Publications by authors named "Capdevila X"

Background: External lumbar drainage (ELD) of cerebrospinal fluid may help control intracranial pressure following a traumatic brain injury. We aimed to assess the efficacy and safety of ELD in post-traumatic intracranial hypertension (IH).

Methods: This retrospective monocentric cohort study was conducted in the trauma critical care unit of the regional Level-I trauma centre between January 2012 and December 2022.

View Article and Find Full Text PDF
Article Synopsis
  • Inadvertent intraneural injections during peripheral nerve blocks are common, and this study compares two detection methods: injection pressure monitoring and ultrasound imaging.
  • The research involved anesthesiologists conducting intraneural injections on fresh cadaver arms, measuring both pressure and sonographic images to evaluate outcomes.
  • Results showed that pressure monitoring detected intraneural injection much earlier than ultrasound (after just 0.2 mL vs. 1.2 mL for swelling), confirming that pressure monitoring is a more sensitive technique.
View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to determine the most effective spontaneous breathing trial (SBT) methods to evaluate a patient's ability to breathe independently after being extubated, focusing on five critical illnesses.
  • In a multicenter randomized crossover design, 100 adult ICU patients underwent three different 15-minute SBTs, measuring their inspiratory efforts using pressure-time-product (PTPmin) before and after extubation.
  • Results showed that the unassisted SBTs, specifically PSV0PEEP0 and T-piece trials, were the best at simulating the breathing effort experienced after extubation, with varying effectiveness among different patient categories.
View Article and Find Full Text PDF

Background: The present study investigated an institutional multidisciplinary strategy for managing traumatic haemorrhagic shock by integrating the placement of REBOA (resuscitative endovascular balloon occlusion of the aorta) by anaesthesiologist-intensivists.

Methods: All severe trauma patients who received percutaneous REBOA placement between January 2013 and December 2022 in our level 1 trauma centre were retrospectively analysed. The data collected included the clinical context, indications and location of REBOA, durations of aortic occlusion (AO), choice of haemostatic procedures and surgical teams, and specific complications.

View Article and Find Full Text PDF

Background: Diaphragm dysfunction is common in intensive care unit and associated with weaning failure and mortality. Diagnosis gold standard is the transdiaphragmatic or tracheal pressure induced by magnetic phrenic nerve stimulation. However, the equipment is not commonly available and requires specific technical skills.

View Article and Find Full Text PDF

Background: Chronic postsurgical pain (CPSP) significantly impairs quality of life and poses a substantial healthcare burden, affecting up to a quarter of patients undergoing surgery. Although acute pain is recognised as a predictor for CPSP development, the role of patient experience remains underexplored. This study examines the predictive value of patient experience alongside traditional risk factors for CPSP after orthopaedic surgery.

View Article and Find Full Text PDF

Background: Walking ability is a key factor in enhanced recovery after foot ambulatory surgery. Plantar compartment block offers an analgesic alternative to popliteal sciatic nerve block (PSNB) for hallux valgus surgery. The objective of this study was to compare these two regional anesthesia strategies on patients' ability to recover a painless unaided walk.

View Article and Find Full Text PDF

Background: Reporting and analysis of adverse events (AE) is associated with improved health system learning, quality outcomes, and patient safety. Manual text analysis is time-consuming, costly, and prone to human errors. We aimed to demonstrate the feasibility of novel machine learning and natural language processing (NLP) approaches for early predictions of adverse events and provide input to direct quality improvement and patient safety initiatives.

View Article and Find Full Text PDF

Objectives: Elevated circulating DNA (cirDNA) concentrations were found to be associated with trauma or tissue damage which suggests involvement of inflammation or cell death in post-operative cirDNA release. We carried out the first prospective, multicenter study of the dynamics of cirDNA and neutrophil extracellular trap (NETs) markers during the perioperative period from 24 h before surgery up to 72 h after curative surgery in cancer patients.

Methods: We examined the plasma levels of two NETs protein markers [myeloperoxidase (MPO) and neutrophil elastase (NE)], as well as levels of cirDNA of nuclear (cir-nDNA) and mitochondrial (cir-mtDNA) origin in 29 colon, prostate, and breast cancer patients and in 114 healthy individuals (HI).

View Article and Find Full Text PDF

Background: The COVID-19 pandemic had a global impact on people life, notably because of lockdown periods. This could particularly affected patients suffering from hip fracture, who could have been more isolated during these periods. We aim at evaluating the impact of the COVID-19 period (including lockdown periods) on quality of life (QOL) in older adult patients 90 days after a surgery for a hip fracture.

View Article and Find Full Text PDF

Background: Patient blood management (PBM) is an evidence-based approach recommended to improve patient outcomes. Change in practices is often challenging. We report here data from French surgical departments before and after a standardized implementation of a PBM program.

View Article and Find Full Text PDF

Background: Hallux valgus surgery is associated with moderate to severe postoperative pain. We hypothesized that a plantar compartment block may be a good technique for postoperative analgesia. We describe an anatomic approach to ultrasound-guided plantar compartment block and assess the clinical efficacy of the block for outpatient surgery.

View Article and Find Full Text PDF

Background: Superiority of perineural over intravenous dexamethasone at extending nerve block analgesia has been suggested but without considering the dose-response relationships for each route of administration.

Methods: Randomised control studies that evaluated intravenous or perineural dexamethasone as an adjuvant to unilateral peripheral nerve blocks in adults were searched up to October 2023 in MEDLINE, Central, Google Scholar, and reference lists of previous systematic reviews. The Cochrane Risk-of-Bias tool was used.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to analyze how the difference in carbon dioxide pressure before and after an oxygenator (∆ EC PCO 2) affects CO 2 removal during extracorporeal respiratory support in ICU patients.* -
  • It involved 18 patients treated with veno-venous extracorporeal membrane oxygenation and tracked blood gas data to calculate CO 2 elimination every 12 hours.* -
  • Findings showed a significant linear relationship between ∆ EC PCO 2 and CO 2 elimination, with most CO 2 being removed from combined CO 2 in plasma rather than from dissolved CO 2 or CO 2 in red blood cells.*
View Article and Find Full Text PDF

Background: The COVID-19 pandemic abruptly increased the inflow of patients requiring intensive care units (ICU). French health institutions responded by a twofold capacity increase with temporary upgraded beds, supplemental beds in pre-existing ICUs, or newly created units (New-ICU). We aimed to compare outcomes according to admission in expert pre-existing ICUs or in New-ICU.

View Article and Find Full Text PDF

Background: Anaemia and blood transfusion are associated with poor outcomes after hip fracture. We evaluated the efficacy of intravenous iron and tranexamic acid in reducing blood transfusions after hip fracture surgery.

Methods: In this double-blind, randomised, 2 × 2 factorial trial, we recruited adults hospitalised for hip fractures in 12 medical centres in France who had preoperative haemoglobin concentrations between 9·5 and 13·0 g/dL.

View Article and Find Full Text PDF

Introduction: Consistency in needle tip positioning within interfascial planes while performing infiltrative blocks under ultrasound guidance can be difficult. The exact determination of such planes may beyond the physical limits of common ultrasound machines. Aim of this pilot study was to understand if real-time continuous injection pressure monitoring at the needle tip, combined with ultrasound guidance, can help to immediately and consistently identify an interfascial plane needle tip placement.

View Article and Find Full Text PDF
Article Synopsis
  • The study is about figuring out the best way to test if patients can breathe on their own after being on a ventilator.
  • Researchers will do a special breathing test called spontaneous breathing trial (SBT) on 100 patients using different methods.
  • They will measure how hard the patients' muscles work to breathe and look at their progress after they stop using the ventilator.
View Article and Find Full Text PDF

Background: The most common long-term symptoms of critically ill COVID-19 patients are fatigue, dyspnea and mental confusion. Adequate monitoring of long-term morbidity, mainly analyzing the activities of daily life (ADLs), allows better patient management after hospital discharge. The aim was to report long-term ADL evolution in critically ill COVID-19 patients admitted to a COVID-19 center in Lugano (Switzerland).

View Article and Find Full Text PDF

Background: The management of perioperative iron deficiency is a component of the concept of patient blood management. The objective of this study was to update French data on the prevalence of iron deficiency in patients scheduled for major surgery.

Methods: The CARENFER PBM study was a prospective cross-sectional study in 46 centers specialized in orthopedic, cardiac, urologic/abdominal, or gynecological surgery.

View Article and Find Full Text PDF

Background: Assessment of anemia and iron deficiency before surgery is pivotal for patient blood management (PBM), but few data on current practices are available in the French context. The objective of this study was to describe anemia and iron deficiency management and blood transfusion use in surgical departments in France.

Methods: This was a national multicenter cross-sectional study in 13 public hospitals and 3 private ones (all with an interest for PBM).

View Article and Find Full Text PDF

Background: Reducing perioperative anxiety and controlling pain in children are essential to optimise recovery and outcomes for both children and their parents. By acting on sensory and affective modulation of anxiety and pain, hypnosis is widely used in medical care, especially in anaesthesia. This randomised controlled clinical trial was designed to compare general anaesthesia and intraoperative hypnosis support for perioperative management of children undergoing superficial surgery.

View Article and Find Full Text PDF

Acute pain has been associated with persistent pain sensitization of nociceptive pathways increasing the risk of transition from acute to chronic pain. We demonstrated the critical role of the FLT3- tyrosine kinase receptor, expressed in sensory neurons, in pain chronification after peripheral nerve injury. However, it is unclear whether injury-induced pain sensitization can also promote long-term mood disorders.

View Article and Find Full Text PDF

Background: Sedation of ventilated critically ill trauma patients requires high doses of opioids and hypnotics. We aimed to compare the consumption of opioids and hypnotics, and patient outcomes using sedation with or without continuous regional analgesia (CRA).

Methods: Multiple trauma-ventilated patients were included.

View Article and Find Full Text PDF