Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Apr 2014
Case ReportsFalse hyperlactatemia in life-threatening ethylene glycol poisoning.
Ethylene glycol poisoning is rare, but prompt diagnosis is crucial, in order to initiate specific treatments. Herein, we report the case of a patient who was admitted to ICU for coma and extreme metabolic acidosis with unexpected hyperlactatemia on initial ICU blood gas analyzer. Ethylene glycol poisoning was diagnosed, and hyperlactatemia was ruled out on a blood sample sent to the biochemistry department. ⋯ Symptoms gradually improved and false hyperlactatemia resolved after renal replacement therapy and fomepizole administration. Time course of ethylene glycol concentration showed similar evolution. After initial confirmation of ethylene glycol presence, this biological interference could thus be used as a surrogate of costly and highly specialised dosages.
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Ann Fr Anesth Reanim · Apr 2014
A survey of percutaneous chest drainage practice in French university surgical ICU's.
Percutaneous chest drainage guidelines were published in 2010 by the British Thoracic Society. On several points (insertion technique, drain size), they seem to differ from French practices. Our objectives were to evaluate practice of pleural drainage in French University surgical intensive care units (ICU's), and to compare it with the British guidelines. ⋯ The frequent use of trocar (and therefore of large drains) for pleural drainage in French ICU's differs significantly from the British guidelines.
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Ann Fr Anesth Reanim · Apr 2014
Observational Study[Tracheostomy in French ICUs and patient outcome: National opinion survey.]
Tracheostomy is a frequent procedure in ICU but patient follow-up and management after ICU has been poorly documented. We conducted a practice survey in French general ICUs and in neurointensive care units concerning tracheostomized ICU patients and their management after ICU. ⋯ Tracheostomy is a frequent procedure, mostly percutaneous. Indications and timing for tracheostomy correspond to the recommendations. Reported difficulties in post-ICU management are important and present nationwide.
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Ann Fr Anesth Reanim · Apr 2014
Observational StudyImpact of a goal-directed therapy protocol on postoperative fluid balance in patients undergoing liver transplantation: A retrospective study.
Liver transplantation carries major risks during the perioperative period. Few studies focused on the hemodynamics of patients undergoing liver transplantation. The present study was aimed to evaluate the impact of the implementation of a protocol including goal-directed therapy in patients undergoing liver transplantation. Our first goal was to determine its impact on the fluid balance. Secondarily, we evaluated possible improvements in the patient outcomes. ⋯ For patients undergoing liver transplantation, the implementation of a protocol aiming to optimize hemodynamics was associated with reduced fluid balance and decreased requirement for mechanical ventilation and postoperative ileus duration.
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Ann Fr Anesth Reanim · Apr 2014
Case Reports[Two cases of pneumocephalus following noninvasive continuous positive airway ventilation after transsphenoidal neurosurgery.]
The early use of continuous positive airway pressure ventilation has been shown to be effective and is recommended for patients with obstructive sleep apnea. The complications of continuous positive airway pressure ventilation are not well described. ⋯ In both cases, pneumocephalus caused major morbidity and required specific treatment and prolonged considerably hospital stay. Based on these observations we believe new precautions in the use of noninvasive continuous positive airway pressure ventilation should be recommended.