Jean-Charles E Preiser

Jean-Charles E Preiser
Université Libre de Bruxelles | ULB · Erasme Hospital

M.D., Ph.D.

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413
Publications
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17,173
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Publications

Publications (413)
Article
Full-text available
Background Stress hyperglycemia can persist during an intensive care unit (ICU) stay and result in prolonged requirement for insulin (PRI). The impact of PRI on ICU patient outcomes is not known. We evaluated the relationship between PRI and Day 90 mortality in ICU patients without previous diabetic treatments. Methods This is a post hoc analysis...
Article
Background Interventional studies investigating blood glucose (BG) management in intensive care units (ICU) have been inconclusive. New insights are needed. We assessed the ability of a new metric, the Glycemic Ratio (GR), to determine the relationship of ICU glucose control relative to preadmission glycemia and mortality. Methods Retrospective co...
Article
Full-text available
Background Clinical research on nutritional and metabolic interventions in critically ill patients is heterogenous regarding time points, outcomes and measurement instruments used, impeding intervention development and data syntheses, and ultimately worsening clinical outcomes. We aimed to identify and develop a set of core outcome domains and asso...
Article
The annual Virtual Hospital Diabetes Meeting was hosted by Diabetes Technology Society on April 1 and April 2, 2022. This meeting brought together experts in diabetes technology to discuss various new developments in the field of managing diabetes in hospitalized patients. Meeting topics included (1) digital health and the hospital, (2) blood gluco...
Article
Full-text available
Background The role of vitamin D in the response to infection has been increasingly acknowledged. However, the influence of severe vitamin D deficiency on the outcome of patients admitted for severe sepsis is unknown. Hence, this study aimed to investigate the association between severe vitamin D deficiency and sepsis-related outcomes in patients p...
Article
Objectives: To determine the associations of relative hypoglycemia and hemoglobin A1c-adjusted time in blood glucose (BG) band (HA-TIB) with mortality in critically ill patients. Design: Retrospective cohort investigation. Setting: University-affiliated adult medical-surgical ICU. Patients: Three thousand six hundred fifty-five patients with...
Article
Full-text available
Intensive care survivors often experience post-intensive care sequelae, which are frequently gathered together under the term “post-intensive care syndrome” (PICS). The consequences of PICS on quality of life, health-related costs and hospital readmissions are real public health problems. In the present Viewpoint, we summarize current knowledge and...
Article
Full-text available
The preferential use of the oral/enteral route in critically ill patients over gut rest is uniformly recommended and applied. This article provides practical guidance on enteral nutrition in compliance with recent American and European guidelines. Low-dose enteral nutrition can be safely started within 48 h after admission, even during treatment wi...
Article
Purpose It has been suggested that ICU follow-up clinics can offer support for ICU survivors and their relatives. However, implementation of such clinics can be challenging. We explored the barriers to implementation of an ICU follow-up program from the healthcare providers' perspective. Methods This was a mixed methods study with a triangulation...
Article
Purpose: Hyperglycaemia is an adaptive response to stress commonly observed in critical illness. Its management remains debated in the intensive care unit (ICU). Individualising hyperglycaemia management, by targeting the patient's pre-admission usual glycaemia, could improve outcome. Methods: In a multicentre, randomized, double-blind, parallel...
Article
Full-text available
Introduction Although prevalent and associated with worsened outcomes, vitamin D severe deficiency is not systematically searched among intensive care unit (ICU) admissions and waiting time for measurement results range from hours to few days. Hence, we developed and internally validated a simple nomogram for predicting severe vitamin D deficiency...
Article
Background Emerging data highlight the interactions of preadmission glycemia, reflected by admission HbA1c levels, glycemic control during critical illness, and mortality. The association of preadmission insulin treatment with outcomes is unknown. Methods This observational cohort study includes 5245 patients admitted to the medical-surgical inten...
Article
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Background and aims To develop a five grade score (0-4 points) for the assessment of gastrointestinal (GI) dysfunction in adult critically ill patients. Methods This prospective multicenter observational study enrolled consecutive adult patients admitted to 11 intensive care units in nine countries. At all sites, daily clinical data with emphasis...
Article
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Background Previous studies unveiled a relation between the severity of COVID‐19 pneumonia and obesity. The aims of this multicenter retrospective cohort study were to disentangle the association of BMI and associated metabolic risk factors (diabetes, hypertension, hyperlipidemia, current smoking) in critically ill patients with COVID‐19. Methods...
Preprint
Full-text available
Objective: Survivors of intensive care often present long-term sequelae, including cognitive impairment and psychological discomfort. Follow-up programs have therefore been developed to assess and manage these long-term complications. Studying the effectiveness of such programs can be limited by the number of patients lost during follow-up. The aim...
Article
Background & aims: Among hospitalized patients with COVID-19, up to 12% may require intensive care management (ICU). The aim of this prospective cohort study is to assess nutritional status and outcome in patients with COVID-19 following ICU discharge. Methods: All patients with COVID-19 requiring a minimum of 14 days stay in the ICU with mechan...
Article
Full-text available
Background This practical guideline is based on the current scientific ESPEN guidelines on nutrition in cancer patients. Methods ESPEN guidelines have been shortened and transformed into flow charts for easier use in clinical practice. The practical guideline is dedicated to all professionals including physicians, dieticians, nutritionists and nur...
Article
Full-text available
Background: Gastrointestinal (GI) dysfunction is frequent in the critically ill but can be overlooked as a result of the lack of standardization of the diagnostic and therapeutic approaches. We aimed to develop a research agenda for GI dysfunction for future research. We systematically reviewed the current knowledge on a broad range of subtopics f...
Article
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The goal of nutrition support is to provide the substrates required to match the bioenergetic needs of the patient and promote the net synthesis of macromolecules required for the preservation of lean mass, organ function, and immunity. Contemporary observational studies have exposed the pervasive undernutrition of critically ill patients and its a...
Article
Enteral feeding intolerance (EFI) is a common feature in critically ill patients worldwide. However, there is no clear, widely agreed‐upon definition available, with various studies rarely using the same definition. The term EFI is frequently used to describe vomiting or large gastric residual volumes associated with enteral feeding as a result of...
Article
Full-text available
Malnutrition is associated to poor outcomes in critically ill patients. Oral nutrition is the route of feeding in less than half of the patients during the intensive care unit (ICU) stay and in the majority of ICU survivors. There are growing data indicating that insufficient and/or inadequate intakes in macronutrients and micronutrients are preval...
Article
Objectives: To determine the relationship between preadmission glycemia, reflected by hemoglobin A1c level, glucose metrics, and mortality in critically ill patients. Design: Retrospective cohort investigation. Setting: University affiliated adult medical-surgical ICU. Patients: The investigation included 5,567 critically ill patients with f...
Article
Introduction Oral nutrition is delivered frequently in intensive care units (ICUs) but rarely studied. The primary objective of this study was to quantify nutrition intakes in patients exclusively orally fed (OF) and in those receiving medical nutrition solutions or both. Methods Adults who stayed in a mixed ICU for ≥3 days were studied. Nutrition...
Article
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Background and Aims Despite the presumed importance of preventing and treating micronutrient and mineral deficiencies, it is still not clear how to optimize measurement and administration in critically ill patients. In order to design future comparative trials aimed at optimizing micronutrient and mineral management, an important first step is to g...
Article
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De acuerdo al Estatuto de las Sociedades Médico–Científico académicas y las Asociaciones Médicas multidisciplinarias con Ordenamiento legal y con cumplimiento a la Ley 3131; por atribución del Colegio Médico de Bolivia, las Sociedades Científicas dependientes de la misma que crean los instrumentos necesarios para normar las actividades de los médic...
Article
Full-text available
Methods to control the blood glucose (BG) levels of patients in intensive care units (ICU) improve the outcomes. The development of continuous BG levels monitoring devices has also permitted to optimize these processes. Recently it was shown that a complexity loss of the BG signal is linked to poor clinical outcomes. Thus, it becomes essential to d...
Article
The right management of oral glucose-lowering drugs aims to identify, assess, and follow patients with diabetes and avoid unnecessary interruptions of the chronic treatment.
Chapter
Health technology improvements lead to an increasing number of intensive care unit (ICU) survivors. However, long-term consequence interventions performed in ICUs may impact the patients’ quality of life. The so-called “post-intensive care syndrome” (PICS) appears to be responsible for difficulties faced by survivors. ICU follow-up programmes can h...
Chapter
Stress hyperglycemia occurs frequently during critical illness due to the increased resistance to insulin. The three domains of dysglycemia, that is, stress hyperglycemia, hypoglycemia, and high glycemic variability, are associated with a poor outcome. The risk-to-benefit ratio of intensive insulin therapy aiming at a blood glucose target ranging f...
Article
Full-text available
Metabolic alterations in the critically ill have been studied for more than a century, but the heterogeneity of the critically ill patient population, the varying duration and severity of the acute phase of illness, and the many confounding factors have hindered progress in the field. These factors may explain why management of metabolic alteration...
Article
Purpose of review: An excessive caloric intake during the acute phase of critical illness is associated with adverse effects, presumably related to overfeeding, inhibition of autophagy and refeeding syndrome. The purpose of this review is to summarize recently published clinical evidence in this area. Recent findings: Several observational studi...
Article
Full-text available
Purpose of Review To provide an update of glycemic management during metabolic stress related to surgery or critical illness. Recent Findings There is a clear association between severe hyperglycemia, hypoglycemia, and high glycemic variability and poor outcomes of postoperative or critically ill patients. However, the impressive beneficial effect...
Article
Background The use of near-continuous blood glucose (BG) monitoring has the potential to improve glycemic control in critically ill patients. The MANAGE IDE trial evaluated the performance of the OptiScanner (OS) 5000 in a multicenter cohort of 200 critically ill patients. Methods An Independent Group reviewed the BG run charts of all 200 patients...
Article
Résumé La prise en charge métabolique et nutritionnelle du patient de réanimation fait partie des priorités et nécessite une collaboration multidisciplinaire systématisée et facilitée par l’utilisation d’arbres décisionnels. Notre politique prévoit une augmentation progressive des apports nutritionnels, selon la tolérance du patient, au vu des effe...
Chapter
At the end of this chapter, you should have learned much more about:
Article
Purpose of review: To summarize the advances in literature that support the best current practices regarding glucose control in the critically ill. Recent findings: There are differences between patients with and without diabetes regarding the relationship of glucose metrics during acute illness to mortality. Among patients with diabetes, an ass...
Article
Résumé Suite à la mise en évidence d’effets néfastes d’un apport nutritionnel important à la phase aiguë de l’agression, le concept de « baby stomach » a été introduit pour illustrer la capacité réduite à utiliser les macro-nutriments et à freiner la production endogène de glucose. Les recommandations de pratique clinique publiées ont évolué parall...
Article
Objective The study aimed to evaluate the impact of the single nucleotide polymorphism (SNP) rs7903146 on the transcription factor 7-like 2 (TCF7L2) gene in stress-related hyperglycaemia (SRH), defined as blood glucose ≥ 11 mmol/L in at least two blood samples during the first 3 days in the intensive care unit (ICU), and on 28-day and 1-year mortal...
Article
Discipline Clinique. Introduction et but de l’étude La dysphagie est un symptôme fréquemment retrouvé chez les patients hospitalisés aux soins intensifs (USI) après intubation trachéale, trachéotomie ou présence d’une sonde naso-gastrique. Les conséquences de la dysphagie comportent une incidence accrue de fausses routes et de pneumonies acquises...
Article
Full-text available
There is considerable physiological and clinical evidence of harm and increased risk of death associated with dysglycemia in critical care. However, glycemic control (GC) currently leads to increased hypoglycemia, independently associated with a greater risk of death. Indeed, recent evidence suggests GC is difficult to safely and effectively achiev...
Article
Full-text available
Abstract The rationale for the provision of nitrogen from proteins given via the enteral route or from intravenous amino acids is to boost the synthesis of muscle proteins, and thereby to limit the severity of intensive care unit-acquired weakness by the prevention of muscle loss. However, the optimal timing for supplemental nitrogen provision is a...
Article
Following the new ESPEN Standard Operating Procedures, the previous guidelines to provide best medical nutritional therapy to critically ill patients have been updated. These guidelines define who are the patients at risk, how to assess nutritional status of an ICU patient, how to define the amount of energy to provide, the route to choose and how...
Article
The aim of this review is to summarize recent developments on the mechanisms involved in stress hyperglycemia associated with critical illness. Different aspects of the consequences of stress hyperglycemia as well as the therapeutic approaches tested so far are discussed: the physiological regulations of blood glucose, the mechanisms underlying str...
Article
Background & aims: This position paper summarizes theoretical and practical aspects of the monitoring of artificial nutrition and metabolism in critically ill patients, thereby completing ESPEN guidelines on intensive care unit (ICU) nutrition. Methods: Available literature and personal clinical experience on monitoring of nutrition and metaboli...
Article
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Background Stress-related hyperglycaemia (SHG) is commonly seen in acutely ill patients and has been associated with poor outcomes in many studies performed in different acute care settings. We aimed to review the available evidence describing the associations between SHG and different outcomes in acutely ill patients admitted to an ICU. Study desi...
Data
Patient characteristics by number of studies and patients. A. Acute Physiology and Chronic Health Evaluation (APACHE) score. B. Mortality type. ICU, intensive care unit; NR, not reported. (PPTX)
Data
Mortality, infections, length of stay, and resource use in patients with or without hyperglycaemia in trauma and mixed ICUs. aRespiratory, genito-urinary, bloodstream; brespiratory infections; cgenitourinary tract infections; dblood infections; eintra-abdominal infections; fskin/soft tissue infections; grespiratory infections, genito-urinary tract...
Data
Blood glucose (BG) variables by number of studies and patients. A. Stress hyperglycaemia (SHG) definition. B. BG sampling site. C. Meter used for BG sampling. POC/gluc, point-of-care/glucometer; BGA, blood gas analyser; Lab, laboratory D. Timing of BG sampling. E. Target BG range. NR, not reported. *Data from the study by Falciglia et al. (2009) we...
Data
Search strategy for Medline and Medline In-Process. (DOCX)