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  1. AU="Daulasim, Anousone"
  2. AU="Juutilainen, Jukka"

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  1. Article ; Online: Hemodynamic clinical phenotyping in septic shock.

    Daulasim, Anousone / Vieillard-Baron, Antoine / Geri, Guillaume

    Current opinion in critical care

    2021  Volume 27, Issue 3, Page(s) 290–297

    Abstract: Purpose of review: Recent studies have failed to show significant benefit from a uniform strategy, suggesting that hemodynamic management must be individually adapted in septic shock depending on different phenotypes. Different approaches that may be ... ...

    Abstract Purpose of review: Recent studies have failed to show significant benefit from a uniform strategy, suggesting that hemodynamic management must be individually adapted in septic shock depending on different phenotypes. Different approaches that may be used to this end will be discussed.
    Recent findings: Fluid management is a cornerstone of resuscitation, as the positive fluid balance has been associated with higher mortality and right ventricular failure. Myocardial evaluation is mandatory, as sepsis patients may present with a hyperkinetic state, left ventricular (systolic and diastolic) and/or right ventricular dysfunction, the latter being associated with higher mortality. Statistical approaches with the identification of hemodynamic clusters based on echocardiographic and clinical parameters might be integrated into daily practice to develop precision medicine. Such approaches may also predict the progression of septic shock.
    Summary: Different hemodynamic phenotypes can occur at any stage of sepsis and be associated with one another. The clinician must regularly assess dynamic changes in phenotypes in septic shock patients. Statistical approaches based on machine learning need to be validated by prospective studies.
    MeSH term(s) Echocardiography ; Hemodynamics ; Humans ; Prospective Studies ; Sepsis ; Shock, Septic
    Language English
    Publishing date 2021-04-26
    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.0000000000000834
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4999: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article: Right ventricular injury in patients with COVID-19-related ARDS eligible for ECMO support: a multicenter retrospective study.

    Petit, Matthieu / Bouaoud, Misylias / Jullien, Edouard / Joseph, Adrien / Evrard, Bruno / Charron, Cyril / Daulasim, Anousone / Legras, Annick / Gourraud, Maeva / Goudelin, Marine / Vignon, Philippe / Vieillard-Baron, Antoine

    Annals of intensive care

    2024  Volume 14, Issue 1, Page(s) 40

    Abstract: Background: Coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome (ARDS) is associated with high mortality. Extracorporeal membrane oxygenation (ECMO) has been proposed in this setting, but optimal criteria to select target ... ...

    Abstract Background: Coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome (ARDS) is associated with high mortality. Extracorporeal membrane oxygenation (ECMO) has been proposed in this setting, but optimal criteria to select target patients remain unknown. Our hypothesis is that evaluation of right ventricular (RV) function could be helpful. The aims of our study were to report the incidence and outcomes of patients eligible for ECMO according to EOLIA criteria, and to identify a subgroup of patients with RV injury, which could be a target for ECMO.
    Methods: Retrospective observational study involving 3 French intensive care units (ICUs) of teaching hospitals. Patients with confirmed SARS-CoV-2 infection between March 2020 and March 2021, presenting ARDS and with available echocardiography, were included. Patients were classified in three groups according to whether or not they met the EOLIA criteria and the presence of RV injury (RVI) ("EOLIA -", "EOLIA + RVI -" and "EOLIA + RVI + "). RVI was defined by the association of RV to left ventricular end-diastolic area ratio > 0.8 and paradoxical septal motion. Kaplan-Meier survival curves were used to analyze outcome as well as a Cox model for 90 day mortality.
    Results: 915 patients were hospitalized for COVID-19, 418 of them with ARDS. A total of 283 patients with available echocardiography were included. Eighteen (6.3%) patients received ECMO. After exclusion of these patients, 107 (40.5%) were classified as EOLIA -, 126 (47.5%) as EOLIA + RVI -, and 32 (12%) as EOLIA + RVI + . Ninety-day mortality was 21% in the EOLIA-group, 44% in the EOLIA + RVI-group, and 66% in the EOLIA + RVI + group (p < 0.001). After adjustment, RVI was statistically associated with 90-day mortality (HR = 1.92 [1.10-3.37]).
    Conclusions: Among COVID-19-associated ARDS patients who met the EOLIA criteria, those with significant RV pressure overload had a particularly poor outcome. This subgroup may be a more specific target for ECMO. This represented 12% of our cohort compared to 60% of patients who met the EOLIA criteria only. How the identification of this high-risk subset of patients translates into patient-centered outcomes remains to be evaluated.
    Language English
    Publishing date 2024-03-26
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2617094-2
    ISSN 2110-5820
    ISSN 2110-5820
    DOI 10.1186/s13613-024-01256-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Feasibility and outcomes of native arteriovenous fistula in octogenarians.

    Daulasim, Anousone / Seris, Pascal / Maheas, Catherine / Hude, Iulia / Ridel, Christophe / Touzot, Maxime

    Clinical nephrology

    2020  Volume 95, Issue 3, Page(s) 136–142

    Abstract: Introduction: While the native arteriovenous fistula (AVF) is the preferred dialysis access, it is a matter of debate for individuals older than 80 years due to reduced primary patency rates.: Materials and methods: We initiated a single-center, ... ...

    Abstract Introduction: While the native arteriovenous fistula (AVF) is the preferred dialysis access, it is a matter of debate for individuals older than 80 years due to reduced primary patency rates.
    Materials and methods: We initiated a single-center, observational retrospective analysis of adult dialysis patients from January 2015 to December 2018. We included all patients older than 70 years with a minimum of 12 months of follow-up, beginning from the AVF creation. Patients were separated into two groups, octogenarians (> 80 years old) and controls (70 - 79 years old). The primary end point was the primary patency (the interval from arteriovenous access creation to the first intervention). The secondary end point were the complications at 3 months (failures of puncture, canceled dialysis sessions, local hematoma, AVF bleeding).
    Results: 29 patients (octogenarian = 17, control = 12) were included in the analysis. The AVF radio-cephalic was the most common vascular access in each group. Primary patency was comparable between groups, but octogenarians required 40% more procedures to obtain or maintain patency. Overall, a functional AVF was obtained for all patients except in cases of complications such as hematomas, which were more frequent in octogenarians compared to controls (25 vs. 82%, p < 0.01). All catheters were removed at 6 months follow-up, with a median time to removal of 27 days (range 5 - 157 days).
    Discussion: Despite a higher rate of interventions and local complications during the first 3 months, AVF and particularly radio-cephalic AVF, is a valid procedure for octogenarians, without lengthening the exposure time to the catheter.
    MeSH term(s) Aged ; Aged, 80 and over ; Arteriovenous Shunt, Surgical/adverse effects ; Arteriovenous Shunt, Surgical/methods ; Feasibility Studies ; Humans ; Renal Dialysis/adverse effects ; Renal Dialysis/methods ; Retrospective Studies ; Treatment Outcome ; Vascular Access Devices/adverse effects ; Vascular Patency
    Language English
    Publishing date 2020-11-19
    Publishing country Germany
    Document type Journal Article ; Observational Study
    ZDB-ID 185101-9
    ISSN 0301-0430
    ISSN 0301-0430
    DOI 10.5414/CN110128
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 873: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

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