Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1996
[Blood loss from diagnostic laboratory tests performed in intensive care units. Preliminary study].
To assess the volume of blood samples withdrawn for laboratory testing in intensive care unit (ICU) patients and to determine the influence of the resulting blood loss on transfusion requirements in patients staying in the ICU for more than seven days. ⋯ Blood losses from blood withdrawal for laboratory tests are important and in agreement with the results of other reports. It is generally accepted that iatrogenic blood loss of this magnitude can cause anaemia if repeated over a prolonged period. Conversely, our data suggest that blood sampling does not contribute significantly to anaemia and transfusion requirements in patients with a prolonged ICU stay.
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Ann Fr Anesth Reanim · Jan 1996
[Inspiratory aid with facial masks during acute respiratory failure without hypercapnia].
This prospective study assessed, in 10 conscious patients without a history of chronic respiratory disease, the feasibility of mechanical pressure support ventilation with PEEP by face mask for the treatment of acute respiratory failure without hypercapnia. Pressure support level was determined to obtain a VT of 5 to 10 mL.kg-1 and a decrease of respiratory rate of more than 20%. FIO2 and PEEP levels were determined to obtain a SpO2 > 92% and a PaO2 > 70 mmHg. ⋯ The technique was efficient in all patients and tracheal intubation was not required. During face mask ventilation, a significant decrease in respiratory rate and an increase in PaO2 and SaO2 were observed. Pressure support ventilation with PEEP by face mask is an efficient technique for the treatment of acute non hypercapnic respiratory failure in conscious and cooperative patients.
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Ann Fr Anesth Reanim · Jan 1996
[Claims related to anesthesia at the University Hospitals of Paris].
To evaluate the number and the reason of anaesthesia-related malpractice claims in university hospitals of Paris. ⋯ There are few anaesthesia-related claims in the Paris university hospitals. Only few claims result in a compensation. By contrast, when a indemnification is alloted, its amount is very high. Locoregional anaesthesia seems to be at a higher risk for malpractice claims.
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Ann Fr Anesth Reanim · Jan 1996
[Resistance to vecuronium in burnt patients. Influence of the burnt surface on the effectiveness of the dose 95].
To assess the neuromuscular blocking effect of vecuronium in adult burn patients, to draw dose-response curves, to determine the ED 95 according to burn surface area, to analyze the time course of this pattern in order to recognize the development of a resistance according to the length of postinjury period. ⋯ Acutely burn patients become resistant to the neuromuscular blocking effect of vecuronium. This resistance is related to the magnitude of burn injury. The mechanism of resistance is related to an increase in nicotonic acetylcholine receptors. In these patients, the dose of vecuronium must be titrated to achieve effective muscular paralysis: the correcting factor is 1.3 for a BSA under 20%, 1.9 for a BSA between 20 and 40%, 2.5 for a BSA between 40 and 60%, and 2.9 for a BSA above 60%.
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Human albumin is available either as a 4 or a 20% solution. Only the latter is a plasma expander which increases volaemia by an amount corresponding to the four-fold of the infused volume. ⋯ Therefore, when the administration of albumin is indicated, the 20% solution should be preferred, as well as for volume expansion as for other uses, due to a decreased sodium load. However, this recommendation has not been substantiated by comparative studies.