Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1998
[Halogenated anesthetic vaporizers: importance of maintenance regulations].
We report a serious dysfunction of 19 halothane vaporisers Vapor 19.3 (Dräger) which delivered a much higher concentration of agent than indicated on the dial. This inaccuracy was linked to a major corrosion of the inner layers of the vaporiser, with a deposit of zinc bromide and chloride in the bypass channel. The main cause for this dysfunction was the absence of an adequate maintenance of the vaporisers since their purchase 3 years before.
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Ann Fr Anesth Reanim · Jan 1998
-The effect of desflurane on cerebral blood flow velocity and cerebrovascular reactivity to CO2 in children-.
To assess in children with a transcranial Doppler the effect on cerebral blood flow velocities of desflurane, whose cerebral vasodilator effects have been studied in animals and in adults with intracranial lesions. ⋯ Desflurane elicits a dose-dependent increase in cerebral blood flow velocities and heart rate, but does not change mean arterial pressure, suggesting that its cerebrovascular action is independent of its systemic vascular action. CO2 reactivity is maintained at one MAC. The results in children are similar to those seen in adults.
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Ann Fr Anesth Reanim · Jan 1998
Case Reports[Intraoperative exchange of the endotracheal tube using the Cook C-CAE airway exchange catheter].
The Cook airway exchange catheter is mainly used in ICU patients to exchange endotracheal tubes. We report three cases where this device was used during anaesthesia in patients with damaged tubes in critical circumstances (oropharyngeal bleeding, head and neck surgery). It allowed a fast and atraumatic exchange of the tubes.
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A 20-year-old man was admitted after a traffic accident for a closed chest trauma. Initial evaluation showed a sternal fracture with a minor pneumomediastinum. Twenty-four hours later be experienced an acute respiratory failure, due to total left pulmonary atelectasis from indirect compression of the left main stem bronchus. ⋯ Oesophageal haematoma secondary to chest trauma is a rare injury, with around 10 cases reported in the literature. Compression of tracheobronchial axis is exceptional. Because of the delayed occurrence of such a complication after chest trauma, with sternal fracture, close clinical surveillance and CT scans are essential.