Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Dec 2004
Case Reports[An unusual aetiology for septic shock: Capnocytophaga canimorsus. Is always dog man's best friend?].
The mortality of overwhelming postsplenectomy infections (OPSI) is significant (50 to 80 percent). Capnocytophaga canimorsus belongs to the normal oral flora of dogs and cats. It is seldom responsible for human infections, but its prognosis is bad (about 30 percent of overall mortality), especially in asplenic patients. ⋯ The course of events was rapidly fatal. Diagnosis and mode of contamination were determined only a few weeks after the patient's death. This late microbiological diagnosis is due to a slow growth of C. canimorsus in vitro.
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Ann Fr Anesth Reanim · Dec 2004
Randomized Controlled Trial Comparative Study Clinical Trial[Comparison of eight deep breaths and tidal volume breathing preoxygenation techniques in morbid obese patients].
To compare two techniques of preoxygenation, eight deep breaths (8DB) and tidal volume breathing in obese patients by measuring end-tidal fractional oxygen concentration (FETO2) and apnea time from 100% of hemoglobin saturation to 95% (T95%). ⋯ 8DB and 3TV preoxygenation techniques in morbid obese patients induce similar FETO2 and T95%. However hyperventilation effects in the 8DB group are unknown.
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Ann Fr Anesth Reanim · Dec 2004
Case Reports[Do we have to monitor foetal heart rate during general anesthesia?].
We present a case of an emergency Caesarean section due to misinterpretation of the cardiotocography (CTG) trace during general anaesthesia for treatment of dental abscess. Following failure of the dental abscess treatment under local anaesthesia, a 29-year-old female in the 36th week of a twin pregnancy was to undergo general anaesthesia. Foetal well-being was monitored with ultrasonographic evaluations of foetal heart rate. ⋯ That was probably due to general anaesthesia. Then, two infants were extracted without neonatal distress necessitating intubation. This case report underlines the risk to misread an intraoperative CTG monitoring and if the CTG monitoring is normal before anaesthesia, reduced foetal beat-to-beat variability with a normal baseline heart rate during general anaesthesia is probably normal.
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Ann Fr Anesth Reanim · Dec 2004
[National survey of emergency management of acute pain in prehospital setting].
Assessment of skill of physicians staffed Mobile Intensive Care Units (MICU) in severe acute pain (SAP) management. ⋯ This survey showed a low knowledge about severe acute pain management in out-of-hospital setting, both for pain assessment and treatment. There were few locals guidelines to overcome this deficiency. A training work is essential to improve care of acute pain in out-of-hospital setting.