Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Mar 2003
Case Reports[Automated external defibrillator use during cardiopulmonary resuscitation during flight].
Automated External Defibrillator (AED) during cardiopulmonary resuscitation should reduce mortality rate after out-of-hospital cardiac arrest. We report a case of defibrillation with AED during flight in a patient suffering cardiac arrest complicating an acute myocardial infarction. Two hours before landing, a 56-years-old man presented sudden cardiac arrest. ⋯ After landing, acute myocardial infarction was diagnosed and treated by prehospital thrombolysis and angioplasty with favorable outcome. AED is a crucial link of the chain of survival, especially where advance cardiac live support cannot be performed, like during flight. Despite an increasing AED availability, survival after cardiac arrest during flight remains exceptional.
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Ann Fr Anesth Reanim · Mar 2003
Case Reports[Neuromuscular blockade monitoring at the corrugator supercilii and ocular myasthenia gravis].
A 67-year-old patient suffering from an ocular myasthenia gravis was scheduled for an elective ENT surgery. General anaesthesia was induced intravenously. Neuromuscular responses after train-of-four stimulation were normal at both the adductor pollicis (T(4)/T(1) = 1) and the corrugator supercilii (4 visual responses). ⋯ The second attempt was successful 4 min after cisatracurium injection (no response at the corrugator supercilii, T(1)/T(0) = 0.05 at the adductor pollicis). Residual neuromuscular blockade was antagonized at the end of surgery (1 h long) allowing an uneventful extubation. We concluded that monitoring neuromuscular blockade at the corrugator supercilii to assess the intubating conditions is not recommended in a case of ocular myasthenia gravis.
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Ann Fr Anesth Reanim · Mar 2003
[In-hospital cardiac arrest resuscitation: medical and paramedical theory skill assessment in an university hospital].
Theory knowledge and attitude assessment about in-hospital cardiac arrest (CA) basic life support by hospital staff. ⋯ This study showed that theoretical knowledge of hospital staff about cardiac arrest diagnostic and management are insufficient from the point of view of national and international guidelines. Analysis is difficult because of weak response number and knowledge people overestimation.
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Ann Fr Anesth Reanim · Mar 2003
[Survey of office space and computer availability offered to full time practitioners in departments of anaesthesia and intensive care of French university hospitals].
Office space and computer facilities offered to medical practitioners in departments of anaesthesia (DA) belonging to university hospitals in metropolitan France in 2002 were surveyed. ⋯ A high response rate was obtained. DA were found to be insufficiently provided with offices and computer facilities in french university hospitals. Such a situation, which is both surprising and questionable in an industrialised country, warrants a debate.
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Ann Fr Anesth Reanim · Mar 2003
Review[Brain oedema following blood-brain barrier disruption: mechanisms and diagnosis].
Brain oedema following blood-brain barrier (BBB) disruption, or vasogenic oedema, is present in most cases of brain oedema. According to the Starling's law, water, ions and plasma proteins cross the BBB toward the interstitium if the driving forces for transmural bulk flow are excessive (mechanical origin) and/or if the BBB permeability is enhanced (chemical origin). Both mechanisms coexist in most cases. ⋯ The BBB permeability can be enhanced by immediate (chemical mediators) or delayed (cellular infiltration) inflammatory response, or by alteration of the membrane integrity. This later can be transient (hyperosmolar BBB disruption), or permanent by activation of matrix metalloproteinase or by neovascularization with BBB breakdown. The reference method for the diagnosis of vasogenic oedema is the MRI diffusion-weighted imaging.