121 research outputs found
Pronostic des patients atteints de cancer pulmonaire non résécable admis en réanimation (étude monocentrique longitudinale sur 6 ans)
No full textAIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocSudocFranceF
Implications du procollagène III et du facteur de croissance et de transformation [bêta]1 dans le pronostic du syndrome de détresse respiratoire aiguë
No full textObjectif : déterminer les cinétiques alvéolaires et systémiques du transforming growth factor 1 (TGFb1) et du procollagène III (PCP III) au cours du SDRA. Etude: prospective observationnelle réalisée dans trois réanimations. Sujets :56 patients en SDRA de moins de 48 heures ont été inclus consécutivement. Mesures : dosages systémiques et alvéolaires de PCP III et de TGFb1 au 1er 3ème 7ème et 14ème jour du SDRA. Résultats: la mortalité au 28ème jour était de 35.7%. Les taux de PCP III sériques et alvéolaires étaient plus élevées dans le groupe non survivant que dans le groupe survivant à J28. En analyse multivariée l'Odds ratio (OR) à l'inclusion du PCP III sérique >8.94 g/L est de 4.82 IC 95%[1.16-20.01] et augmente au 3ème jour (OR à 33.22, IC 95%[2.33-473.13]). Le TGFb1 n'est pas associé à la mortalité au cours du SDRA. Conclusion : Des concentrations élevées de PCP III alvéolaire et systémique sont associées à une augmentation du risque de décès chez les patients en SDRA.AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF
Respiratory rate and peak inspiratory pressure, new targets from the LUNG SAFE study analysis or physiopathological artifacts?
No full textInternational audienc
Effects of neuromuscular blockers on transpulmonary pressures in moderate to severe acute respiratory distress syndrome
No full textInternational audienceTo investigate whether neuromuscular blocking agents (NMBA) exert beneficial effects in acute respiratory distress syndrome (ARDS) by reason of their action on respiratory mechanics, particularly transpulmonary pressures (P (L)). A prospective randomised controlled study in patients with moderate to severe ARDS within 48 h of the onset of ARDS. All patients were monitored by means of an oesophageal catheter and followed up for 48 h. Moderate ARDS patients were randomised into two groups according to whether they were given a 48-h continuous infusion of cisatracurium besylate or not (control group). Severe ARDS patients did not undergo randomisation and all received cisatracurium besylate per protocol. The changes during the 48-h study period in oxygenation and in respiratory mechanics, including inspiratory and expiratory P (L) and driving pressure, were assessed and compared. Delta P (L) (a dagger P (L)) was defined as inspiratory P (L) minus expiratory P (L). Thirty patients were included, 24 with moderate ARDS and 6 with severe ARDS. NMBA infusion was associated with an improvement in oxygenation in both moderate and severe ARDS, accompanied by a decrease in both plateau pressure and total positive end-expiratory pressure. The mean inspiratory and expiratory P (L) were higher in the moderate ARDS group receiving NMBA than in the control group. In contrast, there was no change in either driving pressure or a dagger P (L) related to NMBA administration. NMBA could exert beneficial effects in patients with moderate ARDS, at least in part, by limiting expiratory efforts
Determinants of long-term outcomes in patients with COVID-19 supported with ECMO
No full textInternational audienc
Seismic tomography of the Excavation Damaged Zone of the Gallery 04 in the Mont Terri Rock Laboratory
No full textInternational audienceAn endoscopic antenna is used to perform a seismic cross-hole tomography in the Excavation Damaged Zone (EDZ) of the newG04 gallery of the Mont Terri Underground Rock Laboratory (Switzerland) excavated in Opalinus clay. More than 800 seismic traces were recorded between two vertical boreholes by combining 22 source and 48 receiver locations. A vertical area of 1.2 — 3.4 m under the floor of the gallery is investigated with a high-resolution tomography. Data with a very good quality allow to determine the traveltimes and the amplitudes of a 40 kHz source wavelet propagating between the two boreholes. The analysis of the traveltimes shows that the wave velocity is homogeneous but anisotropic with a minimum value of 2490 ± 45ms-1 in the direction normal to the bedding and a maximum of 3330 ± 90ms-1 parallel to the bedding. The amplitude of the first arrivals strongly varies depending on the sourcereceiver locations, and suggesting an heterogeneous distribution of the attenuation coefficient of the seismic waves. A Bayesian inversion provides likely models of attenuation that are compared with geological observations. The areas where fractures or cracks exist in the Opalinus clay appear as highly absorbing the seismic waves
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