Eric Meaudre - Academia.edu (original) (raw)
Papers by Eric Meaudre
Anesthésie & Réanimation, 2015
Intensive Care Medicine, 2015
Injury, 2012
Hypothermia remains one of the major factors limiting surgery in extensively burned patients. We ... more Hypothermia remains one of the major factors limiting surgery in extensively burned patients. We evaluated the effectiveness of an intravascular rewarming technique using CoolGard 3000™ system and Icy™ catheter to maintain normothermia during surgeries of severe burned patients and compared these findings to a historical control group. This was a controlled non-randomised trial conducted between March 2008 and August 2009. Patients with burns greater than or equal to 40% of the total body surface area were included. Before the first burn excision, the Icy™ catheter was placed in the inferior vena cava via the femoral vein. Warming was then initiated and maintained until the bladder temperature reached over 37.5°C. The bladder temperature was recorded every 30min during surgery and for the first hour post-operatively and compared to a historical control group. We enrolled 4 patients and 11 surgeries in the CoolGard™ group and compared them to 3 patients and 10 surgeries in the historical cohort. All intraoperative bladder temperatures from T=30 were statistically different in the two groups. In the CoolGard™ group, no patient became hypothermic and no surgery was aborted because the patient's temperature had rapidly fallen below the threshold temperature (35.5°C). No device-related complication was reported. The use of an intravenous warming catheter is a novel approach to maintain normothermia during surgery in burn victims and may be more effective than traditional methods.
Annales Françaises d'Anesthésie et de Réanimation, 2006
Anaesthesia Critical Care & Pain Medicine, 2015
Over-triage rates related to the use of Vittel criteria are unknown. We compared severe stable tr... more Over-triage rates related to the use of Vittel criteria are unknown. We compared severe stable trauma patients with and without significant visceral injuries. A single-centre retrospective analysis of a single-centre prospective cohort. Trauma patients with at least one positive Vittel criterion from June 2010 to January 2012 in a level-1 trauma centre. Initial management included a systematic whole-body scanner. All significant lesions in stable trauma patients were recorded. A total of 252 trauma patients were admitted. One hundred and twenty were stable. In this group without vital distress, 72 (60%) had at least one occult lesion, 21 (17.5%) had an isolated orthopaedic injury and 27 (22.5%) had no injury. Thoracic injuries accounted for 44% of visceral injuries, abdominal for 17%, spinal for 16% and cerebral for 15%. Overall, the over-triage rate was 19%. Surgery for significant visceral injury was performed in 13 patients (18%) and arteriography in 4 patients (5.5%). Admission in an intensive care unit was required for 13 patients with occult injuries and for one patient without such a lesion (18% versus 2%, P=0.008). Hospital stays were longer in the group with visceral injuries (4±7 versus 9±8days; P=0.006). Vittel criteria use in trauma patients induces an acceptable over-triage rate. A large proportion of stable trauma patients have occult lesions. These visceral injuries frequently require special care. These data highlight the imperative need to transport major trauma patients immediately to a dedicated trauma centre and supports whole-body scanner use.
Anesthésie & Réanimation, 2015
Revue des Maladies Respiratoires
Annales Françaises d Anesthésie et de Réanimation
We report a case of transient acquired and isolated factor VII deficiency associated with severe ... more We report a case of transient acquired and isolated factor VII deficiency associated with severe head trauma. A 16-year-old boy was involved in a motor vehicle accident. CT scan showed frontal brain contusion and a cerebral haematoma (5 cm). First prothrombine time (PT) was normal. Rapidly, a severe coagulopathy developed, unresponsiving to fresh frozen plasma and vitamin K. Haemostatic markers analysis showed an isolated deficiency of factor VII at 15%. No inhibitory activity against factor VII could be detected. We successfully treated the deficiency with intermittent intravenous human factor VII (factor VII-LFB) during 10 days. Factor VII return to normal at 84%. Physiopathological and therapeutic aspects of this rare pathology are presented.
Anesthésie & Réanimation, 2015
Annales Françaises d Anesthésie et de Réanimation
Anaesthesia Critical Care & Pain Medicine, 2015
Ebola Virus Disease (EVD) causes severe diarrhoea and vomiting, leading to dehydration and electr... more Ebola Virus Disease (EVD) causes severe diarrhoea and vomiting, leading to dehydration and electrolyte abnormalities. Treatment remains supportive and often requires intravenous (IV) access. IV catheters are difficult to insert and maintain in this context. Our primary objective was to compare peripheral venous catheters (PVCs) and central venous catheters (CVCs) for volume resuscitation in patients with EVD. We performed a prospective observational study between January and March 2015 at the Conakry Healthcare Workers Ebola Treatment Unit (ETU). The primary judgement criterion was the ratio of the daily infused volume of fluids to the prescribed volume (DIV/PV). Fourteen patients were admitted. Twenty-eight PVCs and 8 CVCs were inserted. CVCs had a longer survival time (96±34hours versus 33.5±21hours, P<0.001). The mean DIV/PV was higher for the CVCs (0.95±0.08 versus 0.7±0.27, P<0.001), as well as the number of days with full administration of prescribed IV fluids (71.2% versus 34.1%, P=0.002). Inserting CVCs is a safe and reliable way of obtaining IV access in ETUs, provided adequately trained personnel are available. CVCs optimize fluid infusion compared to PVCs. Further studies comparing fluid management strategies in EVD are necessary.
Annales francaises d'anesthesie et de reanimation
Annales françaises de médecine d'urgence, 2012
ABSTRACT Les plaies de la face sont un motif fréquent de recours au service d’accueil des urgence... more ABSTRACT Les plaies de la face sont un motif fréquent de recours au service d’accueil des urgences. Les blocs tronculaires de la face sont simples, efficaces et à faible risque iatrogène. Ils permettent une anesthésie efficace pour les gestes de petite chirurgie. Nous présentons les techniques d’anesthésie locorégionale de la face retenues par la conférence d’experts SFAR — SFMU de 2002: Pratique des anesthésies locales et locorégionales par des médecins non spécialisés en anesthésie-réanimation, dans le cadre des urgences. Les blocs supra-orbitaires et supra-trochléaires présentés dans cet article permettent l’anesthésie de la région frontale.
Annales francaises d'anesthesie et de reanimation
Annales francaises d'anesthesie et de reanimation
Annales francaises d'anesthesie et de reanimation
Journal of special operations medicine : a peer reviewed journal for SOF medical professionals
Background and Objective: Almost 50% of military trauma patients who need transfusions develop a ... more Background and Objective: Almost 50% of military trauma patients who need transfusions develop a coagulopathy. Immediately treating this coagulopathy improves the patient?s prognosis. Field military hospitals often lack laboratory devices needed to diagnose a clinically significant coagulopathy and have limited blood product resources such as plasma. Point-of-care (POC) devices for the measurement of prothrombin time (PT) are available and have been tested in a variety of situations, including hemorrhagic surgery. The authors compared a POC device, the Coaguchek XS Pro (F. Hoffmann-La Roche Ltd., Basel, Switzerland), with laboratory measures for determining the PT in military trauma patients in a field hospital. Methods: This single-center prospective study was designed to compare POC coagulation monitoring with traditional laboratory testing. It was conducted at the French military hospital located at Kabul International Airport. All patients with trauma injuries resulting from war...
Annales francaises d'anesthesie et de reanimation
Propofol infusion syndrome (PRIS) is a new clinical entity reported in critically ill patients. L... more Propofol infusion syndrome (PRIS) is a new clinical entity reported in critically ill patients. Lactic acidosis, cardiac failure and rhabdomyolysis are the features. Lactic acidosis related to short-term propofol administration has been described during general anaesthesia. Lactic acidosis could be an early marker of PRIS. We report here a case of very early lactic acidosis in a 66-year-old-man receiving propofol during a neurosurgery. The outcome was good after discontinuation of propofol.
Anesthésie & Réanimation, 2015
Intensive Care Medicine, 2015
Injury, 2012
Hypothermia remains one of the major factors limiting surgery in extensively burned patients. We ... more Hypothermia remains one of the major factors limiting surgery in extensively burned patients. We evaluated the effectiveness of an intravascular rewarming technique using CoolGard 3000™ system and Icy™ catheter to maintain normothermia during surgeries of severe burned patients and compared these findings to a historical control group. This was a controlled non-randomised trial conducted between March 2008 and August 2009. Patients with burns greater than or equal to 40% of the total body surface area were included. Before the first burn excision, the Icy™ catheter was placed in the inferior vena cava via the femoral vein. Warming was then initiated and maintained until the bladder temperature reached over 37.5°C. The bladder temperature was recorded every 30min during surgery and for the first hour post-operatively and compared to a historical control group. We enrolled 4 patients and 11 surgeries in the CoolGard™ group and compared them to 3 patients and 10 surgeries in the historical cohort. All intraoperative bladder temperatures from T=30 were statistically different in the two groups. In the CoolGard™ group, no patient became hypothermic and no surgery was aborted because the patient's temperature had rapidly fallen below the threshold temperature (35.5°C). No device-related complication was reported. The use of an intravenous warming catheter is a novel approach to maintain normothermia during surgery in burn victims and may be more effective than traditional methods.
Annales Françaises d'Anesthésie et de Réanimation, 2006
Anaesthesia Critical Care & Pain Medicine, 2015
Over-triage rates related to the use of Vittel criteria are unknown. We compared severe stable tr... more Over-triage rates related to the use of Vittel criteria are unknown. We compared severe stable trauma patients with and without significant visceral injuries. A single-centre retrospective analysis of a single-centre prospective cohort. Trauma patients with at least one positive Vittel criterion from June 2010 to January 2012 in a level-1 trauma centre. Initial management included a systematic whole-body scanner. All significant lesions in stable trauma patients were recorded. A total of 252 trauma patients were admitted. One hundred and twenty were stable. In this group without vital distress, 72 (60%) had at least one occult lesion, 21 (17.5%) had an isolated orthopaedic injury and 27 (22.5%) had no injury. Thoracic injuries accounted for 44% of visceral injuries, abdominal for 17%, spinal for 16% and cerebral for 15%. Overall, the over-triage rate was 19%. Surgery for significant visceral injury was performed in 13 patients (18%) and arteriography in 4 patients (5.5%). Admission in an intensive care unit was required for 13 patients with occult injuries and for one patient without such a lesion (18% versus 2%, P=0.008). Hospital stays were longer in the group with visceral injuries (4±7 versus 9±8days; P=0.006). Vittel criteria use in trauma patients induces an acceptable over-triage rate. A large proportion of stable trauma patients have occult lesions. These visceral injuries frequently require special care. These data highlight the imperative need to transport major trauma patients immediately to a dedicated trauma centre and supports whole-body scanner use.
Anesthésie & Réanimation, 2015
Revue des Maladies Respiratoires
Annales Françaises d Anesthésie et de Réanimation
We report a case of transient acquired and isolated factor VII deficiency associated with severe ... more We report a case of transient acquired and isolated factor VII deficiency associated with severe head trauma. A 16-year-old boy was involved in a motor vehicle accident. CT scan showed frontal brain contusion and a cerebral haematoma (5 cm). First prothrombine time (PT) was normal. Rapidly, a severe coagulopathy developed, unresponsiving to fresh frozen plasma and vitamin K. Haemostatic markers analysis showed an isolated deficiency of factor VII at 15%. No inhibitory activity against factor VII could be detected. We successfully treated the deficiency with intermittent intravenous human factor VII (factor VII-LFB) during 10 days. Factor VII return to normal at 84%. Physiopathological and therapeutic aspects of this rare pathology are presented.
Anesthésie & Réanimation, 2015
Annales Françaises d Anesthésie et de Réanimation
Anaesthesia Critical Care & Pain Medicine, 2015
Ebola Virus Disease (EVD) causes severe diarrhoea and vomiting, leading to dehydration and electr... more Ebola Virus Disease (EVD) causes severe diarrhoea and vomiting, leading to dehydration and electrolyte abnormalities. Treatment remains supportive and often requires intravenous (IV) access. IV catheters are difficult to insert and maintain in this context. Our primary objective was to compare peripheral venous catheters (PVCs) and central venous catheters (CVCs) for volume resuscitation in patients with EVD. We performed a prospective observational study between January and March 2015 at the Conakry Healthcare Workers Ebola Treatment Unit (ETU). The primary judgement criterion was the ratio of the daily infused volume of fluids to the prescribed volume (DIV/PV). Fourteen patients were admitted. Twenty-eight PVCs and 8 CVCs were inserted. CVCs had a longer survival time (96±34hours versus 33.5±21hours, P<0.001). The mean DIV/PV was higher for the CVCs (0.95±0.08 versus 0.7±0.27, P<0.001), as well as the number of days with full administration of prescribed IV fluids (71.2% versus 34.1%, P=0.002). Inserting CVCs is a safe and reliable way of obtaining IV access in ETUs, provided adequately trained personnel are available. CVCs optimize fluid infusion compared to PVCs. Further studies comparing fluid management strategies in EVD are necessary.
Annales francaises d'anesthesie et de reanimation
Annales françaises de médecine d'urgence, 2012
ABSTRACT Les plaies de la face sont un motif fréquent de recours au service d’accueil des urgence... more ABSTRACT Les plaies de la face sont un motif fréquent de recours au service d’accueil des urgences. Les blocs tronculaires de la face sont simples, efficaces et à faible risque iatrogène. Ils permettent une anesthésie efficace pour les gestes de petite chirurgie. Nous présentons les techniques d’anesthésie locorégionale de la face retenues par la conférence d’experts SFAR — SFMU de 2002: Pratique des anesthésies locales et locorégionales par des médecins non spécialisés en anesthésie-réanimation, dans le cadre des urgences. Les blocs supra-orbitaires et supra-trochléaires présentés dans cet article permettent l’anesthésie de la région frontale.
Annales francaises d'anesthesie et de reanimation
Annales francaises d'anesthesie et de reanimation
Annales francaises d'anesthesie et de reanimation
Journal of special operations medicine : a peer reviewed journal for SOF medical professionals
Background and Objective: Almost 50% of military trauma patients who need transfusions develop a ... more Background and Objective: Almost 50% of military trauma patients who need transfusions develop a coagulopathy. Immediately treating this coagulopathy improves the patient?s prognosis. Field military hospitals often lack laboratory devices needed to diagnose a clinically significant coagulopathy and have limited blood product resources such as plasma. Point-of-care (POC) devices for the measurement of prothrombin time (PT) are available and have been tested in a variety of situations, including hemorrhagic surgery. The authors compared a POC device, the Coaguchek XS Pro (F. Hoffmann-La Roche Ltd., Basel, Switzerland), with laboratory measures for determining the PT in military trauma patients in a field hospital. Methods: This single-center prospective study was designed to compare POC coagulation monitoring with traditional laboratory testing. It was conducted at the French military hospital located at Kabul International Airport. All patients with trauma injuries resulting from war...
Annales francaises d'anesthesie et de reanimation
Propofol infusion syndrome (PRIS) is a new clinical entity reported in critically ill patients. L... more Propofol infusion syndrome (PRIS) is a new clinical entity reported in critically ill patients. Lactic acidosis, cardiac failure and rhabdomyolysis are the features. Lactic acidosis related to short-term propofol administration has been described during general anaesthesia. Lactic acidosis could be an early marker of PRIS. We report here a case of very early lactic acidosis in a 66-year-old-man receiving propofol during a neurosurgery. The outcome was good after discontinuation of propofol.