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  1. Elective bedside surgery in critically injured patients is safe and cost-effective. Discussion.

    Article, Communication - En anglais

    Annual Scientific Session of the Southern Surgical Association. Hot Springs, VA, USA, 1997/11/30.

    From the Department of Surgery, Division of Trauma, and the Division of Vascular Surgery, t Vanderbilt University Medical Center, Nashville, Tennessee Objective The success of elective minimally invasive surgery suggested that this concept could be adapted to the intensive care unit.

    We hypothesized that minimally invasive surgery could be done safely and cost-effectively at the bedside in critically injured patients.

    Background Data This case series, conducted between October 1991 and June 1997 at a Level I trauma center, examined bedside dilatational tracheostomy (BDT), percutaneous endoscopic gastrostomy (PEG), and inferior vena cava (IVC) filter placement.

    All procedures had been performed in the operating room (OR) before initiation of this study.

    Methods All BDTs and PEGs were performed with intravenous general anesthesia (fentanyl, diazepam, and pancuronium) administered by the surgical team.

    IVC filters were placed using local anesthesia and conscious sedation.

    BDTs were done using a Ciaglia set, PEGs were done using a 20 Fr Flexiflow Inverta-PEG kit, and IVC filters were placed percutaneously under ultrasound guidance.

    Cost difference (deltacost) was defined as the difference in hospital cost and physician charges incurred in the OR as compared to the bedside.

    Results Of 16,417 trauma admissions, 379 patients (2%) underwent 472 minimally invasive procedures (272 BDTs, 129 PEGs, 71 IVC filters).

    There were four major complications (0.8%). (...)

    Mots-clés Pascal : Trachéotomie, Dilatation, Gastrostomie, Voie percutanée, Gastroscopie, Filtre mécanique, Veine cave inférieure, Service urgence, Indication, Coût, Evaluation performance, Homme, Estomac, Chirurgie, ORL pathologie, Appareil respiratoire pathologie, Trachée pathologie, Appareil digestif pathologie, Endoscopie, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Veine pathologie, Economie santé

    Mots-clés Pascal anglais : Tracheotomy, Dilatation, Gastrostomy, Percutaneous route, Gastroscopy, Mechanical filter, Inferior vena cava, Emergency department, Indication, Costs, Performance evaluation, Human, Stomach, Surgery, ENT disease, Respiratory disease, Diseases of the trachea, Digestive diseases, Endoscopy, Cardiovascular disease, Vascular disease, Venous disease, Health economy

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0320881

    Code Inist : 002B25N. Création : 27/11/1998.