Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Apr 2014
Observational Study[Antifungal treatment for suspected or proved candidiasis in the critically ill.]
Describe systemic antifungal therapy in non-neutropenic adult patients in intensive care unit (ICU). ⋯ For ICU non-neutropenic adult patients in our center, antifungal therapy is prescribed two times out of three for suspected, unproved infections, in most cases with fluconazole. Documented infections were more often treated by echinocandin with secondary de-escalation. An interventional prospective study to assess the role of antifungal pre-emptive or empirical therapy is necessary.
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Ann Fr Anesth Reanim · Apr 2014
Randomized Controlled Trial Comparative StudyDoes sevoflurane preserve regional cerebral oxygen saturation measured by near-infrared spectroscopy better than propofol?
The aim of this study was to compare the effect of sevoflurane and propofol on cerebral oxygenation, using regional cerebral oxygen saturation (SrO2) measured by near-infrared spectroscopy (NIRS). ⋯ Cerebral cortical oxygenation measured by NIRS may be better preserved with sevoflurane than with propofol. These findings suggest that sevoflurane anaesthesia could be a good option in patients with compromised cerebral oxygenation, given the absence of intracranial hypertension. Further studies with larger sample sizes are required to support our results.
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Ann Fr Anesth Reanim · Apr 2014
Review Meta Analysis Historical Article[Tourniquet use in civil and military medicines.]
The purpose of this literature review is, after a history and a point about current situation, to present the military use and precautions of use of tourniquet for civil and military medicine. ⋯ The tourniquet has utility in times of war and in peacetime. In each case, indications and complications must be known.
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Ann Fr Anesth Reanim · Apr 2014
Review[Veno-venous extracorporeal oxygenation and veno-arterial extracorporeal oxygenation. Questions, answers.]
A round table, organized by the French Society of Perfusion (Sofraperf) at the French national congress on extracorporeal circulations (Perfusion 2013), was attended by perfusionists, anaesthesiologists, intensivists and surgeons around the theme of respiratory veno-venous support and veno-arterial circulatory support with extracorporeal oxygenation in intensive care units. The debate was conducted in a participatory manner by bi-directional questions-answers session between moderators and assistance. The authors report management of this type of therapy that is not perfectly homogeneous, supported on literature data. Cannulae, cannulation, circuit, oxygenator, anticoagulation, control, surveillance, weaning are subject to paragraphs with defined entry whose contents are mutually enriching.
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Ann Fr Anesth Reanim · Apr 2014
Review[Contribution of ultrasonography for the preoperative assessment of the gastric contents.]
The assessment of the risk of pulmonary aspiration of gastric contents may be difficult in the preoperative period, apart from typical circumstances. The development of ultrasonography in anesthesia and critical care has led to consider ultrasonic imaging of gastric contents for preoperative risk assessment of "full" stomach in clinical practice. Ultrasonography of the body of the stomach allows direct visualization of the gastric contents. ⋯ Qualitative assessment of the gastric antrum allows easily diagnosis of a "full" stomach. The measurement of antral area may allow a more accurate estimate of the presence or absence of gastric contents at risk of lung injury in the event of regurgitation and aspiration (gastric volume >0.8 ml/kg and/or with solid particles), defining the "risk" stomach. The use of antral ultrasonography may help the anesthesiologist to assess the risk of pulmonary aspiration according to clinical history of the patient, in order to choose an appropriate strategy minimizing the occurrence of this complication.