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  1. Article ; Online: Ventilation non invasive dans l’insuffisance respiratoire aiguë des patients d’onco-hématologie : quelle place en 2023 ?

    Mayaux, J / Decavele, M / Dres, M / Lecronier, M / Demoule, A

    Revue des maladies respiratoires

    2024  

    Abstract: Acute respiratory failure (ARF) is a leading cause, along with sepsis, of admission to the intensive care unit (ICU) of patients with active cancer. Presenting variable clinical severity, ARF in onco-hematological patients has differing etiologies, ... ...

    Title translation Non-invasive ventilation in acute respiratory failure of oncology-hematology patients: What are its current benefits and limitations?
    Abstract Acute respiratory failure (ARF) is a leading cause, along with sepsis, of admission to the intensive care unit (ICU) of patients with active cancer. Presenting variable clinical severity, ARF in onco-hematological patients has differing etiologies, primarily represented by possibly opportunistic acute infectious pneumonia (de novo hypoxemic ARF), and decompensation in chronic cardiac or respiratory diseases (e.g., acute pulmonary edema or exacerbated chronic obstructive pulmonary disease). In these patients, orotracheal intubation is associated with a doubled risk of in-hospital mortality. Consequently, over the last three decades, numerous researchers have attempted to demonstrate and pinpoint the precise role of non-invasive ventilation (NIV) in the specific context of ARF in onco-hematological patients. While the benefits of NIV in the management of acute pulmonary edema or alveolar hypoventilation (hypercapnic ARF) are well-demonstrated, its positioning in de novo hypoxemic ARF is debatable, and has recently been called into question. In the early 2000s, based on randomized controlled trials, NIV was recommended as first-line treatment, one reason being that it allowed significantly reduced use of orotracheal intubation. In the latest randomized studies, however, the benefits of NIV in terms of survival orotracheal intubation have not been observed; as a result, it is no longer recommended in the management of de novo hypoxemic ARF in onco-haematological patients.
    Language French
    Publishing date 2024-04-11
    Publishing country France
    Document type English Abstract ; Journal Article ; Review
    ZDB-ID 605743-3
    ISSN 1776-2588 ; 0301-0279 ; 0761-8425
    ISSN (online) 1776-2588
    ISSN 0301-0279 ; 0761-8425
    DOI 10.1016/j.rmr.2024.03.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Weaning from mechanical ventilation in neurocritical care.

    Bureau, C / Demoule, A

    Revue neurologique

    2021  Volume 178, Issue 1-2, Page(s) 111–120

    Abstract: In the intensive care unit (ICU), weaning from mechanical ventilation follows a step-by-step process that has been well established in the general ICU population. However, little data is available in brain injury patients, who are often intubated to ... ...

    Abstract In the intensive care unit (ICU), weaning from mechanical ventilation follows a step-by-step process that has been well established in the general ICU population. However, little data is available in brain injury patients, who are often intubated to protect airways and prevent central hypoventilation. In this narrative review, we describe the general principles of weaning and how these principles can be adapted to brain injury patients. We focus on three major issues regarding weaning from mechanic ventilation in brain injury patients: (1) sedation protocol, (2) weaning and extubation protocol and criteria, (3) criteria, timing and technique for tracheostomy.
    MeSH term(s) Airway Extubation ; Brain Injuries/therapy ; Humans ; Intensive Care Units ; Respiration, Artificial ; Ventilator Weaning
    Language English
    Publishing date 2021-10-18
    Publishing country France
    Document type Journal Article ; Review
    ZDB-ID 4593-7
    ISSN 2213-0004 ; 0035-3787
    ISSN (online) 2213-0004
    ISSN 0035-3787
    DOI 10.1016/j.neurol.2021.08.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Dyspnea in Patients Receiving Invasive Mechanical Ventilation

    Decavèle, M. / Bureau, C. / Demoule, A.

    Annual update in intensive care and emergency medicine

    2023  Volume -, Issue -, Page(s) 191

    Language English
    Document type Article
    ZDB-ID 2600427-6
    ISSN 2191-5709
    Database Current Contents Medicine

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  4. Article: Dyspnea in Patients Receiving Invasive Mechanical Ventilation

    Decavèle, M. / Bureau, C. / Demoule, A.

    Annual update in intensive care and emergency medicine

    2023  Volume -, Issue -, Page(s) 191

    Language English
    Document type Article
    ZDB-ID 2600427-6
    ISSN 2191-5709
    Database Current Contents Medicine

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  5. Article: [No title information]

    Taghboulit, N / Voiriot, G / Demoule, A / Helms, J

    Revue des maladies respiratoires actualites

    2021  Volume 13, Issue 1, Page(s) 1S68–1S71

    Title translation Infections sévères à SARS-CoV-2: Severe SARS-Cov-2 infections.
    Language French
    Publishing date 2021-06-25
    Publishing country France
    Document type Journal Article
    ZDB-ID 2489332-8
    ISSN 1877-1203
    ISSN 1877-1203
    DOI 10.1016/S1877-1203(21)00060-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Bedside video-oculography to assess the caloric vestibulo-ocular reflex in ICU patients, a preliminary study.

    Marois, C / Quirins, M / Seassau, M / Demeret, S / Demoule, A / Naccache, L / Weiss, N

    Revue neurologique

    2023  Volume 179, Issue 9, Page(s) 1030–1034

    MeSH term(s) Humans ; Reflex, Vestibulo-Ocular ; Eye Movements ; Intensive Care Units
    Language English
    Publishing date 2023-07-19
    Publishing country France
    Document type Journal Article
    ZDB-ID 4593-7
    ISSN 2213-0004 ; 0035-3787
    ISSN (online) 2213-0004
    ISSN 0035-3787
    DOI 10.1016/j.neurol.2023.02.069
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: How we approach titrating PEEP in patients with acute hypoxemic failure.

    Heunks, Leo / Piquilloud, Lise / Demoule, Alexandre

    Critical care (London, England)

    2023  Volume 27, Issue 1, Page(s) 415

    MeSH term(s) Humans ; Positive-Pressure Respiration ; Respiratory Insufficiency ; Hypoxia/therapy
    Language English
    Publishing date 2023-10-31
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2041406-7
    ISSN 1466-609X ; 1364-8535
    ISSN (online) 1466-609X
    ISSN 1364-8535
    DOI 10.1186/s13054-023-04694-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Simulation study for evaluating an adaptive-randomisation Bayesian hybrid trial design with enrichment.

    Vinnat, Valentin / Chiche, Jean-Daniel / Demoule, Alexandre / Chevret, Sylvie

    Contemporary clinical trials communications

    2023  Volume 33, Page(s) 101141

    Abstract: Background: As we enter the era of precision medicine, the role of adaptive designs, such as response-adaptive randomisation or enrichment designs in drug discovery and development, has become increasingly important to identify the treatment given to a ... ...

    Abstract Background: As we enter the era of precision medicine, the role of adaptive designs, such as response-adaptive randomisation or enrichment designs in drug discovery and development, has become increasingly important to identify the treatment given to a patient based on one or more biomarkers. Tailoring the ventilation supply technique according to the responsiveness of patients to positive end-expiratory pressure is a suitable setting for such a design.
    Methods: In the setting of marker-strategy design, we propose a Bayesian response-adaptive randomisation with enrichment design based on group sequential analyses. This design combines the elements of enrichment design and response-adaptive randomisation. Concerning the enrichment strategy, Bayesian treatment-by-subset interaction measures were used to adaptively enrich the patients most likely to benefit from an experimental treatment while controlling the false-positive rate.The operating characteristics of the design were assessed by simulation and compared to those of alternate designs.
    Results: The results obtained allowed the detection of the superiority of one treatment over another and the presence of a treatment-by-subgroup interaction while keeping the false-positive rate at approximately 5\% and reducing the average number of included patients. In addition, simulation studies identified that the number of interim analyses and the burn-in period may have an impact on the performance of the scheme.
    Conclusion: The proposed design highlights important objectives of precision medicine, such as determining whether the experimental treatment is superior to another and identifying wheter such an efficacy could depend on patient profile.
    Language English
    Publishing date 2023-04-14
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2451-8654
    ISSN (online) 2451-8654
    DOI 10.1016/j.conctc.2023.101141
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Neurally Adjusted Ventilatory Assist in Difficult Weaning: Promising Findings on a Prickly Issue.

    Demoule, Alexandre / Dres, Martin

    Anesthesiology

    2020  Volume 132, Issue 6, Page(s) 1301–1303

    MeSH term(s) Interactive Ventilatory Support ; Positive-Pressure Respiration ; Respiration ; Respiration, Artificial
    Language English
    Publishing date 2020-05-01
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 269-0
    ISSN 1528-1175 ; 0003-3022
    ISSN (online) 1528-1175
    ISSN 0003-3022
    DOI 10.1097/ALN.0000000000003289
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Diaphragm Dysfunction during Weaning from Mechanical Ventilation: An Underestimated Phenomenon with Clinical Implications

    Dres, M. / Demoule, A.

    Annual update in intensive care and emergency medicine

    2018  Volume -, Issue -, Page(s) 231

    Language English
    Document type Article
    ZDB-ID 2600427-6
    ISSN 2191-5709
    Database Current Contents Medicine

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