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Ancel J, Guecamburu M, Marques Da Silva V, Schilfarth P, Boyer L, Pilette C, Martin C, Devillier P, Berger P, Zysman M, Le Rouzic O, Gonzalez-Bermejo J, Degano B, Burgel PR, Ahmed E, Roche N, Deslee G. [Take-home messages from the COPD 2021 biennial of the French Society of Respiratory Diseases. Understanding to so as to better innovate]. Rev Mal Respir 2022; 39:427-441. [PMID: 35568574 DOI: 10.1016/j.rmr.2022.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 03/11/2022] [Accepted: 03/23/2022] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The first COPD biennial organized by the French Society of Respiratory Diseases (SPLF) took place on 17 December 2021. STATE OF THE ART The objective of the biennial was to discuss current knowledge regarding COPD pathophysiology, current treatments, research development, and future therapeutic approaches. PERSPECTIVES The different lecturers laid emphasis on the complexity of pathophysiologic mechanisms including bronchial, bronchiolar and parenchymal alterations, and also dwelt on the role of microbiota composition in COPD pathenogenesis. They pointed out that addition to inhaled treatments, ventilatory support and endoscopic approaches have been increasingly optimized. The development of new therapeutic pathways such as biotherapy and cell therapy (stem cells…) call for further exploration. CONCLUSIONS The dynamism of COPD research was repeatedly underlined, and needs to be further reinforced, the objective being to "understand so as to better innovate" so as to develop effective new strategies for treatment and management of COPD.
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Affiliation(s)
- J Ancel
- Inserm UMRS-1250, service de pneumologie, université Reims Champagne Ardenne, hôpital Maison Blanche, Reims, France
| | - M Guecamburu
- Service des maladies respiratoires, hôpital du Haut-Lévêque, CHU de Bordeaux, Bordeaux, France
| | - V Marques Da Silva
- Inserm U955, FHU SENEC, université Paris-Est Créteil, institut Mondor de recherche biomédicale, équipe GEIC2O, Créteil, France
| | - P Schilfarth
- Service des maladies respiratoires, hôpital du Haut-Lévêque, CHU de Bordeaux, Bordeaux, France; Inserm U1045, centre de recherche cardio-thoracique de Bordeaux, Pessac, France
| | - L Boyer
- Département de physiologie-explorations fonctionnelles, université Paris-Est, hôpital Henri-Mondor, AP-HP, UMR S955, FHU SENEC, UPEC, Créteil, France
| | - C Pilette
- Département de pneumologie, université catholique de Louvain, cliniques universitaires Saint-Luc et institut de recherche expérimentale et clinique, Bruxelles, Belgique
| | - C Martin
- Inserm U1016, service de pneumologie, AP-HP Paris, hôpital Cochin et institut Cochin, université de Paris, Paris, France
| | - P Devillier
- Département des maladies respiratoires, unité de recherche en pharmacologie respiratoire, VIM Suresnes (UMR 0892, université Paris-Saclay), hôpital Foch, Suresnes, France
| | - P Berger
- Service d'exploration fonctionnelle respiratoire, département de pharmacologie, centre de recherche cardiothoracique, U1045, CIC 1401, Pessac, France
| | - M Zysman
- Service des maladies respiratoires, hôpital du Haut-Lévêque, CHU de Bordeaux, Bordeaux, France; Inserm U1045, centre de recherche cardio-thoracique de Bordeaux, Pessac, France
| | - O Le Rouzic
- Inserm, CIIL Center for infection and immunity of Lille, université de Lille, CHU de Lille, pneumologie et immuno-allergologie, Institut Pasteur de Lille, U1019 - UMR9017, Lille, France
| | - J Gonzalez-Bermejo
- Inserm, UMRS115 neurophysiologie respiratoire expérimentale et clinique, service de pneumologie, médecine intensive et réanimation (département R3S), Sorbonne université, groupe hospitalier universitaire AP-HP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - B Degano
- Inserm 1042, service de pneumologie physiologie, CHU de Grenoble, Grenoble, France
| | - P-R Burgel
- Inserm U1016, service de pneumologie, AP-HP Paris, hôpital Cochin et institut Cochin, université de Paris, Paris, France
| | - E Ahmed
- Département des maladies respiratoires, IRMB, université de Montpellier, CHU de Montpellier, Montpellier, France
| | - N Roche
- Inserm U1016, service de pneumologie, AP-HP Paris, hôpital Cochin et institut Cochin, université de Paris, Paris, France
| | - G Deslee
- Inserm UMRS-1250, service de pneumologie, université Reims Champagne Ardenne, hôpital Maison Blanche, Reims, France.
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Georges M, Perez T, Rabec C, Jacquin L, Finet-Monnier A, Ramos C, Patout M, Attali V, Amador M, Gonzalez-Bermejo J, Salachas F, Morelot-Panzini C. Proposals from a French expert panel for respiratory care in ALS patients. Respir Med Res 2022; 81:100901. [PMID: 35378353 DOI: 10.1016/j.resmer.2022.100901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/27/2021] [Revised: 02/18/2022] [Accepted: 02/25/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by progressive diaphragm weakness and deteriorating lung function. Bulbar involvement and cough weakness contribute to respiratory morbidity and mortality. ALS-related respiratory failure significantly affects quality of life and is the leading cause of death. Non-invasive ventilation (NIV), which is the main recognized treatment for alleviating the symptoms of respiratory failure, prolongs survival and improves quality of life. However, the optimal timing for the initiation of NIV is still a matter of debate. NIV is a complex intervention. Multiple factors influence the efficacy of NIV and patient adherence. The aim of this work was to develop practical evidence-based advices to standardize the respiratory care of ALS patients in French tertiary care centres. METHODS For each proposal, a French expert panel systematically searched an indexed bibliography and prepared a written literature review that was then shared and discussed. A combined draft was prepared by the chairman for further discussion. All of the proposals were unanimously approved by the expert panel. RESULTS The French expert panel updated the criteria for initiating NIV in ALS patients. The most recent criteria were established in 2005. Practical advice for NIV initiation were included and the value of each tool available for NIV monitoring was reviewed. A strategy to optimize NIV parameters was suggested. Revisions were also suggested for the use of mechanically assisted cough devices in ALS patients. CONCLUSION Our French expert panel proposes an evidence-based review to update the respiratory care recommendations for ALS patients in daily practice.
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Affiliation(s)
- M Georges
- Department of Respiratory Diseases and Intensive Care, Reference Center for Adult Rare Pulmonary Diseases, University Hospital of Dijon-Bourgogne, Dijon, France; University of Bourgogne Franche-Comté, Dijon France; Centre des Sciences du Goût et de l'Alimentation, UMR 6265 CNRS 1234 INRA, University of Bourgogne Franche-Comté, Dijon, France.
| | - T Perez
- Department of Respiratory Diseases, University Hospital of Lille, Lille, France; Centre for Infection and Immunity of Lille, INSERM U1019-UMR9017, University of Lille Nord de France, Lille, France
| | - C Rabec
- Department of Respiratory Diseases and Intensive Care, Reference Center for Adult Rare Pulmonary Diseases, University Hospital of Dijon-Bourgogne, Dijon, France; University of Bourgogne Franche-Comté, Dijon France
| | - L Jacquin
- Clinical Training Manager for ResMed SAS company, Saint-Priest, France
| | - A Finet-Monnier
- Department of Neuromuscular Disorders and ALS, University Hospital of Timone, Marseille, France
| | - C Ramos
- CRMR SLA-MNM, Hôpital Pasteur 2, University Hospital of Nice, Nice, France
| | - M Patout
- Service des Pathologies du Sommeil (Département R3S), Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France; Neurophysiologie Respiratoire Expérimentale et Clinique, INSERM UMRS1158, Sorbonne Université, Paris, France
| | - V Attali
- Service des Pathologies du Sommeil (Département R3S), Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France; Neurophysiologie Respiratoire Expérimentale et Clinique, INSERM UMRS1158, Sorbonne Université, Paris, France
| | - M Amador
- Neurology Department, Paris ALS center, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
| | - J Gonzalez-Bermejo
- Neurophysiologie Respiratoire Expérimentale et Clinique, INSERM UMRS1158, Sorbonne Université, Paris, France; Service de Pneumologie (Département R3S), Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
| | - F Salachas
- Neurology Department, Paris ALS center, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
| | - C Morelot-Panzini
- Neurophysiologie Respiratoire Expérimentale et Clinique, INSERM UMRS1158, Sorbonne Université, Paris, France; Service de Pneumologie (Département R3S), Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
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Deslée G, Zysman M, Gonzalez-Bermejo J, Roche N. Première biennale BPCO de la Société de pneumologie de langue française 2021 : enfin ! Rev Mal Respir 2022; 39:411-412. [DOI: 10.1016/j.rmr.2022.03.010] [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] [Received: 03/15/2022] [Accepted: 03/20/2022] [Indexed: 11/26/2022]
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Assouline A, Schernberg A, del Mar Amador M, Morelot-Panzini C, Gonzalez-Bermejo J, Lenglet T, Forestier NL, Bruneteau G, Hesters A, Salachas F, Delanian S, Pradat P. A Retrospective Analysis of 235 Patients and 281 Radiotherapy Plans for Sialorrhea Treatment in Amyotrophic Lateral Sclerosis and Parkinson Patients. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.338] [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: 10/20/2022]
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Assouline A, Schernberg A, del Mar Amador M, Morelot-Panzini C, Gonzalez-Bermejo J, Lenglet T, Le Forestier N, Bruneteau G, Salachas F, Delanian S, Pradat P. OC-0409 Salivary gland Radiotherapy for Sialorrhea Treatment in Amyotrophic Lateral Sclerosis patients. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06896-1] [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: 10/20/2022]
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Andrejak C, Cottin V, Crestani B, Debieuvre D, Gonzalez-Bermejo J, Morelot-Panzini C, Stach B, Uzunhan Y, Maitre B, Raherison C. [Guide for management of patients with possible respiratory sequelae after a SARS-CoV-2 pneumonia. Support proposals developed by the French-speaking Respiratory Medicine Society. Version of 10 November 2020]. Rev Mal Respir 2020; 38:114-121. [PMID: 33280941 PMCID: PMC7691188 DOI: 10.1016/j.rmr.2020.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 11/24/2020] [Indexed: 11/09/2022]
Abstract
La Société de Pneumologie de Langue Française (SPLF) propose un guide pour la prise en charge thérapeutique des patients ayant d’éventuelles séquelles respiratoires après avoir présenté une pneumonie à SARS-CoV-2 (COVID-19). Les propositions s’appuient sur les données connues des précédentes épidémies, les données préliminaires publiées sur le suivi après COVID-19 et les avis d’experts. Les propositions ont été élaborées par un groupe d’experts puis soumises selon la méthode Delphi à un panel composé de 22 pneumologues. Dix-sept propositions ont été validées, qui vont des examens complémentaires à réaliser après le bilan minimal proposé dans le guide de suivi de la SPLF à la place de la corticothérapie inhalée ou systémique et des médicaments antifibrosants. Ces propositions pourront évoluer dans le temps au fil des connaissances sur le sujet. Ce guide insiste sur l’importance de la discussion multidisciplinaire.
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Affiliation(s)
- C Andrejak
- Service de pneumologie, CHU Amiens-Picardie, UR 4294 AGIR, université Picardie Jules-Verne, 80054 Amiens, France.
| | - V Cottin
- Service de pneumologie, centre de référence des maladies pulmonaires rares, Hospices Civils de Lyon, université de Lyon, INRAE, Lyon, France
| | - B Crestani
- Service de pneumologie, hôpital Bichat, université de Paris, inserm UMR1152, 75108 Paris, France
| | - D Debieuvre
- Service de pneumologie, groupe hospitalier de la région Mulhouse Sud-Alsace, hôpital Émile-Muller, Mulhouse, France
| | - J Gonzalez-Bermejo
- Service de pneumologie, médecine intensive et réanimation Pitié-Salpêtrière, Sorbonne Université, inserm, UMRS1158 neurophysiologie respiratoire expérimentale et clinique, Paris, France
| | - C Morelot-Panzini
- Service de pneumologie, médecine intensive et réanimation Pitié-Salpêtrière, Sorbonne Université, inserm, UMRS1158 neurophysiologie respiratoire expérimentale et clinique, Paris, France
| | - B Stach
- Cabinet médical Saint Michel, 59300 Valenciennes, France
| | - Y Uzunhan
- Service de pneumologie, hôpital Avicenne, Assistance Publique - hôpitaux de Paris, Inserm U1272, Laboratoire "Hypoxie et Poumon", université Paris Nord, Bobigny, France
| | - B Maitre
- Service de pneumologie, centre hospitalier intercommunal de créteil, université Paris Est Créteil, 94000 Créteil, France
| | - C Raherison
- Service des maladies respiratoires, CHU de Bordeaux, U1219 Epicene université de Bordeaux, France
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Gonzalez-Bermejo J, Hajage D, Durand-Zaleski I, Arnal JM, Cuvelier A, Grassion L, Jaffre S, Lamia B, Pontier S, Prigent A, Rabec C, Raherison-Semjen C, Saint Raymond C, Soler J, Trzepizur W, Winck JC, Aguiar M, Chaves H, Conde B, Guimarães MJ, Lopes P, Mineiro A, Moreira S, Pamplona P, Rodrigues CM, Sousa S, Antón A, Córdoba-Izquierdo A, Embid C, Esteban González C, Ezzine F, Garcia P, González M, Guerassimova I, López D, Lujan M, Martí Beltran S, Martinez JM, Masa F, Pascual N, Peñacoba N, Resano P, Rey L, Rodríguez Jerez F, Roncero A, Sancho Chinesta J, Sayas Catalán J. Respiratory support in COPD patients after acute exacerbation with monitoring the quality of support (Rescue2-monitor): an open-label, prospective randomized, controlled, superiority clinical trial comparing hospital- versus home-based acute non-invasive ventilation for patients with hypercapnic chronic obstructive pulmonary disease. Trials 2020; 21:877. [PMID: 33092618 PMCID: PMC7578582 DOI: 10.1186/s13063-020-04672-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 08/12/2020] [Indexed: 12/03/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is expected to be the 3rd leading cause of death worldwide by 2020. Despite improvements in survival by using acute non-invasive ventilation (NIV) to treat patients with exacerbations of COPD complicated by acute hypercapnic respiratory failure (AHRF), these patients are at high risk of readmission and further life-threatening events, including death. Recent studies suggested that NIV at home can reduce readmissions, but in a small proportion of patients, and with a high level of expertise. Other studies, however, do not show any benefit of home NIV. This could be related to the fact that respiratory failure in patients with stable COPD and their response to mechanical ventilation are influenced by several pathophysiological factors which frequently coexist in the same patient to varying degrees. These pathophysiological factors might influence the success of home NIV in stable COPD, thus long-term NIV specifically adapted to a patient's "phenotype" is likely to improve prognosis, reduce readmission to hospital, and prevent death. In view of this conundrum, Rescue2-monitor (R2M), an open-label, prospective randomized, controlled study performed in patients with hypercapnic COPD post-AHRF, will investigate the impact of the quality of nocturnal NIV on the readmission-free survival. The primary objective is to show that any of 3 home NIV strategies ("rescue," "non-targeted," and "targeted") will improve readmission-free survival in comparison to no-home NIV. The "targeted" group of patients will receive a treatment with personalized (targeted) ventilation settings and extensive monitoring. Furthermore, the influence of comorbidities typical for COPD patients, such as cardiac insufficiency, OSA, or associated asthma, on ventilation outcomes will be taken into consideration and reasons for non-inclusion of patients will be recorded in order to evaluate the percentage of ventilated COPD patients that are screening failures. ClinicalTrials.gov NCT03890224 . Registered on March 26, 2019.
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Rabec C, Gonzalez-Bermejo J. Respiratory support in patients with COVID-19 (outside intensive care unit). A position paper of the Respiratory Support and Chronic Care Group of the French Society of Respiratory Diseases. Respir Med Res 2020; 78:100768. [PMID: 32707480 PMCID: PMC7255256 DOI: 10.1016/j.resmer.2020.100768] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 04/18/2020] [Revised: 05/09/2020] [Accepted: 05/10/2020] [Indexed: 02/06/2023]
Abstract
With first cases noted towards the end of 2019 in China, COVID-19 infection was rapidly become a devastating pandemic. Even if most patients present with a mild to moderate form of the disease, the estimated prevalence of COVID-19-related severe acute respiratory failure (ARF) is 15–20% and 2–12% needed intubation and mechanical ventilation. In addition to mechanical ventilation some other techniques of respiratory support could be used in some forms of COVID-19 related ARF. This position paper of the Respiratory Support and Chronic Care Group of the French Society of Respiratory Diseases is intended to help respiratory clinicians involved in care of COVID-19 pandemic in the rational use of non-invasive techniques such as oxygen therapy, CPAP, non-invasive ventilation and high flow oxygen therapy in managing patients outside intensive care unit (ICU). The aims are: (1) to focus both on the place of each technique and in describing practical tips (types of devices and circuit assemblies) aimed to limit the risk of caregivers when using those techniques at high risk spreading of viral particles; (2) to propose a step-by-step strategy to manage ARF outside ICU.
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Affiliation(s)
- C Rabec
- Service de Pneumologie et Soins Intensifs Respiratoires, Centre Hospitalier Universitaire de Dijon, 14, rue Gaffarel, 21000 Dijon, France.
| | - J Gonzalez-Bermejo
- Service de Pneumologie, Médecine Intensive et Réanimation (Département R3S, Sorbonne Université, INSERM UMRS 1158 Neurophysiologie respiratoire, expérimentale et clinique, Groupe Hospitalier Universitaire AP-HP Sorbonne Université, AP-HP site Pitié-Salpêtrière, Paris, France
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Nierat MC, Raux M, Redolfi S, Gonzalez-Bermejo J, Biondi G, Straus C, Rivals I, Morélot-Panzini C, Similowski T. Neuroergonomic and psychometric evaluation of full-face crew oxygen masks respiratory tolerance: a proof-of-concept study. J ROY ARMY MED CORPS 2018; 165:317-324. [PMID: 30415218 DOI: 10.1136/jramc-2018-001028] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 09/19/2018] [Accepted: 09/19/2018] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Preventing in-flight hypoxia in pilots is typically achieved by wearing oxygen masks. These masks must be as comfortable as possible to allow prolonged and repeated use. The consequences of mask-induced facial contact pressure have been extensively studied, but little is known about mask-induced breathing discomfort. Because breathlessness is a strong distractor and engages cerebral resources, it could negatively impact flying performances. METHODS Seventeen volunteers (age 20-32) rated respiratory discomfort while breathing with no mask and with two models of quick-donning full-face crew oxygen masks with regulators (mask A, mask B). Electroencephalographic recordings were performed to detect a putative respiratory-related cortical activation in response to inspiratory constraint (experiment 1, n=10). Oxygen consumption was measured using indirect calorimetry (experiment 2, n=10). RESULTS With mask B, mild respiratory discomfort was reported significantly more frequently than with no mask or mask A (experiment 1: median respiratory discomfort on visual analogue scale 0.9 cm (0.5-1.4), experiment 1; experiment 2: 2 cm (1.7-2.9)). Respiratory-related cortical activation was present in 1/10 subjects with no mask, 1/10 with mask A and 6/10 with mask B (significantly more frequently with mask B). Breathing pattern, sigh frequency and oxygen consumption were not different. CONCLUSIONS In a laboratory setting, breathing through high-end aeronautical full-face crew oxygen masks can induce mild breathing discomfort and activate respiratory-related cortical networks. Whether or not this can occur in real-life conditions and have operational consequences remains to be investigated. Meanwhile, respiratory psychometric and neuroergonomic approaches could be worth integrating to masks development and evaluation processes.
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Affiliation(s)
- Marie-Cécile Nierat
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
| | - M Raux
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.,Département d'Anesthésie-Réanimation, AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Paris, France
| | - S Redolfi
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.,Service des Pathologies du Sommeil, Département R3S, AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Paris, France
| | - J Gonzalez-Bermejo
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.,Service de Pneumologie, Médecine Intensive et Réanimation, Département R3S, AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Paris, France
| | - G Biondi
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
| | - C Straus
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.,Service des Explorations de la Fonction Respiratoire, de l'Exercice et de la Dyspnée, Département R3S, AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Paris, France
| | - I Rivals
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.,Equipe de Statistique Appliquée, ESPCI Paris, PSL Research University, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
| | - C Morélot-Panzini
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.,Service de Pneumologie, Médecine Intensive et Réanimation, Département R3S, AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Paris, France
| | - T Similowski
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France .,Service de Pneumologie, Médecine Intensive et Réanimation, Département R3S, AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Paris, France
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Rabec C, Gonzalez-Bermejo J, Cuvelier A, Cervantes P, Foret D, Mounier L, Melloni B, Muir JF. [Cohort of patients initiated to home ventilation. Observational and prospective study]. Rev Mal Respir 2018; 35:88-93. [PMID: 29395564 DOI: 10.1016/j.rmr.2017.05.004] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 05/01/2017] [Indexed: 11/30/2022]
Abstract
Cohort of patients initiated to home ventilation. Observational and prospective study. The effectiveness of home noninvasive ventilation (NIV) for chronic respiratory failure (CRF) is well established. However, few data are available about home NIV prescription and utilization according to the different etiologies of respiratory failure. The ANTADIR Federation, in partnership with the Ventilatory Support Group of the French Speaking Pulmonary Society, has set up a national, observational and multicenter cohort study. The main goal of this study is to analyze the clinical data justifying home NIV prescription in patients with chronic respiratory insufficiency. The secondary objectives will be to assess: the evolution of comorbidities or their occurrence, hospitalizations, NIV compliance, dropout and survival. The population includes patients with chronic respiratory failure newly initiated onto NIV, both in a stable state and following an acute exacerbation who qualify for long-term NIV. Data collected include: diagnosis and comorbidities, age, sex, BMI, biomarkers (hematocrit, arterial blood gases, total CO2) and functional data (FEV1, VC, TLC), nocturnal results (SaO2, PtcCO2), type of ventilator used, ventilator parameters and mask type. Follow-up data will be collected at 4 months, 1 year and 2 years and will include: hospitalizations, changes in prescription, adherence, dropouts and deaths. This work will make it possible to obtain new scientific information on long-term NIV use in France.
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Affiliation(s)
- C Rabec
- Service de pneumologie et soins intensifs respiratoires, centre hospitalier universitaire de Dijon, 14, rue Paul-Gaffarel, 21079 Dijon, France; Fédération ANTADIR, Paris, France.
| | - J Gonzalez-Bermejo
- Inserm, UMRS1158, service de pneumologie et réanimation médicale, neurophysiologie respiratoire expérimentale et clinique, Paris et Sorbonne universités, groupe hospitalier Pitié-Salpêtrière-Charles-Foix, 75106 Paris, France
| | - A Cuvelier
- UPRES EA 3830, service de pneumologie et unité de soins intensifs respiratoires, université de Rouen, CHU de Rouen, Rouen, France
| | - P Cervantes
- Fédération ANTADIR, Paris, France; Service de pneumologie, HPM, hôpital Robert-Schuman, Metz, France
| | - D Foret
- Fédération ANTADIR, Paris, France
| | | | - B Melloni
- Fédération ANTADIR, Paris, France; Service de pneumologie, centre hôspitalier universitaire de Limoges, Limoges, France
| | - J-F Muir
- Fédération ANTADIR, Paris, France; UPRES EA 3830, service de pneumologie et unité de soins intensifs respiratoires, université de Rouen, CHU de Rouen, Rouen, France
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Guerder A, Zhi Li P, Herengt F, Brosson C, Grosbois J, Bender A, Wallaert B, Antoniadis A, Bernardy A, Pernot J, Gonzalez-Bermejo J, Similowski T, Aguilaniu B. Évaluation multimodale simplifiée de la réhabilitation respiratoire selon la sévérité fonctionnelle des patients atteints de BPCO. Rev Mal Respir 2018. [DOI: 10.1016/j.rmr.2017.10.575] [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: 10/18/2022]
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12
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Grassion L, Llontop C, Layachi L, Hubert E, Morelot-Panzini C, Gonzalez-Bermejo J. [Home care ventilator's settings]. Rev Mal Respir 2017; 35:992-996. [PMID: 29246669 DOI: 10.1016/j.rmr.2017.04.004] [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] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 04/08/2017] [Indexed: 10/18/2022]
Affiliation(s)
- L Grassion
- Service des maladies respiratoires, hôpital du Haut-Lévêque, avenue de Magellan, 33604 Pessac, France
| | - C Llontop
- Service des maladies respiratoires, hôpital du Haut-Lévêque, avenue de Magellan, 33604 Pessac, France
| | - L Layachi
- Service des maladies respiratoires, hôpital du Haut-Lévêque, avenue de Magellan, 33604 Pessac, France
| | - E Hubert
- Service des maladies respiratoires, hôpital du Haut-Lévêque, avenue de Magellan, 33604 Pessac, France
| | - C Morelot-Panzini
- Service des maladies respiratoires, hôpital du Haut-Lévêque, avenue de Magellan, 33604 Pessac, France; Neurophysiologie respiratoire expérimentale et clinique, Inserm, UMRS1158, Sorbonne universités, UPMC université Paris 06, 75013 Paris, France
| | - J Gonzalez-Bermejo
- Service des maladies respiratoires, hôpital du Haut-Lévêque, avenue de Magellan, 33604 Pessac, France; Neurophysiologie respiratoire expérimentale et clinique, Inserm, UMRS1158, Sorbonne universités, UPMC université Paris 06, 75013 Paris, France.
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Gonzalez-Bermejo J, Guerder A, Reychler G. [Non-pharmacological management in acute COPD exacerbations]. Rev Mal Respir 2017; 34:477-486. [PMID: 28495297 DOI: 10.1016/j.rmr.2017.03.024] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- J Gonzalez-Bermejo
- Sorbonne universités, UPMC université Paris 06, Inserm, UMRS1158 neurophysiologie respiratoire expérimentale et clinique, 75013 Paris, France
| | - A Guerder
- Département "R3S", service de pneumologie et réanimation médicale, groupe hospitalier Pitié-Salpêtrière Charles-Foix, AP-HP, 75013 Paris, France
| | - G Reychler
- Services de pneumologie et de médecine physique, cliniques universitaires Saint-Luc, 10, avenue Hippocrate, 1200 Bruxelles, Belgique.
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Jouneau S, Dres M, Guerder A, Bele N, Bellocq A, Bernady A, Berne G, Bourdin A, Brinchault G, Burgel P, Carlier N, Chabot F, Chavaillon J, Cittee J, Claessens Y, Delclaux B, Deslée G, Ferré A, Gacouin A, Girault C, Ghasarossian C, Gouilly P, Gut-Gobert C, Gonzalez-Bermejo J, Jebrak G, Le Guillou F, Léveiller G, Lorenzo A, Mal H, Molinari N, Morel H, Morel V, Noel F, Pégliasco H, Perotin J, Piquet J, Pontier S, Rabbat A, Revest M, Reychler G, Stelianides S, Surpas P, Tattevin P, Roche N. Management of acute exacerbations of chronic obstructive pulmonary disease (COPD). Guidelines from the Société de pneumologie de langue française (summary). Rev Mal Respir 2017; 34:282-322. [DOI: 10.1016/j.rmr.2017.03.034] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 08/31/2016] [Indexed: 11/25/2022]
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15
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Nierat MC, Rivals I, Gonzalez-Bermejo J, Morelot-Panzini C, Similowski T, Lamy JC. Cathodal trans-spinal direct current stimulation (tsDCS) is harmful in ALS patients: direct evidence from intradiaphragmatic recordings. Brain Stimul 2017. [DOI: 10.1016/j.brs.2017.01.112] [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: 11/15/2022] Open
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Le X, Soler J, Grassion L, Guerder A, Gonzalez-Bermejo J. Validation d’un dispositif de télésuivi de la fréquence respiratoire de malades sous oxygénothérapie. Rev Mal Respir 2017. [DOI: 10.1016/j.rmr.2016.10.394] [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: 10/20/2022]
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17
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Rabec C, Cuvelier A, Cheval C, Jaffre S, Janssens JP, Mercy M, Prigent A, Rouault S, Talbi S, Vandenbroeck S, Gonzalez-Bermejo J. Ventilation non invasive. Les conseils 2015 du Groupe assistance ventilatoire (GAV) de la Société de pneumologie de langue française (SPLF). Rev Mal Respir 2016; 33:905-910. [DOI: 10.1016/j.rmr.2016.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 05/17/2016] [Indexed: 01/22/2023]
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18
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Gharib A, Khattab A, Housset B, Saeed A, Gomaa N, Gonzalez-Bermejo J. Validation d’un algorithme de diagnostic de l’embolie pulmonaire chez les patients atteints d’obésité. Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.687] [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: 10/22/2022]
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19
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Kelkel E, Herengt F, Ben Saidane H, Veale D, Jeanjean C, Pison C, Pernot J, Pépin JL, Guillaud-Segard B, Gonzalez-Bermejo J, Aguilaniu B. COLIBRI : optimiser la pratique clinique et produire des données scientifiques pertinentes. Rev Mal Respir 2016; 33:5-16. [DOI: 10.1016/j.rmr.2015.02.090] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 02/14/2015] [Indexed: 11/30/2022]
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20
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Gonzalez-Bermejo J, LLontop C, Similowski T, Morélot-Panzini C. Respiratory neuromodulation in patients with neurological pathologies: for whom and how? Ann Phys Rehabil Med 2015; 58:238-244. [PMID: 26260006 DOI: 10.1016/j.rehab.2015.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Accepted: 07/01/2015] [Indexed: 10/23/2022]
Abstract
Implanted phrenic nerve stimulation is a technique restoring spontaneous breathing in patients with respiratory control failure, leading to being dependent on mechanical ventilation. This is the case for quadriplegic patients with a high spinal cord injury level and for patients with congenital central hypoventilation syndrome. The electrophysiological diaphragm explorations permits better patient selection, confirming on the one hand a definite issue with central respiratory command and on the other hand the integrity of diaphragmatic phrenic nerves. Today there are two different phrenic stimulation techniques: the quadripolar intrathoracic stimulation and the bipolar intradiaphragmatic stimulation. Both techniques allow patients to be weaned off their mechanical ventilator, improving dramatically their quality of life. In fact, one of the systems (phrenic intradiaphragmatic stimulation) was granted social security reimbursement in 2009, and now both are reimbursed. In the future, phrenic intradiaphragmatic stimulation may find its place in the intensive care unit, for patients needing it temporarily, for example, after certain surgeries with respiratory complications as well as diaphragmatic atrophies induced by prolonged mechanical ventilation.
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Affiliation(s)
- J Gonzalez-Bermejo
- Service de pneumologie et réanimation médicale (département « R3S »), groupe hospitalier Pitié-Salpêtrière - Charles-Foix, AP-HP, 75013 Paris, France; Inserm, UMRS1158 neurophysiologie respiratoire expérimentale et clinique, UPMC - université Paris 06, Sorbonne universités, 75013 Paris, France.
| | - C LLontop
- Service de pneumologie et réanimation médicale (département « R3S »), groupe hospitalier Pitié-Salpêtrière - Charles-Foix, AP-HP, 75013 Paris, France
| | - T Similowski
- Service de pneumologie et réanimation médicale (département « R3S »), groupe hospitalier Pitié-Salpêtrière - Charles-Foix, AP-HP, 75013 Paris, France; Inserm, UMRS1158 neurophysiologie respiratoire expérimentale et clinique, UPMC - université Paris 06, Sorbonne universités, 75013 Paris, France
| | - C Morélot-Panzini
- Service de pneumologie et réanimation médicale (département « R3S »), groupe hospitalier Pitié-Salpêtrière - Charles-Foix, AP-HP, 75013 Paris, France; Inserm, UMRS1158 neurophysiologie respiratoire expérimentale et clinique, UPMC - université Paris 06, Sorbonne universités, 75013 Paris, France
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Similowski T, Gonzalez-Bermejo J, Straus C, Morelot-Panzini C, Menegaux F, Le Pimpec-Barthes F, Assouad J. Nerf phrénique et diaphragme : considérations anatomiques et physiologiques dans la perspective de la stimulation phrénique implantée chez le blessé médullaire haut. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.871] [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: 10/25/2022]
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22
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Gonzalez-Bermejo J, Perrin C, Janssens JP, Pépin JL, Mroue G, Leger P, Langevin B, Rouault S, Rabec C, Rodenstein D. Proposition pour une analyse systématique de la polygraphie et de la polysomnographie afin d’identifier les évènements anormaux survenant pendant la ventilation non invasive. Rev Mal Respir 2014; 31:312-22. [DOI: 10.1016/j.rmr.2013.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 05/22/2013] [Indexed: 10/26/2022]
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23
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Beaumont L, Mwenge B, Golmard J, Georges M, Morelot-Panzini C, Morel S, Straus C, Similowski T, Gonzalez-Bermejo J. Test en hypoxie sous ventilation non invasive (VNI) chez les patients insuffisants respiratoires dans le cadre de maladies neuromusculaires (MNM) au stade de ventilation : comparaison de l’oxygénothérapie (O2) et de la VNI. Rev Mal Respir 2014. [DOI: 10.1016/j.rmr.2013.10.037] [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: 10/25/2022]
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Aguilaniu B, Kelkel E, Hess D, Herengt F, Ben Saidane H, Guillaud-Segard B, Gonzalez-Bermejo J, Bertrand D, Camara B, Pernot J, Pison C, Pépin JL. COLIBRI-BPCO : observatoire longitudinal basé sur une consultation-web pour les pneumologues hospitaliers (H) et libéraux (L). Rev Mal Respir 2014. [DOI: 10.1016/j.rmr.2013.10.188] [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: 10/25/2022]
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Rabec C, Rodenstein D, Leger P, Rouault S, Perrin C, Gonzalez-Bermejo J. [Ventilator modes and settings during non-invasive ventilation: effects on respiratory events and implications for their identification. 2011]. Rev Mal Respir 2013; 30:818-31. [PMID: 24314706 DOI: 10.1016/j.rmr.2013.08.001] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 05/22/2013] [Indexed: 11/26/2022]
Abstract
Compared with invasive ventilation, non-invasive ventilation (NIV) has two unique characteristics: its non-hermetic nature and the fact that the ventilator-lung assembly cannot be considered as a single-compartment model because of the presence of variable resistance represented by the upper airways. When NIV is initiated, the ventilator settings are determined empirically based on clinical evaluation and blood gas variations. However, NIV is predominantly applied during sleep. Consequently, to assess overnight patient-machine "agreement" and efficacy of ventilation, more specific and sophisticated monitoring is needed. The effectiveness of NIV might therefore be more correctly assessed by sleep studies than by daytime assessment. The simplest monitoring can be done from flow and pressure curves from the mask or the ventilator circuit. Examination of these tracings can give useful information to evaluate if the settings chosen by the operator were the right ones for that patient. However, as NIV allows a large range of ventilatory parameters and settings, it is mandatory to have information about this to better understand patient-ventilator interaction. Ventilatory modality, mode of triggering, pressurization slope, use or not of positive end expiratory pressure and type of exhalation as well as ventilator performances may all have physiological consequences. Leaks and upper airway resistance variations may, in turn, modify these patterns. This article discusses the equipment available for NIV, analyses the effect of different ventilator modes and settings and of exhalation and connecting circuits on ventilatory traces and gives the background necessary to understand their impact on nocturnal monitoring of NIV.
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Affiliation(s)
- C Rabec
- Service de pneumologie et réanimation respiratoire, CHU de Dijon, 2, boulevard du Maréchal-de-Lattre-de-Tassigny, 21079 Dijon, France.
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Gonzalez-Bermejo J, Morelot-Panzini C, Georges M, Demoule A, Similowski T. Can diaphragm pacing improve gas exchange? Insights from quadriplegic patients. Eur Respir J 2013; 43:303-6. [DOI: 10.1183/09031936.00127713] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Assouad J, Masmoudi H, Gonzalez-Bermejo J, Morelot-Panzini C, Diop M, Grunenwald D, Similowski T. Diaphragm pacing after bilateral implantation of intradiaphragmatic phrenic stimulation electrodes through a transmediastinal endoscopic minimally invasive approach: pilot animal data. Eur J Cardiothorac Surg 2012; 42:333-9. [DOI: 10.1093/ejcts/ezr324] [Citation(s) in RCA: 4] [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] [Indexed: 11/12/2022] Open
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Aguilaniu B, Gonzalez-Bermejo J, Regnault A, Barbosa CD, Arnould B, Mueser M, Granet G, Bonnefoy M, Similowski T. Disability related to COPD tool (DIRECT): towards an assessment of COPD-related disability in routine practice. Int J Chron Obstruct Pulmon Dis 2011; 6:387-98. [PMID: 21760726 PMCID: PMC3133511 DOI: 10.2147/copd.s20007] [Citation(s) in RCA: 13] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Chronic Obstructive Pulmonary Disease (COPD) is a worldwide public health concern. It is also a major source of disability that is often overlooked, depriving patients of effective treatments. This study describes the development and validation of a questionnaire specifically assessing COPD-related disability. METHODS The DIsability RElated to COPD Tool (DIRECT) was developed according to reference methods, including literature review, patient and clinician interviews and test in a pilot study. A 12-item questionnaire was included for finalization and validation in an observational cross-sectional study conducted by 60 French pulmonologists, who recruited 275 COPD patients of stage II, III and IV according to the GOLD classification. Rasch modeling was conducted and psychometric properties were assessed (internal consistency reliability; concurrent and clinical validity). RESULTS The DIRECT score was built from the 10 items retained in the Rasch model. Their internal consistency reliability was excellent (Cronbach's alpha = 0.95). The score was highly correlated with the Saint George's Respiratory Questionnaire Activity score (r = 0.83) and the London Handicap Scale (r = -0.70), a generic disability measure. It was highly statistically significantly associated to four clinical parameters (P < 0.001): GOLD classification, BODE index, FEV₁ and 6-minute walk distance. CONCLUSION DIRECT is a promising tool that could help enhance the management of COPD patients by integrating an evaluation of the COPD-related disability into daily practice.
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Affiliation(s)
- B Aguilaniu
- HYLAB, Physiologie Clinique, Grenoble, France
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Pison CM, Cano NJ, Cherion C, Caron F, Court-Fortune I, Antonini MT, Gonzalez-Bermejo J, Meziane L, Molano LC, Janssens JP, Costes F, Wuyam B, Similowski T, Melloni B, Hayot M, Augustin J, Tardif C, Lejeune H, Roth H, Pichard C. Multimodal nutritional rehabilitation improves clinical outcomes of malnourished patients with chronic respiratory failure: a randomised controlled trial. Thorax 2011; 66:953-60. [DOI: 10.1136/thx.2010.154922] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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30
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Morélot-Panzini C, Gonzalez-Bermejo J, Similowski T. La stimulation phrénique implantée. Réanimation 2011. [DOI: 10.1007/s13546-010-0007-3] [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: 11/30/2022]
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31
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Gonzalez-Bermejo J. [A great step in oxygen therapy for COPD? Maybe. A great step in quality control for home respiratory support devices? At last]. Rev Mal Respir 2010; 27:1013-4. [PMID: 21111270 DOI: 10.1016/j.rmr.2010.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Accepted: 10/04/2010] [Indexed: 11/29/2022]
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Gonzalez-Bermejo J, Perrin C, Janssens JP, Pepin JL, Mroue G, Léger P, Langevin B, Rouault S, Rabec C, Rodenstein D. Proposal for a systematic analysis of polygraphy or polysomnography for identifying and scoring abnormal events occurring during non-invasive ventilation. Thorax 2010; 67:546-52. [DOI: 10.1136/thx.2010.142653] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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33
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Rabec C, Gonzalez-Bermejo J, Arnold V, Rouault S, Gillet V, Perrin C, Alluin F, Muir JF, Veale D. Mise en route d’une ventilation non invasive au domicile : propositions du groupe de travail Casavni. Rev Mal Respir 2010; 27:874-89. [DOI: 10.1016/j.rmr.2010.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2009] [Accepted: 03/23/2010] [Indexed: 11/15/2022]
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Le Pimpec-Barthes F, Brian E, Vlas C, Gonzalez-Bermejo J, Bagan P, Badia A, Riquet M, Similowski T. [Surgical treatment of diaphragmatic eventrations and paralyses]. Rev Mal Respir 2010; 27:565-78. [PMID: 20610072 DOI: 10.1016/j.rmr.2010.01.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2009] [Accepted: 01/03/2010] [Indexed: 11/26/2022]
Abstract
Surgical treatment of eventration or paralysis of the diaphragm is symptomatic and non curative, and depends on whether the dysfunction is of peripheral or central origin. Elevation of a hemidiaphragm of peripheral origin, the most frequent situation, needs surgical treatment only in case of major functional effects (effort or positional dyspnoea, cardiac or digestive symptoms, or pain) that persists despite optimal conservative management. Selection of candidates for surgery depends on a thorough morphological and functional investigation of the neuromuscular and respiratory components. Surgical plication of the diaphragm through a lateral thoracotomy or by video-thoracoscopy is a recognized, safe and effective procedure. Its low morbidity and mortality, which are mainly associated with co-morbid factors, and its long-lasting functional benefit of around 100%, show that it is an effective procedure. In the case of bilateral dysfunction, occasional cases of bilateral plication have been reported. Some cases of diaphragmatic paralysis of central causation result in a life of ventilator dependence, even though the peripheral neuromuscular and respiratory systems are intact. In selected cases, following a complete functional investigation, phrenic nerve pacing may be attempted to achieve ventilator weaning. To date, there are two validated indications for this technique: Tetraplegia above C3 and alveolar hypoventilation of central cause. After thoracic implantation, a progressive reconditioning of the diaphragmatic muscle allows weaning from the ventilator in a few weeks in more than 90% of patients. Their quality of life is greatly improved thanks to independence from the ventilator, more physiological respiration, restoration of smell and better speech. Whether the diaphragmatic dysfunction is peripheral or central in origin, the success of surgical treatment depends on rigorous preoperative selection of patients.
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Affiliation(s)
- F Le Pimpec-Barthes
- Service de chirurgie thoracique, hôpital européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75908 Paris cedex 15, France
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Pradat PF, Attarian S, Camdessanché JP, Carluer L, Cintas P, Corcia P, Echaniz-Laguna A, Gonzalez-Bermejo J, Guy N, Nicolas G, Perez T, Soriani MH, Vandenberghe N, Verschueren A. [Research in amyotrophic lateral sclerosis: what is new in 2009?]. Rev Neurol (Paris) 2010; 166:683-98. [PMID: 20472259 DOI: 10.1016/j.neurol.2010.03.006] [Citation(s) in RCA: 4] [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] [Received: 01/16/2010] [Accepted: 03/03/2010] [Indexed: 12/12/2022]
Abstract
This paper, written by French amyotrophic lateral sclerosis (ALS) center experts, presents an update of recent advances in fundamental, epidemiological and clinical research in ALS based on a review of the literature between September 2008 and November 2009. Among other pathophysiological mechanisms, the role of stress of the endoplasmic reticulum and the importance of energetic metabolic disturbances have been underscored. In the field of genetics, research has been advanced through the identification of mutations of the gene FUsed in Sarcoma/Translated in LipoSarcoma (FUS/TLS) in individuals with familial and sporadic ALS. This gene is involved in the regulation of transcription, splicing and RNA transport, and has functional homology to another ALS gene, TARDBP, which suggests that a common mechanism may underlie motor neuron degeneration. A report showed that mice expressing a mutant form of human TDP-43 develop a progressive and fatal neurodegenerative disease reminiscent of both ALS and frontotemporal lobar degeneration with ubiquitin aggregates (FTLD-U), providing a new animal model that may help to better understand the pathophysiology and test new therapeutics. Beside genetic studies, several epidemiologic studies have investigated the role of environmental factors. A recent study suggests that smoking is a risk factor for developing ALS and it is hypothesized that this could occur through lipid peroxidation via formaldehyde exposure. From a neuroprotective perspective, trials with IGF-1, sodium valproate, coenzyme Q or glatiramer acetate have failed to demonstrate any beneficial effect. A study published in 2008 argued that lithium may have a neuroprotective effect in ALS mice and also in patients. However, two preclinical studies failed to replicate the neuroprotective effect of lithium in ALS mice. Therapeutic trials have been performed or are currently ongoing in Europe and North America. Their results have not yet been published.
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Affiliation(s)
- P-F Pradat
- CHU Pitié-Salpêtrière, AP-HP, Paris cedex 13, France.
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Abstract
Efficacy and tolerance of home non-invasive ventilation (NIV) must be assessed by using objective criteria (clinical evaluation, arterial blood gases, oxymetry, and research of side effects such as air leaks, skin problems, etc). In this article, we describe a procedure for long-term follow-up of home NIV. We also suggest an algorithm using available polygraphic tools to ascertain causes of NIV failure, in order to correct them.
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Affiliation(s)
- A Tintignac
- DES pneumologie, département des maladies respiratoires, hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, 13009 Marseille, France
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Adler D, Gonzalez-Bermejo J, Duguet A, Demoule A, Le Pimpec-Barthes F, Hurbault A, Morelot-Panzini C, Similowski T. Diaphragm pacing restores olfaction in tetraplegia. Eur Respir J 2009; 34:365-70. [DOI: 10.1183/09031936.00177708] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Gonzalez-Bermejo J. [What are the peculiarities of management in respiratory insufficiency patients coupled with air travel? Air travel in patients undergoing long-term oxygen therapy]. Rev Mal Respir 2007; 24:4S30-4S33. [PMID: 17707967] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Affiliation(s)
- J Gonzalez-Bermejo
- Service de Pneumologie et Réanimation et Centre SLA Ile-de-France, Groupe Hospitalier Pitié-Salpêtriêre, Paris, France.
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Gonzalez-Bermejo J, Duguet A, Delafosse C, Derenne JP, Similowski T. 132 Consommation d’oxygène du diaphragme au cours de la stimulation phrénique implantée. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)71960-x] [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: 11/27/2022]
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Gonzalez-Bermejo J. [Indications and equipment needs for ventilatory support in amyotrophic lateral sclerosis]. Rev Neurol (Paris) 2006; 162 Spec No 2:4S320-4S322. [PMID: 17128132] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Long term mechanical ventilation improves survival and quality of life in patients with Amyotrophic Lateral Sclerosis (ALS). There is an enormous range of equipment available but there is little evidence pointing to the superiority of one device over another. Another problem is the lack of adaptation of equipment for use by handicapped patients. Indication on mechanical ventilation in ALS is discuss in this article: Symptoms associated with an objective criteria of hypoventilation are often used. In the monitoring of this mechanical ventilation new tools are needed, initiating nocturnal ventilation with systematic respiratory polygraphic studies seems to be justified.
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Affiliation(s)
- J Gonzalez-Bermejo
- Service de Pneumologie et de Réanimation, GH Pitié-Salpêtrière, Assistance Publique, Hôpitaux de Paris, Paris.
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Gonzalez-Bermejo J, Laplanche V, Husseini FE, Duguet A, Derenne JP, Similowski T. Evaluation of the user-friendliness of 11 home mechanical ventilators. Eur Respir J 2006; 27:1236-43. [PMID: 16481386 DOI: 10.1183/09031936.06.00078805] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The home ventilator market has grown in size and complexity. The aim of this study was to determine if common home ventilators are user-friendly for trained intensive care unit (ICU) physicians. Eleven ventilator models were tested by 13 ICU physicians without practical experience in home mechanical ventilation. Six tests were defined (start-up, unlocking, mode and setting recognition, mode change, pressure setting and alarm). For each test, the physicians were timed and their performance compared with a reference time established by a technician. The physicians also had to rate their global assessment of each machine on a visual analogue scale. The start-up test was the only test for which there was no significant difference between the physicians and the technician, except for two ventilators. The physicians were slower than the technician to unlock the ventilator and change the ventilatory mode, with some complete failures during these tests and heterogeneous results between physicians and between ventilators. Mistakes occurred in close to 50% of cases during the ventilatory mode and settings recognition test. The mean time for the most rapid of the physicians for all the tests was 58+/-53 s, compared with 15+/-9 s for the technician. In conclusion, trained intensive care unit physicians perform poorly when confronted with home mechanical ventilators without specific prior training. Therefore, it is hypothesised that the user-friendliness of home ventilators for other categories of users might be questionable.
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Affiliation(s)
- J Gonzalez-Bermejo
- Service de Pneumologie et de Réanimation, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, 47-83, Bd de l'Hôpital, 75651 Paris Cedex 13, France
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Brissot R, Gonzalez-Bermejo J, Lassalle A, Desrues B, Doutrellot PL. Fatigue and respiratory disorders. ACTA ACUST UNITED AC 2006; 49:320-30, 403-12. [PMID: 16780993 DOI: 10.1016/j.annrmp.2006.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2006] [Accepted: 04/03/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To analyze the factors at the origin of fatigue in respiratory disorders. To assess fatigue and its functional impact on patients affected from respiratory diseases. To evaluate the results of comprehensive care on fatigue and functional capacity. MATERIALS AND METHODS We systematically reviewed the literature in Medline and the Cochrane Library, using the following keywords: fatigue, respiratory disorders, questionnaire, evaluation, assessment, randomized controlled trial, meta-analysis. RESULTS Fatigue is a high frequency symptom (90%) and takes an important place, as much as dyspnea, in the genesis of the respiratory induced handicap. Its assessment is varied, according to the studies. It originates from multiple causes, as shown from clinical and experimental studies. The main treatment consists in rehabilitation, using physical exercises. Its efficacy is demonstrated on physical endurance, but is not clear in terms of general fatigue. CONCLUSION Although fatigue is very frequent complaint, along with a major disabling condition, the comprehensive assessment of fatigue, in respiratory disorders, including its physical and cognitive components, is not still really codified. Rehabilitation is the main treatment. Its efficiency has been demonstrated on the physical and functional components of fatigue. Its results on perceived fatigue remains to be evaluated.
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Affiliation(s)
- R Brissot
- Service de Médecine Physique et de Réadaptation, Hôpital de Pontchaillou, CHU de Rennes, France.
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Gonzalez-Bermejo J, Lofaso F, Falaize L, Lejaille M, Raphaël JC, Similowski T, Melchior JC. Resting energy expenditure in Duchenne patients using home mechanical ventilation. Eur Respir J 2005; 25:682-7. [PMID: 15802343 DOI: 10.1183/09031936.05.00031304] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Nutritional status is both important and difficult to assess in patients with Duchenne muscular dystrophy (DMD), particularly in those requiring mechanical ventilation (MV). The current authors evaluated body composition (bio-impedancemetry), resting energy expenditure (REE; indirect calorimetry) and energy intake in 20 adult patients with DMD using home MV (nocturnal: n = 13; continuous: n = 7) and 12 age-matched healthy controls. The patients were smaller in height than the controls and had a lower body weight. Most of the reduction in body mass index was accounted for by a reduction in fat free mass (FFM). REE (kJ) was significantly reduced in the patients (4559+/-853 kJ x 24 h(-1) versus 7407+/-1312 kJ x 24 h(-1)), but the difference disappeared after correction for FFM. REE and FFM were correlated in both the controls and patients, but less strongly in the latter, the lower strength of the association being due to the patients using continuous MV (REE and FFM uncorrelated). The food intake of the patients was 1.2+/-0.4 greater than their REE. This study shows that patients with advanced forms of Duchenne muscular dystrophy have balanced energy intakes and resting energy expenditure.
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Affiliation(s)
- J Gonzalez-Bermejo
- Service de Pneumologie et de Réanimation, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, 47-83, Bd de l'Hôpital, 75651 Paris Cedex 13, France.
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Abstract
Speech is an essential component of quality of life for patients treated with long term mechanical ventilation. Therefore trying to improve phonation should always sought by physicians treating these patients. We review the different tools and techniques available in order to restore speech for patients with home mechanical ventilation whether ventilation is done continuously or not.
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Affiliation(s)
- J Gonzalez-Bermejo
- Service de pneumologie et de réanimation, Groupe Hospitalier PitiéSalpêtrière, Assistance Publique, Hôpitaux de Paris, France.
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Gonzalez-Bermejo J, Godard M, Duguet A, Derenne JP, Similowski T. [Removal of a tracheostomy in ventilator-dependent patients with neuromuscular disease]. Rev Mal Respir 2005; 22:731-7. [PMID: 16272975 DOI: 10.1016/s0761-8425(05)85630-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Ventilation via a tracheostomy is effective but very restricting in patients with neuromuscular disease. Return to non-invasive ventilation (NIV) is possible but this is not common practice, partly for want of standardised procedures ensuring a safe transition. METHODS A procedure for transfer of ventilation via a tracheostomy to a mask has been developed based on the literature and local experience (feasibility of NIV, absence of laryngo-tracheal lesions, adequate leak compensation, effective cough). It has been tested in three patients with severe but stable neuromuscular disorders (chronic polyneuropathy in two cases and progressive spinal amyotrophy on one). RESULTS The three patients were able to be extubated and established on domiciliary ventilation in 6,7 and 10 days, at the end of which all were discharged home. After 4 months in two cases and 6 months in the other no significant complications developed, the respiratory status under NIV was comparable to that previously under tracheostomy and the patients were satisfied with the change. CONCLUSION The proposed algorithm seems to permit a rapid and safe transition from a tracheostomy to a mask. Large scale studies are needed to verify this concept and subsequently to identify within which group a similar approach may be correctly applied.
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Affiliation(s)
- J Gonzalez-Bermejo
- Service de pneumologie et de réanimation, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris, Paris, France.
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Gonzalez-Bermejo J, Prefaut C, Chaory K, Conil P, Jennequin J, Dubreuil C, Lirsac B. [Question 4-1. Physical rehabilitation in the patient with chronic obstructive pulmonary disease]. Rev Mal Respir 2005; 22:7S64-7S73. [PMID: 16340818] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- J Gonzalez-Bermejo
- Service de Pneumologie et de Réanimation, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.
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