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  1. Article ; Online: Quantify or Diagnose Acute Respiratory Distress Syndrome by Lung Ultrasound.

    Volpicelli, Giovanni / Bouhemad, Belaid

    American journal of respiratory and critical care medicine

    2023  Volume 208, Issue 1, Page(s) 112–113

    MeSH term(s) Humans ; Lung/diagnostic imaging ; Respiratory Distress Syndrome/diagnostic imaging ; Ultrasonography ; Thorax
    Language English
    Publishing date 2023-05-02
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202303-0603LE
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Reply: Air Bronchogram Is Not Specific for Pneumonia.

    Bouhemad, Belaid

    American journal of respiratory and critical care medicine

    2017  Volume 195, Issue 1, Page(s) 144

    Language English
    Publishing date 2017-01-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.201607-1429LE
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Exploring the association between gastrointestinal dysfunction and abdominal venous congestion in ICU.

    Guinot, Pierre-Grégoire / Gallner, Doriane / De Baros, Jose Dantas / Nguyen, Maxime / Bouhemad, Belaid

    Intensive & critical care nursing

    2024  Volume 82, Page(s) 103639

    MeSH term(s) Humans ; Hyperemia ; Abdomen ; Intensive Care Units
    Language English
    Publishing date 2024-02-10
    Publishing country Netherlands
    Document type Letter
    ZDB-ID 1105892-4
    ISSN 1532-4036 ; 0964-3397
    ISSN (online) 1532-4036
    ISSN 0964-3397
    DOI 10.1016/j.iccn.2024.103639
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  4. Article ; Online: Exploring congestion endotypes and their distinct clinical outcomes among ICU patients: A post-hoc analysis.

    Guinot, Pierre-Gregoire / Longrois, Dan / Andrei, Stefan / Nguyen, Maxime / Bouhemad, Belaid

    Anaesthesia, critical care & pain medicine

    2024  Volume 43, Issue 3, Page(s) 101370

    Abstract: Background: In the intensive care unit (ICU) patients, fluid overload and congestion are associated with worse outcomes. Because of the heterogeneity of ICU patients, we hypothesized that there may exist different endotypes of congestion. The aim of ... ...

    Abstract Background: In the intensive care unit (ICU) patients, fluid overload and congestion are associated with worse outcomes. Because of the heterogeneity of ICU patients, we hypothesized that there may exist different endotypes of congestion. The aim of this study was to identify endotypes of congestion and their association with outcomes.
    Methods: We conducted an unsupervised hierarchical clustering analysis on 145 patients admitted to ICU to identify endotypes. We measured several parameters related to clinical context, volume status, filling pressure, and venous congestion. These parameters included NT-proBNP, central venous pressure (CVP), the mitral E/e' ratio, the systolic/diastolic ratio of hepatic veins' flow velocity, the mean diameter of the inferior vena cava (IVC) and its variations, stroke volume changes following passive leg raising, the portal vein pulsatility index, and the venous renal impedance index.
    Results: Three distinct endotypes were identified: (1) "hemodynamic congestion" endotype (n = 75) with moderate alterations of ventricular function, increased CVP and left filling pressure values, and moderate fluid overload; (2) "volume overload congestion" endotype (n = 50); with normal cardiac function and filling pressure despite high positive fluid balance (fluid overload); (3) "systemic congestion" endotype (n = 20) with severe alterations of left and right ventricular functions, increased CVP and left ventricular filling pressure values. These endotypes vary significantly in ICU admission reasons, acute kidney injury rates, mortality, and length of ICU/hospital stay.
    Conclusions: Our analysis revealed three unique congestion endotypes in ICU patients, each with distinct pathophysiological features and outcomes. These endotypes are identifiable through key ultrasonographic characteristics at the bedside.
    Clinical trial gov: NCT04680728.
    Language English
    Publishing date 2024-03-08
    Publishing country France
    Document type Journal Article
    ISSN 2352-5568
    ISSN (online) 2352-5568
    DOI 10.1016/j.accpm.2024.101370
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  5. Article ; Online: The weaning from mechanical ventilation: a comprehensive ultrasound approach.

    Santangelo, Erminio / Mongodi, Silvia / Bouhemad, Bélaid / Mojoli, Francesco

    Current opinion in critical care

    2022  Volume 28, Issue 3, Page(s) 322–330

    Abstract: Purpose of review: Due to heart, lung and diaphragm interactions during weaning from mechanical ventilation, an ultrasound integrated approach may be useful in the detection of dysfunctions potentially leading to weaning failure. In this review, we will ...

    Abstract Purpose of review: Due to heart, lung and diaphragm interactions during weaning from mechanical ventilation, an ultrasound integrated approach may be useful in the detection of dysfunctions potentially leading to weaning failure. In this review, we will summarize the most recent advances concerning the ultrasound applications relevant to the weaning from mechanical ventilation.
    Recent findings: The role of ultrasonographic examination of heart, lung and diaphragm has been deeply investigated over the years. Most recent findings concern the ability of lung ultrasound in detecting weaning induced pulmonary edema during spontaneous breathing trial. Furthermore, in patients at high risk of cardiac impairments, global and anterolateral lung ultrasound scores have been correlated with weaning and extubation failure, whereas echocardiographic indexes were not. For diaphragmatic ultrasound evaluation, new indexes have been proposed for the evaluation of diaphragm performance during weaning, but further studies are needed to validate these results.
    Summary: The present review summarizes the potential role of ultrasonography in the weaning process. A multimodal integrated approach allows the clinician to comprehend the pathophysiological processes of weaning failure.
    MeSH term(s) Airway Extubation ; Diaphragm/diagnostic imaging ; Humans ; Respiration, Artificial/adverse effects ; Ultrasonography/methods ; Ventilator Weaning/adverse effects ; Ventilator Weaning/methods
    Language English
    Publishing date 2022-03-09
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1235629-3
    ISSN 1531-7072 ; 1070-5295
    ISSN (online) 1531-7072
    ISSN 1070-5295
    DOI 10.1097/MCC.0000000000000941
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  6. Article: Editorial: Lung Ultrasound and COVID-19 Interstitial Pneumonia in Different Medical Care Settings.

    Vetrugno, Luigi / De Marchi, Lorenzo / Bouhemad, Belaid

    Frontiers in medicine

    2022  Volume 9, Page(s) 951706

    Language English
    Publishing date 2022-06-23
    Publishing country Switzerland
    Document type Editorial
    ZDB-ID 2775999-4
    ISSN 2296-858X
    ISSN 2296-858X
    DOI 10.3389/fmed.2022.951706
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  7. Article ; Online: Prospective randomized double-blind study to evaluate the superiority of Vasopressin versus Norepinephrine in the management of the patient at renal risk undergoing cardiac surgery with cardiopulmonary bypass (NOVACC trial).

    Guinot, Pierre-Grégoire / Desebbe, Olivier / Besch, Guillaume / Guerci, Philippe / Gaudard, Philippe / Lena, Diane / Mertes, Paul Michel / Abou-Arab, Osama / Bouhemad, Belaid

    American heart journal

    2024  Volume 272, Page(s) 86–95

    Abstract: Background: Cardiac surgery-associated acute kidney injury (CS-AKI) affects up to 30% of patients, increasing morbidity and healthcare costs. This condition results from complex factors like ischemia-reperfusion injury and renal hemodynamic changes, ... ...

    Abstract Background: Cardiac surgery-associated acute kidney injury (CS-AKI) affects up to 30% of patients, increasing morbidity and healthcare costs. This condition results from complex factors like ischemia-reperfusion injury and renal hemodynamic changes, often exacerbated by surgical procedures. Norepinephrine, commonly used in cardiac surgeries, may heighten the risk of CS-AKI. In contrast, vasopressin, a noncatecholaminergic agent, shows potential in preserving renal function by favorably affecting renal hemodynamic. Preliminary findings, suggest vasopressin could reduce the incidence of CS-AKI compared to norepinephrine. Additionally, vasopressin is linked to a lower incidence of postoperative atrial fibrillation, another factor contributing to longer hospital stays and higher costs. This study hypothesizes that vasopressin could effectively reduce CS-AKI occurrence and severity by optimizing renal perfusion during cardiac surgeries.
    Study design: The NOVACC trial (NCT05568160) is a multicenter, randomized, double blinded superiority-controlled trial testing the superiority of vasopressin over norepinephrine in patients scheduled for cardiac surgery with cardiopulmonary bypass (CPB). The primary composite end point is the occurrence of acute kidney injury and death. The secondary end points are neurological, cardiologic, digestive, and vasopressor related complications at day 7, day 30, day 90, hospital and intensive care unit lengths of stay, medico-economic costs at day 90.
    Conclusion: The NOVACC trial will assess the effectiveness of vasopressin in cardiac surgery with CPB in reducing acute kidney injury, mortality, and medical costs.
    Clinical trial registration: NCT05568160.
    MeSH term(s) Humans ; Acute Kidney Injury/prevention & control ; Acute Kidney Injury/etiology ; Acute Kidney Injury/epidemiology ; Double-Blind Method ; Cardiopulmonary Bypass/methods ; Cardiopulmonary Bypass/adverse effects ; Norepinephrine/therapeutic use ; Vasopressins/therapeutic use ; Cardiac Surgical Procedures/methods ; Vasoconstrictor Agents/therapeutic use ; Prospective Studies ; Postoperative Complications/prevention & control ; Postoperative Complications/epidemiology ; Male ; Female
    Chemical Substances Norepinephrine (X4W3ENH1CV) ; Vasopressins (11000-17-2) ; Vasoconstrictor Agents
    Language English
    Publishing date 2024-03-16
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 80026-0
    ISSN 1097-6744 ; 0002-8703
    ISSN (online) 1097-6744
    ISSN 0002-8703
    DOI 10.1016/j.ahj.2024.03.008
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  8. Article: Endotoxemia in Acute Heart Failure and Cardiogenic Shock: Evidence, Mechanisms and Therapeutic Options.

    Nguyen, Maxime / Gautier, Thomas / Masson, David / Bouhemad, Belaid / Guinot, Pierre-Grégoire

    Journal of clinical medicine

    2023  Volume 12, Issue 7

    Abstract: Acute heart failure and cardiogenic shock are frequently occurring and deadly conditions. In patients with those conditions, endotoxemia related to gut injury and gut barrier dysfunction is usually described as a driver of organ dysfunction. Because ... ...

    Abstract Acute heart failure and cardiogenic shock are frequently occurring and deadly conditions. In patients with those conditions, endotoxemia related to gut injury and gut barrier dysfunction is usually described as a driver of organ dysfunction. Because endotoxemia might reciprocally alter cardiac function, this phenomenon has been suggested as a potent vicious cycle that worsens organ perfusion and leading to adverse outcomes. Yet, evidence beyond this phenomenon might be overlooked, and mechanisms are not fully understood. Subsequently, even though therapeutics available to reduce endotoxin load, there are no indications to treat endotoxemia during acute heart failure and cardiogenic shock. In this review, we first explore the evidence regarding endotoxemia in acute heart failure and cardiogenic shock. Then, we describe the main treatments for endotoxemia in the acute setting, and we present the challenges that remain before personalized treatments against endotoxemia can be used in patients with acute heart failure and cardiogenic shock.
    Language English
    Publishing date 2023-03-29
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12072579
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  9. Article ; Online: Real life use of vasopressin in patients with cardiogenic shock: a retrospective cohort analysis.

    Nguyen, Maxime / Berthoud, Vivien / Rizk, Alexis / Bouhemad, Bélaïd / Guinot, Pierre-Grégoire

    Critical care (London, England)

    2023  Volume 27, Issue 1, Page(s) 291

    MeSH term(s) Humans ; Shock, Cardiogenic/drug therapy ; Retrospective Studies ; Vasopressins/therapeutic use ; Cohort Studies
    Chemical Substances Vasopressins (11000-17-2)
    Language English
    Publishing date 2023-07-19
    Publishing country England
    Document type Letter
    ZDB-ID 2041406-7
    ISSN 1466-609X ; 1364-8535
    ISSN (online) 1466-609X
    ISSN 1364-8535
    DOI 10.1186/s13054-023-04574-8
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  10. Article ; Online: Prevalence of systemic venous congestion assessed by Venous Excess Ultrasound Grading System (VExUS) and association with acute kidney injury in a general ICU cohort: a prospective multicentric study.

    Andrei, Stefan / Bahr, Pierre-Alain / Nguyen, Maxime / Bouhemad, Belaid / Guinot, Pierre-Grégoire

    Critical care (London, England)

    2023  Volume 27, Issue 1, Page(s) 224

    Abstract: Background: The importance of assessing venous congestion in ICU patients is widely acknowledged, but its study is hampered by the lack of a practical evaluation tool. The Venous Excess Ultrasound Grading System (VExUS), based on a semi-quantitative ... ...

    Abstract Background: The importance of assessing venous congestion in ICU patients is widely acknowledged, but its study is hampered by the lack of a practical evaluation tool. The Venous Excess Ultrasound Grading System (VExUS), based on a semi-quantitative combined ultrasound assessment, has been associated with acute kidney injury (AKI) in cardiac ICU patients. The objectives of this study were to assess the prevalence of congestion using VExUS in general ICU patients, and to evaluate the association between VExUS, AKI and death.
    Methods: This prospective, observational study included adult patients within 24 h of ICU admission. VExUS and hemodynamic parameters were measured four times during the ICU stay: within 24 h of ICU admission, after day 1 (between 24 and 48 h), after day 2 (between 48 and 72 h), and last day of ICU stay. The prevalence of AKI during the first week in ICU and 28-day mortality were assessed.
    Results: Among the 145 patients included, the percentage of patients with a VExUS score of 2 (moderate congestion) and 3 (severe congestion) was 16% and 6%, respectively. The prevalence did not change over the study period. There was no significant association between admission VExUS scores and AKI (p = 0.136) or 28-day mortality (p = 0.594). Admission VExUS ≥ 2 was not associated with AKI (OR 0.499, CI
    Conclusions: In general ICU cohort the prevalence of moderate to severe venous congestion was low. Early assessment of systemic venous congestion using VExUS scores was not associated with the development of AKI or with 28-day mortality.
    MeSH term(s) Adult ; Humans ; Prospective Studies ; Prevalence ; Hyperemia/complications ; Intensive Care Units ; Acute Kidney Injury/etiology ; Acute Kidney Injury/complications
    Language English
    Publishing date 2023-06-08
    Publishing country England
    Document type Observational Study ; Multicenter Study ; Journal Article
    ZDB-ID 2041406-7
    ISSN 1466-609X ; 1364-8535
    ISSN (online) 1466-609X
    ISSN 1364-8535
    DOI 10.1186/s13054-023-04524-4
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