References of "HANS, Grégory"
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See detailImpact of 6 % hydroxyethyl starch (HES) 130/0.4 on the correlation between standard laboratory tests and thromboelastography (TEG(R)) after cardiopulmonary bypass.
HANS, Grégory ULg; Hartstein, Gary ULg; Roediger, Laurence et al

in Thrombosis research (2015), 135(5), 984-9

BACKGROUND: Hydroxyethyl starches (HES) affect the results of thromboelastography (TEG(R)). We sought to determine whether using HES rather than crystalloids for cardiopulmonary bypass (CPB) prime and ... [more ▼]

BACKGROUND: Hydroxyethyl starches (HES) affect the results of thromboelastography (TEG(R)). We sought to determine whether using HES rather than crystalloids for cardiopulmonary bypass (CPB) prime and intraoperative fluid therapy changes the TEG cutoff values best identifying patients with a low platelet count or a low fibrinogen level after CPB. METHODS: Data from 96 patients who had on-pump cardiac surgery, a TEG(R) (kaolin-heparinase) and standard investigations of blood clotting performed after separation from CPB and protamine administration were retrospectively reviewed. Patients were assigned to the HES or crystalloid group according to whether balanced 6% HES 130/0.4 or balanced crystalloids were used for intraoperative fluid therapy and pump prime. Mutlivariable linear regression models with computation of the standardized regression coefficients were used to identify independent associations between the four main TEG parameters (R time, alpha angle, K time and MA) and the type of fluid used, the INR, the aPTT, the fibrinogen level and the platelet count. Receiver-operating-characteristic curves were used to assess the effect of HES on the ability of TEG parameters to identify patients with a platelet count<80.000mul(-1) or a fibrinogen level<1.5 gr l(-1) and on the cutoff values best identifying these patients. RESULTS: The type of fluid used significantly affected the MA (P<0.001), the K time (P<0.001) and the alpha angle (P<0.001) regardless of the results of the standard clotting tests. According to standardized ss regression coefficients the platelet count and the type of fluid used were stronger predictors of the MA, the alpha angle and the K time than the fibrinogen level. MA better predicted platelets<80.000mul(-1) than K time and alpha angle (P=0.023). The best cutoff value of MA identifying patients with platelets<80.000mul(-1) was 62mm in the crystalloid group and 53mm in the HES group. MA, K time and alpha angle were poor predictors of the postoperative fibrinogen level. CONCLUSION: HES significantly changes the cutoff value of TEG(R) MA best identifying patients<80.000mul(-1) after on-pump cardiac surgery. [less ▲]

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See detailThe effect of intraoperative 6% balanced hydroxyethyl starch (130/0.4) during cardiac surgery on transfusion requirements.
HANS, Grégory ULg; Ledoux, Didiier; Roediger, Laurence et al

in Journal of cardiothoracic and vascular anesthesia (2015), 29(2), 328-32

OBJECTIVES: To compare transfusion requirements in adult cardiac surgery patients when balanced hydroxyethyl starches (HES) (130/0.4) or balanced crystalloids is used for pump prime and intraoperative ... [more ▼]

OBJECTIVES: To compare transfusion requirements in adult cardiac surgery patients when balanced hydroxyethyl starches (HES) (130/0.4) or balanced crystalloids is used for pump prime and intraoperative fluid therapy. DESIGN: Data were obtained retrospectively from medical records and perfusion charts. Matching based on propensity scores was used to adjust for potential confounders. SETTING: A university hospital. PARTICIPANTS: Adult patients undergoing cardiac surgery with the use of cardiopulmonary bypass. INTERVENTIONS: Allocation to one of the study groups according to whether balanced HES or balanced crystalloids was used for pump prime and intraoperative fluid therapy. MEASUREMENTS AND MAIN RESULTS: 240 propensity-matched patients were retained for final analyses. Forty-eight patients (40%) of the colloid group and 28 patients (23.3%) of the crystalloid group received blood products, with an odd ratio (95% CI) of 2.1(1.2-3.8 (P=0.009). After bypass HES patients had lower hemoglobin levels (8.4 [1.3] gr/dL vs 9.6 [2] gr/dL; P<0.001) and a higher cumulative chest drain output after 3 hours (180 [210] mL vs 140 [100] mL, P<0.001]. Heparinase thromboelastogram (TEG(R)) showed longer K times (2.5[1.1] vs 1.6[0.8], P<0.001) and lower maximal amplitudes (55.1[12.5] vs 63.4[9.8], P=0.008). CONCLUSIONS: HES patients required more transfusions, owing to greater hemodilution, HES-induced clotting disturbances, and bleeding. [less ▲]

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See detailLa Narcolepsie-Cataplexie aujourd'hui
DEPIERREUX, Frédérique ULg; FANIELLE, Julien ULg; Martin-Lecomte, Marianne ULg et al

in Revue Médicale de Liège (2014), 69(2), 72-81

Diagnostic criteria and pathophysiology of narcolepsy- cataplexy have evolved considerably over the last 10 years. The main cause, already mentioned in a previous paper, in the Revue Médicale de Liège, in ... [more ▼]

Diagnostic criteria and pathophysiology of narcolepsy- cataplexy have evolved considerably over the last 10 years. The main cause, already mentioned in a previous paper, in the Revue Médicale de Liège, in 2002, is based, in human beings, on a destruction of specific cells located in the lateral and posterior part of the hypothalamus (the perifornical nuclei, containing some 70,000 neurons), producing peptides which stimulate the central nervous system; they are called hypocretins or orexins. The role of autoimmunity in their disappearance becomes more evident. The treatment is simplified but remains symptomatic. It is mainly based on Sodium Oxybate or Gamma-Hydroxybutyrate, syrup, prescribed for the night. The authors report on their own experience in this regard and on future therapeutics more targeted towards the cause of the disease. [less ▲]

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See detailThe metabolic syndrome is a risk factor for postoperative obstructive apnoea and hypoxaemia in morbidly obese patients: 5AP3-1
Devillers, H.; HANS, Grégory ULg; Brichant, Jean-François ULg et al

in European Journal of Anaesthesiology (EJA) (2014), 31

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See detailRecruitment of lung volume during surgery neither affects the postoperative spirometry nor the risk of hypoxaemia after laparoscopic gastric bypass in morbidly obese patients: a randomized controlled study.
DEFRESNE, Aline ULg; HANS, Grégory ULg; GOFFIN, Pierre ULg et al

in British journal of anaesthesia (2014), 113(3), 501-7

BACKGROUND: Intraoperative recruitment manoeuvres (RMs) combined with PEEP reverse the decrease in functional residual capacity (FRC) associated with anaesthesia and improve intraoperative oxygenation ... [more ▼]

BACKGROUND: Intraoperative recruitment manoeuvres (RMs) combined with PEEP reverse the decrease in functional residual capacity (FRC) associated with anaesthesia and improve intraoperative oxygenation. Whether these benefits persist after operation remains unknown. We tested the hypothesis that intraoperative RMs associated with PEEP improve postoperative spirometry including FRC and reduce the incidence of postoperative hypoxaemia in morbidly obese (MO) patients undergoing laparoscopic gastric bypass. METHODS: After IRB approval and informed consent, 50 MO patients undergoing laparoscopic gastric bypass under volume-controlled ventilation (tidal volume 6 ml kg(-1) of IBW) were randomly ventilated with either 10 cm H(2)O PEEP or with 10 cm H(2)O PEEP and one RM carried out after induction of pneumoperitoneum, and another after exsufflation. Anaesthesia and analgesia were standardized. Spirometry was assessed before operation and 24 h after surgery. Postoperative oxygenation and the apnoea-hypopnoea index (AHI) were recorded during the first postoperative night. RESULTS: Age, BMI, and STOP BANG score were similar in both groups. FRC decrease after surgery was minimal [0.15 (0.14) litre in control and 0.38 (0.19) litre in the RM group] and similar between the groups (P=0.35). FVC, FEV1, mean [Formula: see text], percentage of time spent with [Formula: see text] below 90%, and AHI did not differ significantly between the groups. CONCLUSIONS: This study demonstrates that when added to a protective mechanical ventilation combining low tidal volume and high PEEP, two RMs do not improve postoperative lung function including FRC, arterial oxygenation, and the incidence of obstructive apnoea in MO patients after laparoscopic upper abdominal surgery. CLINICAL TRIAL REGISTRATION: EudraCT 2011-000999-33. [less ▲]

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See detail[Narcolepsy-cataplexy today].
Depierreux-Lahaye, F.; Fanielle, J.; Martin-Lecomte, M. et al

in Revue medicale de Liege (2014), 69(2), 72--81

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See detailSTOP BANG but not BMI predicts postoperative obstructive apnoea and hypoxaemia after laparoscopic upper-abdominal surgery: 5AP2-5
Pirenne, S.; HANS, Grégory ULg; Joris, J. et al

in European Journal of Anaesthesiology (2013), 30

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See detailPreoperative Anaemia
HANS, Grégory ULg; Jones, Nicola

in Continuous Education in Anaesthesia, Critical Care & Pain (2013), 13(3), 71-74

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See detailMechanical Ventilation During Anaesthesia: Pathophysiology and Clinical Implications
Dresse, Caroline; JORIS, Jean ULg; HANS, Grégory ULg

in Trends in Anaesthesia and Critical Care (2012), 2(2), 71-75

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See detailEffect of a fluid challenge on the Surgical Pleth Index during stable propofol-remifentanil anaesthesia.
Hans, Pol; VERSCHEURE, Sara ULg; Uutela, K. et al

in Acta Anaesthesiologica Scandinavica (2012), 56(6), 787-96

BACKGROUND: The Surgical Pleth Index (SPI), derived from pulse amplitude and heartbeat interval, is proposed to monitor anti-nociception during anaesthesia. Its response to noxious stimulation can be ... [more ▼]

BACKGROUND: The Surgical Pleth Index (SPI), derived from pulse amplitude and heartbeat interval, is proposed to monitor anti-nociception during anaesthesia. Its response to noxious stimulation can be affected by the intravascular volume status. This study investigated the effect of a fluid challenge (FC) on SPI during steady-state conditions. METHODS: After Institutional Review Board approval, 33 consenting patients undergoing neurosurgery received a 4 ml/kg starch FC over less than 5 min under stable surgical stimulation conditions and stable propofol (Ce(PPF) ) and remifentanil (Ce(REMI) ) effect-site concentrations as estimated by target-controlled infusion systems. Intravascular volume status was assessed using the Delta Down (DD). We looked at the SPI response to FC according to DD, Ce(PPF) , and Ce(REMI) . RESULTS: Following FC, SPI did not change in 16, increased in 12, and decreased in 3 patients. Ce(REMI) poorly affected the SPI response to FC. In normovolaemic patients, the probability of an SPI change after FC was low under common Ce(PPF) (0.9 to 3.9 mug/ml). A decrease in SPI was more probable with worsening hypovolaemia and lowering Ce(PPF) , while an increase in SPI was more probable with increasing Ce(PPF) . SPI changes were only attributable to modifications in pulse wave amplitude and not in heart rate. CONCLUSIONS: During stable anaesthesia and surgery, SPI may change in response to FC. The effect of FC on SPI is influenced by volaemia and Ce(PPF) through pulse wave amplitude modifications. These situations may confound the interpretation of SPI as a surrogate measure of the nociception-anti-nociception balance. [less ▲]

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See detailComparison of the Surgical Pleth Index (TM) with haemodynamic variables to assess nociception-anti-nociception balance during general anaesthesia
Bonhomme, Vincent ULg; Uutela, K.; Hans, Grégory ULg et al

in British Journal of Anaesthesia (2011), 106(1), 101-11

BACKGROUND: The Surgical Pleth Index (SPI) is proposed as a means to assess the balance between noxious stimulation and the anti-nociceptive effects of anaesthesia. In this study, we compared SPI, mean ... [more ▼]

BACKGROUND: The Surgical Pleth Index (SPI) is proposed as a means to assess the balance between noxious stimulation and the anti-nociceptive effects of anaesthesia. In this study, we compared SPI, mean arterial pressure (MAP), and heart rate (HR) as a means of assessing this balance. METHODS: We studied a standard stimulus [head-holder insertion (HHI)] and varying remifentanil concentrations (CeREMI) in a group of patients undergoing neurosurgery. Patients receiving target-controlled infusions were randomly assigned to one of the three CeREMI (2, 4, or 6 ng m(1)), whereas propofol target was fixed at 3 microg ml(1). Steady state for both targets was achieved before HHI. Intravascular volume status (IVS) was evaluated using respiratory variations in arterial pressure. Prediction probability (Pk) and ordinal regression were used to assess SPI, MAP, and HR performance at indicating CeREMI, and the influence of IVS and chronic treatment for high arterial pressure, as possible confounding factors. RESULTS: The maximum SPI, MAP, or HR observed after HHI correctly indicated CeREMI in one of the two patients [accurate prediction rate (APR)=0.5]. When IVS and chronic treatment for high arterial pressure were taken into account, the APR was 0.6 for each individual variable and 0.8 when all of them predicted the same CeREMI. That increase in APR paralleled an increase in Pk from 0.63 to 0.89. CONCLUSIONS: SPI, HR, and MAP are of comparable value at gauging noxious stimulation-CeREMI balance. Their interpretation is improved by taking account of IVS, treatment for chronic high arterial pressure, and concordance between their predictions. [less ▲]

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See detailComparison of the Surgical Pleth Index™ with haemodynamic variables to assess nociception--anti-nociception balance during general anaesthesia
Bonhomme, Vincent; Uutela, K.; HANS, Grégory ULg et al

in British journal of anaesthesia (2011), 106(1), 101--111

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See detailLipomatous hypertrophy of the interatrial septum: the typical echographic aspect is worth being known
ROYER, Ludovic ULg; HANS, Grégory ULg; CANIVET, Jean-Luc ULg et al

in Acta Anaesthesiologica Belgica (2011), 62(3), 157-159

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See detailIntravenous lidocaine infusion reduces bispectral index-guided requirements of propofol only during surgical stimulation.
Hans, Grégory ULg; Lauwick, Séverine ULg; Kaba, Abdourahmane ULg et al

in British Journal of Anaesthesia (2010), 105(4), 471-9

BACKGROUND: I.V. lidocaine reduces volatile anaesthetics requirements during surgery. We hypothesized that lidocaine would also reduce propofol requirements during i.v. anaesthesia. METHODS: A randomized ... [more ▼]

BACKGROUND: I.V. lidocaine reduces volatile anaesthetics requirements during surgery. We hypothesized that lidocaine would also reduce propofol requirements during i.v. anaesthesia. METHODS: A randomized controlled study of 40 patients tested the effect of i.v. lidocaine (1.5 mg kg(-1) then 2 mg kg(-1) h(-1)) on propofol requirements. Anaesthesia was maintained with remifentanil and propofol target-controlled infusions (TCI) to keep the bispectral index (BIS) around 50. Effect-site concentrations of propofol and remifentanil and BIS values were recorded before and after skin incision. Data were analysed using anova and mixed effects analysis with NONMEM. Two dose-response studies were then performed with and without surgical stimulation. Propofol TCI titrated to obtain a BIS around 50 was kept constant. Then patients were randomized into four groups: A, saline; B, 0.75 mg kg(-1) bolus then infusion 1 mg kg(-1) h(-1); C, 1.5 mg kg(-1) bolus and infusion 2 mg kg(-1) h(-1); and D, 3 mg kg(-1) bolus and infusion 4 mg kg(-1) h(-1). Lidocaine administration coincided with skin incision. BIS values and haemodynamic variables were recorded. Data were analysed using linear regression and two-way anova. RESULTS: Lidocaine decreased propofol requirements (P<0.05) only during surgery. In the absence of surgical stimulation, lidocaine did not affect BIS nor haemodynamic variables, whereas it reduced BIS increase (P=0.036) and haemodynamic response (P=0.006) secondary to surgery. CONCLUSIONS: The sparing effect of lidocaine on anaesthetic requirements seems to be mediated by an anti-nociceptive action. [less ▲]

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See detailSurgical Pleth Index to assess the anti-nociceptive component of general anaesthesia: Comparison with haemodynamic parameters and identification of confounding factors: 3AP3--3
HANS, Grégory ULg; Bonhomme, V.; Maquoi, I. et al

in European Journal of Anaesthesiology (EJA) (2010), 27(47), 50

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See detailEffect of intravenous infusion of lidocaine on spontaneous recovery from cisatracurium-induced neuromuscular block: Preliminary results: 9AP4--3
HANS, Grégory ULg; Defresne, A.; Ki, B. et al

in European Journal of Anaesthesiology (EJA) (2010), 27(47), 149

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