Philippe Jouvet

Philippe Jouvet
CHU Sainte-Justine · Department of Paediatric

MD PhD MBA
Research in Artificial Intelligence applied to pediatric critical care medicine to help caregivers making decisions.

About

337
Publications
70,345
Reads
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Introduction
Dr Philippe Jouvet obtained his MD in 1989 at U of Paris V and MD speciality in Pediatrics, MD subspeciality in Intensive Care at U of Paris V and a MBA in hospital management. He completed a PhD in 2001 at University of Paris VII and joined the pediatric intensive care unit of CHU Sainte Justine in 2004. He holds a co-chair in artificial intelligence, conducts research on computerized decision support systems and on disaster preparedness.
Additional affiliations
March 2004 - present
CHU Sainte-Justine
Position
  • Professor (Full)
Description
  • Working as a clinical researcher in the Pediatric Intensive Care Unit (PICU) and research center. Medical director of the PICU 2011-2018.
November 1996 - September 1997
Ealing, Hammersmith & West London College
Position
  • Research Associate
Description
  • Research on neural cells
November 1989 - February 2004
Paris Descartes, CPSC
Position
  • Fellow and attending Physician in Pediatric Intensive Care
Education
January 2001 - June 2002
July 1997 - June 2001
Université Paris 7 Jussieu
Field of study
  • Physiology and Pathophysiology of Human Nutrition and Metabolism
November 1996 - October 1997
Imperial College Healthcare NHS Trust
Field of study
  • Research Fellow in Weston Laboratory

Publications

Publications (337)
Article
Full-text available
Background: Mechanical power is a composite variable for energy transmitted to the respiratory system over time that may better capture risk for ventilator-induced lung injury than individual ventilator management components. We sought to evaluate if mechanical ventilation management with a high mechanical power is associated with fewer ventilator...
Article
Objective To describe antibiotic treatment durations that pediatric infectious diseases (ID) and critical care clinicians usually recommend for bloodstream infections in critically ill children. Design Anonymous, online practice survey using five common pediatric-based case scenarios of bloodstream infections. Setting Pediatric intensive care uni...
Article
Full-text available
Objectives To synthesize knowledge describing the impact of social distancing measures (SDM) during the first wave of the COVID-19 pandemic on acute illness in children by focusing on the admission to pediatric emergency departments (PED) and pediatric intensive care units (PICU). Methods We searched Cochrane Database of Systematic Reviews, Cochra...
Article
Full-text available
Objectives We used modified contingent valuation methodology to determine how noninferiority margin sizes influence clinicians’ willingness to accept clinical trial results that compare mortality in critically ill children. Methods We surveyed pediatric infectious diseases and critical care clinicians in Canada, Australia, and New Zealand and rand...
Preprint
BACKGROUND: Mathematical models based on the physiology when programmed as a software can be used to teach cardiorespiratory physiology and to forecast the effect of various ventilatory support strategies. We developed a cardiorespiratory simulator for children called “SimulResp”. The purpose of this study was to evaluate the quality of SimulResp....
Article
Full-text available
Background Bloodstream infections (BSIs) cause significant morbidity and mortality in critically ill children but treatment duration is understudied. We describe the durations of antimicrobial treatment that critically ill children receive and explore factors associated with treatment duration. Methods We conducted a retrospective observational co...
Article
Full-text available
Introduction The survivability of mass casualties exposed to a chemical attack is dependent on clinical knowledge, evidence-based practice, as well as protection and decontamination capabilities. The aim of this systematic review was to identify the knowledge gaps that relate to an efficient extraction and care of mass casualties caused by exposure...
Article
OBJECTIVES To describe the patient characteristics, clinical management, and infectious etiology in critically ill children with bronchiolitis. The secondary objective was to determine the association between antibiotic use and hospital length of stay among patients without concomitant bacterial infections. METHODS Retrospective cohort study inclu...
Article
Full-text available
Acute kidney injury is common in critically ill children, but the long-term outcomes are not well defined. Objectives: Evaluated whether nonrecovery of kidney function, following acute kidney injury, was associated with postdischarge mortality, healthcare utilization, and chronic kidney disease. Design: Retrospective, two-center, observational...
Article
In this paper, we propose a novel approach to deal with the integration of the cancellation probability due to congestion in the intensive care unit in the (long term) surgical case assignment problem. This problem consists of selecting patients from the wait list to be on the operating list of surgeons for a selected horizon, and assigning a day,...
Article
CONTEXT Respiratory dysfunction is a component of every organ failure scoring system developed, reflecting the significance of the lung in multiple organ dysfunction syndrome. However, existing systems do not reflect current practice and are not consistently evidence based. OBJECTIVE We aimed to review the literature to identify the components of...
Article
Prior criteria for organ dysfunction in critically ill children were based mainly on expert opinion. We convened the Pediatric Organ Dysfunction Information Update Mandate (PODIUM) expert panel to summarize data characterizing single and multiple organ dysfunction and to derive contemporary criteria for pediatric organ dysfunction. The panel was co...
Article
Full-text available
The temperature distribution at the skin surface could be a useful tool to monitor changes in cardiac output. Goal: The aim of this study was to explore infrared thermography as a method to analyze temperature profiles of critically ill children. Methods: Patients admitted to the PICU were included in this study. An infrared sensor was used to take...
Article
Full-text available
The efficacy of convalescent plasma for coronavirus disease 2019 (COVID-19) is unclear. Although most randomized controlled trials have shown negative results, uncontrolled studies have suggested that the antibody content could influence patient outcomes. We conducted an open-label, randomized controlled trial of convalescent plasma for adults with...
Article
Full-text available
Background The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruit...
Article
Objectives: Our understanding of pediatric acute respiratory distress syndrome is based on information from studies reporting intermittent, serial respiratory data. We have analyzed a high-resolution, longitudinal dataset that incorporates measures of hypoxemia severity, metrics of lung mechanics, ventilatory ratio, and mechanical power and examin...
Article
Objectives: To determine the association between the implementation of an antimicrobial stewardship program at a local PICU and to determine the association between the presence of an antimicrobial stewardship programs and antimicrobial use across three Canadian PICUs, among critically ill children with bronchiolitis. Design: A multicenter retro...
Article
Full-text available
Pao2 is the gold standard to assess acute hypoxic respiratory failure, but it is only routinely available by intermittent spot checks, precluding any automatic continuous analysis for bedside tools. Objective: To validate a continuous and noninvasive method to estimate hypoxemia severity for all Spo2 values. Derivation cohort: All patients who...
Chapter
Acute liver failure is a common disease seen in pediatric intensive care and is secondary to various pathologies. The management aims to maintain hemodynamic and respiratory status, avoid bleeding, and prevent infections in order to prevent progression to multiorgan failure. Several extracorporeal liver support therapies (ELST) are proposed to addr...
Chapter
Children with liver failure may have an acute respiratory failure following one or several simultaneous insults including hepatic encephalopathy, volume overload, pulmonary hemorrhage, pulmonary edema, acute lung injury, and other comorbidities such as ascites with intra-abdominal hypertension, hydrothorax, and muscle weakness due to poor nutrition...
Chapter
Acute liver failure is characterized by a rapid deterioration in liver functions leading to an encephalopathy, but it has good chances of survival. This chapter details the aetiologies of acute liver failures according to patients age, the clinical presentation, the main complications, management, and prognosis.
Chapter
Liver injury is frequent in the intensive care unit and its occurrence is associated with poorer outcomes. Multiple and interrelated mechanisms are involved. We review four major pathophysiological pathways of secondary liver injury in critically ill children: hypoxic liver injury, sepsis and the systemic inflammatory response syndrome, venous cong...
Article
Full-text available
Objectives: Significant resources are devoted to neonatal prolonged mechanical ventilation (NPMV), but little is known about the outcomes in those children. Our primary objective was to describe the NPMV respiratory, digestive, and neurological outcomes at 18 months corrected age. Our second objective was on the early identification of which patien...
Chapter
Full-text available
The Centre Hospitalier Universitaire Sainte-Justine (Montreal, Canada) is a pediatric academic tertiary hospital that has begun the implementation of a commercial computerized provider order entry system (CPOE) in October 2019. The objectives of this paper are 1) to estimate the impact of the CPOE system on medication errors, and 2) to identify vul...
Chapter
Full-text available
To support the pediatric intensive care unit with the COVID-19 pandemic, we followed a user-centered design process to create a dashboard in a context where direct access to users was impossible. To this end, we applied contextual inquiry, user interview, requirement definition, iterative design with user validation and usability testing in a remot...
Preprint
The purpose of the study presented herein is to develop a machine learning algorithm based on natural language processing that automatically detects whether a patient has a cardiac failure or a healthy condition by using physician notes in Research Data Warehouse at CHU Sainte Justine Hospital. First, a word representation learning technique was em...
Preprint
Full-text available
This paper proposes a joint clinical natural language representation learning and supervised classification framework based on machine learning for detecting concept labels in clinical narratives at CHU Sainte Justine Hospital (CHUSJ). The novel framework jointly discovers distributional syntactic and latent semantic (representation learning) from...
Chapter
Some inborn errors of metabolism involve enzyme defects in the catabolic pathway of amino acids that induce a metabolic encephalopathy by accumulation of neurotoxic metabolites (endogenous intoxication). In these diseases, detailed in this chapter, intermediate products of amino acid catabolism are not detoxified by the liver, accumulate, and contr...
Article
Background Acute kidney Injury (AKI) in children undergoing cardiac surgery (CS) is strongly associated with hospital morbidity. Post-discharge CS AKI outcomes are less clear. We evaluated associations between AKI and post-discharge (a) healthcare utilization, (b) chronic kidney disease (CKD) or hypertension and (c) mortality.Methods This is a retr...
Chapter
Respiratory failure is one of the most common reasons for admission to the pediatric intensive care unit (PICU), and about half of the patients admitted to PICU need ventilator support. Development of mechanical ventilation has dramatically changed the outcome of pediatric respiratory failure from a commonly fatal condition to a one with very low m...
Article
Few studies have characterized follow-up after pediatric acute kidney injury (AKI). Our aim was to describe outpatient AKI follow-up after pediatric intensive care unit (PICU) admission. Two-center retrospective cohort study (0–18 years; PICU survivors (2003–2005); noncardiac surgery; and no baseline kidney disease). Provincial administrative datab...
Article
Full-text available
Background Long-term care facilities (LTCF) are environments particularly favourable to coronavirus disease (SARS-CoV-2) pandemic outbreaks, due to the at-risk population they welcome and the close proximity of residents. Yet, the transmission dynamics of the disease in these establishments remain unclear. Methods Air and no-touch surfaces of 31 r...
Article
Full-text available
Background: Clinical data on patients admitted to hospital with coronavirus disease 2019 (COVID-19) provide clinicians and public health officials with information to guide practice and policy. The aims of this study were to describe patients with COVID-19 admitted to hospital and intensive care, and to investigate predictors of outcome to charact...
Book
In recent years, substantial progress has been made in the approaches to diagnosis and treatment of severe liver diseases in the pediatric ICU, from various forms of liver failure and hepatitis to acute and chronic liver disease. New techniques and tools are being utilized to prevent patients from experiencing complications and for patients in reco...
Article
Full-text available
Background. The current COVID-19 pandemic has resulted in over 54,800,000 SARS-CoV-2 infections worldwide with a mortality rate of around 2.5%. As observed in other airborne viral infections such as influenza and SARS-CoV-1, healthcare workers are at high risk for infection when performing aerosol-generating medical procedures (AGMP). Additionally,...
Article
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Assessment of respiratory function allows early detection of potential disorders in the respiratory system and provides useful information for medical management. There is a wide range of applications for breathing assessment, from measurement systems in a clinical environment to applications involving athletes. Many studies on pulmonary function t...
Article
Full-text available
Objectives As there is no treatment for COVID-19 with a proven mortality benefit at this moment in the pandemic, supportive management including mechanical ventilation is the core management in an intensive care unit (ICU). It is a challenge to provide consistent care in this situation, highly demanding and leading to potential staff shortages in I...
Article
Full-text available
The worldwide repercussions of COVID-19 sparked important research efforts, yet the detailed contribution of aerosols in the transmission of SARS-CoV-2 has not been elucidated. In an attempt to quantify viral aerosols in the environment of infected patients, we collected 100 air samples in acute care hospital rooms hosting 22 patients over the cour...
Article
Background Reliable localization and tracking of the eye region in the pediatric hospital environment is a significant challenge for clinical decision support and patient monitoring applications. Existing work in eye localization achieves high performance on adult datasets but performs poorly in the busy pediatric hospital environment, where face a...
Article
Full-text available
Objectives: To assess the impact of the use of aerosol barrier device, Splashguard-CG, on the endotracheal intubation with different types of laryngoscope. Design: A pilot randomized sequential crossover simulation study. Setting: A single academic center in Japan. Subjects: Physicians in a single academic university hospital in Japan. Inte...
Article
Full-text available
Introduction: Chest physiotherapy (CPT) and intrathoracic percussion ventilation have been recognised as to encourage dislodging the secretions; nonetheless, the tolerance to the procedure and its efficiency have not been proven to be sufficient. Method and analyses: This study aims to examine the tolerance, feasibility and physiological effects...
Article
Influenza virus is a major cause of acute hypoxemic respiratory failure. Early identification of patients who will suffer severe complications can help stratify patients for clinical trials and plan for resource use in case of pandemic. Objective: We aimed to identify which clinical variables best predict prolonged acute hypoxemic respiratory fai...
Conference Paper
Automatic and accurate lung segmentation in chest X-ray (CXR) images is fundamental for computer-aided diagnosis systems since the lung is the region of interest in many diseases and also it can reveal useful information by its contours. While deep learning models have reached high performances in the segmentation of anatomical structures, the larg...
Article
Objective: We aim to create a predictive model capable of giving a noninvasive, immediate and reliable estimate of the arterial partial pressure of carbon dioxide (PaCO2) in mechanically ventilated children with a better reliability than its estimation from end-tidal CO2 (PetCO2) and minute ventilation volume (Vmin) evolution. Methods: We collec...
Article
PurposeDefinitions of acute respiratory distress syndrome (ARDS) include radiographic criteria, but there are concerns about reliability and prognostic relevance. This study aimed to evaluate the independent relationship between chest imaging and mortality and examine the inter-rater variability of interpretations of chest radiographs (CXR) in pedi...
Article
Rationale High data quality is essential to ensure the validity of clinical and research inferences based on it. However, these data quality assessments are often missing even though these data are used in daily practice and research. Aims and objectives Our objective was to evaluate the data quality of our high‐resolution electronic database (HRD...
Article
Full-text available
Hyperammonaemia in children can lead to grave consequences in the form of cerebral oedema, severe neurological impairment and even death. In infants and children, common causes of hyperammonaemia include urea cycle disorders or organic acidaemias. Few studies have assessed the role of extracorporeal therapies in the management of hyperammonaemia in...
Article
Objectives Pediatric tracheostomy has evolved significantly in the past few decades and the optimal timing to perform it in children with respiratory assistance is still debated. The objective of this study was to describe the indications, timing, complications, and outcomes of infants on respiratory support who had a tracheostomy in a tertiary ped...
Article
Objectives: The Pediatric Logistic Organ Dysfunction-2 is a validated score that quantifies organ dysfunction severity and requires complex data collection that is time-consuming and subject to errors. We hypothesized that a computer algorithm that automatically collects and calculates the Pediatric Logistic Organ Dysfunction-2 (aPELOD-2) score wo...
Article
Objectives: To investigate adaptive skills, behavior, and quality health-related quality of life in children from 32 centers enrolling in the Heart And Lung Failure-Pediatric INsulin Titration randomized controlled trial. Study design: This prospective longitudinal cohort study compared the effect of 2 tight glycemic control ranges (lower target...
Chapter
Understanding of chest imaging is paramount in the diagnosis and treatment of PARDS and, as recommended by the consensus conference on PARDS (PALICC), children with or at risk of PARDS should receive, at a minimum, clinical monitoring of cardiac and respiratory rates, continuous pulse oximetry, and blood pressure. In the first part of this chapter,...
Article
Full-text available
In a situation of respiratory failure (RF), patients show signs of increased work of breathing leading to the involvement of accessory respiratory muscles and a desynchronization between rib cage and abdomen known as thoraco-abdominal asynchrony (TAA). Proper assessment of these signs requires sufficiently skilled and trained medical staff. However...
Article
This paper describes a new approach for quantitative evaluation of respiration in the pediatric intensive care unit (PICU). Video sequences of thorax movements are recorded by two depth cameras to cover the 3D surface of the torso and its lateral sides. The breathing activity implies a frame-by-frame surface deformation, which can be described by t...