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  1. Artikel ; Online: Deciding When to Start Renal Replacement Therapy After Cardiac Surgery in Real Life.

    Guillot, Olivier / Vandroux, David / Tiquet, Bérénice / Abdallah, Sahar / Jouan, Jérome / Tricard, Jeremy / Pihan, Franck

    Journal of cardiothoracic and vascular anesthesia

    2022  Band 37, Heft 4, Seite(n) 675–677

    Mesh-Begriff(e) Humans ; Cardiac Surgical Procedures ; Renal Replacement Therapy ; Continuous Renal Replacement Therapy ; Acute Kidney Injury
    Sprache Englisch
    Erscheinungsdatum 2022-12-26
    Erscheinungsland United States
    Dokumenttyp Letter
    ZDB-ID 1067317-9
    ISSN 1532-8422 ; 1053-0770
    ISSN (online) 1532-8422
    ISSN 1053-0770
    DOI 10.1053/j.jvca.2022.12.021
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: A Massive Venlafaxine Intoxication: Evolution of Cardiac Toxicity with Venlafaxine and O-Desmethylvenlafaxine Elimination Kinetics: A Grand Round.

    Couderc, Sylvain / Gabriel, Anthony / Decheiver, Sarah / N'Zoué Kanga, Sita / Fikanni, Amine / Flint, Harry / Pihan, Franck / Sahar, Abdallah / Tifrea, Marius / Tifrea, Andrea / Marsaud, Jean-Philippe / Vandroux, David

    Therapeutic drug monitoring

    2023  Band 46, Heft 2, Seite(n) 133–137

    Abstract: Background: This study presents the case of a 19-year-old woman who attempted suicide by ingesting 11.25 g of venlafaxine (V). She was admitted to the hospital with severe biventricular dysfunction, progressing to cardiac arrest requiring extracorporeal ...

    Abstract Background: This study presents the case of a 19-year-old woman who attempted suicide by ingesting 11.25 g of venlafaxine (V). She was admitted to the hospital with severe biventricular dysfunction, progressing to cardiac arrest requiring extracorporeal circulatory life support for 11 days. The pharmacokinetics of venlafaxine during impaired cardiac output and the effect of its active metabolite, the O-desmethylvenlafaxine (ODV), are currently not very well understood.
    Methods and results: Serum concentrations of V and ODV were monitored twice daily for 3 weeks. The maximum concentrations of venlafaxine and ODV were at 14 hours after ingestion, with 29,180 mcg/L for V and 5399 mcg/L for ODV. Half-lives increased, requiring 2 weeks to eliminate the drug. The left ventricular ejection fraction significantly improved when V + ODV was below 1000 mcg/L and remained altered until the ODV concentrations were lower than 400 mcg/L.
    Conclusions: This report, with complete elimination kinetic of V and ODV in a monodrug intoxication, provides information about the modification of pharmacokinetics in the case of an overdose managed by extracorporeal circulatory life support, the cardiac toxicity of ODV, and the value of the toxic threshold for the active moiety.
    Mesh-Begriff(e) Female ; Humans ; Young Adult ; Cardiotoxicity ; Desvenlafaxine Succinate ; Stroke Volume ; Teaching Rounds ; Venlafaxine Hydrochloride ; Ventricular Function, Left
    Chemische Substanzen Desvenlafaxine Succinate (ZB22ENF0XR) ; Venlafaxine Hydrochloride (7D7RX5A8MO)
    Sprache Englisch
    Erscheinungsdatum 2023-12-29
    Erscheinungsland United States
    Dokumenttyp Case Reports ; Journal Article
    ZDB-ID 424443-6
    ISSN 1536-3694 ; 0163-4356
    ISSN (online) 1536-3694
    ISSN 0163-4356
    DOI 10.1097/FTD.0000000000001167
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel ; Online: Clues of incomplete reversal of heparin in cardiac surgery.

    Tiquet, Bérénice / Pihan, Franck / Thomasset, Philippe / Denizou, Michel / Tifrea, Marius / Tifrea, Andreaa / Orsel, Isabelle / Marsaud, Jean Philippe / Jouan, Jérome / Vandroux, David

    Perfusion

    2023  Band 39, Heft 4, Seite(n) 784–789

    Abstract: Objectives: In our center, an unusual rate of patients had abnormalities of hemostasis in immediate postoperative period of cardiac surgery. Our objectives were to identify the cause of these sudden hemostasis abnormalities and to evaluate the ... ...

    Abstract Objectives: In our center, an unusual rate of patients had abnormalities of hemostasis in immediate postoperative period of cardiac surgery. Our objectives were to identify the cause of these sudden hemostasis abnormalities and to evaluate the performances of point of care coagulation testing.
    Methods: In this prospective and descriptive study, we included 33 consecutive patients undergoing elective cardiac surgery for 1 month. Heparin-induced anticoagulation and calculation of the protamine dose were tested by the Hemostasis Management System Plus device (Medtronic, Minneapolis, MN, USA). Fifteen minutes after the end of the protamine infusion, activated clotting time (ACT), activated partial thromboplastin time and anti Xa activity were measured. In case of unusual clinical bleeding, a Quantra analysis (Stago, HemoSonics LLC, Charlottesville, VA) was added.
    Results: Residual antiXa activity >0.2 IU/mL after neutralization was present in 44% of patients. Our investigation concluded incomplete heparin reversal. There was no association between cellular reinfusate and the presence of heparin. The unusual rate of hemostasis abnormalities was explained by a less efficient protamine reversal of heparin. ACT and Clot Time Ratio (CTR, Quantra system) correlated with AntiXa with Spearman's coefficients of 0.85 (
    Conclusion: The use of point of care coagulation testing is effective in detecting incomplete reversal of heparin.
    Mesh-Begriff(e) Humans ; Heparin/adverse effects ; Heparin/therapeutic use ; Male ; Female ; Cardiac Surgical Procedures/methods ; Aged ; Prospective Studies ; Middle Aged ; Protamines/therapeutic use ; Anticoagulants/therapeutic use ; Anticoagulants/pharmacology ; Blood Coagulation Tests/methods
    Chemische Substanzen Heparin (9005-49-6) ; Protamines ; Anticoagulants
    Sprache Englisch
    Erscheinungsdatum 2023-02-22
    Erscheinungsland England
    Dokumenttyp Journal Article
    ZDB-ID 645038-6
    ISSN 1477-111X ; 0267-6591
    ISSN (online) 1477-111X
    ISSN 0267-6591
    DOI 10.1177/02676591231160268
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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