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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

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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Article: Transesophageal echocardiography for cardiovascular risk estimation in patients with sepsis and new-onset atrial fibrillation: a multicenter prospective pilot study.

Labbé, Vincent / Ederhy, Stephane / Lapidus, Nathanael / Joffre, Jérémie / Razazi, Keyvan / Laine, Laurent / Sy, Oumar / Voicu, Sebastian / Chemouni, Frank / Aissaoui, Nadia / Smonig, Roland / Doyen, Denis / Carrat, Fabrice / Voiriot, Guillaume / Mekontso-Dessap, Armand / Cohen, Ariel / Fartoukh, Muriel

Annals of intensive care

2021 Volume 11, Issue 1, Page(s) 146

Abstract: Background: Echocardiographic parameters have been poorly investigated for estimating cardiovascular risk in patients with sepsis and new-onset atrial fibrillation. We aim to assess the prevalence of transesophageal echocardiographic abnormalities and ... ...

Abstract	Background: Echocardiographic parameters have been poorly investigated for estimating cardiovascular risk in patients with sepsis and new-onset atrial fibrillation. We aim to assess the prevalence of transesophageal echocardiographic abnormalities and their relationship with cardiovascular events in mechanically ventilated patients with sepsis and new-onset atrial fibrillation. Methods: In this prospective multicenter pilot study, left atrial/left atrial appendage (LA/LAA) dysfunction, severe aortic atheroma, and left ventricular systolic dysfunction were assessed using an initial transesophageal echocardiographic study, which was repeated after 48-72 h to detect LA/LAA thrombus formation. The study outcome was a composite of cardiovascular events at day 28, including arterial thromboembolic events (ischemic stroke, non-cerebrovascular arterial thromboembolism, LA/LAA thrombus), major bleeding, and all-cause death. Results: The study population comprised 94 patients (septic shock 63%; 35% women; median age 69 years). LA/LAA dysfunction, severe aortic atheroma, and left ventricular systolic dysfunction were detected in 17 (19%), 22 (24%), and 27 (29%) patients, respectively. At day 28, the incidence of cardiovascular events was 46% (95% confidence interval [CI]: 35 to 56). Arterial thromboembolic events and major bleeding occurred in 7 (7%) patients (5 ischemic strokes, 1 non-cerebrovascular arterial thromboembolism, 2 left atrial appendage thrombi) and 18 (19%) patients, respectively. At day 28, 27 patients (29%) died. Septic shock (hazard ratio [HR]: 2.36; 95% CI 1.06 to 5.29) and left ventricular systolic dysfunction (HR: 2.06; 95% CI 1.05 to 4.05) were independently associated with cardiovascular events. Conclusions: Transesophageal echocardiographic abnormalities are common in mechanically ventilated patients with sepsis and new-onset atrial fibrillation, but only left ventricular systolic dysfunction was associated with cardiovascular events at day 28.
Language	English
Publishing date	2021-10-18
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2617094-2
ISSN	2110-5820
ISSN	2110-5820
DOI	10.1186/s13613-021-00934-1
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Article ; Online: What is the prognosis of acute stroke patients requiring ICU admission?

Sonneville, Romain / Gimenez, Laetitia / Labreuche, Julien / Smonig, Roland / Magalhaes, Eric / Bouadma, Lila / Timsit, Jean-François / Mazighi, Mikael

Intensive care medicine

2017 Volume 43, Issue 2, Page(s) 271–272

MeSH term(s)	Acute Disease ; Aged ; Female ; Humans ; Intensive Care Units/statistics & numerical data ; Length of Stay ; Male ; Middle Aged ; Prognosis ; Respiration, Artificial ; Severity of Illness Index ; Stroke/mortality
Language	English
Publishing date	2017-02
Publishing country	United States
Document type	Letter
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/s00134-016-4553-7
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Article: Impact of natural light exposure on delirium burden in adult patients receiving invasive mechanical ventilation in the ICU: a prospective study.

Smonig, Roland / Magalhaes, Eric / Bouadma, Lila / Andremont, Olivier / de Montmollin, Etienne / Essardy, Fatiah / Mourvillier, Bruno / Lebut, Jordane / Dupuis, Claire / Neuville, Mathilde / Lermuzeaux, Mathilde / Timsit, Jean-François / Sonneville, Romain

Annals of intensive care

2019 Volume 9, Issue 1, Page(s) 120

Abstract: Objective: To determine whether potential exposure to natural light via windows is associated with reduced delirium burden in critically ill patients admitted to the ICU in a single room.: Design: Prospective single-center study.: Setting: Medical ...

Abstract	Objective: To determine whether potential exposure to natural light via windows is associated with reduced delirium burden in critically ill patients admitted to the ICU in a single room. Design: Prospective single-center study. Setting: Medical ICU of a university hospital, Paris, France. Patients: Adult patients receiving invasive mechanical ventilation. Methods: Consecutive patients admitted to a single room with (LIGHT group) or without (DARK group) exposure to natural light via windows were evaluated for delirium. The primary endpoint was the incidence of delirium. Main secondary endpoints included incidence of severe agitation intervened with antipsychotics and incidence of hallucinations. Results: A total of 195 patients were included (LIGHT group: n = 110; DARK group: n = 85). The incidence of delirium was similar in the LIGHT group and the DARK group (64% vs. 71%; relative risk (RR) 0.89, 95% CI 0.73-1.09). Compared with the DARK group, patients from the LIGHT group were less likely to be intervened with antipsychotics for agitation episodes (13% vs. 25%; RR 0.52, 95% CI 0.27-0.98) and had less frequent hallucinations (11% vs. 22%; RR 0.49, 95% CI 0.24-0.98). In multivariate logistic regression analysis, natural light exposure was independently associated with a reduced risk of agitation episodes intervened with antipsychotics (adjusted odds ratio = 0.39; 95% CI 0.17-0.88). Conclusion: Admission to a single room with potential exposure to natural light via windows was not associated with reduced delirium burden, as compared to admission to a single room without windows. However, natural light exposure was associated with a reduced risk of agitation episodes and hallucinations.
Language	English
Publishing date	2019-10-17
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2617094-2
ISSN	2110-5820
ISSN	2110-5820
DOI	10.1186/s13613-019-0592-x
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Article ; Online: Semi-quantitative cultures of throat and rectal swabs are efficient tests to predict ESBL-Enterobacterales ventilator-associated pneumonia in mechanically ventilated ESBL carriers.

Andremont, Olivier / Armand-Lefevre, Laurence / Dupuis, Claire / de Montmollin, Etienne / Ruckly, Stéphane / Lucet, Jean-Christophe / Smonig, Roland / Magalhaes, Eric / Ruppé, Etienne / Mourvillier, Bruno / Lebut, Jordane / Lermuzeaux, Mathilde / Sonneville, Romain / Bouadma, Lila / Timsit, Jean-François

Intensive care medicine

2020 Volume 46, Issue 6, Page(s) 1232–1242

Abstract: Purpose: In ICU patients with carriage of extended spectrum beta-lactamase producing Enterobacterales (ESBL-E) and suspected Gram-negative bacilli ventilator-associated pneumonia (GNB-VAP), the quantification of the rectal and throat ESBL-E carriage ... ...

Abstract	Purpose: In ICU patients with carriage of extended spectrum beta-lactamase producing Enterobacterales (ESBL-E) and suspected Gram-negative bacilli ventilator-associated pneumonia (GNB-VAP), the quantification of the rectal and throat ESBL-E carriage might predict the ESBL-E involvement in GNB-VAP. Our aim was to evaluate whether a semi-quantitative assessment of rectal/throat ESBL-E carriage can predict ESBL-E-associated VAP in medical ICU patients. Methods: From May 2014 to May 2017, all ESBL-E carriers had a semi-quantitative assessment of ESBL-E density in swabs cultures. For those who developed GNB-VAP (diagnosed using bronchoalveolar lavage or plugged telescopic catheter with significant quantitative culture), the last positive swab collected at least 48 h before GNB-VAP onset was selected. Clinical data were extracted from a prospectively collected database. Results: Among 365 ESBL-E carriers, 82 developed 107 episodes of GNB-VAP (ESBL-E VAP, n = 50; and non-ESBL-E GNB-VAP, n = 57) after 13 days of mechanical ventilation in median. Antimicrobials use before VAP onset was similar between groups. The last swabs were collected 5 days in median before VAP onset. ESBL-E. coli carriers developed ESBL-E VAP less frequently (n = 13, 34%) than others (n = 32, 67.3%, p < .01). Throat swab positivity (39 (78%) vs. 12 (23%), p < .01) was more frequent for ESBL-E VAP. ESBL-E VAP was associated with significantly higher ESBL-E density in rectal swabs. In multivariate models, non-E. coli ESBL-E carriage and rectal ESBL-E carriage density, or throat carriage, remained associated with ESBL-E VAP. Conclusion: In carriers of ESBL-E other than E. coli, ESBL-E throat carriage or a high-density ESBL-E rectal carriage are risk factors of ESBL-E VAP in case of GNB-VAP.
MeSH term(s)	Escherichia coli ; Humans ; Intensive Care Units ; Pharynx ; Pneumonia, Ventilator-Associated/diagnosis ; Respiration, Artificial ; beta-Lactamases
Chemical Substances	beta-Lactamases (EC 3.5.2.6)
Keywords	covid19
Language	English
Publishing date	2020-04-20
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/s00134-020-06029-y
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Article ; Online: Impact of Loading Dose of Caspofungin in Pharmacokinetic-Pharmacodynamic Target Attainment for Severe Candidiasis Infections in Patients in Intensive Care Units: the CASPOLOAD Study.

Bailly, Sébastien / Gautier-Veyret, Elodie / Lê, Minh P / Bouadma, Lila / Andremont, Olivier / Neuville, Mathilde / Mourvillier, Bruno / Sonneville, Romain / Magalhaes, Eric / Lebut, Jordane / Radjou, Aguila / Smonig, Roland / Wolff, Michel / Massias, Laurent / Dupuis, Claire / Timsit, Jean-François

Antimicrobial agents and chemotherapy

2020 Volume 64, Issue 12

Abstract: This study evaluated the impact of a high loading dose of caspofungin (CAS) on the pharmacokinetics of CAS and the pharmacokinetic-pharmacodynamic (PK-PD) target attainment in patients in intensive care units (ICU). ICU patients requiring CAS treatment ... ...

Abstract	This study evaluated the impact of a high loading dose of caspofungin (CAS) on the pharmacokinetics of CAS and the pharmacokinetic-pharmacodynamic (PK-PD) target attainment in patients in intensive care units (ICU). ICU patients requiring CAS treatment were prospectively included to receive a 140-mg loading dose of CAS. Plasma CAS concentrations (0, 2, 3, 5, 7, and 24 h postinfusion) were determined to develop a two-compartmental population PK model. A Monte Carlo simulation was performed and the probabilities of target attainment (PTAs) were computed using previously published MICs. PK-PD targets were ratios of area under the concentration-time curve from 0 to 24 h (AUC
MeSH term(s)	Antifungal Agents/therapeutic use ; Candidiasis/drug therapy ; Caspofungin ; Echinocandins ; Humans ; Intensive Care Units ; Lipopeptides ; Microbial Sensitivity Tests ; Monte Carlo Method
Chemical Substances	Antifungal Agents ; Echinocandins ; Lipopeptides ; Caspofungin (F0XDI6ZL63)
Language	English
Publishing date	2020-11-17
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	217602-6
ISSN	1098-6596 ; 0066-4804
ISSN (online)	1098-6596
ISSN	0066-4804
DOI	10.1128/AAC.01545-20
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Article ; Online: Constipation is independently associated with delirium in critically ill ventilated patients.

Smonig, Roland / Wallenhorst, Timothée / Bouju, Pierre / Letheulle, Julien / Le Tulzo, Yves / Tadié, Jean Marc / Gacouin, Arnaud

Intensive care medicine

2016 Volume 42, Issue 1, Page(s) 126–127

MeSH term(s)	Aged ; Comorbidity ; Constipation/epidemiology ; Constipation/etiology ; Critical Illness ; Delirium/epidemiology ; Delirium/etiology ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Prospective Studies ; Respiration, Artificial/adverse effects ; Respiration, Artificial/statistics & numerical data ; Severity of Illness Index
Language	English
Publishing date	2016-01
Publishing country	United States
Document type	Letter ; Observational Study
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/s00134-015-4050-4
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Article ; Online: Early Electroencephalography Findings in Cardiogenic Shock Patients Treated by Venoarterial Extracorporeal Membrane Oxygenation.

Sinnah, Fabrice / Dalloz, Marie-Amélie / Magalhaes, Eric / Wanono, Ruben / Neuville, Mathilde / Smonig, Roland / Radjou, Aguila / Mourvillier, Bruno / Bouadma, Lila / Timsit, Jean-François / d'Ortho, Marie-Pia / Rouvel-Tallec, Any / Sonneville, Romain

Critical care medicine

2018 Volume 46, Issue 5, Page(s) e389–e394

Abstract: Objectives: We aimed to assess early electroencephalography findings in patients treated by venoarterial extracorporeal membrane oxygenation and their association with neurologic outcome.: Design: Single-center observational study.: Setting: ... ...

Abstract	Objectives: We aimed to assess early electroencephalography findings in patients treated by venoarterial extracorporeal membrane oxygenation and their association with neurologic outcome. Design: Single-center observational study. Setting: Medical ICU of a university hospital. Patients: An early standardized electroencephalography assessment, that is, standard electroencephalography followed by continuous electroencephalography, was performed in consecutive cardiogenic shock patients requiring venoarterial extracorporeal membrane oxygenation. Associations between electroencephalography findings and outcome, defined as a composite of acute brain injury or death at 14 days, were investigated. Measurements and main results: Twenty-two patients with a median Full Outline of Unresponsiveness score of 4 (interquartile range, 3-6) were studied. Pupillary light reflex, corneal reflex, and cough reflex were preserved in 20 (90%), 17 (77%), and 17 (77%) patients, respectively. Overall, standard electroencephalography findings consisted of diffuse slowing in 21 patients (95%) and severe background abnormalities in 13 patients (59%) (i.e., a discontinuous [n = 5; 23%] and/or an unreactive background [n = 9; 41%]). Severe background abnormalities on standard electroencephalography (poor outcome rate: 69% vs 22%; p = 0.03) and absence of sleep transients on continuous electroencephalography (poor outcome rate: 67% vs 14%; p = 0.02) were associated with a poor outcome, whereas neurologic findings and doses of sedation were not. Patients without sleep transients on continuous electroencephalography tended to have lower Full Outline of Unresponsiveness scores than patients with preserved sleep transients-appearing patterns. Conclusions: In patients treated by venoarterial extracorporeal membrane oxygenation, early severe background abnormalities on standard electroencephalography provide important information on neurologic outcome. The lack of sleep transients on continuous electroencephalography reflects the severity of brain dysfunction and might represent an additional prognostic marker.
MeSH term(s)	Aged ; Brain/physiopathology ; Brain Injuries/diagnosis ; Brain Injuries/etiology ; Electroencephalography ; Extracorporeal Membrane Oxygenation ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; Reflex, Pupillary ; Shock, Cardiogenic/complications ; Shock, Cardiogenic/therapy
Language	English
Publishing date	2018-02-01
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/CCM.0000000000003010
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Article: Correction to: Changes in the clinical presentation and outcomes of patients treated for severe malaria in a referral French university intensive care unit from 2004 to 2017.

Annals of intensive care

2020 Volume 10, Issue 1, Page(s) 29

Abstract: After publication of the original article [1], we were notified that family names have been exchanged with the first names for all authors. Below the name are tagged correctly. ...

Abstract	After publication of the original article [1], we were notified that family names have been exchanged with the first names for all authors. Below the name are tagged correctly.
Language	English
Publishing date	2020-03-03
Publishing country	Germany
Document type	Published Erratum
ZDB-ID	2617094-2
ISSN	2110-5820
ISSN	2110-5820
DOI	10.1186/s13613-020-0646-0
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Article: Changes in the clinical presentation and outcomes of patients treated for severe malaria in a referral French university intensive care unit from 2004 to 2017.

Annals of intensive care

2020 Volume 10, Issue 1, Page(s) 21

Abstract: Background: In France, the incidence of severe imported malaria cases increased since early 2000. Artesunate was available (temporarily use authorization) since mid-2011 in France and commonly used for severe malaria since early 2013. Thus, the study ... ...

Abstract	Background: In France, the incidence of severe imported malaria cases increased since early 2000. Artesunate was available (temporarily use authorization) since mid-2011 in France and commonly used for severe malaria since early 2013. Thus, the study objectives were to describe the patients with severe imported malaria admitted in intensive care unit (ICU) and assess the changes in clinical presentation and outcomes before and after this date. Methods: Retrospective observational single-center study in the infectious diseases ICU of a referral university hospital, conducted on patients admitted for severe imported malaria from 2004 to 2017. Demographic variables, severity scores, WHO's severity criteria on admission, treatment, and ICU and hospital lengths of stay were collected. Patients' characteristics and outcomes were compared between both periods. A poor outcome was defined as the composite endpoint of death, or requirement for vasopressors, invasive mechanical ventilation and/or renal replacement therapy. Results: 189 patients were included, 98 in 2004-2012 and 91 in 2013-2017, most often from West and Central African countries (96%). The number of WHO criteria for severe malaria was comparable in both groups, but SAPS II, SOFA and ICU length of stay were significantly higher in 2004-2012, while patients of African origin living in France were less frequent (p < 0.01). The outcome was poor for 41/98 cases in 2004-2012 and 12/91 cases in 2013-2017 (p < 0.01). The risk factors of poor outcome on the multivariate logistic regression were a neurological failure (adjusted odds ratio (adjOR = 3.23; 95% CI (1.03-10.08), p = 0.004), cardio-circulatory failure (adjOR = 9.92; 95% CI (2.34-42), p = <0.01) and creatinine blood levels > 265 µmol/L (adjOR = 10.76; 95% CI (3.17-36.53), p < 0.01). In the multivariate analysis, IV artesunate was not associated with a better outcome. Patients of African origin did not seem to have a better outcome than Caucasian patients or those from other origins (adjOR = 0.59; 95% CI (0.21-1.65), p = 0.31). Conclusion: Patients with imported malaria admitted in ICU in 2013-2017 were less severely ill than those in 2004-2012. These trends could be partially explained by the increasing proportion of African patients visiting friends or relatives or living in endemic areas.
Language	English
Publishing date	2020-02-12
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2617094-2
ISSN	2110-5820
ISSN	2110-5820
DOI	10.1186/s13613-020-0634-4
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