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B Charbit

Publications and source records attributed to B Charbit.

3 recordsLinked to original sources

The decrease of fibrinogen is an early predictor of the severity of postpartum hemorrhage.

BACKGROUND: Postpartum hemorrhage (PPH) is a major source of maternal morbidity. OBJECTIVES: This study's objective was to determine whether changes in hemostasis markers during the course of PPH are predictive of its severity. PATIENTS AND METHODS: We enrolled 128 women with PPH requiring uterotonic prostaglandin E2 (sulprostone) infusion. Two groups were defined (severe and non-severe PPH) according to the outcome during the first 24 hours. According to our criteria, 50 of the 128 women had severe PPH. Serial coagulation tests were performed at enrollment (H0), and 1, 2, 4 and 24 hours thereafter. RESULTS: At H0, and through H4, women with severe PPH had significantly lower fibrinogen, factor V, antithrombin activity, protein C antigen, prolonged prothrombin time, and higher D-dimer and TAT complexes than women with non-severe PPH. In multivariate analysis, from H0 to H4, fibrinogen was the only marker associated with the occurrence of severe PPH. At H0, the risk for severe PPH was 2.63-fold higher for each 1 gL(-1) decrease of fibrinogen. The negative predictive value of a fibrinogen concentration >4 gL(-1) was 79% and the positive predictive value of a concentration <or=2 gL(-1) was 100%. CONCLUSION: These findings indicate that a simple fibrinogen measurement can anticipate the risk of severe bleeding in PPH.

Adult↗

[Interference between a dual-chamber pacemaker and argon electrocautery device during hepatectomy].

We report an unusual electromagnetic interference induced by an argon electrocautery device during a left hepatectomy on a dual chamber pacemaker, implanted for sinus node dysfunction in 87-year-old patient. Argon electrocautery induced inhibition of atrial stimulation and occurrence of irregular ventricular triggered activity. Normal pacemaker function resumed after electrocautery interruption. This case illustrates the need to focus on cardiac rhythm when a new electrical device is used in a pacemaker patient.

Aged↗

Factors influencing indoor concentrations of nitric oxide in a Parisian intensive care unit.

In low concentrations, inhaled nitric oxide (NO) increases arterial oxygenation in patients with severe acute respiratory distress syndrome. When present in the ambient atmosphere, NO and its oxidative derivate, nitrogen dioxide (NO2), are considered pollutants. The aim of this study was to assess whether the administration of inhaled NO to mechanically ventilated patients was associated with an increased risk of exposure to NO and NO2 for medical and paramedical staff. During a 1-yr period, indoor and outdoor NO and NO2 concentrations were measured using chemiluminescence in a 14-bed intensive care unit (ICU) to assess the possible influence of therapeutic NO administration on indoor pollution. Ambient concentrations of NO within the ICU were 237 +/- 147 parts per billion (ppb) during periods of NO administration and 289 +/- 147 ppb during periods without NO administration (mean +/- SD, NS). Indoor concentrations of NO and NO2 were entirely dependent on outdoor concentrations and were mainly influenced by climatic conditions such as atmospheric pressure, mass of clouds, and speed of the wind. Therapeutic administration of concentrations of inhaled NO < or = 5 ppm to critically ill patients did not affect the ambient concentration of NO and NO2 within the ICU, which was mainly dependent on the outdoor air pollution. As a consequence, scavenging of exhaust NO from the breathing circuit in the ventilator does not appear mandatory in ICUs located in areas with significant urban pollution when NO concentrations < or = 5 ppm are administered.

Administration, Inhalation↗