• Neosynephrine

    DCI = phenylephrine

  • alpha agoniste pur

  • vasoconstricte lit artériel
    bradycardie “réflexe”

  • Pubmed bourrin
    ((“phenylephrine”[MeSH Terms] OR “phenylephrine”[All Fields]) AND (“anaesthesia”[All Fields] OR “anesthesia”[MeSH Terms] OR “anesthesia”[All Fields])) AND (“2010/12/30”[PDat] : “2015/12/28”[PDat] AND “humans”[MeSH Terms] AND English[lang])

  • Obstétrique

  • CCV

  • chirurgie carotidienne

  • Utilisé dans césarienne
    rachi = bloc sympathique

  • échec des moyens “faciles” de prévention du collapsus

  • amélioration hémodynamique passe par vasoconstricteur

  • monitoring
    impédance thoracique
    analyse de l’onde de pouls
    doppler sus sternal

  • Auteur clé = Ngan Kee

  • appréciée chez le coronarien ou RAo pour maintenir PA et limiter élévation FC…

  • … mais augmente consommation oxygène du myocarde
    augmentation du stress sur la paroi du VG

  • tétralogie de Fallot

  • Rachi fait chuter les RVS
    Chez le sujet sain DC augmente un tout petit peu

  • Remplissage bof
    Compression veineuse bof
    Positionnement bof

  • ephedrine
    ephedrine + phenylephrine
    phenylephrine seule
    noradrénaline

  • limites
    mesures continues vs ponctuelles
    validité de ces monitoring avec amines ?

  • Articles comparant ephedrine vs neo
    puis en 2015 neo vs noradré

  • Avec néo :
    Baisse du débit cardiaque
    Et baisse oxygénation cérébrale ?

  • Etude chez volontaires sains avec doppler = bof
    Effet sur la peau en fait ?

  • bolus
    versus
    continu
    +/- guidé par informatique (cloed-loop

  • patiente qui reçoit phenylephrine pendant césar
    -> FC diminue
    -> DC diminuerait un peu ?

  • Est-ce qu’on chercher à laver plus blanc que blanc ?

  • noradré 20 fois plus puissante que phenylephrine dans études précliniques

  • Edito Robert Dyer
    http://anesthesiology.pubs.asahq.org/article.aspx?articleid=2111044&resultClick=3

    Du coup quid de l’intérêt de donner une stimulation béta

  • closed loop uniquement sur PA au brassard ?
    safety considerations related to the influence of maternal movement and shivering artifacts on blood pressure readings used by a computerized system need to be considered.

  • Est-ce que ça a une pertinence clinique ?

{"cards":[{"_id":"60ee178938bccf558f00001d","treeId":"60ee163938bccf558f00001a","seq":5680026,"position":1,"parentId":null,"content":"Neosynephrine\n\nDCI = phenylephrine"},{"_id":"60ee182a38bccf558f00001e","treeId":"60ee163938bccf558f00001a","seq":5680027,"position":1,"parentId":"60ee178938bccf558f00001d","content":"Obstétrique"},{"_id":"60ee1ab638bccf558f000023","treeId":"60ee163938bccf558f00001a","seq":5680041,"position":1,"parentId":"60ee182a38bccf558f00001e","content":"Utilisé dans césarienne\nrachi = bloc sympathique\n"},{"_id":"60ee6e9938bccf558f00002e","treeId":"60ee163938bccf558f00001a","seq":5680158,"position":1,"parentId":"60ee1ab638bccf558f000023","content":"Rachi fait chuter les RVS\nChez le sujet sain DC augmente un tout petit peu"},{"_id":"60ee543d38bccf558f000026","treeId":"60ee163938bccf558f00001a","seq":5680104,"position":1.5,"parentId":"60ee182a38bccf558f00001e","content":"échec des moyens \"faciles\" de prévention du collapsus"},{"_id":"60ee54f738bccf558f000027","treeId":"60ee163938bccf558f00001a","seq":5680106,"position":1,"parentId":"60ee543d38bccf558f000026","content":"Remplissage bof\nCompression veineuse bof\nPositionnement bof"},{"_id":"60ee574238bccf558f000028","treeId":"60ee163938bccf558f00001a","seq":5680107,"position":1.75,"parentId":"60ee182a38bccf558f00001e","content":"amélioration hémodynamique passe par vasoconstricteur"},{"_id":"60ee57c838bccf558f000029","treeId":"60ee163938bccf558f00001a","seq":5680111,"position":1,"parentId":"60ee574238bccf558f000028","content":"ephedrine\nephedrine + phenylephrine\nphenylephrine seule\nnoradrénaline"},{"_id":"60ee58ad38bccf558f00002a","treeId":"60ee163938bccf558f00001a","seq":5680109,"position":1,"parentId":"60ee57c838bccf558f000029","content":"bolus\nversus\ncontinu\n+/- guidé par informatique (cloed-loop"},{"_id":"60ee738438bccf558f000030","treeId":"60ee163938bccf558f00001a","seq":5680160,"position":2,"parentId":"60ee57c838bccf558f000029","content":"patiente qui reçoit phenylephrine pendant césar \n-> FC diminue\n-> DC diminuerait un peu ?"},{"_id":"60ee74fe38bccf558f000031","treeId":"60ee163938bccf558f00001a","seq":5680161,"position":3,"parentId":"60ee57c838bccf558f000029","content":""},{"_id":"60ee5a2f38bccf558f00002c","treeId":"60ee163938bccf558f00001a","seq":5680113,"position":1.875,"parentId":"60ee182a38bccf558f00001e","content":"monitoring\nimpédance thoracique\nanalyse de l'onde de pouls\ndoppler sus sternal"},{"_id":"60ee5b3a38bccf558f00002d","treeId":"60ee163938bccf558f00001a","seq":5680114,"position":1,"parentId":"60ee5a2f38bccf558f00002c","content":"limites\nmesures continues vs ponctuelles\nvalidité de ces monitoring avec amines ?"},{"_id":"60ee1c5c38bccf558f000024","treeId":"60ee163938bccf558f00001a","seq":5680102,"position":2,"parentId":"60ee182a38bccf558f00001e","content":"Auteur clé = Ngan Kee"},{"_id":"60ee531c38bccf558f000025","treeId":"60ee163938bccf558f00001a","seq":5680103,"position":1,"parentId":"60ee1c5c38bccf558f000024","content":"Articles comparant ephedrine vs neo\npuis en 2015 neo vs noradré"},{"_id":"60ee792638bccf558f000034","treeId":"60ee163938bccf558f00001a","seq":5680164,"position":1,"parentId":"60ee531c38bccf558f000025","content":"Est-ce qu'on chercher à laver plus blanc que blanc ?"},{"_id":"60ee7b0d38bccf558f000035","treeId":"60ee163938bccf558f00001a","seq":5680165,"position":2,"parentId":"60ee531c38bccf558f000025","content":"noradré 20 fois plus puissante que phenylephrine dans études précliniques"},{"_id":"60ee702638bccf558f00002f","treeId":"60ee163938bccf558f00001a","seq":5680166,"position":3,"parentId":"60ee531c38bccf558f000025","content":"Edito Robert Dyer\nhttp://anesthesiology.pubs.asahq.org/article.aspx?articleid=2111044&resultClick=3\n\nDu coup quid de l'intérêt de donner une stimulation béta "},{"_id":"60ee783f38bccf558f000033","treeId":"60ee163938bccf558f00001a","seq":5680167,"position":4,"parentId":"60ee531c38bccf558f000025","content":"closed loop uniquement sur PA au brassard ? \nsafety considerations related to the influence of maternal movement and shivering artifacts on blood pressure readings used by a computerized system need to be considered."},{"_id":"60ee751838bccf558f000032","treeId":"60ee163938bccf558f00001a","seq":5680168,"position":5,"parentId":"60ee531c38bccf558f000025","content":"Est-ce que ça a une pertinence clinique ?"},{"_id":"60ee188138bccf558f00001f","treeId":"60ee163938bccf558f00001a","seq":5680028,"position":2,"parentId":"60ee178938bccf558f00001d","content":"CCV"},{"_id":"60ee8bf938bccf558f000036","treeId":"60ee163938bccf558f00001a","seq":5680169,"position":1,"parentId":"60ee188138bccf558f00001f","content":"appréciée chez le coronarien ou RAo pour maintenir PA et limiter élévation FC..."},{"_id":"60ee8cbd38bccf558f000037","treeId":"60ee163938bccf558f00001a","seq":5680170,"position":2,"parentId":"60ee188138bccf558f00001f","content":"... mais augmente consommation oxygène du myocarde\naugmentation du stress sur la paroi du VG"},{"_id":"6109cbc6623e0a7955000033","treeId":"60ee163938bccf558f00001a","seq":5692569,"position":3,"parentId":"60ee188138bccf558f00001f","content":"tétralogie de Fallot"},{"_id":"60eebc0138bccf558f000038","treeId":"60ee163938bccf558f00001a","seq":5680175,"position":3,"parentId":"60ee178938bccf558f00001d","content":"chirurgie carotidienne"},{"_id":"60eebc5d38bccf558f000039","treeId":"60ee163938bccf558f00001a","seq":5680177,"position":1,"parentId":"60eebc0138bccf558f000038","content":"auto-régulation DSC"},{"_id":"60eebcc738bccf558f00003a","treeId":"60ee163938bccf558f00001a","seq":5680183,"position":2,"parentId":"60eebc0138bccf558f000038","content":"Etude pavé dans la mare/princeps Meng Cannesson\nephedrine versus neo\n\nhttp://www.ncbi.nlm.nih.gov/pubmed/21642644\n"},{"_id":"60eef3c238bccf558f00003d","treeId":"60ee163938bccf558f00001a","seq":5680196,"position":2,"parentId":"60eebcc738bccf558f00003a","content":"Avec néo :\nBaisse du débit cardiaque \nEt baisse oxygénation cérébrale ?"},{"_id":"60eebdf138bccf558f00003b","treeId":"60ee163938bccf558f00001a","seq":5680198,"position":3,"parentId":"60eebcc738bccf558f00003a","content":"Etude chez volontaires sains avec doppler = bof\nEffet sur la peau en fait ?"},{"_id":"60ee18a838bccf558f000020","treeId":"60ee163938bccf558f00001a","seq":5680030,"position":2,"parentId":null,"content":"alpha agoniste pur"},{"_id":"60ee18f038bccf558f000021","treeId":"60ee163938bccf558f00001a","seq":5680037,"position":3,"parentId":null,"content":"vasoconstricte lit artériel\nbradycardie \"réflexe\""},{"_id":"60eee75838bccf558f00003c","treeId":"60ee163938bccf558f00001a","seq":5680181,"position":4,"parentId":null,"content":"Revues de la littérature\nhttp://www.ncbi.nlm.nih.gov/m/pubmed/21519050/\n\nhttp://www.ncbi.nlm.nih.gov/m/pubmed/21519053/"},{"_id":"610a1098623e0a7955000034","treeId":"60ee163938bccf558f00001a","seq":5692776,"position":5,"parentId":null,"content":"Pubmed bourrin\n ((\"phenylephrine\"[MeSH Terms] OR \"phenylephrine\"[All Fields]) AND (\"anaesthesia\"[All Fields] OR \"anesthesia\"[MeSH Terms] OR \"anesthesia\"[All Fields])) AND (\"2010/12/30\"[PDat] : \"2015/12/28\"[PDat] AND \"humans\"[MeSH Terms] AND English[lang])"}],"tree":{"_id":"60ee163938bccf558f00001a","name":"phenylephrine","publicUrl":"phenylephrine"}}