Effect of continuous versus intermittent subglottic suctioning on tracheal mucosa by the mallinckrodt taperguard evac oral tracheal tube in intensive care unit ventilated patients A prospective randomized study

International audienceBackground and Aims: A risk of tracheal mucosa injury induced by subglottic suctioning has been raised. Therefore, this prospective randomized study aims to compare the effect of continuous suctioning of subglottic secretions versus intermittent suctioning of subglottic secretions (CSSS vs. ISSS) secretions on tracheal mucosa in front of the suctioning port of the endotracheal tube.Patients and Methods: Patients requiring intubation or reintubation in Intensive Care Unit with an expected ventilation duration > 24 h were eligible. Participants received CSSS at -20 mmHg or ISSS at -100 mmHg during 15 s and no suction during 8 s. The effect on tracheal mucosa in front of the suction port was assessed after intubation (T0) and before extubation (T1) using bronchoscopy. Tracheal mucosa damages were graded into five categories (no injury, erythema, edema, ulceration, or necrosis). The occurrence (no injury observed at T0 but present at T1) or the worsening (injury observed at T0 exacerbating at T1) was studied.Results: Seventy-three patients were included and 53 patients (CSSS, n = 26 and ISSS, n = 27) were evaluable on the primary endpoint. The occurrence or worsening of tracheal mucosal damages did not differ between the two groups (CSSS, n = 7 [27%] vs. ISSS, n = 5 [17%], P = 0.465). Daily average volume of suctioned secretion was higher with ISSS (74 ± 100 ml vs. 20 ± 25 ml, P < 0.001). Impossibility to aspirate was higher with CSSS (0.14 ± 0.16 per day vs. 0.03 ± 0.07 per day, P < 0.001).Conclusions: Our results suggest that tracheal mucosal damages did not differ between CSSS and ISSS. The aspirated volume was higher and impossibility to aspirate was lower with ISSS.Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT01555229

Studying the function of mitochondrial ING2, a tumor suppressor protein frequently lost in non-small cell lung cancer

PosterInternational audienc

Sécurité et efficacité de l’immunothérapie selon un schéma double dose dans le CBNPC avancé : étude rétrospective multicentrique IDEE

National audienceAu cours de la pandémie COVID-19, l’utilisation du pembrolizumab à 400 mg toutes les 6 semaines et Nivolumab 480 4 a été proposée pour limiter venues patients porteurs d’un CBNPC avancé. Cette proposition reposait uniquement sur des données pharmacocinétique pharmacodynamie compatible. L’étude IDEE objectif principal déterminer sécurité l’efficacité ce schéma thérapeutique en condition vie réelle. Nous avons réalisé une étude observationnelle, rétrospective, multicentrique dans centres hospitaliers bretons. Tous atteints avancé ayant reçu au moins dose adaptée entre le 1er mars 2020 2021 ont inclus l’étude. Le suivi effectué jusqu’en 2022. Les cliniques recueillies partir dossiers médicaux. Quatre-vingt-onze l’étude (38 nivolumab semaines, 53 semaines). L’âge médian l’inclusion était 68 ans. La plupart avaient un stade IV (n = 7