Annales françaises d'anesthèsie et de rèanimation
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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
Review[Improving vital organs perfusion by the respiratory pump: Physiology and clinical use.]
In this article, we review the effects of the respiratory pump to improve vital organ perfusion by the use of an inspiratory threshold device. ⋯ The clinical and animal studies support the use of the intrathoracic pump to treat different clinical conditions: hemorrhagic shock, orthostatic hypotension, septic shock, and cardiac arrest.
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Ann Fr Anesth Reanim · Sep 2013
Observational Study[Obstetric epidural: Focus on French information's quality on the Internet in 2009 and 2010.]
The variability of the medical information available on the Internet (MedInfoWeb) raises concern about its quality. There is no data about the quality of MedInfoWeb concerning epidural analgesia for labour (EAL). Our aims were to assess the quality of MedInfoWeb concerning EAL and to study the stability of MedInfoWeb and the ranking of website into search engine (SE) during 1year. ⋯ The quality of MedInfoWeb concerning EAL is poor and did not improve between 2009 and 2010. The MedInfoWeb is unstable: 42% of the websites disappeared in 1year. No website or SE is currently able to give reliable medical information concerning EAL.
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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.
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Ann Fr Anesth Reanim · Sep 2013
Observational Study[Predictive factors of organ failure in patients admitted in intensive care unit for acute gastrointestinal bleeding.]
Gastrointestinal hemorrhage is an emergency requiring usually an admission in intensive care unit (ICU), which may prove abusive secondarily. The aim of this study was to identify predictive risk factors of organ failure in patients admitted for GH in our ICU. ⋯ Our results confirmed that a large proportion of patients admitted in ICU for the primary diagnosis of gastrointestinal hemorrhage developed any organ failure. The history of cirrhosis and the systemic consequences of the hemorrhagic syndrome as myocardial damage represents important risk factors of morbidity and mortality and thus should be considered during the management.