Publications by authors named "Jonathan Chelly"
Background: Although shock following cardiac arrest is common and contributes significantly to mortality, the influence of the modalities used to manage the hemodynamic situation, particularly with regard to fluid balance, remains unclear. We evaluated the association between positive fluid balance and outcome after out-of-hospital cardiac arrest (OHCA).
Methods: We conducted a multicenter study from August 2020 to June 2022, which consecutively enrolled adult OHCA patients in 17 intensive care units.
Background: Medication waste is a contributor to the healthcare environmental footprint and impacts ecosystems. Data on medication waste in the intensive care unit (ICU) are scarce, and therefore are essential to develop new sustainable strategies.
Methods: The GAME-OVER French multicenter prospective observational study was conducted from November 2022 to March 2023, over a 24-h period of choice, at the discretion of each participating center.
Introduction: The high incidence of morbidity and mortality associated with the post-cardiac arrest (CA) period highlights the need for novel therapeutic interventions to improve the outcome of out-of-hospital cardiac arrest (OHCA) patients admitted to the intensive care unit (ICU). The aim of this study is to assess the ability of high-dose intravenous vitamin C (Vit-C) to improve post-CA shock.
Methods And Analysis: This is a single-blind, open-label, multicentre, randomised controlled trial, involving 234 OHCA patients with post-CA shock planned to be enrolled in 10 French ICUs.
Article Synopsis
- The study aimed to evaluate the effectiveness of the 2021 ERC/ESICM algorithm in predicting neurological outcomes for cardiac arrest survivors in intensive care.
- A total of 337 patients were examined, with the algorithm successfully identifying all 175 patients predicted to have poor neurological outcomes and showing high specificity for various predictive tools like EEG and clinical examination.
- For patients with uncertain outcomes, favorable indicators could help predict positive recovery, providing valuable guidance in prognosis and treatment decisions.
Article Synopsis
- A study was conducted across 49 ICUs in France to investigate the clinical outcomes and severity of severe Pneumocystis jirovecii pneumonia (PJP), focusing on how delayed antibiotic treatment and corticosteroid therapy affect patient survival.
- The study included 158 patients, mainly admitted due to acute respiratory failure, and found high mortality rates (31.6% in ICU, 40.5% at 6 months), with delayed antibiotic treatment beyond 96 hours linked to a significantly higher risk of death.
- The results indicate that most patients did not receive preventive antibiotic therapy before needing intensive care, and both delayed antibiotic treatment and the use of corticosteroids worsened mortality rates in those with severe PJP.
Rationale: About 60 to 70% of out-of-hospital cardiac arrest (OHCA) survivors who worked before cardiac arrest return to work within one year but the precise conditions for this resumption of professional activity remain little known. The objective of this study was to assess components of return to work among OHCA survivors.
Patients And Methods: We used the French national multicentric cohort AfterRosc to include OHCA survivors admitted between April 1st 2021 and March 31st 2022, discharged alive from the Intensive Care Unit (ICU), and who were less than 65 years old.
Article Synopsis
- Out-of-hospital cardiac arrest (OHCA) varies in cause and prognosis, prompting a study to assess the effectiveness of the Cardiac Arrest Prognosis (CAHP) Score compared to traditional methods (Utstein style criteria) for predicting patient outcomes.
- The study collected data from 24 ICUs in France and Belgium on comatose patients with OHCA who had a stable return of spontaneous circulation, aiming to evaluate various predictive scores and their accuracy in anticipating neurological outcomes after 90 days.
- Among the 658 patients analyzed, results showed a 63% mortality rate and noted that while Utstein criteria had moderate predictive capability (AUROC of 0.79), other scores demonstrated a range of performance, with some showing
Background And Objectives: To report the prevalence of acute encephalopathy and outcomes in patients with severe coronavirus disease 2019 (COVID-19) and to identify determinants of 90-day outcomes.
Methods: Data from adults with severe COVID-19 and acute encephalopathy were prospectively collected for patients requiring intensive care unit management in 31 university or university-affiliated intensive care units in 6 countries (France, United States, Colombia, Spain, Mexico, and Brazil) between March and September of 2020. Acute encephalopathy was defined, as recently recommended, as subsyndromal delirium or delirium or as a comatose state in case of severely decreased level of consciousness.
Article Synopsis
- The study aimed to analyze the characteristics and outcomes of adult patients admitted to ICUs for Convulsive Status Epilepticus (CSE), specifically comparing those with impaired functional status to those without.
- Of 499 patients, 11.2% had a preadmission Glasgow Outcome Scale (GOS) score of 3, which indicated a higher need for treatment limitations and greater 1-year mortality compared to those with GOS scores of 4 or 5.
- Factors linked to poorer outcomes included being older than 59, having serious preexisting conditions, experiencing refractory CSE, a cerebral cause of CSE, and higher Logistic Organ Dysfunction scores upon ICU admission.
Objectives: To describe early electrocardiogram (ECG) abnormalities after status epilepticus (SE) and evaluate their association with 90-day neurological outcomes.
Design: Retrospective analysis of a multicenter, national prospective registry between February 2018 and June 2020.
Setting: Sixteen ICUs in France, IctalGroup Research Network.
Background: The optimal first-line noninvasive respiratory support (NIRS) to improve outcome in patients affected by COVID-19 pneumonia admitted to ICU is still debated.
Methods: We conducted a retrospective study in seven French ICUs, including all adults admitted between July and December 2020 with documented SARS-CoV-2 acute respiratory failure (PaO2/FiO2<300 mmHg), and treated with either high-flow nasal therapy (HFNT) alone, noninvasive ventilation alone or in combination with HFNT (NIV), or continuous positive airway pressure alone or in combination with HFNT (CPAP). The primary outcome was NIRS failure at day 28, defined as the need for endotracheal intubation (ETI) or death without ETI.
Introduction: Status epilepticus (SE) is a common life-threatening neurological emergency that can cause long-term impairments. Overall outcomes remain poor. Major efforts are required to clarify the epidemiology of SE and the determinants of outcomes, thereby identifying targets for improved management.
View Article and Find Full Text PDFBackground: Initial reports have described the poor outcome of unexpected cardiac arrest (CA) in intensive care unit (ICU) among COVID-19 patients in China and the USA. However, there are scarce data on characteristics and outcomes of such CA patients in Europe.
Methods: Prospective registry in 35 French ICUs, including all in-ICU CA in COVID-19 adult patients with cardiopulmonary resuscitation (CPR) attempt.
Aim: We assessed the ability of the Out-of-Hospital Cardiac Arrest (OHCA) and the Cardiac Arrest Hospital Prognosis (CAHP) scores to predict neurological outcome following in-hospital cardiac arrest (IHCA).
Methods: Retrospective review of a seven-year French multicentric database including ten intensive care units. Primary endpoint was the outcome at hospital discharge using the Cerebral Performance Category score (CPC) in all IHCA patients.
Objective: To evaluate the association between systemic factors (mean arterial blood pressure, arterial partial pressures of carbon dioxide and oxygen, body temperature, natremia, and glycemia) on day 1 and neurologic outcomes 90 days after convulsive status epilepticus.
Methods: This was a post hoc analysis of the Evaluation of Therapeutic Hypothermia in Convulsive Status Epilepticus in Adults in Intensive Care (HYBERNATUS) multicenter open-label controlled trial, which randomized 270 critically ill patients with convulsive status epilepticus requiring mechanical ventilation to therapeutic hypothermia (32°C-34°C for 24 hours) plus standard care or standard care alone between March 2011 and January 2015. The primary endpoint was a Glasgow Outcome Scale score of 5, defining a favorable outcome, 90 days after convulsive status epilepticus.
Background: Hypoxia is common during daily nursing procedures (DNPs) routinely performed on mechanically ventilated patients. The impact of automated ventilation on the incidence and severity of blood oxygen desaturation during DNPs remains unknown.
Methods: A prospective randomized controlled crossover trial was carried out in a French intensive care unit to compare blood oxygen pulse saturation (SpO) during DNPs performed on patients mechanically ventilated in automated and conventional ventilation modes (AV and CV, respectively).
Regional citrate anticoagulation (RCA) is a recommended method for extracorporeal circuit anticoagulation during renal replacement therapy (RRT). Increased risk of citrate accumulation by default of hepatic metabolism limits its use in liver failure patients. A Ca /Ca ratio ≥2.
View Article and Find Full Text PDFBackground: Prone position (PP) is highly recommended in moderate-to-severe ARDS. However, the optimal duration of PP sessions remains unclear. We searched to evaluate the time required to obtain the maximum physiological effect, and to search for parameters related to patient survival in PP.
View Article and Find Full Text PDFCabazitaxel Induced Thrombotic Microangiopathy in a Patient with Prostate Cancer.
Case Rep Nephrol
November 2019
Cancer-associated thrombotic microangiopathy (TMA) refers to a group of disorders characterized by microangiopathic haemolytic anemia, thrombocytopenia, and ischemic organ damage. TMA manifestations can be induced by cancer or by chemotherapy. We report the case of a 64-year-old man with metastatic prostate cancer who experienced a Cabazitaxel-induced TMA manifestation.
View Article and Find Full Text PDFAim: To determine whether the urine biomarkers tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) can identify patients who will develop severe acute kidney injury (AKI) soon after cardiac arrest.
Methods: We performed a prospective, multicentre study in three French ICUs. The performance of [TIMP-2]*[IGFBP7] was assessed for urine samples collected a median [IQR] of 240 [169-315] minutes post-collapse.
Objectives: Cardiac arrest is a catastrophic event that may arise during the management of convulsive status epilepticus. We aimed to report the clinical characteristics, outcomes, and early predictors of convulsive status epilepticus-related cardiac arrest.
Design: Retrospective multicenter study.