Praticien en Anesthesie Reanimation最新文献

{"title":"Préhabilitation des patients âgés","authors":"Gilles Albrand ,&nbsp;Marc Beaussier","doi":"10.1016/j.pratan.2024.05.007","DOIUrl":"https://doi.org/10.1016/j.pratan.2024.05.007","url":null,"abstract":"<div><p>L’âge est un facteur de risque identifié de complications postopératoires. Afin de réduire ce risque, il est possible d’optimiser la prise en charge dès la période préopératoire. Cette optimisation consiste, en premier lieu, à savoir dépister les sujets les plus fragiles à l’aide de tests spécifiques. Des mesures simples, telles que la prévention des sevrages, le tri des médicaments, la correction d’une anémie ou d’une dénutrition, doivent être mises en œuvre. La pré-habilitation consiste à appliquer des mesures visant à améliorer la fonctionnalité préopératoire, par la réalisation d’exercices physiques, la re-nutrition et la préparation psychologique. Cette préparation a montré qu’elle pouvait réduire la morbidité postopératoire, en particulier chez les patients les plus fragiles opérés de chirurgie lourde. Elle s’intègre dans une filière de soin multidisciplinaire spécifique, intégrant les gériatres et les anesthésistes. Cette revue fait le point sur la collaboration nécessaire entre ces deux spécialités pour préparer au mieux le patient âgé fragile à la chirurgie.</p></div><div><p>Age is identified as a risk factor for postoperative complications. In order to reduce this risk, it is possible to optimize the management of the patients during the preoperative period. This consists, first of all, in knowing how to detect the most fragile subjects by using specific tests. Simple measures, such as preventing drug withdrawals, making choice in medications, correcting anemia or malnutrition, must be implemented. The pre-habilitation program consists in the application of measures aiming at improving the preoperative functionality of these patients, through physical exercises, renutrition and psychological preparation. It has been demonstrated to reduce postoperative morbidity, particularly in the most fragile patients undergoing major surgery. This preparation should be performed in a specific multidisciplinary care pathway, involving geriatricians and anesthesiologists. This review presents the collaboration necessary between these two specialties to best prepare the frail elderly patients for surgery.</p></div>","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141289381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Déficit en facteur XI en obstétrique","authors":"Alice Soumare,&nbsp;Olivier Imauven,&nbsp;Yoann Elmaleh","doi":"10.1016/j.pratan.2024.05.011","DOIUrl":"https://doi.org/10.1016/j.pratan.2024.05.011","url":null,"abstract":"<div><p>La prise en charge des parturientes présentant une carence en facteur XI est complexe. La littérature sur le sujet est limitée et les recommandations se fondent souvent sur des données de faible qualité. Illustrée cas d’une patiente enceinte ayant un déficit en facteur XI, nous proposons une stratégie de gestion qui recommande l’administration préventive de concentrés en facteur XI uniquement lorsque les taux biologiques sont inférieurs à 15 %. De plus, nous suggérons qu’un taux supérieur à 30 % serait suffisant pour garantir la sécurité d’une anesthésie locorégionale en l’absence d’antécédents hémorragiques.</p></div><div><p>The management of patients scheduled for surgery with a factor XI deficiency is complex. Recommendations are based on limited data. Illustrated by the case of a parturient with a factor XI deficiency we suggest a strategy based on the plasma concentration. Factor XI administration should be performed when the plasma level is less than 15%. A value greater than 30% should be sufficient to allow the performance of a regional block in patients without a history of bleeding.</p></div>","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141290478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"De l’importance de la prise en compte des examens prescrits","authors":"Francis Bonnet,&nbsp;Nathalie Durieux","doi":"10.1016/j.pratan.2024.05.005","DOIUrl":"10.1016/j.pratan.2024.05.005","url":null,"abstract":"<div><p>Ce cas clinique qui a fait l’objet de suites médicojudiciaires relate la problématique des examens prescrits et non interprétés résultant d’une perte de chance dans la prise en compte de complications.</p></div><div><p>This judiciary case describes a patient who developed a postoperative serious complication partly related to the fact that the results of previously ordered complementary examinations, were not considered, resulting in a loss of chance to recover without complication.</p></div>","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141138621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LU POUR VOUS","authors":"","doi":"10.1016/j.pratan.2024.04.001","DOIUrl":"10.1016/j.pratan.2024.04.001","url":null,"abstract":"","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141138938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prise en charge des troubles conductifs induits par la chirurgie cardiaque","authors":"Olivier Imauven ,&nbsp;Benjamin Frossard ,&nbsp;Fiorella Salerno","doi":"10.1016/j.pratan.2024.05.008","DOIUrl":"https://doi.org/10.1016/j.pratan.2024.05.008","url":null,"abstract":"<div><p>La chirurgie cardiaque et l’implantation percutanée de valve aortique sont pratiquées à longueur d’année en France et dans le monde. En dépit de progrès techniques manifestes, certaines de ces interventions sont à risque de provoquer des troubles de la conduction cardiaque pendant la période postopératoire. Les facteurs de risques individuels, de mieux en mieux connus, permettent de dépister précocement les patients qui auront besoin de l’implantation de pacemakers. Il est du devoir de tout anesthésiste réanimateur amené à prendre en charge ces patients de savoir reconnaître et prendre en charge de manière adaptée ces anomalies acquises de la conduction.</p></div><div><p>Cardiac surgery and trancatheter aortic valve implantations are performed year-round. Despite clear advances in techniques, some of these procedures carry a high risk of cardiac conduction disorders in the postoperative period. These disorders, whether transient or permanent, are frequent and warrant close vigilance. Patient's risk factors, which are becoming better known, may help in the early identification of patients requiring pacemaker implantation. It is the duty of all anesthesiologist-intensivist involved in the care of these patients to be able to recognize and appropriately manage these acquired conduction anomalies.</p></div>","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141289378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Méningite nosocomiale : une complication rare mais grave de la rachianesthésie","authors":"Othmane Laidouni ,&nbsp;Jaouad Laoutid ,&nbsp;Jaber El Kaissi ,&nbsp;Taoufik El Akef","doi":"10.1016/j.pratan.2024.05.009","DOIUrl":"https://doi.org/10.1016/j.pratan.2024.05.009","url":null,"abstract":"<div><p>La rachianesthésie, du fait d’une injection dans le liquide céphalorachidien, comporte un risque d’infection méningée nosocomiale. Cette complication grave doit être diagnostiquée et traitée rapidement. Le diagnostic peut en effet être difficile du fait d’une sémiologie trompeuse avec notamment la prédominance des céphalées. La prévention passe par des règles d’asepsie stricte incluant le port du masque lors de la réalisation du geste.</p></div><div><p>Spinal anaesthesia, because of intrathecal injection, is associated with a risk of nosocomial meningeal infection. This severe complication needs to be diagnosed and treated rapidly due to the risk of neurologic sequelae. Non-postural headache is the key symptom not to be confused with postdural puncture headache. Nosocomial meningitis is best prevented by an aseptic technique including wearing a facial mask during the procedure.</p></div>","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141290476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthésie locale : le gaïacol, un rival très éphémère de la cocaïne","authors":"Louis-Jean Dupré","doi":"10.1016/j.pratan.2024.05.004","DOIUrl":"https://doi.org/10.1016/j.pratan.2024.05.004","url":null,"abstract":"","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141290474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"De l’art de siroter…","authors":"Marc Gentili","doi":"10.1016/j.pratan.2024.05.001","DOIUrl":"https://doi.org/10.1016/j.pratan.2024.05.001","url":null,"abstract":"","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141290475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Terminologie et dose de noradrénaline : une clarification s’impose","authors":"Fanny Bounes ,&nbsp;Isabelle Goyer ,&nbsp;Philippe Guerci ,&nbsp;Marc Leone ,&nbsp;Nicolas Mongardon","doi":"10.1016/j.pratan.2024.05.002","DOIUrl":"https://doi.org/10.1016/j.pratan.2024.05.002","url":null,"abstract":"","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141290477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Difficultés à retirer un cathéter épidural : que faire ?","authors":"Marc Gentili","doi":"10.1016/j.pratan.2024.05.010","DOIUrl":"https://doi.org/10.1016/j.pratan.2024.05.010","url":null,"abstract":"","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141290473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}