Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Oct 2013
Observational Study[Usefulness of Bispectral Index (BIS) monitoring for early detection of cerebral hypoperfusions.]
The goal of the study was to assess whether clinically significant cerebral hypoperfusion in awake patients would be associated with some alterations in the values of the bispectral index (BIS) monitoring. ⋯ In awake patients, the observed values of the BIS monitoring seem to be associated with clinically relevant cerebral hypoperfusion.
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Blood transfusion is an aspect of medical care on the battlefield. French assets include: red blood cell units (RBCu), lyophilized plasma (PLYO), fresh whole blood (FWB) but neither fresh-frozen plasma (FFP) nor platelets. French transfusion strategy in military operations follows the evolution of knowledge and resources. We describe the characteristics of the transfusion at the military hospital in Kabul. ⋯ The use of the FWB and PLYO in substitution of FFP and platelets can provide cares of high quality in a logistically constrained context while controlling costs.
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Ann Fr Anesth Reanim · Oct 2013
Randomized Controlled TrialTarget-controlled induction with 2.5% sevoflurane does not avoid the risk of electroencephalographic abnormalities.
Epileptiform discharges (ED) can occur during sevoflurane induction, especially in young female patients and when high alveolar concentrations are used. The aim of this study was to evaluate whether low sevoflurane concentration reduces the occurrence of ED in female patients. ⋯ Induction of anesthesia with low target concentration of sevoflurane (2.5%) fails to totally prevent the occurrence of ED in young female patients and should be used carefully in this population.
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Ann Fr Anesth Reanim · Oct 2013
[Off-label use of recombinant factor VII (rFVIIa) in teaching hospitals in Paris in 2010.]
Recombinant activated factor VII (rFVIIa) (Novoseven(®)) was initially developed as a substitutive treatment in haemophiliacs but has then been used in situations of major haemorrhage in non-haemophiliacs (off-label use). The goal of the present study was to assess the practice patterns when rFVIIa is used in off-label indications in major teaching hospitals of Paris in 2010. ⋯ In the vast majority of patients who received rFVIIa for off-label indications in teaching hospitals of the Paris area in 2010, prescriptions were in line with recommendations.
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Ann Fr Anesth Reanim · Oct 2013
Case Reports[Cesarean section and sismotherapy in a severe psychotic parturient: A case report.]
Psychiatric disorders may complicate the pregnancy and is one of the causes of maternal and fetal morbidity. We report the case of a patient with severe decompensated schizophrenia during her pregnancy that required prolonged hospitalization in psychiatric ward. The psychiatric status of the patient required the realization of a caesarean section at 36 weeks of amenorrhea. ⋯ Moreover, general anaesthesia permitted to combine cesarean section with a first session of electroconvulsive therapy, which had been declined during pregnancy. Given the huge amount of antipsychotic agents administered to the patient, we also studied their transplacental transfer and found a very high loxapine concentration in the fetus. Finally, this case raised several important ethical issues related to the management of the mother and her fetus in case of severe psychiatric disorders.