Anaesthesia, critical care & pain medicine
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Anaesth Crit Care Pain Med · Apr 2018
Randomized Controlled TrialEffect of sleep deprivation after a night shift duty on simulated crisis management by residents in anaesthesia. A randomised crossover study.
Sleep deprivation has been associated with an increased incidence of medical errors and can jeopardise patients' safety during medical crisis management. The aim of the study was to assess the effect of sleep deprivation on the management of simulated anaesthesia crisis by residents in anaesthesiology. ⋯ The present study showed that sleep deprivation is associated with impairment of performance to manage crisis situations by residents in anaesthesia.
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Anaesth Crit Care Pain Med · Apr 2018
Short-term effects of low-volume resuscitation with hypertonic saline and hydroxyethylstarch in an experimental model of lung contusion and haemorrhagic shock.
This study aimed to assess the short-term respiratory tolerance and haemodynamic efficiency of low-volume resuscitation with hypertonic saline and hydroxyethylstarch (HS/HES) in a pig model of lung contusion and controlled haemorrhagic shock. We hypothesised that a low-volume of HS/HES after haemorrhagic shock did not impact contused lungs in terms of extravascular lung water 3hours after trauma. ⋯ In this pig model of lung contusion, the short-term assessment of fluid resuscitation after haemorrhagic shock with 4ml/kg of HS/HES showed that pulmonary oedema was avoided compared to fluid resuscitation with 10ml/kg of NS.
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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.