Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Oct 2003
Review[Activation of adhesion molecules in patients with septic shock].
To analyze the pattern of adhesion molecules in patients with septic shock. Data sources. - References obtained from Pubmed databank. ⋯ The endothelium has been identified as the central effector in the inflammatory response. Adhesion molecules are strongly involved in the inflammatory process by modulating the leukocyte trafficking. The most important adhesion molecules are the selectins (E-, L-, and P-selectins) and members of the immunoglobulin superfamily (intercellular adhesion molecule-1 and vascular cell adhesion molecule-1). Plasma levels of these molecules are increased in septic shock patients, which may be related to a marked activation of the endothelium. However, a dichotomous profile is observed between plasma and tissue expression. The inhibition of adhesive molecule actions could make it possible to control the inflammatory response.
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Ann Fr Anesth Reanim · Oct 2003
Comparative Study Clinical Trial[Impact of 2 strategies of analgesia on postoperative pain after emergency hand surgery performed on an ambulatory basis].
The assessment of the impact of various analgesic regimens on postoperative pain at home, following emergency and ambulatory hand surgery. ⋯ Multimodal analgesic regimens are more effective than free prescriptions. This study underlines the need to further educate surgeons in this area. Despite these written protocols, there remains a 21% incidence of pain at home on day one.
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Ann Fr Anesth Reanim · Oct 2003
[Prospective assessment of information programme for blood transfusion in critical care patients].
Assessment of oral and written information programme for blood transfusion in critical care patients and study of factors associated with the biological follow-up. ⋯ Biological follow-up was obtained for only one third of blood recipients, because, in first, only 64% of critical care patients remembered oral information, particularly the younger patients. Perhaps, written information systematically given to the patient could permit a high biological follow-up. This study confirmed the lack of sensitivity of all hospital physician for haemovigilance.
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Ann Fr Anesth Reanim · Oct 2003
Clinical Trial[Postoperative nausea and vomiting: cost and advantage induced by a quality insurance programme. Part I: post anaesthesia care unit].
To report the efficiency and direct cost induced by a quality insurance programme (QIP) aimed to reduce the incidence of post-operative nausea and vomiting (PONV) in the post-anaesthesia care unit. ⋯ Despite an increase in the individual cost of PONV prophylaxis, the selection of patients by a "home" score of risk limits the indications of prophylactic treatment. Thus the increase in cost remains in acceptable ranges.
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Ann Fr Anesth Reanim · Oct 2003
Clinical Trial[Starting experience with non-invasive ventilation in paediatric intensive care unit].
Non-invasive ventilation in pressure support (NIV) is well described in the adult and child over 5 years. However, its use in children less than 1 year of age remains anecdotal. ⋯ The use of NIV resulted in a significant decrease of both the respiratory rate (from 53 to 39 breaths per min, p < 0.01) and the PvCO(2) (from 9.33 to 6.28 kPa, p < 0.01). These results show that NIV can be used in children under 1 year of age with improvement of physiological parameters.