[The elusive gift].

When the only geno-identical donor is a minor child with autistic type disorders, the question of consent arises. Reflection on the decision to transplant bone marrow in this specific context.

Effect of Lung-Protective Ventilation in Organ Donors on Lung Procurement and Recipient Survival.

Previous studies have shown that a lung-protective strategy, which aims at minimizing ventilator-induced lung injury (with low Vt/high positive end-expiratory pressure as the main pillars), in selected potential organ donors after brain death increased lung eligibility and procurement. This prospective nationwide cohort study aimed to evaluate the impact of lung-protective ventilation (PV) in nonselected donors on lung procurement and recipient survival after lung transplantation. We included all reported donors aged 18-70 years after brain death without a lung recovery contraindication and with at least one organ recovered between January 2016 and December 2017.

Performing diagnostic coronary angiography to evaluate high-risk cardiac donors: A French nationwide cohort study.

Background: Allograft shortage might be overcome by the use of hearts from expanded-criteria donors (ECD) but their estimated high-risk of coronary artery disease (CAD) results in a limited utilization of these hearts for transplantation. We aimed to determine if performing coronary angiography (CA) in ECD enhances cardiac procurement and to develop a predictive model estimating their probability of absence of CAD.

Methods: We retrospectively used the French National Transplant Registry CRISTAL and considered all donors aged 45 to 70 with ≥ 1 organ harvested between March 2012 and June 2014 to derive a high-risk donor population.

Impact of donor coronary angiography on kidney transplantation outcomes.

Coronary angiography (CA) is the gold standard evaluation of coronary artery disease in potential multi-organ donors. This use of iodinated contrast media could lead to contrast-induced acute kidney injury and consequently to delayed graft function (DGF). All patients in France who received a kidney from a 45-70-year-old donor without medical contraindication for cardiac donation and with at least one cardiovascular risk factor were included.

[Beneficence and nonmaleficence in care].

Is a medical decision rationally founded on the application of statistically efficient evidence-based medicine procedures fair and right for any given patient? Medical ethics invite us to consider the caregiving action through the prism of guidelines based on autonomy, beneficence/nonmaleficence and justice.

Early tracheotomy versus prolonged endotracheal intubation in unselected severely ill ICU patients.

Objective: Although several advantages are attributed to tracheotomy in ICU patients requiring mechanical ventilation (MV), true benefits and the optimal timing of tracheotomy remain controversial. In this study, we compared early tracheotomy (ET) with prolonged intubation (PI) in severely ill patients requiring prolonged MV.

Design: Prospective, randomized study.

The Internal jugular veins are asymmetric. Usefulness of ultrasound before catheterization.

Objective: To demonstrate an asymmetry of the internal jugular veins, a finding which will have consequences for catheterization.

Design: Prospective study.

Setting: The medical ICU of a university-affiliated teaching hospital.

Endocarditis Caused by Multiply Resistant Bacteroides fragilis: Case Report and Review.

A 78-year-old woman developed fatal endocarditis of her prosthetic aortic valve, caused by Bacteroides fragilis fragilis, and associated with ovarian carcinoma. The strain showed multiple antibiotic resistance, including resistance to beta-lactam agents and combinations with beta-lactamase inhibitors. Seventeen previously described cases of endocarditis caused by Bacteroides spp.

[Natriuresis and atrial natriuretic factors during extracorporeal circulation for cardiac surgery].

At the end of cardiopulmonary bypass (CPB) diuresis and natriuresis are widely modified. Those are classically due to the CPB conditions (mean arterial pressure, non pulsatile flow, hypothermia, long duration ..

[Bacterial infections after heart surgery under extracorporeal circulation. Effects of autologous and homologous transfusions].

To verify that the rate of post operative infections is higher with homologous transfusion rather than without, 86 coronary artery bypass patient charts were retrospectively studied. Inclusion criteria were those of the autologous transfusion group. Four groups were defined : Gr 1 : No transfusion.