Constipation is independently associated with delirium in critically ill ventilated patients

International audienceDelirium is a central nervous system (CNS) dysfunction reported in up to 80 % of intensive care unit (ICU) patients associated with negative short- and long-term outcomes [1, 2]. Gastrointestinal motility disorders are frequent in ICU patients leading to frequent delayed passage of stools [3]. Because there is a bi-directional communication between the CNS and the digestive tract [4], we believed it relevant to test the hypothesis that constipation and delirium are related in ICU patients

Year in review in Intensive Care Medicine 2010: III. ARDS and ALI, mechanical ventilation, noninvasive ventilation, weaning, endotracheal intubation, lung ultrasound and paediatrics

SCOPUS: re.jinfo:eu-repo/semantics/publishe

Lettere al Duca di Valentinois

Il volume raccoglie quattro lettere e un telegramma inediti conservati negli archivi del Principato di Monaco e inviati nell'estate e autunno 1920 dal quarantanovenne Proust al giovane Pierre de Polignac, che nel marzo di quell'anno aveva sposato la principessa Charlotte de Monaco, divenendo così duca di Valentinois. Nella più lunga delle quattro lettere Proust offre al duca qualche consiglio letterario e gli chiede di sottoscrivere un'edizione di lusso del volume "All'ombra delle fanciulle in fiore". Come spiega Jean-Marc Quaranta nel saggio che segue le lettere (il volume è integrato da una lettera a Montesquiou già pubblicata), lo scambio epistolare, governato da un tortuoso cerimoniale, rappresenta per lo scrittore un luogo d'invenzione romanzesca, che costringe i destinatari a faticosi esercizi di ginnastica sentimentale per assecondarne o respingerne la tentacolare invadenza. Non tutti gli interlocutori sono disposti a prestarsi a tale corvée. Tra questi il duca di Valentinois che, stanco dell'invadenza di Proust, ignora la richiesta di sottoscrizione, spingendo lo scrittore a troncare ogni relazione. A fare le spese di questa rottura sarà il conte di Nassau, personaggio della Recherete ispirato al duca di Valentinois, che diventerà oggetto di un ritratto perfidamente malevol

Lettres au duc de Valentinois

Proust was a friend of Pierre de Polignac, who in 1920 became Prince of Monaco, father of Rainier III. Their quarrel dates back to the prince's marriage and has fuelled literary legends, encouraged by Abbé Mugnier and Céleste Albaret. This collection of letters provides the key; the reality is less imaginative than the legend, but no less astonishing. The longest of these letters provides an unpublished, precise and poignant autobiographical account of the slow coming to light of the writer Marcel Proust.Proust a été l’ami de Pierre de Polignac, devenu en 1920 prince de Monaco, père de Rainier III. Leur brouille remonte au mariage du prince et a alimenté les légendes littéraires, encouragées par l’abbé Mugnier et Céleste Albaret. Cet ensemble de lettres permet d’en donner la clé ; la réalité se révèle moins imaginative que la légende, mais non moins étonnante. La plus longue de ces lettres livre un récit autobiographique inédit, précis et poignant de la lente venue au jour de l’écrivain Marcel Proust

Intensive care medical procedures are more complicated, more stressful, and less comfortable with Ebola personal protective equipment: A simulation study

International audienceEbola virus disease (EVD) is a life-threatening condition. Appropriate management of organ failure, hemodynamic instability, and metabolic disorders significantly improves survival. This implies that life-saving procedures are undertaken in case of need, including endotracheal intubation, nasogastric tube placement and central venous catheter (CVC) insertion. The challenge is to provide high quality of care to patients with life-threatening EVD, under optimal safety conditions for health care workers, i.e. with reinforced personal protective equipment (PPE), ensuring that no exposure to patient blood or any other body fluid occur.1, 2 and 3 We assessed the impact of Ebola PPE use on the performance of senior ICU physicians during common intensive care unit (ICU) procedures, and on the workload, in a simulation environment..

Doppler sonography of cerebral blood flow for early prognostication after out-of-hospital cardiac arrest DOTAC study

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Herpes simplex virus and cytomegalovirus reactivations among severe COVID-19 patients

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Respiratory Influenza viral load as a marker of poor prognosis in patients with severe symptoms

International audienceBACKGROUND: The link between influenza virus (IV) viral load (VL) in respiratory samples and disease severity is not clearly established. This study was designed to assess IV-VL in respiratory samples from flu patients admitted to intensive care unit (ICU). METHODS: Patients admitted to ICU for IV infection, as documented by RT-PCR, with respiratory failure were included in the study during 5 flu-seasons (2014-2018). Routine ICU management parameters were recorded. Real-time amplification Ct-values for IV and cell GAPDH gene were measured in each respiratory sample collected at ICU admission. RESULTS: Among 105 included patients, 59 (56.1%) presented an acute respiratory distress syndrome (ARDS). The overall mortality was 21%. IV-load assessed by amplification Ct-values and virus-over-cell ratio (expressed as log(10)) in each respiratory sample ranged from 20 to 40 and -5.2-3.7, respectively, and did not differ according to the type of sample and IV-A or -B type. Cell richness was higher in samples from ARDS patients compared to non-ARDS (p = 0.0003) but no difference was noted for IV Ct-values. In ARDS-patients, IV Ct-values (p = 0.020) and the virus-per-cell ratio (p = 0.038) were significantly higher in sample from patients who eventually died compared to those who survived. These 2 parameters remain independently associated with mortality with an odd-ratio of 1.21 and 2.19, respectively (p < 0.05). CONCLUSIONS: While IV-VL does not seem to predict disease evolution in ICU flu-patients, normalized measurement of IV-VL in respiratory samples could be useful in ARDS patients to identify patients at higher risk of mortality

Herpesviridae systemic reactivations in COVID-19 associated ARDS patients

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