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Prognostic Factors of Comas in the Intensive Care Unit of the University Teaching Hospital of Parakou (Benin)

Journal of Behavioral and Brain Science 2015年第11期5卷 503-512页

作者： tchaou blaise adelin Adoukonou Thierry Armel Zoumenou Eugene Mehou Loko Ulrich Donald Lokossou C. Thomas Unité d’Enseignement et de Recherche de Anesthésie Réanimation Faculté de Médecine Université de Parakou Parakou Benin Unité d’Enseignement et de Recherche de Neurologie Faculté de Médecine Université de Parakou Parakou Benin Unité d’Enseignement et de Recherche de Anesthésie Réanimation Faculté des Sciences de la Santé Université d’Abomey-Calavi Abomey-Calavi Benin Service d’Anesthésie Réanimation du Centre Hospitalier Universitaire Départemental de Parakou Parakou Benin

Background: Coma is a highly frequent situation associated with several diseases. Objective: That is to assess the prognostic factors of comas at the intensive care unit of the university teaching hospital of Parakou. Patients and Methods: It is a cross-sectional study with descriptive and analytical purpose based on prospective gathering of data. It has been performed from March 1 to July 31, 2014. The population study consists of 100 adult patients admitted to the intensive care unit for coma. The vital and functional prognosis data are studied. Results: The admission frequency of comatose patients to the intensive care unit is 44.4%. Patients’ mean age is 27 ± 13.9 years with extremes of 16 and 88 years. The average length of stay in the intensive care unit is 5.2 ± 5.6 days with extremes of 2 hours 30 minutes and 30 days. Mortality rate is 30%. Poor prognostic factors are: average Glasgow score of 6.8 ± 2.9 (p = 0.01), average outpatient simplified severity index (OSSI) of 9.1 ± 3.5 (p = 0.02), pupillary abnormality (p = 0.00), motor weakness (p = 0.00), average glycemia of 1.5 ± 0.82 g/L (p = 0.02), average systolic blood pressure of 130.9 ± 44.5 mm Hg (p = 0.03), average diastolic blood pressure of 80.8 ± 22.3 mm Hg (p = 0.03), average respiratory rate of 30.9 ± 10.6 cycles/min (p = 0.03) and average temperature of 37.8°C ± 1.2°C (p = 0.03). Conclusion: Coma is a pathological entity with high frequency in clinical medicine. Its positive diagnosis is easy, but etiological research is hard. Hospital mortality is high and influenced by several factors. Taking into account, those factors in care strategies can improve their prognosis.

关键词： Coma Prognostic Factors Morbidity Mortality

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The Bispectral Index Interest during General Anesthesia at the University Hospital of Parakou (Republic of Benin) in 2019

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Open Journal of Anesthesiology 2021年第3期11卷 59-71页

作者： tchaou blaise adelin Tchégnonsi N'vènonfon Charles Frédéric Ezadjomo Evouna Ndoh Agnès Nina Zoumenou Eugene Brouh Yapo Chobli Martin Department of Anesthesia-Resuscitation and Emergency Borgou-Alibori University Hospital Center Parakou Benin Anesthesia-Resuscitation and Pediatric Emergencies Hospital of Mother and Child of Bingerville Bingerville Rep. Cote d’Ivoire

Background: The bispectral index (BIS) derived from the electroencephalogram is an additional means of monitoring the depth of narcosis. Objective: To compare the monitoring of the depth of narcosis by the BIS associated with clinical data versus standard monitoring at the University Hospital of Parakou in Benin in 2019. Methods: This was an observational study for descriptive and analytical purposes with prospective data collection, carried out in general surgery and intensive care unit for 4 months. The inclusion criteria were: an age ≥ 18 years, an ASA score ≤ 3, surgery under general anesthesia and informed consent of the patient. Two groups were formed: non-BIS group monitored by clinical parameters (PA, FC, FR, EtCO2, and SpO2) only and BIS group monitored by bispectral index in addition to clinical parameters. Patients were seen 48 hours after the procedure. Results: 36 patients were collected. The mean age was 40.63 ± 16.77 years with a sex ratio of 3. ASA 1 patients represented 86.11% of the sample and ASA2 patients 13.89%. The average doses of Propofol were not significantly reduced in the BIS group (p = 0.555). On the other hand, the period of intraoperative recovery (p-value = 0.007) and the NVPO (p = 0.043;O

关键词： General Anesthesia Narcosis Bispectral Index Monitoring

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Contribution of EFAST Ultrasound in the Management of Chest and Abdomen’s Blunt Trauma in the City of Parakou, Benin

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Open Journal of Anesthesiology 2020年第11期10卷 388-407页

作者： tchaou blaise adelin Savi De Tovè Kofi-Mensa Tchégnonsi N’vènonfon Charles Frederic Gandji Elohonnan Wilfred Ngamo Deugoue Gabriel Marie Allodé Salako Alexandre Department of Anesthesia Resuscitation and Emergency CHUD Parakou The Republic of Benin Department of Radio-Diagnostic and Medical Imagery CHUD Parakou The Republic of Benin Department of Visceral Surgery National Teaching Hospital-HKM Cotonou The Republic of Benin Department of General Surgery CHUD Parakou The Republic of Benin

Background: Blunt thoracic and abdominal traumas are frequent and have a poor prognosis in the absence of prompt diagnosis and adequate management. An ultrasound performed in the emergency room allows a precise diagnosis and a better orientation of the victims. Objective: To assess the contribution of EFAST ultrasound in the management of blunt thoracic and abdominal traumas. Patients and method: Cross-sectional descriptive and analytical study with prospective data collection carried out from February 20th to August 20th, 2017 in the emergency and intensive care units of the Parakou University Hospital Centre. An ultrasound machine fitted with a 3.5 MHz convex probe was used to search for post-traumatic effusion by the EFAST technique on admission and then as needed over 24 hours and after surgery. Results: Sixty-three patients were collected with an 85.71% male predominance. The average age was 31.36 ± 13.29 years. The time to perform the EFAST ultrasound was 7 ± 3 min. EFAST was positive in 50.79% of patients. Five patients (7.93%) received emergency treatment for hemodynamic instability and positive EFAST within an average of 3.46 ± 2 hours. Eighteen patients (27.58%) received after monitoring by EFAST, surgery within 9 hours 12 minutes (hemoperitoneum) and 27 hours 58 minutes (hemothorax). Two patients were tested positively for EFAST after surgery. Conclusion: The introduction of an EFAST ultrasound as a sorting tool in an environment with limited resources is desirable and feasible.

关键词： Emergencies Blunt Trauma EFAST Thorax Abdomen

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The Bispectral Index Interest during General Anesthesia at the University Hospital of Parakou (Republic of Benin) in 2019

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Open Journal of Anesthesiology 2021年第3期

作者： tchaou blaise adelin TchégnonsiN'vènonfonCharlesFrédéric

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Management of Arterial Hypotension Induced by Spinal Anesthesia during Cesarean Section at the Parakou University Hospital in Benin in 2020: Ephedrine versus Noradrenaline

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Open Journal of Anesthesiology 2022年第12期12卷 351-367页

作者： blaise adelin tchaou Samaké Broulaye Massaoulé Dossou Bodjrènou Marjolaine Oriane Brouh Yapo Department of Anesthesia-Intensive Care and Emergencies University and Departmental Hospital Center of Borgou/Alibori Parakou Benin Department of Intensive Care Unit at the University Hospital Gabriel Touré Bamako Mali Department of Anesthesia-Intensive Care and Pediatric Emergencies Mother-Child Hospital of Bingerville Bingerville C&ocirc te d’Ivoire

Background: Spinal anesthesia (SA) is a preferred anesthetic technique for childbirth through caesarean section. It causes a sympathetic block responsible for low blood pressure which can be prevented or treated with vasopressors. Aim: This research aims to compare the effect of Noradrenaline with that of Ephedrine in the management of arterial hypotension caused by SA during Caesarean act. Study method: It was a cross-sectional study with two comparative settings which took place at the Teaching hospital of Parakou from April 15th to August 15th 2020. It included all parturients who underwent a caesarian act and received spinal anesthesia. To prevent hypotension two groups were formed. The first group parturient received Noradrenaline (10 γ) as prophylactic and the second group received Ephedrine (10 mg) before anesthesia. The main evaluation criteria were the time before the hypotension occurs and, the secondary endpoint was the number of hypotension episode. The two groups were compared using the usual statistical tests. The study received the approval of the Local Ethical committee of University of Parakou. Results: Two hundred and four parturients were compiled with 102 in each group. The mean age was 28.37 ± 6.15 years with extremes of 16 and 45 years. The main indications for Caesarean section were respectively iterative Caesarean section (46.57%) for scheduled Caesarean section and acute fetal distress (15.69%) for emergency Caesarean section. The incidence of hypotension was 38.24%. The mean delay of occurrence of hypotension was significantly longer in adrenaline group (19.90 min) than ephedrine group (12.53 min) with P = 0.001. According to the secondary endpoint the number of episodes of hypotension, number of tachycardia, and the total doses of each vasopressor were significantly lower in adrenaline group than in the ephedrine group. Conclusion: The use of Noradrenaline according to the established protocol demonstrated its efficie

关键词： Spinal Anesthesia Caesarean Section Hypotension Ephedrine Noradrenaline

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Endoscopic Aspects of Caustic Injuries of the Upper Gastrointestinal Tract in Parakou, Benin Republic: A Multicenter Study

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Journal of Biosciences and Medicines 2023年第10期11卷 15-24页

作者： Saké Khadidjatou Fanou Coffi Dénis Agbeille Mohamed Falilatou Hountondji Astrid Alexandrine Tamou Sambo Bio Elie tchaou blaise Adélin Sehonou Jean Kodjoh Nicolas Faculty of Medicine University of Parakou Parakou Benin Military Teaching Hospital-Regional Teaching Hospital of Parakou Parakou Benin Faculty of Health Sciences University of Abomey Calavi Cotonou Benin

Objective: Caustic ingestion is a medico-surgical emergency. The objective of this study is to describe endoscopic lesions of the upper gastrointestinal tract secondary to caustic ingestion in Parakou, Benin Republic. Patients and Methods: This was a retrospective and descriptive cross-sectional study. The study was multicenter in the gastrointestinal endoscopy units of the Teaching Hospital Center of Borgou-Alibori and the Military Teaching Hospital of Parakou. It covered the period from July 2015 to October 2021. This included any patient who ingested a caustic substance and performed a gastroscopy in one of the two endoscopy units. The variables studied were: socio-demographic data, the nature of the caustic substance ingested, the time between the caustic ingestion and the performance of gastroscopy and injuries of the upper gastrointestinal tract. Results: Out of the 24 patients included, 19 were men, i.e. a sex ratio of 3.8. Their average age was 25.54 ± 12.04 years with extremes of 6 and 50 years. Five subjects (20.83%) were under the age of 18 and the ingestion was accidental in them. Among the 19 patients aged at least 18 years, caustic ingestion was voluntary in 14 (73.68%). The caustic substance ingested was either a base (sodium hydroxide or caustic soda) or an acid (sulfuric acid) in 14 cases (58.33%) and 10 cases (41.67%), respectively. The time between the caustic ingestion and the performance of gastroscopy varied from 1 to 1095 days. The endoscopic lesions objectified were: stenosis (37.5%), ulcerations (29.17%), necrosis (20.83%), or erythema (12.25%). Conclusion: In Parakou, caustic ingestion, usually bases, is often voluntary in adult men. Endoscopic lesions were often ulcerative but sometimes necrotic.

关键词： Caustic Injuries Bases Acids Endoscopy Parakou

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Prognosis Value of Two Gravity Scores in Patients Admited to the Intensive Care Unit at University Hospital of Parakou in Benin

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Open Journal of Anesthesiology 2020年第4期10卷 144-156页

作者： blaise adelin tchaou Nvènonfon Charles Frédéric Tchégnonsi Hervé Philippe Minsili Bikolo Patrick Stéphane Kouomboua Mfin Martin Chobli Service d’Anesthésie-Réanimation et des Urgences Centre Hospitalier Universitaire et Départemental du Borgou/Alibori Parakou Benin

Introduction: The gravity of the clinical state of the patient of intensive care is linked to the existence of one or several lesions and visceral defaults putting its forecast into play. Objective: To determine the prognosis value of two general graveness’ scores of patients admitted to intensive care at University Hospital of Parakou in Benin. Patients and Methods: Descriptive and analytical observational study data were collected from March 1st to June 30th, 2017. The SAPS II and APACHE II were calculated during first 24 hours of hospitalization to assess the clinical graveness and predict patient’s mortality. Results: We enrolled 185 patients representing 89.37% of admissions, majority were men (63.78%). Mean age was 38.89 ± 17.92 years (16 to 99), mean of hospitalization duration was 4.36 ± 2.2 days. Neurological failure was the most common disorder observed (58.37%). Mean SAPS II and APACHE II were 29.54 ± 19.04 and 14.24 ± 10.49 respectively. Mean predicted mortality of SAPS II and APACHE II was 19.12 ± 5.05 and 25.69 ± 5.00 respectively. The mortality rate was 25.95% and increased with severity scores. The sensibility of APACHE II and SAPS II score was 72.90% and 66.70% respectively. SAPS II score was found to be more specific (85.40%) than APACHE II (80.03%). Conclusion: Those severity patient scores accurately predicted the prognosis of patients in intensive care unit and should be integrated into our practice.

关键词： Indications of Gravities Prognosis Mortality Intensive Care

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Complications of Obesity in Cesarized Parturients in the Teaching Centers of Cotonou

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Open Journal of Endocrine and Metabolic Diseases 2018年第6期8卷 137-144页

作者： Annelie Kerekou Hode Eugène Zoumenou Benjamin Hounkpatin Serge Mewanou blaise tchaou Martin Chobli Service of Endocrinology Hospital and University National Center Hubert Koutoukou Maga of Cotonou Cotonou Benin Service of Anesthesia and Reanimation Hospital Mother and Child of Cotonou Cotonou Benin Service of Gynecology and Obstetrics Hospital Mother and Child of Cotonou Cotonou Benin Service of Anesthesia and Reanimation Hospital and University National Center Hubert Koutoukou Maga of Cotonou Cotonou Benin Department of Anesthesia and Reanimation Hospital and University of Parakou Parakou Benin Emergency Department of Hospital and University National Center Hubert Koutoukou Maga of Cotonou Cotonou Benin

This survey had the objective to determine the frequency of the obesity at the parturient, to value the impact of the obesity on the childbirth by Caesarean and the complications postoperative immediate in the teaching hospitals of Cotonou. Patients and Method: We did a prospective, comparative and analytic survey from January 13 to April 13, 2012. Eight hundred ninety-one consecutive parturients having had a Caesarean were included. We studied the anesthetic techniques, the techniques of control of the aerial ways, the number of necessary tests for the tracheal intubation, the complications and aftercare of the first 48 hours. A comparison has been made according to the BMI. The obesity has been defined by a BMI ≥ 30 kg/m2. The parturient has been classified in two groups: Non-obese: BMI ≤ 30 kg/m2, obese: BMI ≥ 30. Results: There were 703 (78.90%) Caesareans in emergency and 188 (21.09%) programmed Caesareans. The obesity which has been recovered at 286 parturient is 32.10%. The obese parturient also required more frequently several lumbar punctures (p Conclusion: Many changes led by pregnancy are added to those of the obesity to drive to functional changes, a reduction of the physiological reserve and finally to an increased anesthetic and obstetric risk. The obesity is frequent at the parturient in Benin. The post-operative complications are more frequent after the Caesarean at the obese parturient.

关键词： Obesity Caesarean Anesthesia Complication Benin

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Short Term (3 Months) Prognosis of Stroke in Parakou

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Neuroscience & Medicine 2018年第2期9卷 81-93页

作者： Thierry Adoukonou Oyéné Kossi Mendinatou Agbétou blaise tchaou Gottfried Agballa Dismand Houinato Faculté de Médecine Université de Parakou Parakou Benin Faculté des Sciences de la Santé Université Abomey-Calavi Abomey-Calavi Benin

Background: The burden of stroke is very high in sub-Saharan Africa. The identification of the factors influencing poor outcome can help to reduce this burden. Objective: To study factors influencing the prognosis of stroke at Parakou. Methods: It was a prospective study conducted over two periods: inclusion period between 1st January and 30 June 2013;monitoring period of survivors between 1st July and 30 September. All consecutive patients admitted in the hospitals for stroke in the study period were included. The functional outcomes were assessed by the RANKIN scale (RANKIN > 2). Epi-info version 7 and SPSS version 16 were used for the statistical analyses. Results: We recruited 85 patients;mean age was 52 ± 15 years. The housewives and the unschooled represented respectively 33% and 65%. The mortality rates at 1 and 3 month were respectively 27% and 32%. Factors associated with mortality were female gender, stroke severity, disorders of consciousness, hyperthermia and hyperglycemia at admission, overweight, pneumonia, anemia, hyperleucocytosis, higher total and LDL serum cholesterol levels at 1 month;housewife status and pneumonia were associated at 3 month. 47% of survivors were independent at 1 month. Stroke severity and length of hospital stay were associated with disability at 1 month whereas previous stroke and disability history, stroke severity, weight and length of hospital stay were related with 3 month poor functional outcome. Conclusion: This study showed the poor outcome of stroke patients in Parakou which were influenced by many factors. Taking account of these factors in the strategies of care in the acute phase may improve the prognosis of stroke patients.

关键词： Mortality Prognosis Stroke Parakou

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Outcome of the Post-Operative Patients’ Admissions in the Field of Resuscitation in Mali

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Open Journal of Anesthesiology 2020年第3期10卷 73-79页

作者： Samaké Broulaye Massaoulé Beye Seydina Alioune tchaou blaise Adélin Kassogué André Tall Fadima Koureissi Keita Mohamed Service of Anesthesia Resuscitation Academic Hospital Gabriel Touré Bamako Mali Service of Anesthesia Resuscitation Academic Hospital Point G. Bamako Mali Service of Anesthesia Resuscitation and Emergencies Academic Hospitable Center and Department of the Bourgou/Alibori Parakou Benin Service of Anesthesia Resuscitation Academic Hospital Kati Bamako Mali

Introduction: In spite of the use of the less and less invasive and the more and more effective techniques and the use of fast rehabilitation conditions of the patients in surgery, the post-operative complications (POC) stay the main reasons of admission in resuscitation service. Objective: To determine the post-operative outcome of the patients admitted in resuscitation. Patient and method: It was about a retrospective and transverse survey from June 2017 to May 2018 in the service of polyvalent resuscitation of the academic hospital center of Gabriel Touré. Have been included the patients operated for surgical or obstetric gynecology—pathologies admitted in resuscitation for post-operative complications established or potential precocious or late. The used statistical test was the Chi2 with p Results: During the period, 514 patients have been admitted in resuscitation of which 140 cases of post-operatively represented 27.2% of the admissions. Under hospitalization 35.7% of patients have presented a complication. The middle age of patients was 37.72 ± 20.9 years. The sex ratio was 0.70. The middle length of interventions was 122 ± 83 min with extremes going from 20 to 434 min. The predominant admission motive was hemodynamic instability. The delay of appearance intervening of the complications was 3 days in 94%. The predominant complications were: respiratory (32%), infectious (28%) and Cardiovascular (20%). The middle length of hospitalization was of 3.36 ± 2.90 days. The death rate was 15%. The complications were related age, the class of Alteme?er, the ASA, and the perioperative undesirable events with p Conclusion: The post-operative admissions in resuscitation are frequent including several factors of morbi-mortality. A better management per and postoperative of the patients operated would reduce the death rate. The profile mark is the one of a patient admitted for hemodynamic instability.

关键词： Post-Operative Admission Outcome Resuscitation Academic Hospital Gabriel Touré

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