Antifungal concentrations in mechanically ventilated COVID-19 patients with or without ECMO: The CAPADOSE observational retrospective multicenter Study.

Purpose: COVID-19-associated pulmonary aspergillosis (CAPA) is a major co-infection in critically ill patients and is linked to increased mortality. Critical illness and ECMO may affect antifungal pharmacokinetics, raising concerns about drug efficacy.

Methods: This multicenter retrospective study included CAPA patients requiring mechanical ventilation in 20 intensive care units (ICUs) (March 2020 to November 2021), provided at least one antifungal blood level was available.

Prophylaxis against Pneumocystis jirovecii pneumonia and toxoplasmosis with low-dose Trimethoprim-sulfamethoxazole (cotrimoxazole 20/100 mg) in heart transplant patients. The PAPTO-LOCO observational comparative study.

Objectives: Practice concerning post-transplant Pneumocystis prophylaxis remains heterogeneous. SXT benefits must be balanced with frequent toxicity. We aimed to assess whether a low-dose SXT strategy might limit toxicities while maintaining an undisrupted prophylaxis compared with a standard dose in a retrospective cohort of heart transplant population.

Lung resistance - but not compliance - impairs P0.1 and maximal inspiratory pressure measurements.

Introduction: Bedside tools have been developed to assess inspiratory muscle function and inspiratory drive for patients under invasive mechanical ventilation. Occlusion maneuvers are currently considered but their pitfalls remain underexplored. We aimed to assess the impact of respiratory system compliance and resistance on P0.

Electrical impedance tomography to set high pressure in time-controlled adaptive ventilation.

Introduction: TCAV (Time controlled adaptive ventilation), a combination of settings applied to the APRV (airway pressure release ventilation) mode, provides personalized ventilation tailored to the lung condition in ARDS (acute respiratory distress syndrome). The objective was to evaluate whether electrical impedance tomography (EIT) could serve as a tool for guiding P level in TCAV for ARDS patients.

Methods: Eleven patients with moderate or severe ARDS were enrolled in a prospective single-center study in 2023.

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).

Importance of Transplant Era on Post-Heart Transplant Predictive Models: A UNOS Cohort Analysis.

Background: The application of posttransplant predictive models is limited by their poor statistical performance. Neglecting the dynamic evolution of demographics and medical practice over time may be a key issue.

Objectives: Our objective was to develop and validate era-specific predictive models to assess whether these models could improve risk stratification compared to non-era-specific models.

Contribution of electrical impedance tomography to personalize positive end-expiratory pressure under ECCOR.

Extracorporeal Carbon Dioxide Removal (ECCOR) is used in acute respiratory distress syndrome (ARDS) patients to facilitate lung-protective ventilatory strategies. Electrical Impedance Tomography (EIT) allows individual, non-invasive, real-time, bedside, radiation-free imaging of the lungs, providing global and regional dynamic lung analyses. To provide new insights for future ECCO2R research in ARDS, we propose a potential application of EIT to personalize End-Expiratory Pressure (PEEP) following each reduction in tidal volume (VT), as demonstrated in an illustrative case.

Albumin Infusion Reduces Fluid Loading for Postresuscitation Syndrome in a Pig Model of Refractory Cardiac Arrest Resuscitated With Venoarterial Extra Corporeal Membrane Oxygenation.

Hemodynamic instability in postresuscitation syndrome worsens survival and neurological outcomes. Venoarterial extracorporeal membrane oxygenation (VA ECMO) for refractory cardiac arrest might improve outcomes. Hemodynamical support under VA ECMO relies on norepinephrine and crystalloids.

The medical treatment of cardiogenic shock.

Cardiogenic shock (CS) is a leading cause of mortality worldwide. CS presentation and management in the current era have been widely depicted in epidemiological studies. Its treatment is codified and relies on medical care and extracorporeal life support (ECLS) in the bridge to recovery, chronic mechanical device therapy, or transplantation.

Association between vasoactive-inotropic score, morbidity and mortality after heart transplantation.

Objectives: The aim of this study was to evaluate the association between vasoactive-inotropic score (VIS), calculated in the 24 h after heart transplantation, and post-transplant mortality and morbidity.

Methods: This was an observational single-centre retrospective study. Patients admitted to surgical intensive care unit after transplantation, between January 2015 and December 2018, were reviewed consecutively.

Practical application of the French two-score heart allocation scheme: Insights from a high-volume heart transplantation centre.

Background: In 2018, a cardiac allocation scheme based on an individual score considering the risk of death both on the waitlist and after heart transplantation was implemented in France.

Aims: To analyse the practical application of the pre- and post-transplant risk score in a French high-volume heart transplantation centre.

Methods: All consecutive adult patients listed for a first non-combined heart transplantation between 02 January 2018 and 30 June 2022 at our centre were included.

Beta-blockers in septic shock: What is new?

The use of beta(β)-blockers during septic shock aimed at countering peripheral adrenergic stress may be justified by the early reduction in deleterious effects resulting from sympathetic overactivation, and could improve the prognosis of patients in septic shock. Animal studies have demonstrated either a maintenance or increase in cardiac output (CO) despite the decrease in heart rate (HR) associated with improved myocardial performance. The mechanism by which β-blockers alter hemodynamics in septic shock is debated; however, preclinical and clinical data show that β-blockers are safe when started at a low dose.

Measurement of airborne particle emission during surgical and percutaneous dilatational tracheostomy COVID-19 adapted procedures in a swine model: Experimental report and review of literature.

Introduction: Surgical tracheostomy (ST) and Percutaneous dilatational tracheostomy (PDT) are classified as high-risk aerosol-generating procedures and might lead to healthcare workers (HCW) infection. Albeit the COVID-19 strain slightly released since the vaccination era, preventing HCW from infection remains a major economical and medical concern. To date, there is no study monitoring particle emissions during ST and PDT in a clinical setting.

Impaired Pharmacokinetics of Amiodarone under Veno-Venous Extracorporeal Membrane Oxygenation: From Bench to Bedside.

Background: Adjusting drug therapy under veno-venous extracorporeal membrane oxygenation (VV ECMO) is challenging. Although impaired pharmacokinetics (PK) under VV ECMO have been reported for sedative drugs and antibiotics, data about amiodarone are lacking. We evaluated the pharmacokinetics of amiodarone under VV ECMO both in vitro and in vivo.