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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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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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State of Shock: Epidemiological, Etiological and Therapeutic Aspects at the pediatric Unit of the Medical and Surgical emergencies of the Donka National Hospital

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Open Journal of pediatrics 2019年第4期9卷 302-308页

作者： Diallo Mohamed Lamine Barry Ibrahima Koolo Camara Emmanuel Ondima Hermann Laurent Marion Sossouadouno Elisabeth Sita Diallo Saliou Bella emergencies pediatric Donka National Hospital Conakry Guinea Institute of Nutrition and Child Health (INSE) Donka National Hospital Conakry Guinea pediatric Department Donka National Hospital Conakry Guinea

Introduction: The objective of this study was to write the epidemiological, etiological and therapeutic aspects of shock in children in the paediatric medico-surgical emergency unit of the National Donka Hospital. Method: This was a forward-looking, descriptive 6-month study, including all children aged 0 to 15 who were received in the paediatric medico-surgical emergency unit at The Donka National Hospital, where the shock diagnosis was retained and the patients received care. Results: In our study, 26 out of 1123 patients were received in a state of shock. Hypovolemic shock was more common at 24 (92%). Vascular filling by Ringer’s milk was the basic treatment. The 6 to 11 month age group was the most affected and the sex-ratio M/F was 1.6. The acute febrile gastroenteritis and dehydration status were the most frequent causes. The outcome was favorable in 25 patients (96%). Conclusion: Rapid and effective management would improve the vital and functional prognosis of children in shock.

关键词： Choc Children Urgences Paediatrics Donka

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Multi-Systemic Inflammatory Syndrome in Children

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Open Journal of pediatrics 2023年第4期13卷 529-542页

作者： Ilham Tadmori Soukaina Seddiki Samir Atmani Moustapha Hida Department of pediatrics and pediatric emergencies Mother and Child Hospital CHU Hassan II Fez Morocco

The objective of our work is to study the multi-systemic inflammatory syndrome (PIMS) in children, to determine its frequency, by analyzing the epidemiological, clinical, paraclinical, therapeutic, and evolutionary profile of these patients. A retrospective study spanning a period of 2 years from April 2020 to March 2022. It concerns all children under the age of 16 admitted and cared for in the pediatric emergency department of the university hospital Hassan II of Fez for multi-system inflammatory syndrome (PIMS). Twenty cases of PIMS were collected over this period. Multi-system inflammatory syndrome in children has been described in temporal association with COVID-19, usually within 2 to 6 weeks of illness or exposure. The age of the patients varies between 8 months and 15 years. All patients presented with fever and cutaneous signs, followed by digestive signs and neurological signs. The inflammatory syndrome is frankly positive in all patients who had a COVID-19 PCR and/or positive serology. The treatment is based on the administration of immunoglobulins in association with corticosteroid therapy and non-specific antibiotic therapy in the majority of cases (80%). The evolution was favorable. PIMS should be considered in all children presenting with a clinical and/or biological inflammatory syndrome associated with COVID-19.

关键词： Multisystemic Inflammatory Syndrome Child COVID-19 PIMS

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Obstructed infracardiac total anomalous pulmonary venous connection:The challenge of palliative stenting for the stenotic vertical vein

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pediatric Investigation 2020年第2期4卷 141-144页

作者： Mansour Al‐Mutairi Adnan Aselan Mustafa Al‐Muhaya Hany Abo‐Haded pediatric Cardiology Department Madinah Cardiac Centre(MCC)MadinahSaudi Arabia pediatric Cardiology Team Pediatric Cardiology UnitDepartment of PediatricsMaternity and Children Hospital(MCH)Al‐Madinah Al‐MunawarahSaudi Arabia pediatric Cardiology Unit Department of PediatricsFaculty of MedicineMansoura UniversityMansouraEgypt

Introduction Obstructed total anomalous pulmonary venous connection(TAPVC)is one of the commonest seen emergencies in pediatric cardiology *** presentation Our case was diagnosed to have this anomaly,showing early respiratory distress resulting from severe pulmonary *** stenting of the obstruction was done,which helped in stabilizing the debilitated hemodynamics of the baby before surgery,thus a good surgical outcome and prognosis are *** This intervention may be listed as a vital measurement in the preoperative cardiac stabilization plan for infants with obstructed TAPVC.

关键词： Obstruction Total anomalous pulmonary venous connection(TAPVC) Palliative stent

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Management of pediatric Abdominal Surgical emergencies in Northern Benin

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Open Journal of pediatrics 2020年第2期10卷 314-319页

作者： M. G. Yassegoungbe B. Tamou Sambo D. M. Seto M. A. Hodonou S. B. Noukpozounkou B. R. Assan S. A. Allode pediatric Surgery National Teaching Hospital Hubert Koutoukou Maga Cotonou Benin General Surgery Teaching Hospital of Parakou Parakou Benin University Clinic of Visceral Surgery National Teaching Hospital Hubert Koutoukou Maga Cotonou Benin

Background: pediatric abdominal surgical emergencies are major causes of morbidity and mortality. The goal was to identify the main determinants of their management and access to assess their evolution. Patients and m... 详细信息

Background: Pediatric abdominal surgical emergencies are major causes of morbidity and mortality. The goal was to identify the main determinants of their management and access to assess their evolution. Patients and methods: This is a prospective, descriptive and analytical study performed at Parakou teaching hospital and Tanguieta district hospital. It has been conducted from January 1st to July 31st 2016. All children were included aged 0 to 15 years and admitted for an abdominal surgical emergency with a Clinical Classification of Emergency Patients listed from 3 to 5. Results: Pediatric abdominal surgical emergencies accounted for 42.8% of pediatric surgical emergencies. The average age was 9.3 ± 3.5 years old. The sex ratio was 1.7. The most encountered etiologies were peritonitis (36.76%), abdominal trauma (16.17%) and anorectal malformations (14.71%). The comparison of the delay in operative treatment with the World Society of Emergency Surgery shows a delay in 82.35% of cases. Mortality was high preoperatively and was related to the neonatal period (p = 0.027) and to a resuscitation length of stay higher than 36 hours (p = 0.035). Conclusion: Surgical care was delayed, mainly due to the lack of technical capacities. Morbidity and mortality were relatively low.

关键词： Abdominal Surgical Emergency pediatrics Peritonitis Delay in Surgery

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Rehabilitation of vulnerable groups in emergencies and disasters： A systematic review

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World Journal of Emergency Medicine 2017年第4期8卷 253-263页

作者： Hojjat Sheikhbardsiri Mohammad H. Yarmohammadian Fatemeh Rezaei Mohammad Reza Maracy Department of Emergency Operation Center (EOC) Disasters and Emergencies Management Center Kerman Universityof Medical Sciences Kerman Iran Health Management and Economics Research Center Faculty of Management and Medical Informatics IsfahanUniversity of Medical Sciences Isfahan Iran Department of Epidemiology & Biostatistics School of Public Health Isfahan University of Medical Sciences Isfahan Iran

BACKGROUND: Natural and man-made disasters, especially those occurring in large scales not only result in human mortality, but also cause physical, psychological, and social disabilities. Providing effective rehabilitation services in time can decrease the frequency of such disabilities. The aim of the current study was to perform a systematic review related to rehabilitation of vulnerable groups in emergencies and ***: The systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses(PRISMA) guidelines. The key words "recovery", "rehabilitation", "reconstruction", "transformation", "transition", "emergency", "disaster", "crisis", "hazard", "catastrophe", "tragedy", "mass casualty incident", "women", "female", "children", "pediatric", "disable", "handicap", "elder", "old" and "vulnerable" were used in combination with Boolean operators OR and AND. ISI Web of Science, PubM ed, Scopus, Science Direct, Ovid, ProQ uest, Wiley, Google Scholar were ***: In this study a total of 11 928 articles were considered and 25 articles were selected for f inal review of rehabilitation of vulnerable groups based on the objective of this study. Twenty-f ive studies including six qualitative, sixteen cross-sectional and three randomized controlled trials were reviewed for rehabilitation of vulnerable groups in emergencies and disasters. Out of the selected papers, 23 were studied based on rehabilitation after natural disasters and the remaining were man-made disasters. Most types of rehabilitation were physical, social, psychological and ***: The review of the papers showed different programs of physical, physiological, economic and social rehabilitations for vulnerable groups after emergencies and disasters. It may help health field managers better implement standard rehabilitation activities for vulnerable groups.

关键词： Rehabilitation Vulnerable group emergencies Disasters

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Rare Neonatal Digestive Surgical emergencies at the Brazzaville University Hospital Center

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Open Journal of pediatrics 2020年第3期10卷 463-473页

作者： Lucienne Irène Patricia Ondima Caryne Mboutol-Mandavo Moïse Service Yanguedet Didace Massamba Miabaou Jean-Claude Mieret Cardinale Princilia Okiemy Niendet Gracia Christelle Ossete Peggy Dahlia Gallou Mawandza Neli Yvette Ngakengni Gaston Ekouya Bowassa Department of pediatric Surgery University Hospital Center Brazzaville Republic of Congo Department of Visceral Surgery University Hospital Center Brazzaville Republic of Congo Department of Intensive care and anesthesia University Hospital Center Brazzaville Republic of Congo Department of Neonatology University Hospital Center Brazzaville Republic of Congo

The purpose of our study was to evaluate the morbidity-morality of rare neonatal digestive emergencies in order to improve their management. Observations: 7 newborns ranging in age from 6 hours to 3 weeks were treated for rare digestive pathologies between January 2013 and July 2017 (a period of 3 years and 6 months) in the Department of Pediatric surgery of Brazzaville University Center, Congo. Males were predominant (5 versus 2 females). Pathologies listed were: 1 antenatal volvulus of the small intestine, 1 annular pancreas and 5 gastric perforations. The average time of care in the operating room was 12 hours. The newborns were hospitalized in the pediatric surgery department in 28.6% of cases (n = 2), and 71.4% (n = 5) in the neonatology department. The antenatal volvulus of the intestine and annulus pancreas were integrated into a nosologic entity named neonatal occlusion (NNO). The postoperative outcomes were simple for 4 patients (57.14%) while 3 patients died immediately after surgery (42.86%). Conclusion:

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Characteristics of In-Hospital Patients with Congenital Heart Disease Requiring Rapid Response System Activations: A Japanese Database Study

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Congenital Heart Disease 2022年第1期17卷 31-43页

作者： Taiki Haga Tomoyuki Masuyama Yoshiro Hayashi Takahiro Atsumi Kenzo Ishii Shinsuke Fujiwara Department of pediatric Critical Care Medicine Osaka City General HospitalOsaka534-0021Japan Department of Emergency and Critical Care Medicine Jichi Medical University Saitama Medical CenterSaitama330-8503Japan Department of Intensive Care Medicine Kameda Medical CenterChiba296-8602Japan Department of Emergency Medicine Seirei Hamamatsu General HospitalShizuoka430-8558Japan Department of Anesthesiology Intensive Care UnitFukuyama City HospitalHiroshima721-8511Japan Department of Emergency Medicine NHO Ureshino Medical CenterSaga843-0393Japan

Objectives:This study aimed to study the characteristics of in-hospital deterioration in patients with congenital heart disease who required rapid response system activation and identify risk factors associated with 1-month ***:We retrospectively analysed data from a Japanese rapid response system registry with 35 participating *** included consecutive patients with congenital heart disease who required rapid response system activation between January 2014 and March *** regression analyses were performed to examine the associations between 1-month mortality and other patient-specific ***:Among 9,607 patients for whom the rapid response system was activated,only 82(0.9%)had congenital heart *** few patients with congenital heart disease were being treated at the cardiology and cardiovascular surgery departments(12.3%and 9.9%,respectively).Moreover,the incidences of rapid-response events after intensive care unit discharge or surgery were low(6.8% and 12.2%,respectively).The most common reason for rapid response system activation was respiratory dysfunction(desaturation:35.4%,tachypnoea:25.6%,and new dyspnoea:19.5%).Rapid response system interventions and intensive care unit transfers were required for 65.9% and 20.7%of patients,*** mortality rate was 1.2% at the end of the rapid response system intervention and 11.0% after 1 ***,decreased respiratory rate and decreased heart rate at rapid response system activation were associated with increased 1-month *** adjusted odds ratio was 1.10(95% confidence interval 1.02–1.19)and 1.02(95% confidence interval,1.00–1.04) for respiratory rate and heart rate,***:Rapid response systems were rarely activated after cardiac surgery and intensive care unit discharge,which were situations with a high risk of sudden deterioration in patients with congenital heart ***,encouraging the use of the rapid response sys

关键词： Heart defects congenital emergencies clinical deterioration hospital rapid response team critical care This

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Perfusionist strategies for blood conservation in pediatric cardiac surgery

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World Journal of Cardiology 2010年第2期2卷 27-33页

作者： Yves Durandy Perfusion and Intensive Care Unit Pediatric Cardiac SurgeryInstitut Hospitalier Jacques CartierMassy 91300France

There is increasing concern about the safety of homologous blood transfusion during cardiac surgery,and a restrictive transfusion practice is associated with improved ***-free pediatric cardiac surgery is unrealistic for the vast majority of procedures in neonates or small infants;however,considerable progress has been made by using techniques that decrease the need for homologous blood products or even allow bloodless surgery in older infants and *** techniques involve a decrease in prime volume by downsizing the bypass circuit with the help of vacuumassisted venous drainage,microplegia,autologous blood predonation with or without infusion of recombinant(erythropoietin),cell salvaging,ultrafiltration and retrograde autologous *** three major techniques which are simple,safe,efficient,and cost-effective are:a prime volume as small as possible,cardioplegia with negligible hydric balance and circuit residual blood salvaged without any ***,these three techniques can be used for all the patients,including emergencies and small *** every pediatric surgical unit,a strategy to decrease or avoid blood bank transfusion must be implemented.A strategy to minimize transfusion requirement requires a combined effort involving the entire surgical team with pre-,peri-,and postoperative planning and management.

关键词： Autologous blood predonation Blood conservation Cardiopulmonary bypass Cell-salvage Microplegia pediatric open-heart surgery Prime volume reduction Retrograde autologous priming Ultrafiltration Vacuum-assisted venous drainage

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