dataesr/scientific-paragraphs-categorization huggingface dataset:
Patients and methods All adults (≥18 years) admitted between January 2006 and December 2014 to a French tertiary care medical ICU (staffed by onsite intensivist 24 h a day and 7 days a week) were included in the study. Patients' characteristics, medical management, and mortality were extracted from our prospective ICU database. Patients were grouped according to their admission time: weekday, weeknight, and weekend. ICU mortality was the primary outcome, and adjusted hazard ratios (HR) of death were analyzed by multivariate Cox model. Results A total of 2. 428 patients were included: age 62 ± 18 years, male: 1515 (62 %), and median SAPSII score: 38 (IQ, 27-52). A total of 1. 449 (59. 7 %) patients received invasive mechanical ventilation, 790 (32. 5 %) patients received vasopressors (epinephrine or norepinephrine) and 162 (6.
The objective of this study was to describe the prevalence of supratherapeutic BL serum levels in septic ICU patients requiring replacement therapy for acute renal failure and their link with potential clinical toxicity. Patients and methods Observational cohort study of patients admitted to the medical surgical ICU of the Saint Joseph Hospital from 1999 to 2013. This was a retrospective analysis of data prospectively collected into the French multicenter Outcomerea database and into the databases of the microbiological and pharmacological laboratory of the hospital. We included consecutive patients with sepsis and ARF, who had been sampled for a BL trough serum level assessment within 7 days of sepsis and 3 days after intermittent dialysis. Sera were sampled before the next administration in case of intermittent infusion and at 24 h in case of continuous infusion.
Patients and methods We used in routine care a CDDS for blood glucose control in the ICU. This CDSS is a second-generation software (CDSS-2) derived from that used during the CGAO-REA trial (NCT01002482), a nonblinded parallel-group randomized controlled trial involving adult patients admitted to ICUs and comparing tight glucose control (TGC) with a first-generation CDSS (CDSS-1, BG range between 4. 4 and 6. 1 mmol/l) and conventional glucose control (CGC) protocols (BG < 10 mmol/l). The BG target has been set by default to 5-7. 5 mmol/l in the CDSS-2. The embedded algorithm used for the calculation of the next insulin rate (to be applied after each BG measure) was of the type proportional integral with variable coefficients to take into account variations of insulinosensitivity throughout the ICU stay.
Patients and methods The study, led by the local team of the French Institute for Public Health Surveillance (InVS) and the Regional Health Agency of Ile-de-France (ARS-IDF), is based on the descriptive analysis of patient data collected by the Paris Poison Control Center (CAPTV), an emergency department (SU) participating in the Oscour ® network, a medical and toxicological intensive care unit (RMT) whose results were extended using the CUBRéa database, the regional coordination of pharmacovigilance (CRPV) in Ile-de-France, and two toxicological laboratories conducting judicial forensic expertise after extra-hospital deaths. Acute poisoning having occured in the Ile-de-France (IDF) region, in 2010 and 2011, whatever the circumstances and severity were included. Deaths were collected prospectively in 2014.
This study is an analysis of the Outcomerea database. We sought to determine whether diabetes mellitus is associated with increased risk of BSI and VAP. Patients and methods Outcomerea is a prospective observational multicenter cohort of patients admitted to 12 French ICUs. We studied the subgroup of patients with ICU length of stay >3 days and who needed invasive mechanical ventilation within the first 3 days of their admission. Patients with complicated diabetes mellitus were compared to patients with uncomplicated diabetes mellitus and with patients without DM. Endpoint was occurrence of ICU-acquired sepsis (first bacterial or fungal BSI and VAP occurring later than the second day of ICU admission, and up to 2 days after extubation, exit or death, data censored at day 28). To estimate the influence of baseline covariates on sepsis occurrence, we used the proportional hazards regression Fine and Gray model for competing risk.
Through an ongoing database, clinical and physiological data gathering in critical care and its reorganization in time can lead to the new concept of the perpetual patient. Competing interests None. P145 Transportation of children on extracorporeal membrane oxygenation: 1-year experience of a tertiary referral center in theIntroduction Extracorporeal membrane oxygenation (ECMO) is used as a rescue therapy in patients with severe and refractory respiratory and/or hemodynamic failure. Ideally, neonates or children candidates for ECMO support should be transferred to a referral ECMO center. However, sometimes patients are too ill to be safely moved with conventional ventilator support. In these situations, ECMO cannulation at the referring facility and transfer by a transport ECMO team is a potentially lifesaving intervention.
Patients and methodsWe analyzed a prospective collected database including patients consecutively admitted in our ICU between January 1, 2014 and June 30, 2015. Patients' autonomy was assessed by Katz's Activity of Daily Living (ADL) questionnaire recorded at admission, while current autonomy status was evaluated by phone call on August 2015. ADL scale was compared before and after ICU stay using Wilcoxon test. Results Two hundred and ninety-five patients were admitted to our ICU, during the study period [median age: 62 years (42. 5-72), median SAPS III: 50. 5 (42-61), sex ratio (H/F):1. 42, NIV as initial ventilatory mode in 53. 3 %], median ADL scale at admission for the whole population: 12 (11-12). Fifty-seven patients died in the ICU (21 %), while 167 were discharged alive and were actually eligible for the second evaluation.
001). In vitro, restoration of T-cell proliferation after CD14pos and CD15pos depletion confirmed the suppressive properties of M-and G-MDSCs, respectively. Quantitative analysis of amino acids concentrations in culture supernatants revealed an arginase activity specifically burden by G-MDSCs and an IDO activity burden by both M-and G-MDSCs. Conclusion In patients with septic shock, M-MDSC and G-MDSC counts are increased and promote the occurrence of nosocomial infections. Those subsets bear IDO and arginase activities and exert a suppressive activity on T-cell proliferation. These new insights highlight the complex mechanisms underlying immune dysfunction in septic patients and could promote future therapeutic approaches. This work was supported by the 2012 experimental research grant from French Intensive Care Society.
For each patient, the following data were retrospectively Introduction In the lack of guidelines, prescription of laboratory tests obtained from medical records and institutional databases: demo- in ICU sometimes seems to pertain to individual or team habits. We graphic and severity of illness parameters, the amount and costs of aimed to assess the impact of clinical guidelines to improve the vol- laboratory tests, daily blood volume drawn, number of red cells trans- ume of laboratory tests performed. fusions and ICU and in-hospital outcomes. Materials and methods It was a monocentric, comparative study, Results A total of 3568 patients were included between January 1, before and after guidelines implementation at patient bedside, in a 2008, and December 31, 2012. Patient's characteristics were similar surgical ICU of a French university hospital.
6 %. 85. 3 % of our patients were polytraumatized, and trauma of the head was the most frequent lesion with a proportion of 85. 3 % followed by the thorax with a frequency of 62. 8 % and finally the abdomen with a rate of 21 %. The average ICU stay was 19. 19 days. The outcome was unfavorable in 30. 9 % of patients Discussion In our study, we found that the polytrauma mainly 1 , Soumia Benbernou 2 , Ahmed Dernane 3 , Fouad touched young males under 40 years old. This constitution is similar to Bouakkaz 2 , Khalida Bouyacoub 4 , Abdelkader Azza 4 1 that reported by David J. Thurman and collaborators in the published Urgences médicales et réanimation chuoran, Faculté de Médecine report on the brain injury in the USA. In the Annual Report of 2013 of d'Oran, Oran, Algeria; 2 Urgences Medicales Chuoran, Faculté de méde-the Trauma Data Bank and by the state of 805 health centers in the cine d'Oran, Oran, Algeria; 3 Umc, Hospital Center And University D'oran, USA, the fall was the leading cause of head injury with a frequency of Oran, Algeria; 4 Urgences medicales, chu oran, oran, Algeria 40.
aissaoui@egp. aphp. fr Annals of Intensive Care 2016, 6(Suppl 1):P94 Introduction There is a lack of data concerning the characteristics, the outcome and temporal trends in mortality of cardiogenic shock (CS) patients admitted in critical care unit (CCU). Accordingly, we provide an extended 15 years long perspective into changing trends in key features of patients, use of life-supporting therapies and in-CCU death rates. Patients and methods We conducted a retrospective study using prospectively collected data from the 1997-2012 database of Parisian area critical care units-the CubRea (Intensive Care Database User Group). We assessed temporal trends in the use of life-supporting therapies and patient outcomes (Crude and SAPS II-Standardized Mortality, discharge location). Results Among 316,905 patients admitted in CCUs, 19, 416 (6.
The rate of patients given birth by caesarian is superior to those given birth by low way, with 60. 77 and 31. 54 %, respectively. Most patients were admitted in severe status, 37. 69 % of the deaths occurred less than 24 h after admission, while 19. 23 % of patients died after 7 days of resuscitation's care. Introduction Many studies have shown a good correlation between the value of the International Society of Thrombosis and Hemostasis (ISTH) score, diagnosis of severe coagulopathy and mortality, especially during severe sepsis and polytrauma. However, physiological changes in hemostasis during pregnancy probably alter the significant thresholds of the ISTH score compromising the application and interpretation of it for the diagnosis of disseminated intravascular coagulopathy (DIC). The morbidity and mortality associated with severe hemorrhage and consumption coagulopathy leading to DIC during pregnancy emphasize the need for the adjustment of this ISTH DIC score to these patients On this basis, an Israeli team recently created from a large retrospective database study (n = 24,693 deliveries), a score of DIC.
We compared them with patients who stayed less than 30 days (short stay patients = SSP), for some data available in our database (age, sex, SAPSII and mortality). SSP, where in-hospital transfer and direct admission were more well balanced (respectively, 52 and 48 %, p < 0. 0001). Sixty-one percentage had a preserved autonomy (autonomy score A and B) and only 38 % had a life-threatening comorbidity (defined as a McCabe score of 2 or 3). The reasons for admission in the ICU were: acute respiratory failure (43 %), sepsis (29 %), weaning from ventilation (10 %), neurological failure (7. 5 %), cardiac arrest (4. 5 %), circulatory failure (3. 5 %),.
P144 From high-quality electronic database to the new concept of perpetual patient. Preliminary results David Brossier 1 , Redha Eltaani 2 , Michaël Sauthier 1 , Guillaume Emeriaud 1 , Bernard Guillois 3 , Philippe Jouvet 1 1 Soins intensifs pédiatriques, CHU Sainte-Justine, Montréal, Canada;.
92 0. 68 -0. 1 0. 71 0. 054 0. 001 0. 066 0. 86 0. 051 Patients and methods We performed a multicenter database study. Hematological patients (i. e. , patients with hematological malignancies) were identified in the database using the International Classification of Diseases coding or through the specific disease-related variable of the SAPS II score. Only extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) or methicillin-resistant Staphylococcus aureus (MRSA) colonization was considered. Intestinal carriage of ESBL-Materials and methods This observational before/after study is conducted over 24 months separated in 2 periods: October 2013 to October 2014 (before the moving) and October 2014 to October 2015 (after the moving). All clinical samples growing with PA were identified.
The data were retrieved from the databases of the adult HSCT unit and the intensive care unit. The short-term outcome was assessed through the intensive care unit and in-hospital mortality rates. Overall survival was the retained long-term outcome criteria and was calculated from intensive care unit admission to death from any cause. Observations of patients still alive on January 1, 2015, were censored at this date. vival distribution was not significantly different according to the source of hematopoietic stem cells (log-rank test p value = 0. 232). Poor performance status remained correlated with lower overall survival (p = 0. 003) in multivariate analysis. After adjustment on variables independently associated with outcome, the in-hospital mortality remained similar between UCB and BM and PBSC recipients (odds ratio: 0.
Differences and results across gender remain unknown. We assessed the relationship between gender and coronary reperfusion after OHCA and the relationship between PCI and outcome according to gender. Materials and methods All patients admitted in our center after OHCA were prospectively included in an electronic registry database, from 2000 to 2013. Characteristics were collected according to the Utstein style. We assessed the association between gender and coro- nary reperfusion (using multivariate logistic regression and propensity score analysis) and between PCI and outcome (according to gender). Results One thousand eight hundred and seventeen patients were included (520 women, 29 %). Women were older (62. 8 vs 59. 1 years, P < 0. 0001), with less cardiomyopathy. They had less bystander cardio- pulmonary resuscitation (84 % vs 88 %, P < 0.
Outcome of elderly patients was most often reported for octogenarians. The mean age in studies was roughly 84 years old. The ICU and hospital mortality were 12 and 25 %, respectively, for scheduled surgery (1). For the same endpoints, it was 38-64 and 45-55 % for medical and unscheduled surgery (2). The primary aim of this study was to precise outcome of youngest patients (80-89 years old) vs oldest (>90 years old). The secondary aim was to evaluate outcome according to supporting care in wards units compared to geriatric units after ICU discharge for the nonagenarians. Patients and methods A multicenter (14 ICUs) observational study (1997-2013) was performed in 14 ICUs belonging to the Outcomerea study group. We extracted from the prospective database Rhea patient's characteristics, intensity of treatment, decisions of limitations of treatment (withholding, withdrawing and anticipated withholding), nurse workload (NEMS: Nine Equivalents of nursing Manpower Score), patient status at ICU and hospital discharge.
Patients and methods This retrospective study using prospectively maintained databases was conducted in the intensive care unit (ICU) of two tertiary hospitals. Adults admitted to ICU between 2008 and 2014 were included. Characteristics of patients who received PLTs were compared to those of patients who did not receive PLTs. The associa-tion between PLTs administration and hospital mortality or infection including bacteraemia and/or bacteriuria was modelled using multi-ple logistic regression. A Cox regression on outcomes using transfu-sion variables as time-varying variables was also performed. Results Of the 18 965 patients included, 2 250 (14. 5 %) received PLTs in ICU. Patients who received PLTs were younger, more often male, were more severe at ICU admission (mean APACHE III score 65 ± 29 versus 52 ± 25, p < 0.
S75 old hospitalized in 14 centers during the study period. Among them, 176 (7. 2 %) were more than 90 years old and represented the cases patients. We matched 176 patients aged 90 years old with patients between 80 and 89 years old hospitalized in the same center and the same severity of illness at admission (Table 57). 10/14 (71 %) of centers had a geriatric unit. Factors associated with transfer in a geriatric unit for nonagenarians vs other wards were severity of illness (SAPS-age, median [IQR] 35 [20. 5-41] vs 23 [17-32], p = 0. 03), use of dobutamine (6/16, 37. 5 % vs 13/114, 11. 4 %), length of stay before ICU admission (0 [0-0. 5] vs 1 [1-0. 5], p < 0. 01). The hos-pital mortality rate was not different (4, 25 vs 20, 17. 5 %, p = 0. 47). The main limitation of the study was the impossibility to research long-Outcome of selected Results The database included 2416 patients aged more than 80 years term outcome due to higher rate of missing data.
There ing complications. The French guidelines consider that starting RRT were no data on the effects of chloride balance on renal function on 48 h after the patient reached the KDIGO 3 level is late and starting survivors from cardiac arrest (CA). Aim: To investigate whether chloride serum and urinary levels as well as chloride load, balance and the anion urinary gap in the first day since admission are associated with the development of AKI among CA survivors. Materials and methods Retrospective analysis of an institutional database including all adult comatose patients admitted to the Intensive Care Unit (ICU) after CA from January 2007 to December 2014. Inclusion criteria were as follows: age ≥18; non-traumatic arrest; complete data available on serum and urinary samples for at least 3 days; survival ≥72 h after admission.
Patients with previous AKI and with anuria on ICU admission and on chronic haemodialy-sis were excluded. Demographics, CA-related findings and outcome information were included in the database. We collected chloride levels on daily blood (BCl) and urinary (UCl) analyses; chloride load (CL) was calculated by considering the amount of chloride present in the IV fluids administered daily to the patient, while chloride bal-ance (CB) was calculated as: CL-CO, where CO is chloride output (UCl × daily urine output). Creatinine clearance (CrCl) was calculated on 24-h urinary collection. AKI was defined according to standard RRT at the KDIGO 2 level is early. Therefore, if we could predict that a patient will not progress from a KDIGO level ≤2 toward the KDIGO 3 level we would be able to discriminate the population that should not benefit of an early RRT.
Matching criteria were participating center, SAPS II ± 10, insertion site (jugular or femoral), side for jugular site, and duration between ICU admission and DC placement. DC colonization was defined Results Of the 404 eligible patients, 102 met the inclusion criteria and were eventually analysed. Median age was 58 [49-74] years, and 3 S91 Postpartum acute renal failure: a multicenter study of risk factors in patients admitted to ICU. http://www. annalsofintensivecare. com/content/4/1/36. run lasted 6 to 12 h. Sodium citrate and calcium chloride infusion was set according to a homemade protocol. The SLED run efficacy was evaluated by the online KT/V data delivered by the dialysis system. Results A total of 41 patients who benefited from 104 RRT sessions are extracted from the database. Sixty-seven runs are exploitable due to lack of information for other runs.
03). Introduction In large-scale trials, endotracheal intubation (EI) associated with mechanical ventilation is performed in 40-85 % of patients with septic shock possibly indicating an important variation in practice across physicians. No study has been dedicated until now to define the place of this procedure in shock patients, and recent guidelines does not put forward any recommendation. The objective of the study was to determine the characteristics associated with endotracheal intubation in septic shock patients. Patients and methods This is a post hoc analysis of the database of the SEPSISPAM study, including patients with septic shock. Results Among the 776 SEPSISPAM patients, 633 (82 %) were intubated within 12 h of study inclusion (early intubation), 113 (15 %) were never intubated, and 30 (4 %) had delayed intubation.
critically ill patients: epidemiological trends, clinical features and ICU outcome Laura Platon 1 , Philippe Rispail 2 , Vincent Brunot 1 , N. Besnard 1 , Patrice Ceballos3 , Kada Klouche 1 Introduction Invasive fungal infections (IFIs) are associated with high morbidity and mortality in critically ill patients, especially those immunocompromised. Aspergillus spp. remain an important cause of IFIs, but other moulds have emerged over recent years as significant opportunistic pathogens and are associated with even higher mortality rates. In this retrospective study, we aimed to describe epidemiological trends and clinical features of IFIs caused by emerging moulds and to assess their outcome in intensive care unit (ICU) settings. Patients and methods From our ICU database, we extracted all records of patients admitted to the ICU from 2006 to 2014, in which IFI due to emerging moulds was diagnosed.
HTBM HTBM uses the Hierarchical Token Bucket (HTB) queuing discipline to shape the HTTP adaptive streams. HTB is integrated in Linux with the traffic controller tool of the iproutes2 utility package. It uses one link, designated as the parent class, to emulate several slower links, designated as the children classes. Different types of traffic may be served by the emulated links. HTB is exploited by the bandwidth manager of HTBM in order to define a child class for each HAS session. HTB also employs the tokens and buckets concept, combined with the class-based system for better control over traffic and for shaping in particular  [16]. A fundamental component of the HTB queuing discipline is the borrowing mechanism: children classes borrow tokens from their parent once they have exceeded the shaping rate.
Congestion rate The congestion detection events influence to an extreme degree both the QoS and QoE of HAS because the server decreases its sending rate after each congestion detection. Hence, by analyzing the code description of the four TCP congestion control algorithms (NewReno, Vegas, Illinois, and Cubic), we found that the congestion event appears when the value of parameter slow start threshold (ssthresh) decreases (see Algorithm 1). Hence, we define a metric called congestion rate, denoted by , that computes the rate of congestion events that are detected on the server side, corresponding to the HAS flow between client C and server S during a K-second test duration as shown in equation (  4 ): where is the number of times the ssthresh has been decreased for the C-S HAS session during the Ksecond test duration.
-Home network In the modeled home network, the clients are connected directly to the gateway. The total download bitrate, or home available bandwidth, is limited to 8 Mbps. We choose this value because it is lower than twice the video encoding bitrate of the highest quality level. Accordingly, two clients in the home network cannot select the highest quality level at the same time. In this case, one client should select quality level n° 4 and the other should select the quality level n° 3 as optimal qualities. We do not test a use case in which two clients have the same optimal quality level, because this is a very specific case, and dissimilarity between optimal quality levels is more general. -Home gateway The emulated home gateway consists of a Linux machine configured as a network bridge to forward packets between the home network and the best effort network.