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Publications (94)
A number of indigenous populations have resided at high-altitude for generations, resulting in various phenotypical adaptations promoting successful high-altitude adaptation. While many of these adaptations have been investigated in adults, little is known regarding how children residing at high-altitudes adapt, particularly with regards to the cer...
Background: Discordant results have been previously reported regarding the impact of high-altitude exposure on the coagulation. We aimed to investigate changes in coagulation parameters in lowlanders exposed to high altitude for 14 days using a combination of dynamic coagulation assays and conventional in vitro tests.
Material and Methods: We asses...
The erythrocyte sedimentation rate (ESR) is one of the oldest diagnostic tools already known by the ancient Greeks. When blood is placed in a tube, a phase separation between blood plasma and the remaining part of the blood containing the cells appears. The distance between the top of the liquid and the phase boundary determines the sedimentation h...
Permanent residence at high-altitude and chronic mountain sickness (CMS) may alter the cerebrovascular homeostasis and orthostatic responses. Healthy male participants living at sea-level (LL; n = 15), 3800 m (HL3800m; n = 13) and 5100 m (HL5100m; n = 17), respectively, and CMS highlanders living at 5100 m (n = 31) were recruited. Middle cerebral a...
Grimm, Mirjam, Lucie Ziegler, Annina Seglias, Maamed Mademilov, Kamila Magdieva, Gulzada Mirzalieva, Aijan Taalaibekova, Simone Suter, Simon R. Schneider, Fiona Zoller, Vera Bissig, Lukas Reinhard, Meret Bauer, Julian Müller, Tanja L. Ulrich, Arcangelo F. Carta, Patrick R. Bader, Konstantinos Bitos, Aurelia E. Reiser, Benoit Champigneulle, Damira A...
We investigated highlanders, permanently living at an altitude of 5100 m and compared Chronic Mountain Sickness (CMS) patients with control volunteers. While we found differences in systemic parameters such as blood oxygen content, hematocrit, hemoglobin concentration, and blood viscosity, the mechanical and rheological properties of single red blo...
Chronic mountain sickness is a maladaptive syndrome that affects individuals living permanently at high altitude and is characterized primarily by excessive erythrocytosis (EE). Recent results concerning the impact of EE in Andean highlanders on clotting and the possible promotion of hypercoagulability, which can lead to thrombosis, were contradict...
Exposure to chronic hypobaric hypoxia imposes a significant physiological burden to more than 80 million humans living above 2500 m throughout the world. Among them, 50 000 live in the world's highest city, La Rinconada, located at 5000–5300 m in southern Peru. Expedition 5300 is the first scientific and medical programme led in La Rinconada to inv...
Red blood cell (RBC) metabolic reprogramming upon exposure to high altitude contributes to physiological human adaptations to hypoxia, a multifaceted process critical to health and disease. To delve into the molecular underpinnings of this phenomenon, first, we performed a multi-omics analysis of RBCs from six lowlanders after exposure to high-alti...
Background. Low daily physical activity and poor exercise tolerance are cardinal features in fibrotic interstitial lung disease (f-ILD) (1, 2). Besides, cerebral hypoxia may exacerbate the perception of fatigue during exercise.(3) We previously showed that activity-related hypoxaemia, another hallmark of f-ILD, dose-dependently impairs cerebral oxy...
Permanent residence at high-altitude and chronic mountain sickness (CMS) may alter the cerebrovascular homeostasis and orthostatic responses. 15/13/17 healthy participants living at sea-level (LL), 3,800m (HL3800m) and 5,100m (HL5100m), respectively, and 31 additional highlanders with CMS living at 5,100m were recruited. Middle cerebral artery mean...
Purpose:
Cerebral hypoxia may exacerbate the perception of fatigue. We previously demonstrated that exercise-related hypoxemia, a hallmark of fibrotic interstitial lung disease (f-ILD), dose-dependently impairs cerebral oxygenation in these patients. It is unknown whether normalizing cerebral oxygenation with O2 supplementation would be associated...
Introduction and Objectives: Chronic Mountain Sickness (CMS) syndrome, combining excessive erythrocytosis and clinical symptoms in highlanders, remains a public health concern in high-altitude areas, especially in the Andes, with limited therapeutic approaches. The objectives of this study were to assess in CMS-highlanders permanently living in La...
Investigation of pulmonary gas exchange efficacy usually requires arterial blood gas analysis (aBGA) to determine arterial partial pressure of oxygen (mPaO2) and compute the Riley alveolar-to-arterial oxygen difference (A-aDO2); that is a demanding and invasive procedure. A noninvasive approach (AGM100), allowing the calculation of PaO2 (cPaO2) der...
Background/aims
Amongst numerous travelers to high altitude are many with the highly prevalent chronic obstructive pulmonary disease (COPD), who are at particular risk for altitude-related adverse health effects (ARAHE). We investigated hypoxia altitude simulation testing (HAST) to predict ARAHE in COPD patients traveling to altitude.
Methods/resu...
High altitude exposes humans to hypobaric hypoxia, which induces various physiological and molecular changes. Recent studies point toward interaction between circadian rhythms and the hypoxic response, yet their human relevance is lacking. Here, we examine the effect of different high altitudes in conjunction with time of day on human whole-blood t...
Purpose
Both prolonged exercise and acute high-altitude exposure are known to induce cardiac changes. We sought to describe the cardiac responses to speed climbing at high-altitude, including left ventricular (LV) performance assessment using the myocardial work index (MWI), a new index derived from 2D speckle tracking echocardiography (STE).
Meth...
Purpose
The combined effects of acute hypoxia and exercise on cognition remain to be clarified. We investigated the effect of speed climbing to high altitude on reactivity and inhibitory control in elite climbers.
Methods
Eleven elite climbers performed a speed ascent of the Mont-Blanc (4810 m) and were evaluated pre- (at 1000 m) and immediately p...
Background
In relatives of patients dying in intensive care units (ICUs), inadequate team support can increase the prevalence of prolonged grief and other psychological harm. We aimed to evaluate whether a proactive communication and support intervention would improve relatives' outcomes.
Methods
We undertook a prospective, multicentre, cluster ra...
High-altitude exposure results in a hyperventilatory-induced respiratory alkalosis followed by renal compensation (bicarbonaturia) to return arterial blood pH(a) toward sea-level values. However, acid-base balance has not been comprehensively examined in both lowlanders and indigenous populations - where the latter are thought to be fully adapted t...
A study to measure the composition of exhaled air was carried out in subjects living in the highest city in the world: La Rinconada in Peru. People living at high altitude have a strongly disturbed metabolism and have to deal with major physiological disturbances. It is very likely that these subjects develop a disturbance of their redox system. It...
Objectives
Geotrichum spp can be responsible for severe infections in immunocompromised patients. We aim to describe Geotrichum-related infections in the ICU and to assess risk factors of mortality.
Methods
retrospective multicentre study, conducted in 14 French ICUs between 2002 and 2018, including critically ill adult patients with proven or pro...
Champigneulle, Benoit, Ivan Hancco, Richard Renan, Stéphane Doutreleau, Emeric Stauffer, Aurélien Pichon, Julien V. Brugniaux, Hélène Péré, Pierre Bouzat, David Veyer, and Samuel Verges. High-altitude environment and COVID-19: SARS-CoV-2 seropositivity in the highest city in the world. High Alt Med Biol. 22: 000-000, 2021. Background: A reduced cor...
Abstract Background Hyperoxemia has been associated with increased mortality in critically ill patients, but little is known about its effect in trauma patients. The objective of this study was to assess the association between early hyperoxemia and in-hospital mortality after severe trauma. We hypothesized that a PaO2 ≥ 150 mmHg on admission was a...
Little is known about hemostasis modifications induced by chronic hypoxic exposure in high-altitude residents, especially in those who develop excessive erythrocytosis (EE, i.e. hemoglobin concentration ≥ 21 g·dL-1 in male and ≥ 19 g·dL-1 in female). The aim of this preliminary study was to assess coagulation alterations in highlanders with or with...
In severe COVID-19 pulmonary failure, hypoxia is mainly related to pulmonary vasodilation with altered hypoxic pulmonary vasoconstriction (HPV). Besides prone positioning, other non-ventilatory strategies may reduce the intrapulmonary shunt. This study has investigated almitrine, a pharmacological option to improve oxygenation.
Patients and Method....
A 44-year-old woman, victim of a road accident in Mali was diagnosed with left knee arthritis. Joint effusion aspiration and subcutaneous surgical biopsies were positive for a melanized asexual ascomycete. Using microscopy and molecular biology, the fungus was identified as Curvularia sp. In vitro antifungal susceptibility was determined by the EUC...
Background:
Acute aortic syndrome (AAS) comprises a complex and potentially fatal group of conditions requiring emergency specialist management. The aim of this study was to build a prediction algorithm to assist prehospital triage of AAS.
Methods:
Details of consecutive patients enrolled in a regional specialist aortic network were collected pr...
Background:
This study aimed at describing usual anesthetic practices for brain-dead donors (BDD) during an organ procurement (OP) procedure and to assess the knowledge and self-confidence of French anesthesiologists with this practice.
Methods:
An electronic and anonymous survey with closed-questions about anesthetic management of BDD was distr...
Résumé
Le syndrome d’embolie graisseuse (SEG) est une complication grave pouvant survenir après un polytraumatisme. L’atteinte pulmonaire est souvent révélatrice et peut s’accompagner de signes neurologiques. L’observation clinique est celle d’un SEG particulier avec prédominance d’une défaillance neurologique sévère sans atteinte respiratoire et d...
Aims:
The HOPE score, based on covariates available at hospital admission, predicts the probability of in-hospital survival after extracorporeal life support (ECLS) rewarming of a given hypothermic cardiac arrest patient with accidental hypothermia. Our goal was to externally validate the HOPE score.
Methods:
We included consecutive hypothermic...
Objectives:
Severe hypoxemia is the most common serious adverse event during endotracheal intubation. Preoxygenation is performed routinely as a preventive measure. The relative efficacy of the various available preoxygenation devices is unclear. Here, our objective was to assess associations between preoxygenation devices and pulse oximetry value...
Background:
After resuscitation of cardiac arrest (CA), an acute circulatory failure occurs in about 50% of cases, which shares many characteristics with septic shock. Most frequently, supportive treatments are poorly efficient to prevent multiple organ failure and death. We evaluated whether an early plasma removal of inflammatory mediators using...
Background: This study aimed at describing usual anesthetic practices for brain-dead donors (BDD) during an organ procurement (OP) procedure and to assess the knowledge and self-confidence of French anesthesiologists with this practice. Methods: An electronic and anonymous survey with closed-questions about anesthetic management of BDD was distribu...
Background: There is no specific guidelines concerning intraoperative management of brain-dead donors (BDD) during organ procurement (OP). This study aimed at describing usual anesthetic practices for BDD during an OP procedure and to assess the knowledge and self-confidence of French anesthesiologists with this practice.
Methods: An electronic, na...
Aim:
Due to collapse and cardiopulmonary resuscitation (CPR) maneuvers, major traumatic injuries may complicate the course of resuscitation for out-of-hospital cardiac arrest patients (OHCA). Our goals were to assess the prevalence of these injuries, to describe their characteristics and to identify predictive factors.
Methods:
We conducted an o...
Purpose:
Although guidelines on post-resuscitation care recommend the use of short-acting agents for sedation during targeted temperature management (TTM) after cardiac arrest (CA), the potential advantages of this strategy have not been clinically demonstrated.
Methods:
We compared two sedation regimens (propofol-remifentanil, period P2, vs mid...
Background:
Whether the route of early feeding affects outcomes of patients with severe critical illnesses is controversial. We hypothesised that outcomes were better with early first-line enteral nutrition than with early first-line parenteral nutrition.
Methods:
In this randomised, controlled, multicentre, open-label, parallel-group study (NUT...
Objectives:
Family members of patients who die in the ICU often remain with unanswered questions and suffer from lack of closure. A letter of condolence may help bereaved relatives, but little is known about their experience of receiving such a letter. The objective of the study was to understand bereaved family members' experience of receiving a...
Background
Respective proportions of final etiologies are disparate in cohorts of cardiac arrest patients, depending on examined population and diagnostic algorithms. In particular, prevalence and characteristics of sudden unexplained death syndrome (SUDS) are debated. We aimed at describing etiologies in a large cohort of aborted out-of-hospital c...
Objectives:
To describe the characteristics, management, and outcome of patients admitted to ICUs for pheochromocytoma crisis.
Design:
A 16-year multicenter retrospective study.
Setting:
Fifteen university and nonuniversity ICUs in France.
Patients:
Patients admitted in ICU for pheochromocytoma crisis.
Interventions:
None.
Measurement and...
Purpose:
Family members of patients who die in the intensive care unit (ICU) may experience symptoms of stress, anxiety, depression, posttraumatic stress disorder (PTSD), and/or prolonged grief. We evaluated whether grief symptoms were alleviated if the physician and the nurse in charge at the time of death sent the closest relative a handwritten...
Background:
Even if a large majority of out-of-hospital cardiac arrest (OHCA) survivors appear to have a good neurological recovery with no important sequellae, whether health-related quality of life (HRQOL) is altered is less explored.
Patients and methods:
HRQOL was evaluated by telephone interview using SF-36 questionnaire. Each OHCA case was...
Aim:
Early invasive strategy, including percutaneous coronary intervention (PCI), may improve survival in out-of-hospital-cardiac-arrest (OHCA) due to coronary artery disease but selection of suitable patients is challenging. Differences and results across gender remain unknown. We aimed to assess the relationship between gender and the use of an...
Background
It is well recognized that sleep is severely disturbed in patients in intensive care units (ICU) and that this can compromise their rehabilitation potential. However, it is still difficult to objectively assess sleep quantity and quality and the determinants of sleep disturbance remain unclear. The aim of this study was therefore to eval...
Importance:
In the intensive care unit (ICU), orotracheal intubation can be associated with increased risk of complications because the patient may be acutely unstable, requiring prompt intervention, often by a practitioner with nonexpert skills. Video laryngoscopy may decrease this risk by improving glottis visualization.
Objective:
To determin...
A1154
Principal features in potsurgical patients with multidrug-resistant
organisms isolation, acquired before the admission at the
intensive care unit.
G.E. Kaminsky, R. Carreño, A. Escribá, M. Fuentes, V. Gálvez, R. Del Olmo, B. Nieto, C. Vaquerizo, J. Alvarez, M.A. De la Torre, E. Torres. Hospital Universitario de Fuenlabrada, Intensive Care Un...
Table of contents:
PHYSICIANS ABSTRACTSO1 Impact of tracheal cuff shape on microaspiration of gastric contents in intubated critically ill patients: a multicenter randomized controlled study (BEST CUFF)Emmanuelle Jaillette, Christophe Girault, Guillaume Brunin, Farid Zerimech, Arnaud Chiche, Céline Broucqsault-Dedrie, Cyril Fayolle, Franck Minacor...
Purpose:
Although prolonged unconsciousness after cardiac arrest (CA) is a sign of poor neurological outcome, limited evidence shows that a late recovery may occur in a minority of patients. We investigated the prevalence and the predictive factors of delayed awakening in comatose CA survivors treated with targeted temperature management (TTM).
M...
Aim:
Hypoxic hepatitis (HH) may complicate the course of resuscitated out-of-hospital cardiac arrest (OHCA) patients admitted in intensive care unit (ICU). Aims of this study were to assess the prevalence of HH, and to describe the factors associated with HH occurrence and outcome.
Methods:
We conducted an observational study over a 6-year perio...
To the Editor We read with interest the article by Nabozny et al1 concerning withholding or withdrawing care from some intensive care unit (ICU) patients. We agree with much of their analysis. However, we were surprised by their conclusion about the futility of cardiopulmonary resuscitation (CPR) in patients with metastatic cancer. In our opinion,...
Introduction:
Critically ill patients with acute respiratory, neurological or cardiovascular failure requiring invasive mechanical ventilation are at high risk of difficult intubation and have organ dysfunctions associated with complications of intubation and anaesthesia such as hypotension and hypoxaemia. The complication rate increases with the...
Background:
The ability to perform objective pain assessment is very important in paediatric patients. The goal of this study was to investigate the relationship between the analgesia nociception index (ANI), which is based on the heart rate variability, and objective measurements of pain intensity in young or cognitively impaired children, after...
Introduction: Data on health-related quality of life (HRQOL) of resuscitated out-of-hospital cardiac arrest (OHCA) patients remain scarce. Our aims were to compare long-term HRQOL of OHCA with that of the general population, and to assess factors associated with better HRQOL.
Methods: We used a large cohort of OHCA patients admitted in a tertiary m...
Achieving and maintaining perfect homeostasis, particularly in terms of metabolism, represent a major goal for post-cardiac arrest (CA) care. Since cooling may provoke different physiological responses, it is of particular importance to be aware of these changes that may require specific treatment adjustments during this recovery period [1]. Severa...
Low survival rate was previously described after cardiac arrest in cancer patients and may challenge the appropriateness of intensive care unit (ICU) admission after return of spontaneous circulation (ROSC). Objectives of this study were to report outcome and characteristics of cancer patients admitted to the ICU after cardiac arrest.
A retrospecti...
La mort encéphalique (ME) est susceptible d’entraîner une dysfonction cardiocirculatoire, par l’intermédiaire de différents mécanismes résultant de l’ischémie cérébrale: orage catécholaminergique, dysfonction neurohormonale et inflammation systémique. Cette dysfonction cardiovasculaire est potentiellement exacerbée par les antécédents du potentiel...
To assess the first three years of French activity related to liver transplantation from uncontrolled donation after cardiac death (uDCD).
Prospective and observational study in the three active centres authorized by the French Biomedicine Agency.
All patients deceased between 2010 and 2012 after an uncontrolled cardiac arrest admitted to one of th...
Background:
Thrombocytopenia is a frequent finding in critically ill cancer patients for whom indications of platelet transfusions are unclear. We herein addressed the current practices in platelet transfusion and the risk of bleeding in cancer patients with hypoproliferative thrombocytopenia in the intensive care unit (ICU).
Methods:
A retrospe...
Neuroprotective effects of hypothermia may explain surprisingly high survival rates reported after drowning in cold water despite prolonged submersion. We described a cohort of refractory hypothermic cardiac arrests (CA) due to drowning treated by extracorporeal life support (ECLS) and aimed to identify criteria associated with 24-hour survival.
El...
Le développement d’une anémie euvolémique est un événement fréquent chez les patients de réanimation, parfois favorisé par une pathologie sous-jacente, mais plus souvent liée à une altération de l’érythropoïèse et à des spoliations sanguines répétées. De fait, les patients hospitalisés en réanimation sont fréquemment exposés à des transfusions de c...
Introduction
The overall outcome of septic shock has been recently improved. We sought to determine whether this survival gain extends to the high-risk subgroup of patients with cirrhosis.
Methods
Cirrhotic patients with septic shock admitted to a medical intensive care unit (ICU) during two consecutive periods (1997-2004 and 2005-2010) were retro...
Postoperative ileus is a frequent problem after abdominal surgery. Local inflammation, endogenous opioids, and sympathetic nervous system stimulation are contributive factors. Postoperative ileus impairs patient's comfort while inducing pain, nausea and vomiting. In addition, it may be responsible for postoperative complications such as respiratory...
