Publications by authors named "Fabien Lambiotte"

Article Synopsis
  • The study investigates the experiences of ICU healthcare professionals regarding controlled donation after circulatory death (cDCD), amid ethical concerns between end-of-life care and organ donation.
  • Conducted in 32 ICUs in France, the study surveyed 206 physicians and nurses after the deaths of patients considered potential cDCD donors, measuring their anxiety levels and feelings of tension related to the donation process.
  • Results show that cDCD does not significantly increase anxiety for healthcare professionals compared to regular end-of-life situations, with a general positive perception of cDCD among them, suggesting a need for better support in balancing life support decisions and organ donation.
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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.

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Background: Critical-illness survivors may experience post-traumatic stress disorder (PTSD) and quality-of-life impairments. Resilience may protect against psychological trauma but has not been adequately studied after critical illness. We assessed resilience and its associations with PTSD and quality of life, and also identified factors associated with greater resilience.

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  • A study was conducted across 49 ICUs in France to investigate the clinical outcomes and severity of severe Pneumocystis jirovecii pneumonia (PJP), focusing on how delayed antibiotic treatment and corticosteroid therapy affect patient survival.
  • The study included 158 patients, mainly admitted due to acute respiratory failure, and found high mortality rates (31.6% in ICU, 40.5% at 6 months), with delayed antibiotic treatment beyond 96 hours linked to a significantly higher risk of death.
  • The results indicate that most patients did not receive preventive antibiotic therapy before needing intensive care, and both delayed antibiotic treatment and the use of corticosteroids worsened mortality rates in those with severe PJP.
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Background: The intravenous form of fosfomycin, a bactericide antibiotic used to treat multiresistant bacterial infections is little prescribed. The most common reported adverse effects are hypokaliemia and hypernatremia. We describe a case of agranulocytosis, a rarely described side effect that may be fatal.

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Background: Hyperglycaemia is common in critically ill patients, but blood glucose and insulin management may differ widely among intensive care units (ICUs). We aimed to describe insulin use practices and the resulting glycaemic control in French ICUs. We conducted a multicentre 1-day observational study on November 23, 2021, in 69 French ICUs.

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  • A study called the NUTRIREA-3 trial explored whether lower calorie and protein intake during the early treatment of critically ill patients could lead to better outcomes compared to standard nutrition guidelines.
  • Conducted in 61 ICUs across France, the trial involved over 3,000 patients who received either low or standard nutrition after being put on mechanical ventilation for shock.
  • Results showed no significant difference in 90-day mortality rates but indicated that patients on the low nutrition plan had a slightly quicker ICU discharge time and experienced fewer gastrointestinal issues and liver dysfunction.
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  • Ventilator-associated pneumonia (VAP) frequently affects patients with severe COVID-19 who are on mechanical ventilation, prompting this study to examine how corticosteroids might influence VAP risk.
  • A multicenter study analyzed data from 545 patients in 36 ICUs to determine if corticosteroid use impacted VAP incidence, finding that the relationship varied after 48 hours of mechanical ventilation.
  • Overall, no significant link was established between corticosteroid treatment and VAP, though the effect seemed to shift over time during the ICU stay.
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Background: Little information is available on current practice in beta-lactam dosing during continuous renal replacement therapy (CRRT). Optimized dosing is essential for improving outcomes, and there is no consensus on the appropriate dose regimens. The objective of the present study was to describe current practice for beta-lactam dosing during CRRT in intensive care units (ICUs).

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  • - This study aimed to compare the incidence of invasive pulmonary aspergillosis (IPA) in critically ill patients with COVID-19 versus those with influenza, using data from a large European cohort that included over 1,000 patients on mechanical ventilation for pneumonia.
  • - Results showed that the incidence of putative IPA was significantly lower in the COVID-19 group (2.5%) compared to the influenza group (6%), indicating that COVID-19 patients had a reduced risk for this fungal infection.
  • - The study also found that having putative IPA was linked to increased 28-day mortality and longer ICU stays, affirming its severity, but overall the incidence of IPA was low across both patient groups.
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Early empirical antimicrobial treatment is frequently prescribed to critically ill patients with coronavirus disease (COVID-19) based on Surviving Sepsis Campaign guidelines. We aimed to determine the prevalence of early bacterial identification in intubated patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia, as compared with influenza pneumonia, and to characterize its microbiology and impact on outcomes. A multicenter retrospective European cohort was performed in 36 ICUs.

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Background: Patients with SARS-CoV-2 infection are at higher risk for ventilator-associated pneumonia (VAP). No study has evaluated the relationship between VAP and mortality in this population, or compared this relationship between SARS-CoV-2 patients and other populations. The main objective of our study was to determine the relationship between VAP and mortality in SARS-CoV-2 patients.

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In late December 2019, SARS-CoV-2 was discovered, which is responsible for a new human disease called COVID-19. Among all laboratory-confirmed COVID-19 cases, 14% were hospitalized, with 2% admitted to intensive care units (ICU) with acute respiratory distress syndrome (ARDS) requiring mechanical ventilation [1]. SARS-CoV-2 has spread quickly across the world, with more than one hundred million confirmed cases and more than 2,500,000 dead.

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Introduction: International guidelines include early nutritional support (≤48 hour after admission), 20-25 kcal/kg/day, and 1.2-2 g/kg/day protein at the acute phase of critical illness. Recent data challenge the appropriateness of providing standard amounts of calories and protein during acute critical illness.

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Introduction: Coronavirus disease 2019 or COVID-19 is a new infectious disease responsible for potentially severe respiratory impairment associated with initial immunosuppression. Similarly to influenza, several authors have described a higher risk of fungal infection after COVID-19, in particular for invasive pulmonary aspergillosis. The main objective here is to define the prevalence of invasive pulmonary aspergillosis (IPA) in a cohort of COVID-19 patients with moderate to severe acute respiratory disease syndrome (ARDS).

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Purpose: Although patients with SARS-CoV-2 infection have several risk factors for ventilator-associated lower respiratory tract infections (VA-LRTI), the reported incidence of hospital-acquired infections is low. We aimed to determine the relationship between SARS-CoV-2 pneumonia, as compared to influenza pneumonia or no viral infection, and the incidence of VA-LRTI.

Methods: Multicenter retrospective European cohort performed in 36 ICUs.

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Objectives: Evaluation of the efficacy of empirical aminoglycoside in critically ill patients with bloodstream infections caused by extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-E BSI).

Methods: Patients treated between 2011 and 2018 for ESBL-E BSI in the ICU of six French hospitals were included in a retrospective observational cohort study. The primary endpoint was mortality on day 30.

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Purpose: To report the incidence, risk factors, clinical presentation, and outcome predictors of severe leptospirosis requiring intensive care unit (ICU) admission in a temperate zone.

Methods: LEPTOREA was a retrospective multicentre study conducted in 79 ICUs in metropolitan France. Consecutive adults admitted to the ICU for proven severe leptospirosis from January 2012 to September 2016 were included.

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Background: Despite the extensive use of high-flow nasal cannula (HFNC) therapy in intensive care units (ICU) for acute respiratory failure (ARF), its daily clinical practice has not been assessed. We designed a regional survey in ICUs in North-west France to evaluate ICU physicians' clinical practice with HFNC.

Materials And Methods: We sent an observational survey to ICU physicians from 34 French ICUs over a 6-month period in 2016-2017.

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Introduction: Current severity-of-illness indexes are unable to assess the long-term prognosis of patients requiring prolonged mechanical ventilation. A prognostic scoring system (Prognosis for Prolonged Ventilation score - ProVent - score) seems able to evaluate one-year mortality of such patients. However, testing of the model outside the developers' centers has not been reported.

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Introduction: Although prompt initiation of appropriate antifungal therapy is essential for the control of invasive Candida infections and an improvement of prognosis, early diagnosis of invasive candidiasis remains a challenge and criteria for starting empirical antifungal therapy in ICU patients are poorly defined. Some scoring systems, such as the "Candida score" could help physicians to differentiate patients who could benefit from early antifungal treatment from those for whom invasive candidiasis is highly improbable. This study evaluated the performance of this score in a cohort of critically ill patients.

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Background: A veterinary euthanasia drug containing embutramide, mebezonium, tetracaine, and dimethylformamide (DMF; T-61® or Tanax®) may cause serious manifestations or even fatalities after self-poisoning. Immediate toxicity is mainly due to a general anesthetic and due to a neuromuscular blocking agent, while delayed hepatotoxicity seems related to the solvent DMF. The protective role of N-acetylcysteine (NAC) administration remains debatable.

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