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Yves Ozier

Publications and source records attributed to Yves Ozier.

7 recordsLinked to original sources
PubMed2004

The effect of erythropoietin on allogeneic blood requirement in patients undergoing elective liver resection: a model simulation.

UNLABELLED: We investigated whether recombinant human erythropoietin (rHuEPO) administration would reduce red blood cell (RBC) transfusion requirements in patients undergoing elective liver resection. We retrospectively investigated 200 patients undergoing elective liver resection. Factors likely to predict perioperative RBC transfusion were studied using a logistic regression analysis. A mathematical model was used to simulate RBC transfusion requirements if (a). transfusion thresholds had been predefined at a hemoglobin concentration of 7-8 g/dL, (b). preoperative hemoglobin concentrations had been increased to 15 g/dL by rHuEPO administration in patients with preoperative hemoglobin concentration in the range 10-13 g/dL, and (c). both interventions had been used. A cost/benefit evaluation of rHuEPO administration formed part of this simulation. RBC transfusion was correlated with major and median liver resection, total liver vascular exclusion, and a combined nonhepatic abdominal surgery but was not correlated with a preoperative hemoglobin concentration in the range 10-13 g/dL. Adherence to a small transfusion threshold or rHuEPO administration alone would have resulted in a slight reduction in transfusion requirements and transfusion rates for the whole population. However, the two interventions in combination would have significantly reduced both variables. One-hundred-eighteen patients undergoing median and major liver resection received 92% of RBC transfused. Sixty-six of these 118 patients had preoperative hemoglobin concentrations in the range 10-13 g/dL and could have received rHuEPO before surgery. rHuEPO alone would have avoided the transfusion of 63 RBC packs of 203 in this subgroup and 12 transfused patients of 31 (P = 0.02). rHuEPO administration to these 66 patients would have cost 186000 Euro. The 63 RBC saved would have cost 10,710 Euro. IMPLICATIONS: A mathematical model simulation suggests that the routine preoperative administration of erythropoietin to patients scheduled for major and median liver resection presenting with a preoperative hemoglobin concentration in the range 10-13 g/dL could reduce blood transfusion requirements. However, the cost/benefit ratio warrants consideration.

Aged↗
PubMed2003

Institutional variability in transfusion practice for liver transplantation.

We prospectively evaluated the institutional variability in perioperative transfusion therapy in orthotopic liver transplantation (OLT). Adult OLTs completed during a 12-mo period were studied until the 48th postoperative hour at 8 centers. A multivariate analysis using mixed-effects logistic regression included variables predisposing to blood loss and a center random effect. In addition, the influence of the calculated perioperative hemoglobin (Hb) loss on the individual probability of receiving red blood cells (RBCs), fresh frozen plasma (FFP), and platelets in excess of the overall median were explored. The analysis was performed on 301 cases. The overall median numbers transfused were 5 RBC units, 6 FFP units, and the median platelet dose was 5.10(11), with significant intercentric differences in the proportions of cases given more than the overall median. Intercentric differences remained significant after adjustment for factors independently associated with a large blood component use. Intercentric differences in RBCs, FFP, and platelet use decreased but persisted after adjustment for the perioperative Hb loss. Intercentric differences in RBC use disappeared after adjustment for the postoperative Hb concentration. The significant heterogeneity in transfusion therapy mandates reassessment of the rational use of blood products in OLT.

Adult↗
PubMed2002

Acute postoperative glaucoma after nonocular surgery remains a diagnostic challenge.

IMPLICATIONS: Anesthesia may acutely reveal angle-closure glaucoma. This complication is an ophthalmologic emergency. However, symptoms of acute glaucoma may be overlooked or misinterpreted in a sedated or comatose patient, and this may result in delayed treatment. Immediate diagnosis and appropriate treatment should be done to prevent visual loss.

Acute Disease↗
PubMed2002

Severe hypernatremia after hypertonic saline irrigation of hydatid cysts.

IMPLICATIONS: Patients with iatrogenic hypernatremia and serum sodium levels >170 mmol/L either die or sustain severe central nervous system damage. We report the first case of an adult patient who survived an extreme iatrogenic acute hypernatremia (200 mmol/L) resulting from a hypertonic saline irrigation of multiple intraabdominal hydatid cysts. It is a unique report of an intraoperatively developed serum sodium increase without subsequent neurological damage.

Adult↗