Annales françaises d'anesthèsie et de rèanimation
-
Ann Fr Anesth Reanim · Mar 2007
Review[Cardiopulmonary interactions in patients under positive pressure ventilation].
Heart-lung interactions during positive-pressure ventilation are characterized by an extreme sensibility to the patient's intravascular volume status. Indeed, a fall in cardiac output due to decreased ventricular preload can be observed when initiating positive-pressure ventilation. This phenomenon is due to the close anatomic-functional association between heart and lungs, and to the fact that pulmonary volume and intrathoracic pressure variations cyclically modify heart-lung interactions. The present review address the questions of the physiological and physiopathological effects of positive-pressure ventilation on the right and left venous returns, and on pulmonary and systemic vascular resistances.
-
Ann Fr Anesth Reanim · Mar 2007
Review[The abnormal activated partial thromboplastin time biphasic waveform: a red flag in the sepsis? Technique and interest as marker of the sepsis].
The biphasic waveform (BPW) is an abnormality of the optical transmission waveform obtained during measurement of the activated partial thromboplastin time on a specific photometric haemostasis autoanalyzer. This abnormality is related to calcium-dependent formation of complexes between C reactive protein and very low density lipoprotein. Biphasic waveform had a high sensitivity and negative predictive value for the identification of patients with severe sepsis and septic shock. ⋯ Further trials should be necessary using BPW for diagnostic and management procedures. Compared with other laboratory markers such as C reactive protein or procalcitonin, activated partial thromboplastin time waveform analysis is a tool that is rapid, inexpensive, effective and available 24 hours a day. When the analyzer is locally available, waveform analysis of this routine coagulation test provides information for the diagnosis of severe sepsis and the prognosis of septic patients.
-
Ann Fr Anesth Reanim · Mar 2007
Randomized Controlled Trial[Hydroxyzine premedication does not alter bispectral index changes following etomidate induction of general anaesthesia].
Various drugs including hydroxyzine are preoperatively administered to facilitate the induction of general anaesthesia. We investigated the effect of hydroxyzine premedication on BIS-based etomidate induction of general anaesthesia. ⋯ Oral weight-related hydroxyzine premedication does not alter BIS-based etomidate induction of GA.
-
Ann Fr Anesth Reanim · Mar 2007
Clinical Trial[The LTD laryngeal tube: a new single-use airway device].
Clinical study of a new supraglottic single use airway device, the LTD with evaluation of insertion, efficiency during intermittent positive pressure ventilation and side effects. ⋯ The learning curve was low< or =10. Insertion is easy. The quality of airway protection allows secure positive pressure ventilation. Postoperative side effects are minor and transient.
-
Ann Fr Anesth Reanim · Mar 2007
[Evaluation of a training method for transtracheal punction for emergency oxygenation].
Transtracheal oxygenation is a lifesaving technique in a cannot-ventilate, cannot-intubate situation, in setting percutaneous transtracheal catheter. ⋯ Percutaneous transtracheal catheter setting is a life saving technique with which every anaesthesiologist should be familiar. Viewing a pedagogic videotape and training on cadavers provides a rapid and effective training method for cricoid membrane puncture. Four attempts seem necessary to obtain an optimal success rate.