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Publisher: Elsevier   (Total: 3030 journals)

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Showing 1 - 200 of 3030 Journals sorted alphabetically
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 20, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 16, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 79, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 22, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 27, 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: 303, 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  
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 196, 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: 9, 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: 21, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 5, 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: 3, 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: 4)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 5)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 20)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 120, 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: 16, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 8, 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: 24, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 3)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 6, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 10, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 21, 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: 5, SJR: 2.139, h-index: 42)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 24, 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: 8, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28, 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 Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 4)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 22)
Advances in Ecological Research     Full-text available via subscription   (Followers: 39, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 25, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 38, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 8)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 41, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 14)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 11)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 18, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 22)
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: 33, 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: 4)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 4)
Advances in Life Course Research     Hybrid Journal   (Followers: 7, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 8)
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: 5, 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: 21)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 6, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 3)
Advances in Oncobiology     Full-text available via subscription   (Followers: 3)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 20, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 14)
Advances in Pharmacology     Full-text available via subscription   (Followers: 13, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 7, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 4)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 17, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 56)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 5, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 1, SJR: 0.1, h-index: 2)
Advances in Space Research     Full-text available via subscription   (Followers: 332, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 7)
Advances in Surgery     Full-text available via subscription   (Followers: 6, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 28, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 14)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 12)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 42, 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: 304, 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: 4, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 7, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 390, 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: 29, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 36, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 1)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 48, 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: 3, 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: 9, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 5)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access  
Algal Research     Partially Free   (Followers: 7, 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)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 6, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 45, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 5)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 3)
American Heart J.     Hybrid Journal   (Followers: 45, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 47, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 34, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 6, 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: 25, 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: 48, 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: 174, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 51, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 2)
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: 22, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 23, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 21, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 32, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 13, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 5)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 52, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 3)
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: 2, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 38, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 154, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 7, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 10)
Anesthésie & Réanimation     Full-text available via subscription  
Anesthesiology Clinics     Full-text available via subscription   (Followers: 21, 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: 143, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)
Animal Reproduction Science     Hybrid Journal   (Followers: 5, SJR: 0.711, h-index: 78)
Annales d'Endocrinologie     Full-text available via subscription   (SJR: 0.394, h-index: 30)
Annales d'Urologie     Full-text available via subscription  
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (SJR: 0.177, h-index: 13)
Annales de Chirurgie de la Main et du Membre Supérieur     Full-text available via subscription  
Annales de Chirurgie Plastique Esthétique     Full-text available via subscription   (Followers: 2, SJR: 0.354, h-index: 22)
Annales de Chirurgie Vasculaire     Full-text available via subscription   (Followers: 1)

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Journal Cover Anaesthesia Critical Care & Pain Medicine
  [3 followers]  Follow
    
   Full-text available via subscription Subscription journal  (Not entitled to full-text)
   ISSN (Online) 2352-5568
   Published by Elsevier Homepage  [3030 journals]
  • Where do ultrasounds have to go?
    • Authors: Paul J. Zetlaoui; Dan Benhamou
      Pages: 77 - 78
      Abstract: Publication date: April 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 2
      Author(s): Paul J. Zetlaoui, Dan Benhamou


      PubDate: 2017-04-13T14:28:00Z
      DOI: 10.1016/j.accpm.2017.03.002
       
  • Aprotinin as an alternative to tranexamic acid in cardiac surgery – Is
           this where we started from?
    • Authors: Anne Godier; Beverley J. Hunt
      Pages: 79 - 81
      Abstract: Publication date: April 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 2
      Author(s): Anne Godier, Beverley J. Hunt


      PubDate: 2017-04-13T14:28:00Z
      DOI: 10.1016/j.accpm.2017.03.001
       
  • Comparison of a GPS needle-tracking system, multiplanar imaging and 2D
           imaging for real-time ultrasound-guided epidural anaesthesia: A
           randomized, comparative, observer-blinded study on phantoms
    • Authors: Cécilia Menacé; Olivier Choquet; Bertrand Abbal; Sophie Bringuier; Xavier Capdevila
      Pages: 83 - 89
      Abstract: Publication date: April 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 2
      Author(s): Cécilia Menacé, Olivier Choquet, Bertrand Abbal, Sophie Bringuier, Xavier Capdevila
      Background The real-time ultrasound-guided paramedian sagittal oblique approach for neuraxial blockade is technically demanding. Innovative technologies have been developed to improve nerve identification and the accuracy of needle placement. The aim of this study was to evaluate three types of ultrasound scans during ultrasound-guided epidural lumbar punctures in a spine phantom. Methods Eleven sets of 20 ultrasound-guided epidural punctures were performed with 2D, GPS, and multiplanar ultrasound machines (660 punctures) on a spine phantom using an in-plane approach. For all punctures, execution time, number of attempts, bone contacts, and needle redirections were noted by an independent physician. Operator comfort and visibility of the needle (tip and shaft) were measured using a numerical scale. Results The use of GPS significantly decreased the number of punctures, needle repositionings, and bone contacts. Comfort of the physician was also significantly improved with the GPS system compared with the 2D and multiplanar systems. With the multiplanar system, the procedure was not facilitated and execution time was longer compared with 2D imaging after Bonferroni correction but interaction between the type of ultrasound system and mean execution time was not significant in a linear mixed model. There were no significant differences regarding needle tip and shaft visibility between the systems. Conclusions Multiplanar and GPS needle-tracking systems do not reduce execution time compared with 2D imaging using a real-time ultrasound-guided paramedian sagittal oblique approach in spine phantoms. The GPS needle-tracking system can improve performance in terms of operator comfort, the number of attempts, needle redirections and bone contacts.

      PubDate: 2017-04-13T14:28:00Z
      DOI: 10.1016/j.accpm.2016.05.002
       
  • Ultrasound-guided intermediate cervical block versus superficial cervical
           block for carotid artery endarterectomy: The randomized-controlled
           CERVECHO trial
    • Authors: Arslane Alilet; Pascal Petit; Benedicte Devaux; Corinne Joly; Emmanuel Samain; Sebastien Pili-Floury; Guillaume Besch
      Pages: 91 - 95
      Abstract: Publication date: April 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 2
      Author(s): Arslane Alilet, Pascal Petit, Benedicte Devaux, Corinne Joly, Emmanuel Samain, Sebastien Pili-Floury, Guillaume Besch
      Introduction The value of ultrasound guidance for intermediate cervical blocks in patients undergoing carotid artery endarterectomy is poorly described. This study aimed at comparing the efficacy of ultrasound-guided intermediate cervical block to superficial cervical block for carotid artery endarterectomies. Patients and methods We conducted a single-centre randomized-controlled study in a French University Hospital, from April 2011 to March 2012. The anaesthesia technique was randomly allocated to patients scheduled for carotid artery endarterectomy under regional anaesthesia (ropivacaine 4.75mg/mL): superficial cervical block in the Control group, and ultrasound-guided intermediate cervical block in the Echo group. The main outcome measure was the percentage of surgery performed without supplemental topical anaesthesia. The secondary outcomes were: rate of conversion to general anaesthesia, amount of supplemental topical lidocaine and block-related complications. P <0.05 was considered significant. Results Demographic data for the 86 patients included [mean (SD) age 73 (11) years] did not differ between groups. Surgery was performed without supplemental topical lidocaine in 23% and 7% of the patients in the Echo and Control groups, respectively (P =0.068). Conversion to general anaesthesia for inadequate analgesia was needed in 0 and 2 patients in the Echo and Control groups, respectively. The mean dose of topical lidocaine was not different between groups. No complication directly related to a cervical block was observed. Conclusions Ultrasound-guided intermediate cervical plexus block and superficial cervical blocks performed for carotid artery surgery seems to provide similar results, but this study was probably underpowered to detect any difference. Trial registration European Union Drug Regulating Authorities Clinical Trials (Eudra-CT) registration number: 2010-A 01490-39.

      PubDate: 2017-04-13T14:28:00Z
      DOI: 10.1016/j.accpm.2016.03.007
       
  • Critical incidents in a French department of paediatric anaesthesia
    • Authors: Elisa Kupersztych-Hagege; Caroline Duracher-Gout; Rocio Ortego; Pierre Carli; Gilles Orliaguet
      Pages: 103 - 107
      Abstract: Publication date: April 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 2
      Author(s): Elisa Kupersztych-Hagege, Caroline Duracher-Gout, Rocio Ortego, Pierre Carli, Gilles Orliaguet
      Background Several studies have highlighted the importance of critical incident (CI) reporting in order to enhance patient safety. We have implemented an anonymous procedure for CI reporting in our department of paediatric anaesthesia. This study aims at analysing those CIs so as to improve patient care and risk management. Material and methods CIs were reported by the anaesthetic team using the World Health Organization classification and analysed using the ORION methodology. CIs were classified according to type, surgery and complications. Risk factors and consequences for patients and for the institution were analysed. Risk factors with high degree of harm for the patient were identified using a univariate analysis and odds ratios (OR). Results Over an 18-month period, 114 CIs were reported for 103 patients (median age: 7.0 years [95% CI: 3.6–9.8]). We found that 29.9% of reported CIs had consequences for the patients and 76.3% were considered preventable. The two main types of CI were “respiratory” (28.8%) and “drug-related” (22.8%) incidents. The main risk factor was ‘human error’ (42.3%). Several consequences for the patient and the hospital were identified. An ASA score≥3 (OR: 2.52; [95% CI: 1.10–5.78]) was an independent risk factor for a high degree of patient harm. Conclusion Improving quality of care must be a priority for paediatric anaesthesiologists as most of the CIs observed are preventable and have consequences for the patient and the institution.

      PubDate: 2017-04-13T14:28:00Z
      DOI: 10.1016/j.accpm.2016.04.004
       
  • The efficacy of intra-articular lidocaine administration in chronic knee
           pain due to osteoarthritis: A randomized, double-blind, controlled study
    • Authors: H. Evren Eker; Oya Yalcin Cok; Anis Aribogan; Gulnaz Arslan
      Pages: 109 - 114
      Abstract: Publication date: April 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 2
      Author(s): H. Evren Eker, Oya Yalcin Cok, Anis Aribogan, Gulnaz Arslan
      Background Intra-articular injections for the treatment of knee pain due to osteoarthritis are performed when conservative therapies have failed. The intra-articular injection of lidocaine may be an effective treatment modality due to its neuronal membrane-stabilizing effect and long-lasting anti-inflammatory action. In this study, we compared the efficacy of intra-articular 0.5% lidocaine versus saline injection on pain, stiffness and physical function in patients with osteoarthritis. Methods Patients with osteoarthritis were randomly allocated to two groups. Group I (n =26) received 7mL 0.5% lidocaine and group II (n =26) received 7mL saline into the painful knee for a series of three injections spaced by 1 week intervals under ultrasound guidance. Knee pain was measured with a numeric rating score (NRS) at baseline and 3 months after the 3rd injection. WOMAC scales, including pain (WOMAC-P), stiffness (WOMAC-S) and physical function (WOMAC-F), were assessed and recorded at baseline, 30minutes after the 1st injection, immediately prior to the 2nd and 3rd injections and 3 months after the 3rd injection. Results Demographic data were comparable between groups. The NRS after 3 months was significantly lower in group I (P =0.001). The WOMAC-P, immediately prior to the 3rd injection and 3 months afterwards, was significantly lower in group I (P =0.006, P =0.001, respectively). The WOMAC-S was improved prior to the 3rd injection and sustained until 3 months in group I (P =0.035, P =0.004, respectively). The WOMAC-F was improved after the 1st injection and sustained until 3 months in group I (P =0.002, P <0.0001 and P <0.0001, respectively). Conclusions Intra-articular 0.5% lidocaine injection under ultrasound guidance has a potential role in the management of chronic knee pain due to osteoarthritis for a 3-month period.

      PubDate: 2017-04-13T14:28:00Z
      DOI: 10.1016/j.accpm.2016.05.003
       
  • Ready-to-use pre-filled syringes of atropine for anaesthesia care in
           French hospitals – a budget impact analysis
    • Authors: Dan Benhamou; Vincent Piriou; Cyrille De Vaumas; Pierre Albaladejo; Jean-Marc Malinovsky; Marianne Doz; Antoine Lafuma; Hervé Bouaziz
      Pages: 115 - 121
      Abstract: Publication date: April 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 2
      Author(s): Dan Benhamou, Vincent Piriou, Cyrille De Vaumas, Pierre Albaladejo, Jean-Marc Malinovsky, Marianne Doz, Antoine Lafuma, Hervé Bouaziz
      Background Patient safety is improved by the use of labelled, ready-to-use, pre-filled syringes (PFS) when compared to conventional methods of syringe preparation (CMP) of the same product from an ampoule. However, the PFS presentation costs more than the CMP presentation. Objective To estimate the budget impact for French hospitals of switching from atropine in ampoules to atropine PFS for anaesthesia care. Methods A model was constructed to simulate the financial consequences of the use of atropine PFS in operating theatres, taking into account wastage and medication errors. The model tested different scenarios and a sensitivity analysis was performed. Results In a reference scenario, the systematic use of atropine PFS rather than atropine CMP yielded a net one-year budget saving of €5,255,304. Medication errors outweighed other cost factors relating to the use of atropine CMP (€9,425,448). Avoidance of wastage in the case of atropine CMP (prepared and unused) was a major source of savings (€1,167,323). Significant savings were made by means of other scenarios examined. The sensitivity analysis suggests that the results obtained are robust and stable for a range of parameter estimates and assumptions. Study limitations The financial model was based on data obtained from the literature and expert opinions. Conclusion The budget impact analysis shows that even though atropine PFS is more expensive than atropine CMP, its use would lead to significant cost savings. Savings would mainly be due to fewer medication errors and their associated consequences and the absence of wastage when atropine syringes are prepared in advance.

      PubDate: 2017-04-13T14:28:00Z
      DOI: 10.1016/j.accpm.2016.03.009
       
  • Chloride toxicity in critically ill patients: What's the evidence?
    • Authors: Sabri Soussi; Axelle Ferry; Maité Chaussard; Matthieu Legrand
      Pages: 125 - 130
      Abstract: Publication date: April 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 2
      Author(s): Sabri Soussi, Axelle Ferry, Maité Chaussard, Matthieu Legrand
      Crystalloids have become the fluid of choice in critically ill patients and in the operating room both for fluid resuscitation and fluid maintenance. Among crystalloids, NaCl 0.9% has been the most widely used fluid. However, emerging evidence suggests that administration of 0.9% saline could be harmful mainly through high chloride content and that the use of fluid with low chloride content may be preferable in major surgery and intensive care patients. Administration of NaCl 0.9% is the leading cause of metabolic hyperchloraemic acidosis in critically ill patients and side effects might target coagulation, renal function, and ultimately increase mortality. More balanced solutions therefore may be used especially when large amount of fluids are administered in high-risk patients. In this review, we discuss physiological background favouring the use of balanced solutions as well as the most recent clinical data regarding the use of crystalloid solutions in critically ill patients and patients undergoing major surgery.

      PubDate: 2017-04-13T14:28:00Z
      DOI: 10.1016/j.accpm.2016.03.008
       
  • Spinal bupivacaine and clonidine for orthopaedic and general paediatric
           surgery in remote location
    • Authors: Marc. E. Gentili; Jean-Noël Ligier; Jacques Dermer; Jean-Christian Sleth
      Pages: 131 - 132
      Abstract: Publication date: April 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 2
      Author(s): Marc. E. Gentili, Jean-Noël Ligier, Jacques Dermer, Jean-Christian Sleth


      PubDate: 2017-04-13T14:28:00Z
      DOI: 10.1016/j.accpm.2016.09.003
       
  • Protective ventilation during cardiac surgery: More than tidal volume?
    • Authors: Benoît Courteille; Jennifer Brunet; Alexandre Ouattara; François Stéphan; Jean-Louis Gérard; Emmanuel Lorne; Marc-Olivier Fischer
      Pages: 133 - 134
      Abstract: Publication date: April 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 2
      Author(s): Benoît Courteille, Jennifer Brunet, Alexandre Ouattara, François Stéphan, Jean-Louis Gérard, Emmanuel Lorne, Marc-Olivier Fischer


      PubDate: 2017-04-13T14:28:00Z
      DOI: 10.1016/j.accpm.2016.11.003
       
  • Diaphragmatic ultrasound cannot replace medical reasoning
    • Authors: Laurent Zieleskiewicz; Belaid Bouhemad
      Pages: 1 - 2
      Abstract: Publication date: February 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 1
      Author(s): Laurent Zieleskiewicz, Belaid Bouhemad


      PubDate: 2017-02-25T21:13:20Z
      DOI: 10.1016/j.accpm.2016.09.001
       
  • Ultrasonographic diaphragmatic excursion is inaccurate and not better than
           the MRC score for predicting weaning-failure in mechanically ventilated
           patients
    • Authors: Cédric Carrie; Chloé Gisbert-Mora; Eline Bonnardel; Bernard Gauche; Matthieu Biais; Frédéric Vargas; Gilles Hilbert
      Pages: 9 - 14
      Abstract: Publication date: February 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 1
      Author(s): Cédric Carrie, Chloé Gisbert-Mora, Eline Bonnardel, Bernard Gauche, Matthieu Biais, Frédéric Vargas, Gilles Hilbert
      Purpose To assess the ability of diaphragmatic ultrasound (US) to predict weaning failure in mechanically ventilated patients undergoing a first spontaneous breathing trial (SBT). Methods During a 4-month period, 67 consecutive patients eligible for a first SBT underwent US measurements of maximal diaphragmatic excursion (MDE) by a right anterior subcostal approach. Weaning failure was defined as either the failure of SBT or the need for resumption of ventilatory support for acute respiratory failure or death within 48h following successful extubation. The accuracy of diaphragmatic ultrasound and the Medical Research Council (MRC) score when predicting weaning failure was assessed via a receiver operating curve analysis. Results The feasibility rate for the ultrasound measurements was 63%. Mean values of MDE were significantly higher in patients who succeeded at their first weaning attempt (4.1±2.1 versus 3±1.8cm, P =0.04). Using a threshold of MDE≤2.7cm, the sensitivity and specificity of diaphragmatic ultrasound in predicting weaning failure were 59% [39–77%] and 71% [57–82%] with an AUC at 0.65 [0.51–0.78]. There was no significant difference between MDE values and MRC scores for predicting weaning failure (P =0.73). Conclusion A decrease in MDE values may be associated with an unfavourable weaning outcome. Diaphragmatic excursion measured by ultrasound is however unable by itself to predict weaning failure at the bedside of patients undergoing a first spontaneous breathing trial and does not provide any additional value compared to the MRC score.

      PubDate: 2017-02-25T21:13:20Z
      DOI: 10.1016/j.accpm.2016.05.009
       
  • What are the therapeutic alternatives to dextropropoxyphene in France? A
           prescribers’ survey
    • Authors: F. Aubrun; E. Chrétien; L. Letrilliart; M. Ginoux; M. Belhassen; M. Lanteri-Minet; E. Van Ganse; H. Beloeil; V. Martinez; C. Aveline; S. Bloc; J. Cabaton; M. Carles; P. Cuvillon; C. Dadure; E. Marret; K. Nouette-Gaulain; M. Olivier; P. Zetlaoui
      Pages: 15 - 19
      Abstract: Publication date: February 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 1
      Author(s): F. Aubrun, E. Chrétien, L. Letrilliart, M. Ginoux, M. Belhassen, M. Lanteri-Minet, E. Van Ganse, H. Beloeil
      About a year after dextropropoxyphene (DXP) withdrawal from the French market, we conducted a survey among members of the French Society of Anesthesia & Intensive Care Medicine (Sfar) and of the French Society of the Study and Treatment of Pain (SFETD) to identify the indications for which this WHO level II analgesic had been prescribed, the prescriber's feedback following withdrawal, and the substitutive analgesics prescribed. DXP had been prescribed by more than 75% of the 430 anaesthesiologists and 230 pain specialists interviewed, mainly for acute and chronic non-cancer pain of moderate intensity. While two thirds of pain specialists were not satisfied with DXP withdrawal, this decision did not affect the majority of anaesthesiologists. In both groups, the main substitutive analgesic was tramadol combined with acetaminophen, while only 24% of prescribers considered acetaminophen alone as a substitute.

      PubDate: 2017-02-25T21:13:20Z
      DOI: 10.1016/j.accpm.2016.01.007
       
  • Evolution of stress in anaesthesia registrars with repeated simulated
           courses: An observational study
    • Authors: Antoine Gouin; Cédric Damm; Grégory Wood; Sébastien Cartier; Marie Borel; Karen Villette-Baron; Sylvain Boet; Vincent Compère; Bertrand Dureuil
      Pages: 21 - 26
      Abstract: Publication date: February 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 1
      Author(s): Antoine Gouin, Cédric Damm, Grégory Wood, Sébastien Cartier, Marie Borel, Karen Villette-Baron, Sylvain Boet, Vincent Compère, Bertrand Dureuil
      Background and objective High-fidelity medical simulation is a source of stress for participants. The aim of this study was to assess if repeated simulated courses decrease perceived stress and/or physiological stress level and increase performance in anaesthesiology registrars. Method Fourteen anaesthesiology specialty registrars participated individually in three successive sessions of crisis simulation in the operating room. Participants’ perceived stress levels were measured by self-assessment (simple numerical scale from 0 to 10 [0=no stress, 10=maximum stress]) and physiological stress was estimated via the maximal heart rate measured by a Holter system). Technical and non-technical performances were also assessed. Data are expressed as medians with interquartile ranges and extremes (median (IQR [Min–Max])). Results Between the first and third session, simulation repetition was associated with a decrease in perceived stress (9 (8–10 [5–10]) versus 7 (5–8 [2–9]) from session 1 to session 3 respectively, P =0.02), whereas physiological stress assessed by the maximum heart rate remained unchanged (130 beats per minute (116–141 [85–170]) and 123 beats per minute (115–136 [88–166]) between sessions 1 and 3 respectively). There was also a significant inverse correlation between perceived stress levels experienced by registrars during the session and non-technical performance (P =0.008). Conclusion We observed a reduction in perceived stress levels experienced by registrars while physiological stress was unchanged with repeating simulation sessions combining simulated practice and debriefing. Learning through simulation could improve perceived stress management in critical situations.

      PubDate: 2017-02-25T21:13:20Z
      DOI: 10.1016/j.accpm.2016.02.008
       
  • Remote peripheral tissue oxygenation does not predict postoperative free
           flap complications in complex head and neck cancer surgery: A prospective
           cohort study
    • Authors: Marie-Laurence Guye; Cyrus Motamed; Sarah Chemam; Nicolas Leymarie; Stéphanie Suria; Grégoire Weil
      Pages: 27 - 31
      Abstract: Publication date: February 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 1
      Author(s): Marie-Laurence Guye, Cyrus Motamed, Sarah Chemam, Nicolas Leymarie, Stéphanie Suria, Grégoire Weil
      Background Patients undergoing free flap reconstruction after head and neck cancer may develop free flap complications. In the perioperative period, haemoglobin content and oxygen tissue saturation (StO2) measured directly on the free flap reflect peripheral tissue oxygenation. However, in this type of surgery, StO2 cannot always be applied directly or proximate to the free flap. The aim of this study was to assess the possible value of StO2 measured at the thenar eminence and other 24hour perioperative factors on free flap complications. Methods Inclusion criteria corresponded to patients with head and neck cancer with free flap surgery in whom direct StO2 could not be monitored on the flap nor in its peripheral area. Patient characteristics and intraoperative data, such as haemoglobin and fluid management, were prospectively collected. StO2 was measured remotely on the thenar eminence. Data were collected for 24hours and free flap complications were recorded for up to 15days after surgery. Patients were thereafter classified into two groups: with or without free flap complications and the data were compared in consequence. Results Forty consecutive patients were prospectively included. Ten patients had postoperative free flap complications and were compared to the 30 other patients without complications. The haemoglobin level at the reperfusion of the flap: (AUC 0.80 [0.65–0.91], threshold 9.9g/dL, P <0.001) and body mass index [BMI] (AUC 0.80 [0.64–0.72], threshold 24.5kg/m2, P <0.01) were significantly related to complications. Conclusion In head and neck complex oncologic reconstructive surgery, haemoglobin and BMI were the most sensitive tools for predicting postoperative free flap complications, while thenar eminence StO2 was not.

      PubDate: 2017-02-25T21:13:20Z
      DOI: 10.1016/j.accpm.2016.01.008
       
  • Target-controlled inhalation anaesthesia: A cost-benefit analysis based on
           the cost per minute of anaesthesia by inhalation
    • Authors: Sébastien Ponsonnard; Antoine Galy; Jérôme Cros; Armelle Marie Daragon; Nathalie Nathan
      Pages: 33 - 37
      Abstract: Publication date: February 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 1
      Author(s): Sébastien Ponsonnard, Antoine Galy, Jérôme Cros, Armelle Marie Daragon, Nathalie Nathan
      Background End-tidal target-controlled inhalational anaesthesia (TCIA) with halogenated agents (HA) provides a faster and more accurately titrated anaesthesia as compared to manually-controlled anaesthesia. This study aimed to measure the macro-economic cost-benefit ratio of TCIA as compared to manually-controlled anaesthesia. Methods This retrospective and descriptive study compared direct drug spending between two hospitals before 2011 and then after the replacement of three of six anaesthesia machines with TCIA mode machines in 2012 (Aisys carestation®, GE). The direct costs were obtained from the pharmacy department and the number and duration of the anaesthesia procedures from the computerized files of the hospital. Results The cost of halogenated agents was reduced in the hospital equipped with an Aisys carestation® by 13% as was the cost of one minute of anaesthesia by inhalation (€0.138 and €0.121/min between 2011 and 2012). The extra cost of the implementation of the 3 anaesthesia machines could be paid off with the resulting savings over 6 years. Discussion TCIA appears to have a favourable cost-benefit ratio. Despite a number of factors, which would tend to minimise the saving and increase costs, we still managed to observe a 13% savings. Shorter duration of surgery, type of induction as well as the way HA concentration is targeted may influence the savings results obtained.

      PubDate: 2017-02-25T21:13:20Z
      DOI: 10.1016/j.accpm.2016.02.005
       
  • Decongestive effects of levosimendan in cardiogenic shock induced by
           postpartum cardiomyopathy
    • Authors: I. Labbene; M. Arrigo; M. Tavares; Z. Hajjej; J.L. Brandão; H. Tolppanen; E. Feliot; E. Gayat; M. Ferjani; A. Mebazaa
      Pages: 39 - 42
      Abstract: Publication date: February 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 1
      Author(s): I. Labbene, M. Arrigo, M. Tavares, Z. Hajjej, J.L. Brandão, H. Tolppanen, E. Feliot, E. Gayat, M. Ferjani, A. Mebazaa
      Background Catecholamines and/or levosimendan have been proposed for haemodynamic restoration during cardiogenic shock (CS). In CS induced by post-partum cardiomyopathy (PPCM), levosimendan might be particularly favourable. The aim of this study was to evaluate the haemodynamic and echocardiographic effects of levosimendan in patients with CS, in particular in patients with PPCM-induced CS. Methods Twenty-eight patients with refractory CS were retrospectively included in the study. Among them, a cohort of 8 women with PPCM-induced CS was included. All patients were treated with levosimendan (loading dose followed by a continuous infusion for 24 h) and were invasively monitored, including a pulmonary artery catheter, for 48hours. Echocardiographic measurements were performed at baseline and during follow-up. Results Significant improvements in haemodynamic parameters were observed 48 h after starting levosimendan. The cardiac index increased (+1.2±0.6L/min, P <0.001) and filling pressures decreased (pulmonary artery occlusion pressure, PAOP: −11.2±4.3mmHg, P <0.001; right-atrial pressure, RAP: −6.1±4.9mmHg, P <0.001). The left ventricular ejection fraction was significantly higher at 48 h compared to baseline (38% [34–46%] versus 27% [22–30%], P <0.001). Despite similar characteristics at baseline, in the subgroup of patients with PPCM, more profound decongestive effects at 48hours were observed: PAOP (13±2 versus 17±4mmHg, P =0.007) and RAP (12±4 versus 17±4mmHg, P =0.006) were significantly lower in the PPCM subgroup compared to the non-PPCM subgroup. Conclusions Haemodynamics and left-ventricular ejection fraction rapidly improved after treatment with levosimendan. In patients with PPCM-induced CS, a more profound reduction of congestion was observed.

      PubDate: 2017-02-25T21:13:20Z
      DOI: 10.1016/j.accpm.2016.02.009
       
  • Triage in military settings
    • Authors: E. Falzone; P. Pasquier; C. Hoffmann; O. Barbier; M. Boutonnet; A. Salvadori; A. Jarrassier; J. Renner; B. Malgras; S. Mérat
      Pages: 43 - 51
      Abstract: Publication date: February 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 1
      Author(s): E. Falzone, P. Pasquier, C. Hoffmann, O. Barbier, M. Boutonnet, A. Salvadori, A. Jarrassier, J. Renner, B. Malgras, S. Mérat
      Triage, a medical term derived from the French word “trier”, is the practical process of sorting casualties to rationally allocate limited resources. In combat settings with limited medical resources and long transportation times, triage is challenging since the objectives are to avoid overcrowding medical treatment facilities while saving a maximum of soldiers and to get as many of them back into action as possible. The new face of modern warfare, asymmetric and non-conventional, has led to the integrative evolution of triage into the theatre of operations. This article defines different triage scores and algorithms currently implemented in military settings. The discrepancies associated with these military triage systems are highlighted. The assessment of combat casualty severity requires several scores and each nation adopts different systems for triage on the battlefield with the same aim of quickly identifying those combat casualties requiring lifesaving and damage control resuscitation procedures. Other areas of interest for triage in military settings are discussed, including predicting the need for massive transfusion, haemodynamic parameters and ultrasound exploration.

      PubDate: 2017-02-25T21:13:20Z
      DOI: 10.1016/j.accpm.2016.05.004
       
  • Criteria for choosing an intravenous infusion line intended for multidrug
           infusion in anaesthesia and intensive care units
    • Authors: Aurélie Maiguy-Foinard; Stéphanie Genay; Damien Lannoy; Christine Barthélémy; Gilles Lebuffe; Bertrand Debaene; Pascal Odou; Bertrand Décaudin
      Pages: 53 - 63
      Abstract: Publication date: February 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 1
      Author(s): Aurélie Maiguy-Foinard, Stéphanie Genay, Damien Lannoy, Christine Barthélémy, Gilles Lebuffe, Bertrand Debaene, Pascal Odou, Bertrand Décaudin
      Objective The aims are to identify critical parameters influencing the drug mass flow rate of infusion delivery to patients during multidrug infusion and to discuss their clinical relevance. Data sources A review of literature was conducted in January 2016 using Medline, Google Scholar, ScienceDirect, Web of Science and Scopus online databases. Data extraction References relating to the accuracy of fluid delivery via gravity-flow intravenous (IV) infusion systems and positive displacement pumps, components of IV administration sets, causes of flow rate variability, potential complications due to flow rate variability, IV therapies especially at low flow rates and drug compatibilities were considered relevant. Data synthesis Several parameters impact the delivery of drugs and fluids by IV infusion. Among them are the components of infusion systems that particularly influence the flow rate of medications and fluids being delivered. By their conception, they may generate significant start-up delays and flow rate variability. Performing multidrug infusion requires taking into account two main points: the common dead volume of drugs delivered simultaneously with potential consequences on the accuracy and amount of drug delivery and the prevention of drug incompatibilities and their clinical effects. Conclusion To prevent the potentially serious effects of flow rate variability on patients, clinicians should receive instruction on the fluid dynamics of an IV administration set and so be able to take steps to minimise flow rate changes during IV therapy.

      PubDate: 2017-02-25T21:13:20Z
      DOI: 10.1016/j.accpm.2016.02.007
       
  • Comparison of the visualisation of the subclavian and axillary veins: An
           ultrasound study in healthy volunteers
    • Authors: Claire Roger; Meriem Sadek; Sophie Bastide; Pascal Jeannes; Laurent Muller; Xavier Bobbia; Jean-Yves Lefrant
      Pages: 65 - 68
      Abstract: Publication date: February 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 1
      Author(s): Claire Roger, Meriem Sadek, Sophie Bastide, Pascal Jeannes, Laurent Muller, Xavier Bobbia, Jean-Yves Lefrant
      Objective To compare the area of the lumen of the axillary and subclavian veins using ultrasound (US) in 50 healthy volunteers. Methods Using an ultrasound device, depth, area, short axis vein length and long axis vein, vein-artery and vein-pleura distances were measured for axillary and subclavian approaches. Results The mean cross-sectional area of the axillary vein was greater than the mean cross-sectional area of the subclavian vein (327±89 mm2 versus 124±46 mm2, P <0.001). Both the mean transverse (10±2mm versus 9±2mm) and longitudinal axes (39±8mm versus 17±7mm) of the axillary vein were greater than those of subclavian vein (P <0.01, P <0.001, respectively). The depths of the axillary and subclavian veins were similar (21±6mm versus 20±6mm, P =0.43). The axillary and subclavian arteries were visualised in 3 and 45 volunteers, respectively (P <0.001). The pleura was seen in 25 and 37 volunteers with the axillary and subclavian approaches, respectively (P =0.01). The distance between the pleura and the subclavian vein was smaller (6±2mm versus 8±3mm, P <0.04). Conclusion The present US study shows that visualisation of the axillary vein under US is greater than that for the subclavian vein, mainly due to a better alignment with the long axis of the axillary vein leading to a greater cross-sectional area of the axillary vein. Trial register number NCT01647815.

      PubDate: 2017-02-25T21:13:20Z
      DOI: 10.1016/j.accpm.2016.05.007
       
  • Apnoea after extubation following an inadvertent remifentanil bolus
    • Authors: Arsen Uvelin; Vladimir Vrsajkov; Nada Anđelić; Sanja Vicković; Dunja Mihajlović
      Pages: 69 - 70
      Abstract: Publication date: February 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 1
      Author(s): Arsen Uvelin, Vladimir Vrsajkov, Nada Anđelić, Sanja Vicković, Dunja Mihajlović


      PubDate: 2017-02-25T21:13:20Z
      DOI: 10.1016/j.accpm.2016.07.002
       
  • Pulmonary embolism of cement after knee prosthesis replacement
    • Authors: Patrice Talec; Mélanie Fromentin; Charles-Marc Samama
      Pages: 71 - 72
      Abstract: Publication date: February 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 1
      Author(s): Patrice Talec, Mélanie Fromentin, Charles-Marc Samama


      PubDate: 2017-02-25T21:13:20Z
      DOI: 10.1016/j.accpm.2016.05.011
       
  • Management of direct oral anticoagulants in patients undergoing elective
           surgeries and invasive procedures: Updated guidelines from the French
           Working Group on Perioperative Hemostasis (GIHP) – September 2015
    • Authors: Pierre Albaladejo; Fanny Bonhomme; Normand Blais; Jean-Philippe Collet; David Faraoni; Pierre Fontana; Anne Godier; Juan Llau; Dan Longrois; Emmanuel Marret; Patrick Mismetti; Nadia Rosencher; Stéphanie Roullet; Charles-Marc Samama; Jean-François Schved; Pierre Sié; Annick Steib; Sophie Susen
      Pages: 73 - 76
      Abstract: Publication date: February 2017
      Source:Anaesthesia Critical Care & Pain Medicine, Volume 36, Issue 1
      Author(s): Pierre Albaladejo, Fanny Bonhomme, Normand Blais, Jean-Philippe Collet, David Faraoni, Pierre Fontana, Anne Godier, Juan Llau, Dan Longrois, Emmanuel Marret, Patrick Mismetti, Nadia Rosencher, Stéphanie Roullet, Charles-Marc Samama, Jean-François Schved, Pierre Sié, Annick Steib, Sophie Susen
      Since 2011, data on patients exposed to direct oral anticoagulants (DOAs) while undergoing invasive procedures have accumulated. At the same time, an increased hemorrhagic risk during perioperative bridging anticoagulation without thrombotic risk reduction has been demonstrated. This has led the GIHP to update their guidelines published in 2011. For scheduled procedures at low bleeding risk, it is suggested that patients interrupt DOAs the night before irrespective of type of drug and to resume therapy six hours or more after the end of the invasive procedure. For invasive procedures at high bleeding risk, it is suggested to interrupt rivaroxaban, apixaban and edoxaban three days before. Dabigatran should be interrupted according to the renal function, four days and five days if creatinine clearance is higher than 50mL/min and between 30 and 50mL/min, respectively. For invasive procedures at very high bleeding risk such as intracranial neurosurgery or neuraxial anesthesia, longer interruption times are suggested. Finally, bridging with parenteral anticoagulation and measurement of DOA concentrations can no longer routinely be used.

      PubDate: 2017-02-25T21:13:20Z
      DOI: 10.1016/j.accpm.2016.09.002
       
  • A pilot study of mechanical chest compression with the LifeLine ARM device
           during simulated cardiopulmonary resuscitation: Reply
    • Authors: Jean Cotte
      Abstract: Publication date: Available online 17 April 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Jean Cotte


      PubDate: 2017-04-21T14:58:48Z
      DOI: 10.1016/j.accpm.2017.04.005
       
  • The clinical impact and prevalence of emergency point-of-care ultrasound:
           a prospective multicentre study
    • Authors: Xavier Bobbia; Laurent Zieleskiewicz Christophe Pradeilles Hudson Laurent Muller Pierre
      Abstract: Publication date: Available online 13 April 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      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 centres. 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: 2017-04-13T14:28:00Z
       
  • Video-laryngoscopes for intubation in paediatrics: is a better view makes
           everything?
    • Authors: Souhayl Dahmani
      Abstract: Publication date: Available online 13 April 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Souhayl Dahmani


      PubDate: 2017-04-13T14:28:00Z
       
  • Preventing Medication Errors in Anesthesia and Critical Care (abbreviated
           version)
    • Authors: Vincent Piriou; Alexandre Theissen; Ségolène Arzalier-Daret; Marie Marcel; Pierre Trouiller; Stéphanie Parat; Catherine Stamm; Rémy Collomp
      Abstract: Publication date: Available online 10 April 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Vincent Piriou, Alexandre Theissen, Ségolène Arzalier-Daret, Marie Marcel, Pierre Trouiller, Stéphanie Parat, Catherine Stamm, Rémy Collomp


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

      PubDate: 2017-04-13T14:28:00Z
      DOI: 10.1016/j.accpm.2017.04.003
       
  • 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
      Abstract: Publication date: Available online 29 March 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      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: 2017-04-13T14:28:00Z
      DOI: 10.1016/j.accpm.2017.02.003
       
  • Perioperative use of gabapentinoids in France
    • Authors: Valéria Martinez; Michel Carles; Emmanuel Marret; Hélène Beloeil
      Abstract: Publication date: Available online 28 March 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Valéria Martinez, Michel Carles, Emmanuel Marret, Hélène Beloeil
      Background Gabapentinoids have governmental health agency approval for “chronic neuropathic pain.” Over the last decade, however, the perioperative prescription of gabapentinoids has become more popular among anaesthesiologists due to their anxiolytic and antihyperalgesic proprieties, despite weak scientific evidence supporting the risk/benefit ratio for this indication. Methods Our aim was to extensively describe the use of perioperative gabapentinoids by French anaesthesiologists. An online questionnaire was sent to the French Society of Anaesthesiology members. The questionnaire, focusing on gabapentinoid prescriptions, included questions on demographic data, patient conditions and types of surgeries, mode of prescription, motives, and presumed side effects (dizziness, confusion, desaturation and visual disorders). Results 508 questionnaires were analysed, among which 70 % reported gabapentinoid use. Twenty five per cent of prescribers stated using gabapentinoids in all types of surgeries, 30 % in outpatient surgeries and 46 % in combination with regional anaesthesia. In 66 % of the cases, preoperative and postoperative prescriptions were combined. Sedation, dizziness and visual disturbance were expected side effects according to 68 %, 45 % and 20 % of anaesthesiologists, respectively. Reported reasons in favour of gabapentinoid prescription were prevention of chronic pain (93 %), expected high postoperative acute pain, i.e. painful surgeries (91 %), a history of chronic pain (72 %), and patient opioid dependence (72 %). Discussion French Anaesthesiologists have recently included gabapentinoids in the multimodal management of postoperative pain but they are unaware of certain frequent side-effects. Moreover, their expectations about the prevention of chronic pain are not validated. Our survey is a call to moderate the systematic prescription of these drugs in the perioperative period.

      PubDate: 2017-04-13T14:28:00Z
      DOI: 10.1016/j.accpm.2017.01.010
       
  • ULTRASOUND GUIDED SERRATUS PLANE BLOCK FOR MANAGEMENT OF ACUTE THORACIC
           HERPES ZOSTER
    • Authors: Ahiskalioglu Ali; Alici Haci Ahmet; Yayik Ahmet Murat; Celik Mine; Oral Ahiskalioglu Elif
      Abstract: Publication date: Available online 21 March 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Ahiskalioglu Ali, Alici Haci Ahmet, Yayik Ahmet Murat, Celik Mine, Oral Ahiskalioglu Elif


      PubDate: 2017-04-13T14:28:00Z
      DOI: 10.1016/j.accpm.2017.01.008
       
  • Comparison of the McGrath® MAC video laryngoscope with direct Macintosh
           laryngoscopy for novice laryngoscopists in children without difficult
           intubation: a randomized 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
      Abstract: Publication date: Available online 18 March 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      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 42 s (35-50) versus 48 s (43-58; P = 0.002). The Time To Best View was similar between the two groups (10 s (7-16) versus 10 s (8-15); P = 0.50). The Tube Passage Time was shorter with DL (29 s (25-35) versus 35 s (30-45); P = 0.0002) and boyj Cormack & 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: 2017-04-13T14:28:00Z
      DOI: 10.1016/j.accpm.2017.02.007
       
  • Hypercarbia complicating endoscopic sphincterotomy
    • Authors: Marc- E Gentili; Aurélien Colleu; Sébastien Lemière; Jean-Robert Robert
      Abstract: Publication date: Available online 18 March 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Marc- E Gentili, Aurélien Colleu, Sébastien Lemière, Jean-Robert Robert


      PubDate: 2017-04-13T14:28:00Z
      DOI: 10.1016/j.accpm.2017.01.009
       
  • Is a two-tiered prehospital response system which engages an emergency
           physician relevant for less emergent patients? Preliminary data from an
           observational study with the Paris Fire Brigade
    • Authors: Olga Maurin; Daniel Jost; Paola Vanhaecke; François-Valéry Viard; Olivier YAVARI-SARTAKHTI
      Abstract: Publication date: Available online 18 March 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Olga Maurin, Daniel Jost, Paola Vanhaecke, François-Valéry Viard, Olivier YAVARI-SARTAKHTI


      PubDate: 2017-04-13T14:28:00Z
      DOI: 10.1016/j.accpm.2017.02.005
       
  • 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-Etienne Bazin; Vincent Sapin; Laurence Roszyk; Bruno Pereira; Jean-Michel Constantin
      Abstract: Publication date: Available online 18 March 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Matthieu Jabaudon, Thomas Godet, Emmanuel Futier, Jean-Etienne 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: 2017-04-13T14:28:00Z
      DOI: 10.1016/j.accpm.2017.02.006
       
  • Burnout among French anaesthetists and intensivists: adequate progress is
           still lacking
    • Authors: Georges Mion; Kani Boiguile; Annick Bidou; Marion Limare
      Abstract: Publication date: Available online 11 March 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Georges Mion, Kani Boiguile, Annick Bidou, Marion Limare


      PubDate: 2017-03-13T02:49:05Z
      DOI: 10.1016/j.accpm.2017.02.004
       
  • A pilot study of mechanical chest compression with the LifeLine ARM device
           during simulated cardiopulmonary resuscitation
    • Authors: Jolanta MAJER; Jaroslaw KEDZIORA; Marcin MADZIAŁA
      Abstract: Publication date: Available online 11 March 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Jolanta MAJER, Jaroslaw KEDZIORA, Marcin MADZIAŁA


      PubDate: 2017-03-13T02:49:05Z
      DOI: 10.1016/j.accpm.2017.01.007
       
  • Guidelines on smoking management during the perioperative period
    • Authors: Sébastien Pierre; Caroline Rivera; Béatrice Le Maitre; Anne-Marie Ruppert; Benoît Chaput; Hervé Bouaziz; Nathalie Wirth; Jacques Saboye; Alain Sautet; Alain Charles Masquelet; Jean-Jacques Tournier; Yves Martinet; Bertrand Dureuil
      Abstract: Publication date: Available online 24 February 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Sébastien Pierre, Caroline Rivera, Béatrice Le Maitre, Anne-Marie Ruppert, Benoît Chaput, Hervé Bouaziz, Nathalie Wirth, Jacques Saboye, Alain Sautet, Alain Charles Masquelet, Jean-Jacques Tournier, Yves Martinet, Bertrand Dureuil


      PubDate: 2017-02-25T21:13:20Z
      DOI: 10.1016/j.accpm.2017.02.002
       
  • A special article following the relicence of aprotinin injection in Europe
    • Authors: David ROYSTON; Stefan De Hert; Jan van der Linden; Alexandre OUATTARA; Kai Zacharowski
      Abstract: Publication date: Available online 13 February 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): David ROYSTON, Stefan De Hert, Jan van der Linden, Alexandre OUATTARA, Kai Zacharowski


      PubDate: 2017-02-19T16:59:02Z
      DOI: 10.1016/j.accpm.2017.02.001
       
  • Saving money: an ideal driver for improved perioperative care?
    • Authors: T E F Abbott; R M Pearse
      Abstract: Publication date: Available online 30 January 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): T E F Abbott, R M Pearse


      PubDate: 2017-02-01T16:51:09Z
      DOI: 10.1016/j.accpm.2017.01.006
       
  • Neonatal and maternal Outcomes of pRegnancy with MAterNal cardiac Disease
           (the NORMANDY study): Years 2000-2014
    • Authors: Vincent Bonnet; Thérèse Simonet; Fabien Labombarda; Patricia Dolley; Paul Milliez; Michel Dreyfus; Jean-Luc Hanouz
      Abstract: Publication date: Available online 30 January 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Vincent Bonnet, Thérèse Simonet, Fabien Labombarda, Patricia Dolley, Paul Milliez, Michel Dreyfus, Jean-Luc Hanouz
      Pregnancies complicated by congenital or acquired heart diseases are at high risk of maternal, obstetrical and neonatal poor outcomes. During the period 2000-2014, 197 pregnancies occurring in 147 women with heart disease were managed in our institution. A maternal cardiac event complicated 13 pregnancies. Obstetrical and neonatal complications occurred respectively in 35.0 % (95 % CI [28.3 - 41.7]) and 37.0 % (95 % CI [30.3 - 43.7]) of pregnancies. All complications were more frequent amongst cardiomyopathies or obstructive and conotruncal lesions, whereas left-to-right shunts were less prone to present with complications. Complications occurred between the end of the second trimester and the middle of the third trimester or during the post-partum period. Caesarean section was the mode of delivery in 37 % (95 % CI [30.3 - 43.7]) of cases, and general anaesthesia was performed in 8.6 % of cases (95 % CI [4.7 - 12.5]). Although reporting relatively mild heart diseases, this retrospective study shows an evolution in the management of pregnancies complicated by cardiopathies. Vaginal delivery under loco-regional anaesthesia can be achieved in many pregnancies, whereas others require strict multi-disciplinary follow-up in a specialized centre. The creation of a large, multi-centric registry might help improve and personalize the management of these high-risk pregnancies.

      PubDate: 2017-02-01T16:51:09Z
      DOI: 10.1016/j.accpm.2017.01.005
       
  • Formalized Expert Recommendations Chest Trauma: First 48hours management
    • Authors: Pierre Bouzat; Mathieu Raux; Jean Stéphane David; Karim Tazarourte; Michel Galinski; Thibault Desmettre; Delphine Garrigue; Laurent Ducros; Pierre Michelet
      Abstract: Publication date: Available online 16 January 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Pierre Bouzat, Mathieu Raux, Jean Stéphane David, Karim Tazarourte, Michel Galinski, Thibault Desmettre, Delphine Garrigue, Laurent Ducros, Pierre Michelet
      Chest Trauma remains an issue for health services for both severe and apparently mild trauma management. Severe chest trauma is associated with high mortality and is considered liable for 25% of mortality in multiple traumas. Moreover, mild trauma is also associated with significant morbidity especially in patients with preexisting conditions. Thus, whatever the severity, a fast-acting strategy must be organized. At this time there are no guidelines available from scientific societies. These expert recommendations aim to establish guidelines for chest trauma management in both pre hospital an in hospital settings, for the first 48hours. The « Société Française d’Anesthésie Réanimation » and the « Société Française de Médecine d’Urgence » worked together on the 7 following questions: • Criteria defining severity and for appropriate hospital referral. • Diagnosis strategy in both pre and in hospital settings. • Indications and guidelines for ventilatory support • Management of analgesia • Indications and guidelines for chest tube placement • Surgical and endovascular repair indications in Blunt chest trauma. • Definition, medical and surgical specificity of penetrating chest trauma For each question, prespecified « crucial » (and sometimes also « important ») outcomes were identified by the panel of experts because it mattered for patients. We rated evidence across studies for these specific clinical outcomes. After a systematic GRADE® approach, we defined 60 recommendations. Each recommendation has been evaluated by all the experts according to the DELPHI method.

      PubDate: 2017-01-17T18:00:43Z
      DOI: 10.1016/j.accpm.2017.01.003
       
  • Combat Casualty Care improvement: a quality process
    • Authors: Jean-Pierre Tourtier
      Abstract: Publication date: Available online 16 January 2017
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Jean-Pierre Tourtier


      PubDate: 2017-01-17T18:00:43Z
      DOI: 10.1016/j.accpm.2017.01.002
       
  • Epidural anaesthesia for caesarean section in pituitary dwarfism
    • Authors: Riuhua Li; Hongbo Li; Bao Lang
      Abstract: Publication date: Available online 22 December 2016
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Riuhua Li, Hongbo Li, Bao Lang
      We describe the anaesthetic management for caesarean section in a 32-year-old patient with pituitary dwarfism. In addition to supportive treatment, we offered a postoperative epidural analgesia pump. The patient recovered well without any complications.

      PubDate: 2016-12-23T15:54:56Z
      DOI: 10.1016/j.accpm.2016.02.010
       
  • The learners’ stress during high fidelity simulation
    • Authors: Issam Tanoubi
      Abstract: Publication date: Available online 18 December 2016
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Issam Tanoubi


      PubDate: 2016-12-23T15:54:56Z
      DOI: 10.1016/j.accpm.2016.12.003
       
  • Are we missing dextropropoxyphene'
    • Authors: Dominique Fletcher
      Abstract: Publication date: Available online 8 December 2016
      Source:Anaesthesia Critical Care & Pain Medicine
      Author(s): Dominique Fletcher


      PubDate: 2016-12-15T15:03:29Z
       
 
 
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