Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Nov 2003
Case Reports[Glanzmann's thrombasthenia and pregnancy: a case and review of the literature].
Glanzmann's thrombasthenia is a thrombopathy due to a qualitative or quantitative abnormality of glycoproteins GP IIb-IIIa. Pregnancy is uncommon and dangerous. Delivery often results in important haemorrhage, which is treated with HLA compatible platelet and packed red blood cells transfusions. ⋯ Caesarean section has no proven advantage. We report a case with caesarean, which was successfully managed by platelet transfusion over seven peripartum days, with no adverse event. Literature is discussed.
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Ann Fr Anesth Reanim · Nov 2003
Case Reports[Fat embolism after total hip prosthesis replacement preserving the femoral stem].
Fat embolism is a known complication of traumatology, especially in long bone fractures. It may also occur in liposuction and articular surgery (0.1%). Fat embolic events are most often clinically insignificant and difficult to recognize since clinical manifestations are varied and there is no routine laboratory or radiographic diagnosis. ⋯ We report the case of a 33-year-old woman who developed acute respiratory distress 10 days after hip arthroplasty. Several aetiologies such as fibrinocruoric pulmonary embolism, pulmonary aspiration and bacterial pneumonia were discussed. Fat embolism was diagnosed, based on suggestive clinical manifestations, radiographic and laboratory findings, although fat embolism after hip arthroplasty without intramedullary pressurization is infrequent.
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Ann Fr Anesth Reanim · Nov 2003
Clinical Trial[Infectious complications related to non-tunneled central venous catheters in immunocompromised patients: prospective study about 210 cases].
To evaluate infectious complications related to non-tunneled central venous catheter in immunocompromised patients, in a bone marrow unit. ⋯ Non-tunneled catheters in immunocompromised patients (adults and children) is a safe technique, and is an alternative to the Hickman catheters which are most widely used today in patients undergoing bone marrow transplantation.
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Ann Fr Anesth Reanim · Nov 2003
Case Reports[Shock occurring shortly after inferior vena cava interruption using an endovascular device: think of filter thrombosis].
We report the case of a 47-year-old man who experienced a pulmonary embolism associated with a femoral thrombus after a traumatic intracranial haematoma and had caval interruption using a new generation endovascular percutaneous filter. A shock occurred soon after the procedure, associated with inferior cava system inflation related to a filter thrombosis. ⋯ The situation became stable after intensive volume expansion. This report underlines the risk of complication associated to vena cava interruption despite the use of new generation filters and the significance of mechanical measures in prevention of thrombosis when anticoagulants are contraindicated.
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Ann Fr Anesth Reanim · Nov 2003
Review[Critical review of the literature concerning the comparative use of two antiseptic solutions before intravascular or epidural catheterization].
To analyze the most pertinent data from the literature concerning the use of an antiseptic solution before the elaboration of invasive procedures such as blood cultures, insertion of peripheral or central intravenous catheters, and arterial or epidural catheters, and to identify, if any, the "ideal" antiseptic or, at least, the most efficient. ⋯ Even if the in vitro studies favor iodine products, chlorhexidine in alcoholic solution seems more efficient than povidone iodine in aqueous solution in the clinical setting. Several explanations are suggested to understand the in vitro/in vivo discordances. The place of povidone iodine in alcoholic solution, whose performances on the healthy skin are similar to those of alcoholic chlorhexidine, is being in evaluation.