Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jul 2011
Case Reports[Microcirculatory dysfunction after cardiac surgery: Interest of NIRS technology with two case reports].
Near infrared spectroscopy (NIRS) seems to be an interesting technology to study microcirculatory dysfunction. These alterations have been described after cardiac surgery under cardiopulmonary bypass. ⋯ These two parameters are early altered notably in case of cardiac dysfunction (decrease of StO(2) and reperfusion slope). We discuss the interest of microcirculatory measurement in this context.
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Ann Fr Anesth Reanim · Jul 2011
[Impact of anaesthesia management on post-surgical ventilation in post-anaesthesia care unit].
Control of residual muscle paralysis and hypothermia reduce postoperative complications rate. Short context sensitive half life anaesthetic agents allow a better adjustment of anaesthesia depth according to surgical requirement and a safe early extubation. Using a large clinical database, impact of these three strategies was assessed on clinical criteria such as use of neostigmine in postanaesthesia care unit (PACU), temperature, sedation score at the arrival into PACU and mechanical ventilation weaning. ⋯ Implementation of new intraoperative protocols induced major effects on postoperative clinical parameters and especially postoperative mechanical ventilation. Failure of our hypothermia prevention associated with a fast return of consciousness lead to wean from mechanical ventilation hypothermic patients. Risks of this strategy were not estimated.
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Ann Fr Anesth Reanim · Jul 2011
[Does pulmonary contusion expose to the risk of Streptococcus pneumoniae infections? Results of an experimental study].
To create a reliable and reproducible model of pulmonary contusion (PC) in rats in order to evaluate the influence of PC on bacterial lung proliferation. ⋯ This experimental model is reliable and reproducible. The initially high mortality seems to decrease with the experience of operators. The CP significantly increases intra-pulmonary bacterial proliferation when the inoculation is low. A high inoculum neutralizes the effect of CP. These results suggest that enhanced prevention of micro-inhalation could be beneficial in cases of CP.