Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 2002
Case Reports[Cardiac arrest in a traumatized child from an unusual cause: atlanto-occipital luxation].
We report the case of a trauma child who developed a cardiac arrest due to atlanto-occipital luxation of the cervical spine. The occurrence of a rapidly reversible cardiac arrest in a trauma patient should alert physicians about cervical trauma. ⋯ Thorough application of these resuscitation techniques should increase the survival rate on admission to trauma centres of paediatric patients presenting with such a severe condition. Nevertheless, atlanto-occipital luxation is a major cause of paediatric cervical trauma mortality and our patient did not survive this condition.
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Ann Fr Anesth Reanim · Jan 2002
Case Reports[Difficult intubation in patients with endotracheal prosthesis].
We report a case of two consecutive episodes of difficult intubation in a patient with an endotracheal Dumon's prosthesis inserted two years before. Despite several preanaesthetic visits and ENT examination, the absence of recollection by the patient and the lack of information in her previous medical records led to the impossibility to introduce a normal tube into her trachea during two consecutive anaesthetic procedures. This case points out the limits of preanaesthetic visits. It allows to remind special measures that must be taken in patients having tracheal prosthesis and scheduled for anaesthesia and surgery.
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Gas embolism at the end of infusion is a well known hazard, that should have disappeared with the use of flexible bags. However, some cases have been reported after pressure infusion. ⋯ However, to be on the safe side, the manufacturer recommends to expel any residual air before pressure administration. This recommendation applies to any bag containing residual air, and since many people are not aware of this, it is rarely put into practice.
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Ann Fr Anesth Reanim · Jan 2002
Case Reports[Antipublic antibodies and pregnancy: use of iron sucrose in autologous blood donation with cryopreservation].
An autologous blood donation with cryopreservation in a pregnant woman with natural antibody against a high frequency alloantigen is reported. A natural anti Gerbich antibody and a rare erythrocyte phenotype at high risk of polyimmunization was discovered during the third month of pregnancy. This leads to recommend the constitution of an autologous blood reserve. ⋯ Epidural analgesia was used for delivery. No haemorrhage occurred. The reserve was not used and remained available for future use (one year for fresh frozen plasma and without limit for red cells).
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We report the case of a parturient with a history of narcolepsy that delivered under epidural anaesthesia without any complication. Patients with narcolepsy might be at risk of delayed recovery or of apneic episodes after general anaesthesia while narcolepsy-cataplexy fits might be more frequent during regional anaesthesia. Avoiding sedative premedication and continuing medical therapy on the day of surgery are recommended to avoid these complications.