Publications by authors named "Mayaux J"
Near Infrared Spectroscopy (NIRS) is a non-invasive optical technique allowing a continuous measurement of brain's hemoglobin (Hb) saturation in oxygen (rSO2). It is a marker of cerebral insult and rSO2 < 50% is associated with increased neurological impairment. Cirrhotic patients with gastrointestinal bleeding (GIB) often develop hepatic encephalopathy (HE).
View Article and Find Full Text PDFPurpose: The pathogenesis of life-threatening coronavirus disease 2019 (COVID-19) pneumonia in ICU patients can involve pre-existing auto-antibodies (auto-Abs) neutralizing type I interferons (IFNs). The impact of these auto-Abs on SARS-CoV-2 clearance in the lower respiratory tract (LRT) is unclear.
Methods: We performed a retrospective study in 99 ICU patients with COVID-19 pneumonia between March and May 2020.
Article Synopsis
- In critically ill patients, deep sedation and mechanical ventilation can lead to cognitive issues by suppressing the brain-diaphragm-lung interactions.
- This study explored whether phrenic nerve stimulation could improve brain activity and connectivity in six patients with acute respiratory distress syndrome.
- Results showed that phrenic stimulation, combined with mechanical ventilation, enhanced brain activity and synchronization similar to what occurs during natural diaphragmatic breathing, indicating its potential to restore important neural communication.
Background: Gastrointestinal (GI) bleeding is a leading cause of intensive care unit (ICU) admission in pancreatic cancer patients.
Aims: To analyze causes, ICU mortality and hemostatic treatment success rates of GI bleeding in pancreatic cancer patients requiring ICU admission.
Methods: Retrospective multicenter cohort study between 2009 and 2021.
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.
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- Severe thrombotic antiphospholipid syndrome (APS) significantly affects critical organs and has not been thoroughly studied in ICU patients, particularly regarding hematological issues.
- A retrospective study in France tracked 134 APS patients in ICUs, revealing high rates of anemia (95%) and thrombocytopenia (93%), with low platelet counts linked to increased mortality.
- The findings highlight the importance of understanding the causes of thrombocytopenia in APS patients, as conditions like thrombotic microangiopathy (TMA), heparin-induced thrombocytopenia (HIT), and disseminated intravascular coagulation (DIC) are prevalent in this population.
Outcomes in Critically Ill Allogeneic Hematopoietic Stem-Cell Transplantation Recipients.
Am J Respir Crit Care Med
October 2024
Article Synopsis
- A study examined the mortality and factors affecting outcomes for 1,164 patients who underwent allogeneic hematopoietic stem-cell transplantation and were admitted to ICUs in France from 2015 to 2020.
- The findings revealed a 90-day mortality rate of 48%, with higher risks linked to age, time from transplant to ICU admission, and the need for invasive treatments like vasopressors and mechanical ventilation.
- Despite high mortality rates, many critically ill patients who received intensive care did survive their ICU stays, prompting the need for a careful evaluation of treatment options for those with multiple risk factors.
Background: Morphine relieves dyspnea in various clinical circumstances. Whether or not this applies to patients admitted to intensive care units (ICUs) for acute respiratory failure (ARF) is unknown. We evaluated the efficacy and safety of low-dose morphine on dyspnea in patients admitted to the ICU for ARF.
View Article and Find Full Text PDFBackground: Alongside the recent worldwide expansion of hypervirulent Klebsiella pneumoniae (KP) infections, the available literature regarding cases of community acquired pneumonias (KP-CAP) remains scarce but reports a strikingly high and early mortality. We performed a retrospective multicenter study (7 ICU in France) between 2015 and 2019, comparing prognosis and severity of KP-CAP versus Streptococcus pneumoniae - CAP (SP-CAP).
Methods: For each KP-CAP, three SP-CAP admitted in ICUs within the same center and within the same 6-month window were selected.
Article Synopsis
- This study investigates COVID-19-associated pulmonary aspergillosis (CAPA) among critically ill patients during the Omicron variant wave, finding it affects 5.1% of patients and 9.1% of those on invasive mechanical ventilation.
- CAPA patients showed higher rates of immunosuppression and required more intensive care measures, like vasopressors and renal therapy, compared to non-CAPA patients.
- While CAPA did not significantly impact day-28 mortality, it was linked to longer mechanical ventilation and ICU stays, suggesting a shift in outcomes with emerging SARS-CoV-2 variants.
Article Synopsis
- - The STROMA-CoV-2 study evaluated the effects of umbilical cord-derived mesenchymal stromal cells (UC-MSCs) on patients with severe respiratory issues from SARS-CoV-2, finding no significant effectiveness despite good safety results after 28 days.
- - An extended follow-up assessed the long-term safety and health outcomes of UC-MSC administration in the same patient cohort at 6 and 12 months post-hospital discharge, focusing on various health metrics.
- - Results indicated a favorable safety profile with no significant differences between UC-MSC and placebo groups, although some patients experienced lingering lung issues and declines in quality of life over the year.
Acute respiratory failure (ARF) is a leading cause, along with sepsis, of admission to the intensive care unit (ICU) of patients with active cancer. Presenting variable clinical severity, ARF in onco-hematological patients has differing etiologies, primarily represented by possibly opportunistic acute infectious pneumonia (de novo hypoxemic ARF), and decompensation in chronic cardiac or respiratory diseases (e.g.
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.
Background: Lung protective ventilation aims at limiting lung stress and strain. By reducing the amount of pressure transmitted by the ventilator into the lungs, diaphragm neurostimulation offers a promising approach to minimize ventilator-induced lung injury. This study investigates the physiologic effects of diaphragm neurostimulation in acute respiratory distress syndrome (ARDS) patients.
View Article and Find Full Text PDFPurpose: Studies have suggested benefits from magnesium sulphate in thrombotic thrombocytopenic purpura (TTP). We aimed to measure the effects of magnesium sulphate supplementation on TTP recovery.
Methods: In this multicenter, randomised, double-blind, controlled, superiority study, we enrolled adults with a clinical diagnosis of TTP.
Background: We sought to describe the reasons for intensive care unit (ICU) admission and outcomes of patients with pancreatic cancer requiring unplanned medical ICU admission.
Patients And Methods: Retrospective cohort study in five ICUs from 2009 to 2020. All patients with pancreatic cancer admitted to the ICU were included.
Article Synopsis
- The study examines how sensory interventions, such as music and air flux stimulation, can help relieve dyspnoea (difficulty breathing) in critically ill patients on mechanical ventilation.
- Researchers found that increasing pressure support on the ventilator significantly reduced dyspnoea, as did auditory stimulation with music compared to pink noise, and facial air flow compared to limb air flow.
- The findings suggest that these sensory interventions could effectively alleviate dyspnoea in ventilated patients without needing medications or increasing ventilator support, which is important for patient care protocols.
Identification of natural killer markers associated with fatal outcome in COVID-19 patients.
Front Cell Infect Microbiol
June 2023
Article Synopsis
- COVID-19 severity is linked to dysregulated immune responses, particularly due to natural killer (NK) cell dysfunction in critically ill patients.
- A study with 50 non-vaccinated hospitalized patients highlighted that NK cells in COVID-19 patients were more activated but had impaired function, correlating with disease severity and patient outcomes.
- Findings indicate that an uncoordinated inflammatory response, driven by a specific subset of activated NK cells, may contribute to fatalities in severe COVID-19 cases.
Autoantibodies (auto-Abs) neutralizing type I interferons (IFNs) are found in the blood of at least 15% of unvaccinated patients with life-threatening COVID-19 pneumonia. We report here the presence of auto-Abs neutralizing type I IFNs in the bronchoalveolar lavage (BAL) of 54 of the 415 unvaccinated patients (13%) with life-threatening COVID-19 pneumonia tested. The 54 individuals with neutralizing auto-Abs in the BAL included 45 (11%) with auto-Abs against IFN-α2, 37 (9%) with auto-Abs against IFN-ω, 54 (13%) with auto-Abs against IFN-α2 and/or ω, and five (1%) with auto-Abs against IFN-β, including three (0.
View Article and Find Full Text PDFObjectives: To determine the impact of high doses of corticosteroids (HDCT) in critically ill COVID-19 patients with nonresolving acute respiratory distress syndrome (ARDS) who had been previously treated with dexamethasone as a standard of care.
Design: Prospective observational cohort study. Eligible patients presented nonresolving ARDS related to severe acute respiratory syndrome coronavirus 2 infection and had received initial treatment with dexamethasone.
We aimed to explore the relationships between specific viral mutations/mutational patterns and ventilator-associated pneumonia (VAP) occurrence in COVID-19 patients admitted in intensive care units between October 1, 2020, and May 30, 2021. Full-length SARS-CoV-2 genomes were sequenced by means of next-generation sequencing. In this prospective multicentre cohort study, 259 patients were included.
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- Breathing difficulties in critically ill patients can lead to high stress levels and increased risk of posttraumatic issues, especially when patients are noncommunicative, making it hard to assess their dyspnea directly.
- The study investigated the effectiveness of the Mechanical Ventilation-Respiratory Distress Observation Scale (MV-RDOS) as a tool to evaluate dyspnea in noncommunicative, intubated patients alongside other measurements like EMG and EEG.
- Results showed a significant reduction in MV-RDOS scores indicating relief from dyspnea after ventilator changes and morphine, suggesting that MV-RDOS is a useful method for monitoring respiratory symptoms in these patients.
Background: The extent of the consequences of an episode of severe acute kidney injury (AKI) on long-term outcome of critically ill patients remain debated. We conducted a prospective follow-up of patients included in a large multicenter clinical trial of renal replacement therapy (RRT) initiation strategy during severe AKI (the Artificial Kidney Initiation in Kidney Injury, AKIKI) to investigate long-term survival, renal outcome and health related quality of life (HRQOL). We also assessed the influence of RRT initiation strategy on these outcomes.
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