Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Nov 2011
Review[Epidemiology of war injuries, about two conflicts: Iraq and Afghanistan].
Since March 2003, military operations in Iraq "Operation Iraqi Freedom" (OIF) and in Afghanistan "Operation Enduring Freedom" (OEF), have made many wounded and killed in action (KIA). This article proposes to highlight the specific epidemiology of combat casualties, met in these both non-conventional and asymmetric conflicts. Personal protective equipments, Kevlar helmet and body armor, proved their efficiency in changing features of war injuries. ⋯ This analysis concluded that during modern conflicts, most injuries are caused by explosive devices; injuries are more severe and interestingly more specifically the head region and extremities than the trunk. Hemorrhage is the first cause of death, leading to the concept of avoidable death. Specific databases focused on mechanisms and severity of injuries, diagnostic and treatment difficulties, outcomes can guide research programs to improve war injuries prevention and treatment.
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Ann Fr Anesth Reanim · Nov 2011
Case Reports[Extremely prolonged neuromuscular block after a single dose of rocuronium].
Postoperative curarization in patients has been established. Nevertheless, extremely prolonged neuromuscular blockades are rare. We report the case of a prolonged neuromuscular blockade (lasting 10 hours) following a single dose of rocuronium, in an elderly patient with severe renal failure. We have studied the possible causes of prolonged curarization, and discussed the interest of the use of sugammadex in such cases.
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Ann Fr Anesth Reanim · Nov 2011
[Proton pump inhibitors: impact of professional practice evaluation on prescriptions pertinence].
To improve the quality of proton pump inhibitors (PPI) prescription in an orthopaedic department. ⋯ This study confirmed the interest of professional practice evaluation protocols to improve PPI prescription. A strong implication of all medical staff members is mandatory to maintain such benefits over time.
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Ann Fr Anesth Reanim · Nov 2011
French survey on current use of ultrasound in the critical care unit: ECHOREA.
Over the last ten years, ultrasound became standard procedure in the intensive care unit (ICU). ⋯ Ultrasound, and particularly echocardiography, has taken on a more prominent role in the routine assessment of critically ill patients. The availability of equipment and of training has increased over the last ten years, but the demand for training in this area remains strong. This French survey confirms this technique became the "extension of the hand" of the intensivist in ICU.
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Ann Fr Anesth Reanim · Nov 2011
Case Reports[Bradykinin-mediated angioedema secondary to angiotensin converting enzyme: initiate treatment from the prehospital phase].
We are reporting the case of a bradykinin-mediated angioedema, secondary to the angiotensin converting enzyme inhibitors, which delayed treatment could have unfavorably influence the vital prognostic of the patient. Initially, the patient had an isolated edema of the superior lip. Prehospital treatment included methylprednisolone, hydroxyzine and epinephrine. ⋯ This observation is consistent with the early use of the specific therapeutic in bradykinin-mediated angioedema. Any delay in administering the treatment can negatively impact the prognostic. The availability of such treatments should therefore be organized during the prehospital phase.