Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jul 2010
[Does the second cycle of French medical studies prepare students to be future anesthesiologists and intensivists?].
To analyze the factors influencing the choice of the specialty "anesthesiology and intensive care" by medical students at the end of the second cycle of the French medical curriculum. This study had three aims: to measure the attraction of students for this specialty, to assess the perception of this specialty at this stage of the medical studies, and to study the influence of the teaching of "anesthesiology and intensive care" during this second cycle on student perceptions of the specialty. ⋯ Numerous medical students want to become intensivists. Anesthesiology is less well-known at this stage of the medical studies. The teaching of the "anesthesiology and intensive care" specialty needs to be optimized.
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The purpose of this review is to draw up a statement on current knowledge available on the more recent hydroxyethyl starch (HES). ⋯ The first HES was made available in the United States in 1970. The development of a new generation of HES restarted the discussion on clinical interest and the limits in the use of these macromolecules. This interest is also strengthened today by the recent data attached to plasma substitution in intensive care or perioperative resuscitation. The interest for crystalloids and colloids is still widely debated, and among the latter, the relative interest of the HES last generation compared to older ones. Recent HES development is in line with a decrease molecular weight, change rate molar substitution and to amend the glucose to hydroxyethyl report. The ultimate goal is to reduce the side effects of these molecules preventing their use. Side effects are dominated by haemostasis and renal dysfunction. The latest developments are the so-called HES "balanced" solutions.