Administration of low-dose of PCC significantly decreased postoperative bleeding after CPB.

Neurological complications and severe thrombocytopenia were more common after pulmonary endarterectomy in patients with than without APS. Haemodynamic results and ICU mortality rate were similar in the two groups.

Little is known about the resolution of symptoms of nosocomial pneumonia (NosoP) after lung and heart-lung transplantation. The aim of this study was to describe the clinical response to antimicrobial therapy in (ICU) patients with NosoP after lung or heart-lung transplantation. Between January 2008 and August 2010, 79 lung or heart-lung transplantations patients were prospectively studied. NosoPwas confirmed by quantitative cultures of bronchoalveolar lavage or endotracheal aspirates. Clinical variables, sequential organ failure assessment (SOFA) score, and radiologic score were recorded from start of therapy until day 9. Thirty-five patients (44%) experienced 64 episodes of NosoP in ICU. Fourteen patients (40%) had NosoP recurrence. Most frequently isolated organisms were Enterobacteriaceae (30%), Pseudomonas aeruginosa (25%), and Staphylococcus aureus (20%). Sequential organ failure assessment (SOFA) score improved significantly at day 6 and C-reactive protein level at day 9. SOFA and radiologic scores differed significantly between patients with and without NosoP recurrence at day 3 and 9. The ICU mortality rate did not differ between patients with and without NosoP recurrence, and free of NosoP (14.3%, 9.5%, 11.4%, respectively) (p = 0.91). Severities of illness and lung injury were the two major risk factors for NosoP recurrence. Occurrence of NosoP has no impact on ICU mortality.

Accurate extravascular lung water measurements were obtained after pulmonary endarterectomy. Extravascular lung water may prove valuable for diagnosing reperfusion pulmonary edema after pulmonary endarterectomy and had prognostic value. Extravascular lung water values were significantly higher in patients with severe compared with nonsevere chronic thromboembolic pulmonary hypertension.

Purpose: Currently, there is no consensus regarding the choice of anesthetic technique for parturients with sickle cell disease (SCD). The aim of the study was to determine the impact of the anesthetic technique on the occurrence of postnatal sickling complications. Methods:We reviewed the charts of all pregnant women with SCD who had given birth in our institution between January 2002 and January 2007. Data related to pregnancy and anesthetic management and complications related, or unrelated, to SCD were recorded. Full blood count and lactate dehydrogenase values were recorded on the day of delivery. Risk factors for postnatal sickling complications were evaluated using a logistic regression analysis to estimate odds ratios (OR) and their 95% confidence intervals (95% CI). Results:Fourteen of the 55 women (24%) experienced at least one postnatal sickling complication. Women who developed postnatal sickling complications were found to have a higher leukocyte count (17.0 ± 6.1 × 10 9 ·L -1 vs 12.8 ± 4.4 ×10 9 ·L -1 , P = 0.008) and a lower hemoglobin level (7.8 ± 1.1 vs 8.9 ± 1.0 g.dL -1 , P = 0.002). General anesthesia (OR = 16.0; 95% CI, 1.6 to 165.6) and a leukocyte count ≥ 15 × 10 9 ·L -1 (OR = 8.4; 95% CI, 1.6 to 44.5) were identified as risk factors. Neuraxial anesthesia and use of ephedrine were not identified as risk factors. There were no deaths. Conclusion: Our study suggests that general anesthesia could be associated with postnatal sickling complications, even when the severity of illness was taken into account.