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La Chaussée-Saint-Victor, France

Bernasinski M.,Pole anesthesie reanimation medecine durgence | Mertes P.-M.,Hopitaux Universitaires Of Strasbourg | Carlier M.,Unite dhemovigilance | Dupont H.,Pole anesthesie reanimation medecine durgence | And 4 more authors.
Transfusion Clinique et Biologique | Year: 2014

Respiratory complications of blood transfusion have several possible causes. Transfusion-Associated Circulatory Overload (TACO) is often the first mentioned. Transfusion-Related Acute Lung Injury (TRALI), better defined since the consensus conference of Toronto in 2004, is rarely mentioned. French incidence is low. Non-hemolytic febrile reactions, allergies, infections and pulmonary embolism are also reported. The objective of this work was to determine the statistical importance of the different respiratory complications of blood transfusion. This work was conducted retrospectively on transfusion accidents in six health centers in Champagne-Ardenne, reported to Hemovigilance between 2000 and 2009 and having respiratory symptoms. The analysis of data was conducted by an expert committee. Eighty-three cases of respiratory complications are found (316,864 blood products). We have counted 26 TACO, 12 TRALI (only 6 cases were identified in the original investigation of Hemovigilance), 18 non-hemolytic febrile reactions, 16 cases of allergies, 5 transfusions transmitted bacterial infections and 2 pulmonary embolisms. Six new TRALI were diagnosed previously labeled TACO for 2 of them, allergy and infection in 2 other cases and diagnosis considered unknown for the last 2. Our study found an incidence of TRALI 2 times higher than that reported previously. Interpretation of the data by a multidisciplinary committee amended 20 % of diagnoses. This study shows the imperfections of our system for reporting accidents of blood transfusion when a single observer analyses the medical records. © 2014 Elsevier Masson SAS. Source

Bernasinski M.,Pole anesthesie reanimation medecine durgence | Gette S.,Pole Anesthesie Reanimation | Malinovsky J.-M.,Reims University Hospital Center | Viry Babel F.,Nancy University Hospital Center | And 9 more authors.
Transfusion Clinique et Biologique | Year: 2013

"Transfusion-related acute lung injury" (TRALI) is a post-transfusion lesional pulmonary edema, potentially severe, better defined since the conference of Toronto in 2004. The incidence of TRALI reported in France remains low in part because of its ignorance by physicians. The objective of our study was to evaluate retrospectively transfusion accidents with respiratory complications that occurred in Nancy University Hospital and reported to the haemovigilance between 1996 and 2006, from the software "Traceline" listing all the blood transfusion complications from signs observed. The analysis of the files has been performed by applying rigorously diagnostic criteria of Toronto. Forty-one cases of respiratory complications were found in 34,573 blood products. Ten cases of TRALI were diagnosed while only one case had been reported to the haemovigilance. The remaining nine cases were previously labeled transfusion-associated circulatory overload (TACO). No cases of TRALI have been identified in the ICU. Our work can find an incidence of TRALI 10 times greater than previously reported. Ignorance of TRALI and the lack of consensus definition before 2004 are not sufficient to explain these results. This study demonstrates the potential interest of database and computerized declaration system based on the symptoms observed. It highlights the vulnerability of the current haemovigilance too dependent on a single medical observer. Although TRALI are recognized as serious complications, sometimes requiring resuscitative care, our work was not isolated severe TRALI in ICU. Physician awareness of TRALI to the identification and to the declaration, including ICU should be continued. Finally, the diagnostic criteria for TRALI must be adapted to the ICU. © 2013 Elsevier Masson SAS. Source

Lorne E.,Pole anesthesie reanimation medecine durgence | Lorne E.,University of Picardie Jules Verne | Nuzzo D.,Pole anesthesie reanimation medecine durgence | Suzanne S.,Pole anesthesie reanimation medecine durgence | And 17 more authors.
Annales Francaises d'Anesthesie et de Reanimation | Year: 2012

Objective: Storage of cisatracurium at room temperature seems to have no effect on its degradation in vitro contrary to the recommendations of storage at +4°C. The purpose of this study was to evaluate the influence of cisatracurium' s storage temperature on its onset time. Study design: Prospective, randomized, double-blind trial study. Patients and methods: Thirty patients were enrolled. The control group consisted of 15 patients receiving cisatracurium (0.15. mg/kg) stored at room temperature and the intervention consisted of 15 patients receiving cisatracurium (0.15. mg/kg) stored at +4°C. The primary endpoint was to compare cisatracurium onset time depending on the storage temperature. Results: Cisatracurium onset time was 235 (180-292) seconds in the " room temperature" group vs. 240 (210-292) seconds in the " refrigerated" group. There was no difference between the onset of cisatracurium depending on the temperature of storage (p=0.51). Subgroups analysis in the " room temperature" group did not show any difference in cisatracurium onset depending on whether it was stored at room temperature for one, two or three weeks. Excellent intubation score was obtained for 100% of the patients. Conclusion: This study demonstrated that cisatracurium's storage at room temperature had no influence on its onset time. It provides an argument for the preservation of cisatracurium at room temperature for a period not exceeding 21 days. Monitoring the onset of curarization may increase the quality score of intubation. © 2012. Source

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