Vincent Minville

Paul Sabatier University - Toulouse III, Tolosa de Llenguadoc, Midi-Pyrénées, France

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Publications (135)285.6 Total impact

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    ABSTRACT: Le choc hémorragique est une urgence pouvant bénéficier d’une prise en charge préhospitalière médicalisée en France. Notre objectif était de réaliser un état des lieux des moyens disponibles dans les 370 Services mobiles d’urgence et de réanimation (Smur) français pour la prise en charge des situations hémorragiques en préhospitalier.
    Annales francaises d'anesthesie et de reanimation 10/2014; · 0.77 Impact Factor
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    ABSTRACT: Postoperative acute kidney injury (AKI) is a cause of morbidity and mortality. Its diagnosis requires better markers than variations in diuresis or postoperative serum creatinine.
    European journal of anaesthesiology. 07/2014;
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    ABSTRACT: Accidental dural puncture (ADP) is a common complication of epidural catheter insertion, and may lead to post-dural puncture headache (PDPH), especially in obstetric patients. Epidural blood patch (BP) is the most effective treatment of PDPH. Prophylactic BP has shown its efficacy to prevent PDPH; nevertheless, this method may be insufficient. We report an ADP case before induction of labor in a 28-year-old parturient. To avoid PDPH, an intrathecal catheter was immediately inserted after ADP and an epidural catheter was also inserted at the interspace above. Catheters were kept in place for more than 24hours. A prophylactic BP was performed immediately after removal of the intrathecal catheter. The patient did not experience any headache. This combination of treatments (intrathecal catheter insertion+prophylactic BP) may be a good alternative approach to prevent PDPH, even if it has to be warranted by other clinical studies.
    Annales francaises d'anesthesie et de reanimation 05/2014; · 0.77 Impact Factor
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    ABSTRACT: Preoperative flushing of an anesthesia workstation is an alternative for preparation of the anesthesia workstation before use in malignant hyperthermia-susceptible patients (MHS). We studied in vitro, using a test lung, the washout profile of sevoflurane in 7 recent workstations during adult and, for the first time, pediatric ventilation patterns. Anesthesia workstations were first primed with 3% sevoflurane for 2 hours and then prepared according to the recommendations of the Malignant Hyperthermia Association of the United States. The flush was done with maximal fresh gas flow (FGF) with a minute ventilation equal to 600 mL × 15, to reach a sevoflurane concentration of <5 parts per million. After flush, 2 clinical situations were simulated in vitro to test the efficiency of preparation: decrease of FGF from max to 10 L/min, or decrease of minute ventilation to 50 mL × 30, to simulate the ventilation of an MHS infant. We report washout delays for MHS patients for previously studied workstations (Primus®, Avance®, and Zeus®) and more interestingly, for machines not previously tested (Felix®, Flow-I®, Perseus®, and Leon®). An increase of sevoflurane concentration was observed when decreasing FGF (except for flow-I® and Leon®) and during simulation of MHS infant ventilation (except for Felix®). This descriptive study strongly suggests that washout profiles may differ for each anesthesia workstation. We advise the use of maximal FGF during preparation and anesthesia. Required flushing times are longer when preparing an anesthesia workstation before providing anesthesia for MHS infants.
    Anesthesia and analgesia 05/2014; · 3.08 Impact Factor
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    ABSTRACT: Data from previous studies indicate that optimal conditions for intubation are met 120 seconds after administration of 0.15 mg.kg-1 cisatracurium (ED95 x 3) following the induction of anesthesia. The aim of this study was to compare the doses required for complete paralysis after induction of anesthesia in ICU patients with the dose used in patients undergoing elective surgery. Seventeen ICU patients undergoing percutaneous tracheostomy and 17 patients undergoing an elective surgical procedure under muscle relaxation were included. In both groups, an initial intravenous bolus of cisatracurium besylate was given at a dose of 0.15 mg.kg-1 followed by repeated boluses of 0.03 mg.kg-1 every four minutes. The objective was to obtain no response to the train-of-four (TOF). The contractile response of the corrugator supercilii muscle was monitored every minute by observing the TOF in response to a peripheral nerve stimulator with a constant current set to 60 mA. After the initial dose of cisatracurium, none of ICU patients (0/17) versus 15/17 of the elective surgery patients were completely paralyzed (P < 0.0001). There was a delay in the onset of neuromuscular blockade among the ICU patients. The cumulative doses of cisatracurium were significantly higher in the ICU group with 38 +/- 14 mg (that is, 10 +/- 4.7 ED95) versus 11 +/- 2 mg (that is, 3 +/- 0.3 ED95) in the elective surgery group (P < 0.0001). The dosing of cisatracrurium for ICU patients, which is based on the dose recommended for elective anesthesia, is unsuitable because the onset is too slow. This phenomenon is probably caused by changes in the pharmacodynamics and pharmacokinetics. These data suggest that neuromuscular monitoring should be used in the ICU.
    Annals of intensive care. 02/2014; 4(1):3.
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    ABSTRACT: La brèche durale accidentelle est une complication commune lors des abords périduraux ; elle peut être à l’origine de céphalées post-brèche durale (CPBD), en particulier en obstétrique. Le « blood patch » (BP) est le traitement le plus efficace des CPBD. Le BP préventif a fait preuve d’efficacité pour prévenir les CPBD ; néanmoins, cette technique est parfois insuffisante. Nous rapportons un cas de brèche durale accidentelle, survenue avant l’induction du travail chez une femme de 28 ans. Pour éviter les CPBD, nous avons immédiatement introduit un cathéter intrathécal, puis inséré un second cathéter dans l’espace péridural sus-jacent. Les deux cathéters étaient laissés en place pendant plus de 24 heures. Un BP prophylactique, via le cathéter péridural, était pratiqué immédiatement après le retrait du cathéter intrathécal. La patiente n’a pas présenté de CPBD. Cette combinaison de traitement (insertion d’un cathéter intrathécal + BP préventif) pourrait être une solution pour éviter l’apparition de CPBD, mais elle doit être confirmée par des études cliniques.
    Annales francaises d'anesthesie et de reanimation 01/2014; · 0.77 Impact Factor
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    ABSTRACT: Introduction Le patient polytraumatisé présente une dépense énergétique majeure, un hypercatabolisme associé à une protéolyse, une lipolyse et un déficit en micronutriments. Son statut en carnitine a été peu étudié. Cette amine quaternaire est pourtant l’élément clé de la β-oxydation des acides gras à chaînes longues et la lipolyse est une source majeure d’énergie durant cette phase d’hypercatabolisme liée à l’agression tissulaire aiguë. Chez l’Homme, 75 % de la carnitine provient de l’alimentation mais les produits de nutrition artificielle en sont dépourvus. Matériel et méthodes Étude observationnelle sur 38 patients polytraumatisés (dont 18 avec traumatisme crânien) hospitalisés en réanimation polyvalente. La carnitine plasmatique libre a été dosée au 3e jour post-traumatique, sur des reliquats de prélèvements de sang restant issus des bilans réalisés pour la prise en charge habituelle, chez ces patients recevant progressivement une nutrition entérale à partir de j2. Résultats La carnitine plasmatique est abaissée chez 95 % des patients avec une médiane est de 18 μmol/L [11–47] pour une norme entre 36 et 46 μmol/L. Cette diminution est plus importante chez les polytraumatisés cérébro-lésés : 7,72 [11–36] vs 21,5 [11–47] μmol/L (p = 0,031). En analyse univariée, on observe une relation entre la carnitinémie et l’IMC (p = 0,049), le DFG estimé par le CKD-EPI (p = 0,0171) et l’urée sanguine (p = 0,0022). Pour les patients présentant les carnitinémies les plus diminuées (< 18 μmol/L), en analyse multivariée, les facteurs en cause sont l’association à un traumatisme crânien (p = 0,0151) et l’urée plasmatique (0,0371) ( Fig. 1). Discussion La concentration plasmatique de carnitine libre est abaissée précocement chez le patient polytraumatisé et de façon significativement plus importante chez les cérébro-lésés. Différents mécanismes peuvent être évoqués : diminution de la synthèse de novo et des apports exogènes, augmentation de l’élimination, majoration de l’utilisation et/ou association des divers mécanismes. La relation entre la carnitinémie et le DFG évoque augmentation de l’excrétion urinaire déjà montrée par Cerderblad puis Davis. La majoration de l’utilisation de la carnitine peut être incriminée chez les traumatisés crânien présentant la dépense énergétique la plus élevée. Une adaptation métabolique ne peut être exclue. Les conséquences de ce déficit peuvent être évoquées en prenant en compte l’effet neuro-protecteur potentiel de la carnitine.
    Annales francaises d'anesthesie et de reanimation 01/2014; 33:A24–A25. · 0.77 Impact Factor
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    ABSTRACT: Perioperative blood pressure management is a key factor of patient care for anesthetists, as perioperative hemodynamic instability is associated with cardiovascular complications. Hypertension is an independent predictive factor of cardiac adverse events in noncardiac surgery. Intraoperative hypotension is one of the most encountered factors associated with death related to anesthesia. In the preoperative setting, the majority of antihypertensive medications should be continued until surgery. Only renin-angiotensin system antagonists may be stopped. Hypertension, especially in the case of mild to moderate hypertension, is not a cause for delaying surgery. During the intraoperative period, anesthesia leads to hypotension. Hypotension episodes should be promptly treated by intravenous vasopressors, and according to their etiology. In the postoperative setting, hypertension predominates. Continuation of antihypertensive medications and postoperative care may be insufficient. In these cases, intravenous antihypertensive treatments are used to control blood pressure elevation.
    Integrated Blood Pressure Control 01/2014; 7:49-59.
  • Annales francaises d'anesthesie et de reanimation 01/2014; · 0.77 Impact Factor
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    ABSTRACT: To evaluate the feasibility of guidewire detection in right cardiac cavities by transthoracic echocardiography (TTE) in order to detect catheter misplacement and to optimize central venous catheter (CVC) positioning. Ultrasonic control for catheter tip positioning was compared to that by chest X-ray (CXR). We conducted a monocentric prospective observational study (January-November 2010). All consecutive patients undergoing CVC insertion were included. The puncture was performed using the landmark method or ultrasound guidance. TTE was performed during the procedure to follow the arrival of the guidewire in the right cardiac cavities. Catheter misplacement was defined as an aberrant position on the postprocedural CXR (catheter positioning in ipsilateral or contralateral veins). The primary endpoint was the prediction of catheter misplacement by guidewire detection in the cardiac cavities. The secondary endpoint was the optimization of the catheter tip placement in the superior vena cava. A total of 98 patients received 101 CVC. The guidewire was visualized in 92 cases. In five cases, the guidewire was not seen in the right cardiac cavities and CXR showed catheter misplacement. In four cases, poor echogenicity led to the ultrasound examination being abandoned. Catheter misplacement was detected by TTE with a sensitivity of 96 % (CI 90-98 %), a specificity of 83 % (CI 44-97 %), a positive predictive value of 98 %, and a negative predictive value of 55 %. Likelihood ratios were LR+ 5.7 (CI 0.96-34.4) and LR- 0.05 (CI 0.02-0.14). Guidewire removal under TTE avoided an excessively distal position of the catheter tip in all cases. TTE is a reliable tool to detect catheter misplacement and to optimize catheter tip positioning during the procedure of CVC insertion.
    European Journal of Intensive Care Medicine 09/2013; · 5.17 Impact Factor
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    ABSTRACT: To estimate the agreement between radial or femoral, and ascending aortic invasive blood pressure values. Prospective study on 32 patients who underwent an aortic endografting under general anesthesia. After deploying the prosthesis under controlled hypotension, a catheter was introduced in the aorta to measure the staged systolic (SAP), diastolic (DAP) and mean (MAP) arterial pressures, in particular at the level of ascending aorta and femoral artery. No differences were observed between SAP, DAP or MAP measured in the aorta versus femoral or radial arteries. A better agreement was observed between the aortic and femoral MAP (bias of 1mmHg, limits of agreement between: -8.8mmHg and +10.8mmHg) than between the aortic and the radial MAP (bias of 1.7mmHg, limits of agreement between: -14.1mmHg and +17.5mmHg). The comparison between radial and femoral MAP was not satisfying (bias of -4.7mmHg and limits of agreement between -19.1mmHg and +9.7mmHg). The femoral MAP is more accurate to predict value of the aortic MAP than the radial MAP in a hypotensive setting. The clinician should be aware of these discrepancies in conditions of hemodynamic impairment to optimize the treatment.
    Annales francaises d'anesthesie et de reanimation 08/2013; · 0.77 Impact Factor
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    ABSTRACT: The operating room (OR) is a high-risk complex setting, where patient safety relies on the coordinated efforts of multiple team members. However, little attention has been paid to evaluating the strategies employed by OR practitioners to prevent and correct incidents that inevitably occur during surgery. Therefore, we were prompted to investigate human factor (HF) engineering methods that have been used in an innovative way in order to systematically observe and analyze the management of incidents in the neurosurgical OR of a French university hospital. A technical case report illustrates our approach that associates the following procedures: the recording of OR team member activities and behaviour by video cameras and direct observation of a HF researcher, with the description and the explicit demonstration of safety related procedures in self- and cross-confrontation interviews of OR team members. This technical report emphasizes complementary aspects of clinical performance related to safety skills. Moreover, individual and team performances rely on complementary abilities that associate practical knowledge, skills, and attitudes, which are engaged at various degrees to prevent and manage incidents. This report also enlightens new quality-improvement opportunities as well as further objectives for future studies.
    Neurochirurgie 08/2013; · 0.32 Impact Factor
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    ABSTRACT: The purpose of the study is to determine if femoral artery blood flow Doppler parameters can assess cardiac response to a fluid challenge (FC). We prospectively recorded in 52 critically ill ventilated patients' velocity time integral variation (%VTIf) and maximal systolic velocity variation (%Vfmax) derived from femoral Doppler analysis and aortic velocity time integral variation registered on transthoracic echocardiography before and after an FC of 500-mL saline. According to Pearson coefficient, %Vfmax and %VTIf were found to be positively correlated with aortic velocity time integral variation (r(2) = 0.46 and 0.51, respectively; P < .0001) and were significantly different between responder patients and nonresponders (11% ± 3.4% vs 5.9% ± 4.3% and 14.9% ± 4.2% vs 5.5% ± 5.5%, respectively; P < .0001). Increase of %VTIf 10% or higher and %Vfmax 7% or higher after an FC showed a sensitivity of 80% and 84%, a specificity of 85% and 73%, and an area under the curve of 0.905 and 0.851, respectively, for discriminating responder and nonresponder patients. Variation of femoral Doppler parameters before and after FC mirrors cardiac response to fluid loading. This tool could be considered as an alternative to transthoracic echocardiography in case of poor thoracic insonation.
    Journal of critical care 07/2013; · 2.13 Impact Factor
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    ABSTRACT: Mice with genetic alterations are used in heart research for the extrapolation of human diseases. Echocardiography is an essential tool for evaluating cardiac and hemodynamic functions in small animals. The purpose of this study was to compare the effect of different anesthetic regimens and the conscious state on the evaluation of cardiac function by echocardiography. Mice were examined in the conscious state after three days of training, and then for a 7 min period after a single intraperitoneal injection of ketamine at 100 mg/kg, etomidate at 10, 20 or 30 mg/kg, or after inhalation of isoflurane at 1.5% with or without a short period of induction with isoflurane 3%. Intra- and inter-observer variabilities were assessed. The operator's comfort was also assessed. Heart rate, left ventricular end diastolic diameter, fraction shortening and cardiac output were measured using echocardiography. Ketamine at 5 and 7 min after induction and isoflurane at 3, 5 and 7 min after induction provided good anesthetic conditions and a quick awakening time, and did not influence cardiac performance, whereas the conscious state was associated with a non-physiological sympathetic activation and other anesthetic drugs induced a significant decrease in heart rate. Etomidate 10 mg/kg and 20 mg/kg were not enough to provide adequate anesthesia. Etomidate 30 mg/kg induced a good anesthetic condition but influenced cardiac performance and had a long awakening time. Our results indicate that ketamine and isoflurane with a short induction period are better anesthetic drugs than isoflurane without induction or etomidate for evaluating cardiac function in healthy mice.
    Laboratory Animals 07/2013; · 1.26 Impact Factor
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    ABSTRACT: We report a video laryngoscopic tracheal intubation under sedation in a patient with a hip fracture. Preoperative assessment revealed signs of difficult airway management linked to a cervical spine immobilization. Here we describe an alternative method to awake fiber optic flexible intubation.
    Annales francaises d'anesthesie et de reanimation 04/2013; · 0.77 Impact Factor
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    ABSTRACT: Objective Pulmonary embolism remains a leading cause of maternal death in France and in other developed countries. Prevention is well codified, but management remains complex both for diagnosis and therapeutics. The objective of this review was to update the knowledge on diagnosis and treatment of pulmonary embolism during pregnancy.Article typeReview.Data sourceMedline® database looking for articles published in English or French between 1965 and 2012, using pulmonary embolism, pregnancy, heparin, thrombolysis and vena cava filter as keywords. Editorials, original articles, reviews and cases reports were selected.Data synthesisPulmonary embolism is one of the leading causes of maternal death in France. Clinical signs and biologic tests are not specific during pregnancy. Doppler ultrasound is helpful for diagnosis and avoids maternal and fetal radiation. Treatment is based on full anticoagulation. Low molecular weight heparin is the treatment of choice. A temporary vena cava filter may be proposed, especially at the end of pregnancy, or when heparin is contraindicated. In case of pulmonary embolism with cardiogenic shock, thrombolysis is an alternative treatment.Conclusion Diagnostic approach is first based on the use of ultrasound- Doppler, and frequently on-to computed tomographic pulmonary angiography or ventilation–perfusion lung scanning. The treatment is based on low molecular weight heparin. Others therapeutics, such as thrombolysis or temporary vena cava filter, may be useful in certain circumstances.
    Annales francaises d'anesthesie et de reanimation 04/2013; 32(4):257–266. · 0.77 Impact Factor
  • Vincent Minville, Christine Tran, Pierre Albaladejo
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    ABSTRACT: Preoperative anesthesia consultation before general anesthesia, regional anesthesia, regional analgesia or sedation, is an opportunity to better document comorbidities, optimize the patient's condition, facilitate referrals to specialists, order complementary investigations, prevent surgical risk, and to determine guidelines for perioperative care. The aim of this review is to discuss the implications of recent studies and guidelines evaluating the processes-of-care and outcomes related to preoperative anesthesia consultation.
    Le Praticien en Anesthésie Réanimation 04/2013; 17(2):106–111.
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    ABSTRACT: OBJECTIVE: Pulmonary embolism remains a leading cause of maternal death in France and in other developed countries. Prevention is well codified, but management remains complex both for diagnosis and therapeutics. The objective of this review was to update the knowledge on diagnosis and treatment of pulmonary embolism during pregnancy. ARTICLE TYPE: Review. DATA SOURCE: Medline(®) database looking for articles published in English or French between 1965 and 2012, using pulmonary embolism, pregnancy, heparin, thrombolysis and vena cava filter as keywords. Editorials, original articles, reviews and cases reports were selected. DATA SYNTHESIS: Pulmonary embolism is one of the leading causes of maternal death in France. Clinical signs and biologic tests are not specific during pregnancy. Doppler ultrasound is helpful for diagnosis and avoids maternal and fetal radiation. Treatment is based on full anticoagulation. Low molecular weight heparin is the treatment of choice. A temporary vena cava filter may be proposed, especially at the end of pregnancy, or when heparin is contraindicated. In case of pulmonary embolism with cardiogenic shock, thrombolysis is an alternative treatment. CONCLUSION: Diagnostic approach is first based on the use of ultrasound- Doppler, and frequently on-to computed tomographic pulmonary angiography or ventilation-perfusion lung scanning. The treatment is based on low molecular weight heparin. Others therapeutics, such as thrombolysis or temporary vena cava filter, may be useful in certain circumstances.
    Annales francaises d'anesthesie et de reanimation 03/2013; · 0.77 Impact Factor
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    ABSTRACT: BACKGROUND:: Effective postoperative analgesia is essential for early rehabilitation after surgery. Continuous wound infiltration (CWI) of local anesthetics has been proposed as an alternative to epidural analgesia (EA) during colorectal surgery. This prospective, double-blind trial compared CWI and EA in patients undergoing elective open colorectal surgery. METHODS:: Fifty consecutive patients were randomized to receive EA or CWI for 48 h. In both groups, patients were managed according to Enhanced Recovery After Surgery recommendations. The primary outcome was the dynamic pain score measured during mobilization 24 h after surgery (H24) using a 100-mm verbal numerical scale. Secondary outcomes were time to functional recovery, analgesic technique-related side effects, and length of hospital stay. RESULTS:: Median postoperative dynamic pain score was lower in the EA than in the CWI group (10 [interquartile range: 1.6-20] vs. 37 [interquartile range: 30-49], P < 0.001) and remained lower until hospital discharge. The median times to return of gut function and tolerance of a normal, complete diet were shorter in the EA than in the CWI group (P < 0.01 each). Sleep quality was also better in the EA group, but there was no difference in urinary retention rate (P = 0.57). The median length of stay was lower in the EA than in the CWI group (4 [interquartile range: 3.4-5.3] days vs. 5.5 [interquartile range: 4.5-7] days; P = 0.006). CONCLUSION:: Within an Enhanced Recovery After Surgery program, EA provided quicker functional recovery than CWI and reduced length of hospital stay after open colorectal surgery.
    Anesthesiology 03/2013; 118(3):622-630. · 5.16 Impact Factor
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    ABSTRACT: BACKGROUND: This study was design to investigate the prognostic value for death at day-28 of lactate course and lactate clearance during the first 24 hours in Intensive Care Unit (ICU), after initial resuscitation. METHODS: Prospective, observational study in one surgical ICU in a university hospital. Ninety-four patients hospitalized in the ICU for severe sepsis or septic shock were included. In this septic cohort, we measured blood lactate concentration at ICU admission (H0) and at H6, H12, and H24. Lactate clearance was calculated as followed: [(lactateinitial - lactatedelayed)/ lactateinitial] x 100%]. RESULTS: The mean time between severe sepsis diagnosis and H0 (ICU admission) was 8.0 +/- 4.5 hours. Forty-two (45%) patients died at day 28. Lactate clearance was higher in survivors than in nonsurvivors patients for H0-H6 period (13 +/- 38% and -13 +/- 7% respectively, p = 0.021) and for the H0-H24 period (42 +/- 33% and -17 +/- 76% respectively, p < 0.001). The best predictor of death at day 28 was lactate clearance for the H0-H24 period (AUC = 0.791; 95% CI 0.6-0.85). Logistic regression found that H0-H24 lactate clearance was independently correlated to a survival status with a p = 0.047 [odds ratio = 0.35 (95% CI 0.01-0.76)]. CONCLUSIONS: During the first 24 hr in the ICU, lactate clearance was the best parameter associated with 28-day mortality rate in septic patients. Protocol of lactate clearance-directed therapy should be considered in septic patients, even after the golden hours.
    Annals of intensive care. 02/2013; 3(1):3.

Publication Stats

487 Citations
285.60 Total Impact Points

Institutions

  • 2005–2014
    • Paul Sabatier University - Toulouse III
      Tolosa de Llenguadoc, Midi-Pyrénées, France
    • Assistance Publique – Hôpitaux de Paris
      Lutetia Parisorum, Île-de-France, France
    • Université Paris 13 Nord
      Île-de-France, France
  • 2005–2013
    • University of Toulouse
      Tolosa de Llenguadoc, Midi-Pyrénées, France
  • 2005–2011
    • Centre Hospitalier Universitaire de Toulouse
      Tolosa de Llenguadoc, Midi-Pyrénées, France