Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Sep 2013
Randomized Controlled Trial[Influence of pressure- and volume-controlled ventilation on pulse pressure variations: Randomized study.]
Pulse pressure variation (ΔPP) has been demonstrated to be an accurate dynamic parameter to predict fluid responsiveness. However, the impact of different ventilator modes on this parameter is unknown. We compared ΔPP values calculated alternatively during pressure- and volume-controlled ventilation. ⋯ ΔPP values obtained with both ventilator modes were not interchangeable. On average, ΔPP decreases by more than two points in the passage VVC to VPC for a given patient, all others things being equal.
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Ann Fr Anesth Reanim · Sep 2013
Observational StudyDelirium in older people after proximal femoral fracture repair: Role of a preoperative screening cognitive test.
Preoperative cognitive impairment has been identified as a major risk factor for postoperative delirium in older people. The aim of this study was to evaluate whether a validated and rapid screening cognitive test - COgnitive Disorder EXamination (CODEX) - performed preoperatively before proximal femoral fracture repair, was associated with a risk of postoperative delirium. ⋯ Abnormal preoperative rapid screening test CODEX is independently associated with postoperative delirium in older people undergoing hip fracture surgery and free of known dementia.
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Ann Fr Anesth Reanim · Sep 2013
Case Reports[Multiple organ failure complicating a severe acute necrotising pancreatitis secondary of a severe hypertriglyceridemia: A case report.]
We report the case of a 42-year-old man admitted for a multi-organ failure with a coma, a hemodynamic instability, a respiratory distress syndrome, an acute renal failure and a thrombocytopenia. The blood samples highlighted a milky serum and allowed to diagnose an acute pancreatitis associated with a major dyslipidemia: hypertriglyceridemia 11,800 mg/dL and hypercholesterolemia 1195 mg/dL. The CT-scans do not reveal any cerebral abnormalities but highlighted pancreatic lesions without biliary obstruction. ⋯ The clinical and biological course was good in parallel of the normalization of lipid abnormalities. The patient was discharged at day 17 with a lipid-lowering therapy. We discuss the various treatments available for the management of acute pancreatitis complicating a severe hypertriglyceridemia and their actual relevance in the absence of clear recommendations.