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Article ; Online: Constructive conflicts of interest: an alternative perspective from industry?

Wysocki, Marc

2018 Volume 45, Issue 5, Page(s) 722–724

MeSH term(s)	Biomedical Research ; Conflict of Interest ; Critical Care ; Humans
Language	English
Publishing date	2018-12-19
Publishing country	United States
Document type	Editorial ; Comment
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/s00134-018-5505-1
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Article ; Online: Improving the intensive care experience from the perspectives of different stakeholders.

Latour, Jos M / Kentish-Barnes, Nancy / Jacques, Theresa / Wysocki, Marc / Azoulay, Elie / Metaxa, Victoria

Critical care (London, England)

2022 Volume 26, Issue 1, Page(s) 218

Abstract: The intensive care unit (ICU) is a complex environment where patients, family members and healthcare professionals have their own personal experiences. Improving ICU experiences necessitates the involvement of all stakeholders. This holistic approach ... ...

Abstract	The intensive care unit (ICU) is a complex environment where patients, family members and healthcare professionals have their own personal experiences. Improving ICU experiences necessitates the involvement of all stakeholders. This holistic approach will invariably improve the care of ICU survivors, increase family satisfaction and staff wellbeing, and contribute to dignified end-of-life care. Inclusive and transparent participation of the industry can be a significant addition to develop tools and strategies for delivering this holistic care. We present a report, which follows a round table on ICU experience at the annual congress of the European Society of Intensive Care Medicine. The aim is to discuss the current evidence on patient, family and healthcare professional experience in ICU is provided, together with the panel's suggestions on potential improvements. Combined with industry, the perspectives of all stakeholders suggest that ongoing improvement of ICU experience is warranted.
MeSH term(s)	Critical Care ; Family ; Humans ; Intensive Care Units ; Survivors ; Terminal Care
Language	English
Publishing date	2022-07-18
Publishing country	England
Document type	Journal Article
ZDB-ID	2041406-7
ISSN	1466-609X ; 1364-8535
ISSN (online)	1466-609X
ISSN	1364-8535
DOI	10.1186/s13054-022-04094-x
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Article ; Online: Assessment of Bohr and Enghoff Dead Space Equations in Mechanically Ventilated Children.

Bourgoin, Pierre / Baudin, Florent / Brossier, David / Emeriaud, Guillaume / Wysocki, Marc / Jouvet, Philippe

Respiratory care

2017 Volume 62, Issue 4, Page(s) 468–474

Abstract: Background: Recent findings suggest that using alveolar P: Methods: From June 2013 to December 2013, mechanically ventilated children with various respiratory conditions were included in this study. Demographic data, medical history, and ventilatory ... ...

Abstract	Background: Recent findings suggest that using alveolar P Methods: From June 2013 to December 2013, mechanically ventilated children with various respiratory conditions were included in this study. Demographic data, medical history, and ventilatory parameters were recorded. Volumetric capnography indices (NM3 monitor) were obtained over a period of 5 min preceding a blood sample. Bohr's and Enghoff's dead space, S2 and S3 slopes, and the S2/S3 ratio were calculated breath-by-breath using dedicated software (FlowTool). This study was approved by Ste-Justine research ethics review board. Results: Thirty-four subjects were analyzed. Mean V Conclusions: This study suggests that V
MeSH term(s)	Capnography/methods ; Capnography/statistics & numerical data ; Case-Control Studies ; Child ; Child, Preschool ; Female ; Humans ; Male ; Models, Theoretical ; Monitoring, Physiologic/methods ; Monitoring, Physiologic/statistics & numerical data ; Respiration, Artificial/statistics & numerical data ; Respiratory Dead Space ; Respiratory Distress Syndrome, Adult/physiopathology ; Respiratory Distress Syndrome, Adult/therapy ; Tidal Volume
Keywords	covid19
Language	English
Publishing date	2017-04
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.05108
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Article ; Online: Is there an optimal breath pattern to minimize stress and strain during mechanical ventilation?

Brunner, Josef X / Wysocki, Marc

Intensive care medicine

2009 Volume 35, Issue 8, Page(s) 1479–1483

Abstract: Background: Inappropriate selection of tidal volume and rate on mechanical ventilators in patients with reduced lung volume may cause lung damage. In spite of this rather recent insight, the optimal breath pattern and the relative importance of ... ...

Abstract	Background: Inappropriate selection of tidal volume and rate on mechanical ventilators in patients with reduced lung volume may cause lung damage. In spite of this rather recent insight, the optimal breath pattern and the relative importance of elevating end-expiratory lung volume (EELV) are still debated. A recent hypothesis is that lung injury is caused by excessive stress and strain. This paper elaborates on that hypothesis and proposes a new approach to optimizing the breath pattern. Methods: An index to quantify the impact of positive pressure ventilation on the lungs is defined (Stress-Strain Index, SSI) and calculated as a function of the breath pattern (tidal volume Vt and respiratory rate f) for five different levels of EELV. The breath pattern at which SSI is minimal (mSSI strategy) was compared with three other strategies: the "6 ml/kg Vt," minimal work of breathing and minimal force to breathe, for the different EELV levels. Results: In the mathematical analysis, SSI was mainly determined by EELV and was much higher with low EELV. For each EELV level, a distinct minimum of SSI was found, defined by a particular Vt-f combination. The mSSI strategy yielded lower Vt and higher f (0.252 l and 39 b/min) as compared to the "6 ml/kg Vt" strategy (0.420 l and 17 b/min). Conclusion: The EELV is the main determinant of the SSI. For a given EELV, the SSI can be minimized by an optimal Vt-f combination.
MeSH term(s)	Humans ; Lung Injury/etiology ; Lung Injury/prevention & control ; Lung Volume Measurements/methods ; Models, Statistical ; Positive-Pressure Respiration ; Respiration, Artificial/adverse effects ; Respiratory Dead Space/physiology ; Respiratory Mechanics/physiology ; Tidal Volume/physiology ; Work of Breathing/physiology
Language	English
Publishing date	2009-06-20
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/s00134-009-1510-8
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Article ; Online: Closed loop mechanical ventilation.

Wysocki, Marc / Jouvet, Philippe / Jaber, Samir

Journal of clinical monitoring and computing

2013 Volume 28, Issue 1, Page(s) 49–56

Abstract: Mechanical ventilation is a sophisticated technique with very narrow therapeutic ranges i.e. highly efficient and able to keep alive the most severe patients, but with considerable side effects and unwanted complications if not properly and timely used. ... ...

Abstract	Mechanical ventilation is a sophisticated technique with very narrow therapeutic ranges i.e. highly efficient and able to keep alive the most severe patients, but with considerable side effects and unwanted complications if not properly and timely used. Computerized protocols, closed loop systems, decision support, all terms which need to be defined, may help making mechanical ventilation safer and more efficient. The present paper will provide a short overview on technical and engineering considerations regarding closed loop controlled ventilation as well as tangible clinical evidences supporting the previous statement.
MeSH term(s)	Automation ; Clinical Alarms ; Clinical Trials as Topic ; Computer Graphics ; Critical Care/methods ; Decision Support Systems, Clinical ; Equipment Design ; Humans ; Patient Safety ; Respiration, Artificial/instrumentation ; Respiration, Artificial/methods ; User-Computer Interface
Language	English
Publishing date	2013-04-07
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1418733-4
ISSN	1573-2614 ; 1387-1307 ; 0748-1977
ISSN (online)	1573-2614
ISSN	1387-1307 ; 0748-1977
DOI	10.1007/s10877-013-9465-2
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Article: Noninvasive Estimation of Arterial CO2 From End-Tidal CO2 in Mechanically Ventilated Children: The GRAeDIENT Pilot Study.

Baudin, Florent / Bourgoin, Pierre / Brossier, David / Essouri, Sandrine / Emeriaud, Guillaume / Wysocki, Marc / Jouvet, Philippe

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

2016 Volume 17, Issue 12, Page(s) 1117–1123

Abstract: Objectives: The aim of our pilot study was to develop a model to better predict Paco2 in mechanically ventilated children using noninvasive parameters including volumetric capnography.: Design: Prospective clinical pilot study.: Setting: Level III ...

Abstract	Objectives: The aim of our pilot study was to develop a model to better predict Paco2 in mechanically ventilated children using noninvasive parameters including volumetric capnography. Design: Prospective clinical pilot study. Setting: Level III PICU. Patients: Sixty-five mechanically ventilated children. Interventions: None. Materials and methods: We conducted a prospective clinical pilot study that included all children admitted to the PICU (< 18 yr; weight, > 3 kg; mechanically ventilated, > 6 hr; with an arterial line). A predictive model for PaCO2 was developed using linear multivariable regression. Among the data collected in PICU patients, candidate predictors of PaCO2 were defined by a panel of experts and included end-tidal partial pressure of carbon dioxide, ventilation parameters, and data resulting from the analysis of volumetric capnogram recorded 5 minutes before an arterial blood gas. Children with tidal volume less than 30 mL were excluded because of technical limits. Results: A total of 65 children (43 boys, 65%) (65 [21-150] mo old) were analyzed. By linear multivariable regression, the best model included the mean airway pressure, end-tidal partial pressure of carbon dioxide, FIO2, and the capnographic index with an R equal to 0.90, p value less than 0.001. After correction, 95% (n = 62) of children had an estimated PaCO2 at ± 5 mm Hg. Conclusion: Our model developed provides an accurate estimation of the PaCO2 using end-tidal CO2 and noninvasive variables. Studies are needed to validate the equation in PICUs.
MeSH term(s)	Adolescent ; Arteries ; Biomarkers/metabolism ; Blood Gas Analysis ; Capnography ; Carbon Dioxide/blood ; Carbon Dioxide/metabolism ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Linear Models ; Male ; Pilot Projects ; Prospective Studies ; Respiration, Artificial ; Tidal Volume
Chemical Substances	Biomarkers ; Carbon Dioxide (142M471B3J)
Language	English
Publishing date	2016-09-13
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	2052349-X
ISSN	1947-3893 ; 1529-7535
ISSN (online)	1947-3893
ISSN	1529-7535
DOI	10.1097/PCC.0000000000000935
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Article: Closed-loop ventilation: an emerging standard of care?

Wysocki, Marc / Brunner, Josef X

Critical care clinics

2007 Volume 23, Issue 2, Page(s) 223–40, ix

Abstract: The rational for using closed loop ventilation is becoming strong and stronger. Studies are now available supporting the hypothesis that patient outcome is improved by using closed loop ventilation. In the highly sophisticated ICU world driven by the ... ...

Abstract	The rational for using closed loop ventilation is becoming strong and stronger. Studies are now available supporting the hypothesis that patient outcome is improved by using closed loop ventilation. In the highly sophisticated ICU world driven by the triumvirate of cost-efficiency, quality, and safety, closed loop ventilation will become definitely unavoidable. The challenge is how to make that change effortless, "friendly" and as fast as possible. Introducing novel graphical user interfaces and providing data displays that are pertinent, integrative and dynamic will reduce cognitive resources of the clinician and have the potential to make ventilation safer. They may be the key to adopt closed loop ventilation in everyday practice.
MeSH term(s)	Critical Care/standards ; Humans ; Intensive Care Units/manpower ; Medical Errors/mortality ; Positive-Pressure Respiration/trends ; Pulmonary Disease, Chronic Obstructive/therapy ; Respiration, Artificial/economics ; Respiration, Artificial/methods ; Respiration, Artificial/standards
Language	English
Publishing date	2007-04
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1006423-0
ISSN	1557-8232 ; 0749-0704
ISSN (online)	1557-8232
ISSN	0749-0704
DOI	10.1016/j.ccc.2006.12.011
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Article: Ventilator software version markedly affects time to trigger and time delay.

Wysocki, Marc / Kistler, Michael / Garbarini, Paul / Hamilton, Robert

Respiratory care

2011 Volume 56, Issue 11, Page(s) 1866–7; author reply 1867

MeSH term(s)	Humans ; Ventilators, Mechanical
Keywords	covid19
Language	English
Publishing date	2011-11
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	603252-7
ISSN	0020-1324 ; 0098-9142
ISSN	0020-1324 ; 0098-9142
DOI	10.4187/respcare.01523
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Article ; Online: Development and implementation of explicit computerized protocols for mechanical ventilation in children.

Jouvet, Philippe / Hernert, Patrice / Wysocki, Marc

Annals of intensive care

2011 Volume 1, Issue 1, Page(s) 51

Abstract: Mechanical ventilation can be perceived as a treatment with a very narrow therapeutic window, i.e., highly efficient but with considerable side effects if not used properly and in a timely manner. Protocols and guidelines have been designed to make ... ...

Abstract	Mechanical ventilation can be perceived as a treatment with a very narrow therapeutic window, i.e., highly efficient but with considerable side effects if not used properly and in a timely manner. Protocols and guidelines have been designed to make mechanical ventilation safer and protective for the lung. However, variable effects and low compliance with use of written protocols have been reported repeatedly. Use of explicit computerized protocols for mechanical ventilation might very soon become a "must." Several closed loop systems are already on the market, and preliminary studies are showing promising results in providing patients with good quality ventilation and eventually weaning them faster from the ventilator. The present paper defines explicit computerized protocols for mechanical ventilation, describes how these protocols are designed, and reports the ones that are available on the market for children.
Language	English
Publishing date	2011-12-21
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2617094-2
ISSN	2110-5820 ; 2110-5820
ISSN (online)	2110-5820
ISSN	2110-5820
DOI	10.1186/2110-5820-1-51
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Article ; Online: Adaptive support ventilation with and without end-tidal CO2 closed loop control versus conventional ventilation.

Sulemanji, Demet S / Marchese, Andrew / Wysocki, Marc / Kacmarek, Robert M

Intensive care medicine

2012 Volume 39, Issue 4, Page(s) 703–710

Abstract: Purpose: Our aim was to compare adaptive support ventilation with and without closed loop control by end tidal CO2 (ASVCO2, ASV) with pressure (PC) and volume control ventilation (VC) during simulated clinical scenarios [normal lungs (N), COPD, ARDS, ... ...

Abstract	Purpose: Our aim was to compare adaptive support ventilation with and without closed loop control by end tidal CO2 (ASVCO2, ASV) with pressure (PC) and volume control ventilation (VC) during simulated clinical scenarios [normal lungs (N), COPD, ARDS, brain injury (BI)]. Methods: A lung model was used to simulate representative compliance (mL/cmH2O): resistance (cmH2O/L/s) combinations, 45:5 for N and BI, 60:7.7 for COPD, 15:7.7 and 35:7.7 for ARDS. Two levels of PEEP (cmH2O) were used for each scenario, 12/16 for ARDS, and 5/10 for others. The CO2 productions of 2, 3, 4 and 5 mL/kg predicted body weight/min were simulated. Tidal volume was set to 6 mL/kg during VC and PC. Outcomes of interest were end tidal CO2 (etCO2) and plateau pressure (P Plat). Results: EtCO2 levels in N and BI and COPD were similar for all modes. In ARDS, etCO2 was higher in ASVCO2 than in other modes (p < 0.001). Under all mechanical conditions ASVCO2 revealed a narrower range of etCO2. P Plat was similar for all modes in all scenarios but ARDS where P Plat in ASV and ASVCO2 were lower than in VC (p = 0.001). When P Plat was ≥ 28 cmH2O, P plat in ASV and ASVCO2 were lower than in VC and PC (p = 0.024). Conclusion: All modes performed similarly in most cases. Minor differences observed were in favor of the closed loop modes. Overall, ASVCO2 maintained tighter CO2 control. The ASVCO2 had the greatest impact during ARDS allowing etCO2 to increase and protecting against hypocapnia evident with other modes while ensuring lower P plat and tidal volumes.
MeSH term(s)	Brain Injuries/physiopathology ; Brain Injuries/therapy ; Computer Simulation ; Humans ; Lung/physiology ; Lung/physiopathology ; Positive-Pressure Respiration/methods ; Pulmonary Disease, Chronic Obstructive/physiopathology ; Pulmonary Disease, Chronic Obstructive/therapy ; Pulmonary Gas Exchange/physiology ; Respiration, Artificial/methods ; Respiratory Distress Syndrome/physiopathology ; Respiratory Distress Syndrome/therapy ; Tidal Volume/physiology
Keywords	covid19
Language	English
Publishing date	2012-11-14
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
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/s00134-012-2742-6
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