ブックタイトル第43回日本集中治療医学会学術集会プログラム・抄録集

概要

第43回日本集中治療医学会学術集会プログラム・抄録集

－175－IL10Southwest Pulmonary Associates at Texas Health Presbyterian Dallas, USAGary L WeinsteinFollowing the diagnosis of Ebola Virus Disease in Dallas, Texas in the fall of 2014, we became acutely aware of the need toscreen and be prepared for all potential diseases that may possibly come to our hospital.This talk will include information about- which diseases are considered emerging diseases- how to screen patients for emerging diseases- what type of isolation is recommended for each- how to handle PUIs（Patients Under Investigation）- how to set up a care area for these patients- use of a phone tree for notification- who should be caring for theses patients- the importance of training and drilling- managing the message招聘講演 10 2月13日（土）　16：50～17：30　第8会場Management of Patients with a Novel Virus（Emerging Diseases）IL11Department of Anesthesia and Critical care, University Hospitals Saint Louis-Lariboisiere; U942 Inserm; University ParisDiderot, Paris, FranceAlexandre MebazaaIntroduction. Previous studies have shown that ICU（intensive care unit）survivors have decreased long-term survival ratescompared to the general population. However, knowledge about how to identify ICU survivors with higher risk of death and theadjustable factors associated with mortality is still lacking.Objectives. FROG-ICU aims to identify the clinical and biological phenotype of patients with different levels of probability ofdeath in the year after ICU discharge.Methods. The FROG-ICU study was an epidemiological, observational, non-interventional, prospective and multicenter cohortstudy where ICU survivors were followed up to one year after ICU discharge. All consecutive patients admitted to the 22participating centers during the study period and receiving mechanical ventilation and/or vasopressors for more than 24h wereincluded. Every subject underwent a complete evaluation at admission, throughout the ICU stay and at ICU discharge. Theglobal, especially cardiovascular, assessment of each subject was performed through a complete clinical exam and biologicalparameters. Blood and urine samples were collected at admission and at discharge with the primary goal to assess effectivenessof novel biomarkers, with potential interest in risk stratification for patients who survive an ICU stay. The follow up included acareful tracking of patients through telephone calls and questionnaires at 3, 6 and 12 months after ICU discharge.Results. Among the 2087 patients analyzed, 452（26.7%）died during their ICU stay. The frequent causes of ICU admissionwere severe sepsis or septic shock（26%）, acute respiratory failure（19%）and cardiac arrest（9%）. Analyses concern 1570patients ICU survivors. One year after ICU discharge, 333（19.6%）patients died. Multivariate analysis identified comorbidities,ICU length of stay > 20 days, blood pressure and inflammatory markers as independent factors of one-year mortality. Two novelcardiovascular biomarkers, soluble ST2 and bioactive adrenomedullin, had strong added value to risk stratify patients at ICUdischarge.Conclusions. In this prospective, multicenter, observational study, one patient over five did not survive at one year after havingbeen discharged alive from ICU. Preliminary analysis of FROG ICU suggests that comorbidities are important factors associatedwith the risk of death in the year following ICU stay. Cardiovascular biomarkers have strong added value.Aknowledgement. This study was supported by a national grant from the PHRC（AON 10-216）and from the Societe Francaised’Anesthesie ? Reanimation（SFAR）. A special thanks to all investigators and their team, to patients and families, to the URCLariboisiere, to the DRCD of APHP and to Marie-Celine Fournier for her major contribution to the study.招聘講演 11 2月13日（土）　14：40～15：30　第11会場Post-ICU disease: the French and euRopean Outcome reGistry in Intensive Care Unit（FROG-ICU）study