Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1984
[Anesthesia and intensive care in cardiac surgery. Activity at the French centers in 1982].
A national survey was carried out to inquire about the practice of anaesthesia and surgical intensive care in cardiac surgery in French hospitals. In 1982, 15,797 surgical procedures with cardiopulmonary bypass were collected; 1,360 and 555 were performed in children and infants respectively. Coronary surgery accounted for 46% of the total. ⋯ With the exception of arterial blood pressure monitoring, there was no consensus on the method or the extent of monitoring of patients undergoing cardiac surgery. A Swan-Ganz catheter was only used in 18% of cases. Neuroleptanalgesia was the anaesthetic technique most often used.
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Ann Fr Anesth Reanim · Jan 1984
[Urinary excretion of creatinine and 3-methylhistidine in multiply injured patients].
The daily urinary excretion of 3,methylhistidine (3,MeHis) was measured in eight severely injured patients for periods of at least two weeks to at most one month after the trauma. The patients were fed with 0.20 +/- 0.05 g X kg-1 X 24 h-1 of nitrogen and 25 +/- 5 kcal X kg-1 X 24 h-1 given as glucose. The pattern of 3,MeHis and creatinine excretion as well as the weight loss suggested the following: 1) the muscle protein breakdown in these patients was approximately twice the normal value (the mean 3,MeHis excretions were respectively 7.98, 7.21, 6.26 and 5.14 mumol X kg-1 X 24 h-1 for the four week study period, compared with the normal value of 3.73); 2) the creatinine excretion decreased slowly. ⋯ Various factors could be responsible for increasing and extending the muscle protein catabolism: the importance of muscle damage, the metabolic response to neurotrauma, sepsis and prolonged immobilization. In these conditions, it would seem useless and even harmful to try, at all costs, to obtain a positive nitrogen balance. The authors suggest therefore an average intake of 0.2 g X kg-1 X 24 h-1 of nitrogen, which should be sufficient to meet the requirements for protein synthesis.
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Ann Fr Anesth Reanim · Jan 1984
Case Reports[Pourfour Du Petit syndrome following brachial plexus block].
While Horner's syndrome resulted from a paralysis of the cervical sympathetic outflow, its opposite, Pourfour Du Petit's syndrome, was caused by the irritation of these nerves. The case described occurred after brachial plexus block.
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Ann Fr Anesth Reanim · Jan 1984
[Muscle relaxant effect of atracurium in patients with chronic renal failure].
The muscle relaxant effect of atracurium was monitored by measuring the strength of the adductor pollicis muscle (TH) elicited by supramaximal stimulation of the ulnar nerve at the wrist. In order to facilitate tracheal intubation, a dose of 0.6 mg X kg-1 was administered in 10 patients with complete renal failure. The results were compared with those obtained from 20 normal patients. ⋯ The duration of effect was similar in both groups. The delay between injection and 75% recovery of TH was of 62 min in controls and 52 min in patients with renal failure. Only the recovery index (the time elapsed between 25% and 75% recovery) was shorter in patients with renal failure (p less than 0.01): 8 min instead of 14 min in the controls.