Annales françaises d'anesthèsie et de rèanimation
-
Bilateral thalamic infarction is a very rare affection. We report here a case of bithalamic infarction during subclavian catheterization related to the accidental migration and complete occlusion of an arterial embolism to the Percheron's artery. Percheron's artery is an anatomical variation described in 1977, constituted by a solitary arterial trunk arising from one of the proximal segments of a posterior cerebral artery supplying the paramedian thalami and the rostral midbrain bilaterally. We review here the clinical presentation and discuss the aetiologies of such a cerebral infarction.
-
The purpose of this review is to draw up a statement on current knowledge available on the more recent hydroxyethyl starch (HES). ⋯ The first HES was made available in the United States in 1970. The development of a new generation of HES restarted the discussion on clinical interest and the limits in the use of these macromolecules. This interest is also strengthened today by the recent data attached to plasma substitution in intensive care or perioperative resuscitation. The interest for crystalloids and colloids is still widely debated, and among the latter, the relative interest of the HES last generation compared to older ones. Recent HES development is in line with a decrease molecular weight, change rate molar substitution and to amend the glucose to hydroxyethyl report. The ultimate goal is to reduce the side effects of these molecules preventing their use. Side effects are dominated by haemostasis and renal dysfunction. The latest developments are the so-called HES "balanced" solutions.
-
Ann Fr Anesth Reanim · Jul 2010
Continuous non-invasive arterial pressure measurement: evaluation of CNAP device during vascular surgery.
Standard non-invasive blood pressure (BP) monitoring is an intermittent, discontinuous procedure. Beat-to-beat BP monitoring requires invasive measurement via an arterial catheter and may be associated with serious complications. The Infinity CNAP SmartPod (Dräger Medical AG & Co. KG, Lübeck, Germany) has recently been proposed for non-invasive continuous beat-to-beat BP measurements. The present study was designed to compare BP obtained with the CNAP and with an invasive method in the operating room. ⋯ Despite low accuracy for SAP and DAP measurements, CNAP system seems more accurate for MAP measurement in patients undergoing vascular surgery.