Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Apr 2003
Case Reports[Intestinal gas explosion during operation: a case report].
A case of intestinal gas explosion during the course of carcinologic surgery in a 51-year-old patient is reported. This accident, often dramatic, has become exceptional since the use of mannitol for colonic preparation has disappeared. ⋯ The colon incision with an electrocautery was contemporaneous with a violent deflagration accountable for organic lesions. This case report reminds us that the risk of a dangerous explosion persists in relation with surgical, anaesthetic and individual risk factors.
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Ann Fr Anesth Reanim · Apr 2003
[Oxygen cylinders with an integrated pressure regulator with cylinder valves].
The different possibilities of oxygen delivery cylinders with integrated pressure regulator have taken a preponderant place since their arrival in 1995 in both health establishments and home care. This is mainly due to their safe and easy use. These cylinders are made of a light material (aluminium alloy coated with synthetic polymers) and have obtained, as the other medicinal oxygen forms, a French marketing authorization in 1997. ⋯ French manufacturers are aware of this development; meanwhile it remains limited to other EU countries. The offer is generally satisfying, similar upon safety and advantages (weight, residual pressure valve, and easiness of handling) with a large flow choice and maintenance under the responsibility of the manufacturer. The choice of these cylinders for hospital is particularly notified and has to be encouraged because avoiding risk of accidents due to the erratic maintenance of pressure regulators fitted with usual cylinders where it is not accomplished by technicians duly educated and qualified for this purpose.
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Ann Fr Anesth Reanim · Apr 2003
Review[Blood-brain barrier pathophysiology and ischaemic brain oedema].
Cerebral oedema is a potentially lethal complication of brain infarction. Ischemia, by altering membrane ionic pump function, induces cell swelling and cytotoxic oedema. It also initiates early oxidative and inflammatory cascades leading to blood-brain barrier disruption, vasogenic oedema and haemorrhagic transformation. ⋯ This treatment also increases vasogenic oedema and the risk of symptomatic haemorrhagic transformation, reducing the benefit of reperfusion. Experimental studies suggest that the inhibition of blood-brain barrier proteolysis reduces vasogenic oedema and the risk of haemorrhage. This recent progress in the understanding of blood-brain barrier disruption during ischaemia brings forward new therapeutic strategies using agents capable of interfering with the ischaemic cascade in order to increase the therapeutic window between the onset of ischaemia and thrombolytic reperfusion.
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Acute mountain sickness and high altitude cerebral edema are specific pathologies of high altitude exposure. The usual symptoms of acute mountain sickness are headache, nausea, vomiting, insomnia, lassitude, dizziness and ataxia. ⋯ Molecular and cellular mechanisms underlying acute mountain sickness and high altitude cerebral oedema are still poorly understood. The regulation of cerebral blood flow by nitric oxide seems to play a major role.