37 results match your criteria: "University Versailles Saint Quentin-University Paris Saclay[Affiliation]"

Article Synopsis
  • - The study analyzed 79 patients with severe tuberculosis-related ARDS who received ECMO treatment at 20 centers worldwide, focusing on their 90-day survival rates and related complications.
  • - Results showed that 51% of patients survived for 90 days, with significant complications including major bleeding and infections; miliary TB patients had a notably higher survival rate than those with cavitary TB.
  • - Factors like older age, drug-resistant TB, and higher pre-ECMO SOFA scores were identified as key predictors of mortality, suggesting that ECMO could be a valuable intervention for patients with TB-induced ARDS.
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Diagnostic tests for infections in critically ill immunocompromised patients.

Intensive Care Med

November 2024

Department of Medical Intensive Care Unit, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Paris, France.

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Fluid responsiveness in acute respiratory distress syndrome patients: a post hoc analysis of the HEMOPRED study.

Intensive Care Med

November 2024

Medical and Surgical intensive care unit, University Hospital Ambroise Paré, GHU Paris-Saclay, Assistance Publique Hôpitaux de Paris, Boulogne-Billancourt, France.

Purpose: Optimal fluid management in patients with acute respiratory distress syndrome (ARDS) is challenging due to risks associated with both circulatory failure and fluid overload. The performance of dynamic indices to predict fluid responsiveness (FR) in ARDS patients is uncertain.

Methods: This post hoc analysis of the HEMOPRED study compared the performance of dynamic indices in mechanically ventilated patients with shock, with and without ARDS, to predict FR, defined as an increase in aortic velocity time integral (VTI)  > 10% after passive leg raising (PLR).

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Article Synopsis
  • Mechanical ventilation for myasthenic crisis lacks standardization and is prone to failure; a study investigated using prolonged spontaneous breathing trials (SBT) and pulmonary function tests (PFT) to improve weaning outcomes.
  • Of the 126 analyzed cases, the weaning failure rate was 14.3%, notably lower when the cause of the crisis was identified, although factors like mechanical ventilation duration and infection risk influenced prolonged weaning.
  • The study suggests that implementing standardized protocols could enhance extubation success, emphasizing the need for further research to validate these findings in larger trials.
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Acute Management of Sepsis beyond 24 Hours.

Semin Respir Crit Care Med

August 2024

Department of Intensive Care, APHP University Versailles Saint Quentin-University Paris Saclay, Raymond Poincaré Hospital, Garches, France.

Article Synopsis
  • * Early treatment involves controlling the source of infection, using antibiotics, and supporting organ function, while later care addresses metabolic, nutritional, and immune needs.
  • * Effective management includes moderate glucose control, careful nutritional support to prevent muscle loss, and using corticosteroids to help patients with shock and organ dysfunction, emphasizing a personalized approach for better recovery.
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Background: The COVID-19 pandemic related to SARS-CoV-2 virus was responsible for global pandemic. The severe form of the disease was linked to excessive activation of immune pathways together with a systemic cytokine storm response and thrombotic venous or arterial complications. Factors predicting severe outcomes including venous and/or pulmonary thrombosis (VT) and death were identified, but the prognostic role of their combination was not addressed extensively.

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Article Synopsis
  • Patients with COVID-19 requiring mechanical ventilation have a high risk of developing ventilator-associated pneumonia (VAP), particularly caused by Enterobacterales, with limited data on extended-spectrum beta-lactamase producing Enterobacterales (ESBL-E).
  • In a study involving 591 patients with Enterobacterales related VAP, 19% developed ESBL-E infections, primarily from Enterobacter sp, K. pneumoniae, and E. coli, while a very small percentage experienced carbapenem-resistant Enterobacterales (CRE) infections.
  • Key risk factors for ESBL-E related VAP included African origin, time between intubation and VAP development, the patient's oxygenation status, and prior exposure to trimethopr
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Treatment of COVID-19-associated ARDS with umbilical cord-derived mesenchymal stromal cells in the STROMA-CoV-2 multicenter randomized double-blind trial: long-term safety, respiratory function, and quality of life.

Stem Cell Res Ther

April 2024

Multidisciplinary Intensive Care Unit, Department of Anesthesiology-Critical Care and Perioperative Medicine, La Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (APHP) Sorbonne University, 47-83, boulevard de l'Hôpital, 75651, Paris Cedex 13, France.

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.
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The chain of survival and rehabilitation for sepsis: concepts and proposals for healthcare trajectory optimization.

Ann Intensive Care

April 2024

SAMU 972, Centre Hospitalier Universitaire de Martinique, Fort-de-France Martinique, University of the Antilles, French West Indies, Antilles, France.

This article describes the structures and processes involved in healthcare delivery for sepsis, from the prehospital setting until rehabilitation. Quality improvement initiatives in sepsis may reduce both morbidity and mortality. Positive outcomes are more likely when the following steps are optimized: early recognition, severity assessment, prehospital emergency medical system activation when available, early therapy (antimicrobials and hemodynamic optimization), early orientation to an adequate facility (emergency room, operating theater or intensive care unit), in-hospital organ failure resuscitation associated with source control, and finally a comprehensive rehabilitation program.

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Hydrocortisone plus fludrocortisone for community acquired pneumonia-related septic shock: a subgroup analysis of the APROCCHSS phase 3 randomised trial.

Lancet Respir Med

May 2024

Department of Intensive Care, Raymond Poincaré Hospital, APHP University Versailles Saint Quentin-University Paris Saclay, Garches, France; Institut Hospitalo Universitaire PROMETHEUS, Garches, France; Laboratory of Infection & Inflammation-U1173, School of Medicine, INSERM, University Versailles Saint Quentin-University Paris Saclay, Garches, France; FHU SEPSIS, Garches, France. Electronic address:

Article Synopsis
  • The study explores the effectiveness of hydrocortisone and fludrocortisone treatments in patients with septic shock caused by community-acquired pneumonia (CAP) compared to non-CAP cases.
  • It includes data from the phase 3 APROCCHSS trial, which initially tested these treatments across multiple centers in France, focusing specifically on how they impact mortality outcomes.
  • Results indicate that patients with CAP may respond differently to these treatments, and various mortality rates and recovery metrics were analyzed to determine the overall benefit of the steroid regimen.
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Antibiotics in anesthesia and critical care.

Ann Transl Med

February 2024

Department of Intensive Care, Hôpital Raymond Poincaré, Groupe Hospitalo-Universitaire GHU AP-HP, University Versailles Saint Quentin-University Paris-Saclay, Garches, France.

Sepsis is life-threatening organ dysfunction due to a dysregulated host response to an underlying acute infection. Sepsis is a major worldwide healthcare problem. An annual estimated 48.

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Barriers to research findings utilization amongst critical care nurses and allied health professionals: An international survey.

Intensive Crit Care Nurs

April 2024

Medical Intensive Care Unit, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Université Paris Cité (APHP.Centre-Université Paris Cité), Paris, France; INSERM UMR 1266, Institut de Psychiatrie et Neurosciences de Paris (IPNP), Université Paris Cité, Paris, France.

Objectives: To determine the perceived barriers to the implementation of research findings in clinical practice among critical care nurses and allied health professionals.

Methods: A cross-sectional study was conducted using an online questionnaire sent to critical care nurses and allied health professionals in French-speaking countries. The primary objective was the identification and grading of perceived barriers to implementation of research findings into clinical practice, using a previously validated tool (French version of the BARRIERS scale).

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Simvastatin in Critically Ill Patients with Covid-19.

N Engl J Med

December 2023

From the Medical Research Institute of New Zealand, Wellington (T.E.H., S. McGuinness, A.M.T., C.J.M.), and Middlemore Hospital (T.E.H.), Te Toka Tumai Auckland City Hospital (T.E.H., S. McGuinness, R.L.P., C.J.M.), and the School of Nursing, University of Auckland (R.L.P.), Auckland - all in New Zealand; Berry Consultants, Austin, TX (E.L., L.R.B., M.A.D., M.F., A.M., C.T.S., R.J.L., S.M.B.); Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast (M. Shyamsundar, C.M.O., D.F.M.), the Department of Critical Care, Belfast Health and Social Care Trust (M. Shyamsundar, D.F.M.), and the Centre for Public Health, Queen's University Belfast, Belfast Health and Social Care Trust, and the Department of Health (I.S.Y.), Belfast, Imperial College London (F.A.-B., A.C.G.), the Intensive Care National Audit and Research Centre (C.A., D.A.H., L.L., A.J.M., P.R.M., K.M.R.), University College London Hospitals (R.H.), and Imperial College Healthcare NHS Trust (A.C.G.), London, the Institute for Regeneration and Repair (A. Beane) and the Centre for Inflammation Research (R.H., M.S.-H.), University of Edinburgh, Edinburgh, the Faculty of Health Sciences, University of Bristol, and Bristol Haematology and Oncology Centre, University Hospitals Bristol and Weston NHS Trust, Bristol (C.A.B.), and NHS Blood and Transplant, Oxford (L.J.E.) - all in the United Kingdom; Institut Hospitalo-Universitaire Prometheus, University Paris-Saclay, the Department of Intensive Care, Raymond Poincaré Hospital, Assistance Publique-Hôpitaux de Paris, University Versailles Saint Quentin-University Paris-Saclay, the Laboratory of Infection and Inflammation-Unité 173, School of Medicine Simone Veil, University Versailles Saint Quentin-University Paris-Saclay, INSERM, and Fédération Hospitalo-Universitaire SEPSIS (Saclay and Paris Seine Nord Endeavor to Personalize Interventions for Sepsis) - all in Garches, France (D. Annane); King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia (Y.A.); Nepal Intensive Care Research Foundation, Kathmandu (D. Aryal); Mahidol Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand (D. Aryal, A. Beane); Unity Health Toronto (Z.B., J.C.M., M. Santos), the Interdepartmental Division of Critical Care Medicine, University of Toronto, and Toronto General Hospital Research Institute (E.C.G.), Peter Munk Cardiac Centre at University Health Network (P.R.L.), and Keenan Centre for Biomedical Research (J.C.M.), Toronto, Université de Sherbrooke, Sherbrooke, QC (F.L.), McGill University Health Centre, Montreal (P.R.L.), the Faculty of Medicine, University of British Columbia, Vancouver (S. Murthy), the Population Health and Optimal Practices Research Unit, Centre Hospitalier Universitaire de Québec-Université Laval Research Center, and the Department of Anesthesiology and Critical Care Medicine, Université Laval, Quebec City (A.F.T.), and the University of Manitoba and CancerCare Manitoba, Winnipeg (R.Z.) - all in Canada; Julius Center for Health Sciences and Primary Care (M. Bonten, L.P.G.D.) and the Intensive Care Center (L.P.G.D.), University Medical Center Utrecht, Utrecht University, and the European Clinical Research Alliance on Infectious Diseases (M. Bonten), Utrecht, and Radboud University Medical Center, Nijmegen (F.V.) - all in the Netherlands; the Department of Anesthesiology and Intensive Care Medicine (F.M.B., S.W.) and the Institute for Infection Disease and Infection Control (S.W.), Jena University Hospital, Friedrich-Schiller University, and Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute (S.W.) - both in Jena, Germany; the School of Public Health and Preventive Medicine (A. Burrell, A.C.C., C.G., A.M.H., Z.K.M., A.D.N., J.C.P., C.J.M., S.A.W.) and the School of Clinical Sciences (A.C.C.), Monash University, Alfred Hospital (A. Burrell, A.D.N.), and Monash Health (A.C.C., Z.K.M.), Melbourne, VIC, the Faculty of Medicine, University of Queensland, and the Intensive Care Unit, Princess Alexandra Hospital, Brisbane (P.S.K.), and St. John of God Health Care, Perth, WA (S.A.W.) - all in Australia; the Global Coalition for Adaptive Research, Larkspur (M. Buxton), the Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine, and the Department of Anesthesia, University of California, San Francisco, San Francisco (C.S.C.), and Harbor-UCLA Medical Center, Torrance (R.J.L.) - all in California; the Department of Biomedical Sciences, Humanitas University, and IRCCS Humanitas Research Hospital, Milan (M.C.); National University Hospital Singapore, Singapore (M.E.C.); Dr. Kamakshi Memorial Hospital (D.J.) and Apollo Speciality Hospitals (E.R.) - both in Chennai, India; the University of Antwerp, Antwerp, Belgium (H.G.); National Intensive Care Surveillance-MORU, Colombo, Sri Lanka (R.H.); Ziauddin University, Karachi, Pakistan (M.H.); the University of Pittsburgh (D.T.H., B.J.M., M.D.N., C.W.S., D.C.A.) and the University of Pittsburgh Medical Center (D.T.H., B.J.M.) - both in Pittsburgh; Jikei University School of Medicine and the University of Tokyo, Tokyo (N.I.), and St. Marianna University School of Medicine, Yokohama Seibu Hospital, Yokohama (H.S.) - all in Japan; University College Dublin Clinical Research Centre, St. Vincent's University Hospital, Dublin (A.D.N.); Universidad de La Sabana and Clínica Universidad de La Sabana - both in Chia, Colombia (L.F.R.); the Division of Clinical and Translational Research, Division of Critical Care, Department of Anesthesiology, Washington University School of Medicine, St. Louis (P.S.); and the Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (B.T.T.).

Article Synopsis
  • The study aimed to evaluate the effectiveness of simvastatin in critically ill Covid-19 patients compared to a control group not receiving statins.
  • A total of 2684 patients were analyzed, showing a median of 11 organ support-free days in the simvastatin group versus 7 in the control group, with a high probability indicating simvastatin’s potential superiority.
  • However, the study was halted due to decreasing Covid-19 cases, and while simvastatin had some benefits, it also led to more reported serious adverse effects, such as elevated liver enzymes.
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Corticosteroids in ARDS.

J Clin Med

May 2023

Department of Intensive Care, Hôpital Raymond Poincaré, APHP University Versailles Saint Quentin-University Paris Saclay, 92380 Garches, France.

Article Synopsis
  • ARDS often occurs alongside sepsis, both driven by excessive inflammation in the body.
  • Corticosteroids, known for their anti-inflammatory properties, are now being explored for their potential benefits in treating ARDS, especially after showing reduced mortality in severe pneumonia cases.
  • The review emphasizes the need for high-quality research to clarify how corticosteroids can best be used in ARDS treatment, focusing on timing, dosing, and length of therapy.
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Article Synopsis
  • The RECORDS trial investigates how different adult patients with sepsis respond to corticosteroids by categorizing them into distinct groups based on their likelihood of responding to treatment.
  • It is a large, placebo-controlled study that includes 1800 adults with conditions like pneumonia and septic shock, randomly assigning them to receive either corticosteroids or placebo for 7 to 10 days.
  • The primary goal is to assess the impact of corticosteroids on mortality and organ dysfunction after 90 days, with the findings expected to be shared at conferences and published in scientific journals.
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Epidemiology, risk factors and prognosis of ventilator-associated pneumonia during severe COVID-19: Multicenter observational study across 149 European Intensive Care Units.

Anaesth Crit Care Pain Med

February 2023

Sorbonne University, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Saint-Antoine Hospital, Public Health Department, F75012 Paris, France.

Article Synopsis
  • COVID-19 patients on mechanical ventilation face a significant risk of developing ventilator-associated pneumonia (VAP), with about 45.5% of the analyzed patients experiencing VAP after around 7 days of ventilation.!* -
  • Key risk factors for developing VAP include male gender, pre-existing bacterial pneumonia, certain ventilation parameters, and the use of corticosteroids. VAP notably increases the risk of 90-day mortality, especially when it occurs later during ventilation.!* -
  • The study highlights the need to explore modifiable risk factors further, as VAP substantially impacts survival rates among COVID-19 patients who require prolonged mechanical ventilation, particularly during the second and third weeks of care.!*
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Does Measles, Mumps, and Rubella (MMR) Vaccination Protect against COVID-19 Outcomes: A Nationwide Cohort Study.

Vaccines (Basel)

November 2022

Clinical Research Unit AP-HP, Paris-Saclay, Hôpital Raymond Poincare, School of Medicine Simone Veil, University Versailles Saint Quentin-University Paris Saclay, INSERM (National Institute of Health and Medical Research), CESP, Anti-Infective Evasion and Pharmacoepidemiology Team, 78180 Montigny-Le-Bretonneux, France.

Cross-protection from previous live attenuated vaccines is proposed to explain the low impact of COVID-19 on children. This study aimed to evaluate the effect of live attenuated MMR vaccines on the risk of being hospitalized for COVID-19 in children. An exposed (MMR vaccine)-non-exposed cohort study was conducted using the nationwide French National Health Data System (SNDS).

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Effect of an enteral amino acid blend on muscle and gut functionality in critically ill patients: a proof-of-concept randomized controlled trial.

Crit Care

November 2022

General Intensive Care Unit, Raymond Poincaré Hospital (AP-HP), University of Versailles Saint-Quentin en Yvelines, University Paris Saclay, 104, Boulevard Raymond Poincaré, 92380, Garches, France.

Background: A defining feature of prolonged critical illness is muscle wasting, leading to impaired recovery. Supplementation with a tailored blend of amino acids may bolster the innate gut defence, promote intestinal mucosa repair and limit muscle loss.

Methods: This was a monocentric, randomized, double-blind, placebo-controlled study that included patients with sepsis or acute respiratory distress syndrome.

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Article Synopsis
  • The study examines the mucosal antibody response in the lungs of patients with severe COVID-19, focusing on the roles of IgG and IgA antibodies against different viral proteins.
  • The researchers found that mucosal IgA levels were higher than IgG in the lung and persisted even after the virus was cleared, especially in patients who experienced fatal outcomes.
  • Low levels of IL-1β in the lungs and the presence of non-neutralizing mucosal IgA were linked to worse COVID-19 outcomes, suggesting that these antibodies might have harmful effects despite their potential protective roles.*
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Infection of lung megakaryocytes and platelets by SARS-CoV-2 anticipate fatal COVID-19.

Cell Mol Life Sci

June 2022

Laboratory Mucosal Entry of HIV and Mucosal Immunity, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Cité, 75014, Paris, France.

SARS-CoV-2, although not being a circulatory virus, spread from the respiratory tract resulting in multiorgan failures and thrombotic complications, the hallmarks of fatal COVID-19. A convergent contributor could be platelets that beyond hemostatic functions can carry infectious viruses. Here, we profiled 52 patients with severe COVID-19 and demonstrated that circulating platelets of 19 out 20 non-survivor patients contain SARS-CoV-2 in robust correlation with fatal outcome.

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Background: Repeated rotation of empiric antibiotic treatment strategies is hypothesized to reduce antibiotic resistance. Clinical rotation studies failed to change unit-wide prevalence of antibiotic resistant bacteria (ARB) carriage, including an international cluster-randomized crossover study. Unit-wide effects may differ from individual effects due to "ecological fallacy".

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Introduction: COVID-19 induces venous, arterial and microvascular thrombosis, involving several pathophysiological processes. In patients with severe COVID-19 without macrovascular thrombosis, escalating into high-dose prophylactic anticoagulation (HD-PA) or therapeutic anticoagulation (TA) could be beneficial in limiting the extension of microvascular thrombosis and forestalling the evolution of lung and multiorgan microcirculatory dysfunction. In the absence of data from randomised trials, clinical practice varies widely.

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Background: To ensure the success of COVID-19 vaccination, public authorities need to have the support of the entire population and build vaccine confidence. Identifying and understanding the determinants of vaccine acceptance is essential for conducting vaccine strategy. The aim was to estimate vaccine hesitancy among healthcare students in France and to investigate the associated factors.

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Treatment of COVID-19-associated ARDS with mesenchymal stromal cells: a multicenter randomized double-blind trial.

Crit Care

February 2022

APHP, Hôpital Saint-Louis, Unité de Thérapie Cellulaire, Centre d'Investigation Clinique en Biothérapies CBT501, INSERM, Université de Paris, Paris, France.

Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-induced acute respiratory distress syndrome (ARDS) causes high mortality. Umbilical cord-derived mesenchymal stromal cells (UC-MSCs) have potentially relevant immune-modulatory properties, whose place in ARDS treatment is not established. This phase 2b trial was undertaken to assess the efficacy of UC-MSCs in patients with SARS-CoV-2-induced ARDS.

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