Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · May 2012
[Anaesthesia and vasomotor tone during CPB: intravenous anaesthetics].
Anaesthesia during CBP is frequently provided using intravenous anaesthetic drugs, particularly propofol. The effects of the different drugs have been studied during CPB. These drugs have an arterial and venous vasodilator effect during CPB which is dose dependent and is more pronounced for propofol. High doses of propofol or thiopental reduce cerebral blood flow but provide no additional neurological protection.
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Ann Fr Anesth Reanim · May 2012
Case Reports[Occurrence of severe cardiac alterations in Amanita proxima poisoning: two original observations].
Amanita proxima is one species of white mushroom which can induce poisonings called in France "proximien" syndrome. The clinical feature of "proximien" syndrome is mainly characterized by early digestive troubles, mild hepatic cytolysis and late renal impairment. ⋯ The outcome was good for the two patients thanks to symptomatic treatment. The cases reported here suggest that A. proxima have a potential severe cardiac toxicity leading to include early and precise cardiac examination in the management of patients poisoned by these mushrooms.
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Ann Fr Anesth Reanim · May 2012
[Ultrasound evaluation of the nasogastric tube position in prehospital].
To assess the feasibility and actual performance of ultrasound control in verification of the correct positioning of a nasogastric tube in pre-hospital settings. ⋯ The ultrasound test performed in our study to verify correct positioning of a nasogastric tube is feasible in a pre-hospital setting. This technique is rapid and non-irradiating and is more sensitive and specific than the syringe tests commonly used in pre-hospital settings, and it may be performed in place of the latter tests.
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Ann Fr Anesth Reanim · May 2012
Case Reports[Oxygenator thrombosis without heparin resistance in polycythemia vera].
A 55-year-old male with a history of positive HIV serology and polycythemia vera underwent coronary artery bypass graft surgery with normothermic extracorporeal circulation. Following heparin administration the activated clotting time (ACT) was 633 seconds (Hemocron with kaolin). Lower than expected arterial and venous oxygen partial pressures together with high pressure (350 mmHg) in the arterial line upstream of the oxygenator were observed. ⋯ Electronic microscopic examination of the oxygenator membrane and thermic exchanger revealed fibrin and platelet deposits. Similar cases are described in the literature during polycythemia vera. Therefore the prevention might be a preoperative treatment with antiplatelet therapy in polycytemia vera.
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Ann Fr Anesth Reanim · May 2012
[Vasoreactivity changes during extracorporeal circulation: effects of halogenated agents].
During cardiopulmonary bypass (CPB), endothelium is exposed to multiple disturbances leading to significant vasomotor tone and vascular systemic resistances (VSR) level modifications. Properties of endothelial function on vascular tone were summarized herein. According bibliographic findings, physiological and clinical impacts of respectively halogenated agents and CPB concerning vasomotor tone were reported. ⋯ Incidence of severe vasoplegia was established to 9.5 % in the studied population and this result was similar as others. More over predicting factors of severe vasoplegia were the same as previously reported : severity of preoperative clinical status according Euroscore, hemodynamical instability before induction of anesthesia, surgical procedure complexity and CPB duration. Absence of deleterious effects in SVR decrease when administering isoflurane during normothermic CPB was assumed but prospective comparative studies comparing effects of halogenated agents and other anesthetic agents are needed in order to confirm these findings.