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Publisher: Elsevier   (Total: 3049 journals)

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Showing 1 - 200 of 3049 Journals sorted alphabetically
A Practical Logic of Cognitive Systems     Full-text available via subscription   (Followers: 7)
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 25, SJR: 1.402, h-index: 51)
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Accident Analysis & Prevention     Partially Free   (Followers: 86, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 25, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 30, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 4)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 363, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 25, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 1)
Acta de Investigación Psicológica     Open Access   (Followers: 2)
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Acta Haematologica Polonica     Free   (SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
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Acta Oecologica     Hybrid Journal   (Followers: 10, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription   (Followers: 1)
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Acta Pharmaceutica Sinica B     Open Access   (Followers: 1)
Acta Poética     Open Access   (Followers: 4)
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Acta Urológica Portuguesa     Open Access  
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Acupuncture and Related Therapies     Hybrid Journal   (Followers: 4)
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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: 6)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 21)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 132, SJR: 5.2, h-index: 222)
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Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 9, SJR: 1.268, h-index: 45)
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Advances in Fluorine Science     Full-text available via subscription   (Followers: 8)
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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: 26)
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: 36, 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: 9)
Advances in Marine Biology     Full-text available via subscription   (Followers: 16, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 6, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 22)
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Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 4)
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Advances in Radiation Oncology     Open Access  
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Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 44, 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: 331, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 5, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 8, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 417, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 16, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 30, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 40, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 2)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 55, 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: 8, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 3)
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Allergology Intl.     Open Access   (Followers: 4, SJR: 0.776, h-index: 35)
Alpha Omegan     Full-text available via subscription   (SJR: 0.121, h-index: 9)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 9, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 46, 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: 5)
American Heart J.     Hybrid Journal   (Followers: 49, 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: 40, 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: 32, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 46, 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: 198, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 59, 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: 25, 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: 25, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 35, 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: 58, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 12)
Anales de Cirugia Vascular     Full-text available via subscription  
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Analytic Methods in Accident Research     Hybrid Journal   (Followers: 4, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 37, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 166, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 8, SJR: 0.18, h-index: 2)
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Anesthésie & Réanimation     Full-text available via subscription   (Followers: 1)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 22, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access  
Animal Behaviour     Hybrid Journal   (Followers: 172, SJR: 1.907, h-index: 126)

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Journal Cover Anaesthesia Critical Care & Pain Medicine
  [12 followers]  Follow
    
   Full-text available via subscription Subscription journal
   ISSN (Online) 2352-5568
   Published by Elsevier Homepage  [3049 journals]
  • Video-laryngoscopes for intubation in paediatrics: Is a better view makes
           everything'
    • Authors: Souhayl Dahmani
      Pages: 259 - 260
      Abstract: Publication date: October 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 5
      Author(s): Souhayl Dahmani


      PubDate: 2017-11-05T10:25:42Z
      DOI: 10.1016/j.accpm.2017.04.004
       
  • Comparison of the McGrath® MAC video laryngoscope with direct Macintosh
           laryngoscopy for novice laryngoscopists in children without difficult
           intubation: A randomised controlled trial
    • Authors: Antoine Giraudon; Maryline Bordes-Demolis; Barbara Blondeau; Nadia Sibai de Panthou; Nathan Ferrand; Maeva Bello; Victoria Dahlet; François Semjen; Matthieu Biais; Karine Nouette-Gaulain
      Pages: 261 - 265
      Abstract: Publication date: October 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 5
      Author(s): Antoine Giraudon, Maryline Bordes-Demolis, Barbara Blondeau, Nadia Sibai de Panthou, Nathan Ferrand, Maeva Bello, Victoria Dahlet, François Semjen, Matthieu Biais, Karine Nouette-Gaulain
      Introduction Airway management and tracheal intubation are routinely performed in paediatric anaesthesia and yet are associated with preventable adverse events. The McGrath® MAC is a video laryngoscope with a curved blade similar to the Macintosh blade, which has not been previously described in first intention paediatric tracheal intubation. We aimed to compare direct laryngoscopy to the McGrath® MAC video laryngoscope among novice laryngoscopists. Methods Six paediatric anaesthesia residents with novice skills in paediatric laryngoscopy were randomly assigned to perform tracheal intubation using either direct Macintosh laryngoscopy (DL) or the McGrath® MAC video laryngoscope (MM) as the first attempted device in children weighing between 10 and 20kg without difficult intubation. Results Our study enrolled 132 children between August 2013 and April 2015. The time to intubation was shorter in the DL group (n =67) compared to the MM group (n =65) with 42s (35–50) versus 48s (43–58) P =0.002. The time to best view was similar between the two groups (10s [7–16] versus 10s [8–15]; P =0.50). The tube passage time was shorter with DL (29s [25–35] versus 35s [30–45]; P =0.0002) and either Cormak & Lehane grade or Percentage Of Glottis Opening (POGO) scores were similar between groups. Minor reversible respiratory adverse events were similar between groups: 12 in the DL group (17.9%) versus 12 in the MM group (18.5%). Discussion McGrath® MAC video laryngoscopy, when performed by a novice laryngoscopist on easy-to-intubate children, is associated with longer intubation times.

      PubDate: 2017-11-18T23:49:34Z
      DOI: 10.1016/j.accpm.2017.02.007
       
  • Children with challenging airways: What about GlideScope®
           video-laryngoscopy'
    • Authors: Chrystelle Sola; Anne-Charlotte Saour; Christine Macq; Sophie Bringuier; Olivier Raux; Christophe Dadure
      Pages: 267 - 271
      Abstract: Publication date: October 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 5
      Author(s): Chrystelle Sola, Anne-Charlotte Saour, Christine Macq, Sophie Bringuier, Olivier Raux, Christophe Dadure
      Background GlideScope® video-laryngoscopy is becoming increasingly used, including in paediatrics. However, to date, very few data are available on efficiency during situations involving difficult intubation. Our objective was to describe the usefulness of the GlideScope® in children with presumed challenging airway criteria. Methods In this observational study, all children with predicted criteria of potential difficult intubation and requiring general anaesthesia with tracheal intubation were prospectively enrolled over a 12-month period. The Cormack and Lehane (CMK) grade was first assessed by direct laryngoscopy. In case of a CMK≥3, the same experienced anaesthesiologist scored the CMK scale under GlideScope® videoscopy. Data related to GlideScope® use under difficult intubation conditions were analysed. Results Out of the sixty-one patients (median [25th–75th interquartile range] age of 12 [4–37] months) included, 37 (62%) patients have confirmed a high probability of difficult intubation. Compared to direct laryngoscopy, GlideScope® video-laryngoscopy was significantly associated with an improved CMK grade (P <0.001). Tracheal intubation with the GlideScope® was successful after the first attempt in almost one half of cases and ultimately in 100% of patients. The median time required for successful GlideScope® intubation was 42.5 [30–60] s. No per procedure complications were recorded. Conclusion In children with challenging airways, GlideScope® video-laryngoscopy resulted in a significant improvement of the glottic view with an excellent success rate and satisfactory time to intubation. How these devices are to be positioned in difficult airway management algorithms and guidelines remain to be defined.

      PubDate: 2017-11-05T10:25:42Z
      DOI: 10.1016/j.accpm.2016.10.005
       
  • Fiber optic bronchoscopy and remifentanil target-controlled infusion in
           critically ill patients with acute hypoxaemic respiratory failure: A
           descriptive study
    • Authors: Saïda Rezaiguia-Delclaux; Florent Laverdure; Talna Kortchinsky; Léa Lemasle; Audrey Imbert; François Stéphan
      Pages: 273 - 277
      Abstract: Publication date: October 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 5
      Author(s): Saïda Rezaiguia-Delclaux, Florent Laverdure, Talna Kortchinsky, Léa Lemasle, Audrey Imbert, François Stéphan
      Introduction Sedation optimizes patient comfort and ease of execution during fiber optic bronchoscopy (FOB). Our objective was to describe the safety and efficacy of remifentanil-TCI during FOB in non-intubated, hypoxaemic, thoracic surgery ICU patients. Methods Consecutive spontaneously breathing adults requiring FOB after thoracic surgery were included if they had hypoxaemia (PaO2/FiO2 <300mmHg or need for non-invasive ventilation [NIV]) and prior FOB failure under topical anaesthesia. The remifentanil initial target was chosen at 1ng/mL brain effect-site concentration (Cet), then titrated to 0.5ng/mL Cet increments according to patient comfort and coughing. Outcomes were patient-reported pain and discomfort (Visual Analogue Scale scores), ventilatory support intensification within 24hours after bronchoscopy, and ease of FOB execution. Results Thirty-nine patients were included; all had a successful FOB. Their median PO2/FiO2 before starting FOB was 187±84mmHg and 24 patients received NIV. Median [interquartile range] pain scores were not different before and after FOB (1.0 [0.0–3.0] and 0.0 [0.0–2.0], respectively). Discomfort was reported as absent or minimal by 27 patients (69%; 95% confidence interval [95% CI], 54–81%) and as bothersome but tolerable by 12 patients (31%; 95% CI, 19–46%). Mean FiO2 returned to baseline within 2hours after FOB in 30 patients; the remaining 9 patients (23%; 95% CI, 13–38%) received ventilatory support intensification. Ease of execution was good or very good in 34 patients (87%; 95% CI, 73–94%), acceptable in 4 patients, and poor in 1 patient (persistent cough). Conclusion Sedation with remifentanil-TCI during FOB with prior failure under topical anaesthesia alone was effective and acceptably safe in non-intubated hypoxaemic thoracic surgery patients.

      PubDate: 2017-11-05T10:25:42Z
      DOI: 10.1016/j.accpm.2016.07.004
       
  • Learning curve for real-time ultrasound-guided percutaneous tracheostomy
    • Authors: Sandra Petiot; Pierre-Grégoire Guinot; Momar Diouf; Elie Zogheib; Hervé Dupont
      Pages: 279 - 283
      Abstract: Publication date: October 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 5
      Author(s): Sandra Petiot, Pierre-Grégoire Guinot, Momar Diouf, Elie Zogheib, Hervé Dupont
      Objectives The objective of this study was to demonstrate and quantify the ultrasound-guided percutaneous tracheostomy (UPDT) learning curve in a single team since the first UPDT. Study design and patients This was a cohort of all consecutive patients undergoing UPDT in the Amiens teaching hospital surgical intensive care unit between 2010 and 2014. Methods The learning process was evaluated according to three aspects: duration of the various steps involved in UPDT, incidence of consecutive complications, and procedure difficulty. Results During the study period, 85 consecutive patients underwent UPDT with no deaths. The mean total procedure time was 22 (10) minutes (range: 7 to 60). Analysis of mean cumulative UPDT procedure times showed that total UPDT time decreased to a stable duration of 25minutes after 54 procedures. Complications were observed in 24 (28%) of the 85 patients. The overall complication rate decreased to below a stable percentage of 30% after 70 procedures. The minor complication rate decreased below 25% after 64 procedures. The moderate complication rate decreased to below a stable percentage of 10% after 10 procedures. The major complication rate decreased to below a stable percentage of 5% after 20 procedures. Most complications were observed in the first 50 patients (25 [50%] versus 6 [13%], P <0.05). Conclusions Our study demonstrated that UPDT is associated with a fairly long learning curve. At least 50 procedures are necessary to perform UPDT with an acceptable complication rate and procedure time.

      PubDate: 2017-11-18T23:49:34Z
      DOI: 10.1016/j.accpm.2016.07.005
       
  • Upper airway modifications in head extension during development
    • Authors: Antoine Bécret; Renaud Vialet; Kathia Chaumoitre; Anderson Loundou; Nathalie Lesavre; Fabrice Michel
      Pages: 285 - 290
      Abstract: Publication date: October 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 5
      Author(s): Antoine Bécret, Renaud Vialet, Kathia Chaumoitre, Anderson Loundou, Nathalie Lesavre, Fabrice Michel
      Background One of the requirements of laryngoscopy is to determine which head position will result in optimal visualization. Our hypothesis was that parameters derived from magnetic resonance imaging (MRI) can help quantify the effect of age on airway modifications due to head extension during development. Method In children undergoing planned MRI, additional sequences on the upper airways were performed: one in a near-neutral position, the other with the head extended at 35°. The axis of the face, the pharynx, the larynx, the trachea, and the line of glottic visualization were determined. The following angles were calculated: the Visu-Lar angle, formed by the line of glottic visualization and the laryngeal axis, and the Phar-Lar angle, formed by the pharyngeal and laryngeal axes. Results One hundred and fifty-five patients (1 to 222 months of age [25–145] months) were included and 54% were under general anaesthesia. Age had no effect on the variation in the Visu-Lar angle, which diminished as a function of head extension, nor on the variation in the Phar-Lar angle, which was minimal in the neutral position. During extension, anatomical axes rotated similarly, and the visualization axis rotated the most, followed by the pharyngeal and laryngeal axes. These results were not correlated with general anaesthesia. Conclusion Regardless of age, head extension diminished the Visu-Lar angle, and increased the Phar-Lar angle. This study supports that, as in adults, head extension is probably the key factor for good visualization conditions during laryngoscopy on children, but clinical data is needed to confirm this result.

      PubDate: 2017-11-05T10:25:42Z
      DOI: 10.1016/j.accpm.2016.04.003
       
  • Non-dominant hand quicker to insert peripheral venous catheters under
           echographic guidance: A randomised trial
    • Authors: Lucas Durand-Bailloud; Ludwig-Serge Aho; Georges Savoldelli; Fiona Ecarnot; Claude Girard; Mehdi Benkhadra
      Pages: 291 - 296
      Abstract: Publication date: October 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 5
      Author(s): Lucas Durand-Bailloud, Ludwig-Serge Aho, Georges Savoldelli, Fiona Ecarnot, Claude Girard, Mehdi Benkhadra
      Background Ultrasound guidance for venous catheter placement requires the use of both hands. An accurate and stable ultrasound image is fundamental for obtaining good quality images, consequently permitting accurate needle placement. We hypothesized that the dominant hand could be used to perform echography, leaving the non-dominant hand available for peripheral venous catheter (PVC) insertion. Methods Prospective, open-label, randomized, crossover study. Group 1 inserted the PVC with the dominant hand, and held the probe with the non-dominant hand in a first series of 20 insertions, and vice versa in a second series of 20 insertions performed 11days later. Group 2 punctured with the non-dominant hand in Series 1 and vice versa in series 2. The study population comprised female student nurses (aged 20–30years) who had learned neither ultrasound techniques nor catheter insertion. The primary endpoint was time to successful puncture. We recorded age, sex, video game use, and the laterality of hands, feet and eyes. Results One left-handed and nine right-handed nurses were randomized to each group. Puncture by the non-dominant hand was significantly quicker in both series (P <0.001). There was no difference between groups for time to successful puncture with the dominant hand; however a significant difference was found for the non-dominant hand (P <0.01). According to multivariate analysis, the time to successful puncture was significantly lower when the non-dominant hand was used to puncture (adjusted difference 5.6s, P <0.0001). Conclusion Using the dominant hand to hold the ultrasound probe and the non-dominant hand to puncture and insert the catheter achieves successful insertion in a significantly shorter time.

      PubDate: 2017-11-05T10:25:42Z
      DOI: 10.1016/j.accpm.2016.08.008
       
  • The CAM-ICU has now a French “official” version. The translation
           process of the 2014 updated Complete Training Manual of the Confusion
           Assessment Method for the Intensive Care Unit in French (CAM-ICU.fr)
    • Authors: Gérald Chanques; Océane Garnier; Julie Carr; Matthieu Conseil; Audrey de Jong; Christine M. Rowan; E. Wesley Ely; Samir Jaber
      Pages: 297 - 300
      Abstract: Publication date: October 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 5
      Author(s): Gérald Chanques, Océane Garnier, Julie Carr, Matthieu Conseil, Audrey de Jong, Christine M. Rowan, E. Wesley Ely, Samir Jaber
      Introduction Delirium is common in Intensive-Care-Unit (ICU) patients but under-recognized by bed-side clinicians when not using validated delirium-screening tools. The Confusion-Assessment-Method for the ICU (CAM-ICU) has demonstrated very good psychometric properties, and has been translated into many different languages though not into French. We undertook this opportunity to describe the translation process. Material and methods The translation was performed following recommended guidelines. The updated method published in 2014 including introduction letters, worksheet and flowsheet for bed-side use, the method itself, case-scenarios for training and Frequently-Asked-Questions (32 pages) was translated into French language by a neuropsychological researcher who was not familiar with the original method. Then, the whole method was back-translated by a native English-French bilingual speaker. The new English version was compared to the original one by the Vanderbilt University ICU-delirium-team. Discrepancies were discussed between the two teams before final approval of the French version. Results The entire process took one year. Among the 3692 words of the back-translated version of the method itself, 18 discrepancies occurred. Eight (44%) lead to changes in the final version. Details of the translation process are provided. Conclusions and relevance The French version of CAM-ICU is now available for French-speaking ICUs. The CAM-ICU is provided with its complete training-manual that was challenging to translate following recommended process. While many such translations have been done for other clinical tools, few have published the details of the process itself. We hope that the availability of such teaching material will now facilitate a large implementation of delirium-screening in French-speaking ICUs.

      PubDate: 2017-11-18T23:49:34Z
      DOI: 10.1016/j.accpm.2017.02.003
       
  • Rationale, study design and analysis plan of the lung imaging morphology
           for ventilator settings in acute respiratory distress syndrome study (LIVE
           study): Study protocol for a randomised controlled trial
    • Authors: Matthieu Jabaudon; Thomas Godet; Emmanuel Futier; Jean-Étienne Bazin; Vincent Sapin; Laurence Roszyk; Bruno Pereira; Jean-Michel Constantin
      Pages: 301 - 306
      Abstract: Publication date: October 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 5
      Author(s): Matthieu Jabaudon, Thomas Godet, Emmanuel Futier, Jean-Étienne Bazin, Vincent Sapin, Laurence Roszyk, Bruno Pereira, Jean-Michel Constantin
      Different acute respiratory distress syndrome (ARDS) phenotypes may explain controversial results in clinical trials. Lung-morphology is one of the ARDS-phenotypes and physiological studies suggest different responses in terms of positive-end-expiratory-pressure (PEEP) and recruitment-manoeuvres (RM) according to loss of aeration. To evaluate whether tailored ventilator regimens may impact ARDS outcomes, our group has designed a randomised-clinical-trial of ventilator settings according to lung morphology in moderate-to-severe ARDS (LIVE study). Method Patients will be enrolled within the first 12hours of ARDS onset. In both groups, volume-controlled ventilation with low tidal-volumes (Vt) will be used to target a plateau pressure≤30 cmH2O. In the control group, the PEEP level and inspired fraction of oxygen (FiO2) will be set using the ARDSNet table; a Vt of 6 mL/kg of predicted body weight (PBW) will be set and prone position (PP) will be applied. In the intervention arm, the ventilator will be set according to lung morphology (focal/non-focal) that will be assessed according to CT-scan±chest x-ray+lung echography. For focal ARDS patients, a Vt of 8 mL/kg PBW will be used along with low PEEP and PP. For non-focal ARDS patients, a Vt of 6 mL/kg PBW will be used with RM and PEEP to reach a plateau pressure≤30 cmH2O. The primary outcome is all-cause 90-day mortality and the secondary outcomes are: in-hospital mortality, mortality at day 28, 60, 180 and 365; ventilator-free days at day 30, quality of life at one year; ventilator-associated pneumonia rate; barotrauma; ICU and hospital length of stay. This RCT is registered on Clinicaltrials.gov under identifier NCT02149589.

      PubDate: 2017-11-05T10:25:42Z
      DOI: 10.1016/j.accpm.2017.02.006
       
  • The structure, organisation and perioperative management of ambulatory
           surgery and anaesthesia in France: Methodology of the SFAR-OPERA study
    • Authors: Pierre Albaladejo; Frédéric Aubrun; Charles-Marc Samama; Laurent Jouffroy; Marc Beaussier; Dan Benhamou; Pauline Romegoux; Kristina Skaare; Jean-Luc Bosson; Claude Ecoffey
      Pages: 307 - 312
      Abstract: Publication date: October 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 5
      Author(s): Pierre Albaladejo, Frédéric Aubrun, Charles-Marc Samama, Laurent Jouffroy, Marc Beaussier, Dan Benhamou, Pauline Romegoux, Kristina Skaare, Jean-Luc Bosson, Claude Ecoffey
      The organization of health care establishments and perioperative care are essential for ensuring the quality of care and safety of patients undergoing outpatient surgery. In order to correctly inventory these organizations and practices, in 2013–2014, the French society of anaesthesia and intensive care organized an extensive practical survey in French ambulatory surgery units entitled the “OPERA” study (Organisation periopératoire de l’anesthésie en chirurgie ambulatoire). From among all of the ambulatory surgery centres listed by the Agences régionales de santé (Regional health agencies, France), 206 public and private centres were randomly selected. A structural (typology, organization) survey and a medical-practice survey (focusing on the management of postoperative pain, nausea and vomiting as well as the prevention of venous thromboembolism) were collected and managed by a prospective audit of practices occurring on two randomly selected days. The latter was further accompanied by an additional audit specifically focussing on ten representative procedures: (1) stomatology surgery (third molar removal); (2) knee arthroscopy; (3) surgery of the abdominal wall (including inguinal hernia); (4) perianal surgery; (5) varicose vein surgery; (6) digestive laparoscopy–cholecystectomy; (7) breast surgery (tumourectomy); (8) uterine surgery; (9) hallux valgus and (10) hand surgery (excluding carpal tunnel). Over the 2 days of observation, 7382 patients were included comprising 2174 patients who underwent one of the procedures from the above list. The analysis of these data will provide an overview of the organization of health establishments, the modalities thus supported and compliance with standards.

      PubDate: 2017-11-18T23:49:34Z
      DOI: 10.1016/j.accpm.2016.10.002
       
  • Haemodialysis catheters in the intensive care unit
    • Authors: Laetitia Huriaux; Paul Costille; Hervé Quintard; Didier Journois; John A. Kellum; Thomas Rimmelé
      Pages: 313 - 319
      Abstract: Publication date: October 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 5
      Author(s): Laetitia Huriaux, Paul Costille, Hervé Quintard, Didier Journois, John A. Kellum, Thomas Rimmelé
      Ten to 15% of critically ill patients need renal replacement therapy (RRT) for severe acute kidney injury. The dialysis catheter is critical for RRT quality and efficiency. Catheters have several properties that must be optimized to promote RRT success. The distal tip has to be located in a high blood flow location, which means central venous territory. Therefore, catheters are mostly inserted into the right internal jugular vein or in femoral veins. External diameter should vary from 12 to 16 Fr in order to ensure adequate blood flow inside the catheter. Lumen shapes are theoretically designed to limit thrombotic risk with low turbulences and frictional forces against the internal wall. With low aspiration pressure, distal tip shape has to deliver sufficient blood flow, while limiting recirculation rate. Catheter material should be biocompatible. Despite in vitro data, no strong evidence supports the use of coated catheters in the ICU in order to reduce infectious risk. Antibiotic “lock” solutions are not routinely recommended. Ultrasound guidance for catheterization significantly decreases mechanical complications. Clinicians should select the optimal catheter according to patient body habitus, catheter intrinsic properties and RRT modality to be used.

      PubDate: 2017-11-05T10:25:42Z
      DOI: 10.1016/j.accpm.2016.10.003
       
  • Does perfusion pressure offer more brain protection than haemoglobin
           level' A case of aortic injury during laparoscopic bariatric surgery
    • Authors: Ahed Zeidan; Osamah Al-Sanea; Sameh Barayan
      Pages: 321 - 322
      Abstract: Publication date: October 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 5
      Author(s): Ahed Zeidan, Osamah Al-Sanea, Sameh Barayan


      PubDate: 2017-11-05T10:25:42Z
      DOI: 10.1016/j.accpm.2017.04.008
       
  • Ultrasound guided serratus plane block for management of acute thoracic
           herpes zoster
    • Authors: Ali Ahiskalioglu; Haci Ahmet Alici; Ahmet Murat Yayik; Mine Celik; Elif Oral Ahiskalioglu
      Pages: 323 - 324
      Abstract: Publication date: October 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 5
      Author(s): Ali Ahiskalioglu, Haci Ahmet Alici, Ahmet Murat Yayik, Mine Celik, Elif Oral Ahiskalioglu


      PubDate: 2017-11-05T10:25:42Z
      DOI: 10.1016/j.accpm.2017.01.008
       
  • Transient neurologic symptoms (TNS) after intrathecal injection of
           ropivacaine through a dural tap during an attempted epidural for labour
           pain relief
    • Authors: A. Blanie; S. Figueiredo; G. Lorre; D. Benhamou
      Pages: 325 - 326
      Abstract: Publication date: October 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 5
      Author(s): A. Blanie, S. Figueiredo, G. Lorre, D. Benhamou


      PubDate: 2017-11-05T10:25:42Z
      DOI: 10.1016/j.accpm.2017.03.004
       
  • Hospital-Acquired Pneumonia In Icu
    • Authors: Marc Leone; Lila Bouadma; Bélaïd Bouhemad; Olivier Brissaud; Stéphane Dauger; Sébastien Gibot; Sami Hraiech; Boris Jung; Eric Kipnis; Yoann Launey; Charles-Edouard Luyt; Dimitri Margetis; Fabrice Michel; Djamel Mokart; Philippe Montravers; Antoine Monsel; Saad Nseir; Jérôme Pugin; Antoine Roquilly; Lionel Velly; Jean-Ralph Zahar; Rémi Bruyère; Gérald Chanques
      Abstract: Publication date: Available online 15 November 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Marc Leone, Lila Bouadma, Bélaïd Bouhemad, Olivier Brissaud, Stéphane Dauger, Sébastien Gibot, Sami Hraiech, Boris Jung, Eric Kipnis, Yoann Launey, Charles-Edouard Luyt, Dimitri Margetis, Fabrice Michel, Djamel Mokart, Philippe Montravers, Antoine Monsel, Saad Nseir, Jérôme Pugin, Antoine Roquilly, Lionel Velly, Jean-Ralph Zahar, Rémi Bruyère, Gérald Chanques


      PubDate: 2017-11-18T23:49:34Z
      DOI: 10.1016/j.accpm.2017.11.006
       
  • New markers for early detection of acute kidney injury after transcatheter
           aortic valve implantation
    • Authors: Cedrick 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): Cedrick 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: 2017-11-18T23:49:34Z
      DOI: 10.1016/j.accpm.2017.10.004
       
  • Intraoperative analgesia guided by the Analgesia Nociception Index in
           bariatric surgery: An unmatched case-control study
    • Authors: Lisa Le Gall; Anaëlle David; Pauline Carles; Sébastien leuillet; Brigitte Chastel; Catherine Fleureau; Antoine Dewitte; Alexandre Ouattara
      Abstract: Publication date: Available online 12 October 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Lisa Le Gall, Anaëlle David, Pauline Carles, Sébastien leuillet, Brigitte Chastel, Catherine Fleureau, Antoine Dewitte, Alexandre Ouattara
      Introduction Analgesia Nociception Index (ANI) has been proposed for the evaluation of the nociception-antinociception balance in the perioperative period. In obese patient, where the management of analgesia may be rendered difficult by pharmacological changes, we hypothesized that the monitoring of analgesia with ANI would reduce intraoperative opioid consumption during bariatric surgery. Methods This monocentric, observational, unmatched case-control study aimed to compare perioperative data from obese subjects (body mass index ≥ 35kg.m-2) during bariatric surgery with or without the use of ANI monitoring (ANI+ group versus ANI- group). Intraoperative analgesia was provided by injection of sufentanil, which was performed according to the clinician's assessment in the ANI- group or to the ANI value in the ANI+ group. The primary outcome was the mean hourly intraoperative sufentanil requirement. Secondary outcomes included the need for postoperative morphine titration, incidence of nausea and vomiting, respiratory distress and pain scores in the first 24hours. Results Between December 2013 and September 2016, 60 obese patients (i.e. 30 per group) were included. The mean hourly consumption of sufentanil was significantly lower in the ANI+ group (0.15±0.05μg.kg-1.h-1 versus 0.17±0.05μg.kg-1.h-1, P=0.038). We found no difference between groups regarding the incidence of nausea and vomiting, acute respiratory distress, the need for postoperative morphine titration, or pain scores in the first 24 postoperative hours. Conclusion The use of ANI monitoring might reduce intraoperative consumption of sufentanil during bariatric surgery but does not appear to be accompanied by a reduction in its side effects.

      PubDate: 2017-11-18T23:49:34Z
      DOI: 10.1016/j.accpm.2017.09.004
       
  • Management of septic shock in intermediate care unit
    • Authors: Eric Meaudre; Cédric Nguyen; Claire Contargyris; Ambroise Montcriol; Erwan d’Aranda; Pierre Esnault; Mourad Bensalah; Bertrand Prunet; Julien Bordes; Philippe Goutorbe
      Abstract: Publication date: Available online 5 August 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Eric Meaudre, Cédric Nguyen, Claire Contargyris, Ambroise Montcriol, Erwan d’Aranda, Pierre Esnault, Mourad Bensalah, Bertrand Prunet, Julien Bordes, Philippe Goutorbe
      Background While guidelines advocate goal-directed resuscitation based on timed bundles, the management of septic shock (SS) outside an ICU setting has been poorly studied in intermediate care units (IMCU). Patients and method We reviewed all cases of septic shock patients admitted to our IMCU between January 2013 and June 2014. The characteristics of sepsis, compliance of bundles, and outcomes were collected. The IMCU population was compared with the SS patients admitted to the ICU during the same period. The primary objective was to evaluate the feasibility of care in an IMCU. Results We treated 59 patients in the IMCU. Forty-three patients (73%) were fully managed in the IMCU and 16 patients (27%) were secondarily transferred to the ICU. In the first 3hours, the compliance to bundles was: blood cultures (95%), plasma lactate concentration (90%), vascular filling volume (1500ml (1000-2000)) and antibiotics (100%). A central venous line and an arterial catheter were inserted in 85% and 98.3% of the cases. At 24h, patients who were transferred to the ICU had higher lactate concentrations than the other patients (1.4±0.7mmol versus 2.9±3.4mmol; P =0.03). A 24 hours-SOFA score>4 was correlated with a transfer in ICU (OR 7,75 (95% CI 2.08–28,81; P =0.002)). Conclusions Our work demonstrated the ability to manage SS patients solely in an IMCU. It showed that the SS resuscitation bundle can be successfully implemented outside the ICU. A lack of improvement at the 24th hour is associated with a transfer to the ICU.

      PubDate: 2017-11-18T23:49:34Z
      DOI: 10.1016/j.accpm.2017.07.004
       
  • Rescue Transtracheal Jet Ventilation during difficult intubation in
           patients with upper airway cancer
    • Authors: G Bouroche; C Motamed; JM de Guibert; D Hartl; JL Bourgain
      Abstract: Publication date: Available online 10 November 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): G Bouroche, C Motamed, JM de Guibert, D Hartl, JL 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 63905 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 fiberoptic-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: 2017-11-11T23:00:39Z
      DOI: 10.1016/j.accpm.2017.10.005
       
  • A new national quality indicator reflecting pain relief in the PACU has
           been launched and initial results show positive performance of French
           teams
    • Authors: Dan Benhamou; Claude Ecoffey; Sophie Calmus; Fréderic Capuano; Marc Dahlet; Arnaud Fouchard
      Abstract: Publication date: Available online 10 November 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Dan Benhamou, Claude Ecoffey, Sophie Calmus, Fréderic Capuano, Marc Dahlet, Arnaud Fouchard


      PubDate: 2017-11-11T23:00:39Z
      DOI: 10.1016/j.accpm.2017.10.007
       
  • Initial training of French residents in obstetric anaesthesia: A National
           Survey
    • Authors: Ludovic Hilt; Delphine Herbain; Nour Eddine Baka; Jérôme Feugeas; Hervé Bouaziz; Vial Florence
      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, Vial Florence


      PubDate: 2017-11-11T23:00:39Z
      DOI: 10.1016/j.accpm.2017.10.006
       
  • Comparing McGrath® MAC video laryngoscope with Macintosh direct
           laryngoscopy for novice laryngoscopists in children. Reply
    • Authors: Antoine Giraudon; Maryline Bordes-Demolis; François Semjen; Matthieu Biais; Karine Nouette-Gaulain
      Abstract: Publication date: Available online 10 November 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Antoine Giraudon, Maryline Bordes-Demolis, François Semjen, Matthieu Biais, Karine Nouette-Gaulain


      PubDate: 2017-11-11T23:00:39Z
      DOI: 10.1016/j.accpm.2017.10.003
       
  • Comparing McGrath® MAC video laryngoscope with Macintosh direct
           laryngoscopy for novice laryngoscopists in children
    • Authors: Hui-Xian Li; Fu-Shan Xue; Gui-Zhen Yang; Ya-Yang Liu
      Abstract: Publication date: Available online 10 November 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Hui-Xian Li, Fu-Shan Xue, Gui-Zhen Yang, Ya-Yang Liu


      PubDate: 2017-11-11T23:00:39Z
      DOI: 10.1016/j.accpm.2017.11.002
       
  • Austral Influenza Outbreak and its impact on an Intensive Care Unit
    • Authors: David Vandroux; Jérôme Allyn; Bernard-Alex Gaüzère; Olivier Martinet; Julien Jabot
      Abstract: Publication date: Available online 10 November 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): David Vandroux, Jérôme Allyn, Bernard-Alex Gaüzère, Olivier Martinet, Julien Jabot


      PubDate: 2017-11-11T23:00:39Z
      DOI: 10.1016/j.accpm.2017.11.001
       
  • A massive overdose of potassium pills
    • Authors: Christopher Schaeffer; Sébastien Poincet; Bettina Teruzzi; Thomas Galas; David Vandroux
      Abstract: Publication date: Available online 18 October 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Christopher Schaeffer, Sébastien Poincet, Bettina Teruzzi, Thomas Galas, David Vandroux


      PubDate: 2017-10-29T09:49:42Z
      DOI: 10.1016/j.accpm.2017.10.001
       
  • Veno-Arterial-ECMO in the Intensive Care Unit:From Technical Aspects to
           Clinical Practice
    • Authors: Arthur Le Gall; Arnaud Follin; Bernard Cholley; Jean Mantz; Nadia Aissaoui; Romain Pirracchio
      Abstract: Publication date: Available online 13 October 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Arthur Le Gall, Arnaud Follin, Bernard Cholley, Jean Mantz, Nadia Aissaoui, Romain Pirracchio
      The use of Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) as a salvage therapy in cardiogenic shock is becoming of current practice. While VA-ECMO is potentially a life-saving technique, results are sometimes mitigated, emphasising the need for selecting the right indication in the right patient. This relies upon a clear definition of the individual therapeutic project, including the potential for recovery as well as the possible complications associated with VA-ECMO. To maximise the benefits of VA-ECMO, the basics of extracorporeal circulation should be perfectly understood since VA-ECMO can sometimes be detrimental. Hence, to be successful, VA-ECMO should be used by teams with sufficient experience and initiated after a thorough multidisciplinary discussion considering patient's medical history, pathology as well the anticipated evolution of the disease.

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

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

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


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


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

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

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


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


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


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

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


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


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


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


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

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


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

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

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


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

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

      PubDate: 2017-08-29T11:25:40Z
      DOI: 10.1016/j.accpm.2017.04.007
       
  • Impact of a visual aid on discordance between physicians and family
           members
    • Authors: Gabrielle Burelli; Chloé Berthelier; Hélène Vanacker; Léonard Descaillot; Bénédicte Philippon-Jouve; Xavier Fabre; Mahmoud Kaaki; Jean-Charles Chakarian; Alexandre Domine; Pascal Beuret
      Abstract: Publication date: Available online 5 August 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Gabrielle Burelli, Chloé Berthelier, Hélène Vanacker, Léonard Descaillot, Bénédicte Philippon-Jouve, Xavier Fabre, Mahmoud Kaaki, Jean-Charles Chakarian, Alexandre Domine, Pascal Beuret
      Objective This study aimed to evaluate the impact of a visual aid on the discordance about prognosis between physicians and family members. Methods The study was performed in a general intensive care department with two 6-bed units. In the unit A, family members could consult a visual aid depicting day by day the evolution of global, hemodynamic, respiratory, renal and neurological conditions of the patient on a 10 point scale. In the unit B, they only received oral medical information. On day 7 of the ICU stay, the physician and family members estimated the prognosis of the patient among four proposals (life threatened; steady state but may worsen; steady state, should heal; will heal). Then we compared the rate of discordance about prognosis between physicians and family members in the two units. Results Seventy-nine consecutive patients admitted in the intensive care department and still present at day 7, their family members and physicians, were enrolled. Patients in the two units were comparable in age, sex ratio, reason for admission, SAPS II at admission and SOFA score at day 7. In the unit A physician-family members discordance about prognosis occurred for 12 out of 39 patients (31%) vs. 22 out of 40 patients (55%) in the unit B (p=0.04). Conclusion In our study, adding a visual aid depicting the evolution of the condition of critically ill patients day by day to classic oral information allowed the family to have an estimate of the prognosis less discordant with the estimate of the physician.

      PubDate: 2017-08-09T13:18:45Z
      DOI: 10.1016/j.accpm.2017.05.006
       
 
 
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