Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Apr 2014
Incidence and prediction of inadequate preoxygenation before induction of anaesthesia.
Preoxygenation aims to obtain an expired oxygen fraction (FEO2)≥90%. Little is known about the incidence and predictors of inadequate preoxygenation in the clinical setting. ⋯ Inadequate preoxygenation, defined as an FEO2 <90% despite 3-min tidal volume breathing, was a common occurrence. The predictive factors share an overlap with those previously identified for difficult mask ventilation.
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Ann Fr Anesth Reanim · Apr 2014
Observational Study[Antifungal treatment for suspected or proved candidiasis in the critically ill.]
Describe systemic antifungal therapy in non-neutropenic adult patients in intensive care unit (ICU). ⋯ For ICU non-neutropenic adult patients in our center, antifungal therapy is prescribed two times out of three for suspected, unproved infections, in most cases with fluconazole. Documented infections were more often treated by echinocandin with secondary de-escalation. An interventional prospective study to assess the role of antifungal pre-emptive or empirical therapy is necessary.
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Ann Fr Anesth Reanim · Apr 2014
Case Reports[Cardiac arrest secondary to pacemaker dysfunction during general anesthesia in a young adult patient.]
The number of patients with cardiac pacemaker is continuously increasing. The anesthetic management of these patients is often trivialized, particularly during minor surgery. ⋯ We report a case of cardiac arrest during general anesthesia for a day-surgery secondary to pacemaker dysfunction by increasing pacing thresholds in a young adult patient. Rapid onset after induction, without any surgical stimulation, has raised the question of the involvement of anesthetic drugs like propofol.
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Ann Fr Anesth Reanim · Apr 2014
In vitro evaluation of diffusion of lidocaine and alkalinized lidocaine through the polyurethane membrane of the endotracheal tube.
Endotracheal tube (ETT) and its inflated cuff are likely to induce specific reactivity at the emergence time. In ICU, the tolerance of the ETT cuff could be a part of patient agitation and increased of sedation. ⋯ The safety, controlled release, and lack of deleterious effects on cuff membrane were confirmed. In case of unexpected cuff rupture, an adequate determination of the mixture allows to obtain a safe solution with the achievement of a physiological pH (7.4) and the small dose of lidocaine (40 mg).
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Ann Fr Anesth Reanim · Apr 2014
Case Reports[Spontaneous pneumomediastinum secondary to inhalation of crack.]
The use of cocaine causes numerous cardiovascular and pulmonary side effects. In this context, the occurrence of a pneumomediastinum represents a specific complication, often misunderstood by primary care physicians. ⋯ A short observation period with outpatient follow-up is appropriate in the majority of patients. Invasive procedures have a low yield and should be based on a high degree of clinical suspicion for esophageal rupture or bronchial tree laceration.