Iris Pélieu - Academia.edu (original) (raw)
Papers by Iris Pélieu
Anesthésie & Réanimation, Mar 1, 2023
Le Praticien en Anesthésie Réanimation
Annales Francaises D Anesthesie Et De Reanimation, May 1, 2011
Journal of Neurology, Dec 7, 2010
Hyperammonemic coma is rare except in association with hepatic encephalopathy. When liver disease... more Hyperammonemic coma is rare except in association with hepatic encephalopathy. When liver disease is ruled out, hyperammonemia should suggest the existence of a porto-systemic shunt or an inherited urea cycle defect [1]. Urinary ureterocolic diversion (UD) that has been ...
Journal of Neurology, 2010
Hyperammonemic coma is rare except in association with hepatic encephalopathy. When liver disease... more Hyperammonemic coma is rare except in association with hepatic encephalopathy. When liver disease is ruled out, hyperammonemia should suggest the existence of a porto-systemic shunt or an inherited urea cycle defect [1]. Urinary ureterocolic diversion (UD) that has been ...
Intensive Care Medicine, 2013
Annales Françaises d'Anesthésie et de Réanimation, 2011
Critical Care Medicine, 2010
Pressure-support ventilation is widely used during the weaning phase in patients with acute respi... more Pressure-support ventilation is widely used during the weaning phase in patients with acute respiratory distress syndrome. The pressure-support level is adjusted to prevent ventilator-induced lung injury while limiting the patient's work of breathing. Neurally adjusted ventilatory assist is an assist mode that applies a positive pressure proportional to the integral of the electrical activity of the diaphragm. The objective was to assess the physiologic response to varying pressure-support ventilation and neurally adjusted ventilatory assist levels in selected acute respiratory distress syndrome patients and to evaluate the effect of neural triggering. Methods: We prospectively assessed 11 consecutive patients with acute respiratory distress syndrome attributable to pulmonary diseases. Pressure-support ventilation and neurally adjusted ventilatory assist were used in random order. Neurally adjusted ventilatory assist was used with a low electrical activity of the diaphragm trigger (neurally adjusted ventilatory assist-electrical activity of the diaphragm) and with a high electrical activity of the diaphragm trigger that led to rescue triggering by inspiratory flow (neurally adjusted ventilatory assist-inspiratory flow). With each ventilation modality, four levels of assistance (100%, 120%, 140%, and 160%) were used in random order. Statistical analysis was performed using analysis of variance for repeated measurements and mixed models. Main Results: Contrary to pressure-support ventilation, neurally adjusted ventilatory assist-electrical activity of the diaphragm and neurally adjusted ventilatory assist-inspiratory flow were associated with stable tidal volume levels despite increasing assistance. For the asynchrony index, an interaction was present between ventilation mode and assist level (p ؍ .0076) because asynchrony index increased significantly with the pressure-support ventilation level (p ؍ .004), but not with the neurally adjusted ventilatory assist-electrical activity of the diaphragm or neurally adjusted ventilatory assist-inspiratory flow level. The lowest asynchrony index was obtained with neurally adjusted ventilatory assist-electrical activity of the diaphragm. Conclusion: Compared to pressure-support ventilation, neurally adjusted ventilatory assist in acute respiratory distress syndrome patients holds promise for limiting the risk of overassistance, preventing patient-ventilator asynchrony, and improving overall patient-ventilator interactions. Neural triggering (neurally adjusted ventilatory assist-electrical activity of the diaphragm) considerably decreased patient-ventilator asynchrony.
Medical Sciences, 2019
Traumatic brain injury (TBI) is a major healthcare problem and a major burden to society. The ide... more Traumatic brain injury (TBI) is a major healthcare problem and a major burden to society. The identification of a TBI can be challenging in the prehospital setting, particularly in elderly patients with unobserved falls. Errors in triage on scene cannot be ruled out based on limited clinical diagnostics. Potential new mobile diagnostics may decrease these errors. Prehospital care includes decision-making in clinical pathways, means of transport, and the degree of prehospital treatment. Emergency care at hospital admission includes the definitive diagnosis of TBI with, or without extracranial lesions, and triage to the appropriate receiving structure for definitive care. Early risk factors for an unfavorable outcome includes the severity of TBI, pupil reaction and age. These three variables are core variables, included in most predictive models for TBI, to predict short-term mortality. Additional early risk factors of mortality after severe TBI are hypotension and hypothermia. The ex...
BMJ Open
ObjectivesTo explore allophone immigrant women’s knowledge and perceptions of epidural analgesia ... more ObjectivesTo explore allophone immigrant women’s knowledge and perceptions of epidural analgesia for labour pain, in order to identify their information needs prior to the procedure.DesignWe conducted focus groups interviews with allophone women from five different linguistic immigrant communities, with the aid of professional interpreters. Thematic analysis of focus group transcripts was carried out by all authors.SettingWomen were recruited at two non-profit associations offering French language and cultural integration training to non-French speaking immigrant women in Geneva.ParticipantsForty women from 10 countries who spoke either Albanian, Arabic, Farsi/Dari, Tamil or Tigrigna took part in the five focus groups. Four participants were nulliparous, but all others had previous experience of labour and delivery, often in European countries. A single focus group was conducted for each of the five language groups.ResultsWe identified five main themes: (1) Women’s partial knowledge...
Le Praticien en Anesthésie Réanimation
Anesthésie & Réanimation, Mar 1, 2023
Le Praticien en Anesthésie Réanimation
Annales Francaises D Anesthesie Et De Reanimation, May 1, 2011
Journal of Neurology, Dec 7, 2010
Hyperammonemic coma is rare except in association with hepatic encephalopathy. When liver disease... more Hyperammonemic coma is rare except in association with hepatic encephalopathy. When liver disease is ruled out, hyperammonemia should suggest the existence of a porto-systemic shunt or an inherited urea cycle defect [1]. Urinary ureterocolic diversion (UD) that has been ...
Journal of Neurology, 2010
Hyperammonemic coma is rare except in association with hepatic encephalopathy. When liver disease... more Hyperammonemic coma is rare except in association with hepatic encephalopathy. When liver disease is ruled out, hyperammonemia should suggest the existence of a porto-systemic shunt or an inherited urea cycle defect [1]. Urinary ureterocolic diversion (UD) that has been ...
Intensive Care Medicine, 2013
Annales Françaises d'Anesthésie et de Réanimation, 2011
Critical Care Medicine, 2010
Pressure-support ventilation is widely used during the weaning phase in patients with acute respi... more Pressure-support ventilation is widely used during the weaning phase in patients with acute respiratory distress syndrome. The pressure-support level is adjusted to prevent ventilator-induced lung injury while limiting the patient's work of breathing. Neurally adjusted ventilatory assist is an assist mode that applies a positive pressure proportional to the integral of the electrical activity of the diaphragm. The objective was to assess the physiologic response to varying pressure-support ventilation and neurally adjusted ventilatory assist levels in selected acute respiratory distress syndrome patients and to evaluate the effect of neural triggering. Methods: We prospectively assessed 11 consecutive patients with acute respiratory distress syndrome attributable to pulmonary diseases. Pressure-support ventilation and neurally adjusted ventilatory assist were used in random order. Neurally adjusted ventilatory assist was used with a low electrical activity of the diaphragm trigger (neurally adjusted ventilatory assist-electrical activity of the diaphragm) and with a high electrical activity of the diaphragm trigger that led to rescue triggering by inspiratory flow (neurally adjusted ventilatory assist-inspiratory flow). With each ventilation modality, four levels of assistance (100%, 120%, 140%, and 160%) were used in random order. Statistical analysis was performed using analysis of variance for repeated measurements and mixed models. Main Results: Contrary to pressure-support ventilation, neurally adjusted ventilatory assist-electrical activity of the diaphragm and neurally adjusted ventilatory assist-inspiratory flow were associated with stable tidal volume levels despite increasing assistance. For the asynchrony index, an interaction was present between ventilation mode and assist level (p ؍ .0076) because asynchrony index increased significantly with the pressure-support ventilation level (p ؍ .004), but not with the neurally adjusted ventilatory assist-electrical activity of the diaphragm or neurally adjusted ventilatory assist-inspiratory flow level. The lowest asynchrony index was obtained with neurally adjusted ventilatory assist-electrical activity of the diaphragm. Conclusion: Compared to pressure-support ventilation, neurally adjusted ventilatory assist in acute respiratory distress syndrome patients holds promise for limiting the risk of overassistance, preventing patient-ventilator asynchrony, and improving overall patient-ventilator interactions. Neural triggering (neurally adjusted ventilatory assist-electrical activity of the diaphragm) considerably decreased patient-ventilator asynchrony.
Medical Sciences, 2019
Traumatic brain injury (TBI) is a major healthcare problem and a major burden to society. The ide... more Traumatic brain injury (TBI) is a major healthcare problem and a major burden to society. The identification of a TBI can be challenging in the prehospital setting, particularly in elderly patients with unobserved falls. Errors in triage on scene cannot be ruled out based on limited clinical diagnostics. Potential new mobile diagnostics may decrease these errors. Prehospital care includes decision-making in clinical pathways, means of transport, and the degree of prehospital treatment. Emergency care at hospital admission includes the definitive diagnosis of TBI with, or without extracranial lesions, and triage to the appropriate receiving structure for definitive care. Early risk factors for an unfavorable outcome includes the severity of TBI, pupil reaction and age. These three variables are core variables, included in most predictive models for TBI, to predict short-term mortality. Additional early risk factors of mortality after severe TBI are hypotension and hypothermia. The ex...
BMJ Open
ObjectivesTo explore allophone immigrant women’s knowledge and perceptions of epidural analgesia ... more ObjectivesTo explore allophone immigrant women’s knowledge and perceptions of epidural analgesia for labour pain, in order to identify their information needs prior to the procedure.DesignWe conducted focus groups interviews with allophone women from five different linguistic immigrant communities, with the aid of professional interpreters. Thematic analysis of focus group transcripts was carried out by all authors.SettingWomen were recruited at two non-profit associations offering French language and cultural integration training to non-French speaking immigrant women in Geneva.ParticipantsForty women from 10 countries who spoke either Albanian, Arabic, Farsi/Dari, Tamil or Tigrigna took part in the five focus groups. Four participants were nulliparous, but all others had previous experience of labour and delivery, often in European countries. A single focus group was conducted for each of the five language groups.ResultsWe identified five main themes: (1) Women’s partial knowledge...
Le Praticien en Anesthésie Réanimation