Supplementary Material for: A Role of Remote Organs Effect in Acute Kidney Injury Outcome?

<p>Acute kidney injury (AKI) has been associated with both short- and long-term outcomes. To date, there is still a debate whether the increase risk of morbidity and mortality is directly due to AKI occurrence. There is, however, a potential causal impact of AKI on outcome, but evidence of this association is yet lacking. The hypothesis of remote organ damage and dysfunction (heart, lung, liver, brain, etc.) has emerged over the last decade and may explain the reason for the potential negative impact of AKI on outcome. The aim of this review was to describe findings concerning the remote effect of AKI in animal models and human studies.</p

Premiers retours d'expérience sur l'utilisation des transpondeurs actifs Ultra Hautes Fréquences pour le suivi de la mobilité des galets en rivières

International audienc

Elevated plasma Galectin-3 is associated with major adverse kidney events and death after ICU admission.

BackgroundGalectin-3 (Gal-3) is a proinflammatory and profibrotic protein especially overexpressed after Acute Kidney Injury (AKI). The early renal prognostic value of Gal-3 after AKI in critically ill patients remains unexplored. The objective was to evaluate the prognostic value of plasma level of Gal-3 for Major Adverse Kidney Events (MAKE) and mortality 30&nbsp;days after ICU admission across AKI stages.MethodsThis is an ancillary study of a prospective, observational, multicenter cohort (FROG-ICU). AKI was defined using KDIGO definition.ResultsTwo thousand and seventy-six patients had a Gal-3 plasma level measurement at ICU admission. Seven hundred and twenty-three (34.8%) were females and the median age was 63 [51, 74] years. Eight hundred and seven (38.9%) patients developed MAKE, 774 (37.3%) had AKI and mortality rate at 30&nbsp;days was 22.4% (N = 465). Patients who developed MAKE had higher Gal-3 level at admission compared to patients without (30.2 [20.8, 49.2] ng/ml versus 16.9 [12.7, 24.3] ng/ml, p &lt; 0.001, respectively. The area under the receiver operating characteristic curve&nbsp;of Gal-3 to predict MAKE was 0.76 CI95% [0.74-0.78], p &lt; 0.001. Gal-3 was associated with MAKE (OR 1.80 CI95% [1.68-1.93], p &lt; 0.001, non-adjusted and OR 1.37 CI95% [1.27-1.49], p &lt; 0.001, adjusted). The use of Gal-3 improved prediction performance of prediction model including SAPSII, Screatadm, pNGAL with a NRI of 0.27 CI95%(0.16-0.38), p &lt; 0.001. Median Gal-3 was higher in non-survivors than in survivors at 30&nbsp;days (29.2 [20.2, 49.2] ng/ml versus 18.8 [13.3, 29.2] ng/ml, p &lt; 0.001, respectively).ConclusionPlasma levels of Gal-3 were strongly associated with renal function, with an increased risk of MAKE and death after ICU admission. Trial registration ClinicalTrials.gov NCT01367093. Registered on 6 June 2011

Elevated plasma Galectin-3 is associated with major adverse kidney events and death after ICU admission

International audienceBackground: Galectin-3 (Gal-3) is a proinflammatory and profibrotic protein especially overexpressed after Acute Kidney Injury (AKI). The early renal prognostic value of Gal-3 after AKI in critically ill patients remains unexplored. The objective was to evaluate the prognostic value of plasma level of Gal-3 for Major Adverse Kidney Events (MAKE) and mortality 30 days after ICU admission across AKI stages. Methods: This is an ancillary study of a prospective, observational, multicenter cohort (FROG-ICU). AKI was defined using KDIGO definition. Results: Two thousand and seventy-six patients had a Gal-3 plasma level measurement at ICU admission. Seven hundred and twenty-three (34.8%) were females and the median age was 63 [51, 74] years. Eight hundred and seven (38.9%) patients developed MAKE, 774 (37.3%) had AKI and mortality rate at 30 days was 22.4% (N = 465). Patients who developed MAKE had higher Gal-3 level at admission compared to patients without (30.2 [20.8, 49.2] ng/ml versus 16.9 [12.7, 24.3] ng/ml, p < 0.001, respectively. The area under the receiver operating characteristic curve of Gal-3 to predict MAKE was 0.76 CI 95% [0.74-0.78], p < 0.001. Gal-3 was associated with MAKE (OR 1.80 CI 95% [1.68-1.93], p < 0.001, non-adjusted and OR 1.37 CI 95% [1.27-1.49], p < 0.001, adjusted). The use of Gal-3 improved prediction performance of prediction model including SAPSII, Screat adm , pNGAL with a NRI of 0.27 CI 95% (0.16-0.38), p < 0.001. Median Gal-3 was higher in non-survivors than in survivors at 30 days (29.2 [20.2, 49.2] ng/ml versus 18.8 [13.3, 29.2] ng/ml, p < 0.001, respectively). Conclusion: Plasma levels of Gal-3 were strongly associated with renal function, with an increased risk of MAKE and death after ICU admission

Capillary refill time for the management of acute circulatory failure: a survey among pediatric and adult intensivists

International audienceINTRODUCTION: Recent studies have shown the prognostic value of capillary refill time (CRT) and suggested that resuscitation management guided by CRT may reduce morbidity and mortality in patients with septic shock. However, little is known about the current use of CRT in routine clinical practice. This study aimed to assess the modalities of CRT use among French adult and pediatric intensivists. METHODS: A cross-sectional survey exploring CRT practices in acute circulatory failure was performed. The targeted population was French adult and pediatric intensivists (SFAR and GFRUP networks). An individual invitation letter including a survey of 32 questions was emailed twice. Descriptive and analytical statistics were performed. RESULTS: Among the 6071 physicians who received the letter, 418 (7%) completed the survey. Among all respondents, 82% reported using CRT in routine clinical practice, mainly to diagnose acute circulatory failure, but 45% did not think CRT had any prognostic value. Perfusion goal-directed therapy based on CRT was viewed as likely to improve patient outcome by 37% of respondents. The measurement of CRT was not standardized as the use of a chronometer was rare (3%) and the average of multiple measurements rarely performed (46%). Compared to adult intensivists, pediatric intensivists used CRT more frequently (99% versus 76%) and were more confident in its diagnostic value and its ability to guide treatment. CONCLUSION: CRT measurement is widely used by intensivists in patients with acute circulatory failure but most often in a non-standardized way. This may lead to a misunderstanding of CRT reliability and clinical usefulness

OSR - Observatoire des Sédiments du Rhône. 12 années de recherche pour la connaissance et la gestion hydro-sédimentaire du fleuve. Bilans et perspectives scientifiques

L’Observatoire des Sédiments du Rhône (OSR) est un dispositif de recherche créé en 2009 à la suite de questions sur la gestion sédimentaire du fleuve qui ont émergé dans le cadre du Plan Rhône. Il a été co-construit par les scientifiques et les gestionnaires du fleuve. Il bénéficie du soutien technique et financier des partenaires du Plan Rhône. Cet observatoire a pour mission de produire, rassembler et diffuser des connaissances afin de caractériser les processus hydro-sédimentaires, ainsi que les pollutions associées aux stocks et aux flux de sédiments. L’OSR a été créé dans le cadre de la Zone Atelier Bassin du Rhône (ZABR). Il nourrit les problématiques scientifiques de l’Observatoire Hommes-Milieux Vallée du Rhône (OHM VR) et apporte des connaissances robustes sur le fonctionnement du fleuve. La ZABR et l’OHM VR sont deux dispositifs labellisés par le CNRS. Le GRAIE a en charge leur animation et accompagne la coordination et la valorisation de l’OSR