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  1. Article: Cardiac tamponade during thoracic endovascular aortic repair.

    Bousselmi, Radhouane / Lebbi, Anis / Chaouech, Nazih / Ferjani, Mustapha

    Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences

    2014  Volume 19, Issue 6, Page(s) 571–573

    Abstract: Thoracic endovascular aortic repair (TEVAR) is still associated with complications which include mortality in 7.3% of cases. In this report, we describe the case of a man with a pseudoaneurysm of the aortic isthmus that was scheduled to undergo ... ...

    Abstract Thoracic endovascular aortic repair (TEVAR) is still associated with complications which include mortality in 7.3% of cases. In this report, we describe the case of a man with a pseudoaneurysm of the aortic isthmus that was scheduled to undergo endovascular repair. During the procedure, the patient had a sudden cardiac arrest due to a compressive hemopericardium caused by perforation of the ascending aorta. The diagnosis was not clear and was made by transthoracic echocardiography after five minutes of resuscitation. In spite of the evacuation of the hemopericardium and suture of the perforation, the patient died. The diagnosis would have been easier and faster if the patient had been monitored continuously by transesophageal echocardiography during the procedure.
    Language English
    Publishing date 2014-08-12
    Publishing country India
    Document type Case Reports
    ZDB-ID 2513029-8
    ISSN 1735-7136 ; 1735-1995
    ISSN (online) 1735-7136
    ISSN 1735-1995
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    Zs.A 6810: Show issues Location:
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  2. Article ; Online: Cardiac tamponade during thoracic endovascular aortic repair

    Radhouane Bousselmi / Anis Lebbi / Nazih Chaouech / Mustapha Ferjani

    Journal of Research in Medical Sciences, Vol 19, Iss 6, Pp 571-

    2014  Volume 573

    Abstract: Thoracic endovascular aortic repair (TEVAR) is still associated with complications which include mortality in 7.3% of cases. In this report, we describe the case of a man with a pseudoaneurysm of the aortic isthmus that was scheduled to undergo ... ...

    Abstract Thoracic endovascular aortic repair (TEVAR) is still associated with complications which include mortality in 7.3% of cases. In this report, we describe the case of a man with a pseudoaneurysm of the aortic isthmus that was scheduled to undergo endovascular repair. During the procedure, the patient had a sudden cardiac arrest due to a compressive hemopericardium caused by perforation of the ascending aorta. The diagnosis was not clear and was made by transthoracic echocardiography after five minutes of resuscitation. In spite of the evacuation of the hemopericardium and suture of the perforation, the patient died. The diagnosis would have been easier and faster if the patient had been monitored continuously by transesophageal echocardiography during the procedure.
    Keywords Cardiac arrest ; endovascular procedures ; hemopericardium ; pseudoaneurysm ; thoracic aorta ; Medicine ; R
    Language English
    Publishing date 2014-01-01T00:00:00Z
    Publisher Wolters Kluwer Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article: Myocardial ischemic conditioning: Physiological aspects and clinical applications in cardiac surgery.

    Bousselmi, Radhouane / Lebbi, Mohamed Anis / Ferjani, Mustapha

    Journal of the Saudi Heart Association

    2013  Volume 26, Issue 2, Page(s) 93–100

    Abstract: Ischemia-reperfusion is a major determinant of myocardial impairment in patients undergoing cardiac surgery. The main goal of research in cardioprotection is to develop effective techniques to avoid ischemia-reperfusion lesions. Myocardial ischemic ... ...

    Abstract Ischemia-reperfusion is a major determinant of myocardial impairment in patients undergoing cardiac surgery. The main goal of research in cardioprotection is to develop effective techniques to avoid ischemia-reperfusion lesions. Myocardial ischemic conditioning is a powerful endogenous cardioprotective phenomenon. First described in animals in 1986, myocardial ischemic conditioning consists of applying increased tolerance of the myocardium to sustained ischemia by exposing it to brief episodes of ischemia-reperfusion. Several studies have sought to demonstrate its effective cardioprotective action in humans and to understand its underlying mechanisms. Myocardial ischemic conditioning has two forms: ischemic preconditioning (IPC) when the conditioning stimulus is applied before the index ischemia and ischemic postconditioning when the conditioning stimulus is applied after it. The cardioprotective action of ischemic conditioning was reproduced by applying the ischemia-reperfusion stimulus to organs remote from the heart. This non-invasive manner of applying ischemic conditioning has led to its application in clinical settings. Clinical trials for the different forms of ischemic conditioning were mainly developed in cardiac surgery. Many studies suggest that this phenomenon can represent an interesting adjuvant to classical cardioprotection during on-pump cardiac surgery. Ischemic conditioning was also tested in interventional cardiology with interesting results. Finally, advances made in the understanding of mechanisms that underlie the cardioprotective action of ischemic conditioning have paved the way to a new form of myocardial conditioning which is pharmacological conditioning.
    Language English
    Publishing date 2013-11-13
    Publishing country Saudi Arabia
    Document type Journal Article ; Review
    ZDB-ID 2515647-0
    ISSN 1016-7315
    ISSN 1016-7315
    DOI 10.1016/j.jsha.2013.11.001
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  4. Article: Ultrasound-guided spinal anesthesia in an obese patient.

    Lebbi, Mohamed Anis / Trabelsi, Walid / Bousselmi, Radhouane / Messaoudi, Abdelhakim / Labbène, Iheb / Ferjani, Mustapha

    La Tunisie medicale

    2014  Volume 92, Issue 2, Page(s) 164–166

    Abstract: We describe the case of 62-year-old man with a body mass index of 53, hypertension, diabetes mellitus and obstructive sleep apnea that was proposed for transurethral resection of prostate under spinal anesthesia. The surface landmark-guided approach was ... ...

    Abstract We describe the case of 62-year-old man with a body mass index of 53, hypertension, diabetes mellitus and obstructive sleep apnea that was proposed for transurethral resection of prostate under spinal anesthesia. The surface landmark-guided approach was difficult and was abandoned after many unsuccessful attempts. Spinal anesthesia was achieved in one attempt with ultrasound guidance using the midline approach at the identified level. The trajectory was determined from the transducer angle.
    MeSH term(s) Anesthesia, Spinal/methods ; Body Mass Index ; Humans ; Male ; Middle Aged ; Obesity/complications ; Obesity/surgery ; Prostatic Diseases/complications ; Prostatic Diseases/surgery ; Sleep Apnea, Obstructive/complications ; Sleep Apnea, Obstructive/surgery ; Transurethral Resection of Prostate/methods ; Ultrasonography, Interventional/methods
    Language English
    Publishing date 2014-02
    Publishing country Tunisia
    Document type Case Reports ; Journal Article
    ZDB-ID 128627-4
    ISSN 0041-4131
    ISSN 0041-4131
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    Zs.B 223: Show issues Location:
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  5. Article: Anesthetic management of a giant extracranial internal carotid artery aneurysm.

    Bousselmi, Radhouane / Lebbi, Mohamed Anis / Romdhani, Chihebeddine / Ben Gabsia, Abdelkader / Massoudi, Abdelhakim / Chaouech, Nazih / Manaa, Jameleddine / Ferjani, Mustapha

    La Tunisie medicale

    2014  Volume 92, Issue 6, Page(s) 430–431

    MeSH term(s) Aged ; Anesthesia ; Aneurysm/surgery ; Carotid Artery, Internal/pathology ; Female ; Humans
    Language English
    Publishing date 2014-06
    Publishing country Tunisia
    Document type Case Reports ; Letter
    ZDB-ID 128627-4
    ISSN 0041-4131
    ISSN 0041-4131
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  6. Article: Hemodiafiltration using pre-dilutional on-line citrate dialysate: A new technique for regional citrate anticoagulation: A feasibility study.

    Bousselmi, Radhouane / Baffoun, Anis / Hajjej, Zied / Saleh, Mohamed Ben / Labbene, Iheb / Ferjani, Mustapha / Hmida, Mohamed Jalel

    Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia

    2015  Volume 26, Issue 4, Page(s) 739–742

    Abstract: A prospective, observational, feasibility study was carried out on four patients with end-stage renal failure undergoing bicarbonate hemodialysis to study the feasibility of an on-line hemodiafiltration technique using a citrate dialysate with pre- ... ...

    Abstract A prospective, observational, feasibility study was carried out on four patients with end-stage renal failure undergoing bicarbonate hemodialysis to study the feasibility of an on-line hemodiafiltration technique using a citrate dialysate with pre-dilutional infusion of citrate as a technique for regional citrate anticoagulation. All patients had contraindication to systemic heparin anticoagulation. The dialysis technique consisted of an on-line hemodiafiltration with a citrate dialysate without calcium using a Fresenius 4008S dialysis machine and Fresenius Polysulfone F60 dialyzers. The infusion solution was procured directly from the dialysate and was infused into the arterial line. To avoid the risk of hypocalcemia, calcium gluconate was infused to the venous return line. The study was carried out in two stages. During the first stage, the citrate infusion rate was 80 mL/min and the calcium infusion rate was 9 mmol/h. At the second stage, the rates were 100 mL/min and 11 mmol/h, respectively. The primary endpoint of this study was the incidence of thrombosis in the extracorporeal blood circuit and/or the dialyzer. A total of 78 sessions were conducted. All the sessions were well tolerated clinically and there were no major incidents in any of the four patients. At the first stage of the study, there were five incidences of small clots in the venous blood chamber, an incidence of extracorporeal blood circuit thrombosis of 12.5%. At the second stage of the study, no cases of extracorporeal blood circuit or dialyzer thrombosis were noted. Hemodiafiltration with on-line citrate dialysate infusion to the arterial line is safe and allows an effective regional anticoagulation of the extracorporeal blood circuit without the need for systemic anticoagulation.
    Language English
    Publishing date 2015-07
    Publishing country Saudi Arabia
    Document type Journal Article
    ZDB-ID 1379955-1
    ISSN 1319-2442
    ISSN 1319-2442
    DOI 10.4103/1319-2442.160195
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    Zs.A 4735: Show issues Location:
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  7. Article: Mechanical post-conditioning in STEMI patients undergoing primary percutaneous coronary intervention.

    Boukhris, Marouane / Bousselmi, Radhouane / Tomasello, Salvatore Davide / Elhadj, Zied Ibn / Azzarelli, Salvatore / Marzà, Francesco / Galassi, Alfredo R

    Journal of the Saudi Heart Association

    2014  Volume 27, Issue 3, Page(s) 192–200

    Abstract: Although early myocardial reperfusion via primary percutaneous coronary intervention (PCI) allows the preservation of left ventricular function and improves outcome, the acute restoration of blood flow may contribute to the pathophysiology of infarction, ...

    Abstract Although early myocardial reperfusion via primary percutaneous coronary intervention (PCI) allows the preservation of left ventricular function and improves outcome, the acute restoration of blood flow may contribute to the pathophysiology of infarction, a complex phenomenon called reperfusion injury. First described in animal models of coronary obstruction, mechanical post-conditioning, a sequence of repetitive interruption of coronary blood flow applied immediately after reopening of the occluded vessel, was able to reduce the infarct size. However, evidence of its real benefit remains controversial. This review describes the mechanisms of post-conditioning action and the different protocols employed focusing on its impact on primary PCI outcome.
    Language English
    Publishing date 2014-11-20
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 2515647-0
    ISSN 1016-7315
    ISSN 1016-7315
    DOI 10.1016/j.jsha.2014.11.001
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  8. Article ; Online: Hemodiafiltration using pre-dilutional on-line citrate dialysate

    Radhouane Bousselmi / Anis Baffoun / Zied Hajjej / Mohamed Ben Saleh / Iheb Labbene / Mustapha Ferjani / Mohamed Jalel Hmida

    Saudi Journal of Kidney Diseases and Transplantation, Vol 26, Iss 4, Pp 739-

    A new technique for regional citrate anticoagulation: A feasibility study

    2015  Volume 742

    Abstract: A prospective, observational, feasibility study was carried out on four patients with end-stage renal failure undergoing bicarbonate hemodialysis to study the feasibility of an on-line hemodiafiltration technique using a citrate dialysate with pre- ... ...

    Abstract A prospective, observational, feasibility study was carried out on four patients with end-stage renal failure undergoing bicarbonate hemodialysis to study the feasibility of an on-line hemodiafiltration technique using a citrate dialysate with pre-dilutional infusion of citrate as a technique for regional citrate anticoagulation. All patients had contraindication to systemic heparin anticoagulation. The dialysis technique consisted of an on-line hemodiafiltration with a citrate dialysate without calcium using a Fresenius 4008S dialysis machine and Fresenius Polysulfone F60 dialyzers. The infusion solution was procured directly from the dialysate and was infused into the arterial line. To avoid the risk of hypocalcemia, calcium gluconate was infused to the venous return line. The study was carried out in two stages. During the first stage, the citrate infusion rate was 80 mL/min and the calcium infusion rate was 9 mmol/h. At the second stage, the rates were 100 mL/min and 11 mmol/h, respectively. The primary endpoint of this study was the incidence of thrombosis in the extracorporeal blood circuit and/or the dialyzer. A total of 78 sessions were conducted. All the sessions were well tolerated clinically and there were no major incidents in any of the four patients. At the first stage of the study, there were five incidences of small clots in the venous blood chamber, an incidence of extracorporeal blood circuit thrombosis of 12.5%. At the second stage of the study, no cases of extracorporeal blood circuit or dialyzer thrombosis were noted. Hemodiafiltration with on-line citrate dialysate infusion to the arterial line is safe and allows an effective regional anticoagulation of the extracorporeal blood circuit without the need for systemic anticoagulation.
    Keywords Diseases of the genitourinary system. Urology ; RC870-923 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2015-01-01T00:00:00Z
    Publisher Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article: Lidocaine reduces endotracheal tube associated side effects when instilled over the glottis but not when used to inflate the cuff: A double blind, placebo-controlled, randomized trial.

    Bousselmi, Radhouane / Lebbi, Mohamed Anis / Bargaoui, Abderrahmen / Ben Romdhane, Marien / Messaoudi, Abdelhakim / Ben Gabsia, Abdelkader / Ferjani, Mustapha

    La Tunisie medicale

    2014  Volume 92, Issue 1, Page(s) 29–33

    Abstract: Background: Tracheal intubation results in an alteration of the laryngeal mucosa which can lead to undesirable effects at emergence from anaesthesia. Local anesthetics, when administered topically, may represent an interesting alternative to reduce ... ...

    Abstract Background: Tracheal intubation results in an alteration of the laryngeal mucosa which can lead to undesirable effects at emergence from anaesthesia. Local anesthetics, when administered topically, may represent an interesting alternative to reduce these side effects.
    Aim: In this trial, we aimed to evaluate the effect of lidocaine in preventing tracheal intubation related side effects at emergence from anaesthesia, when instilled onto the glottis before intubation or used to inflate the endotracheal tube cuff.
    Methods: Eighty patients scheduled to elective surgery of less than 120 minutes under general anaesthesia were enrolled in this prospective, randomized, controlled, double blind study. As they receive instillation of 2% lidocaine or saline onto the glottis before intubation, and as they have their endotracheal tube cuff filled with 2% lidocaine or saline, the patients were randomized in four groups. S-S (Saline instillation and saline in the cuff); S-Lido (saline instillation and lidocaine in the cuff); Lido-S (lidocaine instillation and saline in the cuff); Lido-Lido (lidocaine instillation and lidocaine in the cuff). The primary outcome was the incidence of coughing before extubation. The secondary outcomes were sore throat scores at H1 and H24 postoperatively and incidence of dysphagia, dysphonia and laryngeal dyspnea during the first 24 hours.
    Results: Coughing occurred in 80%, 70%, 30% and 20% of patients in S-S, S-Lido, Lido-S and Lido-Lido groups respectively. When compared to S-S group, the incidence of coughing was significantly reduced in Lido-S and Lido-Lido groups but not in S-Lido group (p1=0.003; p2=0.0003; p3=0.7 respectively). Sore throat scores at H1 and H24 were significantly lower in Lido-S and Lido-Lido groups (p1=0.00002 and p2=0.01). There was no significant difference between groups regarding the incidence of dysphagia, dysphonia and laryngeal dyspnea.
    Conclusion: When instilled onto the glottis before intubation, lidocaine reduced both the incidence of coughing and the severity of postoperative sore throat in surgery of less than 120 minutes. Intracuff lidocaine was not effective to reduce neither coughing nor sore throat severity.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anesthetics, Local/administration & dosage ; Cough/epidemiology ; Cough/prevention & control ; Double-Blind Method ; Female ; Glottis/drug effects ; Humans ; Instillation, Drug ; Intubation, Intratracheal/adverse effects ; Intubation, Intratracheal/instrumentation ; Intubation, Intratracheal/methods ; Lidocaine/administration & dosage ; Male ; Middle Aged ; Pharyngitis/epidemiology ; Pharyngitis/prevention & control ; Placebos ; Postoperative Complications/prevention & control ; Young Adult
    Chemical Substances Anesthetics, Local ; Placebos ; Lidocaine (98PI200987)
    Language English
    Publishing date 2014-01
    Publishing country Tunisia
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 128627-4
    ISSN 0041-4131
    ISSN 0041-4131
    Database MEDical Literature Analysis and Retrieval System OnLINE

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