Annales françaises d'anesthèsie et de rèanimation
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Hypernatremia is defined by a serum sodium concentration of more than 145 mmol/L and reflects a disturbance of the regulation between water and sodium. The high incidence of hypernatremia in patients with severe brain injury is due various causes including poor thirst, diabetes insipidus, iatrogenic sodium administration, and primary hyperaldosteronism. ⋯ Because of the rapid brain adaptation to extracellular hypertonicity, sustained hypernatremia exposes the patient to an exacerbation of brain edema during attempt to normalize natremia. Like serum glucose, serum sodium concentration must be tightly monitored in the intensive care unit.
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Ann Fr Anesth Reanim · Jun 2014
Letter Case Reports[Diffuse encephalitis and coma on isotretinoin treated patient.]
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Ann Fr Anesth Reanim · Jun 2014
Case Reports[Recurrent syncope in head and neck cancer: A case report.]
The repeated syncopes in case of head and neck cancer are a complication rarely described in the literature. They occur when the tumor invade the carotid sinus or the afferent fibers of the glossopharyngeal nerve. ⋯ A computerized tomography showed a voluminous tumor expanded to the carotid and parapharyngeal spaces. After treatment by isporenaline chlorhydrate in intensive care unit, a pacemaker was implanted to prevent syncopes and allowed the beginning of the chemotherapy.
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Ann Fr Anesth Reanim · Jun 2014
Review[Intravenous lipid emulsion and local anesthetic-induced systemic toxicity: Mechanisms and limits.]
Intravenous lipid emulsions (ILE) are recommended today in cases of local anesthetic-induced systemic toxicity (LAST). The objectives of this review consists in describing mechanisms involved in the interaction between ILE and local anesthetic (LA) factors influencing this interaction and the limits associated with the use of ILE. ⋯ Prescription of ILE is recommended by published guidelines on LAST resuscitation. ILE cannot substitute to the standard resuscitation protocol. It should be added to that protocol. Experimental studies as well as a case report registry will allow understanding further the effects induced by the ILE-LA association.
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Ann Fr Anesth Reanim · Jun 2014
Guideline[Storing succinylcholine in prehospital settings following the recommendations of the French National Agency for the safety of medicines.]
The French National Pharmaceuticals Agency (ANSM) has recommanded in July 2012 not to break the cold chain before using succinylcholine (Celocurine®). ⋯ After recommendations from ANSM, conservation modes and destruction of succinylcholine in a prehospital environment were significantly impacted.