Annales françaises d'anesthèsie et de rèanimation
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To assess the feasibility of switching disposable laryngoscope blades and to compare the disposable blades available on the market to reusable blades within the context of a new variant of Creutzfeldt-Jakob disease. ⋯ The disposable blades were not easily accepted by the anaesthetists particularly for difficult intubations, which is why reusable blades should not be totally removed from practice. Single-use blades proposed by different manufacturers are not identical. We chose 670166 Rusch-Pilling blades, the best adapted to our institution. The switch to disposable blades would require that blade manufacturers improve the quality of the blades.
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Ann Fr Anesth Reanim · Jul 2004
[Victims of fall from height. Study of 287 patients and determination of clinical prognostic factors].
Fall from height is a common cause of severe blunt urban trauma but this mechanism of trauma is poorly documented. ⋯ Immediate mortality after fall from heights is high and remains low after day 3. GCS, ABP and RTS are independent prognostic factors.
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Ann Fr Anesth Reanim · Jul 2004
Review[Indications and limits of recombinant human erythropoietin in intensive care unit].
To analyze the data from the literature on erythropoietin and the future indications of recombinant human erythropoietin in intensive care unit (ICU) patients. ⋯ An anemia is often observed in patients hospitalized in ICU. This anemia may be due to many reasons. The management of anemia consists on the treatment of the underlying disease associated with the transfusion of red blood cells. Recent studies provided evidence of an association between transfusions and mortality in ICU patients. The anemia of ICU patients is compared to the anemia of chronic diseases, which is characterized by a blunted erythropoietin. A treatment with rHuEPO may be a future therapeutic of the anemia in such patients. A multicentric study shows the efficacy of recombinant erythropoietin therapy on a decrease in the use of red blood cell, and another clinical trial highlights a decrease of the proportion of ICU patients receiving red blood cell. Recombinant erythropoietin could be an alternative to transfusion in certain conditions and certain ICU patients. Further studies are needed to determine the consequences on mortality rate and to clarify the place of this therapy in ICU patients.
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Ann Fr Anesth Reanim · Jul 2004
[Target-controlled infusion of propofol for intraoperative sedation: determination of effect-site concentration and assessment of bispectral index].
To determine the effect-site concentration (Ce) of propofol, required to achieving adequate sedation. To assess the efficacy and safety of a target-controlled infusion system during monitored anaesthesia care and to evaluate the ability of bispectral index (BIS) to predict sedation level. Study design. - Prospective clinical study. ⋯ Target-controlled infusion of propofol provides easy and safe management of intraoperative sedation, allowing a fast and precise adjustment of the propofol concentration to the clinical response of the patient.
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To estimate qualitatively and quantitatively analgesic methods used after thoracotomy. ⋯ Intravenous patient-controlled analgesia and thoracic epidural analgesia are the most commonly analgesic techniques used after thoracotomy for pulmonary surgery. In the latter case, most centres choose to maintain these patients in high dependency units.