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.

Glucagon-like peptide 1 level and risk of death within 90 days after intensive care unit admission: A substudy of the IVOIRE cohort.

Background: Elevated plasma levels of glucagon-like peptide-1 (GLP-1) have been associated with poor clinical outcome in patients with sepsis. This study investigated the association between GLP-1 levels, and survival at 90 days in a large cohort of critically ill patients.

Methods: All patients aged ≥ 18 years admitted to the intensive care unit (ICU) in a large university hospital, and receiving ≥1 life support therapy for organ failure were eligible for inclusion.

Barriers to and facilitators of rehabilitation according to socio-economic status, after acute respiratory distress syndrome due to COVID-19: A qualitative study in the RECOVIDS cohort.

Background: The COVID-19 pandemic may have compounded social disparities in access to healthcare, with possible deleterious consequences on the functional prognosis of patients after a stay in the intensive care unit (ICU). In the previous RECOVIDS study, we reported that despite comparable pulmonary sequelae and similar access to rehabilitation, socio-economically "vulnerable" patients had lower quality of life at 6 months after an ICU stay. We aimed to describe the barriers to, and facilitators of participation in rehabilitation, among patients from the RECOVIDS study, regardless of their socio-economic situation.

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.

Practice survey on recent changes in post cardiac arrest care and temperature management in French intensive care units.

Background: Recent guidelines for post-cardiac arrest (CA) management have undergone significant changes regarding targeted therapeutic management (TTM), transitioning from hypothermia to temperature control. We aimed to assess changes in post-CA management in French intensive care units following the new recommendations.

Methods: Two declarative web surveys were conducted from March to August 2023.

Ventilatory Management of Patients with Acute Respiratory Distress Syndrome Due to SARS-CoV-2.

The emergence of the new SARS-CoV-2 in December 2019 caused a worldwide pandemic of the resultant disease, COVID-19. There was a massive surge in admissions to intensive care units (ICU), notably of patients with hypoxaemic acute respiratory failure. In these patients, optimal oxygen therapy was crucial.

Role of the interstitium during septic shock: a key to the understanding of fluid dynamics?

Background: While not traditionally included in the conceptual understanding of circulation, the interstitium plays a critical role in maintaining fluid homeostasis. Fluid balance regulation is a critical aspect of septic shock, with a well-known association between fluid balance and outcome. The regulation of transcapillary flow is the first key to understand fluid homeostasis during sepsis.

Pneumococcal pneumonia and endotoxemia: An experimental and clinical reappraisal.

Background: Circulating endotoxins could result from bacterial digestive translocation during sepsis, thus contributing to uncontrolled systemic inflammation, leading in turn to organ dysfunction. We addressed this issue in the setting of severe pneumococcal pneumonia.

Methods: Endotoxemia was measured in a clinically relevant rabbit model of ventilated pneumococcal pneumonia and in 110 patients with bacteraemic pneumonia, using a patented mass spectrometry (LC-MS/MS) method for detection of 3-OH fatty acids (C10, C12, C14, C16 and C18), which are molecules bound to the lipid A motif of LPS.

ICU stays that are judged to be non-beneficial: A qualitative study of the perception of nursing staff.

Introduction: Non-beneficial stays in the intensive care unit (ICU) may have repercussions for patients and their families, but can also cause suffering among the nursing staff. We aimed explore the perceptions of nursing staff in the ICU about patient stays that are deemed to be "non-beneficial" for the patient, to identify areas amenable to intervention, with a view to improving how the nursing staff perceive the patient pathway before, during and after intensive care.

Methods: Multicentre, qualitative study using individual, semi-structured interviews.

Management of renal replacement therapy among adults in French intensive care units: A bedside practice evaluation.

Background: This study aimed to investigate renal replacement therapy (RRT) practices in a representative nationwide sample of French intensive care units (ICUs).

Methods: From July 1 to October 5 2021, 67 French ICUs provided data regarding their ICU and RRT implementation. We used an online questionnaire to record general data about each participating ICU, including the type of hospital, number of beds, staff ratios, and RRT implementation.

The accuracy of intensive care nurses' interpretation of chest radiographs to recognise misplacement of endotracheal and nasogastric tubes after a single training session and comparison with residents' interpretation.

Background: Misplacements of endotracheal and nasogastric tubes are frequent encounters in critically ill patients.

Objectives: The purpose of this study was to assess the effectiveness of a single standardised training session on the ability of intensive care registered nurses (RNs) to recognise the misplacement of endotracheal and nasogastric tubes on bedside chest radiographs of patients in intensive care units (ICUs).

Methods: In eight French ICUs, RNs received a 110-min standardised teaching on the position of endotracheal and nasogastric tubes on chest radiographs.

Criteria deemed important by ICU patients when designating a reference person.

Background: We investigated the criteria that hospitalized patients in intensive care units (ICUs) deem important when designating relatives who are best qualified to interact with the caregiving staff.

Methods: We conducted an exploratory, observational, prospective, multicenter study between March 1, 2018, and October 31, 2018, within two ICUs. A 12-item questionnaire was distributed to patients in the ICUs by the investigating physicians.

Non-beneficial admission to the intensive care unit: A nationwide survey of practices.

Introduction: In a nationwide survey of practices, we sought to define the criteria, circumstances and consequences of non-beneficial admissions to the intensive care unit (ICU), with a view to proposing measures to avoid such situations.

Methods: ICU physicians from a French research in ethics network participated in an online survey. The first part recorded age, sex, and years' experience of the participants.

Endotracheal tube biofilm in critically ill patients during the COVID-19 pandemic : description of an underestimated microbiological compartment.

Biofilm (BF) growth is believed to play a major role in the development of ventilator-associated pneumonia (VAP) in the intensive care unit. Despite concerted efforts to understand the potential implication of endotracheal tube (ETT)-BF dispersal, clinically relevant data are lacking to better characterize the impact of its mesostructure and microbiological singularity on the occurrence of VAP. We conducted a multicenter, retrospective observational study during the third wave of the COVID-19 pandemic, between March and May 2021.

Anticipating need for intensive care in the healthcare trajectory of patients with chronic disease: A qualitative study among specialists.

Introduction: We investigated the reflections and perceptions of non-ICU physicians about anticipating the need for ICU admission in case of acute decompensation in patients with chronic disease.

Methods: We performed a qualitative multicentre study using semi-structured interviews among non-ICU specialist physicians. The interview guide, developed in advance, focused on 3 questions: (1) What is your perception of ICU care? (2) How do you think advance directives can be integrated into the patient's healthcare goals? and (3) How can the possibility of a need for ICU admission be integrated into the patient's healthcare goals? Interviews were recorded, transcribed and analysed by thematic analysis.

Beyond QuantiFERON-TB Results, the Added Value of a Weak Mitogen Response.

Introduction: While QuantiFERON-TB gold (QFT) is frequently used, little attention is paid to the mitogen response. How it could be impacted and associated with outcomes is poorly known.

Methods: Retrospective, case-control study in hospitalized patients who underwent QFT testing in two hospitals between 2016 and 2019.

A general mathematical model for the in vitro assembly dynamics of intermediate filament proteins.

Intermediate filament (IF) proteins assemble into highly flexible filaments that organize into complex cytoplasmic networks: keratins in all types of epithelia, vimentin in endothelia, and desmin in muscle. Since IF elongation proceeds via end-to-end annealing of unit-length filaments and successively of progressively growing filaments, it is important to know how their remarkable flexibility, i.e.

Adverse Mechanical Ventilation and Pneumococcal Pneumonia Induce Immune and Mitochondrial Dysfunctions Mitigated by Mesenchymal Stem Cells in Rabbits.

Background: Mechanical ventilation for pneumonia may contribute to lung injury due to factors that include mitochondrial dysfunction, and mesenchymal stem cells may attenuate injury. This study hypothesized that mechanical ventilation induces immune and mitochondrial dysfunction, with or without pneumococcal pneumonia, that could be mitigated by mesenchymal stem cells alone or combined with antibiotics.

Methods: Male rabbits underwent protective mechanical ventilation (8 ml/kg tidal volume, 5 cm H2O end-expiratory pressure) or adverse mechanical ventilation (20 ml/kg tidal-volume, zero end-expiratory pressure) or were allowed to breathe spontaneously.

New Methodologies to Study DNA Repair Processes in Space and Time Within Living Cells.

DNA repair requires a coordinated effort from an array of factors that play different roles in the DNA damage response from recognizing and signaling the presence of a break, creating a repair competent environment, and physically repairing the lesion. Due to the rapid nature of many of these events, live-cell microscopy has become an invaluable method to study this process. In this review we outline commonly used tools to induce DNA damage under the microscope and discuss spatio-temporal analysis tools that can bring added information regarding protein dynamics at sites of damage.

Non-readmission decisions in the intensive care unit: A qualitative study of physicians' experience in a multicentre French study.

Purpose: Deciding not to re-admit a patient to the intensive care unit (ICU) poses an ethical dilemma for ICU physicians. We aimed to describe and understand the attitudes and perceptions of ICU physicians regarding non-readmission of patients to the ICU.

Materials And Methods: Multicenter, qualitative study using semi-directed interviews between January and May 2019.

CXCL10 could drive longer duration of mechanical ventilation during COVID-19 ARDS.

Background: COVID-19-related ARDS has unique features when compared with ARDS from other origins, suggesting a distinctive inflammatory pathogenesis. Data regarding the host response within the lung are sparse. The objective is to compare alveolar and systemic inflammation response patterns, mitochondrial alarmin release, and outcomes according to ARDS etiology (i.