Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Sep 2010
[Management of newborns with meconium-stained amniotic fluid: prospective evaluation of practice].
Regional guideline for immediate tracheal suctioning (ITS) in vigorous and non-vigorous infants born through meconium-stained amniotic fluid (MSAF) has been established in 2003. The objective of this study was to evaluate guideline application. ⋯ Recommendations for ITS were implemented in 70% of cases but only in 42% of cases in non-vigorous babies. We have to improve formation and circulation of new recommendations.
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Ann Fr Anesth Reanim · Sep 2010
Case ReportsAnaesthetic management for caesarean section in a parturient with uncorrected coarctation of the aorta.
We present the case of a woman who refused RMI examination to diagnose a coarctation of her aorta before her third pregnancy. At term of 34 weeks of gestation the caesarean delivery was scheduled under spinal-epidural anaesthesia. Despite the use of a titrated regional anaesthesia, an important arterial hypotension occurred, restored with low doses of vasopressive agents.
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Ann Fr Anesth Reanim · Sep 2010
Case Reports[Respiratory support using veno-venous ECMO during lung resection for aspergilloma].
Respiratory support using extra corporeal membrane oxygenation (ECMO) is rarely used in the setting of adult lung surgery, with the exception of lung transplantation. We report the case of a patient with pulmonary aspergilloma, for whom selective bronchial intubation was required to facilitate surgery. ⋯ Intra-operatively, an attempt to lung exclusion was responsible for severe hypoxemia. The use of veno-venous ECMO allowed to improve oxygenation and lung resection was carried out successfully at the expense of major intra-operative bleeding.
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Ann Fr Anesth Reanim · Sep 2010
[Does intracranial pressure monitoring improve outcome after severe traumatic brain injury?].
Raised intracranial pressure (ICP) is frequent and associated with poor outcome after severe traumatic brain injury (TBI). Information obtained by ICP monitoring allows early detection of high ICP and goal-directed therapy. ⋯ ICP monitoring and guided therapy are not risk-free. A rational use of ICP as a guide to therapy must take into account of the absolute threshold for treatment, but also of the risk/benefit balance of the used intervention.
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Ann Fr Anesth Reanim · Sep 2010
[Ultrasound-guided supraclavicular subclavian vein catheterization: a novel approach in children].
The subclavian vein (SCV) is often the preferred site for long-term central venous catheterization in children. It has many advantages over the internal jugular vein. But with the classical landmark technique for SCV catheterization the ultrasound-guidance technique is usually not suitable, because of the clavicle (a bright hyperechoic structure with an acoustic shadow beneath it). Because the SCV can easily be visualized via a supraclavicular approach, we developed a useful ultrasound-guided approach for SCV catheterization in infants and children.