Baclofène : traitement révolutionnaire ou polémique française ?

Morpho-functional evaluation of lung aeration as a marker of sickle-cell acute chest syndrome severity in the ICU: a prospective cohort study

“…All patients over 18 years suffering from severe ACS were prospectively included in this single-centre prospective observational study within the first 12 h of admission into the Tenon University Hospital ICU (Paris, France) between March 2013 and September 2014. ACS was defined as new pulmonary infiltrate on the chest X-ray and at least one of the following criteria: fever, cough, acute dyspnoea, thoracic pain, pulmonary crackles or tubal blowing sound [7, 11]. ACS severity was defined according to French recommendations (see Additional file 1: Methods) [11].…”

“…ACS was defined as new pulmonary infiltrate on the chest X-ray and at least one of the following criteria: fever, cough, acute dyspnoea, thoracic pain, pulmonary crackles or tubal blowing sound [7, 11]. ACS severity was defined according to French recommendations (see Additional file 1: Methods) [11]. Patients re-admitted for a second severe ACS during the study period were not re-included.…”

“…Inclusion did not modify patient care, conducted according to French recommendations [11]. Briefly, standard care included bed rest, oxygen therapy, respiratory physiotherapy, incentive spirometry, intravenous hydration, and folate supplementation.…”

“…Briefly, standard care included bed rest, oxygen therapy, respiratory physiotherapy, incentive spirometry, intravenous hydration, and folate supplementation. Pain was managed using an incremental protocol adapted from national recommendations [11] (Additional file 3: Figure S1). Indication of red blood cell transfusion followed recommendations [11] and was systematically validated jointly by a local SCD referent physician and the attending intensivist before transfusion.…”

“…More recently, lung ultrasound (LU) has been reported as a reliable tool for diagnosis of lung condensation compared to CT-scan [8, 10]. Finally, a functional approach could be used to estimate the amount of aerated lung, notably by measuring the Inspiratory Vital Capacity (IVC) at bedside when patients performed incentive spirometry [11, 12].…”