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Publisher: Elsevier   (Total: 3120 journals)

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Showing 1 - 200 of 3120 Journals sorted alphabetically
A Practical Logic of Cognitive Systems     Full-text available via subscription   (Followers: 8)
AASRI Procedia     Open Access   (Followers: 14)
Academic Pediatrics     Hybrid Journal   (Followers: 26, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 22, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 90, 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: 31, 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: 379, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 26, 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   (Followers: 1, 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: 25, 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)
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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: 6)
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: 7)
Additive Manufacturing     Hybrid Journal   (Followers: 8, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 22)
Advanced Cement Based Materials     Full-text available via subscription   (Followers: 3)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 141, 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: 27, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 4)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 9, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 12, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 23, 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: 26, 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: 6, SJR: 2.139, h-index: 42)
Advances in Cell Aging and Gerontology     Full-text available via subscription   (Followers: 4)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 13)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 27, 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: 14)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 12)
Advances in Digestive Medicine     Open Access   (Followers: 7)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 6)
Advances in Drug Research     Full-text available via subscription   (Followers: 23)
Advances in Ecological Research     Full-text available via subscription   (Followers: 47, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 27, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 9)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 46, 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: 53, 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: 17, 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 Human Factors/Ergonomics     Full-text available via subscription   (Followers: 27)
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: 37, 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 Intl. Accounting     Full-text available via subscription   (Followers: 4)
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: 10)
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: 6)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 5, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 23)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 9, 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: 2)
Advances in Organ Biology     Full-text available via subscription   (Followers: 2)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 16, 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: 16, 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: 7)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 5)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 20, SJR: 1.5, h-index: 62)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 6, 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 Biology and Medicine     Full-text available via subscription   (Followers: 5)
Advances in Space Research     Full-text available via subscription   (Followers: 374, 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: 9, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 31, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 16)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 6, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 45, 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: 342, 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: 6, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 9, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 436, 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: 31, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 42, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 3)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 56, 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: 11, 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   (Followers: 1)
Algal Research     Partially Free   (Followers: 9, 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: 5, 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: 9, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 49, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 4)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 4)
Ambulatory Pediatrics     Hybrid Journal   (Followers: 6)
American Heart J.     Hybrid Journal   (Followers: 48, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 48, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 42, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 9, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 32, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 26, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 31, 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: 209, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 61, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 6)
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: 24, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 27, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 26, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 36, 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: 6)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 60, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 14)
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: 173, 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: 12)
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   (Followers: 1)
Animal Behaviour     Hybrid Journal   (Followers: 178, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)

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Journal Cover Anaesthesia Critical Care & Pain Medicine
  [14 followers]  Follow
    
   Full-text available via subscription Subscription journal
   ISSN (Online) 2352-5568
   Published by Elsevier Homepage  [3120 journals]
  • Perioperative management of asplenic patients in France: A national survey
           among anaesthetists
    • Authors: Ludivine Rousseau; Thomas Kerforne; Matthieu Boisson; Olivier Mimoz; Claire Dahyot-Fizelier
      Pages: 359 - 363
      Abstract: Publication date: December 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 6
      Author(s): Ludivine Rousseau, Thomas Kerforne, Matthieu Boisson, Olivier Mimoz, Claire Dahyot-Fizelier


      PubDate: 2018-02-17T08:11:01Z
      DOI: 10.1016/j.accpm.2017.06.009
       
  • Comparison of three stimulation sites on the pupillary dilation reflex
           amplitude evoked by a standardized noxious test
    • Authors: Florian Roquet; Laila Guezouli; Bozena Wachowska; Iulia Balcan; Philippe Montravers; Dan Longrois; Jean Guglielminotti
      Pages: 365 - 369
      Abstract: Publication date: December 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 6
      Author(s): Florian Roquet, Laila Guezouli, Bozena Wachowska, Iulia Balcan, Philippe Montravers, Dan Longrois, Jean Guglielminotti


      PubDate: 2018-02-17T08:11:01Z
      DOI: 10.1016/j.accpm.2017.06.007
       
  • A comparison of balanced and unbalanced crystalloid solutions in surgery
           patient outcomes
    • Authors: Tomas Kuca; Michael B. Butler; Mete Erdogan; Robert S. Green
      Pages: 371 - 376
      Abstract: Publication date: December 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 6
      Author(s): Tomas Kuca, Michael B. Butler, Mete Erdogan, Robert S. Green
      Introduction The objective of this study was to evaluate adverse patient outcomes associated with the choice of intravenous fluid administered during general anaesthesia. Methods This study was a retrospective chart review of vascular surgery patients at a Canadian tertiary care hospital. Patients were separated into three groups: those who were intraoperatively administered normal saline (NS), balanced crystalloids, or a combination of both solutions. Multivariate analysis was performed to determine association between volume of each fluid type administered and adverse outcomes including in-hospital mortality, prolonged intensive care unit admission, vasopressor requirement, ventilator requirement, hemodialysis requirement, and a composite endpoint of any of these adverse events occurring. Results Overall, 796 vascular surgery patients were included in the analysis. There were 425 patients who received balanced crystalloids, 158 patients who received NS, and 213 patients received both balanced crystalloids and NS. Groups were similar in age (P =0.06), but varied in gender (P <0.001) and overall health (ASA≥2; P =0.027). The most common adverse event was ventilator requirement (NS: 27.9%, balanced: 7.5%, both: 38.0%; P <0.001). Mortality was lowest in the group that received balanced fluids (NS: 12.0%, balanced: 5.9%, both: 10.8%; P =0.018). Patients who were administered NS or both fluids were more likely to reach the composite endpoint than patients receiving balanced crystalloid alone. Conclusion The administration of an unbalanced crystalloid solution was associated with poor patient outcomes in our study population.

      PubDate: 2018-02-17T08:11:01Z
      DOI: 10.1016/j.accpm.2016.10.001
       
  • Dynamic arterial elastance obtained using arterial signal does not predict
           an increase in arterial pressure after a volume expansion in the operating
           room
    • Authors: Romain Lanchon; Karine Nouette-Gaulain; Laurent Stecken; Musa Sesay; Jean-Yves Lefrant; Matthieu Biais
      Pages: 377 - 382
      Abstract: Publication date: December 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 6
      Author(s): Romain Lanchon, Karine Nouette-Gaulain, Laurent Stecken, Musa Sesay, Jean-Yves Lefrant, Matthieu Biais
      Introduction Dynamic arterial elastance (Eadyn) is defined as the ratio between pulse pressure variations (PPV) and stroke volume variations (SVV). Eadyn has been proposed to predict an increase in mean arterial pressure (MAP) after volume expansion with conflicting results. The aim of the present study was to test the reliability of Eadyn in hypotensive patients (MAP<65mmHg) in the operating room (OR). Patients and methods The study pooled data from 51 patients. They were included after the induction of anaesthesia and before skin incision. Eadyn, MAP and stroke volume (FloTrac™, Vigileo™, Edwards Lifesciences, Irvine,CA) were recorded before and after volume expansion (500mL starch 6% given over 10minutes). Pressure-responders were defined as an increase MAP≥15% after volume expansion. Changes in MAP were predicted using the area under the curves (AUC) with their 95% Confidence Interval (95%CI) derived from Receiver Operating Characteristic curves. Results Seventeen patients responded to volume expansion. Heart rate, PPV, SVV and Eadyn were similar between pressure-responders and non-responders. Baseline values of stroke volume, cardiac output and MAP were lower in responders. Volume expansion induced significant variations in stroke volume, cardiac output, SVV and PPV, but not in Eadyn. Baseline Eadyn failed to predict MAP increase (AUC=0.53, 95%CI=0.36–0.70, P >0.05) and was not correlated with volume expansion-induced changes in MAP (P >0.05). In preload responsive patients (changes in SV≥15% after volume expansion, n =24), the AUC was 0.54 (95%CI=0.29–0.78; P >0.05). Conclusion In the present study performed in the OR and in hypotensive patients, Eadyn obtained using arterial signal was unable to predict an increase in MAP after volume expansion.

      PubDate: 2018-02-17T08:11:01Z
      DOI: 10.1016/j.accpm.2017.05.001
       
  • The clinical impact and prevalence of emergency point-of-care ultrasound:
           A prospective multicenter study
    • Authors: Xavier Bobbia; Laurent Zieleskiewicz; Christophe Pradeilles; Chloé Hudson; Laurent Muller; Pierre Géraud Claret; Marc Leone; Jean-Emmanuel de La Coussaye
      Pages: 383 - 389
      Abstract: Publication date: December 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 6
      Author(s): Xavier Bobbia, Laurent Zieleskiewicz, Christophe Pradeilles, Chloé Hudson, Laurent Muller, Pierre Géraud Claret, Marc Leone, Jean-Emmanuel de La Coussaye
      Objective The main objectives of our study were to evaluate the prevalence of emergency point-of-care ultrasound (POCUS) use and to assess the impact of POCUS on: diagnostic, therapeutic, patient orientation and imaging practices. Methods This was a one-day, prospective, observational study carried out across multiple centers. Fifty emergency departments (EDs) recorded all POCUS performed over a 24h period. The prevalence of POCUS was defined as the number of POCUS/number of patients seen in all units. The “diagnostic impact” was defined as a POCUS-induced confirmation or change to the initial clinical diagnosis. The “therapeutic impact” was defined as a POCUS-induced change in treatment. The “orientation impact” was defined as an ultrasound-induced confirmation or change in the initial orientation. The “imaging change” was defined as a radiologic imaging prescription modification. Results Two hundred and twenty-nine (5%) POCUS were performed on 192 patients (4%) from among the 4671 patients seen on the study day in the 50 EDs. No ultrasound procedural guidance was given during the study day. The diagnostic, therapeutic and orientation impacts were respectively 82%, 47% and 85%. In 101 cases (44%), POCUS led to at least one imaging change. The clinical value of POCUS, i.e. considering at least one impact and/or imaging change, was assessed at 95%. Conclusion This study shows that POCUS is used on a minority of emergency patients. However, when used, it significantly affects diagnostic and therapeutic practices in the emergency setting.

      PubDate: 2018-02-17T08:11:01Z
      DOI: 10.1016/j.accpm.2017.02.008
       
  • 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; Pierre Asfar; Alain Mercat; Thomas Gaillard; Soizic Gergaud; Sigismond Lasocki; Cyrille Sargentini; Claire Geneve; Philippe Montravers; Thibault Lefebvre; Herve Puy; Grégoire Mercier; Nicolas Nagot; Constance Delaby; Christophe Hirtz; Sylvain Lehmann; Jérôme Vialaret; Gerald Chanques; Samir Jaber; Karim Asehnoune; Antoine Roquilly; Claire Dahyot-Fizelier; Olivier Mimoz; Sonia Isslame; Philippe Seguin; Mathilde Barbaz; Martine Ferrandiere
      Pages: 391 - 396
      Abstract: Publication date: December 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 6
      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 ≥5days. 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: 2018-02-17T08:11:01Z
      DOI: 10.1016/j.accpm.2017.04.009
       
  • Peripheral venous catheter insertion simulation training: A randomized
           controlled trial comparing performance after instructor-led teaching
           versus peer-assisted learning
    • Authors: Sophie Pelloux; Arnaud Grégoire; Patrice Kirmizigul; Sandrine Maillot; Bernard Bui-Xuan; Guy Llorca; Sylvain Boet; Jean-Jacques Lehot; Thomas Rimmelé
      Pages: 397 - 402
      Abstract: Publication date: December 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 6
      Author(s): Sophie Pelloux, Arnaud Grégoire, Patrice Kirmizigul, Sandrine Maillot, Bernard Bui-Xuan, Guy Llorca, Sylvain Boet, Jean-Jacques Lehot, Thomas Rimmelé
      Introduction Peripheral venous catheter insertion is a procedural skill that every medical student should master. Training is often limited to a small number of students and is poorly evaluated. The objective of this study was to evaluate the performance of peer-assisted learning in comparison to instructor-led teaching for peripheral venous catheter insertion training. Methods Students were randomized to the control group attending a traditional instructor-led training session (slideshow and demonstration by an anesthetist instructor, followed by training on a procedural simulator) or to the test group attending a peer-assisted training session (slideshow and demonstration video-recorded by the same instructor, followed by training on a procedural simulator). The primary endpoint was the performance of peripheral venous catheter insertion, assessed on procedural simulator one week later by blinded experts using a standardized 20-item grid. Students self-evaluated their confidence levels using a numeric 10-point scale. Results Eighty-six students were included, 73 of whom attended the assessment session. The median performance score was 12/20 [8–15] in the instructor-led teaching group versus 13/20 [11–15] in the peer-assisted learning group (P =0.430). Confidence levels improved significantly after the assessment session and were significantly higher in the peer-assisted learning group (7.6/10 [7.0–8.0] versus 7.0/10 [5.0–8.0], P =0.026). Conclusion Peer-assisted learning is effective for peripheral venous catheter insertion training and can be as effective as instructor-led teaching. Given the large number of students to train, this finding is important for optimizing the cost-effectiveness of peripheral venous catheter insertion training.

      PubDate: 2018-02-17T08:11:01Z
      DOI: 10.1016/j.accpm.2016.11.007
       
  • Physiological and self-assessed psychological stress induced by a high
           fidelity simulation course among third year anesthesia and critical care
           residents: An observational study
    • Authors: Thomas Geeraerts; Philippe Roulleau; Gaëlle Cheisson; Fouad Marhar; Karl Aidan; Karim Lallali; Morgan Leguen; David Schnell; Fabien Trabold; Philippe Fauquet-Alekhine; Jacques Duranteau; Dan Benhamou
      Pages: 403 - 406
      Abstract: Publication date: December 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 6
      Author(s): Thomas Geeraerts, Philippe Roulleau, Gaëlle Cheisson, Fouad Marhar, Karl Aidan, Karim Lallali, Morgan Leguen, David Schnell, Fabien Trabold, Philippe Fauquet-Alekhine, Jacques Duranteau, Dan Benhamou
      Introduction The use of high fidelity simulators in Medicine can improve knowledge, behaviour and practice but may be associated with significant stress. Our objective was to measure physiological and psychological self-assessed intensity of stress before and after a planned simulation training session among third year anaesthesia and critical care residents. Methods A convenience sample of 27 residents participating in a simulation training course was studied. Stress was evaluated by self-assessment using a numerical scale and by salivary amylase concentration before and after the session. Technical and non-technical (using the Aberdeen Anaesthetists’ Non Technical Skills scale) performances were assessed through videotapes analysis. Results The median stress score was 5 (2–8) before and 7 (2–10) after the simulation session (P <0.001). For 48% of residents studied, the stress score after the session was superior or equal to 8/10. Salivary amylase concentration increased significantly after the session compared to before the session, respectively (1,250,440±1,216,667 vs. 727,260±603,787IU/L, P =0.008). There was no significant correlation between stress parameters and non-technical performance. Discussion Simulation-induced stress, as measured by self-assessment and biological parameter, is high before the session and increases significantly during the course. While this stress did not seem to impact performance negatively, it should be taken into account.

      PubDate: 2018-02-17T08:11:01Z
      DOI: 10.1016/j.accpm.2017.06.002
       
  • Repeated failure with regional blocks: Technical problem or resistance to
           local anaesthetics'
    • Authors: David Leconte; Romain Lemarchand; Cécile Petitjean; Marc E. Gentili
      First page: 407
      Abstract: Publication date: December 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 6
      Author(s): David Leconte, Romain Lemarchand, Cécile Petitjean, Marc E. Gentili


      PubDate: 2018-02-17T08:11:01Z
      DOI: 10.1016/j.accpm.2017.06.005
       
  • Axillary nerve block for a wrist fracture in a patient with
           facioscapulohumeral (Landouzy-Dejerine) disease
    • Authors: Mostafa Mazboudi; Samy Figueiredo; Bausard Latrech; Dan Benhamou
      Pages: 409 - 410
      Abstract: Publication date: December 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 6
      Author(s): Mostafa Mazboudi, Samy Figueiredo, Bausard Latrech, Dan Benhamou


      PubDate: 2018-02-17T08:11:01Z
      DOI: 10.1016/j.accpm.2017.05.004
       
  • Eye protection in anaesthesia and intensive care
    • Authors: Hawa Keita; Jean-Michel Devys; Jacques Ripart; Marie Frost; Isabelle Cochereau; Frédérique Boutin; Claude Guérin; Dominique Fletcher; Vincent Compère
      Pages: 411 - 418
      Abstract: Publication date: December 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 6
      Author(s): Hawa Keita, Jean-Michel Devys, Jacques Ripart, Marie Frost, Isabelle Cochereau, Frédérique Boutin, Claude Guérin, Dominique Fletcher, Vincent Compère


      PubDate: 2018-02-17T08:11:01Z
      DOI: 10.1016/j.accpm.2017.08.001
       
  • Sustainability of anaesthesia components of an enhanced recovery program
           (ERP) in colorectal and orthopaedics surgery
    • Authors: Helene Beloeil; Karem Slim; the Francophone Group of enhanced recovery after surgery
      Abstract: Publication date: Available online 15 February 2018
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Helene Beloeil, Karem Slim, the Francophone Group of enhanced recovery after surgery
      Background Sustainability of ERP is a challenge and data are scarce on the subject. The aim of this study was to assess if application of enhanced recovery elements through the Francophone Group of Enhanced Recovery after Surgery (Grace) in the anaesthesia management was sustainable 2 years after its implementation. Materials and methods We conducted a retrospective analysis of the prospective Grace database between October 2014 and October 2016. The evolution of each recommendation item over time was analysed using non-parametric Spearman correlation coefficient. Results A total of 67 and 43 centres corresponding to 2067 and 3022 patients participated to the Grace audit in colorectal and orthopaedics surgery, respectively. Colorectal surgery: Mean length of stay was 5 (± 4) days and readmission rate was 6.6%. Application of most items did not statistically change. It worsened over time for PONV prophylaxis (p=0.01) and prevention of intraoperative hypothermia (p= 0.02); and improved for NSAID administration (p = 0.01). Orthopaedics surgery: Mean length of stay was 3 (± 2) days and readmission rate was 1.7%. There was a trend towards improvement for most items. It reached statistical significance for PONV prophylaxis (p = 0.001), limited preoperative fasting (p = 0.01). While the use of a perineural catheter (p = 0.001) decreased over time, infiltration of the surgical site statistically increased (p = 0.05). Conclusion This study shows on a large scale a trend towards less application of all ERP items over time. Continuous audits should be encouraged to expect further improvements.

      PubDate: 2018-02-17T08:11:01Z
      DOI: 10.1016/j.accpm.2018.01.005
       
  • Thromboprophylaxis for ambulatory surgery: results from a prospective
           national cohort
    • Authors: Charles Marc Samama; Dan Benhamou; Frédéric Aubrun; Jean-Luc Bosson; Pierre Albaladejo
      Abstract: Publication date: Available online 15 February 2018
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Charles Marc Samama, Dan Benhamou, Frédéric Aubrun, Jean-Luc Bosson, Pierre Albaladejo
      Background Venous thromboembolism (VTE) prophylaxis is not always part of the usual care of ambulatory surgery patients, and few guidelines are available. Objectives To collect data on the application of VTE prophylaxis in ambulatory patients. Design The OPERA study is a large national survey performed in 221 healthcare facilities. Patients 2174 patients who underwent one of ten selected procedures over two pre-defined days of investigation. Main outcome measures Assessment and management of the post-operative VTE risk. Results The postoperative VTE risk was assessed as nil (4.1% of the physicians), low (74%) or moderate (20%). This risk was assessed as lower (71%) in ambulatory surgery as compared to conventional surgery. In most centres (94%), a personal patient history of VTE was recorded preoperatively, and in 72% a prophylaxis protocol was systematically applied but only 40% of the responding centres had a written protocol for VTE prophylaxis. The postoperative period (discharge at home) was covered by a VTE protocol for 75% of the centres, with VTE prophylaxis starting postoperatively in 21% of the patients. In these patients, different treatments were applied: below-knee compression stockings (25%); thigh-length compression stockings (21%); intermittent pneumatic compression in the recovery room (1.2%); unfractionated heparin (2.0%); low molecular weight heparins (65%); vitamin K antagonists (0.5%); other treatments, including direct oral anticoagulants (0.5%). Conclusion These data underline the need for a better assessment of the VTE risk in ambulatory patients and new studies either with conventional or new agents to be able to build guidelines in this new setting.

      PubDate: 2018-02-17T08:11:01Z
      DOI: 10.1016/j.accpm.2018.01.003
       
  • Sevoflurane For Procedural Sedation In Critically Ill Patients: A
           Pharmacokinetic Comparative Study Between Burn And Non-Burn Patients
    • Authors: Sebastien Perbet; Daniel Bourdeaux; Alexandre Lenoire; Claire Biboulet; Bruno Pereira; Malha Sadoune; Benoit Plaud; Jean-Marie Launay; Jean-Etienne Bazin; Valerie Sautou; Alexandre Mebazaa; Pascal Houze; Jean-Michel Constantin; Matthieu Legrand
      Abstract: Publication date: Available online 15 February 2018
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Sebastien Perbet, Daniel Bourdeaux, Alexandre Lenoire, Claire Biboulet, Bruno Pereira, Malha Sadoune, Benoit Plaud, Jean-Marie Launay, Jean-Etienne Bazin, Valerie Sautou, Alexandre Mebazaa, Pascal Houze, Jean-Michel Constantin, Matthieu Legrand
      Background Sevoflurane has anti-inflammatory proprieties and short lasting effects making it of interest for procedural sedation in critically ill patients. We evaluated the pharmacokinetics of sevoflurane and metabolites in severely ill burn patients and controls. The secondary objective was to assess potential kidney injury. Methods prospective interventional study in a burn and a surgical intensive care unit 24 mechanically ventilated critically ill patients (12 burns, 12 controls) were included,. The sevoflurane was administered with an expired fraction target of 2% during short-term procedural sedation. Plasma concentrations of sevoflurane, hexafluoroisopropanolol (HFIP) and free fluoride ions were recorded at different times. Kinetic Pro (Wgroupe, France) was used for pharmacokinetic analysis. Kidney injury was assessed with neutrophil gelatinase associated lipocalin (NGAL). Results The mean total burn surface area was 36 ± 11%. The average plasma concentration of sevoflurane was 70.4 ± 37.5mg.L-1 in burns and 57.2 ± 28.1mg.L-1 in controls at the end of the procedure (p = 0.58). The volume of distribution was higher (46.8 ± 7.2 vs 22.2 ± 2.50 l, p<0.001), and the drug half-life longer in burns (1.19 ± 0.28hours vs 0.65 ± 0.04h, p<0.0001). Free metabolite HFIP was higher in burns. Plasma fluoride was not different between burns and controls. NGAL didn’t rise after procedures. Conclusion We observed an increased volume of distribution, slower elimination rate, and altered metabolism of sevoflurane in burn patients compared to controls. Repeated use for procedural sedation in burn patients needs further evaluation. No renal toxicity was detected. Trial registry number ClinicalTrials.gov Identifier NCT02048683

      PubDate: 2018-02-17T08:11:01Z
      DOI: 10.1016/j.accpm.2018.02.001
       
  • Preoperative Risk Factors for Unexpected Postoperative Intensive Care Unit
           Admission: A Retrospective Case Analysis
    • Authors: Joshua B. Knight; Evan E. Lebovitz; Theresa A. Gelzinis; Ibtesam A. Hilmi
      Abstract: Publication date: Available online 15 February 2018
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Joshua B. Knight, Evan E. Lebovitz, Theresa A. Gelzinis, Ibtesam A. Hilmi
      Introduction The purpose of this retrospective case-control study was to investigate preoperative risk factors for unexpected postoperative intensive care unit (ICU) admissions in patients undergoing non-emergent surgical procedures in a tertiary medical centre. Methods A medical record review of adult patients undergoing elective non-cardiac and non-transplant major surgical procedures during the period of January 2011 through December 2015 in the operating rooms of a large university hospital was carried out. The primary outcome assessed was unexpected ICU admission, with mortality as a secondary outcome. Demographic data, length of hospital and ICU stay, and preoperative comorbidities were also obtained as exposure variables. Propensity score matching was then employed to yield a study and control group. Results The group of patients who met inclusion criteria in the study and the control group that did not require ICU admission were obtained, each containing 1191 patients after propensity matching. Patients with acute and/or chronic kidney injury (odds ratio (OR) 2.20 [1.75-2.76]), valvular heart disease (OR 1.94 [1.33-2.85]), peripheral vascular disease (PVD) (OR 1.41 [1.02-1.94]), and congestive heart failure (CHF) (OR 1.80 [1.31-2.46]) were all associated with increased unexpected ICU admission. History of cerebrovascular accident (CVA) (OR 3.03 [1.31-7.01]) and acute and/or chronic kidney injury (OR 1.62 [1.12-2.35]) were associated with increased mortality in all patients; CVA was also associated with increased mortality (OR 3.15 [1.21-8.20]) specifically in the ICU population. Conclusions CHF, acute/chronic kidney injury, PVD, and valve disease were significantly associated with increased unexpected ICU admission; patients with CVA suffered increased mortality when admitted to the ICU.

      PubDate: 2018-02-17T08:11:01Z
      DOI: 10.1016/j.accpm.2018.02.002
       
  • Ultrasound-guided erector spine plane block provides effective
           perioperative analgesia and anaesthesia for thoracic mass excision: A
           report of two cases
    • Authors: Sevim Cesur; Ayse Nur Ay; Murat Yayik; M.Emin Naldan; Yavuz Gurkan
      Abstract: Publication date: Available online 13 February 2018
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Sevim Cesur, Ayse Nur Ay, Murat Yayik, M.Emin Naldan, Yavuz Gurkan


      PubDate: 2018-02-17T08:11:01Z
      DOI: 10.1016/j.accpm.2018.01.002
       
  • Male requires a higher median target effect-site concentration of propofol
           for I-gel placement when combined with dexmedetomidine
    • Authors: Ming-Ming Han; Fu-Shan Xue; Fang Kang; Xiang Huang; Juan Li
      Abstract: Publication date: Available online 13 February 2018
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Ming-Ming Han, Fu-Shan Xue, Fang Kang, Xiang Huang, Juan Li
      Objective The supraglottic airway device (SAD) can be used for airway management of spontaneous breathing patients, and propofol is commonly applied for the SAD placement. This study was designed to assess the effect of gender on median target effect-site concentration (Ce50) of propofol for I-gel placement when combined with dexmedetomidine. Material and method 19 males and 18 females, aged 18 to 59 and undergoing elective surgery, were enrolled. After intravenous infusion of dexmedetomidine 1.0μg/kg over 10min followed by continuous infusion of 0.4μg/kg/h, target-controlled infusion of propofol under Marsh model was started and the initial Ce of propofol was set at 4.79μg/ml and 4.35μg/ml in the male and female patients, respectively. The I-gel was inserted when the Ce of propofol reached the pre-set concentration and bispectral index value was less than 60. The Ce of propofol required for I-gel placement was determined by the Dixon up-and-down method. Results The Ce50 (95% confidence interval) of propofol required for I-gel placement were 4.082μg/ml (3.798-4.332μg/ml) and 3.509μg/ml (3.266-3.749μg/ml) in male and female patients, respectively, with a significant higher Ce50 in males. Conclusion When combined with dexmedetomidine, male compared with female requires a higher Ce50 of propofol for I-gel placement.

      PubDate: 2018-02-17T08:11:01Z
      DOI: 10.1016/j.accpm.2018.01.004
       
  • Effectiveness of a blended learning course and flipped classroom in first
           year anaesthesia training
    • Authors: Antoine Marchalot; Bertrand Dureuil; Benoit Veber; Jean-Luc Fellahi; Jean-Luc Hanouz; Hervé Dupont; Emmanuel Lorne; Jean-Louis Gerard; Vincent Compère
      Abstract: Publication date: Available online 22 November 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Antoine Marchalot, Bertrand Dureuil, Benoit Veber, Jean-Luc Fellahi, Jean-Luc Hanouz, Hervé Dupont, Emmanuel Lorne, Jean-Louis Gerard, Vincent Compère
      Background Blended learning, which combines internet-based platform and lecturing, is used in anaesthesiology and critical care teaching. However, the benefits of this method remain unclear. Methods We conducted a prospective, multicentre, non-randomised work between 2007 and 2014 to study the effect of blended learning on the results of first year anaesthesia and critical care residents in comparison with traditional teaching. Blended learning was implemented in Rouen University Hospital in 2011 and residents affiliated to this university corresponded as the blended learning group. The primary outcome was the resident's results as measured with multiple-choice questions between blended learning and control groups after beginning blended learning (post-interventional stage). The secondary outcomes included residents’ results between pre and post-interventional stages and homework's time. Moreover, comparison between control and blended learning group before beginning blended learning (pre-interventional stage) was performed. Results From 2007 to 2014, 308 residents were included. For the pre-interventional period, the mean score in the blended learning group (n =53) was 176 (CI 95% 163 to 188) whereas the mean score in the control group (n =106) was 167 (CI 95% 160 to 174) (no difference). For the post-interventional period, the mean score in blended learning group (n =54) was 232 on 300 (CI95% 227–237) whereas the mean score in the control group (n =95) is 215 (CI95% 209–220) (P <0.001). In the two groups, comparison between pre and post-interventional stages showed the increase of mean score, stronger for blended learning group (32% and 28% in blended learning and control group, P <0.05). The average time of homework in the blended learning group was 27h (CI 95% 18.2–35.8) and 10h in the control group (CI 95% 2–18) (P <0.05). Conclusions This work suggests the positive effect of blended learning (associating internet-based learning and flipped classroom) on the anaesthesia and critical care residents’ knowledge by increasing their homework's time.

      PubDate: 2018-02-17T08:11:01Z
      DOI: 10.1016/j.accpm.2017.10.008
       
  • Veno-arterial ECMO in critically ill patients: The age of maturity'
    • Authors: Nicolas Mongardon; Quentin De Roux; Simon Clariot
      Abstract: Publication date: Available online 15 November 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Nicolas Mongardon, Quentin De Roux, Simon Clariot


      PubDate: 2018-02-17T08:11:01Z
      DOI: 10.1016/j.accpm.2017.10.002
       
  • New markers for early detection of acute kidney injury after transcatheter
           aortic valve implantation
    • Authors: Cédrick Zaouter; Frédérique Priem; Lionel Leroux; Guillaume Bonnet; Marie-Lise Bats; Marie-Christine Beauvieux; Alain Rémy; Alexandre Ouattara
      Abstract: Publication date: Available online 13 November 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Cédrick Zaouter, Frédérique Priem, Lionel Leroux, Guillaume Bonnet, Marie-Lise Bats, Marie-Christine Beauvieux, Alain Rémy, Alexandre Ouattara
      Background Acute kidney injury (AKI) is a frequent complication after a transcatheter aortic valve implantation (TAVI). Biomarkers such as urinary G1 cell cycle arrest proteins (TIMP-2 and IGFBP7) and sonographic evaluation (Doppler Renal Resistive Index [RRI]) have been advocated to predict AKI at an early stage after a TAVI-procedure. The primary aim was to determine the predictive value of these markers to detect AKI after a TAVI-procedure at an early phase. Patients and methods In a prospective observational study, 62 consecutive patients were scheduled for a TAVI. AKI was assessed based on the KDIGO criteria. Biomarkers and RRI were measured concomitantly before TAVI, at the first micturition post-implantation and the first micturition on the morning after the procedure. Results Twenty-two patients (35%) developed AKI. On the first day after the TAVI-procedure, urinary TIMP-2 and IGFBP7 concentrations increased significantly in patients who developed AKI (0.1, [interquartile] [0.1–0.35] to 0.40 [0.10–1.00] vs. 0.2 [0.1–0.5] to 0.10 [0.10–0.20], P =0.012) with an area under the receiver-operating characteristic curve of 0.71 [0.55–0.83]. Sensitivity was 0.57 and specificity was 0.83 for a cut-off value of 0.35. No significant increases in RRI were found in patients who developed AKI. Conclusions Based on the current guidelines for the diagnosis of AKI, the urinary proteins TIMP-2 and IGFBP7 do not detect AKI at an early stage accurately in patients undergoing a TAVI-procedure.

      PubDate: 2018-02-17T08:11:01Z
      DOI: 10.1016/j.accpm.2017.10.004
       
  • Initial training of French residents in obstetric anaesthesia: A national
           survey
    • Authors: Ludovic Hilt; Delphine Herbain; Nour-Eddine Baka; Jérôme Feugeas; Hervé Bouaziz; Florence Vial
      Abstract: Publication date: Available online 10 November 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Ludovic Hilt, Delphine Herbain, Nour-Eddine Baka, Jérôme Feugeas, Hervé Bouaziz, Florence Vial


      PubDate: 2018-02-17T08:11:01Z
      DOI: 10.1016/j.accpm.2017.10.006
       
  • Rescue transtracheal jet ventilation during difficult intubation in
           patients with upper airway cancer
    • Authors: G. Bouroche; C. Motamed; J.M. de Guibert; D. Hartl; J.L. Bourgain
      Abstract: Publication date: Available online 10 November 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): G. Bouroche, C. Motamed, J.M. de Guibert, D. Hartl, J.L. Bourgain
      Introduction The failure rates of intubation and/or mask ventilation are higher in patients with neck or upper airway disease. To ensure oxygenation, rescue trans-tracheal jet ventilation (RTTJV) may be used. In this critical situation, a high rate of complications has been reported. The aim of this study was to report RTTJV performed by a jet ventilator with an end-expiratory pressure control in an experienced institution. Patients and methods From a computerised database of 63,905 anaesthesia cases, the anaesthetic reports of patients who underwent emergency RTTJV during intubation were studied retrospectively. The following information were analysed: anaesthetic procedures, data from the monitoring: lowest SpO2, duration of SpO2 <90%, and complications. Success of emergency RTTJV was defined when SpO2 was>90% under jet ventilation. Results RTTJV was used in 31 patients, of whom 26 had upper airway cancer, (pre-treatment, n =9, post-treatment, n =17). Difficult intubation was anticipated in 15 out of 31 cases including six fiber-optic-aided intubations under spontaneous ventilation. RTTJV was effective in all cases with quick restoration of oxygenation (SpO2 >90%). During jet ventilation, final airway control was performed either by oral intubation (n =25) or tracheotomy (n =1) in a short delay (mean: 8.1±1.7min). Subcutaneous emphysema was observed in one case without pneumothorax. Conclusion RTTJV with end-expiratory pressure control allowed oxygenation during difficult intubation, with a low rate of complications.

      PubDate: 2018-02-17T08:11:01Z
      DOI: 10.1016/j.accpm.2017.10.005
       
  • Comparison of techniques for visualisation of the airway anatomy for
           ultrasound-assisted intubation: A prospective study of emergency
           department patients
    • Authors: Michael Romano; Jacques Lee Jordan. Chenkin
      Abstract: Publication date: Available online 4 February 2018
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Michael J. Romano, Jacques S. Lee, Jordan. Chenkin
      Purpose Ultrasound has been shown to be a highly accurate adjunct for confirming endotracheal tube (ETT) placement, however there is no universally accepted scanning technique. The objective of this study was to determine which ultrasound technique provides the highest rate of adequate airway visualisation in a sample of stable emergency department (ED) patients. Methods We conducted a prospective observational study using a convenience sample of ED patients. Airway imaging was performed using the following five techniques: 1) transcricothryoid membrane (TCM), 2) suprasternal notch (SSN) without transducer pressure, 3) SSN with pressure, 4) SSN with pressure to the left of the trachea and 5) SSN with pressure to the right of the trachea. A blinded reviewer scored the adequacy of airway visualisation for each technique. Results A total of 100 patients were enrolled in the study. SSN to the left of the trachea with pressure had the highest rate of adequate airway visualisation (93.0%, 95% CI 86.1-97.1%), followed by 82.0% (95% CI 73.1-89.0%) for SSN with pressure, 74.0% (95% CI 64.3-82.3%) for TCM, 44.0% (95% CI 34.1-54.3%) for SSN without pressure, and 1.0% (95% CI 0.0-5.4%) for SSN to the right of the trachea. In 76.0% (95% CI 66.4-84.0%) of patients, the SSN view was improved by moving the probe off the midline towards the patient's left. Conclusions In a sample of ED patients, the airway anatomy relevant for use in endotracheal intubation is best visualised at the SSN to the left of the trachea with transducer pressure applied.

      PubDate: 2018-02-05T17:48:04Z
       
  • Position of the French Working Group on Perioperative Haemostasis (GIHP)
           on viscoelastic tests: What role for which indication in bleeding
           situations'
    • Authors: Stéphanie Roullet; Emmanuel de Maistre; Brigitte Ickx; Normand Blais; Sophie Susen; David Faraoni; Delphine Garrigue; Fanny Bonhomme; Anne Godier; Dominique Lasne
      Abstract: Publication date: Available online 3 February 2018
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Stéphanie Roullet, Emmanuel de Maistre, Brigitte Ickx, Normand Blais, Sophie Susen, David Faraoni, Delphine Garrigue, Fanny Bonhomme, Anne Godier, Dominique Lasne
      Purpose Viscoelastic tests (VETs), thromboelastography (TEG®) and thromboelastometry (ROTEM®) are global tests of coagulation performed on whole blood. They evaluate the mechanical strength of a clot as it builds and develops after coagulation itself. The time required to obtain haemostasis results remains a major problem for clinicians dealing with bleeding, although some teams have developed a rapid laboratory response strategy. Indeed, the value of rapid point-of-care diagnostic devices such as VETs has increased over the years. However, VETs are not standardised and there are few recommendations from the learned societies regarding their use. In 2014, the recommendations of the International Society of Thrombosis and Haemostasis (ISTH) only concerned haemophilia. The French Working Group on Perioperative haemostasis (GIHP) therefore proposes to summarise knowledge on the clinical use of these techniques in the setting of emergency and perioperative medicine. Methods A review of the literature. Principal findings The role of the VETs seems established in the management of severe trauma and in cardiac surgery, both adult and paediatric. In other situations, their role remains to be defined: hepatic transplantation, postpartum haemorrhage, and non-cardiac surgery. They must be part of the global management of haemostasis based on algorithms defined in each centre and for each population of patients. Their position at the bedside or in the laboratory is a matter of discussion between clinicians and biologists. Conclusion VETs must be included in algorithms. In consultation with the biology laboratory, these devices should be situated according to the way each centre functions.

      PubDate: 2018-02-05T17:48:04Z
      DOI: 10.1016/j.accpm.2017.12.014
       
  • Evaluation and comparison of Epidural Analgesia in Labour related
           Information on French and English-speaking websites
    • Authors: Fabien Espitalier; Sabine De Lamer; Mathilde Barbaz; Marc Laffon; Francis Remérand
      Abstract: Publication date: Available online 31 January 2018
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Fabien Espitalier, Sabine De Lamer, Mathilde Barbaz, Marc Laffon, Francis Remérand
      Objectives The medical information on the Internet is better in English than in other languages. The information about Epidural Analgesia In Labour (EAIL) available on French-speaking websites is of poor quality. The quality of the information about EAIL should be better in English, but there is no comparison available. This study has assessed and compared the quality of the information about EAIL available on French and English-speaking websites. Method Keywords “epidural”, “épidurale” and/or “péridurale” were used in the French, Canadian and American Google® and Yahoo® search engines. Two independent assessors assessed the 20 first websites for each engine search. They used an evaluation form created from French, Canadian and American recommendations. This form assessed the structure quality (Structure Score /25) and the medical information quality (Medical Information Score /30) of the websites. The addition of both scores gives the Global Score (/55). Results 71 websites were assessed, 39 French-speaking and 32 English-speaking websites. Structure, Medical Information and Global Scores (expressed as mean (SD)) were respectively 11 (4), 13 (5), 24 (8) for the French-speaking websites and 11 (4), 12 (4), 23 (7) for the English-speaking websites. There was no statistical significant difference between both languages. Conclusion Information about EAIL available on French and English-speaking websites is of poor quality and there is no difference in the information quality, whatever the language. A consideration on Internet medical information improvement is needed. A high quality dedicated website should be created and broadcasted.

      PubDate: 2018-02-05T17:48:04Z
      DOI: 10.1016/j.accpm.2017.12.013
       
  • Paediatric video laryngoscopy and airway management: What's the clinical
           evidence'
    • Authors: Xue Fu-Shan; Liu Ya-Yang; Li Hui-Xian; Yang Gui-Zhen
      Abstract: Publication date: Available online 10 January 2018
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Xue Fu-Shan, Liu Ya-Yang, Li Hui-Xian, Yang Gui-Zhen
      The major complications of paediatric airway management are uncommon, but the outcomes are often severe. Over the last decade, additions and advancements in the devices and technology have significantly improved our ability to manage difficult paediatric airways safely. Videolaryngoscopy involves the use of video and optical technology to facilitate indirect visualisation of the larynx during intubation and has been seen as an evolutionary step in intubation technology. Over the past few years, video laryngoscopes have been receiving plenty of attention as new airway devices for use in paediatric patients. The objective of this narrative review is to specify the existing clinical evidence regarding the efficiency and safety of video laryngoscopy in paediatric airway management.

      PubDate: 2018-01-14T16:06:48Z
      DOI: 10.1016/j.accpm.2017.11.018
       
  • Perioperative management of adult diabetic patients
    • Authors: Cheisson Gaëlle; Jacqueminet Sophie; Cosson Emmanuel; Ichai Carole; Leguerrier Anne-Marie; Nicolescu-Catargi Bogdan; Ouattara Alexandre; Tauveron Igor; Valensi Paul; Benhamou Dan
      Abstract: Publication date: Available online 6 January 2018
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Cheisson Gaëlle, Jacqueminet Sophie, Cosson Emmanuel, Ichai Carole, Leguerrier Anne-Marie, Nicolescu-Catargi Bogdan, Ouattara Alexandre, Tauveron Igor, Valensi Paul, Benhamou Dan
      A patient should be referred to a diabetologist perioperatively in several circumstances: preoperative recognition of a previously unknown diabetes or detection of glycaemic imbalance (HbA1c <5% or >8%); during hospitalisation, recognition of a previously unknown diabetes, persisting glycaemic imbalance despite treatment or difficulty resuming previously used chronic treatment; postoperatively and after discharge from hospital, for all diabetic patients in whom HbA1c is >8%.

      PubDate: 2018-01-14T16:06:48Z
      DOI: 10.1016/j.accpm.2017.10.009
       
  • Impact of learner's role (active participant-observer or observer only) on
           learning outcomes during high-fidelity simulation sessions in anaesthesia:
           a single centre, prospective and randomised study
    • Authors: Antonia Blanié; Sophie Gorse; Philippe Roulleau; Samy Figueiredo; Dan Benhamou
      Abstract: Publication date: Available online 5 January 2018
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Antonia Blanié, Sophie Gorse, Philippe Roulleau, Samy Figueiredo, Dan Benhamou
      Aim The increasing use of high-fidelity simulation is limited by the imbalance between the growing number of students and the human resources available in such a way that all residents cannot play a role during scenarios. The learning outcomes of observers need to be studied. Methods This prospective randomised study was approved by the institutional review board. Anaesthesia residents attending a one-day training session were enrolled. In each of the four scenarios, three residents played an active role while others observed in a separate room. All participants attended debriefing sessions. Residents were randomised between active participant-observer group (AP-O group) and observer group (O group). A similar questionnaire was distributed before, immediately after the session and after three months and included self-reported assessment of satisfaction, medical knowledge (noted 0-16), and non-technical skills. Results 104 questionnaires were analysed. Immediately after the simulation, a significantincrease in medical knowledge was recorded but was higher in the AP-O group (6 [5-8] to 10 [8-11]/16) than in the O group (7 [5-8] to 9 [7-10]/16). High scores for non-technical skills were similarly observed in both groups. Satisfaction was high in both groups but was higher in the AP-O group (9 [8-9] versus 8 (8-9]/10, p=0.019). Decay of knowledge was observed for most main outcomes at three months. Conclusion This study suggests an immediate improvement of learning outcomes for both roles after immersive simulation but some learning outcomes may be better for residents engaged as players in scenarios.

      PubDate: 2018-01-14T16:06:48Z
      DOI: 10.1016/j.accpm.2017.11.016
       
  • Eyes should be taped closed during rapid sequence induction of anaesthesia
    • Authors: Hans-Joachim Priebe
      Abstract: Publication date: Available online 5 January 2018
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Hans-Joachim Priebe


      PubDate: 2018-01-14T16:06:48Z
      DOI: 10.1016/j.accpm.2017.12.010
       
  • Management Of Antiplatelet Therapy In Patients Undergoing Elective
           Invasive Procedures Proposals From The French Working Group On
           Perioperative Hemostasis (Gihp) And The French Study Group On Thrombosis
           And Hemostasis (Gfht) In Collaboration With The French Society For
           Anesthesia And Intensive Care (Sfar)
    • Authors: Anne Godier; Pierre Fontana; Serge Motte; Annick Steib; Fanny Bonhomme; Sylvie Schlumberger; Thomas Lecompte; Nadia Rosencher; Sophie Susen; André Vincentelli; Yves Gruel; Pierre Albaladejo; Jean-Philippe Collet
      Abstract: Publication date: Available online 5 January 2018
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Anne Godier, Pierre Fontana, Serge Motte, Annick Steib, Fanny Bonhomme, Sylvie Schlumberger, Thomas Lecompte, Nadia Rosencher, Sophie Susen, André Vincentelli, Yves Gruel, Pierre Albaladejo, Jean-Philippe Collet
      The French Working Group on Perioperative Hemostasis (GIHP) and the French Study Group on Hemostasis and Thrombosis (GFHT) in collaboration with the French Society for Anesthesia and Intensive Care (SFAR) drafted up-to-date proposals for the management of antiplatelet therapy in patients undergoing elective invasive procedures. The proposals were discussed and validated by a vote; all proposals but one could be assigned with a high strength. The management of antiplatelet therapy is based on their indication and the procedure. The risk of bleeding related to the procedure can be divided into high, moderate and low categories depending on the possibility of performing the procedure in patients receiving antiplatelet agents (none, monotherapy and dual antiplatelet therapy respectively). If discontinuation of antiplatelet therapy is indicated before the procedure, a last intake of aspirin, clopidogrel, ticagrelor and prasugrel 3, 5, 5 and 7 days before surgery respectively is proposed. The thrombotic risk associated with discontinuation should be assessed according to each specific indication of antiplatelet therapy and is higher for patients receiving dual therapy for coronary artery disease (with further refinements based on a few well-accepted items) than for those receiving monotherapy for cardiovascular prevention, for secondary stroke prevention or for lower extremity arterial disease. These proposals also address the issue of the potential role of platelet functional tests and consider management of antiplatelet therapy for regional anaesthesia, including central neuraxial anesthesia and peripheral nerve blocks, and for coronary artery surgery.

      PubDate: 2018-01-14T16:06:48Z
      DOI: 10.1016/j.accpm.2017.12.012
       
  • Application of tourniquet in civilian trauma: systematic review of the
           literature
    • Authors: Charlotte Beaucreux; Benoît Vivien; Ethan Miles; Sylvain Ausset; Pierre Pasquier
      Abstract: Publication date: Available online 5 January 2018
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Charlotte Beaucreux, Benoît Vivien, Ethan Miles, Sylvain Ausset, Pierre Pasquier
      Introduction The effectiveness of a tourniquet (TQ) in case of extremity haemorrhages is well recognised to prevent death on the battlefield. However, little is known about the usefulness of TQ in civilian trauma settings, including terrorist attack situations. The aim of this systematic review was to analyse the evidence-based medical literature in order to precise the use of TQ in the management of extremity haemorrhages in civilian setting. Methods Analysis of all studies published until 12/31/2016 on the Embase, Medline and Opengrey databases. To be included, studies had to contain descriptions, discussions or experiences of TQ application in civilian setting. The quality of the studies was evaluated using the PRISMA and the STROBE criteria. Results Of the 380 studies identified, 24 were included. The overall level of evidence was low. 3028 TQ placements were reported. Most of them concerned the Combat Application Tourniquet: CAT®. Haemorrhages implied in the use of TQ were almost exclusively traumatic, most of the time regarding young men (27-44 years old). Effectiveness rates of TQ varied between 78% and 100%. Complications rates associated with the use of TQ remained low, even when used in elderlies or patients with comorbidities. Finally, caregivers reported a common fear of adverse effects, while reported complications were rare (<2%). Conclusion This systematic review revealed TQ to be an effective tool for the management of extremity haemorrhages in civilian trauma, associated with few complications. Larger studies and dedicated training courses are needed to improve the use of TQ in the civilian standards of care.

      PubDate: 2018-01-14T16:06:48Z
      DOI: 10.1016/j.accpm.2017.11.017
       
  • Ultrasound-guided transversus abdominis plane (TAP) block in pedicled
           groin flap
    • Authors: Cédric NGUYEN; Quentin MATHAIS; Mickael CARDINALE; Christophe DROUIN; Bertrand PRUNET; Eric MEAUDRE
      Abstract: Publication date: Available online 4 January 2018
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Cédric NGUYEN, Quentin MATHAIS, Mickael CARDINALE, Christophe DROUIN, Bertrand PRUNET, Eric MEAUDRE


      PubDate: 2018-01-14T16:06:48Z
      DOI: 10.1016/j.accpm.2017.12.011
       
  • Effective concentration of levobupivacaine and ropivacaine in 80% of
           patients receiving epidural analgesia (EC80) in the first stage of labour:
           a study using the Continual Reassessment Method
    • Authors: Agnès Le Gouez; Marie-Pierre Bonnet; Thomas Leclerc; Jean-Xavier Mazoit; Dan Benhamou; Frédéric J. Mercier
      Abstract: Publication date: Available online 30 December 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Agnès Le Gouez, Marie-Pierre Bonnet, Thomas Leclerc, Jean-Xavier Mazoit, Dan Benhamou, Frédéric J. Mercier
      Background A comparison of the effective dose in 50% of patients (ED50) has suggested that the potency of levobupivacaine lies between that of bupivacaine and ropivacaine. However, for clinical purposes, knowledge and use of doses close to the ED95 are more relevant. This study was designed to determine the EC80 (effective concentration) for both epidural levobupivacaine and ropivacaine using the continual reassessment method (CRM) during obstetric analgesia. Methods In this double blind randomised study, term parturients were included by cohorts of 6 if cervical dilatation was ≤ 5cm and visual analogue pain score (VAPS) > 30mm. Efficacy was defined by a decrease of VAPS to a value ≤ 10, thirty minutes after epidural injection of 20 mL of levobupivacaine or ropivacaine. The first cohort received the lowest dose. Every next cohort received a dose according to the response's probability calculated using a Bayesian method, incorporating data from all consecutive previous patients. In addition, a logistic equation was fitted a-posteriori to the whole data set to determine the whole dose-probability curve. Results Fifty-four patients were enrolled. Levobupivacaine 0.17% and ropivacaine 0.2% gave probabilities of success of 82% and 72 % respectively. By fitting the logistic model to the data, the concentration leading to a probability of 0.8 (EC80) was 0.14% for levobupivacaine and 0.24% for ropivacaine while the EC50 were 0.09% for levobupivacaine and 0.17% for ropivacaine respectively. Conclusion This study suggests that epidural levobupivacaine used as the sole drug for labour analgesia has an EC80 lower than that of ropivacaine.

      PubDate: 2018-01-03T13:44:06Z
      DOI: 10.1016/j.accpm.2017.12.009
       
  • MANAGEMENT OF SEVERE TRAUMATIC BRAIN INJURY (First 24 hours)
    • Authors: Thomas Geeraerts; Lionel Velly; Lamine Abdennour; Karim Asehnoune; Gérard Audibert; Pierre Bouzat; Nicolas Bruder; Romain Carrillon; Vincent Cottenceau; François Cotton; Sonia Courtil-Teyssedre; Claire Dahyot-Fizelier; Frédéric Dailler; Jean-Stéphane David; Nicolas Engrand; Dominique Fletcher; Gilles Francony; Laurent Gergelé; Carole Ichai; Etienne Javouhey; Pierre-Etienne Leblanc; Thomas Lieutaud; Philippe Meyer; Sébastien Mirek; Gilles Orliaguet; François Proust; Hervé Quintard; Catherine Ract; Mohamed Srairi; Karim Tazarourte; Bernard Vigué; Jean-François Payen
      Abstract: Publication date: Available online 27 December 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Thomas Geeraerts, Lionel Velly, Lamine Abdennour, Karim Asehnoune, Gérard Audibert, Pierre Bouzat, Nicolas Bruder, Romain Carrillon, Vincent Cottenceau, François Cotton, Sonia Courtil-Teyssedre, Claire Dahyot-Fizelier, Frédéric Dailler, Jean-Stéphane David, Nicolas Engrand, Dominique Fletcher, Gilles Francony, Laurent Gergelé, Carole Ichai, Etienne Javouhey, Pierre-Etienne Leblanc, Thomas Lieutaud, Philippe Meyer, Sébastien Mirek, Gilles Orliaguet, François Proust, Hervé Quintard, Catherine Ract, Mohamed Srairi, Karim Tazarourte, Bernard Vigué, Jean-François Payen
      The latest French Guidelines for the management in the first 24hours of patients with severe traumatic brain injury (TBI) were published in 1998. Due to recent changes (intracerebral monitoring, cerebral perfusion pressure management, treatment of raised intracranial pressure), an update was required. Our objective has been to specify the significant developments since 1998. These guidelines were conducted by a group of experts for the French Society of Anesthesia and Intensive Care Medicine (Société Francaise d’Anesthésie Réanimation (SFAR)) in partnership with the Association de Neuro-Anesthésie-Réanimation de Langue Française (ANARLF), the Société Française de Neurochirurgie (SFN), the Groupe Francophone de Réanimation et d’Urgences Pédiatriques (GFRUP) and the Association des Anesthésistes-Réanimateurs Pédiatriques d’Expression Française (ADARPEF). The method used to elaborate these guidelines was the GRADE® method. After two Delphi rounds, 32 recommendations were formally developed by the experts focusing on the evaluation the initial severity of traumatic brain injury, the modalities of prehospital management, imaging strategies, indications for neurosurgical interventions, sedation and analgesia, indications and modalities of cerebral monitoring, medical management of raised intracranial pressure, management of multiple trauma with severe traumatic brain injury, detection and prevention of post-traumatic epilepsia, biological homeostasis (osmolarity, glycaemia, adrenal axis) and paediatric specificities.

      PubDate: 2018-01-03T13:44:06Z
      DOI: 10.1016/j.accpm.2017.12.001
       
  • Impact factor: An assessment tool for journals or for scientists'
    • Authors: Karem Slim; Aurélien Dupré; Bertrand Le Roy
      Pages: 347 - 348
      Abstract: Publication date: December 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 6
      Author(s): Karem Slim, Aurélien Dupré, Bertrand Le Roy


      PubDate: 2017-12-22T14:46:45Z
      DOI: 10.1016/j.accpm.2017.06.004
       
  • OPERA, an overview of the organisation of day-case surgery in France
    • Authors: Francis Bonnet; Anissa Houhou
      First page: 349
      Abstract: Publication date: December 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 6
      Author(s): Francis Bonnet, Anissa Houhou


      PubDate: 2017-12-22T14:46:45Z
      DOI: 10.1016/j.accpm.2017.11.004
       
  • Prevention of eye injuries in anaesthesia and intensive care: New expert
           guidelines
    • Authors: Karen B. Domino
      Pages: 351 - 352
      Abstract: Publication date: December 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 6
      Author(s): Karen B. Domino


      PubDate: 2017-12-22T14:46:45Z
      DOI: 10.1016/j.accpm.2017.11.005
       
  • Operation and organisation of ambulatory surgery in France. Results of a
           nationwide survey; The OPERA study
    • Authors: Marc Beaussier; Pierre Albaladejo; Didier Sciard; Laurent Jouffroy; Dan Benhamou; Claude Ecoffey; Frederic Aubrun; Aline Albi; Sebastien Bloc; Marie-Paule Charriot; Vincent Compère; Christophe Dadure; Laurent Delaunay; Nicolas Dufeu; Michel Fiani; Elisabeth Gaertner; Thomas Lanz; Didier Sirieix; François Sztark; Nathalie Vialles
      Pages: 353 - 357
      Abstract: Publication date: December 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 6
      Author(s): Marc Beaussier, Pierre Albaladejo, Didier Sciard, Laurent Jouffroy, Dan Benhamou, Claude Ecoffey, Frederic Aubrun
      Operation and organisation of ambulatory surgical activity in France remains largely undocumented. This nationwide observational prospective survey, carried out between December 2013 and December 2014, was undertaken to characterise the organisational processes of ambulatory surgery in France. Three hundred centres were randomly chosen from a list of 891 hospitals practicing ambulatory surgery, with stratification according to the type of facility (public general hospital, university hospital, private hospital) and region. An email was sent to the board of the randomly chosen facilities with an attached information letter explaining how the survey worked. Hospitals who did not reply to this email were contacted by phone. Among the 206 hospitals that answered the survey, 92 were private, 78 were public and 36 were university hospitals. Median accommodation capacities of ambulatory units were 8 beds, mostly distinct from conventional surgical ward. Patient pathways dedicated to ambulatory surgery appear as the current predominant practice. 77% of the French ambulatory units have a head nurse in charge of logistics and coordination. Several items still have to be improved, such as the adherence to modern fasting rules and the unnecessary use of stretcher to move the patient. Objective discharge score is used in 77% of ambulatory units. This survey highlights the implementation of some positive organisational parameters corresponding to common good practices recommendations. In contrast, several other recommendations are still insufficiently applied and may hamper the development of safe ambulatory surgery. This brings up new challenges for health regulatory boards, hospitals and ambulatory units managers.

      PubDate: 2017-12-22T14:46:45Z
      DOI: 10.1016/j.accpm.2017.07.003
       
  • In memoriam: Max-André Doppia (1953–2017)
    • Authors: Francis Bonnet; Jean-Louis Gérard; Paul-Michel Mertes
      Abstract: Publication date: December 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 6
      Author(s): Francis Bonnet, Jean-Louis Gérard, Paul-Michel Mertes


      PubDate: 2017-12-22T14:46:45Z
      DOI: 10.1016/j.anrea.2017.11.001
       
  • Continuous Ultrasound Guided Erector Spinae Plane Block for Management of
           Chronic Pain
    • Authors: Ali Ahiskalioglu; Haci Ahmet Alici; Bahadir Ciftci; Mine Celik; Omer Karaca
      Abstract: Publication date: Available online 15 December 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Ali Ahiskalioglu, Haci Ahmet Alici, Bahadir Ciftci, Mine Celik, Omer Karaca


      PubDate: 2017-12-22T14:46:45Z
      DOI: 10.1016/j.accpm.2017.11.014
       
  • Anaesthesia management by residents does not alter the incidence of
           self-reported anaesthesia awareness: a teaching hospital-based propensity
           score analysis
    • Authors: Aya Takechi; Satoki Inoue; Masahiko Kawaguchi
      Abstract: Publication date: Available online 15 December 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Aya Takechi, Satoki Inoue, Masahiko Kawaguchi
      Background Intraoperative awareness during general anaesthesia is rare but one of the major anaesthesia-related complications. Intraoperative awareness may be a result of inadequate anaesthesia management. Therefore, the incidence can be related with the experience of anaesthetists. To assess whether the incidence of intraoperative awareness is related to anaesthetists’ experience, we compared the incidence of self-reported intraoperative awareness between patients managed by anaesthesia residents or by experienced anaesthetists. Methods This is a retrospective review of an institutional registry containing 21606 general anaesthesia cases. It was conducted with the ethics board approval. Propensity score analysis was used to generate a set of matched cases (resident managements) and controls (anaesthetist managements), yielding 4940 matched patient pairs. The incidence of self-reported intraoperative awareness compared as primary outcomes. Additionally, a multivariate logistic analysis in the entire cohort, using the incidence of self-reported intraoperative awareness as dependent variable, was conducted to confirm the result of the primary outcome. Results In the unmatched population, contrary to our hypothesis, the incidence of self-reported intraoperative awareness was lower in resident management compared with anaesthetist management (1.1% vs. 1.5%, p= 0.028). However, after propensity score matching, there was no difference in incidences of self-reported intraoperative awareness (1.5% vs. 1.3%, 0.38). The multivariate analysis confirmed the result of the primary outcome from the matched pair analysis and showed that ASA physical status (OR=1.40, 95%CI=1.08 to 1.81), emergency case (CI=2.05, 95%CI=1.40 to 3.00), and application of postoperative analgesia (OR=0.70, 95%CI=0.50 to 0.97) were independently associated with incidence of self-reported intraoperative awareness. Conclusion In conclusion, when supervised by an anaesthetist, resident anaesthesia management is no more likely to result in complaints about intraoperative recall than anaesthetist managements.

      PubDate: 2017-12-22T14:46:45Z
      DOI: 10.1016/j.accpm.2017.11.015
       
  • Postoperative fasting after general anaesthesia: A survey of French
           anaesthesiology practices
    • Authors: Sylvain Le Pape; Matthieu Boisson; Thibault Loupec; FabienVigneau; Bertrand Debaene; Denis Frasca
      Abstract: Publication date: Available online 9 December 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Sylvain Le Pape, Matthieu Boisson, Thibault Loupec, FabienVigneau, Bertrand Debaene, Denis Frasca
      Background Preoperative fasting is well-codified worldwide. In contrast, the literature on the postoperative fasting (POF) is scarce leading to potentially wide discrepancies among anaesthesiology practices. This survey assessed French POF practices. Methods From March 2013 to January 2014, a survey was conducted among anaesthesiologists, members of the French Society of Anaesthesiology and Critical Care. The POF durations of either fluid or solid food intake was assessed according to airway management procedures (endotracheal intubation [EI] or laryngeal mask [LMA]) and age of the patients (adult or paediatric). Results Seven hundred and fifty-four surveys were returned (67% from public hospital practitioners and 33% from private hospital and clinic practitioners). The majority of anaesthesiologists allowed fluid intake 2 h after EI and immediately after discharge from PACU following LMA. For solid food resumption, it was 2 h for children and 4 h for adults after EI and 2 h for both children and adults after LMA. Regardless of the airway management procedures, fasting was permitted immediately after PACU discharge more frequently in public than in private hospitals (36% vs. 33%, p < 0.05). Four hours after the end of surgery, the rate was significantly higher in private than in public hospitals (93% vs. 89 %, p < 0.001). Conclusions All in all, POF lasted less than 4hours after surgery regardless of airway management. They were shorter with regard to fluid intake, paediatric patients, and LMA in comparison with solid food, adult patients and EI respectively.

      PubDate: 2017-12-22T14:46:45Z
      DOI: 10.1016/j.accpm.2017.11.012
       
  • Paediatric minimally invasive abdominal and urological surgeries: current
           trends and perioperative management
    • Authors: Myriam Bellon; Alia Skhiri; Florence Julien-Marsollier; Serge Malbezin; Diallo Thierno; Julie Hilly; Alaa ElGhoneimi; Arnaud Bonnard; Daphné Michelet; Souhayl Dahmani
      Abstract: Publication date: Available online 9 December 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Myriam Bellon, Alia Skhiri, Florence Julien-Marsollier, Serge Malbezin, Diallo Thierno, Julie Hilly, Alaa ElGhoneimi, Arnaud Bonnard, Daphné Michelet, Souhayl Dahmani
      Minimally invasive surgery during abdominal, thoracic and urological procedures has become the standard management of many surgical interventions in adults. Recent development of smaller devices has allowed the management of many paediatric surgeries using these minimally invasive techniques. However, the lack of knowledge of (a) adequate management of haemodynamic and respiratory alterations occurring during those procedures and (b) postoperative advantages of these techniques over open surgeries, still impairs their development. The current review aimed to clarify mechanisms of those haemodynamic and respiratory alterations, propose easy rules in order to overcome them and shed the light on potential postoperative advantages of minimally invasive surgery in paediatrics.

      PubDate: 2017-12-22T14:46:45Z
      DOI: 10.1016/j.accpm.2017.11.013
       
  • Comparison of 3 techniques in Percutaneous Tracheostomy: Traditional
           landmark technique; Ultrasonography Guided Long-Axis Approach;and
           Short-Axis Approach –Randomised Controlled Study
    • Authors: Kupeli Ilke; Nalbant Aysenur
      Abstract: Publication date: Available online 7 December 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Kupeli Ilke, Nalbant Aysenur
      Introduction The aim of this study is to compare the reliabilities of traditional landmark method, ultrasonography-guided long-axis in-plane application, and ultrasonography-guided short-axis out-of-plane application in percutaneous dilatational tracheostomy. Patients and methods A total of 60 patients were divided in 3 random groups undergoing percutaneous tracheostomy by using landmark method, ultrasonography-guided out-of-plane method, and ultrasonography-guided in-plane method. While demographic data of the patients were recorded before the procedure, number of punctures, success rate at the first entry, rate of successful tracheostomy tube placement, total tracheostomy time, and complications were recorded during and after the procedure. Results and Discussion It was found that 23 women and 37 men were included in the study, the average age of the cases was 68.0±15.5; mean body mass index was 27.9±4.3; mean APACHE II scores were 27.4±4.6 and there was no significant difference between the groups in terms of demographic data. The ultrasonography-guided out-of-plane application had significantly lower number of punctures, higher first entry success, and less complications compared to the other groups. Independently from the groups, first entry success was significantly low in advanced age and number of punctures significantly increased the complication rate. Conclusion In this randomised controlled study, it was found that ultrasonography-guided out-of-plane application had lower number of punctures, higher first entry success rate, and less complications. It was observed that advanced age negatively affected the first entry success and as number of punctures increased, the complication rate increased. ClinicalTrials.gov ID NCT02855749

      PubDate: 2017-12-22T14:46:45Z
      DOI: 10.1016/j.accpm.2017.11.011
       
  • Sepsis and thrombosis: An unusual extensive inferior vena cava thrombosis
    • Authors: Melanie Fromentin; Patrice Talec; Jean Stephanazzi; Charles Marc Samama
      Abstract: Publication date: Available online 5 December 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Melanie Fromentin, Patrice Talec, Jean Stephanazzi, Charles Marc Samama


      PubDate: 2017-12-22T14:46:45Z
      DOI: 10.1016/j.accpm.2017.11.008
       
  • Spontaneous pure subacute subdural haematoma without subarachnoid
           haemorrhage caused by rupture of middle cerebral artery aneurysm
    • Authors: Quentin Mathais; Pierre Esnault; Arnaud Dagain; Aurore Sellier; Philippe Yves Simon; Bertrand Prunet; Eric Meaudre
      Abstract: Publication date: Available online 5 December 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Quentin Mathais, Pierre Esnault, Arnaud Dagain, Aurore Sellier, Philippe Yves Simon, Bertrand Prunet, Eric Meaudre


      PubDate: 2017-12-22T14:46:45Z
      DOI: 10.1016/j.accpm.2017.11.010
       
  • Assessing usefulness of GlideScope® video laryngoscope in children with
           difficult direct laryngoscopy
    • Authors: Gui-Zhen Yang; Fu-Shan Xue; Ya-Yang Liu; Hui-Xian Li
      Abstract: Publication date: Available online 5 December 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Gui-Zhen Yang, Fu-Shan Xue, Ya-Yang Liu, Hui-Xian Li


      PubDate: 2017-12-22T14:46:45Z
      DOI: 10.1016/j.accpm.2017.11.009
       
  • Science, ethics and kindness
    • Authors: Plaud
      Abstract: Publication date: December 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 6
      Author(s): Benoît Plaud


      PubDate: 2017-12-22T14:46:45Z
       
 
 
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