Impact of prolonged requirement for insulin on 90-day mortality in critically ill patients without previous diabetic treatments: a post hoc analysis of the CONTROLING randomized control trial.

Background: Stress hyperglycemia can persist during an intensive care unit (ICU) stay and result in prolonged requirement for insulin (PRI). The impact of PRI on ICU patient outcomes is not known. We evaluated the relationship between PRI and Day 90 mortality in ICU patients without previous diabetic treatments.

Intensive care-related loss of quality of life and autonomy at 6 months post-discharge: Does COVID-19 really make things worse?

Objective: To compare old patients hospitalized in ICU for respiratory distress due to COVID-19 with old patients hospitalized in ICU for a non-COVID-19-related reason in terms of autonomy and quality of life.

Design: Comparison of two prospective multi-centric studies.

Setting: This study was based on two prospective multi-centric studies, the Senior-COVID-Rea cohort (COVID-19-diagnosed ICU-admitted patients aged over 60) and the FRAGIREA cohort (ICU-admitted patients aged over 70).

Senior-COVID-Rea Cohort Study: A Geriatric Prediction Model of 30-day Mortality in Patients Aged over 60 Years in ICU for Severe COVID-19.

The SARS-COV2 pandemic induces tensions on health systems and ethical dilemmas. Practitioners need help tools to define patients not candidate for ICU admission. A multicentre observational study was performed to evaluate the impact of age and geriatric parameters on 30-day mortality in patients aged ≥60 years of age.

Association between out-of-bed mobilization during the ICU stay of elderly patients and long-term autonomy: A cohort study.

Purpose: Our objective was to estimate the impact of the absence of Out-of-Bed (OoB) mobilization during intensive care unit (ICU) stay among patients ≥70 years on their long-term autonomy.

Methods: We conducted an ancillary study of the multicenter FRAGIREA study, including patients aged over 70 years, admitted to ICU for more than 48 h. We excluded the patients who died before day 180, who were lost to follow-up, and for whom the baseline autonomy (ADL) score was not available.

Individualised versus conventional glucose control in critically-ill patients: the CONTROLING study-a randomized clinical trial.

Purpose: Hyperglycaemia is an adaptive response to stress commonly observed in critical illness. Its management remains debated in the intensive care unit (ICU). Individualising hyperglycaemia management, by targeting the patient's pre-admission usual glycaemia, could improve outcome.

Associations between peripheral perfusion disorders, mean arterial pressure and dose of norepinephrine administrated in the early phase of septic shock.

The aim of the study was to explore the correlations between peripheral perfusion, mean arterial pressure and the dose-rate of norepinephrine (NE) infused for the treatment of septic shock. The study is retrospective analysis of data acquired prospectively on 57 patients during the first 24 hours after the occurrence of the shock. Clinical and haemodynamic characteristics, skin perfusion parameters (capillary refill time [CRT], mottling score and temperature gradients) and the dose rate of NE infusion were collected.

Mottling Incidence and Mottling Score According to Arterial Lactate Level in Septic Shock Patients.

Objectives: Mottling score is estimated from 0-5 according to mottling over the knee and described as clinical evaluation of tissue perfusion. This score was developed with ancient definitions of sepsis without lactate level, a major prognostic parameter when superior to 2 mmol/L. This study describes mottling incidence and mottling score in septic shock patients according to lactate level.

Core-to-skin temperature gradient measured by thermography predicts day-8 mortality in septic shock: A prospective observational study.

Background: Septic shock is associated with altered peripheral perfusion. Core-to-skin temperature gradient depends on skin perfusion and microcirculatory function. We hypothesized that a high core-to-skin temperature gradient is correlated with mortality in septic shock.

Mottling score and skin temperature in septic shock: Relation and impact on prognosis in ICU.

Introduction: Mottling score, defined by 5 areas over the knee is developed to evaluate tissue perfusion at bedside. Because of the subjective aspect of the score, we aimed to compare mottling score and skin temperature in septic shock with infrared thermography in ICU and the correlation to survival.

Methods: We conducted a prospective and observational study in a teaching hospital in France during 8 months in ICU.

Procalcitonin algorithm to guide initial antibiotic therapy in acute exacerbations of COPD admitted to the ICU: a randomized multicenter study.

Purpose: To compare the efficacy of an antibiotic protocol guided by serum procalcitonin (PCT) with that of standard antibiotic therapy in severe acute exacerbations of COPD (AECOPDs) admitted to the intensive care unit (ICU).

Methods: We conducted a multicenter, randomized trial in France. Patients experiencing severe AECOPDs were assigned to groups whose antibiotic therapy was guided by (1) a 5-day PCT algorithm with predefined cutoff values for the initiation or stoppage of antibiotics (PCT group) or (2) standard guidelines (control group).

An attempt to validate the modification of the American-European consensus definition of acute lung injury/acute respiratory distress syndrome by the Berlin definition in a university hospital.

Purpose: The Berlin definition for acute respiratory distress syndrome (ARDS) is a new proposal for changing the American-European consensus definition but has not been assessed prospectively as yet. In the present study, we aimed to determine (1) the prevalence and incidence of ARDS with both definitions, and (2) the initial characteristics of patients with ARDS and 28-day mortality with the Berlin definition.

Methods: We performed a 6-month prospective observational study in the ten adult ICUs affiliated to the Public University Hospital in Lyon, France, from March to September 2012.

Evaluation of blind nasotracheal suctioning and non-bronchoscopic mini-bronchoalveolar lavage in critically ill patients with infectious pneumonia: a preliminary study.

Background: We evaluated the diagnostic performance and safety of combined blind nasotracheal suctioning and non-bronchoscopic mini-bronchoalveolar lavage (mini-BAL) to obtain respiratory secretion specimens from spontaneously breathing, non-intubated patients with infectious pneumonia in intensive care.

Methods: Patients suspected of having infectious pneumonia were included prospectively. Three samples were obtained: expectorated sputum, nasotracheal suctioning, and mini-BAL via a double telescopic catheter (Combicath).

Six-month outcome in acute kidney injury requiring renal replacement therapy in the ICU: a multicentre prospective study.

Objective: To assess quality of life (QOL), mortality rate and renal function 6 months after onset of renal replacement therapy (RRT) for acute kidney injury (AKI) in the ICU.

Participants And Setting: This prospective observational study was conducted in seven ICUs in France over 9 months. Inclusion criteria were: age > or =18 years, RRT delivered for AKI and informed consent signed.

Do antibiotics administered at the time of central venous catheter removal interfere with the evaluation of colonization?

Objective: Catheter colonization is commonly used as an end point in studies on central venous catheter (CVC) infections. This study aimed at comparing the rates of catheter colonization in patients according to the administration of antibiotics at removal.

Design: Prospective study over a 5-year period.

Evolution of thrombin formation and fibrinolysis markers, including thrombin-activatable fibrinolysis inhibitor, during severe meningococcemia.

A 17-year-old girl presented with Neisseria meningitidis sepsis, with evidence of disseminated intravascular coagulation. Substitution therapy with both antithrombin and protein C concentrates was initiated, leading to clinical and biological improvement. Sequential dosages were performed for biological markers including thrombin-activatable fibrinolysis inhibitor (TAFI).

[Estimating the specificity of a University Hospital Centre. Example of the colonoscopy (EPAGE survey)].

Objective: The specificity of a University Hospital Centre is usually assessed from its teaching and research capacity. The EPAGE survey, an instrument used to help decision making available on the Internet, permitted us to compare the prescription of a routine exploration, gastrointestinal endoscopy, between the University Hospital Center in Clermont-Ferrand and the Hospital Centre in Moulins. The aim was to demonstrate the differences in daily practice between these two geographically close hospital centres and hence to underline the specificity of a University Hospital Centre that is not taken into account in the financing systems of such hospitals.