Publications by authors named "Montmollin E"

Background: Sepsis-associated encephalopathy (SAE) may be worsened by early systemic insults. We aimed to investigate the association of early systemic insults with outcomes of critically ill patients with severe SAE.

Methods: We performed a retrospective analysis using data from the French OUTCOMEREA prospective multicenter database.

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Introduction: Prognostication of outcome in severe stroke patients necessitating invasive mechanical ventilation poses significant challenges. The objective of this study was to assess the prognostic significance and prevalence of early electroencephalogram (EEG) abnormalities in adult stroke patients receiving mechanical ventilation.

Methods: This study is a pre-planned ancillary investigation within the prospective multicenter SPICE cohort study (2017-2019), conducted in 33 intensive care units (ICUs) in the Paris area, France.

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Background: The influence of socioeconomic deprivation on health inequalities is established, but its effect on critically ill patients remains unclear, due to inconsistent definitions in previous studies.

Methods: Prospective multicenter cohort study conducted from March to June 2018 in eight ICUs in the Greater Paris area. All admitted patients aged ≥ 18 years were enrolled.

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Objectives: Neurologic outcomes of patients under venoarterial extracorporeal membrane oxygenation (VA-ECMO) may be worsened by secondary insults of systemic origin. We aimed to assess whether sepsis, commonly observed during ECMO support, is associated with brain injury and outcomes.

Design: Single-center cohort study of the "exposed-non-exposed" type on consecutive adult patients treated by VA-ECMO.

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Article Synopsis
  • Ventilator associated pneumonia (VAP) caused by wild-type AmpC-producing Enterobacterales is common in ICU patients, and the study explores the effectiveness of different antimicrobial therapies (AMT), specifically piperacillin ± tazobactam (PTZ) and third-generation cephalosporins (3GCs).
  • In a study involving 274 ICU patients, no significant differences in treatment success at day 7 were found between the groups receiving PTZ, 3GCs, or other control treatments, with all groups showing success rates around 68-74%.
  • However, patients treated with 3GCs had a higher likelihood of pneumonia recurrence by day 28 compared to those on PTZ
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Background: Current guidelines for adult patients with pneumococcal meningitis (PM) recommend initial management in intermediate or intensive care units (ICU), but evidence to support these recommendations is limited. We aimed to describe ICU admission practices of patients with PM.

Methods: We conducted a retrospective analysis of the French medico administrative database of consecutive adult patients with PM and sepsis criteria hospitalized between 2011 and 2020.

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Article Synopsis
  • * There was no increased risk of acute kidney injury (AKI) in patients receiving combination therapy, suggesting it may not be more harmful than single-drug therapy.
  • * The research utilized data from a multicenter database and included various analyses based on patient characteristics and the resistance profiles of the bacteria involved, indicating a comprehensive approach to assessing treatment outcomes.
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Fever can be viewed as an adaptive response to infection. Temperature control in sepsis is aimed at preventing potential harms associated with high temperature (tachycardia, vasodilation, electrolyte and water loss) and therapeutic hypothermia may be aimed at slowing metabolic activities and protecting organs from inflammation. Although high fever (>39.

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Background: Data on ventilator associated pneumonia (VAP) in COVID-19 and influenza patients admitted to intensive care units (ICU) are scarce. This study aimed to estimate day-60 mortality related to VAP in ICU patients ventilated for at least 48 h, either for COVID-19 or for influenza, and to describe the epidemiological characteristics in each group of VAP.

Design: Multicentre retrospective observational study.

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Sepsis-associated encephalopathy is a severe neurologic syndrome characterized by a diffuse dysfunction of the brain caused by sepsis. This review provides a concise overview of diagnostic tools and management strategies for SAE at the acute phase and in the long term. Early recognition and diagnosis of SAE are crucial for effective management.

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Purpose Of Review: This article aims to provide an updated review on the epidemiology and outcomes of severe meningoencephalitis.

Recent Findings: Meningoencephalitis is a critical medical condition characterized by inflammation in both the meninges and brain parenchyma. Bacterial, viral, or fungal infections are common causes, although noninfectious factors, such as autoimmune causes, can also contribute.

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Article Synopsis
  • * Out of 364 patients, 66.5% experienced poor functional outcomes after one year, with a significant portion (52.2%) having died, while age, comorbidities, initial coma score, and stroke type were key factors linked to worse outcomes.
  • * Notably, delays in starting mechanical ventilation after stroke diagnosis appeared to improve survival chances, and over half of the survivors reported ongoing physical and mental health issues one year later.
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Cefiderocol (FDC) is a siderophore cephalosporin now recognized as a new weapon in the treatment of difficult-to-treat-resistant (DTR) Gram-negative pathogens, including carbapenemase-producing enterobacterales and non-fermentative Gram-negative bacilli (GNB). This article reports our experience with an FDC-based regimen in the treatment of 16 extremely severe patients (invasive mechanical ventilation, 15/16; extracorporeal membrane oxygenation, 9/16; and renal replacement therapy, 8/16) infected with DTR GNB. Our case series provides detailed insight into the pharmacokinetic profile and the microbiological data in real-life conditions.

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Aminoglycosides are a family of rapidly bactericidal antibiotics that often remain active against resistant Gram-negative bacterial infections. Over the past decade, their use in critically ill patients has been refined; however, due to their renal and cochleovestibular toxicity, their indications in the treatment of sepsis and septic shock have been gradually reduced. This article reviews the spectrum of activity, mode of action, and methods for optimizing the efficacy of aminoglycosides.

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Introduction: Acute exacerbation of chronic obstructive pulmonary disease (COPD) is a frequent cause of intensive care unit (ICU) admission. However, data are scarce and conflicting regarding the impact of systemic corticosteroid treatment in critically ill patients with acute exacerbation of COPD. The aim of the study was to assess the impact of systemic corticosteroids on the occurrence of death or need for continuous invasive mechanical ventilation at day 28 after ICU admission.

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Article Synopsis
  • This study aimed to understand the outcomes of patients with severe meningoencephalitis in intensive care, analyzing data from 599 adults across 68 medical centers in 7 countries from 2017 to 2020.
  • Results showed that more than half of the patients (50.5%) had poor functional outcomes at three months, with 25.8% resulting in death; causes of meningoencephalitis were varied, with acute bacterial meningitis being the most common.
  • Key factors linked to worse outcomes included being older than 60, having a weakened immune system, delays in ICU admission, and severe neurological impairments, highlighting the need for timely care and monitoring.
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  • Upper gastrointestinal bleeding (UGIB) is a frequent issue in adults undergoing VA-ECMO for severe heart problems, with the study aiming to identify its risk factors and outcomes.
  • In a study of 455 patients, 10% experienced UGIB, with a significantly higher mortality rate and longer hospital stays compared to those without UGIB.
  • Key risk factors for UGIB included a history of peptic ulcers, use of dual antiplatelet therapy, and undergoing extracorporeal cardiopulmonary resuscitation.
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Purpose: Despite antiviral therapy (ART), 800,000 deaths still occur yearly and globally due to HIV infection. In parallel with the good virological control and the aging of this population, multiple comorbidities [HIV-associated-non-AIDS (HANA) conditions] may now be observed.

Methods: HIV adult patients hospitalized in intensive care unit (ICU) from all the French region from university and non-university hospital who participate to the OutcomeRea™ database on a voluntary basis over a 24-year period.

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Objectives: Respiratory syncytial virus (RSV) is a common agent of viral respiratory infections with significant morbidity and mortality in adults. The objective of this study was to determine risk factors for mortality and invasive mechanical ventilation and to describe the characteristics of patients who received ribavirin.

Methods: A retrospective multicentre observational cohort study was conducted in Great Paris area hospitals, including patients hospitalised between 1 January 2015 and 31 December 2019 for documented RSV infection.

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Background: Severe hypothyroidism (SH) is a rare but life-threatening endocrine emergency. Only a few data are available on its management and outcomes of the most severe forms requiring ICU admission. We aimed to describe the clinical manifestations, management, and in-ICU and 6-month survival rates of these patients.

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Ventilator-associated pneumonia (VAP) incidence is high among critically ill COVID-19 patients. Its attributable mortality remains underestimated, especially for unresolved episodes. Indeed, the impact of therapeutic failures and the determinants that potentially affect mortality are poorly evaluated.

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Background: Electroencephalography (EEG) is recommended for the practical approach to the diagnosis and prognosis of encephalitis. We aimed to investigate the prognostic value of standard EEG (EEG) in adult patients with severe herpes simplex encephalitis.

Methods: We performed a retrospective analysis of consecutive ICU patients with severe herpes simplex encephalitis in 38 French centers between 2006 and 2016.

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Objectives: Our aim was to describe changes in the management of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) by ICUs and patient outcomes.

Design: We extracted data from the OutcomeRea database concerning patients admitted for AECOPD between 1997 and 2018. We analyzed trends in the use of ventilatory support, corticosteroid therapy, antibiotic therapy, and patient survival.

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