Annales françaises d'anesthèsie et de rèanimation
-
Ann Fr Anesth Reanim · Apr 2001
Case Reports[Barotrama during apnea testing for the determination of brain death].
We describe three cases of tension pneumothorax occurring during apnea testing for the determination of brain death. Every case needed needle thoracostomy for emergency chest deflation and/or a chest tube to be inserted rapidly. ⋯ This was uneventful for the two first patients (organs harvesting was contra-indicated or not consented by the patient's family), but might be responsible for damaging lungs in the third patient and consequently loosing the pulmonary graft. Limitation of oxygen insufflation up to 8 L.min-1 with a 12 F oxygen supply tubing inserted within 5 cm into the endotracheal tube should be recommended to avoid this iatrogenic complication.
-
Ann Fr Anesth Reanim · Apr 2001
Case Reports[Esophageal bezoar resulting from nasogastric enteral feeding in an intensive care unit].
We report two cases of oesophageal bezoar in patients given enteral nutrition by nasogastric tubing in an intensive care unit. These two complications occurred during the year following the replacement of our standard enteral feed by a new preparation enriched in proteins. In both patients, the bezoar could be endoscopically removed. The enteral feeding solution is likely to be responsible for the development of this complication because no other factor known to favour this complication such as concomitant administration of sulfacrate or anti-acid agents was given to the patients; and the bezoar developed shortly after the new enteral feeding solution was used, a hypothesis supported by several similar case reports in the medical literature.
-
To analyse the results of the immediate evaluation of an European teaching session using a questionnaire provided by the French College of anaesthesiologists. ⋯ The analysis of medical evaluation should allow to determine an acceptable zone of quality which may be useful for accreditation. However, distorting results according to the professional mode of exercise and the own medical practise should encourage the development of adapted continuous medical education. Delayed evaluation may be necessary to objective the putative benefits of CME on medical practise.