Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · May 2012
Multicenter Study[Anaesthetic management of brain-dead for organ donation: impact on delayed graft function after kidney transplantation].
The aim of this study was to report current anaesthetic management brain-dead organ donors and to assess its impact on delayed kidney graft function (DGF). ⋯ During organ retrieval, 62% of organ donors received anaesthetic drugs. Use of anaesthesia lead to lower MAP requiring more fluid challenge with colloids but did not influence the DGF.
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Ann Fr Anesth Reanim · May 2012
Case Reports[Vasoplegic syndrome after cardiac surgery with cardiopulmonary bypass].
A 71-year-old valvular patient with cardiac arrhythmia, low ejection fraction, administered angiotensin converting enzyme inhibitor underwent aortic and mitral valvular replacement. Starting during normothermic cardiopulmonary bypass (CPB), hypotension occurred, refractory to phenylephrine, noradrenaline, terlipressin, hydrocortisone and dexchlorpheniramine. ⋯ The responsability of sepsis and anaphylaxis were ruled out and post-CPB vasoplegic syndrome appeared to be involved. Moderate and severe vasoplegic syndromes are discussed with regards to risk factors, physiology and treatment, including prophylaxis with vasopressin and methylene blue.
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Ann Fr Anesth Reanim · May 2012
Randomized Controlled Trial Comparative Study[Prospective trial comparing Airtraq and Glidescope techniques for intubation of obese patients].
Videolaryngoscope techniques are more and more in use and tend to modify our approach for patients difficult to intubate. We compared two techniques, Airtraq and Glidescope with direct laryngoscopy, with special emphasis on ease of access to airway (Intubation Difficulty Score - IDS score, duration and success of intubation) and the impact on hemodynamic variables among patients with a BMI of more than 30. ⋯ In obese patients, Glidescope allows intubation relatively easily without rescue techniques.
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This article provides a synthesis of physiology and pathophysiology of the cardiovascular system and briefly presents the principles of regulation at the level of the whole organism and regional circulations. Decision algorithms, based on knowledge of physiology and pathophysiology are proposed. Their goal is to contribute to the improvement of cardiopulmonary bypass practice.