Publications by authors named "Albaladejo P"
Background: Similar to other continents, Europe is experiencing a shortage of anaesthesia workforce, which profoundly impacts the national healthcare systems of affected countries.
Objective: To assess the current landscape of the anaesthesia workforce, organisational practices, rules and responsibilities of anaesthesiologists and other anaesthesia providers in operating rooms.
Design: Survey.
Background: Any surgical procedure carries a risk for venous thromboembolism (VTE), albeit variable. Improvements in medical and surgical practices and the shortening of care pathways due to the development of day surgery and enhanced recovery after surgery, have reduced the perioperative risk for VTE.
Objective: A collaborative working group of experts in perioperative haemostasis updated in 2024 the recommendations for the Prevention of perioperative venous thromboembolism published in 2011.
Article Synopsis
- The study investigates how Obstructive Sleep Apnea (OSA) contributes to respiratory issues and cardiac arrhythmias in patients after general anesthesia during the night following surgery.
- It involved analyzing patients with varying degrees of OSA and assessing the frequency of hypoxic episodes and cardiac irregularities during their first and third nights post-operation.
- Findings show that patients with moderate OSA experienced a higher incidence of cardiac arrhythmias linked to hypoxia on the third night after surgery, highlighting the need for better preoperative screening for OSA.
Introduction: European regulations have recently moved towards more stringent requirements for demonstrating the safety and performance of medical devices (MDs).
Objective: To apply an innovative testing method using medical simulation to the evaluation of three medical devices at different stages of their life cycle.
Method: The methodology for evaluating DMs using simulation is based on seven stages: definition of the context, training, construction of a scenario to test the DM, validation of the scenario, realization of the scenario, evaluation of the scenario by the players and validation and exploitation of the results.
Background: Although Patient Blood Management (PBM) is recommended by international guidelines, little evidence of its effectiveness exists in abdominal surgery. The aim of this study was to evaluate the benefits of the implementation of a PBM protocol on transfusion incidence and anaemia-related outcomes in major urological and visceral surgery.
Methods: In this before-after study, a three-pillar PBM protocol was implemented in 2020-2021 in a tertiary care centre, including preoperative correction of iron-deficiency anaemia, intraoperative tranexamic acid administration, and postoperative restrictive transfusion.
Background: The incidence, causes and impact of diaphragm thickness evolution in veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for cardiogenic shock are unknown. Our study investigates its evolution during the first week of VA-ECMO and its relationship with sweep gas flow settings.
Methods: We conducted a prospective monocentric observational study in a 12-bed ICU in France, enrolling patients on the day of the VA-ECMO implantation.
Introduction: Above and beyond the environmentally responsible operating theater, the environmental impact of the pathways of surgically treated patients seems essential but has seldom been considered in the literature. On a parallel track, enhanced recovery programmes (ERP) programs are presently deemed a standard of care. The objective of this review is to determine the carbon footprint of the ERP approach in colorectal surgery.
View Article and Find Full Text PDFPurpose: The efficacy of noninvasive ventilation (NIV) during procedures that require sedation and analgesia has not been established. We evaluated whether NIV reduces the incidence of respiratory events.
Methods: In this randomized controlled trial, we included 195 patients with an American Society of Anesthesiologists Physical Status of III or IV during electrophysiology laboratory procedures.
Background: Traumatic hemorrhage guidelines include point-of-care viscoelastic tests as a standard of care. Quantra (Hemosonics) is a device based on sonic estimation of elasticity via resonance (SEER) sonorheometry to assess whole blood clot formation.
Objectives: Our study aimed to assess the ability of an early SEER evaluation to detect blood coagulation test abnormalities in trauma patients.
Background: Extubation strategy in extracorporeal life support patients remains unclear, and literature only reports studies with significant biases.
Objectives: To explore the prognostic impact of an early ventilator-weaning strategy in assisted patients after controlling for confounding factors.
Methods: A 10-year retrospective study included 241 patients receiving extracorporeal life support for at least 48 h, corresponding to a total of 977 days spent on assistance.
Article Synopsis
- The updated guidelines from the European Society of Anaesthesiology and Intensive Care (ESAIC) focus on improving the management of peri-operative bleeding, aiming to reduce complications and enhance patient care.
- A systematic literature review from 2015 to 2021 was conducted, resulting in a comprehensive assessment that reshaped previous guidelines based on new evidence, with a strong consensus reached among experts.
- Key recommendations emphasize the importance of evaluating a patient's pre-operative health, coagulation status, and the details of surgical procedures to provide tailored and effective treatment during all phases of the surgical process.
Background: Andexanet alfa is a modified recombinant inactive factor Xa (FXa) designed to reverse FXa inhibitors. ANNEXA-4 (Andexanet Alfa, a Novel Antidote to the Anticoagulation Effects of Factor Xa Inhibitors) was a multicenter, prospective, phase-3b/4, single-group cohort study that evaluated andexanet alfa in patients with acute major bleeding. The results of the final analyses are presented.
View Article and Find Full Text PDFArticle Synopsis
- High preoperative fibrinogen levels are linked to lower postoperative bleeding volumes but higher rates of mortality and complications after cardiac surgery.
- A study divided 1,628 patients into high fibrinogen and normal fibrinogen groups based on a specific cutoff, finding a mortality rate of 2.7% in the high group compared to 1.1% in the normal group.
- Although higher fibrinogen levels resulted in less bleeding within the first day, they led to an increased need for blood transfusions and more major complications.
Background: Patients treated with direct oral anticoagulants (DOACs) may require urgent procedures. Managing these patients is challenging due to different bleeding risks and may include laboratory testing, procedural delays, or haemostatic/reversal agent administration.
Objective: We evaluated management strategies and outcomes of urgent, non-haemostatic invasive procedures in patients treated with DOACs.
Objective: To provide guidelines for the choice of items of clothing (except sterile surgical gown) for staff working in the operating theatre.
Design: A committee of nine experts from SFAR and the SF2H learned societies was convened. A formal conflict-of-interest policy was developed at the beginning of the process and enforced throughout.
Background: Tension in the supply of highly consumed drugs for patients with COVID-19 (propofol, midazolam, curares) led the French government to set up a centralized supply of hospitals with distribution based on the number of resuscitation beds in March 2020. The French Societies of Clinical Pharmacy and of Anesthesia and Critical Care aimed to evaluate the changes in total needs and the distribution between anesthesia and critical care activities (CCU), to prepare resumed surgical activity.
Methods: National declarative survey among pharmacists, via an online form (SurveyMonkey®), was conducted in April and May 2020.
Background: Communication and teamwork are critical non-technical skills in the operating theatre. However, prevention of events associated with communication failures by large simulation-based programs remains to be evaluated. The objective was to assess the impact of an interprofessional simulation-based training course on communication, teamwork, checklist adherence, and safety culture.
View Article and Find Full Text PDFPrevention of venous thromboembolism and haemostasis monitoring in patients with COVID-19: Updated proposals (April 2021): From the French working group on perioperative haemostasis (GIHP) and the French study group on thrombosis and haemostasis (GFHT), in collaboration with the French society of anaesthesia and intensive care (SFAR).
Anaesth Crit Care Pain Med
August 2021