Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Nov 2001
Case Reports[A case of hepatic pseudoaneurysm treated with percutaneous embolization in a child with multiple trauma].
Hepatic artery pseudoaneurysms are rare complications of blunt abdominal trauma in children. Diagnosis is frequently delayed and made by splanchnic angiography. Most of the indications for surgical treatment have disappeared after the development of selective catheterization and embolization. ⋯ A direct percutaneous puncture and embolization of the aneurysm allowed a complete exclusion of the lesion. Eventually, recovery was complete. This percutaneous technique could be a valuable alternative to classical embolization and could avoid surgical treatment that still carries a high morbidity.
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Ann Fr Anesth Reanim · Nov 2001
[Rational choice, prediction, and medical decision. Contribution of severity scores].
The aim of this study was to determine what type of representation the medical doctor adopted concerning the uncertainty about the future in critically ill patients in the context of preoperative evaluation and intensive care medicine and to explore through the representation of the patient health status the different possibilities of choice he was able to make. The role played by the severity classification systems in the process of medical decision-making under probabilistic uncertainty was assessed according to the theories of rational behaviour. In this context, a medical rationality needed to be discovered, going beyond the instrumental status of the objective and/or subjective constructions of rational choice theories and reaching a dimension where means and expected ends could be included.
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Ann Fr Anesth Reanim · Nov 2001
Case Reports[Thigh cellulitis: atypical presentation of intra-abdominal infection].
The initial clinical presentation of intraabdominal disease can be an extraabdominal location. We report three cases of patients admitted to our intensive care unit because of a severe soft tissue infection of the lower extremity. ⋯ Despite an unusual presentation, a high index of suspicion for lower intestine perforation must always be considered in face of a patient presenting with a spontaneous thigh cellulitis. Immediate radical debridement, appropriate antibiotics, and intensive care support are critical to control these life-threatening infections.
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Ann Fr Anesth Reanim · Nov 2001
Letter Randomized Controlled Trial Clinical Trial[Audit of the management of postoperative pain in children].
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Ann Fr Anesth Reanim · Nov 2001
Case Reports[Extracorporeal circulation with danaparoid sodium for valve replacement in thrombocytopenia induced by type II heparin].
A type II heparin-induced thrombocytopenia (HIT) was diagnosed in a 64-year-old woman at day 20 of intravenous unfractionated heparin (UFH) therapy, given after myocardial infarction treated by angioplasty and intracoronary stent. The infarction was complicated by a mitral insufficiency that led to a mitral valve replacement. Cardiopulmonary bypass was successfully performed with sodium danaparoid (Orgaran), as an alternative to UFH, without thrombotic or haemorrhagic complications and the follow-up was uneventful.