Praticien en Anesthesie Reanimation最新文献

{"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":"28 3","pages":"Pages 157-168"},"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":"28 3","pages":"Pages 179-182"},"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":"28 3","pages":"Pages 189-195"},"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":"28 3","pages":"Pages 137-138"},"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":"28 3","pages":"Pages 139-141"},"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":"28 3","pages":"Pages 176-178"},"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}

{"title":"Interruptions de tâches et leurs conséquences","authors":"Ambre Verlière","doi":"10.1016/j.pratan.2024.05.006","DOIUrl":"https://doi.org/10.1016/j.pratan.2024.05.006","url":null,"abstract":"<div><p>Les interruptions de tâches sont fréquentes dans le milieu de santé, imprévisibles et universelles. Les interruptions de tâches peuvent avoir des conséquences majeures, qui ont été largement étudiées depuis plusieurs années, pour les soignants (épuisement et stress) et pour les patients (erreurs médicamenteuses ou retard de prise en charge). De multiples pistes ont été évoquées pour en limiter le nombre et la portée, mais plusieurs obstacles se dressent : leur ambivalence (conséquence parfois bénéfique), leur omniprésence dans le fonctionnement hospitalier ou encore leur acceptabilité. Cet article fait un état des lieux des connaissances sur les interruptions de tâches, leurs conséquences, les moyens de lutte mis en place et les perspectives futures.</p></div><div><p>Task interruptions of healthcare providers are frequent, unpredictable and universal. They have been extensively studied for several years, and demonstrated to have major consequences for health care personnel (exhaustion and stress) and patients (medication errors or delays in treatment). Many studies have evaluated protocols to limit task interruptions and their deleterious consequences, but several obstacles stand in the way: their ambivalence (potentially beneficial consequences), their omnipresence in hospital culture and their acceptability. This article reviews the current state of knowledge on task interruptions, their consequences, the means of combating them and future prospects.</p></div>","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":"28 3","pages":"Pages 183-188"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141291544","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":"Crise des opioïdes en France et en Europe","authors":"Hélène Beloeil","doi":"10.1016/j.pratan.2024.03.010","DOIUrl":"10.1016/j.pratan.2024.03.010","url":null,"abstract":"","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":"28 2","pages":"Pages 65-66"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140402853","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.2024.03.004","DOIUrl":"https://doi.org/10.1016/j.pratan.2024.03.004","url":null,"abstract":"","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":"28 2","pages":"Pages 133-136"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140549184","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":"Ischémie médullaire périopératoire de chirurgie de l’aorte thoraco-abdominale : état des lieux en 2024","authors":"Olivier Montandrau ,&nbsp;Sarah-Julie Weisslinger ,&nbsp;Ivan Philip ,&nbsp;Fabien Koskas ,&nbsp;Marc Beaussier","doi":"10.1016/j.pratan.2024.03.008","DOIUrl":"10.1016/j.pratan.2024.03.008","url":null,"abstract":"<div><p>En chirurgie de l’aorte thoraco-abdominale, tant ouverte que par voie endovasculaire, l’ischémie médullaire périopératoire reste une complication redoutable. Une évaluation préopératoire approfondie est nécessaire pour identifier les patients à risque et permettre une prise en charge dans un centre adapté. En chirurgie ouverte, l’ischémie médullaire est principalement associée au clampage prolongé de l’aorte et aux lésions de reperfusion lors du déclampage. Pour prévenir ce risque et maintenir une perfusion adéquate de la moelle épinière en per- et postopératoire, plusieurs stratégies sont possibles. Parmi les mesures liées à la prise en charge anesthésique, on retrouve principalement le drainage du liquide cérébrospinal, l’hypothermie contrôlée, le contrôle tensionnel, et de l’oxygénation, voire la circulation extracorporelle partielle. Le monitorage médullaire per- et postopératoire est essentiel pour détecter rapidement tout signe d’ischémie médullaire et prendre des mesures correctives immédiates. De nombreuses stratégies préventives n’ont pas fait la preuve de leur efficacité et des études comparatives de plus grande ampleur sont nécessaires pour améliorer la prise en charge de ces patients.</p></div><div><p>Perioperative spinal cord ischemia following thoracoabdominal aortic aneurysm repair remains a dreaded complication in both open and endovascular approaches. The risk of spinal cord ischemia requires thorough preoperative evaluation to identify high-risk patients and management in an expert center. In open surgery, the risk is notably associated with prolonged aortic clamping and reperfusion injuries during declamping. To prevent spinal cord ischemia and maintain adequate spinal cord perfusion perioperatively, several strategies are employed. Anaesthetic management measures include, cerebrospinal fluid drainage, controlled hypothermia, blood pressure and oxygenation control, as well as partial extracorporeal circulation. Perioperative and postoperative spinal cord monitoring is essential to promptly detect any signs of spinal cord ischemia and take immediate corrective actions. Many preventive strategies have not demonstrated their effectiveness, and larger comparative studies are needed to improve the management of these patients.</p></div>","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":"28 2","pages":"Pages 86-94"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140403575","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}