Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 2003
Randomized Controlled Trial Comparative Study Clinical Trial[Effects of equiosmolar load of 20% mannitol, 7.5% saline and 0.9% saline on plasma osmolarity, haemodynamics and plasma concentrations of electrolytes].
Mannitol 20% (M) and NaCl 7.5% (H) are hypertonic solutions used in-patient in hypovolaemic shock and in case of increased ICP. To our knowledge no study in humans compared them in an equiosmolar load. The objectives of this study were to compare the pharmacokinetics of both solutions in an equiosmolar load with an isotonic solution (NaCl 0.9% (C)) in terms of osmolarity, electrolytes and haemodynamic parameters over time. ⋯ A single infusion of 4.95 mOsm kg(-1) of mannitol 20% or NaCl 7.5% induces a similar osmolar variation over time with a maximal effect after 10 min.
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Ann Fr Anesth Reanim · Jan 2003
Case Reports[Allergy investigations after two cases of adverse reactions to a neuromuscular blocking agent and management for subsequent general anaesthesia].
We report two cases of severe anaphylactic reactions to rocuronium. Diagnosis was confirmed by skin tests and specific IgE assay. ⋯ Intradermal tests and leukocyte histamine release were negative for cisatracurium. The two patients had undergone a subsequent general anaesthesia using cisatracurium and did not present any adverse reaction.
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Ann Fr Anesth Reanim · Jan 2003
Case Reports[Pneumomediastinum and bilateral tension pneumothorax as a complication of oxygen therapy using a nasal cannula].
We report the case of a patient who developed a subcutaneous and submucosal emphysema in association with a pneumomediastinum, a bilateral pneumothorax and a pneumoperitoneum. This complication was secondary to oxygen supply via a nasal cannula, which allowed a wrong submucosal pathway previously, created by the traumatic placement of a nasogastric tube. The evolution was uneventful. We comment the pathophysiological mechanism of such a complication and propose simple actions to prevent the reproduction.
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Ann Fr Anesth Reanim · Jan 2003
Case Reports[Single ventricle and obstetric anaesthesia: two cases report].
Single ventricle is a relatively rare abnormality found only in 0.5-1.5% of patients with congenital heart disease. Pregnancy results in an increased maternal morbidity and mortality in patients with right to left shunting, especially in cases associated with pulmonary hypertension and polycythemia and decreased arterial oxygen saturation. ⋯ For this reason, the major regional anaesthetic techniques are often avoided in these patients. The authors reported two successful management of regional anaesthesia for both caesarean and vaginal delivery.
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Ann Fr Anesth Reanim · Jan 2003
[The impact of a French guideline on the clinical management of severe head injury (SHI) published in 1999].
To evaluate the impact of a French guideline on the clinical management of severe head injury (SHI) published in 1999. ⋯ The French guidelines had a significant impact and seem to have provided a useful aid to clinical management of SHI patients. ICP monitoring and the shortage in post-ICU facilities are remaining issues.