Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1998
Comparative Study-Anesthesia and analgesia practice patterns in French obstetrical patients-.
To assess the rate of epidural analgesia (EA) for parturition and the techniques of anaesthesia for Caesarean section (CS). ⋯ In France in 1991, the average rate of 37.2% for EA for obstetrics was high when compared to the rate in United Kingdom. It was equivalent to those in United States and Ontario, Canada. The discrepancies between hospitals were mainly related to structural and organizational factors. The influence of the size of the maternity hospital, the 24-hour service of EA was also shown in other studies. However, the difference between GA and UH and PH is a French particularity. The high rate of GA for CS differs largely with those in the UK or the USA. The time saving aspect of GA was probably an important factor for the choice of this technique. This study must be reactualized and enlarged to determine the demand of EA for labour by parturients and obstetricians.
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Ann Fr Anesth Reanim · Jan 1998
Case Reports-Coagulopathy suggestive of a primary fibrinolysis after head injuries with brain death-.
Coagulopathies associated with severe head trauma are usually of disseminated intravascular coagulation type with secondary fibrinolysis. We report a case whose semeiology was in part suggestive of a primary fibrinolysis.
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To evaluate the incidence and the causes of early intra- and postoperative deaths in a multidisciplinary hospital. ⋯ In this survey, mortality due to anaesthesia was higher than the rates reported in other studies. Human error remained the main cause.
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Ann Fr Anesth Reanim · Jan 1998
[Pressure-controlled mechanical ventilation: a simplified titration method of the extrinsic positive expiratory pressure].
Extrinsic positive end-expiratory pressure (PEEPe) may improve gas distribution within the lungs, induce alveolar recruitment or, conversely, produce pulmonary overdistension, and modify the respiratory impedance. Under pressure-controlled mechanical ventilation (PCV) this phenomenon modifies the minute ventilation and the dynamic compliance of the respiratory system (Crs,dyn). This study was aimed to assess the incidence of a significant gain in Crs,dyn under the effect of PEEPe during PCV. ⋯ In 50% of the studied patients a significant gain in Crs,dyn was found, allowing a less traumatic PCV. These results suggest the clinical usefulness of this method of titration of PEEPe, which requires neither specific devices nor a disconnection of the patient.