Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Mar 2002
Comparative Study Clinical Trial[Diagnosis of ventilator-associated pneumonia: a prospective comparison of the telescoping plugged catheter with the endotracheal aspirate].
Quantitative culture of endotracheal aspirates (EA) is widely accepted for the diagnosis of ventilator-associated pneumonia (VAP). The aim of the study was to compare the diagnostic accuracy of the EA with the blinded plugged telescoping catheter (PTC) in patients suspected of VAP. ⋯ EA is a good diagnostic test when a non-invasive test has been chosen. The diagnosis of VAP could be excluded in 90% of cases when the EA cultures yielding were < 10(5) cfu.mL-1. His low specificity could drive in an over treatment of bronchopulmonar bacterial colonization. The accuracy of the EA compares well with that of the TPC for the diagnostic of VAP.
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Ann Fr Anesth Reanim · Mar 2002
[Evaluation of an information document about patients and transfusion].
To evaluate the understanding of written information contained in the information sheet for patients intended to receive an homologous transfusion and to know their opinion about this document. ⋯ The value of a written information for the patients is confirmed by the study. In addition, patients were not generally worried by this information. The partition of the document has been appreciated. It is noteworthy that a gap exist between the patient's perception of the information and their actual level of understanding.
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Ann Fr Anesth Reanim · Mar 2002
[Survey of bibliographic facilities offered in departments of anesthesia and intensive care of French univeristy hospitals].
We assessed bibliographic facilities offered in departments of anaesthesia (DA) belonging to university hospitals in metropolitan France. ⋯ DA offers a wide variation in bibliographic facilities in French university hospitals.
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Ann Fr Anesth Reanim · Mar 2002
Case Reports[Anaphylaxis after rocuronium: advantage of blood tests for early diagnosis].
A 56-year-old patient was scheduled for coronary artery bypass surgery, because of a severe coronary artery disease. Soon after induction of anaesthesia, he rapidly developed a cardiovascular collapse with bronchospasm and rash. Specific immunoglobulin E and tryptase measurements supported the diagnosis of grade III anaphylactic shock due to rocuronium bromide. A few days later, a general anaesthesia was administered without muscle relaxant and was uneventful.
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We report the case of a 76-year-old man who received a spinal anaesthesia for inguinal hernia repair surgery. A cranial CT scan which was performed because the patient complained of postoperative headache and hemiparesis showed an important pneumocephalus. Because postoperative questioning revealed that the patient had a chronic and neglected rhinorrhea, we hypothesise that this pneumocephalus was secondary to an old unknown osteodural leak with intracranial air entry secondary to the spinal anaesthesia-releated decrease in CSF pressure.