S. Rousseau

Assistance Publique Hôpitaux de Marseille, Marsiglia, Provence-Alpes-Côte d'Azur, France

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Publications (13)19.27 Total impact

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    ABSTRACT: In a prospective, double blind, and randomized study, we compared methylprednisolone and ketoprofen after anesthesia for multiple third molar extraction. In addition to paracetamol, 90 patients were allocated to receive intravenously either ketoprofen 100 mg or methylprednisolone 1 mg/kg. Severity of pain was measured with visual analogue scale (VAS) in recovery room. Sixty-three percent of patients receiving methylprednisolone had a VAS score <30 mm compared with 42% of those receiving ketoprofen (P = 0.04), with no difference in the consumption of morphine. We observed only marginal difference between methylprednisolone and ketoprofen to relieve pain after this surgery.
    Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 01/2007; 103(1):e7-9. · 1.50 Impact Factor
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    ABSTRACT: Vasopressin (antidiuretic hormone) is emerging as a potentially major advance in the treatment of septic shock. Terlipressin (tricyl-lysine-vasopressin) is the synthetic, long-acting analogue of vasopressin, and has comparable pharmacodynamic but different pharmacokinetic properties. Vasopressin mediates vasoconstriction via V1 receptor activation on vascular smooth muscle. Septic shock first causes a transient early increase in blood vasopressin concentrations; these concentrations subsequently decrease to very low levels as compared with those observed with other causes of hypotension. Infusions of 0.01-0.04 U/min vasopressin in septic shock patients increase plasma vasopressin concentrations. This increase is associated with reduced need for other vasopressors. Vasopressin has been shown to result in greater blood flow diversion from nonvital to vital organ beds compared with adrenaline (epinephrine). Of concern is a constant decrease in cardiac output and oxygen delivery, the consequences of which in terms of development of multiple organ failure are not yet known. Terlipressin (one or two boluses of 1 mg) has similar effects, but this drug has been used in far fewer patients. Large randomized clinical trials should be conducted to establish the utility of these drugs as therapeutic agents in patients with septic shock.
    Critical care (London, England) 05/2005; 9(2):212-22. · 4.72 Impact Factor
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    ABSTRACT: The target blood concentrations of propofol and remifentanil, when used in combination, required to blunt the cough response to tracheal intubation, cuff inflation, and tracheal suctioning without neuromuscular blocking agents are not known. In a randomized prospective study, 81 patients were enrolled to determine which of three target remifentanil blood concentrations was required to blunt coughing during intubation, cuff inflation, and tracheal suctioning. Anaesthesia was achieved with propofol at a steady effect-site concentration of 3.5 microg ml(-1). The target blood remifentanil concentrations were 5, 10, or 15 ng ml(-1). These concentrations were maintained for 12 min before intubation. There was no cough response to intubation in more than 74% of patients and no significant difference in the incidence of coughing with intubation between the three groups. Significant difference in coughing, diminishing with increasing remifentanil target concentration, was observed with cuff inflation (P=0.04) and tracheal suctioning (P=0.007). Bradycardia and hypotension was more frequent with the remifentanil target concentration of 15 ng ml(-1). Tracheal suctioning resulted in more coughing than intubation (P=0.01) or cuff inflation (P=0.004). Target remifentanil blood concentrations of 5, 10, and 15 ng ml(-1) associated with a 3.5 microg ml(-1) propofol target blood concentration provided good intubating conditions and absence of cough about 75% of the time. Higher target remifentanil concentrations were associated with less coughing during tracheal tube cuff inflation and tracheal suctioning.
    BJA British Journal of Anaesthesia 12/2004; 93(5):660-3. · 4.24 Impact Factor
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    ABSTRACT: To analyze the data from the literature on erythropoietin and the future indications of recombinant human erythropoietin in intensive care unit (ICU) patients. References were obtained from computerized bibliographic research (Pubmed) from 1986 to 2003, except for some physiologic data. Original articles, reviews, and letters to editor in French and English were selected and analyzed. An anemia is often observed in patients hospitalized in ICU. This anemia may be due to many reasons. The management of anemia consists on the treatment of the underlying disease associated with the transfusion of red blood cells. Recent studies provided evidence of an association between transfusions and mortality in ICU patients. The anemia of ICU patients is compared to the anemia of chronic diseases, which is characterized by a blunted erythropoietin. A treatment with rHuEPO may be a future therapeutic of the anemia in such patients. A multicentric study shows the efficacy of recombinant erythropoietin therapy on a decrease in the use of red blood cell, and another clinical trial highlights a decrease of the proportion of ICU patients receiving red blood cell. Recombinant erythropoietin could be an alternative to transfusion in certain conditions and certain ICU patients. Further studies are needed to determine the consequences on mortality rate and to clarify the place of this therapy in ICU patients.
    Annales Françaises d Anesthésie et de Réanimation 08/2004; 23(7):714-21. · 0.84 Impact Factor
  • European Journal of Anaesthesiology - EUR J ANAESTH. 01/2004; 21.
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    ABSTRACT: Objective. – To analyze the data from the literature on erythropoietin and the future indications of recombinant human erythropoietin in intensive care unit (ICU) patients.Data source. – References were obtained from computerized bibliographic research (Pubmed®) from 1986 to 2003, except for some physiologic data.Data selection. – Original articles, reviews, and letters to editor in French and English were selected and analyzed.Data synthesis. – An anemia is often observed in patients hospitalized in ICU. This anemia may be due to many reasons. The management of anemia consists on the treatment of the underlying disease associated with the transfusion of red blood cells. Recent studies provided evidence of an association between transfusions and mortality in ICU patients. The anemia of ICU patients is compared to the anemia of chronic diseases, which is characterized by a blunted erythropoietin. A treatment with rHuEPO may be a future therapeutic of the anemia in such patients. A multicentric study shows the efficacy of recombinant erythropoietin therapy on a decrease in the use of red blood cell, and another clinical trial highlights a decrease of the proportion of ICU patients receiving red blood cell. Recombinant erythropoietin could be an alternative to transfusion in certain conditions and certain ICU patients. Further studies are needed to determine the consequences on mortality rate and to clarify the place of this therapy in ICU patients.
    Annales Francaises D Anesthesie Et De Reanimation - ANN FR ANESTH REANIM. 01/2004; 23(7):714-721.
  • European Journal of Anaesthesiology - EUR J ANAESTH. 01/2004; 21.
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    ABSTRACT: To evaluate the impact on morbidity and mortality of pulmonary contusion in multiple-trauma patients with severe head trauma. Matched-paired, case-control study ICU at a tertiary university hospital. During a 3-year period, 313 consecutive multiple-trauma patients with severe head trauma (Glasgow coma scale [GCS], </= 8) who were admitted to the ICU. Case-control matching criteria were as follows: (1) age difference within 5 years; (2) sex; (3) GCS in two categories; (4) similar pattern of injury; and (5) simplified acute physiology score II in five categories. A pulmonary contusion, defined by the clinical context and the result of a chest CT scan, was diagnosed in 90 patients. Analysis was performed on 90 pairs who were matched with 100% success. Ninety patients (29%) presented a diagnosis of pulmonary contusion. The presence of pulmonary contusion had an impact on the PaO(2)/fraction of inspired oxygen (FIO(2)) ratio, which was significantly reduced in patients with a pulmonary contusion. The ICU stay, the occurrence of complications such as nosocomial pneumonia or ARDS, the Glasgow outcome scale, and the mortality rate did not significantly differ between case patients and control subjects. Mortality also was not affected when patients were stratified according to the severity of the PaO(2)/FIO(2) ratio. In the study patients, pulmonary contusion alters gas exchange but does not appear to increase the morbidity and mortality of multiple-trauma patients with head trauma. A sample-size effect may limit the interpretation of the study.
    Chest 01/2004; 124(6):2261-6. · 7.13 Impact Factor
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    ABSTRACT: Vasopressin (antidiuretic hormone) is emerging as a potentially major advancement in the treatment of septic shock. Vasopressin is both a vasopressor and an antidiuretic hormone. It also has haemostatic, gastrointestinal, and thermoregulatory effects. This article reviews the physiology of vasopressin and all the relevant clinical literature on its use in the treatment of septic shock. Extraction from Pubmed database of French and English articles on the physiology and clinical use of vasopressin. The following key words were selected: vasodilatory shock, vasopressin, septic shock, catecholamines, norepinephrine, renal function, diuresis, mesenteric haemodynamic. The collected articles were reviewed and selected according to their quality and originality. Vasopressin mediates vasoconstriction via V1-receptor activation on vascular smooth muscle. Septic shock causes first a transient early increase in blood vasopressin concentrations that decreases later to very low concentrations compared to other causes of hypotension. Vasopressin infusion of 0.01-0.04 U min(-1) in septic shock patients increases plasma vasopressin concentrations. This increase is associated with a lesser need for other vasopressors. Vasopressin has been shown to produce greater blood flow diversion from non-vital to vital organ beds than does adrenaline. A large randomized clinical trial should be performed to assess its place as a therapeutic agent of septic shock patient.
    Annales Françaises d Anesthésie et de Réanimation 08/2003; 22(7):600-8. · 0.84 Impact Factor
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    ABSTRACT: Objective. – Vasopressin (antidiuretic hormone) is emerging as a potentially major advancement in the treatment of septic shock. Vasopressin is both a vasopressor and an antidiuretic hormone. It also has haemostatic, gastrointestinal, and thermoregulatory effects. This article reviews the physiology of vasopressin and all the relevant clinical literature on its use in the treatment of septic shock.Data sources and extraction. – Extraction from Pubmed database of French and English articles on the physiology and clinical use of vasopressin. The following key words were selected: vasodilatory shock, vasopressin, septic shock, catecholamines, norepinephrine, renal function, diuresis, mesenteric haemodynamic. The collected articles were reviewed and selected according to their quality and originality.Data synthesis. – Vasopressin mediates vasoconstriction via V1–receptor activation on vascular smooth muscle. Septic shock causes first a transient early increase in blood vasopressin concentrations that decreases later to very low concentrations compared to other causes of hypotension. Vasopressin infusion of 0.01–0.04 U min–1 in septic shock patients increases plasma vasopressin concentrations. This increase is associated with a lesser need for other vasopressors. Vasopressin has been shown to produce greater blood flow diversion from non-vital to vital organ beds than does adrenaline. A large randomized clinical trial should be performed to assess its place as a therapeutic agent of septic shock patient.
    Annales Francaises D Anesthesie Et De Reanimation - ANN FR ANESTH REANIM. 01/2003; 22(7):600-608.
  • M. Léone, S. Rousseau, C. Martin
  • S. Rousseau, M. Leone, C. Martin
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    ABSTRACT: La chirurgia delle paratiroidi è generalmente quella degli iperparatiroidismi. I pazienti e la gravità della malattia sottostante sono molto variabili. I progressi effettuati nello screening e nello sviluppo di tecniche chirurgiche meno invasive hanno radicalmente modificato la gestione degli iperparatiroidismi primitivi: la chirurgia si indirizza sempre più a pazienti asintomatici o paucisintomatici. Ciononostante, l’iperparatiroidismo e le sue conseguenze sull’equilibrio fosfocalcico, nonché le patologie spesso associate (diabete, insufficienza renale cronica), possono mettere in gioco la prognosi quoad vitam.
    EMC - Anestesia-Rianimazione. 14(4):1–9.
  • S. Rousseau, M. Leone, C. Martin
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    ABSTRACT: En general, la cirugía de las glándulas paratiroideas se practica en los hiperparatiroidismos. El tipo de paciente y la gravedad de la enfermedad subyacente son muy variables. Los progresos realizados en cuanto al diagnóstico, así como el desarrollo de técnicas quirúrgicas menos invasivas, han modificado radicalmente el tratamiento de los hiperparatiroidismos primarios: la cirugía está indicada cada vez más en los pacientes asintomáticos o paucisintomáticos. Sin embargo, el hiperparatiroidismo y sus consecuencias sobre el equilibrio fosfocálcico, así como las enfermedades que a menudo se asocian (diabetes, insuficiencia renal crónica), pueden comprometer el pronóstico vital.
    EMC - Anestesia-Reanimación. 36(1):1–10.