Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Nov 2013
Case Reports[Tension pneumocephalus after surgical treatment of a bilateral chronic subdural hematoma: A banal and serious complication].
The occurrence of postoperative pneumocephalus is a common event and is often trivial. When the intracranial air volume is significant, it creates intracranial hypertension causing tension pneumocephalus. ⋯ The attending physicians should be aware of the possibility of occurrence of such complication. Treatment and prevention of pneumocephalus should also be well known by the medical staff.
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Ann Fr Anesth Reanim · Nov 2013
Case Reports[Group A streptococcal meningitis: Streptococcus pneumoniae is not the only one to seep into the CSF fluid leak!]
We reported a case of group A streptococcal meningitis in a patient with a CSF fluid leak. This case underlined several relevant points: (i) an unfrequent cause of bacterial meningitis; (ii) the main diagnosis to evoke when the direct examination of CSF shows Gram+ cocci with a negative pneumococcal antigen; (iii) that bacteria other than Streptococcus pneumoniae are possible in front of a meningitis associated with a CSF fluif leak.
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Ann Fr Anesth Reanim · Nov 2013
[ICU patients and days of intensive care: A mathematical model optimizing the consequences of ICU unit function, intensive care and continual monitoring on incurred supplementary costs.]
"Critical Care Units" are intended to admit patients with multiple organ failure. The severity of patients admitted is variable. The aim of the study was to estimate the number of days that an optimum care organization could release, and therefore the additional admissions that would have been allowed. Estimates of earnings related to the various supplements were carried out jointly. ⋯ Optimization of the patients flow between "Critical Care", Intensive Care and Continuous Monitoring Units would increase the number of patients admitted in "Critical Care" Units without any financial loss related to supplements.
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Ann Fr Anesth Reanim · Nov 2013
[Impact of the decrease of nitrous oxide use on the consumption of halogenated agents.]
Nitrous oxide (N2O) toxicity and its impact on pollution lead to restrict its use. A decrease of N2O consumption should increase the hypnotic inhaled consumption. This monocentric study estimated consumptions and costs of halogenated agents (HA) and N2O over 5 years when the N2O consumption was reduced. ⋯ N2O consumption decrease had an impact on the consumption of HA. The cost reduction of the N2O was counterbalanced by the increase of halogenated vapor cost. The profit of the ecological impact of the reduction in N2O use could be quantified.
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Ann Fr Anesth Reanim · Nov 2013
Case Reports[Malignant hyperthermia: Multifactorial events leading to a crisis.]
This case-report focused on the occurrence of a crisis of malignant hyperthermia on a young biker (21 y.o.) victim of a severe traffic accident. This observation gives some key points: the delayed occurrence of the crisis after 4 hours of surgery, the multi-factorial events that triggered the crisis; the choice to perform a quick diagnosis through gene analysis in comparison to the standard tests of caffeine on a muscular biopsy. These different points are discussed with a proposal of algorithm in the situation.