Publications by authors named "J Y LeFrant"

Introduction: Intensive care unit (ICU) patients under mechanical ventilation experience mild-to-severe pain. International guidelines emphasise the importance and benefits of multimodal analgesia to minimise opioid consumption and its side effects. However, no recommendation about drugs or protocol has been formulated.

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Article Synopsis
  • A multicenter study evaluated the impact of a restrictive fluid strategy versus a standard fluid strategy in ICU patients with septic shock, aiming to minimize fluid intake to avoid complications from positive fluid balance.
  • By analyzing 48 patients over 5 days, the restrictive group received significantly less fluid (89.7 ml/kg vs. 114.3 ml/kg), resulting in a smaller cumulative fluid balance.
  • However, after 28 days, both groups showed similar mortality and survival without life support, indicating no clear benefits of the restrictive strategy despite differences in fluid management during the initial week.
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Background: During central venous catheterization (CVC), ultrasound (US) guidance has been shown to reduce mechanical complications and increase success rates compared to the anatomical landmark (AL) technique. However, the impact of US guidance on catheter-related infections remains controversial. This systematic review and meta-analysis aimed to compare the risk of catheter-related infection with US-guided CVC versus AL technique.

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Clinical pharmacy is a fast-growing discipline in Europe, ensuring optimisation and a guarantee of safety in therapeutic management. Within a hospital the intensive care unit (ICU) typically admits the most severely ill patients who require expensive medications. These patients may be at risk for potentially serious adverse events, especially when medication errors occur.

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Introduction: The maximal norepinephrine (NE) dose >1 μg/kg/min during circulatory shock apparently is associated with higher mortality, but this threshold needs confirmation. This study aimed at investigating whether NE infusion at a dose >1 μg/kg/min could predict early intensive care unit (ICU) mortality (first 5 days). The secondary objective was to assess the day-by-day relationship between NE dose during the first 4 days of ICU stay and subsequent mortality.

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