- P.GRIS, I.PERLOT,
A.FLEMALE, J.P.DELMEZ, J.P.DIERCKX. Coxsackie B3 virus
infection, an unusual cause of mediastinal nodal enlargement.
Respiration 1988; 53:246-250.
- P.GRIS, P.BURTON. La
Zidovudine dans le traitement du Sida : premier bilan te perspectives.
Abstract 1987; 16:8-11.
- P.GRIS. Eicosanoides,
éosinophiles, médiateurs des réactions inflammatoires et
allergiques. Abstract 1988; 23:11-14.
- P.GRIS, M.COFFERNILS,
T.ALAME, T.P.KIMBIMBI. Intoxication volontaire par Verapamil,
à propos d’un cas, revue de la littérature. Sem. Hôp. Paris
1989; 65:435-438.
- P.GRIS, P.DUCHATELET,
J.P.DIERCKX, H.DEMOL, A.QUOIDBACH, E.DUPONT.
Pleural fluid in Wegener’s granulomatosis (letter). Chest 1989;
96:224.
- P.GRIS, G.VINCKE,
J.P.DELMEZ, J.P.DIERCKX. Neisseria Sicca pneumonia and
bronchiectasis. Eur. Respir. J. 1989; 2:685-687.
- P.GRIS, M.COFFERNILS,
M.LEON, C.REUSE, J.L.VINCENT. Right ventricular
dysfunction in patient with septic shock. Resuscitation 1989 (in
press).
- T.ALAME, A.DEWEWEIRE,
P.GRIS, M.COFFERNILS, B. VAN DEN HEULE, J.P.DELMEZ,
E.LONGEVAL. Réaction leucémoïde et hypercalcémie au cours d’un
adénocarcinome de la vessie. Rev. Méd. Brux. 1990; 11:59-62.
- P.GRIS, Y.PIRSON,
J.HAMELS, J.P.VAERMAN, A.QUOIDBACH, H.DEMOL.
Anti-glomerular basement membrane nephritis induced by IgA1 antibodies.
Nephron 1991; 58:418-424.
- J.BAKKER, M.COFFERNILS, M.LEON,
P.GRIS, J.L.VINCENT. Blood lactate levels are superior to
oxygen derived variables in predicting outcome in human septic shock .
Chest 1991; 99:956-962.
- P.GRIS. Déficit en Alpha-1-
Antitrypsine: données actuelles . Best of Pneumology 1991; 1:8-9.
- P.GRIS. Corticoïdes dans la
maladie obstructive: quelle voie d’administration ? . Best of Pneumology
1991; 3:9-10.
- P.GRIS. Les infections respiratoires
basses en pratique. Medisearch 1992; 58:31-35.
- J.BAKKER, J.L.VINCENT,
P.GRIS, , M.LEON, M.COFFERNILS, R.J.KAHN.
Veno-arterial carbon dioxide gradient in human septic shock.
Chest 1992; 101:509-515.
- J.L.VINCENT, P.GRIS,
M.COFFERNILS, M.LEON, M.PINSKY, C.REUSE,
R.J.KAHN. Myocardial depression characterizes the fatal course of septic
shock. Surgery 1992; 111:660-667.
- P.GRIS. Asthme et grossesse.
Best of Pneumology 1992; 5:15-19.
- D.LEDUC, P.GRIS,
P.LHEUREUX, P.A.GEVENOIS, P.DE VUYST, J.C.YERNAULT.
Acute and long term respiratory damage following inhalation of ammonia.
Thorax 1992; 47:755-757.
- P.GRIS, E.PANOPOULOS,
M.DE JONGHE. La vieille dame toussait depuis longtemps (Trachéobronchopathie
Ostéochondroblastique). Actualité Médicale Belge (A.M.B.) 1993;
402: 10 et 13.
- P.GRIS. Comparaison d’un traitement
bronchodilatateur avec ou sans corticostéroides inhalés dans les
maladies obstructives des voies aériennes. Best of Pneumology
1993;8:7-9.
- P.GRIS. Quels sont les patients
qui peuvent bénéficier d’une oxygénothérapie chronique à domicile?. Best
of Pneumology 1993;8:17-18.
- P.GRIS, B.WILMET, D.TACK.
Quelle était la cause de ces pneumonies à répétition ? Actualité
Médicale Belge (A.M.B.) 1994; 419:11.
- P.GRIS. Quel traitement pour quel
type d’asthme ? Best of Pneumology (Special Pharmacists) 1994;
Sept.:8-9.
- P.GRIS, B.WILMET,
A.BENCHILLAL, D.TACK, D.WERY, M.DE JONGHE,
C.GILLARD. Veine cave supérieure gauche persistante. A propos de
deux observations. Rev. de Pneumol. Clin. 1995; 51:33-35.
- P.GRIS. Antibiothérapie :
critères de choix . Le Monde Médical 1995; 295: 18-19.
- P.GRIS. Once-daily, 3-day
azithromycin versus a three times-daily, 10-day course of co-amoxiclav
in the treatment of adults with lower respiratory tract infections:
results of a randomized, double-blind comparative study. Journal
of Antimicrobial Chemotherapy 1996; 37, Suppl.C : 93-101.
- P.GRIS. Qualité de vie du patient
asthmatique...Optimale ?. Best of Pneumology 1996; 15: 10-11.
- J.BAKKER, P.GRIS, M.COFFERNILS,
RJ.KAHN, JL.VINCENT. Blood lactate levels can predict the development of
multiple organ failure following septic shock. Am. J. Surg.1996; 171:
221-226.
- P.GRIS. La toux, un symptôme
bien mystérieux. Medical News 1997; 14 : 23-29.
- C.DECOSTER, P.GRIS. Comparaison du
flixotide haute dose via aérosol doseur et budesonide suspension chez
l’adulte asthmatique. Best of Respiratory 1997 ; 16 : 10-12.
- D.TACK, J .JAUCOT, P. GRIS, C.
DELCOUR. Left azygos continuation. Radiological Documents 1997;
11: 1-3.
- P.GRIS. Infections respiratoires
bactériennes post viroses. Infectiologics, décembre 1997 : 19-20.
- P.GRIS. Le pneumocoque fait de la
résistance. Medical News 1997 ;22 :31-33.
-
P.GRIS, A.BAULER. Le Salbutamol en salle d’urgence. Best
of Respiratory 1997 ;18 :6-7.
- P.GRIS, D.VOGELAERS. Les anaérobies.
Quid Infectio 1998 ;3 :1-3.
- P.GRIS, P.VERVACKE. Pneumocoque et
mycoplasme, un diagnostic parfois difficile. Cahier Cas Clinique Medical
News, avril 1998 :2-4.
- D.TACK, L.LENAERTS, P.GRIS,
C.DELCOUR. Barotrauma. Radiological Documents 1998 ;3 :1-3.
- P.GRIS. Salmeterol et BPCO.
Best of Respiratory 1998 ;19 :7-8.
- D.TACK, P.GRIS, C.DECOSTER,
C.DELCOUR. Masse thoracique asymptomatique. Rev. Mal.
Respir.1998 ,15 :309-311.
- P.GRIS, D.TACK, C.GILLARD,
J.THIRIAUX. Right tracheal bronchus. Clin. Pulmon. Med.
1998 ;5 :200-201.
- A.BAULER, D.TACK, P.GRIS.
Aspergillose semi-invasive : cas clinique et revue de la littérature.
Astra Respiratory Journal 1998 ;2 :6-11.
- P. GRIS.Traitement et prophylaxie de
la tuberculose. Bulletin de la Société Clinique du CHU de
Charleroi.1998 ;4 : 169-173.
- D. TACK, J. JAUCOT , P. GRIS, C.
DELCOUR. Anomaly of the vena cava. JBR-TBR 1999; 82: 125.
- P. GRIS. Pneumocoque et voies
aériennes. Medibytes 2000 ; 5 : 12 – 13.
- P. GRIS . Les infections du site
chirurgical. Vaisseaux, Cœur, Poumons 2000 ; 5 : 138-140.
- D. TACK, LENAERTS L, P. GRIS,
DELCOURT C. Pulmonary interstitial gas. JBR-BTR 2000 ; 83:25.
- P. GRIS .
Antibiothérapie : traitement long, traitement court ? Tempo
Médical 2002 ; 230 : 44 – 45.
|
Chest, Vol 101, 509-515, Copyright © 1992 by American
College of Chest Physicians
www.chestjournal.org
 Veno-arterial
carbon dioxide gradient in human septic shock
J Bakker, JL Vincent, P
Gris,
M Leon, M Coffernils and RJ Kahn
Department of Intensive Care, Erasme University
Hospital, Free University of Brussels, Belgium.
Recent reports have shown that venous hypercarbia,
resulting in a widening of the veno-arterial difference in PCO2
(dPCO2), is related to systemic hypoperfusion in various forms
of low-flow state. Although septic shock usually is a
hyperdynamic state, other factors can influence the CO2
production and elimination, and thus dPCO2 in septic shock This study
examined the dPCO2 and acid-base balance together with cardiac
output measurements and oxygen-derived variables in 64 adult
patients with documented septic shock. For a total of 191
observations, a significant exponential relation between dPCO2
and CO was found. At time of first measurement, 15 patients had
an increased dPCO2 (above 6 mm Hg) and a higher mixed venous
PCO2 (PvCO2) (47.2 +/- 10.0 vs 35.9 +/- 7.3 mm Hg, p less than
0.001). These patients had a lower cardiac index (2.9 +/- 1.3 vs
3.8 +/- 2.0 L/min.m2, p less than 0.01), a higher oxygen extraction
ratio, but a similar VO2 than patients with normal dPCO2. The
higher dPCO2 could also be related to an impaired CO2
elimination as indicated by a higher PaCO2 and a lower
PaO2/FIO2 in these patients. Nonsurvivors had a significantly
higher dPCO2 than survivors (5.9 +/- 3.4 vs 4.4 +/- 2.3 mm Hg,
p less than 0.05) in the presence of similar cardiac output. The higher
dPCO2 in these patients was probably related to the higher blood
lactate levels (7.7 +/- 5.3 mmol/L vs 4.5 +/- 2.8 mmol/L, p
less than 0.01) and the more severe pulmonary impairment (SaO2
90 +/- 8 percent vs 95 +/- 4 percent, p less than 0.001).
Arteriovenous oxygen content difference (dAVO2) and VO2 were
similar in survivors and nonsurvivors. In conclusion, dPCO2
patients with septic shock is related principally to cardiac output
but apparently also to the degree of pulmonary impairment. Although
dPCO2 is larger in nonsurvivors, its prognostic value is modest.
|
Chest, Vol 99, 956-962, Copyright © 1991 by American
College of Chest Physicians
www.chestjournal.org
Blood
lactate levels are superior to oxygen-derived variables in predicting
outcome in human septic shock
J Bakker, M Coffernils, M Leon, P
Gris
and JL Vincent
Department of Intensive Care, Erasme University
Hospital, Free University of Brussels, Belgium.
Recent reports have shown that oxygen delivery (Do2) and
oxygen uptake (Vo2) could be related to outcome of critically
ill patients. In this study, we examined measurements of
cardiac output, oxygen-derived variables, and blood lactate
levels in 48 patients with documented septic shock. There were
27 survivors and 21 nonsurvivors from the shock episode. For
all 174 observations, there was a significant linear relationship
between Vo2 and Do2 (Vo2 = 79 + 0.17 x Do2, r = 0.64, p less than
0.001). There were no significant differences in Do2 between
survivors and nonsurvivors at the onset of septic shock (mean
+/- SD, 540 +/- 219 vs 484 +/- 222 ml/min.m2, NS) or in the
final phase of septic shock (506 +/- 163 vs 443 +/- 187
ml/min.m2, NS). Also, no significant differences were found in
Vo2 and oxygen extraction between survivors and nonsurvivors. However,
survivors had significantly lower blood lactate levels both
initially (5.1 +/- 2.7 vs 8.2 +/- 5.4 mmol/L, p less than 0.05)
and in the final phase of septic shock (2.6 +/- 1.9 vs 7.7 +/-
5.6 mmol/L, p less than 0.001). Only the survivors had a
significant decrease in blood lactate levels during the course
of septic shock (p less than 0.001). We conclude that the
oxygen-derived variables, Do2 and Vo2, cannot be used as prognostic
indicators in human septic shock. In contrast, blood lactate levels
are closely related to ultimate survival from septic shock.
Furthermore, decreases in blood lactate levels during the
course of septic shock could indicate a favorable outcome.
Therefore, blood lactate levels can serve as a reliable
clinical guide to therapy.
|