Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Dec 2011
Review[From iatrogenesis to medical errors: review of the literature and analytical approach].
Iatrogenesis and medical errors have been increasingly studied over the past years. Because of the lack of consensus concerning the definitions, it remains difficult to draw general conclusions from the published. Moreover, it is still likely to be underestimated because of underreporting. This review aims at evaluating the overall incidence of iatrogenesis and medical errors in anaesthesia and intensive care and at discussing the strategies to prevent these incidents, at the individual or systemic level.
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Ann Fr Anesth Reanim · Dec 2011
[Reliability of the pulse contour analysis for cardiac output measurement for assessing the fluid responsiveness].
The cardiac output (CO) is classically measured in intensive care unit patients. pulse contour (PC) method allows monitoring of CO. ⋯ In ICU patients with shock, PC cannot replace thermodilution to diagnose fluid responsiveness.
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To assess family satisfaction in the intensive care unit (ICU) and to identify parameters for improvement. ⋯ Quality of family reception in the ICU needs to be improved concerning waiting time, visiting hours, social and emotional support.
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Ann Fr Anesth Reanim · Dec 2011
[Morbidity and mortality conferences in anaesthesia and intensive care: experience feedback from Nancy university hospital].
Assessment of the morbidity mortality conferences (MMC) durableness in the Anaesthesiology and Surgical Intensive Care Department of the Urban Hospitals of Nancy University Hospital; evaluation of the proportion of medical education in the corrective actions implemented, and research for improvement ways. ⋯ The development process of a culture of the safety has been initiated and perpetuated. Some ways of improvement have been proposed: MMC must certainly be widened as well regarding to the categories of addressees, as the topics (any event deemed to be noteworthy for the safety of care) or the time scale of the analysis. Others propositions: preparation of the presentations with a colleague experienced in MMC; participation of external MMC experts; monitoring of local markers of security of care and of corrective measures efficiency; inclusion of MMC cases presentation in the trainees pedagogic objectives.
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Ann Fr Anesth Reanim · Dec 2011
Case Reports[Cerebral amyloid angiopathy is difficult to diagnose in the intensive care unit].
Cerebral amyloid angiopathy is a common cause of intracerebral haemorrhage in elderly patients. The diagnosis of cerebral amyloid angiopathy is based on the Boston criteria combining clinical and radiological criteria with no other cause of intracerebral haemorrhage. ⋯ Typical cerebral microbleeds using MRI and the absence of other cause of intracerebral haemorrhage argued in favour of the diagnosis of cerebral amyloid angiopathy. The patient outcome was favourable with a discharge from the intensive care unit on day 16.