Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Oct 2011
[Imprecision of vancomycin prepared for intravenous administration at the bedside in a neonatal intensive care unit].
In pediatric units, most of the intravenous medications are prepared by the attending nurse at the bedside that can be affected by an error margin, so can be imprecise. Despite the possible consequences of imprecise medications administration, published studies on the topic are scarce. The main objective of this study was to measure the difference between the prescribed vancomycine concentration and the actual concentration measured in the medication administered to the patient. ⋯ Bedside vancomycin preparations, like preparations for other molecules, are far more imprecise than industrial intravenous medications. Our results urge that all pediatric intravenous medications should be made only by manufacturers or pharmacists. However, it also urged clinical studies, in parallel to pharmacodynamic and pharmacokinetic studies, to make intravenous treatments as accurate as they should be.
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We report a case of delayed rocuronium-induced deep block antagonization with sugammadex, thus requiring a total of three injections and a cumulative dose of 12 mg/kg over a 30 min period. The patient was an emergency case with full stomach that had required a rapid sequence induction. Because of hyperkaliemia due to an acute renal failure, rocuronium was preferred to succinylcholine. Use of sugammadex in the acute renal failure context is discussed.
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Ann Fr Anesth Reanim · Oct 2011
Case Reports[Two cases of chronic pain after regional anaesthesia].
We are reporting two cases of chronic neuropathic pain after traumatism during regional anaesthesia (RA). Nerve injury is a rare complication of RA and it is the neurogical deficit, which is the most often quoted in medical literature. ⋯ The reunion of the clinical element, which incorporates possible traumatism during regional anaesthesia, characteristics of pain and unusual painful localization of surgery, should have allowed a more early diagnostic and treatment. In both cases, persistent neuropathic pain incapacitates the patient several years after the traumatism.
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Ann Fr Anesth Reanim · Oct 2011
[Risk of accumulation of CO₂ in the oxygen chamber in "HOOD" (Experimental study on test bed)].
Oxygen hood is largely used to deliver O₂ to newborn infants with respiratory failure in the northern region of France. The oxygen flow is set to obtain the target arterial blood oxygen saturation. Thus, O₂ flow delivers into the hood may be below the recommended gas flow of 6L/min. However, gas flow below 6L/min exposes to CO₂ rebreathing. The aim of this study was to evaluate the effect of various rates of gas flows on the values of partial pressure of CO₂ into the hood. ⋯ Risk of CO₂ rebreathing exists as soon as the gas is delivered into the hood at minimal flow rates below 6L/min.
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Ann Fr Anesth Reanim · Oct 2011
Case Reports[Acute valproic acid intoxication: interest of a treatment by extracoporeal elimination combined with L-carnitine].
We present the case of a 24-year-old-female patient, who made an attempt to autolysis with valproic acid, benzodiazepines and neuroleptic. The valproic acid plasma level was very high (1437 μg/mL), confirming it was a severe intoxication. ⋯ The evolution was favourable despite the occurrence of a nosocomial ventilation acute lung injury. The patient had motor sequelae of cranial nerves following status epilepticus extended, which disappeared spontaneously after several days.