Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1997
Case Reports[Anuric renal insufficiency caused by bilateral ureteral lithiasis].
A 73-year-old man was admitted to the ICU for anuria. He reported no history of urinary disease. ⋯ Bilateral retrograde ureteroscopy and drainage allowed a rapid recovery. When the abdominal roentgenography and echography cannot explain the occurrence of anuria, the computed tomography, or better the helical CT, can demonstrate the presence of otherwise unrecognized calculi.
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Ann Fr Anesth Reanim · Jan 1997
[Anesthesia and intensive care of craniostenosis and craniofacial dysmorphism in children].
Craniosynostosis occurs in one out of 2,000 births. It results in primary skull deformations requiring surgical repair, in infants with a body weight of less than 10 kg. Pure craniosynostosis is the most frequent situation, where the risk for cerebral compression during brain development is the lowest. ⋯ With experienced teams, this high-risk surgery carries a low peroperative mortality (less than 1%) and morbidity rate. The latter includes essentially transient peroperative hypotension. The excellent final cosmetic and functional results justify the practice of this surgery in children with a bodyweight of less than 10 kg.
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Ann Fr Anesth Reanim · Jan 1997
[Interviews with families of organ donors: analysis of motivation for acceptance or refusal of donation].
The reasons for organ donation acceptance or refusal are still unclear. This study analysed the influence of the circumstances of the conversations with the relatives of brain dead patients on their consent for organ donation. ⋯ The circumstances of conversation with families play an essential role in their decision-making. A written guideline implementation for these conversations would probably be beneficial for the decisions of families in favour of organ donation.
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Ann Fr Anesth Reanim · Jan 1997
[Defective gas mixers, a cause of retro-pollution of medical gas distribution pipelines].
A defective Air/O2 mixer of a ventilator located downstream of the gas outlets of two pipelines is a potential cause of retropollution. Retropollution of O2 with Air or vice versa carries a risk of either a) a hypoxic gas mixture delivery during anaesthesia, including O2-N2O administration, when the O2 pipeline supplies Air instead of O2, or b) a hyperoxic gas mixture delivery in the intensive therapy unit for neonates during administration of a O2-Air mixture, when the Air pipeline supplies O2 instead of Air. A defective O2/N2O flowmeter-mixer of an anaesthesia machine, with N2O flow control by O2 through a differential pressure manometer, can cause retropollution of O2 supply pipeline with N2O or vice versa. ⋯ The mixer or flowmeter-mixer responsible for retropollution can be recognized in plunging successively the various quick couplers underwater into a glass, while the others remain connected to their outlets and the mixer set at a O2 concentration of 50 vol% or the flowmeters set at a similar flow. In case of retropollution, the gas reflow produces bubbles. It is recommended: a) in anaesthetic areas to set the O2 pressure at about 0.2 bar above that of Air and the latter at a pressure of about 0.2 bar above that of N2O; b) in intensive therapy units for neonates, to set the Air pressure at about 0.2 bar above that of O2; c) in all areas to disconnect from the gas outlets the devices equipped with a mixer or a flowmeter-mixer when not in use.
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Ann Fr Anesth Reanim · Jan 1997
Case Reports[Fatal hepatitis in a young child: probable role of halothane].
A 3-year-old boy, who underwent multiple anaesthetics including halothane in a short period of time, developed 3 days after the last operation abdominal pain, jaundice and fever. Laboratory tests showed hepatic failure, with cytolysis, cholestasis and eosinophilia. Tests for hepatitis A, B, C, CMV and EBV were negative. ⋯ Despite symptomatic treatment, the child died 5 days after the last anaesthetic. Post mortem liver biopsy showed massive hepatic necrosis. The authors discuss factors increasing the risk for halothane-hepatitis, especially multiple exposures.