يعرض 1 - 10 نتائج من 14 نتيجة بحث عن '"Cinotti, Raphaël"', وقت الاستعلام: 1.04s تنقيح النتائج
  1. 1
  2. 2
    دورية أكاديمية

    المصدر: BMC Anesthesiology ; volume 23, issue 1 ; ISSN 1471-2253

    مصطلحات موضوعية: Anesthesiology and Pain Medicine

    الوصف: Background Goal-Directed Fluid Therapy (GDFT) is recommended to decrease major postoperative complications. However, data are lacking in intra-cranial neurosurgery. Methods We evaluated the efficacy of a GDFT protocol in a before/after multi-centre study in patients undergoing elective intra-cranial surgery for brain tumour. Data were collected during 6 months in each period (before/after). GDFT was performed in high-risk patients: ASA score III/IV and/or preoperative Glasgow Coma Score (GCS) < 15 and/or history of brain tumour surgery and/or tumour greater size ≥ 35 mm and/or mid-line shift ≥ 3 mm and/or significant haemorrhagic risk. Major postoperative complication was a composite endpoint: re-intubation after surgery, a new onset of GCS < 15 after surgery, focal motor deficit, agitation, seizures, intra-cranial haemorrhage, stroke, intra-cranial hypertension, hospital-acquired related pneumonia, surgical site infection, cardiac arrythmia, invasive mechanical ventilation ≥ 48 h and in-hospital mortality. Results From July 2018 to January 2021, 344 patients were included in 3 centers: 171 in the before and 173 in the after (GDFT) period. Thirty-six (21.1%) patients displayed a major postoperative complication in the Before period, and 50 (28.9%) in the After period ( p = 0.1). In the propensity score analysis, we matched 48 patients in each period: 9 (18.8%) patients in the After period and 14 (29.2%) patients in the Before period displayed a major perioperative complication ( p = 0.2). Sixty-two (35.8%) patients received GDFT in the After period, with great heterogeneity among centers ( p < 0.05). Conclusions In our before-after study, GDFT was not associated with a decrease in postoperative major complications in elective intra-cranial neurosurgery.

  3. 3
    دورية أكاديمية
  4. 4
    دورية أكاديمية
  5. 5
    دورية أكاديمية

    المصدر: BMC Anesthesiology ; volume 22, issue 1 ; ISSN 1471-2253

    مصطلحات موضوعية: Anesthesiology and Pain Medicine

    الوصف: Background There are limited data to detail the perioperative anesthetic management and the incidence of postoperative respiratory complications among patients requiring an anesthetic procedure while being SARS-CoV-2 positive or suspected. Methods An observational multicenter cohort study was performed including consecutive patients who were SARS-CoV-2 confirmed or suspected and who underwent scheduled and emergency anesthesia between March 17 and May 26, 2020. Results A total of 187 patients underwent anesthesia with SARS-CoV-2 confirmed or suspected, with ultimately 135 (72.2%) patients positive and 52 (27.8%) negative. The median SOFA score was 2 [0; 5], and the median ARISCAT score was 49 [36; 67]. The major respiratory complications rate was 48.7% ( n = 91) with 40.4% ( n = 21) and 51.9% ( n = 70) in the SARS-CoV-2–negative and –positive groups, respectively ( p = 0.21). Among both positive and negative groups, patients with a high ARISCAT risk score (> 44) had a higher risk of presenting major respiratory complications ( p < 0.01 and p = 0.1, respectively). Discussion When comparing SARS-COV-2–positive and –negative patients, no significant difference was found regarding the rate of postoperative complications, while baseline characteristics strongly impact these outcomes. This finding suggests that patients should be scheduled for anesthetic procedures based on their overall risk of postoperative complication, and not just based on their SARS-CoV-2 status.

  6. 6
    دورية أكاديمية
  7. 7
    دورية أكاديمية
  8. 8
    دورية أكاديمية
  9. 9
    دورية أكاديمية
  10. 10
    دورية أكاديمية