Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jul 2003
Case Reports[Left ventricular thrombus and myocarditis induced by paraphenylenediamine poisoning].
We showed that the paraphenylenediamine (PPD) poisoning caused myocarditis but there is no data on the echocardiographic features. We report a case of myocarditis induced by PPD poisoning with echographic data. After ingestion of 5 g of PPD, a 18-year-old woman was admitted to the hospital with asphyxia and rhabdomyolysis. ⋯ A follow-up echocardiogram performed on the 15th day showed normalization of ventricular function and disappearance of the thrombus. No embolic event was noted. Echocardiography is indicated in the myocarditis induced by PPD poisoning to prove the ventricular function as well as the presence of a thrombus.
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Ann Fr Anesth Reanim · Jul 2003
Case Reports[Lepirudin during cardiopulmonary bypass in a patient with heparin-induced thrombocytopenia].
Lepirudin is an alternative anticoagulant therapy in heparin-induced thrombocytopenia (HIT) during cardiopulmonary bypass (CPB). We report a case of a female patient with HIT referred for aortocoronary bypass graft despite persistence of antibodies to platelet factor 4-heparin complexes. Anticoagulation management is described. ⋯ Total lepirudin administration was 44 mg. No haemorrhagic or thrombotic events were observed during surgical procedure and postoperative course. Despite lepirudin administration is not yet clearly precise for CPB procedure, its use seems adapted and safe in subjects without renal insufficiency but requiring precise coordination for anaesthesiological, surgical and biological teams.
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We report the case of an 11 months old boy who felt from 3 m high. He had an isolated brain injury with contusion and bleeding in the right frontal lobe. ⋯ This peritoneal fluid was transudative ascitic fluid which appeared to be mediated by beta-sympathetic hyperactivity of central origin. Sequential echography showed progressive improvement and disappearance of the ascite on 19th day post trauma.