Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jul 2003
Review[Difficult tracheal intubation in paediatric: myth or reality?].
Difficult tracheal intubation is a rare event according to the airway feature in child. This situation is mostly predictable, occurring in identified malformations and in specific diseases. Pre-operative clinical evaluation must detect facial abnormalities (lip or palate cleft, microtia, facial asymmetry.), micro or retrognathia, limited mouth opening, reduced distance between thyroid cartilage and chin, macroglossia and external ear malformations. According to this clinical evaluation, a strategy for managing difficult tracheal intubation is planned.
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Ann Fr Anesth Reanim · Jul 2003
Review[Indications of vasopressin in the management of septic shock].
Vasopressin (antidiuretic hormone) is emerging as a potentially major advancement in the treatment of septic shock. Vasopressin is both a vasopressor and an antidiuretic hormone. It also has haemostatic, gastrointestinal, and thermoregulatory effects. This article reviews the physiology of vasopressin and all the relevant clinical literature on its use in the treatment of septic shock. ⋯ Vasopressin mediates vasoconstriction via V1-receptor activation on vascular smooth muscle. Septic shock causes first a transient early increase in blood vasopressin concentrations that decreases later to very low concentrations compared to other causes of hypotension. Vasopressin infusion of 0.01-0.04 U min(-1) in septic shock patients increases plasma vasopressin concentrations. This increase is associated with a lesser need for other vasopressors. Vasopressin has been shown to produce greater blood flow diversion from non-vital to vital organ beds than does adrenaline. A large randomized clinical trial should be performed to assess its place as a therapeutic agent of septic shock patient.
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Ann Fr Anesth Reanim · Jul 2003
Randomized Controlled Trial Comparative Study Clinical Trial[Topical methylprednisolone vs lidocaïne for the prevention of postoperative sore throat].
We assessed the efficacy of topical methylprednisolone or lidocaine for prevention of postoperative sore throat. ⋯ Topical methylprednisolone may therefore be a useful adjuvant in the prevention of sore throat after intubation.