Review
Critical Care Medicine
Giacomo Grasselli, Emanuele Cattaneo, Gaetano Florio
Summary: This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2021, with more information available at the provided links.
Review
Medicine, General & Internal
Catia Cilloniz, Antoni Torres, Michael S. Niederman
Summary: Severe pneumonia is associated with high mortality and complications, making appropriate diagnosis and early antimicrobial treatment crucial. Identifying causative pathogens and adhering to guidelines are important in improving outcomes, although challenges remain in establishing etiological diagnosis and treatment. Continued research in severe pneumonia is necessary to explore various aspects like host immunological responses, risk factors, diagnostic tests, and therapeutic options.
BMJ-BRITISH MEDICAL JOURNAL
(2021)
Article
Critical Care Medicine
Eloisa Sofia Tanzarella, Gianmarco Lombardi, Silvia Baroni, Francesca Sarlo, Salvatore Lucio Cutuli, Simone Carelli, Melania Cesarano, Veronica Gennenzi, Gabriele Pintaudi, Joel Vargas, Antonio Maria Dell'Anna, Domenico Luca Grieco, Andrea Urbani, Massimo Antonelli, Gennaro De Pascale
Summary: The use of Anapnoguard endotracheal tubes and its control unit in COVID-19 acute respiratory distress syndrome patients provides effective cuff pressure control and subglottic secretions drainage. However, it has not been demonstrated to reduce the incidence of ventilator-associated pneumonia, and further evaluation is needed.
Review
Pharmacology & Pharmacy
Rachael Cusack, Alexis Garduno, Khalid Elkholy, Ignacio Martin-Loeches
Summary: The prevalence of ventilator-associated pneumonia (VAP) has been highlighted by the Covid-19 pandemic, underscoring the need for new antimicrobial approaches. This narrative review examines novel investigational drugs for VAP in the ICU setting, including monoclonal antibody treatments and phage antibiotic synthesis. The post-antibiotic era is approaching, emphasizing the importance of infection control measures and personalized medicine for severe infections.
EXPERT OPINION ON INVESTIGATIONAL DRUGS
(2022)
Article
Anesthesiology
T. W. Felton, W. Ahmed, I. R. White, P. van Oort, N. J. W. Rattray, C. Docherty, J. Bannard-Smith, B. Morton, I. Welters, R. McMullan, S. A. Roberts, R. Goodacre, P. M. Dark, S. J. Fowler
Summary: Ventilator-associated pneumonia is common in critically ill patients, leading to overuse of antibiotics and antimicrobial resistance. This study explores the non-invasive diagnosis of ventilator-associated pneumonia through the detection of volatile organic compounds in exhaled breath.
Article
Multidisciplinary Sciences
Pasu Siriyanyongwong, Rawee Teanpaisan, Nuntiya Pahumunto, Supattra Uppanisakorn, Veerapong Vattanavanit
Summary: This study evaluated the efficacy and safety of using Moraceae with CHX mouthwash in reducing oral bacterial count in critically ill patients, compared to using CHX-alone mouthwash. The results showed that Moraceae with CHX mouthwash had the same effectiveness as CHX alone on bacterial flora but exhibited fewer intolerable side effects.
SCIENTIFIC REPORTS
(2022)
Editorial Material
Microbiology
Savino Spadaro
Summary: This Special Issue of Microorganisms examines the epidemiology, diagnostic innovations, and strategies applied in the context of infections in critically ill patients with MDR infections, emphasizing the importance of optimizing antimicrobial drug dosing in intensive care units.
Article
Multidisciplinary Sciences
Thomas Maldiney, Valentin Pineau, Catherine Neuwirth, Linda Ouzen, Isabelle Eberl, Geraldine Jeudy, Sophie Dalac, Lionel Piroth, Mathieu Blot, Marc Sautour, Frederic Dalle, Caroline Abdulmalak, Romain Ter Schiphorst, Paul-Simon Pugliesi, Thomas Poussant, Agathe Ogier-Desserrey, Isabelle Fournel, Melchior de Giraud D'Agay, Marine Jacquier, Marie Labruyere, Francois Aptel, Jean-Baptiste Roudaut, Thibault Vieille, Pascal Andreu, Sebastien Prin, Pierre-Emmanuel Charles, Mael Hamet, Jean-Pierre Quenot
Summary: Biofilm growth is important in the development of ventilator-associated pneumonia in intensive care units. The study reveals two different morphological aspects of endotracheal tube-deposited biofilm, as well as higher acquired resistance compared to other colonization sites. These findings have significant clinical implications for antimicrobial treatment in critically ill patients.
SCIENTIFIC REPORTS
(2022)
Review
Medicine, General & Internal
Adel Salah Bediwy, Mohammed Al-Biltagi, Nermin Kamal Saeed, Hosameldin A. Bediwy, Reem Elbeltagi
Summary: Pleural effusion is common in ICU patients and its diagnosis and management are important. There are difficulties in diagnosing pleural effusion in ICU patients due to clinical, radiological, and laboratory challenges. Pleural effusion can impact patient prognosis and outcome, and pleural effusion drainage can modify clinical outcomes.
WORLD JOURNAL OF CLINICAL CASES
(2023)
Article
Infectious Diseases
Alex R. Schuurman, Robert F. J. Kullberg, Willem Joost Wiersinga
Summary: There has been significant progress in understanding the gut microbiome in health and disease over the past decade. The gut microbiome interacts with the immune system and plays a crucial role in defending the host against pathogens. However, disturbances in the gut microbiome due to disease or interventions like antibiotic treatment can have negative consequences. This review focuses on the potential role of probiotics in the ICU, summarizes evidence from randomized clinical trials, and discusses challenges and future prospects.
Article
Critical Care Medicine
Ying Li, Xue Yuan, Bing Sun, Hai-chao Li, Hui-wen Chu, Li Wang, Yu Zhao, Xiao Tang, Rui Wang, Xu-yan Li, Zhao-hui Tong, Chen Wang
Summary: The study demonstrates that the rapid-flow expulsion maneuver (RFEM) is as effective and safe as subglottic secretion drainage (SSD) in preventing ventilator-associated pneumonia (VAP). RFEM could be considered as an alternative method in the treatment of respiratory ICU patients.
ANNALS OF INTENSIVE CARE
(2021)
Article
Critical Care Medicine
Mailis Maes, Ellen Higginson, Joana Pereira-Dias, Martin D. Curran, Surendra Parmar, Fahad Khokhar, Delphine Cuchet-Lourenco, Janine Lux, Sapna Sharma-Hajela, Benjamin Ravenhill, Islam Hamed, Laura Heales, Razeen Mahroof, Amelia Solderholm, Sally Forrest, Sushmita Sridhar, Nicholas M. Brown, Stephen Baker, Vilas Navapurkar, Gordon Dougan, Josefin Bartholdson Scott, Andrew Conway Morris
Summary: This study found that COVID-19 patients were more likely to develop VAP, with 3 cases of invasive aspergillosis identified among them and herpesvirade activation being more frequent. The causative organisms of secondary pneumonia observed were similar between COVID-19 and non-COVID-19 patients, suggesting a link to pulmonary dysbiosis caused by COVID-19.
Article
Microbiology
Arthur Orieux, Raphael Enaud, Sebastien Imbert, Philippe Boyer, Erwan Begot, Adrian Camino, Alexandre Boyer, Patrick Berger, Didier Gruson, Laurence Delhaes, Renaud Prevel
Summary: The composition of the gut microbiota differs between critically ill patients who subsequently develop ventilator-associated pneumonia (VAP) and those who do not, while alpha-diversity remains similar. Megasphaera massiliensis is associated with the absence of VAP occurrence, whereas the presence of Alternaria sp. is associated with VAP occurrence. Large multicenter cohort studies are encouraged to further investigate the role of the gut-lung axis and oropharyngeal colonization in the development of VAP in ICU patients.
MICROBIOLOGY SPECTRUM
(2023)
Review
Integrative & Complementary Medicine
Jianying Xiong, Shanggan Zeng, Hua Xu, Ying Cao
Summary: The study examined the role of emergency nurses in ICUs, finding that nurses are responsible not only for oxygen management but also for other critical health services to reduce respiratory failure in ICU patients.
ALTERNATIVE THERAPIES IN HEALTH AND MEDICINE
(2021)
Article
Microbiology
Arthur Orieux, Raphael Enaud, Sebastien Imbert, Philippe Boyer, Erwan Begot, Adrian Camino, Alexandre Boyer, Patrick Berger, Didier Gruson, Laurence Delhaes, Renaud Prevel
Summary: The composition of the gut microbiota differs between critically ill patients who subsequently develop VAP and those who do not, suggesting a potential role of gut microbiota in the development of VAP. Specifically, the presence of Megasphaera massiliensis is associated with the absence of VAP occurrence, while the presence of the fungal genus Alternaria sp. is associated with the occurrence of VAP.
MICROBIOLOGY SPECTRUM
(2023)
Article
Nutrition & Dietetics
Claudia Martinez-Tapia, Thomas Diot, Nadia Oubaya, Elena Paillaud, Johanne Poisson, Mathilde Gisselbrecht, Laure Morisset, Philippe Caillet, Aurelie Baudin, Frederic Pamoukdjian, Amaury Broussier, Sylvie Bastuji-Garin, Marie Laurent, Florence Canoui-Poitrine
Summary: The study found that only older obese women with cancer who had minimal weight loss before diagnosis had a lower risk of mortality compared to normal-weight counterparts. However, overweight and obese men did not have a lower mortality risk regardless of weight loss.
AMERICAN JOURNAL OF CLINICAL NUTRITION
(2021)
Article
Primary Health Care
Emilie Ferrat, Julie Fabre, Philippe Galletout, Emmanuelle Boutin, Julien Le Breton, Vincent Renard, Paul Frappe, Sylvie Bastuji-Garin
Summary: A study in a French national primary care cohort found that nearly 40% of patients received inappropriate prescriptions of DOACs, mostly due to inappropriate dosage, particularly under-dosing. Multivariate analysis revealed that factors associated with under-dosing included older age, specific drug prescriptions, and higher CHA2DS2-VASc scores, while factors associated with over-dosing included kidney failure, higher HAS-BLED scores, and older age. The study concluded that the appropriateness of DOAC prescribing for NVAF can be improved through the involvement of general practitioners in implementing appropriate prescribing strategies.
BRITISH JOURNAL OF GENERAL PRACTICE
(2021)
Article
Oncology
Charlotte Lafont, Anne Chah Wakilian, Cedric Lemogne, Clement Gouraud, Virginie Fossey-Diaz, Galdric Orvoen, Nathalie Lhuillier, Elena Paillaud, Sylvie Bastuji-Garin, Sonia Zebachi, Olivier Hanon, Francois Goldwasser, Pascaline Boudou-Rouquette, Florence Canoui-Poitrine
Summary: The GDS-4 shows high sensitivity and specificity in detecting depression in older cancer patients. Asking four questions can help physicians screen older cancer patients for depression and guide them towards further clinical evaluation and appropriate care if needed.
Article
Multidisciplinary Sciences
Lauriane Segaux, Amaury Broussier, Nadia Oubaya, Claire Leissing-Desprez, Marie Laurent, Henri Naga, Isabelle Fromentin, Jean-Philippe David, Sylvie Bastuji-Garin
Summary: Many frailty parameters are already altered in middle-aged individuals and are predictive of adverse health events. Our findings highlight a possible need for frailty screening and preventive programs targeting middle-aged individuals.
SCIENTIFIC REPORTS
(2021)
Article
Medicine, General & Internal
Frederic Schlemmer, Agnes Hamzaoui, Sonia Zebachi, Aurelie Le Thuaut, Gilles Mangiapan, Isabelle Monnet, Amel Boudjema, Laurence Jabot, Bruno Housset, Sylvie Bastuji-Garin, Laurence Bassinet, Bernard Maitre
Summary: This study aimed to develop a clinical score to identify adult patients with bronchiectasis who are at higher risk of having cystic fibrosis or primary ciliary dyskinesia. Through diagnostic work-ups and logistic-regression analyses, specific factors associated with CF/PCD diagnosis were identified and a score was validated in a second cohort. The results showed that age at symptom onset, chronic ENT symptoms, digestive symptoms, and specific microbial isolates from sputum were significantly associated with CF or PCD diagnosis, with the developed score demonstrating good performance in identifying high-risk patients.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Nutrition & Dietetics
Elena Paillaud, Johanne Poisson, Clemence Granier, Antonin Ginguay, Anne Plonquet, Catherine Conti, Amaury Broussier, Agathe Raynaud-Simon, Sylvie Bastuji-Garin
Summary: This study investigated the association between serum leptin levels and healthcare-associated infections in hospitalized older patients. The results showed that women with lower leptin levels were more likely to experience healthcare-associated infections, and this association may be mediated by nutritional status.
Article
Oncology
Claudia Martinez-Tapia, Marie Laurent, Elena Paillaud, Philippe Caillet, Emilie Ferrat, Jean-Leon Lagrange, Jean-Paul Rwabihama, Mylene Allain, Anne Chahwakilian, Pascaline Boudou-Rouquette, Sylvie Bastuji-Garin, Etienne Audureau
Summary: Screening tools such as G8 and modified G8 have been developed to identify older cancer patients in need of complete geriatric assessment (GA). Our study compared the diagnostic performance of these tools using multiple clinically relevant reference standards, with evidence of better performance for the modified G8 tool.
Article
Cardiac & Cardiovascular Systems
Pascal Lim, Clement Delmas, Olivier Sanchez, Nicolas Meneveau, Roger Rosario, Helene Bouvaist, Anne Bernard, Jacques Mansourati, Francis Couturaud, Mustapha Sebbane, Pierre Coste, Gwenole Rohel, Bernard Tardy, Caroline Biendel, Olivier Lairez, Fabrice Ivanes, Romain Gallet, Jean-Luc Dubois-Rande, Damien Fard, Gilles Chatelier, Tabassome Simon, Muriel Paul, Pierre-Andre Natella, Richard Layese, Sylvie Bastuji-Garin
Summary: In normotensive patients with intermediate-risk PE, a single bolus of furosemide improved the primary efficacy outcome at 24 hours and maintained stable renal function. In the furosemide group, urine output increased, without demonstrable improvement in heart rate, systolic blood pressure, or arterial oxygenation.
EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE
(2022)
Article
Immunology
Paul Engeroff, Aude Belbezier, Antoine Monsel, David Klatzmann
Summary: This study evaluated the therapeutic potential of interleukin (IL)-1 blockade using Anakinra in a mouse model of lipopolysaccharide (LPS)-induced acute lung injury (ALI). The results showed that Anakinra treatment reduced weight loss induced by ALI, decreased inflammatory cytokines levels, and reduced leukocyte infiltration. After nine days of treatment, mice treated with Anakinra displayed lower levels of leukocytes and alveolar macrophages in bronchoalveolar lavage fluids.
IMMUNITY INFLAMMATION AND DISEASE
(2022)
Article
Geriatrics & Gerontology
Lauriane Segaux, Nadia Oubaya, Claire Leissing-Desprez, Laurent Cleret De Langavant, Amaury Broussier, Henri Naga, Isabelle Fromentin, Jean-Philippe David, Sylvie Bastuji-Garin
Summary: The prevalence of understated executive dysfunction (UED), assessed using the clock-drawing test (CDT) and the Frontal Assessment Battery (FAB), was investigated in middle-aged adults without cognitive complaints. The study found that more than one third of participants had UED, which was associated with obesity and metabolic syndrome. Screening tests targeting executive functions could be useful for early detection of UED and initiating interventions to improve cognitive performance.
AGING & MENTAL HEALTH
(2023)
Article
Oncology
Florence Canoui-Poitrine, Lauriane Segaux, Marc-Antoine Benderra, Fredegonde About, Christophe Tournigand, Marie Laurent, Philippe Caillet, Etienne Audureau, Emilie Ferrat, Jean-Leon Lagrange, Elena Paillaud, Sylvie Bastuji-Garin
Summary: Prognostic assessment is crucial in making cancer treatment decisions for older patients. We evaluated the prognostic performance of eight comorbidity indices in a cohort of older patients with cancer. The results showed that all comorbidity indices were independently associated with one-year mortality in older patients with nonmetastatic cancer, while only CIRS-G was predictive of one-year mortality in older patients with metastatic cancer.
Article
Health Care Sciences & Services
Florence Canoui-Poitrine, Claudia Martinez-Tapia, Elena Paillaud, Simone Mathoulin-Pelissier, Frederic Pamoukdjian, Matthieu Frasca, Anna-Maija Tolppanen, Michael Bringuier, Etienne Brain, Amaury Broussier, Sylvie Bastuji-Garin, Marie Laurent, Etienne Audureau
Summary: This study assessed the direct and indirect effects of six geriatric domains on 6- and 12-month mortality in older cancer patients, finding that functional impairment and poor nutritional status were the strongest direct predictors of mortality.
JOURNAL OF CLINICAL EPIDEMIOLOGY
(2022)
Article
Medicine, General & Internal
Sylvie Bastuji-Garin, Ludivine Brouard, Irma Bourgeon-Ghittori, Sonia Zebachi, Emmanuelle Boutin, Francois Hemery, Frederic Fourreau, Nadia Oubaya, Quentin De Roux, Nicolas Mongardon, Slim Fourati, Jean-Winoc Decousser
Summary: This study investigated the relative contributions of occupational and community sources of COVID-19 among healthcare workers in a tertiary medical center in Paris. The findings suggest a higher risk of hospital-acquired infections, especially in geriatric hospitals, and a link between job roles and infection risk. The results highlight the importance of strengthening preventive measures in hospitals, particularly in geriatric settings.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Primary Health Care
Jonathan Yana, Laura Moscova, Julien Le Breton, Emmanuelle Boutin, Tiphaine Siess, Pascal Clerc, Sylvie Bastuji-Garin, Emilie Ferrat
Summary: In France, general practitioners commonly prescribe benzodiazepines and Z-drugs to older adults, despite their unfavorable risk-benefit ratio in this population. This study found that a greater burden of chronic disease and the number of drug prescriptions per consultation were associated with overprescription of BZD/ZDs, but sociodemographic and practice-related characteristics of the general practitioners were not. Targeted actions are needed to help general practitioners limit the prescription of BZD/ZDs to older patients with multiple comorbidities and polypharmacy.
Article
Critical Care Medicine
Antoine Monsel, Caroline Hauw-Berlemont, Miryam Mebarki, Nicholas Heming, Julien Mayaux, Otriv Nguekap Tchoumba, Jean-Luc Diehl, Alexandre Demoule, Djillali Annane, Clemence Marois, Sophie Demeret, Emmanuel Weiss, Guillaume Voiriot, Muriel Fartoukh, Jean-Michel Constantin, Bruno Megarbane, Gaetan Plantefeve, Stephanie Malard-Castagnet, Sonia Burrel, Michelle Rosenzwajg, Nicolas Tchitchek, Helene Boucher-Pillet, Guillaume Churlaud, Audrey Cras, Camille Maheux, Chloe Pezzana, Mamadou Hassimiou Diallo, Jacques Ropers, Philippe Menasche, Jerome Larghero
Summary: The efficacy of UC-MSCs in patients with SARS-CoV-2-induced ARDS was assessed in this study. The results showed no significant difference in respiratory indicators between the UC-MSCs and placebo groups. The repeated UC-MSCs infusions did not lead to any serious adverse events during treatment or thereafter.