Taking automated laboratory hemoglobin measurement as a reference, the study shows that SpHb monitoring with Radical-7® gives lower readings than does the HemoCue® for assessment of hemoglobin concentration during hemorrhagic surgery.

A postal survey of the use of cuffed or uncuffed tracheal tubes for tracheal intubation in children and infants was performed to investigate the criteria used for deciding the choice of tube and the manner of inflating the cuff in the case of use of a cuffed tracheal tube (CTT). From 200 questionnaires despatched, replies were received from 130 paediatric anaesthesiologists (response rate 65%). In paediatric practice, the CTT was routinely used by 25% of respondents for more than 80% of their patients, while more than 37% of respondents use them in less than 20% of the cases. The three main criteria used for inflating a cuff were: (i) the presence of a leak, (ii) the type of surgery associated with the presence of a leak and (iii) the patient's age associated with the type of surgery and the presence of a leak. These criteria were specified, respectively, by 32%, 24% and 18% of the respondents. The cuff was inflated in response to a leak in 18% of the cases and as a response to a pressure manometer in 15% of the cases. Few paediatric anaesthesiologists use a cuffed tracheal tube routinely for tracheal intubation in children, and fewer actually use a pressure monitoring device, while it is suggested that the cuff pressure should be monitored in case of CTT.

Propofol did not modify intrinsic myocardial contractility in normal hamsters, and no significant differences were observed between normal and cardiomyopathic hamsters. These results may be useful because, unlike propofol, most anesthetics decrease myocardial contractility. Nevertheless, indirect cardiac effects of propofol may be more important than its direct cardiac effects in patients with impaired cardiac function.

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The chemical structure of organophosphate compounds (OPs) is a well-known factor which modifies the acute toxicity of these compounds. We compared ventilation at rest and cholinesterase activities in male Sprague-Dawley rats poisoned with dimethyl paraoxon (DMPO) and diethyl paraoxon (DEPO) at a subcutaneous dose corresponding to 50% of the median lethal dose (MLD). Ventilation at rest was recorded by whole body plethysmography. Total cholinesterase activities were determined by radiometric assay. Both organophosphates decreased significantly the respiratory rate, resulting from an increase in expiratory time. Dimethyl-induced respiratory toxicity spontaneously reversed within 120 min post-injection. Diethyl-induced respiratory toxicity was long-lasting, more than 180 min post-injection. Both organophosphates decreased cholinesterase activities from 10 to 180 min post-injection with the same degree of inhibition of total cholinesterase within an onset at the same times after injection. There were no significant differences in residual cholinesterase activities between dimethyl and diethyl paraoxon groups at any time. The structure of the alkoxy-group is a determinant factor of the late phase of poisoning, conditioning duration of toxicity without significant effects on the magnitude of alteration of respiratory parameters. For same duration and magnitude of cholinesterase inhibition, there was a strong discrepancy in the time-course of effects between the two compounds.

Pour faire face à l'attentat terroriste multisite du 13 novembre 2015, une régulation médicale zonale des huit Samu de la région Île-de-France a été mise en place au Samu de Paris. Elle a permis, en utilisant une stratégie de sectorisation des moyens Smur et des ressources hospitalières, la médi-calisation des sites, la régulation et le transport par des équipes médicales de la majorité des victimes en urgence absolue. Des moyens Smur et des hôpitaux ont pu être gardés en réserve pour faire face à une aggravation de la situation (notamment sur le site du Bataclan) et à d'éventuelles autres attaques. L'analyse de cette expérience montre de nombreux points forts mais aussi des pistes d'amélioration utiles pour tous ceux qui seraient confrontés à un tel événement.Abstract To face the multisite terrorist attacks on November 13, 2015, a medical zonal regulation system was set up at the Samu de Paris in order to coordinate the 8 Samu of the Île-de-France region. This system, by using a sectorization strategy of the medical means (mobile intensive care unit [MICU]) and hospital resources, enabled on site medicalization, regulation and transportation by medical teams of most of the patients presenting immediate emergencies. MICU and hospitals were kept available in case the situation had worsened (especially on the Bataclan site) or other attacks had occurred. The analysis of this experience shows many strong points but also useful areas of improvement for all those who might face such event.

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