for Journals by Title or ISSN
for Articles by Keywords
help

Publisher: Elsevier   (Total: 3043 journals)

 A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z  

        1 2 3 4 5 6 7 8 | Last   [Sort by number of followers]   [Restore default list]

Showing 1 - 200 of 3043 Journals sorted alphabetically
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 22, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 21, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 84, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 25, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 30, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 4)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 350, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 25, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 1)
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 240, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 10, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription   (Followers: 1)
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 2)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 23, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 4)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 4, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 2)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 5, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 4, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 4)
Acute Pain     Full-text available via subscription   (Followers: 13)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 5)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 21)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 135, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 17, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 9, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 15, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 25, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 3)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 6, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 11, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 22, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 16, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 3, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 25, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 26, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 9, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 29, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 18, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 16, SJR: 0.223, h-index: 22)
Advances in Dermatology     Full-text available via subscription   (Followers: 12)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 6)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 22)
Advances in Ecological Research     Full-text available via subscription   (Followers: 41, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 25, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 41, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 50, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 16)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 11)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 22, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 0.497, h-index: 31)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 35, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 3, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 2)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 9)
Advances in Marine Biology     Full-text available via subscription   (Followers: 16, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 6, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 22)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 4)
Advances in Oncobiology     Full-text available via subscription   (Followers: 3)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 24, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 13)
Advances in Pharmacology     Full-text available via subscription   (Followers: 15, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 4)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 17)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 20, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 61)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 5, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 3, SJR: 0.1, h-index: 2)
Advances in Space Research     Full-text available via subscription   (Followers: 353, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 8)
Advances in Surgery     Full-text available via subscription   (Followers: 7, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 30, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 17)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 43, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 5, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 325, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 5, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 8, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 405, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 30, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 39, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 1)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 54, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 5, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 10, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 8)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access  
Algal Research     Partially Free   (Followers: 8, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 3)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 4, SJR: 0.776, h-index: 35)
Alpha Omegan     Full-text available via subscription   (SJR: 0.121, h-index: 9)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 8, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 48, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 6)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 5)
American Heart J.     Hybrid Journal   (Followers: 49, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 47, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 39, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 8, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 15, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 31, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 25, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 32, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 45, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 237, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 57, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 5)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 25, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 26, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 22, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 34, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 5)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 57, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 11)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 2, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 4, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 37, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 166, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 8, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 11)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 1)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 22, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access  
Animal Behaviour     Hybrid Journal   (Followers: 160, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)
Animal Reproduction Science     Hybrid Journal   (Followers: 5, SJR: 0.711, h-index: 78)
Annales d'Endocrinologie     Full-text available via subscription   (Followers: 1, SJR: 0.394, h-index: 30)
Annales d'Urologie     Full-text available via subscription  
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (SJR: 0.177, h-index: 13)
Annales de Chirurgie de la Main et du Membre Supérieur     Full-text available via subscription  
Annales de Chirurgie Plastique Esthétique     Full-text available via subscription   (Followers: 2, SJR: 0.354, h-index: 22)
Annales de Chirurgie Vasculaire     Full-text available via subscription   (Followers: 1)

        1 2 3 4 5 6 7 8 | Last   [Sort by number of followers]   [Restore default list]

Journal Cover Anaesthesia Critical Care & Pain Medicine
  [11 followers]  Follow
    
   Full-text available via subscription Subscription journal
   ISSN (Online) 2352-5568
   Published by Elsevier Homepage  [3043 journals]
  • Postoperative neurosurgery complication in 2017: A new window to take into
           account surgical ischaemic events
    • Authors: C. Bombled; A. André; A. Jacquens; F. Clarençon; V. Degos
      Pages: 203 - 204
      Abstract: Publication date: August 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 4
      Author(s): C. Bombled, A. André, A. Jacquens, F. Clarençon, V. Degos


      PubDate: 2017-08-09T13:18:45Z
      DOI: 10.1016/j.accpm.2017.07.001
       
  • Residual anxiety after high fidelity simulation in anaesthesiology: An
           observational, prospective, pilot study
    • Authors: Jean-Noël Evain; Lana Zoric; Laurent Mattatia; Olivier Picard; Jacques Ripart; Philippe Cuvillon
      Pages: 205 - 212
      Abstract: Publication date: August 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 4
      Author(s): Jean-Noël Evain, Lana Zoric, Laurent Mattatia, Olivier Picard, Jacques Ripart, Philippe Cuvillon
      Background High fidelity simulation (HFS) in anaesthesiology intentionally provides stress on students, but anxiety may be detrimental if it goes on through debriefing. The primary goal of this study was to estimate the proportion of students with significant anxiety remaining after debriefing (residual anxiety [RA]). Secondary goals were to evaluate the instructors’ ability to estimate students’ RA and to identify potential risk factors for high RA. Subjects and methods Following IRB approval and informed consent, data from a cohort of subjects were prospectively collected by an independent expert. State-anxiety after debriefing (RA) was prospectively measured using the State-Trait Anxiety Inventory (a score varying from 20 to 80/80). RA was considered significant when≥36/80. Instructors simultaneously estimated the levels of subjects’ RA via a visual analogue scale. Data about subjects, stress during scenarios (including continuous heart rate monitoring), and debriefings (including DASH© quality scores) were also collected. Results Seventy study subjects (30 residents, 26 nurses and 14 anaesthetists) were enrolled during 52 HFS sessions. As concerns the primary endpoint, RA was≥36/80 in 15 subjects (21%; 95% CI: 13–32). The median RA was 30/80 [25–35]. For secondary endpoints, the instructors’ estimations poorly correlated with measurements: rho=0.36 (P <0.01); limits of agreement: –16 and 22. Subjects with RA≥36/80 had significantly higher trait-anxiety (P <0.01). An easy scenario (P =0.04) and low quality debriefing (P =0.04) were associated with higher RAs. Conclusion Most students experienced low anxiety after debriefing. Instructors seem to be unable to reliably estimate students’ RA. Students with an anxious personality are more likely to be anxious after debriefing.

      PubDate: 2017-08-09T13:18:45Z
      DOI: 10.1016/j.accpm.2016.09.008
       
  • Postoperative complications after craniotomy for brain tumor surgery
    • Authors: Laurent Lonjaret; Marine Guyonnet; Emilie Berard; Marc Vironneau; Françoise Peres; Sandrine Sacrista; Anne Ferrier; Véronique Ramonda; Corine Vuillaume; Franck-Emmanuel Roux; Olivier Fourcade; Thomas Geeraerts
      Pages: 213 - 218
      Abstract: Publication date: August 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 4
      Author(s): Laurent Lonjaret, Marine Guyonnet, Emilie Berard, Marc Vironneau, Françoise Peres, Sandrine Sacrista, Anne Ferrier, Véronique Ramonda, Corine Vuillaume, Franck-Emmanuel Roux, Olivier Fourcade, Thomas Geeraerts
      Introduction After elective craniotomy for brain tumour surgery, patients are usually admitted to an intensive care unit (ICU) for monitoring. Our goal was to evaluate the incidence and timing of neurologic and non-neurologic postoperative complications after brain tumour surgery, to determine factors associated with neurologic events and to evaluate the timing and causes of ICU readmission. Patients and methods This prospective, observational and analytic study enrolled 188 patients admitted to the ICU after brain tumour surgery. All postoperative clinical events during the first 24hours were noted and classified. Readmission causes and timing were also analysed. Results Twenty-one (11%) of the patients were kept sedated after surgery; the remaining 167 patients were studied. Thirty one percent of the patients presented at least one complication (25% with postoperative nausea and vomiting (PONV), 16% with neurologic complications). The occurrence of neurological complications was significantly associated with the absence of preoperative motor deficit and the presence of higher intraoperative bleeding. Seven patients (4%) were readmitted to the ICU after discharge; 43% (n =3) of them had a posterior fossa surgery. Conclusion Postoperative complications, especially PONV, are frequent after brain tumour surgery. Moreover, 16% of patients presented a neurological complication, probably justifying the ICU postoperative stay for early detection. The absence of preoperative motor deficit and intraoperative bleeding seems to predict postoperative neurologic complications. Finally, patients may present complications after ICU discharge, especially patients with fossa posterior surgery, suggesting that ICU hospitalization may be longer in this type of surgery.

      PubDate: 2017-08-09T13:18:45Z
      DOI: 10.1016/j.accpm.2016.06.012
       
  • Bicarbonate-buffered ropivacaine-mepivacaine solution for medial caruncle
           anaesthesia
    • Authors: Gilles Guerrier; David Boutboul; Cédric Chanat; Charles Marc Samama; Christophe Baillard
      Pages: 219 - 221
      Abstract: Publication date: August 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 4
      Author(s): Gilles Guerrier, David Boutboul, Cédric Chanat, Charles Marc Samama, Christophe Baillard
      Background To compare self-reported pain during injection of plain versus alkalinised 0.75% ropivacaine–2% mepivacaine solution for anaesthesia performed at the medial caruncle site for eye surgery. Methods This prospective, monocentric, double blind, randomised, controlled trial involved 40 consecutive patients who received either a standard local anaesthetic solution (0.75% ropivacaine 5ml and 2% mepivacaine 5ml with a pH of 5.9), or an alkalinised solution composed with a pH-adjusted solution of 7.0 through adjunction of 0.15mEq sodium bicarbonate per 10ml of the same mixture. Before anaesthesia, patients received intravenous midazolam (0.03mg/kg) to ease potential anxiety. During injection performed at the medial caruncle site, patients were asked to grade a pain VRS (0 to 10) for the injection using a verbal analogue scale. The primary end point was to investigate pain during injection of local anaesthetics. Results Anxiety levels before anaesthesia were low and similar for both groups. The mean pain score for the alkalinised group was significantly reduced compared to the control group (6 [25–75%, IQR 4–9] versus 3 [25–75%, IQR 1–5]; P =0.02; 95% CI for the difference in median pain scores [1.9–3.3]). Conclusion Buffering local anaesthetics used in caruncular injection for eye surgery significantly reduces pain during injection. This simple strategy should be tested in routine clinical practice to improve patient satisfaction.

      PubDate: 2017-08-09T13:18:45Z
      DOI: 10.1016/j.accpm.2016.09.007
       
  • Burnout syndrome in critical care team members: A monocentric cross
           sectional survey
    • Authors: Stéphanie Malaquin; Yazine Mahjoub; Arianna Musi; Elie Zogheib; Alexis Salomon; Mathieu Guilbart; Hervé Dupont
      Pages: 223 - 228
      Abstract: Publication date: August 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 4
      Author(s): Stéphanie Malaquin, Yazine Mahjoub, Arianna Musi, Elie Zogheib, Alexis Salomon, Mathieu Guilbart, Hervé Dupont
      Introduction There has been a growing interest in evaluating the occurrence of burnout syndrome (BOS) among intensive care units (ICU) team over recent years. The aims of this study were to determine the prevalence of BOS among staff working in the Amiens University Hospital and to assess associated factors. Patients and methods Prospective observational study based on self-administered questionnaires filled in by physicians and non-physicians working in 3 ICUs. Demographic data, well-being assessment, work relationships, level of BOS and depressive symptoms were investigated. Logistic regression analysis was performed to identify variables independently associated with BOS. Results One hundred and sixty-one questionnaires were analysed. Participation rate was 90%. Thirty-two respondents were physicians and 129 were non-physicians. The prevalence of BOS was 51% and was not significantly different between physicians and non-physicians (56% versus 50%; P =0.501). Respondents who reported BOS less frequently had regular leisure activities (54 [66%] versus 70 [87%], P =0.001). In the BOS group, well-being was significantly lower (4.8±2.5/10 versus 6±2/10, P =0.001), a desire to leave the job was more frequently expressed (50 [61%] versus 32 [40%], P =0.009) and depressive symptoms were significantly more frequent (41 [50%] versus 21 [27%], P =0.002). Factors independently associated with BOS were regular leisure activities (OR 0.24 [0.1–0.59]; P =0.002), the presence of depressive symptoms (OR 2.71 [1.26–5.84]; P =0.011) and a well-being visual analogue scale≥5 (OR 0.40 [0.18–0.89]; P =0.024). Conclusions BOS affects all ICU workers and is determined by multiple factors. Leisure activities and measures designed to improve well-being should be promoted.

      PubDate: 2017-08-09T13:18:45Z
      DOI: 10.1016/j.accpm.2016.06.011
       
  • A targeted remifentanil administration protocol based on the analgesia
           nociception index during vascular surgery
    • Authors: Georges Daccache; Edouard Caspersen; Michel Pegoix; Kelly Monthé-Sagan; Ludovic Berger; Dominique Fletcher; Jean-Luc Hanouz
      Pages: 229 - 232
      Abstract: Publication date: August 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 4
      Author(s): Georges Daccache, Edouard Caspersen, Michel Pegoix, Kelly Monthé-Sagan, Ludovic Berger, Dominique Fletcher, Jean-Luc Hanouz
      Background The intraoperative modulation of opioids continues to be based on clinical signs. This may result in adverse events such as sympathetic reactivity or opioid-induced hyperalgesia. Recently, the Analgesia/Nociception Index (ANI), a non-invasive 0–100 index derived from heart rate variability analysis, has been proposed for nociception assessment. However, the ability of the ANI to adequately guide intraoperative opioid administration has never been demonstrated. We designed a prospective study to evaluate the ability of the ANI to guide remifentanil administration in vascular surgery. Methods One hundred and eighty adults presenting for elective surgery were included. All received total intravenous anaesthesia with propofol adjusted to entropy and remifentanil adjusted to the ANI. The primary endpoint was the number of patients without any episode of reactivity defined as a 20% increase in heart rate or arterial pressure or the occurrence of movement. Secondary endpoints included opioid use and maximal pain rate in the first postoperative day. Results Anaesthesia was achieved without any episode of reactivity in 160 (89%) patients. Twenty-five episodes of reactivity occurred in 20 (11%) patients. The median remifentanil dose was 0.042 [0.040–0.044]μg.kg− 1.min−1. At 24hours, the maximal NRS pain score was 2 [2,3]. One hundred and fifty-five patients (86%) did not receive any postoperative opioids, whereas 25 (14%) received a median dose of 5[5–10] mg of oxycodone. Conclusion This prospective study demonstrated that the ANI can be used to adequately guide intraoperative remifentanil administration during vascular surgery. Such guidance resulted in low remifentanil consumption, low postoperative pain rates and low opioid rescue analgesia.

      PubDate: 2017-08-09T13:18:45Z
      DOI: 10.1016/j.accpm.2016.08.006
       
  • Large vein injection alleviates rocuronium-induced pain in gynaecologic
           patients
    • Authors: Xing-Mei Zhang; Qun Wang; Wei-Si Wang; Meng Wang
      Pages: 233 - 235
      Abstract: Publication date: August 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 4
      Author(s): Xing-Mei Zhang, Qun Wang, Wei-Si Wang, Meng Wang
      Background Rocuronium-induced pain upon injection is very common in the clinical setting. Using the antecubital rather than the hand vein can avoid pain due to propofol injection. We aimed to investigate whether the use of the antecubital vein for injection would alleviate rocuronium-induced pain in a similar fashion. Methods Sixty patients (ASA classes I and II) scheduled for gynaecologic laparoscopy were randomised into two groups. Rocuronium (0.6mg/kg) was injected either into the vein on the dorsum of the hand (group D) or a large vein in the antecubital fossa (group A). Pain was assessed and recorded using a four-point scale. Results Compared with group D, the incidence of pain and severe pain was lower in group A patients. The rate of no pain was also higher in group A patients. Conclusion The incidence and severity of rocuronium-induced injection pain were significantly alleviated via use of a large vein for rocuronium injection.

      PubDate: 2017-08-09T13:18:45Z
      DOI: 10.1016/j.accpm.2016.03.010
       
  • A trans-atlantic high-fidelity mannequin based telesimulation experience
    • Authors: Anne Beissel; Marc Lilot; Christian Bauer; Keith Beaulieu; Christopher Hanacek; Olivier Desebbe; Maxime Cannesson; Jean-Jacques Lehot; Cameron Ricks
      Pages: 239 - 241
      Abstract: Publication date: August 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 4
      Author(s): Anne Beissel, Marc Lilot, Christian Bauer, Keith Beaulieu, Christopher Hanacek, Olivier Desebbe, Maxime Cannesson, Jean-Jacques Lehot, Cameron Ricks


      PubDate: 2017-08-09T13:18:45Z
      DOI: 10.1016/j.accpm.2016.09.006
       
  • Comparison of learning outcomes between learning roles (spectator and
           actor) during an immersive simulation
    • Authors: Antonia Blanié; Philippe Roulleau; Claire Mengelle; Dan Benhamou
      Pages: 243 - 244
      Abstract: Publication date: August 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 4
      Author(s): Antonia Blanié, Philippe Roulleau, Claire Mengelle, Dan Benhamou


      PubDate: 2017-08-09T13:18:45Z
      DOI: 10.1016/j.accpm.2016.09.005
       
  • Cheyne-Stokes respiration: Implications for anaesthesiologists
    • Authors: Philippe Ariès; Marc Danguy des Déserts; Ba Vinh Nguyen; Mehdi Ould-Ahmed
      Pages: 245 - 246
      Abstract: Publication date: August 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 4
      Author(s): Philippe Ariès, Marc Danguy des Déserts, Ba Vinh Nguyen, Mehdi Ould-Ahmed


      PubDate: 2017-08-09T13:18:45Z
      DOI: 10.1016/j.accpm.2016.11.004
       
  • Burnout among French anaesthetists and intensivists: Adequate progress is
           still lacking
    • Authors: Georges Mion; Kani Boiguile; Annick Bidou; Marion Limare
      Pages: 247 - 248
      Abstract: Publication date: August 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 4
      Author(s): Georges Mion, Kani Boiguile, Annick Bidou, Marion Limare


      PubDate: 2017-08-09T13:18:45Z
      DOI: 10.1016/j.accpm.2017.02.004
       
  • A pilot study of mechanical chest compression with the LifeLine ARM device
           during simulated cardiopulmonary resuscitation
    • Authors: Jolanta Majer; Jaroslaw Kedziora; Marcin Madziala
      First page: 249
      Abstract: Publication date: August 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 4
      Author(s): Jolanta Majer, Jaroslaw Kedziora, Marcin Madziala


      PubDate: 2017-08-09T13:18:45Z
      DOI: 10.1016/j.accpm.2017.01.007
       
  • Veno-Arterial-ECMO in the Intensive Care Unit:From Technical Aspects to
           Clinical Practice
    • Authors: Arthur Le Gall; Arnaud Follin; Bernard Cholley; Jean Mantz; Nadia Aissaoui; Romain Pirracchio
      Abstract: Publication date: Available online 13 October 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Arthur Le Gall, Arnaud Follin, Bernard Cholley, Jean Mantz, Nadia Aissaoui, Romain Pirracchio
      The use of Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) as a salvage therapy in cardiogenic shock is becoming of current practice. While VA-ECMO is potentially a life-saving technique, results are sometimes mitigated, emphasising the need for selecting the right indication in the right patient. This relies upon a clear definition of the individual therapeutic project, including the potential for recovery as well as the possible complications associated with VA-ECMO. To maximise the benefits of VA-ECMO, the basics of extracorporeal circulation should be perfectly understood since VA-ECMO can sometimes be detrimental. Hence, to be successful, VA-ECMO should be used by teams with sufficient experience and initiated after a thorough multidisciplinary discussion considering patient's medical history, pathology as well the anticipated evolution of the disease.

      PubDate: 2017-10-13T20:39:04Z
      DOI: 10.1016/j.accpm.2017.08.007
       
  • Predictive factors of early postoperative respiratory complications after
           tonsillectomy in children with unidentified risks for this complication
    • Authors: Florence julien-marsollier; Pierre Salis; Rachida abdat; Thierno Diallo; Thierry van Den Abbelle; Souhayl Dahmani
      Abstract: Publication date: Available online 12 October 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Florence julien-marsollier, Pierre Salis, Rachida abdat, Thierno Diallo, Thierry van Den Abbelle, Souhayl Dahmani
      Introduction Tonsillectomy is considered as a therapeutic option in obstructive sleep apnoea syndrome (OSAS). Postoperative respiratory failure is a complication that can require respiratory support. The main objective of our study is to determine risk factors of postoperative respiratory complications in children undergoing tonsillectomy. Material and Methods This is a retrospective single centre observational study including patients with unanticipated postoperative respiratory failure. Patients with a planned preoperative intensive care admission were excluded (age is lower than 2 years, overweight (>95 % percentile of BMI), moderate or severe asthma, major medical conditions). Those patients were compared with randomly selected control patients. Factors studied were: age, weight, indication of surgery, ASA status, preoperative illness conditions, durations of surgery and anaesthesia and administered medications. Statistics used a univariate analyses and a multivariate logistic regression. Results 805 patients underwent adenotonsillectomy during the study period and 25 developed postoperative respiratory failure. These patients were compared to 103 non-complicated control patients. Age (< 4 years), weight (< 18kg), indication of surgery (as SOAS), laryngomalacia, stable and minor congenital cardiac malformation and duration of anaesthesia were found statistically associated. Multivariate analysis found that weight < 18kg is a risk factor associated with the occurrence of postoperative respiratory failure. Overall the model shows a strong accuracy with an area under the curve of ROC analysis of 0.9 [95% confidence interval: 0.85 – 0.95]. Discussion our study found that weight < 18kg is a major risk factor for predicting a postoperative respiratory complication.

      PubDate: 2017-10-13T20:39:04Z
      DOI: 10.1016/j.accpm.2017.09.002
       
  • Evaluation of the Effect of Serratus Anterior Plane Block for Pain
           Treatment after Video-Assisted Thoracoscopic Surgery
    • Authors: Korgun Okmen; Burcu Metin Okmen
      Abstract: Publication date: Available online 12 October 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Korgun Okmen, Burcu Metin Okmen
      Background Analgesia following video-assisted thoracoscopic surgery (VATS) is important for the prevention of postoperative pulmonary complications. Various regional methods of anaesthesia are currently being used to achieve this goal. In our study, we aim to assess the effectiveness of SAPB on postoperative VATS analgesia in our study. Methods A total of 40 patients aged between 18 and 70 years, those who were in the Society of Anaesthesiologists (ASA) I-III class and underwent VATS were included in the study. Patients were randomised to either Group T (intravenous patient-controlled analgesia tramadol; n=20) or Group S (intravenous patient-controlled analgesia tramadol + SAPB; n=20). Visual Analogue Scale (VAS) was used for postoperative pain, the primary outcome measure, were evaluated at post-anaesthetic care unit (PACU), 2, 6, 12, and 24hours. Secondary outcomes included the postoperative 2nd, 6th, 12th, and 24th hour follow-up results were evaluated to identify the quantity of tramadol use, Ramsay sedation scale (RSS), side effect profile, and additional analgesic use. Results The VAS scores between the two groups were found to be statistically significantly lower in Group S during the PACU observation (P<0.05). The mean values of the quantity of tramadol use at the 6th, 12th, and 24th hours were found to be statistically significantly lower in Group S (P<0.05).There was no statistically significant difference in the rate of side effects and RSS outcomes between the groups (p>0.05). Conclusions Our study results suggest that SAPB is an effective treatment option for VATS analgesia.

      PubDate: 2017-10-13T20:39:04Z
      DOI: 10.1016/j.accpm.2017.09.005
       
  • A History Of Community-Aquired Hypervirulent Klebsiella Pneumoniae Severe
           Sepsis
    • Authors: Camille Delatour; Nellie Chalvon; Nathalie Prieur; Philippe Mateu
      Abstract: Publication date: Available online 12 October 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Camille Delatour, Nellie Chalvon, Nathalie Prieur, Philippe Mateu


      PubDate: 2017-10-13T20:39:04Z
      DOI: 10.1016/j.accpm.2017.09.003
       
  • Immediate postoperative plasma Neutrophil Gelatinase-Associated Lipocalin
           to predict acute kidney injury after major open abdominal aortic surgery:
           a prospective observational study
    • Authors: Philippe guerci; Jean-Louis claudot; Emmanuel novy; Nicla settembre; Jean-Marc lalot; Marie-Reine losser
      Abstract: Publication date: Available online 12 October 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Philippe guerci, Jean-Louis claudot, Emmanuel novy, Nicla settembre, Jean-Marc lalot, Marie-Reine losser


      PubDate: 2017-10-13T20:39:04Z
      DOI: 10.1016/j.accpm.2017.09.006
       
  • Sevoflurane induced cardioprotection in coronary artery bypass graft
           surgery: randomised trial with clinical and ex-vivo endpoints
    • Authors: Sandrine Lemoine; Lan Zhu; Jean-Louis Grard; Jean-Luc Hanouz
      Abstract: Publication date: Available online 21 September 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Sandrine Lemoine, Lan Zhu, Jean-Louis Grard, Jean-Luc Hanouz
      Background Myocardial ischemia reperfusion injury following cardiac surgery with cardiopulmonary bypass increases postoperative mortality. Setting techniques to protect the heart during this critical period therefore represents a considerable challenge. Method A randomised controlled study in Caen University Hospital Centre, investigated whether the clinical cardio protective effects of administration sevoflurane before cardiopulmonary bypass during coronary artery bypass graft surgery (CABG) could translate into protected atrial trabeculae contractility against hypoxia–reoxygenation in vitro. Patients undergoing elective on-pump CABG surgery were allocated to receive either sevoflurane (n=24) or no halogenated volatile anaesthetic (n=21). Main outcome measures: the relationship between sevoflurane exposure before CPB and the incidence of major adverse cardiac events, with primary endpoint: the postoperative troponin I peak level, and secondary endpoints: the inotropic support, and the duration of stay in intensive unit and in hospital stay were chosen as study endpoints. The right atrial was collected at the beginning of bypass surgery for the in vitro experimentation. Isometrically contracting isolated human right atrial trabeculae obtained from the two groups were exposed to 30-min hypoxia followed by 60-min reoxygenation. Results The patients receiving sevoflurane prior to aortic clamping significantly exhibited less cardiac Troponin I (1.39[0.34–2.97] vs. 2.80[2.54–3.64] ng.ml-1 in Control; p=0.03) and required a reduced inotropic drug support (p<0.001). Isolated trabeculae from patients receiving sevoflurane enhanced the recovery of force after reoxygenation compared to the control group (79±5% vs. 53±8% of baseline in Control; p<0.001). Conclusions Administration of sevoflurane before CPB induced cardioprotection in patients undergoing CABG and preconditioned human myocardium against hypoxia-reoxygenation in vitro.

      PubDate: 2017-09-23T13:33:21Z
      DOI: 10.1016/j.accpm.2017.05.009
       
  • Bundle of care for blunt chest trauma patients improves analgesia but
           increases rates of intensive care unit admission: a retrospective
           case-control study
    • Authors: Cédric Carrie; Laurent Stecken; Elsa Cayrol; Vincent Cottenceau; Laurent Petit; Philippe Revel; Matthieu Biais; François Sztark
      Abstract: Publication date: Available online 21 September 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Cédric Carrie, Laurent Stecken, Elsa Cayrol, Vincent Cottenceau, Laurent Petit, Philippe Revel, Matthieu Biais, François Sztark
      Introduction This single-centre retrospective case-control study aimed to assess the effectiveness of a multidisciplinary clinical pathway for blunt chest trauma patients admitted in emergency department (ED). Patients and Methods All consecutive blunt chest trauma patients with more than 3 rib fractures and no indication of mechanical ventilation were compared to a retrospective cohort over two 24-month periods, before and after the introduction of the bundle of care. Improvement of analgesia was the main outcome investigated in this study. The secondary outcomes were the occurrence of secondary respiratory complications (pneumonia, indication for mechanical ventilation, secondary ICU admission for respiratory failure or death), the intensive care unit (ICU) and hospital length of stay (LOS). Results 69 pairs of patients were matched using a 1:1 nearest neighbour algorithm adjusted on age and indices of severity. Between the two periods, there was a significant reduction of the rate of uncontrolled analgesia (55 vs. 17%, p < 0.001). A significant increase in the rate of primary ICU transfer during the post-protocol period (23 vs. 52%, p < 0.001) was not associated with a reduction of secondary respiratory complications or a reduction of ICU or hospital LOS. Only the use of non-steroidal anti-inflammatory drugs appeared to be associated with a significant reduction of secondary respiratory complications (OR = 0.3 [0.1 – 0.9], p = 0.03). Conclusion Implementation of a multidisciplinary clinical pathway significantly improves pain control after ED management, but increases the rate of primary ICU admission without significant reduction of secondary respiratory complications.

      PubDate: 2017-09-23T13:33:21Z
      DOI: 10.1016/j.accpm.2017.05.008
       
  • Uninterrupted dabigatran for ablation in atrial fibrillation: peering into
           the black box of intra-procedural anticoagulation
    • Authors: Anne-Céline Martin; Anne Godier
      Abstract: Publication date: Available online 20 September 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Anne-Céline Martin, Anne Godier


      PubDate: 2017-09-23T13:33:21Z
      DOI: 10.1016/j.accpm.2017.08.003
       
  • The use of a checklist improves anaesthesiologists’ technical and
           
    • Authors: Hardy Jean-Baptiste; Gouin Antoine; Damm Cédric; Compère Vincent; Veber Benoît; Dureuil Bertrand
      Abstract: Publication date: Available online 20 September 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Hardy Jean-Baptiste, Gouin Antoine, Damm Cédric, Compère Vincent, Veber Benoît, Dureuil Bertrand


      PubDate: 2017-09-23T13:33:21Z
      DOI: 10.1016/j.accpm.2017.07.009
       
  • Use of the TotalTrack VLM for endotracheal intubation in a patient with a
           giant thyroglossal duct cyst and airway compression.
    • Authors: Manuel Ángel Gómez-Ríos; Iria Silva-Carballal; Enrique Freire-Vila
      Abstract: Publication date: Available online 19 September 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Manuel Ángel Gómez-Ríos, Iria Silva-Carballal, Enrique Freire-Vila


      PubDate: 2017-09-23T13:33:21Z
      DOI: 10.1016/j.accpm.2017.07.007
       
  • Recent Directions in Personalised Acute Respiratory Distress Syndrome
           Medicine
    • Authors: Matthieu Jabaudon; Raiko Blondonnet; Jules Audard; Marianne Fournet; Thomas Godet; Vincent Sapin; Jean-Michel Constantin
      Abstract: Publication date: Available online 19 September 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Matthieu Jabaudon, Raiko Blondonnet, Jules Audard, Marianne Fournet, Thomas Godet, Vincent Sapin, Jean-Michel Constantin
      Acute respiratory distress syndrome (ARDS) is heterogeneous by definition and patient response varies depending on underlying biology and their severity of illness. Although ARDS subtypes have been identified with different prognoses in past studies, the concept of phenotypes or endotypes does not extend to the clinical definition of ARDS. This has possibly hampered the development of therapeutic interventions that target select biological mechanisms of ARDS. Recently, a major advance may have been achieved as it may now be possible to identify ARDS subtypes that may confer different responses to therapy. The aim of personalised medicine is to identify, select, and test therapies that are most likely to be associated with a favourable outcome in a specific patient. Several promising approaches to ARDS subtypes capable of predicting therapeutic response, and not just prognosis, are highlighted in this perspective paper. An overview is also provided of current and future directions regarding the provision of personalised ARDS medicine. The importance of delivering the right care, at the right time, to the right patient, is emphasised.

      PubDate: 2017-09-23T13:33:21Z
      DOI: 10.1016/j.accpm.2017.08.006
       
  • Should we add tranexamic acid to postpartum haemorrhage protocols after
           the WOMAN trial publication'
    • Authors: Anne-Sophie Ducloy-Bouthors; Anne Godier
      Abstract: Publication date: Available online 18 September 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Anne-Sophie Ducloy-Bouthors, Anne Godier


      PubDate: 2017-09-23T13:33:21Z
      DOI: 10.1016/j.accpm.2017.08.002
       
  • Massive air embolism from central venous catheter during
           veno-arterial-ECMO therapy
    • Authors: Edris Omar; Guillaume Lebreton; Adrien Bouglé; Julien Amour
      Abstract: Publication date: Available online 18 September 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Edris Omar, Guillaume Lebreton, Adrien Bouglé, Julien Amour


      PubDate: 2017-09-23T13:33:21Z
      DOI: 10.1016/j.accpm.2017.07.008
       
  • Retrospective study of anaesthetic management of pregnant patients with
           mechanical heart valve prosthesis and anticoagulants
    • Authors: Benoît Cousin; Jean Guglielminotti; Bernard Iung; Philippe Montravers
      Abstract: Publication date: Available online 18 September 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Benoît Cousin, Jean Guglielminotti, Bernard Iung, Philippe Montravers


      PubDate: 2017-09-23T13:33:21Z
      DOI: 10.1016/j.accpm.2017.08.005
       
  • Supraventricular tachycardia in a trauma patient masquerading as a wolf
           Parkinson white syndrome
    • Authors: Abdelghafour Elkoundi; Amine Meskine; Zakaria Lahlafi; Mustapha Bensghir; Salim Jaafar Lalaoui
      Abstract: Publication date: Available online 18 September 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Abdelghafour Elkoundi, Amine Meskine, Zakaria Lahlafi, Mustapha Bensghir, Salim Jaafar Lalaoui


      PubDate: 2017-09-23T13:33:21Z
      DOI: 10.1016/j.accpm.2017.08.004
       
  • Impact of iron deficiency diagnosis using hepcidin Mass Spectrometry
           dosage methods on hospital stay and costs after a prolonged ICU stay:
           study protocol for a multicentre, randomised, single-blinded
           medico-economic trial.
    • Authors: Sigismond Lasocki; Hervé Puy; Grégoire Mercier; Sylvain Lehmann
      Abstract: Publication date: Available online 14 September 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Sigismond Lasocki, Hervé Puy, Grégoire Mercier, Sylvain Lehmann
      Background Iron deficiency (ID) is frequent but difficult to diagnose in critically ill patients. ID may be responsible for prolonged post-ICU hospital stays, since it results in fatigue, muscle weakness and anaemia. Hepcidin, the key iron metabolism hormone, may be a good marker of ID in these patients. The aim of this study is to determine whether using mass spectrometry hepcidin determination to diagnose (and treat) ID after prolonged ICU stays may reduce patients’ subsequent hospital stays and costs in comparison with conventional (ferritin) methods. Methods This is a randomised, controlled, single-blinded, multicentre medico-economic study. Hepcidin quantification will be performed in anaemic (WHO criteria) critically ill adults about to be discharged, after a stay ≥ 5 days. In the intervention arm (Hepcidin) results will be given to the ICU-physicians, and not in the control arm. ID Treatment will be recommended in intervention arm: IV iron when hepcidin is <20μg/l; IV iron + erythropoietin when hepcidin is between 20-41μg/l; in the control arm: IV iron when ferritin <300μg/l and Transferrin saturation <20%. The primary endpoint will be the number of days spent in hospital 90 days after ICU discharge and the direct hospital costs. Secondary endpoints will be anaemia and iron deficiency on D15, fatigue and the proportion of patients alive and at home on D30 and D90. Discussion The results of this study will show whether diagnosing iron deficiency using MS hepcidin determination methods is liable to reduce patients’ post-ICU hospital stay and costs, as well as their anaemia and fatigue.

      PubDate: 2017-09-18T13:05:58Z
      DOI: 10.1016/j.accpm.2017.04.009
       
  • Intubation And Extubation Of The Icu Patient
    • Authors: Hervé Quintard; Erwan l’Her; Julien Pottecher; Frédéric Adnet; Jean-Michel Constantin; Audrey Dejong; Pierre Diemunsch; Rose Fesseau; A. Freynet; Christophe Girault; Christophe Guitton; Y. Hamonic; Eric Maury; Armand Mekontso-Dessap; F. Michel; P. Nolent; Sébastien Perbet; Gwénaël Prat; Antoine Roquilly; Karim Tazarourte; Nicolas Terzi; Arnaud W. Thille; Mikael Alves; Etienne Gayat; Laurence Donetti
      Abstract: Publication date: Available online 14 September 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Hervé Quintard, Erwan l’Her, Julien Pottecher, Frédéric Adnet, Jean-Michel Constantin, Audrey Dejong, Pierre Diemunsch, Rose Fesseau, A. Freynet, Christophe Girault, Christophe Guitton, Y. Hamonic, Eric Maury, Armand Mekontso-Dessap, F. Michel, P. Nolent, Sébastien Perbet, Gwénaël Prat, Antoine Roquilly, Karim Tazarourte, Nicolas Terzi, Arnaud W. Thille, Mikael Alves, Etienne Gayat, Laurence Donetti


      PubDate: 2017-09-18T13:05:58Z
      DOI: 10.1016/j.accpm.2017.09.001
       
  • Tracheal extubation with suction vs. positive pressure during emergence
           from general anaesthesia in adults: a randomised controlled trial
    • Authors: Joël L’Hermite; Olivier Wira; Chritel Castelli; Jean-Emmanuel de La Coussaye; Jacques Ripart; Philippe Cuvillon
      Abstract: Publication date: Available online 4 September 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Joël L’Hermite, Olivier Wira, Chritel Castelli, Jean-Emmanuel de La Coussaye, Jacques Ripart, Philippe Cuvillon
      Background After general anaesthesia (GA) in adults, the optimal tracheal extubation technique (positive pressure or suctioning) remains debated. The primary endpoint of this study was to assess the effects of these techniques on onset time of desaturation (SpO2 < 92%). Methods Sixty-nine patients with a body mass index < 30 scheduled for elective orthopaedic surgery were allocated to positive pressure (PP) or suctioning (SUC) group. GA was standardised with propofol and remifentanil via target-controlled infusion. A morphine bolus of 0.15mg/kg was administered 20–30minutes before the end of surgery. The effect of extubation technique on onset time of desaturation (T92) was assessed during the first 10minutes after extubation during the spontaneous air breathing. Secondary endpoints included: frequency of desaturation, respiratory complications, need to use oxygen therapy and SpO2 at the end of the first hour while breathing in air (ClinicalTrials.gov identifier: NCT01323049). Results Baseline patient characteristics and intraoperative management data for the 68 patients included had no relevant clinical difference between groups. T92 (sec) after tracheal extubation was 214 (168) vs. 248 (148) in the PP and SUC groups, respectively (p = 0.44). In the PP and SUC groups, 50% and 43% reached a SpO2 < 92% within the first 10minutes after extubation respectively (p = 0.73). There were no statistically significant differences between groups for any secondary endpoints. Conclusions Positive pressure extubation as compared with suctioning extubation did not seem to delay onset time of desaturation after GA in standard weight adult patients.

      PubDate: 2017-09-06T12:01:00Z
      DOI: 10.1016/j.accpm.2017.07.005
       
  • Effect of sleep deprivation after a night shift duty on simulated crisis
           management by residents in anaesthesia. A randomised crossover study.
    • Authors: Ségolène Arzalier-Daret; Clément Buléon; Marie-Laure Bocca; Pierre Denise; Jean-Louis Gérard; Jean-Luc Hanouz
      Abstract: Publication date: Available online 4 September 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Ségolène Arzalier-Daret, Clément Buléon, Marie-Laure Bocca, Pierre Denise, Jean-Louis Gérard, Jean-Luc Hanouz
      Background Sleep deprivation has been associated with an increased incidence of medical errors and can jeopardise patients’ safety during medical crisis management. The aim of the study was to assess the effect of sleep deprivation on the management of simulated anaesthesia crisis by residents in anaesthesiology. Methods A randomised, comparative, monocentric crossover study involving 48 residents in anaesthesia was performed on a high fidelity patient simulator. Each resident was evaluated in a sleep deprived state (Deprived group, after a night shift duty) and control state (Control group, after a night of sleep). Performance was assessed through points obtained during crisis scenario 1 (oesophageal intubation followed by anaphylactic shock) and scenario 2 (anaesthesia-related bronchospasm followed by ventricular tachycardia). Sleep periods were recorded by actigraphy. Two independent observers assessed the performances. The primary endpoint of the study was the score obtained for each scenario. Results Resident's crisis management performance is associated with sleep deprivation (Scenario 1: Control=39 [33-42] points vs Deprived=26 [19-40] points, p=0.02; scenario 2: Control= 21 [17-24] vs Deprived= 14 [12-19], p=0.01). The main errors observed were: error in drug administration and dose, delay in identification of hypotension, and missing communication with the surgical team about situation. Conclusions The present study showed that sleep deprivation is associated with impairment of performance to manage crisis situations by residents in anesthesia.

      PubDate: 2017-09-06T12:01:00Z
      DOI: 10.1016/j.accpm.2017.05.010
       
  • Perioperative management of asplenic patients in France: a national survey
           among anaesthetists-intensivists.
    • Authors: Ludivine Rousseau; Thomas Kerforne; Matthieu Boisson; Olivier Mimoz; Claire Dahyot-Fizelier
      Abstract: Publication date: Available online 1 September 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Ludivine Rousseau, Thomas Kerforne, Matthieu Boisson, Olivier Mimoz, Claire Dahyot-Fizelier


      PubDate: 2017-09-06T12:01:00Z
      DOI: 10.1016/j.accpm.2017.06.009
       
  • Hypoprothrombinemia and severe perioperative haemorrhagic complications in
           cardiac surgery patients treated with high-dose cefazolin for infective
           endocarditis
    • Authors: Emeline Angles; Christine Mouton; Justine Perino; Alain Remy; Alexandre Ouattara
      Abstract: Publication date: Available online 1 September 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Emeline Angles, Christine Mouton, Justine Perino, Alain Remy, Alexandre Ouattara
      Endocarditis is a serious and common disease that requires prolonged antimicrobial therapy. The recent shortage of oxacillin has led to the use of other antimicrobial agents such as cefazolin to treat endocarditis due to methicillin-sensitive Staphylococcus aureus. We describe four cases of life-threatening haemorrhagic complications (fatal in two cases) in patients treated with high-dose cefazolin. All of these patients with major bleeding presented with hypoprothrombinemia secondary to hypovitaminosis K. This adverse event may be due to inhibition of vitamin K epoxide reductase and/or gamma-glutamyl-carboxylase by the 2-methyl-1,2,3-thiadiazol-5-thiol group of cefazolin. This inhibition may result in hypoprothrombinemia by altering the synthesis of vitamin K-dependent coagulation factors. The increasing use of cefazolin, especially at a high dose and for a prolonged period of time, should be accompanied by regular monitoring of coagulation, including prothrombin index, and vitamin K supplementation.

      PubDate: 2017-09-06T12:01:00Z
      DOI: 10.1016/j.accpm.2017.07.006
       
  • Dental injury associated with anaesthesia: an 8-year database analysis of
           592 claims from a major French insurance company
    • Authors: Giraudon Antoine; Guillaume de Saint Maurice; Matthieu Biais; Dan Benhamou; Karine Nouette-Gaulain
      Abstract: Publication date: Available online 22 August 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Giraudon Antoine, Guillaume de Saint Maurice, Matthieu Biais, Dan Benhamou, Karine Nouette-Gaulain
      Introduction Dental injury is the most common incident associated with anaesthesia. Regarding recent recommendations on informed consent and changes in airway management practices, a large series of claims related to dental injury has not been recently described. The aim of this study was to analyse a recent database in order to describe the characteristics of dental injury in France. Methods A database that prospectively collected claims reported to Le Sou Médical-MACSF between January 2003 and December 2010, was analysed. 592 cases were reported. The following characteristics were analysed: number and type of teeth injured, mechanism of injury, anaesthetic procedure, risk factors and dental outcome after injury. Results Amongst the 1514 claims related to anaesthesia, 592 (39.2%) were classified as dental damage. Preoperative informed consent concerning possible perioperative dental injury was documented in only 34.8% of patients. Only one tooth was affected in 65.2% of patients, dental bridge injury in 12.8% of cases and damage to two or more teeth in 14% of patients. Incisors were involved in 50% of cases. Fracture was the most common type of injury (64.2%). Poor dentition was the most common risk factor (23.1%) followed by difficult intubation (15.4%). Both risks were combined in only 7.6% of cases. Tracheal intubation was the highest risk procedure (41.6%). Conclusion Dental injury remains the most common anaesthesia-related claim. Dental examination and documentation in patient medical files requires improvement and better informed consent on dental injury risk needs to be provided to patients

      PubDate: 2017-08-29T11:25:40Z
      DOI: 10.1016/j.accpm.2017.04.007
       
  • Eye protection in anaesthesia and intensive care
    • Authors: Hawa Keita; Jean-Michel Devys; Jacques Ripart; Marie Frost; Frédérique Boutin; Claude Guérin; Dominique Fletcher
      Abstract: Publication date: Available online 5 August 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Hawa Keita, Jean-Michel Devys, Jacques Ripart, Marie Frost, Frédérique Boutin, Claude Guérin, Dominique Fletcher


      PubDate: 2017-08-09T13:18:45Z
      DOI: 10.1016/j.accpm.2017.08.001
       
  • Impact of a visual aid on discordance between physicians and family
           members
    • Authors: Gabrielle Burelli; Chloé Berthelier; Hélène Vanacker; Léonard Descaillot; Bénédicte Philippon-Jouve; Xavier Fabre; Mahmoud Kaaki; Jean-Charles Chakarian; Alexandre Domine; Pascal Beuret
      Abstract: Publication date: Available online 5 August 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Gabrielle Burelli, Chloé Berthelier, Hélène Vanacker, Léonard Descaillot, Bénédicte Philippon-Jouve, Xavier Fabre, Mahmoud Kaaki, Jean-Charles Chakarian, Alexandre Domine, Pascal Beuret
      Objective This study aimed to evaluate the impact of a visual aid on the discordance about prognosis between physicians and family members. Methods The study was performed in a general intensive care department with two 6-bed units. In the unit A, family members could consult a visual aid depicting day by day the evolution of global, hemodynamic, respiratory, renal and neurological conditions of the patient on a 10 point scale. In the unit B, they only received oral medical information. On day 7 of the ICU stay, the physician and family members estimated the prognosis of the patient among four proposals (life threatened; steady state but may worsen; steady state, should heal; will heal). Then we compared the rate of discordance about prognosis between physicians and family members in the two units. Results Seventy-nine consecutive patients admitted in the intensive care department and still present at day 7, their family members and physicians, were enrolled. Patients in the two units were comparable in age, sex ratio, reason for admission, SAPS II at admission and SOFA score at day 7. In the unit A physician-family members discordance about prognosis occurred for 12 out of 39 patients (31%) vs. 22 out of 40 patients (55%) in the unit B (p=0.04). Conclusion In our study, adding a visual aid depicting the evolution of the condition of critically ill patients day by day to classic oral information allowed the family to have an estimate of the prognosis less discordant with the estimate of the physician.

      PubDate: 2017-08-09T13:18:45Z
      DOI: 10.1016/j.accpm.2017.05.006
       
  • Changes in the availability of bedside ultrasound practice in emergency
           rooms and pre-hospital settings in France
    • Authors: X Bobbia; M Abou-Badra; N Hansel; P Pes; T Petrovic; P.G. Claret; J.Y. Lefrant; J.E. de la Coussaye
      Abstract: Publication date: Available online 4 August 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): X Bobbia, M Abou-Badra, N Hansel, P Pes, T Petrovic, P.G. Claret, J.Y. Lefrant, J.E. de la Coussaye
      Objective Ensuring the availability of ultrasound devices is the initial step in implementing clinical ultrasound (CUS) in emergency services. In France in 2011, 52% of emergency departments (EDs) and only 9% of mobile intensive care stations (MICS) were equipped with ultrasound devices. The main goal of this study was to determine the movement of these rates since 2011. Methods We conducted a cross-sectional, descriptive, multi-centre study in the form of a questionnaire. To estimate the numbers of EDs and MICS equipped with at least one ultrasound system with a confidence level of 95% and margin of error of 5%, 170 responding EDs and 145 MICS were required. Each service was solicited three times by secure online questionnaire and then by phone. Results 328 (84%) services responded to the questionnaire: 179 (86%) EDs and 149 (82%) MICS. At least one ultrasound machine was available in 127 (71%, 95% CI [64; 78]) EDs vs 52% in 2011 (p < 0.01). 42 (28%, 95% CI [21; 35]) MICS were equipped vs 9% in 2011 (p < 0.01). In 97 (76%) EDs and 24 (55%) MICS, less than a half of physicians were trained. CUS was used at least three times a day in 52 (41%) EDs and in 8 (19%) MICS. Conclusion Our study demonstrates improved access to ultrasound devices in French EDs and MICS. Almost three-quarters of EDs and nearly one-third of MICS are now equipped with at least one ultrasound device. However, the rate of physicians trained per service remains insufficient.

      PubDate: 2017-08-09T13:18:45Z
      DOI: 10.1016/j.accpm.2017.06.008
       
  • Association between augmented renal clearance and clinical failure of
           antibiotic treatment in brain-injured patients with ventilator-acquired
           pneumonia: a preliminary study
    • Authors: Cédric Carrie; Merry Bentejac; Vincent Cottenceau; Françoise Masson; Laurent Petit; Jean François Cochard; François Sztark
      Abstract: Publication date: Available online 26 July 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Cédric Carrie, Merry Bentejac, Vincent Cottenceau, Françoise Masson, Laurent Petit, Jean François Cochard, François Sztark
      OBJECTIVES This preliminary study aimed to determine whether augmented renal clearance (ARC) impacts negatively on the clinical outcome in traumatic brain-injured patients (TBI) treated for a first episode of ventilator-acquired pneumonia (VAP). METHODS During a 5-year period, all TBI patients who had developed VAP were retrospectively reviewed to assess variables associated with clinical failure in multivariate analysis. Clinical failure was defined as an impaired clinical response with a need for escalating antibiotics during treatment and/or within 15 days after the end-of-treatment. Recurrence was considered if at least one of the initial causative bacterial strains was growing at a significant concentration from a second sample. Augmented renal clearance (ARC) was defined by an enhanced creatinine clearance exceeding 130mL/min/1.73m2 calculated from a urinary sample during the first three days of antimicrobial therapy. MAIN RESULTS During the study period, 223 TBI patients with VAP were included and 59 (26%) presented a clinical failure. Factors statistically associated with clinical failure were GSC ≤ 7 (OR = 2.2 [1.1 – 4.4], p = 0.03), early VAP (OR = 3.9 [1.9 – 7.8], p = 0.0001), bacteraemia (OR = 11 [2.2 – 54], p = 0.003) and antimicrobial therapy ≤ 7 days (OR = 3.7 [1.8 – 7.4], p = 0.0003). ARC was statistically associated with recurrent infections with an OR of 4.4 [1.2 – 16], p = 0.03. CONCLUSION ARC was associated with recurrent infection after a first episode of VAP in TBI patients. The optimal administration and dosing of the antimicrobial agents in this context remain to be determined.

      PubDate: 2017-07-30T12:34:41Z
      DOI: 10.1016/j.accpm.2017.06.006
       
  • Axillary nerve block for a wrist fracture in a patient with
           facioscapulohumeral (Landouzy-Dejerine) disease
    • Authors: Mostafa Mazboudi; Samy Figueiredo; Bausard Latrech; Dan Benhamou
      Abstract: Publication date: Available online 26 July 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Mostafa Mazboudi, Samy Figueiredo, Bausard Latrech, Dan Benhamou


      PubDate: 2017-07-30T12:34:41Z
      DOI: 10.1016/j.accpm.2017.05.004
       
  • Ventilation for thoracic surgery in the newborn: don’t forget High
           Frequency Oscillatory Ventilation
    • Authors: Charlotte Rémond; Chloé Alliana; Karin Jonckheer; Jean-François Lecompte; François de la Brière
      Abstract: Publication date: Available online 26 July 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Charlotte Rémond, Chloé Alliana, Karin Jonckheer, Jean-François Lecompte, François de la Brière


      PubDate: 2017-07-30T12:34:41Z
      DOI: 10.1016/j.accpm.2017.07.002
       
  • Debriefing values in high-fidelity simulation
    • Authors: Antonia Blanié; Morgan Le Guen
      Abstract: Publication date: Available online 16 June 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Antonia Blanié, Morgan Le Guen


      PubDate: 2017-06-24T08:26:51Z
      DOI: 10.1016/j.accpm.2017.06.001
       
  • A pilot study of mechanical chest compression with the LifeLine ARM device
           during simulated cardiopulmonary resuscitation: Reply
    • Authors: Jean Cotte
      Abstract: Publication date: Available online 17 April 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Jean Cotte


      PubDate: 2017-04-21T14:58:48Z
      DOI: 10.1016/j.accpm.2017.04.005
       
  • Preventing Medication Errors in Anesthesia and Critical Care (abbreviated
           version)
    • Authors: Vincent Piriou; Alexandre Theissen; Ségolène Arzalier-Daret; Marie Marcel; Pierre Trouiller; Stéphanie Parat; Catherine Stamm; Rémy Collomp
      Abstract: Publication date: Available online 10 April 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Vincent Piriou, Alexandre Theissen, Ségolène Arzalier-Daret, Marie Marcel, Pierre Trouiller, Stéphanie Parat, Catherine Stamm, Rémy Collomp


      PubDate: 2017-04-13T14:28:00Z
      DOI: 10.1016/j.accpm.2017.04.002
       
  • Successful management of a neck hematoma following simulation training
    • Authors: Marie-Ève Bélanger; Issam Tanoubi; Mihai Georgescu; Roger Perron; Arnaud Robitaille; Marie-Pierre Charron; Pierre Drolet
      Abstract: Publication date: Available online 10 April 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Marie-Ève Bélanger, Issam Tanoubi, Mihai Georgescu, Roger Perron, Arnaud Robitaille, Marie-Pierre Charron, Pierre Drolet
      Simulation-based education is gaining widespread acceptance in many medical specialties as an effective method to teach technical and non-technical skills. The ultimate goal of simulation is to improve health care and patient safety. Boet et al. [1] published a review on simulation-based crisis resources management (CRM) teaching, looking for evidence that it can lead to improved workplace practices and patient safety. Amongst hundreds of studies pertaining to CRM, he found only nine that were relevant, and only one that showed reduced mortality. Elaborating and putting forward studies designed to measure the impact of simulation on patient safety and outcomes is by no mean an easy task [2]. Indeed, most studies present various problems, such as biases introduced by the use of historical cohorts rather than control groups, and sample sizes based on convenience rather than power analysis. Furthermore, many significant outcomes such as mortality and major morbidity rates need to be measured over an extended period of time, which leaves room for variables other than the introduction of a simulation-based teaching program to play a confounding role [2]. These are some of the reasons why the majority of publications in simulation-based teaching are focusing mostly if not exclusively on measuring participants’ satisfaction and performance in a simulated environment. At the Université de Montréal, we developed surgical high-fidelity simulation-based CRM scenarios focusing on teamwork. The specific simulation based training on CRM, which includes this airway management scenario, is given only once a year, in the beginning of their second year of residency. This highly appreciated training [3] place surgical residents in rare and urgent situations, but within a safe simulated environment. One of these scenarios focuses on the management of neck hematoma after thyroidectomy. It teaches a step-by-step approach that emphasizes, amongst other things, the need for bedside evacuation in the setting of significant and life-threatening airway obstruction (figure 1). The purpose of this case report is to describe how a postgraduate year 3 (PGY 3) surgical residents used and credited the training acquired during a simulation-based CRM scenario for positively influencing a patient's outcome.

      PubDate: 2017-04-13T14:28:00Z
      DOI: 10.1016/j.accpm.2017.04.003
       
 
 
JournalTOCs
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762
Fax: +00 44 (0)131 4513327
 
Home (Search)
Subjects A-Z
Publishers A-Z
Customise
APIs
Your IP address: 54.80.236.48
 
About JournalTOCs
API
Help
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-2016