Christine Kummerlen

CHRU de Strasbourg | CHRU strasbourg · Pôle Urgences / réanimations médicales / CAP

Background: Neurotropism of SARS-CoV-2 and its neurological manifestations have now been confirmed. We aimed at describing delirium and neurological symptoms of COVID-19 in ICU patients. Methods: We conducted a bicentric cohort study in two French ICUs of Strasbourg University Hospital. All the 150 patients referred for acute respiratory distres...

Abstract Background Nutrition guidelines recommendations differ on the use of parenteral nutrition (PN), and existing clinical trial data are inconclusive. Our recent observational data show that amounts of energy/protein received early in the intensive care unit (ICU) affect patient mortality, particularly for inadequate nutrition intake in patien...

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...

Lipid emulsions used in parenteral nutrition are an essential factor of artificial nutrition in intensive care. When given according to the guidelines, they are effective on the nutritional point of view and metabolically well tolerated. Soon after being available on the market, the first generation emulsions, made from soybean oil, were thought to...

La nutrition parentérale nécessite la mise en œuvre de différentes procédures indispensables à connaître pour que ce mode ďalimentation artificielle soit fiable et efficace.

The nutritional guidelines in patients suffering from acute respiratory insufficiency are close to these recommended in the critically ill patients. But in acute respiratory failure, the constancy of an oxygen debt and the frequent high carbon dioxide levels, are particular elements to consider at the time of the choice of the nutrition support. Li...

A fatality involving verapamil, a calcium channel blocker agent, is presented. A 51-year old male ingested 7200 mg of sustained-release (SR) verapamil at T0 and died 40 hours later of refractory, mixed shock and multiorgan failure. The symptoms displayed during hospitalization were quite typical and involved altered consciousness, hypotension, brad...

Malnutrition affects a high number of hospitalized patients and worsen their outcome. Nutritional support is then essential and the appropriate way is in the most cases represented by dietary supplementation or enteral feeding. Parenteral nutrition may be required in some cases of particularly severe malnutrition. Its efficiency is widely proved an...

In critically ill patients suffering from acute respiratory failure, weaning from ventilatory assistance is a key survival factor in intensive care units (ICU). The aim of this study was to provide deeper insight into laboratory methods allowing improved monitoring of that critical period. Eighty-three ICU patients (mean age 63.9 years), classified...

Artificial nutrition is an inevitable component of ICU techniques, and usually comes with side effects. Among these, the effects of parenteral lipids on pulmonary function has been described in patients with abnormalities of the ventilation/perfusion ratio. Underlying mechanisms are well-known and involve, under the effect of lipidic infusion, a ch...

Artificial nutrition is an inevitable component of ICU techniques, and usually comes with side effects. Among these, the effects of parenteral lipids on pulmonary function has been described in patients with abnormalities of the ventilation/ perfusion ratio. Underlying mechanisms are well-known and involve, under the effect of lipidic infusion, a c...

We report on an unusual, albeit potentially severe, complication of the performance of a pleural lavage with streptokinase in two patients demonstrating parapneumonic pleural effusion. During the time they underwent repeated pleural lavages with saline and streptokinase, they suddenly demonstrated focal neurological signs. As a result of early diag...

Introduction Neuromuscular complications acquired during the stage in the intensive care unit form a new entity. Aim In light of this account, we describe the features of these neuromuscular complications. Results Three neuromuscular deficits are described: the so-called critical illness polyneuropathy, the neuromyopathic changes associated with...

Total parenteral nutrition (TPN) has for a long time been considered as the optimal route of substrate delivery in intensive care unit patients. It is easier to administer and the fear of gastro-intestinal intolerance has discouraged the use of enteral nutrition in critical illness. However, because of a large number of serious complications and th...

Les émulsions lipidiques, mises au point à partir d'huile de soja et dont l'efficacité nutritionnelle est largement vérifiée depuis plus de trente ans d'utilisation, constituent un élément essentiel de la nutrition parentérale. Au fil des années, leurs caractéristiques métaboliques, leur impact physiologique et leurs effets secondaires ont été préc...

Neuromuscular complications acquired in the intensive care unit form a new clinical entity. Three neuromuscular deficits are described: so-called critical illness polyneuropathy where neuromyopathic changes are associated with corticosteroid and/or neuromuscular blocking agents, and catabolic myopathy. We report four new cases: three of them concer...

Neuromuscular complications acquired in the intensive care unit form a new clinical entity. Three neuromuscular deficits are described: so-called critical illness polyneuropathy where neuromyopathic changes are associated with corticosteroid and/or neuromuscular blocking agents and catabolic myopathy. We report four new cases: three of them concern...

We report a case of meningo-encephalitis with HIV seroconversion. Clinical presentation was an acute meningo-encephalitis in a non immuno-compromised patient. In this situation, diagnosis was supported by HIV seroconversion with negative other viral serology, and negativity of other bacterial and parasitological investigations. Previously reported...

We have followed the time-course of the morphological and functional recovery of intestinal mucosa after 90 min of mesenteric vascular occlusion. At the end of the ischemic period the villi were smashed, but crypts were preserved. Microvillous hydrolase activities showed a dramatic drop when compared with sham-operated controls. Reperfusion was fol...

We report a case of brain aspergillosis occuring after a road accident with open depressed fracture of the skull. Clinical presentation features a necrotizing meningo-encephalitis in an immuno-responsive patient with no underlying disease. Two cerebro-spinal fluid samples drawn at different times grow Aspergillus fumigatus thus establishing the dia...

We studied thirty-six patients with non traumatic vegetative state (US) and treated in our ICU for more than 30 days clinical features and outcome are reported. Mean age is 58 years and four aetiological groups were identified : post-anoxic (17 cases), haemorragic stroke (8 cases), ischaemic stroke (9 cases), meningitis or encephalitis (2 cases). T...

The authors report the case of a patient with a stable IgA kappa gammapathy over several years which finally evolved to an IgA lambda myeloma during which the initial gammapathy regressed. As the two gammapathies probably arose from two different cellular populations, the regression of the IgA kappa dysglobulinaemia is an additional argument in fav...