[Sedative practice in intensive care units: results of a Maghrebian survey]

sedation is central to the management of intensive care patients. The aim of this study was to establish the current sedation practice in Maghrebian intensive care units [ICUs]. The use of sedation policies with or without a written protocol. The use of scoring systems, the influence of costs on drug choice, the most common drugs for sedation and the use of neuromuscular blocking agents. A self-administered questionnaire composed of 20 items was sent to 138 intensivists in the Maghreb working in 25 teaching hospitals and 16 private clinics 50 of 138 questionnaires were returned [response rate = 36.2%]. Midazolam and Fentanyl were the sedative agents used [respectively 98% and 87%] less than 14% of the ICUs used the Propofol mainly in the first 48 hours. A sedation policy was adopted in 63.6% with a written protocol in 20% of cases. Sedation scoring systems were noted in 14.3% of cases [RAMSAY scale in 100%]. Economic aspect was important for 64.6% of ICUs. sedation may seem secondary in the initial management of intensive care patients,only 63% of our respondents had a sedation policy and 20% a written protocol though its use is thought to improve outcome and reduce costs. Economic aspect was important for the choice of the drug to use [64%], this may explain the preferential use of Midazolam 98% in association with an analgesic [Fentanyl: 85%] while Propofol is used only in 14% though pharmacoeconomic studies may be in fact in favor of the latter. Neuromuscular blocking agents are less frequently used [16%] mainly because of the risk of complications

Facteurs associees a la mortalite maternelle chez les preeclamptiques: a propos de 55 cas

Retrospective study about 55 preeclamptic parurients. Data was collected from the medical files of the patients hospitalized during two consecutive years. Admittance of preeclamptic women in the intensive care unit was 6,37% [55/689]. Mortality rate was 11% [6 deaths]. Complications associated with the maternal death were renal failure, disseminated intravascular coagulopathy and Hemorrhagic shock after subcapsular liver hematoma. Advanced maternal age is a factor associated to maternal mortality. All these risk factors of deaths may be avoided if adequate management is performed