Research Topics
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Publications
Efficacy and safety of intravenous infusion of doripenem versus imipenem in ventilator-associated pneumonia: a multicenter, randomized studyJean Chastre
Service de Reanimation Medicale, Groupe Hospitalier Pitie Salpetriere, Assistance Publique Hopitaux de Paris, Universite Pierre et Marie Curie Paris 6, Paris, France
Crit Care Med 36:1089-96. 2008..This large, phase III study compared doripenem with imipenem for the treatment of ventilator-associated pneumonia...
Ventilator-associated pneumoniaJean Chastre
Service de Reanimation Medicale, Groupe Hospitalier Pitie Salpetriere, France
Am J Respir Crit Care Med 165:867-903. 2002..Further trials will be needed to clarify the optimal duration of treatment and the circumstances in which monotherapy can be safely used...
Conference summary: ventilator-associated pneumoniaJean Chastre
Service de Reanimation Medicale, Institut de Cardiologie, Hopital Pitie Salpetriere, 43 87 bd de l Hôpital, 75651 Paris Cedex 13, France
Respir Care 50:975-83. 2005....
Antimicrobial treatment of hospital-acquired pneumoniaJean Chastre
Service de Réanimation Médicale Institut de Cardiologie, Hopital Pitie Salpetriere, Paris, France
Infect Dis Clin North Am 17:727-37, vi. 2003..Great efforts should be placed to obtain reliable pulmonary specimens for direct microscopic examination and cultures in each patient clinically suspected of having developed nosocomial pneumonia before new antibiotics are administered...
Ventilator-associated pneumonia: what is new?Jean Chastre
Institut de Cardiologie, Hopital Pitie Salpetriere, Paris, France
Surg Infect (Larchmt) 7:S81-5. 2006..However, effective antimicrobial therapy for patients with true VAP can be achieved while avoiding excessive antibiotic use and the emergence of multidrug-resistant strains in the ICU...
The invasive (quantitative) diagnosis of ventilator-associated pneumoniaJean Chastre
Service de Reanimation Medicale, Institut de Cardiologie, Hopital Pitie Salpetriere, 43 87 bd de l Hôpital, 75651 Paris Cedex 13, France
Respir Care 50:797-807; discussion 807-12. 2005..Bronchoalveolar lavage may also provide useful clues for the diagnosis of other forms of respiratory failure, such as pulmonary hemorrhage or other types of infections, especially in immunocompromised patients...
Use of quantitative cultures and reduced duration of antibiotic regimens for patients with ventilator-associated pneumonia to decrease resistance in the intensive care unitJean Chastre
Service de Reanimation Medicale, Institut de Cardiologie, Groupe Hospitalier Pitie Salpetriere, 75651 Paris Cedex 13, France
Clin Infect Dis 43:S75-81. 2006....
Evolving problems with resistant pathogensJ Chastre
Universite Paris 6 Pierre et Marie Curie, Service de Reanimation Medicale, Institut de Cardiologie, Hopital Pitie Salpetriere, AP HP, Paris, France
Clin Microbiol Infect 14:3-14. 2008..Managing infections caused by today's pathogens requires avoidance of antimicrobial agent overuse and appropriate selection, dosing and duration of efficacious antimicrobial therapy...
Early predictors for infection recurrence and death in patients with ventilator-associated pneumoniaAlain Combes
Service de Reanimation Medicale, Hopital Pitie Salpetriere, Assistance Publique Hopitaux de Paris, Universite Pierre et Marie Curie, Paris 6, France
Crit Care Med 35:146-54. 2007..The objective of this study was to describe resolution of VAP variables and to determine early predictors of VAP recurrence and death...
Nosocomial pneumonia in patients with acute respiratory distress syndromeJ Chastre
Service de Reanimation Medicale, Hopital Bichat, Paris, France
Am J Respir Crit Care Med 157:1165-72. 1998..aureus and other multiresistant microorganisms...
Role of serial routine microbiologic culture results in the initial management of ventilator-associated pneumoniaJan Hayon
, and Service de Microbiologie, , , Paris, France
Am J Respir Crit Care Med 165:41-6. 2002..Based on these data, the contribution of routine microbiologic specimens in guiding initial antimicrobial therapy decisions for patients with suspected VAP appears limited...
Problem pathogens (Pseudomonas aeruginosa and Acinetobacter)J Chastre
Service de Reanimation Medicale, H pital Bichat Claude Bernard, Paris, France
Semin Respir Infect 15:287-98. 2000..Future research efforts should also aim to improve our ability to diagnose and exclude infection in the ICU setting to avoid administering unnecessary antibiotics to patients without true pulmonary infection...
Value of the clinical pulmonary infection score for the identification and management of ventilator-associated pneumoniaCharles-Edouard Luyt
, Institut de Cardiologie, , , 75651 Paris Cedex 13, France
Intensive Care Med 30:844-52. 2004..CONCLUSION: A strategy based on the CPIS to decide which patients with suspected VAP should receive prolonged administration of antibiotics would appear to over-prescribe these agents, as compared to a strategy based on bronchoscopy...
Use of procalcitonin to reduce patients' exposure to antibiotics in intensive care units (PRORATA trial): a multicentre randomised controlled trialLila Bouadma
Service de Reanimation Medicale, Universite Paris 7 Denis Diderot, Hopital Bichat Claude Bernard, Assistance Publique Hopitaux de Paris, Paris, France
Lancet 375:463-74. 2010..We aimed to establish the effectiveness of an algorithm based on the biomarker procalcitonin to reduce antibiotic exposure in this setting...
Diagnosis and treatment of nosocomial pneumonia in ALI/ARDS patientsJ Y Fagon
Services de Réanimation Médicale, Hôpital Européen Georges Pompidou and Groupe Hospitalier Pitié Salpêtrière, Paris, France
Eur Respir J Suppl 42:77s-83s. 2003..Thus, before new antiboitics are administered, reliable pulmonary specimens must be obtained for direct examination and cultures...
Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trialJean Chastre
, , AP-HP, Paris, France
JAMA 290:2588-98. 2003..The 8-day group had less antibiotic use...
Impact of piperacillin resistance on the outcome of Pseudomonas ventilator-associated pneumoniaAlain Combes
Groupe Hospitalier Pitie Salpetriere, Assistance Publique, Hôpitaux de Paris Université Pierre et Marie Curie, Paris 6, Service de Reanimation Medicale, Institut de Cardiologie, Paris, France
Intensive Care Med 32:1970-8. 2006....
Controversies in ventilator-associated pneumoniaAlain Combes
Service de Reanimation Medicale, Hopital Pitie Salpetriere, Assistance Publique Hopitaux de Paris, Universite Pierre et Marie Curie, Paris, France
Semin Respir Crit Care Med 31:47-54. 2010....
Novel and innovative strategies to treat ventilator-associated pneumonia: optimizing the duration of therapy and nebulizing antimicrobial agentsIvan Goldstein
, Institut de Cardiologie, , Paris, France
Semin Respir Crit Care Med 27:82-91. 2006..The superiority in terms of pulmonary penetration and antibacterial efficacy of this route of administration was demonstrated in a model of ventilated piglets with and without bronchopneumonia...
Mortality among patients admitted to intensive care units during weekday day shifts compared with "off" hoursCharles Edouard Luyt
Service de Reanimation Medicale, Institut de Cardiologie, Groupe Hospitalier Pitie Salpetriere, Paris, France
Crit Care Med 35:3-11. 2007....
Morbidity, mortality, and quality-of-life outcomes of patients requiring >or=14 days of mechanical ventilationAlain Combes
, , , France
Crit Care Med 31:1373-81. 2003..Future studies should focus on physical or psychosocial rehabilitation that could lead to improved management of patients after their ICU stay...
Pulmonary disposition of roxithromycin (RU 28965), a new macrolide antibioticJ Chastre
Service de Reanimation Medicale, Hopital Bichat, Paris, France
Antimicrob Agents Chemother 31:1312-6. 1987....
Pseudomonas aeruginosa ventilator-associated pneumonia: comparison of episodes due to piperacillin-resistant versus piperacillin-susceptible organismsJ L Trouillet
Hopital Pitie Salpetriere, 75651 Paris Cedex 13, France
Clin Infect Dis 34:1047-54. 2002..Restricted fluoroquinolone use is the sole independent risk factor for PRPA VAP that is open to medical intervention...
Is it possible to cure mediastinitis in patients with major postcardiac surgery complications?A Combes
Service de Reanimation Medicale, Hopital Bichat, Paris, France
Ann Thorac Surg 72:1592-7. 2001..The prognosis for mediastinitis after cardiac operation has improved during the last two decades, but most series do not include patients who already have a major postoperative complication when the infection developed...
Tidal volume reduction for prevention of ventilator-induced lung injury in acute respiratory distress syndrome. The Multicenter Trail Group on Tidal Volume reduction in ARDSL Brochard
Medical Intensive Care Unit, Henri Mondor Hospital, Assistance Publique Hopitaux de Paris, Université Paris XII and INSERM U 492, Creteil, France
Am J Respir Crit Care Med 158:1831-8. 1998....
Incidence and outcome of polymicrobial ventilator-associated pneumoniaAlain Combes
Service de Reanimation Medicale, Hopital Bichat, AP HP, Paris, France
Chest 121:1618-23. 2002..To determine the epidemiology and outcome of polymicrobial ventilator-associated pneumonia (VAP)...
Factors predicting ventilator-associated pneumonia recurrenceAlain Combes
, , , Paris, France
Crit Care Med 31:1102-7. 2003..CONCLUSIONS: Factors of ventilator-associated pneumonia recurrence evaluated on D8 of a 14-day course of antibiotics are linked to the severity of lung injury and persistence of fever, but not to first-episode pathogen(s)...
Does invasive diagnosis of nosocomial pneumonia during off-hours delay treatment?Charles Edouard Luyt
Universite Pierre et Marie Curie, Service de Reanimation Medicale, Groupe Hospitalier Pitie Salpetriere, Assistance Publique Hopitaux de Paris, 47 Boulevard de l Hopital, 75651, Paris Cedex 13, France
Intensive Care Med 33:734-7. 2007..m. to 8:29 a.m. the next day for night shifts, from Saturday 1:00 p.m. to Monday 8:29 a.m. for weekends, and from 8:30 a.m. to 8:29 a.m. the following morning for public holidays)...
[New legislation about clinical research involving "usual care": reminder of recent problems]Francois Lemaire
Service de Reanimation Medicale, Hopital Henri Mondor, AP HP, Universite Paris Val de Marne, Creteil
Presse Med 36:1167-73. 2007..2004-800) and on data (the so-called CNIL act, L. 2004-801). The value of this set of texts (statutes, decrees, and regulations) is that it diversifies and clarifies the different forms of clinical research...
Clinical and autopsy diagnoses in the intensive care unit: a prospective studyAlain Combes
Services de Réanimation Médicale, Hopital Bichat, Assistance Publique Hopitaux de Paris, Paris, France
Arch Intern Med 164:389-92. 2004..Autopsy rates have declined worldwide, but recent retrospective intensive care unit (ICU) data indicate major discrepancies between more than 25% of clinical and autopsy diagnoses...
New diagnostic and prognostic markers of ventilator-associated pneumoniaJean Chastre
Medical Intensive Care Unit, Pitie Salpetriere Hospital, Pierre and Marie Curie University, Paris, France
Curr Opin Crit Care 12:446-51. 2006..The purpose of this review is to analyze the potential advantages and drawbacks of using biomarkers of bacterial infection for the diagnosis and prognosis of ventilator-associated pneumonia...
The impact of methicillin resistance on the outcome of poststernotomy mediastinitis due to Staphylococcus aureusAlain Combes
Service de Reanimation Medicale, Institut de Cardiologie, Hôpital PitiéSalpêtrière, Paris, France
Clin Infect Dis 38:822-9. 2004..Methicillin resistance did not significantly affect ICU mortality among patients with poststernotomy mediastinitis who benefited from optimal treatments...
Impact of methicillin resistance on outcome of Staphylococcus aureus ventilator-associated pneumoniaAlain Combes
Service de Reanimation Medicale, Hopital Pitie Salpetriere, 75651 Paris Cedex 13, France
Am J Respir Crit Care Med 170:786-92. 2004....
Acute poststernotomy mediastinitis managed with debridement and closed-drainage aspiration: factors associated with death in the intensive care unitJean Louis Trouillet
Service de Reanimation Medicale, Hôpital La Pitié Salpêtrière Assistance Publique Hôpitaux de Paris, France
J Thorac Cardiovasc Surg 129:518-24. 2005..The purpose of the study is to describe an intensive care unit's experience in the treatment of poststernotomy mediastinitis and to identify factors associated with intensive care unit death...
Antimicrobial treatment of hospital-acquired pneumoniaJean Yves Fagon
University Paris 5, Service de Reanimation Medicale, Hopital Europeen Georges Pompidou, 20, rue Leblanc, Paris 75015, France
Clin Chest Med 26:97-104. 2005..To meet these goals, a strategy for the management of suspected ventilator-associated pneumonia should include obtaining reliable pulmonary specimens for direct microscope examination and cultures before new antibiotics are administered...
Procalcitonin kinetics as a prognostic marker of ventilator-associated pneumoniaCharles Edouard Luyt
Service de Reanimation Medicale, Institut de Cardiologie, Groupe Hospitalier Pitie Salpetriere, 47, Boulevard de l Hopital, 75651 Paris Cedex 13, France
Am J Respir Crit Care Med 171:48-53. 2005..Multivariate analyses retained serum procalcitonin levels on Days 1, 3, and 7 as strong predictors of unfavorable outcome. Based on these data, procalcitonin could be a prognostic marker of outcome during VAP...
Diagnostic techniques and procedures for establishing the microbial etiology of ventilator-associated pneumonia for clinical trials: the pros for quantitative culturesJean Chastre
Service de Reanimation Medicale, Institut de Cardiologie, Hopital Pitie Salpetriere, Assistance Publique Hopitaux de Paris, Universite Pierre et Marie Curie, Paris, France
Clin Infect Dis 51:S88-92. 2010....
Is tracheostomy associated with better outcomes for patients requiring long-term mechanical ventilation?Alain Combes
Service de Reanimation Medicale, Hopital Pitie Salpetriere, Assistance Publique Hopitaux de Paris, Universite Pierre et Marie Curie, Paris, France
Crit Care Med 35:802-7. 2007..To evaluate the effect of tracheostomy on intensive care unit (ICU) and in-hospital mortality for patients requiring prolonged (> 3 days) mechanical ventilation (MV)...
Usefulness of procalcitonin for the diagnosis of ventilator-associated pneumoniaCharles Edouard Luyt
Service de Reanimation Medicale, Groupe Hospitalier Pitie Salpetriere, Universite Paris 6, 75651, Paris Cedex 13, France
Intensive Care Med 34:1434-40. 2008..To assess the predictive capacity for the diagnosis of ventilator-associated pneumonia (VAP) of serum procalcitonin levels before and on the day it is suspected...
Adverse effect on a referral intensive care unit's performance of accepting patients transferred from another intensive care unitAlain Combes
, , Paris, France
Crit Care Med 33:705-10. 2005..Future benchmarking and profiling systems should evaluate and adequately account for the ICU-transfer factor to provide healthcare payers and consumers with more accurate and valid information on the true performance of referral centers...
Viral infections in the ICUCharles Edouard Luyt
Service de Reanimation Medicale, Institut de Cardiologie, Groupe Hospitalier Pitie Salpetriere, Paris, and Université Paris 6 Pierre et Marie Curie, France
Curr Opin Crit Care 14:605-8. 2008..The present study reviews the precise role of viruses as causes of pneumonia in mechanically ventilated patients...
Other therapeutic modalities and practices: implications for clinical trials of hospital-acquired or ventilator-associated pneumoniaJean Chastre
Service de Reanimation Medicale, Institut de Cardiologie, Hopital Pitie Salpetriere, Assistance Publique Hopitaux de Paris, Universite Pierre et Marie Curie, Paris, France
Clin Infect Dis 51:S54-8. 2010..Until results of these trials are known, antibiotic aerosolization can be recommended only for treating patients with multidrug-resistant VAP, for which no effective intravenous regimen is available...
Prolonged mechanical ventilation after cardiac surgery: outcome and predictorsJean Louis Trouillet
Service de Reanimation Medicale, Institut de Cardiologie, Hopital Pitie Salpetriere, Assistance Publique Hopitaux de Paris, Universite Paris 6 Pierre et Marie Curie, Paris, France
J Thorac Cardiovasc Surg 138:948-53. 2009..Our objective was to identify patients still requiring mechanical ventilation 3 days after the operation and those successfully weaned by day 10 to avoid needless and potentially hazardous interventions, such as tracheostomy...
Pharmacokinetics and lung delivery of PDDS-aerosolized amikacin (NKTR-061) in intubated and mechanically ventilated patients with nosocomial pneumoniaCharles Edouard Luyt
Service de Reanimation Medicale, Groupe Hospitalier Pitie Salpetriere, Assistance Publique Hopitaux de Paris, Université Paris Pierre et Marie Curie, 75651 Paris Cedex 13, France
Crit Care 13:R200. 2009....
Gender impact on the outcomes of critically ill patients with nosocomial infectionsAlain Combes
Service de Reanimation Medicale, Hopital Pitie Salpetriere, Assistance Publique Hopitaux de Paris, Universite Pierre et Marie Curie, Paris, France
Crit Care Med 37:2506-11. 2009..Highly controversial data exist regarding gender-related differences in outcomes of severe nosocomial infections, reflecting potential confounders related to case-mixes or heterogeneity of populations evaluated...
Incidence and prognostic value of right ventricular failure in acute respiratory distress syndromeDavid Osman
Service de Reanimation Medicale, Hopital de Bicetre, Centre Hospitalo Universitaire de Bicêtre, Assistance Publique Hopitaux de Paris, Université Paris 11 Sud, Le Kremlin Bicetre, France
Intensive Care Med 35:69-76. 2009..To analyse the incidence and the impact on outcome of right ventricular failure (RVF) in patients with acute respiratory distress syndrome (ARDS)...
Etomidate versus ketamine for rapid sequence intubation in acutely ill patients: a multicentre randomised controlled trialPatricia Jabre
Samu 93 Equipe d accueil EA 3409, Hopital Avicenne, AP HP, Universite Paris 13, Bobigny, France
Lancet 374:293-300. 2009..We compared early and 28-day morbidity after a single dose of etomidate or ketamine used for emergency endotracheal intubation of critically ill patients...
Is bronchoalveolar lavage with quantitative cultures a useful tool for diagnosing ventilator-associated pneumonia?Jean Yves Fagon
Réanimation Médicale, Hopital Europeen Georges Pompidou, Assistance Publique Hopitaux de Paris, Universite Paris Descartes, Paris, France
Crit Care 11:123. 2007..Such a strategy has two requirements: immediate administration of adequate therapy in patients with true VAP, and avoidance of administering antibiotics in patients without bacterial infection...
Impact of tracheotomy on sedative administration, sedation level, and comfort of mechanically ventilated intensive care unit patientsAnia Nieszkowska
, , Paris, France
Crit Care Med 33:2527-33. 2005..CONCLUSION: On the basis of these observations, we conclude that tracheotomized mechanically ventilated ICU patients required less intravenous sedative administration, spent less time heavily sedated, and achieved more autonomy earlier...
Aerosolized antibiotics to treat ventilator-associated pneumoniaCharles Edouard Luyt
Service de Reanimation Medicale, Institut de Cardiologie, Groupe Hospitalier Pitie Salpetriere, 47 83 boulevard de l Hopital, Paris Cedex 13, France
Curr Opin Infect Dis 22:154-8. 2009..This review summarizes the recent data on antibiotic aerosolization to treat ventilator-associated pneumonia...
Herpes simplex virus lung infection in patients undergoing prolonged mechanical ventilationCharles Edouard Luyt
Service de Reanimation Medicale, Institut de Cardiologie, Groupe Hospitalier Pitie Salpetriere, Université de Paris Pierre et Marie Curie, Assistance Publique Hopitaux de Paris, Paris Cedex 13, France
Am J Respir Crit Care Med 175:935-42. 2007....
Antibiotic prescribing for ventilator-associated pneumonia: get it right from the beginning but be able to rapidly deescalateJean Chastre
Intensive Care Med 31:1463-5. 2005
Methicillin-resistant Staphylococcus aureus prolongs intensive care unit stay in ventilator-associated pneumonia, despite initially appropriate antibiotic therapyAndrew F Shorr
Pulmonary and Critical Care Medicine, Washington Hospital Center, Washington, DC, USA
Crit Care Med 34:700-6. 2006..Confronting the adverse impact of MRSA will require efforts that address more than the initial antibiotic prescription...
Infective endocarditis in the intensive care unit: clinical spectrum and prognostic factors in 228 consecutive patientsBruno Mourvillier
, , AP-HP, 46 rue Henri-Huchard, 75877 Paris Cedex 18, France
Intensive Care Med 30:2046-52. 2004..Most complications occur early making the decision process for optimal medical and surgical management more difficult. Surgical treatment appears to improve in-hospital outcome...
Hemodynamic monitoring in shock and implications for management. International Consensus Conference, Paris, France, 27-28 April 2006Massimo Antonelli
Istituto di Anestesiologia e Rianimazione, Policlinico Universitario A Gemelli, Universita Cattolica del Sacro Cuore, Largo A Gemelli, 8, 00168 Rome, Italy
Intensive Care Med 33:575-90. 2007..The goal of this consensus statement is to provide recommendations regarding the monitoring and management of the critically ill patient with shock...
Diagnosis of ventilator-associated pneumoniaJean Chastre
N Engl J Med 356:1469; author reply 1470-1. 2007
Preventing ventilator-associated pneumonia: could silver-coated endotracheal tubes be the answer?Jean Chastre
JAMA 300:842-4. 2008
Year in review in Intensive Care Medicine, 2007. I. Experimental studies. Clinical studies: brain injury and neurology, renal failure and endocrinologyMassimo Antonelli
, Department of Intensive Care and Anesthesiology, Policlinico Universitario A. Gemelli, Largo A. Gemelli, 8, 00168 Rome, Italy
Intensive Care Med 34:229-42. 2008
A randomized double-blind trial of iseganan in prevention of ventilator-associated pneumoniaMarin Kollef
Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8052, St Louis, MO 63110, USA
Am J Respir Crit Care Med 173:91-7. 2006..The drug has shown little resistance in vitro and to be safe and well tolerated in 800 patients with cancer treated for up to 6 wk...
Year in review in Intensive Care Medicine, 2007. II. Haemodynamics, pneumonia, infections and sepsis, invasive and non-invasive mechanical ventilation, acute respiratory distress syndromeMassimo Antonelli
Department of Intensive Care and Anaesthesiology, Policlinico Universitario A. Gemelli, , Largo A. Gemelli 8, 00168 Rome, Italy
Intensive Care Med 34:405-22. 2008
Year in review in Intensive Care Medicine, 2007. III. Ethics and legislation, health services research, pharmacology and toxicology, nutrition and paediatricsMassimo Antonelli
Department of Intensive Care and Anesthesiology, Policlinico Universitario A. Gemelli, Largo A. Gemelli, 8, 00168, Rome, Italy
Intensive Care Med 34:598-609. 2008
