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  1. Article ; Online: Evaluation of the Analgesia Nociception Index and videopupillometry to predict post-tonsillectomy morphine requirements in children

    Evrard, Bruno / Lefebvre, Cyrielle / Spiry, Paul / Hodler, Charles / Chapellas, Catherine / Youssef, Baher / Gauthier, François / Marais, Loïc / Labrunie, Anaïs / Douchez, Marie / Senges, Patrick / Cros, Jérôme / Nathan-Denizot, Nathalie

    BJA open

    2022  Volume 3, Page(s) 100024

    Abstract: Background: Tonsil surgery causes significant and challenging postoperative pain. The Analgesia Nociception Index (ANI) and videopupillometry are two techniques of interest to monitor nociception in adults and may predict postoperative morphine ... ...

    Abstract Background: Tonsil surgery causes significant and challenging postoperative pain. The Analgesia Nociception Index (ANI) and videopupillometry are two techniques of interest to monitor nociception in adults and may predict postoperative morphine requirements. We hypothesised that these techniques could predict the need for morphine after tonsillectomy in children. The main objective was to assess the prognostic significance of ANI and videopupillometry, measured at the end of surgery, on morphine consumption determined by a Face, Legs, Activity, Cry, Consolability (FLACC) scale score >3 in the Post Anesthesia Care Unit (PACU).
    Methods: A single-centre, prospective, interventional study evaluating children between 2 and 7 yr old undergoing tonsil surgery was performed. ANI and videopupillometry with tetanic stimulation were measured under general anaesthesia 4 min after the end of the surgical procedure. Each child was evaluated every 10 min by a nurse using the FLACC scale in the PACU and blinded to the measurements performed in the operating theatre.
    Results: Eighty-nine children were analysed and 39 (44%) received morphine in the PACU. Neither ANI values nor videopupillometry values were predictive of postoperative morphine consumption (areas under the receiver operating characteristic curve 0.54, 95% confidence interval [CI; 0.42-0.65], and
    Conclusions: Neither ANI nor videopupillometry performed at the end of surgery can predict morphine consumption in the PACU in children undergoing tonsillectomy.
    Language English
    Publishing date 2022-07-31
    Publishing country England
    Document type Journal Article
    ISSN 2772-6096
    ISSN (online) 2772-6096
    DOI 10.1016/j.bjao.2022.100024
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Facial purpura associated with Capnocytophaga canimorsus septicaemia; role of sunlight?

    Kennel, Céline / Barraud, Olivier / Lapebie, François-Xavier / Sparsa, Agnes / Duvoid, Tiffany / Chapellas, Catherine / Hidri, Nadia / Francois, Bruno

    European journal of dermatology : EJD

    2013  Volume 23, Issue 3, Page(s) 427–428

    MeSH term(s) Capnocytophaga ; Facial Dermatoses/microbiology ; Gram-Negative Bacterial Infections/etiology ; Humans ; Male ; Middle Aged ; Purpura Fulminans/microbiology ; Sepsis/etiology ; Sunlight/adverse effects
    Language English
    Publishing date 2013-05
    Publishing country France
    Document type Case Reports ; Letter
    ZDB-ID 1128666-0
    ISSN 1952-4013 ; 1167-1122
    ISSN (online) 1952-4013
    ISSN 1167-1122
    DOI 10.1684/ejd.2013.2032
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Prognostic impact of left ventricular diastolic function in patients with septic shock.

    Gonzalez, Céline / Begot, Emmanuelle / Dalmay, François / Pichon, Nicolas / François, Bruno / Fedou, Anne-Laure / Chapellas, Catherine / Galy, Antoine / Mancia, Claire / Daix, Thomas / Vignon, Philippe

    Annals of intensive care

    2016  Volume 6, Issue 1, Page(s) 36

    Abstract: Background: Left ventricular (LV) diastolic dysfunction is highly prevalent in the general population and associated with a significant morbidity and mortality. Its prognostic role in patients sustaining septic shock in the intensive care unit (ICU) ... ...

    Abstract Background: Left ventricular (LV) diastolic dysfunction is highly prevalent in the general population and associated with a significant morbidity and mortality. Its prognostic role in patients sustaining septic shock in the intensive care unit (ICU) remains controversial. Accordingly, we investigated whether LV diastolic function was independently associated with ICU mortality in a cohort of septic shock patients assessed using critical care echocardiography.
    Methods: Over a 5-year period, patients hospitalized in a Medical-Surgical ICU who underwent an echocardiographic assessment with digitally stored images during the initial management of a septic shock were included in this retrospective single-center study. Off-line echocardiographic measurements were independently performed by an expert in critical care echocardiography who was unaware of patients' outcome. LV diastolic dysfunction was defined by the presence of a lateral E' maximal velocity <10 cm/s. A multivariate analysis was performed to determine independent risk factors associated with ICU mortality.
    Results: Among the 540 patients hospitalized in the ICU with septic shock during the study period, 223 were studied (140 men [63 %]; age 64 ± 13 years; SAPS II 55 ± 18; SOFA 10 ± 3; Charlson 3.5 ± 2.5) and 204 of them (91 %) were mechanically ventilated. ICU mortality was 35 %. LV diastolic dysfunction was observed in 31 % of patients. The proportion of LV diastolic dysfunction tended to be higher in non-survivors than in their counterparts (28/78 [36 %] vs. 41/145 [28 %]: p = 0.15). Inappropriate initial antibiotic therapy (OR 4.17 [CI 95 % 1.33-12.5]: p = 0.03), maximal dose of vasopressors (OR 1.38 [CI 95 % 1.16-1.63]: p = 0.01), SOFA score (OR 1.16 [CI 95 % 1.02-1.32]: p = 0.02) and lateral E' maximal velocity (OR 1.12 [CI 95 % 1.01-1.24]: p = 0.02) were independently associated with ICU mortality. After adjusting for the SAPS II score, inappropriate initial antibiotic therapy and maximal dose of vasopressors remained independent factors for ICU mortality, whereas a trend was only observed for lateral E' maximal velocity (OR 1.11 [CI 95 % 0.99-1.23]: p = 0.07).
    Conclusion: The present study suggests that LV diastolic function might be associated with ICU mortality in patients with septic shock. A multicenter prospective study assessing a large cohort of patients using serial echocardiographic examinations remains required to confirm the prognostic value of LV diastolic dysfunction in septic shock.
    Language English
    Publishing date 2016-04-21
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2617094-2
    ISSN 2110-5820
    ISSN 2110-5820
    DOI 10.1186/s13613-016-0136-6
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