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Toutain T, Philip CA, Bollon L, Cros M, Fraissenon A, Dupont C, Gaucher L, Haesebaert J, Nohuz E, Cortet M. Surgical management of a loss of pregnancy in the first trimester: Patient experience and influencing factors, a prospective observational study. J Gynecol Obstet Hum Reprod 2023; 52:102602. [PMID: 37187317 DOI: 10.1016/j.jogoh.2023.102602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 04/30/2023] [Accepted: 05/07/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVE Describe the "patient experience" regarding care provided during the surgical management of a loss of pregnancy in the first trimester and identify the factors influencing this experience. MATERIAL AND METHODS It is an observational prospective study conducted in two type III, academic, maternity wards in Lyon, France, carrying out 8,500 deliveries per year. Adult female patients, having undergone a suction curettage for a loss of pregnancy in the first trimester from 24 December 2020 to 13 June 2021 were inculded. The "patient experience" was assessed using the 15 questions of the Picker Patient Experience (PPE-15) questionnaire, and research was conducted on factors influencing the patient experience. The main outcome was the percentage of patients reporting a problem in response to at least one of the PPE-15 questions. RESULTS 58 out of 79 patients (73% CI [62-83]) reported at least one problem with their care. The largest proportion of problems was raised in question about "Opportunity for family/loved ones to talk to the doctor" (76% CI [61-87]). The lowest proportion of problems was raised in question about "Treated with respect and dignity" (8% CI [3-16]). No factors influencing the patient experience were identified. DISCUSSION Almost three out of four patients reported a problem in the experience as a patient. The main areas of improvement reported by patients were the participation of their family/relatives and the emotional support provided by the healthcare team. TWEETABLE ABSTRACT Better communication with patient families and emotional support could improve patient experience during the surgical management of a loss of pregnancy in the first trimester.
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Affiliation(s)
- T Toutain
- Department of Obstetrics and Gynaecology, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon 69004, France
| | - C-A Philip
- Department of Obstetrics and Gynaecology, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon 69004, France; LabTAU INSERM U1032, Université Lyon1, Lyon 69003, France
| | - L Bollon
- Faculty of Maieutic, Lyon, France
| | - M Cros
- Faculty of Maieutic, Lyon, France
| | - A Fraissenon
- Mother and Child Radiology Department, North University Hospital, Saint Etienne 42000, France; Paediatric Imaging Department, Woman-Mother-Child University Hospital, Hospices Civils de Lyon, Bron 69500, France
| | - C Dupont
- Research on Healthcare Performance (RESHAPE) INSERM U1290, Lyon 69003, France; AURORE Perinatal Network, Lyon 69004, France
| | - L Gaucher
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Midwifery Department, Geneva, Switzerland; Hospices Civils de Lyon, Public Healthcare Centre, Lyon F-69008, France
| | - J Haesebaert
- Research on Healthcare Performance (RESHAPE) INSERM U1290, Lyon 69003, France; Hospices Civils de Lyon, Public Healthcare Centre, Lyon F-69008, France
| | - E Nohuz
- Department of Obstetrics and Gynaecology, Woman-Mother-Child University Hospital, Hospices Civils de Lyon, Bron 69500, France
| | - M Cortet
- Department of Obstetrics and Gynaecology, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon 69004, France; LabTAU INSERM U1032, Université Lyon1, Lyon 69003, France.
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Rousseau A, Dubel-Jam M, Schantz C, Gaucher L. Barrier measures implemented in French maternity hospitals during the COVID-19 pandemic: A cross-sectional survey. Midwifery 2023; 118:103600. [PMID: 36680960 PMCID: PMC9839455 DOI: 10.1016/j.midw.2023.103600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/12/2022] [Accepted: 01/11/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVES The objectives of this survey were 1) to describe the changes over time of barrier measures in maternity units, specifically, co-parent visits and women wearing masks in birth rooms, and 2) to identify potential institutional determinants of these barrier measures. DESIGN We used an online questionnaire to conduct a descriptive cross-sectional survey from May to July 2021. SETTING All districts in mainland France. PARTICIPANTS Midwife supervisor of each maternity unit. MEASUREMENTS Primary outcomes were "banning of visits" in the postnatal department during the first lockdown (March-May 2020), and "mandated mask-wearing in birth rooms" during the survey period (May-July 2021); the independent variables were maternity unit characteristics and location in a crisis area. Co-parent visits were considered only during the first lockdown as they were mostly allowed afterwards, and the wearing of masks was studied only during the survey period, as masks were unavailable for the population during the first lockdown. RESULTS We obtained 343 responses, i.e., 75.2% of French maternity units. Visits to the postnatal department were forbidden in 39.3% of the maternity units during the first lockdown and in none during the study period. Maternity hospitals with neonatal intensive care units were the most likely to ban co-parent hospital visits (adjusted OR 2.34 [1.12; 4.96]). However, those were the maternity units least likely to encourage or require women to wear masks while pushing (adjusted OR, 0.31; 95% confidence interval [CI], 0.11-0.77). Maternity units in crisis areas (i.e., with very high case counts) during the first lockdown banned visits significantly more often (adjusted OR, 1.68; 95% CI, 1.05-2.70). KEY CONCLUSIONS Our study showed that barrier measures evolved during the course of the pandemic but remained extremely variable between facilities. IMPLICATIONS FOR PRACTICE Maternity units implemented drastic barrier measures at the beginning of the pandemic but were able to adapt these measures over time. It is now time to learn from this experience to ensure that women and infants are no longer harmed by these measures.
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Affiliation(s)
- A. Rousseau
- Midwifery Department, EA 7285, Versailles Saint Quentin University, F-78180 Montigny-le-Bretonneux, France,Department of Obstetrics and Gynecology, Poissy-Saint Germain Hospital, F-78300 Poissy, France,Université Paris-Saclay, UVSQ, Inserm, Équipe Epidémiologie clinique, CESP, 78180 Montigny le Bretonneux, France,Corresponding author at: UFR Simone Veil-Santé - 2 avenue de la Source de la Bièvre, F-78180 Montigny-le-Bretonneux, France
| | - M. Dubel-Jam
- Midwifery Department, EA 7285, Versailles Saint Quentin University, F-78180 Montigny-le-Bretonneux, France,Department of Obstetrics and Gynecology, Poissy-Saint Germain Hospital, F-78300 Poissy, France
| | - C. Schantz
- Université Paris Cité, IRD, Inserm, Ceped, F-75006 Paris, France
| | - L. Gaucher
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts, Western Switzerland, Geneva, Switzerland,Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, F-69008 Lyon, France,Hospices Civils de Lyon, Hôpital Femme Mère-Enfant, F-69500 Bron, France
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Sauvegrain P, Schantz C, Gaucher L, Chantry AA. Avenues for measuring and characterising violence in perinatal care to improve its prevention: A position paper with a proposal by the National College of French Midwives. Midwifery 2023; 116:103520. [PMID: 36384064 DOI: 10.1016/j.midw.2022.103520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/27/2022] [Accepted: 10/17/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND France is somewhat behind other countries in its consideration of the issue of violence in perinatal care. Its consequences on maternal, but also neonatal and infant health are recognised internationally. Nonetheless, research and data measuring its frequency and its determinants are inadequate, and the relevant definitions are not always consensual. In this context, we, as midwives and researchers in public health and as members of the National College of French Midwives, seek to propose a scientific and clinical contribution to this debate. AIM We propose avenues for measuring and characterising violence in perinatal care. Our objective is to quantify and characterise the situations of violence in perinatal care in population-based studies and based on the perceptions of each woman questioned. DISCUSSION This proposal for questions, simplified compared with those currently in used in the international scientific literature, has the advantage of focusing reflection around three categories: inappropriate medical care, inappropriate human behaviours in care, and sexual abuse. It should also allow the identification of the contexts of care during which violence may be experienced, as well as the categories of health-care workers concerned. CONCLUSION It seems important to us to distinguish these situations, causal and context, for they require different responses if we hope to reduce the frequency and the effects of violence in perinatal care in the future. We propose questions that could also be used in clinical situations by midwives and other clinicians.
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Affiliation(s)
- P Sauvegrain
- Midwifery School AP-HP- Sorbonne Université, F-75012 Paris, France; Université Paris Cité, Epidemiology and Statistics Research Center/CRESS/EPOPé Research Team, INSERM, INRA, F-75014 Paris, France.
| | - C Schantz
- Université Paris Cité, IRD, Inserm, Ceped, F-75006 Paris, France.
| | - L Gaucher
- Hospices Civils de Lyon, Hôpital Femme Mère-Enfant, F-69500 Bron, France; Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts, Western Switzerland, Geneva, Switzerland.
| | - A A Chantry
- Université Paris Cité, Epidemiology and Statistics Research Center/CRESS/EPOPé Research Team, INSERM, INRA, F-75014 Paris, France; Midwifery School of Baudelocque, AP-HP, Université Paris Cité, F-75006 Paris, France.
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André C, Delalay S, Gaucher L, Mernissi T, Moreau F, Gras V, Masmoudi K, Hennart B, Lemaire-Hurtel AS, Bodeau S. Intoxication pédiatrique au tramadol et polymorphisme génétique du cytochrome P450 2D6. Toxicologie Analytique et Clinique 2021. [DOI: 10.1016/j.toxac.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Gaucher L, Le Ray C. Oxytocin administration during spontaneous labor: Guidelines for clinical practice. Chapter 2: Indications of oxytocin according the first and second stages of spontaneous labor. J Gynecol Obstet Hum Reprod 2017; 46:479-487. [PMID: 28473289 DOI: 10.1016/j.jogoh.2017.04.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- L Gaucher
- Hôpital Femme-Mère-Enfant, Lyon University Hospital (HCL), 69500 Bron, France; HESPER EA 7425, Lyon University, University Claude-Bernard Lyon 1, 69008 Lyon, France; Centre of Medical Information and Research Evaluation (IMER), Lyon University Hospital (HCL), 69003 Lyon, France.
| | - C Le Ray
- Port Royal Maternity, Hôpitaux Universitaires Paris Centre, AP-HP, Paris Descartes University, 75014 Paris, France; Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), center for epidemiology and statistics Sorbonne Paris Cité, 75014 Paris, France; DHU risks in pregnancy, 75014 Paris, France
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Dupont C, Carayol M, Le Ray C, Barasinski C, Beranger R, Burguet A, Chantry A, Chiesa C, Coulm B, Evrard A, Fischer C, Gaucher L, Guillou C, Leroy F, Phan E, Rousseau A, Tessier V, Vendittelli F, Deneux-Tharaux C, Riethmuller D. Recommandations pour l’administration d’oxytocine au cours du travail spontané. Texte court des recommandations. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.sagf.2016.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Dupont C, Carayol M, Le Ray C, Barasinski C, Beranger R, Burguet A, Chantry A, Chiesa C, Coulm B, Evrard A, Fischer C, Gaucher L, Guillou C, Leroy F, Phan E, Rousseau A, Tessier V, Vendittelli F, Deneux-Tharaux C, Riethmuller D. [Oxytocin administration during spontaneous labour: Guidelines for clinical practice. Guidelines short text]. ACTA ACUST UNITED AC 2017; 45:56-61. [PMID: 28238320 DOI: 10.1016/j.gofs.2016.12.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/21/2016] [Accepted: 12/21/2016] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To define the different stages of spontaneous labour. To determine the indications, modalities of use and the effects of administering synthetic oxytocin. And to describe undesirable maternal and perinatal outcomes associated with the use of synthetic oxytocin. METHOD A systematic review was carried out by searching Medline database and websites of obstetrics learned societies until March 2016. RESULTS The 1st stage of labor is divided in a latence phase and an active phase, which switch at 5cm of cervical dilatation. Rate of cervical dilatation is considered as abnormal below 1cm per 4hour during the first part of the active phase, and below 1cm per 2hours above 7cm of dilatation. During the latent phase of the first stage of labor, i.e. before 5cm of cervical dilatation, it is recommended that an amniotomy not be performed routinely and not to use oxytocin systematically. It is not recommended to expect the active phase of labor to start the epidural analgesia if patient requires it. If early epidural analgesia was performed, the administration of oxytocin must not be systematic. If dystocia during the active phase, an amniotomy is recommended in first-line treatment. In the absence of an improvement within an hour, oxytocin should be administrated. However, in the case of an extension of the second stage beyond 2hours, it is recommended to administer oxytocin to correct a lack of progress of the presentation. If dynamic dystocia, it is recommended to start initial doses of oxytocin at 2mUI/min, to respect at least 30min intervals between increases in oxytocin doses delivered, and to increase oxytocin doses by 2mUI/min intervals without surpassing a maximum IV flow rate of 20mUI/min. The reported maternal adverse effects concern uterine hyperstimulation, uterine rupture and post-partum haemorrhage, and those of neonatal adverse effects concern foetal heart rate anomalies associated with uterine hyperstimulation, neonatal morbidity and mortality, neonatal jaundice, weak suck/poor breastfeeding latch and autism. CONCLUSION The widespread use of oxytocin during spontaneous labour must not be considered as simply another inoffensive prescription without any possible deleterious consequences for mother or foetus. Conditions for administering the oxytocin must therefore respect medical protocols. Indications and patient consent have to be report in the medical file.
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Affiliation(s)
- C Dupont
- Pôle IMER, Réseau périnatal Aurore, hospices civils de Lyon, 69003 Lyon, France; HESPER EA 7425, université Lyon, université Claude-Bernard-Lyon 1, 69008 Lyon, France.
| | - M Carayol
- Service de PMI, direction des familles et de la petite enfance, mairie de Paris, 75196 Paris, France
| | - C Le Ray
- Maternité Port Royal, hôpital Cochin, Assistance publique-Hôpitaux de Paris, 75014 Paris, France; Inserm U1153, épidémiologie obstétricale, périnatale et pédiatrique (équipe EPOPé), centre de recherche en épidémiologie et statistiques Sorbonne Paris Cité (CRESS), DHU risques et grossesse, université Paris Descartes, 75014 Paris, France
| | - C Barasinski
- EA 4681 PEPRADE, université d'Auvergne, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - R Beranger
- Inserm U1085, IRSET, équipe 9 « recherches épidémiologiques sur l'environnement, la reproduction et le développement », 35000 Rennes, France
| | | | - A Chantry
- Inserm U1153, épidémiologie obstétricale, périnatale et pédiatrique (équipe EPOPé), centre de recherche en épidémiologie et statistiques Sorbonne Paris Cité (CRESS), DHU risques et grossesse, université Paris Descartes, 75014 Paris, France; École de sages-femmes Baudelocque, université Paris Descartes, DHU risques et grossesse, Assistance publique-Hôpitaux de Paris, 75014 Paris, France
| | - C Chiesa
- Inserm U1153, épidémiologie obstétricale, périnatale et pédiatrique (équipe EPOPé), centre de recherche en épidémiologie et statistiques Sorbonne Paris Cité (CRESS), DHU risques et grossesse, université Paris Descartes, 75014 Paris, France
| | - B Coulm
- Inserm U1153, épidémiologie obstétricale, périnatale et pédiatrique (équipe EPOPé), centre de recherche en épidémiologie et statistiques Sorbonne Paris Cité (CRESS), DHU risques et grossesse, université Paris Descartes, 75014 Paris, France
| | - A Evrard
- Association bien naître, 69003 Lyon, France
| | - C Fischer
- Maternité Port Royal, hôpital Cochin, Assistance publique-Hôpitaux de Paris, 75014 Paris, France
| | - L Gaucher
- HESPER EA 7425, université Lyon, université Claude-Bernard-Lyon 1, 69008 Lyon, France; Hôpital Femme-Mère-Enfant, hospices civils de Lyon, 69500 Bron, France; Pôle information médicale évaluation recherche, 69003 Lyon, France
| | - C Guillou
- Clinique Natecia, 69008 Lyon, France
| | - F Leroy
- Hôpital Montélimar, 26200 Montélimar, France
| | - E Phan
- Association d'usagers, collectif inter-associatif autour de la naissance (CIANE), 75014 Paris, France
| | - A Rousseau
- Département de Maïeutique, UFR des sciences de la santé Simone-Veil, université Versailles-Saint-Quentin, 78000 Versailles, France
| | - V Tessier
- Département hospitalo-universitaire « risques et grossesse », groupe hospitalier Cochin, AP-HP, 53, avenue de l'Observatoire, 75014 Paris, France
| | - F Vendittelli
- EA 4681 PEPRADE, université d'Auvergne, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - C Deneux-Tharaux
- Inserm U1153, épidémiologie obstétricale, périnatale et pédiatrique (équipe EPOPé), centre de recherche en épidémiologie et statistiques Sorbonne Paris Cité (CRESS), DHU risques et grossesse, université Paris Descartes, 75014 Paris, France
| | - D Riethmuller
- Pôle Mère-Femme, CHRU de Besançon, 3, boulevard Fleming, 25000 Besançon, France
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Billon M, Bagou G, Gaucher L, Comte G, Balsan M, Rudigoz RC, Dupont C. [Unexpected out-of-hospital deliveries: Management and risk factors]. ACTA ACUST UNITED AC 2015; 45:285-90. [PMID: 25934383 DOI: 10.1016/j.jgyn.2015.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 03/25/2015] [Accepted: 04/01/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To estimate the frequency of accidental out-of-hospital deliveries (OHDs), to describe the home care and the complications occurred, and to identify risk factors. MATERIALS AND METHODS A retrospective case-control study from 1st January 2012 to 31 December 2012 in Lyon urban area. Cases were identified from the Emergency Medical Aid Service 69 (SAMU 69) registry and control from the birth registry of the maternity corresponding to the case, recruiting two controls per case. RESULTS The frequency of the OHDs was 0.3% [0.2-0.4]. At home, the prophylactic administration of oxytocin was performed in 18.3% [9.31-27.3] of cases and prevention of neonatal hypothermia was performed in 45.7% [34.1%-57.3%] of cases. Multiparity [OR: 3.43 (1.65-7.23)], a precarious situation [OR: 37.63 (5.02-7.81)], and lack of antenatal care [OR: 3.36 (2.72-4.15)] were OHDs' risk factors. CONCLUSION The practical prevention of postpartum hemorrhage, and that of the home neonatal hypothermia could be improved. Points of vigilance for the medical teams to look for during the pregnancy monitoring are precariousness and less than 3 consultations scheduled.
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Affiliation(s)
- M Billon
- Hôpital Femme-Mère-Enfant, 69500 Bron, France
| | - G Bagou
- SAMU 69, 69437 Lyon cedex 03, France
| | - L Gaucher
- Hôpital Femme-Mère-Enfant, 69500 Bron, France
| | - G Comte
- SAMU 69, 69437 Lyon cedex 03, France
| | - M Balsan
- Faculté de médecine et de maïeutique, Lyon Sud-Charles-Mérieux, 69921 Oullins, France
| | - R-C Rudigoz
- Réseau périnatal Aurore, laboratoire « santé, individu, société », faculté de médecine Laennec, université Lyon-Est, EA 4129, 69372 Lyon cedex 08, France
| | - C Dupont
- Réseau périnatal Aurore, laboratoire « santé, individu, société », faculté de médecine Laennec, université Lyon-Est, EA 4129, 69372 Lyon cedex 08, France.
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Dupont C, Occelli P, Fassier T, Gaucher L, Colin C, Francois P, Deneux-Tharaux C, Rudigoz RC. Évaluation de l’impact des revues de morbi-mortalité en obstétrique : revue de la littérature. ACTA ACUST UNITED AC 2012; 41:255-61. [DOI: 10.1016/j.jgyn.2012.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Revised: 02/17/2012] [Accepted: 03/07/2012] [Indexed: 11/24/2022]
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Gaucher L, Grunchec N, Haloun A, Ordronneau J. [Alveolar lavage and pulmonary fibrosis caused by hard metals]. Presse Med 1986; 15:440. [PMID: 2938174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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Gaucher L, Paineau J, Ordronneau J, Diot B, Blanloeil Y. [Unusual complication of costal fracture. Stercoraceous pyopneumothorax]. Presse Med 1985; 14:1154. [PMID: 3158988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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Gaucher L, Patra P, Ferry D, Ordronneau J, Ginet JD, Dupon H. [Calculation of the regional perfusion index by transcutaneous oximetry in arteritis of the lower limbs]. Presse Med 1984; 13:1790. [PMID: 6235515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Ordronneau J, Chailleux E, Gaucher L, Ginet JD, Moigneteau C. [Reliability of the transcutaneous PO2 measurement in the adult by the TCM 1 radiometer electrode]. Bull Eur Physiopathol Respir 1984; 20:303-6. [PMID: 6743873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The accuracy of transcutaneous PO2 measurements (PtcO2; Radiometer TCM 1) was evaluated by comparison with arterial PO2 (PaO2) on 115 recordings in 35 patients: 20 during exercise testing (group I) and 14 during assisted ventilation at different FIO2 values (group II). The correlation coefficient between PaO2 and PtcO2 was satisfactory (r = 0.977; n = 115). However PaO2 and PtcO2 mean values were significantly different in group I, and in group II at 45% FIO2. The analysis of variance showed that the difference between PaO2 and PtcO2 was significant among the patients but did not vary with exercise and FIO2 changes (group I: F19 = 6.28, p less than 0.001; group II: F19(19) = 2.54, p less than 0.025). In the adult, transcutaneous PO2 measurement by TCM 1 radiometer electrode seems to be interesting in the context of monitoring blood gases with exercise and assisted ventilation. The significant variation with arterial PO2 sometimes registered should make one cautious in the interpretation of accurate measurements.
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Tasseau F, Gaucher L, Nicolas F. [Cell-mediated immunity studied by skin tests in patients receiving intensive care. Prognostic value of repeated tests. Study of some factors predisposing towards anergy (author's transl)]. Sem Hop 1982; 58:781-4. [PMID: 6283652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Cell-mediated immunity was assessed by three skin tests (using tuberculin, candidin, and Varidase) in one-hundred patients in a medical intensive care unit. Anergy on admission was most often found after major blood loss and massive transfusion as well as in patients over sixty. For the 49 patients who were anergic on admission the mortality rate was 32%, against 12% for the 51 reactive subjects (p less than 0.01). Repetition of skin tests considerably improved their prognostic value. No deaths occurred among the 21 patients who were reactive on admission and throughout the course of their disease, or among the 16 patients who, after being anergic on admission, became reactive subsequently. Conversely, the survival rate was only 40% for the 22 patients who remained or became anergic. Our results confirm the value of skin tests for assessing cell-mediated immunity in patients receiving intensive care. Repeated tests allow early detection of high risk patients in whom fatal outcome, whether due to infection or not, is more frequent. Two factors which predispose to anergy are underlined: advanced age and massive transfusion after major blood loss.
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Gaucher L, Ordronneau J, Chailleux E, Calamel J, Ginet JD, Moigneteau C. [Oxygen enrichers and different ways of using them]. Respiration 1981; 41:224-31. [PMID: 7302388 DOI: 10.1159/000194386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Different ways of using oxygen enrichers have been studied. First, the performances of two different devices were tested: the results were very similar to the constructors' previsions. Second, oxygen concentrations in venturi masks connected to enrichers were measured with a mass spectrometer. The authors suggest to adjust the flow delivered by enrichers at 3 liters/min for any type of venturi mask. Pharyngeal oxygen concentration curves show the reliability of masks connected to enrichers compared to other modes of administration (nasal cannulae, nasal catheter).
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