Publications by authors named "Deye N"

Introduction: The high incidence of morbidity and mortality associated with the post-cardiac arrest (CA) period highlights the need for novel therapeutic interventions to improve the outcome of out-of-hospital cardiac arrest (OHCA) patients admitted to the intensive care unit (ICU). The aim of this study is to assess the ability of high-dose intravenous vitamin C (Vit-C) to improve post-CA shock.

Methods And Analysis: This is a single-blind, open-label, multicentre, randomised controlled trial, involving 234 OHCA patients with post-CA shock planned to be enrolled in 10 French ICUs.

View Article and Find Full Text PDF

Background: Recent guidelines for post-cardiac arrest (CA) management have undergone significant changes regarding targeted therapeutic management (TTM), transitioning from hypothermia to temperature control. We aimed to assess changes in post-CA management in French intensive care units following the new recommendations.

Methods: Two declarative web surveys were conducted from March to August 2023.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to evaluate the effectiveness of the 2021 ERC/ESICM algorithm in predicting neurological outcomes for cardiac arrest survivors in intensive care.
  • A total of 337 patients were examined, with the algorithm successfully identifying all 175 patients predicted to have poor neurological outcomes and showing high specificity for various predictive tools like EEG and clinical examination.
  • For patients with uncertain outcomes, favorable indicators could help predict positive recovery, providing valuable guidance in prognosis and treatment decisions.
View Article and Find Full Text PDF
Article Synopsis
  • - Ventilator-associated pneumonia (VAP) is common in cardiac arrest patients, but diagnosing it post-arrest is difficult, leading to debate over the effectiveness of biomarkers like C-reactive protein (CRP) and procalcitonin (PCT) for this purpose.
  • - The study analyzed the role of various biomarkers in diagnosing and predicting VAP within 48 hours following cardiac arrest and therapeutic hypothermia, using a randomized clinical trial as a foundation.
  • - Results showed that VAP patients had distinct clinical features and higher biomarker levels indicating VAP; CRP was notably associated with VAP, demonstrating an area under the curve (AUC) greater than 0.70 in analyses.
View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to use standardized and automated CT assessments to predict outcomes for patients who suffered out-of-hospital cardiac arrest.
  • Involving 140 unconscious patients, results showed that while qualitative assessments and various gray-white-matter ratio (GWR) models achieved 100% specificity in predicting poor outcomes, sensitivity rates varied, with automated GWR proving robust.
  • The research concluded that these CT assessment methods could reliably indicate poor functional outcomes, and automated GWR could enhance accessibility for medical centers handling cardiac arrest cases.
View Article and Find Full Text PDF

Background: The COVID-19 pandemic has highlighted the importance of intensive care units (ICUs) and their organization in healthcare systems. However, ICU capacity and availability are ongoing concerns beyond the pandemic, particularly due to an aging population and increasing complexity of care. This study aimed to assess the current and future shortage of ICU physicians in France, ten years after a previous evaluation.

View Article and Find Full Text PDF
Article Synopsis
  • The SEPSISCOOL II trial aims to determine if actively cooling fevered patients in septic shock improves survival and organ function compared to not treating the fever.
  • It is a multicenter, randomized controlled trial involving 820 patients admitted to intensive care units, with the primary endpoint being mortality at day 60.
  • Funded by the French health ministry and approved by an ethics committee, the findings will be shared in peer-reviewed journals upon completion.
View Article and Find Full Text PDF
Article Synopsis
  • Out-of-hospital cardiac arrest (OHCA) varies in cause and prognosis, prompting a study to assess the effectiveness of the Cardiac Arrest Prognosis (CAHP) Score compared to traditional methods (Utstein style criteria) for predicting patient outcomes.
  • The study collected data from 24 ICUs in France and Belgium on comatose patients with OHCA who had a stable return of spontaneous circulation, aiming to evaluate various predictive scores and their accuracy in anticipating neurological outcomes after 90 days.
  • Among the 658 patients analyzed, results showed a 63% mortality rate and noted that while Utstein criteria had moderate predictive capability (AUROC of 0.79), other scores demonstrated a range of performance, with some showing
View Article and Find Full Text PDF

Background: While the short-term prognosis of cardiac arrest patients - nearly 250,000 new cases per year in Europe - has been extensively studied, less is known regarding the mid and long-term outcome of survivors.

Objective: The aim of the DESAC study is to describe mid- and long-term survival rate and functional status of cardiac arrest survivors, and to assess the influence of pre and intra hospital therapeutic strategies on these two outcomes.

Methods: Between Jul 2015 and Oct 2018, adult patients over 18 years who were discharged alive from any intensive care units (public and private hospitals) in the Ile-de-France area (Paris and suburbs, France) after a non-traumatic cardiac arrest were screened for participation in this multicentric study.

View Article and Find Full Text PDF

Objective: Over 300 000 cases of out-of-hospital cardiac arrests (OHCAs) occur each year in the USA and Europe. Despite decades of investment and research, survival remains disappointingly low. We report the trends in survival after a ventricular fibrillation/pulseless ventricular tachycardia OHCA, over a 13-year period, in a French urban region, and describe the simultaneous evolution of the rescue system.

View Article and Find Full Text PDF

Metabolomics in clinical toxicology aim at reliably identifying and semi-quantifying a broad array of endogenous and exogenous metabolites using dedicated analytical methods. Here, we developed a three-step-based workflow to investigate the metabolic impact of the antidepressant drug venlafaxine in a poisoned patient who developed life-threatening cardiac failure managed with extracorporeal membrane oxygenation. Both targeted quantitative and untargeted semi-quantitative metabolomic analyses using liquid chromatography hyphenated to high-resolution tandem mass spectrometry were performed to determine the plasma kinetics of venlafaxine, -desmethyl-venlafaxine, and -desmethyl-venlafaxine and to identify sixteen different venlafaxine-derived metabolites including one unknown (, venlafaxine conjugated to a hexosyl-radical), respectively.

View Article and Find Full Text PDF

Background: Despite multimodal assessment (clinical examination, biology, brain MRI, electroencephalography, somatosensory evoked potentials, mismatch negativity at auditory evoked potentials), coma prognostic evaluation remains challenging.

Methods: We present here a method to predict the return to consciousness and good neurological outcome based on classification of auditory evoked potentials obtained during an oddball paradigm. Data from event-related potentials (ERPs) were recorded noninvasively using four surface electroencephalography (EEG) electrodes in a cohort of 29 post-cardiac arrest comatose patients (between day 3 and day 6 following admission).

View Article and Find Full Text PDF

Background: Recent guidelines have emphasized actively avoiding fever to improve outcomes in patients who are comatose following resuscitation from cardiac arrest (ie, out-of-hospital cardiac arrest). However, whether targeted temperature management between 32 °C and 36 °C (TTM32-36) can improve neurologic outcome in some patients remains debated.

Research Question: Is there an association between the use of TTM32-36 and outcome according to severity assessed at ICU admission using a previously derived risk score?

Study Design And Methods: Data prospectively collected in the Sudden Death Expertise Center (SDEC) registry (France) between May 2011 and December 2017 and in the Resuscitation Outcomes Consortium Continuous Chest Compressions (ROC-CCC) trial (United States and Canada) between June 2011 and May 2015 were used for this study.

View Article and Find Full Text PDF
Article Synopsis
  • Head CT is a recommended method for predicting outcomes after cardiac arrest, but there is no standardized assessment system for diagnosing hypoxic-ischaemic encephalopathy (HIE).
  • The study is part of an international trial (TTM2) aiming to evaluate CT images of patients who are still unconscious 48 hours after cardiac arrest, using a standardized protocol to assess HIE severity and related brain function.
  • The outcomes will be measured through functional assessments at six months post-arrest, and findings will help establish reliable criteria for using CT in neuroprognostication after cardiac arrest.
View Article and Find Full Text PDF
Article Synopsis
  • ECLS (Extracorporeal Life Support) can enhance circulation in severe cases of cardiac dysfunction or arrest, particularly in patients poisoned by cardiotoxic substances.
  • The review focused on specific drugs, especially antiarrhythmics and aluminium phosphide, analyzing literature from the past 30 years and finding mostly single case reports with limited controlled studies.
  • While ECLS showed better survival rates in refractory cardiovascular failure (about 80%) compared to cardiac arrest (25%-66%), clearer selection criteria for its use in poisoned patients are needed due to the low-to-moderate evidence quality.
View Article and Find Full Text PDF
Article Synopsis
  • ICU admission decisions for elderly COVID-19 patients are complex, influenced by potential patient-centered benefits and often involve discussions about limiting therapeutic efforts (LTE), which have been understudied.
  • A study was conducted with 82 patients aged 70 and above, highlighting that 27% had early LTE discussions, which were more common in older and frailer patients; however, this did not correlate with higher in-hospital mortality rates.
  • Early LTE discussions led to significantly reduced use of invasive procedures and shorter ICU stays, suggesting that such discussions may optimize care for elderly patients without increasing mortality risks, but further research is necessary to confirm these findings.
View Article and Find Full Text PDF
Article Synopsis
  • Many young people who have sudden cardiac arrest (SCA) and die in the hospital don’t have a clear reason why it happened.
  • Researchers looked at over 4,000 patients and found that a lot of tests weren't done to figure out the cause in those young patients.
  • Doing more early tests can help doctors understand SCA better and could prevent similar cases in families.
View Article and Find Full Text PDF

Context: Since recovery or death is generally observed within a few days after intensive care unit (ICU) admission of self-poisoned patients in the developed countries, reasons for the prolonged ICU stay are of interest as they have been poorly investigated. We aimed to identify the characteristics, risk factors, outcome, and predictors of death in self-poisoned patients requiring prolonged ICU management.

Methods: We conducted an eight-year single-center cohort study including all self-poisoned patients who stayed at least seven days in the ICU.

View Article and Find Full Text PDF
Article Synopsis
  • * Out of 1,359 ICU patients, 372 received echocardiography, which was more common in those with cardiac issues, revealing lower heart function metrics compared to other patients.
  • * Overall, early echocardiography did not significantly impact survival rates for all ICU patients, but it did improve one-year survival rates for those admitted specifically for cardiac conditions.
View Article and Find Full Text PDF

Introduction: Coronavirus disease-2019 (COVID-19) may lead to acute respiratory distress syndrome requiring extracorporeal membrane oxygenation (ECMO). Patterns of inflammatory bronchoalveolar cells in COVID-19 patients treated with ECMO are not well described.

Objective: We aimed to describe inflammatory cell subpopulations in blood and bronchoalveolar lavages (BALs) obtained in critically ill COVID-19 patients shortly after ECMO implementation.

View Article and Find Full Text PDF

Medical imaging plays a major role in coronavirus disease-2019 (COVID-19) patient diagnosis and management. However, the radiation dose received from medical procedures by these patients has been poorly investigated. We aimed to estimate the cumulative effective dose (CED) related to medical exposure in COVID-19 patients admitted to the intensive care unit (ICU) in comparison to the usual critically ill patients.

View Article and Find Full Text PDF

Purpose: Whether epinephrine or norepinephrine is preferable as the continuous intravenous vasopressor used to treat post-resuscitation shock is unclear. We assessed outcomes of patients with post-resuscitation shock after out-of-hospital cardiac arrest according to whether the continuous intravenous vasopressor used was epinephrine or norepinephrine.

Methods: We conducted an observational multicenter study of consecutive patients managed in 2011-2018 for post-resuscitation shock.

View Article and Find Full Text PDF

Objective: COVID-19 is associated with an increased prevalence of deep venous thrombosis (DVT), mainly in the lower limbs. However, the characteristics and rheological conditions, which contribute to facilitating DVT occurrence have been poorly investigated. We aimed to report DVT characteristics, vein diameters and peak blood flow velocities (PBFV) in the common femoral veins (CFVs) of critically ill COVID-19 patients.

View Article and Find Full Text PDF