Publications by authors named "Mokart D"

Introduction: Transhiatal esophagectomy (THE) is used for specific gastroesophageal junction adenocarcinomas. THE is a high-risk surgical procedure. We aimed to assess the impact of postoperative sepsis (sepsis or septic shock) on the 1-year mortality after THE and to determine the risk factors associated with these outcomes.

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Acute myeloid leukemias (AMLs) are the hematological malignancies with the highest need for intensive care unit (ICU) admission due to their association with various life-threatening situations. Limited data exist regarding the outcomes of elderly individuals with AML admitted to the ICU. However, current therapeutic protocols offer the potential for extended survival in this population.

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Introduction: The effect of neutropenia and the use of granulocyte colony-stimulating factor (G-CSF) in critically ill patients with cancer are controversial, notably in those with lung injury. Neutropenia recovery can be associated with an acute respiratory failure (ARF) requiring intensive care unit (ICU) admission, especially when G-CSF is administered.

Methods: In a single-center retrospective study, we evaluated (1) the effect of neutropenia recovery on the 90-day mortality and (2) the impact of G-CSF use on the outcome of patients with cancer and neutropenia with ARF admitted to the ICU.

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Background: Radical cystectomy (RC) is a major surgery associated with a high morbidity rate. Perioperative fluid management according to enhanced recovery after surgery (ERAS) protocols aims to maintain patients in an optimal euvolemic state while exposing them to acute kidney injury (AKI) in the event of hypovolemia. Postoperative AKI is associated with severe morbidity and mortality.

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Article Synopsis
  • Many cancer patients and people with weakened immune systems face a higher risk of serious infections because their bodies can't fight germs as well.
  • Factors like age, other health problems, and the type and stage of cancer can make them even more vulnerable to severe conditions like septic shock.
  • To improve survival rates, it's important to quickly identify infections and provide specialized care, using new technologies and teamwork among healthcare providers.
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Background: The accuracy of a diagnostic test depends on its intrinsic characteristics and the disease incidence. This study aims to depict post-test probability of Pneumocystis pneumonia (PJP), according to results of PCR and Beta-D-Glucan (BDG) tests in patients with acute respiratory failure (ARF).

Materials And Methods: Diagnostic performance of PCR and BDG was extracted from literature.

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  • 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.
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Background: Current guidelines recommend using antifungals for selected patients with health care-associated intra-abdominal infection (HC-IAI), but this recommendation is based on a weak evidence. This study aimed to assess the association between early empirical use of antifungals and outcomes in intensive care unit (ICU) adult patients requiring re-intervention after abdominal surgery.

Methods: A retrospective, multicentre cohort study with overlap propensity score weighting was conducted in three ICUs located in three medical institutions in France.

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Purpose Of Review: The purpose of this review is to investigate the long-term outcomes of cancer patients who experience sepsis or septic shock.

Recent Findings: Sepsis is a frequent cause of ICU admission in cancer patients, accounting for approximately 15% of such cases. Short-term mortality rates among these patients vary widely across studies, but they are consistently found to be slightly higher than those of noncancer patients.

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Purpose: Prophylactic platelet transfusions (PT) aim to reduce bleeding. We assessed whether restrictive PT compared to prophylactic strategy could apply in ICU.

Material And Methods: We conducted a retrospective monocentric study including patients >18 yo with haematological malignancy admitted to the ICU with thrombocytopenia <20 G/L between 2018 and 2021.

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Article Synopsis
  • Patients with hematological malignancies face high risks of serious complications, and this study aimed to assess how hyperoxemia (high levels of oxygen in the blood) impacts mortality rates within 28 days in critically ill individuals.
  • An analysis of data from over 11,000 patients revealed a U-shaped relationship between arterial oxygen levels (PaO) and mortality, indicating that both low and high oxygen levels can increase the risk of death.
  • The study found that excessive use of oxygen was significantly linked to increased mortality rates, especially in certain patient groups, highlighting the importance of careful oxygen management in these critically ill patients.
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Background: Acute pulmonary embolism (PE) is a life-threatening situation in cancer patients. In this situation, anticoagulant therapy is complex to administer due to the risk of bleeding. Only few studies have been conducted when these patients are admitted to the intensive care unit (ICU).

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Allogeneic stem cell transplantation (Allo-SCT) is the only rapidly available curative treatment modality in patients with severe sickle cell disease (SCD). The development of reduced-toxicity myeloablative conditioning (RT-MAC) regimen and the use of partially matched family donors with post-transplantation cyclophosphamide (PT-Cy) have widened the access to Allo-SCT. Antibodies against donor-specific HLA (DSA) increase the risk of engraftment failure in HLA mismatched Allo-SCT.

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We studied 50 patients with invasive nocardiosis treated during 2004-2023 in intensive care centers in France and Belgium. Most (65%) died in the intensive care unit or in the year after admission. Nocardia infections should be included in the differential diagnoses for patients in the intensive care setting.

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Article Synopsis
  • Invasive fusariosis is a serious fungal infection that particularly threatens immunocompromised patients in intensive care, with a
  • mortality rate of 56%
  • identified in a study of 55 cases in French ICUs.
  • Most patients (76%) developed pneumonia, which often resulted in
  • acute respiratory failure
  • Key risk factors for increased mortality include high organ failure scores at ICU admission and prior history of
  • stem cell transplantation or hematologic cancers
  • , highlighting the need for careful monitoring in at-risk patients.
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  • Ibrutinib, a treatment for chronic lymphocytic leukemia (CLL) and non-Hodgkin lymphoma, is associated with significant immunomodulatory effects that can lead to increased risk of serious infections, particularly in patients who require ICU care.
  • A study analyzed 69 patients on ibrutinib admitted to French ICUs between 2015 and 2020, revealing that 19% had invasive fungal infections, with acute respiratory failure being the most common organ injury.
  • The mortality rate in the ICU was 29%, with a 90-day mortality of 55%, highlighting more severe organ dysfunction and a greater need for mechanical ventilation in those who did not survive compared to those who did.
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The clinical features and short-term prognosis of patients admitted to the intensive care unit for herpes hepatitis are lacking. Of 33 patients admitted between 2006 and 2022, 22 were immunocompromised, 4 were pregnant women, and 23 died. Sixteen patients developed a hemophagocytic syndrome.

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Background: Biliary sepsis is common in patients with digestive cancer. Recommendations call for antibiotic de-escalation (ADE) as a strategy for antibiotic treatment of sepsis or septic shock. The aim of this study was to identify factors influencing 90-day mortality and to evaluate the impact of ADE.

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  • Acute respiratory failure (ARF) is common in ICU admissions, particularly among immunocompromised patients, yet there is limited understanding of the role of viruses in this context.
  • In a study of 4038 immunocompromised patients, 9.2% had virus-detected ARF, with influenza being the most prevalent virus; significant mortality and factors influencing it were identified, including neutropenia and invasive mechanical ventilation needs.
  • Remarkably, patients with virus-detected ARF had lower mortality rates compared to those with ARF from other causes, suggesting that certain viruses may have a less severe impact overall.
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Background: The number of elderly patients undergoing major abdominal surgery is increasing, but the factors affecting their postoperative outcomes remain unclear. This study aimed to identify the factors associated with 1-year mortality among elderly patients (age ≥ 80 years) with cancer undergoing major abdominal surgery.

Methods: This retrospective cohort study was conducted from March 2009 to December 2020.

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Background: Acute respiratory failure (ARF) is the leading cause of intensive care unit (ICU) admission in patients with Acute Myeloid Leukemia (AML) and data on prognostic factors affecting short-term outcome are needed.

Methods: This is a post-hoc analysis of a multicenter, international prospective cohort study on immunocompromised patients with ARF admitted to ICU. We evaluated hospital mortality and associated risk factors in patients with AML and ARF; secondly, we aimed to define specific subgroups within our study population through a cluster analysis.

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Background: The aims of this study were to describe pharmacokinetic/pharmacodynamic target attainment in intensive care unit (ICU) patients treated with continuously infused -lactam antibiotics, their associated covariates, and the impact of dosage adjustment.

Methods: This prospective, observational, cohort study was performed in three ICUs. Four -lactams were continuously infused, and therapeutic drug monitoring (TDM) was performed at days 1, 4, and 7.

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