Accueil Recommandations



Projet SSP check-list fin de CEC

Les recommandations d'ARCOTHOVA
Proposition pour l’usage de l’acide tranéxamique (AT) en chirurgie cardiaque en alternative thérapeutique à l’aprotinine
(Demande AFSSAPS 27/05/2008)

Données de la littérature :
Le schéma thérapeutique de l’ AT pour le patient à haut risque hémorragique (ceux qui relevaient de l’aprotinine dans notre proposition antérieure) pourrait être :

-Une injection avant la CEC (dose de charge)
-Une administration dans le priming (hémodilution)
-Une administration pendant la CEC pour une CEC d’une durée prévisible de plus d’une heure.
-Il n’y a pas d’argument scientifique pour une administration aprés la CEC.
-L’évaluation de l’hémostase biologique au lit du malade est àencourager pour orienter la thérapeutique hémostatique (dont l’utilisation d’antifibrinolytiques en cas de fibrinolyse) en post-opératoire.
La posologie chez le patient à fonction rénale normale pourrait s’inspirer de celle préconisée par Dowd et col (Anesthesiology, 2002) en recommandation 3 (plus haute dose) telle qu’elle est utilisée dans l’étude BART : 30 mg/kg, 2 mg/kg dans le priming, et 16mg/kg/h. Le bénéfice d’une posologie supérieure à30 mg/kg en dose de charge n’est pas établi. D’aprés les quelques études de cinétique (Dowd, 2002; Horrow, 1995) en chirurgie cardiaque, la décroissance plasmatique est rapide (demi-vie estimée à 60min) et le maintien d’un taux plasmatique stable semble justifier soit une injection continue (Dowd, 2002), soit une administration répétée (Horrow, 1995) pendant la CEC. L’influence de la fonction rénale sur le taux plasmatique d’AT est alors àprendre en compte car le produit s’accumule d’autant plus que la fonction rénale est altérée. (Nuttall JCVA 2008).

Association d’Anesthésistes Réanimateurs du Cœur, du Thorax, et des Vaisseaux

Une simplification en convertissant en ml (préparation unique de l’AT en ampoules de 0,5 g/5ml) par administration peut être proposée au moins chez l’adulte.

En resumé,

Le schéma thérapeutique pour le patient adulte à haut risque hémorragique (ceux qui relevaient de l’aprotinine) pourrait être :
-Injection avant la CEC : 20 ml (2 g – 4 ampoules) IV en 10 minutes
-Administration dans le priming : 5 ml (0,5g – 1 ampoule) dans le priming de la CEC -Administration pendant la CEC (CEC de plus d’une heure) : en cas de fonction rénale normale 10 ml/heure en SE (2 ampoules par heure) en cas d’insuffisance rénale : réduction de moitié(5ml/heure), ou 10 ml/heure mais arrêt aprés 2 heures d’administration.

Les indispensables
Experts’ recommendations for the management of cardiogenic shock in children

Brissaud et al. Annals of Intensive Care 2016

Olivier Brissaud, Astrid Botte, Gilles Cambonie, Stephane Dauger, Laure de Saint Blanquat,
Philippe Durand, Veronique Gournay, Elodie Guillet, Daniela Laux, Francis Leclerc, Philippe Mauriat, Thierry Boulain and Khaldoun Kuteifan

Abstract Cardiogenic shock which corresponds to an acute state of circulatory failure due to impairment of myocardial contractility is a very rare disease in children, even more than in adults. To date, no international recommendations regarding its management in critically ill children are available. An experts’ recommendations in adult population have recently been made (Levy et al. Ann Intensive Care 5(1):52, 2015). We present herein recommendations for the management of cardiogenic shock in children, developed with the grading of recommendations’ assessment, development, and evaluation system by an expert group of the Groupe Francophone de Reanimation et Urgences Pediatriques (French Group for Pediatric Intensive Care and Emergencies). The recom-mendations cover four major fields of application such as: recognition of early signs of shock and the patient pathway, management principles and therapeutic goals, monitoring hemodynamic and biological variables, and circulatory support (indications, techniques, organization, and transfer criteria). Major principle care for children with cardiogenic shock is primarily based on clinical and echocardiographic assessment. There are few drugs reported as effective in childhood in the medical literature. The use of circulatory support should be facilitated in terms of organization and reflected in the centers that support these children. Children with cardiogenic shock are vulnerable and should be followed regularly by intensivist cardiologists and pediatricians. The experts emphasize the multidisciplinary nature of management of children with cardiogenic shock and the importance of effective communication between emergency medical assistance teams (SAMU), mobile pediatric emergency units (SMUR), pediatric emergency departments, pediatric cardiology and cardiac surgery departments, and pediatric intensive care units.


2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care

Charanjit S. Rihal et al. JACC vol. 65, n°. 19, 2015

CharanjitS.Rihal,MD,FSCAI,FACC1** Srihari S. Naidu, MD, FSCAI, FACC, FAHA2, Michael M. Givertz, MD, FACC3 Wilson Y. Szeto, MD4, James A. Burke, MD, PHD, FACC5 Navin K. Kapur, MD6, Morton Kern, MD, MSCAI, FACC7 Kirk N. Garratt, MD, FSCAI, FACC8 James A. Goldstein, MD, FSCAI, FACC9, Vivian Dimas, MD10, Thomas Tu, MD11, From the Society for Cardiovascular Angiography and Interventions (SCAI), Heart Failure Society of America (HFSA), Society of Thoracic Surgeons (STS), American Heart Association (AHA), and American College of Cardiology (ACC)

Abstract : Although historically the intra-aortic balloon pump has been the only mechanical circulatory support device available to clinicians, a number of new devices have become commercially available and have entered clinical practice. These include axial flow pumps, such as Impella; left atrial to femoral artery bypass pumps, specifically the TandemHeart; and new devices for institution of extracorporeal membrane oxygenation. These devices differ significantly in their hemodynamic effects, insertion, monitoring, and clinical applicability. This document reviews the physiologic impact on the circulation of these devices and their use in specific clinical situations. These situations include patients undergoing high-risk percutaneous coronary intervention, those presenting with cardiogenic shock, and acute decompensated heart failure. Specialized uses for right-sided support and in pediatric populations are discussed and the clinical utility of mechanical circulatory support devices is reviewed, as are the American College of Cardiology/American Heart Association clinical practice guidelines
Experts’ recommendations for the management of adult patients with cardiogenic shock

Levy et al. Annals of Intensive Care 2015

Bruno Levy, Olivier Bastien, Karim Bendjelid, Alain Cariou, Tahar Chouihed, Alain Combes, Alexandre Mebazaa, Bruno Megarbane, Patrick Plaisance, Alexandre Ouattara, Christian Spaulding, Jean-Louis Teboul, Fabrice Vanhuyse, Thierry Boulain and Kaldoun Kuteifan

Abstract Unlike for septic shock, there are no specific international recommendations regarding the management of cardiogenic shock (CS) in critically ill patients. We present herein recommendations for the management of cardiogenic shock in adults, developed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system by an expert group of the French-Language Society of Intensive Care (Société de Réanimation de Langue Française (SRLF)), with the participation the French Society of Anesthesia and Intensive Care (SFAR), the French Cardiology Society (SFC), the French Emergency Medicine Society (SFMU), and the French Society of Thoracic and Cardiovascular Surgery (SFCTCV). The recommendations cover 15 fields of application such as: epidemiology, myocardial infarction, monitoring, vasoactive drugs, prehospital care, cardiac arrest, mechanical assistance, general treatments, cardiac surgery, poisoning, cardiogenic shock complicating end-stage cardiac failure, post-shock treatment, various etiologies, and medical care pathway. The experts highlight the fact that CS is a rare disease, the management of which requires a multidisciplinary technical platform as well as specialized and experienced medical teams. In particular, each expert center must be able to provide, at the same site, skills in a variety of disciplines, including medical and interventional cardiology, anesthesia, thoracic and vascular surgery, intensive care, cardiac assistance, radiology including for interventional vascular procedures, and a circulatory support mobile unit.

Keywords Cardiogenic shock; Myocardial infarction; Monitoring; Extracorporeal membrane oxygenation


2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

Roffi et al. Eur Heart J 2015

Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC)

Authors/Task Force Members: Marco Roffi* (Chairperson) (Switzerland), Carlo Patrono * (Co-Chairperson) (Italy), Jean-Philippe Collet† (France), Christian Mueller† (Switzerland), Marco Valgimigli† (The Netherlands), Felicita Andreotti (Italy),
Jeroen J. Bax (The Netherlands), Michael A. Borger (Germany), Carlos Brotons (Spain), Derek P. Chew (Australia), Baris Gencer (Switzerland), Gerd Hasenfuss (Germany), Keld Kjeldsen (Denmark), Patrizio Lancellotti (Belgium), Ulf Landmesser (Germany), Julinda Mehilli (Germany), Debabrata Mukherjee (USA), Robert F. Storey (UK), and Stephan Windecker (Switzerland)

Management of Abdominal Aortic Aneurysms Clinical Practice Guidelines of the European Society for Vascular Surgery

Moll et al. Eur J Vasc Endovasc Surg 2011

F.L. Moll a,*, J.T. Powell b, G. Fraedrich c, F. Verzini d, S. Haulon e,
M. Waltham f, J.A. van Herwaarden a, P.J.E. Holt g, J.W. van Keulen a,h, B. Rantner c, F.J.V. Schlo ̈sser h, F. Setacci i, J.-B. Ricco j

a Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
b Imperial College, London, UK
c University Hospital Innsbruck, Austria
d Azienda Ospedaliera di Perugia, Italy
e Hoˆpital Cardiologique, CHRU de Lille, Lille, France
f St Thomas’ Hospital, London, UK
g St George’s Vascular Institute, London, UK
h Yale University – School of Medicine, New Haven, Connecticut, USA
i University of Siena, Siena, Italy
j University of Poitiers, Poitiers, France

2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management

Kristensen et al. Eur Heart J 2014

The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA)

Authors/Task Force Members: Steen Dalby Kristensen* (Chairperson) (Denmark), Juhani Knuuti* (Chairperson) (Finland), Antti Saraste (Finland), Stefan Anker (Germany), Hans Erik Bøtker (Denmark), Stefan De Hert (Belgium), Ian Ford (UK), Jose Ramo ́ n Gonzalez-Juanatey (Spain), Bulent Gorenek (Turkey), Guy Robert Heyndrickx (Belgium), Andreas Hoeft (Germany), Kurt Huber (Austria), Bernard Iung (France), Keld Per Kjeldsen (Denmark), Dan Longrois (France), Thomas F. Lu ̈ scher (Switzerland), Luc Pierard (Belgium), Stuart Pocock (UK), Susanna Price (UK), Marco Roffi (Switzerland), Per Anton Sirnes (Norway), Miguel Sousa-Uva (Portugal), Vasilis Voudris (Greece), Christian Funck-Brentano (France).

ESC Committee for Practice Guidelines: Jose Luis Zamorano (Chairperson) (Spain), Stephan Achenbach (Germany), Helmut Baumgartner (Germany), Jeroen J. Bax (Netherlands), He ́ ctor Bueno (Spain), Veronica Dean (France), Christi Deaton (UK), Cetin Erol (Turkey), Robert Fagard (Belgium), Roberto Ferrari (Italy), David Hasdai (Israel), Arno W. Hoes (Netherlands), Paulus Kirchhof (Germany/UK), Juhani Knuuti (Finland), Philippe Kolh (Belgium), Patrizio Lancellotti (Belgium), Ales Linhart (Czech Republic), Petros Nihoyannopoulos (UK), Massimo F. Piepoli (Italy), Piotr Ponikowski (Poland), Per Anton Sirnes (Norway), Juan Luis Tamargo (Spain), Michal Tendera (Poland), Adam Torbicki (Poland), William Wijns (Belgium), Stephan Windecker (Switzerland).

ESA Clinical Guidelines Committee: Maurizio Solca (Chairperson) (Italy), Jean-Franc ̧ois Brichant (Belgium), Stefan De Herta, (Belgium), Edoardo de Robertisb, (Italy), Dan Longroisc, (France), Sibylle Kozek Langenecker (Austria), Josef Wichelewski (Israel).

2015 ESC Guidelines for the management of infective endocarditis

Habib et al. Eur Heart J 2015

The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC)

Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM)

Authors/Task Force Members: Gilbert Habib* (Chairperson) (France),
Patrizio Lancellotti* (co-Chairperson) (Belgium), Manuel J. Antunes (Portugal), Maria Grazia Bongiorni (Italy), Jean-Paul Casalta (France), Francesco Del Zotti (Italy), Raluca Dulgheru (Belgium), Gebrine El Khoury (Belgium), Paola Anna Erbaa (Italy), Bernard Iung (France), Jose M. Mirob (Spain), Barbara J. Mulder (The Netherlands), Edyta Plonska-Gosciniak (Poland), Susanna Price (UK), Jolien Roos-Hesselink
(The Netherlands), Ulrika Snygg-Martin (Sweden), Franck Thuny (France),
Pilar Tornos Mas (Spain), Isidre Vilacosta (Spain), and Jose Luis Zamorano (Spain)

Document Reviewers: Çetin Erol (CPG Review Coordinator) (Turkey), Petros Nihoyannopoulos (CPG Review Coordinator) (UK), Victor Aboyans (France), Stefan Agewall (Norway), George Athanassopoulos (Greece),
Saide Aytekin (Turkey), Werner Benzer (Austria), He ́ctor Bueno (Spain), Lidewij Broekhuizen (The Netherlands), Scipione Carerj (Italy), Bernard Cosyns (Belgium), Julie De Backer (Belgium), Michele De Bonis (Italy), Konstantinos Dimopoulos (UK), Erwan Donal (France), Heinz Drexel (Austria), Frank Arnold Flachskampf (Sweden), Roger Hall (UK), Sigrun Halvorsen (Norway), Bruno Hoenb (France), Paulus Kirchhof (UK/Germany), Mitja Lainscak (Slovenia), Adelino F. Leite-Moreira (Portugal), Gregory Y.H. Lip (UK), Carlos A. Mestresc (Spain/United Arab Emirates), Massimo F. Piepoli (Italy), Prakash P. Punjabi (UK), Claudio Rapezzi (Italy), Raphael Rosenhek (Austria), Kaat Siebens (Belgium), Juan Tamargo (Spain), and David M. Walker (UK)

2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism

Konstantinides S et al. Eur Heart J 2014

The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC)

Endorsed by the European Respiratory Society (ERS)

Authors/Task Force Members: Stavros V. Konstantinides* (Chairperson) (Germany/ Greece), Adam Torbicki* (Co-chairperson) (Poland), Giancarlo Agnelli (Italy), Nicolas Danchin (France), David Fitzmaurice (UK), Nazzareno Galie` (Italy),
J. Simon R. Gibbs (UK), Menno V. Huisman (The Netherlands), Marc Humbert† (France), Nils Kucher (Switzerland), Irene Lang (Austria), Mareike Lankeit (Germany), John Lekakis (Greece), Christoph Maack (Germany), Eckhard Mayer (Germany), Nicolas Meneveau (France), Arnaud Perrier (Switzerland), Piotr Pruszczyk (Poland), Lars H. Rasmussen (Denmark), Thomas H. Schindler (USA), Pavel Svitil (Czech Republic), Anton Vonk Noordegraaf (The Netherlands), Jose Luis Zamorano (Spain), Maurizio Zompatori (Italy)

ESC Committee for Practice Guidelines (CPG): Jose Luis Zamorano (Chairperson) (Spain), Stephan Achenbach (Germany), Helmut Baumgartner (Germany), Jeroen J. Bax (Netherlands), Hector Bueno (Spain), Veronica Dean (France), Christi Deaton (UK), Çetin Erol (Turkey), Robert Fagard (Belgium), Roberto Ferrari (Italy), David Hasdai (Israel), Arno Hoes (Netherlands), Paulus Kirchhof (Germany/UK), Juhani Knuuti (Finland), Philippe Kolh (Belgium), Patrizio Lancellotti (Belgium), Ales Linhart (Czech Republic), Petros Nihoyannopoulos (UK), Massimo F. Piepoli

2014 ESC Guidelines on the diagnosis and treatment of aortic diseases

Erbel R et al. Eur Heart J 2014

Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult

The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC)

Authors/Task Force members: Raimund Erbel* (Chairperson) (Germany), Victor Aboyans* (Chairperson) (France), Catherine Boileau (France), Eduardo Bossone (Italy), Roberto Di Bartolomeo (Italy), Holger Eggebrecht (Germany), Arturo Evangelista (Spain), Volkmar Falk (Switzerland), Herbert Frank (Austria), Oliver Gaemperli (Switzerland), Martin Grabenwo ̈ ger (Austria), Axel Haverich (Germany), Bernard Iung (France), Athanasios John Manolis (Greece), Folkert Meijboom (Netherlands), Christoph A. Nienaber (Germany), Marco Roffi (Switzerland), Herve ́ Rousseau (France), Udo Sechtem (Germany), Per Anton Sirnes (Norway), Regula S. von Allmen (Switzerland), Christiaan J.M. Vrints (Belgium).

ESC Committee for Practice Guidelines (CPG): Jose Luis Zamorano (Chairperson) (Spain), Stephan Achenbach (Germany), Helmut Baumgartner (Germany), Jeroen J. Bax (Netherlands), Hector Bueno (Spain), Veronica Dean (France), Christi Deaton (UK), Çetin Erol (Turkey), Robert Fagard (Belgium), Roberto Ferrari (Italy), David Hasdai (Israel), Arno Hoes (The Netherlands), Paulus Kirchhof (Germany/UK), Juhani Knuuti (Finland), Philippe (Belgium), Patrizio Lancellotti (Belgium), Ales Linhart (Czech Republic), Petros Nihoyannopoulos (UK), Massimo F. Piepoli (Italy), Piotr Ponikowski (Poland), Per Anton Sirnes (Norway), Juan Luis Tamargo (Spain), Michal Tendera (Poland), Adam Torbicki (Poland), William Wijns (Belgium), and Stephan Windecker (Switzerland).

Document reviewers: Petros Nihoyannopoulos (CPG Review Coordinator) (UK), Michal Tendera (CPG Review Coordinator) (Poland), Martin Czerny (Switzerland), John Deanfield (UK), Carlo Di Mario (UK), Mauro Pepi (Italy), Maria Jesus Salvador Taboada (Spain), Marc R. van Sambeek (The Netherlands), Charalambos Vlachopoulos (Greece), and Jose Luis Zamorano (Spain).

Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults†

Franck et al. BJA 2015

C. Frerk1,*, V. S. Mitchell2, A. F. McNarry3, C. Mendonca4, R. Bhagrath5, A. Patel6, E. P. O’Sullivan7, N. M. Woodall8 and I. Ahmad9, Difficult Airway Society intubation guidelines working group

1Department of Anaesthesia, Northampton General Hospital, Billing Road, Northampton NN1 5BD, UK, 2Department of Anaesthesia and Perioperative Medicine, University College London Hospitals NHS Foundation Trust, 235 Euston Road, London NW1 2BU, UK, 3Department of Anaesthesia, NHS Lothian, Crewe Road South, Edinburgh EH4 2XU, UK, 4Department of Anaesthesia, University Hospitals Coventry & Warwickshire NHS Trust, Clifford Bridge Road, Coventry CV2 2DX, UK, 5Department of Anaesthesia, Barts Health, West Smithfield, London EC1A 7BE, UK, 6Department of Anaesthesia, The Royal National Throat Nose and Ear Hospital, 330 Grays Inn Road, London WC1X 8DA, UK, 7Department of Anaesthesia, St James’s Hospital, PO Box 580, James’s Street, Dublin 8, Ireland, 8Department of Anaesthesia, The Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich NR4 7UY, UK, and 9Department of Anaesthesia, Guy’s and St Thomas’ NHS Foundation Trust, Great Maze Pond, London SE1 9RT, UK

Antibody-Mediated Rejection in Cardiac Transplantation: Emerging Knowledge in Diagnosis and Management A Scientic Statement From the American Heart Association

Colvin et al. Circulation 2015

Endorsed by the International Society for Heart and Lung Transplantation

Monica M. Colvin, MD, MS, Chair; Jennifer L. Cook, MD, Co-Chair; Patricia Chang, MD;
Gary Francis, MD, FAHA; Daphne T. Hsu, MD, FAHA; Michael S. Kiernan, MD;
Jon A. Kobashigawa, MD, FAHA; JoAnn Lindenfeld, MD, FAHA; So a Carolina Masri, MD; Dylan Miller, MD; John O’Connell, MD; E. Rene Rodriguez, MD; Bruce Rosengard, MD;
Sally Self, MD; Connie White-Williams, RN, FAHA; Adriana Zeevi, PhD; on behalf of the American Heart Association Heart Failure and Transplantation Committee of the Council on Clinical Cardiology, Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation, Council on Cardiovascular Disease in the Young, Council on Cardiovascular and Stroke Nursing, Council on Cardiovascular Radiology and Intervention, and Council on Cardiovascular Surgery and Anesthesia

2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary

Alpert et al. Circulation 2014

A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society

Craig T. January, MD, PHD, FACC, Chair
L. Samuel Wann, MD, MACC, FAHA, Vice Chair*
Joseph S. Alpert, MD, FACC, FAHA*y
Hugh Calkins, MD, FACC, FAHA, FHRS*zx Joaquin E. Cigarroa, MD, FACCy
Joseph C. Cleveland JR, MD, FACCjj
Jamie B. Conti, MD, FACC, FHRS*y
Patrick T. Ellinor, MD, PHD, FAHAz
Michael D. Ezekowitz, MB, CHB, FACC, FAHA*y Michael E. Field, MD, FACC, FHRSy
Katherine T. Murray, MD, FACC, FAHA, FHRSy
Jeffrey L. Anderson, MD, FACC, FAHA, Chair Jonathan L. Halperin, MD, FACC, FAHA, Chair-Elect
Nancy M. Albert, PhD, RN, FAHA Biykem Bozkurt, MD, PhD, FACC, FAHA Ralph G. Brindis, MD, MPH, MACC Mark A. Creager, MD, FACC, FAHA# Lesley H. Curtis, PhD, FAHA
David DeMets, PhD#
Robert A. Guyton, MD, FACC#
Judith S. Hochman, MD, FACC, FAHA#
Ralph L. Sacco, MD, FAHAy
William G. Stevenson, MD, FACC, FAHA, FHRS*{ Patrick J. Tchou, MD, FACCz
Cynthia M. Tracy, MD, FACC, FAHAy
Clyde W. Yancy, MD, FACC, FAHAy
Richard J. Kovacs, MD, FACC, FAHA
E. Magnus Ohman, MD, FACC
Susan J. Pressler, PhD, RN, FAHA
Frank W. Sellke, MD, FACC, FAHA Win-Kuang Shen, MD, FACC, FAHA William G. Stevenson, MD, FACC, FAHA# Clyde W. Yancy, MD, FACC, FAHA#