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  1. Article: Correction: Which severe COVID-19 patients could benefit from high dose dexamethasone? A Bayesian post-hoc reanalysis of the COVIDICUS randomized clinical trial.

    Chevret, Sylvie / Bouadma, Lila / Dupuis, Claire / Burdet, Charles / Timsit, Jean-Francois

    Annals of intensive care

    2023  Volume 13, Issue 1, Page(s) 95

    Language English
    Publishing date 2023-09-29
    Publishing country Germany
    Document type Published Erratum
    ZDB-ID 2617094-2
    ISSN 2110-5820
    ISSN 2110-5820
    DOI 10.1186/s13613-023-01194-x
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  2. Article ; Online: Severe meningoencephalitis: epidemiology and outcomes.

    Thy, Michael / de Montmollin, Etienne / Bouadma, Lila / Timsit, Jean-François / Sonneville, Romain

    Current opinion in critical care

    2023  Volume 29, Issue 5, Page(s) 415–422

    Abstract: 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 ...

    Abstract 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. In patients requiring intensive care, meningoencephalitis is associated with a severe prognosis, including mortality rates ranging from 11 to 25% and functional disability in 15-25% of survivors. Recent multicenter studies have identified several parameters linked to poor outcomes, including older age, immunocompromised status, focal neurologic signs, abnormal brain imaging, and delayed administration of antimicrobials. The use of new multiplex PCR techniques for diagnosis has generated debate based on recent data. Investigation is still needed to determine the effectiveness of adjunctive therapies, including seizure prophylaxis, and adjunctive steroids for nonbacterial causes.
    Summary: Recent multicenter studies have enhanced our understanding of the current epidemiology and outcomes of severe meningoencephalitis in adult patients.
    MeSH term(s) Adult ; Humans ; Meningoencephalitis/epidemiology ; Inflammation ; Brain ; Critical Care ; Immunocompromised Host
    Language English
    Publishing date 2023-08-09
    Publishing country United States
    Document type Review ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1235629-3
    ISSN 1531-7072 ; 1070-5295
    ISSN (online) 1531-7072
    ISSN 1070-5295
    DOI 10.1097/MCC.0000000000001087
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    In stock of ZB MED Cologne/Königswinter

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  3. Article ; Online: Oral care with chlorhexidine: beware!

    Bouadma, Lila / Klompas, Michael

    Intensive care medicine

    2018  Volume 44, Issue 7, Page(s) 1153–1155

    MeSH term(s) Anti-Infective Agents, Local ; Chlorhexidine ; Mouthwashes
    Chemical Substances Anti-Infective Agents, Local ; Mouthwashes ; Chlorhexidine (R4KO0DY52L)
    Language English
    Publishing date 2018-05-28
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0340-0964 ; 0342-4642 ; 0935-1701
    DOI 10.1007/s00134-018-5221-x
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  4. Article: Which severe COVID-19 patients could benefit from high dose dexamethasone? A Bayesian post-hoc reanalysis of the COVIDICUS randomized clinical trial.

    Chevret, Sylvie / Bouadma, Lila / Dupuis, Claire / Burdet, Charles / Timsit, Jean-François

    Annals of intensive care

    2023  Volume 13, Issue 1, Page(s) 75

    Abstract: Background: The respective benefits of high and low doses of dexamethasone (DXM) in patients with severe acute respiratory syndrome coronavirus 2 (SARS-Cov2) and acute respiratory failure (ARF) are controversial, with two large triple-blind RCTs ... ...

    Abstract Background: The respective benefits of high and low doses of dexamethasone (DXM) in patients with severe acute respiratory syndrome coronavirus 2 (SARS-Cov2) and acute respiratory failure (ARF) are controversial, with two large triple-blind RCTs reaching very important difference in the effect-size. In the COVIDICUS trial, no evidence of additional benefit of high-dose dexamethasone (DXM20) was found. We aimed to explore whether some specific patient phenotypes could benefit from DXM20 compared to the standard of care 6 mg dose of DXM (DXMSoC).
    Methods: We performed a post hoc exploratory Bayesian analysis of 473 patients who received either DXMSoc or DXM20 in the COVIDICUS trial. The outcome was the 60 day mortality rate of DXM20 over DXMSoC, with treatment effect measured on the hazard ratio (HR) estimated from Cox model. Bayesian analyses allowed to compute the posterior probability of a more than trivial benefit (HR < 0.95), and that of a potential harm (HR > 1.05). Bayesian measures of interaction then quantified the probability of interaction (Pr Interact) that the HR of death differed across the subsets by 20%. Primary analyses used noninformative priors, centred on HR = 1.00. Sensitivity analyses used sceptical and enthusiastic priors, based on null (HR = 1.00) or benefit (HR = 0.95) effects.
    Results: Overall, the posterior probability of a more than trivial benefit and potential harm was 29.0 and 51.1%, respectively. There was some evidence of treatment by subset interaction (i) according to age (Pr Interact, 84%), with a 86.5% probability of benefit in patients aged below 70 compared to 22% in those aged above 70; (ii) according to the time since symptoms onset (Pr Interact, 99%), with a 99.9% probability of a more than trivial benefit when lower than 7 days compared to a < 0.1% probability when delayed by 7 days or more; and (iii) according to use of remdesivir (Pr Interact, 91%), with a 90.1% probability of benefit in patients receiving remdesivir compared to 19.1% in those who did not.
    Conclusions: In this exploratory post hoc Bayesian analysis, compared with standard-of-care DXM, high-dose DXM may benefit patients aged less than 70 years with severe ARF that occurred less than 7 days after symptoms onset. The use of remdesivir may also favour the benefit of DXM20. Further analysis is needed to confirm these findings.
    Trial registration: NCT04344730, date of registration April 14, 2020 ( https://clinicaltrials.gov/ct2/show/NCT04344730?term=NCT04344730&draw=2&rank=1 ); EudraCT: 2020-001457-43 ( https://www.clinicaltrialsregister.eu/ctr-search/search?query=2020-001457-43 ).
    Language English
    Publishing date 2023-08-27
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2617094-2
    ISSN 2110-5820
    ISSN 2110-5820
    DOI 10.1186/s13613-023-01168-z
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  5. Article ; Online: Association of Sepsis With Neurologic Outcomes of Adult Patients Treated With Venoarterial Extracorporeal Membrane Oxygnenation.

    Tridon, Chloé / Bachelet, Delphine / El Baied, Majda / Eloy, Philippine / Ortuno, Sofia / Para, Marylou / Wicky, Paul-Henri / Vellieux, Geoffroy / de Montmollin, Etienne / Bouadma, Lila / Manceau, Hana / Timsit, Jean-François / Peoc'h, Katell / Sonneville, Romain

    Critical care explorations

    2024  Volume 6, Issue 2, Page(s) e1042

    Abstract: 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 ...

    Abstract 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.
    Setting: Medical ICU of a university hospital, France, 2013-2020.
    Patients: Patients with sepsis at the time of VA-ECMO cannulation ("sepsis" group) were compared with patients without sepsis ("no sepsis" group). The primary outcome measure was poor functional outcome at 90 days, defined by a score greater than or equal to 4 on the modified Rankin scale (mRS), indicating severe disability or death.
    Interventions: None.
    Measurements and main results: A total of 196 patients were included ("sepsis,"
    Conclusion: We observed a detrimental role of sepsis on neurologic outcomes in the subgroup of patients who had experienced pre-ECMO cardiac arrest, but not in other patients.
    Language English
    Publishing date 2024-02-07
    Publishing country United States
    Document type Journal Article
    ISSN 2639-8028
    ISSN (online) 2639-8028
    DOI 10.1097/CCE.0000000000001042
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  6. Article ; Online: Emergency craniotomy in semi-lateral position for posterior fossa hemorrhage evacuation under venoarterial extracorporeal membrane oxygenation.

    Papin, Grégory / Sonneville, Romain / Nataf, Partick / Bouadma, Lila

    Intensive care medicine

    2019  Volume 45, Issue 8, Page(s) 1152–1153

    MeSH term(s) Adult ; Craniotomy/methods ; Extracorporeal Membrane Oxygenation/methods ; Humans ; Intracranial Hemorrhages/complications ; Intracranial Hemorrhages/surgery ; Male ; Patient Positioning/methods
    Language English
    Publishing date 2019-01-21
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0340-0964 ; 0342-4642 ; 0935-1701
    DOI 10.1007/s00134-019-05525-0
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  7. Article: Impact of direct ICU admission of pneumococcal meningitis in France: a retrospective analysis of a French medico-administrative (PMSI) database.

    Thy, Michael / Dupuis, Claire / Mageau, Arthur / Mourvillier, Bruno / Bouadma, Lila / Ruckly, Stéphane / Perozziello, Anne / Strukov, Andrey / Van-Gysel, Damien / de Montmollin, Etienne / Sonneville, Romain / Timsit, Jean-François

    Annals of intensive care

    2024  Volume 14, Issue 1, Page(s) 15

    Abstract: 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 ... ...

    Abstract 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. We defined two groups, "Direct ICU" corresponding to a direct ICU admission and "Delayed ICU" corresponding to a secondary ICU admission.
    Results: We identified 4052 patients hospitalized for a first episode of PM, including 2006 "Direct ICU" patients (50%) and 2046 "delayed ICU" patients (50%). The patients were mainly males [n = 2260 (56%)] with median age of 61 years [IQR 50-71] and a median Charlson index of 1 [0-3]. Among them, median SAPS II on admission was 46 [33-62], 2173 (54%) had a neurological failure on admission with 2133 (53%) in coma, 654 (16%) with brainstem failure, 488 (12%) with seizures and 779 (19%) with focal signs without coma. PM was frequently associated with pneumonia [n = 1411 (35%)], and less frequently with endocarditis [n = 317 (8%)]. The median ICU length of stay and hospital length of stay were 6 days [2-14] and 21 days [13-38], respectively. In-hospital mortality was 27% (n = 1100) and 640 (16%) patients were secondarily transferred to rehabilitation care unit. Direct ICU group was significantly more severe but after adjustment for age, sex, comorbidities, organ failures on admission and admission from home, direct ICU admission was significantly associated with a lower mortality (Odds ratio 0.67 [0.56-0.80], p < 0.01). This corresponded to one death avoided for 11 PM directly admitted in ICU.
    Conclusions: Among patients with PM and sepsis, direct ICU admission was associated with lower mortality rates when compared to delayed admission.
    Language English
    Publishing date 2024-01-27
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2617094-2
    ISSN 2110-5820
    ISSN 2110-5820
    DOI 10.1186/s13613-023-01239-1
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  8. Article ; Online: Why biomarkers failed in sepsis.

    Jensen, Jens-Ulrik / Bouadma, Lila

    Intensive care medicine

    2016  Volume 42, Issue 12, Page(s) 2049–2051

    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Biomarkers/analysis ; Clinical Trials as Topic ; Humans ; Sepsis/diagnosis ; Sepsis/drug therapy ; Severity of Illness Index
    Chemical Substances Anti-Bacterial Agents ; Biomarkers
    Language English
    Publishing date 2016-12
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0340-0964 ; 0342-4642 ; 0935-1701
    DOI 10.1007/s00134-016-4531-0
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  9. Article: Natural light exposure and delirium in ICU: does the dark side cloud everything?

    Sonneville, Romain / Smonig, Roland / Dupuis, Claire / Bouadma, Lila / de Montmollin, Etienne / Timsit, Jean-François

    Annals of intensive care

    2020  Volume 10, Issue 1, Page(s) 25

    Language English
    Publishing date 2020-02-27
    Publishing country Germany
    Document type Letter
    ZDB-ID 2617094-2
    ISSN 2110-5820
    ISSN 2110-5820
    DOI 10.1186/s13613-020-0643-3
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  10. Article ; Online: Chlorhexidine use in adult patients on ICU.

    Bouadma, Lila / Karpanen, Tarja / Elliott, Tom

    Intensive care medicine

    2018  Volume 44, Issue 12, Page(s) 2232–2234

    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Anti-Infective Agents, Local/therapeutic use ; Catheter-Related Infections/drug therapy ; Chlorhexidine/therapeutic use ; Critical Care/standards ; Cross Infection/prevention & control ; Female ; Humans ; Male ; Middle Aged ; Practice Guidelines as Topic ; Skin Diseases, Bacterial/drug therapy
    Chemical Substances Anti-Infective Agents, Local ; Chlorhexidine (R4KO0DY52L)
    Language English
    Publishing date 2018-03-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0340-0964 ; 0342-4642 ; 0935-1701
    DOI 10.1007/s00134-018-5137-5
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