Publications by authors named "Louai Missri"

Background: Therapeutic plasma exchanges (TPE), which affect the humoral response, are often performed in combination with immunosuppressive drugs. For this reason, TPE may be associated with an increased susceptibility to infections. We aimed to describe blood stream infection (BSI) incidence in ICU patients treated with TPE and to identify associated risk factors.

View Article and Find Full Text PDF
Article Synopsis
  • Platelet transfusions are commonly administered in ICUs for patients with low platelet counts (thrombocytopenia), but the specific practices and their outcomes are not well-documented.
  • In a study of 504 ICU patients across Europe and the U.S., 20.8% received platelet transfusions, primarily using pooled products, with varying practices in dosage and volume across different countries.
  • The research found that while platelet transfusions are frequent, they provide limited increases in platelet counts, indicating potential inconsistencies in their effectiveness and administration practices.
View Article and Find Full Text PDF

Background: Suspected upper gastrointestinal bleeding (SUGIB) is a common issue during ICU stay. In the absence of specific guidelines on the indication and timing of esophagogastroduodenoscopy (EGD), there is substantial variability in EGD indication depending on accessibility and clinical presentation. This study aimed to investigate factors associated with the need for per-EGD hemostatic therapy and to create a score predicting therapeutic benefit of emergency bedside EGD in ICU patients with SUGIB.

View Article and Find Full Text PDF

Background: Albumin has potential endothelial protective effects through antioxidant and anti-inflammatory properties. However, the effect of albumin on peripheral tissue perfusion in human sepsis remains poorly known.

Methods: Bi-centric prospective study included patients with sepsis with or without shock and prolonged CRT > 3 s despite initial resuscitation.

View Article and Find Full Text PDF

Background: Out-of-plane (OOP) approach is frequently used for ultrasound-guided insertion of central venous catheter (CVC) owing to its simplicity but does not avoid mechanical complication. In-plane (IP) approach might improve safety of insertion; however, it is less easy to master. We assessed, a homemade needle guide device aimed to improve CVC insertion using IP approach.

View Article and Find Full Text PDF

Background: Extubation failure is associated with increased mortality. Cough ineffectiveness may be associated with extubation failure, but its quantification for patients undergoing weaning from invasive mechanical ventilation (IMV) remains challenging.

Methods: Patients under IMV for more than 24 h completing a successful spontaneous T-tube breathing trial (SBT) were included.

View Article and Find Full Text PDF

Purpose: Bleeding risk evaluation of thrombocytopenic patients admitted in ICU has been poorly investigated.

Methods: A prospective observational study conducted in an 18-bed medical ICU. Consecutive patients with thrombocytopenia (<150 Giga/L) and no bleeding at admission were included.

View Article and Find Full Text PDF

Background: Data are scarce regarding epidemiology and management of critically ill patients with lung abscesses.

Research Question: What are the clinical and microbiological characteristics of critically ill patients with lung abscesses, how are they managed in the ICU, and what are the risk factors of in-ICU mortality?

Study Design And Methods: This was a retrospective observational multicenter study, based on International Classification of Diseases, 10th Revision, codes, between 2015 and 2022 in France. In-ICU mortality-associated factors were determined by multivariate logistic regression.

View Article and Find Full Text PDF

Background: Immunosuppressors (IS) such as Dexamethasone (DXM), Tocilizumab, and high-dose methylprednisolone boli (HDMB), are used in COVID-19-related acute respiratory distress syndrome (ARDS). This study aimed to determine whether COVID-19 ARDS-related combined IS therapy was associated with an increased incidence of ICU-acquired pneumonia (IAP).

Methods: We retrospectively analyzed COVID-19-ARDS admitted to ICU from March 2020 to April 2022.

View Article and Find Full Text PDF

Background: Immune-mediated thrombotic thrombocytopenic purpura (iTTP) is a rare disease characterized by arteriolar and capillary microthrombosis precipitating organ failure. However, the contribution of endothelial dysfunction on impaired microvascular blood flow in iTTP patients has been poorly explored. This pilot observational study aimed to explore endothelial-mediated vasoreactivity in iTTP patients at admission and its changes after plasma exchange therapy (PE).

View Article and Find Full Text PDF

ACUTE RESPIRATORY FAILURE IN THE ELDERLY PATIENTS Acute respiratory failure (ARF) requiring an admission in intensive care unit in the old patients presents specific characteristics that must be considered for diagnosis, treatment and prognosis. Old patients are at increased risk of ARF after any assault. It is imperative to assess the prognosis of an old patient requiring invasive treatment in the ICU f or an ARF.

View Article and Find Full Text PDF

Background: Capillary refill time (CRT) is a valuable tool for triage and to guide resuscitation. However, little is known about CRT kinetics after fluid infusion.

Methods: We conducted a prospective observational study in a tertiary teaching hospital.

View Article and Find Full Text PDF

PRIORISATION OF OLD CRITICALLY-ILL PATIENTS FOR AN ICU ADMISSION There are currently no national or international recommendations for admission decisions to an intensive care unit (icu) for patients over 80 years of age. The decision, whether, or not to admit an elderly patient to intensive care is probably one of the most difficult decisions for an intensivist with the double risk of loss of chance in the event of refusal or non-beneficial care in the event of acceptance. Doubt should always benefit the patient with icu admission in case of prognosis uncertainty.

View Article and Find Full Text PDF

Extra-European studies report high rates of multi-drug resistant bacteria colonization of healthcare workers' mobile phones in intensive care units. We aimed to assess the prevalence of bacterial colonization of healthcare workers' mobile phones in an intensive care unit in France and the effectiveness of a sanitization product. We designed a prospective, monocentric study in a 15-bed intensive care unit within a 300-bed private hospital.

View Article and Find Full Text PDF