Publications by authors named "Jean-Michel Liet"
Article Synopsis
- Sickle cell disease (SCD) affects many people worldwide, and a serious issue related to it is called acute chest syndrome (ACS), which can make patients really sick and require hospitalization.
- Researchers studied data from 1998 to 2022 about young people with SCD who needed a special treatment called ECMO to help their lungs.
- They found that 55.8% of patients survived ECMO treatment, but there were complications, and not all patients, especially young kids and some adults, survived when ECMO was used for heart resuscitation.
Objectives: Extracorporeal life support can lead to rapid reversal of hypoxemia but the benefits and harms of different oxygenation targets in severely ill patients are unclear. Our primary objective was to investigate the association between the Pa o2 after extracorporeal membrane oxygenation (ECMO) initiation and mortality in neonates treated for respiratory failure.
Design: Retrospective analysis of the Extracorporeal Life Support Organization (ELSO) Registry data, 2015-2020.
Article Synopsis
- Carboxyhemoglobin (COHb) levels can be a new indicator of hemolysis and circuit-related issues in children on ECMO, but data on this is limited.
- A study from January 2018 to December 2021 involved 58 children, tracking COHb levels before, during, and after ECMO.
- COHb levels notably increased after 6 hours of ECMO and remained high; a drop in COHb within 24 hours after circuit changes suggested a link to reduced complications, with strong predictive ability for circuit-related issues.
The primary objective was to investigate the association between partial pressure of carbon dioxide (PaCO 2 ) change after extracorporeal membrane oxygenation (ECMO) initiation and neurologic outcome in neonates treated for respiratory failure. A retrospective analysis of the Extracorporeal Life Support Organization (ELSO) database including newborns supported by ECMO for respiratory indication during 2015-2020. The closest Pre-ECMO (Pre-ECMO PaCO 2 ) and at 24 hours after ECMO initiation (H24 PaCO 2 ) PaCO 2 values allowed to calculate the relative change in PaCO 2 (Rel Δ PaCO 2 = [H24 PaCO 2 - Pre-ECMO PaCO 2 ]/Pre-ECMO PaCO 2 ).
View Article and Find Full Text PDFObjectives: To review use of semiautomated regional citrate anticoagulation (saRCA) for continuous kidney replacement therapy (CKRT) in young children.
Design: Retrospective cohort study.
Setting: Three independent PICUs.
Purpose: Early prognostication of neurologic outcome in neonates and children supported with extra-corporeal membrane oxygenation (ECMO) is challenging. Amplitude-integrated EEG (aEEG) offers the advantages of continuous monitoring and 24-hours availability at the bedside for intensive care unit providers. The objective of this study was to describe the early electrophysiological background patterns of neonates and children undergoing ECMO and their association with neurologic outcomes.
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- The study examines the effects of cervical cannulation on neurological outcomes in children undergoing venoarterial ECMO for severe sepsis or septic shock.
- A total of 559 children were analyzed, with 87% receiving cervical cannulation and a 32% occurrence rate of acute neurologic events.
- The study found no significant link between the type of cannulation and neurologic outcomes, with pre-ECMO acidosis being the only independent factor associated with adverse neurological events.
Article Synopsis
- This study aimed to evaluate the use of extracorporeal membrane oxygenation (ECMO) in critically ill neonates and children across a pediatric critical care network in West France, focusing on decision-making for patients initially admitted to non-ECMO facilities.
- Over a four-year period, 8,189 children and 3,947 newborns were treated, with 8.1% of children and 9.4% of newborns requiring ECMO; most patients needing ECMO were admitted first to non-ECMO centers, and various critical conditions were noted.
- The survival rates after 28 days post-ICU were similar for patients from non-ECMO centers compared to those from ECMO centers,
Article Synopsis
- The study investigates how cerebral autoregulation (CA) is affected in children undergoing extracorporeal membrane oxygenation (ECMO), particularly focusing on variations in arterial CO2 (PaCO) and O2 (PaO) tensions, which are linked to neurological outcomes and mortality.
- Data was retrospectively analyzed from 30 children treated with ECMO in a pediatric intensive care unit, examining correlations between regional cerebral oxygen saturation, mean arterial blood pressure, and CA through various calculated indices.
- Results showed the highest cerebral oxygenation reactivity index (COx) on the first day of ECMO, with significant but weak correlations between COx, PaCO, and the limits of
Objective: Cerebral autoregulation (CA) impairment may pose a risk factor for neurological complications among children supported by extracorporeal membrane oxygenation (ECMO). Our first objective was to investigate the feasibility of CA continuous monitoring during ECMO treatment and to describe its evolution over time. The second objective was to analyze the association between CA impairment and neurological outcome.
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- Children on extracorporeal membrane oxygenation (ECMO) face a heightened risk of neurological problems, with carotid cannulation potentially leading to injury.
- This study discusses two infants who developed right watershed infarction following right-sided carotid artery cannulation during septic shock treatment.
- The findings suggest that impaired cerebral collateral flow may increase the risk of neurological injury, highlighting the importance of assessing blood flow before and after cannulation in critically ill infants.
Article Synopsis
- Researchers studied lung development defects in neonates by analyzing samples from deceased infants with specific lung disorders.
- They found genetic variants linked to the genes TBX4 and FGF10 in over half of the cases, indicating a possible genetic basis for the lethal lung conditions.
- The study highlights the significance of TBX4-FGF10-FGFR2 signaling in lung development and provides insights into the genetic factors contributing to these severe lung abnormalities.
Article Synopsis
- The study aimed to compare the effectiveness of two different flow rates (2 L/kg/min and 3 L/kg/min) for high-flow nasal cannula therapy in infants with acute viral bronchiolitis.
- Results showed similar failure rates in both groups, with respiratory distress being the main reason for failure; however, discomfort and length of stay in the pediatric ICU were greater in the 3 L/kg/min group.
- The conclusion indicated that increasing the flow rate to 3 L/kg/min did not provide any additional benefits over 2 L/kg/min for managing respiratory support in these infants.
New Modalities for the Administration of Inhaled Nitric Oxide in Intensive Care Units After Cardiac Surgery or for Neonatal Indications: A Prospective Observational Study.
Anesth Analg
April 2018
Background: Nitric oxide (NO) has a well-known efficacy in pulmonary hypertension (PH), with wide use for 20 years in many countries. The objective of this study was to describe the current use of NO in real life and the gap with the guidelines.
Methods: This is a multicenter, prospective, observational study on inhaled NO administered through an integrated delivery and monitoring device and indicated for PH according to the market authorizations.
Article Synopsis
- Nasal continuous positive airway pressure (nCPAP) is the standard treatment for moderate to severe acute viral bronchiolitis in infants, while high flow nasal cannula (HFNC) is also being used but lacks strong evidence of safety and effectiveness.
- A randomized controlled trial compared nCPAP with HFNC for infants under 6 months with moderate to severe viral bronchiolitis, measuring the failure rate within 24 hours as the primary outcome.
- Results showed that HFNC did not meet the noninferiority criteria compared to nCPAP, indicating that nCPAP had a significantly higher success rate, although both treatments had comparable rates of other outcomes and no severe adverse events were reported.
Background: Neurally Adjusted Ventilatory Assist (NAVA) is a mode of assisted mechanical ventilation that delivers inspiratory pressure proportionally to the electrical activity of the diaphragm. To date, no pediatric study has focused on the effects of NAVA on hemodynamic parameters. This physiologic study with a randomized cross-over design compared hemodynamic parameters when NAVA or conventional ventilation (CV) was applied.
View Article and Find Full Text PDFImplementation of a Nurse-Driven Sedation Protocol in a PICU Decreases Daily Doses of Midazolam.
Pediatr Crit Care Med
January 2017
Objectives: To evaluate the impact of a nurse-driven sedation protocol on the length of mechanical ventilation, total daily doses of sedatives, and complications of sedation.
Design: A single-center prospective before and after study was conducted from October 2010 to December 2013.
Setting: Twelve-bed surgical and medical PICU of the university-affiliated hospital in Nantes, France.
Homozygous frameshift variants in CNTNAP1 have recently been reported in patients with arthrogryposis and abnormal axon myelination. In two brothers with severe congenital hypotonia and foot deformities, we identified compound heterozygous variants in CNTNAP1, reporting the first causative missense variant, p.(Cys323Arg).
View Article and Find Full Text PDFBackground: Bronchiolitis is the leading cause of hospitalisation among infants in high-income countries. Acute viral bronchiolitis is associated with airway obstruction and turbulent gas flow. Heliox, a mixture of oxygen and the inert gas helium, may improve gas flow through high-resistance airways and decrease the work of breathing.
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- The study aimed to analyze the relationship between plasma transfusion after cardiac surgery and the risk of nosocomial infections in children under 1 year old.
- A total of 233 children were included, with 40% receiving plasma transfusions; the overall infection rate was 24%.
- Initial findings indicated a higher odds of nosocomial infections with plasma transfusion, but after adjusting for other factors, there was no significant association found.