Intensive Care Medicine

, Volume 33, Issue 2, pp 214–229 | Cite as

Year in review in Intensive Care Medicine, 2006. II. Infections and sepsis, haemodynamics, elderly, invasive and noninvasive mechanical ventilation, weaning, ARDS

  • Peter Andrews
  • Elie Azoulay
  • Massimo Antonelli
  • Laurent BrochardEmail author
  • Christian Brun-Buisson
  • Daniel De Backer
  • Geoffrey Dobb
  • Jean-Yves Fagon
  • Herwig Gerlach
  • Johan Groeneveld
  • Duncan Macrae
  • Jordi Mancebo
  • Philipp Metnitz
  • Stefano Nava
  • Jerôme Pugin
  • Michael Pinsky
  • Peter Radermacher
  • Christian Richard
Year in Review 2006

Respiratory infections

Acute exacerbations of chronic obstructive pulmonary disease

Cameron et al. [1] investigated the possible role of viruses in 107 episodes of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). They used modern diagnostic tests, including immunofluorescence assay and polymerase chain reaction, on nasopharyngeal aspirates. They identified infections in 64% of cases, with viruses as probable responsible pathogens in 43%: influenza type A (13%) and rhinovirus (8%) were the most common organisms. Bacteria were found in 23% of cases, with Haemophilus influenzae as the most common pathogen (11%). The authors failed to find significant differences in clinical characteristics and outcome between virus-infected and noninfected patients. In his related editorial, Luyt [2] comments more generally on virus in intensive care unit (ICU) patients, emphasizing (1) the questionable relationship between viral diseases and outcome, (2) the doubtful reliability of...


Pulmonary Arterial Hypertension Intensive Care Unit Patient Severe Acute Respiratory Syndrome Acute Respiratory Distress Syndrome Patient Medical Emergency Team 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Cameron RJ, de Wit D, Welsh TN, Ferguson J, Grissell TV, Rye PJ (2006) Virus infection in exacerbations of chronic obstructive pulmonary disease requiring ventilation. Intensive Care Med 32:1022–1029PubMedCrossRefGoogle Scholar
  2. 2.
    Luyt CE (2006) Virus diseases in ICU patients: a long time underestimated; but be aware of overestimation. Intensive Care Med 32:968–970PubMedCrossRefGoogle Scholar
  3. 3.
    Tu CY, Hsu WH, Hsia TC, Chen HJ, Chiu KL, Hang LW, Shih CM (2006) The changing pathogens of complicated parapneumonic effusions or empyemas in a medical intensive care unit. Intensive Care Med 32:570–576PubMedCrossRefGoogle Scholar
  4. 4.
    Gomersall CD, Joynt GM, Ho OM, Ip M, Yap F, Derrick JL, Leung P (2006) Transmission of SARS to healthcare workers. The experience of a Hong Kong ICU. Intensive Care Med 32:564–569PubMedCrossRefGoogle Scholar
  5. 5.
    Lasocki S, Scanvic A, Le Turdu F, Restoux A, Mentec H, Bleichner G, Sollet JP (2006) Evaluation of the Binax NOW Streptococcus pneumoniae urinary antigen assay in intensive care patients hospitalized for pneumonia. Intensive Care Med 32:1766–1772PubMedCrossRefGoogle Scholar
  6. 6.
    Pneumatikos I, Konstantonis D, Tsagaris I, Theodorou V, Vretzakis G, Danielides V, Bouros D (2006) Prevention of nosocomial maxillary sinusitis in the ICU: the effects of topically applied alpha-adrenergic agonists and corticosteroids. Intensive Care Med 32:532–537PubMedCrossRefGoogle Scholar
  7. 7.
    Vargas F, Bui HN, Boyer A, Bebear CM, Lacher-Fougere S, De-Barbeyrac BM, Salmi LR, Traissac L, Gbikpi-Benissan G, Gruson D, Hilbert G (2006) Transnasal puncture based on echographic sinusitis evidence in mechanically ventilated patients with suspicion of nosocomial maxillary sinusitis. Intensive Care Med 32:858–866PubMedCrossRefGoogle Scholar
  8. 8.
    Mori H, Hirasawa H, Oda S, Shiga H, Matsuda K, Nakamura M (2006) Oral care reduces incidence of ventilator-associated pneumonia in ICU populations. Intensive Care Med 32:230–236PubMedCrossRefGoogle Scholar
  9. 9.
    Lorente L, Lecuona M, Jimenez A, Mora ML, Sierra A (2006) Tracheal suction by closed system without daily change versus open system. Intensive Care Med 32:538–544PubMedCrossRefGoogle Scholar
  10. 10.
    Maggiore SM (2006) Endotracheal suctioning, ventilator-associated pneumonia, and costs: open or closed issue? Intensive Care Med 32:485–487PubMedCrossRefGoogle Scholar
  11. 11.
    Vonberg RP, Eckmanns T, Welte T, Gastmeier P (2006) Impact of the suctioning system (open vs. closed) on the incidence of ventilation-associated pneumonia: meta-analysis of randomized controlled trials. Intensive Care Med 32:1329–1335PubMedCrossRefGoogle Scholar
  12. 12.
    Veinstein A, Brun-Buisson C, Derrode N, Alvarez A, Pinsard M, Robert R, Blot F (2006) Validation of an algorithm based on direct examination of specimens in suspected ventilator-associated pneumonia. Intensive Care Med 32:676–683PubMedCrossRefGoogle Scholar
  13. 13.
    Orlikowski D, Sharshar T, Porcher R, Annane D, Raphael JC, Clair B (2006) Prognosis and risk factors of early onset pneumonia in ventilated patients with Guillain–Barre syndrome. Intensive Care Med 32:1962–1969PubMedCrossRefGoogle Scholar
  14. 14.
    Combes A, Luyt CE, Fagon JY, Wolff M, Trouillet JL, Chastre J (2006) Impact of piperacillin resistance on the outcome of Pseudomonas ventilator-associated pneumonia. Intensive Care Med 32:1970–1978PubMedCrossRefGoogle Scholar
  15. 15.
    Sprung CL, Sakr Y, Vincent JL, Le Gall JR, Reinhart K, Ranieri VM, Gerlach H, Fielden J, Groba CB, Payen D (2006) An evaluation of systemic inflammatory response syndrome signs in the Sepsis Occurrence in Acutely ill Patients (SOAP) study. Intensive Care Med 32:421–427PubMedCrossRefGoogle Scholar
  16. 16.
    Mackenzie I, Woodhouse J (2006) C-reactive protein concentrations during bacteraemia: a comparison between patients with and without liver dysfunction. Intensive Care Med 32:1344–1351PubMedCrossRefGoogle Scholar
  17. 17.
    Kruger P, Fitzsimmons K, Cook D, Jones M, Nimmo G (2006) Statin therapy is associated with fewer deaths in patients with bacteraemia. Intensive Care Med 32:75–79PubMedCrossRefGoogle Scholar
  18. 18.
    Mekontso-Dessap A, Brun-Buisson C (2006) Statins: the next step in adjuvant therapy for sepsis? Intensive Care Med 32:11–14PubMedCrossRefGoogle Scholar
  19. 19.
    Rossi C, Simini B, Brazzi L, Rossi G, Radrizzani D, Iapichino G, Bertolini G (2006) Variable costs of ICU patients: a multicenter prospective study. Intensive Care Med 32:545–552PubMedCrossRefGoogle Scholar
  20. 20.
    Schwartz DS, Barone JE (2006) Correlation of urinalysis and dipstick results with catheter-associated urinary tract infections in surgical ICU patients. Intensive Care Med 32:1797–1801PubMedCrossRefGoogle Scholar
  21. 21.
    Bouman CS, van Kan HJ, Koopmans RP, Korevaar JC, Schultz MJ, Vroom MB (2006) Discrepancies between observed and predicted continuous venovenous hemofiltration removal of antimicrobial agents in critically ill patients and the effects on dosing. Intensive Care Med 32:2013–2019PubMedCrossRefGoogle Scholar
  22. 22.
    Damas P, Canivet JL, Ledoux D, Monchi M, Melin P, Nys M, De Mol P (2006) Selection of resistance during sequential use of preferential antibiotic classes. Intensive Care Med 32:67–74PubMedCrossRefGoogle Scholar
  23. 23.
    Heininger A, Meyer E, Schwab F, Marschal M, Unertl K, Krueger WA (2006) Effects of long-term routine use of selective digestive decontamination on antimicrobial resistance. Intensive Care Med 32:1569–1576PubMedCrossRefGoogle Scholar
  24. 24.
    Reinhart K, Kuhn HJ, Hartog C, Bredle DL (2004) Continuous central venous and pulmonary artery oxygen saturation monitoring in the critically ill. Intensive Care Med 30:1572–1578PubMedCrossRefGoogle Scholar
  25. 25.
    Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M, Group T. e. G.-D. T. C (2001) Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 345:1368–1377PubMedCrossRefGoogle Scholar
  26. 26.
    Varpula M, Karlsson S, Ruokonen E, Pettila V (2006) Mixed venous oxygen saturation cannot be estimated by central venous oxygen saturation in septic shock. Intensive Care Med 32:1336–1343PubMedCrossRefGoogle Scholar
  27. 27.
    Michard F, Boussat S, Chemla D, Anguel N, Mercat A, Lecarpentier Y, Richard C, Pinsky MR, Teboul JL (2000) Relation between respiratory changes in arterial pulse pressure and fluid responsiveness in septic patients with acute circulatory failure. Am J Respir Crit Care Med 162:134–138PubMedGoogle Scholar
  28. 28.
    Gunn SR, Kim HK, Harrigan PW, Pinsky MR (2006) Ability of pulse contour and esophageal Doppler to estimate rapid changes in stroke volume. Intensive Care Med 32:1537–1546PubMedCrossRefGoogle Scholar
  29. 29.
    Jansen JR (2006) Standard pulse contour methods are not applicable in animals. Intensive Care Med 32:2084–2085PubMedCrossRefGoogle Scholar
  30. 30.
    Monnet X, Rienzo M, Osman D, Anguel N, Richard C, Pinsky MR, Teboul JL (2005) Esophageal Doppler monitoring predicts fluid responsiveness in critically ill ventilated patients. Intensive Care Med 31:1195–1201PubMedCrossRefGoogle Scholar
  31. 31.
    Shochat M, Charach G, Meyler S, Meisel S, Weintraub M, Mengeritsky G, Mosseri M, Rabinovich P (2006) Prediction of cardiogenic pulmonary edema onset by monitoring right lung impedance. Intensive Care Med 32:1214–1221PubMedCrossRefGoogle Scholar
  32. 32.
    Merlani PG, Chenaud C, Cottini S, Reber G, Garnerin P, de Moerloose P, Ricou B (2006) Point of care management of heparin administration after heart surgery : A randomized, controlled trial. Intensive Care Med 32:1357–1364PubMedCrossRefGoogle Scholar
  33. 33.
    Finfer S, Bellomo R, Boyce N, French J, Myburgh J, Norton R, SAFE investigators (2004) A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N Engl J Med 350:2247–2256PubMedCrossRefGoogle Scholar
  34. 34.
    Schortgen F, Lacherade JC, Bruneel F, Cattaneo I, Hemery F, Lemaire F, Brochard L (2001) Effects of hydroxyethylstarch and gelatin on renal function in severe sepsis: a multicentre randomised study. Lancet 357:911–916PubMedCrossRefGoogle Scholar
  35. 35.
    Verheij J, van Lingen A, Beishuizen A, Christiaans HM, de Jong JR, Girbes AR, Wisselink W, Rauwerda JA, Huybregts MA, Groeneveld AB (2006) Cardiac response is greater for colloid than saline fluid loading after cardiac or vascular surgery. Intensive Care Med 32:1030–1038PubMedCrossRefGoogle Scholar
  36. 36.
    Brochard L, Boussignac G, Adnot S, Bertrand C, Isabey D, Harf A (1996) Efficacy of cardiopulmonary resuscitation using intratracheal insufflation. Am J Resp Crit Care Med 154:1323–1329PubMedGoogle Scholar
  37. 37.
    Bertrand C, Hemery F, Carli P, Goldstein P, Espesson C, Ruttimann M, Macher JM, Raffy B, Fuster P, Dolveck F, Rozenberg A, Lecarpentier E, Duvaldestin P, Saissy JM, Boussignac G, Brochard L (2006) Constant flow insufflation of oxygen as the sole mode of ventilation during out-of-hospital cardiac arrest. Intensive Care Med 32:843–851PubMedCrossRefGoogle Scholar
  38. 38.
    Lellouche F, Qader S, Taille S, Lyazidi A, Brochard L (2006) Under-humidification and over-humidification during moderate induced hypothermia with usual devices. Intensive Care Med 32:1014–1021PubMedCrossRefGoogle Scholar
  39. 39.
    Jones D, Bellomo R, Bates S, Warrillow S, Goldsmith D, Hart G, Opdam H (2006) Patient monitoring and the timing of cardiac arrests and medical emergency team calls in a teaching hospital. Intensive Care Med 32:1352–1356PubMedCrossRefGoogle Scholar
  40. 40.
    Monteban-Kooistra WE, van den Berg MP, Tulleken JE, Ligtenberg JJ, Meertens JH, Zijlstra JG (2006) Brugada electrocardiographic pattern elicited by cyclic antidepressants overdose. Intensive Care Med 32:281–285PubMedCrossRefGoogle Scholar
  41. 41.
    Isbister GK, Friberg LE, Duffull SB (2006) Application of pharmacokinetic–pharmacodynamic modelling in management of QT abnormalities after citalopram overdose. Intensive Care Med 32:1060–1065PubMedCrossRefGoogle Scholar
  42. 42.
    Megarbane B, Bloch V, Deye N, Baud FJ (2007) Pharmacokinetic/pharmacodynamic modelling of cardiac toxicity in venlafaxine overdose. Intensive Care Med 33:195–196PubMedCrossRefGoogle Scholar
  43. 43.
    Isbister GK, Friberg LE, Duffull SB (2007) Reply to Dr. Megarbane et al. regarding “Pharmacokinetic/pharmacodynamic modelling of cardiac toxicity in venlafaxine overdose”. Intensive Care Med 33:197PubMedCrossRefGoogle Scholar
  44. 44.
    Seguin P, Laviolle B, Maurice A, Leclercq C, Malledant Y (2006) Atrial fibrillation in trauma patients requiring intensive care. Intensive Care Med 32:398–404PubMedCrossRefGoogle Scholar
  45. 45.
    de Rooij SE, Govers A, Korevaar JC, Abu-Hanna A, Levi M, de Jonge E (2006) Short-term and long-term mortality in very elderly patients admitted to an intensive care unit. Intensive Care Med 32:1039–1044PubMedCrossRefGoogle Scholar
  46. 46.
    Torres OH, Francia E, Longobardi V, Gich I, Benito S, Ruiz D (2006) Short- and long-term outcomes of older patients in intermediate care units. Intensive Care Med 32:1052–1059PubMedCrossRefGoogle Scholar
  47. 47.
    Garrouste-Orgeas M, Timsit JF, Montuclard L, Colvez A, Gattolliat O, Philippart F, Rigal G, Misset B, Carlet J (2006) Decision-making process, outcome, and 1-year quality of life of octogenarians referred for intensive care unit admission. Intensive Care Med 32:1045–1051PubMedCrossRefGoogle Scholar
  48. 48.
    Boumendil A, Guidet B (2006) Elderly patients and intensive care medicine. Intensive Care Med 32:965–967PubMedCrossRefGoogle Scholar
  49. 49.
    Demoule A, Decailliot F, Jonson B, Christov C, Maitre B, Touqui L, Brochard L, Delclaux C (2006) Relationship between pressure–volume curve and markers for collagen turn-over in early acute respiratory distress syndrome. Intensive Care Med 32:413–420PubMedCrossRefGoogle Scholar
  50. 50.
    El Solh AA, Bhora M, Pineda L, Aquilina A, Abbetessa L, Berbary E (2006) Alveolar plasminogen activator inhibitor-1 predicts ARDS in aspiration pneumonitis. Intensive Care Med 32:110–115PubMedCrossRefGoogle Scholar
  51. 51.
    Karagiorga G, Nakos G, Galiatsou E, Lekka ME (2006) Biochemical parameters of bronchoalveolar lavage fluid in fat embolism. Intensive Care Med 32:116–123PubMedCrossRefGoogle Scholar
  52. 52.
    Lesur O, Langevin S, Berthiaume Y, Legare M, Skrobik Y, Bellemare JF, Levy B, Fortier Y, Lauzier F, Bravo G, Nickmilder M, Rousseau E, Bernard A (2006) Outcome value of Clara cell protein in serum of patients with acute respiratory distress syndrome. Intensive Care Med 32:1167–1174PubMedCrossRefGoogle Scholar
  53. 53.
    Beiderlinden M, Kuehl H, Boes T, Peters J (2006) Prevalence of pulmonary hypertension associated with severe acute respiratory distress syndrome: Predictive value of computed tomography. Intensive Care Med 32:852–857PubMedCrossRefGoogle Scholar
  54. 54.
    Groeneveld AB, Verheij J (2006) Extravascular lung water to blood volume ratios as measures of permeability in sepsis-induced ALI/ARDS. Intensive Care Med 32:1315–1321PubMedCrossRefGoogle Scholar
  55. 55.
    Decailliot F, Demoule A, Maggiore SM, Jonson B, Duvaldestin P, Brochard L (2006) Pressure–volume curves with and without muscle paralysis in acute respiratory distress syndrome. Intensive Care Med 32:1322–1328PubMedCrossRefGoogle Scholar
  56. 56.
    Moran I, Bellapart J, Vari A, Mancebo J (2006) Heat and moisture exchangers and heated humidifiers in acute lung injury/acute respiratory distress syndrome patients. Effects on respiratory mechanics and gas exchange. Intensive Care Med 32:524–531PubMedCrossRefGoogle Scholar
  57. 57.
    Aboab J, Jonson B, Kouatchet A, Taille S, Niklason L, Brochard L (2006) Effect of inspired oxygen fraction on alveolar derecruitment in acute respiratory distress syndrome. Intensive Care Med 32:1979–1986PubMedCrossRefGoogle Scholar
  58. 58.
    Hedenstierna G (2006) The hidden pulmonary dysfunction in acute lung injury. Intensive Care Med 32:1933–1934PubMedCrossRefGoogle Scholar
  59. 59.
    Lemasson S, Ayzac L, Girard R, Gaillard S, Pavaday K, Guerin C (2006) Does gas exchange response to prone position predict mortality in hypoxemic acute respiratory failure? Intensive Care Med 32:1987–1993PubMedCrossRefGoogle Scholar
  60. 60.
    Demoule A, Girou E, Richard JC, Taille S, Brochard L (2006) Increased use of noninvasive ventilation in French intensive care units. Intensive Care Med 32:1747–1755PubMedCrossRefGoogle Scholar
  61. 61.
    Demoule A, Girou E, Richard JC, Taille S, Brochard L (2006) Benefits and risks of success or failure of noninvasive ventilation. Intensive Care Med 32:1756–1765PubMedCrossRefGoogle Scholar
  62. 62.
    Battisti A, Roeseler J, Tassaux D, Jolliet P (2006) Automatic adjustment of pressure support by a computer-driven knowledge-based system during noninvasive ventilation: a feasibility study. Intensive Care Med 32:1523–1528PubMedCrossRefGoogle Scholar
  63. 63.
    Thille AW, Rodriguez P, Cabello B, Lellouche F, Brochard L (2006) Patient–ventilator asynchrony during assisted mechanical ventilation. Intensive Care Med 32:1515–1522PubMedCrossRefGoogle Scholar
  64. 64.
    Kondili E, Prinianakis G, Alexopoulou C, Vakouti E, Klimathianaki M, Georgopoulos D (2006) Respiratory load compensation during mechanical ventilation–proportional assist ventilation with load-adjustable gain factors versus pressure support. Intensive Care Med 32:692–699PubMedCrossRefGoogle Scholar
  65. 65.
    Volta CA, Alvisi V, Bertacchini S, Marangoni E, Ragazzi R, Verri M, Alvisi R (2006) Acute effects of hyperoxemia on dyspnoea and respiratory variables during pressure support ventilation. Intensive Care Med 32:223–229PubMedCrossRefGoogle Scholar
  66. 66.
    Clini EM, Antoni FD, Vitacca M, Crisafulli E, Paneroni M, Chezzi-Silva S, Moretti M, Trianni L, Fabbri LM (2006) Intrapulmonary percussive ventilation in tracheostomized patients: a randomized controlled trial. Intensive Care Med 32:1994–2001PubMedCrossRefGoogle Scholar
  67. 67.
    Raux M, Thicoipe M, Wiel E, Rancurel E, Savary D, David JS, Berthier F, Ricard-Hibon A, Birgel F, Riou B (2006) Comparison of respiratory rate and peripheral oxygen saturation to assess severity in trauma patients. Intensive Care Med 32:405–412PubMedCrossRefGoogle Scholar
  68. 68.
    Vassilakopoulos T, Routsi C, Sotiropoulou C, Bitsakou C, Stanopoulos I, Roussos C, Zakynthinos S (2006) The combination of the load/force balance and the frequency/tidal volume can predict weaning outcome. Intensive Care Med 32:684–691PubMedCrossRefGoogle Scholar
  69. 69.
    Mekontso-Dessap A, de Prost N, Girou E, Braconnier F, Lemaire F, Brun-Buisson C, Brochard L (2006) B-type natriuretic peptide and weaning from mechanical ventilation. Intensive Care Med 32:1529–1536PubMedCrossRefGoogle Scholar
  70. 70.
    Tobin MJ, Jubran A (2006) Variable performance of weaning-predictor tests: role of Bayes' theorem and spectrum and test-referral bias. Intensive Care Med 32:2002–2012PubMedCrossRefGoogle Scholar
  71. 71.
    Connors AF Jr (2006) A fresh look at the weaning process. Intensive Care Med 32:1928–1929PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Peter Andrews
    • 1
  • Elie Azoulay
    • 2
  • Massimo Antonelli
    • 3
  • Laurent Brochard
    • 4
    Email author
  • Christian Brun-Buisson
    • 5
  • Daniel De Backer
    • 6
  • Geoffrey Dobb
    • 7
  • Jean-Yves Fagon
    • 8
  • Herwig Gerlach
    • 9
  • Johan Groeneveld
    • 10
  • Duncan Macrae
    • 11
  • Jordi Mancebo
    • 12
  • Philipp Metnitz
    • 13
  • Stefano Nava
    • 14
  • Jerôme Pugin
    • 15
  • Michael Pinsky
    • 16
  • Peter Radermacher
    • 17
  • Christian Richard
    • 18
  1. 1.Intensive Care Medicine UnitWestern General HospitalEdinburghUK
  2. 2.Intensive Care Medicine UnitSaint Louis HospitalParisFrance
  3. 3.Department of Intensive Care and AnesthesiologyUniversita Cattolica del Sacre CuoreRomeItaly
  4. 4.Réanimation Médicale, AP-HP, Hôpital Henri MondorUniversité Paris 12, INSERM U 651CréteilFrance
  5. 5.Réanimation Médicale, AP-HP, Hôpital Henri MondorUniversité Paris 12CréteilFrance
  6. 6.Service des Soins IntensifsErasme HospitalBrusselsBelgium
  7. 7.Intensive Care Medicine UnitRoyal Perth HospitalPerthAustralia
  8. 8.Intensive Care Medicine UnitEuropean Georges Pompidou HospitalParisFrance
  9. 9.Department of AnesthesiologyVivantes-Klinikum NeukoellnBerlinGermany
  10. 10.Intensive Care Medicine UnitVUMCAmsterdamThe Netherlands
  11. 11.Pediatric Intensive Care UnitRoyal Brompton HospitalLondonUK
  12. 12.Intensive Care Medicine UnitHospital Sant PauBarcelonaSpain
  13. 13.Department of Anesthesia and General Intensive Care MedicineUniversity Hospital of ViennaViennaAustria
  14. 14.Intensive Care Medicine UnitFondazione S. MaugeriPaviaItaly
  15. 15.Intensive Care Medicine UnitUniversity Hospital of GenevaGenevaSwitzerland
  16. 16.Intensive Care Medicine UnitUniversity of Pittsburgh Medical CenterPittsburghUSA
  17. 17.Department of AnesthesiaUniversity Medical School of UlmUlmGermany
  18. 18.Intensive Care UnitUniversity Hospital of Le Kremlin-BicetreLe Kremlin-BicetreFrance

Personalised recommendations