Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Oct 2008
Guideline[Field 3. Structural and managerial skills for improvement in safety practice. French-speaking Society of Intensive Care. French Society of Anesthesia and Resuscitation].
ICU activity has to be authorized by regional hospital agencies. The structural aspects of ICU have been defined in official text in 2002. Thus, quality related to structural issues should be settled in the next future. ⋯ This new quality-security oriented policy must be supported by the institution. The volume-outcome relationship has been demonstrated across a wide range of medical and surgical procedures. On average, higher volume is associated with higher quality and better outcome.
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Ann Fr Anesth Reanim · Oct 2008
Practice Guideline Guideline[Field 5. Safety practices procedures for mechanical ventilation. French-speaking Society of Intensive Care. French Society of Anesthesia and Resuscitation].
Invasive or endotracheal mechanical ventilation can lead to numerous complications likely to burden morbidity and mortality of patients in the intensive care unit. Various safety practices for mechanical ventilation may involve intubation, the mechanical ventilation period, weaning and extubation, the use of tracheostomy as well as non-invasive ventilation. The main objective of safety practices described in this chapter is to prevent or avoid the main risks due to invasive mechanical ventilation.
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Ann Fr Anesth Reanim · Oct 2008
Practice Guideline[Field 6. Safety practices for haemodynamic procedures (administration of vasoactive drugs, vascular and cardiac catheterization). French-speaking Society of Intensive Care. French Society of Anesthesia and Resuscitation].
Arterial and central venous catheterizations and their use for continuous infusion of vasoactive drugs could lead to serious adverses events that could be life threatening. The incidence of human errors related patient adverses events could be decreased by the uses of algorithms and procedures. Concerning the continuous infusion of vasoactive drugs, the name of drug and its concentration should be clearly notified. ⋯ These catheters should be removed when they are not indicated. Concerning the pulmonary artery catheter, the balloon tip should be inflated with visual control of the pulmonary artery pressure. Its removal is recommended within the first five days.
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Ann Fr Anesth Reanim · Oct 2008
Case Reports[Superior vena cava syndrome: cause of secondary raise of intracranial pressure after traumatic brain injury].
A 41-year-old male is admitted for cranial trauma, having fallen from his own height. His state of extreme agitation imposes sedation, intubation and mechanical ventilation. A CT-scan reveals acute right hemispheric subdural haematoma, with discrete midline shift, and diffuse cerebral oedema. ⋯ Within a few days of anticoagulant therapy, SVCS resolved. Impeded cerebral venous drainage is often forgotten or ignored as a cause of secondary elevated ICP. In face of persisting or recurring raised ICP and cerebral oedema, or apparition of communicant hydrocephalus, cerebral venous drainage should be investigated.
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Ann Fr Anesth Reanim · Oct 2008
[Evaluation of the learning curve of residents in localizing a phantom target with ultrasonography].
Few information are available regarding the learning curve in ultrasonography and even less for ultrasound-guided regional anesthesia. This study aimed to evaluate in a training program the learning curve on a phantom of 12 residents novice in ultrasonography. ⋯ Four trials were necessary to adjust correctly the machine, to localize a target, and to complete hydrolocalization. Ultrasonography in regional anesthesia seems to be a fast-learning technique, using this kind of practical training.