Purpose: This quality improvement project evaluated interventions implemented to enhance individual adherence to a lung-protective ventilation strategy and its triad: low tidal volume, PEEP ≥ 5, recruitment manoeuvres.
Methods: For two years, nine anaesthesia workstations were connected to an automated cloud-based analytics software tool, which automatically recorded ventilation parameters as soon as a new patient case was opened. Four quality improvement periods were determined over the first year: baseline, intervention, no intervention, intervention + digital.
The present study assessed the proportion of intensive care unit (ICU) patients who had a vancomycin serum concentration between 20 and 25 mg/L after 24-48 h of intravenous vancomycin administration. From 2016 to 2018, adult ICU patients with vancomycin continuous infusion (CI) for any indication were included. The primary outcome was the proportion of patients with a first-available vancomycin serum concentration between 20-25 mg/L at 24 h (D2) or 48 h (D3).
View Article and Find Full Text PDFIntroduction: Prevalence and tobacco-related perioperative complications have been largely reported. The impact of vaping (e-cigarette use) on the perioperative period has been rarely evaluated. The purpose of this multicentre cross-sectional survey was to assess the prevalence of vaping and behaviour of patients undergoing elective surgery.
View Article and Find Full Text PDFLung ultrasound (LUS) increases clinical diagnosis performance in intensive care unit (ICU). Real-time three-dimensional (3-D) imaging was compared with two-dimensional (2-D) LUS by assessing the global diagnosis concordance. In this single center, prospective, observational, pilot study, one trained operator performed a 3-D LUS immediately after a 2-D LUS in eight areas of interest on the same areas in 16 ventilated critically ill patients.
View Article and Find Full Text PDFObjective: The main objectives of our study were to evaluate the prevalence of emergency point-of-care ultrasound (POCUS) use and to assess the impact of POCUS on: diagnostic, therapeutic, patient orientation and imaging practices.
Methods: This was a one-day, prospective, observational study carried out across multiple centers. Fifty emergency departments (EDs) recorded all POCUS performed over a 24h period.
Introduction: During acute dyspnea (AD), respiratory exhaustion is mainly due to diaphragm fatigue. The primary objective was to validate interobserver reproducibility of diaphragmatic excursion (DE) in emergency department (ED) patients admitted for AD. The secondary objectives were to assess the feasibility of DE measurement and intraobserver reproducibility.
View Article and Find Full Text PDFIntroduction: The use of focused cardiac ultrasound (FoCUS) in a prehospital setting is recommended. Pocket ultrasound devices (PUDs) appear to be well suited to prehospital FoCUS. The main aim of our study was to evaluate the interpretability of echocardiography performed in a prehospital setting using a PUD based on the experience of the emergency physician (EP).
View Article and Find Full Text PDFFocused cardiac ultrasound by the emergency physician has become a fundamental tool to expedite the diagnostic evaluation of the patient at bedside. We report the case of a patient admitted to the emergency department for respiratory distress. He was examined by an emergency physician who performed a bedside echocardiography.
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