Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 2001
[Blood transfusion in adults: description of a quality assurance program].
In 1995, a fatal transfusion complication led to the development of a quality-assurance programme (QAP). Initial analysis showed important deficiencies in practice patterns for both nurses and physicians. No written guidelines had been previously produced. ⋯ The success of a change of practice patterns relies on hospital administration positive role, education and feedback, written and immediately available guidelines, employment of specially trained personnel, long-standing actions. Future accreditation of hospitals based on well-defined and well-implemented procedures will also be a major help to increase the quality of the transfusion process.
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To analyze the current knowledge concerning xenon anaesthesia. ⋯ The noble gas xenon has anaesthetic properties that have been recognized 50 years ago. Xenon is receiving renewed interest because it has many characteristics of an ideal anaesthetic. In addition to its lack of effects on cardiovascular system, xenon has a low solubility enabling faster induction of and emergence from anaesthesia than with other inhalational agents. Nevertheless, at present, the cost and arety of xenon limit its widespread use in clinical practice. The developement of closed rebreathing system that allowed recycling of xenon and therefore reducing its waste has led to a recent interest in this gas. Reducing its cost will help xenon to find its place among anaesthetic agents. An European multicentric clinical trial under submission will contribute to the discussion of the opportunity for xenon introduction in anaesthesia.
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Ann Fr Anesth Reanim · Jan 2001
Case Reports[Epidural anesthesia for Cesarean section in a patient with von Hippel-Lindau syndrome].
Von Hippel-Lindau (VHL) disease is an autosomal dominant disorder with variable penetrance. It is mainly characterized by haemangioblastomas of the retina and central nervous system. ⋯ We report the case of a 28-year-old woman with an history of VHL disease who had an epidural anaesthesia for labour and for Caesarean section performed because of failure to progress and of fetal distress. The overall maternal and neonatal outcomes were excellent.
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Ann Fr Anesth Reanim · Jan 2001
Case Reports[Intraoperative ventilatory obstruction by twisting of a reusable coiled expiratory breathing tube].
A case of intraoperative subtotal obstruction of a reusable coiled expiratory breathing tube is reported. Partial occlusion by twisting was made possible by detachment of the coil from the external face of the tube after multiple reprocessings with high drying temperatures. A technique for tube checking before reuse is described.
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Ann Fr Anesth Reanim · Dec 2000
Case Reports[Unusual course of a pulmonary artery catheter through a persistent superior vena cava] .
We report the unusual course of a pulmonary artery catheter through a persistent left-sided superior vena cava. After left subclavian vein cannulation and downward left-sided paramediastinum course, the Swan-Ganz catheter enters the right pulmonary artery. Haemodynamic monitoring was consistent with the diagnosis of septic shock developed by this 56-year-old woman, after cephalic duodenopancreatectomy. ⋯ It drains into the right atrium through the coronary sinus in 92% of cases and is associated with an absent right superior vena cava in 20% of cases. The left-sided superior vena cava persists when the caudal part of the left anterior cardinal vein does not degenerate. A persistent left superior vena cava may be medically relevant during implantation of pacemaker leads or radiofrequency ablation, during cardiac surgery for placement of a retrograde coronary sinus cardioplegia catheter and during transjugular intrahepatic portosystemic shunt placement.