Publications by authors named "Paer Abback"
Background: To our knowledge, no large observational study has compared the incidence and risk factors for extubation failure within 48 h and during ICU stay in the same cohort of unselected critically ill patients with and without obesity.
Research Question: What are the incidence and risk factors of extubation failure in patients with and without obesity?
Study Design And Methods: In the prospective multicenter observational Practices and Risk Factors for Weaning and Extubation Airway Failure in Adult Intensive Care Unit: A Multicenter Trial (FREEREA) study in 26 ICUs, the primary objective was to compare the incidence of extubation failure within 48 h in patients with and without obesity. Secondary objectives were to describe and to identify the independent specific risk factors for extubation failure using first a logistic regression model and second a decision tree analysis.
Article Synopsis
- The study focuses on the rising aging population in France and Western Europe, specifically individuals aged 85 and older, and their mortality risk in trauma centers' ICUs.
- Conducted from 2013 to 2022, the research analyzed 365 severely injured older patients in 14 ICU trauma centers, assessing their frailty and other clinical variables.
- High mortality rates were found, with 43.5% in the ICU and 45.5% at 30 days, linked to factors like traumatic brain injury and severe hemorrhage, highlighting the need for early geriatric interventions to improve patient outcomes.
Article Synopsis
- Mydriasis during prehospital management of traumatic brain injury (TBI) might indicate severe intracranial hypertension, leading to discussions on whether to use mannitol or hypertonic saline solution (HSS) for treatment.
- This study aims to determine if HSS is associated with better survival rates in adult trauma patients with TBI and mydriasis compared to mannitol.
- A cohort of 1,417 patients was analyzed from a national registry, using matching methods to compare outcomes, with no significant differences found in the baseline characteristics or prehospital management of the two treatment groups.
Article Synopsis
- The study investigates severe penetrating trauma, specifically gunshot and stab wounds, in trauma centers across France, as previous research on this topic has been limited.
- It analyzed data from 8128 trauma patients over four years, finding that 12% of cases involved penetrating trauma, primarily due to stab wounds.
- Results showed that penetrating trauma had a higher incidence of severe hemorrhage and a notable difference in mortality rates, with gunshot wound patients experiencing significantly higher mortality than those with stab wounds.
Background: Fibrinogen concentrate is widely used in traumatic hemorrhagic shock despite weak evidence in the literature. The aim of the study was to evaluate the effect of fibrinogen concentrate administration within the first 6 hours on 24-hour all-cause mortality in traumatic hemorrhagic shock using a causal inference approach.
Methods: Observational study from a French multicenter prospective trauma registry was performed.
Background: Patients liberated from invasive mechanical ventilation are at risk of extubation failure, including inability to breathe without a tracheal tube (airway failure) or without mechanical ventilation (non-airway failure). We sought to identify respective risk factors for airway failure and non-airway failure following extubation.
Methods: The primary endpoint of this prospective, observational, multicenter study in 26 intensive care units was extubation failure, defined as need for reintubation within 48 h following extubation.
Tranexamic acid in severe trauma patients managed in a mature trauma care system.
J Trauma Acute Care Surg
June 2018
Background: Tranexamic acid (TXA) use in severe trauma remains controversial notably because of concerns of the applicability of the CRASH-2 study findings in mature trauma systems. The aim of our study was to evaluate the outcomes of TXA administration in severely injured trauma patients managed in a mature trauma care system.
Methods: We performed a retrospective study of data prospectively collected in the TraumaBase registry (a regional registry collecting the prehospital and hospital data of trauma patients admitted in six Level I trauma centers in Paris Area, France).
Objective: Alveolar fibrocytes are monocyte-derived mesenchymal cells associated with poor prognosis in patients with acute respiratory distress syndrome. Our aims were to determine the following: 1) the ability of monocytes from acute respiratory distress syndrome patients to differentiate into fibrocytes; 2) the influence of the acute respiratory distress syndrome alveolar environment on fibrocyte differentiation; and 3) mediators involved in this modulation, focusing on serum amyloid P.
Design: Experimental in vitro investigation.