Annales françaises d'anesthèsie et de rèanimation
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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
Review[Temporary epicardial pacing following cardiac surgery: Practical aspects.]
To review the practical aspects of temporary epicardial pacing following open heart surgery. ⋯ Temporary epicardial pacing following cardiac surgery is a simple method, more effective than transcutaneous pacing and easier to implement than transvenous pacing. Its practical management should be known by all physicians (anesthetists, cardiac surgeons) as well as paramedical personnel in order to avoid the risks of suboptimal functioning. A good practice protocol is proposed at the end of the manuscript.
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ICU acquired neuromyopathy (IANM) is the most frequent neurological pathology observed in ICU. Nerve and muscle defects are merged with neuromuscular junction abnormalities. Its physiopathology is complex. ⋯ IANM is usually diagnosed in view of difficulties in weaning from mechanical ventilation, but electrophysiology may allow an earlier diagnosis. There is no curative therapy, but early treatment of sepsis, glycemic control as well as early physiotherapy may decrease its incidence. The outcomes of IANM are an increase in morbi-mortality and possibly long-lasting neuromuscular abnormalities as far as tetraplegia.