Publications by authors named "Alexandre Behouche"
Acute type A aortic syndromes and ski: management in an emergency care network.
J Cardiovasc Surg (Torino)
December 2024
Background: Skiing can cause aortic syndromes. The pre-hospital management of these patients may be compromised by the mountainous terrain. A regional emergency care network helps to optimize time frames, especially in a challenging geography.
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- The study investigated the effects of a new CPR technique called AHUP-CPR, which combines head/thorax elevation, active compression-decompression, and an impedance threshold device, compared to traditional CPR in out-of-hospital cardiac arrest patients.
- It was conducted in France from October 2019 to October 2022, involving 122 patients, and aimed to measure the peak end tidal carbon dioxide (ETCO) values as a marker for cardiac output and organ perfusion during CPR.
- Results showed that AHUP-CPR significantly increased the mean peak ETCO values (from 30.3 mmHg to 40.7 mmHg), indicating better circulation, but there was no significant difference in the rates of
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.
A 64-year-old patient required emergency surgery with high risk of intubation failure, without any possibility to perform neither a direct transtracheal access nor VV-ECMO canulation. The patient was managed thanks to a VA-ECMO despite the absence of cardiac function impairment. This report describes perioperative challenges and management of this unconventional case with favorable outcome.
View Article and Find Full Text PDFBackground: 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.
Toward individualized sedation in patients with acute brain damage.
Anaesth Crit Care Pain Med
August 2023
Sedation/analgesia in patients with acute brain damage, either traumatic or non-traumatic, is paramount to prevent alterations in brain perfusion secondary to the injury. Despite reviews on sedative and analgesic drugs, adequate sedation is an overlooked therapy in the prevention and treatment of intracranial hypertension. When to indicate continued sedation? How to guide the level of sedation? How to terminate sedation? This narrative review provides a practical approach to the individualized use of sedative/analgesic drugs in patients with acute brain damage.
View Article and Find Full Text PDFObjectives: The respiratory workload, according to the diaphragm thickening fraction (TF) during sweep gas flow (SGF), decrease during weaning from venoarterial extracorporeal membrane oxygenation (VA ECMO) was evaluated for the present study.
Design: Prospective observational study.
Setting: Monocentric.