References of "MORIMONT, Philippe"
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See detailFeasibility and safety of extracorporeal CO2 removal to enhance protective ventilation in acute respiratory distress syndrome: the SUPERNOVA study.
Combes, Alain; Fanelli, Vito; Ranieri, Vito Marco et al

in Intensive Care Medicine (2019)

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See detailExtracorporeal CO2 removal and regional citrate anticoagulation in an experimental model of hypercapnic acidosis.
Morimont, Philippe ULiege; Habran, Simon; Desaive, Thomas ULiege et al

in Artificial Organs (2019)

Low flow extracorporeal veno-venous CO2 removal (ECCO2 R) therapy is used to remove CO2 while reducing ventilation intensity. However, the use of this technique is limited because efficiency of CO2 ... [more ▼]

Low flow extracorporeal veno-venous CO2 removal (ECCO2 R) therapy is used to remove CO2 while reducing ventilation intensity. However, the use of this technique is limited because efficiency of CO2 removal and potential beneficial effects on pulmonary hemodynamics are not precisely established. Moreover, this technique requires anticoagulation that may induce severe complications in critically ill patients. This study aimed at determining precisely efficiency of CO2 extraction and its effects on right ventricular (RV) afterload, and comparing regional anticoagulation with citrate to systemic heparin anticoagulation during ECCO2 R. ECCO2 R was highly efficient to normalize pH and PaCO2 and to reduce RV afterload resulting from hypercapnic acidosis. Regional anticoagulation with citrate solution was as effective as standard heparin anticoagulation but did not improve CO2 removal and lead to more hypocalcemia and hypotension. [less ▲]

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See detailInsulin-Only STAR: Liège Clinical Trial Interim Results on Safety and Efficacy
Uyttendaele, Vincent ULiege; Knopp, Jennifer L.; PIROTTE, Marc ULiege et al

Poster (2018, November)

Objective: Stress-induced hyperglycaemia and insulin resistance is common in critically ill patients and associated with worsened outcomes. STAR (Stochastic TARgeted) glycaemic control (GC) has proven ... [more ▼]

Objective: Stress-induced hyperglycaemia and insulin resistance is common in critically ill patients and associated with worsened outcomes. STAR (Stochastic TARgeted) glycaemic control (GC) has proven effective over different units and clinical practices. However, this risk-based dosing approach uses both insulin and nutrition to control glycemia, where virtually all others use insulin only. This study uses STAR with insulin only and nutrition set clinically in the University Hospital of Liège, Belgium, to assess safety and efficacy in this use. Method: STAR-Liège is an insulin-only version of STAR targeting 80-145mg/dL. Patient are included if two successive BG measurements are >145mg/dL. Insulin is administered through IV catheter continuously and nutrition clinically set. GC was stopped after 72h or if BG was stable at insulin rate ≤2U/h. Safety is assessed by the %BG in severe (<40mg/dL), mild (<72mg/dL) hypoglycaemia, and >180mg/dL. Performance is evaluated by the %BG within target band and median BG. Clinical data from the first 11 patients is analysed, totalling 645 hours of control. Ethics approval was granted by the University Hospital of Liège Ethics Committee. Results: The insulin-only STAR-Liège protocol showed high performance, with median [IQR] BG of 122 [106, 147] mg/dL and 78% BG in target band. Mild hypoglycaemia occurred 1.6% of time, but there was no incidence of severe hypoglycaemia. Additionally, only 9.8% BG>180mg/dL, and administered insulin and nutrition was 4.0 [1.8, 4.6] U/h and 8.1 [4.9, 9.2] g/h. Conclusions: Insulin-only GC with the STAR-Liège protocol provided equally high control safety and quality for all patients. These results are encouraging, comparable to previous studies, and supporting STAR risk-based dosing approach as a robust solution across different ICU settings and usages, and support continuation of the clinical trial. [less ▲]

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See detailLeft ventricular ejection fraction depends on loading conditions.
MORIMONT, Philippe ULiege; LAMBERMONT, Bernard ULiege

in ASAIO Journal (2018)

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See detailMathematical modeling of extracorporeal CO2 removal therapy. A validation carried out on ten pigs
Habran, Simon ULiege; Desaive, Thomas ULiege; MORIMONT, Philippe ULiege et al

in Medical and Biological Engineering and Computing (2018), 56(3), 421-434

The extracorporeal CO2 removal device (ECCO2RD) is used in clinics to treat patients suffering from respiratory failures like acute respiratory distress syn- drome (ARDS) or chronic obstructive pulmonary ... [more ▼]

The extracorporeal CO2 removal device (ECCO2RD) is used in clinics to treat patients suffering from respiratory failures like acute respiratory distress syn- drome (ARDS) or chronic obstructive pulmonary disease (COPD). The aim of this device is to decarboxylate blood externally with low blood flow. A mathematical model is proposed to describe protective ventilation, ARDS, and an extracorporeal CO2 removal therapy (ECCO2RT). The sim- ulations are compared with experimental data carried out on ten pigs. The results show a good agreement between the mathematical simulations and the experimental data, which provides a nice validation of the model. This model is thus able to predict the decrease of PCO2 during ECCO2RT for different blood flows across the extracorporeal lung support. [less ▲]

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See detailAfterload burden on the right ventricle is enhanced when ARDS is associated with hypercapnic acidosis.
MORIMONT, Philippe ULiege; Habran, Simon ULiege; Desaive, Thomas ULiege et al

in Annals of Intensive Care (2018, February 05), 8(1),

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See detailCost-Effectivness of ECCO2R in the management of acute respiratory distress syndrome (ARDS)
Ethgen, Olivier ULiege; Makhija, Dilip; Harenski, Kai et al

in Critical Care Medicine (2018)

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See detailPreliminary results from the STAR-Liège clinical trial: Virtual trials, safety, performance, and compliance analysis
Uyttendaele, Vincent ULiege; Knopp, Jennifer L.; PIROTTE, Marc ULiege et al

in IFAC-PapersOnLine (2018)

Glycaemic control has been shown to improve outcome in critically ill patients, but hard to achieve in a safe and effective manner. This paper presents the preliminary results of 8 patients controlled at ... [more ▼]

Glycaemic control has been shown to improve outcome in critically ill patients, but hard to achieve in a safe and effective manner. This paper presents the preliminary results of 8 patients controlled at the University Hospital of Liège under STAR-Liège, an insulin-only version of the model-based STAR glycaemic controller framework. Clinical data is compared with virtual trial simulations of the glycaemic control outcomes for the STAR-Liège protocol, and with the standard of care protocol of this intensive care unit, to assess safety, performance, and compliance of the new protocol. Results show 78% of clinical blood glucose measurements in target band. Only 3% of blood glucose measurements were below 4.4 mmol/L (79 mg/dL), with only 1% mild hypoglycaemia and no severe hypoglycaemia. These results are similar to simulation of the protocol, but slightly higher workload is observed clinically due to nursing choice. Compared to standard protocol virtual trial simulations, STAR-Liège achieved tighter and less variable control with similar safety, and less percentage time in higher blood glucose levels. Clinically, 14% of insulin intervention were increased or decreased from recommendation with median [IQR] change of 1 [1, 2] or -2 [-3, -2] U/hr respectively. Clinical and simulation results show STAR-Liège better controls glycaemia to lower ranges compared to the standard protocol, while ensuring safety. Lower time in higher blood glucose ranges potentially improves patient outcomes. Compliance analysis shows potential nurse fears in protocol changes and different insulin dosing. These results are encouraging for the continuation of the clinical trial realised in this medical intensive care unit and its extension to insulin and nutrition control. [less ▲]

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See detailA mathematical model of respiration under protective ventilation and extracorporeal CO2 removal therapy
Habran, Simon ULiege; Desaive, Thomas ULiege; MORIMONT, Philippe ULiege et al

Conference (2017, September 27)

The aim of the present study is to build a mathematical model of the respiratory system connected to an extracorporeal CO2 removal device (ECCO2RD) to optimize the gas exchanges efficiency. The model must ... [more ▼]

The aim of the present study is to build a mathematical model of the respiratory system connected to an extracorporeal CO2 removal device (ECCO2RD) to optimize the gas exchanges efficiency. The model must be simple enough to provide rapid solutions and to estimate specific parameters from available clinical data. But it also must be complex enough to be able to simulate the respiratory system when protective ventilation is used and when this system is assisted by an ECCO2RD. [less ▲]

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See detailMinimally invasive estimation of ventricular dead space volume through use of Frank-Starling curves.
Davidson, Shaun; Pretty, Chris; Pironet, Antoine et al

in PLoS ONE (2017), 12(4), 1-11

This paper develops a means of more easily and less invasively estimating ventricular dead space volume (Vd), an important, but difficult to measure physiological parameter. Vd represents a subject and ... [more ▼]

This paper develops a means of more easily and less invasively estimating ventricular dead space volume (Vd), an important, but difficult to measure physiological parameter. Vd represents a subject and condition dependent portion of measured ventricular volume that is not actively participating in ventricular function. It is employed in models based on the time varying elastance concept, which see widespread use in haemodynamic studies, and may have direct diagnostic use. The proposed method involves linear extrapolation of a Frank-Starling curve (stroke volume vs end-diastolic volume) and its end-systolic equivalent (stroke volume vs end-systolic volume), developed across normal clinical procedures such as recruitment manoeuvres, to their point of intersection with the y-axis (where stroke volume is 0) to determine Vd. To demonstrate the broad applicability of the method, it was validated across a cohort of six sedated and anaesthetised male Pietrain pigs, encompassing a variety of cardiac states from healthy baseline behaviour to circulatory failure due to septic shock induced by endotoxin infusion. Linear extrapolation of the curves was supported by strong linear correlation coefficients of R = 0.78 and R = 0.80 average for pre- and post- endotoxin infusion respectively, as well as good agreement between the two linearly extrapolated y-intercepts (Vd) for each subject (no more than 7.8% variation). Method validity was further supported by the physiologically reasonable Vd values produced, equivalent to 44.3-53.1% and 49.3-82.6% of baseline end-systolic volume before and after endotoxin infusion respectively. This method has the potential to allow Vd to be estimated without a particularly demanding, specialised protocol in an experimental environment. Further, due to the common use of both mechanical ventilation and recruitment manoeuvres in intensive care, this method, subject to the availability of multi-beat echocardiography, has the potential to allow for estimation of Vd in a clinical environment. [less ▲]

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See detailComment je traite... l'intoxication massive aux bêta-bloquants: approches pharmacologiques et place de l'ECMO
HORWARD, P; LAMBERMONT, Bernard ULiege; DEFRAIGNE, Jean ULiege et al

in Revue Médicale de Liège (2017)

Nous rapportons un cas d’intoxication sévère aux bêta-bloquants. Après l’échec des traitements pharmacologiques, la patiente a bénéficié d’une assistance circulatoire externe de type ECMO (ExtraCorporeal ... [more ▼]

Nous rapportons un cas d’intoxication sévère aux bêta-bloquants. Après l’échec des traitements pharmacologiques, la patiente a bénéficié d’une assistance circulatoire externe de type ECMO (ExtraCorporeal Membrane Oxygenation ou oxygénation par membrane extracorporelle). Nous discutons des traitements pharmacologiques conventionnels et des traitements qui ont émergé durant cette dernière décennie, comme l’insulinothérapie à haute dose et les émulsions lipidiques. L’ECMO a fait des progrès importants ces dernières années et est devenue, à l’heure actuelle, la méthode d’assistance circulatoire externe de première ligne en cas de défaillance cardiaque et/ou respiratoire. Nous verrons sa place dans la prise en charge de l’intoxication massive aux drogues cardiodépressives. [less ▲]

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See detailThe added value of plasma or urinary NGAL concentrations in clinical practice
Gregoire, Emilien ULiege; Claisse, Guillaume; GUIOT, Julien ULiege et al

Poster (2017, January 13)

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See detailEffect of citrate anticoagulation on CO2 extraction during low flow extracorporeal veno-venous CO2 removal therapy
MORIMONT, Philippe ULiege; Habran, Simon ULiege; Hubert, Romain et al

in Intensive Care Medicine Experimental (2016), 4

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See detailA Comparison between four Techniques to Measure Cardiac Output
Pironet, Antoine ULiege; Dauby, Pierre ULiege; Chase, J. Geoffrey et al

in Proceedings of the 38th International Conference of the IEEE Engineering in Medicine and Biology Society (2016, August 17)

Cardiac output is an important variable when monitoring hemodynamic status. In particular, changes in cardiac output represent the goal of several circulatory management therapies. Unfortunately, cardiac ... [more ▼]

Cardiac output is an important variable when monitoring hemodynamic status. In particular, changes in cardiac output represent the goal of several circulatory management therapies. Unfortunately, cardiac output is very difficult to estimate, either in experimental or clinical settings. The goal of this work is to compare four techniques to measure cardiac output: pressure-volume catheter, aortic flow probe, thermodilution, and the PiCCO monitor. These four techniques were simultaneously used during experiments of fluid and endotoxin administration on 7 pigs. Findings show that, first, each individual technique is precise, with a relative coefficient of repeatability lower than 7 %. Second, 1 cardiac output estimate provided by any technique relates poorly to the estimates from the other 3, even if there is only small bias between the techniques. Third, changes in cardiac output detected by one technique are only detected by the others in 62 to 100 % of cases. This study confirms the difficulty of obtaining a reliable clinical cardiac output measurement. Therefore, several measurements using different techniques should be performed, if possible, and all such should be treated with caution. [less ▲]

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See detailA Comparison between four Techniques to Measure Cardiac Output
Pironet, Antoine ULiege; Dauby, Pierre ULiege; Chase, J. Geoffrey et al

Poster (2016, August 17)

Detailed reference viewed: 38 (11 ULiège)