Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Oct 2012
Case Reports[About safety parameters for patient-controlled analgesia (PCA) devices].
During the course of preparation of an opioid prescription, the nurse in charge became aware that the patient-controlled analgesia (PCA) syringe driver did not permit programming for the delivery as required: a maximum bolus number (Bmax) was indicated but only a maximum cumulative dose (Dcmax) could be programmed. The prescription dose criteria were consistent with the guidelines of the French societies of palliative care, anesthesiology, and reanimation (Société française d'accompagnement et de soins palliatifs [Sfap] and Société française d'anesthésie réanimation [Sfar]). A Dcmax dose simulation was programmed and used in order to test this problem. ⋯ Most of the syringe driver devices are configured for the Dcmax, but not all of them, and the physician is often forced to use the parameter of the available device restricting the choice between Bmax and Dcmax. This is not justified, whether by scientific evidence, industrial, manufacturing or commercial standards. It becomes only a technical option that does not promote standardization of dose delivery and compromises the main safety feature of PCA.
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Ann Fr Anesth Reanim · Oct 2012
Clinical Trial[Changes in kaliemia following rapid sequence induction with succinylcholine in critically ill patients].
Evaluate the changes in potassium following rapid sequence induction with succinylcholine in critically ill-patients and determine whether hospital length of stay could influence the succinylcholine-induced hyperkaliemia. ⋯ Induction with succinylcholine is followed by significant but transient hyperkaliema. The ICU length of stay before giving succinylcholine could influence significantly the amplitude of potassium increase.
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Ann Fr Anesth Reanim · Oct 2012
[Economic and clinical impact of a controlled sedation procedure in an intensive care unit].
Since the last consensus conducted by Sfar/SRLF, the use of protocol for sedation became the reference in our ICUs. Decrease in length of stay and length of mechanical ventilation with used of these protocols have been already described. We would like to investigate the economic impact associated. ⋯ We confirm in this study that use of sedation protocol in ICU is associated with a clinical impact but also with an economic effect.