Amniotic Fluid Embolism Coagulopathy Guided by the Point-of-Care Quantra QStat® Hemostasis System: A Case Report.

Amniotic fluid embolism (AFE) is a rare pregnancy complication associated with high maternal mortality that occurs during labor or in the early postpartum period. The diagnosis of AFE is challenging because signs and symptoms are common to other obstetric complications. Early identification and management of profound coagulopathy associated with AFE is essential to improve patient survival. We present a case of a 31-year-old woman with placenta previa and clinical suspicion of AFE after cesarean section. Immediately after delivery, the parturient presented hypotension, hypoxia, coagulopathy, and severe postpartum hemorrhage. We hereby discuss the role of the most recently developed point-of-care viscoelastic testing device, the Quantra QStat® system (Stago Group Company; HemoSonics LLC, Durham, NC), for early detection of acute obstetric coagulopathy and guided hemostatic treatment.

Performance of the extended use of the FilmArray® BCID panel kit for bronchoalveolar lavage analysis.

Ventilator-associated pneumonia (VAP) are responsible for an increase in morbidity, mortality, and prolonged hospital stay. A multiplex PCR kit such as the FilmArray® BCID panel could allow early adaptation of antimicrobial therapy, which is crucial for clinical outcomes. The purpose of this study was to test the performances of FilmArray® BCID panel for the detection of bacteria producing VAP. We tested the FilmArray® BCID panel on 50 bronchoalveolar lavages (BALs), from patients hospitalized in two intensive care units at the Angers university hospital, compared to the conventional culture-based method. The sensitivity and the specificity of the FilmArray® BCID panel were 67.2% and 98.9% respectively. They were 88.6% and 98.3% respectively when considering BALs with a positive culture > 104 CFU/mL, and 94.7% and 99.6% respectively if considering BALs with a positive direct examination. This study underlines the good performance of the FilmArray® BCID panel for BAL fluid analysis. In case of positive direct examination, this test allows reliable results that can be obtained at an early stage, facilitating the early adaptation of antimicrobial therapy.