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Papers by Patrick Schoettker
BJA: British Journal of Anaesthesia, Jul 1, 2020
Schweizerische Medizinische Wochenschrift, Sep 26, 2022
Introduction: We sought to study the operational and medical aspects of helicopter rescue mission... more Introduction: We sought to study the operational and medical aspects of helicopter rescue missions involving the use of a winch. Setting: A single helicopter-based medical service of a pre-alpine region of Switzerland. Methods: We prospectively studied consecutive primary rescue interventions involving winching of a physician, from October 1, 1998 to October 1, 2002. Demographic, medical and operational aspects as well as outcome at 48 hours were analyzed. Results: We included 133 patients. Most (74%) were male, with traumatic injuries (77%). The median scene time of the nine severely injured patients (Injury Severity Scale [ISS] 15) was significantly longer compared with the other patients (54 vs 37 minutes; P .05). The main medical procedures performed were orotracheal intubation (n 5), fracture reductions (n 5), major analgesia with sedation (n 4), and intravenous fluid administration of more than 1,500 mL (n 4). Fourteen (10%) patients suffering from minor injuries were triaged by the physician and not airlifted to the hospital. All 133 patients were alive at 48 hours. Sixty-nine (52%) were still hospitalized. No secondary interhospital transfer was required. Conclusion: Our study provides a better knowledge of injury profile, medical aspects, and outcomes of patients rescued necessitating a winching procedure.
Annales Francaises D Anesthesie Et De Reanimation, May 1, 2004
Resume Les indications a la sedation en neuroreanimation peuvent etre groupees dans deux classes ... more Resume Les indications a la sedation en neuroreanimation peuvent etre groupees dans deux classes principales : 1) des indications generales, semblables a celles des autres patients de reanimation : permettre les traitements de soutien (facilitation therapeutique), rendre supportable les traitements intensifs, controler les etats d'agitation, etc. ; 2) des indications specifiques liees aux effets neurophysiologiques des sedatifs : favoriser le controle de la pression intracrânienne, reduire l'excitabilite corticale lors de crises epileptiques et ainsi favoriser la recuperation du tissu cerebral et diminuer les lesions secondaires. Il faut d'emblee souligner que l'administration de sedatifs est habituellement combinee a celle d'opiaces qui potentialisent l'effet central des sedatifs et peuvent moduler leurs effets. L'arret de la sedation peut etre prolonge ou transitoire. L'arret complet est envisage lorsque l'etat clinique et cerebral du patient ne justifie plus une sedation, alors que l'arret temporaire est effectue pour permettre une evaluation neurologique. L'abondance de litterature sur la sedation et l'analgesie en reanimation contraste avec la pauvrete des etudes en neuroreanimation : en janvier 2002, la Societe americaine de soins intensifs a publie des recommandations dans ce domaine sans meme mentionner l'arret de la sedation en neuroreanimation. Le but de cette revue est de resumer les donnees de la litterature qui concernent les effets lies a l'interruption de la sedation et de la sedation–analgesie chez le patient de neuroreanimation.
Clinical Chemistry, Aug 1, 2013
Introduction: Electroconvulsive therapy (ECT) may be used to treat severe depression and needs a ... more Introduction: Electroconvulsive therapy (ECT) may be used to treat severe depression and needs a specific general anaesthesia. Important cardiovascular changes occur during the ECT with a parasympathetic induced bradycardia followed by a sympathetic response. A dedicated protocol was designed 6 years ago. The goal of this study was to analyse the management of anaesthesia for ECT in our institution, the adherence to the protocol and the occurrence of adverse events during anaesthesia. Methods: After Institutional Ethics Committee approval, we conducted a retrospective analysis of our anaesthesia protocol for patients scheduled for electroshock therapy during a five years period (2004- 2008). The protocol includes administration of atropine subcutaneously 30 minutes before the procedure, followed by general anaesthesia induced with etomidate (0.2 mg/kg). Suxamethonium (1 mg/kg) is administered after the inflation of a pneumatic tourniquet on the opposite arm, in order to observe the electroshocks convulsive effects. The psychiatrist initiates the convulsive crisis once curarisation is achieved. Face mask ventilation is then applied during the post-ictal phase with closed blood pressure monitoring. : 228 ECT were performed in 25 patients. The median dosage of etomidate was 0.37 mg/kg and suxamethonium 1.20 mg/kg. Hypertension during the ECT procedure was present in 62.7% of cases, tachycardia 23.2% and bradycardia 10.5%. Esmolol was administered in 73.4% of hypertensive patients in a range of 0 to 30 mg. The protocol was followed in half of the cases in regards to atropine administration (50.4%). We observed a significant increase of hypertension (73.9%, p = 0.001) after atropine administration, without effect on heart rate. Conclusions: The management of anaesthesia for ECT is specific and follows a predefined protocol in our institution. Adherence to our protocol was poor. Adverse events are frequent and significant association between the administration of atropine and the incidence of hypertension as well as poor protocol adherence implies reconsideration of our anaesthesia protocol for electroconvulsive therapy and better quality control of the clinical practice
BJA: British Journal of Anaesthesia, Jul 1, 2020
BJA: British Journal of Anaesthesia, May 1, 2016
Journal of the American College of Cardiology, Mar 1, 2023
Risk of symptomatic heterotopic ossification following plate osteosynthesis in multiple trauma pa... more Risk of symptomatic heterotopic ossification following plate osteosynthesis in multiple trauma patients: an analysis in a level-1 trauma centre
British Journal of Anaesthesia, 2016
Revue médicale suisse, Aug 25, 2021
This article is a descriptive analysis of the organizational steps undertaken to transform eight ... more This article is a descriptive analysis of the organizational steps undertaken to transform eight OR (operating rooms) of the University Hospital Lausanne CHUV into a dedicated ICU (intensive care unit) during the COVID-19 pandemic. An efficient response of our institution was mandatory to timely increase the number of ICU beds. The transformation of an entire floor of a functioning operating ward was deemed the most appropriate solution to provide rapidly a significant number of beds. The newly created ICU was the first additional ICU to open and admitted its first patient 48 hours after the beginning of the transformation.
Pediatric Emergency Care, Dec 13, 2019
Journal of Hypertension, Jun 1, 2022
BMC Anesthesiology, Aug 15, 2022
Journal of Clinical Monitoring and Computing, Aug 18, 2021
To provide information about the clinical relevance of blood pressure (BP) measurement difference... more To provide information about the clinical relevance of blood pressure (BP) measurement differences between a new smartphone application (OptiBP™) and the reference method (automated oscillometric technique) using a noninvasive brachial cuff in patients admitted to the emergency department. We simultaneously recorded three BP measurements using both the reference method and the novel OptiBP™ (test method), except when the inter-arm difference was > 10 mmHg BP. Each OptiBP™ measurement required 1-min and the subsequent reference method values were compared to the values obtained with OptiBP™ using a Bland–Altman analysis and error grid analysis. Among the 110 patients recruited, OptiBP™ BP values could be collected on 61 patients (55%) and were included in the statistical analysis. The mean of differences (95% limits of agreement) between the reference method and the test method were − 0.1(− 22.5 to 22.4 mmHg) for systolic arterial pressure (SAP), − 0.1(− 12.9 to 12.7 mmHg) for diastolic arterial pressure (DAP) and − 0.3(− 18.1 to 17.4 mmHg) for mean arterial pressure (MAP). The proportions of measurements in risk zones A-E were 86.9%, 13.1%, 0%, 0%, and 0% for MAP and 89.3%, 10.7%, 0%, 0%, and 0% for SAP. In this pilot study conducted in stable and awake patients admitted to the emergency department, the absolute agreement between the OptiBP™ and the reference method was moderate. However, when BP measurements were made immediately after an initial calibration, error grid analysis showed that 100% of measurement differences between the OptiBP™ and reference method were categorized as no- or low-risk treatment decisions for all patients. Trial Registration: ClinicalTrials.gov Identifier: NCT04121624.
Anesthésie & Réanimation, Nov 1, 2017
Anaesthesia, critical care & pain medicine, Dec 1, 2018
Schweizerische Medizinische Wochenschrift, 2010
Reference EPFL-CONF-172110View record in Web of Science Record created on 2011-12-16, modified on... more Reference EPFL-CONF-172110View record in Web of Science Record created on 2011-12-16, modified on 2016-08-09
Anaesthesia, critical care & pain medicine, Oct 1, 2023
BJA: British Journal of Anaesthesia, Jul 1, 2020
Schweizerische Medizinische Wochenschrift, Sep 26, 2022
Introduction: We sought to study the operational and medical aspects of helicopter rescue mission... more Introduction: We sought to study the operational and medical aspects of helicopter rescue missions involving the use of a winch. Setting: A single helicopter-based medical service of a pre-alpine region of Switzerland. Methods: We prospectively studied consecutive primary rescue interventions involving winching of a physician, from October 1, 1998 to October 1, 2002. Demographic, medical and operational aspects as well as outcome at 48 hours were analyzed. Results: We included 133 patients. Most (74%) were male, with traumatic injuries (77%). The median scene time of the nine severely injured patients (Injury Severity Scale [ISS] 15) was significantly longer compared with the other patients (54 vs 37 minutes; P .05). The main medical procedures performed were orotracheal intubation (n 5), fracture reductions (n 5), major analgesia with sedation (n 4), and intravenous fluid administration of more than 1,500 mL (n 4). Fourteen (10%) patients suffering from minor injuries were triaged by the physician and not airlifted to the hospital. All 133 patients were alive at 48 hours. Sixty-nine (52%) were still hospitalized. No secondary interhospital transfer was required. Conclusion: Our study provides a better knowledge of injury profile, medical aspects, and outcomes of patients rescued necessitating a winching procedure.
Annales Francaises D Anesthesie Et De Reanimation, May 1, 2004
Resume Les indications a la sedation en neuroreanimation peuvent etre groupees dans deux classes ... more Resume Les indications a la sedation en neuroreanimation peuvent etre groupees dans deux classes principales : 1) des indications generales, semblables a celles des autres patients de reanimation : permettre les traitements de soutien (facilitation therapeutique), rendre supportable les traitements intensifs, controler les etats d'agitation, etc. ; 2) des indications specifiques liees aux effets neurophysiologiques des sedatifs : favoriser le controle de la pression intracrânienne, reduire l'excitabilite corticale lors de crises epileptiques et ainsi favoriser la recuperation du tissu cerebral et diminuer les lesions secondaires. Il faut d'emblee souligner que l'administration de sedatifs est habituellement combinee a celle d'opiaces qui potentialisent l'effet central des sedatifs et peuvent moduler leurs effets. L'arret de la sedation peut etre prolonge ou transitoire. L'arret complet est envisage lorsque l'etat clinique et cerebral du patient ne justifie plus une sedation, alors que l'arret temporaire est effectue pour permettre une evaluation neurologique. L'abondance de litterature sur la sedation et l'analgesie en reanimation contraste avec la pauvrete des etudes en neuroreanimation : en janvier 2002, la Societe americaine de soins intensifs a publie des recommandations dans ce domaine sans meme mentionner l'arret de la sedation en neuroreanimation. Le but de cette revue est de resumer les donnees de la litterature qui concernent les effets lies a l'interruption de la sedation et de la sedation–analgesie chez le patient de neuroreanimation.
Clinical Chemistry, Aug 1, 2013
Introduction: Electroconvulsive therapy (ECT) may be used to treat severe depression and needs a ... more Introduction: Electroconvulsive therapy (ECT) may be used to treat severe depression and needs a specific general anaesthesia. Important cardiovascular changes occur during the ECT with a parasympathetic induced bradycardia followed by a sympathetic response. A dedicated protocol was designed 6 years ago. The goal of this study was to analyse the management of anaesthesia for ECT in our institution, the adherence to the protocol and the occurrence of adverse events during anaesthesia. Methods: After Institutional Ethics Committee approval, we conducted a retrospective analysis of our anaesthesia protocol for patients scheduled for electroshock therapy during a five years period (2004- 2008). The protocol includes administration of atropine subcutaneously 30 minutes before the procedure, followed by general anaesthesia induced with etomidate (0.2 mg/kg). Suxamethonium (1 mg/kg) is administered after the inflation of a pneumatic tourniquet on the opposite arm, in order to observe the electroshocks convulsive effects. The psychiatrist initiates the convulsive crisis once curarisation is achieved. Face mask ventilation is then applied during the post-ictal phase with closed blood pressure monitoring. : 228 ECT were performed in 25 patients. The median dosage of etomidate was 0.37 mg/kg and suxamethonium 1.20 mg/kg. Hypertension during the ECT procedure was present in 62.7% of cases, tachycardia 23.2% and bradycardia 10.5%. Esmolol was administered in 73.4% of hypertensive patients in a range of 0 to 30 mg. The protocol was followed in half of the cases in regards to atropine administration (50.4%). We observed a significant increase of hypertension (73.9%, p = 0.001) after atropine administration, without effect on heart rate. Conclusions: The management of anaesthesia for ECT is specific and follows a predefined protocol in our institution. Adherence to our protocol was poor. Adverse events are frequent and significant association between the administration of atropine and the incidence of hypertension as well as poor protocol adherence implies reconsideration of our anaesthesia protocol for electroconvulsive therapy and better quality control of the clinical practice
BJA: British Journal of Anaesthesia, Jul 1, 2020
BJA: British Journal of Anaesthesia, May 1, 2016
Journal of the American College of Cardiology, Mar 1, 2023
Risk of symptomatic heterotopic ossification following plate osteosynthesis in multiple trauma pa... more Risk of symptomatic heterotopic ossification following plate osteosynthesis in multiple trauma patients: an analysis in a level-1 trauma centre
British Journal of Anaesthesia, 2016
Revue médicale suisse, Aug 25, 2021
This article is a descriptive analysis of the organizational steps undertaken to transform eight ... more This article is a descriptive analysis of the organizational steps undertaken to transform eight OR (operating rooms) of the University Hospital Lausanne CHUV into a dedicated ICU (intensive care unit) during the COVID-19 pandemic. An efficient response of our institution was mandatory to timely increase the number of ICU beds. The transformation of an entire floor of a functioning operating ward was deemed the most appropriate solution to provide rapidly a significant number of beds. The newly created ICU was the first additional ICU to open and admitted its first patient 48 hours after the beginning of the transformation.
Pediatric Emergency Care, Dec 13, 2019
Journal of Hypertension, Jun 1, 2022
BMC Anesthesiology, Aug 15, 2022
Journal of Clinical Monitoring and Computing, Aug 18, 2021
To provide information about the clinical relevance of blood pressure (BP) measurement difference... more To provide information about the clinical relevance of blood pressure (BP) measurement differences between a new smartphone application (OptiBP™) and the reference method (automated oscillometric technique) using a noninvasive brachial cuff in patients admitted to the emergency department. We simultaneously recorded three BP measurements using both the reference method and the novel OptiBP™ (test method), except when the inter-arm difference was > 10 mmHg BP. Each OptiBP™ measurement required 1-min and the subsequent reference method values were compared to the values obtained with OptiBP™ using a Bland–Altman analysis and error grid analysis. Among the 110 patients recruited, OptiBP™ BP values could be collected on 61 patients (55%) and were included in the statistical analysis. The mean of differences (95% limits of agreement) between the reference method and the test method were − 0.1(− 22.5 to 22.4 mmHg) for systolic arterial pressure (SAP), − 0.1(− 12.9 to 12.7 mmHg) for diastolic arterial pressure (DAP) and − 0.3(− 18.1 to 17.4 mmHg) for mean arterial pressure (MAP). The proportions of measurements in risk zones A-E were 86.9%, 13.1%, 0%, 0%, and 0% for MAP and 89.3%, 10.7%, 0%, 0%, and 0% for SAP. In this pilot study conducted in stable and awake patients admitted to the emergency department, the absolute agreement between the OptiBP™ and the reference method was moderate. However, when BP measurements were made immediately after an initial calibration, error grid analysis showed that 100% of measurement differences between the OptiBP™ and reference method were categorized as no- or low-risk treatment decisions for all patients. Trial Registration: ClinicalTrials.gov Identifier: NCT04121624.
Anesthésie & Réanimation, Nov 1, 2017
Anaesthesia, critical care & pain medicine, Dec 1, 2018
Schweizerische Medizinische Wochenschrift, 2010
Reference EPFL-CONF-172110View record in Web of Science Record created on 2011-12-16, modified on... more Reference EPFL-CONF-172110View record in Web of Science Record created on 2011-12-16, modified on 2016-08-09
Anaesthesia, critical care & pain medicine, Oct 1, 2023