Subcutaneous interstitial pressure measurement during early septic shock: an exploratory study.

Fluid therapy is crucial in managing septic shock but may result in harmful fluid overload due to capillary leakage, causing interstitial fluid accumulation. Burns and endotoxemia models demonstrate that interstitium can reduce its hydrostatic pressure, increasing permeability, but this has not been clinically investigated in human sepsis. This study aimed to examine the changes in subcutaneous interstitial pressure (SIP) during sepsis.

Posttraumatic Growth in Intensive Care Unit Health Care Professionals After COVID-19.

Importance: Posttraumatic growth (PTG) refers to positive psychological changes following adversity, including deeper relationships and a greater appreciation for life.

Objective: To assess PTG among intensive care unit (ICU) health care professionals 4 years after the COVID-19 pandemic and explore its association with resilience, anxiety, and depression.

Design, Setting, And Participants: This cross-sectional study invited ICU health care professionals (nursing staff, medical staff [residents, interns, clinical fellows, and senior intensivists], and other professionals providing patient care) in ICUs in general or university-affiliated hospitals in France and Belgium to complete online questionnaires between March 15 and May 15, 2024.

Clinical Significance of Respiratory Torque Teno Virus in Immunocompromised Patients with Acute Respiratory Failure.

Objective: Among immunocompromised patients with acute respiratory failure, identification of those at higher risk for opportunistic infections is crucial to optimize management. The Torque teno virus (TTV) DNA burden in the blood has been identified as a surrogate marker of functional immunity in solid organ transplant recipients. This study investigates the clinical relevance of TTV DNA in nasopharyngeal swabs of immunocompromised patients with acute respiratory failure (ARF).

Immunosuppressive therapy management during sepsis in kidney transplant recipients: a prospective multicenter study.

Background: Sepsis is the leading cause of Intensive Care Unit (ICU) admissions in kidney transplant recipients (KTRs). However, the optimal immunosuppressive therapy (IST) management in this context is not well-defined. We aimed to evaluate the impact of IST management in the ICU on mortality rates and kidney graft function 6 months after inclusion in KTRs admitted for sepsis.

Epidemiology and Impact of Staff Training in Controlling Complications Related to Central Venous Catheters in 4 Intensive Care Units in a French University Hospital: Protocol of a Prospective, Quasi-Experimental, Before-After Study.

Background: Central venous catheters (CVCs) are essential tools in the management of critically ill patients in intensive care units (ICUs). However, their use is associated with several preventable complications, including central line-associated bloodstream infections (CLABSIs), catheter-related thrombosis, and mechanical events (eg, occlusion and rupture). Despite the availability of evidence-based guidelines from the French Society of Hospital Hygiene for CVC insertion and maintenance, adherence variability persists across health care settings, contributing to prolonged hospitalization, increased morbidity and mortality, and even increased health care costs.

Characteristics and outcomes of ICU patients with sepsis transmitted by cats and dogs: the PETSEPSIS multicentre retrospective observational cohort study.

Background: Millions of households have cats or dogs as pets, and infections due to bites or scratches are increasing, with the most common pathogens being spp., spp., spp, and .

Combined use of a multiplex PCR and serum procalcitonin to reduce antibiotic exposure in critically ill patients with community-acquired pneumonia: the MULTI-CAP randomized controlled trial.

Purpose: Multiplex polymerase chain reaction (mPCR) testing has the potential to rapidly and accurately identify causative microorganisms in patients with community-acquired pneumonia (CAP). Its use in a management strategy, along with biomarkers, may reduce antibiotic exposure and improve clinical outcomes.

Methods: The MULTI-CAP trial was a multicenter (n = 20), parallel-group, superiority, open-label, randomized trial.

Adjunctive corticosteroids in non-AIDS patients with severe Pneumocystis jirovecii pneumonia (PIC): a multicentre, double-blind, randomised controlled trial.

Background: Pneumocystis jirovecii pneumonia in HIV-negative immunocompromised patients has a hospital mortality rate of 30-50%. Adjunctive corticosteroids improve outcomes of P jirovecii pneumonia in HIV-positive patients. The aim of this trial was to assess the effects of early adjunctive corticosteroid therapy for 21 days in HIV-negative patients with P jirovecii pneumonia responsible for acute hypoxaemia respiratory failure.

Self-extubation in critically ill patients: from the French OUTCOMEREA Network.

Background: Self-extubation is a common complication in intubated patients in the intensive care unit (ICU) and is associated with a high rate of reintubation. This study aimed to identify predictors of reintubation following self-extubation (SE) and assess the prognosis of these patients.

Methods: Data were extracted from the French ICU database, OutcomeRea™.

Severe Parvovirus B19 Infection in Patients with Sickle Cell Disease Hospitalized in Intensive Care Unit.

Parvovirus B19 infection can lead to severe complications in patients with chronic haemolysis. The aim of this study was to describe severe Parvovirus B19 infections in adult patients with sickle cell disease (SCD). In this multicentre, retrospective, observational cohort study, adult patients with SCD admitted to intensive care units (ICUs) between 2011 and 2024 with acute Parvovirus B19 infection were included.

Post-mortem lung biopsies in fatal Covid-19 acute respiratory distress syndrome: a prospective cohort study of 169 patients (HISTOCOVID).

Background: Refractory acute respiratory distress syndrome (ARDS) is the leading cause of death in patients with Covid-19. Large studies of lung pathology in patients who died of Covid-19-ARDS may help to understand the mechanisms of death and to guide further research.

Methods: This prospective multicentre cohort study included 338 post-mortem, percutaneous, lung biopsies from 169 patients who died of Covid-19-ARDS between 22/04/2020 and 08/03/2021 in 26 intensive care units in France.

Incidence of nosocomial pneumonia in two intensive care units of a French University Hospital from 2016 to 2022 in the era of COVID-19 pandemic.

Background: Hospital-Acquired Pneumonia (HAP) are common in intensive care units (ICUs). The COVID-19 pandemic led to a global increase in healthcare-associated infections (HAI) among ICU patients. The aim of this study was to evaluate the trends in HAP incidence over a seven-year period of surveillance in two ICUs at a French University Hospital, and to assess the impact of COVID-19 (as well as the associated bacterial ecology).

Study protocol and statistical plan for the ICRAKI trial: Intermittent haemodialysis versus continuous renal replacement therapy for severe acute kidney injury in critically ill patients.

Background: The effect of intermittent haemodialysis (IHD) continuous renal replacement therapy (CRRT) on mortality and/or renal function recovery in adults with acute kidney injury (AKI) and a recognised indication for renal replacement therapy (RRT) remains controversial.

Objective: To summarise the protocol and statistical analysis plan for the ICRAKI trial.

Design Settings And Participants: ICRAKI is a non-inferiority multicentre randomised controlled trial comparing IHD and CRRT.

Characteristics of SARS-CoV-2-associated severe episodes of monoclonal gammopathy-associated capillary leak syndrome (Clarkson disease).

Background: Monoclonal gammopathy-associated capillary leak syndrome (MG-CLS) is a rare condition characterized by recurrent episodes of hypovolemic shock caused by a sudden increase in capillary permeability. The COVID-19 pandemic has been associated with a rise in MG-CLS episodes and increased mortality. We aimed to explore the association between MG-CLS and SARS-CoV-2 infection.

Outcomes in immunocompromised patients with acute hypoxemic respiratory failure treated by high-flow nasal oxygen.

Purpose: Acute hypoxemic respiratory failure (ARF) is a major challenge in immunocompromised patients, often complicated by severe respiratory distress and organ dysfunction. High-flow nasal oxygen (HFNO) therapy is the standard of care, but data on its effectiveness and outcomes are limited. This study evaluated the outcomes of HFNO in this population, predictors of invasive mechanical ventilation (IMV), and factors associated with 28-day mortality.

Prognosis of liver abscess in the intensive care unit (POLAIR), a multicentre observational study.

Background: Liver abscess (LA) is a rare but potentially serious condition with a high mortality rate. Current epidemiological data of LA patients requiring intensive care unit (ICU) admission are limited.

Methods: This multicentre retrospective study included adults admitted to 24 ICUs in France between January 2010 and December 2020.

PD-L1 plasma cells suppress T lymphocyte responses in patients with sepsis and mouse sepsis models.

Sepsis, a leading cause of death in intensive care units, is associated with immune alterations that increase the patients' risk of secondary infections and mortality, so better understandings of the pathophysiology of sepsis-induced immunosuppression is essential for the development of therapeutic strategies. In a murine model of sepsis that recapitulates immune alterations observed in patients, here we demonstrate that PD-L1CD44B220CD138IgM regulatory plasma cells are induced in spleen and regulate ex vivo proliferation and IFNɣ secretion induced by stimulation of T splenocytes. This effect is mediated both by cell-cell contact through increased PD-L1 expression on plasma cells and by production of a soluble factor.

Amikacin use in critically ill patients requiring renal replacement therapy: the AMIDIAL-ICU study.

Background: Acute kidney injury (AKI) requiring renal replacement therapy (RRT) is common in intensive care units (ICUs), yet optimal amikacin dosing in this context remains poorly understood.

Methods: We conducted a prospective observational study across 18 French hospitals from April 2020 to January 2022. Adult ICU patients (aged > 18 years) receiving their first amikacin dose while on RRT were included.

Early bacterial co-infections and ventilator-associated lower respiratory tract infections among intubated patients during the first and second COVID-19 waves: a European comparative cohort study.

Background: The management of severe SARS-CoV-2 pneumonia, alongside logistical constraints, evolved between the first and subsequent COVID-19 waves. This study aimed to compare the prevalence of early bacterial pulmonary co-infections and the incidence of ventilator-associated lower respiratory tract infections (VA-LRTI) across the first and second waves of the pandemic, and to characterize their microbiology.

Methods: Latter part of a multicenter retrospective European cohort analysis conducted in 35 ICUs.

Dexmedetomidine to Reduce Vasopressor Resistance in Refractory Septic Shock: α2 Agonist Dexmedetomidine for REfractory Septic Shock (ADRESS): A Double-Blind Randomized Controlled Pilot Trial.

Objectives: Increasing evidence has suggested the benefits of dexmedetomidine in patients with sepsis. Dexmedetomidine may increase vasopressor sensitivity, which may be of interest in the setting of refractory septic shock. The α2 Agonist Dexmedetomidine for REfractory Septic Shock (ADRESS) pilot study aimed to evaluate the effect of dexmedetomidine on the vasopressor response in patients with refractory septic shock.

Prognostic Impact of Early Appropriate Antimicrobial Therapy in Critically Ill Patients With Nosocomial Pneumonia Due to Gram-Negative Pathogens: A Multicenter Cohort Study.

Objectives: To evaluate whether early appropriate antimicrobial therapy (EAAT) is associated with improved outcomes in critically ill patients with hospital-acquired pneumonia (HAP), ventilated HAP (vHAP), or ventilator-associated pneumonia (VAP) involving Gram-negative bacteria (GNB).

Design: Retrospective cohort study based on prospectively collected data.

Setting: Thirty-two French ICUs (OutcomeRéa network).

A multivariable prediction model for invasive pulmonary aspergillosis in immunocompromised patients with acute respiratory failure (IPA-GRRR-OH score).

Purpose: Invasive pulmonary aspergillosis (IPA) is a life-threatening opportunistic infection in immunocompromised patients. The diagnosis is often made late, with mortality reaching 90% when mechanical ventilation is needed. We sought to develop and validate a risk prediction model for the diagnosis of IPA.

Cardiogenic shock in patients with active onco-hematological malignancies: A multicenter retrospective study.

Purpose: Onco-hematological (OH) patients face significant cardiovascular risks due to malignancy and drug toxicity. Data are limited on the characteristics and outcomes of OH patients with cardiogenic shock (CS) in intensive care units (ICUs).

Methods: This multicenter retrospective study included 214 OH patients with CS across 22 ICUs (2010-2021).