End-Expiratory Occlusion Test to Predict Fluid Responsiveness Is Not Suitable for Laparotomic Surgery.

Background: The end-expiratory occlusion test predicts fluid responsiveness in ventilated intensive care patients; however, its utility in the operating room is questioned. We assessed end-expiratory occlusion test in laparotomic surgery for predicting volume expansion.

Methods: Forty-six patients were included in this study: stage 1 (n = 26) with an end-expiratory occlusion test of 15 seconds, followed by volume expansion, which consisted of 250 mL of colloid over 5 minutes and stage 2 (n = 20) with an end-expiratory occlusion test of 25 seconds followed by volume expansion.

Comparison of Proaqt/Pulsioflex and oesophageal Doppler for intraoperative haemodynamic monitoring during intermediate-risk abdominal surgery.

Objective: To compare cardiac index (CI) between Proaqt/PulsioFlex and oesophageal Doppler (OD) and the ability of the PulsioFlex to track CI changes induced by fluid challenge and secondly to assess the impact of the time interval between two auto-calibrations of PulsioFlex on the accuracy of the measured CI.

Methods: In a single hospital, 49 intermediate-risk oncologic abdominal surgery patients were included in an observational study. We measured the cardiac Index (CI) provided by OD and by the Proaqt/PulsioFlex before and after internal calibration, which were performed randomly at specific intervals after the initial one (30, 60, 90 and 120min).

A Hemodynamic Monitor as a Simulation Tool, a Novel Use of the PiCCO2: Technical Description of the Method and Its Application.

Introduction: The PiCCO2 is a commonly used monitor, which education remains theoretical and demonstration based. Simulation allows active learning, which may help achieve a better understanding and handling of this device, hence a safer and more effective use. Because of the lack of availability of dedicated simulators and the uselessness of the demonstration mode of monitors for simulation purpose, simulation remains seldom used.

How to rationalize preoperative tests? A method to implement local guidelines successfully.

Background: Preoperative screening includes clinical examination and tests. Systematic prescription leads to excessive tests. We conducted an observational retrospective study to assess the success of implementing a protocol-guided prescription procedure for preoperative tests (PTs).

Measurement of cardiac index by transpulmonary thermodilution using an implanted central venous access port: a prospective study in patients scheduled for oncologic high-risk surgery.

Background: Transpulmonary thermodilution allows the measurement of cardiac index for high risk surgical patients. Oncologic patients often have a central venous access (port-a-catheter) for chronic treatment. The validity of the measurement by a port-a-catheter of the absolute cardiac index and the detection of changes in cardiac index induced by fluid challenge are unknown.

The use of a clinical database in an anesthesia unit: focus on its limits.

Anesthesia information management system (AIMS) can be used a part of quality assurance program to improve patient care, however erroneous or missing data entries may lead to misinterpretation. This study assesses the accuracy of information extracted for six consecutive years from a database linked to an automatic anesthesia record-keeping system. An observational study was conducted on a database linked AIMS system.