Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Feb 2010
[French national survey on evaluation by residents in anesthesiology and critical care of choice's motivations of the specialty and their practical and theoretical training].
The duration of Anesthesiology and Intensive Care (AIC) residency increased from four to five years in 2002 in France. AIC is a specialty increasingly chosen in relation to medical and surgical specialties. We conducted a national survey by questionnaire on the evaluation of their theoretical and practical training by the French residents. ⋯ French AIC residents seem satisfied with almost all their training and referred the same choice of specialty.
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Ann Fr Anesth Reanim · Feb 2010
Review[ARDS and influenza A (H1N1): patients' characteristics and management in intensive care unit. A literature review].
Novel influenza A (H1N1) at the origin of the 2009 pandemic flu developed mainly in subjects of less than 65 years contrary to the seasonal influenza, which usually developed in elderly patients of more than 65 years. Elderly subjects are partly protected by old meetings with close stocks. Influenza A(H1N1) can arise in serious forms within 60 to 80% of cases a fulminant acute respiratory distress syndrome (ARDS) "malignant and fulminant influenza" in subjects without any comorbidity, which makes the gravity and the fear of this influenza. ⋯ Obesity, pregnancy and respiratory diseases (asthma, COPD) seem to be associated to the development of a severe viral pneumonia due to influenza A (H1N1) often with ARDS. Older age, high APACHE II and SOFA scores and a delay of initiation of the antiviral treatment by oseltamivir are associated to higher morbidity and mortality. Other analyses of the results obtained from the first published papers included more patients and future studies would permitted to better define the role of therapeutics such as steroids and ECMO.
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Ann Fr Anesth Reanim · Feb 2010
Review[Microcirculatory alterations in critically ill patients: pathophysiology, monitoring and treatments].
Microcirculation represents a complex system devoted to provide optimal tissue substrates and oxygen. Therefore, pathophysiological and technological knowledge developments tailored for capillary circulation analysis should generate major advances for critically ill patients' management. In the future, microcirculatory monitoring in several critical care situations will allow recognition of macro-microcirculatory decoupling, and, hopefully, it will promote the use of treatments aimed at preserving tissue oxygenation and substrate delivery.
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Ann Fr Anesth Reanim · Feb 2010
Multicenter Study[Practice assessment of central venous lines care in surgical ICU of French university hospitals].
Recommendations on insertion and maintenance of central venous catheters (CVC) in intensive care unit (ICU) patients were updated in 2002. The aim of this study was to estimate their knowledge and/or application by physicians in French university hospital ICUs. ⋯ The high number of answers allows setting of a precise state of CVCs insertion practices in adult surgical ICUs. Recommendations for central venous catheter insertion and maintenance are not still known and\or applied.