Publications by authors named "Julio Badie"
Introduction: First-line oxygenation strategy in patients with acute hypoxaemic respiratory failure consists in standard oxygen or high-flow nasal oxygen therapy. Clinical practice guidelines suggest the use of high-flow nasal oxygen rather than standard oxygen. However, findings remain contradictory with a low level of certainty.
View Article and Find Full Text PDFBackground: POINCARE-2 trial aimed to assess the effectiveness of a strategy designed to tackle fluid overload through daily weighing and subsequent administration of treatments in critically ill patients. Even in highly standardized care settings, such as intensive care units, effectiveness of such a complex intervention depends on its actual efficacy but also on the extent of its implementation. Using a process evaluation, we aimed to provide understanding of the implementation, context, and mechanisms of change of POINCARE-2 strategy during the trial, to gain insight on its effectiveness and inform the decision regarding the dissemination of the intervention.
View Article and Find Full Text PDFBackground: 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.
View Article and Find Full Text PDFPurpose: The effect of renal replacement therapy (RRT) in comatose patients with acute kidney injury (AKI) remains unclear. We compared two RRT initiation strategies on the probability of awakening in comatose patients with severe AKI.
Methods: We conducted a post hoc analysis of a trial comparing two delayed RRT initiation strategies in patients with severe AKI.
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.
Background: Intention-to-treat analyses of POINCARE-2 trial led to inconclusive results regarding the effect of a conservative fluid balance strategy on mortality in critically ill patients. The present as-treated analysis aimed to assess the effectiveness of actual exposure to POINCARE-2 strategy on 60-day mortality in critically ill patients.
Methods: POINCARE‑2 was a stepped wedge randomized controlled trial.
Article Synopsis
- The study investigates the impact of socio-economic status on respiratory issues in survivors of ARDS due to COVID-19, finding that 40% of patients were socio-economically deprived.
- After a follow-up of 6 months post-ICU, 80% of the 401 patients showed respiratory issues, but socio-economic status did not significantly affect the prevalence of these complications.
- The results suggest that, regardless of socio-economic background, the majority of ARDS survivors experienced respiratory sequelae, indicating the widespread impact of COVID-19 on lung health.
Background: Activation of the TREM-1 pathway is associated with outcome in life threatening COVID-19. Data suggest that modulation of this pathway with nangibotide, a TREM-1 modulator may improve survival in TREM-1 activated patients (identified using the biomarker sTREM-1).
Methods: Phase 2 double-blind randomized controlled trial assessing efficacy, safety, and optimum treatment population of nangibotide (1.
Article Synopsis
- 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.
Article Synopsis
- A phase 3 clinical trial investigated if intravenous hydrocortisone could reduce mortality in patients with severe community-acquired pneumonia compared to a placebo.
- The study involved 800 patients, and results showed that those receiving hydrocortisone had a significantly lower death rate (6.2%) at 28 days versus 11.9% in the placebo group.
- Additionally, patients on hydrocortisone required less mechanical ventilation and vasopressors compared to those on placebo, with similar rates of hospital-acquired infections and bleeding risks.
Article Synopsis
- The RECORDS trial investigates how different adult patients with sepsis respond to corticosteroids by categorizing them into distinct groups based on their likelihood of responding to treatment.
- It is a large, placebo-controlled study that includes 1800 adults with conditions like pneumonia and septic shock, randomly assigning them to receive either corticosteroids or placebo for 7 to 10 days.
- The primary goal is to assess the impact of corticosteroids on mortality and organ dysfunction after 90 days, with the findings expected to be shared at conferences and published in scientific journals.
Background: In critically ill patients, positive fluid balance is associated with excessive mortality. The POINCARE-2 trial aimed to assess the effectiveness of a fluid balance control strategy on mortality in critically ill patients.
Methods: POINCARE-2 was a stepped wedge cluster open-label randomized controlled trial.
Article Synopsis
- The study examines the effectiveness of high-flow nasal cannula oxygen compared to standard oxygen in reducing mortality and the need for intubation in COVID-19 patients experiencing respiratory failure in ICUs.
- Conducted across 34 ICUs in France, the SOHO-COVID trial involved 711 patients, randomly assigned to receive either high-flow oxygen or standard oxygen.
- Results showed no significant difference in mortality rates at day 28 between the two groups, with 10% mortality for high-flow and 11% for standard oxygen, suggesting both methods are similarly effective.
Introduction: Refractory septic shock (RSS) is characterized by high vasopressor requirements, as a consequence of vasopressor resistance, which may be caused or enhanced by sympathetic hyperactivation. Experimental models and clinical trials show a reduction in vasopressor requirements and improved microcirculation compared to conventional sedation. Dexmedetomidine did not reduce mortality in clinical trials, but few septic shock patients were enrolled.
View Article and Find Full Text PDFBackground: Stress hyperglycemia can persist during an intensive care unit (ICU) stay and result in prolonged requirement for insulin (PRI). The impact of PRI on ICU patient outcomes is not known. We evaluated the relationship between PRI and Day 90 mortality in ICU patients without previous diabetic treatments.
View Article and Find Full Text PDFArticle Synopsis
- * A new multicentre study, called RECOVIDS, aims to explore how social vulnerability impacts recovery in patients who were hospitalized for ARDS related to COVID-19, incorporating both quantitative measurements and qualitative insights into patient experiences.
- * The study will examine patients admitted to intensive care for severe COVID-19 and track their lung health six months post-discharge, focusing on identifying lung sequelae through various tests and assessing the role of socio-economic status in their rehabilitation process.
Background: Intermittent hemodialysis (IHD) and continuous renal replacement therapy (CRRT) are the two main RRT modalities in patients with severe acute kidney injury (AKI). Meta-analyses conducted more than 10 years ago did not show survival difference between these two modalities. As the quality of RRT delivery has improved since then, we aimed to reassess whether the choice of IHD or CRRT as first modality affects survival of patients with severe AKI.
View Article and Find Full Text PDFArticle Synopsis
- Tocilizumab trials show mixed results partly due to the diverse patient populations involved.
- A meta-analysis included nine studies, revealing a lower mortality rate in the tocilizumab group (24.5%) compared to the control group (29.1%), particularly for severe COVID-19 patients.
- The study concludes that tocilizumab effectively improves survival and reduces the need for mechanical ventilation in hospitalized COVID-19 patients, especially those with severe cases.
Background: We investigated the impact of the COVID-19 crisis on mental health of professionals working in the intensive care unit (ICU) according to the intensity of the epidemic in France.
Methods: This cross-sectional survey was conducted in 77 French hospitals from April 22 to May 13 2020. All ICU frontline healthcare workers were eligible.
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.
View Article and Find Full Text PDFArticle Synopsis
- The study explored whether delaying renal replacement therapy (RRT) initiation in critically ill patients with severe acute kidney injury could lead to more days without the need for RRT.
- Conducted in 39 intensive care units in France, the trial randomized 278 patients into two groups: an immediate RRT group and a more-delayed group that only started RRT based on specific clinical indicators.
- Results showed similar complications and a median of 12 RRT-free days for the delayed group compared to 10 days for the more-delayed group, leading to a conclusion that delaying RRT does not significantly enhance patient outcomes.
Importance: Coronavirus disease 2019 (COVID-19) is associated with severe lung damage. Corticosteroids are a possible therapeutic option.
Objective: To determine the effect of hydrocortisone on treatment failure on day 21 in critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and acute respiratory failure.