Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Mar 2012
Case Reports[Interest of echocardiography in the diagnosis and monitoring of a pulmonary embolism complicating a free-floating thrombus in right heart cavities].
We report the case of a 50-year-old patient admitted in ICU for a pulmonary embolism associated with a large thrombus in right heart cavities discovered during an assessment of faintness. Despite an excellent haemodynamic tolerance, there was a systolic and diastolic right ventricular failure and immediate threat to life. The treatment mainly relies on intravenous thrombolysis with excellent results both on thrombus lysis and on the right heart performance. Echocardiography proved to be an essential tool during the management of this patient to ensure the effectiveness and to monitor the whole procedure of thrombolysis.
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Ann Fr Anesth Reanim · Mar 2012
Case Reports[Severe hydrogen sulfide intoxication: a pediatric case of survival].
We report a paediatric case of survival following severe hydrogen sulfide (H2S) gas intoxication. A 13-year-old boy was found submerged to the neck in a manure tank. He was hypothermic, unresponsive with bilateral mydriasis, and had poor oxygen saturation. ⋯ Such exposures can evolve to severe ARDS and benefit from high frequency percussive ventilation. Hypothermia and other metabolic abnormalities are now better explained thanks to actual knowledge about endogenous H2S function. Lessons learned from paediatric accidents should result in better information about this threat for farmers and families living in houses with septic tanks, reducing the risk to their own and their children's safety.
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Ann Fr Anesth Reanim · Mar 2012
Case Reports[Transcient improvement of extrapyramidal syndrome after general anaesthesia].
We describe the case of a patient with an untreated Parkinson's disease who underwent surgery for a temporal meningioma. Extrapyramidal syndrome, initially attributed to the meningioma, had improved over the 48 hours following the procedure and then reappeared. This observation raises the question about the impact of drugs used during perioperative days in patients with Parkinson's disease not treated with levodopa.
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Ann Fr Anesth Reanim · Mar 2012
[Conditions of decision making of admission or non-admission in surgical intensive care unit].
To describe the condition of the decision-making of admission and non-admission in intensive care unit. ⋯ Thus, this study shows that in its current form the intensivists of the service estimate that in the majority of the cases the instruction of the files was collegial. However, the conditions of seniorisation of the decision, the collection of opinion of the patient and/or his close relations and the traceability are tracks of improvement to be implemented in certain circumstances of admission or non-admission.
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Ann Fr Anesth Reanim · Mar 2012
Case Reports[Haemophagocytic syndrome in pregnancy: a case report].
Haemophagocytic syndrome (HPS) results from an inappropriate stimulation of macrophages in bone marrow and lymphoid organs, leading to haemophagocytosis and hypercytokinemia. HPS may be primitive, essentially in pediatric population, or secondary to malignancy, infection or autoimmune disease. ⋯ We report one HPS case in a pregnant patient at 21 week's gestation with systemic lupus erythematosus. We discuss diagnostic difficulties, obstetrical complications and therapeutic options.