Cerebral hemodynamic changes in severe head injury patients undergoing decompressive craniectomy.

Objective: To assess the intracranial hemodynamic modifications induced by a decompressive craniectomy (DC) after severe traumatic brain injury (TBI), using transcranial Doppler (TCD) ultrasonography and intracranial pressure (ICP) sensor. Mortality rate and neurological outcomes were also evaluated after this procedure.

Design: A prospective study was carried out on 26 TBI patients, measuring transcranial Doppler and ICP before, immediately after, and 48 hours after the DC, allowing for statistical analysis of hemodynamic changes.

Modifications of low-molecular weight heparin use in a French university hospital after implementation of new guidelines.

Background: Previous studies performed in 1999 and 2000 showed frequent misuse of low-molecular weight heparins (LMWHs) in France, leading to an increasing risk of bleeding. In 2002, the French Medicine Agency (Agence Française de Sécurité Sanitaire des Produits de Santé) released guidelines on the prescription and monitoring of LMWH. This study assesses LMWH use before and after the implementation of these guidelines.