Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jun 2014
Case Reports[Severe lactic acidosis revealing hematologic malignancy.]
A 75-year-old woman is hospitalised for sepsis. The diagnosis of cholecystitis is made and an antibiotic therapy is debuted. The clinical worsening leads to realise an urgent cholecystectomy. ⋯ A severe lactic acidosis persisted since the cholecystectomy despite a continuous hemofiltration. The diagnosis of type B lactic acidosis secondary to malignancy was suspected. An osteomedullar biopsy revelled B-cell lymphoma EBV induced.
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Ann Fr Anesth Reanim · Jun 2014
Case Reports[Ischemic heart failure making the diagnosis of a Vaquez disease: A rare event.]
We present the case of a 46-year-old patient without any past medical history, admitted to our ICU for cardiogenic shock complicating acute coronary syndrome. The blood tests found polycethemia, a polycethemia vera was suspected and confirmed by genetic analysis. Ischemic heart failure as an initial symptom of polycethemia vera and its treatment by arterial bleeding is a rare event that we describe in this article.
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Ann Fr Anesth Reanim · May 2014
Comparative StudyComparative study of three methods of estimation of creatinine clearance in critically ill patients.
At the bedside, the reference method for creatinine clearance determination is based on the measurement of creatinine concentrations in urine and serum (mCrCl). Several models are available to calculate the creatinine clearance from the serum creatinine concentration. This observational survey aimed at testing the hypothesis that the proposed equations are unreliable to determine accurate creatinine clearance in patients admitted to intensive care unit (ICU). ⋯ Regarding the high percentage of outliers, the use of these equations cannot be recommended in ICU patients.