Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · May 2002
Review[The importance of detecting methicillin-resistant Staphylococcus aureus in an intensive care setting].
In recent years, the fight against nosocomial infections has constituted a major public health challenge. Measures aimed at preventing the spread of multiresistant bacteria (MRB) through carriage combine the more or less systematic detection of carriers and precautions concerning isolation. In the light of published data, elements for the evaluation of a cost-efficiency ratio for measures concerning detection and isolation in intensive care are presented. ⋯ Although isolation precautions appear to be effective, the value of detecting MRSA remains a subject of debate. Such detection has several objectives: the identification of carriers, assistance in the implementation of isolation precautions, the eradication of carriage and the evaluation of strategy. These different objectives are discussed.
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Ann Fr Anesth Reanim · May 2002
Clinical Trial[Value of cervical plain radiography in unconscious trauma patient].
The aim of this study was to evaluate the diagnostic value of cervical spine standard radiographs, performed in emergency, and compared with entire cervical helical CT with multiplanar reconstructions as reference. ⋯ The diagnostic value of standard radiographs was weak whatever the physician. Therefore, helical CT of the entire cervical spine is absolutely necessary and must be performed during the initial evaluation, if the haemodynamic conditions are required.
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To evaluate what could be the benefit in terms of alarm suppression, of a new syringe pumps system, which allows automatic relay without alarms. ⋯ New syringe pumps allow both reduction of alarms in ICU and a better management of nurse workload. Indeed syringe relay can be planned in advance.
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Ann Fr Anesth Reanim · May 2002
Case Reports[Coronary thrombosis on patient with the factor V Leiden mutation].
We report a documented observation of coronary thrombosis occurring in a 25-year-old patient with no risk factor, presenting a hereditary thrombophilia (facteur V Leiden) diagnosed a few months earlier in a context of venous thrombosis. This patient had a spread out anterior myocardial infarction with cardiac arrest due to a ventricular fibrillation; although he was quickly rescued by the mobile intensive Care Unit, the patient died 48 hours later, after cerebral anoxia. The mutation called factor V Leiden is a widely spread hereditary family thrombophilia (5 to 6% of the population) and is characterized by a resistance to activated C protein provoking a hypercoagulable state. The unexpected arterial thrombosis, very rare in that case, can be extremely serious and raises the question of a preventive medication such as antiplatelet agent or low-molecular-weight heparin as soon as the genetic abnormally has been proved to be symptomatic.