The depth of neuromuscular blockade is not related to chest wall elastance and respiratory mechanics in moderate to severe acute respiratory distress syndrome patients. A prospective cohort study.

Background: Data concerning the depth of neuromuscular blockade (NMB) required for effective relaxation of the respiratory muscles in ARDS are scarce. We hypothesised that complete versus partial NMB can modify respiratory mechanics.

Method: Prospective study to compare the respiratory mechanics of ARDS patients according to the NMB depth.

Prediction of pulmonary aspergillosis in patients with ventilator-associated pneumonia.

Background: Predictors of ICU-acquired pulmonary aspergillosis (IPA) are not well-established in critically ill patients with ventilator-associated pneumonia (VAP), making IPA commonly misdiagnosed and anti-fungal therapy delayed. We aimed to develop a clinical score for prediction of IPA among patients with VAP.

Methods: Mechanically ventilated patients who developed VAP in 4 ICUs in Bretagne, Western France, were included.

Treating Acute Severe Eosinophilic Asthma with IL-5 Inhibitors in ICU.

Introduction: About 10% of the 300 million people worldwide who suffer from asthma have a severe disease that is uncontrolled despite treatment with inhaled corticosteroids and long-acting beta agonists. The eosinophilic inflammation pathway in the respiratory tract and blood is involved and interleukin-5 (IL-5) has recently been identified as a major promotor of this pathway. The anti-IL-5 antibodies reduce the incidence of exacerbation and allowed steroid sparing in severe asthma patients but only two case reports have been published on their use in critical care.

Neuron-Specific Enolase Levels in Adults Under Venoarterial Extracorporeal Membrane Oxygenation.

Objectives: We aimed to determine if elevations in serum neuron-specific enolase are associated with brain injury and outcomes in adults who require venoarterial extracorporeal membrane oxygenation.

Design: Prospective observational study.

Setting: Two ICUs of a university hospital, Paris, France.

Impact of Loading Dose of Caspofungin in Pharmacokinetic-Pharmacodynamic Target Attainment for Severe Candidiasis Infections in Patients in Intensive Care Units: the CASPOLOAD Study.

This study evaluated the impact of a high loading dose of caspofungin (CAS) on the pharmacokinetics of CAS and the pharmacokinetic-pharmacodynamic (PK-PD) target attainment in patients in intensive care units (ICU). ICU patients requiring CAS treatment were prospectively included to receive a 140-mg loading dose of CAS. Plasma CAS concentrations (0, 2, 3, 5, 7, and 24 h postinfusion) were determined to develop a two-compartmental population PK model.

Early EEG for Prognostication Under Venoarterial Extracorporeal Membrane Oxygenation.

Background/objectives: Tools for prognostication of neurologic outcome of adult patients under venoarterial ECMO (VA-ECMO) have not been thoroughly investigated. We aimed to determine whether early standard electroencephalography (EEG) can be used for prognostication in adults under VA-ECMO.

Methods: Prospective single-center observational study conducted in two intensive care units of a university hospital, Paris, France.

Semi-quantitative cultures of throat and rectal swabs are efficient tests to predict ESBL-Enterobacterales ventilator-associated pneumonia in mechanically ventilated ESBL carriers.

Purpose: In ICU patients with carriage of extended spectrum beta-lactamase producing Enterobacterales (ESBL-E) and suspected Gram-negative bacilli ventilator-associated pneumonia (GNB-VAP), the quantification of the rectal and throat ESBL-E carriage might predict the ESBL-E involvement in GNB-VAP. Our aim was to evaluate whether a semi-quantitative assessment of rectal/throat ESBL-E carriage can predict ESBL-E-associated VAP in medical ICU patients.

Methods: From May 2014 to May 2017, all ESBL-E carriers had a semi-quantitative assessment of ESBL-E density in swabs cultures.

Impact of natural light exposure on delirium burden in adult patients receiving invasive mechanical ventilation in the ICU: a prospective study.

Objective: To determine whether potential exposure to natural light via windows is associated with reduced delirium burden in critically ill patients admitted to the ICU in a single room.

Design: Prospective single-center study.

Setting: Medical ICU of a university hospital, Paris, France.

The Effects of Photobiomodulation on Inflammatory Infiltrate During Muscle Repair in Advanced-Age Rats.

Photobiomodulation (PBM) enhances muscle repair in aged animals, but its effect on the modulation of the phenotype of immune cells has not yet been determined. Rats (20-month-old) were submitted to cryoinjury of the tibialis anterior muscle and were treated with PBM. After 1, 3, and 7 days, the muscles were submitted to immunohistochemical analysis for the determination of neutrophils and macrophage phenotypes.

Infrared Laser Improves Collagen Organization in Muscle and Tendon Tissue During the Process of Compensatory Overload.

Background: The photobiomodulation using the low-level laser therapy (LLLT) exerts a positive modulating effect on the synthesis of collagen in skeletal muscles and tendons. However, few studies have addressed this effect during the compensatory overload.

Objective: Evaluate the effect of infrared laser on the deposition and organization of collagen fibers in muscle and tendon tissue during compensatory overload of the plantar muscle in rats.

Early Electroencephalography Findings in Cardiogenic Shock Patients Treated by Venoarterial Extracorporeal Membrane Oxygenation.

Objectives: We aimed to assess early electroencephalography findings in patients treated by venoarterial extracorporeal membrane oxygenation and their association with neurologic outcome.

Design: Single-center observational study.

Setting: Medical ICU of a university hospital.

Early impairment of intracranial conduction time predicts mortality in deeply sedated critically ill patients: a prospective observational pilot study.

Background: Somatosensory (SSEP) and brainstem auditory (BAEP) evoked potentials are neurophysiological tools which, respectively, explore the intracranial conduction time (ICCT) and the intrapontine conduction time (IPCT). The prognostic values of prolonged cerebral conduction times in deeply sedated patients have never been assessed. Sedated patients are at risk of developing new neurological complications, undetected.

Systematic overdosing of oxa- and cloxacillin in severe infections treated in ICU: risk factors and side effects.

Background: Oxacillin and cloxacillin are the most frequently used penicillins for the treatment of severe methicillin-susceptible Staphylococcus aureus infections in intensive care units (ICUs), especially endocarditis. International recommendations do not suggest any adaptation of the dosage in case of renal impairment. We wanted to assess the risk factors for overdosing in ICU and the related observed side effects.

Central nervous system infections in immunocompromised patients.

Purpose Of Review: Although rare, central nervous system (CNS) infections are increasingly being recognized in immunocompromised patients. The goal of the present review is to provide a practical diagnostic approach for the intensivist, and to briefly discuss some of the most prevalent conditions.

Recent Findings: Immunocompromised patients presenting with new neurological symptoms should always be suspected of a CNS infection.

Anti-N-Methyl-d-Aspartate Receptor Encephalitis in Adult Patients Requiring Intensive Care.

Rationale: Encephalitis caused by anti-N-methyl-d-aspartate receptor (NMDAR) antibodies is the leading cause of immune-mediated encephalitis. There are limited data on intensive care unit (ICU) management of these patients.

Objectives: To identify prognostic factors of good neurologic outcome in patients admitted to an ICU with anti-NMDAR encephalitis.

Early Standard Electroencephalogram Abnormalities Predict Mortality in Septic Intensive Care Unit Patients.

Introduction: Sepsis is associated with increased mortality, delirium and long-term cognitive impairment in intensive care unit (ICU) patients. Electroencephalogram (EEG) abnormalities occurring at the acute stage of sepsis may correlate with severity of brain dysfunction. Predictive value of early standard EEG abnormalities for mortality in ICU septic patients remains to be assessed.

Determinants of recovery from severe posterior reversible encephalopathy syndrome.

Objective: Few outcome data are available about posterior reversible encephalopathy syndrome (PRES). We studied 90-day functional outcomes and their determinants in patients with severe PRES.

Design: 70 patients with severe PRES admitted to 24 ICUs in 2001-2010 were included in a retrospective cohort study.