Preoperative vaping prevalence and behavior of French surgical patients: A multicentre study

International audienceINTRODUCTION: Prevalence and tobacco-related perioperative complications have been largely reported. The impact of vaping (e-cigarette use) on the perioperative period has been rarely evaluated. The purpose of this multicentre cross-sectional survey was to assess the prevalence of vaping and behaviour of patients undergoing elective surgery.METHODS: After institutional review board committee and patient approvals, patients (aged ≥18 years) scheduled for elective non-cardiac surgery in six French hospitals were assessed preoperatively. Demographic characteristics, and information on vaping, smoking or dual-use status and consumption were reported.RESULTS: In six centres, 1712 eligible patients were approached and 1664 patients were included in this study from June 2016 to January 2017. Of these, 62 patients used e-cigarettes in the preoperative period (3%; 95% CI: 2-4), including 24 exclusive e-cigarette users (1%; 95% CI: 1-2), 38 dual-users (2%; 95% CI: 2-3) and 365 smokers (22%; 95% CI: 20-24). Vapers were older than smokers (53 vs 47 years old; p=0.01). During the preoperative period, 12 patients (1%) reported vaping the morning of surgery.CONCLUSIONS: In the preoperative period, vaping was ten-fold less prevalent than smoking. Although the clinical relevance may be weak, further research is needed to explore the real impact of vaping on patients' outcomes and to elaborate on clinical recommendations

Impact of 30 mg/kg amikacin and 8 mg/kg gentamicin on serum concentrations in critically ill patients with severe sepsis

Objectives:Low first-dose peak serum concentrations of amikacin and gentamicin are commonly reported in ICU patients. The present study aimed to assess whether 30 mg/kg amikacin or 8 mg/kg gentamicin achieved target concentrations in ICU patients with severe sepsis

Role of the internet as an information resource before anaesthesia consultation: A French prospective multicentre survey

International audienceBACKGROUND:Use of the internet as an information search tool has increased dramatically. Our study assessed preoperative use of the internet by patients to search for information regarding anaesthesia, surgery, pain or outcomes.OBJECTIVE(S):The aim of this study was to test whether patients used the internet prior to surgery and what kinds of information they looked for (anaesthetic technique, pain, adverse events, outcomes and surgery). Correlation between patient age and information sought about surgery from the internet was also explored.DESIGN:A prospective multicentre observational study.SETTING:In total, 14 French private and public institutions from May 2015 to January 2016.PATIENTS:In total, 3161 adult patients scheduled for elective surgery under regional or general anaesthesia.INTERVENTION(S):An anonymous questionnaire was presented to adult patients scheduled for elective surgery under regional or general anaesthesia for completion before the first meeting with the anaesthesiologist. The investigator at each centre completed specific items that the patient could not complete.MAIN OUTCOME MEASURES:We defined the primary endpoint as the number of patients who searched for information about their anaesthesia or surgery on the internet by the time of the their preanaesthetic consultation.RESULTS:Of the 3234 questionnaires distributed, responses were received from 3161 patients. Within this respondent sample, 1304 (45%) were professionally active and 1664 (59%) used the internet at least once per day. Among 3098 (98%) patients who answered the question concerning the primary endpoint, 1506 (48%) had searched the internet for information about their health. In total, 784 (25%) used the internet to find information about their surgery and 113 (3.5%) looked for specific information about anaesthesia. Of the 3161, 52% reported difficulty searching for appropriate information about anaesthesia on the internet. 'Daily use of the web' [odds ratio (OR) 2.0; (95% CI: 1.65 to 2.55) P < 0.001], 'use of the web on mobile devices' [OR 1.24; (95% CI: 1.02 to 1.50) P = 0.02] and 'asking general practitioner or surgeon about information' [OR 1.35; (95% CI: 1.11 to 1.64) P = 0.002] were significantly associated with the primary endpoint.CONCLUSION:The internet was not widely used by patients scheduled for elective surgery to search for information about anaesthesia and surgery in our French multicentre study

Standard dosing of amikacin and gentamicin in critically ill patients results in variable and subtherapeutic concentrations

Low peak plasma concentrations (C-max) of amikacin and gentamicin are reported in intensive care unit( ICU) patients after administration of the first dose. The present study aimed to describe the proportion of ICU patients in whom an adequate C-max was achieved throughout the course of therapy. Septic ICU patients with an indication for intravenous amikacin or gentamicin were eligible for inclusion in this single-centre observational study. The first and subsequent doses and the corresponding C-max values were recorded. The target C-max was >= 60 mg/L for amikacin and >= 30 mg/L for gentamicin. Amikacin and gentamicin plasma concentrations were available in 66 and 24 patients, respectively (59 +/- 17 years; 79 +/- 19 kg; height 169 +/- 12 cm; SAPS II score 46 +/- 19). Pulmonary, abdominal and urinary tract infections were diagnosed in 64 patients. Culture-positive infection was confirmed in 65 patients (72%). A target first C-max was achieved in 17/90 patients (19%). For amikacin, the target C-max was achieved in 16/66 patients (24%) after the initial dose. In the 50 remaining patients, a change in dosing was performed in 14 patients, leading adequate peak plasma level in 2 patients. For gentamicin, the targeted C-max was achieved in only 1/24 patient (4%) after the initial dose and was never achieved after the third dose. In conclusion, standard dosing of amikacin or gentamicin led to adequate C-max in only 19% of patients. Subtherapeutic C-max were not significantly corrected after subsequent doses. (C) 2015 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved