Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Apr 1999
[Severe head injuries: effects of pre-hospital mechanical ventilation on capnia].
To assess the effect on PaCO2 of mechanical ventilation during prehospital management of severely head-injured patients. ⋯ In 81% of patients, mechanical ventilation was inadequate as far as PaCO2 levels are concerned. Major hypocapnia and hypercapnia carry a potential risk for cerebral ischaemic. Therefore it is recommended to monitor PETCO2 during prehospital transport in medical ambulances and to determine arterial blood gases at arrival of severely head-injured patients in the admission unit for emergencies.
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Ann Fr Anesth Reanim · Apr 1999
Clinical Trial[Patient-controlled sedation with propofol for extracorporeal shock wave lithotripsy].
Evaluation of patient-controlled sedation with propofol for extracorporeal shock wave lithotripsy (ESWL) using an EDAP LT01 lithotriptor. ⋯ Patient-controlled sedation with propofol is a safe and efficient mode of administration of an hypnotic agent for ESWL.
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Ann Fr Anesth Reanim · Apr 1999
Clinical Trial[Intratracheal intubation without muscle relaxant with the use of remifentanil-propofol].
To assess tracheal intubation conditions after induction of anaesthesia with remifentanil and propofol, using itemized scoring criteria. ⋯ Induction of anaesthesia using remifentanil and propofol allows satisfactory tracheal intubation without a muscle relaxant. However this technique is contraindicated: a) in patients with a full stomach, as intubation is not always successful at the first attempt; b) in patients scheduled to undergo neurosurgery or ophthalmic surgery, as tracheal intubation may elicit cough, increasing intra-cranial and intra-ocular pressure; c) in patients in poor circulatory status, as it decreases significantly arterial pressure and heart rate.
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Ann Fr Anesth Reanim · Apr 1999
Case Reports[Severe lactic acidosis and thiamine deficiency during parenteral nutrition in a child].
We report the case of a leukemic child treated with chemotherapy and parenteral nutrition for three weeks, who developed a severe lactic acidosis. Clinical features included both digestive and neurological disorders associated with a moderate cardiovascular collapse. ⋯ The diagnosis was confirmed by a low plasmatic concentration of thiamin. Thiamin deficiency must be suspected in case of severe lactic acidosis during parenteral nutrition and systematically prevented by supply of vitamins.
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We report five cases of phaeochromocytoma in patients admitted for myocardial infarction, severe cardiac failure, with shock, stroke and ischaemic gangrene of a lower limb respectively. The pathophysiology of these events is discussed. Early surgery prevents visceral damage from massive release of catecholamines.