Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Feb 2006
Review[How to improve central venous catheter use in intensive care unit?].
Central venous catheter (CVC) insertion is routinely performed in critically ill patients but causes mechanical, thrombotic, or infectious adverse events in 15% of cases. It should be possible to improve the benefit/risk ratio of central venous catheterization in intensive care unit. ⋯ Studies evaluating the risk/benefit ratio of CVCs versus peripheral catheters are needed to develop a venous-access strategy for ICU patients. When a CVC is mandatory, recent data are available to improve the risk/benefit ratio and can be used to build a decision algorithm.
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Ann Fr Anesth Reanim · Feb 2006
Case Reports[A mixed acid-base disorder revealing a cystic dystrophy of aberrant pancreatic tissue].
We report about a patient presenting with a mixed acid-base disorder. His blood gas analysis showed a metabolic acidosis caused by renal failure and lactic acidosis combined with a hypochloraemic alkalosis. The underlying pathology was a cystic dystrophy of aberrant pancreatic tissue leading to excessive vomiting, extracellular dehydration with a renal failure and hypochloraemia.
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Long lasting postural puncture headache secondary to an unintentional dural puncture (UDP) during epidural anaesthesia (EA) or following deliberate dural puncture for spinal anaesthesia, and neurological or neuroradiological examination, is becoming unusual. Placing the bevel of Tuohy needle parallel to the longitudinal axis of the dural cylinder when searching for epidural space, and in the later cases, widespread use of small diameter, atraumatic needles, have decreased both its incidence and severity. ⋯ Authors report an original case of a fainthearted patient who underwent caesarean section under EA when she was 31-year-old, and whose disabling painful symptoms related to a UDP were successfully relieved by one EBP that she ended to accept more than seven years later. On the occasion of a short literature review, physiopathology and management are debated.
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Ann Fr Anesth Reanim · Feb 2006
[Evaluation of a continuous training program at Bichat hospital for in-hospital cardiac arrest resuscitation].
Management of in-hospital cardiac arrest is now considered as a hospital quality indicator. Such management actually requires training health care workers (HCWs) for basic life support (BLS). ⋯ Short mandatory training courses are stimulating and well appreciated amongst HCWs. Although basic knowledge and skills improve dramatically, no improvement of on-scene BLS performance occurs.