Network


Latest external collaboration on country level. Dive into details by clicking on the dots.

Hotspot


Dive into the research topics where Nadia Smail is active.

Publication


Featured researches published by Nadia Smail.


Journal of Trauma-injury Infection and Critical Care | 2005

Early embolization and vasopressor administration for management of life-threatening hemorrhage from pelvic fracture.

Pascal Fangio; Karim Asehnoune; Alain Edouard; Nadia Smail; Dan Benhamou

BACKGROUND In this retrospective study, we reviewed our protocol for management of hemodynamically unstable patients with pelvic injury. METHODS We managed the patients with the same predetermined plan including controlled hemodynamic resuscitation with early use of vasopressors and pelvic angiography as a first-line treatment. RESULTS Of 311 patients with pelvic fracture, 32 hemodynamically unstable patients (10.3%) underwent pelvic angiography, which was followed by embolization in 25 cases. Angiography was successful for 24 patients (96%) and extrapelvic bleeding was diagnosed in 5 patients (15%). Three of six laparotomies performed before angiography were nontherapeutic. One of seven laparotomies performed after angiography was negative. CONCLUSION A protocol for management of patients with pelvic injury and hemodynamic instability that is associated with controlled resuscitation including vasopressor and early pelvic angioembolization is effective for treating pelvic hemorrhage and diagnosing extrapelvic hemorrhage. Further studies are needed to confirm the respective place of angiographic and surgical control of bleeding.


Critical Care Medicine | 2010

Mechanism, glasgow coma scale, age, and arterial pressure (MGAP): a new simple prehospital triage score to predict mortality in trauma patients

Danielle Sartorius; Yannick Le Manach; Jean-Stéphane David; Elisabeth Rancurel; Nadia Smail; Michel Thicoïpé; Eric Wiel; Agnès Ricard-Hibon; Frederic Berthier; Pierre-Yves Gueugniaud; Bruno Riou

Objectives:Prehospital triage of trauma patients is of paramount importance because adequate trauma center referral improves survival. We developed a simple score that is easy to calculate in the prehospital phase. Design:Multicenter prospective observational study. Setting:Prehospital physician-staffed emergency system in university and nonuniversity hospitals. Interventions:We evaluated 1360 trauma patients receiving care from a prehospital mobile intensive care unit in 22 centers in France during 2002. The association of prehospital variables with in-hospital death was tested using logistic regression, and a simple score (the Mechanism, Glasgow coma scale, Age, and Arterial Pressure [MGAP] score) was created and compared with the triage Revised Trauma Score, Revised Trauma Score, and Trauma Related Injury Severity Score. The model was validated in 1003 patients from 2003 through 2005. Measurements and Main Results:Four independent variables were identified, and each was assigned a number of points proportional to its regression coefficient to provide the MGAP score: Glasgow Coma Scale (from 3–15 points), blunt trauma (4 points), systolic arterial blood pressure (>120 mm Hg: 5 points, 60 to 120 mm Hg: 3 points), and age <60 yrs (5 points). The area under the receiver operating characteristic curve of MGAP was not significantly different from that of the triage Revised Trauma Score or Revised Trauma Score, but when sensitivity was fixed >0.95 (undertriage of 0.05), the MGAP score was more specific and accurate than triage Revised Trauma Score and Revised Trauma Score, approaching those of Trauma Related Injury Severity Score. We defined three risk groups: low (23–29 points), intermediate (18–22 points), and high risk (<18 points). In the derivation cohort, the mortality was 2.8%, 15%, and 48%, respectively. Comparable characteristics of the MGAP score were observed in the validation cohort. Conclusion:The MGAP score can accurately predict in-hospital death in trauma patients.


Critical Care Medicine | 1999

Continuous venovenous hemofiltration improves cardiac performance by mechanisms other than tumor necrosis factor-α attenuation during endotoxic shock

Peter Rogiers; Haibo Zhang; Nadia Smail; Dirk Pauwels; Jean Louis Vincent

OBJECTIVE To assess the effects of continuous venovenous hemofiltration (CWH) on global and regional hemodynamics, plasma lactate, and tumor necrosis factor-oa (TNF-a) levels during endotoxic shock in dogs. METHODS Thirty pentobarbital-anesthetized and mechanically ventilated dogs were divided into six groups of five dogs each. Group 1 served as a control, undergoing CWH at 3 Uhr without endotoxin. Group 2 served as the endotoxin-alone time-matching group. Group 3 received CWH 1 hr after endotoxin at 3 Uhr for 270 mins. Group 4 received CWH 1 hr after endotoxin at 3 Uhr for 150 mins and at 6 Uhr for an additional 120 mins. Group 5 and group 6 received the ultrafiltrate from group 1 and group 3, respectively. MEASUREMENTS AND MAIN RESULTS Three hours after endotoxin challenge, dogs treated with CWH at 3 Uhr had a higher cardiac output (4.9 + 0.6 vs. 2.9 + 0.6 Umin; p < .05) and stroke volume (35 + 7 vs. 20 + 4 mL; p < .05) and a lower pulmonary vascular resistance (116 26 vs. 331 + 126 dyne-sec/cm5; p < .05) than the endotoxin-alone group. Five hours after endotoxin, dogs treated with CWH at 6 Uhr also had higher hepatic (464 + 164 vs. 126 + 75 mUmin; p < .05) and femoral (95 + 46 vs. 30 + 34 mL/min; p < .05) blood flow. Moreover, dogs treated with CWH at 6 Uhr had higher mean arterial blood pressure (84 + 24 vs. 40 + 15 mm Hg; p < .05) and left ventricular stroke work index (1.1 + 0.6 vs. 0.2 + 0.2 g/kg; p < .05) than the endotoxin-alone group. Plasma lactate levels were lower in the CWH group at 6 Uhr (2.7 + 1.1 mmol/L) than in the endotoxin-alone group (4.4 + 0.6 mmol/L; p < .05). Plasma TNF-ao levels were unaffected, and only minor amounts of TNF-o were found in the ultrafiltrate. CONCLUSION In this acute endotoxic shock model, CWH at 3 Uhr improved cardiac performance and decreased pulmonary vasoconstriction. Moreover, CWH at 6 LUhr also increased arterial blood pressure and left ventricular stroke work, increased hepatic and femoral arterial blood flow, and decreased blood lactate levels. These effects were not attributable to TNF-alpha removal.


Journal of Trauma-injury Infection and Critical Care | 1998

Resuscitation after Uncontrolled Venous Hemorrhage: Does Increased Resuscitation Volume Improve Regional Perfusion

Nadia Smail; Ping Wang; William G. Cioffi; Kirby I. Bland; Irshad H. Chaudry

BACKGROUND Recent studies have questioned the use of aggressive fluid resuscitation after uncontrolled arterial hemorrhage until the bleeding is controlled. However, it remains unknown whether resuscitation after hemorrhage from a venous origin (usually nonaccessible to surgical intervention) has any beneficial or deleterious effects on regional perfusion. The aim of this study, therefore, was to determine whether increased volume of fluid resuscitation after uncontrolled venous hemorrhage improves hemodynamic profile and regional perfusion in various tissues. MATERIALS AND METHODS After methoxyflurane anesthesia and midline laparotomy, both lumbar veins in the rat were severed, which resulted in lowering the mean arterial blood pressure to approximately 40 mm Hg. This pressure was maintained for 45 minutes by allowing further bleeding from the lumbar veins. The abdominal incision was then closed in layers and the animals received either 0, 10, or 30 mL of lactated Ringers solution intravenously over a period of 60 minutes. Cardiac output and regional blood flow were determined by radioactive microspheres immediately or at 1.5 hours after the completion of resuscitation. RESULTS Fluid resuscitation with 10 or 30 mL lactated Ringers solution increased mean arterial blood pressure and cardiac output immediately after resuscitation compared with the nonresuscitated animals. At both time points, regional perfusion in the heart, kidney and intestines remained significantly decreased compared with the sham values, irrespective of the volume of fluid resuscitation. Moreover, no further improvements in hemodynamics or regional perfusion occurred when volume resuscitation was increased from 10 mL to 30 mL. Total hepatic blood flow, however, increased with 10 mL lactated Ringers solution compared with the other hemorrhage groups and the increase was evident even at 1.5 hours after resuscitation. CONCLUSIONS Fluid resuscitation after uncontrolled venous bleeding transiently increased cardiac output and mean arterial blood pressure compared with nonresuscitated animals. Moderate fluid administration, i.e., 10 mL, however, did increase total hepatic blood flow. In contrast, increasing the resuscitation volume to 30 mL did not improve hemodynamic parameters or regional perfusion. Thus moderate instead of no resuscitation or larger volume of resuscitation is recommended in an uncontrolled model of venous hemorrhage.


Journal of Critical Care | 1998

The Platelet-Activating Factor Antagonist BB-882 Does Not Improve Tissue Oxygen Extraction in Endotoxic Shock

Herbert D. Spapen; Haibo Zhang; Virginie Verhaeghe; Nadia Smail; Jean Louis Vincent

PURPOSE We investigated whether BB-882, a novel potent PAF antagonist, could influence systemic and pulmonary hemodynamics and oxygen extraction capabilities during an acute reduction in blood flow induced by cardiac tamponade after endotoxin challenge. MATERIALS AND METHODS Twenty-one anesthetized, ventilated, and endotoxin-shocked (2 mg/kg i.v. Escherichia coli endotoxin) dogs were randomly divided in three groups. One group (N = 7) served as control. A second group (N = 7) received BB-882 as a single bolus dose of 5 mg/kg, 30 minutes before endotoxin administration. A third group (N = 7) received BB-882 as a continuous infusion of 5 mg/kg x h, started 30 minutes after endotoxin. Hemodynamic and gazometric measurements were obtained in all dogs 30 minutes after endotoxin injection and repeated 30 minutes after cardiac filling pressures were restored to baseline by generous saline infusion. Saline infusion rate was then set at 20 mL/kg x h and tamponade was induced by repeated bolus injections of warm saline into the pericardial sac. RESULTS Compared with controls, pretreatment with BB-882 attenuated the early endotoxin-induced decrease in arterial pressure (70 +/- 17 v 51 +/- 14 mm Hg, P < .05), cardiac index (118 +/- 29 v 91 +/- 15 mL/ kg x min, P < .05), stroke index (1.0 +/- 0.2 v 0.7 +/- 0.3 mL/kg, P < .05), and left ventricular stroke work index (0.9 +/- 0.3 v 0.4 +/- 0.2 g x m/kg, P < .05), but these effects were not sustained after fluid resuscitation. In contrast, BB-882 post-treatment maintained arterial pressure and improved cardiac performance at lower filling pressures in the later phase of endotoxic shock. BB-882 did not influence pulmonary hemodynamics. Treatment with BB-882 did not influence oxygen extraction at critical oxygen delivery (51.5 +/- 9.9% and 52.8 +/- 13.9% v 46.6 +/- 9.0%, respectively BB-882 pretreatment and post-treatment v control). CONCLUSIONS We conclude that in this model of endotoxic shock the administration of BB-882, either before or after endotoxin challenge, has time-related beneficial hemodynamic and cardiac effects but does not improve global oxygen extraction capabilities. The potential benefit of adjunctive treatment with a platelet-activating factor antagonist in sepsis remains doubtful.


American Journal of Respiratory and Critical Care Medicine | 1998

Does hepato-splanchnic VO2/DO2 dependency exist in critically ill septic patients?

Daniel De Backer; Jacques Creteur; Oaleed Noordally; Nadia Smail; Béatrice Gulbis; Jean Louis Vincent


Journal of Surgical Research | 1998

Increased Gut Permeability after Hemorrhage Is Associated with Upregulation of Local and Systemic IL-6

Weiyang Wang; Nadia Smail; Ping Wang; Irshad H. Chaudry


American Journal of Respiratory and Critical Care Medicine | 1997

Effects of norepinephrine on regional blood flow and oxygen extraction capabilities during endotoxic shock.

Haibo Zhang; Nadia Smail; Ana Cabral; Peter Rogiers; Jean Louis Vincent


Journal of Applied Physiology | 1997

Effects of nitric oxide on blood flow distribution and O2 extraction capabilities during endotoxic shock

Haibo Zhang; Peter Rogiers; Nadia Smail; Ana Cabral; Jean-Charles Preiser; Marie-Odile Peny; Jean Louis Vincent


Archives of Surgery | 1998

Gut and Liver: The Organs Responsible for Increased Nitric Oxide Production After Trauma-Hemorrhage and Resuscitation

Nadia Smail; Robert A. Catania; Ping Wang; William G. Cioffi; Kirby I. Bland; Irshad H. Chaudry

Collaboration


Dive into the Nadia Smail's collaboration.

Top Co-Authors

Avatar

Jean Louis Vincent

Université libre de Bruxelles

View shared research outputs
Top Co-Authors

Avatar

Peter Rogiers

Free University of Brussels

View shared research outputs
Top Co-Authors

Avatar
Top Co-Authors

Avatar

Ana Cabral

Free University of Brussels

View shared research outputs
Top Co-Authors

Avatar
Top Co-Authors

Avatar

Ping Wang

University of Alabama at Birmingham

View shared research outputs
Top Co-Authors

Avatar
Top Co-Authors

Avatar
Top Co-Authors

Avatar
Top Co-Authors

Avatar

Marie-Odile Peny

Free University of Brussels

View shared research outputs
Researchain Logo
Decentralizing Knowledge