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Frédéric Thys

Publications and source records attributed to Frédéric Thys.

8 recordsLinked to original sources
PubMed2007

Emergency orthopaedic surgery under noninvasive ventilation after refusal for general anaesthesia.

In this observation, we report a novel use of noninvasive positive pressure ventilation in the operating room to support ventilation in an acidotic hypercapnic patient with severe acute chronic respiratory failure refuted for general anaesthesia, operated under spinal anaesthesia for a femoral fracture. The feasibility of noninvasive ventilatory assistance during surgery performed under regional anaesthesia is reported here. In selected cases, noninvasive ventilation can be used in the management of patients with acute or chronic respiratory failure requiring an urgent surgical intervention but in whom the respiratory status excluded a general anaesthesia.

Aged↗
PubMed2005

Versatile clinical information system design for emergency departments.

Compared to other hospital units, the emergency department presents some distinguishing characteristics of its own. Emergency health-care delivery is a collaborative process involving the contribution of several individuals who accomplish their tasks while working autonomously under pressure and sometimes with limited resources. Effective computerization of the emergency department information system presents a real challenge due to the complexity of the scenario. Current computerized support suffers from several problems, including inadequate data models, clumsy user interfaces, and poor integration with other clinical information systems. To tackle such complexity, we propose an approach combining three points of view, namely the transactions (in and out of the department), the (mono and multi) user interfaces and data management. Unlike current systems, we pay particular attention to the user-friendliness and versatility of our system. This means that intuitive user interfaces have been conceived and specific software modeling methodologies have been applied to provide our system with the flexibility and adaptability necessary for the individual and group coordinated tasks. Our approach has been implemented by prototyping a web-based, multiplatform, multiuser, and versatile clinical information system built upon multitier software architecture, using the Java programming language.

Belgium↗
PubMed2004

Volumetric capnography as a bedside monitoring of thrombolysis in major pulmonary embolism.

OBJECTIVE: To describe the use of volumetric capnography, a plot of expired CO(2) concentration against expired volume, in monitoring fibrinolytic treatment of major pulmonary embolism. DESIGN AND SETTING: Two case reports in the emergency department of a teaching hospital. PATIENTS: Two conscious and spontaneously breathing patients (69- and 31-year-old women) with major pulmonary embolism requiring thrombolysis. Decision for thrombolysis was based on the association of right ventricular afterload on echocardiography, with respiratory failure and hypotension in the first patient, and dyspnea and hemodynamically stable parameters in the second one. INTERVENTIONS: Successive capnographic measurements were performed before, during, and after thrombolysis. Curves of volumetric capnography were obtained from a sidestream gas monitor with flow sensor and an arterial blood gas analysis for CO(2) partial pressure. MEASUREMENTS AND RESULTS: We calculated late deadspace fraction, previously suggested as the most effective capnographic parameter in the diagnosis of pulmonary embolism. Late deadspace fraction decreased in the two patients, respectively, from 64.4% to 1.1% and from 25.6% to 5.7% after thrombolysis, with a concomitant disappearance of right heart dysfunction signs on echocardiography. CONCLUSIONS: Volumetric capnography can monitor thrombolysis in major pulmonary embolism. Differences between volumetric capnography technology and the more traditional arterial to end-tidal CO(2) gradient are important to take into account for clinical application.

Adult↗
PubMed2004

Volumetric capnography as a screening test for pulmonary embolism in the emergency department.

STUDY OBJECTIVE: To compare the diagnostic performance of volumetric capnography (VCap), which is the plot of the expired CO(2) partial pressure against the expired volume during a single breath, with the PaCO(2) to end-tidal CO(2) (EtCO(2)) gradient, in the case of suspected pulmonary embolism (PE). DESIGN: Single-center, prospective study. SETTING: Emergency department of a teaching hospital. PATIENTS: A total of 45 outpatients with positive enzyme-linked immunosorbent assay d-dimer levels of > 500 ng/mL. The diagnosis of PE was confirmed in 18 outpatients according to a validated procedure based on the ventilation-perfusion lung scan and/or spiral CT scanning. INTERVENTIONS: Curves of VCap were obtained from a compact monitor connected to a computer. A sequence of four to six stable breaths allowed the calculation of the following several variables: alveolar dead space fraction; the ratio of alveolar dead space (VDalv) to airway dead space (VDaw); the VDalv to physiologic dead space (VDphys) fraction; the slope of phase 3; and the late dead space fraction (Fdlate) corresponding to the extrapolation of the capnographic curve to a volume of 15% of the predicted total lung capacity. RESULTS: The mean (+/- SD) PaCO(2)-EtCO(2) gradient was 5.3 +/- 0.7 mm Hg in the PE-positive group and 2.8 +/- 0.7 mm Hg in the PE-negative group (p = 0.019). Four variables of the VCap exhibited a statistical difference between both groups, as follows: the VDalv/VDaw fraction(;) the slope of phase 3; the VDalv/VDphys fraction; and the Fdlate, which was 8.2 +/- 3.3% vs -7.7 +/- 2.8%, respectively (p = 0.000011). The diagnostic performance expressed as the mean area under a receiver operating characteristic curve comparison was 75.9 +/- 7.4% for the PaCO(2)-EtCO(2) gradient and 87.6 +/- 4.9% for the Fdlate (p = 0.02). CONCLUSION: Fdlate, a variable of VCap, had a statistically better diagnostic performance in suspected PE than the PaCO(2)-EtCO(2) gradient. VCap is a promising computer-assisted bedside application of pulmonary pathophysiology. Future research should define the place of this technique in the diagnostic workup of PE, especially in the presence of positive d-dimers.

Breath Tests↗
PubMed2002

Effervescent paracetamol poisoning: a case report.

Severe poisoning with effervescent paracetamol tablets has never been described in the literature. Indeed, the effervescent formulation contains high amounts of sodium and bicarbonate, both responsible for important emetic properties in the case of massive ingestion. Moreover, dissolving more than 6-8 tablets in the same glass appears to be difficult. We report a well-documented case of a patient with potentially hepatotoxic serum levels after the ingestion of 16 g effervescent paracetamol, apparently without vomiting. We show that the difficulties of a massive oral intake may be overcome by a slow intake. Nevertheless, this case report does not modify the important assertion that effervescent paracetamol use could limit the risk of life-threatening intoxication by a single massive acute overdose.

Acetaminophen↗