Identifying optimal heparin management during cardiopulmonary bypass in obese patients: A prospective observational comparative study.

Background: The heparin regimen providing anticoagulation during cardiopulmonary bypass (CPB) is usually adapted to total body weight (TBW), but may be inaccurate in obese patients in whom TBW exceeds their ideal body weight.

Objectives: The objective is to compare the effects of heparin injection based on TBW on haemostatic parameters between obese and nonobese patients during cardiac surgery and to calculate the optimal heparin regimen.

Design: Prospective comparative study.

"Immunonutrition" Has Failed to Improve Peritonitis-Induced Septic Shock in Rodents.

Background: Immunonutrition in sepsis, including n-3 poly-unsaturated fatty acids (PUFAs) or L-arginine supplementation, is a controversial issue that has yielded a great number of studies for the last thirty-five years, and the conclusions regarding the quantity and quality of this support in patients are deceiving. The aim of the present experimental study is to investigate the effects of a pretreatment with enteral nutrition enriched with n-3 PUFAs or L-arginine on vascular dysfunctions, inflammation and oxidative stress during septic shock in rats.

Design: Rats were fed with enteral Peptamen® HN (HN group), Peptamen® AF containing n-3 PUFAs (AF group) or Peptamen® AF enriched with L-arginine (AFA group).

Once versus twice daily injection of enoxaparin for thromboprophylaxis in bariatric surgery: effects on antifactor Xa activity and procoagulant microparticles. A randomized controlled study.

Background: The optimal scheme of thromboprophylaxis in bariatric surgery remains uncertain, because clinical practice is different between countries and randomized trials are lacking.

Objectives: The primary objective of this randomized multicenter study was to determine the optimal regimen of enoxaparin providing an antifactor Xa peak activity between .3 and .

[New direct oral anticoagulants and venous thromboprophylaxis].

The new direct oral anticoagulants currently available are dabigatran, rivaroxaban and apixaban. These three drugs have been labeled in France for the prevention of venous thromboembolism after elective orthopaedic surgery including total hip or knee arthroplastly. Rivaroxaban is also labeled for the secondary prevention of thrombosis recurrence following an initial acute event.

Pharmacological modulation of procoagulant microparticles improves haemodynamic dysfunction during septic shock in rats.

Circulating microparticles play a pro-inflammatory and procoagulant detrimental role in the vascular dysfunction of septic shock. It was the objective of this study to investigate mechanisms by which a pharmacological modulation of microparticles could affect vascular dysfunction in a rat model of septic shock. Septic or sham rats were treated by activated protein C (aPC) and resuscitated during 4 hours.