[SY18-1] Time is muscle: A universal scenario in the critically ill
【
同時通訳付き】
University positions
2000-now Professor in Anesthesiology and Critical Care Medicine, Paris Diderot School of Medicine,
2009– now Co-Director of the Biomarker in cardiac failure team at U 942 Inserm, 42 Boulevard de la Chapelle, 75010, Paris, France
Clinical activities
2012- now Chairman of the Department of Anesthesia and Critical Care, Hôpitaux Universitaires Saint-Louis & Lariboisière Hospitals, 2 Rue A Paré, 75475 Paris Cedex 10, Paris, France
Major publications of the last years among 300+ articles on PubMed
Maack C, Eschenhagen T, Hamdani N, Heinzel FR, Lyon AR, Manstein DJ, Metzger J, Papp Z, Tocchetti CG, Yilmaz MB, Anker SD, Balligand JL, Bauersachs J, Brutsaert D, Carrier L, Chlopicki S, Cleland JG, de Boer RA, Dietl A, Fischmeister R, Harjola VP, Heymans S, Hilfiker-Kleiner D, Holzmeister J, de Keulenaer G, Limongelli G, Linke WA, Lund LH, Masip J, Metra M, Mueller C, Pieske B, Ponikowski P, Ristic A, Ruschitzka F, Seferovic PM, Skouri H, Zimmermann WH, Mebazaa A. Treatments targeting inotropy. Eur Heart J. 2018 in press
Mebazaa A, Combes A, van Diepen S, Hollinger A, Katz JN, Landoni G, Hajjar LA, Lassus J, Lebreton G, Montalescot G, Park JJ, Price S, Sionis A, Yannopolos D, Harjola VP, Levy B, Thiele H. Management of cardiogenic shock complicating myocardial infarction. Intensive Care Med. 2018 in press
Léopold V, Gayat E, Pirracchio R, Spinar J, Parenica J, Tarvasmäki T, Lassus J, Harjola VP, Champion S, Zannad F, Valente S, Urban P, Chua HR, Bellomo R, Popovic B, Ouweneel DM, Henriques JPS, Simonis G, Lévy B, Kimmoun A, Gaudard P, Basir MB, Markota A, Adler C, Reuter H, Mebazaa A, Chouihed T. Epinephrine and short-term survival in cardiogenic shock: an individual data meta-analysis of 2583 patients. Intensive Care Med. 2018;44:847-856
Milton Packer, Christopher O’Connor, John J.V. McMurray, Janet Wittes, William T Abraham, Stefan Anker, Kenneth Dickstein, Gerasimos Filippatos, Richard Holcomb, Henry Krum, Aldo P. Maggioni, Alexandre Mebazaa, Frank Peacock, Mark C. Petrie, Piotr Ponikowski, Frank Ruschitzka, Dirk J. van Veldhuisen, Lisa S. Kowarski, Mark Schactman, and Johannes Holzmeister, on behalf of the TRUE-AHF Investigators and Committees Effect of Ularitide on Cardiovascular. Mortality in Acute Heart Failure. N Engl J Med. 2017, 3761956-1964
Mebazaa A et al Recommendations on pre-hospital and early hospital management of acute heart failure: a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emergency Medicine. Eur Heart J. 2015;36:1958-66.
Morelli A, Ertmer C, Westphal M, Rehberg S, Kampmeier T, Ligges S, Orecchioni A, D'Egidio A, D'Ippoliti F, Raffone C, Venditti M, Guarracino F, Girardis M, Tritapepe L, Pietropaoli P, Mebazaa A, Singer M Effect of heart rate control with esmolol on hemodynamic and clinical outcomes in patients with septic shock: a randomized clinical trial. JAMA. 2013;310:1683-91
Cohen AT, Spiro TE, Büller HR, Haskell L, Hu D, Hull R, Mebazaa A, Merli G, Schellong S, Spyropoulos AC, Tapson V; MAGELLAN Investigators. Rivaroxaban for thromboprophylaxis in acutely ill medical patients. N Engl J Med. 2013;368:513-23.
Active participation with the industry
Chairman or member of the Steering Committee of more than 15 phase II and III studies on heart failure. The most recent are: FROG-ICU (2015, data presented as Late Bracking Trial at the European Society of Intensive Care Medicine, 2015), TRUE-AHF (2016, data presented as Late Bracking Trial, in Rome at the European Society of Cardiology in August 2016).
Member of the Board or Senior Consultant of the following Medical and biotech companies:
- Sphyngotec (sphyngotec.com): I lead the program of assessing the prognostic value of plasma adrenomedullin in intensive care units; data are provided by the international FROG-ICU study (2200 patients). In addition, Adrenoss (600 septic shock patients, 1.5 Millions Euros) was finished in July 2016.
- Adrenomed (adrenomed.com): Chair of the Adrecizumab Program in humans (5 Millions Euros) with the objective of assessing benefits of antibodies against adrenomedulline in improving organ dysfunction in sepsis; a paper was published to recommend how to design phase II in sepsis Mebazaa A et al. Designing phase 3 sepsis trials: application of learned experiences from critical care trials in acute heart failure. J Intensive Care. 2016 31;4:24
- Magnisense: cardiovascular biomarker measured by microbeads, I helped raising 2 Millions Euros financed by BPI (Banque Publique d’Investissement, Paris France)
- Epygon (epygon.com): minimally invasive mitral valve, member of the Board
- NeuroTronik Limited: assessing benefits of stimulations of vessels in heart failure, senior consultant
Co-owner of the following patents
- Post-partum hemorrhage score based on biomarkers (United States Patent Application 20130190585, French and World patent), licenced by Magnisense
- Calcium sensitisers for treating symptoms of venomous bites and stings Brevet (WO 2005/102347 A1)
- Biomarkers to diagnose Peripartum heart failure (Feb 2014)
- Non-invasive diagnosis of heart failure in ICU, 2 patents 2016.
Mortality in the ICU is still very high. More importantly, the large majority of patients who survive ICU stay have poor quality of life in the following year. One of the main determinants of poor outcome whether short- or long-term is the delay between admission and therapies and the appropriateness of therapies.
In many medical or surgical circumstances including, thrombolytic therapy in stroke, antibiotics in sepsis, surgery for peritonitis, immediate therapies save lives. In cardiovascular area, especially in acute myocardial infarction, time is muscle. The earlier the coronary artery is open the better is outcome. In acute heart failure, increasing evidence shows that early therapies in acute heart failure and in cardiogenic shock are associated with better outcome. In acute heart failure, immediate treatment of congestion with diuretics was associated with better therapies. This was also seen with non-invasive ventilation for which a very early administration is associated with better outcome. In cardiogenic shock, there is increasing use of temporary mechanical circulatory support, mainly veno-arterial ECMO and/or Impella. A rapid decision to use those devises is often made by a “HEART “team. Three important trials are held in Europe to assess whether
early veno-arterial ECMO is associated with better survival rate in cardiogenic shock, mostly secondary to acute myocardial infarction.
In summary, increasing evidence in many area of critical care support a rapid start of effective therapies to save organs, specially the heart.
In many medical or surgical circumstances including, thrombolytic therapy in stroke, antibiotics in sepsis, surgery for peritonitis, immediate therapies save lives. In cardiovascular area, especially in acute myocardial infarction, time is muscle. The earlier the coronary artery is open the better is outcome. In acute heart failure, increasing evidence shows that early therapies in acute heart failure and in cardiogenic shock are associated with better outcome. In acute heart failure, immediate treatment of congestion with diuretics was associated with better therapies. This was also seen with non-invasive ventilation for which a very early administration is associated with better outcome. In cardiogenic shock, there is increasing use of temporary mechanical circulatory support, mainly veno-arterial ECMO and/or Impella. A rapid decision to use those devises is often made by a “HEART “team. Three important trials are held in Europe to assess whether
early veno-arterial ECMO is associated with better survival rate in cardiogenic shock, mostly secondary to acute myocardial infarction.
In summary, increasing evidence in many area of critical care support a rapid start of effective therapies to save organs, specially the heart.