<html><head><meta http-equiv="Content-Type" content="text/html charset=utf-8"></head><body style="word-wrap: break-word; -webkit-nbsp-mode: space; -webkit-line-break: after-white-space;"><div>VANCOMYCINE</div><div>De notre coté nous préférons un taux résiduel vallée de 20-30.</div><div><br></div><div>Nous tenons compte dans ce raisonnement de l’évolution des CMI des MRSE plus que de MRSA, de ce qui doit être couvert (diffusion de la vancomycine parfois faible dans certains tissus cfr premier travaux de banco continue pour couvrir le LCR dans les année 90, ), et bien entendu on peut discuter aussi l’aspect fraction libre en IRC Vd</div><div><br></div><div>Selon le type d’infection suspectée et probabilité nous faisons revenir le patient le lendemain pour une dose supplémentaire (car souvent la premier charge aura une vallée <20 (foi >10) dans les 24h). </div><div><br></div><div>En secteur HDc nous obtenons le dosage de la vancomycine en 1h.</div><div><br></div><div>Nous préconisons une pompe volumétrique par sécurité (éviter les flush et red man syndrome).</div><div><br></div><div>Si vous souhaitez quelques références je pense que mon collègue a fait récemment un travail sur le sujet en DP </div><div><br></div><div>HEPARINE:</div><div>idem, </div><div>nous avons également simplifié note protocole héparine avec un tableau poids/risque pour nos ordres aux infirmières.</div><div>Il faut rester clinique, hémostase oblige , dernièrement nous avons eu un accident hémorragique d’une patient qui répondait trop bien à (l’héparine), un bilan est en cours…</div><div><br></div><div><br></div><div><br></div><div><br></div><div>en ps mon mail hospitalier</div><div><br></div><div>Bien à vous</div><div>Dr Guillen A MA</div><div><br></div><div><br></div><div>PS</div><div><a href="mailto:Miguel-Ange.Guillen@EpiCURA.be">Miguel-Ange.Guillen@EpiCURA.be</a></div><br><div><div>Le 2 févr. 2016 à 17:19, BOUKELMOUNE MAKHLOUF <<a href="mailto:Makhlouf.Boukelmoune@ch-toulon.fr">Makhlouf.Boukelmoune@ch-toulon.fr</a>> a écrit :</div><br class="Apple-interchange-newline"><blockquote type="cite"><div style="margin-top: 0px; margin-bottom: 0px; font-family: Calibri, Arial, Helvetica, sans-serif; font-size: 16px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-text-stroke-width: 0px;"><br class="Apple-interchange-newline">Bonjour,</div><div style="margin-top: 0px; margin-bottom: 0px; font-family: Calibri, Arial, Helvetica, sans-serif; font-size: 16px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-text-stroke-width: 0px;"><br></div><div style="margin-top: 0px; margin-bottom: 0px; font-family: Calibri, Arial, Helvetica, sans-serif; font-size: 16px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-text-stroke-width: 0px;">Pour les antibiotiques , on a tendance parfois à négliger leur posologie par poids du patient. Le GPR recommande : une dose de charge initiale de 30 mg/kg et un entretien 10 mg/kg toutes les 48h avec un Tx résiduel à 10 - 20 mg/l.<br></div><div style="margin-top: 0px; margin-bottom: 0px; font-family: Calibri, Arial, Helvetica, sans-serif; font-size: 16px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-text-stroke-width: 0px;">Bien à vous.<br></div><div style="margin-top: 0px; margin-bottom: 0px; font-family: Calibri, Arial, Helvetica, sans-serif; font-size: 16px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-text-stroke-width: 0px;"><br></div><div style="margin-top: 0px; margin-bottom: 0px; font-family: Calibri, Arial, Helvetica, sans-serif; font-size: 16px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-text-stroke-width: 0px;"><br></div><div style="margin-top: 0px; margin-bottom: 0px; font-family: Calibri, Arial, Helvetica, sans-serif; font-size: 16px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-text-stroke-width: 0px;">Dr Boukelmoune.<br></div><div style="margin-top: 0px; margin-bottom: 0px; font-family: Calibri, Arial, Helvetica, sans-serif; font-size: 16px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-text-stroke-width: 0px;"><br></div><div style="margin-top: 0px; margin-bottom: 0px; font-family: Calibri, Arial, Helvetica, sans-serif; font-size: 16px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-text-stroke-width: 0px;">CH de Toulon<br></div><div style="font-family: Calibri, Arial, Helvetica, sans-serif; font-size: 16px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-text-stroke-width: 0px; color: rgb(33, 33, 33);"><hr tabindex="-1" style="display: inline-block; width: 635px;"><div id="divRplyFwdMsg" dir="ltr"><font face="Calibri, sans-serif" style="font-size: 11pt;"><b>De :</b><span class="Apple-converted-space"> </span>Renaliste <<a href="mailto:renaliste-bounces@nephrodial.org" style="color: rgb(149, 79, 114); text-decoration: underline;">renaliste-bounces@nephrodial.org</a>> de la part de Amar AMAOUCHE <<a href="mailto:aamaouche@aurar.fr" style="color: rgb(149, 79, 114); text-decoration: underline;">aamaouche@aurar.fr</a>><br><b>Envoyé :</b><span class="Apple-converted-space"> </span>mardi 2 février 2016 14:30<br><b>À :</b><span class="Apple-converted-space"> </span>'Liste des néphrologues francophones'<br><b>Objet :</b><span class="Apple-converted-space"> </span>Re: [Renaliste] Administration de la Vancomycine en hémodialyse et protocole d'anticoagulation chez le patient hémodialysé</font><div> </div></div><div><div class="Section1"><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="navy" face="Arial"><span style="font-size: 10pt; font-family: Arial; color: navy;">Bonjour</span></font></div><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="navy" face="Arial"><span style="font-size: 10pt; font-family: Arial; color: navy;"> </span></font></p><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="navy" face="Arial"><span style="font-size: 10pt; font-family: Arial; color: navy;">Pour la Vanco plutôt 1g/30mn après la séance de dialyse(reco. d’ICAR)</span></font></div><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="navy" face="Arial"><span style="font-size: 10pt; font-family: Arial; color: navy;"> </span></font></p><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="navy" face="Arial"><span style="font-size: 10pt; font-family: Arial; color: navy;">Pour l’heparine 25u/kg en dose de charge (bolus) puis 15 u/kg en entretien avec arret 30mn avant la fin de la séance</span></font></div><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="navy" face="Arial"><span style="font-size: 10pt; font-family: Arial; color: navy;"> </span></font></p><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="navy" face="Arial"><span style="font-size: 10pt; font-family: Arial; color: navy;">Cordialement</span></font></div><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="navy" face="Arial"><span style="font-size: 10pt; font-family: Arial; color: navy;">Amar Amaouche</span></font></div><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="navy" face="Arial"><span style="font-size: 10pt; font-family: Arial; color: navy;">Saint pierre</span></font></div><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="navy" face="Arial"><span style="font-size: 10pt; font-family: Arial; color: navy;"> </span></font></p><div><div style="margin-top: 0px; margin-bottom: 0px;"><font size="2" color="navy" face="Arial"><span style="font-size: 10pt; font-family: Arial; color: navy;">_______________________________</span></font><font color="navy"><span class="Apple-converted-space"> </span><br></font><font size="2" color="navy" face="Arial"><span style="font-size: 10pt; font-family: Arial; color: navy;">Dr Amar AMAOUCHE</span></font><font color="navy"><span class="Apple-converted-space"> </span><br></font><font size="2" color="navy" face="Arial"><span style="font-size: 10pt; font-family: Arial; color: navy;">AURAR PNS 1</span></font><font color="navy"><span class="Apple-converted-space"> </span><br></font><font size="2" color="navy" face="Arial"><span style="font-size: 10pt; font-family: Arial; color: navy;">15 rue des Roches</span></font><font color="navy"><span class="Apple-converted-space"> </span><br></font><font size="2" color="navy" face="Arial"><span style="font-size: 10pt; font-family: Arial; color: navy;">97410 SAINT PIERRE</span></font><font color="navy"><span class="Apple-converted-space"> </span><br></font><font size="2" color="navy" face="Arial"><span style="font-size: 10pt; font-family: Arial; color: navy;">Tél. 0262 54 99 40</span></font><font color="navy"><span class="Apple-converted-space"> </span><br></font><font size="2" color="navy" face="Arial"><span style="font-size: 10pt; font-family: Arial; color: navy;">Fax 0262 54 99 38</span></font><font color="navy"><span class="Apple-converted-space"> </span><br></font><font size="2" color="navy" face="Arial"><span style="font-size: 10pt; font-family: Arial; color: navy;">Portable : 0692 23 84 91</span></font><font color="navy"><span style="color: navy;"></span></font></div></div><div><div class="MsoNormal" align="center" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman'; text-align: center;"><font size="3" face="Times New Roman"><span style="font-size: 12pt;"><hr size="2" width="100%" align="center" tabindex="-1"></span></font></div><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><b><font size="2" face="Tahoma"><span style="font-size: 10pt; font-family: Tahoma; font-weight: bold;">De :</span></font></b><font size="2" face="Tahoma"><span style="font-size: 10pt; font-family: Tahoma;"><span class="Apple-converted-space"> </span>Renaliste [<a href="mailto:renaliste-bounces@nephrodial.org" style="color: rgb(149, 79, 114); text-decoration: underline;">mailto:renaliste-bounces@nephrodial.org</a>]<span class="Apple-converted-space"> </span><b><span style="font-weight: bold;">De la part de</span></b><span class="Apple-converted-space"> </span><a href="mailto:seigneuric.b@chu-toulouse.fr" style="color: rgb(149, 79, 114); text-decoration: underline;">seigneuric.b@chu-toulouse.fr</a><br><b><span style="font-weight: bold;">Envoyé :</span></b><span class="Apple-converted-space"> </span>mardi 2 février 2016 15:46<br><b><span style="font-weight: bold;">À :</span></b><span class="Apple-converted-space"> </span><a href="mailto:coulibaly1981@yahoo.fr" style="color: rgb(149, 79, 114); text-decoration: underline;">coulibaly1981@yahoo.fr</a>;<span class="Apple-converted-space"> </span><a href="mailto:renaliste@nephrodial.org" style="color: rgb(149, 79, 114); text-decoration: underline;">renaliste@nephrodial.org</a><br><b><span style="font-weight: bold;">Objet :</span></b><span class="Apple-converted-space"> </span>Re: [Renaliste] Administration de la Vancomycine en hémodialyse et protocole d'anticoagulation chez le patient hémodialysé</span></font></div></div><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="3" face="Times New Roman"><span style="font-size: 12pt;"> </span></font></p><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="#1f497d" face="Calibri"><span style="font-size: 11pt; font-family: Calibri; color: rgb(31, 73, 125);">Bonjour,</span></font></div><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="#1f497d" face="Calibri"><span style="font-size: 11pt; font-family: Calibri; color: rgb(31, 73, 125);"> </span></font></p><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="#1f497d" face="Calibri"><span style="font-size: 11pt; font-family: Calibri; color: rgb(31, 73, 125);">Concernant la vancomycine nous l’administrons à 1 g/H ; si la dose à administrer est supérieure à 1 g on prolonge sur 1H30 voire 2H en deuxième partie de séance.</span></font></div><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="#1f497d" face="Calibri"><span style="font-size: 11pt; font-family: Calibri; color: rgb(31, 73, 125);">Concernant l’HNF nous commençons par :</span></font></div><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="#1f497d" face="Calibri"><span style="font-size: 11pt; font-family: Calibri; color: rgb(31, 73, 125);">- une dose de charge au branchement : ½ mg/Kg avec 10 mg = 1000U soit 3000 U pour un sujet de 60Kg, puis</span></font></div><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="#1f497d" face="Calibri"><span style="font-size: 11pt; font-family: Calibri; color: rgb(31, 73, 125);">- une dose d’entretien de 333 à 666 U/ H d’héparine sur 3H30 lors d’une dialyse de 4H sur FAV et sur toute la séance pour un cathéter. On ne dépasse pas 999U/H.</span></font></div><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="#1f497d" face="Calibri"><span style="font-size: 11pt; font-family: Calibri; color: rgb(31, 73, 125);">On adapte secondairement les doses en fonction de l’état du rein et du patient.</span></font></div><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="#1f497d" face="Calibri"><span style="font-size: 11pt; font-family: Calibri; color: rgb(31, 73, 125);">Avec les bains au citrate la dose d’héparine a pu être baissée.</span></font></div><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="#1f497d" face="Calibri"><span style="font-size: 11pt; font-family: Calibri; color: rgb(31, 73, 125);"> </span></font></p><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="#1f497d" face="Calibri"><span style="font-size: 11pt; font-family: Calibri; color: rgb(31, 73, 125);">Cordialement</span></font></div><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="#1f497d" face="Calibri"><span style="font-size: 11pt; font-family: Calibri; color: rgb(31, 73, 125);"> </span></font></p><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="#1f497d" face="Calibri"><span style="font-size: 11pt; font-family: Calibri; color: rgb(31, 73, 125);"> </span></font></p><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="#1f497d" face="Times New Roman"><span style="font-size: 10pt; color: rgb(31, 73, 125);">Dr B. Seigneuric</span></font></div><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="#1f497d" face="Times New Roman"><span style="font-size: 10pt; color: rgb(31, 73, 125);">Praticien Hospitalier</span></font></div><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="#1f497d" face="Times New Roman"><span style="font-size: 10pt; color: rgb(31, 73, 125);">Département de Néphrologie, Dialyse et Transplantation d’Organes - Unité de Dialyse Périodique</span></font></div><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="#1f497d" face="Times New Roman"><span style="font-size: 10pt; color: rgb(31, 73, 125);">CHU Rangueil – Larrey</span></font></div><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="#1f497d" face="Times New Roman"><span style="font-size: 10pt; color: rgb(31, 73, 125);">31059 Toulouse Cedex 9</span></font></div><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="#1f497d" face="Times New Roman"><span style="font-size: 10pt; color: rgb(31, 73, 125);">Tel 05 67 77 18 90</span></font></div><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="#1f497d" face="Times New Roman"><span style="font-size: 10pt; color: rgb(31, 73, 125);">Fax 05 67 77 18 88</span></font></div><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="#1f497d" face="Calibri"><span style="font-size: 11pt; font-family: Calibri; color: rgb(31, 73, 125);"> </span></font></p><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="#1f497d" face="Calibri"><span style="font-size: 11pt; font-family: Calibri; color: rgb(31, 73, 125);"> </span></font></p><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="#1f497d" face="Calibri"><span style="font-size: 11pt; font-family: Calibri; color: rgb(31, 73, 125);"> </span></font></p><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="2" color="#1f497d" face="Calibri"><span style="font-size: 11pt; font-family: Calibri; color: rgb(31, 73, 125);"> </span></font></p><div><div style="border-style: solid none none; border-top-color: rgb(225, 225, 225); border-top-width: 1pt; padding: 3pt 0cm 0cm;"><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><b><font size="2" face="Calibri"><span style="font-size: 11pt; font-family: Calibri; font-weight: bold;">De :</span></font></b><font size="2" face="Calibri"><span style="font-size: 11pt; font-family: Calibri;"><span class="Apple-converted-space"> </span>Renaliste [<a href="mailto:renaliste-bounces@nephrodial.org" style="color: rgb(149, 79, 114); text-decoration: underline;">mailto:renaliste-bounces@nephrodial.org</a>]<span class="Apple-converted-space"> </span><b><span style="font-weight: bold;">De la part de</span></b><span class="Apple-converted-space"> </span>moussa coulibaly<br><b><span style="font-weight: bold;">Envoyé :</span></b><span class="Apple-converted-space"> </span>mardi 2 février 2016 11:16<br><b><span style="font-weight: bold;">À :</span></b><span class="Apple-converted-space"> </span>Liste des néphrologues francophones<br><b><span style="font-weight: bold;">Objet :</span></b><span class="Apple-converted-space"> </span>[Renaliste] Administration de la Vancomycine en hémodialyse et protocole d'anticoagulation chez le patient hémodialysé</span></font></div></div></div><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="3" face="Times New Roman"><span style="font-size: 12pt;"> </span></font></p><div><div id="yui_3_16_0_1_1454407169002_5400"><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman'; background-color: white;"><font size="1" face="Helvetica"><span style="font-size: 9pt; font-family: Helvetica;">Bonjour,</span></font></div></div><div id="yui_3_16_0_1_1454407169002_5402"><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman'; background-color: white; background-position: initial initial; background-repeat: initial initial;"><font size="1" face="Helvetica"><span style="font-size: 9pt; font-family: Helvetica;"> </span></font></p></div><div id="yui_3_16_0_1_1454407169002_5380"><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman'; background-color: white;"><font size="1" face="Helvetica"><span style="font-size: 9pt; font-family: Helvetica;">J'ai deux questions concernant l'administration de la vancomycine chez le patient hémodialysé et l'héparine en continue chez les patients hémodialysés</span></font></div></div><div id="yui_3_16_0_1_1454407169002_5379"><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman'; background-color: white;"><font size="1" face="Helvetica"><span style="font-size: 9pt; font-family: Helvetica;">qui ont un risque hémorragique et de coagulation du circuit.</span></font></div></div><div id="yui_3_16_0_1_1454407169002_5417"><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman'; background-color: white;"><font size="1" face="Helvetica"><span style="font-size: 9pt; font-family: Helvetica;">J'ai eu toujours l'habitude d'administrer la Vancomycine sur la dernière heure de dialyse. Avez vous d'autres habitudes?</span></font></div></div><div id="yui_3_16_0_1_1454407169002_5378"><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman'; background-color: white;"><font size="1" face="Helvetica"><span style="font-size: 9pt; font-family: Helvetica;">Concernant l'héparine, j'applique le protocole suivant : 25 UI/kg/h la première heure de dialyse puis 12.5 UI/kg/h la 2ème et 3ème heure de dialyse puis j'arrête la dernière heure de dialyse. Avez vous d'autres façons de faire en dehors de l'utilisation des membranes héparinées.</span></font></div></div><div id="yui_3_16_0_1_1454407169002_5416"><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman'; background-color: white; background-position: initial initial; background-repeat: initial initial;"><font size="1" face="Helvetica"><span style="font-size: 9pt; font-family: Helvetica;"> </span></font></p></div><div id="yui_3_16_0_1_1454407169002_5452"><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman'; background-color: white;"><font size="1" face="Helvetica"><span style="font-size: 9pt; font-family: Helvetica;">Merci</span></font></div></div><div id="yui_3_16_0_1_1454407169002_5451"><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman'; background-color: white; background-position: initial initial; background-repeat: initial initial;"><font size="1" face="Helvetica"><span style="font-size: 9pt; font-family: Helvetica;"> </span></font></p></div><div id="yui_3_16_0_1_1454407169002_5410"><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman'; background-color: white;"><font size="1" face="Helvetica"><span style="font-size: 9pt; font-family: Helvetica;">Dr COULIBALY Moussa</span></font></div></div><div id="yui_3_16_0_1_1454407169002_5408"><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman'; background-color: white;"><font size="1" face="Helvetica"><span style="font-size: 9pt; font-family: Helvetica;">Centre Hospitalier d'Agen</span></font></div></div><div id="yui_3_16_0_1_1454407169002_5409"><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman'; background-color: white; background-position: initial initial; background-repeat: initial initial;"><font size="1" face="Helvetica"><span style="font-size: 9pt; font-family: Helvetica;"> </span></font></p></div></div><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="3" face="Times New Roman"><span style="font-size: 12pt;"> </span></font></p><div class="MsoNormal" align="center" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman'; text-align: center;"><font size="3" face="Times New Roman"><span style="font-size: 12pt;"><hr size="2" width="100%" align="center"></span></font></div><div style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: 'Times New Roman';"><font size="1" color="gray" face="Arial"><span style="font-size: 7.5pt; font-family: Arial; color: gray;"><br>Ce message et les éventuelles pièces jointes sont confidentiels et peuvent être protégés par la loi. 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