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Papers by Marc Trippaerts
Revue médicale de Liège, 1999
Objectif : Evaluation des resultats du traitement des cardiopathies congenitales a Liege. Materie... more Objectif : Evaluation des resultats du traitement des cardiopathies congenitales a Liege. Materiel et methode : nous avons etudie les resultats, la mortalite et la morbidite du catheterisme cardiaque diagnostique et interventionnel, et de la chirurgie cardiaque infantile chez les 123 enfants cardiopathes qui nous ont ete referes durant les trois premieres annees de fonctionnement de notre equipe medico-chirurgicale. Resultats : 89 enfants ont subi un catheterisme cardiaque, dont 12 a caractere interventionnel, alors que 68 ont ete operes. Dans les deux secteurs d'activite, les resultats sont tout a fait comparables a ceux des centres etablis. Conclusion : l'elargissement de l'activite de cardiologie pediatrique et la creation d'une activite de chirurgie cardiaque infantile a Liege nous paraissaient importantes pour la qualite de la prise en charge des enfants cardiopathes. Ce but ne pouvait etre atteint que si nos resultats etaient comparables a ceux de la litteratur...
Annals of Intensive Care, 2016
Background: Organ dysfunction scores, based on physiological parameters, have been created to des... more Background: Organ dysfunction scores, based on physiological parameters, have been created to describe organ failure. In a general pediatric intensive care unit (PICU) population, the PEdiatric Logistic Organ Dysfunction-2 score (PELOD-2) score had both a good discrimination and calibration, allowing to describe the clinical outcome of critically ill children throughout their stay. This score is increasingly used in clinical trials in specific subpopulation. Our objective was to assess the performance of the PELOD-2 score in a subpopulation of critically ill children requiring plasma transfusions. Methods: This was an ancillary study of a prospective observational study on plasma transfusions over a 6-week period, in 101 PICUs in 21 countries. All critically ill children who received at least one plasma transfusion during the observation period were included. PELOD-2 scores were measured on days 1, 2, 5, 8, and 12 after plasma transfusion. Performance of the score was assessed by the determination of the discrimination (area under the ROC curve: AUC) and the calibration (Hosmer-Lemeshow test). Results: Four hundred and forty-three patients were enrolled in the study (median age and weight: 1 year and 9.1 kg, respectively). Observed mortality rate was 26.9 % (119/443). For PELOD-2 on day 1, the AUC was 0.76 (95 % CI 0.71-0.81) and the Hosmer-Lemeshow test was p = 0.76. The serial evaluation of the changes in the daily PELOD-2 scores from day 1 demonstrated a significant association with death, adjusted for the PELOD-2 score on day 1. Conclusions: In a subpopulation of critically ill children requiring plasma transfusion, the PELOD-2 score has a lower but acceptable discrimination than in an entire population. This score should therefore be used cautiously in this specific subpopulation.
Acta Paediatrica, 2015
Non-invasive ventilation (NIV) is commonly used in paediatric intensive care units (PICUs) for re... more Non-invasive ventilation (NIV) is commonly used in paediatric intensive care units (PICUs) for respiratory failure. This review aims to improve paediatricians' understanding of NIV, by specifying technical or practical considerations, giving advice about selecting patients and presenting pertinent published data about NIV in different circumstances. Conclusion: NIV is useful in PICUs if children are appropriately selected and carefully monitored. Technological advances and future clinical research will improve its use and success rate in PICU.
Revue médicale de Liège, 2005
The Hemolytic Uremic Syndrome (HUS) is the prime cause for acute renal failure in children. The H... more The Hemolytic Uremic Syndrome (HUS) is the prime cause for acute renal failure in children. The HUS is a combination of hemolytic anemia, thombopenia and acute nephropathy: all signs of a thrombotic microangiopathy. Onset occurs generally in infancy and is often associated with severe bloody diarrhea. Most of those cases are caused by Escherichia coli O157:H7 witch produces an exotoxin responsible for the microangiopathy. We discuss the treatment of HUS based on the experience acquired since 1994 in our Paediatric Intensive Care Unit (PICU), University of Liege. The frequent association of dehydration, multi-systemic impairment and reno-vascular hypertension justifies the early admission for PICU-surveillance. This allows the difficult fluid balance management in a setting of renal and pre-renal failure.
Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie, 2002
Psittacosis is rare among children and severe cases appear exceptional. We describe a child with ... more Psittacosis is rare among children and severe cases appear exceptional. We describe a child with psittacosis and multiorgan involvement. T., a ten-year-old boy, was admitted for a prolonged fever associated with meningism. Laboratory tests showed an important inflammatory response, mild renal failure and coagulation disorders. On admission, the chest X-Ray and the cerebrospinal fluid were normal. He rapidly developed shock, acute abdomen, oxygenodependency, pneumonia and bilateral pleural effusion. No improvement was observed after 48 hours of cefotaxime therapy. History revealed the presence of two parrots at home. Treatment by intravenous clarithromycin was therefore initiated. Serology for Chlamydia psittaci was strongly positive. All symptoms disappeared a few days later. The case reported was particular for two reasons: severe disease with multi-organ involvement and young age of the patient. We emphasize the need to search for a history of contact with birds in any case of une...
Revue médicale de Liège, 2000
Meningococcemia is a severe Gram negative septicemia whose mortality may be as high as 30%. It oc... more Meningococcemia is a severe Gram negative septicemia whose mortality may be as high as 30%. It occurs more frequently in children but the proportion of teenagers is increasing in Belgium. During the past decade, a slow but sustained rise in the incidence of this illness has been noted, with a predominance of the serogroup B. We describe the symptoms, which often are poor in the early stage, the different therapies, most of them being still under investigation, and the chemoprophylaxis. Without being alarmist, the diagnosis must be considered in any child with cutaneous rash, even atypical and tachycardia.
Revue médicale de Liège, 1999
Evaluation of the results obtained in the management of congenital heart diseases in Liège. We ev... more Evaluation of the results obtained in the management of congenital heart diseases in Liège. We evaluated the results, the mortality and the morbidity of diagnostic and interventional cardiac catheterization, and of the cardiac surgery in the 123 cardiac children who were referred to us during the three first years of operation of our medico-surgical team. 89 children underwent a catheterization, including 12 therapeutic interventions, whereas 68 were operated. In the two domains, the results are completely comparable with those of the established centers. The widening of the activity of paediatric cardiology and the creation of an activity of pediatric cardiac surgery in Liège appeared important to us for the quality of management of the cardiac children. This goal could be reached only if our results were comparable with those of the literature. The bet seems to be held. The ultimate objective is to contribute by an adequate policy of management to the quality of life and the healt...
Acta cardiologica, 1998
We describe a 1-month-old infant who developed a cardiogenic shock. Echocardiography suspected an... more We describe a 1-month-old infant who developed a cardiogenic shock. Echocardiography suspected an aortic coarctation. Left brachial artery counter-current aortography gave safe and adequate imaging of the aortic coarctation. We see many advantages to this approach: (1) most complications associated with classical cardiac catheterization are significantly reduced, (2) adequate imaging of coarctation, anatomy of the aortic arch and eventually collateral circulation is obtained, (3) the volume of contrast is reduced, (3) increased risk of femoral artery injury is avoided, (4) the procedure lasts only a few minutes, and (5) no sedation is needed. We conclude that left brachial artery counter-current aortography is a safe, quick and relatively non-invasive procedure which can be used in infants in whom clinical, cross-sectional, and Doppler echocardiographic findings are suggestive but not conclusive of anomalies of the aortic arch, especially when magnetic resonance imaging is not avail...
Journal de Radiologie, 2004
Archives de Pédiatrie, 2002
La psittacose est rare chez l'enfant et les cas sévères exceptionnels. Nous décrivons le cas d'un... more La psittacose est rare chez l'enfant et les cas sévères exceptionnels. Nous décrivons le cas d'un enfant atteint de psittacose avec atteinte multisystémique sévère. Observation clinique.-T., dix ans, a été hospitalisé pour une fièvre persistante accompagnée de signes méningés. La biologie montrait un syndrome inflammatoire important, une insuffisance rénale modérée et des perturbations de l'hémostase. La radiographie du thorax et le liquide céphalorachidien étaient normaux à l'admission. Son état s'est progressivement dégradé avec état de choc, abdomen aigu, oxygénodépendance, bronchopneumonie et épanchement pleural bilatéral. Aucune amélioration n'a été constatée après 48 heures de traitement par céfotaxime. Un complément d'anamnèse révéla la présence de deux perruches au domicile. Un traitement par voie intraveineuse par clarithromycine a été dès lors entrepris. Une sérologie Chlamydia psittaci était fortement positive. Une résolution complète des symptômes a été observée en quelques jours. Conclusion.-Le cas présenté était particulier à plus d'un titre : il s'agissait d'une forme sévère avec atteinte multiviscérale et touchant un jeune patient. Nous insistons sur la nécessité de rechercher la notion d'un contact avec un oiseau devant tout cas de pneumonie inexpliquée. © 2002 Éditions scientifiques et médicales Elsevier SAS Chlamydia / psittacose Summary-Severe psittacosis with multiorgan failure in a 10 year-old boy. Psittacosis is rare among children and severe cases appear exceptional. We describe a child with psittacosis and multiorgan involvement. Case report.-T., a ten-year-old boy, was admitted for a prolonged fever associated with meningism. Laboratory tests showed an important inflammatory response, mild renal failure and coagulation disorders. On admission, the chest X-Ray and the cerebrospinal fluid were normal. He rapidly developed shock, acute abdomen, oxygenodependency, pneumonia and bilateral pleural effusion. No improvement was observed after 48 hours of cefotaxime therapy. History revealed the presence of two parrots at home. Treatment by intravenous clarithromycin was therefore initiated. Serology for Chlamydia psittaci was strongly positive. All symptoms disappeared a few days later. Conclusion.-The case reported was particular for two reasons: severe disease with multi-organ involvement and young age of the patient. We emphasize the need to search for a history of contact with birds in any case of unexplained pneumonia.
Revue médicale de Liège, 1999
Objectif : Evaluation des resultats du traitement des cardiopathies congenitales a Liege. Materie... more Objectif : Evaluation des resultats du traitement des cardiopathies congenitales a Liege. Materiel et methode : nous avons etudie les resultats, la mortalite et la morbidite du catheterisme cardiaque diagnostique et interventionnel, et de la chirurgie cardiaque infantile chez les 123 enfants cardiopathes qui nous ont ete referes durant les trois premieres annees de fonctionnement de notre equipe medico-chirurgicale. Resultats : 89 enfants ont subi un catheterisme cardiaque, dont 12 a caractere interventionnel, alors que 68 ont ete operes. Dans les deux secteurs d'activite, les resultats sont tout a fait comparables a ceux des centres etablis. Conclusion : l'elargissement de l'activite de cardiologie pediatrique et la creation d'une activite de chirurgie cardiaque infantile a Liege nous paraissaient importantes pour la qualite de la prise en charge des enfants cardiopathes. Ce but ne pouvait etre atteint que si nos resultats etaient comparables a ceux de la litteratur...
Annals of Intensive Care, 2016
Background: Organ dysfunction scores, based on physiological parameters, have been created to des... more Background: Organ dysfunction scores, based on physiological parameters, have been created to describe organ failure. In a general pediatric intensive care unit (PICU) population, the PEdiatric Logistic Organ Dysfunction-2 score (PELOD-2) score had both a good discrimination and calibration, allowing to describe the clinical outcome of critically ill children throughout their stay. This score is increasingly used in clinical trials in specific subpopulation. Our objective was to assess the performance of the PELOD-2 score in a subpopulation of critically ill children requiring plasma transfusions. Methods: This was an ancillary study of a prospective observational study on plasma transfusions over a 6-week period, in 101 PICUs in 21 countries. All critically ill children who received at least one plasma transfusion during the observation period were included. PELOD-2 scores were measured on days 1, 2, 5, 8, and 12 after plasma transfusion. Performance of the score was assessed by the determination of the discrimination (area under the ROC curve: AUC) and the calibration (Hosmer-Lemeshow test). Results: Four hundred and forty-three patients were enrolled in the study (median age and weight: 1 year and 9.1 kg, respectively). Observed mortality rate was 26.9 % (119/443). For PELOD-2 on day 1, the AUC was 0.76 (95 % CI 0.71-0.81) and the Hosmer-Lemeshow test was p = 0.76. The serial evaluation of the changes in the daily PELOD-2 scores from day 1 demonstrated a significant association with death, adjusted for the PELOD-2 score on day 1. Conclusions: In a subpopulation of critically ill children requiring plasma transfusion, the PELOD-2 score has a lower but acceptable discrimination than in an entire population. This score should therefore be used cautiously in this specific subpopulation.
Acta Paediatrica, 2015
Non-invasive ventilation (NIV) is commonly used in paediatric intensive care units (PICUs) for re... more Non-invasive ventilation (NIV) is commonly used in paediatric intensive care units (PICUs) for respiratory failure. This review aims to improve paediatricians' understanding of NIV, by specifying technical or practical considerations, giving advice about selecting patients and presenting pertinent published data about NIV in different circumstances. Conclusion: NIV is useful in PICUs if children are appropriately selected and carefully monitored. Technological advances and future clinical research will improve its use and success rate in PICU.
Revue médicale de Liège, 2005
The Hemolytic Uremic Syndrome (HUS) is the prime cause for acute renal failure in children. The H... more The Hemolytic Uremic Syndrome (HUS) is the prime cause for acute renal failure in children. The HUS is a combination of hemolytic anemia, thombopenia and acute nephropathy: all signs of a thrombotic microangiopathy. Onset occurs generally in infancy and is often associated with severe bloody diarrhea. Most of those cases are caused by Escherichia coli O157:H7 witch produces an exotoxin responsible for the microangiopathy. We discuss the treatment of HUS based on the experience acquired since 1994 in our Paediatric Intensive Care Unit (PICU), University of Liege. The frequent association of dehydration, multi-systemic impairment and reno-vascular hypertension justifies the early admission for PICU-surveillance. This allows the difficult fluid balance management in a setting of renal and pre-renal failure.
Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie, 2002
Psittacosis is rare among children and severe cases appear exceptional. We describe a child with ... more Psittacosis is rare among children and severe cases appear exceptional. We describe a child with psittacosis and multiorgan involvement. T., a ten-year-old boy, was admitted for a prolonged fever associated with meningism. Laboratory tests showed an important inflammatory response, mild renal failure and coagulation disorders. On admission, the chest X-Ray and the cerebrospinal fluid were normal. He rapidly developed shock, acute abdomen, oxygenodependency, pneumonia and bilateral pleural effusion. No improvement was observed after 48 hours of cefotaxime therapy. History revealed the presence of two parrots at home. Treatment by intravenous clarithromycin was therefore initiated. Serology for Chlamydia psittaci was strongly positive. All symptoms disappeared a few days later. The case reported was particular for two reasons: severe disease with multi-organ involvement and young age of the patient. We emphasize the need to search for a history of contact with birds in any case of une...
Revue médicale de Liège, 2000
Meningococcemia is a severe Gram negative septicemia whose mortality may be as high as 30%. It oc... more Meningococcemia is a severe Gram negative septicemia whose mortality may be as high as 30%. It occurs more frequently in children but the proportion of teenagers is increasing in Belgium. During the past decade, a slow but sustained rise in the incidence of this illness has been noted, with a predominance of the serogroup B. We describe the symptoms, which often are poor in the early stage, the different therapies, most of them being still under investigation, and the chemoprophylaxis. Without being alarmist, the diagnosis must be considered in any child with cutaneous rash, even atypical and tachycardia.
Revue médicale de Liège, 1999
Evaluation of the results obtained in the management of congenital heart diseases in Liège. We ev... more Evaluation of the results obtained in the management of congenital heart diseases in Liège. We evaluated the results, the mortality and the morbidity of diagnostic and interventional cardiac catheterization, and of the cardiac surgery in the 123 cardiac children who were referred to us during the three first years of operation of our medico-surgical team. 89 children underwent a catheterization, including 12 therapeutic interventions, whereas 68 were operated. In the two domains, the results are completely comparable with those of the established centers. The widening of the activity of paediatric cardiology and the creation of an activity of pediatric cardiac surgery in Liège appeared important to us for the quality of management of the cardiac children. This goal could be reached only if our results were comparable with those of the literature. The bet seems to be held. The ultimate objective is to contribute by an adequate policy of management to the quality of life and the healt...
Acta cardiologica, 1998
We describe a 1-month-old infant who developed a cardiogenic shock. Echocardiography suspected an... more We describe a 1-month-old infant who developed a cardiogenic shock. Echocardiography suspected an aortic coarctation. Left brachial artery counter-current aortography gave safe and adequate imaging of the aortic coarctation. We see many advantages to this approach: (1) most complications associated with classical cardiac catheterization are significantly reduced, (2) adequate imaging of coarctation, anatomy of the aortic arch and eventually collateral circulation is obtained, (3) the volume of contrast is reduced, (3) increased risk of femoral artery injury is avoided, (4) the procedure lasts only a few minutes, and (5) no sedation is needed. We conclude that left brachial artery counter-current aortography is a safe, quick and relatively non-invasive procedure which can be used in infants in whom clinical, cross-sectional, and Doppler echocardiographic findings are suggestive but not conclusive of anomalies of the aortic arch, especially when magnetic resonance imaging is not avail...
Journal de Radiologie, 2004
Archives de Pédiatrie, 2002
La psittacose est rare chez l'enfant et les cas sévères exceptionnels. Nous décrivons le cas d'un... more La psittacose est rare chez l'enfant et les cas sévères exceptionnels. Nous décrivons le cas d'un enfant atteint de psittacose avec atteinte multisystémique sévère. Observation clinique.-T., dix ans, a été hospitalisé pour une fièvre persistante accompagnée de signes méningés. La biologie montrait un syndrome inflammatoire important, une insuffisance rénale modérée et des perturbations de l'hémostase. La radiographie du thorax et le liquide céphalorachidien étaient normaux à l'admission. Son état s'est progressivement dégradé avec état de choc, abdomen aigu, oxygénodépendance, bronchopneumonie et épanchement pleural bilatéral. Aucune amélioration n'a été constatée après 48 heures de traitement par céfotaxime. Un complément d'anamnèse révéla la présence de deux perruches au domicile. Un traitement par voie intraveineuse par clarithromycine a été dès lors entrepris. Une sérologie Chlamydia psittaci était fortement positive. Une résolution complète des symptômes a été observée en quelques jours. Conclusion.-Le cas présenté était particulier à plus d'un titre : il s'agissait d'une forme sévère avec atteinte multiviscérale et touchant un jeune patient. Nous insistons sur la nécessité de rechercher la notion d'un contact avec un oiseau devant tout cas de pneumonie inexpliquée. © 2002 Éditions scientifiques et médicales Elsevier SAS Chlamydia / psittacose Summary-Severe psittacosis with multiorgan failure in a 10 year-old boy. Psittacosis is rare among children and severe cases appear exceptional. We describe a child with psittacosis and multiorgan involvement. Case report.-T., a ten-year-old boy, was admitted for a prolonged fever associated with meningism. Laboratory tests showed an important inflammatory response, mild renal failure and coagulation disorders. On admission, the chest X-Ray and the cerebrospinal fluid were normal. He rapidly developed shock, acute abdomen, oxygenodependency, pneumonia and bilateral pleural effusion. No improvement was observed after 48 hours of cefotaxime therapy. History revealed the presence of two parrots at home. Treatment by intravenous clarithromycin was therefore initiated. Serology for Chlamydia psittaci was strongly positive. All symptoms disappeared a few days later. Conclusion.-The case reported was particular for two reasons: severe disease with multi-organ involvement and young age of the patient. We emphasize the need to search for a history of contact with birds in any case of unexplained pneumonia.