Ivan Goldstein

Hôpital américain de paris

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Trends

Author Order

Document Type

Co-Authors

Jean‐Jacques Rouby

Assistance Publique – Hôpitaux de Paris

Charles‐Hugo Marquette

Université Côte d'Azur

Gilles Lenaour

Pitié-Salpêtrière Hospital

Fábio Ferrari

Universidade Estadual Paulista (Unesp)

Alfonso Sartorius

Pitié-Salpêtrière Hospital

Qin Lü

Zhejiang University

Pierre Coriat

Pitié-Salpêtrière Hospital

Daniel A. Lichtenstein

Tel Aviv Sourasky Medical Center

Marc Tonnellier

Sorbonne Université

Florent Wallet

Centre National de la Recherche Scientifique

Cooperative Institutions

Sorbonne Université

Assistance Publique – Hôpitaux de Paris

Pitié-Salpêtrière Hospital

Université Paris Cité

Inserm

Centre National de la Recherche Scientifique

Université Claude Bernard Lyon 1

Hôpital américain de paris

Hôpital Ambroise-Paré

Universidade Federal do Rio Grande do Sul

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Field

Experimental ventilator-associated pneumonia: distribution of lung infection and consequences for lung aeration

The Brazilian Journal of Infectious Diseases (2003)

Sílvia Regina Rios Vieira Ivan Goldstein Gilles Lenaour Charles‐Hugo Marquette Jean‐Jacques Rouby

Ventilator-associated pneumonia (VAP) has been described in humans and in experimental animals. The most severe lesions are located in dependent lung segments along a sterno-vertebral axis, however the cephalocaudal distribution of lung infection remains unknown. We used an experimental model to evaluate the distribution of lung infection, considering its anteroposterior and cephalocaudal gradient, and its impact on lung aeration. Ten healthy domestic piglets were anesthetized, paralyzed and mechanically ventilated for 59 hours in the prone position. At the end of the experiment they were sacrificed and their lungs were fixed. Six segments were analyzed: a non-dependant (ND) and a dependant (D) segment of the upper (UL), middle (ML) and lower (LL) lobes. The presence of healthy lung or of histological infectious lesions was analyzed with a semi-quantitative method. The regional distribution of lung infection was compared between upper, middle and lower lobes, as well as between dependant and non-dependant regions. The presence of infectious lesions was correlated with measurements of lung aeration. Nine of the ten piglets developed VAP. Infectious lesions were distributed along a sterno-vertebral and a cephalocaudal gradient; the lower and middle lobes were more frequently infected than the upper lobes. There was an inverse correlation (R= - 0.902) between the development of lung lesions and lung aeration. In conclusion, VAP was a frequent complication in healthy mechanically ventilated piglets, showing an anteroposterior as well as a cephalocaudal gradient. As expected, development of lung infection was accompanied by a corresponding loss of aeration.

Lung infection

10.1590/s1413-86702003000300007

Cite

Citations (8)

Bronchopulmonary penetration of inhaled amikacine during mechanical ventilation in piglets

European Journal of Anaesthesiology (2000)

Ivan Goldstein Charles‐Hugo Marquette L. Kedziora J. Robert Pierre Coriat

European Society of Anaesthesiologists; 8th Annual Meeting with the Austrian International Congress; Vienna, Austria, 1-4 April 2000

10.1097/00003643-200000002-00532

Cite

Citations (0)

A method for surveillance of influenza epidemics.

American Journal of Public Health (1976)

Ivan Goldstein Gene D. Block

A method for surveillance of influenza epidemics. I F Goldstein, and G BlockCopyRight https://doi.org/10.2105/AJPH.66.10.992 Published Online: October 07, 2011

2019-20 coronavirus outbreak

Pandemic

10.2105/ajph.66.10.992

Cite

Citations (6)

Mechanical ventilation and lung infection in the genesis of air-space enlargement.

Critical Care (2007)

Alfonso Sartorius Qin Lü Sílvia Regina Rios Vieira Marc Tonnellier Gilles Lenaour

Abstract Introduction Air-space enlargement may result from mechanical ventilation and/or lung infection. The aim of this study was to assess how mechanical ventilation and lung infection influence the genesis of bronchiolar and alveolar distention. Methods Four groups of piglets were studied: non-ventilated-non-inoculated (controls, n = 5), non-ventilated-inoculated ( n = 6), ventilated-non-inoculated ( n = 6), and ventilated-inoculated ( n = 8) piglets. The respiratory tract of intubated piglets was inoculated with a highly concentrated solution of Escherichia coli . Mechanical ventilation was maintained during 60 hours with a tidal volume of 15 ml/kg and zero positive end-expiratory pressure. After sacrifice by exsanguination, lungs were fixed for histological and lung morphometry analyses. Results Lung infection was present in all inoculated piglets and in five of the six ventilated-non-inoculated piglets. Mean alveolar and mean bronchiolar areas, measured using an analyzer computer system connected through a high-resolution color camera to an optical microscope, were significantly increased in non-ventilated-inoculated animals (+16% and +11%, respectively, compared to controls), in ventilated-non-inoculated animals (+49% and +49%, respectively, compared to controls), and in ventilated-inoculated animals (+95% and +118%, respectively, compared to controls). Mean alveolar and mean bronchiolar areas significantly correlated with the extension of lung infection ( R = 0.50, p < 0.01 and R = 0.67, p < 0.001, respectively). Conclusion Lung infection induces bronchiolar and alveolar distention. Mechanical ventilation induces secondary lung infection and is associated with further air-space enlargement. The combination of primary lung infection and mechanical ventilation markedly increases air-space enlargement, the degree of which depends on the severity and extension of lung infection.

Respiratory tract

10.1186/cc5680

Cite

Citations (25)

Ultrasound diagnosis of occult pneumothorax*

Critical Care Medicine (2005)

Daniel A. Lichtenstein Gilbert Mezière Nathalie Lascols Philippe Biderman Jean-Paul Courret

Pneumothorax can be missed by bedside radiography, and computed tomography is the current alternative. We asked whether lung ultrasound could be of any help in this situation.Retrospective study.The medical intensive care unit of a university-affiliated teaching hospital.All patients admitted to the intensive care unit are routinely scanned with whole-body ultrasound (including screening for pneumothorax) and chest radiography. The study population included 200 consecutive undifferentiated intensive care unit patients who received a chest computed tomography scan in addition to ultrasound and chest radiograph. Forty-seven consecutive cases of radioccult pneumothorax were compared with 310 consecutive hemithoraces free from pneumothorax in the intensive care unit.None.Three signs were investigated at the anterolateral chest wall in supine patients: lung sliding, the A line sign, and the lung point. A total of 357 hemithoraces were analyzed in this study, 47 with occult pneumothorax and 310 controls. Four of the 47 cases of pneumothorax were excluded from the final analysis (parietal emphysema) as well as eight of the 310 controls (large dressings), leaving a final study population of 345 hemithoraces in 197 patients. Feasibility was 98%. Ultrasound scans in all 43 examinable patients with pneumothorax showed absent lung sliding, 41 of 43 patients had the A line sign, and 34 exhibited a lung point. Among 302 analyzable controls, 65 had absent lung sliding, 16 of them showed an A line sign, and none showed a lung point. For the diagnosis of occult pneumothorax, the abolition of lung sliding alone had a sensitivity of 100% and a specificity of 78%. Absent lung sliding plus the A line sign had a sensitivity of 95% and a specificity of 94%. The lung point had a sensitivity of 79% and a specificity of 100%.For the diagnosis of occult pneumothorax, ultrasound can decrease the need for computed tomography.

Chest radiograph

Occult

Supine position

10.1097/01.ccm.0000164542.86954.b4

Cite

Citations (614)

Perianesthetic concerns for the non-COVID-19 patients requiring surgery during the COVID-19 pandemic outbreak: An observational study

Journal of Clinical Anesthesia (2020)

G. Boccara David Cassagnol L. Bargues Thierry Guenoun Benjamin Aubier

Pandemic

2019-20 coronavirus outbreak

Betacoronavirus

10.1016/j.jclinane.2020.109923

Cite

Citations (0)

Lung deposition of continuous and intermittent intravenous ceftazidime in experimental Pseudomonas aeruginosa bronchopneumonia

Intensive Care Medicine (2006)

Cassio Girardi Marc Tonnellier Ivan Goldstein Alfonso Sartorius Frédéric Wallet

Bolus (digestion)

10.1007/s00134-006-0272-9

Cite

Citations (15)

Novel and Innovative Strategies to Treat Ventilator-Associated Pneumonia: Optimizing the Duration of Therapy and Nebulizing Antimicrobial Agents

Seminars in Respiratory and Critical Care Medicine (2006)

Ivan Goldstein Jean Chastre Jean‐Jacques Rouby

Ventilator-associated pneumonia (VAP) is responsible for approximately half of the infections acquired in the intensive care unit (ICU) and represents one of the principal reasons for prescribing antibiotics in this setting. Because unnecessary prolongation of antimicrobial therapy and insufficient dosing of antibiotics at the site of infection in patients with true bacterial infection may lead to the selection of multidrug-resistant microorganisms without improving clinical outcome, efforts to reduce the duration of therapy and optimize pulmonary penetration of antimicrobial agents are warranted. An 8-day regimen can probably be standard for patients with VAP. Possible exceptions to this recommendation include immunosuppressed patients, those whose initial antimicrobial treatment was not appropriate for the causative microorganism(s), and patients whose infection was caused by very difficult-to-treat microorganisms and had no improvement in clinical signs of infection. Nebulizing concentration-dependent antibiotics such as aminoglycosides during mechanical ventilation can markedly increase tissue penetration in foci of pneumonia as compared with intravenous administration. The superiority in terms of pulmonary penetration and antibacterial efficacy of this route of administration was demonstrated in a model of ventilated piglets with and without bronchopneumonia.

Ventilator-associated Pneumonia

Regimen

10.1055/s-2006-933676

Cite

Citations (13)

Lung Tissue Concentrations of Nebulized Amikacin during Mechanical Ventilation in Piglets with Healthy Lungs

American Journal of Respiratory and Critical Care Medicine (2002)

Ivan Goldstein Frédéric Wallet J. Robert M.H. Becquemin Charles‐Hugo Marquette

The tissue concentration of aminoglycosides in lung parenchyma is the main determinant of bactericidal efficiency. The aim of the study was to compare the lung deposition of amikacin administered either by an ultrasonic nebulizer or by intravenous infusion during mechanical ventilation. Eighteen healthy ventilated piglets received a single daily dose of amikacin by intravenous infusion (15 mg · kg− 1) and 18 by aerosol (1 g in 12 ml). The amount of aerosolized amikacin reaching the tracheobronchial tree represented 40 ± 5% of the initial dose with an aerodynamic size distribution showing 50% of particles ranging between 0.5 and 5 μ m mass median diameter. Animals were killed at different time intervals after the second dose. Tissue concentrations of amikacin were determined on cryomixed multiple lung specimen by an immunoenzymatic method. The lung concentrations of nebulized amikacin, peaking at 208 ± 76 μ g · g− 1, were more than 10-fold higher than the lung concentrations of intravenous amikacin and were homogeneously distributed throughout the lung parenchyma. Amikacin plasma concentrations lower than 5 mmol · l− 1 were measured after the sixth hour after the nebulization. In conclusion, the ultrasonic nebulization of amikacin resulted in high tissue concentrations, far above the minimal inhibitory concentrations of most gram-negative strains.

Amikacin

Parenchyma

Aerosolization

Nebulizer

10.1164/ajrccm.165.2.2107025

Cite

Citations (97)

Histological assessment of ventilator-induced alveolar oedema during experimental pneumonia in piglets

European Journal of Anaesthesiology (2000)

Ivan Goldstein T. Bugalho Luíz Marcelo Sá Malbouisson Charles‐Hugo Marquette Gilles Lenaour

European Society of Anaesthesiologists; 8th Annual Meeting with the Austrian International Congress; Vienna, Austria, 1-4 April 2000

10.1097/00003643-200000002-00560

Cite

Citations (0)