Abstract:
BACKGROUND:While the process of sepsis-induced immunosuppression is now well described in adults, very little information is available on immune functions in pediatric sepsis. The current study investigated this in children with septic shock by performing immunomonitoring, including both innate (monocyte human leukocyte antigen-DR, mHLA-DR, expression) and adaptive immunity (lymphocyte subsets count), as well as cytokine concentrations (IL-6, IL-8, IL-10, IL-1Ra, TNF-α, IFN-γ). Subsequent objectives were to assess the associations between inflammatory response, potential immunosuppression and secondary acquired infection occurrence. METHODS:Single-center prospective observational study, including children aged between 1 month and 18 years admitted to pediatric intensive care unit (PICU) for septic shock. Age-matched controls were children hospitalized for elective surgery without any infectious criteria. Blood was sampled at day 1-2, 3-5, and 7-9 after sepsis onset. mHLA-DR and lymphocyte subsets count were measured by flow cytometry and cytokine concentrations by Luminex technology. RESULTS:A total of 26 children and 30 controls were included. Patients had lymphopenia, and mHLA-DR levels were significantly lower than controls at each time point (p < 0.0001). All cytokines peaked at day 1-2. Children with secondary acquired infection had lower day 3-5 mHLA-DR and higher pro-inflammatory cytokine concentrations (IL-6, IL-8 and TNF-α) at day 1-2 compared to children without secondary acquired infection. CONCLUSIONS:The higher initial inflammatory cytokine production was, the more innate immunity was altered, while evaluated by low mHLA-DR expression. Children with decreased mHLA-DR expression developed more secondary acquired infections. Upon confirmation in multicenter cohorts, these results pave the way for immunostimulation for the most immunosuppressed children in order to prevent nosocomial infections in PICU. Trial registration PedIRIS study NCT02848144. Retrospectively registered 28 July 2016.
journal_name
Ann Intensive Carejournal_title
Annals of intensive careauthors
Remy S,Kolev-Descamps K,Gossez M,Venet F,Demaret J,Javouhey E,Monneret Gdoi
10.1186/s13613-018-0382-xsubject
Has Abstractpub_date
2018-03-13 00:00:00pages
36issue
1issn
2110-5820pii
10.1186/s13613-018-0382-xjournal_volume
8pub_type
杂志文章abstract:BACKGROUND AND AIMS:Data on outcome of critically ill children with cirrhosis are scarce. We aimed to evaluate the prognostic accuracy of sequential organs scoring systems in children with cirrhosis admitted to Paediatric Intensive Care Units (PICU). METHODS:We performed a multicentre retrospective analysis of childre...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00753-w
更新日期:2020-10-14 00:00:00
abstract::Pharmacological interventions are commonly considered in acute respiratory distress syndrome (ARDS) patients. Inhaled nitric oxide (iNO) and neuromuscular blockers (NMBs) are used in patients with severe hypoxemia. No outcome benefit has been observed with the systematic use of iNO. However, a sometimes important impr...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-3-20
更新日期:2013-07-03 00:00:00
abstract::An amendment to this paper has been published and can be accessed via the original article. ...
journal_title:Annals of intensive care
pub_type: 已发布勘误
doi:10.1186/s13613-020-00691-7
更新日期:2020-06-02 00:00:00
abstract:BACKGROUND:The echocardiography working group of the European Society of Intensive Care Medicine recognized the need to provide structured guidance for future CCE research methodology and reporting based on a systematic appraisal of the current literature. Here is reported this systematic appraisal. METHODS:We conduct...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/s13613-020-00662-y
更新日期:2020-04-25 00:00:00
abstract:BACKGROUND:Endotoxins can induce an excessive inflammatory response and result in microcirculatory dysfunction. Polymyxin-B hemoperfusion (PMX-HP) has been recognized to effectively remove endotoxins in patients with sepsis and septic shock, and a rat sepsis model revealed that PMX-HP treatment can maintain a better mi...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00699-z
更新日期:2020-06-12 00:00:00
abstract:BACKGROUND:Aneurysmal subarachnoid hemorrhage (SAH) is a serious condition associated with high mortality rates and long-term disability. We investigated the impact of fluid balance on neurologic outcome after adjustment for possible confounders related to intensive care therapy and extra-cerebral organ failure during ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-016-0128-6
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:The consequences of the ageing population concerning ICU hospitalisation need to be adequately described. We believe that this discussion should be disease specific. A focus on respiratory infections is of particular interest, because it is strongly associated with old age. Our objective was to assess trends...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0430-6
更新日期:2018-08-15 00:00:00
abstract:: Cancer is a leading cause of death in children. In the past decades, there has been a marked increase in overall survival of children with cancer. However, children whose treatment includes hematopoietic stem cell transplantation still represent a subpopulation with a higher risk of mortality. These improvements in m...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-2-14
更新日期:2012-06-12 00:00:00
abstract:BACKGROUND:The effects of perioperative statin therapy on clinical outcome after cardiac or non-cardiac surgery are controversial. We aimed to assess the association between perioperative statin therapy and postoperative outcome. METHODS:Electronic databases were searched up to May 1, 2018, for randomized controlled t...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/s13613-018-0441-3
更新日期:2018-09-27 00:00:00
abstract:BACKGROUND:Hyperglycaemia is commonplace in the adult intensive care unit (ICU), associated with increased morbidity and mortality. Effective glycaemic control (GC) can reduce morbidity and mortality, but has proven difficult. STAR is a proven, effective model-based ICU GC protocol that uniquely maintains normo-glycaem...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0351-9
更新日期:2018-01-10 00:00:00
abstract:BACKGROUND:Delayed intubation is associated with high mortality. There is a lack of objective criteria to decide the time of intubation. We assessed a recently described combined oxygenation index (ROX index) to predict intubation in immunocompromised patients. The study is a secondary analysis of randomized trials in ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-021-00801-z
更新日期:2021-01-27 00:00:00
abstract:BACKGROUND:Optimal sedation and analgesia is a challenge in paediatric intensive care units (PICU) because of difficulties in scoring systems and specific metabolism inducing tolerance and withdrawal. Excessive sedation is associated with prolonged mechanical ventilation and hospitalisation. Adult and paediatric data s...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0256-7
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:The impact on infectious risk of ultrasound guidance at insertion remains controversial in short-term arterial catheters (ACs). The present study investigated the association between ultrasound guidance (US) during AC insertion and major catheter-related infections (MCRI), catheter-related bloodstream infect...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00705-4
更新日期:2020-07-08 00:00:00
abstract:BACKGROUND:Assessment of maximum respiratory pressures is a common practice in intensive care because it can predict the success of weaning from ventilation. However, the reliability of measurements through an intubation catheter has not been compared with standard measurements. The aim of this study was to compare max...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0362-1
更新日期:2018-01-30 00:00:00
abstract::Although chest X-ray remains a fundamental lung imaging technique, through the years, CT scan has significantly improved our knowledge of the pathophysiological process and currently is the reference lung imaging tool for both a visual and quantitative computer-based analysis. The application of lung CT in the early p...
journal_title:Annals of intensive care
pub_type: 社论
doi:10.1186/s13613-019-0497-8
更新日期:2019-01-22 00:00:00
abstract:BACKGROUND:Among intensive care unit (ICU) patients with acute respiratory distress syndrome (ARDS), apart from acute cor pulmonale (ACP), the frequency and prognostic impact of basic critical care echocardiography (BCCE) abnormalities are not well defined. METHODS:Observational study of patients with ARDS, admitted f...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0343-9
更新日期:2017-12-19 00:00:00
abstract:Introduction:Acute respiratory failure is the main reason for admission to the intensive care unit (ICU) in HIV-infected adults. There is little data about the epidemiology of respiratory viruses in this population. Methods:HIV-infected adults admitted to two intensive care units over a 6-year period for an acute resp...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00738-9
更新日期:2020-09-14 00:00:00
abstract:BACKGROUND:We performed a meta-analysis of randomized controlled trials (RCTs) to determine if daily bathing with chlorhexidine decreased hospital-acquired BSIs in critically ill patients. METHODS:We searched the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases to identify randomized contr...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-015-0073-9
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:The initial management of a trauma patient is a critical and demanding period. The use of extended focused assessment sonography for trauma (eFAST) has become more prevalent in trauma rooms, raising questions about the real "added value" of chest X-rays (CXRs) and pelvic X-rays (PXR), particularly in haemody...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-016-0166-0
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Patients in the intensive care unit (ICU) are more prone to drug-drug interactions (DDIs). The software and charts that indicate all interactions may not be proper for clinical usage. This study aimed to identify the main drug classes associated with clinically significant DDIs in cardiothoracic ICU and cate...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-015-0086-4
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Venous thromboembolism (VTE) is one of the most common preventable causes of in-hospital death in trauma patients surviving their injuries. We assessed the prevalence, incidence and risk factors for deep venous thrombosis (DVT) and pulmonary embolism (PE) in critically ill trauma patients, in the setting of ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0315-0
更新日期:2017-09-12 00:00:00
abstract:INTRODUCTION:About 30% of patients with Guillain-Barré syndrome become ventilator dependent, of whom roughly 75% develop pneumonia. This trial aimed at assessing the impact of early mechanical ventilation (EMV) on pneumonia occurrence in GBS patients. We hypothesize that EMV will reduce the incidence of pneumonia. MET...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00742-z
更新日期:2020-09-30 00:00:00
abstract:BACKGROUND:Preliminary reports have described significant procoagulant events in patients with coronavirus disease-2019 (COVID-19), including life-threatening pulmonary embolism (PE). MAIN TEXT:We review the current data on the epidemiology, the possible underlying pathophysiologic mechanisms, and the therapeutic impl...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/s13613-020-00741-0
更新日期:2020-09-16 00:00:00
abstract:BACKGROUND:The impact of neutropenia in critically ill immunocompromised patients admitted in a context of acute respiratory failure (ARF) remains uncertain. The primary objective was to assess the prognostic impact of neutropenia on outcomes of these patients. Secondary objective was to assess etiology of ARF accordin...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00764-7
更新日期:2020-10-22 00:00:00
abstract::The 2018 Paris Intensive Care symposium entitled "Update in Neurocritical Care" was organized in Paris, June 21-22, 2018, under the auspices of the French Intensive Care Society. This 2-day post-graduate educational symposium comprised several chapters, aiming first to provide all-board intensivists with current stand...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/s13613-019-0523-x
更新日期:2019-04-16 00:00:00
abstract:BACKGROUND:Intensivists' clinical decision making pursues two main goals for patients: to decrease mortality and to improve quality of life and functional status in survivors. Patient-important outcomes are gaining wide acceptance in most fields of clinical research. We sought to systematically review how well patient-...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/s13613-017-0243-z
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Infection and sepsis are a main cause of acute-on-chronic liver failure (ACLF). Adequate dosing of antimicrobial therapy is of central importance to improve outcome. Liver failure may alter antibiotic drug concentrations via changes of drug distribution and elimination. We studied the pharmacokinetics of mer...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00666-8
更新日期:2020-04-22 00:00:00
abstract:BACKGROUND:Critical illness has detrimental effects on the diaphragm, but the impact of critical illness on other major muscles of the respiratory pump has been largely neglected. This study aimed to determine the impact of critical illness on the most important muscles of the respiratory muscle pump, especially on the...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00731-2
更新日期:2020-08-27 00:00:00
abstract:BACKGROUND:Middle East respiratory syndrome coronavirus (MERS-CoV) has caused several hospital outbreaks, including a major outbreak at King Abdulaziz Medical City, a 940-bed tertiary-care hospital in Riyadh, Saudi Arabia (August-September 2015). To learn from our experience, we described the critical care response to ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-016-0203-z
更新日期:2016-12-01 00:00:00
abstract:: Thrombocytopenia is a very frequent disorder in the intensive care unit. Many etiologies should be searched, and therapeutic approaches differ according to these different causes. However, no guideline exists regarding optimum practices for these situations in critically ill patients. We present recommendations for t...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-2-42
更新日期:2012-08-28 00:00:00