Annales françaises d'anesthèsie et de rèanimation
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To propose the different modalities of management of the allergic risk occurring during paediatric anaesthesia. ⋯ Allergic reactions to NMBAs occurring during paediatric anaesthesia are rare whereas those with latex are more frequent. Therefore, the reduction of the allergic risk during paediatric anaesthesia essentially requires a latex-free environment.
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Ann Fr Anesth Reanim · Mar 2010
Randomized Controlled Trial Comparative Study[Inspiratory support versus spontaneous breathing during preoxygenation in healthy subjects. A randomized, double blind, cross-over trial].
Applying an inspiratory support (AI) and a positive end expiratory pressure (PEP) could increase the effectiveness of the preoxygenation. ⋯ This study shows applying AI plus PEP during preoxygenation improves its effectiveness in the healthy subjects. It also suggests that, in a population of healthy volunteers, combination AI-4/PEP-4 is preferable to AI-6/PEP-4 because so effective, but better tolerated.
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Ann Fr Anesth Reanim · Mar 2010
Review[Noninvasive mechanical ventilation in paediatric intensive care units: which indications in 2010?].
Noninvasive ventilation (NVI) is increasingly used in paediatrics, although there is a high variety of practices and a paucity of published data in paediatrics. The last French consensus conference recognized a specific role of NVI for infants suffering from acute bronchiolitis with apnoea, and acute respiratory failure due to laryngotracheomalacia and cystic fibrosis. ⋯ All these adult recommendations have not been validated in the pediatric setting, and, thus, taking the paediatric characteristics into account is essential. In 2010, NVI had an important place in PICU, and must be managed by a trained team whose practice is regularly evaluated.
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Ann Fr Anesth Reanim · Mar 2010
Review[What non invasive haemodynamic assessment in paediatric intensive care unit in 2009?].
The haemodynamic assessment of the patients is a daily activity in paediatric intensive care unit. It completes and is guided by the clinical examination. The will to develop the least invasive possible coverage of the patients is a constant concern. ⋯ We shall blame it for its cost and for the fact that it is an intermittent monitoring but both in the diagnosis and in the survey, it has no equal among the non-invasive tools of haemodynamic assessment from part the quality and the quantity of the obtained information. The learning of the basic functions (contractility evaluation, cardiac output, cardiac and the vascular filling) useful for the start of a treatment is relatively well-to-do. We shall miss the absence of training in this tool in France in its paediatric and neonatal specificity within the university or interuniversity framework.
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In France, the incidence of PE is estimated to range between 1 and 3% in the nuliparous and between 0.5 and 1.5% in the multiparous women. Factors associated with the development of PE are of various types. Studies conducted on families affected by PE suggest the existence of a genetic component to the disease, even though the association between PE and certain genes, allotypes and polymorphisms are still under scrutiny. ⋯ Several well designed epidemiological studies confirm that tobacco consumption is itself associated with a 20 to 50% reduction in the development of PE, although being itself associated with an increase in other vascular gestational complications such as retroplacental haemorrhage and IUGR. Living conditions and stress, especially at work are also associated with the occurrence of PE. All these identified risk factors by far do not account for all the reported cases of PE and do not bear sufficient positive or negative predictive value.