Increased incidence of co-infection in critically ill patients with influenza.
Identifieur interne : 000092 ( Main/Exploration ); précédent : 000091; suivant : 000093Increased incidence of co-infection in critically ill patients with influenza.
Auteurs : Ignacio Martin-Loeches [Irlande (pays), Espagne] ; Marcus J Schultz [Pays-Bas] ; Jean-Louis Vincent [Belgique] ; Francisco Alvarez-Lerma [Espagne] ; Lieuwe D. Bos [Pays-Bas] ; Jordi Solé-Violán [Espagne] ; Antoni Torres [Espagne] ; Alejandro Rodriguez [Espagne]Source :
- Intensive care medicine [ 1432-1238 ] ; 2017.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Co-infection (épidémiologie), Espagne (épidémiologie), Facteurs de risque (MeSH), Femelle (MeSH), Grippe humaine (épidémiologie), Humains (MeSH), Incidence (MeSH), Infections communautaires (épidémiologie), Maladie grave (épidémiologie), Mâle (MeSH), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Études prospectives (MeSH).
- MESH :
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Coinfection (epidemiology), Community-Acquired Infections (epidemiology), Critical Illness (epidemiology), Female (MeSH), Humans (MeSH), Incidence (MeSH), Influenza, Human (epidemiology), Male (MeSH), Middle Aged (MeSH), Prospective Studies (MeSH), Risk Factors (MeSH), Spain (epidemiology).
- MESH :
- epidemiology : Coinfection, Community-Acquired Infections, Critical Illness, Influenza, Human, Spain.
- Adult, Aged, Aged, 80 and over, Female, Humans, Incidence, Male, Middle Aged, Prospective Studies, Risk Factors.
Abstract
BACKGROUND
Co-infection is frequently seen in critically ill patients with influenza, although the exact rate is unknown. We determined the rate of co-infection, the risk factors and the outcomes associated with co-infection in critically ill patients with influenza over a 7-year period in 148 Spanish intensive care units (ICUs).
METHODS
This was a prospective, observational, multicentre study. Influenza was diagnosed using the polymerase chain reaction. Co-infection had to be confirmed using standard bacteriological tests. The primary endpoint of this analysis was the presence of community-acquired co-infection, with secondary endpoints including ICU, 28-day and hospital mortality.
RESULTS
Of 2901 ICU patients diagnosed with influenza, 482 (16.6 %) had a co-infection. The proportion of cases of co-infection increased from 11.4 % (110/968) in 2009 to 23.4 % (80/342) in 2015 (P < 0.001). Compared with patients without co-infection, patients with co-infection were older [adjusted odds ratio (aOR) 1.1, 95 % confidence interval 1.1-1.2; P < 0.001] and were more frequently immunosuppressed due to existing HIV infection (aOR 2.6 [1.5-4.5]; P < 0.001) or preceding medication (aOR 1.4 [1.1-1.9]; P = 0.03). Co-infection was an independent risk factor for ICU mortality (aOR 1.4 [1.1-1.8]; P < 0.02), 28-day mortality (aOR 1.3 [1.1-1.7]; P = 0.04) and hospital mortality (aOR 1.9 [1.5-2.5]; P < 0.001).
CONCLUSIONS
Co-infection in critically ill patients with influenza has increased in recent years. In this Spanish cohort, age and immunosuppression were risk factors for co-infection, and co-infection was an independent risk factor for ICU, 28-day and hospital mortality.
DOI: 10.1007/s00134-016-4578-y
PubMed: 27709265
Affiliations:
- Belgique, Espagne, Irlande (pays), Pays-Bas
- Catalogne, Communauté de Madrid, Hollande-Septentrionale, Région de Bruxelles-Capitale
- Amsterdam, Barcelone, Bruxelles, Madrid
- Université libre de Bruxelles
Links toward previous steps (curation, corpus...)
Le document en format XML
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xml:lang="fr">Irlande (pays)</country><wicri:regionArea>Multidisciplinary Intensive Care Research Organization (MICRO), Wellcome Trust-HRB Clinical Research, Department of Clinical Medicine, Trinity Centre for Health Sciences, St James's University Hospital, Dublin</wicri:regionArea><wicri:noRegion>Dublin</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:affiliation>CIBERes, Madrid, Spain. drmartinloeches@gmail.com.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>CIBERes, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="J Schultz, Marcus" sort="J Schultz, Marcus" uniqKey="J Schultz M" first="Marcus" last="J Schultz">Marcus J Schultz</name><affiliation wicri:level="3"><nlm:affiliation>Department of Intensive Care, Academic Medical Center, Amsterdam, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Intensive Care, Academic Medical Center, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Vincent, Jean Louis" sort="Vincent, Jean Louis" uniqKey="Vincent J" first="Jean-Louis" last="Vincent">Jean-Louis Vincent</name><affiliation wicri:level="4"><nlm:affiliation>Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Brussels</wicri:regionArea><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region></placeName><orgName type="university">Université libre de Bruxelles</orgName></affiliation></author><author><name sortKey="Alvarez Lerma, Francisco" sort="Alvarez Lerma, Francisco" uniqKey="Alvarez Lerma F" first="Francisco" last="Alvarez-Lerma">Francisco Alvarez-Lerma</name><affiliation wicri:level="3"><nlm:affiliation>Service of Intensive Care Medicine, Parc de Salut Mar, Universitat Autonoma de Barcelona, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Service of Intensive Care Medicine, Parc de Salut Mar, Universitat Autonoma de Barcelona, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Bos, Lieuwe D" sort="Bos, Lieuwe D" uniqKey="Bos L" first="Lieuwe D" last="Bos">Lieuwe D. Bos</name><affiliation wicri:level="3"><nlm:affiliation>Department of Intensive Care, Academic Medical Center, Amsterdam, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Intensive Care, Academic Medical Center, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Sole Violan, Jordi" sort="Sole Violan, Jordi" uniqKey="Sole Violan J" first="Jordi" last="Solé-Violán">Jordi Solé-Violán</name><affiliation wicri:level="1"><nlm:affiliation>Intensive Care Unit, Hospital Universitario Dr. Negrín, CIBERES, Las Palmas de Gran Canaria, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Intensive Care Unit, Hospital Universitario Dr. Negrín, CIBERES, Las Palmas de Gran Canaria</wicri:regionArea><wicri:noRegion>Las Palmas de Gran Canaria</wicri:noRegion></affiliation></author><author><name sortKey="Torres, Antoni" sort="Torres, Antoni" uniqKey="Torres A" first="Antoni" last="Torres">Antoni Torres</name><affiliation wicri:level="3"><nlm:affiliation>Hospital Clinic Barcelona, Universidad Barcelona, CIBERES, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Hospital Clinic Barcelona, Universidad Barcelona, CIBERES, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Rodriguez, Alejandro" sort="Rodriguez, Alejandro" uniqKey="Rodriguez A" first="Alejandro" last="Rodriguez">Alejandro Rodriguez</name><affiliation wicri:level="3"><nlm:affiliation>Centro de Investigación Biomédica En Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Centro de Investigación Biomédica En Red de Enfermedades Respiratorias (CIBERES), Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation><affiliation wicri:level="1"><nlm:affiliation>Critical Care Department, Institut d'Investigació Sanitària Pere Virgili (IISPV), Joan XXIII University Hospital, Universitat Rovira i Virgili, Tarragona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Critical Care Department, Institut d'Investigació Sanitària Pere Virgili (IISPV), Joan XXIII University Hospital, Universitat Rovira i Virgili, Tarragona</wicri:regionArea><wicri:noRegion>Tarragona</wicri:noRegion></affiliation></author></analytic><series><title level="j">Intensive care medicine</title><idno type="eISSN">1432-1238</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Coinfection (epidemiology)</term><term>Community-Acquired Infections (epidemiology)</term><term>Critical Illness (epidemiology)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Incidence (MeSH)</term><term>Influenza, Human (epidemiology)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Prospective Studies (MeSH)</term><term>Risk Factors (MeSH)</term><term>Spain (epidemiology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Co-infection (épidémiologie)</term><term>Espagne (épidémiologie)</term><term>Facteurs de risque (MeSH)</term><term>Femelle (MeSH)</term><term>Grippe humaine (épidémiologie)</term><term>Humains (MeSH)</term><term>Incidence (MeSH)</term><term>Infections communautaires (épidémiologie)</term><term>Maladie grave (épidémiologie)</term><term>Mâle (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term><term>Études prospectives (MeSH)</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coinfection</term><term>Community-Acquired Infections</term><term>Critical Illness</term><term>Influenza, Human</term><term>Spain</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Co-infection</term><term>Espagne</term><term>Grippe humaine</term><term>Infections communautaires</term><term>Maladie grave</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Humans</term><term>Incidence</term><term>Male</term><term>Middle Aged</term><term>Prospective Studies</term><term>Risk Factors</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Incidence</term><term>Mâle</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Co-infection is frequently seen in critically ill patients with influenza, although the exact rate is unknown. We determined the rate of co-infection, the risk factors and the outcomes associated with co-infection in critically ill patients with influenza over a 7-year period in 148 Spanish intensive care units (ICUs).</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>This was a prospective, observational, multicentre study. Influenza was diagnosed using the polymerase chain reaction. Co-infection had to be confirmed using standard bacteriological tests. The primary endpoint of this analysis was the presence of community-acquired co-infection, with secondary endpoints including ICU, 28-day and hospital mortality.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Of 2901 ICU patients diagnosed with influenza, 482 (16.6 %) had a co-infection. The proportion of cases of co-infection increased from 11.4 % (110/968) in 2009 to 23.4 % (80/342) in 2015 (P < 0.001). Compared with patients without co-infection, patients with co-infection were older [adjusted odds ratio (aOR) 1.1, 95 % confidence interval 1.1-1.2; P < 0.001] and were more frequently immunosuppressed due to existing HIV infection (aOR 2.6 [1.5-4.5]; P < 0.001) or preceding medication (aOR 1.4 [1.1-1.9]; P = 0.03). Co-infection was an independent risk factor for ICU mortality (aOR 1.4 [1.1-1.8]; P < 0.02), 28-day mortality (aOR 1.3 [1.1-1.7]; P = 0.04) and hospital mortality (aOR 1.9 [1.5-2.5]; P < 0.001).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Co-infection in critically ill patients with influenza has increased in recent years. In this Spanish cohort, age and immunosuppression were risk factors for co-infection, and co-infection was an independent risk factor for ICU, 28-day and hospital mortality.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">27709265</PMID><DateCompleted><Year>2017</Year><Month>11</Month><Day>16</Day></DateCompleted><DateRevised><Year>2018</Year><Month>11</Month><Day>13</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1432-1238</ISSN><JournalIssue CitedMedium="Internet"><Volume>43</Volume><Issue>1</Issue><PubDate><Year>2017</Year><Month>Jan</Month></PubDate></JournalIssue><Title>Intensive care medicine</Title><ISOAbbreviation>Intensive Care Med</ISOAbbreviation></Journal><ArticleTitle>Increased incidence of co-infection in critically ill patients with influenza.</ArticleTitle><Pagination><MedlinePgn>48-58</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1007/s00134-016-4578-y</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Co-infection is frequently seen in critically ill patients with influenza, although the exact rate is unknown. We determined the rate of co-infection, the risk factors and the outcomes associated with co-infection in critically ill patients with influenza over a 7-year period in 148 Spanish intensive care units (ICUs).</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">This was a prospective, observational, multicentre study. Influenza was diagnosed using the polymerase chain reaction. Co-infection had to be confirmed using standard bacteriological tests. The primary endpoint of this analysis was the presence of community-acquired co-infection, with secondary endpoints including ICU, 28-day and hospital mortality.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Of 2901 ICU patients diagnosed with influenza, 482 (16.6 %) had a co-infection. The proportion of cases of co-infection increased from 11.4 % (110/968) in 2009 to 23.4 % (80/342) in 2015 (P < 0.001). Compared with patients without co-infection, patients with co-infection were older [adjusted odds ratio (aOR) 1.1, 95 % confidence interval 1.1-1.2; P < 0.001] and were more frequently immunosuppressed due to existing HIV infection (aOR 2.6 [1.5-4.5]; P < 0.001) or preceding medication (aOR 1.4 [1.1-1.9]; P = 0.03). Co-infection was an independent risk factor for ICU mortality (aOR 1.4 [1.1-1.8]; P < 0.02), 28-day mortality (aOR 1.3 [1.1-1.7]; P = 0.04) and hospital mortality (aOR 1.9 [1.5-2.5]; P < 0.001).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Co-infection in critically ill patients with influenza has increased in recent years. In this Spanish cohort, age and immunosuppression were risk factors for co-infection, and co-infection was an independent risk factor for ICU, 28-day and hospital mortality.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Martin-Loeches</LastName><ForeName>Ignacio</ForeName><Initials>I</Initials><Identifier Source="ORCID">http://orcid.org/0000-0002-5834-4063</Identifier><AffiliationInfo><Affiliation>Multidisciplinary Intensive Care Research Organization (MICRO), Wellcome Trust-HRB Clinical Research, Department of Clinical Medicine, Trinity Centre for Health Sciences, St James's University Hospital, Dublin, Ireland. drmartinloeches@gmail.com.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>CIBERes, Madrid, Spain. drmartinloeches@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>J Schultz</LastName><ForeName>Marcus</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Intensive Care, Academic Medical Center, Amsterdam, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vincent</LastName><ForeName>Jean-Louis</ForeName><Initials>JL</Initials><AffiliationInfo><Affiliation>Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Alvarez-Lerma</LastName><ForeName>Francisco</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Service of Intensive Care Medicine, Parc de Salut Mar, Universitat Autonoma de Barcelona, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bos</LastName><ForeName>Lieuwe D</ForeName><Initials>LD</Initials><AffiliationInfo><Affiliation>Department of Intensive Care, Academic Medical Center, Amsterdam, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Solé-Violán</LastName><ForeName>Jordi</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Intensive Care Unit, Hospital Universitario Dr. Negrín, CIBERES, Las Palmas de Gran Canaria, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Torres</LastName><ForeName>Antoni</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Hospital Clinic Barcelona, Universidad Barcelona, CIBERES, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rodriguez</LastName><ForeName>Alejandro</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Centro de Investigación Biomédica En Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Critical Care Department, Institut d'Investigació Sanitària Pere Virgili (IISPV), Joan XXIII University Hospital, Universitat Rovira i Virgili, Tarragona, Spain.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016448">Multicenter Study</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>10</Month><Day>05</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Intensive Care Med</MedlineTA><NlmUniqueID>7704851</NlmUniqueID><ISSNLinking>0342-4642</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Intensive Care Med. 2017 Jan;43(1):107-109</RefSource><PMID Version="1">27798740</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D060085" MajorTopicYN="N">Coinfection</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D017714" MajorTopicYN="N">Community-Acquired Infections</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016638" MajorTopicYN="N">Critical Illness</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015994" MajorTopicYN="N">Incidence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013030" MajorTopicYN="N">Spain</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Co-infection</Keyword><Keyword MajorTopicYN="N">Influenza</Keyword><Keyword MajorTopicYN="N">Intensive care</Keyword><Keyword MajorTopicYN="N">Outcome</Keyword><Keyword MajorTopicYN="N">Risk factors</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2016</Year><Month>06</Month><Day>25</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2016</Year><Month>09</Month><Day>26</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2016</Year><Month>10</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>11</Month><Day>29</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2016</Year><Month>10</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">27709265</ArticleId><ArticleId IdType="doi">10.1007/s00134-016-4578-y</ArticleId><ArticleId 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IdType="pubmed">21385717</ArticleId></ArticleIdList></Reference><Reference><Citation>Intensive Care Med. 2010 Nov;36(11):1976-7</Citation><ArticleIdList><ArticleId IdType="pubmed">20689914</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>Belgique</li><li>Espagne</li><li>Irlande (pays)</li><li>Pays-Bas</li></country><region><li>Catalogne</li><li>Communauté de Madrid</li><li>Hollande-Septentrionale</li><li>Région de Bruxelles-Capitale</li></region><settlement><li>Amsterdam</li><li>Barcelone</li><li>Bruxelles</li><li>Madrid</li></settlement><orgName><li>Université libre de Bruxelles</li></orgName></list><tree><country name="Irlande (pays)"><noRegion><name sortKey="Martin Loeches, Ignacio" sort="Martin Loeches, Ignacio" uniqKey="Martin Loeches I" first="Ignacio" last="Martin-Loeches">Ignacio Martin-Loeches</name></noRegion></country><country name="Espagne"><region name="Communauté de Madrid"><name sortKey="Martin Loeches, Ignacio" sort="Martin Loeches, Ignacio" uniqKey="Martin Loeches I" first="Ignacio" last="Martin-Loeches">Ignacio Martin-Loeches</name></region><name sortKey="Alvarez Lerma, Francisco" sort="Alvarez Lerma, Francisco" uniqKey="Alvarez Lerma F" first="Francisco" last="Alvarez-Lerma">Francisco Alvarez-Lerma</name><name sortKey="Rodriguez, Alejandro" sort="Rodriguez, Alejandro" uniqKey="Rodriguez A" first="Alejandro" last="Rodriguez">Alejandro Rodriguez</name><name sortKey="Rodriguez, Alejandro" sort="Rodriguez, Alejandro" uniqKey="Rodriguez A" first="Alejandro" last="Rodriguez">Alejandro Rodriguez</name><name sortKey="Sole Violan, Jordi" sort="Sole Violan, Jordi" uniqKey="Sole Violan J" first="Jordi" last="Solé-Violán">Jordi Solé-Violán</name><name sortKey="Torres, Antoni" sort="Torres, Antoni" uniqKey="Torres A" first="Antoni" last="Torres">Antoni Torres</name></country><country name="Pays-Bas"><region name="Hollande-Septentrionale"><name sortKey="J Schultz, Marcus" sort="J Schultz, Marcus" uniqKey="J Schultz M" first="Marcus" last="J Schultz">Marcus J Schultz</name></region><name sortKey="Bos, Lieuwe D" sort="Bos, Lieuwe D" uniqKey="Bos L" first="Lieuwe D" last="Bos">Lieuwe D. Bos</name></country><country name="Belgique"><region name="Région de Bruxelles-Capitale"><name sortKey="Vincent, Jean Louis" sort="Vincent, Jean Louis" uniqKey="Vincent J" first="Jean-Louis" last="Vincent">Jean-Louis Vincent</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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