[When are we dead? Still debates!].

When are we dead? Still debates ! Set the time of death has always raised many debates. They oppose vitalists and pragmatics. The first accept death when it was full, having reached the last cell and were not in hurry to declare the death, before the beginning of body rot.

[Could the number of brain-dead organ donors be increased in France].

While brain-dead organ donor rates per million populations are useful to follow and to compare organ donation activities, they cannot be used to estimate the potential of brain-dead organ donors. The comparison of available data from national vital statistics system, specific studies on potential of organ donation, and the hospital diagnosis related group (DRG) based information system allow to estimate the potential of brain-dead organ donors between 3500 and 4500. In 2007, 3147 potential donors were identified and 9691 patients still registered at the beginning of 2007 or registered during 2007 for a kidney transplant.

CT angiography for brain death diagnosis.

Background And Purpose: Lack of cerebral circulation is an important confirmatory test for brain death (BD). Conventional angiography remains the standard imaging method, but CT angiography (CTA) is emerging as an alternative. France accepts BD diagnoses relying on a score based on lack of opacification of 7 intracerebral vessels in CTA images.

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.

Factors associated with regional disparities for registration on the French national liver transplantation waiting list.

Aim: This study compared the gap between supply and need for liver transplantation among the geographic regions of France.

Methods: Supply was estimated by registration rates on the national waiting list and need by cirrhosis-related death rates. Hierarchical ascendant classification and principal component analysis were applied to identify regional patterns in the gap between supply and need.

[Influenza incidence estimated with a rapid diagnostic test in critically ill patients with acute respiratory failure during the 2005 and 2006 winter flu epidemics].

Objective: To estimate the incidence of influenza infection with a rapid diagnostic test in patients hospitalized in an intensive care unit (ICU) during the epidemic periods of two consecutive winters (2005-2006).

Methods: This study tested nasal aspirate of all patients admitted to the ICU for acute respiratory failure during the influenza epidemic period with the QuickVue influenza rapid diagnostic test.

Results: The study included 39 patients: 22 men and 17 women.

[Organ procurement and transplantation from non-heart-beating donors].

Despite a significant increase in procurement and transplantation activities observed in France in the last eight years, the shortage in grafts is on the rise and demand keeps being much higher than supply. Since 1968 and until now, procurement was limited to heart beating brain donors. The results of kidneys transplanted from non-heart-beating donors have significantly improved and are nowadays comparable to those of kidney transplantations from brain death donors, thanks to a more accurate selection of donors and recipients, to better respect of preventing cold and warm ischemia times and to several major therapeutic innovations.

[Organ donation: scarce and fragile resources].

Organ transplantation, the gold standard therapy for end-stage organ failures, has become a victim of its success. Indeed, the number of patients listed for transplantation has been increasing faster than that of available grafts. The number of brain-dead donors, the primary source of organ donation in France, is limited, but this figure is becoming more and more comprehensive, thanks to the work carried out by hospital transplant coordination units.

Reliability of HemoCue in patients with gastrointestinal bleeding.

Objective: HemoCue is routinely used to manage bleeding patients, but few studies have evaluated its accuracy in this population. We compared HemoCue with laboratory determination of blood hemoglobin in patients with gastrointestinal bleeding.

Design And Setting: A prospective observational study in a 14-bed medicosurgical ICU and an emergency department in an urban general hospital.