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French Intensive Care Society, International congress – Réanimation 2016

  • Emmanuelle JailletteEmail author
  • Christophe Girault
  • Guillaume Brunin
  • Farid Zerimech
  • Arnaud Chiche
  • Céline Broucqsault-Dedrie
  • Cyril Fayolle
  • Franck Minacori
  • Isabelle Alves
  • Stephanie Barrailler
  • Laurent Robriquet
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  • Damien Thellier
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  • Alain Duhamel
  • Saad Nseir
  • Xavier ValetteEmail author
  • Isabelle Desmeulles
  • Benoit Savary
  • Romain Masson
  • Amélie Seguin
  • Cédric Daubin
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  • Pierre Verrier
  • Véronique Pottier
  • Marie Orabona
  • Désiré Samba
  • Gérald Viquesnel
  • Mathilde Lermuzeaux
  • Pascal Hazera
  • Jean-Luc Hanouz
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  • Marc Clavel
  • Camille Rolland-Debord
  • Sébastien Perbet
  • Nicolas Terzi
  • Achille Kouatchet
  • Florent Wallet
  • Hadrien Roze
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  • Claude Guérin
  • Jean Dellamonica
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  • Christine Binquet
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  • Saber-Davide Barbar
  • Sandrine Vinault
  • Valérie Deckert
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  • Rémi Bruyère
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  • Christophe Adrie
  • Boris JungEmail author
  • Aurelien Daurat
  • Audrey De JongEmail author
  • Gérald Chanques
  • Martin Mahul
  • Marion Monnin
  • Nicolas Molinari
  • Olivier LheureuxEmail author
  • Eric Trepo
  • Maya Hites
  • Frederic Cotton
  • Fleur Wolff
  • Rudy Surin
  • Jacques Créteur
  • Jean-Louis Vincent
  • Thierry Gustot
  • Frederique Jacobs
  • Fabio Silvio TacconeEmail author
  • Mathilde NeuvilleEmail author
  • Jean-François Timsit
  • Najoua El-Helali
  • Alban Le Monnier
  • Eric Magalhaes
  • Aguila Radjou
  • Roland Smonig
  • Jean-François Soubirou
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  • Romain Sonneville
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  • Sandrine Roisin
  • Daniel De Backer
  • Valerie Van RuycheveltEmail author
  • Eric Carlier
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  • Michel Vanhaeverbeek
  • Christine Danguy
  • Patrick Biston
  • Siu-Ming Au
  • Emmanuelle Begot
  • François Dalmay
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Open Access
Meeting abstracts

Table of contents

PHYSICIANS ABSTRACTS

O1 Impact of tracheal cuff shape on microaspiration of gastric contents in intubated critically ill patients: a multicenter randomized controlled study (BEST CUFF)

Emmanuelle Jaillette, Christophe Girault, Guillaume Brunin, Farid Zerimech, Arnaud Chiche, Céline Broucqsault-Dedrie, Cyril Fayolle, Franck Minacori, Isabelle Alves, Stephanie Barrailler, Laurent Robriquet, Fabienne Tamion, Emmanuel Delaporte, Damien Thellier, Claire Delcourte, Alain Duhamel, Saad Nseir

O2 Bicarbonate versus saline for contrast-induced acute kidney injury prevention in critically ill patients

Xavier Valette, Isabelle Desmeulles, Benoit Savary, Romain Masson, Amélie Seguin, Cédric Daubin, Bertrand Sauneuf, Jennifer Brunet, Pierre Verrier, Véronique Pottier, Marie Orabona, Désiré Samba, Gérald Viquesnel, Mathilde Lermuzeaux, Pascal Hazera, Jean-Luc Hanouz, Jean-Jacques Parienti, Damien Du Cheyron

O3 Neurally adjusted ventilatory assist in the early phase of weaning from mechanical ventilation: a multicenter randomized study

Alexandre Demoule, Marc Clavel, Camille Rolland-Debord, Sébastien Perbet, Nicolas Terzi, Achille Kouatchet, Florent Wallet, Hadrien Roze, Frédéric Vargas, Claude Guérin, Jean Dellamonica, Samir Jaber, Thomas Similowski

O4 Very high volume hemofiltration with the Cascade system in septic shock patients

Jean-Pierre Quenot, Christine Binquet, Christophe Vinsonneau, Saber-Davide Barbar, Sandrine Vinault,, Valérie Deckert, Stephanie Lemaire, Ali Ait Hssain, Rémi Bruyère, Bertrand Souweine, Laurent Lagrost, Christophe Adrie

O5 Effect of rapid response systems on hospital mortality, a prospective interventional study and systematic review

Boris Jung, Aurelien Daurat, Audrey De Jong, Gérald Chanques, Martin Mahul,, Marion Monnin, Nicolas Molinari, Samir Jaber

O6 Beta-lactams serum concentrations in critically ill cirrhotic patients: a matched control study

Olivier Lheureux, Eric Trepo, Maya Hites, Frederic Cotton, Fleur Wolff, Rudy Surin, Jacques Créteur, Jean-Louis Vincent, Thierry Gustot, Frederique Jacobs, Fabio Silvio Taccone

O7 Systematic overdosing of oxa- and cloxacillin in severe infections treated in ICU: Risk factors and side effects

Mathilde Neuville, Jean-François Timsit, Najoua El-Helali, Alban Le Monnier, Eric Magalhaes, Aguila Radjou, Roland Smonig, Jean-François Soubirou, Guillaume Voiriot, Romain Sonneville, Lila Bouadma, Bruno Mourvillier

O8 Amikacin peak concentrations in patients receiving extracorporeal membrane oxygenation (ECMO) support: a case–control study

Elodie Gélisse, Mathilde Neuville, Etienne De Montmollin, Guillaume Voiriot, Jean-François Soubirou, Roland Smonig, Aguila Radjou, Eric Magalhaes, Lila Bouadma, Bruno Mourvillier, Jean-François Timsit, Romain Sonneville

O9 A high aminoglycoside regimen associated with renal replacement therapy for the treatment of multi-drug-resistant pathogens

Alexandre Brasseur, Maya Hites, Sandrine Roisin, Frederic Cotton, Jean-Louis Vincent, Daniel De Backer, Frederique Jacobs, Fabio Silvio Taccone

O10 Optimization of administration of vancomycin in septic patients: a prospective randomized study

Valerie Van Ruychevelt, Eric Carlier, Michael Piagnerelli, Michel Vanhaeverbeek, Christine Danguy, Patrick Biston

O11 Impact of elevated intra-abdominal pressure on the ability of dynamic parameters to predict fluid responsiveness

Siu-Ming Au, Emmanuelle Begot, François Dalmay, Xavier Repessé, Gwenael Prat, Koceila Bouferrache, Michel Slama, Philippe Vignon, Antoine Vieillard-Baron

O12 Passive leg raising for predicting fluid responsiveness: a systematic review and meta-analysis

Xavier Monnet, Paul Marik, Jean-Louis Teboul

O13 Predicting volume responsiveness by using combined end-expiratory and end-inspiratory occlusion tests with echocardiography

Mathieu Jozwiak, Jean-Louis Teboul, Christian Richard, Xavier Monnet

O14 Early dynamic left intraventricular obstruction is associated with hypovolemia and hight mortality in septic shock patients

Jean-Louis Chauvet, Shari El-Dash, Olivier Delastre, Bernard Bouffandeau, Dominique Jusserand, Jean-Baptiste Michot, Fabrice Bauer, Julien Maizel, Michel Slama

O15 Predictive factors for poor hemodynamic tolerance to fluid removal in ICU: the DepleRea study

François Brazier, Pablo Mercado, Loay Kontar, Dimitri Titeca, Bertand De Cagny, Gaelle Bacari-Risal, Antoine Riviere, Michel Slama, Julien Maizel

O16 High-flow nasal cannula: first-line treatment of noninvasive ventilation for infants with bronchiolitis. Applicability and risk factors for failure

Camille Guillot, Claire Le Reun, Marie Lampin, Ahmed Sadik, Astrid Botte, Alain Duhamel, Stéphane Leteurtre

O17 Is high-flow nasal cannula better than nasal continuous positive airway pressure for bronchiolitis management in pediatric intensive care unit?

Aurélie Collins, Céline Kempeneers, Nathalie Cajgfinger

O18 Interest and risk of high-flow cannula during acute hypoxemic pneumonia in children: a retrospective study

Camille Ohlmann, Robin Pouyau, Fabien Subtil, Florent Baudin, Bruno Massenavette, Etienne Javouhey

O19 Interest of high-flow nasal cannula (HFNC) versus nasal continuous positive airway pressure (nCPAP) during the initial management of severe bronchiolitis in infants: a multicenter randomized controlled trial

Christophe Milesi, Sandrine Essouri, Robin Pouyau,, Jean-Michel Liet, Mickael Afanetti, Julien Baleine, Sabine Durand, Philippe Durand, Etienne Javouhey, Jean Christophe Roze, Didier Dupont, Gilles Cambonie

O20 Outcome of severe cerebral venous thrombosis in intensive care unit: a cohort study

Benjamin Soyer, Marco Rusca, Anne-Claire Lukaszewicz, Isabelle Crassard, Jean-Pierre Guichard, Damien Bresson, Didier Payen de la Garanderie

O21 Brain lesion spectrum characterization in an experimental model of infective endocarditis

Marie Cantier, Candice Sabben, Liliane Louedec, Sandrine Delbosc, Clément Journé, Phalla Ou, Isabelle Klein, Françoise Chau, Agnes Lefort, Jean-Philippe Desilles, Jean-Baptiste Michel, Romain Sonneville, Mikaël Mazighi

O22 Outcome of patients with Parkinson’s disease admitted in intensive care unit

Omar Ben Hadj Salem, Sophie Demeret, Alexandre Demoule, Thomas Similowski, Francis Bolgert, Tarek Sharshar, David Grabli

O23 Cerebrospinal fluid glucose and lactate concentrations after subarachnoid hemorrhage

Safa Arib, Ilaria Alice Crippa, Jacques Créteur, Jean-Louis Vincent, Fabio Silvio Taccone

O24 Spontaneous angionegative subarachnoidal hemorrhage: neurological outcome based on a retrospective study of 68 patients

Alexis Soummer, Nicolas Engrand, Pierre Guedin, Grégoire Trebbia, Sorin Aldea, Charles Cerf

O25 Serious game evaluation of a one-hour training basic life support session for secondary school students: new tools for future bystanders

Victoire Desailly, Pierre Pasquier, Patrick Brun, Damien Roux, Jonathan Messika, Gwendoline Latournerie, Laetitia Kasprzyk, Vincent Grosjean, Amine Latreche, Pierre Habert, Stephane Huot, Timon Jobin, Antoine Tesnière, Didier Dreyfuss, Jean-Damien Ricard, Alexandre Mignon, Stéphane Gaudry

O26 Refractory out-of-hospital refractory cardiac arrest treated by veno-arterial extracorporeal membrane oxygenation. A retrospective single-center experience from 2012 to 2015. CARECMO program (Cardiac ARrest Extra Corporeal Membrane Oxygenation)

François-Xavier Laithier, Antoine Kimmoun, Tahar Chouihed, Stéphane Albizzati, Edoardo Camenzind, Fabrice Vanhuyse, Bruno Levy

O27 Decreased monocyte HLA-DR expression after out-of-hospital cardiac arrest

Martin Cour, Fabienne Venet, Romain Hernu, Julie Demaret, Guillaume Monneret, Laurent Argaud

O28 Is emergent PCI associated with a clinical benefit in post-cardiac arrest patients without ST-segment elevation pattern? Insights from the PROCAT II registry

Florence Dumas, Wulfran Bougouin, Guillaume Geri, Lionel Lamhaut, Julien Rosencher, Frédéric Pène, Jean-Daniel Chiche, Olivier Varenne, Pierre Carli, Xavier Jouven, Jean-Paul Mira, Christian Spaulding, Alain Cariou

O29 Predictors of long-term quality of life after cardiac arrest: insights from the Parisian registry

Guillaume Geri, Florence Dumas, Franck Bonnetain,, Wulfran Bougouin, Benoit Champigneulle, Michel Arnaout, Pierre Carli, Eloi Marijon, Olivier Varenne, Jean-Paul Mira, Jean Philippe Empana, Alain Cariou

O30 Red blood cell transfusions in early resuscitation of severe sepsis and septic shock in patients with hematological malignancies

Adrien Mirouse, Matthieu Resche-Rigon, Virginie Lemiale, Djamel Mokart, François Vincent, Julien Mayaux, Antoine Rabbat, Martine Nyunga, Anne Pascale Meert, Dominique Benoit, Achille Kouatchet, Michaël Darmon, Fabrice Bruneel, Elie Azoulay, Frédéric Pène

O31 Causal effect of transfusion on mortality and other adverse events among critically ill septic patients: an observational study with a marginal structural model

Claire Dupuis, Michaël Darmon, Carole Schwebel, Elie Azoulay, Romain Sonneville, Lila Bouadma, Roland Smonig, Yves Cohen, Stéphane Ruckly, Christophe Adrie, Dany Goldgran-Toledano, Sébastien Bailly, Guillaume Marcotte, Maïté Garrouste-Orgeas, Jean-François Timsit

O32 Autoimmune hemolytic anemia in the intensive care unit

Antoine Lafarge, Claire Pichereau, Sandrine Valade, Marion Venot, Akli Chermak, Igor Theodose, Marion Scotto, Delphine Kemlin, Claire Givel, Leïla Mourtada, Etienne Ghrenassia, Emmanuel Canet, Virginie Lemiale, Benoît Schlemmer, Elie Azoulay, Eric Mariotte

O33 Pre-ICU location, lead time bias and outcomes in patients with thrombotic microangiopathies

Damien Vimpere, Sandrine Valade, Marion Venot, Claire Pichereau, Akli Chermak, Virginie Lemiale, Emmanuel Canet, Lionel Galicier, Elie Azoulay, Eric Mariotte

O34 Septic shocks with no early etiological diagnosis: a multicenter prospective cohort study (the shock 24 study)

Damien Contou, Damien Roux, Sebastien Jochmans, Remi Coudroy, Emmanuel Guérot, David Grimaldi, Sylvie Ricome, Eric Maury, Gaëtan Plantefève, Julien Mayaux, Armand Mekontso Dessap, Christian Brun-Buisson, Nicolas de Prost

O35 Respective contribution of diaphragm and limbs muscles weakness on weaning from mechanical ventilation outcome

Alexandre Demoule, Bruno-Pierre Dubé, Julien Mayaux, Julie Delemazure, Thomas Similowski, Martin Dres

O36 Impact of sleep quality on the duration of weaning from mechanical ventilation

Ludivine Rousseau, Xavier Drouot, Véronique Diaz, Yohann Rebollar, Jean-Pierre Frat, Remi Coudroy, René Robert, Arnaud, W Thille, Groupe ALIVE

O37 Integrative ultrasound assessment of lung, cardiac and diaphragm function during a successful weaning trial predicts postextubation distress

Dalinda Ait Aissa, Pierre Coquet, Jean Ruiz, Fabrice Ferre, Lucille Hoarau, Béatrice Riu-Poulenc, Benoit Bataille, Stein Silva

O38 ETCO 2 improved outcome prediction of mechanical ventilation weaning

Jean-Luc Baudel, Simon Bourcier, Claire Pichereau, Naïke Bigé, Jalel Tahiri, Vincent Dubée, Bertrand Guidet, Eric Maury, Hafid Ait-Oufella

O39 Characteristics of 150 cases of weaning-induced pulmonary oedema and effects of diuretics

Liu Jinglun, Feng Shen, Jean-Louis Teboul, Christian Richard, Xavier Monnet

O40 Antifungal de-escalation was not associated with adverse outcome in critically ill patients treated for invasive candidiasis

Sébastien Bailly, Olivier Leroy, Philippe Montravers, Jean-Michel Constantin, Hervé Dupont, Didier Guillemot, Olivier Lortholary, Jean-Paul Mira, Pierre-François Perrigault, Jean-Pierre Gangneux, Elie Azoulay, Jean-François Timsit

O41 Intensive care acquired pneumonia due to extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) among patients with prior colonization: Frequency, risk factors and prognosis

Keyvan Razazi, Armand Mekontso-Dessap, Chloe Jansen, Nicolas de Prost, Christian Brun-Buisson

O42 Epidemiology, characteristics and outcomes of septic critically ill patients after the removal of a totally implantable venous-access ports

Marie Lecronier, Valade Sandrine, Naïke Bigé, Nicolas de Prost, Damien Roux, Jean-Damien Ricard, Eric Maury, Julien Mayaux, Elie Azoulay, Alexandre Demoule, Martin Dres

O43 Genetic risk of Pseudomonas aeruginosa ventilator-associated pneumonia: the EXTENSE study

Jean-Paul Mira, Sophie Blein, Nathalie Marin, Christophe Rousseau, Julien Charpentier, Jean-Daniel Chiche, Alexandre Pachot

O44 Cytomegalovirus reactivation enhances the virulence of a Staphylococcus aureus pneumonia in a mouse model

Sami Hraiech, Julien Bordes, Samuel Lehingue, Lamballerie Xavier De, Jean-Louis Mège, Jean-Marie Forel, Christophe Guervilly, Mélanie Adda, Didier Raoult, Laurent Papazian

O45 Families looking back: meaning-making after a decision to accept or refuse organ donation. A qualitative approach

Nancy Kentish-Barnes, Zoé Cohen-Solal, Elie Azoulay

O46 The letter of condolence at the heart of family centered care. A qualitative approach of relatives’ experience

Nancy Kentish-Barnes, Zoé Cohen-Solal, Virginie Souppart, Elie Azoulay

O47 Use of a children information booklet to support young relatives visiting a critically ill adult: impact on ICU practices

Lionel Kerhuel, Carole Haubertin, Isabelle Exbrayat, Elodie Rozières, Audrey Argain, Agnès Suc, Michel Vignes, Pierre Cougot, Béatrice Riu-Poulenc, Stein Silva, Olivier Fourcade, Elodie Brunel

O48 Withdrawal of life-support therapies reporting in ICU randomized controlled trial: Let us move to a transparent reporting—a systematic review

Jonathan Messika, Stéphane Gaudry, Florence Tubach, Emeline Dubief, Blandine Pasquet, Sylvie Guillo, Didier Dreyfuss, Jean-Damien Ricard

O49 Gasp during children end-of-life: healthcare providers’ feelings and knowledge

Charlotte Pierron, Marion Grimaud, Caroline Farnoux, Amélie Maillard

O50 Prognosis of malignant primary brain tumors in intensive care unit

Maxens Decavèle, Nicolas Weiss, Hélène Prodanovic, Julien Mayaux, Ahmed Idbaih, Agusti Alentorn, Jean-Yves Delattre, Thomas Similowski, Alexandre Demoule

O51 Impact of early immunomodulating treatment on outcome of adult patients with anti-N-methyl-d-aspartate receptor encephalitis requiring intensive care: a multicentre study with prospective long-term follow-up

Etienne De Montmollin, Sophie Demeret, Noelle Brule, Marie Conrad, Frédéric Dailler, Nicolas Lerolle, Jean-Christophe Navellou, Carole Schwebel, Mikael Alves, Martin Cour, Nicolas Engrand, Jean-Marie Tonnelier, Stephane Ruckly, Géraldine Picard, Véronique Rogemond, Jean-François Timsit, Jérôme Honnorat, Romain Sonneville, ENCEPHALITICA study group

O52 Determinants of outcome in critically ill patients with hematological malignancy and central neurological failure: data from the TRIAL OH study

Chiara Marzorati, Virginie Lemiale, Djamel Mokart, Frédéric Pène, Achille Kouatchet, Julien Mayaux, François Vincent, Martine Nyunga, Fabrice Bruneel, Antoine Rabbat, Christine Lebert, Pierre Perez, Dominique Benoit, Giuseppe Citerio, Elie Azoulay, Stéphane Legriel

O53 Ammonemia predicts severity and outcome in cirrhotic patients with hepatic encephalopathy in ICU

Simona Tripon, Maxime Mallet, Marika Rudler, Francoise Imbert-Bismut, Dominique Thabut, Nicolas Weiss

O54 Acute varicella zoster encephalitis admitted to the ICU: a case series of 47 patients

Emmanuel Canet, Adrien Mirouse, Romain Sonneville, Laurent Argaud, Stanislas Faguer, Keyvan Razazi, Claude Guérin, Pierre Perez, Anne-Sophie Moreau, Claire Pichereau, François Barbier, Sybille Merceron, Amélie Seguin, Julien Mayaux, Guillaume Geri, Christophe Guitton, Francois Labadie, Elie Azoulay

O55 High-flow nasal cannula for acute respiratory failure in immunocompromised patients

Virginie Lemiale, Matthieu Resche-Rigon, Djamel Mokart, Frédéric Pène, Etienne Faucher, Christophe Guitton, Antoine Rabbat, Christophe Girault, Achille Kouatchet, François Vincent, Fabrice Bruneel, Martine Nyunga, Amélie Seguin, Kada Klouche, Sylvie Chevret, Elie Azoulay, Groupe de Recherche en Reanimation Respiratoire du patient d’Onc-hématologie

O56 High-flow oxygen therapy through a nasal cannula in immunocompromised patients with acute hypoxemic respiratory failure

Jean-Pierre Frat, Stéphanie Ragot, Christophe Girault, Remi Coudroy, René Robert, Jean-Michel Constantin, Gwenael Prat, Thierry Boulain, Angéline Jamet,, Alain Mercat, Laurent Brochard, Arnaud, W. Thille

O57 Prospective validations of the PASTEIL score to assess the clinical pretest probability of Pneumocystis jirovecii pneumonia (PjP) in patients with hematologic malignancies (HMs) and acute respiratory failure (ARF)

Elie Azoulay, Sylvie Chevret, Antoine Roux, Etienne Faucher, François Vincent, Antoine Rabbat, Achille Kouatchet, Frédéric Pène, Julien Mayaux, Pierre Perez, Martine Nyunga, Christophe Guitton, Fabrice Bruneel, Kada Klouche, Djamel Mokart, Virginie Lemiale

O58 Bedside contribution of electrical impedance tomography (EIT) to set mechanical ventilation for severe acute respiratory distress syndrome (ARDS) on extracorporeal membrane oxygenation (ECMO)

Guillaume Franchineau, Nicolas Brechot, Guillaume Lebreton, Guillaume Hekimian, Ania Nieszkowska, Charles-Edouard Luyt, Pascal Leprince, Jean Louis Trouillet, Alain Combes, Matthieu Schmidt

O59 Liberal oxygenation versus restrictive oxygenation in ICU patients: effects on proinflammatory cytokines, sRAGE and organ dysfunctions - results of an ancillary study

Loïc Barrot, Gaël Piton, Michael Bailey, Rakshit Panwar, Nicolas Belin, François Belon,, Cyrille Patry, Jean-Christophe Navellou, Mathilde Grandperrin, Claire Chaignat, Guylaine Labro, Bérengère Vivet, Gilles Capellier

O60 Immature granulocyte level at the acute phase of sepsis, a potential prognostic marker of clinical deterioration. The Septiflux 2 multicenter trial

Thomas Daix, Estelle Guérin, Elsa Tavernier, Emmanuelle Mercier, Valérie Gissot, Christine Vallejo, Jean-Paul Mira, Christophe Guitton, Bruno François, Septiflux trial Group

O61 Analysis of microbiome and resistome using next-generation sequencing in urine samples from patients with sepsis, severe sepsis or septic shock

Céline Ravry, Bruno François, Emmanuelle Begot, Nicolas Pichon, Catherine Chapellas, Anne-Laure Fedou, Antoine Galy, Marie-Cécile Ploy, Olivier Barraud, Philippe Vignon

O62 Patients metabolomic profiles at intensive care admission

Aurelie Thooft, Raphael Conotte, Jean-Marie Colet, Patrick Biston, Michael Piagnerelli

O63 Lymphocyte phenotype during severe sepsis and septic shock

Matthieu Le Dorze, Virginie Tarazona,, Caren Brumpt,, Hélène Moins-Teisserenc,, Anne-Claire Lukaszewicz, Didier Payen de la Garanderie

O64 Myeloid-derived suppressor cells expressing arginase-1 and IDO play a major role in immune dysfunction during septic shock

Fabrice Uhel, Imane Azzaoui,, Murielle Gregoire, Céline Pangault, Joëlle Dulong,, Luc Cynober,, Jean-Marc Tadié, Mikaël Roussel,, Yves Le Tulzo, Karin Tarte

O65 Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis admitted to the intensive care unit: a multicenter study

Julien Demiselle,, Johann Auchabie,, Julie Boisramé-Helms, Pierre François Dequin, Damien Du Cheyron, Michaël Darmon, Nicolas Chudeau, Guillaume Geri, René Robert, François Fourrier, Steven Grange, Christophe Guitton, Lise Piquilloud, Alexandre Lautrette, Sonia Boyer, Emmanuel Guérot, Julien Letheulle, Nicolas Lerolle

O66 Continuous renal replacement therapy versus intermittent hemodialysis: impact on mortality and renal recovery

Anne Sophie Truche, Michaël Darmon, Sébastien Bailly, Christophe Clec’h, Claire Dupuis, Benoit Misset, Elie Azoulay, Carole Schwebel, Lila Bouadma, Christophe Adrie, Guillaume Marcotte, Philippe Zaoui, Virginie Laurent, Dany Goldgran Toledano, Romain Sonneville, Bertrand Souweine, Jean-François Timsit

O67 Hospital survival and need of renal replacement therapy with respect to AKI duration in critically ill patients: results of a multicenter cohort study

Sophie Perinel Ragey, Anne Sophie Truche, Bertrand Souweine, Sébastien Bailly, Elie Azoulay, Lila Bouadma, Christophe Clec’h, Maïté Garrouste-Orgeas, Antoine Gros, Carole Schwebel, Christophe Adrie, Anne Sylvie Dumenil, Laurent Argaud, Samir Jamali, Dany Goldgran Toledano, Guillaume Marcotte, Michaël Darmon, Jean-François Timsit, For the OUTCOMEREA study group

O68 Early versus delayed initiation of renal replacement therapy in septic acute kidney injury: a retrospective study

Mikhael Chouraqui, Antoine Dewitte, Brigitte Chastel, Pauline Carles, Catherine Fleureau, Olivier Joannes-Boyau, Alexandre Ouattara

O69 Renal recovery after severe acute kidney injury in critically ill myeloma patients

Adrien Joseph, Marion Venot, Sandrine Valade, Eric Mariotte, Claire Pichereau, Akli Chermak, Virginie Lemiale, Elie Azoulay, Emmanuel Canet

O70 Impact of proactive nurse participation in ICU family conferences: a Mixed-Method Study

Maïté Garrouste-Orgeas, Adeline Max, Talia Lerin, Charles Grégoire, Stephane Ruckly, Martin Kloeckner, Cédric Bruel, Sandie Brochon, Francois Philippart, Emmanuelle Pichot, Clara Simons, Jean-François Timsit, Benoit Misset

O71 Duration of platelet storage and outcome of critically ill patients

Andrew Flint, Cécile Aubron, Michael Bailey, Rinaldo Bellomo, David Pilcher, Allen Cheng, Colin Hegarty, Anthony Martinelli, Benjamin Howden, Michael Reade, Zoe Mcquilten

O72 REA-C-SUR safety culture in intensive care in France: is there a link with morbi-mortality conferences?

Cédric Bretonnière, Daniel Villers, Christophe Guitton, Groupe RMM, Qualité et Sécurité des Soins - CBPR-CFAR

O73 Survival of critically ill solid cancer patients: results of a retrospective multicentre study

M Soares, Virginie Lemiale, Djamel Mokart, Frédéric Gonzalez, Fabrice Bruneel, Yves Cohen, Elie Azoulay, Michaël Darmon, François Vincent, for the GrrrOH: Groupe de recherche en réanimation respiratoire en Onco-Hématologie (Group for Research in Respiratory Intensive Care Onco-Hematology)

O74 Encouraging results of the French controlled donation after circulatory death Maastricht category III Program

Clémence Fauché, Michel Muller, Samuel Gay, Olivier Skowron, Albrice Levrat, Didier Dorez

O75 Clinical significance of cardiac troponin I release in severe trauma patients

Maxens Decavèle, Arnaud Foucrier, Sebastian Pease, Tobias Gauss, Catherine Paugam

O76 The modified Glasgow prognostic score is helpful in screening lung cancer patient at risk of hospitalization at the emergency department

Julie Gorham, Lieveke Ameye, Marianne Paesmans, Thierry Berghmans, Jean-Paul Sculier, Anne-Pascale Meert

O77 Relationship between body mass index classes and massive transfusion needs in trauma patients and predictive performance of the TASH score in obese and non-obese populations: a retrospective study on 910 trauma patients

Audrey De Jong, Pauline Deras, Orianne Martinez, Pascal Latry, Samir Jaber, Xavier Capdevila, Jonathan Charbit

O78 The Eschmann stylet as first tracheal access tool during emergency difficult tracheal intubation: An initial simulation trial followed by a clinical study

Jaubert J., Celia Etiennar, Lucie Ginoux, Jean-Luc Sebbah, Hakim Haouache, Gilles Dhonneur

O79 Maternal mortality risk factors for eclampsia

Chaigar Mohammed Cheikh, I. Moussaid, O. Ghazaoui, Kamal Belkadi, S. El Youssoufi, S. Salmi

O80 Use of aminoglycosides in cirrhotic patients admitted in intensive care for severe sepsis or septic shock: short- and intermediate-term impact on renal function and mortality

Laure Pajot, Benjamin Zuber, Carole Schwebel, Romain Sonneville, Benoit Misset, Michael Darmon, Guillaume Marcotte, Anne Sophie Truche, Dany Goldgran-Toledano, Bertrand Souweine, Samir Jamali, Stephane Ruckly, Elie Azoulay, Christophe Clec’h, Jean Pierre Bedos, Jean-François Timsit, OutcomeRéa

O81 Diagnostic yield and therapeutic impact of liver biopsy in the intensive care unit

Bertrand Sauneuf, Benoit Dupont, Axelle Eugène, Jean-Luc Hanouz, Françoise Galateau-Sallé, Nicolas Terzi

O82 Critically ill patients requiring liver transplantation: a 7-year monocentric retrospective experience

Baptiste Michard, Benjamin Lebas, Alexandra Boivin, Max Guillot, Jean-Etienne Herbrecht, Marie-Line Harlay, Ralf Janssen-Langenstein, Maleka Schenck, Bernard Ellero, Marie-Lorraine Woehl-Jaegle, Camille Besch, Vincent Castelain, Philippe Bachellier, Francis Schneider

O83 Hospital survival and access to liver transplantation of MARS-treated patients in France, 2004–2008: a retrospective multicenter study (RETROMARS)

Christophe Camus, Fawzi Saliba, Bernard Goubaux, Agnès Bonadona, Laurence Lavayssiere, Catherine Paugam, Alice Quinart, Olivier Barbot, Sebastien Dharancy, Bertrand Delafosse, Nicolas Pichon, Helene Barraud, Arnaud Galbois, Benoit Veber, Sophie Cayot, Bruno Souche, Clara Locher, RETROMARS Study Group

Olivier Roux, Francesco Figorilli, Antonella Putignano, Pauline Houssel, Claire Francoz, Emmanuel Weiss, Catherine Paugam, Banwari Agarwal, Rajiv Jalan, François Durand

P1 Severe brain injuries: epidemiology and outcome in a Tunisian medical intensive care unit

Hassen Ben Ghezala, Salah Snouda, Rebeh Daoudi, Moez Kaddour

P2 Stroke prognosis in the ICU of the regional hospital of Bizerte and withhold and withdrawal treatment decisions

Hatem Ghadhoune, E. Rachedi, J. Guissouma, A. Ben Slimene, W. Azzeza, H. Brahmi, H. Elghord

P3 Brain death predictive factors for traumatic brain injury

Ahmed Youssef Kada, Radia Chikh, Roza Slimani, Kheireddine.a Bouyoucef

P4 Guillain–Barré syndrome in intensive care unit: epidemiology and prognostic factors: analysis of 30 patients

Kais Regaieg, Chtara Kamilia, Najeh Baccouch, Olfa Turki, Anis Chaari, Hmida Chokri Ben, Mabrouk Bahloul, Mounir Bouaziz

P5 Eclampsia: epidemiological and clinical study about 194 cases

Fatma Kaaniche Medhioub, Najeh Baccouch, Manel Zekri, Kais Rgieg, Chokri Bhimada, Bouaziz Mounir

P6 Neuroimagery in eclampsia and preclampsia

Chaigar Mohammed Cheikh, I. Moussaid, Kamal Belkadi, O. Ghazaoui, S. El Youssoufi, S. Salmi

P7 Interest of brain oxygen tension measurement (PbrO2) in the diagnosis of cerebral vasospasm after aneurismal subarachnoid hemorrhage

Elodie Lang, Stephane Welschbillig, Fabian Roy-Gash, Nicolas Engrand

P8 Noninvasive ventilation: an alternative to the intubation during myasthenic crisis

Mathilde Perrin, Fabian Roy-Gash, Stephane Welschbillig, Jean-Michel Devys

P9 Interest of the transcranial Doppler ultrasound in the management of severe traumatic brain injury

Soumia Benbernou, Houria Mokhtari-Djebli, Sofiane Ilies, Khalida Bouyacoub, Abdelkader Azza

P10 VV-ECMO on ARDS: toward a lower anticoagulation ratio?

Elie Zogheib, Joseph Nader, Léonie Villeret, Mathieu Guilbart, Patricia Besserve, Thierry Caus, Hervé Dupont

P11 Inter-hospital transportation of patients implanted with veno-venous ECMO: Experience of the Pitié-Salpêtrière mobile ECMO team

Nicolas Brechot, Ciro Mastroianni, Matthieu Schmidt, Francesca Santi, Guillaume Lebreton, Charles-Edouard Luyt, Jean Louis Trouillet, Ania Nieszkowska, Guillaume Hékimian, Leprince Pascal, Jean Chastre, Alain Combes

P12 Evolution of tidal volume and compliance under pressure-controlled mode during the first 24 hours of ECMO ARDS patients transported to a referral center

Hadrien Roze, Benjamin Repusseau, Jean-Christophe Richard, Virginie Perrier, Alexandre Ouattara

P13 Extracorporeal dioxide carbon removal (ECCO2R), a French national survey

Benjamin Deniau, Jean-Damien Ricard, Jonathan Messika, Didier Dreyfuss, Stéphane Gaudry

P14 Levels of microparticles in acute respiratory distress syndrome with veno-venous extra-corporeal membrane oxygenation

Christophe Guervilly, Fanny Klasen, Sami Hraiech, Jean-Marie Forel, Laurent Papazian

P15 In patients under extracorporeal CO2 removal therapy (ECCO2R) for ARDS can we do prone position? Efficiency, stability and safety of the maneuver

Jean Pierre Ponthus, Polysie Ngasseu, Virginie Amilien, Elise Barsam, Pierre Lehericey, Martial Tchir, Jean Francois Georger

P16 Feasibility of the implementation of a technique of extra-corporeal CO2 removal (ECCO2R) in an intensive care unit which does not use ECMO and its real utilization

Virginie Amilien, Jean Pierre Ponthus, Polysie Ngasseu, Martial Tchir, Elise Barsam, Pierre Lehericey, Jean Francois Georger

P17 Six-hour daily session of high-frequency oscillatory ventilation in moderate-to-severe ARDS: impact on the end-expiratory lung volume, compliance and oxygenation

Bérénice Puech, David Vandroux, Arnaud Roussiaux, Dominique Belcour, Cyril Ferdynus, Olivier Martinet, Julien Jabot

P18 Can we optimize prescription of laboratory tests in surgical intensive care unit (ICU)? Study of appropriateness of care

Marion Fresco, Gaëlle Demeilliers-Pfister, Véronique Merle, Valéry Brunel, Benoit Veber, Bertrand Dureuil

P19 Impact of the implementation of guidelines for laboratory testing in an intensive care unit

Sébastien Leydier, Isabelle Clerc-Urmes, Jérémie Lemarie, Charles-Henri Maigrat, Marie Conrad, Aurélie Cravoisy-Popovic, Damien Barraud, Lionel Nace, Sébastien Gibot, Nelly Agrinier, Pierre-Edouard Bollaert

P20 Identifying useless precaution to reduce costs in ICU

Vincent Peigne, Jean-Louis Daban, Mathieu Boutonnet, Guillaume Dumas, Elisabeth Falzone, Patrick Jault, Bernard Lenoir

P21 The ICU of the teaching hospital of Kinshasa

Joseph Nsiala Makunza, Nathalie Mejeni

P22 Security culture and risk management in intensive care units: risk cartography in a French intensive care unit

Amélie Mazaud, Sébastien Béague, Anne-Flore Rousselle, Alain Durocher

P23 Acquiring messages of medical articles according to the reading style: the BIBLIOFLASH multicenter study

Romain Sonneville, Benjamin Sztrymf, Emmanuel Canet, for the BIBLIOFLASH study group

P24 ICU portrayal in social media channels

Pauline Perez, Alexandra Grinea, Nicolas Weiss

P25 The burnout syndrome in a Tunisian intensive care unit: what is the truth?

Hassen Ben Ghezala, Naoures Bedoui, Salah Snouda, Rebeh Daoudi, Moez Kaddour

P26 Resistance of endotracheal tubes measured after extubation in ICU patients

Alina Stoian, Loredana Baboi, Florent Gobert, Hodane Yonis, Romain Tapponier, Jean-Christophe Richard, Claude Guérin

P27 Length of endotracheal tube, humidification system and airway resistance: an experimental bench study

Frédéric Duprez, Arnaud Bruyneel, Thierry Bonus, Grégory Cuvelier, Sharam Machayeckhi, Sandra Olieuz, Alexandre Legrand

P28 Diagnosis contribution and safety of bronchoalveolar lavage in intensive care unit

Fatma Feki, Amira Jamoussi, Takoua Merhebene, Emna Braham, Asma Ghariani, Faouzi El Mezni, Leila Slim, Jalila Ben Khelil, Mohamed Besbes

P29 Impact of fiberoptic bronchoscopy performed under noninvasive ventilation on the outcome of critically ill patients: a cohort study over 11 years

Antoine Marchalot, Christophe Girault, Gaetan Beduneau, Dorothée Carpentier, Steven Grange, Emmanuel Besnier, Gioia Gastaldi, Julien Abily, Marion Beuzelin, Fabienne Tamion

P30 New single-use flexible bronchoscope dedicated for the invasive mechanical ventilation: a proof of concept

Mai-Anh Nay, Adrien Auvet, Julie Mankikian, Virginie Hervé, Antoine Guillon

P31 Incidence of and risk factors for difficult intubation in ICU

Marie Soulie, Pierrick Cronier, Elie Kantor, Laura Federici, Marion Gilbert, Ilham Mezhari, Gérald Choukroun, Sophie Marque

P32 Endotracheal self-extubation in the intensive care unit: a two-year observational study

Z. Coppere, Maxens Decavèle, Jean-Pierre Fulgencio, Clarisse Blayau, Tai Pham, Muriel Fartoukh, Michel Djibre

P33 Criteria to assess extubation readiness and prediction of successful weaning

Matthieu Reffienna, Michel Arnaout, Sébastien Lefort, Anne-Sophie Debue, Fabrice Daviaud, Sarah Cabon, Frédéric Pène, Julien Charpentier, Alain Cariou, Jean-Paul Mira, Jean-Daniel Chiche, Working Group on Mechanical Ventilation

P34 Domestic accidents during school holidays in children

Nabil Tabet Aoul, Zakaria Addou, Ali Douah, Mohamed Moussati, Kamel Belhabiche, Nabil Aouffen

P35 Pediatric ARDS: interest of prone positioning and NAVA ventilation during veno-venous ECMO

Sylvie Soulier, Philippe Mauriat, Nadir Tafer, Alexandre Ouattara

P36 Esogastric pressure measurement as a guide for noninvasive ventilation in unexplained hypercapnic respiratory failure in infants

Guillaume Mortamet, Alessandro Amaddeo, Sonia Khirani, Brigitte Fauroux

P37 Experience Of Antibacterial Treatment Of Bone And Joint Sepsis Of Young Children

Gennadiy Khanes, Olga Liutko, Svitlana Bidnenko

P38 Comparison of toxic and septic shocks in children

Solenn Remy, Emilie Doye, Nicolas Voirin, Delphine Maucort-Boulch, Karine Kolev-Descamp, Guillaume Monneret, Etienne Javouhey

P39 Pediatric carbon monoxide poisoning in the Ile-de-France Region, Link between HbCO level and clinical presentation

Imane El Aouane, Aben Essid, Wallid Hammami, Isabelle Haegy, Jacques Bataille, Jean Bergounioux

P40 Refractory septic shock in children: an ESPNIC definition

Luc Morin, Samiran Ray, Graeme Maclaren, Etienne Javouhey, Simon Nadel, Martin Kneyber, Mark Peters, Koos Jansen, Daniele De Luca, Clare Wilson, Luregn Schlapbach, Pierre Tissières, The infection, inflammation and sepsis section of the ESPNIC

P41 Impact of the Leonetti law on end-of-life practices in a French NICU and PICU, from January 2011 to December 2014

Anne-Claire Girard, Elodie Savajols, Antoine Burguet, Denis Semama, Stephanie Litzler-Renault

P42 Mortality risk factors for anticoagulant-related bleeding

Ines Sedghiani, Hana Fredj, Malek Hassouna, Youssef Zied El Hechmi, Mohamed Ali Cherif, Jerbi Zouheir

P43 Management of the polytrauma in the emergency department of CHUOran

Houria Mokhtari-Djebli, Soumia Benbernou, Ahmed Dernane, Fouad Bouakkaz, Khalida Bouyacoub, Abdelkader Azza

P44 Realization of a feedback system of respiratory parameters during CPR

Lhoucine Ben Taleb, Elmaati Essoukaki, A Zeddine Mouhsen, Aissam Lyazidi, Jean-Christophe Marie Richard, Ahmed Mouhsen, Mohammed Harmouchi, Mourad Rattal

P45 Burns from French military operations: a 14-year retrospective observational analysis

Matthias Huck, Thomas Leclerc, Nicolas Donat, Audrey Cirodde, Jean-Vivien Schaal, Yannick Masson, Clément Hoffmann

P46 Drowning in Martinique—characteristics and infectious complications

Dabor Resiere, Laura Cerland, Ruddy Valentino, C Chabartier, Laurent Villain-Coquet, Jean-Louis Ferge, Y Brouste, Bruno Megarbane, Hossein Mehdaoui

P47 Prevalence, characteristics, and associated factors to physician’s conflicts in Emergency Department: A multicentric Moroccan study

Jihane Belayachi, Maha Louriz, Naoufal Madani, Fatiha Amlaiky, Tarek Dendane, Khalid Abidi, Aicha Zekraoui, Amine Ali Zeggwagh, Redouane Abouqal

P48 Serious peripartum complications needing admission in obstetrical ICU: retrospective study about 127 cases

Affra Brahim, Fehmi Ferhi, Hosni Khouadja, Mohamed Amine Bouslama, Khalil Tarmiz, Khaled Benjazia

P49 Epidemiology of suicide in emergency department

Neila Maaroufi, Abid Zeineb, Dhaouadi Mahassen

P50 Beneficial cardiovascular effects of O-GlcNAc stimulation in early phase of septic shock

Julien Cadiet, Marine Ferron, Valentine Prat, Angelique Erraud, Virginie Aillerie, Mathieu Mevel, Amandine Grabherr, John C. Chatham, Chantal Gauthier, Benjamin Lauzier, Bertrand Rozec

P51 MiR-21 deficiency increases mortality during experimental septic shock

Jeremie Joffre, Xavier Loyer, Jean-Rémi Lavillegrand, Lynda Zeboudj, Ludivine Laurans, Bruno Esposito, Alain Tedgui, Ziad Mallat, Hafid Ait-Oufella

P52 Isolated heart rate reduction by ivabradine does not improve cardiac and vascular function in experimental septic shock

Chaojie Wei, Narimane Al Kattani, Huguette Louis, Sophie Orlowski, Bruno Levy, Antoine Kimmoun

P53 Exploration and modulation of the EGF-R during experimental septic shock

Jean-Rémi Lavillegrand, Lynda Zeboudj, Jeremie Joffre,, Ludivine Laurans,, Bruno Esposito, Alain Tedgui, Pierre-Louis Tharaux, Hafid Ait-Oufella

P54 An intravenous omega-3 bolus at reperfusion time improves shock and vascular dysfunction in a myocardial ischemia–reperfusion rat model

Mélanie Burban, Grégory Meyer, Anne Olland, Blandine Yver, Florence Toti, Valérie Schini-Kerth, Alexandra Monnier, Alexandra Boivin, Pierrick Leborgne, Ferhat Meziani, Julie Boisramé-Helms

P55 Impact of urantide antagonist of urotensinergic system on myocardial function during a murine model of septic shock

Emmanuel Besnier, Thomas Clavier, Mulder Paulus, Hélène Castel, Vincent Richard, Fabienne Tamion

P56 Association of dexamethasone and antibodies to poly-β(1,6)-n-acetyl-glucosamine in prevention and treatment of neonatal bacterial meningitis: an experimental study

Stéphanie Pons, Bruno Mourvillier, David Skurnik

P57 Hyperoxemia as a risk factor for ventilator-associated pneumonia

Sophie Six, Karim Jaffal, Saad Nseir

P59 Significance of prior digestive colonisation with extended-spectrum beta-lactamase producing Enterobacteriaceae in patients with ventilator-associated pneumonia

Rémi Bruyère, Clara Vigneron, Audrey Large, Julien Bador, Serge Aho, Sebastien Prin, Jean-Pierre Quenot, Pierre-Emmanuel Charles

P60 Lower respiratory tract colonization in mechanically ventilated patients: Incidence, risk factors and impact on prognosis

Yosr Touil, Soufia Ayed, Habiba Sik Ali, Najla Tilouch, Houda Mateur, I Talik, Rim Gharbi, Mohamed Fekih Hassen, Souheil Elatrous

P61 Epidemiology of ventilator-associated pneumonia in the ICU among patients already hospitalized: early- versus late-onset pneumonia

Mathilde Grandperrin, Isabelle Patry, Xavier Bertrand, Jean-Christophe Navellou, Gaël Piton, Gilles Capellier

P62 Systematic review of inclusion/exclusion criteria, judgment criteria and statistical hypothesis in randomized controlled trials assessing the efficacy of antimicrobials for hospital-acquired and ventilator-associated pneumonia treatment

Emmanuel Weiss, Jean-Ralph Zahar, Christophe Adrie, Wafa Essaied, Martin Wolkewitz, Jean-François Timsit

P63 Gram stain identification resulting from blindly inserted telescoping plugged catheter material. Does it contribute to diagnosis and treatment of ventilator-associated pneumonia?

Mickaël Soued, Fabrice Cook, David Lobo, Roman Mounier, Aurélie Emirian, Jean Winoc Decousser, Gilles Dhonneur

P64 Colistin in nosocomial pneumonia in intensive care

Hanane Ezzouine, Mohamed Toufik Slaoui, Abdellatif Benslama

P65 Bedside tissue perfusion evaluation predicts intradialytic hemodynamic instability in critically ill patients

Naïke Bigé, Claire Pichereau, Jean-Rémi Lavillegrand, Arnaud Galbois, Mikael Alves, Jean-Luc Baudel, Simon Bourcier, Vincent Dubée, Jalel Tahiri, Eric Maury, Bertrand Guidet, Hafid Ait-Oufella

P66 Evaluation of electrolytes and acid–base disorders in patients undergoing citrate-based anticoagulation for continuous renal replacement therapy in intensive care unit

Benjamin Delmas, Olivier Joannes-Boyau, Antoine Dewitte, Julien Jabot, Dorothée Valance, Nicolas Allou, Jérôme Allyn, Catherine Fleureau,, Alexandre Ouattara

P67 Continuous venovenous hemofiltration in critically ill patients with acute kidney injury: a cost study impact of replacement fluids consumptions

Elodie Jean-Bart, Floriane Bel., Fabienne Morey, Rémi Bruyère, Nicholas Sedillot

P68 Acute kidney injury in patients receiving liposomal amphotericin B in an intensive care unit: register of 104 patients from 2008 to 2014

Marion Venot, Lucie Biard, Sylvie Chevret, Sandrine Valade, Eric Mariotte, Claire Pichereau, Virginie Lemiale, Elie Azoulay, Emmanuel Canet

P69 Regional citrate-based anticoagulation for dummies in continuous venovenous hemofiltration: does it work?

Dorothée Valance, Richard Galliot, Romain Zunarelli, David Vandroux, Cyril Ferdynus, Bernard-Alex Gauzere, Olivier Martinet, Julien Jabot

P70 Incidence of and risk factors for acute kidney injury in early postoperative liver transplantation according to AKIN classification

Jean-Charles Cartier, Thomas Jouve, Marie-Noëlle Hilleret, Rebecca Hamidfar-Roy, Claire Ara-Somohano, Clémence Minet, Agnès Bonadona, Carole Schwebel

P71 Metabolic acidosis uncompensated by kidney in septic patients: a predictive factor for acute kidney injury?

Aline Pourcelet, Jean-Michel Hougardy, Pierre Defrance, Patrick Biston, Michael Piagnerelli

P72 Blood volume monitoring is useful to predict intradialytic hypotension during intermittent hemodialysis

Louis De Laforcade, Alexandre Boyer, Didier Gruson, Benjamin Clouzeau

P73 Risk factors for occurrence of acute kidney injury in diabetic ketoacidosis

Najah Hajjam, Ines Sedghiani, Houda Nasri, Hamdi Doghri, Youssef Zied El Hechmi, Mohamed Ali Cherif, Jerbi Zouheir

P74 Face-to-face tracheal intubation with the video laryngoscope Airtraq in the sitting patients: a report of 3-year experience in patients after failed conventional tracheal intubation technique

Gilles Dhonneur, Nicolas Mongardon, Eric Levesque, Hakim Haouache

P75 Ultrasound-guided central venous access technique among French intensivists

Marie-Anaïs Bastide, Jack Richecoeur, Eric Frenoy, Christian Lemaire, Bertrand Sauneuf, Fabienne Tamion, Saad Nseir, Damien Du Cheyron, Hervé Dupont, Julien Maizel, BoReal Study Group

P76 Ultrasound-guided venous catheter insertion. What do French intensivists really do?

Hafid Ait-Oufella, Eric Maury, Julien Maizel, Frédérique Schortgen, Cécile Aubron, Christophe Clec’h, Christophe Guitton, Kada Klouche, Nicolas Lerolle, Frédéric Pène, Sebastien Preau, Carole Schwebel, Nicolas Terzi, Frédéric Vargas, Vincent Castelain

P77 Can we trust new connected devices recording heart rate and oxygen saturation? A concordance assessment in intensive care unit

Franck Ehooman, Yacine Tandjaoui-Lambiotte, Claire Montlahuc, Guillaume Van Der Meersch, Johanna Oziel, Jean Bardon, Matthieu Resche-Rigon, Nicolas Postel-Vinay, Yves Cohen

P78 Hemoglobin monitoring with HemoCue©, spectrophotometry and blood cells analyzer: comparison of agreement, completion time and costs

Mehdi Lafi, Frédéric Jacobs, Dominique Prat, Matthieu Le Meur, Olfa Hamzaoui, Anne Sylvie Dumenil, Guy Moneger, Nadège Demars, Pierre Trouiller, Benjamin Sztrymf

P79 Activated partial thromboplastin time and anti-Xa measurements in heparin monitoring among critical care patients

Noémie Tencé, Inès Zaien, Martine Wolf, Pierre Trouiller, Frédéric Jacobs

P80 Agreement between the Point-Of-Care Siemens RAPIDPoint® 500 Blood gas system and central laboratory measurement of hemoglobin, hematocrit, glucose and electrolytes in ICU patients

Jérôme Allardet-Servent, Melissa Lebsir, Christian Dubroca, Mireille Portugal, Matthias Castanier, Thomas Signouret, Guillemette Thomas, Rettinavelou Soundaravelou, Anne Lepidi, Philippe Halfon, Jean-Marie Seghboyan

P81 Clinical features and prognosis of pesticide poisoning

Neila Maaroufi, Dhaouadi Mahassen, Abid Zeineb

P82 Variability of neurobehavioral toxicity of naphyrone, a new synthetic cathinone, according to its acute or binge administration

Camille Gamblin, Nadia Benturquia, Olivier Roussel, Lucie Chevillard, Patricia Risede, Jacques Callebert, Bruno Megarbane

P83 Acute acenocoumarin poisoning: an epidemiological and clinical study

A. M’rad, Hana Fredj, Messaouda Khelfa, Youssef Blel, H. Thabet, Nozha Brahmi, M. Amamou

P84 Death by deliberate self-poisoning in Sfax, Tunisia: Victims characteristics and toxic substance profile

Youssef Nouma, Wiem Ben Amar, Sami Bardaa, Karama Regaieg, Kaouthar Jammeli, Mabrouk Bahloul, Zouheir Hammami, Maatoug Samir

P85 Adverse drug reactions (ADRs) collected by medical-staffed ambulances: pilot study

A. Lillo-Le Louët, F. Baud, C. Le Beller, B. Vivien, L. Soufir, P. Carli and H. Le Louët

P86 Prognostic value of plasma concentration of acebutolol in acute poisoning

A. M’rad, Youssef Blel, Fatma Essafi, Nasreddine Foudhaili, Abdelaziz Ben Slimen, Nozha Brahmi, M. Amamou

P87 Baseline pharmacologic treatment for patients admitted in ICU for AECOPD: trends in use and conformity to the GOLD guidelines

Islem Ouanes, Rami Jabla, Hedia Hammed, Mahdi Marzouk, Nesrine Boujelbene, Fahmi Dachraoui, Asma Hachani, Saousen Ben Abdallah, Hend Ben Lakhal, Chaima Ghribi, Imen Ben Ali, Imen Abdellaoui, Lamia Ouanes-Besbes, Fekri Abroug

P88 Blood eosinophils levels and acute exacerbations of COPD

Islem Ouanes, Asma Hachani, Lamia Ouanes-Besbes, Saousen Ben Abdallah, Rami Jabla, Hedia Hammed, Mahdi Marzouk, Hend Ben Lakhal, Imen Ben Ali, Imen Abdellaoui, Chaima Ghribi, Fahmi Dachraoui, Fekri Abroug

P89 POFE: postoperative outcomes of chronic obstructive pulmonary disease (COPD) frequent exacerbators after pulmonary resection—a pilot study

Suela Demiri, Christine Lorut, Van Lang, Daniel Luu, Antoine Rabbat, Aurélie Lefebvre, Marco Alifano, Jean-Francois Reignard, Marc Samama, Daniel Dusser, Nicolas Roche

P90 Optimal delivery of salbutamol with a pressurized metered-dose inhaler within a high-flow nasal therapy circuit

François Réminiac, Cassandre Landel, Samuel Gensburger, Thomas Bocar, Lydiane Mordier, Marion Philippe, Déborah Le Pennec, Laurent Vecellio, Stephan Ehrmann

P91 Differences in perceptions between the various healthcare professionals working at the bedside of the risks related to the rehabilitation procedures

Laurent Poiroux, David Thevoz, Julien Simons, Cheryl Hickmann, Jean Roeseler, Anthéa Loiez, Stéphanie Gérard, Nicolas Dousse, Tai Pham, Nicolas Terzi, Lise Piquilloud

P92 Early rehabilitation in critically ill patients: a prospective multicenter assessment of real-life practice

Lorraine Ducroux, Sylvie L’hotellier, Elodie Baumgarten, Stéphanie Borschneck, Francis Schneider, Vincent Castelain

P93 Extracorporeal membrane oxygenation for pheochromocytoma-induced cardiogenic shock: report of nine cases

Guillaume Hékimian, Nicolas Brechot, Matthieu Schmidt, Fatima Kharcha, Cécile Ghander, Guillaume Lebreton, Christophe Tresallet, Jean Louis Trouillet, Pascal Leprince, Alain Combes, Charles-Edouard Luyt

P94 Mortality related to cardiogenic shock in critically ill patients in France, 1997–2012

Etienne Puymirat, Jean-Yves Fagon, Philippe Aegerter, Florence Boissier, Jean-Luc Diehl, Caroline Hauw-Berlemont, Bertrand Guidet, Gilles Chatellier, Nicolas Danchin, Nadia Aissaoui

P95 Benefits of extracorporeal life support (ECLS) in elderly patients with postcardiotomy refractory cardiogenic shock

Nadia Aissat, R. Bernard, Guillaume Lebreton, Dimitri Margetis, Julien Amour, Pascal Leprince, Adrien Bouglé

P96 Heart transplantation versus ventricular assist device: which therapy for patients with refractory cardiogenic shock?

Charles Vidal, Guillaume Lebreton, Djavidi Nima, Varnous Shaida, Adrien Bouglé, Pascal Leprince, Julien Amour

P97 Refractory cardiogenic shock in immunocompromised patients rescued by veno-arterial extracorporeal membrane oxygenation

Amandine Dorget, Nicolas Bréchot, Guillaume Lebreton, Guillaume Hekimian, Ania Nieszkowska, Charles-Edouard Luyt, Pascal Leprince, Jean Louis Trouillet, Alain Combes, Matthieu Schmidt

P98 Which index severity to use in obstetric medium? (Comparison of 4 scores)

Rabi Toufiki, Youssef Mouaffak, Ahmed Rhassan El Adib, M. Amine

P99 Maternal mortality in obstetric department of UH IBN ROCHD, Casablanca, Morocco

Kamal Belkadi, I. Moussaid, Chaigar Mohammed Cheikh, S. Moumine, S. El Youssoufi, S. Salmi

P100 Disseminated intravascular coagulation in pregnant women: evaluation of a new score

Marie Jonard, Anne Sophie Ducloy-Bouthors, François Fourrier

P101 Validity of severity scores in critically ill obstetric patients

Fatma Kaaniche Medhioub, Anis Chaari, Olfa Turki, Kais Rgieg, Mabrouk Bahloul, Hmida Chokri Ben, Bouaziz Mounir

P102 Evaluation of a neuromuscular blockade with benzylisoquinoliniums: a comparison of a train of four with a clinical assessment

Pierre Bouju, Nicolas Barbarot, Arnaud Gacouin, Fabrice Uhel, Julien Letheulle, Pierre Fillatre, Guillaume Grillet, Angélique Goepp, Jean-Marc Tadié, Yves Le Tulzo

P103 The use of enteral route for drug administration in the ICU is dimly rational

Anne-Laure Clairet, Gilles Capellier, Samuel Limat, Christian Cornette, Gaël Piton

P104 Microcirculatory effects of norepinephrine in septic shock: a muscle microdialysis study

Amira Fatnassi, Zied Hajjej, Chiheb Romdhani, Walid Sammoud, Iheb Labbene, Mustapha Ferjani

P105 Administration of drugs per os by stomach tube for enteral feeding in surgical ICU

Hind Taibi, Ijlal Elatiqi, A Iraqui, Rachid Cherkab, Wafae Haddad, Chafik Elkettani, Lahoucine Barrou

P106 Implementation of an intensive care follow-up clinic

Fabien Cave, Alain Mercat, Nicolas Lerolle

P107 Needs assessment of adults post-intensive care rehabilitation department in Amiens University Hospital

Gaelle Bacari-Risal, Pierre Louis Doutrellot, Benoit Vaysse, M. Inan, K. Khelfoun, M. Nasserallah, Julien Maizel, C. Legrand-Monteil, S. Tasseel-Ponche

P108 Factors of degradation on independence and quality of life at 3 and 6 months after stay in intensive care unit

Benjamin Kowalski, Anne Guaguere, Claire Boulle-Geronimi

P109 Octavie: Epidemiological study of mortality and autonomy 3 and 6 months after ICU stay for very elderly patients

Juliette Masse, Clément Vanbaelinghem, Patrick Herbecq

P110 Analysis of burn injuries in the elderly

Amel Mokline, Syrine Draief, Lazhari Gharsallah, Imen Rahmani, Bahija Gasri, Sofiene Tlaili, Rym Hammouda, Amen Allah Messadi

P111 ICU admission criteria for patients 85 years and older

Philippe Michel, Bruno Gelée, Fouad Fadel, Marie Thuong

P112 Facteurs pronostiques chez les patients âgés admis en réanimation médicale. Prognostic factors in elderly patients admitted in medical intensive care

Sandra Ait-Aoudia, Salima Laddi, Mohamed-Mohcen Sahraoui

P113 Uncontrolled donation after circulatory determination of death: 42 months of experience in a general hospital

Clémence Fauché, Samuel Gay, Michel Muller, Anna Faucher, Olivier Skowron, Albrice Levrat, Didier Dorez

P114 Epidemiology of long stays in ICU

Bertrand Hermann, Caroline Hauw Berlemont, Alexandra Monnier, Florence Boissier, Nadia Aissaoui, Jean-Yves Fagon, Jean-Luc Diehl, Emmanuel Guérot

P115 Are daily sedation stops safe in a medical ICU?

Michel Arnaout, Julien Charpentier, Benoit Champigneulle, Julie Busson, Anne-Sophie Debue, Julie Dhumeaux, Guillaume Geri, Wulfran Bougouin, Nicole Ericher, Sébastien Lefort, Pierre Lucas, Alain Cariou, Jean-Paul Mira, Frédéric Pène, Jean-Daniel Chiche, Groupe de travail sur la ventilation

P116 Delay in awakening after stopping continuous sedation in critically ill patients: incidence, risk factors and impact on ventilator weaning

Magalie Dumas, Celine Chapelle, Benedicte Philippon-Jouve, Jerome Morel, Pascal Beuret

P117 Risk factors and prognosis impact of decreased patient–ventilator synchrony in mechanically ventilated patients—a prospective study

Côme Bureau, Camille Rolland-Debord, Tymothée Poitou, Marc Clavel, Sébastien Perbet, Nicolas Terzi, Achille Kouatchet, Thomas Similowski, Alexandre Demoule, Université Paris 6—Pierre et Marie Curie and Institut National pour la Santé et la Recherche Médicale, UMRS1158, Paris

P118 High-flow oxygen therapy through a nasal cannula versus noninvasive ventilation versus in immunocompromised patients with acute respiratory failure

Remi Coudroy, Angéline Jamet, Philippe Petua, René Robert, Jean-Pierre Frat, Arnaud, W. Thille

P119 The use of dexmedetomidine in patients with noninvasive ventilation: a preliminary study

Hassen Ben Ghezala, Salah Snouda, Rebeh Daoudi, Moez Kaddour

P120 Comparison of tolerance of 4 interfaces for preventive noninvasive ventilation after abdominal surgery in intensive care units assessed by patients and caregivers

Audrey De Jong, Albert Prades, Marion Monnin, Martin Mahul, Marion Basty, Clément Monet, Benjamin Mounet, Emmanuel Futier, Gérald Chanques, Samir Jaber

P121 Dexmedetomidine, new approach in sedation analgesia: a prospective and observational study of mechanically ventilated patients in adults intensive care units in a university hospital during the first year of use

Audrey Leroux, Xavier Oudinot, Gaëlle Demeilliers-Pfister, Marc Laurent

P122 Pain, confusion, and agitation associated with noninvasive ventilation

Nesrine Boujelbene, Rami Jabla, Fahmi Dachraoui, Islem Ouanes, Saousen Ben Abdallah, Mahdi Marzouk, Asma Hachani, Hedia Hammed, Hend Ben Lakhal, Imen Ben Ali, Chaima Ghribi, Imen Abdellaoui, Lamia Ouanes-Besbes, Fekri Abroug

P123 Impact of metformin on prognosis of ICU patients

Sebastien Jochmans, Jean-Emmanuel Alphonsine, Ly Van Vong, Nathalie Rolin, Oumar Sy, Jean Serbource-Goguel, Jonathan Chelly, Olivier Ellrodt, Mehran Monchi, Christophe Vinsonneau

P124 Serum cholinesterase activity in the diagnosis of septic shock due to bacterial infections: a new specific biomarker of sepsis

Mabrouk Bahloul, Turki Olfa, Najeh Baccouche, Kais Regaieg, Chtara Kamilia, Benhamida Chokri, Hedi Chelly, Mounir Bouaziz

P125 Is hyperoxaemia a rare event during septic shock patients management?

Amélie Trichot, Gwenhaël Colin, Jean-Baptiste Lascarrou, Isabelle Vinatier, Konstantinos Bachoumas, Jean-Claude Lacherade, Maud Fiancette, Aurélie Joret, Aihem Yehia, Christine Lebert, Matthieu Henry-Laguarrigue, Laurent Martin-Lefèvre

P126 Myocardial depressant factor during human septic shock: screening of twenty-three cytokines and chemokines

Keyvan Razazi, Florence Boissier, Mathieu Surenaud, Alexandre Bedet, Nicolas de Prost, Aurelien Seemann, Christian Brun-Buisson, Sophie Hüe, Armand Mekontso-Dessap

P127 Plasma of septic shock patients modifies in vitro mitochondrial respiration of human PBMC as well as lymphocytes and monocytes cell lines

Raphaël Clere-Jehl, Julie Boisramé-Helms, Anne-Laure Charles, Pierrick Leborgne, Xavier Delabranche, Bernard Geny, Ferhat Meziani, Pascal Bilbault

P128 Assessment of skin endothelial functions during severe infections

Simon Bourcier, Claire Pichereau, Vincent Dubée, Gabriel Lejour, Jean-Luc Baudel, Arnaud Galbois, Jalel Tahiri, Naïke Bigé, Eric Maury, Bertrand Guidet, Hafid Ait-Oufella

P129 Toe-to-Room temperature gradient correlates with tissue perfusion and predicts outcome during septic shock

Simon Bourcier, Claire Pichereau, Pierre Yves Boêlle, Nemlaghi Safaa, Vincent Dubée, Gabriel Lejour, Jean-Luc Baudel, Arnaud Galbois, Jean-Rémi Lavillegrand, Naïke Bigé, Jalel Tahiri, Eric Maury, Bertrand Guidet, Hafid Ait-Oufella

P130 Determination of HLA-DR expression on monocytes in heart recipients and clinical outcome correlation

Sylvie Paulus, Claire Flamens, Guillaume Monneret, Julie Demaret, Jean Neidecker

P131 Nosocomial infections in neonates under ECMO

Jerome Rambaud, Cecile Allioux, Romain Guedj, Isabelle Guellec, Julia Guilbert, Pierre-Louis Leger, Maryne Demoulin, Amélie Durandy, Sandrine Jean, Ricardo Carbajal

P132 Point-of-care ultrasound in pediatric and neonatal intensive care units: prospective, observational transversal study

Aurélie Morand, Laurent Zieleskiewicz, Olivier Brissaud, Stéphane Le Bel, Mickael Afanetti, Zoé Meresse, Astrid Botte, Michel Panuel, Laurent Thomachot, Jean-Michel Constantin, Marc Leone, Fabrice Michel

P133 Use of continuous infusion of clonidine for sedation in critically ill children: indications, efficacy and side effects

Anna Deho’, Laïly Sadozai, Stéphane Dauger, Sonia Prot-Labarthe

P134 Pharmacokinetic analysis of continuous infusion vancomycin therapy in critically ill children

Mathieu Genuini, Mehdi Oualha, Moulin Florence, Jean-Marc Treluyer, Fabrice Lesage, Sylvain Renolleau

P135 Incidence of central venous catheter-associated bacteraemia in a paediatric intensive care unit

Emmanuelle Chalavon, Claire Le Reun, Rodrigue Dessein, Bruno Grandbastien, Alain Duhamel, Sarah Pesin, François Dubos, Stéphane LeteurtreEmmanuelle Chalavon, Claire Le Reun, Rodrigue Dessein, Bruno Grandbastien, Alain Duhamel, Sarah Pesin, François Dubos, Stéphane Leteurtre

P136 Outcome at 2 months at the infectious level of the pediatric central venous catheters: prospective evaluation of the guidelines optimization impact

Marie-Aude Puel, Marie Szulc, Anais Philippe, François Severac, Dominique Astruc, Pierre Kuhn, Philippe DesprezMarie-Aude Puel, Marie Szulc, Anais Philippe, François Severac, Dominique Astruc, Pierre Kuhn, Philippe Desprez

P137 Ten years of intensive care in children hospital in Oran, Algeria

Nabil Tabet Aoul, zakaria addou, Ali Douah, Mohamed Moussati, Kamel Belhabiche, Nabil AouffenNabil Tabet Aoul, zakaria addou, Ali Douah, Mohamed Moussati, Kamel Belhabiche, Nabil Aouffen

P138 High-frequency percussive ventilation during neonatal transportation: a pilot study

Benoît Colomb, Karine Kolev-Descamp, Anne Marie Petion, Laurent Queudet, Elodie Savajols, Stephanie Litzler-Renault, Denis Semama

P139 Lymphopenia after severe infectious shock in children: association with severity and risk for nosocomial infection

Emilie Doye, Solenn Remy, Nicolas Voirin, Delphine Maucort-Boulch, Karine Kolev-Descamp, Guillaume Monneret, Etienne Javouhey

P140 Importance of troponin evaluation in scorpion envenomation in pediatric intensive care unit

Mouaffak Youssef

P141 Hyperosmolar therapy in pediatric traumatic brain injury: a retrospective study

Nadia Roumeliotis, Christian Dong, Geraldine Pettersen, Louis Crevier, Guillaume Emeriaud

P142 Cerebral sinovenous thrombosis in children: report of seven cases

Mouaffak Youssef

P143 Optimising nurse confidence and skill acquisition in paediatric continuous renal replacement therapy (pCRRT) through a training programme: result of the first-year experience in a tertiary care centre

Jérôme Naudin, Laetitia Abdallah, Marion Ganier, Karine Frannais, Dylia Douglas, Cecile Flusin, Anna Deho’, Stéphane Dauger

P144 From high-quality electronic database to the new concept of perpetual patient. Preliminary results

David Brossier, Redha Eltaani, Michaël Sauthier, Guillaume Emeriaud, Bernard Guillois, Philippe Jouvet

P145 Transportation of children on extracorporeal membrane oxygenation: 1-year experience of a tertiary referral center in the Paris regionJerome Rambaud, Pierre-Louis Leger, Michelle Larroquet, Alain Amblard, Noella Lode, Julia Guilbert, Sandrine Jean, Isabelle Guellec, Isabelle Casadevall, Katia Kessous, Hervé Walti, Ricardo Carbajal

P146 Acute neurotoxicity of bath salts combining 3,4-methylenedioxypyrovalerone and mephedrone in the rat

Christophe Poiré, Nadia Benturquia, Olivier Roussel, Lucie Chevillard, Patricia Risede, Jacques Callebert, Huixiong Chen, Bruno Megarbane

P147 Acute organophosphate poisoning: what about pralidoxime use?

A. M’rad, Sahar Habacha, Bassem Chatbri, Youssef Blel, H Thabet, Nozha Brahmi, M. Amamou

P148 Acute nifedipine poisoning: clinical and prognosis aspects

A. M’rad, Fatma Essafi, Nasreddine Foudhaili, Youssef Blel, H. Thabet, Nozha Brahmi, M. Amamou

P149 Acute behavioral toxicity and addictive liability of the new synthetic cathinone 3,4-methylenedioxypyrovalerone (MDPV) in the rat

Cyril Masniere, Nadia Benturquia, Olivier Roussel, Lucie Chevillard, Patricia Risede, Jacques Callebert, Bruno Megarbane

P150 Clinical and therapeutic characteristics of metformin poisoningA. M’rad, Messaouda Khelfa, Hana Fredj, Youssef Blel, H. Thabet, Nozha Brahmi, M. Amamou

P151 Calcium channel blockers poisoning

Samar Souissi, Hatem El Ghord, N. Kouraichi, N. Brahmi, H. Thabet, M. Amamou

P152 Characteristics and outcomes in patients with community-acquired pneumonia admitted to intensive care unit

Takoua Marhbène, Islam Mejri, Amira Jamoussi, Douha Lakhdar, Asma Ghariani, Leila Slim, Jalila Ben Khelil, Mohamed Besbes

P153 Comparison of characteristics and outcomes of pneumococcal community-acquired pneumonia versus other pathogens

Takoua T. Merhabane, Héla Maamouri, Amira Jamoussi, Asma Ghariani, Leila Slim, Jalila Ben Khelil, Mohamed Besbes

P154 Outcome of L. pneumophila pneumonia and risk factors for ICU admission

Oestreicher Charlotte, Helena Wegelius, Caroline Landelle, Jacques Schrenzel, Laurent Kaiser, Jérôme Pugin

P155 The descending necrotizing mediastinitis: report of 60 cases

Hind Belhadj

P156 Characteristics, mortality risk factors and therapeutic approach of ARDS in patients with severe leptospirosis in Reunion Island

Paul Chanareille, Julien Jabot, Benjamin Delmas, Arnaud Roussiaux, Cyril Ferdynus, Bernard-Alex Gauzere, Olivier Martinet, David Vandroux

P157 Characterization of organ dysfunction in severe leptospirosis

Adélie Ladureau, Alice Sanna, Amélie Rolle, Bertrand Pons, Pascale Piednoir, Fanny Ardisson, Frédéric Martino, Thomas Bernos, Khalid Elkoun, Elie Elain, Roland Lawson, Matthieu Resh-Rigon, Sophie Belorgey, Guillaume Thiery

P158 Report of experience: management of a pre-XDR and XDR-TB population hospitalized in a medical ICU

Caroline Hauw Berlemont, Cyprian Pricopi, Florence Boissier, Alexandra Monnier, Françoise Barthes, Jean-Luc Diehl, Jean-Yves Fagon, Emmanuel Guérot

P159 Benefit of magnesium sulfate for tetanus management in adults: case of the provincial general referral hospital of Kinshasa

Thansya Doddie, Mj Nsiala, Nh Situakibanza, Be Amisi, Mj Kazadi, Ma Kilembe

P160 Ebola fever outbreak: questioning the delivery of care

Christophe Clement, François Lamontagne

P161 Marked decrease in the incidence of ventilator-associated pneumonia using a bundle of care containing selective oropharyngeal decontamination

Boyer, Valérie Nocquet, Caroline Landelle, Sébastien Naimo, Ronan Raulais, Emilie Genevois, Lucie Bouchoud, Filippo Boroli, Nour Abidi, Mohamed Abbas, Stefan Harbarth, Jérôme Pugin

P162 Ventilator-associated pneumonia prevention by oral care improvement: a before–after study

Pierre-Emmanuel Charles, Caroline Dereux, Audrey Large, Rémi Bruyère, Sebastien Prin, Julien Bador, Jean-Pierre Quenot

P163 Impact of a multifaceted bundle ventilator-associated pneumonia prevention program in a secondary care medical–surgical intensive care unit

Stanislas De Guillebon, Eloise Morisse, Julie France, Deborah Gasser, Philippe Badia, Walter Picard

P164 Daily chlorhexidine bathing in a medical intensive care unit: effects on healthcare-associated infections and on acquisition of multidrug-resistant bacteria

P. Corne, Nicolas Molinari, I. De Boulastel, S. Seguin, A. Blasco, V. Ledur, Olivier Jonquet, Kada Klouche

P165 Impact of twin bedrooms intensive care unit on the epidemiology of extended-spectrum beta-lactamase-producing enterobacteriaceae

Paktoris-Papine Sophie, Margaux Artiguenave, Faten El Sayed, Florence Espinasse, Aurélien Dinh, Cyril Charron, Xavier Repessé, Antoine Vieillard-Baron

P166 Prophylactic confinement after liver transplant: a necessity or a useless precaution?

Benjamin Lebas, Sophie Hatsch, Quentin Maestraggi, Anne-Florence Dureau, Vincent Castelain, Bernard Ellero, François Faitot, Max Guillot, Francis Schneider

P167 Proteomic response and adaptation mechanisms of E. coli 536 to overcome the inhibitory effect of cranberry proanthocyanidins

Dimitri Margetis, Odile Bouvet, Didier Chevret, Didier Dreyfuss, Erick Denamur, Jean-Damien Ricard

P168 Is daily measurement of CRP useful to detect earlier ventilator-associated pneumonia?

Justine Simonet, Mathieu Boutonnet, Jean-Louis Daban, Elisabeth Falzone, Guillaume Dumas, Philippe Vest, Vincent Peigne

P169 Clinical and biological features of healthcare-associated coagulase-negative Staphylococci meningitis: results of a retrospective study

Severine Couffin, David Lobo, Gilles Dhonneur, Roman Mounier

P170 Prognostic value of electrocardiographic abnormalities in patients with acute pulmonary embolism

M. Cheikh Bouhlel, Ahmed Khedher, Kaoula Meddeb, A. Azouzi, Y. Hamdaoui, Jihene Ayachi, W. Brahim, Rania Bouneb, Mohamed Boussarsar

P171 Does mean arterial pressure alarm improve the time spent within blood pressure target range in septic shock? A before and after study

Nans Florens, Martin Cour, Julie Varéon, Arnaud Malatray, Romain Hernu, Laurent Argaud

P172 Respiratory change of pulse pressure is not indicative of preload reserve in cardiac surgery patients

Pierre Dupland, Thomas D’humières, Romain Vergier, Pauline Issaurat, Philippe Estagnasié, Pierre Squara, Alain Brusset

P173 Importance of diastolic arterial pressure to optimize pulse pressure variation performances for patients receiving norepinephrine

Vincent Génin, David Vandroux, Cyril Ferdynus, Arnaud Roussiaux, Jérôme Allyn, Nicolas Allou, Olivier Martinet, Julien Jabot

P174 Multi-parameter monitoring for tissue perfusion in septic shock: correlations between macrohemodynamic and metabolic parameters: Preliminary results

Ali Jendoubi, Rifka Jlassi, Bassem Hamrouni, Yahia Marzougui, Jihen Kouka, Salma Ghedira, Mohamed Houissa

P175 Correlation between changes in levels of N-terminal pro-brain natriuretic peptide (NT-pro-BNP) and weight before and after dialysis

Kaouther Dhifaoui, Zied Hajjej, Walid Sammoud, Iheb Labbene, Mustapha Ferjani

P176 Impact of colonization with multidrug-resistant bacteria on the outcome of patients with hematological malignancies admitted to the intensive care medicine

Johanna Oziel, Carole Schwebel, Elie Azoulay, Michaël Darmon, Bertrand Souweine, Lila Bouadma, Guillaume Marcotte, Christophe Clec’h, Yves Cohen, Outcomerea Study Group

P177 ICU moving followed by a drop of imipenem-resistant Pseudomonas aeruginosa

Alexy Tran Dinh, Caroline Neulier, Marlène Amara, Nicaise Nebot, Gilles Troché, Nelly Breton, Benjamin Zuber, Sébastien Cavelot, Béatrice Pangon, Jean Pierre Bedos, Jacques Merrer, David Grimaldi

P178 Risk factors of carbapenem resistance acquisition in intensive care unit

François Labaste, Jean-Marie Conil, Julia Grossac, Stéphanie Ruiz, Marion Grare, Olivier Fourcade, Vincent Minville, Bernard Georges

P179 Risk factors for subsequent infection among patients with extended-spectrum beta-lactamase-producing enterobacteriaceae colonization: a retrospective study

Guillaume Van Der Meersch, Johanna Oziel, Yacine Tandjaoui-Lambiotte, Frédéric Gonzalez, Philippe Karoubi, Christophe Huang, Christophe Clec’h, Yves Cohen

P180 Is rectal colonisation predictive of extended-spectrum β-lactamase-producing enterobacteriaceae presence in respiratory samples performed in the intensive care unit?

Helene Carbonne, Matthieu Le Dorze, Rishma Amarsy, Joaquim Mateo, Didier Payen de la Garanderie

P181 Antibiotic therapy in intensive care unit patients: appraisal of medical attitude related to therapy appropriateness, severity of infection and outcome

Sophie Leloup Von Edelsberg, Christelle Vercheval, Monique Nys, Pierre Damas

P182 Epidemiology and associated factors of ICU-acquired infections in critically ill patients: a prospective cohort study

Zied Hajjej, Chaker Bouguerra, Noura Naas, Walid Sammoud, Iheb Labbene, Mustapha Ferjani

P183 The impact of nosocomial infection acquired in intensive care units on mortality and length of stay until hospital discharge: a retrospective, monocentric, 10-year study

Joris Muller, François Severac, Mickael Schaeffer, Pierre Tran Ba Loc, Stéphanie Deboscker, Maleka Schenck, Marie-Line Harley, Ralf Janssen-Langenstein, Jean-Etienne Herbrecht, Benjamin Lebas, Max Guillot, Vincent Castelain, Francis Schneider, Thierry Lavigne

P184 Incidence and prognosis of catheter-associated urinary tract infections in intensive care unit: the IPRIUS study

Jennifer Brunet, Bertrand Canoville, Cédric Daubin, Amélie Seguin, Nicolas Terzi, Xavier Valette, Pierre Verrier, Damien Du Cheyron

P185 Automatic tube compensation during mechanical ventilation in ICU patients. Meta-analysis of trials on weaning outcome and physiologic effects

Alina Stoian, Claude Guérin

P186 Automated oxygen titration during high-flow oxygen therapy. Evaluation of the feasibility in healthy subjects

François Lellouche, Erwan L’her, Pierre Alexandre Bouchard, Mathieu Delorme, Tamer Elfaramawy, Benoit Gosselin

P187 Accuracy of ventilators for intermediate care to deliver tidal volume. A bench study

Claude Guérin, Loredana Baboi, Sarah Guegan, Fabien Subtil

P188 Efficiency of ventilators for intermediate care to deliver adequate FIO2. A bench study

Claude Guérin, Loredana Baboi, Fabien Subtil, Sarah Guegan

P189 In vitro comparison of inspiratory-synchronized and continuous nebulization modes during noninvasive ventilation: analysis of inhaled and lost doses

Jean-Bernard Michotte, Enrico Staderini, Jonathan Dugernier, Rares Rusu, Jean Roeseler, Giuseppe Liistro, Gregory Reychler

P190 Short-term physiological effects of nasal high flow in patients with respiratory distress. Impact of flow rates on the work of breathing

Mathieu Delorme, Pierre Alexandre Bouchard, Mathieu Simon, François Lellouche

P191 Design and implementation of an active artificial lung

Elmaati Essoukaki, Lhoucine Ben Taleb, Mohammed Harmouchi, Mourad Rattal, Ahmed Mouhsen, Jean-Christophe Marie Richard, A Zeddine Mouhsen, Aissam Lyazidi

P192 Assessment of the accuracy of ventilator simulation softwares

Frédéric Duprez, Jean Bernard Michotte, Olivier Contal, Thierry Bonus, Sandra Olieuz, Grégory Cuvelier, Sharam Machayeckhi

P193 Outcome and early prognostic factors in neutropenic patients admitted to the intensive care unit

Becem Trabelsi, Zied Hajjej, Walid Sammoud, Hedi Garsallah, Mustapha Ferjani

P194 Blood loss and transfusion practice in medical surgical intensive care unit: 1-year study

Walid Sammoud, Zied Hajjej, Khaoula Harira, Hedi Garsallah, Mustapha Ferjani

P195 Atypical hemolytic and uremic syndrome in critically ill adult patients

Elie Azoulay, Akli Chermak, Cédric Rafat, Claire Pichereau, Emmanuel Canet, Virginie Lemiale, Valade Sandrine, Marion Venot, Benoît Schlemmer, Eric Mariotte

P196 Outcome of critically ill patients after allogeneic hematopoietic stem cell transplantation: comparison of cord blood cells with others cells as hematopoietic stem cells source

Caroline Le Jeune, Florent Wallet, Pascal Roy, Laurent Argaud, Mauricette Michallet

P197 Outcome of patients with organ failures related to solid malignancies and receiving chemotherapy in the intensive care unit

Yoann Zerbib, Julien Maizel, Naïke Bigé, Benoit Misset, Nicolas de Prost, Virginie Lemiale, Sylvie Ricome, François Baudin, Muriel Fartoukh, Frédéric Jacobs, François Blot, Matthieu Schmidt, Antoine Rabbat, Julien Mayaux, Frédéric Gonzalez, Caroline Bornstain, Elie Azoulay, Frédéric Pène

P198 Characteristics and outcomes of patients with hematological malignancies (HMs) admitted to the intensive care unit

Stéphanie Gelinotte, Dorothée Carpentier, Steven Grange, Julien Abily, Marion Beuzelin, Emmanuel Besnier, Gioia Gastaldi, Gaetan Beduneau, Jean-Philippe Rigaud, Christophe Girault, Fabienne Tamion

P199 Influence of neutropenia on mortality of critically ill cancer patients: Results of a systematic review and meta-analysis of available evidences

Marie Bouteloup, Sophie Perinel Ragey, Elie Azoulay, Djamel Mokart, Michaël Darmon, Groupe de Recherche en Réanimation Respiratoire et Onco-Hematologique (GRRROH)

P200 Thrombotic Microangiopathy (TMA) Syndromes in the ICU: experience of a Tunisian ICU

Jihene Ayachi, Ahmed Khedher, Kaoula Meddeb, A. Azouzi, Y Hamdaoui, H. Nouira, Rania Bouneb, Mohamed Boussarsar

P201 “Immunonutrition” failed to improve septic shock-induced vascular dysfunction in a rat model

Julie Boisramé-Helms, Grégory Meyer, Su Degirmenci, Mélanie Burban, Valérie Schini-Kerth, Alexandra Boivin, Raphaël Clere-Jehl, Alexandra Monnier, Christine Kummerlen, Ferhat Meziani

P202 PTP1B gene deletion improves glucose metabolism and limits cardiovascular dysfunction in experimental septic shock

Eugénie Delile, Pierre-Alain Thiébaut, Jean-Claude Do Rego, David Coquerel, Rémi Nevière, Vincent Richard, Fabienne Tamion

P203 Ascitic fluid TREM-1 for the diagnosis of spontaneous bacterial peritonitis

Laure Ichou, Nicolas Carbonell, Pierre-Emmanuel Rautou, Ludivine Laurans, Simon Bourcier, Claire Pichereau, Jean-Luc Baudel, Jean-Baptiste Nousbaum, Christophe Renou, Rodolphe Anty, Jacques Tankovic, Eric Maury, Bertrand Guidet, Luce Landraud, Hafid Ait-Oufella

P204 Modulation of inflammatory response related to severe peritonitis by polymyxin-B hemoperfusion

Remi Coudroy, Jean-Claude Lecron, Didier Payen de la Garanderie, René Robert, ABDOMIX Group

P205 Descriptive study of ultrasonographic data inside a surgical intensive care unit for cholestasis diagnosis: dechorea study

Michael Helary, Jonathan Paillot, Sebastien Pili-Floury

P206 In-hospital mortality and predictive risk factors for patients with cirrhosis

Sana Khedher, Amira Maoui, Asma Ezzamouri, Mohamed Salem

P207 CONSTIPREA: evaluation of the management of constipation in intensive care—National Survey of French intensivits

Lamia Kerdjana, Mihaela Dumitrescu, Olivier Mimoz, Bertrand Debaene, Virginie Migeot, Claire Dahyot-Fizelier

P208 Corrosive ingestion in adults: endoscopic findings and agents involved

Sana Khedher, Asma Ezzamouri, Amira Maoui, Mohamed Salem, Amira A. Maoui

P209 Hypoxic hepatitis after out-of-hospital cardiac arrest: incidence, determinants and prognosis

Benoit Champigneulle, Guillaume Geri, Wulfran Bougouin, Florence Dumas, Michel Arnaout, Lara Zafrani, Frédéric Pène, Julien Charpentier, Jean-Paul Mira, Alain Cariou

P210 Aspiration pneumonitis in comatose patients treated with invasive mechanical ventilation. The SPIRE prospective survey

Jean-Baptiste Lascarrou, Floriane Lissonde, Aurélie Le Thuaut, Konstantinos Bachoumas, Gwenhaël Colin, Matthieu Henry-Laguarrigue, Maud Fiancette, Jean-Claude Lacherade, Christine Lebert, Isabelle Vinatier, Aihem Yehia, Aurélie Joret, Laurent Martin-Lefèvre, Jean Reignier

P211 Ventilator-associated pneumonia (VAP) in cancer patients: impact of 1-year survival

Laura Platon, Jerôme Lambert, David Lagier, Jeanpaul Brun, Antoine Sannini, Laurent Chow-Chine, Magali Bisbal, Marion Faucher, Djamel Mokart

P212 High-resolution computed tomography (HRCT) patterns in patients with pneumocystis pneumonia

Leïla Mourtada, Lemiale Virgnie, Claire Givel, Valade Sandrine, Claire Pichereau, Emmanuel Canet, Eric Mariotte, Elie Azoulay

P213 Plasma endocan predicts the occurrence of acute respiratory distress syndrome (ARDS) in severe sepsis and septic shock patients

Alexandre Gaudet, Erika Parmentier-Decrucq, Nathalie De Freitas Caires, Sylvain Dubucquoi, Philippe Lassalle, Daniel Mathieu

P214 Comparison of 3 diagnostic methods to identify fluid responsiveness during prone position in ARDS

Jean-Christophe Richard, Hodane Yonis, Florent Gobert, Romain Tapponnier, Claude Guérin

P215 Low pressure support-high PEEP for early severe acute respiratory distress syndrome: a retrospective analysis

Luc Quintin, C. Pichot, F. Petitjeans

P216 Neutrophil proteases alter the interleukin-22-receptor-dependent lung antimicrobial defence

Antoine Guillon, Youenn Jouan, Daborah Breah, Fabien Gueugnon, Emilie Dalloneau, Thomas Baranek, Clemence Henry, Eric Morello, Jc Renauld, M Pichavant, Philippe Gosset, Y Courty, Patrice Diot, Mustapha Si-Tahar

P217 Impaired phagocytosis of apoptotic neutrophils in human ARDS: beneficial effects of metformin

Fabrice Uhel, Murielle Gregoire, Arnaud Gacouin, Yves Le Tulzo, Karin Tarte, Jean-Marc Tadié

P218 What are the deteP219 Emergency thoracotomy: development and results in a military trauma centerrminants of needle aspiration success in primary spontaneous pneumothorax?

Constance Vuillard, Jean-Damien Ricard, Béatrice La Combe, Stéphane Gaudry, Didier Dreyfuss, Jonathan Messika

P219 Emergency thoracotomy: development and results in a military trauma center

Pauline Ponsin, Jean-Louis Daban, Guillaume Boddaert, Bertrand Grand, Vincent Peigne, Yohan Baudoin, Mathieu Boutonnet, Patrick Jault, Stéphane Bonnet

P220 Management of isthmic aortic rupture in polytraumatized patients in ICU: a report of 12 cases

Chtara Kamilia, Kais Regaieg, Olfa Turki, Najeh Baccouch, Anis Chaari, Hmida Chokri Ben, Mabrouk Bahloul, Mounir Bouaziz

P221 NT-proBNP levels and echocardiography findings in the etiologic diagnosis of acute dyspnea

Salah Snouda, Hassen Ben Ghezala, Mohamed Fehmi Abbes, Rebeh Daoudi, Moez Kaddour, Imen Benchiekh

P222 Cardiac decompensation in peripartum

Kamal Belkadi, I. Moussaid, Chaigar Mohammed Cheikh, S. El Youssoufi, S. Salmi

P223 Peripheral intravenous catheter-related complications in an emergency ward

Ines Sedghiani, Hana Fredj, Hamdi Doghri, Youssef Zied El Hechmi, Mohamed Ali Cherif, Jerbi Zouheir

P224 Burnout in the emergency room

Neila Maaroufi, Abid Zeineb

P225 Prevalence, and characteristics of elderly patient admitted in a Moroccan Medical Unit for the Acute Care

Jihane Belayachi, Leila Debono, Naoufal Madani, Fatiha Amlaiky, Tarek Dendane, Khalid Abidi, Aicha Zekraoui, Amine Ali Zeggwagh, Redouane Abouqal

P226 Metabolic phenotyping in bronchoalveolar lavage fluids distinguishes influenza and pneumococcal pneumonia

Adrien Auvet, Antoine Guillon, Lydie Nadal-Desbarats, Thomas Baranek, Eric Morello, François Réminiac, Mustapha Si-Tahar

P227 Microbiological documentation of pneumonia in the ICU by per-bronchoscopic bronchial aspiration (PBA) is very similar to that obtained by bronchoalveolar lavage (BAL)

Jean-Luc Baudel, Jacques Tankovic, Redouane Dahoumane, Arnaud Galbois, Hafid Ait Oufella, Georges Offenstadt, Eric Maury, Bertrand Guidet

P228 Compliance with the H3 bundle of the 2012 surviving sepsis campaign according to the chain of care of septic patients: the sepsis CHOC study

Amel Filali, Emmanuel Faure, Nicolas Van Grunderbeeck, Olivier Nigeon, Juliette Masse, H Bazus, Jihad Mallat, Didier Thevenin

P229 CRP ratio as a predictive tool for mortality in ICU septic patients

Sophie Lempereur-Legros, Didier Ledoux, Monique Nys, Pierre Damas

P230 Candidemia in ICU: Epidemiology and prognostic factors

Zied Hajjej, Walid Sammoud, Becem Trabelsi, Iheb Labbene, Mustapha Ferjani

P231 Extracorporeal membrane oxygenation cannula-associated infections: implication of virulent Escherichia coli phylogroups

Jonathan Messika, Olivier Clermont, Matthieu Schmidt, Alexandra Aubry, Romain Fernandes, Erick Denamur, Alain Combes, Jean-Damien Ricard

P232 Is diabetes mellitus a risk factor for intensive care unit-acquired infections in intensive care unit patients with hematologic malignancies?

Marion Venot, Sylvie Chevret, Djamel Mokart, Frédéric Pène, Virginie Lemiale, Achille Kouatchet, Julien Mayaux, François Vincent, Martine Nyunga, Fabrice Bruneel, Elie Azoulay

P233 Should we need aerobic–anaerobic or specific blood culture bottles for diagnosing candidemia in ICU patients?

Sébastien Bailly, Jean-François Timsit, Cécile Garnaud, Muriel Cornet, Patricia Pavese, Rebecca Hamidfar-Roy, Luc Foroni, Sandrine Boisset, Carole Schwebel, Danièle Maubon

P234 Invasive Candida infection in a Tunisian ICU: an observational cohort study

Islem Ouanes, Maha Abid, Hend Ben Lakhal, Saousen Ben Abdallah, Fahmi Dachraoui, Hedia Hammed, Rami Jabla, Asma Hachani, Mahdi Marzouk, Imen Abdellaoui, Chaima Ghribi, Imen Ben Ali, Lamia Ouanes-Besbes, Fekri Abroug

P235 Causes of admission in medical intensive care of patients suffering from severe psychiatric disorders

Hanane Ezzouine, Constant Aniolo Edith, Abdellatif Benslama

P236 Unplanned extubation in critical care: still to learn from local survey

Frédéric Jacobs, Dominique Prat, Matthieu Le Meur, Olfa Hamzaoui, Anne Sylvie Dumenil, Guy Moneger, Nadège Demars, Pierre Trouiller, Benjamin Sztrymf

P237 Mortality associated with nights and weekends admission to intensive care unit (ICU): results of a 9-year cohort study (2006–2014)

Vincent Brunot, Jean-Emmanuel Serre, P. Corne, Nicolas Molinari, L. Landreau, Olivier Jonquet, Kada Klouche

P238 Determinants and outcomes associated with decisions to deny admission in a Tunisian ICU

Rania Bouneb, Kaoula Meddeb, Y. Hamdaoui, H Nouira, A. Azouzi, Jihene Ayachi, Ahmed Khedher, Mohamed Boussarsar

P239 Characteristics and outcomes of patients not admitted to ICU

Nesrine Boujelbene, Rami Jabla, Fahmi Dachraoui, Islem Ouanes, Mahdi Marzouk, Hedia Hammed, Asma Hachani, Hend Ben Lakhal, Chaima Ghribi, Imen Abdellaoui, Imen Ben Ali, Saousen Ben Abdallah, Lamia Ouanes-Besbes, Fekri Abroug

P240 Long-term outcomes of critically ill patients with severe acute kidney injury requiring renal replacement therapy

Vanessa Jean-Michel, Francis Couturaud, Elizabeth Moore, Pierre-Yves Egreteau, Jean-Michel Boles, Cécile Aubron

P241 Nowadays, SAPSII better predicts 1-year mortality than hospital mortality

Jean-Etienne Herbrecht, Max Guillot, Quentin Maestraggi, Charlotte Kaeuffer, Ralf Janssen-Langenstein, Sylvie L’hotellier, Sophie Hatsch, Benjamin Lebas, Alexandra Boivin, Maleka Schenck, Marie-Line Harlay, Anne Meyer, Vincent Castelain, Francis Schneider

P242 Impact of diabetes on burn injury: preliminary results from retrospective study

Amel Mokline, Imen Rahmani, Khaouther Ben Arfi, Lazhari Gharsallah, Sofiene Tlaili, Bahija Gasri, Rym Hammouda, Amen Allah Messadi

P243 Withdrawal or withholding of life-sustaining treatments decisions: Is there a risk of excessive influence of medical imaging?

Fabrice Lesage, Sylvie Séguret, Laurent Dupic, Laure De Saint Blanquat, Sylvain Renolleau

P244 Withholding and withdrawal of life-sustaining treatments in intensive care unit patients: predisposing factors and implementation

Anne-Sophie Baptiste, Hugues Georges, Pierre-Yves Delannoy, Patrick Devos, Olivier Leroy

P245 Advanced directives in an old patient with suicide attempt: analysis of ICU physicians perception

Dolores Albarracin, A. Ducousso-Lacaze, Angéline Jamet,, Julien Dufour, Séverin Cabasson, Anne Veinstein, Delphine Chatellier, Jean-Pierre Frat, René Robert

P246 Having the talk about advance directives in the daily practice: Is a stay in an intensive care unit a good opportunity?

Vivien Hong Tuan Ha, Nicolas Lau, Lucie Mimoun, Xavier Forceville

P247 Long-term outcome of patients who have withheld life support in intensive care

Adel Maamar, Stéphanie Chevalier, Vlad Botoc, Yves Le Tulzo

P248 Epidemiology of refusals in a polyvalent intensive care unit ad outcome of refused patients

Stephane Rouleau, David Schnell, Arnaud Desachy, Sylvie Calvat, Philippe Petua, Charles Lafon, Christophe Cracco

P249 Ten critical sentences you have already heard in the Intensive Care Unit and the Emergency Department, their real meanings and consequences

Nicolas Van Grunderbeeck, J. Temime, Perrine Molmy, Stephanie Barrailler, G. Gasan, Olivier Nigeon, Didier Thevenin

P250 Communication with the parents: a challenge in the pediatric intensive care unit

Agathe Béranger, Charlotte Pierron, Laure De Saint Blanquat, Sandrine Jean, Hélène Chappuy

P251 End of life in the intensive care unit: between practice and knowledge

Pierre-Marie Bertrand, Alexandra Beurton, Laetitia Bodet-Contentin, Julie Boisramé-Helms, Pierre-éRic Danin, Elsa Dubois, Elodie Gélisse, Yasemin Karaca, Pierre Mora, Nicolas de Prost, Damien Roux, Alexis Soummer, Dominique Vodovar, Committee of young intensivists of the French Society for Intensive Care Medicine (FICS)

S1 The HICU Score (Hematologic Intensive Care Unit Score): a new prognostic score for predicting 30-day and 1-year mortality of patients with hematologic malignancies admitted in ICU

Yohan Desbrosses, Guylaine Labro, Gaël Piton, Adrien Chauchet, Etienne Daguindau, François Blot, Eric Deconinck, Gilles Capellier

S2 Patients with multiple myeloma in the ICU: trends of use and outcomes over time

Akli Chermak, Adrien Joseph, Virginie Lemiale, Claire Pichereau, Marinne Baron, Emmanuel Canet, Eric Mariotte, Michaël Darmon, Elie Azoulay

S3 Impact of bone marrow aspiration on the management of adult critically ill patients

Laure Calvet, Anne Françoise Sapin, Bruno Pereira, Alexandre Lautrette, Bertrand Souweine

S4 Red blood cells transfusion in ICU: descriptive analysis of French cohort from “Age BLood Evaluation” clinical trial

Lucie Vettoretti, Sebastien Pili-Floury, Gaël Piton, Jacques Lacroix, Lucy Clayton, Elham Sabri, Laurent Bardiaux, Pierre Tiberghien, Paul Hebert, Gilles Capellier, ABLE French Investigators

S5 Graft-versus-host disease trajectories and mortality in critically ill allogeneic stem cell recipients

Claire Pichereau, Etienne Lengliné, Anne-Sophie Moreau, Eric Mariotte, Marion Venot, Sandrine Valade, Akli Chermak, Virginie Lemiale, Emmanuel Canet, Gérard Socié, Benoît Schlemmer, Elie Azoulay

S6 Outcome of 544 patients with solid cancer in the intensive care unit: the Oncoréa study

Edith Borcoman, Virginie Lemiale, Eric Mariotte, Claire Pichereau, Emmanuel Canet, Adrien Joseph, Akli Chermak, Sandrine Valade, Marion Venot, Benoît Schlemmer, Elie Azoulay

S7 Assessing the process of ICU admission refusal in critically ill patients with hematological malignancies

Katerina Rusinova, Virginie Lemiale, Matthieu Resche-Rigon, Djamel Mokart, Antoine Rabbat, Frédéric Pène, Achille Kouatchet, Fabrice Bruneel, Julien Mayaux, François Vincent, Pierre Perez, Martine Nyunga, Elie Azoulay, Groupe de Recherche en Réanimation Respiratoire en Onco-Hématologie

S8 Neurologic and hepatic failures at ICU admission are associated with worst prognosis for patients with lymphomas

Aurélien Sutra Del Galy, Achille Kouatchet, Mélanie Mercier, Jean-François Hamel, Tommy Raveau, Marie-Pierre Moles, Aline Clavert, Mathilde Hunault-Berger, Alain Mercat, Norbert Ifrah, Aline Schmidt-Tanguy

S9 Impact of earplugs and eye mask on sleep in critically ill patients: a prospective randomized polysomnographic study

Alexandre Demoule, Serge Carreira, Sophie Lavault, Olivier Pallanca, Elise Morawiec, Julien Mayaux, Isabelle Arnulf, Thomas Similowski

S10 Diaphragmatic paralysis after adult cardiac surgery: incidence and predicting factors

Thomas D’humières, Pierre Dupland, Pauline Issaurat, Romain Vergier, Philippe Estagnasié, Alain Brusset, Pierre Squara

S11 Ultrasound evaluation of diaphragmatic dysfunction: prognostic marker of ICU weaning failure

Cédric Carrié, Chloé Gisbert-Mora, Eline Bonnardel, Matthieu Biais, Frédéric Vargas, Gilles Hilbert

S12 A prospective multicentric study to evaluate the impact of breathing variability on clinical outcomes in mechanically ventilated patients

Côme Bureau, Camille Rolland-Debord, Tymothée Poitou, Marc Clavel, Sébastien Perbet, Nicolas Terzi, Achille Kouatchet, Thomas Similowski, Alexandre Demoule, Université Paris 6 —Pierre et Marie Curie and Institut National pour la Santé et la Recherche Médicale, UMRS1158, Paris

S13 Nurse-driven sedation protocol with sedation vacation and incidence of unplanned extubations

Pierre Lucas, Julien Charpentier, Michel Arnaout, Thomas Joannon,, Sébastien Lefort, Aude Marincamp, Anne-Sophie Debue, Matthieu Reffienna, Frédéric Pène, Jean-Paul Mira, Alain Cariou, Jean-Daniel Chiche, Working Group on Mechanical Ventilation

S14 Lung ultrasound enables to detect weaning-induced cardiogenic pulmonary oedema

Alexis Ferre, Max Guillot, Jean-Louis Teboul, Daniel Lichtenstein, Gilbert Meziere, Christian Richard, Xavier Monnet

S15 Pleural effusion during the weaning from mechanical ventilation: prevalence and impact

Damien Roux, Tai Pham, Alexandra Beurton, Muriel Fartoukh, Jean-Damien Ricard, Alexandre Demoule, Martin Dres

S16 Prognostic impact of left ventricular diastolic dysfunction in patients with septic shock

Céline Gonzalez, François Dalmay, Emmanuelle Begot, Nicolas Pichon, Bruno François, Anne-Laure Fedou, Catherine Chapellas, Antoine Galy, Philippe Vignon

S17 Norepinephrine exerts an inotropic effect at the early phase of human septic shock

Olfa Hamzaoui, Mathieu Jozwiak, Thomas Geffriaud, Benjamin Sztrymf, Dominique Prat, Frédéric Jacobs, Xavier Monnet, Pierre Trouiller, Christian Richard, Jean-Louis Teboul

S18 Effect of high PEEP after recruitment maneuver on right ventricular function in ARDS: Is it good for the lung and for the heart?

Shari El-Dash, Loay Kontar, François Leleu, Bertand De Cagny, François Brazier, Dimitri Titeca, Gaelle Bacari-Risal, Julien Maizel, Michel Slama

S19 Myocardial dysfunction during septic shock: prevalence, prognosis and role of loading conditions

Florence Boissier, Keyvan Razazi, Aurelien Seemann, Arnaud, W Thille, Nicolas de Prost, Elise Cuquemelle,, Filippo Boroli,, Alexandre Bedet, Pascal Lim, Christian Brun-Buisson, Armand Mekontso Dessap

S20 Echocardiography for the critically ill: 1-year experience of a noninvasive intensive care unit

W Brahim, R Amara, A Azouzi, Ahmed Khedher, Jihene Ayachi, Rania Bouneb, Y Hamdaoui, Kaoula Meddeb, Mohamed Boussarsar

S21 Echocardiographic indices to predict fluid responsiveness in ventilated patients with circulatory failure: which threshold for which aim?

Emmanuelle Begot, Xavier Repessé, Julie Léger, Gwenael Prat, Cyril Charron, Pierre-Yves Egreteau, Christophe Jacob, Koceila Bouferache, Loay Kontar, Julien Maizel, Michel Slama, Antoine Vieillard-Baron, Philippe Vignon

S22 Effects of norepinephrine on the right ventricle assessed by transthoracic echocardiography in the ICU

Claire Ragot, Laure Corradi, Frédéric Vargas

S23 Effect of recruitment maneuver on left ventricular systolic strain

Pablo Mercado, Julien Maizel, Loay Kontar, Bertand De Cagny, François Brazier, Dimitri Titeca, Gaelle Bacari-Risal, Antoine Riviere, Shari El-Dash, Michel Slama

S24 Management of diabetic ketoacidosis in two pediatric intensive care units: comparison of two care protocols

Laure Maurice, Stéphane Dauger, S Julliand, Anna Deho, Fleur Le Bourgeois

S25 NUTRI-REAPED: Nutritional status on admission to the pediatric intensive care unit—a French multicentric study

Aurelien Jacquot, Frederic Valla, Bénédicte Gaillard-Le Roux, Flavie Letois, Gilles Cambonie, NutriSIP

S26 Apnea test in children for brain death diagnosis: efficacy and complications

Alexandre Salvadori, Gaia Ottonello, Stéphane Blanot, Juliette Montmayeur, Gilles Orliaguet

S27 Interest of the ultrasound in the central venous catheterization in children poses in intensive care unit

Fehmi Ferhi, Hosni Khouadja, Mohamed Amine Bouslama, Affra Brahim, Khalil Tarmiz, Khaled Benjazia

S28 Supraclavicular approach to the innominate vein in pediatric intensive care unit: interest in the prevention of thrombosis and catheter-related blood stream infection

Flora Habas, Julien Baleine, Julia Lebouhellec, Christophe Milesi, Clementine Combes, Gilles Cambonie

S29 EPURE Study: Preliminary results on the organization of pediatric acute dialysis in 2 French-speaking countries

Maryline Chomton, Philippe Jouvet, Bruno Ranchin, Marie Alice Macher, Théophile Gaillot, EPURE Study Group

S30 Hyperglycemia in severe scorpion envenomed children: incidence and impact outcome

Mabrouk Bahloul, Najeh Baccouche, Kais Regaieg, Turki Olfa, Chtara Kamilia, Benhamida Chokri, Hedi Chelly, Mounir Bouaziz

S31 Prehospital care and initial hospital care of pediatric patients with severe trauma hospitalized in the ICU at Grenoble University Hospital, data from the “TRENAU” trauma-system

Murielle Moine, François Xavier Ageron, Claire Jannel, Thierry Debillon, Isabelle Wroblewski

S32 Ventilator-associated pneumonia due to multi- or extensively drug-resistant Pseudomonas aeruginosa: comparison with susceptible strains

Matthieu Duprey, Nicolas Bréchot, Alexandra Aubry, Guillaume Hekimian, Matthieu Schmidt, Ania Nieszkowska, Jean Louis Trouillet, Vincent Jarlier, Alain Combes, Jean Chastre, Charles-Edouard Luyt

S33 Can we predict a secondary documented infection in patients empirically treated for an invasive candidiasis?

Sébastien Bailly, Olivier Leroy, Jean-Paul Mira, Hervé Dupont, Jean-Pierre Gangneux, Philippe Montravers, Jean-Michel Constantin, Didier Guillemot, Olivier Lortholary, Pierre-François Perrigault, Elie Azoulay, Jean-François Timsit

S34 Should aminoglycosides be administered to hematological patients with septic shock? Data from the Groupe de Recherche respiratoire en Réanimation Onco-Hématologique (Grrr-OH)

Thomas Longval, Sylvie Chevret, Fabrice Bruneel, Djamel Mokart, Frédéric Pène, Julien Mayaux, Achille Kouatchet, Martine Nyunga, Antoine Rabbat, Pierre Perez, Christine Lebert, Dominique Benoit, François Vincent, Virginie Lemiale, Elie Azoulay

S35 Is de-escalation of antimicrobial therapy safe in hematology patients?

David Schnell, Claire Montlahuc, Matthieu Resche-Rigon, Achille Kouatchet, Jean-Ralph Zahar, Michaël Darmon, Frédéric Pène, Virginie Lemiale, Antoine Rabbat, François Vincent, Fabrice Bruneel, Djamel Mokart, Elie Azoulay

S36 Pharmacokinetics and absolute bioavailability of voriconazole administered through a nasogastric tube with continuous enteral feeding to critically ill ventilated patients

Philippe Karoubi, Christophe Huang, Antoine Rabbat, Johanna Oziel, Guillaume Van Der Meersch, Yacine Tandjaoui-Lambiotte, Frédéric Gonzalez, Christophe Clec’h, Christophe Padoin, Yves Cohen

S37 Which optimal daily dose for linezolid in burn patients?

Amel Mokline, Lazhari Gharsallah, Imen Rahmani, Emna Gaies, Sofiene Tlaili, Bahija Gasri, Rym Hammouda, Sameh Triki, Anis Klouz, Amen Allah Messadi

S38 Predictive factors of sub-therapeutic peak concentration after a single dose of amikacin in postoperative cardiovascular critically ill patients

Mouhamed Moussa, Flavie Desrumaux

S39 Supra-therapeutic serum levels and toxicity of beta-lactam antibiotics in septic ICU patients requiring replacement therapy for acute renal failure: a single-center cohort study

Faten May, Marion Perrin, Najoua El-Helali, Jean-Claude Nguyen, Kelly Tiercelet, Stephane Ruckly, Julien Fournier, Mélanie Cherin, Cédric Bruel, Francois Philippart, Maïté Garrouste-Orgeas, Marie Dominique Kitzis, Alban Le Monnier, Jean-François Timsit, Benoit Misset

S40 Post-cardiac arrest syndrome: lessons from a monocentric retrospective study

Cyrille Mathien, Antoine Poidevin, Luis Donatti, Joy Mootien, Luis Pinto, Mathieu Egard, Gokhan Bodur, Guillaume Barberet, Carmen Ionescu, Frederique Ganster, Philippe Guiot, Khaldoun Kuteifan

S41 Out-of-hospital cardiac arrest (OHCA) score for prediction of outcome of in-hospital cardiac arrest: results of the OSPICA pilot study

Alain Mpela, Jonathan Chelly, Jennifer Brunet, Stéphane Legriel, Laurent Guérin, Romain Persichini, Alexis Soummer, Bertrand Sauneuf, Tai Pham, Thomas Hullin, Nicolas Deye, Pierre Aubertein, Mehran Monchi

S42 Delayed awakening after cardiac arrest: causes and outcome in the Parisian registry

Marine Paul, Wulfran Bougouin, Guillaume Geri, Florence Dumas, Benoit Champigneulle, Stéphane Legriel, Julien Charpentier, Jean-Paul Mira, Claudio Sandroni, Alain Cariou

S43 Incidence and characteristics of sudden unexplained cardiac death: insights from the Parisian registry

Olivier Passouant, Guillaume Geri, Florence Dumas, Wulfran Bougouin, Benoit Champigneulle, Michel Arnaout, Jonathan Chelly, Jean-Daniel Chiche, Olivier Varenne, Jean-Paul Mira, Alain Cariou

S44 Supranormal oxygen tension is not associated with an impaired redox balance in patients resuscitated from cardiac arrest

Jean-François Llitjos, Camille Chenevier-Gobeaux, Julien Charpentier, Florence Dumas, Guillaume Geri, Wulfran Bougouin, Benoit Champigneulle, Michel Arnaout, Jean-Paul Mira, Frédéric Pène, Frederic Batteux, Alain Cariou

S45 Impaired biological response to aspirin in comatose patients resuscitated from out-of-hospital cardiac arrest

Jean-François Llitjos, Ludovic Drouet, Sebastian Voicu, Nicolas Deye, Bruno Megarbane, Patrick Henry, Jean-Guillaume Dillinger

S46 Gender differences in coronary reperfusion after cardiac arrest

Wulfran Bougouin, Florence Dumas, Eloi Marijon, Guillaume Geri, Benoit Champigneulle, Jean-Daniel Chiche, Olivier Varenne, Christian Spaulding, Jean-Paul Mira, Xavier Jouven, Alain Cariou

S47 Prognostic factors of out-of-hospital cardiac arrests in Martinique: prospective study over a period of 29 months, about 385 cases

Dabor Resiere, A. L. Dessoy, Ruddy Valentino, C. Chabartier, Laurent Villain-Coquet, Jean-Louis Ferge, Y. Brouste, Bruno Megarbane, Hossein Mehdaoui

S48 Incubation of immune cells in septic plasma: effect on glucose utilization and on phenotypic expression on monocytes, polymorphonuclears and lymphocytes

Benjamin Soyer, Valérie Faivre, Charles Damoisel, Anne-Claire Lukaszewicz, Didier Payen de la Garanderie

S49 Ex vivo effects of hyperglycemia on phenotype and production of reactive oxygen species by the NADPH oxidase of human immune cells in acute inflammatory response

Benjamin Soyer, Valérie Faivre, Charles Damoisel, Anne-Claire Lukaszewicz, Didier Payen de la Garanderie

S52 HMGB1 induces neutrophils dysfunction after septic shock

Fabrice Uhel, Murielle Gregoire, Arnaud Gacouin, Caroline Piau, Yves Le Tulzo, Karin Tarte, Jean-Marc Tadié

S53 Rapid mobilization of myeloid-derived suppressor cells during sepsis and relation with clinical course

Thomas Daix, Robin Jeannet, Emmanuelle Begot, Nicolas Pichon, Anne-Laure Fedou, Estelle Guérin, Philippe Vignon, Jean Feuillard, Bruno François

S54 Targeted endothelial TREM-1 deletion protects mice during septic shock

Lucie Jolly, Amir Boufenzer, Jérémie Lemarie, Kevin Carrasco, Marc Derive, Sebastien Gibot

S55 Polymicrobial sepsis inhibits tumor growth in cancer mice

Hamid Merdji, Jean-François Llitjos, Christophe Rousseau, Nadia Belaidouni, Julie Toubiana, Jean-Paul Mira, Jean-Daniel Chiche, Frédéric Pène

S56 Telestroke implementation in the biggest French region (12 millions inhabitants): the project ORTIF

Yann L’Hermitte, France Woimant, Catherine Oppenheim, Christophe Couvreur, François Dolveck

S57 Free haemoglobin concentration in patients with sickle cell disease referred to the emergency room: Is it useful?

Pierre Mora, Magali Devriese, Sophie Dupeyrat, Patrick Ray, Guillaume Lefevre, Muriel Fartoukh

S58 Evaluation of the prescription and use of antibiotics in an emergency department of a general hospital by Gyssens Method

Nicolas Roothaer, Amélie Carpentier, Fabien Vaniet, Antoine Maisonneuve, Eric Wiel

S59 High dosages of norepinephrine in trauma patients

Sébastien Canu, Emmanuelle Hammad, Francois Antonini, Marion Poirier, Laurent Zieleskiewicz, Coralie Vigne, Malik Haddam, Julie Alingrin, Marc Leone

S60 Bleeding risk of pleural procedures in patients taking antiplatelet therapy: a multicentric prospective study

Laurence Dangers, Gilles Mangiapan, Mikael Alves, Naïke Bigé, Jonathan Messika, Elise Morawiec, Mathilde Neuville, Christophe Cracco, Gaetan Beduneau, Nicolas Terzi, Isabelle Huet, Xavier Dhalluin, Nathalie Bautin, Jean Jacques Quiot, Corinne Appere De Vecchi, Thomas Similowski, Cécile Chenivesse

S61 Interest of the association fibrinogen/tranexamic acid in the management of severe postpartum hemorrhage

Khalil Tarmiz, Fehmi Ferhi, Hosni Khouadja, Affra Brahim, Mohamed Amine Bouslama, Khaled Benjazia

S62 HELLP syndrome in ICU: epidemiological, clinical and prognostic study about 112 cases

Fatma Kaaniche Medhioub, Kais Rgieg, Olfa Turki, Mariem Smaoui, Anis Chaari, Benhamida Chokri, Mabrouk Bahloul, Bouaziz Mounir

S63 Neurological complications in eclampsia

Chaigar Mohammed Cheikh, I. Moussaid, Kamal Belkadi, E. El Alami, S. El Youssoufi, S. Salmi

S64 Brain water contain is dependent on plasmatic ammonemia levels in hyperammoniemic encephalopathy, a quantitative CT scan study

Nicolas Weiss, Fanny Mochel, Damien Galanaud, Louis Puybasset, Dominique Thabut, Brain Liver Pitié-Salpêtrière Study Group (BLIPS), Paris, France

S65 Sodium phenylbutyrate administration to avoid neurological worsening in hepatic encephalopathy patients in ICU

Simona Tripon, Marion Lodey, Elsa Guiller, Maxime Mallet, Marika Rudler, Dominique Thabut, Nicolas Weiss, Brain Liver Pitié-Salpêtrière Study Group (BLIPS), Paris, France

S66 Disruption of posteromedial large-scale neural communication predicts recovery from coma

Stein Silva, Béatrice Riu-Poulenc, Jean Ruiz, Corine Vuillaume, Francesco De Pasquale, Jean Francois Demonet

S67 Loss of sleep elements on continuous EEG monitoring is associated with mortality in patients with cardiogenic shock requiring veno-arterial extra-corporeal membrane oxygenation (ECMO)

Fabrice Sinnah, Marie Amelie Dalloz, Eric Magalhaes, Mathilde Neuville, Roland Smonig, Aguila Radjou, Bruno Mourvillier, Lila Bouadma, Jean-François Timsit, Marie Pia D’ortho, Anny Rouvel-Tallec, Romain Sonneville

S68 Protective effects of high-density lipoprotein therapy in a mouse model of ischemic stroke hemorrhagic transformation due to acute hyperglycemia

David Couret, Aurélie Catan, Brice Nativel, Cynthia Planesse, Nicolas Diotel, Olivier Meilhac

S69 Glucocorticoids as a “rescue therapy” for delayed intracranial hypertension after acute brain injury: a retrospective study

Fabian Roy-Gash, Stephane Welschbillig, Elodie Lang, Christophe Lebard, Nicolas Engrand

S70 Organ donation: early talks (ET) to relatives before occurence of brain death

Anne-Gaelle Si Larbi, Virginie Gaudin, France Bonnin, Oceane Sultan,, Alexis Soummer, Grégoire Trebbia, Cecile Hoc, Emmanuel Mathieu, Bertrand Lapergue, Frederic Bourdain, Charles Cerf

S71 Remifentanil target-controlled infusion for procedures generating pain or discomfort in the ICU: feasibility, safety and tolerance evaluation

Margot Caron, Antoine Parrot, Maxens Decavèle, Clarisse Blayau, Jean-Pierre Fulgencio, Vincent Labbe, Michel Djibre, El Mahdi Hafiani, Christophe Quesnel, Muriel Fartoukh, Tai Pham

S72 Minimizing dead-volume infusion devices leads to a reduction in hypoglycaemia in surgery patients admitted to a perioperative intensive care unit

Stephanie Genay, Bertrand Décaudin, Sabine Ethgen, Pascal Odou, Gilles Lebuffe

S73 Patient-important outcomes in randomized controlled trials in critically ill patients

Stéphane Gaudry, Jonathan Messika, Jean-Damien Ricard, Blandine Pasquet, Sylvie Guillo, Emeline Dubief, Didier Dreyfuss, Florence Tubach

S74 Epidemiology of platelets transfusion in critically ill patients

Cécile Aubron, Andrew Flint, Michael Bailey, Rinaldo Bellomo, David Pilcher, Allen Cheng, Colin Hegarty, Anthony Martinelli, Benjamin Howden, Michael Reade, Zoe Mcquilten

S75 Outcome of selected nonagenarians admitted in ICUs: a multicenter study from the Outcomerea research group

Maïté Garrouste-Orgeas, Stephane Ruckly, Francois Philippart, Anne Sylvie Dumenil, Dany Goldgran Toledano, Samir Jamali, Carole Schwebel, Lilia Soufir, Christophe Clec’h, Michaël Darmon, Bernard Allaouchiche, Laurent Argaud, Bruno Verdière, Muriel Fartoukh, Mélanie Cherin, Elie Azoulay, Jean-François Timsit

S76 A systematic follow-up consultation guarantee quality of care in intensive care unit

Martine Nyunga, Noémie Banaias, Clément Vanbaelinghem, Céline Broucqsault-Dedrie, Delphine Colling, Marie Kauv, Erik Blondeau, Patrick Herbecq

S77 Change in functional autonomy following ICU stay

Islem Ouanes, Mahdi Marzouk, Lamia Ouanes-Besbes, Rami Jabla, Chaima Ghribi, Nesrine Boujelbene, Asma Hachani, Saousen Ben Abdallah, Hedia Hammed, Hend Ben Lakhal, Imen Ben Ali, Imen Abdellaoui, Fahmi Dachraoui, Fekri Abroug

S78 Outcome of Intensive Care Unit (ICU) elderly patients admitted with solid tumor

Edouard Auclin, Emmanuel Guérot, Caroline Haw-Berlemont, Julien Taieb, Stéphane Oudard, Jean-Luc Diehl, Jean-Yves Fagon, Nadia Aissaoui

S79 Risks factors for mortality in critically ill children with acute kidney injury requiring renal replacement therapy

Genevieve Morissette, Wassim Kechaou, Catherine Litalien, Aïcha Merouani, Véronique Phan, Josée Bouchard, Philippe Jouvet

S80 Epinephrine use in pediatric septic shock: a retrospective, single-center study on 117 patients

Julie Starck, Mehdi Oualha, Nelly Briand, Jean-Marc Treluyer, Sylvain Renolleau, Laurent Dupic

S81 Sickle cell disease in pediatric intensive care unit: a five-year retrospective monocentric study of 74 patients

Philippe Sachs, S Julliand, François Angoulvant, Julie Sommet, L Holvoet, M Benkerrou, Stéphane Dauger

S82 Implementation and evaluation of a paediatric nurse-driven sedation protocol in a PICU

Lélia Dreyfus, Fabienne Bordet, Sandrine Touzet, Angélique Denis, Etienne Javouhey

S83 Diagnostic evaluation and management of new-onset seizures and seizures with known epilepsy in children: a retrospective and comparative analysis

Julien Le Coz, Gérard Chéron, Rima Nabbout, Geraldine Patteau, Claire Heilbronner, Philippe Hubert, Sylvain Renolleau, Mehdi Oualha

S84 MRI sedation in children in pediatric hospital in Oran, Algeria

Nabil Tabet Aoul, zakaria addou, Ali Douah, Mohamed Moussati, Kamel Belhabiche, Nabil Aouffen

S85 Neurally adjusted ventilatory assist in pediatric patients following cardiac surgery: feasibility in clinical practice and impact on ventilation pressures

Benjamin Crulli, Baruch Toledano, Nancy Poirier, Suzanne Vobecky, Guillaume Emeriaud

S86 Percutaneous central venous cannulation: a Seldinger technique versus an ultrasound guidance technique in a pediatric intensive care unit

Fehmi Ferhi, Hosni Khouadja, Mohamed Amine Bouslama, Affra Brahim, Khalil Tarmiz, Khaled Benjazia

S87 Effect of remote ischemic preconditioning on renal resistive index in healthy volunteers

René Robert, M. Vinet, Angéline Jamet, Remi Coudroy, Arnaud W. Thille

S88 Peak concentration of high-dose AMIKACIN does not affect renal recovery at day 90: a retrospective study of 93 patients in a single medical Intensive Care Unit

Camille Vinclair, Romain Sonneville, Bruno Mourvillier, Mathilde Neuville, Roland Smonig, Eric Magalhaes, Guillaume Voiriot, Aguila Radjou, Jean-François Soubirou, Stephane Ruckly, Lila Bouadma, Jean-François Timsit

S89 Resuscitating chronic hypertensive patient with a high mean arterial pressure target during septic shock protects against acute renal failure

Julie Boisramé-Helms, Ferhat Meziani, Jean-François Hamel, François Beloncle, Jean-Louis Teboul, Peter Radermacher, Pierre Asfar

S90 Guidewire exchange vs new-site placement for temporary dialysis catheters insertion in ICU patients: Is there a greater risk of colonization or dysfunction?

Elisabeth Coupez, Jean-François Timsit, Stephane Ruckly, Carole Schwebel, Didier Gruson, Emmanuel Canet, Kada Klouche, Laurent Argaud, Julien Bohé, Maïté Garrouste-Orgeas, François Vincent, Sophie Cayot, Michaël Darmon, Alexandre Boyer, Elie Azoulay, Lila Bouadma, Alexandre Lautrette, Bertrand Souweine

S92 Assessment of chloride levels on renal function after cardiac arrest

Cláudia Righy Shinotsuka, Pietro Caironi, Paola Villois, Vito Fontana, Jean-Louis Vincent, Jacques Creteur, Fabio Silvio Taccone

S93 Sustained low-efficiency dialysis with regional citrate anticoagulation is safe for patients with acute liver failure or cirrhosis

Franck Pourcine, Ly Vong, Jonathan Chelly, Sebastien Jochmans, Oumar Sy, Olivier Ellrodt, Nathalie Rolin, Jean-Emmanuel Alphonsine,, Claire Marie Weyer, Jean Serbource-Goguel, Benoit Akando, Razach Abdallah, Mehran Monchi, Christophe Vinsonneau

S94 The new biomarker Nephrocheck™ can discriminate the population of septic shock patients with an AKIN 1 or 2 acute renal failure who will not progress toward the AKIN 3 level

Morgane Wetzstein, Loay Kontar, Dimitri Titeca, François Brazier, Bertand De Cagny, Gaelle Bacari-Risal, Antoine Riviere, Michel Slama, Julien Maizel

S95 Is thrombocytopenia an early prognostic marker in septic shock?

Nadiejda Antier, Christine Binquet, Sandrine Vinault, Ferhat Meziani, Julie Boisramé-Helms, Jean-Pierre Quenot

S96 Assessment of fibrinolysis in critically ill patients

Yasmina Serroukh, Karim Zouaoui Boudjeltia, Anne Joosten, Alexandre Rousseau, Patrick Biston, Michael Piagnerelli

S97 Early detection of disseminated intravascular coagulation during septic shock: a multicentre prospective study

Xavier Delabranche, Jean-Pierre Quenot, Thierry Lavigne, Emmanuelle Mercier, Bruno François, François Severac, Lélia Grunebaum, Laure Stiel, Florence Toti, Ferhat Meziani, Julie Boisramé-Helms, CRICS Network

S98 Activation or dysregulation of coagulation during septic shock: How to stratify patients in 2016?

Xavier Delabranche, Thierry Lavigne, Laure Stiel, Julie Boisramé-Helms, Achille Kouatchet, Maleka Schenck, Lélia Grunebaum, Yoganaden Mootien, Nicolas Lerolle, Ferhat Meziani

S99 Associated factors to early high blood pressure after weaning vasopressors during septic shock

Rostane Gaci, Jean-Romain Garric, Damien Barraud, Marie Conrad, Aurélie Cravoisy-Popovic, Jérémie Lemarie, Charles-Henri Maigrat, Pierre-Edouard Bollaert, Sébastien Gibot

S100 Impact of endotracheal intubation on septic shock outcome: a post hoc analysis of the SEPSISPAM trial

Agathe Delbove, Cédric Darreau, Nicolas Lerolle, Pierre Asfar, CNER DESC réanimation grand ouest

S101 Corporal Contention at the Onset of Septic shock (COCOONs): study protocol and preliminary results of a phase II trial

Auguste Dargent, Audrey Large, Agnès Soudry-Faure, Sebastien Prin, Pierre-Emmanuel Charles, Jean-Pierre Quenot, COCOONs Study Group

S102 Veno-arterial ECMO for refractory cardiogenic shock following cardiac arrest

Marc Pineton De Chambrun, Nicolas Bréchot, Guillaume Hekimian, Guillaume Lebreton, Matthieu Schmidt, Pierre Demondion, Ania Nieszkowska, Jean Louis Trouillet, Pascal Leprince, Jean Chastre, Alain Combes, Charles-Edouard Luyt

S103 Outcome of patients with pulmonary embolism treated by extra-corporeal life support (ECLS)

Jean-Christophe Blanchard, François Belon, Sydney Chocron, Nicolas Meneveau, Loïc Barrot, Nicolas Belin, Bérengère Vivet, Guylaine Labro, Jean-Christophe Navellou, Cyrille Patry, Gaël Piton, Gilles Capellier

S104 Acute massive pulmonary embolism rescued by veno-arterial extracorporeal membrane oxygenation

Filippo Corsi, Guillaume Lebreton, Nicolas Bréchot, Guillaume Hékimian, Ania Nieszkowska, Charles-Edouard Luyt, Pascal Leprince, Jean Louis Trouillet, Alain Combes, Matthieu Schmidt

S105 Outcome of patient recused for extracorporeal membrane oxygenation for ARDS

Pierre-Emmanuel Meynieu, Benjamin Repusseau, Virginie Perrier, Arnaud Germain, Antoine Dewitte, Hadrien Roze, Alexandre Ouattara

S106 Refractory electrical storm rescued by venoarterial extracorporeal membrane oxygenation

Guillaume Baudry, Guillaume Lebreton, Guillaume Hekimian, Nicolas Brechot, Ania Nieszkowska, Charles-Edouard Luyt, Jean Louis Trouillet, Pascal Leprince, Alain Combes, Matthieu Schmidt

S107 Incidence and determinants of severe bleeding among patients with extra-corporeal membrane oxygenation (ECMO)

Lucie Hierle, François Belon, Guillaume Besch, Sebastien Pili-Floury, Loïc Barrot, Bérengère Vivet, Guylaine Labro, Jean-Christophe Navellou, Cyrille Patry, Nicolas Belin, Gaël Piton, Gilles Capellier

S108 Venovenous extracorporeal membranous oxygenation device-related infections and colonizations

Guillemette Thomas, Jean-Marie Forel, Nadim Cassir, Sami Hraiech, Christophe Guervilly, Fanny Klasen, Mélanie Adda, Stéphanie Dizier, Antoine Roch, Laurent Papazian

S109 High emergency lung transplant for end-stage cystic fibrosis: ECMO as a bridge to transplant for patients with temporary contraindications

Grégoire Trebbia, Kiruba Govindaradjou, Alexis Soummer, Jérôme Devaquet, Clément Picard, Antoine Roux, François Parquin, Elise Cuquemelle, Morgan Leguen, Marie-Louise Felten, Edouard Sage, Alain Chapelier, Charles Cerf

S110 Malignant acute respiratory distress syndrome in diffuse lepidic adenocarcinoma (DLA): diagnosis and current issues

Maxens Decavèle, Antoine Parrot, Michael Duruisseaux, Jocelyne Fleury, Martine Antoine, Marie-France Carette, Marie Wislez, Muriel Fartoukh

S111 Acute respiratory failure from pulmonary leukemic infiltrates: diagnosis contribution of high-resolution computed tomography (HRCT)

Claire Givel, Virginie Lemiale, Constance De Margerie-Mellon, Etienne Lengliné, Leïla Mourtada, François Vincent, Akli Chermak, Eric De Kerviler, Elie Azoulay

S112 Characteristics and outcome of patients with interstitial lung disease admitted to the intensive care unit over a 15-year period

Yacine Tandjaoui-Lambiotte, Frédéric Gonzalez, Olivia Freynet, Guillaume Van Der Meersch, Johanna Oziel, Christophe Huang, Philippe Karoubi, Christophe Clec’h, Yves Cohen

S113 Outcome of patients admitted in intensive care unit for acute manifestation of small vessel vasculitis

Antoine Kimmoun, Elisabeth Baux, Vincent Das, Nicolas Terzi, Patrice Talec, Stephan Ehrmann, Guillaume Geri, Steven Grange, Nadia Anguel, Alexandre Demoule, Anne-Sophie Moreau, Elie Azoulay, Jean-Pierre Quenot, Julie Boisramé-Helms, Guillaume Louis, Romain Sonneville, Nicolas Girerd, Bruno Levy

S114 A monocenter retrospective study of predictive factors of prolonged intensive care unit hospitalization after a whole lung lavage procedure for patients with pulmonary alveolar proteinosis

Pauline Tallon, Alice Hadchouel-Duvergé, Nadège Salvi, Pascale Cairet, Jean-Marc Treluyer, Mehdi Oualha, Fabrice Lesage, Laure De Saint Blanquat, Sylvain Renolleau, Christophe Delacourt, Laurent Dupic

S115 Free fatty acids plasma profile during acute chest syndrome in adult patients with sickle cell disease: a pilot study

Blandine Lefebvre Blandine, Guillaume Lefevre, Laurence Beraud, Pierre Mora, Zoé Coppere, Antonin Lamaziere, François Lionnet, Muriel Fartoukh

S116 Extravascular lung water and lung ultrasound to predict severe primary graft dysfunction following lung transplantation

Samuel Lehingue, Christophe Guervilly, Stéphanie Dizier, Laurent Zieleskiewicz, Xavier D’journo, Guillemette Thomas, Fanny Klasen, Mélanie Adda, Antoine Roch, Forel Jean-Marie, Marc Leone, Laurent Papazian

S117 Results of the international multicentric prospective observational study Phase Angle Project: phase angle measured by bioimpedance analysis at intensive care unit (ICU) admission predicts 28-day survival

Ronan Thibault, Anne-Marie Makhlouf, Aurélien Mulliez, Cristina Gonzalez, Sylvain Dadet, Gintautas Kekstas, Jean-Charles Preiser, Kozjek Nada Rotovnik, Isabel Ceniceros Rozalen, Kinga Kupczyk, Zeljko Krznaric, Fabienne Tamion, Noël Cano, Claude Pichard, Phase angle project Investigators

S118 Nutrireaped: a survey of physician nutrition practices and knowledge in French-speaking pediatric intensive care units

Bénédicte Gaillard-Le Roux, Aurelien Jacquot, Corinne Jotterand, Shancy Rooze, Clemence Moullet, Flavie Letois, Frederic Valla

S119 A computerized tool increases compliance to caloric and protein targets and may lower mortality in neutropenic hematologic patients in the ICU: the NUTCHOCO study: NUTritionnal Care in Hematologic Oncologic patients and Critical Outcome

Aurélia Henin, Florence Ettori, Christophe Zemmour, Laurent Chow-Chine, Jeanpaul Brun, Antoine Sannini, Magali Bisbal, Marion Faucher, Jean Marie Boher, Djamel Mokart

S120 Systemic evaluation of intakes in patients receiving noninvasive ventilation: the STARVE study

Michel Arnaout, Aude Marincamp, Matthieu Reffienna, Anne-Sophie Debue, Pierre Lucas, Audrey Feltry, Julien Charpentier, Benoit Champigneulle, Wulfran Bougouin, Guillaume Geri, Frédéric Pène, Jean-Paul Mira, Alain Cariou, Jean-Daniel Chiche, Groupe de travail sur la ventilation

S121 Computerized glucose control in the ICU

Salah Adel Ben, Juliette Audibert, Alexandre Conia, Olivier Gontier, Mouldi Hamrouni, Thierry Lherm, Abdelkader Ouchenir, Jérôme Rétif, Alain Proudhom, Chantal Lagardere, Stéphane Tissot, Pierre Kalfon

S122 Toxicodynetics in mono-intoxications with oxazepam and nordiazepam: an approach to a better understanding of drug–drug interaction

Lynn Sacre, Antoine Villa, Alaywa Khadija, Robert Garnier, Frederic Baud

S123 Rapid triage of victims suspected of a chemical attack: a one-page sheet allowing identifying the toxidrome: the doctors without borders (MSF) experience

Frederic Baud, Robert Garnier, Brigitte Vasset, Annette Heinzelman

S124 Low sensitivity of toxicological analysis in daily practice of acute poisonings: an endless rupture in spite of modern technology

Frederic Baud, Alaywa Khadija, Romain Jouffroy, Lionel Lamhaut

S125 Context of the request and interest of toxicological screening in a medical intensive care unit

Elsa Démarest Durand, Fabienne Tamion, Christophe Girault, Gaetan Beduneau, Dorothée Carpentier, Patricia Compagnon, Steven Grange

S126 Acute poisoning in emergency department

Neila Maaroufi, Dhaouadi Mahassen

S127 Management of poising: Are there differences between specialised and non-specialised emergencies?

A M’rad, Alia Jebri, Youssef Blel, Hend Ben Lakhal, Messaouda Khelfa, Nozha Brahmi, H Thabet

S128 Jusquiame poisoning: report of a family intoxication

Hassen Ben Ghezala, Salah Snouda, Rebeh Daoudi, Moez Kaddour

S129 Morbi-mortality of poisoning episodes in Paris region: a test for a multisource surveillance system

Céline Legout, Robert Garnier, Antoine Villa, Frederic Baud, Philippe Aegerter, Anne Castot-Villepelet

S130 Atypical pneumonia in the ICU: a retrospective multicentric study

Sandrine Valade, Virginie Lemiale, Laurent Argaud, Frédéric Pène, Laurent Papazian, Fabrice Bruneel, Amélie Seguin, Achille Kouatchet, Johanna Oziel, Olivier Lesieur, Florence Boissier, Bruno Megarbane, Naïke Bigé, Noelle Brule, Anne-Sophie Moreau, Alexandre Lautrette, Elie Azoulay

S131 Severe leptospirosis: analysis of mortality and organ failures in 134 patients hospitalized in intensive care unit

Benjamin Delmas, Julien Jabot, Paul Chanareille, Jérôme Allyn, Nicolas Allou, Cyril Ferdynus, Bernard-Alex Gauzere, Olivier Martinet, David Vandroux

S132 In severe pneumonia, respiratory viruses are not passengers but pathogens

Guillaume Voiriot, Benoit Visseaux, Johana Cohen, Liem Binh Luong Nguyen, Mathilde Neuville, Caroline Morbieu, Charles Burdet, Aguila Radjou, François-Xavier Lescure, Roland Smonig, Laurence Armand-Lefevre, Bruno Mourvillier, Yazdan Yazdanpanah, Jean-François Soubirou, Stephane Ruckly, Nadira Houhou-Fidouh, Jean-François Timsit

S133 Critical care management of patients with HHV8-associated disorders

Marine Cazaux, Claire Pichereau, Marion Venot, Sandrine Valade, Virginie Lemiale, Akli Chermak, Emmanuel Canet, Le Goff Jérôme, Veronique Meignin, David Boutboul, Lionel Galicier, Elie Azoulay, Eric Mariotte

S134 Emerging moulds in critically ill patients: epidemiological trends, clinical features and ICU outcome

Laura Platon, Philippe Rispail, Vincent Brunot, N. Besnard, Patrice Ceballos, Kada Klouche

S135 Intensive care unit-associated bloodstream infection and ventilator-associated pneumonia in critically ill cancer patients: a 12-year retrospective study

Annabelle Stoclin, Federico Rotolo, Muriel Wartelle, Yosr Hicheri, Sylvia Maillet, Elisabeth Chachaty, Jean-Pierre Pignon, François Blot

S136 Is diabetes mellitus a risk factor for intensive care unit-acquired infections?

Marion Venot, Stephane Ruckly, Christophe Clec’h, Michaël Darmon, Bernard Allaouchiche, Dany Goldgran Toledano, Maïté Garrouste-Orgeas, Christophe Adrie, Jean-François Timsit, Elie Azoulay

PHYSIOTHERAPISTS ABSTRACTS

O85 Short-term physiological effects of nasal high-flow in healthy subjects. Impact of flow rates on the work of breathing

Mathieu Delorme, Pierre Alexandre Bouchard, Mathieu Simon, François Lellouche

O86 High-flow therapy allows a decreased workload of accessory respiratory muscles

Emilie Bialais, Dupuis Julie, Laura Paoloni, Gregory Reychler, Xavier Wittebolle

O87 Patient perception and feasibility of early mobilization in the critically ill

Cheryl Hickmann, Diego Castanares-Zapatero, Emilie Bialais, Jonathan Dugernier, Antoine Tordeur, Lise Colmant, Xavier Wittebole, Giuseppe Tirone, Jean Roeseler, Pierre-François Laterre

P252 Early rehabilitation in critically ill patients: a prospective multicenter assessment of real-life practice

Lorraine Ducroux, Sylvie L’hotellier, Elodie Baumgarten, Stéphanie Borschneck, Francis Schneider, Vincent Castelain

P253 Motor imagery and functional magnetic resonance imaging

Claire Kemlin, Eric Moulton, Charlotte Rosso

P254 Thoracic ultrasound: potential new tool for physiotherapists in respiratory management—a narrative review

Aymeric Le Neindre, Silvia Mongodi, Francois Philippart, Béaïd Bouhemad

P255 In vitro comparison of a vibrating-mesh nebulizer operating in expiratory synchronized and inspiratory nebulization modes during noninvasive ventilation

Joana Rodrigues, Caroline Botteau, Jonathan Dugernier, Giuseppe Liistro, Gregory Reychler, Jean-Bernard Michotte

P256 Evaluation of a new system of oxygen administration: the Wenoll system

Frédéric Duprez, François Waroquier, Karel Christiaens, Grégory Cuvelier, Frank Vantrimpont, Sharam Machayeckhi

P257 Evaluation of three portable oxyconcentrators in high altitude

Frédéric Duprez, François Waroquier, Karel Christiaens, Grégory Cuvelier, Charbel Elkhawand, Frank Vantrimpont, Sharam Machayeckhi, Frank Vermeesh

PHYSICIANS ABSTRACTS

O1 Impact of tracheal cuff shape on microaspiration of gastric contents in intubated critically ill patients: a multicenter randomized controlled study (BEST CUFF)

Emmanuelle Jaillette1, Christophe Girault2, Guillaume Brunin3, Farid Zerimech4, Arnaud Chiche5, Céline Broucqsault-Dedrie6, Cyril Fayolle7, Franck Minacori8, Isabelle Alves9, Stephanie Barrailler10, Laurent Robriquet1, Fabienne Tamion11, Emmanuel Delaporte3, Damien Thellier5, Claire Delcourte1, Alain Duhamel12, Saad Nseir1

1Centre de réanimation, C.h.r.u. Lille, Lille, France; 2Réanimation Médicale, Centre Hospitalier Universitaire Rouen, Rouen, France; 3Reanimation, Hospital Center De Boulogne-Sur-Mer, Boulogne-sur-Mer, France; 4Laboratoire de biochimie et biologie moléculaire, C.h.r.u. Lille, Lille, France; 5Réanimation, Centre Hospitalier de Tourcoing, Tourcoing, France; 6Réanimation, Hôpital Victor Provo, Roubaix, France; 7Reanimation, Hospital Center De Dunkerque, Dunkerque, France; 8Reanimation, Hospital Saint Philibert, Lille, France; 9Reanimation, Hospital Center De Valenciennes, Valenciennes, France; 10Reanimation, C.H. de Lens, Lens, France; 11Réanimation médicale, Hospital Center University Rouen, Rouen, France; 12Clinique de santé publique, plateforme d’aide méthodologique, C.h.r.u. Lille, Lille, France
Correspondence: Emmanuelle Jaillette - emmanuelle.jaillette@chru-lille.fr

Annals of Intensive Care 2016, 6(Suppl 1):O1

Introduction Ventilator-associated pneumonia (VAP) is the most common ICU-acquired infection in intubated critically ill patients. Microaspiration of gastric and oropharyngeal contaminated secretions represents the primary mechanism involved in the pathogenesis of VAP. Tracheal cuff plays an important role in stopping the progression of contaminated secretions into the lower respiratory tract. In vitro and animal studies suggested that leakage was significantly reduced with polyvinyl chloride (PVC) conical-cuffed tubes compared with barrel (standard) or cylindrical cuffs. Clinical studies found conflicting results. Therefore, the aim of this study is to determine the superiority of PVC conical- versus barrel (standard)-cuffed tracheal tube on abundant microaspiration of gastric contents in intubated critically ill patients.

Materials and methods BEST CUFF is a prospective multicenter (ten French ICUs) cluster randomized controlled crossover and open-label trial performed in patients with predicted duration of mechanical ventilation ≥48 h. Patients were allocated to be intubated using a PVC standard (barrel)-shaped or a PVC conical-shaped tracheal tube. Prevention measures of VAP were standardized in all ICUs. The main objective was to demonstrate the superiority of conical versus standard cuff shape in reducing abundant microaspiration of gastric contents (pepsin level >200 ng/ml in at least 30 % of tracheal aspirates). After inclusion, tracheal aspirates were collected for 48 h to measure pepsin and salivary amylase, and diagnose gastric and oropharyngeal microaspiration. To diagnose tracheobronchial colonization, quantitative aspirate was performed after intubation and two times a week until extubation. In patients with suspected VAP, quantitative tracheal aspirate or bronchoalveolar lavage was performed to confirm the diagnosis. We hypothesized that the use of conical-cuffed tracheal tubes would reduce the incidence of abundant microaspiration of gastric contents from 50 to 30 % of study patients. With a two-sided alpha risk of 5 %, a power of 80 %, and to account for an anticipated rate of 10 % of patients without any tracheal secretions, 312 patients had to be recruited.

Results A total of 326 patients were included during the study period (June 2014–September 2015). Pepsin and salivary amylase measurement is actually performed, and all results should be available in November 2015. Statistical analyses will be performed in mid-December, and study results will be presented at the 2016 Réanimation Congress.

Discussion Our study is sufficiently powered to detect a significant difference in microaspiration of gastric contents between patients intubated with conical-cuffed tracheal tubes and standard-cuffed tracheal tubes. One of the strengths of this study is the use of quantitative measurement of pepsin as a marker of microaspiration.

Conclusion BEST CUFF is the first randomized controlled study evaluating the impact of PVC tracheal cuff shape on microaspiration of gastric contents. The results will be presented at the 2016 Réanimation Congress.

Competing interests None.

O2 Bicarbonate versus saline for contrast-induced acute kidney injury prevention in critically ill patients

Xavier Valette1, Isabelle Desmeulles2, Benoit Savary3, Romain Masson2, Amélie Seguin1, Cédric Daubin1, Bertrand Sauneuf1, Jennifer Brunet2, Pierre Verrier1, Véronique Pottier2, Marie Orabona2, Désiré Samba2, Gérald Viquesnel2, Mathilde Lermuzeaux2, Pascal Hazera3, Jean-Luc Hanouz2, Jean-Jacques Parienti4, Damien Du Cheyron1

1Réanimation médicale, C.H.U de Caen, Caen, France; 2Réanimation chirurgicale, C.H.U de Caen, Caen, France; 3Réanimation polyvalente, C.H. Mémorial France - Etats-Unis (Saint-Lô), Saint-Lô, France; 4Unité de biostatistique et de recherche clinique, C.H.U de Caen, Caen, France
Correspondence: Xavier Valette - valette3l2ax@sfr.fr

Annals of Intensive Care 2016, 6(Suppl 1):O2

Introduction The administration of contrast media for imaging and interventional procedures is frequent in intensive care unit (ICU). Whether volume expansion with bicarbonate is better than isotonic saline to reduce the risk of contrast-induced acute kidney injury (CI-AKI) in critically ill patients is unknown.

Materials and methods The HYDRAREA study was a randomized, double-blind, multicenter trial including adults admitted in three ICUs in France who received intravascular contrast media. Patients with unstable renal function (increase in serum creatinine level of at least 0.3 mg/dL during the previous 48 h, anuria during the previous 12 h, renal replacement therapy) or contraindication to volume expansion or bicarbonate load (uncontrolled cardiogenic pulmonary edema, metabolic alkalosis with pH >7.50, hypokalemia <3 mmol/L, chronic hypercapnia) were not included. Patients were randomized in a 1:1 ratio to receive 0.9 % sodium chloride or 1.4 % sodium bicarbonate administered with the same infusion protocol: 3 mL/kg for 1 h started before contrast media administration followed by 1 mL/kg/h for 6 h. The primary outcome was the incidence of CI-AKI defined by the Acute Kidney Injury Network criteria within 72 h after contrast medium administration. Secondary outcomes included CI-AKI using alternative definitions (AKIN without urine output criteria, RIFLE classification, creatinine increase ≥0.5 mg/dL or 25 %), need for renal replacement therapy, ICU length of stay and mortality.

Results Among the 307 patients randomized, the mean (SD) age was 56 ± 15 years and 208 (68 %) patients were male. Patients were admitted in ICU for medical reason in 132 (43 %) patients, for emergency surgery in 118 (38 %) patients, following trauma in 45 (15 %) patients and after a scheduled surgery in 12 (4 %) patients. The mean (SD) SAPS II and SOFA scores at ICU admission were 42 ± 17 and 7 ± 4, respectively. Contrast media were used for computed tomography in 193 (63 %) patients and for arteriography in 114 (37 %) patients. Low-osmolar contrast media were used in 276 (90 %) patients. At randomization, 243 (79 %) patients were under mechanical ventilation, 100 (33 %) patients needed vasopressor, 104 (34 %) patients had sepsis, and 40 (13 %) patients had a RIFLE stage equal or higher than the “Risk of Kidney Injury” class. Patient characteristics were well balanced between groups excepted for the use of nephrotoxic medications which was more common in saline group (40 (26 %) patients vs 59 (38 %) patients; p < 0.05).

As expected, patients receiving bicarbonate (n = 151) had higher urinary pH at the end of the infusion than patients receiving saline (n = 156) (6.7 ± 2.1 vs 6.2 ± 1.8, respectively; p < 0.001). The incidence of CI-AKI was similar in both groups: 52 (33.3 %) patients in saline group and 53 (35 %) patients in bicarbonate group (RR 0.96; 95 % CI [0.70–1.30]; p = 0.81). There was no difference between groups whatever the definition used to define CI-AKI. The need for renal replacement therapy (five (3.2 %) patients in saline group vs six (4 %) patients in bicarbonate group; RR 0.81; 95 % CI [0.25–2.59]; p = 0.77), ICU length of stay (24.7 ± 22.9 days in saline group vs 23 ± 23.8 days in bicarbonate group, p = 0.52) and mortality (25 (16 %) patients in saline group vs 24 (15.9 %) patients in bicarbonate group; RR 1.00; 95 % CI [0.60–1.68]; p = 0.97) were also similar between groups.

Conclusion Hydration with sodium bicarbonate for CI-AKI prevention in critically ill patients does not provide supplementary beneficial effect in comparison with hydration by isotonic sodium chloride.

Competing interests None.

O3 Neurally adjusted ventilatory assist in the early phase of weaning from mechanical ventilation: a multicenter randomized study

Alexandre Demoule1, Marc Clavel2, Camille Rolland-Debord1, Sébastien Perbet3, Nicolas Terzi4, Achille Kouatchet5, Florent Wallet6, Hadrien Roze7, Frédéric Vargas8, Claude Guérin9, Jean Dellamonica10, Samir Jaber11, Thomas Similowski12

1Intensive Care and Respiratory Division, Pitié-Salpêtrière Hospital, Paris, France; 2Service de réanimation polyvalente, Centre Hospitalier Universitaire de Limoges, Limoges, France; 3Service de réanimation adultes, C.H.U. Estaing, Clermont-Ferrand, France; 4Service de réanimation médicale, Clinique de Réanimation Médicale, Grenoble, France; 5Réanimation médicale, Centre Hospitalier Universitaire d’Angers, Angers, France; 6Réanimation médicale et chirurgicale, CHU Lyon Sud, Lyon, France; 7Sar 2, unité réanimation thoracique greffe, CHU de Bordeaux, Bordeaux, France; 8Réanimation médicale, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France; 9Réanimation médicale, Hôpital de la Croix-Rousse, Lyon, France; 10Réanimation médicale, Centre Hospitalier Universitaire Archet, Nice, France; 11DAR B, Hôpital Saint Eloi, Montpellier, France; 12Service de pneumologie et réanimation médicale, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
Correspondence: Alexandre Demoule - alexandre.demoule@aphp.fr

Annals of Intensive Care 2016, 6(Suppl 1):O3

Introduction Neurally adjusted ventilatory assist (NAVA) is a ventilatory mode that tailors the level of assistance delivered by the ventilator to the electromyographic activity of the diaphragm. The objective of the present study was to compare the impact of mechanical ventilation with NAVA or pressure support ventilation (PSV) on the early phase of weaning from mechanical ventilation.

Patients and methods A multicenter randomized controlled trial of 128 intubated adults recovering from an acute respiratory failure was conducted in 11 intensive care units (ICUs) from April 2010 to June 2012. Patients were randomly assigned to NAVA or PSV. The primary endpoint was the probability to remain in an assisted mode during the entire first 48 h. Secondary endpoints included asynchrony index, duration of mechanical ventilation and hospital mortality at 28 days.

Results The proportion of patients remaining in an assisted mode during the entire first 48 h was 67.7 % in the NAVA group versus 69.4 % in the PSV group (p = 0.47). The time spend in an assisted mode similar in the two groups (47 [43–48] vs. 47 [40–48], p = 0.55). The asynchrony index was lower in the NAVA group (19.7 vs. 32.6 %). Duration of mechanical ventilation was similar in the two groups (12.0 [7.0–17.0] in the NAVA group vs. 13.5 [10.0–21.0] in the PSV group, p = 0.121) as was the ICU mortality rate (12.9 vs. 21.2 %, p = 0.21). More patients required post-extubation noninvasive mechanical ventilation in the PSV group (66.6 vs. 43.5 %, p = 0.008).

Conclusion NAVA can be applied efficiently in a clinical setting and improves patient ventilator interaction. However, NAVA does not increase the probability to remain in an assisted mode during the first 48 h.

Competing interests A. Demoule: reserche contract with Maquet, Drager, Philips, Covidien. Consulting for Covidien. Speaker for Covidien.

O4 Very high volume hemofiltration with the Cascade system in septic shock patients

Jean-Pierre Quenot1, Christine Binquet2, Christophe Vinsonneau3, Saber-Davide Barbar4, Sandrine Vinault,2, Valérie Deckert5, Stephanie Lemaire5, Ali Ait Hssain6, Rémi Bruyère7, Bertrand Souweine6, Laurent Lagrost5, Christophe Adrie8

1Réanimation médicale, CHU Dijon, Dijon, France; 2Centre d’investigation clinique, Chu Dijon, Dijon, France; 3Réanimation polyvalente, Centre Hospitalier Marc Jacquet, Melun, France; 430, Chru De Nîmes, Nîmes, France; 521, Faculté de médecine, Dijon, France; 6Réanimation médicale, CHU Gabriel-Montpied, Clermont-Ferrand, France; 701, CH de Fleyrat, Bourg-en-Bresse, France; 8Physiologie, Hôpital Cochin, Paris, France
Correspondence: Jean-Pierre Quenot - jean-pierre.quenot@chu-dijon.fr

Annals of Intensive Care 2016, 6(Suppl 1):O4

Introduction We compared hemodynamic and biological effects of the Cascade system, which uses very high volume hemofiltration (HVHF) (120 ml/kg/h), with those of usual care in patients with septic shock.

Patients and methods Multicenter, prospective, randomized, open-label trial was conducted in three intensive care units (ICU). Adults with septic shock with administration of epinephrine/norepinephrine were eligible. Patients were randomized to usual care plus HVHF (Cascade group) or usual care alone (Control group). Primary endpoint was the number of catecholamine-free days up to 28 days after randomization. Secondary endpoints were number of days free of mechanical ventilation, renal replacement therapy (RRT) or ICU up to 90 days, and 7-, 28- and 90-day mortality.

Results We included 60 patients (29 Cascade and 31 usual care). Baseline characteristics were comparable. Median number of catecholamine-free days was 22 [IQR 11–23] versus 20 [0–25] for Cascade versus Control; there was no significant difference even after adjustment. There was no significant difference in number of mechanical ventilation-free days or ICU requirement. Median number of RRT-free days was 85 [46–90] versus 74 [0–90] for Cascade versus Control groups, p = 0.42. By multivariate analysis, the number of RRT-free days was significantly higher in the Cascade group (up to 25 days higher after adjustment). There was no difference in mortality at 7, 28 or 90 days.

Conclusion Very HVHF using the Cascade system can safely be used in patients presenting septic shock, but was not associated with a reduction in the need for catecholamines during the first 28 days.

Competing interests None.

O5 Effect of rapid response systems on hospital mortality, a prospective interventional study and systematic review

Boris Jung1, Aurelien Daurat1, Audrey De Jong1, Gérald Chanques1, Martin Mahul,1, Marion Monnin2, Nicolas Molinari3, Samir Jaber1

1Dar b, Hôpital Saint Eloi, Montpellier, France; 2Dar b, CHRU Hôpital Saint Eloi, Montpellier, France; 3Dim, Hôpital La Colombière, Montpellier, France
Correspondence: Boris Jung - boris.jung@me.com

Annals of Intensive Care 2016, 6(Suppl 1):O5

Introduction Although rapid response systems (RRSs) are known to reduce in hospital cardiac arrest rate, their effect on mortality remains in question. The present study aimed at evaluating the effect of a medical emergency team (MET) implementation on mortality in hospitalized patients.

Patients and methods A prospective study was conducted in the four hospitals of the regional healthcare center of Montpellier, France. An intensivist-led MET was implemented on a 24/7 basis in only one of the four hospitals from January 2012 to June 2012. Patients >18 years admitted for more than 24 h in the medical-surgical wards from July 2010 to December 2011 (pre-MET period) and from July 2012 to December 2013 (MET period) were included. The main outcome was unexpected mortality in hospitalized patients. An updated systematic review and meta-analysis were also performed.

Results A total of 137,251 patients were admitted for 24 h or more in the medical-surgical wards during the pre-MET and MET periods. MET implementation was associated with a decrease in unexpected mortality rate in the hospital that implemented MET (from 21.9 to 17.4 per 1000 admissions; P = 0.002). Reduction in unexpected mortality associated with MET implementation could be estimated at 1.5 lives saved per week in the MET hospital. In the three other hospitals, mortality rate was not significantly modified (from 19.5 to 19.9 per 1000 admissions; P = 0.69). Patients in the MET hospital were more frequently admitted to the intensive care unit (ICU) during the MET period (45.8 vs 52.9 per 1000; P = 0.002), and their sequential organ failure assessment (SOFA) score upon ICU admission significantly decreased from 7 [4–10] to 5 [2–9]; P < 0.001. The updated meta-analysis including the present results showed that RRS was associated with a significant decrease in both unexpected (OR 0.51; 95 % CI 0.35–0.76) and overall mortality (OR 0.89; 95 % CI 0.85–0.93).

Conclusion In the present prospective study, implementation of a MET was associated with a decrease in unexpected and overall mortality. Updated meta-analysis confirms the benefit of RRS on unexpected and overall mortality (Fig. 1).
Fig. 1

Evolution of unexpected death rate per 1000 admissions by month in the MET pavilion (left side) and in the three other pavilions (right side). Dotted lines represent the mean rate per month. Grey rectangles represent the standard deviations

Competing interests None.

O6 Beta-lactams serum concentrations in critically ill cirrhotic patients: a matched control study

Olivier Lheureux1, Eric Trepo2, Maya Hites3, Frederic Cotton4, Fleur Wolff4, Rudy Surin3, Jacques Créteur1, Jean-Louis Vincent1, Thierry Gustot2, Frederique Jacobs3, Fabio Silvio Taccone1

1Service de soins intensifs, Hospital Erasme, Brussel, Belgium; 2Service de gastroentérologie, Hospital Erasme, Brussel, Belgium; 3Service de maladies infectieuses, Hospital Erasme, Brussel, Belgium; 4Service de biochimie médicale, Hospital Erasme, Brussel, Belgium
Correspondence: Olivier Lheureux - olheureu@ulb.ac.be

Annals of Intensive Care 2016, 6(Suppl 1):O6

Introduction Few data are available on the pharmacokinetics of β-lactams in critically ill cirrhotic patients. The objective of this study was to evaluate whether β-lactam concentrations were altered in patients with cirrhosis compared with other critically ill patients and to identify the principal risk factors for any differences.

Materials and methods We reviewed data from critically ill cirrhotic patients and matched controls in which routine therapeutic drug monitoring of broad-spectrum β-lactam antibiotics (piperacillin/tazobactam; meropenem) was performed. Serum drug concentrations were measured twice during the elimination phase by high-performance liquid chromatography. Antibiotic pharmacokinetics was calculated using a one-compartment model. We considered therapy was adequate when serum drug concentrations were between 4 and 8 times the minimal inhibitory concentration of Pseudomonas aeruginosa during optimal periods of time for each drug ≥50 % for piperacillin/tazobactam; ≥40 % for meropenem).

Results We studied 38 cirrhotic patients (16 for piperacillin/tazobactam and 22 for meropenem) and 38 matched controls. Drug dosing was similar in the two groups. The pharmacokinetic analysis showed a lower volume of distribution of meropenem (p = 0.05) and a lower antibiotic clearance of piperacillin/tazobactam (p = 0.009) in patients with cirrhosis when compared to non-cirrhotic patients. Patients with cirrhosis more often had excessive (23/38) than insufficient (5/38) or adequate (10/38) serum β-lactam concentrations; they also had excessive drug concentrations more frequently than did control patients (23/38 vs. 13/38—p = 0.02), particularly for piperacillin/tazobactam (9/16 vs. 2/16—p = 0.01). The only variable significantly associated with insufficient drug concentrations was the creatinine clearance on the day of the therapeutic drug monitoring. No specific variable was associated with excessive drug concentrations.

Conclusion This case–control study shows that standard doses of β-lactams result in excessive serum concentrations in two-thirds of critically ill patients with cirrhosis, especially in those treated with piperacillin/tazobactam. Our results support routine β-lactam therapeutic drug monitoring in this patient population.

Competing interests None.

References
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    Roberts JA, Paul SK, Akova M, Bassetti M, De Waele JJ, Dimopoulos G et al. DALI: defining antibiotic levels in intensive care unit patients: are current β-lactam antibiotic doses sufficient for critically ill patients? Clin Infect Dis. 2014;58(8):1072–1083.

     
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    Gustot T, Felleiter P, Pickkers P, Sakr Y, Rello J, Velissaris D et al. Impact of infection on the prognosis of critically ill cirrhotic patients: results from a large worldwide study. Liver Int. 2014;34(10):1496–1503.

     

O7 Systematic overdosing of oxa- and cloxacillin in severe infections treated in ICU: Risk factors and side effects

Mathilde Neuville1, Jean-François Timsit1, Najoua El-Helali2, Alban Le Monnier2, Eric Magalhaes1, Aguila Radjou1, Roland Smonig1, Jean-François Soubirou1, Guillaume Voiriot1, Romain Sonneville1, Lila Bouadma1, Bruno Mourvillier1

1Réanimation médicale et infectieuse, Hôpital Bichat-Claude Bernard, Paris, France; 2Unité de microbiologie clinique et dosages des anti-infectieux, Groupe hospitalier Paris Saint-Joseph, Paris, France
Correspondence: Mathilde Neuville - mathilde.neuville@aphp.fr

Annals of Intensive Care 2016, 6(Suppl 1):O7

Introduction Oxacillin and cloxacillin are the most frequently used penicillins for the treatment of severe methicillin-susceptible Staphylococcus aureus (MSSA) infections in intensive care units (ICU), especially endocarditis. No adaptation of the dosage is required in case of renal failure. We wanted to assess the risk factors for overdosing in ICU, and the related observed side effects.

Patients and methods All patients with a therapeutic drug monitoring (TDM) of oxa- or cloxa-cillin between 2008 and 2014 were included. The optimal trough concentration was considered to be 20 mg/L, i.e., 10 times the minimum inhibitory concentration of cloxaxillin for MSSA. Data concerning the medical history, the characteristics of the infection, the given treatment, the renal function and the attributed side effects of overdosing were collected. A negative binomial model was used to compute the measured trough concentrations.

Results Sixty-two patients were included in this study. We found a median trough plasma concentration of 134.3 mg/L [IQR 65.3–201 mg/L]. Only one patient reached the target concentration; all other patients were overdosed. Eleven patients (17.7 %) experienced neurological side effects attributed to a high antibiotic concentration, i.e., persistent coma and delirium. When adjusted on the dosage used, the first trough concentration was significantly increased by a creatinine clearance below 10 ml/min (with or without hemodialysis) and by endocarditis as the source of infection (Fig. 2).
Fig. 2

Univariate and multivariate statistical analysis. Day 0 = day of ICU admission, T-day = day of treatment initiation, D-day = day of TDM

Conclusion With the recommended dose of 12 g/day for cloxacillin treatment in case of endocarditis and severe infections occurring in ICU, almost all patients are largely overdosed. Considering the high frequency of observed side effects, doses should be accurately monitored and reduced, particularly when renal replacement therapy is needed.

Competing interests None.

O8 Amikacin peak concentrations in patients receiving extracorporeal membrane oxygenation (ECMO) support: a case–control study

Elodie Gélisse1, Mathilde Neuville2, Etienne De Montmollin3, Guillaume Voiriot2, Jean-François Soubirou2, Roland Smonig2, Aguila Radjou2, Eric Magalhaes2, Lila Bouadma2, Bruno Mourvillier2, Jean-François Timsit2, Romain Sonneville2

1Unité de réanimation robert debré, CHU Reims, Reims, France; 2Service de réanimation médicale et infectieuse, Hôpital Bichat-Claude Bernard-APHP, Paris, France; 3Réanimation, C.H. Général Saint Denis hôpital Delafontaine, Saint-Denis, France
Correspondence: Elodie Gélisse - elodie.gelisse@gmail.com

Annals of Intensive Care 2016, 6(Suppl 1):O8

Introduction More than half of adult patients receiving extracorporeal membrane oxygenation (ECMO) require an antibiotic therapy during their stay in ICU. Amikacin is the most used aminoglycoside for the treatment of septic shock given its good bactericidal activity on Pseudomonas aeruginosa and the low resistance rate observed with the other Gram-negative bacilli. However, data on pharmacokinetics of amikacin in patients receiving ECMO support have scantly been studied in these conditions. We aimed to report on the distribution of peak serum concentration (C max) of amikacin and on factors associated with insufficient Cmax in a population of critically ill patients receiving ECMO.

Materials and methods We conducted an observational single-center study of patients admitted to a general ICU. Inclusion criteria were: (1) age ≥18 years and (2) a suspected Gram-negative infection requiring a loading dose of intravenous amikacin. Amikacin was routinely administered intravenously at a dose of 25 mg/kg of total body weight over a 30-min infusion time. C max was measured 30 min after the end of infusion and trough serum concentration 24 h after the end of infusion (C min). ECMO patients were matched with critically ill patients without ECMO support (controls) for characteristics that had been previously identified as independent predictors for insufficient C max, namely body mass index (BMI), cirrhosis and 24-h fluid balance. An amikacin C max >60 mg/L and <80 mg/l was considered the target concentration (adequate drug concentrations). An amikacin C max <60 mg/L was considered as an insufficient drug concentration, and a C max >80 mg/l was considered as an excessive one. The primary outcome was the distribution of C max (mg/L) between ECMO patients and controls.

Results A total of 50 episodes in 46 ECMO patients were matched with 50 controls. Baseline characteristics did not differ between groups, except for age (61 vs. 63.5 years), reason for ICU admission and SOFA score (12 [10–14] vs. 9 [6–11]). At the day of C max, in ECMO patients the SOFA score was 9 [5.3–9.8], and 100 % episodes required mechanical ventilation, 96 % vasopressors and 44 % renal replacement therapy. There were no significant differences in serum concentrations between ECMO and non-ECMO patients: The amikacin Cmax was 71.7 [58.9–79.7] mg/l for ECMO patients versus 68.4 [53–81] mg/l for non-ECMO patients (p = 0.36). The proportion of insufficient [13/50 (26 %) episodes vs. 17/50 (34 %) episodes), adequate (25/50 (50 %) episodes vs. 18/50 (36 %) episodes] and excessive [12/50 (24 %) episodes vs. 15/50 (30 %) episodes] drug concentrations was similar in ECMO and non-ECMO patients (Table 1). C min was measured in 43 (86 %) episodes, and 28/43 (65 %) measurements were above the toxic threshold of 5 mg/L in ECMO patients versus 30/50 (60 %) in non-ECMO patients.
Table 1

Episodes characteristics at ICU admission and time of C max

Variables

ECMO (n = 50)

Non-ECMO (n = 50)

P value

Characteristics at ICU admission

 Age (years)

61 (43–68)

63.5 (54–72)

0.03

 Cirrhosis

2 (4)

4 (8)

0.68

 Acute respiratory failure

7 (14)

13 (26)

<0.001

 Severe sepsis/septic shock

5 (10)

12 (24)

 

 Cardiogenic shock

21 (42)

4 (8)

 

 Cardiac surgery

10 (20)

11 (22)

 

 Post-cardiac arrest

5 (10)

3 (6)

 

 Others

2 (4)

7 (14)

 

 BMI (kg/m2)

26.5 (24.2–29.4)

26.3 (24.5–30.9)

0.50

 SAPS II

51 (42.5–73.3)

53.5 (41–73.3)

0.98

Characteristics at time of therapeutic monitoring

 SOFA score

12 (10–14)

9 (6–11)

<0.001

 24-h fluid balance (mL)

100 (−925 to 1860)

100 (−1550 to 1019)

0.52

 Weight (kg)

88.5 (73–100)

82 (70–93)

0.37

 Amikacin dose (mg)

2250 (1825–2500)

2000 (1713–2300)

0.17

 Amikacin regimen (mg/kg)

25 (25–25.6)

24.9 (24.5–25.5)

0.10

 Amikacin C max (mg/L)

71.7 (58.9–79.7)

68.4 (53–81)

0.36

 Patients with C max <60 mg/L

13 (26)

17 (34)

0.51

 Patients with C max >80mgL

12 (24)

15 (30)

0.65

 Amikacin C min (mg/L)

8.5 (3–15.4)

9.6 (2.5–16.9)

0.45

Conclusion ECMO therapy did not significantly impact on peak and trough serum concentrations of amikacin.

Competing interests None.

References
  1. 1.

    Schmidt M, Brechot N, Hariri S, Guiguet M, Luyt CE, Makri R, et al. Nosocomial Infections in Adult Cardiogenic Shock Patients Supported by Venoarterial Extracorporeal Membrane Oxygenation. Clin Infect Dis. 2012 Dec 15;55(12):1633–41.

     
  2. 2.

    De Montmollin E, Bouadma L, Gault N, Mourvillier B, Mariotte E, Chemam S, et al. Predictors of insufficient amikacin peak concentration in critically ill patients receiving a 25 mg/kg total body weight regimen. Intensive Care Med. 2014 Jul;40(7):998–1005.

     

O9 A high aminoglycoside regimen associated with renal replacement therapy for the treatment of multi-drug-resistant pathogens

Alexandre Brasseur1, Maya Hites2, Sandrine Roisin3, Frederic Cotton4, Jean-Louis Vincent5, Daniel De Backer6, Frederique Jacobs2, Fabio Silvio Taccone7

1Soins Intensifs, Hôpital Erasme, Bruxelles, Belgium; 2Service de maladies infectieuses, Hospital Erasme, Brussel, Belgium; 3Service de microbiologie clinique, Hospital Erasme, Brussel, Belgium; 4Service de biochimie médicale, Hospital Erasme, Brussel, Belgium; 5Service de Réanimation Médico-Chirurgicale, Hôpital Erasme, Bruxelles, Belgium; 6Soins intensifs, Hospital Erasme, Brussel, Belgium; 7Service de Soins Intensifs, Hôpital Erasme, Bruxelles, Belgium
Correspondence: Alexandre Brasseur - albrasse@ulb.ac.be

Annals of Intensive Care 2016, 6(Suppl 1):O9

Introduction Infections caused by multi-drug-resistant (MDR) Gram-negative (GN) organisms in critically ill patients are a therapeutic challenge. The administration of high-dose aminoglycoside (HDA) therapy coupled with high-flow continuous venovenous hemodiafiltration (CVVHDF) could allow required high drug peaks to be achieved with acceptable drug elimination.

Patients and methods All adult patients present on the intensive care unit (ICU) between October 2009 and July 2014 who had MDR-GN sepsis were considered for HDA and high-flow (>45 mL/kg/h) CVVHDF when an isolated pathogen was susceptible or intermediate susceptible to aminoglycosides, and the patient’s condition was not improving with conventional therapy. Optimal antibacterial activity was defined as a peak concentration of at least eight times the minimal inhibitory concentration.

Results Fifteen patients infected with MDR-GN pathogens (11 with Pseudomonas aeruginosa; ten with abdominal and five with respiratory infections) were treated with amikacin (n = 11), gentamicin (n = 3) or tobramycin (n = 1) and high-flow CVVHDF. A favorable clinical response was observed in eight (53 %) patients, including three in whom microbial eradication was obtained. Six patients were discharged alive from the ICU and five from the hospital. No renal toxicity was observed among survivors.

Conclusion In this cohort of septic patients with MDR-GN infections, HDA combined with high-flow CVVHDF represented a valuable therapeutic option. The effectiveness of this approach should be further evaluated in larger studies.

Competing interests None.

O10 Optimization of administration of vancomycin in septic patients: a prospective randomized study

Valerie Van Ruychevelt1, Eric Carlier1, Michael Piagnerelli1, Michel Vanhaeverbeek2, Christine Danguy3, Patrick Biston1

1Intensive Care Unit, Hôpital Civil Marie Curie, Charleroi, Belgium; 2Internal medicine, Hospital André Vésale, Montigny-le-Tilleul, Belgium; 3Pharmacy, Hospital André Vésale, Montigny-le-Tilleul, Belgium
Correspondence: Valerie Van Ruychevelt - vvruyche@ulb.ac.be

Annals of Intensive Care 2016, 6(Suppl 1):O10

Introduction Continuous intravenous administration of vancomycin (CIV) in intensive care unit (ICU) patients requires dose adjustment according to weight and renal function, but its assessment remains difficult. The aim of this study was to validate a new dose regimen of CIV correlated with renal function assessed by creatinine clearance (Creat Cl).

Materials and methods In this prospective randomized study, we evaluated septic critically ill patients in whom CIV was given for more than 48 h in the absence of renal replacement therapy. The CIV protocol was developed based on recommendations of IDSA for the loading dose (30 mg/kg), but a new protocol for the maintenance dose was tested (depending on weight and daily Creat Cl). The serum target vancomycin (vanco) concentration was 25–30 μg/ml. Patients were randomized in three groups by daily assessment of renal function by a Creat Cl of 4 h (from 4 to 8 a.m.) or 12 h of Creat Cl (from 8 p.m. to 4 a.m.) or by the MDRD. Acute kidney injury (AKI) was defined as a daily urine output <0.5 ml/kg/h and/or an increase in the serum creatinine of ≥0.3 mg/dL from baseline levels. Multivariable logistic regression analysis was performed to identify predictors of CIV under-/over-dose and predictors of AKI.

Results During 23 months, in a medico-surgical 36 beds ICU (CHU Charleroi, Belgium), 67 patients were randomized: 21 (31 %) in the MDRD group, 21 (31 %) in the 4 h Creat Cl and 25 (38 %) in the 12 h Creat Cl. The three groups were comparable in demographic terms, severity score, kidney function before CIV and bacteriology. For 7/67 (10 %) patients, CIV was targeted on bacteriological findings (one MRSA and six Enterococcus faecium). In the other patients, vanco was introduced empirically for clinically evolving sepsis. Vanco concentration <25 μg/ml on day 1 was found in 15 patients (22 %) in the MDRD group, 11 (16 %) in 4 h Creat Cl and 15 (22 %) in 12 h Creat Cl (p = 0.5), and in 12 (17 %), 12 (17 %) and 13 (19 %), respectively, on day 2 (p = 0.8). In logistic regression analysis, BMI <30 and an elevated Creat Cl >90 were found independent predictors of under-dosing vanco (<25 μg/ml) at day 1 with an OR of 1.098 [1.01–1.19] and 0.935 [0.8–1], respectively. The day 1–day 2 CIV overdose was found to be an independent risk factor for AKI with an OR of 7.5 [2.2–23.7].

Discussion Our protocol cannot optimally achieve target levels on days 1–2. However, the chosen therapeutic target (25–30 μg/ml) seems a posteriori not justified given the local epidemiology. With the target proposed in the literature (20–30 μg/ml), vanco concentration at day 1 was <20 μg/ml in nine patients (43 %) in MDRD group, four (19 %) in 4 h CCU and nine (36 %) in 12 h CCU, and in 3 (14 %), 3 (14 %) and 5 (20 %), respectively, at day 2. It would therefore be preferable to target therapeutic levels between 25 and 30 μg/ml only for patients in the presence of multi-resistant germs demonstrated. For empirical antibiotic choice, therapeutic target [20–30 μg/ml] is probably enough and more careful. The assessment of renal function using three different methods failed to highlight difference in Creat Cl. The evaluation of Creat Cl by the MDRD formula may be sufficient.

Conclusion Insufficient vancomycin concentration is a frequent finding at days 1–2. Predictors were BMI and high Creat Cl. Vanco level >30 μg/ml at days 1–2 is an independent predictive factor for AKI with an OR of 7.5.

Competing interests None.

References
  1. 1.

    Rybak, M. et al. Therapeutic monitoring of vancomycin in adult patients: a consensus review of the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists. Am. J. Health-Syst. Pharm. AJHP Off. J. Am. Soc. Health-Syst. Pharm. 66, 82–98 (2009).

     
  2. 2.

    Ocampos-Martinez, E. et al. Determinants of early inadequate vancomycin concentrations during continuous infusion in septic patients. Int. J. Antimicrob. Agents 39, 332–337 (2012).

     

O11 Impact of elevated intra-abdominal pressure on the ability of dynamic parameters to predict fluid responsiveness

Siu-Ming Au1, Emmanuelle Begot2, François Dalmay3, Xavier Repessé4, Gwenael Prat5, Koceila Bouferrache6, Michel Slama7, Philippe Vignon2, Antoine Vieillard-Baron4

1Icu, Hospital Ambroise Paré, Boulogne-Billancourt, France; 2Service de réanimation polyvalente, Centre Hospitalier Universitaire de Limoges, Limoges, France; 3Réanimation Polyvalente, CHU Limoges, Limoges, France; 4Réanimation médico-chirurgicale, Assistance Publique - Hôpitaux de Paris, Hôpital Ambroise Paré, Boulogne-Billancourt, France; 5Réanimation médicale, CHRU de Brest, Brest, France; 6Icu, Hospital Foch, Suresnes, France; 7Réanimation médicale, Centre Hospitalier Universitaire, Amiens, France
Correspondence: Antoine Vieillard-Baron - antoine.vieillard-baron@apr.aphp.fr

Annals of Intensive Care 2016, 6(Suppl 1):O11

Introduction Elevated intra-abdominal pressure (IAP) has been suggested to decrease the accuracy of dynamic parameters of fluid responsiveness, especially for the distensibility index of the inferior vena cava (∆IVC). The goal of our study was to confirm this limitation in a large series of unselected patients.

Materials and methods This is a sub-study of an observational, prospective and multicenter study (Hemopred) that we conducted between November 2012 and November 2014. All sedated patients under mechanical ventilation who required an echocardiographic assessment for an acute circulatory failure, with an inserted central venous catheter and arterial catheter, were eligible. Acute circulatory failure was defined as a sustained hypotension (systolic blood pressure <90 mmHg or mean blood pressure <65 mmHg) and/or the presence of clinical signs of hypoperfusion (e.g., mottled skin, oliguria), metabolic acidosis (pH <7.35 and base excess less than −5 mmol/L), elevated lactate (>2 mmol/L) or decreased central venous oxygen saturation (ScvO2 <70 %). Dynamic parameters used to predict fluid responsiveness assessed in this study were pulse pressure variations (∆PP) and the following echocardiographic indices: respiratory variations of aortic Doppler maximal velocity (∆V max), collapsibility index of superior vena cava (∆SVC) and ∆IVC.

At the time of echocardiography, a systematic measurement of the bladder pressure was performed as recommended and elevated IAP was defined as a pressure ≥12 mmHg.

Response to fluids was defined by an increase in cardiac output of more than 10 % during a passive leg raising (PLR), as previously validated. Area under the ROC curve (AUC) was built for each recorded dynamic parameter.

Results Among the 540 patients included in the study, 174 (32 %) had an elevated IAP (group 1). No difference was observed compared with the remaining patients without elevated IAP (group 2), except for patients with an abdominal surgery (32 vs 23 %, p = 0.03). Among group 1, 81 patients had an IAP between 12 and 15 mmHg and 93 patients had an IAP >15 mmHg. Central venous pressure (CVP) was increased in group 1 compared with group 2 (11 ± 5 vs 9 ± 5 mmHg, p < 0.001), as well as plateau pressure (Pplat) (20 ± 5 vs 18 ± 5 cmH2O, p < 0.001). In group 1, 81 (46 %) patients were classified as responders by the PLR, compared with 124 (40 %) in group 2 (p = 0.18). No difference between the AUC for ∆IVC (0.64 vs 0.59, p = 0.46), ∆PP (0.71 vs 0.66, p = 0.47) and ∆V max (0.83 vs 0.71, p = 0.06) was observed between groups 1 and 2, respectively, although AUC was increased in group 1 for ∆SVC (0.72 vs 0.82, p = 0.02). No difference was observed regarding the feasibility between the two groups for any parameters, although feasibility for ∆IVC was 74 % in group 1 compared with 80 % in group 2 (p = 0.1).

Conclusion Thirty-two percent of patients in our series of unselected ventilated patient with shock had an elevated IAP. They demonstrated higher CVP and Pplat and more benefited from abdominal surgery. Elevated IAP did not have significant effect on accuracy of dynamic parameters of fluid responsiveness, even though ∆IVC was less frequently recorded (nonsignificant) and ∆SVC had a better prediction.

Competing interests None.

O12 Passive leg raising for predicting fluid responsiveness: a systematic review and meta-analysis

Xavier Monnet1, Paul Marik2, Jean-Louis Teboul1

1Service de réanimation médicale, inserm umr_s 999, Hôpital de Bicêtre, Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France; 2Department of medicine, division of pulmonary and critical care medicine, Eastern Virginia Medical School, Norfolk, USA
Correspondence: Xavier Monnet - xavier.monnet@aphp.fr

Annals of Intensive Care 2016, 6(Suppl 1):O12

Introduction We performed a systematic review and meta-analysis of studies that investigated the passive leg raising (PLR)-induced changes in cardiac output (CO) or surrogates and the PLR-induced changes in arterial pulse pressure (PP) as predictors of fluid responsiveness in adults.