[Use of platelet concentrates: a regional experience]. / Utilisation des concentrés plaquettaires : expérience d'une région.

PURPOSE OF THE STUDY: The Établissement français du sang (EFS) distributes two types of platelet concentrates: using a single donor in aphaeresis platelet concentrate (SDAP), versus pooled platelet concentrates (PPC). A retrospective study performed by the Blood Derivatives Group at Observatory for Drugs, Medical Devices and Therapeutic Innovations (OMEDIT), in collaboration with EFS and haemovigilance correspondents from eight regional health care establishments, has analyzed platelet concentrates prescriptions and the position of the prescribers concerning PPC supply. MATERIAL AND METHODS: Between the 2nd and 6th June 2008, 151 platelet concentrates were supplied by ESF. Data were collected for 144 platelet concentrates and in 83 transfused patients with an average age of 50years. During this study, 33 PPC (23%) and 111 SDAP (77%) were supplied. RESULTS: With regards to the 111 SDAP, the supply of PPC was refused in 47 cases (42%), accepted in 18 cases (16%) and unknown for 46 cases (42%). A total of 51 PPC could be supplied during this period, which represented 35% of platelet concentrates prescriptions. The rate of platelets before transfusion was known for 121 platelet concentrates, the median was 32G·L(-1) for SDAP and 44G·L(-1) for PPC. CONCLUSION: More frequent PPC use, with comparable therapeutic efficacy, could be interesting in a context of increasing platelet concentrates consumption in health care establishments. Moreover, prescribers did not seem to be against the idea. An information pamphlet on platelet concentrates was drafted and distributed to prescribers in order to promote the prescription of PPC. A second assessment is planned to measure the impact of this communication.

[Retrograde cerebral perfusion for replacement of the aortic arch. Apropos of a case]. / Perfusion cérébrale rétrograde pour remplacement de la crosse aortique. A propos d'un cas.

The authors report a case of cerebral protection with retrograde cerebral perfusion during aortic arch surgery. The duration of retrograde cerebral perfusion and the favorable neurological outcome seem to confirm the promising results of this technique developed in Japan.

[Long-term retrograde cerebral perfusion in surgery of the aortic arch. Apropos of 2 cases]. / Perfusion cérébrale rétrograde de longue durée dans la chirurgie de la crosse aortique. A propos de deux cas.

The authors present two cases of aortic arch replacement for aortic dissection: one in a male patient 58 years old and the other in a female patient 78 years old. Cerebral protection during repair of the aortic arch was performed with retrograde cerebral perfusion (RCP). Durations of RCP were 75 and 120 minutes respectively. Good neurological recovery in both patients appeared to confirm the efficacy of RCP with respect to cerebral protection during surgery of the aortic arch.