ANESTHESIOLOGIE REANIMATION HAITI (HUEH)

18 JUIN 2011 - 18 JUIN 2014

AUJOURD'HUI LE RESEAU ANESTHESIOLOGIE HUEH/HAITI FETE SES 3 ANS. MERCI DE VOTRE SOUTIEN   ANESTHESIOLOGIE HUEH/HAITI C'EST  1 BLOG                              :  http://sarhueh.blogspot.com ( 47708 pages vues  -  291 articles ,) 1 COMPTE FACEBOOK :  https://www.facebook.com/anesthesiologie.hueh (3500 amis) 4 GROUPES FACEBOOK :  a) Residents et MDS : 27 membres b) SHA & International : 90 membres c) Amis-SAR                 : 394 membres d) Collaborateurs           : 1062 membres 1 COMPTE GOOGLE+    :    google.com/+AnesthesiologieHAITI (107 amis) 2 PAGES COMMUNAUTAIRES FACEBOOK :  a)Anesthesiologie reanimation hueh haiti : https://www.facebook.com/AnesthesiologieReanimationHuehHaiti (1060 j'aime) b)Videolaryngoscopie Haiti :  https://www...

Compartment syndrome (CS) occurs when fascial compartment pressures exceed perfusion pressure, leading to irreversible tissue ischemia and necrosis .While literature emphasizes the acute phase, it is important to note that compartment syndrome exists on a spectrum, ranging from acute to chronic. With careful attention to details such as intraoperative positioning, anesthetic choice, and placement of stockings and splints, orthopedic surgeons have the opportunity to modify risk. The sequelae of compartment syndrome have functional, cosmetic, and legal ramifications. Effective treatment begins with early diagnosis. It is the intent of this article to review common and uncommon causes of compartment syndrome, to highlight the difficulties associated with the identification of patients at risk, and to discuss unique problems surrounding the diagnosis and management of compartment syndrome. Further, we present an algorithm designed to provide a standardized method of patient assessment g...

Ambulatory surgery is becoming increasingly adopted and today more complex procedures and not only ASA 1–2 patients are scheduled to undergo surgery according to a fast track concept. Rapid recovery and resumption of capacity to stand, walk, void, eat and drink is essential for safe discharge. There is, however, an increasing need for better way to assess and measure recovery and outcome after surgery and anaesthesia. Morbidity and unplanned admission are no longer deemed adequate for assessing quality of performance or to use as tool to measure efforts to improve the medical care and or logistics. There are several aspects that should be considered when analysing the recovery process and measuring outcome after ambulatory surgery and anaesthesia. The Postoperative Quality of Recovery scale is a multi-dimensional tool that has been shown to be able to quantify and discriminate the recovery process. This review will provide an overview of recovery and outcome following ambulatory surger...

Recent introduction of new analgesics into the clinic is best described as a slow process with activity classified into two main areas: improving analgesic efficacy/potency and reducing side-effect profile. This review article describes some of the recent advances with an emphasis on use in the acute setting. In this respect, opioids continue to be the mainstay (but not the only) analgesic and there have been important improvements in their clinical effect profile. For example, tapentadol has been introduced as a mixed opioid and norepinephrine uptake inhibitor which, unlike tramadol, does not require metabolic activation and does not suffer from isomer-dependent pharmacodynamics. Opioid antagonists have received much attention recently either used alone, methylnaltrexone (s.c) or alvimopan (p.o), or in combination, Targinact (oxycodone/naloxone), and appear to be effective in reducing opioid side-effects such as those in the gastrointestinal tract. Other agents where there has been re...

DR. GERALD BARTHOLD (R3)     : 2 JUIN DR. SYBILLE MICHEL        (MDS) : 3 JUIN

Background: Research regarding difficult mask ventilation (DMV) combined with difficult laryngoscopy (DL) is extremely limited even though each technique serves as a rescue for one another. Methods: Four tertiary care centers participating in the Multicenter Perioperative Outcomes Group used a consistent structured patient history and airway examination and airway outcome definition. DMV was defined as grade 3 or 4 mask ventilation, and DL was defined as grade 3 or 4 laryngoscopic view or four or more intubation attempts. The primary outcome was DMV combined with DL. Patients with the primary outcome were compared to those without the primary outcome to identify predictors of DMV combined with DL using a non-parsimonious logistic regression. Results: Of 492,239 cases performed at four institutions among adult patients, 176,679 included a documented face mask ventilation and laryngoscopy attempt. Six hundred ninety-eight patients experienced the primary outcome, an overall incidenc...

Objective Nowadays, conventional analgesic agents, which are widely used for pain relief after cesarean section, provide suboptimal analgesia with occasional serious side effects. We designed a randomized, double-blind, placebo-controlled study to evaluate the analgesic efficacy of intrathecal ketamine added to bupivacaine after cesarean section. Methods Sixty patients scheduled for cesarean section under spinal anesthesia were randomly allocated to one of the two groups to receive either bupivacaine 10 mg combined with 0.1 mg/kg ketamine, or bupivacaine 10 mg combined with 0.5 mL distilled water intrathecally. The time to the first analgesic request, analgesic requirement in the first 24 hours after surgery, onset times of sensory and motor blockades, the durations of sensory and motor blockades, and the incidences of adverse effects such as hypotension, ephedrine requirement, bradycardia, and hypoxemia, were recorded. Results Patients who received ketami...

Anaphylactic or Anaphylactoid/Allergic or Non-allergic The European Academy of Allergy and Immunology (EAACI) redefined anaphylaxis as a severe, life-threatening, generalized, or systemic hypersensitivity reaction, sub-divided into 'allergic' and 'non-allergic' reactions. Allergic anaphylaxis has an incidence between 1/5000–1/20 000 with a 3:1 female preponderance. Despite initially increased reporting of adverse events to new drugs (Weber effect), there is generally under reporting to databases (e.g. the UK yellow card system). Anaphylaxis-related mortality is 3–6% and an additional 2% have a poor neurological outcome. [2] Allergic anaphylaxis implies an immunological reaction (IgE, IgG, or complement mediated). Antigen exposure results in mast cell and basophil bound antibody formation. Subsequent antigen exposure causes mast cell degranulation and the release of mediators including histamine, tryptase, leukotrienes, and prostaglandins. In 'non-allergic...

Background:  Factors capable of impacting hospital mortality in patients with septic shock remain uncertain. Our objective was to identify predictors of hospital mortality among patients who received appropriate antimicrobial therapy for bacteremic septic shock after accounting for severity of illness, resuscitation status, and processes of care. Methods:  We conducted a secondary subgroup analysis of a prospective severe sepsis cohort study. Patients with septic shock and positive blood cultures who received appropriate antimicrobial therapy were included. Univariable analyses were used to identify differences between hospital survivors and non-survivors, and a multivariable logistic regression model revealed independent determinants of hospital mortality. Results:  From January 2008 to December 2010, 58 of 224 included patients died in the hospital. Multivariable logistic regression analysis demonstrated 2 independent predictors of hospital mortality. These include...

Factors capable of impacting hospital mortality in patients with septic shock remain uncertain. Our objective was to identify predictors of hospital mortality among patients who received appropriate antimicrobial therapy for bacteremic septic shock after accounting for severity of illness, resuscitation status, and processes of care. >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>SOURCE