著者

Masao Takahashi Gauthier Mouillet Asmaa Khaled Madjid Boukantar Romain Gallet Vladimir Rubimbura Pascal Lim Jean-Luc Dubois-Rande Emmanuel Teiger

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

pp.19-296, (Released:2020-01-17)

参考文献数

27

被引用文献数

3

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Transcatheter aortic valve implantation (TAVI) using a transfemoral approach under local anesthesia with conscious sedation (LACS) is becoming an increasingly common TAVI strategy. However, patients who are awake during the TAVI procedure can experience stress, anxiety, and pain, even when LACS is used. Clinical hypnotherapy is an anxiolytic intervention that can be beneficial for patients undergoing invasive surgery. This study aimed to assess the perioperative outcomes of adjunctive hypnotherapy undergoing transfemoral TAVI with LACS.Consecutive patients (n = 143) with symptomatic severe aortic stenosis who underwent transfemoral TAVI with LACS only (n = 107) or with LACS and hypnotherapy (n = 36) between January 2015 and April 2016 were retrospectively included in the study. The clinical outcomes were compared between the two groups. The LACS with hypnotherapy group had a significantly shorter length of stay in the intensive care unit (ICU; LACS only versus LACS with hypnotherapy: 4.0 (4.0-5.5) days versus 3.0 (3.0-5.0) days, P < 0.01). Moreover, the use of anesthetics (propofol and remifentanil) and norepinephrine was significantly lower in the LACS with hypnotherapy group (e.g., for propofol, LACS only versus LACS with hypnotherapy: 96.4 ± 104.7 mg versus 15.0 ± 31.8 mg, P < 0.001). The multiple regression analysis showed that being male, hypnotherapy, and the composite complication score were independently associated with the length of stay in the ICU.The adjunctive hypnotherapy on LACS among transfemoral TAVI patients may facilitate perioperative management. However, a prospective randomized study is necessary to confirm the efficacy of hypnotherapy among TAVI patients.

著者

Julien Ternacle Romain Gallet Armand Mekontso-Dessap Guy Meyer Bernard Maitre Alexandre Bensaid Priscille Jurzak Pascal Gueret Jean-Luc Dubois Randé Pascal Lim

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-13-0404, (Released:2013-07-13)

参考文献数

22

被引用文献数

16 19

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Background: The benefit of load expansion is controversial in acute pulmonary embolism (PE). The aim of this study was to evaluate the benefit of furosemide in cases of normotensive acute PE. Methods and Results: We retrospectively included 70 consecutive normotensive patients (systolic blood pressure ≥90mmHg) admitted for acute PE with right ventricular dilation. Overall, 40 patients were treated during the first 24h by repeated bolus of furosemide (78±42mg, range 40–160mg) and 30 patients received isotonic saline solution (1.6±0.9L). Severity of hemodynamic status was similar in both groups, but patients in the furosemide group were older and had a greater creatinine level. At 24h, only the furosemide group had a decreased shock index (0.82±0.22 vs. 0.63±0.16, P<0.0001) with improved systolic blood pressure (118±18 vs. 133±17mmHg, P<0.0001), and creatinine levels. After treatment, there were fewer patients with simplified pulmonary embolism severity index ≥1 in the diuretic group (45% vs. 55%, P=0.03) than in the fluid expansion group (47% vs. 40%, P<0.0001). Finally, oxygen requirement at 24h decreased only in the diuretic group (75% to 47%, P=0.0004), and in-hospital survival without death and PE-related shock were similar between the 2 groups. Conclusions: In normotensive PE with RV dilatation, diuretics may improve hemodynamics and oxygenation requirement.

著者

Julien Ternacle Romain Gallet Armand Mekontso-Dessap Guy Meyer Bernard Maitre Alexandre Bensaid Priscille Jurzak Pascal Gueret Jean-Luc Dubois Randé Pascal Lim

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.77, no.10, pp.2612-2618, 2013 (Released:2013-09-25)

参考文献数

22

被引用文献数

4 19

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Background: The benefit of load expansion is controversial in acute pulmonary embolism (PE). The aim of this study was to evaluate the benefit of furosemide in cases of normotensive acute PE. Methods and Results: We retrospectively included 70 consecutive normotensive patients (systolic blood pressure ≥90mmHg) admitted for acute PE with right ventricular dilation. Overall, 40 patients were treated during the first 24h by repeated bolus of furosemide (78±42mg, range 40–160mg) and 30 patients received isotonic saline solution (1.6±0.9L). Severity of hemodynamic status was similar in both groups, but patients in the furosemide group were older and had a greater creatinine level. At 24h, only the furosemide group had a decreased shock index (0.82±0.22 vs. 0.63±0.16, P<0.0001) with improved systolic blood pressure (118±18 vs. 133±17mmHg, P<0.0001), and creatinine levels. After treatment, there were fewer patients with simplified pulmonary embolism severity index ≥1 in the diuretic group (45% vs. 55%, P=0.03) than in the fluid expansion group (47% vs. 40%, P<0.0001). Finally, oxygen requirement at 24h decreased only in the diuretic group (75% to 47%, P=0.0004), and in-hospital survival without death and PE-related shock were similar between the 2 groups. Conclusions: In normotensive PE with RV dilatation, diuretics may improve hemodynamics and oxygenation requirement.  (Circ J 2013; 77: 2612–2618)