Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Feb 1999
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial[Phare study. Comparative study of combined cefepime-amikacin versus ceftazidime combined with amikacin in the treatment of nosocomial pneumonias in ventilated patients. Multicenter group study].
To compare the associations of cefepime (2 g x 2/day) + amikacin (7.5 mg.kg-1 x 2/day) (= cefe-ami) and ceftazidime (2 g x 3/day) + amikacin (7.5 mg.kg-1 x 2/day) (= cefta-ami) in patients under mechanical ventilation suffering from a nosocomial pneumonia. ⋯ The efficacy rates of cefe-ami and cefta-ami combinations were similar in ICU patients under mechanical ventilation with a nosocomial pneumonia. However the cefe-ami association was significantly more efficient in the population with a bacteriologically documented pneumonia.
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Ann Fr Anesth Reanim · Feb 1999
Review[Cellular energy metabolism: physiologic and pathologic aspects].
Cellular homeostasis requires permanent energy production and consumption. Adenosine triphosphate (ATP) is the major energy component for the cell. Its synthesis occurs mainly in mitochondria where the oxidative phosphorylations realise the coupling between oxygen consumption and phosphorylation of adenosine diphosphate. ⋯ Such effects could be associated with toxic effects of these molecules. NMR or near-infrared spectroscopy are non invasive techniques for monitoring energetic metabolism in vivo. Clinical applications are developed for analysing brain, muscle or cardiac function in physiological and pathological conditions.
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Ann Fr Anesth Reanim · Feb 1999
Case Reports[Effect of inhaled nitric oxide in a patient with intracranial hypertension].
Inhaled nitric oxide (NO) may be beneficial in patients with acute respiratory distress syndrome (ARDS). The effects of inhaled NO on intracranial pressure have not yet been assessed. This case shows the beneficial effects of inhaled NO in a patient with ARDS and intracranial hypertension.
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Accessory or ancillary anaesthesia breathing systems can be defined as all those connected to the fresh gas outlet of the anaesthetic apparatus and used instead of the circle system associated with the ventilator, which is the main circuit. They include: the Mapleson systems, the systems with a nonrebreathing valve and the disposable systems with a carbon dioxide absorber. They can be a cause of major accidents when not checked before and monitored during use. This technical note describes techniques of preanaesthetic checking and monitoring during anaesthesia.
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Ann Fr Anesth Reanim · Feb 1999
[The Medical Device Surveillance Central Commission. Evaluation and perspectives].
In France, a national surveillance commission for medical devices ("Commission de Matériovigilance") functions to a) analyse declarations of incidents/accidents occurring or liable to occur with medical devices; b) propose preventive measures; c) propose surveys or studies concerning the practice of materiovigilance. One of the eight sub-commissions is in charge of the problems raised by devices used in anaesthesia and intensive therapy. The commission considered 406 alarm forms in 1996, 986 in 1997 and 1,200 were expected to arrive in 1998. ⋯ Among the 624 fully processed "alarm forms", at the time of writing this article, 407 (65%) were incidents without or only with minor consequences, 206 (33%) were significant accidents and 11 (2%) were associated with a lethal outcome. Non compliance with the instructions for use and a failure of the device were the main causes for incidents/accidents. Major corrective measures were mainly taken for misconceptions and quality insurance in production of the devices.