Annales françaises d'anesthèsie et de rèanimation
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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.
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To evaluate recent data provided on new treatments of patients with septic shock. ⋯ The improvement of survival in septic syndrome patients is a difficult challenge. The uses of different new therapeutic options like protein C reactive, steroids, or early goal therapy in association should make it possible to reduce the mortality in septic patients.