[Blood transfusion on battlefield. The Kabul hospital experience]. / Transfusion sanguine en opération extérieure. Expérience à l'hôpital médico-chirurgical de Kaboul.

OBJECTIVES: Blood transfusion is an aspect of medical care on the battlefield. French assets include: red blood cell units (RBCu), lyophilized plasma (PLYO), fresh whole blood (FWB) but neither fresh-frozen plasma (FFP) nor platelets. French transfusion strategy in military operations follows the evolution of knowledge and resources. We describe the characteristics of the transfusion at the military hospital in Kabul. PATIENTS AND METHODS: Retrospective study of records of patients transfused between October 2010 to December 2011 conducted in Kabul from transfusion register. Variables studied were: patient characteristics, biology at admission, type and amount of transfusion products, evolution. RESULTS: One hundred and twenty-six patients were transfused: 49 military (39%) which 22 French soldier (17%), most of time afghan (n=97; 77%), mean age at 24 years old (3-66). Two hundred and seventy-three RBCu from France were transfused and 350 unused were destroyed. Conditions leading to a transfusion were: 76 war wounds (60%), 21 trauma (17%) and 29 other (23%). In the first 24 hours, patients received in mean: two RBCu (0-12), one unit of FWB (0-18) and two PLYO (0-14). PLYO/RBCu ratio was 1/1.6. A massive transfusion (more than 10 RBCu) concerned 9% of patients. Twenty-seven percent of patients received FWB. We note 17 dead people (13.5%). CONCLUSION: The use of the FWB and PLYO in substitution of FFP and platelets can provide cares of high quality in a logistically constrained context while controlling costs.

Images reproducibility of an electrical impedance tomography (EIT) prototype. Analysis of the EIT sensibility in rats in pathological in vivo conditions.

The development of a 16 electrode-electrical impedance tomography (EIT) prototype to be applied in neurological fields such as epilepsy in rats has been previously reported. Approaching residual problems in order to improve its performance, this work reports results about changes made in the system hardware as follows: 1) replacing the current source demultiplexing circuit that could impact on a better spatial localization, and 2) a new current source design that increases the current amplitude up to 5 mA/sub rms/. System was evaluated by means of: a) image reproducibility starting from 4 test elements in homogeneous conditions; and b) spatial localization evaluation in conductivity perturbation conditions; this feature is evaluated too in preliminary acute in vivo experiments where an epileptic seizure is induced, and an impedance increase is expected. Results show a 95% of proper images for a) analysis. Spatial localization reports improvement up to 20% transversely and 5.5% longitudinally with regard to previous results. In vivo results are lack of interpretation due poor changes obtained in images. In order to conclude or not a reliable correlation between the perturbation measured and the seizure activity, a new definition of grey scale or other changes could be proposed.