Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 2014
Case ReportsRemote cerebellar hemorrhage as an early and potentially lethal complication of a discal lumbar herniation surgery.
Remote cerebellar hemorrhage (RCH) is an infrequent but serious complication after lumbar herniation surgery. Little is known about this complication but excessive cerebrospinal fluid (CSF) leakage is thought to be a leading cause of RCH. We describe the case of a patient suffering from a life-threatening RCH, which occurred a few hours after lumbar disc herniation surgery.
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Ann Fr Anesth Reanim · Jan 2014
Case Reports[Patient with acute renal injury presenting dabigatran overdose: Hemodialysis for surgery.]
Dabigatran is a direct thrombin inhibitor indicated for stroke and systemic embolism prevention in patients with non-valvular atrial fibrillation. No reversal agent exists, but hemodialysis has been proposed as dabigatran removal method. We report a case of an 80-year-old man presenting hemorrhage with dabigatran overdose caused by obstructive acute renal failure. Before nephrostomy, several hemodialysis sessions were necessary to remove dabigatran probably because of its large volume of distribution.
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Ann Fr Anesth Reanim · Jan 2014
Observational Study[Esophageal cancer surgery: Evolution of pain management, hemodynamics and ventilation practices during 16 years.]
To describe the evolution of perioperative anesthesia practices in for esophageal cancer surgery. ⋯ During these previous years, anesthesia practices in ventilation, hemodynamics and analgesia for esophageal cancer surgery have changed.
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Ann Fr Anesth Reanim · Jan 2014
Case ReportsBispectral index transiently decreased to "0" during per-embolization rupture of an intracranial aneurysm.
Interpreting a Bispectral Index (BIS) of "0", corresponding to an isolelectric electroencephalography, can be difficult. After ruling out technical issues, such as leads disconnection, several possible causes for a decrease in the BIS persists, including deep anesthesia, hypothermia, decrease in the cerebral perfusion pressure and cerebral ischemia. We report a sudden transient decrease of the BIS to "0" in a patient that underwent a coil embolization of a ruptured intracranial aneurysm and suggest that the change in BIS values could provide useful information about the cerebral hemodynamic during aneurysm treatment and might provide indications of a serious cerebral event.
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Ann Fr Anesth Reanim · Jan 2014
Case Reports[No surgery without previous compression ultrasound in patients with a superficial venous thrombosis: A case of massive paradoxical embolism.]
Lower limbs superficial venous thrombosis (LLSVT) is usually considered as common and of a benign prognosis. LLSVT can, however, be responsible for major thromboembolic complications: lower limbs deep vein thrombosis (LLDVT) and pulmonary embolism (PE). ⋯ Venous ultrasonography of the lower limbs must be systematically performed in case of LLSVT, in order to evaluate the presence of an associated LLDVT. A rigorous diagnostic and therapeutic approach is the only way to optimize the treatment of this disorder, and to avoid the occurrence of dramatic venous thromboembolic complications.