Anaesthesia, critical care & pain medicine
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Anaesth Crit Care Pain Med · Feb 2018
The use of a checklist improves anaesthesiologists' technical and non-technical performance for simulated malignant hyperthermia management.
Anaesthesiologists may occasionally manage life-threatening operating room (OR) emergencies. Managing OR emergencies implies real-time analysis of often complicated situations, prompt medical knowledge retrieval, coordinated teamwork and effective decision making in stressful settings. Checklists are recommended to improve performance and reduce the risk of medical errors. This study aimed to assess the usefulness of the French Society of Anaesthesia and Intensive Care's (SFAR) "Malignant Hyperthermia" (MH) checklist on a simulated episode of MH crisis and management thereof by registered anesthesiologists. ⋯ Registered anaesthesiologists' use of the MH checklist during a simulation session widely improved their adherence to guidelines and non-technical skills. This study strongly suggests the benefit of checklist tools for emergency management. Notwithstanding, better awareness and training for anaesthesiologists could further improve the use of this tool.
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Anaesth Crit Care Pain Med · Feb 2018
Observational StudyAssociation between augmented renal clearance and clinical failure of antibiotic treatment in brain-injured patients with ventilator-acquired pneumonia: A preliminary study.
This preliminary study aimed to determine whether augmented renal clearance (ARC) impacts negatively on the clinical outcome in traumatic brain-injured patients (TBI) treated for a first episode of ventilator-acquired pneumonia (VAP). ⋯ ARC was associated with recurrent infection after a first episode of VAP in TBI patients. The optimal administration and dosing of the antimicrobial agents in this context remain to be determined.
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Anaesth Crit Care Pain Med · Feb 2018
Dental injury associated with anaesthesia: An 8-year database analysis of 592 claims from a major French insurance company.
Dental injury is the most common incident associated with anaesthesia. Regarding recent recommendations on informed consent and changes in airway management practices, a large series of claims related to dental injury has not been recently described. The aim of this study was to analyse a recent database in order to describe the characteristics of dental injury in France. ⋯ Dental injury remains the most common anaesthesia-related claim. Dental examination and documentation in patient medical files requires improvement and better informed consent on dental injury risk needs to be provided to patients.
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Anaesth Crit Care Pain Med · Feb 2018
Forced vital capacity assessment for risk stratification of blunt chest trauma patients in emergency settings: A preliminary study.
The aim of this study was to assess the performance of Forced Vital Capacity (FVC) for prediction of secondary respiratory complications in blunt chest trauma patients. ⋯ The non-improvement of FVC≤50% at emergency discharge is associated with secondary respiratory complications and should prevent the under-triage of patients with no sign of respiratory failure at admission.
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Anaesth Crit Care Pain Med · Feb 2018
Perioperative use of gabapentinoids in France. Mismatch between clinical practice and scientific evidence.
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. ⋯ 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.