Annales françaises d'anesthèsie et de rèanimation
-
Ann Fr Anesth Reanim · Jan 1995
Review Practice Guideline Guideline[French Society of Anesthesia and Intensive Care. Arterial catheterization and invasive measurement of blood pressure in anesthesia and intensive care in adults].
A group of 13 experts appointed by the French Society of Anaesthesia and Intensive Care has produced the following guidelines for arterial catheterisation and invasive measurement of systemic arterial blood pressure in adults. Teflon or polyurethane catheters are recommended with a maximal size of 18 gauge for femoral and axillary arteries and 20 gauge for the others. For small arteries (radial and pedious arteries) a maximal length of 3-5 cm should be preferred. ⋯ The catheter removal should be considered as an aseptic surgical procedure. The catheter completeness has to be checked. A systematic culture of the catheter is not required.
-
Ann Fr Anesth Reanim · Jan 1995
Review[High frequency jet ventilation combined with conventional mechanical ventilation in the treatment of adult respiratory distress syndrome].
Better understanding of the physiopathology of ventilatory mechanisms associated with ARDS and the recent re-evaluation of the iatrogenic potential of mechanical ventilation (MV) brings us closer to the best suited ventilatory mode for these patients. In severely ill ARDS patients, only a small lung volume is ventilated, and remains available for the totality of the gas exchanges (baby lung concept). The goal of MV is to restore and maintain an optimal exchange volume while limiting mechanical agression of the lung tissue. ⋯ Though HFV alone can maintain lung volumes oscillating around a mean value, it cannot re-expand atelectatic areas. The small VT's used are insufficient to overcome these area's elevated opening pressures. Volume recruitment by periodic hyperinflations, or sighs, though generally considered useless in conventional MV, have been shown to be of great benefit in HFV.(ABSTRACT TRUNCATED AT 400 WORDS)
-
Ann Fr Anesth Reanim · Jan 1995
Case Reports[Blood-patch treatment of headache occurring after post-dural puncture at the thoracic level].
A 23-year-old woman experienced headache following a high thoracic epidural analgesia to control postoperative pain after thoracoscopic treatment of a recurrent pneumothorax. On fourth postoperative day, a blood patch has been sited with 17 mL of autologous blood, injected into the thoracic epidural space at T1-T2 level, which was immediately effective. ⋯ The technique of thoracic blood patch is similar to the lumbar one, except some minor modifications. According to this case of a thoracic epidural blood patch which is seemingly the first one reported in the literature and our expertise with two other unpublished cases, a volume of 10 mL of blood may be sufficient and free of adverse effects.