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Bahloul M, Kharrat S, Bouchaala K, Chtara K, Bouaziz M. Takotsubo cardiomyopathy following scorpion envenomation: a literature review. Am J Cardiovasc Dis 2023; 13:354-362. [PMID: 38205067 PMCID: PMC10774618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/10/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Takotsubo syndrome is comparable to microvascular acute coronary syndrome. It may partly share the same pathophysiology debated during scorpion envenomation (SE), with an adrenergic storm, without myocardial infarction due to the absence of coronary artery stenosis. Takotsubo cardiomyopathy can help to better understand the pathophysiology of cardiac involvement during scorpion envenomation. However, Takotsubo syndrome seems to be underestimated in the literature in patients suffering from cardiac failure following SE. METHODS In this review, we aimed to detail all described cases, the mechanism, and outcomes of scorpion envenomation complicated by Takotsubo cardiomyopathy. We used the PubMed database by using the following keywords in MeSH research: scorpion envenomation, Takotsubo cardiomyopathy, and Takotsubo syndrome. RESULTS The literature analysis showed the existence of only four cases of confirmed Takotsubo cardiomyopathy following severe SE. All four patients developed a transient reversible left ventricular systolic dysfunction in the absence of coronary artery disease, following a positive history of scorpion envenomation. A cardiac MRI was performed in all cases, showing a ballooning in the left ventricle associated with a left ventricular ejection fraction in all cases. All patients were improved under symptomatic treatment, and complete recovery of the wall motion was observed. CONCLUSION Takotsubo syndrome, although not often reported in the literature in severe SE, can represent an effective hypothesis explaining the pathophysiology of cardiac involvement during SE. In severe scorpion envenomation, multiple mechanisms exist and can explain the development of Takotsubo syndrome. Its management is based on oxygen, with invasive or non-invasive ventilator support in patients with respiratory failure and/or cardiogenic shock. Beta-blockers, mineralocorticoid receptor antagonists, and diuretics are usually used in Takotsubo syndrome. However, in severe scorpion envenomation, all reported cases of Takotsubo cardiomyopathy are associated with cardiogenic shock and acute pulmonary edema. As a consequence, we advise the use of Dobutamine since it has already been confirmed that cardiac dysfunction following scorpion envenomation improves well and safely under Dobutamine infusion.
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Affiliation(s)
- Mabrouk Bahloul
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University Sfax, Tunisia
| | - Sana Kharrat
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University Sfax, Tunisia
| | - Karama Bouchaala
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University Sfax, Tunisia
| | - Kamilia Chtara
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University Sfax, Tunisia
| | - Mounir Bouaziz
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University Sfax, Tunisia
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Elloumi N, Bahloul M, Benabdallah E, Kharrat S, Fakhfakh R, Bouchaala K, Abida O, Chtara K, Masmoudi H, Bouaziz M. Genes regulating oxidative-inflammatory response in circulating monocytes and neutrophils in septic syndrome. Biol Futur 2023; 74:199-207. [PMID: 37291472 DOI: 10.1007/s42977-023-00168-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 05/13/2023] [Indexed: 06/10/2023]
Abstract
Despite significant progress in the past decades, sepsis still lacks a specific treatment. Under normal conditions, leucocytes play a critical role in controlling infection and it is suggested that their activity is impaired during sepsis which contribute to the dysregulation of immune reactions. Indeed, in response to infection, several intracellular pathways are affected mainly those regulating the oxidative- inflammatory axis. Herein, we focused on the contribution of NF-kB, iNOS, Nrf2, HO-1 and MPO genes in the pathophysiology of septic syndrome, by analyzing the differential expression of their transcripts in circulating monocytes and neutrophils, and monitoring the nitrosative/oxidative status in septic syndrome patients. Circulating neutrophils of septic patients displayed a significant overexpression of NF-kB compared to other groups. In monocytes, patients with septic shock expressed the highest levels of iNOS and NF-kB mRNA. However, genes involved in cytoprotective response had increased expression in patients with sepsis, in particular, the Nrf2 and its target gene HO-1. Moreover, patient monitoring indicates that the iNOS enzyme expression and NO plasma levels may play a role in assessing the severity of septic conditions. Overall, in either monocytes or neutrophils, we pointed out the major role of NF-κB and Nrf2 in the pathophysiological process. Therefore, therapies targeted to redox abnormalities may be useful for better management of septic patients.
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Affiliation(s)
- Nesrine Elloumi
- Research Laboratory LR18/SP12 Auto-Immunity, Cancer and Immunogenetics, Immunology Department, Habib Bourguiba University Hospital, University of Sfax, 3029, Sfax, Tunisia.
| | - Mabrouk Bahloul
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Emna Benabdallah
- Research Laboratory LR18/SP12 Auto-Immunity, Cancer and Immunogenetics, Immunology Department, Habib Bourguiba University Hospital, University of Sfax, 3029, Sfax, Tunisia
| | - Sana Kharrat
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Raouia Fakhfakh
- Research Laboratory LR18/SP12 Auto-Immunity, Cancer and Immunogenetics, Immunology Department, Habib Bourguiba University Hospital, University of Sfax, 3029, Sfax, Tunisia
| | - Karama Bouchaala
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Olfa Abida
- Research Laboratory LR18/SP12 Auto-Immunity, Cancer and Immunogenetics, Immunology Department, Habib Bourguiba University Hospital, University of Sfax, 3029, Sfax, Tunisia
| | - Kamilia Chtara
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Hatem Masmoudi
- Research Laboratory LR18/SP12 Auto-Immunity, Cancer and Immunogenetics, Immunology Department, Habib Bourguiba University Hospital, University of Sfax, 3029, Sfax, Tunisia
| | - Mounir Bouaziz
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
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Fereidooni R, Shirzadi S, Ayatizadeh SH, Bahloul M, Tavangar A, Zomorodian SA, Roshanshad A, Ardekani A. Scorpion envenomation-associated myocarditis: A systematic review. PLoS Negl Trop Dis 2023; 17:e0011219. [PMID: 37018229 PMCID: PMC10075437 DOI: 10.1371/journal.pntd.0011219] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/06/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Scorpion envenomation is associated with several complications. One of the most serious complications is the cardiac involvement in the form of myocarditis that remains the main reason for mortalities associated with scorpion envenomation. The present review aims to elucidate clinical and paraclinical findings associated with scorpion-related myocarditis, and to explore different management strategies and subsequent outcomes. METHODS We searched PubMed, Web of Science, Scopus, and Google Scholar for articles related to keywords of myocarditis associated with scorpion envenomation up to May 1, 2022. Each article was carefully reviewed by two independent researchers. In case of disagreement for inclusion, we sought a third researcher opinion. RESULTS A total of 703 cases from 30 case reports and 34 case series were included in our review. Myocarditis associated with scorpion envenomation was usually reported in children presenting with cardiopulmonary symptoms including pulmonary edema (60.7%) and shock or hypotension (45.8%). The most common ECG findings are sinus tachycardia (82%) followed by ST-T changes (64.6%). The management typically included inotropes (especially dobutamine), prazosin, diuretics, nitroglycerine and digoxin, when indicated. Mechanical ventilation was required in 36.7% of the patients. Mortality in confirmed scorpion-related myocarditis cases is estimated at 7.3%. Almost all survived cases showed rapid recovery and improvement in the left ventricular function. CONCLUSION Even though myocarditis associated with scorpion envenomation is rare, it remains a serious and in some of cases a fatal consequence of scorpion sting. In case of relative presentations, particularly in envenomed children, diagnosis of myocarditis should be considered. Early screening using serial cardiac markers and echocardiography can guide the treatment. Prompt treatment that focuses on cardiogenic shock and pulmonary edema usually results in a favorable outcome.
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Affiliation(s)
- Reza Fereidooni
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saeedreza Shirzadi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mabrouk Bahloul
- Department of Intensive Care, Habib Bourguiba University Hospital. Faculté de medicine de Sfax. Sfax University. Sfax, Tunisia
| | - Amirali Tavangar
- Digestive Health Institute, University of California, Irvine Medical Center, Orange, California, United States of America
| | | | | | - Ali Ardekani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Bahloul M, Makni A, Kharrat S, Alila I, Suissi B, Bouaziz M. A possible cause of cholesterol crystal embolism in a polytrauma patient? J Med Vasc 2023; 48:88-90. [PMID: 37422333 DOI: 10.1016/j.jdmv.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 06/09/2023] [Indexed: 07/10/2023]
Affiliation(s)
- M Bahloul
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia.
| | - A Makni
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - S Kharrat
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - I Alila
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - B Suissi
- Department of Radiology, Habib Bourguiba Hospital, Sfax University, Sfax, Tunisia
| | - M Bouaziz
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
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Chtara K, Bradai S, Baccouche N, Toumi N, Amar WB, Chelly H, Bahloul M, Bouaziz M. Post-traumatic cerebral venous sinus thrombosis in an intensive care unit: A case series of ten patients. J Med Vasc 2023; 48:62-68. [PMID: 37422329 DOI: 10.1016/j.jdmv.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 03/23/2023] [Indexed: 07/10/2023]
Abstract
Post-traumatic cerebral venous sinus thrombosis is one of the several causes of cerebral venous thrombosis, but its early diagnosis and management are still difficult in this traumatic context. Our objective is to describe clinical and radiological presentations and to report specific management and outcomes of this rare post-traumatic complication. We reported in this manuscript a case series of 10 patients hospitalized in the intensive care department with post-traumatic cerebral venous thrombosis. Demographic, clinical, and radiological data and their medical management are reported. The incidence of post-traumatic cerebral venous sinus thrombosis in our institution was 4.2%. Cerebral thrombophlebitis was diagnosed incidentally on the initial body scan, on ICU admission in five patients. The left or right lateral sinus was affected in four patients; the sigmoid sinus was affected in 6 patients. Five patients had a thrombosis in the jugular vein. Seven patients had 2 or 3 sites of occlusion. All patients had medical treatment. No hemorrhagic complications were reported. The total duration of anticoagulation was available in 5 cases. A follow-up of MRI or CT scan at 3 months revealed complete sinus recanalization in three patients. Post-traumatic cerebral venous sinus thrombosis in the intensive care department remains underdiagnosed because of the common clinical presentation of traumatic brain injury. Its incidence is increasing because of the increase in high-velocity accidents. And, it seems necessary to conduct prospective studies with a large cohort of patients in the intensive care department.
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Affiliation(s)
- Kamilia Chtara
- Department of Intensive Care, Habib-Bourguiba University Hospital, University of Sfax, 3029 Sfax, Tunisia.
| | - Sabrine Bradai
- Department of Intensive Care, Habib-Bourguiba University Hospital, University of Sfax, 3029 Sfax, Tunisia
| | - Najeh Baccouche
- Department of Intensive Care, Habib-Bourguiba University Hospital, University of Sfax, 3029 Sfax, Tunisia
| | - Nozha Toumi
- Department of Radiology, Habib-Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Wiem Ben Amar
- Department of Forensic Medicine, Habib-Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Hedi Chelly
- Department of Intensive Care, Habib-Bourguiba University Hospital, University of Sfax, 3029 Sfax, Tunisia
| | - Mabrouk Bahloul
- Department of Intensive Care, Habib-Bourguiba University Hospital, University of Sfax, 3029 Sfax, Tunisia
| | - Mounir Bouaziz
- Department of Intensive Care, Habib-Bourguiba University Hospital, University of Sfax, 3029 Sfax, Tunisia
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Bahloul M, Kharrat S, Makni S, Baccouche N, Ammar R, Eleuch A, Berrajah L, Chtourou A, Turki O, Ben Hamida C, Chelly H, Chtara K, Ayedi F, Bouaziz M. Prognostic Value of Serum Cholinesterase Activity in Severe SARS-CoV-2-Infected Patients Requiring Intensive Care Unit Admission. Am J Trop Med Hyg 2022; 107:tpmd210934. [PMID: 35895337 PMCID: PMC9490658 DOI: 10.4269/ajtmh.21-0934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 05/20/2022] [Indexed: 11/07/2022] Open
Abstract
We evaluated the prognostic value of serum cholinesterase (SChE) levels in SARS-CoV-2-infected patients requiring intensive care unit (ICU) admission. This is a retrospective study of severe, critically ill, adult COVID-19 patients, all of whom had a confirmed SARS-CoV-2 infection and were admitted into the ICU of a university hospital. We included all patients admitted to our ICU and whose SChE levels were explored on ICU admission and during ICU stay. One hundred and thirty-seven patients were included. There were 100 male and 37 female patients. The mean of SChE activity on ICU admission was 5,656 ± 1,818 UI/L (range: 1926-11,192 IU/L). The SChE activity on ICU admission was significantly lower in nonsurvivors (P < 0.001). A significant association between the SChE activity on ICU admission and the need for invasive mechanical ventilation was found. We also found a significant correlation between the SChE activity and other biomarkers of sepsis (C-reactive protein, procalcitonin, and leukocytes) on ICU admission and during the ICU stay. A significant correlation among SChE nadir value activity recorded during ICU stay, the occurrence of nosocomial infection, and the outcome of studied patients was found. Our study shows that the low SChE activity value is associated with a severe outcome. It might be used as a biomarker to aid in prognostic risk stratification in SARS-CoV-2-infected patients. Further studies for external validation of our findings are needed on this subject.
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Affiliation(s)
- Mabrouk Bahloul
- Department of Intensive Care, Habib Bourguiba University Hospital, and University of Sfax, Sfax, Tunisia
| | - Sana Kharrat
- Department of Intensive Care, Habib Bourguiba University Hospital, and University of Sfax, Sfax, Tunisia
| | - Saba Makni
- Department of Intensive Care, Habib Bourguiba University Hospital, and University of Sfax, Sfax, Tunisia
| | - Najeh Baccouche
- Department of Intensive Care, Habib Bourguiba University Hospital, and University of Sfax, Sfax, Tunisia
| | - Rania Ammar
- Department of Intensive Care, Habib Bourguiba University Hospital, and University of Sfax, Sfax, Tunisia
| | - Aida Eleuch
- Biochemistry Laboratory, Habib Bourguiba Hospital, and University of Sfax, Sfax, Tunisia
| | - Lamia Berrajah
- Laboratory of Microbiology, Habib Bourguiba University Hospital, Faculty of Medicine, University of Sfax, Sfax Tunisia
| | - Amel Chtourou
- Laboratory of Microbiology, Habib Bourguiba University Hospital, Faculty of Medicine, University of Sfax, Sfax Tunisia
| | - Olfa Turki
- Department of Intensive Care, Habib Bourguiba University Hospital, and University of Sfax, Sfax, Tunisia
| | - Chokri Ben Hamida
- Department of Intensive Care, Habib Bourguiba University Hospital, and University of Sfax, Sfax, Tunisia
| | - Hedi Chelly
- Department of Intensive Care, Habib Bourguiba University Hospital, and University of Sfax, Sfax, Tunisia
| | - Kamilia Chtara
- Department of Intensive Care, Habib Bourguiba University Hospital, and University of Sfax, Sfax, Tunisia
| | - Fatma Ayedi
- Biochemistry Laboratory, Habib Bourguiba Hospital, and University of Sfax, Sfax, Tunisia
| | - Mounir Bouaziz
- Department of Intensive Care, Habib Bourguiba University Hospital, and University of Sfax, Sfax, Tunisia
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Bahloul M, Toumi N, Chelly H, Bouaziz M. Severe corpus callosum damage due to fat embolism. Intensive Care Med 2022; 48:1088-1089. [PMID: 35678831 DOI: 10.1007/s00134-022-06755-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 05/20/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Mabrouk Bahloul
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, 3029, Sfax, Tunisia.
| | - Nozha Toumi
- Department of Radiology, Habib Bourguiba Hospital, Sfax University, Sfax, Tunisia
| | - Hedi Chelly
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, 3029, Sfax, Tunisia
| | - Mounir Bouaziz
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, 3029, Sfax, Tunisia
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Bahloul M, Bouchaala K, Baccouche N, Chtara K, Chelly H, Bouaziz M. The role of cardiac dysfunction and post-traumatic pulmonary embolism in brain-lung interactions following traumatic brain injury. Acute Crit Care 2022; 37:266-268. [PMID: 35698767 PMCID: PMC9184987 DOI: 10.4266/acc.2022.00374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/06/2022] [Indexed: 11/30/2022] Open
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Ammar R, Chelly H, Kolsi F, Smaoui M, Hamida CB, Bahloul M, Boudawara Z, Bouaziz M. Decompressive craniectomy after traumatic brain injury: An observational study of 147 patients admitted in a Tunisian ICU. Interdisciplinary Neurosurgery 2022. [DOI: 10.1016/j.inat.2021.101421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Bahloul M, Kharrat S, Chtara K, Chelly H, Hamida CB, Bouaziz M. Gravity-induced ischemia in the brain and prone positioning for COVID-19 patients breathing spontaneously: still far from the truth! Acute Crit Care 2022; 37:134-136. [PMID: 35279983 PMCID: PMC8918717 DOI: 10.4266/acc.2022.00199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 11/30/2022] Open
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Bahloul M, Kharrat S, Hafdhi M, Maalla A, Turki O, Chtara K, Ammar R, Suissi B, Hamida CB, Chelly H, Mahfoudh KB, Bouaziz M. Impact of prone position on outcomes of COVID-19 patients with spontaneous breathing. Acute Crit Care 2021; 36:208-214. [PMID: 34380290 PMCID: PMC8435443 DOI: 10.4266/acc.2021.00500] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/16/2021] [Indexed: 12/27/2022] Open
Abstract
Background In this study, we explored whether early application of the prone position (PP) can improve severe hypoxemia and respiratory failure in coronavirus disease 2019 (COVID-19) patients with spontaneous breathing. Methods This is a prospective observational study of severe, critically ill adult COVID-19 patients admitted to the intensive care unit. All vital parameters were recorded in real time for all patients. Moreover, the results of chest computed tomography (CT), when available, were analyzed. Results PP was applied in 21 patients who were breathing spontaneously. The application of PP was associated with a significant increase in oxygen saturation measured by pulse oximetry (SpO2) from 82%±12% to 96%±3% (P<0.001) 1 hour later. Moreover, PP was associated with a significant reduction in respiratory rate from 31±10 to 21±4 breaths/min (P<0.001). Furthermore, the number of patients who exhibited signs of respiratory distress after PP was reduced from 10 (47%) to 3 (14%) (P=0.04). Early PP application also led to a clear improvement on CT imaging. It was not, however, associated with a reduction in mortality rate or in the use of invasive mechanical ventilation (P>0.05 for both). Conclusions Our study confirmed that the early application of PP can improve hypoxemia and tachypnea in COVID-19 patients with spontaneous breathing. Randomized controlled trials are needed to confirm the beneficial effects of PP in COVID-19 patients with spontaneous breathing.
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Affiliation(s)
- Mabrouk Bahloul
- Department of Intensive Care, Habib Bourguiba University Hospital and Sfax University, Sfax, Tunisia
| | - Sana Kharrat
- Department of Intensive Care, Habib Bourguiba University Hospital and Sfax University, Sfax, Tunisia
| | - Malek Hafdhi
- Department of Intensive Care, Habib Bourguiba University Hospital and Sfax University, Sfax, Tunisia
| | - Anis Maalla
- Department of Radiology, Habib Bourguiba University Hospital and Sfax University, Sfax, Tunisia
| | - Olfa Turki
- Department of Intensive Care, Habib Bourguiba University Hospital and Sfax University, Sfax, Tunisia
| | - Kamilia Chtara
- Department of Intensive Care, Habib Bourguiba University Hospital and Sfax University, Sfax, Tunisia
| | - Rania Ammar
- Department of Intensive Care, Habib Bourguiba University Hospital and Sfax University, Sfax, Tunisia
| | - Basma Suissi
- Department of Radiology, Habib Bourguiba University Hospital and Sfax University, Sfax, Tunisia
| | - Chokri Ben Hamida
- Department of Intensive Care, Habib Bourguiba University Hospital and Sfax University, Sfax, Tunisia
| | - Hedi Chelly
- Department of Intensive Care, Habib Bourguiba University Hospital and Sfax University, Sfax, Tunisia
| | | | - Mounir Bouaziz
- Department of Intensive Care, Habib Bourguiba University Hospital and Sfax University, Sfax, Tunisia
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Bahloul M, Kharrat S, Chtara K, Hafdhi M, Turki O, Baccouche N, Ammar R, Kallel N, Hsairi M, Chakroun-Walha O, Hamida CB, Chelly H, Mahfoudh KB, Karoui A, Karray H, Rekik N, Bouaziz M. Clinical characteristics and outcomes of critically ill COVID-19 patients in Sfax, Tunisia. Acute Crit Care 2021; 37:84-93. [PMID: 34380191 PMCID: PMC8918704 DOI: 10.4266/acc.2021.00129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 04/11/2021] [Indexed: 12/15/2022] Open
Abstract
Background Africa, like the rest of the world, has been impacted by the coronavirus disease 2019 (COVID-19) pandemic. However, only a few studies covering this subject in Africa have been published. Methods We conducted a retrospective study of critically ill adult COVID-19 patients—all of whom had a confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection—admitted to the intensive care unit (ICU) of Habib Bourguiba University Hospital (Sfax, Tunisia). Results A total of 96 patients were admitted into our ICU for respiratory distress due to COVID-19 infection. Mean age was 62.4±12.8 years and median age was 64 years. Mean arterial oxygen tension (PaO2)/fractional inspired oxygen (FiO2) ratio was 105±60 and ≤300 in all cases but one. Oxygen support was required for all patients (100%) and invasive mechanical ventilation for 38 (40%). Prone positioning was applied in 67 patients (70%). Within the study period, 47 of the 96 patients died (49%). Multivariate analysis showed that the factors associated with poor outcome were the development of acute renal failure (odds ratio [OR], 6.7; 95% confidence interval [CI], 1.75–25.9), the use of mechanical ventilation (OR, 5.8; 95% CI, 1.54–22.0), and serum cholinesterase (SChE) activity lower than 5,000 UI/L (OR, 5.0; 95% CI, 1.34–19). Conclusions In this retrospective cohort study of critically ill patients admitted to the ICU in Sfax, Tunisia, for acute respiratory failure following COVID-19 infection, the mortality rate was high. The development of acute renal failure, the use of mechanical ventilation, and SChE activity lower than 5,000 UI/L were associated with a poor outcome.
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Affiliation(s)
- Mabrouk Bahloul
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Sana Kharrat
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Kamilia Chtara
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Malek Hafdhi
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Olfa Turki
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Najeh Baccouche
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Rania Ammar
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Nozha Kallel
- Department of Radiology, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Majdi Hsairi
- Department of Anesthesiology, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Olfa Chakroun-Walha
- Department of Emergency Medicine, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Chokri Ben Hamida
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Hedi Chelly
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | | | - Abelhamid Karoui
- Department of Anesthesiology, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Hela Karray
- Department of Microbiology, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Noureddine Rekik
- Department of Emergency Medicine, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Mounir Bouaziz
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
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Ben Jemaa A, Bahloul M, Kallel H, Turki O, Dlela M, Bouaziz M. [Inverted Takotsubo Syndrome due to Severe Scorpion Envenomation: Report of one Case]. Med Trop Sante Int 2021; 1:PWX0-M245. [PMID: 35586636 PMCID: PMC9022762 DOI: 10.48327/pwx0-m245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 12/01/2020] [Indexed: 11/17/2022]
Abstract
Scorpion envenomation (SE) is common in tropical and subtropical regions. Cardio-respiratory manifestations, mainly cardiogenic shock and pulmonary oedema are the leading causes of death after scorpion envenomation. Cardiac failure can be due to massive release of catecholamines, myocardial damage induced by the venom or myocardial ischemia. Although it has been exceptionally reported, Takotsubo syndrome during SE can help to better elucidate the pathophysiology of this cardiomyopathy. We report a case of inverted Takotsubo following a SE in a 26-year-old patient admitted to the Intensive care unit department for severe scorpion envenomation. His evolution was favorable. We concluded that cardiac involvement in this case fulfills all clinical and paraclinical criteria of Takotsubo syndrome emphasizing the importance of catecholaminergic discharge during scorpion envenomation. We discuss again the management of this syndrome in this specific condition.
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Affiliation(s)
- A. Ben Jemaa
- Département de soins intensifs, Hôpital universitaire Habib Bourguiba, 3029, Sfax, Tunisie
| | - M. Bahloul
- Faculté de Médecine de Sfax. Université de Sfax, Boulevard Majida Boulila, Sfax 3029, Tunisie,*
| | - H. Kallel
- Département de soins intensifs, Hôpital universitaire Habib Bourguiba, 3029, Sfax, Tunisie
| | - O. Turki
- Département de soins intensifs, Hôpital universitaire Habib Bourguiba, 3029, Sfax, Tunisie
| | - M. Dlela
- Département de soins intensifs, Hôpital universitaire Habib Bourguiba, 3029, Sfax, Tunisie
| | - M. Bouaziz
- Département de soins intensifs, Hôpital universitaire Habib Bourguiba, 3029, Sfax, Tunisie
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14
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Bahloul M, Dlela M, Bouchaala K, Kallel H, Ben Hamida C, Chelly H, Bouaziz M. Post-traumatic pulmonary embolism: incidence, physiopathology, risk factors of early occurrence, and impact outcome. A narrative review. Am J Cardiovasc Dis 2020; 10:432-443. [PMID: 33224594 PMCID: PMC7675152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/16/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Venous thromboembolism (VTE) is a well-established complication of trauma. So far, the factors that are related to early post-traumatic pulmonary embolism (PE) occurrence have been given little attention. AIMS We have conducted this literature review in order to analyze the incidence and the physiopathology of post-traumatic PE among intensive care unit (ICU) trauma patients, analyze the incidence of early post-traumatic PE, and elucidate risk factors associated with post-traumatic PE. Moreover, we aim to study the impact/outcome of post-traumatic PE in the ICU. METHODS We used the PubMed and EMBASE databases and entered the following key words in MeSH research: Deep vein thrombosis (DVT), Post-traumatic Pulmonary embolism, Early pulmonary-embolism, risk factors, and Prognosis. RESULTS The incidence of PE among trauma patients varies considerably, ranging from 0.35% to 24%. The incidence of early post-traumatic PE varies widely from 10 to 42%. After a traumatic injury, many factors have been found to be responsible for the formation of DVT and PE. In addition to the risk factors of hypercoagulability described by Virchow in his original triad, inflammation acting via endothelial damage may be considered as a fourth factor. The literature review showed that lower limb fractures and age are the most frequent factors associated with PE (particularly in early PE). The heterogeneity among studies limits reliable conclusions regarding the true risk factors for the timing of the occurrence of post-traumatic PE. Fatality from pulmonary embolism (PE) is close to 50% in some series. Moreover, high mortality rates, a high rate of nosocomial infections, and a prolonged stay in an ICU and/or in a hospital were found to be associated with the development of PE. CONCLUSION Post-traumatic PE is frequent in ICUs. Inflammation acting via endothelial damage may be considered as a fourth factor in addition to the Virchow's triad of risk factors for venous thrombosis. Fractures of the lower extremities, obesity, and age happen to be the most frequent factors associated with PE (in particular early PE). PE development was associated with high rates of mortality, nosocomial infections, and a prolonged stay in an ICU and/or in a hospital. Therefore, prevention is warranted.
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Affiliation(s)
- Mabrouk Bahloul
- Department of Intensive Care, Habib Bourguiba University Hospital, Faculté de Medicine de Sfax, Sfax University Sfax, Tunisia
| | - Mariem Dlela
- Department of Intensive Care, Habib Bourguiba University Hospital, Faculté de Medicine de Sfax, Sfax University Sfax, Tunisia
| | - Karama Bouchaala
- Department of Intensive Care, Habib Bourguiba University Hospital, Faculté de Medicine de Sfax, Sfax University Sfax, Tunisia
| | - Hela Kallel
- Department of Intensive Care, Habib Bourguiba University Hospital, Faculté de Medicine de Sfax, Sfax University Sfax, Tunisia
| | - Chokri Ben Hamida
- Department of Intensive Care, Habib Bourguiba University Hospital, Faculté de Medicine de Sfax, Sfax University Sfax, Tunisia
| | - Hedi Chelly
- Department of Intensive Care, Habib Bourguiba University Hospital, Faculté de Medicine de Sfax, Sfax University Sfax, Tunisia
| | - Mounir Bouaziz
- Department of Intensive Care, Habib Bourguiba University Hospital, Faculté de Medicine de Sfax, Sfax University Sfax, Tunisia
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Heni S, Ammar R, Barhoumi H, Chtara K, Bahloul M, Bouaziz M. Post-traumatic acute renal failure: The epidemiological, clinical, etiological aspects and the predictive factors for the occurrence of post-traumatic AKI. Nephrol Ther 2020. [DOI: 10.1016/j.nephro.2020.07.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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16
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Bahloul M, Dlela M, Bouchaala K, Triki A, Chelly H, Hamida CB, Haddar S, Bouaziz M. Early post-traumatic pulmonary embolism in intensive care unit: incidence, risks factors, and impact outcome. Am J Cardiovasc Dis 2020; 10:207-218. [PMID: 32923103 PMCID: PMC7486531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 08/04/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Venous thromboembolism (VTE) is a well-established complication of trauma. Recent studies suggest that pulmonary embolism (PE) may occur very early, and even immediately, after injury. The aim of this study is to analyze the incidence, risk factors and prognosis of early PE among ICU trauma patients. PATIENTS AND METHODS We conducted a twenty-month-long prospective cohort study, including all trauma patients with a confirmed PE diagnosis admitted to our ICU between January 1st, 2017 and August 31st, 2018. Early post traumatic PE was defined as pulmonary embolism diagnosed within the first 72 hrs of injury. All the patients who were included were systematically screened for early PE on day 3. RESULTS During the study period, 365 trauma patients were admitted. The diagnosis of post-traumatic PE was confirmed in 66 patients (18%). In our study, 27 patients (41.5%) developed a PE within 72 hrs of trauma. According to our analysis, the factors associated with the development of early post-traumatic PE in multivariate analysis were obesity (P=0.049; OR=4.04), high SOFA score (P=0.003; OR=1.67), and the use of surgical procedures (P=0.033; OR=4.87). Furthermore, sepsis and ventilator-acquired pneumonia were associated with late PE (P=0.019; OR=5.87). Overall, the mortality rate was at 19.7%. Yet, the patients who were diagnosed with early PE had a higher mortality rate compared to the late PE group (33% vs. 10.2%, respectively). We found that the only independent predictive factor of mortality among the patients with early post-traumatic PE included in this study was the APACHEII score on ICU admission (P=0.011; OR=1.44). CONCLUSION Our study cohort showed that many of the post-traumatic PEs occur early in the post-traumatic period. To the best of our knowledge, this is the first prospective study conducted in an ICU to apply a systematic screening protocol for post-traumatic PE diagnosis. Further studies with larger patient populations are required to create more accurate predictive models.
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Affiliation(s)
- Mabrouk Bahloul
- Department of Intensive Care, Habib Bourguiba University Hospital, Faculté de Medicine de Sfax, Sfax UniversitySfax, Tunisia
| | - Mariem Dlela
- Department of Intensive Care, Habib Bourguiba University Hospital, Faculté de Medicine de Sfax, Sfax UniversitySfax, Tunisia
| | - Karama Bouchaala
- Department of Intensive Care, Habib Bourguiba University Hospital, Faculté de Medicine de Sfax, Sfax UniversitySfax, Tunisia
| | - Amal Triki
- Department of Intensive Care, Habib Bourguiba University Hospital, Faculté de Medicine de Sfax, Sfax UniversitySfax, Tunisia
| | - Hedi Chelly
- Department of Intensive Care, Habib Bourguiba University Hospital, Faculté de Medicine de Sfax, Sfax UniversitySfax, Tunisia
| | - Chokri Ben Hamida
- Department of Intensive Care, Habib Bourguiba University Hospital, Faculté de Medicine de Sfax, Sfax UniversitySfax, Tunisia
| | - Sondes Haddar
- Department of Radiology, Habib Bourguiba University Hospital, Faculté de Medicine de Sfax, Sfax UniversitySfax, Tunisia
| | - Mounir Bouaziz
- Department of Intensive Care, Habib Bourguiba University Hospital, Faculté de Medicine de Sfax, Sfax UniversitySfax, Tunisia
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Bahloul M, Ketata W, Lahyeni D, Mayoufi H, Kotti A, Smaoui F, Kallel N, Daoud E, Bouaziz M, Kammoun S. Pulmonary capillary leak syndrome following COVID-19 virus infection. J Med Virol 2020; 93:94-96. [PMID: 32519786 PMCID: PMC7300440 DOI: 10.1002/jmv.26152] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Mabrouk Bahloul
- Department of Intensive Care, HabibBourguiba University Hospital, Faculté de medicine de sfax, Sfax University, Sfax, Tunisia
| | - Wajdi Ketata
- Department of Pneumology, Hedi Chaker University Hospital, Faculté de medicine de sfax, Sfax University, Sfax, Tunisia
| | - Dorra Lahyeni
- Department of infectious diseases, Hedi Chaker University Hospital, Faculté de medicine de sfax, Sfax University, Sfax, Tunisia
| | - Houda Mayoufi
- Department of Intensive Care, HabibBourguiba University Hospital, Faculté de medicine de sfax, Sfax University, Sfax, Tunisia
| | - Amina Kotti
- Department of Pneumology, Hedi Chaker University Hospital, Faculté de medicine de sfax, Sfax University, Sfax, Tunisia
| | - Fatma Smaoui
- Department of infectious diseases, Hedi Chaker University Hospital, Faculté de medicine de sfax, Sfax University, Sfax, Tunisia
| | - Nessrine Kallel
- Department of Pneumology, Hedi Chaker University Hospital, Faculté de medicine de sfax, Sfax University, Sfax, Tunisia
| | - Emna Daoud
- Department of Radiology, Hedi Chaker University Hospital, Faculté de medicine de sfax, Sfax University, Sfax, Tunisia
| | - Mounir Bouaziz
- Department of Intensive Care, HabibBourguiba University Hospital, Faculté de medicine de sfax, Sfax University, Sfax, Tunisia
| | - Samy Kammoun
- Department of Pneumology, Hedi Chaker University Hospital, Faculté de medicine de sfax, Sfax University, Sfax, Tunisia
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18
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Bahloul M, Bradai S, Turki O, Bouchaala K, Bouaziz N, Chelly H, Haddar S, Bouaziz M. Thromboembolic complications in patients with septic shock requiring invasive mechanical ventilation: Incidence, risk factors, and outcomes. J Anaesthesiol Clin Pharmacol 2020; 36:135-137. [PMID: 32174683 PMCID: PMC7047704 DOI: 10.4103/joacp.joacp_163_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 04/09/2019] [Accepted: 08/26/2019] [Indexed: 11/04/2022] Open
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19
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Bahloul M, Regaieg K, Dlela M, Turki O, Nouri H, Bradaii S, Ben Hamida C, Bouaziz NK, Chabchoub I, Haddar S, Chelly H, Bouaziz M. Pulmonary embolism in intensive care units: More frequent or more Known? Prospective study of 75 cases. Clin Respir J 2019; 13:513-520. [PMID: 31287237 DOI: 10.1111/crj.13053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 01/15/2019] [Accepted: 07/01/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE to evaluate the current rate of pulmonary embolism (PE) in our medico-surgical intensive care unit (ICU), to identify risk factors, and to determine the outcome of PE in ICU. METHODS We performed a prospective cohort study of consecutive patients requiring intensive care admission during a one-year period. We included, in this prospective study, all the patients with confirmed PE admitted in ICU with more than 18 years of age, and expected to stay in ICU for more than 48 hours. Only the patients who had a clinical suspicion (unexplained hypoxemia and/or shock) for PE underwent diagnostic studies. RESULTS During the study period, 842 patients were admitted in our ICU. One hundred and two patients were excluded. The diagnosis of PE was confirmed in 75 patients (10.1%). In our study, all patients (100%) had received some forms of pharmaceutical prophylaxis (PP) during ICU stay. The median time from ICU admission to diagnosis of PE was 6 days. The diagnosis of PE was made by spiral CT in 74 patients (98.7%), and by echocardiography in 1 case (1.3%). The mean ICU stay was 26.3 ± 26.5 days (median: 20 days). During their ICU stay, 73 patients (97.3%) developed one, or more, organ failure. Respiratory failure was the most observed (97.3%). Moreover, 38 patients (50.6%) developed nosocomial infections and 29 (38.6%) died. The multivariate analysis showed that the risk factors associated with mortality were the presence of shock the day of PE diagnosis and the presence of right ventricular dilatation on echocardiography. CONCLUSION Our findings confirm that subjects in the ICU are at high risk of PE, due to a high number of risk-factors. PE was associated with higher ICU mortality and a significantly higher ICU LOS. Our results invite to revise the preventive strategies of deep venous thrombosis and PE in patients requiring ICU admission.
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Affiliation(s)
- Mabrouk Bahloul
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia.,Faculté de medicine de Sfax, Sfax University, Sfax, Tunisia
| | - Kais Regaieg
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia.,Faculté de medicine de Sfax, Sfax University, Sfax, Tunisia
| | - Mariem Dlela
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia.,Faculté de medicine de Sfax, Sfax University, Sfax, Tunisia
| | - Olfa Turki
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia.,Faculté de medicine de Sfax, Sfax University, Sfax, Tunisia
| | - Hana Nouri
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia.,Faculté de medicine de Sfax, Sfax University, Sfax, Tunisia
| | - Sabrine Bradaii
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia.,Faculté de medicine de Sfax, Sfax University, Sfax, Tunisia
| | - Chokri Ben Hamida
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia.,Faculté de medicine de Sfax, Sfax University, Sfax, Tunisia
| | | | - Imen Chabchoub
- Department of Pediatrics Hedi Chaker University Hospital, Sfax University, Sfax, Tunisia
| | - Sondes Haddar
- Department of Radiology Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Hedi Chelly
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia.,Faculté de medicine de Sfax, Sfax University, Sfax, Tunisia
| | - Mounir Bouaziz
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia.,Faculté de medicine de Sfax, Sfax University, Sfax, Tunisia
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20
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Kammoun MM, Karray R, Regaieg K, Bahloul M, Bouaziz M. [An exceptional cause of peritonitis: ileal perforation due to a foreign body during reduction of an inguinal hernia]. Pan Afr Med J 2019; 31:37. [PMID: 30918563 PMCID: PMC6430839 DOI: 10.11604/pamj.2018.31.37.11758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 07/11/2018] [Indexed: 11/25/2022] Open
Abstract
La péritonite secondaire est fréquemment rapportée dans la littérature. Les causes sont multiples. Nous rapportons un cas d'une perforation iléale par une cause exceptionnelle. Il s'agit d'une perforation iléale par un corps étranger lors de la réduction d'une hernie inguinale, responsable d'une péritonite grave avec tableau de défaillance multiviscérale.
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Affiliation(s)
| | - Rim Karray
- Service de Réanimation Médicale CHU Habib Bourguiba Route El Ain, Sfax, Tunisie
| | - Kais Regaieg
- Service de Réanimation Médicale CHU Habib Bourguiba Route El Ain, Sfax, Tunisie
| | - Mabrouk Bahloul
- Service de Réanimation Médicale CHU Habib Bourguiba Route El Ain, Sfax, Tunisie
| | - Mounir Bouaziz
- Service de Réanimation Médicale CHU Habib Bourguiba Route El Ain, Sfax, Tunisie
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21
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Cheikhrouhou F, Ammar R, Bellili S, Jdidi I, Bahloul M, Ayadi A, Bouaziz M. Macrophage activation syndrome in a patient affected by Plasmodium falciparum Aeroport malaria. Tunis Med 2019; 97:379-382. [PMID: 31539098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Malaria is a worldwide problem. Infection with Plasmodium. falciparum that may cause a multi-organ-failure, especially if the diagnose wasn't at time. Macrophage activation syndrome is a clinical and biological syndrome caused by an excessive proliferation of T lymphocytes. Plasmodium falciparum infection was rarely reported as a cause of this syndrome reported in the literature. We report a case of severe airport malaria in a 62-year-old man complicated by Macrophage activation syndrome. The patient was treated with intravenous quinine for 7days, catecholamine, volume expansion, mechanical ventilation, sedation and dialysis. But the evolution was marked by a multi-organ failure leading to the death of the patient. The occurrence of airport malaria stresses the need for sensitization of clinicians for considering malaria in febrile individuals even when they have not traveled to an endemic area. Clinicians should be aware of Macrophage activation syndrome when malaria does not respond to conventional therapy, since early diagnosis and prompt treatment may dramatically reduce the mortality associated with this condition.
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22
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Bahloul M, Dlela M, Khlaf Bouaziz N, Turki O, Chelly H, Bouaziz M. Early post-traumatic pulmonary-embolism in patients requiring ICU admission: more complicated than we think! J Thorac Dis 2018; 10:S3850-S3854. [PMID: 30631496 PMCID: PMC6297454 DOI: 10.21037/jtd.2018.09.49] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 09/12/2018] [Indexed: 08/30/2023]
Affiliation(s)
- Mabrouk Bahloul
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Mariem Dlela
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
| | | | - Olfa Turki
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Hedi Chelly
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Mounir Bouaziz
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
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23
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Maaloul I, Ameur SB, Chabchoub I, Kolsi R, Bahloul M, Kamoun T, Bouaziz M, Hachicha M. Fulminant mulch pneumonitis in a previously healthy child. Arch Pediatr 2018; 25:495-496. [PMID: 30340947 DOI: 10.1016/j.arcped.2018.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 09/09/2018] [Accepted: 09/23/2018] [Indexed: 10/28/2022]
Abstract
Chronic granulomatous disease (CGD) is associated with multiple and recurrent infections. In patients with CGD, invasive pulmonary infection with aspergillus species remains the greatest cause of mortality. Acute fulminant presentations of fungal pneumonia are catastrophic. It is a medical emergency, and currently the treatment is based on association of corticosteroids and antifungal therapy. We describe the case of an 11-year-old boy, with late initial presentation of CGD, which was revealed by fulminant aspergillus pneumonia. He was successfully treated with an association of high doses of steroids and voriconazole.
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Affiliation(s)
- I Maaloul
- Department of pediatrics, Sfax Medical School, Hedi Chaker Hospital, Sfax, Tunisia.
| | - S Ben Ameur
- Department of pediatrics, Sfax Medical School, Hedi Chaker Hospital, Sfax, Tunisia
| | - I Chabchoub
- Department of pediatrics, Sfax Medical School, Hedi Chaker Hospital, Sfax, Tunisia
| | - R Kolsi
- Department of pediatrics, Sfax Medical School, Hedi Chaker Hospital, Sfax, Tunisia
| | - M Bahloul
- Intensive care unit, Sfax Medical School, Habib Bourguiba Hospital, Sfax, Tunisia
| | - T Kamoun
- Department of pediatrics, Sfax Medical School, Hedi Chaker Hospital, Sfax, Tunisia
| | - M Bouaziz
- Intensive care unit, Sfax Medical School, Habib Bourguiba Hospital, Sfax, Tunisia
| | - M Hachicha
- Department of pediatrics, Sfax Medical School, Hedi Chaker Hospital, Sfax, Tunisia
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24
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Bahloul M, Turki O, Chaari A, Bouaziz M. Incidence, mechanisms and impact outcome of hyperglycaemia in severe scorpion-envenomed patients. Ther Adv Endocrinol Metab 2018; 9:199-208. [PMID: 29977498 PMCID: PMC6022972 DOI: 10.1177/2042018818772779] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 04/03/2018] [Indexed: 12/15/2022] Open
Abstract
Hyperglycaemia is often observed in severe scorpion-envenomed patients. It is due to a severe autonomic storm with a massive release of catecholamines, increased glucagon levels, cortisol levels, and either decreased insulin levels or insulin resistance. The presence of hyperglycaemia is an indicator of severity in this specific condition. Indeed, hyperglycaemia was associated with the severity of clinical manifestations of severe scorpion envenomation requiring intensive care unit (ICU) admission. In fact, the presence of hyperglycaemia was associated with the presence of respiratory failure, pulmonary oedema, haemodynamic instability, neurological failure, multisystem organ failure, and an increased mortality and ICU length of stay. As a consequence, we think the presence of hyperglycaemia in scorpion-envenomed patients at the emergency department prompts searching for presence of systemic manifestations or cardiorespiratory manifestations. As a consequence, the presence of hyperglycaemia can help screen severe patients at the emergency department. The current management of severe scorpion envenomation involves the admission and close surveillance in the ICU, where vital signs and continuous monitoring enable early initiation of therapy for life-threatening complications. The use of antivenom for scorpion stings remains controversial. All patients with pulmonary oedema should receive prazosin and possibly dobutamine, according the scorpion's species. Mechanical ventilation is usually used in severe cases. Insulin should be reserved for severe cases with confirmed excessive hyperglycaemia (>10 mmol/l).
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Affiliation(s)
| | - Olfa Turki
- Service de Réanimation médicale, Hôpital Habib Bourguiba, Sfax, Tunisie
| | - Anis Chaari
- Service de Réanimation médicale, Hôpital Habib Bourguiba, Sfax, Tunisie
| | - Mounir Bouaziz
- Service de Réanimation médicale, Hôpital Habib Bourguiba, Sfax, Tunisie
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Chakroun-Walha O, Karray R, Jerbi M, Nasri A, Issaoui F, Amine BR, Bahloul M, Bouaziz M, Ksibi H, Rekik N. Update on the Epidemiology of Scorpion Envenomation in the South of Tunisia. Wilderness Environ Med 2018; 29:29-35. [DOI: 10.1016/j.wem.2017.09.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 09/20/2017] [Accepted: 09/22/2017] [Indexed: 01/18/2023]
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Bahloul M, Chrifi-Alaoui L, Drid S, Souissi M, Chaabane M. Robust sensorless vector control of an induction machine using Multiobjective Adaptive Fuzzy Luenberger Observer. ISA Trans 2018; 74:144-154. [PMID: 29395127 DOI: 10.1016/j.isatra.2018.01.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 12/17/2017] [Accepted: 01/05/2018] [Indexed: 06/07/2023]
Abstract
This paper presents an inherent speed estimation scheme associated to the Indirect Field Oriented Control in case of Induction motor sensorless control. Indeed, through the design of a Multiobjective Adaptive Fuzzy Luenberger Observer, the speed sensorless control issue even at low speed, the observer poles' assignment issues and the speed estimation's sensitivity to rotor resistance uncertainties issue are treated concurrently. First of all, the structure of the proposed Takagi-Sugeno adaptive observer is described. Secondly, based on Lyapunov theory, observer gains are designed and a fuzzy speed estimation scheme is provided. The design's objectives consist of minimizing the sensitivity of the proposed observer to rotor resistance uncertainties (using the L2 techniques) and to guarantee a specified observer dynamic performances through a D-stability analysis. The design conditions are formulated into Linear Matrix Inequalities terms. Finally, experiments are conducted to demonstrate the effectiveness of the proposed results regardless of uncertainties in the rotor resistance.
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Affiliation(s)
- M Bahloul
- International Energy Research Centre (IERC),Tyndall National Institute, Cork, T12 R5CP, Ireland; Lab-STA Laboratory, National, School of Engineering of Sfax, 3038 Sfax, Tunisia.
| | - L Chrifi-Alaoui
- LTI, University of Picardie Jules Verne, 13 Av. F. Mitterrand, 02880 Cuffies, France.
| | - S Drid
- LSPIE Laboratory, Electrical Engineering Department, University of Batna 2, 05000 Batna, Algeria.
| | - M Souissi
- Lab-STA Laboratory, National, School of Engineering of Sfax, 3038 Sfax, Tunisia.
| | - M Chaabane
- Lab-STA Laboratory, National, School of Engineering of Sfax, 3038 Sfax, Tunisia.
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Chelly H, Bahloul M, Ammar R, Dhouib A, Mahfoudh KB, Boudawara MZ, Chakroun O, Chabchoub I, Chaari A, Bouaziz M. Clinical characteristics and prognosis of traumatic head injury following road traffic accidents admitted in ICU "analysis of 694 cases". Eur J Trauma Emerg Surg 2017; 45:245-253. [PMID: 29234838 DOI: 10.1007/s00068-017-0885-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 12/01/2017] [Indexed: 01/21/2023]
Abstract
BACKGROUND The aim of the present study is to analyze the clinical and epidemiological characteristics of Traumatic Brain Injury (TBI) following Road Traffic Accidents (RTAs). Moreover, we aim to evaluate the outcome of the TBI victims referred to our medico-surgical Intensive Care Unit (ICU), and to define predictive factors associated with poor prognosis. METHODS A retrospective study over a 4-year period (2009 to 2012) of 694 patients with head injuries, incurred during road traffic accidents, admitted to the Intensive Care Unit (ICU) of a university hospital (Sfax-Tunisia). Basic demographic, clinical, biological, and radiological data were recorded on admission and during the ICU stay. RESULTS There were 592 males (85.3%), and 102 female patients. The mean age was at 31.8 ± 17.8 years (range 1-91). The mechanism of the accident was detailed in 666 patients (96%). The majority of the victims were motorcycle riders and/or passengers (40.5%), followed by pedestrians (29.1%). Extra-cranial pathology was present in 452 patients (65%). A total of 677 patients (97.6%) required intubation, mechanical ventilation, and sedation. Mean ICU stay was 16 ± 17.4 days. A total of 187 patients (26.9%) died during their hospital stay. The GOS performed within a mean delay of 6 months after hospital discharge was as follows: 198 deaths (28.5%), 13 vegetative state (1.9%), and 349 (50.3%) good recovery and/or moderate disability. A multivariate analysis showed that the factors which correlated with a poor prognosis (mortality and severe disability) were: age > 38 years, Glasgow coma scale score < 8, subdural hematoma, and development of secondary systemic insults (respiratory, circulatory, and metabolic). CONCLUSION In Tunisia, traumatic brain injury due to RTAs is a frequent cause of ICU admission, especially among young adults, and is associated with high mortality and morbidity rates. The majority of the victims were motorcycle riders and/or passengers and pedestrians. The factors associated with a poor outcome were: age > 38 years, Glasgow Coma Scale score < 8, subdural hematoma, and development of secondary systemic insults (respiratory, circulatory, and metabolic). As a consequence, prevention is highly warranted.
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Affiliation(s)
- Hedi Chelly
- Department of Intensive Care, Habib Bourguiba University Hospital, 3029, Sfax, Tunisia
| | - Mabrouk Bahloul
- Department of Intensive Care, Habib Bourguiba University Hospital, 3029, Sfax, Tunisia.
| | - Rania Ammar
- Department of Intensive Care, Habib Bourguiba University Hospital, 3029, Sfax, Tunisia
| | - Ahmed Dhouib
- Department of Intensive Care, Habib Bourguiba University Hospital, 3029, Sfax, Tunisia
| | | | | | - Olfa Chakroun
- Departement of Emergency Medicine, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Imen Chabchoub
- Department of Pediatrics, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Anis Chaari
- Department of Intensive Care, Habib Bourguiba University Hospital, 3029, Sfax, Tunisia
| | - Mounir Bouaziz
- Department of Intensive Care, Habib Bourguiba University Hospital, 3029, Sfax, Tunisia
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Bahloul M, Chtara K, Turki O, Khlaf Bouaziz N, Regaieg K, Hammami M, Ben Amar W, Chabchoub I, Ammar R, Ben Hamida C, Chelly H, Ayedi A, Bouaziz M. Yarrowia lipolytica fungemia in patients with severe polytrauma requiring intensive care admission: analysis of 32 cases. Intensive Care Med 2017; 43:1921-1923. [PMID: 28780658 DOI: 10.1007/s00134-017-4900-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 07/27/2017] [Indexed: 12/18/2022]
Affiliation(s)
- Mabrouk Bahloul
- Department of Intensive Care, Habib Bourguiba University Hospital, 3029, Sfax, Tunisia.
| | - Kamilia Chtara
- Department of Intensive Care, Habib Bourguiba University Hospital, 3029, Sfax, Tunisia
| | - Olfa Turki
- Department of Intensive Care, Habib Bourguiba University Hospital, 3029, Sfax, Tunisia
| | | | - Kais Regaieg
- Department of Intensive Care, Habib Bourguiba University Hospital, 3029, Sfax, Tunisia
| | - Maha Hammami
- Department of Intensive Care, Habib Bourguiba University Hospital, 3029, Sfax, Tunisia
| | - Wiem Ben Amar
- Department of Forensic Medicine, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Imen Chabchoub
- Department of Pediatrics, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Rania Ammar
- Department of Intensive Care, Habib Bourguiba University Hospital, 3029, Sfax, Tunisia
| | - Chokri Ben Hamida
- Department of Intensive Care, Habib Bourguiba University Hospital, 3029, Sfax, Tunisia
| | - Hedi Chelly
- Department of Intensive Care, Habib Bourguiba University Hospital, 3029, Sfax, Tunisia
| | - Ali Ayedi
- Fungal and Parasitic Molecular Biology Laboratory, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Mounir Bouaziz
- Department of Intensive Care, Habib Bourguiba University Hospital, 3029, Sfax, Tunisia
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Chakroun-Walha O, Karray R, Jerbi M, Ben Rebeh A, Jammeli C, Bahloul M, Ammar R, Chabchoub I, Bouaziz M, Nasri A, Rekik N. Value of troponin levels in the diagnosis of cardiac dysfunction in moderate scorpion envenomation. Hum Exp Toxicol 2017; 37:580-586. [DOI: 10.1177/0960327117722822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Context: Cardiac dysfunction is one of the most serious consequences of scorpion envenomation. The best tool to evaluate cardiac function is echocardiography, but it is not available at all emergency departments. Many studies aimed to describe biological predictive factors of cardiac dysfunction in scorpion envenomation. Troponin is one of these biomarkers but its correlation with myocarditis is not well established. The aim of this study was to evaluate correlation between troponin levels and cardiac dysfunction in moderate scorpion envenomation. Methods: A retrospective monocentric study including patients admitted in the emergency department for moderate scorpion envenomation with troponin measurement during their early management. On arrival, an electrocardiogram and a chest X-ray were realized for all patients. Results: We enrolled 132 patients with a mean age at 31.3 ± 24.4 years and a 1.35 sex-ratio. All patients had moderate systemic manifestations. There were 28 patients with clinical manifestations of cardiac dysfunction without life-threatening troubles (21.2%). Troponin was undetectable in 69 patients (56%). The mean value of troponin level (pg/ml) was higher in patients with clinical manifestations of left ventricular dysfunction (1.80 ± 3.8 vs. 0.11 ± 0.5; p = 0.02). Troponin levels were significantly higher in patients with positive T wave on electrocardiogram. Conclusion: In patients with moderate scorpion envenomation with positive T wave, high values of troponin suggest the presence of cardiac dysfunction.
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Affiliation(s)
- O Chakroun-Walha
- Emergency Department, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - R Karray
- Emergency Department, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - M Jerbi
- Emergency Department, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - A Ben Rebeh
- Emergency Department, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - C Jammeli
- Emergency Department, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - M Bahloul
- Intensive Care Unit, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - R Ammar
- Intensive Care Unit, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - I Chabchoub
- Paediatric Department, University Hospital Hedi Chaker Sfax, Sfax, Tunisia
| | - M Bouaziz
- Intensive Care Unit, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - A Nasri
- Emergency Department, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - N Rekik
- Emergency Department, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
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30
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Bahloul M, Ammar R, Bouattour A, Bellil S, Chelly H, Chaari A, Bouaziz M. Effects of early administration of acetazolamide on the duration of mechanical ventilation in patients with chronic obstructive pulmonary disease: still far from the truth? J Thorac Dis 2017; 9:1393-1395. [PMID: 28740640 DOI: 10.21037/jtd.2017.05.41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Mabrouk Bahloul
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Rania Ammar
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Abir Bouattour
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Samar Bellil
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Hedi Chelly
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Anis Chaari
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Mounir Bouaziz
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
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31
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Bahloul M, Baccouch N, Chtara K, Turki M, Turki O, Hamida CB, Chelly H, Ayedi F, Chaari A, Bouaziz M. Value of Serum Cholinesterase Activity in the Diagnosis of Septic Shock Due to Bacterial Infections. J Intensive Care Med 2017; 32:346-352. [DOI: 10.1177/0885066616636549] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Background: We aimed to investigate whether serum cholinesterase (SChE) activity can be helpful for the diagnosis of septic shock and to evaluate its usefulness in comparison with procalcitonin (PCT) and C-reactive protein (CRP). Methods: A prospective single-blinded study conducted in an intensive care unit of university hospital. Patients were classified as having cardiogenic shock, septic shock, or hemorrhagic shock. We also included a control group without neither hemodynamic instability nor sepsis. For all included patients, SChE, PCT, and CRP were simultaneously sampled. Results: The comparison of sepsis markers between all groups showed that the mean values of PCT and CRP were significantly higher in patients with septic shock. However, SChE activity was significantly lower in this group. The SChE activity was found to be more accurate than PCT and CRP for the diagnosis of septic shock. In fact, an SChE activity ≤ 4000 UI/L predicted the diagnosis of septic shock with a sensitivity of 78%, a specificity of 89%, a predictive negative value of 97%, and a predictive positive value of 65%. However, the prognostic value of SChE activity was poor in multivariate analysis. Conclusion: The SChE activity level was significantly decreased in patients with septic shock. However, its prognostic value is poor. Our results suggest that SChE activity is useful for the diagnosis of septic shock. Further studies are warranted to confirm our findings.
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Affiliation(s)
- Mabrouk Bahloul
- Service de Réanimation Médicale, CHU Habib Bourguiba, Sfax, Tunisie
| | - Najeh Baccouch
- Service de Réanimation Médicale, CHU Habib Bourguiba, Sfax, Tunisie
| | - Kamilia Chtara
- Service de Réanimation Médicale, CHU Habib Bourguiba, Sfax, Tunisie
| | - Mouna Turki
- Laboratoire de Biochimie, CHU Habib Bourguiba, Sfax, Tunisie
| | - Olfa Turki
- Service de Réanimation Médicale, CHU Habib Bourguiba, Sfax, Tunisie
| | | | - Hedi Chelly
- Service de Réanimation Médicale, CHU Habib Bourguiba, Sfax, Tunisie
| | - Fatma Ayedi
- Laboratoire de Biochimie, CHU Habib Bourguiba, Sfax, Tunisie
| | - Anis Chaari
- Service de Réanimation Médicale, CHU Habib Bourguiba, Sfax, Tunisie
| | - Mounir Bouaziz
- Service de Réanimation Médicale, CHU Habib Bourguiba, Sfax, Tunisie
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32
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Bahloul M, Regaieg K, Chabchoub I, Kammoun M, Chtara K, Bouaziz M. Severe scorpion envenomation: pathophysiology and the role of inflammation in multiple organ failure. Med Sante Trop 2017; 27:214-221. [PMID: 28655685 DOI: 10.1684/mst.2017.0688] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Scorpion stings occur on every continent except Antarctica. The correlation between young age and severity of clinical manifestations after this envenomation is well-established. Several studies have emphasized the relevance of pro-inflammatory mediators in the pathophysiological manifestations of human scorpion envenomation. Moreover, there is a significant association between pro-inflammatory cytokine levels in the blood and the severity of scorpion envenomation. Release of these cytokines increases the severity of the visceral damage induced by the direct action of the venom and the activation of both the sympathetic and parasympathetic nervous systems.
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Affiliation(s)
- M Bahloul
- Hôpital Habib Bourguiba, service de réanimation médicale, route El Ain Km 1, 3029 Sfax, Tunisie
| | - K Regaieg
- Hôpital Habib Bourguiba, service de réanimation médicale, route El Ain Km 1, 3029 Sfax, Tunisie
| | - I Chabchoub
- Hôpital Hedi Chaker, service de pédiatrie générale, route El Ain Km 1, 3029 Sfax, Tunisie
| | - M Kammoun
- Hôpital Habib Bourguiba, service de réanimation médicale, route El Ain Km 1, 3029 Sfax, Tunisie
| | - K Chtara
- Hôpital Habib Bourguiba, service de réanimation médicale, route El Ain Km 1, 3029 Sfax, Tunisie
| | - M Bouaziz
- Hôpital Habib Bourguiba, service de réanimation médicale, route El Ain Km 1, 3029 Sfax, Tunisie
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Bahloul M, Regaieg K, Chtara K, Turki O, Baccouch N, Chaari A, Bouaziz M. [Posttraumatic thromboembolic complications: Incidence, risk factors, pathophysiology and prevention]. Ann Cardiol Angeiol (Paris) 2017; 66:92-101. [PMID: 28110934 DOI: 10.1016/j.ancard.2016.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 12/08/2016] [Indexed: 06/06/2023]
Abstract
Venous thromboembolism (VTE) remains a major challenge in critically ill patients. Subjects admitted in intensive care unit (ICU), in particular trauma patients, are at high-risk for both deep vein thrombosis (DVT) and pulmonary embolism (PE). The rate of symptomatic PE in injured patients has been reported previously ranging from 1 to 6%. The high incidence of posttraumatic venous thromboembolic events is well known. In fact, major trauma is a hypercoagulable state. Several factors placing the individual patient at a higher risk for the development of DVT and PE have been suggested: high ISS score, meningeal hemorrhage and spinal cord injuries have frequently been reported as a significant risk factor for VTEs after trauma. Posttraumatic pulmonary embolism traditionally occurs after a period of at least 5 days from trauma. The prevention can reduce the incidence and mortality associated with the pulmonary embolism if it is effective. There is no consensus is now available about the prevention of venous thromboembolism in trauma patients.
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Affiliation(s)
- M Bahloul
- Service de réanimation médicale, hôpital Habib Bourguiba, route el Ain Km 1, 3029 Sfax, Tunisie.
| | - K Regaieg
- Service de réanimation médicale, hôpital Habib Bourguiba, route el Ain Km 1, 3029 Sfax, Tunisie
| | - K Chtara
- Service de réanimation médicale, hôpital Habib Bourguiba, route el Ain Km 1, 3029 Sfax, Tunisie
| | - O Turki
- Service de réanimation médicale, hôpital Habib Bourguiba, route el Ain Km 1, 3029 Sfax, Tunisie
| | - N Baccouch
- Service de réanimation médicale, hôpital Habib Bourguiba, route el Ain Km 1, 3029 Sfax, Tunisie
| | - A Chaari
- Service de réanimation médicale, hôpital Habib Bourguiba, route el Ain Km 1, 3029 Sfax, Tunisie
| | - M Bouaziz
- Service de réanimation médicale, hôpital Habib Bourguiba, route el Ain Km 1, 3029 Sfax, Tunisie
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Regaieg K, Bahloul M, Gargouri R, Bouattour A, Chelly H, Bouaziz M. [A rare complication of generalized tetanus: pulmonary embolism]. Pan Afr Med J 2017; 25:172. [PMID: 28292134 PMCID: PMC5326023 DOI: 10.11604/pamj.2016.25.172.9875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 09/09/2016] [Indexed: 11/11/2022] Open
Abstract
Le tétanos est une maladie caractérisée par une paralysie spastique et des spasmes. C’est une pathologie grave. Elle nécessite une prise en charge en milieu de réanimation. La mortalité est essentiellement liée aux complications neurovégétatives et infectieuses. Les complications thromboemboliques sont exceptionnelles au cours de cette maladie. A notre connaissance, l’embolie pulmonaire n’a jamais été rapportée et confirmée au cours du tétanos généralisé. Nous présentons à travers cette observation un cas de tétanos généralisé compliqué d’une embolie pulmonaire fibrino cruorique.
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Affiliation(s)
- Kais Regaieg
- Service de Réanimation Polyvalente, CHU Habib Bourguiba, Sfax, Tunisie
| | - Mabrouk Bahloul
- Service de Réanimation Polyvalente, CHU Habib Bourguiba, Sfax, Tunisie
| | - Rahma Gargouri
- Service de Réanimation Polyvalente, CHU Habib Bourguiba, Sfax, Tunisie
| | - Abir Bouattour
- Service de Réanimation Polyvalente, CHU Habib Bourguiba, Sfax, Tunisie
| | - Hèdi Chelly
- Service de Réanimation Polyvalente, CHU Habib Bourguiba, Sfax, Tunisie
| | - Mounir Bouaziz
- Service de Réanimation Polyvalente, CHU Habib Bourguiba, Sfax, Tunisie
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35
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Regaieg K, Bahloul M, Turki O, Mnif B, Bouaziz M. [The efficacy of the tigecycline-colistin association in the treatment of multi-resistant Acinetobacter baumannii meningitis]. Med Mal Infect 2017; 47:175-177. [PMID: 28215823 DOI: 10.1016/j.medmal.2017.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 01/18/2017] [Indexed: 02/07/2023]
Affiliation(s)
- K Regaieg
- Service de réanimation polyvalente, CHU Habib Bourguiba, Sfax, Tunisie
| | - M Bahloul
- Service de réanimation polyvalente, CHU Habib Bourguiba, Sfax, Tunisie.
| | - O Turki
- Service de réanimation polyvalente, CHU Habib Bourguiba, Sfax, Tunisie
| | - B Mnif
- Laboratoire de microbiologie, CHU Habib Bourguiba, Sfax, Tunisie
| | - M Bouaziz
- Service de réanimation polyvalente, CHU Habib Bourguiba, Sfax, Tunisie
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36
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Bougouin W, Marijon E, Planquette B, Karam N, Dumas F, Celermajer D, Jost D, Lamhaut L, Beganton F, Cariou A, Meyer G, Jouven X, Bureau C, Charpentier J, Salem OBH, Guillemet L, Arnaout M, Ferre A, Geri G, Mongardon N, Pène F, Chiche JD, Mira JP, Labro G, Belon F, Luu VP, Chenet J, Besch G, Puyraveau M, Piton G, Capellier G, Martin M, Lascarrou JB, Le Thuaut A, Lacherade JC, Martin-Lefèvre L, Fiancette M, Vinatier I, Lebert C, Bachoumas K, Yehia A, Henry-Laguarrigue M, Colin G, Reignier J, Privat E, Escutnaire J, Dumont C, Baert V, Vilhelm C, Hubert H, Robert-Edan V, Lakhal K, Quartin A, Hobbs B, Cely C, Bell C, Pham T, Schein R, Geng Y, Ng C, Ehrmann S, Gandonnière CS, Boisramé-Helms J, Le Tilly O, De Bretagne IB, Mercier E, Mankikian J, Bretagnol A, Meziani F, Halimi JM, Le Guellec CB, Gaudry S, Hajage D, Tubach F, Pons B, Boulet E, Boyer A, Chevrel G, Lerolle N, Carpentier D, de Prost N, Lautrette A, Mayaux J, Nseir S, Ricard JD, Dreyfuss D, Robert R, Garzotto F, Kipnis E, Tetta C, Ronco C, Schnell D, Aurelie B, Reynaud M, Clec’h C, Benyamina M, Vincent F, Mariat C, Bornstain C, Gloulou O, Boussarsar M, Zelmat SA, Batouche DD, Chaffi B, Mazour F, Benatta N, Fathallah I, Aloui R, Zoubli A, Rouleau S, Kouraichi N, Fathallah I, Kouraichi N, Salem S, Vicaut E, Megarbane B, Ambroise D, Loriot AM, Bourgogne E, Megarbane B, Leroy C, Ghadhoune H, Jihene G, Trabelsi I, Allouche H, Brahmi H, Samet M, Ghord HE, Lebeau R, Laplanche JL, Benturquia N, Cohen Y, Megarbane B, Blel Y, M’rad A, Essafi F, Benabderrahim A, Jouffroy R, Resiere D, Sanchez B, Inamo J, Megarbane B, Morel J, Batouche DD, Zerhouni A, Tabeliouna K, Negadi A, Mentouri Z, Le Gall F, Hanouz JL, Normand H, Khoury A, Sall FS, Legrand M, De Luca A, Pugin A, Pazart L, Vidal C, Leroux F, Khoury A, L’Her E, Marjanovic N, Khoury A, Desmettre T, Terreaux J, Lambert C, Ragey SP, Baboi L, Bazin JE, Koffel C, Dhonneur G, Bouzit Z, Bradai L, Ayed IB, Aissa F, Darmon M, Haouache H, Marechal Y, Biston P, Piagnerelli M, Bortolotti P, Colling D, Colas V, Voisin B, Dewavrin F, Onimus T, Cantier M, Girardie P, Saulnier F, Urbina T, Nguyen Y, Druoton AL, Soudant M, Barraud D, Conrad M, Cravoisy-Popovic A, Nace L, Morisot A, Bollaert PE, Martin R, Bitker L, Richard JC, Brossier D, Goyer I, Marquis C, Lampin M, Duhamel A, Béhal H, Guérot E, Dhaoui T, Godeffroy V, Devouge E, Evrard D, Delepoulle F, Racoussot S, Grandbastien B, Lampin M, Heilbronner C, Roy E, Canet E, Masson A, Hadchouel-Duvergé A, Rigourd V, Delacroix E, Wroblewski I, Pin I, Ego A, Payen V, Debillon T, Millet A, De Montmollin E, Denot J, Berthelot V, Thueux E, Reymond M, De Larrard A, Amblard A, Leger PL, Aoul NT, Lemiale V, Oziel J, Voiriot G, Brule N, Moreau AS, Marhbène T, Sellami S, Jamoussi A, Ayed S, Mhiri E, Slim L, Khelil JB, Besbes M, Neuville M, Chawki S, Hamdi A, Ciroldi M, Cottereau A, Obadia E, Zerbib Y, Andrejak C, Ricome S, Dupont H, Baudin F, Timsit JF, Dureau P, Tanguy A, Arbelot C, Ben HK, Charfeddine A, Granger B, Laporte L, Hermetet C, Regaieg K, Khemakhem R, Sonneville R, Chelly H, Cheikh CM, Mountij H, Rghioui K, Haddad W, Cherkab R, Barrou H, Naima A, bennani OM, Regaieg K, Fayssoil A, Douib A, Samet A, Cungi PJ, Nguyen C, Cotte J, D’aranda E, Meaudre E, Avaro JP, Slaoui MT, Mokline A, Stojkovic T, Rahmani I, Laajili A, Amri H, Gharsallah L, Gasri B, Tlaili S, Hammouda R, Messadi AA, Behin A, Ogna A, Lofaso F, Laforet P, Wahbi K, Prigent H, Duboc D, Orlikowski D, Eymard B, Annane D, Le Guennec L, Cholet C, Bréchot N, Hekimian G, Besset S, Lebreton G, Nieszkowska A, Trouillet JL, Leprince P, Combes A, Luyt CE, Griton M, Sesay M, De Panthou NS, Bienvenu T, Biais M, Nouette-Gaulain K, Fossat G, Baudin F, Coulanges C, Bobet S, Dupont A, Courtes L, Benzekri D, Kamel T, Muller G, Bercault N, Barbier F, Runge I, Skarzynski M, Mathonnet A, Boulain T, Jouan Y, Teixera N, Hassen-Khodja C, Guillon A, Gaborit C, Grammatico-Guillon L, Rebière C, Azoulay E, Misset B, Ruckly S, Garrouste-Orgeas M, Kentish-Barnes 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H, Moussati M, Belhabiche K, Mir S, Abada S, Amel Z, Aouffen N, Bouzit Z, Grati AH, Dhonneur GF, Boussarsar M, Lau N, Mezhari I, Roucaud N, Le Meur M, Paulet R, Coudray JM, Ghomari WI, Boumlik R, Peigne V, Daban JL, Boutonnet M, Lenoir B, Yassine H, Mohamed CC, Khalid A, Ihssan M, Said E, Said S, Jazia AB, Fatima J, Wafa S, Maha B, Khaoula BA, Sami T, Abdallah Taeib B, Medhioub FK, Rollet-Cohen V, Sachs P, Merchaoui Z, Renolleau S, Oualha M, Eloi M, Jean S, Demoulin M, Valentin C, Guilbert J, Walti H, Carbajal R, Leger PL, Karaca-Altintas Y, Botte A, Labreuche J, Drumez E, Devos P, Bour F, Leclerc F, Ahmed A, khaled M, Louati A, Aida B, Ammar K, Narjess G, Ahmed H, Asma B, Jaballah NB, Leger PL, Pansiot J, Besson V, Palmier B, Baud O, Cauli B, Charriaut-Marlangue C, Mansuy A, Michel F, Le Bel S, Boubnova J, Ughetto F, Ovaert C, Fouilloux V, Paut O, Jacquet-Lagrèze M, Tiebergien N, Hanna N, Evain JN, Baudin F, Courtil-Teyssedre S, Bompard D, Lilot M, Chardonal L, Fellahi JL, Claverie C, Pouessel G, Dorkenoo A, Renaudin JM, Eb M, Deschildre A, Leteurtre S, Yassine H, Kamal B, Adil O, Ouafa A, Mouhamed M, Rachid C, Lahoucine B, Dachraoui F, Nakkaa S, Zaineb H, Mlika D. Proceedings of Réanimation 2017, the French Intensive Care Society International Congress. Ann Intensive Care 2017. [PMCID: PMC5225387 DOI: 10.1186/s13613-016-0223-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Gainnier M, Papazian L, Guervilly C, Garnero A, Arnal JM, Roze H, Richard JC, Repusseau B, Dewitte A, Joannes-Boyau O, Ouattara A, Harbouze N, Amine AM, Olandzobo AG, Herbland A, Richard M, Girard N, Lambron L, Lesieur O, Wainschtein S, Hubert S, Hugues A, Tran M, Bouillard P, Loteanu V, Leloup M, Laurent A, Lheureux F, Prestifilippo A, Cruz MDM, Romain R, Antonelli M, Blanch TL, Bonnetain F, Grazzia-Bocci M, Mancebo J, Samain E, Paul H, Capellier G, Zavgorodniaia T, Soichot M, Malissin I, Voicu S, Garçon P, Goury A, Kerdjana L, Deye N, Bourgogne E, Megarbane B, Mejri O, Hmida MB, Tannous S, Chevillard L, Labat L, Risede P, Fredj H, Léger M, Brunet M, Le Roux G, Boels D, Lerolle N, Farah S, Amiel-Niemann H, Kubis N, Declèves X, Peyraux N, Baud F, Serafini M, Alvarez JC, Heinzelman A, Jozwiak M, Millasseau S, Teboul JL, Alphonsine JE, Depret F, Richard N, Attal P, Richard C, Monnet X, Chemla D, Jerbi S, Khedhiri W, Necib H, Scarfo P, Chevalier C, Piagnerelli M, Lafont A, Galy A, Mancia C, Zerhouni A, Tabeliouna K, Gaja A, Hamrouni B, Malouch A, Fourati S, Messaoud R, Zarrouki Y, Ziadi A, Rhezali M, Zouizra Z, Boumzebra D, Samkaoui MA, Brunet J, Canoville B, Verrier P, Ivascau C, Seguin A, Valette X, Du Cheyron D, Daubin C, Bougouin W, Aissaoui N, Lamhaut L, Jost D, Maupain C, Beganton F, Bouglé A, Dumas F, Marijon E, Jouven X, Cariou A, Poirson F, Chaput U, Beeken T, Maxime L, Haikel O, Vodovar D, Chelly J, Marteau P, Chocron R, Juvin P, Loeb T, Adnet F, Lecarpentier E, Riviere A, De Cagny B, Soupison T, Privat E, Escutnaire J, Dumont C, Baert V, Vilhelm C, Hubert H, Leteurtre S, Fresco M, Bubenheim M, Beduneau G, Carpentier D, Grange S, Artaud-Macari E, Misset B, Tamion F, Girault C, Dumas G, Chevret S, Lemiale V, Mokart D, Mayaux J, Pène F, Nyunga M, Perez P, Moreau AS, Bruneel F, Vincent F, Klouche K, Reignier J, Rabbat A, Azoulay E, Frat JP, Ragot S, Constantin JM, Prat G, Mercat A, Boulain T, Demoule A, Devaquet J, Nseir S, Charpentier J, Argaud L, Beuret P, Ricard JD, Teiten C, Marjanovic N, Palamin N, L’Her E, Bailly A, Boisramé-Helms J, Champigneulle B, Kamel T, Mercier E, Le Thuaut A, Lascarrou JB, Rolle A, De Jong A, Chanques G, Jaber S, Hariri G, Baudel JL, Dubée V, Preda G, Bourcier S, Joffre J, Bigé N, Ait-Oufella H, Maury E, Mater H, Merdji H, Grimaldi D, Rousseau C, Mira JP, Chiche JD, Sedghiani I, Benabderrahim A, Hamdi D, Jendoubi A, Cherif MA, Hechmi YZE, Zouheir J, Bagate F, Bousselmi R, Schortgen F, Asfar P, Guérot E, Fabien G, Anguel N, Sigismond L, Matthieu HL, Gonzalez F, François L, Guitton C, Schenck M, Jean-Marc D, Dreyfuss D, Radermacher P, Frère A, Martin-Lefèvre L, Colin G, Fiancette M, Henry-Laguarrigue M, Lacherade JC, Lebert C, Vinatier I, Yehia A, Joret A, Menunier-Beillard N, Benzekri-Lefevre D, Desachy A, Bellec F, Plantefève G, Quenot JP, Meziani F, Tavernier E, Ehrmann S, Chudeau N, Raveau T, Moal V, Houillier P, Rouve E, Lakhal K, Gandonnière CS, Jouan Y, Bodet-Contentin L, Balmier A, Messika J, De Montmollin E, Pouyet V, Sztrymf B, Thiagarajah A, Roux D, De Chambrun MP, Luyt CE, Beloncle F, Zapella N, Ledochowsky S, Terzi N, Mazou JM, Sonneville R, Paulus S, Fedun Y, Landais M, Raphalen JH, Combes A, Amoura Z, Jacquemin A, Guerrero F, Marcheix B, Hernandez N, Fourcade O, Georges B, Delmas C, Makoudi S, Genton A, Bernard R, Lebreton G, Amour J, Mazet C, Bounes F, Murat G, Cronier L, Robin G, Biendel C, Silva S, Boubeche S, Abriou C, Wurtz V, Scherrer V, Rey N, Gastaldi G, Veber B, Doguet F, Gay A, Dureuil B, Besnier E, Rouget A, Gantois G, Magalhaes E, Wanono R, Smonig R, Lermuzeaux M, Lebut J, Olivier A, Dupuis C, Radjou A, Mourvillier B, Neuville M, D’ortho MP, Bouadma L, Rouvel-Tallec A, Rudler M, Weiss N, Perlbarg V, Galanaud D, Thabut D, Rachdi E, Mhamdi G, Trifi A, Abdelmalek R, Abdellatif S, Daly F, Nasri R, Tiouiri H, Lakhal SB, Rousseau G, Asmolov R, Grammatico-Guillon L, Auvet A, Laribi S, Garot D, Dequin PF, Guillon A, Fergé JL, Abgrall G, Hinault R, Vally S, Roze B, Chaplain A, Chabartier C, Savidan AC, Marie S, Cabie A, Resiere D, Valentino R, Mehdaoui H, Benarous L, Soda-Diop M, Bouzana F, Perrin G, Bourenne J, Eon B, Lambert D, Trebuchon A, Poncelet G, Le Bourgeois F, Michael L, Camille G, Naudin J, Deho A, Dauger S, Sauthier M, Bergeron-Gallant K, Emeriaud G, Jouvet P, Tiebergien N, Jacquet-Lagrèze M, Fellahi JL, Baudin F, Essouri S, Javouhey E, Guérin C, Lampin M, Mamouri O, Devos P, Karaca-Altintas Y, Vinchon M, Brossier D, Eltaani R, Teyssedre S, Sabine M, Bouchut JC, Peguet O, Petitdemange L, Guilbert AS, Aoul NT, Addou Z, Aouffen N, Anas B, Kalouch S, Yaqini K, Chlilek A, Abdou R, Gravellier P, Chantreuil J, Travers N, Listrat A, Le Reun C, Favrais G, Coppere Z, Blanot S, Montmayeur J, Bronchard R, Rolando S, Orliaguet G, Leger PL, Rambaud J, Thueux E, De Larrard A, Berthelot V, Denot J, Reymond M, Amblard A, Morin-Zorman S, Lengliné E, Pichereau C, Mariotte E, Emmanuel C, Poujade J, Trumpff G, Janssen-Langenstein R, Harlay ML, Zaid N, Ait-Ammar N, Bonnal C, Merle JC, Botterel F, Levesque E, Riad Z, Mezidi M, Yonis H, Aublanc M, Perinel-Ragey S, Lissonde F, Louf-Durier A, Tapponnier R, Louis B, Forel JM, Bisbal M, Lehingue S, Rambaud R, Adda M, Hraiech S, Marchi E, Roch A, Guerin V, Rozencwajg S, Schmidt M, Hekimian G, Bréchot N, Trouillet JL, Besset S, Franchineau G, Nieszkowska A, Pascal L, Loiselle M, Sarah C, Laurence D, Guillemette T, Jacquens A, Kerever S, Guidet B, Aegerter P, Das V, Fartoukh M, Hayon J, Desmard M, Fulgencio JP, Zuber B, Soufi A, Khaleq K, Hamoudi D, Garret C, Peron M, Coron E, Bretonnière C, Audureau E, Audrey W, Christophe D, Christian J, Daniel A, Cyrille F, Aissaoui W, Rghioui K, Haddad W, Barrou H, Carteaux-Taeib A, Lupinacci R, Manceau G, Jeune F, Tresallet C, Habacha S, Fathallah I, Zoubli A, Aloui R, Kouraichi N, Jouet E, Badin J, Fermier B, Feller M, Serie M, Pillot J, Marie W, Gisbert-Mora C, Vinclair C, Lesbordes P, Mathieu P, De Brabant F, Muller E, Robaux MA, Giabicani M, Marchalot A, Gelinotte S, Declercq PL, Eraldi JP, Bougerol F, Meunier-Beillard N, Devilliers H, Rigaud JP, Verrière C, Ardisson F, Kentish-Barnes N, Jacq G, Chermak A, Lautrette A, Legrand M, Soummer A, Thiery G, Cottereau A, Canet E, Caujolle M, Allyn J, Valance D, Brulliard C, Martinet O, Jabot J, Gallas T, Vandroux D, Allou N, Durand A, Nevière R, Delguste F, Boulanger E, Preau S, Martin R, Cochet H, Ponthus JP, Amilien V, Tchir M, Barsam E, Ayoub M, Georger JF, Guillame I, Assaraf J, Tripon S, Mallet M, Barbara G, Louis G, Gaudry S, Barbarot N, Jamet A, Outin H, Gibot S, Bollaert PE, Holleville M, Legriel S, Chateauneuf AL, Cavelot S, Moyer JD, Bedos JP, Merle P, Laine A, Natalie DS, Cornuault M, Libot J, Asehnoune K, Rozec B, Dantal J, Videcoq M, Degroote T, Jaillette E, Zerimech F, Malika B, Llitjos JF, Amara M, Lacave G, Pangon B, Mavinga J, Makunza JN, Mafuta ME, Yanga Y, Eric A, Ilunga J, Kilembe M, Alby-Laurent F, Toubiana J, Mokline A, Laajili A, Amri H, Rahmani I, Mensi N, Gharsallah L, Tlaili S, Gasri B, Hammouda R, Messadi AA, Allain PA, Gault N, Paugam-Burtz C, Foucrier A, Chatbri B, Bourbiaa Y, Thabet L, Neuschwander A, Vincent L, Beck J, Vibol C, Amelie Y, Resche-Rigon M, Pirracchio JM, Bureau C, Decavèle M, Campion S, Ainsouya R, Niérat MC, Prodanovic H, Raux M, Similowski T, Dubé BP, Demiri S, Dres M, May F, Quintard H, Kounis I, Saliba F, André S. Proceedings of Réanimation 2017, the French Intensive Care Society International Congress. Ann Intensive Care 2017. [PMCID: PMC5225389 DOI: 10.1186/s13613-016-0224-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Regaieg K, Chtara K, Bahloul M, Mnif B, Hammami A, Bouaziz M. [Guillain-Barré syndrome complicating Shigella flexneri infection]. Presse Med 2016; 46:244-245. [PMID: 28024833 DOI: 10.1016/j.lpm.2016.11.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 09/24/2016] [Accepted: 11/21/2016] [Indexed: 10/20/2022] Open
Affiliation(s)
- Kais Regaieg
- Hôpital Habib Bourguiba, service de réanimation médicale, route El Ain Km 1, 3029 Sfax, Tunisie
| | - Kamilia Chtara
- Hôpital Habib Bourguiba, service de réanimation médicale, route El Ain Km 1, 3029 Sfax, Tunisie
| | - Mabrouk Bahloul
- Hôpital Habib Bourguiba, service de réanimation médicale, route El Ain Km 1, 3029 Sfax, Tunisie.
| | - Basma Mnif
- Hôpital Habib Bourguiba, service de microbiologie, route El Ain Km 1, 3029 Sfax, Tunisie
| | - Adnène Hammami
- Hôpital Habib Bourguiba, service de microbiologie, route El Ain Km 1, 3029 Sfax, Tunisie
| | - Mounir Bouaziz
- Hôpital Habib Bourguiba, service de réanimation médicale, route El Ain Km 1, 3029 Sfax, Tunisie
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Zhang Z, Smischney NJ, Zhang H, Van Poucke S, Tsirigotis P, Rello J, Honore PM, Sen Kuan W, Ray JJ, Zhou J, Shang Y, Yu Y, Jung C, Robba C, Taccone FS, Caironi P, Grimaldi D, Hofer S, Dimopoulos G, Leone M, Hong SB, Bahloul M, Argaud L, Kim WY, Spapen HD, Rocco JR. AME evidence series 001-The Society for Translational Medicine: clinical practice guidelines for diagnosis and early identification of sepsis in the hospital. J Thorac Dis 2016; 8:2654-2665. [PMID: 27747021 PMCID: PMC5059246 DOI: 10.21037/jtd.2016.08.03] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Sepsis is a heterogeneous disease caused by an infection stimulus that triggers several complex local and systemic immuno-inflammatory reactions, which results in multiple organ dysfunction and significant morbidity and mortality. The diagnosis of sepsis is challenging because there is no gold standard for diagnosis. As a result, the clinical diagnosis of sepsis is ever changing to meet the clinical and research requirements. Moreover, although there are many novel biomarkers and screening tools for predicting the risk of sepsis, the diagnostic performance and effectiveness of these measures are less than satisfactory, and there is insufficient evidence to recommend clinical use of these new techniques. As a consequence, diagnostic criteria for sepsis need regular revision to cope with emerging evidence. This review aims to present the most updated information on diagnosis and early recognition of sepsis. Recommendations for clinical use of different diagnostic tools rely on the Grades of Recommendation Assessment, Development and Evaluation (GRADE) framework. Because most of the studies were observational and did not allow a reliable assessment of these tools, a two-step inference approach was employed. Future trials need to confirm or refute a particular index test and should directly explore relevant patient outcome parameters.
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Affiliation(s)
- Zhongheng Zhang
- Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
- Department of Critical Care Medicine, Jinhua Hospital of Zhejiang University, Jinhua 321000, China
| | | | - Haibo Zhang
- Keenan Research Center for Biomedical Science of St. Michael’s Hospital, Departments of Anesthesia and Physiology, Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
| | - Sven Van Poucke
- Departments of Anesthesiology, Critical Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Panagiotis Tsirigotis
- 2nd Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Jordi Rello
- CIBERES, Vall d’Hebron Institut of Research, Universitat Autonoma de Barcelona, Spain
| | - Patrick M. Honore
- Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel Brussels, Brussels, Belgium
| | - Win Sen Kuan
- Emergency Medicine Department, National University Hospital, National University Health System, Singapore and the Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Juliet June Ray
- DeWitt Daughtry Family Department of Surgery, Jackson Memorial Hospital, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Jiancang Zhou
- Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - You Shang
- Department of Critical Care Medicine, Union Hospital, Tongji Medical Collegue, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yuetian Yu
- Department of Critical Care Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200001, China
| | - Christian Jung
- University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Germany
| | - Chiara Robba
- Neurosciences Critical Care Unit, Addenbrooke’s Hospital, Cambridge, UK
| | - Fabio Silvio Taccone
- Department of Intensive Care, Hôpital Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Pietro Caironi
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Fondazione IRCCS Ca’ Granda – Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - David Grimaldi
- Intensive Care Department, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Stefan Hofer
- Department of Anesthesiology, University of Heidelberg, Heidelberg, Germany
| | - George Dimopoulos
- Department of Critical Care, University Hospital ATTIKON, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Marc Leone
- Service d’anesthésie et de réanimation, Hôpital Nord, Assistance Publique – Hôpitaux de Marseille, Aix Marseille Université, Marseille, France
| | - Sang-Bum Hong
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Mabrouk Bahloul
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Laurent Argaud
- Medical Intensive Care Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Won Young Kim
- Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Herbert D. Spapen
- Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel Brussels, Brussels, Belgium
| | - Jose Rodolfo Rocco
- Department of Internal Medicine and Post-graduated Program, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Bahloul M, Chtara K, Gargouri R, Majdoub A, Chaari A, Bouaziz M. Failure of noninvasive ventilation in adult patients with acute asthma exacerbation. J Thorac Dis 2016; 8:744-7. [PMID: 27162642 DOI: 10.21037/jtd.2016.03.07] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Mabrouk Bahloul
- 1 Service de Réanimation médicale, CHU Habib Bourguiba, 3029 Sfax, Tunisie ; 2 Hospital Tahar Sfar de Mahdia, Service Anesthésie Réanimation Chirurgicale, Mahdia, Tunisie
| | - Kamilia Chtara
- 1 Service de Réanimation médicale, CHU Habib Bourguiba, 3029 Sfax, Tunisie ; 2 Hospital Tahar Sfar de Mahdia, Service Anesthésie Réanimation Chirurgicale, Mahdia, Tunisie
| | - Rahma Gargouri
- 1 Service de Réanimation médicale, CHU Habib Bourguiba, 3029 Sfax, Tunisie ; 2 Hospital Tahar Sfar de Mahdia, Service Anesthésie Réanimation Chirurgicale, Mahdia, Tunisie
| | - Ali Majdoub
- 1 Service de Réanimation médicale, CHU Habib Bourguiba, 3029 Sfax, Tunisie ; 2 Hospital Tahar Sfar de Mahdia, Service Anesthésie Réanimation Chirurgicale, Mahdia, Tunisie
| | - Anis Chaari
- 1 Service de Réanimation médicale, CHU Habib Bourguiba, 3029 Sfax, Tunisie ; 2 Hospital Tahar Sfar de Mahdia, Service Anesthésie Réanimation Chirurgicale, Mahdia, Tunisie
| | - Mounir Bouaziz
- 1 Service de Réanimation médicale, CHU Habib Bourguiba, 3029 Sfax, Tunisie ; 2 Hospital Tahar Sfar de Mahdia, Service Anesthésie Réanimation Chirurgicale, Mahdia, Tunisie
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Bahloul M, Chtara K, Chelly H, Regaieg K, Chaari A, Bouaziz M. Acetazolamide use in severe COPD exacerbations requiring invasive mechanical ventilation: impact on duration of mechanical ventilation. J Thorac Dis 2016; 8:762-764. [PMID: 27162647 PMCID: PMC4842826 DOI: 10.21037/jtd.2016.03.65] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 03/11/2016] [Indexed: 08/30/2023]
Affiliation(s)
- Mabrouk Bahloul
- Service de Réanimation Médicale, CHU Habib Bourguiba, Sfax, Tunisia
| | - Kamilia Chtara
- Service de Réanimation Médicale, CHU Habib Bourguiba, Sfax, Tunisia
| | - Hedi Chelly
- Service de Réanimation Médicale, CHU Habib Bourguiba, Sfax, Tunisia
| | - Kais Regaieg
- Service de Réanimation Médicale, CHU Habib Bourguiba, Sfax, Tunisia
| | - Anis Chaari
- Service de Réanimation Médicale, CHU Habib Bourguiba, Sfax, Tunisia
| | - Mounir Bouaziz
- Service de Réanimation Médicale, CHU Habib Bourguiba, Sfax, Tunisia
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Majdoub A, Bahloul M, Ouaz M, Chtara K, Msakni Y, Regaieg K, Bouaziz M, Haddad B. Severe acute biliary pancreatitis requiring Intensive Care Unit admission: Evaluation of severity score for the prediction of morbidity and mortality. Int J Crit Illn Inj Sci 2016; 6:155-156. [PMID: 27722119 PMCID: PMC5051060 DOI: 10.4103/2229-5151.190653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
- Ali Majdoub
- ICU, Tahar Sfar University Hospital, Mahdia-Tunisia
| | - Mabrouk Bahloul
- ICU, Habib Bourguiba University Hospital - 3029, Sfax, Tunisia
| | - Mounaa Ouaz
- ICU, Tahar Sfar University Hospital, Mahdia-Tunisia
| | - Kamilia Chtara
- ICU, Habib Bourguiba University Hospital - 3029, Sfax, Tunisia
| | | | - Kais Regaieg
- ICU, Habib Bourguiba University Hospital - 3029, Sfax, Tunisia
| | - Mounir Bouaziz
- ICU, Habib Bourguiba University Hospital - 3029, Sfax, Tunisia
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Medhioub Kaaniche F, Chaari A, Bacouch N, Bahloul M, Bouaziz M. Syndrome hémolytique et urémique de l’adulte jeune par trouble du métabolisme de la cobalamine : à propos d’un cas. Presse Med 2016; 45:148-50. [DOI: 10.1016/j.lpm.2015.10.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 08/29/2015] [Accepted: 10/14/2015] [Indexed: 10/22/2022] Open
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Turki O, Bahloul M, Chtara K, Chelly H, Bouaziz M. [Acute necrotizing pancreatitis secondary to post-traumatic fat embolism "a case report"]. Presse Med 2015; 44:1283-5. [PMID: 26585746 DOI: 10.1016/j.lpm.2015.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Accepted: 07/05/2015] [Indexed: 10/22/2022] Open
Affiliation(s)
- Olfa Turki
- CHU Habib Bourguiba, service de réanimation médicale, route el Ain Km 1, 3029 Sfax, Tunisie
| | - Mabrouk Bahloul
- CHU Habib Bourguiba, service de réanimation médicale, route el Ain Km 1, 3029 Sfax, Tunisie.
| | - Kamilia Chtara
- CHU Habib Bourguiba, service de réanimation médicale, route el Ain Km 1, 3029 Sfax, Tunisie
| | - Hédi Chelly
- CHU Habib Bourguiba, service de réanimation médicale, route el Ain Km 1, 3029 Sfax, Tunisie
| | - Mounir Bouaziz
- CHU Habib Bourguiba, service de réanimation médicale, route el Ain Km 1, 3029 Sfax, Tunisie
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Chaari A, Pham T, Mnif B, Chtara K, Medhioub F, Baccouche N, Bahloul M, Hammami A, Bouaziz M. Colistin–tigecycline versus colistin–imipenem–cilastatin combinations for the treatment of Acinetobacter baumannii ventilator-acquired pneumonia: a prognosis study. Intensive Care Med 2015; 41:2018-9. [DOI: 10.1007/s00134-015-4010-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2015] [Indexed: 10/23/2022]
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Chtara K, Bahloul M, Turki O, Baccouche N, Regaieg K, Ben Hamida C, Chelly H, Chabchoub I, Chaari A, Bouaziz M. Incidence and impact outcome of hyperglycaemia in severe scorpion envenomed children requiring intensive care admission. Intensive Care Med 2015. [PMID: 26208749 DOI: 10.1007/s00134-015-3991-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Kamilia Chtara
- Service de Réanimation Médicale, CHU Hôpital Habib Bourguiba, Route el Ain Km 1, 3029, Sfax, Tunisia
| | - Mabrouk Bahloul
- Service de Réanimation Médicale, CHU Hôpital Habib Bourguiba, Route el Ain Km 1, 3029, Sfax, Tunisia.
| | - Olfa Turki
- Service de Réanimation Médicale, CHU Hôpital Habib Bourguiba, Route el Ain Km 1, 3029, Sfax, Tunisia
| | - Najeh Baccouche
- Service de Réanimation Médicale, CHU Hôpital Habib Bourguiba, Route el Ain Km 1, 3029, Sfax, Tunisia
| | - Kais Regaieg
- Service de Réanimation Médicale, CHU Hôpital Habib Bourguiba, Route el Ain Km 1, 3029, Sfax, Tunisia
| | - Chokri Ben Hamida
- Service de Réanimation Médicale, CHU Hôpital Habib Bourguiba, Route el Ain Km 1, 3029, Sfax, Tunisia
| | - Hedi Chelly
- Service de Réanimation Médicale, CHU Hôpital Habib Bourguiba, Route el Ain Km 1, 3029, Sfax, Tunisia
| | - Imen Chabchoub
- Service de Pédiatrie Générale, CHU Hedi Chaker, Sfax, Tunisia
| | - Anis Chaari
- Service de Réanimation Médicale, CHU Hôpital Habib Bourguiba, Route el Ain Km 1, 3029, Sfax, Tunisia
| | - Mounir Bouaziz
- Service de Réanimation Médicale, CHU Hôpital Habib Bourguiba, Route el Ain Km 1, 3029, Sfax, Tunisia
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Bahloul M, Chaari A, Tounsi A, Turki O, Chtara K, Hamida CB, Ghadhoune H, Dammak H, Chelly H, Bouaziz M. Impact of acetazolamide use in severe exacerbation of chronic obstructive pulmonary disease requiring invasive mechanical ventilation. Int J Crit Illn Inj Sci 2015; 5:3-8. [PMID: 25810957 PMCID: PMC4366825 DOI: 10.4103/2229-5151.152296] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To analyse the impact of acetazolamide (ACET) use in severe acute decompensation of chronic obstructive pulmonary disease requiring mechanical ventilation and intensive care unit (ICU) admission. PATIENTS AND METHODS Retrospective pair-wise, case-control study with 1:1 matching. Patients were defined as cases when they had received acetazolamide (500 mg per day) and as controls when they did not received it. Patients were matched according to age, severity on admission (pH, PaO2/FiO2 ratio) and SAPSII score. Our primary endpoint was the effect of ACET (500 mg per day) on the duration of mechanical ventilation. Our secondary endpoints were the effect of ACET on arterial blood gas parameters, ICU length of stay (LOS) and ICU mortality. RESULTS Seventy-two patients were included and equally distributed between the two studied groups. There were 66 males (92%). The mean age (± SD) was 69.7 ± 7.4 years ranging from 53 to 81 years. There were no differences between baseline characteristics of the two groups. Concomitant drugs used were also not significantly different between two groups. Mean duration of mechanical ventilation was not significantly different between ACET(+) and ACET(-) patients (10.6±7.8 days and 9.6±7.6 days, respectively; P = 0.61). Cases had a significantly decreased serum bicarbonate, arterial blood pH, and PaCO2 levels. We did not found any significant difference between the two studied groups in terms of ICU LOS. ICU mortality was also comparable between ACET(+) and ACET(-) groups (38% and 52%, respectively; P = 0.23). CONCLUSION Although our study some limitations, it suggests that the use of insufficient acetazolamide dosage (500 mg/d) ACET (500 mg per day) has no significant effect on the duration of mechanical ventilation in critically ill COPD patients requiring invasive mechanical ventilation. Our results should be confirmed or infirmed by further studies.
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Affiliation(s)
- Mabrouk Bahloul
- Intensive Care Unit, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Anis Chaari
- Intensive Care Unit, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Ahmed Tounsi
- Intensive Care Unit, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Olfa Turki
- Intensive Care Unit, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Kamilia Chtara
- Intensive Care Unit, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Chokri Ben Hamida
- Intensive Care Unit, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Hatem Ghadhoune
- Intensive Care Unit, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Hassen Dammak
- Intensive Care Unit, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Hedi Chelly
- Intensive Care Unit, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Mounir Bouaziz
- Intensive Care Unit, Habib Bourguiba University Hospital, Sfax, Tunisia
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Turki O, Bahloul M, Chtara K, Regaieg K, Haddar S, Bouaziz M. Kyste hydatique du foie compliqué d’un accident vasculaire cérébral ischémique: à propos d’un cas. Pan Afr Med J 2015; 22:355. [PMID: 26985273 PMCID: PMC4779637 DOI: 10.11604/pamj.2015.22.355.8108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 11/14/2015] [Indexed: 11/16/2022] Open
Abstract
Le kyste hydatique du foie (KHF) est une maladie assez répandue dans les pays nord-africains. La rupture post-traumatique ou spontanée du kyste compliquée d'un choc anaphylactique et d'un AVC ischémique a été exceptionnellement rapportée. Nous rapportons un cas d'un kyste hydatique du foie (KHF) fissuré et compliqué d'un choc anaphylactique et d'un AVC ischémique.
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Affiliation(s)
- Olfa Turki
- Service de Réanimation Médicale, CHU Habib Bourguiba, Sfax, Tunisie
| | - Mabrouk Bahloul
- Service de Réanimation Médicale, CHU Habib Bourguiba, Sfax, Tunisie
| | - Kamilia Chtara
- Service de Réanimation Médicale, CHU Habib Bourguiba, Sfax, Tunisie
| | - Kais Regaieg
- Service de Réanimation Médicale, CHU Habib Bourguiba, Sfax, Tunisie
| | - Sondes Haddar
- Service d'Imagerie Médicale CHU Habib Bourguiba, Sfax, Tunisie
| | - Mounir Bouaziz
- Service de Réanimation Médicale, CHU Habib Bourguiba, Sfax, Tunisie
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Bahloul M, Chaari A, Dammak H, Ammar R, Medhioub F, Hamida CB, Chelly H, Bouaziz M. Efficacy of corticosteroid therapy in severe decompensation of chronic obstructive pulmonary disease requiring mechanical ventilation. Am J Ther 2014; 20:630-7. [PMID: 23344101 DOI: 10.1097/mjt.0b013e318269123e] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to analyze the efficacy of corticosteroids in severe acute decompensation of chronic obstructive pulmonary disease requiring mechanical ventilation and intensive care unit (ICU) admission. Pairwise retrospective case-control study with 1:1 matching. Patients were defined as cases when they received corticosteroids and as controls when they did not received any steroids. Patients were matched according to age, severity factors at admission represented by the PaO2/FiO2 ratio, and simplified acute physiology score. Thirty-four patients were included. There were 17 patients in the case group and 17 patients in the control group. There were 27 men (80%) and 7 women (20%). The mean age (±SD) was 70 ± 9 years with a range of 40-85 years. Thirty-two patients (94 %) were older than 60 years. The comparison between the 2 groups showed that they had the same epidemiological, clinical, and biological findings on ICU admission. Homodynamic parameters were also not significantly different between the 2 groups. Moreover, there is the same proportion of invasive mechanical ventilation use in 2 groups. Concomitant drugs used were also not significantly different between the 2 groups. Finally, the comparison of outcome between the steroid and steroid-free groups showed that mortality rate was not significantly different (64% vs. 58%, P = 0.72). However, systemic corticosteroid therapy was associated with a significant increase in a reduction in the duration of mechanical ventilation (P = 0.004) and a trend toward a shorter length of ICU stay (P = 0.053). Although the authors detected no significant difference in mortality rate at the time of discharge between steroid and streroid-free patients, this study confirms that systemic corticosteroid therapy in patients with chronic obstructive pulmonary disease exacerbations requiring mechanical ventilation is associated with a significant reduction in the duration of mechanical ventilation. Other studies are needed on this subject.
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Affiliation(s)
- Mabrouk Bahloul
- Service de Réanimation médicale, CHU Habib Bourguiba, Sfax, Tunisie
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50
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Bahloul M, Chaari A, Tounsi A, Baccouche N, Abid H, Chtara K, Ben Hamida C, Ghadhoune H, Dammak H, Chelly H, Bouaziz M. Incidence and impact outcome of pulmonary embolism in critically ill patients with severe exacerbation of chronic obstructive pulmonary diseases. The Clinical Respiratory Journal 2014; 9:270-7. [DOI: 10.1111/crj.12131] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 02/19/2014] [Accepted: 03/02/2014] [Indexed: 01/11/2023]
Affiliation(s)
- Mabrouk Bahloul
- Service de Réanimation Médicale; CHU Habib Bourguiba; Sfax Tunisie
| | - Anis Chaari
- Service de Réanimation Médicale; CHU Habib Bourguiba; Sfax Tunisie
| | - Ahmed Tounsi
- Service de Réanimation Médicale; CHU Habib Bourguiba; Sfax Tunisie
| | - Najeh Baccouche
- Service de Réanimation Médicale; CHU Habib Bourguiba; Sfax Tunisie
| | - Hanen Abid
- Department of Radiology; CHU Habib Bourguiba; Sfax Tunisie
| | - Kamilia Chtara
- Service de Réanimation Médicale; CHU Habib Bourguiba; Sfax Tunisie
| | | | - Hatem Ghadhoune
- Service de Réanimation Médicale; CHU Habib Bourguiba; Sfax Tunisie
| | - Hassen Dammak
- Service de Réanimation Médicale; CHU Habib Bourguiba; Sfax Tunisie
| | - Hedi Chelly
- Service de Réanimation Médicale; CHU Habib Bourguiba; Sfax Tunisie
| | - Mounir Bouaziz
- Service de Réanimation Médicale; CHU Habib Bourguiba; Sfax Tunisie
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