Publications by authors named "Raphael Favory"
Sepsis Induces Long-Term Muscle and Mitochondrial Dysfunction due to Autophagy Disruption Amenable by Urolithin A.
J Cachexia Sarcopenia Muscle
August 2025
Background: Sepsis survivors often experience sustained muscle weakness, leading to physical disability, with no pharmacological treatments available. Despite these well-documented long-term clinical consequences, research exploring the cellular and molecular mechanisms is sorely lacking.
Methods: Bioinformatic analysis was performed in the vastus lateralis transcriptome of human ICU survivors 7 days after ICU discharge (D7), 6 months (M6) and age- and sex-matched controls.
Survivors of intensive care unit (ICU) are increasingly numerous because of better hospital care. However, several consequences of an ICU stay, known as post-intensive care syndrome, worsen long-term prognoses. A predominant feature in survivors is reduced muscle strength, mass, and physical function.
View Article and Find Full Text PDFBackground: Alterations in the classical Renin-Angiotensin Aldosterone System (RAAS) have been described during septic shock and are associated with patient outcomes. Since the alternative RAAS has also been reported to be altered in critically ill patients, and given that the RAAS can be modulated by specific therapeutics, such as angiotensin II, understanding its pathophysiology is of primary interest.
Objective: To describe the alterations in the classical and alternative RAAS during septic shock in comparison with healthy controls.
Alterations in the Renin-Angiotensin System in Experimental Septic Shock.
Crit Care Explor
October 2024
Article Synopsis
- The study aimed to investigate changes in the renin-angiotensin system during septic shock, particularly looking at ACE activity and the levels of different angiotensin peptides using mass spectrometry.
- Experimental septic shock was induced in pigs, with further interventions like fluid resuscitation and antibiotics, while monitoring various time points.
- Results showed increased renin and angiotensin levels, decreased ACE activity, and a shift towards the angiotensin-(1-7) axis, indicating possible adaptive responses within the RAS that could inform future sepsis treatments.
Article Synopsis
- Dipeptidyl peptidase 3 (DPP3) is linked to worse outcomes in sepsis and can degrade angiotensin II; the study evaluates Procizumab (PCZ), an antibody targeting cDPP3's effects during septic shock.
- The research involved 16 pigs with induced peritonitis, comparing PCZ treatment to standard care, assessing various health indicators over a 12-hour period post-treatment.
- Results showed PCZ reduced cDPP3 levels, lowered the need for norepinephrine and fluids, decreased myocardial injury, and improved oxygenation, indicating its potential benefits in managing septic shock.
Article Synopsis
- This study investigates COVID-19-associated pulmonary aspergillosis (CAPA) among critically ill patients during the Omicron variant wave, finding it affects 5.1% of patients and 9.1% of those on invasive mechanical ventilation.
- CAPA patients showed higher rates of immunosuppression and required more intensive care measures, like vasopressors and renal therapy, compared to non-CAPA patients.
- While CAPA did not significantly impact day-28 mortality, it was linked to longer mechanical ventilation and ICU stays, suggesting a shift in outcomes with emerging SARS-CoV-2 variants.
Article Synopsis
- The study investigated the effects of sodium-β-O-Methyl cellobioside sulfate (mCBS), a substance that neutralizes extracellular histones, on sepsis severity in sheep.
- It involved 24 female sheep with sepsis induced by fecal peritonitis, divided into three groups: control, early treatment, and late treatment, with treatment timing affecting outcomes.
- Results showed that early mCBS treatment led to better blood pressure maintenance, lower need for norepinephrine, and improved overall health markers compared to controls, with all mCBS-treated animals surviving.
Article Synopsis
- The study examines heart failure and cardiogenic shock (CS) in older adults, highlighting that the incidence is rising due to an aging population, with limited data available on this demographic.
- The research involved a registry called FRENSHOCK, which included 772 CS patients, revealing that 30.6% were over 75 years old, with higher comorbidities and lower treatment intensity compared to younger patients.
- Results indicated that older adults have more than double the risk of death at 1 month and 1 year post-CS, emphasizing the need for targeted research to determine effective treatment strategies for this age group.
Article Synopsis
- Anticoagulants are commonly used but can cause significant bleeding, leading to ICU admissions, with data showing a rise in such cases from 2007 to 2018, particularly for direct oral anticoagulants.
- A study of 486 ICU patients revealed that most had multiple health issues, were primarily older males, and had a high incidence of severe organ failure and complications upon admission.
- The ICU mortality rate was 27%, and factors like chronic hypertension and the need for vasopressors were linked to increased mortality, highlighting the need for better treatment guidelines and educational efforts.
Objective : The hemodynamic parameters used to accurately predict fluid responsiveness (FR) in spontaneously breathing patients (SB) require specific material and expertise. Measurements of the central venous pressure (CVP) are relatively simple and, importantly, are feasible in many critically ill patients. We analyzed the accuracy of respiration-related variations in CVP (vCVP) to predict FR in SB patients and examined the optimization of its measurement using a standardized, deep inspiratory maneuver.
View Article and Find Full Text PDFArticle Synopsis
- A study was conducted on 158 adult patients with acute respiratory failure due to SARS-CoV-2, focusing on the impact of various Omicron sublineages, including BA.2, BA.4/BA.5, and BQ.1.1.
- Patients infected with the recent BQ.1.1 variant displayed a higher rate of obesity and a lower rate of immunosuppression compared to those with earlier sublineages.
- Despite these differences in patient characteristics, there was no significant variation in disease severity at ICU admission, organ support needs, or 28-day mortality across the different sublineage groups.
Article Synopsis
- - Sepsis-induced myopathy leads to muscle fiber atrophy and mitochondrial issues, impacting recovery outcomes, but the role of overall energy deficit in this process was not previously studied.
- - In the experiment, three mouse groups were analyzed: sepsis mice with reduced caloric intake, sham-fed mice, and sham mice fed in line with the sepsis group's intake, to determine energy balance and muscle characteristics.
- - Results indicated that while sepsis caused a 17% reduction in muscle size and decreased mitochondrial function, the energy deficit alone did not fully explain the observed muscle issues, suggesting different metabolic adaptations in the sham pair-fed mice compared to the sepsis group.
Article Synopsis
- The study investigates the effects of angiotensin 1-7 (Ang-(1-7)), an anti-inflammatory peptide, on septic shock in a controlled experiment using sheep.
- In the trial, Ang-(1-7) was administered to one group of sheep after inducing sepsis, while another group received a placebo, with both groups monitored for changes in their condition.
- Results showed that the Ang-(1-7) group experienced significantly reduced septic shock development, lower norepinephrine requirements, and improved indicators of inflammation and kidney function compared to the placebo group.
Effects of high oxygen tension on healthy volunteer microcirculation.
Diving Hyperb Med
December 2022
Article Synopsis
- Previous studies have mainly focused on how hyperoxia affects microcirculation, but this research examines the specific impacts of hyperbaric oxygen (HBO) on healthy individuals.
- The study involved 15 volunteers and measured microcirculatory changes under various oxygen conditions using advanced techniques like laser Doppler and echocardiography.
- Results revealed that hyperbaric hyperoxia caused significant increases in arterial pressure and lower heart rates, leading to vasoconstriction in the microcirculation, which seemed to be an adaptive response to protect cellular health, while overall vascular reactivity remained stable.
Article Synopsis
- * A study of 259 patients revealed distinct clinical profiles between those infected with Omicron and those with Delta, but no significant impact of variant sublineages on 28-day mortality rates.
- * Immunocompromised patients infected with Omicron experienced higher mortality rates compared to non-immunocompromised individuals, despite many having received at least two vaccine doses and showing poor immune responses.
Background: Angiotensin II is one of the vasopressors available for use in septic shock. However, its effects on the septic myocardium remain unclear. The aim of the study was to compare the effects of angiotensin II and norepinephrine on cardiac function and myocardial oxygen consumption, inflammation and injury in experimental septic shock.
View Article and Find Full Text PDFAssessment of Metabolic Dysfunction in Sepsis in a Retrospective Single-Centre Cohort.
Julien Goutay
,
Juliette Perche
,
Aurelia Toussaint
,
Elodie Drumez
,
Michael Howsam
,
Raphael Favory
Crit Care Res Pract
December 2021
Article Synopsis
- The study aimed to evaluate how certain metabolic dysfunction parameters could predict short-term mortality in ICU patients with infections, alongside the SOFA score.
- Researchers analyzed data from 956 patients at Lille University Hospital and found that maximal lactatemia was the strongest predictor of death within 90 days, while age and the Charlson comorbidity score were also significant factors.
- They proposed a combined scoring system, the "SOFA + MACA" score, which incorporates lactatemia, age, and comorbidity to enhance early identification of high-risk patients, though further validation is needed.
Article Synopsis
- - The study aimed to analyze EEG patterns in critically ill COVID-19 patients suspected of having encephalopathy and how these patterns relate to their clinical outcomes.
- - Of the 33 patients analyzed, abnormal EEG findings included slowed activity in 85% of cases, with significant associations noted between unreactive patterns and poor clinical outcomes at 14 days.
- - The research suggests that the specific EEG abnormalities observed may indicate encephalopathy and are useful in predicting short-term recovery in COVID-19 patients.
Article Synopsis
- A retrospective multicenter study analyzed 382 patients admitted to ICUs for acute cholangitis (AC) from 2005 to 2018, noting a 29% in-hospital mortality rate.
- Factors linked to higher mortality included SOFA score, lactate levels, total serum bilirubin, and complications from AC.
- Over time, mortality rates improved significantly, particularly with prompt biliary decompression; delays of more than 48 hours were associated with increased risk of death.