Jean-Michel Arnal
A5067387754- Respiratory Support and Mechanisms
- Intensive Care Unit Cognitive Disorders
- Cardiac Arrest and Resuscitation
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Airway Management and Intubation Techniques
- Family and Patient Care in Intensive Care Units
- Neonatal Respiratory Health Research
- Obstructive Sleep Apnea Research
- Neuroscience of respiration and sleep
- Sepsis Diagnosis and Treatment
- Mechanical Circulatory Support Devices
- Cardiomyopathy and Myosin Studies
- Muscle Physiology and Disorders
- Nosocomial Infections in ICU
- Cellular transport and secretion
- Hemodynamic Monitoring and Therapy
- Neurogenetic and Muscular Disorders Research
- Traumatic Brain Injury and Neurovascular Disturbances
- Renal function and acid-base balance
- Long-Term Effects of COVID-19
- Hydraulic and Pneumatic Systems
- Amyotrophic Lateral Sclerosis Research
- Anesthesia and Sedative Agents
- Heart Rate Variability and Autonomic Control
- Emergency and Acute Care Studies
Hôpital Sainte-Périne
2012-2024
Hôpital d'Instruction des Armées Sainte-Anne
2013-2024
Hamilton Medical (Switzerland)
2015-2022
Centre Hospitalier Intercommunal Toulon-La Seyne-sur-Mer
2010-2022
Bambino Gesù Children's Hospital
2019
Institut de Myologie
2019
Centre National de la Recherche Scientifique
2012-2018
Lourdes Hospital
2018
Inserm
2018
Aix-Marseille Université
2012
In patients undergoing mechanical ventilation for the acute respiratory distress syndrome (ARDS), neuromuscular blocking agents may improve oxygenation and decrease ventilator-induced lung injury but also cause muscle weakness. We evaluated clinical outcomes after 2 days of therapy with in early, severe ARDS.
Difficult intubation in the intensive care unit (ICU) is a challenging issue.To develop and validate simplified score for identifying patients with difficult ICU to report related complications.Data collected prospective multicenter study from 1,000 consecutive intubations 42 ICUs were used of intubation, which was then validated externally 400 procedures 18 other internally by bootstrap on iterations.In multivariate analysis, main predictors (incidence = 11.3%) patient (Mallampati III or...
Objective To evaluate the effects of a 48-hr neuromuscular blocking agents (NMBA) infusion on gas exchange over 120-hr time period in patients with acute respiratory distress syndrome. Design Multiple center, prospective, controlled, and randomized trial. Setting Four adult medical or mixed medical-surgical intensive care units. Patients A total 56 syndrome Pao2/Fio2 ratio <150 at positive end-expiratory pressure ≥5 cm H2O. Interventions After randomization, received either conventional...
Patients liberated from invasive mechanical ventilation are at risk of extubation failure, including inability to breathe without a tracheal tube (airway failure) or (non-airway failure). We sought identify respective factors for airway failure and non-airway following extubation.The primary endpoint this prospective, observational, multicenter study in 26 intensive care units was defined as need reintubation within 48 h extubation. A multinomial logistic regression model used...
Simulation studies are often used to examine ventilator performance. However, there no standards for selecting simulation parameters. This study collected data in passively-ventilated adult human subjects and summarized the results as a set of parameters that can be intubated, passive, with normal lungs, COPD, or ARDS.Consecutive patients admitted ICU were included if they deeply sedated mechanically ventilated <48 h without any spontaneous breathing activity. Subjects classified having...
Because X-linked myotubular myopathy (XLMTM) is a rare neuromuscular disease caused by mutations in the MTM1 gene with large phenotypic heterogeneity, to ensure clinical trial readiness, it was mandatory better quantify burden and determine best outcome measures.We designed an international prospective longitudinal natural history study patients XLMTM assessed muscle strength motor respiratory functions over first year of follow-up. The humoral immunity against adeno-associated virus...
Abstract Background Flow starvation is a type of patient-ventilator asynchrony that occurs when gas delivery does not fully meet the patients’ ventilatory demand due to an insufficient airflow and/or high inspiratory effort, and it usually identified by visual inspection airway pressure waveform. Clinical diagnosis cumbersome prone underdiagnosis, being opportunity for artificial intelligence. Our objective develop supervised intelligence algorithm identifying deformation during square-flow...
The COPD Patient Management European Trial (COMET) investigated the efficacy and safety of a home-based disease management intervention for severe patients. study was an international open-design clinical trial in patients (forced expiratory volume 1 s <50% predicted value) randomised 1:1 to or usual practices at centre. included self-management programme, home telemonitoring, care coordination medical management. primary end-point number unplanned all-cause hospitalisation days...
Objective: The improvement in oxygenation with prone positioning is not persistent when patients acute respiratory distress syndrome (ARDS) are turned supine. High-frequency oscillatory ventilation (HFOV) aims to maintain an open lung volume by the application of a constant mean airway pressure. aim this study was show that HFOV able prevent impairment ARDS back from supine position. Design: Prospective, comparative randomized study. Setting: A medical intensive care unit. Patients:...
Abstract Background Reverse triggering (RT) is a dyssynchrony defined by respiratory muscle contraction following passive mechanical insufflation. It potentially harmful for the lung and diaphragm, but its detection challenging. Magnitude of effort generated RT currently unknown. Our objective was to validate supervised methods automatic using only airway pressure (Paw) flow. A secondary describe magnitude efforts during RT. Methods We developed algorithms Paw flow waveforms. Experts having...
Objective To determine whether positive end-expiratory pressure (PEEP) and prone position present a synergistic effect on oxygenation if the of PEEP is related to computed tomography scan lung characteristic. Design Prospective randomized study. Setting French medical intensive care unit. Patients Twenty-five patients with acute respiratory distress syndrome. Interventions After was obtained, measurements were performed in all at four different levels (0, 5, 10, 15 cm H2O) applied random...
Abstract Introduction IntelliVent-ASV ™ is a full closed-loop ventilation mode that automatically adjusts and oxygenation parameters in both passive active patients. This feasibility study compared settings selected by among three predefined lung conditions (normal lung, acute respiratory distress syndrome (ARDS) chronic obstructive pulmonary disease (COPD)) The of use was assessed based on the number safety events, need to switch conventional for any medical reason, sensor failure. Method...
Rationale: During noninvasive ventilation (NIV) for chronic obstructive pulmonary disease (COPD) exacerbations, helium/oxygen (heliox) reduces the work of breathing and hypercapnia more than air/O2, but its impact on clinical outcomes remains unknown.Objectives: To determine whether continuous administration heliox 72 hours, during in-between NIV sessions, was superior to air/O2 in reducing failure (25–15%) severe hypercapnic COPD exacerbations.Methods: This a prospective, randomized,...
There is an equipoise regarding closed-loop ventilation modes and the ability to reduce workload for providers. On one hand some settings are managed by ventilator but on another automatic mode introduces new user.This randomized controlled trial compared number of manual setting changes between a full closed loop oxygenation (INTELLiVENT-ASV®) conventional (volume assist control pressure support) in Intensive Care Unit (ICU) patients. The secondary endpoints were compare arterial blood gas...