with COVID-19 pneumonia might result from hypoxic pulmonary vasoconstriction, contributing to ventilation/perfusion (V/Q) mismatch. Because almitrine improves V/Q, it might reduce the risk for mechanical ventilation (MV) in such patients. Our primary objective was to determine the effect of almitrine on the need for MV at day 7.

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  • The study investigates the relationship between medication administered during the perioperative care of older patients (70+) who underwent hip fracture surgery and the incidence of postoperative delirium.
  • Conducted in a Paris academic hospital, it included 490 patients, with a notable 44% experiencing delirium post-surgery.
  • Key findings revealed that factors like advanced age, dementia, depression, and preoperative beta-blocker use were more strongly linked to delirium than the medications used during care.
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Background: Optimal management of severe trauma patients with active hemorrhage relies on adequate initial resuscitation. Early administration of coagulation factors improves post-traumatic coagulation disorders, and four-factor prothrombin complex concentrate (PCC) might be useful in this context. Our main hypothesis is that four-factor PCC in addition to a massive transfusion protocol decreases blood product consumption at day 1 in severe trauma patients with major bleeding.

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  • Controlled donation after circulatory death (cDCD) is used for kidney transplants from donors with poorer outcomes and has been implemented in France since 2015, utilizing strategies like normothermic regional perfusion.
  • A study compared kidney transplant results from cDCD and brain-dead (DBD) donors, matching the two groups based on donor and recipient characteristics, finding a lower rate of delayed graft function (20% for cDCD vs. 28% for DBD).
  • Despite differences in early outcomes, the one-year graft survival rates were similar between cDCD and matched DBD transplant recipients in this French program.
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Backround: Triage is key in the management of mass casualty incidents.

Objective: The objective of this study was to assess the prehospital triage performed during the 2015 Paris area terrorist attack.

Design Setting And Participant: This was a retrospective cohort study that included all casualties of the attacks on 13 November 2015 in Paris area, France, that were admitted alive at the hospital within the first 24 h after the events.

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Background: The average length of stay (LOS) in the intensive care unit (ICU_ALOS) is a helpful parameter summarizing critical bed occupancy. During the outbreak of a novel virus, estimating early a reliable ICU_ALOS estimate of infected patients is critical to accurately parameterize models examining mitigation and preparedness scenarios.

Methods: Two estimation methods of ICU_ALOS were compared: the average LOS of already discharged patients at the date of estimation (DPE), and a standard parametric method used for analyzing time-to-event data which fits a given distribution to observed data and includes the censored stays of patients still treated in the ICU at the date of estimation (CPE).

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  • A multicentric study in Paris analyzed characteristics and outcomes of 821 hospitalized patients aged 70 and older with confirmed COVID-19 from March to April 2020.
  • Patients had a mean age of 86, with 85% having two or more pre-existing health conditions, and exhibiting common symptoms such as asthenia, fever, and dyspnea.
  • The in-hospital mortality rate was 31%, with factors like male gender, lower functional status, and specific health anomalies increasing the likelihood of death, highlighting the importance of early risk assessment for older patients.
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Hip fracture (HF) in older patients is associated with a high six-month mortality rate. Several clinical conditions may affect outcome, including baseline characteristics, co-existing acute illnesses, perioperative factors, and postoperative complications. Our primary objective was to estimate the respective effect of these four domains on six-month mortality after HF.

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Background: Liver transplantation (LT) from controlled donation after circulatory death (cDCD) was initiated in France in 2015 under a protocol based on the use of normothermic regional perfusion (NRP) before organ procurement. The aim was to compare outcomes following cDCD LT with NRP and donation after brain death (DBD) LT.

Methods: This is a multicenter retrospective study comparing cDCD LT with NRP and DBD LT.

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Objectives: Crowding is a frequent concern in the emergency department (ED). Laboratory point-of-care testing (POCT) has been proposed to decrease patients' length of stay (LOS). Our objective was to determine whether an extended panel of POCT solutions could reduce LOS.

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Objective: Hemorrhage is the leading cause of death after terrorist attack, and the immediacy of labile blood product (LBP) administration has a decisive impact on patients' outcome. The main objective of this study was to evaluate the transfusion patterns of the Paris terrorist attack victims, November 13, 2015.

Methods: We performed a retrospective analysis including all casualties admitted to hospital, aiming to describe the transfusion patterns from admission to the first week after the attack.

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Background: Biomarkers prove valuable for diagnosing postoperative bacterial infection, but data in elderly patients are scarce. Here we analyze how procalcitonin and C-reactive protein (CRP) perform for bacterial infection diagnosis after traumatic orthopedic surgery in elderly patients.

Methods: We included all patients admitted to our perioperative geriatrics unit after traumatic orthopedic surgery.

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Purpose: The majority of terrorist acts are carried out by explosion or shooting. The objective of this study was first, to describe the management implemented to treat a large number of casualties and their flow together with the injuries observed, and second, to compare these resources according to the mechanism of trauma.

Methods: This retrospective cohort study collected medical data from all casualties of the attacks on November 13th 2015 in Paris, France, with physical injuries, who arrived alive at any hospital within the first 24 h after the events.

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Purpose: Postoperative pain after cardiac surgery, exacerbated by cough and sternal mobilization, limits clearance of bronchopulmonary secretions and may predispose to postoperative pneumonia. In this study, we tested the ability of local anesthetic continuous wound infusion to prevent pneumonia after cardiac surgery with sternotomy and cardiopulmonary bypass (CPB) owing to better analgesia and bronchopulmonary drainage.

Methods: In this randomized, double-blind, placebo-controlled trial conducted in five academic centers, patients undergoing cardiac surgery with sternotomy and CPB were enrolled from February 2012 until November 2014, and were followed over 30 days.

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