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Biomedical subjects

Lucien Lecuyer

Publications and source records attributed to Lucien Lecuyer.

3 recordsLinked to original sources
PubMed2006

Biomarker-based strategy for screening right ventricular dysfunction in patients with non-massive pulmonary embolism.

OBJECTIVE: To evaluate the usefulness of B-type natriuretic peptide and troponin I measurements in predicting right ventricular dysfunction (RVD) in non-massive pulmonary embolism. DESIGN: Prospective observational study. SETTING: University-affiliated emergency unit, cardiology and pneumology departments. PATIENTS: Sixty-seven patients admitted because of acute pulmonary embolism, without shock on admission, completed the study. INTERVENTIONS: Blood samples and echocardiography were obtained on admission for subsequent and independent assessment of B-type natriuretic peptide (BNP) and troponin I levels as well as RVD. MEASUREMENTS AND RESULTS: Echocardiographic RVD was diagnosed in 36 patients and was severe in 13 on admission. BNP and troponin I levels were higher in patients with RVD than in those with no RVD [62 (27-105) vs. 431 (289-556) pg/ml for BNP, p<0.001; 0.01 (0-0.09) vs. 0.16 (0.03-0.32) microg/l for troponin I, p=0.005]. The area under the receiving operating characteristic curve (AUC) for diagnosing RVD was 0.93 for BNP and 0.72 for troponin I. The troponin I level increased further when RVD was severe, compared with moderate, and the AUC was 0.91 for identifying severe RVD. Diagnoses of RVD and severe RVD were ruled out by BNP 100 pg/ml and troponin I >0.10 microg/l. CONCLUSION: In hemodynamically stable pulmonary embolism, BNP/troponin I measurement is helpful on admission, especially for ruling out RVD, i.e. patients with in-hospital high-risk.

Aged↗
PubMed2006

Reliability of HemoCue in patients with gastrointestinal bleeding.

OBJECTIVE: HemoCue is routinely used to manage bleeding patients, but few studies have evaluated its accuracy in this population. We compared HemoCue with laboratory determination of blood hemoglobin in patients with gastrointestinal bleeding. DESIGN AND SETTING: A prospective observational study in a 14-bed medicosurgical ICU and an emergency department in an urban general hospital. PATIENTS: 94 patients admitted to the emergency department or to the ICU for gastrointestinal bleeding. INTERVENTIONS: Blood was drawn at admission to measure laboratory hemoglobin and capillary hemoglobin was measured simultaneously by HemoCue. The unit of hospitalization and the presence or absence of impaired vital signs (tachycardia and/or hypotension and/or shock) were recorded. MEASUREMENTS AND RESULTS: The mean difference between HemoCue and hemoglobin (bias) was -0.06 g/dl and standard deviation (precision) 0.87 g/dl. (95% CI -1.8 to 1.68). Discrepancies between HemoCue and hemoglobin were greater than 1 g/dl in 21% of cases. Bias was comparable between patients admitted to the ICU and those in the emergency department. The accuracy of HemoCue was not affected by the presence of impaired vital signs or by a hemoglobin level below 9 g/dl or 7 g/dl. CONCLUSIONS: Although we demonstrated a low bias between HemoCue and blood hemoglobin determination, large HemoCue vs. hemoglobin differences may still occur, and therefore therapeutic decisions based upon capillary HemoCue alone should be very cautious.

Gastrointestinal Hemorrhage↗