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  1. Article ; Online: Safety and harms of bronchoalveolar lavage (BAL) for acute respiratory failure.

    Kamel, Toufik / Boulain, Thierry

    Respiratory investigation

    2022  Volume 60, Issue 6, Page(s) 861–862

    MeSH term(s) Humans ; Bronchoalveolar Lavage ; Respiratory Distress Syndrome ; Respiratory Insufficiency ; Bronchoalveolar Lavage Fluid
    Language English
    Publishing date 2022-08-12
    Publishing country Netherlands
    Document type Letter
    ZDB-ID 2660821-2
    ISSN 2212-5353 ; 2212-5345
    ISSN (online) 2212-5353
    ISSN 2212-5345
    DOI 10.1016/j.resinv.2022.06.014
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  2. Article ; Online: Paracetamol use and lowered risk of acute kidney injury in patients with rhabdomyolysis.

    Desgrouas, Maxime / Boulain, Thierry

    Journal of nephrology

    2021  Volume 34, Issue 5, Page(s) 1725–1735

    Abstract: Background: Mortality with rhabdomyolysis-associated acute kidney injury can be as high as 80%. Experimental data from mouse models of rhabdomyolysis showed that paracetamol reduces the expected increase in serum creatinine level. We aimed to assess the ...

    Abstract Background: Mortality with rhabdomyolysis-associated acute kidney injury can be as high as 80%. Experimental data from mouse models of rhabdomyolysis showed that paracetamol reduces the expected increase in serum creatinine level. We aimed to assess the association between paracetamol use and the need for starting renal replacement therapy (RRT).
    Methods: We conducted a propensity score-matched cohort study in Orléans Hospital, France (a 1136-bed, public, university-affiliated and teaching hospital). All patients with serum creatine phosphokinase (CK) level > 5000 IU/L between January 1st, 2008 and December 31st, 2017 were included. A propensity score was calculated for each included patient by using multivariable logistic regression and all available baseline characteristics. The main outcome was the incidence of RRT initiation from day 1 to day 28 in the propensity score-matched cohort between patients exposed and unexposed to paracetamol.
    Results: Over the study period, 1065 patients with at least one CK level measurement > 5000 IU/L were included; 40 (3.8%) had at least one RRT session. Among the 343 matched pairs, 10 (2.9%) exposed and 24 (7.0%) unexposed patients underwent RRT before day 28 (P = 0.021). Primary time-to-event analysis showed that exposure to paracetamol was significantly associated with reduced absolute risk of RRT: absolute risk difference = - 3.18% (95% CI - 5.23 to - 1.20, P = 0.001). All secondary analyses showed a significantly reduced absolute risk of RRT in patients exposed to paracetamol.
    Conclusion: Our study showed a significant association between paracetamol exposure and reduced incidence of RRT among patients with rhabdomyolysis.
    MeSH term(s) Acetaminophen/adverse effects ; Acute Kidney Injury/chemically induced ; Acute Kidney Injury/diagnosis ; Acute Kidney Injury/epidemiology ; Animals ; Cohort Studies ; Humans ; Mice ; Renal Replacement Therapy ; Retrospective Studies ; Rhabdomyolysis/chemically induced ; Rhabdomyolysis/diagnosis ; Rhabdomyolysis/epidemiology
    Chemical Substances Acetaminophen (362O9ITL9D)
    Language English
    Publishing date 2021-01-05
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 1093991-x
    ISSN 1724-6059 ; 1120-3625 ; 1121-8428
    ISSN (online) 1724-6059
    ISSN 1120-3625 ; 1121-8428
    DOI 10.1007/s40620-020-00950-7
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  3. Article ; Online: Comparing high-flow nasal oxygenation or standard oxygenation for gastrointestinal endoscopy with sedation. Response to BrJ Anaesth 2021; 127, e90-e91.

    Nay, Mai-Anh / Boulain, Thierry

    British journal of anaesthesia

    2021  Volume 127, Issue 3, Page(s) e92

    MeSH term(s) Anesthesia ; Endoscopy, Gastrointestinal ; Humans
    Language English
    Publishing date 2021-07-16
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 80074-0
    ISSN 1471-6771 ; 0007-0912
    ISSN (online) 1471-6771
    ISSN 0007-0912
    DOI 10.1016/j.bja.2021.06.013
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  4. Article ; Online: Effect of nutritional supplementation on bone mineral density in children with sickle cell disease: protocol for an open-label, randomised controlled clinical trial.

    Condé, Mohamed / Lespessailles, Eric / Wanneveich, Mathilde / Allemandou, Delphine / Boulain, Thierry / Dimitrov, Georges

    BMJ open

    2024  Volume 14, Issue 4, Page(s) e080235

    Abstract: Introduction: Children with sickle cell disease show a significant decrease in bone mineral density, an increase in resting energy expenditure of more than 15%, a decrease in fat and lean mass as well as a significant increase in protein turnover, ... ...

    Abstract Introduction: Children with sickle cell disease show a significant decrease in bone mineral density, an increase in resting energy expenditure of more than 15%, a decrease in fat and lean mass as well as a significant increase in protein turnover, particularly in bone tissue. This study aims to evaluate the effectiveness of an increase in food intake on bone mineral density and the clinical and biological complications of paediatric sickle cell disease.
    Methods and analysis: The study is designed as an open-label randomised controlled clinical trial conducted in the Paediatrics Unit of the Orléans University Hospital Centre. Participants aged 3-16 years will be randomly divided into two groups: the intervention group will receive oral nutritional supplements (pharmacological nutritional hypercaloric products) while the control group will receive age-appropriate and gender-appropriate nutritional intake during 12 months. Total body less head bone mineral density will be measured at the beginning and the end of the trial. A rigorous nutritional follow-up by weekly 24 hours recall dietary assessment and planned contacts every 6 weeks will be carried out throughout the study. A school absenteeism questionnaire, intended to reflect the patient's school productivity, will be completed by participants and parents every 3 months. Blood samples of each patient of both groups will be stocked at the beginning and at the end of the trial, for future biological trial. Clinical and biological complications will be regularly monitored.
    Ethics and dissemination: The protocol has been approved by the French ethics committee (Comité de Protection des Personnes Sud-Ouest et Outre-Mer 2, Toulouse; approval no: 2-20-092 id9534). Children and their parents will give informed consent to participate in the study before taking part. Results will be disseminated through peer-reviewed journals or international academic conferences.
    Trial registration number: NCT04754711.
    MeSH term(s) Humans ; Child ; Bone Density ; Dietary Supplements ; Bone and Bones ; Anemia, Sickle Cell/therapy ; Randomized Controlled Trials as Topic
    Language English
    Publishing date 2024-04-05
    Publishing country England
    Document type Clinical Trial Protocol ; Journal Article
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2023-080235
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  5. Article ; Online: Cough Peak Flow Assessment Without Disconnection From the ICU Ventilator in Mechanically Ventilated Patients.

    Fossat, Guillaume / Desmalles, Emmanuelle / Courtes, Léa / Fossat, Cécile / Boulain, Thierry

    Respiratory care

    2023  Volume 68, Issue 4, Page(s) 470–477

    Abstract: Background: Because ICU ventilators incorporate flow velocity measurement, cough peak expiratory flow (CPF) can be assessed without disconnecting the patient from the ICU ventilator. Our goal was to estimate the correlation between CPF obtained with the ...

    Abstract Background: Because ICU ventilators incorporate flow velocity measurement, cough peak expiratory flow (CPF) can be assessed without disconnecting the patient from the ICU ventilator. Our goal was to estimate the correlation between CPF obtained with the built-in ventilator flow meter (ventilator CPF) and CPF obtained with an electronic portable handheld peak flow meter connected to the endotracheal tube.
    Methods: Cooperative mechanically ventilated patients who entered the weaning process and who were ventilated with pressure support < 15 cm H
    Results: We analyzed CPF obtained in 61 subjects. The mean ± SD value of ventilator CPF and peak flow meter CPF were 72.6 ± 27.5 L/min and 31.1 ± 13.4 L/min. The Pearson correlation coefficient was 0.63 (95% CI 0.45-0.76),
    Conclusions: CPF measurements using a built-in ventilator flow meter were feasible in routine practice with cooperative ICU subjects who were intubated and correlated with CPF assessed by an electronic portable peak flow meter.
    MeSH term(s) Humans ; Respiration, Artificial ; Cough ; Ventilators, Mechanical ; Intubation, Intratracheal ; Intensive Care Units ; Ventilator Weaning
    Language English
    Publishing date 2023-03-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603252-7
    ISSN 1943-3654 ; 0098-9142 ; 0020-1324
    ISSN (online) 1943-3654
    ISSN 0098-9142 ; 0020-1324
    DOI 10.4187/respcare.10412
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  6. Article: Does diaphragm ultrasound improve the rapid shallow breathing index accuracy for predicting the success of weaning from mechanical ventilation?

    Fossat, Guillaume / Daillet, Blanche / Desmalles, Emmanuelle / Boulain, Thierry

    Australian critical care : official journal of the Confederation of Australian Critical Care Nurses

    2021  Volume 35, Issue 3, Page(s) 233–240

    Abstract: Background: This prospective study investigated whether taking into account diaphragmatic excursion (DE) measured by ultrasonography would improve the performance of the rapid shallow breathing index (RSBI) to predict extubation success or failure.: ... ...

    Abstract Background: This prospective study investigated whether taking into account diaphragmatic excursion (DE) measured by ultrasonography would improve the performance of the rapid shallow breathing index (RSBI) to predict extubation success or failure.
    Objectives: The aim of the study was to compare the new composite index named the rapid shallow diaphragmatic index (RSDI), and the RSBI measured during a spontaneous breathing trial regarding their ability to predict the need for re-intubation at 72 h.
    Methods: One hundred mechanically ventilated patients underwent daily 30-min spontaneous breathing trials (SBTs) under pressure support ventilation of 6 cm H
    Results: RSBI and RSBI/DE showed AUCs with 95% confidence intervals consistently extending below 0.50, either at the 5th (0.55 [0.36-0.74] and 0.55 [0.34-0.75], respectively) or at the 25th minute of SBT (0.49 [0.27-0.71] and 0.50 [0.29-0.68], respectively) for predicting weaning success at 72 h or at 7 d (5th min: 0.53 [0.37-0.70] and 0.54 [0.37-0.70], respectively; 25th min: 0.54 [0.37-0.71] and 0.55 [0.39-0.71], respectively). An exploratory index incorporating the accessory respiratory muscle activity, DE, DTF, and respiratory rate at 5th min of SBT showed AUCs for predicting extubation success at 7 d in the 78 patients with DTF measurement (0.77 [0.64-0.90]) that were significantly higher than that of the RSBI (P = 0.017) and RSBI/DE (P < 0.001) in the same respective populations.
    Conclusions: The RSBI and the ratio RSBI/DE failed to predict weaning success when measured during an SBT performed under minimal pressure support. Predictive indices incorporating ultrasound DE and DTF may merit further investigation.
    MeSH term(s) Diaphragm/diagnostic imaging ; Humans ; Prospective Studies ; Respiration, Artificial ; Ultrasonography ; Ventilator Weaning
    Language English
    Publishing date 2021-07-30
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 1159493-7
    ISSN 1878-1721 ; 1036-7314
    ISSN (online) 1878-1721
    ISSN 1036-7314
    DOI 10.1016/j.aucc.2021.05.008
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  7. Article ; Online: Sensitivity and specificity of heat and moisture exchange filters sampling for SARS-CoV-2 detection in mechanically ventilated COVID-19 patients.

    Kamel, Toufik / Guillaume, Clémence / Muller, Grégoire / Baala, Lekbir / Boulain, Thierry

    Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi

    2022  Volume 55, Issue 6 Pt 1, Page(s) 1122–1125

    Abstract: We assessed the sensitivity and specificity of SARS-CoV-2 detection by polymerase chain reaction in heat and moisture exchange filters (HMEF) in mechanically ventilated COVID-19 patients. We showed that testing HMEF might obviate the need for a tracheal ... ...

    Abstract We assessed the sensitivity and specificity of SARS-CoV-2 detection by polymerase chain reaction in heat and moisture exchange filters (HMEF) in mechanically ventilated COVID-19 patients. We showed that testing HMEF might obviate the need for a tracheal sample to affirm that a patient is not ready to end isolation.
    MeSH term(s) Humans ; COVID-19/diagnosis ; SARS-CoV-2 ; Respiration, Artificial ; Hot Temperature ; Sensitivity and Specificity
    Language English
    Publishing date 2022-04-14
    Publishing country England
    Document type Journal Article
    ZDB-ID 1497590-7
    ISSN 1995-9133 ; 1684-1182 ; 0253-2662
    ISSN (online) 1995-9133
    ISSN 1684-1182 ; 0253-2662
    DOI 10.1016/j.jmii.2022.04.002
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  8. Article ; Online: Comparison of two methods for converting central venous values of acid-base status to arterial values in critically ill patients.

    Shastri, Lisha / Boulain, Thierry / Rees, Stephen Edward / Thomsen, Lars Pilegaard

    Computer methods and programs in biomedicine

    2021  Volume 203, Page(s) 106022

    Abstract: Background: Assessment of the critically ill patient requires arterial acid-base status. Venous blood could provide a surrogate, with methods transforming venous values to arterial, improving their utility. This manuscript compares two of these methods, ...

    Abstract Background: Assessment of the critically ill patient requires arterial acid-base status. Venous blood could provide a surrogate, with methods transforming venous values to arterial, improving their utility. This manuscript compares two of these methods, a statistical and a physiological method. Where these methods are inadequate to describe critically ill patients, physiological mechanisms are explored to explain discrepancies.
    Methods: 1109 paired arterial and central-venous blood samples, from patients diagnosed with acute circulatory failure, were available for retrospective analysis. Of these, 386 samples were used previously to validate the statistical model. The statistical method of Boulain et al. 2016 and the physiological method of Rees et al. 2006 were applied to the 386 sample pairs, and compared using Bland-Altman analysis. A subset of the 1109 samples, where the physiological method could not accurately calculate arterial values, were analysed further to assess the necessary addition of CO
    Results: Bias (LoA) for comparison of calculated and measured arterial values (n = 386) were similar for the statistical method (pH: -0.003 (-0.051 to 0.045), PCO
    Conclusion: Both methods appear equal in their ability to transform central-venous values to arterial, albeit warranting caution when using either in a critically ill population. The physiological approach was able to describe arterio-venous differences not explained by aerobic metabolism alone.
    MeSH term(s) Arteries ; Blood Gas Analysis ; Critical Illness ; Humans ; Hydrogen-Ion Concentration ; Retrospective Studies ; Veins/diagnostic imaging
    Language English
    Publishing date 2021-02-24
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 632564-6
    ISSN 1872-7565 ; 0169-2607
    ISSN (online) 1872-7565
    ISSN 0169-2607
    DOI 10.1016/j.cmpb.2021.106022
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  9. Article ; Online: Manually Controlled, Continuous Infusion of Phenylephrine or Norepinephrine for Maintenance of Blood Pressure and Cardiac Output During Spinal Anesthesia for Cesarean Delivery: A Double-Blinded Randomized Study.

    Belin, Olivier / Casteres, Charlotte / Alouini, Souhail / Le Pape, Marc / Dupont, Abderrahmane / Boulain, Thierry

    Anesthesia and analgesia

    2022  Volume 136, Issue 3, Page(s) 540–550

    Abstract: Background: To counteract the vasoplegia induced by spinal anesthesia (SA) and maintain blood pressure (BP) during cesarean delivery, phenylephrine is currently recommended, but norepinephrine might offer superior preservation of cardiac output. We ... ...

    Abstract Background: To counteract the vasoplegia induced by spinal anesthesia (SA) and maintain blood pressure (BP) during cesarean delivery, phenylephrine is currently recommended, but norepinephrine might offer superior preservation of cardiac output. We aimed to compare the hemodynamic effects of phenylephrine and norepinephrine administered by manually adjusted continuous infusion during elective cesarean delivery.
    Methods: In this pragmatic, parallel-group, double-blind randomized controlled trial, 124 parturients scheduled for elective cesarean delivery under SA in a tertiary maternity in France, between February 2019 and December 2020, were randomized to receive norepinephrine at a starting rate of 0.05 μg·kg -1 ·min -1 (n = 62) or phenylephrine at a starting rate of 0.5 μg·kg -1 ·min -1 (n = 62). In both groups, the vasopressor infusion rate was then manually adjusted to maintain maternal systolic BP above 90% of the baseline value. The primary outcome, the change in cardiac index (CI) measured by thoracic bioreactance from SA to umbilical cord clamping, was analyzed through repeated measures analysis of variance and post hoc t tests. Secondary outcomes included maternal BP and neonatal outcomes.
    Results: In the norepinephrine group, cardiac index was maintained between 90% and 100% of baseline from SA to umbilical cord clamping, whereas it was maintained at significantly lower values (81%-88%) in the phenylephrine group ( P = .001). The percentage of elapsed time with a mean maternal BP <65 mm Hg and with systolic BP <80% of the baseline value was higher in the phenylephrine group: 2.9% (7.3) vs 0.5% (1.8) (absolute risk difference [ARD], -2.4%; 95% confidence interval, -4.4 to -0.5; P = .012) and 8.5% (16.6) vs 2.3% (5.2) (ARD, -6.2%; 95% confidence interval, -10.6 to -1.8; P = .006). Excluding parturients with gestational diabetes, severe neonatal hypoglycemia was more common in the phenylephrine group at 19.6% (9/46) vs 4.1% (2/49) ( P = .02). The other neonatal outcomes did not differ significantly between the groups.
    Conclusions: When administered by manually adjusted infusion during SA for cesarean delivery, norepinephrine was associated with a higher CI; both infusions were effective for maintaining BP.
    MeSH term(s) Infant, Newborn ; Female ; Pregnancy ; Humans ; Phenylephrine ; Blood Pressure ; Norepinephrine/adverse effects ; Anesthesia, Spinal/adverse effects ; Hypotension/drug therapy ; Infusions, Intravenous ; Vasoconstrictor Agents ; Cardiac Output ; Double-Blind Method
    Chemical Substances Phenylephrine (1WS297W6MV) ; Norepinephrine (X4W3ENH1CV) ; Vasoconstrictor Agents
    Language English
    Publishing date 2022-10-24
    Publishing country United States
    Document type Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80032-6
    ISSN 1526-7598 ; 0003-2999
    ISSN (online) 1526-7598
    ISSN 0003-2999
    DOI 10.1213/ANE.0000000000006244
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  10. Article: Correction: Clinical spectrum and prognostic impact of cancer in critically ill patients with HIV: a multicentre cohort study.

    Szychowiak, Piotr / Boulain, Thierry / Timsit, Jean-François / Elabbadi, Alexandre / Argaud, Laurent / Ehrmann, Stephan / Issa, Nahema / Canet, Emmanuel / Martino, Frédéric / Bruneel, Fabrice / Quenot, Jean-Pierre / Wallet, Florent / Azoulay, Élie / Barbier, François

    Annals of intensive care

    2024  Volume 14, Issue 1, Page(s) 27

    Language English
    Publishing date 2024-02-14
    Publishing country Germany
    Document type Published Erratum
    ZDB-ID 2617094-2
    ISSN 2110-5820
    ISSN 2110-5820
    DOI 10.1186/s13613-024-01254-w
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