Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 2011
Clinical Trial[Tranexamic acid reduces haematomas but not pain after total knee arthroplasty].
Tranexamic acid (TxA) reduces total blood losses (TBL) and allogenic transfusion (TH) after total knee arthroplasty (TKA). TBL can be external (surgical field, drains), or hidden (haematomas). Haematomas induce pain and limit postoperative rehabilitation. The aim of the study was to evaluate if TxA reduces haematomas and pain after TKA. ⋯ After TKA, TxA reduces the volume of hematomas, without any improvement in analgesia and rehabilitation until the sixth postoperative month.
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Ann Fr Anesth Reanim · Jan 2011
[Agreement between lung ultrasonography and chest radiography in the intensive care unit].
Because the chest radiograph currently remains the routine choice of imaging for the examination of the chest in the intensive care unit, we compared lung ultrasonography with chest radiography. ⋯ There was only moderate agreement between lung ultrasonography and chest radiography for the diagnosis of interstitial syndrome, alveolar consolidation and pleural effusion in intensive care unit. This result is mainly explained by the higher number of ultrasound abnormalities. With the ability to provide fast diagnosis, good reproducibility and high feasibility, ultrasound scan could represent an alternative exam for chest exploration in intensive care unit.
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Ann Fr Anesth Reanim · Jan 2011
Case Reports[Severe acute asthma: isoflurane administration via AnaConDa™, is it safe?].
Standard treatments against severe acute asthma can be insufficient and need salvation treatments, such as isoflurane delivery. These treatments have not been much assessed and could lead to unrecognized side-effects. We report the case of a young man who suffered from intracranial hypertension associated with severe hypercapnia during the delivery of isoflurane via the system AnaConDa™ or Anaesthetic Conserving Device™ (ACD) (Sedama Medical). The rising of PaCO(2) appears to be linked to an ACD-dependent increase in the dead space.
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The mistake-proofing concept often refers to physical devices that prevent actors from making a wrong action. In anaesthesiology, one immediately thinks to specific design of outlets for medical gases. More generally, the principle of mistake-proofing is to avoid an error, by placing knowledge in the world rather than knowledge in the head. ⋯ The mistake-proofing concept may be applied to prevention, detection, and mitigation of errors. The forcing functions are a specific part of mistake-proofing: they prevent a wrong action or they force a virtuous one. Grout proposes a little shortcut to identify mistake-proofing devices: "If it is not possible to picture it in action, it is probably not a mistake-proofing device".
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Ann Fr Anesth Reanim · Jan 2011
Case Reports[Postpartum reversible cerebral angiopathy: an unusual cause of headache].
We present the case of a 34-year-old woman who developed, in postpartum period of an uncomplicated pregnancy, a thunderclap headache with visual disturbance associated with a severe arterial hypertension. Both clinical evolution and cerebral imaging including angio-MR confirmed the diagnosis of postpartum reversible vasoconstriction syndrome. One of the leading causes of this syndrome is the use of vasoactive drugs as it was observed in the case of this patient. It is important to consider this syndrome in the differential diagnosis in patients presenting with headache in the postpartum period.