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Anaesthesia, Critical Care & Pain Medicine

Helene Beloeil, Karem Slim, The Francophone Group Of Enhanced Recovery After Surgery
BACKGROUND: Sustainability of ERP is a challenge and data are scarce on the subject. The aim of this study was to assess if application of enhanced recovery elements through the Francophone Group of Enhanced Recovery after Surgery (Grace) in the anaesthesia management was sustainable 2 years after its implementation. MATERIALS AND METHODS: We conducted a retrospective analysis of the prospective Grace database between October 2014 and October 2016. The evolution of each recommendation item over time was analysed using non-parametric Spearman correlation coefficient...
February 15, 2018: Anaesthesia, Critical Care & Pain Medicine
Joshua B Knight, Evan E Lebovitz, Theresa A Gelzinis, Ibtesam A Hilmi
INTRODUCTION: The purpose of this retrospective case-control study was to investigate preoperative risk factors for unexpected postoperative intensive care unit (ICU) admissions in patients undergoing non-emergent surgical procedures in a tertiary medical centre. METHODS: A medical record review of adult patients undergoing elective non-cardiac and non-transplant major surgical procedures during the period of January 2011 through December 2015 in the operating rooms of a large university hospital was carried out...
February 15, 2018: Anaesthesia, Critical Care & Pain Medicine
Charles Marc Samama, Dan Benhamou, Frédéric Aubrun, Jean-Luc Bosson, Pierre Albaladejo
BACKGROUND: Venous thromboembolism (VTE) prophylaxis is not always part of the usual care of ambulatory surgery patients, and few guidelines are available. OBJECTIVES: To collect data on the application of VTE prophylaxis in ambulatory patients. DESIGN: The OPERA study is a large national survey performed in 221 healthcare facilities. PATIENTS: 2174 patients who underwent one of ten selected procedures over two pre-defined days of investigation...
February 15, 2018: Anaesthesia, Critical Care & Pain Medicine
Sebastien Perbet, Daniel Bourdeaux, Alexandre Lenoire, Claire Biboulet, Bruno Pereira, Malha Sadoune, Benoit Plaud, Jean-Marie Launay, Jean-Etienne Bazin, Valerie Sautou, Alexandre Mebazaa, Pascal Houze, Jean-Michel Constantin, Matthieu Legrand
BACKGROUND: Sevoflurane has anti-inflammatory proprieties and short lasting effects making it of interest for procedural sedation in critically ill patients. We evaluated the pharmacokinetics of sevoflurane and metabolites in severely ill burn patients and controls. The secondary objective was to assess potential kidney injury. METHODS: prospective interventional study in a burn and a surgical intensive care unit 24 mechanically ventilated critically ill patients (12 burns, 12 controls) were included,...
February 15, 2018: Anaesthesia, Critical Care & Pain Medicine
Ming-Ming Han, Fu-Shan Xue, Fang Kang, Xiang Huang, Juan Li
OBJECTIVE: The supraglottic airway device (SAD) can be used for airway management of spontaneous breathing patients, and propofol is commonly applied for the SAD placement. This study was designed to assess the effect of gender on median target effect-site concentration (Ce 50 ) of propofol for I-gel placement when combined with dexmedetomidine. MATERIAL AND METHOD: 19 males and 18 females, aged 18 to 59 and undergoing elective surgery, were enrolled. After intravenous infusion of dexmedetomidine 1...
February 13, 2018: Anaesthesia, Critical Care & Pain Medicine
Sevim Cesur, Ayse Nur Ay, Murat Yayik, M Emin Naldan, Yavuz Gurkan
No abstract text is available yet for this article.
February 13, 2018: Anaesthesia, Critical Care & Pain Medicine
Michael J Romano, Jacques S Lee, Jordan Chenkin
PURPOSE: Ultrasound has been shown to be a highly accurate adjunct for confirming endotracheal tube (ETT) placement, however there is no universally accepted scanning technique. The objective of this study was to determine which ultrasound technique provides the highest rate of adequate airway visualisation in a sample of stable emergency department (ED) patients. METHODS: We conducted a prospective observational study using a convenience sample of ED patients. Airway imaging was performed using the following five techniques: 1) transcricothryoid membrane (TCM), 2) suprasternal notch (SSN) without transducer pressure, 3) SSN with pressure, 4) SSN with pressure to the left of the trachea and 5) SSN with pressure to the right of the trachea...
February 4, 2018: Anaesthesia, Critical Care & Pain Medicine
Fabien Espitalier, Sabine De Lamer, Mathilde Barbaz, Marc Laffon, Francis Remérand
OBJECTIVES: The medical information on the Internet is better in English than in other languages. The information about Epidural Analgesia In Labour (EAIL) available on French-speaking websites is of poor quality. The quality of the information about EAIL should be better in English, but there is no comparison available. This study has assessed and compared the quality of the information about EAIL available on French and English-speaking websites. METHOD: Keywords "epidural", "épidurale" and/or "péridurale" were used in the French, Canadian and American Google® and Yahoo® search engines...
January 31, 2018: Anaesthesia, Critical Care & Pain Medicine
Stéphanie Roullet, Emmanuel de Maistre, Brigitte Ickx, Normand Blais, Sophie Susen, David Faraoni, Delphine Garrigue, Fanny Bonhomme, Anne Godier, Dominique Lasne
PURPOSE: Viscoelastic tests (VETs), thromboelastography (TEG®) and thromboelastometry (ROTEM®) are global tests of coagulation performed on whole blood. They evaluate the mechanical strength of a clot as it builds and develops after coagulation itself. The time required to obtain haemostasis results remains a major problem for clinicians dealing with bleeding, although some teams have developed a rapid laboratory response strategy. Indeed, the value of rapid point-of-care diagnostic devices such as VETs has increased over the years...
January 17, 2018: Anaesthesia, Critical Care & Pain Medicine
Xue Fu-Shan, Liu Ya-Yang, Li Hui-Xian, Yang Gui-Zhen
The major complications of paediatric airway management are uncommon, but the outcomes are often severe. Over the last decade, additions and advancements in the devices and technology have significantly improved our ability to manage difficult paediatric airways safely. Videolaryngoscopy involves the use of video and optical technology to facilitate indirect visualisation of the larynx during intubation and has been seen as an evolutionary step in intubation technology. Over the past few years, video laryngoscopes have been receiving plenty of attention as new airway devices for use in paediatric patients...
January 10, 2018: Anaesthesia, Critical Care & Pain Medicine
Cheisson Gaëlle, Jacqueminet Sophie, Cosson Emmanuel, Ichai Carole, Leguerrier Anne-Marie, Nicolescu-Catargi Bogdan, Ouattara Alexandre, Tauveron Igor, Valensi Paul, Benhamou Dan
A patient should be referred to a diabetologist perioperatively in several circumstances: preoperative recognition of a previously unknown diabetes or detection of glycaemic imbalance (HbA1c <5% or >8%); during hospitalisation, recognition of a previously unknown diabetes, persisting glycaemic imbalance despite treatment or difficulty resuming previously used chronic treatment; postoperatively and after discharge from hospital, for all diabetic patients in whom HbA1c is >8%.
January 6, 2018: Anaesthesia, Critical Care & Pain Medicine
Charlotte Beaucreux, Benoît Vivien, Ethan Miles, Sylvain Ausset, Pierre Pasquier
INTRODUCTION: The effectiveness of a tourniquet (TQ) in case of extremity haemorrhages is well recognised to prevent deaths on the battlefield. However, little is known about the usefulness of TQ in civilian trauma settings, including terrorist attack situations. The aim of this systematic review was to analyse the evidence-based medical literature in order to precise the use of TQ in the management of extremity haemorrhages in civilian setting. METHODS: Analysis of all studies published until 12/31/2016 on the Embase, Medline and Opengrey databases...
January 5, 2018: Anaesthesia, Critical Care & Pain Medicine
Antonia Blanié, Sophie Gorse, Philippe Roulleau, Samy Figueiredo, Dan Benhamou
AIM: The increasing use of high-fidelity simulation is limited by the imbalance between the growing number of students and the human resources available in such a way that all residents cannot play a role during scenarios. The learning outcomes of observers need to be studied. METHODS: This prospective randomised study was approved by the institutional review board. Anaesthesia residents attending a one-day training session were enrolled. In each of the four scenarios, three residents played an active role while others observed in a separate room...
January 5, 2018: Anaesthesia, Critical Care & Pain Medicine
Anne Godier, Pierre Fontana, Serge Motte, Annick Steib, Fanny Bonhomme, Sylvie Schlumberger, Thomas Lecompte, Nadia Rosencher, Sophie Susen, André Vincentelli, Yves Gruel, Pierre Albaladejo, Jean-Philippe Collet
The French Working Group on Perioperative Hemostasis (GIHP) and the French Study Group on Hemostasis and Thrombosis (GFHT) in collaboration with the French Society for Anesthesia and Intensive Care (SFAR) drafted up-to-date proposals for the management of antiplatelet therapy in patients undergoing elective invasive procedures. The proposals were discussed and validated by a vote; all proposals but one could be assigned with a high strength. The management of antiplatelet therapy is based on their indication and the procedure...
January 5, 2018: Anaesthesia, Critical Care & Pain Medicine
Hans-Joachim Priebe
No abstract text is available yet for this article.
January 5, 2018: Anaesthesia, Critical Care & Pain Medicine
Cédric Nguyen, Quentin Mathais, Mickael Cardinale, Christophe Drouin, Bertrand Prunet, Eric Meaudre
No abstract text is available yet for this article.
January 4, 2018: Anaesthesia, Critical Care & Pain Medicine
Agnès Le Gouez, Marie-Pierre Bonnet, Thomas Leclerc, Jean-Xavier Mazoit, Dan Benhamou, Frédéric J Mercier
BACKGROUND: A comparison of the effective dose in 50% of patients (ED50) has suggested that the potency of levobupivacaine lies between that of bupivacaine and ropivacaine. However, for clinical purposes, knowledge and use of doses close to the ED95 are more relevant. This study was designed to determine the EC80 (effective concentration) for both epidural levobupivacaine and ropivacaine using the continual reassessment method (CRM) during obstetric analgesia. METHODS: In this double blind randomised study, term parturients were included by cohorts of 6 if cervical dilatation was ≤ 5cm and visual analogue pain score (VAPS) > 30mm...
December 30, 2017: Anaesthesia, Critical Care & Pain Medicine
Thomas Geeraerts, Lionel Velly, Lamine Abdennour, Karim Asehnoune, Gérard Audibert, Pierre Bouzat, Nicolas Bruder, Romain Carrillon, Vincent Cottenceau, François Cotton, Sonia Courtil-Teyssedre, Claire Dahyot-Fizelier, Frédéric Dailler, Jean-Stéphane David, Nicolas Engrand, Dominique Fletcher, Gilles Francony, Laurent Gergelé, Carole Ichai, Etienne Javouhey, Pierre-Etienne Leblanc, Thomas Lieutaud, Philippe Meyer, Sébastien Mirek, Gilles Orliaguet, François Proust, Hervé Quintard, Catherine Ract, Mohamed Srairi, Karim Tazarourte, Bernard Vigué, Jean-François Payen
The latest French Guidelines for the management in the first 24hours of patients with severe traumatic brain injury (TBI) were published in 1998. Due to recent changes (intracerebral monitoring, cerebral perfusion pressure management, treatment of raised intracranial pressure), an update was required. Our objective has been to specify the significant developments since 1998. These guidelines were conducted by a group of experts for the French Society of Anesthesia and Intensive Care Medicine (Société Francaise d'Anesthésie Réanimation (SFAR)) in partnership with the Association de Neuro-Anesthésie-Réanimation de Langue Française (ANARLF), the Société Française de Neurochirurgie (SFN), the Groupe Francophone de Réanimation et d'Urgences Pédiatriques (GFRUP) and the Association des Anesthésistes-Réanimateurs Pédiatriques d'Expression Française (ADARPEF)...
December 27, 2017: Anaesthesia, Critical Care & Pain Medicine
Mathieu Boutonnet, Sylvain Ausset
No abstract text is available yet for this article.
December 22, 2017: Anaesthesia, Critical Care & Pain Medicine
Nicolas Mongardon, Quentin De Roux, Simon Clariot
No abstract text is available yet for this article.
December 19, 2017: Anaesthesia, Critical Care & Pain Medicine
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