Philippe Vignon

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BACKGROUND International guidelines for management of septic shock recommend that dopamine or norepinephrine are preferable to epinephrine. However, no large comparative trial has yet been done. We aimed to compare the efficacy and safety of norepinephrine plus dobutamine (whenever needed) with those of epinephrine alone in septic shock. METHODS This(More)
Sepsis syndrome (SS) is associated with depressed PAF acetylhydrolase, the enzyme responsible for the degradation of platelet activating factor. PAF acetylhydrolase is in a large part produced by macrophages, whose inadequate activation with haemophagocytosis is frequent in patients with SS. The aim of this study was to test the hypothesis that PAF(More)
INTRODUCTION Conventional pulsed wave Doppler parameters are known to be preload dependent, whereas newly proposed Doppler indices may be less influenced by variations in loading conditions. The aim of the present study was to evaluate the effects of haemodialysis-induced preload reduction on both conventional and new Doppler parameters for the assessment(More)
INTRODUCTION To evaluate the ability of transthoracic echocardiography (TTE) to detect the effects of spontaneous breathing trial (SBT) on central hemodynamics and to identify indices predictive of cardiac-related weaning failure. METHODS TTE was performed just before and at the end of a 30-min SBT in 117 patients fulfilling weaning criteria. Maximal(More)
BACKGROUND The efficacy of corticosteroids in reducing the incidence of postextubation laryngeal oedema is controversial. We aimed to test our hypothesis that methylprednisolone started 12 h before a planned extubation could prevent postextubation laryngeal oedema. METHODS We did a placebo-controlled, double-blind multicentre trial in 761 adults in(More)
STUDY OBJECTIVES To compare the diagnostic capability of recently available hand-held echocardiography (HHE) and of conventional transthoracic echocardiography (TTE) used as a gold standard in critically ill patients under mechanical ventilation. DESIGN A prospective and descriptive study. SETTING The general intensive care unit of a teaching hospital.(More)
BACKGROUND Non-invasive evaluation of left ventricular filling pressure has been scarcely studied in critically ill patients. Accordingly, we prospectively assessed the ability of transoesophageal echocardiography (TEE) Doppler to predict an invasive pulmonary artery occlusion pressure (PAOP) < or = 18 mmHg in ventilated patients. METHODS During two(More)
INTRODUCTION We evaluated the efficacy of and tolerance to mild therapeutic hypothermia achieved using an endovascular cooling system, and its ability to reach and maintain a target temperature of 33 degrees C after cardiac arrest. METHODS This study was conducted in the medical-surgical intensive care unit of an urban university hospital. Forty patients(More)
INTRODUCTION Assessment of cardiac function is key in the management of intensive care unit (ICU) patients and frequently relies on the use of standard transthoracic echocardiography (TTE). A commercially available new generation ultrasound system with two-dimensional imaging capability, which has roughly the size of a mobile phone, is adequately suited to(More)
BACKGROUND Diastolic wall motion asynchrony is a major determinant of impaired left ventricular (LV) filling in patients with concentric hypertrophy and coronary artery disease. We evaluated the ability of Color Kinesis, a new echocardiographic technique that color-encodes endocardial motion, to quantitatively assess global and regional LV filling(More)