Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Dec 2014
Case Reports[Postoperative dissection of the vertebral artery in two steps.]
The diagnosis of perioperative vertebral artery dissection can be difficult because of non-specific clinical signs. We report a case revealed by a tegmento-thalamic stroke after an abdominal second surgical look. ⋯ We discuss here the different factors possibly involved in the pathophysiology of postoperative vertebral artery dissection: positioning, cervical manipulation, subclavian central venous access and cisplatin toxicity. Vertebral artery dissection should be discussed in case of postoperative neck pain, especially with non-typical symptomatology.
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Ann Fr Anesth Reanim · Dec 2014
Review Meta Analysis[Epidemiology of cerebral perioperative vascular accidents.]
Stroke is a well-described postoperative complication, after carotid and cardiac surgery. On the contrary, few studies are available concerning postoperative stroke in general non-cardiac non-carotid surgery. The high morbid-mortality of stroke justifies an extended analysis of recent literature. ⋯ Postoperative stroke is a quality marker of the surgical teams' skill and has specific onset time and induces an increase of postoperative mortality.
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Ann Fr Anesth Reanim · Dec 2014
Review[Specific anaesthetic procedures for nasal and sinus surgery.]
In nasal and sinus surgery, the anaesthetist must share the operating field with the surgeon and take into account some patients' specific pathologies. Bleeding must be avoided by different means but the accurate gesture of the surgeon, added to the properties of the new anaesthetic drugs, may reduce the risk of this functional surgery.
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Ann Fr Anesth Reanim · Dec 2014
Case Reports[Acute respiratory distress syndrome complicating an acute chest syndrome: Potential benefit of early combination of exchange transfusion and prone positioning.]
We report the case of an 8-year-old sickle cell anemia child admitted for acute respiratory failure complicating acute chest syndrome. Because of threatening respiratory failure, tracheal intubation was performed immediately after ICU admission. The patient met the criteria for ARDS with a PaO2/FiO2 ratio of 94mmHg. ⋯ Steroids were given for 48h and the patient was successfully extubated on day 7. She was discharged from the ICU on day 8, and from the hospital on day 12. We discuss the various treatments available for the management of acute chest syndrome and their actual relevance in acute respiratory distress syndrome in the absence of strong evidence-based guidelines in pediatric ARDS.
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Ann Fr Anesth Reanim · Dec 2014
Observational Study[Impact of a program designed to improve continuous renal replacement therapy stability.]
During continuous renal replacement therapy (CRRT), circuit clotting increases nursing workload, cost of the therapy and blood loss. The aim of this study was to assess the impact of a program designed to improve CRRT stability on unexpected circuit clotting. ⋯ Our program designed to improve CRRT stability reduced filter losses by reducing unexpected circuit clotting.