Annales françaises d'anesthèsie et de rèanimation
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Haemodynamic effects of hypertonic saline solutions (HSS) have been extensively studied in animals and humans. Hypertonic sodium chloride (7.5%, 2,500 mOsm. L-1) either alone or combined with colloids, remains the standard solution. ⋯ Haemorrhagic shock is the main indication for small volume resuscitation with HSS. Other potential situations for the use of HSS are volume replacement in perioperative period, septic shock or burn injury and cardiopulmonary resuscitation. Before recommending the clinical use of HSS, additional clinical studies are required to substantiate the benefits of HSS over colloids.
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Ann Fr Anesth Reanim · Jan 1997
Review[Treatment of intracranial hypertension in the case of severe craniocerebral injuries].
More than 50% of severely head-injured patients develop increased intracranial pressure, risking exacerbating ischaemic insults to the already injured brain. In approximately 10% of these cases, intracranial pressure may become unresponsive to medical or surgical treatment, with a resulting mortality of over 90%. ⋯ Recently, an algorithm for treating intracranial hypertension under three different therapeutic situations has been suggested, based on the successive application of effective agents with increasing associated risks. Therapeutic modalities of this protocol are discussed.
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Basing on the experience of the Chamonix hospital team which managed in six years 89 cases of hypothermia in trauma patients, this article reviewed the literature concerning the association hypothermia-trauma. Shock is a major triggering factor. The deleterious effects of hypothermia on the outcome is due to inadequate cardiorespiratory adaptation to shock and to increased bleeding. ⋯ It can be more progressive and less invasive in other cases. During recovery from anaesthesia the patient must be closely monitored. In spite of a possible protecting effect, hypothermia remains an aggravating factor in traumatology and must therefore be either prevented or amended.
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Ann Fr Anesth Reanim · Jan 1997
Review[How to demonstrate, correct and prevent tissue hypoxia in intensive care patients? 3rd European Consensus Conference on intensive care organized by the French Language Intensive Care Society with the American Thoracic Society and the European Society of Intensive Care Medicine. Versailles, December 7-8, 1995].