Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Sep 2014
Observational Study[Observational study on outpatient sleeve gastrectomy.]
The development of outpatient surgery is one of the major goals of the public health policy in 2010. The purpose of this observational study is to evaluate the feasibility of the laparoscopic sleeve gastrectomy (LSG) in ambulatory. ⋯ The laparoscopic sleeve gastrectomy in ambulatory is feasible with a dedicated anesthesiological concept in an expert surgical team. Appropriate patient selection is important in order to secure safety and quality of care within outpatient program. The risk versus benefit must be adequately evaluated on an individual basis.
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Ann Fr Anesth Reanim · Sep 2014
Review[Argatroban, a new antithrombotic treatment for heparin-induced thrombocytopenia application in cardiac surgery and in intensive care.]
Although heparin-induced thrombocytopemia (HIT) is uncommon, its thromboembolic complications are potentially life-threatening. The low-molecular weight heparins are less responsible of HIT than unfractionated heparin (UFH) but this latter is still indicated in some circumstances such as cardiac surgery. Argatroban, a selective thrombin inhibitor, recently available, has been indicated in HIT treatment. This review presents the main pharmacological characteristics, its indications and uses in the context of cardiac surgery and in intensive care medicine. ⋯ Argatroban is a new direct competitive thrombin inhibitor well evaluated as treatment of HIT after cardiac surgery. In HIT management, argatroban is an interesting alternative to lepirudin that is not anymore available and danaparoid because of supply disturbances.
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Ann Fr Anesth Reanim · Sep 2014
Observational Study[Iatrogenic events: A significant cause of admission in intensive care units.]
Identification and analysis of iatrogenic events leading to admission in intensive care units. ⋯ Iatrogenic event is a significant cause of ICU admission, involved in 12% of all the hospitalizations in our unit. It has an impact on the patient's profile (significantly older) and their ICU stay (increased need for transfusion). More than a third of events could be preventable and potentially accessible to corrective actions.