Anaesthesia Critical Care & Pain Medicine最新文献

{"title":"Elevating anesthesia standards for adult congenital heart disease patients: Comprehensive guidelines for non-cardiac surgery","authors":"Magalie Ladouceur , Tuan-Chen Aw , Michael A. Gatzoulis","doi":"10.1016/j.accpm.2025.101528","DOIUrl":"10.1016/j.accpm.2025.101528","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 4","pages":"Article 101528"},"PeriodicalIF":3.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term quality of life after refractory cardiac arrest requiring ECLS: A 10 years single-center analysis","authors":"Alexandre Behouche ,&nbsp;Lucie Gaide-Chevronnay ,&nbsp;Cecile Blacque ,&nbsp;Stephane Priem ,&nbsp;Geraldine Dessertaine ,&nbsp;Timothee Abaziou ,&nbsp;Amelie Hebrard ,&nbsp;Fahd Bennani ,&nbsp;Alexandre Sebestyen ,&nbsp;Pierre Albaladejo","doi":"10.1016/j.accpm.2025.101516","DOIUrl":"10.1016/j.accpm.2025.101516","url":null,"abstract":"<div><h3>Background</h3><div>Impact of V-A ECMO to treat cardiac arrest on quality of life is unclear. a</div></div><div><h3>Methods</h3><div>In 2021, all patients treated in the intensive care unit (ICU) of our tertiary university hospital for cardiac arrest requiring V-A ECMO from 2006 to 2018, were contacted by mail and by phone in order to complete an SF-36 form. Quality of life was then compared with reference values (patients with cardiovascular diseases, patients with ischemic heart disease, ICU-survivor patients at 36 months after discharge, and cardiac arrest survivors not treated with V-A ECMO).</div></div><div><h3>Results</h3><div>Among 45 survivors, 25 patients completed the SF-36 form with a mean time for assessing quality of life of 6.9 ± 2.3 years. Sub-scores were globally comparable with those observed in referent cohorts.</div></div><div><h3>Discussion</h3><div>Cardiac arrest marks the beginning of a medical journey that includes intensive care management and the onset of cardiac disease, often of ischemic origin. Our data suggest that quality of life of patients treated with V-A ECMO for cardiac arrest is comparable to those reported in referent cohorts (ICU-survivors, patients with cardiovascular diseases of ischemic heart disease, and cardiac arrest survivors not treated with mechanical circulatory support).</div></div><div><h3>Conclusion</h3><div>Survivor patients who experienced cardiac arrest and treated with V-A ECMO presented a good long-term quality of life. Decision regarding V-A ECMO implantation should not be limited by concerns about patients’ future quality of life.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 4","pages":"Article 101516"},"PeriodicalIF":3.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult fluid pleural effusion in critical care","authors":"Thomas Clavier ,&nbsp;Morgane Huguenin-Vuillemenet ,&nbsp;Fanny Vardon ,&nbsp;Christophe Le Terrier ,&nbsp;Nathalie Zappella ,&nbsp;on behalf of the ACCPM SoMe Team","doi":"10.1016/j.accpm.2025.101525","DOIUrl":"10.1016/j.accpm.2025.101525","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 4","pages":"Article 101525"},"PeriodicalIF":3.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines For Adult Pleural Fluid Effusion In Critical Care","authors":"Bélaid Bouhemad,&nbsp;Charlotte Arbelot,&nbsp;Elise Artaud-Macari,&nbsp;Laurent Brouchet,&nbsp;Olivier Collange,&nbsp;Marios Froudarakis,&nbsp;Anne Godier,&nbsp;Sophie Hamada,&nbsp;Sabrina Garnier-Kepka,&nbsp;Françoise Le Pimpec-Barthes,&nbsp;Marie-Reine Losser,&nbsp;Tania Marx,&nbsp;Jean Michel Maury,&nbsp;Nicolas Mayeur,&nbsp;Francis Remérand,&nbsp;Hadrien Rozé,&nbsp;Béatrice Riu-Poulenc,&nbsp;Matthieu Jabaudon,&nbsp;Hélène Charbonneau","doi":"10.1016/j.accpm.2025.101527","DOIUrl":"10.1016/j.accpm.2025.101527","url":null,"abstract":"<div><h3>Objective</h3><div>Chest drainage is a very common procedure in critical care. It is performed by practitioners from various specialties in a wide range of clinical settings. Liquid pleural effusions are the most frequent indication for chest drainage. However, practices regarding chest tube insertion, monitoring, and removal vary considerably between institutions. The objective of these recommendations is to provide guidance for the optimal management of pleural effusion (excluding purulent pleurisy, haemothorax, and malignant pleural effusion) in adult critical care patients.</div></div><div><h3>Development</h3><div>Fifteen experts from the French Society of Anaesthesia and Intensive Care Medicine (SFAR), the French Society of Thoracic and Cardiovascular Surgery (SFCTCV), the French Language Pulmonology Society (SPLF), and the French Society of Emergency Medicine (SFMU) were convened. All experts declared their conflicts of interest at the beginning of the guideline development process. This process was conducted independently and without any industry funding. The authors followed the GRADE methodology (Grading of Recommendations Assessment, Development and Evaluation) to assess the level of evidence in the scientific literature.</div></div><div><h3>Methods</h3><div>Four thematic areas were defined: (1) diagnosis and consequences of pleural effusions, (2) procedure for chest tube placement, (3) monitoring the efficacy and complications of pleural drainage, (4) chest tube removal procedure. For each area, the recommendations aimed to answer a series of questions formulated according to the PICO model (Population, Intervention, Comparison, Outcome). An extensive literature review was performed and analysed according to the GRADE methodology. Recommendations were then formulated using the GRADE approach and submitted to a vote by all experts using the GRADE Grid method.</div></div><div><h3>Results</h3><div>A total of 25 recommendations regarding the drainage of pleural effusion in adult critical care patients were formulated by the expert panel from SFAR, SFCTCV, SPLF, and SFMU. After four rounds of voting, strong agreement was reached for all 25 recommendations. For three additional questions, no recommendation could be formulated.</div></div><div><h3>Conclusion</h3><div>Strong expert consensus was reached to provide recommendations for optimising the management of pleural effusion drainage in adult critical care patients.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 4","pages":"Article 101527"},"PeriodicalIF":3.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To drain or not to drain? Disentangling common clinical dilemmas around pleural effusion management in critically ill patients. An introduction to a French multi-society and multi-specialty guideline","authors":"Silvia Mongodi,&nbsp;Daniele De Luca ,&nbsp;Santi Di Pietro ,&nbsp;Giuseppe Maggio,&nbsp;Francesco Mojoli","doi":"10.1016/j.accpm.2025.101524","DOIUrl":"10.1016/j.accpm.2025.101524","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 4","pages":"Article 101524"},"PeriodicalIF":3.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peri-partum reference range for the point-of-care viscoelastic testing device Quantra® QStat in healthy pregnancy and non-haemorrhagic post-partum – A short communication","authors":"Oliver Lukowiak ,&nbsp;Agnès Le Gouez ,&nbsp;Maxime Djebbour ,&nbsp;Frédéric J. Mercier ,&nbsp;Anne-Sophie Bouthors","doi":"10.1016/j.accpm.2025.101521","DOIUrl":"10.1016/j.accpm.2025.101521","url":null,"abstract":"<div><h3>Introduction</h3><div>The Quantra® QStat is a novel point-of-care viscoelastometric test based on sonorheometry technology. Reference ranges in obstetric settings have not yet been established. The QStat measures five parameters: clotting time (CT, seconds (s)), clotting stiffness (CS, hectopascals (hPA)), fibrinogen (FCS, hPA) and platelet contribution to clot stiffness (PCS, hPA), and clot stability to lysis (CSL, percentage (%)).</div></div><div><h3>Methods</h3><div>A prospective observational study was conducted in two French academic hospitals to determine the reference range in full-term healthy pregnant women. The QStat measurements were performed upon admission to the delivery room and thirty to sixty minutes after uncomplicated vaginal or caesarean delivery. The primary analysis involved defining reference intervals, expressed as the means, standard deviations, distributions, and dispersions. The secondary analysis compared values between pregnant and nonpregnant patients, between the prepartum and postpartum periods, and between vaginal and caesarean delivery methods.</div></div><div><h3>Results</h3><div>Over one year, in 84 patients, the QStat parameter ranges were established for the end of pregnancy and immediate postpartum periods. The CT and FCS values differed between pregnant and nonpregnant women. No significant difference was found between the prepartum and postpartum values or between vaginal and caesarean delivery groups.</div></div><div><h3>Discussion and Conclusion</h3><div>The QStat is a promising point-of-care viscoelastometric testing device that is now desirable for managing postpartum haemorrhage to enable haemostasic goal-oriented therapies. Similar to viscoelastometric testing in trauma and cardiac surgery, the QStat provides reliable measurements. Further research is needed to establish pathological reference values specific to the obstetric bleeding scenario.</div></div><div><h3>Registration</h3><div>ClinicalTrial.gov: NCT 04753671.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 4","pages":"Article 101521"},"PeriodicalIF":3.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting sustainability within intensive care nursing: Ten tips for environmental responsibility","authors":"Matthieu Bernat ,&nbsp;Heather Baid ,&nbsp;David Grimaldi ,&nbsp;Laurent Zieleskiewicz","doi":"10.1016/j.accpm.2025.101506","DOIUrl":"10.1016/j.accpm.2025.101506","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 2","pages":"Article 101506"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reversing aminosteroid neuromuscular blocking drugs with sugammadex — Pipecuronium, rocuronium and vecuronium are not the same","authors":"Andrew Bowdle,&nbsp;Stephan R. Thilen","doi":"10.1016/j.accpm.2025.101496","DOIUrl":"10.1016/j.accpm.2025.101496","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 2","pages":"Article 101496"},"PeriodicalIF":3.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving paediatric undertriage in a regional trauma network — A registry cohort study","authors":"François-Xavier Ageron ,&nbsp;Jean-Noël Evain ,&nbsp;Julie Chifflet ,&nbsp;Cécile Vallot ,&nbsp;Jules Grèze ,&nbsp;Guillaume Mortamet ,&nbsp;Pierre Bouzat ,&nbsp;Tobias Gauss","doi":"10.1016/j.accpm.2025.101497","DOIUrl":"10.1016/j.accpm.2025.101497","url":null,"abstract":"<div><h3>Background</h3><div>Trauma remains a leading cause of death in children worldwide. Management in dedicated paediatric trauma centres is beneficial, making accurate prehospital triage crucial. We assessed undertriage in a regional trauma system after implementing a revised paediatric triage rule.</div></div><div><h3>Methods</h3><div>This retrospective, multicentre registry study included all injured children &lt;15 years admitted to hospitals in the Northern French Alps with suspected major trauma and/or an Abbreviated Injury Scale ≥3. Triage performance was assessed before and after implementation of a revised paediatric triage rule. Multivariate logistic regression identified predictors of undertriage defined as a child with major trauma (need for trauma intervention) not directly transported to the paediatric trauma centre.</div></div><div><h3>Results</h3><div>All 1524 injured children from January 2009 to December 2020 were included. Of these, 725/1524 (47.6%) presented with major trauma; 593/1524 (38.9%) were referred to a non-paediatric trauma centre, and 220/1524 (15%) were considered undertriaged. Over the years, undertriage decreased from 15% to 9%, after the implementation of a revised triage rule. After adjustment, revised paediatric triage rules decreased undertriage, OR = 0.5; 95% CI: 0.3–0.9; <em>P</em> &lt; <em>0.02.</em> The multivariate regression model identified the following risk factors of undertriage: children &gt;10 years, two-wheel vehicle road traffic accident, girls after a fall, for boys after a winter ski accident, and infants with severe limb and pelvic injuries.</div></div><div><h3>Conclusion</h3><div>The implementation of regional revised triage rule contributed to a reduction in the paediatric undertriage rate to 9%; several clinical factors were associated with undertriage.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 2","pages":"Article 101497"},"PeriodicalIF":3.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of naloxegol on transit recovery in patients undergoing cardiac surgery: A randomized, double-blind, placebo-controlled trial","authors":"Driss Laghlam ,&nbsp;Hadrien Gibert ,&nbsp;Messaouda Merzoug ,&nbsp;Didier Leclerc ,&nbsp;Lucas Coroyer ,&nbsp;Philippe Estagnasie ,&nbsp;Pierre Squara ,&nbsp;Lee S. Nguyen ,&nbsp;Guillaume Geri","doi":"10.1016/j.accpm.2025.101498","DOIUrl":"10.1016/j.accpm.2025.101498","url":null,"abstract":"<div><h3>Background</h3><div>Paralytic ileus is a major surrounding after cardiac surgery and worsens patients’ prognosis.</div></div><div><h3>Methods</h3><div>We conducted a single-centre, randomized, double-blind, placebo-controlled phase 3 study. We enrolled patients over 18 years old who underwent non-urgent cardiac surgery. Eligible patients were randomly allocated to Naloxegol or matching placebo in an equal ratio. The participants were randomly assigned to one of the following groups: (1) Naloxegol 12,5 mg 2 h before index surgery, and then Naloxegol 25 mg once daily, or (2) matching placebo. Naloxegol or placebo was administered for up to 5 days and permanently stopped if the patient had transit recovery. The primary endpoint was the time of postoperative gastrointestinal transit recovery after the index cardiac surgery, defined as the time in hours between the anaesthetic induction and the emission of the first significant stool.</div></div><div><h3>Results</h3><div>Between October 14, 2020, and January 28, 2022, 299 participants were included in modified intention-to-treat efficacy analyses (151 in the Naloxegol group and 148 in placebo). The mean age was 62 ± 10.1 years old, 81.6% were male, 53.8% had hypertension, 20.7% had diabetes mellitus, and the median body mass index was 25.9 (IQR 23.7−29.4) kg/m². Time-to-transit recovery did not differ between Naloxegol group and placebo (76.0, [IQR 69.3−93.5] <em>vs.</em> 78.3, [IQR 70.0−95.8] h, <em>p</em> value = 0.40). We did not observe any difference in the prespecified secondary efficacy between both groups. Pain levels and a number of serious adverse events were not different in both groups.</div></div><div><h3>Conclusions</h3><div>Naloxegol was not found to be effective in improving the transit time recovery after elective cardiac surgery.</div><div>The trial was registered on ClinicalTrials.gov (NCT04433390) on June 16^th, 2020.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 2","pages":"Article 101498"},"PeriodicalIF":3.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}