Women’s visibility at European Society for Clinical Nutrition and Metabolism congresses from 2011 to 2019: Is the floor yours?

International audiencePurpose Participating in international conferences is an essential way to promote scholarly work. We aimed to assess the trend of women’s visibility at the European Society for Clinical Nutrition and Metabolism (ESPEN) congress by describing the evolution of the proportion of women speakers between 2011 and 2019. Materials and methods This is a retrospective study including public data obtained from the 2011, 2015, and 2019 ESPEN congresses. The primary endpoint was the percentage of women speakers in major oral sessions (oral communications and specific conferences including prestigious lectures). The secondary endpoints were the proportion of women in other high-visibility positions (moderators, industry-led symposia interventions) and countries of origin. Results The proportion of women speakers in oral communications remained stable between 2011 and 2019 [43% (43/100) vs. 41% (46/111), respectively; p = 0.89]. The proportion of women moderators in oral communications sessions significantly increased between 2011 and 2019 [13% (6/45) vs. 41% (19/46), respectively; p = 0.004]. The percentage of women speakers and moderators in industry-led symposia significantly increased between 2011 and 2019 [11% (2/18) vs. 41% (11/27), p = 0.05; 0% (0/6) vs. 60% (6/10), p = 0.03, respectively]. The percentage of women moderators in educational sessions also remained stable during the period with a marked under-representation of women in 2015. During all three congresses, women from the host countries were over-represented as moderators compared to women from other countries. Conclusion The percentage of women speakers in oral communications remained stable in the last 8 years at ESPEN congresses, although women’s representation in other high-visibility positions has increased. As men remained over-represented, women should be more encouraged to promote their academic work in the field of clinical nutrition, particularly during this international congress

Épidémiologie, facteurs et complications associée à l’utilisation de noradrénaline en chirurgie cardiaque avec circulation extracorporelle : une étude observationnelle française multicentrique et prospective

International audienceBackgroundThe present study was designed to describe the prevalence of norepinephrine use, the factors associated with its use, and the incidence of postoperative complications according to norepinephrine use, in patients undergoing cardiac surgery with cardiopulmonary bypass.MethodWe performed a prospective, multicenter, observational study in 4 University-affiliated medico-surgical cardiovascular units. We analyzed all patients treated with cardiac surgery after excluding pre-ECMO surgery, LVAD implantation, heart transplantation and intraoperative hemorrhage.ResultsOf 9316 patients screened during the study period, 2862 were included and 2510 were analyzed. Among them, 1549 (61%) were treated with norepinephrine with a median maximal dose of 0.11 [0.06–0.2] μg/kg/min–1 and a median duration of 10 h [2–24]. Norepinephrine was most often started in the operating room before cardiopulmonary bypass. The multiple regression logistic analysis identified several modifiable (haematocrit, maintenance of beta-blocker, cardiopulmonary bypass time, glucose-insulin-potassium, Custodiol cardioplegia, Delnido cardioplegia, and fibrinogen transfusion) and non-modifiable factors (age, ASA score, chronic high blood pressure, coronary disease, dyslipidemia, right ventricular dysfunction, left ventricular dysfunction, active endocarditis, and valvular aortic surgery) associated with norepinephrine use. Mortality, morbidity (neurological and renal complications, death) and length of stay in the ICU were higher in patients treated with norepinephrine.ConclusionNorepinephrine is often used in cardiac surgical patients but for < 24 h with a low dose. Many preoperative and surgical factors are associated with norepinephrine use. Patients supported by norepinephrine have a higher incidence of major postoperative events.ContexteL’objectif de cette étude était de décrire la prévalence de l’utilisation de la noradrénaline, les facteurs associés à son utilisation, et l’incidence des complications postopératoires en fonction de son utilisation ou non, chez les patients opérés d’une chirurgie cardiaque avec circulation extracorporelle (CEC).MéthodeNous avons réalisé une étude prospective, multicentrique et observationnelle dans 4 unités médicochirurgicales cardiovasculaires de CHU. Nous avons analysé tous les patients de chirurgie cardiaque après avoir exclu les patients avec une ECMO avant la chirurgie, l’implantation d’un LVAD (définir), la transplantation cardiaque et l’hémorragie peropératoire.RésultatsSur les 9316 patients éligibles pendant la période de l’étude, 2862 ont été inclus et 2510 ont été analysés. La noradrénaline a été utilisée chez 1549 (61 %) patients avec une dose maximale médiane de 0,11 (0,06–0,2) μg/kg–1 min–1 et une durée médiane de 10 heures (2–24). La noradrénaline a le plus souvent été administrée au bloc opératoire, avant la CEC. L’analyse par régression logistique multiple a identifié plusieurs facteurs modifiables (hématocrite, maintien du bêta-bloquant, durée de CEC, glucose-insuline-potassium, la cardioplégie Custodiol, la cardioplégie Delnido et la transfusion de fibrinogène) et non modifiables (âge, score ASA, hypertension artérielle chronique, maladie coronarienne, dyslipidémie, insuffisance cardiaque droite, insuffisance cardiaque gauche, endocardite active et chirurgie valvulaire aortique) associés à l’utilisation de la noradrénaline. La mortalité, la morbidité (complications neurologiques et rénales, décès) et la durée du séjour en unité de soins intensifs étaient plus élevées chez les patients traités par noradrénaline.ConclusionLa noradrénaline est souvent utilisée chez les patients en chirurgie cardiaque, mais à faible dose pendant moins de 24 heures. De nombreux facteurs préopératoires et chirurgicaux sont associés à l’utilisation de la noradrénaline. Les patients traités par noradrénaline présentaient une incidence plus élevée d’événements postopératoires majeurs

Epidemiology, risk factors and outcomes of norepinephrine use in cardiac surgery with cardiopulmonary bypass: a multicentric prospective study

Background: The present study was designed to describe the prevalence of norepinephrine use, the factors associated with its use, and the incidence of postoperative complications according to norepinephrine use, in patients undergoing cardiac surgery with cardiopulmonary bypass.Method: We performed a prospective, multicenter, observational study in 4 University-affiliated medico-surgical cardiovascular units. We analyzed all patients treated with cardiac surgery after excluding pre-ECMO surgery, LVAD implantation, heart transplantation and intra-operative hemorrhage.Results: Of 9316 patients screened during the study period, 2862 were included and 2510 were analyzed. Among them, 1549 (61%) were treated with norepinephrine with a median maximal dose of 0.11 [0.06-0.2] µg. kg-1. min-1 and a median duration of 10 hours 2-24. Norepinephrine was most often started in the operating room before cardiopulmonary bypass. The multiple regression logistic analysis identified several modifiable (haematocrit, maintenance of beta-blocker, cardiopulmonary bypass time, glucose-insulin-potassium, Custodiol cardioplegia, Delnido cardioplegia, and fibrinogen transfusion) and non-modifiable factors (age, ASA score, chronic high blood pressure, coronary disease, dyslipidemia, right ventricular dysfunction, left ventricular dysfunction, active endocarditis, and valvular aortic surgery) associated with norepinephrine use. Mortality, morbidity (neurological and renal complications, death) and length of stay in the ICU were higher in patients treated with norepinephrine.Conclusion: Norepinephrine is often used in cardiac surgical patients but for less than 24 hours with a low dose. Many preoperative and surgical factors are associated with norepinephrine use. Patients supported by norepinephrine have a higher incidence of major postoperative events

Epidemiology, risk factors and outcomes of norepinephrine use in cardiac surgery with cardiopulmonary bypass: a multicentric prospective study

Background: The present study was designed to describe the prevalence of norepinephrine use, the factors associated with its use, and the incidence of postoperative complications according to norepinephrine use, in patients undergoing cardiac surgery with cardiopulmonary bypass.Method: We performed a prospective, multicenter, observational study in 4 University-affiliated medico-surgical cardiovascular units. We analyzed all patients treated with cardiac surgery after excluding pre-ECMO surgery, LVAD implantation, heart transplantation and intra-operative hemorrhage.Results: Of 9316 patients screened during the study period, 2862 were included and 2510 were analyzed. Among them, 1549 (61%) were treated with norepinephrine with a median maximal dose of 0.11 [0.06-0.2] µg. kg-1. min-1 and a median duration of 10 hours 2-24. Norepinephrine was most often started in the operating room before cardiopulmonary bypass. The multiple regression logistic analysis identified several modifiable (haematocrit, maintenance of beta-blocker, cardiopulmonary bypass time, glucose-insulin-potassium, Custodiol cardioplegia, Delnido cardioplegia, and fibrinogen transfusion) and non-modifiable factors (age, ASA score, chronic high blood pressure, coronary disease, dyslipidemia, right ventricular dysfunction, left ventricular dysfunction, active endocarditis, and valvular aortic surgery) associated with norepinephrine use. Mortality, morbidity (neurological and renal complications, death) and length of stay in the ICU were higher in patients treated with norepinephrine.Conclusion: Norepinephrine is often used in cardiac surgical patients but for less than 24 hours with a low dose. Many preoperative and surgical factors are associated with norepinephrine use. Patients supported by norepinephrine have a higher incidence of major postoperative events

Low versus standard calorie and protein feeding in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group trial (NUTRIREA-3)

International audienc