Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jul 2012
Multicenter Study[Use of indicators of fluid responsiveness in septic shock: a survey in public emergency departments].
Fluid therapy is one of the major elements of severe sepsis and septic shock management. A systematic initial fluid bolus is recommended before evaluation of left ventricular filling pressure by the use of indicators of fluid responsiveness, preferentially dynamic ones. A massive fluid therapy could be damaging for the patient. Dynamic indicators of fluid responsiveness are not often relevant in the emergency department. This study was aimed to evaluate the use of indicators of fluid responsiveness by emergency practitioners during septic shock management. ⋯ Emergency practitioners use preferentially less invasive and less time-consuming indicators of fluid responsiveness.
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Ann Fr Anesth Reanim · Jul 2012
Editorial Comment[Transfusion thresholds: Guidelines and real life].
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Ann Fr Anesth Reanim · Jul 2012
Review[From medical complication to compensation for the prejudice].
Claims in anesthesia and intensive care remains high, despite the reduction of morbidity and mortality associated with this activity. The absence of a national register makes it difficult to quantify. The Medical Committee of MACSF-Sou Medical Group, professional liability insurer of more than half of French physicians, provided us support. ⋯ With the establishment of the Regional Commissions of Conciliation and Compensation (RCCI) and the National Office for Compensation of Medical Accident (Oniam), it is now possible for a patient to be compensated for an injury resulting from an accident Medical non-offending, while acknowledging the lack of accountability of the practitioner. The expertise conducted by an RCCI is adversarial. For the practitioner called to the cause, it is important to prepare for both substance and form, with the assistance of the medical board's insurance company.
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Ann Fr Anesth Reanim · Jul 2012
Review[Catheter-related bladder discomfort in post-anaesthesia care unit].
Catheter-related bladder discomfort (CRBD) is an unrecognized clinical event. Symptoms of CRBD secondary to an indwelling urinary catheter mimic those of an overactive bladder, i.e. urinary frequency and urgency with or without urge incontinence. ⋯ Antimuscarinic drugs, as oxybutynin, are today the main treatment. Further studies are warranted to confirm efficacy of ketamine, tramadol and gabapentin in this situation.