0000000000116006

AUTHOR

Jean-michel Constantin

showing 6 related works from this author

Pressure support ventilation + sigh in acute hypoxemic respiratory failure patients: Study protocol for a pilot randomized controlled trial, the PROT…

2018

Background Adding cyclic short sustained inflations (sigh) to assisted ventilation yields optimizes lung recruitment, decreases heterogeneity and reduces inspiratory effort in patients with acute hypoxemic respiratory failure (AHRF). These findings suggest that adding sigh to pressure support ventilation (PSV) might decrease the risk of lung injury, shorten weaning and improve clinical outcomes. Thus, we conceived a pilot trial to test the feasibility of adding sigh to PSV (the PROTECTION study). Methods PROTECTION is an international randomized controlled trial that will be conducted in 23 intensive care units (ICUs). Patients with AHRF who have been intubated from 24 h to 7 days and under…

procedurePressure supportTime Factorsgenetic structuresbreathingmedicine.medical_treatmentMedicine (miscellaneous)Pilot Projects[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tractintensive care unitlaw.inventionPositive-Pressure RespirationStudy Protocol0302 clinical medicineMechanical ventilationRandomized controlled triallawtime factorClinical endpointpatient safetyMulticenter Studies as TopicPharmacology (medical)030212 general & internal medicinerandomized controlled trial (topic)Intervention study; Mechanical ventilation; Positive-pressure ventilation; Pressure support; Recruitment; Sigh; Ventilator-induced lung injury; Weaning; Feasibility Studies; Humans; Hypoxia; Intubation Intratracheal; Lung; Multicenter Studies as Topic; Pilot Projects; Positive-Pressure Respiration; Recovery of Function; Respiratory Insufficiency; Time Factors; Treatment Outcome; Randomized Controlled Trials as Topic; Medicine (miscellaneous); Pharmacology (medical)HypoxiaLungpathophysiologyendotracheal intubationRandomized Controlled Trials as TopicVentilator-induced lung injurylcsh:R5-920Intervention studyadultpilot studyfeasibility studytreatment outcome Feasibility Studie3. Good healthTreatment OutcomeAnesthesiapositive end expiratory pressureBreathingmulticenter study (topic)oxygenationRecruitmentlcsh:Medicine (General)Respiratory Insufficiencyrespiratory tract intubationcirculatory and respiratory physiologyHumanextubationPressure support ventilationWeaningLung injuryArticleSpontaneous breathing trialNO03 medical and health sciencesIntensive care[SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO]medicineIntubation IntratrachealHumanscontrolled studyPilot ProjectSightreatment failureMechanical ventilationhypoxemiapressure support ventilationtreatment durationbusiness.industrylung inflationrespiratory failureconvalescenceRecovery of Functionmajor clinical studymortalitywater acute respiratory failurehospital dischargeIntratracheal030228 respiratory systemrandomized controlled trialFeasibility StudiesbusinessPositive-pressure ventilationIntubationclinical protocol
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Sigh in Patients With Acute Hypoxemic Respiratory Failure and ARDS

2021

Background Sigh is a cyclic brief recruitment maneuver: previous physiologic studies showed that its use could be an interesting addition to pressure support ventilation to improve lung elastance, decrease regional heterogeneity, and increase release of surfactant. Research Question Is the clinical application of sigh during pressure support ventilation (PSV) feasible? Study Design and Methods We conducted a multicenter noninferiority randomized clinical trial on adult intubated patients with acute hypoxemic respiratory failure or ARDS undergoing PSV. Patients were randomized to the no-sigh group and treated by PSV alone, or to the sigh group, treated by PSV plus sigh (increase in airway pr…

Pulmonary and Respiratory MedicineARDSbusiness.industryPressure support ventilationCritical Care and Intensive Care Medicinemedicine.diseaseSpontaneous breathing triallaw.invention03 medical and health sciences0302 clinical medicine030228 respiratory systemRandomized controlled triallawAnesthesiaBreathingMedicine030212 general & internal medicineCardiology and Cardiovascular MedicinebusinessRespiratory minute volumePositive end-expiratory pressureTidal volumeChest
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Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients From 29 Countries

2021

Importance: Tracheal intubation is one of the most commonly performed and high-risk interventions in critically ill patients. Limited information is available on adverse peri-intubation events. Objective: To evaluate the incidence and nature of adverse peri-intubation events and to assess current practice of intubation in critically ill patients. Design, Setting, and Participants: The International Observational Study to Understand the Impact and Best Practices of Airway Management in Critically Ill Patients (INTUBE) study was an international, multicenter, prospective cohort study involving consecutive critically ill patients undergoing tracheal intubation in the intensive care units (ICUs…

Malemedicine.medical_specialtyCritical Illnessmedicine.medical_treatmentAged; Critical Illness; Female; Heart Arrest; Humans; Hypotension; Hypoxia; Intensive Care Units; Intubation Intratracheal; Logistic Models; Male; Medical Errors; Middle Aged; Prospective Studies; Respiration Artificial; Respiratory Insufficiency; Vasoconstrictor Agents01 natural sciencesNOtracheal intubation ; adverse peri-intubation events03 medical and health sciences0302 clinical medicineInterquartile rangeIntensive careSettore MED/41 - ANESTESIOLOGIAIntubation IntratrachealHumansVasoconstrictor AgentsMedicineIntubationIntubation Critical CareProspective Studies030212 general & internal medicine0101 mathematics610 Medicine & healthHypoxiaProspective cohort studyAgedMedical Errorsbusiness.industryRespiration010102 general mathematicsTracheal intubationGeneral MedicineMiddle AgedRespiration ArtificialHeart ArrestIntratrachealIntensive Care UnitsIntubation procedureLogistic ModelsRespiratory failureArtificialEmergency medicineFemaleAirway managementHypotensionIntubationRespiratory Insufficiencybusiness
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Noninvasive respiratory support in the hypoxaemic peri-operative/periprocedural patient: A joint ESA/ESICM guideline.

2020

Hypoxaemia is a potential life-threatening yet common complication in the peri-operative and periprocedural patient (e.g. during an invasive procedure at risk of deterioration of gas exchange, such as bronchoscopy). The European Society of Anaesthesiology (ESA) and the European Society of Intensive Care Medicine (ESICM) developed guidelines for the use of noninvasive respiratory support techniques in the hypoxaemic patient in the peri-operative and periprocedural period. The panel outlined five clinical questions regarding treatment with noninvasive respiratory support techniques [conventional oxygen therapy (COT), high flow nasal cannula, noninvasive positive pressure ventilation (NIPPV) a…

Peri-operativePeriproceduralmedicine.medical_treatment[SDV]Life Sciences [q-bio]Critical Care and Intensive Care Medicinemedicine.disease_causeConference Report and Expert Panel0302 clinical medicine030202 anesthesiology[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseasesAnesthesiologyOxygen therapyMedicineContinuous positive airway pressureHypoxiaComputingMilieux_MISCELLANEOUS[SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology[SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system3. Good health[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseasesRespiratory InsufficiencyNasal cannulaHFNT[SDV.MP.PAR] Life Sciences [q-bio]/Microbiology and Parasitology/ParasitologyAdultmedicine.medical_specialtyCritical Care03 medical and health sciences[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular systemAnesthesiologyIntensive careHumans[SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/ParasitologyhypoxemiaNoninvasive Ventilationbusiness.industryOxygen Inhalation Therapy030208 emergency & critical care medicineEvidence-based medicineGuidelinePerioperative[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/BacteriologyVentilationNIV CPAPAnesthesiology and Pain Medicine030228 respiratory systemRespiratory failureEmergency medicine[SDV.MP.BAC] Life Sciences [q-bio]/Microbiology and Parasitology/BacteriologybusinessHypoxaemiaHypoxaemia; Peri-operative; Periprocedural; VentilationEuropean journal of anaesthesiology
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Personalised mechanical ventilation tailored to lung morphology versus low positive end-expiratory pressure for patients with acute respiratory distr…

2019

The effect of personalised mechanical ventilation on clinical outcomes in patients with acute respiratory distress syndrome (ARDS) remains uncertain and needs to be evaluated. We aimed to test whether a mechanical ventilation strategy that was personalised to individual patients' lung morphology would improve the survival of patients with ARDS when compared with standard of care.We designed a multicentre, single-blind, stratified, parallel-group, randomised controlled trial enrolling patients with moderate-to-severe ARDS in 20 university or non-university intensive care units in France. Patients older than 18 years with early ARDS for less than 12 h were randomly assigned (1:1) to either th…

Pulmonary and Respiratory MedicineMalemedicine.medical_specialtyARDSmedicine.medical_treatment[SDV]Life Sciences [q-bio]law.inventionPositive-Pressure Respiration03 medical and health sciences0302 clinical medicineRandomized controlled triallawInternal medicineFraction of inspired oxygenIntensive caremedicineProne PositionTidal VolumeHumansSingle-Blind Method030212 general & internal medicineProspective StudiesPrecision MedicineLungPositive end-expiratory pressureTidal volumeComputingMilieux_MISCELLANEOUSProportional Hazards ModelsMechanical ventilationRespiratory Distress Syndromebusiness.industryHazard ratioMiddle Agedmedicine.diseaseRespiration Artificial3. Good health[SDV] Life Sciences [q-bio]Intensive Care UnitsEditorial CommentaryTreatment Outcome030228 respiratory systemFemaleFrancebusiness
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Additional file 1: of Pressure support ventilation + sigh in acute hypoxemic respiratory failure patients: study protocol for a pilot randomized cont…

2018

SPIRIT 2013 checklist: Recommended items to address in a clinical trial protocol and related documents. (DOC 121 kb)

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